The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,...The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.展开更多
China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the ap...China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the appearance of adverse reactions,and target is the internal mechanism.The establishment of feature and target correlation model will contribute to the development of this field.This paper introduces the four steps of feature-target correlation method that risk identification,feature extraction,sign target correlation and experimental research.Xiyanping-Ribavirin combination is as an example to illustrate this method.It is expected that the method will be popularized and applied to protect clinical safety.展开更多
Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases charact...Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases characterized by cardiac hypertrophy and myocardial remodeling,and the pathophysiological processes of which include oxidative stress,endoplasmic reticulum homeostasis,apoptosis,autophagy,energy metabolism disorder,etc.The regulation of protein homeostasis intrinsically interrelates the above pathophysiological processes.Therefore,it is imperative to elucidate the molecular mechanism from the perspective of protein homeostasis to find new therapeutic targets for HF treatment.The dynamic regulation and post-translational modification of protein synthesis and degradation play a vital role in response of living organisms to physiological changes.The ubiquitin-proteasome system(UPS),which degrades 70-90%of endogenous proteins,plays an integral part in the pathophysiological processes of HF.The UPS can regulate oxidative stress,endoplasmic reticulum homeostasis,apoptosis and autophagy of cardiomyocytes(CMs),energy metabolism,targeting degradation signals and structural proteins,thus modulating cardiac hypertrophy,fibrosis and remodeling,finally contributing to the occurrence and progression of HF.Thus,regulating UPS is a promising effective strategy to treat HF.Increasing evidence indicates that traditional Chinese medicine(TCM)targeting the UPS is potential to ameliorate HF.This review will summarize the current knowledge focusing on the underlying mechanism and the important research advances related to UPS in treating HF,and the traditional Chinese medicine targeting UPS.展开更多
Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of ...Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of PubMed,Embase,Web of Science,SinoMed,China Network Knowledge Infrastructure,Wanfang Data,and Chinese Scientific Journals Database was performed to identify GAPT mouse/rat studies published from inception to July 2019.The outcomes extracted were Morris water maze results and molecular biological quantifications.Results:A total of 19 studies were included in this analysis.The analysis indicated that GAPT was able to significantly improve learning and memory abilities compared with model mice/rats,as assessed by Morris water maze,and showed similar efficacy as donepezil.Subgroup analyses showed that low,medium,and high doses resulted in no obvious dose-dependent effects.Additionally,the GAPT group had significantly reduced expression levels of amyloid-beta peptide,presenilin 1,phosphorylated tau,acetylcholinesterase,and glycogen synthase kinase-3b,but increased expression levels of Shank1,and protein phosphatase-2A,and improved synapses structures compared with the model group,and subgroup analyses showed the medium dose of GAPT was superior to the low and high doses.Conclusions:Based on the pooled analysis,GAPT improved the learning and memory abilities and regulated the expression levels of related proteins during the progression of AD in mouse/rat studies.Notably,the medium dose of GAPT exhibited better performance than the other two doses,providing experimental evidence for further applications of GAPT during clinical practice.展开更多
Phytochemical investigation of the vinegar-prepared Corydalis yanhusuo led to the isolation of one aristolactam derivative,1,2,8,9-tetramethoxy-5-methyldibenzo[cd,f]indol-4-(5H)-one(1),and seven aporphine alkaloids,in...Phytochemical investigation of the vinegar-prepared Corydalis yanhusuo led to the isolation of one aristolactam derivative,1,2,8,9-tetramethoxy-5-methyldibenzo[cd,f]indol-4-(5H)-one(1),and seven aporphine alkaloids,including 2,9,10-trimethoxydibenz[de,g]quinolin-7-one(2),1-hydroxy-2,9,10-trimethoxy-7H-dibenzo(de,g)quinoline-7-one(3),oxoglaucine(4),N-methyloxoglaucine trifluoroacetate trifluoroacetate(5),corunine acetate(6),pontevedrine(7),and oxoglaucidaline trifluoroacetate(8).The structures of the isolated compounds were elucidated by extensive spectroscopic data analysis and comparison with the previous reports.Among them,compounds 1 and 2 were obtained as natural products for the first time,and their NMR data were unambiguously assigned.In addition,compound 1 exhibited moderate cytotoxic activity against HepG2 cells with an IC50 value of 16.0±6.4μM.展开更多
Severe pneumonia is one of the most serious infectious diseases.Delayed intervention may lead to pulmonary fibrosis,which greatly threatens people’s life and health.Blood stasis syndrome is an important underlying sy...Severe pneumonia is one of the most serious infectious diseases.Delayed intervention may lead to pulmonary fibrosis,which greatly threatens people’s life and health.Blood stasis syndrome is an important underlying syndrome throughout the evolution of severe pneumonia-pulmonary fibrosis.Xuebijing injection(XBJ)was developed under the theoretical system of“Three syndromes and three methods”,demonstrating a good efficacy in treating severe pneumonia and pulmonary fibrosis due to its effect of removing blood stasis and dispersing toxins.Previous studies have shown that XBJ can protect vascular endothelial function,improve coagulation function and regulate immunity by inhibiting inflammatory.Hence,the research hypothesis is put forward that XBJ treats blood stasis syndrome by removing blood stasis and dredging blood vessels,to inhibit the disease progress of severe pneumonia to pulmonary fibrosis.Further researches are need to confirm the function and explore the mechanism of XBJ.展开更多
Objective:In order to explore the development trend and research hotspots of clinical researches of acupuncture and moxibustion and provide some insight into the key research direction for researchers.Methods:The clin...Objective:In order to explore the development trend and research hotspots of clinical researches of acupuncture and moxibustion and provide some insight into the key research direction for researchers.Methods:The clinical studies of acupuncture and moxibustion were searched in PubMed.Using the method of bibliometry,the year,country,journals,authors were analyzed.The cluster analysis was used to analyze subject terms by the social network analysis.Results:A total of 4237 literature were retrieved,published in 617 journals.The number of clinical studies on acupuncture and moxibustion has been increased substantially since 2006.The clinical researches on acupuncture and moxibustion have been conducted worldwide,specifically in China,the United States,Britain,Sweden,etc.Three major author cooperation networks(China,South Korea and European and North American countries)has been formed.The cluster analysis based on 53 high-frequency theme words indicates that the clinical researches on acupuncture and moxibustion are mainly concerned about acupoint selection associated with pain,stroke,knee osteoarthritis and other diseases in different age groups,blind,treatment outcomes,time factor of acupuncture,etc.Conclusion:Clinical researches on acupuncture and moxibustion have been widely concerned by international medicine.The research direction is clear,Thematic is concentrate,and research paradigm has been formed.However,international influence is still limited academically.The cooperation between different authors or teams is insufficient.The core research hotspots include the selection of acupoint,acupuncture and moxibustion tools,research design,treatment outcome,blind,time factor,follow-up,placebo,clinical protocol,quality of life,patient satisfaction and so on.展开更多
