1.Effect of RNF113A on the malignant biological behavior of hepatocellular carcinoma cells
Hai-Jie DAI ; Xia HUANG ; Li-Jun DONG ; Ming-Xuan XING ; Teng-Yue ZOU ; Wen-Xiao LI
Chinese Journal of Current Advances in General Surgery 2024;27(4):275-281
		                        		
		                        			
		                        			Objective:To explore the effects of RNF113A on the proliferation,migration,in-vasion,apoptosis,and autophagy of hepatocellular carcinoma cells.Methods:Hep3B cells were divided into control group and RNF113A overexpression group(RNF113A-OE),HepG2 was divided into control group and RNF113A knockdown group(si-RNF113A),CCK-8 assay was used to detect changes in cell viability,clone formation assay was used to detect changes in cell proliferation abili-ty,Transwell assay was used to detect changes in cell invasion ability,wound healing assay was used to detect changes in cell migration ability,and flow cytometry was used to detect changes in cell apoptosis ability,Western blot experiments were used to detect changes in protein expression of autophagy related genes and AMPK signaling pathway related genes.Results:Compared with the control group,the proliferation,cloning,invasion,and migration abilities of Hep3B cells in the RNF113A-OE group were improved,while apoptosis and autophagy abilities were decreased,and the AMPK signaling pathway was inhibited;In the si-RNF113A group,the proliferation,cloning,in-vasion,and migration abilities of HepG2 cells were significantly reduced,while apoptosis and au-tophagy abilities were increased,and the activation of the AMPK signaling pathway was promoted.Conclusion:RNF113A promotes the proliferation,cloning,invasion,and migration of hepatocel-lular carcinoma cells,and inhibited apoptosis and autophagy by inhibiting the AMPK signaling path-way.
		                        		
		                        		
		                        		
		                        	
2.Use of indocyanine green fluorescence navigation in laparoscopic anatomical hepatectomy.
Zi Qi HOU ; Qing Yun XIE ; Ming Heng LIAO ; Chang LIU ; Guo Teng QIU ; Zhao Xing JIN ; Shi Zheng MI ; Ji Wei HUANG
Chinese Journal of Surgery 2023;61(5):368-374
		                        		
		                        			
		                        			Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ2 test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.
		                        		
		                        		
		                        		
		                        	
3.Mechanism of Panlongqi Tablets intervening in vertebral artery type of cervical spondylosis in rats through PI3K/AKT signaling pathway based on network pharmacology and experimental verification.
Rui-Rui MING ; Yan-Qiong ZHANG ; Ying XU ; Teng-Teng XU ; Luo-Chang-Ting FANG ; Jin-Xia WANG ; Xiao-Xiao WANG ; Zhi-Xing HU ; Chao YANG ; Ke-Xin JIA ; Lu WANG ; Chun-Fang LIU ; Na LIN
China Journal of Chinese Materia Medica 2022;47(16):4454-4461
		                        		
