ABSTRACT
Herpes simplex virus encephalitis (HSE) is a common form of viral encephalitis, often with a single-phase course. A case of HSE with abnormal mental behavior as the main manifestation, admitted in Peking University Shenzhen Hospital in Octorber 2020, which improved after sufficient antiviral treatment was reported. After 2 months, abnormal mental behavior with memory deterioration recurred. It was considered as anti-N-methyl-D-aspartate receptor antibody combined with anti-glutamic decarboxylase antibody double-positive encephalitis, and improved after rituximab treatment. At present, there is no clinical report of such double antibody positive autoimmune encephalitis secondary to HSE. The purpose of this case report is to raise clinician awareness of post-HSE autoimmune encephalitis.
ABSTRACT
The quality of Chinese materia medica is the premise to ensure its safety and effectiveness in clinical application， and the standardization of Chinese materia medica quality is the most important to realize the sustainable development of traditional Chinese medicine （TCM）. At present， the quality control system of Chinese materia medica has been transformed from a single chemical evaluation to the overall quality control guided by clinical efficacy. However， some quality control items of decoction pieces are still lacking or imperfect in the drug standard of prescription， which makes it difficult to guarantee the effectiveness and safety of Chinese materia medica in clinical application. Based on this， the quality control models and innovative ideas of Chinese materia medica were analyzed and discussed from the perspectives of chemical analysis， biological evaluation and clinical application in this paper. Aiming at the existing problems and actual needs in the control system of Chinese materia medica， this paper proposed the improvement strategies in accordance with the characteristics of TCM， in order to provide theoretical basis for the related research on quality control of Chinese materia medica.
ABSTRACT
The quality of Chinese materia medica is the premise to ensure its safety and effectiveness in clinical application， and the standardization of Chinese materia medica quality is the most important to realize the sustainable development of traditional Chinese medicine （TCM）. At present， the quality control system of Chinese materia medica has been transformed from a single chemical evaluation to the overall quality control guided by clinical efficacy. However， some quality control items of decoction pieces are still lacking or imperfect in the drug standard of prescription， which makes it difficult to guarantee the effectiveness and safety of Chinese materia medica in clinical application. Based on this， the quality control models and innovative ideas of Chinese materia medica were analyzed and discussed from the perspectives of chemical analysis， biological evaluation and clinical application in this paper. Aiming at the existing problems and actual needs in the control system of Chinese materia medica， this paper proposed the improvement strategies in accordance with the characteristics of TCM， in order to provide theoretical basis for the related research on quality control of Chinese materia medica.
ABSTRACT
Objective:To determine the dose-effect relationship of oxycodone inhibiting responses to endotracheal intubation with combination of etomidate-rocuronium during induction of general anesthesia.Methods:A total of 120 patients, aged 20-63 yr, with body mass index of 18.0-25.2 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery under general anesthesia with tracheal intubation, were divided into 4 groups ( n=30 each) using a random number table method: group O 0.15, group O 0.23, group O 0.34 and group O 0.51.In O 0.15, O 0.23, O 0.34 and O 0.51 groups, oxycodone 0.15 mg/kg, 0.23 mg/kg, 0.34 mg/kg and 0.51 mg/kg were injected intravenously, respectively, 3 min later etomidate 0.3 mg/kg and rocuronium 0.8 mg/kg were intravenously injected in turn, and tracheal intubation was performed using Macintosh laryngoscope.Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure immediately before intubation and the peak levels of HR, BP and diastolic blood pressure within 3 min after intubation were recorded.The response to endotracheal intubation was defined by the SBP and (or) HR having increased by more than 30% following intubation.The occurrence of adverse events during induction of anesthesia were recorded. Results:The rate of response to endotracheal intubation was 97%, 73%, 27%, and 3% in O 0.15, O 0.23, O 0.34 and O 0.51 groups, respectively.The median effective dose (ED 50) (95% confidence interval) of oxycodone inhibiting responses to endotracheal intubation was 0.259 (0.230-0.292) mg/kg, and the 95% effective dose (ED 95) (95% confidence interval) was 0.387 (0.358-0.420) mg/kg.Only the incidence of hypotension (27%) was significantly higher in group O 0.51 than in the other 3 groups ( P<0.05). Conclusion:With combination with etomidate-rocuronium, the ED 50 and ED 95 of oxycodone inhibiting responses to endotracheal intubation performed using Macintosh laryngoscope during induction of general anesthesia are 0.259 mg/kg and 0.387 mg/kg, respectively, and the optimum dose 0.51 mg/kg is recommended.
