Deep brain stimulation in the posterior subthalamic area in the treatment of essential tremor

To evaluate the posterior subthalamic area (PSA) as a target for deep brain stimulation (DBS) in the treatment of essential tremor (ET). The ventral intermediate nucleus of the thalamus is the traditional target for DBS in the treatment of ET. Recent studies have presented beneficial effects of DBS in the PSA in the treatment of tremor. Twenty‐one patients with ET were included in this study. All patients were evaluated before and 1 year after surgery, on and off stimulation, using the essential tremor rating scale (ETRS). A marked microlesional effect was noticed in 83%, in some cases obviating the need for electrical stimulation for many months. The total ETRS was reduced from 46.2 at baseline to 18.7 (60%). Item 5/6 (tremor of the upper extremity) was improved from 6.2 to 0.3 (95%), and items 11 to 14 (hand function) from 9.7 to 1.3 (87%) concerning the contralateral hand. Activities of daily living were improved by 66%. No severe complication occurred. Eight patients presented a postoperative mild dysphasia that regressed within days to weeks. DBS in the PSA resulted in a marked reduction of tremor. © 2010 Movement Disorder Society     

基于系统评价的原发性高血压心肝火盛、热毒内生病机学说探讨

目的：系统评价从心肝火盛、热毒内生论治原发性高血压的疗效和安全性,探讨其发病机制。方法：制定高敏感检索策略,全面检索截至2009年10月从心肝火盛、热毒内生论治原发性高血压的中医药临床对照研究文献,电子检索数据库包括：①Co.chrane对照试验注册资料库;②Pubmed;③中国生物医学文献数据库;④中国期刊网;⑤维普数据库;⑥万方数据库。手工检索17种中医药期刊。利用Rev Man4.2.2软件对多个研究结果的总体效应进行Meta分析,并进行敏感性分析;用漏斗图分析发表性偏倚。结果：最终10项研究纳入本研究,共纳入患者496例。有2项试验得分为3分,属高质量文献,其余属低质量文献。Meta分析降压疗效评价合并效应量RR（fixed）及95%可信区间（CI）为1.19（1.10,1.29）,中医症状疗效评价合并效应量RR（fixed）及95%可信区间（CI）为1.27（1.14,1.41）,安全性评价合并效应量RR（fixed）及95%可信区间（CI）为0.24（0.09,0.63）,不良反应主要表现为轻微恶心,发生率为2.352%。结论：清肝宁心、清热解毒方药治疗原发性高血压均安全有效,且其Meta-分析结果稳定可靠。按照以方测证原则分析,认为原发性高血压心肝火盛、热毒内生的病机学说具有科学性。     

应用经方为主治疗慢性肾功能衰竭

研究探讨经方为主治疗慢性肾功能衰竭的思路和方法。通过总结自己多年来应用经方针对慢性肾功能衰竭复杂多变的病情随证选方、灵活用药的要领和经验。为中医药治疗慢性肾功能衰竭提供借鉴和参考。中医经方为主化裁对子慢性肾功能衰竭有一定的治疗效果。     

原发性高血压合并心力衰竭患者血清神经调节蛋白-1与心室重塑的相关性分析

目的 探讨原发性高血压合并心力衰竭(以下简称心衰)患者血清神经调节蛋白-1(NRG-1)水平与心室重塑的相关性.方法 选取2019年1月—2020年12月东部战区总医院收治的原发性高血压合并心衰患者216例作为观察组,另取同期该院131例原发性高血压未合并心衰患者作为对照组.比较两组患者一般情况、实验室指标、心功能指标...     

基本药物制度下乡镇卫生院面临的挑战及建议

随着基本药物制度在基层医疗机构推广,不仅其本身存在的问题开始凸现,而且对乡镇卫生院的挑战也日益的明显。从基本药物制度存在的问题出发,分析其对乡镇卫生院的挑战,进而提出应对建议。     

Immunomodulatory active compounds from Tinospora cordifolia

Ethnopharmacological relevance

Tinospora cordifolia mentioned as “Rasayana” is extensively used in various herbal preparations for the treatment of different ailments for its general tonic, antiperiodic, antispasmodic, antiinflammatory, antiarthritic, antiallergic and antidiabetic properties. It is extensively used in Ayurveda due to its potential in improving the immune system and the body resistance against infections.

