1.Ethyl Lithospermate Reduces Lipopolysaccharide-Induced Inflammation through Inhibiting NF-κB and STAT3 Pathways in RAW 264.7 Cells and Zebrafish.
Chun-Hong ZHOU ; Hua YANG ; Li-Fang ZOU ; Di-Fa LIU ; Lin-Zhong YU ; Hui-Hui CAO ; Li-E DENG ; Zhang-Wei WANG ; Zi-Bin LU ; Jun-Shan LIU
Chinese journal of integrative medicine 2023;29(12):1111-1120
OBJECTIVE:
To explore the anti-inflammatory effects of ethyl lithospermate in lipopolysaccharide (LPS)-stimulated RAW 264.7 murine-derived macrophages and zebrafish, and its underlying mechanisms.
METHODS:
3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazoliumbromide (MTT) assays were performed to investigate the toxicity of ethyl lithospermate at different concentrations (12.5-100 µ mol/L) in RAW 264.7 cells. The cells were stimulated with LPS (100 ng/mL) for 12 h to establish an inflammation model in vitro, the production of pro-inflammatory cytokines interleukin (IL)-6 and tumor necrosis factor α (TNF-α) were assessed by enzyme linked immunosorbent assay (ELISA). Western blot was used to ascertain the protein expressions of signal transducer and activator of transcription 3 (STAT3), nuclear factor kappa B (NF-κB) p65, phospho-STAT3 (p-STAT3, Tyr705), inhibitor of NF-κB (IκB) α, and phospho-I κB α (p-IκB α, Ser32), and confocal imaging was used to identify the nuclear translocation of NF-κB p65 and p-STAT3 (Tyr705). Additionally, the yolk sacs of zebrafish (3 days post fertilization) were injected with 2 nL LPS (0.5 mg/mL) to induce an inflammation model in vivo. Survival analysis, hematoxylin-eosin (HE) staining, observation of neutrophil migration, and quantitative real-time polymerase chain reaction (qRT-PCR) were used to further study the anti-inflammatory effects of ethyl lithospermate and its probable mechanisms in vivo.
RESULTS:
The non-toxic concentrations of ethyl lithospermate have been found to range from 12.5 to 100 µ mol/L. Ethyl lithospermate inhibited the release of IL-6 and TNF-α(P<0.05 or P<0.01), decreased IκBα degradation and phosphorylation (P<0.05) as well as the nuclear translocation of NF-κB p65 and p-STAT3 (Tyr705) in LPS-induced RAW 264.7 cells (P<0.01). Ethyl lithospermate also decreased inflammatory cells infiltration and neutrophil migration while increasing the survival rate of LPS-stimulated zebrafish (P<0.05 or P<0.01). In addition, ethyl lithospermate also inhibited the mRNA expression levels of of IL-6, TNF-α, IκBα, STAT3, and NF-κB in LPS-stimulated zebrafish (P<0.01).
CONCLUSION
Ethyl lithospermate exerts anti-Inflammatory effected by inhibiting the NF-κB and STAT3 signal pathways in RAW 264.7 macrophages and zebrafish.
Animals
;
Mice
;
NF-kappa B/metabolism*
;
Lipopolysaccharides
;
RAW 264.7 Cells
;
Zebrafish
;
NF-KappaB Inhibitor alpha/metabolism*
;
Interleukin-6/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
STAT3 Transcription Factor/metabolism*
;
Inflammation/metabolism*
;
Anti-Inflammatory Agents/therapeutic use*
2.The role of activation of the ferroptosis pathway in the inhibition of esophageal cancer proliferation and metastasis by realgar
Xue-lian ZHANG ; Ru-yi YANG ; Hong-bin WANG ; Zhao SUN ; Jun WANG ; Qiu-ping WANG ; Fa-zhang CHEN
Acta Pharmaceutica Sinica 2022;57(11):3322-3330
This study was designed to investigate the role of activation of the ferroptosis pathway in the inhibition of esophageal cancer proliferation and metastasis by realgar, using esophageal cancer Eca109 and KYSE150 cells as the target cells. The rate of inhibition and half-inhibitory concentration (IC50) were measured by the CCK-8 method; clone formation ability was measured by clone formation assay; the changes in reactive oxygen species (ROS) were detected by flow cytometry; the ultrastructure of the cells was observed by transmission electron microscopy; the distribution of intracellular iron particles was observed by Prussian blue staining; the expression of glutathione peroxidase 4 (GPX4) was detected by immunofluorescence staining; the scratch assay was used to detect the cell migration ability; the Transwell assay was used to detect the cell invasion ability; and western blotting was used to detect E-cadherin, Slug and N-cadherin protein expression in the cells. The results show that realgar inhibited the proliferation of Eca109 and KYSE150 cells in a time- and concentration-dependent manner, and the IC50 of Eca109 and KYSE150 cells was 64.297 and 51.337 μmol‧L-1, respectively. Compared with the control group, many mitochondria in the cytoplasm of Eca109 and KYSE150 cells in the realgar 2IC50 group were swollen and blue-stained particles of different sizes and amounts were found, and ROS fluorescence intensity was significantly increased while GPX4 protein expression was significantly reduced (
3.Optimization and evaluation of Xiaoer Pudilan Xiaoyan Syrup based on characterization of material properties.
