Effects and mechanisms of total flavones of Abelmoschus manihot in attenuating diabetic tubulopathy by targeting endoplasmic reticulum stress-induced cell apoptosis / 中国中药杂志

Renal tubular injury in patients with diabetic kidney disease(DKD) may be accompanied by glomerular and microvascular diseases. It plays a critical role in the progression of renal damage in DKD, and is now known as diabetic tubulopathy(DT). To explore the multi-targeted therapeutic effects and pharmacological mechanisms in vivo of total flavones of Abelmoschus manihot(TFA), an extract from traditional Chinese medicine for treating kidney disease, in attenuating DT, the authors randomly divided all rats into four groups: a normal control group(normal group), a DT model group(model group), a DT model+TFA-treated group(TFA group) and a DT model+rosiglitazone(ROS)-treated group(ROS group). The DT rat model was established based on the DKD rat model by means of integrated measures. After successful modeling, the rats in the four groups were continuously given double-distilled water, TFA suspension, and ROS suspension, respectively by gavage every day. After 6 weeks of treatment, all rats were sacrificed, and the samples of their urine, blood, and kidneys were collected. The effects of TFA and ROS on various indicators related to urine and blood biochemistry, renal tubular injury, renal tubular epithelial cell apoptosis and endoplasmic reticulum stress(ERS), as well as the activation of the protein kinase R-like endoplasmic reticulum kinase(PERK)-eukaryotic translation initiation factor 2α(eIF2α)-activating transcription factor 4(ATF4)-C/EBP homologous protein(CHOP) signaling pathway in the kidney of the DT model rats were investigated. The results indicated that hypertrophy of renal tubular epithelial cells, renal tubular hyperplasia and occlusion, as well as interstitial extracellular matrix and collagen deposition occurred in the DT model rats. Moreover, significant changes were found in the expression degree and the protein expression level of renal tubular injury markers. In addition, there was an abnormal increase in tubular urine proteins. After TFA or ROS treatment, urine protein, the characteristics of renal tubular injury, renal tubular epithelial cell apoptosis and ERS, as well as the activation of the PERK-eIF2α-ATF4-CHOP signaling pathway in the kidney of the DT model rats were improved to varying degrees. Therein, TFA was superior to ROS in affecting the pathological changes in renal tubule/interstitium. In short, with the DT model rats, this study demonstrated that TFA could attenuate DT by multiple targets through inhibiting renal tubular ERS-induced cell apoptosis in vivo, and its effect and mechanism were related to suppressing the activation of the PERK-eIF2α-ATF4-CHOP signaling pathway in the kidney. These findings provided preliminary pharmacological evidence for the application of TFA in the clinical treatment of DT.

A pilot study on the clinical characteristics of blood pressure circadian rhythm disorder and its impact on orthostatic hypotension in Parkinson′s disease / 中华神经科杂志

