1.Models of acute radiation enteritis: a comparison and evaluation of two modeling methods
Yingjie WANG ; Shunjin WANG ; Lianggeng GONG ; Hailong WU
Chinese Journal of Radiation Oncology 2016;25(6):628-633
Objective To investigate the reliable methods for establishing models of acute radiation enteritis (ARE) and the criteria used to judge whether the model is successfully established.Methods A total of 98 rats were randomly divided into normal control group (group A),fractionated dose group B (4 Gy/fraction for 3 fractions),fractionated dose group C (4 Gy/fraction for 4 fractions),fractionated dose group D (4 Gy/fraction for 5 fractions),single fraction group E (12 Gy in a single fraction),single fraction group F (16 Gy in a single fraction),and single fraction group G (20 Gy in a single fraction).Abdominal irradiation was performed for all rats,and the changes in body weight and defecation were observed.Magnetic resonance imaging (MRI) was performed on days 3-5 after irradiation,and on the 4th day,anatomy was performed to measure the length of small intestine with edema,blood samples were collected to measure endotoxins,and the specimens of small intestine were collected to observe pathological changes.The independent-samples t-test was used for comparison between groups.Results After irradiation,groups D,E,F,and G experienced varying degrees of diarrhea and had positive results from endotoxins test.Group D had a longer length of small intestine with edema than group C (P=0.00) and had a similar length as group E (P=0.46).Groups E,F,and G showed dilation and dropsy in the intestinal canal on MRI,and groups F and G showed patchy signals of dropsy in the abdominal cavity.Groups F and G showed varying degrees of necrosis in the small intestine and died within 14 days after irradiation.Conclusions When the radiation dose is 33-46 Gy (biologically equivalent dose),both single dose and fractionated dose can successfully establish the model of ARE,while fractionated dose can be better controlled.
2.Efficacy of Rituximab Combined with CHOP for B Cell Non-Hodgkin's Lymphoma
Chunying XIE ; Anwen LIU ; Ling LI ; Shunjin WANG
Chinese Journal of Clinical Oncology 2009;36(24):1398-1400
Objective: To evaluate the therapeutic effects of Rituximab combined with CHOP on B cell non-Hodgkin's lymphoma. Methods: A prospective study with concurrent control group was carried out. A total of 60 cases of B cell non-Hodgkin's lympoma were divided into 2 groups. The 30 cases in the research group received Rituximab combined with CHOP regimen. The 30 cases in the control group were treated with CHOP regimen alone. CHOP regimen (Cyclophospham 600mg/m~2 IV, Vincristine 1.4mg/m~2 Ⅳ, and Adriamy-cin piarubicin 50mg/m~2 IV) was administered on the first day of chemotherapy course. Prednisone 100mg/m~2 was administered orally from the first day to the fifth day. The cycle was repeated every 21 days and the patients received at least 3-6 cycles of chemotherapy. The therapeutic effect was assessed. Results: The complete remission (CR) rate and total response rate were 66.7% (20/30) and 90.0% (27/30) in the research group and 39.97% (12/30) and 56.7% (17/30) in the control group. The therapeutic differences between the two groups showed a statistical significance (P<0.05). Conclusion: Compared with CHOP regimen chemotherapy, Rituximab combined with CHOP regimen shows better therapeutic effect. The side effects in the research group are similar to those in the control group. Rituximab combined with CHOP regimen can be the first choice in the treatment for B cell non-Hodgkin's lymphoma.
3.Effects of Qingshen Granule on serum interleukin-8 and -18 levels in patients with a sharp deterioration of chronic renal failure and dampness-heat syndrome: a randomized controlled trial.
