Objective:To evaluate clinical efficacy of Xuanbai Chengqi Decoction in the treatment of severe pneumonia with gastrointestinal dysfunction of syndrome of lung heat and fu-organ excess; To discuss its effects on short chain fatty acid (SCFA)/G protein coupled receptor 43 (GPR43) axis.Methods:It was a randomized controlled trial. From January 2020 to January 2022, 60 hospitalized patients with severe pneumonia complicated with gastrointestinal dysfunction (syndrome of lung heat and fu-organ excess) in the Intensive Care Department and Emergency Intensive Care Unit of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were selected as the observation subjects. They were divided into experimental group and control group according to random number table method, with 30 cases in each group. Patients in the control group were treated with conventional Western medicine, while patients in the experimental group received Xuanbai Chengqi Decoction combined with conventional Western medicine. Both groups were treated continuously for 7 days and followed up for 28 days. TCM syndrome scores were evaluated before and after treatment. Clinical Pulmonary Infection Score (CPIS) was used to assess pulmonary infection, Gastrointestinal Dysfunction Score (GIDS) was used to assess the degree of gastrointestinal dysfunction, and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was used to assess the prognosis. ELISA was used to detect levels of procalcitonin (PCT), IL-6, CRP, D-lactate (D-LA), short chain fatty acids (SCFA), and G protein coupled receptor 43 (GPR43). The fully automated blood analyzer (flow cytometry) was used to detect white blood cells (WBC) and the proportion of neutrophils (N%). Indirect bladder pressure measurement method was used to measure the intra-abdominal pressure of patients. During treatment, the adverse reactions or events were recorded. Patients were followed up for 28 days and the 28-day mortality rate was recorded.Results:The total effective rate was 73.33% (22/30) in the experimental group and 40.00% (12/30) in the control group, with statistical significance ( χ2=6.79, P<0.05). After treatment, TCM syndrome scores, CPIS, GIDS, and APACHEⅡ score in the experimental group were lower than those in the control group ( t values were 2.84，3.34，2.75，3.05，respectively， P<0.01), serum PCT [(0.35 ± 0.11) μg/L vs. (0.64 ± 0.10) μg/L, t=2.45], IL-6 [(19.33 ± 3.54) ng/L vs. (60.13 ± 15.01) ng/L, t=2.98], N% [(78.84 ± 2.09)% vs. (83.30±2.31)%, t=3.43], and CRP [(28.43 ± 6.38) mg/L vs. (54.48 ± 9.03) mg/L, t=4.02], intra-abdominal pressure [(9.11 ± 2.55) mmHg vs.(11.70 ± 3.02) mmHg, t=7.78] and D-LA [(0.11±0.05) mmol/L vs. (0.18±0.12) mmol/L, t=6.45] in the experimental group were lower than those in the control group ( P<0.05 or P<0.01). After treatment, serum SCFA [(48.18 ± 36.31) μmol/L vs. (35.10 ± 19.32)μmol/L, t=1.95] and GPR43 [(1 254.61 ± 437.40) ng/L vs. (990.15 ± 403.03) ng/L, t=2.13] in the experimental group were higher than those in the control group ( P<0.05). The 28-day mortality rates of the experimental group and the control group were 20.00% (6/30) and 46.67% (14/30) respectively, with statistical significance ( χ2=4.80, P<0.05). During the trial, there were no serious adverse reactions or adverse events in either group. Conclusion:Xuanbai Chengqi Decoction can effectively treat severe pneumonia complicated with gastrointestinal dysfunction. The mechanism may involve the up-regulation of SCFA/GPR43 axis.

OBJECTIVE To explore the effect of Xuanbai Chengqi Decoction on respiratory and oxygenation functions and the ex-pression levels of serum aquaporin(AQP)1 and AQP5 in patients with severe pneumonia complicated with gastrointestinal dysfunction of lung heat and fu-organ repletion type.METHODS 60 patients with severe pneumonia complicated with gastrointestinal dysfunc-tion of lung heat and fu-organ repletion type were randomly divided into control group and treatment group,with 30 cases each.The control group received standardized Western medicine treatment,and the treatment group was treated with Xuanbai Chengqi Decoction in addition to the control group.Both groups were treated for 7 d.The respiratory rate and oxygenation index,mechanical ventilation u-tilization rate,the clinical score including CURB-65 and CPIS scores,TCM syndrome score,gastrointestinal function indicators inclu-ding intra-abdominal pressure,serum gastrin(GAS)and vasoactive intestinal peptide(VIP),AQP1 and AQP5 levels were compared between the two groups before and after treatment.Ventilation utilization and ICU hospitalization days during treatment were compared between the two groups.RESULTS After treatment,compared with the control group,the respiratory rate,TCM syndrome score and intra-abdominal pressure in the treatment group were decreased significantly(P<0.05,P<0.01);meanwhile,the oxygenation index and the levels of serum GAS,AQP1 and AQP5 were increased significantly(P<0.05,P<0.01).CONCLUSION Xuanbai Chengqi Decoction can significantly improve clinical symptoms such as respiratory and oxygenation functions in patients,and its mechanism may be related to the regulation of AQP1 and AQP5.

Objective To investigate the effects of Ligustrazine on TNF-α-induced TGF-β and CTGF expression in human peritoneal mesothelial cells (HPMCs). Methods HPMCs were isolated from human omenta by trypsin di-gestion. Then, the subcultured HPMCs were divided into control group, TNF-α-induced (1 μg/L) group and TNF-α-induced plus low-, medium-and high-dose Ligustrazine (10, 20 and 40 mg/L Ligustrazine respectively) groups. The viability of HPMCs was measured by MTT assay. RT-PCR was used to detect the expressions of TGF-β1 and CTGF mRNAs in HPMCs. TGF-β1 and CTGF in supernatants were measured by ELISA. Cell protein concentration was measured by trace bicinchoninic acid (BCA) method to validate the ELISA assay results. Results Ligustrazine significantly decreases TNF-α-induced TGF-β1 and CTGF expression in a dose-dependent manner at both protein and gene levels ( P < 0. 05 ). In addition, medium-and high-dose Ligustrazine injection significantly ameliorates the viability of HPMCs inhibited by TNF-α ( P < 0. 05 ). Conclusion Ligustrazine inhibits expressions of TGF-β and CTGF of HPMCs in an inflammatory conditions.

To investigate the effects of ligustrazine injection on type I collagen, matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) expressions in human peritoneal mesothelial cells (HPMCs) cultured in high glucose conditions.

Objective To investigate the effects of Ligustrazine on TNF-?-induced TGF-?1 and CTGF expression in human peritoneal mesothelial cells (HPMCs). Methods HPMCs were isolated from human omenta by trypsin digestion. Then,the subcultured HPMCs were divided into control group,TNF-?-induced (1 ?g/L) group and TNF-?-induced plus low-,medium-and high-dose Ligustrazine (10,20 and 40 mg/L Ligustrazine respectively) groups. The viability of HPMCs was measured by MTT assay. RT-PCR was used to detect the expressions of TGF-?1 and CTGF mRNAs in HPMCs. TGF-?1 and CTGF in supernatants were measured by ELISA. Cell protein concentration was measured by trace bicinchoninic acid (BCA) method to validate the ELISA assay results.ResultsLigustrazine significantly decreases TNF-?-induced TGF-?1 and CTGF expression in a dose-dependent manner at both protein and gene levels (P