Consensus on diagnostic criteria for deficiency syndrome in hypertension: a modified Delphi study.

OBJECTIVE: To reach consensus on the diagnostic criteria for deficiency syndrome in hypertension (YDSH) patients by a modified Delphi method. METHODS: Our study was consistent with T/CACM 1032-2017. The methodology of RAND/UCLA appr-opriateness was used to develop consensus guidance statements. A nationwide panel of experienced clinical experts from 19 provinces was constructed. These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases. This con-sensus process consisted of two rounds of ques-tionnaires and a final round of consultation to analyze the weight score of each item. Moreover, the data extraction process is carried out independently by third-party researchers (LIANG Junya, SUN Yang, and DU Xiaona). When there is disagreement in all three rounds, the expert panel group (odd number) are invited to vote, and the one with more votes wins. In the questionnaires, participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale. The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement. And then the diagnostic criteria of YDSH were formed according to the weight score in the final round. RESULTS: Twenty-eight experts (84.8%) participated in the first round, and thirty-one (93.9%) finished the second round. After two rounds, the consensus of YDSH was reached on 11 items (25.6%), including symptoms, signs, and pulse condition. Twenty-one experts (63.6%) com-pleted the final round in which they used a grading system for each item. Red tongue with scanty fur had the highest weighting (22.8%), followed by heat in the palms and soles (20.1%). CONCLUSIONS: The consensus-based diagnostic criteria for YDSH, formed by a modified Delphi method, can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

Inhibitory effect of chikusetsusaponin IVa on proliferation of triple negative breast cancer cells / 药学学报

Chikusetsusaponin IVa (CsIVa) is a natural active monomer of triterpene saponins in the Chinese herbal medicine of Panax japonicus, which has anti-inflammatory, anti-tumor and other effects. However, its function and mechanism in triple negative breast cancer (TNBC) remain unclear. This study investigated the inhibitory effect and mechanisms of CsIVa on the proliferation of triple negative breast cancer cell line MDA-MB-231. In this study, we found that CsIVa could significantly inhibit the proliferation of MDA-MB-231 cells and eliminate its potential toxic effect on normal breast cells (MCF-10A). The transcriptome sequencing results showed that the inhibition of proliferation of MDA-MB-231 cells by CsIVa was closely related to cell cycle and the pathway regulating cell cycle. Further studies confirmed that CsIVa blocked the cell cycle in G2/M phase by down-regulating the expression of cyclin dependent kinase 1 (CDK1), cyclin B1 and up-regulating the expression of cyclin dependent kinase inhibitor 1A (p21). Moreover, CsIVa can block cell cycle through inhibiting PI3K/AKT signal pathway. In conclusion, CsIVa regulates the expression of cell cycle related proteins (p21, CDK1, cyclin B1) via inhibiting the activity of PI3K/AKT signaling pathway, blocks TNBC cell cycle, and thus exerts its anti-tumor activity.

Mechanism of Qi-invigorating and Blood-activating Therapy in Mediating Autophagy of Precancerous Lesions of Atrophic Gastritis by miR216b/Beclin1 / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Qi-invigorating and blood-activating therapy on the miR216b/Beclin1 pathway in mice with atrophic precancerous lesions of gastric cancer （PLGC） and analyze its mechanism in autophagy of PLGC. MethodSeventy-five healthy male SPF KM mice were randomly divided into a blank group and a model group. Mice in the model group were given 1-methyl-3-nitroso-1-nitrosoguanidine （MNNG） solution （150 mg·L-1） for free drinking and gavage and ranitidine solution （0.03 g·kg-1） daily for 12 weeks. According to the random control table， mice were divided into a model group， a Qi-invigorating group （3.5 g·kg-1 of Astragali Radix）， a blood-activating group （0.7 g·kg-1 of Notoginseng Radix et Rhizoma powder）， a Qi-invigorating and blood-activating group （3.5 g·kg-1 of Astragali Radix + 0.7 g·kg-1 of Notoginseng Radix et Rhizoma powder）， and a folic acid group （2 mg·kg-1）. The corresponding drugs were given to mice in each group for 8 weeks and then the tissues were collected. Hematoxylin-eosin （HE） staining was carried out to observe the changes in gastric mucosa. Western blot was used to detect the protein expression of microtuble-associated protein 1 light chain 3 （LC3）Ⅰ， LC3Ⅱ， and Beclin1. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of Beclin1 and miR-216b. ResultPathological observation showed that as compared with the blank group， the intrinsic glands of gastric mucosa decreased with atrophy and intestinal metaplasia in the model group， which were improved in all treatment groups， and the improvement of the Qi-invigorating and blood-activating group was the most obvious. As compared with the blank group， the content of LC3Ⅰ， LC3Ⅱ， LC3Ⅱ/LC3Ⅰ， and Beclin1 protein in gastric tissues of the model group was significantly decreased （P<0.05）. As compared with the model group， the content of LC3Ⅰ， LC3Ⅱ， LC3Ⅱ/LC3Ⅰ， and Beclin1 protein in gastric tissues of each treatment group was increased （P<0.05， P<0.01）. The increase was most obvious in the Qi-invigorating and blood-activating group. As compared with the blank group， the mRNA expression of Beclin1 in the model group was decreased （P<0.05）， and that of miR216b was increased （P<0.05）. As compared with the model group， the mRNA expression of Beclin1 was increased and that of miR216b was decreased in each treatment group （P<0.05）， and the changes were the most obvious in the Qi-invigorating and blood-activating group. ConclusionThe mechanism of the Qi-invigorating and blood-activating therapy， represented by Astragali Radix and Notoginseng Radix et Rhizoma， in treating PLGC may be through inhibiting the expression of miR216b and activating Beclin1， thus promoting autophagy and repairing gastric mucosa.

