Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus

Background@#Type 2 diabetes mellitus (T2DM) is characterized by elevated fasting glucagon and impaired suppression of postprandial glucagon secretion, which may participate in diabetic complications. Therefore, we investigated the associations of plasma glucagon with estimated glomerular filtration rate (eGFR), albuminuria and diabetic kidney disease (DKD) in T2DM patients. @*Methods@#Fasting glucagon and postchallenge glucagon (assessed by area under the glucagon curve [AUCgla]) levels were determined during oral glucose tolerance tests. Patients with an eGFR <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g who presented with diabetic retinopathy were identified as having DKD. @*Results@#Of the 2,436 recruited patients, fasting glucagon was correlated with eGFR and UACR (r=–0.112 and r=0.157, respectively; P<0.001), and AUCgla was also correlated with eGFR and UACR (r=–0.267 and r=0.234, respectively; P<0.001). Moreover, 31.7% (n=771) presented with DKD; the prevalence of DKD was 27.3%, 27.6%, 32.5%, and 39.2% in the first (Q1), second (Q2), third (Q3), and fourth quartile (Q4) of fasting glucagon, respectively; and the corresponding prevalence for AUCgla was 25.9%, 22.7%, 33.7%, and 44.4%, respectively. Furthermore, after adjusting for other clinical covariates, the adjusted odds ratios (ORs; 95% confidence intervals) for DKD in Q2, Q3, and Q4 versus Q1 of fasting glucagon were 0.946 (0.697 to 1.284), 1.209 (0.895 to 1.634), and 1.521 (1.129 to 2.049), respectively; the corresponding ORs of AUCgla were 0.825 (0.611 to 1.114), 1.323 (0.989 to 1.769), and 2.066 (1.546 to 2.760), respectively. Additionally, when we restricted our analysis in patients with glycosylated hemoglobin <7.0% (n=471), we found fasting glucagon and AUCgla were still independently associated with DKD. @*Conclusion@#Both increased fasting and postchallenge glucagon levels were independently associated with DKD in T2DM patients.

Quality value transmitting of volatile components in personalized preparations:a case study of Menthae Haplocalycis Herba / 中国中药杂志

Considering the characteristic chromatograms and quality value transmitting of three volatile components, this study investigated the changes in volatile components of Menthae Haplocalycis Herba in each heating process of personalized preparations and identified the critical control points for the application of volatile components from traditional Chinese medicine in such preparations. The characteristic chromatograms of volatile components in Menthae Haplocalycis Herba were established by gas chromatography, followed by the quantitative determination of three volatile components menthone, menthol, and piperitone and the comparison of retention rates of volatile components during the crushing, extraction, concentration and drying of preparation products and their change rules in characteristic peaks. The results showed that the volatile components of Menthae Haplocalycis Herba were reduced in each process. The loss rate was low in the crushing process when the volatile component peaks were present, but high in the extraction and concentration processes, manifested as the absence of partial component peaks and the presence of new component peaks. The changes in volatile components of Chuanxiong Chatiao Granule in the drying process were compared with those in Chuanxiong Chatiao Pill, both of which were prepared from the raw Menthae Haplocalycis Herba powder, and the findings demonstrated that Chuanxiong Chatiao Pill was superior to Chuanxiong Chatiao Granule. This study confirmed that the retention rates of volatile components in Menthae Haplocalycis Herba were mostly affected by the extraction and concentration processes, and the packing of preparations helped to reduce the loss of volatile components in Menthae Haplocalycis Herba powder, which has provided reference for the application of Chinese medicinal materials containing volatile components in the personalized preparations.

Preparation of personalized traditional Chinese medicine condensed water pill without excipients based on correlation between concentrate viscosity and molding quality / 中国中药杂志

To explore the correlation between concentrate viscosity and molding quality of personalized traditional Chinese medicine(TCM) condensed water pill, this study established a concentrate viscosity characterization method with rotational rheometry. Seven model prescriptions were respectively concentrated to different degrees and the viscosity of each concentrate was determined. The pre-sence of 'viscosity jump' in the middle stage of 'flag hanging' of all the model prescriptions implied that there might be an ideal viscosity range in the preparation of condensed water pill. The further study of 22 model prescriptions demonstrated that the optimum viscosity range of concentrate was 5-15 Pa·s(25 ℃) for approximately 82% of the prescriptions. About 18% of the prescriptions had a wide range, which might be caused by the high proportions of mineral and crustacean drugs in the crushing part and sugar and fibrous drugs in the decocting part. This study clarified the optimum viscosity range for concentrates of personalized TCM condensed water pills and achieved a preparation technology without any excipient, laying a foundation for the on-line control of the preparation.

