Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin.

BACKGROUD: The interactions between Chinese herbs and drugs pose a great challenge to the combined clinical application of Chinese herbs and drugs. Chinese medicinal products contain complex pharmacologically active components that may influence the in vivo processes of drugs in a variety of ways. In China, drugs based on Panax ginseng total saponins (PNS) are often combined with warfarin for the treatment of cardiovascular diseases. OBJECTIVES: To assess the effects of Panax notoginseng saponins (PNS) on the pharmacokinetics of warfarin and its mechanism. METHOD: Blood was collected for the determination of the prothrombin time (PT) and international normalized ratio (INR) from rats treated with warfarin alone or with warfarin + PNS. The plasma concentration of warfarin was determined by high-performance liquid chromatography. Western blot was used to detect the expression of cytochrome P450 (CYP) enzymes. RESULTS: When warfarin and PNS were co-administered, the PT and INR increased compared to when warfarin was given alone. 72 hours after administration, compared to the warfarin alone group, the warfarin + low-dose PNS, warfarin + medium-dose PNS, and warfarin + high-dose PNS groups showed 110%, 122%, and 126% increases in PT, respectively (all P < 0.05), as well as 111%, 124%, and 128% increases in INR (all P < 0.05). Compared with the warfarin alone group, the clearance rate (CL/F) of warfarin in the warfarin + low-dose PNS, warfarin + medium-dose PNS, and warfarin + high-dose PNS groups was 10% (P > 0.05), 23% (P < 0.05), and 33% (P < 0.05) lower, respectively, while the systemic exposure (area under the concentration-time curve, AUC0-t) increased by 106% (P > 0.05), 119% (P < 0.05), and 134% (P < 0.05), respectively, and the blood concentration of warfarin incresed by 112%, 113%, and 114%, respectively (all P > 0.05). After combined treatment of HepG2 cells with warfarin + PNS, CYP1A2 expression was upregulated (P < 0.05) and CYP3A4 was downregulated (P < 0.05) but there was no effect on CYP2C9. In animal experiments, PNS had different effect on the expression of CYP1A2 in different doses. While a low dose of PNS resulted in downregulated CYP1A2 expression (P < 0.05), a medium dose resulted in upregulation (P < 0.05), and CYP1A2 expression was not significantly affected by a high dose of PNS (P > 0.05). Meanwhile, PNS at all doses downregulated the expression of CYP3A4 (P < 0.05) but had no effect on the expression of CYP2C9 (P > 0.05). CONCLUSION: PNS can increase the blood concentration of warfarin, as well as the exposure time, and it can enhance the anticoagulant effect of warfarin by inhibiting the expression of the liver enzyme CYP3A4.

[Acupoint injection of human placenta tissue fluid combined with oral administration of metformin hydrochloride enteric-coated tablets treating type 2 diabetes:a randomized controlled trial].

OBJECTIVE: To observe the difference for type 2 diabetes between acupoint injection of human placenta tissue fluid combined with oral administration of metformin and simple metformin. METHODS: Sixty patients with type 2 diabetes were randomly assigned into a medication group and an injection group,30 cases in each one. In the oral medication group,metformin hydrochloride enteric-coated tablets was applied orally for continuous eight weeks,0.25 g a time,twice a day. In the injection group,based on the same oral administration,human placenta tissue fluid was injected into Diji(SP 8) and Yishu(EX-B 5) for two courses(four weeks as one course),once every other day and three times a week. Fast blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(HbAlc) and clinical effect were observed in the two groups before and after treatment. RESULTS: Compared with those before treatment,FBG,PBG and HbAlc were decreased in the two groups after treatment (all P<0.05),with more apparent change in the injection group(all P<0.05). The total effective rate of the injection group was 90.0%(27/30),which was obviously better than 63.3%(19/30) of the medication group (P<0.05). CONCLUSIONS: Acupoint injection of human placenta tissue fluid combined with metformin hydrochloride enteric-coated tablets for type 2 diabetes can better lower blood glucose than simple metformin hydrochloride enteric-coated tablets.

Effects of preconception counseling on maternal health care of migrant women in China: a community-based, cross-sectional survey.

