痹证1号联合醋氯芬酸钠治疗湿热阻络型急性痛风性关节炎临床研究

目的:评价痹证1号联合醋氯芬酸钠治疗湿热阻络型急性痛风性关节炎的临床疗效。方法:将符合入选标准的160例湿热阻络型急性痛风性关节炎患者采用SAS软件产生的随机数字分为观察组及对照组,每组80例,两组均给予调整生活方式、饮食结构,观察组给予醋氯芬酸钠+痹证1号,对照组给醋氯芬酸钠治疗,均治疗2周。观察两组治疗前后关节肿胀程度、关节压痛评分及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、尿酸(UA)、红细胞沉降率(ESR)变化;采用中医临床标准、尿酸标准评价临床疗效。结果:观察组关节肿胀程度评分治疗后明显低于对照组(P<0.05);观察组关节压痛评分治疗后低于对照组,但无统计学意义(P>0.05);观察组治疗后血清IL-1β、TNF-α、UA、ESR均低于对照组(P<0.05);中医临床疗效总有效率观察组93.2%,对照组87.5%,两组疗效比较差异有统计学意义(P=0.044);UA疗效观察组总有效率92.5%,对照组79.7%,总有效率比较差异有统计学意义(P=0.026)。结论:痹证1号联合醋氯芬酸钠能够有效缓解急性痛风性关节炎关节肿胀、关节压痛的临床症状,未发生不良反应,其机制可能与降低血清IL-1β、TNF-α、UA、ESR水平及减少炎性刺激有关。     

Clinical Experience in Treatment of Alzheimer''s Disease with Jiannao Yizhi Formula (健脑益智方) and Routine Western Medicine

Objective: To investigate the long-term therapeutic effects of the Chinese medicine Jiannao Yizhi Formula(健脑益智方, JYF) in the treatment of Alzheimer's disease(AD). Methods: Sixty mild-to-moderate AD participants were recruited and randomly allocated to the treatment(30 with JYF) and the control groups(30 with donepezil) for 6 months with the random numbers. The primary outcomes were scores of Alzheimer's Disease Rating Scale-Cognitive(ADAS-Cog) and Chinese Medicine Symptom Scale(CM-SS). The secondary outcomes were scores of Mini Mental State Examination(MMSE), Montreal Cognitive Assessment(MoCA), and Activities of Daily Living(ADL). Safety assessments were conducted at baseline and the 6 th month of treatment. Serum levels of acetylcholine(Ach), amyloid-β protein 42(Aβ_(42)), and the microtubule-associated protein tau(Tau) were also determined by enzyme-liked immunosorbent assay. Results: Fifty-one participants were included in the final analyses(JYF n=27; donepezil n=24). Compared with baseline, both JYF and donepezil increased the MoCA and MMSE scores and decreased the ADAS-Cog and CM-SS scores(P0.05 or P0.01). Both drugs increased the serum levels of Ach and decreased the serum levels of Aβ_(42) and Tau(all P0.05). There was no significant difference in these variables between the two groups, which showed that JYF was not inferior to donepezil. No obviously significant changes were observed in the ADL. No severe adverse events were observed in both groups. Conclusion: The effect and safety of JYF for the treatment of AD were not inferior to those of donepezil.     

补肾益智方治疗阿尔茨海默病斑马鱼模型的作用及机制研究

目的 通过阿尔茨海默病斑马鱼模型,探讨补肾益智方的作用机制。方法 选取6月龄斑马鱼,随机分成5组,分为空白对照组（n=12）、模型组（n=10）、阳性药组（n=10）、补肾益智方高剂量组（n=11）和低剂量组（n=12）。除空白对照组,其余各组均用AlCl₃·6H₂O配制成浓度为100 μg/L的溶液持续浸泡斑马鱼30 d,每天更换一半的染毒培养液。染毒结束后利用T迷宫实验剔除染毒失败的斑马鱼。造模结束后,分别给予阳性药组多奈哌齐20 μg/mL,高、低剂量组补肾益智方30、10 μg/mL浸泡14 d。给药结束后,通过T迷宫实验检测斑马鱼学习记忆能力;免疫组化染色观察神经元变化;qPCR检测相关基因的表达;Western blot检测相关蛋白的表达。结果 ①在T迷宫测试第4天,模型组潜伏时间为（198.00±45.78）s,补肾益智方低剂量组为（12.75±2.29）s,补肾益智方高剂量组为（7.27±0.90）s,补肾益智方治疗组斑马鱼的潜伏时间明显低于模型组,差异有统计学意义（P<0.05）;②补肾益智方治疗组斑马鱼的端脑神经元数量较模型组明显增多、排列变整齐,星型胶质细胞增多;③补肾益智方组斑马鱼脑ACHE活力显著降低（P<0.01）、ChAT活力显著增加（P<0.05）;④补肾益智方治疗组斑马鱼脑组织中appb、bace1表达显著降低（P<0.01）,sod、cat、nrf2基因表达显著增加（P<0.01）,keap1基因表达显著降低（P<0.01）;⑤补肾益智方治疗组斑马鱼脑组织蛋白表达情况与qPCR结果一致,APP、BACE1表达显著降低（P<0.01）,Nrf2表达显著增加（P<0.01）,Keap1表达显著降低（P<0.01）。结论 补肾益智方能有效改善AD斑马鱼的学习记忆能力,减少Aβ生成,减轻氧化应激。      

