墨旱莲化学成分、药理作用及临床应用研究进展

墨旱莲是菊科鳢肠属植物鳢肠Eclipta prostrata L．的干燥地上部分。其味酸、甘，性凉，入肝、肾、胃经。具有滋补肝肾、凉血、止血的功能。墨旱莲含有多种活性成分。现代药理学研究表明，墨旱莲具有抗肿瘤、免疫调节、抗炎等药理作用。临床上用于治疗冠心病、出血性疾病等。本文对墨旱莲化学成分、药理作用以及临床应用作一综述，以为其进一步研发提供有价值的参考。     

一测多评法同时测定不同产地墨旱莲中9种成分及其质量评价研究

目的 建立一测多评法同时测定墨旱莲中9种成分,并对不同产地墨旱莲质量进行综合评价。方法 采用HPLC,使用Agilent ZORBAX Eclipse Plus C18色谱柱(250 mm×4.6 mm,5μm),以乙腈-0.2%磷酸水溶液为流动相,梯度洗脱,流速1 mL·min^–1,进样量20μL,柱温维持在25℃,检测波长210,349 nm。以蟛蜞菊内酯为内参物,计算其他8个成分的相对校正因子,并计算含量,同时采用外标法测定墨旱莲中9种成分的含量,比较一测多评法计算值与外标法实测值的差异。采用灰色关联度法构建墨旱莲质量的灰色关联质量评价模型。结果 以蟛蜞菊内酯为内参物测得的其他成分相对校正因子系统适应性良好,一测多评法得到的结果与实测值之间无显著性差异。不同产地墨旱莲相对关联度范围为0.440～0.747,说明各产地墨旱莲的质量存在差异。结论 建立的一测多评法适合于墨旱莲多成分含量测定,基于灰色关联度模型可以更客观地评价不同产地墨旱莲的质量。     

中药墨旱莲中的三萜皂苷

目的　研究中药墨旱莲Ecliptaprostrata L.中的三萜皂苷化合物。方法　应用柱色谱和HPLC法分离纯化,通过光谱分析(IR ,MS ,¹HNMR ,¹³CNMR ,DEPT ,HMQC和HMBC)鉴定其化学结构。结果　分离并鉴定了5个三萜皂苷,其中2个新化合物eclalbasaponinsXI(4)和XII(5 )的结构分别为:3-O-[β-D-吡喃葡糖(1→2 )-β-D-吡喃葡糖]-16α-乙氧基 齐墩果酸-28-O-β-D-吡喃葡糖苷(4)和3-O-[(2O-硫酰基-β-D-吡喃葡糖) (1→2 )-β-D-吡喃葡糖] 刺囊酸-28-O-β-D-吡喃葡糖苷(5 )。结论　4和5为新化合物,1和5具有诱导稻瘟霉菌丝变形活性。     

极超低出生体质量儿临床转归及危险因素分析

目的 探讨极低出生体质量儿(VLBW)和超低出生体质量儿(ELBW)的临床转归及其危险因素。方法 回顾性分析2017年1月至2019年9月在安徽省儿童医院就诊的138例ELBW、VLBW的临床资料,分析影响患儿临床转归的危险因素。结果 患儿临床转归与胎龄、体质量、双胎或多胎、母亲围产期病史以及母亲既往病史有关(P<0.05)。患儿体质量、双胎或多胎为负性临床结局的保护因素(P<0.05),母亲围产期病史中胎膜早破是负性临床结局的危险因素(P<0.05)。结论 ELBW与VLBW的生存率较低、并发症多,临床预后影响因素多。在提高临床诊疗和护理质量的同时,应加强围生期保健治疗及护理宣教,及早发现影响ELBW与VLBW临床结局的不利因素,及时干预,改善预后。     

阿比多尔分散片的制剂工艺和质量研究

目的 对阿比多尔分散片的制剂工艺和质量进行研究。方法 采用紫外分光光度法测定主药阿比多尔的溶出度及含量。结果 3批样品分散均匀性及溶出度合格;含量测定线性范围为3.62～24.16μg·ml^-1,相关系数0.9998;平均回收率99.7%,RSD为0.94%(n=9)。结论 本制剂设计合理,质量可控,稳定性较好,能够满足临床需要。     

