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This study aims to explore the efficacy of Chinese medicine injections( CMIs) for promoting blood circulation and removing blood stasis for acute cerebral infarction from the perspectives of clinical medication and mechanism of action based on two complex network analysis methods. Firstly,the current 13 kinds of CMIs for acute cerebral infarction were obtained from 2019 List of medicines for national basic medical insurance,industrial injury insurance and maternity insurance with the method of network Meta-analysis. Secondly,with the use of network pharmacology,the mechanisms of top 2 CMIs with the highest therapeutic effect for acute cerebral infarction were explored from two levels including core target and network function enrichment. The result of network Meta-analysis showed Mailuoning Injection was superior to Danhong Injection in terms of total effectiveness rate for neurological deficit score and NIHSS score. The network pharmacology results showed that Mailuoning Injection had more core targets,interaction networks,enriched biological functions and more signaling pathways than Danhong Injection for cerebral infarction. Both two CMIs can play a role in treating cerebral infarction through core targets such as TP53 and NOS3,biological processes such as fibrinolysis,nitric oxide biosynthesis,nitric oxide-mediated signal transduction,negative regulation of apoptosis in endothelial cells and apoptosis process,as well as the signaling pathways such as PI3 K-Akt signaling pathway,HIF-1 signaling pathway and cell apoptosis signaling pathways. The results of pharmacological studies explained their differences in clinical efficacy to a certain extent. A research strategy based on curative effect should be advocated in efficacy evaluation of traditional Chinese medicine,where comparative research on clinical efficacy can be conducted firstly,and then mechanism research based on outstanding effective drugs to better provide references and basis for selection of similar competitive drugs for one disease in the clinical practice.
Subject(s)
Female , Humans , Pregnancy , Cerebral Infarction/drug therapy , Drugs, Chinese Herbal/therapeutic use , Endothelial Cells , Injections , Medicine, Chinese Traditional , Signal TransductionABSTRACT
Objective To investigate the effect of ultrasound guided percutaneous nephrostomy combined with Mailuoning injection on renal function, TGF- β 1 and α -SMA in patients with obstructive hydronephrosis. Methods 37 cases with obstructive hydronephrosis treated in our hospital from June 2014 to December 2016 were enrolled as the research object, all patients after admission were perfect relevant examination, after exclude contraindications underwent ultrasound-guided percutaneous nephrostomy combined with Mailuoning injection treatment. The operative time, the success rate of first puncture, the amount of bleeding during operation, hospitalization time, incidence of complications, preoperative and postoperative 3 d, 7 d renal function preoperative, postoperative, 7 d urine transforming growth factor β 1 (TGF- β 1) and alpha smooth muscle actin (α -SMA) were observed. Results The operation time was 52~93 minutes in 37 patients, the average operation time was (62.31±8.26) minutes; One puncture was successful in 37 cases, the success rate of one puncture was 100%. The intraoperative blood loss was 51 ~ 102 mL, the average amount of bleeding was (80.27±18.15) mL. The hospitalization time was 3 ~ 9 d, the average time was (6.12±1.97)d.In 37 cases, three cases were blocked by ostomy, the incidence rate was 8.11 %; The fistula was removed in one cases, the incidence rate was 2.70%; seven cases with dermatitis around the fistula, the incidence rate was 18.92%. At 3 d after surgery, BUN and Cr were significantly decreased than before operation (P<0.05). At 7 d after surgery, BUN and Cr were significantly decreased compared with preoperative and postoperative 3 d (P<0.05). The levels of TGF-β1 and α-SMA in patients were significantly lower than those before operation at 7 days after operation (P<0.05). Conclusion Ultrasound guided percutaneous nephrostomy combined with Mailuoning injection in the treatment of obstructive hydronephrosis can timely drainage of urine, improve renal function, avoid ipsilateral renal interstitial fibrosis. The utility model has the advantages of high rate of success and safe operation.