Aim of the study

The aim of the study was to isolate and characterise the immunomodulatory active compounds of Tinospora cordifolia.

Materials and methods

The immunomodulatory activity of different extracts, fractions and isolated compounds in relation to phagocytosis and reactive oxygen species production in human neutrophil cells have been investigated using the PMN phagocytic function studies, NBT, NO and chemiluminescence assay.

Results

The results obtained indicate that ethyl acetate, water fractions and hot water extract exhibited significant immunomodulatory activity with an increase in percentage phagocyctosis. Chromatographic purification of these fraction led to the isolation of a mixture of two compounds 2, 3 isolated for the first time from natural source and five known compounds 1, 4–7 which were characterized as 11-hydroxymustakone (2), N-methyl-2-pyrrolidone (3), N-formylannonain (1), cordifolioside A (4), magnoflorine (5), tinocordiside (6), syringin (7) by nuclear magnetic resonance (NMR) and mass spectrometry (MS) and comparing the spectral data with reported one. Cordifolioside A and syringin have been reported to possess immunomodulatory activity. Other five compounds showed significant enhancement in phagocytic activity and increase in nitric oxide and reactive oxygen species generation at concentration 0.1–2.5 μg/ml.

Conclusions

Seven immunomodulatory active compounds belonging to different classes have been isolated and characterised indicating that the immunomodulatory activity of Tinospora cordifolia may be attributed to the synergistic effect of group of compounds.     

The antimicrobial,antioxidative, anti-inflammatory activity and cytotoxicity of different fractions of four South African Bauhinia species used traditionally to treat diarrhoea

Ethnopharmacological importance

Many Bauhinia species, including those indigenous to South Africa, are used in traditional medicine across the world for treating ailments such as gastrointestinal tract (GIT) disorders, diabetes, infectious diseases and inflammation.

Aims

Several relevant aspects of different fractions of leaf extracts of Bauhinia bowkeri (BAB), Bauhinia galpinii (BAG), Bauhinia petersiana (BAP), and Bauhinia variegata (BAV) used in South African traditional medicine to alleviate diarrhoea related symptoms were evaluated.

Materials and Methods

The antioxidative activities of the extracts were determined using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH), 2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid (ABTS⁺) radical scavenging and ferric reducing antioxidant power (FRAP) methods. In vitro antimicrobial activities of the extracts were determined against bacterial strains (Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus faecalis) and clinical isolates of the opportunistic fungal strains (Aspergillus fumigatus, Candida albicans, and Cryptococcus neoformans) using a serial dilution microplate method. The polyphenolic contents were quantified using standard methods, and anti-inflammatory activities of the crude extracts were determined using the cyclooxygenase and soybean 15-lipoxygenase enzyme inhibitory assays. The safety of the extracts was evaluated by determining the cytotoxicity against Vero cell lines.

Results

The acidified 70% acetone crude extract and their fractions had good antiradical potency against the DPPH and ABTS radicals. The methanol soluble portions of the butanol fractions were more potent (EC₅₀ ranges from 0.64±0.05 to 1.51±0.07 and 0.88±0.18 to 1.49±0.09 μg/ml against DPPH and ABTS radical respectively) compared to the standard, trolox and ascorbic acid (EC₅₀ ranges from 1.47±0.24 to 1.70±0.27 μg/ml) for both DPPH and ABTS. The crude extracts contained variable quantities of phenolic content. The crude extracts and their fractions had weak to good antimicrobial activities, inhibiting the growth of the organisms at concentrations ranging from 39 to 2500 μg/ml. The BAG crude extract and its fractions were the most active against the fungi (MICs ranging from 39 to 625 μg/ml) while the BAB extract and its fractions were the least active with the MICs ranging between 39 and 2500 μg/ml. Aspergillus fumigatus was the least susceptible fungus while Cryptococcus neoformans was the most susceptible.The phenolic-rich crude extracts of BAB, BAG, and BAP had moderate to good dose-dependent cyclooxygenase-1 enzyme inhibitory activity with inhibitions between 22.8% and 71.4%. The extracts were however, inactive against cyclooxygenase-2. The extracts had some level of cytotoxicity towards Vero cell lines, reducing cell viability to less than 10% at concentrations more than 50 μg/ml.

