Effects of Rehmanniae Radix and Rehmanniae Radix Praeparata on proteomics and autophagy in mice with type 2 diabetes mellitus induced by high-fat diet coupled with streptozotocin / 中国中药杂志

To compare the pancreatic proteomics and autophagy between Rehmanniae Radix-and Rehmanniae Radix Praeparata-treated mice with type 2 diabetes mellitus(T2DM). The T2DM mouse model was established by high-fat diet coupled with streptozotocin(STZ, intraperitoneal injection, 100 mg·kg~(-1), once a day for three consecutive days). The mice were then randomly assigned into a control group, low-(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix groups, low-(150 mg·kg~(-1)) and high-dose(300 mg·kg~(-1)) catalpol groups, low-(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix Praeparata groups, low-(150 mg·kg~(-1)) and high-dose(300 mg·kg~(-1)) 5-hydroxymethyl furfuraldehyde(5-HMF) groups, and a metformin(250 mg·kg~(-1)) group. In addition, a normal group was also set and each group included 8 mice. The pancreas was collected after four weeks of administration and proteomics tools were employed to study the effects of Rehmanniae Radix and Rehmanniae Radix Praeparata on protein expression in the pancreas of T2DM mice. The expression levels of proteins involved in autophagy, inflammation, and oxidative stress response in the pancreatic tissues of T2DM mice were determined by western blotting, immunohistochemical assay, and transmission electron microscopy. The results showed that the differential proteins between the model group and Rehmanniae Radix/Rehmanniae Radix Prae-parata group were enriched in 7 KEGG pathways, such as autophagy-animal, which indicated that the 7 pathways may be associated with T2DM. Compared with the control group, drug administration significantly up-regulated the expression levels of beclin1 and phosphorylated mammalian target of rapamycin(p-mTOR)/mTOR and down-regulated those of the inflammation indicators, Toll-like receptor-4(TLR4) and Nod-like receptor protein 3(NLRP3), in the pancreas of T2DM mice, and Rehmanniae Radix showed better performance. In addition, the expression levels of inducible nitric oxide synthase(iNOS), nuclear factor erythroid 2-related factor 2(Nrf2), and heine oxygenase-1(HO-1) in the pancreas of T2DM mice were down-regulated after drug administration, and Rehmanniae Radix Praeparata demonstrated better performance. The results indicate that both Rehmanniae Radix and Rehmanniae Radix Praeparata can alleviate the inflammatory symptoms, reduce oxidative stress response, and increase the autophagy level in the pancreas of T2DM mice, while they exert the effect on different autophagy pathways.

Effect of Guilu Erxiangao on Alzheimer's Disease and Its Mechanism Based on Kidney-brain Correlation / 中国实验方剂学杂志

ObjectiveTo investigate the effect and mechanism of Guilu Erxiangao on Alzheimer's disease （AD） model rats induced by hydrocortisone and amyloid β-protein（Aβ） based on the theory of kidney-brain correlation. MethodIntraperitoneal injection of hydrocortisone and intracerebroventricular injection of Aβ were performed to induce AD in rats， and different concentrations of Guilu Erxiangao were used for intervention. The indexes of hippocampus， kidney and adrenal gland were measured， and the spatial learning and memory ability of AD rats was observed by Morris water maze experiment. The levels of testosterone （T） and corticosterone （CORT） in serum samples were determined by enzyme-linked immunosorbent assay （ELISA）. Liquid chromatography-mass spectrometry （LC-MS） was used to collect and analyze the serum metabolic data of model rats. The active components and corresponding targets of Guilu Erxiangao were collected using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP）， a Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine （BATMAN-TCM） and Traditional Chinese Medicine Integrated Database（TCMID）. GeneCards and Online Mendelian Inheritance in Man （OMIM） were retrieved to obtain AD-related targets， and protein-protein interaction （PPI） network was constructed to perform gene ontology （GO）and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis. The expression level of interleukin-6 （IL-6） in the hippocampus of rats was detected by Western blot. ResultCompared with the model group， the low-， medium- and high-dose groups of Guilu Erxiangao exhibited significantly increased hippocampus index， kidney index and adrenal gland index， reduced CORT levels in serum and down-regulated IL-6 levels in hippocampal tissues. According to the results of water maze experiment， as compared with the model group， the platform crossing times of rats was significantly increased in the low- and high-dose groups of Guilu Erxiangao， with evidently prolonged distance traveled in quadrant Ⅲ （%） and time in quadrant Ⅲ （%）. A total of 24 serum differential metabolites associated with AD were identified by LC-MS， and 50 high-frequency common compounds and 187 high-frequency common targets for AD treatment were screened by network pharmacology method. Results demonstrated phosphatidylinositol 3-kinases（PI3K）/protein kinase B（Akt） signaling pathway plays an important role in the complex AD pathological mechanism. ConclusionGuilu Erxiangao can significantly improve the cognitive dysfunction of AD model rats induced by hydrocortisone and Aβ， reduce serum CORT levels and IL-6 levels in hippocampal tissues， and regulate the metabolic level， which provides a reference for its clinical application.

