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Tripterygium wilfordii is widely used in the treatment of immune system disease and has a remarkable curative effect. Triptolide and Tripterygium glycosides are the most commonly used active ingredients in clinical practice， but their treatment window is narrow and there are many side effects. The damage involves the reproductive system， blood system， cardiovascular system， digestive system， etc. Based on clinical observations and literature summaries， the symptoms of adverse reactions mostly occur in the digestive system （liver and gastrointestinal tract）. Relevant scholars have launched a lot of studies of the manifestations of liver injury induced by T. wilfordii and the mechanism of liver injury. The mechanism is mainly related to liver cell apoptosis， induction of oxidative stress， immune injury， excessive autophagy of liver cells， abnormal fatty acid metabolism， and abnormal enzyme metabolism in liver tissues. This article reviewed and summarized relevant literature on gastrointestinal injury caused by T. wilfordii， but there are few studies on the manifestations and mechanisms of adverse reactions， which still need further research by scholars. In addition， this article also summarized the research on how to reduce toxicity and enhance efficacy of prescriptions prepared from T. wilfordii in the digestive system， mainly involving compatibility with western medicines （Methotrexate， Leflunomide， Iguratimod， etc.）， use along or combination with Chinese medicines （single Chinese medicine， Chinese medicine monomers， and Chinese medicine compounds）， acupuncture and moxibustion （electroacupuncture and moxibustion）， dosage form improvement （glycol plastid gel， self-dissolving microneedle， solid lipid nanoparticles， gastric floating sustained-release capsules， etc.）， processing （steaming， stir-frying， radish seed processing， money grass processing， licorice processing， etc.）， and other methods to reduce toxicity. To sum up， this article analyzed the manifestations， mechanisms， and methods of reducing toxicity and enhancing efficacy of T. wilfordii-induced liver injury and gastrointestinal injury by sorting out relevant literature， in order to provide a reference for the clinical application of T. wilfordii and some research ideas for the future in-depth study of T. wilfordii-induced digestive system injury.
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Objective To evaluate the safety and efficacy of peripheral chemoembolization by using ethanol-soaked gelatin sponge (ESG) combined with chemotherapeutic drugs and/or iodized oil in treating patients with hepatocellular carcinoma (HCC) complicated by moderate-to-severe hepatic arterio-portal shunts (APS).Methods The clinical data of 106 HCC patients associated with moderate-to-severe APS,who were treated with ESG chemoembolization during the period from June 2008 to December 2015,were retrospectively analyzed.The postoperative improvement of APS,the procedure-related complications,the tumor response,the survival time,the prognostic factors,etc.were statistically analyzed.Results In the 106 HCC patients associated with moderate-to-severe APS,the median survival time was 278 days,and the 6-,12-and 18-month cumulative survival rates were 70.8％,36.1％ and 16％,respectively.Univariate analysis showed that sex,total bilirubin level,maximal tumor diameter,history of previous treatment,tumor response and postoperative improvement of APS were closely correlated with the patient's prognosis.Multivariate regression analysis indicated that tumor response and postoperative improvement of APS were the independent protection factors,while the female sex and the maximal tumor size ≥5 cm were the independent risk factors.Conclusion For the treatment of HCC complicated by moderate-to-severe hepatic APS,transarterial chemoembolization by using ESG combined with chemotherapeutic drugs and/or iodized oil is safe and effective.The presence of tumor response to treatment and the postoperative improvement of APS indicate a better prognosis.The female sex and the maximal tumor size ≥5 cm are the independent prognostic risk factors.
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Objective To investigate the curative effect of transarterial embolization (TAE) for the treatment of spontaneous rupture with bleeding of hepatocellular carcinoma (HCC),and to discuss the factors influencing prognosis.Methods A total of 57 patients with HCC complicated by spontaneous rupture and bleeding,who received initial TAE during the period from June 2012 and June 2016,were enrolled in this study.The last follow-up visit was in October 2016.Kaplan-Meier method was used to calculate the cumulative survival rate,and Cox regression model was adopted to analyze prognostic factors.Results In this series of 57 patients,the median survival time was 208 days.The 6-month,1-year and 2-year cumulative survival rates were 50.3％,35.9％ and 14.7％,respectively.Multivariate Cox regression analysis indicated that tumor size,Child-Pugh classification,history of shock,and the used embolization materials were the independent prognostic factors.Conclusion The use of selective TAE,as an initial therapy,for HCC complicated by spontaneous rupture and bleeding is safe and effective.This study reveals that larger diameter of the tumor,poor Child-Pugh classification,the presence of shock history indicate a poor prognosis.TACE using lipiodol combined with gelatin sponge particles can expect a better prognosis than TACE using PVA particles alone.
