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Complement factor Ⅰ knockdown inhibits colon cancer development by affecting Wnt/β-catenin/c-Myc signaling pathway and glycolysis

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2646-2662页

作者： Yong-Jun Du Yue Jiang Yan-Mei Hou Yong-Bo Shi Department of Proctology Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina school of Clinical medicine Chengdu University of Traditional Chinese MedicineChengdu 610075Sichuan ProvinceChina Department of Proctology Zigong Hospital of Traditional Chinese MedicineZigong 643000Sichuan ProvinceChina

BACKGROUND Colon cancer(CC)occurrence and progression are considerably influenced by the tumor ***,the exact underlying regulatory mechanisms remain *** To investigate immune infiltration-related differentially expressed genes(DEGs)in CC and specifically explored the role and potential molecular mechanisms of complement factor I(CFI).METHODS Immune infiltration-associated DEGs were screened for CC using *** reverse transcription polymerase chain reaction was used to examine hub DEGs expression in the CC cell *** CFI-knockdown HT29 and HCT116 cell lines were constructed,and the diverse roles of CFI in vitro were assessed using CCK-8,5-ethynyl-2’-deoxyuridine,wound healing,and transwell *** and eosin staining and immunohistochemistry staining were employed to evaluate the influence of CFI on the tumorigenesis of CC xenograft models constructed using BALB/c male nude *** proteins associated with glycolysis and the Wnt pathway were measured using western *** Six key immune infiltration-related DEGs were screened,among which the expression of CFI,complement factor B,lymphoid enhancer binding factor 1,and SRY-related high-mobility-group box 4 was upregulated,whereas that of fatty acid-binding protein 1,and bone morphogenic protein-2 was ***,CFI could be used as a diagnostic biomarker for ***,CFI silencing inhibited CC cell proliferation,migration,invasion,and tumor ***,CFI knockdown downregulated the expression of key glycolysis-related proteins(glucose transporter type 1,hexokinase 2,lactate dehydrogenase A,and pyruvate kinase M2)and the Wnt pathway-related proteins(β-catenin and c-Myc).Further investigation indicated that CFI knockdown inhibited glycolysis in CC by blocking the Wnt/β-catenin/c-Myc *** The findings of the present study demonstrate that CFI plays a crucial role in CC development by influencing g

关键词： Colon cancer Immune infiltration Complement factor I Glycolysis Wnt/β-catenin/c-Myc pathway

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Anti-inflammatory mechanism of the non-volatile ingredients performance liquid chromatography-heated electron spray ionization-high resolution mass spectroscope and cell metabolomics

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Journal of traditional Chinese medicine 2024年第2期44卷 260-267页

作者： JING Wenguang LIN Xiaoyu LI Chu ZHAO Xiaoliang CHENG Xianlong WANG Penglong WEI Feng MA Shuangcheng Institute of Control of Chinese traditional medicine and Ethnic medicine National Institutes for Food and Drug ControlBeijing 102629China school of traditional Chinese medicine Beijing University of Chinese MedicineBeijing 102488China Beijing Key Laboratory of traditional Chinese medicine Basic Research on Prevention and Treatment of Major Diseases Experimental Research CenterChina Academy of Chinese Medical SciencesBeijing 100700China

OBJECTIVE:To explore the anti-inflammatory components and mechanism of the non-volatile ingredients of ***:High performance liquid chromatographyheated electron spray ionization-high resolution mass spectroscope(HPLC-HESI-HRMS)was used to analyze the chemical constituents of the non-volatile ingredients of *** anti-inflammatory activity of ingredients was evaluated using lipopolysaccharide(LPS)induced RAW264.7 cell inflammation model,and the antiinflammatory mechanism was investigated using multivariate statistical analysis of cell ***:The non-volatile ingredients of patchouli were characterized by HPLC-HESI-HRMS,and 36 flavonoids and 18 other components were *** ingredients of patchouli not only had a good protective effect on the LPS-induced inflammation model of RAW264.7 cells,but also regulated the expression levels of arginine,L-leucine,cholesterol,fructose and sorbitol by down-regulating arginine metabolism,aminoacyl-tRNA biosynthesis,polyol/sorbitol pathway,so as to reduce inflammation and reduce cell ***:The non-volatile ingredients of patchouli had good anti-inflammatory effect and exerted its curative effect by regulating endogenous metabolic pathway to reduce inflammatory response.