Observation of the efficacy and safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation for patients with prediabetes / 针灸推拿医学（英文版）

Objective: To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods: One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method, with 51 cases in each group. All patients received the general behavioral intervention for prediabetes, with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group. Both groups received the intervention for six months. Results: Fourteen patients dropped out during the treatment, and a total of 88 patients completed the trial, including 45 cases in the manipulation group and 43 cases in the control group. After the treatment, the prediabetes control rate was 93.3％ in the manipulation group and 74.4％ in the control group, and the difference between the two groups was statistically significant (P<0.05); no patient in the manipulation group progressed to diabetes, while the rate of conversion to diabetes in the control group was 6.9％, with a significant difference between the two groups (P<0.05). After the treatment, the body mass index (BMI), glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG) level during an oral glucose tolerance test (OGTT), fasting insulin (FINS), homeostasis model assessment-2 of insulin resistance (HOMA2-IR), total cholesterol (TC), and triglycerides (TG) decreased in both groups versus baseline, with significant differences within the groups; the levels of all indicators were lower in the manipulation group than in the control group (P<0.05), and the differences between the two groups were more prominent at the sixth month (P<0.01). At the sixth month, the high-density lipoprotein cholesterol (HDL-C) in the manipulation group was increased, while there was no significant change in the control group. In the control group, three patients reported mild gastrointestinal reactions at the initial dosing, which improved after medication adjustment. No other adverse events were observed in either group. Conclusion: Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes, but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.

The origin, development and academic thoughts of the blood-pricking school / 中国针灸

This study sorted out the records of blood-pricking therapy in ancient and modern medical literature, and clarified the origin and development of blood-pricking school. The main stages of the school development included origin and germination stage, the theoretical development stage, the experience accumulation stage, the theoretical innovation and characteristic formation stage, the continuous improvement and maturity stage and the unprecedented development stage. The main academic thoughts included the idea of resolutely eliminating the blood-excess, the idea of completely expelling evil, the idea of simultaneous application of acupuncture-moxibustion and medication and the idea of focusing the use of jing-well point. This school has a far-reaching impact on modern clinical practice.

Protective effects of Lonicerae Japonicae Flos against acute alcoholic liver injury in rats based on network pharmacology / 中国中药杂志