The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and te...The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and technology,but the low operability and slow update of integrated traditional Chinese and Western Medicine guidelines,and the lack of integration between guidelines and clinical practice,result in the guidelines not having the desired clinical effects in practice.The application of Artificial Intelligence(AI)to the field of CPGs development aims to shorten the development time,optimize and accelerate the whole process of CPG’s development.This article summarized the current research and application status of AI in development and implementation CPGs for TCM and Integrated Traditional Chinese and Western medicine and proposed the method of Combining real world data and AI technology to enrich for TCM and Integrated Traditional Chinese and Western medicine.展开更多
Objective:To observe the effect of Xingnaojing injection on penumbra transformation in rats with acute cerebral ischemia.Methods:The rat model of middle cerebral artery occlusion(Middle cerebral artery occlusion,MCAO)...Objective:To observe the effect of Xingnaojing injection on penumbra transformation in rats with acute cerebral ischemia.Methods:The rat model of middle cerebral artery occlusion(Middle cerebral artery occlusion,MCAO)was established by suture occlusion.Except the sham operation group,the other groups were randomly divided into model group and Xingnaojing group.The rats in Xingnaojing group were intraperitoneally injected with Xingnaojing injectionaccording to 0.18ml/100g,and the sham operation group and model group were given the same amount of normal saline respectively.24 hours after the establishment of the model,the morphological changes of neurons in the penumbra of the rats were observed by Nissl staining,the ultrastructural changes of neurovascular unit(Neurovascular unit,NVU)were observed by transmission electron microscope(Transmission electron microscope,TEM),and the apoptosis of the ischemic penumbra was detected by in situ apoptosis(TdT-mediated Dutp Nick-End Labeling,TUNEL).Magnetic resonance imaging was used to observe the ischemic evolution of the penumbra of the same rat at 4.5 h and 24 h,respectively.Results:Compared with the sham operation group,the number of neurons in the model group was significantly reduced,the structure of Nissl corpuscles was destroyed,the outline was blurred or disappeared,the pathological morphology of NVU ultrastructure was obviously damaged under transmission electron microscope,a large number of apoptotic cells could be seen in the model group by TUNEL staining(P<0.01),and magnetic resonance imaging showed that there was a large area infarction in the brain tissue of the model group.Compared with the model group,the pathomorphology of neurons and NVU ultrastructure in Xingnaojing group was significantly improved,the number of apoptotic cells was significantly decreased(P<0.01),and the loss rate of penumbra was significantly lower in Xingnaojing group(P<0.05).Conclusion:Xingnaojing injection can improve the state of neurons in ischemic penumbra,reduce the injury of glial cells and microvessels,inhibit apoptosis,promote the transformation of penumbra in rats with acute cerebral ischemia,and save part of penumbra to some extent.it has a certain protective effect on the brain tissue of penumbra in the acute stage of cerebral ischemia.展开更多
Objective:To investigate the protective effect of Xingnaojing injection on cerebral ischemia-reperfusion in rats and its metabolic pathway and mechanism.Methods:The cerebral ischemia reperfusion model of rats was esta...Objective:To investigate the protective effect of Xingnaojing injection on cerebral ischemia-reperfusion in rats and its metabolic pathway and mechanism.Methods:The cerebral ischemia reperfusion model of rats was established by suture occlusion.After successful model evaluation,he rats were randomly divided into model group and Xingnaojing group with eight rats in each group.In the sham operation group,only blood vessel separation was performed without embolization.Xingnaojing group was given intraperitoneal injection,model group and sham operation group were given the same dose of normal saline,twice a day.Three days later,HE staining and GC-MS metabolomics were used to detect the changes of endogenous metabolites in the rat brain tissue.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were used to screen out differential metabolites and analyze their metabolic pathways.Results:Endogenous metabolites were disturbed after cerebral ischemia-reperfusion injury in rats.Seventy-one different metabolites were screened from the model group and the sham group,of which three were down-regulated and sixty-eight were up-regulated.Eighty-eight different metabolites were found between Xingnaojing group and sham operation group,among which eight were down-regulated and eighty up-regulated.After screening of Xingnaojing group and model group,twelve different metabolites were obtained,among which seven were down-regulated and five up-regulated.By analyzing the differences of metabolites,Xingnaojing injection was considered to be involved in the metabolic pathway after cerebral ischemia-reperfusion in rats,including amino acid metabolism(beta alanine metabolism,alanine,glutamic acid and aspartic acid metabolism,histidine metabolism,arginine and proline metabolism),glutathione metabolism,pyrimidine metabolism,ABC transporter,nitrogen metabolism and other metabolic pathways.Conclusion:Xingnaojing injection can restore the levels of metabolites in cerebral ischemia-reperfusion rats in certain degrees,mainly through amino acid metabolism,ABC transporter,glutathione metabolism and other metabolic pathways to regulate cerebral ischemia-reperfusion injury in rats.展开更多