Mining and Evaluation of Post-marketing Safe Alert Signals of Pegaspargase and L-asparaginase Based on BCPNN Method / 中国药房

OBJECTIVE： To mine and evaluate the post-marketing safety alert signals of pegaspargase （PEG-ASP） and L-asparaginase （L-ASP），and compare the safety differences between them ，so as to provide reference for clinical safe and rational drug use. METHODS ： The adverse drug event （ADE） reports of PEG-ASP and L-ASP issued by FDA adverse event reporting system from Jan. 1st，2004-Jun. 30th，2020 were retrieved. BCPNN method was used to mine the safety signals of these two drugs under the condition that the lower limit of information component （IC－2SD）＞0 and the number of events ≥3. The medium and strong signals of two drugs with IC －2SD≥1.5 were evaluated and compared in 8 system organ class，such as gastrointestinal system ，hepatobiliary system ，blood and lymphatic system ，blood vessels and lymphatic vessels ， nervous system ，immune system ，metabolism and nutrition ，various examinations. IC value of specific ADE signal and its 95％ confidence interval were analyzed by time scanning spectrum. RESULTS & CONCLUSIONS ：The reports of PEG-ASP and L-ASP as suspected drugs were 2 324 and 3 824；67 and 68 medium and strong signals were included ，respectively. In gastrointestinal system，the common strong signal of PEG-ASP and L-ASP was necrotic pancreatitis. In hepatobiliary system ，both of them showed strong signal in venoocclusive liver disease ，and this ADE was not included in the drug instruction. In blood and lymphatic system ， common strong signals of the two drugs were febrile neutropenia ，coagulation disorder ，neutropenia and febrile bone marrow regeneration disorder ；in blood vessels and lymphatic vessels ，in addition to haemodynamic instability ，IC values of other signals of L-ASP were higher than those of PEG-ASP. In nervous system ，IC values of other signals of L-ASP were higher than those of PEG-ASP except for intracranial haemorrhage. In immune system ，anaphylactic reaction was a medium signal for L-ASP but was a strong signal for PEG-ASP. In metabolism and nutritional diseases ，except for tumor lysis syndrome ，IC values of other signals of L-ASP were higher than those of PEG-ASP. The results of time scanning spectrum showed that the signals of necrotic pancreatitis and coagulation disorder of PEG-ASP were stable ，while the signals of veno occlusive liver disease and hypersensitivity were unstable and needed to be observed ；above four signals of L-ASP were stable signals. When using PEG-ASP or L-ASP clinically ， close attention should be paid to the safety problems such as hypersensitivity ，coagulation disorder ，thrombosis，necrotic pancreatitis，venoocclusive liver disease and hypoproteinemia.

ADR Signal Mining of Paclitaxel for Injection （Albumin-bound Type ）Based on FDA Adverse Event Database / 中国药房

OBJECTIVE：To utilize ADR signal of Paclitaxel for injection （albumin-bound type ）by using FDA adverse event reporting system （FAERS），and to provide reference for rational use of drugs in the clinic. METHODS ：The reporting odds ratio （ROR）method was used for data mining of adverse events （AEs）related to Paclitaxel for injection （albumin-bound type ）reported by FDA public data program （Open-FDA）during Jan. 1st，2004-Dec. 31th，2019. The demographic characteristics ，constituents and signals of ADR were analyzed. RESULTS ：A total of 1 659 AEs were identified for Paclitaxel for injection （albumin-bound type）. The female （1 169 cases，70.5％）was more than the male （345 cases，20.8％）. The age was mainly 45-64 years old （519 cases，31.3％）. ADR signal mainly involved nerve system ，blood and lymphatic system ，gastrointestinal system ，hepatobiliary system，respiratory system ，thoracic and mediastinal system and general ADR. Twenty positive ADR signals which were not recorded in the drug instructions were found in the study ，mainly including leucopenia ，lymphopenia，macular edema ，abdominal pain，dysphagia，shivering，jaundice，liver failure ，cirrhosis，urinary tract infection ，purulent secretion ，decreased ejection fraction，hypocalcemia，hypokalemia，hyponatremia，bone pain ，facial paralysis ，mental state change ，epistaxis，atelectasis. Among them ，lymphopenia，macular edema and mental state changes were not recorded in the drug instructions ，while others were the specific manifestations of ADR recorded in the drug instructions. CONCLUSIONS ：In the clinical application of Paclitaxel for injection（albumin-bound type ），in addition to ADR mentioned in the drug instructions ，great importance should be closely paid to neurotoxicity，lymphocyte changes ，regular eye monitoring 2021MSXM041） and mental state monitoring ，so as to avoid drug withdrawal or organ injury induced by ADR.

