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In this study, J774A.1 macrophages stimulated by lipopolysaccharide(LPS) and adenosine triphosphate(ATP) were used to establish an in vitro model of pyroptosis, and the intervention mechanism of free total rhubarb anthraquinones(FTRAs) on pyroptosis was investigated. J774A.1 macrophages were cultured in vitro, and the experiment was assigned to the control group and groups with different concentrations of LPS(0.25, 0.5, and 1 μg·mL~(-1)) and ATP(1.25, 2.5, and 5 mmol·L~(-1)). An in vitro model of macrophage pyroptosis was established by detecting cell viability through CCK-8, propidium iodide(PI) apoptotic cell staining, lactate dehydrogenase(LDH), interleukin(IL)-18, and tumor necrosis factor(TNF)-α release. Then, J774A.1 macrophages were randomly divided into six groups: blank control group, LPS+ATP group, high-dose FTRA group, and low, medium, and high-dose FTRA pre-protection group. The phenotypic characteristics and key indicators of pyroptosis were detected as the basis for evaluating the effect of FTRAs on pyroptosis induced by LPS and ATP. Western blot and RT-PCR were used to detect the expression levels of protein and mRNA related to the pyroptosis pathway in caspase-1/11 and elucidate the molecular mechanism of the anti-pyroptosis effect. The results showed that the stimulation condition of 0.50 μg·mL~(-1) LPS+5.00 mmol·L~(-1) ATP was the most effective in the in vitro model of macrophage pyroptosis. FTRAs pre-protected cells for 24 h and then can increase cell viability under pyroptosis conditions, alleviate cell damage, lower the positive rate of PI staining, and reduce the release of LDH, IL-18, and TNF-α. FTRAs were able to significantly inhibit the activation of GSDMD proteins and significantly down-regulate the protein expression of the pyroptosis pathway signature molecules, TLR4, NLRP3, cleaved-caspase-1, and cleaved-caspase-11, but they had no significant effect on ASC proteins. FTRAs were also able to significantly inhibit the mRNA expression of caspase-1, caspase-11, and GSDMD. These results indicate that FTRAs have an inhibitory effect on the pyroptosis model induced by LPS and ATP and play an anti-pyroptosis effect by regulating classical and non-classical pyroptosis signaling pathways and reducing the production of inflammatory cytokines.

The objective of this study was to investigate the potential targets and mechanism of Rheum palmatum L in the treatment of colorectal cancer based on the network pharmacology and molecular docking, which could provide the theoretical basis for clinical applications. The potential components were screened using TCMSP database and articles. The gene targets of colorectal cancer were screened through the Genecards database and Online Mendelian Inheritance in Man database. Then, the common targets of components and colorectal cancer were used to construct the network diagram of active components and targets in Cytoscape 3.7.0. The protein-protein interaction (PPI) diagram was generated using String database, and the targets were further analyzed by gene ontology and Kyoto Encyclopedia of Genes and Genomes. Molecular docking between gene targets and active components was analyzed via AutoDock, and visualized through PyMol. Among this study, main targets might be TP53, EGF, MYC, CASP3, JUN, PTGS2, HSP90AA1, MMP9, ESR1, PPARG. And 10 key elements might associate with them, such as aloe-emodin, beta-sitosterol, gallic acid, eupatin, emodin, physcion, cis-resveratrol, rhein, crysophanol, catechin. The treatment process was found to involve nitrogen metabolism, p53 signaling pathway, and various cancer related pathway, as well as the AGE-RAGE signaling pathway, estrogen signaling pathway, interleukin-17 signaling pathway and thyroid hormone signaling pathway. The molecular docking was verified the combination between key components and their respective target proteins. Network pharmacological analysis demonstrated that R palmatum was could regulated p53, AGE-RAGE, interleukin-17 and related signaling pathway in colorectal cancer, which might provide a scientific basis of mechanism., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

In traditional Japanese medicine, Rhei Rhizoma is used as a purgative, blood stasis-resolving and antipsychotic drug. The latter two properties are possibly related to anti-inflammatory effects. Microglia regulate inflammation in the central nervous system. M1 microglia induce inflammation, while M2 microglia inhibit inflammation and show neurotrophic effects. This study investigated the effects from water extracts of roots of cultivated Rheum species in Nagano Prefecture, Japan (strain C, a related strain to a Japanese cultivar, 'Shinshu-Daio'; and strain 29, a Chinese strain) and 3 kinds of Rhei Rhizoma available in the Japanese market, and also examined their constituents on the polarization of cultured microglia. All extracts significantly decreased M1 microglia, and strains C and 29 significantly increased M2 microglia. Furthermore, the extracts of both strains significantly increased the M2/M1 ratio. Among the constituents of Rhei Rhizoma, ( +)-catechin (2), resveratrol 4'-O-β-D-(6″-O-galloyl) glucopyranoside (5), isolindleyin (8), and physcion (15) significantly increased the M2/M1 ratio. The contents of the constituents in water extract of each strain were quantified using HPLC. The extracts of strains C and 29 contained relatively large amounts of 2 and 5; and 2, 8, and 15, respectively. This study showed the water extracts of roots of cultivated Rheum strains in Japan had the effects of M2 polarization of microglia, suggesting that these strains become the candidate to develop anti-inflammatory Rhei Rhizoma. Moreover, the suitable chemical composition to possess anti-inflammatory activity in the brain was clarified for the future development of new type of Rhei Rhizoma., (© 2023. The Author(s) under exclusive licence to The Japanese Society of Pharmacognosy.)

Non-small cell lung cancer (NSCLC) is one of the leading causes of death in the world. Rhubarb, a traditional Chinese medicine, has been widely used in the treatment of inflammatory and autoimmune diseases. This study aimed to investigate the possible mechanism of the rhubarb herb in the treatment of NSCLC by means of network pharmacology and molecular docking and to provide a theoretical basis for experiments and clinical application of traditional Chinese medicine for treating lung cancer. The main active chemical components and targets of rhubarb were screened through Swiss Target Prediction, TargetNet, and Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. The protein-protein interaction (PPI) network was built via an in-depth exploration of the relationships between the proteins. The enrichment analyses of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were applied to predict the potential roles in the pathogenesis of NSCLC via the R package cluster Profiler. Potential targets and active ingredients associated with anti-tumor effects of rhubarb were screened by reverse molecular docking. By searching databases and literature, a total of 295 targets were found for the 21 active ingredients in rhubarb. There were 68 common target genes associated with NSCLC, of which 9 are derived from FDA-approved drugs. GO Gene Set Enrichment Analysis (GSEA) explored up to 1103 biological processes, 62 molecular functions, and 18 cellular components. KEGG GSEA explored 65 basic pathways, and 71 disease pathways. Four key targets (JUN, EGFR, BCL2, and JAK2) were screened through the protein-protein interaction network, target-pathway network, and FDA drug-target network. Molecular docking results showed that these key targets had relatively strong binding activities with rhubarb's active ingredients. The present study explored the potential pharmacological mechanisms of rhubarb on NSCLC, promoting the clinical application of rhubarb in treating NSCLC, and providing references for advanced research., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Ethnopharmacological Relevance: Rheum palmatum L. (RP) and Coptis chinensis Franch. (CC), frequently used as herbal pair (HP) in clinical practicing of traditional Chinese medicine, exerted predominate efficacies in colitis treatment. However, the mechanism of their synergism lacks scientific explanation., Aim of the Study: By integrating network pharmacology and DSS-induced colitis model, the anti-colitis effects and synergistic molecular mechanisms of RP-CC combination was determined., Materials and Methods: In vivo study, mice were divided into control, model, RP, CC and RP-CC (low, middle, high) groups, 2.5% DSS was administrated to induce colitis for consecutive 7 days, subsequently, the therapeutic effects were evaluated from body weight changes, disease activity index (DAI), and pathological conditions. After determining the shared and exclusive targets of RP and CC, respectively by network pharmacology, CETSA, WB, and qPCR were utilized to verify the action modes of RP and CC on specific targets., Results: Compared to RP or CC used alone, RP-CC combination can significantly protect colon tissues from inflammatory damage in a dose-dependent manner via remarkably alleviating DAI and colon shortening. Network pharmacological analysis suggested that AKT1 would be the core target for RP-CC synergism since these two herbs could simultaneously but non-competitively bind to AKT1 at different sits. Furthermore, RP and CC could also influencing HIF and MAPK pathways, respectively, these additional actions attribute to more optimizing effectiveness towards colitis., Conclusion: In contrast to the mild therapeutic effects of RP or CC individually, RP-CC herb pair could exert strong and synergistic effects in treatment of colitis via non-competitive binding to AKT1 simultaneously, as well as exclusively influencing MAPK and HIF pathways. Our study not only provides the evidence for understanding the combined effect of RP and CC, but also brings up a new strategy and suggestive thoughts for the rationality of HP-based TCM formula., Competing Interests: Declaration of competing interest No conflict of interest exits in the submission of this manuscript. The work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Context: Zhishi Rhubarb Soup (ZRS) is a traditional Chinese medicine formula used in the clinic to treat acute cerebral infarction (ACI) for many years. However, the exact mechanism of the treatment remains unclear., Objective: This study elucidates the multitarget mechanisms underlying the effects of ZRS on ACI using network pharmacology analysis and verify its effect by performing animal experiments., Materials and Methods: Using the network pharmacology approach, the multiple components, critical targets and potential mechanisms of ZRS against ACI were investigated. Six herbal names of ZRS and 'acute cerebral infarction' were used as keywords to search the relevant databases. In addition, we established the MCAO model to verify the results of network pharmacology enrichment analysis. ZRS (10 g crude drug/kg) was gavaged once per day for 7 consecutive days beginning 3 h after model establishment. After ZRS treatment, TTC staining, Western blot analysis, IHC and ELISA were conducted to further explore the mechanism of ZRS intervention in ACI., Results: The network pharmacology approach identified 69 key targets, 10 core genes and 169 signalling pathways involved in the treatment of ACI with ZRS. In vivo experiment showed that ZRS treatment significantly reduced cerebral infarction volume (42.76%). It also reduced the expression level of AGE, RAGE and P65; and inhibited the expression of inflammatory MMP-9 and IFN-γ., Conclusions: This study demonstrated that ZRS improved cerebral ischaemic injury by inhibiting neuroinflammation partly via the AGE-RAGE signalling pathway. It provides a theoretical basis for the clinical application of ZRS in the treatment of ACI.

