Table of Content

Volume 24 Issue 4
26 April 2019

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Astragalus saponins inhibit high glucose-induced autophagy in human retinal pigment epithelial cells by regulating protein kinase R-like endoplasmic reticulum kinase pathway

YU Jing, ZHAO Hailan, CHENG Kaiyao, SHEN Pingyu, HUANG Jinlin

2019, 24(4):  361-368.  doi:10.12092/j.issn.1009-2501.2019.04.001

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AIM: To investigate the effects of astragalus saponins on the regulation of PERK pathway in high glucose-induced autophagy in human retinal pigment epithelial cells.  METHODS: Human retinal pigment epithelial cells were cultured in vitro. The experiment was divided into NC group (5.5 mmol/L glucose), HG group (30 mmol/L glucose), and Ast group (30 mmol/L glucose+2.5, 5, 10 μg/mL astragalus saponins). The activity of ARPE-19 cells was detected by MTT. The apoptotic rate was detected by flow cytometry. The expression levels of autophagy-related proteins and key factors of PERK pathway were detected by Western blot. The effect on the level of autophagy was determined by Western blot analysis with the addition of PERK-specific inhibitor GSK2606414. RESULTS:Compared with the normal control group, the activity of ARPE-19 cells in the high glucose group was decreased. The apoptotic rate was increased, the expression level of autophagy-related protein LC3 was significantly increased. The expression level of p62 protein was significantly decreased. The protein levels of GRP78, Perk and CHOP, the key factors of PERK pathways, were significantly up-regulated, and the difference was statistically significant (P＜0.05). Compared with the high glucose group, the activity of ARPE-19 cells in the astragalus saponins group was increased. The apoptotic rate was decreased, the expression level of LC3 protein was down-regulated, the expression level of p62 protein was up-regulated, and the protein levels of GRP78, Perk and CHOP were significantly decreased. The concentration dependence was statistically significant (P＜0.05). PERK-specific inhibitor GSK2606414 was able to further inhibit the expression of LC3 protein in the ARPE-19 cells of the astragalus saponins group and up-regulate the expression of p62 protein, the difference was statistically significant (P＜0.05). CONCLUSION: Astragalus saponins can inhibit the autophagy of human retinal pigment epithelial cells induced by high glucose, and its mechanism is related to the inhibition of protein kinase R-like endoplasmic reticulum kinase pathway.

Mechanism of heat shock transcription factor 2 promotes inflammatory response in Crohn's disease through HMGB1-TLR4-NF-κB signaling

RUAN Shuiliang，GUAN Qiaobing

2019, 24(4):  369-375.  doi:10.12092/j.issn.1009-2501.2019.04.002

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AIM: To study the mechanism of heat shock transcription factor 2 (HSF2) promoting the inflammatory response of Crohn's disease in mice through HMGB1-TLR4-NF-κB signaling. METHODS: The model of Crohn's disease mice was established by 2,4,6-three nitrobenzene sulfonic acid (TNBS). Mice were divided into normal group, model group, control group and experimental group. The control group used high mobility group protein 1 (HMGB1) antibody to block the HMGB1 signal. The control group and the experimental group were treated with recombinant HSF2. To observe the general living conditions of mice (including survival, body weight, stool traits, eating and drinking state, hair glossiness, mental state and activity state), the disease activity index (DAI) of mice was used to evaluate the condition of the mice. Hematoxylin eosin (HE) staining was used to detect the pathological changes of intestinal tissue in mice. Immunohistochemical staining (IHC) was used to detect the expression of P-65 in intestinal tissue of mice. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the colon tissue of mice. Western-Blot was used to detect the expression level of HMGB1, Toll like receptor 4 (TLR4), NF-κB (p-P65) and myeloid differentiation factor (MyD88) in colonic tissue. RESULTS:TNBS induced mouse Crohn's disease successfully. The general living condition of the experimental group was poor, and the DAI score was significantly higher than that of the control group and the model group, with statistical significance (P<0.05). HE staining showed that the degree of erosion, edema and inflammatory reaction of the colon mucosa in the experimental group was higher than that in the model group and the control group. The levels of inflammatory factors IL-1β, TNF-α, IL-6 in the colon tissue of the experimental group were significantly higher than those of the model group and the control group (P<0.05). The expression level of HMGB1, TLR4, NF-κB (p-P65) and MyD88 in the tissues was significantly higher than that in the model group and the control group (P<0.05). CONCLUSION:HSF2 can promote the inflammatory response of Crohn's disease in mice by activating HMGB1-TLR4- NF-κB signaling.

