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Whether children can exercise their medical decision-making power has always been a controversial topic in law and ethics, and it is also the focus of attention of people from all walks of life. In this regard, combined with the problems existing in the exercise of children’s medical decision-making power, such as conflict with the right to life and health, insufficient guarantee of the right to informed consent system, and the legal guardian’s exercise of children’s medical decision-making power may not be in the best interests of children. This paper discussed the dilemma and feasibility of children’s exercise of medical decision-making power from three aspects: children’s right to life and health, the evaluation of informed consent and medical decision-making ability, and the thinking of children’s informed consent and medical decision-making ability, and pointed out that children who are able to make self-determination should be fully endowed with legal medical decision-making power, so as to ensure their best interests in medical clinic.
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Whether children can exercise their medical decision-making power has always been a controversial topic in law and ethics, and it is also the focus of attention of people from all walks of life. In this regard, combined with the problems existing in the exercise of children’s medical decision-making power, such as conflict with the right to life and health, insufficient guarantee of the right to informed consent system, and the legal guardian’s exercise of children’s medical decision-making power may not be in the best interests of children. This paper discussed the dilemma and feasibility of children’s exercise of medical decision-making power from three aspects: children’s right to life and health, the evaluation of informed consent and medical decision-making ability, and the thinking of children’s informed consent and medical decision-making ability, and pointed out that children who are able to make self-determination should be fully endowed with legal medical decision-making power, so as to ensure their best interests in medical clinic.
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Objective:To explore the application of career planning combined with layered training mode in management of clinical research nurses(CRN)and its effect evaluation.Methods:100 CRNs from 8 tertiary hospitals in Shanxi province were randomly enrolled and divided into an intervention group and a control group. Both groups participated in training and meetings organized by drug research institutions. On this basis, the intervention group was added with a management method combining career planning guidance and layered training for 10 months. Before and after the intervention, career status questionnaire was used to evaluate the career status of the two groups of CRNs.Results:Before the intervention, the total scores of CRN career evaluation in the two groups were(66.64 ± 12.71)and(66.68 ± 12.88), respectively, and the difference was not statistically significant( P>0.05). The score of career evaluation in the intervention group was(79.94 ± 12.26)points after intervention, which was significantly higher than that before intervention(66.64 ± 12.71)points; the score of career evaluation in the intervention group was also higher than that in the control group after the intervention; the differences were statistically significant( P<0.05). After the intervention, the CRN career evaluation scores of the junior and senior seniority were higher than those of the middle seniority( P<0.05). Conclusions:Career planning combined with layered training mode can play a positive role in CRN management. Especially, it has a more significant impact on the career status of CRNs of junior and senior seniority.
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Objective To explore the correlation between plasma Klotho and FGF23 levels with senile hypertension .Methods Totally 180 cases of hypertension aged more than 60 years old were selected as the research group and divided into the grade 1 hypertension group(60 cases) ,grade 2 hypertension group(60 cases) and grade 3 hypertension group(60 cases) .The age and pro‐portion of male to female were basically consistent .60 elderly people without hypertension were selected as the control group .The level of plasma Klotho and FGF23 protein were tested by ELISA .The lipid level was detected by the automatic biochemical analy‐zer .The detection results were compared with those in the control group for analyzing their correlation .Results Plasma Klotho protein level in each hypertension group was lower than that in the control group ,while plasma FGF23 protein level and BMI were significantly higher than those in the control group(P0 .05) .Conclusion Plasma Klotho protein and FGF23 protein levels have obvious correlation with the blood pressure level ,which may jointly participate in the occurrence and development of hypertension .
