Ameliorative effects of arctiin from Arctium lappa on experimental glomerulonephritis in rats

Membranous glomerulonephritis (MGN) remains the most common cause of adult-onset nephrotic syndrome in the world and up to 40% of untreated patients will progress to end-stage renal disease. Although the treatment of MGN with immunosuppressants or steroid hormones can attenuate the deterioration of renal function, numerous treatment-related complications have also been established. In this study, the ameliorative effects of arctiin, a natural compound isolated from the fruits of Arctium lappa, on rat glomerulonephritis induced by cationic bovine serum albumin (cBSA) were determined. After oral administration of arctiin (30, 60, 120 mg/kgd) for three weeks, the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) and 24-h urine protein content markedly decreased, while endogenous creatinine clearance rate (ECcr) significantly increased. The parameters of renal lesion, hypercellularity, infiltration of polymorphonuclear leukocyte (PMN), fibrinoid necrosis, focal and segmental proliferation and interstitial infiltration, were reversed. In addition, we observed that arctiin evidently reduced the levels of malondialdehyde (MDA) and pro-inflammatory cytokines including interleukin-6 (IL-6) and tumor necrosis factor (TNF-alpha), suppressed nuclear factor-kappaB p65 (NF-kappaB) DNA binding activity, and enhanced superoxide dismutase (SOD) activity. These findings suggest that the ameliorative effects of arctiin on glomerulonephritis is carried out mainly by suppression of NF-kappaB activation and nuclear translocation and the decreases in the levels of these pro-inflammatory cytokines, while SOD is involved in the inhibitory pathway of NF-kappaB activation. Arctiin has favorable potency for the development of an inhibitory agent of NF-kappaB and further application to clinical treatment of glomerulonephritis, though clinical studies are required.

[Clinical study on modified sanmiao powder in treating chronic uric acid nephropathy]

OBJECTIVE

To investigate the clinical efficacy of modified Sanmiao Powder (SMP) in treating chronic uric acid nephropathy (CUAN).

METHODS

Ninety-four patients with CUAN were equally randomized to the treated group and the control group. Conventional treatment was given to all patients and the treated group was administered with SMP additionally for 12 weeks. Changes of symptoms were observed, and laboratory indexes, as urinary protein quantity (UPro), urinary RBC count (URBC), urinary beta2 microglobulin (beta2-M), urinary beta-N-acetylglucosaminidase (NAG), blood urea nitrogen (BUN), serum creatine (SCr) and serum uric acid (SUA), were detected before and after treatment.

RESULTS

The total effective rate in the treated group was 87.2% (41/47), and in the control group was 61.7% (21/47), showing significant difference between groups (P < 0.01); significant improvement of UPro, URBC, beta2-M, NAG, BUN, SCr and SUA were shown in the treated group (P < 0.05, P < 0.01); but in the control group, only URBC count was significantly decreased (P < 0.05), no statistically significant change of other indexes was found (P > 0.05). SUA decreased in both groups (P < 0.01), which was markedly lower in the treated group than in the control group (P < 0.05); SCr and BUN were also decreased in the treated group (P < 0.01).

CONCLUSIONS

Combined therapy of SMP and conventional Western medicine shows a favorable effect in treating CUAN. It could not only reduce SUA, but also alleviate the albuminuria and hematuria, lower the urinary levels of beta2-M and NAG to improve renal function.

Flavonoids from Inula britannica L. inhibit injury-induced neointimal formation by suppressing oxidative-stress generation

AIM OF THE STUDY

We aimed to investigate whether and how the total flavonoid extracts (TFE) from Inula britannica L. block neointimal hyperplasia induced by balloon injury in rats.

MATERIALS AND METHODS

Rats were administered orally TFE doses of 12.5, 25 and 50 mg/kg/d by gastric gavage from 3 days before balloon injury to 14 days after the injury. The ratio of intima (I) to media (M) thickness (I/M) in carotid arteries was examined by morphological analyses. The MDA content and SOD activity in plasma were measured. The O(2)(-) production in vascular tissues was detected in situ. The expression of p47(phox) in carotid arteries was analyzed by Western blot analysis and immunohistochemistry.

RESULTS

The rats treated with TFE 50 mg/kg/d showed a reduction in neointimal hyperplasia, and the ratio of I/M of balloon injured-carotid arteries was significantly reduced by over 70% after TFE treatment, compared with the injured group. The inhibitory effect of TFE on neointimal hyperplasia was almost consistent with that of atorvastatin, a positive control. The plasma SOD activity was obviously increased by TFE treatment (P<0.01), while plasma MDA production was markedly decreased by TFE treatment (P<0.05). On day 14 after balloon injury, the carotid arteries showed an increase in O(2)(-) production that was most evident in the neointimal and medial layer of the vessel. Thus, TFE significantly inhibited injury-induced O(2)(-) production and p47(phox) expression in carotid arteries.

CONCLUSION

Our results suggest that TFE inhibit the neointimal hyperplasia after balloon injury, at least partly, by suppressing oxidative-stress generation.

