Effect of Xuanfuhua decoction on a mouse model of nonalcoholic steatohepatitis induced by high-fat, high-fructose, and high-cholesterol diet / 临床肝胆病杂志

Objective To investigate the intervention effect of Xuanfuhua decoction on mice with nonalcoholic steatohepatitis (NASH) induced by high-fat, high-fructose, and high-cholesterol diet. Methods A total of 32 male C57/BL6J mice were randomly divided into normal group, model group, Xuanfuhua decoction group, and obeticholic acid group, with 8 mice in each group. Since week 24 of modeling using high-fat, high-fructose, and high-cholesterol diet, each group was given the corresponding drug for intervention at a dose of 14.19 g/kg by gavage for the Xuanfuhua decoction group and 10 mg/kg by gavage for the obeticholic acid group and a volume of 20 mL/kg for gavage, once a day for 6 consecutive weeks. HE staining, oil red O staining, Sirius Red staining, and Masson staining were used to observe the pathological changes, lipid deposition, and collagen deposition of liver tissue; related kits were used to measure the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and glucose, as well as the content of TG and hydroxyproline (Hyp) in liver tissue; quantitative real-time PCR was used to measure the expression of genes associated with lipid metabolism, inflammation, and fibrosis in liver tissue; immunohistochemical staining was used to observe the positive expression of F4/80 and α-SMA in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the normal group, the model group had significant increases in body weight, liver wet weight, and serum levels of AST, ALT, TC, TG, LDL-C and glucose (all P < 0.01). HE staining showed hepatocyte steatosis, a large number of fat vacuoles, hepatocyte ballooning degeneration, and inflammatory cell infiltration in liver tissue of the mice in the model group, and the model group had a significant increase in NAFLD activity score (NAS) compared with the normal group ( P < 0.01). Oil red O staining showed the deposition of a large number of red lipid droplets with different sizes in hepatocytes of the mice in the model group, and compared with the normal group, the model group had significant increases in the area percentage of oil red O staining and the content of TG in the liver ( P < 0.01). Sirius Red staining and Masson staining showed significant collagen fiber hyperplasia in the perisinusoidal area, the central vein, and the portal area in the model group, and the model group had a significant increase in the content of Hyp in liver tissue compared with the normal group ( P < 0.05). Compared with the model group, the Xuanfuhua decoction group had significant reductions in the serum levels of AST, ALT, TC, TG, LDL-C, and glucose (all P < 0.05), significant improvements in hepatic steatosis, inflammatory infiltration, lipid droplet deposition, and collagen fiber hyperplasia, and significant reductions in NAS score, area percentage of oil red O staining, and content of TG and Hyp in the liver (all P < 0.05). Compared with the normal group, the model group had significant increases in the mRNA expression levels of lipid metabolism-related genes (SREBP-1c, FASN, SCD-1, PPAR-γ, and CD36), inflammation-related genes (F4/80, TNF-α, CCL2, and CD11b), and the fibrosis-related gene α-SMA (all P < 0.05), and immunohistochemical staining showed significant increases in the positive expression of F4/80 and α-SMA ( P < 0.01). Compared with the model group, the Xuanfuhua decoction group had significant reductions in the mRNA expression levels of SREBP-1c, FASN, SCD-1, PPAR-γ, CD36, F4/80, TNF-α, CCL2, CD11b, and α-SMA in liver tissue (all P < 0.05), and immunohistochemical staining showed significant reductions in the positive expression of F4/80 and α-SMA ( P < 0.01). Conclusion Xuanfuhua decoction has a good intervention effect on mice with NASH induced by high fat, high fructose, and high-cholesterol diet and can significantly inhibit hepatic lipid deposition, inflammatory response, and liver fibrosis.

