Chinese Herbal Medicine for Chemotherapy-Induced Leukopenia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials.

Aim: We conducted a systematic review of high-quality randomized controlled trials (RCTs) to assess the efficacy and safety of Chinese herbal medicine (CHM) for the treatment of chemotherapy-induced leukopenia (CIL). Methods: Eight electronic databases were searched from the date of inception to November 4, 2020 for high-quality RCTs that met the requirements of at least four key domains of the Cochrane risk of bias (RoB) tool. RevMan 5.3 was applied for the meta-analysis. Results: Fourteen RCTs involving 1,053 patients were included. The pooled results showed that CHM + chemotherapy exerted greater beneficial effects on white blood cell (WBC), neutrophil (NEU), hemoglobin (Hb), and platelet (PLT) counts in addition to the Karnofsky performance scale (KPS) score, but showed no significant difference on granulocyte colony-stimulating factor (G-CSF) dosage compared with chemotherapy alone. Placebo (PBO) + chemotherapy and CHM + chemotherapy groups showed no significant differences in terms of reduction of the incidence of neutropenia. CHM + chemotherapy was superior to Western medicine (WM) + chemotherapy in improving the WBC count, KPS, infection amount, G-CSF use rate, and incidence of leukopenia. In addition, no severe adverse events were observed in the 14 RCTs. Conclusion: CHM in combination with chemotherapy could effectively improve the clinical symptoms of CIL when compared with chemotherapy alone or Western medicine + chemotherapy, except when comparing with PBO + chemotherapy. While CHMs were generally safe for clinical use and exerted no severe side effects in the 14 RCTs, high-quality RCTs with larger sample sizes are essential to reduce study heterogeneity.

The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjögren's Syndrome: A Systematic Review and Meta-Analysis.

Objective: To assess the effectiveness and safety of the total glucosides of paeony (TGP) on the treatment of primary Sjögren's syndrome (pSS) by conducting a meta-analysis. Methods: Eight databases were searched from their inception to December 10, 2018 for randomized controlled trials (RCTs). The Revman 5.3 software was used for this meta-analysis. Results: Nine RCTs which included 770 participants were identified. Pooled results showed that significant difference in Schirmer's test (P < 0.00001) comparing TGP with placebo (PBO). However, the pooled results displayed significant differences in salivary flow rate, Schirmer's test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), serum γ-globulin, immunoglobulin G (IgG), IgA, IgM, and effective rate (P ≤ 0.01) in the co-administration of TGP with immunosuppressant (IS) compared with IS alone. Subgroup analyses revealed both heterogeneities in ESR and serum γ-globulin were eliminated, showing combined intervention of TGP + IS being more advantageous than single usage of IS (P < 0.00001). However, the advantage varied among three subgroups and showed a gradual weakening over time. Furthermore, our results showed statistical significance in Schirmer's test (P = 0.0006), when hydroxychloroquine (HCQ) was jointly applied, but not in the case of combined TGP with methotrexate (MTX) (P = 0.41). For the safety analysis, the most common adverse events (AEs) were diarrhea or gastrointestinal discomfort, and no severe AEs were reported in TGP group. Meanwhile, six trials showed statistically insignificant differences between TGP + IS and IS in AEs (P = 0.76). Conclusions: Improving the lacrimal gland secretion (Schirmer's test) is the prominent function of TGP compared with PBO. TGP + IS can improve the clinical symptoms, such as lacrimal and salivary gland secretion function (Schirmer's test, salivary flow rate), inflammatory indices (ESR, CRP, and RF) and immunoglobulins (γ-globulin, IgG, IgA, and IgM) on the basis of IS monotherapy. In addition, TGP has an acceptable safety profile and AEs were not increased when TGP combined with IS in pSS. Therefore, TGP can be considered to be a potentially valid and safe drug for the treatment of pSS in the clinic. In view of the limitations of the included trials, the potential beneficial effectiveness and safety of TGP need additional high-quality, multi-center, and large-scale RCTs to assess its use in pSS treatment.