Objective:To investigate the clinical characteristics of circadian rhythm disorder of blood pressure and its impact on orthostatic hypotension (OH) in Parkinson′s disease (PD).Methods:A total of 165 PD patients from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2019 to October 2021 were consecutively enrolled. Medical history and scores of motor and non-motor symptoms of patients were collected. Twenty-four-hour ambulatory blood pressure and OH data were collected, and the OH questionnaire was completed. The incidence of each type of circadian rhythm disorder of blood pressure was investigated. The t test, chi-square test and Mann-Whitney U test were used to determine between-group differences of circadian rhythm disorder of blood pressure. The linear trends in clinical characteristics were tested by linear regression analysis. Logistic regression analysis was used to analyze the relationship between different circadian rhythm disorders of blood pressure and OH as well as symptomatic OH (SOH). Results:In 165 PD patients, the incidence of reverse dipping pattern was 39.39% (65/165), nocturnal hypertension was 43.64% (72/165), and awakening hypotension was 31.52% (52/165). Compared with patients without reverse dipping pattern, patients with reverse dipping pattern were older [(71.72±7.81) years vs (65.29±9.68) years, t=-4.491, P<0.001], had later onset age [(66.67±9.10) years vs (62.16±10.66) years, t=-2.809, P=0.006], longer duration [36.00(20.50, 95.50) months vs 24.00(12.00, 41.75) months, Z=-3.393, P<0.001], higher dose of levodopa (LD) [(426.15±267.38) mg/d vs (284.00±235.58) mg/d, t=-3.590, P<0.001], higher levodopa equivalent dose (LED) [(514.80±360.03) mg/d vs (341.44±284.57) mg/d, t=-3.440, P=0.001], higher Unified Parkinson′s Disease Rating Scale (UPDRS)-Ⅱ scores (12.92±6.38 vs 9.54±5.59, t=-3.434, P=0.001), higher UPDRS-Ⅲ scores (28.34±11.60 vs 21.41±12.18, t=-3.508, P=0.001) and higher percentages of hallucinations [18.46% (12/65) vs 7.00% (7/100), χ2 =5.079, P=0.024]. Compared with patients without awakening hypotension, patients with awakening hypotension were older [(70.83±7.09) years vs (66.44±10.16) years, t=-2.811, P=0.006]. Compared with patients without nocturnal hypertension, patients with nocturnal hypertension had longer duration [39.50(15.00, 96.00) months vs 24.00 (12.00, 36.00) months, Z=-2.944, P=0.003], higher LD [(398.61±251.19) mg/d vs (294.62±254.25) mg/d, t=-2.619, P=0.010], higher LED [(493.28±344.02) mg/d vs (345.05±298.59) mg/d, t=-2.959, P=0.004], higher percentages of hallucinations [19.44% (14/72) vs 5.38% (5/93), χ2 =7.882, P=0.005], higher UPDRS-Ⅱ scores (12.08±6.33 vs 10.00±5.86, t=-2.086, P=0.039), higher UPDRS-Ⅲ scores (26.50±11.72 vs 22.42±12.66, t=-2.034, P=0.044), and greater blood pressure variability (BPV) (20.66±5.47 vs 17.44±5.36, t=-3.798, P<0.001). Trend analysis showed that the variety of circadian rhythm was positively correlated with age and duration, use of levodopa and monoamine oxidase B inhibitors and amantidine, morning and daily LD and LED, UPDRS-Ⅱ, UPDRS-Ⅲ and Hamilton Anxiety Scale scores, hallucinations, OH and SOH, and BPV in PD ( P<0.05). Multivariate Logistic regression analysis showed that awakening hypotension ( OR=3.35, 95% CI 1.55-7.22, P=0.002) and nocturnal hypertension ( OR=2.44, 95% CI 1.20-4.97, P=0.014) were risk factors for OH, and LED ( OR=1.21, 95% CI 1.01-1.43, P=0.035), UPDRS-Ⅲ scores ( OR=1.09, 95% CI 1.02-1.16, P=0.009) and w-BPV ( OR=1.14, 95% CI 1.01-1.29, P=0.029) were independent risk factors for SOH. Conclusions:Circadian rhythm disorder of blood pressure was correlated with age, duration, severity of motor symptoms. Awakening hypotension and nocturnal hypertension are independent risk factors for OH in PD.

Study on predictive role of dopamine transporter imaging in Parkinson′s disease with wearing-off phenomenon / 中华神经科杂志

Objective:To investigate whether the presynaptic dopamine neuronal depletion in different striatal subregions predicts future development of wearing-off (WO) in Parkinson′s disease (PD) patients.Methods:A retrospective longitudinal study included 57 PD patients who were referred to the Department of Neurology of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2020, and completed 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane dopamine transporter (DAT) positron emission tomography scans at the initial evaluation and received dopaminergic drugs for at least 12 months during follow-up. The time of starting dopaminergic drug treatment and the occurrence of WO were recorded. After adjusting for clinical related factors, the predictive value of DAT uptake and related parameters in striatal subregions for WO was evaluated by Cox proportional hazards model. Results:During a median follow-up period of 23 months, 10 patients (18.18%) developed WO. Patients with WO exhibited less DAT uptake in the caudate nucleus and anterior putamen nucleus (0.66±0.52 vs 1.08±0.42, t=2.76, P=0.008 and 0.66±0.20 vs 0.87±0.28, t=2.27, P=0.027 respectively), especially in these subregions contralateral to the less-affected side of the body, compared to those without WO. Cox proportional hazard models revealed that after adjusting for gender, age, course of disease, baseline Unified Parkinson′s Disease Rating Scale Ⅲ score and increment of levodopa equivalent dosage, the lower the DAT uptake of the caudate ipsilateral to the less-affected side of the body ( HR=0.20, 95% CI 0.07-0.63, P=0.006), as well as the lower the DAT uptake of the caudate nucleus and posterior putamen nucleus ( HR=0.28, 95% CI 0.11-0.69, P=0.006 and HR=0.08, 95% CI 0.01-0.64, P=0.018 respectively) and the higher the ratio of putamen/caudate contralateral to the less-affected side of the body ( HR=2.33, 95% CI 1.02-5.33, P=0.045), the higher the risk of WO. Conclusion:The presynaptic dopamine neuronal loss, particularly bilateral caudate nucleus dopaminergic depletion at the early stage, has predictive value of development of WO in PD.

