1.Mechanism of Huangqintang in Treatment of Ulcerative Colitis and Related Colon Cancer: A Review
Xue FENG ; Yaqing LIU ; Bin LIU ; Xuran MA ; Dunfang WANG ; Weipeng YANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(7):1-10
Ulcerative colitis (UC) is a chronic intestinal disease with unknown etiology, with main symptoms of abdominal pain, diarrhea, mucus, pus, and blood in the stool. It can be accompanied by various complications and has a high risk of developing to colon cancer. In recent years, the incidence of UC and related colon cancer has been increasing, which seriously affects human health and quality of life. The operation, immunosuppressant, etc. are the main approaches in the modern clinical treatment of UC and related colon cancer, but these methods all have different toxic and side effects, and the therapeutic effect is not ideal. For many years, traditional Chinese medicine (TCM) has attracted much attention in the treatment of UC and related colon cancer due to its slightly toxic side effects and remarkable curative efficacy. Huangqintang, derived from the Shang Han Lun (伤寒论), is composed of Scutellariae Radix, Paeoniae Radix Alba, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus with the functions of clearing heat, checking diarrhea, harmonizing the middle, and relieving pain, and has a significant effect on the treatment of UC. Huangqintang has complex compositions and plays roles with multiple targets and pathways. According to the literature and the research results of this research group for many years, it was found that the mechanism of Huangqintang in the treatment of UC and related colon cancer was presumably related to the protection of the intestinal mucosal barrier, inhibition of inflammatory response, promotion of mitophagy, inhibition of oxidative stress, regulation of intestinal flora, cell cycle, and gene expression, suppression of cell proliferation, and promotion of apoptosis. To provide theoretical references for an in-depth study of the mechanism and clinical use of Huangqintang, this paper reviewed the research advances in recent years.
2.Effect of Huangqintang on Intestinal Flora in Mice with Ulcerative Colitis and Its Protective Mechanism on Intestinal Mucosal Barrier
Yaqing LIU ; Hangyu XU ; Dunfang WANG ; Bin LIU ; Xuran MA ; Xue FENG ; Weipeng YANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(7):11-19
ObjectiveTo evaluate the pharmacodynamic effect of Huangqintang (HQT) on ulcerative colitis (UC) model mice and investigate its protective effect against UC by regulating intestinal flora. MethodMale Balb/c mice were randomly divided into control group,model group, high-, medium-, and low-dose HQT groups (20, 10, 5 g·kg-1), flora interference group, flora interference model group, and flora interference-drug treatment group (HQT, 20 g·kg-1). The flora interference model was constructed through intragastric administration of antibiotics (200 mg·kg-1 bacitracin and 200 mg·kg-1 vancomycin) for 8 d, and the UC model was constructed by allowing mice with free access to 3% dextran sulfate sodium (DSS) solution for 7 d. HQT was administered for 7 d. After the experiments, the mice were sacrificed, and blood, colon, and feces were collected. Hematoxylin-eosin (HE) staining was performed to observe the colonic lesions. The serum levels of interleukin (IL)-4, IL-6, IL-10, and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein expression of Claudin1, MUC1, Occludin, and zonula occludens-1(ZO-1) in colon tissues was detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively. The fecal DNA of mice was extracted and analyzed by high-throughput sequencing. ResultCompared with the normal group, the model group showed increased serum content of IL-4, IL-6, and TNF-α (P<0.05, P<0.01) and decreased IL-10 (P<0.05). Compared with the model group, the HQT groups displayed decreased serum levels of IL-4, IL-6, and TNF-α (P<0.05, P<0.01), increased IL-10 content (P<0.01), increased mRNA and protein expression levels of Claudin1, MUC1, Occludin, and ZO-1 (P<0.05, P<0.01). After flora interference, the diversity and abundance of intestinal bacteria decreased. To be specific, Proteobacteria increased (P<0.01), and Firmicutes and Bacteroidetes decreased (P<0.01). After UC induction by DSS, Bacteroidetes and Tenericutes decreased (P<0.05). The high-, medium-, and low-dose HQT groups showed increased Bacteroidetes and Tenericutes (P<0.05, P<0.01) and decreased Firmicutes (P<0.05). Additionally, the abundance of Lactobacillus, Lachnospiraceae NK4A136 group, Escherichia-Shigella, and Helicobacteris was positively proportional to the dose of HQT. ConclusionHQT can inhibit the inflammatory response of UC mice, restore the imbalance of intestinal flora, and repair the damaged intestinal mucosal barrier.
