Evaluation of individualized treatment of nonproliferative diabetic retinopathy: a multicenter, randomized, parallel-controlled study.

OBJECTIVE: To evaluate the differences in the efficacy of stationary treatment and individualized treatment for patients with nonproliferative diabetic retinopathy (NPDR). METHODS: This study was a randomized, controlled, multicenter clinical trial. Participants with NPDR were randomized into the stationary treatment group or the individualized treatment group. The stationary treatment group was given the basic treatment and Qiming granules, and the individualized treatment group was given the basic treatment, Qiming granules, and individualized Chinese herbal medicines over a 12-week period. The individualized therapeutic formula was also changed over time to adjust to the changes in the clinical presentation of the patient. We conducted observations of fundus retinal exudation and hemorrhage, visual acuity, Traditional Chinese Medicine symptom scores and other indicators. RESULTS: A total of 140 participants with NPDR were randomized into the stationary treatment group or the individualized treatment group, and 132 participants completed this study. Following the 12-week treatment, significant improvements in both primary and secondary outcomes were observed in the stationary and individualized treatment groups. No remarkable difference in the primary outcomes between the two groups was observed. However, there was a significant difference in the Traditional Chinese Medicine symptom scores (18 ± 7 vs 15 ± 6; P < 0.05). There were no severe adverse effects. CONCLUSION: Compared with stationary treatment, individualized treatment is more effective at relieving the Traditional Chinese Medicine symptoms and improving vision and fundus lesions at 12 weeks post treatment.

Stationary Treatment Compared with Individualized Chinese Medicine for Type 2 Diabetes Patients with Microvascular Complications: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Microvascular complications in type 2 diabetes (T2DM), including diabatic retinopathy (DR), diabetic kidney disease (DKD), diabetic peripheral neuropathy (DPN) are the leading causes of visual loss, end-stage renal disease or amputation, while the current therapies are still unsatisfactory. Chinese medicine (CM) has been widely used for treating diabetic mellitus. However, most of the previous studies focused on the single complication. The role of CM treatment in T2DM patients with 2 or multiple microvascular complications is not clear. OBJECTIVE: To appraise the curative effect of CM in T2DM patients with 2 or multiple microvascular complications, and to compare the effects of stationary treatment and individualized treatment in T2DM patients with microvascular complications. METHODS: This trial will be an 8-center, randomized, controlled study with 8 parallel groups. A total of 432 patients will be randomized to 8 groups: DR study group (32 cases) and a corresponding control group (32 cases), DR+DKD study group (64 cases) and a corresponding control group (64 cases), DR+DPN study group (64 cases) and a corresponding control group (64 cases), DR+DKD+DPN study group (56 cases) and a corresponding control group (56 cases). The control group will receive stationary treatment, and the study group will receive individualized treatment based on CM syndrome differentiation in addition to stationary treatment. The study duration will be 50 weeks, comprising a 2-week run-in period, 24 weeks of intervention, and 24 weeks of follow-up. The outcomes will assess efficacy of treatment, improvement in CM symptoms, safety assessments, adherence to the treatment, and adverse events. CONCLUSION: This study will provide evidence of evidence-based medicine for CM treatment in two or multiple microvascular complications caused by T2DM. (Registration No. ChiCTR-IPR-15007072).

A new lyoniresinol derivative from Smilax microphylla.

A new lignan, lyoniresinol-9-O-8"-syringylglycerol ether (1), together with five known compounds, piceatannol (2), resveratrol (3), oxyresveratrol (4), quercetin-3'-glucoside (5) and diosgenin (6) were isolated from the rhizomes of Smilax microphylla. The structure of the new compound was determined by means of chemical evidence and 1D-and 2D-NMR (1H, 13C, HSQC, HMBC, 1H-1H COSY and NOESY) spectroscopic analysis and HR-ESI-MS.

[Callus cultivation and determination of gentiopicroside from Gentiana macrophylla].

OBJECTIVE: To explore and improve the utilization efficiency of Gentiana macrophylla resources. METHODS: The germination of Gentiona macrophylla seeds were used as explants to induce calluses; Cultured on various culture media and condition for callus induction and subculture by test; The content of gentiopicroside in callus was determined by HPLC. RESULTS: The optimum medium for callus was MS +2,4-D (1.0 mg/L) + 6-BA (0.5 mg/L), and MS +2,4-D (1.0 mg/L) +6-BA (0.5 mg/L) + NAA (0.5 mg/L) was the optimum for subculture,the optimum time of subculture was 30 d; The accumulated gentiopicroside reached the highest level with 0.78 mg/g DW when entered 28-30 d. CONCLUSION: The optimized culture method of callus of Gentiana. macrophylla is obtained; The growth curve of callus of Gentiona macrophylla turns on "S" appearance and the accumulated gentiopicroside increases along with the callus appreciation.

Steroidal saponins and pregnane glycosides from Smilax microphylla.

Six steroidal saponins and two pregnane glycosides were isolated from the BuOH subfraction of 70% EtOH extract of Smilax microphylla C.H.Wright, among them two were new compounds (1 and 7). Pregnane glycosides were firstly isolated from the genus Smilax (Smilacaceae). Structures of the new compounds were determined on the basis of HR-ESI-MS, 1D and 2D NMR spectroscopic analysis.

[Iron chloride for simultaneous denitrification and chemical-biological flocculation process].