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Objective To explore the effect of leukotriene receptor antagonist on the airway inflammation in bronchiolitis after respiratory syncytial virus(RSV)infection and the prevention of post-bronchiolitis asthma by studying the changes of serum concentration of inflammatory cellular factors including ECP,IL-12,IL-13 and LTE4.Methods 156 children with mild and moderate RSV bronchiolitis were recruited in the study and they were randomly divided into three groups after alleviation of asthmatic symptoms:the intervention group with montelukast sodium tablets oral;hormone intervention group with Budesonide suspension spray;control group.Blood samples were collected on the first day on admission,before treatment,3 months after medication.Serum concentrations of ECP,IL-12,IL-13 and LTE4 were measured by ELISA.Clinical and telephone follow up was done for one year.Results Compared to control group,the ECP,IL-13 and LTE4 levels of 156 RSV bronchiolitis in acute phase and recovery phase were signifieantly increased,while the IL-12 level was significantly decreased.The ECP,IL-13levels of singulair intervention group and the hormone intervention group were decreased after intervention,and the IL-12 level rise to normal;the LTE4 level of singulair intervention group and the hormone intervention group decreased significantly than before intervention,singulair intervention group recovered to normal levels(t=1.0866,P＞0.05),but hormone treatment group did not recover to normal levels(t=3.4355,P＜0.01).Singulair intervention group had lower recurrence of asthma(χ2=7.8156,P＜0.01).Conclusion The leukotriene receptorantagonists could regulate the imbalance of Th1/Th2,reduce the release of LTE4 and the activation of eosinophils,alleviate airway inflammation and airway hyperreactivity,reduce wheezing,and it play a role in the prevention of asthma.
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BACKGROUND: The onset of vascular dementia (VD) is closely related to brain ischemic-hypoxia. Previous research has proved that behavioral disturbance can be obviously attenuated by xingnao qizhi capsule in VD rats; however, it remains unclear whether the improvement of VD is due to the protection on ischemic cells.OBJECTIVE: Pheochromocytoma PC12 cells were cultured in vitro and exposed to Na2S2O4 to induce hypoxia injury. Then serum pharmacological technique was used to investigate the protection of xingnao qizhi drug serum on hypoxia-injured PC12 cells.DESIGN: Randomized controlled study.SETTING: School of Traditional Chinese Medicine of Hebei Medical College.PARTICIPANTS: This study was conduced at the Experimental Animal Laboratory and Cell Culture Laboratory, School of Traditional Chinese Medicine of Hebei Medical College, between June and December 2003.Forty SD rats were randomized into 5 groups, namely serum control group (n=12) and xingnao qizhi serum 25.42, 12.71, 6.35 and 3.18 g/kg groups (n=7). PC12 cell line was purchased form the Cell Center of Chinese Academy of Medical Sciences.serum 25.42, 12.71, 6.35 and 3.18 g/kg groups were exposed through gastric lavage to xingnao qizhi of corresponding dosages (composed of wolfberwhile normal saline was given by gastric lavage to rats in control group in dosage of 10 mL/kg, twice a day at an interval of 12 hours for 3 consecutive days. One hour after the last administration, femoral blood samples were collected when rats were deeply anaesthetized and serum was sepainto 6 groups. Cells in control group were cultured with control serum while in experimental model groups cells were exposed to Na2S2O4 to induce hypoxia injury 1 hour later. Cells in Xingnao Qizhi 25.42, 12.71,6.35 and 3.18 g/kg groups were cultured in 5% drug serum with corresponding dosage of xingnao qizhi drug for 1 hour before being exposed to changes of PC12 cells in the six groups were observed under reversal microscope after exposure to Na2S2O4 for 16 hours; the inhibition rate of lactate dehydrogenase production and PC12 cell injury (MTT method) was calculated for assessing cell activity.nase production and PC12 cell injury.of xingnao qizhi displayed better refraction, with fewer cell fragments that tion: It was 81.6%, 69.6%, 54.4% and 27.8% in xingnao qizhi 25.42,PC12 cell injury: It was 82.9%, 75.6%, 65.9% and 53.7% in Xingnao Qizhi 25.42, 12.71, 6.35 and 3.18 g/kg groups, respectively.CONCLUSION: xingnao qizhi drug serum can markedly attenuate hypoxia injury of PC12 cells in dose-dependant manner, which is presented by strengthened cell activity and decreased lactate dehydrogenase activity.