中医分时辨治与盐酸氟西汀比较治疗糖尿病合并抑郁症的Meta分析＊

目的 系统评价中医分时辨治糖尿病合并抑郁症的效果。方法 计算机检索中国期刊全文数据库（CNKI）、维普中文科技期刊全文数据库（VIP）、万方数据库（Wanfang Data），中国生物医学文献数据库（CBM），搜集国内有关中医分时辨治相关的随机病例对照研究，检索时限均从2010年1月1日到至2020年12月20日。由2名独立研究者对文献资料进行提取，并评价纳入研究的偏倚风险后，采用RevMan5.3软件进行研究合并Meta分析。结果 共纳入10个相关研究，包括1008名研究对象。Meta分析结果显示：与盐酸氟西汀相比较，中医分时辨治糖尿病合并抑郁症在降低汉密尔顿抑郁量表（HAMD）［MD=-0.61， 95%CI （-3.68， 2.46）， P<0.00001］与汉密尔顿焦虑量表（HAMA）［MD=-0.21， 95%CI （-3.49， 3.08）， P<0.00001］评分没有统计学意义，但对空腹血糖（FPG）［MD=-0.80， 95%CI （-0.94， -0.65）， P<0.00001］、餐后2 h血糖（2HPG）［MD=-0.74， 95%CI （-1.02， -0.46）， P<0.00001］、糖化血红蛋白（HbA1c）［MD=-0.21， 95%CI （-0.38， -0.04）， P=0.02］、总胆固醇（TG）［MD=-0.48， 95%CI （-0.61， -0.36）， P<0.00001］、总甘油三酯（TC）［MD=-0.47， 95%CI （-0.62， -0.32）， P<0.00001］水平下降明显。结论 当前的证据表明，中医分时辨治方法治疗糖尿病合并抑郁症相对于西药盐酸氟在降低抑郁症状方面没有明显优势，但在降低血糖与血脂水平方面有较高的临床价值，这可能与分时辨治的药物有关，但同时结论受研究数量和质量的影响，更多高质量临床研究仍需开展，对上述结论予以确认。     

夏枯草对乳腺疾病作用机制概述

夏枯草是唇形科植物夏枯草的干燥果穗，是一种具有多种功能的传统药食两用植物。夏枯草具清肝泻火、明目、散结消肿等功效，其味辛、苦，性寒，归肝、胆经，为常用的清热药，自古便在乳腺疾病的治疗中多有应用。随着社会生活的发展，乳腺疾病逐渐成为女性最主要的健康问题。中医所述乳痈、乳癖、乳岩等病皆属于现代乳腺疾病范畴，且认为肝经与之最为密切。现代药理研究表明夏枯草含有萜类、酚酸类、黄酮类等多种生物活性成分，具有抗炎、抑菌、调节激素、抗肿瘤等作用。夏枯草通过抑制p38丝裂原活化蛋白激酶（p38 MAPK）/核转录因子-κB（NF-κB）通路以起到抗乳腺炎的作用，干预雌激素受体的作用效果或调节血脂水平以治疗乳腺增生，通过促进乳腺癌细胞凋亡、抑制乳腺癌细胞的迁移、调控乳腺癌细胞的分裂等多种方式协同作用发挥治疗乳腺癌的效果。在查阅夏枯草相关文献时，发现夏枯草往往通过多途径、多靶点调控发挥药理作用，但大部分的研究并未明确其发挥药效的具体靶点，有待后续深入研究。该综述对夏枯草治疗各类乳腺疾病的作用及其机制进行总结，为夏枯草在临床上发挥更加广泛的治疗作用及其治疗乳腺疾病作用的深入研究提供参考。     

类风湿关节炎骨破坏及其针灸治疗的骨免疫学机制研究现状

免疫系统和骨骼系统共享多种信号通路和细胞因子，并通过免疫细胞与骨组织细胞相互连接，骨免疫学的主要内容即是研究两者之间相互作用的复杂关系，类风湿关节炎骨破坏的机制亦在于此。针灸具有良好的抗炎镇痛、调节免疫与内分泌、改善微循环等作用，其治疗类风湿关节炎骨破坏的机制主要包括调节破骨细胞、调节NF-κB受体激活蛋白配体（RANKL）-RANK-骨保护素（OPG）通路、调节炎症因子等。参考文献35篇。     

The association between immunoglobulin concentrations and prediabetes prevalence in a large Chinese cohort

