Targeted trace ingredients coupled with chemometric analysis for consistency evaluation of Panax notoginseng saponins injectable formulations / 中国天然药物

Evaluating the consistency of herb injectable formulations could improve their product quality and clinical safety, particularly concerning the composition and content levels of trace ingredients. Panax notoginseng Saponins Injection (PNSI), widely used in China for treating acute cardiovascular diseases, contains low-abundance (10%-25%) and trace saponins in addition to its five main constituents (notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, and ginsenoside Rd). This study aimed to establish a robust analytical method and assess the variability in trace saponin levels within PNSI from different vendors and formulation types. To achieve this, a liquid chromatography-triple quadrupole mass spectrometry (LC-MS/MS) method employing multiple ions monitoring (MIM) was developed. A "post-column valve switching" strategy was implemented to eliminate highly abundant peaks (NR1, Rg1, and Re) at 26 min. A total of 51 saponins in PNSI were quantified or relatively quantified using 18 saponin standards, with digoxin as the internal standard. This study evaluated 119 batches of PNSI from seven vendors, revealing significant variability in trace saponin levels among different vendors and formulation types. These findings highlight the importance of consistent content in low-abundance and trace saponins to ensure product control and clinical safety. Standardization of these ingredients is crucial for maintaining the quality and effectiveness of PNSI in treating acute cardiovascular diseases.

Clinical observation of ticagrelor combined with Compound xueshuantong capsule in the treatment of unstable angina pectoris / 中国药房

OBJECTIVE To observe the efficacy and safety of ticagrelor combined with Compound xueshuantong capsules in the treatment of unstable angina pectoris. METHODS Totally 120 patients with unstable angina pectoris with deficiency of Qi and Yin combined admitted to Sanmenxia Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were randomly divided into clopidogrel group （group A）， ticagrelor group （group B） and combined medication group （group C）， with 40 patients in each group. In addition to conventional treatment， group A was given clopidogrel orally； group B was given ticagrelor orally； group C was given ticagrelor and Compound xueshuantong capsule orally. After 12 weeks of treatment， the clinical efficacy， frequency of angina attacks， coagulation function indicators， cardiac function indicators， traditional Chinese medicine syndrome efficacy， and the incidence of adverse cardiovascular events and bleeding incidence were evaluated in the 3 groups. RESULTS The total effective rates of group A， group B and group C were 77.5%， 85.0% and 90.0%， respectively. The incidence of adverse cardiovascular events and bleeding events were 7.5%， 7.5% and 5.0% in the respective groups， with no statistically significant difference （P＞0.05）. The frequency of angina attacks， duration of angina attacks and duration of dyspnea were significantly reduced or shortened in all 3 groups after treatment compared to before treatment （P＜0.05）. The frequency of angina attacks in group C was significantly lower than that in groups A and B after treatment （P＜0.05）. The levels of fibrinogen （FBG） and D-dimer in all 3 groups were significantly lower after treatment compared to before treatment （P＜0.05）； group A had significantly higher levels of FBG and D-dimer compared to group B and C （P＜0.05）. The left ventricular end-diastolic diameter and left ventricular end-systolic diameter in all three groups were significantly shorter after treatment， and the left ventricular ejection fraction was significantly higher compared to before treatment （P＜0.05）， but there were no statistically significant differences among those groups （P＞0.05）. The total effective rates of traditional Chinese medicine syndrome efficacy in groups A， B and C were 67.5%， 80.0% and 87.5%， respectively， with group C being significantly higher than group A （P＜0.05）. CONCLUSIONS In addition to conventional treatment， ticagrelor combined with Compound xueguantong capsules can more significantly reduce the frequency of angina attacks in patients with unstable angina pectoris， reduce the levels of FBG and D- dimer， improve traditional Chinese medicine syndrome efficacy， and do not increase the risk of bleeding.

Comprehensive Clinical Evaluation of Xueshuantong for Injection（Lyophilized） in Treatment of Acute Cerebral Infarction / 中国实验方剂学杂志