Inhibitory effects of citrus extracts on the experimental pulmonary fibrosis

AIM OF THE STUDY

A Chinese herbal formula, Hu-qi-yin possessed an anti-pulmonary fibrosis effect. Pericarp of Citrus reticulata, one of the herbal drugs contained in this formula showed the most potent inhibitory activity on the proliferation of human embryonic lung fibroblasts (HELF). The present study was designed to clarify the active principles responsible for the activity and further explore the anti-pulmonary fibrosis effect in vivo.

MATERIALS AND METHODS

The water, 75% ethanol and flavonoids-enriched extracts of Citrus reticulata were prepared and screened for their anti-proliferation activity using HELF culture system. The ethanol extract was further administered orally at doses of 100 and 200 mg/(kg day) to bleomycin (BLM)-induced pulmonary fibrosis rats. The analyses of the rat body weight, hydroxyproline levels in serum and lung, scores of alveolitis and fibrosis, as well as the expression of transforming growth factor-beta(1) (TGF-beta(1)) at the protein and the messenger ribonucleic acid (mRNA) levels in lung were performed.

RESULTS

The ethanol extract showed the strongest inhibitory activity on HELF proliferation. Further research using BLM-induced rat model revealed that the ethanol extract at the doses of 100 and 200 mg/(kg day) caused a marked increase of body weight at first 7 days, significantly lowered the hydroxyproline levels in lung, greatly improved the pathologic scores, as well as inhibited the overexpressions of TGF-beta(1) protein and mRNA.

CONCLUSIONS

The results suggest that the ethanol extract of Citrus reticulata has anti-pulmonary fibrosis effects and might have a great potential for the treatment of fibrosis of lung.

Immunosuppressive effects of an ethyl acetate extract from Urtica dentata Hand on skin allograft rejection

AIM OF THE STUDY

To investigate the immunosuppressive effects of HPLC qualitied ethyl acetate extract (EAE) from Urtica dentate Hand on skin allograft rejection in a murine model.

MATERIALS AND METHODS

Allo-skin transplantation model was established by placing skin allograft of C57BL/6 mice in the wound bed which was on the back of Balb/c mice. We used FACS to study the effects of EAE on dendritic cells (DCs) maturation and CD4(+)CD25(+)T regulatory cells (Tregs) differentiation. We also studied spleen lymphocyte proliferation and T-bet gene expression in DCs. Concentration of Th1/Th2 cytokines was monitored as markers of Th1/Th2 responses by ELISA.

RESULTS

A significant prolongation of skin allografts survival was observed as a dose-dependent manner in the animals treated with EAE. By FACS, we found that treatment with EAE (200 mg kg(-1)) resulted in an immature statement of DCs and stimulated the differentiation of CD4(+)CD25(+)Tregs. Additionally, the expression of T-bet gene and the proliferation of spleen lymphocytes were efficiently abated in EAE treated mice. Comparing to the model control, EAE-treated recipients showed a significant down-regulation (P<0.01) of Th1 cytokines (IL-2, IFN-gamma) and an obviously increase (P<0.01) of Th2 cytokine (IL-10) in the serum, which presented in a dose-related way.

CONCLUSIONS

The anti-allograft rejection effect of EAE by enhancing CD4(+)CD25(+)Tregs differentiation and sustaining DCs immaturation makes EAE to be a possible choice for treating autoimmune diseases in a way of inducing a stable immunological tolerance state.

Effects of the traditional Japanese medicine Tokaku-jyoki-to in rat-models for menopausal hot flash

AIM OF STUDY

Luteinizing hormone-releasing hormone (LH-RH) has been suggested as an inducer of centrally mediated elevation of skin temperature, and calcitonin gene-related peptide (CGRP) is one of the potent vasodilator neuropeptides that has been suggested as an inducer of peripherally mediated elevation of skin temperature. We investigate the effect of the Japanese herbal medicine Tokaku-jyoki-to using two rat-models for menopausal hot flash.

MATERIALS AND METHODS

Tokaku-jyoki-to used in present study was prepared as a spray-dried powder from hot-water extract. Skin temperature was measured by thermister thermometer. Estrogen receptor (ER) binding assay of Tokaku-jyoki-to extract was performed using human recombinant ERalpha or ERbeta.

RESULTS

Oral Tokaku-jyoki-to (1000 mg/kg) restored skin temperature rise induced by LH-RH or CGRP in ovariectomized (OVX) rats as well as subcutaneous 17beta-estradiol (0.010 mg/kg) did. Tokaku-jyoki-to did not affect the lower concentration of plasma estradiol and the decreased uterine weight due to ovariectomy, although the hormone replacement of 17beta-estradiol restored them. In estrogen receptor ligand-binding study, Tokaku-jyoki-to extract bound to human ERalpha poorly and did not bound to human ERbeta.

CONCLUSIONS

These results suggest that Tokaku-jyoki-to, which appears to contain organ-specific selective estrogen receptor modulator, may be useful for the treatment of hot flashes in patients for whom estrogen replacement therapy is contraindicated as well as menopausal women.

Effect of Laggera alata on hepatocyte damage induced by carbon tetrachloride in vitro and in vivo

ETHNOPHARMACOLOGICAL RELEVANCE

Laggera alata, as a traditional Chinese herbal medicine, has been widely used to ameliorate some ailments associated with inflammation including hepatitis in folk.

