Analysis on Components Absorbed into Blood and Cerebrospinal Fluid of Schisandrae Chinensis Fructus Based on Sequential Metabolism / 中国实验方剂学杂志

ObjectiveTo identify the prototypical components and metabolites absorbed into blood and cerebrospinal fluid of Schisandrae Chinensis Fructus（SCF） based on sequential metabolism combined with liquid chromatography-mass spectrometry. MethodBlood and cerebrospinal fluid samples of integrated metabolism， intestinal metabolism and hepatic metabolism were collected from male SD rats after gavage and in situ intestinal perfusion administration， and ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC Q-Exactive Orbitrap MS） was used to analyze and compare the differences in the spectra of SCF extract， blank plasma， administered plasma， blank cerebrospinal fluid and administered cerebrospinal fluid with ACQUITY UPLC BEH Shield RP18 column（2.1 mm×100 mm， 1.7 µm）， the mobile phase was acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-7 min， 95%B； 7-12 min， 95%-35%B； 12-17 min， 35%-15%B； 17-20 min， 15%-12%B； 20-22 min， 12%-5%B； 22-23 min， 5%B； 23-25 min， 5%-95%B； 25-28 min， 95%B）. And heated electrospray ionization（HESI） was used with positive and negative ion modes， the scanning range was m/z 100-1 500. The prototypical constituents and their metabolites absorbed into blood and cerebrospinal fluid of SCF were identified according to the retention time， characteristic fragments， molecular formulae and the information of reference substances. ResultA total of 42 chemical components were identified in the extract of SCF， including lignans， flavonoids， amino acids， tannins， and others， of which lignans were the main ones. A total of 27 prototypical components and 14 metabolites were identified in plasma samples from different sites. A total of 15 prototypical components and 9 metabolites were identified in cerebrospinal fluid. The main metabolic reactions involved in the formation of metabolites were mainly demethylation， methylation， demethoxylation and hydroxylation. ConclusionThrough the systematic identification of the prototypical components and metabolites of SCF in rats， it provides data support for further better exploring the material basis of SCF in the treatment of central nervous system diseases.

Analysis of Inhibitory Effect of Berberine Compounds on Acetylcholinesterase and Blood-brain Barrier Permeability / 中国实验方剂学杂志

ObjectiveTo examine the inhibitory effects of berberine compounds， including columbamine， on acetylcholinesterase from the perspectives of drug-target binding affinity and kinetics and explore the blood-brain barrier （BBB） permeability of these compounds in different multi-component backgrounds. MethodThe median inhibitory concentration （IC50） of acetylcholinesterase by berberine compounds including columbamine was measured using the Ellman-modified spectrophotometric method. The binding kinetic parameters （Koff） of these compounds with acetylcholinesterase were determined using the enzyme activity recovery method. A qualitative analysis of the ability of these components to penetrate the BBB and arrive at the brain tissue in diverse multi-component backgrounds （including medicinal herbs and compound formulas） was conducted using ultra performance liquid chromatography-high resolution mass spectrometry （UPLC-HRMS）. ResultBerberine compounds， including columbamine， exhibited strong inhibition of acetylcholinesterase， with IC50 values in the nanomolar range. Moreover， they displayed better drug-target binding kinetics characteristics （with smaller Koff values） than the positive control of donepezil hydrochloride （P<0.01）， indicating a longer inhibition duration of acetylcholinesterase. Berberine components such as columbamine could penetrate the BBB to arrive at brain tissue in the form of a monomer， as well as in the multi-component backgrounds of Coptis and Phellodendri Chinensis Cortex medicinal extracts and the compound formula Huanglian Jiedutang. ConclusionThese berberine compounds such as columbamine exhibit a strong inhibitory effect on acetylcholinesterase and can arrive at brain tissue in multi-component backgrounds. In the level of pharmacological substance， this supports the clinical efficacy of compound Huanglian Jiedutang in improving Alzheimer's disease， providing data support for elucidating the pharmacological basis of compound Huanglian Jiedutang.

