[Efficacy and safety of integrative medical program based on blood cooling and detoxification recipe in treating patients with hepatitis B virus related acute-on-chronic liver failure: a randomized controlled clinical study].

OBJECTIVE: To evaluate the clinical efficacy and safety of integrative medical program based on blood cooling and detoxification recipe (BCDR) in treating patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) of heat-toxicity accumulation syndrome (HTAS). METHODS: Adopting randomized controlled clinical design, a total of 105 HBV-ACLF patients of HTAS were randomly assigned to the trial group (64 cases) and the control group (41 cases). Patients in the control group were treated with comprehensive Western therapy, while those in the trial group were treated with comprehensive Western therapy plus BCDR. All were treated for 8 weeks and followed up for 40 weeks. Effect and safety of the treatment were assessed, including fatality, liver functions [total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), and aspartate transaminase (AST)], and prothrombin activity (PTA) after treatment and at week 48 of follow-ups. RESULTS: After 8-week treatment, there was statistical difference in the overall fatality rate (15.63% vs 34.15%), the fatality rate in the mid-term (25.0% vs 64.7%), TBIL at week 8 (64.54 +/- 79.75), AST [at week 2: (178.97 +/- 44.24) U/L vs (288.48 +/- 58.49) U/L; at week 4: (61.65 +/- 27.36) U/L vs (171.12 +/- 89.11) U/L] and PTA [at week 4: (58.30 +/- 15.29) vs (42.56 +/- 15.27); at week 6: (60.77 +/- 20.40) vs (43.08 +/- 12.79)] (all P < 0.05). At week 48 of the followup, the fatality rate of the trial group (21.88%) decreased by 17. 14% when compared with that of the control group (39.02%; P < 0.05). No obvious adverse event occurred in the two groups during the 8-week treatment period. CONCLUSION: BCDR could significantly reduce the mortality of HBV-ACLF patients.

[Randomized controlled study of integrated treatment of traditional Chinese medicine and western medicine on AIDS with pulmonary inflammation patients].

OBJECTIVE: To compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation. METHOD: A multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed. RESULT: Twenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group. CONCLUSION: The integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.

[Preliminary study on features of syndrome distribution and cluster analysis for AIDS patients with pulmonary infection].

OBJECTIVE: To investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection. METHODS: Using cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis. RESULTS: Basic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05). CONCLUSIONS: AIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.

[Effect of Ganoderma lucidum polysaccharides on intestinal mucosal immune system in H22 liver cancer bearing mice].

OBJECTIVE: To observe the mucosal immune mechanism of anti-tumor action of Ganoderma lucidum polysaccharides (GLP). METHODS: The concentration of H22 cells in suspension were adjusted to 1 x 10(9)/ L, and 0.2 mL of the cell suspension was injected subcutaneously in the right oxter of Kunming mice. Then the H22 bearing mice were randomly divided into 4 groups: the GLP group, the Cytoxan (CTX) group, the CTX + GLP group and the untreated model group, 8 mice in each group. Besides, a blank control group was set up. Starting from the 2nd day of modeling, GLP, at the dose of 1.02 g/kg was given to GLP group and GLP + CTX group by gastrogavage once a day for 12 successive days; CTX at the dose of 100 mg/kg was administered via peritoneal injection to the CTX group and the GLP + CTX group on the 1st day and the 6th day of the experimental course; but to the model group and the blank group, only equal volume of distilled water was given. All mice were sacrificed on the 14th day, the ileum at 1 cm upper to cecum was taken, through 4% paraform fixation and paraffin section, it was used for immunohistochemical detecting expressions of immunoglobulin A (IgA), tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-10 (IL-10) in ileum. Besides, the lymphocyte subsets in the intraepithelial lymphocyte (IEL), lamina propria lymphocytes (LPL), and Peyer's patch lymphocytes (PPL) were analyzed by immune fluorescence technique and flow cytometry. RESULTS: Compared with the blank control group, the phenotype of lymphocytes and the expression of cytokines in ileum in the model group changed significantly; and the phenotype was variant in different regions. Compared with the model group, both indexes were adjusted in the GLP, CTX and GLP + CTX group to different degrees. CONCLUSION: The adjustment of GLP on intestinal mucosal immune is probably another path for its anti-tumor action.

[Exploration on relationship between TCM syndrome type and expression of human leucocyte antigen locus-DRB1 in patients with chronic hepatitis B].