AIM OF THE STUDY

Based on anti-inflammatory activity of total phenolics from Laggera alata (TPLA), to further validate the remarkable curative effect Laggera alata in hepatitis, hepatoprotective effect of TPLA was examined.

MATERIALS AND METHODS

TPLA was prepared and its principle components were quantificationally analyzed. The hepatoprotective effects of TPLA were studied using a CCl(4)-induced injury model in primary cultured neonatal rat hepatocytes, and a CCl(4)-induced acute and chronic damage model in vivo.

RESULTS

TPLA significantly reduced cellular leakage of hepatocyte aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and improved cell viability in vitro. TPLA markedly decreased the serum AST and ALT levels of the mice, the levels of AST, ALT, total protein, albumin, and sialic acid in rat serum, and the hydroxyproline level in rat liver. Meanwhile, severe hepatic lesions induced by CCl(4) in mice/rats were remarkably improved by the administration of TPLA.

CONCLUSIONS

This investigation verifies the hepatoprotective effect of TPLA in vitro/in vivo and clarifies its active components dicaffeoylquinic acids responsible for hepatoprotective potential.

Berberine and Coptidis rhizoma as novel antineoplastic agents: a review of traditional use and biomedical investigations

ETHNOPHARMACOLOGICAL RELEVANCE

Coptidis rhizoma (huanglian) and its major component, berberine, have drawn extensive attention toward their antineoplastic effects in the recent years. The antineoplastic effects are related to the Chinese Medicine (CM) properties of huanglian in treating diseases by removing damp-heat and purging fire and counteracting toxicity.

AIM OF THE REVIEW

To trace the long history of the traditional use of huanglian from folk medicines, especially from Chinese medicine, to recent pharmacological studies of huanglian and berberine, with an emphasis on their antineoplastic effects and the promise as novel antineoplastic agents.

METHODS

A total of seven databases were extensively searched for literature research. The terms and keywords for searching included huanglian, berberine, Coptis, Coptidis rhizoma, anticancer, anti-invasion, antimatastasis and mechanism. The papers including ours with studies on anticancer and mechanism, pharmacology and toxicology of huanglian and/or berberine were focused.

RESULTS

In view of traditional use, the anticancer effects of huanglian can be ascribed to its CM trait by removing damp-heat, fire and toxicity. From modern biomedical studies, anticancer effects have been demonstrated in both huanglian and berberine. The underlying molecular mechanisms involve cell-cycle arrest, apoptosis induction and anti-inflammation. Berberine is an essential anticancer compound in huanglian. In some studies, the use of huanglian was shown to be more effective and beneficial than the use of berberine alone. The presence of other protoberberine-type alkaloids in huanglian might give synergistic effects for the anticancer effects. Berberine also demonstrates effects of antiangiogenesis, anti-invasion and anti-metastasis in some cancer cell lines, however, more investigations are required to unravel the underlying mechanisms involved.

CONCLUSIONS

The modern evidences of treating cancer with huanglian and berberine have a strong linkage with traditional concept and rules of using huanglian in CM practice. As anticancer candidates with low toxicity, berberine and its altered structure, as well as huanglian and its formulae, will attract scientists to pursue the potential anticancer effects and the mechanisms by using technologies of genomics, proteomics and other advanced approaches. On the other hand, relatively few in vivo studies have been conducted on anticancer effects of huanglian and berberine. The clinical application of berberine or huanglian as novel cancer therapeutic agents requires in vivo validations and further investigations of their anticancer mechanisms.

[Effect of XueBiJing injection upon related proinflammatory factors and blood coagulation factors of vascular endothelial cells in severe septic patients]

OBJECTIVE

To evaluate the effect of Xue Bijing injection in related proinflammatory factors and blood coagulation factors of vascular endothelial cell in severe septic patients.

METHODS

Fifty-two patients were randomly divided into Xue Bijing injection treatment group (Group B) and control group (Group A). Both groups were treated with routine integration treatment, and additionally, patients in Group B received Xue Bijing injection 100 ml intravenous once a day for 7 days while those in Group A received an equal quantity of normal saline as placebo. The changes of VCAM-1, ICAM-1, NO, AT-III, TM, TPA, VWF and PAI-1 in blood serum were tested at Day 0, 3, 7. And the mortality was calculated at Day 28.

RESULTS

The 28-day mortality rate was 32.1% (9/28) in Group B while that of Group A was 62.5% (15/24). There was a significant difference between two groups (P < 0.05). The concentrations of blood serum VCAM-1 and ICAM-1 were significantly lower in Group B than Group A. And the concentrations of blood serum NO, AT-III, TM, TPA, VWF and PAI-1 were significantly higher in Group B than Group A.

CONCLUSION

Xue Bijing injection improves a patient's condition and reduces 28-day mortality of severe septic patients. The reason may be that it can stabilize vascular endothelial cell to improve serious inflammatory reaction and blood coagulation dysfunction.