关键词： Pogostemon non-volatile ingredients anti-inflammatory cell metabolomics

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Therapeutic Role of Chinese medicine Targeting Nrf2/HO-1 Signaling Pathway in Myocardial Ischemia/Reperfusion Injury

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Chinese Journal of Integrative medicine 2024年第10期30卷 949-960页

作者： LIU Chang-xing GUO Xin-yi ZHOU Ya-bin WANG He First Clinical Medical school Heilongjiang University of Chinese Medicine Clinical Medical school Chengdu University of Traditional Chinese Medicine Department of Cardiology the First Affiliated Hospital of Heilongjiang University of Chinese Medicine

Acute myocardial infarction(AMI), characterized by high incidence and mortality rates, poses a significant public health threat. Reperfusion therapy, though the preferred treatment for AMI, often exacerbates cardiac damage, leading to myocardial ischemia/reperfusion injury(MI/RI). Consequently, the development of strategies to reduce MI/RI is an urgent priority in cardiovascular therapy. Chinese medicine, recognized for its multi-component, multi-pathway, and multi-target capabilities, provides a novel approach for alleviating MI/RI. A key area of interest is the nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1) pathway. This pathway is instrumental in regulating inflammatory responses, oxidative stress, apoptosis, endoplasmic reticulum stress, and ferroptosis in MI/RI. This paper presents a comprehensive overview of the Nrf2/HO-1 signaling pathway's structure and its influence on MI/RI. Additionally, it reviews the latest research on leveraging Chinese medicine to modulate the Nrf2/HO-1 pathway in MI/RI treatment.

关键词： Chinese medicine mechanisms myocardial ischemia/reperfusion injury nuclear factor E2-related factor 2/heme oxygenase-1 signaling pathway

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Efficacy and Safety of Chinese Herbal medicines Combined with Chemical Drugs for Alzheimer's Disease:A Systematic Review and Meta-Analysis

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World Journal of traditional Chinese medicine 2024年第1期10卷 1-13页

作者： Li Xu Wen-Jun Chen Cai-Jun Tian Yan Zhang Yan Ma Tian-Hao Li Hong-Jie Liu Zhe Zhang Department of the First College English College of Foreign LanguageShandong University of Traditional Chinese MedicineJinanChina Department of Oncology Linyi People's HospitalLinyiChina Department of Internal medicine of traditional Chinese medicine The First Clinical CollegeShandong University of Traditional Chinese MedicineJinanChina Department of Chinese Materia Medica College of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineJinanChina Department of Medicinal Chemistry College of PharmacyShandong University of Traditional Chinese MedicineJinanChina Community Healthcare Center Shenzhen Traditional Chinese Medicine HospitalShenzhenChina Department of Fundamentals of traditional Chinese medicine School of Traditional Chinese MedicineJinan UniversityGuangzhouChina Shandong Co-Innovation Center of Classic TCM Formula College of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineJinanChina

Objective:To evaluate the efficacy and safety of Chinese herbal medicines(CHMs)combined with chemical drugs for the treatment of Alzheimer's disease(AD).Materials and Methods:Databases were searched to retrieve randomized controlled trials(RCTs)of CHMs combined with tacrine,galantamine,rivastigmine,donepezil,or memantine,following strict inclusion and exclusion *** research papers published in English,Chinese,and Japanese were *** primary outcome was the mini-mental state examination(MMSE)score and the secondary outcomes were AD assessment scale cognitive subscale(ADAS-Cog)score and safety ***-analysis was carried out using Rev Man 5.3 and subgroup analysis was conducted to identify the sources of ***:A total of 15 RCTs with 1386 participants were included in this *** donepezil was used in the retrieved ***-analyses showed that the combination of CHMs with donepezil led to significant improvement in the MMSE score(Z=9.45;P<0.00001;weighted mean difference[WMD]=2.68,95%confidence interval[CI]:2.12-3.24)and a significant decrease in the ADAS-Cog score(Z=5.53;P<0.00001;WMD=-3.79;95%CI:-5.13--2.44).Safety evaluation demonstrated that these combination treatments relieved adverse events such as insomnia(risk ratio[RR]=0.20,95%CI:0.06-0.68;P=0.01)and hive(RR=0.10;95%CI:0.01-0.73;P=0.02).Conclusions:The combination of CHMs with a chemical drug like donepezil led to significant improvements in patient cognition as well as a better safety profile when compared to the application of a chemical drug alone.

关键词： Alzheimer's disease Chinese herbal medicine donepezil memantine meta-analysis randomized controlled trials rivastigmine

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Efficacy and safety of Huzhang Granule,a compound Chinese herbal medicine,for acute gouty arthritis:A double-blind,randomized controlled trial

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Journal of Integrative medicine 2024年第3期22卷 270-278页

作者： Hao Wang Si-ting Chen Xiao-jie Ding Le Kuai Liang Hua Xin Li Yi-fei Wang Ming Zhang Bin Li Rui-ping Wang Mi Zhou Department of Dermatology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China Institute of Dermatology Shanghai Academy of Traditional Chinese MedicineShanghai 201203China Department of Dermatology the Affiliated Hospital of Jiangxi University of Chinese MedicineNanchang 330000Jiangxi ProvinceChina Shanghai Skin Disease Hospital School of MedicineTongji UniversityShanghai 200443China Institute of Dermatology School of MedicineTongji UniversityShanghai 200443China

Background:Acute gouty arthritis(AGA)is an inflammatory joint disease with a high *** medical interventions,including nonsteroidal anti-inflammatory drugs,colchicine and glucocorticoids,can have serious adverse *** Granule(HZG),a compound Chinese herbal medicine,has been used to treat AGA for more than 30 years with satisfactory effects and no significant adverse ***,the efficacy and safety of HZG in AGA patients remains ***:The present investigation was designed to examine the efficacy and safety profile of HZG in managing AGA ***,setting,participants and interventions:The current study was conducted as a noninferiority,randomized controlled clinical trial on 180 eligible enrolled *** were randomly assigned into the HZG and etoricoxib *** were administered for 5 d,during which the HZG group received HZG and placebo etoricoxib,while the etoricoxib group received etoricoxib and placebo HZG in the same ratio(1:1).Main outcome measures:The primary outcome was pain experienced by the patient in the gout-afflicted joint from days 2 to 5 of the treatment *** pain level was measured via a visual analogue scale,ranging from 0 mm to 100 *** secondary outcomes comprised joint tenderness and swelling,reduction of inflammatory biomarkers,and the patient’s and investigator’s global evaluations of therapeutic ***:The mean reduction in pain was-51.22 mm(95%confidence interval[CI],[-53.42,-49.03]mm)for the HZG and-52.00 mm(95%CI,[-54.06,-49.94]mm)for the etoricoxib *** mean difference between the two groups was 0.78 mm(95%CI,[-2.25,3.81]mm).All additional efficacy endpoints,covering decreased inflammation and pain relief,yielded compelling proof of *** in the HZG group exhibited a comparatively lower rate of adverse events compared to those in the etoricoxib group(4.44%vs 13.33%;P≤0.05).Conclusion:HZG and etoricoxib groups demons

关键词： Acute gouty arthritis Huzhang Granule Randomized controlled trial Blind

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Bio-soft matter derived from traditional Chinese medicine:Characterizations of hierarchical structure,assembly mechanism,and beyond

