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      Adjuvant therapy efficacy of Chinese drugs pharmaceutics for COPD patients with respiratory failure: a meta-analysis

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          Abstract

          We performed a meta-analysis to evaluate the efficacy and safety of Western medicine combined with Tanreqing for patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. We comprehensively searched several online databases from the times of their inception to November 2018. The trial quality was assessed using the bias risk tool recommended by the Cochrane library. Relative risks (RRs) and their 95% confidence intervals (CIs) for binary outcomes and weighted mean differences (MDs) with 95% CIs for continuous data were calculated. A fixed effect model indicated that integrated Tanreqing group experienced higher overall treatment effectiveness (RR = 1.23, 95% CI: 1.17–1.30, P=0.000). Pooled results from random effects models indicated the oxygen partial pressure of the test group was significantly higher than that of the control groups (MD = 9.55, 95% CI: 4.57–14.52, P<0.000). The carbon dioxide pressure of the test group was significantly lower than that of the control groups (MD = –6.06, 95% CI: –8.19 to –3.93, P=0.000). The lung function score of the test group was significantly higher than that of the control group (MD = 7.87, 95% CI: 4.45–11.29). Sensitivity analysis indicated that the data were statistically robust. Clinical effects of Western medicine combined with Tanreqing used to treat combined COPD/respiratory failure were better than those afforded by Western medicine; no serious adverse reactions were noted. However, publication bias was evident, and further trials with larger sample sizes are required.

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          Cytotoxicity, antiviral and antimicrobial activities of alkaloids, flavonoids, and phenolic acids.

          Some natural products consisting of the alkaloids yohimbine and vincamine (indole-type), scopolamine and atropine (tropane-type), colchicine (tropolone-type), allantoin (imidazolidine-type), trigonelline (pyridine-type) as well as octopamine, synephrine, and capsaicin (exocyclic amine-type); the flavonoid derivatives quercetin, apigenin, genistein, naringin, silymarin, and silibinin; and the phenolic acids namely gallic acid, caffeic acid, chlorogenic acid, and quinic acid, were tested for their in vitro antiviral, antibacterial, and antifungal activities and cytotoxicity. Antiviral activity of the compounds was tested against DNA virus herpes simplex type 1 and RNA virus parainfluenza (type-3). Cytotoxicity of the compounds was determined using Madin-Darby bovine kidney and Vero cell lines, and their cytopathogenic effects were expressed as maximum non-toxic concentration. Antibacterial activity was assayed against following bacteria and their isolated strains: Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis, and Bacillus subtilis, although they were screened by microdilution method against two fungi: Candida albicans and Candida parapsilosis. Atropine and gallic acid showed potent antiviral effect at the therapeutic range of 0.8-0.05 µg ml(-1), whilst all of the compounds exerted robust antibacterial effect. Antiviral and antimicrobial effects of the compounds tested herein may constitute a preliminary step for further relevant studies to identify the mechanism of action.
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            Pharmacological effects and pharmacokinetics properties of Radix Scutellariae and its bioactive flavones.

            Radix Scutellariae is the dried root of the medicinal plant Scutellariae baicalensis Georgi. It exhibits a variety of therapeutic effects and has a long history of application in traditional formulations as well as in modern herbal medications. It has been confirmed that flavonoids are the most abundant constituents and induce these therapeutic effects. Six flavones are proven to be the major bioactive flavones in Radix Scutellariae existing in the forms of aglycones (baicalein, wogonin, oroxylin A) and glycosides (baicalin, wogonoside, oroxylin A-7-glucuronide). All six flavones are pharmacologically active and show great potential in the treatment of inflammation, cancers and virus-related diseases. The current review covers the preparation of the herb Radix Scutellariae, quantification of its major bioactive ingredients, and pharmacological effects of the proposed six bioactive flavones. In addition, this review summarizes the pharmacokinetic profiles of the bioactive flavones reported so far that could be used for further improvement of their pharmacokinetic study. Moreover, due to abundant co-occurring bioactive components in Radix Scutellariae, our review further documents the pharmacokinetic interactions among them. Copyright © 2011 John Wiley & Sons, Ltd.
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              Acute exacerbations and respiratory failure in chronic obstructive pulmonary disease.

              Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) describe the phenomenon of sudden worsening in airway function and respiratory symptoms in patients with COPD. These exacerbations can range from self-limited diseases to episodes of florid respiratory failure requiring mechanical ventilation. The average patient with COPD experiences two such episodes annually, and they account for significant consumption of health care resources. Although bacterial infections are the most common causes of AECOPD, viral infections and environmental stresses are also implicated. AECOPD episodes can be triggered or complicated by other comorbidities, such as heart disease, other lung diseases (e.g., pulmonary emboli, aspiration, pneumothorax), or systemic processes. Pharmacologic management includes bronchodilators, corticosteroids, and antibiotics in most patients. Oxygen, physical therapy, mucolytics, and airway clearance devices may be useful in selected patients. In hypercapneic respiratory failure, noninvasive positive pressure ventilation may allow time for other therapies to work and thus avoid endotracheal intubation. If the patient requires invasive mechanical ventilation, the focus should be on avoiding ventilator-induced lung injury and minimizing intrinsic positive end-expiratory pressure. These may require limiting ventilation and "permissive hypercapnia." Although mild episodes of AECOPD are generally reversible, more severe forms of respiratory failure are associated with a substantial mortality and a prolonged period of disability in survivors.
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                Author and article information

                Journal
                Biosci Rep
                Biosci. Rep
                ppbioscirep
                BSR
                Bioscience Reports
                Portland Press Ltd.
                0144-8463
                1573-4935
                21 February 2019
                30 April 2019
                05 April 2019
                : 39
                : 4
                : BSR20182279
                Affiliations
                [1 ]Department of Integrated Traditional Chinese and Western Medicine On Oncology, Tangshan People’s Hospital, Tangshan 063000,China
                [2 ]Department of TCM Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
                [3 ]Department of Respiration, Xuanwu TCM Hospital Beijing, Beijing 10000, China
                Author notes
                Correspondence: Chunqiu Liu ( liuchunqiu86@ 123456163.com ).
                Author information
                http://orcid.org/0000-0001-6193-3566
                Article
                10.1042/BSR20182279
                6449520
                30792261
                2098bbf6-ba07-48cc-a429-1905fe1d88c5
                © 2019 The Author(s).

                This is an open access article published by Portland Press Limited on behalf of the Biochemical Society and distributed under the Creative Commons Attribution License 4.0 (CC BY).

                History
                : 11 December 2018
                : 24 January 2019
                : 29 January 2019
                Page count
                Pages: 10
                Categories
                Research Articles
                Research Article
                49
                48

                Life sciences
                chronic obstructive pulmonary disease,meta-analysis,respiratory failure
                Life sciences
                chronic obstructive pulmonary disease, meta-analysis, respiratory failure

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