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Objective To investigate the association between plasma Klotho protein level and lacunar cerebral infarction in the elderly.Methods Eighty eight patients with lacunar cerebral infarction aged over 60 years were selected as the observation group,and 90 age-and gender-matched elderly patients without lacunar infarction as the control group.The protein level of Klotho was tested by enzyme linked immunosorbent assay (ELISA).Klotho protein level was compared between the observation and control groups.The correlation between plasma Klotho level and lacunar infarction in elderly patients was analyzed.Results Compared with the control group,lacunar infarction group showed that Klotho protein level was decreased [(689.4±40.8) ng/L vs.(848.5±38.7) ng/L,P=0.009],and the proportion of patients with hypertension was increased (83.0% vs.66.7%,P=0.04).There was no significant difference in age,gender,body mass index (BMI),dyslipidemia,diabetes mellitus and coronary heart disease between the two groups.The multivariate logistic regression analysis showed that the low plasma level of Klotho protein and hypertension were identified as the independent risk factors for Lacunar infarction (OR=3.325 and 2.413,P=0.003 and 0.021,respectively).Conclusions Klotho protein level may be associated with lacunar cerebral infarction in elderly people.Monitoring plasma Klotho protein level has an important clinical significance in the prevention,diagnosis and prognosis of lacunar cerebral infarction.
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Aquaporin4(AQP4),a member of the aquaporin family,is mainly expressed inastrocytes end-feet in the central nervous system. A large number of experimental studies have show n that AQP4 expression plays an important role in the occurrence, development, and regression of brain edema after different types of stroke. In addition, the AQP4 expression can affect the development process of cerebrovascular disease through the mechanisms such as affecting the integrity of the blood-brain barrier and promoting astrocyte migration, nerve regeneration, and neuroinflammatory response. Investigation of regulation mechanisms of AQP4 in transmembrane transport of substance in brain and intracel ular and extracel ular environmental balance and its expression in model of cerebrovascular disease have an important significance for understanding the occurrence, development, protection, and treatment of clinical cerebrovascular disease.
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Spontaneous intracerebral hemorrhage is the most deadly type of stroke.Its 30-day mortality rate is nearly 40%.More than 30% of patients with spontaneous intracerebral hemorrhage will have hematoma growth,which lead to poor outcomes.In addition to the classic predictors,some inaging signs also have important implications for identifying hematoma growth,such as swirl sign,blend sign,and black hole sign on nonenhanced CT scans,extravasation sign on contrast-enhanced CT scans,spot sign on CT angiography,leak sign revealed by the modified imaging method,as well as the spot sign on CT peffusion imaging.
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The aim of the study is to evaluate the effects of the single and mixed decoction of Thallus laminariae (kelp) and Glycyrrhiza glabra (licorice) on the metabolism and their difference. The mixed decoction of kelp and licorice and the single decoction were made and intragastrically administered to the SD rats. The effect on system metabolism, the toxicity of liver and kidney were assessed by GC-MS profiling of the endogenous molecules in serum, routine biochemical assays and histographic inspection of tissues from SD rats, separately. The mixed decoction of kelp and licorice induced more obvious pathological abnormalities in SD rats than a single decoction of kelp, while the extracts of licorice did not show any pathological change. Neither the mixed, nor the single decoction showed abnormal histopathology. After intragastric administration of extracts for 5 days, the mixed decoction induced a decrease of ALT (no significant change in the groups of single decoction) and an increase of BUN (so did the single decoction of kelp). Metabolomic profile of the molecules in serum revealed that the metabolic patterns were all obviously affected for the three groups, i.e., the mixed and single decoction of kelp and licorice. The rats given with the single decoction of kelp showed a similar pattern to that of the mixed decoction, indicating that the kelp primarily contributed the perturbation of metabolism for the mixed decoction. All three groups induced a decrease of branched chain amino acids, TCA cycle intermediates and glycolysis intermediates (e.g., pyruvic acid and lactic acid) and an increase of 3-hydroxybutyric acid. Kelp decoction showed stronger potential in reducing TCA cycle intermediates and glycolysis intermediates than the other two groups, while the levels of branched chain amino acids were the lowest after licorice extracts were given. These results suggested that the effect of the mixed decoction on metabolism was closely associated with both kelp and licorice. The continuous administration of single decoction of kelp and the mixed decoction of licorice and kelp resulted in pathological abnormalities in kidney of SD rats. The mixed decoction of kelp and licorice distinctly perturbed sera molecules and hence system metabolism, which showed associated with those of kelp and licorice. Although the metabolic effect was associated with both kelp and licorice, the results suggested kelp contributed to it primarily.