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Journal of Pharmaceutical Analysis 2024年第6期14卷 823-839页

作者： Guiya Yang Yue Liu Yuying Hu Yue Yuan Yunan Qin Quan Li Shuangcheng Ma school of traditional Chinese medicine Beijing University of Chinese MedicineBeijing102488China Institute for Control of Chinese traditional medicine and Ethnic medicine National Institutes for Food and Drug ControlBeijing100050China Tianjin Key Laboratory of Therapeutic Substance of traditional Chinese medicine School of Chinese Materia MedicaTianjin University of Traditional Chinese MedicineTianjin301617China Collaborative Innovation Center for Advanced Organic Chemical Materials Co-constructed by the Province and Ministry Ministry-of-Education Key Laboratory for the Synthesis and Application of Organic Functional MoleculesCollege of Chemistry and Chemical EngineeringHubei UniversityWuhan430062China

Structural and functional explorations on bio-soft matter such as micelles,vesicles,nanoparticles,aggregates or polymers derived from traditional Chinese medicine(TCM)has emerged as a new topic in the field of *** discovery of such cross-scaled bio-soft matter may provide a unique perspective for unraveling the new effective material basis of TCM as well as developing innovative medicine and *** the rapid rise of TCM-derived bio-soft matter,their hierarchical structure and assembly mechanism must be unambiguously probed for a further in-depth understanding of their pharmacological *** this review,the current emerged TCM-derived bio-soft matter assembled from either small molecules or macromolecules is introduced,and particularly the unambiguous elucidation of their hierarchical structure and assembly mechanism with combined electron microscopic and spectroscopic techniques is *** pros and cons of each technique are also *** future challenges and perspective of TCM-derived bio-soft matter are outlined,particularly the requirement for their precise in situ structural determination is highlighted.

关键词： Electron microscopy Spectroscopy traditional Chinese medicine Bio-soft matter Structural characterization

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Electroacupuncture Promotes Functional Recovery after Facial Nerve Injury in Rats by Regulating Autophagy via GDNF and PI3K/m TOR Signaling Pathway

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Chinese Journal of Integrative medicine 2024年第3期30卷 251-259页

作者： YAO Jun-peng FENG Xiu-mei WANG Lu LI Yan-qiu ZHU Zi-yue YAN Xiang-yun YANG Yu-qing LI Ying ZHANG Wei Acupuncture and Tuina school Chengdu University of Traditional Chinese MedicineChengdu611137China Department of Rehabilitation medicine Guanghan People’s HospitalGuanghanSichuan Province618399China Academic Affairs Office Chengdu University of Traditional Chinese MedicineChengdu611137China

Objective:To explore the mechanism of electroacupuncture(EA) in promoting recovery of the facial function with the involvement of autophagy,glial cell line-derived neurotrophic factor(GDNF),and phosphatidylinositol-3-kinase(PI3K)/mammalian target of rapamycin(mTOR) signaling ***:Seventy-two male Sprague-Dawley rats were randomly allocated into the control,sham-operated,facial nerve injury(FNI),EA,EA+3-methyladenine(3-MA),and EA+GDNF antagonist groups using a random number table,with 12 rats in each *** FNI rat model was established with facial nerve crushing *** intervention was conducted at Dicang(ST 4),Jiache(ST 6),Yifeng(SJ 17),and Hegu(LI 4) acupoints for 2 *** Simone’s 10-Point Scale was utilized to monitor the recovery of facial *** histopathological evaluation of facial nerves was performed using hematoxylin-eosin(HE) *** levels of Beclin-1,light chain 3(LC3),and P62 were detected by immunohistochemistry(IHC),immunofluorescence,and reverse transcriptionpolymerase chain reaction,***,IHC was also used to detect the levels of GDNF,Rai,PI3K,and ***:The facial functional scores were significantly increased in the EA group than the FNI group(P<0.05 or P<0.01).HE staining showed nerve axons and myelin sheaths,which were destroyed immediately after the injury,were recovered with EA *** expressions of Beclin-1 and LC3 were significantly elevated and the expression of P62 was markedly reduced in FNI rats(P<0.01);however,EA treatment reversed these abnormal changes(P<0.01).Meanwhile,EA stimulation significantly increased the levels of GDNF,Rai,PI3K,and mTOR(P<0.01).After exogenous administration with autophagy inhibitor 3-MA or GDNF antagonist,the repair effect of EA on facial function was attenuated(P<0.05 or P<0.01).Conclusions:EA could promote the recovery of facial function and repair the facial nerve damages in a rat model of *** may exert this neuroreparative effect through

