Oral Chinese Herbal Medicine for Depressive Disorder in Patients after Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To evaluate the effectiveness and safety of oral Chinese herbal medicines (CHMs) on post-percutaneous coronary intervention (PCI) patients with depressive disorder in coronary heart disease (CHD).@*METHODS@#A literature search was conducted through databases including PubMed, Cochrane Library, Chinese National Knowledge Infrastructure Databases (CNKI), Chinese Biomedical Literature Database (SinoMed), Chongqing VIP Chinese Science and Technology Periodical Database (VIP) and Wanfang Database up to August 2018. Randomized controlled trials (RCTs) comparing CHMs with placebo or no additional treatments on the basis of standard conventional pharmacological therapies were included. Data extraction, analyses and quality assessment were performed according to the Cochrane standards. RevMan 5.3 software was used to synthesize the results.@*RESULTS@#A total of 16 RCTs enrolling 1,443 participants were included in this systematic review. When compared with antidepressants alone, CHMs showed similar benefits with less side effects [risk ratio=0.54, 95% confidence interval (CI) 0.43 to 0.69, 582 patients]; meanwhile, the combination therapy may have more advantages than antidepressants alone [mean difference (MD)=-1.03, 95%CI-1.81 to-0.25, 267 patients). When identified with placebo, CHMs seem to have more advantages in relieving depressive symptoms (MD=-19.00, 95%CI-20.02 to-17.98, 189 patients). However, when compared with basic treatment of post- PCI, CHMs showed different results in two trials. In terms of post-PCI related clinical symptoms, CHMs seem to have more advantages in relieving chest pain and other general clinical symptoms. However, the heterogeneity in this review was generally high, it may be caused by different interventions used in each trial and the low quality of the trials.@*CONCLUSIONS@#In total, CHMs showed potentially beneficial effects on depressive symptoms and post-PCI related clinical symptoms. However, because of small sample size and potential bias of most trials, this result should be interpreted with caution. More rigorous trials with larger sample size and higher quality are warranted to give high quality of evidence to support the use of CHMs for CHD complicated with depression.

UPLC-MS/MS-based pharmacokinetics of self-microemulsion containing total flavonoids from Sophora flavescens in rats / 中草药

Objective: To establish a UPLC-MS/MS method for simultaneous determination of sophoraflavanone G (SFG), kurarinone (Kur), and isoxanthohumol (Iso) in rat plasma using rutin as the internal standard (IS), and to study the pharmacokinetic parameters of total flavonoids (TF) from Sophora flavescens and TF self-microemulsion drug delivery system (TF-SMEDDS) in rats. Methods: Analysis was carried out on an ACQUITY UPLC® HSS T3 C18 column using acetonitrile-0.1% formic acid in water as the mobile phase at a flow rate of 0.2 mL/min. The plasma samples were prepared by liquid-liquid extraction with ethyl acetate. The detection was performed on a triple quadrupole tandem mass spectrometer by multiple reaction monitoring with an electro-spray ionization source in negative ionization mode. All statistical analysis was performed using DAS 2.0 software package. Results: The calibration curves of Kur, SFG, and Iso exhibited good linearity (r2 > 0.995 9) over the range of (0.02-1 600.00), (0.015-1 200.000), and (0.01-800.00) ng/mL, respectively. Precision, accuracy, average extraction recovery, and matrix effects were all in line with biological sample analysis requirements. The pharmacokinetic parameters of Kur, SFG, and Iso from TF were as follows: t1/2z (7.04 ±2.46), (4.54 ± 2.13), (4.73 ± 1.67) h, and AUC0-∞ (3 469.57 ± 555.37), (2 524.48 ± 425.83), (1 006.47 ± 85.46) ng∙h/mL. The pharmacokinetic parameters of Kur, SFG, and Iso from TF-SMEDDS were as follows: t1/2z (13.10 ± 2.67), (11.47 ± 4.17), and (12.67 ± 4.97) h, and AUC0-∞ (13 002.49 ± 2 498.09), (8 070.80 ± 2 264.62), (3 918.85 ± 429.76) ng∙h/mL. The relative bioavailabilities of Kur, SFG, and Iso in TF-SMEDDS were approximately 374.76%, 319.70%, and 389.37%, respectively. Conclusion: The UPLC-MS/MS method can be used to study the pharmacokinetics of three components in S. flavescens in rats. The bioavailability of TF-SMEDDS in rats was significantly increased.

