Hypercoagulability in cancer patients grouped by syndromes differentiated with the theory of abnormal hilit in traditional Uyghur medicine

OBJECTIVE： To investigate the relationship in ma- lignant-neoplasm patients of hypercoagulability between syndromes differentiated with the theory of abnormal hilit in traditional Uyghur medicine（TUM）. METHODS： A total of 248 patients with malignant tumors were enrolled. Based on the theory of TUM they were divided into two groups： abnormal Sav- da and abnormal Non-Savda（including abnormal Khan, abnormal Sepra and abnormal Belghem types）; fifty healthy volunteers were selected as controls. Platelet（PLT）, prothrombin time（PT）, plas- ma fibrinogen（FIB）, thrombin time（TT）, activated partial thromboplastin time（aPTT） and D-Dimer（D-D） were measured in both groups. RESULTS： Compared with the control and abnor-mal Non-Savda groups, in the abnormal Savda group the PLT count increased（P0.05）, the PT was lengthened（P0.01）, and the FIB significantly in- creased（P0.01）. D-Ds in the three groups were sig- nificantly different（P0.05）. No significant differ- ence was found inTT and aPTT values（P0.05）. CONCLUSION： Hypercoagulability existed in pa- tients with malignant tumors in the different types of TUM syndromes, especially in the abnormal Sav- da group; this was characterized by increased blood viscosity, platelet aggregation and thrombo- sis. D-D appears to be a significant predictor for the therapeutic effect of TUM in relation to malignant tumor therapies.     

DT-13, a saponin of dwarf lilyturf tuber,exhibits anti-cancer activity by down-regulating C-C chemokine receptor type 5 and vascular endothelial growth factor in MDA-MB-435 cells简

AIM： To investigate the anticancer activity of DT-13 under normoxia and determine the underlying mechanisms of action. METHODS： MDA-MB-435 cell proliferation, migration, and adhesion were performed to assess the anticancer activity of DT-13, a saponin from Ophiopogonjaponicus, in vitro. In addition, the effects of DT-13 on tumor growth and metastasis in vivo were evaluated by orthotopic implantation of MDA-MB-435 cells into nude mice; mRNA levels of vascular endothelial growth factor （VEGF）, C-C chemokine receptor type 5 （CCR5） and hypoxia-inducible factor 1a （HIF-1a） were evaluated by real-time quantitative PCR; and CCR5 protein levels were detected by Western blot assay. RESULTS： At 0.01 to 1 umol·L -1, DT-13 inhibited MDA-MB-435 cell proliferation, migration, and adhesion significantly in vitro. DT-13 reduced VEGF and CCR5 mRNAs, and decreased CCR5 protein expression by down-regulating HIF-1 a. In addition, DT-13 inhibited MDA-MB-435 cell lung metastasis, and restricted tumor growth slightly in vivo. CONCLUSION： DT-13 inhibited MDA-MB-435 cell proliferation, adhesion, and migration in vitro, and lung metastasis in vivo by reducing VEGF, CCR5, and HIF-la expression.     

Combinatorial effects of conception and governor vessel electroacu- puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE： To investigate the combinatorial ef- fects of conception and governor vessel electroacu- puncture （EA） and human umbilical cord blood-de- rived mesenchymal stem cells （HUCB-MSCs） on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS： With the HUCB-MSCs isolated, cultured and identified and the models of cerebral isch- emia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted andthe EA at conception and governor vessels was ap- plied. The pathomorphologic lesion by hematoxy- lin-eosin staining and the cellular apoptosis by ter- minal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic fo- cus were observed. RESULTS： The cultured adherent HUCB-MSCs ex- hibited a spindle shape and expressed MSC-specif- ic markers, with the cell purity and proliferation rate significantly increasing after the primary pas- sage. HE staining showed that there were no patho- logical changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs trans- plantation ＋ EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treat- ment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION： HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs trans- plantation.     