Xuan LI ; Ke DING ; Dang YANG ; Meng-Hua JIANG ; Chao LI ; Fa-Gen ZHU ; Jian-Guo SHAO ; E SUN ; Liang FENG ; Xiao-Bin JIA
China Journal of Chinese Materia Medica 2022;47(21):5746-5756
According to the taste analysis of Pudilan Xiaoyan Oral Liquid, the unpleasant taste of the oral liquid is mainly caused by the inherent taste of Chinese medicine and the taste introduced in the preparation process, which leads to its unpopularity among children. Therefore, aiming at the special children patient group, Xiaoer Pudilan Xiaoyan Syrup was developed via technology optimization and dosage form improvement to improve the unpleasant taste and enhance the medication compliance among children. Based on the material properties of Pudilan Xiaoyan Oral Liquid and Xiaoer Pudilan Xiaoyan Syrup extracts, the authors compared the properties(pH, density, turbidity, viscosity, chromaticity, particle size), taste, content of five quality markers and in vivo pharmacokinetic characteristics of these two preparations, to evaluate the suitability of Xiaoer Pudilan Xiaoyan Syrup. The results showed that compared with those of Pudilan Xiaoyan Oral Liquid, the pH, density, turbidity, viscosity and chromaticity of Xiaoer Pudilan Xiaoyan Syrup were significantly changed, and the unpleasant taste was reduced by 26%; the transfer rate of the main active ingredients chicoric acid was increased, while the transfer rate of baicalin had small difference from that of the oral liquid. In addition, pharmacokinetics revealed that the total absorption amount of baicalin in vivo was higher, and the time to peak T_(max) of baicalin and oroxindin in the syrup and the mean residence time MRT_(last )of corynoline in vivo were significantly prolonged. The absorption degree of Xiaoer Pudilan Xiaoyan Syrup and Pudilan Xiaoyan Oral Liquid in the body was the same: baicalin>oroxindin>corynoline. The new dosage form process was simpler than that of the original dosage form, safe, environmentally friendly, reasonable and feasible, meeting the mass production demand. This provided a basis for the reasonable and scientific optimization of Xiaoer Pudilan Xiaoyan Syrup, and also laid a foundation for its further safe and rational use, so as to expand the clinical application in children.
