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Aim: To reinvestigate the chemical constituents of the ethanolic extract of Meconopsis quintuplinervia Regel which is a traditional Tibetan medicine used for treatments of hepatitis, tuberculosis etc..; Methods: The compounds were enriched by column chromatography techniques over silica gel, macro porous resin and Sephadex LH-20 absorbents, and finally purified by reverse phase preparative HPLC methods with isocratic mobile phase systems of methanol-H2O-acetic acid (500:500:1) and acetonitrile-H2O-acetic acid (200:800:1). Structural determination of the pure compounds were based on extensive analyses of modern spectroscopic methods including IR, MS, HRMS, 1D- and 2D-NMR spectra.; Results: Three alkaloids were obtained and their structures were elucidated as norsanguinarine (I), O-methylflavinantine (II) and 6-methoxy-17-methyl-2, 3-[methylenebis (oxy)]-morphin-5-en-7-one (III).; Conclusion: Norsanguinarine (I) was isolated from genus Meconopsis for the first time, and 6-methoxy-17-methyl-2,3-[methylenebis(oxy)]-morphin-5-en-7-one (III) is a new alkaloid named as meconoquintupline.;

Background: Swertia chirayita, has been commonly used under the name "Zang-yin-chen" for the treatment of liver infections, inflammation, abdominal pain, and bacterial infection in traditional Tibetan medicine. However, the bioactive components with anti-inflammatory activities and underlying mechanisms remain poorly evaluated.Study Design/methods: Repeated column chromatography yielded two main xanthones from petroleum ether (PE) and ethyl acetate fractions of whole plants of S. chirayita, and their structures were determined as bellidifolin (1) and swerchirin (2) on the basis of spectroscopic data and literature analysis. The anti-inflammatory activities and mechanisms of anti-inflammation of these two isolated xanthones were determined via enzyme-linked immunosorbent assay (ELISA) and western blot in lipopolysaccharide (LPS)-stimulated RAW 264.7 murine macrophages in vitro.Results: Anti-inflammation assay demonstrated that 1 and 2 inhibit the production of the pro-inflammatory cytokines interleukin-6 (IL-6) and TNF-α in LPS-stimulated RAW 264.7 macrophages. Xanthone 1 also potently inhibited the production of prostaglandin E2 (PGE2) by suppressing the protein expression of cyclooxygenase-2 (COX-2) in LPS-stimulated RAW 264.7 macrophages. Western blot showed that the phosphorylation of c-Jun N-terminal kinases (JNK), extracellular signal-regulated kinase (ERK), and p38 MAPKs were remarkably attenuated by 1 in a concentration-dependent manner. Particularly, Compound 1 suppressed the phosphorylation of the inhibitor κB kinase-β (IKK-β), Akt, and p65 subunit of nuclear factor-kappaB (NF-κB).Conclusion: The potent suppressive effects of 1 from S. chirayita on inflammatory mediators by blocking the expression of COX-2 and phosphorylation of Akt, IKK-β, MAPK and NF-κB, activation in LPS-stimulated macrophages suggest that 1 can be a preventive therapeutic candidate for the management of inflammatory-mediated immune disorders.

As important secondary plant metabolites, naphthoquinones exhibit a wide range of biological activities. However, their potential as sustainable alternatives to synthetic acaricides has not been studied. This study for the first time investigates the acaricidal activity of naphthoquinones against Psoroptes cuniculi in vitro. Furthermore, the in vivo activity, the skin irritation effects, the cytotoxicity and the inhibitory activities against mite acetylcholinesterase (AChE) and glutathione S-transferase (GST) of the two compounds that displayed the best insecticidal activity in vitro were evaluated. Among fourteen naphthoquinones and their analogs, juglone and plumbagin were observed to possess the strongest acaricidal activities against P. cuniculi with LC50 values of 20.53 ppm and 17.96 ppm, respectively, at 24 h. After three treatments, these two chemicals completely cured naturally infested rabbits in vivo within 15 days, and no skin irritation was found in any of the treated rabbits. Compared to plumbagin, juglone presented no or weak cytotoxicity against HL-7702 cells. Moreover, these two chemicals significantly inhibited AChE and GST activity. These results indicate that juglone has promising toxicity against P. cuniculi, is safe for both humans and animals at certain doses, and could be used as a potential alternative bio-acaricide for controlling the development of psoroptic mange in agricultural applications.