Clinical value of changes of gait characteristics in the progression of Parkinson′s disease / 中华神经科杂志

Objective:To determine the evolution of gait impairment over the course of Parkinson′s disease (PD) by assessing the changes of gait characteristics in different disease stages, which could be helpful for disease monitoring.Methods:A total of 276 PD patients [PD group, Hoehn-Yahr (H-Y) stage 1-3] and 63 healthy controls (control group) enrolled in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2021 were included in this cross-sectional study. The gait spatiotemporal variables were recorded by a portable inertial measurement unit system. Exploratory factor analysis was performed to obtain gait domains representing different gait characteristics. One way analysis of variance was used to evaluate the differences of gait variables and gait domains among the control group and 3 different H-Y stages of the PD group, as well as the differences among the control group and 2 motor subtypes of PD in different stages. The sensitivity of different gait variables and gait domains in evaluating the severity of gait impairments at different disease stages was compared.Results:Eleven gait spatiotemporal variables were grouped in 4 gait domains: pace (step length, gait speed and stride length), rhythm/phase (cadence, stride time and double support time), pace-related variability/asymmetry [step length coefficient of variation (CV), gait speed CV and step length asymmetry] and rhythm/phase-related variability/asymmetry (swing time CV and swing time asymmetry). As the disease progresses, most evolution trends of the 4 gait domains in the tremor-dominant PD patients were consistent with those in the non-tremor-dominant subtype. Compared with the control group, PD patients at H-Y stage 1 began to show the mild impairment of rhythm/phase-related variability/asymmetry (effect size 0.42; standardized score -0.03±0.69 vs -0.33±0.49, P<0.05), especially swing time asymmetry in tremor-dominant patients; the pace domain was damaged moderately in PD patients at H-Y stage 2 (effect size 0.64; standardized score 0.12±0.80 vs 0.64±0.81, P<0.05), especially in non-tremor-dominant PD patients, but not in PD patients at H-Y stage 1 ( P>0.05). Pace-related variability/asymmetry showed great impairment in PD patients at H-Y stage 3 (effect size 0.62; standardized score 0.27±1.12 vs -0.27±0.52, P<0.05), but not in PD patients at H-Y stages 1 and 2 ( P>0.05). Conclusions:The characteristic impairments of gait in PD evolve in the process of disease progression. The rhythm/phase-related variability/asymmetry domain may be a marker to distinguish early PD from healthy controls. The pace domain and the pace-related variability/asymmetry domain are important markers to evaluate the progression of PD.

Circadian rhythm disorder of blood pressure in Parkinson′s disease / 中华神经科杂志

Circadian rhythm disorder of blood pressure is a common abnormal form of blood pressure in Parkinson′s disease, including abnormal circadian blood pressure pattern, nocturnal hypertension, increased blood pressure variability and awakening hypotension. The pathogenesis of circadian rhythm disorder of blood pressure in Parkinson′s disease is complex, which involves the disruption of circadian rhythm, cardiovascular dysfunction, abnormal hormone secretion and the disorders of sleep-wake cycle and structure. At the same time, it is affected by many factors such as circadian activity rhythm, emotion, anti-Parkinson′s disease drugs and so on. Studies have shown that the circadian rhythm disturbance of blood pressure is closely related to the clinical phenotypes, progression and prognosis of Parkinson′s disease. Therefore, it is suggested to enhance the screening and intervention of circadian rhythm disorders of blood pressure to optimize treatment and improve quality of life in Parkinson′s disease.

