尖海龙商品调查与《中国药典》中海龙的基原考证

目的:海龙是我国重要的动物药材,用药历史悠久,基原众多。该研究的目的是澄清海龙尤其是尖海龙的物种基原,为海龙类药材的鉴定和质量标准提供依据。方法:对历代海龙本草文字记载、图片和照片进行考证,结合形态和DNA序列分析,对中国科学院动物研究所、中国食品药品检定研究院等标本馆馆藏动物标本、中药标本及我国主要中药市场市售样本进行药源调查,推断本草及2015年版《中国药典》中海龙的物种基原。结果:从我国7个省份的药店或药材经销商处收集到标为"尖海龙"的36批药材,以及中药标本馆中历年来存留的8批"尖海龙"样品的形态与DNA均符合舒氏海龙Syngnathus schlegeli (Kaup,1856)。2015年版《中国药典》收载海龙性状描述也为舒氏海龙鉴别特征。中国的尖海龙S.acus可能是舒氏海龙S.schlegeli的错误鉴定。结论:2015年版《中国药典》中海龙的基原应修订为刁海龙Solegnathus hardwickii(Gray,1830),拟海龙Syngnathoides biaculeatus (Bloch,1785)或舒氏海龙S.schlegeli (Kaup,1856)的干燥品。2015年版《中国药典》收载的尖海龙S.acus应修订为舒氏海龙S.schlegeli。并建议增加鉴别方法,完善海龙质量控制标准。     

Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study

ObjectiveCoronavirus disease 2019 (COVID-19) has spread worldwide, and several virus variants have emerged. Vaccines are administered to help prevent the infection. In Republic of Korea, most people take herbal medicine. This study investigated the use of herbal medicine to counter the side effects of COVID-19 vaccines.MethodsThis cross-sectional study was conducted using an online survey. Chi-square tests were used to determine differences in the use of herbal medication according to sociodemographic characteristics. Independent two-sample and paired t-tests were performed to examine the effect and satisfaction of herbal medicine use for countering the side effects of COVID-19 vaccines. One-way analysis of variance was used to determine vaccine-related differences.ResultsA total of 233 and 181 participants received the first and second doses of COVID-19 vaccines, respectively. The majority of herbal medicine users were in their thirties, had a bachelor’s degree, suffered from side effects of vaccination, and received Vaxzevria for their first COVID-19 vaccine dose and Comirnaty for their second dose. The herbal medicine group had a higher satisfaction level of post-vaccination side effects than the non-herbal medicine group (P < 0.0001). The numeric rating scale scores for vaccination side effects were lower among participants who took herbal medication to alleviate those symptoms (P < 0.0001). The most commonly used herbal formula was Shuanghetang.ConclusionA third of participants receiving COVID-19 vaccines used herbal medication to counter the side effects of vaccination. The use of herbal medicine was associated with age, education level, vaccine brand, and whether side effects of vaccination occurred. Herbal medication use was associated with greater satisfaction compared to vaccine recipients not using herbal medication.Please cite this article as: Yoon HC. Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study. J Integr Med. 2023; 21(4):361–368.     

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial

BackgroundMajor depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.ObjectiveThis study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.Design, setting, participants and interventionThis six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.Main outcome measuresPrimary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.ResultsFifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).ConclusionThe herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.Trial registration number: IRCT2016102430459N1 on Iranian Registry of Clinical Trials.     

Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial

BackgroundConstipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly.ObjectiveThis study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life.Design, setting, participants and interventionThis double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks.Main outcome measuresConstipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire.ResultsA total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group.ConclusionAlthough both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).     