The efficiency of iron chloride on simultaneous denitrification and chemical-biological flocculation process was investigated through a lab-scale study. The results showed that: there were not significant differences in the denitrification rate, COD and NO3(-) -N removal efficiency between the control reactor and the denitrification reactor with the dosage of 20 mg x L(-1) Fe after 14 days' domestication. Meanwhile the TP removal efficiency was increased to over 80%. Though sludge concentration was increased by adding FeCl3, the settling performance wasn't change because the sludge density was increased and the particle size was reduced. The sludge settling volume (SV30) and specific resistance of filtration (SRF) after adding FeCl3 were only 22% and 1.5 x 10(12) m x kg(-1), which were lower than the values in the control reactor and benefit for sludge treatment.

[Study on seed morphology of the section Cruciata Gaudin].

OBJECTIVE: To provide a scientific evidence for the identification of the section Cruciata Gaudin. METHODS: Seed morphology of the section Cruciata Gaudin in different regions from Gansu were studied by means of scanning electronic microscopy (SEM). RESULTS: The seeds of section Cruciata Gaudin had relative conformability in terms of shape,size and ornamentation. But the reticulate cell of Gentiana dahurica was obviously wider than those of other species. CONCLUSION: This study provides some useful information for classification and identification of section Cruciata Gaudin.

[Study on the quality and genetic diversity of Gentiana macrophylla pall of different habitats].

OBJECTIVE: To study the quality and genetic diversity in Gentiana macrophylla of different habitats for controlling the quality of Gentiana macrophylla. METHODS: Main characteristics and microscopic identification were adapted to identify Gentiana macrophylla; HPLC method was applied for analysising the contents of Gentiana macrophylla. RAPD method was applied to study genetic structure and genetic diversity of Gentiana macrophylla. RESULTS: The experiment showed that the Gentiana macrophylla of different habitats have different main charactericstics, microscopic identifications and contents, and effective ingredient contents of gentiopicroside. The levels of population genetic diversity of various groups followed by HUANGZHONG County population (K) > HUAN County population (J) > ZiWU Mountain population (H). CONCLUSION: The study of external morphology, internal structure, active ingredient content and genetic level of Gentiana macrophylla from different areas provides a scientific basis for protecting wild species and ensuring the quality in introducing and cultivating Gentiana macrophylla.

[Karyotype analysis of Gentiana straminea].

OBJECTIVE: Study on chromosome number, karyotype of Gentiana straminea for the first time. Compare karyotypes of Gentiana straminea, Gentiana macrophylla and Gentiana dahurica. Provide cytological evidence for further studies on genetics and evolution. METHODS: Soak the root tip in 0.002 mol/L 8-oxychinolin solution for 5.7 h. Decomposed in 2.5% mixed enzyme solution for 1.6 h at 25 degrees C and use Hypotonic treatment for 3 h in refrigerator. At last, make specimen slides by the Air-drying technique. Sections combined with micrograph were used to analyze chromosome. RESULTS: The karyotypes formula of Gentiana straminea is K(2n) = 26 = 2M + 24 m, the AS. K was 52.68%, which belong to "1A" type. CONCLUSION: Compare karyotypes of Gentiana straminea, Gentiana macrophylla and Gentiana dahurica, the result showed that Gentiana macrophylla lives in highest stage of evolution. Gentiana straminea is intermediate between Gentiana macrophylla and Gentiana dahurica.

[Studies on plantlet regeneration and propagation of Gentiana stramines].

OBJECTIVE: To provide scientific basis for large scale production by studying the technique of tissue culture of Gentiana stramines. METHOD: Callus was induced from germ-free stem segment of G. stramines on a MS medium supplemented with different hormones. RESULT: The MS medium with 0.5-1.0 mg x L(-1) BA and 0.5 mg x L(-1) NAA was suitable for the induction and proliferation of cluster bads. MS medium with 1.0 mg x L(-1) IAA and 3 mg x L(-1) BA was suitable for the induction of calli. MS medium with 1.0 mg x L(-1) IAA and 2.0-3.0 mg x L(-1) BA was suitable for the subculture of calli. MS medium with 2.0 mg x L(-1) BA and 0.5 mg x L(-1) NAA was suitable for the differentiation of calli. CONCLUSION: Aseptic seeding of G. stramines can be quickly propagated by shoot culture.

[Primary study on measuring the internal transcribed spacer I regions of rRNA genein seeds of Gentiana dahurica].

OBJECTIVE: To amplify the PCR with the internal transcribed spacerl regions measure the base sequence of the amplified products of DNA, and to set up an identified standard on the level of molecule. METHOD: DNA from the seeds of G. dahurica was extracted by conventional method, and composed peculiar primer was used to amplify with the internal transcribed spacerl regions of the rRNA gene, and the base sequence of the amplified products by stopping the circle of the end of double deoxidation of four color fluorescent mark was measured. RESULT: It was proved by agar sugar gel electrophoresis that the PCR amplified products of the internal transcribed spacerl regions of the rRNA gene existed. The base sequence of the seeds of G. dahurica's internal transcribed spacerl regions of the rRNA gene was measured. CONCLUSION: To measure the base sequence of internal transcribed spacerl regions of the rRNA gene in the seeds of G. dahurica's is a method to identify vegetal Chinese traditional medicine on the level of molecule.