Clinical Efficacy and Mechanism of Modified Erxian Decoction in Treating Osteoporosis with Yang Deficiency / 中国实验方剂学杂志

Objective::To observe the effect of modified Erxian decoction on the physical condition, pain in the lower back and joints, limb activity, bone density, bone metabolism and biochemical indexes in patients with osteoporosis caused by Yang deficiency, in order to explore the possible mechanism. Method::Totally 100 cases of osteoporosis with Yang deficiency were randomly divided into treatment group and control group, with 50 cases in each group. The control group was treated with basic anti-osteoporosis therapy, and the treatment group was give modified Erxian decoction combined with basic therapy for 6 weeks. Short physical performance battery (SPPB) scores of low back and joint pain and Yang deficiency symptom score before and after treatment were recorded and analyzed. before and after treatment, the changes of blood serum calcium (Ca), phosphorus (P), L1-4, femoral neck bone mineral density(BMD), osteocalcin (BGP) and type I collagen peptide amino end level (P1NP) were measured. Result::The scores of lumbar back and joint pain, Yang deficiency symptom score, limb function and activity, lumbar spine 1-4 (L1-4), femoral neck BMD, Ca, P, BGP and P1NP between two groups before treatment had no statistically significant difference. After 6 weeks of treatment, limb activity score, L1-4, femoral neck BMD, serum Ca and P levels in treatment group were significantly higher than those in control group (P<0.05). The scores of the pain in the lower back and joints, Yang deficiency symptom score, BGP and P1NP in treatment group were significantly lower than those in control group (P<0.05). Conclusion::Modified Erxian decoction can significantly alleviate the pain in the lower back and joints of patients with osteoporosis caused by Yang deficiency, enhance the limb function and activity status, improve the physical condition and bone density of patients, reduce bone conversion, with a good effect in treating and alleviating symptoms of osteoporosis caused by Yang deficiency.

Influence of cationic cyclopeptide on microstructure and permeability of Caco-2 cell membrane / 药学学报

The microstructure of cationic cyclopeptide (TD-34) treated Caco-2 cell membrane was observed, and we discussed the relationship between membrane structure and insulin transmembrane permeability. Atomic force microscope (AFM) was used to observe living cell membrane in air condition and tapping mode. Results showed that the surface of Caco-2 cell membrane treated with TD-34 lost its smoothness and nearly doubled its roughness. Apparent permeability coefficients (P(app)) of insulin in Caco-2 cell monolayers increased 2.5 times. In conclusion, AFM can be used to observe microstructure of cationic cyclopeptide treated cell membrane and cationic cyclopeptide enhanced insulin delivery across Caco-2 cell membrane by increasing membrane fluidity.

Effect of paeoniflorin on the pharmacokinetics of glycyrrhizic acid and glycyrrhetinic acid in rats / 中国药学杂志

OBJECTIVE: To explore the effect of paeoniflorin on the pharmacokinetics of glycyrrhizic acid and its active metabolite glycyrrhetinic acid after oral administration. METHODS: After the administration of glycyrrhizic acid alone or with paeoniflorin, blood samples were collected, and the plasma concentration-time profiles of glycyrrhizic acid and glycyrrhetinic acid were established. Pharmacokinetic parameters were calculated and analyzed with Topfit 2.0 software. RESULTS: When glycyrrhizic acid was co-administered with paeoniflorin, the ρmax and AUC of glycyrrhizic acid decreased to 9% and 33% of those of glycyrrhizic acid administered alone, respectively; the tmax prolonged markedly, CL increased, and Vd became larger. For glycyrrhetinic acid, only the t1/2 prolonged significantly while other PK parameters had little change. CONCLUSION: Paeoniflorin dramatically inhibits the absorption rate and extent of glycyrrhizic acid in rats when simultaneously orally administered, but has only small effect on the absorption of glycyrrhetinic acid. Copyright 2012 by the Chinese Pharmaceutical Association.

Pharmacokinetic study of lappaconitine hydrobromide in mice by LC-MS / 药学学报

A high sensitive and rapid method was developed for the analysis of lappaconitine in mouse plasma using liquid chromatography coupled to mass spectrometry (LC-MS). Detection was performed by positive ion electrospray ionization (ESI) in multiple reaction monitoring (MRM) mode, monitoring the transitions m/z 585 --> m/z 535 and m/z 356 --> m/z 192, for the quantification of lappaconitine and tetrahydropalmatine (internal standard, IS), respectively. The method was linear over the concentration range of 3.0-2000.0 ng x mL(-1). The lower limit of quantification was 3.0 ng x mL(-1). Intra- and inter-run precisions (RSD) were both less than 9.9% and accuracy (RE) within +/- 4.8%. After single intravenous injections of lappaconitine hydrobromide at 1.0, 2.0 and 4.0 mg x kg(-1), the elimination half-lives (t(1/2)) were 0.47, 0.48 and 0.49 h, and the areas under the curve (AUC(0-t)) were 55.5, 110.5 and 402.9 ng x h x mL(-1), separately. The pharmacokinetic profile of lappaconitine was linear at relatively lower dose levels (1.0-2.0 mg x kg(-1)). When the dose increased farther to 4.0 mg x kg(-1), the Vz and CL decreased, and the increase fold of the AUC was much larger than that of the dose.