Efficacy of rabdosia rubescens in the treatment of gingivitis

This study evaluated the efficacy of rabdosia rubescens against gingivitis and compared the therapeutic efficacy of different dosage forms of rabdosia rubescens. A multi-center, randomized, double-blind, double-simulation, positive-controlled and parallel trial was conducted. A total of 136 patients exhibiting clinical symptoms of gingivitis were enrolled. The subjects were randomly assigned to two groups: test group (n=67), in which rabdosia rubescens drop pill (960 mg) and 4 tablets of simulation agent of rabdosia rubescen were orally given to the subjects three times a day for 5 days; and control group (n=69), in which the subjects were administered the tablets of rabdosia rubescens (1000 mg) and 24 drop pills of simulation agent of rabdosia rubescens thrice daily for 5 days. The experimental protocols and diagnostic criteria were established by expert panel prior to the experiment. The clinical symptoms were graded according to the severity of the disease and quantified. The total scores and scores for each clinical symptom of gingivitis were assessed at baseline and on the 6th day post-treatment. The therapeutic efficacy was compared between the two groups and in each group itself before and after the treatment. The results showed that in the two groups, the subjects who were given rabdosia rubescens, drop pill or tablet, had a decrease in total scores and scores for each clinical symptom when compared with those before treatment (P<0.01). There was significant difference in the therapeutic efficacy between the test group and the control group with the efficacy rate being 92.54% and 79.71% respectively (P<0.05). It was concluded that rabdosia rubescens showed great promise in treating gingivitis. And rabdosia rubescens drop pill was more efficacious than rabdosia rubescens tablet.

Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome

BACKGROUND

Chronic fatigue is increasingly common. Conventional medical care is limited in treating chronic fatigue, leading some patients to use traditional Chinese medicine therapies, including herbal medicine.

OBJECTIVES

To assess the effectiveness of traditional Chinese medicine herbal products in treating idiopathic chronic fatigue and chronic fatigue syndrome.

SEARCH STRATEGY

The following databases were searched for terms related to traditional Chinese medicine, chronic fatigue, and clinical trials: CCDAN Controlled Trials Register (July 2009), MEDLINE (1966-2008), EMBASE (1980-2008), AMED (1985-2008), CINAHL (1982-2008), PSYCHINFO (1985-2008), CENTRAL (Issue 2 2008), the Chalmers Research Group PedCAM Database (2004), VIP Information (1989-2008), CNKI (1976-2008), OCLC Proceedings First (1992-2008), Conference Papers Index (1982-2008), and Dissertation Abstracts (1980-2008). Reference lists of included studies and review articles were examined and experts in the field were contacted for knowledge of additional studies.

SELECTION CRITERIA

Selection criteria included published or unpublished randomized controlled trials (RCTs) of participants diagnosed with idiopathic chronic fatigue or chronic fatigue syndrome comparing traditional Chinese medicinal herbs with placebo, conventional standard of care (SOC), or no treatment/wait lists. The outcome of interest was fatigue.

DATA COLLECTION AND ANALYSIS

13 databases were searched for RCTs investigating TCM herbal products for the treatment of chronic fatigue. Over 2400 references were located. Studies were screened and assessed for inclusion criteria by two authors.

MAIN RESULTS

No studies that met all inclusion criteria were identified.

AUTHORS' CONCLUSIONS

Although studies examining the use of TCM herbal products for chronic fatigue were located, methodologic limitations resulted in the exclusion of all studies. Of note, many of the studies labelled as RCTs and conducted in China did not utilize rigorous randomization procedures. Improvements in methodology in future studies is required for meaningful synthesis of data.

Chinese medicinal herbs for measles

BACKGROUND

Measles is an infectious disease caused by the Morbilli virus. Chinese physicians believe that medicinal herbs are effective in alleviating symptoms and preventing complications. Chinese herbal medicines are dispensed according to the particular symptoms. This is an update of a Cochrane review first published in 2006.

OBJECTIVES

To assess the effectiveness and possible adverse effects of Chinese medicinal herbs in treating measles.

SEARCH STRATEGY

We searched the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library 2009, issue 1) which contains the Cochrane Acute Respiratory Infection Group's Specialised Register; MEDLINE (1966 to March 2009); EMBASE (1980 to March 2009); the Chinese Biomedical Database (1976 to March 2009); VIP Information (1989 to March 2009); and China National Knowledge Infrastructure (CNKI) (1994 to March 2009). We searched the metaRegister of Controlled Trials for ongoing trials.

SELECTION CRITERIA

Randomised controlled trials (RCTs) in which patients with measles without complications were treated with Chinese medicinal herbs.

DATA COLLECTION AND ANALYSIS

Three review authors (YZ, RG, TW) independently assessed trial quality and extracted data. We telephone interviewed the study authors for missing information regarding participant allocation. Some trials allocated participants according to the sequence they were admitted to the trials, that is to say, by using a pseudo-random allocation method; none of the trials concealed the allocation or blinding method.

MAIN RESULTS

We did not identify any suitable trials for inclusion. In this updated review we identified 61 trials which claimed to use random allocation. We contacted 29 trial authors by telephone and learned that the allocation methods used were not randomised. We excluded 34 studies because the patients experienced complications such as pneumonia. Both reasons excluded 10 studies. Another study was excluded because the trial author had not confirmed the diagnosis of measles. We were unable to contact the remaining seven trials' authors, so that they require further assessment and, meanwhile are allocated to the 'Studies awaiting classification' section.

