Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial / 中西医结合学报

BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.

Progress in Research of Kangxianling Decoction in Delaying Renal Fibrosis / 中国实验方剂学杂志

Renal fibrosis is a common pathological change in the later stages of all kidney diseases. It is a multi-cytokine, multi-signal pathway, multi-factor driven chronic kidney disease. It includes renal interstitial fibrosis, tubular sclerosis and glomerular sclerosis, which eventually leads to chronic renal failure. From health through injury to loss of function, the disease process is closely related to the degree of deterioration of renal function and the prognosis of chronic kidney disease. There is no effective western medicine for the treatment of renal fibrosis. Professor HE Liqun from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine has summarized the Kangxianling decoction through decades of long-term practical experience. It has the effects in strengthening the spleen and replenishing Qi, clearing away dampness and heat, promoting blood circulation and removing phlegm, and strengthening turbidity. It is composed of Salviae Miltiorrhizae Radix et Rhizoma 15 g, Persicae Semen 12 g, Angelicae Sinensis Radix 12 g, Achyranthis Bidentatae Radix 9 g, Rhei Radix et Rhizoma 15 g. Kangxianling can affect the synthesis and secretion of cytokines and inflammatory factors by expanding blood vessels, and can improve renal tubular fibrosis. It has a good multi-channel, multi-target and multi-directional protective effect on renal function. It also can delay the progress of chronic renal fibrosis by significantly alleviating such symptoms as fatigue and edema in patients with chronic renal fibrosis, and reducing serum creatinine, urea nitrogen and urine protein. In this paper, 5/6 nephrectomy, ischemia reperfusion injury, adriamycin-induced nephropathy, unilateral ureteral obstruction and other different modeling methods are listed. The mechanism of Kangxianling decoction in antagonizing renal fibrosis is discussed and summarized, which further provided new ideas and directions for future clinical and scientific research.

Effect of Kangxianling Decoction on Renal Fibrosis and ACE-AngⅡ-AT1R Axis in 5/6 Nephrectomized Rats / 中国实验方剂学杂志

Objective: To study the therapeutic effect of Kangxianling decoction on renal fibrosis induced by 5/6 nephrectomy, and angiotensin converting enzyme-angiotensin Ⅱ-angiotensin Ⅱ 1 receptor (ACE-AngⅡ-AT1R) axis. Method: Totally 50 SD rats were randomly divided into the following groups:control group (n=10), sham-operation group (n=10), 5/6 nephrectomized renal fibrosis model group (n=30). After two weeks, the rats in operation group were divided into the model group, Kangxianling group, and losartan potassium group, n=10 in each group. Rats in losartan potassium group were administered with losartan potassium by gastrogavage, and rats in Kangxianling group were administered with Kangxianling by gastrogavage. Equal volume of saline was administered to rats in the other groups. The rats were put to death after 16 weeks of consecutive medication, and serum creatinine(SCr), blood urea nitrogen(BUN), 24 h urine protein(24 h-Pro) were measured in each group. Hematoxylin-eosin(HE) staining was used to observe the pathological changes of kidney tissues, and the degree of renal fibrosis was observed by Masson staining. The expressions of ACE1 and AT1R were detected by immunohistochemistry. The protein expression levels of ACE1, AngⅡ and AT1R were determined by Western blot. Result: Compared with control and sham-operation groups, SCr, BUN and 24 h-Pro in model group were significantly increased (PPPPConclusion: Kangxianling decoction can delay the progress of renal fibrosis in 5/6 nephrectomized rats, which is closely related to the inhibition of ACE-AngⅡ-AT1R axis activation.

Effect of Kangxianling Decoction on Renal Function and Kidney ECM Expression in Rats with Renal Fibrosis / 中国实验方剂学杂志

