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1.
China Pharmacy ; (12): 897-903, 2021.
Article in Chinese | WPRIM | ID: wpr-876256

ABSTRACT

OBJECTIVE:To evaluate the price and affordability of rare disease drugs in China and provide the suggestions for the improvement of rare disease drug affordability in order to provide reference for the relevant decision-making of government departments. METHODS :According to the List of the First Batch of Rare Diseasesand Diagnosis and Treatment Guideline for Rare Diseases(2019 edition),rare disease drugs were selected. The median price ratio (MPR)was used to evaluate the drug price level , and the ratio of the annual drug costs to the annual disposable income of urban or rural residents was used to evaluate the affordability,and the impact of price management policieson drug prices and affordability. RESULTS and CONCLUSIONS :A total of 71 kinds of rare disease drugs were included ,and the median MPR of them was 0.83;among them ,the median MPR of the original drugs was 1.13,and the median MPR of the generic drugs was 0.37. The annual cost of 71 rare disease drugs was 0.001-178.43 times the average annual income of urban residents ,and 0.003-456.57 times the average annual income of rural residents. There were 21 and 28 drugs whose annual cost exceeded the annual income of urban and rural residents.After the implementation of national medical insurance negotiation or volume based procurement of 14 drugs,the median MPR of these drugs decreased from 1.71 to 0.46. For urban residents ,the number of unaffordable drugs had been reduced from 8 to 0;for rural residents,it had been reduced from 10 to 5. In summary ,the price level of orphan drugs in China was slightly lower than international reference price ,but the price level of original drugs was higher than the international reference price ,and the cost of some drugs far exceeded the residents ’ability to pay. It is suggested that the government should strengthen the price management of original drugs ,promote the substitution of high-quality generic drugs for original drugs ,and improve the payment system for high-value rare disease drugs.

2.
Article in English | WPRIM | ID: wpr-915083

ABSTRACT

Objective@#Cytoreductive surgery followed by adjuvant chemotherapy is a standard frontline treatment for epithelial ovarian cancer (EOC). We aimed to develop an ovarian cancer risk score (OVRS) based on the expression of 10 ovarian-cancer-related genes to predict the chemoresistance, and outcomes of EOC patients. @*Methods@#We designed a case-control study with total 149 EOC women including 75 chemosensitives and 74 chemoresistants. Gene expression was measured using the quantitative real-time polymerase chain reaction. We tested for correlation between the OVRS and chemosensitivity or chemoresistance, disease-free survival (DFS), and overall survival (OS), and validated the OVRS by analyzing patients from the TCGA database. @*Results@#The chemosensitive group had lower OVRS than the chemoresistant group (5 vs.15, p≤0.001, Mann-Whitney U test). Patients with disease relapse (13 vs. 5, p60 months) of patients with OVRS ≥10 were significantly shorter than those of patients with OVRS <9). The high OVRS group also had significantly shorter median OS than the low OVRS group in 255 patients in the TCGA database (39 vs. 49 months, p=0.046). @*Conclusions@#Specific genes panel can be clinically applied in predicting the chemoresistance and outcome, and decision-making of epithelial ovarian cancer.

