BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitor...BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.展开更多
OBJECTIVE:To assess the acute organ toxicity of Strychnos nux-vomica with zebrafish model visually.METHODS:To assess acute toxicity,we initially determined the lethal concentration after Strychnos nux-vomica treatment...OBJECTIVE:To assess the acute organ toxicity of Strychnos nux-vomica with zebrafish model visually.METHODS:To assess acute toxicity,we initially determined the lethal concentration after Strychnos nux-vomica treatment for 24 h.Zebrafish was treated with five concentrations Strychnos nux-≦vo LC10 for 24 h,and the effects ofmica on morphology,function of heart,central nervous system,liver,kidney and organ-specific cell death were assessed.Next,we assessed the reversibility of toxic effect.RESULTS:Strychnos nux-vomica has an effect on the different organs of zebrafish,including heart,central nervous system,liver,and kidney,and cadiotoxicity induced by Strychnos nux-vomica was reversible to some extent.CONCLUSION:Zebrafish model is suitable for confirming the toxic target organs for Chinese traditional medicine.展开更多
To explore the effect of particle size on the quality uniformity and in vitro release performance of Strychnos nux-vomica powder, seven samples of Strychnos nux-vomica powder with different particle sizes were prepare...To explore the effect of particle size on the quality uniformity and in vitro release performance of Strychnos nux-vomica powder, seven samples of Strychnos nux-vomica powder with different particle sizes were prepared.Microstructures and particle sizes were analyzed, and high performance liquid chromatography(HPLC) was used to test the contents and in vitro release performances of brucine and strychnine in the samples. Results showed that the contents and the in vitro release rates of brucine(or strychnine) in different samples were different since there are different proportions of endosperms to epidermal cells in Strychnos nux-vomica powder with different particle sizes. Brucine and strychnine in each sample were promptly released in the first ten minutes and their cumulative release rates were higher than 70% after ten minutes. Eighty minutes later, the cumulative release rate tended to be a constant. Considering the quality uniformity and safety of Strychnos nux-vomica powder used as traditional Chinese medicine, it would be better to control the particle size of Strychnos nux-vomica powder between 100 and 140 mesh in which the maximum cumulative release rate in vitro of brucine and strychnine can be relatively low within this range.展开更多
Objective:To explore the potential mechanism of hepatotoxicity induced by Nux Vomica through network toxicology.Methods:The active components and targets of Nux Vomica were identified and screened by Traditional Chine...Objective:To explore the potential mechanism of hepatotoxicity induced by Nux Vomica through network toxicology.Methods:The active components and targets of Nux Vomica were identified and screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform Database(TCMSP),literature research,PubChem Database,Swiss Target Prediction database,etc.Genecards,pharmGKB and OMIM databases were used to collect hepatotoxicity related targets,then,cross them with active component targets to obtain potential targets of hepatotoxicity caused by Nux Vomica.A"Nux Vomica-Potential active components-Potential targets-Hepatotoxicity"network was constructed with Cytoscape 3.8.0 software.The String 11.0 database was used to construct the protein-protein interaction(PPI)network of the targets and to screen out the core targets.In addition,Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were conducted by R software,and then the obtained pathways directly related to hepatotoxicity were integrated.Results:In this study,37 active components were screened via TCMSP and literature research,468 targets for the active components of Nux Vomica were obtained.There were 533 hepatotoxicity-related targets,73 potential targets for hepatotoxicity caused by Nux Vomica,and 26 potential active components,among which Ferulic acid,Novacine,Icajine,Simiarenol were the key active components for hepatotoxicity caused by Nux Vomica,and JUN,RELA,and STAT3 were the core target proteins of hepatotoxicity caused by Nux