The neuroprotective effects of Herba siegesbeckiae extract on cerebral ischemia/reperfusion in rats / 中国药理学通报

Aim To study the neuroprotective effects of Herba siegesbeckiae extract on cerebral ischemia/ reperfusion rats and its mechanism. Methods Sixty SD rats were randomly divided into model group, low, middle and high dose groups of Herba siegesbeckiae, and Sham operation group, and the drug was given continuously for seven days. The degree of neurologic impairment was evaluated by mNSS, and the infarct volume was measured by MRI. The number of Nissl-posi- tive cells was detected by Nissl staining, and the apop- tosis was accessed by Tunel staining. Furthermore, the expression of Bax, Bcl-2 and NeuN was observed by Western blot, and the expression of NeuN was detected by immunofluorescence staining. The expression of IL- 1β, TNF-α and IL-6 mRNA was performed by RT- qPCR. Results The mNSS score and the volume of ischemic cerebral infarction in the model group were significantly increased, and Herba siegesbeckiae extract treatment significantly decreased the mNSS score and infarct volume (P<0.05, P<0.01). Herba siegesbeckiae extract could increase the number of Nissl-pos- itive cells and the expression of NeuN (P<0.01), and reduce the number of Tunel-positive cells (P<0.01). Western blot showed that Herba siegesbeckiae extract inhibited the expression of Bax, increased Bcl-2 and NeuN in ischemic brain tissue (P<0.01). RT-qPCR showed that Herba siegesbeckiae extract inhibited the expression of IL-1 β, TNF-α and IL-6 mRNA in the is-chemic brain tissue (P<0.01). Conclusions Herba siegesbeckiae extract can reduce the cerebral infarction volume, improve the neurological function damage, inhibit the apoptosis of nerve cells and the expression of inflammatory factors and promote the expression of NeuN, there by exerting protective effects on MCAO rats.

Opportunities and challenges of pediatric medical education in the new era of China / 中华医学教育探索杂志

Medical education in China has undergone many changes amid the revolution of medical education worldwide. The Healthy China initiative in the new era highlights the increasing demand for a high-quality children's health service system as well as more excellent pediatricians. This article aims to delve into the current opportunities and challenges of pediatric education in China, summarize the response strategies, and take a look at the new mode of talent cultivation in pediatric medicine. With the rapid shift in the newborn population, the strengthening of multidisciplinary collaboration, the development of medical informatization, and the continuous improvement in scientific research levels, pediatric medical education is facing unprecedented opportunities. However, the late start of pediatrics and the lack of high-level talents have also brought great challenges to pediatric medical education. Therefore, future efforts should be focused on multi-disciplinary cooperation and innovative education and teaching to nurture pediatrician-scientists with innovative abilities and practical experience.

Anti-depression mechanism of Zuojin Pills:based on UHPLC-TOF-MS, network pharmacology, and experimental verification / 中国中药杂志

This study aims to explore the anti-depression mechanism of Zuojin Pills based on the plasma constituents, network pharmacology, and experimental verification. UHPLC-TOF-MS was used for qualitative analysis of Zuojin Pills-containing serum. Targets of the plasma constituents and the disease were retrieved from PharmMapper and GeneCards. Then the protein-protein interaction(PPI) network was constructed and core targets were screened for GO term enrichment and KEGG pathway enrichment. Cytoscape 3.7.2 was employed construct the "compound-target-pathway" network and the targets and signaling pathways of Zuojin Pills against depression were predicted. CUMS-induced depression mouse model was established to verify the key targets. The results showed that a total of 21 constituents migrating to blood of Zuojin Pills were identified, which were mainly alkaloids. A total of 155 common targets of the constituents and the disease and 67 core targets were screened out. KEGG enrichment and PPI network analysis showed that Zuojin Pills may play a role in the treatment of depression through AMPK/SIRT1, NLRP3, insulin and other targets and pathways. Furthermore, the results of animal experiments showed that Zuojin Pills could significantly improve the depression behaviors of depression, reduce the levels of IL-1β, IL-6 and TNF-α in hippocampus and serum, activate AMPK/SIRT1 signaling, and reduce the protein expression of NLRP3. In conclusion, Zuojin Pills may play a role in the treatment of depression by activating AMPK/SIRT1 signaling pathway, and inhibiting NLRP3 activation and neuroinflammation in the hippocampus of mice.

