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Objective To study the curative effects of traditional Chinese medicine paste combined with Baduanjin in treatment of osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP). Methods 120 OVCF patients treated with PVP in our hospital from January 2016 to September 2017 were divided into the observation group (60 cases) and the control group (60 cases) according to the random number table method. The control group was given calcium carbonate D3 chewable tablets orally with routine guidance. In addition to the same treatment as the control group, the observation group received the traditional Chinese medicine paste orally with Baduanjin exercise. Both groups were treated for 6 months and followed-up for 3 years. The curative effects in the two groups after 6 months treatment and the low back pain after 1, 3 and 6 months of treatment were recorded. The changes of bone mineral density (BMD), kyphosis angle (Cobb angle), anterior wall height of vertebral body (AVBH) and level of bone metabolism indexes in the two groups were compared before and after treatment for 6 months. The follow-up times and the incidences of push-back fracture after PVP during follow-up were recorded. Results After 6 months of treatment, the clinical cure rate of the observation group was 73.33%, which was higher than 53.33% of the control group(P<0.05). Compared with pretreatment, the scores of visual analogue scale (VAS) in the two groups gradually decreased after 3 and 6 months of treatment, and the observation group had a lower scores than the control group (P<0.05). After 6 months treatment, BMD and AVBH of lumbar vertebrae and femoral neck in both groups increased, and the observation group was higher than that in the control group. The Cobb angle and serum levels of Type I procollagen degradation products (β-Cross I), the n-terminal middle osteocalcin (N-MID Ost) and parathyroid hormone (PTH) decreased in both groups, and the observation group was lower than those in the control group (P<0.05). There was no significant difference in fracture incidence after PVP in the year 1, year 1 to 3 follow up between the two groups (P>0.05). During the 3 years follow-up, the incidence of push-body fracture after PVP in the observation group was 3.33%, which was lower than that in the control group 20.00%( P<0.05). Conclusion Traditional Chinese medicine paste combined with Baduanjin reduced the serum levels of β-Cross I, N-MID Ost and PTH, regulated bone metabolism, improved BMD and AVBH of lumbar vertebrae and femoral neck, reduced Cobb angle, promoted the recovery of lumbar function, alleviated patients' back pain, lowered the incidence of push-body fracture after PVP. The curative effects were remarkable.
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Objective To establish a method and study the pharmacokinetics for concentration determination of effective components in Xiakucao Xiaoliu mixture in Normal Rat Plasma By LC-MS/MS. Methods The mobile phase was methanol-water (0.1% formic acid) system under the positive ion mode of C18 chromatographic column, gradient elution was adopted, and the flow rate was 0.3 ml/min. In the negative ion mode, the mobile phase was acetonitrile-water (0.1% formic acid) system, gradient elution, with a flow rate of 0.4 ml/min. Caffeic acid, rosmarinic acid, syringic acid, rutin in positive ion mode and Atractylodes lactone II and Atractylodes lactone III in negative ion mode were respectively determined. Normal rats were intragastrically given Xiakucao Xiaoliu Mixture 7.8 ml/kg, and blood was taken from the orbit at different time points after the administration. The blood concentration was determined by the validated LC-MS/MS method and the non-standard DAS2.0 software was used. The pharmacokinetic parameters of rats after administration were calculated by the compartment model. Results The pharmacokinetic parameters belonged to non atrioventricular model. The pharmacokinetic characteristics of the four main anti-cancer active ingredients of Caffeic acid, Rosmarinic acid, Syringic acid and Atractylodes Ⅲ in rats after administration of Xiakucao Xiaoliu Mixture were significantly different from those reported in the literature after the administration of monomers. Conclusion The established method was simple, accurate and sensitive, which could be suitable for the content determination of effective components in Xiakucao Xiaoliu mixture in Normal Rat Plasma, which would be a valuable information for the study on main anticancer active substances.
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Objective To evaluate the role of clinical pharmacists on the pharmacological monitoring and management of diabetic patients. Methods 406 adult outpatients with diabetes in outpatient were selected as research object. The patients were given the questionnaire and intervened with diabetes education and management by the clinical pharmacist regularly. The patient’s knowledge of the diabetes medication before and after intervention, blood glucose and glycosylated hemoglobin values, treatment compliance, non-reserved outpatient visit, emergency, hospitalization, etc. were compared and statistically analyzed. Results After pharmacy intervention, the patients' knowledge of diabetes and drug-related information, treatment compliance, blood glucose and glycosylated hemoglobin were better than before intervention, P<0.01. Non-reserved outpatient visits and emergency cases were better than before intervention, P<0.05. There are significant differences. Conclusion Clinical pharmacists carry out diabetes chronic disease management and build a clinical pharmacist-led chronic disease management model, which helps to promote standardized treatment, improve patient compliance, promote rationalized medication, achieve the goal of controlling blood sugar and reduce complications.
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Objective To investigate the therapeutic effect of Xiakucao Xiaoliu mixture on Lewis lung cancer mice. Methods 30 mice with C57BL/6 mouse Lewis lung cancer xenograft model were randomly divided into three groups: model control group, Xiakucao Xiaoliu mixture group (M group), cisplatin group (DDP group). M group and DDP group were administered continuously for 14 days. Through the general observation of Lewis lung cancer mice, tumor size was determined, HE staining method was used to determine the histopathological changes of tumors, and the expression of CyclinD1 and P16 in tumor tissues was determined by immunohistochemistry. Results The tumor weight of the model control group was the heaviest, and the difference was statistically significant compared with other groups. (P<0.05). Survival state and quality of life of mice had been improved to some extent in M group. The results of tumor growth curve and HE staining in each group of mice showed that the growth of tumor cells had been inhibited and normal cells had been protected. The positive expression of CyclinD1 was significantly decreased in M group and DDP group (P<0.01), but the effect of M group on the improvement of P16 positive expression was not significant. Conclusion Xiakucao Xiaoliu mixture had a good effect on inhibiting lung tumor growth.
