Screening of quantitative preparation quality markers of Zhibao Sanbian Wan / 药学学报

On the basis of the qualitative preparation quality markers of Zhibao Sanbian Wan (ZBSBW), we screened out the quantitative markers and evaluated the content consistency of ZBSBW. A method capable of simultaneously determining 34 compounds in ZBSBW was established based on HPLC-MS/MS, and 16 batches of ZBSBW were simultaneously analyzed by this method. Furthermore, we explored a general strategy for analyzing the component migration in preparation, plasma, brain tissue and cerebrospinal fluid. The methodological investigation was confirmed by linear range, recovery (85.10%-105.07%), precision (RSD: 1.37%-4.58%), stability, and repeatability (3.00%-12.45%), the established method was suitable for the detection and quantification of the compounds in ZBSBW. The contents of compounds in ZBSBW were all lower than 1 mg·g-1, and the contents and daily dose of nystose were the highest, followed by echinacoside, paeoniflorin, osthole and paeonol. The results of systematic clustering showed that the contents were consistent for ordinary preparations of ZBSBW. The principal component analysis showed that the components of berberine, ginsenoside Re, ginsenoside Rg1, pinoresinol diglucoside and tenuifolin had large variation, which contributed significantly to the grouping. The contents of echinacoside, verbascoside, polygalaxanthone Ⅲ, β-ecdysterone, osthole, alisol B 23-acetate, liquiritin and glycyrrhizic acid were stable from batch to batch. The animal experiment results showed that osthole, paeonol and liquiritin in ZBSBW could be absorbed into the blood and enter the brain tissue by passing through the blood-brain barrier. All animal studies were reviewed and approved by the Institutional Animal Care and Use Committee at Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences (No. 2020B071). The above compounds contributed the quantitative preparation quality markers of ZBSBW. In conclusion, the HPLC-MS/MS method established in this study was sensitive, accurate and rapid, and could be used for simultaneous quantification of 34 compounds and content consistency evaluation of multiple batches of preparations in ZBSBW. The result provided a methodological basis for the screening of quantitative preparation quality markers and material basis research of ZBSBW.

Effect of modified citrus pectin on synovial fibroblasts / 国际生物医学工程杂志

Objective:To study the effects of modified citrus pectin (MCP) on the viability and gene expressions of synovial fibroblasts (SF) as well as SF treated by galectin-3 (Gal-3).Methods:Rabbit SF was isolated and cultured in vitro. Then SF was treated with different concentrations of MCP (0, 250, 500, and 750 mg/L). In addition, SF was further treated with the same different concentrations of MCP after treatment with 10 μg/ml Gal-3 for 24 h. The viability of SF was detected by CCK-8 on the first, third, and fifth day after treatment. The mRNA expression of transforming growth factor-β1 (TGF-β1), type I collagen (COL1A2), and Gal-3 in SF was detected by real-time quantitative PCR. The synthesis of type I collagen in SF was investigated by immunofluorescence staining. Results:MCP, especially at a concentration of 500 mg/L can inhibit the proliferation of SF significantly (all P < 0.05) on the first, third, and fifth day after treatment. Compared with the control group, MCP at different concentrations induced different gene expression profiles. In particular, MCP at high concentrations can upregulate the expression of TGF-β1, COL1A2 and Gal-3 in SF. However, MCP shows no significant effect on the synthesis of type I collagen in SF. MCP can down-regulate the expression of TGF-β1, COL1A2, and significantly reduce the synthesis of type I collagen in SF after Gal-3 treatment. Particularly, the effect of MCP at a concentration of 500 mg/L on inhibiting the expression of TGF-β1, COL1A2, and Gal-3 in SF is significant. Conclusions:MCP can inhibit the excessive proliferation of SF and regulate gene expression in SF.

In Vitro Pharmacokinetics and Pharmacodynamic Evaluation of Jiaojiang Cataplasms / 中国实验方剂学杂志