Rehmanniae Radix and Rehmanniae Radix Praeparata improve diabetes induced by high-fat diet coupled with streptozotocin in mice through AMPK-mediated NF-κB/NLRP3 signaling pathway / 中国中药杂志

This study investigated the differential mechanisms of Rehmanniae Radix and Rehmanniae Radix Praeparata in improving diabetes in mice through AMPK-mediated NF-κB/NLRP3 signaling pathway. The diabetic mouse model was established with high-fat diet coupled with streptozotocin(STZ, intraperitoneal injection, 100 mg·kg~(-1), once a day for three consecutive days), after which the mice were randomly divided into model group, low-dose(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix groups, low-dose(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix Praeparata groups, catalpol group(250 mg·kg~(-1)), 5-hydroxymethylfurfural(5-HMF) group(250 mg·kg~(-1)), metformin group(250 mg·kg~(-1)), with the normal group also set. The organ indexes of heart,liver, spleen, lung, kidney and pancreas were calculated after four weeks of administration. The pathological changes and fibrosis of pancreas, kidney and liver in mice were observed by hematoxylin-eosin(HE) staining and Masson staining. Western blot was used to determine the expression levels of Toll-like receptor-4(TLR4), nuclear factor-κB(NF-κB), Nod-like receptor protein 3(NLRP3),interleukin-1β(IL-1β), adenosine monophosphate-activated protein kinase(AMPK), phosphorylated AMPK(p-AMPK) in the pancreas, kidney and liver of mice. Compared with the model group, the administration groups witnessed significant decrease in the liver,spleen, kidney, pancreas and fat indexes of diabetic mice, and there was no significant difference in heart and lung indexes. The pathological states and fibrosis of pancreatic, kidney and liver tissues were significantly improved after administration. Additionally, the expression levels of TLR4, NF-κB and NLRP3 in pancreas, kidney and liver of diabetic mice were significantly lowered. The expression levels of p-AMPK/AMPK were enhanced significantly in kidney and liver of mice in Rehmanniae Radix group while in pancreas, kidney and liver in Rehmanniae Radix Praeparata group. This suggests that Rehmanniae Radix and Rehmanniae Radix Praeparata differ in the mechanism of regulating energy metabolism of multiple organs and thereby exerting anti-inflammatory effects to alleviate symptoms of diabetic mice.

Treatment of floating knee injury in children with elastic intramedullary nail / 中国骨伤

OBJECTIVE@#To observe the clinical effect of elastic intramedullary nail in minimally invasive treatment of floating knee injury in children.@*METHODS@#From January 2009 to September 2017, 11 children with floating knee injury were treated with one-off open reduction and elastic intramedullary nail or external fixator fixation, including 7 males and 4 females, aged 5.0 to 11.0 years, with an average age of 8.3 years. The treatment results were evaluated according to karlstrom's standard.@*RESULTS@#Eleven patients were followed up for 8 to 48 months, with an average of 28 months. All the fractures healed at one time, and there were no complications such as nonunion, malunion and serious dysfunction of knee joint. The length of the affected limb in 2 cases was 1.2 to 1.5 cm longer than that in the opposite side without shortening. According to Karlstrom scoring standard, 8 cases were excellent, 1 case was good and 2 cases were middle.@*CONCLUSION@#Elastic intramedullary nail minimally invasive treatment of floating knee injury in children is a safe and effective treatment, which can effectively reduce the fracture and promote bone healing, which is conducive to early functional recovery.

Quantification of Chinese yam processing methods based on pyrolysis characteristics and its relation to Maillard reaction / 中草药·英文版

