Effect and mechanism of Zexie Decoction in promoting white adipose tissue browning/brown adipose tissue activation based on GLP-1R/cAMP/PKA/CREB pathway / 中国中药杂志

This study investigated the mechanism of Zexie Decoction(ZXD) in promoting white adipose tissue browning/brown adipose tissue activation based on the GLP-1R/cAMP/PKA/CREB pathway. A hyperlipidemia model was induced by a western diet(WD) in mice, and the mice were divided into a control group, a model group(WD), and low-, medium-, and high-dose ZXD groups. An adipogenesis model was induced in 3T3-L1 cells in vitro, and with forskolin(FSK) used as a positive control, low-, medium-, and high-dose ZXD groups were set up. Immunohistochemistry and immunofluorescence results showed that compared with the WD group, ZXD promoted the expression of UCP1 in white and brown adipose tissues, and also upregulated UCP1, CPT1β, PPARα, and other genes in the cells. Western blot analysis showed a dose-dependent increase in the protein expression of PGC-1α, UCP1, and PPARα with ZXD treatment, indicating that ZXD could promote the white adipose tissue browning/brown adipose tissue activation. Hematoxylin-eosin(HE) staining results showed that after ZXD treatment, white and brown adipocytes were significantly reduced in size, and the mRNA expression of ATGL, HSL, MGL, and PLIN1 was significantly upregulated as compared with the results in the WD group. Oil red O staining and biochemical assays indicated that ZXD improved lipid accumulation and promoted lipolysis. Immunohistochemistry and immunofluorescence staining for p-CREB revealed that ZXD reversed the decreased expression of p-CREB caused by WD. In vitro intervention with ZXD increased the protein expression of CREB, p-CREB, and p-PKA substrate, and increased the mRNA level of CREB. ELISA detected an increase in intracellular cAMP concentration with ZXD treatment. Molecular docking analysis showed that multiple active components in Alismatis Rhizoma and Atractylodis Macrocephalae Rhizoma could form stable hydrogen bond interactions with GLP-1R. In conclusion, ZXD promotes white adipose tissue browning/brown adipose tissue activation both in vivo and in vitro, and its mechanism of action may be related to the GLP-1R/cAMP/PKA/CREB pathway.

Mechanism of Zexie Decoction in improvement of nonalcoholic fatty liver disease based on LKB1/AMPK/PGC-1α pathway / 中国中药杂志

The present study investigated the pharmaceutical effect and underlying mechanism of Zexie Decoction(ZXD) on nonalcoholic fatty liver disease(NAFLD) in vitro and in vivo via the LKB1/AMPK/PGC-1α pathway based on palmitic acid(PA)-induced lipid accumulation model and high-fat diet(HFD)-induced NAFLD model in mice. As revealed by the MTT assay, ZXD had no effect on HepG2 activity, but dose-dependently down-regulated alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in the liver cell medium induced by PA, and decreased the plasma levels of ALT and AST, and total cholesterol(TC) and triglyceride(TG) levels in the liver. Nile red staining showed PA-induced intracellular lipid accumulation, significantly increased lipid accumulation of hepatocytes induced by PA, suggesting that the lipid accumulation model in vitro was properly induced. ZXD could effectively improve the lipid accumulation of hepatocytes induced by PA. Oil red O staining also demonstrated that ZXD improved the lipid accumulation in the liver of HFD mice. JC-1 staining for mitochondrial membrane potential indicated that ZXD effectively reversed the decrease in mitochondrial membrane potential caused by hepatocyte injury induced by PA, activated PGC-1α, and up-regulated the expression of its target genes, such as ACADS, CPT-1α, CPT-1β, UCP-1, ACSL-1, and NRF-1. In addition, as revealed by the Western blot and immunohistochemistry, ZXD up-regulated the protein expression levels of LKB1, p-AMPK, p-ACC, and PGC-1α in vivo and in vitro. In conclusion, ZXD can improve NAFLD and its mechanism may be related to the regulation of the LKB1/AMPK/PGC-1α pathway.