This study aims to explore underlying mechanism of Lonicerae Japonicae Flos(LJF) in protecting rats against acute alcoholic liver injury(ALI) based on mitogen-activated protein kinase(MAPK) pathway. First, the targets of LJF in preventing ALI were predicted by network pharmacology and the component-target-pathway network was constructed, so that the key targets of LJF components acting on MAPK pathway were screened. Second, male SD rats were randomized into the control(KB) group, model(MX) group, positive(YX) group, and LJF high-(GJ), medium-(ZJ), and low-(DJ) dose groups. Each administration group was given(ig) corresponding drugs for 7 days and KB group and MX group received(ig) equal volume of distilled water every day. Except for KB group, rats were given Chinese spirit(56%, 3 days) for ALI modeling. The levels of aspartate transaminase(AST), alanine transaminase(ALT), interleukin-6(IL6) and tumor necrosis factor-α(TNF-α) in serum and malondialdehyde(MDA), glutathione(GSH), superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in liver tissue of rats in each group were detected. Furthermore, we employed quantitative real-time PCR(qRT-PCR) to probe the effects of LJF on the key targets of MAPK pathway in ALI rats. A total of 28 active components of LJF were screened from TCMSP database, and 317 intersected with ALI-related targets. According to Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis, the 317 targets involved 226 pathways, which were mainly liver disease, inflammation, immunity, apoptosis and other related pathways. According to the MAPK pathway-target-active component network, the key active components of LJF, such as chlorogenic acid, hederagenol, and hyperoside, acted on 25 key targets of MAPK pathway. The results of in vivo experiments showed decreased levels of AST, ALT, and MDA in DJ, ZJ, and GJ groups(P<0.01 or P<0.05), reduced levels of IL6 in DJ and GJ groups(P<0.01 or P<0.05), and improved levels of SOD and GSH in ZJ and GJ groups(P<0.01 or P<0.05). The results of qRT-PCR demonstrated that the expression levels of mitogen-activated protein kinase kinase 4(MAPK2 K4) and mitogen-activated protein kinase 3(MAPK3) were decreased in DJ, ZJ, and GJ groups(P<0.01). The network pharmacology and experimental verification showed that the active components in LJF can reduce the inflammatory factor level and enhance the activities of SOD and GSH-Px by inhibiting the expression of key targets of MAPK pathway, thus alleviating and preventing liver damage caused by alcohol.

Research Progress in Pharmacology of Xiaoyaowan / 中国实验方剂学杂志

In traditional Chinese medicine， it is believed that the spleen is the foundation of acquired nature and the source of Qi and blood. All life activities of a person since birth depend on the water and grain essence transported by spleen and stomach. The liver helps the spleen to strengthen the movement， the liver and spleen cooperate with each other. The liver and the spleen are invigorated， so that the Qi and blood are sufficient. The external energy can nourish the limbs， muscles and fur. The Qi and blood can be supplied to the internal organs， meridians and bones， and the body can be nourished both inside and outside to strengthen the acquired foundation. Emotional dissatisfaction can lead to stagnation of liver Qi， loss of spleen Qi， failure to dredge Qi， and deficiency of spleen Qi， forming the syndrome of liver depression and spleen deficiency. Its clinical manifestations include the symptoms of liver Qi stagnation such as depression， stamina， and chest fullness， as well as symptoms of spleen deficiency such as anorexia， abdominal distension， loose stools. Xiaoyaowan is an effective classic prescription for the treatment of liver stagnation and spleen deficiency syndrome， which is based on the dosage form of Xiaoyaosan in Prescriptions of the Bureau of Taiping People's Welfare Pharmacy. It has the effect of relieving depression， nourishing blood and invigorating spleen. In modern research， it has been found that Xiaoyaowan has good curative effect in the treatment of endocrine diseases， liver diseases， immune diseases， and neurological diseases， etc. It was praised by the famous medical scientist YE Tian-shi in the Qing Dynasty as "the holy medicine for women"， with a wide range of significant curative effects gynecology. Progress has been also made in pharmacological research. In this article， we have searched and consulted the relevant literature reports of Xiaoyaowan in recent years， summarized the key directions of the pharmacological research literature， and proposed deficiencies to provide relevant basis for the in-depth study of Xiaoyao pill in the future.

A six-herb Chinese medicine composition ointment as a promising candidate for treatment of hypertrophic scars / 中草药·英文版

Objective: To study the anti-hypertrophic scar effect of the six-herb Chinese medicine composition (SCMC) ointment on the rabbit ear hypertrophic scar models. Methods: The optimal formulation of SCMC ointment matrix was screened by the orthogonal designs and a series of evaluation tests. The SCMC ointment was prepared through emulsifying method. The rabbit ear hypertrophic scar models were established and used to investigate the anti-hypertrophic scar effect of SCMC ointment. Results: Our results demonstrated that all the quality control indications of the SCMC ointment met the requirements. Anti-hypertrophic scar activity results showed that all the rabbit ear scar tissues appeared different degrees of shrink and fading, and took an unobvious but palpable shift from hard to soft texture with the low, middle and high concentration SCMC ointments treatments in vivo. Additionally, on 21st day the scar area and thickness in different concentrations of SCMC ointment groups were significantly reduced than control group, in a concentration-dependent manner. The immunohistochemical results also indicated that the SCMC ointment had good anti-hypertrophic scar properties and could inhibit hypertrophic scar formation. Conclusion: The SCMC ointment could improve the blood circulation condition of hypertrophic scar tissues. Our research has demonstrated the Chinese medicine composition ointment with good anti-hypertrophic scar properties that could be used to treat hypertrophic scars. Meanwhile, it provides a theoretical basis for further clinical application.