BACKGROUND: Conventional medicine, lifestyle modification, and complementary and alternative medicine (CAM) are potential strategies to decrease the risk of late effects in pediatric cancer survivors. This study aimed to compare the characteristics and usage patterns of CAM and lifestyle therapies among survivors of childhood cancer. METHODS: We report the results of a cross sectional survey comparing usage patterns of CAM and lifestyle therapies among childhood cancer survivors. CAM therapies were defined by NCCAM classifications and lifestyle therapies were defined as dietary changes, conventional supplements with dietary reference intake values, and exercise. RESULTS: One hundred fifty-five (95%) patients approached in person and 45 (34%) patients approached by mail consented to participate. Sixty-eight used at least one lifestyle therapy and 58% used at least one CAM therapy. CAM users had 4.7 times the odds of using lifestyle therapies than non-CAM users (P < .0001); the odds of using dietary change and conventional supplements was greater in CAM users than non-CAM users (odds ratio [OR] = 3.55, P < .0001 and OR = 4.80, P < .0001 respectively). Use of the top three CAM therapies was associated with overall lifestyle therapy use (OR = 12.52 and P < .0001, OR = 7.071 and P = .0004, and OR = 2.925 and P = .0089 for juicing, yoga/movement, and touch therapies, respectively). Lifestyle therapies and CAM had similar perceived efficacy (92%-90%, respectively). CONCLUSIONS: This data reports a strong association between CAM and lifestyle therapies and may identify a population with commitment to general wellness. Use of one therapy may promote use of other therapies and this potential synergistic relationship can be targeted in future interventions.

ETHNOPHARMACOLOGICAL RELEVANCE: Rhodiola sacra (Crassulaceae) exhibits cardiovascular bioactivities and is used in Tibetan medicine for promoting circulation and preventing hypertension. However, the underlying mechanisms of its cardiovascular effects are poorly understood.AIM OF THE STUDY: The aim of this study was therefore to evaluate the cardiovascular activity of water-soluble fraction (WtF) and n-butanol-soluble fraction (BtF) of Rhodiola sacra radix and to explore its mechanism of action in propofol anesthetized Sprague-Dawley rats. MATERIALS AND METHODS: The changes of blood pressure, heart rate and cardiac contractility after systemic administration of the extracts (10-75 mg/kg) were examined for at least 40 min. Different antagonists were used to evaluate the mechanisms of cardiovascular effects of the extracts. RESULTS: Intravenous injection of the WtF (10, 25, 35, 50 or 75 mg/kg) exhibited dose-dependent hypotension and increases in heart rate and cardiac contractility. In contrast, mild alterations in the same cardiovascular parameters were detected only at high dose (75 mg/kg) BtF. The WtF-induced hypotensive, positive inotropic and chronotropic effects were significantly abolished by pretreatment with hexamethonium (30 mg/kg, i.v.) or reserpine (5 mg/kg, i.v.), whereas the hypotensive, but not the positive inotropic or chronotropic effect was potentiated by captopril (2.5 mg/kg, i.v.). Pretreatment with methylatropine (1 mg/kg, i.v.), on the other hand, reversed the positive inotropic and chronotropic but not the hypotensive effects of WtF. The WtF-induced cardiovascular responses were not affected in rats pretreated with N(G)-nitro-l-arginine methyl ester (20 mg/kg, i.v.). CONCLUSIONS: We conclude that systemic administration of the WtF of Rhodiola sacra radix elicited a potent hypotensive effect that was mediated by the withdrawal of sympathetic vasomotor tone and interaction with the circulatory angiotensin system. The positive inotropic and chronotropic effects of WtF may result from a direct vagal inhibition on the heart.