EGCG elevates wild-type cTnI expression in a cTnI-R193H mouse model of restrictive cardiomyopathy

ZHANG Mingqing，LIU Lingjuan，TIAN Jie

2019, 24(4):  376-382.  doi:10.12092/j.issn.1009-2501.2019.04.003

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AIM: To increase the expression level of normal cTnI in mice with cTnIR193H restricted cardiomyopathy by EGCG. METHODS: 8 weeks old wild type C57 mice and 8 weeks old cTnIR193H restricted cardiomyopathy model mice were randomly divided into EGCG intervention, DMSO intervention group and non intervention group. After 5 days of intervention, the heart tissues of mice were collected after 3 months. mRNA expression levels of HDAC1, GATA4 and cTnI were detected by Western blot and RT-PCR respectively. The acetylation level of histone H3K9, the binding level of GATA4 and HDAC1 in cTnI gene promoter region were detected by ChIP-Q-PCR. RESULTS:The level of protein level in the EGCG intervention group and the expression of normal cTnI at the level of mRNA, the level of mRNA expression of GATA4, the level of histone H3K9 acetylation, and the binding level of GATA4 were higher than those of the unpretreated group (P<0.05). The level of HDAC1 binding and HDAC1 mRNA expression level in cTnI promoter region were lower than those in the non intervention group (P<0.05). CONCLUSION: In the R193H model mice, EGCG inhibits the expression of HDAC1 and inhibits the binding of HDAC1 in the promoter region of cTnI, thus promoting the expression of cardiac transcription factor GATA4, the acetylation of histone H3K9, and the combination of GATA4 in the promoter region of cTnI, and up regulation of the cTnI expression of myocardium.

miR-1304 inhibits non-small cell lung cancer cell invasion and proliferation in vitro via targeting heme oxygenase-1

Yuan ShaoFei

2019, 24(4):  383-390.  doi:10.12092/j.issn.1009-2501.2019.04.004

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AIM:To investigate the direct target of miR-1304 and its function in NSCLC in vitro. METHODS: Real-time quantitative PCR was used to detect the expression of miR-1304 in lung cancer cell A549 and NCI-H1975 .Transwell assay was used to test the role of miR-1304 on regulating invasion and migration of cells. The cell proliferation and survival were investigated via cell counting, MTT and colony-formation assays. Cell apoptosis and cell cycle were examined using annexin V-PE/7-AAD and PI staining assays, respectively. Dual luciferase reporter gene was used to analyze the binding between miR-1304 and 3'UTR of heme oxygenase-1, Western blot detected the HO-1 protein levels. RESULTS:MiR-1304 significantly decreased the number and viability of NSCLC cells and colony formation, and induced cell apoptosis and G0/G1 phase cell cycle arrest. HO-1 was demonstrated to be a direct target of miR-1304 in NSCLC cells. Furthermore, altered expression of miR-1304 by transfection of pre-miR-1304 mimics and inhibitor signifcantly affected the ability of invasion and proliferation of lung cancer cells. Altered expression of miR-1304 markedly down-regulated the HO-1 protein levels of lung cancer cells. In addition, dual luciferase reporter gene assay indicated that miR-1304 regulated HO-1 expression by binding to the 3'UTR of HO-1 mRNA. CONCLUSION: MicroRNA-1304 is a tumor suppressor and HO-1 is its direct target in NSCLC. The results suggest the potential for miR-1304 as a therapeutic target for NSCLC.

