In this paper, the theoretical and experimental researches concerning the prevention and treatment of myocardial ischemia/reperfusion (I/R) injury by Chinese medicine (CM) therapy of activating blood circulation and removing stasis in recent five years were reviewed, and the mechanisms were summarized. Thereby, based upon the current development of molecular biology and application of new technology, the authors offered their suggestions on the emphasized points and methods of present CM study in this scope.
Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Myocardial Ischemia ; drug therapy ; Myocardial Reperfusion Injury ; drug therapy ; prevention & control ; Phytotherapy

Fourteen compounds were isolated from 95% ethanol extract by silica gel, MCI, and ODS column chromatography. These compounds were respectively identified as quercetin (1), kaempferol (2), (+)-catechin (3), fraxin (4), protocatechuic acid (5), gallic acid (6), methyl gallate (7), ethyl gallate (8), apocynol A (9), baccatin (10), cerevisterol (11), ellagic acid (12), 3, 3',4'-tri-0-methylellagic acid(13) and N-benzoyl-L-phenylalaninyl-N-benzoyl-L-phenylalaninate(14) by analyzing their spectral data and comparing with the previously reported literatures. Except for gallic acid (6), all other compounds were isolated from this plant for the first time. Compounds 1, 2 and 6 showed moderate anti-proliferation activities on tumor cells.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Euphorbiaceae ; chemistry ; Humans ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To systematically evaluate the clinical efficacy of relieving fever with sweet and warm drugs (Ganwen Chure Therapy) for noninfectious fever caused by vital-energy deficiency based on Meta-analysis. Methods Literature about RCTs of Ganwen Chure Therapy for noninfectious fever caused by vital-energy deficiency in CNKI, Wanfang Database, CBM, VIP, Pub Med, Cochrane Library, and Embase was retrieved by computers from establishment of database to April 2017. After two researchers independently conducted literature screening, cross-checking, data extraction, and literature quality evaluation, cumulative Meta-analysis was performed on the outcome indicators in order of publication time and sample size, and the trend of the results was tested. Then the quality of the literature based on GRADE was under an overall evaluation. Results Totally 27 articles were included in this study, involving 2599 patients. The results of cumulative Meta-analysis showed that the total effective rates of using Ganwen Chure Therapy only [OR=3.875, 95％CI (2.87, 5.24), Z=8.82, P=0.000 1]and Ganwen Chure Therapy combined with routine therapy [OR=5.791, 95％CI (3.55, 9.45), Z=7.03, P=0.000 1]were better than the routine therapy, with statistical significance. Trend test showed that there was variability in the timing of drug combination study, showing that the cumulative Meta-analysis results were not stable. Conclusion Ganwen Chure Therapy has certain efficacy for noninfectious fever caused by vital-energy deficiency. However, the overall quality of the included studies was low, with relatively high homogeneity. There are biases in publication, yet more high-quality clinical research is needed for further verification.

Sixteen compounds have been isolated from the EtOAc fraction of 95% ethanolic extract of Sophora dunnii through silica gel, Sephadex LH-20 and semi-prerarative HPLC column chromatographies. Their structures were identified on the basis of NMR and MS spectra data as phaseollidin (1), L-maackiain (2), 2-(2',4'-dihidroxyphenyl)-5,6-methylenedioxy benzofuran (3), 8-demethyl-farrerol (4), liquiritigenin (5), genistein (6), 6-methylgenistein (7), 5-O-methyl genistein (8), 7,2',4'-trihydroxys-5-methoxy-isoflavanone (9), 7, 3', 4'-trihydroxy-isoflavanone (10), erythribyssin D (11), calycosin (12), trans-resveratrol (13), cis-resveratrol (14), stigmasterol (15), β-sitosterol (16). Among these, compounds 1-14 and 16 were isolated from this plant for the first time.
Chemical Fractionation ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Sophora ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

BACKGROUNDNon-valvular atrial fibrillation is associated with an increased risk of ischemic stroke; however, the appropriate intensity of anticoagulation therapy for Chinese patients has not been determined. The purpose of this study was to compare the safety and the efficacy of standard-intensity warfarin therapy, low-intensity warfarin therapy, and aspirin therapy for the prevention of ischemic events in Chinese patients with non-valvular atrial fibrillation (NVAF).

