ABSTRACT
Sophorae Tonkinensis Radix et Rhizoma （STRER） is a commonly used Chinese medicine in clinical practice， which has the effects of clearing heat， removing the toxin， alleviating edema， and relieving sore throat. In recent years， the clinical reports of STRER-induced poisoning have gradually increased， with neurotoxicity and hepatotoxicity as the main characteristics of the acute attack. Timely treatment will lead to the good prognosis， but long-term or high-dose administration will cause irreversible damage. Therefore， the safety of clinical use of STRER should be highlighted. The chemical components in STRER mainly include alkaloids， flavonoids， triterpenoids， triterpenoid saponins， and polysaccharides， as well as small amounts of proteins， organic acids， and trace elements， where alkaloids both serve as the important material basis for the pharmacodynamic action and the main substances causing toxicity. The adverse events induced by STRER and its alkaloids include nerve injury, Hepatic injury, cardiovascular injury, kidney injury and reproductive injury， and gastrointestinal reaction. Quinolizidine alkaloids are the main toxic components， mainly including matrine， oxymatrine， cytisine， sophocarpine， oxysophocarpine， sophoridine， sophoramine， and lehmannine. Many studies have been carried out on the toxicity of different extracts and alkaloids of STRER in China and abroad， but there are no comprehensive and detailed reports on the toxicity mechanism of alkaloids in STRER. As a Chinese medicine， STRER is widely used. It's an urgent problem to clarify the material basis and mechanism of toxicity caused by STRER and reduce the toxicity for good clinical application. The present study reviewed the components of alkaloids， toxicity， and toxic mechanism of extracts and alkaloids in STRER to provide the basis for further development and clinical safe and effective application of STRER.
ABSTRACT
Objective To research the serum amyloid A(SAA)levels of primary unexplained recurrent early pregnancy loss (REPL),and discuss the viability of regarding the SAA as a independent indicator of REPL.Methods A prospective study was conducted among 96 women with missed spontaneous abortion at Baoji Maternal and Child Care Hospital from January to December 2014.A control group was formed of pregnant women with no history of REPL.Serum samples of both groups were collected to measure SAA levels by enzyme linked immunosorbent assay.The association between SAA and primary unexplained REPL were analyzed according to the multiple factors Logistic models,and the diagnostic value of SAA to RE-PL were detected through receiver operating characteristic.Results Median SAA level was significantly higher among women with REPL(50 μg/ml,interquartile range 26.0~69.0 μg/ml),than that in the control group(11.6 μg/ml,inter-quartile range 6.2~15.5 μg/ml,P=0.000<0.01).The diagnose value of SAA to REPL was perfect good(AUC=0.91), and the most accurate value was 18 μg/ml.The SAA level was an independent indicator of primary unexplained REPL,after adjusting for maternal age and gestational age(OR:1.12,P=0.000).Conclusion Elevated SAA levels found among women with primary unexplained REPL could represent a novel biomarker for this complication of pregnancy.