[A historical review of general medicine].

The first official general medicine was established in the United States, and society of general medicine established in 1947. After that the European and American countries began to study of general medicine and construct system. In 1966, the commonwealth launched the first global residency training program in general medicine.At present, many countries have formed a perfect general practitioner training system. In 1988, the concept of general medicine was introduced into China. In 1989, the Chinese Medical Association established the General Medicine Education Committee, marked the beginning of general medical education in China. In 1993, General Medicine Branch of Chinese Medical Association was set up, was a symbol of the birth of general medicine in China. Compared with some European and American countries, China's general medicine was a late starter, and the training of general practitioners has experienced the development of diversification, at present, it is in line with the international training mode.

A Traditional Chinese Patent Medicine ZQMT for Neovascular Age- Related Macular Degeneration: A Multicenter Randomized Clinical Trial.

BACKGROUND: Anti-VEGF agent ranibizumab has been extensively used as a standard treatment for wet AMD. We investigated whether traditional Chinese medicine could serve as a complementary therapy for this disease. METHODS: 144 patients with neovascular age-related macular degeneration received either intravitreal ranibizumab treatment as needed plus placebo or intravitreal ranibizumab treatment as needed plus an FDA approved traditional Chinese patent medicine named ZQMT. Both groups received treatment for 24 weeks. The primary outcome was the mean change of visual acuity at week 24 as compared to the baseline. RESULTS: We found that intravitreal ranibizumab treatment plus ZQMT was non-inferior to the treatment with intravitreal ranibizumab alone in improving visual acuity scores at week 24 with patients in both groups who gained substantial numbers of letters. In addition, we found that ZQMT treatment resulted in significant improvements in reducing retinal hemorrhage, fluid, and lesion size. Importantly, administration of ZQMT reduced the number of needed ranibizumab injections (P<0.0001, analysis of variance) in wet AMD patients leading to a significant reduction of drug cost. CONCLUSION: The combinatory therapy of ranibizumab and traditional Chinese patent medicine ZQMT had equivalent effects on visual acuity improvement and safety profiles as the ranibizumab treatment alone. Ranibizumab injections coupled with ZQMT offer therapeutic advantages in terms of reduction of retinal lesions and ease the financial burden of patients undergoing treatment by reducing the frequency of necessary ranibizumab injections.

Salidroside protects against premature senescence induced by ultraviolet B irradiation in human dermal fibroblasts.

OBJECTIVES: Salidroside, the predominant component of a Chinese herbal medicine, Rhodiola rosea L., becomes an attractive bio-agent due to its multifunction. Although it is well proposed that this herbal medicine may have photoprotective effect according to the folk hearsay, the direct supportive experimental evidences linking the drug with skin ageing have rarely been reported so far. The study was conducted to investigate the photoprotective role of salidrosdie and its related mechanisms in vitro. METHODS: First, a premature senescence model induced by UVB irradiation (250 mJ cm(-2)) in human dermal fibroblasts (HDFs) was established, and senescent phenotypes were evaluated by cell morphology, cell proliferation, senescence-associated beta-galactosidase (SA-ß-gal) activity and cell cycle distribution. Then the photoprotective effect of salidroside was investigated. Cells were pre-treated with various doses of salidroside (1, 5 and 10 µM) followed by the sublethal dosage of UVB exposure and then were harvested for various detections, including senescence-associated phenotypes and molecules, alteration of oxidative stress, matrix metalloproteinase-1 (MMP-1) secretion and inflammatory response. RESULTS: Pre-treatment of salidroside dose dependently reversed the senescent state of HDFs induced by UVB as evidenced by elevated cell viability, decreased SA-ß-gal activity and relieving of G1/G0 cell cycle arrest. UVB-induced increased protein expression of cyclin-dependent kinase (CDK) inhibitors p21(WAF) (1) and p16(INK) (4) was also repressed by salidrosdie treatment in a dose-dependent manner. Meanwhile, the increment of malondialdehyde (MDA) level in UVB-irradiated HDFs was inhibited upon salidroside treatment. Additionally, salidroside significantly attenuated UVB-induced synthesis of MMP-1 as well as the production of IL-6 and TNF-α in HDFs. CONCLUSION: Our data provided the evidences for the protective role of salidroside against UVB-induced premature senescence in HDFs probably via its anti-oxidative property and inhibition on production of MMP-1 and pro-inflammatory cytokines, which indicated its potential utilization as an active ingredient in the preparation of photoprotective formulation.