正交试验结合熵权TOPSIS优选麻黄-桂枝药对水提工艺

目的 优选麻黄-桂枝药对的水提工艺。方法 建立麻黄-桂枝药对超高效液相色谱法指纹图谱,采用Ｌ₉（3⁴）正交试验设计,以煎煮次数、加水量、煎煮时间为考察因素,以指纹图谱及醇溶性浸出物的含量为评价指标,结合熵权逼近理想解排序法（TOPSIS）对正交水提工艺进行综合评价。结果 优选麻黄-桂枝药对最佳水提工艺为加10倍量水煎煮3次,每次煎煮30 min。结论 优选的麻黄-桂枝药对水提工艺科学合理、稳定可行,可为麻黄-桂枝药对的工业生产提供参考。     

不同剂量黄芪对糖尿病大鼠肾脏氧化应激的抑制作用

  目的：研究不同剂量黄芪对链脲佐菌素诱导的糖尿病大鼠肾脏氧化应激的抑制作用  方法：40只健康雄性Wistar大鼠随机选取8只作为正常对照组,然后将剩余大鼠用链脲佐菌素诱导为糖尿病模型,并将建模成功大鼠随机分为糖尿病组,黄芪低、中、高剂量组。干预12周末检测各组大鼠糖化血红蛋白、24 h尿蛋白、肾功能等生化指标,大鼠尿液、血清及肾皮质中超氧化物歧化酶(SOD)活性、肾皮质丙二醛(MDA)及8-羟基脱氧鸟苷(8-OHdG)的含量,并对肾脏组织进行形态学观察  结果：与糖尿病组比较,黄芪各剂量组MDA及8-OHdG含量明显下降,SOD活性显著增强(P<0.05,P<0.01),肾功能指标明显改善(P<0.01),病理改变明显减轻;其中以高剂量组改善最为明显  结论：黄芪可减轻糖尿病大鼠肾脏氧化应激损伤程度,且存在明显的量效关系。     

A comparative study of Salvia miltiorrhiza Radix & Rhizoma raw material and granule products using chromatographic analysis and antioxidant activityOA

Objective: Granules of herbal extracts are a popular medicinal preparation consumed in traditional Chinese medicine clinical practice. However, their quality and efficacy evaluation are lacking. This study aimed to compare the quality and anti-oxidant activity of Dan Shen(Salvia miltiorrhiza Radix & Rhizoma)granule extracts with their herbal extracts.Methods: Chromatographic method was used to determine the content of 7 marker compounds in the water extracts of the herb compared to that of 1...     

Effect of wrist-ankle acupuncture on propofol dosage in painless bronchoscopy of elderly patients: A randomized controlled trial: 腕踝针对高龄无痛气管镜检查患者丙泊酚用量的影响:随机对照研究

ObjectiveTo observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.MethodsA total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group, 30 cases in each one. In the wrist-ankle acupuncture group, wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room. In the control group, no any intervention was provided. The patients in two groups all received venous administration of midazolam, nalorphine and lidocaine and target controlled infusion of propofol. When the patient's consciousness was lost and the eyelash reflex disappeared, bronchoscopy was performed and the propofol dosage was increased accordingly during operation. Propofol dosage, vital signs and occurrence of adverse reactions, bronchoscopist satisfaction, operation time and recovering time were recorded in the patients of two groups.ResultsPropofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group, indicating the statistical differences (both P < 0.05). The vital signs were stable during bronchoscopy in patients of two groups. The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group, indicating the statistical differences (both P < 0.05). Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group, and the operation time and recovering time were lower than the control group, indicating the statistical differences (all P < 0.05).ConclusionIn painless bronchoscopy, wrist-ankle acupuncture may effectively reduce propofol dosage, alleviate respiratory suppression, reduce adverse reaction and shorten the recovering time in elderly patients.     

Therapeutic effects of the extract of Sancao Formula,a Chinese herbal compound,on imiquimod-induced psoriasis via cysteine-rich protein 61

Objective: Psoriasis is a common chronic inflammatory skin disease that is prone to recurrence, and the proinflammatory factor, cysteine-rich protein 61(Cyr61), is important in its pathophysiology. Long-term clinical practice has shown that Sancao Formula(SC), a Chinese herbal compound, is effective in the treatment of psoriasis, but the precise mechanism remains unknown. In this study, we investigate the mechanism by which SC extract alleviates imiquimod(IMQ)-induced psoriasis.Methods: The expr...     

