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      2022 Year 28 Vol. 8 Issue

        Original Article

      • Yi ZHANG,Yan QIAO,Li LI,Dan-dan GAO,Jing-yan SONG,Zhen-gao SUN
        2022, 28(8): 675-682. DOI: 10.1007/s11655-022-3515-2
        Abstract：Objective:To evalvate efficacy of Qizi Yusi Pills (QYP), a Chinese medicine compound preparation, on in vitro fertilization-embryo transfer (IVF-ET) in women of advanced reproductive age.Methods:This multicenter, randomized, double-blind, placebo-controlled trial was conducted from June 2018 to October 2019. A total of 124 patients were randomly allocated to either the QYP group or the placebo group using a stratified block randomization design, with 62 patients in each group. All patients completed controlled ovarian stimulation using a standard gonadotropin-releasing hormone agonist (GnRH-a) long protocol. As the QYP group, QYP was administered while the control group received placebo. QYP and placebo were administered for a total of 24 to 30 days from the day of GnRH-a pituitary downregulation to transvaginal oocyte retrieval. Both medications were taken orally at doses of 10 g three times each day. The primary outcome was cumulative pregnancy rate, and the secondary outcomes were periodic medication, follicular status, serum hormone and endometrial receptivity. Follow-up continued until 4 weeks after delivery. Maternal and neonatal complications, such as gestational diabetes, were also observed.Results:Overall, 119 patients completed the study, 60 in the QYP group and 59 in the placebo group. Per protocol (PP) analysis revealed that 6-month cumulative pregnancy rate in the QYP group was significantly higher than that in the placebo group [43.33% (26/60) vs. 25.42% (15/59), P=0.040). Additionally, more oocytes were retrieved from the QYP group than those from the placebo group (8.95±3.12 vs. 7.85±1.91, P=0.022). Moreover, the endometrial thickness of HCG day in the QYP group was significantly higher than that in the placebo group (11.78±2.27 mm vs. 10.68±2.07 mm, P=0.012). Maternal and neonatal complications between the two groups were not significantly different (P>0.05). Intention-to-treat analysis was in line with PP results.Conclusions:QYP can enhance ovarian reserve capacity and ovarian response, and possibly promote endometrial receptivity. QYP effectively improves cumulative pregnancy rates in older patients (≥35 years) undergoing IVF-ET. (Registration No. ChiCTR1800014427)  
        Keywords：advanced age;Qizi Yusi Pills;in vitro fertilization-embryo transfer;randomized controlled trial   
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        Published：2022-07-20