Emission characteristics of polycyclic aromatic hydrocarbons from combustion of different residential coals in North China.

Emission properties of polycyclic aromatic hydrocarbons (PAHs) from combustion of six residential coals in North China were investigated. The results indicated that, the total emission factors (EFs) for 15 PAH species in gaseous and particulate phases ranged from 52.8 to 1434.8 mg/kg with a decreasing sequence of local bituminous coals and anthracite coals, and honeycomb briquettes were largely dependent on the raw coals used to produce them. Particulate phase, dominated by median or high molecular weight components, made a major contribution (68.8%-76.5%) to the total EFs for bituminous coals, while gaseous phase with principal low molecular weight species accounted for most (86.3%-97.9%) of the total EFs for anthracite coals. The phase partitioning of PAH emission for honeycomb briquettes was similarly dependent on the crude coals. The total EFs, phase partitioning and component profiles of emitted PAHs were mainly influenced by the inner components of the studied coals. Burning mode and flue number on household coal-stoves also affected the emission characteristics by means of the oxygen supply. A sum of seven carcinogenic PAHs, benzo(a)pyrene(BaP)-equivalent carcinogenic power and total toxicity potency expressed in 2,3,7,8-tetrachlorodibenzo-dioxin(TCDD) toxic equivalence exhibited that bituminous coals and produced honeycomb briquettes had remarkably elevated values. Fluoranthene, benzo(b)fluoranthene, benzo(k)fluoranthene, chrysene and indeno(1,2,3-cd)pyrene from anthracite coals showed higher levels of BaP-based toxic equivalent factor, though the other toxicity indices were rather low for this type of coal.

Methylation protects dietary flavonoids from rapid hepatic metabolism.

The metabolic stability of two potential cancer chemopreventive flavones, i.e. 5,7-dimethoxyflavone (5,7-DMF) and 3',4'-dimethoxyflavone (3',4'-DMF), compared with the non-methylated flavone galangin (3,5,7-trihydroxyflavone), was investigated in human hepatic preparations. Galangin, as expected, was extensively metabolized mainly by glucuronidation in human liver S9 fractions in the presence of appropriate co-factors. In contrast, 5,7-DMF and 3',4'-DMF were metabolically highly stable with only a small fraction of 3',4'-DMF undergoing oxidation. Consistent with the S9 fraction results, galangin was almost completely depleted after 2-h incubations in freshly plated hepatocytes. The hepatocytes also showed some metabolism of 3',4'-DMF, but virtually none of 5,7-DMF. In human liver microsomes, 5,7-DMF was more metabolically stable than 3',4'-DMF. The observations present a new strategy for examining the metabolic stability of dietary flavonoids and suggest that methylated flavonoids may have a high oral bioavailability compared with their non-methylated forms, which will make them more likely to be useful as cancer chemoprotectants.

Acupuncture therapy for the symptoms of Parkinson's disease.