Establishment of prediction model for personalized water-paste pills based on classification of traditional Chinese medicine materials / 中国中药杂志

The purpose of the present study was to investigate the relationship of the classification of traditional Chinese medicine(TCM) materials with the suitable binder concentration and dosage in the preparation of personalized water-paste pills and establish a model for predicting the binder concentration and dosage. Five representative TCM materials were selected, followed by mixture uniform design. The water-paste pills were prepared by extrusion and spheronization with hypromellose E5(HPMC E5) as the binder. The quality of intermediates and final products was evaluated, and the resulting data were subjected to multivariate statistical analysis. The prediction models for binder concentration and dosage were established as follows: binder concentration: Y_1=0.378 6 + 0.570 1X_A + 2.271 2X_B-0.894 5X_C-0.458 2X_D-1.145 4X_E(when Y_1 < 0, 10% HPMC E5 was required; when Y_1 > 0, 20% HPMC E5 was required), with the accuracy reaching up to 100%; binder dosage: Y_2=32.38 + 0.25X_A + 1.85X_B-0.013X_B~2-0.002 5X_C~2(R~2=0.932 6, P < 0.001). The results showed that the binder concentration and dosage were correlated positively with the proportion of fiber material but negatively with the proportions of sugar material and brittle material. Then the validation experiments were conducted with the prediction models and all the prescriptions could be successfully prepared at one time. These demonstrated that following the classification of TCM materials and the calculation of their proportions in the prescription, the established mathematical model could be adopted for predicting the binder concentration and dosage required in the preparation of personalized water-paste pills, which contributed to reducing the pre-formulation research and guiding the actual production of personalized water-paste pills.

Material classification of decoction pieces based on physical properties of powder / 中国中药杂志

Chinese medicinals feature different medicinal parts and enriched components, which makes their powders show obvious microscopic identification characteristics and specific physical properties. On this basis, the commonly used Chinese medicinals can be divided into several categories, such as powdery, fibrous, sugar, oil, and brittle materials, which is of great importance to the research and development of personalized Chinese medicinal preparation technology. However, the existing classification methods are highly subjective and thus difficult to meet the requirements for the development of personalized Chinese medicinal preparations with high quality. In this study, 55 representative Chinese medicinals, such as Dioscoreae Rhizoma and Leonuri Herba, were selected, and the physical properties of their powders were systematically characterized by comprehensive powder tester, torque rheometer, texture analyzer, etc., based on which a data set encompassing physical properties of these powders was built. The typical physical fingerprints of powders from the above 5 categories were established by multivariate statistical analysis. Then, the Chinese medicinals were classified according to the Euclidean distance between each of them and the typical value in the PCA score plot. For those with multiple material properties, whose classification boundary was fuzzy, the proportions of different types of materials were calculated with the combination of Euclidean distance, powder properties, microscopic identification characteristics, and chemical composition, so as to achieve the multivariate quantitative classification of Chinese medicinals. This lays the foundation for the further creation of intelligent personalized Chinese medicinal preparation technology.

Characteristics and development assumptions of personalized traditional Chinese medicine granules / 中国中药杂志

Personalized traditional Chinese medicine(TCM) granules are positioned as a solid dosage form of TCM decoctions, boasting strong applicability and wide application range. The market prospect of personalized TCM granules is promising in that their preparation by mixed decoction makes up for the shortcoming of formula granules like the Chinese patent medicine granules and classical TCM prescription granules whose components cannot be changed flexibly. However, such factors as insufficient basic research, equipment mismatch, and low process commonality have limited their clinical application. After analyzing the characteristics of perso-nalized TCM granules, their production status, and the bottlenecks restricting their development, this paper pointed out the meaning and key points of developing a generalized preparation process for personalized TCM granules and affirmed the vital roles of the preparation and process prediction system and the on-line detection technology in improving the productivity of granulation. Finally, some assumptions on technology development for solving the specific problems of personalized TCM granules were shared to provide some ideas for the application and development of personalized TCM granules in clinical practice.