Analysis on Components Absorbed into Blood of Citri Reticulatae Pericarpium in Rats Based on Sequential Metabolism and UPLC-HRMS / 中国实验方剂学杂志

ObjectiveTo study the metabolism of chemical components from Citri Reticulatae Pericarpium（CRP）in different parts of rats by sequential metabolism and ultra performance liquid chromatography-high resolution mass spectrometry（UPLC-HRMS）. MethodSD male rats were employed as experimental subjects， and blood samples of intestinal metabolism and hepatic metabolism were prepared after administration of CRP ethanol extract by in situ intestinal perfusion， and comprehensive metabolic samples were collected after intragastric administration. UPLC-HRMS was used to analyze the samples with acetonitrile（A）-0.1% formic acid aqueous solution（B）as the mobile phase for gradient elution（0-10 min， 10%-30%A； 10-30 min， 30%-95%A； 30-31 min， 95%-10%A； 31-35 min， 10%A）at a flow rate of 0.35 mL·min-1， using a heated electrospray ionization with positive and negative ion mode scanning in the range of m/z 100-1 500. Under these conditions， the differences in the profiles of CRP ethanol extract， blank plasma and drug-containing plasma under different treatment groups were compared， and the chemical components of each sample were analyzed and identified based on the retention time， accurate relative molecular mass， primary and secondary ion fragments， and the information of reference substances. ResultA total of 44 chemical components were identified in the CRP ethanol extract， including flavone-O-glycosides， flavone-C-glycosides and polymethoxyflavonoids， etc. The results of sequential metabolism showed that 22 chemical components in CRP were detected in the intestinal metabolic sample， 18 chemical components were detected in the hepatic metabolic sample， and 9 identical chemical components（narirutin， hesperidin， meranzin， 5，7，8，3ʹ，4ʹ，5ʹ-hexamethoxy-flavone， isosinensetin， sinensetin， 3，5，6，7，8，3ʹ，4ʹ-heptamethoxyflavone， nobiletin and tangeretin）could be detected in all three metabolic samples， with a total of 22 compounds entering the blood in prototype form. ConclusionThe identified 21 components with well-defined structures entering the blood as prototypes may be potential active components of CRP， and differences in the components at different metabolic parts can provide an experimental basis for elucidating the in vivo biotransformation process of the metabolic components of CRP.

Effects of salidroside on cerebral vascular endothelial cells in MCAO rats / 中国药理学通报

Aim To study the effect of salidroside (SAL) on cerebral vascular endothelial cells of rats with ischemic brain injury and its mechanism of action. Methods Twenty-four healthy adult SD male rats were prepared by bolt plugging method to prepare MCAO models,and randomly divided into sham surgery group ( Sham ) , model group ( MCAO ) , and SAL administration group (MCAO + SAL) ,and the concentration of SAL was 50 mg • kg ~ , with a continuous administration for six days. Western blot was used to detect the protein expression of ICAM-1, VCAM-1 , E-se-lectin,and P-selectin in injured brain tissue of rats. In vitro cell experiments using HUVECs were subjected to different concentrations of salidroside (0. 1,1,10 jjunol • L ) and LPS (100

Pharmacokinetics and blood-brain barrier penetration of a novel salidroside derivative pOBz in rats / 中国药理学通报

Aim To develop a ultra-high performance liquid chromatography electrospray-ionization tandem mass spectrometry ( UPLC-MS/MS ) method for the simultaneous determination of salidroside derivative pOBz in rat plasma and brain tissue, and to study the pharmacokinetic profile and penetration of the blood-brain barrier in rats after a single dose intravenous administration of pOBz. Methods SD rats were administered pOBz at a dose of 50 mg • kg

The neuroprotective effect of salidroside prophylactic administration on MCAO model rats / 中国药理学通报

Aim To investigate the neuroprotective effect of prophylactic administration of salidroside (Sal) on MCAO rats. Methods A total of 52 SD adult male rats were randomly divided into sham operation group (Sham), model group (MCAO) and salidroside pre-administration group (MCAO + Sal). The dose of Sal was 50 mg·kg