健脾活络方治疗脾虚络瘀型的糖尿病远端对称性多发性神经病变的临床研究

目的探讨健脾活络方治疗脾虚络瘀型的糖尿病远端对称性多发性神经病变(DSPN)的临床疗效。方法将80例脾虚络瘀型的DSPN患者随机分为治疗组和对照组,各40例。两组均给予基础治疗配合甲钴胺片治疗(500μg,3次/d,口服),治疗组在对照组治疗基础上加用健脾活络方煎服治疗。治疗8周后,观察比较两组治疗前后多伦多临床评分(TCSS)、震动感觉阈值(VPT)检查结果、生活质量评分及疗效。结果治疗后,两组TCSS评分、VPT检查结果、生活质量评分均明显改善,差异有统计学意义(P<0.05),两组之间比较,差异有统计学意义(P<0.05)。临床疗效方面,治疗组总有效率85.00%、对照组60.00%,两组之间比较,差异有统计学意义(P<0.05)。结论健脾活络方明显改善脾虚络瘀型DSPN患者神经功能和生活质量,提高疗效。     

温阳活血退黄方对阴黄证大鼠肝功能肝组织病理及超微结构的影响

目的：探讨温阳活血退黄方对阴黄证大鼠的治疗作用。方法：72只大鼠随机分为6组：正常对照组、阴黄模型对照组、阳黄对照组、温阳活血退黄方高剂量组、温阳活血退黄方低剂量组、茵陈术附汤组。检测大鼠肝功能、肝组织病理及超微结构的变化。结果：经温阳活血退黄方(高、低剂量)和茵陈术附汤治疗后，ALT、AST、TBil、ALP、TBA均较阴黄模型组明显下降(P0．05)，且温阳活血退黄方能明显改善阴黄大鼠肝组织病理及超微结构的变化。结论：温阳活血退黄方对阴黄证大鼠有良好的治疗作用。     

Cefdinir-induced red stool and purple discoloration of nutritional formula: A case report

This case report describes a 4-year-old girl with food aversion who received three separate courses of cefdinir mixed with PediaSure®, an iron-fortified nutritional formula. The patient's stool turned red with variable onset during all three courses of treatment. Moreover, the PediaSure® formula turned purple after mixed with cefdinir, an interaction that has not been previously reported. We recommend that medication counseling for pediatric patients taking cefdinir include a mention of these possible discolorations.     

益心解毒方对Nox2和Nox4亚基过表达的心肌细胞NADPH氧化酶活性的影响

目的通过观察益心解毒方含药血清对Nox2、Nox4亚基过表达的H9c2心肌细胞NADPH氧化酶活性的影响,揭示其作用环节是否与干预相应亚型的NADPH氧化酶调控环节有关。方法采用PCR方法扩增Nox2、Nox4基因全长序列,经双酶切、连接载体和转化后提取重组质粒,经酶切鉴定的阳性质粒进行DNA测序,测序正确后按照lipofectamine 2000试剂的说明书瞬时转染H9c2细胞,转染后的心肌细胞分组给予不同的药物干预,24 h后检测NADPH氧化酶活性。结果 1含有Nox2/Nox4亚基的重组质粒载体通过测序鉴定,结果与Gen Bank报道的完全一致。2通过荧光显微镜下观察转染72 h后的H9c2细胞,可见大量发绿色荧光的细胞,流式细胞术计数结果显示转染率均在60%左右,符合实验要求。3空质粒载体组、模型组、益心解毒方组的NADPH氧化酶活性表达明显高于正常组(P<0.01,P<0.05);模型组和益心解毒方组的NADPH氧化酶活性表达高于空载体组(P<0.01);模型组NADPH氧化酶活性表达均明显高于其他各组,而益心解毒方各组的NADPH氧化酶活性表达均明显低于模型组(P<0.01,P<0.05)。结论成功构建大鼠心肌细胞Nox2、Nox4亚基的重组质粒载体,该重组质粒载体可以在心肌细胞中过表达,益心解毒方可以有效地降低NADPH氧化酶活性的表达。提示此复方治疗心衰的机制可能是抑制了Nox2和Nox4型NADPH氧化酶的表达。     