Ethnopharmacological Relevance: Xuanbai-Chengqi decoction (XBCQ) is a traditional Chinese medicine (TCM) compound used in the treatment of pulmonary infection in China. Despite the popular usage of XBCQ, its underlying protective roles and the associated molecular mechanisms with the gut-lung axis in influenza remain unclear., Aim of the Study: We aimed to explore the protective effects and the underlying mechanism of XBCQ efficacy on lung and intestine injuries induced by influenza A virus as well as to identify the main active components through integrated network pharmacology, intestinal flora analysis and pathway validation., Materials and Methods: The potential active components and therapeutic targets of XBCQ in the treatment of influenza were hypothesized through a series of network pharmacological strategies, including components screening, targets prediction and bioinformatics analysis. Inflammatory cytokines and pathway proteins were assayed to validate the results of network pharmacology. Then the mechanism of XBCQ alleviating lung and intestine injuries was further explored via intestinal flora analysis. The important role of Rhubarb in the formula was verified by removing Rhubarb., Results: XBCQ could significantly improve the survival rate in IAV-infected mice. The network pharmacology results demonstrated that JUN, mitogen-activated protein kinase (MAPK), and tumor necrosis factor (TNF) are the key targets of XBCQ that can be useful in influenza treatment as it contains the core components luteolin, emodin, and aloe-emodin, which are related to the pathways of TNF, T-cell receptor (TCR), and NF-κB. Verification experiments demonstrated that XBCQ could significantly alleviate the immune injury of the lungs and the gut of the mice, which is attributable to the inhibition of the release of inflammatory cytokines (such as TNF-α, IL-6, and IL-1β), the downregulation of the protein expression levels of Toll-like receptors-7 (TLR7), MyD88, and p-NF-κB65, and the reduction in the relative abundance of Enterobacteriaceae and Proteus, while an increase in that of Firmicutes and Lachnospiraceae. The overall protective role of XBCQ contributing to the treatment of the lungs and the gut was impaired when Rhubarb was removed from XBCQ., Conclusions: Our results suggest that the efficacy of XBCQ is related to the inhibition of the immune injury and remodeling of the intestinal flora, wherein Rhubarb plays an important role, which cumulatively provide the evidence applicable for the treatment of viral pneumonia induced by a different respiratory virus with XBCQ., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Safety concerns, caused by complex and unpredictable adulterants, run through the entire industrial chain of traditional Chinese medicines (TCMs). However, the conventional circulation traceability system only focuses on a certain end or link at the back end of the TCM industrial chain, ignoring the integrity of the links cross the entire industrial chain and lacking traceability. In consequence, a strict and rational supervision system is urgently required for the entire industrial chain., Hypothesis/purpose: We hypothesize that DNA barcoding would be a suitable measure for the traceability of adulterants in the entire TCM industrial chain., Methods: In this study, Rhei Radix et Rhizoma was selected as a model to establish a traceability system for the entire TCM industrial chain. A total of 110 samples, including leaves, seeds, roots, decoction pieces, and traditional Chinese patent medicines (TCPMs), were collected upstream, midstream, and downstream of the entire industrial chain of Rhei Radix et Rhizoma. The ndhF-rpl32 fragment rather than the universal DNA barcodes, which could not distinguish the three original species of Rhei Radix et Rhizoma, was selected as a specific DNA barcode to evaluate the practical application of DNA barcoding in the chain., Results: The results showed that the ndhF-rpl32 fragment in all samples could be amplified and bi-directionally sequenced. Based on the standard operating procedures of DNA barcoding, the ndhF-rpl32 fragment clearly distinguished the seven Rheum species collected upstream of the entire industrial chain. For the samples collected midstream and downstream of the entire industrial chain, 25% of the 36 commercial decoction pieces samples were identified as adulterants, whereas the eight TCPM samples were all derived from genuine Rhei Radix et Rhizoma., Conclusions: This study shows that DNA barcoding is a powerful and suitable technology that can be applied to trace TCMs in the entire industrial chain, thereby assuring clinical medication safety., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Rhei Radix et Rhizoma formula granule (RRFG) , Winy Rhei Radix et Rhizoma formula granule(WRFG) and Rhubarb charcoal formula granules (RCFG) are the three most popular and effective formula granules of rhubarb in China and anthraquinone components are their main active ingredients. In order to discuss the difference in anthraquinone components of these three drugs, a simultaneous quantitative analysis method of multicomponents by single-marker (QAMS) was developed. Emodin was chosed as the internal reference standard, the relative correction factors (RCFs) of aloe-emodin, rhein, chrysophanol and physcion were established and the contents of the four components were calculated based on the RCFs, respectively. Meanwhile, the contents of these components was determined by external standard method (ESM) and compared with QAMS to verify its rationality, feasibility and repeatability. The results showed that there were no significant difference between QAMS and ESM (RSDs≤2.26%). The contents of anthraquinone components showed a wide variation in these three drugs. All of 5 components were higher in RRFG than that in the others and RCFG had the lowest content. This method was successfully applied for the evaluation on difference of these drugs and the wide variation in anthraquinone components indicated there were different pharmacodynamic basis.

Objective: To establish the quality standard of Zhiqingshu lotion by high-performance liquid chromatography (HPLC)., Methods: HPLC was used to determine emodin, chrysophanol, caffeic acid, and berberine hydrochloride content, key water-soluble components of rhubarb, dandelion, and Phellodendron amurense in Zhiqingshu lotion. The macrophage inflammation model was used to analyze the anti-inflammatory effects of Zhiqingshu lotion., Results: HPLC results showed that the contents of emodin, chrysophanol, caffeic acid, and berberine hydrochloride in Zhiqingshu lotion were 7.93 ± 2.25, 20.85 ± 4.27, 48.9 ± 6.79, and 58.4 ± 10.3  μ g/mL, respectively. Moreover, RT-qPCR results showed that different concentrations of Zhiqingshu lotion significantly reduced the expression of inflammatory factor tumor necrosis factor- (TNF-) α and interleukin- (IL-) 1 β in lipopolysaccharide-induced macrophages., Conclusion: HPLC could quantitatively and qualitatively analyze and identify the main components of Zhiqingshu lotion as rhodopsin, rhodopsin, caffeic acid, and berberine hydrochloride. And Zhiqingshu lotion has an excellent anti-inflammatory effect. This method was simple and reliable and could be used for the identification of the ingredients and content of Zhiqingshu lotion, thus improving the quality control of the drug., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Benren Tan et al.)