ObjectiveTo study the in vitro kinetics of Jiaojiang cataplasms and evaluate its pharmacodynamics， so as to provide a feasible basis for the development of this preparation. MethodThe improved Franz diffusion cell was used for the in vitro release in semipermeable membrane and transdermal absorption in in vitro mouse skins. The contents of hydroxy-α-sanshool， 6-gingerol， ginsenoside Rb1 were determined by high performance liquid chromatography （HPLC）， to evaluate the in vitro release and transdermal absorption of Jiaojiang cataplasms. The mobile phase of 6-gingerol and hydroxy-α-sanshool was water-acetonitrile-methanol （2∶1∶1） with the detection wavelength of 280 nm. The mobile phase of ginsenoside Rb1 was acetonitrile-0.1% phosphoric acid aqueous solution （31∶69） with the detection wavelength of 203 nm. A mouse intestinal paralysis model was established， and mice were randomly divided into five groups， namely sham operation group， model group， domperidone group （3.9 mg·kg-1） and high- and low-dose groups of Jiaojiang cataplasms （6.2， 3.1 g·kg-1， measured by crude drug dosage）， to observe the effect of this preparation on gastrointestinal propulsion function. ResultAverage release rates of hydroxy-α-sanshool， 6-gingerol and ginsenoside Rb1 at 24 h were 16.41， 4.23， 4.15 μg∙cm-2∙h-1， the average transdermal rates of them at 24 h were 2.31， 0.64， 0.29 μg∙cm-2∙h-1， their skin retention values were 19.56， 3.59， 1.61 μg， respectively. According to the Ritger-Peppas equation， the release of hydroxy-α-sanshool， 6-gingerol， ginsenoside Rb1 was non-Fick diffusion. The high-dose group of Jiaojiang cataplasms could improve intestinal function of model mice after small intestinal friction injury， and promote intestinal peristalsis and small intestinal propulsion rate （P<0.05）. ConclusionJiaojiang cataplasms has in vitro release and transdermal properties， the in vitro release conforms to Higuchi equation， and transdermal absorption behavior conforms to zero-order kinetic equation， which can improve the postoperative function of the small intestine and the propulsion function of small intestine. It preliminarily indicates that the preparation has certain clinical development value.

Analysis of Chemical Constituents in Different Parts of Gentiana straminea Based on UPLC-Q-TOF-MS/MS / 中国实验方剂学杂志

ObjectiveUltra-performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry （UPLC-Q-TOF-MS/MS） was used to analyze the chemical constituents in the aerial part and roots of Gentiana straminea from different areas of Qinghai province， and the main chromatographic peaks and differential components of different parts were identified. MethodThe chromatographic separation was performed on a Waters ACQUITY UPLC HSS T3 column （2.1 mm×100 mm， 1.8 μm） with 0.1% formic acid aqueous solution （A）-acetonitrile （B） as the mobile phase for gradient elution （0-1 min， 1%-13%B； 1-5 min， 13%-18%B； 5-7 min， 18%-50%B； 7-9.5 min， 50%-60%B； 9.5-11 min， 60%-99%B； 11-14 min； 99%B； 14-15 min， 99%-1%B； 15-16 min， 1%B）， the column temperature at 40 ℃， and the flow rate of 0.3 mL·min-1. Electrospray ionization （ESI） and negative ion full scan mode were selected for the mass spectrometric conditions to analyze the samples， and the detection range was m/z 50-1 200. Chemical constituents of the aerial part were qualitatively analyzed with the reference substances， literature information and ChemSpider. Principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） were used to analyze the classification trend， correlation and differential chemical components between aerial part and roots of G. straminea. ResultA total of 68 components， including 24 iridoids， 13 flavonoids， 8 triterpenoids， 6 xanthones， 5 fatty acids， 4 saccharides， 3 phenolic glycosides， 2 alkaloids， 2 sterols and 1 lignan， were preliminarily identified from the aerial part of G. straminea. Among them， 42 components were firstly reported in 4 Gentiana species included in the 2020 edition of Chinese Pharmacopoeia. Eight differential components were screened out， namely sucrose， maltotriose， loganic acid， shanzhiside methyl ester， 6′-O-β-D-glucosylgentiopicroside， swertiamarin， gentiopicrin and isovitexin. ConclusionThe aerial part of G. straminea is rich in chemical constituents and has good medicinal potential. There were significant differences in the chemical components between the aerial part and roots of G. straminea， and the main differential components were iridoids， which could provide a basis for exploring efficacy differences in different parts of G. straminea.