Raddeanin inhibits the invasion and metastasis of HEC-1-B cells in human endometrial carcinoma by inhibiting the JAK/STAT3 signaling pathway

CHEN Yuequn, ZHAI Hongbo, TONG Jinyi, QU Wanglei

2019, 24(4):  391-396.  doi:10.12092/j.issn.1009-2501.2019.04.005

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AIM: To investigate the effect of raddeanin on the invasion and metastasis of human endometrial carcinoma HEC-1-B cells, and the effects of the JAK/STAT3 signaling pathway.  METHODS: HEC-1-B cells were selected from human endometrial carcinoma in logarithmic phase. One group was treated with raddeanin, which was the observation group. The other group was treated with saline as a control group. The scratch test was used to detect the cell migration at different time points in the two groups. The invasiveness of cells in two groups was compared by Transwell. The proliferation capacity of cells in two groups was measured by CCK-8. The expression of JAK and STAT3 in cells was detected by fluorescence quantitative PCR and Western blot. RESULTS:After 48 h, the migration distance of the observation group was shorter than that of the control group (P<0.05). The number of cells invading the lower compartment was less than that of the control group (P<0.05). The differences in cell proliferation between the two groups were not statistically significant during 48 h（P>0.05）. Compared with the control group, the results of fluorescence quantitative PCR and Western blot showed decreased expression of JAK and STAT3 genes in the observation group（P<0.05）. CONCLUSION: Raddeanin can significantly inhibit the invasion and metastasis of human endometrial carcinoma HEC-1-B cells and its mechanism may be through regulating the JAK/STAT3 signaling pathway.

NBP inhibits ox-LDL induced apoptosis of endothelial cells through endoplasmic reticulum stress pathway

GUAN Qiaobing，YANG Yi，GUO Li，HAN Chenyang

2019, 24(4):  397-402.  doi:10.12092/j.issn.1009-2501.2019.04.006

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AIM: To investigate the effect of N-butylphthalide (NBP) on endothelial cell apoptosis induced by low density lipoprotein (ox-LDL) through endoplasmic reticulum stress pathway.  METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured in vitro, pretreated with NBP (5, 10, 20 mg/L) and 4-phenylbutyric acid (4-PBA, 4 mmol/L) for 1 hour, and then cultured with ox-LDL (100 mg/L). CCK-8 assay was used to detect cell viability, flow cytometry to detect apoptosis, LDH kit to detect the level of lactate dehydrogenase (LDH) in culture medium, Hoechst 33342 staining to observe the level of apoptosis. Western blot and RT-QPCR were used to detect the expression levels of CHOP and GRP78 in the endoplasmic reticulum stress signal. RESULTS:ox-LDL could induce the activation of ER stress pathway in HUVECs and promote the apoptosis of HUVECs. NBP inhibited the injury of HUVECs induced by ox-LDL in a dose-dependent manner, increased the cell viability, decreased the apoptosis rate and decreased the level of LDH. NBP, similar to PBA, could inhibit the expression of CHOP and GRP78 and the activation of ER stress.CONCLUSION: NBP can inhibit the apoptosis of HUVECs induced by ox-LDL, and the mechanism is related to the inhibition of ER stress pathway.

Expression of miR-34a-5p in bladder cancer and its effect on invasion and migration of bladder cancer cells

LI Peng, YANG Ronghua, ZHANG Minghua, XIAO Xin, TANG Jianer

2019, 24(4):  403-410.  doi:10.12092/j.issn.1009-2501.2019.04.007

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AIM: To study the expression of miR-34a-5p in bladder cancer and its effect on invasion and migration of bladder cancer cells. METHODS: 50 cases of bladder cancer and corresponding adjacent tissues were collected, the expression of miR-34a-5p was detected by qRT-PCR. The miR-34a-5p mimics were transfected into bladder cancer cells. The levels of miR-34a-5p, the number of invasion and migration, and the expression levels of E-cadherin, N-cadherin and Vimentin were detected by qRT-PCR, Transwell chamber and Western blot, respectively. Target gene prediction software found that TPD52 might be the target gene of miR-34a-5p; luciferase reporter vector was constructed to identify the target gene. The effect of miR-34a-5p mimics on the expression of TPD52 in bladder cancer cells were detected by Western blot. The expression of TPD52 in bladder cancer and adjacent tissues were detected by qRT-PCR, and the correlation between the expression of TPD52 and miR-34a-5p in bladder cancer were analyzed. The miR-34a-5p mimics and pcDNA3.1-TPD52 were co-transfected into bladder cancer cell. TPD52 protein, number of invasion and migration, and expression of E-cadherin, N-cadherin and Vimentin were detected by the above methods. RESULTS:The expression of miR-34a-5p in bladder cancer tissue was decreased. miR-34a-5p mimics increased the expression level of miR-34a-5p in bladder cancer cells, reduced the invasion and migration ability, reduced the expression of N-cadherin and Vimentin, increased the expression of E-cadherin protein. miR-34a-5p regulated the expression of TPD52, moreover, miR-34a-5p mimics inhibited the expression of TPD52 protein in cells. TPD52 was highly expressed in bladder cancer, which was negatively correlated with the expression level of miR-34a-5p in bladder cancer tissue. Compared with co-transfected cells of miR-34a-5p mimics and pcDNA3.1, co-transfection of miR-34a-5p mimics and pcDNA3.1-TPD52 enhanced the expression of TPD52 in bladder cancer cells, increased the invasive and migratory ability of bladder cancer cells, and promoted the expression of N-cadherin and Vimentin, reduced the expression of E-cadherin protein. CONCLUSION: The expression of miR-34a-5p in bladder cancer tissue was low. Upregulation of miR-34a-5p targeting TPD52 inhibits the invasion and migration of bladder cancer cells.

