Objective: In order to obtain the best treatment program for Knee Osteoarthritis (KOA), to alleviate the pain of patients with KOA, and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA. Methods: we used computer to search the databases of CNKI (1989-2018.10), Wanfang (1989-2018.10), VIP (1989-2018.10), PubMed (1966-2018.10), EMbase (1986-2018.10) and Cochrane Library (the 3rd issue of 2018). And the literature quality was evaluated by Jadad scale. Results: A total of 19 eligible RCT studies were included, and a total of 2,088 patients participated in the eligible clinical study. Meta-analysis results showed that the total effective rate OR combination =2.85[OR =3.98, 95%CI (2.98,5.32), P < 0.00001]. The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies. Conclusion: Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA. Due to the impact of the original study on Meta-analysis results, more large samples and high-quality clinical trials are still needed to verify.
Highlights Knee osteoarthritis (KOA) is one of the most common orthopedic diseases. Most of the patients were elderly, and the clinical manifestations were mainly pain. This paper aims to explore the research progress of TCM acupuncture and cupping therapy for the prevention and treatment of KOA. In this paper, we reviewed the published literature, systematically evaluated and Meta analyzed the efficacy of acupuncture and cupping therapy for the treatment of knee osteoarthritis, and provided better evidence for the clinical treatment of knee osteoarthritis patients.
Quality marker (Q-marker) of Chinese materia medica (CMM) plays an important role in quality control of CMM products. However, its research strategy and technique remain unclear. Based on the fact that quality standard of CMM should be associated with clinical efficacy, taking Jinqi Jiangtang tablet treating type 2 diabetes as an example, the Q-marker related to activity via the reverse analysis of drug metabolism in clinic and traceability of botanic biosynthetic pathways is discovered and validated. Therefore, we proposed a new research strategy of Q-marker of CMM with "Discovery of clinical active constituents as guidance, Reverse analysis of metabolic transformations as link, and Traceability of biosynthesis pathways as key", to improve quality control of CMM products.
Highlights: "Discovery of clinical active constituents as guidance, Reverse analysis of metabolic transformations as link, and Traceability of biosynthesis pathways as key", a new research strategy for discovering quality marker of Chinese materia medica (CMM), promotes quality standard of CMM.
Esterases participate in the metabolism of ~10% of the clinical drugs that contain ester or amide bonds, but the esterases mediated drug/herb-drug interactions (DDIs or HDIs) have not been reviewed in depth. Carboxylesterases (CEs), the most abundant esterases expressed in the metabolic organ of mammals, play a pivotal role in hydrolysis of a variety of endogenous and xenobiotic esters. In the human body, two predominant carboxylesterases including hCE1 and hCE2 have been identified and extensively studied over the past decade. These two enzymes have been found with hydrolytic activity towards a variety of endogenous esters and ester-containing drugs. Recent studies have demonstrated that strong inhibition on hCEs may slow down the hydrolysis of CEs substrates, which may affect their pharmacokinetic properties and thus trigger potential DDIs or HDIs. Over the past decade, many herbal extracts and herbal constitutes have been found with strong inhibitory effects against CEs, and their potential risks on herb-drug interactions (HDIs) have also attracted much attention. This review focused on recent progress in hCEs mediated herb-drug interactions. The roles of hCEs in drug metabolism, the inhibitory capacities and inhibition mechanism of a variety of herbal extract and herbal constitutes against hCEs have been well summarized. Furthermore, the challenges and future perspectives in this field are highlighted by the authors. All information and knowledge presented in this review will be very helpful for the pharmacologists to deeper understand the metabolic interactions between herbal constituents and hCEs, as well as for clinical clinicians to reasonable use herbal medicines for alleviating hCEs-associated drug toxicity or avoiding the occurrence of clinically relevant hCEs-mediated HDIs.
Highlights This review summarized recent progress in human carboxylesterases (hCEs) mediated herb-drug interactions (HDIs). The key roles of hCEs in drug metabolism, the inhibitory capacities and inhibition mechanism of a variety of herbal extract and herbal constitutes against hCEs have been well summarized. Furthermore, the challenges and future perspectives in this field are highlighted by the authors. All information and knowledge presented here will be very helpful for the pharmacologists to deeper understand the interactions between herbal constituents and hCEs, as well as for clinical clinicians to reasonable use herbal medicines for alleviating hCEs-associated drug toxicity or avoiding the occurrence of clinically relevant hCEs-mediated HDIs.