两面针商品药材的质量评价

目的:对市售两面针商品药材进行质量调查和评价。方法:参照2010年版《中国药典》两面针项下方法,对18批两面针商品药材进行性状鉴别、薄层色谱及高效液相法检测氯化两面针碱含量,并建立两面针HPLC指纹图谱方法,结合相似度评价对样品药材进行鉴别分析。结果:样品性状,薄层鉴别和含量测定的结果显示,9批药材有伪品掺杂现象;样品总灰分的含量是2.4%~6.4%,水分含量是7.0%~12.1%,醇溶性浸出物含量是2.2%~8.6%;HPLC测定中有2批样品检测不到氯化两面针碱,11批样品图谱与对照指纹图谱相似度低于0.8;18批药材均不符合2010年版《中国药典》标准。结论:目前市场上的两面针药材品质参差不齐,伪品掺杂现象比较严重。     

补肾利湿法对急性痛风性关节炎大鼠VEGF表达水平的影响

目的： 观察补肾利湿法对痛风性关节炎大鼠血管内皮生长因子（VEGF）表达水平的影响,探讨补肾利湿法防治急性痛风性关节炎（GA）的作用机制。方法： 将70只Wistar大鼠随机分为7组:空白组、模型组、中药对照组、西药对照组及中药低、中、高剂量组,每组10只。采用尿酸钠联合氧嗪酸钾诱导大鼠急性痛风性关节炎模型,应用ELISA法,分别检测各组大鼠血清VEGF的含量,并对关节滑膜组织进行病理组织学检查。结果： 7组VEGF水平差异均有统计学意义（P<0.01）,模型组VEGF含量明显高于空白组（P<0.01）;中药对照组、西药对照组和中药低、中、高剂量组VEGF含量均较模型组低（P<0.01）,其中,西药对照组和中药中剂量组效果更明显;中药中剂量组与中药对照组、中药低剂量组、中药高剂量组相比有显著性差异（P<0.01）,但与西药对照组相比无显著性差异。结论： 补肾利湿法处方可抑制急性痛风性关节炎大鼠VEGF的表达,对防治痛风性关节炎具有一定作用。     

Chinese herbal medicine for chronic heart failure: a multicenter,randomized, double-blind,placebo-controlled trial

ObjectiveThe purpose of this study was to assess the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of chronic heart failure (CHF) patients according to syndrome differentiation.MethodsIn this multicenter, randomized, double-blind, placebo-controlled clinical trial, a total of 220 CHF patients were assigned to receive CHM or placebo granules without decoction according to syndrome differentiation in addition to their standard western treatment for 4 weeks. The change in the left ventricular ejection fraction (LVEF) was the primary outcome, and the changes in the TCM syndrome scores (TCM-SS) and New York Heart Association functional classification (NYHA-FC) were the secondary outcomes.ResultsAfter 4 weeks of treatment, the mean changes in the LVEF (13.1 ± 9.78 vs. 7.34 ± 7.40, P < 0.001) and the TCM syndrome scores (−34.2 ± 24.6 vs. −23.5 ± 25.2, P = 0.002) were better in the CHM group than in the placebo group. After two weeks of treatment, the mean changes in the LVEF (9.26 ± 7.83 vs. 4.72 ± 5.60, P < 0.001) and the TCM syndrome scores (−23.5 ± 18.6 vs. −14.0 ± 15.9, P < 0.001) were better in the CHM group than in the placebo group. In addition, repeated-measures analysis of variance (ANOVA) indicated significant time course effects of CHM versus placebo in the LVEF and TCM syndrome cores (P < 0.001 for all). The distention of the jugular vein (P = 0.021), expectoration (P = 0.044), abdominal distention (P = 0.004), and rib pain (P = 0.005) were significantly less in the CHM group than in the placebo group after two weeks of treatment. Fatigue (P = 0.001), less gas and lazy words (P = 0.001), dizziness (P = 0.003), gasping for breath (P = 0.027), abdominal distention (P = 0.011), nausea (P = 0.001) and emesis (P = 0.012) were significantly less in the CHM group than in the placebo group after treatment for four weeks. After four weeks of treatment, the change in the NYHA functional classification in the CHM group was better than that in the placebo group (P < 0.001). There was one death in the placebo group, and one patient in the CHM group experienced atrial fibrillation.ConclusionCHM treatment according to syndrome differentiation effectively improved the LVEF, TCM-SS, and NYHA-FC in patients with CHF and also appeared to be safe. Thus, CHM treatment could be used as an adjuvant therapy in the treatment of CHF (Clinical trial registration: NCT01939236).     

