OBJECTIVETo explore combination rules of Chinese herbal prescriptions from effective cases for treatment of unstable angina (UA).

METHODSPrescription data from 156 UA patients effectively treated at Cardiovascular Diseases Centre of Xiyuan Hospital were analyzed using complex network method.

RESULTSAccording to multi-scale analysis of backbone network and pointwise mutual information analysis, core prescriptions from the 156 UA patients were presented as follows: Rhizoma Ligustici wallichii, Radix Paeoniae rubra, Radix Codonopsis, Rhizoma Pinelliae, poria, and Angelica sinensis. Meanwhile, core couplet medicines for these patients covered Rhizoma Ligustici wallichii and Radix paeoniaerubra, Angelica sinensis and Rhizoma Ligustici wallichii, Radix Codonopsis and Rhizoma Ligustici wallichii, Rhizoma Ligustici wallichii and Rhizoma Pinelliae, Rhizoma Atractylodis Macrocephalae and poriacocos, Bulbus Alli Macrostemi and Rhizoma Pinelliae. Among different primary symptoms, there was slightly difference in core prescriptions.

CONCLUSIONThe core prescriptions for the treatment of UA include blood-activating drug, phlem-resolving drugs. As an exploration of combination rules of Chinese herbal prescriptions in treating UA based on complex network, it can be used as a reference for further researches.

Angelica sinensis ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; standards ; therapeutic use ; Humans ; Pinellia ; Plant Roots ; Practice Guidelines as Topic ; Prescriptions ; standards

Limonin existed in citrus fruits has been shown to have anti-bacterial, anti-viral, anti-feedant, anti-nociceptive, anti-inflammatory activities and anti-carcinogenic activities. But the clinical use is limited by its low bioavailability. The aim of this study is to observe the absorption and secretion transport mechanisms of limonin in intestine which can pave the way for the further study and clinical use. The transport characteristics and mechanisms of limonin in rat were studied by in situ intestine perfusion and in vitro Caco-2 cells method. The intestinal absorption of limonin was probably via a facilitated diffusion pathway which was poor and without segment-selection. Verapamil and ketoconazole improved the absorption remarkably according to the result of in vitro Caco-2 cells study; however, probenecid had no significant effect on the absorption. The P-gp efflux and CYP3A4 metabolism were involved in the poor intestinal absorption and low bioavailability of limonin. The exploration of the intestinal absorption mechanism is crucial to the design of dosage form and clinical use of limonin.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Animals ; Biological Availability ; Biological Transport ; drug effects ; Caco-2 Cells ; Cytochrome P-450 CYP3A ; metabolism ; Dose-Response Relationship, Drug ; Humans ; Intestinal Absorption ; drug effects ; Ketoconazole ; pharmacology ; Limonins ; administration & dosage ; pharmacokinetics ; Male ; Perfusion ; Probenecid ; pharmacology ; Rats ; Verapamil ; pharmacology

Animals ; Arrestins ; metabolism ; Hypoxia ; metabolism ; Male ; Prefrontal Cortex ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; metabolism ; beta-Arrestin 1 ; beta-Arrestins

