论中医“症”描述的准确性与规范化

“症”是中医诊断体系中最具体的要素,症状信息规范化其关键在于明确“症”的认识和理解,文章系统分析中医“症”的内涵,分析目前“症”规范化中存在的主要问题,如缺乏统一标准、各家之言迥异、中西医“症”的混杂等,这些一定程度上阻碍了中医临床与科研,不利于中医学术的交流及中医诊断学的现代化研究。因此提出从明确症名定义、统一规范症名、拆分复合症名、区分症状轻重、避免诊断性症名、纳入客观指征等几个方面对中医“症”的描述进行规范,通过建立系统标准体系,进行“症”的量化分级,规范信息采集过程,借助微观指标辨证等开展中医“症”的规范化研究。     

Improved in vitro and in vivo hepatoprotective effects of liposomal silymarin in alcohol-induced hepatotoxicity in Wistar rats

BackgroundSilymarin, a known hepatoprotectant, owing to its poor oral bioavailability, has limited pharmacological effects. The present study was designed to improve its in vitro and in vivo hepatoprotection and increase its oral bioavailability against alcohol intoxication by formulating it in four different liposomal formulations namely conventional, dicetyl phosphate, stearyl amine and PEGylated liposomes.MethodThe liposomes were prepared using phosphatidylcholine, cholesterol, and silymarin in addition to dicetyl phosphate, stearyl amine and DSPE mPEG 2000 by film hydration method with 5% sucrose as a cryo-protectant. The optimized formulations were studied for their release profile at pH 1.2 and 6.8. Liposomes were studied for in vitro protection on Chang liver cells and efficacious liposomes were selected for in vivo hepatoprotection study. Further, conventional liposomes were studied for bioavailability in alcohol intoxicated Wistar rats.ResultsThe conventional liposomes increased in vitro release profile at pH 1.2 and 6.8 and also showed better in vitro protection compared to silymarin alone. Conventional and PEGylated liposomes showed better improvement in liver function, better efficacy in combating inflammatory conditions, better improvement in antioxidant levels and reversal of histological changes compared to silymarin alone. Conventional also showed an almost fourfold increase in area under the curve compared to silymarin suspension.ConclusionConventional and PEGylated liposomes of silymarin were found to be more efficacious as hepatoprotective against alcohol-induced hepatotoxicity by its free radical scavenging and anti-inflammatory effects. Conventional liposomes showed enhanced bioavailability compared to silymarin alone.     

从“木郁克土”角度探讨围绝经期综合征肝郁证大鼠胃肠动力的改变

目的从“木郁克土”角度探讨围绝经期综合征(PPS)肝郁证大鼠胃肠动力的改变。方法选择3月龄SPF级SD雌性大鼠,分为假手术组、PPS组、PPS肝郁组和柴胡疏肝散组,采用去势法结合慢性不可预知性温和应激建立PPS肝郁证大鼠模型,用柴疏疏肝散进行干预,观察大鼠体重增长率、饲料消耗量、胃残留率及肠推进率变化。结果在体重增长率方面,PPS组显著高于假手术组(P<0.01);PPS肝郁组显著低PPS组(P<0.01);柴胡疏肝散组显著高于PPS肝郁组(P<0.01)。在饲料消耗方面,PPS组高于假手术组,PPS肝郁组低于PPS组;柴胡疏肝散组高于PPS肝郁组。在胃残留率方面,PPS肝郁组显著高于假手术组和PPS组(P<0.01);柴胡疏肝散组显著低于PPS肝郁组(P<0.01)。在肠推进率方面,PPS肝郁组显著低于假手术组和PPS组(P<0.01);柴胡疏肝散组显著高于PPS肝郁组(P<0.01)。结论PPS肝郁大鼠的体重和饲料消耗量发生了改变,体重的增长与饲料的消耗量存在一定的联系,且与大鼠胃肠动力有关。从“木郁克土”角度提示其机制可能是肝郁状态影响到了脾胃功能的正常运行。     