ObjectiveThis study investigates the breathing frequency (BF)-independent effect of Tai Chi Chuan (TCC) on autonomic nervous modulation in TCC practitioners.MethodsTwenty-five TCC practitioners and 25 sedentary normal controls were recruited. The stationary heart rate variability (HRV) measures of TCC practitioners and controls were compared. The same HRV measures in TCC practitioners and among the controls, TCC practitioners before TCC and TCC practitioners 30 min after TCC were compared.ResultsIn TCC practitioners, the BF, normalized high-frequency power (nHFP), and normalized very low-frequency power were significantly increased, while the normalized low-frequency power (nLFP) was significantly decreased 30 min after TCC. The BF correlated significantly and negatively with heart rate (HR), nHFP and nLFP, and correlated significantly and positively with mean RR interval (MnRR) before TCC in TCC practitioners. A slower BF is associated with a higher HR, a greater vagal modulation, and a greater combined sympatho-vagal modulation before TCC. To remove the effect of BF on HRV measures, new indices such as HR*BF, nHFP*BF, nLFP*BF, and MnRR/BF were introduced for comparison among the controls, TCC practitioners before TCC, and TCC practitioners 30 min after TCC. Thirty minutes after TCC, the MnRR/BF of TCC practitioner was smaller whereas HR*BF and nHFP*BF were greater than those before TCC.InterpretationThe BF-independent effects of TCC on the autonomic nervous modulation of TCC practitioners are an increase in vagal modulation and HR, and a decrease in mean RR interval. The mechanism underlying the parallel increase in HR and vagal modulation in TCC practitioners is not understood yet at present.

Background: Meditation refers to a group of practices commonly proposed to treat stress-related conditions and improve overall wellness. In particular, meditation might exert beneficial actions on heart rate variability (HRV) by acting on autonomic tone with an increase in the vagal activity. The effects of heartfulness meditation (HM) on HRV remain poorly defined. Methods: We investigated the effects of HM on HRV in a group of 26 healthy subjects. Subjects were regularly practicing this form of meditation on a daily basis. We assessed the HRV and residual HRV (rHRV) at rest and during meditation. We also used as control a period of respiratory rhythm imposed by an auditory signal, with the imposed breathing rhythm being identical to the spontaneous rhythm recorded during meditation. Results: During deep meditation period, the standard deviation of RR intervals (SDRR), coefficient of variation of RR intervals (CVRR), and total power (TP) were decreased while the low-frequency power (LFP), normalized LFP (nLFP), and normalized residual LFP (nrLFP) were increased as compared with those at rest, suggesting that the global vagal modulation was suppressed while the baroreflex was increased during deep medication. At the end of meditation, the LFP, residual LFP (rLFP), nLFP, nrLFP, low-/high-frequency power ratio (LHR), and residual LHR (rLHR) were increased while the residual very low-frequency power (rVLFP), normalized high-frequency power (nHFP), and normalized residual HFP (nrHFP) were decreased, as compared with those during paced breathing, suggesting that the vagal modulation was decreased while the sympathetic modulation was increased by deep meditation. During paced breathing period, the SDRR, CVRR, TP, LFP, rLFP, nLFP, nrLFP, LHR, and rLHR were decreased while nHFP and nrHFP were increased as compared with at rest, suggesting that paced breathing could suppress the sympathetic modulation and enhance the vagal modulation. Conclusion: HM can induce a suppression of global vagal modulation and increased the sympathetic modulation and baroreflex. In addition, paced breathing can suppress the sympathetic modulation and enhance the vagal modulation. Unlike studies using other types of meditation, we did not identify evidence of increased vagal tone during HM.

