The quality of information available about Ephedra sinica on online vendor websites: The Canadian consumer experience

BackgroundEphedra sinica (ES) is a natural health product used to promote weight loss, enhance athletic performance, and treat common ailments such as the common cold or flu. Due to restrictions within Canada, Canadians interested in purchasing this product turn to online vendors for the ease and discrete nature of online transactions. However, the information available on these websites for consumers looking to purchase the substance is variable. This study investigated the quality of information about ES available to Canadian consumers on the websites of these online vendors.MethodsFollowing searches on Google.ca, eligible websites were assessed using the DISCERN instrument, a tool consisting of 16 questions, each rated on a five-point Likert scale, to assess the quality of health information about a treatment choice. The data was used to determine the overall quality of information about ES available to consumers on these websites.ResultsA total of 660 webpages were identified, of which 28 websites were found to be eligible. It was determined that the overall quality of information of websites selling ES products online was poor, as 79 % of online vendors received an average score of 2 or below.ConclusionConsumers looking to purchase ES online are lacking critical information about this herbal product that is necessary to make an informed decision about its use. This study's findings can be used by clinicians and researchers to inform patients about the poor quality of information about ES on these websites and help them identify quality sources of information.     

麻杏石甘汤治疗痰热壅肺型重症肺炎的临床研究

目的：评价麻杏石甘汤治疗痰热壅肺型重症肺炎患者的疗效。方法收集2013年1－12月大连市中心医院中医科重症肺炎患者60例。按随机数字表随机分为2组各30例。对照组给予抗感染、补液、呼吸机支持等治疗。治疗组在对照组基础上鼻饲麻杏石甘汤。比较2组治疗前后平均动脉压（MAP）、乳酸（Lac）含量、氧合指数（PaO2/FiO2）、临床肺部感染评分（clinical pulmonary infection score, CPIS）、急性生理与慢性健康评分Ⅱ（acute physiology and chronic health evaluation II, APACHEⅡ）。结果治疗组总有效率为80.0%（24/30）,对照组为73.3%（16/30）,2组比较差异有统计学意义（χ2＝4.800,P＝0.029）。2组MAP[治疗组：(102.4±11.9)mmHg比(70.4±6.4)mmHg,t＝12.972,P＝0.000;对照组：(101.2±12.5)mmHg比(69.8±6.6)mmHg,t＝12.1672,P＝0.000]、PaO2/FiO2[治疗组：(265.4±19.7)mmHg比(78.6±10.5)mmHg,t＝45.833,P＝0.000;对照组：(124.8±13.4)mmHg比(79.1±11.1)mmHg,t＝14.385, P＝0.000]均显著高于治疗前,Lac均显著低于治疗前[治疗组：（1.04±0.42）mmol/L比（6.37±2.27）mmol/L, t＝12.65,P=0.000;对照组：（3.88±1.45）mmol/L比（6.39±2.32）mmol/L,t＝5.025,P=0.000];治疗组Lac（t＝10.304,P＝0.000）和 PaO2/FiO2（t＝32.323,P＝0.000）改善情况优于对照组。CPIS[治疗组：（2.2±1.5）分比（6.7±1.7）分,t＝10.872,P＝0.000;对照组：（4.5±2.7）分比（6.8±1.8）分,t＝3.882, P＝0.000]和APACHEⅡ[治疗组：（5.3±2.1）分比（13.8±3.8）分,t＝10.723,P＝0.000;对照组：（9.3±3.5）分比（13.7±3.5）分,t＝4.869,P＝0.000]评分均较治疗前显著降低,且治疗组CPIS（t＝4.079, P＝0.000）和APACHEⅡ（t＝5.368,P＝0.000）下降情况优于照组。结论麻杏石甘汤对痰热壅盛型重症肺炎的疗效确切。     

马融教授治疗小儿长期发热经验撷菁

发热为儿科疾病的常见症状。马融教授在辨治小儿长期发热方面经验丰富,笔者通过典型验案3则体会其辨治特点:治疗应以证为纲,不因炎症而滥施寒凉;辨证及调护重视脾胃;组方注重气机升降。     

不同采收期肉苁蓉中松果菊苷、毛蕊花糖苷、半乳糖醇、甜菜碱及可溶性多糖量的测定及其道地性研究

目的考察春、秋两采收期道地产区内蒙古阿拉善盟肉苁蓉Cistanche deserticola中松果菊苷、毛蕊花糖苷、半乳糖醇、甜菜碱、可溶性多糖及其浸出物的量,并研究其道地性。方法采用HPLC-UV法测定松果菊苷及毛蕊花糖苷量,采用HPLC-ELSD法测定半乳糖醇及甜菜碱量,采用UV-VIS法测定可溶性多糖量,采用醇溶性浸出物测定法测定浸出物。结果春季、秋季肉苁蓉中指标成分总量均达到《中国药典》2015年版规定水平,且春季的量较高,达12.21 mg/g,是秋季样品量的3倍多,为《中国药典》2015年版规定量的4倍。毛蕊花糖苷的量在春季样品显著高于秋季,约为秋季的30倍,波动极大;甜菜碱的量在春季样品中也显著高于秋季;可溶性多糖的量在春、秋季样品中均处于较高水平,尤其是秋季样品中高达13.7%;半乳糖醇及浸出物的量在秋季样品中显著高于春季。结论肉苁蓉春季、秋季样品中毛蕊花糖苷量波动极大;本品含有丰富的可溶性多糖、半乳糖醇,而"油亮、体重、肥厚、质柔润、味甘"为肉苁蓉道地性内在品质特征,丰富的多糖、半乳糖醇是其品质形成的物质基础,可增加多糖作为评价其质量特征的指标成分之一。     

