Khat in the Horn of Africa: Historical perspectives and current trends

Aim of the study

This article looks at the history of the expansion of khat consumption from the traditional chew regions to Western countries and assesses the implication of possible international control for its use and trade in the Horn of Africa.

Materials and methods

Ten months of initial field work in Ethiopia, three follow up field work, archival work in Ethiopia and Europe, as well as study of available relevant literature.

Results

The debut of khat in the West in the 1980s was initially greeted with disdain and indifference. Authorities dismissed it on grounds that the mode of consumption, chewing the leaves for an extended period of time to extract a miniscule amount of the active ingredient, would not be appealing to Western users. Following the Mogadishu debacle of 1993, as depicted in the movie Black Hawk Down, authorities in the West began to express concern that khat was a new drug of abuse. Its trade was increasingly linked with terrorism because of its association with immigrants from the traditional khat use countries in the Horn of Africa and the Arabian Peninsula. Amid hysteria and moral panic, many Western countries classified khat as a highly potent controlled substance, rendering its possession, cultivation, and trade illegal.

Conclusion

This article argues that more and more Western governments, out of panic rather than definitive evidence of harm, will be instituting national laws banning the leaves, but khat will not be placed under international control because the scientific evidence of harm is unlikely to rise to a critical mass that would justify its illegalization. States in the source countries would continue to tolerate khat because banning it would be disastrous from an economic and social welfare standpoint. Because of its ambiguous legal position and the unstable nature of its active ingredient, cathinone, khat would not be successfully commoditized as a global commodity or transformed into a highly concentrated illicit drug. In this situation, khat would continue to be chewed in the traditional-use areas of the Red Sea littoral marketed by local syndicates who work with a large network of petty commodity traders.     

国外传统医学管理模式探讨

传统医学以其在疾病治疗及预防保健中的确切功效,在世界范围内得到越来越广泛的应用。各国政府在接受并认可传统医学的同时,也加强了对包括中医药在内的传统医学的监管。本文分析了世界各国对于传统医学及补充替代医学的主要管理模式,概括为独立立法管理模式、纳入补充替代医学综合立法管理模式及民间行业协会自律管理模式,并对存在问题及发展前景进行了分析与探索。     

金铁锁活性成分基因调控网络及其产物评价研究进展

对西南特有植物金铁锁的活性成分基因调控网络及其产物评价的研究进展进行了综述,为金铁锁植物代谢途径生物工程的应用,研究和开发提供一定的理论依据。     

不同穴位对胃运动异常大鼠双相调节效应研究

目的:探讨不同穴位对胃运动异常大鼠的双相调节效应以及产生这种效应的神经机制。方法:采用神经电生理学方法,用微电极细胞外记录大鼠孤束核单个神经元的活动,观察在正常生理状态及胃运动增强和胃运动抑制的病理状态下,分别针刺"足三里""内关""中脘""气海"对孤束核神经元放电及胃内压的影响。结果:在正常生理状态及胃运动增强和胃运动抑制的病理状态下,针刺"足三里""内关"均以促进胃运动为主,而针刺"中脘""气海"均以抑制胃运动为主,且针刺以上不同穴位均有效激活了孤束核神经元放电。结论:穴位的双相调节作用并不一定是同一穴位对不同病理状态下的内脏器官有双相调节效应,可能表现为不同穴位的综合作用是纠正机体机能活动向正常平衡与稳态状态方向的良性调节。     

