Effect and mechanism of total flavonoids of Lichi Semen on CCl_4-induced liver fibrosis in rats, and prediction of Q-marker / 中国中药杂志

This paper was to investigate the effect of total flavonoids of Lichi Semen(TFL) on carbon tetrachloride(CCl_4)-induced liver fibrosis in rats, analyze and predict its mechanism of action and potential quality markers(Q-marker). Firstly, male SD rats were taken and injected subcutaneously with a 40% CCl_4-vegetable oil solution twice a week for 8 consecutive weeks to establish a rat model of liver fibrosis. The rats with liver fibrosis were randomly divided into model group, silybin group(43.19 mg·kg~(-1)), Fuzheng Huayu Capsules group(462.75 mg·kg~(-1)), and TFL groups(100 mg·kg~(-1) and 25 mg·kg~(-1)), with normal rats as a blank group, 10 rats in each group. Except for the blank group, the rats in the other groups were subcutaneously injected with 40% CCl_4-vegetable oil solution of a maintenance dose, once a week. The rats in various treatment groups received corresponding doses of drugs, while the rats in the blank group and model group received the same volume of normal saline once a day for 4 weeks. At the end of the experiment, blood was collected from the abdominal aorta and the liver tissues were collected. The levels of total bilirubin(TBiL), direct bilirubin(DBiL), indirect bilirubin(IBiL), alanine aminotransferase(ALT), and aspartate aminotransferase(AST) in serum were detected by using an automatic biochemical detector. Masson staining was used to observe the histopathological changes of rat liver. Then, the chemical compositions of TFL were collected, and the action targets of these chemical compositions were predicted through SWISS database and reverse molecular docking server(DRAR-CPI). After screening of disease targets of liver fibrosis by Gene Cards database, the protein-protein interaction was analyzed with use of STRING database, and GO(gene ontology) analysis and KEGG(Kyoto encyclopedia of genes and genomes) enrich analysis were also carried out. Moreover, an iTRAQ proteomics technology was used to determine protein expression in liver tissues of rats in TFL, model and blank groups to verify the targets. Furthermore, Cytoscape software was used to establish and visualize the network of chemical components, targets and pathways, and predict the potential Q-marker of TFL. The results showed that the levels of TBiL, DBiL, IBiL, ALT, and AST in the model group were significantly higher than those in the blank normal group(P<0.05), and the above levels in the treatment groups were lower than those in the model group, but with no significant differences. Masson staining showed that the liver damage and the degree of fibrosis were severe in the model group, and were relieved to different degrees in the treatment groups. Then, 74 chemical components were screened, which could act on 865 targets such as EGFR and SRC, participating in the regulation of cancer pathways, PI3 K-Akt signaling pathway, HIF-1 signaling pathway and other signaling pathways closely related to liver fibrosis. Pinocembrin, quercetin, epicatechin, procyanidin A2, naringenin, nobiletin, phlorizin and rutin showed the highest correlation with liver fibrosis-related targets and pathways. Proteomics results showed that a total of 18 proteins among the 45 proteins predicted by internet pharmacology were identified, among which 6 proteins were significantly expressed, including 5 up-regulated proteins and 1 down-regulated protein. The protein expression of ALB, PLG, HSP90 AA1, EGFR and MAP2 K1 was significantly returned to a normal state in the TFL treatment groups. In conclusion, TFL may demonstrate the anti-hepatic fibrosis and potential hepatoprotective effects by regulating the expression of ALB, PLG, HSP90 AA1, EGFR and MAP2 K1, which may be associated with the regulation of multiple signaling pathways related to liver fibrosis such as PI3 K-Akt pathway. Pinocembrin, quercetin, epicatechin, procyanidin A2, naringenin, nobiletin, phlorizin and rutin could be regarded as potential Q-markers of TFL for quality control.

Effects of adult cleft palate surgery combined with pharyngoplasty / 口腔疾病防治

Objective@#To assess the voice recoverment of pharynplasty given at the same time with the velopharyngeal closure surgery.@*Methods@#36 cases of cleft palate patients aged 18-32 years were divided into control group (18 cases) and experimental group (18 cases). Only cleft palate surgery was given in the control group, while pharyngoplasty combined with the palate closure surgery were given in the experimental group. Wound healing assessment were performed after 1 week , and voice improvement were compared in the 2 groups after 3 months.@*Results@#Well wound healings without any infections were achieved in all the cases, except for 1 case had a palate dehiscence 1 week after the operation. Dysarthria and nasal leak were improved significantly in the experiment group (P < 0.05), however the nasal resonance improvement between the 2 groups were not significantly different (P > 0.05).@*Conclusion@#Adult cleft palate surgery combined with the pharyngeal angioplasty is a recommended method.

Current status of antiplatelet treatment before and after ischemic stroke, and an analysis of factors associated with antiplatelet treatment, in the Qingdao area of China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Stroke is the most common neurological disease in China, and antiplatelet treatment is important for primary and secondary prevention. This study aimed to describe the current status of antiplatelet treatment before, immediately after, and 1 month after ischemic stroke in the Qingdao area of China, and to determine the factors and potential barriers influencing use.</p><p><b>METHODS</b>A total of 1114 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area. Patient demographic data, clinical data, and treatment before and after the stroke were recorded. Univariate analysis (two sample t-test or Mann-Whitney U test, and chi-square test) and multivariate Logistic regression analysis were used to determine the frequency of antiplatelet treatment, and factors associated with treatment, at three time points: before the stroke, in hospital after the stroke, and at 1-month follow-up.</p><p><b>RESULTS</b>The frequency of antiplatelet treatment was 6.4% before the stroke, 91.5% in hospital, and 77.2% at 1 month. Aspirin pretreatment was independently associated with higher education level, higher income level, history of hyperlipidemia, and history of cerebral vascular disease. Antiplatelet treatment in hospital was independently associated with treatment in an urban hospital, National Institutes of Health Stroke Scale at onset, and statin use in hospital. Antiplatelet treatment at 1-month follow-up was independently associated with higher income level, diagnosis of transient ischemic attack, antiplatelet treatment in hospital, large artery atherosclerosis according to the Trial of Org 10172 in Acute Stroke Treatment classification, and statin use at follow-up. Modified Rankin Scale ≥ 4 at 1-month follow-up and history of coronary heart disease were negatively associated with antiplatelet treatment at follow-up.</p><p><b>CONCLUSIONS</b>This study documents the current status of antiplatelet treatment in primary and early secondary prevention of ischemic stroke in China. Further education of clinicians and the public about stroke prevention is important.</p>