3.
Article in Chinese | WPRIM | ID: wpr-910871

ABSTRACT

Objective:To investigate the correlation between different serum uric acid (SUA) levels and impaired fasting glucose (IFG) in adults.Methods:From March 2019 to February 2020, 5006 adults in Wuxi area of Taihu Sanatorium in Jiangsu Province were selected as subjects. Quintile method was divided into the following five groups: Q1: SUA<270 μmol/L, Q2: 270 μmol/L SUA 318 μmol/L or less, Q3: 319 μmol/L ≤SUA≤360 μmol/L, Q4: 361 μmol/L SUA 410 μmol/L or less, and Q5: SUA>410 μmol/L. Correlation was analyzed by logistic analysis, with IFG as the outcome index, five SUA groups as the observation index, and gender, age, body mass index (BMI), blood lipid, and blood pressure as confounding factors. Three logistic regression analysis models were constructed to explore the relationship between different SUA level groups and IFG risk, as well as the influence of BMI on the risk correlation between SUA and IFG.Results:The BMI, DBP, FPG, TC, TG, and LDL-C all increased with the increase in SUA level; however, HDL-C gradually decreased with the increase in SUA level (P<0.01). The SUA levels among the five groups were positively correlated with fasting blood glucose level in the IFG group ( r=0.589, P<0.001). After adjusting for age, sex, and BMI, SUA level was strongly associated with fasting glucose in the IFG group ( r=0.534, P<0.001). After further adjustment for blood lipid and blood pressure, the correlation persisted ( r=0.523, P<0.001). With Q1 as the control group, the calculated OR values of IFG risk were 1.199, 2.660, 2.784 and 3.629, respectively. After further adjustment for various confounding factors, the calculated OR values of each group were 1.130, 2.389, 2.350 and 2.895, respectively. The IFG risk in the group with SUA level in the corresponding Q2 and Q5 groups was 1.13 times and 2.90 times higher, respectively, than that in the normal group, indicating that with the increase in SUA level, the IFG risk in the population increased. With the increase in BMI and SUA levels after BMI stratification, the mean fasting glucose level increased ( P<0.001). Conclusion:The SUA level and IFG risk are closely related. Increased SUA level increases IFG risk, and SUA and IFG are associated with weight gain, which should be paid attention to.

4.
Acta Pharmaceutica Sinica ; (12): 3370-3376, 2021.
Article in Chinese | WPRIM | ID: wpr-906850

ABSTRACT

italic>Tripterygium wilfordii Hook. f. is a valuable medicinal plant, with anti-tumor, anti-inflammatory, immunosuppressive and other pharmacological activities. Triterpenoids are one of the main active components that exert pharmacological effects. However, the content of triterpenoids dominated by triptolide is very low in Tripterygium wilfordii, and the analysis of the biosynthetic pathway of triterpenoids in Tripterygium wilfordii provides an effective new idea for obtaining these compounds. 2,3-Oxidosqualene cyclases (OSCs) are the key enzyme that catalyzes the formation of triterpene skeleton diversity. Based on the genome and transcriptome data of Tripterygium wilfordii, 16 OSC genes were identified and analyzed. Phylogenetic analysis showed that 16 TwOSC proteins could be mainly classified as four groups. They are β-amyrin synthase group, friedelin synthase group, multifunctional amyrin synthase and cycloartenol synthase group. TwOSC6 was successfully cloned. Functional characterization analysis revealed that TwOSC6 can catalyze the formation of α-amyrin and β-amyrin. This indicates that TwOSC6 is a multifunctional amyrin synthase. This provides new gene resources for the diversity of Tripterygium wilfordii triterpenoids, as well as new gene elements for biosynthesis triterpenoids.

5.
China Pharmacy ; (12): 139-145, 2021.
Article in Chinese | WPRIM | ID: wpr-862634

ABSTRACT

OBJECTIVE:To provide reference for improving medical insurance reimbursement for multi-indication drugs based on value-based pricing in China. METHODS:The theory and practice of value-based pricing for multi-indication drugs were sorted out,and the value standards and medical insurance reimbursement strategies based on value-based pricing in France,Germany,UK,Italy and Sweden were analyzed,so as to provide the suggestions for medical insurance reimbursement of multi-indication drugs in China. RESULTS & CONCLUSIONS:The realization of value-based pricing first needed to develop a value framework to define,measure and integrate value,and then established a model to convert the total value into price. The overall idea of value-based pricing for multi-indication drugs was consistent,but there were differences in the value standard. In the UK and Sweden, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) measured by pharmacoeconomicsare used as the value standard. France,Germany and Italy were more focused on the therapeutic value and clinical benefit improvement. As for medical insurance reimbursement strategies,France adopted single weighting method based on expected volume. Germany adopted combination weighting method based on value and volume. UK introduced the Patient Access Schemes and Italy introduced the Managed Entry reements,both based on the nominal reimbursement standard. Sweden adopted independent reimbursement for different indications by different brand names. It is suggested that China can explore the value-based pricing strategies of multi-indication drugs on the basis of the above international experiences,reference and use these variety of medical insurance reimbursement strategies comprehensively. Simultaneously,the information collection mechanism of patients and drug use should be improved to provide data support for the implementation of China’s value-based pricing and reimbursement strategies for multi-indication drugs.

