Therapeutic Effect of Canagliflozin on Nephrotic Syndrome and Its Ultrasonic Evaluation / 中山大学学报(医学科学版)

ObjectiveTo investigate the therapeutic effect of antidiabetic drug canagliflozin （CGLZ） on adriamycin-induced nephrotic syndrome （NS） in rats， and the evaluation of contrast-enhanced ultrasound （CEUS） combined with color Doppler flow imaging （CDFI） during the treatment. MethodsA total of 56 male SD rats were randomly divided into normal group （NG）， model group （MG）， prednisone （PAT） group （PG）， low-dose single CGLZ group （LSCG）， high-dose single CGLZ group （HSCG）， low-dose CGLZ + PAT group （LUCG） and high-dose CGLZ + PAT group （HUCG）， with 8 rats in each group. The NS model in rats was induced by injecting adriamycin twice into the tail vein， and then the NS rats were treated by intragastric administration daily for 6 weeks with reference of PAT. Twenty-four hour urine total protein （24 h-UTP） was assessed one day before the start of oral administration and at the end of 2， 4 and 6 weeks after oral administration， respectively. CDFI and CEUS were performed on the right renal artery at the end of 6 weeks after oral administration， and the blood of abdominal aorta was taken for serological test the next day. ResultsCompared with those detection index of NG rats， the 24-hour UTP of MG rats increased （P＜0.01）， the serum ALB decreased and TG， TC， LDL increased （P＜0.01）， and CDFI shows that RRCT was thinner （P＜0.01） and the renal artery blood flow indicators RA-PI， RA-RI， RA-S/D all increased （P＜0.05）， and CEUS image shows that the TIC curve parameters TTP， AT， AUC all increased and DPI decrease in MG rats （P＜0.01）. After drug treatment， compared with those detection index of MG rats， 24 h-UTP decrease in LSCG after 2 weeks （P＜0.01）， and decrease significantly in all drug groups after 6 weeks （P＜0.01）； the serological test results show that the serum ALB in all CGLZ groups increased （P＜0.05）， TG decrease in LSCG （P＜0.01）， TC and LDL also decrease in LUCG after 6 weeks （P＜0.05）； CDFI shows that the RRCT thinning degree in all CGLZ is reduced （P＜0.01）， and the RA-PI in LSCG， RA-RI in PG， and RA-S/D in PG， LSCG， HSCG and LUCG rats all decreased （P＜0.05）； CEUS shows that the TTP， AT and AUC of renal TIC curve in drug treatment groups all decreased （P＜0.01）， and the DPI in PG， HSCG， LUCG and HUCG rats increased （P＜0.01）. ConclusionsCGLZ has the effect of treating NS， and the small dose is the best. CEUS combined with CDFI can be used to evaluate the renal morphology and hemodynamic changes of NS model rats before and after drug treatment， which is helpful to guide clinical application.

Study on the current status and feasibility of payment reform for TCM dominant diseases from the perspective of clinicians / 中国药房

OBJECTIVE To understan d the c urrent situation and feasibility of payment reform for TCM dominant diseases from the perspective of clinicians ，so as to provide reference for optimizing and improving the reform scheme. METHODS A questionnaire was designed by ourselves ，and a simple random sampling method was used to select clinicians from the pilot hospitals of payment reform for TCM dominant diseases in Guizhou province to conduct a face-to-face questionnaire survey. SPSS 20.0 software was used for statistical analysis. The single-factor analysis and ordered Logistic regression analysis of multi-factor were used to analyze the influential factors of reform feasibility. RESULTS A total of 420 questionnaires were distributed in this survey，and 413 valid questionnaires were recovered ，with an effective rate of 98.3％. Totally 86.0％ of the clinicians thought that it was feasible for the reform to be carried out in their hospitals ，and 81.8％ thought that the selected TCM dominant diseases in the pilot hospitals were reasonable. After the reform was carried out ，61.0％ and 58.8％ of clinicians indicated that the daily number of patients treated in their departments and their willingness to communicate with patients increased ，respectively；60.3％ indicated that the difficulties and obstacles encountered in the reform were the complexity and diversity of TCM diseases ，for the treatment of patients with integrated traditional Chinese and Western medicine ，which was difficult to use a unified disease and surgery code to correctly code ；76.3％ indicated that the greatest advantage of the reform implementation was the improvement of medical quality ，while 54.2％ indicated that the greatest disadvantage was the excessive restriction of doctors ’autonomy. The results of multi-factor ordered Logistic regression analysis showed that changes in treatment services （changes in readmission rate of patient），the reasonableness of the selection of TCM dominant diseases ，and whether to reduce medical costs ，improve doctor-patient relationship ， and promote hierarchical treatment were the influential factors of reform feasibility after the implementation of reform （P＜0.05）. CONCLUSIONS It is feasible to carry out payment reform for TCM dominant diseases in Guizhou province ，but it is still in the exploratery stage ，and there are many factors affecting the feasibility of the reform. It is suggested that in the future ，when promoting in the whole pr ovince and even the whole c ountry，we should pay attention to selecting more and more reasonable dominant diseases for payment reform ， further standardize the diagnosis and treatment behavior of clinicians ， control the unreasonablegrowth of medical expenses ， strengthen communication between clinicians and patients， improve the accurate diagnosis rate of traditional Chinese medicine diseases ，implement hierarchical calculation of dominant diseases ，and promote hierarchical diagnosis and treatment of medical institutions.