		                        			
		                        			This study aimed to further explore the relevant mechanism of action by network pharmacology integrated with animal experimental verification based on previous proven effective treatment of vertebral artery type of cervical spondylosis(CSA) by Panlongqi Tablets. Bionetwork analysis was performed to establish drug-disease interaction network, and it was found that the key candidate targets of Panlongqi Tablets were enriched in multiple signaling pathways related to CSA pathological links, among which phosphatidylinositol 3-kinase(PI3 K)/serine-threonine kinase(AKT/PKB) signaling pathway was the most significant. Further, mixed modeling method was used to build the CSA rat model, and the rats were divided into normal, model, Panlongqi Tablets low-, medium-and high-dose(0.16, 0.32, 0.64 g·kg~(-1)) and Jingfukang Granules(positive drug, 1.35 g·kg~(-1)) groups. After successful modeling, the rats were administered for 8 consecutive weeks. Pathological changes of rat cervical muscle tissues were detected by hematoxylin-eosin(HE) staining, and the content of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), vascular endothelial cell growth factor(VEGF) and chemokine(C-C motif) ligand 2(CCL2) in rat serum and/or cervical tissues was determined by enzyme-linked immunosorbent assay(ELISA). Western blot was employed to detect the protein expression levels of chemokine(C-C motif) receptor 2(CCR2), PI3 K, AKT, phosphorylated AKT(p-AKT), I-kappa-B-kinase beta(IKK-beta/IKKβ), nuclear factor kappa B(NF-κB P65) and phosphorylated nuclear factor kappa B(NF-κB p-P65) in rat cervical tissues, and positive expression of p-NF-κB P65 in rat cervical muscle tissues was detected by immunofluorescence. The results showed that Panlongqi Tablets at different doses improved the degree of muscle fibrosis and inflammation in cervical muscle tissues of CSA rats, and reduced the content of inflammatory factors IL-1β, TNF-α, VEGF, CCL2 and CCR2 in serum and/or cervical tissues. The protein expression levels of PI3 K, p-AKT, IKKβ and p-NF-κB P65 as well as the nuclear entry of p-NF-κB P65 in cervical tissues were down-regulated. These findings suggest that Panlongqi Tablets can significantly inhibit the inflammatory response of CSA rats, and the mechanism of action may be related to the down-regulation of the activation of PI3 K/AKT signaling pathway.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Drugs, Chinese Herbal
		                        			;
		                        		
		                        			I-kappa B Kinase/pharmacology*
		                        			;
		                        		
		                        			NF-kappa B/metabolism*
		                        			;
		                        		
		                        			Network Pharmacology
		                        			;
		                        		
		                        			Phosphatidylinositol 3-Kinases/metabolism*
		                        			;
		                        		
		                        			Protein Serine-Threonine Kinases
		                        			;
		                        		
		                        			Proto-Oncogene Proteins c-akt/metabolism*
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Signal Transduction
		                        			;
		                        		
		                        			Spondylosis/drug therapy*
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha/metabolism*
		                        			;
		                        		
		                        			Vascular Endothelial Growth Factor A/genetics*
		                        			;
		                        		
		                        			Vertebral Artery/metabolism*
		                        			
		                        		
		                        	
4.Effect of Jianpi Huogu Formula on function damage of vascular endothelial cells induced by glucocorticoid.
Teng-Teng XU ; Jin-Xia WANG ; Rui-Rui MING ; Chao YANG ; Luo-Chang-Ting FANG ; Xiao-Xiao WANG ; Zhi-Xing HU ; Wei-Heng CHEN ; Chun-Fang LIU ; Na LIN
China Journal of Chinese Materia Medica 2022;47(6):1625-1631
		                        		
		                        			
		                        			This study aimed to observe the intervention effect of Jianpi Huogu Formula(JPHGF) on the functional damage of vascular endothelial cells caused by glucocorticoid, and explore its action mechanism from the PI3 K/Akt and mitogen activated protein kinase(MAPK) signaling pathways. The extracted thoracic aorta ring of normal SD rats were intervened first with vascularendothelial growth factor(VEGF, 20 μg·L-1) and/or sodium succinate(MPS, 0. 04 g·L-1) in vitro and then with JPHGF(8, 16, and 32 μg·L-1) for five mcontinuous ethylpdays, rednisolofollowed nebythe statistics of the number, length, and area of microvessels budding fromvascular rings. In addition, the human umbilical vein endothelial cells(HUVECs) induced by VEGF(20 μg·L-1) were added with MPS(0. 04 g·L-1) and then with JPHGF(8, 16, and 32 μg·L-1) for observing the migration, invasion, and luminal formation abilities of HUVECs in the migration, invasion and luminal formation experiments. The protein expression levels of PI3 K, p-Akt, p-JN K, and p-ERK in HUVECs were assayed by Western blot. The results showed that JPHGF dose-dependently improved the num-ber,length, and area of microvessels in MPS-induced rat thoracic aortic ring, reversed the migration, invasion and lumen formation abiliti es of HUVECs reduced by MPS, and up-regulated the protein expression levels of PI3 K, p-Akt, and p-JNK in HUVECs. All thesehave suggested that JPHGF exerts the protective effect against hormone-induced damage to the angiogenesis of vascular endothelial cells by activating the PI3 K/Akt and MAPK signaling pathways, which has provided reference for exploring the mechanism of JPHGF in treating s teroid-induced avascular necrosis of femoral head(SANFH) and also the experimental evidence for enriching the scientific connotationof spleen-invigorating and blood-activating therapy.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Glucocorticoids/pharmacology*
		                        			;
		                        		