Comparison of Relative Molecular Weight Distribution and Immune Activity of Polysaccharides in Polygonati Rhizoma Before and After Processing / 中国实验方剂学杂志

Objective:To study the relative molecular weight and distribution of polysaccharides in Polygonati Rhizoma （PR） before and after processing， as well as the effects of different polysaccharide fractions on immune function and inflammatory response of mouse peritoneal macrophages. Method:High-performance gel permeation chromatography （HPGPC） was used to determine the relative molecular weight and distribution of polysaccharides in PR （named SC） and polysaccharides in PR processed with wine （named JC）， and polysaccharide fractions with different relative molecular weights were obtained by dialysis. Different polysaccharide fractions were applied to mouse peritoneal macrophages， which was normal or induced by lipopolysaccharide （LPS）. Cell counting kit-8 （CCK-8） method was used to select the optimal administration concentration. Enzyme linked immunosorbent assay （ELISA） was used to determine the concentrations of tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） in the cell supernatant. The Griess method was used to detect the concentration of nitric oxide （NO）. Result:SC and JC could be divided into four parts according to relative molecular weight and its distribution range， including part Ⅰ（14 800-2 273 kDa）， part Ⅱ（2 148-296 kDa）， part Ⅲ（12-1 kDa） and part Ⅳ（818-362 Da）. Based on the differences of part Ⅰ and part Ⅲ after processing， the SC and JC were divided into two-part according to the weight-average relative molecular weight （<italic>M</italic>_W）. For normal mouse peritoneal macrophages， JC could significantly promote the secretion of TNF-<italic>α</italic> （<italic>P</italic><0.01）， while SC had no significant effect. Four polysaccharide fractions， named SD （SC fraction with <italic>M</italic>_W>50 kDa）， JD （JC fraction with <italic>M</italic>_W>50 kDa）， SX （SC fraction with <italic>M</italic>_W<50 kDa） and JX （JC fraction with <italic>M</italic>_W<50 kDa）， also could<italic> </italic>significantly promote the secretion of TNF-<italic>α</italic> （<italic>P</italic><0.01）， but only JX could significantly promote the secretion of NO （<italic>P</italic><0.05）. In addition， the effect of JX group stimulated secretion of TNF-<italic>α</italic> was better than the JD group （<italic>P</italic><0.01）. For the LPS-induced macrophage model， JC and SC group could<italic> </italic>significantly inhibit the secretion of TNF-<italic>α</italic> and IL-1<italic>β</italic> （<italic>P</italic><0.01）， and the effect of JC was stronger. To compare different polysaccharide fractions， the impact of JX on inhibiting the secretion of TNF-<italic>α</italic> and IL-1<italic>β</italic> was<italic> </italic>significantly stronger than JD （<italic>P</italic><0.01）， and SX inhibited the secretion of TNF-<italic>α</italic> was significantly stronger than SD （<italic>P</italic><0.01）. Conclusion:The relative molecular weight and distribution of polysaccharides in PR before and after processing have changed. JC and SC improve the immune regulation mainly by inhibiting the inflammatory response， the fraction of <italic>M</italic>_W<50 kDa is the main effective part， and the effect of PR polysaccharides in inhibiting the inflammatory is enhanced after processing with wine.

Clinical effect of Guanggu Jisheng decoction in treatment of recovery stage coronavirus disease 2019 / 第二军医大学学报

Objective To observe the clinical effect of Guanggu Jisheng decoction on the treatment of coronavirus disease 2019 (COVID-19) during recovery stage. Methods A total of 122 convalescent COVID-19 patients in Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province were treated with Guanggu Jisheng decoction for 3 consecutive courses, each course lasting 3 days. The changes of traditional Chinese medicine (TCM) syndromes before and after treatment were compared. Scores were recorded according to the laboratory testing and the severity of symptoms (no symptom, mild, common and severe) to investigate the clinical curative effect of Guanggu Jisheng decoction on the treatment of convalescent COVID-19. Results According to the TCM syndrome scores, after one course of treatment (3 days), the total effective rate was 75.41% (92/122), with the effective rate being 31.97% (39/122), the significant efficiency being 21.31% (26/122), and the clinical recovery rate being 22.13% (27/122). After two courses of treatment (6 days), the total effective rate was 86.89% (106/122), with the effective rate being 32.79% (40/122), the significant efficiency being 28.69% (35/122), and the clinical recovery rate being 25.41% (31/122). After three courses of treatment (9 days), the total effective rate was 88.52% (108/122), with the effective rate being 16.39% (20/122), the significant efficiency being 31.15% (38/122), and the clinical recovery rate being 40.98% (50/122). The symptoms of cough, fatigue, shortness of breath and sweating were significantly improved. No patients turned positive again from negative of respiratory pathogen nucleic acid. Conclusion Guanggu Jisheng decoction has a good clinical effect on convalescent COVID-19 patients. It can significantly improve the clinical symptoms.