关键词： electroacupuncture facial nerve injury autophagy glial cell line-derived neurotrophic factor phosphatidylinositol-3-kinase/mammalian target of rapamycin Chinese medicine

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Therapeutic effects of Lingguizhugan decoction in a rat model of high-fat diet-induced insulin resistance

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World Journal of Diabetes 2024年第6期15卷 1291-1298页

作者： Xiao-Ming Liu Shi-Qing Yuan Ying Ning Shi-Jia Nie Xu-Qiong Wang Hong-Yi Jia Xiu-Li Zheng Department of Basic medicine School of Basic Medicine Chengdu University of Traditional Chinese MedicineChengdu 611137Sichuan ProvinceChina Department of Clinical medicine Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina

BACKGROUND Lingguizhugan(LGZG)decoction is a widely used classic Chinese medicine formula that was recently shown to improve high-fat diet(HFD)-induced insulin resistance(IR)in animal *** To assess the therapeutic effect of LGZG decoction on HFD-induced IR and explore the potential underlying *** To establish an IR rat model,a 12-wk HFD was administered,followed by a 4-wk treatment with *** determination of IR status was achieved through the use of biochemical tests and oral glucose tolerance *** a targeted metabolomics platform to analyze changes in serum metabolites,quantitative real-time PCR(qRT-PCR)was used to assess the gene expression of the ribosomal protein S6 kinase beta 1(S6K1).RESULTS In IR rats,LGZG decreased body weight and indices of hepatic *** effectively controlled blood glucose and food intake while protecting islet *** analysis revealed significant differences between the HFD and HFDLGZG *** intervention reduced branched-chain amino acid *** of IR-related metabolites such as tryptophan,alanine,taurine,and asparagine decreased *** may be linked to amino acids due to the contemporaneous increase in S6K1 expression,as shown by *** Our study strongly suggests that LGZG decoction reduces HFD-induced *** may activate S6K1 via metabolic *** findings lay the groundwork for the potential of LGZG as an IR treatment.

关键词： Lingguizhugan decoction High-fat diet-induced insulin resistance Amino acid metabolism S6K1

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YTE-17 inhibits colonic carcinogenesis by resetting antitumor immune response via Wnt5a/JNK mediated metabolic signaling

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Journal of Pharmaceutical Analysis 2024年第4期14卷 525-541页

作者： Hua Sui Wanli Deng Qiong Chai Bing Han Yuli Zhang Zhenzhen Wei Zan Li Ting Wang Jiling Feng Man Yuan Qingfeng Tang Hongxi Xu Medical Experiment Center Jiading Branch of Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai201803China Translational medicine Research Center for Cancer Prevention and Treatment Shanghai General Hospital Jiading Branch-School of Pharmacy of Shanghai University of Traditional Chinese Medicine Joint LaboratoryShanghai201803China Department of Medical Oncology Putuo HospitalShanghai University of Traditional Chinese MedicineShanghai200062China school of Pharmacy Shanghai University of Traditional Chinese MedicineShanghai201203China The Second Clinical Medical College of Henan University of traditional Chinese medicine Zhengzhou450000China Shanghai University of traditional Chinese medicine Shanghai201203China Precision Research Center for Refractory Diseases Institute for Clinical ResearchShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai201620China