Mixed nanomicelles loaded with thymopeptides-sodium deoxycholate/phospholipid improveDrugabsorption简

AIM： To improve the absorption of thymopeptides （TH） by preparing sodium deoxycholate/phospholipid-mixed nanomicelles （SDC/PL-MMs）. METHODS： TH-SDC/PL-MMs were prepared by a film dispersion method, and then evaluated using photon correlation spectroscopy （PCS）, zeta potential measurement, as well as their physical stability after storage for several days. Further- more, in situ intestinal single-pass perfusion experiments and pharmacodynamics in immunodeficient mice were performed to make a comparison with TH powders and the control drug in absorption properties. RESULTS： A narrow size distribution of nanomicelles, with a mean particle size of （149 ± 8.32） nm and a zeta potential of （-31.05 ± 2.52） mV, was obtained. The in situ intestine perfusion experiments demonstrated a significant advantage in absorption characteristics for TH compared to the other formulations, and oral administration of TH-SDC/PL-MMs potentiated an equivalent effect with i.h. TH in pharmacodynamic studies in immunodeficient mice. CONCLUSIONS： TH-SDC/PL-MMs prepared by a film dispersion method are able to improve the absorption of TH. SDC/PL-MMs might be a good approach for the more effective delivery of drugs like TH.     

Qingkailing injection for the treatment of acute stroke： a systematic review and Meta-analysis

OBJECTIVE: To evaluate systematically the clinical efficacy and safety of Qingkailing(QKL) injection in the treatment of acute stroke.METHODS: Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database,Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software.RESULTS: A total of 13 studies with 1110participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk(RR) in the acute cerebral hemorrhage(ACH) sub-group was 1.17 [95%confidence interval(CI)(1.08, 1.26), P=0.0001]. In the acute cerebral infarction(ACI) sub-group, RR was 1.27 [95% CI(1.14, 1.42), P0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI(1.20,1.50),P0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference(MD)=﹣3.73, 95%CI(﹣4.48, ﹣2.98), P0.000 01],decreased neurological damage in ACI [MD=﹣5.60, 95% CI(﹣8.50, ﹣2.70), P=0.0002] and ACH[MD= ﹣ 4.08, 95% CI( ﹣ 8.00, ﹣ 0.16), P=0.04],promoted the recovery of awareness [RR=1.56, 95%CI(1.09, 2.21), P=0.01] and reduced the whole blood viscosity coefficient [MD=﹣ 0.75, 95% CI( ﹣1.47, ﹣0.03), P=0.04]. There were no adverse drug reactions reported in the included studies.CONCLUSION: Based on this systematic review,QKL combined with conventional therapy was effective compared with control treatment.However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.     

Study on perfume stimulating olfaction with volatile oil of Acorus gramineus for treatment of the Alzheimer's disease rat

Objective：To probe into the therapeutic efect of perfume stimulating olfaction with volatile oil of Acorus Gramineus on the Alzheimer＇s disease （AD） rat. Methods： Totally 50 adult SD rats, male,weighing 300±10 g, were randomly divided into 5 groups, normal group （group A）, olfactory nerve severing model group （group B）, AD model group （group C）, AD model plus perfume stimulation group （group D）, AD model olfactory nerve severing plus perfume stimulation group （group E）, 10 rats in each group. After perfume stimulation, Morris maze test was conducted for valuating the learning and memory ability; Malondaldehyde （MDA） content, and superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） activities in the brain, and the brain weight were detected. Results： Compared with the AD model group,the average escape latency and swimming distance in 6 days were significantly shorter than those in the group A, B, D （P〈0.01）, with no significant differences between the group C and the group E （P〉0.05）; Compared with the group A, B and D, MDA content in the group C significantly increased （P〈0.01）, and SOD and GSH-Px activities significantly decreased （P〈0.01）, and brain weight/body weight decreased significantly in the group C （P〈0.01）, with no significant differences between the group C and the group E （P〉0.05）. Conclusion： Perfume stimultating olfaction with volatile oil of Acorus Gramineus can significantly increase the learning-memory ability, decrease MDA content and increase SOD and GSH-Px activities and weight of brain in AD rats.     

Effects of Chaiyuwendan decoction on endocannabinoids levels in adipose tissue of rats with chronic stress-induced depression

