Theoretical thinking on guiding research and development of new drugs of traditional Chinese medicine / 中国中药杂志

This article proposes that the research and development of new Chinese medicines should be based on the clinical values of traditional Chinese medicine(TCM), and expounds the multiple clinical values of new Chinese medicines such as therapeutic effects, adjuvant treatment effects, improvement of disease symptoms, improvement of quality of life, prevention of diseases, etc., so as to broaden the clinical indications of new Chinese medicines. It is pointed out that the clinical value of TCM determines the clinical efficacy evaluation method of new Chinese medicines, so as to construct a clinical evaluation system of new Chinese medicines with the characteristics of TCM. It is proposed that the clinical value of new Chinese medicines should be found under the guidance of TCM theo-ry and clinical practice, and the theoretical innovation of TCM should be emphasized. There is no difference in the clinical value of drugs, and the key is to meet the clinical needs of patients. The research and development of new Chinese medicines ignores the theoretical guidance of Chinese medicine, and relying solely on animal experiment data may lead to failure of clinical trials. Different from the individualized treatment of TCM clinical syndrome differentiation, summarizing the core pathogenesis of TCM is the basis for the development of new Chinese medicines. It is necessary to summarize the pathogenesis of the disease under the guidance of TCM theory and encourage the application of modern medical methods to clarify the diagnosis of the disease. In view of the characteristics of new Chinese medicine research and development, it is proposed that the supporting role of human experience should be emphasized, and the technical points of clinical trials of new syndrome-type Chinese medicines should be explained.The use of objective indicators for syndrome evaluation, the selection of appropriate scales, and the formulation of reasonable treatment courses are advocated. During the research and development of new Chinese medicines, it is not only necessary to pay attention to modern medical safety indicators, but also to observe the evolution of TCM syndromes and specific TCM symptoms.

Expression of miR-93 and miR-21 in patients with diabetic retinopathy and its clinical values / 眼科新进展

Objective To investigate the expression and clinical value of plasma miR-93 and miR-21 in patients with diabetic retinopathy (DR).Methods Ninety-eight patients with DR (DR group),40 patients with type 2 diabetes mellitus (DM group) and 40 healthy subjects (control group) from January 2015 to March 2017 were enrolled in this study.And the expression levels of miR-93 and miR-21 in the plasma were detected by real-time quantitative PCR (RT-qPCR) techniques.ROC curve was used to evaluate the values of miR-93 and miR-21 for the diagnosis of DR,and the risk factors of DR were analyzed by multivariate logistic regression analysis.Finally,Pearson correlation analysis was utilized to evaluate the correlation of plasma miR-93 and miR-21 with biochemical indicators including total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) and creatinine (Cr),blood urea nitrogen (BUN),urinary albumin/creatinine (UACR),glycosylated hemoglobin (HbAlc) and fasting blood glucose (FPG) in DR patients.Results Both DR and DM groups had significantly higher UACR,HbAlc and FPG than the control group (all P ＜ 0.05),and the DR group was significantly higher than DM group (all P ＜ 0.05).The expression levels of plasma miR-93 and miR-21 in the DR group (1.84 ±0.27,1.95 ±0.34) were significantly higher than those in the DM group (1.09 ± 0.13,1.13 ± 0.18) and the control group (1.02 ± 0.08,1.08 ±0.16),and there were statistical differences (all P ＜ 0.05).Meanwhile,the levels of plasma miR-93 and miR-21 in PDR group (2.31 ± 0.57,2.28 ± 0.61) were significantly higher than those in NPDR group (1.40 ± 0.21,1.52 ± 0.24),and there were statistical differences (all P ＜ 0.05).The area under the curve (95％ CI) of plasma miR-93,miR-21 and both indicators for DR diagnosis was 0.892 (0.824-0.961),0.836 (0.770-0.905),0.937 (0.868-0.992),respectively.Multivariate logistic regression analysis showed that UACR,HbAlc,FPG,miR-93 and miR-21 were independent risk factors for DR.Correlation analysis showed that plasma miR-93 and miR-21 were positively correlated with UACR,HbAlc and FPG in the patients with DR (all P ＜ 0.01),and miR-93 was positively correlated with miR-21 (P ＜ 0.01).Conclusion Plasma miR93 and miR-21 are closely related to the initiation and development of DR and can be used as the potential markers for the diagnosis of DR.

Endoscopic ultrasonography (EUS) in diagnosis of colorectal submucosal lesions / 中国内镜杂志

Objective To investigate the role of endoscopic ultrasonography (EUS) in diagnosis and treatment of colorectal submucosal lesions. Methods EUS were applied in 74 patients with suspected colorectal submucosal lesions. According to the origin of submucosal lesion, the patients had received biopsy, endoscopic ultrasonography-fine needle aspiration (EUS-FNA) and endoscopic treatment or surgery. The correlation between EUS and clinical pathology is analyzed retrospectively. Results In the diagnosis based on EUS, there were 28 cases of neuroendocrine tumors (occurred in the rectum), 15 lipomas (4 cases occurred in ileocecal, 1 in transverse colon, 8 in ascending colon, 2 in sigmoid colon), 2 rectal gastrointestinal stromal tumor (1 in muscularis propria and the other in muscularis mucosa), 14 external pressure changes (9 ovarian tumor, 2 lymph nodes, 3 pelvic tumor), 5 cyst (4 in transverse colon, 1 in ascending colon), 1 gas cyst, 3 sigmoid colon endometriosis, 4 rectum malignant tumor invasion, 2 intestinal lymphoma. All the patients had received biopsy, EUS-FNA, endoscopic treatment or surgery. Compared with pathology, a total coincidence rate of 91.9% (68/74) was achieved by EUS, and 2 cases were pathologically diagnosed as leiomyoma, which is considered as rectal carcinoma by EUS at first, 1 case of intestinal lymphoma instead of lipoma, 2 inflammatory mass instead of malignant tumor around the rectum, and 1 rectal carcinoma instead of endometriosis. Conclusion The digestive tract structure could be showed clearly with EUS, and the size of the colon and rectal submucosal lesions, the layer of origin and the structural relationship of adjacent tissues could also be detected. Then, the appropriate treatment against the colon and rectal submucosal lesions would be adopted after the accurate judgment of lesions with EUS.

Clinical significance of serum anti-CCP antibody and TNF-α expression in patients with rheumatoid arthritis / 重庆医学

Objective To investigate the value of serum anti-CCP antibody and TNF-α in the diagnosis and therapeutic effect evaluation of rheumatoid arthritis(RA).Methods One hundred and sixty-eight RA patients in our hospital from January 2012 to December 2015 were selected and included 86 cases of active stage(active group)and 80 cases of remission stage(remission group).Other 80 outpatient healthy controls served as the control group.The levels of RF,anti-CCP antibody and TNF-α in the active group,remission group and control group were measured by using the immunoadsorption and ELISA.Then the detection results were analyzed.Results The serum anti-CCP antibody and TNF-α levels in the active group and remission group were higher than those in the control group,moreover the serum anti-CCP antibody and TNF-α levels in the active group were significantly higher than those in the remission group,the difference was statistically significant(P＜0.05).Comparing the RA patients with the control group,the sensitivity and specificity of combined detection of anti-CCP antibody and TNF-α was 73.8％ and 97.5％,which were higher than those of other 2-index combined detection,the difference was statistically significant(P＜0.05).The serum TNF-α level was positively correlated with the DAS28 score(P＜0.01).Conclusion The combined detection of serum anti-CCP antibody and TNF-α has an important clinical value for the RA diagnosis and disease condition monitoring.