Effect of Process Change on in Vitro Release and Percutaneous Penetration of Zushima Guanjie Zhitong Gao / 中国实验方剂学杂志

Objective:To investigate the effect of the production process of Zushima Guanjie Zhitong Gao from solvent method to hot-pressed method on <italic>in vitro</italic> kinetic behavior of this preparation. Method:Solvent and hot-pressed methods were used to prepare three batches of samples above pilot scale， and <italic>in vitro</italic> release and percutaneous penetration of the index components （7，8-dihydroxycoumarin and methyl salicylate） in Zushima Guanjie Zhitong Gao were investigated by modified Franz diffusing cells. Result:The contents of 7，8-dihydroxycoumarin and methyl salicylate in Zushima Guanjie Zhitong Gao prepared by solvent method were 73.72， 494.67 μg/patch， and their contents in hot-pressed method samples were 159.21， 2 638.99 μg/patch， respectively. In the solvent method samples， the average cumulative release amounts of 7，8-dihydroxycoumarin and methyl salicylate in 24 h were 2.04， 12.21 μg， and their average cumulative release amounts in 24 h of hot-pressed method samples were 2.16， 36.24 μg， respectively. In the solvent method samples， the average cumulative permeation amounts of 7，8-dihydroxycoumarin and methyl salicylate in 24 h were 0.38， 2.79 μg， and they were 0.40， 7.49 μg in hot-pressed method samples. The cumulative release and permeation amounts in 24 h of 7，8-dihydroxycoumarin in the hot-pressed method samples were basically the same as those of the solvent method samples， but the cumulative release and permeation amounts in 24 h of methyl salicylate in the hot-pressed method samples were significantly higher than those of the solvent method samples （<italic>P</italic><0.05）. Conclusion:The retention of 7，8-dihydroxycoumarin and methyl salicylate by hot-pressed method is better than that of the solvent method. The process change has no significant effect on the <italic>in vitro</italic> kinetics of 7，8-dihydroxycoumarin in Zushima Guanjie Zhitong Gao， however， after the change from the solvent method to the hot-pressed method， the methyl salicylate in this preparation has a higher cumulative release and permeation amounts.

Investigation of Transdermal Constituents and Molecular Mechanism of Euodiae Fructus in Treatment of Diarrhea by Transdermal Drug Delivery Based on Integrated Pharmacology and UPLC-Q-TOF-MS / 中国实验方剂学杂志

Objective:To identify the transdermal constituents of Euodiae Fructus and predict its molecular mechanism in treating diarrhea by transdermal drug delivery. Method:Ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS） and integrated pharmacology methods were used. The rapid identification of transdermal constituents of Euodiae Fructus was realized by the means of comparison of reference substances， analysis of UNIFI system and mass spectrometry. On this basis， Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP） v2.0， SymMap， DisGeNET databases and literature were used to collected potential targets of transdermal constituents of Euodiae Fructus and targets for diarrhea-related diseases. The disease targets and drug targets were topologically analyzed to obtain the core targets， which were used for the Gene Ontology （GO） function and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. Finally， Cytoscape 3.6.0 was used to build up a network of transdermal constituents-core targets-key pathways. Result:A total of 19 chemical constituents were speculatively identified from Euodiae Fructus extract， including quinolone alkaloids， limonins， indole alkaloids， organic acids and sterols. A total of 174 core targets of Euodiae Fructus for treating diarrhea were obtained by a topology analysis， signaling pathways of inflammatory response， cell proliferation， nutrient regulation and energy metabolism， signal transduction， bacterial infection were obtained through the analysis of KEGG enrichment. Conclusion:In this study， the transdermal constituents of Euodiae Fructus are identified for the first time， they can participate in the regulation of intestinal inflammation， maintain the integrity of intestinal mucosa， repaire and adjust the metabolism of the body by acting on Rac protein family， phosphatidylinositol 3-kinase， cytochrome P450 enzymes and aldo-keto reductase， respectively. In general， the molecular mechanism of Euodiae Fructus in the treatment of diarrhea is preliminarily elucidated.