Effects of Clematis chinensis Osbeck mediated by low-intensity pulsed ultrasound on transforming growth factor-ß/Smad signaling in rabbit articular chondrocytes.

PURPOSE: Clematis chinensis Osbeck (CCO) is an essential herb that has been shown to promote the biological functions of cartilage cells. In this study, we aimed to explore whether and how low-intensity pulsed ultrasound (LIPUS) enhanced CCO delivery into chondrocytes and stimulated biological activity in vitro. METHODS: Chondrocytes were isolated from knee articular cartilage of 2-week-old rabbits and treated with LIPUS plus CCO or recombinant transforming growth factor beta 1 (TGF-ß1; 0.5 ng/mL), with or without anti-TGF-ß1 antibodies (10 µg/mL), for 3 days. Cell proliferation was assessed by Cell-Counting Kit-8 assays. Immunocytochemistry, western blotting, and quantitative polymerase chain reaction were applied to detect the expression of type II collagen and some molecules in the TGF-ß1 signal pathway. RESULTS: LIPUS plus 0.1 mg/mL CCO solution promoted chondrocyte proliferation and type II collagen and TGF-ß1 expression synergistically in vitro (P < 0.05). In addition, treatment with anti-TGF-ß1 antibodies blocked this effect (P < 0.01), but not completely. CCO plus LIPUS also showed more enhanced effects on promoting TGF-ß receptor II and Smad2 signaling and reducing Smad7 signaling than either intervention separately (P < 0.05). CONCLUSIONS: CCO plus LIPUS promoted extracellular matrix deposition by accelerating the TGF-ß/Smad-signaling pathway in chondrocytes.

[Optimization of Scutellaria baicalensis extraction process by orthogonal experiment combined with pharmacodynamic index].

To optimize the Scutellaria baicalensis extraction process, the filter paper method and the bacteriostatic ratio method were adopted to determine the in vitro bacteriostatic efficacy of water extracts and 60% alcohol extracts from S. baicalensis. The quantitative analysis of multi-components by single-marker (QAMS) was used to determined the contents of four active components, baicalin, wogonoside, baicalein and wogonin. In addition, with the bacteriostatic ratio and the overall desirability of the contents of four active components as indexes, the orthogonal experiment was adopted to detect the effect of water addition, extraction frequency and extraction time. The optimal extraction process was to add 12 times of water for the first time, 10 times of water for the second time, extract for 2 time, 2 h for each time. This optimization process is stable and feasible, with a higher bacteriostatic ratio in extracts.

[Evaluation of mid-term effectiveness of medium-and-long-term programme for prevention and control of schistosomiasis in Anhui Province].

OBJECTIVE: To evaluate the mid-term effectiveness of the medium-and-long-term programme for prevention and control of schistosomiasis in Anhui Province. METHODS: In the programme, the comprehensive measures were carried out, including the schistosomiasis detection and chemotherapy for residents and livestock, snail control, health education, and infectious source control. The mid-term effectiveness of the programme was observed and evaluated longitudinally. RESULTS: From 2004 to 2009, 750 798 schistosomiasis patients and 547 069 persons with the history of infested water contacting were treated. The number of positive cattle treated was 8 462 cattle-times and the number of cattle with history of infested water contact treated was 117 023 cattle-times. The area with snails control by molluscicides was 30 532.0 hm2, and the area with snails control by environmental modification was 13 979.5 hm2. The number of persons who received health education was 31.73 million person-times. The infectious source control measures were carried out in 40% of endemic villages with human infection rate being more than 1%. Up to 2009, the infection rates of population and cattle, and the incidence rate of acute schistosomiasis reduced to 0.51%, 1.25% and 0.30/100 000, respectively. During the period of 2004-2009, the areas with snails fluctuated from 29 065.4 to 29 740.3 hm2. The densities of living snails and infected snails both showed a declining trend in general. During these years, the whole province reached the criteria of infection control, 4 counties reached the criteria of transmission control, and 4 counties reached the criteria of transmission interruption. CONCLUSION: The effect of the comprehensive strategy of schistosomiasis control is remarkable.