Child
;
Humans
;
Drugs, Chinese Herbal
;
Glucuronates
4.Quality Evaluation of Aurantii Fructus Based on Fingerprint Qualitative Analysis, Multi-component Quantitative Analysis and Chemometrics
Min-yong ZHONG ; Ri-fa QIAO ; Tao LUO ; Lin YANG ; Wu-liang YANG ; Jin-bin YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(4):138-145
ObjectiveTo establish an integrated method of fingerprint qualitative, multi-component quantitative analysis and chemometrics, and to evaluate the quality attributes and differences of Aurantii Fructus from different production areas and origins. MethodAnalysis was performed on COSMOSIL 5C18-MS-Ⅱ column (4.6 mm×250 mm, 5 μm) with the mobile phase of acetonitrile-0.2% phosphoric acid solution for gradient elution (0-4 min, 19%A; 4-5 min, 19%-21%A; 5-18 min, 21%A; 18-19 min, 21%-28%A; 19-27 min, 28%A; 27-28 min, 28%-40%A; 28-36 min, 40%A; 36-37 min, 40%-50%A; 37-42 min, 50%-60%A; 42-46 min, 60%-95%A; 46-55 min, 95%-100%A), the flow rate was 1 mL·min-1, the column temperature was 30 ℃, the detection wavelength was set at 320 nm, and the injection volume was 10 μL. High performance liquid chromatography (HPLC) fingerprints of Aurantii Fructus from different production areas and origins were established. Then, the quality of 26 batches of samples was evaluated by cluster analysis (CA), principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). A method for the determination of 12 components was developed and verified, and a thermal map-based CA of Aurantii Fructus from different production areas and origins was carried out based on the content difference of samples. ResultThe fingerprint and determination methods were well verified. The similarity of HPLC fingerprint of 12 batches of Aurantii Fructus was 0.85-0.996, 20 common peaks were calibrated and 14 of them were assigned. The resolution and linear relationship of 12 components in quantitative analysis were good. The recovery rates were 99.2%-101.0% with RSD≤2.0%. The results of CA, PCA and OPLS-DA indicated that the differentiation of Aurantii Fructus in different production areas was great, and there were differences among different cultivars. ConclusionThe qualitative analysis of fingerprint and quantitative analysis of multiple indexes based on the same chromatographic analysis conditions are convenient, accurate and reliable, and combined with chemometrics, the identification and quality analysis of Aurantii Fructus from different production areas and origins can be realized, which can provide reference for quality control and evaluation of Aurantii Fructus.
5.A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data.
Xue Wei DING ; Zhi Chao ZHENG ; Qun ZHAO ; Gang ZHAI ; Han LIANG ; Xin WU ; Zheng Gang ZHU ; Hai Jiang WANG ; Qing Si HE ; Xian Li HE ; Yi An DU ; Lu Chuan CHEN ; Ya Wei HUA ; Chang Ming HUANG ; Ying Wei XUE ; Ye ZHOU ; Yan Bing ZHOU ; Dan WU ; Xue Dong FANG ; You Guo DAI ; Hong Wei ZHANG ; Jia Qing CAO ; Le Ping LI ; Jie CHAI ; Kai Xiong TAO ; Guo Li LI ; Zhi Gang JIE ; Jie GE ; Zhong Fa XU ; Wen Bin ZHANG ; Qi Yun LI ; Ping ZHAO ; Zhi Qiang MA ; Zhi Long YAN ; Guo Liang ZHENG ; Yang YAN ; Xiao Long TANG ; Xiang ZHOU
Chinese Journal of Gastrointestinal Surgery 2021;24(5):403-412
Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Chemotherapy, Adjuvant
;
Female
;
Gastrectomy
;
Humans
;
Male
;
Neoadjuvant Therapy
;
Neoplasm Staging
;
Prognosis
;
Retrospective Studies
;
Stomach Neoplasms/surgery*
6.Dryness comparison of different fractions of Aurantii Fructus extract on normal mice and gastrointestinal motility disorder rats and spectrum-dryness study.
Ri-Fa QIAO ; Min-Yong ZHONG ; Min ZHANG ; Lin YANG ; Xi-Qin DU ; Fu-Lin TUO ; Jin-Bin YUAN
China Journal of Chinese Materia Medica 2021;46(20):5291-5303
Aurantii Fructus is a commonly used qi-regulating medicinal herb in China. Both traditional Chinese medicine theory and modern experimental research demonstrate that Aurantii Fructus has dryness effect, the material basis of which remains unclear. In recent years, spectrum-effect relationship has been widely employed in the study of active ingredients in Chinese medicinal herbs, the research ideas and methods of which have been constantly improved. Based on the idea of spectrum-effect study, the ultra-high perfor-mance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS) fingerprints of different fractions of Aurantii Fructus extract were established for the identification of total components. Then, the dryness effects of the fractions on normal mice and gastrointestinal motility disorder(GMD) rats were systematically compared. Finally, principal component analysis(PCA), Pearson bivariate correlation analysis and orthogonal partial least squares analysis(OPLS) were integrated to identify the dryness components of Aurantii Fructusextract. The results showed that narirutin, naringin, naringenin, poncirin, oxypeucedanin, and eriodictyol-7-O-glucoside had significant correlations with and contributed to the expression of AQP2 in kidney, AQP3 in colon, and AQP5 in submandibular gland, which were the main dryness components in Aurantii Fructus.