New eudesmane sesquiterpenoids from Atractylodis Macrocephalae Rhizoma and their inhibitory activities against SREBPs / 中国中药杂志

Three sesquiterpenoids were isolated and purified from the 95% ethanol extract of Atractylodis Macrocephalae Rhizoma by column chromatography on silica gel, Sephadex LH-20, ODS, and high-performance liquid chromatography(HPLC). Their chemical structures were identified on the basis of spectroscopic analysis and physiochemical properties as(7Z)-8β,13-diacetoxy-eudesma-4(15),7(11)-diene(1), 7-oxo-7,8-secoeudesma-4(15),11-dien-8-oic acid(2), and guai-10(14)-en-11-ol(3). Compounds 1 and 2 are new compounds and compound 3 was obtained from Compositae family for the first time. Compounds 1, 2, and 3 showed weak inhibitory activities against sterol regulatory element-binding proteins(SREBPs).

Discovery of a potent FKBP38 agonist that ameliorates HFD-induced hyperlipidemia

The mammalian target of rapamycin (mTOR)-sterol regulatory element-binding proteins (SREBPs) signaling promotes lipogenesis. However, mTOR inhibitors also displayed a significant side effect of hyperlipidemia. Thus, it is essential to develop mTOR-specific inhibitors to inhibit lipogenesis. Here, we screened the endogenous inhibitors of mTOR, and identified that FKBP38 as a vital regulator of lipid metabolism. FKBP38 decreased the lipid content

Differences in clinical characteristics and laboratory parameters of primary and recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#Pterygium is a common conjunctival disease which is mainly attributed to chronic ultraviolet light exposure. Previous studies have focused primarily on the clinical characteristics, surgical management and the pathogenesis of pterygium, but the differences between primary pterygium and recurrent pterygium have been less frequently documented. This article reviews the differences in clinical manifestations, histopathological findings, and laboratory parameters between primary pterygium and recurrent pterygium and summarises the latest findings regarding these differences.

Protective Effects of Salvianolate on Myocardial Injury or Myocardial Infarction after Elective Percutaneous Coronary Intervention in NSTE-ACS Patients: A Randomized Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the protective effects of salvianolate on percutaneous coronary intervention (PCI) related myocardial injury or myocardial infarction after elective PCI in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients.@*METHODS@#A total of 149 patients with NSTE-ACS who underwent elective PCI were enrolled. The patients were randomly allocated in a 1:1 ratio to the salvianolate group (74 cases) or the control group (75 cases). After exclusion criteria of coronary angiography, 60 patients with PCI therapy remained in the salvianolate group and 68 in the control group. The incidence and the severity of PCI related myocardial injury or myocardial infarction, in addition to major adverse cardiac events (MACEs) during 1 year follow-up after PCI were studied between the two groups. Multivariate logistic regression analysis was used to determine the independent factors for PCI related myocardial injury or myocardial infarction after elective PCI.@*RESULTS@#Compared with the control group, salvianolate treatment reduced the incidence of PCI related severe myocardial injury or myocardial infarction (11.7% vs. 26.5%, P=0.035). The rate of MACEs or all-cause death within 1 month or 1 year after the procedure was not significantly different between the two groups.@*CONCLUSIONS@#Periprocedural treatment with salvianolate reduces the incidence of PCI related severe myocardial injury or myocardial infarction, although it does not influence clinical prognosis. [Chinese clinical trial registry: ChiCTR1800016992].

