Pharmaceutical care of vascular dementia patients with drug-induced liver injury caused by the Compound Congrong Yizhi Capsules: a case report.

BACKGROUND: Drug-induced liver injury (DILI) is a newly discovered adverse drug reaction of Compound Congrong Yizhi Capsules (CCYC) in the treatment of vascular dementia (VD), and targeted pharmaceutical care is urgently needed to be explored. CASE REPORT: DILI was found in a patient who was admitted to the hospital with a diagnosis of VD after treatment with Compound Congrong Yizhi Capsules. According to the guidelines, the patient was initially treated with magnesium isoglycyrrhizinate injection. After 4 days, the clinical pharmacist monitored liver function: alanine aminotransferase (ALT): 153 IU/L, aspartate aminotransferase (AST): 160 IU/L, total bilirubin (TBil): 4.5 µmol/L, and alkaline phosphatase (ALP): 551 IU/L, which indicated that DILI was further aggravated. In addition, the increased blood pressure (156/65 mmHg) indicated the requirement to adjust the medication. Then, the hepatoprotective drugs were adjusted with reduced glutathione combined with ursodeoxycholic acid. After 12 days of treatment, the liver function was significantly improved, the clinical treatment was effective, and the blood pressure was controlled stably with no obvious adverse drug reactions. CONCLUSIONS: With pharmaceutical care guided by clinical pharmacists, the DILI caused by Compound Congrong Yizhi capsules could be reversed to improve the clinical outcome and avoid the occurrence of serious complications.

Baicalin alleviates silica-induced lung inflammation and fibrosis by inhibiting TLR4/NF-?B pathway in rats.

Silicosis is an occupational lung disease caused by inhaling silica dust. The disease is characterized by early lung inflammation and late irreversible pulmonary fibrosis. Here we report the effect of Baicalin, a main flavonoid compound from the roots of Chinese herbal medicine Huang Qin on silicosis in a rat model. Results showed Baicalin (50 or 100 mg/kg/day) can mitigate the silica-induced lung inflammation and reduce the harm of alveolar structure and the blue region of collagen fibers in rat lung at 28 days after administration. At the same time, Baicalin also diminished the level of interleukin-1beta (IL-1beta, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1) in lung tissues. The protein expression of collagen I (Col-1), alpha-smooth muscle actin (alpha-SMA) and vimentin were down-regulated while E-cadherin (E-cad) was increased in Baicalin-treated rats. In addition, the Toll Like Receptor 4 (TLR4)/ nuclear factor kappaB (NF-kappaB) pathway was enabled at 28 days after silica infusion, and the treatment of Baicalin diminished the expression of TLR4 and NF-?B in the lungs of rat with silicosis. These results suggested that Baicalin inhibited the pulmonary inflammatory and fibrosis in a rat model of silicosis, which could be attributed to inhibition of the TLR4/NF-kappaB pathway.

Effect of pharmaceutical care on the treatment of community-acquired pneumonia in the elderly: a case report.

OBJECTIVE: Elderly patients with community-acquired pneumonia (CAP) have more comorbidities, decreased organ function, and weakened immune function, which can easily lead to various adverse reactionsduring anti-infection treatment. Comprehensive geriatric assessment is a commonly used method to optimize the management of the clinical treatment of the elderly, of which the clinical pharmacists are the core member. However, few studies have focused on the participation of relevant clinical pharmacists of comprehensive geriatric assessment (CGA) of elderly CAP patients. CASE PRESENTATION: A case where the clinical pharmacist participated in the entire process of medical treatment of an elderly patient with CAP. From the first day of admission to the hospital, anti-infective drugs were selected based on the condition combined with the distribution and drug-resistance of common local pathogens, paying attention to the changes of various indicators during treatment, the drug dose was adjusted in time, and targeted anticoagulation, cardiotonic, diuretic, potassium supplementation, intestinal flora regulation and anti-fungal treatment were carried out, as well as the prevention and treatment of antibiotic-related diarrhea. After 24 days of hospitalization, the patient was in a stable condition after treatment and was discharged from the hospital. CONCLUSIONS: The participation of clinical pharmacists in CGA had positive significance for the clinical treatment of elderly CAP, and it was worthy of further improvement and clinical promotion.