[Screening of endophytic fungi against southern blight disease pathogen-Sclerotium delphinii in Dendrobium catenatum].

In order to screen the endophytic fungi that can enhance the host(Dendrobium catenatum) resistance to Sclerotium delphinii, the antagonism between each of the 43 endophytic fungi and the pathogen S. delphinii were tested. The results showed that 6 endophytic fungi(DCR2, DCR5, DCR21, DCR22, DCR42, DCR43) have strong activities against the pathogen, the inhibition rates were 49.2%, 49.2%, 47.2%, 56.2%, 53.2%, 48.0%, respectively. Then D. catenatum plantlets were inoculated with both S. delphinii and each of these six endophytic fungi. As a result, the incidence rates of leaves and stems of the D. catenatum plantlets inoculated with DCR2 and the pathogen were both significantly lower than those with other treatments, and the plantlet death rate was 0. It showed that DCR2 Trichoderma polysporum could effectively inhibit the southern blight disease of D. catenatum. Through the endophytic fungal re-isolation test, it was found that DCR2 can colonize in the roots, stems, and leaves of D. catenatum. The research will provide new ideas for the prevention and treatment of the southern blight disease of D. catenatum. It is also significant for reducing pesticide use, ensuring food safety, and promoting the sustainable development of D. catenatum industry. Furthermore, it will provide a basis for the disease control in other crops.

[Study on anti-inflammatory mechanism of Lonicera fulvotometosa on acute lung injury model in rats].

To study the effect of Lonicera fulvotometosa(LFH) on expression of genes related to inflammatory pathways in the lung tissue of rats with acute lung injury(ALI) induced by lipopolysaccharide(LPS), explore the lung-protective effects and inflammatory mechanisms of L. fulvotometosa water extract, and provide experimental and theoretical basis for the clinical application of LFH. Forty SD rats were randomly divided into 4 groups: normal group, model group(LPS, 5 mg·kg~(-1)), LFH group(7.2 g·kg~(-1)) and dexa-methasone group(Dexa, 5 mg·kg~(-1)). The rats in LFH group received intragastric administration of water extract once a day for 5 days; rats in dexamethasone group received intraperitoneal injection for 2 hours before modeling. Except the normal group, the rats in other groups were injected intraperitoneally with LPS(5 mg·kg~(-1)) to induce ALI rats model. Serum, bronchoalveolar lavage fluid(BALF) and lung tissues were collected 6 hours after modeling. The lung tissues were taken for pathological observation; enzyme-linked immunosorbent assay(ELISA) was used to detect changes of inflammatory factors in serum and BALF; Real-time quantitative polymerase chain reaction(RT-qPCR) was applied to detect mRNA expression of tumor necrosis factor alpha inducible protein 3(TNFAIP3), interleukin(IL) 1 R1, interleukin(IL) 6 R and nuclear factor κB inhibitor α(NFKBIA) in the lung tissues. The degree of lung injury was lighter in LFH group than that in the LPS group. As compared with the LPS group, the levels of interleukin-1ß(IL-1ß), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) in serum and BALF, malondialdehyde(MDA) and myeloperoxidase(MPO) in lung tissues were significantly reduced in LFH group and Dexa group, while glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) in lung tissues were significantly increased; the mRNA expression of TNFAIP3, IL1 R1, IL6 R and NFKBIA in the lung tissues of the LFH group was significantly lower than that of the LPS group. The water extract of LFH can significantly reduce the content of inflammatory factors in rats with ALI, and down-regulate the mRNA expression of TNFAIP3, IL1 R1, IL6 R and NFKBIA in the lung tissues, showing significant anti-inflammatory effect. Its mechanism may be related to the regulation of NF-κB signaling pathway, and the pulmonary inflammation response may be reduced by down-regulating the expression of downstream-related inflammatory factors.