Vomica.There were 1859 GO entries(P-value<0.05),including 1709 entries of Biological Process(BP),39 entries of Cellular Component(CC),and 111 entries of Molecular Function(MF).KEGG enrichment analysis revealed 145 pathways(value<0.05),of which PI3K/AKT signaling pathway,HIF-1 signaling pathway,EGFR tyrosine kinase inhibitor resistance were strongly correlated with the hepatotoxicity caused by Nux Vomica.Conclusion:Through network toxicology analysis,it was found that lots of potential components in Nux Vomica may be involved in the activation of the excessive inflammatory response,oxidative stress,and the LPS response through multiple targets and multiple pathways,resulting in the generation of hepatotoxicity.展开更多
Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN...Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.展开更多
目的建立蕤仁Prinsepiae nux饮片多指标定量检测方法,结合化学模式识别及CRITIC(criteria importance though intercrieria correlation)-逼近理想解排序(technique for order preferenceby similarity to ideal solution,TOPSIS)法评...目的建立蕤仁Prinsepiae nux饮片多指标定量检测方法,结合化学模式识别及CRITIC(criteria importance though intercrieria correlation)-逼近理想解排序(technique for order preferenceby similarity to ideal solution,TOPSIS)法评价不同产地蕤仁饮片质量。方法采用高效液色谱法,以槲皮素、β-谷甾醇为内参物,分别计算没食子酸、原儿茶酸、香草酸、山柰酚与槲皮素,熊果酸、齐墩果酸、委陵菜酸、胡萝卜苷与β-谷甾醇的相对校正因子,对蕤仁饮片中10个成分进行定量检测;同时检测醇溶性浸出物、总灰分和酸不溶性灰分含量。采用化学模式识别以及CRITIC-TOPSIS法评价不同产地蕤仁饮片质量。结果外标法方法学验证结果良好;各相对校正因子重复性良好;外标法与一测多评(quantitative analysis of multicomponents by single marker,QAMS)法计算结果无明显差异(P>0.05)。主成分分析(principal component analysis,PCA)结果显示不同产地16批蕤仁饮片分成3类;正交偏最小二乘法-判别分析(orthogonal partial least squares discriminant analysis,OPLS-DA)结果显示没食子酸、槲皮素、β-谷甾醇、熊果酸、委陵菜酸、齐墩果酸和山柰酚变量重要性投影值均>1,是区分不同产地蕤仁饮片质量的差异性标志物;CRITIC-TOPSIS分析结果显示,法16批蕤仁饮片综合质量评价指标的相对贴近度为0.4072~0.5935,其中陕西、甘肃和山西产蕤仁饮片排名靠前,样品质量较优。结论通过建立蕤仁饮片中多指标定量,结合化学模式识别及CRITIC-TOPSIS分析评价了不同产地蕤仁饮片质量,为蕤仁饮片质量标准的研究及其质量标志物的研究提供参考。展开更多
文摘BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.
基金Supported by the Scientific Research And Postgraduate Education Joint Project(Key Technology Research and Application of Safety Evaluation for Toxic Chinese Medicinal Materials on the Basis of the Characteristics of Chemical Composition and Zebrafish,No.2050205)
文摘OBJECTIVE:To assess the acute organ toxicity of Strychnos nux-vomica with zebrafish model visually.METHODS:To assess acute toxicity,we initially determined the lethal concentration after Strychnos nux-vomica treatment for 24 h.Zebrafish was treated with five concentrations Strychnos nux-≦vo LC10 for 24 h,and the effects ofmica on morphology,function of heart,central nervous system,liver,kidney and organ-specific cell death were assessed.Next,we assessed the reversibility of toxic effect.RESULTS:Strychnos nux-vomica has an effect on the different organs of zebrafish,including heart,central nervous system,liver,and kidney,and cadiotoxicity induced by Strychnos nux-vomica was reversible to some extent.CONCLUSION:Zebrafish model is suitable for confirming the toxic target organs for Chinese traditional medicine.
基金Supported by the Plan Issue of Shanghai Science &Technology Committee(No.13401901100)
文摘To explore the effect of particle size on the quality uniformity and in vitro release performance of Strychnos nux-vomica powder, seven samples of Strychnos nux-vomica powder with different particle sizes were prepared.Microstructures and particle sizes were analyzed, and high performance liquid chromatography(HPLC) was used to test the contents and in vitro release performances of brucine and strychnine in the samples. Results showed that the contents and the in vitro release rates of brucine(or strychnine) in different samples were different since there are different proportions of endosperms to epidermal cells in Strychnos nux-vomica powder with different particle sizes. Brucine and strychnine in each sample were promptly released in the first ten minutes and their cumulative release rates were higher than 70% after ten minutes. Eighty minutes later, the cumulative release rate tended to be a constant. Considering the quality uniformity and safety of Strychnos nux-vomica powder used as traditional Chinese medicine, it would be better to control the particle size of Strychnos nux-vomica powder between 100 and 140 mesh in which the maximum cumulative release rate in vitro of brucine and strychnine can be relatively low within this range.