Research progress in establishment of N-methyl-N'-nitro-N-nitroso-guanidine-induced rat model of Precancerous lesion of gastric cancer / 中国中药杂志

Gastric cancer(GC), one of the most common malignancies worldwide, seriously threatens human health due to its high morbidity and mortality. Precancerous lesion of gastric cancer(PLGC) is a critical stage for preventing the occurrence of gastric cancer, and PLGC therapy has frequently been investigated in clinical research. Exploring the proper animal modeling methods is necessary since animal experiment acts as the main avenue of the research on GC treatment. At present, N-methyl-N'-nitro-N-nitroso-guanidine(MNNG) serves as a common chemical inducer for the rat model of GC and PLGC. In this study, MNNG-based methods for modeling PLGC rats in related papers were summarized, and the applications and effects of these methods were demonstrated by examples. Additionally, the advantages, disadvantages, and precautions of various modeling methods were briefly reviewed, and the experience of this research group in exploring modeling methods was shared. This study is expected to provide a reference for the establishment of MNNG-induced PLGC animal model, and a model support for the following studies on PLGC.

The applications of periodontal gingival surgery. Ⅱ: alternative materials / 华西口腔医学杂志

The main purposes of periodontal graft surgery include achieving root coverage, improving the clinical attachment level and keratinized tissue, and advancing the procedure of periodontal plastic surgery. Autogenous graft, such as subepithelial connective tissue graft-based procedure, provide the best outcomes for mean and complete root coverage, as well as increase in keratinized tissue. However, a disadvantage of the procedure is in the location of the operation itself: the additional surgical site (palate). Therefore, clinicians are always looking for graft substitutes. This article will discuss the evidence supporting the use of 1) acellular dermal matrix (ADM); 2) xenogeneic collagen matrix (XCM); 3) recombinant human platelet-derived growth factor (rhPDGF); 4) enamel matrix derivative (EMD); 5) guided tissue regeneration (GTR); 6) living cellular construct (LCC), all of which are used in conjunction with coronally advanced flaps as alternatives to autogenous donor tissue. The decision tree for treatments of Miller recession-type defects are also discussed.