Objective: To investigate the effect of Dingjifumai Decoction (DJFM) on Electrocardiogram (ECG) and sodium potassium pump in rats with ventricular arrhythmia. Methods: Forty healthy male SD rats (200 ± 20g) were randomly divided into blank group, model group, Metoprolol group and DJFM group. Ten rats in each group were fed with normal diet and free drinking water. Each group was given gavage, and the amount of gavage in each group was calculated according to body weight. In the model group, 0.001% Aconitine was injected into the tail vein at 30ug/kg. In the Metoprolol group, Metoprolol suspension was given according to the standard of 5.2mg/kg per day. In the DJFM group, DJFM was given at 17.6g/kg per day. After 2 weeks of administration, the biologic experiment system BL-420F was used to monitor the II lead ECG curve, and the ECG changes were observed and recorded. Then, the left ventricle of the rat was taken, and part of the heart tissue sodium potassium pump was detected. Results: (1) The effect of DJFM on ECG of rats with ventricular arrhythmia: After intravenous injection of aconitine, the incidence of Ventricular Premature beat (VP), Ventricular Tachycardia (VT), Ventricular Fibrillation (VF) in the model group was 100%, suggesting that the model building of rats with ventricular arrhythmia was successful. (2) VP, VT, and VF time: Compared with model group, DJFM group and Metoprolol group can significantly delay the VP, VT and VF, the difference was statistically significant (P < 0.05). The effect of DJFM group and Metoprolol group on delaying the appearance of VP, VT and VF was the same, there was no significant difference (P > 0.05). (3) The effect of DJFM on sodium potassium pump in rat ventricular arrhythmia heart tissues: Compared with the blank group, the sodium potassium pump value in the model group was significantly decreased, and the difference was statistically significant (P < 0.05). Compared with the model group, the sodium potassium pump value of the tissues in the Metoprolol group and the DJFM group increased, and the difference was statistically significant (P < 0.05). There was no significant difference in sodium potassium pump between the Metoprolol group and the DJFM group (P > 0.05). Conclusion: 1. The rat model of ventricular arrhythmia can be successfully prepared by intravenous injection of Aconitine. 2. DJFM can prolong the occurrence time of cardiac arrhythmias caused by aconitine in rats, such as VP, VT, VF, et al. The mechanism may be related to fast Na+ channel, and it may prevent and control arrhythmias by inhibiting Na+ influx and reducing the fast response cellular self-discipline. 3. DJFM can protect the myocardial tissue sodium potassium pump, which can protect the myocardial cells and improve the myocardial metabolism.
Highlights In this study, the effects of Dingjifumai Decoction (DJFM) on Electrocardiogram and sodium potassium pump of rats with ventricular arrhythmia were observed, and the effects and mechanism of DJFM on ventricular arrhythmia were discussed. We found that DJFM can prolong the occurrence time of cardiac arrhythmias caused by aconitine in rats, such as VP, VT, VF, et al. The mechanism may be related to fast Na+ channel, and it may prevent and control arrhythmias by inhibiting Na+ influx and reducing the fast response cellular self-discipline. DJFM can protect the myocardial tissue sodium potassium pump, which can protect the myocardial cells and improve the myocardial metabolism
Objective: To explore the main chemical compounds in Xiaoer Qixing Cha Formulae (XQCF), and investigate its mechanisms for the treatment of infantile functional dyspepsia (IFD). Methods: The chemical components were identified by UPLC-QTOF/MS analytic technique. Targets of the compounds were screened from TCMSP and SWISS database, and disease targets were screened from OMIM and TTD online database. Candidate targets of compounds were mapped to the disease targets as predict therapeutic targets for XQCF. Several networks were constructed and analyzed by Cytoscape ver. 3.2.1. Meanwhile, prescription compatibility in XQCF was interpreted from the network perspective based on distribution of the number of targets. Furthermore, Gene Ontology (GO) enrichment analysis and KEGG pathway analysis were operated via Clue Go to illustrate complex relationships between the potential targets and pharmacological mechanisms. Results: A total of fifty-three compounds were recognized or tentatively characterized belonging to XQCF based on MS data and online chemical database. Sixty-three therapeutic targets were screened. AKT1, FOS, SLC6A4, COMT and 5-HT receptors were focused as therapeutic targets of XQCF. Pathways including carbohydrate digestion and absorption, serotonergic synapse, calcium signaling pathway and cAMP signaling pathway were predicted as significant regulatory pathways. The results indicated that the predicted targets and pathways related in brain-gut axis to a great extent, which could be potential pharmacological mechanism of XQCF for the treatment of IFD. Conclusions: The findings in this study provided the experimental and theoretical basis for further research for XQCF. Those also illustrated a reasonable method worth intensive study on pharmacodynamic mechanisms of TCM Formulae.