Fei WANG ; Yiping WANG ; Dong WANG ; Wan CHENG ; Shunjin HU ; Yong LU ; Ling LIU
Journal of Integrative Medicine 2010;8(4):328-31
Background: Dampness-heat syndrome is a major syndrome type in patients with a sharp deterioration of chronic renal failure (CRF). Qingshen Decoction, a compound traditional Chinese herbal medicine, could relieve the clinical symptoms of CRF patients, and was considered to have a certain reversal effect on rapid deterioration of renal function. Objective: To observe the changes of serum interleukin-8 (IL-8) and IL-18 levels in CRF patients with a sharp deterioration and dampness-heat syndrome, and to explore the curative efficacy of Qingshen Granule. Design, setting, participants and interventions: Sixty CRF patients with a sharp deterioration and dampness-heat syndrome from Department of Nephrology, the First Affiliated Hospital of Anhui College of Traditional Chinese Medicine, were randomly divided into treatment group (30 cases) and control group (30 cases), with another 20 healthy individuals as normal control. The patients in the treatment and control groups were all treated with Jiedu Xiezhuo II, a compound traditional Chinese herbal medicine, given as retention enema. Qingshen Granule was additionally administered to the patients in the treatment group with 1 dosage each time and 3 times a day. The treatment course was one month. Main outcome measures: The levels of serum IL-8 and IL-18 in the normal individuals and before and after treatment in the treatment and control groups were detected. Results: The total response rates of treatment group in clinical efficacy assessment and assessment of syndrome of traditional Chinese medicine (86.67% and 86.67%) were higher than those of the control group (56.67% and 60%), and there were significant differences between the two groups (P<0.05). The levels of serum IL-8 and IL-18 in CRF patients before treatment were obviously higher than those in the healthy individuals (P<0.01), and there were no differences in the levels of IL-8 and IL-18 before treatment between the treatment group and control group (P>0.05). After one-month treatment, the levels of serum IL-8 and IL-18 were markedly decreased in the two groups (P<0.01), and the levels of serum IL-8 and IL-18 in the treatment group were markedly lower than those in the control group (P<0.05). There were differences in decreased degrees of IL-8 and IL-18 levels between the two groups (P<0.05). Conclusion: CRF patients with a sharp deterioration and dampness-heat syndrome have high serum IL-8 and IL-18 levels. Qingshen Granule can reduce the levels of serum IL-8 and IL-18, and improve the renal function and ameliorate the clinical symptoms.
4.A study on Qingshen granule for treatment of renal fibrosis in patients with chronic renal failure accompanied by damp-heat syndrome and its mechanism
Yiping WANG ; Xuelian ZHANG ; Dong WANG ; Yong LYU ; Ling WEI ; Yanping MAO ; Shunjin HU ; Liyuan WANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;(6):561-564
Objective To observe the anti-fibrosis therapeutic effect and mechanism of Qingshen granule for treatment of patients with chronic renal failure (CRF) accompanied by damp-heat syndrome.Methods Sixty-eight patients with CRF accompanied by damp-heat syndrome were randomly divided into a control group and a observation group, and the study was completed only in 61 patients, 31 in the control group and 30 in the observation group. Thirty subjects having taken physical health examination were assigned in a healthy control group. All the patients in both treatment groups were treated with conventional western medical therapy and traditional Chinese medicine (TCM) retention enema, and for patients in observation group, Qingshen granule was given additionally, 1 bag (10 g) thrice a day taken orally. The therapeutic course was 8 weeks. The clinical therapeutic effect, the levels of serum creatinine (SCr), the glomerular filtration rate (eGFR), serum interleukin-17 (IL-17), collagen type Ⅲ (Col-Ⅲ) and nuclear factor-κB p65 (NF-κB p65) in peripheral blood mononuclear cells (PBMC) were measured before and after treatment in the two treatment groups, and the above results were compared with those in healthy control group.Results Clinically, the total effective rates of the disease and of the TCM syndrome in observation group were significantly higher than those in the control group (86.67% vs. 58.06%, 83.33% vs. 45.16%, bothP < 0.01). In the observation group, the level of SCr was obviously lower, and the level of eGFR was markedly higher after treatment, and compared with the control group, the changes in above data after treatment in observation group were more significant [SCr (μmol/L): 250.62±164.97 vs. 393.72±183.64, eGFR (mL·min-1·1.73 m-2): 33.42±17.24 vs. 39.72±23.85, bothP < 0.05]. After treatment, the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC were obviously lowered in both treatment groups compared with those before treatment, the therapeutic effect in observation group being superior to that in the control group [IL-17 (ng/L): 17.47±8.87 vs. 25.51±16.69, Col-Ⅲ (μg/L): 17.06±8.76 vs. 23.77±10.44, NF-κB p65 (μg/L): 0.58±0.34 vs. 0.83±0.30, allP < 0.05].Conclusion The Qingshen granule can ameliorate the clinical symptoms, improve renal function, decrease the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC, intervene renal fibrosis in patients with CRF and damp-heat syndrome, ultimately delaying the progress of CRF.