RN1, a novel galectin-3 inhibitor, inhibits pancreatic cancer cell growth in vitro and in vivo via blocking galectin-3 associated signaling pathways.

Galectin-3 (Gal-3) has been implicated in pancreatic ductal adenocarcinoma (PDAC), and its candidacy as a therapeutic target has been evaluated. Gal-3 is widely upregulated in tumors, and its expression is associated with the development and malignancy of PDAC. In the present study, we demonstrate that a polysaccharide, RN1, purified from the flower of Panax notoginseng binds to Gal-3 and suppresses its expression. In addition, RN1 markedly inhibits PDAC cells growth in vitro, in vivo and in patient-derived xenografts. Mechanistically, RN1 binds to epidermal growth factor receptor (EGFR) and Gal-3, thereby disrupting the interaction between Gal-3 and EGFR and downregulating extracellular-related kinase (ERK) phosphorylation and the transcription factor of Gal-3, Runx1 expression. Inhibiting the expression of Runx1 by RN1, suppresses Gal-3 expression and inactivates Gal-3-associated signaling pathways, including the EGFR/ERK/Runx1, BMP/smad/Id-3 and integrin/FAK/JNK signaling pathways. In addition, RN1 can also bind to bone morphogenetic protein receptors (BMPR1A and BMPR2) and block the interaction between Gal-3 and the BMPRs. Thus, our results suggest that a novel Gal-3 inhibitor RN1 may be a potential candidate for human PDAC treatment via multiple targets and multiple signaling pathways.

Ca/Mg infusions for the prevention of oxaliplatin-related neurotoxicity in patients with colorectal cancer: a meta-analysis.

BACKGROUND: Oxaliplatin-related neurotoxicity is the main limitation for its continuation in adjuvant and palliative chemotherapy for patients with colorectal cancer. The purpose of this meta-analysis was to determine the efficacy of calcium and magnesium (Ca/Mg) infusions in oxaliplatin-induced neurotoxicity. METHODS: Two independent authors conducted database searches of the literature to find clinical-controlled trials analyzing Ca/Mg infusions in oxaliplatin-induced neurotoxicity. The keywords used to search were oxaliplatin, neurotoxicity, calcium, magnesium, neuropathy, and peripheral. Clinical studies that included at least one primary or secondary event were eligible for the analysis, where primary events were incidences of acute and cumulative neurotoxicity, and secondary events were the total doses and cycles of oxaliplatin, response rate (RR), overall survival (OS), and progression-free survival (PFS). Odds ratios (ORs) and weighted mean differences (MD) were analyzed using models of fixed and random effects. RESULTS: This meta-analysis comprised four prospective randomized clinical trials and three retrospective clinical trials involving 1170 colorectal cancer patients, of which 802 received Ca/Mg infusions (Ca/Mg group) and 368 did not (control group). According to the National Cancer Institute-Common Terminology Criteria for Adverse Events, the incidence of grade 3 acute neurotoxicity in those who received Ca/Mg was significantly lower than that of the control group (OR=0.26; 95% confidence interval (CI), 0.11 to 0.62; P=0.0002). The total rate of cumulative neurotoxicity, and that of grade 3 in particular, was significantly lower in the Ca/Mg group than in the control group (OR=0.42; 95% CI 0.26-0.65; P=0.0001; OR=0.60; 95% CI 0.39-0.92; P=0.02, respectively). The differences in total doses and cycles of oxaliplatin were also significant between the Ca/Mg and control group (MD=246.73 mg/m2; 95% CI 3.01-490.45; P=0.05; MD=1.55; 95% CI 0.46-2.63; P=0.005, respectively). No significant differences were found in median PFS (MD=0.71 month; 95% CI -0.59-2.01; P=0.29), median OS (MD=0.10 month; 95% CI -0.41-0.61; P=0.70) or RRs (OR=0.82; 95% CI 0.61-1.10; P=0.18). CONCLUSION: Ca/Mg infusions tend to decrease the incidence of oxaliplatin-induced acute and cumulative neurotoxicity and thus enhance patients' tolerance to oxaliplatin, without significantly altering the efficacy of chemotherapy.

Inhibition of p38 MAPK during cellular activation modulate gene expression of head kidney leukocytes isolated from Atlantic salmon (Salmo salar) fed soy bean oil or fish oil based diets.

Head kidney leukocytes isolated from Atlantic salmon fed either a diet based on fish oil (FO) or soy bean oil (VO) were used in order to evaluate if different lipid sources could contribute to cellular activation of the salmon innate immune system. A specific inhibitor of p38 MAPK, SB202190, was used to investigate the effect of lipopolysaccharide (LPS) signalling in the head kidney leukocytes. The results show that LPS up regulate IL-1ß, TNF-α, Cox2 expression in leukocytes isolated from fish fed either diet. The p38 MAPK inhibitor, SB202190, reduced the LPS induced expression of these genes in both dietary groups. In LPS stimulated leukocytes isolated from VO fed fish, SB202190 showed a clear dose dependent inhibitory effect on IL-1ß, TNF-α and Cox2 expression. This effect was also observed for Cox2 in leukocytes isolated from FO fed fish. Furthermore, there was a stronger mean induction of Cox2 in LPS stimulated leucocytes isolated from the VO-group compared to LPS stimulated leukocytes isolated from the FO-group. In both dietary groups, LPS stimulation of salmon head kidney leukocytes increased the induction of CD83, a dendrite cell marker, while the inhibitor reduced CD83 expression in the VO fed fish only. The inhibitor also clearly reduced hsp27 expression in VO fed fish. Indicating a p38 MAPK feedback loop, LPS significantly inhibited the expression of p38MAPK itself in both diets, while SB202190 increased p38MAPK expression especially in the VO diet group. hsp70 expression was not affected by any treatment or feed composition. There were also differences in p38MAPK protein phosphorylation comparing treatment groups but no obvious difference comparing the two dietary groups. The results indicate that dietary fatty acids have the ability to modify signalling through p38 MAPK which may have consequences for the fish's ability to handle infections and stress. Signalling through p38MAPK is ligand dependent and affects gene and protein expression differently.

Identification and characterization of a novel zinc finger protein (HZF1) gene and its function in erythroid and megakaryocytic differentiation of K562 cells.

A novel zinc finger protein (HZF1) gene was identified and characterized by screening a human bone marrow cDNA library, using a new expression sequence tag probe that contains sequences encoding zinc finger motifs. There are at least three transcripts that may result from different splicing of the pre-mRNA, but the differences among them are only involved in 5' non-translation region of HZF1 mRNA. HZF1 gene contains four exons and three introns. The putative protein consists of 670 amino-acid residues including 15 typical C2H2 and 2 C2RH zinc finger motifs. This structure characterization of HZF1 and the nuclear location of the protein suggest that HZF1 may function as a transcription factor. HZF1 mRNA expression was detected in ubiquitous tissues and various hematopoietic cell lines. Increased HZF1 mRNA expression was observed following erythroid differentiation of K562 cells induced by hemin or megakaryocytic differentiation of K562 cells induced by phorbol myristate acetate (PMA). Both of the antisense method and RNA interference assay revealed that repression of the intrinsic expression of HZF1 blocked the hemin-induced erythroid differentiation and reduced the PMA-induced megakaryocytic differentiation of K562 cells, which suggested that HZF1 play important roles in erythroid and megakaryocytic differentiation.

[Identification of herba pogostemonis and its confused species Anisomeles indica].

The article reports the morphological, histological and TLC identification for Herba Pogostemonis and its adulterant, Anisomeles indica, which appears recently. It provides foundation for identificating Herba Pogostemonis.

[Expression of retinoic acid receptor gamma gene in ES cells and its effect on their differentiation and apoptosis].

We have constructed pSG5-RAR gamma-neo plasmid containing mouse retinoic acid receptor gamma (RAR gamma) gene and neo gene, and introduced it into embryonic stem ES-5 cells, by calcium phosphate mediated transfection. Some G418-resistant clones were isolated and from RNA dot blot analysis of these clones, a clone overexpressing RAR gamma gene was established, designated as ES-gamma cell line. Northern blot hydridization and Southern blot hydridization analysis of ES-gamma cells (Fig 3, 4) demonstrated that ES-gamma cells overexpressed exogenous RAR gamma mRNA and the exogenous RAR gamma cDNA integrated into the genome of ES cells. ES-gamma cells retained undifferentiated morphology and positive alkaline phosphatase activity (Plate I, Fig. 1, 2), so it resembled ES-5 cells in terms of stem cell characteristics. When ES-gamma cells were subcutaneously inoculated into nude mouse and differentiated in vivo, tumorous nodules containing various tissue structures were obtained, demonstrating their pluripotent properties just like parent ES-5 cells. Contrasting with ES-5 cells, the histological features of tumors showed no cartilage tissues, but abundant muscle tissues and keratinized cyst like structures constituted by stratified squamous epithelia (Plate I, Fig. 3). Differentiating in vitro by hanging drop culture methods, ES-gamma cells differentiated mostly into fibroblast-like cells, (Plate II, Fig. 1-5). The above results indicated that overexpression of RAR gamma gene changed the cell type of ES cells differentiating in vivo and in vitro. During the differentiation of ES-5 cells induced by RA, a large number of cells rounded up, detached from the dish and tended to die. We suspected that this phenomenon may be apoptosis. The ultrastructure appearance of the dying cells displayed typical apoptotic changes including chromatin condensation and nuclear fragmentation (Plate I, Fig. 4, 5). Detection of DNA fragments using agarose gel electrophoresis showed characteristic laddered patterns of apoptotic DNA fragments (Fig. 5). The above results indicated that RA induced apoptosis of ES-5 cells in the course of differentiation. The percentage of apoptosis of ES-5 cells increased accordingly, with the increase of RA concentration (Fig. 6). With the same concentration of RA 10(-7) mol/L, the percentage of apoptotic of ES-gamma death was roughly one times more than that of ES-5 cells (Fig. 7), a fact indicating that RAR gamma may mediate the apoptotic signal transduction of ES cells by RA.

[Determination of ferulic acid and peoniflorin in siwu decoction prepared by different methods of yellow rice wine].

OBJECTIVE: To compare the influence of different methods with YRW (yellow rice wine) on the composition of Siwu decoction. METHOD: TCL-SM was used to determine the ferulic acid, paeoniflorin and matters dissolved in ether in Siwu decoction. RESULT: The Siwu decoction with YRW preparation has the highest contents, while the Siwu decoction containing Chinese Angelica root and Rehmammia root prepared with YRW has the lowest contents. CONCLUSION: The Siwu decoction prepared with YRW or added with YRW is more helpful for ferulic acid and paeoniflorin to be dissolved out than the Siwu decoction containing Chinese Angelica root and Rehmannia root prepared with YRW.

In vivo phosphorylation of phosphoenolpyruvate carboxylase in guard cells of Vicia faba L. is enhanced by fusicoccin and suppressed by abscisic acid.

Plants regulate water loss and CO2 gain by modulating the aperture sizes of stomata that penetrate the epidermis. Aperture size itself is increased by osmolyte accumulation and consequent turgor increase in the pair of guard cells that flank each stoma. Guard cell phosphoenolpyruvate carboxylase (PEPC, EC 4.1.1.31), which catalyzes the regulated step leading to malate synthesis, is crucial for charge and pH maintenance during osmolyte accumulation. Regulation of this cytosolic enzyme by effectors is well documented, but additional regulation by posttranslational modification is predicted by the alteration of PEPC kinetics during stomatal opening (FEBS Lett. 352, 45-48). In this study, we have investigated whether this alteration is associated with the phosphorylation status of this enzyme. Using sonicated epidermal peels ("isolated" guard cells) preloaded with 32PO4, we induced stomatal opening and guard cell malate accumulation by incubation with 5 microM fusicoccin (FC). In corroboratory experiments, guard cells were incubated with the FC antagonist, 10 microM abscisic acid (ABA). The phosphorylation status of PEPC was assessed by immunoprecipitation, electrophoresis, immunoblotting, and autoradiography. PEPC was phosphorylated when stomata were stimulated to open, and phosphorylation was lessened by incubation with ABA. Thus, we conclude that regulation of guard cell PEPC in vivo is multifaceted; the effects of regulatory metabolites and the activation status of the enzyme are integrated to control malate synthesis. These results, together with the coincident alteration in the kinetics of the enzyme (FEBS Lett. 352, 45-48), constitute the first unequivocal demonstration of regulatory posttranslational modification of a guard cell protein that is specifically implicated in stomatal movements.

[Stability of jingu tongxial pills].

The stability of Jingu Tongxiao Pills was studied on the basis of accelerated destruction and sample-reserving observation at room temperature. According to the changes of tanshinone IIA in the sample, the time of efficacy determined by the two methods is 1.89 and 2.30 years respectively. Based on the analysis of other indices, the effective period is tentatively determined as two years.

Copper metabolism of holstein and jersey cows and heifers fed diets high in cupric sulfate or copper proteinate.

Eight Holstein and 8 Jersey primiparous cows (3 d postcalving) and 8 Holstein and 8 Jersey growing heifers were randomly assigned to 1 of 8 treatments in a 2 x 2 x 2 factorial arrangement to compare Cu metabolism between Holsteins and Jerseys and the bioavailabilities of Cu in Cu proteinate and CuSO4. The variables were Holstein or Jersey, Cu supplementation at 5 or 80 mg/kg of DM, and supplements of CuSO4 or Cu proteinate. Jerseys had higher hepatic Cu concentrations than did Holsteins on d 60 (346 vs. 303 micrograms/g of DM). At the high Cu supplementation, hepatic Cu increased more rapidly, and content was higher in Jerseys than in Holsteins by d 60 (520 vs. 439 micrograms/g of DM). On d 0, plasma Cu concentrations were 0.99 and 0.80 microgram/ml, and, on d 60, concentrations were 0.96 and 0.88 microgram/ml for Jerseys and Holsteins, respectively. Overall, serum ceruloplasmin oxidase activity was greater for Jerseys than for Holsteins. Jersey cows and heifers also had greater hepatic Fe (208 vs. 173 micrograms/g of DM) and lower hepatic Zn (82 vs. 91 micrograms/g of DM) than did Holstein cows and heifers at d 60. The bioavailability of Cu in Cu proteinate and CuSO4 was the same. Plasma Cu concentration and ceruloplasmin have limited value as indicators of Cu status and availability to dairy cows and heifers.

Utilization of copper in copper proteinate, copper lysine, and cupric sulfate using the rat as an experimental model.

One hundred twenty male Sprague-Dawley rats, averaging 108.6 g initial body weight, were used in two feeding experiments to evaluate the utilization of Cu in Cu proteinate, Cu lysine, and cupric sulfate. In Exp. 1, 60 rats were randomly assigned to 12 treatments in a 2 x 2 x 3 factorial arrangement of treatments, with Zn supplementation at 0 or 1000 mg/kg diet, Cu supplementation at 5 or 15 mg/kg diet, and Cu form of CuSO4.5H2O, Cu proteinate, or Cu lysine. The purified basal diet contained .81 mg Cu, 20 mg Zn, and 60 mg Fe/kg diet. Experiment 2 was similar to Exp. 1 except Zn was replaced by Fe. In Exp. 1, feed intake of Cu proteinate (15.74 g/d) and Cu lysine (15.74 g/d) treatments was higher (P < .05) than that of CuSO4 (15.33 g/d). Body weight gain and feed intake were increased by high dietary Cu at either requirement or high levels of dietary Zn (P < .05). There were no differences in feed intake or body weight gain among the treatment groups in Exp. 2 (P > .05). The Cu utilization of Cu proteinate and Cu lysine were higher (P < .05) based on the liver Cu content. The rats fed Cu complexes had a higher liver Fe or Zn content (P < .05) than the rats fed CuSO4, suggesting that Cu complexes are absorbed via another mechanism that differs from that of inorganic Cu and does not interfere with Zn and Fe. Spleen Cu content may be a sensitive indicator of Cu status. High dietary Zn decreased Cu utilization, but this effect was overcome by high dietary Cu.

[Investigation and experimental study on the standards and quality of leech pieces].

It has been confirmed by investigation that Whitmania pigra is the main medicinal breed of leech, and filiform pieces are the best for extraction. The quality of leech processed by 3 different methods has been studied qualitatively and quantitatively in terms of amounts of extraction, TLC, electrophoresis of protein and anti-thrombin action.

Efficacy of tablet huperzine-A on memory, cognition, and behavior in Alzheimer's disease.

AIM: To evaluate the efficacy and safety of tablet huperzine-A (Hup) in patients with Alzheimer's disease. METHODS: Using multicenter, prospective, double-blind, parallel, placebo controlled and randomized method, 50 patients were administered orally 0.2 mg (4 tablets) Hup and 53 patients were given po 4 tablets of placebo bid for 8 wk. All patients were evaluated with Wechsler memory scale, Hasegawa dementia scale, mini-mental state examination scale, activity of daily living scale, treatment emergency symptom scale, and measured with BP, HR, ECG, EEG, ALT, AKP, BUN, Cr, Hb, WBC, and urine routine. RESULTS: About 58% (29/50) of patients treated with Hup showed improvements in their memory (P < 0.01), cognitive (P < 0.01), and behavioral (P < 0.01 functions. The efficacy of Hup was better than placebo (36%, 19/53) (P < 0.05). No severe side effect was found. CONCLUSION: Hup is a promising drug for symptomatic treatment of Alzheimer's disease.

Kinetic characterization of phosphoenolpyruvate carboxylase extracted from whole-leaf and from guard-cell protoplasts of Vicia faba L. (C3 plant) with respect to tissue pre-illumination.

Whole leaves and guard-cell protoplasts of the C3 plant Vicia faba L. (broad bean) were separately extracted following a period of illumination or following a period of darkness. Kinetic parameters of phosphoenolpyruvate carboxylase (PEPC, EC 4.1.1.31), Vmax and Km(PEP.Mg), were determined as a function of assay pH (7.0 or 8.1), the presence of 5 mM glucose-6-Pfree (Glc-6-P, an activator), and the presence of 5 mM malatefree (an inhibitor). On the basis of these parameters, guard-cell PEPC was distinguished from that of whole leaf, indicating either that guard cells contain a unique isoenzyme of PEPC or a different complement of isoenzymes or--and less likely--that the obligatorily different methodologies for the leaf (intact organ) and the guard-cell (protoplast) enzymes altered them specifically. The values of Vmax were relatively unchanged, regardless of assay conditions or tissue pretreatment. The values obtained for whole-leaf PEPC Vmax were restricted to a small range (52.4 +/- 5.9 (SD) to 64.4 +/- 4.8 (SD) mumol.g fresh mass-1.h-1; the high value coincided with the presence of Glc-6-P, and the low value was obtained in the presence of malate. Guard-cell PEPC Vmax was also restricted to a small range: 7.48 +/- 0.89 (SD) pmol.guard-cell pair-1.h-1 (pH 8.1, light, +Glc-6-P) to 5.79 +/- 0.60 (SD) pmol.guard-cell pair-1.h-1 (pH 7.0, dark, +malate). Depending on effectors, and particularly pH, large changes in Km(PEP.Mg) were calculated (whole-leaf PEPC: 0.03 to 3.84 mM; guard-cell PEPC: 0.06 to 3.43 mM).(ABSTRACT TRUNCATED AT 250 WORDS)