Expression and significance of FOXO3 and IL-2 in conjunctival epithelial cells and tears of patients with dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the expression and significance of forkhead box class O3(FOXO3)and interleukin-2(IL-2)in conjunctival epithelial cells and tears of patients with dry eye(DE).METHODS:A perspective study. A total of 106 DE patients who accepted from March 2019 to March 2021 were prospectively gathered, and 85 healthy subjects in the same period were selected as the control group. The level of FOXO3 in the conjunctival epithelial cells and tear fluid was measured by real-time fluorescent quantitative PCR(qRT-PCR)method; The level of IL-2 in the sample was measured by enzyme-linked immunosorbent(ELISA)method; The changes in clinical indicators of the ocular surface such as break-up time(BUT), Schirmer Ⅰtest(SⅠt), cornea fluorescein staining(CFS)in DE patients before and after treatment were analyzed; The correlation between the levels of FOXO3 and IL-2 in the conjunctival epithelial cells and tears of DE patients and the relationship between the two and clinical indicators were analyzed by Pearson correlation analysis.RESULTS:Compared with the control group, the level of FOXO3 in conjunctival epithelial cells and tear fluid in the DE group was obviously reduced, and the level of IL-2 was obviously increased(all P&#x003C;0.01). Compared with before treatment, the level of FOXO3 in conjunctival epithelial cells and tear fluid of DE patients was obviously up-regulated, and the level of IL-2 was obviously down-regulated(all P&#x003C;0.05). Pearson correlation analysis showed that the levels of FOXO3 and IL-2 in conjunctival epithelial cells and tear fluid were obviously inversely correlated(r=-0.531, -0.469, all P&#x003C;0.01). After treatment, BUT and SⅠt indexes of DE patients increased compared with before treatment, while CFS decreased(all P&#x003C;0.01). The level of FOXO3 in conjunctival epithelial cells of DE patients was obviously directly correlated with BUT and SⅠt(r=0.431, 0.457, all P&#x003C;0.01), and it was obviously inversely correlated with CFS(r=-0.469, P&#x003C;0.01), and the level of IL-2 was obviously inversely correlated with BUT and SⅠt(r=-0.416, -0.447, all P&#x003C;0.01), and it was obviously directly correlated with CFS(r=0.424, P&#x003C;0.01); tear FOXO3 was positively correlated with BUT and SⅠt(r=0.421, 0.443, all P&#x003C;0.01), and it was negatively correlated with CFS(r=-0.474, P&#x003C;0.01), and IL-2 was negatively correlated with BUT and SⅠt(r=-0.408, -0.429, all P&#x003C;0.01), and it was positively correlated with CFS(r=0.419, P&#x003C;0.01).CONCLUSION: the level of FOXO3 in conjunctival epithelial cells and tears of DE patients is decreased, and the level of IL-2 is increased. The two of which are closely related to the ocular surface indicators of patients. They are expected to become laboratory auxiliary indicators for clinical monitoring and prognostic evaluation of DE.

Study on the effect of Zizyphus jujube kernel freeze-dried powder on sleep awakening state and energy metabolism rate in rats / 中国药理学通报

Objective To explore the effeet of Zizyphus jujubekernelfreeze - dried powder on sleep and wakefulness and energy metabolism rate in rats under 24 h eontinuous darkness and its mechanism. Method U- sing the eortieal eleetroeneephalography method and the experimental animal monitoring system (CLAMS) and taking the time of wakefulness and sleep as well as the number of activities, food intake, and caloric pro- duetion as indicators to explore the funetion of it on improving energy metabolism rate. Theenzyme - linked immunoassay was used to determine the changes in the eontent of LEP, POMC, and NPY involved in energy regulation in the hypothalamus, so as to study the energy change mechanism of it. Result Compared with the DD group, the MAT group had redueed daytime awakening time, increased sleep time, deereased aetivities, no signifieant differenee in food intake, and inereased caloric production. There was no significant difference in night awakening and sleep time, no significant difference in the number of activities, reduced food intake , and increased caloric production. The weight gain of rats decreased; Compared with the DD group, the LEP content in the hypothalamus of the MAT group increased, the POMC content increased and the NPY content decreased. Conclusion By increasing LEP, POMC content and decreasing NPY content in hypothalamus , Zizyphus jujubekemelfreeze - dried powder collected the disturbance of sleep and wakefulness state and abnormal energy metabolism rate of rats caused by 24 h continuous dark condition.

