中医药治疗表皮生长因子受体抑制剂相关皮疹的系统性评价

目的:评价中医药治疗表皮生长因子受体抑制剂(EGFRIs)相关皮疹的疗效及安全性。方法:在外文Web of Science、PubMed、Cochrane Library和维普数据库(VIP)、中国学术期刊全文数据库(CNKI)、万方数据库中检索从创建以来至2018年3月关于中医药治疗EGFRIs相关皮疹的随机对照试验,并手工检索补充相应文献。由研究人员对文献进行筛选和数据提取,并用Rev Man5.3进行异质性检验、敏感性分析和Meta分析。结果:纳入21项研究,共1394例肿瘤患者,Meta分析结果显示中医药治疗EGFRIs相关皮疹的有效率、减轻皮肤瘙痒的有效率、中医症状缓解的有效率明显优于对照组(P<0.01),且中医药观察组的患者生命质量明显改善,极少出现治疗相关的不良反应。实体瘤治疗总有效率与未予中医药观察组相当(P>0.05)。结论:中医药治疗可明显缓解EGFRIs相关皮疹和瘙痒,明显缓解中医证候,提高患者的生命质量,且不影响EGFRI的抗肿瘤疗效。     

Correlation of gut microbiota and neurotransmitters in a rat model of post-traumatic stress disorder

ObjectiveTo determine the effect of gut microbiota on a rat model of post-traumatic stress disorder (PTSD) and explore the correlation of gut microbiota with behavior and neurotransmitters.MethodsWe established a single prolonged stress (SPS) model to examine the pathogenesis of PTSD on rat behavior, gut microbiota, and neurotransmitter levels. Rats were separated into control and model groups, and neurotransmitter levels were measured using enzyme linked immunosorbent assay. Then, 16 S rRNA sequencing was used to compare the gut microbiota between the control and model groups.ResultsCompared with those in the control group, freezing time significantly increased, while number of standing upright, crossing frequency, time spent in the central arena, and total distance traveled were significantly reduced in the model group after exposure to SPS (all P < .05). Meanwhile, serotonin, or 5-hydroxytryptamine, levels in the brain in the model group were significantly lower than those the control group (P = .0332). In addition, changes were observed in the gut microbiota diversity and relative abundances of bacterial phyla, orders, families, and genera in the model group. Especially, changes in Firmicutes, Bacteroidetes, Cyanobacteria, and Proteobacteria levels were most pronounced after SPS exposure. Correlation analysis showed that the strongest positive correlation was found between Bacteroidaceae and 5-HT (P = .0009). Moreover, RF32 abundance was the most negatively related to 5-HT (P = .0009), crossing frequency (P = .0007), and total distance (P = .0003).ConclusionOur results suggest that SPS model rats showed differences in behavior, neurotransmitter levels, and gut microbiota with control rats. Moreover, Firmicutes, Bacteroidetes, Cyanobacteria, and Proteobacteria were most relevant to the exhibited fear-like and anxiety-like behaviors and significant serotonin content reduction in SPS model rats.     

扶正祛风方治疗特发性膜性肾病的临床观察

目的:探讨扶正祛风方治疗特发性膜性肾病疗效。方法:选取2017年4月至2019年1月北京中医药大学东方医院收治的特发性膜性肾病患者86例进行回顾性分析,按照治疗方法不同分为对照组和观察组,每组43例,对照组常规西医治疗,观察组加扶正祛风方,均治疗6个月,观察2组患者治疗前、完成治疗后肾功能、血脂、凝血功能、免疫功能、氧化应激变化并比临床疗效。结果:1)治疗后2组患者24 h尿蛋白定量(24 h-UTP)、总胆固醇(TC)、三酰甘油(TG)、血管性血友病因子(vWF)、E-选择素(CD62E)、血小板计数(PLT)、CD8+较治疗前下降,白蛋白(ALB)、超氧化物歧化酶(SOD)、丙二醇(MDA)、凝血酶原时间(PT)、凝血酶时间(TT)、CD4+、CD4+/CD8+较治疗前升高(P<0.05),且观察组优于对照组(P>0.05),而2组患者治疗后血清肌酐(Scr)、尿素氮(BUN)比较差异无统计学意义(P>0.05)。2)观察组临床控制率、总有效率为37.21%、88.37%,高于对照组的20.93%、74.42%,比较差异有统计学意义(P<0.05)。结论:扶正祛风方可抑制尿蛋白形成,改善肾脏微循环,提高免疫功能,从而提高特发性膜性肾病疗效。     

Cardioprotective effect of Yiqi Huoxue granule through regulation of mitophagy after myocardial infarction in rats