Treatment strategy and microsurgical operation of complex cerebral arteriovenous malformations / 中华外科杂志

<p><b>OBJECTIVE</b>To study the treatment strategies and operative principles of complex cerebral arteriovenous malformation (CAVM).</p><p><b>METHODS</b>Total 27 cases of complex CAVM were microsurgically resected from June 2004 to May 2011. These account for 67.5% of CAVMs in the same time. Of the CAVM, 25 were eloquent CAVMs and 2 were non-eloquent CAVM. Among the 27 cases, the size of CAVM was large in 12 cases, median in 8, and small in 7. According to Spetzler-Martin CAVM grading, 8 cases were grade II, 5 cases were grade III, 9 cases were grade IV, and 5 cases were grade V. Pre-operative endovascular embolizations were carried out in 2 large CAVMs. All CAVMs were resected by microsurgical techniques.</p><p><b>RESULTS</b>There were 23 cases of complex CAVMs totally removed. The total resection rate was 85.2%. The residual CAVMs were found in postoperative digital subtraction angiography (DSA) in 4 cases. Three of these residual cases were treated with gamma knife. Nineteen cases recovered very well after operation. The main complications were hemianopsia in 2 cases, moderate weakness in 4 cases. Two patients in coma before operation were still comatose after operation. The follow-up period were 2 months to 6 years. Twenty-two cases were Glasgow outcome scale (GOS) 5, 3 cases were GOS 4, and 2 comatose patients were improved a little during the follow-up.</p><p><b>CONCLUSIONS</b>The microsurgical total resection of the CAVMs is the most effective method to cure the disease. With the use of microsurgical technique skillfully, mose complex CAVMs can achieve good outcomes. Preoperative embolization and radiosurgery on the residual nidus are good supplementary methods to treat the complex CAVMs.</p>

Changes of Toll-like receptor 4 and its downstream cytokines in spinal cord of rat model of neuropathic pain / 第二军医大学学报

Objective: To investigate the changes of toll-like receptor 4 expression and its downstream cytokines TNF-α, IL-1β in the spinal cord in rat chronic constriction injury (CCI) models, and to discuss the potential target for treatment of neuropathic pain. Methods: Neuropathic pain was produced by CCI of right sciatic nerve as described previously. On the 1st, 3rd, 7th and 14th day after surgery, the expression of TLR4 mRNA and protein in L4-L6 was assessed by RT-PCR and Western blotting, respectively; the distribution of TLR4 in the spinal cord was detected by immunofluorescence. The levels of TNF-α, IL-1β in the spinal cord were detected by ELISA. Thermal and mechanical nociceptive thresholds were assessed with paw withdrawal latency to radiant heat and von Frey filaments. Rats receive sham operation served as controls. Results: The mechanical allodynia and thermal hyperalgesia were induced in animals after CCI. The paw withdrawal latency (PWL) and paw withdrawal threshold (PWT) of right paw were decreased after CCI (P<0.05), and the expression of TLR4 mRNA and protein was significantly increased (P<0.05); the levels of TNF-α and IL-β in SF were also significantly increased after CCI compared with that in the sham control (P<0.05). Conclusion: CCI-induced toll-like receptor 4 activation may increase the expression of cytokines and subsequently decrease pain threshold, indicating that TLR4 might be a potential target for the treatment of neuropathic pain.

Remifentanil preconditioning attenuates hepatic ischemia and reperfusion injury in rats / 第二军医大学学报