早期应用替罗非班对急性ST段抬高型心肌梗死患者PCI术后冠脉血流及并发症影响的Meta-分析

目的 系统评价早期应用替罗非班对急性ST段抬高型心肌梗死（STEMI）经皮冠状动脉介入（PCI）术后冠脉血流及并发症影响。方法 检索PubMed、Embase、Cochrane图书馆、中国学术期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）和维普中文期刊全文数据库（VIP）和万方数据库关于STEMI患者急诊行PCI并早期应用替罗非班的临床对照研究（RCT）,检索年限均为建库起至2020年4月30日。试验组为PCI术前开始应用替罗非班,对照组为PCI术中或术后应用替罗非班,数据提取和质量评价,应用RevMan 5.3软件进行Meta-分析。结果 共纳入15项RCT,共计2 214例患者。Meta-分析结果显示,术前应用替罗非班组较术中或术后用药组,PCI术后TIMI血流分级为3级（RR=1.10,95%CI=1.06~1.15,P<0.01）和（RR=1.10,95%CI=1.03~1.17,P<0.01）、ST段下落幅度（SMD=0.44,95%CI=0.17~0.70,P=0.001）和（SMD=1.85,95%CI=1.53~2.17,P<0.01）、ST段回落率（RR=1.51,95%CI=1.20~1.89,P<0.01）和（RR=1.20,95%CI=1.05~1.39,P=0.01）均显著优于术中或术后用药;术前应用组提高左心室射血分数（LVEF%）（SMD=0.46,95%CI=0.13~0.79,P=0.007）和降低主要心血管不良事件（MACE）发生率（RR=0.53,95%CI=0.39~0.73,P<0.01）均优于术中用药组。术前应用组与术后应用组的LVEF%和MACE发生率比较均无显著性差异。术前应用组出血及并发症发生率与术中及术后应用组比较均无显著性差异。结论 与PCI术中及术后应用替罗非班相比,术前应用更能显著改善STEMI患者微循环障碍、增加心肌组织有效的再灌注、减少心肌梗死范围。     

墨旱莲有效成分的提取工艺与药理作用研究进展

摘 要 药食两用的墨旱莲因其具有较为显著的药理活性和较高的安全性,近年来受到了越来越多学者的关注。本文综述了近十年来墨旱莲主要有效成分的提取工艺和药理作用的研究进展,以期为墨旱莲的深入研究和开发利用提供参考依据。     

护理风险防范培训在ICU进修护士带教中的应用

目的 探讨护理风险防范培训在重症监护病房（ICU）进修护士带教中的应用效果。方法 将2015年安徽省立医院急救中心ICU 78名进修护士纳为试验组,将2014年70名进修护士列为对照组。对照组进行常规专科培训,试验组则在常规专科培训的基础上,增加护理风险防范培训。比较分析两组护士的考核成绩、护理质量评分及护理差错缺陷发生情况等。结果 试验组通过护理风险防范培训后,考核平均成绩、临床护理质量评分、护理文书质量评分、医护满意度等显著高于对照组,差异有统计学意义（P<0.05）。试验组护士出现非计划性拔管、交班遗漏、患者物品丢失、给药缺陷及仪器操作失误等发生情况显著低于对照组,差异有统计学意义（P<0.05）。结论 护理风险防范培训有效提升了ICU进修护士临床护理能力,减少了护理差错,提高临床护理质量,保障危重患者的护理安全。     

墨旱莲药材的高效液相指纹图谱及聚类分析

目的建立墨旱莲药材的指纹图谱研究方法并进行聚类分析。方法色谱柱:Betasil C18柱(250 mm×4.6 mm,5μm);流动相:体积分数为1%的磷酸水溶液和体积分数为1%的磷酸乙腈溶液,采用梯度洗脱;流速:1.0 mL.min-1;检测波长:330 nm;柱温:30℃。结果精密度与重复性试验中各共有峰的相对峰面积RSD小于5.0%,根据聚类分析结果,可将墨旱莲药材分为合格品和非合格品2类,合格品产地为浙江、江西、广东、武汉、江苏(苏州)、江苏(南京)、湖南、辽宁、河北、山西、北京、上海、安徽、海南,非合格品产地为河南、吉林、福建、山东、陕西(西安)。结论该指纹图谱研究及聚类分析方法可用于控制墨旱莲药材质量。     