Comparable effects of Jiedu Granule,a compound Chinese herbal medicine,and sorafenib for advanced hepatocellular carcinoma: A prospective multicenter cohort study

ObjectiveSorafenib has been extensively used for the treatment of advanced hepatocellular carcinoma (HCC), and Chinese herbal medicine has also been used to manage advanced HCC. The present work evaluates the effectiveness and safety of Jiedu (JD) Granule, a compound of traditional Chinese herbal medicine, side-by-side with sorafenib for the treatment of advance HCC.MethodsPatients with advanced HCC receiving treatment with JD Granule or sorafenib were enrolled from December 2014 to March 2018. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS) and safety. Propensity score matching (PSM) analysis was used to control for possible selection bias from the study group allocation process.ResultsOf the 325 patients included, 161 received JD Granule and 164 received sorafenib. No significant differences were found in OS or PFS among patients receiving JD Granule compared to sorafenib (P > 0.05). Median OS of the two study groups was 6.83 months (95% confidence interval [CI]: 5.83–9.47) in the group receiving JD Granule and 8 months (95% CI: 6.67–9.80) in the group receiving sorafenib, with half-, 1- and 2-year survival rates of 53.6%, 31.2% and 13.2% vs 60.1%, 35.5% and 14.2%, respectively. Even after PSM, the median survival time did not differ between the JD Granule group (9.03 months; 95% CI: 6.37–14.2) and the sorafenib group (7.93 months; 95% CI: 6.5–9.97), with comparable half-, 1- and 2-year survival rates. The most common adverse events (AEs) were diarrhea (13.7%) and fatigue (5.6%) in the JD Granule group, and hand-foot skin reaction (46.3%) and diarrhea (36.6%) in the sorafenib group. The JD Granule was more cost-effective than sorafenib treatment for advanced HCC.ConclusionCompared to sorafenib, JD Granule was more cost-effective and caused fewer AEs for the treatment of Chinese patients with advanced HCC.     

Hepatic protective effects of Shenling Baizhu powder,a herbal compound,against inflammatory damage via TLR4/NLRP3 signalling pathway in rats with nonalcoholic fatty liver disease

ObjectiveHigh-fat diet (HFD) and inflammation are two key contributors to nonalcoholic fatty liver disease (NAFLD). Shenling Baizhu powder (SLBZP), a classical herbal compound, has been successfully used to alleviate NAFLD. However, its specific mechanisms are not fully understood. In this study, we assessed the anti-NAFLD effect of SLBZP in vivo.MethodsRats were fed an HFD with or without SLBZP or with probiotics. At the end of week 16, an echo magnetic resonance imaging (EchoMRI) body composition analyser was used to quantitatively analyse body composition; a micro-computed tomography (micro-CT) imaging system was used to evaluate whole body and liver fat; and the Moor full-field laser perfusion imager 2 was used to assess liver microcirculation, after which, all rats were sacrificed. Then, biochemical indicators in the blood and the ultrastructure of rat livers were evaluated. Protein expression related to the liver Toll-like receptor 4 (TLR4)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) signalling pathway was assessed using Western blot analysis. Further, high-throughput screening of 29 related inflammatory factors in liver tissue was performed using a cytokine array.ResultsSLBZP supplementation reduced body weight, serum free fatty acid, and insulin resistance index (P < 0.05). It also ameliorated liver microcirculation and ultrastructural abnormalities. EchoMRI and micro-CT quantitative analyses showed that treatment with SLBZP reduced fat mass and visceral fat (P < 0.05 and P < 0.01, respectively). In addition, SLBZP decreased the expression of lipopolysaccharide (LPS)-activated TLR4/NLRP3 signalling pathway-related proteins and altered the expression levels of some inflammatory cytokines in liver tissues.ConclusionSLBZP can inhibit NLRP3 inflammasome activation and interleukin-1β release by suppressing LPS-induced TLR4 expression in rats with HFD-induced NAFLD. Thus, SLBZP may be beneficial for the prevention and treatment of inflammatory damage and associated diseases.     