Effect of various cells on the activation of hepatic stellate cells in liver microenvironment / 临床肝胆病杂志

Liver fibrosis is a dynamic pathological process characterized by excessive deposition of extracellular matrix (ECM) or hyperplasia of scar tissue. The activation of hepatic stellate cells (HSCs) is generally considered the central link in the formation of liver fibrosis. HSC activation is regulated by various factors in liver microenvironment, including physical and chemical stimulations and intercellular interactions. Intrinsic cells and immune cells in the liver and HSCs together establish a complex regulatory system to regulate HSC activation and regression. This article introduces the regulatory effect of the cells in liver microenvironment on HSC activation, in order to expand thinking for the research on new diagnosis and treatment methods for liver fibrosis.

Effects of electrical stimulation at acupoints in the distribution area of auricular vagus nerve combined with sound masking method on auditory brainstem response and neurotransmitters of inferior colliculus in rats of tinnitus / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of electrical stimulation at acupoints in the distribution area of auricular vagus nerve combined with sound masking on auditory brainstem response (ABR) and contents of neurotransmitters of γ-aminobutyric acid (γ-GABA), 5-hydroxytryptamine (5-HT) and acetyl choline (Ach) in inferior colliculus of tinnitus rats.</p><p><b>METHODS</b>Twenty-four male adult SD rats were randomized into a control group, a model group, a 7-d treatment group and a 15-d treatment group. Except the control group, rats in the remaining groups were treated with intraperitoneal injection of 10% salicylate sodium at a dose of 350 mg/kg to establish tinnitus model. Rats in the control group were treated with injection of 0.9% NaCl. Rats in the 7-d treatment group and 15-d treatment group were treated with electrical stimulation at "Shenmen (TF₄)" and "Yidan (CO₁₁)" in the distribution area of auricular vagus nerve combined with sound masking, once a day, for 7 days and 15 days. The SigGenRP software of TDT system was applied to provide voice for single ear and collect the signal, and the voice threshold of ABR was tested. The levels of γ-GABA, 5-HT and Ach in inferior colliculus of rats were detected by enzyme linked immunosorbent assay (ELISA) and compared.</p><p><b>RESULTS</b>Compared with the model group, the threshold values of ABR in 12 kHz and 16 kHz voice stimulation in the 7-d treatment group were significantly lower all P < 0.05); the threshold values of ABR from 4 kHz to 28 kHz voice stimulation in the 15-d treatment group were signally reduced (P < 0.05, P < 0.01), which was more significant than those in the 7-d treatment group. The level of γ-GABA in the model group was significantly lower than that in the control group (P < 0.05), and that in the 15-d treatment group was apparently higher than that in the model group (P < 0.05). The level of 5-HT in the model group was markedly higher than that in the control group (P < 0.05), and that in the 7-d treatment group was lower than that in the model group (P < 0.05), while that in the 15-d treatment group was apparently higher than that in the model group (P < 0.05). The level of Ach in the model group was obviously; lower than that in the control group (P < 0.05), and that in the 7-d treatment group was higher than that in the model group (P < 0.05).</p><p><b>CONCLUSION</b>Electrical stimulation at auricular vagus nerve combined with sound masking) could regulate the threshold of ABR, especially in the 15-d treatment group. This may be ascribed to modulating the levels of neurotransmitter of γ-GABA, 5-HT and Ach in inferior colliculus.</p>

Analysis on Clinical Adverse Drug Reaction of Tonic Chinese Medicinal Herbs Based on Literature / 中国中医药信息杂志

Objective To analyze the occurrence of clinical adverse drug reaction (ADR) of tonic Chinese medicinal herbs. Methods Articles about ADR of tonic Chinese medicinal herbs reported from January 1990 to February 2014 were collected from databases of CNKI, VIP, CBM, Pubmed and Embase according to incorporation and exclusion standard. Metrology analysis was also conducted. Results Totally 378 effective articles showed tonic Chinese medicinal herbs most likely to induce ADR were as follows:individual Chinese medicinal herbs including Polygoni Multiflori Radix, Ginseng Radix et Rhizoma, Lycii Fructus and Astragali Radix;injection containing Shenmai Injection, Shengmai Injection and Acanthopanax Injection;other herbal preparation covering Polygoni Multiflori tablets. The most common ADR involved the damage on skin tissue, nervous system and digestive system, with prominent relevant clinical symptoms such as itching, skin rash, dizziness, unconsciousness, nausea, vomiting, and liver dysfunction. Conclusion Correct understanding adverse reaction of tonic Chinese medicinal herbs will be conducive to rational drug use and avoiding risk.