Utility of 64 multislice CT-virtual laryngoscopy in presurgical planning of laryngeal and hypopharyngeal carcinomas

Objective

To evaluate the utility of 64-multislice CT with virtual laryngoscopy in diagnosis and pre-therapeutic planning of laryngeal and hypopharyngeal carcinomas in comparison with conventional laryngoscopy.

Patients and methods

Forty patients with laryngeal and hypopharyngeal carcinomas were subjected to 64-multislice CT examinations with multiplanar reformation and CT-virtual laryngoscopy. The results were compared with those of direct and indirect laryngoscopy. Multiple variables like primary subsite of the mass, invasion of anterior commissure, posterior commissure and subglottic extension of mass were analyzed and the Chi-square test was used to study the association between each 2 variables.

Results

Excellent correlation was found between direct laryngoscopy and CTVL in detection and localization of primary subsite of laryngeal carcinomas. A statistically significant difference existed between both modalities in favor of CTVL in identifying subglottic extension, anterior and posterior commissures invasion (P ? 0.001) as well as in evaluating the hidden areas of the hypopharynx. Direct endoscopy was more valuable, however in identifying mucosal surface irregularities and vocal cord involvement diagnosed as cord fixation(P ? 0.001).

Conclusion

Virtual laryngoscopy is a noninvasive and reliable technique that in combination with axial and MPR CT images is valuable in staging and pretherapeutic planning of laryngeal/hypopharyngeal carcinomas. It is not an alternative to conventional laryngoscopy but may assist direct endoscopy without causing additional radiation exposure or discomfort to the patient.     

Inulin-enriched pasta improves intestinal permeability and modifies the circulating levels of zonulin and glucagon-like peptide 2 in healthy young volunteers

Apart from the intestinal environment, inulin induces physiological effects, which includes a reduction in glucose and lipid concentrations and modulation of gastrointestinal motility through the release of different peptides. We hypothesized that inulin-enriched pasta may also improve small intestine permeability in relation to zonulin and glucagon-like peptide 2 (GLP-2) levels in healthy young subjects. Twenty healthy, young male volunteers completed a randomized, double-blind crossover study consisting of a 2-week run-in period and two 5-week study periods (11% inulin-enriched or control pasta), with an 8-week washout period in between. The intestinal barrier function was assessed by lactulose-mannitol excretion in urine. Zonulin values and GLP-2 release were evaluated by enzyme-linked immunosorbent assay. In the inulin group, the urinary lactulose recovery was significantly lower than the other 2 groups. There were no significant differences in urinary mannitol levels between groups. Accordingly, the lactulose-mannitol excretion ratio was significantly decreased in the inulin-enriched pasta group compared with the other 2 groups. The inulin-enriched pasta group had significantly lower zonulin serum values and significantly higher GLP-2 basal values when compared with the baseline and control pasta groups. The dietary use of inulin-enriched pasta preserves intestinal mucosal barrier functioning and modulates circulating levels of zonulin and GLP-2, suggesting that prebiotics could be used in the prevention of gastrointestinal diseases and metabolic disorders.     

马居里教授治疗慢性肾功能衰竭的临床经验

陕西省名中医马居里教授,临床治疗慢性肾功能衰竭经验丰富,重视本病的综合一体化治疗,主张中西医结合分期治疗,辨证与辨病相结合。在治疗中注重益气活血,化湿泄浊,以参芪地黄汤为主方灵活加减用药,改变方药补益的阴阳属性、扶正祛邪的力量,在改善症状,延缓病情进展方面疗效显著。     

缪希雍关门弟子马兆圣考

[目的]探究明代医家马兆圣的生平。[方法]通过文献学研究[方法]对马兆圣的生卒年代、亲友关系、医学著述、师承脉络和医学成就等相关情况进行详细考证。[结果]马兆圣,字瑞伯,号无竞,自号遇丹道人。为明代江苏常熟人,其生卒年代大致为1570--1650年。父为马元俊,弟为马兆祯,共有四子：马觉字伯先,马察字仲昭,马梦桂字秋卿,马廷桂字丹谷。其医学著述有十多种,但多散佚,仅存《医林正印》全本和《谈医管见序》全文,为缪希雍的关门弟子。其用药首重炮制修合,临证和著述俱丰。[结论]对马兆圣的全面考证,为分析其医学成就提供了重要史料,便于深入研究缪希雍的师门脉络、医学思想和临床经验。