Research progress in rehabilitation treatment of stroke patients A bibliometric analysis

BACKGROUND: Stroke presents as a transient or chronic brain dysfunction and is associated with high morbidity and high mortality. The doctors and scientists would like to argue how to enhance the validity of the rehabilitation treatment and how to further improve the level of treatment on stroke. OBJECTIVE: The aim of this study was to quantitatively analyze the current worldwide progress in research on stroke rehabilitation treatment based on Web of Science database and ClinicalTrial.gov in the past 10 years. METHODS: We conducted a quantitative analysis of clinical trial articles regarding stroke rehabilitation published in English from 2003 to 2013 and indexed in the National Institutes of Health Clinical Trials registry and Web of Science databases. Data were downloaded on March 15, 2013. RESULTS: (1) From 2003 to 2013, 2 654 clinical trials investigating stroke were indexed in ClinicalTrials.gov. There were only 58 clinical trials registered in 2003, and there was a marked increase from 2005. A total of 605 clinical trials on the rehabilitation of stroke were conducted in the past 10 years. (2) The analysis showed that most of the trials in the field were registered by North American institutions. With respect to the Asian countries, China and Taiwan area of China also published a reasonable proportion of the trials, but comparatively speaking, the number of trials is really rare. Most of the interventions were drugs, followed by the devices, and behavioral interventions were ranked third. (3) In the past 10 years, there were 4 052 studies on stroke indexed by Web of Science database. CONCLUSION: From perspective of research progress, we found that the number of clinical trials and papers on stroke rehabilitation has increased significantly in the past 10 years, between them a remarkable positive correlation exists.     

超声下观察芎芍胶囊对心肌梗死大鼠缺血心肌血管新生的作用

目的探讨中成药芎芍胶囊对心肌梗死大鼠缺血心肌血管新生作用。方法采用开胸冠状动脉左前降支的方法建立心肌梗死模型,清洁级(或SPF级)SD大鼠32只(雄性)分为空白组、模型组、芎芍组、丹参组,每组8只,分别用生理盐水、芎芍胶囊、丹参粉末进行灌胃给药,连续给药。6周后采集数据分离样本,通过二维超声观察大鼠心功能指标,以及大鼠心肌组织中外源性血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)的表达。结果芎芍组、丹参组与模型组比较,左心室收缩末期内径(LVESD)、舒张末期内径(LVEED)、左心室射血分数(LVEF)差异均有统计学意义(P<0.01),芎芍组、丹参组与AMI组比较,VEGF、bFGF差异均有统计学意义(P<0.01)。VEGF、bFGF与LVEF呈正相关(r值分别为0.813、0.589,P<0.01)。结论芎芍胶囊较丹参更具有促进心肌梗死大鼠缺血心肌血管新生,提高心肌梗死大鼠心功能,保护心肌缺血性损伤的作用。     

Use of the ImmuKnow assay to evaluate the effect of alemtuzumab-depleting induction therapy on cell-mediated immune function after renal transplantation

Background

Good outcomes after renal transplantation are dependent on effective immunosuppression while minimizing infection. Alemtuzumab (Campath or Campath-1H) is an anti-CD52 humanized monoclonal IgG1 antibody which induces rapid and sustained depletion of circulating lymphocytes and has been effectively used as an immunosuppressant in post-transplant induction therapy.

Methods

We used the ImmuKnow assay to compare cell-mediated immune function in renal transplant patients treated with alemtuzumab or with conventional immunosuppressive tri-therapy. The ImmuKnow method determines the levels of adenosine triphosphate (ATP) released from CD4 cells following stimulation with a mitogen.