		                        			Human Umbilical Vein Endothelial Cells
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Neovascularization, Pathologic/metabolism*
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Vascular Endothelial Growth Factor A/metabolism*
		                        			
		                        		
		                        	
5.68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy.
Teng-Cheng LI ; Yu WANG ; Chu-Tian XIAO ; Ming-Zhao LI ; Xiao-Peng LIU ; Wen-Tao HUANG ; Liao-Yuan LI ; Ke LI ; Jin-Ming DI ; Xing-Qiao WEN ; Xin GAO
Asian Journal of Andrology 2022;24(1):97-101
		                        		
		                        			
		                        			To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.
		                        		
		                        		
		                        		
		                        			Gallium Isotopes
		                        			;
		                        		
		                        			Gallium Radioisotopes
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Indocyanine Green
		                        			;
		                        		
		                        			Ligands
		                        			;
		                        		
		                        			Lymph Node Excision
		                        			;
		                        		
		                        			Lymphatic Metastasis/diagnostic imaging*
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Neoplasm Recurrence, Local/surgery*
		                        			;
		                        		
		                        			Positron Emission Tomography Computed Tomography
		                        			;
		                        		
		                        			Prostate
		                        			;
		                        		
		                        			Prostatectomy
		                        			;
		                        		
		                        			Prostatic Neoplasms/surgery*
		                        			;
		                        		
		                        			Salvage Therapy
		                        			
		                        		
		                        	
6.Regulation Effect of Myeloid Leukemia No.1 Chinese Herb Medicine Prescription Combined with Chemotherapy on Th17 Cells in Bone Marrow of Patients with Acute Myeloid Leukemia.
Guo-Liang ZHANG ; Ming PAN ; Yan-Zhi WANG ; Jian-Xia HUANG ; Gang-Shou GU ; Yan WANG ; Qing WU ; Li-Teng YAO ; Huan-Rong XIE ; Xing-Jiang HU
Journal of Experimental Hematology 2021;29(2):328-332
		                        		
		                        			OBJECTIVE:
		                        			To explore the regulation effect of myeloid leukemia No.1 Chinese herb medicine prescription combined with chemotherapy on Th17 cells in bone marrow fluid of AML patients, so as to provide guidance for improving AML treatment effect and patients' long-term survival.
		                        		
		                        			METHODS:
		                        			Seventy patients with AML who were hospitalized in Department of Hematology, Wuwei People's Hospital from April 2017 to August 2019 were selected and enrolled in AML group, 25 healthy volunteers were selected and enrolled in control group; then according to therapeutic regimen, AML patients were divided into 2 groups: combined therapy group (myeloid leukemia NO.1 Chinese herb medicine prescription combined with chemotherapy) and non-combined therapy group (chemotherapy alone). Flow cytometry was used to detect the ratio of CD3
		                        		
		                        			RESULTS:
		                        			The ratio of CD3
		                        		
		                        			CONCLUSION
		                        			Th17 cells expression in bone marrow of newly diagnoses and relapsed AML patients significantly increase, and decrease significantly after treatment. Myeloid leukemia No.1 Chinese herb prescription combined with chemotherapy can significantly increase the CR rate and reduce the RL rate for AML.
		                        		
