OBJECTIVE: To explore the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine for nourishing liver and improving choleresis, on the rate of gallstone formation and content of plasma cholecystokinin in guinea pigs with induced cholesterol gallstones. METHODS: Eighty guinea pigs were randomly divided into 4 groups, which were normal control group, untreated group, YGLDG-treated group and ursodeoxycholic acid (UDCA)-treated group (n=20). Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. YGLDG (1.81 g/kg daily) and UDCA (30.12 mg/kg daily) were given orally to guinea pigs in the corresponding group respectively for seven weeks; however, the guinea pigs of normal control group and untreated group were administered with normal saline. The physical signs of the guinea pigs and the rates of gallstone formation were examined, and the content of cholecystokinin (CCK) in the plasma was detected by radio-immunoassay. RESULTS: YGLDG could obviously improve the ethological signs of the guinea pigs. Gallstone formation rate of the untreated group (82.35%) was significantly increased as compared with that of the normal control group (5.26%) (P<0.01), while the gallstone formation rates of the YGLDG-treated group (27.28%) and UDCA-treated group (38.89%) were lower than that of the untreated group (P<0.05). The content of CCK in plasma of the untreated group was significantly lower than that of the normal control group (P<0.01), while CCK content of the YGLDG-treated group and UDCA-treated group was lower than that of the normal control group, but both of them were significantly higher than that of the untreated group (P<0.01). The difference of CCK levels between YGLDG-treated group and UDCA-treated group had no statistical significance (P>0.05). CONCLUSION: YGLDG can significantly decrease the rate of gallstone formation in guinea pigs. It may be related to elevating the content of CCK in the plasma.

OBJECTIVE: To study the role of estrogen receptor (ER) and progesterone receptor (PR) in the formation of cholesterol calculus and investigate the effects of Shengqing Capsule (SQC), a Chinese patent herbal medicine with the function of soothing liver and draining gallbladder, on ER and PR expressions. METHODS: A total of 80 female guinea pigs were divided into normal control group, untreated group, ursodeoxycholic acid group (UDCA group) and SQC group. The cholesterol gallstone was induced by feeding the guinea pigs with high-fat lithogenic diet. SQC and UDCA were separately administered to the guinea pigs in the SQC group and UDCA group. After 7-week administration, all the animals were sacrificed to calculate the incidence of calculus formation and detect the expressions the ER and PR in the epithelial tissue of gallbladder by immunohistochemical method. RESULTS: Gallstone was cholesterol calculus detected by infrared spectrum. The incidence of calculus formation in the SQC group (27.78%) was significantly lower than that in the untreated group (81.25%) (X(2)=9.721 5, P=0.001 8). On the basis of Reiner standard, the expression distribution of ER and PR increased gradually from the normal control group through the SQC group and UDCA group to the untreated group. Except for the former two groups and the latter two groups, the differences between the other groups and UDCA group were statistically significant (P<0.05). Besides, the differences of positive expression rates between groups were statistically significant (P<0.05). CONCLUSION: Increased expressions of ER and PR are closely related to the formation of cholesterol stone. And Shengqing Capsule can down-regulate the expressions of ER and PR.

OBJECTIVE: To observe the changes of intracellular free calcium level ([Ca(2+)]i) in gallbladder cells of guinea pigs with gallstones so as to study the mechanisms of gallstone formation and the prevention and treatment function of traditional Chinese herbs for nourishing the liver. METHODS: Eighty guinea pigs were randomly divided into four groups, which were normal control group, untreated group, nourishing-liver Chinese drug (NLCD) group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Gallstones were induced in the guinea pigs of the latter 3 groups by the feed of diet inducing cholelithiasis with high cholesterol, while the corresponding medicines were used in NLCD group and UDCA group for prevention and treatment for 7 weeks. Then the state of the guinea pigs, the formation of gallstones, and the changes of [Ca(2+)]i in gallbladder cells were observed. RESULTS: The [Ca(2+)]i in gallbladder cells of guinea pigs in the untreated group was decreased significantly. NLCD improved the behavioral signs of the guinea pigs, significantly decreased the formative rate of gallstones and increased the [Ca(2+)]i in gallbladder cells. CONCLUSIONS: The [Ca(2+)]i in gallbladder cells is the important factor for contractile function of gallbladder and the information of gallstones. Traditional Chinese herbs for nourishing the liver may significantly increase the [Ca(2+)]i in gallbladder cells to facilitate contraction of the smooth muscle cells of gallbladder and relieve the cholestatis. It may be one of the mechanisms of traditional Chinese herbs for nourishing the liver in preventing and treating cholelithiasis.