Results

We showed a statistically significant difference in the distribution of outcome after transplantation between the conventional and the Campath groups (P = 0.010). A significantly higher number of patients treated with alemtuzumab induction therapy were stable after transplantation compared to those treated with conventional immunosuppressive tri-therapy (96.6 vs. 75.7 %). ATP values were significantly higher in the conventional group compared to the Campath group at 180 days after transplantation (P < 0.001). ATP levels did not change significantly over time in clinically stable kidney recipients treated with alemtuzumab induction therapy (P = 0.554).

Conclusions

The ImmuKnow assay is a useful tool for evaluating the global immune response in alemtuzumab-treated renal transplant patients. Alemtuzumab-depleting induction therapy remains effective for at least 180 days.     

芍药苷干预阿尔茨海默病作用机制研究进展

阿尔茨海默病(Alzheimer’sdisease,AD)是造成老龄人口认知能力减退的主要疾病之一。芍药苷是毛茛科(Ranunculaceae)植物芍药Paeonia lactiflora或牡丹Paeonia suffruticosa根皮中提取出的水溶性单萜苷,具有改善认知能力、镇静、抗炎、镇痛、解痉等作用,可以有效调节AD动物及细胞模型异常磷酸化的Tau蛋白和过度沉积的β-淀粉样蛋白(Aβ)水平,恢复乙酰胆碱、神经生长因子、Ca2+、α7烟碱样乙酰胆碱受体和腺苷受体等神经递质及神经受体的平衡状态,降低组织炎症反应和氧化应激反应并减少细胞凋亡的发生。对近10年来国内外有关芍药苷干预AD的研究进展进行综述,为探索中药防治AD研究提供理论依据。     

金铁锁根中2个新的麦芽酚苷类化合物

目的研究金铁锁Psammosilene tunicoides根的化学成分。方法经硅胶、Sephadex LH-20凝胶、ODS反相硅胶等柱色谱方法进行分离,并运用NMR、HR-ESI-MS等波谱学方法进行化合物的结构鉴定。结果从金铁锁根80%乙醇水提取物中分离得到2个麦芽酚苷类化合物,分别鉴定为麦芽酚-3-O-[6-O-(4-O-α-L-吡喃鼠李糖基)-Z-p-香豆酰基]-β-D-吡喃葡萄糖苷(1)和麦芽酚-3-O-[6-O-(4-O-α-L-吡喃鼠李糖基)-E-p-香豆酰基]-β-D-吡喃葡萄糖苷(2)。结论化合物1和2为新的麦芽酚苷类化合物,分别命名为金铁锁酚苷A和B。     

UHILIC-MS/MS法同时测定复方三维右旋泛酸钙糖浆中5种维生素的含量

目的 建立一种超高效亲水作用色谱串联三重四极杆质谱法（UHILIC-MS/MS）,同时测定复方三维右旋泛酸钙糖浆中维生素B₁、维生素B₂、维生素B₆、烟酰胺和泛酸钙的含量。方法 采用超高效液相色谱仪,Waters ACQUITY BEHHILIC Amide色谱柱（2.1 mm×100 mm,1.7 μm）,以90%乙腈（含0.5%甲酸）-10 mmol/L甲酸铵水（含0.5%甲酸）为流动相,进行梯度洗脱,流速0.30 ml/min;在电喷雾（ESI）正离子模式下,用多反应监测（MRM）模式进行含量测定。结果 在5 min内,样品中5种维生素分别在各自考察的浓度范围内呈良好的线性关系,相关系数（r）均大于0.998 4;整体加样回收率在93.27%~100.39%之间,RSD为1.41%~4.96%;10批样品中维生素B₁、维生素B₂、维生素B₆、烟酰胺、泛酸钙的含量测定结果分别为32.40~38.91、7.002~8.462、9.677~11.17、33.64~39.58、3.276~3.771 mg/250 g。结论 本研究建立的UHILIC-MS/MS方法可快速实现对复方三维右旋泛酸钙糖浆中5种维生素类成分定性鉴定或定量检测,为复方三维右旋泛酸钙糖浆的开发利用和质量评价提供了可靠的技术检测方法。