Synergistic mechanism of stir-baked curcumae radix with vinegar in dysmenorrhea rats based on UPLC-Q-TOF/MS metabolomics.

Curcumae Radix (i.e. Huangsiyujin: HSYJ), a well-known traditional Chinese medicine (TCM), has been widely used in clinical practice for many years to treat depression and primary dysmenorrhea. Modern pharmacological researches have demonstrated its anti-inflammatory, antidepressant, and dysmenorrhea relief effects. According to the processing theory of TCM, it is believed that stir-baked HSYJ with vinegar may enhance the ability to disperse stagnant hepatoqi and alleviate pain. However, whether the vinegar concoction of HSYJ can enhance the therapeutic effect on the Qi stagnation due to liver depression (LDQS) type of dysmenorrhea and what its mechanism has not been well explained. Based on the processing drugs theory of "stir-baked with vinegar into liver", a metabolomic approach was used to investigate the therapeutic effect and mechanism of stir-baked HSYJ with vinegar to enhance the treatment of dysmenorrhea in rats. By establishing a rat model of dysmenorrhea of the "LDQS" type, observation of hemorheology, uterine pathological sections, COX-2 and OTR protein expression and other indicators; analysis of urinary metabolic changes in rats by UPLC-Q-TOF-MS technique, to compare the differential biomarkers and metabolic pathways in the treatment of dysmenorrhea due to "liver stagnation and qi stagnation" before and after stir-baked HSYJ with vinegar. Stir-baked HSYJ with vinegar significantly inhibited the writhing response of rats, improved hemorheology, repaired damaged diseased uterus and inhibited high expression of COX-2 and OTR proteins in uterus; 68 differential metabolites were screened from the urine of rats, compared with the raw HSYJ, the levels of 14 metabolites were significantly changed in stir-baked HSYJ with vinegar, involving the pathways of phenylalanine, tyrosine and tryptophan metabolism, cysteine and methionine metabolism, aspartate and glutamate metabolism. The potentiating effect of stir-baked HSYJ with vinegar may be related to the regulation of multiple amino acid metabolic pathways.

Baseline Interleukin-6 and Erythrocyte Sedimentation Rate Can Predict Clinical Response of TNF Inhibitor Treatment in Patients with Ankylosing Spondylitis.

OBJECTIVE: The objective of this study is to investigate the baseline predictors of clinical response from tumor necrosis factor (TNF) inhibitor within ankylosing spondylitis (AS) patients. METHODS: We selected 60 AS patients and 24 healthy individuals. The interleukin (IL)-1ß, IL-6, IL-17A and TNF-α levels were measured using the cytometric bead array. The receiver operating characteristic curve was used to analyze the cut off values of baseline predictors. A binary logistic regression test was used to investigate the association between baseline predictors and clinical response. RESULTS: At baseline, the IL-1ß, IL-6 and TNF-α level were positively correlated with disease activity. After 12 weeks of treatment, good responders had lower baseline IL-6 level and erythrocyte sedimentation rate (ESR) than non/poor responders. The cut off value of baseline IL-6 level and ESR to predict clinical response of TNF inhibitor treatment were 9.05 pg/mL and 47.00 mm/h, respectively. Binary logistic regression found that baseline IL-6 levels and ESR had an adverse relationship with clinical response, and the combination of IL-6 level and ESR could predict clinical response more effectively. CONCLUSIONS: The baseline IL-6 level and ESR can predict the clinical response of TNF inhibitor treatment within AS patients, which might facilitate the selection and adjustment of medication regimens for subjects.

Effective serum level of etanercept biosimilar and effect of antidrug antibodies on drug levels and clinical efficacy in Chinese patients with ankylosing spondylitis.

OBJECTIVES: To investigate the effective serum level of etanercept biosimilar in Chinese patients with ankylosing spondylitis (AS) who achieve AS Disease Activity Score-C-reactive protein (ASDAS-CRP) < 2.1, and the effect of antidrug antibodies on drug levels and clinical efficacy. METHODS: Our study enrolled 60 patients with AS who were treated with etanercept biosimilar. Serum and clinical data were collected at baseline and treatment weeks 4, 12, and 24. Drug levels and antidrug antibody levels were measured using an enzyme-linked immunosorbent assay while tumour necrosis factor (TNF)-α levels were measured using cytometric bead array. A receiver operating characteristic (ROC) curve was used to analyse effective serum level of etanercept biosimilar. RESULTS: Patients with ASDAS-CRP ≥ 2.1 exhibited significantly lower drug levels than those with ASDAS-CRP < 2.1 did. The cut-off values of effective serum level of patients with AS who achieved ASDAS-CRP < 2.1 at weeks 4, 12, and 24 were 2.32, 2.12, and 2.36 µg/mL, respectively. Patients with drug levels above the cut-off value had lower Bath AS Disease Activity Index (BASDAI) and TNF-α levels. Antidrug antibodies had no effect on the Assessment of Spondylosis Arthritis International Society (ASAS) remission rates, but patients with antidrug antibodies had lower drug levels and higher TNF-α levels. CONCLUSIONS: Detecting serum drug levels and antidrug antibody levels might facilitate estimation of the clinical efficacy and adjustment of medication regimen during etanercept biosimilar therapy in Chinese patients with AS.