Screening of Qualitative Preparation Quality Markers of Yuliantang / 中国实验方剂学杂志

Objective:To screen qualitative preparation quality markers of Yuliantang， in order to provide data support for the selection of indicator components， and establish the direct connection between indicator components and efficacy （Xiehuo Zhitong） for achieving the quantity-effect combination. Method:The stability of preparation process of Yuliantang lyophilized powder was investigated by HPLC fingerprint technology， then， the components in Yuliantang lyophilized powder were identified by UHPLC-LTQ-Orbitrap-MS. By referring to the relevant literature， the pharmacological activities of these identified compounds were compared with the pharmacological effects corresponding to the efficacy of Yuliantang， and the composition of the qualitative preparation quality markers of Yuliantang lyophilized powder was determined. Result:The similarities between HPLC fingerprint of 10 batches of Yuliantang lyophilized powder and the control fingerprint were >0.9， indicating that the preparation process was stable and feasible. A total of 29 components were identified from Yuliantang， of which 23 alkaloids， 3 phenylpropanoids， 2 sesquiterpenoids and 1 limonoid， and there were 15 ingredients of<italic> </italic>Coptidis Rhizoma， 12 ingredients of<italic> </italic>Euodiae Fructus， and 2 ingredients of<italic> </italic>Aucklandiae Radix. The composition of the qualitative preparation quality markers of Yuliantang was initially determined as magnoflorine or 10-hydroxy-2，3，9-trimethoxyberberine， phellodendrine， menisperine， thalifendine， groenlandicine， dehydroevodiamine， coptisine， jatrorrhizine， columbamine， methylcoptisine， berberine， epiberberine， palmatine， evodiamine， rutaecarpine， neochlorogenic acid， cryptochlorogenic acid， chlorogenic acid， limonin， costunolide， dehydrocostus lactone. Conclusion:The method for researching and screening the preparation quality markers in Yuliantang lyophilized powder is scientific， reasonable and feasible， it can provide reference for the determination of component indicators in the process research of Yuliantang and qualitative and quantitative indexes in its quality standard.

Screening of quantitative preparation quality markers of Yulian Decoction / 中国中药杂志

On the basis of the qualitative preparation quality markers of Yulian Decoction, we screened out the quantitative markers and explored a general strategy for analyzing the component migration in Chinese herbal pieces, preparations, and plasma. A method capable of simultaneously determining 28 chemical components in Yulian Decoction was established based on HPLC-MS/MS. This method was used to determine the migrated components in herbal pieces-lyophilized powder preparations-rat plasma after administration of Yulian Decoction. Liquid chromatography was performed under the following conditions: C_(18)-reversed phase chromatographic column(2.1 mm × 100 mm, 1.8 μm); acetonitrile-water(containing 0.1% formic acid) as the mobile phase for gradient elution; the flow rate of 0.2 mL·min~(-1). Electrospray ionization source was adopted for mass spectrometry detection, in which positive and negative ion modes and multiple reaction monitoring were applied. Confirmed by the methodological investigation in linear range, recovery(95.48%-103.4%), precision(RSD, 0.45%-3.8%), stability, and repeatability(RSD, 5.6%-14%), the established method was suitable for the detection and quantification of the components in Yulian Decoction. The results showed that in the lyophilized powder of Yulian Decoction, berberine was greater than 5% in mass fraction, magnoflorine, epiberberine, coptisine, palmatine, and limonin in the range of 1%-5%, and dehydroevodiamine, evodiamine, rutaecarpine, costunolide, and dehydrocostus lactone in the range of 0.002%-1%. Of the 28 components detected in pieces, 27 were found to migrate to the lyophilized powder, and 11 were detected in rat plasma. Fifteen components were preliminarily determined as quantitative preparation quality markers for Yulian Decoction, including berberine, epiberberine, coptisine, palmatine, evodiamine, rutaecarpine, limonin, costunolide, dehydrocostus lactone, magnoflorine, jatrorrhizine, columbamine, groenlandicine, chlorogenic acid, and neochlorogenic acid. In conclusion, the HPLC-MS/MS general strategy was established for analyzing the migration of multiple components in Chinese herbal pieces, preparations, and plasma, which can provide the basis for the screening of quantitative preparation quality markers and multi-index quality control of Yulian Decoction.

Observation of acupoint application of gel plaster on insomnia / 中国针灸

OBJECTIVE@#To observe the effect of acupoint application of gel plaster on quality of sleep and life in patients with insomnia.@*METHODS@#A total of 63 patients with insomnia were randomized into a gel plaster group (32 cases, 1 case dropped off) and a placebo plaster group (31 cases). Acupoint application of gel plaster was applied at Yintang (GV 29) and Yongquan (KI 1) in the gel plaster group, placebo plaster was applied at the same acupoints in the placebo plaster group. The treatment was given from bedtime to early moming of the next day, 5 days were as one course, with 2-day interval, totally 4 courses were required in the both groups. Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS) and Flinders fatigue scale were used to evaluate the sleep quality and fatigue level of the patients in the both groups before and after treatment and at 2 weeks of follow-up. The variations of insomnia TCM syndrome score and the 36-item short-form health survey (SF-36) score before and after treatment were observed.@*RESULTS@#Compared before treatment, the scores of PSQI, ESS and FFS after treatment and at follow-up were decreased in the both groups (@*CONCLUSION@#Acupoint application of gel plaster can effectively improve the quality of sleep and life in patients with insomnia.