Objective To discuss the treatment of renal or adrenal tumor with cancer thrombus in the inferior vena cava. Methods From Jan 1984 to Apr 2008,29 cases of renal or adrenal malignancy with thrombosis involving the inferior vena cava underwent treatment.The diagnoses were confirmed by Doppler uhrasonography,CT and MRI.In the 29 surgical patiens the tumor thrombus was level I in 7,level Ⅱ in 10,level Ⅲ in 8 and levelⅣin 4.According to TNM classification,23 cases were classified to T2N.M.,1 case was T2Nl Mo,1 case was TzNlMl,1 case was T3NoMo,2 case were T3NlMl and 1 case was T3N2Mo.The mean tumor size was 8.7(4.O-16.O)cm in diameter.The mean tumor thrombosis length was 3.2(2.5-4.0)cm in level I,5.3(4.5-6.0)cm in level Ⅱ,8.2(6.5-9.O)cm in levelⅢand 15.1(12.0-18.5)cm in level IV. Results The operation was performed succesgfullv in 29 patients Patholocieal examination showed that 18 cases of clear cellcarcinoma,3 cases sarcomatoid carcinoma,2 cases renal papillary adenocarcinoma,1 case renal cell carcinoma (undifferentiated),1 case granule carcinoma,3 cases adrenocortical carcinoma and 1 case metastatic malignant melanoma of adrenal gland.Of 29 patients,3 were out of contact.Twenty-six patients were followed up for 35(0-62)months after treatment,3-and 5-year survival rates were 15/26 and 11/26.Three-year survival rates for stage T2 and T3 were 14/22 and 1/4.Five-year survival rates for stage T2 and T3 were 10/22 and 1/4.Three-year survival rates for level I、Ⅱ、Ⅲ andⅣ were 4/6,5/8,5/8 and 1/4.Five-year survival rates for level I,Ⅱ、Ⅲ andⅣ were 3/6,4/8,3/8 and 1/4.Three-year survival rates for a tumor thrombus in the below or above diaphragm were 14/22 versus 1/4,5-year survival rates were 10/22 versus 1/4.Three-year and 5-year survival rates for the patients without distant metastases and lymph node involvement were 12/18 and 9/18.Three-year and 5-year surviral rates for the patients with distant metastases and lymph node involvement were 3/8 and 2/8.The 3 surgical patients with metastatic disease died at 6,10,22 months. Conclusions Surgical treatment could be the preferred approach for the patients of renal or adrenal tumor with cancer thrombus in the inferior vena cava without distant metastases and lymph node involvement.It could improve the quality of life and may prolong survival.

OBJECTIVETo observe the effect of coptis root extract (CRE) on the gene expressions of perilipin and peroxisome proliferator activated receptor gamma (PPAR-gamma) in atherosclerotic plaque of ApoE-gene knockout mice for exploring its plaque stabilizing action and possible mechanism.

METHODSThirty-three ApoE knockout mice, 6-8 weeks old, were fed with high-fat diet for 13 weeks. After mature atherosclerotic plaques being formed, the animals were randomly allocated into the control group, the CRE group, and the simvastatin group (as positive control) , 11 in each group. They were continuously fed with high-fat diet and to the two drug-treated groups, respective drugs in clinically recommended dose were given for another 13 weeks. Then all mice were sacrificed by the end of experiment. The morphology and composition of atherosclerotic plaques in 4 sections of aortic roots were examined with HE and Movat stain, the average number of fibrous caps buried in the plaque was observed and counted, and the gene expressions of perilipin and PPAR-gamma mRNA were determined by Real-time fluorescent quantitative PCR technology.

RESULTSAfter treatment for 13 weeks, the number of fibrous caps and the gene expression of perilipin mRNA in the CRE group was significantly lower (P<0.05), but gene of PPAR-gamma mRNA was higher (P<0.01) than those in the model group.

CONCLUSIONIn a clinically recommended dose, CRE can significantly decrease the frequency of plaque rupture in aorta of ApoE-gene knockout mice and do favour to plaque stability, its mechanism may be related to the promotion of PPAR-gamma mRNA expression and the inhibition of perilipin mRNA expression.

