Efficacy of Yangyin Yiqi Huoxue Granule () in Treatment of Ischemic Stroke Patients with Qi-Yin Deficiency and Blood Stasis Syndrome: A Randomized, Double-Blind, Multicenter, Phase-2 Clinical Trial

OBJECTIVE

To evaluate the efficacy and safety of Yangyin Yiqi Huoxue Granule (, YYHG) in the treatment of ischemic stroke (IS) patients with qi-yin deficiency and blood stasis syndrome (QYDBSS), and to explore its effective dosage.

METHODS

The total of 288 patients were randomly assigned to the YYHG high-dose, YYHG low-dose, positive control (administered Xiaoshuantong Granule, XSTG, ), or placebo control (administered inert granule) groups (72 cases per group) by software-drived competitive block randomization. The trial was conducted for a 28-day period, with a 180-day follow-up period. The primary outcome was the comprehensive curative evaluation, and secondary outcomes were the National Institute of Health Stroke Scale (NIHSS) score, Barthel activities of daily living (ADL) index score, the quality of life index (QLI) score, and the Chinese medicine syndrome (CMS) score. All analyses were done on an intention-to-treat basis. The clinical safety was also assessed.

RESULTS

The total of 288 participants were recruited between June 1, 2008 and September 30, 2009, and 287 patients received intervention; the treatment groups were well balanced at baseline. The comprehensive cure rates of YYHG high-dose, low-dose, positive and placebo control groups were 63.38%, 31.94%, 36.11% and 6.14%, respectively; there was a statistical difference between the two groups (P<0.01), while the high-dose YYHG treatment group was significantly higher than the other 3 groups (P<0.01). The improvement of NIHSS, ADL, QLI and CMS scores of the YYHG high-dose and low-dose groups was significantly better than that of the positive control group and the placebo control group (P<0.05). In terms of improving the classification of the NIHSS scale and the assessment of the ADL scale, the YYHG high-dose group was significantly better than the other three groups (P<0.05), and the YYHG low-dose group was better than the placebo control group (P<0.01). At the same time, except for the QLI score, the high-dose group was better than the low-dose group (P<0.05). In terms of safety, adverse reactions after YYHG treatment were generally mild (3.78%), and no serious adverse reactions have been reported.

CONCLUSION

YYHG is safe and effective in the treatment of IS patients with QYDBSS.

Protective mechanisms of hypaconitine and glycyrrhetinic acid compatibility in oxygen and glucose deprivation injury

This study investigated the protective effect of the compatibility of hypaconitine (HA) and glycyrrhetinic acid (GA) on H9c2 cells under oxygen and glucose deprivation (OGD)-induced injury, and the possible mechanisms. We found that HA+GA significantly improved pathology and morphology of the nucleus and ultrastructure of H9c2 cells under OGD as determined by Hoechst 33342 staining and transmission electron microscopy (TEM) tests. It also reduced the releases of lactate dehydrogenase (LDH), creatine kinase-myocardial band isoenzyme (CK-MB), and aspartate transaminase (AST) from the cultured supernatant of H9c2 cells, which were tested by enzyme-linked immune sorbent assay (ELISA) kits. In addition, it lessened the apoptotic rate as determined by a fluorescein isothiocyanate-annexin V/propidium iodide (FITC-AV/PI) double staining assay. It was also found that HA+GA might regulate the protein expression associated with the phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway. Overall, the study demonstrated that HA+GA protected H9c2 cells against OGD-induced injury, and the signaling mechanism might be related to the PI3K/Akt signaling pathway.

Pharmacokinetics of Active Components From Guhong Injection in Normal and Pathological Rat Models of Cerebral Ischemia: A Comparative Study

Background and Objectives: Guhong Injection (GHI) is usually administered for the treatment of stroke in clinics. Aceglutamide and hydroxyl safflower yellow A (HSYA) are its key ingredients for brain protective effect. To investigate the pharmacokinetics of aceglutamide and HSYA under pathological and normal conditions, the pharmacokinetic parameters and characteristics of middle cerebral artery occlusion (MCAO) and normal rats given the same dosage of GHI were studied compared. Methods: 12 SD rats were divided into two groups, namely, MCAO and normal groups. Both groups were treated with GHI in the same dosage. Plasma samples were collected from the jaw vein at different time points and subsequently tested by high-performance liquid chromatography (HPLC). Results: After administration of GHI, both aceglutamide and HSYA were immediately detected in the plasma. Ninety percent of aceglutamide and HSYA was eliminated within 3 h. For aceglutamide, statistically significant differences in the parameters including AUC_(0-t), AUC_(0-∞), AUMC_(0-t), AUMC_(0-∞), C_max (P < 0.01), and V_z (P < 0.05). Meanwhile, compared with the MCAO group, in the normal group, the values of AUC_(0-t), AUMC_(0-t), VRT_(0-t), and C_max (P < 0.01) for HSYA were significantly higher, whereas the value of MRT_(0-t) was significantly lower in the normal group. Conclusions: The in vivo trials based on the different models showed that, the pharmacokinetic behaviors and parameters of aceglutamide and HSYA in GHI were completely different. These results suggest that the pathological damage of ischemia-reperfusion has a significant impact on the pharmacokinetic traits of aceglutamide and HSYA.