中药复方联合TAM对MCF-7乳腺癌细胞周期及CyclinD1、Bcl-2、Bax表达的影响

目的观察中药复方联合三苯氧胺(TAM)对MCF-7乳腺癌细胞周期及细胞周期素Dl(Cyclin D1)、Bcl-2、Bax表达的影响。方法将造模成功的裸鼠随机分为模型组、三苯氧胺(TAM)组、乳结合组(乳岩宁方+TAM)和益结合组(益气养阴方+TAM)。连续给药21 d后脱颈处死裸鼠,完整剥离出瘤体,切开标本取材。采用流式细胞仪(FCM)检测乳腺癌细胞周期的分布,Western blotting法检测瘤组织中Bax、Bcl-2、Cyclin D1蛋白表达。结果各用药组G0/G1期细胞的比例增多,S期比例明显减少,与模型组比较差异有统计学意义(P0.01);但是乳结合组与益结合组分别对比G0/G1期、S期的细胞比例均无统计学差异(P0.05)。各用药组均可下调Bcl-2及Cyclin D1蛋白的表达,上调Bax蛋白的表达,降低Bcl-2/Bax的比值,与模型组相比差异有统计学意义(P0.01);两个结合组与TAM组比较,差异有统计学意义(P0.01);乳结合组与益结合组之间比较,差异无统计学意义(P0.05)。结论中药复方联合TAM通过阻滞细胞周期进程、下调细胞周期相关蛋白Cyclin D1、抑制Bcl-2的表达、促进Bax的表达来抑制MCF-7乳腺癌细胞增殖,同时中药复方对TAM有协同作用。     

An optimal medicinal and edible Chinese herbal formula attenuates particulate matter-induced lung injury through its anti-oxidative, anti-inflammatory and anti-apoptosis activities

Objective: Identifying novel strategies to prevent particulate matter (PM)-induced lung injury is crucial for the reduction of the morbidity of chronic respiratory diseases. The combined intervention represented by herbal formulae for simultaneously targeting multiple pathological processes can provide a more beneficial effect than the single intervention. The aim of this paper is therefore to design a safe and effective medicinal and edible Chinese herbs (MECHs) formula against PM-induced lung injury. Methods: PM-induced oxidative stress, inflammatory response and apoptosis A549 cell model were used to screen anti-oxidant, anti-inflammatory and anti-apoptotic MECHs, respectively. A network pharmacology method was utilized to rationally design a novel herbal formula. Ultra performance liquid chromatography-mass spectrometer was utilized to assess the quality control of MECHs formula. The excretion of magnetic iron oxide nanospheres of the MECHs formula was estimated in zebrafish. The MECH formula against PM-induced lung injury was investigated with mice experiments. Results: Five selected herbs were rationally designed to form a new MECH formula, including Citri Exocarpium Rubrum (Juhong), Lablab Semen Album (Baibiandou), Atractylodis Macrocephalae Rhizoma (Baizhu), Mori Folium (Sangye) and Polygonati Odorati Rhizoma (Yuzhu). The formula effectively promoted the magnetic iron oxide nanospheres excretion in zebrafish. The mid/high dose formula significantly prevented PM-induced lung damage in mice by enhancing the activity of SOD and GSH-Px, reducing the MDA and ROS level and attenuating the upregulation of pro-inflammatory cytokine (IL-6, IL-8, IL-1β and TNF-α), down regulating the protein expression of NF-κB, STAT3 and Caspase-3. Conclusion: Our findings suggest that the effective MECHs formula will become a novel strategy for preventing PM-induced lung injury and provide a paradigm for the development of functional foods using MECHs.     