Objective: Chinese yam (Shanyao in Chinese, SY) as one of the representatives for Chinese medicines can be used as both of medicine and food with rich nutritional and medicinal value. Most of Chinese herbal medicines need to be processed prior to be used in clinical practice. SY was divided into Maoshanyao (Hairy Shanyao, MSY) and Guangshanyao (Smooth Shanyao, GSY) based on different processing methods at the place of origin, and it also could be processed as stir-fried SY and bran stir-fried SY to meet the different clinical use. Moreover, during the processing of Chinese herbal medicines, more complicated Maillard reaction occurs compared to food processing. Therefore, the objective of this research is to quantify the firepower of SY processing, and combined this with the relevant parameters of Maillard reaction. Methods: The MSY and GSY produced in Shanxi and Henan Provinces were chosen as the research objects. By using thermal analysis technology, we first established the correlation between pyrolysis and processing of SY and its mixtures. We also quantified the firepower of Shaoyao processing, and combined this with the relevant parameters of Maillard reaction (pH value, amino acid, and 5-HMF) and the changes in medicinal ingredients (allantoin). Results: The SY was mainly fried with moderate-fire (190 °C−200 °C), and the starting temperatures of different SY–ingredient mixtures were (176.3 ± 5.33) °C for (honey) bran, and (205.9 ± 8.05) °C for rice. The upper limits of processing temperature were (289.9 ± 6.47) °C for (honey) bran and (298.9 ± 1.15) °C for rice. The cooking time was (10.80 ± 1.76) min for soil stir-fry, (10.31 ± 1.06) min for bran stir-fry, and (8.43 ± 0.68) min for rice stir-fry. Moreover, the pH values and the content of 5-HMF were increased (P < 0.001), while the content of glycine was decreased significantly (P < 0.001) after processing. Conclusion: The results verified and quantified the firepower of traditional processing of SY, and also provided scientific reference for other studies related to SY processing.

Analysis of Mechanism of Phytolaccae Radix and Its Processed Products on Doxorubicin-induced Nephropathy in Rats / 中国实验方剂学杂志

Objective: To compare the protective effect of Phytolaccae Radix and its processed products on nephropathy induced by doxorubicin (DOX) in rats, and explore its mechanism. Method: A rat model of nephropathy was established by a single tail intravenous injection of DOX hydrochloride. Content of esculentoside A (EsA) in Phytolaccae Radix and its processed products was determined by HPLC-ELSD. Contents of serum total protein (TP), albumin (Alb), urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TC) and urine protein (UP) were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein expression of transforming growth factor-β (TGF-β) in renal tissue of rats was examined by real-time quantitative polymerase chain reaction (Real-time PCR) and immunohistochemistry. Result: A single intravenous injection of DOX could induce a severe nephrotic syndrome associated with decreased serum TP, Alb and elevated serum BUN, SCr, TC, and a high urinary excretion of protein (Pβ in renal tissue of model group rats was significantly higher than that of blank group (PPPConclusion: Phytolaccae Radix and its processed products can improve the symptoms of DOX nephropathy model rats in different degrees, among which the vinegar prepared products have the strongest effect, and this effect may be related to the reduction of TGF-β expression in renal tissue.

Blood-cooling and hemostasis effects of Rehmanniae Radix before and after carbonizing / 中国中药杂志

To compare the blood-cooling and hemostasis effects of Rehmanniae Radix before and after carbonizing on rats with blood heat and hemorrhage syndrome. The blood heat and hemorrhage syndrome rat model was established. Indexes including rectal temperature,whole blood viscosity,plasma viscosity,thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen content(FIB),red blood cell(RBC),hemoglobin(Hb),hematocrit(HCT),blood platelet count(PLT),mean platelet volume(MPV),serum IL-1,serum IL-6 and lung histopathology were detected to investigate the blood-cooling and hemostasis effects of Rehmanniae Radix and its carbonized products. Compared with the blank control group,the rectal temperature was significantly increased with rise of the high,middle and low whole blood viscosities and plasma viscosity(P<0.05); both the high and low whole blood restore viscosity and the high and low whole blood relative viscosity were increased significantly(P< 0.05); TT,APTT and PT were notably prolonged with the increase in FIB content(P<0.05); RBC,Hb and HCT increased significantly(P< 0.05); concentrations of serum IL-1 and IL-6 were also increased(P< 0.05) in model group. Additionally,obvious hemorrhages in lung and stomach were observed in rats of the model group. Rehmanniae Radix and its carbonized products can significantly reduce rectal temperature,high middle and low whole blood viscosities and plasma viscosity(P<0.05). TT and APTT were shortened,with lower expression of FIB in group of Rehmannia Radix and its carbonized products. Hemorrhages of lung and stomach were improved by Rehmannia Radix and its carbonized products. The results indicated that Rehmannia Radix before and after carbonizing had the hemostasis and blood-cooling effects by promoting coagulation,improving blood rheology and inhibiting expressions of IL-1 and IL-6.