[Spatial analysis of distribution of schistosomiasis in Anhui Province].

OBJECTIVE: To study the distribution of schistosomiasis in Anhui Province based on geographic information system (GIS). METHODS: The survey data of disease and Oncomelania snails in Anhui Province in 2006 were collected, GIS databases were set up, and the inverse distance weighted interpolation method (IDW) based on ArcGIS 9.3 was used to analyze the spatial distribution of schistosomiasis across the province. RESULTS: The simulated maps of distribution of human prevalence and positive rate of serological tests were imitated by using IDW. The region with heavier infection rates of schistosomiasis was distributed over the region of the Yangtze River in Anhui Province, and the endemic areas were joined into a patch in the upper and middle reaches and distributed in pieces in the lower reaches. While the endemic areas were compared with the distribution of infected snails, the IDW map of positive rate of serological tests was more exactly than that of the human prevalence. CONCLUSIONS: The IDW method is helpful to show the distribution of schistosomiasis. The positive rate of serological tests is more sensitive to reflect the current endemic situation of schistosomiasis in Anhui Province.

[Analysis of trend of Oncomelania snail status in Yangtze River valley of Anhui Province, 1998-2009].

OBJECTIVE: To understand the trend of Oncomelania hupensis snail distribution in Yangtze River valley of Anhui Province so as to provide an evidence for making out schistosomiasis prevention and control strategies in the future. METHODS: The snail data from 1998 to 2009 of the Yangtze River valley in Anhui Province were collected including the snail area, newly occurred and re-occurred snail areas, densities of snails and infected snails, etc., and the trend and influence factors were analyzed. RESULTS: With several fluctuations, the snail area showed a trend of declining in general after the devastating summer flooding in 1998. From 1998 to 2009, 3 peaks of newly occurred snail areas appeared in 1998, 2004 and 2006 and 2 peaks of reoccurred snail areas appeared in 1998 and 2004. The densities of living snails and infected snails were more severe in banks of the Yangtze River than in islets of the Yangtze River. During 12 years, 1 peak of living snail density appeared in 2003, and 3 peaks of infected snail density appeared in 1999, 2003-2004 and 2006 in the islets of the Yangtze River. The densities of living snails and infected snails in banks of the Yangtze both appeared 1 peak in 1998. CONCLUSIONS: The distribution of snails in the Yangtze River valley is related to nature, society and financial circumstances, and it is hard to completely perform the snail control in a short-term. Therefore, at the same time of strengthening snail control, we should also strengthen infectious source control.

Necessary conditions for the globalization of traditional Chinese medicine.

With the current trend of globalization, unprecedented opportunities and enormous changes have emerged for the global development of traditional Chinese medicine (TCM). However, many old and new challenges and problems still remain, including partial or limited comprehension of acupuncture, oriental medicine and TCM, the existence of non-standardized institutes of TCM and acupuncture training schools, unqualified TCM practitioners, and problems concerning Chinese herbal medicine and inexperience in conducting TCM business. These problems will doubtlessly impede the further development of TCM worldwide in the foreseeable future. It is also clear that the globalization of TCM will require a large scale systematic project and constitute an arduous historical task. This paper aims to consolidate 6 strategic development modes to reinforce and facilitate the process of TCM globalization through a detailed analysis of both the present status and existing problems concerning the development of TCM in the United States.

[Simultaneous detection of measles and rubella virus by multiplex real-time RT-PCR with an internal control].

Measles and rubella virus cause fever rash diseases that are uneasy to differentiate clinically from each other. Specific primers and fluorescence-labeled probes were designed, and a multiplex Real-time RT-PCR with an internal control was developed to simultaneously identify the measles and rubella virus. The multiplex Real-time RT-PCR assay was specific and no false positive or false negative results were found. The sensitivity of the assay was 0.1TCID50/mL and 1TCID50/mL for measles and rubella virus respectively. Analysis with 0.1-10(3)TCID50/mL measles or rubella virus samples demonstrated high validity and reproducibility with the coefficient of variability(CV) of below 0.9% for both measles and rubella virus. Using ribonuclease P (RNase P) as internal false negative control, the developed multiplex Real-time RT-PCR assay is suitable for rapid clinical diagnosis of measles and rubella virus.