Effects of rat nerve growth factor on the expression of phosphorylated p38MAPK in dorsal root ganglia of rats with sciatica

CHEN Feng, ZOU Yi, HU Bo, HU Song, CHEN Yong, GAO Daxin

2019, 24(4):  411-417.  doi:10.12092/j.issn.1009-2501.2019.04.008

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AIM: To analyze the effects of rat nerve growth factor on neuroelectrophysiology and expression of phosphorylated p38MAPK in dorsal root ganglion (DRG) in rats with sciatica caused by lumbar disc herniation. METHODS: 90 SPF-level Wistar male rats were randomly divided into 6 groups: normal group, model group, positive control group, low, medium and high dose groups of rat nerve growth factor, 15 in each group. Except the normal group, rats in other groups were prepared for sciatica caused by lumbar disc herniation. The low, medium and high doses groups were injected into the epidural space at 2.5 μL/100 g, 5 μL/100 g, 10 μL/100 g of rat nerve growth factor, respectively. The positive control group was given 7.5 mg/kg of indomethacin solution, the model group and the normal group were injected with the same dose of normal saline once a day for 7 days. The general activity, mechanical contraction response threshold (PWT), heat-shrinking foot reflex latency (PWL), neuroelectrophysiology, inflammatory factors in DRG, calcitonin gene-related peptide (CGRP), substance P (SP), and phosphorylation p38MAPK expression of the rats in each group were observed. RESULTS:Compared with the normal group, the PWL and PWT of the model group decreased after 3 and 7 days of administration. Compared with model group, the PWL and PWT of positive control group, middle and high dose group of rat nerve growth factor increased after 3 and 7 days of administration (P<0.05), and the effects of 7 days after administration was better than that of 3 days after administration (P<0.05). Compared with the normal group, the contents of SP, CGRP, TNF-a, IL-6 and IL-1 in DRG in the model group increased. Compared with the model group, the contents of SP, CFRP, TNF-a, IL-6 and IL-1 in DRG of rats in the positive control group and the middle and high dose groups of rat nerve growth factor decreased (P<0.05). Compared with the normal group, the expression of p38MAPK in the DRG of the model group increased; compared with the model group, the expression of p38MAPK in the DRG of the positive control group, the middle and high dose groups of the rat nerve growth factor decreased (P<0.05). CONCLUSION:Rat nerve growth factor can reduce the expression of phosphorylated p38MAPK and inflammatory factors in DRG of rats with sciatica caused by lumbar disc herniation, and improve nerve conduction function.

Population pharmacokinetics of tamoxifen in patients with breast cancer

WU Min, GUO Yiyun, XIE Haitang

2019, 24(4):  418-423.  doi:10.12092/j.issn.1009-2501.2019.04.009

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AIM:To investigate the population pharmacokinetic characteristics of tamoxifen (TAM) in breast cancer patients and factors that might impact its clearance. METHODS: Blood samples of breast cancer patients who regularly took TAM were collected and the blood concentration of TAM and its metabolite Endoxifen was determined by HPLC-MS/MS and analyzed with nonlinear mixed-effect model (NONMEM). The population pharmacokinetics parameters were compared with those of volunteers in literatures. After that, 1 000 bootstraps were performed to validate the final model. RESULTS:A total of 29 patients took TAM. The mean age and BMI was (46.9±6.4) years and (23.70±2.87) kg/cm2, respectively. Typical population estimates of Ka, CLTAM, CLMET, VTAM, VEND, CLEND, Q were 0.830 h-1, 6.61 L/h, 0.707 L/h, 753 L, 400 L, 5.10 L/h, 61.8 L, respectively. Covariable screening showed OATP1B1*521 gene polymorphism and menopause time had an effect on metabolic constant CLTAM in the process of forward inclusion (P<0.05), but no significant covariable (P<0.001) was found in the process of backward elimination. The model validation of bootstraps results showed the success rate was 96.8%.CONCLUSION: The population pharmacokinetics model of TAM and END is established successfully. And it can provide some information for TAM clinical individualized medication from the perspective of pharmacometrics.