Value of Diffusion-weighted Imaging and Apparent Diffusion Coefficient in the Differential Diagnosis of Posterior Fossa Solid Hemangioblastoma / 中国医学科学院学报

To investigate the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the diagnosis and differential diagnosis of posterior fossa solid hemangioblastoma(PFSH). We retrospectively analyzed the clinical data of 15 PFSH patients and 58 patients with other hypervascular tumors in the posterior fossa(the latter included 23 cases of meningioma,5 cases of medulloblastoma,8 cases of acoustic neuroma,4 cases of hemangiopericytoma,5 cases of lymphoma,9 cases of metastatic tumor,3 cases of astrocytoma,and 1 case of choroid plexus papilloma)confirmed by operation and pathology.All patients underwent axial DWI scans,and the mean ADC value of solid part of the tumors and the adjacent normal cerebellar white matter were measured,and then the normalized ADC was calculated.In addition, test was used to compare the differences in mean ADC and normalized ADC between these two groups,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic performance of normalized ADC. Of all the 15 PFSH patients,DWI appeared hypointense in 12 patients and isointense in 3 patients;the signals on ADC maps were isointense or hyperintense;the mean ADC value of PFSHs was(1.881±0.445)×10 mm /s and the normalized ADC was 2.70±0.62.In contrast,in 58 patients with other tumors in the posterior fossa,DWI appeared hyperintense in 51 cases,isointense in 3 cases,and hypointense in 4 cases;the mean ADC value was(0.771±0.202)×10 mm /s,and the normalized ADC was 1.17±0.33.Thus,the ADC value and normalized ADC value were significantly higher in PFSH than in other tumors in the posterior fossa(=9.419,<0.001;=9.184,<0.001).The cut-off value of the normalized ADC for the diagnosis of solid hemangioblastoma was 1.89,with the sensitivity and specificity being 100%and 96.6%respectively,and the area under the ROC curve was 0.989. ADC and normalized ADC are valuable in the differential diagnosis of PFSH from other tumors with abundant blood supply.

Hyperbaric oxygen improves functional recovery of rats after spinal cord injury via activating stromal cell-derived factor-1/CXC chemokine receptor 4 axis and promoting brain-derived neurothrophic factor expression / 中华医学杂志(英文版)

BACKGROUND@#Spinal cord injury (SCI) is a worldwide medical concern. This study aimed to elucidate the mechanism underlying the protective effect of hyperbaric oxygen (HBO) against SCI-induced neurologic defects in rats via exploring the stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) axis and expression of brain-derived neurotrophic factor (BDNF).@*METHODS@#An acute SCI rat model was established in Sprague-Dawley rats using the Allen method. Sixty rats were divided into four groups (n = 15 in each group): sham-operated, SCI, SCI treated with HBO (SCI + HBO), and SCI treated with both HBO and AMD3100 (an antagonist of CXCR4; SCI + HBO + AMD) groups. The rats were treated with HBO twice a day for 3 days and thereafter once a day after the surgery for up to 28 days. Following the surgery, neurologic assessments were performed with the Basso-Bettie-Bresnahan (BBB) scoring system on postoperative day (POD) 7, 14, 21, and 28. Spinal cord tissues were harvested to assess the expression of SDF-1, CXCR4, and BDNF at mRNA and protein levels, using quantitative real-time polymerase chain reaction, Western blot analysis, and histopathologic analysis.@*RESULTS@#HBO treatment recovered SCI-induced descent of BBB scores on POD 14, (1.25 ± 0.75 vs. 1.03 ± 0.66, P < 0.05), 21 (5.27 ± 0.89 vs. 2.56 ± 1.24, P < 0.05), and 28 (11.35 ± 0.56 vs. 4.23 ± 1.20, P < 0.05) compared with the SCI group. Significant differences were found in the mRNA levels of SDF-1 (mRNA: day 21, SCI + HBO vs. SCI + HBO + AMD, 2.89 ± 1.60 vs. 1.56 ± 0.98, P < 0.05), CXCR4 (mRNA: day 7, SCI + HBO vs. SCI, 2.99 ± 1.60 vs.1.31 ± 0.98, P < 0.05; day 14, SCI + HBO vs. SCI + HBO + AMD, 4.18 ± 1.60 vs. 0.80 ± 0.34, P < 0.05; day 21, SCI + HBO vs. SCI, 2.10 ± 1.01 vs.1.15 ± 0.03, P < 0.05), and BDNF (mRNA: day 7, SCI + HBO vs. SCI, 3.04 ± 0.41 vs. 2.75 ± 0.31, P < 0.05; day 14, SCI + HBO vs. SCI, 3.88 ± 1.59 vs. 1.11 ± 0.40, P < 0.05), indicating the involvement of SDF-1/CXCR4 axis in the protective effect of HBO.@*CONCLUSIONS@#HBO might promote the recovery of neurologic function after SCI in rats via activating the SDF-1/CXCR4 axis and promoting BDNF expression.

Research Progress on Diagnosis and Treatment of Chronic Osteomyelitis / 中国医学科学杂志(英文版)

We review the representatives literatures on chronic osteomyelitis, sum up the new insights in recent years into diagnostic options and treatment regimens, analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies, and propose areas of interest to make current diagnostic and treatment strategies more specific.