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Objective To investigate use of magnetic resonance diffusion tensor imaging (MR-DTI) for quantitatively evaluating the efficacy of Mailuoning Injection on non-compressive lumbar radiculitis.Methods Nine Bama mini pigs were selected and divided into group A,B and C,3 cases in each group.The non-compressive lumbar radiculitis model was established under CT-guiding.The corresponding therapeutic drugs (group A:10 mL Mailuoning;group B:10 mL normal saline;group C:10 mL diminishing inflammation fluid) were given by epidural injection on 14 d after constructing model.MR-DTI was performed before model construction,14 d after model construction and before treatment.One experimental pig in each group was taken on 3,7,14 d after treatment,performed MR-DTI and killed for taking the nerve root sample to conduct the immunohistochemical detection.The fractional anisotropy (FA) values of nerve root in MR-DTI imaging were measured.The FA values and immunohistochemical detection results were statistically analyzed.Results MR-DTI:the FA values after model construction in each group was decreased (P0.05),but the FA values increase in the group C was earlier and more rapid than other two groups (P0.05),while the FA values had statistical difference between the group B and C (P<0.05).The immunohistochemical results:TNF-α integral absorbency value(IA value) on 7 d after treatment in the group A began to decline;the TNF-α IA value on 14 d after treatment in the group A and C was significantly decreased compared to group B,the difference was statistically significant (P<0.05).Conclusion Mailuoning Injection has a certain effect on non-compressive lumbar radiculitis,which can be evaluated by using DTI.
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OBJECTIVE:To observe clinical efficacy and safety of Mailuoning injection in adjunctive treatment of acute cere-bral infarction. METHODS:A total of 65 patients with acute cerebral infarction selected from neurology department of our hospital were divided into control group(32 cases)and observation group(33 cases)according to random number table. Control group was given conventional treatment. Observation group was additionally given Mailuoning injection 10 mL added into 0.9% sodium chlo-ride injection 250 mL intrnrenously,ivgtt,qd,on the basis of control group. Both group were treated for 15 d. Clinical efficacy as well as serum levels of ox-LDL,BNP and MMP-9,NIHSS score before and after treatment,the occurrence of ADR were com-pared between 2 groups. RESULTS:The response rate of observation group was 90.91%,which was significantly higher than 65.63%,with statistical significance(P0.05). After treatment,serum levels of ox-LDL,BNP and MMP-9,NIHSS score in 2 groups were all decreased significantly,and the observation group was significantly lower than the control group,with statis-tical significance (P0.05). CONCLU-SIONS:Mailuoning injection has significant therapeutic efficacy for acute cerebral infarction,can significantly reduce serum levels of ox-LDL,BNP and MMP-9,promotes neurological function and the recovery of patients with cerebral infarction with good safety.
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Objective To investigate the effect of ultrasound guided percutaneous nephrostomy combined with Mailuoning injection on renal function, TGF- β 1 and α -SMA in patients with obstructive hydronephrosis. Methods 37 cases with obstructive hydronephrosis treated in our hospital from June 2014 to December 2016 were enrolled as the research object, all patients after admission were perfect relevant examination, after exclude contraindications underwent ultrasound-guided percutaneous nephrostomy combined with Mailuoning injection treatment. The operative time, the success rate of first puncture, the amount of bleeding during operation, hospitalization time, incidence of complications, preoperative and postoperative 3 d, 7 d renal function preoperative, postoperative, 7 d urine transforming growth factor β 1 (TGF- β 1) and alpha smooth muscle actin (α -SMA) were observed. Results The operation time was 52~93 minutes in 37 patients, the average operation time was (62.31±8.26) minutes; One puncture was successful in 37 cases, the success rate of one puncture was 100%. The intraoperative blood loss was 51 ~ 102 mL, the average amount of bleeding was (80.27±18.15) mL. The hospitalization time was 3 ~ 9 d, the average time was (6.12±1.97)d.In 37 cases, three cases were blocked by ostomy, the incidence rate was 8.11 %; The fistula was removed in one cases, the incidence rate was 2.70%; seven cases with dermatitis around the fistula, the incidence rate was 18.92%. At 3 d after surgery, BUN and Cr were significantly decreased than before operation (P<0.05). At 7 d after surgery, BUN and Cr were significantly decreased compared with preoperative and postoperative 3 d (P<0.05). The levels of TGF-β1 and α-SMA in patients were significantly lower than those before operation at 7 days after operation (P<0.05). Conclusion Ultrasound guided percutaneous nephrostomy combined with Mailuoning injection in the treatment of obstructive hydronephrosis can timely drainage of urine, improve renal function, avoid ipsilateral renal interstitial fibrosis. The utility model has the advantages of high rate of success and safe operation.