阿加曲班联合尤瑞克林治疗急性缺血性脑卒中的疗效观察及对神经损伤标志物的影响

目的 探讨阿加曲班联合尤瑞克林治疗急性缺血性脑卒中的临床效果及对神经损伤标志物的影响。方法 前瞻性选择2018年10月—2021年1月邢台市第三医院收治的202例急性缺血性脑卒中患者,随机将患者分成对照组和试验组,每组各101例,对照组患者在基础治疗的同时加用注射用尤瑞克林,应用100 mL 0.9%氯化钠注射液稀释0.15 PNA注射用尤瑞克林,静脉滴注,每日1次,疗程为30 d。试验组患者在对照组的基础上应用阿加曲班注射液,治疗前2 d,使用60 mg阿加曲班,稀释液为1 500 mL 0.9%氯化钠注射液,静脉滴注24 h;从第3天开始,阿加曲班剂量更改为10 mg,100 mL 0.9%氯化钠注射液稀释,静脉滴注持续3 h,每日1次,阿加曲班和尤瑞克林均持续用药30 d。比较两组患者神经功能、日常生活能力、生活质量、临床疗效、炎性因子、血液流变学、神经损伤标志物、安全性及预后等指标。结果 治疗后,两组反映患者神经功能的美国国立卫生研究院卒中量表（NIHSS）评分较治疗前均显著降低（P＜0.05）,反映患者日常生活能力的改良版Barthel指数（MBI）评分和反映患者生活质量的世界卫生组织生存质量测定量表（WHOQOL-100）评分均显著升高（P＜0.05）。治疗后,试验组NIHSS评分明显低于对照组（P＜0.01）,且MBI评分和WHOQOL-100评分明显高于对照组（P＜0.01）。试验组患者临床总有效率（88.12%）明显高于对照组（68.32%）,经χ²检验,差异具有统计学意义（P＜0.01）。治疗后,试验组患者血清炎性因子C反应蛋白（CRP）、白细胞介素-2（IL-2）水平及血小板聚集率、纤维蛋白原、红细胞比容、血浆黏度等血液流变学指标均显著低于对照组（P＜0.01）,试验组血清谷氨酸、S100β蛋白、神经元特异性烯醇化酶等神经损伤标志物水平均显著低于对照组（P＜0.01）。试验组患者不良反应发生率与对照组比较,差异不显著（P＞0.05）。试验组患者预后良好率（60.00%）显著高于对照组（41.41%）,差异具有统计学意义（P＜0.01）。结论 阿加曲班联合尤瑞克林治疗急性缺血性脑卒中,可有效改善患者神经功能,增强日常生活能力,提高生活质量,消除炎症反应,改善血液流变学指标,降低神经损伤标志物的水平,临床应用有效。     

Antimetastatic effects of Eclipta prostrata extract on oral cancer cells

Eclipta prostrata, a traditional Chinese medication, has been used for the treatment of several diseases. However, the molecular mechanism underlying the effects of Eclipta prostrata extracts (EPE) on human oral cancer cell metastasis remains unclear. We thus examined the effects of EPE on metastasis promoting proteins in oral cancer. Our results revealed that the EPE attenuated SCC‐9, HSC‐3, and TW2.6 cell migration and invasiveness by reducing matrix metalloproteinase (MMP)‐2 enzyme activities. In addition, Western blot analysis revealed that EPE significantly reduced the levels of phosphorylated extracellular signal‐regulated kinase 1/2 (ERK 1/2) but not those of c‐Jun N‐terminal kinase (JNK) 1/2 and p38. In conclusion, we found that EPE could inhibit oral cancer metastasis through the inhibition of MMP‐2 expression. Therefore, EPE may be used to prevent the metastasis of oral cancer, and has the potential to be applied to cancer treatment.     