Video-assisted thoracoscopic versus conventional surgery in internal fixation of multiple rib fractures / 中华急诊医学杂志

Objective:To compare the effects between video-assisted thoracoscopic surgery (VATS) and conventional surgery in internal fixation of multiple rib fractures.Methods:Patients with multiple rib fractures, who were admitted to Emergency Center of Shenzhen People's Hospital from June 2010 to May 2020, were included. Patients were divided into the VATS group (incision positioning with VATS) and the conventional group (incisionpositioning with CT scan). The primary outcome measures was the risk of complications, and the secondary outcome measures included postoperative pain, incision length, operation time, and mechanical ventilation rate. Continuous and categorical variables were compared using LSD- t test and Chi-square test. Repeated measures analysis of variance was performed to assess the trend of postoperative pain over time. A logistic regression analysis was used to explore the association of VATS with postoperative complications. Results:A total of 221 patients, including 128 patients in the VATS group and 93 patitents in the conventional group, were enrolled. Baseline characteristics were identical between the two groups ( P>0.05). In the VATS group, the length of incision, intraoperative blood loss, operation time, mechanical ventilation rate after operation, ventilation time, thoracic tube indwelling time, ICU and total length of stay, and medical costs were better than those in the conventional group (all P<0.05). Repeated measures analysis of variance showed that pain relief was faster and more profoundly in the VATS group than in the conventional group ( F=3 517.808, P<0.01). Logistic regression analysis indicated that VATS was an independent protective factor for reducing postoperative complications ( OR=0.225, 95% CI:0.121-0.416, P<0.01). Conclusions:During internal fixation of multiple rib fractures, VATS is an effective approach to reduce postoperative pain and complications. Moreover, video-assisted technique is associated with a rapid recovery for patients, resulting in shorter length of hospital stay and less medical costs.

New Method for Determination of Astragaloside Ⅳ in Astragali Radix / 中国实验方剂学杂志

Objective::To study on the feasibility of a new method for determination of astragaloside Ⅳ in Astragali Radix. Method::By summarizing the literatures about the method for determining the content of astragaloside Ⅳ in Astragali Radix and analyzing the results of the preliminary test, a new method for preparing a test solution of astragaloside was established, named " Reflow alkalization derivatization method" . The content determination test was carried out, and the content data of astragaloside Ⅳ in different batches of Astragali Radix measured by the pharmacopoeia method were compared with that by the Reflow alkalization derivatization method. Result::The new method for the determination of astragaloside Ⅳ conformed to the corresponding regulations. The content of astragaloside Ⅳ in astragali radix determined by the new method was higher than that by the pharmacopoeia method. The standard curve was Y=1.315X+ 6.311 2(r=0.999 7, n=6, linear range is 0.044 6-8.92 μg). The RSDs of intraday precision and daytime precision were 0.5% and 0.6%, respectively. The RSD of the repetitive experiment was 1.2%. The RSD of the 48 h stability test was 2.1%, and the RSD of the recovery test was 2.0%. The contents of astragaloside Ⅳ in 16 batches of Astragali Radix determined by Reflow alkalization derivatization method and pharmacopoeia method were 0.371%, 0.203%, 0.315%, 0.218%, 0.386%, 0.221%, 0.353%, 0.192%, 0.303%, 0.197%, 0.373%, 0.188%, 0.361%, 0.114%, 0.349%, 0.112%; 0.243%, 0.152%, 0.214%, 0.168%, 0.274%, 0.157%, 0.221%, 0.133%, 0.203%, 0.141%, 0.257%, 0.132%, 0.238%, 0.084%, 0.242%, and 0.096%. Conclusion::The Reflow alkalization derivatization method can be used to determine the content of astragaloside Ⅳ in Astragali Radix. This method is simpler to operate than the pharmacopoeia method, and the conversion efficiency of astragalus glycosides derivatives is better and reproducible. This method can provide reference for the formation of a fast, scientific and accurate method for the determination of astragalus Ⅳ.

