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This study was aimed to discuss the external treatment of diabetic foot ulcer with traditional Chinese medicine (TCM) Yin-Huang-San (YHS) and to observe its promoting healing effect. Analysis was made on AGEs correlated with inflammatory factors and growth factors. A total of 60 patients with damp-heat-toxin pattern standard diabetic foot ulcer patients were randomly divided into the treatment group and control group. External application of YHS was given in the treatment group. And external application of metronidazole and glucose injection was given in the control group. The dressing was changed once a day. Blood was drawn 1 d before the treatment, and 7 d, 14 d, 21 d, 28 d after the medication. Improvements of patients’ clinical symptoms were observed. Dynamic monitoring was given on changes of hs-CRP, TNF-α, IL-1, VEGF, EGF, bFGF, PDGF and AGEs. The results showed that the total efficiency of the treatment group was 96.7%; and the total efficiency of the control group was 83.3%. Compared with the control group, external treatment with YHS can obviously improve clinical symptoms of diabetic foot ulcer (P<0.01), reduce AGEs and inflammatory factor, and increase the number of growth factors. AGEs had significant positive correlation with inflammatory factor; it had significant negative correlation with growth factors. It was concluded that YHS was effective in the treatment of diabetic foot ulcer patients with damp-heat-toxin pattern.
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This study was aimed to observe the clinical efficacy of Jie-Du Tong-Mai (JDTM) decoction (i.e., detoxi-fication unclogg artery soup) of arteriosclerosis obliterans. A total of 246 arteriosclerosis obliterans cases with the pattern of blood stasis were selected and randomly divided into two groups. In the control group of 120 cases, 0.1 g of aspirin and 20 mg of simvastatin tablets were orally administrated, once a day. In the treatment group of 126 cas-es, JDTM decoction was combined on the basis of oral administration of aspirin and simvastatin tablets. After 8 weeks of treatment, observations were made on improvement of clinical symptoms and changes of ABI, Hs-CRP, TcpO2. The results showed that compared with the control group, clinical symptoms of the treatment group were obvi-ously improved (P< 0.05). And the ABI, CRP, TcpO2 were also obviously increased (P< 0.01). It was concluded that JDTM decoction was effective in the treatment of arteriosclerosis obliterans with the pattern of blood stasis. It al-so indirectly proved the guiding meaning of traditional Chinese medicine that evil causing stasis.
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Objective To investigate the action mechanism of an anti-photosensitivity mixture on skin photodamage. Methods Twenty-eight BLAB/c mice were divided into 4 groups, i.e., normal control group,treatment group, negative and positive control groups; the last three groups were irradiated with a single dose of UVB at 300 mJ/cm2 after 7-day pretreatment with sodium chloride physiological solution, anti-photosensitivity mixture, and hydroxychloroquine, respectively. Twenty-four hours after the irradiation, mice were killed and skin tissue samples were obtained at the irradiated sites. Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) and immunohistochemical staining were carried out to detect cell apoptosis,Fas and Caspase-3 protein expressions respectively. Results An increase was observed in the expression level of Fas and Caspase-3 and in the apoptotic index in keratinocytes from UV-irradiated mice compared with unirradiated control mice (all P ＜ 0.01 ). In comparison with sodium chloride physiological solution, the antiphotosensitivity mixture suppressed the UV irradiation-induced increase in the expression intensity of Fas and Caspase-3 and apoptotic index in keratinocytes (P ＜ 0.05 or 0.01 ). Conclusions The anti-photosensitivity mixture could alleviate UV-induced inflammatory damage to and apoptosis in epidermal keratinocytes, likely by regulating cell apoptosis and Caspase-3 pathway.
