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??OBJECTIVE To study the chemical constituents of Fomes fomentarius (L.Ex.Fr.). METHODS The compounds were isolated by chromatography on silica gel column, Sephadex LH-20 column, and their structures were elucidated by spectral analysis. RESULTS Six compounds were obtained and identified as fomentarinin (1), 2-hydroxy hexacosanoic acid ethyl ester (2),syringic acid (3), syringyl alcohol (4), vanillin (5), and ergosta-7,22-diene-3,6-dione (6), respectively. CONCLUSION Compound 1 is a new compound, and compound 2-6 are isolated from the fungus for the first time.
     

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??OBJECTIVE To systematically evaluate the economics of saxagliptin for treatment of type 2 diabetes mellitus. METHODS PubMed, Embase, Cochrane Library, NHS EED, CNKI, Wanfang and CBM were systematically searched. Literatures were screened according to pre-defined inclusion criteria. The quality of included studies were evaluated by CHEERS statement and the economic RESULTS were systematically analyzed. RESULTS Eight cost-effectiveness analyses were included, one of which was conducted in China. Patients among the studies all had blood glucose non-adeguately controlled by monotherapy. When added on to metformin, saxagliptin was cost-effective compared with sulfonylureas (glipizide and glimepiride) and thiazolidinediones (pioglitazone and rosiglitazone). When added on to metformin or sulfonylureas, saxagliptin was cost-effective compared with NPH insulin. CONCLUSION Saxagliptin represents a cost-effective option in treatment of type 2 diabetes mellitus patients with non-adequately controlled blood glucose after monotherapy.     

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??Polygonati Rhizoma as one of the most common Chinese herbal medicine and food was widely distributed in China. In TCM clinic, it was used for diabetes, hyperlipemia and rehabilitation therapy of cancer. Nowadays, with the rapid development of health industry, Polygonati Rhizoma shows excellent functions on healthcare, and then a surge of demands was coming. But there are so many species belongs to this genus and the classification criteria are not unified, so some important problems become urgently to be resolved, such as how to guarantee the quality and how to keep sustainable development. In this paper, the origin, distribution in China, chemical composition, pharmacological, and clinical application are reviewed. Its prospect is discussed to be helpful to promote the comprehensive development of Polygonatum.     

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??OBJECTIVE Blood tends to deposit in atrium to form thrombus in patients with atrial fibrillation. Patients with diabetes are in high coagulation state, for whom thrombosis is easy to occur. The number of diabetic patients with atrial fibrillation is large. Warfarin is one of the most widely used oral anticoagulants, which can cause major or fatal bleeding, so it is necessary to perform regular monitoring of international normalized ratio (INR) on all patients treated with warfarin. New kinds of antidiabetic drugs are widely used in clinic, among which a lot affect INR levels achieved with warfarin therapy. Clinical pharmacists should pay attention to drug interactions and monitor adverse drug reactions. As a new antidiabetic drug, exenatide has less reports of interaction with warfarin. The characteristic of the interaction between exenatide and warfarin was investigated, with the aim to optimize the rational and individualized medication. METHODS A case was introduced in which exenatide was administrated combined with warfarin, so that the possible mechanism of exenatide affecting to warfarin were analyzed. RESULTS INR declined from 2.13 to 1.57 after exenatide being added, and decreased further to 1.43 with concurrency of the increasing exenatide dose. On the contrary, INR was on rise as result of discontinuing exenatide. At last, INR returned to 1.78 when the patient discharged. CONCLUSION Exenatide inhibited the absorption of warfarin, which lead to INR decline attributed to its effect of slowing down the gastric emptying. When exenatide and warfarin are combined,the dose of warfarin must be adjusted based on INR under clinical monitoring.     