Objective:To explore the intervention effects and mechanism of Simiao Yongan(SMYA)Decoction on carotid atherosclerotic plaque in ApoE knockout mice by antagonizing lipid metabolism of oxidation low density lipoprotein...Objective:To explore the intervention effects and mechanism of Simiao Yongan(SMYA)Decoction on carotid atherosclerotic plaque in ApoE knockout mice by antagonizing lipid metabolism of oxidation low density lipoprotein(Ox-LDL).Methods:ApoE-/-mice were fed high-fat feeding for 2 weeks,combined with perivascular collar placement(PCCP)and high fat feeding for 8 weeks to establish carotid AS plaque model.All the mouses were divided into 5 groups,after successful AS model preparation.The sham operation as well as model group intragastrically administered with deionized water.The rest mouses were intragastrically administered with SMYA decoction or Pioglitazone,or treated with Atorvastatin for 8 weeks.Then adopting automatic biochemical analyzer to test total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)content.The content of ox-LDL in serum,which was tested by enzyme-linked immunosorbent assay(ELISA).The pathological changes of carotid artery were observed by hematoxylin-eosin(HE)staining and the vascular parameters were measured.Immunohistochemical method and Western blot assay was used to detect the manifestations of protein include fatty acid binding protein 4(FABP4)and peroxisome proliferator-activated receptorγ(PPARγ)as well as matrix metalloproteinase 2(MMP 2).Results:Compared with the sham operation group,the serum ox-LDL content of the model group was increased,and the intima thickness(IT),intima-media thickness(IT/MT),plaque area(PA)as well as lumen area ratio of plaque vessels(PA/LA)were enlarged(P<0.05).Immunohistochemistry and Western blot results showed that the relative expression of FABP4 and MMP2 in the model group increased markedly,while the relative expression of PPARγsignificantly decreased.Compared SMYA decoction group and Atorvastatin group as well as Pioglitazone with model group,the serum ox-LDL content was decreased(P<0.05).In the mean time,the IT,PA,IT/MT and PA/LA in carotid artery were reduced(P<0.05).Immunohistochemistry and Western blot results showed that the expression of FABP4 and MMP2 was reduced,while PPARγprotein expression increased of mouses in each administration group.Conclusion:SMYA decoction is able to antagonize Ox-LDL,increase the expression of PPARγ,decrease the level of FABP4,reduce MMP2 in carotid arteries of ApoE-/-atherosclerotic mice,and increase the stability of plaque.展开更多
Sepsis is a life-threatening organ dysfunction that is associated with a high risk of death.Xuebijing(XBJ)injection,a Chinese herbal compound preparation,has been widely used for the treatment of sepsis in China.The p...Sepsis is a life-threatening organ dysfunction that is associated with a high risk of death.Xuebijing(XBJ)injection,a Chinese herbal compound preparation,has been widely used for the treatment of sepsis in China.The purpose of this research is to decipher the underlying multi-target pharmacological mechanism of XBJ in the treatment of sepsis using a systems pharmacology approach.Compounds in XBJ were collected by literature retrieval.The corresponding putative targets of XBJ were screened from the Traditional Chinese Medicine Systems Pharmacology(TCMSP),Swiss Target Prediction(STP),and Search Tool for Interacting Chemicals(STITCH)databases.Sepsis-related targets were summarized using the Genecards,DrugBank,and Online Mendelian Inheritance in Man(OMIM)databases.The intersection targets were obtained with Venny 2.1.Subsequently,protein-protein interaction(PPI)networks were constructed with the STRING database and Cytoscape 3.7.1.Then,degree,betweenness,and closeness were calculated to recognize the core targets in the PPI network.Moreover,the pharmacological mechanism of XBJ against sepsis was predicted via gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment.After the literature review,the 33 most commonly cited chemical ingredients,were screened out as major compounds.Bioinformatics analysis revealed that the major compounds of XBJ modulated 218 common targets associated with sepsis.Through PPI network analysis,41 genes,including IL-6,AKT1,STAT3,TP53,and MAPK1,were identified as core targets.The results of GO and KEGG enrichment revealed that the potential biological functions of XBJ against sepsis were mainly involved in cytokine receptor binding,cytokine activity,growth factor receptor binding,growth factor activity,and chemokine activity.The crucial pathways were closely associated with initial immune activation(CLR/TLR4-NF-κB/MAPK pathway),the acute inflammatory response(TNFMAPK/caspase and IL-MAPK/STAT pathways),and the late inflammation and coagulation process(HMGB1-RAGE and HIF-1 signaling pathways).This study revealed that the multiple components of XBJ exert multitarget effects against sepsis by regulating initial immune activation,the acute inflammatory response,and the late inflammation and coagulation process.展开更多
Background:To examine the outcomes heterogeneity of clinical trial protocols of coronavirus disease 2019(COVID-19)to prioritize the establishment of a core outcome set.Methods:Databases of the International Committee ...Background:To examine the outcomes heterogeneity of clinical trial protocols of coronavirus disease 2019(COVID-19)to prioritize the establishment of a core outcome set.Methods:Databases of the International Committee of Medical Journal Editors–accepted clinical trial registry platforms were searched on February 14,2020 and May 31,2020.Randomized controlled trials and non-randomized controlled trials of COVID-19 were considered.Patient condition was classified as common,severe,or critical.Interventions included traditional Chinese medicine and Western medicine.We excluded trials that involved discharged patients,psychological intervention,and complications of COVID-19.The general information and outcomes,outcome measurement instruments,and measurement times were extracted.The results were analyzed by descriptive analysis.Results:In all,19 registry platforms were searched.A total of 97 protocols were selected from among 160 protocols for the first search.For protocols of traditional Chinese medicine clinical trials,76 outcomes from 16 outcome domains were reported,and almost half(34/76,44.74%)of the outcomes were reported only once;the most frequently reported outcome was time taken for severe acute respiratory syndrome coronavirus 2 RNA to become negative.Twenty-seven(27/76,35.53%)outcomes provided one or more outcome measurement instruments.Ten outcomes provided one or more measurement time frame.For protocols of Western medicine clinical trials,126 outcomes from 17 outcome domains were reported;almost half(62/126,49.21%)of the outcomes were reported only once;the most frequently reported outcome was proportion of patients with negative severe acute respiratory syndrome coronavirus 2.Twenty-seven outcomes provided one or more outcome measurement instruments.Forty(40/126,31.75%)outcomes provided one or more measurement time frame.There were>40 duplicated outcomes between the clinical trials protocols of traditional Chinese medicine and western medicine protocols.All of them were included in the Delphi survey when developing core outcome set for COVID-19.A total of 1,027 protocols were selected from 2,741 protocols for the second search.Forty-two new outcomes and 47 new outcome measurement instruments were reported.Conclusion:Outcome reporting in clinical trial protocols of COVID-19 is inconsistent.Thus,establishing a core outcome set is necessary for diagnosis and management.展开更多