An exploratory study of quantitative analysis of gait characteristics in patients with early Parkinson′s disease / 中华神经科杂志

Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.

Disruption of circadian rhythm in Parkinson′s disease / 中华神经科杂志

Parkinson′s disease (PD) is the common progressive neurodegenerative disorder affecting older adults. Alterations of the circadian system occur in PD patients. However, the molecular mechanisms and pathophysiological process remain elusive. Circadian rhythm is modulated by both internal and external factors and using bright light and melatonin as chronotherapeutic tools may be potential therapies to improve symptoms of PD in the future. This article reviewed the abnormal changes of circadian parameters in clinical symptoms of PD and the possible mechanisms of circadian rhythm to provide basis for exploring the therapeutic strategies of circadian rhythm in PD.

Management experiences of hematopoietic stem cell transplantation center under the pandemic of COVID-19 / 中华器官移植杂志

With a global pandemic trend, coronavirus disease-2019 (COVID-19), starting a breakout in December 2019, has posed a great threat to people's lives, health and safety. Regarding how to manage hematopoietic stem cell transplantation (HSCT) center, treat non-COVID-19 HSCT patients, follow up patients after HSCT and resume the orderly treatment of transplant patients, our transplantation center has accumulated a wealth of practical experience and formulated a series of standard processes. This article was intended to summarize the management experiences of HSCT center under the pandemic of COVID-19 epidemic, provide references for effectively managing HSCT center in future public health crises and treat noncommunicable disease transplant patients in a timely and effective manner.

Research on Textual Research and Methods of Chinese Herbs in Famous Classical Formulas / 中国实验方剂学杂志

As the essential part of tratidional Chinese medicine(TCM), the research and development of classic formula have become a hot spot in TCM industry. However, with the change of the age, the species, medical part and origin of TCM have more or less changed. It is of great significance for the safety and effectiveness of the classical prescription to clarify the varieties and medicinal parts of TCM. In this paper, based on the discussion of the methods of textual research on the Chinese herbs, the species and medical parts, origin of Chinese herbs in a list of 100 famous classical formulas which promulgated by the state administration of TCM were analyzed. The textual research of Chinese herbs shows that most of the herbs involved in the classical formula have the problems of species, medical part, and origin. Therefore, it is of great significance for the selection of the species and medical parts, origin of the Chinese herbs in the research and development process of the classical formula.

Comparable effects of Jiedu Granule, a compound Chinese herbal medicine, and sorafenib for advanced hepatocellular carcinoma: A prospective multicenter cohort study / 中西医结合学报

OBJECTIVE@#Sorafenib has been extensively used for the treatment of advanced hepatocellular carcinoma (HCC), and Chinese herbal medicine has also been used to manage advanced HCC. The present work evaluates the effectiveness and safety of Jiedu (JD) Granule, a compound of traditional Chinese herbal medicine, side-by-side with sorafenib for the treatment of advance HCC.@*METHODS@#Patients with advanced HCC receiving treatment with JD Granule or sorafenib were enrolled from December 2014 to March 2018. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS) and safety. Propensity score matching (PSM) analysis was used to control for possible selection bias from the study group allocation process.@*RESULTS@#Of the 325 patients included, 161 received JD Granule and 164 received sorafenib. No significant differences were found in OS or PFS among patients receiving JD Granule compared to sorafenib (P > 0.05). Median OS of the two study groups was 6.83 months (95% confidence interval [CI]: 5.83-9.47) in the group receiving JD Granule and 8 months (95% CI: 6.67-9.80) in the group receiving sorafenib, with half-, 1- and 2-year survival rates of 53.6%, 31.2% and 13.2% vs 60.1%, 35.5% and 14.2%, respectively. Even after PSM, the median survival time did not differ between the JD Granule group (9.03 months; 95% CI: 6.37-14.2) and the sorafenib group (7.93 months; 95% CI: 6.5-9.97), with comparable half-, 1- and 2-year survival rates. The most common adverse events (AEs) were diarrhea (13.7%) and fatigue (5.6%) in the JD Granule group, and hand-foot skin reaction (46.3%) and diarrhea (36.6%) in the sorafenib group. The JD Granule was more cost-effective than sorafenib treatment for advanced HCC.@*CONCLUSION@#Compared to sorafenib, JD Granule was more cost-effective and caused fewer AEs for the treatment of Chinese patients with advanced HCC.

