Study on component-target-pathway multiple interactive network to reveal mechanism of Salvia miltiorrhiza in treatment of microcirculation disturbance / 中草药

Objective: To explore the mechanism of Salvia miltiorrhiza in treatment of microcirculatory disturbance based on network pharmacology. Methods: The targets of S. miltiorrhiza’s active components for treatment of microcirculatory disturbance were screened and predicted by utilizing TCMSP, PubChem Search, Genecards database and Swiss target prediction online tool. Cytoscape 3.3.0 software was adopted to construct an active component-microcirculatory disturbance target network. The protein-protein interaction (PPI) network was established by using STRING database. DAVID database was used to analyze metabolism pathway in target gene ontology (GO) biological process, Kyoto encyclopedia of genes and gnomes (KEGG). Results: Totally 65 active components of S. miltiorrhiza and nine related targets were screened. GO and KEGG pathway enrichment analysis revealed that active components of S. miltiorrhiza participated in oxidation-reduction process, cellular calcium ion homeostasis and other biological processes, and S. miltiorrhiza may regulate VEGF signaling pathway, cholinergic synapse signal transduction, oxytocin signaling pathway, aldosterone-regulated sodium reabsorption pathway and so on. Conclusion: This study reflects the characteristics of multi-components, multi-targets, and multi-pathways of S. miltiorrhiza in the treatment of microcirculation disturbance, which may provide new ideas and methodology for further research on the treatment of microcirculatory disturbance using S. miltiorrhiza.

Clinical study of traditional Chinese medicine anti-inflammatory mixture for the microcirculation disturbance in patients with sepsis targetting at vascular endothelium / 国际中医中药杂志

Objective To observe the clinical effect of traditional Chinese medicine inflammatory mixture on vascular endothelial cell injury, mcrocirculation disorder and organ dysfunction in sepsis. Methods 73 patients with sepsis were randomly divided into two groups: Anti-inflammatory mixture-treated group (40 cases) and control group (33 cases). Routine medicine therapy was given in both groups.Additionally, in the Anti-inflammatory mixture-treated group, 100 ml Anti-inflammatory mixture was given By oral or nasal feeding, every 12 hours for consecutive 7 days. Vascular endothelial injury index (Soluble thrombomodulin,Vascular endothelial growth factor-2, endothelial specific molecule-1), mcrocirculation disorder index (arterial blood lactate, central venous oxygen saturation, total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index) of two group patients before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment. Results After treatment, the indexes of vascular endothelial injury sTM (12.37 ± 5.08 μg/L vs. 18.77 ± 6.88 μg/L, t=3.448), VEGF-2 [45.6 ng/L (14.3, 112.5) vs. 52.4 ng/L (17.2, 123.6), Z=4.009], ESM-1 (15.54 ± 4.09 ng/ml vs. 17.64 ± 6.79 ng/ml, t=-1.551), Lac (2.6 ± 1.2 mmol/L vs. 3.7 ± 1.8 mmol/L, t=4.115) and SOFA (4.1 ± 1.7 vs. 6.1 ± 3.2, t=-2.118) in anti-inflammatory mixture group decreased significantly than those in the control group. but the ScvO2(0.719 ± 0.243 vs. 0.603 ± 0.201, t=-2.773), PVD (14.8 ± 5.8 mm/mm2 vs. 13.1±5.1 mm/mm2, t=-5.114), PPV (59.1% ± 22.5% vs. 53.9% ± 20.6%, t=1.779), MFI (9.4 ± 4.6 vs. 7.2 ± 2.2, t=4.339) in the anti-inflammatory mixture group were significantly higher than those in the control group. Correlation analysis showed that the sTM and PPV were significantly negatively correlated (r=-0.875, P＜0.01), ESM-1 was significantly negatively correlated with PVD, PPV and MFI (r=-0.877, P＜0.01; r=-0.799, P＜0.01; r=-0.821, P＜0.01) and ESM-1 and SOFA were significantly positively correlated (r=0.840, P＜0.01). Conclusions Anti-inflammatory mixture of Chinese medicine has a certain therapeutic effect on sepsis by protecting vascular endothelial cell function.

Clinical Observation of Intravenous Drip of Alprostadil Combined with Acupuncture in the Treatment of Diabetic Foot Ulcer / 中国药房

OBJECTIVE:To investigate clinical efficacy of intravenous drip of alprostadil combined with acupuncture in the treatment of diabetic foot ulcer and its effects on inflammatory factors levels and wound microvascular density. METHODS:A total of 72 patients with diabetic foot ulcer in our hospital during May 2014 to Sept. 2015 were divided into observation group and con-trol group according to random number table,with 36 cases in each group. Control group was given Alprostadil injection 10μg add-ed into 250 mL 0.9% Sodium chloride injection intravenously,qd,on the basis of routine treatment as insulin. Observation group was additionally given acupuncture therapy (Sanyinjiao,Zusanli,Fenglong,Yanglingquan,Yinlingquan and other acupuncture points),qd,on the basis of control group. Treatment courses of 2 groups lasted for 3 weeks. Clinical efficacy,wound healing time,fasting blood glucose,urine microalbumin,inflammatory factors,wound microvascular density as well as the occurrence of ADR were compared between 2 groups. RESULTS:The total response rate of observation group(91.67%)was significantly higher than that of control group(72.22%),and wound healing time was significantly shorter than control group,with statistical signifi-cance(P0.05). After treatment,above indexes of 2 groups were significantly lower than before,and urine microalbumin and inflammatory factors of the observation group was significantly lower than the control group,with statisti-cal significance (P<0.05). 14,21 d after treatment,wound microvessel density of observation group was significantly higher those of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Intrave-nous drip of Alprostadil combined with acupuncture can boost angiogenesis through mitigating inflammatory reactions,thus shorten the time of wound healing and enhance therapeutic efficacy.