Lipidomics analysis on schisandrol B-induced liver enlargement in mice / 药学学报

Schisandrol B (SolB) is one of the active constituents from a traditional Chinese medicine Schisandra chinensis or Schisandra sphenanthera. Our previous studies found that SolB exerts hepatoprotective effects against drug-induced liver injury and promotes liver regeneration. We further found that SolB significantly induces liver enlargement but the mechanisms remain unclear. The purpose of this study was to investigate the change of lipidome in liver tissues during SolB-induced hepatomegaly. The animal experiment protocol was approved by the Institutional Animal Care and Use Committee at Sun Yat-sen University. Serum and liver samples of male C57BL/6 mice were collected after intraperitoneal injection of SolB (100 mg·kg-1·d-1) for 5 days. Lipidomics analysis was performed using Q Exactive UHPLC-MS/MS system. The results showed that SolB significantly promoted liver enlargement in mice without liver injury and inflammation. Lipid accumulation was observed in the liver tissues after SolB treatment. Thirty-five lipids were identified with significant change and triglycerides (TG) were found to have the most significant increase in SolB-treated group, indicating the increase of energy production during SolB-induced hepatomegaly. This study reveals the impact of SolB on lipid metabolism and provides a potential explanation for liver enlargement induced by SolB.

Correlation analysis of happiness, job burnout and mindfulness of nurses in Beijing Emergency Department / 中国实用护理杂志

Objective@#To explore the influencing factors of happiness of nurses in Beijing Emergency Department and analyze their correlation with job burnout and mindfulness.@*Methods@#From February 2018 to February 2019, 184 nurses in Emergency Departments of five 3A hospitals in Beijing were investigated by convenient sampling method. General data of nurses were collected by using self-made sociodemographic characteristics data. Mindfulness awareness questionnaire was used to evaluate nurses′ mindfulness thoughts. Nurses′ job burnout was evaluated by nurses′ job burnout questionnaire. The occupational well-being scale was used to evaluate nurses′ well-being, and then single-factor and multi-factor Logistic regression was used to analyze the influencing factors of nurses′ well-being in Beijing Emergency Department, and the mediating effect of mindfulness on job burnout and well-being.@*Results@#The mindfulness scores of 184 nurses were (65.23±5.48), of which 54 (29.35%) had low mindfulness level, 80 (43.48%) had medium mindfulness level, and 50 (27.17%) had high mindfulness level. The emotional exhaustion (EE) score of job burnout was (29.76±4.32), depersonalization (DP) score was (9.66±1.30) and dimindished personal accomplishmen (tPA) score was (30.15±3.28), of which 63 (33.70%) were mild burnout, 70 (38.04%) were moderate burnout and 52 (28.26%) were severe burnout. The score of occupational well-being was (64.68±7.38). Univariate results showed that the factors affecting the happiness of nurses in Emergency Department included age, education level, professional title, working years, overtime work, monthly income and nature of employment. The scores of occupational well-being of Emergency Department nurses with mild, moderate and severe job burnout were (69.97±8.21), (61.72±9.21) and (56.41±7.02) respectively, with statistically significant difference (F=32.176, P<0.01). The occupational well-being scores of Emergency Department nurses with low mindfulness level, medium mindfulness level and high mindfulness level were (59.43±8.11), (63.72±9.51) and (76.41±6.98) respectively, the difference was statistically significant (F=40.291, P<0.01). Logistic regression analysis showed that working years, overtime work and job burnout were independent risk factors affecting the happiness of nurses in Emergency Department, while mindfulness was the protective factor. Occupational well-being of nurses in Emergency Department was proportional to mindfulness (r=0.812, P< 0.01), proportional to dimindished personal accomplishmen score in job burnout (r=0.713, P=0.008), and inversely proportional to EE score (r=-0503, P<0.01) and DP score (r=-0.614, P=0.012) in job burnout. The mediating effect of mindfulness was -0.179 4, accounting for 27.63% of the total effect.@*Conclusions@#Job burnout affects job burnout and well-being of nurses in emergency department, and mindfulness was the protective factor of well-being of nurses in emergency department.