Interest in alternative medical treatments, including acupuncture, is increasing. Alternative treatments must be subjected to the same objective standards as all medical treatments. A non-blinded pilot study of the safety, tolerability, and efficacy of acupuncture (ACUPX) for the symptoms of (PD) was performed. Twenty PD patients (mean age, 68 years; disease duration, 8.5 years; Hoehn and Yahr [H&Y] stage, 2.2; Unified Parkinson's Disease Rating Scale score [UPDRS], 38.7) each received acupuncture treatments by a licensed acupuncturist. All patients were treated with two acupuncture treatment sessions per week. The first seven patients received 10 treatments and the last 13 patients 16 treatments. Patients were evaluated before and after ACUPX with the Sickness Impact Profile (SIP); UPDRS; H & Y; Schwab and England (S & E); Beck Anxiety Inventory (BAI); Beck Depression Inventory (BDI); quantitative motor tests, including timed evaluations of arm pronation supination movements, finger dexterity, finger movements between two fixed measured points, and the stand-walk-sit test; and a patient questionnaire designed for the study. Following ACUPX, there were no significant changes in the UPDRS, H&Y, S&E, BAI, BDI, quantitative motor tests, total SIP or the two SIP Dimension scores. Analysis of the 12 SIP categories not corrected for multiple comparisons revealed a post-ACUPX improvement in the sleep and rest category only (P = 0.03). On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety. There were no adverse effects. ACUPX therapy is safe and well tolerated in PD patients. A range of PD and behavioral scales failed to show improvement following ACUPX other than sleep benefit, although patients reported other discrete symptomatic improvements. A broad battery of tests in PD patients suggested that ACUPX resulted in improvement of sleep and rest only. This finding needs to be verified using more in-depth and controlled evaluation of ACUPX for PD-related sleep disturbance.

[Protective effects of Chinese herb-compound on cellular immunological function (correction of funcion) in tail-suspended rats].

Objective. To observe the protective effects of two kinds of Chinese herb-compounds (Dan-huang-ci compound and Shen-chuan-shu compound) on cellular immunology in tail-suspended rats. Method. The rats were divided into: 1) normal control group; 2) tail-suspended group; 3) tail-suspended + Dan-huang-ci compound; and 4) tail-suspended + Shen-chuan-shu compound. Ability of lymphocyte proliferation and production of IL-2 in rats in the four groups were compared after 21 d. Result. The immunological function of tail-suspended control group decreased significantly as compared with normal control group. Shen-chuan-shu compound could improve immunological function of tail-suspended rats obviously. Conclusion. Shen-chuan-shu compound could enhance cellular immunological function in rats under simulated weightlessness.

A gene expression profile of Alzheimer's disease.

Postmortem analysis of brains of patients with Alzheimer's disease (AD) has led to diverse theories about the causes of the pathology, suggesting that this complex disease involves multiple physiological changes. In an effort to better understand the variety and integration of these changes, we generated a gene expression profile for AD brain. Comparing affected and unaffected brain regions in nine controls and six AD cases, we showed that 118 of the 7050 sequences on a broadly representative cDNA microarray were differentially expressed in the amygdala and cingulate cortex, two regions affected early in the disease. The identity of these genes suggests the most prominent upregulated physiological correlates of pathology involve chronic inflammation, cell adhesion, cell proliferation, and protein synthesis (31 upregulated genes). Conversely, downregulated correlates of pathology involve signal transduction, energy metabolism, stress response, synaptic vesicle synthesis and function, calcium binding, and cytoskeleton (87 downregulated genes). The results support several separate theories of the causes of AD pathology, as well as add to the list of genes associated with AD. In addition, approximately 10 genes of unknown function were found to correlate with the pathology.

In vitro bioactive behavior of hydroxylapatite-coated porous Al(2)O(3).

To produce bioactive materials for bone substitutes, two major deposition methods, suspension method and thermal deposition method, were employed to develop bioactive, mechanically strong, and porous ceramics. Hydroxylapatite (HA) has been uniformly coated onto inner pore surfaces of reticulated alumina substrates. It has been found that the in vitro bioactivity of HA coatings was affected by both structural crystallinity and specific surface area. Well-crystallized HA heat-treated at high temperatures has resulted in reduced bioactivity. The bio-reaction rate was found to increase with the surface area of HA. We have found that the stability of the well-crystallized HA is associated with the high driving force required for the formation of hydroxy-carbonate apatite (HCA) phase.

Purification, cloning, and characterization of the CEL I nuclease.

CEL I, isolated from celery, is the first eukaryotic nuclease known that cleaves DNA with high specificity at sites of base-substitution mismatch and DNA distortion. The enzyme requires Mg(2+) and Zn(2+) for activity, with a pH optimum at neutral pH. We have purified CEL I 33 000-fold to apparent homogeneity. A key improvement is the use of alpha-methyl-mannoside in the purification buffers to overcome the aggregation of glycoproteins with endogenous lectins. The SDS gel electrophoresis band for the homogeneous CEL I, with and without the removal of its carbohydrate moieties, was extracted, renatured, and shown to have mismatch cutting specificity. After determination of the amino acid sequence of 28% of the CEL I polypeptide, we cloned the CEL I cDNA. Potential orthologs are nucleases putatively encoded by the genes BFN1 of Arabidopsis, ZEN1 of Zinnia, and DSA6 of daylily. Homologies of CEL I with S1 and P1 nucleases are much lower. We propose that CEL I exemplifies a new family of neutral pH optimum, magnesium-stimulated, mismatch duplex-recognizing nucleases, within the S1 superfamily.

High-level expression of I kappa B-beta in the surface epithelium of the colon: in vitro evidence for an immunomodulatory role.

The intestinal epithelium is spatially segregated into two compartments, one containing undifferentiated cells in a proliferative state and one with non-proliferative differentiated cells. Although this epithelium can produce many immunemodulating substances, emerging evidence suggests that the differentiated cell compartment is less immune responsive. Indeed, it is the differentiated cellular compartment that represents the interface between the highly antigenic luminal environment and the mucosal immune system. The NF-kappaB/rel family of transcriptional activators play a critical role in regulating the inflammatory response by activating a wide variety of immune-modulating genes. These transcription factors are maintained in an inactive state in the cytoplasmic compartment by interaction with inhibitory proteins of the IkappaB family. In this study we show by immunohistochemistry that IkappaB-beta is expressed at high levels specifically in the differentiated surface epithelium of the colonic mucosa. Using a naturally occurring compound found in the colon of vertebrates, butyrate, we provide evidence in an intestinal cell line that alteration of IkappaB-beta expression can modulate the transcriptional activation of the interleukin-8 (IL-8) gene by preventing the nuclear translocation of NF-kappaB proteins. Therefore, the expression of IkappaB-beta in the differentiated surface epithelium of the colon may help these cells act as an immunological barrier to prevent activation of the mucosal immune system.

[Effects of Squama manitis on cardiac systolic function and platelet aggregation].

OBJECTIVE: To study the effect of Squama Manitis(S. M.) on cardiac function and platelet aggregation in vitro. METHOD: Isolated working rat hearts were prepared, and cardiac performance was measured before and after adding S. M. in the Krebs-Hensleit(K-H) perfusion buffer. Controls with K-H buffer were also investigated. Rich platelet plasma and Poor platelet plasma were centrifuged from the blood of 15 patients with coronary heart disease. Each sample was divided into three parts for use by three groups: control, group of S. M. and group of aspirin. Platelet aggregation was stimulated by adenosine diphosphate. RESULT: LVSP, +dP/dtmax and CO of isolated working rat hearts were significantly increased after treating with S. M. liquor. S. M. had no obvious effect on -dP/dtmax and LVEDP. These parameters did not change significantly in the control. Percentages of platelet aggregation were significantly lower in the group of S. M. and the group of aspirin as compared with the control. CONCLUSION: S. M. increases cardiac systolic function, has positive inotropic effect on myocardium and inhibits platelet aggregation.

Characterisation of an anti-ulcer pectic polysaccharide from leaves of Panax ginseng C.A. Meyer.