Volume kinetics of Ringer's lactate in acute inflammatory disease

YE Xiaomin, YI Shenghua, ZHU Yeke, CHAN Yue, TENG Yitong, TENG Wenbin, LI Yuhong

2019, 24(4):  424-432.  doi:10.12092/j.issn.1009-2501.2019.04.010

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AIM: To explore the volume kinetics of Ringer's lactate (RL) in acute inflammatory disease and whether the inflammatory biomarker would be associated with altered distribution and elimination of RL. METHODS: In this prospective cohort study, we enrolled 40 ASA physical status I-II patients undergoing elective laparoscopic cholecystectomy (cholecystitis group, n=20) or emergency laparoscopic appendectomy (appendicitis group, n=20). All of the patients were infused RL (15 mL/kg) intravenously over 35 min, starting before the induction of general anesthesia. Plasma concentrations of inflammatory (tumor necrosis factor-α, interleukin-10, and C-reactive protein) and endothelial damage (syndecan-1, SDC-1) biomarkers were quantified by enzyme-linked immunosorbent assay (ELISA). The kinetics of RL and the effects of covariates were calculated by plasma dilution based on the dilution of hemoglobin-time curve, urinary excretion by using Phoenix software for mixed effects modeling. RESULTS:Compared with the cholecystitis group, the rate constant for fluid transfer from the peripheral fluid space to the central fluid space (k21) decreased significantly in the appendicitis group (14×10-3min-1 versus 35×10-3min-1; P=0.012), in whom higher plasma concentrations of C-reactive protein (CRP) were measured ［median: 38.1(1.8-143.6) μg/mL versus 1.3(0.1-159.0) μg/mL, P<0.001］. Compared with conscious period, ongoing anesthesia (duration: 30 min-45 min after beginning of infusion) increased the rate constant for fluid transfer from the plasma to the extravascular space (k12) significantly (57×10-3min-1 versus 32×10-3min-1), and decreased the elimination rate constant (k10: from 0.6×10-3min-1 to 5.3×10-3min-1; P<0.001). A lower mean arterial pressure was associated with reduced elimination, independent of conscious/anaesthetized state. However, no biomarkers for inflammation or endothelial damage were significantly associated covariates in the kinetic model. CONCLUSION: No association was found between the volume kinetics of Ringer's lactate and the degree of inflammation (as indicated by established biomarkers) in patients with cholecystitis or appendicitis. However, the rate of elimination was greatly retarded by general anesthesia in both groups.

Clinical study of anticoagulant therapy on hypercoagulable state and anti-tumor metastasis in advanced gastric cancer

ZHANG Tengyue, YANG Guangshan, MA Kelong, FAN Pingsheng

2019, 24(4):  433-439.  doi:10.12092/j.issn.1009-2501.2019.04.011

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AIM: To analyze the relationship between coagulation parameters and clinic pathological features of gastric cancer patients, and observe the effect of anticoagulant therapy on hypercoagulable state, tumor metastasis/recurrence, survival status and safety evaluation of gastric cancer. METHODS: 140 patients with gastric cancer were selected to analyze the relationship between coagulation parameters and clinic pathological features. 172 patients with stage III gastric cancer were enrolled, including 116 patients in the treatment group (prophylactic anticoagulant therapy combined with postoperative adjuvant chemotherapy) and 56 patients in the control group (postoperative adjuvant chemotherapy). The anticoagulant therapy was observed on hypercoagulable state and tumor metastasis/recurrence, impact of survival and safety assessment. RESULTS:D-dimer of lymph node metastasis N1-3 group was higher than N0 group (P<0.05), stage III and IV were higher than stage I and II of FIB, D-dimer, and APTT value was decreased (P<0.05). Before and after anticoagulant therapy in the treatment group, PT and APTT were prolonged, D-dimer and FIB were decreased (P<0.05). The rate of lymph node and liver metastasis in the treatment group was lower than that in the control group in 12, 24 and 36 months (P<0.05). The 2-year and 3-year survival rates of the treatment group were higher than those of the control group (P<0.05), and the median survival and disease-free survival were longer than the control group. There was no significant difference in the incidence of gingival bleeding, thrombocytopenia, and ecchymosis of the skin between the two groups (P>0.05). CONCLUSION:The factors influencing the hypercoagulable state of gastric cancer are lymph node metastasis and TNM staging. Anticoagulant therapy can improve hypercoagulability, reduce the rate of lymph node and liver metastasis, and prolong survival without increasing the incidence of adverse reactions.