Protective Effects of Salvianolate on Myocardial Injury or Myocardial Infarction after Elective Percutaneous Coronary Intervention in NSTE-ACS Patients: A Randomized Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the protective effects of salvianolate on percutaneous coronary intervention (PCI) related myocardial injury or myocardial infarction after elective PCI in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients.@*METHODS@#A total of 149 patients with NSTE-ACS who underwent elective PCI were enrolled. The patients were randomly allocated in a 1:1 ratio to the salvianolate group (74 cases) or the control group (75 cases). After exclusion criteria of coronary angiography, 60 patients with PCI therapy remained in the salvianolate group and 68 in the control group. The incidence and the severity of PCI related myocardial injury or myocardial infarction, in addition to major adverse cardiac events (MACEs) during 1 year follow-up after PCI were studied between the two groups. Multivariate logistic regression analysis was used to determine the independent factors for PCI related myocardial injury or myocardial infarction after elective PCI.@*RESULTS@#Compared with the control group, salvianolate treatment reduced the incidence of PCI related severe myocardial injury or myocardial infarction (11.7% vs. 26.5%, P=0.035). The rate of MACEs or all-cause death within 1 month or 1 year after the procedure was not significantly different between the two groups.@*CONCLUSIONS@#Periprocedural treatment with salvianolate reduces the incidence of PCI related severe myocardial injury or myocardial infarction, although it does not influence clinical prognosis. [Chinese clinical trial registry: ChiCTR1800016992].

Clinical Study on Acupuncture at Lower He-Sea Point for Promoting Functional Recovery after Stomach Cancer Surgery / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture at lower He-Sea point in promoting functional recovery after stomach cancer surgery.Methods Sixty patients who had undergone stomach cancer surgery were randomly allocated to treatment and control groups by using random number table method according to registration order, 30 cases each. The control group received general treatment and the treatment group, acupuncture in addition. Post-treatment gastric tube removal time, borborygmus recovery time and first fart time, the average hospitalization days, and the total cost were observed and the Quality of Life Questionnaire Core 30 (QLQ-C30) score was recorded in the two groups of patients. Post-treatment incidence of adverse reactions, peripheral white blood cell (WBC) counts, C-reactive protein (CRP) levels and plateletcrits (PCT) were compared between the two groups.Results There were statistically significant differences in post-treatment gastric tube removal time, borborygmus recovery time, first fart time and hospitalization days, and the total hospitalization expenses between the two groups of patients (P<0.01). There were also statistically significant differences in post-treatment incidences of nausea, vomiting, abdominal pain and abdominal distension between the two groups (P<0.05). Post-treatment QLQ-C30 score was (38.35±15.25) in treatment group and (76.23±10.67) in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant differences in WBC and CRP levels at the end of operation and 24 hrs after treatment between the two groups (P<0.01,P<0.05). Conclusions Acupuncture can be used for early treatment after stomach cancer surgery. It can promote the recovery of gastrointestinal function and improve the overall quality of life in the patients.

Research Progress and Necessity Analysis on Construction of Medical Quality Evaluation Index System in Integrated Traditional Chinese Medicine Hospitals / 中国中医药信息杂志

This article made a definition for the concept of medical quality and medical quality evaluation, clarified logical relations between medical quality and medical service quality. Meanwhile, compared domestic and foreign standards of medical quality evaluation, combed the implementation of medical quality evaluation in China since 1970s. It summarized research development in current medical quality evaluation in China. At last, the necessity of medical quality evaluation construction in TCM hospitals was analyzed for further research in the future.

Clinical Study on Acupuncture at Lower He-Sea Point for Promoting Functional Recovery after Stomach Cancer Surgery / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture at lower He-Sea point in promoting functional recovery after stomach cancer surgery.Methods Sixty patients who had undergone stomach cancer surgery were randomly allocated to treatment and control groups by using random number table method according to registration order, 30 cases each. The control group received general treatment and the treatment group, acupuncture in addition. Post-treatment gastric tube removal time, borborygmus recovery time and first fart time, the average hospitalization days, and the total cost were observed and the Quality of Life Questionnaire Core 30 (QLQ-C30) score was recorded in the two groups of patients. Post-treatment incidence of adverse reactions, peripheral white blood cell (WBC) counts, C-reactive protein (CRP) levels and plateletcrits (PCT) were compared between the two groups.Results There were statistically significant differences in post-treatment gastric tube removal time, borborygmus recovery time, first fart time and hospitalization days, and the total hospitalization expenses between the two groups of patients (P<0.01). There were also statistically significant differences in post-treatment incidences of nausea, vomiting, abdominal pain and abdominal distension between the two groups (P<0.05). Post-treatment QLQ-C30 score was (38.35±15.25) in treatment group and (76.23±10.67) in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant differences in WBC and CRP levels at the end of operation and 24 hrs after treatment between the two groups (P<0.01,P<0.05). Conclusions Acupuncture can be used for early treatment after stomach cancer surgery. It can promote the recovery of gastrointestinal function and improve the overall quality of life in the patients.