Somatic symptom disorder in the context of Chinese yin-yang culture:A case report and literature review / 中南大学学报(医学版)

Somatic symptom disorder (SSD) is a somatic disorder characterized by excessive anxiety over various somatic symptoms for a long time, which makes patients feel very painful and the quality of personal life significantly decreased. Previous studies have shown that there is a connection between the clinical manifestations of SSD patients and their cultural background. The patient in this case report was highly affected by Chinese yin-yang culture, displaying obvious Chinese characteristics. We report a patient with SSD, whose clinical manifestations were mainly sexual dysfunction and mood symptoms which were closely related to the Traditional Chinese culture of Yin and Yang. In this case, Hamilton Anxiety Scale, Hamilton Depression Scale, and International Erectile Function Questionnaire were used to evaluate the patients ' anxiety, depression, and sexual function, and the scores were 32, 33, and 9, respectively. The patient was treated with a combination of venlafaxine and mirtazapine. After 5 weeks of treatment, the patient's clinical symptoms improved significantly. The clinical manifestations of some Chinese SSD patients have obvious characteristic relevance to Chinese theory of Yin and Yang, making SSD easily to be misdiagnosed. Therefore, clinicians should pay atlention to this situation. In addition, the combination of venlafaxine and mirtazapine may have a better effect on SSD patients with chronic pain and sexual dysfunction.

Cobalamin metabolism and the clinical application in its different forms / 中华实用儿科临床杂志

Cobalamin, also known as Vitamin B 12, is the most complex vitamin in nature, and also one of essential vitamins in human body, which involved in many physiological activities, including homocysteine metabolism and translation of methylmalonyl-CoA to succinyl-CoA as a biological coenzyme.As a higher organism, human cannot synthesize cobalamin by themselves, so cobalamin needs to be supplemented by diet or medicine.At present, there are various forms of cobalamin, including cyanocobalamin (a common form of Vitamin B 12), hydroxylcobalamin, mecoba-lamin and 5′-adenosylcobalamin.These different forms of cobalamin are similar in structures and physiochemical pro-perties, but have some differences in the pharmacokinetics of absorption, distribution, metabolism and elimination, as well as clinical application and therapeutic efficacy.Among them, cyanocobalamin and hydroxycobalamin are widely used in Europe and the United States.Mecobalamin is more commonly used in Asia.5′-adenosylcobalamin has been approved in China, but less widely used in the world.Cyanocobalamin and mecobalamin are mainly used for the treatment of diseases caused by peripheral neuropathy and cobalamin deficiency.Hydroxycobalamin has been approved as an antidote to cyanide and has shown some potential in the treatment of methylmalonic acidemia in recent years.Now, the chemical structures, physiochemical properties, pharmacokinetic characteristics and clinical applications of the four cobalamins were compared and distinguished, so as to provide references for clinicians in clinical rational drug use and to avoid confusion.

Correlation analysis of happiness, job burnout and mindfulness of nurses in Beijing Emergency Department / 中国实用护理杂志

Objective:To explore the influencing factors of happiness of nurses in Beijing Emergency Department and analyze their correlation with job burnout and mindfulness.Methods:From February 2018 to February 2019, 184 nurses in Emergency Departments of five 3A hospitals in Beijing were investigated by convenient sampling method. General data of nurses were collected by using self-made sociodemographic characteristics data. Mindfulness awareness questionnaire was used to evaluate nurses′ mindfulness thoughts. Nurses′ job burnout was evaluated by nurses′ job burnout questionnaire. The occupational well-being scale was used to evaluate nurses′ well-being, and then single-factor and multi-factor Logistic regression was used to analyze the influencing factors of nurses′ well-being in Beijing Emergency Department, and the mediating effect of mindfulness on job burnout and well-being.Results:The mindfulness scores of 184 nurses were (65.23±5.48), of which 54 (29.35%) had low mindfulness level, 80 (43.48%) had medium mindfulness level, and 50 (27.17%) had high mindfulness level. The emotional exhaustion (EE) score of job burnout was (29.76±4.32), depersonalization (DP) score was (9.66±1.30) and dimindished personal accomplishmen (tPA) score was (30.15±3.28), of which 63 (33.70%) were mild burnout, 70 (38.04%) were moderate burnout and 52 (28.26%) were severe burnout. The score of occupational well-being was (64.68±7.38). Univariate results showed that the factors affecting the happiness of nurses in Emergency Department included age, education level, professional title, working years, overtime work, monthly income and nature of employment. The scores of occupational well-being of Emergency Department nurses with mild, moderate and severe job burnout were (69.97±8.21), (61.72±9.21) and (56.41±7.02) respectively, with statistically significant difference ( F=32.176, P<0.01). The occupational well-being scores of Emergency Department nurses with low mindfulness level, medium mindfulness level and high mindfulness level were (59.43±8.11), (63.72±9.51) and (76.41±6.98) respectively, the difference was statistically significant ( F=40.291, P<0.01). Logistic regression analysis showed that working years, overtime work and job burnout were independent risk factors affecting the happiness of nurses in Emergency Department, while mindfulness was the protective factor. Occupational well-being of nurses in Emergency Department was proportional to mindfulness ( r=0.812, P< 0.01), proportional to dimindished personal accomplishmen score in job burnout ( r=0.713, P=0.008), and inversely proportional to EE score ( r=-0503, P<0.01) and DP score ( r=-0.614, P=0.012) in job burnout. The mediating effect of mindfulness was -0.179 4, accounting for 27.63% of the total effect. Conclusions:Job burnout affects job burnout and well-being of nurses in emergency department, and mindfulness was the protective factor of well-being of nurses in emergency department.