ABSTRACT
OBJECTIVE：To understand the current status of clinical understanding of “prohibiting”“avoiding”“using caution ” in the application of TCM ，and to provide reference for standardizing the connotation and rational application of “prohibiting” “avoiding”“using caution ”of TCM. METHODS ：Based on the theory of “knowledge-attitude-behavior”，doctor-pharmacist questionnaires and patient questionnaires were designed on the basis of literature research and clinical practice. Through the “Tencent questionnaire ”platform，800 doctor-pharmacist questionnaires were distributed to nearly 300 medical institutions from 32 provinces（cities，autonomous regions ）and 800 patient questionnaires were distributed to public patiants who had used TCM nationwide by anonymous online method. After dimensionality reduction of the questionnaire from three dimensions of cognition ， attention and behavior ，the cognition ，attention and behavior of “prohibiting”“avoiding”“using caution ”in the application of TCM were evaluated by 10 points system. RESULTS ：A total of 703 doctor-pharmacist questionnaires were collected ，including 638 valid questionnaires with recovery rate of 87.9％ and effective rate of 90.8％；Cronbach alpha coefficient was 0.90. A total of 644 patient questionnaires were collected ，including 621 valid questionnaires with recovery rate of 80.5％ and effective rate of 96.4％ . The cognition score of doctors and pharmacists to the terms of “prohibiting”“avoiding”“using caution ”in clinical application of TCM was （7.94±1.21），and that of patients was （5.64±1.54）. The score of doctors and pharmacists ’attention to the above terms was （9.47±1.15）（Spearman Rho correlation coefficient with cognition score was 0.077，P＞0.05），and the score of behavioral ability of patients was （7.01±1.71）（Spearman Rho correlation coefficient with cognition score was －0.021，P＞ 0.05）. The score of behavior ability was （7.43 ± 1.72） （Spearman Rho correlation coefficient with cognition score was 0.233，P＜0.01）. TCM textbooks （89.2％），trainingmeetings （66.5％） and herbal prescriptions （58.2％） were the main ways for doctors and pharmacists to learn the above taboos. Medical staff （74.2％）and internet （52.5％）were the main ways for patients to understand the above taboos. CONCLUSIONS ：Doctors，pharmacists and patients pay more attention to the terms of “prohibiting”“avoiding”“using caution ”in the clinical application of TCM ，but their cognition and executive power were low. Clinical cognition of “prohibiting”“avoiding”“using caution ”in the application of TCM is relatively vague，and the corresponding clinical practice behavior is lacking. It is yet to establish clinical specialist consensus in the field of TCM and publicize it actively to improve the level of clinical rational drug use.
ABSTRACT
Objective To evaluate the characteristics of three blood sampling method in quails. Methods 300 healthy 5-week old male quails were randomly divided into 3 groups: blood samples were taken from the wing root vein, the left jugular vein, and the right jugular vein, respectively, 100 quails in each group. The advantages and disadvantages of the three methods of blood sampling were compared, including the difficulty of blood collecting, the quality of blood serum obtained, the amount of bleeding after venepuncture, and the general condition of the quails after blood collection. Results All quails survived well. The right jugular vein was relatively small, and the quality of obtained serum was good, the bleeding amount after blood collection was small, the wound was easy to recover, and the general condition of the quails was good. The left jugular vein method was a little bit more difficult to collect blood, the quality of the obtained serum was good, the bleeding amount of quails after blood collection was larger, and the general state post puncture was rather good. The blood collection from the wing root vein was relatively difficult, with more massive bleeding after the vein puncture, therefore, is not suitable for large amount blood collection. Conclusions Blood samples in a large amount can be collected from both the right or left jugular veins. Small quantity of blood samples can be collected by either one of the three method.