HighlightsChemical components in Xiaoer Qixing Cha Formulae were firstly identified by UPLC-QTOF/MS analytic technique and collated into data source. Then the mechanisms of the Formulae for the treatment of infantile functional dyspepsia were predicted by interactive network pharmacology. The results suggested that targets and pathways related in brain-gut axis might exert regulating effects on digestive process and digestive system function.
Ventricular premature beat, a kind of arrhythmia, is one of common diseases which not only decreases the quality of life but also has the danger of death. The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation. The teacher, Li Yuan, has worked in clinic for decades and considered that the important pathogenesis of the VP beat is “heat transformed from Yang”, which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.
Highlights Ventricular premature beat, the common arrhythmia disease in clinic, not only greatly decreases the quality of life but also has the danger of death. The teacher, Li Yuan, with decades clinical experience, considered that the important pathogenesis of the VP beat, that is “heat transformed from Yang”, should not be ignored, which is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.
Diabetic nephropathy is one of the most serious complications of diabetes mellitus. In the early stage, edema and proteinuria are the main clinical manifestations. In the later stage, glomerulosclerosis and interstitial fibrosis will occur. And the prognosis is poor. Nowadays, traditional Chinese medicine has a remarkable curative effect in the treatment of diabetic nephropathy. There are more and more studies on the treatment of diabetic nephropathy with traditional Chinese medicine, but most of them focus on the syndromes of diabetic nephropathy, which are short of in-depth research and summary on the mechanism of Chinese herbal prescriptions. In this paper, the traditional Chinese medicine inheritance support system and network pharmacology BATMAN-TCM software were used to collect and analyze the relevant literature. It was found that the core compatibility of Shanzhuyu, Fuling and Shuyu in the treatment of diabetic nephropathy is closely related to the signal transduction pathway and target of diabetic nephropathy, and has a positive effect on the improvement of clinical symptoms such as proteinuria, glycometabolism disorder, edema, etc. This paper explores the core compatibility of Shanzhuyu, Fuling and Shuyu on diabetic nephropathy, in order to provide reference for clinical treatment.
HighlightsDiabetic nephropathy is one of the most serious complications of diabetes mellitus, which seriously affects the quality of life of patients for the poor prognosis. Nowadays, Traditional Chinese Medicine has a remarkable curative effect in the treatment of diabetic nephropathy, which has brought some enlightenment to our research ideas. Traditional Chinese Medicine Inheritance Assistant Platform System (TCM Inheritance Assistant Platform) is an organic combination of computer science and TCM. By intellectualized processing of disease prescription, the data of disease information, syndrome information and compatibility of TCM can be more intuitive, which make Chinese herbal medicine and drug pairs for treating diseases more specialized and precise. Network pharmacology is based on system biology to analyze multi-target networks of drugs, and can combine Drug targets with diseases, which make the treatment of diseases more targeted. This paper collects and summarizes the prescriptions of traditional Chinese medicine for diabetic nephropathy in the past 10 years from China Knowledge Net, and uses the system of traditional Chinese Medicine Inheritance assistant platform and BATMAN-TCM database of network pharmacology to analyze the medication rules and action signal pathways. We concluded that Shanzhuyu（Cornus officinalis Sieb. et Zucc）, Fuling (Poria cocos (Schw.) Wolf) and Shuyu (Dioscorea opposite) have certain positive effects on the compatibility in the prevention and treatment of diabetic nephropathy and hope to provide new ideas for the research and clinical treatment of diabetic nephropathy with TCM.