Objective:To study the chemical constituents of the roots of Paeonia lactiflora.Materials and methods:The isolation and purification were carried out by column chromatography on macroporous adsorbent resin,MCI gel,sil...Objective:To study the chemical constituents of the roots of Paeonia lactiflora.Materials and methods:The isolation and purification were carried out by column chromatography on macroporous adsorbent resin,MCI gel,silica gel,and Sephadex LH-20,as well as semi-preparative RP-HPLC.The structures were elucidated on the basis of physicochemical properties and spectroscopic analysis,as well as the ECD quantum chemical computation methods.Results:A sesquiterpenoidal glucoside(1)along with two sesquiterpenoids(2-3)were isolated from the roots of Paeonia lactiflora,and their structures were identified as(+)-(1R,2R,4S,5S,10R)-2-α-D-glucopyranosyloxy-2-hydroxy-cadin-6,12-dien-15-oic acid(1),drim-7-en-3β,11,12-triol(2),and 3β-hydroxy-11,12-O-isopropylidenedrimene(3),respectively.Conclusion:Compound 1 was identified as a new sesquiterpenoidal glucoside.展开更多
Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence...Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases,i.e.PubMed,Excerpt Medica Database,China Biology Medicine disc and China National Knowledge Infrastructure.However,no relevant study on the subjects of interest was identified.Therefore,drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine,we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial.Further,we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders.Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research.The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.展开更多
Objective: To provide evidence-based recommendations for clinical application and provoke thoughts for future researchers by conducting a comprehensive summary and evaluation of the current evidence profile for the ro...Objective: To provide evidence-based recommendations for clinical application and provoke thoughts for future researchers by conducting a comprehensive summary and evaluation of the current evidence profile for the role of Chinese medicine(CM) in treating myocardial infarction(MI). Methods: Online databases including Pub Med, EMBase, Cochrane Library, Chinese National Knowledge Infrastructure(CNKI), Chinese Biomedical Medicine(CBM), VIP Journal Integration Platform, and Wanfang database were systematically searched for literatures on CM in treating MI. After screening, studies were categorized into 5 types, i.e. systematic review(SR), randomized controlled trial(RCT), observational study, case report and basic research. General information was abstracted, and the quality levels of these studies and their conclusions were summarized and assessed. Results: A total of 452 studies including 10 SRs, 123 RCTs, 47 observational studies, 28 case reports, and 244 basic researches were selected. Clinical studies centered primarily on herbal decoction and mostly were not rigorously performed. High-quality studies were predominantly on Chinese patent medicines(CPMs) such as Danshen Injection(丹参注射液), Shenmai Injection(参麦注射液), Shengmai Injection(生脉注射液) and Qishen Yiqi Dripping Pills(芪参益气滴丸). The most frequently observed pattern of drug combination was decoction plus injection. Results of SRs and clinical studies showed that CM may reduce mortality, decrease risk of complication, reduce myocardial injury, improve cardiac function and inhibit ventricular remodeling. Findings from basic researches also supported the positive role of CM in reducing infarct size and myocardial injury, promoting angiogenesis, preventing ventricular remodeling and improving cardiac function. According to the current evidence body, CM has proven effects in the prevention and treatment of MI. It is also found that the effects of CPMs vary with indications. For instance, Shenmai Injection has been found to be especially effective for reducing the incidence of acute clinical events, while CPMs with qi-nourishing and bloodcirculating properties have been proven to be effective in inhibiting ventricular remodeling. High quality evidence supports the use of CM injection for acute MI and CPM for secondary prevention. Reports on adverse events and other safety outcomes associated with CM for MI are scarce. Conclusions: Sufficient evidence supported the use of CM as an adjuvant to Western medicine for preventing and treating MI. The choice of drug use varies with disease stage and treatment objective. However, the quality of the evidence body remains to be enhanced.展开更多
Objective: To compare the efficacy of traditional Chinese medicine(TCM) based on Zheng differentiation with angiotensin receptor blocker/angiotensin-converting enzyme inhibitor(ARB/ACEI) in treating diabetic kidney d...Objective: To compare the efficacy of traditional Chinese medicine(TCM) based on Zheng differentiation with angiotensin receptor blocker/angiotensin-converting enzyme inhibitor(ARB/ACEI) in treating diabetic kidney disease(DKD) from the aspects of decreasing urinary microalbumin, declining 24-h urinary protein, reducing endpoint events, and renal function protection. Methods: The Chinese Biomedical Literature Database(CBM), the Chinese Academy of Sciences database(CNKI), the VIP Chinese journal database, Wanfang DATA, Medline database, Cochrane library, excerpt medical database(Embase), and Web of science were used for literature searching. The reviewer manager5.3 software was utilized to analyze the data. Results: Twenty-four studies including 1956 participants were involved in this review. Results showed that TCM had a better effect(mean difference [MD],-23.20, 95% confidence interval [CI],-30.60 to-15.79, P < 0.00001) than ARB/ACEI on lowering urinary albumin excretion rate(UAER) and urine albumin-to-creatinine ratio(MD-4.56 mg/mmol, 95% CI,-5.76 to-3.36, P < 0.00001). Moreover, the advantage of decreasing UAER was greater as the follow-up period become longer(P = 0.04). TCM also had a better effect in 24-h urinal protein, decreasing 0.36 g/24 h(95% CI,-0.45 to-0.27, P < 0.00001) more than the control in shorter follow-up period(ranged from 12 to 24 weeks) subgroup but only 0.08 g/24 h(95% CI,-0.13 to-0.03, P = 0.0006) in the longer follow-up period(>24 weeks) subgroup. TCM worked as well as ACEI/ARB in reducing endpoint events(relative risk, 0.67, 95% CI, 0.20–2.224, P = 0.51)and decreasing urinary albumin concentration(UAC)(MD,-16.50, 95% CI,-46.28–13.28, P = 0.28). As for protecting renal function, TCM had an equal effect to AECI/ARB in improving creatinine clearance ratio(MD,-3.30, 95% CI,-6.66–0.03, P = 0.05) or estimated glomerular filtration rate(MD, 1.00, 95% CI,-0.59–2.58, P = 0.22). However, TCM had a better effect in releasing the glomerular hyperfiltration state(MD,-9.64, 95% CI,-14.45 to-4.84, P < 0.0001). Conclusions: TCM based on Zheng differentiation can work as well as ACEI/ARB in treating DKD and even better in decreasing urinary microalbumin and releasing glomerular hyperfiltration. It is a good alternative treatment of DKD.展开更多
基金supported by Ministry of Science and Technology of the People's Republic of China(Grant No.:2022YFC3502300)Beijing Natural Science Foundation(Grant No.:L222150)+2 种基金the National Natural Science Foundation of China(Grant No.:82072247)the second batch of“Ten thousand plan”National High Level Talents Special Support Plan(Grant No.:W02020052)Beijing University of Chinese Medicine(Grant Nos.:XJYS21005,JY21024,MSGZF-202001,2022-syjs-05,and 2022-syjs-10).