6.
Acta Pharmaceutica Sinica ; (12): 414-431, 2021.
Article in Chinese | WPRIM | ID: wpr-873760

ABSTRACT

Protein kinases are intimately involved in the pathogenesis of many diseases such as cancer, inflammation, and autoimmune and neurological diseases. Therefore, kinases have been widely studied as drug targets over the past three decades. As of April, 2020, the FDA had approved 59 small molecule kinase inhibitors (SMKIs) in the emerging field of targeted drug therapy. This paper focuses on the biochemistry and pharmacology of these 59 SMKIs and 121 SMKIs for which structures can be retrieved and that are now in phase Ⅱ and Ⅲ clinical trials. In addition, this paper also conducts a simple analysis of several popular targets and their inhibitors.

7.
Chinese Medical Journal ; (24): 821-828, 2021.
Article in English | WPRIM | ID: wpr-878109

ABSTRACT

BACKGROUND@#Colorectal cancer is harmful to the patient's life. The treatment of patients is determined by accurate preoperative staging. Magnetic resonance imaging (MRI) played an important role in the preoperative examination of patients with rectal cancer, and artificial intelligence (AI) in the learning of images made significant achievements in recent years. Introducing AI into MRI recognition, a stable platform for image recognition and judgment can be established in a short period. This study aimed to establish an automatic diagnostic platform for predicting preoperative T staging of rectal cancer through a deep neural network.@*METHODS@#A total of 183 rectal cancer patients' data were collected retrospectively as research objects. Faster region-based convolutional neural networks (Faster R-CNN) were used to build the platform. And the platform was evaluated according to the receiver operating characteristic (ROC) curve.@*RESULTS@#An automatic diagnosis platform for T staging of rectal cancer was established through the study of MRI. The areas under the ROC curve (AUC) were 0.99 in the horizontal plane, 0.97 in the sagittal plane, and 0.98 in the coronal plane. In the horizontal plane, the AUC of T1 stage was 1, AUC of T2 stage was 1, AUC of T3 stage was 1, AUC of T4 stage was 1. In the coronal plane, AUC of T1 stage was 0.96, AUC of T2 stage was 0.97, AUC of T3 stage was 0.97, AUC of T4 stage was 0.97. In the sagittal plane, AUC of T1 stage was 0.95, AUC of T2 stage was 0.99, AUC of T3 stage was 0.96, and AUC of T4 stage was 1.00.@*CONCLUSION@#Faster R-CNN AI might be an effective and objective method to build the platform for predicting rectal cancer T-staging.@*TRIAL REGISTRATION@#chictr.org.cn: ChiCTR1900023575; http://www.chictr.org.cn/showproj.aspx?proj=39665.


Subject(s)
Artificial Intelligence , Humans , Magnetic Resonance Imaging , Neoplasm Staging , Neural Networks, Computer , Rectal Neoplasms/pathology , Retrospective Studies
8.
Article in Chinese | WPRIM | ID: wpr-877561

ABSTRACT

OBJECTIVE@#To compare the therapeutic effect between long-snake moxibustion combined with western medication and simple medication on diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney @*METHODS@#A total of 60 patients with IBS-D of spleen and kidney @*RESULTS@#Compared before treatment, the symptom scores of abdominal pain, defecation frequency, mucous stool and appetite reduction were decreased (@*CONCLUSION@#Long-snake moxibustion combined with western medication can effectively treat the IBS-D of spleen and kidney


Subject(s)
Acupuncture Points , Animals , Diarrhea/drug therapy , Humans , Irritable Bowel Syndrome/drug therapy , Kidney , Moxibustion , Quality of Life , Snakes , Spleen , Yang Deficiency/drug therapy
9.
Article in Chinese | WPRIM | ID: wpr-882557