Research on mechanism of salidroside activating HIF-1 a signaling pathway to promote MOB proliferation / 中国药理学通报

Aim To explore the effeet of salidroside (SAL) on proliferation of osteoblasts and its possible mechanism by using mouse primary osteoblasts ( MOB) as the research object.Methods Alkaline phosphatase ( ALP) staining was used to identify the extracted primary cells.MTT was used to detect the effect of SAL on the proliferation.RT-PCR, Western blot, ELISA were used to investigate the molecular mechanism of SAL.Results The extracted cells generated black-brown deposits by ALP staining, which were shown to be osteoblasts clearly.SAL promoted the pro liferation of MOB.Meanwhile, SAL could up-regulate the mRNA and protein expression levels of hypoxia-inducible factor-lcx ( HIF-1 ex), vascular endothelial growth factor ( VEGF ) , angiopoietin-like protein 4 (ANGPTL4) and interleukin 6 ( IL-6 ) , which were down-regulated by using the HIF-lex blocker YC-1.Conclusions SAL could promote the proliferation of MOB through HIF-1 a/VEGF, ANGPTL4, IL-6 signaling pathway.

Effect of state anxiety on sleep-wake cycle in mice / 中国药理学通报

Aim To observe the effect of state anxiety on the sleep-wake cycle of mice in the Triple test.Methods Eighteen male ICR mice were selected, and the electroencephalogram(EEG)and electromyogram(EMG)electrodes were embedded in the cortex and neck muscles of the mice under the conditions of anesthesia.There was a continuous 24 h tracing of mice under normal conditions after the recovery period.The model replication and behavioral evaluation of the state anxiety took place in the Triple test and the mouse sleep for 24 h was recorded for 7 consecutive days after the daily test.Results The behavioral evaluation showed that compared with 1st d, the time spent in central and% time in OF on 3 ?4 ?5 ?7 d of modeling was significantly reduced(P<0.05; P<0.01); the number of entries and% time of 4-7 d in EPM signifi-cantly increased(P<0.01); 2nd and 4th day of time spent in dark compartment of LDB increased significantly(P<0.05; P<0.01).The results of EEG analysis showed that compared with the sleep-wake cycle under normal conditions, the sleep and wake cycles had undergone significant changes, and the awakening time and its proportion were significantly prolonged(P<0.05; P<0.01), NREM sleep and its proportion markedly decreased on the 1-5 and 7 d(P<0.05; P<0.01), and a significant increase occurred in REM sleep and its proportion on 1st, 2nd, and 4th day(P<0.05).Conclusion The sleep-wake cycle of state anxiety mice replicated with the Triple test changes, and the impact on daytime sleep is more obvious.

Study of attention network of benign childhood epilepsy with centrotemporal spikes / 中华神经科杂志

Objective:To investigate whether children with benign childhood epilepsy with centrotemporal spikes (BECT) still have attention network damage and its correlative factors after complete remission.Methods:Thirty BECT patients over 16 years old and without seizures over two years (BECT group; 21 males, nine females, median age 17 years) in the Department of Neurology, Provincial Children′s Hospital Affiliated to Anhui Medical University from January 1, 2009 to December 31, 2010 and 42 healthy controls (control group; 30 males, 12 females, median age 17 years) from the First Affiliated Hospital of Anhui Medical University were tested by the attention network test tool.Results:There was not statistically significant difference in the accuracy rate and total reaction time of attention network test between the BECT group and the control group [97.0% (95.0%, 99.0%) vs 98.0% (95.5%, 98.0%), Z=-0.437, P=0.662; 587.50 (523.50, 668.75) ms vs 610.00 (584.25, 631.75) ms, Z=-0.320, P=0.749; respectively]. And there was not statistically significant difference in the efficiency of the alert network, directional network, and executive control network in the BECT group compared with the control group [(46.13±24.97) ms vs (48.52±27.65) ms, t=-0.376, P=0.708; (32.23±18.12) ms vs (33.21±19.68) ms, t=-0.215, P=0.830; (124.50±39.87) ms vs (117.60±50.13) ms, t=0.626, P=0.533; respectively]. The accuracy of attention network test was positively correlated with the age of onset ( b=0.925, P=0.012), and was negatively correlated with the total number of seizures ( b=-0.853, P=0.025). Conclusion:Although the accuracy of attention network test in BECT patients after remission was correlated with age of onset and total number of seizures, BECT patients had no attention network damage after complete remission compared with healthy controls.