OBJECTIVE： To investigate how Chaiyuwendan de- coction（CWD） affects endocannabinoid levels in the adipose tissue of depressed rats. METHODS： Twenty-four male Sprague-Dawley rats were randomly divided into four groups with six rats in each. One group was randomly selected as the control group. The remaining three groups were subjected to chronic stress to induce depression. Groups were randomly assigned as a model group, CWD group, and amitriptyline group. CWD was giv- en to the CWD group once a day from the second day of modeling. The amitriptyline group was ad- ministered amitriptyline intragastrically（10 mg/kg） once a day. After treatment for 21 days, body weight and fat weight were measured and the lev- els of N-arachidonoylethanolamine（AEA）, 2-arachi- donoylglycerol（2-AG）, and N-palmitoylethanol- amine（PEA） in adipose tissue were determined with liquid chromatography-mass spectrometry.RESULTS： Compared with the control group, body weight, fat weight, AEA, and PEA were significantly lower, and 2-AG was higher, in the model group（P 0.05, P0.01）. Compared with the model group, body weight, fat weight, the AEA, and PEA levels were significantly higher, and 2-AG level was signifi- cantly lower in the CWD group（P0.05）. However, the levels did not differ significantly between the CWD group and the amitriptyline group. CONCLUSION： CWD could regulate the levels of AEA, 2-AG, and PEA in rats with depression induced by chronic stress.     

Therapeutic effect in patients with coronary heart disease based on information analysis from Traditional Chinese Medicine four diagnostic methods

OBJECTIVE： To study information gained by Tradi- tional Chinese Medicine（TCM） four diagnostic methods and characteristics of syndrome develop- ment before and after treatment in patients with coronary heart disease, and to probe into assess- ment indexes of therapeutic effects with distinctive TCM features. METHODS： Information from the four diagnostic methods before and after treatment in 100 patients with coronary heart disease was collected using the TCM interrogation scale, a pulse condition in- strument, a tongue-face diagnosis instrument, anda voice diagnosis information collection system. Changes in the four diagnostic method results from before and after treatment were analyzed with frequency analysis and t-test methods. RESULTS： Before treatment, deficiency syndrome complicated with hyperactivity of pathogenic fac- tors was most common. After treatment, deficiency syndrome was most common. This change from complex syndromes to single syndromes indicates disease and syndrome alleviation. Frequencies of symptoms gained by interrogation after treatment for syndrome of deficiency of heart-Qi, syndrome of deficiency of heart-Yin, and turbid phlegm syn- drome were all less severe than those before treat- ment. Parameters of face color, color on all sub-re- gions of tongue, color of tongue fur, septic and greasy fur, and lip color after treatment all had sig- nificant changes. After treatment, part of the voice diagnosis parameters in the deficiency of heart-Yin and turbid phlegm syndromes had significant changes, but no significant changes were found in the deficiency of heart-Qi syndrome. CONCLUSION： Use of the TCM four diagnostic methods can provide an effective basis forTCM syn- drome diagnosis, observation of development of state of illness, and evaluation of clinical therapeu- tic effects.     

Electroacupuncture on the Head Points for Improving Gnosia in Patients with Vascular Dementia

Objective： To investigate the clinical effects of electroacupuncture （EA） on the head points for improving gnosia in patients with vascular dementia （VD）. Methods： 90 VD patients were randomly divided into a drug group, an EA group and an EA plus drug group. Scoring with the M/VISE scale and detecting the relevant potentials were done before treatment and after a 6-week treatment. Results： Gnosia was improved after treatment in all the three groups with no significant difference by the intergroup comparison. Conclusion： The above three therapies can all improve gnosia, reduce the psychological stress, strengthen attention and shorten the awaiting time for recognition; and EA plus Nimodipine seems to be the best in the curative effect.     

Effects of feeding tyrosine and phenylalanine on the accumulation of phenylethanoid glycosides to Cistanche deserticola cell suspension culture

AIM： To investigate the effects of feeding phenylalanine （Phe） and tyrosine （Tyr） on the accumulation of total phenolic compounds and four phenylethanoid glycosides （PeGs） to a cell suspension culture of the parasitic plant Cistanche deserticola.METHOD： A cell suspension culture of C. deserticola was established and precursors of different concentrations were fed. In each group, the cell was sampled at the 24^th day after inoculation. The content of total phenolic compounds and four PeGs compounds were determined using the Folin-Ciocalteu method and an HPLC method, respectively.RESULTS： In the Phe fed cells, the maximum PeGs yield was achieved when Phe was fed at 1.5 mmol·L^-1 and the yield reached 1.13 times the control cell concentration. In the Tyr fed cells, the maximum yield of PeGs was 1.60 times of control when 0.75 mmol·L^-1 Tyr was fed to the cells. Furthermore, it was found that the salidroside yield was 4.01 times of control group when 5 mmol·L^-1 Tyr was fed.CONCLUSION： Tyr is a better precursor for PeGs accumulation compared with Phe, and the rate limiting enzymes might be involved in the Tyr branch.     