AUTHORS' CONCLUSIONS

There is no evidence from RCTs for or against Chinese medicinal herbs as a treatment for measles. We hope high quality, robust RCTs in this field will be conducted in the future.

Chinese herbal medicines for esophageal cancer

BACKGROUND

Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese herbal medicines are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer.

OBJECTIVES

To assess the efficacy and possible adverse effects of the addition of Chinese herbal medicines to treatment with radiotherapy or chemotherapy for esophageal cancer.

SEARCH STRATEGY

We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register, The Cochrane Library, MEDLINE, EMBASE, AMED (Allied and Complementary Medicine Database), CBM (Chinese Biomedical Database), China National Knowledge Infrastructure, the Chinese Cochrane Centre Controlled Trials Register and CISCOM (The Research Council for Complementary Medicine) (up to 10 July, 2008). Databases of ongoing trials, the Internet and reference lists were also searched.

SELECTION CRITERIA

Randomised controlled trials comparing the use of radiotherapy or chemotherapy with and without the addition of Chinese herbal medicines.

DATA COLLECTION AND ANALYSIS

At least two review authors extracted data and assessed trial quality.

MAIN RESULTS

We identified 43 trials which claimed to use random allocation. The first authors of all the RCTs we initially identified were contacted by telephone and we discovered that the authors had misunderstood the randomisation procedure. Using this new information, we reassigned all the identified RCTs as non-randomised trials. Because we identified no authentic randomised controlled trials, we were unable to perform a meta-analysis.

AUTHORS' CONCLUSIONS

We were unable to find any evidence from RCTs on the effectiveness of TCM in the treatment of esophageal cancer. New trials should be carried out and we recommend that they are large scaled, correctly randomised and that the assessors of the results are blinded to the conditions of allocation.

Chinese herbal medicines for people with impaired glucose tolerance or impaired fasting blood glucose

BACKGROUND

Around 308 million people worldwide are estimated to have impaired glucose tolerance (IGT); 25% to 75% of these will develop diabetes within a decade of initial diagnosis. At diagnosis, half will have tissue-related damage and all have an increased risk for coronary heart disease.

OBJECTIVES

The objective of this review was to assess the effects and safety of Chinese herbal medicines for the treatment of people with impaired glucose tolerance or impaired fasting glucose (IFG).

SEARCH STRATEGY

We searched the following databases: The Cochrane Library, PubMed, EMBASE, AMED, a range of Chinese language databases, SIGLE and databases of ongoing trials.

SELECTION CRITERIA

Randomised clinical trials comparing Chinese herbal medicines with placebo, no treatment, pharmacological or non-pharmacological interventions in people with IGT or IFG were considered.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data. Trials were assessed for risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, outcome assessors and intervention providers, incomplete outcome data, selective outcome reporting and other sources of bias.

MAIN RESULTS

This review examined 16 trials lasting four weeks to two years involving 1391 participants receiving 15 different Chinese herbal medicines in eight different comparisons. No trial reported on mortality, morbidity or costs. No serious adverse events like severe hypoglycaemia were observed. Meta-analysis of eight trials showed that those receiving Chinese herbal medicines combined with lifestyle modification were more than twice as likely to have their fasting plasma glucose levels return to normal levels (i.e. fasting plasma glucose <7.8 mmol/L and 2hr blood glucose <11.1 mmol/L) compared to lifestyle modification alone (RR 2.07; 95% confidence intervall (CI) 1.52 to 2.82). Those receiving Chinese herbs were less likely to progress to diabetes over the duration of the trial (RR 0.33; 95% CI 0.19 to 0.58). However, all trials had a considerable risk of bias and none of the specific herbal medicines comparison data was available from more than one study. Moreover, results could have been confounded by rates of natural reversion to normal glucose levels.

AUTHORS' CONCLUSIONS

The positive evidence in favour of Chinese herbal medicines for the treatment of IGT or IFG is constrained by the following factors: lack of trials that tested the same herbal medicine, lack of details on co-interventions, unclear methods of randomisation, poor reporting and other risks of bias.

Improving insulin resistance with traditional Chinese medicine in type 2 diabetic patients

Some clinical studies and animal researches have evaluated the efficacy of Traditional Chinese Medicine (TCM) and compared its effects with placebo or other antidiabetic drugs. TCM involves three particular plants, as an antidiabetic drug. Our present research planned to evaluate the efficacy of TCM on insulin sensitivity and other related metabolic factors in type 2 diabetic patients. There were 43 newly diagnosed type 2 diabetic patients enrolled in this study, who did not use any antidiabetic drugs before. They were randomly assigned into TCM and placebo groups, administrated with TCM and placebo, respectively. Glucose disposal rate, fasting plasma glucose, postprandial plasma glucose, glycated hemoglobin, and other metabolic components were assessed at baseline and end point. Glucose disposal rate increased from 5.12 +/- 2.20 to 6.37 +/- 3.51 mg kg(-1) min(-1) in the TCM group, ANCOVA analysis showed that glucose disposal rate in the TCM group was significantly improved as compared to that in the placebo group (P < 0.05). Other metabolic related components such as fasting plasma glucose, postprandial plasma glucose, glycated hemoglobin, systolic blood pressure, diastolic blood pressure, body mass index, retinol binding protein 4 were improved in TCM group, but no statistical differences was detected between the two groups. No severe side effect was found in TCM group. TCM can ameliorate insulin resistance in type 2 diabetes and it is safe and effective in newly diagnosed diabetic patients.