ObjectiveTo systematically review the existing studies on Xueshuantong for injection（lyophilized） in the treatment of acute cerebral infarction（ACI）， and to clarify the clinical value of Xueshuantong for injection（lyophilized） through comprehensive clinical evaluation， so as to promote clinical rational drug use and relevant policy transformation. MethodEvidence of Xueshuantong for injection（lyophilized） in terms of safety， effectiveness， economy， innovation， suitability， accessibility， traditional Chinese medicine（TCM） characteristics（6+1 dimensions） and information service was comprehensively collected. Evidence-based medicine， questionnaire survey， health technology assessment， pharmacoeconomic evaluation and other research methods were used， and the multi-criteria decision analysis model was used to measure each dimension， in order to comprehensively evaluate the clinical value of Xueshuantong for injection（lyophilized）. ResultSpontaneous reporting system， Meta-analysis of adverse reactions， and active safety monitoring study showed that the main adverse reactions of Xueshuantong for injection（lyophilized） were rash， pruritus， chest tightness， headache， dizziness and other general adverse reactions， the incidence of serious adverse reactions was judged to be rare， the known risk was small， the evidence was sufficient， and the safety evaluation was grade A. The results of Meta-analysis showed that Xueshuantong for injection（lyophilized） combined with conventional treatment for ACI was superior to conventional treatment in terms of improving neurological deficit score， improving daily activity score and clinical efficacy， and the effectiveness evaluation was grade B. The results of pharmacoeconomic evaluation showed that Xueshuantong for injection（lyophilized） combined with conventional treatment was relatively economic compared with conventional treatment alone， with the total clinical effective rate as the effect parameter， but the incremental effect was not significant， the economic evaluation was grade B. In addition to ACI and unstable angina of coronary heart disease， the drug also had good clinical efficacy in central retinal vein occlusion， and had a wider range of indications and awarded 16 patents， and its innovation evaluation was grade B. The suitability of medical personnel and patients was good without special technical and management requirements， and the suitability was evaluated as grade B. Xueshuantong for injection（lyophilized） had reasonable price， good affordability， certain prescription restrictions and general availability， the accessibility evaluation was grade B. Since the drug is an injection of effective parts of TCM， no grade evaluation of its TCM characteristics is conducted. The legal and non-legal information evaluation results of Xueshuantong for injection（lyophilized） showed that all the information was complete and in accordance with the requirements of national standards. Based on the grade scores of the 6 dimensions， the clinical comprehensive evaluation of Xueshuantong for injection（lyophilized） in the treatment of ACI was calculated as category B by CSC 2.0. ConclusionThe clinical value of Xueshuantong for injection（lyophilized） is good， and it is suggested that it can be directly translated into relevant policy outcomes for basic clinical medication management.

Xueshuantong improves cerebral microcirculation disorder: action mechanism based on network pharmacology and experimental validation / 药学学报

This study is to explore the mechanism of Xueshuantong improving cerebral microcirculation disorder through the combination of network pharmacology and experimental validation in vivo. Structural formulas of main Panax notoginseng saponins, including notoginsenoside R1, and ginsenoside Rg1, Re, Rb1 and Rd were obtained from Pubchem website and their potential targets were predicted by Swiss Target Prediction database. Potential molecular targets of brain microcirculation disorder were acquired from OMIM and GeneCards database. The overlapped molecular targets between the drug and disease were analyzed. Protein interaction analysis and topology maps were constructed through the STRING online analysis platform and Cytoscape software. Core action targets were selected. GO function and KEGG pathway were analyzed by DAVID database. Immunohistochemical method was used to examine the expression of platelet endothelial cell adhesion molecule-1 (CD31) in the ischemic cortex of middle cerebral artery occlusion and reperfusion (MCAO/R) rats. The levels of mRNA and protein expressions of core action targets in MCAO/R model rats′ brain microvessels were verified by RT-qPCR and Western blot. Based on network pharmacology, 242 targets of Xueshuantong, 425 targets of brain microcirculation disorder, and 35 overlapped targets were obtained. The potential key targets of Xueshuantong, protein kinase B (AKT1), vascular endothelial growth factor A (VEGFA), caspase 3 (CASP3), matrix metallopeptidase 9 (MMP-9), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), signal transducer and activator of transcription 3 (STAT3) involved in the alleviation of cerebral microcirculation disorder were obtained by setting degree and betweenness centrality as screening parameters. Xueshuantong at the dose of 48 mg·kg-1 was shown to significantly improve the injury of neurological behaviors, as well as the density and morphology of microvessels of MCAO/R model rats. Xueshuantong could down-regulate the mRNA levels of AKT1, MMP-9, and STAT3, increase the protein expression levels of CD31, phosphorylated AKT and phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K), and the ratio of B-cell lymphoma 2/Bcl-2-associated X (Bcl-2/Bax), but decrease the protein expression levels of MMP-9, cleaved caspase-3 and phosphorylated STAT3. In summary, Xueshuantong could improve ischemic cerebral microcirculation disorder and thereby reduce nerve damage in ischemia-reperfusion rats by regulating signaling pathways related with PI3K, AKT, MMP-9, STAT3 and caspase-3 in microvessels. The study strictly adhered to all ethical protocols that experimental animals should follow in the course of medical research.

Efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion(RVO).METHODS: The clinical data of 90 patients(90 eyes)with RVO treated in our hospital from January 2020 to December 2021 were analyzed retrospectively, and they were divided into control group and observation group according to treatment methods. A total of 38 patients(38 eyes)in the control group were treated with intravenous Xueshuantong+oral compound Xueshuantong capsule+enteric-coated aspirin, and 52 patients(52 eyes)in the observation group were treated with Danshen injection iontophoresis on this basis. The treatment time of the two groups was 3mo. The clinical efficacy, best corrected visual acuity, retinal condition and hemorheological indexes(whole blood low shear viscosity, fibrinogen)were compared between the two groups before and after treatment.RESULTS: The total effective rate of the observation group was significantly higher than that in the control group(87% vs 58%,P<0.05)at 3mo after treatment. The best corrected visual acuity in both groups was better than that before treatment, and the observation group was better than the control group(all P<0.05).The circulation time of retinal vein, the relative diameter of retinal vein and the relative area of retinal hemorrhage in the observation group were lower than those before treatment,and the observation group was lower than the control group(all P<0.05). The whole blood low shear viscosity and fibrinogen levels in the two groups were lower than those before treatment, and the observation group was lower than those in the control group(all P<0.05).CONCLUSION: Danshen injection iontophoresis is effective in the treatment of patients with RVO, which can effectively improve the visual acuity, treat fundus lesions and improve the abnormal blood flow.

Efficacy of anti-VEGF therapy combined with iontophoresis of Xueshuantong injection on retinal vein obstruction with macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the clinical effects and safety of iontophoresis of xueshuantong injection combined with anti-vascular endothelial growth factor(VEGF)in the treatment of retinal vein occlusion(RVO)with macular edema(ME). <p>METHODS: Totally 106 patients(106 eyes)with RVO and ME in the hospital between June 2017 and June 2019 were divided into observation group and control group according to the random number table method with 53 cases(53 eyes)in each group, and they were all given intravitreal injection of conbercept, and observation group was additionally given iontophoresis of Xueshuantong injection for intervention, and they were treated for 3mo. Both groups were followed up for 1a and given supplementary therapy according to the condition of the disease. The best corrected visual acuity(BCVA), central retinal thickness(CRT)in macular area, supplementary therapy status, VEGF level in aqueous humor and adverse drug reactions were observed and compared between the two groups before and after treatment. <p>RESULTS: After treatment, the BCVA of the two groups was significantly improved(<i>P</i><0.05)while the CRT in macular area was significantly thinned(<i>P</i><0.05), and the BCVA on the 3, 6 and 12mo of treatment in observation group was better than that in control group while the CRT was thinner than that in control group(<i>P</i><0.05). The macular volume and VEGF level in aqueous humor were significantly reduced in the two groups after treatment(<i>P</i><0.05), and the macular volume and VEGF level on the 1, 3, 6 and 12mo of treatment in observation group were lower than those in control group(<i>P</i><0.05). The injection frequencies of conbercept and triamcinolone acetonide and the proportion of patients with laser photocoagulation in observation group were lower than those in control group(<i>P</i><0.05). During treatment, there was 1 eye of intraocular pressure increase and 3 eyes of subconjunctival hemorrhage in observation group, and there were 2 eyes of subconjunctival hemorrhage and 1 eye of endophthalmitis in control group(<i>P</i>>0.05).<p>CONCLUSION: Xueshuantong iontophoresis combined with intravitreal injection of conbercept for RVO with ME can effectively inhibit the expression of VEGF, reduce the ME and improve the visual acuity of the affected eyes. The efficacy and safety are worthy of recognition.

Effects of Xueshuantong Injection on thrombosis formation and blood flow in rats / 中国中药杂志

The aim of this paper was to explore the effect of Xueshuantong Injection(freeze-dried powder,XST) on κ-carrageenan-induced thrombosis and blood flow from the aspects of interactions among blood flow,vascular endothelium and platelets. Fifty male Sprague-Dawley rats(190-200 g) were randomized into five groups: control group, model group, heparin sodium(1 000 U·kg~(-1)) group, low-dose and high-dose(50, 150 mg·kg~(-1)) XST groups. Rats were intraperitoneally injected with corresponding drugs and normal saline(normal control and model groups) for 10 days. One hour after drugs were administered intraperitoneally on the 7 th day, each rat was injected with κ-carrageenan(Type Ⅰ, 1 mg·kg~(-1)) which was dissolved in physiological saline by intravenous administration in the tail to establish tail thrombus model. The lengths of black tails of the rats were measured at 2, 6, 24 and 48 h after modeling. Vevo®2100 small animal ultrasound imaging system was used to detect the internal diameter of rat common carotid artery, blood flow velocity and heart rate, and then the blood flow and shear rate were calculated. Meanwhile, the microcirculatory blood flow perfusion in the thigh surface and tail of rats were detected by laser speckle blood flow imaging system. Platelet aggregometry was used to detect the max platelet aggregation rate in rats. Pathological changes in tail were observed through hematoxylin-eosin staining, and Western blot was used to detect the protein content of platelet piezo1. According to the results, XST could inhibit the rat tail arterial thrombosis and significantly reduce the length of black tail(P<0.05). The blood flow of common carotid artery in XST low dose group was significantly higher than that in the model group(P<0.05). XST high dose group could significantly increase the microcirculatory blood flow perfusion of the tail in rats as compared with the model group(P<0.05). XST high dose group could significantly inhibit platelet aggregation rate(P<0.05) and XST low dose group could significantly inhibit platelet piezo1 protein expression(P<0.01). In summary, XST could play an effect in fighting against thrombosis induced by κ-carrageenan in rats, which may be related to significantly inhibiting platelet aggregation, improving body's blood flow state, maintaining normal hemodynamic environment and affecting mechanical ion channel protein piezo1.