Effect of Liangxuehuoxue Decoction combined with cupping therapy on plaque psoriasis

CHEN Shengli, LIU Jifeng, SHAN Yunyun

2019, 24(4):  440-445.  doi:10.12092/j.issn.1009-2501.2019.04.012

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AIM: To study the curative effect of Liangxuehuoxue Decoction combined with cupping therapy on plaque psoriasis.  METHODS:138 patients with plaque psoriasis from July 2015 to October 2017 in the Hangzhou Third People's Hospital were randomly divided into treatment group (69 cases) and control group (69 cases) by random number table method. Patients in the treatment group were treated with Liangxuehuoxue Decoction combined with cupping therapy, while patients in the control group were treated with Liangxuehuoxue Decoction only for 8 weeks and followed up for 6 months. The clinical efficacy, psoriatic lesion area and severity index (PASI score), skin CT changes, safety and recurrence of the two groups were observed. RESULTS:There were significant differences in clinical efficacy between the two groups (Z=-2.045，P=0.041). The effective rate of the treatment group was significantly higher than that of the control group (98.55% vs. 79.71%，χ2=12.641，P=0.000). After treatment 4 weeks, 6 weeks, 8 weeks, the traditional Chinese medical syndrome scores in the two groups of patients were significantly reduced, and the traditional Chinese medical symptom scores of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the PASI scores of the two groups were significantly reduced, and the PASI score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the thickness of the spinous layer and the width of the nipple ring of the two groups were significantly reduced, and these two indicators in the treatment group were significantly lower than those in the control group (P<0.05). There were no obvious abnormalities in the three routine tests, coagulation function and biochemical examination before and after treatment. The recurrence rate of the treatment group was significantly lower than that of the control group (3.23% vs. 25.81%, χ2= 4.679, P=0.031). CONCLUSION:Liangxuehuoxue Decoction combined with cupping therapy can significantly improve the clinical efficacy and has high safety in the treatment of plaque psoriasis. Therefore, this treatment is worthy of clinical promotion.

Effects of aripiprazole combined with escitalopram oxalate on DA, 5-HT and cortisol in patients with severe depression

CHEN Lianzhou, LI Songhua, PU Ben

2019, 24(4):  446-450.  doi:10.12092/j.issn.1009-2501.2019.04.013

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AIM: To investigate the effects of aripiprazole combined with escitalopram oxalate on DA, 5-HT and cortisol in patients with severe depression.  METHODS: 94 patients with severe depression were divided into observation group and control group. The control group was treated with escitalopram oxalate. The observation group was treated with aripiprazole combined with escitalopram oxalate. Hamilton Anxiety Scale (HAMD-17) was used to assess the depressive state of patients. The levels of dopamine (DA), 5-hydroxytryptamine (5-HT) and cortisol were measured before and after treatment in both groups. Health status questionnaire (SF-36) was used to assess patients' quality of life, including physiological function, physical pain, physiological function, mental health, emotional function, life vitality, social function and overall health. The occurrences of adverse reactions in the course of treatment in two groups were observed. RESULTS:The effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, cortisol and HAMD-17 scores in both groups decreased significantly as compared with before treatment, while DA and 5-HT increased significantly (P<0.05). After treatment, cortisol and HAMD-17 scores in the observation group were lower than those in the control group, while DA and 5-HT scores in the observation group were higher than those in the control group (P<0.05). After treatment, the physiological function, physical pain, physiological function, mental health, emotional function, vitality, social function and overall health of the two groups increased significantly (P<0.05). After treatment, the physiological function, physical pain, physiological function, mental health, emotional function, vitality, social function and overall health of the observation group were higher than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. CONCLUSION:Aripiprazole can further regulate the levels of DA, 5-HT and cortisol in patients with severe depression, and improve the clinical efficacy and quality of life.