ObjectiveTo investigate the cardioprotective effect of Yiqi Huoxue granule (YQHXG) in the regulation of autophagy in rats induced with myocardial infarction (MI).MethodsAn acute MI animal model was established by ligation of the left anterior descending branch of the coronary artery in Sprague-Dawley rats. Besides, 20 rats received sham operation were classified into a control group. The remaining 59 rats were randomly divided into MI model group (n = 19), YQHXG group (n = 20), and perindopril group (n = 20). Relevant indicators on days 7 and 28 were observed in each group. Left ventricular function was determined by echocardiography. The structure and morphology of mitochondria, and the number of autophagic vesicles, were observed by transmission electron microscopy. The mRNA and protein expression levels of LC3, FUNDC1, Beclin-1, and BNIP3 were examined in the tissue of the MI marginal area.ResultsCompared with the MI model group, YQHXG showed obvious improvements in cardiac functions. Observing the microscopic morphology of the heart tissue, myocardial tissue damage attenuated, autophagic signs of autophagosomes and autolysosomes reduced, vacuolization in mitochondria mitigated, and mitochondria arranged in order. YQHXG could reduce the degree of tissue lesion after MI and regulate the expression of autophagy-related molecules at different stages. On Day 7, YQHXG significantly downregulated the expression of Fundc1, Becn1, Bnip3 mRNA and reduced the levels of FUNDC1, Beclin-1, BNIP3, and LC3 B proteins expression (all P < .001). On Day 28, YQHXG could upregulate the expression of Becn1, Fundc1 and Bnip3 mRNA and increased the levels of the corresponding proteins expression (all P < .001). Besides, it also increased LC3 B protein expression level (P = .0344).ConclusionYQHXG regulated the expression of mitochondrial autophagy-related factors in myocardial tissue and mitochondrial autophagic activity at different stages to protect the heart following MI.     

Yiqi Huoxue Decoction modifies the expression of myocardial cytoskeleton-associated proteins by regulating the AMPK signaling pathway in H9c2 cells exposed to hypoxic conditions

BackgroundIn myocardial ischemia, hypoxia leads to destruction of the cytoskeleton, and especially the imbalance of microtubule polymerization-depolymerization, which seriously affects the structure and function of cardiomyocytes. We previously showed that a Yiqi Huoxue Decoction (YQHX) improves mitochondrial function and decreases anti-oxidative effects in hypoxia-induced H9c2 cell injury. Therefore, in this study we investigated whether YQHX protects against hypoxia-induced damage by decreasing damage to the cardiac cytoskeleton.MethodsAfter reaching 70%–80% confluence, H9c2 cells were synchronized in serum-free Dulbecco's Modified Eagle Medium for 6 hours, then divided into control, model, and YQHX (100, 200, 400 μg/mL) groups, which were then grown in a hypoxic atmosphere for 12 hours. Cardiac cell viability was assessed using an xCELLigence system. The levels of lactate dehydrogenase, maleic dialdehyde, and superoxide dismutase in H9c2 cell supernatants were measured. Hoechst 33258 staining was employed to observe cardiac cell apoptosis. Confocal microscopy, immunofluorescence, and western blot analysis were performed to evaluate the protective effects of the YQHX against hypoxia-induced injury in the H9c2 cell line.ResultsCells that were pretreated with YQHX were more able to maintain their microtubule structure in the early stages of hypoxia and had better myocardial fitness in response to hypoxia compared with cells that were not pretreated. However, hypoxia-induced upregulation of α-tubulin and β-tubulin expression antagonized the protective effect of YQHX (100 μg/mL). In addition, YQHX (100 μg/mL) treatment significantly upregulated MAP4 protein expression (P = .003) and downregulated p-AMPKα protein expression (P < .001) compared with the model group.ConclusionThe results indicate that YQHX plays a role in protecting against oxidative stress injury and apoptosis in H9c2 cells. Notably, our results suggested that the YQHX could mitigate the damage to the cardiac cytoskeleton and the dysregulation of AMPK-related protein signaling pathways that are induced by hypoxia.     

从升降理论探讨浆细胞性乳腺炎

浆细胞性乳腺炎是临床常见病症,目前其发病原因尚不明确,且易反复发作.气机升降理论最早见于《黄帝内经》,气机升降与脏腑功能密切相关,其中"肝升肺降""脾升胃降""心肾相交"等尤为重要,升降失常是多数疾病发生的内在机制,乳腺疾病也不例外,从升降理论探讨浆细胞性乳腺炎的发病机制和治疗原则具有重要的临床价值.