ABSTRACT
Objective To identify the median effective volume (EV50) of 0.3 ％ ropivacaine in the old patients with femoral intertrochanteric fracture undergoing ultrasound-guided fascia iliaca compartment block (FICB).Methods Thirty-nine patients,18 males and 21 females,aged 65-98 years old,ASA physical status Ⅱ or Ⅲ,scheduled for femoral intertrochanteric fracture surgery were sequentially received ultrasound-guided FICB.Patients were sequentially given a pre-set volume of 0.3％ ropivacaine according to our pilot study.A sign of "+" was marked if the patient was positive to FICB and totally pain-free 30 min after block,and the next patient would be assigned to a lower volume of ropivacaine.Otherwise,a sign of was marked if the patient was negative to FICB that was partially or not pain-reliefed 30 min after block,and the next patient would be assigned to a larger volume of ropivacaine.The trial was terminated when 7 inflection points appeared.The EV50 of 0.3％ ropivacaine with 95％ confidence interval (CI) was calculated according to sequential method.Results Twenty (51.3％) in a total of 39 patients received a successful ultrasound-guided FICB.The EV50 and 95 ％ CI of 0.3 ％ ropivacaine using ultrasound-guided FICB in old patients with femoral intertrochanteric fracture was 25.37 ml (95％CI 22.06-29.19 ml).Conclusion The EV50 of 0.3％ ropivacaine using ultrasound-guided FICB in the old patients with femoral intertrochanteric fracture is 25.37 ml.
ABSTRACT
[ ABSTRACT] AIM:To explore the effect of renal transporter glucose transporter 9 ( Glu9 ) on hyperuricemia in the rats induced by fructose.METHODS:SD male rats (n=30) were randomly divided into normal group, model group and benzbromarone group , according to the weight .The rats in normal group was given water , while the rats in model group and benzbromarone group were given 10%fructose solution to establish hyperuricemia model .At the same time , the rats in normal group and model group were given a gavage of distilled water , while the rats in benzbromarone group were given benzbromarone at the dose of 20 mg/kg.The rats were sacrificed on the 40th day.The serum uric acid (SUA) and urinary uric acid (UUA) were detected to calculate the clearance rate of uric acid (CUA) in the kidney.The activity of hepatic xanthine oxidase ( XOD) was also measured .The expression of renal Glut 9 at mRNA and protein levels was determined by RT-qPCR and immunohistochemical staining .RESULTS:From the 20th day to the 40th day, the SUA in model group was significantly higher than that in normal group , but the UUA and CUA had no difference .On the 20th day, the SUA in benzbromarone group was markedly decreased as compared with model group , but UUA and CUA had no significant differ-ence.On the 40th day, the hepatic XOD activity in model group was significantly elevated , and no difference of XOD be-tween model group and the benzbromarone group was observed .Compared with normal group , the protein expression of Glut9 in the renal tissues of model group were markedly increased , and that in benzbromarone group was significantly lower than that in model group .However, no difference of the Glut9 mRNA expression was observed among groups .CONCLU-SION:Fructose drinking induces hyperuricemia in rats , which is probably related to the up-regulation of renal Glut9 ex-pression at protein level , and the increase in the reabsorption of uric acid in the kidneys .
ABSTRACT
Objective To explore the normal range of serum uric acid in quails.Method The data were collect-ed from male and female quails of different strains in 11 experiments, and analyzed by the way of medical reference value. Result The mean value of serum uric acid of male Difake strain quails was (221.06 ±79.59)μmol/L,and the normal range was (87.32 to 382.34)μmol/L.The mean value of serum uric acid of female Difake strain quails was (189.85 ± 68.58)μmol/L, and the normal range was ( 72.72 to 369.73 )μmol/L.The mean value of serum uric acid of male Longcheng strain quails was (217.22 ±72.91)μmol/L,and the normal range was (82.92 to 360.24)μmol/L.The mean value of serum uric acid of female Longcheng strain quails was ( 197.27 ±66.84 )μmol/L, and the normal range was (95.36 to 348.73)μmol/L.The serum uric acid value of female quails was significantly lower than that of male quails. There was no significant difference in the value of serum uric acid between female and male quails from each day-age groups.Conclusions This study has established the normal ranges for serum uric acid in quails of different strains and genders.