The figwort genus <i>Scrophularia</i> L. (Scrophulariaceae) comprises 200-300 species and is widespread throughout the temperate Northern Hemisphere. Due to reticulate evolution resulting from hybridization and polyploidization, the taxonomy and phylogeny of <i>Scrophularia</i> is notoriously challenging. Here we report the complete chloroplast (cp) genome sequences of <i>S. henryi</i> Hemsl. and <i>S. dentata</i> Royle ex Benth. and compare them with those of <i>S. takesimensis</i> Nakai and <i>S. buergeriana</i> Miq. The <i>Scrophularia</i> cp genomes ranged from 152 425 to 153 631 bp in length. Each cp genome contained 113 unigenes, consisting of 78 protein-coding genes, 31 transfer RNA genes, and 4 ribosomal RNA genes. Gene order, gene content, AT content and IR/SC boundary structure were nearly identical among them. Nine cpDNA markers (<i>trnH-psbA</i>, <i>rps15</i>, <i>rps18-rpl20</i>, <i>rpl32-trnL</i>, <i>trnS-trnG</i>, <i>ycf15-trnL</i>, <i>rps4-trnT</i>, <i>ndhF-rpl32</i>, and <i>rps16-trnQ</i>) with more than 2% variable sites were identified. Our phylogenetic analyses including 55 genera from Lamiales strongly supported a sister relationship between ((Bignoniaceae + Verbenaceae) + Pedaliaceae) and (Acanthaceae + Lentibulariaceae). Within Scrophulariaceae, a topology of (<i>S. dentata</i> + (<i>S. takesimensis</i> + (<i>S. buergeriana</i> + <i>S. henryi</i>))) was strongly supported. The crown age of Lamiales was estimated to be 85.1 Ma (95% highest posterior density, 70.6-99.8 Ma). The higher core Lamiales originated at 65.6 Ma (95% highest posterior density, 51.4-79.4 Ma), with a subsequent radiation that occurred in the Paleocene (between 55.4 and 62.3 Ma) and gave birth to the diversified families. Our study provides a robust phylogeny and a temporal framework for further investigation of the evolution of Lamiales.

The comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in view of history development, theoretic basis, bloodletting location, bloodletting tool, operation method, bloodletting amount, indications, contraindications and the others are conducted in this paper. It is pointed out that the bloodletting therapy could be better carried forward and developed through the interaction and integration of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in term of the theoretic, practical and development patterns under the guidance of these two different medical theoretical systems.

Plant-based natural products represent an alternative to chemical compounds for the control of mites in veterinary medicine. Here, the essential oil of Elsholtzia densa (E. densa) Benth was extracted using hydrodistillation at a rate of 1.2%. The chemical composition of the essential oil was determined by gas chromatographymass spectrometry (GC-MS) analysis. The GC-MS analysis indicated that the principal compounds in the volatile oil of the sample were 4-Pyridinol (28.16%) and thymol (26.58%). The acaricidal activity of E. densa oil against Sarcoptes scabiei (S. scabiei) was tested in vitro. Toxicity test data were analysed using a complementary log-log (CLL) model. The E. densa oil was prepared in five concentrations by dilution with liquid paraffin (1, 2, 4, 8 and 16 mg/ml) and exhibited strong toxicity against S. scabiei with LT50 values of 16.637, 5.075, 2.884, 1.184 and 0.760 h, respectively. The LC50 values were 7.678, 4.623, 2.543, 1.502, 1.298 and 0.981 mg/ml for S. scabiei at 1, 2, 4, 8, 16 and 24 h, respectively. Compared to the control, the essential oil showed significant effects against S. scabiei in vitro. At 16 mg/ml, E. densa oil was found to kill all mites within a 16-h period. The results indicate that E. densa oil possesses potential acaricidal activity in vitro and may be exploited as a novel drug for the effective control of S. scabiei. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To develop an HPLC method for the determination of a Tibetan medicine Meconopsis quintuplinervia.METHOD: A Hypersil-Keystone-C18 column (4.6 mm x 250 mm, 5 microm) was used with the isocratic elution of acetonitrile and 0.012% glacial acetic acid. The flow rate was 1.0 mL x min(-1), and the detection wavelength was set at 237 nm. RESULT: The linear range of 0-methylflavinantine was 0.2-2.4 microg (r = 0.999 7). The average recovery was 96.26%. CONCLUSION: The developed method was reliable, and can be used for the quality control of M. quintuplinervia Regel.