Qangxin Granule Intervened Chronic Heart Failure Rats with Xin-qi Deficiency Complicated Blood Stasis and Edema Syndrome: an Experimental Study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study and evaluate the curative effect and mechanism of Qiangxin Granule (QXG) in intervening chronic heart failure (CHF) rats with Xin-qi deficiency complicated blood stasis and edema syndrome (XQD-BS-ES).</p><p><b>METHODS</b>Totally 72 SD rats of clean grade were randomly divided to the normal control group (n =10) and the model group (n = 62). The XQD-BS-ES rat model was established by adriamycin plus propylthiouracil method. Survived modeled rats were then randomly divided to 5 groups i.e., the model group (n = 11, administered with normal saline by gastrogavage), the Western medicine (WM) group (n =11 , administered with perindopril and hydrochlorothiazide by gastrogavage), the low dose QXG (QXG(L)) group (n = 11, administered with 9.26 g/kg QXG by gastrogavage), the middle dose QXG (QXG(M)) group (n = 11, administered with 18.52 g/kg QXG by gastrogavage), the high dose QXG (QXG(H)) group (n = 11, administered with 37.04 g/kg QXG by gastrogavage). After 4 weeks of treatment, left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), brain natriuretic peptide (BNP), heart rate (HR), respiratory rate (RR), urine output, ear temperature, exhaustive swimming test (EST), tri-iodothyronine (T3), tetra-iodothyronine (T4), thyroid stimulating hormone (TSH), as well as heart, lung, liver weight index and their pathological sections, and high sensitivity C-reactive protein (HS-CRP), angiotensin II (Ang II), carbohydrate antigen 125 (CA125) were detected and compared.</p><p><b>RESULTS</b>Compared with the normal control group, LVEF, LVFS, BNP, HR, RR, urine output, ear temperature, EST, T3, T4, TSH, HS-CRP, Ang II, and CA125 changed significantly in the model group (P < 0.01). Compared with the model group after treatment, LVEF, LVFS, BNP, urine output, EST, T4, heart and liver weight index, HS-CRP, Ang II, CA125 were significantly improved in each QXG group (P < 0.05, P < 0.01). Moreover, TSH was improved in the QXGL and QXG(M) groups (P < 0.05); ear temperature and T3 in the QXG(M) were also improved (P < 0.05); the lung weight index decreased in the QXG(M) and QXG(H) groups (P < 0.01). Compared with the WM group, T4 and CA125 were obviously improved in all QXG groups (P < 0.01); BNP and ear temperature were obviously improved in QXG(L) and QXG(M) groups (P < 0.05, P < 0.01); LVEF, LVFS and TSH were obviously improved in the QXG(M) group (P < 0.05, P < 0.01). And as far as each treatment group, LVEF, LVFS, urine output increased significantly after treatment (P < 0.01); EST obviously increased in QXG(M) and QXG(H) groups (P < 0.01); ear temperature increased in all QXG groups (P < 0.05, P < 0.01). Moreover, compared with the model group, pathological changes of heart, lung, and liver were improved to some degree in each treatment group, especially in the QXG(M) group.</p><p><b>CONCLUSIONS</b>Good curative effect was shown in each QXG group. QXG could improve LVEF, LVFS and BNP of CHF rats of XQD-BS-ES, as well as T3, T4, TSH, EST, urine output, and ear temperature. Moreover, QXG showed superiority than WM group in this respect.</p>

Establishment of chronic heart failure rat model of Xin-qi deficiency complicated blood stasis and edema syndrome and judgment of diagnosis information integration / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To establish and evaluate chronic heart failure (CHF) rat model of Xin-qi deficiency complicated blood stasis and edema syndrome (XQD-BSES).</p><p><b>METHODS</b>Totally 40 SD rats were randomly divided into the normal control group (Control), the propylthiouracil (PTU) group, the adriamycin (ADR), and the ADR + PTU group. Normal saline was used as equivalent solvent of each group. Rats in the Control group were intragastrically and intraperitoneally injected with normal saline. Rats in the PTU group were intragastrically injected with PTU suspension and intraperitoneally injected with normal saline. Rats in the ADR group were intragastrically injected with ADR solution and intraperitoneally injected with normal saline. And rats in the ADR + PTU group were intragastrically injected with PTU suspension and intraperitoneally injected with ADR solution. The dose of PTU was 0.2% of daily forage weight, once daily. The dose of ADR was 3.5 mg/kg, once per week. The modeling lasted for 6 weeks. Left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), brain natriuretic peptide (BNP), heart rate (HR), respiratory rate (RR), urine output, ear temperature, exhaustive swimming test (EST), Tri-iodothyronine (T3), tetra-iodothyronine(T4), thyroid stimulating hormone (TSH) as well as heart, lung, liver weight indices and their pathological sections were integrated and compared.</p><p><b>RESULTS</b>Compared with the Control group, LVEF, LVFS, BNP, HR, RR, heart, lung, liver weight indices, urine output, ear temperature, EST, and T3, T4, and TSH changed significantly in the ADR group, the PTU group, and the ADR + PTU group with statistical significance (P < 0.05), and pathological changes of heart failure occurred in pathological sections of heart, lung, and liver. Compared with the ADR group, LVEF, LVFS, BNP, and lung, liver weight indices, urine output, ear temperature, T3, T4, and TSH changed significantly in the ADR + PTU group with statistical significance (P < 0.05), and pathological changes of heart failure were more serious in pathological sections of heart, lung, and liver. Compared with the PTU group, LVEF, LVFS, BNP, HR, RR, urine output, EST, T4, heart and lung weight indices changed significantly in the ADR + PTU group with statistical significance (P < 0.05), and pathological changes of heart failure were quite serious in pathological sections of heart, lung, and liver.</p><p><b>CONCLUSION</b>ADR + PTU was an appropriate method to establish CHF rat model of XQD-BSES.</p>