ABSTRACT
Hyperuricemia is closely associated with abdominal obesity .The prevalence of hyperuricemia combined with abdominal obesity has been increased significantly in recent years , along with the improvement of daily life and the changes in dietary structure .The state of hyperuricemia combined with abdominal obesity is most harmful , and becomes a common and high risk metabolic disease .Animal model with hyperuricemia combined with abdominal obesity is very impor-tant for the research of pathomechanism and treatment of this disease .
ABSTRACT
The personnel training is one of the core tasks of clinical Chinese pharmacy.Since the professional training of clinical Chinese pharmacy has started relatively late in China,the teaching contents and curriculum still need further improvements.This paper is aiming at analyzing the post tasks of personnel of clinical Chinese pharmacy,defining the knowledge structure of them,and learning from the characteristics of clinical Chinese pharmacy teaching systems of the foreign and domestic universities.On such basis,the paper proposes the ideas about constructing the curriculum system of clinical Chinese pharmacy,to provide a reference for the higher educational personnel training of clinical Chinese pharmacy.
ABSTRACT
Knowledge Discovery in Databases is gaining attention and raising new hopes for traditional Chinese medicine (TCM) researchers. It is a useful tool in understanding and deciphering TCM theories. Aiming for a better understanding of Chinese herbal property theory (CHPT), this paper performed an improved association rule learning to analyze semistructured text in the book entitled Shennong's Classic of Materia Medica. The text was firstly annotated and transformed to well-structured multidimensional data. Subsequently, an Apriori algorithm was employed for producing association rules after the sensitivity analysis of parameters. From the confirmed 120 resulting rules that described the intrinsic relationships between herbal property (qi, flavor and their combinations) and herbal efficacy, two novel fundamental principles underlying CHPT were acquired and further elucidated: (1) the many-to-one mapping of herbal efficacy to herbal property; (2) the nonrandom overlap between the related efficacy of qi and flavor. This work provided an innovative knowledge about CHPT, which would be helpful for its modern research.
ABSTRACT
The quail model of hyperuricemia combined with abdominal obesity was induced by high purine diet.Body weight in model group showed no change.Serum uric acid level in model group was increased significantly on 7,14,21,and 28 d( P＜0.05 or P＜0.01 ).Abdominal fat index in model group increased significantly on 28d.On 7 d and 28 d,serum free fatty acid level was increased significantly.Acetyl-CoA carboxylase( ACC ) protein expression in the liver of model quail was increased as shown by ELISA and immunohistochemisty ( P＜0.05 or P＜0.01 ),suggesting that the alteration of ACC expression contributes to the pathogenesis of hyperuricemia combined with abdominal obesity.
ABSTRACT
Traditional Chinese medicine (TCM) property theory is believed to be a key and difficult point of basic theory studies of TCM. Complex concepts, components and characteristics of TCM property have long puzzled researchers and urged them to develop new angles and approaches. In the view of cognitive science, TCM property theory is a cognitive process of storing, extracting, rebuilding and summarizing the sensory information about TCMs and their effects during the medical practice struggling against diseases under the guidance of traditional Chinese philosophical thinking. The cognitive process of TCM property has particular cognitive elements and strategies. Taking into account clinical application characteristics of TCMs, this study defines the particular cognitive elements. In the combination of research methods of modern chemistry, biology and mathematics, and on the basis early-stage work for five years, we have built a TCM property cognition model based on three elements and practiced with drugs with pungent and hot properties as example, in the hope of interpreting TCM properties with modern science and providing thoughts for the nature of medical properties and instruction for rational clinical prescription.
