Establishment of UPLC fingerprint and study on anti-respiratory syncytial virus spectrum-effective relationship of ethanol extract from Callicarpa nudiflora / 中国药房

OBJECTIVE To establish the fingerprint of the ethanol extract from Callicarpa nudiflora， analyze its anti- respiratory syncytial virus （RSV） activity in vitro， and study the relationship between spectrum and effect. METHODS Using 10%， 30%， 50%， 70% and 90% ethanol as solvent， 20 batches of ethanol extracts from 4 batches of C. nudiflora were prepared. The fingerprints for 20 batches of ethanol extracts from C. nudiflora were mapped by ultra-high-performance liquid chromatography （UPLC）， and the similarity evaluation was conducted by using the Similarity Evaluation System for Traditional Chinese Medicine Chromatographic Fingerprints （2012 edition）. The cytopathic effect method and MTT method were used to investigate the in vitro inhibitory activity of the ethanol extracts from C. nudiflora on RSV. Pearson correlation analysis， grey correlation degree and orthogonal partial least squares （OPLS） analysis were used to study the spectrum-effect relationship. RESULTS There were 25 common peaks in 20 batches of ethanol extracts from C. nudiflora， and the similarities ranged from 0.912 to 0.998， and the RSDs of common peak areas were 33.54%-162.28%. The average values of IC50 for RSV of 20 batches of ethanol extracts from C. nudiflora were 9.55-272.23 μg/mL. The results of Pearson correlation analysis， grey correlation analysis and OPLS analysis showed that the Pearson correlation coefficients （P＜0.05） of the common peaks 8， 10， 12， 16， 18-19， 22-24 with pharmacodynamic indicators and regression coefficients were all negative， the correlation coefficients were all greater than 0.6， and the values of variable importance in projection were all greater than 1. CONCLUSIONS Twenty batches of ethanol extracts from C. nudiflora have similar components but significant differences in content， and exhibit different degrees of anti-RSV activity in vitro. The corresponding components of common peaks 8， 10， 12， 16， 18-19， 22-24 may be the characteristic components of anti-RSV of C. nudiflora.

Early Efficacy Predictors of Bushen Shengxue Prescription Combined with Western Medicine in Treatment of Aplastic Anemia / 中国实验方剂学杂志

ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia， and provide prognosis indicators for the treatment of aplastic anemia （AA） with kidney-tonifying therapy in traditional Chinese medicine （TCM） combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment， the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age， sex， disease severity （including severe aplastic anemia and non-severe aplastic anemia）， course of disease， degree of bone marrow nucleated cell proliferation， baseline hemogram levels ［including white blood cell count （WBC）， absolute neutrophil count （ANC）， hemoglobin （HGB）， platelets （PLT）， and reticulocytes （RET）］， T lymphocytes subsets， and the expression levels of T-box transcription factor （T-bet） and GATA-binding protein-3 （GATA-3） were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of ［20， 40） and ［60， 80） were higher in the 4-month effective group （P<0.05）. The sex， disease severity， course of disease， and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB， WBC， ANC， and PLT than the 4-month ineffective group （P<0.05）， and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time， while other indicators did not affect the onset time. The receiver operating characteristic （ROC） curve was established to analyze the value of PLT level before treatment for predicting the onset time， and the area under the curve was 0.691. With the critical value of 40.5×109/L， the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893， respectively. The two groups of patients were graded according to age ｛（14， 20）， ［20， 40）， ［40， 60）， and ［60， 80）｝ and PLT level before treatment （PLT<40×109/L， PLT≥40×109/L）. The proportion of the patients with PLT≥40×109/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group （P<0.05）. The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment （P<0.05）. The levels of Th1 cells， Th2 cells， CD4+ T cells， and CD8+ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment （P<0.05）， while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of ［20， 40） or ［40， 60）， with higher levels of HGB， WBC， ANC， and PLT （especially those with PLT≥40×109/L）， lower level of total T lymphocytes， or higher T-bet expression level before treatment.

Analysis of Predictive Factors for Efficacy of Yiqi Yangxue Prescription Combined with Western Medicine in Treatment of Aplastic Anemia in Non-elderly Adults / 中国实验方剂学杂志

