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Background: Prednisone plus azathioprine is considered the mainstay of therapy in the current recommendations for autoimmune hepatitis (AIH). However, it does not provide good benefits for AIH patients because of its serious side effects. Therefore, more and more AIH patients prefer to seek for traditional Chinese medicine (TCM) to manage their symptoms and reduce the side effects of steroids in China. Shu-Gan-Jian-Pi Decoction is a popular used Chinese herbal formula in Guangdong province of China, which has demonstrated the effect of improving efficacy and reducing side effects of corticosteroids in AIH patients. The aim of this study is to evaluate the effects of Shu-Gan-Jian-Pi Decoction combined with steroid in AIH patients. So, this study aims to explore whether the combination treatment of Shu-Gan-Jian-Pi Decoction and steroid standard therapy could improve the clinical management of AIH., Methods: A prospective non-randomized study on AIH will be conducted between October 2015 and June 2017 in Guangdong Provincial hospital of Chinese medicine. Eligible AIH patients will be classified as the case group (n = 66) and the control group (n = 66) based on the interventions. Patients taking Shu-Gan-Jian-Pi Decoction combined with prednisone and azathioprine will be in the case group and those taking prednisone and azathioprine will be in the control group. The whole study will last 48 weeks, including a 24-week observation period and a 24-week follow-up period. The primary outcome was complete response to therapy, defined as complete biochemical remission at the patient's last visit of observation period and the absence of predefined steroid-specific side effects throughout treatment., Discussion: This trial will evaluate the efficacy and safety of Shu-Gan-Jian-Pi Decoction combined with prednisone and azathioprine on AIH patients. The achievement of this trial will provide evidence-based data for Shu-Gan-Jian-Pi Decoction, which could provide good benefits for AIH patients., Trial Registration: Chinese Clinical Trial Registry: ChiCTR-OOC-15006155 . Registration date: 28 March 2015.

Objective: To observe the effects of warming yang method, nourishing yin method, activating blood method, and the combined treatment method on the ventricular remodeling (VR) and the heart function of heart failure (HF) rats of Shen-yang deficiency syndrome (SYDS)., Methods: The Sprague-Dawley (SD) HF rat model of SYDS was established by continuously intravenous dripping adriamycin after economizing bilateral thyroid tissues. Rats were then randomly divided into the model group (administered with normal saline at the daily dose of 6 mL/kg by gastrogavage), the warming yang group (administered with Wenyang Jianxinling Extractum at the daily dose of 6 mL/kg by gastrogavage), the activating blood group (administered with Ligusticum Wallichii and Salvia Miltiorrhiza Extractum at the daily dose of 6 mL/kg by gastrogavage), the nourishing yin group (administered with Radix Ophiopogonis and Rhizoma Anemarrhenae Extractum at the daily dose of 6 mL/kg by gastrogavage), and the combined treatment group (administered with Yin-Yang Supplementing Extractum at the daily dose of 6 mL/kg by gastrogavage), 10 in each group. Another 10 SD rats were taken as the normal control group. They ate food and drank water freely. All rats were intervened for four successive weeks. The left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), maximal rate of left ventricular pressure of development ( +dp/dtmax), and maximal rate of left ventricular pressure of decline (-dp/dtmax) were observed. The systolic blood pressure (SBP) and the diastolic blood pressure (DBP) were determined. The mean arterial pressure (MAP) was calculated. The heart rate (HR) was recorded. Then all rats were killed and their hearts were taken out to weigh the heart mass (HM), the left ventricular mass (LVM), the right ventricular mass (RVM). The heart mass index (HMI) and the left ventricular mass index (LVMI) were calculated. The mRNA expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP1) in the myocardium were detected using RT-PCR. The serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), MMP-9, and TIMP-1 were assayed by double antibody sandwich ELISA., Results: Compared with the normal control group, HR, LVEDP, HM, LVM, HMI, RVM, LVMI, NT-proBNP, MMP-9, and MMP-9 mRNA significantly increased, but SBP, DBP, MAP, LVSP, +/- dp/dtmax, TIMP-1, and TIMP-1 mRNA significantly decreased in the model group with statistical difference (P<0.05). Compared with the model group, SBP and DBP, +/-dp/dtmax increased,while LVEDP, NT-proBNP, and MMP-9 decreased in the warming yang group. HR, LVEDP, HM, LVM, HMI, RVM, LVMI, MMP-9 mRNA, NT-proBNP, and MMP-9 significantly decreased, while TIMP-1 mRNA increased in the activating blood group. HR, LVEDP, +/- dp/dtmax, LVMI, NT-proBNP, and MMP-9 decreased, while TIMP-1 increased in the combined treatment group, showing statistical difference (P<0.05). Compared with the warming yang group, SBP and +dp/dtmax decreased in the nourishing yin group; HR and MMP-9 mRNA decreased in the activating blood group, HR decreased in the combined treatment group, all showing statistical difference (P<0.05). There was no statistical difference in the rest indices (P>0.05)., Conclusion: Activating blood method and combined treatment method could regulate the expressions of MMP-9 and TIMP1 mRNA of HF rats of SYDS, effectively ameliorate the VR, and improve the HF.

Warming yang, which is one of the treatment principles of traditional Chinese Medicine, is very important in treating chronic heart failure, especially late-stage heart failure. It has been proved in many experiments and clinical trials that warming yang can improve the hemodynamic parameters. The treatment strategy for heart failure has changed from short-term correction of hemodynamic parameters to long-term rehabilitation approaches. We discussed the possible negative-effects of warming yang on neuroendocrine responses and myocardial remodeling. The potential beneficial effects of treatment for nourishing yin or nourishing yin combined with warming yang on heart failure were also explored.

Objective: To study the effects of Ligustrazine (Lig) and Radix Astragali (Rad) on activities of myosin adenosine triphosphatase (mATPase) of soleus muscle and atrophy in tail-suspended rat., Method: Weightlessness was simulated by tail suspension in female rats. The activities of mATPase of intrafusal and extrafusal fibres in soleus muscle were detected by method of Ca2(+)-ATPase., Result: 1) Compared with tail-suspended (TS) group, the percentage of type II fibres of SOL in both Ligustrazine (Lig) group and Rad group decreased distinctly. Furthermore, the percentage of type I and type II fibres of SOL in Rad group showed no difference with control (CON) group. 2) The type I CSA of Lig group was markedly larger than that in TS group, and there was no difference as compared with that of CON group. CSA of type I, II and average CSA of Rad group were remarkably larger than those in TS group, and there were no difference as compared with those of CON group. 3) mATPase activities of intrafusal fibres in both Lig group and Rad group were approximate to that of CON group., Conclusion: Lig and Rad are both able to effectively prevent muscle atrophy caused by tail suspension, restrain the slow-twitch muscle transform to fast-twitch muscle and control the increase of mATPase activities caused by weightlessness.