A pair of stable isotope labeling (SIL) reagents, <b>N</b>-(4-(carbazole-9-yl)-phenyl)-<b>N</b>-maleimide (NCPM-d0) and its heavy analogue NCPM-d2, were used for labeling thiol-containing drugs. On basis of SIL, a global isotope internal standard quantitative method for the detection of five thiol-containing drugs by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was developed. The NCPM-d0 and NCPM-d2 can easily label thiol-containing drugs under mild conditions within 10 min at 40 °C. The NCPM-d0 and NCPM-d2 labeled thiol-containing drugs can generate two characteristic product ions (<b>m</b>/<b>z</b> at 372.5 and 374.5) under collision induced dissociation, respectively, which is used to establish the multiple reaction monitoring (MRM) based detection. The NCPM labeling combined with MRM analysis not only allowed trace detection of thiol-containing drugs due to the extremely high sensitivity, but also efficiently corrected the matrix effects during HPLC-MS/MS and the instrument fluctuation in the MS/MS signal intensity. The detection sensitivities of thiol-containing drugs improved by 14.5-650.5-fold due to NCPM-labeling, while the matrix and ion suppression effects were markedly minimized by the SIL strategy. The limits of detection (LODs) and the limits of quantitation (LOQs) were in the range 10.0-15.0 ng·mL−1 and 31.0-50.0 ng·mL−1, respectively. The proposed method was used for the simultaneous determination of five thiol-containing drugs in plasma samples with satisfactory recoveries in the range of 95.0-97.5%.<br>• A stable isotope labeling strategy for analyzing thiol-containing drugs has been developed. • A pair of SIL reagents NCPM-d0 and NCPM-d2 were used to label thiol-containing drugs. • The detection sensitivities of thiol-containing drugs improved by 14.5-650.5-fold. • The proposed method was successfully applied to pharmacokinetic study of captopril.

The separation of minor compounds, especially those with similar polarities from a complex sample, remains challenging. In the proposed study, an effective method based on medium-pressure liquid chromatography and recycling high-speed counter-current chromatography was developed for the enrichment and separation of three minor components from <i>Dracocephalum tanguticum</i>. The crude extract was directly introduced to medium-pressure liquid chromatography for the enrichment of the three minor components. Based on high-performance liquid chromatography analysis, the total content of these three compounds increased from 0.48% in the crude extract to 85.3% in the medium-pressure liquid chromatography fraction. In addition, high-speed counter-current chromatography was employed to separate the enriched compounds using the solvent system hexane/ethyl acetate/methanol/water (1.18:8.82:1.18:8.82, v/v/v/v). As a result, compound <b>3</b> and a mixture of compounds <b>1</b> and <b>2</b> were obtained. In order to improve the resolution of compounds <b>1</b> and <b>2</b> while saving separation time, a recycling and heart-cut mode was used. Finally, compounds <b>1</b> and <b>2</b> were obtained after five cycles. These compounds were identified as 3-phenylethyl β-d-glucopyranoside (<b>1</b>), tazettoside E (<b>2</b>), and cirsiliol-4′-glucoside (<b>3</b>). Compounds <b>1</b> and <b>2</b> were primarily separated from <i>D. tanguticum</i>. Moreover, the developed method provided a reference for the separation of minor components from the complex sample.

PURPOSE: To evaluate the effectiveness on reducing anxiety of a diaphragmatic breathing relaxation (DBR) training program.DESIGN AND METHODS: This experimental, pre-test-post-test randomized controlled trial with repeated measures collected data using the Beck Anxiety Inventory and biofeedback tests for skin conductivity, peripheral blood flow, heart rate, and breathing rate. FINDINGS: The experimental group achieved significant reductions in Beck Anxiety Inventory scores (p < .05), peripheral temperature (p = .026), heart rate (p = .005), and breathing rate (p = .004) over the 8-week training period. The experimental group further achieved a significant reduction in breathing rate (p < .001). PRACTICE IMPLICATIONS: The findings provide guidance for providing quality care that effectively reduces the anxiety level of care recipients in clinical and community settings.

Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analyse the effect of group (intervention vs. control) on changes in the outcome variables. There were significant improvements at one week post-intervention in all outcome variables: mindfulness (β = 0.19, ΔR2 = 0.04, p = .040, f 2 = 0.05), perceived stress (β = −0.26, ΔR2 = 0.07, p = .009, f 2 = 0.10); mental distress (β = −0.28, ΔR2 = 0.10, p = .003, f 2 = 0.15); and self-efficacy (β = 0.30, ΔR2 = 0.09, p < .001, f 2 = 0.21). Six months after the intervention, those who had joined the program reported higher self-efficacy compared to those in the control group (β = 0.24, ΔR2 = 0.06, p = .020, f 2 = 0.08); but there was no difference in other outcome measures. More than 90 % of the participants found the program applicable in helping patients and all reported that they would recommend it to others. This study indicates that the program is potentially an effective stress management program for medical students in Malaysia.