3.Anti-inflammatory Effect of Huangqintang on LPS-induced RAW264.7 Inflammatory Cells
Yaqing LIU ; Bin LIU ; Xuran MA ; Dunfang WANG ; Xue FENG ; Weipeng YANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(7):20-28
ObjectiveTo explore the anti-inflammatory mechanism of Huangqintang based on the inflammation model in RAW264.7 cells. MethodHuangqintang was prepared and the safe dose to RAW264.7 cells was screened out. The RAW264.7 cells were seeded in 24-well plates and incubated with Huangqintang and lipopolysaccharide (LPS), successively. The concentrations of nitric oxide (NO), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and prostaglandin E2 (PGE2) were measured by Griess assay and enzyme-linked immunosorbent assay (ELISA), respectively. Meanwhile, RAW264.7 cells were inoculated in 6-well plates, and normal group, LPS group, LPS+Huangqintang group, nuclear factor-κB (NF-κB) p65 inhibitor PDTC group, p38 mitogen-activated protein kinase (MAPK) inhibitor SB203580 group, extracellular signal-regulated kinase (ERK) inhibitor PD98059 group, c-Jun N-terminal kinase (JNK) inhibitor SP600125 group, and Janus kinase (JAK) inhibitor AG490 group were set up. After the cells were incubated with corresponding inhibitors and Huangqintang and stimulated by LPS, RNA and protein were extracted. The mRNA and protein expression levels of NF-κB p65, p38 MAPK, ERK, JNK, and JAK were detected by Real-time fluorescence-based quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively, to explore the anti-inflammatory mechanism of Huangqintang by regulating the NF-κB, MAPK, and JAK/signal transducer and activator of transcription protein (STAT) signaling pathways. ResultAfter stimulation with LPS, the concentrations of NO, IL-6, TNF-α, and PGE2 in the cells of the model group increased significantly(P<0.05,P<0.01). Compare with the model group, after incubation with Huangqintang, the secretion of NO, IL-6, TNF-α, and PGE2 showed a downward trend (P<0.05,P<0.01). Compared with the normal group, the model group showed increased mRNA expression of p38 MAPK, ERK, JNK, JAK, and NF-κB p65 and total protein expression in cells after stimulation with LPS (P<0.05,P<0.01). Compare with the model group,after incubation with Huangqintang, the total protein and mRNA expression of p38 MAPK, ERK, JNK, JAK, and NF-κB p65 in inflammatory cells decreased (P<0.05,P<0.01). Meanwhile, the expression of NF-κB p65 total protein and mRNA in each inhibitor group showed a downward trend (P<0.05,P<0.01). ConclusionHuangqintang can inhibit the inflammatory response through the NF-κB, MAPK, and JAK-STAT signaling pathways.
4.Anti-oxidative Stress Effect and Mechanism of Huangqintang on Caco-2 Cells Through Nrf2 Signaling Pathway
Xue FENG ; Yaqing LIU ; Bin LIU ; Xuran MA ; Dunfang WANG ; Weipeng YANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(7):29-37
ObjectiveTo verify the anti-oxidative stress effect of Huangqintang based on the nuclear factor E2-related factor 2 (Nrf2) signaling pathway by using Caco-2 cells as a carrier and RNA interference (RNAi) technology with in vitro experiments. MethodThe Caco-2 cells in the logarithmic growth phase were transfected with siRNA to construct siRNA Caco-2 cells. After normal Caco-2 cells and siRNA Caco-2 cells were incubated with Huangqintang of different doses, RNA and protein were extracted. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to detect the mRNA and protein expression of heme oxygenase-1 (HO-1), NAD(P)H quinone oxidoreductase 1 (NQO1), glutathione S-transferase (GST), Kelch-like ECH-associated protein 1 (Keap1), and Nrf2. Meanwhile, the activities of superoxide dismutase (SOD) and GSH-Px, as well as the expression levels of malondialdehyde (MDA) and reactive oxygen species (ROS), were detected by the colorimetric method and the probe method. ResultCompared with the results in the normal group, only the 400 mg·L-1 Huangqintang group and the sulforaphane (SFN) group could reduce the content of ROS and MDA in Caco-2 cells (P<0.01), while the activities of SOD and GSH-Px in the cells of the Huangqintang groups and the SFN group showed an upward trend. Furthermore, there were significant differences in the 400 mg·L-1 Huangqintang group/the SFN group and the normal group (P<0.01). Meanwhile, the protein and mRNA expression levels of