Research Progress and Necessity Analysis on Construction of Medical Quality Evaluation Index System in Integrated Traditional Chinese Medicine Hospitals / 中国中医药信息杂志

This article made a definition for the concept of medical quality and medical quality evaluation, clarified logical relations between medical quality and medical service quality. Meanwhile, compared domestic and foreign standards of medical quality evaluation, combed the implementation of medical quality evaluation in China since 1970s. It summarized research development in current medical quality evaluation in China. At last, the necessity of medical quality evaluation construction in TCM hospitals was analyzed for further research in the future.

Non-fastidous antibiotic-resistance bacteria pollution in tap water / 军事医学

Objective To study the non-fastidous antibiotic-resistance bacteria pollution in tap water from a neighborhood in Tianjin.Methods Tap water samples were collected and bacteria were isolated by R2A agar,and 16S rRNA gene sequence for the identification of bacteria isolates was used.Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method.Results Among the 39 non-fastidous bacteria isolates,the resistance rate of antibioticresistance bacteria was 79.49％,including Enterococcus,Staphylococcus,Acinetobacter and Pseudomonas.Some bacteria (28.21％) showed resistance against only one antibiotic.The others (51.28％) were multiple resistant bacteria.Trimethoprim/sulfamethoxazole resistance was most prevalent (53.85％),and sulfamethoxazole resistance was also widely distributed (28.21％).Conclusion Tap water from this neighborhood is heavily polluted by non-fastidous antibioticresistantance bacteria,which deserves more attention.

Effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) on skeletal muscle strength in the elderly / 针灸推拿医学（英文版）

Objective: To observe the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) on the muscle strength in senile sarcopenia. Methods: Sixty-five old people with sarcopenia were randomized into Yi Jin Jing group and a blank control group. Thirty-three patients in Yi Jin Jing group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises), while 32 patients in the blank control group didn't receive any interventions. The muscle strength was measured before and after 12-week training. Results: During the study, each group had 1 dropout. The muscle strength was improved after 12-week training in Yi Jin Jing group, and the difference was statistically significant (P<0.05); there was no significant difference in the blank control group (P>0.05). After the intervention, there was a significant difference between Yi Jin Jing group and the blank control group in comparing the muscle strength (P<0.05). Conclusion: Constant Yi Jin Jing (Sinew-transforming Qigong Exercises) training can notably improve skeletal muscle strength in senile sarcopenia.

Jiawei Erzhiwan improves menopausal metabolic syndrome by enhancing insulin secretion in pancreatic β cells / 中国天然药物

Menopausal metabolic syndrome (MMS) is a series of syndrome caused by ovarian function decline and hormone insufficiency, and is a high risk factor for cardiovascular diseases (CVD) and type II diabetes mellitus (T2DM). Erzhiwan (EZW), composed of Herba Ecliptae and Fructus Ligustri Lucidi, is a traditional Chinese herbal formula that has been used to treat menopausal syndrome for many years. We added Herba Epimedii, Radix Rehmanniae, and Fructus Corni into EZW, to prepare a new formula, termed Jiawei Erzhiwan (JE). The present study was designed to determine the anti-MMS effects of JE using ovariectomized (OVX) adult female rats that were treated with JE for 4 weeks, and β-tc-6 cells and INS cells were used to detected the protect effectiveness of JE. Our results showed JE could increase insulin sensitivity and ameliorated hyperlipidemia. Metabolomics analysis showed that the serum levels of branched and aromatic amino acids were down-regulated in serum by JE administration. Moreover, JE enhanced the function of islet β cells INS-1 and β-tc-6, through increasing the glucose stimulated insulin secretion (GSIS), which was abolished by estrogen receptor (ER) antagonist, indicating that JE functions were mediated by ER signaling. Additionally, JE did not induce tumorigenesis in rat mammary tissue or promoted proliferation of MCF-7 and Hela cells. In conclusion, our work demonstrated that JE ameliorated OVX-induced glucose and lipid metabolism disorder through activating estrogen receptor pathway and promoting GSIS in islet β cells, thus indicating that JE could be a safe and effective medication for MMS therapy.