Xueshuantong for Injection (Lyophilized, ) Alleviates Streptozotocin-Induced Diabetic Retinopathy in Rats / 中国结合医学杂志

OBJECTIVE@#To investigate the ameliorate effect and underlying mechanism of Xueshuantong for Injection (Lyophilized, , XST) in streptozocin (STZ)-induced diabetic retinopathy (DR) rats.@*METHODS@#Diabetes mellitus (DM) model was induced by intraperitoneal (i.p.) injection of STZ (60 mg/kg) in Sprague-Dawley rats. Diabetic rats were randomized into 3 groups (n=10) according to a random number table, including DM, XST50 and XST100 groups. XST treatment groups were daily i.p. injected with 50 or 100 mg/kg XST for 60 days, respectively. The control and DM groups were given i.p. injection with saline. Blood glucose level and body weight were recorded every week. Histological changes in the retina tissues were observed with hematoxylin-eosin staining. Apoptosis and inflammation related factors, including cleaved caspase-3, glial fifibrillary acidic protein (GFAP), tumor necrosis factor-α (TNF-α) and intercellular cell adhesion molecule-1 (ICAM-1) were detected by Western blot or real-time polymerase chain reaction. Then, the levels of advanced glycation end product (AGE) and its receptor (RAGE) were investigated. Tight junctions proteins (Zonula occludens-1 (ZO-1), Occludin and Claudin-5) of blood-retinal barrier were detected by Western blot. The levels of retinal fifibrosis, transforming growth factor-β1 (TGF-β1)-Smad2/3 signaling pathway were evaluated at last.@*RESULTS@#There was no signifificant difference in the body weight and blood glucose level between XST and DM groups (P>0.05). Compared with the DM group, XST treatment signifificantly increased the retinal thickness of rats (P<0.05 or P<0.01), and suppressed cleaved caspase-3 expression (P<0.01). XST increased the protein expressions of ZO-1, Occludin and Claudin-5 and decreased the mRNA expressions of matrix metalloproteinase 2 (MMP-2) and MMP-9 (P<0.05 or P<0.01). Moreover, XST signifificantly reduced the productions of AGE and RAGE proteins in the retina of rats (P<0.05 or P<0.01), suppressed the over-expression of TNF-α, and decreased the elevated level of ICAM-1 in retina of rats (P<0.05 or P<0.01). XST signifificantly reduced the levels of α-smooth muscle actin (α-SMA), connective tissue growth factor (CTGF), TGF-β1 and phosphorylation of Smad2/3 protein in rats (P<0.05 or P<0.01).@*CONCLUSIONS@#XST had protective effects on DR with possible mechanisms of inhibiting the inflammation and apoptosis, up-regulating the expression of tight junction proteins, suppressing the productions of AGE and RAGE proteins, and blocking the TGF-β/Smad2/3 signaling pathway. XST treatment might play a role for the future therapeutic strategy against DR.

Effect of Salvianolate Lyophilized Injection and Xueshuantong Injection (Lyophilized) on Permeability of Blood-brain Barrier via Inhibition of MMPs in Cerebral Ischemia/Reperfusion Injury Rats / 中国实验方剂学杂志

