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OBJECTIVE To investigate the influence of Huayu xiaozhong decoction （HXD） on inflammatory response in rats with deep vein thrombosis （DVT）. METHODS The male SD rats were divided into control group （CK group）， model group （Model group）， HXD low-dose group （HXD-L group， HXD 10.86 mg/kg）， HXD medium-dose group （HXD-M group， HXD 21.71 mg/kg）， HXD high-dose group （HXD-H group， HXD 32.57 mg/kg）， positive control group （LMWHS group， low molecular weight heparin sodium 600 IU/kg）， silent information regulator 2 （SIRT2） inhibitor group （AK-7 group， AK-7 20 mg/kg）， HXD-M+AK-7 group （HXD 21.71 mg/kg+AK-7 20 mg/kg）， with 12 rats in each group. Except for the CK group， the DVT rat was induced by the Reyers method in other groups； after modeling， administration groups were given relevant medicine intragastrically/intraperitoneally， once a day， for consecutive 2 weeks. Twenty-four hours after the last medication， the coagulation function indexes [activated partial thromboplastin time （APTT）， thrombin time （TT）， prothrombin time （PT）， fibrinogen （FIB）] and inflammatory indexes in serum and inferior vena cava tissue [interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α）] of rats were detected. The formation of thrombus was observed， and the wet and dry masses of the thrombus were weighed. The protein expressions of tissue factor （TF） and SIRT2 as well as the phosphorylation and acetylation levels of nuclear factor kappa B （NF-κB） p65 in inferior vena cava tissue were detected. RESULTS Compared with CK group， APTT， TT and PT of rats in Model group were shortened significantly（P＜0.05）； the content of FIB， the levels of IL-1β， IL-6 and TNF-α， wet weight and dry weight of venous thrombus， TF protein staining score， the phosphorylation and acetylation levels of NF-κB p65 protein increased significantly （P＜0.05）； the inferior vena cava was full of thrombus， and the protein expression of SIRT2 decreased （P＜0.05）. Compared with Model group， above indexes of HXD-L group， HXD-M group， HXD-H group and LMWHS group were improved， while the improvement effects of HXD-M group， HXD-H group and LMWHS group were significantly better than those of HXD-L group （P＜0.05）. The trends of the corresponding indicators in AK-7 group were opposite to the above （P＜0.05）； AK-7 attenuated the inhibitory effect of medium-dose HXD on the inflammatory response in model rats （P＜0.05）.CONCLUSIONS HXD may inhibit the inflammatory response of DVT rats by activating SIRT2/NF-κB signaling pathway.
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@#AIM: To preliminary evaluate retinal sensitivity and the fixation alterations in patients with diabetic macular edema(DME)under Xiaozhong decoction combined intravitreal conbercept therapy. <p>METHODS: The 40 patients with DME were randomly divided into two groups. Treatment group: 20 patients(20 eyes), Xiaozhong decoction combined with conbercept group and treatment group; 20 patients(20 eyes), placebo combined with conbercept group in our hospital from January to October in 2017. The two groups were taken oral Chinese medicinals or placebo for 3mo respectively. BCVA(ETDRS visual acuity test)and CRT(OCT)of the two groups were observed, and the retinal sensitivity and fixation stability(P1, P2)were measured by MAIA microperimetry.<p>RESULTS: After 3mo of treatment, BCVA of treatment group and control group increased by 4(-1, 11.5)and 0(-4, 0.75)letters compared with baseline(<i>P</i><0.05), and CRT decreased by 123.5±42.61 and 18.1±12.84μm respectively(<i>P</i><0.05). The retinal sensitivity increased slightly after treatment in the two groups, but there was no significant difference between the two groups and over the course of treatment in control group(<i>P</i>>0.05). The sensitivity of retina in treatment group was the highest(20.11±4.98dB)at 2mo. P1 and P2 in the two groups increased significantly after treatment. The increase of P1 in the treatment group was significantly higher than that in the control group at 2mo(<i>P</i><0.05). But there was no difference in the increase of P2 between the two groups after treatment(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal conbercept could improve the fixation stability in DME patients, combined with Xiaozhong decoction was conducive to maintain fixation stability.
