Background:The incidence of idiopathic nlembranous nephropathy(IMN)has recently increased remarkably.Immune dysfunction caused by disordered intestinal flora might be an important factor affecting IMN.The Jian Pi Qu S...Background:The incidence of idiopathic nlembranous nephropathy(IMN)has recently increased remarkably.Immune dysfunction caused by disordered intestinal flora might be an important factor affecting IMN.The Jian Pi Qu Shi Formula(JPQSF)shows promise in treating IMN.Here,we sequenced 16S rRNA genes to compare intestinal flora between patients with IMN and healthy persons.We also conducted a randomized controlled clinical trial to further compare the intestinal flora of patients with IMN treated with traditional Chinese medicine(TCM)and western medicine(WM).Methods:Among 40 patie nls with IMN treated at Department of Nephrology in Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine between July 2016 and December 2018,we compared 30 of them with 10 healthy persons(controls).The IMN group was randomly assigned to receive JPQSF(TCM)or immunosuppressant WM therapy in(n=15 per group)for 6 months.Intestinal microbiota diversity was analyzed using alpha diversity and beta diversity.Intestinal flora that significantly differed between the groups was analyzed using MetaStat.The effects and safety of the therapies were determined based on the values for plasma albumin,24-h urine protein excretion,serum creatinine,urea nitrogen,estimate glomerular filtration rate(eGFR),complete blood count,and liver enzymes.All data were statistically analyzed using Statistical Package for the Social Sciences(SPSS)20.0 statistical software.Results:Baseline characteristics did not significanlly differ between the IMN and healthy groups,or the TCM and WM groups.After six months of treatment,24-h urinary protein significantly declined in the TCM and WM groups(before and after treatment:3.24±1.74 vs.1.73±1.85 g,P<0.05 and 3.94±1.05 vs.1.91±1.18 g,P<0.05,respectively).Plasma albumin was significantly increased in the TCM group(before vs.after treatment:32.44±9.04 vs.39.99±7.03 g/L,P<0.05),but did not significantly change in the WM group(31.55±4.23 vs.34.83±9」4 g/L,P>0.05).Values for urea nitrogen,serum creatinine,and eGFR did n展开更多
AIM: To study the anti-hepatofibrosis mechanism of Bie Jia Jian oral liquid (BOL). METHODS: The model was induced by subcutaneous injection of CCl(4). BOL was administered and the change of serum hyaluronic acid (HA) ...AIM: To study the anti-hepatofibrosis mechanism of Bie Jia Jian oral liquid (BOL). METHODS: The model was induced by subcutaneous injection of CCl(4). BOL was administered and the change of serum hyaluronic acid (HA) and laminin (LN) was observed and the degeneration of liver cells and the degree of fibre hyperplasia analyzed. Changes of ultra micro-structure in liver cells were observed in some samples. RESULTS: HA was reduced in both the groups with low and high dosage of BOL, which showed a remarkable difference as compared with that of the model group (low dosage group: 376.15 microg/L+/-35.48 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05; high dosage group: 340.14 microg/L+/-30.18 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05). The LN content of low and high dosage group of BOL was lower than that of model group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 133.94 microg/L+/-14.45 microg/L P 【0.01; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 133.94 microg/L+/-14.45 microg/L P【0.01) and colchicine group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【 0.05; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【0.05). Examined by Ridit, BOL could reduce the degeneration and necrosis of liver cells (chi(2)=11.99 P【0.05), the degree of fibre hyperplasia (chi(2)=13.24 P【0.05) and the pathological change of ultra micro-structure as well. CONCLUSION: The BOL has certain therapeutic effect on the experiment hepatofibrosis. Its mechanisms might include: protecting the function of liver cells, inhibiting excessive synthesis and secretion of extracellular matrix from hepatic stellate cells, relieving the capillarization of hepatic sinusoid, improving liver micro-circulation, and regulating immune function.展开更多
Background and Aims:The aim was to evaluate the efficacy and safety of Yanggan Jian(YGJ)in HBV-infected patients with decompensated cirrhosis.Methods:This randomized,double-blind controlled trial enrolled 160 patients...Background and Aims:The aim was to evaluate the efficacy and safety of Yanggan Jian(YGJ)in HBV-infected patients with decompensated cirrhosis.Methods:This randomized,double-blind controlled trial enrolled 160 patients with HBV-related decompensated cirrhosis who were already receiving or about to start antiviral therapy.Patients were randomly assigned to receive YGJ or placebo for 24 weeks,and were followed-up to 36 weeks.The primary outcome was the proportion of patients with a≥2 point reduction in Child-Turcotte-Pugh(CTP)score from baseline at week 24.Secondary outcomes were CTP class and score,serum liver function indices,mortality,incidence of hepatocellular carcinoma and variceal bleeding.Results:The proportion of patients with a CTP score reduction≥2 was significantly greater in the YGJ than in the placebo group(p=0.009);the percentage of patients with CTP class C was significantly less than that in the placebo group(p<0.05),and the YGJ group had a significantly greater mean change from baseline in CTP score at week 24(p=0.034).The improvement in measured values and change from baseline of prothrombin time,serum albumin,platelets,cholinesterase,international normalized ratio,and activated partial thromboplastin time were significantly better with YGJ than with placebo.Between-group differences in cumulative rates of variceal bleeding,hepatocellular carcinoma,death,or the frequency of any adverse event(AE),AEs related to treatment,or discontinuation because of AEs were not significant.Conclusions:YGJ significantly improved CTP scores and hepatic synthetic and reserve function in patients with HBV-related decompensated cirrhosis,and was safe and well tolerated.展开更多
基金This study was supported by grants from the National Key R&D Plan of China(No.2019 YFC1708500)the National Natural Science Foundation of China(No.81374036)the Natural Science Foun dation of Wan nan Medical College under Grant(No.WYRCQD2018009).