Preliminary investigation on processing mechanism of Kansui Radix by liquorice based on thermal analysis technology / 中国中药杂志

In the thermal analysis, the pyrolysis characteristics of crude Kansui Radix, alcohol extract of Kansui Radix, petroleum ether extract, chloroform extract, ethyl acetate extract, n-butanol extract, and licorice vinegar were analyzed with simulated air (N₂-O₂ 4:1) as the carrier gas, at a temperature increase rate of 10 °C·min⁻¹ and a volume flow rate of 60 mL·min⁻¹, respectively. The results showed that due to the different polarity of the extraction solvent, the type and quantity of the chemical components contained in each polar part were different, and with the increase in the amount of solid powder of licorice, the peak of the maximum heat loss rate occurred in advance. For petroleum ether, chloroform, and ethyl acetate fractions, (157.40±1.06), 3.50, (25.83±1.66) °C in advance respectively, but the weight loss rate of the chloroform fraction was increased by (2.62±5.19) °C, while decreased by (33.90±1.72), (19.28±1.11) °C for the petroleum ether and ethyl acetate fractions. So we can conclude that with the addition of licorice, the pyrolysis rate of the petroleum ether and chloroform fractions in the toxic part of Kansui Radix was increased; the temperature point at the peak of the maximum weight loss rate was decreased, and the ethyl acetate fraction (effective part) showed a decrease in temperature rising process, but its overall ratio of weight loss and weight loss rate were relatively small, retaining the effect of medicinal ingredients. This proved the mechanism of licorice system Kansui Radix on attenuating toxicity after processing and the scientificity and rationality of licorice system Kansui Radix. At the same time, as the proportion of glycyrrhizin was increased, the peak of the maximum heat loss rate of petroleum ether, chloroform and ethyl acetate fractions occurred in advance; the peak temperature was decreased, with easy pyrolysis. Among them, the thermogravimetric rate of the mixture of petroleum ether and chloroform fractions (10:1) was relatively large, with a low peak temperature, while ethyl acetate fraction showed opposite results. This conclusion has certain guiding significance for the ratio of gansui to licorice.

Study on Attitudes towards Deprescribing among Elderly Patients with Chronic Diseases in Several Communities of Chongqing / 中国药房

OBJECTIVE:To provide reference for promoting smoothly implementation of deprescribing. METHODS:A total of 335 elderly patients with chronic disease were randomly selected from 4 communities and 9 village clinic of a Chongqing community health service center. Questionnaire survey was conducted about general information of respondents,disease and drug use condition and attitude to deprescribing by using Australian Patients'Attitudes Towards Deprescribing questionnaire as reference. The results of questionnaire survey were analyzed statistically. The cognitive function was assessed by Hastgawa Dementia Scale. The degree of weakness was evaluated by Chinese edition of Edmonton Frail Scale. The quality of life was evaluated by Chinese edition of European Five Dimensional Health (EQ-5D) Scale. RESULTS:Totally 311 valid questionnaires were obtained,with effective recovery rate of 92.8％. Overall,311 participants were recruited,with a median age of 70 years,5 types of median disease (hypertension was most common) and 5 types of median medication (mainly calcium channel blocker and non-insulin hypoglycemic agent);54.7％(170 cases)participants took multiple drugs. The attitudes towards deprescribing were that 39.5％ of respondents believed that they took too many drugs;73.9％ had a desire to reduce their drugs;83.6％ reported that they would be willing to reduce drugs if their doctor said it was possible. The patients taking multiple drugs preferred to use less drugs (P=0.001) and reduce current drugs (P=0.001),and were more willing to reduce drug cost by reducing drug use;they were also more worried about drug side effects than those without taking multiple drugs (P=0.005). CONCLUSIONS:The phenomenon of elderly chronic diseases patients with multiple diseases and multiple drug use are popular in community. It is necessary to simpilfy prescription. Most elderly patients would like to reduce their medications if doctors say it is possible;the patients with multiple drug use are more willing to simplify prescription than those without multiple drug use.

Investigation on the Demands and Evaluation of Medical Personnel and Patients towards Clinical Pharmacists in 56 Third Grade Class A Hospitals of 17 Provinces(Regions,Cities) / 中国药房