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Aim To observe the differences of tonify-ing blood effect for the combination of Danggui and Honghua ( GH) with different proportions on blood de-ficiency mice, and choose the proportion of GH which has the optimal tonifying blood effect. Methods The blood deficient mice model was induced by injection of phenylhydrazine and cyclophosphamide. On the basis of multi-attribute comprehensive index method, the op-timal dose was determined through three doses of GH 1: 1 , which was the highest frequency proportion of GH used in the “Dictionary of Chinese Medicine Prescrip-tions”. According to the optimal dose, the change reg-ulation of tonifying blood effect of GH with different proportions was observed. Results Among three do- ses (1, 3 and 5 times of clinical dose), the tonifying blood effect of GH was best when the dosing concentra-tion of GH was clinical dose. Among nine proportions (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1), GH 1 : 1 had the best effect. Conclusion The results are consistent with regulations of medi-cine usage that GH 1 : 1 has the highest frequency used in Herbal Formulae, which could provide scientif-ic basis for more effective application of Danggui and Honghua in modern clinic medicine.
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The combination of Danggui and Honghua (GH) is a popular herb pair commonly used in clinic for the treatment of blood stasis syndrome in China. To evaluate the activating blood circulation and dissipating blood stasis effects of the combination of different proportions of Danggui and Honghua on acute blood stasis rats, and optimize the proportion of GH to have the best activating blood circulation and dissipating blood stasis effect. Acute blood stasis rat model was induced by subcutaneous injection of adrenaline and ice water bath. The blood stasis rats were administrated intragastrically with GH (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1: 2, 1 : 4 and 0 : 1) extracts. The whole blood viscosity (WBV), plasma viscosity (PV), and high shear whole blood relative index (HSWBRI), low shear whole blood relative index (LSWBRI), and erythrocyte aggregation index (EAI) were tested to observe the effects of GH on hemorheology of blood stasis rats. And the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of GH on platelet aggregation index of blood stasis rats. In addition, the prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and plasma fibrinogen (FIB) were tested to observe the effects of GH on blood coagulation function of blood stasis rats. Then principal component analysis and multi-attribute comprehensive index methods were both used to comprehensively evaluate the total activating blood circulation and dissipating blood stasis effects of GH. The results showed that the hemorheological indexes and coagulation parameters of model group both had significant differences with normal group. Compared with model group, GH (1 : 0, 4 : 1, 2: 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1) could improve all the blood hemorheology indexes and regulate part indexes of blood coagulation function and platelet aggregation in acute blood stasis rats. Based on principal component analysis and multi-attribute comprehensive index methods, GH 1 : 1 and GH 3 : 2 both had the best effect of blood circulation and dissipating blood stasis, and the effect of GH 1 : 1 was slightly better than GH 3 : 2. These results suggest that GH could obviously ameliorate the abnormality of hemorheology and blood coagulation function in acute blood stasis rats. The optimized proportion of GH was consistent with regulations of medicine usage that GH 1 : 1 had the highest frequency used in traditional Chinese formulae. It could provide scientific basis for more effective application of the compatibility between Danggui and Honghua in modern clinic medicine.