ObjectiveTo explore the predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating aplastic anemia （AA） in non-elderly adults， so as to provide a reference for predicting the prognosis of this therapy. MethodA retrospective study was conducted with the clinical data of non-elderly adult AA patients who visited 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 and were treated with Yiqi Yangxue Prescription combined with western medicine. According to the efficacy evaluation results at the 6th month of treatment， the patients were assigned into effective and ineffective groups. The two groups were compared in terms of the gender， age， disease classification ［non-severe aplastic anemia （NSAA）/severe aplastic anemia （SAA）］， course of disease， family history， complications， history of drug allergy， baseline blood routine examination ［hemoglobin （HGB）， white blood cell （WBC）， neutrophil （ANC）， platelet （PLT）， and reticulocyte （Ret）］， T lymphocyte subsets， degree of proliferation of nucleated cells in bone marrow， and expression of T-bet and GATA-3. ResultA total of 101 non-elderly adult AA patients were enrolled in this study， including 81 in the effective group and 20 in the ineffective group. The effective group had a higher proportion of the patients without a history of drug allergy than the ineffective group （P<0.05）. The body height， body weight， gender， age， disease classification， course of disease， family history， and complications showed no significant differences between two groups. The effective group had higher levels of ANC and PLT before treatment （P<0.05） and higher proportion of patients with ANC≥1.6×109/L and PLT≥25×109/L （P<0.05， P<0.01） than the ineffective group. The baseline levels of WBC， HGB， and Ret showed no significant statistical differences between two groups. The levels of CD3+HLA-DR+T cells in the effective group before treatment was higher than that in the ineffective group （P<0.05）. The levels of CD3+CD19-T cells， CD4+T cells， CD8+T cells， Th1 cells， Th2 cells， and CD3+CD25+T cells showed no significant statistical differences between two groups before treatment. The proportion of patients with active bone marrow nucleated cells proliferation in the effective group before treatment were significantly higher than that in the ineffective group, while the proportion of patients with reduced or extremely reduced proliferation were significantly lower than that in the ineffective group （P<0.05）. The expression levels of T-bet and GATA-3 genes had no significant differences between two groups before treatment. The multivariate binary logistic regression analysis showed that the ANC level before treatment and history of drug allergy were independent influencing factors for efficacy （P<0.05， P<0.01）， while other indicators were not influencing factors for efficacy. The receiver operating characteristic （ROC） curve was applied to analyze the predictive value of the ANC level before treatment in the treatment of AA in non-elderly adults with Yiqi Yangxue prescription combined with western medicine. The area under the curve was 0.679 （P<0.05）， with the critical value of 1.595×109/L， the sensitivity of 0.42， and the specificity of 0.95. ConclusionThe history of drug allergy， pre-treatment ANC， PLT， CD3+HLA-DR+ T cell levels， and proliferation of nucleated cells in bone marrow before treatment are predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating AA in non-elderly adults. This therapy tends to be more effective for the patients with no history of drug allergy， higher ANC and PLT levels before treatment， especially those with ANC≥1.6×109/L， PLT≥25×109/L， and higher CD3+ HLA-DR+T cell levels and the more active proliferation of nucleated cells in bone marrow before treatment.

Clinical Effect of Bushen Shengxue Prescription on Chronic Aplastic Anemia and Its Effect on T Cell Subsets and Expression of T-bet and GATA3 / 中国实验方剂学杂志

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ2=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ2=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ2=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4+， and CD4+/CD8+ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19-， HLA/DR+， and CD25+ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4+， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Progress on pharmacokinetics and dosage regime of teicoplanin in children / 中华临床感染病杂志

Teicoplanin is a glycopeptide antibiotic for treatment of gram-positive bacterial infections in children, especially for methicillin-resistant staphylococcus aureus infection.The body clearance of teicoplanin differs between child and adult.This article explores the suitable testing indicators based on the clinical medication guide and the latest research progress , as well as the pharmacokinetic and pharmacodynamics of teicoplanin , to provide information for individualized dosage regime of teicoplanin in children.

Effect of Shenzhi HuoXue capsule on hard channel puncture drainage in patients with hypertensive intracerebral hemorrhage / 中国生化药物杂志

Objective To observe the influences of Shenzhi Huoxue capsule to prognosis of patients with hypertensive intracerebral hemorrhage after hard channel puncture and drainage.MethodsTo divide 106 patients with hypertensive intracerebral hemorrhage from May 2013 to April 2015 into two groups.The observation group with 53 cases received Shenzhi Huoxue capsule after hard channel puncture and drainage, the control group did not receive Shenzhi Huoxue capsule.To observe the complications rate, the number of deaths during hospitalization, the number of persons with disabilities after treatment, GOS score, BI index, SSS score and NCSE score of two groups.Results(During treatment, the infection, liver and renal dysfunction and rebleeding rates of observation group were lower than control group, and the infection ratio was significant (P<0.05).(During treatment, the proportion of deaths of observation group was 18.87%,lower than control group with 26.42%, but the differences were not statistically significant.The proportion of disabilities of observation group was 26.42%,lower than control group with 45.28%, and the differences were statistically significant (P<0.05).After treatment, GOS score and BI index of two groups were higher than before treatment(P<0.05).GOS score and BI index of the observation group were (12.85±0.81,83.95±4.37)score, higher than the control group with (10.05±0.73,74.95±4.06)score, and the differences all were statistically significant (P<0.05).After treatment, the SSS score and NCSE score of two groups were higher than before treatment(P<0.05),the SSS score and NCSE score of observation group were (47.10±4.18,66.72±3.99)score, higher than the control group with (38.42±3.05,59.34±3.45)score, and the differences were statistically significant (P<0.05).ConclusionAdding Shenzhi Huoxue capsule to patients with hypertensive intracerebral hemorrhage after hard channel puncture and drainage can reduce the number of persons with disabilities and improve life self-care ability and cognitive ability.

