Randomized controlled trial outcome indicators of traditional Chinese medicine for gastrointestinal dysfunction in sepsis in recent two years / 中国中药杂志

The purpose of the study is to analyze the outcomes of randomized controlled trial(RCT) of Chinese herbal medicine formula(CHMF) in the treatment of gastrointestinal dysfunction in sepsis in recent two years. We systematically searched four Chinese databases, three English databases, and two clinical trial registries to analyze the reports of outcome indicators of clinical trials, and evaluated the risk of bias by using the ROB tool of Cochrane Collaboration. After screening, 55 clinical RCTs were included. The results showed that the current clinical studies of gastrointestinal dysfunction in sepsis reported the efficacy and safety indicators. The efficacy indicators included APACHE Ⅱ scores, gastrointestinal dysfunction scores, bowel sound scores, and inflammatory indicator such as C-reactive protein and procalcitonin. The safety indicators mainly include gastrointestinal reactions, skin reactions, and other adverse events and adverse reactions. However, there was no distinction between primary and secondary outcomes. The relevant indicators of health economics were not reported, and the quality of research methodology was poor. Therefore, we suggest that future researchers should be well prepared in the top-level design stage and actively construct the core outcome set, so as to improve the quality of clinical trials.

Sesamin and vitamin E ameliorate aortic endothelial dysfunction rats induced by D-galactose and aluminum trichloride via regula?tion of endothelial nitric oxide synthase and NAD(P)H oxidase 4 / 中国药理学与毒理学杂志

OBJECTIVE To observe the protective effect of sesamin (Ses) and vitamin E (Vit E) against aortic endothelial dysfunction in rats induced by D-galactose (D-gal) and aluminum trichloride (AlCl3), and explore its conceivable mechanisms. METHODS A model of aortic endothelial dysfunction rats was established by D-gal (180 mg · kg-1, ip) combined with AlCl3 (15 mg · kg-1, ig) for 84 d. Model rats were randomly divided into model, model+Vit E 10 mg·kg-1, model+Ses 160 mg·kg-1, and model+Ses 160 mg · kg-1+Vit E 10 mg · kg-1 groups. After 70 d of treatment with Ses and Vit E, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were measured by tail cuff. The rats were anesthetized by sodium pentobarbital (30 mg·kg-1, ip). Thoracic aortas from the rats were removed and divided into two parts (3 mm in length). The relaxation of the aortic ring induced by acetylcholine (ACh) and sodium nitroprusside was measured. The primary pathologic changes in the aorta were observed by HE staining. Total antioxidant capacity (T-AOC), hydrogen peroxide (H2O2) and nitric oxide (NO) in serum were measured by colorimetric analysis. The expression of endothelial nitric oxide synthase (eNOS) positive cells in the aorta were measured by immunohistochemistry. The expres?sions of eNOS and NAD(P)H oxidase 4 (NOX4) protein in the aortal were detected by Western blotting. RESULTS Compared with the model group, the relaxation response with increase in ACh concentra?tion (1×10-7-1×10-4 mol·L-1) was enhanced (P<0.01) in model+Ses+Vit E, SBP, DBP and MBP decreased (P<0.01), the serum T-AOC and NO level were increased (P<0.01), the serum H2O2 levels were reduced (P<0.01), the eNOS expression was increased (P<0.01) and NOX4 expression was reduced (P<0.01) in each treatment group. Compared with model+Ses, the SBP, DBP and MBP were lower (P<0.01 or P<0.05), the serum H2O2 level was lower (P<0.01), the serum NO level was increased (P<0.05), the eNOS expression level was higher (P<0.01) and the NOX4 expression level was reduced (P<0.05) in model+Ses+Vit E. Compared with the model+Vit E, the serum T-AOC and NO levels were increased (P<0.05), the serum H2O2 level was lower (P<0.01), eNOS expression was increased (P<0.01) and NOX4 expression was reduced (P<0.05) in model+Ses+Vit E group. CONCLUSION Ses and Vit E can ameliorate aortic endothelial dysfunction of rats induced by D-gal and AlCl3 via the regulation of eNOS and NOX4.