Objective:To investigate the effect of salvianolate lyophilized injection and Xueshuantong injection (lyophilized) on the permeability of blood-brain barrier (BBB) via inhibition of metallomatrix protease（MMPs） in cerebral ischemia/reperfusion injury rats. Method:The focal cerebral ischemia/reperfusion model in rats was built by middle cerebral artery occlusion/reperfusion (MCAO/R) technique. Male Wistar rats were randomly divided into sham operation group, ischemia/reperfusion (I/R) group, edaravone (Eda, 6 mg·kg-1) group, salvianolate lyophilized injection (SLI, 21 mg·kg-1) group, Xueshuantong (XST, 100 mg·kg-1) group and SLI combined with XST (SLI+XST, 21 mg·kg-1+100 mg·kg-1) group. Drugs were injected via tail vein for 2 d, while sham group and I/R group were injected with the same amount of normal saline. Neurological deficit score, hematoxylin-eosin (HE) staining and Nissl staining were assessed 2 d after MCAO/R. The permeability of BBB was observed by the leakage of IgG/CD31. The expressions of Claudin-5，Occludin，collagen-Ⅳ（Col- Ⅳ），Laminin，Fibronectin were observed by immunofluorescence staining，and MMP-2 and MMP-9 were observed by Western blot. Result:Compared with the I/R group, SLI group, XST group and SLI+XST group showed improvements in neurological deficit score, HE staining and Nissl staining. The leakage of IgG was alleviated; The positive expressions of Claudin-5，Occludin，Col-Ⅳ，Laminin，Fibronectin in ischemic penumbra were significantly up-regulated, while the expressions of MMP-2 and MMP-9 were down-regulated. The effect in improving SLI combined with XST was much better than a single factor. Conclusion:Salvianolate lyophilized injection and Xueshuantong injection (lyophilized) can alleviate cerebral ischemia/reperfusion injury and exert the synergistic effect when they are used in combination. The mechanisms might be associated with the improvement in the permeability of blood-brain barrier by inhibiting MMPs in cerebral ischemia/reperfusion injury rats.

Effictiveness and safety of Xueshuantong Injection in treatment of unstable angina pectoris: a systematic review and Meta-analysis of randomized controlled trials / 中国中药杂志

To assess the effectiveness and safety of Xueshuantong Injection in the treatment of unstable angina pectoris. Literatures were retrieved in PubMed,the Cochrane Library,EMbase,the China National Knowledge Infrastructure Database( CNKI),the Chongqing VIP Chinese Science Database( VIP),the Chinese Biomedical Literature Database( Sino Med) and Wanfang Data. The time limitation ranged from the commencement of each database to April 28,2019. The assessment of ethodological quality was based on the Cochrane Handbook 5.1,and the data were analyzed by using Rev Man 5.3 software. A total of 38 RCTs involving 4 074 patients were included. The included trials were all of low quality. Xueshuantong Injection combined with routine basic treatment( RBT) was superior to RBT alone in alleviating clinical symptoms,with statistically significant differences between the groups( RR = 1. 19,95% CI[1. 15,1. 24]). Xueshuantong Injection combined with RBT was better than RBT alone in the efficiency of anginal symptom( RR = 1.23,95%CI[1.18,1.29]). Xueshuantong Injection combined with RBT reduced the consumption of nitroglycerin,which was more effectively than RBT alone,with statistically significant differences between the groups( RR = 1.64,95%CI[1.23,2.19]). Xueshuantong Injection combined with RBT decreased hs-CRP levels,which was more effectively than RBT alone,with statistically significant differences between the groups( MD =-0.48,95%CI[-0.57,-0.40]). However,there was no statistical difference between groups in the incidence of myocardial infarction. The reported adverse effects of Xueshuantong Injection were mainly dizziness,headache,itchy skin and gastrointestinal symptoms. Xueshuantong Injection combined with RBT can alleviate unstable angina pectoris. However,due to the low quality of included studies,further well-designed multicenter and large-scale RCTs are still needed to evaluate the efficacy of Xueshuantong Injection.

Pharmacological mechanism of Compound Xueshuantong in treatment of diabetic retinopathy based on network pharmacology / 药学学报

The aim of this study was to discover the pharmacological mechanism of Compound Xueshuantong in the treatment of diabetic retinopathy using network pharmacology. TCMSP software was used to search the active ingredients of Compound Xueshuantong, and the targets of its active ingredients were obtained. The targets of diabetic retinopathy were searched by OMIM, TTD, pharmGkb, DiGSeE and GAD database. The same 37 targets were analyzed by GO and KEGG using DAVID software. The results were verified using the SystemsDock. Cytoscape 3.6.1 software was used to establish an ingredient-target-pathway network model. Network pharmacological studies suggest that Compound Xueshuantong treated diabetic retinopathy through the vascular endothelial growth factor signaling pathways, mitogen-activated protein kinase signaling pathways and Toll-like receptor signaling pathways. Compound Xueshuantong alleviated diabetic retinopathy through multi-component, multi-target, and multi-pathway. This study provides a theoretical basis for further elucidation of the pharmacological mechanism of Compound Xueshuantong in the treatment of diabetic retinopathy.