Oligomers of resveratrol and ferulic acid prepared by peroxidase-catalyzed oxidation and their protective effects on cardiac injury.

Peroxidase extracted from Momordica charantia was used for the oligomerization of trans-resveratrol and ferulic acid on a preparative scale. One new heterocoupling oligomer, trans-3 E-3-[(4-hydroxy-3-methoxyphenyl)methylene]-4-(3,5-dihydroxyphenyl)-5-(4-hydroxyphenyl)tetrahydro-2-franone (6), and six resveratrol dimers, leachianol G (1), restrytisol B (2), parthenostilbenins A (3) and B (5), 7- O-acetylated leachianol G (4), and resveratrol trans-dehydrodimer (8), and one known ferulic acid dehydrodimer, (3alpha,3aalpha,6alpha,6aalpha)tetrahydro-3,6-bis(4-hydroxy-3-methoxyphenyl)-1 H,4 H-furo[3,4-c]furan-1,4-dione (7) were obtained. Bioactive experiments showed that compounds 6- 8 have strong free radical scavenging effects and also have protective effects on doxorubicin-induced cardiac cell injury when tested in vitro.

[Genetic analysis on HA1 and NA regions of influenza virus subtype A3 isolates of Zhejiang province during 1998-2005].

OBJECTIVE: To study the relationship between influenza epidemic and genetic characteristic on HA and NA regions of influenza virus subtype A3 isolates of Zhejiang province in the recent years. METHODS: RNA of 25 influenza virus subtype A3 isolates, circulated in Zhejiang province during 1998 to 2005, was extracted. HA1 and NA regions were amplified and sequenced. All the sequence data were analyzed using BioEdit. RESULTS: HA1 and NA regions of all the isolates belonged to 987nt and 1362nt, encoding protein of 329 and 454 amino acids respectively. Isolates shared amino acid homology of 90.9%-99.3% and 95.2%-99.5% on HA1 and NA regions, while divergence on HA1 was greater than that on NA region. During a period of 8 years, 30 amino acids on HA1 region were substituted and 14 of which refer to 4 antigenic determinant sites. Meanwhile,21 amino acids on NA region were substituted and 5 of which referred to 3 antigenic determinant sites. Significant divergences, both in HA1 and NA, were observed among isolates in 1998 and 2002, showing that they belonged to absolutely different branches. Additionally, influenza virus subtype A3 isolates identified in recent years, with 11 N-linked glyeosylation sites in HA1 region, had 5 sites more than early A/Aichi/2/68 strain. Since 1998,3 sites had been inserted in epidemic strains, indicating the accelerated trend of glyeosylation sites were increasing. CONCLUSION: There is a correlation between antigenic drift of influenza virus subtype A3 and the two epidemics in Zhejiang province in 1998 and 2002.

[Analysis on the genetic characteristics of the wide-type measles virus circulating in Zhejiang province in 2005].

OBJECTIVE: To study the genetic characteristics of measles viruses circulating in Zhejiang province in 2005. METHODS: 4 groups of measles viruses isolated in outbreaks and the H and N gene were amplified by reverse transcription polymerase chain reaction (RT-PCR). PCR products were purified, sequenced and data was analyzed. RESULTS: All of the 4 measles isolates belonged to genotype H1 which had been a main genotype containing all of the isolates in China. The isolates shared 99.2% -99.7% identity of amino acid sequence on H and 99.8% identity of amino acid sequence on N gene. When comparing to the China vaccine strain (Shanghai 191), there were 95.2%-95.5% homogeneties and 95.5% homogeneties on H and N gene respectively. CONCLUSION: Data from phylogenic trees of H and N gene revealed that the wide-type measles viruses circulating in Zhejiang province in 2005 all belonged to genotype H1. There were obvious differences on genetic characteristics between the isolates and the genotype A (Shanghai 191).