Research progress on influencing factors of female telomere-telomerase system in critical period / 中国临床药理学与治疗学

The telomere/telomerase system, as a biological marker of aging, plays an important role in maintaining woman's health. The vulnerability of telomere-telomerase system is heightened in female during puberty, pregnancy and perimenopause period, which not only affect themselves, but also affect the healthy growth of offspring. Therefore, the purpose of this article is to provide basis for intervention time and method for delaying women aging due to the effects of estrogen levels, dietary, stress, movement, insulin resistance and sleep on the telomere/telomerase system during puberty, pregnancy and perimenopausal period.

Bioequivalence and safety of sofosbuvir tablets in the healthy Chinese subjects / 临床肝胆病杂志

ObjectiveTo investigate the pharmacokinetic characteristics of sofosbuvir tablets, and to evaluate the bioequivalence and safety of two preparations. MethodsHealthy volunteers were recruited through the platform of clinical trial recruitment in The Affiliated Hospital of Changchun University of Chinese Medicine. Screening physical examination was performed for fasting group on September 18, 2018 and for postprandial group on September 28, 2018, and the volunteers were enrolled after their physical examination results met the inclusion criteria. The fasting group and the postprandial group, with 40 volunteers in each group, were given oral administration of the test preparation sofosbuvir tablets or the reference preparation sofosbuvir tablets (SOVALDI, 400 mg). This was a randomized, open-label, two-sequence, four-cycle, single-dose, and completely repeated cross-over bioequivalence test in the fasting or postprandial state in the healthy population; in the fasting group, 20 volunteers each received oral administration of the test preparation and the reference preparation, and in the postprandial group, 20 volunteers each received oral administration of the test preparation and the reference preparation. Liquid chromatography-tandem mass spectrometry was used to measure the content of sofosbuvir and its major metabolite GS-331007 in human EDTA-K2 plasma; the plasma concentration of sofosbuvir was measured at 15 time points from 0 hour to 8 hours after administration, and that of GS-331007 was measured at 16 time points from 0 hour to 72 hours after administration. WinNonlin software was used to calculate pharmacokinetic parameters and evaluate bioequivalence. ResultsAfter the administration of the test preparation and the reference preparation in the fasting state, when the pharmacokinetic parameters of sofosbuvir was used to evaluate the bioequivalence of the test preparation and the reference preparation, the ratios of the geometric means of Cmax, AUC0-t, and AUC0-inf were 90.55%, 97.26%, and 94.62%, respectively; when the pharmacokinetic parameters of GS-331007 was used to evaluate the bioequivalence of the test preparation and the reference preparation, the ratios of the geometric means of Cmax, AUC0-t, and AUC0-inf were 98.91%, 98.98%, and 99.46%, respectively. All of the above values were within the range of 80.00%-125.00%. An analysis of variance was performed after the pharmacokinetic parameters of sofosbuvir Cmax, AUC0-t, and AUC0-inf were transformed by natural logarithm, and the results showed that sequence, cycle, and preparation had no marked influence on Cmax, AUC0-t, and AUC0-inf (all P＞0.05). ConclusionThe test preparation of sofosbuvir tablets is bioequivalent to the reference preparation in the fasting and postprandial states.