Protection of Salvianolate Lyophilized Injection combined with Xueshuantong Injection (Lyophilized) against focal cerebral ischemia/reperfusion injury in rats through suppression of inflammatory response / 中草药·英文版

Objective: Inflammatory reactions induced by microglia in the brain play an important part in the pathogenesis of focal cerebral ischemia/reperfusion (I/R) injury, resulting in neuronal death. Salvianolate Lyophilized Injection (SLI) and Xueshuantong Injection (Lyophilized) (XST), which have been widely used in the treatment of acutely cerebral infarction clinically in China, exhibit various biological activities. In this study, the neuroprotective properties of SLI combined with XST in a rat model of middle cerebral artery occlusion- reperfusion (MCAO/R) were investigated. Methods: In this study, male Wistar rats were subjected to 1.5 h of middle cerebral artery occlusion followed by reperfusion for 24 h. The rats were randomly divided into the following six groups: normal group (NOR), model group (MOD), SLI group (21 mg/kg, SLI), XST group (100 mg/kg, XST), SLI combined with XST (XST 100 mg/kg + SLI 21 mg/kg, 1X1S), and Edaravone (as a positive control drug, 6 mL/kg, EDI), once a day for 3 d. The neuronal injury, the expression of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (IBA-1), and the changes of pro-inflammatory mediators interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and anti-inflammatory mediator interleukin-10 (IL-10) were observed. Results: 1X1S treatment significantly increased the number of neuron, compared with the MOD group, SLI group and XST group. Gliosis (GFAP and IBA-1) and expression of pro-inflammatory mediators IL-6 and TNF-α were significantly reduced. Meanwhile, 1X1S significantly increased the expression of anti-inflammatory mediator IL-10 in the brains of MCAO/R rats, compared with the MOD group, SLI and XST groups. SLI and XST also remarkably down-regulated the expression of IL-6 and TNF-α compared with the MOD group. Conclusions: This study shows that SLI combined with XST (1X1S) can protect cerebral ischemia-reperfusion injury due to its anti-inflammatory property, and may provide a potential promising new therapeutic strategy for acute ischemic stroke.

Curative effect evaluation of compound Xueshuantong capsule combined with calcium dobesilate for patients with early diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the clinical effect of compound Xueshuantong capsule combined with calcium dobesilate in the treatment for patients with early diabetic retinopathy ( DR) .?METHODS: According to the random table method, 54 cases of DR patients ( 68 eyes ) in the ophthalmological clinic of our hospital from February 2015 to November 2016 were divided into control group and research group with 27 cases (34 eyes) in each group. Patients in the control group were treated with calcium dobesilate tablets, while patients in the research group were treated with compound xueshuantong capsule based on the control group. The duration of treatment was 5mo in both groups. The total clinical efficiency of the two groups was calculated, and the visual, blood glucose and inflammatory factors of the two groups were detected before and after treatment, in addition the adverse reaction and recurrence rate were observed.?RESULTS:The total clinical efficiency of the patients in the research group was 91％ ( 31/34 ) , which was significantly higher than 68％ (23/34) of the control group (P<0. 05). Compared with before treatment, the vision, the volume of hemangioma, macular thickness, plaque area, grey value view, blood glucose and inflammatory factor levels of two groups of patients after treatment dropped significantly, meanwhile the vision, blood sugar and inflammation index levels of research group were better than control group, and the differences were statistically significant (P<0. 05). No adverse reactions occurred during the treatment of the two groups. The recurrence rate of research group was 3％ ( 1/31 ) , which was significantly lower than that of the control group as 26％ (6/23) (P=0. 039).? CONCLUSION: The curative effect of compound xueshuantong capsule combined with calcium dobesilate in the treatment of patients with early DR is significant. It can significantly improve eyesight, blood glucose and inflammatory response and has a good forward curative effect.

Analysis on Clinical Rational Application of Xueshuantong Injection in Gansu Provincial Hospital of Traditional Chinese Medicine / 中国中医药信息杂志

Objective To investigate the influence of TCM Xueshuantong Injection on the clinical benefit and risk factors; To promote rational medication. Methods HIS system of Gansu Province Hospital of Traditional Chinese Medicine was used, and the medical records and information of patients who used Xueshuantong Injection from August 1st,2015 to August 1st,2016 were selected,including patient information, medicine information, and medicine application information. SPSS19.0 software statistics was used for rational analysis on the clinical application of Xueshuantong;two-class Logistic regression analysis was used to look for adverse reactions related factors. Results Totally 1229 patients with 10 974 medical records were included in the study. Irrational use of medicine was mainly for inappropriate indications (accounted for 21.11%), time of unreasonable administration (accounted for 1.87%), and too large dosage (accounted for 0.9%). Regression analysis showed: 1. Patients with history of allergies to food, medicine, and other substances, increased the risk of adverse reactions 8.725 times after application of Xueshuantong Injection; 2. The medicine combination increased the risk of adverse reaction of Xueshuantong Injection 1.799 times; 3. Medicine combination with Xiaozhong Zhitong Mixture, Jianwei Xiaoshi Mixture, ossotide injection, cobamamide, dextran injection, polyene lipid phosphoryl acid choline injection, and glucosamine hydrochloride tablets, may have potential risk factors for adverse reaction of Xueshuantong Injection. Conclusion Clinical irrational medicine use factors of Xueshuantong Injection mainly manifest in the indications are not suitable, the dosage of the drug medicine is too large and the course of treatment is too long. Adverse reactions occur mainly in patients with allergic history,combination of medication and large dosage.