文摘The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.
基金supported by the National Natural Science Foundation of China(No.82204937).
文摘China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the appearance of adverse reactions,and target is the internal mechanism.The establishment of feature and target correlation model will contribute to the development of this field.This paper introduces the four steps of feature-target correlation method that risk identification,feature extraction,sign target correlation and experimental research.Xiyanping-Ribavirin combination is as an example to illustrate this method.It is expected that the method will be popularized and applied to protect clinical safety.
基金This work was supported by Beijing Natural Science Foundation(Grant No.JQ18026)the National Natural Science Foundation of China(NNSFC+2 种基金Grant Nos.82073978,81773589)Fundamental Research Funds for the Central Universities(2021-JYB-XJSJJ-053)Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases(No.2018B030322012,MB2020KF01).
文摘Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases characterized by cardiac hypertrophy and myocardial remodeling,and the pathophysiological processes of which include oxidative stress,endoplasmic reticulum homeostasis,apoptosis,autophagy,energy metabolism disorder,etc.The regulation of protein homeostasis intrinsically interrelates the above pathophysiological processes.Therefore,it is imperative to elucidate the molecular mechanism from the perspective of protein homeostasis to find new therapeutic targets for HF treatment.The dynamic regulation and post-translational modification of protein synthesis and degradation play a vital role in response of living organisms to physiological changes.The ubiquitin-proteasome system(UPS),which degrades 70-90%of endogenous proteins,plays an integral part in the pathophysiological processes of HF.The UPS can regulate oxidative stress,endoplasmic reticulum homeostasis,apoptosis and autophagy of cardiomyocytes(CMs),energy metabolism,targeting degradation signals and structural proteins,thus modulating cardiac hypertrophy,fibrosis and remodeling,finally contributing to the occurrence and progression of HF.Thus,regulating UPS is a promising effective strategy to treat HF.Increasing evidence indicates that traditional Chinese medicine(TCM)targeting the UPS is potential to ameliorate HF.This review will summarize the current knowledge focusing on the underlying mechanism and the important research advances related to UPS in treating HF,and the traditional Chinese medicine targeting UPS.
基金Institutions of Higher Education for Academic Disciplinary Innovations(the“111 Project”)(B08006)Program for Changjiang Scholars and Innovative Research Team in University(IRT0810)+1 种基金Research Project for Practice Development of National TCM Clinical Research Bases(JDZX2015297)the National Natural Science Foundation of China(81573824,81503625,and 81473518).
文摘Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of PubMed,Embase,Web of Science,SinoMed,China Network Knowledge Infrastructure,Wanfang Data,and Chinese Scientific Journals Database was performed to identify GAPT mouse/rat studies published from inception to July 2019.The outcomes extracted were Morris water maze results and molecular biological quantifications.Results:A total of 19 studies were included in this analysis.The analysis indicated that GAPT was able to significantly improve learning and memory abilities compared with model mice/rats,as assessed by Morris water maze,and showed similar efficacy as donepezil.Subgroup analyses showed that low,medium,and high doses resulted in no obvious dose-dependent effects.Additionally,the GAPT group had significantly reduced expression levels of amyloid-beta peptide,presenilin 1,phosphorylated tau,acetylcholinesterase,and glycogen synthase kinase-3b,but increased expression levels of Shank1,and protein phosphatase-2A,and improved synapses structures compared with the model group,and subgroup analyses showed the medium dose of GAPT was superior to the low and high doses.Conclusions:Based on the pooled analysis,GAPT improved the learning and memory abilities and regulated the expression levels of related proteins during the progression of AD in mouse/rat studies.Notably,the medium dose of GAPT exhibited better performance than the other two doses,providing experimental evidence for further applications of GAPT during clinical practice.
基金This work was financially supported by Beijing Natural Science Foundation(Grant No.JQ18026)the National Key R&D Program of China(Grant No.2017YFC1700400)+1 种基金the National Natural Science Foundation of China(Grant No.82073978)the Fundamental Research Funds for the Central Universities(Grant No.2021-BUCMXJKY007).
文摘Phytochemical investigation of the vinegar-prepared Corydalis yanhusuo led to the isolation of one aristolactam derivative,1,2,8,9-tetramethoxy-5-methyldibenzo[cd,f]indol-4-(5H)-one(1),and seven aporphine alkaloids,including 2,9,10-trimethoxydibenz[de,g]quinolin-7-one(2),1-hydroxy-2,9,10-trimethoxy-7H-dibenzo(de,g)quinoline-7-one(3),oxoglaucine(4),N-methyloxoglaucine trifluoroacetate trifluoroacetate(5),corunine acetate(6),pontevedrine(7),and oxoglaucidaline trifluoroacetate(8).The structures of the isolated compounds were elucidated by extensive spectroscopic data analysis and comparison with the previous reports.Among them,compounds 1 and 2 were obtained as natural products for the first time,and their NMR data were unambiguously assigned.In addition,compound 1 exhibited moderate cytotoxic activity against HepG2 cells with an IC50 value of 16.0±6.4μM.
基金the second batch of“Ten thousand plan”-National high level talents special support plan(W02020052).
文摘Severe pneumonia is one of the most serious infectious diseases.Delayed intervention may lead to pulmonary fibrosis,which greatly threatens people’s life and health.Blood stasis syndrome is an important underlying syndrome throughout the evolution of severe pneumonia-pulmonary fibrosis.Xuebijing injection(XBJ)was developed under the theoretical system of“Three syndromes and three methods”,demonstrating a good efficacy in treating severe pneumonia and pulmonary fibrosis due to its effect of removing blood stasis and dispersing toxins.Previous studies have shown that XBJ can protect vascular endothelial function,improve coagulation function and regulate immunity by inhibiting inflammatory.Hence,the research hypothesis is put forward that XBJ treats blood stasis syndrome by removing blood stasis and dredging blood vessels,to inhibit the disease progress of severe pneumonia to pulmonary fibrosis.Further researches are need to confirm the function and explore the mechanism of XBJ.