OBJECTIVE:To provide reference for the clinical pharmacists to determine their work orientation,and improve their work mode and pharmaceutical care level. METHODS:The questionnaire survey was conducted among doctors,nurses, patients and pharmacists from 65 third grade class A hospitals of 18 provinces(regions,cities)in China. The collected data were analyzed statistically and suggestions were presented. RESULTS:Totally 3 840 questionnaires were sent out,3 045 were effectively received with a recovery of 79.30%[involving 56 third grade class A hospitals of 17 provinces(regions,cities)]. Of 3 045 valid questionnaires,1 001 questionnaires were filled out by the doctors and nurses,1 013 questionnaires were filled by the pharmacists and 1 031 questionnaires were filled out by the patients. 88.45% of the survey doctors and nurses thought that clinical pharmacists were needed in their wards. The major clinical pharmaceutical care they needed were the participation of clinical pharmacists in the clinical ward round,patients management,difficult case discussions,consultation(77.32%),etc. 64.54% of the survey doctors and nurses thought that clinical pharmacists could participate the clinical work and solve some simple medicine-related problems, and 27.17% of the survey doctors and nurses thought that clinical pharmacists could resolve clinical medicine-related problems. 14.59% of the survey doctors and nurses believed that clinical pharmacists lacked clinical thinking and could not communicate with medical staff. The most common problems the survey medical staff met were as follows:ADR (78.02%),usage and dosage(72.83%),contraindications(72.63%),drug indication(63.14%)and solvent selection (61.74%),etc. As regards the ratio of working time which clinical pharmacists spent on their clinical work,over 50%(35.55%)and 30%(23.46%)were most chosen by the survey pharmacists,while 13.19% of the survey pharmacists thought clinical pharmacists almost did not participate in clinical work. The survey pharmacists thought that there were some deficiencies in the knowledge structure of clinical pharmacists, such as clinical medical science and therapeutics(92.50%), communication skills(47.19%),professional knowledge of pharmacy(46.10%),etc. 87.90% of the survey patients were willing to accept the medication guidance provided by clinical pharmacists. The services they required were as follows:medication guidance(79.92%),observation and discovery of medication problem(71.00%),etc. CONCLUSIONS:Medical staff and patients have demands in many ways associated with clinical work and rational drug use provided by clinical pharmacists,while the clinical pharmacists have yet not reached the demands of medical staff and patients in regard to their evaluation. It is suggested that the clinical pharmacists should ascertain their work orientation,improve their work mode,participate the clinical work in full-time, complete their knowledge structure and ascent their pharmaceutical service level.

Physicochemical properties of hydroxyapatite/dicalcium phosphate dehydrate bone cement / 中国组织工程研究

BACKGROUND:β-tricalcium phosphate (β-TCP) and monocalciumphosphate monohydrate (MCPM) are traditionally considered as reactants for dicalcium phosphate dehydrate (DCPD) bone cement,but little is reported on the hydroxyapatite (HA) as a reactant.OBJECTIVE:To verify whether HA and MCPM can be used to prepare DCPD bone cement and to explore the physicochemical properties.METHODS:The HA and β-TCP were prepared by wet chemical precipitation method,and mixed with appropriate proportion of MCPM.Then,the HA-DCPD and β-TCP-DCPD were obtained by adding a proper amount of curing water.The composition and structure of the two materials were analyzed by X-ray diffraction,the morphology was observed by scanning electron microscope,and the mechanical strength was tested by Instron5567 universal material test machine.These two kinds of materials were placed in simulated body fluid for detecting the weight loss ratio,soaked for 14 days and taken out for X-ray diffraction and scanning electron microscope detection.RESULTS AND CONCLUSION:X-ray diffraction findings indicated that these two kinds of materials both belonged to high-purity DCPD bone cement.Under the scanning electron microscope,β-TCP-DCPD bone cement had dense crystal structure,with less pore number;however,the HA-DCPD bone cement presented with finer grains,loose structure,and higher pore number.With the increase of curing time,the mechanical strength of two kinds of bone cements was correspondingly increased,but the compressive strength of β-TCP-DCPD bone cement was significantly higher than that of HA-DCPD bone cement (P ＜ 0.05).In the simulated body fluid,the weight loss ratio of β-TCP-DCPD bone cement was significantly lower than that of HA-DCPD bone cement (P ＜ 0.05).At 14 days after soaking in the simulated body fluid,a layer of spherical particles that was formed on the surface of both materials was identified as hydroxyapatite by scanning electron microscope observation and X-ray diffraction analysis.In summary,HA-DCPD bone cement has good biodegradability,excellent bioactivity and bone conductivity,but poor mechanical properties.