		                        		
		                        		
		                        			Bone Marrow
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Leukemia, Myeloid, Acute/drug therapy*
		                        			;
		                        		
		                        			Medicine
		                        			;
		                        		
		                        			Prescriptions
		                        			;
		                        		
		                        			Th17 Cells
		                        			;
		                        		
		                        			Vascular Endothelial Growth Factor A
		                        			
		                        		
		                        	
7.High Expression of Bone Marrow VEGF in Patients with Acute Leukemia and Its Correlation with Prognosis.
Ming PAN ; Guo-Liang ZHANG ; Yan-Zhi WANG ; Jian-Xia HUANG ; Gang-Shou GU ; Yan WANG ; Qing WU ; Li-Teng YAO ; Huan-Rong XIE ; Xing-Jiang HU
Journal of Experimental Hematology 2021;29(2):428-432
		                        		
		                        			OBJECTIVE:
		                        			To detect the level of vascular endothelial growth factor (VEGF) in bone marrow of patients with non-M3 acute leukemia (AL), and estimate its relationship with prognosis.
		                        		
		                        			METHODS:
		                        			From January 2016 to December 2019, 114 patients with AL in department of Hematology, Wuwei People's Hospital were selected as study group, and 25 healthy volunteers were enrolled as control group. The concentration of VEGF in bone marrow was detected by ELISA. The patients were divided into high and low concentration group according to the level of VEGF. The overall survival (OS) and event-free survival (EFS) were compared among different groups.
		                        		
		                        			RESULTS:
		                        			The level of VEGF in patients with AL was significantly higher than that in the control group. The median OS and EFS in the low concentration group was 34.5 and 32 months, respectively, while, in the high concentration group was 30 and 26 months, respectively. The differences between the two groups were statistically significant (P=0.010). There were significant differences in OS rate (P=0.035) and EFS rate (P=0.026) between low and high concentration group. Multivariate analysis showed that high VEGF concentration was an independent risk factor affecting OS (HR=2.619, 95%CI 1.070-6.406, P=0.035) and EFS (HR=2.221, 95%CI 1.074-4.552, P=0.031) in AL patients.
		                        		
		                        			CONCLUSION
		                        			VEGF highly expresses in the bone marrow of patients with AL at initial diagnosis and relapse, and shows adverse effects on the prognosis.
		                        		
		                        		
		                        		
		                        			Bone Marrow
		                        			;
		                        		
		                        			Disease-Free Survival
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Leukemia, Myeloid, Acute
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Vascular Endothelial Growth Factor A
		                        			
		                        		
		                        	
8.Pterostilbene Ameliorates Glycemic Control, Dyslipidemia and Liver Injury in Type 2 Diabetes Rats.
Yu Jing ZHANG ; Hua Lei SUN ; Teng WANG ; Xin Xin LIU ; Chang LIU ; Fang SHEN ; Bing Ya WANG ; Run Rong DING ; Yi Ming LIU ; Guo Yu HUANG ; Wen Jie LI ; Xing LI
Biomedical and Environmental Sciences 2020;33(5):365-368
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Chemical and Drug Induced Liver Injury
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			Diabetes Mellitus, Experimental
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			Diabetes Mellitus, Type 2
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			Dyslipidemias
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			Glycemic Load
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Protective Agents
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Specific Pathogen-Free Organisms
		                        			;
		                        		
		                        			Stilbenes
		                        			;
		                        		
		                        			pharmacology
		                        			
		                        		
		                        	
9.Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study.
Li-Li REN ; Ye-Ming WANG ; Zhi-Qiang WU ; Zi-Chun XIANG ; Li GUO ; Teng XU ; Yong-Zhong JIANG ; Yan XIONG ; Yong-Jun LI ; Xing-Wang LI ; Hui LI ; Guo-Hui FAN ; Xiao-Ying GU ; Yan XIAO ; Hong GAO ; Jiu-Yang XU ; Fan YANG ; Xin-Ming WANG ; Chao WU ; Lan CHEN ; Yi-Wei LIU ; Bo LIU ; Jian YANG ; Xiao-Rui WANG ; Jie DONG ; Li LI ; Chao-Lin HUANG ; Jian-Ping ZHAO ; Yi HU ; Zhen-Shun CHENG ; Lin-Lin LIU ; Zhao-Hui QIAN ; Chuan QIN ; Qi JIN ; Bin CAO ; Jian-Wei WANG
Chinese Medical Journal 2020;133(9):1015-1024
		                        		
		                        			BACKGROUND:
		                        			Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans.
		                        		