      • Yao ZHENG,Lei LEI,Shuai LIANG,Jiao AI,Xin DENG,Yan-qiu LI,Tian-pei ZHANG,Shi-biao PU,Yong-shen REN
        2022, 28(8): 683-692. DOI: 10.1007/s11655-021-3295-8
        Abstract：目的:比较新鲜/干蒲公英提取物对对乙酰氨基酚 (APAP) 诱导的肝毒性的保护作用.方法:将90只昆明种小鼠按体重随机分为10组 (每组9只) . 正常对照组和模型 (溶媒对照) 组小鼠仅给予羧甲基纤维素钠 (CMC-Na, 0.5%) . 给药组包括: 高剂量和低剂量的干蒲公英提取物预处理组 (1000或500 g新鲜草药, 经干燥后煎煮成120 mL溶液, DDE-H和DDE-L) ; 低剂量、中剂量和高剂量蒲公英汁组 (250 g、500 g、1000 g鲜蒲公英榨汁后分别浓缩至120 mL, DJ-L、DJ-M和DJ-H) ; 新鲜蒲公英汁旋蒸水组 (120 mL, DEJW) ; 用纯水溶解的干蒲公英提取物组 (相当于1000 g鲜蒲公英干燥后提取物用纯水溶解至120 mL, DDED-PW) 及DEJW溶解的干蒲公英提取物组 (相当于1000 g鲜蒲公英干燥后提取物用DEJW溶解至120 mL, DDED-DEJW) . 上述药物以0.5 mL溶液/10 g体重的剂量经口灌胃溶解的干蒲公英提取物7天. 除正常对照组外, 其余各组均腹腔注射APAP 350mg/kg诱导肝损伤. APAP给药后20 h, 收集血清和肝组织, 用生化试剂盒定量测定血清丙氨酸氨基转移酶 (AST) 、天冬氨酸转氨酶 (ALT) 、碱性磷酸酶 (AKP) 、丙二醛 (MDA) 、谷胱甘肽 (GSH) 、超氧化物歧化酶 (SOD) 活性; 采用酶联免疫吸附测定试剂盒测定肝组织肿瘤坏死因子 (TNF-α) 、白细胞介素 (IL-2) 和白细胞介素-1β含量. 苏木精-伊红 (H&E) 染色观察肝组织病理变化; TUNEL法和Hoechst 33258染色用于细胞凋亡评估. Western blot法分析检测血红素加氧酶-1 (HO-1) 、核因子红系-2相关因子2 (Nrf-2) 、半胱天冬酶-9、B细胞白血病/淋巴瘤2 (Bcl-2) 、Bax和p-JNK表达.结果:与溶媒对照组比较, 新鲜蒲公英汁 (FDJ, 包括DJ-L、DJ-M、DJ-H、DEJW和DDED-DEJW) 预处理明显降低血清ALT、AST、AKP、TNF-α和IL-1β水平 (P<0.05或P<0.01) . 此外, 与溶媒对照组比较, FDJ可降低肝脏MDA水平, 恢复了肝脏GSH水平和SOD活性 (P<0.05或P<0.01) . FDJ抑制包括环氧合酶-2和诱导型一氧化氮合酶在内的促炎因子在肝组织中的过度表达 (P<0.05或P<0.01) . 此外, Western-blot分析显示, FDJ预处理通过降低Bax、caspase-9和JNK蛋白表达来抑制凋亡信号通路激活, 并抑制JNK通路激活 (P<0.05或P<0.01) . 肝脏组织病理学观察进一步证明FDJ预处理可明显抑制APAP诱导的肝细胞坏死、炎性细胞浸润和充血.结论:FDJ预处理可通过激活Nrf-2/HO-1通路和抑制内源性凋亡通路来保护APAP诱导的小鼠急性肝损伤, 且新鲜蒲公英提取物的作用优于干燥蒲公英提取物.  
        Keywords：fresh dandelion juice;acetaminopheninduced liver injury;oxidative stress;anti-inflammation;anti-apoptosis   
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        Published：2022-07-20
      • Xin XU,Xiao-fang XIE,Yan-hong DONG,Hui-qiong ZHANG,Cheng PENG
        2022, 28(8): 693-701. DOI: 10.1007/s11655-022-3509-0
        Abstract：目的:探讨人参皂苷Rg1 (Rg1) 和乌头碱 (AC) 对乳鼠心肌细胞 (NRCMs) 和戊巴比妥钠 (PS) 诱导的受损NRCMs的协同作用机制.方法:药物暴露1h后, 用MTT法分别筛选出AC的毒性、无毒性和有效剂量, 及Rg1对正常和受损NRCMs的最适配伍浓度. 然后, 筛选出的不同浓度的AC单独或与Rg1配伍, 与正常或受损的NRCMs 共同孵育1小时, 观察细胞活性、细胞超微结构、凋亡、酸性磷酸酶 (ACP) 和乳酸脱氢酶 (LDH) 水平、细胞内钠离子[Na+]、钾离子[K+]和钙离子[Ca2+]水平以及Nav1.5、Kv4.2和RyR2基因的表达.结果:对于正常NRCMs, 3000μmol/L AC显著抑制细胞活力 (P<0.01) , 促进细胞凋亡, 破坏细胞结构 (P<0.05) , 低于3000μmol/L的低剂量AC和AC与Rg1的配伍对NRCMs的毒性较小. 与AC单独作用于NRCMs比较, 3000μmol/L和10μmol/L AC与1μmol/L Rg1配伍显著降低细胞内Ca2+水平 (P<0.01和P<0.05) , 3000μmol/L AC与1μmol/L Rg1配伍通过调节Nav1.5和RyR2表达显著降低细胞内Ca2+水平 (P<0.01) . 对于受损NRCMs, 1500μmol/L AC加重了细胞损伤 (P<0.01) , 0.1μmol/L和0.001μmol/L AC对受损NRCMs具有一定的保护作用. 与AC单独作用比较, Rg1与AC的配伍减少了细胞损伤, 0.1μmol/L AC与1μmol/L Rg1配伍显著抑制细胞内Na+水平 (P<0.05) , 1500μmol/L AC与1μmol/L Rg1配伍通过调节受损NRCMs中Nav1.5、Kv4.2、RyR2的表达显著抑制细胞内K+水平 (P<0.01) .结论:Rg1通过调节[Na+]、[K+]和[Ca2+]离子通道, 抑制了AC的心脏毒性, 增强了AC的强心作用.  