Therapeutic effect of bisoprolol combined with salvianolate on patients with coronary heart disease after PCI

CHEN Miao, ZHANG Xinjin, MENG Hongli, YANG Bei, SONG Lijuan, ZOU Chuannan, GUAN Yingxia

2019, 24(4):  451-457.  doi:10.12092/j.issn.1009-2501.2019.04.014

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AIM: To analyze the influence of bisoprolol combined with salvianolate on the inflammatory microenvironment and hemorheology indexes of patients with coronary heart disease after percutaneous coronary intervention (PCI). METHODS: Totally 120 cases of patients with coronary heart disease treated in our hospital from July, 2015 to May, 2017 who underwent PCI were randomly divided into control group and experimental group according to computer-generated number table method, with 60 cases in each group. The patients in control group were given conventional treatment, and the patients in experimental group were administered bisoprolol combined with salvianolate on that basis. The inflammatory microenvironment and hemorheology indexes of the patients in both groups were comparatively analyzed. RESULTS:After treatment, the levels of hypersensitive C-reactive protein (hs-CRP), TNF-α, lipoprotein-associated phospholipase A2 (Lp-PLA2), soluble intercellular adhesion molecule-1 (sICAM-1), Toll-like receptors 4 (TLR4) and soluble vascular cell adhesionmolecula-1 (sVCAM-1) in experimental group were all lower than those in control group, with statistically significant (P＜0.05). The hematokrit, whole blood high shear viscosity, fibrinogen, whole blood low shear viscosity, erythrocyte aggregation index as well as plasma viscosity in experimental group were all lower than those in control group, while the erythrocyte deformation index was higher, with statistically significant (P＜0.05). Both the left ventricular end diastolic diameter and the left ventricular end systolic diameter in experimental group were lower than those in control group, whereas the left ventricular ejection fraction showed the opposite response, with statistically significant (P＜0.05). The levels of monocyte chemoattractant protein-1 (MCP-1), growth differentiation factor-15 (GDF-15) and lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) in the experimental group were all lower than those in control group, while the level of visceral adipose tissue- derived serine protease inhibitor (Vaspin) in the experimental group was higher than that of the control group, with statistically significant (P＜0.05). CONCLUSION:The combination of bisoprolol and salvianolate is conducive to improving the inflammatory microenvironment, hemorheology and cardiac function indexes of patients with coronary heart disease after PCI, and is worthy to be popularized.

Effect of compound glycyrrhizin on the expression and clinical prognosis of antibacterial peptide LL-37 in patients with pigmentary purpuric skin disease

SONG Xin, WANG Xue, ZHOU Huanghong, ZHAO Tianyi

2019, 24(4):  458-463.  doi:10.12092/j.issn.1009-2501.2019.04.015

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AIM:To study the therapeutic effect and the antimicrobial peptide LL-37 level of compound glycyrrhizin in patients with pigmented purpuric dermatosis（PPD）. METHODS:A total of 54 patients with PPD admitted to our hospital from April 2015 to April 2018 were enrolled in the study.They were randomly divided into observation group and control group,27 cases in each group,and 30 normal subjects were selected as a normal group.In the control group,oral methylprednisolone tablets and butyl flufenamate ointment were applied to the skin lesions;the observation group was given oral compound glycyrrhizin tablets;the normal group was not treated, and after 1 month，the evaluation was observed.The efficacy,adverse reaction rate and recurrence rate of the observation group and the control group were compared.The LL-37 level in serum of the three groups and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum of the three groups were compared.RESULTS:Before treatment,there was no significant difference about the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum between the observation group and the control group(P>0.05).After treatment，the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum were decreased in both groups(P<0.05).The levels of TNF-α,IL-6 and IL-17 in observation group were significantly lower than those of the control group(P<0.05).Before and after treatment,serum LL-37 levels,skin LL-37 levels,and TNF-α,IL-6,and IL-17 levels were significantly higher in the observation group and the control group than those in the normal group (P<0.05).The effective rate of treatment in the observation group was 70.37%,which was significantly higher than that in the control group(51.85%) (P<0.05).The incidence of adverse reactions in the observation group was 18.52%,which was slightly lower than that in the control group(33.33%),but the difference was not statistically significant (P>0.05).The recurrence rate in the observation group was 11.11%,which was slightly lower than that in the control group 18.52%,but the difference was not Statistically significant (P>0.05).CONCLUSION:Compound glycyrrhizin can reduce the expression level of antibacterial peptide LL-37 in patients with pigmentary purpuric skin disease,reduce the inflammatory response,and the incidence of adverse reactions and recurrence rate is lower,the efficacy and safety are better,it is worthy of clinical promotion.