OBJECTIVE: To evaluate the clinical outcome of Ruanjian Xiaoying Decoction (RJXYD) on chronic lymphocytic thyroiditis. METHODS: Eighty patients with chronic lymphocytic thyroiditis were randomly divided into RJXYD-treated group (n=40) and control group (n=40). The patients in the RJXYD-treated group received treatment of RJXYD combined with levothyroxine while the others in the control group received treatment of levothyroxine and prednisone both for 16 weeks. The serum levels of thyroid hormones and the titres of serum antithyroglobulin antibody (anti-TG Ab) and antithyroid microsomal antibody (anti-TM Ab) were all examined before and after treatment. The total response rates of the two groups were evaluated after treatment of 16 weeks. RESULTS: The total response rate of the RJXYD-treated group was 92.5%, while that of the control group was 60.0% (P<0.01). The serum levels of free triiodothyronine (FT(3)) and free thyroxine (FT(4)) were obviously increased after treatment as compared with those before treatment in the two groups. The titres of serum anti-TG Ab and anti-TM Ab and the serum level of thyroid-stimulating hormone (TSH) were all obviously decreased after treatment as compared with those before treatment in the two groups. CONCLUSION: The RJXYD can shrink and soften the enlarged thyroid gland and thyroid nodules, improve the immune function of human body, alleviate the response to thyroid self-antigens and promote the recovery of thyroid function.

BACKGROUND: Researches indicate that inducible nitric oxide synthase(iNOS) plays an important role in relieving destruction of blood brain barrier and protecting vascular endothelium and brain tissue in cerebral ischemia-reperfusion injury.OBJECTIVE: To observe the effect of Shuigou (DU26), Neiguan (PC6)and Zusanli (ST36) on the expression of inducible nitric oxide synthase messenger ribonucleic acid (iNOS mRNA) in hippocampus of the rats with cerebral ischemia-reperfusion.DESIGN: Randomized controlled study.SETTING: Shanghai University of Traditional Chinese Medicine, Shanghai Institute of Acupuncture and Meridian and Huashan Hospital Affiliated to Fudan University.METHODS: The experiment was completed at the Experimental Animal Center in Shanghai University of Traditional Chinese Medicine, Threegrade Acupuncture Immunological Laboratory of Shanghai Research Institute of Acupuncture and Meridian and Huashan Hospital Affiliated to Fudan University from December 2003 to December 2004. Totally 40 SD rats were randomly divided as normal group, sham operation group, model group and electroacupuncture group with 10 in each group. The hypertension model rats were induced with bi-kidney-bi-clip method, then the focal cerebral ischemia-reperfusion rat model was induced by reversible occlusion for a middle cerebral artery with a thread on the stroke prone renovascular hypertensive model rat. While the rats in sham operation group were operated without thread insertion. Shuigou (Du 26), bilateral Neiguan(PC 6) and bilateral Housanli (Zusanli, ST 36) were located according to"Atlas of Experimental Animal Acupoints" made by Hua's. Shuigou (Du26): 1 mm below nasal apex right on the Labium leporinum, be punctured 1 mm obliquely upward; Neiguan (PC 6): at the lateral palm of the forearm3 mm above wrist joint, between ulna and radius, be punctured 1 mm perpendicularly; Housanli (Zusanli, ST 36): under knee joint, 5 mm below the capitulum of fibula, be punctured 7 mm perpendicularly. The skin of Shuigou (Du 26) and the root of right ear, Neiguan (PC 6) and Housanli (Zusanli, ST 36) were connected with electroacupuncture Therapeutic Instrument G6805 with the parameters of continuous wave, 120 times/minute in frequency, 1 mA in intensity for 30 minutes. The treatment was applied once immediately after ischemia operation and again 12 hours after reperfusion. Being killed on 24 hours after reperfusion, the hippocampus of the rats were rapidly picked out. The effect of electroacupuncture on the expression of iNOS mRNA in hippocampus of the rats with cerebral ischemia-reperfusion was detected with fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR).MAIN OUTCOME MEASURES: The expression of iNOS mRNA in hippocampus.RESULTS: All 40 SD rats entered the final analysis. Expression of iNOS mRNA in hippocampus: [1] That in model group was significant higher than that in electroacupuncture group {[(4.85±1.29) ×1 000, (3.19±1.38) ×1 000] copy, (t=2.77, P ＜ 0.05)}; [2] That in model group was significant higher than that in sham operation group {[(4.85±1.29) ×1 000, (4.93±2.17)×10] copy, (t=97.38, P ＜ 0.01)}; [3] That in model group was significant higher than that in normal group {[(4.85±1.29) ×1 000, (3.13±1.68) ×10]copy, (t=11.81, P ＜ 0.01)}.CONCLUSION: Electroacupuncture may significantly inhibit the expression of iNOS mRNA in hippocampus and reduce the synthesis of NO to relieve the cerebral ischemia-reperfusion injury.