文摘Objective:In order to explore the development trend and research hotspots of clinical researches of acupuncture and moxibustion and provide some insight into the key research direction for researchers.Methods:The clinical studies of acupuncture and moxibustion were searched in PubMed.Using the method of bibliometry,the year,country,journals,authors were analyzed.The cluster analysis was used to analyze subject terms by the social network analysis.Results:A total of 4237 literature were retrieved,published in 617 journals.The number of clinical studies on acupuncture and moxibustion has been increased substantially since 2006.The clinical researches on acupuncture and moxibustion have been conducted worldwide,specifically in China,the United States,Britain,Sweden,etc.Three major author cooperation networks(China,South Korea and European and North American countries)has been formed.The cluster analysis based on 53 high-frequency theme words indicates that the clinical researches on acupuncture and moxibustion are mainly concerned about acupoint selection associated with pain,stroke,knee osteoarthritis and other diseases in different age groups,blind,treatment outcomes,time factor of acupuncture,etc.Conclusion:Clinical researches on acupuncture and moxibustion have been widely concerned by international medicine.The research direction is clear,Thematic is concentrate,and research paradigm has been formed.However,international influence is still limited academically.The cooperation between different authors or teams is insufficient.The core research hotspots include the selection of acupoint,acupuncture and moxibustion tools,research design,treatment outcome,blind,time factor,follow-up,placebo,clinical protocol,quality of life,patient satisfaction and so on.
基金the National Key Research and Development Program of China(No.2016YFC0106300)Health and Family Planning Commission of Hubei province joint funding project(No.WJ2018H0009).
文摘The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and technology,but the low operability and slow update of integrated traditional Chinese and Western Medicine guidelines,and the lack of integration between guidelines and clinical practice,result in the guidelines not having the desired clinical effects in practice.The application of Artificial Intelligence(AI)to the field of CPGs development aims to shorten the development time,optimize and accelerate the whole process of CPG’s development.This article summarized the current research and application status of AI in development and implementation CPGs for TCM and Integrated Traditional Chinese and Western medicine and proposed the method of Combining real world data and AI technology to enrich for TCM and Integrated Traditional Chinese and Western medicine.
基金National Natural Science Foundation of China(No.81673899)。
文摘Objective:To observe the effect of Xingnaojing injection on penumbra transformation in rats with acute cerebral ischemia.Methods:The rat model of middle cerebral artery occlusion(Middle cerebral artery occlusion,MCAO)was established by suture occlusion.Except the sham operation group,the other groups were randomly divided into model group and Xingnaojing group.The rats in Xingnaojing group were intraperitoneally injected with Xingnaojing injectionaccording to 0.18ml/100g,and the sham operation group and model group were given the same amount of normal saline respectively.24 hours after the establishment of the model,the morphological changes of neurons in the penumbra of the rats were observed by Nissl staining,the ultrastructural changes of neurovascular unit(Neurovascular unit,NVU)were observed by transmission electron microscope(Transmission electron microscope,TEM),and the apoptosis of the ischemic penumbra was detected by in situ apoptosis(TdT-mediated Dutp Nick-End Labeling,TUNEL).Magnetic resonance imaging was used to observe the ischemic evolution of the penumbra of the same rat at 4.5 h and 24 h,respectively.Results:Compared with the sham operation group,the number of neurons in the model group was significantly reduced,the structure of Nissl corpuscles was destroyed,the outline was blurred or disappeared,the pathological morphology of NVU ultrastructure was obviously damaged under transmission electron microscope,a large number of apoptotic cells could be seen in the model group by TUNEL staining(P<0.01),and magnetic resonance imaging showed that there was a large area infarction in the brain tissue of the model group.Compared with the model group,the pathomorphology of neurons and NVU ultrastructure in Xingnaojing group was significantly improved,the number of apoptotic cells was significantly decreased(P<0.01),and the loss rate of penumbra was significantly lower in Xingnaojing group(P<0.05).Conclusion:Xingnaojing injection can improve the state of neurons in ischemic penumbra,reduce the injury of glial cells and microvessels,inhibit apoptosis,promote the transformation of penumbra in rats with acute cerebral ischemia,and save part of penumbra to some extent.it has a certain protective effect on the brain tissue of penumbra in the acute stage of cerebral ischemia.
基金National Natural Science Foundation of China(No.81673899)。
文摘Objective:To investigate the protective effect of Xingnaojing injection on cerebral ischemia-reperfusion in rats and its metabolic pathway and mechanism.Methods:The cerebral ischemia reperfusion model of rats was established by suture occlusion.After successful model evaluation,he rats were randomly divided into model group and Xingnaojing group with eight rats in each group.In the sham operation group,only blood vessel separation was performed without embolization.Xingnaojing group was given intraperitoneal injection,model group and sham operation group were given the same dose of normal saline,twice a day.Three days later,HE staining and GC-MS metabolomics were used to detect the changes of endogenous metabolites in the rat brain tissue.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were used to screen out differential metabolites and analyze their metabolic pathways.Results:Endogenous metabolites were disturbed after cerebral ischemia-reperfusion injury in rats.Seventy-one different metabolites were screened from the model group and the sham group,of which three were down-regulated and sixty-eight were up-regulated.Eighty-eight different metabolites were found between Xingnaojing group and sham operation group,among which eight were down-regulated and eighty up-regulated.After screening of Xingnaojing group and model group,twelve different metabolites were obtained,among which seven were down-regulated and five up-regulated.By analyzing the differences of metabolites,Xingnaojing injection was considered to be involved in the metabolic pathway after cerebral ischemia-reperfusion in rats,including amino acid metabolism(beta alanine metabolism,alanine,glutamic acid and aspartic acid metabolism,histidine metabolism,arginine and proline metabolism),glutathione metabolism,pyrimidine metabolism,ABC transporter,nitrogen metabolism and other metabolic pathways.Conclusion:Xingnaojing injection can restore the levels of metabolites in cerebral ischemia-reperfusion rats in certain degrees,mainly through amino acid metabolism,ABC transporter,glutathione metabolism and other metabolic pathways to regulate cerebral ischemia-reperfusion injury in rats.
