Preparation and Formulation Optimization of Ketoprofen Microemulsion-based Gel / 中国药学杂志

OBJECTIVE: To prepare the ketoprofen microemulsion-based gel in order to expand its drug loading and increase the transdermal permeability. METHODS: The proportion range of oil phase/surfactant in ketoprofen microemulsion were screened by the pseudo-ternary phase diagram. Optimization of formulation for microemulsion gels was conducted by central composite design-response surface methodology with the cumulative permeation quantity across in vitro rat skin and time-lag as evaluation indexes.The transdermal performance of self prepared gel was compared with the commercially available gel. RESULTS: The optimal oil phase, surfactant and cosurfactant of ketoprofen microemulsion were oleic acid, polyoxy ethylene castor oil (EL-35) and ethanol, respectively.The optimal microemulsion formulation was 1.35% oleic acid, 10.8% EL-35, and 9% ethanol by central composite design experiment. The cumulative penetration quantity in 24 h reached 562.82 μg•cm-2 in vitro rat skin was 1.35 times as much as commercially available gel. CONCLUSION: The ketoprofen microemulsion-based gel prepared in this study has good permeability, which lay the foundation for development of the gel.

Establishment of a Predictive Diagnostic Model for Acute Mycoplasma Pneumoniae Infection in Elderly Patients with Community-acquired Pneumonia / 生物医学与环境科学（英文）

We established a diagnostic model to predict acute Mycoplasma pneumoniae (M. pneumonia) infection in elderly Community-acquired pneumonia (CAP) patients. We divided 456 patients into acute and non-acute M. pneumoniae infection groups. Binary logistic regression and receiver operating characteristic (ROC) curves were used to establish a predictive model. The following independent factors were identified: age ⋝ 70 years; serum cTNT level ⋝ 0.05 ng/mL; lobar consolidation; mediastinal lymphadenopathy; and antibody titer in the acute phase ⋝ 1:40. The area under the ROC curve of the model was 0.923 and a score of ⋝ 7 score predicted acute M. pneumoniae infection in elderly patients with CAP. The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M. pneumoniae infection.

Determination of eight active components in Radix Hedysari by HPLC and its cluster analysis / 药学学报

An HPLC method was established for the determination of adenosine, γ-aminobutyric acid (GABA) and six flavonoids (calycosin-7-glucoside, ononin, calycosin, isoliquiritigenin, formononetin and medicarpin) in Radix Hedysari. The samples were extracted with methanol by refluxing for 4 h. The HPLCDAD was performed on a Diamonsil C18 column (250 mm×4.6 mm, 5 μm) with acetonitrile-water as the mobile phase. The column temperature was at 40℃ and the flow rate was 1.0 mL·min-1, while the temperature of drift tube was 110.5℃ and the nebulizing gas flow was 3.1 L·min-1 for the ELSD system. The results showed all the eight components had good linear relationships (r2=0.992 8-1.000 0) in the range of the test concentration. The RSD of precision, stability and repeatability were less than 2%. The average recovery rates were 96.78%-103.45%, and RSD were 0.29%-1.61%. The index component contents of Radix Hedysari form 24 different origins were determined and used as variable factors in clustering analysis. The results were classified into 2 groups basically in accordance with the regional cluster. And the consequence was in consistent with the results of principal component analysis. This HPLC method is simple, shows good sensitive and accurate, and provides the experimental basis for multi-index control of Radix Hedysari. Clustering analysis for Radix Hedysari quality control has a certain reliability and objectivity.

Metabolic regulatory and anti-oxidative effects of modified Bushen Huoxue decoction on experimental rabbit model of osteoarthritis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the metabolic, regulatory and anti-oxidative effects of modified Bushen Huoxue Decoction (BSHXD), a Chinese herbal medicine for kidney (Shen)-reinforcement and blood-activation, on an osteoarthritis (OA) rabbit model.</p><p><b>METHODS</b>A rabbit model for knee joint OA was established by the classic Hulth's method. The OA model rabbits were randomized into 5 groups: the model control group, the positive control group treated with glucosamine sulfate, and the three BSHXD treated groups treated respectively with low, moderate, and high doses of BSHXD. In addition, a normal control group and a sham-operated group were set up. Experimental animals were sacrificed after a 7-week treatment, and pathological changes in cartilaginous tissue were estimated using the Mankin criteria. Hydroxyproline (Hyp) and malonaldehyde (MDA) contents in blood serum and urine, as well as superoxide dismutase (SOD) activity and nitric oxide (NO) content in blood serum and knee joint synovial homogenates were detected.</p><p><b>RESULTS</b>Mankin scoring showed insignificant statistical differences between the various treatment groups (P >0.05), but all were better than the model control group (P <0.05). Serum and urinary contents of Hyp and MDA as well as serum and synovial levels of NO were significantly lower, but the SOD activity in blood serum and synovial tissue was higher in the BSHXD treated groups than in the model group P <0.01); the effect of BSHXD was dose-dependent to some extent.</p><p><b>CONCLUSION</b>The modified BSHXD shows an effect of improving cartilage metabolism in experimental rabbits with OA, and possesses osteo-chondric protective effects in antagonizing peroxidation injury.</p>