Objective: To investigate the protective effect of remifentanil preconditioning on liver ischemia and reperfusion injury in rats. Methods: Forty-eight healthy adult SD rats, weighing 200-300 g, were divided into 4 groups: ischemic reperfusion group(I/R), ischemic preconditioning group(IPC), sham operation group(Sham), and remifentanil preconditioning group(RPC). The RPC group was further subdivided into 3 subgroups according to the dose of remifentanil: 0.2 μg·kg-1·min-1 (RPC1 group), 1 μg·kg-1·min-1 (RPC2 group), and 10 μg·kg-1·min-1 (RPC3 group). All rats except for those in the sham group were subjected to ischemia for 45 min and followed by reperfusion for 2 hours. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase(AST) and liver homogenate levels of MDA, SOD were determined. H-E staining was used to observe the hepatic histopathological changes and TUNEL staining was used to examine hepatocyte apoptosis. Results: In I/R and RPC1 group, serum ALT and AST were significantly increased; hepatic homogenate MDA content was increased and SOD content was decreased, accompanied by aggravated pathological injury; TUNEL staining showed large amount of apoptotic cells. Compared with I/R and RPC1 groups, serum ALT and AST levels in IPC, RPC2, and RPC3 groups were significantly decreased after liver ischemia and reperfusion, accompanied by decreased homogenate MDA level, increased SOD level, and improved pathological injury. TUNEL staining showed much less apoptotic hepatocytes in IPC, RPC2, and RPC3 groups compared with I/R and RPC1 groups. No obvious changes in histopathology or in other parameters were observed in the sham group. Conclusion: Pre-treatment with remifentanil, like ischemic precondition, can protect liver from ischemia and reperfusion injury.

Microsurgical treatment of ophthalmic segment aneurysms of internal carotid artery: 28 cases report / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the operative modalities and outcomes of 28 cases of ophthalmic segment aneurysms of internal carotid artery.</p><p><b>METHODS</b>Twenty-eight cases of ophthalmic segment aneurysms of internal carotid artery were operated on from May 2004 to August 2009. Of all 28 cases, 20 were large or giant. Nineteen aneurysms were directly clipped or resected with internal carotid artery revascularization. Since 2006, high-flow extracranial-intracranial (EC-IC) bypass were available and performed in 9 patients of large or giant aneurysms and then the aneurysms were resected or trapped.</p><p><b>RESULTS</b>Seventeen patients underwent digital subtraction angiography (DSA), computed tomography angiography (CTA) or magnetic resonance angiography (MRA) postoperatively. The images demonstrated that 5 grafts of bypass were in patency, and 2 were occluded. Only 1 aneurysm was partially clipped and the others disappeared on imaging. The 78% of these cases had good results (GOS 4-5). One patient died after EC-IC bypass due to neck hematoma.</p><p><b>CONCLUSIONS</b>The treatment of ophthalmic segment aneurysms of internal carotid artery, especially the large and giant ones, remains a challenge for neurovascular neurosurgeon. The accessory high-flow EC-IC bypass procedures and selection of suitable aneurysm clips are very important to improve the effectiveness of the operation.</p>

Artificial femoral head replacement for the treatment of unstable intertrochanteric fractures in aged patients: a report 40 cases / 中国骨伤

<p><b>OBJECTIVE</b>To study the operative procedures, indicatrions and short-term effects of the artificial femoral head replacement for the treatment of unstable intertrochanteric fracture in aged patients.</p><p><b>METHODS</b>From January 2001 to October 2008, 40 patients with unstable intertrochanteric fractures were treated with artificial femoral head replacement. Among the patients, 9 patients were male and 31 patients were female, ranging in age from 75 to 95 years, averaged 81.1 years. The duration from injured to the hospitalization ranged from 3 to 48 hours, with a mean of 11.5 h. According to Evans classification, 8 patients were type II , 21 type III, and 11 type IV. The duration from hospitalization to operation ranged from 4 to 8 days, averaged 4.8 day. After the operation, the hip motion was observed and the preoperative and postoperative Harris scores were compared.</p><p><b>RESULTS</b>All the patients were operated successfully, and were kept in bed about 4 to 7 days, 5.9 days in average. Thirty-one patients were followed up for 6 months without loose or dislocation of prothesis, periprosthetic fractures. Fourteen patients resumed to normal activity of the hip joint while 17 patients showed the declination of hip movement. Their hip movements recovered to (66.67+/-26.35)% at 4 months after operations and (76.08+/-25.62)% at 6 months. Among 10 patients with normal ability of hip joints before their injuries were valuated with Harris system at 6 mouths after operations, the results were:5 excellent, 3 good and 2 poor.</p><p><b>CONCLUSION</b>Artificial femoral head replacement for unstable intertrochanteric fractures in aged patients is effective in the recovery of hip joint function in short time with earlier walking and decreased complications.</p>