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Objective To better understand the role of CREB signaling pathway in chronic mild stress (CMS), we investigated the alteration of CREB and p-CREB in CMS rats with and without fluoxetine hydrochloride. Methods Fifty adult male Sprague-Dawley rats were randomly divided into three groups:CMS group (26), fluoxtine group (12) and con-trol group (12). The rats in CMS group and fluoxtine group received 8 weeks of chronic mild stress. Rats in fluoxtine group were administered daily injections of fluoxetine 10mg/kg I.P. Sucrose preference tests and open-field test were car-ried out after the 8th week. Based on endpoint sucrose-intake, animals were further divided into 4 groups:CMS sensitive group, CMS resilient group, fluoxtine group and control group. Western blot was used to detect the expression levels of CREB and p-CREB in the hippocampus and prefrontal cortex. Results The sucrose consumption was significantly de-creased in CMS resilience group compared to sensitive group, control group and fluoxetine-intervention group (all P<0.05). Similarly, the numbers in total arm entries, percentage of entries into open arms and time spent in open arms was significantly lower in CMS resilience group compared to control group(all P<0.05), but not different compared to CMS sensitive group(all P<0.05). The p-CREB in the hippocampus was significantly lower in CMS sensitive rat compared to CMS resilience group, control group and fluoxetine-intervention group(all P<0.05), but CREB was not dfferent among the four groups(all P<0.05). Conclusions The elevated phosphorylation of CREB in the hippocampus and prefrontal cortex of resilience CMS rats may contribute to the mood alteration induced by stress.
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The metabolic effect of Fo-Shou-San on blood deficiency mice was studied by using metabolomic method. UPLC-QTOF/MS was used to analyze the plasma metabolome in blood deficiency mice. MS data were processed by MarkerLynx software. With multivariate statistical analysis of plasma metabolite profiles, a clear separation among control, blood deficiency model, and Fo-Shou-San groups was achieved. Potential biomarkers were selected according to the parameters of variable importance in the projection (VIP) and identified according to MS information and database retrieval. The metabolic network of blood deficiency was predicted via MetPA database. Twenty-two potential biomarkers were identified and used to explain the thiamine metabolism, arachidonic acid metabolism, sphingolipid metabolism, glyoxylate and dicarboxylate metabolism, histidine metabolism, nicotinate and nicotinamide metabolism, cysteine and methionine metabolism, tryptophan metabolism, starch and sucrose metabolism, tyrosine metabolism and citrate cycle (TCA cycle). Those metabolic pathways were disturbed in blood deficiency mice, but which could be regulated nearly to normal state after Fo-Shou-San administration. In this study, the metabolomics of blood deficiency mice and the action mechanism of nourishing blood effect of Fo-Shou-San were evaluated. The physiological and metabolic state of the organism could be represented comprehensively by using metabolomics. And metabolomics can be used to evaluate the pharmacodynamics and related mechanisms of Chinese medicine and formulae.
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<p><b>OBJECTIVE</b>To study the major metabolites of ferulic acid and gallic acid compatible with Danggui Chishaoyao in rat plasma and urine.</p><p><b>METHOD</b>The metabolites of ferulic acid and gallic acid in rat plasma and urine were analyzed after oral administration of compatible Danggui Chishaoyao using UPLC-Q-TOF-MS.</p><p><b>RESULT</b>On the basis of the mass information, it was inferred that in vivo metabolites of ferulic acid were be in the form of methylation products, sulfate conjugation products and glucuronidation conjugation products and so on; meanwhile, gallic acid was mainly transformed into eduction products and methylation products.</p><p><b>CONCLUSION</b>There are kinds of phase I and phase II metabolites of ferulic acid and gallic acid in rat plasma and urine, which provide a basis for its efficacious materials and action mechanism.</p>
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Animais , Masculino , Ratos , Ácidos Cumáricos , Sangue , Metabolismo , Urina , Medicamentos de Ervas Chinesas , Metabolismo , Ácido Gálico , Sangue , Metabolismo , Urina , Interações Ervas-Drogas , Metaboloma , Ratos Sprague-Dawley , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizRESUMO
Vascular endothelial growth factor (VEGF) plays essential roles in embryonic development and angiogenesis of a variety of diseases.In recent years,the neuroprotective effect of VEGF is increasingly receiving attention.The expression of VEGF is upregulated during hemorrhagic cerebrovascular disease.It plays a protective role in cerebral hemorrhage,but its role is controversial in subarachnoid hemorrhage.The relationship between VEGF and hemorrhagic cerebrovascular disease is both close and complex.More research is needed to clarify the relationship between them and to provide new clinical ideas for the prevention and treatment of this kind of disease.