Conclusion

The biological activities observed in Bauhinia species provide a scientific basis for the use of the plants in traditional medicines to treat diseases with multi-factorial pathogenesis such as diarrhoea, with each aspect of activity contributing to the ultimate therapeutic benefit of the plants. However, the use of the phenolic-rich extracts of these plants to treat diarrhoea or any other ailments in traditional medicine needs to be monitored closely because of potential toxic effects and selective inhibition of COX-1 with the associated GIT injury.     

Antimicrobial activity against bacteria with dermatological relevance and skin tolerance of the essential oil from Coriandrum sativum L. fruits

The aim of this work was to determine the antibacterial activity of essential coriander oil (ECO) on bacteria with dermatological relevance and to assess the skin tolerance of antimicrobial effective ECO concentrations. Essential coriander oil was tested on clinical isolates of different bacteria species, all of which may cause superficial skin infections. Antimicrobial susceptibility testing was performed using a standardized macrodilution test. Essential coriander oil showed good antibacterial activity towards the majority of the bacterial strains tested, including Streptococcus pyogenes (Lancefield group A) and methicillin resistant Staphylococcus aureus (MRSA), with mean minimal inhibitory concentrations of 0.04% v/v and 0.25% v/v, respectively. The skin tolerance of a cream and a lotion containing 0.5% and 1.0% ECO was assessed in 40 healthy volunteers using the occlusive patch test. No skin irritation could be observed by sensitive photometric assessment in any of the volunteers. Because of its activity against Streptococcus pyogenes, Staphylococcus aureus and MRSA combined with excellent skin tolerance, ECO might be useful as an antiseptic for the prevention and treatment of skin infections with Gram-positive bacteria.     

活血潜阳方对高血压(血瘀阳亢痰浊证)患者胰岛素抵抗及生活质量的干预

目的:探讨活血潜阳方对高血压(血瘀阳亢痰浊证)合并胰岛素抵抗患者血压、胰岛素抵抗及生活质量的影响。方法:临床收集60例高血压合并胰岛素抵抗(血瘀阳亢痰浊证)的患者,随机分为贝那普利组及贝那普利加用活血潜阳方组,按各组要求给药治疗8周,临床观察各组患者的血压、胰岛素敏感及抵抗指数、临床症状积分,并检测患者治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS),通过比较上述指标的差异,来比较两组治疗对患者血压及生活质量的影响。结果:①两组治疗均能有效降低血压(P<0.01),活血潜阳方组对舒张压的降低疗效优于贝那普利组(P<0.05)。②活血潜阳方组的治疗能明显改善患者的临床症状积分(P<0.01),与贝那普利组相比积分前后下降值间存在统计学差异(P<0.05),临床症状的有效率优于贝那普利组(P<0.05)。③两组的治疗均可降低患者的SAS积分与SDS积分(P<0.01)。活血潜阳方组对患者的SAS积分下降的效果优于贝那普利组(P<0.01)。④活血潜阳方组的治疗能明显降低患者的空腹胰岛素水平(P<0.01),并随以上指标的改善,胰岛素敏感指数显著升高,胰岛素抵抗指数明显下降,治疗前后自身对照存在统计学差异(P<0.05)。结论:高血压兼有血瘀阳亢痰浊证患者存在明显的胰岛素抵抗,联用活血潜阳方治疗高血压合并胰岛素抵抗(血瘀阳亢证)的患者较单用西药贝那普利能更有效的降低血压及胰岛素抵抗,改善临床症状,缓解患者的焦虑状态,显著改善患者的生活质量。因此,活血潜阳方是治疗高血压的有效方剂。