Clinical study on sodium ferulate for intracerebral hemorrhage in early stage / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the clinical application value of sodium ferulate for intracerebral hemorrhage in early stage.</p><p><b>METHOD</b>Sixty patients with cerebral hemorrhage in basal ganglia onset within 24 h were randomly divided into two groups. The two groups showed no evident differences in age, hematoma volume and edema volume, computerized tomography number, and Chinese Stroke Scale. Both groups were given basic treatment with dehydrating, cytidine diphosphocholine, controlling blood pressure, blood sugar and complicating diseases, while the observation group added the treatment of sodium ferulate intravenous drip after 24 h. The hematoma volume, edema volume, and computerized tomographynumber were examined in the 1st day and 14th day, Chinese Stroke Scale in the 1st day, 14th day and 28th day, and the level of serum endothelin in the 1, 3, 5, 7, 14th day.</p><p><b>RESULT</b>After treatment, edema volume and computerized tomography number in the observation group were lower than those in the control group (P < 0.01, P < 0.05). Patients' recovery of neural function were markedly improved in the observation group better than that in the control group (P < 0.05), and also the therapeutic effectiveness (P < 0.05). The serum endothelin level of the 60 patients showed higher significantly than the healthy group in 24 h after hemorrhage (P < 0.01). The control group kept higher in 14 days (P < 0.05), while the observation group showed declined significantly in the 3rd day and close to the healthy group, and lower than the healthy group in the 14th day (P < 0.05).</p><p><b>CONCLUSION</b>With the basic medical therapy, applying sodium ferulate can effectually improve the resolution of the haematoma, reduce the peripheral edema, and enhance the recovery of neural function for the patients with intracerebral hemorrhage in early stag. The therapeutic effectiveness of adding sodium ferulate in patients with intracerebral hemorrhage in early stage is better than that of the basic medical therapy in most of the fields as the above. No evident effect on secondary hemorrhage, or harmful impact on heart, liver and kidney function was found.</p>

Identification of glufosfamide metabolites in rats / 药学学报

<p><b>AIM</b>To elucidate the metabolic pathway of glufosfamide in rats.</p><p><b>METHODS</b>In this study, a liquid chromatography-tandem mass spectrometric method was developed and applied to characterize the metabolites of glufosfamide in rat urine, after an i.v. administration of 50 mg x kg(-1). The analysis was performed under two ionization modes in two different chromatographic systems, separately. To make sure that the compounds detected in rat urine were metabolites or degradation products, the stability of glufosfamide, isophosphoramide mustard (M1), and the degradation products of M1 in urine were investigated.</p><p><b>RESULTS</b>In positive ionization mode, besides glufosfamide, two metabolites, isophosphoramide mustard and monoaziridinyl derivative of isophosphoramide mustard, were detected. In negative ionization mode, only glufosfamide itself was detected, while derivatives of isophosphoramide mustard have no response in such condition.</p><p><b>CONCLUSION</b>Glufosfamide was mainly unchanged excreted in urine, and two metabolites were detected as isophosphoramide mustard and monoaziridinyl derivative of isophosphoramide mustard.</p>

Correlation between APOA gene polymorphism and intracranial aneurysm / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the correlation between a pentanucleotide repeats (PNR) polymorphism of APOA and the genesis of intracranial aneurysm.</p><p><b>METHODS</b>Fifty-eight patients with intracranial aneurysms diagnosed by angiography and 58 healthy controls were enrolled in our study. The gene polymorphism of APOA PNR were detected by polymerase chain reaction (PCR) and non-denatured polyacrylamide gels electropherosis (PAGE).</p><p><b>RESULTS</b>Eight kinds of gene types and 6 kinds of alleles were found in these two groups. There were two sites of sequence variance in the 5' control region of APOA gene, which were significantly different between the patients and controls.</p><p><b>CONCLUSION</b>Correlation may exist between intracranial aneurysm and APOA gene.</p>

Electrospray ion trap mass spectrometry of eight aminoglycoside antibiotics / 药学学报

<p><b>AIM</b>To study the dissociation pathways of aminoglycoside antibiotics.</p><p><b>METHODS</b>In positive mode, eight aminoglycoside antibiotics were elucidated by use of electrospray ion trap mass spectrometry in the multi-stage MS full scan mode.</p><p><b>RESULTS</b>It was demonstrated that the eight aminoglycoside antibiotics gave abundant product ions at m/z 322 (gentamicin, micronomicin and sisomicin), m/z 350 (etimicin, netilmicin and vetilmicin) and m/z 324 (kanamycin and tobramycin) by loss of the C-ring (amino-alpha-D-glucopyranose) in MS2 full scan mode. In MS3 full scan mode, the prominent fragmentation ions at m/z 163 as well as m/z 191 were formed from the fragmentation ions at m/z 322, m/z 350 and m/z 324 by loss of the A-ring (amino-alpha-D-glucopyranose), separately, while the characteristic fragmentation ions at m/z 160 as well as m/z 162 were formed from m/z 322, m/z 350 and m/z 324 by loss of the B-ring (2-deoxy-D-streptamine), separately.</p><p><b>CONCLUSION</b>The structural information was obtained via collision-activated dissociation and these characteristics are applicable to the structural elucidation and quantitative analysis of aminoglycoside compounds.</p>