Rhubarb has been used as herbal purgative with a worldwide long history. In traditional Chinese medicine, rhubarb can be stir-baked to scorch to eliminate the purgative function when it is a side effect. Under-scorched rhubarb still has the side effect of purgative, while over-scorched rhubarb can lose all bioactivities. Empirically, the degree of scorching is determined by manual observation of the rhubarb color. In order to find the reasonable and objective scorching endpoint criteria, visible spectrophotometry, FTIR spectroscopy and HPLC were used to reveal the color-reflected chemical changes. It was found that the blackening of rhubarb corresponded to the elimination of combined anthraquinones and the rise-fall inflection of free anthraquinones. The scorching endpoint criteria should include the upper limit for combined anthraquinones to avoid under-scorch and the lower limit for free anthraquinones to avoid over-scorch. Visible and FTIR spectroscopy can be process analytical techniques for the rhubarb scorching., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In this paper, an HPLC peak fractionation approach combined with homogeneous time-resolved fluorescence analysis is proposed for screening epidermal growth factor receptor inhibitors from Rhei Radix et Rhizoma. With this approach, the amount of sample used for a single HPLC run is sufficient for performing a multiple assay due to the miniaturization ability of the homogeneous time-resolved fluorescence technology. This allows for improving the stability and repeatability of the activity assay for each fraction. From a total of 26 fractions collected from the Rhei Radix et Rhizoma extract, 13 fractions exhibit inhibitory activity against the epidermal growth factor receptor. The structures of activity compounds were determined by HPLC-LTQ-Orbitrap MS, revealing the presence of gallic acid, rhein, and emodin with IC 50 values of 21.5, 5.29, and 10.2 µM, respectively. The ligand epidermal growth factor receptor interactions were explored by molecular docking simulations, and the inhibitory effects of the three compounds on A549 cell growth were tested in vitro by an MTT assay. This study demonstrates the suitability of the present screening method for drug discovery in natural products., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Rhei Radix et Rhizoma is a kind of commonly used Chinese medicinal materials. Due to the overharvesting, the wild resource is endangering. Large market demand caused severely adulterant of commercial Rhei Radix et Rhizoma medicinal materials and decoction pieces. This manuscript reviewed the advances of the original species authentication in the industrial chain of Rhei Radix et Rhizoma during the latest decade, including characteristics and microscopic features, phytochemical analysis on anthraquinones, and molecular authentication based on DNA barcoding. Accordingly, an original species authentication route for the industrial chain of Rhei Radix et Rhizoma was summarized:(1)the identification of seeds and seedlings by DNA barcoding;(2) the selection of high variable sites based on the chloroplast genome;(3)biomonitoring of the Rhei Radix et Rhizoma medicinal materials and decoction pieces by two-dimensional DNA barcode;(4)traceability of Chinese patent medicines by third-generation sequencing. In conclusion, the combination of molecular identification and traditional identification methods provides a new idea for the identification of the original species of Rhei Radix et Rhizoma in the industrial chain and a essential guidance for the research of drug safety and efficacy of Rhei Radix et Rhizoma.

The color characteristic information of Rhei Radix et Rhizoma powder was obtained by spectrophotometer, the feasibility of rapid identification of Rhei Radix et Rhizoma origin based on chromaticity value was studied by statistical analysis. The results of rank correlation analysis showed that a~*(P<0.01), b~*(P<0.01) had significantly correlation with the origin of medicinal herbs, which could be used as two important parameters to distinguish the origin of Rhei Radix et Rhizoma, the larger the a~* value, the more red the powder color,and the greater the b~* value, the more yellow the powder color. Meanwhile, through Fisher discriminant analysis, the linear discriminant functions of different genus Rhei Radix et Rhizoma were established, which was Rheum tanguticum=40.666a~*+0.019b~*-213.303, Rh. palmatum=34.121a~*+0.061b~*-151.770, Rh. officinale=28.071a~*+0.113b~*-104.604 3, the coincidence rate of cross-validation was over 95%, among them, the discriminant rate of Rh. tanguticum and Rh. officinale reached 100%;In addition, using the percentile method to analyze the 90% reference value range of three different origin of Rhei Radix et Rhizoma, as a result, Rh. tanguticum a~*(10.236 5-10.604 7), b~*(32.294 8-34.841 7); Rh. palmatum a~*(8.602 7-8.770 0), b~*(27.534 8-28.968 6), and Rh. officinale a~*(6.825 7-7.464 3),b~*(21.001 6-27.716 4). According to this study, rank correlation analysis and Fisher discriminant analysis are feasible to distinguish the base of Rhei Radix et Rhizoma in a certain range, and provide some theoretical basis for the identification of Rhei Radix et Rhizoma. It also provides a new method and idea for the identification of other multi-base Chinese medicine.

Rhei Radix et Rhizoma was first recorded in Shennong Ben Cao Jing, with a wide range of pharmacological activities. Autoimmune disease is a kind of disease that damages the tissue structure and function of immune cells and their components due to the impairment of immune tolerance function, including atherosclerosis, multiple sclerosis, gout, rheumatoid arthritis, autoimmune thyroiditis, ulcerative colitis, type 1 diabetes and IgA nephropathy. In recent years, clinical and experimental studies show that Rhei Radix et Rhizoma has potential therapeutic effects on autoimmune diseases. Under the guidance of the theory of traditional Chinese medicine, this paper reviews therapeutic and intervening effects of Rhei Radix et Rhizoma and its main active ingredient anthraquinone on autoimmune diseases. It also puts forward new study directions in view of the existing problems in studies of rhubarb and its anthraquinone, with the aim to provide reference for clinical treatment and scientific studies of effect of Rhei Radix et Rhizomaon autoimmune diseases.

Objective: To observe the efficacy of Yiqijiebiao prescription in treating children with influenza B infection (flu)., Methods: A total of 120 children with influenza B infection who were treated at the Traditional Chinese Medicine (TCM) Clinic of Tianjin Children's Hospital from October to December 2019 were enrolled. According to different treatments, the children were divided into Yiqijiebiao prescription treatment group and Western medicine treatment control group, with 60 cases in each group. Yiqijiebiao prescription treatment group was orally given Yiqijiebiao prescription plus and minus treatment (composition: perilla leaf, kudzu root, Bupleurum, Qing Pinellia, Scutellaria baicalensis Georgi each 6 g, tangerine peel, nepeta panicle, Divaricate Saposhniovia root, praecupura, almond, ginseng, platycodon, roasted licorice each 4 g, add plaster and cooked rhubarb for dry stools, add pre-bait, honey loquat leaves for severe cough, add Angelica dahurica and flos magnoliae for runny nose), take 1 dose a day, twice a day; Western medicine treatment control group was orally given Ribavirin, 10 mg/kg each time, 3 times a day. After 7 days of treatment, the changes in clinical symptoms, laboratory results and clinical efficacy of the two groups were observed, and the changes in prognostic indexes of the two groups were analyzed., Results: The numbers of children with normal body temperature and improved or partially improved symptoms such as cough, sore throat, and runny nose in the Yiqijiebiao prescription treatment group were significantly higher than those in the control group (normal body temperature: 49 cases vs. 44 cases, cough relieved: 33 cases vs. 25 cases, sore throat relieved: 27 cases vs. 23 cases, runny nose relieved: 47 cases vs. 42 cases, all P < 0.05). The numbers of children whose nasopharyngeal swabs with influenza B virus antibody (IBV-Ag) turned negative and serum amyloid A (SAA) and C-reactive protein (CRP) in the normal reference value range (< 10 mg/L) were significantly higher than those in Western medicine treatment control group (IBV-Ag negative: 36 cases vs. 31 cases, SAA in the normal reference value range: 49 cases vs. 46 cases, CRP in the normal reference value range: 50 cases vs. 46 cases, all P < 0.05). The total effective rate of Yiqijiebiao prescription treatment group after treatment was significantly higher than that of control group [81.67% (49/60) vs. 75.00% (45/60), P < 0.05]. The numbers of children with constipation, loss of appetite and diarrhea in the Yiqijiebiao prescription treatment group were significantly less than those in the control group (constipation: 11 cases vs. 14 cases, loss of appetite: 8 cases vs. 11 cases, diarrhea: 6 cases vs. 8 cases, all P < 0.05)., Conclusions: Yiqijiebiao prescription can significantly improve the clinical symptoms and laboratory results of children with influenza B infection and increase the total effective rate, and have a definite effect.

A method based on high performance liquid chromatography(HPLC) was developed for simultaneous content determination of 14 components in rhubarb charcoal. After 18 batches of raw rhubarb materials were heated at different temperatures and time points, the contents of 14 components(5 categories) were determined, including gallic acid, 5-hydroxymethylfurfural(5-HMF), 5 kinds of free anthraquinone, 5 kinds of bound anthraquinone and 2 kinds of sennosides. In the analysis of sample color characteristics combined with principal component analysis(PCA), it was found that 18 batches of samples can be grouped into five categories, with the traditional traits &quot;black charred on the surface, dark brown inside&quot; as the standard. Samples of category A, B, C and D were &quot;less&quot; carbonized, and category E samples were carbonized &quot;moderately or a little bit excessively&quot;. The corresponding components sennoside and combined anthraquinone showed a one-way decreasing pattern, and the contents of free anthraquinone, gallic acid and 5-HMF showed an increasing pattern before decreasing. The results showed that the contents of free anthraquinone and gallic acid in the samples were larger than those in raw materials while the contents of glycosides and combined anthraquinone were lower than those in raw materials when the samples were &quot;less&quot; &quot;moderately&quot; or &quot;a little bit excessively&quot; carbonized. The two change modes of the component contents of the studied samples have good robustness, and have a reference value for more comprehensive evaluation and control of different heating conditions from the perspective of chemical characterization on the color and content of rhubarb charcoal and the change mode of the content of other carbon medicines.