Rule of Traditional Chinese Medicine in Treating Tinnitus Based on Literature and Logistic Multiple Regression Analysis / 中国中医药信息杂志

Objective To explore the rule of traditional Chinese medicine in treating tinnitus based on literature and Logistic multiple regression analysis. Methods Articles about tinnitus treatment using traditional Chinese medicine were searched in several databases, i.e. CNKI (1984-2013), VIP (1989-2013), CBM (1990-2013), and PubMed (1984-2013), and medication frequency was analyzed. Then, models for tinnitus medication were established through metrological method and Logistic multiple regression. Results The common prescriptions with highest frequency usage were Liuwei Dihuang Pill, Longdan Xiegan Decoction, and Erlong Zuoci Pill. Corni Fructus, Psoraleae Fructus, and Lycii Fructus were commonly used for kidney-deficiency type of tinnitus;Astragali Radix, Atractylodis Macrocephalae Rhizoma, and Codonopsis Radix were commonly used for the spleen-qi-deficiency type of tinnitus;Gardeniae Fructus, Gentianae Radix et Rhizoma, and Cyperi Rhizoma were commonly used for the liver-qi-dysfunction type of tinnitus;Pinelliae Rhizoma, Aurantii Fructus Immaturus, and Stephaniae Tetrandrae Radix were commonly used for the phlegm-fire disturbance type of tinnitus;Forsythiae Fructus, Menthae Haplocalycis Herba, and Mori Cortex were commonly used for the wind-fire-invasion type of tinnitus. Conclusion Analysis of medication frequency and Logistic multiple regression analysis can provide evidence and reference for the treatment of tinnitus and syndrome differentiation.

Meta Analysis on Domestic and Overseas Acupuncture Treatment for Nervous Tinnitus / 中国中医药信息杂志

Objective To conduct a systematic review with evidence collected from randomized controlled trials (RCTs) of domestic and overseas acupuncture for nervous tinnitus. Methods RCTs were searched in several databases i.e. CNKI, VIP, CBM and PubMed, using the keywords of acupuncture and tinnitus. The efficacy and methodologies were evaluated using meta-analysis by RevMan5.0. Efficacy indexes i.e. recovery rate, significant efficiency rate, total effective rate of acupuncture in treating nervous tinnitus were assessed using odds ratio (OR). Funnel plot was drawn to analyze publication bias. Begg’s rank test and Egger’s linear regression test were conducted to measure symmetry in funnel plot by using Stata 11.0. Results Fifteen RCTs involving 1082 patients met the inclusive criteria. The results of meta-analyses showed that recovery rate (OR=2.82, 95%CI 1.89 to 4.20), significant efficiency rate (OR=1.75, 95%CI 1.26 to 2.44), total effective rate (OR=3.68, 95%CI 2.62 to 5.16) were significantly higher in acupuncture group than control group. Begg’s rank test (P=0.350) and Egger’s linear regression test (P=0.887) showed partly symmetry in funnel plot with unfilled corner, which indicated that some degree of bias existed in the included studies. Conclusion According to the analysis results, acupuncture or acupuncture combining other therapies were superior to pure medication or non-acupuncture treatments. However, high-quality, large-sample, randomized, controlled trials seem to be needed to further confirm the efficacy of acupuncture, owing to the different standards and research methods, limited qualities of the included studies.