        Keywords：aconitine;ginsenoside Rg1;compatibility;ion channel pathway;cardiomyocytes   
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        Published：2022-07-20
      • Yue-jun LI,Lin-li LIAO,Pei LIU,Ping TANG,Hong WANG,Qing-hua PENG
        2022, 28(8): 702-710. DOI: 10.1007/s11655-021-3314-9
        Abstract：目的:探讨四君子汤对胃癌细胞的抑制作用及分子机制.方法:MKN74和MKN45是两种具有干细胞性质的CD44阳性胃癌细胞系. 将细胞分为治疗组及对照组. 治疗组给予四君子汤水提醇沉物(1-5 mg/mL)治疗, 疗程48 h-14 d. 对照组给予等体积的磷酸盐缓冲盐水治疗. 采用细胞计数试剂盒8 (CCK-8) 法测定细胞活力. 通过克隆成球实验和胃癌肿瘤干细胞标记物表达检测胃癌肿瘤干细胞干性. 采用核质分离实验和染色质免疫共沉淀法分别测定四君子汤水提醇沉物处理后β-catenin的细胞内分布和DNA结合活性.结果:四君子汤水提醇沉物抑制MKN74和MKN45细胞株的生长并诱导其凋亡(P<0.05). 四君子汤水提醇沉物可明显抑制胃癌细胞克隆成球能力和胃癌肿瘤干细胞标记物的表达(P<0.05). 在分子机制上, β-catenin是维持胃癌肿瘤干细胞干性的关键调控因子. 四君子汤水提醇沉物科明显降低β-catenin的细胞核内聚集和DNA结合活性(P<0.05).结论:四君子汤通过降低β-catenin转录活性, 抑制胃癌肿瘤干细胞干性.  
        Keywords：Sijunzi Decoction;Chinese medicine;gastric cancer;cancer stem cells;β-catenin   
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        Published：2022-07-20
      • Hai-yan CHEN,Shu ZHANG,Jun LI,Na HUANG,Jin SUN,Bao-hua LI,Jun YANG,Zong-fang LI
        2022, 28(8): 711-718. DOI: 10.1007/s11655-022-3510-7
        Abstract：目的:探讨黄芩素对脓毒症所诱发的免疫功能障碍和器官损伤的作用研究.方法:采用盲肠结扎穿刺法(CLP)建立SD大鼠脓毒症模型. 将无特异致病菌的大鼠随机分为假手术组、CLP组和CLP +黄芩素组 (n = 16/组). CLP + Bai组的大鼠在CLP造模后的1小时和10小时分别静脉注射黄芩素(20 mg/kg). 评估各组大鼠的生存率、细菌载量和器官损伤. 然后在6、12、24 h, 对每组进行评估并观察黄芩素对脓毒症大鼠的免疫细胞和炎性细胞因子的影响.结果:黄芩素治疗能显著提高脓毒症大鼠的存活率, 降低细菌载量, 通过苏木精和伊红染色观察到可以减轻组织损伤(脾脏、肝脏和肺). 黄芩素处理后脓毒症大鼠的外周血和脾脏中发现, CD3+CD4+ T细胞比例及CD4+/CD8+比值显著升高 (均P<0.05). 而且, 黄芩素能降低造模后24 h的脓毒症大鼠的白细胞和脾脏细胞凋亡率(P<0.05). 黄芩素还能显著降低脾脏中肿瘤坏死因子α和白细胞介素-6 (IL-6)的水平, 升高IL-10的水平, 并能显著提高galectin - 9的表达水平(P<0.01).结论:黄芩素可能是一种有效的免疫调节剂, 可减轻严重腹腔性脓毒症的压倒性炎症反应.  