Correlation between the levels of serum Klotho with renal impairment in chronic kidney disease patients / 实用医学杂志

Objective To explore the relationship between the level of serum Klotho with renal impairment in chronic kidney disease (CKD) patients. Methods 100 patients with CKD 1-5 stages (CKD group) and 30 non-CKD patients (control group) were enrolled. The serum of Klotho was detected by ELISA (enzyme-linked immunosorbent assay ) to investigate the correlation between the level of serum Klotho to progression of CKD. Results The levels of serum Klotho in CKD group 9.81 (7.45,12.2) ng/mL and control group 2.97 (1.75,5.23) ng/mL were significantly different (P < 0.01); The Klotho level declined as renal insufficiency progressed. Pearson correlation analysis showed that serum Klotho in CKD patients was positively correlated with eGFR (estimated glomerular filtration rate), blood calcium and hemoglobin,while was negatively correlated with phosphate, age, logserum creatinine, and logFGF-23. Multiple regression analysis showed age, logScr and logFGF-23 were independent factors for expression of serum Klotho in CKD patients. Conclusion Serum Klotho level in CKD patients decreased with the deterioration in renal function and serum Klotho maybe one of indicators to predict the progression of renal function in CKD patients.

The significance of Rh blood group antigen and antibody detection in guaranteeing the safety of blood transfusion / 国际检验医学杂志

Objective Investigate the significance of the antibody and antigen detection of Rh blood group.Methods Detecting Rh blood group antigen phenotypes and screen Rh blood group antibodies in 2 700 inpatients from August 2012 to May 2013.Re-sults Rh blood group antigen phenotypes in descending order of propotion were as follows:CCDee,CcDEe,CcDee,ccDEE,CCDEe. 5 antigen genes in descending order of frequency were D,e,C,c,E.Conclusion For donors and donees,in addition to routine tests, the other 4 types of antigen and antibodies in Rh blood group should be detected too,which helps avoid secondary transfusion diffi-culty because of the immunity antibodies generated in blood transfusion.

The Diagnostic Value of Combined Detection of Osteopontin and Matrix Metalloproteinase-9 for In-stent Restenosis in Patients After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To explore the diagnostic value of combined detection of blood osteopontin (OPN) and matrix metalloproteinase-9 (MMP-9) for in-stent restenosis (ISR) in patients after percutaneous coronary intervention (PCI). Methods: A total of 142 patients who received post-PCI coronary angiography (CAG) in our hospital were studied. The patients were divided into 2 groups based on if there were ISR condition: ISR group,n=21and Non-ISR group,n=121. The blood levels of OPN and MMP-9 were detected upon the follow-up CAG conduction and the basic clinical information with biochemical indexes were compared between 2 groups. Results: Blood levels of OPN and MMP-9 were signiifcantly higher in ISR group than those in Non-ISR group,P<0.001. Multivariate logistic regression analysis revealed that elevated levels of OPN and MMP-9 were the independent risk factors for post-PCI ISR occurrence (OR=2.861 and OR=3.343,P<0.01). The ROC area of OPN and MMP-9 for predicting post-PCI ISR occurrence were 0.821 and 0.887,P<0.001. Taking the optimal cut off value of OPN at 3.68 ng/ml and MMP-9 at 415.24 ng/ml, the combined detection could increase the sensitivity of detection (90.48%) and the negative predictive value (98.06%). Conclusion: Blood levels of OPN and MMP-9 are closely related to ISR occurrence in post-PCI patients, combined detection has certain predictive value for ISR occurrence, especially for negative predictive value.