Clinical characteristics and distribution of peripheral T lymphocyte subsets in patients with schistosomal hepatic diseases in Suzhou City / 中国血吸虫病防治杂志

Objective To investigate the clinical characteristics and the distribution of peripheral blood T lymphocyte sub-sets in patients with schistosomal hepatic cirrhosis in Suzhou City. Methods A total of 32 inpatients with liver diseases due to advanced schistosomiasis at the Department of Infectious Diseases, The First Affiliated Hospital of Soochow University from January 2016 to January 2018 were recruited and assigned into the infection and non-infection groups according to presence of co-infections, and 20 old healthy volunteers served as controls. Venous blood samples were collected on the day of admission, and the proportions of CD4+ T cells, CD8+ T cells, regulatory T (Treg) cells and Th17 cells were detected in peripheral blood using flow cytometry. Results Most patients with liver disorders due to advanced schistosomiasis were admitted to hospital in Suzhou City because of portal hypertension-associated complications, with a high prevalence of co-infections (59.38%, 19/32). The proportions of peripheral CD4+ and CD8+ T cells and Th17 cells were all significantly lower in patients with liver disorders due to advanced schistosomiasis than in controls (t = −5.111, −4.470 and −2.749, all P < 0.05), and a higher proportion of Treg cells was detected in patients than in controls (t = 5.628, P < 0.05). In addition, there were significant differences among the infection group, non-infection group and controls in terms of the percentage of CD4+ T cells, CD8+ T cells, Th17 cells and Treg cells (F = 15.837, 16.594, 9.290 and 27.866, all P < 0.05). Conclusion Portal hypertension-associated complications are predominantly seen in patients with liver diseases due to advanced schistosomiasis at admission in Suzhou City, and co-infections are common. Imbalance of peripheral T cell subsets is detected in patients with liver diseases due to advanced schistosomiasis in Suzhou City.

Increased serum C-C chemokine ligand 19 levels correlated with B cell abnormalities in systemic lupus erythematosus / 北京大学学报(医学版)

Objective:To detect the levels of serum C-C chemokine ligand 19 (CCL19) in patients with systemic lupus erythematosus (SLE) and to evaluate the correlation between CCL19 expression and clinical features and laboratory parameters,trying to reveal the possible role of CCL19 in the pathogenesis of systemic lupus erythematosus.Methods:The levels of serum CCL19 were measured by enzyme linked immunosorbent assay (ELISA) in 90 patients with SLE and 30 healthy controls.These SLE patients included 75 patients who received treatment with glucocorticoids and disease-modifying anti-rheumatic drug (DMARD) and 15 patients without therapy.The frequencies of peripheral blood B cells and the B cell subsets were assessed in the patients with SLE by flow cytometry.The correlation between the clinical data,laboratory parameters,B cell subset frequencies and serum CCL19 levels were analyzed.Independent samples t test,paired t test,Pearson and Spearman correlation were used for statistical analyses.Results:The levels of CCL19 were markedly higher in the SLE patients without therapy and the patients with therapy than in the health controls[(596.25 ±409.19) ng/L and (422.90 ± 395.84) ng/L vs.157.79 ± 125.23) ng/L,all P ＜ 0.001].Serum CCL19 levels in the SLE patients without therapy were higher than the SLE patients who accepted glucocorticoids and DMARD treatment (P ＜ 0.05).The levels of serum CCL19 were positively correlated with anti-double stranded deoxyribonucleic acid (dsDNA),anti-nucleosome antibody (AnuA),IgA,IgG and IgM (r =0.38,P =0.007;r =0.332,P =0.029;r =0.519,P =0.007;r =0.461,P =0.018,respectively).Serum CCL19 levels in the SLE patients with photosensitivity,arthritis and secondary Sj(o)gren's syndrome were higher than the SLE patients without photosensitivity,arthritis and secondary Sj(o)gren's syndrome,respectively [(562.25 ± 399.12) ng/L,(565.6 ± 435.24) ng/L and (694.9 ± 531.02) ng/L vs.(394.7 ± 281.42) ng/L,(385.90-± 325.33) ng/L and (424.8 ± 305.46) ng/L,all P ＜ 0.05].The levels of serum CCL19 were positively correlated with the percentage of CD27-B cells and CD27-IgD-double-negative memory B cells (r =0.519,P =0.007;r =0.461,P =0.018,respectively).However,the levels of serum CCL19 were negatively correlated with the percentage of CD27 + memory B cells and CD27 + IgD-switched memory B cells (r =-0.433,P =0.027;r =-0.616,P =0.001,respectively).Conclusion:The increased serum CCL19 levels in SLE patients were associated with the production of autoantibodies,and CCL19 might be involved in the pathogenesis of SLE by disturbing the homeostasis of B cell subsets.