Critical care medicine is a medical specialty engaging the diagnosis and treatment of critically ill patients who have or are likely to have life-threatening organ failure. Sepsis, a life-threatening condition that arises when the body responds to infection, is currently the major cause of death in intensive care units (ICU). Although progress has been made in understanding the pathophysiology of sepsis, many drawbacks in sepsis treatment remains unresolved. For example, antimicrobial resistance, controversial of glucocorticoids use, prolonged duration of ICU care and the subsequent high cost of the treatment. Recent years have witnessed a growing trend of applying traditional Chinese medicine (TCM) in sepsis management. The TCM application emphasizes use of herbal formulation to balance immune responses to infection, which include clearing heat and toxin, promoting blood circulation and removing its stasis, enhancing gastrointestinal function, and strengthening body resistance. In this paper, we will provide an overview of the current status of Chinese herbal formulations, single herbs, and isolated compounds, as an add-on therapy to the standard Western treatment in the sepsis management. With the current trajectory of worldwide pandemic eruption of newly identified Coronavirus Disease-2019 (COVID-19), the adjuvant TCM therapy can be used in the ICU to treat critically ill patients infected with the novel coronavirus.

The study aimed to investigate the intervening role of Didang decoction (DDD) at different times in macrovascular endothelial defense function, focusing on its effects on the AMP-activated protein kinase (AMPK) signaling pathway. The effects of DDD on mitochondrial energy metabolism were also investigated in rat aortic endothelial cells (RAECs). Type 2 diabetes were induced in rats by streptozotocin (STZ) combined with high fat diet. Rats were randomly divided into non-intervention group, metformin group, simvastatin group, and early-, middle-, late-stage DDD groups. Normal rats were used as control. All the rats received 12 weeks of intervention or control treatment. Western blots were used to detect the expression of AMP-activated protein kinase α1 (AMPKα1) and peroxisome proliferator-activated receptor 1α (PGC-1α). Changes in the intracellular AMP and ATP levels were detected with ELISA. Real-time-PCR was used to detect the mRNA level of caspase-3, endothelial nitric oxide synthase (eNOS), and Bcl-2. Compared to the diabetic non-intervention group, a significant increase in the expression of AMPKα1 and PGC-1α were observed in the early-stage, middle-stage DDD groups and simvastatin group (P < 0.05). The levels of Bcl-2, eNOS, and ATP were significantly increased (P < 0.05), while the level of AMP and caspase-3 were decreased (P < 0.05) in the early-stage DDD group and simvastatin group. Early intervention with DDD enhances mitochondrial energy metabolism by regulating the AMPK signaling pathway and therefore may play a role in strengthening the defense function of large vascular endothelial cells and postpone the development of macrovascular diseases in diabetes., (Copyright © 2017 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.)

Da-Huang-Xiao-Shi decoction has been used to treat damp-heat jaundice for centuries in China. However, the absorbed components of the decoction and their related metabolites are little known until now. In this work, an integrative strategy based on liquid chromatography coupled with mass spectrometry (time-of-flight/triple-quadruple tandem) was adopted to effectively identify the prototypes and their metabolites and to speculate the possible transformation pathways among these compounds. Using pattern recognition approaches, the exogenous compounds in rat plasma were screened out from endogenous compounds and then distinguished into prototypes and metabolites according to the characteristic information from the self-building database of Da-Huang-Xiao-Shi decoction. On this basis, the metabolic profiles of main prototypes (such as iridoid glycosides, alkaloids, and anthraquinones) were proposed. As a result, a total of 62 related prototypes and their metabolites were detected and tentatively identified in rat plasma after administration, and among them, three prototypes were found for the first time. Glucuronidation and sulfation were deduced to be the main metabolic pathways of alkaloids, iridoid glycosides, and anthraquinones. The integrative strategy used in this study was an effective approach to rapidly discover and characterize the prototypes and their metabolites from a complex bio-sample without the use of standard substances., (© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: To investigate the effect of Dahuang-Taoren with different proportion of extraction amount changes of ten kinds of chemical constituents in Rhizoma Rhei., Methods: Uniform method to set different ratio( 1∶ 5,2∶ 5,2∶ 3,1∶ 1,3∶ 2,5∶ 2,5∶ 1),and set the control group ( Dahuang-Taoren( 1 ∶ 0). HPLC was used to determine the content of ten constituents as gallic acid,( +)-catechin,sennoside B,anthraquinones( aloe-emodin,rhein,emodin,chrysophanol,physcion,chrysophanol-1-O-glucoside,emodin major grape glycoside) in different ratio of drug. Different proportions of Dahuang-Taoren on the extraction amount of ten chemical components in Rhizoma Rhei changes were analyzed. ., Results: Compared to the control group, Dahuang-Taoren with different ratio( 5∶ 1,5∶ 2,3∶ 2) in a sample with increasing proportion of Taoren,the extraction amount of ten kinds of constituents of Rhizoma Rhei gradually decreased;Dahuang-Taoren with ratio of 1∶ 1,ten kinds of constituents in extraction of total amount arrived minimum value. Dahuang-Taoren with different ratio( 2∶ 3,2∶ 5,1∶ 5) in a sample with increasing proportion of Taoren,the extraction amount of gallic acid,( +) catechin,chrysophanol of Rhizoma Rhei increased significantly., Conclusion: There is obvious change in chemical constituents of the extraction amount of Rhizoma Rhei with the change of the ratio in Dahuang-Taoren, and Dahuang-Taoren with the ratio( 2∶ 3,2∶ 5,1∶ 5),the extraction amount of gallic acid,( +)-catechin,sennoside B,aloe-emodin,emodin,chrysophanol,physcion,chrysophanol-1-O-glucoside are significantly higher than control group.

In the study, it was hypothesized that Rhubarb Anthraquinones synergistically enhanced the purgative effect on constipation rat from the direct and indirect pathway at the same time. A validated HPLC method was successfully applied to elucidate the synergism mechanism from pharmacokinetics aspect after oral administration of Rhubarb extract with a dose of 0.25 g to normal and constipation rats. Comparison of the pharmacokinetic data of normal and constipation rats showed that there were significant differences (p < 0.05) in the main pharmacokinetic parameters. The C max and AUC of emodin in constipation rats were about ten times that of normal rats, while the t 1/2 was remarkably decreased (p < 0.05). However, a significant decrease (p < 0.05) in AUC value for aloe-emodin and rhein was observed in model group compared with normal group. The results may be attributed to the direct action of aloe-emodin and rhein on intestinal cell membranes and the indirect action of emodin on bowel movement through the adjustment by nervous system.

Background: Accumulating evidence has shown that chronic cerebral ischemia (CCI) is one of the major causes of vascular dementia (VD) characterized by dysregulated cholesterol homeostasis and lipoprotein disturbances. Positive value of lipid-lowering agents has been widely evaluated for the treatment of VD. In the present study, we investigated whether Daming capsule (DMC) protected against CCI-induced VD and its possible mechanisms of action. DMC is a multi-herbal formula composed of Rheum palmatum L., Cassia obtusifolia L., Salvia miltiorrhiza, and Panax ginseng C.A., which has been used to treat hyperlipidemia for years in China., Methods: A network pharmacology method was established to reveal whether DMC contained any chemical constituent targeting CCI-related proteins. Furthermore, the potential anti-CCI effects of DMC (100 mg/kg or 200 mg/kg) administered for 30 days were investigated in vivo on rats that were subjected to permanent bilateral occlusion of the carotid arteries (2-VO). Spatial learning and memory abilities were evaluated using a Morris water maze (MWM) and morphological changes of cerebral cortex and hippocampus were assessed using hematoxylin and eosin staining. Moreover, the lipid peroxidation levels and antioxidative capabilities were measured using biochemical analysis., Results: Our network pharmacology analysis revealed the existence of multiple CCI-related chemical-target interactions in DMC, suggesting a potential protective effect. An in vivo experiment verified that 200 mg/kg DMC improved cognitive deficits of 2-VO rats in the MWM test and attenuated pathological alterations in both the cerebral cortex and the hippocampus. Biochemical assays indicated that DMC decreased malondialdehyde levels and CCI-elevated superoxide dismutase activities, but increased the activities of glutathione peroxidase and catalase., Conclusions: Our findings suggested that DMC protected against cognitive dysfunction and nerve injuries caused by CCI, which is most likely related to its antioxidant actions.