Petroleum ether sub-fraction of rosemary extract improves hyperlipidemia and insulin resistance by inhibiting SREBPs / 中国天然药物

As a culinary and medicinal herb, rosemary is widely used. The present work aimed to investigate the effects of rosemary extracts on metabolic diseases and the underlying mechanisms of action. Liver cells stably expressing SREBP reporter were used to evaluate the inhibitory effects of different fractions of rosemary extracts on SREBP activity. The obese mice induced by Western-type diet were orally administered with rosemary extracts or vehicle for 7 weeks, the plasma and tissue lipids were analyzed. SREBPs and their target genes were measured by quantitative RT-PCR. We demonstrated that the petroleum ether sub-fraction of rosemary extracts (PER) exhibited the best activity in regulating lipid metabolism by inhibiting SREBPs, while water and n-BuOH sub-fraction showed the SREBPs agonist-effect. After PER treatment, there was a significant reduction of total SREBPs in liver cells. PER not only decreased SREBPs nuclear abundance, but also inhibited their activity, resulting in decreased expression of SREBP-1c and SREBP-2 target genes in vitro and in vivo. Inhibiting SREBPs by PER decreased the total triglycerides and cholesterol contents of the liver cells. In the mice fed with Western-type diet, PER treatment decreased TG, TC, ALT, glucose, and insulin in blood, and improved glucose tolerance and insulin sensitivity. Furthermore, PER treatment also decreased lipid contents in liver, brown adipose tissue, and white adipose tissue. Our results from the present study suggested that petroleum ether fraction of rosemary extracts exhibited the best potential of improving lipid metabolism by inhibiting SREBPs activity.

A study on the status and equity of resource allocation for community vaccination services in Zhejiang Province / 预防医学

Objective To evaluate the status and equity of resource allocation for community vaccination services in Zhejiang Province.Methods A descriptive analysis was conducted,and Gini coefficient and Theil index were used to analyze the reasonableness and the demographic equity of resource allocation for community vaccination services in Zhejiang Province in 2013.Results The Gini coefficient of vaccination clinic and clinic staff based on population distribution in Zhejiang Province were 0.403 6 and 0.355 4,respectively.The total Theil index of vaccination clinic and clinic staff were 0.204 4 and 0.207 1,respectively.Both vaccination clinic and clinic staff,Theil index within the region were far higher than inter -regional Theil index.Conclusion The demographic equity of resource allocation for community vaccination services in Zhejiang Province should be improved.The disparity within the region is the main reason of unequal in resource allocation for community vaccination service.

Chemical profiling of Jinqi Jiangtang tablets by HPLC-ESI-Q-TOF/MS / 中国天然药物

AIM@#To profile the chemical constituents in Jinqi Jiangtang tablets.@*METHOD@#Based on the chromatographic retention behavior, fragmentation patterns of chemical components, and published literatures, a high-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (HPLC-ESI-Q-TOF/MS) method was established to characterize and identify components in Jinqi Jiangtang tablets.@*RESULTS@#A total of 52 chemical compounds, including eight iridoid glycosides, seven phenolic acids, twelve alkaloids, six flavonoids, and nineteen saponins, were identified in Jinqi Jiangtang tablets.@*CONCLUSION@#The established method could serve as a powerful tool for structural characterization and quality control of this Chinese herbal preparation.