Objective: To investigate the effect of Kangxianling decoction on renal function and expression of extracellular matrix(ECM) in renal tissue of rats with renal fibrosis induced by 5/6 nephrectomy. Method: Totally 50 SD rats were randomly divided into control group (n=7), sham-operation group (n=7), operation group (n=36). The 5/6 nephrectomized renal fibrosis model was established in operation group. After successful modeling, rats were randomly divided into model group, Kangxianling group and losartan potassium group. The losartan potassium group and the Kangxianling group were given losartan potassium (33.3 g·kg-1) and Kangxianling decoction (21 g·kg-1) every day. The control group, sham-operation group and model group were all treated with equal volume of normal saline. Rats were put to death after 24 weeks of consecutive medication, and renal function, 24 h urine volume and 24 h-Pro quantitation of each group were measured. The expressions of collagen Ⅰ(ColⅠ) and ColⅢ in renal tissues were determined by immunohistochemistry and Western blot. Result: Compared with the normal group and sham-operation group, serum creatinine(SCr), blood urea nitrogen(BUN), 24 h urine volume, 24 h-Pro quantitation, renal tissue ColⅠ and ColⅢ expression levels were significantly increased in the model group (PPPConclusion: Kangxianling decoction can down-regulate the expressions of ColⅠ and ColⅢ in kidney tissue, there by inhibiting the accumulation of ECM, and exerting the effect in delaying renal fibrosis and protecting renal function.

Effect of Kangxianling Decoction on TGF-β1/Smad Signal Pathway in Renal Fibrosis Rats / 中国实验方剂学杂志

Objective: To study the therapeutic effect of Kangxianling Decoction on renal fibrosis induced by 5/6 nephrectomization in rats, and discuss its action mechanism. Method: Totally 50 SD rats were randomly divided into normal control group (n=10), sham-operation group (n=10), and 5/6 nephrectomized renal fibrosis model group (n=30). After successful modeling, rats were randomly divided into the model group, Kangxianling group, and Losartan Potassium group. Rats in the Losartan Potassium group were administered with Losartan Potassium by gastrogavage; rats in the Kangxianling group were administered with Kangxianling by gastrogavage. Equal volume of distilled water was administered to rats in the other groups. Rats were sacrificed after 8 weeks of consecutive medication, and then serum creatinine (SCr), urea nitrogen (BUN), 24 hour urine protein (24 h-Pro) were measured in each group. Hematoxylin-eosin (HE) staining was used to observe the renal pathological changes and the score of Kidney damage was made. Masson staining was used to observe the degree of renal fibrosis. Western blot and real-time fluorescent quantitative polymerase chain reaction(Real-time PCR) were used to detect the protein and mRNA expression levels of transforming growth factor (TGF-β1), Smad2, Smad3, and Smad7 in kidneys. Result: As compared with the normal control and sham-operation group, the renal tissue fibrosis, score of kidney damage, SCr, BUN and 24 h-Pro levels were higher in model group (Pβ1, Smad2, and Smad3 (PPPβ1, Smad2, Smad3 were reduced (PPConclusion: Kangxianling decoction could alleviate renal fibrosis by inhibiting TGF-β1/Smad signal pathway.

Effects of Niaoduqing Particles () on Delaying Progression of Renal Dysfunction: A Post-trial, Open-Label, Follow-up Study / 中国结合医学杂志

OBJECTIVE@#To follow up the participants of the randomized clinical trial "Efficacy and Safety of Niaoduqing Particles () for Delaying Moderate-to-Severe Renal Dysfunction", and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction.@*METHODS@#Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period.@*RESULTS@#After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) μmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were-0.2 (-4.3-2.7) and-2.21 (-5.7-0.8) mL•min•1.73 m, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (-10.0-41.9) and 17.5 (-6.0-50.0) μmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were-2.3 (-6.4-1.9) and-3.7 (-7.5-1.1) mL•min•1.73 m, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min•1.73 m per year.@*CONCLUSION@#Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448).

Clinical study on Yishen Qufeng Shengshi Recipe () for glomerular proteinuria patients: A randomized controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the therapeutic effect of Yishen Qufeng Shengshi Recipe (, YQSR) in patients with glomerular proteinuria METHODS: A total of 145 patients with glomerular proteinuria were selected and randomly assigned to the treatment group (108 cases) and the control group (37 cases) according to a random number table in a ratio of 3:1. All patients received conventional and symptomatic treatment. In addition, patients in the treatment and control groups were given YQSR (200 mL, twice per day, orally) and losartan (50 mg/d orally), respectively for 6 months. The 24-h urine protein quantity, blood urea nitrogen, and serum creatinine in the two groups were measured at multiple time points before and after treatment.</p><p><b>RESULTS</b>At the end of the study, 5 cases were lost to follow-up in the treatment group and 1 in the control group. Finally, the statistical data included 103 cases in the treatment group and 36 cases in the control group. The total effectiveness after 2, 4, and 6 months was 81.6% (84/103), 87.4% (90/103), and 92.2% (95/103), respectively, in the treatment group and 47.2% (17/36), 55.6% (20/36), and 61.1% (22/36), respectively, in the control group, with significant difference between the two groups (P<0.01 at all observation points). In the treatment group, the curative effect after 6 months was better than that after 2 months (P<0.05). The 24-h urine protein quantity was significantly lower in the treatment group at 3, 4, 5, and 6 months than that in the control group (P<0.05 or P<0.01, respectively) CONCLUSION: YQSR could significantly reduce the amount of glomerular proteinuria in the early stage.</p>