Effects of moxibustion on serum IL-6, IL-8 and TNF-α in rats with experimental rheumatoid arthritis / 针灸推拿医学（英文版）

Objective:To observe the effects of moxibustion on serum levels of interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α), and to explore the effects of moxibustion on inflammatory damaging factors in experimental rheumatoid arthritis (RA) model rats; the relationship between the therapeutic effect of moxibustion on RA and the change in the Toll-like receptor (TLR) signaling pathway was analyzed using Toll-like receptor 4 (TLR4) antagonists and agonists. Methods:Fifty Sprague-Dawley (SD) rats were divided into a normal group, a model group, a moxibustion group, a moxibustion plus TLR4 agonist group (agonist group) and a moxibustion plus TLR4 antagonist group (antagonist group) according to the random number table, with 10 rats in each group. Except the normal group, rats in the other four groups were subjected to model preparation with the wind, cold and wet environmental factors plus Freund's complete adjuvant (FCA). Rats in the normal and model groups were not treated; rats in the moxibustion, agonist and antagonist groups started to be treated with the moxibustion (cigarette-type moxa) at bilateral Shenshu (BL 23) and Zusanli (ST 36) from the 4th day after the successful modeling, for 20 min each time with a total of 10 d. Rats in the agonist and the antagonist groups were injected with TLR4 agonist or antagonist [0.1 mg/(kg·bw)] via the tail vein 30 min before moxibustion. The concentrations of serum IL-6, IL-8 and TNF-α in each group were determined by enzyme-linked immunosorbent assay (ELISA). Results:Compared with the normal group, in the model group, the rat's right hind paw swelling was significantly obvious (P<0.01), there was a lot of inflammatory infiltration in the synovial tissues, the surface of the synovial membrane was unsmooth, the synovial membrane was hyperplasia and thicker, and the serum IL-6, IL-8 and TNF-α concentrations increased significantly (P<0.05). Compared with the model group, the paw swelling degrees of the rats in the moxibustion, the agonist and the antagonist groups reduced significantly (allP<0.01); the swelling degree in the antagonist group was milder than that in the agonist group, but the between-group difference was not statistically significant (P>0.05); inflammatory infiltration and synovial membrane hyperplasia in the synovial tissues of the moxibustion group and the antagonist group were all relieved differently; the decrease of synovial layer number in the moxibustion group was more obvious, and there were no obvious improvements in inflammatory infiltration and synovial thickness in the agonist group; the concentrations of IL-6, IL-8 and TNF-α in the moxibustion group were decreased, and the differences in the IL-6 and TNF-α concentrations were statistically significant (allP<0.01); there was no significant between-group difference in the IL-8 concentration (P>0.05); the concentrations of serum IL-8 and TNF-α in the agonist group increased significantly (both P<0.01), while the IL-6 concentration decreased without significant difference (P>0.05); the concentrations of IL-6 and IL-8 in the antagonist group decreased but the between-group differences were statistically insignificant (bothP>0.05), and the TNF-α concentration significantly increased (P<0.05). Compared with the moxibustion group, IL-6, IL-8 and TNF-α concentrations increased in the agonist group, and the differences in the IL-8 and TNF-α concentrations were statistically significant (both P<0.01); the concentrations of IL-6, IL-8 and TNF-α increased in the antagonist group, and the differences in the IL-6 and TNF-α concentrations were statistically significant (bothP<0.01); there was no significant difference in the IL-8 concentration between the groups (P>0.05). The serum levels of IL-6, IL-8 and TNF-α in the antagonist group were lower than those in the agonist group (allP<0.05). Conclusion:Moxibustion at Shenshu (BL 23) and Zusanli (ST 36) can reduce the joint swelling degree and inflammation in synovial tissue of RA model rats, decrease the serum levels of IL-6, IL-8 and TNF-α in RA model rats; the decreases of IL-6 and TNF-α are more significant than the decrease of IL-8; TLR4 agonist and antagonist can significantly attenuate the effect of moxibustion in inhibiting releases of IL-6, IL-8 and TNF-α, so that the change in TLR signaling pathway affects the effect of moxibustion in inhibiting the releases of IL-6, IL-8 and TNF-α.