Xueshuantong capsule alleviates oxygen-glucose deprivation/reoxygenation-induced tight junction damage of HUVEC cells / 中国比较医学杂志

Objective To study the protective effect of Panax notoginseng saponins(PNS)and its components Rg1 and Rb1 on oxygen-glucose deprivation/reoxygenation(OGD/Reox)-induced tight junction damage. Methods Anaerobic box were used to induce OGD in HUVEC cells for 6 h followed by reoxygenation for 24 h. Transepithelial/endothelial electrical resistance(TEER)and cell permeability were detected,immunefluorescence was used to observe the ZO-1 and claudin-5 protein expression. Results PNS 20,40 mg/L and ginsenoside Rb1 significantly inhibited the OGD/Reox-induced decreased tight junction resistance,and the increased cell permeability(P< 0.05). PNS 20,40 mg/L and ginsenoside Rb1 partly restored the inter-cellular tight junctions which were regularly arranged on the cell membrane, and the cells displayed cobble stone-like arrangement. Conclusions PNS ameliorates ischemia-induced vascular endothelial cell tight junction damage via MMP-9 and VEGF/VEGFR2 signaling pathway. Rb1 is one of the effective monomer components.

Analysis of Clinical Application of Xueshuantong for Injection(Lyophilized)in Our Hospital / 中国药房

OBJECTIVE:To provide reference for promoting clinical rational application of Xueshuantong for injection(lyophi-lized). METHODS:By hospital centralized monitoring method,all medical records were retrieved from Hospital Information Sys-tem of our hospital,who received Xushuantong for injection(lyophilized)from Aug. 7 to Oct. 6 in 2015;general information of patients'drug information,drug utilization and the occurrence of ADR were traced and recorded by clinical pharmacists to evaluate the rationality of clinical utilization of Xushuantong for injection(lyophilized). RESULTS:Totally of 1014 medical records were included in the study. Xueshuantong for injection(lyophilized)was mainly used for fracture,cerebral infarction,coronary disease, cataract and other disease. 22 clinical departments as orthopedics department,neurology department,cardiology department and ophthalmology department were involved,accounting for 56.41% of total. For the patients receiving Xushuantong for injection(ly-ophilized),the average age was 63.12 years,the average course was 11 days and dose was 100-500 mg/time. They were given medicine intravenously once a day,and 0.9% Sodium chloride injection was used as solvent (93.29%). There were 10 kinds of drugs for drug combination averagely. The incidence of ADR was 5.92‰,and all ADR resulted from same batch of drugs (No. 15040211);ADR mainly manifested as erythra,erythema,pruritus,chills,etc. In terms of irrational drug use,the incidence of overlong treatment course was 17.85%;that of inadequate solvent dose was 13.71%;that of fast dripping rate was 7.59%;that of unsuitable solvent selection was 0.69%;that of drug use with no indication was 0.39%. CONCLUSIONS:Xueshuantong for injec-tion(lyophilized)is widely used in middle-aged and elderly in the clinic. There are many varieties and irrational drug use. The oc-currence of ADR is properly related to age,treatment course,solvent,dripping speed,product quality and other factors. Clinical pharmacists are required to monitor drug use,promote the rationality of drug use and reduce the occurrence of ADR.

Application of Fufang Xueshuantong capsule in patients with optic atrophy of glaucoma and its influence on ocular hemodynamics / 中国生化药物杂志

Objective To analyze the effect of Fufang Xueshuantong capsule on glaucomatous optic atrophy and its influence on ocular hemodynamics.Methods 124 cases of patients with glaucomatous optic atrophy from April 2014 to December 2016 in our hospital were selected,and randomly divided into experimental group and control group according to the order of hospital admission , with 62 cases in each group.The control group was treated with nerve growth factor plus vitamin needling,the experimental group was treated with nerve growth factor and vitamin and compound Xueshuantong capsule.Observation and comparison the total effective rate, visual function (visual acuity, total gray value) improvement of the two groups of patients, as well as the changes of ocular hemodynamic parameters (systolic peak velocity, diastolic End-stage blood flow velocity, resistance index, pulsatility index).Results The total effective rate of the experimental group was 93.55%(58/62), the total effective rate of the control group was 70.97%(44/62), the total effective rate of the experimental group was higher than the control group (P <0.05)).After treatment, the visual acuity of the experimental group was significantly higher than the control group, the total gray value of the experimental group was significantly lower than the control group (P<0.05).The peak systolic velocity and end diastolic velocity in the experimental group were significantly higher than those in the control group (P<0.05).The resistance index and pulsatility index in the experimental group were lower than those in the control group (P<0.05). Conclusion Compound Xueshuantong capsule is effective in the treatment of glaucomatous optic atrophy , can improve the ocular hemodynamics and improve the visual function.