Application,problems,and development strategies of personalized traditional Chinese medicine preparations / 中国中药杂志

With the continuous improvement of people's living standards and the greatly accelerated pace of life, patients' requirements for traditional Chinese medicine(TCM) pharmaceutical care are constantly raised, and personalized TCM preparations used are increasing year by year. However, a series of problems, such as the bottleneck of preparation technology, the lack of preparation specifications, and the weak legal basis for supervision, have become prominent, leading to the uneven product quality of personalized pre-parations. This paper systematically summarized and analyzed the current situation and existing problems of personalized TCM preparations, including dosage form application, preparation technology, production equipment, quality standard, clinical application, and administration mode. Additionally, it put forward an inheritance and innovation research mode of personalized TCM preparation technology based on the physical fingerprint of raw materials and innovation research and intellectual property protection mode of "research-patent-technology-equipment-standard". Furthermore, innovative development strategies were proposed, such as the production standard system of clinical preparations based on the whole process traceability and the regional processing service mode of clinical preparations based on industry 4.0. The present study is expected to provide beneficial references for the inheritance and innovation development of personalized TCM preparations.

Improving compactibility properties of Lonicera Japonica Flos by Plasdone S-630 / 药学学报

To improve the fluidity and compactibility properties of raw powders of traditional Chinese medicine by particle modification technology, Lonicera Japonica Flos was used as a model drug, fluidized bed bottom spray technology was used, and Plasdone S-630 was used as a modifier to prepare modified particles. The powder properties, tablet compactibility parameters, disintegration time and dissolution were measured. The surface morphology of the powder particles before and after modification and compressed tablets were characterized by combining with scanning electron microscopy technology. The results showed that the particle size of Lonicera Japonica powder has been increased after particle modification, the fluidity, compressibility and compactibility of the powder have been improved to some extent, the disintegration time has also been reduced, and the dissolution in vitro is not affected. Therefore, this study can provide reference and ideas for the common problem that raw powder of traditional Chinese medicine that cannot meet the needs of preparation production due to poor powder properties such as fluidity and compressibility.

Value of TIMI and GRACE score systems in predicting in-hospital events in Chinese patients with non-STsegment elevation myocardial infarction / 第二军医大学学报

Objective To evaluate the clinical value of thrombolysis in myocardial infarction (TIMI) and global registry of acute coronary events (GRACE) score systems in predicting the risk of in-hospital events in Chinese patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods Patients with NSTEMI admitted to the Department of Cardiovasology, Renji Hospital, Shanghai Jiao Tong University School of Medicine between Jan. 1 to Dec. 1, 2017 were consecutively enrolled. The end-point events were in-hospital mortality, reinfarction, heart failure, cardiac skock, and sudden cardiac arrest. Patients were scored by TIMI and GRACE score systems on hospital admission, and receiver operating characteristic (ROC) curve was used to evaluate the value of the two score systems and the combination of both in predicting in-hospital events. TIMI score was used to screen all the patients, and the TIMI medium-risk patients were further divided into GRACE high-risk subgroup (GRACE score≥140) and GRACE non-high-risk subgroup (GRACE score<140). The incidence of in-hospital events was compared between the two subgroups. Results A total of 232 patients were included in this study (163 males and 69 females, with an average age 66.1 years and 95% confidence interval [CI] 64.6-67.6 years). TIMI score grouped 69 (29.7%), 142 (61.2%) and 21 (9.1%) patients into low-, medium- and high-risk, and the incidence rates of in-hospital events were 14.5% (10/69), 24.6% (35/142) and 33.3% (7/21), respectively. GRACE score grouped 41 (17.7%), 85 (36.6%) and 106 (45.7%) paitents into low-, medium- and high-risk, and the incidence rates of in-hospital events were 7.3% (3/41), 11.8% (10/85) and 36.8% (39/106), respectively. GRACE score and TIMI score both demonstrated good discrimination and GRACE performed better for in-hospital events (area under curve [AUC] 0.81 vs 0.62, P<0.001). Further subgrouping the TIMI medium-risk group, we found that GRACE high-risk subgroup had significantly higher incidence rate of in-hospital events than the GRACE non-high-risk subgroup (38.2% [29/76] vs 9.1% [6/66], odds ratio 6.2, 95% CI 2.4-16.1, P<0.001). Combination of TIMI and GRACE scores improved the predictive value of in-hospital events (AUC=0.71, 95% CI 0.65-0.77), with a favorable higher positive predictive value than that of TIMI or GRACE score alone (37.1% vs 33.3% and 36.8%). Conclusion GRACE score has better predictive accuracy than TIMI score in Chinese NSTEMI patients, but sacrifices simplicity. The combination of GRACE and TIMI scores is an easy and effective discriminative tool in predicting in-hospital events in Chinese NSTEMI patients.