[Jinleng method is effective and safe for the treatment of oligospermia and asthenospermia]

OBJECTIVE

The Jinleng method is based on the principle of lowered temperature and diathermic action on the testis. The aim of this study is to investigate the effect and safety of the Jinleng method on oligospermia and asthenospermia.

METHODS

We treated 39 infertile males with oligospermia or asthenospermia with Jinleng underpants (Jinleng method) bid for 3 months, observed the changes in the sperm parameters of the patients after the treatment and recorded the pregnancy outcomes of their wives.

RESULTS

Of the 36 patients who accomplished the treatment, 31 showed significantly improvement in semen volume, sperm concentration, forward sperm motility, total sperm motility, total sperm count and total motile sperm count (P < 0.05), with an effectiveness rate of 86.1%. Five of the patients wives achieved pregnancy in the 2-month follow-up. Adverse effects were found in none of the patients.

CONCLUSION

Jinleng method is effective and safe for the treatment of infertile males with oligospermia and asthenospermia.

[Effects of qingyi II granules on intestinal bacterial translocation in rats with acute necrotizing pancreatitis]

OBJECTIVE

To observe the effects and mechanism of Qingyi II Granules (QYG) on the bacterial translocation in rats with acute necrotizing pancreatitis (ANP).

METHODS

Eighteen Sprague-Dawley rats were randomized equally into 3 groups, the sham-operated group (A), the ANP model group (B) and the treated group (C). Rats in Group B and C were established into ANP model by retrograde injection of 30 g/L sodium taurocholate into pancreatobiliary duct. QYG was administered, beginning from 1 h after modeling, for three times (every 6 h) per day via intragastric infusion to Group C in dose of 10 mL/kg (250 g/L), while to the other two groups, equal volume of saline was infused instead. All animals were sacrificed 24 h after modeling. The contents in mesenteric lymph nodes and distant sites (liver, spleen, pancreas) were taken for bacterial culture and strain identification, the expression of high mobility group box 1 (Hmgb1) mRNA in ileal tissue was assayed by real-time PCR; the levels of nitric oxide (NO) and endothelin-1 (ET-1) were determined by ELISA; the wet/ dry ratio of ileum was measured; and the pathologic features of pancreas and ileum were examined respectively.

RESULTS

In Group B, evident pathological injury in pancreas and ileum was shown, expression of Hmgb1 mRNA up-regulated, levels of NO and ET-1 in ileum tissues increased to 1.67 +/- 0.21 micromol/L and 102.18 +/- 9.19 ng/L respectively, and the bacterial counts in the mesenteric lymph nodes and distant sites increased significantly. Compared with Group B, the level of NO and ET-1 reduced to 1.39 +/- 0.23 micromol/L and 83.15 +/- 5.39 ng/L, respectively in Group C, with all the above-mentioned abnormal changes alleviated significantly.

CONCLUSION

Levels of Hmgb1, NO and ET-1 might play important roles in the ANP model rats with intestinal bacterial translocation. QYG shows effects on preventing the intestinal bacterial translocation by way of down-regulate the Hmgb1 mRNA expression, lowering the concentration of NO and ET, and ameliorating the injury of pancreatic and ileum tissues.

[Effects and mechanisms of total flavonoids of Litsea coreana on insulin resistance in rats with hyperlipidemia]

OBJECTIVE

To study the effects and its mechanisms of total flavonoids of Litsea coreana (TFLC) on insulin resistance (IR) in rats with hyperlipidemia.

METHODS

The rats were fed with high fat emulsion to make IR models. The effects of TFLC on the state of impaired glucose tolerance (IGT), fasting serum glucose (FSG), fasting serum insulin (FINS), fasting serum lipids (TC, TG, LDL-C, HDL-C), free fatty acid (FFA) and Leptin were observed,and the index of insulin sensitivity (ISI) was calculated.

RESULTS

TFLC could significantly improve the state of IGT and depress the level of FSG, FINS, TC, TG, LDL-C, FFA and leptin of model rats, which could also increase the content of HDL-C and ISI significantly and enhance the sensitivity of insulin.

CONCLUSION

TFLC has obvious effects on increasing insulin sensitivity and improving the insulin resistance in rats with hyperlipidemia,which may contribute to the regulating effects on the disturbance of lipid metabolism and the decrease of leptin level.

[Tripterygium wilfordii extract for treating rheumatoid arthritis: systematic review]

OBJECTIVE

To evaluate the efficacy and safety of Tripterygium wilfordii extract (TWE) in treating rheumatoid arthritis.

METHOD

Mainly using the simple methods from the International Cochrane Collaboration as systematic evaluation methods. Using Revman 4.2.5 which Cochrane Cooperation Web recommended to analysis. Using American College of Rheumatology (ACR) core set (ACR20, ACR50, and ACR70) of therapeutic efficacy measures which recommended by ACR, radiographic change of bone and the rate of inefficacy as efficacy methods. Dividing into placebo subgroup and DMARDs (disease modifying anti rheumatism drugs) subgroup according to different control treatments.