Animals ; Aorta ; pathology ; Apolipoproteins E ; deficiency ; genetics ; Atherosclerosis ; genetics ; pathology ; Carrier Proteins ; Coptis ; chemistry ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation ; drug effects ; Gene Knockout Techniques ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; PPAR gamma ; genetics ; Perilipin-1 ; Phosphoproteins ; genetics ; Plant Roots ; chemistry ; RNA, Messenger ; genetics ; metabolism ; Time Factors

In the postgenomic era, the contents of methodology of human genomics researching is similar to the views of holism and syndromes differentiation of traditional Chinese medicine. So far, many scholars have probed beneficially into the essence of syndrome on the gene level. Since the syndrome of TCM have close intrinsic relations with not only the difference of gene expression but also the gene polymorphisms, therefore, it is capable, taking this as a cut-in point, to clarify the essential of syndrome by fully applying the advanced experimental methods and detecting techniques to deeply investigate the gene difference expression spectra based on the study of the relationship between gene polymorphisms and syndrome susceptibility, and analyze the regulatory network of the related genes from the view of functional genomics.
Diagnosis, Differential ; Gene Expression Profiling ; Genomics ; Humans ; Medicine, Chinese Traditional ; Research Design ; Syndrome

OBJECTIVETo comparatively study the expressive conditions of platelet activation related factors (GP I b, GP II b- III a and GMP-140) in healthy subjects and patients with coronary heart disease (CHD) of blood-stasis (BS) or non-blood-stasis (non-BS) syndrome, and to analyze the relationship between the activities of various glycoproteins and the polymorphism of genes.

METHODSWith case control design adopted, patients with the CHD (40 of BS, 37 of non-BS) and 39 healthy subjects for control, all fitting to the inclusion criteria, were selected in this study. The number of affected coronary branches was recorded by the contrast examination. The mean fluorescence intensity (MFI) of GP I b, GP II b- III a, and GMP-140 (CD42b, CD61, CD62p) in patients and healthy persons was measured with flow cytometry, the polymorphism of HPA-3 gene was detected by Taqman probe technique and that of HPA-2 gene was determined by gene sequencing.

RESULTSMFI of CD61 and CD62p was higher in the CHD patients than in the healthy control, which was also higher in patients of BS syndrome than in patients of non-BS syndrome (P<0.05); MFI of CD42b was lower in the CHD patients than in the healthy control (P<0.05), but showing insignificant difference between BS and non-BS syndrome (P>0.05); at the same time, no significant difference of all the above-mentioned three MFI could be found in patients with various numbers of affected coronary branches, neither in patients with different genotypes at GP II b HPA-3 and GP I b HPA-2 polymorphism loci (P>0.05).

CONCLUSION(1) The activities of GP II b- III a and GMP-140 were obviously increased in the genesis and developing process of CHD and CHD of BS syndrome, and so they could be taken as one of the objective indexes for microscopic diagnosis of BS syndrome. (2) The level of GP I b was lower in CHD patients than in healthy persons, but it was not a sensitive indicator for BS syndrome of CHD. (3) Levels of GP II b- III a, GP I b and GMP-140 were not related with the number of affected coronary branches in CHD patients. (4) The changes in amino-acids expression induced by the two loci brought no significant influence on GP I b and GP II b- III a activities.

Coronary Disease ; blood ; genetics ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; P-Selectin ; blood ; genetics ; Platelet Activating Factor ; analysis ; genetics ; Platelet Glycoprotein GPIIb-IIIa Complex ; analysis ; genetics ; Platelet Glycoprotein GPIb-IX Complex ; analysis ; genetics