[Clinical features and disease activity index of Behçet's disease].

OBJECTIVE: The clinical features and two disease activity assessment methods of Behçet's disease were evaluated in order to guide clinical management. METHODS: A total of 116 patients with Behçet's disease from China-Japan Union Hospital of Jilin University in 2007-2014 were analyzed retrospectively for the gender and age distribution as well as clinical features of multisystem involvement. The correlations of Behçet's Disease Current Activity Form (BDCAF) and electronic medical record (EMR)-based activity index (EMRAI) scoring systems with clinical data were compared in Chinese patients for the first time, and clinical suggestion was raised. RESULTS: Behçet's disease was commonly seen in young adults with age between 21-40 years old with mean course of four years.Males had longer duration than females (9.5 years vs 4.0 years, P<0.05), and vasculopathy was more commonly seen in males (11.9% vs 1.36%, P<0.05), while females had wider age distribution. BDCAF and EMRAI scoring systems were positively correlated with each other; the former was well associated with laboratory inflammatory indices, and the latter was simplified for application. CONCLUSIONS: The clinical manifestation of Behçet's disease varies with different gender; BDCAF and EMRAI scoring system well correlate with the laboratory inflammatory indices of patients, and can indicate the disease activity.

A morphologic study of the transcallosal-interventricular foramen approach in endoscopic third ventriculostomy with magnetic resonance imaging.

There is a very wide range of applications in neurosurgery for the treatment of obstructive hydrocephalus by third ventriculostomy. To facilitate the operation, we measured the related data of transcallosal-interventricular foramen approach in endoscopic third ventriculostomy with the magnetic resonance images of the third ventricle from 103 healthy adults. We calculated the mean and standard deviation as well as the 95% confidence interval for the mean value of the measured data, which conformed to normal distribution. We used median and interquartile range to show its concentration and the level of variation when it does not.

Morphological study of surgical approach by superior temporal sulcus-temporal horn of lateral ventricle approach using volume rendering.

In this research, we acquired the length of the superior temporal sulcus, the shortest distance from the superior temporal sulcus to the temporal horn of the lateral ventricle, and the approach angle between the median sagittal plane and the shortest segment from the superior temporal sulcus to the temporal horn of the lateral ventricle measuring 98 specimens by magnetic resonance imaging volume rendering. At the same time, we preliminarily oriented the point of the superior temporal sulcus, which is closest to the temporal horn of the lateral ventricle, aimed at finding out the best entrance point of surgical approach through the superior temporal sulcus to the temporal horn of the lateral ventricle and reducing the damage to optic radiation as well as other nerve fibers during the operation. The results indicate that the point at the front side 3/5 of the superior temporal sulcus may be the ideal surgical approach entrance point, and there is no difference between 2 cerebral hemispheres (P < 0.05).

Investigation of organic pollutants in wastewater-irrigated soil and its DNA damage and oxidative damage on mice.

This work aimed to determine the DNA and oxidative damage on mice by mixtures of organic contaminants in wastewater-irrigated soil, in order to assess their usefulness as markers for this kind of pollution. Wastewater-irrigated soil samples in the vicinity of an industrial area in Tangshan, China were collected, and soil irrigated by underground water satisfying drinking water standards was used as control group. Organic pollutants were extracted from the soil using ultrasonic oscillation, and analyzed by gas chromatography-mass spectrometry (GC-MS). Meanwhile, DNA damage on mice was determined by the Comet assay after oral gavage with the extracts, and changes in total superoxide dismutase (T-SOD) activity, glutathione peroxidase glutathione, GSH peroxidase (GSH-P(X)) activity and malondialdehyde content in serum of mice were investigated. The number of categories and concentrations of organic compounds in the wastewater-irrigated soil is more than those in groundwater-irrigated soil, as identified by the GC-MS. The toxicity test of mice showed that compared with reagent control group, the activities of T-SOD and GSH-P(X) decreased; the tailing rate of peripheral blood lymphocyte of mice increased and was more than that of the control group. This shows that mammalian toxicity end points can be used to determine the joint toxicity of organic pollutants in soil. When there is no means to identify each and every pollutant in soil, it is feasible to evaluate the combined effects of various pollutants to determine the extent to which the soil is polluted.