Analysis of the characteristic changes of macular thickness in patients with Parkinson's disease / 中华神经科杂志

Objective To analyze the characteristic changes of macular thickness in patients with Parkinson's disease by spectral-domain optical coherence tomography (SD-OCT),and find out the association between macular thickness and disease progression,cognitive dysfunction,visuospatial impairment and asymmetry of motor symptoms.Methods Seventy-one Parkinson's disease (PD) patients who were admitted to the Department of Neurology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2016 to May 2018 and sixty-one healthy controls who volunteered to participate for the same period were enrolled and underwent SD-OCT examination.The macular thickness of all retinal quadrant segments,foveal thickness,and macular volume between the two groups were comparatively analyzed.Associations between macular measurements and clinical parameters such as disease duration,Unified Parkinson's Disease Rating Scale part Ⅲ (UPDRS-Ⅲ) scores,Montreal Cognitive Assessment (MoCA) total scores,and visuospatial subscores were analyzed using generalized estimated equation fitted with linear regression models.Results Mean macular thickness in the PD group was significantly reduced compared with those in the control group ((261.94± 12.90) μm vs (270.96± 10.71) μm,B=-8.135,P＜0.01).All quadrants of macular thickness (except fovea and 1 mm central zone) in the PD group were reduced compared with those in the control group.Receiver operating characteristic (ROC) curve analysis revealed that inner superior thickness could predict the presence of PD with an area under ROC of 0.727 (95％CI 0.662-0.792,P＜0.01).UPDRS-Ⅲ scores were negatively correlated with foveal thickness (B=-9.132,P=0.034),1 mm central zone thickness (B=6.963,P=0.036) and all quadrants of the inner ring (superior (B=-7.727,P＜0.01),inferior (B=-5.169,P=0.044),nasal (B=-5.960,P＜0.01) and temporal (B=-5.905,P＜0.01)) macular thickness.The disease duration had no relationship with any quadrant of macular measurements.No statistically significant difference was found between the macula parameters of the hemiretinae corresponding to more and less severely affected cerebral hemisphere.MoCA total scores were positively correlated with all quadrants of the inner ring (superior (B=2.693,P=0.007),inferior (B=3.391,P=0.002),nasal (B=2.609,P=0.001) and temporal (B=2.115,P=0.013)) macular thickness.MoCA visuospatial subscores were positively associated with average macular thickness (B=4.368,P=0.042),macular volume (B=0.161,P=0.004),inferior (B=8.582,6.541),nasal (B=8.130,6.017) and temporal (B=5.938,5.316)quadrants of outer and inner rings macular thickness (all P＜0.05).Conclusions In PD patients,the macular thickness and macular volume were decreased.Asymmetry was not identified between hemiretinae in PD.Some quadrants of macular thickness were associated with disease progression,cognitive dysfunction,and visuospatial impairment.

Comparison of Total Daily Doses of 16 Active Components in Three Dosage Forms of Fuzi Lizhongwan / 中国实验方剂学杂志

Objective:To compare the total daily doses of 16 active components in big honeyed pills, concentrated pills and tablets of Fuzi Lizhongwan. Method:Three dosage forms of Fuzi Lizhongwan were prepared according to the process described in the literature. RRLC-QqQ-MS was employed to analyze the contents of 16 active ingredients with mobile phase of 0.1%formic acid aqueous solution-0.1%formic acid acetonitrile solution for gradient elution,the separation was performed on a Accucore RP-MS column(2.1 mm×100 mm, 2.6 μm) with a flow rate of 0.3 mL·min-1 and the column temperature at 30℃, the mass spectrometry condition was electrospray ion source, positive and negative ion switching mode for detection, multi-reaction monitoring mode(MRM) for scanning. The contents of 16 active ingredients were calculated, and the normalization arithmetic method was used for comparing the total daily doses of these active ingredients in three dosage forms of Fuzi Lizhongwan. Result:Processed products of Aconiti Lateralis Radix Praeparata were used as raw powder in preparation process of the three dosage forms, so there was no significant difference in the contents of six alkaloids in the three dosage forms, while the contents of other 10 active ingredients from Zingiberis Rhizoma, Codonopsis Radix, Atractylodis Macrocephalae Rhizoma and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle were significantly higher in big honeyed pills than those in concentrated pills or tablets(PConclusion:The total daily doses of 16 active ingredients in the three dosage forms of Fuzi Lizhongwan are significantly different caused by preparation process, prescription and dosage.