Study on the metabolin difference of hypertension patients of gan-yang hyperactivity syndrome and yin-yang deficiency syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the metabolin difference between hypertension patients of Gan-yang hyperactivity syndrome (GYHS) and those of yin-yang deficiency syndrome (YYDS).</p><p><b>METHODS</b>Totally 26 hypertension patients at the Base for Chinese Medicine Clinical Research of Hypertension from June 2009 to May 2010 were assigned to two groups, the GYHS group (12 cases) and the YYDS group (14 cases). Besides, 14 healthy volunteers from the affiliated community were recruited as the control group. Their blood plasmas and principle component analysis (PCA) were analyzed by high performance liquid chromatography-time of flight mass spectrometry (HPLC-TOFMS) technology. The correlated metabolin and their metabolic pathways were identified using Metlin Database.</p><p><b>RESULTS</b>The PCA chart showed that the dispersion was larger in the control group than in the other two groups. The data of the GYHS group and the YYDS group showed gathering tendency. Further PCA results showed good spatial separation between the two groups, with significant difference between them. Totally 6 metabolins were detected. Of them, estrodiol, leucotriene, ceramide, and glucose-ceramide increased more in the GYHS group, while triglyceride and diacylglycerol increased more significantly in the YYDS group.</p><p><b>CONCLUSIONS</b>HPLC-TOFMS is capable of primarily identifying and clarifying different metabolic modes of the GYHS and the YYDS. Different contents of estrodiol, leucotriene, ceramide, glucose-ceramide, triglyceride, and diacylglycerol might probably become the differential points for identifying the two syndrome types.</p>

Evaluation on the effects of an education program regarding the sedentary behavior among school-aged children using Transtheoretical Model / 中华流行病学杂志

Objective To evaluate the outcome of a health education program on sedentary behavior among primary and secondary school children through Transtheoretical Model. Methods Five primary schools and four middle schools were selected and students from grade 3 to 5 in primary schools and grade 1 to 2 in middle schools were selected to take part in the program, as control and intervention groups respectively. Corresponding intervention measures were provided to the intervention group, with phase, process and level of changing on sedentary behavior measured for both groups during the follow-up period. Comparison to the above items on the two groups was measured statistically. Results Behavior among the intervention group was gradually changed regarding: phase contemplation, preparation and maintenance, with the proportions in phase action and maintenance higher than the control group. After carrying out of intervention programs, the sedentary time on weekdays between the two groups did not show significant differences. However, the sedentary time on weekends of intervention group was (2.53 ± 1.62) hours, significantly lower than the hours from the baseline survey (2.84 ± 1.82) and the control group (2.78 ± 1.72) respectively.During the follow-up period, the average score of intervention group in the changing process was (2.98 ± 0.77), higher than the control group (2.80 ± 0.81 ). At the same time, the average score of intervention group in the process of changing, decisional balance (pros) and self-efficacy were 2.98 ±0.77, 3.06 ± 0.75 and 3.13 ± 0.72, respectively, all higher than data from the baseline survey. In the control group, the process of changing and the average score on self-efficacy had improved.Conclusion The corresponding intervention program seemed to have played a significant role among the school-aged children on their sedentary behavior during the weekend but no significant difference was found in the weekdays.