Risk factors of leptospirosis in Liping County,Guizhou Province, China——an expanded survey in general population and rodents / 中国人兽共患病学报

Leptospirosis has long been a sporadic zoonosis in Liping County.This study aims to explore the risk factors of leptospirosis infection in general population,and the role rodents play in transmission by an expanded investigation of two deceased cases.Serology survey and demographic investigation were carried out among the general population of two epidemic areas where two deseased cases had been reported,and one extended area where no leptospirosis cases had been diagnosed.Local rodents' kidney samples were collected for Leptospira isolation.In total 44 people (23.4％) tested positive by microscopic agglutination test (MAT) for four strains of Leptospira.Seropositive rate of the extended area was significantly higher (53.3 ％,24/45) than epidemic area (14.0％,20/143).Positive rate increased with age.Other factors such as occupation,gender showed no significance.The proportion of Apodemus agrarius in the captured rodents and the total germ-carrying rates showed no significant difference in two areas.Long-term rodent carrier surveillance is critical to provide valuable information and locate high risk areas,facilitating prophylactic measures.Vaccination was recommended in high risk areas if economical feasibility and demand were proved.

Fever monitoring program in areas with high incidence of typhoid and paratyphoid fever in Guizhou province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation.</p><p><b>METHODS</b>Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever.</p><p><b>RESULTS</b>In the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with the total positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains. 4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella, accounting for 41.00% (82/200), with a detection rate as 1.90%. 6590 samples were cultured at the 'Class C' sites, which identified 79 strains of Salmonella, accounting for 39.50% (79/200), with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them (P < 0.05). The annual peak time of positive detection was in spring and fall. The outbreaks or epidemics often appeared in the same places, with farmers, students as the high-risk populations. Symptoms of both typhoid and paratyphoid fever were not typical.</p><p><b>CONCLUSION</b>Typhoid and paratyphoid monitoring programs which covered primary health care institutions in the high incidence area seemed to be effective in reflecting the pictures as well as the burden of both typhoid and paratyphoid.</p>

Comparison of shear bond strength of different resin cements to ceramic and dentin / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of different resin cements and dentin surface treatment methods on shear bond strength between glass ceramic and human dentin.</p><p><b>METHODS</b>Freshly extracted non-carious human premolars were collected to prepare flat mesial and distal dentin surface with diamond bur. Besides, ceramic discs (3 mm in diameter, 3 mm in height) were fabricated with IPS e. max Press ingots. All samples were randomly divided into five groups, sixteen specimens each. Ceramic discs were cemented on dentin surface using one of the five resin cements [Group A (Variolink II), Group B (Multilink Automix), Group C (Multilink Sprint), Group D (Rely X Unicem) and Group E (BisCem)] respectively. Half of the specimens were stored in water 37 degrees C for 24 h and the other half were additionally thermocycled for 5000 times (5 degrees C/55 degrees C) before shear bond strength test. Dentin bonding surface and transverse plane were examined with a scanning electronic microscope.</p><p><b>RESULTS</b>Group A showed the highest bond strength before thermocycling [(22.3 +/- 3.9) MPa], and the bond strength of Group B [(18.1 +/- 3.5) MPa] was lower than that of Group A (P < 0.05). Group E [(11.7 +/- 4.2) MPa], Group C [(11.3 +/- 3.6) MPa] and Group D [(14.1 +/- 2.3) MPa] had the lowest bond strength. After thermocycling, Group A still showed the highest bond strength [(17.8 +/- 2.3) MPa]. The bond strength of Group B [(14.4 +/- 3.5) MPa] and Group D [(13.2 +/- 2.5) MPa] were lower than that of Group A. Group E [(8.9 +/- 3.2) MPa] and Group C [(7.0 +/- 2.4) MPa] showed the lowest bond strength. The bond strength of all groups decreased notably after thermocycling except Group E and Group D.</p><p><b>CONCLUSIONS</b>The resin cement based on etch-rinsing bonding system has higher bond strength to dentin than those based on self-etch bonding system and self-adhesive resin cements.</p>