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<p><b>OBJECTIVE</b>To compare the component difference of herb materials extracts of sesame oil fry and SFE-CO2 technique for compound ulcer oil.</p><p><b>METHOD</b>Qualitative analysis of main component of dahuan, baizhi and chuangxiong in two extracts above was conducted by TLC. The contents of total anthraquinones, imperatorin and ferulic acid in two extracts were determined by UV and HPLC.</p><p><b>RESULT</b>TLC experiment found that spots color of small Rf value component in oil extract were lighter than that in SFE-CO2 extract, but there was not obvious different between two extracts. Quantity analysis showed that SFE-CO2 extract owned much higher transfer rate of total anthraquinones, and it was 1.9 times of oil extract. Ferulic acid was similar in two extracts, and they were all below 10%. The contents of imperatorin in oil extracts were slight higher than that in SFE-CO2 extract.</p><p><b>CONCLUSION</b>The components in the extracts of sesame oil fry for the herb materials of compound ulcer oil are the same as SFE-CO2 extract. Because SFE-CO2 extracts have no solvent limited for next preparation, it has more advantage.</p>
Subject(s)
Humans , Carbon Dioxide , Chemistry , Chemical Fractionation , Methods , Chromatography, Supercritical Fluid , Methods , Chromatography, Thin Layer , Drugs, Chinese Herbal , Therapeutic Uses , Hot Temperature , Plants, Medicinal , Chemistry , Sesame Oil , Chemistry , Ulcer , Drug TherapyABSTRACT
BACKGROUND:In the initial stage of ischemia,organisms complete angiogenesis and maintain the blood supply of organization through compensatory regulation and repair,in which process a variety of cytokines,especially vascular endothelial growth factor (VEGF),have played a key role.OBJECTIVE:To observe the characteristics and rules of VEGF level changes in both ischemic tissues and blood serums at different time points after establishing rat models of lower limb ischemia.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed at the Loboratory for Key Subjects in Dongzhimen Hospital and the Laboratory of Molecular Biology in Beijing University of Chinese Medicine from April to November in 2007.MATERIALS:A total of 42 male SD rats of 4 weeks were divided by random digits table into 6 groups,namely a control group and a model group which was subdivided into 5 groups at the time points of hour 4,day 3,weeks 1,2 and 4 post modeling respectivly.METHODS:Rat models of lower limb ischemia were established in the model group by performing ligation and mutilation operation to left femoral arteries of rats that were anesthetized with 100 g/L chloral hydrate. At the time points of hour 4,day 3,weeks 1,2 and 4 following modeling respectively,rats were selected to extract their abdominal aorta blood samples whose supernatant was then obtained through 10 minutes of 3 000r/min centrifugalization. Gastrocnemius tissues in left legs of rats were isolated at the same time. Samples in control group were obtained directly from anesthetized rats.MAIN OUTCOME MEASURES:Western blotting method was used for detecting protein expression of VEGF in ischemic tissues and ELASA method for VEGF level in serum.RESULTS:The protein expression of VEGF in ischemic tissues began to increase immediately at hour 4 following ischemia and reached a peak at day 3,after which it reduced gradually till week 2 when it reached its minimum. Then it began to increase again and reached the level close to that of normal tissues by the end of week 4 following ischemia. As for the VEGF level in serum,it decreased immediately after ischemia,with the maximum decrease amplitude between immediate and hour 4 following ischemia,a smaller one between hour 4 and week 1;From week 1 following ischemia on,it began to increase but was still lower than the normal level by the end of week 4 (P＜0.01 ).The VEGF level in serum changed with the tendency of immediate decrease from hour 4,minimum at week 1 and graduate increase after week 1 following ischemia.CONCLUSION:After ischemia in lower limb,VEGF level in ischemic tissues changes in the direction of increase-decrease-increase;VEGF level in serum changed in the direction of decrease-increase. In another words,VEGF levels after ischemia shows the characteristics of being low in serum and high in local ischemic tissues.