Backgrounds: Yin-Chen-Hao-Tang (YCHT), a commonly used as a traditional chinese medicine for liver disease. Several studies indicated that YCHT may improving hepatic triglyceride metabolism and anti-apoptotic response as well as decreasing oxidative stress .However, little is known about the role of YCHT in chlorpromazine (CPZ) -induced chlolestatic liver injury. Therefore, we aimed to facilitate the understanding of the pathogenesis of cholestatic liver injury and evaluate the effect of Yin-Chen-Hao-Tang (YCHT) on chlorpromazine (CPZ)-induced cholestatic liver injury in rats based on the change of bile acids (BAs) and free fatty acids (FFAs) alone with the biochemical indicators and histological examination., Methods: We conducted an experiment on CPZ-induced cholestatic liver injury in Wistar rats with and without YCHT for nine consecutive days. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), total bilirubin (TBIL), total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C) were measured to evaluate the protective effect of YCHT against chlorpromazine (CPZ)-induced cholestatic liver injury. Histopathology of the liver tissue showed that pathological injuries were relieved after YCHT pretreatment. In addition, ultra-performance lipid chromatography coupled with quadrupole mass spectrometry (UPLC-MS) and gas chromatography coupled with mass spectrometry (GC-MS) was applied to determine the content of bile acids, free fatty acids, respectively., Results: Obtained data showed that YCHT attenuated the effect of CPZ-induced cholestatic liver injury, which was manifested by the serum biochemical parameters and histopathology of the liver tissue. YCHT regulated the lipid levels as indicated by the reversed serum levels of TC, TG, and LDL-C. YCHT also regulated the disorder of BA and FFA metabolism by CPZ induction., Conclusions: Results indicated that YCHT exerted a protective effect on CPZ-induced cholestasis liver injury. The variance of BA and FFA concentrations can be used to evaluate the cholestatic liver injury caused by CPZ and the hepatoprotective effect of YCHT.

The original formulation for "Tusujiu," which Japanese people still consume on the morning of January 1st, was created by Hua Tuo, but has not been studied in detail. The book Huatuo Shenyi Bizhuan, found in 1918, describes a concoction, "Biyijiu," that shows great similarity to the current Tusujiu; the ingredients for Biyijiu being rhubarb, atractylodes rhizome, cinnamon bark, platycodon root, zanthoxylum fruit, processed aconite root and smilax rhizome. The procedures for preparing and drinking it are to "pound the ingredients and then put them into a silk bag dyed with madder. During the daytime of the last day of the year, hang the bag in a well to soften the powder. Take the bag out early in the morning of the next day, the first day of the year. Heat the bag in fermented liquor until simmering. Drink the liquid with all family members, doing so while facing east. If one person drinks it, there will be no disease in the family. If the whole family drinks it, there will be no disease in their neighborhood in an area of one square 'li'. In this study, to determine the original formulation for Tusujiu, we examined a number of ancient medical texts from the 3rd to the 13th century that discuss Biyijiu and Tusujiu. As a result, we concluded that "Biyijiu" is likely to be the original formulation developed by Hua Tuo.

Background: Renal fibrosis is common in progressive kidney disease. Transforming growth factors β (TGF-β) are important mediators of all types of fibrosis, including renal fibrosis. Chinese rhubarb has been shown to have antifibrotic properties in part because of inhibition of TGF-β and has slowed the progression of kidney disease in rodent models., Hypothesis: That administration of a Chinese rhubarb supplement will slow the progression of chronic kidney disease (CKD) in cats and the concurrent administration of Chinese rhubarb and benazepril will be more effective than either alone., Animals: Twenty-nine client-owned cats with naturally occurring IRIS Stage 2 or early Stage 3 CKD and without comorbidity such as cancer, urinary tract obstruction, urinary tract infection, poorly controlled hyperthyroidism, or systemic hypertension were enrolled in the study., Methods: A randomized, positive-controlled, prospective study was performed. Cats received Chinese rhubarb, benazepril, or both in addition to standard treatment for CKD. Repeated measures ANOVA was used to assess changes in serum creatinine concentration, body weight, hematocrit, urine protein: urine creatinine ratio (UPC), and systemic arterial blood pressure over time between and within treatment groups over an average of 22 months., Results: No significant differences were detected in serum creatinine concentration, body weight, hematocrit, UPC, and systemic arterial pressure over time between or within treatment groups., Conclusions and Clinical Importance: This study failed to detect a significant difference in the progression of CKD in cats treated with Chinese rhubarb, benazepril, or both. Further study in specific subsets of cats with CKD is warranted., (Copyright © 2014 by the American College of Veterinary Internal Medicine.)

Background: This study was aimed at determining the effects and safety of Da-Cheng-Qi decoction (DCQD) or DCQD combined with conservative therapy in patients with intestinal obstruction., Materials and Methods: PubMed, EMBASE, Cochrane Controlled Trials Register, and several other databases were searched. Randomised controlled trials (RCTs) of DCQD or DCQD plus conservative therapy in patients with intestinal obstruction were eligible. Therapeutic effect was estimated by the improvement of clinical manifestations and diagnostic imaging; dichotomous/ordinal data assessment of overall response to therapy, adverse effects; or continuous variable were identified, including time to first bowel movement, time to first flatus, length of hospital stay., Results: Sixty eligible RCTs including 6,095 patients were identified. Response rate: (1) DCQD versus conservative therapy (6 RCTs, 361 patients, RR of respond =1.13; 95% CI 0.97 to 1.31). (2) DCQD plus conservative therapy versus conservative therapy (48 RCTs, 4,916 patients, RR of respond =1.25 which favoured DCQD plus conservative therapy; 95% CI 1.20 to 1.30). Treatment effect remained similar when RCTs at high risk of bias were excluded. Time to first flatus postoperatively: (1) DCQD versus conservative therapy (2 RCTs, 240 patients, SMD=-3.65; 95% CI -8.17 to 0.87). (2) DCQD plus conservative therapy versus conservative therapy (11 RCTs, 1,040 patients, SMD=-2.09 which favoured DCQD plus conservative therapy; 95% CI -3.04 to -1.15)., Conclusion: DCQD combined with conservative therapy may increase the success rate of conservative therapy for intestinal obstruction significantly and can shorten the duration of postoperative ileus in patients undergoing abdominal surgery compared with conservative therapy alone.

Background: Protein tyrosine phosphatase (PTP) 1B, a negative regulator of the insulin and leptin signaling pathways, is currently considered a promising target for the development of novel therapeutic approaches used to treat insulin-resistant type 2 diabetes mellitus (IR-T2DM). In this study, we examined the PTP1B inhibitory activity of 147 Japanese prescription Kampo formulations to evaluate their potential for clinical application in IR-T2DM treatment., Methods: We specifically defined the prescribed daily dose as 1 Unit (U), and 147 Japanese prescription Kampo formulations were screened for PTP1B inhibitory activity at a final concentration of 0.1 mU/mL. We investigated the dependence of the inhibitory activity on the concentration of the Kampo formulations that exhibited high PTP1B inhibitory activity. Their inhibition mode by kinetic analysis, inhibitory selectivities against four homologous PTPs (TCPTP, VHR, SHP-1 and SHP-2) and cellular activity in the insulin-signaling pathway by increasing the insulin-stimulated Akt phosphorylation level in human hepatocellular liver carcinoma HepG2 cells, were also investigated. The statistical partial least squares regression method was used to identify the crude drugs with the greatest contribution to the PTP1B inhibitory activity of the Kampo formulations., Results: Daiokanzoto, Masiningan, Tokakujokito, Keimakakuhanto and Choijokito exhibited high PTP1B inhibitory activity, which was concentration-dependent. Daiokanzoto, Masiningan and Tokakujokito inhibited PTP1B by mixed inhibition modes and exhibited different inhibitory selectivities against four homologous PTPs. Masiningan also exhibited cellular activity. Statistical analyses indicated that the constituent crude drug Rhei Rhizoma provided the greatest contribution to the PTP1B inhibitory activity of these Kampo formulations., Conclusions: High PTP1B inhibitory activity was predominantly associated with formulations that were classified as Jyokito in Kampo medicine and with a modern clinical indication of constipation. Currently, there is no clinical treatment for IR-T2DM that uses a mechanism of action based on PTP1B inhibition. Thus, we propose the Kampo formulations identified in this study as strong PTP1B inhibitors, which could be developed as clinical therapeutic agents to treat IR-T2DM.

Obesity is a serious medical problem worldwide. As a holistic therapy, traditional Chinese medicine (TCM) may have a potential in obesity management. In this controlled trial, we evaluated the safety and effectiveness of xin-ju-xiao-gao-fang (XJXGF), a TCM herbal formulation, in 140 obese subjects over a 24-week period. The XJXGF formula mainly consists of rhubarb, coptis, semen cassia, and citrus aurantium. Subjects with body mass index (BMI) 28-40 kg/m(2) were recruited at 5 centers in China. We assessed the changes in subjects' body weight, its related parameters, and the reduction of insulin resistance (IR) after administration of XJXGF formula or low-dose XJXGF (10% of the XJXGF formula, as control). After 24-week treatment, among participants in the XJXGF formula group and low-dose XJXGF group, the mean ± SE changes in the body weight were -3.58 ± 0.48 and -1.91 ± 0.38 kg, respectively (p < 0.01). The changes in the IR-index of two groups were -2.65 ± 1.04 and -1.58 ± 1.3, respectively (p < 0 .05). There were no serious adverse events reported during the 24-week trial. Participants reported 7 minor adverse events, 4 in the XJXGF formula group and 3 in the low-dose XJXGF group (p = 0.578). Future studies are needed to investigate the clinical utility of this TCM formulation in the treatment of obese subjects.