Observation for clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion

Aim of the study was to observe and analyze the clinical effect of phellodendron wet compress in treating the phlebitis caused by infusion. The research objects were 600 cases of phlebitis caused by infusion, all of which were treated in our hospital from June 2013 to June 2016. All patients were entitled to the right to know. They were randomly divided into the research group and the control group. Patients in the control group were treated with magnesium sulfate solution wet compress, while patients in the research group were treated with phellodendron wet compress. The effects in these two groups were observed and compared. Compared with the control group, the research group has better overall treatment efficiency, p<0.05; shorter average onset of action, p<0.05; less time in relieving red swelling and pain, p<0.05. Phellodendron wet compress shows a beneficial effect in treating the phlebitis caused by infusion. It can not only obviously shorten the onset of action, but also level up the overall treatment efficiency that helps patients to recover

Effects of Therapy of Wound Pus Promoting Granulation Tissue Growth on Related Factors of Granulation Tissue in Rat Chronic Skin Ulcers Based on Drug-wound Interaction / 广州中医药大学学报

Objective To observe the effects of therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory on the related factors in granulation tissue during the healing of chronic skin ulcer in rats based on drug-wound interaction. Methods Twenty-four rats were randomly divided into normal group, model group, control group, and treatment group, 6 rats in each group. The rats in the normal group had no skin ulcer and was given normal feeding,and the rats with chronic skin ulcer in the other 3 groups were induced by compound factors-overlapped method of hormone intervention-skin defect-bacterial infection. After modeling,the model group was given external use of saline gauze dressing,the control group given external use of vaseline gauze dressing,and the treatment group given external use of Shengji Xiangpi Ointment,changing fresh dressing for wound daily,the treatment lasting for 14 days. Wound sample was taken from the left back of rats, and therapeutic effect was evaluated according to the changes in the wound surface of the rat right back. After intervention for 3,7,and 14 d,the secreta and granulation tissue in the wound surface of rats were observed, the expression levels of vascular endothelial growth factor (VEGF), inducible nitric oxide synthase(iNOS), arginine-1 (Arg-1), and Notch1 in granulation tissue of rat ulcer wound were measured by enzyme-linked immunosorbent assay (ELISA). Results The wound in the treatment group has been healed after treatment for 14 days (P < 0.05 or P < 0.01 as compared with the diameter of the ulcer in the model group and the control group) . At the early stage of wound repairing (3 d),the expression levels of VEGF and Arg-1 in the treatment group were increased, and Notch1 expression level was decreased, the difference being statistically significant as compared with those of the model group and the control group (P < 0.05). At the late stage of wound repairing (14 d),the expression level of iNOS in the treatment group was increased,and the difference was statistically significant as compared with that of the model group(P < 0.05). Conclusion The therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory can promote the healing of chronic skin ulcerative wound in rats and improve the general condition of rats. The therapeutic mechanism may be associated with firstly inhibiting the expression of iNOS induced by M1 type macrophage at early stage and then promoting M2 type macrophage phenotype index Arg-1 expression,and regulating the expression of VEGF and Notch1 in the granulation tissue.

Research on TCM syndrome rule and characteristics of non-alcoholic fatty liver disease in Chongqing City / 重庆医学

