Binding characteristics of plasma protein in active parts of Daidai lipid-lowering flavonoid extract / 中国中药杂志

To study the binding capacity of active ingredients of Daidai lipid-lowering flavonoid extract and plasma protein,investigate the ways to improve the traditional formula for calculating protein binding rates based on ultrafiltration,and increase the stability and reliability of the experimental results. UPLC-MS/MS was used to establish a quantitative analysis method for simultaneous determination of active ingredients( neohesperidin and narngin) in ultrafiltrate. The protein binding rates were calculated by the traditional ultrafiltration formula. The correction factors( F) were introduced later,and the binding rates calculated with the correction factors were compared with those without the correction factors. The binding capacity of the extract and plasma protein was evaluated. The quantitative analysis method established by UPLC-MS/MS had a good specificity. The standard curve and linear range,method accuracy,precision and lower limit of quantitation all met the requirements. The method met the requirement for quantitative detection of the active ingredients in ultrafiltrate after the rat plasma was filtrated in the ultrafiltration tube. Under the experimental conditions,the binding rates of both active ingredients( neohesperidin and narngin) were higher than 90%. The active ingredients and rat plasma protein were bound in a concentration-dependent manner,with statistically significant differences( P<0. 01). There was no statistically significant difference between the protein binding abilities of the two active ingredients with rat plasma protein. Therefore,the active ingredients of Daidai lipid-lowering flavonoid extract had a relatively strong binding strength with rat plasma protein,and they were bound in a concentration-dependent manner. Additionally,when calculating protein binding rates by the traditional ultrafiltration formula,the correction factors could be introduced to effectively reflect the errors of multiple ingredient groups in traditional Chinese medicine extracts.This correction method could provide a reference thinking and practical reference for the improvement of the determination method of the traditional Chinese medicine plasma protein binding ability based on ultrafiltration.

Correlation Study Between CDKN2B-AS1 Gene Polymorphism and Female Premature Coronary Artery Disease Occurrence / 中国循环杂志

Objective:To explore the relationship between single nucleotide polymorphism (SNP) rs4977574 in CDKN2B-AS1 gene and female premature coronary artery disease (pCAD) occurrence. Methods: Our research included 2 groups: pCAD group, n=226 consecutive patients≤65 years of age and Control group, n=79 subjects with matched age,without CAD. The genotype of CDKN2B-AS1 SNP rs4977574 was detected by SNaPshot. Blood levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), uric acid (UA), fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were examined; relationships between rs4977574 polymorphism and the above parameters were assessed. Results: Compared to Control group, pCAD group had increased blood levels of TG, UA, FPG and HbA1c, P<0.05. With adjusted age, body mass index (BMI), relevant disease history and risk factors, elevated HbA1c (HbA1c>6.2%) obviously increased the risk of female pCAD occurrence (OR=3.35, 95%CI 1.41-8.00, P=0.006). The genotype and allele frequency of rs4977574 were different between pCAD group and Control group, P<0.05. Compared to Control group, pCAD group had the higher frequency of G allele(OR=1.24, 95%CI 1.05-1.48, P=0.019); further analysis found that rs4977574 polymorphism was related to high HbA1c. Compared to AA genotype, GG+GA genotype had the increased incidence of high HbA1c(OR=2.08, 95%CI 1.11-3.89, P=0.022). Conclusion: CDKN2B-AS1 SNP rs4977574 was related to female pCAD occurrence and it was also related to high HbA1c.

Scoring System for Predicting the Risk of Side Branch Occlusion Based on Angiographic Visual Estimation in Coronary Bifurcation Intervention / 中国循环杂志

Objective: To establish a scoring system for predicting the risk of side branch occlusion(SBO) in coronary bifurcation intervention based on visual estimation of quantitative coronary angiography (QCA). Methods: RESOLVE scoring system was developed from QCA. A total of 1545 patients with 1601 bifurcation lesions by RESOLVE study were enrolled. Based on RESOLVE scoring system, visual estimation was conducted to compare the consistency. According to SBO occurrence after main branch stent implantation, our research was divided into 2 groups: SBO group, which was defined by coronary angiography confirmed TIMI grade decreasing, n=114 patients with 118 lesions and Non-SBO group, n=1431 patients with 1483 lesions. Using RESOLVE scoring method as reference,V-RESOLVE scoring system was established, the discrimination, goodness-of-fit and V-RESOLVE score for the incidence of SBO were assessed;the diagnostic value for predicting the risk of SBO in coronary bifurcation intervention was compared between 2 scoring systems. Results: The consistency between visual and QCA was from fair to moderate (weighted Kappa=0.22-0.44). Compared with Non-SBO group, SBO group had the higher degrees of pre-operative bifurcation stenosis and side branch stenosis before main branch stent implantation; larger bifurcation angle and vessel diameters in main/side branches, all P<0.01. The area of V-RESOLVE under ROC curve was 0.76(95%CI 0.71-0.81) which was similar to the area of RESOLVE under ROC curve:0.77 (95% CI 0.72-0.81), P=0.74, Hosmer-Lemeshow P=0.17. The patients were categorized into 2 conditions by V-RESOLVE: high risk (V-RESOLVE score≥12)and non-high risk (V-RESOLVE score<12), the incidence of SBO was higher in high risk patients (16.7% vs 4.3%), P<0.01. The incidences of SBO were similar in non-high risk patients by V-RESOLVE and RESOLVE (4.3% vs 3.4%), P=0.22 and in high risk patients (16.7% vs 18.0%), P=0.60. Conclusion: V-RESOLVE scoring system may predict the risk of SBO in patients with coronary bifurcation intervention.