Antiviral effects and mechanisms of Yinhuapinggan granule against H1N1 influenza virus infection in RAW264.7 cells

Yinhuapinggan granule (YHPG), a modified prescription based on Ma-Huang-Tang (MHT), is used in traditional Chinese medicine (TCM) to treat influenza, cough, and viral pneumonia. In this study, we investigated the antiviral effects of YHPG by means of pre-, post-, and co-treatment, and its underlying mechanisms on regulating the levels of inflammatory-related cytokines, modulating the mRNA expressions of interferon-stimulated genes in influenza virus-infected murine macrophage cells (RAW264.7), and evaluating the protein expressions of key effectors in the Type I IFN and pattern recognition receptor (PRRs) signaling pathways. The results showed that YHPG markedly inhibited influenza virus (IFV) replication in pre-, post- and co-treatment assay, especially in post-treatment assay. Antiviral mechanisms studies revealed that YHPG (500 and 250 μg/mL) significantly up-regulated levels of IFN-β, IFN-stimulated genes (Mx-1, ISG-15 and ISG-56) compared with the IFV control group, while the levels of IL-6 and TNF-α were significantly down-regulated. Furthermore, western blot analysis results revealed that the protein expressions of the phosphorylated forms of TBK1, IRF3, ERK1/2, P38 MAPK and NF-κB p65 were significantly down-regulated in RAW264.7 cells with the YHPG (500 and 250 μg/mL) treatment, while the expression of the phosphorylated form of STAT1 was significantly enhanced. Based on these results, YHPG had antiviral effects in IFV-infected RAW264.7 cells, which might be associated with regulation of the inflammatory cytokines production, evaluation of the levels of IFN-stimulated genes, and modulation of the protein expressions of key effectors in the Type I IFN and PRRs signaling pathways.

Effects of Dietary Supplementation of β-hydroxy-β-methylbutyrate on Sow Performance and mRNA Expression of Myogenic Markers in Skeletal Muscle of Neonatal Piglets

The effects of dietary β-hydroxy-β-methylbutyrate (HMB) supplementation during gestation on reproductive performance of sows and the mRNA expression of myogenic markers in skeletal muscle of neonatal pigs were determined. At day 35 of gestation, a total of 20 sows (Landrace × Yorkshire, at third parity) were randomly assigned to two groups, with each group receiving either a basal diet or the same diet supplemented with 4 g/day β-hydroxy-β-methylbutyrate calcium (HMB-Ca) until parturition. At parturition, the total and live litter size were not markedly different between treatments, however, the sows fed HMB diet had a decreased rate of stillborn piglets compared with the sows fed the control (CON) diets (p < 0.05). In addition, piglets from the sows fed HMB diet tended to have an increased birth weight (p = 0.08), and a reduced rate of low birth weight piglets (p = 0.05) compared with piglets from the CON sows. Nevertheless, lower feed intake during lactation was observed in the sows fed the HMB diet compared with those on the CON diet (p < 0.01). The relative weights of the longissimus dorsi (LD) and semitendinosus (ST) muscle were higher (p < 0.05) in neonatal pigs from the HMB than the CON sows. Furthermore, maternal HMB treatment increased the mRNA levels of the myogenic genes, including muscle regulatory factor-4 (MRF4, p < 0.05), myogenic differentiation factor (MyoD) and insulin-like growth factor-1 (IGF-1, p < 0.01). In conclusion, dietary HMB supplementation to sows at 4 g/day from day 35 of gestation to term significantly improves pregnancy outcomes and increases the expression of myogenic genes in skeletal muscle of neonatal piglets, but reduces feed intake of sows during lactation.