Two new polypeptides from extract of deer bone extract / 中国中药杂志

Two new polypeptides were isolated and purified from the extract of deer bone (constitutive part of Cucumis and Cervus polypeptide injection) by various column chromatography including C₄ 300Å and Sephadex G-50, as well as semipreparative HPLC. Their N-terminal amino acid sequences were identified by De Novo sequencing on the basis of MALDI-TOF-MS data and Explorer™ software. The N-terminal amino acid sequences of polypeptides were identified as NH₂-Gly-Pro-Val-Gly-Pro-Thr-Gly-Pro-Val-Gly-Ala-Ala-Gly-Pro-Ser-Gly-Pro-Asp (Mei18 peptide, 1) and NH₂-Ala-Gly-Pro-Ala-Gly-Pro-Leu-Gly-Pro-Leu-Gly-Pro-Leu-Gly-Pro-Leu-Gly-Pro-Pro-Asp-Ser-Try-Asp (Mei23 peptide, 2), respectively. Mei18 and Mei 23 peptides are new polypeptides.

Interventional mechanisms of herbs or herbal extracts on renal interstitial fibrosis / 中西医结合学报

Renal interstitial fibrosis (RIF) is a common development in chronic renal diseases that can lead to uremia and be life-threatening. The RIF pathology has complicated extracellular and intercellular mechanisms, involving many cells and cytokines, resulting in an incomplete mechanistic understanding of the disease. Finding effective herbs or herbal extracts for prevention and treatment of RIF is crucial because current medical approaches do not reliably slow or reverse RIF. In recent years, many experts have worked to identify herbs or herbal extracts to combat RIF both in vivo and in vitro, with some success. This review attempts to summarize the possible interventional mechanisms of herbs or herbal extracts involved in protecting and reversing RIF. The authors found some herbs and their extracts that may ameliorate renal impairments through anti-inflammation, anti-fibrogenesis and stabilization of extra cellular matrix. Among them, tetramethylpyrazine/ligustrazine, curcumin and polyglucoside of Tripterygium have experimentally shown good potential for improving RIF. However, conclusive evidence is still needed, especially in randomized controlled clinical trials. We expect that herbs or herbal extracts will play an important role in RIF treatment and reversal in the future.

A Clinical Multicenter Randomized Controlled Study on JianpiQinghua Decoction in Treating Stage 3 Chronic Kidney Disease with A Syndrome Type of Dampness-heat due to Spleen Deficiency / 中国医学科学院学报

Objective To evaluate the clinical effectiveness of JianpiQinghua decoction in treating stage 3 chronic kidney disease (CKD3) with syndrome type of dampness-heat due to spleen deficiency. Methods A multicenter, randomized, controlled, prospective, double-blind, and double-simulation study was undertaken. A total of 270 CKD3 patients with syndrome type of dampness-heat due to spleen deficiency from the outpatient departments of six general hospitals were randomly divided into telmisartan+analog traditional Chinese medicine (TA) group, traditional Chinese medicine+analog telmisartan (TCMA) group, and telmisartan+traditional Chinese medicine (TTCM) group, in which the corresponding treatment was applied in addition to basic treatment. Six months later, changes in the traditional Chinese medicine (TCM) clinical symptom scores and renal functions before and after treatment were compared among these three groups. Results Of these 270 CKD3 patients who had been enrolled in this study, 30 cases lost to follow-up. The baseline data were comparable among these three groups. After treatment, the TCM clinical symptom scores of both syndrome of spleen-qi deficiency and dampness-heat in TA group were significantly higher than those in TCMA group and TTCM group (P<0.001). With the treatment time prolonged, the TCM clinical symptom scores showed similar descending trends in TCMA group and TTCM group but were different from that in TA group. After treatment, abnormal creatinine rate decreased (P=0.003), and these three treatments and their interactions with each visit had no effect on serum urea nitrogen value (P=0.270, P=0.520); with prolonged treatment, the estimated glomerular filtration rates in three groups tended to be relatively stable after the first rise. The liver function and abnormal serum potassium rate were not statistically significant before and after treatment (P>0.05). Conclusions JianpiQinghua decoction can improve clinical symptoms of TCM in CKD3 patients with syndrome type of dampness-heat due to spleen deficiency and thus improve the quality of life and prognosis. The clinical efficacy of JianpiQinghua decoction alone or combined with telmisartan is superior to telmisartan monotherapy.