Clinics in diagnostic imaging (193). Sporadic Creutzfeldt-Jakob disease (sCJD)

A 68-year-old man presented with a three-week history of rapidly progressive dementia, gait ataxia and myoclonus. Subsequent electroencephalography showed periodic sharp wave complexes, and cerebrospinal fluid assay revealed the presence of a 14-3-3 protein. A probable diagnosis of sporadic Creutzfeldt-Jakob disease was made, which was further supported by magnetic resonance (MR) imaging of the brain showing asymmetric signal abnormality in the cerebral cortices and basal ganglia. The aetiology, clinical features, diagnostic criteria, various MR imaging patterns and radiologic differential diagnosis of sporadic Creutzfeldt-Jakob disease are discussed in this article.

Increased Chondrocyte Apoptosis in Kashin-Beck Disease and Rats Induced by T-2 Toxin and Selenium Deficiency / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate chondrocyte apoptosis and the expression of biochemical markers associated with apoptosis in Kashin-Beck disease (KBD) and in an established T-2 toxin- and selenium (Se) deficiency-induced rat model.</p><p><b>METHODS</b>Cartilages were collected from the hand phalanges of five patients with KBD and five healthy children. Sprague-Dawley rats were administered a selenium-deficient diet for 4 weeks prior to T-2 toxin exposure. The apoptotic chondrocytes were observed by terminal deoxynucleotidyl transferase dUTP nick end labeling staining. Caspase-3, p53, Bcl-2, and Bax proteins in the cartilages were visualized by immunohistochemistry, their protein levels were determined by Western blotting, and mRNA levels were determined by real-time reverse transcription polymerase chain reaction.</p><p><b>RESULTS</b>Increased chondrocyte apoptosis was observed in the cartilages of children with KBD. Increased apoptotic and caspase-3-stained cells were observed in the cartilages of rats fed with normal and Se-deficient diets plus T-2 toxin exposure compared to those in rats fed with normal and Se-deficient diets. Caspase-3, p53, and Bax proteins and mRNA levels were higher, whereas Bcl-2 levels were lower in rats fed with normal or Se-deficiency diets supplemented with T-2 toxin than the corresponding levels in rats fed with normal diet.</p><p><b>CONCLUSION</b>T-2 toxin under a selenium-deficient nutritional status induces chondrocyte death, which emphasizes the role of chondrocyte apoptosis in cartilage damage and progression of KBD.</p>