Improvement on the tableting properties of traditional Chinese medicine extracts by fluid-bed coating and pore forming / 药学学报

This paper aimed to study the effect of combined co-processing of coating and pore forming on the tableting and tablet properties of traditional Chinese medicine (TCM) extracts together with its applicability. Four TCM extracts were co-processed using fluid bed with hydroxypropyl methyl cellulose (HPMC) as coating agent and ammonium bicarbonate (NH4HCO3) as pore-forming agent. Powder properties (such as particle size and size distribution, bulk density, tap density, moisture content) and tablet properties (including tensile strength, compaction ratio, fast elastic stretch, and disintegration time) were measured and compared among the powders. Scanning electron microscopy (SEM) was applied to characterize the surface of particles and tablets. Results showed that the particle size, flowability, and compactibility of the composite particles with HPMC were superior to the parent powders of TCM extracts. These properties of the porous particles with HPMC and NH4HCO3 showed further improvements. In addition, the addition of HPMC prolonged the disintegration time of tablets, whereas the pore-forming effect of NH4HCO3 could shorten the disintegration time. SEM revealed the changes in the morphology of the composite particles and the pores on the surface of the porous particles and tablets. In conclusion, co-processing with HPMC and NH4HCO3 could improve the powder and tablet properties of TCM extract powders, and this method shows certain applicability, which provides a feasible choice for improving the tableting properties of some TCM extract powders.

Change of BMI in catch-up growth of low birth weight infants aged 0-24 months / 上海预防医学

Objective To investigate the changes and characteristics of body mass index (BMI) of low birth weight infants during catch-up growth within 24 months of life. Methods Using the birth cohort method, 126 low birth weight children (birth weight less than 2 500 g) among the registered and permanent born in Jiading District from January 2016 to December 2016, were enrolled in the study voluntarily.According to the calculation of birth weight and gestational week, 73 children were included in the preterm appropriate for gestational age group and 53 in the full-term small for gestational age group.105 children with gestational age of 37-41 weeks and birth weight of 2 500-3 999 g were included as the control group.The differences of BMI mean and standard deviation were compared between 0-24 months old in three groups, and the changes of BMI curve analyzed between 0-24 months old in boys and girls. Results ① There were 231 infants investigated, who were composed by 111 boys and 120 girls; ② The BMI of the two groups of low birth weight infants at birth and at 2 months old were lower than those of the control group.There was no significant difference between the BMI of preterm appropriate for gestational age group and the control group since the age of 4 months.The BMI of the term small for gestational age group was less than the other two groups between 4 and 18 months of age, the difference was statistically significant (P < 0.05);③ The BMI index of the three groups showed a rapid rise after birth.It peaked at 4-6 months of age, and the BMI value of 7-9 months of age began to fall.Preterm appropriate for gestational age group infants caught up with the BMI of normal-weight infants at 6 months of age.Until the age of 24 months, the BMI of small for gestational age group was still different from normal weight infants, but the difference between the three groups decreased.The rising curves of BMI between boys and girls were similar, but the peak of preterm appropriate for gestational age group girls was lengthened. Conclusion There is a significant catch-up growth for low birth weight infants aged 0-24 months, having a similar trend of normal infants in the late stage.It is necessary to deliver proper breeding education and intervention to the low birth weight infants in their early stages.