基金National Natural Science Foundation of China General Program(No.81874446)National Scicnce and Technology Major Project(No.2017ZX09304019)。
文摘Objective:To explore the intervention effects and mechanism of Simiao Yongan(SMYA)Decoction on carotid atherosclerotic plaque in ApoE knockout mice by antagonizing lipid metabolism of oxidation low density lipoprotein(Ox-LDL).Methods:ApoE-/-mice were fed high-fat feeding for 2 weeks,combined with perivascular collar placement(PCCP)and high fat feeding for 8 weeks to establish carotid AS plaque model.All the mouses were divided into 5 groups,after successful AS model preparation.The sham operation as well as model group intragastrically administered with deionized water.The rest mouses were intragastrically administered with SMYA decoction or Pioglitazone,or treated with Atorvastatin for 8 weeks.Then adopting automatic biochemical analyzer to test total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)content.The content of ox-LDL in serum,which was tested by enzyme-linked immunosorbent assay(ELISA).The pathological changes of carotid artery were observed by hematoxylin-eosin(HE)staining and the vascular parameters were measured.Immunohistochemical method and Western blot assay was used to detect the manifestations of protein include fatty acid binding protein 4(FABP4)and peroxisome proliferator-activated receptorγ(PPARγ)as well as matrix metalloproteinase 2(MMP 2).Results:Compared with the sham operation group,the serum ox-LDL content of the model group was increased,and the intima thickness(IT),intima-media thickness(IT/MT),plaque area(PA)as well as lumen area ratio of plaque vessels(PA/LA)were enlarged(P<0.05).Immunohistochemistry and Western blot results showed that the relative expression of FABP4 and MMP2 in the model group increased markedly,while the relative expression of PPARγsignificantly decreased.Compared SMYA decoction group and Atorvastatin group as well as Pioglitazone with model group,the serum ox-LDL content was decreased(P<0.05).In the mean time,the IT,PA,IT/MT and PA/LA in carotid artery were reduced(P<0.05).Immunohistochemistry and Western blot results showed that the expression of FABP4 and MMP2 was reduced,while PPARγprotein expression increased of mouses in each administration group.Conclusion:SMYA decoction is able to antagonize Ox-LDL,increase the expression of PPARγ,decrease the level of FABP4,reduce MMP2 in carotid arteries of ApoE-/-atherosclerotic mice,and increase the stability of plaque.
基金This work was supported by start-up funds from Beijing University of Chinese Medicine to Jianxun Wang(grant number 1000041510051).
文摘Sepsis is a life-threatening organ dysfunction that is associated with a high risk of death.Xuebijing(XBJ)injection,a Chinese herbal compound preparation,has been widely used for the treatment of sepsis in China.The purpose of this research is to decipher the underlying multi-target pharmacological mechanism of XBJ in the treatment of sepsis using a systems pharmacology approach.Compounds in XBJ were collected by literature retrieval.The corresponding putative targets of XBJ were screened from the Traditional Chinese Medicine Systems Pharmacology(TCMSP),Swiss Target Prediction(STP),and Search Tool for Interacting Chemicals(STITCH)databases.Sepsis-related targets were summarized using the Genecards,DrugBank,and Online Mendelian Inheritance in Man(OMIM)databases.The intersection targets were obtained with Venny 2.1.Subsequently,protein-protein interaction(PPI)networks were constructed with the STRING database and Cytoscape 3.7.1.Then,degree,betweenness,and closeness were calculated to recognize the core targets in the PPI network.Moreover,the pharmacological mechanism of XBJ against sepsis was predicted via gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment.After the literature review,the 33 most commonly cited chemical ingredients,were screened out as major compounds.Bioinformatics analysis revealed that the major compounds of XBJ modulated 218 common targets associated with sepsis.Through PPI network analysis,41 genes,including IL-6,AKT1,STAT3,TP53,and MAPK1,were identified as core targets.The results of GO and KEGG enrichment revealed that the potential biological functions of XBJ against sepsis were mainly involved in cytokine receptor binding,cytokine activity,growth factor receptor binding,growth factor activity,and chemokine activity.The crucial pathways were closely associated with initial immune activation(CLR/TLR4-NF-κB/MAPK pathway),the acute inflammatory response(TNFMAPK/caspase and IL-MAPK/STAT pathways),and the late inflammation and coagulation process(HMGB1-RAGE and HIF-1 signaling pathways).This study revealed that the multiple components of XBJ exert multitarget effects against sepsis by regulating initial immune activation,the acute inflammatory response,and the late inflammation and coagulation process.
基金This work was supported by the National High-level Personnel of Special Support Program(W02020052).
文摘Background:To examine the outcomes heterogeneity of clinical trial protocols of coronavirus disease 2019(COVID-19)to prioritize the establishment of a core outcome set.Methods:Databases of the International Committee of Medical Journal Editors–accepted clinical trial registry platforms were searched on February 14,2020 and May 31,2020.Randomized controlled trials and non-randomized controlled trials of COVID-19 were considered.Patient condition was classified as common,severe,or critical.Interventions included traditional Chinese medicine and Western medicine.We excluded trials that involved discharged patients,psychological intervention,and complications of COVID-19.The general information and outcomes,outcome measurement instruments,and measurement times were extracted.The results were analyzed by descriptive analysis.Results:In all,19 registry platforms were searched.A total of 97 protocols were selected from among 160 protocols for the first search.For protocols of traditional Chinese medicine clinical trials,76 outcomes from 16 outcome domains were reported,and almost half(34/76,44.74%)of the outcomes were reported only once;the most frequently reported outcome was time taken for severe acute respiratory syndrome coronavirus 2 RNA to become negative.Twenty-seven(27/76,35.53%)outcomes provided one or more outcome measurement instruments.Ten outcomes provided one or more measurement time frame.For protocols of Western medicine clinical trials,126 outcomes from 17 outcome domains were reported;almost half(62/126,49.21%)of the outcomes were reported only once;the most frequently reported outcome was proportion of patients with negative severe acute respiratory syndrome coronavirus 2.Twenty-seven outcomes provided one or more outcome measurement instruments.Forty(40/126,31.75%)outcomes provided one or more measurement time frame.There were>40 duplicated outcomes between the clinical trials protocols of traditional Chinese medicine and western medicine protocols.All of them were included in the Delphi survey when developing core outcome set for COVID-19.A total of 1,027 protocols were selected from 2,741 protocols for the second search.Forty-two new outcomes and 47 new outcome measurement instruments were reported.Conclusion:Outcome reporting in clinical trial protocols of COVID-19 is inconsistent.Thus,establishing a core outcome set is necessary for diagnosis and management.
基金This research was financially supported by the National Natural Science Foundation of China(NNSFC,Nos.81773589 and 81522050)the National Science and Technology Project of China(No.2018zx09711001-001)the National Key Research and Development Project(No.2019YFC1708901).