益母草对小鼠子宫平滑肌双向调节作用研究

目的：观察益母草提取物对小鼠离体子宫平滑肌的调节作用及对子宫平滑肌细胞胞浆中Ca^2＋含量的影响,探讨其作用机制。方法：按文献方法提取益母草中的水溶性生物碱、脂溶性生物碱、总黄酮和多糖,利用生物信号采集处理系统和恒温平滑肌槽,采用离体子宫实验法观察益母草提取物对小鼠离体子宫平滑肌的影响,记录给药前后小鼠子宫收缩频率、张力及峰面积;采用重量法测定小鼠子宫重量系数,采用甲基百里香酚蓝比色法测定小鼠子宫平滑肌细胞胞浆中Ca^2＋含量。结果：益母草水溶性生物碱、总黄酮对小鼠离体子宫有兴奋作用,其张力和峰面积均较给药前显著增加（P〈0．001）,差异具有统计学意义;益母草脂溶性生物碱对离体子宫有抑制作用,其张力和峰面积较治疗前显著降低（P分别〈0．001、0．01）,差异具有统计学意义。益母草水溶性生物碱和总黄酮能增加小鼠子宫平滑肌细胞胞浆Ca^2＋含量,与空白对照组比较差异具有统计学差异（P〈0．05）。结论：益母草水溶性生物碱和总黄酮对离体子宫有兴奋作用,其作用机制与增加子宫平滑肌细胞胞浆Ca^2＋含量有关,而脂溶性生物碱对离体子宫有一定的抑制作用。     

品管圈活动在提高药物咨询患者追踪成功率中的应用

目的:分析品管圈在提高药物咨询患者追踪成功率的作用和效果,以提高药师对药物咨询患者追踪效果,保障患者用药安全、可追溯。方法:按照品管圈(Quality Control Circle,QCC)10个步骤,主题选定、活动计划拟定、现状把握、目标设定、目标解析、拟定对策、对策实施、效果确认、标准化、检讨与改进。调查药师对药物咨询患者追踪的现状,查找影响追踪的原因,并实施对策进行干预,对干预前后的数据进行分析比较。结果:通过为期5个月的实践,药师对药物咨询患者的追踪成功率由活动前的43.7%(166/380)升至活动后的74.5%(260/349),进步率达70.5%,效果显著。结论:应用品管圈管理法,可提高药物咨询患者的追踪成功率,对促进合理用药、保障服务质量切实有益,可进一步推广应用。     

如何避免或减轻中药在肝病治疗中的毒副反应

文章就如何正确认识中药在肝病治疗过程中的毒副反应等进行了探讨 ,指出应全面了解中药的特性 ,强调辨证论治 ,选择适当的药物剂量 ,注重药物的炮制。     

Commentary: “A systems view on the future of medicine: Inspiration from Chinese medicine?”

Chinese medicine could serve as a source of inspiration for drug development. Using systems biology in combination with reverse pharmacology is a novel way for the discovery of novel biological active compounds and targets as well as for proving the occurrence of synergy and prodrugs. A key factor for coming to evidence-based Chinese medicine will be the quality control. Metabolomics is a very promising tool for this purpose.     

Effect of electro-acupuncture on relapse to heroin-seeking in the heroin self-administrating rats

To observe the effect of electro-acupuncture on the relapse to heroin-seeking induced by heroin-related cues after withdrawal from heroin self-administration in rats.MethodsSixty male Wistar rats were randomized into physiological saline group,withdrawal group A,withdrawal group B,electro-acupuncture(EA)treatment group A and EA treatment group B,with 12 rats in each group.The rats were trained by nose-poke response to self administer heroin (50 μg/kg/per infusion) or saline with one daily 4-h session for 14 consecutive days,the session ended after 25 infusions were eamed or 4 hours had passed,the reinforcement schedule was a progressive ratio.Then rats in withdrawal group A and withdrawal group B were withdrawn from heroin for 1 week and 2 weeks respectively,and then they were reintroduced to their training chambers for 4-h relapse testing which was induced by heroin-related environmental cues;And rats in EA treatment group A and EA treatment group B were also withdrawn from heroin for 1 week and 2 weeks respectively,during which they were given EA treatment for 20 min daily,then they received relapse testing;In the meantime,rats in saline group were trained with saline instead of heroin for 14 days as control.after 7 days of withdrawal from saline,they received relapse testing.ResultsFollowing 7-8 days of drug training,the rats began to establish the stable intravenous heroin self-administration behavior;For the stable heroin self-administrating rats that received EA treatment,when they were reintroduced to their training chambers,their heroin-seeking behaviors were obviously inhibited,and this inhibitory effect related to the cumulativeness of EA stimulation.ConclusionThe results suggested that EA could prevent relapse to heroin-seeking to a certain extent.     