Influence of in ovo injection of disaccharides, glutamine and β-hydroxy-β-methylbutyrate on the development of small intestine in duck embryos and neonates

1. The objective of the present study was to examine the effect of in ovo injection of disaccharides (DS), disaccharides and glutamine (DS + Gln) or disaccharides and β-hydroxy-β-methylbutyrate (DS + HMB) at d 23 of incubation on the development of the small intestine. 2. In DS + Gln-injected ducks, the greatest relative small intestine mass and muscularis layer thickness among 4 treatments was observed from d 25 of incubation to 7 d of age. 3. Jejunal sucrase activity in DS-injected ducks was significantly greater than in controls at hatch and on d 7. 4. In DS + HMB-treated ducks, a tendency toward slightly higher jejunal DNA concentration was observed throughout the experiment. 5. Greater body weight was found in DS + Gln and DS + HMB treated ducks in the first two weeks. However, there was no significant difference in the market weight (35 d) of ducks among the 4 treatments. 6. The results of present study suggest that administering disaccharides and Gln, or disaccharides and HMB, to the duck embryos exerted a beneficial effect on the early development of small intestine and on growth performance.

Prediction of true metabolizable energy from chemical composition of wheat milling by-products for ducks

The present study was conducted to evaluate the effect of chemical composition of wheat by-products on the TME value to ducks and to establish the prediction models estimating TME. Seven representative samples were selected from 23 wheat by-products millings samples based on the neutral detergent fiber (NDF) content. According to the Sibbald method, male Cherry Valley ducks were chosen to assay the TME of 7 representative samples. Stepwise regression analysis was performed to establish the prediction equations of TME using CP, ether extract (EE), NDF, acid detergent fiber, crude fiber, and gross energy (GE) as independent variables. The NDF, CP, and DM of 23 samples of wheat by-product averaged to be 33.39 +/- 11.04%, 19.2 +/- 3.25%, 87.17 +/- 0.95%, respectively. The TME values of 7 representative samples averaged 12.02 MJ/kg, with much larger CV than GE (17.72 vs. 2.82%). The crude fiber, NDF, acid detergent fiber were highly but negatively correlated with TME (P < 0.01), in which the greatest correlation coefficient (r = -0.969) was observed between NDF and TME. No significant correlation of CP, EE, ash, and GE to TME was found among the 7 representative samples. The optimal equation in terms of R(2) from using a single chemical analysis was obtained in the total group: TME = -0.1564NDF + 17.4696 (R(2) = 0.94, P = 0.0003), and the TME prediction equation was improved by the addition of the EE and CP content to sequential analysis: TME = -0.17NDF + 0.98EE - 0.27CP + 19.31 (R(2) = 0.99, residual SD = 0.35, P < 0.01). The results of present study suggest that NDF could be used as an effective indicator for the prediction of the TME value of wheat by-products for ducks.

Enhanced photo--catalytic activity of gold ion and gold modified

The gold ion modified TiO2 was prepared by means of sol-gel whereas gold deposited TiO2 was prepared by means of photo-reduction. The physical properties were influenced significantly by the presence of gold ion or gold. The enhanced photo-activity of gold modified TiO2 was quantified in terms of methylene blue degradation. The presence of gold ion in TiO2 lattices or gold on TiO2 surface enhanced their photo-activity. The optimum molar content of gold ion doping and gold deposition all was 0.5%. The first-order rates constants of gold modified TiO2 was more than that of pure TiO2, and decreased by increasing the content of gold ion and gold when their contents were more than 0.5%. Gold ion doped in TiO2 lattices was more effective to enhance the photo-activity than gold on TiO2 surface. Moreover, the relationship between physical properties, chemical properties and photo-activity has been discussed.

TiO2-assisted photo-catalysis degradation process of dye chemicals

The photo-catalytic degradation pathway and degradation products of methylene blue, rhodamine B, methyl orange, and malachite green in aqueous TiO2 suspension irradiated by high pressure mercury lamp by means of UV-visible absorption spectra and ion chromatography were investigated. The photo-catalysis degradation of dye solutions with charges was greatly effected by pH value owing to the electrostatic model. The photo-degradation rate of dyes anion increased with the decrease of pH value, in contrast, the photo-degradation rate of dyes cation increased with the increase of pH value. And the absorption peaks diminished with a blue shift. After illuminated for 30 minutes, a part of dye chemicals were completely mineralized and transferred into inorganic species including chloride ion, ammonium ion, nitrate ion, sulfate ion. And the addition of 100 mmol/L H2O2 promoted the formation of inorganic species. In this study, the quantity of ammonium ion was much more than that of nitrate ion. That indicated the formation of nitrate is from ammonium. The purification rate of COD in four kinds of dye solution was 71.7%-88.7%. The decrease of COD of dyes solution implies the feasibility of the environmental application of photo-catalyzed process.