Studies on the metabolism of a triptolide derivative (5R)-5-hydroxytriptolide in vitro / 药学学报

The purpose of current study is to investigate the metabolic profile of a triptolide derivative (5R)-5-hydroxytriptolide in vitro. (5R)-5-Hydroxytriptolide was incubated with the hepatocytes of human, monkey, dog, rat or mouse, respectively. Compared with inactivated hepatocytes, four metabolites were identified in hepatocytes from all five species: oxidative ring-opening metabolite (M1), glutathione-conjugating metabolite (M2), and monooxidative combined with glutathione-conjugating metabolites (M3-1 and M3-2), respectively. In human or rat liver microsomes, seven metabolites of (5R)-5-hydroxytriptolide were found, dehydrogenated metabolite (M4) and monooxidative metabolites (M5-1–M5-6), respectively. Reference standards for the metabolites were obtained either through chemical semisynthesis or biotransformation through rat primary hepatocytes. The structures of five metabolites were confirmed, which were 12,13-epoxy ring-opening metabolite M1, 12-glutathione-conjugating metabolite M2, (16S)-, (2R)- and (19R)-monohydroxylated metabolites M5-1, M5-4, and M5-5, respectively. In vitro activity assay revealed that only (2R)-hydroxylated metabolite exhibited weak immunosuppressive activity with less than one-tenth the activity of its parent drug, and a significant decrease in toxicity was observed. It is suggested that (5R)-5-hydroxytriptolide might undergo metabolic inactivation and detoxification in vivo.

Comparison of Pharmaceutical Characterization and Tissue Distribution Between Chuanqi Ophthalmic Microemulsion in situ Gel and Normal in situ Gel / 中国实验方剂学杂志

Objective: In this paper,the effect of microemulsion in Chuanqi ophthalmic microemulsion in situ gel was investigated. Method: The effect of microemulsion was confirmed by the parallel comparison between the Chuanqi microemulsion in situ gel and normal in situ gel,including study of pharmaceutical characterization and tissue distribution. Result: The average particle sizes of Chuanqi microemulsion in situ gel and normal in situ gel were (38.20±0.13) nm and (985±37) nm,respectively.Microemulsion could maintain the properties of nanocarrier in a microemulsion in situ gel composite system.The result of tissue distribution study showed that only ligustilide could be detected.This was related to the nature of these three indicator components(ligustrazine,ligustilide and astragaloside A).The common logarithm of oil and water partition coefficient of ligustilide(lgP) was 2.87,which was consistent with the range of lgP of ideal ophthalmic drugs(lgP=2.0-3.0).The ligustilide from Chuanqi microemulsion in situ gel could be detected in the cornea,vitreous body and retina,and this compound from normal in situ gel could only be detected in the cornea with low content.At the same time,microemulsion could increase the content of ligustilide in corneal tissues. Conclusion: The characteristics of microemulsion nanocarriers can increase the solubility of ligustilide,compared with normal in situ gel,it can be better distributed in the tears outside the corneal,it reaches the cornea with a higher concentration,and forms a corneal concentration gradient,and ligustilide is transported from the anterior ocular region to the posterior ocular region through the transocular barrier.

Safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy: a meta-analysis / 中华肝胆外科杂志

Objective@#To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver during hepatectomy.@*Methods@#The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5.3 software.@*Results@#A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle’s maneuver alone (MD=-314.59, 95%CI: -362.37~-266.81, P<0.05). Bleeding during hepatectomy was significantly lower (MD=-217.79, 95% CI: -284.57~-151.00, P<0.05); so was the intraoperative blood transfusion rate (OR=0.48, 95% CI: 0.36~0.62, P<0.05). The incidence of complications was significantly lower (OR=0.74, 95% CI: 0.57~0.95, P<0.05). However, there were no significant differences in operation time, length of hospital stay, intraoperative monitoring index and postoperative liver and kidney function recovery (P>0.05).@*Conclusions@#Infra-hepatic inferior vena cava clamping combined with Pringle’s maneuver in hepatectomy was safe and reliable. Compared with the Pringle’s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

Safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy:a meta-analysis / 中华肝胆外科杂志

Objective To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy. Methods The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5. 3 software. Results A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle's maneuver alone (MD= -314. 59, 95％CI:-362. 37～ -266. 81, P<0. 05). Bleeding during hepatectomy was significantly lower ( MD= -217. 79, 95％ CI: -284. 57 ～ -151. 00, P<0. 05); so was the intraoperative blood transfusion rate ( OR = 0. 48, 95％ CI: 0. 36 ～ 0. 62, P<0. 05). The incidence of complications was significantly lower (OR =0. 74, 95％ CI: 0. 57 ～0. 95, P<0. 05). However, there were no significant differences in operation time, length of hospital stay, intrao-perative monitoring index and postoperative liver and kidney function recovery ( P >0. 05 ) . Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver in hepatectomy was safe and reliable. Compared with the Pringle' s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.

