中药寒热药性及其毒副作用研究现状

中药寒、热、温、凉四气理论是中药药性理论的重要组成部分,目前相关研究多集中在寒热药性两方面。中药的寒热药性既是治疗疾病的要素,也是导致不良反应的因素。本文通过对中药寒热药性所致毒副作用研究的分析,有针对性地提出了中药所具有的寒热药性偏胜所致毒副作用的防控措施,指出控制中药寒热药性所致毒副作用的重要意义在于促进中药的现代化和国际化。     

三氧化二砷对人体胃肠癌细胞凋亡及p53、survivin表达的影响

目的研究三氧化二砷（arsenic trioxide,As2O3）在人体内诱导胃肠癌细胞凋亡作用及对凋亡相关基因p53、survivin表达的影响,探讨其抗肿瘤作用及发生机制。方法采用原位末端转移酶标记技术（TUNEL）和免疫组化法分别检测As2O3用药前后胃肠癌细胞凋亡指数和凋亡相关基因蛋白P53、Survivin的表达变化情况。结果 As2O3用药后胃肠癌细胞凋亡指数为（17.04±3.67）%,与用药前（6.07±2.21）%相比差异有统计学意义（P〈0.01）;用药后胃肠癌细胞P53蛋白阳性表达率为（35.05±19.64）%,与用药前（34.80±16.48）%相比差异无统计学意义（P〉0.05）;用药后胃肠癌细胞Survivin蛋白阳性表达率为（15.59±3.94）%,与用药前（36.74±20.5）%相比明显下调,差异有统计学意义（P〈0.01）;As2O3作用后胃肠癌细胞Survivin蛋白表达下调时凋亡率升高,二者之间具有相关性（r=-0.47,P=0.04）。结论 As2O3在人体内可诱导胃肠癌细胞凋亡而发挥抗肿瘤作用,其机制可能与下调survivin基因的表达有关。     

The Extraarticular Symptoms Influence ACR Response in the Treatment of Rheumatoid Arthritis with Biomedicine: A Single-blind,Randomized,Controlled,Multicenter Trial in 194 patients

Objective: The extraarticular symptoms are important in the pattern differentiation of traditional Chinese medicine (TCM), and the present study is designed in an attempt to find the associations between the extraarticular symptoms and American College of Rheumatology (ACR) Response in 194 cases of rheumatoid arthritis (RA) treated with biomedicine. Methods: The data were obtained from a randomized clinical trial. One hundred ninety-four RA patients were treated with the biomedical therapy (diclofenec, methotrexate and sulfasalazine). ACR20 response in 24 weeks was used for the efficacy evaluation. Eighteen symptoms (including 13 extraarticular symptoms) that TCM practitioners focus on were collected for exploration on the association between the symptoms and the efficacy of the biomedical therapy with association rules method. Results: After 24 weeks, a total of 135 patients receiving biomedicine had achieved an ACR20 response. The association rules analysis on each symptom showed that soreness in the waist was more associated with ACR20 response, but with lower support (selected sample size based, 20.10% and 14.95% respectively); cold intolerance and cold joint were found to be associated with ACR20 response with higher support (48.97% and 53.61% respectively), and the confidences (predicted effective rate) were 73.08% and 71.23% respectively. The associations between combination of symptoms (among them, there was at least one extraarticular symptom) and ACR20 response indicated that cold intolerance or cold joint with higher confidence and support were the most important extraarticular symptoms. Conclusion: The RA patients with "cold intolerance" and "cold joints", which are the extraarticular symptoms that TCM practitioners focus on, may show higher ACR20 response when treated with the biomedical approach.     

Evidence-based Chinese Medicine for Rheumatoid Arthritis

Chinese medicine (CM) has long been adopted for treatment of rheumatoid arthritis (RA). CM approaches RA as it does for other diseases by holistic treatment, focusing on the whole body condition, and giving a variety of applications in accordance with the stage and symptoms of the disease. For seeking the best evidence of CM in making decisions for the care of RA individual patients, a number of clinical studies have been conducted in China to gain credibility with the researchers’ unremitting efforts. But the heterogeneity in many of these clinical trials and the low quality of design in some previous studies present an obstacle to the meaningful systematic reviews (SR) and meta-analysis. Some favorable results in improvement of response to biomedicine and reduction of severe adverse reactions of conventional RA therapy should be carefully interpreted and need further research. Fortunately, more appropriate quality assurance and control of CM researches are raised for the implementation of CM in RA therapy to pave the evidence-based way. Guidelines for the diagnosis and treatment of RA recommend evidence to the clinicians. In future, randomized controlled trials (RCT) with smart and flexible design as a good approach to evaluate the effectiveness will be widely used in CM for RA clinical study, with better research methods suitable for certain CM clinical researches. The development of evidence-based CM for RA will be full of challenge and opportunity, but we have full confidence.     