Information on co-adherence of different oral bacterial species is important for understanding interspecies interactions within oral microbial community. Current knowledge on this topic is heavily based on pariwise coaggregation of known, cultivable species. In this study, we employed a membrane binding assay coupled with polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) to systematically analyze the co-adherence profiles of oral bacterial species, and achieved a more profound knowledge beyond pairwise coaggregation. Two oral bacterial species were selected to serve as "bait": Fusobacterium nucleatum (F. nucleatum) whose ability to adhere to a multitude of oral bacterial species has been extensively studied for pairwise interactions and Streptococcus mutans (S. mutans) whose interacting partners are largely unknown. To enable screening of interacting partner species within bacterial mixtures, cells of the "bait" oral bacterium were immobilized on nitrocellulose membranes which were washed and blocked to prevent unspecific binding. The "prey" bacterial mixtures (including known species or natural saliva samples) were added, unbound cells were washed off after the incubation period and the remaining cells were eluted using 0.2 mol x L(-1) glycine. Genomic DNA was extracted, subjected to 16S rRNA PCR amplification and separation of the resulting PCR products by DGGE. Selected bands were recovered from the gel, sequenced and identified via Nucleotide BLAST searches against different databases. While few bacterial species bound to S. mutans, consistent with previous findings F. nucleatum adhered to a variety of bacterial species including uncultivable and uncharacterized ones. This new approach can more effectively analyze the co-adherence profiles of oral bacteria, and could facilitate the systematic study of interbacterial binding of oral microbial species.
Adult ; Animals ; Bacterial Adhesion ; DNA, Bacterial ; analysis ; Denaturing Gradient Gel Electrophoresis ; Fusobacterium nucleatum ; physiology ; Humans ; Membranes, Artificial ; Mice ; Microbial Interactions ; physiology ; Polymerase Chain Reaction ; Protein Binding ; Saliva ; microbiology ; Streptococcus mutans ; physiology

OBJECTIVETo initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM).

METHODSBased on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses.

RESULTSThe treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600).

CONCLUSIONAs a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.

Angina, Unstable ; therapy ; Decision Making ; Decision Support Systems, Clinical ; Humans ; Integrative Medicine ; Markov Chains

OBJECTIVETo observe the effects of active ingredients from Chinese drugs for activating blood circulation and detoxicating, including notoginseng saponins (drug 1), Coptis chinensis (drug 2), giant knotweed rhizome (drug 3) and rhubarb (drug 4), on blood lipids and inflammatory reaction of aortic atherosclerotic plaques in ApoE knockout mice.

METHODSApoE knockout mice were fed with high-fat diet for 26 weeks, then they were randomized into 6 groups, the untreated model group and the test groups treated with various test drugs respectively. After ending the 13 weeks of treatment, all the mice were sacrificed with their blood lipids detected, and their heart and aorta were taken out to make slices with paraffin embedding. Four sections from aortic root of each mouse were chosen to measure and calculate the percentage of lipid core (LC) in the total area of plaque (TP) and the lipid/collagen ratio (L/C) in the plaque by HE and Movat staining respectively, and the mean value of the four sections was taken for analysis. The expressions of granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumor necrosis factor-alpha (TNF-alpha) in mice's aorta root were determined by immunohistochemical staining as well.

RESULTSAfter being treated for 13 weeks, either the percentage of LC in TP and the L/C ratio was significantly lower in all the test drug treated groups than those in the model group, respectively (P < 0.01), especially prominent in the group treated with drug 3. Although lowering of the two indexes presented in all the 3 groups treated by drug 1, 2 and 3, significant difference still presented between drug 3 treated group vs drug 1 and 2 treated group (P < 0.05). As for the expressions of GM-CSF and TNF-alpha, in comparing with the untreated model group, significant decreasing of the TNF-alpha showed only in the drug 4 treated group, while that of GM-CSF could be found in all the test drug treated groups (P < 0.05).

CONCLUSIONAll the 4 drugs tested in the recommended dosage can stabilize the vulnerable plaques in ApoE knockout mice by improving the constitution of plaque, among them, drug 3 and 4, the drugs possess both the actions of activating blood circulation and detoxicating, show more significant effect, and their mechanisms may be related to their actions in regulating lipid metabolism and inhibiting inflammatory reaction.

Animals ; Aorta ; drug effects ; metabolism ; pathology ; Apolipoproteins E ; genetics ; Atherosclerosis ; blood ; pathology ; prevention & control ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Granulocyte-Macrophage Colony-Stimulating Factor ; analysis ; Immunohistochemistry ; Lipids ; analysis ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Random Allocation ; Saponins ; pharmacology ; Tumor Necrosis Factor-alpha ; analysis