METHODSA total of 786 patients from 75 Chinese hospitals were enrolled in this study and randomized into three therapy groups: standard-intensity warfarin (international normalized ratio (INR) 2.1 to 2.5) group, low-intensity warfarin (INR 1.6 to 2.0) group and aspirin (200 mg per day) group. All patients were evaluated by physicians at 1, 3, 6, 9, 12, 15, 18, 21 and 24 months after randomization to obtain a patient questionnaire, physical examination and related laboratory tests.

RESULTSThe annual event rates of ischemic stroke, transient ischemic attack (TIA) or systemic thromboembolism were 2.6%, 3.1% and 6.9% in the standard-intensity warfarin, low-intensity warfarin and aspirin groups, respectively (P = 0.027). Thromboembolic event rates in both warfarin groups were significantly lower than that in the aspirin group (P = 0.018, P = 0.044), and there was no significant difference between the two warfarin groups. Severe hemorrhagic events occurred in 15 patients, 7 (2.6%) in the standard-intensity warfarin group, 7 (2.4%) in the low-intensity warfarin group and 1 (0.4%) in the aspirin group. The severe hemorrhagic event rates in the warfarin groups were higher than that in the aspirin group, but the difference did not reach statistical significance (P = 0.101). The mild hemorrhagic and total hemorrhagic event rates in the warfarin groups (whether in the standard-intensity warfarin group or low-intensity warfarin group) were much higher than that in the aspirin group with the annual event rates of total hemorrhages of 10.2%, 7.6% and 2.2%, respectively, in the 3 groups (P = 0.001). Furthermore, there was no significant difference in all cause mortality among the three study groups.

CONCLUSIONIn Chinese patients with NVAF, the warfarin therapy (INR 1.6 - 2.5) for the prevention of thromboembolic events was superior to aspirin.

Aged ; Aged, 80 and over ; Anticoagulants ; administration & dosage ; therapeutic use ; Aspirin ; administration & dosage ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Warfarin ; administration & dosage ; therapeutic use

OBJECTIVETo investigate the mRNA and protein expressions of 11beta-Hydroxysteroid dehydrogenase type 2 (11betaHSD2) in patients with atrial fibrillation.

METHODSRight and left atrial lateral wall tissue samples were obtained during mitral/aortic valve replacement operation from 25 patients with rheumatic heart valve disease (12 in sinus rhythm and 13 in chronic atrial fibrillation). Realtime quantitative PCR and Western blot were used to determine the mRNA and protein expressions of 11betaHSD2 in atria specimens. The distribution of 11betaHSD2 in human atrial tissue was analyzed by specific immunohistochemical staining. Echocardiography examination was performed before operation.

RESULTSThe left atrial diameters were significantly higher in the atrial fibrillation group as compared to sinus rhythm group (P < 0.01). Similarly, mRNA expression of 11betaHSD2 (0.86 +/- 0.14 vs 0.33 +/- 0.12 in right atria, 0.95 +/- 0.15 vs 0.37 +/- 0.10 in left atria, all P < 0.01) and protein expression of 11betaHSD2 (1.18 +/- 0.64 vs 0.71 +/- 0.21 in right atria, P < 0.01; and 1.36 +/- 0.58 vs 0.85 +/- 0.15 in left atria, P < 0.05) were also significantly upregulated in atrial fibrillation groups than those in sinus rhythm groups. The mRNA and protein expressions of 11betaHSD2 were similar between left atria and right atria both in fibrillation and sinus groups (all P > 0.05). The special immunohistochemical staining demonstrated that 11betaHSD2 was abundant in the human atrial myocardium and located mainly in the cytoplasm.

CONCLUSIONThese findings suggested that upregulated 11betaHSD2 might be associated to the development and persistence of atrial fibrillation.