ABSTRACT

Objective:To study the effect of Huanglian-Jiedu Decoction on the white matter lesion of rats with focal cerebral ischemia and to explore the regulative role of the active fraction of Huanglian-Jiedu Decoction on NogoA/NgR. Methods:Male SD rats were randomly divided into sham operation group, model group, total alkaloid group, total flavonoid group, and total iridoid group. Except for the sham operation group, the rats in the other groups were used to establish the middle cerebral artery occlusion rat model by the suture method. 2 hours after modeling, rats in the total alkaloid group were given intragastric administration with 44 mg/kg total alkaloids; rats in the total flavonoid group were given intragastric administration 50 mg/kg total flavonoids; rats in the total iridoid group were given intragastric administration 80 mg/kg total iridoids, the sham operation group and the model group were intragastrically given equal volume of normal saline, once a day, for 7 consecutive days. The pathological changes of rat white matter were observed by HE staining, the pathological changes of rat myelin sheath were observed by Luxol fast blue (LFB) staining, and the expression of Amyloid precursor protein (APP), NogoA, and NgR in the internal and external capsule areas of the brain was detected by immunohistochemical staining. Real-time fluorescence quantitative PCR was used to detect the expression of NogoA and NgR in the tissues surrounding the ischemic infarct.Results:Compared with the model group, the total alkaloid group, total flavonoid group, and total iridoid group had lower pathological damage scores in the internal and external capsule areas of rats ( P<0.05 or P<0.01), increased integral optical density value of LFB staining ( P<0.01), decreased expression of APP and NogoA; the expression of NgR in the internal and external capsules of rats in the total alkaloid group and the total iridoid group decreased ( P<0.05 or P<0.01), and the expression of NgR in the inner capsule of rats in the total flavonoid group decreased ( P<0.01); the expression of NogoA (1.20 ± 0.17, 1.55 ± 0.30, 1.19 ± 0.38 vs. 2.22 ± 0.58) and NgR (1.98 ± 0.55, 1.48 ± 0.31, 1.58 ± 0.27 vs. 3.36 ± 0.41) genes in the tissues around the infarct focus of rats in the total alkaloid group, total flavonoid group and total iridoid group decreased ( P<0.01). Conclusion:The present study investigates the therapeutic effects of Huanglian-Jiedu Decoction, promoting white matter repair by decreasing the overexpression of NogoA and NgR in an experimental animal model of stroke.

10.
China Pharmacy ; (12): 2605-2612, 2021.
Article in Chinese | WPRIM | ID: wpr-904518

ABSTRACT

OBJECTIVE:To analysis the correlation between chrom aticity value and quality index of Atractylodis chinensis decoction piece powder stir-fired with bran ,and to determine its processing time. METHODS :The processed samples of 16 batches of A. chinensis decoction piece stir-fired with bran (S0-S15,S0 is the raw product of A. chinensis )were prepared ,and chromaticity values of all samples were determined ,such as lightness value (L*),yellow blue value (b*),red green value (a*). UPLC fingerprint of sample were analyzed ,and the contents of extract and volatile oil were also determined. Pearson correlation was used to analyze the correlation between the chromaticity value and quality index (relative peak area of each chromatographic peak in UPLC fingerprint ,water-soluble extract content ,alcohol-soluble extract content and volatile oil content ). Multivariate statistical analysis (principal component analysis ,cluster analysis ,partial least squares discriminant analysis )was carried out with chromaticity value and quality index ,and the processing time of A. chinensis decoction piece stir-fired with bran was determined by grey correlation method. RESULTS :In the process of bran frying ,with the extension of processing time ,L* and b* of decoction pieces powder decreased ,and a* increased first and then decreased ;relative areas of peak 1 and peak 2 increased first and then decreased,while relative areas of peak 3(5-hydroxymethyl furfural )increased,and the areas of the other peaks decreased. The content of the extract did not change significantly with time ,and the content of the volatile oil decreased. The results of correlation analysis showed that the relative peak area of peak 2-27,alcohol-soluble extract content and volatile oil content had a certain correlation with the chromaticity value ,while the relative peak area of peak 1 and water-soluble extract content had no linear correlation with the chromaticity value. Results of multivariate statistical analysis showed that the samples were divided into mild (S0-S5),excessive (S12-S15),moderate (S6-processing time of 18-33 min). The results of grey correlation method showed that the processing time of A. chinensis decoction piece stir-fired w ith bran should be controlled in the range of 18-24 min,and the optimal processing time was 18 min. CONCLUSIONS :There is a correlation between chromaticity value of A. chinensis decoction piece powder stir-fired with bran and the relative peak area of 27 chromatographic peaks ,and content of extract and volatile oil. It is suggested that the processing time should be 18 min.

