Clinical study of Yiqi Dihuang Decoction combined with conventional therapy for the patients with early stage diabetic nephropathy and deficiency of qi and yin / 国际中医中药杂志

Objective:To investigate the effect of Yiqi Dihuang Decoction assisting conventional western medicine therapy in the treatment of early diabetic nephropathy (DN) with deficiency of qi and yin.Methods:A total of 117 patients with early DN who met the inclusion criteria from June 2018 to December 2020 in Beijing Hospital of Traditional Chinese Medicine Shunyi Branch were divided into a control group of 58 patients and a treatment group of 59 patients according to the random number table method. The control group was treated with conventional western medicine therapy, and the treatment group was additionally treated with Yiqi Dihuang Decoction on the basis of the control group. Both groups were treated for 1 month. Serum levels of IL-1, macrophage scavenger receptor A (SR-A), TNF-α, C-C motif chemokine 2 (CCL2), GSH-Px and SOD were detected by ELISA before and after treatment. Cystatin C (Cys C) and SCr levels were detected by automatic biochemical analyzer. The urinary albumin was determined by radioimmunoassay, urinary creatinine determined by rate method, and urinary albumin/creatinine ratio (UACR) and glomerular filtration rate (eGFR) were calculated. The adverse events during treatment and clinical efficacy were evaluated.Results:The total effective rate was 94.92% (56/59) in the treatment group and 81.03% (47/58) in the control group, and the difference between the two groups was statistically significant ( χ2=5.35, P=0.021). After treatment, UACR [(92.28±15.42) mg/g vs. (108.42±20.76)mg/g, t=4.78], eGFR [(91.42±13.18) m·min -1·1.73m -2vs. (95.30±15.94) m·min -1·1.73m -2, t=2.02], SCr [(65.30±9.54) μmol/L vs. (70.18±12.53) μmol/L, t=5.42], Cys C [(0.65±0.12)mg/L vs. (1.07±0.26)mg/L, t=11.25] in the treatment group were significantly lower than those in the control group ( P<0.05). Serum SR-A [(37.18±6.10) μg/L vs. (51.51±7.12) μg/L, t=11.70], CCL2 [(13.12±1.63) μg/L vs. (19.68±2.90) μg/L, t=15.12], TNF-α [(20.57±3.50) ng/L vs. (29.68±4.17) ng/L, t=12.81], IL-1 [(8.47±0.97) ng/L vs. (13.12±1.57) ng/L, t=19.31] levels in the treatment group were significantly lower than those in the control group ( P<0.01); serum SOD [(24.09±3.12) mg/L vs. (18.72±2.76) mg/L, t=9.85] activity and GSH-Px [(231.57±25.38) mg/L vs. (174.58±22.96) mg/L, t=12.73] in the treatment group were significantly higher than those in the control group ( P<0.01). During the treatment period, the incidence of adverse events was 10.34% (6/58) in the control group and 6.78% (4/59) in the treatment group, and there was no significant difference between the two groups ( χ2=0.48, P=0.490). Conclusion:Yiqi Dihuang Decoction assisted with conventional western medicine can effectively improve the renal function of patients with early DN syndrome of qi and yin deficiency, inhibit the body's inflammatory response and oxidative stress response, and improve clinical efficacy.

Correlation analysis between the judgment of medical damage liability disputes related to off-label drug use and evidence-based evidence / 中国药房

OBJECTIVE To explore wheth er there is a relationship between the judgment results of medical damage liability disputes related to off-label drug use and evidence-based evidence. METHODS By searching for medical damage liability disputes related to off-label drug use up to 2021 on pkulaw.cn ，documents were extracted to record objective factors ，subjective factors and judgment results ；whether there was evidence-based evidence was judged according to Off-label Drug Use List and Evidence-based Evaluation Standards for Off-label Drug Use of Guangdong Pharmaceutical Association ；univariate analysis was adopted to test the relationship between the judgment results and evidence-based evidence. RESULTS A total of 57 cases were included. Cases mainly occurred in the eastern China （63.2％）and tertiary hospitals （64.9％），the main appraisal agency was the appraisal center or institute（61.4％），and the most common type of off-label drug use was overdose drug use （45.6％）. Among the judgment results ， 23 cases（40.4％）of off-label drug use had a causal relationship with medical damage ，most of the responsibility of doctors was secondary responsibility （28.1％），and the actual compensation amount of the most cases were less than 100，000 yuan（54.4％）. There were 25 cases（43.9％）with evidence-based evidence. Univariate analysis found that for off-label drug use the claim amount of the case with evidence-based evidence was significantly higher than that of the case without evidence-based evidence （P＝ 0.040），and there was no significant correlation between evidence-based evidence and the actual compensation amount of the case （P＝0.741），causality determination （P＝0.256），liability type （P＝0.598）or appraisal agency （P≥0.260）. CONCLUSIONS There is no significant correlation between the judgment results of medical damage liability disputes related to off-label drug use and evidence-based evidence ，indicating that there may be certain differences between judicial trials and medical science. The off-label drug use should be regulated by establishing a complete off-label drug use management system and standardizing informed consent procedure for off-label drug use. 1610307322@pku.edu.cn

Influence of Kuailvning capsule and its drug serum on the concentration of Ca2 + in rat ventricular muscle cells / 中国基层医药