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Objective: In this study, ultrafiltration membrane process is employed first to separate the polysaccharides from industrialization waste in Mailuoning Injection and to promote the resources utilization of the waste. Methods: The waste ethanol sediments in the production of Mailuoning Injection mainly include dendrobium polysaccharides, Achyranthes bidentata polysaccharides (ABPS), and honeysuckle polysaccharides, and the active components of polysaccharide with high content were selected through the immune activity. Six different relative molecular weight cut-off membranes ( 3 × 105) made of polyether sulfone (PES) were used. Six fractions were obtained and named as MFP1, MFP2, MFP3, MFP4, MFP5, and MFP6. Meanwhile, polysaccharides and protein content were determined by phenol-sulfuric acid colorimetry and Coomassie brilliant blue G-250 staining method; Polysaccharides species was analyzed by ELSD-HPLC; Immunocompetence of different fractions were investigated in vitro, including mouse spleen lymphocytes proliferation, transformation, and production of nitric oxide after acting on the macrophage RAW264.7. Results: The results showed MFP4 (3 × 104-1 × 105) have the highest content and immunocompetent, MFP5 (1 × 105-3 × 105) immunocompetent followed, compared to others, purity, and recovery of MFP4 are 76.80% and 10.81%, purity and recovery of MFP5 are 73.23% and 14.73%, respectively. Conclusion: The findings reveal MFP4 and MFP5 serves as our object of exploitation in the future; Moreover, separation of polysaccharides from "Mailuoning Injection" by the membrane is feasible with high recovery and low cost in the realization of circular economy.
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OBJECTIVE:To observe clinical efficacy and safety of Mailuoning injection combined with benazepril in the treat-ment of chronic glomerulonephritis. METHODS:130 patients with chronic glomerulonephritis were randomly divided into observa-tion group and control group,with 65 cases in each group. Both groups received rountine treatment as low salt and fat diet. Control group was additionally given Benazepril tablet 10 mg,qd;observation group was additionally given Mailuoning injection 20 ml added into 5% Sodium chloride injection 250 ml,ivgtt,qd,on the basis of control group,20 days of drug withdrawal every 10 days. Both group received 4 months of treatment. Clinical efficacy of 2 groups were observed as well as the levels of BUN,UCr, SCr and 24 h urine protein quantitative (UPE) before and after the treatment. The incidence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 83.1%,which was significantly higher than 67.7% of control group,with statistical significance (P0.05);those indexes of 2 groups decreased significantly after treatment,and the observation group were lower than the control group,with statistical significance(P0.05). CONCLUSIONS:Mailuoning injection combined with benazepril is effective for chronic glo-merulonephritis,and can effectively improve renal function with good safety.
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OBJECTIVE:To observe the clinical efficacy and safety of Mailuoning injection in the treatment of acute bronchial asthma. METHODS:92 patients with acute bronchial asthma were randomly divided into control group and observation group. Pa-tients in control groups were received routine treatment,including oxygen inhalation,glucocorticoid,β2 agonists,aminophylline and anti-infection,etc. Patients in observation group were added Mailuoning injection 20 ml adding into 5% glucose injection or 0.9% sodium chloride injection 500 ml by intravenous infusion,once a day,based on the treatment of control group. The course was 14 d. The clinical data was observed,including clinical efficacy,hemorheology indicators,pulmonary function,6-keto-PGF1αlevel and incidence of adverse reactions before and after treatment. RESULTS:The total effective rate in observation group was sig-nificantly higher than control group,with significant difference(P<0.05). After treatment,the hemorheology indicators,lung func-tion indicators and 6-keto-PGF1α level in 2 groups were significantly better than before,and observation group was better than con-trol group,with significant difference(P<0.05). There were no obvious adverse reactions. CONCLUSIONS:Routine treatment combined with Mailuoning injection can effectively improve the efficacy of acute bronchial asthma with good safety.