Qili Qiangxin,a compound herbal medicine formula,alleviates hypoxia-reoxygenation-induced apoptotic and autophagic cell death via suppression of ROS/AMPK/mTOR pathway in vitro

ObjectiveQili Qiangxin (QLQX), a compound herbal medicine formula, is used effectively to treat congestive heart failure in China. However, the molecular mechanisms of the cardioprotective effect are still unclear. This study explores the cardioprotective effect and mechanism of QLQX using the hypoxia-reoxygenation (H/R)-induced myocardial injury model.MethodsThe main chemical constituents of QLQX were analyzed using high-performance liquid chromatography-evaporative light-scattering detection. The model of H/R-induced myocardial injury in H9c2 cells was developed to simulate myocardial ischemia–reperfusion injury. Apoptosis, autophagy, and generation of reactive oxygen species (ROS) were measured to assess the protective effect of QLQX. Proteins related to autophagy, apoptosis and signalling pathways were detected using Western blotting.ResultsApoptosis, autophagy and the excessive production of ROS induced by H/R were significantly reduced after treating the H9c2 cells with QLQX. QLQX treatment at concentrations of 50 and 250 μg/mL caused significant reduction in the levels of LC3II and p62 degradation (P < 0.05), and also suppressed the AMPK/mTOR signalling pathway. Furthermore, the AMPK inhibitor Compound C (at 0.5 μmol/L), and QLQX (250 μg/mL) significantly inhibited H/R-induced autophagy and apoptosis (P < 0.01), while AICAR (an AMPK activator, at 0.5 mmol/L) increased cardiomyocyte apoptosis and autophagy and abolished the anti-apoptotic effect of QLQX. Similar phenomena were also observed on the expressions of apoptotic and autophagic proteins, demonstrating that QLQX reduced the apoptosis and autophagy in the H/R-induced injury model via inhibiting the AMPK/mTOR pathway. Moreover, ROS scavenger, N-Acetyl-L-cysteine (NAC, at 2.5 mmol/L), significantly reduced H/R-triggered cell apoptosis and autophagy (P < 0.01). Meanwhile, NAC treatment down-regulated the ratio of phosphorylation of AMPK/AMPK (P < 0.01), which showed a similar effect to QLQX.ConclusionQLQX plays a cardioprotective role by alleviating apoptotic and autophagic cell death through inhibition of the ROS/AMPK/mTOR signalling pathway.     

Effects of a Plantago ovata-based herbal compound in prevention and treatment of oral mucositis in patients with breast cancer receiving chemotherapy: A double-blind,randomized, controlled crossover trial

