Suanzaoren Tang and Its Modified Formulas on Prevention and Treatment of Anxiety Disorders： A Review / 中国实验方剂学杂志

Suanzaoren Tang， as documented in the Synopsis of the Golden Chamber （《金匮要略》），consists of Ziziphi Spinosae Semen， Poria， Anemarrhenae Rhizoma， Chuanxiong Rhizoma， and Glycyrrhizae Radix et Rhizoma， and is indicated for dysphoria， consumptive disease， and insomnia. In modern clinical practice，in addition to sleep disorders，Suanzaoren Tang and its modified formulas can also be used to treat anxiety disorders， as well as insomnia，cardiac intervention，myocardial infarction， and other diseases combined with anxiety. It is also used in combination with other Chinese medicinal formulas （such as Zhizichi Tang，Ganmai Dazaotang，Baihe Zhimu Dihuangtang，and Jinlingzi San），western medicines （such as paroxetine，zopiclone，enalapril，amlodipine，metformin，and sertraline hydrochloride）， acupuncture， and acupoint application to treat anxiety， as well as cardiovascular neurosis，cancer，hypertension，type 2 diabetes， and other diseases combined with anxiety. As revealed by clinical treatment results， Suanzaoren Tang and its modified formulas can significantly reduce anxiety scores such as Hamilton Anxiety Rating Scale（HAMA） and Self-rating Anxiety Scale（SAS），and improve anxiety symptoms with significant efficacy and few side effects. As reported by experimental pharmacological studies， Suanzaoren Tang can regulate the content of neurotransmitters such as dopamine（DA），homovanillic acid（HVA），γ-aminobutyric acid（GABA），noradrenaline （NE），5-hydroxyindoleacetic acid （5-HIAA），glutamic acid（Glu），β-endorphin（β-EP），5-hydroxytryptamine（5-HT）， and nitric oxide （NO）in the brain， and mediate immune function by reducing the levels of inflammatory cytokines such as interleukin-1β（IL-1β）and tumor necrosis factor-α（TNF-α），enhancing the proliferation of B lymphocytes，phagocytosis of peritoneal macrophages， and down-regulating the proliferation of T lymphocytes. Besides， it can also regulate the endocrine level to allow the homeostasis of nervous system， endocrine system， and immune system by increasing adrenocorticotropic hormone（ACTH）and corticosterone（CORT）levels and up-regulating glucocorticoid receptor（GR）expression， finally achieving the effect of anxiety prevention and treatment. The present study systematically reviewed the clinical and basic research progress on the prevention and treatment of anxiety with Suanzaoren Tang to provide references for the research on the mechanism and material basis of Suanzaoren Tang and the development of new drugs for anxiety.

Clinical effects of warmed humidified carbon dioxide insufflation in infants undergoing major laparoscopic surgery.

PURPOSE: Some studies have reported that warmed humidified carbon dioxide (CO2) insufflation in adult laparoscopic surgery could reduce pain and improve the core body temperature (CBT). However, similar studies are lacking in infants. Thus, this study aimed to investigate the clinical effects of warmed, humidified CO2 insufflation in pediatric patients undergoing major laparoscopic surgeries. METHODS: From January 2015 to December 2017, infants who underwent major laparoscopic surgeries in Ningbo Women and Children's Hospital were randomized to Group A (standard CO2 insufflation) or Group B (warmed humidified CO2 insufflation, 35°C, 95% relative humidity). Change in CBT at the end of surgery was the primary outcome. Secondary outcomes included surgery time, intraoperative blood loss, oxygen saturation (SO2), and Face, Legs, Activity, Cry and Consolability (FLACC) scale. These variables were compared between the 2 groups. RESULTS: Sixty-three infants (38 females, 25 males) were included; 30 patients were in Group A and 33 in Group B. The diseases treated with the laparoscopic approach included congenital megacolon, congenital diaphragmatic hernia, and intestinal malrotation. No deaths were noted. CBT was significantly higher in Group B at the end of surgery (P = .021). The occurrence of postoperative shivering (P = .02), hypothermia (P = .032), bowel movement (P = .044), and hospital stay (P = .038) was significantly different between the 2 groups; Group B had less shivering and hypothermia occurrence after surgery. Moreover, Group B demonstrated a more rapid postoperative recovery of bowel movement and shortened hospital stay than Group A. There was no statistical difference in operative time (P = .162), intraoperative blood loss (P = .541), SO2 (P = .59), and FLACC scale (P = .65) between the 2 groups. CONCLUSION: The use of warmed humidified CO2 insufflation in infants undergoing major laparoscopic surgery was helpful for maintaining normothermia and was associated with several positive postoperative outcomes, including less shivering and hypothermia, faster recovery of bowel movement, and shortened hospital stay.