5.The interference effect of traditional Chinese medicine Qingshen granule on signal transduction pathway of fokal adhesion kinase-rat sarcoma-mitogen activated protein kinase in rats with renal fibrosis
Yiping WANG ; Zhaoqiu DAI ; Dong WANG ; Jinnang TANG ; Shunjin HU ; Kejun REN ; Hua JIN
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;(1):28-32
Objective To observe the effect of traditional Chinese medicine (TCM) Qingshen granule on signal transduction pathway of fokal adhesion kinase-rat sarcoma-mitogen activated protein kinase (FAK-Ras-MAPK) in renal tissue of rats with renal interstitial fibrosis (RIF). Methods Forty Spargue-Dawley (SD) rats were randomly divided into normal control, model, Bailing capsule and Qingshen granule groups (each, n = 10). The rat model with RIF was reproduced by unilateral ureteral obstruction (UUO) or ligation method. The rats in Bailing capsule group were treated with Bailing capsule dissolved in 4 mL warm water, and the dosage was 0.3 g·kg-1·d-1 for intragastric administration;the rats in Qingshen granule group were treated with Qingshen granule dissolved in 4 mL warm water, its dosage was 6 g·kg-1·d-1 for intragastric administration, and equal volume of normal saline was given to normal control group and model group by gavage. After treatment for 8 weeks, the levels of blood urea nitrogen (BUN), serum creatinine (SCr), fibronectin (FN),α-smooth muscle actin (α-SMA) were determined in each groups. The renal tissue expression levels of FAK, Ras, p38MAPK, FN, α-SMA were determined in various groups by immunohistochemistry staining method. Results Compared with the normal control group, the levels of serum BUN, SCr, FN and α-SMA were significantly increased in the model group. There were no significant differences in the levels of serum BUN and SCr before administration of drugs between Bailing capsule group and Qingshen granule group (both P>0.05). The levels of BUN, SCr, FN, andα-SMA were all significantly lowered in the two treatment groups than those of the model group after administration, the descent in Qingshen granule group being more marked [BUN (mmol/L):13.18±4.91 vs. 18.56±5.59, SCr (μmol/L): 104.80±12.04 vs. 119.02±12.47, FN (mg/L): 29.72±16.75 vs. 46.38±8.63, α-SMA (kU/L):5.49±2.68 vs. 7.13±2.37, all P < 0.05]. The immunohistochemistry staining showed: the kidney tissue expression levels of FAK, Ras, p38MAPK, FN, and α-SMA in the model group were significantly higher than those of normal control group, above indexes were all significantly lower in Bailing capsule group and Qingshen granule group than those of the model group, and the descent in Qingshen granule group was more obvious (FAK: 3.00±1.41 vs. 5.28±2.21, FN: 4.25±1.04 vs. 6.29±2.06, α-SMA: 3.25±1.28 vs. 4.86±1.57, p38MAPK: 2.50±1.31 vs. 4.71±2.50, Ras:3.50±1.41 vs. 4.29±1.38, all P<0.05). Conclusion Qingshen granule can reduce serum BUN and SCr levels in rats with RIF, and inhibit the activation of FAK-Ras-MAPK signal transduction pathway in the kidney, thereby it may reduce the generation of FN andα-SMA and play a role of anti-RIF.
6.Efficacy and safety of different drugs by balloon catheter injection for no-reflow following percutaneous coronary intervention
Yuping WANG ; Haibin ZHANG ; Zhenghai ZHANG ; Shunjin GAN
Chinese Journal of General Practitioners 2019;18(6):547-552
Objective To evaluate the efficacy and safety of different drugs injected via balloon catheter for no-reflow after percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI).Methods From January 2016 to December 2017,1 280 patients with STEMI were treated in Department of Cardiology,Beijing Luhe Hospital.All patients were underwent PCI and stent implantation in related infarct vessels (IRA).Among 1 280 patients no-reflow occurred in 164 cases (12.81%) during the procedure.No-reflow patients were divided into three study groups according to the order of consultation,who were given verapamil (verapamil group,55 cases),tirofiban (tirofiban group,55 cases) or nitroglycerin (nitroglycerin group,54 cases) by injection through balloon catheter.Coronary blood flow recovery (TIMI grading),myocardial perfusion level TMP grading (TMPG),average dose of drugs (mg) and adverse drug reactions (ADR) were compared among the three groups.Left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) were evaluated by echocardiography 7 and 30 d after operation.The incidence of major adverse cardiovascular events (MACE) was followed up.Results TIMI-3 ratio in verapamil,tirofiban and nitroglycerin groups was 89.90% (49/55),91.82% (45/55) and 61.11% (33/54),respectively (Hc=13.920,P<0.05).TMP-3 ratio was 72.73%(40/55) in verapamil group,65.45% (36/55) in tirofiban group and 50.0% (27/54) in nitroglycerin group,respectively (Hc=6.230,P<0.05).During the procedure,one case (1.82%) had slow heart rate and one case (1.82%) had hypotension in verapamil group;three cases 5.56%) had transient hypotension in nitroglycerin group,and there was no significant difference in the incidence of ADR among the three groups (Hc=0.040,P>0.05).There was no significant difference in LVEF and LVEDV among three groups on the d7 after operation (all P>0.05).The improvement of LVEF and LVEDV was more significant in verapamil group on d30 after operation (all P<0.05).One case (1.82%) of heart failure occurred in tirofiban group,three cases of heart failure and one case of recurrent myocardial infarction occurred in nitroglycerin group during six months of follow-up.There was no significant difference in the overall incidence of MACE among the three groups (Hc=0.070,P>0.05).Conclusion Verapamil can be injected throμgh balloon catheter to restore coronary blood flow rapidly,effectively and safely,and improve left ventricular function in STEMI patients with no-reflux during PCI.