The correlation analysis and predictive value of peak expiratory flow on pulmonary infection after esophageal carcinoma operation / 中华胸心血管外科杂志

Objective To investigate the correlation between perioperative risk factors including pulmonary fuction indexs and the occurance of postoperative pneumonia in esophageal carcinoma patients,and the prediction efficiency of Peak Expiratory Flow (PEF).Methods Two groups of consecutive esophageal carcinoma patients were included,321 patients in group 1 were devided into postoperative pneumonia group (n =30) and control group (n =291) to screen any relavent risk factom on postoperative pneumonia;group 2 (n =50) was to verify the accurancy and sensitivity of the predictive index.Results he results from group 1 showed that preoperative history of diabetes,previous surgery history,lung function index FEV1 and PEF in the presence of significant differences between the postoperative pneumonia group and the control group,after FDR correction FEV1 and PEF still have statistical significance.Multivariate logistic analysis showed that PEF was an independent prognostic factor of lung infection after esophageal cancer surgery.We build a predictive model with PEF as a variable index of lung infection after esophageal cancer surgery in group 2,the results showed that PEF as a predictor of pulmonary infection has good specificity and sensitivity.Conclusion PEF has a significant correlation with postoperative pulmonary infection in patients with esophageal cancer,and PEF can be used as an effective predictor of postoperative pulmonary infection.

The correlation analysis and predictive value of peak expiratory flow on pulmonary infection after esophageal carcinoma operation / 中华胸心血管外科杂志

Objective To investigate the correlation between perioperative risk factors including pulmonary fuction indexs and the occurance of postoperative pneumonia in esophageal carcinoma patients,and the prediction efficiency of Peak Expiratory Flow (PEF).Methods Two groups of consecutive esophageal carcinoma patients were included,321 patients in group 1 were devided into postoperative pneumonia group (n =30) and control group (n =291) to screen any relavent risk factom on postoperative pneumonia;group 2 (n =50) was to verify the accurancy and sensitivity of the predictive index.Results he results from group 1 showed that preoperative history of diabetes,previous surgery history,lung function index FEV1 and PEF in the presence of significant differences between the postoperative pneumonia group and the control group,after FDR correction FEV1 and PEF still have statistical significance.Multivariate logistic analysis showed that PEF was an independent prognostic factor of lung infection after esophageal cancer surgery.We build a predictive model with PEF as a variable index of lung infection after esophageal cancer surgery in group 2,the results showed that PEF as a predictor of pulmonary infection has good specificity and sensitivity.Conclusion PEF has a significant correlation with postoperative pulmonary infection in patients with esophageal cancer,and PEF can be used as an effective predictor of postoperative pulmonary infection.

Processing of calamine with modern analytical techniques: Processed with Huanglian Decoction () and Sanhuang Decoction () / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine the pyrolysis characteristics of calcined and processed calamine, qualitatively and quantitatively compare the contents of related elements, morphology and functional groups of the pyrolysis products dried at different heating temperatures and explore the critical temperature and the optimal drying temperature for the process of calamine with Huanglian Decoction (HLD, ) and San Huang Decoction (SHD, ).</p><p><b>METHODS</b>Pyrolysis products were prepared by programmable and constantly heating the calcined and processed calamine to or at different heating temperatures. Thermogravimetry (TG) was used to test their pyrolysis characteristics. Fourier transform infrared spectroscopy and scanning electron microscopeenergy dispersive spectrometer were used to determine their morphology, functional groups and element contents. Page model was used to investigate the constant drying kinetics of processed calamine.</p><p><b>RESULTS</b>The adding of HLD or SHD to calcined calamine (CC) can slow its weight loss in drying pyrolysis process. The temperature ranges where HLD and SHD can affect its weight loss were 65-150 °C and 74-180 °C, respectively. The drying temperature was optimized as 90 °C. The drying kinetic for the processed calamine fits Page model shows good linearity.</p><p><b>CONCLUSIONS</b>Conclusions: The critical temperature and the optimal drying temperature where HLD and SHD can affect the weight loss rate in the process of calamine were explored using the theories and methods of both biophysical chemistry and processing of Chinese materia medica. This work provides a good example for the study of the process of other Chinese medicines using modern analytical techniques.</p>

Case analysis of linezolid in treatment of hospital-acquired MRSA pneumonia after ineffective glycopeptide antibiotics treatment / 重庆医学

Objective To analyze the case of inezolid in effectively treating hospital-acquired methicillin-resistant staphylo-coccus aureus (MRSA) pneumonia after ineffective glycopeptide antibiotics treatment in order to provide opinions for the clinical use .Methods The antibacterial drugs analysis was performed on 1 case of hospital-acquired MRSA pneumonia after acute subdural hematoma removal operation in this hospital ,and the curative effects and economic indicators of glycopeptide antibacterial drugs and inezolid were conducted the evidence-based evaluation .Results Using glycopeptide antibacterial drugs in this patient had poor cura-tive effect ,and then changing to inezolid anti-infection treatment obtained the success .This patient used vancomycin 2 g ,generic teicoplanin 400 mg and inezolid 1200 mg per day ;the average daily costs were 497 ,341 ,788 Yuan respectively .Conclusion Lin-ezolid can be selected for treating hospital-acquired MRSA pneumonia patient after ineffective glycopeptide antibacterial drugs treat-ment .