文摘Objective:To explore the potential mechanism of hepatotoxicity induced by Nux Vomica through network toxicology.Methods:The active components and targets of Nux Vomica were identified and screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform Database(TCMSP),literature research,PubChem Database,Swiss Target Prediction database,etc.Genecards,pharmGKB and OMIM databases were used to collect hepatotoxicity related targets,then,cross them with active component targets to obtain potential targets of hepatotoxicity caused by Nux Vomica.A"Nux Vomica-Potential active components-Potential targets-Hepatotoxicity"network was constructed with Cytoscape 3.8.0 software.The String 11.0 database was used to construct the protein-protein interaction(PPI)network of the targets and to screen out the core targets.In addition,Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were conducted by R software,and then the obtained pathways directly related to hepatotoxicity were integrated.Results:In this study,37 active components were screened via TCMSP and literature research,468 targets for the active components of Nux Vomica were obtained.There were 533 hepatotoxicity-related targets,73 potential targets for hepatotoxicity caused by Nux Vomica,and 26 potential active components,among which Ferulic acid,Novacine,Icajine,Simiarenol were the key active components for hepatotoxicity caused by Nux Vomica,and JUN,RELA,and STAT3 were the core target proteins of hepatotoxicity caused by Nux Vomica.There were 1859 GO entries(P-value<0.05),including 1709 entries of Biological Process(BP),39 entries of Cellular Component(CC),and 111 entries of Molecular Function(MF).KEGG enrichment analysis revealed 145 pathways(value<0.05),of which PI3K/AKT signaling pathway,HIF-1 signaling pathway,EGFR tyrosine kinase inhibitor resistance were strongly correlated with the hepatotoxicity caused by Nux Vomica.Conclusion:Through network toxicology analysis,it was found that lots of potential components in Nux Vomica may be involved in the activation of the excessive inflammatory response,oxidative stress,and the LPS response through multiple targets and multiple pathways,resulting in the generation of hepatotoxicity.
基金Supported by Zhejiang Province Traditional Chinese Medicine Scientific Research Fund Project(No.2015ZA094)。
文摘Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.
文摘目的建立蕤仁Prinsepiae nux饮片多指标定量检测方法,结合化学模式识别及CRITIC(criteria importance though intercrieria correlation)-逼近理想解排序(technique for order preferenceby similarity to ideal solution,TOPSIS)法评价不同产地蕤仁饮片质量。方法采用高效液色谱法,以槲皮素、β-谷甾醇为内参物,分别计算没食子酸、原儿茶酸、香草酸、山柰酚与槲皮素,熊果酸、齐墩果酸、委陵菜酸、胡萝卜苷与β-谷甾醇的相对校正因子,对蕤仁饮片中10个成分进行定量检测;同时检测醇溶性浸出物、总灰分和酸不溶性灰分含量。采用化学模式识别以及CRITIC-TOPSIS法评价不同产地蕤仁饮片质量。结果外标法方法学验证结果良好;各相对校正因子重复性良好;外标法与一测多评(quantitative analysis of multicomponents by single marker,QAMS)法计算结果无明显差异(P>0.05)。主成分分析(principal component analysis,PCA)结果显示不同产地16批蕤仁饮片分成3类;正交偏最小二乘法-判别分析(orthogonal partial least squares discriminant analysis,OPLS-DA)结果显示没食子酸、槲皮素、β-谷甾醇、熊果酸、委陵菜酸、齐墩果酸和山柰酚变量重要性投影值均>1,是区分不同产地蕤仁饮片质量的差异性标志物;CRITIC-TOPSIS分析结果显示,法16批蕤仁饮片综合质量评价指标的相对贴近度为0.4072~0.5935,其中陕西、甘肃和山西产蕤仁饮片排名靠前,样品质量较优。结论通过建立蕤仁饮片中多指标定量,结合化学模式识别及CRITIC-TOPSIS分析评价了不同产地蕤仁饮片质量,为蕤仁饮片质量标准的研究及其质量标志物的研究提供参考。