7.Impact of domestic bivalirudin on platelet function during emergency percutaneous coronary interven-tion
Yuping WANG ; Jincheng GUO ; Ming ZHANG ; Haibin ZHANG ; Xuekun ZHANG ; Shunjin GAN ; Guowang GAO ; Lixin ZHANG ; Zhenghai ZHANG ; Yiting CAI ; Yu TANG ; Zijing LIU
Chinese Journal of cardiovascular Rehabilitation Medicine 2014;23(5):544-545,546
Objective:To explore the impact of domestic bivalirudin on platelet function during emergency percutane-ous coronary intervention (PCI) .Methods :A total of 100 patients with acute ST segment elevation myocardial in-farction who recieved emergency PCI were randomly divided into unfractionated heparin group (UFH group ,n=53) and bivalirudin group (n=47) .Adenyl diphosphoric acid (ADP)-induced platelet aggregation rate was meas-ured and statistically compared between two groups before and after PCI .Results:Before emergency PCI ,there was no significant difference in ADP-induced platelet aggregation rate between two groups (P=0.99) .After emergency PCI ,ADP-induced platelet aggregation rate in bivalirudin group was significantly lower than that of UFH group [ (16.46 ± 10.23)% vs .(25.21 ± 15.91) % , P<0.01] .Conclusion:During percutaneous coronary intervention , compared with routine heparin anticoagulation , bivalirudin , as an anticoagulant , can more significantly inhibit platelet aggregation and possess antiplatelet effect .
8.Effect of Ronghuang Granule on serum FGF23, FGFRs and Klotho in non-dialysis patients with CKD-MBD and kidney deficiency and damp-heat syndrome.
Shunjin HU ; Dong WANG ; Rui ZHANG ; Yuanru CAO ; Hua JIN ; Yanping MAO ; Ling WEI ; Kejun REN ; Xuelian ZHANG ; Yiping WANG
Journal of Southern Medical University 2018;38(12):1427-1432
OBJECTIVE:
To observe the effect of Ronghuang granule on serum fibroblast growth factor 23 (FGF23), fibroblast growth factor receptor (FGFRs) and Klotho protein levels in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and kidney deficiency and damp heat syndrome.
METHODS:
Seventy non-dialysis CKD-MBD patients with kidney deficiency and dampness-heat syndrome were randomized into control group (=35) and treatment group (=35). All the patients were given routine treatment combined with traditional Chinese medicine retention enema, and the patients in the treatment group received additional Ronghuang granule treatment (3 times a day). After the 12-week treatments, the patients were examined for changes of TCM syndromes. Serum levels of Ca, P, parathyroid hormone (iPTH), FGF23, FGFRs and Klotho proteins were detected before and after treatment. These parameters were also examined in 20 healthy volunteers.
RESULTS:
Sixty-five patients completed the study, including 33 in the control group and 32 in the treatment group. The patients in the treatment group showed significantly better treatment responses than those in the control group ( < 0.05 or 0.01). At 4, 8, and 12 weeks of treatment, the patients in the treatment group had significantly lowered scores of TCM syndromes compared with the score before treatment ( < 0.05 or 0.01), while in the control group, significant reduction of the scores occurred only at 12 weeks ( < 0.05); at each of the time points, the treatment group had significantly greater reductions in the score than the control group ( < 0.01). Significant improvements in serum Ca, P and iPTH levels were observed at 4, 8, and 12 weeks in the treatment group ( < 0.05) but only at 12 weeks in the control group ( < 0.05). The patients in the control and treatment groups all showed elevated serum levels of FGF23, FGFRs and Klotho protein compared with the normal subjects ( < 0.01); FGF23, FGFRs and Klotho levels were significantly reduced in the treatment group ( < 0.05) but remained unchanged in the control group (>0.05), showing significant differences between the two groups.
CONCLUSIONS
Ronghuang granule improves the clinical symptoms of non-dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome by reducing serum levels of FGF23, FGFRs and Klotho, improving calcium and phosphorus metabolism disorder, and inhibiting secondary hyperparathyroidism.
Calcium
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blood
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Chronic Kidney Disease-Mineral and Bone Disorder
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blood
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therapy
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Drugs, Chinese Herbal
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pharmacology
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Enema
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Fibroblast Growth Factors
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blood
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Glucuronidase
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blood
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Humans
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Parathyroid Hormone
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blood
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Phosphorus
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blood
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Receptors, Fibroblast Growth Factor
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blood
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Renal Insufficiency, Chronic
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blood
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therapy
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Sweating Sickness
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blood
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therapy
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Syndrome