Lianmei Qiwu Decoction relieves diabetic cardiac autonomic neuropathy by regulating AMPK/TrkA/TRPM7 signaling pathway / 中国中药杂志

This study investigated the effect of Lianmei Qiwu Decoction(LMQWD) on the improvement of cardiac autonomic nerve remodeling in the diabetic rat model induced by the high-fat diet and explored the underlying mechanism of LMQWD through the AMP-activated protein kinase(AMPK)/tropomyosin receptor kinase A(TrkA)/transient receptor potential melastatin 7(TRPM7) signaling pathway. The diabetic rats were randomly divided into a model group, an LMQWD group, an AMPK agonist group, an unloaded TRPM7 adenovirus group(TRPM7-N), an overexpressed TRPM7 adenovirus group(TRPM7), an LMQWD + unloaded TRPM7 adenovirus group(LMQWD+TRPM7-N), an LMQWD + overexpressed TRPM7 adenovirus group(LMQWD+TRPM7), and a TRPM7 channel inhibitor group(TRPM7 inhibitor). After four weeks of treatment, programmed electrical stimulation(PES) was employed to detect the arrhythmia susceptibility of rats. The myocardial cell structure and myocardial tissue fibrosis of myocardial and ganglion samples in diabetic rats were observed by hematoxylin-eosin(HE) staining and Masson staining. The immunohistochemistry, immunofluorescence, real-time quantitative polymerase chain reaction(RT-PCR), and Western blot were adopted to detect the distribution and expression of TRPM7, tyrosine hydroxylase(TH), choline acetyltransferase(ChAT), growth associated protein-43(GAP-43), nerve growth factor(NGF), p-AMPK/AMPK, and other genes and related neural markers. The results showed that LMQWD could significantly reduce the arrhythmia susceptibility and the degree of fibrosis in myocardial tissues, decrease the levels of TH, ChAT, and GAP-43 in the myocardium and ganglion, increase NGF, inhibit the expression of TRPM7, and up-regulate p-AMPK/AMPK and p-TrkA/TrkA levels. This study indicated that LMQWD could attenuate cardiac autonomic nerve remodeling in the diabetic state, and its mechanism was associated with the activation of AMPK, further phosphorylation of TrkA, and inhibition of TRPM7 expression.

Professor LIN Guo-hua's clinical experience in staging treatment for post-stroke dysphagia / 中国针灸

The paper summarizes professor LIN Guo-hua's clinical experience in staging treatment for post-stroke dysphagia. Professor LIN Guo-hua adheres to "essence and marrow deficiency and primary yang decline" as the pathogenesis and "conducting yin from yang " as the treating principle. By regulating the conception vessel and the governor vessel and focusing on yang meridians, in association with meridian differentiation and the location differentiation, professor LIN provides the staging treatment for post-stroke dysphagia. At the oral phase, yangming is dysfunction, manifested as facial paralysis and flaccid tongue. In treatment, reducing method is predominated at yangming meridian specially. At the pharyngeal phase, shaoyang is invaded by pathogens, manifested as pivoting dysfunction. The treatment focuses on communicating the exterior with the interior and promoting shaoyang meridian. At the esophageal phase, yangming meridian is deficiency and the turbid qi fails to descend, thus the reinforcing method is dominated to promote and tonify yangming. Additionally, the kinesiotherapy of acupuncture is assisted and the Lingnan fire needling therapy is used particularly. All of the summaries above provide the reference for the clinical treatment of post-stroke dysphagia.

Content Determination of 7 Components of Water Decoction of Compatibility of Crataegi Fructus and Rhei Radix et Rhizoma Before and After Stir-frying with Wine / 中国中医药信息杂志

Objective To establish a content determination method for 7 components of water decoction of compatibility of Crataegi Fructus and Rhei Radix et Rhizoma before and after stir-frying with wine; To provide a reference for the clinical compatibility of Rhei Radix et Rhizoma and Crataegi Fructus. Methods HPLC was performed on the column of Thermo-C18 endcapped column (250 mm×4.6 mm, 5 μm). The mobile phase was 0.1% phosphoric acid water-acetonitrile system and a linear gradient elution was used. The column temperature was 25 ℃, and the injection volume was 10 μL. The detection wavelength was set at 254 nm. Results The seven markers including gallic acid, chlorogenic acid, aloe-emodin, rheinic acid, rheum emodin, chrysophanic acid and emodin monomethyl ether, reached baseline separation. The linearity was good, and the average recovery was 104.2%, 100.3%, 99.8%, 102.8%, 103.5%, 98.5%, and 99.5%. RSDs of 7 components were all less than 2.7%. The method showed high precision, stability and reproducibility. After prepared with wine, gallic acid content increased in Rhei Radix et Rhizoma, while aloe emodin, rhein, emodin, chrysophanol and physcion decreased to varying degrees. The content of chlorogenic acid increased in water decoction of compatibility of Crataegi Fructus Rhei Radix et Rhizoma. Conclusion The method can be used for the content determination of 7 components of water decoction of the compatibility of Rhei Radix et Rhizoma and Crataegi Fructus before and after stir-frying with wine, providing references for clinical application.