To investigate the mechanisms of a compound (FF16), compatibility of Rhodiola crenulata, Cordyceps militaris, and Rheum palmatum, on glucose metabolic disorders, the IRF mice charactered with insulin resistance and glucose metabolic disorders induced by high-fat diet in C57BL/6J mice were randomly divided into 3 groups; IRF, rosiglitazone (Rosi) and FF16. The glucose metabolism was evaluated by fasting blood glucose (FBG) levels and intraperitoneal glucose tolerance test (IPGTT). The insulin sensitivity was estimated by insulin tolerance test (ITT), fasting serum insulin levels and the index of HOMA-IR. The expressions of Akt and its phosphorylation levels, GSK3beta and its phosphorylation levels in liver were detected by Western Blot. The results showed that FF16 significantly improved the glucose metabolic disorders through reducing FBG by 15.1%, decreasing AUC values in glucose tolerance tests by 22.3%. FF16 significantly improved the insulin sensitivity through decreasing AUC values in insulin tolerance tests by 22.1%, reducing the levels of serum insulin by 42.9% and of HOMA-IR by 49.5%, comparing with model control, respectively. After the treatment with FF16, the levels of p-Akt and p-GSK3beta were increased by 116.4% and 24.9%, respectively, in the liver of IRF mice. In conclusion, compound FF16 could improve glucose metabolic disorders in IRF mice through enhancing the glyconeogenesis.

Aim: To investigate the effect of rhubarb on MAPK activation in sodium taurocholate-induced pancreatitis in rats., Methods: All rats were randomly divided into three groups: control, acute pancreatitis (AP) and rhubarb treatment groups. The MAPK activation was detected by western blotting. The levels of TNFα and IL6 in serum were estimated by ELISA. The pathological changes of the pancreas were examined microscopically., Results: It was found that hemorrhage, exudates and infiltration of inflammatory cells in the pancreas were significantly less in the rhubarb group than in the AP group. In the AP group, the activation of MAPKs in pancreatic tissues was enhanced significantly at every time point compared with the control group and the levels of TNFα and IL6 were also increased. Rhubarb treatment markedly inhibited activation of MAPKs concomitantly with inhibition of TNFα and IL6 expression., Conclusion: We suggest that rhubarb probably attenuates AP by inhibiting activation of MAPKs and expression of inflammatory mediators.

Objective: To observe the curative efficacy of rhubarb, montmorillonite powder combined with blood purification on treatment for patients with severe acute organophosphorus pesticide poisoning (AOPP)., Methods: 39 patients with AOPP were divided into treatment group (received the combined treatment of rhubarb, montmorillonite powder and blood purification on the basis of routine therapy, n = 21) and control group (only received the routine treatment because of financial difficulties or the will of family members, n = 18). The differences of clinical manifestations, curative effects and prognosis between two groups were compared., Results: The time of consciousness recovery, the duration of mechanical ventilation and the length of stay in hospital in treatment group were (6.5 ± 1.3), (7.9 ± 2.0) and (13.1 ± 3.2) days, which were significantly shorter than those [(8.4 ± 2.4), (10.7 ± 2.9) and (16.5 ± 3.7) days] of control group (P < 0.05). In 5, 6 and 7 day after treatment,the cholinesterase (ChE) activities of treatment group were significantly higher than those of control group (P < 0.05). The total amount and using time of atropine and pyraloxime methylchloride in treatment group were significantly smaller and shorter than those in control group (P < 0.05). The death rate of treatment group was [19.0% (4/21)], which were significantly lower than that of control group [19.0% (4/21)] (P < 0.05)., Conclusion: The combined treatment of rhubarb, montmorillonite powder and blood purification of the AOPP patients has a better curative effect.

Objective: To screen the main component of Dahuangzhechong pill's anti-arterial thrombosis with the orthogonal design and refine Dahuangzhechong pills., Methods: In accordance with the orthogonal design table (L(16)2(15)), divided herbs into 16 groups and made the appropriate liquid. The liquid was gave to SD rats by intragastric administration,the model group, normal control group received the same volume of physiological saline. Isolated rats' carotid artery after intragastric administration a week,modeled according to ferric chloride inducement the carotid artery thrombosis method, then collected blood, detected content of platelet, thromboxane B2 (TXB2) and 6-keto-prostaglandin F1alpha (6-keto-PGF1alpha), sheared and measured dry weight of the modeling artery, then placed arteries in 10% formalin fixation, observed morphological changes in vascular tissue by HE staining., Results: Pathological examination revealed: each experimental group had thrombosis, softening, dissolution, absorption, and intimal injury, but the severity of thrombosis were diferent. Orthogonal analysis showed: 1, influence on dry weight of thrombus: rhubarb, ground beetle, leeches, peach seed, dry paint, except dry paint P<0.05, the others P<0.01.2, influence on plasma 6- keto-PGF1alpha level: peach seed, dry paint, ground beetle, gadfly, grubs, leeches, rhubarb, except rhubarb P<0.05, the others P<0.01.3, influence on plasma TXB2: ground beetle, peach seed, dried paint, rhubarb, leeches, except leech P<0.05, the others P<0.01.4, influence on platelet count: peach seed, dry paint, rhubarb, ground beetle, gadfly, leeches, except gadfly, leeches P<0.05, the others P<0.01., Conclusion: Anti-artery thrombosis of Dahuangzhechong Pill is most closely related with rhubarb, ground beetle, leeches, peach seed, dry paint and gadfly.

Experiential and sensory evaluation is an ancient method that remains important in the current quality control system of Traditional Chinese Medicines (TCMs). The process is rapid and convenient when evaluating the quality of crude materials in TCM markets. However, sensory evaluation has been met with skepticism because it is mainly based on experience and lacks a scientific basis. In this study, rhubarb was selected to demonstrate how color-based sensory evaluation could differentiate the quality of herbal medicines objectively. The colors of the rhubarb samples, expressed as RGB values, were obtained from different parts and forms of the plant, including the plant's surface, fracture surface color, and a powdered form with or without treatment with a color-developing reagent. We first divided the rhubarb samples into three grades based on the total content of five hydroxyanthraquinone derivatives, the major pharmacological components in rhubarb. Then, a three-layer back-propagation artificial neural network (BP-ANN), calibrated with selected training samples, was used to correlate the quality of the rhubarb with its color. The color of the rhubarb powder after coloration attained the highest accuracy (92.3%) in predicting the quality grade of the test samples with the established artificial neural networks. Finally, a standardized colorimetric grading scale was created based on the spatial distribution of the rhubarb samples in a two-dimensional chromaticity diagram according to the colors of the powdered rhubarb after color enhancement. By comparing the color between the scale and the tested samples, similar to performing a pH test with indicator paper, subjects without sensory evaluation experience could quickly determine the quality grade of rhubarb. This work illustrates the technical feasibility of the color-based grading of rhubarb quality and offers references for quantifying and standardizing the sensory evaluation of TCMs, foods and other products.

Objective: To study the correlation between rhubarb and expressions of antimicrobial peptides (AP) in the small intestine of mice by observing the effect of rhubarb on it., Methods: Thirty healthy ICR mice were randomly divided into the test group and the control group, fifteen in each. Ten percent rhubarb decoction and equal volume of normal saline solution was respectively given to mice of the two groups by gastrogavage. Mice were sacrificed 24 h later. The small intestines from the ligament of Treitz to the ileocecal junction were removed by ventrotomy. The lumen of each resected intestine was rinsed with 10% acetic acid solution and the perfusate was collected. The small intestine homogenate was prepared using 30% acetic acid solution. The equivalent samples were electrophoresed on 12.5% AU-PAGE and Tricine-16.5% SDS-PAGE, and peptide bands were visualized with Coomassie brilliant blue R-250 or ammoniacal silver-stained respectively. And then analysis of gel imaging and gel overlay assay were performed. The bactericidal activity and expressions of AP in the small intestine of samples in the two groups were compared. The molecular weight of AP in the small intestine was measured., Results: After gastrogavaged with rhubarb decoction, changes of AP contents in the small intestine homogenate of mice were not obvious, but the molecular weights of AP were different. But the AP contents in the small intestine perfusate obviously increased, with the molecular weights being 14.3 to 18.4 kDa. But its bactericidal capacity showed no statistical difference when compared with that of the control group (P>0.05)., Conclusion: Rhubarb enhanced the expressions of partial APs in the small intestine, which might possibly be one of its mechanisms of protecting and strengthening the intestinal barrier.