Risk factors influencing prognosis in surgical patients with proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical and imaging data of proliferative diabetic retinopathy(PDR)treated by pars plana vitrectomy(PPV), and to further explore the risk factors associated with poor prognosis. <p>METHODS: Data of 90 eyes of 90 patients at Guangxi Zhuang Autonomous Region People's Hospital from January 2016 to December 2018 were retrospectively reviewed. According to the postoperative visual acuity, the patients were divided into favorable prognosis group(group A)and unfavorable prognosis group(group B). To explore the clinical and image risk factors and prognosis of disease outcome. Univariate analysis uses Chi-square analysis,while multivariate analysis takes Logistic regression analysis. <p>RESULTS: Univariate analysis showed that there was much more difference between good prognosis and those with poor prognosis: the preoperational PRP treatment experience(<i>P</i>=0.042), HbA1c(<i>P</i>=0.008), OCT-TRD(<i>P</i>=0.004), OCT-HRF(<i>P</i>=0.005). Multivariate logistic regression analysis showed that HbA1c(<i>OR</i>=1.439, <i>P</i>=0.009)and OCT-TRD(<i>OR</i>=4.007, <i>P</i>=0.040)were independent risk factors for poor prognosis after proliferative diabetic retinopathy. <p>CONCLUSION: HbA1c and OCT-TRD are independent predictors of poor prognosis in PDR patient.

Development status and research strategy of traditional Chinese medicine temporary prescription preparation technology / 中国中药杂志

Temporary prescription preparation is the preparation processed into different dosage forms by relevant pharmacist according to the temporary preparation requirement and the personalized prescription made by the doctor in accordance with the syndrome differentiation and drug performance.It is an important part in personalized pharmaceutical services.Rational design of process route,production equipment and quality control method for the temporary prescription preparation,and establishment of technology research strategy and mode in accordance with the characteristics of traditional Chinese medicine temporary prescription preparations play an important role in promoting the development of the temporary prescription preparations.To promote the normalization,standardization and intelligent development of temporary prescription preparations,we would comprehensively summarize the significance,policy,technology characteristics,technology research status quo and existing problems in this paper,and put forward the research direction of temporary prescription preparation technology based on the physical properties of raw materials,equipment research strategy,and intelligent manufacturing technology.Thus it will push the inheritance and innovation of temporary prescription preparation.

Bioadhesive pellets of astragalosides: preparation and adhesive evaluation based on the physical properties of wet mass / 药学学报

Bioadhesive preparation can be attached to specific sites to control drug release rate, increase drug concentration and increase efficacy, which is based on natural or synthetic polymer material. In this paper, based on the physical properties of wet mass, a method for screening adhesion formulation was proposed, which was different from conventional way of screening optimal formulation, and astragalosides loaded bioadhesive pellets were prepared by extrusion-spheronization method (extrusion speed 30 r·min-1, spheronization speed 808 r·min-1, spheronization time 7.5 min) based on this formulation screening method, small living animal imaging technology and mucin from porcine stomach model were used to evaluate the in vivo and invitro adhesiveness behaviour of the pellets. According to the relationship between the physical properties of wet mass and the formability and adhesiveness of bioadhesive pellets, five key physical properties hardness (Ha), adhesiveness (Ad), springiness (Sp), cohesiveness (Co), chewiness (Ch) were selected as the index of screening optimal formulation, therefore a comprehensive evaluation model was established, which based on principal component analysis, to did digital ranking for these proposed adhesion formulation, the optimal formulation was determined: microcrystalline cellulose: (chitosan∶Carbomer 940 = 2∶1), the adhesive material dosage accounted for 20% of the excipient dosage, and the ratio of drugs to excipients was 1 : 4. All animal experiments have been approved by Ethics Committee of Shanghai University of Traditional Chinese Medicine. The in vivo and in vitro adhesive evaluation results showed the pellets had a clear advantage in intestinal adhesion over normal pellets, its also proved the scientificity and reliability of the method of screening bioadhesive formulation.

