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Escin is a triterpenoid saponin extracted from the fruit of Aesculus wilsonii Rehd. and Aesculus hippocastanum (Hippocastanaceae). Clinically, it is widely used in the treatment of edema induced by either trauma or surgery, as well as treating chronic venous insufficiency. The anti-inflammatory and antiedema effects of escin have been extensively investigated. This article systematically reviews the effects of escin on inflammation and gastrointestinal diseases, including its role in inflammation, as an antioxidant, and in inhibiting gastric acid secretion and promoting gastrointestinal movement, especially, the molecular mechanism. The advantages and potential uses of escin have also been discussed.

ObjectivesDynamic susceptibility contrast perfusion weighted imaging (DSC-PWI) plays an important role in the differential diagnosis between radionecrosis and recurrence of brain metastases (BMs) after gamma knife radiosurgery (GKRS). While the perfusion condition of preliminary hyperperfusion and hypoperfusion BMs when recur has not been studied, as well the separating performance of quantitative DSC-PWI in both kinds of BMs.MethodsFrom February 2017 to October 2019, quantitative DSC-PWI was performed in patients with untreated BMs in this observational study. Patients were assigned to hyperperfusion and hypoperfusion group according the quantitative cerebral blood volume (qCBV). During follow-up after GKRS, patients with a diagnostic pitfall of radionecrosis and recurrence accepted second quantitative DSC-PWI. Final diagnosis was based on the histological results or follow-up results. Receiver operating curve analysis was used to explore the performance of qCBV.ResultsTwenty-nine patients (mean age: 61.3 ± 9.4 years old; male/female: 13/16) were assigned to the group of hypoperfusion group, and 26 patients (mean age: 58 ± 10.4 years old; male/female: 14/12) to hyperperfusion group. The mean qCBV values between hypoperfusion and hyperperfusion groups when recurred were not significantly different (3.17 ± 0.53 ml/100 g vs. 3.27 ± 0.47 ml/100 g, p = 0.63). qCBV was feasible to separate radionecrosis and recurrence in both groups (AUC=0.94 and AUC=0.93, separately).ConclusionBoth premilitary hyperperfusion and hypoperfusion BMs would transform to a high microvascular density when recurs. qCBV is feasible to distinguish radionecrosis and recurrence among both kinds of BMs after GKRS.

Stroke is a devastating disease, intracerebral hemorrhage (ICH) is a devastating subtype. This study aimed to investigate whether cholinergic receptors participate in the process of Angong Niuhuang Pill (ANP) improving neurological function and relieving intestinal injury in ICH mice. The mice were treated with ANP, cholinergic receptor blockers, atropine (ATR), penehyclidine hydrochloride (PHC) or methyllycaconitine (MLA). Male CD-1 mice were randomly divided into 9 groups, Sham, ICH, ANP (0.2 g/kg), ANP plus ATR, ANP plus PHC, ANP plus MLA, ATR, PHC, MLA. ICH model is made by collagenase VII injection (0.075 U). ANP (0.2 g/kg) was administered by gavage after 30 min of ICH. MLA, ATR, PHC was given at 15 min after ICH. Neurological function was evaluated by Garcia test. Intestinal injury was observed by histological analysis. Endotoxin (ET) was measured by enzyme-linked immunosorbent assay. Compared to the Sham group, the score of Garcia test in the ICH significantly decreased. ANP increased significantly the score of ICH mice. ANP also ameliorated the intestinal injury caused by ICH. Cholinergic receptor blockers reversed partially the improvement of neurological function and intestinal injury by ANP. ANP attenuates the neurological deficits and intestinal injury in ICH mice and the protective effect of ANP may be involved in the regulation of the cholinergic system.