11.
Chinese Journal of Geriatrics ; (12): 151-154, 2020.
Article in Chinese | WPRIM | ID: wpr-869353

ABSTRACT

Objective:To explore the correlation between different smoking status and serum uric acid(SUA)in a middle-aged male in health check-up population.Methods:In this cross-sectional study, a total of 26701 middle-aged men who underwent health check-up in Taihu Sanatorium of Jiangsu Province from January 2014 to June 2015 were studied.The correlation between smoking status and SUA was analyzed by questionnaires, physical examination and serum biochemical assay.Smoking state was divided into no smoking, a occasional smoking and smoking groups.Results:With the increase of age, there was a downward trend of SUA( F=7.38, P=0.000). Among the three smoking groups, the group with occasional smoking had the highest level of SUA.The smoking group had lower level of SUA than the non-smoking group and occasional smoking group( P=0.000 and 0.005). In the non-smoking group, the fourth quartile of SUA(41.5%)had a higher percentage than that in first quartile of SUA(38.4%)( χ2=12.266, P=0.000). In the smoking group, the fourth quartile of SUA(54.9%)had lower percentage than that in the first quartile of SUA(58.4%)( χ2=7.049, P=0.008). Compared with the non-smoking group, the prevalence of hyperuricemia(HUA)in smoking group was lower( OR=0.872, 95% CI: 0.821~0.927, P=0.000), the prevalence of HUA in occasional smoking group was higher( OR=1.194, 95% CI: 1.013~1.408, P=0.035). Conclusions:As compared with the non-smoking group, the prevalence of HUA is lower in smoking group and is higher in occasional smoking group.

12.
China Pharmacy ; (12): 1113-1118, 2020.
Article in Chinese | WPRIM | ID: wpr-821503

ABSTRACT

OBJECTIVE:To evalua te the economics of glecaprevir/pibrentasvir (G/P)versus elbasvir/grazoprevir (EBR/GZR) in chronic hepatitis C genotype 1b(GT1b)treatment-naive patients without cirrhosis ,and to provide evidence support for medical and health decision-making. METHODS :Under assuming the bid price of G/P and EBR/GZR therapy schemes before medical insurance negotiation was adopted (scenario 1)and assuming that the price of EBR/GZR was reduced by 85% and the price of G/P was reduced by 80%(scenario 2),Markov model was developed to simulate the lifetime cost and health outcomes progress of 10 000 untreated chronic hepatitis C GT 1b treatment-naive patients without cirrhosis and calculate incremental cost-effectiveness ratio(ICER). Single factor sensitivity analysis and probability sensitivity analysis were conducted to verify the results. The highest price(price reduction ratio )of G/P scheme was analyzed with cost-effectiveness advantage ,when other parametes kept stable under scenario 2. RESULTS :Under 2 kinds of scenarios ,compared with EBR/GZR scheme ,G/P scheme had higher cost (scenario 1:68 800 yuan vs. 62 338 yuan;scenario 2:13 760 yuan vs. 11 490 yuan)and healty utility (scenario 1:14.97 QALY vs. 14.90 QALY;scenario 2:14.97 QALY vs. 14.90 QALY),and ICER value of G/P was lower than willingness-to-pay threshold (scenario 1:92 314 yuan/QALY;scenario 2:32 428 yuan/QALY). The change of most parameters in single factor sensitivity analysis didn ’t influence the results of base-case analysis ,and the findings from the base-case analysis were confirmed by probability sensitivity analyses. The price of G/P scheme needed to be reduced by at least 62% to realize cost-effective advantage. CONCLUSIONS : Under the set price scenario ,G/P scheme has cost-effectiveness advantages than EBR/GZR scheme in chronic hepatitis C GT 1b treatment-naive patients without cirrhosis.