Screening for amblyopia among grade-1 students in primary school with uncorrected vision and stereopsis test in central China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Screening for amblyopia at earliest is important for early treatment and better prognosis. This study aimed to evaluate the validity of uncorrected distant and near visual acuity (VA) and stereoacuity for screening amblyopia in grade-1 students in primary school in central China.</p><p><b>METHODS</b>By stratified cluster sampling, 3112 grade-1 students from 11 Anyang primary schools were selected for the study. All the participants underwent uncorrected distant and near VA, stereopsis test, cycloplegic refraction, best corrected VA (BCVA), cover test, and ocular movement examination. VA was measured with a logarithm of the minimum angle of resolution (logMAR) chart. Stereoacuity was measured with the Lang II stereo card and TNO test. Amblyopia was defined as the BCVA less than or equal to 0.1 logMAR units of any eye in the absence of significant pathological abnormalities. The sensitivity, specificity, and positive and negative predictive value of uncorrected VA and stereoacuity for amblyopia were analyzed.</p><p><b>RESULTS</b>Out of the 3112 eligible students, 2893 (92.96%) completed the examinations. The average age of the students was (7.10 ± 0.41) years. Screened by distant VA with low cutoff (logMAR 0.1), high cutoff (logMAR 0.0), and near VA (logMAR 0.0), 31.64%, 73.18%, and 50.23% students were abnormal, respectively. Screened by stereopsis test, only 4.69% students were abnormal. Diagnosed by a senior pediatric ophthalmologist, 61 students had amblyopia. The sensitivities of distant VA with low/high cutoff and near VA were 92.31%, 100%, and 80.77%, respectively, whereas that of stereoacuity by TNO test was 15.38%. Simultaneous testing of either two of the three tests improved the sensitivity.</p><p><b>CONCLUSIONS</b>Distant VA test of high cutoff alone displays a high sensitivity but a low specificity. Simultaneous testing of distant VA of low cutoff and stereoacuity is a better choice to balance between sensitivity and specificity.</p>

Meta-analysis of bifocal lenses for retarding myopia progression in school-aged myopic children / 中华实验眼科杂志

Background Whether the wearing of bifocal lenses can delay the development of myopia in school childhood is in controversy.To assess the effect of bifocal lenses using evidence-based medicine method is of important significance.Objective Present study was to compare the effect of bifocal lenses with single vision lenses in retarding myopia progression in school-aged myopic children.Methods This was a evidence-based medicine study.The systematical literature search was performed from MEDLINE(1966 to October 2010),EMBASE(1974 to October 2010),Cochrane Library,Chinese Biomedical Database(1978 to October 2010),and Chinese Clinical Trial Registry combined with hand searching of related bibliographies of journals and books were applied to collect the randomized-controlled clinical trial about bifocal lenses.Screening,evaluation and data extraction of the retrieved literature were performed by two investigators independently.Mata-analysis was used to assess the progression of refraction and axial length among included randomized clinical trials.Results Three high-quality randomized-controlled clinical trials meeting the inclusion criterion were included in this meta-analysis.The results showed that the weighted mean difference in progression of refraction was 0.22D between bifocal lenses and single vision lenses(95% CI:-0.24-0.67),and the difference was statistical insignificance(P=0.35).The weighted mean difference in progression of refraction during the follow-up durations of 6,12,18,24 and ＞30 months were 0.15(95% CI:-0.09-0.38),0.17(95% CI:-0.05-0.39),0.42(95% CI:-0.14-0.98),0.23(95% CI:-0.21-0.66) and 0.03(95% CI:-0.40-0.46),respectively without statistical significance.The weighted mean difference in elongation of axial length between two interventions was -0.17mm(95% CI:-0.26-0.08) with a statistically significance(P=0.000).Conclusion Based on currently available studies,bifocal lenses could not significantly slow the progression of myopia in myopic school-aged children in comparison with single vision lenses.Because only few high-quality studies are currently available,this conclusion need to be supported by more large-sample-size clinical trials.

Effects of immunostimulatory CpG ODN on experimental allergic conjunctivitis caused by aspergillus fumigatus / 中华实验眼科杂志