Objective To investigate the traditional Chinese medicine(TCM) syndromes distribution rule of nonalcoholic fatty liver disease(NAFLD) and its correlation with related clinical indexes.Methods The general condition,TCM four diagnostic methods,biochemical and CT results in 1950 cases of NAFLD in Chongqing City were investigated for analyzing the TCM syndromes distribution rule and its correlation with biochemistry and CT.Results In 1950 cases,the accumulation and binding of damp-heat,congestion of dampness turbidity,stagnation of liver-QI with spleen deficiency,intermin-gled phlegm and blood stasis and yin deficiency of both liver and kidney accounted for 36.62 ％,27.69 ％,19.38 ％,10.10 ％ and 6.21 ％ respectively;there was statistically significant difference in age among different TCM syndromes(P＜0.05);the vin deficiency syndrome of both liver and kidney and intermin-gled phlegm and blood stasis in severe fatty liver were maximal;glutamic-pyruvic transaminase(ALT) and glutamic-oxalacetic transaminase(AST) level was higher in the accumulation and binding of damp-heat;the level of fasting plasma gluco se(FBG) was higher in the yin deficiency syndrome of both liver and kidney;the total cholesterol(TC),triglyceride(TG) and FBG levels were lower in the stagnation of liver-QI with spleen deficiency,the differences were statistically significant(P＜0.05).Conclusion In NAFLD patients,the accumulation and binding of damp-heat distribution is maximal,the proportion of severe fatty liver with vin deficiency syndrome of both liver and kidney is higher.Different dialectical types may play an important role in the clinical indexes and disease development.

Nursing care of nine patients with cytokine release syndrome after chimeric antigen receptor T cell immunotherapy / 中华护理杂志

In this paper,we summarized nursing care of 9 patients with cytokine release syndrome after receiving the chimeric antigen receptor T cells immunotherapy.Key points of nursing care were as follows:comfortable and effective antipyresis,preventive rehydration,multiple methods of blood oxygen saturation improvement,iatrogenic pressure ulcer prevention,frequent vital signs monitor,close observation of level of cytokine and inflammatory factors,timely and accurate medication,formulating personalized nursing plan according to patients' condition,close collaboration between doctors and nurses.At last,8 patients recovered and were discharged,and 1 case died due to multiple organ dysfunction syndrome.

Study on active constituents against Alzheimer's disease from Valeriana amurensis / 中国中药杂志

In this study, the chemical constituentsfrom Valeriana amurensis AD-effective fraction were investigated based on the effect of Valeriana amurensis on Alzheimer's disease (AD) in previous study. Valeriana amurensis was extracted with 75% ethanol and the obtained extract were extracted and subjected to AB-8 macroporous resin column to obtain the AD-effective fraction of Valeriana amurensis. 9 compounds (1-9) were isolated with silica gel, ODS column chromatography and preparative HPLC. The structures of these compounds were determined as 6-hydroxy-7-(hydroxymethyl)-4-methylenehexahydrocyclopenta[c]-pyran-1(3H)-one (1), suspensolide F (2), loganin(3), α-morroniside(4), β-morronisid (5), partinovalerosidate (6), zansiumloside A (7), (-)-angelicoidenol-2-O-β-D-glucopyranoside (8), citroside A (9). Compounds 6-9 were isolated from the valerian genus for the first time and further investigated the anti-AD effect of compounds 1-9 in vitro found that compound 2 and 6 protected the PC12 cells from injury significantly.

Compound Tufuling Granules (characters: see text) regulate glucose transporter 9 expression in kidney to influence serum uric acid level in hyperuricemia mice / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effect of Compound Tufuling Granules ([characters: see text], CTG) on regulating glucose transporter 9 (GLUT9) expression in the kidney to influence the uric acid excretion by the kidney and serum uric acid (SUA) level in hyperuricemia mice.</p><p><b>METHODS</b>Sixty Kunming male mice were randomly divided into the control group, model group, benzbromarone group, and CTG high-, middle- and low-dose groups. The yeast extract and uricase inhibition method were used to build hyperuricemia model, and the corresponding drugs were administrated on the 7th day. On the 21st day the 24-h urine was collected, on the 22nd day the blood was collected, the SUA level was detected by uricase colorimetry, and the mRNA and protein expressions of GLUT9 were detected by quantitative real-time polymerase chain reaction and Western blot, respectively.</p><p><b>RESULTS</b>Compared with the model group, the levels of SUA and the mRNA and protein expressions of GLUT9 were significantly decreased, and the fraction excretion of uric acid (FEUA) was significantly increased in the CTG groups and benzbromarone group (all P<0.05). There was no significant difference in the above indicators between the CTG high-dose group and benzbromarone group (P>0.05). SUA is positively related to the GLUT9 mRNA and protein expressions in the kidney (P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>CTG can significantly reduce the SUA and increase the FEUA. In addition, CTG can effectively inhibit the mRNA and protein expressions of GLUT9 in the kidney of hyperuricemia mice to inhibit the uric acid re-absorption, promote uric acid excretion and reduce SUA.</p>