Treatment of Proteinuria in Chronic Glomerular Disease Patients with Pi-Shen Deficiency Complicated Damp-Heat Syndrome by Yishen Qingre Huashi Recipe: a Clinical Study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Yishen Qingre Huashi Recipe (YQHR) in treating proteinuria of chronic glomerular disease patients with Pi-Shen deficiency complicated damp-heat syndrome (PSDCDHS).</p><p><b>METHODS</b>Totally 121 stage 1 -2 primary chronic glomerular disease patients with PSDCDHS were randomly assigned to the treated group (85 cases) and the control group (36 cases) according to 2:1. All patients received conventional and symptomatic treatment. Patients in the treated group took YQHR additionally, while those in the control group took Losartan Potassium Tablet (50 mg each time, once per day) additionally. The therapeutic course for all was 6 months. Changes of 24 h urine protein, blood urea nitrogen (BUN), serum creatinine(SCr), and estimated glomerular filtration rate (eGFR) were observed at different time points. And the difference in therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>Compared with the control group after 6 months of treatment, 24 h urine protein obviously decreased in the treated group (P <0. 05). There was no statistical difference in SCr, BUN, or eGFR between the two groups after 6 months of treatment (P >0. 05). The total effective rate after 2, 4, and 6 months of treatment in the treated group was 77. 6% (66/85 cases), 82. 4% (70/85 cases), and 89. 4% (76/85 cases), respectively. They were 47. 2% (17/36 cases), 55. 6% (20/36 cases), and 61. 1% (22/36 cases) in the control group, respectively. Compared with before treatment in the treated group, the total effective effect after 6 months of treatment was higher than that after 2 months of treatment (χ2=4. 28, P <0. 01). Compared with the control group at the same time points, the total effective rate in the treated group after 2, 4, and 6 months of treatment was higher (χ2=10. 87, 9. 53, 13.16, P <0. 01).</p><p><b>CONCLUSION</b>YQHR could significantly lower proteinuria in chronic glomerular disease patients with PSDCDHS, improve the clinical effect, thereby providing clinical evidence for treating chronic glomerular disease proteinuria from resolving dampness and clearing heat.</p>

Azathioprine Treatment in Systemic Lupus Erythematosus: A Double Edged Sword

Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

Effect and mechanism of jianpi qinghua recipe on renal functions of adriamycin-induced nephropathic rats from the angle of inhibiting renal fibrosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Jianpi Qinghua Recipe (JQR) on renal functions of adriamycin-induced focal segmental glomerular sclerosis (FSGS) rats from the angle of activating fibroblasts to myofibroblast (MyoF).</p><p><b>METHODS</b>Totally 56 rats were randomly divided into the normal control group (n=8), the sham-operation group (n =8), and the model group (n=40). The FSGS rat model was induced by nephrectomy of left kidney plus intravenous injection of adriamycin. Successfully modeled rats were further divided into 5 groups, i.e., the model group, the JQR group, the JPR (Jianpi Recipe) group, the QHR (Qinghua Recipe) group, and the NDQ (Niaoduqing) group, 8 in each group. Corresponding drugs were administered to rats in all groups, 2 mL each time, for 56 days. The effect of JQR on serum creatinine (SCr), urea nitrogen, 24-h urinary protein excretion, a-smooth muscle actin (alpha-SMA) mRNA, collagen type III (Col III) mRNA, fibronectin (FN) mRNA, and collagen type IV (Col IV) mRNA were observed.</p><p><b>RESULTS</b>JQR could significantly lower SCr, urea nitrogen, and 24-h urinary protein excretion levels (P < 0.01), and significantly decrease mRNA levels of alpha-SMA, Col III, FN, and Col IV (P < 0.01). It was advantageous over the NDQ group. Compared with JPR, the relative expression levels of Col III mRNA and FN mRNA of JQR and QHR were significantly lower (P < 0.01).</p><p><b>CONCLUSIONS</b>JQR could improve the renal function and renal fibrosis in the adriamycin-induced nephropathic model rats. Its efficacy was superior to that of NDQ. Its mechanisms might be linked with inhibiting activation of fibroblasts.</p>