Background Researches demonstrated that CpG ODN,a immunostimulatory sequences,has preventing and treating effect on allergic conjunctivitis caused by protein allergen.However,its effect on allergic conjunctivitis caused by fungal allergen is unclear. Objective This study aimed to investigate into whether the Th1-Th2 switching immunostimulatory CpG ODN could reverse the response in the murine allergic conjunctivitis model caused by aspergillus fumigatus. Methods A mixture of spores and hyphae of aspergillus fumigatus strain was used to induce allergic conjunctivitis in male BALB/C mice aged 6-8 weeks.This experiment was designed into preventive or therapeutical treatment program.Under both settings,allergic conjunctivitis of the animals were treated with CpG ODN,nonstimulatory GpC ODN or PBS.After the last challenge with the allergen,the clinical symptoms of the animals were scored based on the criteria of Magone.The animals were sacrificed and the histopathological examination of conjunctiva was performed.Expression of TLR4 mRNA in conjunctiva was analyzed by real-time PCR assay.The responsiveness and populations of lymphocytes in spleen and draining lymph nodes were analyzed by flow cytometry.The use complied with the Standard of Association for Research in Vision and Ophthalmology. Results In the prevention mode.CpG ODN decreased subconjunctival infiltration compared with GpC ODN and PBS groups with the average neutrophil count index(21.25 ±11.59/section,30.75 ±11.44 section and 69.00±9.90/section,respectively).Expression of TLR4 mRNA was up-regulated significantly by CpG ODN.The clinical scores for CpG ODN group were insignificantly lower than those in GpC ODN group and PBS group(P＞0.05).In the therapeutic mode,compared with GpC ODN and PBS groups,the allergic symptom score in CpG ODN group manifested significantly lower(t=4.000.t=2.750,P＜0.01)and showed fewer cellular infiltration(t=4.870,t=3.829,P＜0.01)and higher expression of TLR4 mRNA(P＜0.01).In cultured splenic and draining lymph node cells,increased percentages of CD4+ CD25+ and CD4+ CD25+ CD69+ in CpG ODN group were observed compared with control groups(|P＜0.05). Conclusion CpG ODN can relieve aspergillus fumigatus-induced allergic conjunctivitis via either subconjunctival injection or topical application by upregulating expression of TLR4 and activating Treg lymphocytes.

Promotion of the articular cartilage proteoglycan degradation by T-2 toxin and selenium protective effect / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To identify the relationship between T-2 toxin and Kashin-Beck disease (KBD), the effects of T-2 toxin on aggrecan metabolism in human chondrocytes and cartilage were investigated in vitro.</p><p><b>METHODS</b>Chondrocytes were isolated from human articular cartilage and cultured in vitro. Hyaluronic acid (HA), soluble CD44 (sCD44), IL-1beta and TNF-alpha levels in supernatants were measured by enzyme-linked immunosorbent assay (ELISA). CD44 content in chondrocyte membrane was determined by flow cytometry (FCM). CD44, hyaluronic acid synthetase-2 (HAS-2) and aggrecanases mRNA levels in chondrocytes were determined using reverse transcription polymerase chain reaction (RT-PCR). Immunocytochemical method was used to investigate expressions of BC-13, 3-B-3(-) and 2-B-6 epitopes in the cartilage reconstructed in vitro.</p><p><b>RESULTS</b>T-2 toxin inhibited CD44, HAS-2, and aggrecan mRNA expressions, but promoted aggrecanase-2 mRNA expression. Meanwhile, CD44 expression was found to be the lowest in the chondrocytes cultured with T-2 toxin and the highest in control plus selenium group. In addition, ELISA results indicated that there were higher sCD44, IL-1beta and TNF-alpha levels in T-2 toxin group. Similarly, higher HA levels were also observed in T-2 toxin group using radioimmunoprecipitation assay (RIPA). Furthermore, using monoclonal antibodies BC-13, 3-B-3 and 2-B-6, strong positive immunostaining was found in the reconstructed cartilage cultured with T-2 toxin, whereas no positive staining or very weak staining was observed in the cartilage cultured without T-2 toxin. Selenium could partly inhibit the effects of T-2 toxin above.</p><p><b>CONCLUSION</b>T-2 toxin could inhibit aggrecan synthesis, promote aggrecanases and pro-inflammatory cytokines production, and consequently induce aggrecan degradation in chondrocytes. These will perturb metabolism balance between aggrecan synthesis and degradation in cartilage, inducing aggrecan loss in the end, which may be the initiation of the cartilage degradation.</p>