肝郁脾虚证大鼠双侧杏仁核注射CNQX后行为变化及逍遥散的调节作用

目的:从行为学角度探讨逍遥散治疗肝郁脾虚证的调节机制。方法:75只雄性SD大鼠随机等分为5组,正常组、模型组、假手术组、6-氰基-7-硝基喹喔啉-2,3-二酮(CNQX)组和逍遥散组。以21d慢性束缚应激方法造肝郁脾虚证模型组,在此基础上,运用脑立体定位仪埋管微量注射α-氨基羟甲基恶唑丙酸(AMPA)受体的拮抗剂造CNQX组,为评估手术创伤对模型的影响程度加造假手术组。逍遥散组造模方法和CNQX组相似,突出逍遥散和CNQX二者干预的可比性,于第1、7、14、21天分别比较CNQX组和逍遥散组行为变化各项指标趋势是否一致。结果:模型组大鼠逐步呈现肝郁脾虚证表现;CNQX组起到干预治疗作用,大鼠焦躁状态得到抑制;逍遥散组大鼠表现自然,逍遥散起到较好的调节作用。排除了手术创伤等混杂因子,逍遥散组和CNQX组行为学实验结果变化趋势逐步相似。结论:结合前期RT-PCR和免疫组化实验,从宏观行为学角度,进一步推断逍遥散和CNQX有一条相似作用通路,即通过纠正杏仁核和海马的"兴奋-抑制"失衡,重建稳态,来治疗肝郁脾虚证。     

补肾增效液对辐射损伤小鼠脾组织p53 mRNA及Caspase-3蛋白表达的影响

目的:研究以补肾填精为主的补肾增效液对辐射损伤小鼠p53 mRNA及Caspase-3蛋白表达的影响。方法:设正常对照组、模型组、中药高、中、低剂量组和阳性药组,共灌胃8天。灌胃7天后,除正常对照组外,其余各组以~(60)Coγ射线照射小鼠造成辐射损伤。造模1天后取脾检测。p53 mRNA表达的检测采用原位杂交法;Caspase-3蛋白表达检测采用免疫组化法。结果:运用病理图像分析系统分析,各用药组均能上调辐射后小鼠脾组织p53 mRNA的表达,且与模型组比较,差异具有非常统计学意义(P<0.01);各用药组能下调Caspase-3蛋白表达,其中,阳性药组、高剂量组和中剂量组与模型组比较,差异具有非常统计学意义(P<0.01)。结论:补肾增效液通过调控与DNA损伤密切相关的p53基因及相关Caspase-3蛋白的表达而促进辐射损伤的修复。     

Receptor screening technologies in the evaluation of Amazonian ethnomedicines with potential applications to cognitive deficits

Ethnopharmacological relevance

Amazonian peoples utilize a variety of psychoactive plants that may contain novel biologically active compounds. Efforts to investigate such remedies in terms of neuropharmacology have been limited.

Aim of this study

This study identified Amazonian ethnomedicines with potential for the treatment of cognitive deficits in schizophrenia and dementias, and characterized their interactions with CNS neurotransmitter receptors in vitro.

Materials and methods

Approximately 300 Amazonian species with folk uses or constituents indicative of central nervous system activity were incorporated into a database constructed from literature searches, herbarium surveys, and interviews with traditional practitioners. Approximately 130 of these targeted species were collected in Loreto province, Peru, and 228 fractions derived from them were screened in 31 radioreceptor assays via the resources of the NIMH Psychoactive Drug Screening Program. A subset was also screened in functional assays at selected serotonin, muscarinic, and adrenergic receptors.

Results

Ninety-one samples displayed ≥60% inhibition of radioligand binding activity in receptor assays; 135 samples displayed agonist or antagonist activity (or both) in functional assays.

Conclusions

Potential CNS activity was detected in about 40% of the samples screened, with some correlations to both folk uses and phytochemical constituents. These results may point to novel and potentially therapeutic CNS active compounds.     