Objective: To study the effect of triangle drugs as ginseng, Trichosanthes kirilowii Maxim, and rhubarb on the levels of blood lipids as [total cholesterol (TC), triglyeride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] and pro-inflammatory cytokines as intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and high sensitive C reactive protein (hs-CRP) during the process of treating atherosclerosis., Methods: Twenty New Zealand rabbits were randomly divided into three groups after one-week adaptive feeding, i.e., the normal control group (n=6), the model group (n=6), and the triangle drugs group (n=8). High fat diet was fed to rabbits in the triangle drugs group and the model group at the daily dose of 100 g for six weeks. Iliac artery was injured in the model group and the triangle drugs group at the seventh week using balloon injury. High fat diet was successively fed to those after surgery for six weeks. At the same time of modeling, preventive medication (at the daily dose of dry ginseng 0.64 g/kg, Trichosanthes kirilowii Maxim 2.14 g/kg, and prepared Radix et Rhizoma Rhei with wine 0.43 g/kg, with the volume of 2 mL/kg) was administered by gastrogavage to rabbits in the triangle drugs group. Changes of blood lipids levels and related pro-inflammatory cytokines were dynamically observed., Results: On the 7th week (before surgery), the levels of TC, TG, HDL-C, and LDL-C in the model group, TC, HDL-C, and LDL-C in the triangle drugs group significantly increased, showing significant difference when compared with those of the normal control group (P < 0.05). The levels of pro-inflammatory cytokines in the model group and the triangle drugs group were significantly higher than those in the normal control group (P < 0.05). Levels of TC, TG, and LDL-C were lower in the triangle drugs group than in the model group, showing statistical difference (P < 0.05). After the 8th week the levels of blood lipids and ICAM-1 in the model group, and levels of TC, LDL-C, HDL-C, and ICAM-1 in the triangle drugs group were significantly higher than those of the normal control group, showing statistical difference (P < 0.05). After the 12th week levels of blood lipids in the model group, LDL-C and HDL-C in the triangle drugs group were significantly higher than those of the normal control group, showing statistical difference (P < 0.05). The LDL-C level was lower in the triangle drugs group than in the model group, showing statistical difference (P < 0.05). The levels of VCAM-1, ICAM-1, and hs-CRP in the model group were obviously higher than those in the triangle drugs group and the normal control group, showing statistical significance (P < 0.05). The hs-CRP level was higher in the triangle drugs group than in the normal control group, showing statistical difference (P < 0.05)., Conclusions: The triangle drugs may postpone the process of atherosclerosis by lowering blood lipids levels, especially by lowering the elevating levels of TC and LDL-C. Its roles in decreasing the level of pro-inflammatory cytokines might be associated with lipids lowering and anti-inflammation. Its roles may also be associated with improvement of the endothelial function and inhibition of the smooth muscle proliferation.

Objective: To investigate the therapeutic effect of Rheum offĩcinale on acute pancreatitis., Methods: Buffered sodium taurocholate (3% m/V) was injected into the pancreatico-biliary duct to induce acute pancreatitis. Death rate,coefficient of pancreas, serum amylyse (AMY), hemocuprein (SOD), TNF-alpha and IL-1beta level were examined at 6, 12 and 24 hours after operations. Pathology analysis were also obtained., Results: Compared with corresponding pancreatitis groups,death rate, coefficient of pancreas, serum TNF-alpha and IL-1beta level of drug groups decreased remarkably (P < 0.05), while serum SOD level significantly increased (P < 0.01). Serum AMY level of drug groups increased at 6 h (P < 0.01), decreased at 12 h (P < 0.01) and had no statistics disparity at 24 h (P > 0.05) compared with respective pancreatitis group. Although score points of all drug groups were lower than corresponding pancreatitis groups, the growth tendency of both were similar., Conclusion: Rheum officinale Baill has the effect of prevention to pancreas pathological changes in the animal pattern, but not able to reverse the tendency.

Background: The Daming capsule (DMC) is a traditional Chinese medicine used to treat hyperlipoidemia. Both clinic trials and studies on animal models have demonstrated that DMC is beneficial against diabetic symptoms. Impairment of the baroreflex can cause life-threatening arrhythmias and sudden cardiac death in patients with diabetes mellitus (DM). This study was designed to elucidate the effects of DMC on baroreflexes in streptozocin (STZ)-induced diabetic rats with hyperlipoidemia., Methods: Wistar rats were randomly divided into three groups: untreated controls, rats pretreated STZ and high lipids (a diabetes model or DM rats), and DM rats treated with DMC. The baroreflex sensitivity was examined during intravenous injection of phenylephrine (PE) or sodium nitroprusside (SNP) and quantified by the change in heart rate over the change in mean arterial blood pressure (ΔHR/ΔMABP). Morphological remodeling of baroreceptors was analyzed by transmission electron microscopy (TEM). The mRNA levels and expression of GluR2 and a GABAA receptor subunit were measured by quantitative RT-PCR and Western blotting., Results: Compared to untreated DM rats, DMC significantly elevated the ratio of ΔHR/ΔMABP by enhancing the compensatory reduction in HR (-ΔHR) in response to PE-induced hypertension (+ΔMABP) (P < 0.05). In the presence of SNP, DMC increased the ΔMABP (P < 0.05). In addition, DMC markedly shortened the duration of blood pressure changes elicited by PE or SNP in DM rats compared to the untreated DM group (P < 0.05). Electron microscopy revealed disrupted myelin sheaths, swollen ER, and lysed mitochondria in the nucleus ambiguous (NAm) DM rats. These signs of neuropathology were largely prevented by treatment with DMC for 30 days. Treatment with DMC elevated both mRNA and protein level of GluR2 in the NAm of DM rats, but had no effect on GABAA receptor expression., Conclusion: The Daming capsule partially reversed the parasympathetic baroreflex impairment observed in STZ-induced diabetic rats with hyperlipoidemia. Treatment with DMC also prevented the degeneration of neurons and myelinated axons in the brain stem NAm and reversed the down-regulation of GluR2 mRNA. Rescue of NAm function may contribute to the medicinal properties of DMC in diabetic rats.

Ethnopharmacological Relevance: Rheum officinale Baill. (Da Huang) is one of the herbs commonly used in traditional Chinese medicine formulae against cancer. The traditional decoction is similar to the water extract used in the present study., Aim of the Study: The water extract of Da Huang was investigated to see if it possesses anticancer effects through apoptotic pathways., Materials and Methods: Human lung adenocarcinoma A549 and human breast cancer MCF-7 cell lines were treated with different concentrations of Da Huang water extract at different time intervals. Growth inhibition was detected by MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] and colony formation assays; apoptosis was detected by cell morphologic analysis, DNA fragmentation analysis and COMET assay., Results: Da Huang water extract was found to have significant growth inhibitory effects on both A549 and MCF-7 cell lines with IC(50) values 620+/-12.7 and 515+/-10.1 microg/ml, respectively. Growth inhibitory effects were dose- and time-dependent. A significant decrease in cell number, DNA fragmentation and single DNA strand breakages were observed in the Da Huang water extract treated A549 and MCF-7 cells., Conclusions: This suggests that the water extract of Da Huang exerts potential anticancer activity through growth inhibition and apoptosis on MCF-7 and A549 cells lines.

Rhein, an anthraquinone derivative of rhubarb, inhibits the proliferation of various human cancer cells. In this paper, we focused on studying the effects of rhein on human hepatocelluar carcinoma BEL-7402 cells and further understanding the underlying molecular mechanism in an effort to make the potential development of rhein in the treatment of cancers. Using MTT assay and flow cytometry, we demonstrate a critical role of rhein in the suppression of BEL-7402 cell proliferation in a concentration- and time-dependent manner. The increase of apoptosis rate was observed after incubation of BEL-7402 cells with rhein at 50-200 muM for 48 hours, and the cells exhibit typical apoptotic features including cellular morphological change and chromatin condensation. Moreover, rhein-induced cell cycle S-phase arrest. Additionally, after rhein treatment, expression levels of c-Myc gene were decreased, while those of caspase-3 gene were increased in a dose-dependent manner by using real-time PCR assay. The results demonstrate for the first time that cell cycle S-phase arrest is one of the mechanisms of rhein in inhibition of BEL-7402 cells. Rhein plays its role by inducing cell cycle arrest via downregulation of oncogene c-Myc and apoptosis through the caspase-dependent pathway. It is expected that rhein will be effective and useful as a new agent in hepatocelluar carcinoma treatment in the future.