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Objective To identify the chemical constituents of Xiakucao Xiaoliu mixture by high performance liquid chromatography-high resolution time-of-flight mass spectrometry (HPLC-TOF/MS). Methods The chromatographic separation ACE (3.0mm×150 mm) column was used. The mobile phase was methanol (A) and 0.1% formic acid (B). The gradient elution was: 0-5 min, 5% A; 5-10 min, 5%-15% A; 10-30 min, 15%-45%A; 30-40 min, 45%-70%B; 40-50 min, 70%-90%B. The injection volume was 2 μl. The flow rate was 0.4 ml/min. The column temperature was 25°C. The mass spectrometry was characterized by time-of-flight mass spectrometry, using ESI ion source. The common monitoring was in positive and negative ion mode. The reference ion was m/z 121.9856, 1033.9881. The scanning range was m/z 100-1200. Results A total of 37 chemical constituents were identified in the Xiakucao Xiaoliu mixture, 8 in the positive ion mode fragment voltage of 160 V, 28 in the negative ion mode fragment voltage of 160 V, and 19 in the fragment voltage of 260 V. Both positive and negative ions had 4 responses. The negative ion mode has 16 responses under both fragment voltages. And the ingredients were medicinal. Conclusion An effective method for the identification of the chemical constituents of Prunella vulgaris L. by HPLC-TOF/MS was established, which laid a foundation for its quality control and in-depth study in vivo.
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OBJECTIVE: To improve the quality and efficiency of medication consultation and to promote rational drug use in clinic. METHODS: Totally of 520 cases of medication consultation records from the Affiliated Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM during Oct. 2015-Oct. 2016 were selected according to random number table, and then summarized and analyzed statistically in respects of consultation content, age and type of consultants, department, consulted medicine types, the number of combination of TCM and Western medicine, satisfactory degree of consultants, etc. RESULTS: The main consultation contents included usage and dosage (41. 92％), combination of TCM and Western medicine (12. 88％), etc. Consultants mainly aged 50-70 years old (48. 27％), and were mainly the patients and their family members (95. 96％). Consultants were primarily diagnosed in cardiology department and endocrinology department. Top 3 consulted medicine types were cardiovascular system medicines, nervous system medicines, digestive system medicines, and types of Chinese patent medicines were mainly coordinating medicines and activating blood and removing stasis medicines. Types of TCM combined with Western medicine were less than or equal to 3 kinds in 420 cases (80. 77％). Most patients were very satisfied with outpatient medication consultation (93. 65％). CONCLUSIONS: Rational drug use consultation improves medication compliance of patients, meets the needs of patients on medication safety knowledge, and provides a strong guarantee for safe and rational drug use in clinic.
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Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.
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Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids .Method DDDs ,DUI ,the distribution of cancer pain ,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medi-cal records from January in 2013 to December in 2014 .Results 292 medical records were selected and analyzed .Among them , 89 patients′pain score≥3 .The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives ,which is the main medication in treating the cancer pain patients .And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments .Conclusion Theutilization of opioids was basically rational ,but there still had some deficiencies . The intervention and management of narcotic drugs should be strengthened and deepened .
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Refractory wounds are the common complication of diabetes,and the therapeutic scheme and methods are paid more and more attention nowadays. The influence of traditional Chinese medicines on diabetic wound healing, such as promoting fibroblasts proliferation, enhancing granulation tissue formation, increasing the secretion of growth factors and reducing the wound scar, was re-viewed in the paper to provide scientific basis and reference for traditional Chinese medicines used in diabetic refractory wounds.
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OBJECTIVE: To investigate the prevention effect of aqueous extract of Epimedii sagittatum (ESE) on ovariectomy-induced (OVX) bone loss in rats. METHODS: Rats were divided into sham-operated and OVX groups. The OVX rats were divided into four groups treated with distilled water, 17beta-estradiol (1 mg/kg, ig) and ESE (0.5 and 1 g/kg, ig) for 11 weeks. Serum calcium, phosphorus, estradiol, bone gla protein concentrations and serum alkaline phosphatase activity were measured. Bone density was assayed by dual-energy X-ray absorptiometry. The undecalcified longitudinal proximal tibial metaphysical sections were cut and stained for the bone histomorphometric analysis. RESULTS: In OVX rats, alkaline phosphatase activity in serum was markedly increased by ESE treatment, which had no obvious influence on the body weight. Meanwhile, atrophy of uterus and descent of bone mineral density were suppressed by ESE treatment. In addition, ESE completely corrected the decreased concentrations of calcium and E2 in serum observed in OVX rats. Histological results also showed ESE prevented the increases in trabecular separation (Tb.Sp) in OVX rats whereas it did not alter trabecular thickness (Tb.Th) and trabecular number (Tb.N) in OVX rats. Moreover, ESE had remarkable effect on bone formation rate with bone volume as referent (BFR/BV) and bone formation rate with bone surface as referent (BFR/BS). CONCLUSION: The findings assessed on the basis of biochemical test, bone mineral density and histomorphometric parameters show that aqueous extract of Epimedii sagittatum has a definite antiosteoporotic effect and can prevent the OVX-induced bone loss in rats.