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The combination of Angelicae sinensis Radix (Danggui, DG) and Astragali Radix (Huangqi, HQ) is a popular herb pair commonly used in clinic for the treatment of blood deficiency syndrome in China. The aim of this paper is to study the interaction of DG and HQ nourishing and tonifying blood effects by response surface method. The blood deficiency mice were induced by injecting N-acetylphenylhydrazine (sc) and cyclophosphamide (ip). The blood deficiency mice were administrated intragastrically with DG-HQ extracts (0:1, 1: 5, 2:5, 2:3, 1:1, 3:2, 5:2, 5:1, 1:0). The changes of the peripheral blood indexes and organ indexes were observed. The indexes were integrated by comprehensive index method; the interactions of DG and HQ were analyzed by the response surface diagram established with Matlab software. The results showed that DG and HQ at most of their combination ratios had synergic effect. Within the range of 1:5 - 5:1, all of the extracts of DG-HQ showed synergic effect, and among which, high-doses had better effects than low-doses. The highest value (-1) of the synergic effect was showed when DG was 10 - 40 g at the same time of HQ as 90 -180 g, and DG was 50 - 100 g at the same time of HQ as 20 - 100 g. DG-HQ at all combination dosages within Chinese Pharmacopeia (DG: 6 - 12 g, HQ: 9 - 30 g) had certain synergic effect, and Danggui Buxue Decoction (DG: 6 g, HQ: 30 g) also was at this range. The results provided scientific basis to the clinical application of DG and HQ. And the response surface method was firstly applied to quantitatively evaluate the bio-activity change of herb combination, which provided a novel way for modern basic research on the interaction of herbs.
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<p><b>OBJECTIVE</b>To study the dissolution rate of active components of different extracting solvents of Danggui Chishao drug pair.</p><p><b>METHOD</b>The dissolution rates of phenolic acids (ferulic acid, vanillic acid and gallic acid), monoterpenes (gallic acid, peoniflorin, albiflorin, hydroxypeoniflorin and galloylpaeoniflorin) and phthalates (senkyunolide and ligustilide) contained in Danggui Chishao drug pair were determined by quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS) and ultra high performance liquid chromatography in combination with triple-quadrupole mass spectrometry (UPLC-TQ-MS).</p><p><b>RESULT</b>The dissolution rates of phenolic acids and monoterpenes decreased with the increase in alcohol concentration, on the contrary the rates of phthalates increased. The relative dissolution rates of most active components were relatively high in water and low concentration alcohol than other solvents.</p><p><b>CONCLUSION</b>Liquid chromatography-mass spectrometry is practical for comprehensive multi-component assessment on traditional Chinese medicine preparation processes and can provide reference for optimization of processing parameters.</p>
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4-Butirolactona , Química , Benzoatos , Química , Benzofuranos , Química , Hidrocarbonetos Aromáticos com Pontes , Química , Cromatografia Líquida , Medicamentos de Ervas Chinesas , Química , Ácido Gálico , Química , Glucosídeos , Química , Hidroxibenzoatos , Química , Espectrometria de Massas , Monoterpenos , Química , Ácidos Ftálicos , Química , Solventes , Química , Ácido Vanílico , QuímicaRESUMO