Clinical Effect of Peiyuan Tongnao Capsule Combined with “Zhisanzhen” for Post-stroke Dementia / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of Peiyuan Tongnao capsule combined with "Zhisanzhen" for post-stroke dementia (PSD) and investigate its mechanism.Method: Ninety-eight eligible patients were randomly divided into control group (49 cases) and observation group (49 cases) by random number table.Both groups received donepezil tablet,10 mg/time,qd,and nimodipine tablet,30 mg/time,qd.Patients in control group additionally took "Zhisanzhen" ,qd,5 times/week.Based on the treatment in control group,patients in observation group additionally took Peiyuan Tongnao capsule,3 capsules/time,tid.The treatment course was 12 weeks.Before and at the 4th,8th and 12th week after treatment,mini-mental state examination (MMSE),montreal cognitive assessment (MoCA),activity of daily living scale (ADL),neuropsychiatric inventory (NPI) and symptoms of traditional Chinese medicine (TCM) were evaluated.Before and after treatment,levels of serum hyperhomocysteinemia (Hcy),hepatocyte growth factor (HGF),oxidized low density lipoprotein (Ox-LDL) and acetylcholinesterase (AchE) were detected.Result: The total clinical effective rate was 93.88% in observation group,better than 77.55% in control group (χ2=5.333,PFcontrol=3.947,Fobservation=5.833,PFcontrol=3.876,Fobservation=6.011,Pth and 12th after treatment,scores of MMSE in the observation group were all higher than those in control group (Pth week after treatment,score of MoCA in observation group was higher than that in control group (PPPPPConclusion: Peiyuan Tongnao capsule combined with "Zhisanzhen" can improve cognitive and behavioral abilities,improve clinical efficacy,ameliorate abnormal mental behavior,relieve clinical symptoms,and regulate levels of Hcy,Ox-LDL,AchE and HGF in the treatment of post-stroke dementia.

Effects of Ligustri lucidi Fructus Extract on the Differentiation of Osteoclasts and the Proliferation of Osteoblasts / 中国药房

OBJECTIVE： To investigate the effects of Ligustri lucidi Fructus extract on the differentiation of osteoclasts and the proliferation of osteoblasts. METHODS： Rabbit primary bone marrow cells were induced with 1a，25-Dihydroxyvitamin D3 to obtain osteoclasts. After treated with low-dose， medium-dose and high-dose of L. lucidi Fructus ethanol and water extract （both 2， 20， 200 mg/L）， TRACP activity determined method was used to detect the activity of TRACP in cell lysis solution and the number of TRACP positive cells. The number of celluar bone resorption lacunae and the percentage of bone lacunae area were detected by toluidine blue staining. Osteoblasts were obtained by L-ascorbic acid， β-sodium glycerophosphate and dexamethasone-induced subcloning 14 of cranial parietal anterior osteocytes in mice. MTT assay and APK activity assay were used to detect relative proliferation rate of cells and the activity of APK. RESULTS： After treated with different doses of L. lucidi Fructus extract， the number of TRACP positive cells， the number of bone resorption lacunae and their area were changed in varying degrees. TRACP activity， the number of its positive cells， the number of bone resorption lacunae and the percentage of bone lacunae area in different dosage groups of L. lucidi Fructus ethanol extract and high-dose of water extract； the TRACP activity， the number of its positive cells and the percentage of bone lacunae area in L. lucidi Fructus water extract medium-dose group were decreased significantly， while the number of bone resorption lacunae in L. lucidi Fructus water extract low-dose group was increased significantly （P＜0.05 or P＜0.01）. The relative proliferation rate of cells in L. lucidi Fructus extract low-dose and medium-dose groups and APK activity of cells in extract groups were significantly increased， while the relative proliferation rate of cells were decreased significantly in L. lucidi Fructus ethanol extract and water extract high-dose groups （P＜0.01）. CONCLUSIONS： L. lucidi Fructus extract can inhibit TRACP activity of osteoclasts， change the bone resorption function of osteoclasts and the proliferation behavior of osteoblasts and increase APK activity of osteoclasts.