Long-term efficacy of integrative medicine for treatment of systemic lupus erythematosus / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the long-term efficacy of integrative medicine in treating systemic lupus erythematosus (SLE).</p><p><b>METHODS</b>Adopting randomized grouping method, the SLE patients were assigned to two groups, 74 in each group, the treatment group treated by combined hormonotherapy with Chinese drugs for detoxifying, and the control group treated by hormonotherapy alone. The period of the stable phase and active phase, clinical manifestations, 24-h urinary protein, systemic lupus erythematosus disease activity index (SLEDAI) score and complement 3 (C3), etc. were observed.</p><p><b>RESULTS</b>After 5-year treatment, the clinical manifestations, including arthritis, hydrohymenitis and fever revealed between groups were significantly different (P < 0.05). Comparison between groups in the 5th year of observation showed that the treatment group had a longer time of the stable phase (305.41 +/- 14.32 days); lower SLEDAI scores (8.28 +/- 4.12) and 24-h urinary protein (0.18 +/- 0.01)g, and a higher level of C3 (0.98 +/- 0.35 g/L) than those in the control group (190.22 +/- 15.43 days, 12.79 +/- 5.43 scores, 0.31 +/- 0.06 g and 0.73 +/- 0.34 g/L), respectively, with statistical significances (P < 0.05). Adverse reactions occurred in 15 cases in the treatment group and 62 cases in the control group, also with significant difference between groups (P < 0.05).</p><p><b>CONCLUSION</b>The combined therapy of Chinese and Western medicine can prolong the stable phase time and shorten the lasting period of SLE in patients, which embodies the view of "treating disease before its onset".</p>

Exploration into relationship between TCM syndrome type and laboratory indexes in patients with systemic lupus erythematosus / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the relationship between TCM syndrome type and laboratory indexes in patients with systemic lupus erythematosus (SLE).</p><p><b>METHODS</b>Three hundred and eighty-three SLE patients were differentiated into six syndrome types based on the "toxin" sydrome differentiation of TCM, Type 1, the heat-toxin flourishing type; Type 2, the stasis heat with toxin type; Type 3, the turbid toxin congested type; Type 4, the general deficiency with evil stay type; Type 5, the heat-toxin burning yin type; Type 6, the Gan-stagnant with toxin convergency type. The indexes, including complement C3 (C3), immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), alanine aminotransferase (ALT), 24 h urinary protein quantitation, white blood cell (WBC) and platelet (PLT) count, were determined, and the SLEDAI score was calculated.</p><p><b>RESULTS</b>Levels of IgA and IgM in all patients were basically normal. Level of IgG was higher than the normal range in patients of type 1 and 2, being 18,713.81 mg/L and 23,131.54 mg/L respectively, showing significant difference between the Type 2 and Type 3 (P < 0.05); the lowest mean value of C3 presented in patients of type 1 (586.32 mg/L), and that in patients of type 4 was significantly different to that in patients of other types (P < 0.05); count of WBC and PLT was lower in patients of type 5 and significantly different to that in the other five types (P < 0.05); level of 24 h urinary protein quantitation was higher than normal in all the patients and the highest level (2.78 g/24 h) was found in patients of type 3; and the highest level of ALT (112.75 U/L) appeared in patients of type 6 as compared with that in patients of other types.</p><p><b>CONCLUSION</b>Different variations of laboratory indexes present in SLE patients of different syndrome types, there are certain relationship between the TCM syndrome types and the laboratory indexes, and these rules may provide reference for evaluating clinical therapeutic effects.</p>

Effect of chinese herbs in enhancing prednisone for treatment of refractory rheumatoid arthritis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the Chinese herbal medicine in enhancing effect of prednisone for treatment of refractory rheumatoid arthritis (RA).</p><p><b>METHODS</b>One hundred and twenty patients with refraetory RA were assigned to two groups, the treated group was orally administered with Qingbi Tablet, a patent Chinese herbal preparation formulated based on the clearing heat and removing toxic substances principle, and the control group was treated with intramuscular injection of amethopterin (MTX), oral intake of voltaren 75 mg and hydroxychloroquine 0.2 g once a day. Besides prednisone was given to all patients orally, the initiating dosage used in the treated group was lesser than that in the control group. The clinical index, dosage and adverse reaction of prednisone were recorded every 2 weeks.</p><p><b>RESULTS</b>The curative effect evaluated by American College of Rheumatology (ACR) standard showed no statistical difference between the two groups (P > 0.05). Either clinical or laboratory indexes were improved significantly in both groups (P < 0.05), but the improvement in resting pain, patient's self-evaluation and doctor's evaluation in the treated group were better than those in the control group, showing statistical difference (P < 0.05). The 20-week total amount of prednisone used in the treated group was less than that in the control group (32,935 mg vs. 51,170 mg), while the dosage of prednisone used in various observation time points between the two groups was also significantly different respectively (P < 0.05), the former was less than the latter.</p><p><b>CONCLUSION</b>Chinese herbal medicine can enhance the effect of prednisone in patients of refractory RA and alleviate the adverse reactions of prednisone.</p>