AimsPrediabetes has received public attention owing to the increasing prevalence worldwide. Mounting evidence has indicated that inflammation directly contributed to the etiology of glucose metabolism disorders. Although immunoglobulins play a crucial role in immune responses, little research has been done on the link between immunoglobulins and prediabetes in adults. Hence, the aim of the present study was to explore the associations between immunoglobulins levels and prevalence of prediabetes in a general adult population.MethodsA cross-sectional study was conducted among 8856 adults (mean ± standard deviation age: 48.4 ± 10.7 years) in Tianjin, China. The serum immunoglobulins concentrations were measured by the immunonephelometric technique. Prediabetes was diagnosed using the following parameters in accordance with the American Diabetes Association: fasting plasma glucose, postprandial glucose and glycosylated hemoglobin. The associations between concentrations of immunoglobulins and the prevalence of prediabetes were assessed using multiple logistic regression models.ResultsOverall, the prevalence of prediabetes was 37.4% (3311/8856). After controlling for confounders, compared with the lowest quintile, the odds ratios (95% confidence interval) of prediabetes for the highest quintile of immunoglobulins (immunoglobulin G, immunoglobulin E, immunoglobulin M and immunoglobulin A) were as follows: 1.06 (0.91–1.23), 1.31 (1.13–1.52), 0.86 (0.74–1.01), and 1.19 (1.03–1.38) (P for trend were 0.35, < 0.0001, 0.04 and 0.02), respectively.ConclusionsElevated immunoglobulin E and immunoglobulin A levels were independently and positively associated with prediabetes prevalence. There was also a trending association between immunoglobulin M concentrations and prediabetes prevalence. Further studies are necessary to clarify if there is a causal association of immunoglobulins in prediabetes or if they reflect early immunologic disturbances in these patients.     

“调神益智”针刺法结合尼莫地平治疗脑梗死后轻度认知障碍36例

目的:观察针药并用治疗脑梗死后轻度认知障碍的临床疗效。方法:将72例患者随机分为治疗组和对照组,每组各36例。治疗组采用"调神益智"针刺结合尼莫地平片进行治疗,对照组予尼莫地平片治疗。两组均连续治疗3个月后评价疗效。结果:治疗组显效率为69.4%,总有效率为91.7%,对照组显效率为55.6%,总有效率为80.6%,两组差异具有统计学意义(P0.05)。两组患者治疗后Mo CA量表评分与同组治疗前相比,分数均较治疗前有所增长,且治疗组分数升高幅度大于对照组,差异有统计学意义(P0.05)。结论:"调神益智"针法结合尼莫地平片是治疗脑梗死后轻度认知障碍的有效方法,针药并用的疗效优于单纯服用尼莫地平。     

Curcumin-3,4-Dichloro Phenyl Pyrazole (CDPP) overcomes curcumin's low bioavailability,inhibits adipogenesis and ameliorates dyslipidemia by activating reverse cholesterol transport

BackgroundAdipocyte dysfunction, obesity and associated metabolic disorders are of prime healthcare concern worldwide. Among available medications, natural products and inspired molecules hold 40% space in clinically prescribed medicines. In queue, this study overcomes the drawback of curcumin's low bioavailability with potent anti-adipogenic and anti-dyslipidemic activity.MethodsTo evaluate the role of CDPP on adipocyte differentiation, 3T3-L1 adipocytes were used as an in-vitro model. Flow cytometry was performed for cell cycle analysis. Syrian golden hamsters were used to study pharmacokinetic profile and dyslipidemic activity exhibited by CDPP.ResultCDPP was found to be a potent inhibitor of adipogenesis in-vitro. It blocked mitotic clonal expansion by causing cell cycle arrest. CDPP showed marked improvement in gastrointestinal stability and bioavailability in-vivo as compared to curcumin. Administration of CDPP (100 mg/kg) significantly improved HFD induced dyslipidemic profile in hamsters and activated reverse cholesterol transport machinery.ConclusionCDPP could be used as a potential drug candidate against adipogenesis and dyslipidemia with enhanced gastrointestinal stability and bioavailability.     