Effects and mechanism of "Jianpi Qinghua Decoction" on renal fibrosis in rats with glomerulosclerosis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the mechanism of "Jianpi Qinghua Decoction" (JQD) on renal fibrosis by observing the impact of JQD on serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and kidney tumor necrosis factor-Α (TNF-Α) expressions in focal segmental glomerulosclerosis rats induced by nephrectomy combined with adriamycin.</p><p><b>METHODS</b>Totally 56 male SD rats were divided into normal group, sham operation group, model group, JQD group, Yiqi Jianpi group, Qingre Huashi group, and Niaoduqing group (all n=8). The model of focal segmental glomerulosclerosis was established by the unilateral nephrectomy and the injection of adriamycin in caudal vein of rat at a dose of 3 mg/kg in the latter 5 groups. JQD, the disassembled prescription of Jianpi Qinghua Decoction (Yiqi Jianpi Decoction and Qingre Huashi Decoction), and Niaoduqing Capsule were administered separately for 8 weeks. The serum TC, TG, LDL, and VLDL levels and the expression of Kidney TNF-Α were determined.</p><p><b>RESULTS</b>Compared with normal group and sham operation group, the serum TC, TG, LDL, and VLDL levels and the kidney TNF-Α expression in the model group were significantly higher (all P<0.01). Compared with the model group, the JQD group, Qingre Huashi group, and Niaoduqing group had significantly lower serum TC, TG, LDL, and VLDL levels and kidney TNF-Α expression (all P<0.01). Compared with the model group, the Yiqi Jianpi group had significantly lower serum TC ,TG, and VLDL levels (all P<0.01), while the serum LDL level and kidney TNF-Α expression remained unchanged (all P>0.05).</p><p><b>CONCLUSIONS</b>JQD can regulate serum lipids and lower the TNF-Α expression in kidney tissue and thus improve the renal inflammation and relieve renal fibrosis. The heat-clearing and dampness-removing herbs in the prescription play a central role in fighting against renal fibrosis.</p>

MAPK p38 pathway may be involved in renal function improvement in chronic renal failure rats treated with Jianpi Qinghua decoction / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the involvement of MAPK p38 pathway in treatment of chronic renal failure with Jianpi Qinghua Decoction in rats.</p><p><b>METHODS</b>Forty SPF SD rats were divided into sham group (n=10),model group (n=10), Jianpi Qinghua group (n=10) and losartan group (n=10). Rat chronic renal failure was induced by 5/6 nephrectomy (Platt method) in model, Jianpi Qinghua and losartan groups, and rats in sham group received sham operation. Jianpi Qinghua decoction (3.9 g 200 g(-1)) or losartan (3.3 g 200 g(-1)) daily were administrated by gavage in Jianpi Qinghua and losartan groups for 60 days, respectively, Rats in sham and model groups were orally administered with saline of the same volume. The serum levels of creatinine and urea nitrogen were measured by biochemical method, the expression of MAPK p38 was detected by Western Blot,and renal pathological changes were observed with hematoxylin-eosin staining.</p><p><b>RESULTS</b>Compared to model group,serum creatinine levels after 60d in Jianpi Qinghua and losartan groups were decreased significantly (42.67 ± 5.98 or 40.90 ± 5.07 compared with 60.90 ± 9.54, both P<0.01), the expression of MAPK p38 was significantly down-regulated (0.555 ± 0.004 or 0.587 ± 0.045 compared with 0.930 ± 0.265,both P<0.01) and serum urea nitrogen was also decreased (8.56 ± 0.75 or 7.97 ± 0.86 compared with 8.62 ± 0.62,both P<0.05). The renal pathology in the model group presented glomerular mesangial proliferation,hyperplasia of glomenrulus mesangial cells and interstitial inflammation. Those pathological changes were attenuated significantly in Jianpi Qinghua and losartan groups.</p><p><b>CONCLUSION</b>Jianpi Qinghua Decoctions can improve the renal function and renal pathological changes in a rat with chronic renal failure, which may be associated with down-regulation of MAPK p38 immune inflammatory pathways.</p>