Application of ultrasound-guided erector spinae plane block on intraoperative and postoperative analgesia in patients undergoing chronic empyema / 临床麻醉学杂志

Objective To observe the efficacy of ultrasound-guided erector spinae plane (ESP) block on intraoperative and postoperative analgesia in patients undergoing chronic empyema. Methods Sixty patients scheduled for elective decortication of pleural fibreboard under video-assisted thoracoscopic, 35 males and 25 females, aged 30-70 years, falling into ASA physical status Ⅰ or Ⅱ, were randomized into 2 groups: ESP block combined with general anesthesia group (group E) and only general anesthesia group (group G). Patients in group E received ESP block before general anesthesia, while patients in group G received general anesthesia only. All patients received patient controlled intravenous analgesia (PCIA). The thoracic paravertebral space were recorded using ultrasound. Dermatomes of sensory block on midclavicular line were recorded at 20 min after ESP block. The amount of remifentanil, duration of stay in post-anesthesia care unit, the frequency of PCIA pressing, the pain analog scale (VAS) scores during rest and movement at 1, 4, 12, 24, 48 h after operation were recorded. Results Twenty-four patients in group E showed unclear thoracic paravertebral space, dermatomes of sensory block at 20 min after ESP block were 4.9 ± 1.0 on midclavicular line. The consumption of remifentanil and duration of stay in post-anesthesia care unit and the frequency of PCIA pressing in group E were significantly less than that in group G (P ＜ 0.05). The VAS scores at 1, 4, 12, 24 h in group E were lower than those of group G (P ＜ 0.05). Conclusion The ultrasound-guided erector spinae plane block were safe and effective for patients undergoing chronic empyema, and provided satisfactory intraoperative and postoperative analgesia.

Progress of iridocorneal endothelial syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

@#Iridocorneal endothelial syndrome(ICES)is a rare ocular disease characterized by abnormal structure and proliferation of the corneal endothelium, the anterior chamber angle, and the iris. Common clinical features include corneal edema, secondary glaucoma and iris atrophy. ICES often occurs in young women, and most of them are monocular. Its pathogenesis is still unclear, the symptoms are various, and the blindness rate is high. The disease is difficult to diagnose, and there is no ideal treatment. The purpose of this article is to review the literature on the characteristics, diagnosis and treatment of ICES in order to help the diagnosis and treatment of the disease.

Relationship between the changes of plasma levels of leptin and obesity in patients with insulinoma / 中华消化杂志

Objective To analyze the relationship between the changes of fasting plasma level of leptin and obesity in patients with insulinoma before operation.Methods From January 2003 to May 2008,40 patients with insulinoma diagnosed at Peking Union Medical College Hospital were selected.Preoperative fasting plasma samples of them were collected.From January 2003 to May 2008,the plasma samples of 28 volunteers matched with age,gender and body weight matched with the patients were collected as the controls.All the subjects were divided into overweight-obesity group and normal weight group according to their body mass index (BMI).Plasma levels of leptin of all the subjects were measured by enzyme linked immunosorbent assay (ELISA).The Mann-Whitney U test and the correlation coefficient test were used for statistical analysis.Results The plasma leptin level of patients with insulinoma was 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL),which was higher than that of the control group (0.29 ng/mL,0.25 ng/mL to 1.15 ng/mL),and the difference was statistically significant (U =324.50,P =0.003).In the normal-weight group,the plasma leptin level of the patients with insulinoma was 0.35 ng/mL (0.27 ng/mL to 0.62 ng/mL),which was higher than that of the control group (0.28 ng/mL,0.25 ng/mL to 0.37 ng/mL),and the difference was statistically significant (U =28.000,P =0.001).While in the overweight-obesity group,the plasma leptin levels of the patients with insulinoma and the controls were 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL) and 0.34 ng/mL (0.26 ng/mL to 1.15 ng/mL),respectively,and the difference was not statistically significant (U =153.500,P =0.525).Plasma leptin levels in both the patients with insulinoma and the controls,were correlated with BMI (r =0.355,P =0.025;r =0.571,P =0.001,respectively).Conclusion Preoperative fasting plasma level of leptin increase in patients with insulinoma which is correlated with BMI.