<p><b>OBJECTIVE</b>To compare the toxicity on normal liver cells LO2 before and after Kansui Radix stir-baked with vinegar, and make a preliminary study on the mechanism of detoxication of Kansui Radix stir-baked with vinegar.</p><p><b>METHOD</b>The MTT method was adopted to detect the cell activity, with normal liver cells LO2 as the study object. The morphology of cells were observed, and the level or content of AST, ALT, LDH, SOD, Na+-K+-ATPase, Ca2+-Mg2+ -ATPase, GSH and MDA were determined in cell culture supernatant and splitting supernatant.</p><p><b>RESULT</b>Compared with the control group, Kansui can obviously inhibit the cell activity (P < 0.01) and morphology, and increase the levels of ALT, AST, and LDH (P < 0.01) in the supernatant fluid of cell incubation, and decrease the level of SOD and the content of GSH (P < 0.01). Besides, it significantly increased the content of MDA (P < 0.01) and significantly decreased the level of Na+-K+-ATPase and Ca2+-Mg2+ -ATPase (P < 0.01) in the supernatant fluid of cell dissociation. Compared with Kansui group of various doses, Kansui Radix stir-baked with vinegar can significantly decrease the cell proliferation inhibition and the trend of morphological variation, and obviously decrease the levels of ALT, AST, and LDH (P < 0.01) in the supernatant fluid of cell incubation, and significantly increase the level of SOD and the content of GSH (P < 0.01), and significantly decrease the content of MDA (P < 0.01). Additionally, it significantly increased the level of Na+-K+-ATPase and Ca2+-Mg2+ ATPase (P < 0.01) in the supernatant fluid of cell dissociation, and showed a certain dose-effect relationship.</p><p><b>CONCLUSION</b>Stir-baking with rice vinegar can release the hepatotoxicity of Kansui Radix. Its possible mechanism was that Kansui Radix stir-baked with vinegar can decrease the influence of Kansui Radix on the permeability of liver cells LO2 membrane and oxidative damage, in order to provide basis for further exploration of the detoxication mechanism of Kansui Radix stir-baked with vinegar.</p>
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Humanos , Ácido Acético , Química , Linhagem Celular , Proliferação de Células , Química Farmacêutica , Medicamentos de Ervas Chinesas , Química , Toxicidade , Euphorbia , Química , Fígado , Biologia Celular , Estresse Oxidativo , Raízes de Plantas , Química , ATPase Trocadora de Sódio-Potássio , MetabolismoRESUMO
The present study was performed to investigate competitive interaction between arenobufagin and verapamil hydrochloride with serum albumin.
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The formulae decoctions are commonly used in clinic and have characteristics of simple preparation and rapid effect. It was considered as a complex physical and chemical system. In this article, the physical and chemical properties and chemical components and their relationships were investigated to explore the changes of characteristics resulted from different combinations of drugs of Shaofu Zhuyu decoction. The method of partial leasts-quares regression was adopted to evaluate the correlation between physical and chemical parameters and chemical components. These researches may provide a new way to investigate the state of bioactive components, the action mechanisms, and property of treating diseases of traditional Chinese medicine decoction.
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Química Farmacêutica , Combinação de Medicamentos , Medicamentos de Ervas Chinesas , QuímicaRESUMO
<p><b>OBJECTIVE</b>To study the bioaffinity between 8 bufadienolides(Bu) and tumor cells and analyze the correlation between the bioaffinity and the anti-tumor activities of Bu.</p><p><b>METHOD</b>Mix and cultivate the chloroform extract of Chansu and MGC-803. Measure the content of 8 Bu in supernatant and cells using HPLC and calculate their affinity rate.</p><p><b>RESULT</b>The coefficient correlation between the decrease of Bu in cell supernatant after affinity and its MGC-803 restrictive activities, and between the cotent percentage of the free Bu in free cells with its MGC-803 restrictive activities, and between the difference between the decrease and the percentage and its MGC-803 restrictive activities is r = 0.82 (P < 0.05), r = -0.04 and r = 0.83 (P < 0.05) respectively.</p><p><b>CONCLUSION</b>Eight Bu have different levels of affinity with MGC-803 which correlate with their anti-tumor activities.</p>