Rhubarb has been used to decrease plasma cholesterol levels and reduce vascular endothelial cellular damage in recent years. However, it is not known whether reported lipid-lowering effects are associated with the improvement of endothelial function. This work aimed to elucidate the therapeutic effects of rhubarb on serum lipids and brachial artery endothelial function, as well as to investigate the relationship between them. One hundred and three patients with atherosclerosis were randomly divided into two groups: patients in the control and the trial group received a placebo and rhubarb, respectively, in addition to the 6 month baseline therapy. Serum lipids and brachial artery endothelial functions were measured in all patients before and after treatment. A total of 83 patients completed the 6-month follow-up protocol. Serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the trial group decreased significantly and LDL-C was significantly lower than that in the control group. Flow-mediated dilation (FMD) in the trial group was significantly higher after treatment in comparison to the baseline and to the control group. Improvement in FMD correlated with the decreased magnitude of TC and LDL-C levels. The results obtained appeared to confirm that rhubarb significantly improves endothelial function mainly due to lipid-lowering effects in patients with atherosclerosis.

In traditional oriental medicine, Yin-Chen-Hao decoction is used for the remedy of liver diseases such as hepatitis, fatty liver, hepatocirrhosis and jaundice. However, despite extensive pharmacological study, the molecular mechanism of the anti-inflammatory effect of Yin-Chen-Hao decoction is poorly understood. In this study, we have investigated the pharmacological action on the mechanism of concanavalin A-induced T cell-dependent hepatitis in mice. Concanavalin A administration resulted in a severe liver injury. This was shown through increased levels of serum transaminase and lactic dehydrogenase, and increased liver DNA fragmentation and caspase-3 activity. Pretreatment with the aqueous extract from Yin-Chen-Hao decoction dose-dependently inhibited the elevation in transaminase and lactic dehydrogenase activity, and reduced liver DNA fragmentation and caspase-3 levels. There was an improvement in histological changes including inflammatory infiltration, hepatocyte necrosis and degeneration, and Kupffer cell hyperplasia. In addition, Yin-Chen-Hao decoction significantly inhibited tumour necrosis factor-alpha (TNF-alpha) production in-vitro and in-vivo. Moreover, the activation of nuclear factor kappa B (NF-kappaB), which regulates TNF-alpha production, was blocked by Yin-Chen-Hao decoction in-vitro and in-vivo. In conclusion, Yin-Chen-Hao decoction was capable of regulating T-cell-mediated liver injury in-vivo. This event may have depended on the decrease of TNF-alpha production through the inhibition of NF-kappaB activation.

Objective: To investigate the effects of raw rhubarb (RR) on levels of plasma D-lactate and procalcitonin in patients with sepsis., Methods: Forty patients with sepsis enrolled were randomly divided into two groups, the RR group (n=18, treated with RR 9 g/d) and the control group (n=22, treated with conventional treatment). Plasma procalcitonin and D-lactate were determined before and after treatment., Results: Before treatment, there was no significant difference in the levels of plasma procalcitonin and D-lactate between the two groups (procalcitonin: 6.50 +/- 2.37 microg/L vs 6.98 +/- 2.89 microg/L; D-lactate: 0.18 +/- 0.05 mmol/L vs 0.19 +/- 0.06 mmol/L, P > 0.05). However, after treatment, two indexes in the RR group were significantly lower than those in the control group (procalcitonin: 4.11 +/- 1.40 microg/L vs 2.21 +/- 0.61 microg/L; D-lactate: 0.24 +/- 0.06 ng/L vs 0.09 +/- 0.03 ng/L, both P < 0.05)., Conclusion: RR could ameliorate the intestinal permeability and reduce the shifting of intestinal bacteria, so as to ease the condition of disease in patients with sepsis.

Chronic kidney disease (CKD) is a worldwide public health issue with poor outcomes and high cost. There is growing evidence that some of the adverse outcomes of CKD can be prevented or delayed by early treatment using angiotensin II-converting enzyme inhibitors and angiotensin II-receptor blockers. A great amount of the world's population has been using traditional Chinese herbal medicine (TCHM) for treatment of CKD and has accumulated their experience for years. In this article, the knowledge and the therapeutic principles of traditional Chinese medicine in the treatment of CKD are briefly reviewed. The efficacy of several TCHMs, supported by either clinical evidence or experimental studies, is presented. The future direction for the study of Chinese herbal medicines in CKD is discussed.

Aim: To study the effects of rhubarb (dried root of Rheum officinale Baill.) on contractile activity of isolated gastric muscle strips of guinea pigs and its possible mechanism., Methods: A total of 48 guinea pigs were killed to remove the whole stomach. Then, the stomach was opened and the mucosal layer was removed. Parallel to the circular fibers, muscle strips were cut from the body. Each isolated gastric muscle strip was suspended in a tissue chamber containing 5 mL Krebs solution, constantly warmed by water jacket at 37 degrees and bubbled continuously with a mixed gas of 950 mL/L O2 and 50 mL/L CO2. After being incubated for 1 h with 1 g tension, rhubarb of varied concentrations (1%, 2%, 7%, 20% and 70%) was added cumulatively into the tissue chamber at intervals of 2 min. Atropine (10(-6) mol/L) or isoptin (5 x 10(-8) mol/L) or hexamethonium (10(-5) mol/L) was given 2 min before the administration of rhubarb. The isometrical response was measured with an ink-writing recorder., Results: Rhubarb dose dependently increased the resting tension of gastric body circular muscle (CM) (r = 0.726, P<0.05). Atropine (r = 0.829, P<0.05), isoptin (r = 0.764, P<0.05) and hexamethonium (r = 0.797, P<0.05) did not affect its action in a dose-related manner. Atropine apparently reduced the increasing action of 1%, 3%, 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Isoptin inhibited the effect of 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Hexamethonium reduced the increasing action of 1%, 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Rhubarb increased the contractile frequency of CM of body. While atropine, isoptin and hexamethonium did not inhibit the contractile frequency of gastric body CM in comparison with rhubarb at the same concentration, rhubarb at the highest concentration (100%) decreased the mean contractile amplitude of gastric body CM. Atropine, isoptin and hexamethonium did not affect the mean contractile amplitude of gastric body CM compared to rhubarb at the same concentration., Conclusion: Rhubarb has exciting actions on isolated gastric smooth muscle strips of guinea pig. The exciting action of rhubarb is partly mediated via cholinergic M receptor, cholinergic N receptor and L-type calcium channel.

Objective: To observe the influence of Rhubarb on the the excretion of Type II PLA2 and lysozyme of small intestine of mouse., Methods: Forty ICR mice were randomized to two groups. In the experiment group, the mice were gavaged with 0.3 ml 10% Rhubarb decoction every 8 hours; in the control group, the mice were given normal saline instead of Rhubarb decoction. After 24 hours, the mice were subjected to cervical dislocation, and their jejunum and ileum were taken out. The lumen of each resected intestine was rinsed with 100 g/L acetic acid, and the washed intestines from each mouse were cut into pieces 1-2 mm in length. Then the perfusate and homogenate were prepared, lyophilized, sealed, and stored at -20 degrees C. The Type II PLA2 activity and lysozyme were assayed respectively., Results: The Type II PLA2 activities and lysozyme of homogenate in Rhubarb group were lower than those in Saline group (P<0.01). The type II PLA2 activities and lysozyme of perfusate in Rhubarb group were higher than those in Saline group (P<0.01)., Conclusion: Rhubarb can stimulate the small intestine of mice to excrete Type II PLA2 and lysozyme, thus resulting in the increase of Type II PLA2 and lysozyme contents in the intestinal tract and enhancing the function of mucosal barrier of intestine.

Wen-Pi-Tang, an Oriental medical prescription composed of Rhei Rhizoma, Ginseng Radix, Aconiti Tuber, Zingiberis Rhizoma and Glycyrrhizae Radix, is used clinically as a medicine to treat renal failure. This study was conducted to examine the inhibitory activity of the five crude drug components of Wen-Pi-Tang and several pure compounds isolated from Rhei Rhizoma and Glycyrrhizae Radix against the protein glycation reaction. Rhei Rhizoma exerted the most potent activity, Zingiberis Rhizoma and Glycyrrhizae Radix showed relatively moderate activity, whereas Aconiti Tuber and Ginseng Radix showed weak activity. On the other hand, of 20 compounds obtained from Rhei Rhizoma and Glycyrrhizae Radix, tannins, especially rhatannin, RG-tannin and procyanidin B-2 3,3'-di-O-gallate, showed significantly strong activities that were more effective than the positive control, aminoguanidine. Some flavones such as licochalcone A and licochalcone B, and anthraquinones such as emodin and aloe-emodin, also showed inhibitory activity. These findings may help to explain, at least in part, certain pharmacological activities of Wen-Pi-Tang, whose clinical efficacy against renal failure is already recognized.

Objective: The research was designed to study the meridian tropism theory of traditional Chinese drug through experiments in animals., Method: We used the mouse model of deficient spleen as the object. After administering Atractylodes macrocephala and Poria cocos respectively, we measured the indexes of MDA, SOD, NO to observe the effects of the drugs on various organs and compared the results with the traditional meridian tropism theory., Result: The two drugs had selective effects on the quantity or activity of MDA, SOD, NO in the organs for the normal group and the model group., Conclusion: The selective influence of the two drugs has close relativity with the traditional meridian tropism theory.