Effect of long-chain non-coding RNA AL136359.1 on the proliferation and migration of cholangiocarcinoma cells by up-regulating the expression of AKR1B10 / 中国医师杂志

Objective To detect the expression of AL136359.1 in cholangiocarcinoma tissues and cells and analyze its effect on proliferation and migration of cholangiocarcinoma cells.Methods The expression of AL136359.1 in 8 cholangiocarcinoma tissues and 4 cholangiocarcinoma cell lines (QBC939,RBE,HCCC-9810 and TFK-1) was detected by real-time quantitative PCR (qRT-PCR).Transfection of plasmid carrying AL136359.1 in the cholangiocarcinoma cell line with the lowest expression level of AL136359.1 were used to increase the expression of AL136359.1,and the transfection efficiency was verified by qRT-PCR.qRT-PCR and Western blot were used to detect the expression of AKR1 B10 at mRNA and protein levels.The cell counting kit (CCK-8) and transwell migration assay were used to detect the effect of high expression of AL136359.1 on the proliferation and migration ability of cholangiocarcinoma cells.Results The expression of AL136359.1 in cholangiocarcinoma tissues (0.41± 0.05) was significantly lower than that in adjacent tissues (2.94 ± 0.44,P ＜ 0.01).The expression of AL136359.1 in cholangiocarcinoma cells was significantly lower than that in human normal cholangioepithelial cells (P ＜0.01),and the QBC939 cells had the lowest expression (P ＜ 0.01).High expression of AL136359.1 caused an increase in the expression of AKR1 B10 at mRNA and protein levels (P ＜ 0.01).High expression of AL136359.1 could significantly inhibit the proliferation and migration of cholangiocarcinoma cells (P ＜0.01).Conclusions The expression of AL136359.1 were decreased in cholangiocarcinoma tissues and cell line.The high expression of AL136359.1 could up-regulate the mRNA expression of AKR1B10 gene,which was involved in inhibiting the proliferation and migration of QBC939 cells.

Imaging evaluation of post-myocardial infarction injury / 上海交通大学学报（医学版）

Imaging techniques play a vital role in evaluating myocardial damage in patients with myocardial infarction. Accurate evaluations of postinfarction function and scar can help identify high-risk patients and provide prognosis information, which contributes much to clinical practice. The assessment of myocardial damage mainly includes overall evaluations of ventricular function and remodeling and targeted characterization of myocardial infarction including infarct size, myocardial viability and microvascular obstruction. Echocardiography, cardiac magnetic resonance, CT and nuclear examinations are most common imaging techniques currently. This review is to update evidence on applications of these modalities in evaluation of postinfarction myocardial damage and offer some helps to health workers.

Intervention Effect of Dachuanxiong Fang Multi-component Preparation on Acute Migraine Rat Model by Urine Metabolomics / 中国实验方剂学杂志

Objective: To investigate the intervention effect of Dachuanxiong Fang multi-component preparation on acute migraine rats, in order to explore the possible mechanism by using urine metabolomics technology. Method: The forty SD rats were randomly divided into 5 groups (n=8), control group, model group, low-dose Dachuanxiong Fang multi-component preparation (DCXF) group (0.19 g·kg-1), medium-dose DCXF group (0.37 g·kg-1), and high-dose DCXF group (0.74 g·kg-1). Rats were subcutaneously injected with 10 mg·kg-1 nitroglycerin for modeling, and Dachuanxiong Fang multi-component preparation was administered through intragastric administration. After half an hour of administration, blood was collected from the abdominal aorta, and the content of 5-hydroxytryptamine (5-HT), 5-hydroxyindole-3-acetic acid (5-HIAA), nitric oxide (NO), nitric oxide synthase (NOS), calcitonlin gene related peplide (CGRP), dopamine(DA) in plasma were determined by enzyme-linked immuno sorbent assay (ELISA) kits. The contents of 5-HT and NOS in the hypothalamus and brainstem of the control group and the model group were analyzed, and the average optical density value was used for statistical analysis. UPLC-TOF/MS combined with principal component analysis (PCA) analysis was used to analyze different groups of rats and discover differential metabolites. Differential metabolites were analyzed by MetaboAnalyst 3.0 software for possible metabolic pathways. Result: After modeling, compared with the control group, the content of neurotransmitters in the model group was significantly increased (PPPβ-hydroxybutyrate showed an upward trend. According to the metabolic pathway prediction study, metabolic pathways with a higher correlation were found to be alanine, aspartic acid and glutamate metabolism, propionic acid metabolism, nitrogen metabolism and tryptophan metabolism. Conclusion: The possible metabolism pathway of Dachuanxiong Fang multi-component preparation is mainly amino acid metabolism in urine, and kynurenine is also the product of tryptophan metabolism pathway. The kynurenine metabolic pathway is also one of the main pathways of tryptophan metabolism.