Animals
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Aquaporin 2
;
Chromatography, High Pressure Liquid
;
Citrus
;
Drugs, Chinese Herbal
;
Gastrointestinal Motility
;
Medicine, Chinese Traditional
;
Mice
;
Rats
7.Identification of Prototype Compounds and Their Metabolites in Rat Plasma After Oral Administration of Aurantii Fructus Extract by UPLC-Q-TOF/MS
Fei-ting WEI ; Hao CHENG ; Ri-fa QIAO ; Min ZHANG ; Min-yong ZHONG ; Wu-liang YANG ; Jin-bin YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(21):161-172
Objective:To study the serum pharmacochemistry of Aurantii Fructus (AF), and to investigate the pharmacological material basis of AF
8.Spicy food consumption is associated with cognition and cerebrospinal fluid biomarkers of Alzheimer disease.
Ding-Yuan TIAN ; Jun WANG ; Bin-Lu SUN ; Zhen WANG ; Wei XU ; Yang CHEN ; Ying-Ying SHEN ; Hui-Yun LI ; Dong-Wan CHEN ; Fa-Ying ZHOU ; Xu YI ; Gui-Hua ZENG ; Zhi-Qiang XU ; Li-Yong CHEN ; Jin-Tai YU ; Yan-Jiang WANG
Chinese Medical Journal 2020;134(2):173-177
BACKGROUND:
Recent studies suggest that a healthy diet helps to prevent the development of Alzheimer disease (AD). This study aimed to investigate whether spicy food consumption is associated with cognition and cerebrospinal fluid (CSF) biomarkers of AD in the Chinese population.
METHODS:
We enrolled 55 AD patients and 55 age- and gender-matched cognitively normal (CN) subjects in a case-control study, as well as a cohort of 131 participants without subjective cognitive decline (non-AD) in a cross-sectional study. Spicy food consumption was assessed using the Food Frequency Questionnaire (FFQ). Associations of FFQ scores with cognition and CSF biomarkers of AD were analyzed.
RESULTS:
In the case-control study, spicy food consumption was lower in AD patients than that in CNs (4.0 [4.0-8.0] vs. 8.0 [4.5-10.0], P < 0.001); FFQ scores were positively associated with Mini-Mental Status Examination scores in the total sample (r = 0.218, P = 0.014). In the cross-sectional study, the association between spicy food consumption and cognition levels was verified in non-AD subjects (r = 0.264, P = 0.0023). Moreover, higher FFQ scores were significantly associated with higher β-Amyloid (1-42) (Aβ42) levels and lower phospho-tau/Aβ42 and total tau/Aβ42 ratios in the CSF of non-AD subjects (P < 0.05).
CONCLUSION
Spicy food consumption is closely related to higher cognition levels and reversed AD biomarkers in the CSF, suggesting that a capsaicin-rich diet might have the potential to modify the cognitive status and cerebral pathologies associated with AD.
Alzheimer Disease
;
Amyloid beta-Peptides
;
Biomarkers
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Case-Control Studies
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Cognition
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Cross-Sectional Studies
;
Humans
;
Peptide Fragments
;
tau Proteins
9.Occurrence pattern of musculoskeletal disorders and its influencing factors among manufacturing workers.
Fu Jiang WANG ; Xu JIN ; Mamat NAZAKAT ; Yi Dan DONG ; Shi Juan WANG ; Zhong Bin ZHANG ; Shan Fa YU ; Li Yun YANG ; Li Hua HE
Journal of Peking University(Health Sciences) 2020;52(3):535-540
OBJECTIVE:
To explore the occurrence pattern and its influencing factors of multi-site work-related musculoskeletal disorders (WMSDs) of the main affected body sites among manufacturing workers.
METHODS:
Musculoskeletal disorders questionnaire was adopted to investigate the prevalence of WMSDs and the influencing factors among workers from four manufacturing factories in China. The case of WMSDs was defined as the one who had symptoms such as pain, numbness, discomfort, or limitation of activities in one or more of the nine body sites, including neck, shoulder, elbow, wrist/hand, upper back, lower back, hip/thigh, knee and ankle/foot during the last year, which lasted for more than 24 hours and did not completely relieve after rest. Besides, trauma, disability, other acute injuries or sequelae were excluded. The correlation of WMSDs between different body sites was estimated by the prevalence ratio (PR) calculated by log-binominal model. The influencing factors of multi-site WMSDs of the main affected body sites were analyzed by multinomial logistic regression model.