Effect of Ti bonder on the bond strength between porcelain and titanium / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the influence of GC Initial Ti Bonder on bond strength between Vita Titankeramik porcelain and titanium.</p><p><b>METHODS</b>Forty titanium samples were prepared and randomly assigned to 4 groups with 10 samples in each group. Samples in each group were subjected to one of the following surface treatments, burnishing (Group B), sandblasting (Group S), firing GC Initial Ti Bonder after burnishing (Group BG) and firing GC Initial Ti Bonder after sandblasting (Group SG). Vita Titankeramik porcelain were fired on the surface of each sample in the middle. Three-point bending tests were conducted on each sample according to the ISO 9693. The fracture patterns of all specimens were recorded using zoom stereo microscope (ZSM) and the fracture surfaces were observed under scanning electron microscope (SEM).</p><p><b>RESULTS</b>With fired GC Initial Ti Bonder, the bond strength of Vita Titankeramik porcelain to titanium in Group BG and Group SG were (32.72 +/- 4.46) and (34.25 +/- 6.52) MPa respectively, which reach the ISO 9693 standard for clinical use and were significantly higher than those in Group B [(20.70 +/- 3.15) MPa] and Group S [(23.92 +/- 5.02) MPa].</p><p><b>CONCLUSIONS</b>GC Initial Ti Bonder can significantly improve bond strength between Vita Titankeramik porcelain and titanium.</p>

Effect of Transcutaneous Electric Nerve Stimulation and Physical Therapy on Shoulder Pain after Stroke / 中国康复理论与实践

@#ObjectiveTo observe the effect of transcutaneous electric nerve stimulation (TENS) and physical therapy on shoulder pain after stroke. Methods60 patients of shoulder pain after stroke were randomly divided into treatment group (30 cases) and control group(30 cases). The patients in the treatment group were treated with TENS and physical therapy. The cases in the control group were treated with TENS only. All patients were evaluated with visual analogous score of pain (VAS) and Fugl-Meyer measure (FM) before and after treatment. ResultsThe scores of VAS and FM improved more significantly in treatment group than in control group(P<0.01).ConclusionTranscutaneous electric nerve stimulation combined with physical therapy showed more effective on shoulder pain after stroke.

Adrenergic receptor antagonist prevents the left ventricle with chronic pressure-overload from electrical remodeling / 生理学报

Experiments were performed to investigate the effects of long-term treatment with adrenergic receptor antagonist on electrical remodeling of the left ventricle with chronic pressure-overload. New Zealand rabbits underwent subtotal banding of superrenal abdominal aorta. At 10 weeks after surgery, echocardiography examination was performed, then action potential (AP), inward rectifier potassium current (I(Ki)), delayed rectifier potassium current (I(K)) and Na(+)/Ca(2+) exchanger current (I(Na(+)/Ca(2+))) were recorded in midmyocardial cells isolated from left ventricle of abdominal aorta banded group (banded group), abdominal aorta banding plus Carvedilol intervention group (Carvedilol group), and normal control group rabbits by using the whole-cell patch-clamp techniques. The results showed that left ventricular mass index in control, banded, and Carvedilol groups were 1.78+/-0.06 (n=7), 2.33+/-0.11 (n=7), and 1.87+/-0.08 (n=7), respectively (banded vs control and Carvedilol, P<0.01). At basic cycle length of 2 s, AP duration (measured at 90% repolarization, APD(90), ms) in control, banded, and Carvedilol groups were 522.0+/-19.5 (n=6), 664.7+/-46.2 (n=7), 567.8+/-14.3 (n=8) respectively (banded vs control, P<0.01; Carvedilol vs banded, P<0.05). At test potential of -100 mV, inward I(Ki) density (pA/pF) in control, banded, and Carvedilol groups were -11.8+/-0.50 (n=8), -8.07+/-0.28 (n=8), -10.69+/-0.35 (n=8) respectively (banded vs control and Carvedilol, P<0.01). At test potential of +50 mV, I(K) tail current density (pA/pF) in control, banded, and Carvedilol groups were 0.59+/-0.04 (n=8), 0.40+/-0.02 (n=9), 0.51+/-0.02 (n=8) respectively (banded vs control, P<0.01; Carvedilol vs banded, P<0.05). At test potential of +60 mV, outward I(Na(+)/Ca(2+)) density (pA/pF) in control, banded, and Carvedilol groups were 1.06+/-0.11 (n=8), 1.54+/-0.10 (n=9), 1.24+/-0.07 (n=8), respectively (banded vs control and Carvedilol, P<0.01). At test potential of -120 mV, inward I(Na(+)/Ca(2+)) density (pA/pF) in control, banded, and Carvedilol groups were -0.54+/-0.06 (n =8), -0.75+/-0.04 (n=9), -0.60+/-0.03 (n=8), respectively (banded vs control, P<0.01; Carvedilol vs banded, P<0.05). It is shown that long-term treatment with Carvedilol not only prevents development of cardiac hypertrophy, but also improves the electrophysiological alterations in rabbit hearts with chronic pressure-overload. This finding may add new electrophysiological evidence for the treatment of heart failure and hypertension with adrenergic receptor antagonist.