Clinical observation on treatment of diabetic peripheral neuropathy bytraditional Chinese medicine foot bath combined with Xueshuantong / 中国生化药物杂志

Objective To observe the clinical efficacy of traditional Chinese medicine foot bath combined with Xueshuantong injection in the treatment of diabetic peripheral neuropathy.Methods Sixty patients with diabetic peripheral neuropathy(DPN)were randomly divided into two groups.According to the patients' condition,oral hypoglycemic drugs or insulin were used to control blood glucose.The control group was treated with Xueshuantong injection on routine nutrition nerve program.In the conventional nutrition nerve program based on the use of traditional Chinese medicine foot bath combined with Xueshuantong injection treatment,2 groups were treated after 10 days to evaluate the efficacy.Results The total effective rate of the observation group and the control group was 90％and 66.7％respectively.The sensory and motor function of the observation group were significantly improved after the treatment group,and the blood rheology and serum endothelin level were significantly decreased.Conclusion Chinese medicine foot bath combined with Xueshuantong injection for the treatment of diabetic peripheral neuropathy.

Effect of calcium dobesilate combined with compound Xueshuantong in patients with diabetic retinopathy / 中国生化药物杂志

Objective To explore the clinical effects of calium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect.Methods 112 cases of patients with diabetic retinopathy from February 2014 to February 2016 in our hospital were selected and randomly divided into the observation group and the control group,56 cases in each group.The control group were given compound Xueshuantong, while the observation group were treated with calcium dobesilate orally.And both the two groups were treated for five months.The hemangioma volume , macular thickness, hemorrhagic spot area, visual gray value, visual acuity, CRP, VEGF and IGF-1 levels in two groups were measured before and after treatment, as well as the clinical efficacy and adverse effects during the treatment.Results The total effective rate in the observation group was 94.6%significantly higher than that in the control group 71.4% (P<0.05).After treatment, in the two groups the hemangioma volume, macular thickness, hemorrhagic spot area, visual field gray value, visual acuity and 30°threshold sensitivity were significantly improved (P<0.05),but the improvement in the observation group was more (P<0.05).After treatment, the levels of hs-CRP, VEGF and IGF-1 were all significantly decreased (P<0.05), but the observation group decreased more significantly (P<0.05).Adverse reactions were mainly gastrointestinal reactions, and the incidence of adverse reactions in the two groups had no statistically significant difference.Couclusion Calcium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect can improve the visual field defect of diabetic retinopathy patients.Its clinical effects is better and the safety is higher, which mechanism may be related to reducing the level of inflammatory factors in patients.

Therapeutic Efficacy and Safety of Fibrinolytic Combined with Xueshuantong Injection in the Treatment of Acute Ischemic Stroke: A Meta-analysis / 中国药房

OBJECTIVE:To systematically evaluate the therapeutic efficacy and safety of fibrinolytic combined Xueshuantong injection in the treatment of acute ischemic stroke,and to provide evidence-based reference.METHODS:Retrieved from CJFD,Wanfang database,ScienceDirect and ELSEVIER,RCTs about fibrinolytic combined Xueshuantong injection (trial group) vs.fibrinolytic alone (control group) in the treatment of acute ischemic stroke were collected.After data extraction and quality evaluation according to modified Jadad evaluation,Meta-analysis was conducted by using Rev Man 5.2 and Stata 12.0 statistical software.RESULTS:A total of 14 RCTs were included,involving 1 342 patients.The results of Meta-analysis showed that,total response rate [RR =1.24,95 ％ CI (1.18,1.31),P ＜ 0.001],cure rate [RR=1.59,95 ％ CI (1.23,2.06),P ＜ 0.001] and efficiency rate [RR =1.41,95 ％ CI(1.24,1.60),P＜0.001] of trial group were significantly higher than those of control group.There was no significant difference in the response rate [RR=0.93,95％CI(0.79,1.10),P=0.40] and the incidence of ADR [RR=0.63,95％ CI (0.17,2.36),P=0.49] between 2 groups.CONCLUSIONS:Fibrinolytic combined Xueshuantong injection shows good therapeutic efficacy and safety for acute ischemic stroke.