RESULTS:
The overall prevalence rate of WMSDs was 79.7% among the manufacturing workers. The main affected body sites were lower back, neck, shoulder and upper back, of which the prevalence rates were 62.3%, 55.7%, 45.6%, and 38.7%, respectively. The PR values of WMSDs among these sites were relatively high. The prevalence of multi-site WMSDs involving these four sites at the same time was 25.2%, and that of three to four sites was 41.4%. Multinomial Logistic regression analysis suggested that influencing factors of multi-site WMSDs in 3-4 sites of neck, shoulder, upper back and lower back involved several aspects. Among these factors, females (OR=2.86, 95%CI 2.38-3.33) and individuals with job tenure of 15-19 years (OR=1.87, 95%CI 1.49-2.34) might have higher risk of disease. Biomechanical factors, such as often bending neck forward or holding neck in a forward position for long periods (OR=2.15, 95%CI 1.86-2.48), often twisting neck or holding neck in a twisted position for long periods (OR=1.64, 95%CI 1.40-1.92) and often twisting trunk heavily (OR=1.40, 95%CI 1.20-1.64) might be risk factors. In the aspect of work organization, doing the same work every day (OR=1.73, 95%CI 1.44-2.08), shortage of workers (OR=1.50, 95%CI 1.31-1.71) and often working overtime (OR=1.38, 95%CI 1.20-1.60) might increase the risk of disease. Factors, such as often standing for long periods at work (OR=0.77, 95%CI 0.65-0.91) and feeling breaks sufficient (OR=0.51, 95%CI 0.44-0.59) were suggested to be protective factors with OR<1.
CONCLUSION
The pre-valence rates of WMSDs in neck, shoulder, upper back, and lower back were high among manufacturing workers in this study. The correlation of WMSDs of these four sites was close in this study, and the comorbidity rate of 3-4 sites of these sites was relatively high, suggesting that there might be a multi-site occurrence pattern of WMSDs in "neck-shoulder-upper back-lower back" among manufacturing workers. The main influencing factors of this pattern included individual factors, biomechanical factors and work organization factors.
China
;
Female
;
Humans
;
Musculoskeletal Diseases
;
Occupational Diseases
;
Prevalence
;
Risk Factors
;
Shoulder
;
Surveys and Questionnaires
10.Analysis of adverse reactions' factors to Danhong injection--nested case control study by using hospital centralized monitoring data.
Meng-Meng JI ; Chun-Xiao LI ; Jin-Fa TANG ; Qing-Li ZHANG ; Tao XU ; Ya-Nan YU ; Jun LIU ; Wei YANG ; Wei-Bin YANG ; Zhong WANG ; Zhi-Wei JING ; Xue-Lin LI
China Journal of Chinese Materia Medica 2018;43(8):1714-1719
To study the adverse reactions' factors to Danhong injection in the real world. A multi-center, large sample and prospective hospital centralized monitoring method was adopted, and 30 888 cases of Danhong injection from 37 national 3A hospitals were collected to carry out a nested case control design study. These cases were divided into adverse reaction group and non-adverse group. Single factor logistic regression and multiple factor logistic regression were used to analyze data, and investigate the correlation between adverse reaction and gender, allergy history, methods of administration, and combined drug use. One hundred and eight cases of adverse reactions in 30 888 patients were determined, with an incidence of 0.35%. The results showed that Danhong injection combined with other medication(potassium mendoxine magnesium, thymic peptide, celecoxib, fumarate bisoprolol) with history of adverse reactions including scephalosporin allergy and proprietary Chinese medicine allergies had more adverse reactions than the control group(<0.05, estimated coefficient>0), indicating that these six factors were the risk factors for the adverse reaction of Danhong injection. The adverse reaction of Danhong injection combined with the aspirin was less than that in the control group(<0.05, estimated coefficient<0), indicating that the aspirin was a non-risk factor for the adverse reaction of Danhong injection. All the above results indicate that the adverse factors to Danhong injection include scephalosporin allergy, patent Chinese medicine allergy, Danhong injection combined with medication(potassium mendoxine magnesium, thymic peptide, celecoxib, fumarate bisoprolol), suggesting special attention shall be paid in clinical application.

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