's experience and practice in treatment of stroke / 中国针灸

is the famous acupuncture scholar in modern times and he emphasizes the importance of moxibustion in the diagnosis and treatment of stroke. According to the different stages and types of stroke, the full-period moxibustion treatment is dominant, i.e. the moxibustion therapy for pacifying is used for stroke prevention, the moxibustion therapy for rescuing is for the emergency and the moxibustion therapy for warming and promoting meridian circulation is for the rehabilitation. Moxibustion is applicable in the full-period treatment of stroke. The corresponding treatment regimen and manipulation should be selected in terms of the individual stage and type of stroke.

Effect of Peiyuan Tongnao Capsule on Recovery of Neurological Impairment of Ischemic Stroke in Recovery Period and Its Mechanism of Action / 中国实验方剂学杂志

Objective: To discuss the effect of Peiyuan Tongnao capsules on neurological impairment of patients with ischemic stroke at convalescence, and discuss the mechanism of action in microcirculation improvement, anti-inflammation and neuroprotection. Method: One hundred and thirty one patients were randomly divided into control group (66 cases) and observation group (65 cases) by random number table. Patients in control group were given aspirin enteric-coated tablets, 0.1 g/day, simvastatin tablets, 10 mg/days, and treated by percutaneous nerve electrical stimulator for 30 times, 30 min/time, 1 time/day, 5 times/week. In addition of the therapy in control group, patients in observation group were also given Peiyuan Tongnao capsules, 3 grains/time, 3 times/days. A course of treatment was 12 weeks. Before treatment, and at the 4th, 8th and 12th weeks, neurological deficits in the national institutes of health (NIHSS), activity of daily life scale (ADL), berg balance scale (BBA), fugl-meyer scale (FMA) and traditional Chinese medicine (TCM) syndromes were scored. And levels of brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), homocysteine (Hcy) and serum cystatin C (Cys-C) and hemorheological indicators whole blood viscosity, high shear rate, low shear rate, reduced viscosity, plasma viscosity, platelet aggregation rate, fibrinogen (FIB) and blood sedimentation rate (ESR)were detected. Result: At the 8th and 12th week after treatment, score of NIHSS in observation group was lower than that in control group (PPPα, Hcy, Cys-C and hemorheological indices were all lower than those in control group (PPConclusion: Peiyuan Tongnao capsules can promote the recovery of neurological impairment at recovery period of ischemic stroke, regulate inflammatory factors, improve blood rheology, protect neural function, and improve the effect of routine western medicine rehabilitation therapy.

Investigation and Analysis of TCM Decoction Pieces and Prescription Drugs Dosage in Affiliated Orthopedics and Traumatology Hospital of Guangzhou University of TCM During Sep. 2015 - Sep. 2016 / 中国中医药信息杂志

Objective To statistically analyze the overdose of Chinese materia medica in Orthopedics and Traumatology Outpatient Clinic of The Affiliated Orthopedics and Traumatology Hospital of Guangzhou University of Traditional Chinese Medicine (hereinafter referred to as "our hospital"); To provide references for rational application of Chinese materia medica in orthopedics and traumatology department. Methods Totaiiy 1200 prescriptions during Sep. 2015 - Sep. 2016 in Orthopedics and Traumatology Outpatient Clinic were randomly selected. Based on the Chinese Pharmacopoeia (2015 Edition) and the second edition of the New Century textbook Chinese Medicine as references, the top 30 of the use of TCM decoction pieces were retrospectively analyzed. Results The top 30 of the use of TCM decoction pieces were 100% overdosed, among which 11 TCM decoction pieces were 50% overdosed; 95.93% prescriptions were with 18 kinds of Chinese materia medica. Conclusion Excessive use of Chinese materia medica prescriptions are common in Orthopedics and Traumatology Outpatient Clinic of out hospital, which causes waste of TCM resources and imposes patients' financial burden.