Subject(s)
Animals , Humans , Cognition , Drug Therapy , Psychology , Drugs, Chinese Herbal , Chemistry , Pharmacology , Medicine, Chinese Traditional , Psychology , Models, TheoreticalABSTRACT
ObjectiveTo observe the changes of uric acid level and lipid spectrum, and activities lipid metabolism related enzyme as well as uric acid metabolism-related enzymes on quail abdominal obesity model and then investigate the underlying mechanism of abdominal obesity combined with blood lipid spectrum disorder and hyperuricemia model. MethodsThe quail model of abdominal obesity was induced by feeding with high-fat diet.The body weight and abdominal fat content were measured and the abdominal fat index was calculated. The levels of total cholesterol (TC), high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG), glucose, and uric acid in serum were determined. The changes of adenosine deaminase (ADA),xanthine oxidase (XOD), lipoprotein lipase (LPL), hepatic lipase (HL), and total esterase (TE) activities were also determined. ResultsOn the 7th day, the body weight, abdominal fat content, and abdominal fat index were not significantly different between the model group and control group ( all P ＞0.05 ). On the 14th day, the body weight was not significantly different between these two groups ( P ＞ 0.05 ), while the abdominal fat content [(3.91 ±2. 13) vs. (2.40±0.96) g, P=0.0468] and abdominal fat index (1.92％ ±0.97％ vs. 1.22％ ±0.45％, P =0.0447) were significantly higher in the model group. On the 7th and 14th day, the levels ofTC (P =0.0042 and P =0.0006, respectively), LDL-C ( P =0.0045 and P =0.0010, respectively) in the model group were significantly higher than those in control group, while the level of TG significantly decreased ( P =0.0006 and P =0.0024, respectively ). On the 7th day, compare with the control group, the activities of ADA ( P =0.0237 )and XOD (P =0.0142) in the model group significantly increased, while the activities of LPL, HL, and TE had no significant changes. On the 14th day, compared with the control group, the activities of ADA ( P =0.0060),XOD ( P =0.0071 ), and LPL ( P =0.0419) in the model group significantly increased, while the activities of HL and TE had no significant changes. ConclusionsHigh-fat diet can induce disorders in blood lipid profiles in quail model, but also may incur abdominal obesity and multiple metabolic disorders. Changes in the activities of uric acid and lipid metabolism related enzymes may be the underlying mechanism of disorders in blood lipid profile and its associated hyperuricemia and abdominal accumulation.
ABSTRACT
AIM: To observe the levels of triglyceridemia(TG),uricemia(UA),glycemia(GLU),the activity of 3-glyceraldehyde phosphate dehydrogenase(GAPDH) in blood and the gene expression in the liver in the animal model of hypertriglyceridemia,hyperuricemia and hyperglycemia.METHODS: SD rats were randomly divided into three groups,control group,fructose group,fructose and fenofibrate treated group.Rats in control group were fed with standard chow.Rats in fructose group were fed with high fructose diet.Rats in fructose and fenofibrate group were fed with high fructose diet,and treated with fenofibrate 100 mg?kg-1?d-1 by intragastric administration at the same time.Rats in control group and fructose group were given distilled water by intragastric administration.The levels of TG,UA and GLU were detected.Improved method was used to measure the activity of GAPDH.Quanti Gene technology was applied to determine the transcriptional level of GAPDH mRNA.RESULTS: During 7-28 d,the level of TG in fructose group was significantly and persistently high.During 14-28 d,the level of UA was higher.The level of GLU higher than that in control group was only observed at 28th day.The GAPDH activity change in blood and the expression in liver were significantly lower than that in norma1 during 7-28 d.Fenofibrate had the effect on reducing TG only at 7th day and reduced the level of GLU significantly at 28th day.Fenofibrate also increased the GAPDH activity in blood and the expression in liver at 7th day.CONCLUSION: ① The level of TG is significantly and persistently high in the early days by feeding with excessive fructose.The levels of UA and GLU are higher with the time cause of the model development.② The significantly higher level of TG,UA and GLU may be correlated with the reduction of the GAPDH activity in blood and the expression in liver.③ Fenofibrate has the effect of reducing the TG level only in the condition of hypertriglyceridemia,but not in the condition of accompanying hyperuricemia and hyperglycemia.④ The mechanism of reducing the TG level by fenofibrate may be correlated with the increase in GAPDH activity in blood and the expression in liver.