Protective effects of ω-3 PUFA on the second liver injury in rats with traumatic brain injury and hemorrhagic shock / 中华急诊医学杂志

Objective To investigate the effects of preconditioning with ω-3 polyunsaturated fatty acid (ω-3 PUFA) on the second liver injury in rats with traumatic brain injury and hemorrhagic shock (TBIS) and explore the underlying mechanism.Methods Total of 36 male Wistar rats were assigned randomly (random number) into 3 groups (n =12 in each):sham operation group (C),TBIS model group and PUFA pretreatment group.The arterial blood samples were taken for determination of serum levels of ALT,AST and TNF-α.The liver were removed for determination of levels of superoxide dismutase (SOD),malondialdehyde (MDA) and glutathione (GSH),and microscopic examination.Results Compared with group C,the serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly higher (P ＜0.01),but the liver levels of SOD and GSH in group TBIS and group PUFA were significantly lower (P ＜0.01).The serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly lower (P ＜ 0.01 or P ＜ 0.05),but the levels of SOD and GSH in liver tissues were significantly higher (P ＜ 0.01or P ＜ 0.05) in group PUFA than those in group TBIS.Histological examination revealed the injury of liver in TBIS group,and the rats in PUFA treated group showed alleviated severity of liver injury.Conclusions The supplementation of ω-3 PUFA can ameliorate acute liver injury in rats with TBIS,which may contribute to inhibition of oxygen free radicals and inflammatory cytokines expression.

Effects of ω-3 polyunsaturated fatty acids on systemic inflammatory response and gut barrier in rats with traumatic brain injury and hemorrhagic shock / 中华临床营养杂志

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on systemic inflammatory response and intestinal mucosa barrier in rats with traumatic brain injury and hemorrhagic shock (TBIS).Methods A total of 36 male Wistar rats were equally randomized into 3 groups:sham operation group,TBIS model group,and ω-3 PUFA pretreatment group.The serum levels of tumor necrosis factor-α (TNF-α),8-iso-prostaglandin F2 a (8-iso-PGF2 a),interleukin (IL)-1 β,and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).HE staining was performed for morphological assessment of the intestinal tissue and evaluation of the intestinal mucosa damage index (IMDI).The marked bacilli of the mesenteric lymph nodes,lung,liver,spleen,and kidney tissue were counted under a fluorescent microscope.Results Compared with those in the sham group [ (38.15 ± 6.37) ng/ml,(84.91 ± 17.22) pg/ml,(2.52 ± 0.83 ) μg/L,(2.86 ± 0.82) μg/L,0.36 ±0.14,and 8.33％ ],the serum levels of TNF-α [ (328.11 ±20.09) and (244.37 ±21.82) ng/rrl],8-iso-PGF2a [ (263.47±55.19) and (176.35±41.63) pg/ml],IL-1β [ (27.06±2.61) and (18.91 ±1.78) μg/L],IL-10 [ (7.63 ± 1.29) and (9.52 ± 4.66) μg/L],the IMDI (4.18 ±0.39 and 3.31 ±0.40),and the positive rates of bacterial translocation (56.67％ and 35.00％ ) were significantly higher in both the TBIS model group and ω-3 PUFA group ( all P ＜ 0.01 ).Compared with TBIS model group,the levels of TNF-α,8-iso-PGF2 a,and IL-1 β,the IMDI,and the positive rate of bacterial translocation were significantly lower ( all P ＜ 0.05 ) and the levels of IL-10 were significantly higher in the ω-3 PUFA group (P ＜0.01 ).Conclusion The supplementation of ω-3 PUFA can remarkably inhibit the systemic inflammatory response and protect the integrity of intestinal mucosa in rat with TBIS.

Analysis of the feature of 39 patients with ciguatera fish poisoning / 中国基层医药

Objective To study the clinical feature of ciguatera fish poisoning.Methods Thirty-nine patients with ciguatera fish poisoning were observed.Results The clinical symlptoms of ciguatera poisoning usually began to appear 2～10 hours after eating a poisonous fish and could be classified into three broad groups:neurological,gastrointestinal cardiovascular symptoms.Gastrointes tinal symptoms were the most common complaint.Neurological symptoms generally stayed for 1～2 weeks.The clinical picture was characterized by temperature reversal.Conclusion Ciguatera poisoning can be differentiated by unique features affecting the neurological system.

Studies on the absorption and distribution of low molecular N-trimethyl chitosan chloride in mice / 中国海洋药物

Objective To study the absorption and distribution of low molecular N-trimethyl chitosan chloride in mice.Methods Using tritium marking method to determine the concentrations of low molecular N-trimethyl chitosan chloride in serum after oral administration.Its pharmacokinetics were analysed by DAS ver1.0 program and the distributions in tissues were examined. Results The pharmacokinetics of low molecular N-trimethyl chitosan chloride were consistent with two-compartment model.The radioactive concentrations in liver,kidney,lung and spleen were higher than those in other tissues.And the radioactive concentration in cancer was higher. Conclusion Low molecular N-trimethyl chitosan chloride could be absorbed after oral administration.It was easily conjugate with cancer surface and could be developed as an anticancer drug for oral use in the future.