Objective To observe the influence of Kuailvning capsule(KLN)and its drug serum on the concentration of Ca2 + in rat ventricular muscle cells.Methods SD rats were randomly divided into five groups:the control group,serum control group,KLN high -dose group,KLN medium -dose group and KLN low -dose group,six mice in each group.The rat ventricular myocytes were separated by enzymatic hydrolysis.The influence of KLN and its drug serum on the concentration of Ca2 + in rat ventricular muscle cells were observed by Fluo -3 /AMprobe.Results The mean fluorescence intensity of cytosolic Ca2 + in the KLN high -dose group,KLN medium -dose group and KLN low -dose group after 50s,100s,150s,200s,250s were [(18.75 ±1.55),(16.69 ±0.93),(17.76 ±1.26)], [(25.47 ±1.118),(17.86 ±1.49),(17.81 ±1.13)],[(29.05 ±1.31),(20.14 ±1.73),(18.26 ±1.37)], [(35.21 ±1.33),(23.19 ±0.97),(18.18 ±1.46)],[(41.08 ±1.21),(26.34 ±1.69),(17.91 ±1.01)], which were higher than those in the control group(F =5.556,7.007,8.816,10.208,12.232,all P 0.05).Conclusion KLN drug serum can promote myocardial cell spon-taneous extracellular calcium influx,the mechanism of KLN antiarrhythmic effect may be related to the Ca2 + channel.

Content determination of quercetin,kaempferide and isohamnetin in Chuipencao granules by quantitative analysis of multi-components by single-marker / 中国生化药物杂志

Objective To develop a method of quantitative analysis of multi-components by single marker( QAMS) for determination of quercetin, kaempferide,isohamnetin in Chuipencao granules,providing method to control the quality of Chuipencao granules.Methods The analysis was performed at 30 ℃,on an Shimadzu C18 column(250 mm ×4.6 mm,5μm),and the mobile phase was methanol-0.4% phosphoric acid solution .The flow rate was 1.0 mL/min, and the injection volume was 10 μL.Quercetin as a reference to establish the relative correction factor kaempferol and between isorhmnetin, the method was evaluated for reproducibility, and the difference between calculated and measured values was compared. Results Quercetin, kaempferol and isorhmnetin respectively 32.36-426.43μg, 11.56-136.87μg, 10.45-155.68μg showed a good linear relationship, and the regression equation was: Y=3625.8X-13658 (R2 =0.9998), Y=2682.9X-10253(R2 =0.9999), Y=3012.2X-11223 (R2 =0.9999).The average recoveries were 99.3%, 99.6%, 98.5% (RSD were less than 1.0%).Determination of 10 batches of Chuipencao granules with QAMS and external standard method, kaempferol and isorhamnetin were measured, and measured values were basically the same.Conclusion The QAMS method is reliable and accurate, which might be used for the quality control of Chuipencao granules.

Effect of chondroitin sulfate proteoglycans on the repair of nerve system injury / 中国生化药物杂志

Chondroitin sulfate proteoglycans ( CSPGs) is one kind of proteins that covalently bind with chondroitin sulfate.CSPGs play important roles in the growth and development of the central nervous system and the pathological reaction of nervous injury.This article reviews the functional and mechanism studies of CSPGs in the repair of nerve system injury.

Expression and relationship of MMP-2 and COX-2 in bladder transitional cell carcinoma / 肿瘤研究与临床

Objective To evaluate the level of MMP-2 and COX-2 Protein in bladder transitional cell carcinoma tissue and explore their relationships. Methods A total of 42 patients with bladder transitional cell carcinoma, including Ta-T1 (n=18), T2-T4 (n=24), G1(n=12), G2 (n=19), G3 (n=11), metastasis (n=26) and without metastasis (n=16), were enrolled in the study. Eight normal bladder tissues were selected as control group. Western blotting was performed todetect the mRNA level of MMP-2 and COX-2. Results The relative COX-2 protein level of Ta-T1 (0.729±0.458), T2-T4 (1.248±0.425), G1 (0.61±0.486), G2 (1.055±0.406), G3 (1.422±0.341) were all higher than that of the control group significantly (0.31±0.149, t = 3.56, 4.13; F = 5.98, P ＜0.05). The relative MMP-2 protein level of Ta-T1 (0.844±0.345), T2-T4 (1.458±0.463), G1 (0.971 ±0.370), G2(1.445±0.378), G3 (1.755±0.387) were all higher than that of the control group (0.460±0.213, t = 3.91, 4.83;F = 6.35, P ＜0.05). The COX-2 and MMP-2 protein level in tumor tissues with and without metastasis were 1.246±0.426 vs 0.668±0.421, 1.430±0.461 vs 0.814±0.341, t = 5.89, 6.27, P ＜0.01, respectively. The level of COX-2 protein was positively correlated with MMP-2 positively (r =0.48, P ＜0.01). Conclusion MMP-2 and COX-2 protein are highly expressed in bladder transitional cell carcinoma tissue and their expression is positively correlated with the malignant degree. MMP-2 and COX-2 might play a synergetic role in the carcinogenesis of bladder transitional cell carcinoma.

Determination of Imperatorin and Isoimperatorin in Angelicae Dahuricae from Different Sources by HPLC / 浙江中医药大学学报

[Objective] To determine the contents of imperatorin and isoimperation in Angelicae dahuricae from different sources by HPLC,and prove some scientific evidence for processing standardization and quality control of Angelicae dahuricae decoction pieces.[Methods] An HPLC method was established.XB-C18 column was used,with mixture of acetonitrile and water in a gradient mode.The flow rate was 1.0mL?min-1.[Result] The calibration curve of imperatorin was in good linear over the range of 0.0552～0.276?g with the average assay recovery 99.5%.The calibration curve of isoimperatorin was linear over the range of 0.048～0.24?g with the average assay recovery 98.6% (RSD=1.7%).The contents of imperatorin from different sources in Angelicae dahuricae were between 0.046%～0.145%,isoimperatorin was between 0.038%～0.087%,the total was between 0.084%～0.232%.[Conclusion] This method was proved to be rapid,reproducible and accurate.It is suitable for the quality control of Angelilae dahuricae and its preparation.