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??OBJECTIVE To study and collate the literature on rare diseases in domestic and abroad, and comparative analysis, provide a scientific basis for the domestic rare diseases research. METHODS Retrieved the Web of Science, China National Knowledge Infrastructure from January 2011 to June 2016 published literature about rare diseases. RESULTS Through the screening of literature, finally determine the 200 articles for analysis. It is divided into seven research directions:rare diseases policy research, rare diseases legal and regulatory research, rare diseases medical social security study, orphan drugs availability research, orphan drugs economic evaluation study, orphan drug development research, rare diseases defined standard research. CONCLUSION Rare diseases policy research is the focus of research both domestic and abroad. Compared with foreign countries, the domestic research on the availability and economic evaluation of orphan drug is less, especially the economic evaluation research is almost blank. It is suggested that the researchers study the multiple aspects of rare diseases and drugs, and to provide the basis and reference for build rare disease policy in China.In addition to the field of rare diseases research, rare diseases drugs face many difficulties in pharmaceutical research, production and supply.The precondition to solve these problems is the nation formulate specific policies and regulations for rare diseases,and then clear the official definition standards of rare diseases,establish relevant policies to encourage pharmaceutical companies to develop rare diseases drugs.     

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??OBJECTIVE To synthesize 5-substituted indole-3-deoxypodophyllotoxin derivatives and study their antitumor activity. METHODS The target compounds were synthesized through a series of reactions and their anti-tumor activity in vitro were evaluated against Hela, K562 and K562/A02 cell lines by MTT as assay. RESULTS Ten target compounds were synthesized and confirmed by ¹H-NMR, ¹³C-NMR, and HR-ESI-MS. All the target compounds had different degrees of cytotoxic activity in vitro. Most of the compounds had significant anti-MDR activity in vitro. CONCLUSION 5-Substituted indole-3-deoxypodophyllotoxin derivatives have good antitumor activity and worth of further study.     

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??OBJECTIVE To determine the effects of saxagliptin and exenatide on humerus cancellous bone of diabetes-induced osteopenia rats by histomorphometry. METHODS Thirty-five Cases of female SD rats were randomly divided into normal group (N group, n=7), control group (C group, n=7), and the remaining rats were used to establish the type 2 diabetic model by combination of high-fat&sugar-diet feeding for 4 weeks and then low-dose streptozotocin injection(STZ, 30 mg??kg^-1) . After 10 d, the oral glucose tolerance test and the fasting blood glucose were measured, rats with high OGTT(2 h) above 11.1 mmol??L^-1 and high FBG above 16.7 mmol??L^-1 were divided into model group (M group, n=5), saxagliptin group (G group, n=5) and exenatide group (D group, n=6), and continuously treated for 30 d. The left humerus (proximal humeru metaphometry, PHM) were fixed with 4% paraformaldehyde for 48 h, uncalcified embedded in methyl methacrylate after dehydrated and cleared, and sections were taken for bone histomorphometry after Masson-Goldner Trichrome stained. RESULTS In PHM, there was no statistical significance between N and C group, the trabecular bone area ratio( BV/TV) and trabecular quantity were significantly decreased (P??0.01) in M group, while the trabecular separation degree was increased, comparing with those in C group (P??0.01), and the trabecular bone area ratio( BV/TV) and trabecular quantity in G and D group were higher (P??0.01) than those of model rats, while the trabecular separation degree was decreased, comparing with those in M group (P??0.01). Cell parameters showed no statistical significance between N and C group, the osteocllast number and percentage of osteocllast surface perimeter were significantly reduced(P??0.05, P??0.01) in M group, while the osteoclast number and percent osteocllast surface perimeter were significantly increased (P??0.01) as compared with those in C group, saxagliptin and exenatide were found to significantly induce osteocllast number (P??0.01) and percentage of osteoblast surface perimeter (G group P??0.05, D group P??0.01), while reduce osteoclast number (P??0.01) and percent osteoblast surface perimeter (P??0.05) compared with M group. In growth-plate, there was no statistical significance between N and C group, the thickness of growth-plate and the diameter of the mast cells were reduced in M groups (P??0.01), while the thickness of growth-plate (P??0.01) and the diameter of the mast cells (P??0.05) were increased in G and D group,compared with M group. CONCLUSION Therapeutic effects of saxagliptin and exenatide on diabetes -induced osteopenia rats was showed, and the mechanism may be related to the improved growth rate of growth-plate and the changed bone turnover status.     