HO-1, GST, Keap1, NQO1, and Nrf2 showed an upward trend in all groups (P<0.05, P<0.01). After transfection, compared with the normal group, the model group showed increased content of MDA and ROS, blunted activities of GSH-Px and SOD, and reduced protein and mRNA expression of HO-1, GST, Keap1, and NQO1 (P<0.05, P<0.01). After drug incubation, compared with the model group, the SFN group showed potentiated SOD activity, and the SFN group and the Huangqintang groups showed enhanced GSH-Px activity (P<0.01). Moreover, the activities of SOD and GSH-Px in the 400 and 200 mg·L-1 Huangqintang groups and the SFN group showed an upward trend (P<0.01), and the content of MDA in the 400 mg·L-1 Huangqintang group and the SFN group showed a downward trend. ROS decreased in all groups with drug intervention (P<0.01), and the protein and mRNA expression of HO-1, GST, Keap1, NQO1, and Nrf2 increased to varying degrees (P<0.05, P<0.01). ConclusionHuangqintang can play an anti-oxidative stress role by regulating the Nrf2 pathway.
5.Allosteric inhibition reveals SHP2-mediated tumor immunosuppression in colon cancer by single-cell transcriptomics.
Jian GAO ; Zhigui WU ; Mingxia ZHAO ; Rui ZHANG ; Manru LI ; Dongdong SUN ; Haibo CHENG ; Xianjia QI ; Yuxian SHEN ; Qiang XU ; Hongqi CHEN ; Dijun CHEN ; Yang SUN
Acta Pharmaceutica Sinica B 2022;12(1):149-166
Colorectal cancer (CRC), a malignant tumor worldwide consists of microsatellite instability (MSI) and stable (MSS) phenotypes. Although SHP2 is a hopeful target for cancer therapy, its relationship with innate immunosuppression remains elusive. To address that, single-cell RNA sequencing was performed to explore the role of SHP2 in all cell types of tumor microenvironment (TME) from murine MC38 xenografts. Intratumoral cells were found to be functionally heterogeneous and responded significantly to SHP099, a SHP2 allosteric inhibitor. The malignant evolution of tumor cells was remarkably arrested by SHP099. Mechanistically, STING-TBK1-IRF3-mediated type I interferon signaling was highly activated by SHP099 in infiltrated myeloid cells. Notably, CRC patients with MSS phenotype exhibited greater macrophage infiltration and more potent SHP2 phosphorylation in CD68+ macrophages than MSI-high phenotypes, suggesting the potential role of macrophagic SHP2 in TME. Collectively, our data reveals a mechanism of innate immunosuppression mediated by SHP2, suggesting that SHP2 is a promising target for colon cancer immunotherapy.
6.Application effect of health education based on behavior change theory in patients with allergic asthma
Chinese Journal of Modern Nursing 2022;28(23):3138-3142
Objective:To explore the effect of health education based on behavior change theory on health behavior and quality of life of allergic asthma patients.Methods:Using the convenient sampling method, a total of 108 patients with allergic asthma who were admitted to Huai'an First People's Hospital from May 2019 to December 2020 were selected as the research objects. By the random number table method, they were randomly divided into the control group and the experimental group, with 54 cases in each group. The control group was given routine nursing intervention and health education, while the experimental group was given health education based on behavior change theory. The scores of health behavior and quality of life were compared between the two groups at admission and 6 months after discharge. A total of 108 questionnaires were sent out, of which 2 cases in the experimental group fell off and 52 cases actually completed. In the control group, 6 cases fell off, and 48 cases were actually completed. 100 valid questionnaires were collected, and the effective recovery rate was 92.59% (100/108) .Results:Six months after discharge, scores of disease knowledge, medication management, diet management, exercise management, emotional management and symptom management of the patients in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of asthma symptoms, life disorder, psychological state, response to allergen stimuli and self-health importance were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on behavior change theory can help promote the development of healthy behaviors in patients with allergic asthma, thereby improving the quality of life of patients.