面对全民皆医保医院将如何发展

医保机构、医院、病人处于同一个医疗保险与服务运行系统当中。医保对医院的影响主要体现在医保为医院提供了新的发展机遇、医保有利于医院经营管理规范化、医疗保险给医院带来挑战。医疗机构应确立医保组织管理、确立培训机制,落实医保政策、重视各环节的管理确立新的奖惩机制、完善规章制度谋求医院与医保的协调发展。     

谈针灸临床中如何寻找反应点

该文根据临床上针灸医生选用反应点治疗疾病的案例,将寻找反应点的方法分为在患病部位附近寻找反应点、按经络循行上下寻找反应点、按气街理论前后寻找反应点、按全息理论寻找反应点、按肌肉走行寻找反应点、按对称的方法寻找反应点等,认为反应点选穴法是针灸临床中常用且有效的方法。     

如何保持中医盲法临床试验的盲态

盲法是临床试验中控制和避免测量偏倚的重要手段。中医临床试验中,由于中药的独特性,盲法实施的质量尤为重要。临床试验中实施盲法的质量直接影响到研究结果的准确性。本文从盲法实施过程出发,对影响盲法实施质量的关键环节进行深入探讨和分析,并给出相应的措施和实施原则,以期为中医药临床试验中的盲法实施提供借鉴。     

浅析外泌体参与针刺调节作用的特点分析

针灸作为一种物理刺激,在穴位局部被感知并转化传递到病变部位发挥效应的过程是复杂的.直至目前针灸的起效机制尚未完全阐明.外泌体作为细胞间通讯的新方式,前期研究发现针灸可以调控外泌体的释放,外泌体与针效之间关系密切,发现外泌体可能在针刺信息传递过程中发挥重要作用,是针刺信息传递的重要途径.外泌体具有分布广、来源广、运载物质...     

WHO国际植物药监管合作组织(IRCH)第二工作组章程介绍

国际植物药监管合作组织是由WHO与多国政府发起成立的国际性合作组织,致力于通过完善植物药监管规章,保护并促进公众健康与安全。我国为该组织下属第二工作组(WG2:Quality control of herbal materials and products(including reference standards)的主席国,针对植物药对照物质开展合作和交流,以加强植物药及其制剂的质量控制,保障用药安全有效。本文对作者起草的WHO国际植物药监管合作组织(IRCH)第二工作组章程的英文全文加以介绍,以期为相关国际交流和合作工作提供参考。     

How to achieve deep remission in the treatment of inflammatory bowel disease

Objective

This article investigates the methods of achieving deep remission of inflammatory bowel disease (IBD).

Methods

Increasing recognition of the concept of quality of care is contributing to the evolution of treatment goals in patients with IBD from clinical response and remission (symptom control) toward deep remission. A change in the treatment goal requires a change in the treatment strategy. Optimization of conventional therapy, early treatment, use of the Lemann score, performance of double-balloon endoscopy, treatment using Traditional Chinese Medicine, and good communication between physicians and patients are needed to attain deep remission.

Results

The above-mentioned methods can help to achieve deep remission.

Conclusion

Using the above methods, it will be possible to improve the prognoses of patients with IBD by minimizing complications and bowel damage and thereby changing the course of the disease.     

舒肝汤联合护肝片治疗药物性肝炎随机对照临床观察

[目的]探讨中药治疗药物性肝炎的临床疗效,并与西医护肝药治疗进行分析对比。[方法]回顾性分析我院2009年6月至2012年6月间收治的药物性肝炎患者80例,将其随机分为治疗组和对照组,每组40例。两组患者在治疗期间均停用以前用过的对肝脏有影响的药物。对照组口服护肝片,对照组在治疗组的基础上加服舒肝汤(药用柴胡、连翘、赤芍、红花、板兰根)。治疗4周后观察临床疗效与肝功能变化。[结果]治疗组治愈25例,显效10例,有效3例,无效2例,总有效率95.00%;对照组治愈17例,显效5例,有效2例,无效16例,总有效率60.00%。治疗组临床疗效优于对照组(P<0.05)。[结论]舒肝汤联合护肝片治疗药物性肝炎疗效显著,值得临床推广应用。