13.
Article in Chinese | WPRIM | ID: wpr-862700

ABSTRACT

<b>Objective::To discuss the effect of Zhongfeng Xingnao liquid on neurological recovery of patients of ischemic stroke with Qi deficiency and blood stasis syndrome at early recovery, and the mechanisms of anti-inflammation, neuroprotection and improvement of microcirculation. <b>Method::One hundred and twenty-eight patients were randomly divided into control group (64 cases) and observation group (64 cases) by random number table. Both groups’ patients got atorvastatin, 10 mg/days, aspirin enteric-coated tablets, 100 mg/days, and control of blood pressure and blood sugar, and modern rehabilitation training. Patients in control group orally got Zhongfeng Xingnao liquid, 25 mL/time, 3 times/days. The course of treatment was 90 days. And before and after treatment, national institutes of health neurological deficiency (NIHSS), Barthel index, improvement Rankin scale, brunel balance scale (BBA), Fugl-Meyer scale (FMA), Qi deficiency and blood stasis syndrome (SS-QOL) were scored. And levels of brain-derived neurotrophic factor (BDNF), tumor necrosis factor-alpha (TNF-alpha), homocysteine (Hcy), serum cystatin C (Cys-C), platelet aggregation rate (ADP) and fibrinogen (FIB) were detected. <b>Result::The clinical efficacy in observation group was better than that in control group (<italic>Z</italic>=1.981, <italic>P</italic><0.05). At different time points after treatment, scores of NIHSS and Qi deficiency and blood stasis syndrome were lower than those in control group (<italic>P</italic><0.05), whereas scores of Barthel index, FMA, BBA and SS-QOL were higher than those in control group (<italic>P</italic><0.01). Degrees of disability and dyskinesia in observation group was lighter than those in control group (<italic>Z</italic>=1.932, <italic>P</italic><0.05). Degree of dyskinesia was lighter than that in control group (<italic>Z</italic>=2.149, <italic>P</italic><0.05). And level of BDNF was higher than that in control group (<italic>P</italic><0.01), while levels of TNF-<italic>α</italic>, Hcy, Cys-C, ADP and FIB were lower than those in control group (<italic>P</italic><0.01). <b>Conclusion::In addition to the routine comprehensive rehabilitation measures of western medicine, Zhongfeng Xingnao liquid can promote recovery of nerve function defect of patients of cerebral infarction with Qi deficiency and blood stasis syndrome at convalescence, is beneficial for rehabilitation of patients and improving the quality of life, with certain effects in resisting inflammation, improving microcirculation and protecting nerves, and better efficacy than simple western medicine treatment.