Clinical study on electroacupuncture and traditional chinese medicine combined with pelvic floor muscle training for stress urinary incontinence in perimenopausal women

GU Yiming, PAN Hongyi, SHENG Shaoqin, YING Jiawei, ZHENG Dandan, YAO Jinmin, YU Leiyuan

2019, 24(4):  464-470.  doi:10.12092/j.issn.1009-2501.2019.04.016

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AIM: To explore the effect of electroacupuncture and traditional Chinese medicine combined with pelvic floor muscle training on stress urinary incontinence（SUI）in perimenopausal women. METHODS: 178 patients with mild to moderate SUI were diagnosed in the perimenopausal clinic of the Second Affiliated Hospital of Zhejiang Chinese Medical University from October 2016 to September 2017. Finally, 162 patients completed the treatment and follow-up (Control group n=54, therapy group 1 n=52, therapy group 2 n=56). Kegel exercise training was given to the control group, electrical stimulation biofeedback therapy was given to the therapy group 1 on the basis of the control group. In the therapy group 2, after TCM syndrome differentiation, the treatment of Buzhong Yiqi Decoction and electroacupuncture was given on the basis of the control group. All three groups were treated for 2 courses and regularly followed for 6 months. At the end of treatment, 3 and 6 months after treatment, 1 h urine pad test were performed, and the International Urinary Incontinence Advisory Committee Urinary Incontinence Questionnaire (ICI-Q-SF) were completed. At the end of treatment and 6 months after treatment, urodynamics test were taken, and the efficacy were evaluated. RESULTS:At the end of treatment, 3 and 6 months after treatment, 1 h urine pad test urine leakage and ICI-Q-SF score were significantly lower than those before treatment (P＜0.05); at the end of treatment and 6 months after treatment, abdominal pressure leak point pressure (ALPP), maximum urethral closure pressure (MUCP), bladder compliance (BC) significantly increased as compared with before treatment (P＜0.05). The improvement of the above indicators in the therapy group 1 and 2 was significantly better than those in the control group (P＜0.05), while the therapy group 2 was better than the therapy group 1 in the 1h urine pad test (P＜0.05). In the ICI-Q-SF score, various urodynamic indicators, there was no significant difference between therapy group 1 and 2 (P>0.05).CONCLUSION:The combination of electroacupuncture and traditional Chinese medicine combined with pelvic floor muscle training for the treatment of mild to moderate perimenopausal women with SUI can reduce urine leakage, increase abdominal pressure leakage point pressure (ALPP), maximum urethral closure pressure (MUCP), and improve bladder compliance (BC), significantly improve the quality of life of patients.

Abnormal regulation of autophagy in inflammatory bowel disease and the intervention of traditional Chinese medicine

FAN Qilin，ZHENG Xiao，WANG Shumei，HAO Haiping，LI Ping

2019, 24(4):  471-480.  doi:10.12092/j.issn.1009-2501.2019.04.017

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Autophagy is a lysosome-mediated cell-programmed degradation pathway that plays an important role in maintaining cell homeostasis, eliminating intracellular toxic substances and the balance of metabolic energy. Research shows that autophagy is closely related to the dysregulation of inflammatory immune response, pathogen invasion and the repair of intestinal mucosa, and is an important mechanism of inflammatory bowel disease (IBD). These findings are important for understanding the mechanisms of IBD and optimizing existing treatment strategies. In this review, the commonly used traditional Chinese medicines for IBD treatment were summarized from the perspective of autophagy regulation. The implications of autophagy regulation on the mechanism of research related Chinese medicine ingredients and the problems and development trends of related research were discussed.