沈敏鹤从三焦辨治肿瘤临床经验

沈敏鹤主任医师系国家级名老中医吴良村教授的学术继承人,从事中西医结合肿瘤内科临床工作二十余载,擅长中西医结合治疗各种常见恶性肿瘤,尤其对从三焦辨治肿瘤见解独到。笔者有幸随师侍诊,获益匪浅,现将沈师从三焦辨治肿瘤的临床经验总结介绍如下。     

祛腐生肌法结合手术治疗克罗恩病并发肛瘘验案1则

祛腐、生肌二法是中医外科和肛肠科常用的治法,但许多外科医生认为生肌药物不可早用,须待腐肉脱尽方可采用生肌。如明代汪机在《外科理例》中提到：＂设若脓毒未尽就用生肌,反增溃烂。壮者、轻者不过复溃或迟敛而已;怯者、重者必致内攻或溃烂,不敛者亦多矣。     

Chaiqinchengqi decoction regulates necrosis-apoptosis via regulat- ing the release of mitochondrial cytochrome c and caspase-3 in rats with acute necrotizing pancreatitis

OBJECTIVE： To explore the effect and the mechanism of Chaiqinchengqi decoction （CQCQD） on the apoptosis-necrosis switch of pancreatic acinar cells in acute necrotizing pancreatitis （ANP） in rats. METHODS： Sixty Sprague-Dawley rats were randomized into the control group, the ANP group and the CQCQD group. The acute pancreatitis （AP） model was induced by intraperitoneal injections of 4 g/kg 8% L-Arginine （PH 7.0） twice with a 1 h inter- val. Rats in the CQCQD group were intragastrically administered CQCQD （20 mL/kg every 2 h, 3 times, then 20 mL/kg every 6 h, 3 times）. Rats were killed at the 6 and 24 h after the induction of AP. The pan- creatic tissues were collected for pathology and to isolate pancreatic acinar cells and mitochondria. RESULTS： CQCQD significantly ameliorated the severity of ANP by reducing the pancreatic histopathology score, indicated by lactate dehydrogenase levels at the 6 and 24 h. The CQCQD group promot- ed the apoptosis of pancreatic acinar cells by rais- ing the apoptosis index compared with the ANP group and the control group. Mitochondrial cytochrome c at the 6 and 24 h in the ANP group were lower than that in the control group or the CQCQD group （0.67±0.13 vs 1.54±0.03 vs 0.81 ±0.09; 0.71± 0.08 vs 1.55±0.09 vs 0.89±0.16, P〈0.01）. The cyto- chrome c levels in the cytoplasm at the 6 and 2 h in the CQCQD group were higher than in the control group （1.36±0.15 vs 0.67±0.04, 1.46±0.08 vs 0.59± 0.09, P〈0.01）, or the ANP group （0.96±0.13, P〉0.05; 0.97±0.09, P〈0.05）. CQCQD increased caspase-3 activity over the ANP group at the 6 h. CONCLUSION： CQCQD can induce apoptosis and relieve the necrosis of pancreatic acinar cells via promoting the release of mitochondrial cytochrome c and increasing pancreatic caspase-3 ac- tivity in ANP rats.     

Characterization and evaluation in vivo of baicalin-nanocrystals prepared by an ultra-sonic-homogenization-fluid bed drying method简

AIM： To improve the absorption and bioavailability of baicalin using a nanocrystal （or nanosuspension） drug delivery system. METHODS： A tandem, ultrasonic-homogenization-fluid bed drying technology was applied to prepare baicalin-nanocrystal dried powders, and the physicochemical properties of baicalin-nanocrystals were characterized by scanning electron microscopy, photon correlation spectroscopy, powder X-ray diffraction, physical stability, and solubility experiments. Furthermore, in situ intestine single-pass perfusion experiments and pharmacokinetics in rats were performed to make a comparison between the microcrystals of baicalin and pure baicalin in their absorption properties and bioavailability in vivo. RESULTS： The mean particle size of baicalin-nanocrystals was 236 nm, with a polydispersity index of 0.173, and a zeta potential value of-34.8 mV, which provided a guarantee for the stability of the reconstituted nanosuspension. X-Ray diffraction results indicated that the crystallinity of baicalin was decreased through the ultrasonic-homogenization process. Physical stability experiments showed that the prepared baicalin-nanocrystals were sufficiently stable. It was shown that the solubility of baicalin in the form of nanocrystals, at 495 ug·mL-1, was much higher than the baicalin-microcrystals and the physical mixture （135 and 86.4 ug·mL- 1, respectively）. In situ intestine perfusion experiments demonstrated a clear advantage in the dissolution and absorption characteristics for baicalin-nanocrystals compared to the other formulations. In addition, after oral administration to rats, the particle size decrease from the micron to nanometer range exhibited much higher in vivo bioavailability （with the AUC（0-t） value of 206.96 ± 21.23 and 127.95 ± 14.41 mg·L-1·h-1, respectively）. CONCLUSION： The nanocrystal drug delivery system using an ultrasonic-homogenization-fluid bed drying process is able to improve the absorption and in vivo bioavailability of baicalin, compared with pure baicalin coarse powder and micronized baicalin.     