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Objective To establish a method for content determination of harpagide and harpagoside in Mailuoning injection by HPLC. Methods The experimental condition of HPLC method was as follows: SunfireTM C18 column (4.6 mm ×150 mm, 5 μm), with gradient elution using acetonitrile and 0.03% phosphoric acid; the detected wavelength was 210 nm, and the flow rate was 1.0mL/min.ResuIts Harpagide and harpagoside demonstrated good linear relationship in the range 0.1424~0.8544 μg/mL(r=0.9998) and 0.0732~0.4392μg/mL (r=0.9997) respectively.The average recovery rate were 98.22% and 99.27% with RSD of 1.46% and 1.42%(n=6)respectively.ConcIusion The method is simple, reliable, accurate, reproducible and stable, and it could be used in the determination of harpagide and harpagoside in Mailuoning injection.
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Objective To observe the effect and safety of Mailuoning Injection(MLN) in treating patients with type 2 diabetes mellitus accompanying lower extremity atherosclerotic obliterans.Methods The selected patients were assigned by randomized digital table to a treated group (120 cases treated with MLN) and a control group (60 cases treated with alprostadil). The clinical efficacy was assessed after 4 weeks of treatment. Results The total effective rate in the treated group was 95.0%, better than that in the control group,83.3%(P＜0.01).Conclusion MLN has the effect of activating blood circulation.dissolving stasis and dredging collaterals, reducing the formation of thrombi. MLN is effective and safe when applied in clinical practice for the treatment of lower extremity diabetic atherosclerotic obliterans.
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AIM: To study the pharmacokinetics of phenolic acids from Mailuoning injection in rats. METHODS: SD rats were given a single i.v. administration dose of Mailuoning injection 10 mL/kg, plasma and urine were collected before and after injection. Phenolic acid components in plasma and urine were measured by LC/MS. Pharmacokinetic parameters were determined from the plasma concentration-time data and urinary excretion-time data with the DAS software package. RESULTS: After i.v. of Mailuoning injection, chlorogenic acid (CGA), 1, 5-dicaffeylquinic acid (1,5-DCQA), 3, 4-dicaffeylquinic acid (3,4-DCQA), 3, 5-dicaffeylquinic acid (3,5-DCQA) and caffeic acid (CA) were quickly excrectioned. The t1/2 of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were 0.649, 0.334, 0.479, 0.486 and 0.330 h, respectively. AUC0-∞ were (22.522±2.716), (0.353±0.062), (3.620±1.246), (5.287±1.627) and (2.257±0.360) mg·L-1·h, respectively. After i.v. of Mailuoning injection, CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA can all be detected in the urine. The amounts of CGA, 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA excreted from urine during 0-24 h were (122.22±26.49)%, (3.30±1.26)%, (0.24±0.11)%, (1.93±0.77)% and (18.61±4.99)% of dose given in rats, respectively. CONCLUSION: After i.v. of Mailuoning injection, phenolic acids can be excreted quickly. Only a small quantity of 1,5-DCQA, 3,4-DCQA, 3,5-DCQA and CA were excreted from urine. 3,4-DCQA and 3,5-DCQA may be metabolized into CGA in the rat plasma.
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Objective To determine the optimum water-extracting technology of Mailuoning injection. Methods The orthogonal test was used to select the water extract technology of Mailuoning injection. Results The best technology was that crude drug was added 12 and 8 times water, then soaked 0.5 h, and extracted for l.5 and 1.0 h. Conclusion The study of technology provides the basis for further purification.
