Involvement of spinal cannabinoid receptor type 2 in the analgesia effect of hyperbaric oxygen treatment on paclitaxel-induced neuropathic pain.

BACKGROUND: Chemotherapy-induced neuropathic pain (CINP) is intractable, and spinal cannabinoid receptors (CBRs) are potential therapeutic targets for CINP. Previous studies demonstrated that hyperbaric oxygen (HBO2) may contribute in alleviating specific peripheral neuropathic pain. However, neither CINP nor CBR have been clarified. We hypothesized that HBO2 is capable of alleviating CINP, and the effect could be explained by the activation of spinal CBRs. METHODS: A series of paclitaxel-induced CINP models were established on male Sprague-Dawley rats. Then HBO2 treatment was administered for seven consecutive days at 2.5 atmospheres absolute. Two groups were treated with AM251 (an antagonist of CBR type-1, CBR1) or AM630 (an antagonist of CBR type-2, CBR2) respectively 30 minutes before each HBO2 treatment. The mechanical withdrawal threshold was assessed before, during and at two weeks after HBO2 treatment. Lumbar spinal cords were collected for Western blot analysis of CBR1, CBR2, GFAP and CD11b, and ELISA analysis of proinflammatory cytokines IL-1ß and TNF-α. RESULTS: A mechanical allodynia was successfully exhibited and the spinal GFAP, CD11b, IL-1ß and TNF-α significantly increased after the modeling, and these effects could be further reversed by HBO2 treatment, which could be blocked by AM630, other than AM251. CONCLUSION: HBO2 treatment can alleviate paclitaxel-induced neuropathic pain, and be mediated by CBR2. Spinal glial cells and proinflammatory cytokines are involved in this process.

AB4 inhibits Notch signaling and promotes cancer cell apoptosis in liver cancer.

The etiology for liver cancer has been clearly defined. Unfortunately, therapeutic approaches for liver cancer are rather limited, and liver cancer is insensitive to chemotherapy and radiotherapy. Traditional Chinese medicine (TCM) has become a promising strategy for cancer treatment as TCM elicits broad spectrum anticancer activity. In the present study, we evaluated the anticancer efficacy of AB4, an extract from the medical herb Pulsatilla chinensis (Bunge) Regel, in liver cancer in vitro and in vivo. We found that AB4 readily dose­ and time­dependently inhibited liver cancer HepG2 and Huh­7 cell proliferation and colony formation. Western blot and flow cytometry analyses suggested that AB4 treatment induced liver cancer cell apoptosis. Moreover, these findings could be readily recaptured in vivo, in which the AB4 regimen resulted in tumor suppression and cancer cell apoptosis in xenograft tumor­bearing nude mice. Importantly, we noted that treatment with a Notch signaling inhibitor DAPT produced very similar anticancer efficacy in both HepG2 and Huh­7 cell lines, and administration of DAPT also efficiently suppressed HepG2 xenograft outgrowth. To this end, we anticipated that AB4 and DAPT may act on the same signaling pathway, probably through inhibition of the Notch pathway. Indeed, we found decreased expression of Notch1 protein, as well as downstream targets Hes1 and Hey1, after AB4 treatment. Immunohistochemistry analysis further confirmed the suppression of Notch signaling in HepG2 xenograft­bearing mice. Taken together, our study highlighted the anticancer efficacy of AB4 in liver cancer. We also provided preliminary data showing Notch as a therapeutic target of AB4. It would be interesting to investigate the anticancer efficacy of AB4 in other types of cancer with elevated Notch activity.

Developing an Integrated Electronic Medication Reconciliation Platform and Evaluating its Effects on Preventing Potential Duplicated Medications and Reducing 30-Day Medication-Related Hospital Revisits for Inpatients.