Short-course preoperative radiotherapy with immediate surgery versus long-course chemoradiation with delayed surgery in the treatment of rectal cancer: A systematic review and meta-analysis

BackgroundLong-course chemoradiotherapy (LCRT) with delayed surgery or short-course radiotherapy (SCRT) with immediate surgery is probably the most frequent regimen in the treatment of rectal cancer. Debate is still going on whether SCRT or LCRT is more effective. So we performed this meta-analysis to evaluate the safety and efficacy of SCRT with immediate surgery versus LCRT with delayed surgery for the management of rectal cancer.MethodsLiterature were searched from PubMed, Embase, Web of science, Cochrane Library up to May, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. RevMan 5.3 was used for statistical analysis. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis and sensitivity analysis were employed to explore heterogeneity.Results16 trials were included in the qualitative systematic review. 12 trials were included in meta-analyses. 4 of them were RCTs; other 8 were non-RCTs. Meta-analysis demonstrated that there were no significant differences in overall survival (OS), disease free survival (DFS), local recurrence rate (LRR), distant metastasis rate (DMR), sphincter preservation rate, R0 resection rate and late toxicity. Compared with SCRT, LCRT obviously increased pCR rate [RR = 0.15, 95%CI (0.08, 0.28), P = 0.003], while LCRT obviously increased the grade 3–4 acute toxicity [RR = 0.13, 95%CI (0.06, 0.28), P < 0.00001].ConclusionsSCRT with immediate surgery is as effective as LCRT with delayed surgery for treatment of rectal cancer in terms of OS, DFS, LRR, DMR, Sphincter preservation rate, R0 resection rate and late toxicity. Though LCRT increased pCR rate, LCRT also increased acute toxicity compared with SCRT. SCRT is a better choice in centers with a long waiting list or lack of medical resources.     

Ultra-High Performance Liquid Chromatography/Ion Mobility-Quadrupole Time-of-Flight Mass Spectrometry and Database-Driven Automatic Peak Annotation for the Rapid Profiling and Characterization of the Multicomponents from Stephaniae Tetrandrae Radix (Fang-Ji)

Quality control of traditional Chinese medicine (TCM) begins with elucidation of its chemical basis. The root of Stephania tetrandra, Stephaniae Tetrandrae radix (STR; Fang-Ji), has long been utilized as an antirheumatic, analgesic, and diuretic TCM. Powerful analytical strategies that would enable a multicomponent characterization of STR are still lacking. In the present study, we established a rapid, reliable, and enhanced profiling approach, using ultra?high performance liquid chromatography coupled with ion mobility/quadrupole time?of?flight mass spectrometry (MS) and automatic peak annotation facilitated by computational matching of an in?house library. This approach was used to characterize the multicomponents of STR. Good chromatographic separation was achieved within 17 min on a reversed-phase BEH C18 column eluted with acetonitrile/0.1% ammonium hydroxide in water, whereas data?independent high?definition MSE in the positive mode was applied to acquire the MS2 data using a Vion? IM?QTOF instrument, which, in theory, could cover all the profiled precursor ions. To overcome the interference of three predominant peaks, a knockout strategy was utilized by automated valve switching. An in?house library of 163 compounds was established and incorporated into the UNIFI? platform. By applying this method, we could identify or tentatively characterize 76 alkaloidsfrom the methanolic extract of STR, including 14 aporphine?type, four morphine?type, 48 bisbenzylisoquinoline?type, seven tetrahydroprotoberberine?type, one protopine?type, one benzylisoquinoline?type, and one other. For each component, four?dimensional information, such as retention time, collision cross-section, high-accuracy MS1, and high-accuracy MS2 data, was utilized to achieve the systematic multicomponent characterization of STR.     

Identification of the major allergenic epitopes of Eriocheir sinensis roe hemocyanin: A novel tool for food allergy diagnoses

Crab meat and roe are highly nutritious delicacies in China. While extensive research has been conducted for allergens derived from crab-meat, data relevant to the allergenic potential of crab roe derived proteins, of which hemocyanin is a principal contender, are almost entirely absent. Using bioinformatics prediction and IgE-binding assays, the three principal immunodominant epitopes of hemocyanin were identified and then combined as a single recombinant fusion protein (rHc). This together with the full-length recombinant protein (Hc) were expressed in Escherichia coli and subsequently identified by SDS-PAGE and immunoblotting. Ninety-five percent of our patients were found to carry rHc-specific IgE antibodies by ELISA. Dot-blot inhibition, together with ELISA inhibition studies, showed that pre-incubation of patient sera with the recombinant epitope protein could inhibit26% to 63% (mean: 50%) of IgE binding to immobilized, full-length Hc and the dose-response curve represents as a sigmoid shape. The recombinant protein (rHc) represents a versatile biologic tool with which to diagnose and investigate therapies for E. sinensis allergy.