OBJECTIVE: To study the relationship between TCM syndrome type and expression of human leucocyte antigen-DRB1 (HLA-DRB1) in patients with chronic hepatitis B. METHODS: Using PCR method to amplify the related segments of DNA extracted from peripheral leucocytes by the routine methods, and gene array analysis was performed to detect the expression of HLA-DRB1. RESULTS: HLA-DRB1 * 13 was expressed in healthy person in the control group, but was not expressed in chronic hepatitis B patients, showing significant difference between the two groups. In the patients with five different syndrome types, i.e. the dampness blocking middle-jiao type (A), the Gan-stagnancy with Pi-deficiency type (B), the blood stasis blocking collaterals type (C), the Gan-Shen yin-deficiency type (D) and the Pi-Shen yang-deficiency type (E), the former three belonged to the excessive syndrome and the latter two were deficient syndrome. Most of the CHB patients were differentiated as excessive syndrome. CONCLUSION: Difference of HLA-DR expression exists between chronic hepatitis B patients and healthy persons, the action of the difference is remained for further confirmation. HLA-DR expression in patients with different syndrome types, excessive or deficient, might be different, too.

[An analysis of the relationship between HBV DNA and HBeAg expression and mortality in 799 severe hepatitis patients].

OBJECTIVE: To evaluate the relationship between mortality and HBVDNA and HBeAg expression of severe hepatitis B patients. METHODS: The mortality rates of different types of severe hepatitis patients in our hospital during the last five years were analysed. HBV DNA was detected using the fluorescence quantitative PCR method and the HBeAg expression of severe hepatitis B was studied using a microparticle method. RESULTS: (1) Hepatitis B morbidity was 83.5% in each type of severe hepatitis, and severe chronic hepatitis B morbidity was 96.77% in each type of severe chronic hepatitis. (2) The mortality rate of those with HBV DNA more than 1 x 10(5) copies/ml was 53.25% and the mortality of those with HBV DNA less than 1 x 10(5) copies/ml was 34.50% (P less than 0.01). The HBeAg expression had no influence on the death rate. (3) The death rate descended to 30.38% from 54.64% (HBV DNA more than 1 x 10(5) copies/ml) when treated with Lamivudine (P less than 0.01). CONCLUSION: In severe hepatitis the quantity of virus carried in the patient is one of the key factors of mortality; antivirus treatment can lower mortality.

Effect of Gui Zhi decoction on enteric mucosal immune in mice with collagen-induced arthritis.

AIM: To explore the effect of Gui Zhi decoction on enteric mucosal immune in type II collagen-induced arthritis (CIA) in DBA mice. METHODS: Eighty DBA/1, weighing 18-22 g, were randomly divided into four groups with 20 in each group: control group, CIA group, treatment groups at high dosage and low dosage (GZH and GZL). CIA was induced by immunization with type II collagen (CII) emulsified with equal complete adjuvant at 0.1 mg CII each mouse. Blood lymphocyte suspension was screened for CD4 and CD8 expression using a flow cytometry, the CD4 and CD8 and secretory IgA (sIgA)-positive cells in enteric lamina propria tested with immunohistochemical staining. Tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1)-beta, and IL-6 concentrations in serum were assayed with RIA. RESULTS: Gui Zhi decoction can lower the arthritic scores and decrease the occurrence of arthritis. The CD4, CD8, and sIgA-positive cells in CIA mice are less than in control mice, and in Gui Zhi decoction at high dosage could restore the lowered CD4- and CD8-positive cells in lamina propria, and at both high and low dosages could increase the lowered sIgA-positive cells in lamina propria, even still lower than in normal mice. In periphery, the CD4 cells in periphery are higher in CIA mice than in control mice, and Gui Zhi decoction at high and low dosages could decrease the CD4 and CD8 cells. Also, Gui Zhi decoction at high dosage could decrease the IL-6 and TNF-alpha concentration in serum. CONCLUSION: Gui Zhi decoction can lower the arthritic scores and decrease the incidence of CIA in mice, and the mechanism is in part regulating enteric mucosal immune.

[Effect of guizhi decoction on CD4+, CD8+ T-lymphocytes and SIgA in mucosal immune system in intestine of mice with Bi syndrome (collagen induced immune arthritis)].

OBJECTIVE: To observe the effect of Guizhi Decoction (GZD) on immunological indexes in intestinal mucosal immune system of mice with Bi syndrome (collagen induced immune arthritis). METHODS: Eighty male DBA mice were randomly divided into 4 groups, the normal group, the model group and the high and low dosage GZD groups. Model of Bi syndrome was induced by collagen type II. CD4+, CD8+ T-lymphocytes and SIgA in mice' small intestine and PP node were labeled by immunohistochemical staining and their number was calculated using imaging analyzer. RESULTS: Compared with the normal group, in the model group, after immunization with collagen type II, numbers of CD4+ and CD8+ T-lymphocytes and SIgA in mice' intestinal mucosal immune system reduced significantly (P < 0.05 or P < 0.01). After treatment with GZD of both high and low dosage, CD4+ T-lymphocytes and SIgA increased significantly, but significant difference only showed in comparison between the high dosage GZD group and the model group (P < 0.05 or P < 0.01). CONCLUSION: GZD could enhance the immune function in intestinal mucosa in mice with Bi syndrome, thus it might induce immune tolerance and immune inhibition.