7.Effect of Huangqintang on Th17/Treg and Th1/Th2 Balance in Mice with Ulcerative Colitis
Bin LIU ; Yaqing LIU ; Hongxin SONG ; Xuran MA ; Dunfang WANG ; Xue FENG ; Weipeng YANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(22):7-15
ObjectiveTo study the effect of Huangqintang on intestinal T helper cells(Th)17/regulatory T cells(Treg) and Th1/Th2 balance in experimental ulcerative colitis (UC) mice. MethodSixty male C57BL/6J mice were randomly divided into normal group, model group, sulfasalazine group (0.2 g·kg-1), and Huangqintang low-dose, medium-dose and high-dose groups (4.55,9.1,18.2 g·kg-1, respectively) according to body weight. Except for the normal group, all mice were given 2.5% dextran sodium sulfate (DSS, added to free drinking water) for 5 days to induce UC. After 7 days of continuous intragastric administration, the mice were sacrificed and the mesenteric lymph nodes (MLNs) and colon tissues were collected. The Th17/Treg and Th1/Th2 cell ratios in MLNs of mice were measured by flow cytometry. Interleukin-2 (IL-2), interleukin-17A (IL-17A), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-10 (IL-10) and other cytokines in colon tissues were detected by flow cytometric microsphere-based assay. The colon tissues samples were sectioned, and immunohistochemical method was used to detect the expression levels of T-box transcription factor (T-bet), GATA binding protein 3 (GATA-3), IL-17A and forkhead box P3 (FoxP3) in colon tissues. The content of transforming growth factor-β (TGF-β) in colon tissue of mice was determined by enzyme-linked immunosorbent assay (ELISA). ResultCompared with the normal group, the number of Th1 and Th17 cells in the model group was significantly increased, while the number of Th2 and Treg cells was significantly decreased, and Th1/Th2 and Th17/Treg were significantly increased (P<0.05, P<0.01). The expressions of T-bet, GATA-3, IL-17A and FoxP3 in colon tissues of mice were significantly increased (P<0.05, P<0.01), and the contents of cytokines IL-2, IL-17A, IL-6, TNF-α and IFN-γ were significantly increased. The contents of IL-4, TGF-β and IL-10 were significantly decreased (P<0.05, P<0.01). Compared with the model group, the imbalance of Th1/Th2 and Th17/Treg cells was reversed in each dose group of Huangqin decoction (P<0.01). The expressions of T-bet and GATA-3 in colon of mice were significantly decreased in low-dose, medium-dose and high-dose groups of Huangqintang (P<0.05, P<0.01), and the expression of IL-17A was significantly decreased in high-dose and low-dose groups of Huangqintang (P<0.01). The contents of cytokines IL-2, IL-17A, IFN-γ, IL-6 and TNF-α were significantly decreased in the high-dose and medium-dose groups of Huangqintang, and the contents of TGF-β and IL-10 were significantly increased in the high-dose group of Huangqintang (P<0.05, P<0.01). ConclusionHuangqintang could reduce colonic inflammation and improve colonic tissue damage in UC mice, possibly by regulating Th17/Treg and Th1/Th2 balance and related cytokines levels, and the release level of pro-inflammatory cytokines.
8.Application of palpebral strip suspension on the outside of the lower eyelid for moderate to severe iatrogenic lateral canthal deformities
Xing WEI ; Li YANG ; Gang LI ; Yueli LIU ; Xuran ZHU ; Pingping LIU
Chinese Journal of Plastic Surgery 2021;37(10):1168-1171
Objective:To investigate the application of the palpebral strip suspension on the outer side of the lower eyelid for moderate-to-severe iatrogenic lateral canthal deformities.Methods:From October 2019 to October 2020, patients with moderate to severe lateral canthal deformity caused by lateral canthoplasty were admitted to the Department of Medical Cosmetology of the Second Affiliated Hospital of Zhengzhou University. They received lateral tarsal sling suspension of the lower eyelid. The improvement in lateral canthus shape, lateral angle position, blepharophimosis size and the lid bulb separation was observed and analyzed.Results:Seven female patients, aged from 23 to 48 years, with 14 eyes, were included. Complete correction of the canthal deformity was achieved in all the patients. During the follow-up period of more than 6 months, all patients had complete recovery of the external canthus shape and position, as well as symmetry of the bilateral lid fissure size, and improvement of the lid bulb separation without serious complications.Conclusions:The palpebral strip suspension on the outer side of the lower eyelid for moderate-to-severe iatrogenic lateral canthal deformities is easy to perform, with satisfactory postoperative result and few complications.