Protective effect of aucubinon on the eucommia ulmoides on skin photoaging induced by UVB / 国际中医中药杂志

Objective To explore the protective effect of aucubin on the photoageing of the skin that induced by ultraviolet (UVB) radiation. Methods Human skin fibroblasts were divided into normal group, model group and high, medium and low dose groups of apocynin by random method. Except the normal group, the other groups of cells were subjected to UVB radiation with a radiation wavelength of 311 nm, irradiation intensity of 9.00 mw/cm2, radiation time of 2.8 s, radiation dose of 25 mJ/cm2. The cells in the high, medium and low doses of aglycone were cultured for 24 h at an equal volume of 400, 200, 100 μg/ml, and then subjected to UVB irradiation, and then cultured for 24 h. The normal group and the model group were cultured for 48 h in a common medium. The apoptosis rate of each group was detected by flow cytometry. The levels of IL-1, IL-6 and TNF-α in each group were detected by ELISA. The expressions of Bax and Bcl-2 mRNA in each group were detected by RT-PCR. Results Compared with the model group, the apoptosis rate (4.84% ± 0.24%, 12.32% ± 0.67% vs. 35.63% ± 2.77%) in the medium and high dose group significantly decreased (P<0.05), the content of IL-1 (21.14 ± 1.94 ng/ml, 16.17 ± 0.74 ng/ml vs. 22.55 ± 1.02 ng/ml), IL-6 (17.46 ± 0.93 ng/ml, 14.51 ± 0.79 ng/ml vs. 18.39 ± 2.05 ng/ml), TNF-α (44.21 ± 1.16 ng/ml, 35.94 ± 3.08 ng/ml vs. 45.67 ± 2.28 ng/ml) significantly increased (P<0.05). Compared with the model group, the expression of Bax mRNA (0.29 ± 0.05, 0.42 ± 0.05, 0.51 ± 0.04 vs. 0.59 ± 0.05) significantly decreased, and the expression of Bcl-2 mRNA (0.52 ± 0.04, 0.44 ± 0.03, 0.35 ± 0.03 vs. 0.26 ± 0.04) significantly increased (P<0.05). Conclusions The aucubin has protective function to the damage of skin fibroblasts which is induced by UVB radiation, indicating the protective function of decreasing Bax mRNA expression, increasing Bcl-2 mRNA expression, reducing the expression of inflammatory factor IL-1, IL-6, TNF-α, holding-up the cell apoptosis which is induced by UVB radiation, and inhibiting apoptosis of cell that caused by UVB radiation, playing an role of protective fibroblasts for delay of the photoageing.

Chinese Herbal Medicine Combined with Entecavir for HBeAg Positive Chronic Hepatitis B: Study Protocol for a Multi-Center, Double-Blind Randomized-Controlled Trial / 中国结合医学杂志

<p><b>BACKGROUND</b>The domestic prevalence of chronic hepatitis B (CHB) in China is 7.18% in 2006, imposing great societal healthcare burdens. Nucleot(s)ide analogues (NUCs) anti-hepatitis B virus (HBV) therapies are widely applied despite the relatively low rate of seroconversion and high risk of drug-resistant mutation. More effective treatments for CHB deserve further explorations. Combined therapy of NUCs plus Chinese herbal medicine (CHM) is widely accepted in China, which is recognized as a prospective alternative approach. The study was primarily designed to confirm the hypothesis that Tiaogan-Yipi Granule (, TGYP) or Tiaogan-Jianpi-Jiedu Granule (, TGJPJD) plus entecavir tablet (ETV) was superior over ETV monotherapy in enhancing HBeAg loss rate.</p><p><b>METHODS</b>The study was a nationwide, large-scale, multi-center, double-blind, randomized, placebo-controlled trial with a designed duration of 108 weeks. A total of 16 hospitals and 596 eligible Chinese HBeAg positive CHB patients were enrolled from November 2012 to September 2013 and randomly allocated into 2 groups in 1:1 ratio via central randomization system: experimental group (EG) and control group (CG). Subjects in EG received CM formulae (TGYP or TGJPJD, 50 g per dose, twice daily) plus ETV tablet (or ETV placebo) 0.5 mg per day in the first 24 weeks (stage 1), and CHM granule plus ETV tablet (0.5 mg per day) from week 25 to 108 (stage 2). Subjects in CG received CHM Granule placebo plus ETV tablet (0.5 mg per day) for 108 weeks throughout the trial. The assessments of primary outcomes (HBV serum markers and HBV-DNA) were conducted by a third-party College of American Pathologists (CAP) qualified laboratory. Adverse effects were observed in the hospitals of recruitment.</p><p><b>DISCUSSION</b>The study was designed to compare the curative effect of CM plus ETV and ETV monotherapy in respect of HBeAg loss, which is recognized by the European Association for the Study of the Liver as "a valuable endpoint". We believe this trial could provide a reliable status for patients' "journey" towards durable responses after treatment discontinuation. The trial was registered before recruitment on Chinese Clinical trial registry (No. ChiCTR-TRC-12002784, Version 1.0, 2015/12/23).</p>