        Keywords：黄芩素;中药;脓毒症;脾脏;炎症;淋巴细胞   
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        Published：2022-07-20
      • Yoona Oh,Hongbum Lee,Beodeul Yang,Kim Sura,Hyunwoo Jeong,Hyungwoo Kim
        2022, 28(8): 719-724. DOI: 10.1007/s11655-022-3517-0
        Abstract：Objective:To investigate the anti-inflammatory potential of Ampelopsis japonica on contact dermatitis (CD).Methods:A total of 38 Balb/c mice were divided into 5 groups by using a random number table: normal mice (n=6), CD model mice (n=8), CD mice treated with 3 or 30 mg/kg of the ethanol extract of A. japonica (EEAJ, n=8) and 7.5 mg/kg dexamethasone treated CD mice (DEX, n=8). CD was induced using topical application of 1-fluoro-2,4-dinitrofluorobenzene in mice. EEAJ and DEX were topically applied to the shaved skin of each mouse for 6 days, and the effects of EEAJ and DEX on skin lesions and color, histopathological abnormalities such as epidermal hyperplasia and immune cell infiltration, and tumor necrosis factor (TNF)-α, interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1) production were investigated. The effects on changes in body weights and spleen/body weight ratio were also investigated.Results:EEAJ at 30 mg/kg significantly prevented scaling, erythema and enlargement of skin weight compared to using carbon dioxide. EEAJ also prevented epithelial hyperplasia and immune cell infiltrations induced by repeated application of DNFB (P<0.01). In addition, EEAJ significantly lowered levels of TNF-α, IL-6 and MCP-1 (P<0.05 or P<0.01). The anti-inflammatory effects of EEAJ were similar to those of DEX.Conclusion:A. japonica may be a new therapeutic agent with the potential to reduce or replace corticosteroids and its mechanisms are closely related to regulation of TNF-α production.  
        Keywords：Ampelopsis japonica;Chinese medicine;inflammation;dermatosis;contact dermatitis   
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        Published：2022-07-20
      • Chien-ming CHU,Chih-wen CHI,Chih-hung HUANG,Yu-jen CHEN
        2022, 28(8): 725-729. DOI: 10.1007/s11655-021-3502-7
        Abstract：Objective:To investigate the effect of M3P (containing Deer antler, Cordyceps sinensis, Rhodiola rosea, and Panax ginseng); an herbal remedy with the function of tonifying Kidney (Shen) and invigorating Spleen (Pi), replenishing qi and nourishing blood; on fatigue alleviation, endurance capacity and toxicity.Methods:Swimming with weight-loading of 24 male ICR mice was used to evaluate the endurance capacity, and fatiguerelated plasma biomarkers were determined. Mice were randomly assigned to control or M3P treatment groups with 6 mice for each group and were orally administered with M3P everyday for 8 weeks at doses 0, 10, 33 or 100 mg/kg. Swimming time to exhaustion was measured in a specialized water tank. Lliver and kidney functions, body weight, and hematological profile were determined to evaluate the safety and toxicity after long-term M3P administration.Results:M3P supplementation 100 mg/kg significantly increased swimming endurance time up to approximate 2.4 folds of controls (P<0.05). The plasma concentrations of cortisol and hepatic glycogen content were significantly increased in mice received M3P (P<0.05, P<0.01 respectively). The lactic acid level and blood glucose were not changed after M3P treatment (P>0.05). The liver and kidney functions muscle damage biomarker creatine, body weight, and hemograms were not altered in M3P supplementation (P>0.05).Conclusion:M3P supplementation may improve swimming endurance accompanied by increasing hepatic glycogen content and serum cortisol level without major toxicity.  
        Keywords：swimming endurance;fatigue;tonifying Kidndy (Shen) and invigorating Spleen (Pi);replenishing qi and nourishing blood;M3P;mice;Chinese medicine   
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        Published：2022-07-20

        Acupuncture Research

      • 魏华,黄俊生,赵芳,解志强,夏之阳,甘建辉
        2022, 28(8): 730-735. DOI: 10.1007/s11655-022-3516-1
        Abstract：目的:评价经皮穴位刺激 (TEAS) 对改善接受视频辅助胸腔镜手术 (VATS) 的老年患者术后认知功能的有效性和安全性.方法:从2020年1月至12月, 97名参与者通过随机数字表被随机分配到TEAS组 (49例) 和对照组 (48例) . TEAS组的患者接受TEAS, 在双侧内关 (PC 6) 和足三里 (ST 36) 穴位. 对照组接受假的TEAS. 刺激从手术前30分钟开始, 直到手术结束. 主要结果是术后认知功能障碍 (POCD) 的发生率, 根据小型精神状态检查 (MMSE) 和蒙特利尔认知评估 (MoCA) 分数的变化进行诊断. 次要结果是血浆中S100β蛋白和神经元特异性烯醇化酶 (NSE) 的水平.结果:TEAS组术后第1天和第3天的POCD发生率明显低于对照组[术后第1天: 28.3% (13/46) vs. 52.3% (23/44) , P=0.028; 术后第3天: 21.7% (10/46) vs. 40.9% (18/44) , P=0.043] . 与基线相比, 两组的MMSE和MoCA得分都有不同程度的下降. TEAS组术后第1、3、5天MMSE评分及术后第1、3、5、7天MoCA评分均高于对照组(均P < 0.05 ). 与基线比较, 术后4、8、12、24 h血浆S100β、NSE水平明显升高(均P < 0.05 ). 与对照组比较, TEAS组在术后4、8、12、24 h血浆S100β、NSE水平均较低(均P < 0.05 ). 试验期间未发现明显不良事件.结论:VATS术后老年患者应用TEAS可降低POCD发生率, 改善术后认知功能.  