Transcutaneous oxygen pressure andits clinical significance in patients with type 2 diabetic peripheral neuropathy / 中国糖尿病杂志

Objective To evaluate the transcutaneous oxygen pressure (TcPO2 )and its clinical significance in patients with type 2 diabetic peripheral neuropathy (DPN). Methods A total of 222 hospitalized patients with type 2 diabetes mellitus (T2DM)from the Department of endocrinology of Lianyungang First People's Hospital in Jiangsu Province were enrolled in this study from October 2014 to September 2015.And 50 healthy controls were also selected in this study as control group (NC group). TcPO2 was tested in supine position in all the subjects by TCM400 TcPO2 detector. Patients with T2DM then were divided into two groups according to Nerve conduction velocity (NCV):DPN group (n = 102) and non-DPN group (NDPN group,n = 120).Anthropometric and metabolic parameters were assessed in each group. Results TcPO2 in supine positionwas lower in DPN group than in NC and NDPN group. TcPO2 was positively correlated with diabetes duration,TCSS scores,HbA1 c,SUA,FPG and NCV.Compared with normal TcPO2 group,the prevalence of DPN was increasedin low TcPO2 group,while NCV of motor nerve and sensory nerve were decreasedin low TcPO2 group.Logistic analysis showed that TcPO2 was an independent risk factor for DPN. Conclusion TcPO2 in supine position was decreased in patients with DPN,and is a risk factor for DPN,which may provides valuable information for DPN diagnosis.

Study on the diagnostic method of microcirculation disturbance of patients with chronic hepatitis B / 中国基层医药

ObjectiveTo study the diagnostic method of microcirculation disturbance of patients with chronic hepatitis B (CHB).Methods81 patients with CHB and 5 normal volunteer were observed.Hypoxia-induciable factor was detected by immunohistochemistry stain,TXB2 and 6-Keto-PGF1α were detected by chemiluminescence and HA was detected by RIA,ultrastructure of liver was observed by transmission electron microscope (TEM).ResultsAccompany with the pathological changes of liver in patients with CHB,the strength and range of expression of HIF-1 α enhanced,HA and TXB2 of serum rised gradually( all P ＜ 0.05 ),but 6-Keto-PGF1α of blood plasma fell- off.The electron microscope showed that erythrocyte aggregation,stenosis and blockage of sinus hepaticus turned obviously,collagen fibers deposition and basal membrane formation aggravated gradually.ConclusionAssociated detec tion with HIF-1 α、HA 、TXB2 and 6-Keto-PGF1 α can reflect the condition of microcirculation of liver perfectly.

Insight for Oketsu Syndrome / 日本東洋医学雑誌

The diagnostic criteria for oketsu syndrome which was proposed by K. Terasawa et al. High scores in paranavel resistance and tenderness was characteristic in it. It's evidence was obtained by that blood viscosities of oketsu patients increased than ones of non-oketsu patients. The numbness of seven patients with cerebrovascular accidents in fourteen patients were improved following the four weeks of administration of keishibukuryogan. In this study we could also recognize improvement of intra-vascular erythrocyte aggregation in their conjunctival microcirculation by using the video-microscopic system. These studies had been clarifying that oketsu state might be accompanied to microcirculatory distubance and kampo prescriptions treated for oketsu syndrome could improve it. Important point in using these prescriptions under the traditional standard is to check kyojitsu (robust or asthenia), face color (red or pale) and constipation/or not. I emphasized that role of checking kyojitsu might be bigger in prevention from the adverse effects than in searching drug to treat patient's illness.

Promoting blood circulation by removing blood stasis of Lubai Capsule / 中成药

Objective: To observe the promoting blood circulation by removing blood stasis of Lubai Capsule(LBC)(Rhizoma Phragmitis, Radix Paeoniae Alba, Radix Saposhnikoviae, Flos Schizonepetae, etc.). Methods: Acute blood stasis rat models were established with swimming in iced water and sc adrenalin in order to observe the effect of LBC on blood rheology. Mesenteric microcirculatory disturbance rat models were also established with adrenalin in order to observe the effect of LBC. Clotting time was measured in vitro with prothrombin time(PT) and kaolin partial thromboplastin time(KPTT) kit in order to observe its effects. Results: LBC could decrease the whole blood and plasma viscosity, fibrinogen, erythrocyte sedimentation and aggregation ratio of blood platelets of rats, ease the sticky condition of blood stasis rat models and prevent from forming thrombus. It could also inhibit the constraction and slowing of blood flow of thin artery, the reducing of open capillaries and change of fluid condition caused by adrenalin and improve these phenomena. PT and KPTT could be increased obviously. Conclusion: LBC can significantly promote blood circulation by removing blood stasis, because of improving blood rheology and mesenteric microcirculatory disturbance and inhibit endogenous and exogenous coagulation system.