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Objective To establish a method for determination the contents of six phendic acids in Mailuoning injection by HPLC at same time. Methods Separation was performed on a Kromasil-C18 (4.6 mm? 250 mm, 5 ?m) column with mobile phase consisting of 0.1% phosphoric acid-water and Acetonitrile with gradient elute at the flow rate of 1 mL/min. The UV detection wavelength was set at 327 nm and the column temperature was set at 25 ℃. The sample size was 20 ?L. Results The standard cures of neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, caffeic acid, 3,5-Dicaffeoylquinic acid, 3,4- Dicaffeoylquinic acid were linear within the contentration range of 0.010 90～0.544 8 ?g (r=0.999 9), 0.024 06～1.203 2 ?g (r =1), 0.011 06～0.552 8 ?g (r =1), 0.015 94～0.796 8 ?g (r =1), 0.009 104～0.455 2 ?g (r =1), 0.010 37～0.518 4 ?g (r=1) respectively. And the recovery rates of them were 101.06%, 100.22%, 101.54%, 99.42%, 100.21%, 101.65% respectively. Conclusion The method appeared to be simple, reliable, accurate and can be used to determine the contents of six phendic acids in Mailuoning injection.
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OBJECTIVE:To investigate the regularity and characteristics of ADR induced by Mailuoning injection,and to provide reference for rational use of drugs.METHODS:In retrospective study,ADR/ADE cases of Mailuoning injection reported in Henan province from 2004 to 2009 were analyzed statistically.RESULTS:Main clinical manifestations were lesion of skin and its appendents(24.95%),respiratory system injury(23.81%) and nervous system injury(15.38%).The clinical manifestations of serious ADR/ADE were allergic shock,dyspnea and choking etc.CONCLUSION:Clinical rational use of drugs should be improved to avoid serious ADR and guarantee the safety of drug use.
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Objective: To make a system evaluation on the therapeutic effect and safety of Mailuoning Injection(MI) in treating acute stage of ischemic brain infarction apoplexy(IBIA).Methods: Literatures about randomized controlled trial (RTC) on MI in treating acute stage of IBIA were collected,and the qualified researches were filtrated.Then made a quality evaluation by Jadad scoring method, and took statistics of the correlated data with the methods of heterogeneity test,Meta-analysis,filler-graph analysis and sensitivity analysis etc.Results: There were eight items accorded with bringing into standard.Then the methodology quality of each articles were evaluated adopting Jadad scoring standard,and the trials each get one score,belonging to low-quality literatures.The analytic results of Meta-analysis showed that compared with blank control group,the total effective rate comparison relative risk(RR) to merge equaled 1.19,99% confidence interval(CI) was(1.09,1.30),the case-fatality rate(CFR) comparison relative risk(RR) equaled 0.93,99% confidence interval(CI) was(0.02,36.07). Conclusion: This system evaluation demonstrated that MI was good for treating acute stage of IBIA,and no serious adverse reactions.
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OBJECTIVE: To investigate the general regularity and characteristics of allergic shock which was caused by Mailuoning injection so as to prevent its recurrence and promote the rational use of drugs. METHODS: ADR reports about anaphylactic shock induced by Mailuoning injection which were publicly published in medical journals in China during 1994 Jan～2009 June were retrieved and analyzed statistically. RESULTS: A total of 31 cases of anaphylactic shock induced by Mailuoning injection included 1 death case, of which 21 cases were in males and 10 in females. Anaphylactic shock mostly occurred within 10 min after administration with a total of 25 cases. 25 cases occurred among patients aged above 40 years accounted for 83.87% in total. CONCLUSION: There are many correlated factors that allergic shock is induced by Mailuoning injection with serious consequence. So doctors and pharmacists should pay more attention to it.
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Objective To investigate the effect of blood-flow-activating and blood-stasis-removing herbal medicine on the vision of primary glaucoma patients.Methods A retrospective study was carried out in 60 eyes of primary glaucoma from 32 cases.The cases were allocated to Group A and Group B.Group A(n=33 eyes)was treated with routine drugs of lowering intraocular pressure and operation and Group B(n=27 eyes)with blood-flow-activating and blood-stasis-removing herbal medicine additionally.Results After treatment,the vision of 8 eyes( 24.24%)in Group A and 16 eyes ( 59.26%)in Group B was improved,and the difference was significant(P 0.05).Conclusion Blood-flow-activating and blood-stasis-removing herbal medicine combined with routine treatment is helpful for the increase of vision of primary glaucoma.