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@#AIM: To observe the clinical efficacy of the traditional Chinese medicine Yiqi Yinshui Xiaozhong decoction combined with anti-VEGF drug and retinal laser in the treatment of diabetic macular edema(DME).<p>METHODS: From January 2016 to October 2018, 60 eyes of 60 patients with diabetic macular edema were included in the prospective clinical control study. They were divided into control group and Chinese and Western medicine group according to the random number table method. The patients in control group were injected with anti-vascular drug into the vitreous cavity. After the injection, the patients were treated with photocoagulation. The patients in Chinese and Western medicine group were treated with the Yiqi Yinshui Xiaozhong decoction on the basis of the treatment of the control group. The best corrected visual acuity(BCVA), and macular foveal thickness(CMT)were observed before treatment and at 1, 3, and 6mo after treatment. The macular fluorescence leakage in fluorescein fundus angiography(FFA)and the recurrence rate of macular edema were observed at 6mo after treatment. <p>RESULTS: BCVA was 0.92±0.26 before treatment, 0.58±0.18, 0.60±0.27 and 0.62±0.28 at 1, 3 and 6mo after treatment, BCVA in the Chinese and Western medicine group BCVA was 0.94±0.31 before treatment, 0.56±0.20, 0.50±0.25, 0.51±0.21 after treatment; CMT in the control group was 461.62±84.26 before treatment, 299.92±43.18, 290.60±39.36, 311.10±42.78 at 1, 3 and 6mo after treatment, CMT in the Chinese and Western medicine group was 455.74±83.89 before treatment, 288.96±40.20, 265.86±32.55, 270.38±31.60 at 1, 3 and 6mo after treatment. Both groups had improved BCVA and CMT after treatment(<i>P</i><0.05). There was no significant difference between BCVA and CMT in the Chinese and Western medicine group and the control group at 1mo after treatment(<i>t</i>=0.539, 0.739, <i>P</i>>0.05), BCVA and CMT after 3 and 6mo of treatment in the Chinese and Western medicine group improved significantly, and the difference was statistically significant compared with the control group(3mo after treatment <i>t</i>=2.891, 2.992, <i>P</i>=0.004, 0.021; 6mo after treatment <i>t</i>=3.733, 3.643, <i>P</i><0.01, 0.005). The recurrence rate of macular edema at 6mo after treatment in the Chinese and Western medicine group was lower(χSymbolr@@=4.344, <i>P</i><0.05).<p>CONCLUSION: Combined application of the Yiqi Yinshui Xiaozhong decoction, anti-VEGF drugs and laser to treat diabetic macular edema can improve vision, reduce macular edema, reduce the recurrence rate of edema, and bring better prognosis for patients.
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Objective To investigate the clinical efficiency of Huayu Xiaozhong Decoction (HXD) on preventing peri-operative deep venous thrombosis (DVT) in lower limbs following artificial total hip replacement. Methods Ninety cases following artificial total hip replacement were randomized into blank control group, Rivaroxaban group and HXD group, 30 cases in each group, and were treated with brown sugar water, Rivaroxaban, HXD respectively. Before operation, and one, 3 and 14 days after operation, we monitored the changes of bleeding volume, DVT incidence, hemoglobin, prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , international normalized ratio (INR), and D-dimer (DD) in the three groups. Results (1) Fifteen cases had DVT, with a total incidence rate of 16.67%. Of the 15 cases, 10 were from blank control group, 2 from Rivaroxaban group, and 3 from HXD group. ( 2) The amount of bleeding volume of Rivaroxaban group was larger than that of the blank control group and HXD group (P<0.05), but the bleeding was mild. (3) One, 3 and 14 days after operation, PT and APTT were shortened in blank control group (P<0.01 compared with those before operation). PT, APTT and INR were prolonged, and coagulation function was improved in Rivaroxaban group and HXD group, the differences being significant as compared with the blank control group ( P<0.05). HXD group had better effect on improving INR than Rivaroxaban group ( P<0.05). ( 4) In the three groups, hemoglobin level began to decrease on postoperative day one, arrived to the bottom on postoperative day 3 (P<0.05), and rose up near to the normal level on postoperative day 14; HXD group had higher hemoglobin level than blank control group and Rivaroxaban group on postoperative day 3 and 14 ( P<0.05). The 3 groups had higher plasma DD level than the normal level before the operation, arrived to the highest level on postoperative day one and 3 ( P<0.05) , and fell down near to the normal level on postoperative day 14. The inter-group comparison results showed that Rivaroxaban group and HXD group had lower DD level than the blank control group on postoperative day 3 and 14 ( P<0.05). Conclusion HXD is effective on preventing DVT in the peri-operation period through reducing bleeding, increasing hemoglobin level and improving postoperative anemia. The efficiency and safety of HXD are similar to Rivaroxaban.