Curative effect of Xuebijing injection on severe pulmonary contu- sion

OBJECTIVE： To investigate the curative effects of Xuebijing （XBJ） injection, a Chinese patent medi- cine, on severe pulmonary contusion （PC）. METHODS： Sixty-three patients with PC were ran- domized to conventional therapy plus XBJ injec- tion （n=33） or conventional therapy alone （n=30）. Between groups differences in corticosteroid treat- ment, immune regulation therapy, hemofiltration, infusion volume, transfusion volume and antibiotic period were measured, as were intensive care unit（ICU）-free time, ventilation time, 28-day mortality rate and incidence of ventilation-associated pneu- monia （VAP）. Serum concentrations of procalcito- nin （PCT）, tumor necrosis factor-a （TNF-a）, interleu- kin （IL）-6, and 11_-10, white blood cell （WBC） counts and percentages of human leukocyte antigen DR/ CD14＋ （HLA-DR/CD14＋） peripheral blood mononu- clear cells were compared. Markers of ventilation were determined by blood gas analysis and ventila- tor parameters. RESULTS： WBC counts and serum concentrations of PCT, TNF-a, 11.-6 and IL-10 were reduced signifi- cantly more quickly, and CD14＋ percentage was in- creased significantly earlier, in the XBJ group than in the control group （P〈0.05 each）. The level of ven- tilation and oxygenation index were ameliorated earlier in the XBJ than in the control group （P〈 0.05）. XBJ treatment significantly reduced ICU-free time, ventilation time and incidence of VAP （P〈0.05 each）, but had no effect on 28-day mortality rate （P〉0.05）. CONCLUSION： XBJ treatment can shorten ICU-free and ventilation times and reduce the incidence of VAP, improving outcomes in patients with severe PC. XBJ may act by regulating inflammation and im- munity, alleviating systemic inflammatory response syndrome induced by trauma.     

王氏保赤丸治疗消化系统疾病概述

王氏保赤丸系根据清代道光年间通州著名中医王胪卿祖传九世秘方配制,并由其嫡孙王绵之教授监制的纯中药制剂。该药由大黄、黄连、制天南星、川贝母等组成。方中大黄苦寒,攻积导滞,泻火凉血,行瘀通经;黄连苦寒,清热燥湿,泻火解毒;制天南星苦凉,化痰熄风定惊;川贝母苦寒,化痰止咳,清热散结。王氏     

Preparation and quality assessment of high-purity ginseng total saponins by ion exchange resin combined with macroporous adsorption resin separation

AIM： To prepare high-purity ginseng total saponins from a water decoction of Chinese ginseng root.METHOD： Total saponins were efficiently purified by dynamic anion-cation exchange following the removal of hydrophilic impurities by macroporous resin D101. For quality control, ultrahigh-performance liquid chromatography with a charged aerosol detector （CAD） was applied to quantify marker components. The total saponin content was estimated by a colorimetric method using a vanillin-vitriol system and CAD response. RESULTS： D201, which consisted of a cross-linked polystyrene matrix and -]N＋（CI-13）3 functional groups, was the best of the four anion exchange resins tested. However, no significant difference in cation exchange ability was observed between D001 （strong acid） and D 113 （weak acid）, although they have different functional groups and matrices. After purification in combination with D101, D201, and D 113, the estimated contents of total saponins were 107% and 90% according to the colorimetric method and CAD response, respectively. The total amount of representative ginsenosides Re, Rd, Rgl, and compound K was approximately 22% based on ultrahigh-performance liquid chromatography-CAD quantitative analysis. CONCLUSION： These findings suggest that an ion exchange resin, combined with macroporous adsorption resin separation, is a promising and feasible purification procedure for neutral natural polar components.