文摘Background:The incidence of idiopathic nlembranous nephropathy(IMN)has recently increased remarkably.Immune dysfunction caused by disordered intestinal flora might be an important factor affecting IMN.The Jian Pi Qu Shi Formula(JPQSF)shows promise in treating IMN.Here,we sequenced 16S rRNA genes to compare intestinal flora between patients with IMN and healthy persons.We also conducted a randomized controlled clinical trial to further compare the intestinal flora of patients with IMN treated with traditional Chinese medicine(TCM)and western medicine(WM).Methods:Among 40 patie nls with IMN treated at Department of Nephrology in Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine between July 2016 and December 2018,we compared 30 of them with 10 healthy persons(controls).The IMN group was randomly assigned to receive JPQSF(TCM)or immunosuppressant WM therapy in(n=15 per group)for 6 months.Intestinal microbiota diversity was analyzed using alpha diversity and beta diversity.Intestinal flora that significantly differed between the groups was analyzed using MetaStat.The effects and safety of the therapies were determined based on the values for plasma albumin,24-h urine protein excretion,serum creatinine,urea nitrogen,estimate glomerular filtration rate(eGFR),complete blood count,and liver enzymes.All data were statistically analyzed using Statistical Package for the Social Sciences(SPSS)20.0 statistical software.Results:Baseline characteristics did not significanlly differ between the IMN and healthy groups,or the TCM and WM groups.After six months of treatment,24-h urinary protein significantly declined in the TCM and WM groups(before and after treatment:3.24±1.74 vs.1.73±1.85 g,P<0.05 and 3.94±1.05 vs.1.91±1.18 g,P<0.05,respectively).Plasma albumin was significantly increased in the TCM group(before vs.after treatment:32.44±9.04 vs.39.99±7.03 g/L,P<0.05),but did not significantly change in the WM group(31.55±4.23 vs.34.83±9」4 g/L,P>0.05).Values for urea nitrogen,serum creatinine,and eGFR did n
基金Supported by the Natural Science Foundation of Zhejiang Province,No.398402
文摘AIM: To study the anti-hepatofibrosis mechanism of Bie Jia Jian oral liquid (BOL). METHODS: The model was induced by subcutaneous injection of CCl(4). BOL was administered and the change of serum hyaluronic acid (HA) and laminin (LN) was observed and the degeneration of liver cells and the degree of fibre hyperplasia analyzed. Changes of ultra micro-structure in liver cells were observed in some samples. RESULTS: HA was reduced in both the groups with low and high dosage of BOL, which showed a remarkable difference as compared with that of the model group (low dosage group: 376.15 microg/L+/-35.48 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05; high dosage group: 340.14 microg/L+/-30.18 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05). The LN content of low and high dosage group of BOL was lower than that of model group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 133.94 microg/L+/-14.45 microg/L P 【0.01; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 133.94 microg/L+/-14.45 microg/L P【0.01) and colchicine group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【 0.05; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【0.05). Examined by Ridit, BOL could reduce the degeneration and necrosis of liver cells (chi(2)=11.99 P【0.05), the degree of fibre hyperplasia (chi(2)=13.24 P【0.05) and the pathological change of ultra micro-structure as well. CONCLUSION: The BOL has certain therapeutic effect on the experiment hepatofibrosis. Its mechanisms might include: protecting the function of liver cells, inhibiting excessive synthesis and secretion of extracellular matrix from hepatic stellate cells, relieving the capillarization of hepatic sinusoid, improving liver micro-circulation, and regulating immune function.
基金supported by the National Natural Science Foundation of China (82130120)Shanghai Science and Technology Committee Rising-Star Program (19QA1408900)+1 种基金WBE Liver Fibrosis Foundation (CFHPC2020010)Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine (SGXZ-201908 and SGKJLC-202013).
文摘Background and Aims:The aim was to evaluate the efficacy and safety of Yanggan Jian(YGJ)in HBV-infected patients with decompensated cirrhosis.Methods:This randomized,double-blind controlled trial enrolled 160 patients with HBV-related decompensated cirrhosis who were already receiving or about to start antiviral therapy.Patients were randomly assigned to receive YGJ or placebo for 24 weeks,and were followed-up to 36 weeks.The primary outcome was the proportion of patients with a≥2 point reduction in Child-Turcotte-Pugh(CTP)score from baseline at week 24.Secondary outcomes were CTP class and score,serum liver function indices,mortality,incidence of hepatocellular carcinoma and variceal bleeding.Results:The proportion of patients with a CTP score reduction≥2 was significantly greater in the YGJ than in the placebo group(p=0.009);the percentage of patients with CTP class C was significantly less than that in the placebo group(p<0.05),and the YGJ group had a significantly greater mean change from baseline in CTP score at week 24(p=0.034).The improvement in measured values and change from baseline of prothrombin time,serum albumin,platelets,cholinesterase,international normalized ratio,and activated partial thromboplastin time were significantly better with YGJ than with placebo.Between-group differences in cumulative rates of variceal bleeding,hepatocellular carcinoma,death,or the frequency of any adverse event(AE),AEs related to treatment,or discontinuation because of AEs were not significant.Conclusions:YGJ significantly improved CTP scores and hepatic synthetic and reserve function in patients with HBV-related decompensated cirrhosis,and was safe and well tolerated.