Effect of xuezhikang on blood lipids, serum oxidized low density lipoprotein, C-reactive protein and fibrinogen in patients with unstable angina pectoris / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the lipid regulatory effect of Xuezhikang (XZK) and its effects on serum oxidized low density lipoprotein (OX-LDL), C-reactive protein (CRP) and fibrinogen (FIB) in patients with unstable angina pectoris (UAP).</p><p><b>METHODS</b>UAP patients with hyperlipidemia were treated with XZK 0.6 g, orally taken, twice a day for 2 successive months followed by half dosage for 2 months. To UAP patients with normal blood lipids, Vit E was given orally for 4 months. Levels of blood lipids, OX-LDL, CRP, FIB at the time of entry, 1st and 2nd month of the therapeutic course were observed and end-point events in the two groups was compared.</p><p><b>RESULTS</b>XZK can reduce the serum level of total cholesterol, low density lipoprotein after being administered for 1 month, and the effect further elevated after 2 months. Its effect in lowering triglycerides and increasing high density lipoprotein initiated after 2 months administration. Compared with effect of Vit E, XZK can significantly lower the serum OX-LDL, CRP and FIB after 2 months administration, and reduce the end-point events in 4 months.</p><p><b>CONCLUSION</b>XZK has good regulatory effect on blood lipids, it also can inhibit the development of inflammation in coronary plaque, therefore, is beneficial to the prognosis of UAP patients.</p>

Discussion on Common Problems in Inspecting New Drug Qualification / 中国药房

OBJECTIVE:To strengthen the inspection for qualification of new drugs when introduced in order to guarantee the quality of new drugs and the safety of drug use.METHODS:The problems existing in the inspection for qualification of new drugs were exemplified and classified.RESULTS&CONCLUSION:There existed the problems in the respect of validity,authenticity,effectiveness,and integrality.The good maintainance of the database of SFDA plays a important role in in-specting the new drugs when introduced,while on the other hand such issues as establishment and use of credibility file in medical agencies are worth discussing.

Change of Prescription Administrative Policy vs. Its Trial Edition and Its Problems / 中国药房

OBJECTIVE:To facilitate the in-depth implementation of Prescription Administrative Policy("New Method" in short).METHODS:The change of the Prescription Administrative Policy and its problems were analyzed through comparison between the "New Method" and the trial edition.RESULTS & CONCLUSIONS:Improvements of Prescription Administrative Policy such as the introduction of prescription comment system,clarifying supervising subjects and strengthening requirement on prescription dispensing rights etc play a role in tightening comprehensive management on prescriptions and promoting rational drug use.However,the defects of Prescription Administrative Policy such as the absence of the regulations unsuitable for medical orders in retail pharmacy and endemic areas and the unidentified prescription forms need to be improved step by step in the practice.

Discussion on Quantitative Preliminary Evaluation of Introduced New Drugs / 中国药房

OBJECTIVE: To establish a quantitative preliminary evaluation of introduced drugs. METHODS: A quantitative form was designed for new drugs’ preliminary evaluation, which included many factors, such as qualification of pharmaceutical factory or company, category of drugs in medical insurance, the result of the biding drugs, comparison with other drugs of the same category, PK and PD data,special use and clinical demand. Each factor was given a definite score .If the total scores of a given drug amounted to the expected figure, this drug could pass the preliminary evaluation and enter the next step, and if not, the drug may be eliminated. RESULTS&CONCLUSION: The purpose of evaluating the new drugs scientifically and objectively can be basically achieved through quantitative method, which can lessen the blindness in introduction of new drugs.