Effects of active components extracted from Dachuanxiong Decoction on the expressions of CGRP and its receptors in rats with migraine / 中成药

AIM To study the effects of active components extracted from Dachuanxiong Decoction (DCXD,Chuanxiong Rhizoma,Gastrodiae Rhizoma) on the expressions of calcitonin gene-related peptide (CGRP) and its receptors in hypothalamus and periaqueductal gray (PAG) of rats with migraine.METHODS Seventy-two rats were evenly assigned to six groups at random,normal group,model group,positive drug group,groups of highdose,middle-dose and low-dose DCXD.Each group was then divided into Subgroup A and Subgroup B.The migraine rat model was established by subcutaneous nitroglycerin injection.The expressions of CGRP in Subgroup B's rat hypothalamus and PAG were observed by immunohistochemical staining,while the levels of CGRP in rat plasma,hypothalamus and PAG in Subgroup A were detected by ELISA.All the gene expressions of CGRP and its receptors (CRLR,RCP,RAMP1) in Subgroup A's rat hypothalamus and PAG were assessed by real-time PCR.RESULTS There was a more significant CGRP level increase in plasma,hypothalamus and PAG in the model group than that in the normal group (P ＜ 0.01).The modelled rats found their up-regulated expressions of CGRP and RCP in hypothalamus (P ＜ 0.05),up-regulated expressions of CGRP and CRLR in PAG,and down-regulated expression of RCP (P ＜ 0.05).All low-dose,middle-dose,high-dose active components worked in decreasing the CGRP levels in plasma,hypothalamus and PAG.The middle-dose led to down-regulation of CGRP,RCP expressions in hypothalamus (P ＜0.05,P ＜0.01),down-regulation of CGRP,CRLR expressions in PAG (P ＜0.05),and up-regulation of RCP expression in PAG (P ＜ 0.05).CONCLUSION The mechanism of active components extracted from DCXD in migraine management may associate with its capability in down-regulating CGRP expressions in hypothalamus and PAG,reducing CGRP synthesis and inhibiting neurogenic inflammation.

Bibliometric analysis of healthcare professionals information behavior based on web of science / 中华医学科研管理杂志

Objective To analyze the related research papers and highly cited papers of healthcare professionals' information behavior,explore the research status and trend of this field.Methods Publications on the information behavior of healthcare professionals were searched from Web of Science.Bibliometric analysis was carried out from the aspects of number of publications,periodical dis tribution,productive author,subordinate organizations,distribution of countries or regions and research hotspot.Results Altogether 364 publications were collected on the information behavior of medical personnel;36.13％ (112 articles) were published in 12 journals.The themes focused on health care science services,information science and library science,medical informatics,computer science,etc.There are 18 research organizations with more than 4 articles;The United States was the strongest country in this field which has 112 articles;Publications was cited totally 4698 times,and there are 7 articles which were cited more than 110 times,the highest cited article was cited 23 times over the past 5 years.Conclusions The number of articles in the field of information behavior has been increasing,and the core journals and core research institutions have been basically formed.In the past five years,the highly cited articles reflect the research hotspots and trends.Related Researches needs to be improved in China.

Formation and enlightenment of medical elite education in the United States / 基础医学与临床

The authors attempted to sort out the training experience of higher education pedagogy in America , and truthfully recorded the understanding and experience of the higher medical elite education of America during visiting the University of Nebraska Medical Center .Combined with the current situation of high medical education in Chi-na, the formation and the embodiment of medical elite education mode of America has also been concretely ana -lyzed , which was expected to bring new enlightenment and reference for the development of high medical elite edu -cation mode and the medical teaching remodeling .