14.
Article in Chinese | WPRIM | ID: wpr-873095

ABSTRACT

Objective::To observe the clinical efficacy of Sanju Kechuan oral liquid on phlegm-turbid obstruction of lung syndrome of asthma at acute episode, in order to study its effect on pulmonary function and inflammatory factors. Method::One hundred and seventeen patients were randomly divided into control group (57 cases) and observation group (60 cases) by random number table. Patients in control group got budesonide suspension for inhalation by atomizer, 1-2 mg/time, 2 times/days. Patients who could not control were added with salmeterol xinafoate and fluticasone propionate powder for inhalation in every morning and evening, 50-250 μg/time. In addition to the therapy of control group, patients in observation group was added with Sanju Kechuan oral liquid, 20 mL/time, 3 times/days. The course of treatment was 7 days. And before and after treatment, the severity of asthma at acute episode and the phlegm-turbid obstruction of lung syndrome were scored. And 1-second forced expiratory volume (FEV1), diurnal variability of peak expiratory flow (PEF), fractional exhaled nitric oxide (FeNO), peripheral blood, percentage of sputum eosinophils (Eos) were recorded, and levels of interleukin-2 (IL-2), interferon-gamma (IFN-γ), IL-4, IL-5 and IL-17 were detected. Result::The clinical efficacy in observation group was better than that in control group (Z=1.916, P<0.05). Scores of severity of asthma at acute episode and phlegm-turbid obstruction of lung syndrome were lower than those in control group (P<0.01). And FEV1 was higher than that in control group (P<0.05), while PEF was lower than that in control group (P<0.05). Asthma control in observation group was better than that in control group (Z=2.231, P<0.01). And levels of FeNO, Eos in sputum, Eos in peripheral blood, IL-4, IL-5 and IL-17 were lower than those in control group (P<0.01), whereas levels of IL-2 and IFN-γ were higher than those in control group (P<0.01). Conclusion::In addition to the therapy of routine western medicine, Sanju Kechuan oral liquid can alleviate the severity of phlegm-turbid obstruction of lung syndrome of asthma at acute episode, improve the lung function, control the attack of asthma and inhibit the airway inflammation, with a better the clinical efficacy than pure western medicine treatment.

15.
Chinese Journal of Neurology ; (12): 706-710, 2020.
Article in Chinese | WPRIM | ID: wpr-870873

ABSTRACT

Rotational vertebral artery occlusion syndrome, also known as bow hunter′s syndrome (BHS), is a rare cause of posterior circulation ischemia. Digital subtraction angiography (DSA) is still the gold standard for diagnosis. A case of bilateral cerebellar infarction, with color Doppler ultrasound showing special vertebral artery hemodynamic changes after head and neck rotation, was diagnosed by DSA as BHS and intracranial vertebral artery dissection. Based on the literature published previously, the clinical manifestations and imaging features of BHS were discussed to improve clinicians′ awareness of the syndrome.

16.
Neuroscience Bulletin ; (6): 875-894, 2020.
Article in English | WPRIM | ID: wpr-826752

ABSTRACT

In the central nervous system, hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are essential to maintain normal neuronal function. Recent studies have shown that HCN channels may be involved in the pathological process of ischemic brain injury, but the mechanisms remain unclear. Autophagy is activated in cerebral ischemia, but its role in cell death/survival remains controversial. In this study, our results showed that the HCN channel blocker ZD7288 remarkably decreased the percentage of apoptotic neurons and corrected the excessive autophagy induced by oxygen-glucose deprivation followed by reperfusion (OGD/R) in hippocampal HT22 neurons. Furthermore, in the OGD/R group, p-mTOR, p-ULK1 (Ser), and p62 were significantly decreased, while p-ULK1 (Ser), atg5, and beclin1 were remarkably increased. ZD7288 did not change the expression of p-ULK1 (Ser), ULK1 (Ser), p62, Beclin1, and atg5, which are involved in regulating autophagosome formation. Besides, we found that OGD/R induced a significant increase in Cathepsin D expression, but not LAMP-1. Treatment with ZD7288 at 10 μmol/L in the OGD/R group did not change the expression of cathepsin D and LAMP-1. However, chloroquine (CQ), which decreases autophagosome-lysosome fusion, eliminated the correction of excessive autophagy and neuroprotection by ZD7288. Besides, shRNA knockdown of HCN2 channels significantly reduced the accumulation of LC3-II and increased neuron survival in the OGD/R and transient global cerebral ischemia (TGCI) models, and CQ also eliminated the effects of HCN2-shRNA. Furthermore, we found that the percentage of LC3-positive puncta that co-localized with LAMP-1-positive lysosomes decreased in Con-shRNA-transfected HT22 neurons exposed to OGD/R or CQ. In HCN2-shRNA-transfected HT22 neurons, the percentage of LC3-positive puncta that co-localized with LAMP-1-positive lysosomes increased under OGD/R; however, the percentage was significantly decreased by the addition of CQ to HCN2-shRNA-transfected HT22 neurons. The present results demonstrated that blockade of HCN2 channels provides neuroprotection against OGD/R and TGCI by accelerating autophagic degradation attributable to the promotion of autophagosome and lysosome fusion.