Eclipta prostrata L. phytochemicals: Isolation,structure elucidation,and their antitumor activity

Eclipta prostrata L., (Asteraceae), is used in China for both food and medicine purposes. This research is concerned with the isolation and purification of phytochemical constituents from the aerial parts of E. prostrata, using gradient solvent fractionation, macroporous resin, silica gel, Sephadex LH-20 and ODS columns, and TLC analyses. Four fractions (water, 30% ethanol, 60% ethanol and 90% ethanol) were obtained. Four compounds, wedelolactone (I), eclalbasaponin I (II), luteolin (III) and luteolin-7-O-glucoside (IV) were purified and their structures were identified by the interpretation of spectroscopic analyses including MS, ¹H and ¹³C NMR. Antitumor activities of extracts (total fraction), four fractions and the isolated compounds were assessed using hepatoma cell smmc-7721 as an in vitro assay system. The 30% ethanol fraction and eclalbasaponin I dose-dependently inhibited the proliferation of hepatoma cell smmc-7721 with IC₅₀ values of 74.2399 and 111.1703 μg/ml, respectively, more strongly compared with 5-fluorouracil positive control group with the IC₅₀ value of 195.3131 μg/ml. Antitumor activities of other fractions and compounds were lower than positive control. These results suggested that some specific compounds or extracts from E. prostrata are potential sources of natural anti-tumor materials and worthy of further study.     

New polyacetylenes glycoside from Eclipta prostrate with DGAT inhibitory activity

One new polyacetylene glycoside eprostrata Ⅰ (1), together with seven known compounds (2–8), were isolated from Eclipta prostrata. Their structures were elucidated on the basis of spectroscopic and physico-chemical analyses. All the isolates were evaluated inhibitory activity on DGAT in an in vitro assay. Compounds 1–8 were found to exhibit inhibitory activity of DGAT1 with IC₅₀ values ranging from 74.4 ± 1.3 to 101.1 ± 1.1 μM.     

Eclipta prostrata promotes the induction of anagen,sustains the anagen phase through regulation of FGF-7 and FGF-5

Context: Eclipta prostrata L. (Asteraceae) (EP) has been widely used for the treatment of skin disease in Asian traditional medicine.

Objective: This study investigates the potency of EP in promoting hair growth in vivo and in vitro.

Materials and methods: C57BL/6N mice were divided into four groups (n?=?4) as follows: control (topical treatment of normal saline), topical 3% minoxidil to the dorsal skin of mice for 14 days, and low (1?mg/day) and high (10?mg/day) doses of EP orally administered once a day for 14 days. Dorsal hairs of C57BL/6N mice were depilated to synchronize anagen induction. Hair growth activity was evaluated by gross and microscopic observations. Sections of dorsal skin were stained with haematoxylin and eosin. We also treated the various concentrations of EP (5, 10 and 50?μg/mL) for 24?h on the human dermal papilla cells (HDPs) and examined the effects of EP on the expression of FGF-7 and mTOR signalling.

Results: EP enhanced the induction of anagen in the dorsal skin of mice, characterized by the appearance of inner root sheath along with hair shaft, the emergence of hair shaft through the epidermis. EP increased the expression of FGF-7, while decreased the level of FGF-5 in C57/BL6 mice. EP also increased the expression of FGF-7, activated the mTOR signalling in HDPs.

Discussion and conclusions: These results suggest that EP has a potency to enhance the growth of hair follicle, promoting hair growth through regulation of FGF-7 and FGF-5.     

二至丸及其组成药味保肝药理作用研究进展

二至丸由女贞子和墨旱莲两味中药组成,这两味药及其组方均有不同程度的保肝作用。二至丸中含有多种保肝有效成分,主要有三萜类、环烯醚萜类、苯乙醇-苷类、香豆素醚类等,它们能对抗多种化学性肝损伤、抗缺血再灌注性肝损伤以及抗肝纤维化等,其保肝作用机制包括抗氧化应激、抗炎、抑制肝星状细胞增殖和活化、促进肝星状细胞凋亡以及影响肝细胞代谢过程等。总结二至丸及其组成药味女贞子和墨旱莲的保肝作用,探讨其保肝作用机制,以期为进一步研究二至丸药效物质基础提供参考。     

二至丸药理作用研究进展

二至丸由女贞子、墨旱莲两味药材组成,具有补益肝肾、滋阴止血的功效,在妇科疾病、肾病、肝病等领域均有广泛的临床应用基础。现代药理研究发现二至丸在保肝补肾、改善骨质疏松、围绝经期综合征、免疫调节、抗衰老、改善神经系统疾病等方面具有广泛的药理活性,并对二至丸保护肝脏、抗骨质疏松、抗衰老的作用机制与潜在通路开展了研究。对二至丸的药理作用研究进展进行综述,为进一步利用现代药理学手段阐明二至丸治疗肝肾阴虚证的机制、挖掘中药经典方“多成分、多靶点、多通路”的作用特点以及指导二至丸临床应用提供参考。     