        Keywords：经皮穴位电刺激;电视胸腔镜手术;高龄;术后认知功能障碍   
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        Published：2022-07-20

        Clinical Experience

      • Jia-man WU,Yan NING,Yang-yang YE,Yu-lei LIU,Meng TANG,Shan HU,Yuan-yuan ZHUO
        2022, 28(8): 736-742. DOI: 10.1007/s11655-022-3498-z
        Abstract：目的:观察针刺对于行体外受精-胚胎移植的多囊卵巢患者子宫内膜及妊娠结局的影响.研究方法:用SPSS软件随机数字表将83名患者随机分为观察组 (40例) 和实验组 (43例) . 两组患者均将GnRH激动剂长方案作为常规治疗, 观察组患者每隔一天针刺两组不同的穴位各30分钟. 第一组针刺关元 (CV4) 、气海 (CV6) 、中极 (CV3) 及双侧子宫穴 (EX-CA1) , 第二组针刺命门 (GV4) 、腰阳关 (GV3) 、双侧肾俞 (BL23) 及次髎穴 (BL32) , 两组针刺穴位交替进行. 整个针刺治疗过程从促排卵时开始持续到移植日当天, 总共3个周期, 而实验组未给予针刺治疗. 观察两组患者的Gn剂量和Gn刺激时长, 子宫内膜厚度和类型 (A, B, C) , 人绒毛膜促性腺激素 (HCG) 注射日当天的雌二醇 (E2) 和孕酮 (P) 水平, 临床妊娠率及胎儿活产率. 记录实验过程中的不良反应, 随访全部患者体外受精—胚胎移植后14天的妊娠率及孕后的胎儿活产率, 试验中所有的针刺不良反应均已记录.结果:观察组的Gn剂量和Gn刺激时长低于实验组 (P<0.01) ; 观察组中A型子宫内膜比例高于实验组 (P<0.05) ; 与实验组相比, 观察组在HCG注射日当天E2和P的水平降低, 临床妊娠率更高 (P<0.05) , 本实验过程中无明显不良反应.结论:针刺可以增加A型子宫内膜占比, 控制HCG注射日E2和P值水平, 改善行体外受精—胚胎移植多囊卵巢不孕患者的妊娠率.  
        Keywords：acupuncture;in vitro fertilization-embryo transfer;polycystic ovarian syndrome;endometrium   
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        Published：2022-07-20

        Evidence-Based Integrative Medicine

      • Qin-wei FU,Miao LIU,Lan-zhi ZHANG,Hui YANG,Le-qi ZHANG,Sha-sha YANG,Yan XIE,Xin-xin WAN,Yong TANG,Qin-xiu ZHANG
        2022, 28(8): 743-752. DOI: 10.1007/s11655-022-3722-5
        Abstract：目的:通过评价现有随机对照试验 (RCT) 以研究头部针刺联合Schuell’s言语康复疗法治疗中风后失语症的有效性与安全性证据.方法:截止2021年11月14日, 检索了3个英文数据库和4个中文数据库以获取相关RCT. 纳入标准中, 试验组干预措施为头部针刺联合Schuell’s言语康复疗法, 同时符合假干预 (或空白对照) 、单纯针刺疗法、单纯言语康复疗法, 或单独使用其它对照干预措施的RCT被纳入. 在对数据进行提取、评估, 并评价纳入RCT质量后, 使用固定效应模型进行分析. 依次使用meta影响性分析、meta回归分析、基于回归的亚组分析以解释结果的异质性. 使用树状图和Egger’s检验检测结果的发表偏倚.结果:共纳入32项RCT, 包含1968位中风后失语症者. 