Effects of linggui zhugan decoction combined calorie restriction on the insulin resistance of model rats and mechanisms research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effects of Linggui Zhugan Decoction (LZD) combined calorie restriction on fasting plasma glucose (FPG), the insulin resistance (IR), and the peroxisome proliferator-activated receptor gamma (PPAR-gamma) of IR model rats.</p><p><b>METHODS</b>Totally 48 male Wistar rats were randomly divided into the control group, the model group, the calorie restriction group, and the TCM + calorie restriction group, 12 in each group. Ordinary forage was given to those in the control group, and high fat diet was fed to those in the rest 3 groups for 12 weeks to establish the IR model. After successful modeling, rats in the control group and the model group were continually fed with the original farage for 4 days. The normal saline at the daily dose of 20 mL/kg was given to them by gastrogavage. The normal saline at the daily dose of 20 mL/kg was given to rats in the calorie restriction group by gastrogavage after 4-day calorie restriction. LZD at the daily dose of 20 mL/kg was given to rats in the TCM +calorie restriction group by gastrogavage after 4-day calorie restriction. The body weight, FPG, serum fasting insulin (FINS), insulin resistance index (IRI), and the protein expression of PPAR-y in the omental adipose tissue were compared.</p><p><b>RESULTS</b>After 4-day calorie restriction, the body weight obviously decreased in the calorie restriction group and the TCM +calorie restriction group, when compared with the model group (P <0.01). There was no statistical difference between the former two groups (P >0.05). The FINS and IRI obviously decreased in the calorie restriction group (P <0.01, P <0.05). The FPG, FINS, and IRI significantly decreased in the TCM + calorie restriction group (P <0. 05, P <0.01). The protein expression of PPAR-gamma obviously decreased in the calorie restriction group and the TCM + calorie restriction group (P <0.01).The phlegm dampness state was alleviated, with more significant effects shown in the TCM + calorie restriction group.</p><p><b>CONCLUSIONS</b>LZD combined calorie restriction could reduce the body weight, FPG, and IRI of IR rats. Besides, it showed better effects than calorie restriction alone. Its effects in improving IR might be correlated with inhibiting the activities of PPAR-gamma. Meanwhile, it might play a role in inhibiting the differentiation of fat cells.</p>

Simultaneous Determination of Four Major Steroidal Saponins in seven species of Dioscorea L.By HPLC-ELSD / 中草药·英文版

Objective To control the quality of the species in Dioscorea L. better. Methods An HPLC-ELSD method was developed for the first time to simultaneously determine four bioactive ingredients:dioscin gracillin,protoneodioscin, and protoneogracillin in 31 samples belonging to seven species of Dioscorea L. from different areas. The column was an Inertsil HILIC (250mmx4.6 mm,5pm). The separation was carried out with a gradient program. The mobile phase was acetonitrile-water at a flow rate of 0.8 mL/min. Results The standard curve was rectilinear in the range of 0.464-12.97 gg (r=0.9969) for dioscin, 0.310-7.09 ltg (r = 0.9953) for gracillin, 0.469-11.66 gg (r=0.9970) for protoneodioscin, and 0.276-6.87 gg (r＝0.9992) for protoneogracillin. The recoveries of the markers were 98.1%, 100.1%, 97.2%, and 96.4%, respectively. The contents of the four components were quite different among the seven species of Dioscorea L. Conclusion The proposed HPLC-ELSD method is convenient,fast, accurate, and applicable for simultaneous analysis of multiple bioactive components of species in Dioscorea L.for quality control, which could facilitate discovering new natural resources of steroidal saponin.

Fingerprinting Analysis of Four Variants of Chrysanthemi Morifoli Flos by RP-HPLC / 中草药·英文版

Objective To establish a RP-HPLC fingerprinting analysis method for quality evaluation and control of the four variants of Chrysanthemi Morifoli Flos. Methods RP-HPLC was used to establish the fingerprinting method.Results Despite of the similarity in terms of holistic HPLC chromatograms, the four variants of Chrysanthemi Morifoli Flos exhibit characteristic fingerprints and can be readily recognized by similarity clusters. Conclusion A simple and reliable HPLC fingerprinting method has been developed and validated to authenticate the four variants of Chrysanthemi Morifoli Flos, providing a scientific basis for quality control of Chrysanthemi Morifoli Flos.