BackgroundOral mucositis (OM) is one of the most common complications of mucotoxic cancer therapy. Mucositis induces clinically significant pain, increases the risk of infections and affects the patients’ quality of life.ObjectiveThis study investigated the effects of an herbal preparation from Plantago ovata hydrocolloid in the prevention and treatment of OM, in breast cancer patients undergoing chemotherapy with a regimen including adriamycin.Design, setting, participants, and interventionsThis research was a double-blind, randomized, controlled crossover trial. The herbal compound consisted of a mixture of 500 mg of P. ovate husk in 30 mL water plus three drops of vinegar per dose, which was used as a mouthwash. Phytochemical and physicochemical tests of the compound were also performed. Twenty-eight patients who developed mucositis during the chemotherapy screening cycle were randomized to the herbal compound (n = 14) and placebo (n = 14) groups. They received herbal compound or placebo three times per day during their next chemotherapy cycle (cycle 1 of treatment). Patients were crossed over during cycle 2 of treatment and received the alternative therapy. An oral care protocol was prescribed to all patients in cycles 1 and 2 of the treatment.Main outcome measuresThe patients were visited at baseline, the end of the first and second weeks of the screening cycle, and the end of the first and second weeks of each of two treatment cycles. The degree of mucositis was used as the main treatment outcome. Other indexes, such as the severity of pain, xerostomia grade and the quality of life were also measured.ResultsCompared with the placebo, the herbal compound significantly reduced the degree of mucositis, the severity of pain and the xerostomia grade; it also improved the patients’ quality of life (P < 0.05). Comparison between the screening cycle and placebo treatment group showed that the oral care protocol had a significant effect in the reduction of OM (P < 0.05).ConclusionThe oral care protocol and the herbal compound based on P. ovata are effective ways for preventing and treating OM in patients undergoing mucotoxic cancer therapy.Trial registrationIranian registry of clinical trials IRCT20180923041093N1.     

Tiaozhi Tongmai Granules reduce atherogenesis and promote the expression of ATP-binding cassette transporter A1 in rabbit atherosclerotic plaque macrophages and the liver

ObjectiveATP-binding cassette transporter A1 (ABCA1) is an integral membrane protein that plays a key role in cellular lipid metabolism, preventing the accumulation of lipids that contribute to the initiation and progression of atherosclerosis. Tiaozhi Tongmai Granules are a Chinese herbal compound that is capable of treating atherosclerosis. This study was designed to explore the potential pharmacological mechanism by which Tiaozhi Tongmai Granules protect against atherosclerosis.MethodsForty-nine male New Zealand rabbits were randomly divided into seven groups: normal control group, normal diet; model groups 1 and 2: balloon injury and high-fat diet for 6 or 12 weeks; statin groups 1 and 2: balloon injury and high-fat diet plus atorvastatin for 6 or 12 weeks; and Chinese herb groups 1 and 2: balloon injury and high-fat diet plus Tiaozhi Tongmai Granules for 6 or12 weeks. The granules were administered at a dose of 1.14 g/kg/d, with atorvastatin (1.14 mg/kg/d) serving as positive control. Serum lipid profiles and liver function indices were measured. Atherogenesis was viewed after H&E staining and quantified by thickened intimal area percentage and maximal intimal thickness percentage. The ABCA1 protein expression in atherosclerotic plaque macrophages of the common carotid arteries (CCA), thoracic aortae (TA), and liver tissues were observed by immunohistochemical staining and evaluated using mean optical density (OD) value in macrophages and ABCA1-positive hepatocyte number.ResultsCompared with model group 1 at week 6, Chinese herb group 1 and statin group 1 displayed significant reductions in total cholesterol (TC) (P = 0.027, 0.012) and low-density lipoprotein cholesterol (LDL-C) (P = 0.039, 0.028) levels, as well as marked increases in ABCA1-positive hepatocyte numbers (P all <0.001), and only statin group 1 displayed a markedly reduced maximal intimal thickness percentage in the CCA (P = 0.018). Compared with model group 2 at week 12, Chinese herb group 2 and statin group 2 all presented significant reductions in TC (P = 0.011, 0.003), LDL-C (P = 0.017, 0.010) and thickened intimal area percentage in the CCA (P = 0.001, 0.022), as well as prominent increases in the ABCA1 OD value of both the CCA (P = 0.001, 0.039) and TA (P = 0.001, 0.025) and positive hepatocyte number (P all <0.001). Chinese herb group 2 had a markedly reduced maximal intimal thickness percentage compared with model group 2 (P = 0.006) and a higher positive hepatocytes number than statin group 2 (P = 0.001).ConclusionsTiaozhi Tongmai Granules appear to have an anti-atherogenic effect that is most likely mediated by simultaneously upregulating the protein expression of ABCA1 in rabbit atherosclerotic plaque macrophages and in the liver.