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??OBJECTIVE To determine simultaneously the contents of xanthotoxin,bergaptol, and bergapten in cultivated Changium smyrnioides Wollf and its in vitro cultures by HPLC.METHODS Agilent-C₁₈ column (4.6 mm??250 mm,5 ??m) was used for chromatographic separation and PAD was applied as detector. The flow rate was 1.0 mL??min^-1with a mobile phase of methanol-water in gradient elution mode. The detection wavelength was set at 314 nm while the injection volume was 10 ??L.RESULTS The linear regression equations of xanthotoxin, bergaptol, and bergapten were Y=17 057??-87.689 (r=1.000 0), Y=23 828??-380.44 (r=0.999 9) and Y=37 123??-441.16(r=0.999 9), respectively. The contents of xanthotoxin and bergapten in cultivated and regenerated specimens were obviously higher than those in calli and suspension cells, while bergaptol was only detected in the latter two samples. A larger amount of furanocoumarins accumulated in the cells from leaves and petioles. CONCLUSION The established method is simple and effective with high sensitivity and good repeatability. It can be adopted in studies on the utilization of Changium smyrnioides, especially the regulation and induction of furanocoumarins.     

基于向量自回归模型对我国中药材价格波动影响因素的探讨

该文以向量自回归(VAR)模型为基础,运用在此基础上的格兰杰因果检验、方差分解和脉冲响应分析等技术,综合考察了种植成本、种植面积、自然灾害、居民需求、通货膨胀对我国中药材价格的影响。研究发现,种植成本和通货膨胀与中药材价格之间存在着格兰杰因果关系,在对中药材及中成药价格指数分析的总方差中,中药材价格对本身的波动冲击和贡献率最大,其次是种植成本与通货膨胀。     

构建中医肝病新药临床试验研究技术平台探索

通过中医肝病临床新药伦理委员会、实验方法学、疗效评价、数据管理等技术平台的建设,及相关技术平台的建设,构建符合中医肝病疗效特点的新药临床评价方法和指标体系,从而搭建符合国际GCP 规范的中医肝病新药临床试验技术平台。     

A Review of Quality Assessment and Grading for Agarwood

Agarwood is an important non-timber forest product widely used in religious and cultural activities as perfume and fragrance and as traditional medicine in Asia. The high value of agarwood and the inflated consuming market have led to constant rising of the prices. In general, the price of the agarwood is determined according to its quality, which can be divided into different grades. But up to now, there is not any standard quality grading system which could be used overwhelmingly throughout the agarwood producing, commerce and consumption. Therefore, we reviewed agarwood in diversified grading indexes, systems and methods.     

脾阳虚证动物模型造模方法与模型评价的研究进展

本文通过回顾脾阳虚证模型的造模方法,将其分为模拟传统中医病因的造模方法和现代医学造模方法。目前尚无公认的脾阳虚证造模方法,且主要存在以下问题：现代医学造模方法不符合中医病因病机的规律;模型动物的阳虚症状评价不确切;某些造模方法同时可致其他病症;脾虚证模型的名称混乱不统一;脾阳虚证和脾气虚证的造模方法难以区别等。脾阳虚证模型的评价指标种类繁多,但国内尚未形成标准的模型评价体系。目前,模型评价主要存在以下不规范之处：模型动物的宏观症状缺乏客观量化的评价指标;缺乏中医特色的舌象、脉象;反证方剂的选择不统一;相似的证候未排除;微观指标混乱不成体系等。本文将就脾阳虚证动物模型作一综述。     

近十年清热解毒类方剂干预冠心病临床研究疗效评价指标概况＊

目的 了解清热解毒类方剂干预冠心病临床研究疗效评价指标概况，为设计清热解毒类方干预冠心病的临床研究方案提供借鉴。方法 系统检索近十年国内外主要期刊数据库发表的清热解毒类方剂干预冠心病的临床研究文献，归纳、汇总疗效评价指标。结果 共纳入清热解毒类方剂干预冠心病热相关证临床研究文献53篇，主要包括中医证候计分和症状疗效评价、理化指标（炎症相关指标、脂质代谢指标、血管内皮功能指标、凝血功能指标、血液流变学指标等）、心绞痛评价指标（西雅图心绞痛量表、心绞痛发作次数、持续时间、疼痛程度等）、心脏功能指标（射血分数、每搏量、每分钟心排血量、舒张早期值流速等）、心电图疗效、不良反应等。结论 近十年清热解毒类方剂干预冠心病热相关证理化指标以炎症因子为主，兼具脂质代谢指标、凝血功能指标、血液流变学等指标。     