11-beta-Hydroxysteroid Dehydrogenase Type 2 ; metabolism ; Adult ; Atrial Fibrillation ; metabolism ; physiopathology ; Female ; Heart Atria ; metabolism ; physiopathology ; Humans ; Male ; Middle Aged ; Myocardium ; metabolism ; RNA, Messenger ; genetics ; Rheumatic Heart Disease ; metabolism ; physiopathology

OBJECTIVETo investigate the effect and molecular mechanism of Tiantai No.1, a compound Chinese herbal preparation, for the prevention and reduction of neurotoxicity induced by beta-amyloid peptides (Abeta) in vitro and its effects on nuclear factor-kappa B (NF-kappa B) and cAMP responsive element-binding protein (CREB) pathways using the gene transfection technique.

METHODSB104 neuronal cells were used to examine the effects of Tiantai No.1 on lowering the neurotoxicity induced by Abeta. The cells were pre-treated with Tiantai No.1 at doses of 50, 100, 150, or 200 micro g/mL respectively for 3 days and co-treated with Tiantai No.1 and beta-amyloid peptide1-40 (A beta 1-40, 10 micro mol/L) for 48 h or post-treated with Tiantai No.1 for 48 h after the cells were exposed to beta-amyloid peptides25-35 (A beta 25-35) for 8 h. In gene transfection assays, cells were treated with Tiantai No.1 at 50 micro g/mL and 150 micro g/mL for 5 days or co-treated with Tiantai No.1 and A beta 1-40 (5 micro mo/L) for 3 days after electroporation for the evaluation of NF-kappa B and CREB expression.

RESULTSPre-treating and co-treating B104 neuronal cells with Tiantai No.1 lowered the neurotoxicity induced by Abeta, and post-treating with Tiantai No.1 reduced or blocked B104 neuronal apoptotic death induced by Abeta (P<0.05, P<0.01). With a dose-dependent relationship, the same treatments increased the expression of NF-kappa B or CREB in B104 neuronal cells (P<0.05, P<0.01). Meanwhile, Tiantai No.1 reduced A beta -40 induced inhibition on NF-kappa B expression (P<0.01).

CONCLUSIONSTiantai No.1 can protect neurons against the neurotoxicity induced by Abeta. The neuroprotective mechanisms may be associated with the activation of NF-kappa B and cAMP cellular signal pathways.

Amyloid beta-Peptides ; Animals ; Apoptosis ; drug effects ; Cells, Cultured ; Cyclic AMP Response Element-Binding Protein ; analysis ; Drugs, Chinese Herbal ; pharmacology ; Electroporation ; Luciferases ; Microscopy, Fluorescence ; NF-kappa B ; analysis ; Neurons ; drug effects ; Rats ; Transfection

OBJECTIVETo observe the therapeutic effect of acupuncture combined with massage on irritable bowel syndrome.

METHODSNinety-three cases of irritable bowel syndrome were randomly divided into three groups: group of acupuncture combined with massage (group A), simple acupuncture control group (group B), simple massage control group (group C), 31 cases in each group. Their therapeutic effects were compared.

RESULTSThe cured rate and the effective rate in the group A were significantly higher than those in both group B and group C (P < 0.05).

CONCLUSIONAcupuncture combined with massage therapy shows a better therapeutic effect on irritable bowel syndrome, and they should be jointly used in clinical treatment.

Acupuncture Therapy ; Combined Modality Therapy ; Humans ; Irritable Bowel Syndrome ; therapy ; Massage

OBJECTIVETo explore the protecting mechanism of Yixintong for heart ischemia-reperfusion injury at cellular and subcellular levels, by observing the effects of Yixintong on three kinds of calcium channels.

METHODThe effects of Yixintong on Ca2+ influx on leak calcium channel, receptor-operationg calcium channel (ROC) and pulse-dependent calcium channel (PDC) were observed respectively, by using rat aortic smooth muscle cell and radioactive 45Ca technique.

RESULTYixintong has no effects on leak calcium channel, but can inhibit the Ca2+ influx in ROC and PDC significantly.

CONCLUSIONYixintong can inhibit the Ca2+ influx in slow channel in a dose-dependent manner.

Animals ; Aorta ; cytology ; Calcium Channels ; drug effects ; Crataegus ; chemistry ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Flavonoids ; isolation & purification ; pharmacology ; Male ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; drug effects ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar