Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers / 中华劳动卫生职业病杂志

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Protective Effect of Tangshen Formula () on Interstitial Cells of Cajal in Colon of Diabetic Rats / 中国结合医学杂志

OBJECTIVE@#To explore the effect of Tangshen Formula (, TSF), a Chinese herbal medicine, on interstitial cells of Cajal (ICC) in the colon of diabetic rats.@*METHODS@#Fifty-four male Wistar rats were randomly divided into normal control (NC, n=14) and high-fat diet (HFD) groups (n=40). After 6 weeks, the rats in the HFD group were injected intraperitoneally streptozotocin once (30 mg/kg). Thirty rats with fasting blood glucose higher than 11.7 mmol/L were randomly divided into diabetes (DM) and TSF groups, 15 rats in each group. Rats in the NC and DM groups were intragastrically administered with saline, and those in the TSF group were given with TSF (2.4 g/kg) once daily for 20 weeks. Expression levels of Bax, Bcl-2, and caspase-3 in colonic smooth muscle layer were measured by Western blotting and immunohistochemical staining. The number of ICC was determined by immunohistochemical staining. Immunofluorescence was used for analyzing the ratio of classically activated macrophages (M1) and alternatively activated macrophages (M2) to total macrophages. Electron microscopy was used to observe the epithelial ultrastructure and junctions.@*RESULTS@#TSF appeared to partially prevented loss of ICC in DM rats (P<0.05). Compared with the NC group, expression levels of Bcl-2, Bax, caspase-3, and TNF-α as well as the ratio of M1 to total macrophages increased in DM rats (all P<0.05), and the ratio of M2 to total macrophages decreased (P<0.05 or P<0.01). Compared with the DM group, TSF decreased the expression levels of abovementioned proteins and restore M2 to total macrophages ratio (P<0.05 or P<0.01). TSF appeared to attenuate the ultrastructural changes of epithelia and improve the tight and desmosome junctions between epithelia reduced in the DM rats.@*CONCLUSION@#Reduced number of ICC in DM rats may be associated with damage of the intestinal barrier. The protective effects of TSF on ICC may be through repair of the epithelial junctions, which attenuates inflammation and inflammation-initiated apoptosis in colon of DM rats.

Determination of six effective ingredients in Imperatae Rhizoma concentrated granules by ultra-performance liquid chromatography using two internal references / 药学学报

To simultaneously determine the contents of p-coumaric acid, chlorogenic acid, 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid and ferulic acid in Imperatae Rhizoma concentrated granules, an ultra-high performance liquid chromatography (UPLC) with two internal references method (TIRM) was established and validated. Chromatographic separation was achieved on a ZORBAX RRHD Eclipse Plus C18 column (2.1 mm × 100 mm, 1.8 µm) using 1.7 mmol·L-1 oxalic acid in water and methanol as mobile phase. The flow rate was 0.4 mL·min-1 and the column temperature was set as 35 ℃. The relative correction factors (RCFs) of caffeic acid and ferulic acid using p-coumaric acid as internal reference were calculated and the RCFs of 4-caffeoylquinic acid and 5-caffeoylquinic acid were calculated using chlorogenic acid as the internal reference. The TIRM was fully validated for linearity, accuracy, repeatability, stability and recovery so that it could be compared with the external standard method (ESM). The RCFs of 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid, and ferulic acid were 1.069, 1.022, 1.368, and 1.493, respectively. The TIRM and ESM were used to determine the contents of six ingredients in Imperatae Rhizoma concentrated granules from different manufacturers and the variation between results was within acceptable limits. In conclusion, the newly established TIRM allowed simultaneous determination of six ingredients (p-coumaric acid, chlorogenic acid, 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid, ferulic acid) in Imperatae Rhizoma concentrated granules, providing support for the quality control of this traditional Chinese medicine.

Optimization and practice in pre-review rules of traditional Chinese medicine prescription in medical institutions / 中国药房

OBJECTIVE To improve the a pplicability of the prescription pre-review system to traditional Chinese medicine （TCM），and improve the quality of prescription review and rational drug use. METHODS The inappropriate pre-review rules of TCM prescription in prescription automatic screening system of our hospital were summarizd ，review rules were revised and the review process was standardized purposefully. The data of prescription review of Chinese patent medicine and TCM decoction pieces were collected from outpatient and emergency department of our hospital in the second quarter of 2020 （before the optimization of review rules ）and the fourth quarter of 2021（after the optimization of review rules ）. The reasonable rate of prescription and effective rate of intervention before and after the optimization of review rules were compared，and unreasonable problems were counted. RESULTS In our hospital ，the pre-review system had poor applicability in reviewing TCM prescriptions. There were some problems ，such as inconsistent or nonstandard names of TCM decoction pieces ，unreasonable dosage range settings，mechanical review of repeated drug use ，excessively strict review of “eighteen incompatible medicaments ”and“nineteen medicaments of mutual restraint ”and lack of safety warnings for special populations. In view of the above problems ，our hospital standardized the name of TCM decoction pieces ，and optimized the review rules such as dose range of TCM decoction pieces ， usage and dosage of Chinese patent medicine ，repeated medication ，drug interaction ，drug taboos for special people ，etc. After the revision of the rules ，the qualification rate of Chinese patent medicine prescriptions increased from 97.38％ to 98.17％（P＞0.05）， and the rate of effective intervention increased from 42.86％ to 79.71％（P＜0.05）；the qualification rate of TCM decoction pieces prescriptions increased from 47.98％ to 79.29％（P＜0.05），and the rate of effective intervention increased from 11.17％ to 29.13％（P＜0.05）. The number of unreasonable problems such as excessive daily dosage of TCM ，excessive dosage range ，drug interaction and drug contraindications for special groups decreased significantly in our hospital （P＜0.05）. There was no statistical significance in the number of unreasonable problems of repeated medication between 2 groups （P＞0.05），but there was a downward trend. T he total number of unreasonable problems had also decreased significantly （P＜0.05）. CONCLUSIONS The optimization measures of review rules in our hospital canimprove the applicability of the review system for TCM prescriptions，and improve the quality of prescription review and the level of rational drug use. However ，review rules of indications and the effectiveness of prescription intervention still needs to be further improved.

Analysis of outcome indexes in randomized controlled trials of traditional Chinese medicine for rheumatic heart disease / 中国中药杂志

The present study analyzed the efficacy evaluation indexes of the randomized controlled trials(RCTs) of Chinese medi-cine in the treatment of rheumatic heart disease to lay the foundation for the construction of the corresponding core outcome index set. Clinical RCTs with a definite diagnosis of rheumatic heart disease were retrieved from CNKI, Wanfang, VIP, Sino Med, Pub Med, EMbase, and Cochrane Library from January 1, 2010, to December 31, 2020. Thirty-five RCTs were included, involving 3 314 patients and 41 efficacy evaluation indexes, which covered seven domains [traditional Chinese medicine(TCM) symptoms/syndromes, symp-toms/signs, physical and chemical examination, quality of life, long-term prognosis, economic evaluation, and safety events]. Physi-cal and chemical examination(56. 91%) and symptoms/signs(29. 27%) were the more frequently applied. The number of indexes used in a single trial ranged from 1 to 15, with an average of 4. The measurement time points of the top five indexes in the frequency of use were as follows: total response rate was reported at five measurement time points, ranging from 14 days to 6 months; left ventri-cular ejection fraction was measured at eight time points ranging from 5 days to 6 months; left ventricular end systolic diameter was measured at six time points, ranging from 5 days to 6 months; interleukin-2(IL-2) and tumor necrosis factor-α(TNF-α) were repor-ted 28 days after treatment. At present, there are many problems in the efficacy outcome indexes of RCTs in the treatment of rheumatic heart disease with TCM, such as large difference in quantity, unclear primary and secondary indexes, unreasonable selection of " surro-gate indexes", insufficient attention to long-term prognostic indexes and safety event indexes, non-standard application of composite in-dexes, long measurement period, and lack of TCM characteristics. It is urgent to establish the core outcome set for TCM treatment of rheumatic heart disease.

Anti-liver Cancer Mechanism of Hypericin Based on Network Pharmacology and Molecular Docking / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of hypericin against liver cancer using network pharmacology. MethodThe traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP）， Drug Gene Interaction Database （DGIdb）， Comparative Toxicogenomics Database （CTD） and SwissTargetPrediction were used to predict the targets of hypericin. Five databases including GeneCards and Online Mendelian Inheritance in Man （OMIM） were employed to obtain liver cancer-related targets. The intersection was performed to obtain the targets of hypericin against liver cancer. The Database for Annotation， Visualization and Integrated Discovery （DAVID） v2021q4 was used for Gene Ontology （GO） function annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. The protein-protein interaction （PPI） network of the targets was constructed by Cytoscape 3.6.1 to screen the core targets，and the affinity between hypericin and the core targets was verified by molecular docking. The effects of hypericin on liver cancer and the migration of liver cancer cells were observed by cell viability assay and would healing assay， respectively， and its effects on the mRNA and protein expression of key targets cysteinyl aspartate-specific protease-3（Caspase-3） and mitogen-activated protein kinase 3 （MAPK3） were detected by real-time polymerase chain reaction（Real-time PCR） and Western blot， respectively. ResultA total of 45 genes related to the anti-liver cancer effect of hypericin were obtained， and six core target genes were screened. The signal pathways enriched by KEGG pathway analysis included apoptosis，tumor necrosis factor （TNF） and cancer signal pathways. Molecular docking showed that the core target genes Caspase-3，TNF，estrogen receptor 1 （ESR1），MAPK3，catalase （CAT） and cyclooxygenase 2 （PTGS2） had good affinity with hypericin，especially Caspase-3 and MAPK3. In addition，compared with the conditions in control group， cell experiments demonstrated that hypericin could reduce the viability of liver cancer cells （P<0.05），inhibit their migration，increase the mRNA expression of Caspase-3 （P<0.05） and decrease that of MAPK3 （P<0.05）. ConclusionHypericin exerted the anti-liver cancer effect by affecting the core targets such as Caspase-3，TNF，ESR1，MAPK3，CAT and PTGS2 and jointly interfering with apoptosis，TNF and cancer signal pathways.

Roles of processing and compatibility in antidepression of Sini Powder:a metabonomics study / 中国中药杂志

The antidepressant mechanism of Sini Powder was investigated by metabonomics based on UHPLC-Q-TOF-MS, and the roles of processing and compatibility in the antidepression of Sini Powder were discussed in the present study. The chronic unpredictable mild stress(CUMS) model of depression was induced in the model group, the Bupleuri Radix group, the Paeoniae Radix Alba group, the herb-pair group(Bupleuri Radix-Paeoniae Radix Alba), the Sini Powder group, and the vinegar-processed Sini Powder group(Bupleuri Radix and Paeoniae Radix Alba were vinegar-processed). After the establishment of the model, the rats in each group were continuously administered with corresponding drugs(ig) at a dose of 9.6 g·kg~(-1) for eight days [the rats in the model group and the normal group(without model induction) received the same volume of normal saline at the same time]. Following the last administration, the differential metabolites were identified to analyze metabolic pathways based on the rat plasma samples collected from each group. A total of sixteen potential biomarkers were identified. The metabolites with significant changes were involved in many biological metabolic pathways, such as amino acid metabolism, pentose phosphate pathway, glycerol phospholipid metabolism, sphingolipid metabolism, and purine metabolism. After drug intervention, some biomarkers returned to normal levels. Further comparisons of processing and compatibility revealed that the vinegar-processed Sini Powder group had the most total metabolic pathways where differential metabolites were returned to normal. Compared with the individual herbs, the herb-pair significantly improved the recovery of differential metabolites in the pentose phosphate and purine metabolic pathways. Compared with the Sini Powder, the vinegar-processed Sini Powder facilitated the recovery of differential metabolites in the arginine biosynthesis, and pyrimidine and pentose phosphate metabolic pathways. As indicated by the results, Sini Powder may interfere with depression by regulating lipid and nucleotide metabolisms. The processing and compatibility of Chinese herbal medicines can potentiate the intervention on depression by regulating nucleotide, energy, and amino acid metabolisms to a certain extent.

Effect of electroacupuncture pretreatment on the protein expression of c-fos in fastigial nucleus and lateral hypothalamus area in rats with acute myocardial ischemia-reperfusion injury / 针灸推拿医学（英文版）

Objective: To observe the effect of electroacupuncture (EA) pretreatment on the protein expression of c-fos in fastigial nucleus (FN) and lateral hypothalamus area (LHA) in rats with acute myocardial ischemia-reperfusion injury (MIRI), and to explore the role and mechanism of FN and LHA in EA at the Heart Meridian fighting against acute MIRI reaction. Methods: Seventy Sprague-Dawley rats were randomly divided into a sham operation group, a model group, an EA-Heart Meridian group and an EA-Lung Meridian group, with 14 rats in each group; an LHA lesion plus EA-Heart Meridian group (LHA+EA-Heart Meridian group) and a FN lesion plus EA-Heart Meridian group (FN+EA-Heart Meridian group), with 7 rats in each group. Except the sham operation group, the left anterior descending branch of coronary artery was ligated to establish acute MIRI rat models in the other 5 groups. In the three groups with EA-Heart Meridian treatment, Shenmen (HT 7) and Tongli (HT 5) were selected; Taiyuan (LU 9) and Lieque (LU 7) were selected in the EA-Lung Meridian group. All the EA groups received EA stimulation prior to modeling, with 1 mA in current intensity and 2 Hz in frequency, 20 min each time, once a day for a total of 7 d. The sham operation group and the model group did not receive EA stimulation. The electrocardiogram was observed in the rats to analyze the ST-segment deviation and cardiac arrhythmia score. The expression of c-fos protein in FN and LHA was detected by immunohistochemistry method. Results: Compared with the sham operation group, the ST-segment deviation, cardiac arrhythmia score and the expression of c-fos protein in the FN and LHA increased significantly in the model group (all P<0.05). Compared with the model group, the ST-segment deviation, cardiac arrhythmia score and the expression of c-fos protein in FN and LHA decreased significantly in the EA-Heart Meridian group (all P<0.05). Compared with the EA-Heart Meridian group, the ST-segment deviation and cardiac arrhythmia score increased significantly in the EA-Lung Meridian group, LHA+EA-Heart Meridian group and FN+EA-Heart Meridian group (all P<0.05); the expression of c-fos in FN increased significantly in the EA-Lung Meridian group and LHA+EA-Heart Meridian group (both P<0.05); the expression of c-fos in LHA increased significantly in the EA-Lung Meridian group and FN+EA-Heart Meridian group (both P<0.05). Conclusion: FN and LHA are involved in the mechanism of EA at Heart Meridian to improve the acute MIRI reactions, and the cerebellum may participate in the improvement of cardiac function by EA through the cerebellum-hypothalamus projection.

Research Progress on Screening Active Components from Medicinal Plants Based on Affinity Ultrafiltration Coupled with LC-MS Technology / 中国实验方剂学杂志

Medicinal plants have a long history and play an important role in the prevention and treatment of human diseases. However， the interaction between bioactive components and specific biological targets in many medicinal plants is still unclear. Conventional separation and activity evaluation model of chemical constituents from natural products was time-consuming and laborious， and cannot truly reflect the interaction between the natural conformation of compounds and receptors， so these methods could not meet the urgent needs of modern drug development. Affinity ultrafiltration coupled with liquid chromatography-mass spectrometry （AUF-LC/MS） is a rapid， efficient and precise method focused on identification of bio-components from natural products， it can make up for many shortcomings found in conventional discovery of bio-constituents. However， AUF-LC/MS technology also has some drawbacks in experiments. In this paper， the principle， characteristics and application of AUF-LC/MS in the screening of active ingredients from medicinal plants are systematically reviewed， and its development prospect is prospected， so as to provide scientific basis for rapid and targeted screening of active components from medicinal plants.

Effects of compression treatment on occurrence of venous thromboembolism after tension-free inguinal hernia repair / 中华消化外科杂志

Objective:To investigate the effects of compression treatment on occurrence of venous thromboembolism (VTE) after tension-free inguinal hernia repair.Methods:The retrospective cohort study was conducted. The clinical data of 13 263 patients with inguinal hernia who were admitted to 58 medical centers from January to December in 2017 were collected, including 1 668 in Beijing Chaoyang Hospital of Capital Medical University, 782 in East Hospital Affiliated to Tongji University, 558 in Huadong Hospital of Fudan University, 525 in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 488 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 382 in Tianjin People's Hospital, 378 in Peking University Third Hospital, 364 in Beijing Hospital, 356 in Shengjing Hospital of China Medical University, 348 in Huashan Hospital of Fudan University, 348 in Sichuan Provincial People's Hospital, 328 in Affiliated Hospital of Zunyi Medical University, 304 in Beijing Luhe Hospital of Capital Medical University, 296 in People's Hospital of Changshou District in Chongqing, 290 in Anhui Provincial Hospital, 281 in the First Affiliated Hospital of Dalian Medical University, 281 in Xinjiang Uygur Autonomous People's Hospital, 247 in Qilu Hospital of Shandong University, 220 in Wuhan NO.1 Hospital, 214 in the First Hospital of China Medical University, 213 in West China Hospital of Sichuan University, 206 in the Second Affiliated Hospital of Chongqing Medical University, 202 in Taiyuan Central Hospital of Shanxi Medical University, 197 in the First Affiliated Hospital of Wenzhou University, 191 in Zhongda Hospital of Southeast University, 190 in Tianjin Medical University General Hospital, 189 in Xuzhou Central Hospital, 188 in the First Affiliated Hospital of Harbin Medical University, 187 in the Second Hospital Affiliated to Naval Medical University, 175 in Chengdu Fifth People's Hospital, 173 in Tianjin Nankai Hospital, 172 in the Fourth Affiliated Hospital of China Medical University, 172 in Zhangjiakou First Hospital, 161 in Henan Provincial People's Hospital, 153 in the First Affiliated Hospital of Xi'an Jiaotong University, 149 in Shandong Provincial Hospital, 142 in the Second Hospital of Shandong University, 137 in the First Affiliated Hospital of Hunan University of Medicine, 136 in the Fourth Hospital of Harbin Medical University, 127 in Pingjiang District of the First Affiliated Hospital of Soochow University, 102 in the Central Hospital of Wuhan, 100 in the First Affiliated Hospital of Soochow University, 98 in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, 97 in the First Affiliated Hospital of Chongqing Medical University, 96 in Xijing Hospital Affiliated to Air Force Medical University, 90 in the Fourth Medical Center of Chinese PLA General Hospital, 81 in Hunan Provincial Hospital of Traditional Medicine, 80 in the First Hospital of Tsinghua University, 80 in Xinhua Hospital of Hubei Province, 61 in the First Affiliated Hospital of Zhengzhou University, 57 in Peking University International Hospital, 50 in Peking University First Hospital, 39 in Zhongnan Hospital of Wuhan University, 38 in Jilin Yan'an Hospital, 37 in China-Japan Union Hospital of Jilin University, 20 in Taikang Xianlin Drum Hospital, 16 in Chinese PLA General Hospital, 3 in the First Affiliated Hospital of Fujian Medical University. There were 11 852 males and 1 411 females, aged from 18 to 102 years, with a median age of 64 years. Of 13 263 patients, 9 995 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 3 268 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) compression treatment of patients in the compression group; (2) occurrence of VTE after tension-free inguinal hernia repair in the two groups; (3) analysis of influencing factors for VTE after tension-free inguinal hernia repair. Follow-up using telephone interview was performed to detect history of patient's thrombosis, medical history of patient's family and the incidence of postoperative VTE up to February 2018. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) Compression treatment of patients in the compression group: of the 9 995 patients in the compression group, 6 086 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 1 881 underwent compression treatment with trusses, 745 underwent compression treatment with girdles, 675 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag, and 608 underwent compression treatment with elastic underwear. (2) Occurrence of VTE after tension-free inguinal hernia repair in the two groups: patients of the two groups after matching were followed up. Occurrence of VTE after matching were 15 and 1 in the compression group and non-compression group, respectively, showing no significant difference between the two groups ( χ2=2.010, P>0.05). (3) Analysis of influencing factors for VTE after tension-free inguinal hernia repair: results of univariate analysis showed that cases with varix of lower limb, cases with oral contracep-tives or hormone replacement therapy history, cases with VTE history, clinical classification, clinical typing, surgical method, cases with anticoagulant drugs history, cases undergoing oral antiplatelet drugs, cases undergoing postoperative VTE prevention with medication were related factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=13.98, 37.71, 19.21, 4.43, 4.21, 0.07, 0.08, 0.10, 31.04, 95% confidence interval: 3.15?62.11, 8.35?170.24, 6.15?60.00, 1.43?13.76, 1.20?14.82, 0.01?0.49, 0.02?0.27, 0.04?0.29, 8.53?112.93, P<0.05). Results of multivariate analysis showed that cases with VTE history and surgical method were independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=7.78, 11.19, 95% confidence interval: 2.06?29.42, 1.45?86.55, P<0.05). Conclusion:Cases with VTE history and surgical method are independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair.

Efficacy and safety of Di-Tan Decoction for treating post-stroke neurological disorders: a systematic review and Meta-analysis of randomized clinical trials / 中国天然药物

The management of post-stroke complications plays an important role in the quality of life. Di-Tan Decoction (DTD; ) is a widely used traditional Chinese medicine. This study incorporated systematic review and meta-analysis to evaluate the efficacy of DTD in post-stroke neurological disorders. Randomized clinical trials (RCTs) were searched from English, Chinese and Korean electronic medical databases, by including the keywords "Di-Tan Tang", "Di-Tan Decoction", "Scour Phlegm Decoction", "stroke", and "RCT. Each RCT included control (placebo, conventional therapy, or Western medicine) and experimental (DTD treatment) groups. For patients inflicted with stroke for 1-6 weeks, the outcomes of post-stroke neurological disorders were measured by scales for post-stroke symptoms and were classified as "completely healed", "markedly effective", "effective" and "ineffective". Totally, 11 RCTs (n = 490 controls and n = 502 DTD subjects) were selected from 210 articles identified in the initial search. A meta-analysis of evaluation criteria in post-stroke symptoms revealed that the overall odds ratio (ORs) for alleviating post-stroke neurological disorders were 0.30-fold lower (95% CI = 0.21-0.43) in the DTD group than the control (Western medicine) group (P < 0.000 01). Moreover, regardless of the type of stroke diagnostic scale applied (including NFA, HDS, and NIHSS), the overall post-stroke symptoms determined were less severe in the DTD group (n = 219) than the control group (n = 217). No adverse effects of DTD were observed in the 11 RCTs reviewed. All 11 studies used an appropriate method for randomization of subjects to evaluate the risk of bias (ROB), and 7 studies included allocation concealment as well as blinding of patients and practitioners. High-risk ROB was included in 6 RCTs. No significant publication bias was derived from the funnel plot. Our results indicate that the administration of DTD alone, and DTD in combination with Western medicine, exert greater efficacy for post-stroke complication therapy, than Western medicine administered alone. More rigorous and regulated studies are required to confirm the therapeutic efficacy of DTD for post-stroke neurological disorders. disorders.

Preparation of hydrophilic Indigo Naturalis based on polyethylene glycol( PEG) surface film-forming method and evaluation / 中国中药杂志

Polyethylene glycol (PEG) surface film-forming method was used to prepare hydrophilic Indigo Naturalis decoction pieces with stable effect.The preparation process of modified Indigo Naturalis was optimized and its microscopic properties,hydrophilicity,antipyretic efficacy,and safety were systematically evaluated.With equilibrium contact angle as assessment index,the influence of modifier type,modifier dosage,dispersant dosage,and co-grinding time on water solubility of Indigo Naturalis was investigated by single factor test.The results showed that the optimal preparation process was as follows.The 6%PEG6000 is dissolved in 10%anhydrous ethanol solution by sonification and then the mixture is ground with Indigo Naturalis for 2 min.The resultant product is dried on a square tray in an oven at 60℃to remove ethanol and thereby the PEG-modified hydrophilic Indigo Naturalis decoction pieces are yielded.The morphological observation under scanning electron microscope (SEM) indicated that the modified Indigo Naturalis had smoother surface than Indigo Naturalis,and energy spectrometer measurement showed that the nitrogen (N),calcium(Ca),oxygen (O),and silicon (Si) on the surface of modified Indigo Naturalis powder were less than those of Indigo Naturalis powder.Modified Indigo Naturalis had the equilibrium contact angle 18.96°smaller,polar component 22.222 m J·m~(-2)more,and nonpolar component 7.277 m J·m~(-2)smaller than the Indigo Naturalis powder.Multiple light scattering technique was employed to evaluate the dispersion in water and the result demonstrated that the transmittance of Indigo Naturalis and modified Indigo Naturalis was about85%and 75%,respectively,suggesting the higher dispersity of modified Indigo Naturalis.The suspension rate of modified Indigo Naturalis in water was determined by reflux treatment.The result showed that 57%of Indigo Naturalis was not wetted after refluxing for1 h,while the modified Indigo Naturalis was all wetted and dispersed into water.The dissolution of indigo and indirubin of modified Indigo Naturalis increased and the process was more stable.Then,rats were randomized into the blank group,model group,acetaminophen group,Indigo Naturalis group,and hydrophilic Indigo Naturalis group.The temperature changes of rats were observed after administration and the concentration of IL-1βand TNF-αin serum and IL-1βand PGE_2in hypothalamus was measured.The results indicated that the temperature of Indigo Naturalis group and hydrophilic Indigo Naturalis group dropped and the IL-1βlevel of the hydrophilic Indigo Naturalis group decreased (P<0.05) as compared with those in the model group.Thus,both Indigo Naturalis and hydrophilic Indigo Naturalis had antipyretic effect,particularly the hydrophilic Indigo Naturalis.The acute toxicity test of hydrophilic Indigo Naturalis verified that it had no toxicity to rats.In this study,the hydrophilic Indigo Naturalis decoction pieces were prepared with the PEG surface film-forming method,and the antipyretic efficacy and safety were evaluated,which expanded the technological means of powder modification for Chinese medicine and provided a method for clinical use of Chinese medicine.

Systematic review and Meta-analysis on efficacy and safety of Gongxuening Capsules in treatment of abnormal vaginal bleeding after medical abortion / 中国中药杂志

To systematically evaluate the efficacy and safety of Gongxuening Capsules in the treatment of abnormal vaginal bleeding after medical abortion. CNKI, Wanfang, SinoMed, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to comprehensively collect the clinical randomized controlled trials(RCTs) of Gongxuening Capsules for treatment of abnormal vaginal bleeding after medical abortion from the establishment of the databases to October 10, 2020. Literature screening, data extraction and quality evaluation were conducted independently by two system reviewers according to the inclusion and exclusion criteria. Cochrane Handbook bias risk assessment tool was used for the literature methodology quality evaluation, RevMan 5.3 software was used for Meta-analysis, and the evidence quality of outcomes was evaluated by the evidence quality grading system(GRADE). A total of 16 RCTs were inclu-ded. The results of Meta-analysis showed that as compared with the western medicine treatment alone, the addition of Gongxuening Capsules to the western medicine treatment can reduce the amount of vaginal bleeding(RR=1.23, 95%CI[1.19, 1.27], P<0.000 01), shorten vaginal bleeding time(RR_(≤15 d number of people)=1.39, 95%CI[1.31, 1.48], P<0.000 01; MD_(number ofdays)=-1.20, 95%CI[-1.66,-0.74],P<0.000 01). However, there was no obvious advantage in abortion effect(RR=1.02, 95%CI[0.99, 1.06], P=0.14) and menstrual recovery(MD=-0.35, 95%CI[-0.96, 0.25], P=0.25). The results of GRADE showed that the grading level was low for vaginal bleeding volume and vaginal bleeding time, and extremely low for abortion effect and mens-trual recovery. In terms of safety, 16 studies reported adverse events. Only one study showed no adverse events and the rest showed transient nausea, vomiting, stomach burning, upper abdominal discomfort and other gastrointestinal symptoms. The results show that the addition of Gongxuening Capsules to the application of western medicine in treatment of drug abortion can reduce the amount of vaginal bleeding and shorten vaginal bleeding time, but the abortion effect and menstrual recovery have no obvious advantages. The use of Gongxuening Capsules helps to achieve less adverse reactions and higher safety. Due to the small sample size of the included studies and many methodological quality problems, no conclusions with clinical guidance value can be obtained. Large sample-zise, high-qua-lity randomized controlled trials are still needed for further verification.

Effect of electroacupuncture preconditioning on the contents of dopamine and 5-hydroxytryptamine in lateral hypothalamus area and cerebellar fastigial nucleus of rats with myocardial ischemia-reperfusion injury / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) preconditioning at heart meridian acupoints on the contents of dopamine (DA) and 5-hydroxytryptamine (5-HT) in lateral hypothalamus area (LHA) and cerebellar fastigial nucleus (FN) in the rats with acute myocardial ischemia-reperfusion injury (MIRI), and explore the role and mechanism of LHA and FN in the effect of EA at heart meridian acupoints against acute MIRI.@*METHODS@#Sixty SD rats were randomly divided into a sham-operation group, a model group, an EA heart meridian group and an EA lung meridian group, 12 rats in each group, as well as an LHA plus heart meridian group (damage of bilateral LHA) and an FN plus heart meridian group (damage of bilateral FN), 6 rats in each one. Three days after nucleus destruction, EA was applied to "Shenmen" (HT 7) and "Tongli" (HT 5) in the EA heart meridian group, the LHA plus heart meridian group and the FN plus heart meridian group and EA was applied to "Taiyuan" (LU 9) and "Lieque" (LU 7) in the EA lung meridian group, with 1 V in stimulating voltage and 2 Hz in frequency, lasting 20 minutes each time, once a day, for consecutively 7 days before model replication. Except in the sham-operation group, MIRI rat models were duplicated by ligation of the left anterior descending branch of the coronary artery in the rest groups. Using Power lab physiological recorder, ST segment displacement value was recorded before modeling, 30 min after ligation and 120 min after reperfusion separately. The high performance liquid chromatography-electrochemical detection and analysis system was adopted to determine the contents of DA and 5-HT in LHA and FN dialysate after rat modeling in each group.@*RESULTS@#In comparison of ST segment displacement value 30 min after ligation and 120 min after reperfusion among groups, the value in the model group was higher than that in the sham-operation group (@*CONCLUSION@#EA preconditioning at heart meridian acupoints can effectively alleviate myocardial injury in acute MIRI rats, during which, DA and 5-HT in LHA and FN may be the important material basis.

Evaluation of Astragali Radix quality grade based on appearance characteristics and internal ingredients / 中国中药杂志

This study is to provide the basis of establishing a quality evaluation system, based on the differences in appearance and internal components of Astragali Radix from different sources. The diameter of 18 batches of Astragali Radix, the content of alcohol(water) extract and 7 kinds of flavonoids were determined. The peak area ratio of flavonoid aglycon to aglycone was calculated. PCA and CA were carried out by synthesizing various indexes. The results of PCA and CA showed that Astragali Radix was obviously clustered into three types. Alcohol extract, formononetin/formosan glycosides,(pilose isoflavones+astragalus flavonoid A)/pilose isoflavone glucoside are the most significant differences in the variable importance projection index(VIP) of Astragali Radix. Combining the diameter, alcohol(water) extract, flavonoid aglycon to aglycone peak area ratio can provide an analysis method for the establishment of the grade evaluation system of Astragali Radix.

[Preparation and quality evaluation of orodispersible film containing ginkgolide B novel nanosuspension lyophilized powder].

To prepare a new dosage form that can improve the drug loading of the film--ginkgolide B nanosuspension lyophilized powder orodispersible film(GB-NS-LP-ODF) and to evaluate its quality. Firstly, ginkgolide B nanosuspension(GB-NS) was prepared by media milling method, and then ginkgolide B nanosuspension lyophilized powder(GB-NS-LP) was prepared with freeze-drying method. The mannitol was used as lyoprotectant and its dosage was also investigated. GB-NS-LP-ODF was prepared by solvent casting method and its formulation was screened by single factor test method and optimized by orthogonal test. The appearance, mechanical properties, content uniformity and in vitro dissolution of the optimized GB-NS-LP-ODF were investigated. The particle size of prepared GB-NS was about 201 nm, and the optimal dosage of mannitol was 8%. According to the optimal formula, the GB-NS-LP-ODF was prepared with GB-NS-LP 35.6%, PVA 0588 49.4%, PEG 400 10.7% and CMS-Na 4.3%, and completely disintegrated in about 30 s, and the particle size of reconstituted GB nanoparticles from ODF was about 210 nm. The film with smooth appearance and good mechanical properties was stable within 30 days and the content uniformity(A+2.2 S<15) conformed to the regulations. Scanning electron microscope(SEM) showed that GB-NS-LP-ODFs were evenly distributed and the particle size was about 200 nm. X-rays diffraction(XRD) showed that its crystallinity was significantly lower than that of GB raw drug and GB-ODF. The results of in vitro release test showed that the drug film was completely dissoluted within 10 minutes. These results indicated that nanosuspension lyophilized powder was prepared by freeze drying of nanosuspensions, and then loaded into the orodispersible film to effectively increase the drug loading of the ODF and have broad application prospects.