The aims were to develop an integrated electronic medication reconciliation (ieMR) platform, evaluate its effects on preventing potential duplicated medications, analyze the distribution of the potential duplicated medications by the Anatomical Therapeutic and Chemical (ATC) code for all inpatients, and determine the rate of 30-day medication-related hospital revisits for a geriatric unit. The study was conducted in a tertiary medical center in Taiwan and involved a retrospective quasi pre-intervention (July 1-November 30, 2015) and post-intervention (October 1-December 31, 2016) study design. A multidisciplinary team developed the ieMR platform covering the process from admission to discharge. The ieMR platform included six modules of an enhanced computer physician order entry system (eCPOE), Pharmaceutical-care, Holistic Care, Bedside Display, Personalized Best Possible Medication Discharge Plan, and Pharmaceutical Care Registration System. The ieMR platform prevented the number of potential duplicated medications from pre (25,196 medications, 2.3%) to post (23,413 medications, 3.8%) phases (OR 1.71, 95% CI, 1.68-1.74; p < .001). The most common potential duplicated medications classified by the ATC codes were cardiovascular system (28.4%), alimentary tract and metabolism (26.4%), and nervous system (14.9%), and by chemical substances were sennoside (12.5%), amlodipine (7.5%), and alprazolam (7.4%). The rate of medication-related 30-day hospital revisits for the geriatric unit was significantly decreased in post-intervention compared with that in pre-intervention (OR = 0.12; 95% CI, 0.03-0.53; p < .01). This study indicated that the ieMR platform significantly prevented the number of potential duplicated medications for inpatients and reduced the rate of 30-day medication-related hospital revisits for the patients on the geriatric unit.

The impact of a medication reconciliation programme at geriatric hospital admission: A pre-/postintervention study.

AIMS: The aim of this study was to improve medication reconciliation and reduce the occurrence of duplicate prescriptions by pharmacists and physicians within 72 hours of hospital admission using an intelligent prescription system combined with the National Health Insurance PharmaCloud system to integrate the database with the medical institution computerized physician order entry (CPOE) system. METHODS: This 2-year intervention study was implemented in the geriatric ward of a hospital in Taiwan. We developed an integrated CPOE system linked with the PharmaCloud database and established an electronic platform for coordinated communication with all healthcare professionals. Patients provided written informed consent to access their PharmaCloud records. We compared the intervention effectiveness within 72 hours of admission for improvement in pharmacist medication reconciliation, increased at-home medications documentation and decreased costs from duplicated at-home prescriptions. RESULTS: The medication reconciliation rate within 72 hours of admission increased from 44.0% preintervention to 86.8% postintervention (relative risk = 1.97, 95% confidence interval [CI]: 1.69-2.31; P < .001). The monthly average of patients who brought and took home medications documented in the CPOE system during hospitalization increased by 7.54 (95% CI 5.58-20.49, P = .22). The monthly average of home medications documented increased by 102.52 (95% CI 38.44-166.60; P = .01). Savings on the monthly average prescription expenditures of at-home medication increased by US$ 2,795.52 (95% CI US$1310.41-4280.63; P < .01). CONCLUSION: Integrating medication data from PharmaCloud to the hospital's medical chart system improved pharmacist medication reconciliation, which decreased duplicated medications and reduced in-hospital medication costs.

[Chemical Constituents from Saururus chinensis].

OBJECTIVE: To investigate the chemical constituents of active components of Saururus chinensis on anti-nicotine withdrawal symptoms. METHODS: Various column chromatography were used in the isolation and purification, and physiochemical constant determination and spectral analysis were adopted to determine the chemical structures. RESULTS: Six chemical compounds were isolated from the active part of anti-withdrawal symptoms, and were identified as 4'-hydroxyl-3,3',4,5,5'-pentamethoxy-7,7'-epoxylignan (1) ,3-(2-nitroethyl)-1-methoxyindole(2), elemicin (3), erythro-(7R, 8S) - (-) - (3,4,5-trimethoxy-7-hydroxy-1'-allyl-3', 5'-dimethoxy)-8-O-4'-neolignan (4), 3,4,5-trimethoxy-phenylacrylaldehyde (5) and dibutyl phthalate (6). CONCLUSION: Compound 1 is a novel lignan, compounds 2 - 6 are firstly isolated from this plant.

[Study on chemical constituents of Eucommia ulmoides leaves].