基于不同中风种类与失语症类型, 共划分并分析比较组51组, 结果显示: (1) 对于缺血性中风后失语症患者, 头部针刺联合Schuell’s言语康复疗法显著提高了累积显效率[风险比 (RR) =1.55, 95%置信区间 (CI) : 1.19-2.02, (异质性) I2=0%]和累积有效率 (RR=1.22, 95% CI: 1.36-1.72, I2=0%) ; (2) 对于综合种类中风后失语症患者, 头部针刺联合Schuell’s言语康复疗法显著提高了治愈率 (RR=1.89, 95% CI: 1.39-2.56, I2=0%) 、累积显效率 (RR=1.53, 95% CI: 1.36-1.72, I2=9%) 和累积有效率 (RR=1.14, 95% CI: 1.09-1.19, I2=34%) ; (3) 对于中风后运动性失语症患者, 头部针刺联合Schuell’s言语康复疗法显著提高了治愈率 (RR=2.08, 95% CI: 1.24-3.46, I2=0%) 、累积显效率 (RR=1.49, 95% CI: 1.24-1.78, I2=0%) 和累积有效率 (RR=1.15, 95% CI: 1.06-1.24, I2=39%) ; (4) 对于中风后综合类型失语症患者, 头部针刺联合Schuell’s言语康复疗法显著提高了治愈率 (RR=1.86, 95% CI: 1.28-2.72, I2=0%) 、累积显效率 (RR=1.55, 95% CI: 1.35-1.78, I2=22%) 和累积有效率 (RR=1.17, 95% CI: 1.11-1.23, I2=41%) ; (5) 对于缺血性中风后运动性失语症患者, 头部针刺联合Schuell’s言语康复疗法显著提高了累积显效率 (RR=1.38, 95% CI: 1.06-1.79, I2=0%) 和累积有效率 (RR=1.20, 95% CI: 1.05-1.37, I2=0%) . Meta回归分析结果显示试验组干预措施有效性并未随疾病、干预措施特征改变而变化.结论:对于中风后失语症患者, 头部针刺联合Schuell’s言语康复疗法可显著改善言语能力, 提高治疗有效率. 头部针刺操作应谨慎, 尤其当穴区在眼部、颈项部时.  
        Keywords：language rehabilitation;head acupuncture;stroke;aphasia;systematic review;meta-analysis   
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        Review

      • 远佳瑶,符宇,冯志海,桑锋,邵明义,李蕾蕾
        2022, 28(8): 753-761. DOI: 10.1007/s11655-022-3513-4
        Abstract：核苷酸结合寡聚化结构域样受体3 (NLRP3) 是一种能识别内源性危险信号和外源性刺激物并诱导NLRP3炎症小体组装的胞内感受蛋白. NLRP3炎症小体的激活能够诱导促炎因子白介素 (IL) -1β、IL-18的表达和细胞焦亡. 研究显示, NLRP3炎症小体能够通过胰岛β细胞功能障碍, 胰岛素抵抗, 血管内皮细胞损伤、单核细胞黏附和浸润, 平滑肌细胞增殖和迁移等病理机制, 参与糖尿病动脉粥样硬化的发生和发展. 已经有研究显示, 中医药能够调控NLRP3炎性小体介导的炎症反应从而改善糖尿病动脉粥样硬化. 本文就NLRP3炎症小体在糖尿病动脉粥样硬化发病机制和中医药治疗中的最新进展进行综述.  
        Keywords：中医药;糖尿病动脉粥样硬化;核苷酸结合寡聚化结构域样受体3 (NLRP3) 炎症小体;白介素 (IL) -1β;硫氧还蛋白结合蛋白 (TXNIP);细胞焦亡   
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      • Jing MING,Wei-yi LIU,Hai-yan XIAO,Yong-gang XU,Rou MA,Xiao-mei HU
        2022, 28(8): 762-768. DOI: 10.1007/s11655-020-3254-9
        Abstract：青黄散 (QHP) 是一种口服砷剂, 多年来已成为中国中医科学院西苑医院治疗骨髓增生异常综合征 (MDS) 的有效药物, QHP 的活性成分 As2S2 已被阐明. 考虑到相对安全、免化疗和口服方便的特点, QHP已被广泛用于MDS患者的临床治疗, 尤其是老年患者的治疗. 在这篇综述中, 作者概述了口服含砷化合物 QHP 治疗 MDS 的疗效和安全性, 特别关注 QHP 疗效与细胞遗传学、预后风险、DNA 甲基化、基因突变、血砷浓度、As2S2作用机制及胃肠道不良反应对策.  
        Keywords：arsenic;Qinghuang Powder;myelodysplastic syndromes;review;Chinese medicine   
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