Study on classic preparations / 中国中药杂志

In this paper, classic preparations in Treatise on Febrile Diseases were systematically investigated to obtain their process parameters, and provide literature evidence and technical support for drug research and development. This paper includes the following sections: drug dose, solvents, excipients, and process parameters of classic preparations. The drug dose in Treatise on Febrile Diseases was not consistent with that in Pharmacopoeia of the People's Republic of China 2015, for example, "Yi-Liang" was about 15.625 g, and "Yi-Sheng" was about 200 mL. The solvents of classic preparations can be divided into two types: wine and water. There were eight kinds of water: water, "Dongliu water" "Ganlan water" "acid pulp" "Jinghua water" "Lao water" "Mafei Tang" "spring water". There four kinds of wines: "wine" "Bai wine" "Qing wine" "Ku wine". There were two kinds of excipients: rice and honey. Classic prescription powder had two kinds of processes: "whole prescription powder" and "Yidaoshai Hezhizhi powder". Classic prescription pills had three kinds of processes: direct whole prescription pilling, pilling after extraction, and pilling with excipients after smashing. Classic prescription decoction had six kinds of processes: "wine Tang", "Mafei Tang", "Jingmi Tang", "Mijian Tang", "water Tang" "Zhugao Tang". Drug dose, solvents, excipients, processes and other key parameters of classic preparations were systemically reviewed in this study, and the process parameters were clarified to provide literature evidence and technical support for drug development.

Analysis on Usage of TCM Decoction Pieces in First Hospital of Zhangjiakou City During 2014-2016 / 中国中医药信息杂志

Objective To analyze usage and development trend of TCM decoction pieces in First Hospital of Zhangjiakou City (hereinafter referred to as "our hospital") from 2014 to 2016; To provide the basis for making reasonable purchase plan, reserving TCM decoction pieces and guaranteeing clinical medication.Methods Computer medicine management system was used to conduct statistical analysis on the prescription or order number, dosage, sales, and top 10 TCM decoction pieces among annual consumption and sales of TCM decoction pieces from 2014 to 2016.Results The results showed that the prescription and the order, dosage and sales of TCM decoction pieces decreased year by year. The top 10 TCM decoction pieces in the three years were the same with nine kinds, namely Astragali Radix, Poria, Angelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, Ophiopogonis Radix, Coicis Semen, Citri Reticulatae Pericarpium, and Lycii Fructus. Conclusion The usage of TCM decoction pieces in our hospital is reasonable and the structure of medication is stable.

Research progression of interleukin 22 and inflammatory bowel disease / 医学研究生学报

Inflammatory bowel disease (IBD) is a type of multi-etiology-induced, abnormal immune-mediated chronic recurrent inflammation of the intestine, which includes ulcerative colitis (UC) and Crohn's disease,(CD). IL-22 is a cytokine with unique biological properties. In the intestine, IL-22 has the ability to promote the expression of antimicrobial peptides and mucins that promote mucosal barrier integrity by activating the STAT3 pathway, and may promote intestinal epithelial cell regeneration and enhance intestinal epithelial cell barrier function. IL-22 is significantly increased in the intestinal mucosa of IBD patients. IL-22 can promote the repair of intestinal inflammatory damage, but with environmental changes, such as the level of expression of IL-23, T-bet, IL-22 binding protein, IL-22displayed dural characteristic, on the one hand, it can promote the repair of inflammatory injury, on the other hand it will increase the inflammatory injury response. This article mainly explains the origin of IL-22, its mode of action, and its application prospects in clinical treatment.