Objective To investigate the clinical effects of different dosages of Shenfu injection for treatment of elderly patients with refractory chronic congestive heart failure (CHF).Methods A prospective study was conducted, 360 patients with CHF from Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled, and they were randomly divided into low dose, middle dose and high dose Shenfu injection groups. In the three groups, the patients received the same conventional medicine therapy, and additionally they were treated by low, medium and high dose Shenfu injection (60, 80, 100 mL/d, respectively), once a day. The therapeutic course was 10 days in the three groups. After treatment, the clinic therapeutic effect, left ventricular diastolic end diameter (LVEDD), left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) and plasma B type natriuretic peptide (BNP) were observed in the three groups.Results The total therapeutic effective rate in middle dose Shenfu injection group was significantly higher than that in low dose and high dose Shenfu injection groups [82.5% (99/120) vs. 54.2% (65/120), 60.0% (72/120), bothP < 0.05]. In high dose Shenfu injection group, increase of blood pressure occurred in 15 cases (12.5%), but no such phenomenon appeared in low and middle dose Shenfu injection groups. In the three groups, no cardiac arrhythmia, liver function abnormality, myocardial enzymogram abnormality, etc. adverse reactions occurred. Compared with those before treatment, after treatment in three groups the LVEDD and BNP were significantly decreased, while LVEF, SV, CO and CI were markedly increased. The changes of above index in middle dose Shenfu injection group were more significant [LVEDD (mm): 46.1±6.3 vs. 58.3±4.4; LVEF: 0.561±0.056 vs. 0.324±0.044, SV (mL): 58.1±6.3 vs. 35.7±5.4, CO (L/min): 5.78±0.60 vs. 4.21±0.78, CI (mL·s-1·m-2): 81.85±7.33 vs. 53.01±9.00, BNP (ng/L): 355.4±76.6 vs. 3 263.2±65.7, allP < 0.05]. Conclusion Shenfu injection 80 mL/d is the best effective dosage for treatment of elderly patients with refractory CHF and its incidence of adverse events is low.