Huangqi Danshen decoction attenuates isoproterenol-induced myocardial remodeling via STIM1, TRPC1, CaN and NFATc3 pathways in rats / 中国中药杂志

To investigate the inhibitory effect of Huangqi Danshen decoction (HDD) on isoproterenol (ISO)-induced myocardial remodeling and explore its effect on STIM1, TRPC1, CaN and NFATc3 expressions. ISO (2.5 mg•kg⁻¹•d⁻¹×14 d) was given by subcutaneous injection to establish myocardial remodeling models in rats, and then were randomly divided into control group, ISO model group, HDD5 group (HDD 5 g•kg⁻¹•d⁻¹+ISO), and HDD10 group (HDD 10 g•kg⁻¹•d⁻¹+ISO). After intervention for 4 weeks, the heart mass index (HW/BW) and the left ventricular mass index (LVW/BW) were calculated; the structure of myocardium was observed by echocardiography; the pathological changes of myocardium were observed by HE staining; levels of BNP, CaN and CaM kinases II in serum were detected by ELISA, and the protein expression levels of STIM1, TRPC1, p-CaN, p-NFATc3, and NFATc3 in left ventricular tissues were detected by Western blot. The results showed that the HW/BW and LVW/BW in ISO group were greater than those in HDD5 group and HDD10 group (P<0.05); Echocardiography showed that HDD inhibited ISO-induced increase in LVEDD and LVESD; ELISA results showed that HDD could significantly inhibit the increase of BNP, CaN and CaM kinases II levels in serum of rats with ISO-induced myocardial remodeling (P<0.01). Western blot results showed that STIM1, TRPC1, p-CaN, p-NFATc3 and NFATc3 expression levels were increased in the myocardial tissues of ISO group rats, and after HDD administration, the above expression levels were decreased in group ISO, HDD for myocardial tissue after administration of STIM1, TRPC1, p-CaN, p-NFATc3 and NFATc3 expression decreased (P<0.05). Our findings indicated that HDD can attenuate the myocardial remodeling induced by ISO, and its mechanism may be related to down-regulating the expression levels of STIM1, TRPC1, CaM kinases II, p-CaN/CaN and p-NFATc3/NFATc3.

Effects of recent upper respiratory-tract infections on incidence of the perioperative respiratory adverse events in children: a prospective cohort study / 北京大学学报(医学版)

Objective:To investigate the effects of the recent upper respiratory tract infections (URI) on the incidence of perioperative respiratory adverse events in children scheduled to undergo general anesthesia and elective surgery.Methods:In the study,232 children undergoing general anesthesia with laryngeal mask airway (LMA) for elective ophthalmic surgeries at Peking University First Hospital,Beijing,China,from Nov.1,2015 to May 10,2016 were enrolled.On the day of the surgery,the parents of the children were preoperatively asked to fill out a questionnaire regarding the baseline characteristics and medical history of the children,including gender,age,height,weight,history of URI within the last 2 weeks before anesthesia,history of premature,long-term passive smoking exposure,habitual sleep snoring,and history of asthma.In addition,all adverse respiratory events throughout the perioperative periods (oxygen desaturation,cough,copious secretions,laryngospasm and bronchospasm) as well as perioperative variables (number of attempts to insert the LMA successfully,anesthesia duration and so on) were recorded.Multivariate Logistic regression analysis was applied to identify independent risk factors of perioperative respiratory adverse events.Results:Among the 232 children included in the study,28.0％ (65/232) presented with a history of a recent URI within the last 2 weeks before anesthesia.The presence of the recent URI increased the incidence of oxygen desaturation (23.1％ vs.12.0％,P =0.034),copious secretions (15.4％ vs.6.6％,P =0.036) and any of all the adverse respiratory events (32.3％ vs.18.6％,P =0.024).Multivariate Logistic regression analysis identified two independent risk factors of perioperative adverse respiratory events:a history of URI within the last 2 weeks before general anesthesia (OR =2.021,95％ CI:1.023-3.994,P =0.043) and habitual sleep snoring (OR =3.660,95％ CI:1.517-8.832,P =0.004).Conclusion:A history of a recent URI within 2 weeks before general anesthesia was associated with a higher incidence of oxygen desaturation,copious secretions and the overall respiratory adverse events.For the children with recent URI,we recommend the general anesthesia and elective surgery should be postponed for at least 2 weeks after the URI.