Accuracy of the London Atlas,Haavikko’s Method and Cameriere’s European Formula of dental age estimation in Turkish children

Age estimation is a mandatory procedure when the chronological age is unknown or uncertain. Dental development is the preferred characteristic for estimating a child's age. There are many methods for dental age estimation, but their reliability can differ between populations. This study compared the accuracy of three of these methods—the London Atlas (LA), Haavikko's method (HM), and Cameriere's European formula (CF)—in Turkish children living in northwestern Turkey. Panoramic radiographs of 980 children from northwestern Turkey aged between 6.00 and 14.99 years were examined for the whole study group and separately for different ages and sexes by all three methods. Statistical differences between chronological age and dental age were tested using the paired sample t-test and the Wilcoxon signed-rank test. The LA, HM, and CF accuracies were determined based on the mean absolute error. Spearman's rank correlation coefficient showed that the correlation between chronological age and dental age for both sexes was linear for all methods. The LA overestimated the chronological age by 0.09 years, while HM and CF underestimated it by 0.49 and 0.11 years, respectively. The difference between dental age and chronological age was significant in all samples, for all methods, except for the LA in boys. When boys, girls, and the total sample were evaluated, values with the lowest mean absolute error were obtained by HM and were statistically significant in all three groups. Therefore, HM is more accurate than the LA and CF for dental age estimation in Turkish children living in northwestern Turkey.     

ox-LDL诱导内皮细胞损伤条件培养基及气血并治方有效组分D、E配伍对平滑肌细胞增殖及c-myc mRNA表达的影响

目的观察氧化低密度脂蛋白(ox-LDL)诱导血管内皮细胞(VEC)损伤条件培养基及气血并治方有效组分D(主要为芍药苷)和E(主要为总黄酮)配伍(重量比为1:2)是否对血管平滑肌细胞(VSMC)增殖相关基因表达有影响.方法将VSMC正常培养液、ox-LDL诱导VEC损伤的条件培养基、辛伐他汀加ox-LDL诱导VEC损伤的条件培养基、有效组分D和E配伍加ox-LDL诱导VEC损伤的条件培养基等分别作用于VSMC,采用MTT染色法检测VSMC生长活性,反转录聚合酶链反应(RT-PCR)法测定c-myc mRNA表达.结果 VEC损伤条件培养基作用于VSMC后,与正常培养VSMC相比,细胞生长活性明显增加(P＜0.01),细胞c-myc mRNA表达增强,有效组分D、E配伍与VEC损伤条件培养基作用于VSMC后,与模型组相比,细胞生长活性明显降低(P＜0.01),细胞c-myc mRNA表达减弱.结论气血并治方中有效组分芍药苷和总黄酮配伍可以拮抗ox-LDL诱导VEC损伤条件培养基引起VSMC增殖及c-myc mRNA表达增加,气血并治方防治AS的作用可能与方中有效组分芍药苷和总黄酮配伍抑制VEC损伤条件培养基引起的VSMC增殖相关基因表达增加有关.     

气血并治方有效组分不同配伍对血管内皮细胞损伤条件培养基诱导血管平滑肌细胞增殖的影响

目的观察气血并治方中有效组分D(主要为芍药苷)和E(主要为总黄酮)原方配伍、D和E优化配伍,对氧化低密度脂蛋白(ox-LDL)诱导血管内皮细胞(VEC)损伤条件培养基引起血管平滑肌细胞(VSMC)增殖的抑制作用.方法将正常VSMC培养液、ox-LDL诱导VEC损伤的条件培养基、辛伐他汀加ox-LDL诱导VEC损伤的条件培养基、有效组分D和E原方配伍加ox-LDL诱导VEC损伤的条件培养基、有效组分D和E优化配伍加ox-LDL诱导VEC损伤的条件培养基分别作用于VSMC,采用MTT染色法检测VSMC生长状态,流式细胞仪测定VSMC细胞周期.结果与正常组相比较,VEC损伤条件培养基作用于VSMC后,细胞增殖活性明显增加(P＜0.01)、S期细胞数增加;与VEC损伤条件培养基组相比较,气血并治方中有效组分D和E 原方配伍组(终浓度为1 mg/L)、D和E优化配伍组(终浓度为1 mg/L)细胞增殖活性明显降低(P＜0.01)、细胞周期S期细胞数减少,作用和阳性药辛伐他汀组相似.结论气血并治方有效组分不同配伍能有效地抑制VEC损伤条件培养基诱导VSMC增殖,气血并治方防治AS作用机理与此密切相关.