RESULT

A total of seven randomized controlled trials (RCTs) were collected. They are all of small sample size, six of which exist some methodological defects, resulting in many possible biases. As evaluated by ACR20/50/70, TWE was as effective as DMARDs in reducing number of swelling joints, level of C-reactive protein (CRP), and was more effective than DMARDs in reducing erythrocyte sedimentation rate (ESR) (P <0.01). While TWE was no effect in delaying bone destruction. The incidence of adverse reactions of TWE is higher than DMARDs.

CONCLUSION

TWE can be used as an alternative medicine in treating RA. But owing to lacking of data from high-quality RCTs, however, the efficacy and safety of TWE are desired for further exploration.

[Effect of shuizhongcao granule on cellular immune function of experimental animal with recurrent aphthous stomatitis]

OBJECTIVE

To investigate the effect of Shuizhongcao Granule (SZCG) on cellular immune function in animal model of recurrent aphthous stomatitis (RAS).

METHODS

Experimental animal model of RAS were established by immunological method. The modeled animals were randomized into 4 groups, Group A was the model control group, Group B was treated by Levamisole (2.5 mg/mL), Group C and D was treated with high-dose (0.5 g/mL) and low-dose (0.24 g/mL) SZCG respectively. The medication was administered via gastric perfusion, starting from the 7th week of the experiment, and continued for 28 days. Meanwhile, a normal control group was set up. Percentage of T-lymphocyte subsets, CD3, CD4 and CD8, and serum levels of interleukin 10 and 12 (IL-10 and IL-12) in peripheral blood were detected before and after treatment.

RESULTS

Percentages of CD3, CD4 and CD4/CD8 ratio in the model control group were 40.50 +/- 7.46%, 30.80 +/- 5.33% and 79.56 +/- 8.32 respectively, all lower than those in the normal control group (P<0.05); level of serum IL-10 was higher (8.02 +/- 0.53 ng/L) and that of IL-12 was lower (15.51 +/- 1.35 ng/L) in the model animal than those in normal control (P<0.05). After treatment, levels of CD3, CD4, CD4/CD8 and IL-12 in Group B were 55.30 +/- 6.33%, 43.50 +/- 5.33%, 99.29 +/- 13.84 and 17.72 +/- 1.70 ng/L, those in Group C were 61.50 +/- 4.32%, 47.20 +/- 4.37%, 103.30 +/- 7.42 and 18.18 +/- 1.54 ng/L, and in Group D were 58.50 +/- 6.03%, 42.80 +/- 3.17%, 110.27 +/- 12.85 and 17.74 +/- 1.96 ng/L, respectively, all were higher than those in Group A, but levels of IL-10 in the three treatment groups were lower than that in Goup A (P<0.05 or P<0.01).

CONCLUSION

The immune function of RAS model animals is in the suppressed condition; SZCG can improve the immune suppression to achieve its therapeutic effect on the disease.

[Efficacy of traditional herbal medicine, Yokukansan on patients with neuropathic pain]

BACKGROUND

Neuropathic pain that is the chronic, severe, and intractable pain, interferes with activities of daily living (ADL) and consequently reduces quality of life (QOL). We reported the efficacy of Yokukansan in patients with neuropathic pain, including acute herpetic pain, postherpetic neuralgia, central poststroke pain, post-traumatic spinal cord injury pain, thalamic syndrome, complex regional pain syndrome and symptomatic trigeminal neuralgia. Yokukansan was more effective compared with traditional medicines, such as tricyclic antidepressants, carbamazepine, gabapentin, and opioids etc., which are recommended to treat neuropathic pain. Recently, effects of Yokukansan is reported on the behavioral and psychological symptoms of dementia (BPSD) in elderly patients with dementia. Repeated administration of Yokukansan decreases expression of 5-hydroxytryptamine (5-HT) 2A receptors in the prefrontal cortex in mice, and Yokukansan also protects destruction of myelin sheaths in rats with thiamine deficient-induced encephalopathy. Mechanism of effectiveness of Yokukansan on neuropathic pain has not been established; however, efficacy of Yokukansan on neuropathic pain has been shown clinically.

CONCLUSIONS

As far as we know, this is the first report that Yokukansan was effective on neuropathic pain. Yokukansan without serious adverse reactions may be a possible medicine for treatment of neuropathic pain in future.

[Effects of Astragalus injection in reversing left ventricular hypertrophy induced by renal hypertension in rats]

OBJECTIVE

To explore whether the Astragalus injection (AI) has effect for reversing left ventricular hypertrophy and myocardial fibrosis induced by renal vascular hypertension in rats.

METHODS

Thirty male SD rats were randomized equally into three groups: the AI group, the control group and the sham-operated group. All rats, except those in the sham-operated group, were established into the hypertension models by two kidney one clip (2K1C) operation. Blood pressure was measured before operation and every 4 weeks after operation. AI intervention was given to rats in the AI group starting from the 4th week of experiment at dose of 8 g/kg by peritoneal injecting once a day for 8 weeks, while for rats in the other 2 groups, equal volume of normal saline was given instead. All rats were sacrificed 12 weeks after operation by cervical breaking. And indexes including left ventricular mass index (LVMI), left ventricular wall thickness (LVWT), inter-ventricular septal thickness (IVST), left ventricular diameter (LVD), cardiomyocytes diameter (CCD), collagen volume fraction (CVF), and peri-vascular volume collagen area (PVCA) in rats were measured.