文摘Objective:To study the chemical constituents of the roots of Paeonia lactiflora.Materials and methods:The isolation and purification were carried out by column chromatography on macroporous adsorbent resin,MCI gel,silica gel,and Sephadex LH-20,as well as semi-preparative RP-HPLC.The structures were elucidated on the basis of physicochemical properties and spectroscopic analysis,as well as the ECD quantum chemical computation methods.Results:A sesquiterpenoidal glucoside(1)along with two sesquiterpenoids(2-3)were isolated from the roots of Paeonia lactiflora,and their structures were identified as(+)-(1R,2R,4S,5S,10R)-2-α-D-glucopyranosyloxy-2-hydroxy-cadin-6,12-dien-15-oic acid(1),drim-7-en-3β,11,12-triol(2),and 3β-hydroxy-11,12-O-isopropylidenedrimene(3),respectively.Conclusion:Compound 1 was identified as a new sesquiterpenoidal glucoside.
基金Supported by the National Natural Science Foundation of China(No.81303151)Beijing Nova Program(No.xxjh2015A093and No.Z1511000003150125)National Major Scientific and Technological Special Project for"Significant New Drugs Development"(No.2012ZX09303-010-002)
文摘Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system.A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases,i.e.PubMed,Excerpt Medica Database,China Biology Medicine disc and China National Knowledge Infrastructure.However,no relevant study on the subjects of interest was identified.Therefore,drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine,we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial.Further,we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders.Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research.The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.
基金Supported by the National Natural Science Foundation of China(No.81430098 and 81603495)the National High Level Talents Special Support Plan of the Organization Department of the Central Committee(No.W02020052)
文摘Objective: To provide evidence-based recommendations for clinical application and provoke thoughts for future researchers by conducting a comprehensive summary and evaluation of the current evidence profile for the role of Chinese medicine(CM) in treating myocardial infarction(MI). Methods: Online databases including Pub Med, EMBase, Cochrane Library, Chinese National Knowledge Infrastructure(CNKI), Chinese Biomedical Medicine(CBM), VIP Journal Integration Platform, and Wanfang database were systematically searched for literatures on CM in treating MI. After screening, studies were categorized into 5 types, i.e. systematic review(SR), randomized controlled trial(RCT), observational study, case report and basic research. General information was abstracted, and the quality levels of these studies and their conclusions were summarized and assessed. Results: A total of 452 studies including 10 SRs, 123 RCTs, 47 observational studies, 28 case reports, and 244 basic researches were selected. Clinical studies centered primarily on herbal decoction and mostly were not rigorously performed. High-quality studies were predominantly on Chinese patent medicines(CPMs) such as Danshen Injection(丹参注射液), Shenmai Injection(参麦注射液), Shengmai Injection(生脉注射液) and Qishen Yiqi Dripping Pills(芪参益气滴丸). The most frequently observed pattern of drug combination was decoction plus injection. Results of SRs and clinical studies showed that CM may reduce mortality, decrease risk of complication, reduce myocardial injury, improve cardiac function and inhibit ventricular remodeling. Findings from basic researches also supported the positive role of CM in reducing infarct size and myocardial injury, promoting angiogenesis, preventing ventricular remodeling and improving cardiac function. According to the current evidence body, CM has proven effects in the prevention and treatment of MI. It is also found that the effects of CPMs vary with indications. For instance, Shenmai Injection has been found to be especially effective for reducing the incidence of acute clinical events, while CPMs with qi-nourishing and bloodcirculating properties have been proven to be effective in inhibiting ventricular remodeling. High quality evidence supports the use of CM injection for acute MI and CPM for secondary prevention. Reports on adverse events and other safety outcomes associated with CM for MI are scarce. Conclusions: Sufficient evidence supported the use of CM as an adjuvant to Western medicine for preventing and treating MI. The choice of drug use varies with disease stage and treatment objective. However, the quality of the evidence body remains to be enhanced.
基金supported by National Natural Science Foundation of China (No. 81473664): Based on the PI3k/Akt signaling pathway mediated immune injury of diabetic nephropathy "treatment in terms of the wind" mechanism
文摘Objective: To compare the efficacy of traditional Chinese medicine(TCM) based on Zheng differentiation with angiotensin receptor blocker/angiotensin-converting enzyme inhibitor(ARB/ACEI) in treating diabetic kidney disease(DKD) from the aspects of decreasing urinary microalbumin, declining 24-h urinary protein, reducing endpoint events, and renal function protection. Methods: The Chinese Biomedical Literature Database(CBM), the Chinese Academy of Sciences database(CNKI), the VIP Chinese journal database, Wanfang DATA, Medline database, Cochrane library, excerpt medical database(Embase), and Web of science were used for literature searching. The reviewer manager5.3 software was utilized to analyze the data. Results: Twenty-four studies including 1956 participants were involved in this review. Results showed that TCM had a better effect(mean difference [MD],-23.20, 95% confidence interval [CI],-30.60 to-15.79, P < 0.00001) than ARB/ACEI on lowering urinary albumin excretion rate(UAER) and urine albumin-to-creatinine ratio(MD-4.56 mg/mmol, 95% CI,-5.76 to-3.36, P < 0.00001). Moreover, the advantage of decreasing UAER was greater as the follow-up period become longer(P = 0.04). TCM also had a better effect in 24-h urinal protein, decreasing 0.36 g/24 h(95% CI,-0.45 to-0.27, P < 0.00001) more than the control in shorter follow-up period(ranged from 12 to 24 weeks) subgroup but only 0.08 g/24 h(95% CI,-0.13 to-0.03, P = 0.0006) in the longer follow-up period(>24 weeks) subgroup. TCM worked as well as ACEI/ARB in reducing endpoint events(relative risk, 0.67, 95% CI, 0.20–2.224, P = 0.51)and decreasing urinary albumin concentration(UAC)(MD,-16.50, 95% CI,-46.28–13.28, P = 0.28). As for protecting renal function, TCM had an equal effect to AECI/ARB in improving creatinine clearance ratio(MD,-3.30, 95% CI,-6.66–0.03, P = 0.05) or estimated glomerular filtration rate(MD, 1.00, 95% CI,-0.59–2.58, P = 0.22). However, TCM had a better effect in releasing the glomerular hyperfiltration state(MD,-9.64, 95% CI,-14.45 to-4.84, P < 0.0001). Conclusions: TCM based on Zheng differentiation can work as well as ACEI/ARB in treating DKD and even better in decreasing urinary microalbumin and releasing glomerular hyperfiltration. It is a good alternative treatment of DKD.