Evaluation of antiurolithiatic and antioxidant potential of Lepidagathis prostrata: A Pashanbhed plant

Context: Oxidative stress acts as an essential mediator in the pathophysiology of urolithiasis. Lepidagathis prostrata Dalz. (Acanthaceae) is a Pashanbhed plant that is recommended for the management of urolithiasis; however, no scientific validation has been reported.

Objectives: To evaluate the antiurolithiatic and antioxidant potential of L. prostrata.

Materials and methods: Methanol extract (LPM) and fractions; petroleum ether (LPPE), ethyl acetate (LPEA), n-butanol (LPBU) and aqueous (LPAQ) were prepared. In vitro antiurolithiatic activity was evaluated by the capacity to inhibit calcium oxalate (CaOx) nucleation and aggregation at different concentrations of extract/fractions (0.04–3?mg/mL) for 30?min. Total phenol and flavonoid content and antioxidant potential were determined. A validated HPTLC method was performed to quantify lupeol and β-sitosterol.

Results: LPEA exhibited the highest dose-dependent inhibition of CaOx nucleation (IC₅₀: 336.23?±?30.79?µg/mL) and aggregation (IC₅₀: 149.63?±?10.31?µg/mL), which was significantly (p?<?0.05) better than standard Cystone®. The polar LPBU fraction was enriched with phenols (47.34?±?0.19?mg GAE/g) and flavonoids (20.38?±?0.05?mg QE/g), which correlates with its highest antioxidant potential in DPPH, ABTS, nitric oxide scavenging and iron chelating activities (IC₅₀: 1.18–87.34?µg/mL). To our knowledge, this is the first study reporting the presence of lupeol and β-sitosterol in L. prostrata.

Conclusion: The antiurolithiatic activity of L. prostrata is probably mediated through the inhibition of CaOx crystallization. In addition to its free radical scavenging and antioxidant activities, it would act as an excellent agent for the prevention of urolithiasis.     

云实属植物化学成分、药理作用及质量控制研究进展

云实属Caesalpinia L.植物资源丰富,主要分布在热带和亚热带地区,具有很高的药用价值。目前,已经从云实属植物中分离出的化学成分主要包括黄酮类和萜类两大类,药理研究表明其具有抗炎、抗氧化、抗疟等药理作用。近年来,关于云实属植物的质量控制研究比较单薄,不能全面反映药材质量标准。因此,系统综述了该属植物化学成分、药理作用和质量控制研究进展,以期为云实属植物药用活性成分及其作用机制的研究、资源的充分利用、新药开发提供依据。     

Regulation of Eclipta prostrata L. components on cigarette smoking‐induced autophagy of bronchial epithelial cells via keap1‐Nrf2 pathway

Cigarette smoking extract (CSE)‐induced autophagic injury has been regarded as an important contributor to the pathogenesis of lung cancer. We previously found that Eclipta prostrata L. component (CCE) reduced CSE‐induced bronchial epithelial cells damage. However, the mechanism remains unknown. Human normal bronchial epithelial cells (NHBE) were exposed to CSE to establish stress model. Nrf2‐siRNA and Keap1‐siRNA transfection were performed. mRFP‐GFP‐LC3 dual fluorescence and transmission electron microscopy were used to observe the autophagic characteristics. CCE prevented CSE‐induced Nrf2 transfer into cytoplasm and up‐regulated Keap1 level of NHBE cells. Furthermore, CCE significantly increased p‐p16, p‐p21 and p‐p53 phosphorylation levels in Nrf2‐siRNA‐ or Keap1‐siRNA‐transfected cells. As demonstrated by transmission electron microscopy and mRFP‐GFP‐LC3 dual fluorescence assays, CCE mitigated autophagic injury, and also down‐regulated autophagy‐related Beclin‐1, LC3II/LC3I ratio, Atg5 and ATF4 levels. Our findings showed the attenuation of CCE on CSE‐induced NHBE cells injury was associated with Nrf‐2‐mediated oxidative signaling pathway.