RESULTS

Blood pressure was not different in the three groups before operation (P>0.05), whereas it rose in the control group and the AI group 4, 8 and 12 weeks after operation correspondingly, showing no difference between the two groups, but significantly higher than that in the sham-operated group (P<0.05). The related indexes in the sham-operated group, control group and AI group were: LVMI, 2.71 +/- 0.24, 3.42 +/- 0.26, 3.13 +/- 0.23, respectively; LVWT (mm), 2.25 +/- 0.42, 4.26 +/- 0.48, 3.28 +/- 0.36; IVST (mm), 2.13 +/- 0.38, 3.98 +/- 0.32, 3.02 +/- 0.28; and LVD (mm), 3.76 +/- 0.29, 2.18 +/- 0.27, 2.82 +/- 0.20 respectively. Comparisons showed that LVMI, LVWT and IVST were significantly higher, but LVD was significantly lower in the control group than those in the sham-operated group (P<0.05); LVMI, LVWT and IVST were significantly lower but LVD was significantly higher in the AI group than those in the control group (P<0.05). CCD, CVF and PVCA in the three groups (in the fore-mentioned order) were: CCD (microm), 14.54 +/- 2.25, 19.56 +/- 2.53, 16.58 +/- 2.46; CVF(%), 3.83 +/- 1.40, 11.21 +/- 2.96, 7.83 +/- 1.67; PVCA (%), 15.71 +/- 3.85, 30.58 +/- 6.25, 21.76 +/- 4.36, respectively. These indexes showed that CCD, CVF, PVCA in the control group were significantly higher than those in the sham-operated group (P<0.05); and those were significantly lower in the AI group than in the control group (P<0.05).

CONCLUSION

AI intervention can reverse the left ventricular hypertrophy and myocardial fibrosis induced by renal vascular hypertension in rats.

[Therapeutic effect of anti-anaphylaxis granule on chronic urticaria and its impact on serum levels of RANTES]

OBJECTIVE

To investigate the therapeutic effect of Anti-anaphylaxis Granule (AAG) on chronic urticaria and its impact on cytokine of regulated upon activation of normal T cells expressed and secreted (RANTES), eosinophil chemotactic factor (Eotaxin) and tumor necrosis factor-alpha (TNF-alpha).

METHODS

The therapeutic effects of AAG and cetirizine on chronic urticaria patients allocated in two groups were observed respectively, and the serum levels of RANTES, Eotaxin and TNF-alpha in patients were measured by ELISA before and after treatment, and were compared with those in normal subjects.

RESULTS

The therapeutic effects of AAG group were better in effective rate (88.5% vs 64.0%) and lower in the recurrent rate (5.6% vs 41.9%) than those cetirizine (all P<0.05). Serum levels of RANTES, Eotaxin and TNF-alpha in patients were higher than those in normal subjects (P<0.01), and they could be significantly reduced after AAG treatment (P<0.01).

CONCLUSION

AAG has favorite effect for treatment of chronic urticaria, its regulation on serum levels of RANTES, Eotaxin and TNF-alpha may be the mechanism of action.

[Clinical observation on treatment of hyperemesis gravidarum by integrative Chinese and Western medicine and its influence on serum motilin]

OBJECTIVE

To study the clinical therapeutic effect of integrative Chinese and Western medicine on patients with hyperemesis gravidarum (HG) and its influence on serum level of motilin (MOT).

METHODS

Sixty patients with HG were randomized equally into two groups, the treated group and the control group. They all received the Western medical supportive treatment mainly by fluid infusion, but for patients in the treated group, Chinese herbal medicine, the Yuntu recipe was given orally in combination. The course of treatment was 6 days. Besides, a group of 30 women with regular pregnancy was set up for normal control. Serum levels of MOT and beta-HCG were measured before and after treatment. And patients were followed up for 2 weeks.

RESULTS

The curative rate and the relapse rate was 73.3% (22/30) and 16.7% (5/25) in the treated group; 56.7% (17/30) and 33.3% (10/20) in the control group respectively, the curative rate was significantly higher and the relapse rate was significantly lower in the treated group than those in the control group (P>0.05). Blood 3-HCG levels in the two HG groups were similar to that of the normal control, and changed insignificantly after treatment (P>0.05), while serum level of MOT in them were 67.15 +/- 15.94 ng/L and 70.28 +/- 13.56 ng/L respectively before treatment, significantly lowers than that of the normal control (145.35 +/- 30.12 ng/L, P<0.05), but it increased significantly after treatment in the treated and the control groups (P<0.05), being 151.50 +/- 54.84 ng/ L vs 103.28 +/- 38.31 ng/L and the increasing in the treated group was more significant than that in the control group (P<0.05).

CONCLUSION

The occurrence of HG is correlated with the lowering of serum MOT level. Integrative medical treatment is effective in treating HG by way of increasing the serum level of MOT and promoting the peristalsis of stomach.