The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

BACKGROUND:Neuroblastoma is a common solid tumor in children. Pediatric tumors are little affected by environmental factors, but closely related to child development. The suspension method is an effective and reliable method to harvest neoplastic stem cel s.
OBJECTIVE:To culture the cel clones of human neuroblastoma cel line SK-N-SH and to assess the biological properties of the cel clones.
METHODS:Using the suspension method with no serum media, tumor cel clones were obtained. Immunofluorescence method was used to identify whether tumor cel clones exhibit stem cel properties. SK-N-SH neuroblastoma was labeled by luciferase, and tumor cel clones and tumor cel s were seeded onto the back of nude mice to monitor cel proliferative properties in nude mice using in vivo imaging.
RESULTS AND CONCLUSION:Using the suspension culture method, SK-N-SH neuroblastoma cel s could successful y develop into cloning bal s. Under serum-free culture, cloning bal s were immunofluorescently used to detect molecular markers that showed strong positive expression. Cloning bal s subcutaneously implanted into
nude mice showed the strong ability of self-renewal and differentiation as stem cel s. The cel clones cultured by the suspension method strongly expressed Nestin, but weakly expressed glial fibril ary acidic protein, neuron-specific tubulin, possessing stem cel characteristics and strong proliferation and metastasis in nude mice.

Objective To discuss the effective treatments for fracture of the medial humeral epicondyle in children.Methods Twenty-five children with fracture of the medial humeral epicondyle treated from January 2008 to June 2011 were studied,including 18 males and 7 females at age of 7-14 years (mean,11.4 years).There were 7 cases accompanied with elbow joint dislocation and 2 lateral humeral epicondyle fracture.Patients were assigned to medial elbow approach to open reduction and internal fixation with absorbable rods (Group A,n =13) and open reduction and percutaneous K-wire fixation (Group B,n =12) according to the random number table.A plaster support was applied after surgery.Functional training was initiated 2-3 weeks after operation for Group A and 4-6 weeks after adequate callus formation for Group B.Moreover,follow-up was performed at regular intervals.Results All patients were followed up for 6-41 months (mean,22 months).Mean healing time was 3.8 weeks (range,3-5 weeks) in Group A and 5.6 weeks (range,4-8 weeks) in Group B.At postoperative 6 months,Bede elbow performance score was (93.7 ± 3.3) points in Group A with 10 excellent and 3 good results and (85.3 ±6.3) points in Group B with 3 excellent,7 good,and2 fair results (t=-4.24,P＜0.05).Conclusion Open reduction and internal fixation with absorbable rods gains advantages of rigid immobilization,functional recovery and minor complication and hence is effective for treatment of medial humeral epicondyle fracture in children.

ObjectiveTo investigate the clinical effects of minimally invasive incision in anterior traverse approach for Gartland type Ⅲ humeral supracondylar fractures in children.Methods Forty-two patients with Gartland type Ⅲ displaced supracondylar fractures of the humerus were treated through anterior traverse approach between January 2008 and April 2011.The fractures were fixed using two Kirschner wires from the medial and lateral epicondyles placed crossing each other.There were 31 males and 11 females,at age of 2.6-12 years (average 5.7 years).Three patients were with open fractures.Seven patients were combined with other fractures,four with radial nerve injury and one with median nerve injury,with time from injury to hospitalization for a range of 1 hour to 3 days.Of all the patients,30 patients were with fractures on the right side and 12 with fractures on the left side.All fractures were treated by minimally invasive incision in anterior traverse approach,when the neurovascular and muscular probing and repair were performed. Results Forty patients were followed up for 3-32 months ( average 13 months),which showed incision healing at one stage,with fracture healing time for 3-4 weeks (average 3.6 weeks).No cubitus varus or incision scar were found after operation.According to Flynn' s criteria,the effect of treatment three months after operation were excellent in 32 patients,good in four and fair in four,with excellence rate of 90％.ConclusionsThe minimally invasive incision of anterior traverse approach is characterized by minor trauma,small incision,nil scar and convenient neurovascular and muscular exploration and hence is a safe and reliable treatment for open reduction of Gartland type Ⅲ humeral supracondylar fractures in children.

Objective To investigate the effect of intramedullary stabilization of lower limb fractures with titanium elastic nails (TENs) in children.Methods From June 2004 to October 2010,278 children were stabilized with TENs in our hospital,including 181 boys and 97 girlsat average age of 7.6 years (range,3.0-14 years).There were 162 patients with femoral fractures,of which 35 underwent open reduction and the rest closed reduction.There were 116 patients with tibial fractures,which was treated with closed reduction.Postoperative fixation lasted for 3-4 weeks.The mean hospital stay was seven days.Of all the patients,272 patients received the removal of the TENs six months after operation and 242 received more than one year of follow-up to have a further observation on the limb length,hip and knee mobility and gait condition in children.Results All the patients were followed up for 6-66 months (mean,33 months).All fractures were healed in good alignment without severe complications.There were no intraoperative complications like infections,delayed union,nonunion,TEN broken and femoral or tibial epiphysis injuries.Ten patients suffered from swell and skin irritation in the nail' s position 3-4 months after operation,and the nails were removed in advance.Nineteen patients showed unequal lengths ( within 1 cm) of the lower limbs,with normal function of the lower limb joint but with no obvious limp.According to the Flynn evaluation standard,the excellent and good rate was 100％.Conclusions Characterized by good stability,rapid healing,small incision,anatomic reduction,unimpaired periosteum,short hospital stay and few complications,intramedullary stabilization with titanium elastic nails can achieve effective fixation in the treatment of lower limb fractures in children.

OBJECTIVETo screen the factors that affect indirubin-generated significantly in the process of preparing indigo naturalis, optimize level combination and determine the optimum technology for indirubin-generated.

METHODUsing concentration of indirubin (mg x g(-1)) that generated by fresh leaf as an index, Plackett-Burman design, Box-Behnken design response surface analysis as the statistical method, we screened the significantly influencing factors and the optimal level combination.

RESULTThe soaking and making indirubin process in preparing indigo naturalis was identified as the wax is not removed before immersion with immersion pH 7, solvent volume-leaf weight (mL: g)15, soaked not avoided light, soaking 48 h, temperature 60 degrees C, ventilation time of 180 min, and added ammonia water to adjust pH to 10.5.

CONCLUSIONThe soaking and making indirubin process in preparing indigo naturalis is optimized systematically. It clarify the various factors on the impact of the active ingredient indirubin which controlled by industrialized production become reality in the process of preparing indigo naturalis, at the same time, it lay the foundation for processing principle of indigo naturalis.

Control Groups ; Dose-Response Relationship, Drug ; Hydrogen-Ion Concentration ; Indigo Carmine ; Indigofera ; chemistry ; Indoles ; chemical synthesis ; chemistry ; isolation & purification ; metabolism ; Myanmar ; Plant Leaves ; chemistry

Accessed to literatures at home and abroad, we introduced the process of indigo naturalis transforming from dyestuff industry into pharmaceutical industry. It is affirmed that the precursors of indigo and indirubin are isatan A, isatan B, isatan C and indicant. Meanwhile, author clarified the mechanism of transformation for these precursors transforming into indigo and indirubin. And we summarized methods of determination for these precursors. In summary, these references provide us accordance of study on processing principle of Indigo naturalis, and lay the foundation for technics of making indigo and indirubin entering into modern industry.
Indigo Carmine ; Indoles ; chemistry ; metabolism ; Oxidation-Reduction ; Pigmentation ; Plants ; metabolism ; Temperature