9.Treatment and prognostic analysis of isolated chest wall recurrence of breast cancer after mastectomy
Xuran ZHAO ; Liang XUAN ; Jun YIN ; Yu TANG ; Huiru SUN ; Shikai WU ; Hao JING ; Hui FANG ; Yongwen SONG ; Jing JIN ; Yueping LIU ; Hua REN ; Bo CHEN ; Shunan QI ; Ning LI ; Yuan TANG ; Ningning LU ; Yong YANG ; Yexiong LI ; Bing SUN ; Shulian WANG
Chinese Journal of Oncology 2021;43(11):1203-1208
Objective:To analyze the prognostic factors of breast cancer patients with isolated chest wall recurrence (ICWR) after mastectomy, and investigate the optimal treatment.Methods:A total of 201 breast cancer patients with ICWR after mastectomy who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and the Fifth Medical Center Chinese PLA General Hospital from October 1998 to April 2018 were retrospectively analyzed. The median follow-up was 92.8 months and survival data were obtained.Results:Among 201 patients with ICWR, 103 patients developed subsequent locoregional recurrence (sLRR) and 5-year cumulative sLRR rate was 49.1%; 134 patients developed distant metastasis (DM) and 5-year DM rate was 64.4%; 103 patients died, the median progression-free survival (PFS) was 17.4 months and the 5-year PFS rate was 23.2%; the median overall survival (OS) was 62.5 months and the 5-year OS rate was 52.1%. Multivariate analysis showed that the recurrence interval ( HR=2.17, 95% CI: 1.26-3.73) and the locoregional treatment ( HR=1.59, 95% CI: 1.05-2.40) were the independent prognostic factors for sLRR. The initial HER2 status ( HR=1.60, 95% CI: 1.03-2.48) was the independent prognostic factor for DM. The recurrence interval ( HR=1.99, 95% CI: 1.30-3.04), the locoregional treatment ( HR=1.99, 95% CI: 1.43-2.76) and the treatment modalities after recurrence ( HR=1.70, 95% CI: 1.18-2.46) were the independent prognostic factors for PFS. The initial HER2 status ( HR=1.69, 95% CI: 1.02-2.81), the recurrence interval ( HR=1.85, 95% CI: 1.15-2.98) and the treatment modalities after recurrence ( HR=2.48, 95% CI: 1.56-3.96) were the independent prognostic factors for OS. Conclusions:Breast cancer patients after ICWR have an optimistic OS until now, but the risk of sLRR and DM is high. Comprehensive treatment modalities including surgery, radiotherapy and systemic therapy improve the outcome of breast cancer patients with ICWR after mastectomy.
10.Application of palpebral strip suspension on the outside of the lower eyelid for moderate to severe iatrogenic lateral canthal deformities
Xing WEI ; Li YANG ; Gang LI ; Yueli LIU ; Xuran ZHU ; Pingping LIU
Chinese Journal of Plastic Surgery 2021;37(10):1168-1171
Objective:To investigate the application of the palpebral strip suspension on the outer side of the lower eyelid for moderate-to-severe iatrogenic lateral canthal deformities.Methods:From October 2019 to October 2020, patients with moderate to severe lateral canthal deformity caused by lateral canthoplasty were admitted to the Department of Medical Cosmetology of the Second Affiliated Hospital of Zhengzhou University. They received lateral tarsal sling suspension of the lower eyelid. The improvement in lateral canthus shape, lateral angle position, blepharophimosis size and the lid bulb separation was observed and analyzed.Results:Seven female patients, aged from 23 to 48 years, with 14 eyes, were included. Complete correction of the canthal deformity was achieved in all the patients. During the follow-up period of more than 6 months, all patients had complete recovery of the external canthus shape and position, as well as symmetry of the bilateral lid fissure size, and improvement of the lid bulb separation without serious complications.Conclusions:The palpebral strip suspension on the outer side of the lower eyelid for moderate-to-severe iatrogenic lateral canthal deformities is easy to perform, with satisfactory postoperative result and few complications.

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