Objectives: Evaluating the quality of systematic reviews/meta-analysis of Wenxin granule in treating cardiac arrhythmia to provide evidence for clinical practice, and analyzing the problems in the research to identify potential research priorities for researchers. Method: The systematic reviews of Wenxin granule in treating cardiac arrhythmia were searched from 8 databases. The methodological quality and evidence quality were assessed by AMSTAR and GRADE respectively. Results: Nineteen eligible systematic reviews with 52,905 participants were included. The overall scores of AMSTAR ranged from 3 to 10 with a mean score of 6.5, the median score was 6. There were 9 (9/19, 47.37%) systematic reviews had the score of 7 or more. 6 of them with appropriate information were assessed the quality of evidence by GRADE. The results showed that the overall quality of evidence was limited (range from “very low” to “low”), no “moderate” or “high” quality of evidence existed. For the outcome reporting, no systematic reviews reported endpoints and limited evidence showed that there is causality between Wenxin granule and adverse effects/events. The outcome matrix showed that there are obvious heterogeneity and incompleteness for the outcome reporting in included systematic reviews, so that some included studies cannot be conducted meta-analysis. Meanwhile, there were studies excluded because of inappropriate outcome measures, such as outcome measures did not meet inclusion criteria, treatment time did not meet inclusion criteria, treatment time was unclear, incomplete data or the data cannot be extracted. Conclusions: Wenxin granule have limited efficacy and safety for treating arrhythmia. In the future, high quality of RCTs and systematic reviews should be conducted. Core outcome set for cardiac arrhythmia is needed to improve outcome reporting and decrease waste.
Highlights1. This is the first overview of systematic reviews for Wenxin granule in treating cardiac arrhythmia, which summarized the efficacy and safety of Wenxin granule in treating cardiac arrhythmia and strictly assessed the quality of methodology and evidence.2. Besides methodological quality and evidence quality assessment, this overview also analyzed some other problems, such as outcome reporting in systematic reviews and RCTs, so that researchers may identify potential research priorities from the results.3. The outcome matrix of included reviews showed that there was heterogeneity in outcome reporting, and some clinical trials cannot be included in systematic reviews or cannot be conducted meta-analysis in systematic reviews because of inappropriate outcomes reporting. These problems reduce the value of clinical trials and systematic reviews. This research presents that core outcome set for cardiac arrhythmia is necessary to solve these problems.
Objective: To observe the neuroprotective mechanism of water extract of Fomitopsis Pinicola on MPP+ induced apoptosis of mesencephala dopaminergic cells in vitro. Methods: The antioxidant activity of fungi was determined by FRAP method. The anti-inflammatory activity of the fungi was detected by LPS-induced NO release method. Mesencephalic dopaminergic neurons were labeled by TH staining to observe the survival of THir neurons. Results: In the anti-oxidant activity assay, the Trolox equivalent anti-oxidant capacity (TEAC) of water extract of Fomitopsis Pinicola was determined to be （165.80±7.13）μmol Trolox/g extract. Water extracts of Fomitopsis Pinicola treatment(100,50,25,12.5μg/ml) decreased NO formation significantly. MPP+ induced significant chromatin condensation in the nuclei of mesencephala dopaminergic neurons with nuclear lysis,the mitochondrial membrane potential decreased remarkably, and ROS production increased significantly. Compared with the MPP+ control group, the morphological changes of cell nuclei after apoptosis was reversed by water extract of Fomitopsis Pinicola. Water extract of Fomitopsis Pinicola treatment（50,25,12.5μg/ml） dramatically increased relative mitochondrial membrane potential compared with MPP+ control respectively. Compared with the MPP+ control, water extract of Fomitopsis Pinicola treatment (50, 25μg/ml) significantly decreased relative ROS formation respectively. Conclusions：Water extract of Fomitopsis Pinicola showed significant neuroprotective effect on mesencephala dopaminergic cells induced by MPP+. The water extract of Fomitopsis Pinicola showed antioxidant and anti-inflammatory activities. The mechanism of neuroprotective effect of water extract of Fomitopsis Pinicola may be related to inhibitory on mitochondrial oxidative stress.
HighlightsFomitopsis Pinicola is characterized with anti-oxidant, anti-inflammation and immunostimulant properties. In the present study, primary dopaminergic cell cultures prepared from embryonic mouse mesencephala were used to determine the neuroprotective effects and the potential mechanisms of water extract of Fomitopsis Pinicola on the degeneration of dopaminergic neurons induced by MPP+. The results demonstrated that Water extract of Fomitopsis Pinicola protected dopamine neurons against MPP+. The water extract of Fomitopsis Pinicola showed antioxidant and anti-inflammatory activities. The mechanism of neuroprotective effect of water extract of Fomitopsis Pinicola may be related to inhibitory on mitochondrial oxidative stress.
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