The research on xiaochalhu decoction improving the inflammation of chronic glomerulonephritis patients and relieving the proteinuria / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the balance of T help cell1/2 (Th1/Th2), the changes of correlated proinflammatory cytokines (IFN-gamma and IL-4), and regulated on activation normal T cell expressed and secreted (RANTES), and the abnormal expression of IL-17, the effector of T help cell17 (Th17) in chronic glomerulonephritis (CGN)patients with Shaoyang disease, thus revealing the mechanisms of Xiaochaihu Decoction (XD) for treating proteinuria of CGN patients according to the theory of mediating Shaoyang meridian.</p><p><b>METHODS</b>Totally 70 CGN patients with Shaoyang disease were randomly assigned to two groups, the treatment group (treated by XD) and the control group [treated by Shenyan Kangfu Tablet (SKT)], 35 in each group. Besides, 20 healthy volunteers were recruited as the healthy control group. Besides, routine therapy of chronic kidney disease (CKD), patients in the treatment group and the control group were treated with XD and SKT respectively for 4 weeks. The changes of Chinese medical syndrome, the effectiveness, 24-h urinary protein, renal functions, the peripheral blood IFN-gamma, IL-4, Th1/Th2, IL-17, and RANTES were compared.</p><p><b>RESULTS</b>Before treatment the Th1/Th2, IL-17, and RANTES of the two treated groups were higher, and the IL-4 level was lower than those of the healthy control group (P < 0.05). After treatment the improvement of Chinese medical syndrome, main symptoms, the effectiveness was better in the XD group than in the SKT group (P < 0.05, P < 0.01). The proteinuria obviously decreased in the treatment group, with the efficacy superior to the SKT group (P < 0.05). The Th1/Th2, IL-17, and RANTES decreased to various degrees when compared with the SKT group (P < 0.05, P < 0.01). The IL-4 level increased more obviously in the treatment group than in the control group (P < 0.05). There was no statistical difference in the improvement of the renal function (P > 0.05).</p><p><b>CONCLUSIONS</b>The immune disorder of the CGN patients with Shaoyang disease was correlated with Th1/Th2 imbalance, and abnormal changes of Th17 cell functions and RANTES. XD could improve the inflammation by regulating the immune disorder of CGN patients with Shaoyang disease, which proved that the theory of mediating Shaoyang meridian could be used to improve the inflammation of CGN patients, thus relieving the proteinuria.</p>

GTW-induced abnormal expressions of testicular reproduction-related genes and intervention with kidney-tonifying Chinese herbs / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the abnormal expressions of testicular reproduction-related genes induced by glycosides of Tripterygium wilfordii (GTW) and the intervention with kidney-tonifying Chinese herbs.</p><p><b>METHODS</b>Adult Balb/C male mice were fed on GTW at 30 mg per kg per d for 3 weeks to establish a model of reproductive dysfunction. The model mice were divided into different groups to receive intragastrical administration of saline (0.25 ml/d), GTW (30 mg per kg per d), Cistanche (10 g per kg per d), Rehmannia (10 g per kg per d), and Rehmannia + Cistanche (20 g per kg per d), respectively, once a day for 3 weeks. And a Cistanches pretreatment group was treated with GTW (30 mg per kg per d) and Cistanche (10 g per kg per d) for the same length of time. Then we detected the changed expressions of testicular reproduction-related genes Dzip1, Fas, c-jun and Wnt4 in each group.</p><p><b>RESULTS</b>The model mice showed an obviously down-regulated expression of the Y chromosome microdeletion-related gene Dzip1, and up-regulated expressions of the germ cell apoptosis-related gene Fas, proto-oncogene c-jun, and signal transduction-related gene Wnt4. Intervention with Chinese herbs achieved different degrees of improvement of the mice's reproductivity, and the most obvious efficacy was observed with the combined use of kidney-yang tonifying Cistanche and kidney-yin nourishing Rehmannia.</p><p><b>CONCLUSION</b>GTW exerts significant impact on reproduction-related genes. Both the kidney-yang tonifying drug Cistanche and kidney-yin nourishing drug Rehmannia can counteract some of the reproductive toxicity of GTW, while the combination of the two can further enhance the effect.</p>