The density and composition of lymphocytes infiltrating colon tumors serve as predictive factors for the clinical outcome of colon *** previous studies highlighted the potent anti-cancer properties of the principal compounds found in Garcinia yunnanensis(YTE-17),attributing these effects to the regu-lation of multiple signaling ***,knowledge regarding the mechanism and effect of YTE-17 in the prevention of colorectal cancer is *** this study,we conducted isobaric tags for relative and absolute quantification(iTRAQ)analysis on intestinal epithelial cells(IECs)exposed YTE-17,both in vitro and in vivo,revealing a significant inhibition of the Wnt family member 5a(Wnt5a)/c-Jun N-terminal kinase(JNK)signaling ***,we elucidated the influence and mechanism of YTE-17 on the tumor microenvironment(TME),specifically focusing on macrophage-mediated T helper 17(Th17)cell induction in a colitis-associated cancer(CAC)model with Wnt5a ***,we performed the single-cell RNA sequencing(scRNA-seq)on the colonic tissue from the Wnt5a-deleted CAC model to characterize the composition,lineage,and functional status of immune mesenchymal cells during different stages of colorectal cancer(CRC)***,our findings demon-strate a significant reduction in M2 macrophage polarization and Th17 cell phenotype upon treatment with YTE-17,leading to the restoration of regulatory T(Treg)/Th17 cell balance in azoxymethane(AOM)/dextran sodium sulfate(DSS)***,we also confirmed that YTE-17 effectively inhibited the glycolysis of Th17 cells in both direct and indirect co-culture systems with M2 ***,our study shed light on potential mechanisms linking the non-canonical Wnt5a/JNK signaling pathway and well-established canonical b-catenin oncogenic pathway in ***,we proposed that Wnt5a/JNK signaling activity in IECs promotes the development of cancer stem cells with b-catenin activity within

关键词： Tumor microenvironment Intestinal epithelial cells Treg/Th17 cells Metabolism Wnt5a/JNK signaling Tumorigenesis

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Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease:A multi-centre,randomised,double-blind,placebo-controlled trial

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Journal of Integrative medicine 2024年第5期22卷 561-569页

作者： Hui-zhi Zhu Cheng-yi Li Liang-ji Liu Jia-bing Tong Zhi-hui Lan Shu-guang Tian Qiao Li Xiang-li Tong Ji-feng Wu Zhen-gang Zhu Su-yun Li Jian-sheng Li Department of Respiratory medicine the First Affiliated Hospital of Anhui University of Traditional Chinese MedicineHefei 230031Anhui ProvinceChina Graduate school Anhui University of Traditional Chinese MedicineHefei 230012Anhui ProvinceChina Department of Respiratory medicine Affiliated Hospital of Jiangxi University of Traditional Chinese MedicineNanchang 330006Jiangxi ProvinceChina Department of Respiratory Diseases the First Affiliated Hospital of Henan University of Traditional Chinese MedicineZhengzhou 450000Henan ProvinceChina Department of Pulmonary Diseases Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese MedicineFuyang 236600Anhui ProvinceChina Department of Respiratory and Critical Care medicine Jiangxi Province Hospital of Integrated Chinese and Western MedicineNanchang 330002Jiangxi ProvinceChina Department of Respiratory medicine the First Affiliated Hospital of Tianjin University of Traditional Chinese MedicineTianjin 300381China Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese medicine Development of Henan Province Zhengzhou 450046Henan ProvinceChina

Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD ***,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical ***,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:*** in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine *** patients were followed up for 3 *** outcome measures The primary outcome was time taken to symptom *** secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)***,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the *** The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control *** days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatm

关键词： Acute exacerbation of chronic obstructive pulmonary disease Clinical trial Syndrome of phlegm-heat congesting lung Qingfei Huatan formula traditional Chinese medicine

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