Objective To explore the correlations between different traditional Chinese medicine (TCM) syndromes and the heart rate variability (HRV) accompanying patients with chest pain,and to provide a referen()for clinical syndrome differentiation in such patients.Methods A prospective study was conducted.()hundred and seventeen patients with chest pain admitted into Longhua Hospital Affiliated to Shanghai U()of TCM from January 2015 to October 2016 were assigned in a study object,and according to the diffe()TCM syndromes,they were divided into syndrome of qi deficiency with blood stasis,the blood sta()the deficiency of qi and yin,suppression of the chest yang,phlegm and blood stasis,qi-stagnan ()syndromes.In the same period,123 healthy people having undergone physical examination wer()control group.The time domain indexes of HRV were recorded by dynamic electrocardiogr()normal control group were compared to those of patients with different TCM syndrom()distribution in different TCM syndromes and various HRV time domain indexes we()cycle time domain indexes were as follows:the average standard deviation o()standard deviation of R-R interval (SDNN),24 hours standard deviation of()5 minutes (SDANN),24 hours the mean square root of difference values,()were observed in both groups.Results The chest pain patients a()accounting for the largest proportion (35 cases,29.9％),and ac()smallest proportion (5 cases,4.3％) in the study group;the nu()syndrome (17 cases vs.14 cases),blood stagnation of hea()(6 cases vs.2 cases) and qi-stagnation and blood stasis s()in men;the numbers of patients with deficiency of qi()(4 cases vs.2 cases) in men were more than thos()female patients were lower than those in maj()66.8 (33.4,33.4) vs.103.4 (39.7,135.4),124.7 (88.0,143.4) vs.167.0 (90.5,230.1),84.0 (22.5,132.6) vs.152.4 (31.4,240.0),all P ＜ 0.05].The SDANN in patients with chest discomfort accompanied by any one of the above mentioned types of TCM syndrome was significantly lower than that in the control group,and its degree of descent was more remarkable in the patients with qi deficiency with blood stasis,the blood stagnation of heart and suppression of the chest yang syndromes (ms:74.86± 25.69,80.39± 20.53,70.97± 23.53 vs.131.30± 34.70,all P ＜ 0.05);the SDNN of patients with deficiency of qi and yin syndrome was higher than that in the blood stagnation of heart syndrome,phlegm and blood stasis,and qi-stagnation and blood stasis syndrome significantly (ms:181.25 ± 65.20 vs.97.88± 23.61,84.28 ± 22.34,89.93 ± 8.43,all P ＜ 0.05);the RMSSD of patients with deficiency of qi and yin syndrome was increased significantly compared with that in the healthy controls and in patients with the blood stagnation of heart syndrome (ms:91.94 ± 44.02 vs.28.00± 10.50,32.21 ± 18.25,both P ＜ 0.05).Conclusions Patients with chest pain accompanied by different TCM syndrome types may develop obvious heart rate variability,and the descent of SDANN level was the most significant.The analysis of HRV changes in such patients has positive significance for their diagnosis and treatment.

Objective: To observe the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine, on insulin resistance in guinea pigs with induced cholesterol gallstones. Methods: Eighty guinea pigs were randomly divided into normal control group, untreated group, YGLDG group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. The guinea pigs in the normal control group and the untreated group were administered with normal saline. UDCA and YGLDG were given to the guinea pigs in the corresponding groups for seven weeks. Eight guinea pigs of each group were used to measure the glucose infusion rate (GIR) by using hyperinsulinemic-euglycemic clamp technique. At the end the guinea pigs were killed and their gallstone formation was observed. Results: The gallstones in guinea pigs were identified as cholesterol stones by qualitative analysis through infrared spectrum. The incidence rate of cholelithiasis of the untreated group was 82.35% . The GIR of guinea pigs in the untreated group was obviously lowered down as compared with the normal control group. Compared with the untreated group, the GIRs of the YGLDG group and the UDCA group were obviously increased, especially in the YGLDG group. Conclusion: YGLDG may improve insulin resistance in guinea pigs with cholesterol gallstones by elevating GIR obviously.

OBJECTIVE: To study the mechanisms of Tongxia Huayu Decoction (a Chinese herbal decoction for purgation and removing blood stasis) in prognostic improvement for severe acute pancreatitis by early intervention on pancreatic microcirculatory disturbance. METHODS: Fifty-three patients with severe acute pancreatitis were divided randomly into treatment group (n=28) and control group (n=25). Tongxia Huayu Decoction was given to the patients in treatment group in addition to the normal treatment in control group for one week. The clinical symptoms and signs, hemodiastase, urinary amylase, C-reactive protein (CRP) and endothelin (ET) of the patients in the two groups before and after treatment were observed and detected. RESULTS: The total response rate of the treatment group was 98.4%, while that of the control group was 80%, with significant difference between them (P<0.05). There was no significant difference of the contents of hemodiastase, urinary amylase, CRP and ET between the two groups before treatment, while they were significantly decreased after treatment (P<0.01) with more obvious change in treatment group (P<0.01). CONCLUSION: Tongxia Huayu Decoction brings satisfied therapeutic effect on severe acute pancreatitis. The mechanisms may associate with its reducing function on ET releasing so as to inhibit the pancreatic microcirculatory disturbance and acinar cell injury induced by ET.