OBJECTIVE: To investigate the chemical constituents of Eucommia ulmoides leaves. METHODS: Various column chromatography were used in the isolation and purification, physiochemical constant determination and spectral analysis were adopted to determine the chemical structures. RESULTS: Ten compounds were isolated and identified as borreriagenin (1), n-butyl-O-ß-D-fructopyranoside (2), α-D-glucopyranosyl-(1-->1')-3'-amino-3'-deoxy-ß-D-glucopyranoside (3), ß-D-fructofuranosyl-α-D-galactopyranoside (4), ß-D-fructose (5), diisobutyl phthalate (6), 5-hydroxy-9-isopropylether-guaiacylglycerol (7), 4-hydroxyphenylethanol-8-O-ß-D-apiofuranosyl(1-->6)-ß-D-glucopyranoside (8), lariciresinol (9), and (3S,5R,6R,9S)-tetrahydroxy-7-ene-megastigmane (10). CONCLUSION: All compounds are isolated from this genus for the first time.

[Study on chemical constituents in the roots and rhizome of Trillium tschonoskii (III)].

OBJECTIVE: To investigate the chemical constituents in the roots and rhizome of Trillium tschonoskii. METHODS: The roots and rhizome of Trillium tschonoskii were extracted with 70% ethanol and purified by polyamide, silica gel, RP-C18 and Sephadex LH-20 column chromatography. Chemical structures were identified by MS, 1D and 2D NMR experiments. RESULTS: Twelve compounds were isolated and identified from the ethyl acetate and n-butanol as 7,11-dimethyl-3-methylene-10, 11-dihdroxyl-1,6-dodecadien-diol(1),2, 6,10-trimethyl-2,10-dihdroxyl-6-dodecene-diol(2),3,7,11-trimethyl-3,9,11-trihydroxyl-1,6-dodecadiene-glycerol(3),p-hydroxymethyl-benzyl alcohol(4),20betaF, 22alphaF, 25alphaF-spirostan-5,13-ene-3beta,21alpha-diol(5), 2-methyl-3,4-dihydroxy-hexanedioic acid(6), alpha-Lrhamnopyranosyl(7), epitrillenogenin-24-O-acetate-1-O-[2,3,4,-tri-O-acetyl-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranoside] (8),epitrillenogenin-24-O-acetate-1-O-[2,4, -di-O-acetyl-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranoside](9), epitrillenogenin1-O-[2,3,4,-tri-O-acetyl-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L-arabinopyranoside] (10), epitrillenogenin-1-O-[2,4, -di-O-acetyl-alpha-Lrhamnopyranosyl-(1-->2) -alpha-L-arabinopyranoside] (11) and epitrillenogenin-1-O-[4-O-acetyl-alpha-L-rhamnopyranosyl-(1-->2) -alpha-L-arabinopyranoside] (12). CONCLUSION: Compounds 4-6 are isolated from this genus for the first time, compounds 1-3, 11, 12 are isolated from this plant for the first time.

[Effects of auricular acupuncture on the memory and the expression of ChAT and GFAP in model rats with Alzheimer's disease].

OBJECTIVE: To observe the effects of auricular acupuncture on the learning and memory abilities of model rats with Alzheimer's disease (AD), and investigate its mechanism. METHODS: Thirty SD rats were randomly divided into a control group, a model group and an auricular acupuncture group, 10 rats in each group. The model rats with AD were established by multiple injections with Okadaic Acid into the CA1 region of hippocampus. In the control group, the same quantity injection with Dimethyl Sulfoxide (DMSO) was applied on experimental rats. The auricular acupoints of "Nao" (brain) and "Shen" (kidney) were used for treating in the auricular acupuncture group, in contrast, the auricular region were not treated in the model and the control groups. The learning and memory capabilities of the rats were assessed with Morris Water Maze behavioral test, and the expressions of choline acetyltransferase (ChAT) and glial fibrillary acidic protein (GFAP) were examined by immunohistochemistry. RESULTS: Comparing with the model group, the treated AD rats with auricular acupuncture was showed that the average escape latency was obviously shortened in the place navigation test (P<0.01), the movement time in plateform quadrant was obviously prolonged in the spatial probe test (P<0.05), and the number of traversing platform obviously increased (P<0.01) after the platform was taken away. The expression of ChAT increased in the hippocampus and cortex (P<0.01, P<0.05), but the expression of GFAP obviously decreased in the CA1 region of hippocampus (P<0.01). CONCLUSION: Auricular acupuncture can improve the learning and memory capability of the model rats with AD. Its mechanism might be related with decreasing cholinergic neuron damage and reducing the abnormal activation and hyperplasia of astrocyte.