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BACKGROUND: It has been confirmed that Chinese medicine astragalus mongholicus and radix notoginseng can improve symptoms of lower limb ischemia. It is supposed that this kind of therapy is associated with the promotion effect of astragalus mongholicus and radix notoginseng on differentiation of bone marrow mesenchymal stem cells (BMSCs) into vascular endothelial cells.OBJECTIVE: To identify that whether astragalus mongholicus and radix notoginseng are effective in promoting the proliferation and differentiation of BMSCs into vascular endothelial cells. DESIGN, TIME AND SETTING: The in vitro differentiation experiment was performed at the Key Laboratory of Education Ministry, Dong Zhimen Hospital Affiliated to Beijing University of Chinese Medicine from April to June 2005. MATERIALS: Bone marrow blood from 23 patients with lower limb ischemia was collected routinely at the Dong Zhimen Hospital Affiliated to Beijing University of Chinese Medicine. The density gradient centrifugation was used to separate bone marrow mononuclear cells, I.e. BMSCs. Astragalus mongholicus injection (equal'to 2 g/mL crude drug, Diaojiuhong, China), Xuesaitongfen injection (main component radix notoginseng, Zhenbaodao, China), CD34 antibody (BD, USA) and FACS Calibur flow cytometer (BD, USA) were used in this study. METHODS: BMSCs were incubated with 3 mL low, middle and high doses of astragalus mongholieus (containing 4, 12 and 36 g/L crude drug), and 3 mL low, middle and high doses of Xuesaitong suspension (50, 100 and 200 mg/L radix notoginseng). BMSCs only cultured without drugs served as a blank control group. Medium was changed every other day, for successively 3 weeks.MAIN OUTCOME MEASURES: Three weeks later, cell morphology was observed under an inverted phase contrast microscope. CD34+ cell percentage was detected by flow cytometry.RESULTS: Three weeks after BMSC culture, most cells were spindle-shaped, fascicular, with shape and characteristics of endothelial cells. Compared with the blank control group, the percentage of CD34+ cells were significandy increased in the low and middle doses of astragalus mongholicus group and in the middle and high doses of radix notoginseng group (P < 0.05-0.01). CONCLUSION: Astragalus mongholicus and radix notoginseng have the function of promoting proliferation and differentiation of BMSCs into vascular endothelial cells in a dose dependent effect.
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OBJECTIVE: To evaluate the therapeutic effect of transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine for the treatment of limb ischemia. METHODS: Twenty-three patients with limb ischemia were treated. G-CSF was used to stimulate the bone marrow. The mononuclear cells were separated from the aspirated bone marrow fluid in the stem cell studio. The cell amount was above 1x10(9). The transplantation was performed by the way of intra-muscular multi-injection. Traditional Chinese medicine for replenishing qi to activate blood was prescribed from the first day after operation. The pain, poikilothermia, ulcer or necrosis and ankle/brachial index (ABI) of the ischemic limb were evaluated before and after the treatment. RESULTS: The pain score and poikilothermia score decreased one month after the transplantation, with distinct differences as compared with the scores before the treatment (P<0.05). The ABI increased gradually after the treatment, and one month after the treatment, it was 0.15 higher than that before the treatment. CONCLUSION: Transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine can decrease the symptoms and signs of severe lower limb ischemia effectively, and improve the circulation of the ischemic area.
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Objective To discuss the causes and therapies for the complications induced by endovenous laser treatment (EVLT) in patients with varicose great saphenous vein. Methods From August 2003 to February 2007,totally 342 patients (530 limbs) with varicose great saphenous veins were treated by high ligation combined with EVLT in our hospital. Operative compilations were found in 186 of the limbs.The data of the 186 limbs were analyzed retrospectively. Results The patients were followed up for 6 months,during which 23 limbs showed skin bruises and/or hematoma,65 develped phlebitis,and 20 had skin burns; all of these cases were cured. In addition,77 limbs were diagnosed as having saphenous nerve damage (abnormal skin sensation),57 of them were cured and 20 were improved after treatments. Deep vein thrombosis complicated with pulmonary embolism was found in one case,who was improved after therapies. Conclusions To prevent the complications of EVLT combined with high ligation of the saphenous vein,intraoperative adjustment of laser power according to the surgical sites,gentle operation,postoperative administration of anticoagulants,and early rehabilitation are recommended.