Risk Factor Analysis for In-hospital Mortality in Patients With Non-ST Segment Elevation Myocardial Infarction in China / 中国循环杂志

Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.

Risk Factor Analysis for In-hospital Mortality in Patients With Non-ST Segment Elevation Myocardial Infarction in China / 中国循环杂志

Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.

Effect of compound flumetasone ointment on transepidermal water loss and its clinical application in patients with atopic dermatitis / 中华皮肤科杂志

Objective To evaluate the effect of salicylic acid on skin barrier function and the efficacy of salicylic acid combined with flumetasone ointment for the treatment of atopic dermatitis (AD).Methods Sixtyfour patients with AD (including 31 males and 33 females) aged 18 to 58 years were recruited into the present study.Four lesional areas of similar size and severity were selected at the similar body sites of both sides of each patient,and randomly classified into four groups to be topically treated with compound flumetasone ointment (containing 0.02％ flumetasone and 3％ salicylic acid,compound flumetasone group),flumetasone 0.02％ ointment (flumetasone group),salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group),respectively;two normal skin areas were chosen from apparently normal skin on the similar body sites of both sides of each patient and topically treated with salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group) respectively.All of these preparations were applied twice a day for 3 weeks.Transepidermal water loss (TEWL) was measured by a Tewameter MPA580 (Courage & Khazaka,Germany) at the baseline as well as on week 1,2 and 3 after initiation of treatment.Symptom and sign scores were evaluated before and after the treatment.Meanwhile,two normal skin areas were selected on bilateral forearm of 30 healthy controls and treated with 3％ salicylic acid ointment (salicylic acid group) and vehicle (control group) respectively twice a day for 3 weeks,and TEWL was measured before treatment as well as on week 1 and 3 after initiation of treatment.Results In the healthy controls,TEWL value showed no significant difference between the salicylic acid group and control group at any of these time points.As far as the lesional skin was concerned,no statistical difference was observed in TEWL value at the baseline between the four groups ((34.26 ± 20.82) vs.(33.02 ±16.71) vs.(34.16 ± 18.03) vs.(33.81 ± 17.11) g· m-2· h-1,P ＞ 0.05),but significant difference was noted after treatment (repeated measurement data analysis of variance,F =39.57,P ＜0.01),with the TEWL value being (22.38 ± 16.16),(17.04 ± 12.74),and (15.34 ± 13.13) g·m-2·h-1 respectively in the compound flumetasone group on week 1,2 and 3,(24.63 ± 17.08),(20.37 ± 9.53),(19.06 ± 9.17) g·m-2·h-1 respectively in the flumetasone group,(26.49 ± 8.59),(21.91 ± 8.46),(21.20 ± 9.38) g·m-2·h-1 respectively in the salicylic acid group,and (29.80 ± 12.48),(26.16 ± 8.31),(25.52 ± 6.05) g·m-2·h-1 respectively in the control group.In detail,the decrease in TEWL value was stronger in the compound flumetasone group than in the flumetasone group on week 1,2,and 3 (all P ＜0.05),in the salicylic acid group than in the control group (P ＜0.05 or 0.01),but similar between the flumetasone group and salicylic acid group.In non-lesional skin,the salicylic acid group showed a more intense decrease in TEWL value compared with the control group on week 2 and 3 (both P ＜0.05).Both the cure rate and response rate were significantly higher in the compound flumetasone group than in the flumetasone group (53.1％ vs.34.4％,x2 =4.57,P＜0.05;83.1％ vs.64.1％,x2 =6.90,P＜0.01).Conclusions The salicylic acid 3％ ointment shows a reparative effect on skin barrier in patients with AD,and the compound flumetasone ointment is superior to the flumetasone ointment in the treatment of AD.

Herbal medicine in the treatment of ulcerative colitis

Ulcerative colitis [UC] is a refractory, chronic, and nonspecific disease occurred usually in the rectum and the entire colon. The etiopathology is probably related to dysregulation of the mucosal immune response toward the resident bacterial flora together with genetic and environmental factors. Several types of medications are used to control the inflammation or reduce symptoms. Herbal medicine includes a wide range of practices and therapies outside the realms of conventional Western medicine. However, there are limited controlled evidences indicating the efficacy of traditional Chinese medicines, such as aloe vera gel, wheat grass juice, Boswellia serrata, and bovine colostrum enemas in the treatment of UC. Although herbal medicines are not devoid of risk, they could still be safer than synthetic drugs. The potential benefits of herbal medicine could lie in their high acceptance by patients, efficacy, relative safety, and relatively low cost. Patients worldwide seem to have adopted herbal medicine in a major way, and the efficacy of herbal medicine has been tested in hundreds of clinical trials in the management of UC. The evidences on herbal medicine are incomplete, complex, and confusing, and certainly associated with both risks and benefits. There is a need for further controlled clinical trials of the potential efficacy of herbal medicine approaches in the treatment of UC, together with enhanced legislation to maximize their quality and safety