Effects of mesangial cell on proliferation and function of osteoblast in vitro / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effects and mechanism of mesangial cell (MC) on proliferation and function of osteoblast in vitro from growth factors.</p><p><b>METHODS</b>Osteoblast cultured in vitro were divided into normal blood serum group and MC group and cultured supernatant fluid by 10% serum culture medium and 20% MC culture medium. MTF was used to checked the proliferation of osteoblast at the end of 24, 48, 72, 120 h; Expression of BGP and OPN were tested 72 h and 144 h after culture; Expression of IGF-alpha and TGF-beta were tested 144 h after culture.</p><p><b>RESULTS</b>The proliferation of osteoblast in MC group was obviously higher than normal blood serum group in different times (P < 0.05); The level of BGP and OPN of osteoblast was obviously higher than normal blood serum group (11.3%, 16.4%, 55.0% and 39.6%); and the level of IGF-alpha and TGF-beta of osteoblast was obviously higher than normal blood serum group (10.1% and 47.7%).</p><p><b>CONCLUSION</b>MC can directly act on osteoblast, promote the proliferation and function of osteoblast by promoting secretion of TGF-beta.</p>

Effects of bushen huoxue recipe on urinary levels of albumin, IL-6, TGF-beta1 and MCP-1 in chronic nephritis patients of shen-deficiency blood-stasis syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Bushen Huoxue Recipe (BSHXR, a Chinese medicine recipe for Shen reinforcing and blood circulation activating) on the levels of urinary albumin, interleukin-6 (IL-6), transforming growth factor-beta1 (TGF-beta1), and monocyte chemotactic protein-1 (MCP-1) in chronic nephritis patients of Shen-deficiency blood-stasis syndrome.</p><p><b>METHODS</b>Forty-five patients were blocking assigned randomly to two groups, fifteen patients in the control group and thirty in the treatment group. All orally took Monopril 10 mg, once daily. But BSHXR was given additionally to patients in the treatment group after decocting,one dose per day (taken in two times). The treatment course for both groups was eight weeks. Besides, a normal control group consisting of six healthy subjects from health examination of Shuguang Hospital was set up. The 24-h urinary albumin and contents of TGF-beta1, IL-6 and MCP-1 in urine of all subjects were observed.</p><p><b>RESULTS</b>Compared with before treatment the 24-h urinary albumin was obviously reduced in the treatment group, showing significant difference (P<0.01). The urinary 24-h albumin decreased in the control group, with statistical significance (P<0.05). Statistical difference existed between the treatment group and the control group after treatment (P<0.01). Compared with before treatment, urinary levels of IL-6, TGF-beta1, and MCP-1 were all down-regulated in the treatment group and the control group after treatment (P<0.01), and the decreasing of IL-6 and TGF-beta1, levels was more significant in the treatment group statistically (P<0.05).</p><p><b>CONCLUSIONS</b>BSHXR could attenuate the albuminuria in patients of chronic nephritis. Its mechanism might be possibly correlated with its down-regulation of IL-6, TGF-beta1, and MCP-1 levels.</p>

Effect of Bushen Huoxue recipe on the state of extracellular matrix in glomerulosclerosis rats model / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect and acting mechanism of Bushen Huoxue Recipe (BHR) on the state of extracellular matrix in glomerulosclerosis (GS) rats model.</p><p><b>METHODS</b>GS rat model was established by unilateral nephrectomy and adriamycin injection. Model rats were randomly divided into 4 groups: the normal control group, the model group, the test group treated by BHR, and the positive control group treated with fosinopril sodium, with 11 rats in each group. The 24 h urinary protein and renal function of rats were observed, the contents of matrix metalloproteinase 1 (MMP-1), tissue inhibitor of metalloproteinase 1 (TIMP-1) in renal tissue and transforming growth factor-beta1 (TGF-beta1) in blood plasma, and renal tissue were detected.</p><p><b>RESULTS</b>Compared with those in the normal control group, 24 h urinary protein was increased and renal function was deprived in the model group; TIMP-1 expression increased, MMP1 expression decreased in renal tissue of rats in the model group, showing statistical difference between groups (P < 0.05). As compared with the model group, the abnormal changes of TIMP-1 and MMP1 expressions were ameliorated in the two groups treated either by BHR or fosinopril (P < 0.05). The content of TGF-beta1 in the model group, either in blood or in renal tissue, was significantly higher than those in the normal control group respectively (P < 0.01), showing no significant change after BHR treatment.</p><p><b>CONCLUSION</b>The protective effect of BHR on renal function in rats with GS is possibly by way of influencing expressions of TGF-beta1, TIMP-1 and MMP1 to regulate the state of extracellular matrix and lessen the matrix aggregation.</p>