		                        			METHODS:
		                        			We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed.
		                        		
		                        			RESULTS:
		                        			Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor.
		                        		
		                        			CONCLUSION
		                        			A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Tomography, X-Ray
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
10.Meta-analysis on safety of Tripterygium Glycosides Tablets in treatment of rheumatoid arthritis.
Yi-Qun LI ; Rui-Xue HU ; Ke-Xin JIA ; Jin-Xia WANG ; Teng-Teng XU ; Rui-Zhao CUI ; Rui-Rui MING ; Tai-Xian LI ; Chun-Fang LIU ; Xing LIAO ; Na LIN
China Journal of Chinese Materia Medica 2020;45(4):775-790
		                        		
		                        			
		                        			To systematically evaluate the adverse drug reaction(ADR) of Tripterygium Glycosides Tablets(TGT) in the treatment of rheumatoid arthritis(RA). Four Chinese databases(CNKI, VIP, WanFang, SinoMed) and three English databases(Cochrane Library, EMbase, PubMed), from the time of database establishing to August 2019, were systematically retrieved to collect literature on the treatment of all types of RA with TG. Screening literature and extracting data according to inclusion and exclusion criteria. All studies were assessed by using internationally recognized methodological quality assessment tools or reporting quality evaluation criteria, with data being extracted and Meta-analyzed. There were 79 studies included, randomized controlled trials(RCT) containing TGT in the treatment group, non-randomized controlled trials(non-RCT), case series, case reports, and RCT containing TGT only in the control group were covered. There were in the control group; 765 ADR of 2 214 patients in 30 RCT(treatment group given TGT), 11 non-RCT and 7 case reports. The results of Meta-analysis of these 48 literatures showed that the overall incidence of ADRs was 0.23(95%CI[0.22,0.24]); ADR mainly occured in the reproductive, gastrointestinal, skin and accessories, blood, hepatobiliary system damage and the incidence of ADR in systems mentioned about respectively were 0.14(95%CI[0.12,0.17]),0.07(95%CI[0.06,0.08]),0.06(95%CI[0.04,0.07]),0.04(95%CI[0.03,0.05]),0.04(95%CI[0.03,0.05]). Further subgroup analysis results showed that the incidence of total ADR, especially the gastrointestinal, reproductive and cutaneous ADR of patients with treatment alone was higher than that in those paients with MTX or MTX+LEF therapy; The incidence of ADR, especially the gastrointestinal ADR, was also positively correlated with daily dose and course of treatment, while the incidence of different systems ADR was also correlated with different drug manufacturers, for instance, damage on the female reproductive system occurs most frequently in Hunan manufacture TGT administration, same as the damage on skin and accessories induced by TGT from Jiangsu manufacture. Above all, The clinical treatment of TGT for RA will cause multi-system ADR, with the highest incidence in the reproductive system, followed by the gastrointestinal system, which is closely related to the way of medication(monotherapy), daily dose, course of medication and drug manufacturer. Therefore, it is recommended that, in the treatment of RA, using TGT in combination, low dose or short-course medication, take measures to protect the reproductive system, stomach and liver, and paying attention to the drug manufacturer as well response of patients during administration should be valued to avoid ADRs to the maximum possibility.
		                        		
		                        		
		                        		
		                        			Arthritis, Rheumatoid/drug therapy*
		                        			;
		                        		
		                        			Drugs, Chinese Herbal/therapeutic use*
		                        			;
		                        		
		                        			Glycosides/therapeutic use*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Non-Randomized Controlled Trials as Topic
		                        			;
		                        		
		                        			Randomized Controlled Trials as Topic
		                        			;
		                        		
		                        			Tablets
		                        			;
		                        		
		                        			Tripterygium/chemistry*
		                        			
		                        		
		                        	
            
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