Content Determination and Quality Analysis of Polygalae Radix and Glycyrrhizae Radix et Rhizoma in Fufang Jiegeng Zhike Pian / 中国实验方剂学杂志

Objective: To establish the method for determining the content of Polygalae Radix (3,6'-disinapoylsucrose) and Glycyrrhizae Radix et Rhizoma (glycyrrhizic acid) in Fufang Jiegeng Zhike Pian,so as to know the overall quality condition of Fufang Jiegeng Zhike Pian and ensure the safety and effectiveness of public medication. Method: HPLC was performed of MG C18 chromatographic column (4.6 mm×250 mm,5 μm) and mobile phase acetonitrile-0.05% phosphoric acid solution were used to test Polygalae Radix (3,6'-disinapoylsucrose) and Glycyrrhizae Radix et Rhizoma (glycyrrhizic acid),with the sample amount of 20 μL,flow rate of 1.0 mL·min-1,and column temperature of 30℃,where the mobile phase acetonitrile-0.05% phosphoric acid solution and detection wavelength were 18:82 and 320 nm for Polygalae Radix (3,6'-disinapoylsucrose) and 35:65 and 250 nm for Glycyrrhizae Radix et Rhizoma (glycyrrhizic acid). Result: 3,6'-Disinapoylsucrose and glycyrrhizic acid presented high linearity with the peak area at 0.105 8-2.643 8 μg(r=0.999 5) and 0.077 0-5.773 0 μg (r=1.000 0) respectively,and the average recovery rate was 96.2%(RSD 1.2%) and 95.6%(RSD 0.9%). After content determination of Polygalae Radix and Glycyrrhizae Radix et Rhizoma in 178 batches of samples,it was found that some producers input no,only a few or even poor medicinal materials (medicinal slices) during production,and the quality varied a lot among products from different producers and products of different batches from a same producer. Conclusion: The method is simple,accurate,and highly reproducible and sensitive,providing scientific basis for the overall quality control of Fufang Jiegeng Zhike Pian.

HPLC simultaneous determination of contents of 5 saponin constituents in Ophiopogonis Radix / 中国中药杂志

This research is to establish an HPLC method for the simultaneous determination of ophiopogonin D, ophiopogonin D', ophiopogonin C, deacetylophiopojaponin A and ophiogenin-3-O-α-L-rhamnosyl-(1-->2)-β-D-glucoside in Ophiopogonis Radix. HPLC-ELSD analysis was performed on a Kromasil 100-5 C₁₈ column (4.6 mm x 250 mm, 5 µm), with the mobile phase of acetonitrile (A) -water (B) in gradient elution mode (0-45 min, 35%-55% A), at a flow rate of 1 mL · min⁻¹. The column temperature was 35 °C and the drift tube temperature was 100 °C in a gas flow rate of 3.0 L · min⁻¹. The result showed that baseline of all the 5 constituents was well separated, and every constituent had wide linearity range and good linear relation (r > 0.999). The recovery rate was between 95.75% and 103.1%. The new established method for simultaneous determination of saponin constituents in Ophiopogonis Radix was sensitive and has good, repeatability. It could be applied to quality evaluation of Ophiopogonis Radix.