病证结合模式下慢性阻塞性肺疾病疗效指标体系的构建

目的：探讨病证结合模式下慢性阻塞性肺疾病（COPD）疗效指标体系的构建。方法：基于COPD的疗效评价指标体系研究现况,提出病证结合模式下的COPD疗效评价指标体系,并对该框架下目前常用的评价指标进行了分析。结果：COPD疗效评价指标体系的框架应包括：医护人员注重的指标,患者注重的指标,实验室指标,中医证候相关指标或中医疗效优势的指标等四部分。结论：病证结合模式下的COPD疗效评价指标体系的提出对,临床治疗和评价有一定的指导意义。     

止咳中成药的品种特点研究

目的：揭示止咳中成药的品种特点,为新止咳中成药的开发立项提供参考。方法：以《中华人民共和国药典》和《新编国家中成药》中收载的具有国家标准中成药为对象,收录在功能、主治中出现“止 咳”、“镇咳”、“止嗽”、“咳嗽”、“久咳”等关键字的中成药,开展“止咳中成药的数目、批准文号、民族药品种、儿童用药品种、国家中药保护品种、药味数”的情况统计,分析通用名称和剂型特点。结果：收录止咳中成药684 个,占7 260 个中成药总数的8.60%;共获得7 450 个批准文号,约33%的中成药仅有1 个批准文号,平均每个中成药拥有16.6 个批准文号;民族药品种有藏族验方十五味沉香丸等3 种,蒙古族验方四味土木香散等4 种;儿童用品种数占止咳中成药的14%,涉及9 种剂型;药品通用名称的命名类型多达16种,其中以处方中主要药材缩写来命名者最为常见;处方药味数多为8 味左右,在16 味以内;涉及16 种剂型,其中固体制剂的使用比例大于液体制剂者。结论：止咳中成药具有品种丰富、剂型多样、药味数合理、零售市场份额高和儿童用品种可满足临床需要等特点,存在通用名称不规范、同质化竞争激烈、民族药品种少等问题。     

吐鲁番出土药价残片探微

以吐鲁番出土原卷图片文献资料为依据,运用文献考证与历史比较的方法对其药价部分予以考察后发现：吐鲁番药价残片反映了唐代天宝年间部分药材的市场价格,如果以常用生活必需品白面作为参照物进行比较,则当时的药价普遍比白面的价格高,常用药品的价格与今天相比则差别不大,但部分珍稀药材的古今价格相差极大。     

天津市国医堂运行情况评价指标体系的方法学研究

[目的]了解天津市社区国医堂运行情况。[方法]通过文献研究、小组讨论、专家咨询等方式确定国医堂运行评价指标从而构建评价指标体系;通过文献研究、核心小组讨论等方式确定运用层次分析法评价国医堂运行情况,确定运用专家咨询法确定各指标的重要程度赋值,初步了解目前国医堂运行情况。[结果]构建了国医堂运行评价指标体系,将指标体系分成3个准则层,10个次准则层,23个指标层。通过对国医堂内管理人员、患者、医护人员分别进行国医堂运行情况问卷调研后得出天津市国医堂总体指数良好,初步达到天津市卫生局"三方向"、"三目的"的要求,但"两升两降"的目标尚不明显。[结论]天津市国医堂运行评价指标体系是比较合理的,并且目前运行情况基本良好。     

市场经济下院内中药制剂的地位及制度障碍

院内中药制剂是中医临床的中坚力量,是传承中医药的载体和中医药特色学科建设重要支撑,更是中医药实现价值的现代手段。现行相关法规对院内中药制剂的定位不准确,监管不合理,定价制度不能体现其内在价值,制约了院内中药制剂的发展。