BACKGROUND: Migrants have long been a disadvantaged group in China's health care system, especially in terms of maternal health care. Many studies have explored the factors associated with a lack of maternal health care and found many determinants, including social, economic, behavioral, and environmental factors. However, studies focusing on factors associated with maternal health care have rarely examined preconception counseling (PCC). This study explored factors related to PCC uptake among migrant women, and investigated the association between PCC and maternal health care in migrant women. METHODS: A community-based cross-sectional study was conducted from July to December 2011, in Nanhai, Guangdong Province, and Pinghu, Zhejiang Province, China. A total of 1,012 migrant women who had their most recent pregnancy within 1 year of the survey answered a standardized interviewer-administered questionnaire about maternal health care. Descriptive statistics and multivariable logistic regression were used to analyze the data. RESULTS: Only 208 (20.6%, 95% confidence interval [CI]: 18.1-23.1%) of 1,012 migrant women had received PCC. Younger age, having more than one child, lack of knowledge of maternal health care and inter-province migration were predictors of a lack of PCC. PCC was associated with higher consumption of folic acid supplements during the preconception period (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.66-4.23). Among migrants who were resident in Nanhai or Pinghu for less than 5 years, PCC was related to better quality prenatal care (AOR = 3.07, 95% CI: 1.79-5.24). CONCLUSIONS: The prevalence of PCC among migrant women was low (20.6%, 95% CI: 18.1-23.1%). Positive associations were found between the receipt of PCC and preconception folic acid supplements and quality prenatal care. Future studies focusing on maternal health care should pay attention to PCC and explore the effects of PCC on maternal health care through intervention studies. Continued efforts to increase PCC in migrants should target specific age groups (20-24 years), families with more than one child, and women who have migrated between provinces, as well as provide in-depth knowledge of maternal health care.

Synthesis of MCM-22 zeolite by an ultrasonic-assisted aging procedure.

The synthesis of MCM-22 zeolite under hydrothermal crystallization conditions has been performed by an ultrasonic-assisted aging procedure. The ultrasonic-assisted aging of the initial aluminosilicate gel can shorten the crystallization time of MCM-22, decrease the amount of hexamethyleneimine (HMI) used, and broaden the range of SiO(2)/Al(2)O(3) ratios. By using the ultrasonic aging, pure phase of high-silica MCM-22 products with SiO(2)/Al(2)O(3)>100 can be obtained. When SiO(2)/Al(2)O(3)

[Studies on preparation of recombinant hirudin-2 liposome and its pharmacokinetics by nasal delivery in rats].

OBJECTIVE: To promote the nasal absorption of recombinant hirudin-2, the preparation and physicochemical properties of recombinant hirudin-2 liposomes, as well as its pharmacokinetic characteristics and bioavailability in rats after nasal administration were investigated. METHOD: Recombinant hirudin-2 liposomes were prepared by reversal phase evaporation; the test of physicochemical properties including encapsulation efficiency, particle size and stability of liposome suspensions were determined by HPLC; Recombinant hirudin-2 concentration in plasma was determined by chromogenic substrate method and the relative bioavailability and pharmacokinetic parameters were also calculated using software program 3p87. RESULT: The encapsulation efficiency of recombinant hirudin-2 liposome reached greater than 76.95%, with an average particle size of about 168.3 nm, size distribution ranging from 24 to 286 nm, relative peak width of +/- 0.47, and a good stability. CONCLUSION: Compared with recombinant hirudin-2 solution, liposome preparation enhanced the nasal absorption of recombinant hirudin-2.

[A review of recent ten-year study on alpha-asarone].

This article is brief review of study on alpha-asarone after 1996. The summary mainly includes the dosage forms, pharmacokinetics, bioavailability, pharmacological effects, toxicology and clinical uses during the past ten years.

[Comparative study on quality of Tongrentang red ginseng and Korean red ginseng--determination of ginsenosides and polysaccharides].

OBJECTIVE: To establish methods for quantitative determination of ginseng saponins, ginsenoside Rg1, Re, Rb1 and polysaccarides and compare the qualities of Tongrentang Red Ginseng and Korean Red Ginseng. METHOD: Macroreticular resin-colorimetric method was developed to determine ginseng saponins and a new HPLC method with gradient eluents was established for determination of ginsenoside Rg1, Re, Rb1. For ginseng polysaccharides, phenol-oil of vitriol colorimetric method was developed and some factors were also optimized. RESULT: The content of ginseng saponins in Tongrentang Red Ginseng was not lower than that of Korean Red Ginseng. Ginsenoside Rg1 and Rb1 in Tongrentang Red Ginseng were higher than those in Korean Red Ginseng, while Ginsenoside Re was slightly lower than that of Korean Red Ginseng. However, the amount of Ginseng Polysaccharides in Tongrentang Red Ginseng was greater than those in Korean Red Ginseng. CONCLUSION: The contents of ginseng saponins and ginsenoside Rg1, Re, Rb1 in Tongrentang Red Ginseng were not lower than that in Korean Red Ginseng. The methods for determination of ginsenosides and ginseng polysaccharides were quite accurate and reliable to the quality control of Ginseng.