17.
Article in Chinese | WPRIM | ID: wpr-826720

ABSTRACT

Based on the three books of - (1931), - (1940) and - (1955) written by Mr. -, the classification of facial diseases as well as the records and evolution process of Chinese and western disease names are summarized and analyzed to discuss Mr. -'s understanding of facial diseases in different periods. Through the systematic analysis and comparison in the trilogy of acupuncture and moxibustion, the characteristics of syndrome differentiation and diagnosis-treatment of acupuncture-moxibustion treatment for facial diseases by Mr. - are summarized, including clinical syndrome differentiation and treatment, which is adjusted with syndrome changes; simplified selection of acupoints, with attention on empirical acupoints; the strength of acupuncture is based on efficacy; acupuncture and moxibustion has specific indication; combination of acupuncture and medication could bring out the best in each other.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Books , Face , Pathology , Humans , Moxibustion
18.
Article in Chinese | WPRIM | ID: wpr-826335

ABSTRACT

To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(=0.019),the maximum diameter of tumours on axial images(=0.003),the maximum upper and lower diameters(=0.004),Shamblin classification(=0.012),and number of blood supply arteries(<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.


Subject(s)
Carotid Body Tumor , Diagnostic Imaging , Computed Tomography Angiography , Head , Humans , Neck , Retrospective Studies
19.
China Pharmacy ; (12): 1739-1745, 2020.
Article in Chinese | WPRIM | ID: wpr-823053

ABSTRACT

OBJECTIVE:To e stablish UPLC characteristic chrom atograms of Euodia rutaecarpa ,processed E. rutaecarpa decoction piece ,water decoction and formula granules ,and to compare its relationship and difference. METHODS :UPLC method was used. The determination was performed on YMC Triart C 18 column with mobile phase consisted of acetonitrile- 0.1% phosphoric acid water solution (gradient elution )at the flow rate of 0.3 mL/min. The detection wavelength was set at 254 nm,and column temperature was 30 ℃. The sample size was 1 μL. Using limonin as reference,the characteristic chromatograms of E. rutaecarpa , processd E. rutaecarpa decoction piece ,water decoction and formula granules (each 10 batches,totally 60 batches)were drawn. The similarity was evaluated with TCM Chromatographic Fingerprint Similarity Evaluation System (2012 edition),and to determine the common characteristic peak. The differences of ratio of common characteristic peak area were evalucoted according to variance analysis. Meanwhile ,the cluster analysis and principal component analysis (PCA) were performed to research the differences of E. rutaecarpa ,processed E. rutaecarpa decoction piece ,water decoction and formula granules by using SPSS 20.0 software. RESULTS :Totally 16 and 17 common peaks were respectively confirmed in characteristic chromatograms of E. rutaecarpa samples and processed E. rutaecarpa samples(decoction piece ,water decoction and formula granules ). No. 8,9,11, 17 peaks were identified as limonin ,evodiamine,rutaecarpine and glycyrrhizic acid. Compared with decoction piece ,the similarities of characteristic peak between water decoction and formula granules were lower than 0.55,while those between water decoction and formula granule were higher than 0.95. Cluster analysis and PCA results showed that E. rutaecarpa decoction piece and processed E. rutaecarpa decoction piece could be clustered into one category ;E. rutaecarpa water decoction and formula granules could be clustered into one category ;processed E. rutaecarpa water decoction and formula granules could be clustered into one category. CONCLUSIONS :Compared with E. rutaecarpa ,processed E. rutaecarpa additionally contain glycyrrhizic acid ; main che mical components of decoction piece ,water decoction and formula granules are basically the same ,but the contents of the components between decoction piece to water decoction and formula granules are different.

20.
Article in Chinese | WPRIM | ID: wpr-828024

ABSTRACT

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.


Subject(s)
Adolescent , Adult , Betacoronavirus , Coronavirus Infections , Drug Therapy , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Middle Aged , Pandemics , Pneumonia, Viral , Drug Therapy , Prospective Studies , Young Adult
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