Structural characterisation of an anti-ulcer polysaccharide (GL-BIII), purified from leaves of Panax ginseng C.A. Meyer, was studied. Methylation analysis indicated that GL-BIII consisted mainly of terminal Arap, 4- or 5-substituted Ara, 2,4-disubstituted Rha, 4- and 6-substituted Gal, and 3,6-disubstituted Gal. Single radial gel diffusion using beta-glucosyl-Yariv antigen indicated that GL-BIII contained a small proportion of a beta-(1-->3,6)-galactan moiety. GL-BIII also contained terminal, 4-substituted, and 3,4-disubstituted GalA, and terminal and 4-substituted GlcA. Base-catalysed beta-elimination suggested that some 2-substituted Rha in GL-BIII was attached to position 4 of a 4-substituted uronic acid. Both mild acid hydrolysis and endo-alpha-(1-->4)-polygalacturonase digestion of GL-BIII did not give fragments consisting mainly of GalA. Methylation analysis and GC-MS analysis of acidic oligosaccharides liberated by partial acid hydrolysis indicated that GL-BIII contained a GalA-(1-->4)-Rha unit in addition to longer acidic units consisting of 2-substituted Rha and 4-substituted GalA. Lithium-mediated degradation of GL-BIII followed by borohydride reduction gave small amounts of fractions containing long and intermediate neutral oligosaccharide-alditols and a large amount of a fraction containing short oligosaccharide-alditols. The long neutral oligosaccharide-alditol fraction mainly comprised 4- or 5-substituted Ara, terminal Galf, 6-substituted Glc, and 2-substituted Man, whereas the intermediate oligosaccharide-alditol fraction consisted mainly of terminal and 6-substituted Galp, 6-substituted Glc, and 2-substituted Man. Methylation analysis and GC-MS analysis of the short oligosaccharide-alditol fraction suggested that it contained at least 14 kinds of di- to tetra-saccharide-alditols such as Gal-(1-->2)-Rha-ol, Gal-(1-->4)-Rha-ol, Ara-->Ara-ol, and Ara-->Ara-->Ara-ol.

[Steroid alkaloids from stems and leaves of Fritillaria ussuriensis Maxim].

Three crystalline chemical components were isolated from the stems and leaves of Fritillaria ussuriensis by column chromatographic technique. On the basis of the IR, MS and 1HNMR spectra, the structure has been identified as pingbeimine B, pingbeimine C and pingbeininoside.

Medicinal protection with Chinese herb-compound against radiation damage.

Experiments were carried out on mice and the subjects irradiated for cancer therapy to evaluate the protective efficacy of a Chinese medicinal herb-compound (CMHC). The lethality and the degree of leucopenia caused by radiation in mice medicated with CMHC were significantly less in comparison with control mice (p less than 0.01 and p less than 0.001, respectively). CMHC significantly improved the WBC and the thrombocytes in irradiated workers (p less than 0.01 and p less than 0.001, respectively). The WBC count of 40 patients under radiotherapy while treated with CMHC recovered from 3450 +/- 77/c.mm to 5425 +/- 264/c.mm (p less than 0.001); whereas, in the control group, without any medication, the WBC count dropped significantly (p less than 0.001). Our results revealed the applicabilities of CMHC in protection against radiation damage in spaceflight and in other fields.

[Structure of pingbeimine C].

A new C-nor-D-homosteroid alkaloid, C27H43O6N, mp 171.5-173 degrees C, named pingbeimine C, was isolated from the bulb of Fritillaria ussuriensis Maxim. On the basis of IR, MS, 1HNMR and 13CNMR spectroscopic data, particularly X-ray crystallographic analysis, structure IV has been assigned to this alkaloid.

[Structure of pingbeidinoside, an alkaloid isolated from the stems and leaves of Fritillaria ussuriensis Maxim].

A new steroid alkaloid glucoside, pingbeidinoside, was isolated from the stem and leaf of Fritillaria ussuriensis Maxim by column chromatographic techniques. On the basis of the IR, MS, 1HNMR and 13CNMR spectra of pingpeidinoside and products of its transformation, the structure of pingbeidinoside has been established as 3 beta,16 alpha,20-trihydroxy-delta 5-22,26-epiminocholestane-25-O-beta-D- glucoside.