Research on the behavior of fruit and vegetable intake in adolescents with Transtheoretical Model / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the current situation and factors influencing the behavior of fruit and vegetable intake in adolescents, and to discuss health education strategy related to the behavior.</p><p><b>METHODS</b>1677 students were selected from primary school and middle school in urban area of Hangzhou by a multistage sampling method. The behavior of fruit and vegetable intake was surveyed by questionnaires of the patient-centered assessment and counseling for exercise plus nutrition project (PACE+) for adolescent-scale of fruit and vegetable consumption, and analyzed by Transtheoretical Model on the servings of intake, the stage of change, process of change, decisional balance and the current status of self-efficacy.</p><p><b>RESULTS</b>The average intake of fruit and vegetable in adolescents was (3.21 +/- 1.50) servings per day ("one serving" means 100 g cooked vegetable or 100 g fruit). The behavior of consuming fruit and vegetable in most of the adolescents was in the contemplation stage, accounting for 36.91% (619/1677). The process of behavior change, decisional balance (Pros) and self-efficacy existed a positive correlation with the process of stage (r(process) = 0.38, r(decisional balance (Pros)) = 0.26, r(self-efficacy) = 0.33, t values were 16.78, 11.02 and 14.31, P < 0.05). The servings of fruit and vegetable intake existed a positive correlation with stage transition and self-efficacy (beta(stage transition) = 0.665, t = 35.07, P < 0.05; beta(self-efficacy) = 0.050, t = 2.63, P < 0.05), and existed a negative correlation with decisional balance (Cons) (beta(decisional balance (Cons)) = -0.051, t = -2.84, P < 0.05).</p><p><b>CONCLUSION</b>Fruit and vegetable intake of these adolescents are under the recommended dietary intake. Along with behavior stage development and self-efficacy improvement, the intake of fruit and vegetable also increased correspondingly. Intervention strategies should aim at improving the awareness of adolescents on the health benefits of fruit and vegetable intake and promoting their confidence to reach the recommended servings.</p>

Recommendations for dental clinical management in China / 华西口腔医学杂志

Comparing of dental clinical management in the USA, the authors would like to make some suggestions to Chinese colleagues in the following five aspects. They are included disadvantages of using disposable examination kit, using chair side X-ray machine, stopping using chair side spittoon, using topical anesthesia instead of using topical disinfection, patient management in the university hospital setting. The aims of this article were to open discussion and improve Chinese dental clinical management.

Effect of ginkgolide B on the function of rat aorta smooth cells and U937 cells stimulated by oxLDL / 药学学报

<p><b>AIM</b>To investigate the effect of ginkgolide B on the proliferation of VSMC and the secretion of chemokines by U937 cells stimulated by oxLDL or PAF. In addition, to analyze whether the effect of oxLDL is mediated through PAF receptor.</p><p><b>METHODS</b>Using 3H-Tdr incorporation assay, the proliferation of VSMC was measured. The protein and mRNA level of MCP-1 and IL-8 in U937 cells were determined by RT-PCR and ELISA. Using Western blotting the p65 and IkappaB was quantified. The binding of oxLDL to U937 cell was measured by a radio-ligand binding assay of 3H-PAF.</p><p><b>RESULTS</b>Ginkgolide B inhibited, in dose-dependent manner, the proliferation of VSMC and the secretion of chemokines by U937 cells stimulated by oxLDL, and inhibited the oxLDL-induced p65 activation and depletion of IKappaB. oxLDL inhibited PAF binding to U937 cells.</p><p><b>CONCLUSION</b>Ginkgolide B, as a PAF antagonist, possesses the effect of inhibiting the proliferation of VSMC and the secretion of chemokines by U937 cells stimulated by oxLDL in vitro. The effect of oxLDL is, at least in part, mediated through PAF receptor.</p>

Inhibitory effect of diacerein on osteoclastic bone destruction and its possible mechanism of action / 药学学报

<p><b>AIM</b>To study the inhibitory action of diacerein on the formation of osteoclasts (OCLs) and their activity in bone resorption as well as the relationship between this action and the expression of osteoprotegerin (OPG) and receptor activator of NF-kappaB ligand (RANKL) in MC3T3-E1 cells.</p><p><b>METHODS</b>A coculture system constituted with MC3T3-E1 cells and bone marrow cells for osteoclasts formation was established in vitro. TRAP-positive and multinucleated cells with three or more nuclei in each cell were counted as osteoclasts and the number of pits formed on the dentine slices was determined to judge the activity of osteoclasts. Western blotting, RT-PCR and flow cytometer were used to detect the expression of OPG and RANKL in MC3T3-E1 cells.</p><p><b>RESULTS</b>Diacerein significantly inhibited the formation and function of the cultured osteoclasts stimulated by IL-1beta. sRANKL could reverse the effect of diacerein. Diacerein inhibited protein and mRNA expression of RANKL but enhanced those of OPG in MC3T3-E1 cells.</p><p><b>CONCLUSION</b>Diacerein may inhibit osteoclastic bone destruction through the inhibition of RANKL expression and the increase of OPG expression in MC3T3-E1 cells.</p>