[Identification of metabolites of Zhali Nusi Prescription in rat plasma, bile, urine and feces after oral administration].

This study was designed to determine the metabolites of Zhali Nusi Prescription(ZLNSP) in rats. The ultra-high performance liquid chromatography-LTQ Orbitrap mass spectrometric(UHPLC-LTQ-Orbitrap-MS) and mass defect filter techniques were applied to analyze the metabolites of ZLNSP in rat plasma, bile, urine and feces. The biological samples were analyzed by ACQUITY UPLC BEH T_3 column(2.1 mm×100 mm,1.7 µm), with 0.1% formic acid water(A)-acetonitrile(B) as mobile phase, and the biological samples were analyzed in negative ion mode by electrospray ionization mass spectrometry(ESI-MS). An analytical method for biological samples of rats was established, and 8 prototype components and 36 metabolites were identified. The results showed that the metabolic pathways of the main components of ZLNSP in rats included methylation, glucuronidation, sulfation and so on. It provi-ded information for the therapeutic effect of ZLNSP in vivo.

From natural dye to herbal medicine: a systematic review of chemical constituents, pharmacological effects and clinical applications of indigo naturalis.

BACKGROUND: Indigo naturalis is a blue dye in ancient, as well as an extensive used traditional Chinese medicine. It has a wide spectrum of pharmacological properties and can be used to treat numerous ailments such as leukemia, psoriasis, and ulcerative colitis. This article aims to expand our understanding of indigo naturalis in terms of its chemical constituents, pharmacological action and clinical applications. METHODS: We searched PubMed, web of science, CNKI, Google academic, Elsevier and other databases with the key words of "Indigo naturalis", and reviewed and sorted out the modern research of indigo naturalis based on our research results. RESULTS: We outlined the traditional manufacturing process, chemical composition and quality control of indigo naturalis, systematically reviewed traditional applictions, pharmacological activities and mechanism of indigo naturalis, and summarized its clinical trials about treatment of psoriasis, leukemia and ulcerative colitis. CONCLUSIONS: Indigo naturalis has a variety of pharmacological activities, such as anti-inflammatory, antioxidant, antibacterial, antiviral, immunomodulatory and so on. It has very good clinical effect on psoriasis, leukemia and ulcerative colitis. However, it should be noted that long-term use of indigo naturalis may produce some reversible adverse reactions. In summarize, indigo naturalis is an extremely important drug with great value and potential.

[Chemical constituents and their biosynthesis mechanisms of Polygonum cuspidatum].

This article reviews the research progress of the chemical constituents and biosynthesis mechanisms of Polygonum cuspidatum. The chemistry components isolated from P. cuspidatum are mainly anthraquinones, naphthoquinones, stilbenes, flavonoids, and other compounds. The synthase genes involved in the biosynthesis process were summarized. The biosynthesis mechanism of stilbenes and anthraquinones was discussed. This article hopefully to provide a reference for further research, development and utilization of P. cuspidatum.

Ingredients changes in Rehmanniae Radix processing based by HPLC-ELSD specific chromatogram / 中国中药杂志

To establish the HPLC-ELSD specific chromatogram analysis method of Rehmanniae Radix and Rehmanniae Radix Prae-parata, and analyze and compare their chemical compositions, so as to reveal the change regularity of compositions during the proces-sing. By HPLC-ELSD method, the chromatographic column for Prevail Carbohydrate ES(4.6 mm ×250 mm, 5 μm) was adopted, with acetonitrile(A)-water(B) as mobile phase for gradient elution, and the evaporative light-scattering detector was used. A total of 23 batches of Rehmannia Radix samples, and 25 batches of Rehmanniae Radix Praeparata samples and processing dynamic samples were compared. The established method had a great repeatability, precision and stability. Eight common chromatographic peaks were extracted from 23 batches of Rehmanniae Radix samples, 8 common peaks were extracted from 25 Rehmanniae Radix Praeparata, and 7 chromatographic peaks were identified. The composition ratio of Rehmannia Radix was changed greatly during the processing. When the simila-rity≥0.95 and the fructose peak area was more than 2 times of stachyose tetrahydrate or more than 20 times of raffinose, the processing degree conformed to the requirements of empirical identification. The three main oligosaccharides of Rehmanniae Radix were sucrose that was heated to generate fructose and glucose, stachyose tetrahydrate that was heated to generate melibiose, sucrose and fructose, and stachyose tetrahydrate that was heated to generate manninotriose. The change in the index of proportion between monosaccharides and oligosaccharides can be used as the quantitative criterion for the processing quality of Rehmanniae Radix Praeparata.