Objective This study was conducted to evaluate the effectiveness of a brief mindfulness-based training program in reducing stress and promoting well-being among critical care nurses. Design A quasi-experimental, single-group, pre-post study design was used to evaluate the effectiveness of the program. Setting This study was conducted in a tertiary referral centre in Malaysia. Subjects A non–probability voluntary sample of 41 critical care nurses participated in the program. Thirty seven (90%) completed the program, with at least 80% attendance. Intervention The intervention is an adapted and brief version of Mindfulness-based Cognitive Therapy (b-MBCT) using the local promotional name of ‘Mindful-Gym’. b-MBCT is a group-based program, carried out for five weeks at two hours per week with practice sessions in between. It was delivered as part of the hospital’s continuing nursing education program. Main outcome measures Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS) were used to measure the stressrelated outcomes. As for the well-being outcomes, the Mindfulness Attention and Awareness Scale and Subjective Happiness Scale (SHS) were used.Results fter completing the program, the participants reported significant improvement in the level of perceived stress (PSS: p < .001; r = 0.50), stress (DASS-S: p = .002; d = 0.56), anxiety (DASS-A: p < .001; r =0.38), depression (DASS-D: p < .001; r = 0.37), mindfulness (MAAS: p < .001; d = 1.002), and happiness (SHS: p = .028; d = 0.57), with a moderate to large effect size. Conclusion Results support the effectiveness of b-MBCT in reducing stress and promoting well-being among critical care nurses.

We are often overwhelmed by everyday stressors. Mindfulness meditation can help slow things down and bring one’s attention into the present moment. Given the prevalence of smartphones, mindfulness-based mobile applications (MBMAs) have received much attention. Current MBMAs mainly use the guided meditation method which may not be always effective, e.g., users may not be able to follow the pace of instructions and they need a private environment. This paper presents a framework for interactive MBMAs which allows users to self-regulate their attention according to their abilities and conditions. The framework is described by an AttentionRegulation Process and has two components: (1) Relaxation Response and (2) Attention Restoration Theory. The framework is validated by our experiment. It also informs future development for interactive meditation and has broad implications for designing mindfulness and well-being.

<p>Lower social class (or socioeconomic status) is associated with fewer resources, greater exposure to threat, and a reduced sense of personal control. Given these life circumstances, one might expect lower class individuals to engage in less prosocial behavior, prioritizing self-interest over the welfare of others. The authors hypothesized, by contrast, that lower class individuals orient to the welfare of others as a means to adapt to their more hostile environments and that this orientation gives rise to greater prosocial behavior. Across 4 studies, lower class individuals proved to be more generous (Study 1), charitable (Study 2), trusting (Study 3), and helpful (Study 4) compared with their upper class counterparts. Mediator and moderator data showed that lower class individuals acted in a more prosocial fashion because of a greater commitment to egalitarian values and feelings of compassion. Implications for social class, prosocial behavior, and economic inequality are discussed.</p>
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Abstract Ethnopharmacological relevance Herpetospermum caudigerum Wall. (HCW) is a traditional Tibetan medicine, which has been used to ameliorate liver injuries in the folk. Aim of the study Liver fibrosis has been recognized as a major lesion of the liver that leads to liver cirrhosis/hepatocarcinoma and even to death in the end. This study aims to demonstrate the protective effect of HCW against CCl 4 -induced liver injury in rats and to explore the underlying mechanisms. Materials and methods Hepatic fibrosis was induced by intraperitoneal injection of CCl 4. Liver function markers, fibrosis markers, serum anti-oxidation enzymes as well as elements levels were determined. Serum and liver tissues were subjected to NMR-based metabolomics and multivariate statistical analysis. Results HCW could significantly reduce the elevated levels of fibrosis markers such as hyaluronidase, laminin, Type III procollagen and Type IV collagen in the serum, improve the activities of the antioxidant enzymes, and effectively reverse the abnormal levels of elements in liver fibrosis rats. Correlation network analysis revealed that HCW could treat liver fibrosis by ameliorating oxidative stress, repairing the impaired energy metabolisms and reversing the disturbed amino acids and nucleic acids metabolisms. Conclusion This integrated metabolomics approach confirmed the validity of the traditional use of HCW in the treatment of liber fibrosis, providing new insights into the underlying mechanisms. Graphical abstract fx1 [ABSTRACT FROM AUTHOR]

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