基于文本挖掘技术的肥胖和高脂血症处方规律研究

目的:利用数据挖掘技术探索肥胖和高脂血症的中药用药规律。方法:在中国生物医学文献数据库中收集中医药治疗"肥胖"和"高脂血症"的文献,建立Access数据库,运用SQL对数据进行处理,Cytoscape 2.7软件对数据分析结果进行可视化,分析中医药治疗肥胖和高脂血症的用药规律。结果:治疗肥胖的常用药物为丹参、山楂、泽泻、黄芪、大黄、茯苓、白术、半夏;其治疗的核心药物是黄芪、白术、大黄。治疗高脂血症的最常用药物为丹参、山楂、泽泻、黄芪、大黄、何首乌;其治疗的核心药物是丹参和山楂。结论:中医治疗肥胖和高脂血症的处方虽有相同之处,但是其治疗的核心却大不相同。文本挖掘分析技术在中医临床用药规律研究中具有良好的应用前景。     

芍药苷对KCl诱导原代培养大鼠皮层神经元损伤的保护作用

目的 观察芍药苷对KCl诱导原代培养大鼠皮层神经元损伤的保护作用.方法 采用细胞培养方法,以出生24h内大鼠大脑皮层神经元为材料,利用KCl复制神经元损伤模型,测定细胞活性、乳酸脱氢酶(LDH)活力、丙二醛(MDA)含量,超氧化物歧化酶(SOD)活性.结果 芍药苷能够显著提高损伤模型中神经细胞的活性,降低损伤模型中MDA含量和LDH活力,提高SOD的活性,与模型对照组比较差异有显著性.结论 芍药苷对KCl所诱导的大鼠皮层神经元损伤具有保护作用.     

麻杏石甘汤防治甲型H1N1流感分子机制的生物信息学分析

目的: 通过构建分子网络及解析生物学通路,探讨麻杏石甘汤防治甲型H1N1流感的分子机制。 方法: 查找麻杏石甘汤中药成分的有效化合物,在PubChem数据库中检索有效成分的靶蛋白,在Gene数据库中查找甲型H1N1流感的相关基因,运用Ingenuity Pathway Analysis (IPA)软件对二者进行构图和解析。 结果: 查找到麻杏石甘汤的靶蛋白186个,甲型H1N1流感相关基因7个。二者的分子网络复杂,生物功能多样,在共同作用的8条生物通路中,有4条通路为细胞免疫相关通路:病毒模式识别受体信号通路、巨噬细胞白介素12(IL-12)信号和生产通路、蛋白激酶(PKR)在干扰素诱导的抗病毒反应中作用通路、肿瘤坏死因子受体I (TNFR1)信号通路。麻杏石甘汤可以调节细胞免疫相关通路中的Toll样受体9(TLR9)、磷脂酰肌醇3-激酶(PI3K)、核苷酸结合的寡聚结构域2受体(NOD2)等多个位点。 结论: 麻杏石甘汤可以通过干预细胞免疫相关通路中的多个位点起到防治甲型H1N1流感的作用。     

丹参与三七配伍协同分子机制的系统分析

目的：应用系统生物学方法计算机模拟分析丹参与三七配伍协同的分子机制。方法：采用TCMGeneDIT数据库系统,文本挖掘丹参、三七各自所能影响的基因或蛋白质数据;从多个分子相互作用数据库以及文献中查询与这些基因或蛋白质相互作用蛋白质的信息,构建丹参、三七及其配伍后的蛋白质相互作用网络,以Cytoscape软件进行可视化;应用Merge程序比较3个网络的异同;采用IPCA软件分析网络中的高连接区,BiNGO计算机工具进行基因本位论的聚类分析。结果：21个蛋白质与三七和41个与丹参相关,其中9个相同,去除冗余有53个基因应与两药配伍后药理机制相关;构建的3个网络均由数百上千个蛋白质参与组成;丹参、三七相关网络相同蛋白质构成的子网络明显多于直接用重叠基因相互作用信息建立的网络（651:572）,模拟配伍后网络与三七、丹参相关网络比较,出现了一个由480新蛋白质相互作用构成的子网络;在丹参、三七相关网络相同蛋白质构成的子网络中,存在4高连接区,基因本位论注释均主要与凋亡、增殖的细胞进程有关,模拟配伍后出现的新子网络功能主要与小G蛋白信号转导通路有关。结论：本研究方法可以更全面模拟药物作用机制,且能模拟分析系统的涌现性;丹参和三七配伍可能主要在凋亡、增殖等以及小G蛋白信号转导通路上发挥协同作用而有效治疗冠心病。     

丁樱教授运用藤类药物治疗紫癜性肾炎的经验

过敏性紫癜性肾炎是儿童时期最常见的继发性肾小球疾病,近年来呈相对增多趋势。丁樱教授从事小儿肾脏病研究30余年,认为本病实为络病,善用藤类药物;概括本病病机为热、瘀、虚三个方面,辨证加用祛风清热、活血化瘀、养血补虚等藤类药物,每获良效。     

非梗阻性原发无精与少精症男性DAZ基因突变研究

目的:探讨DAZ基因突变对男性生殖的影响及表型特征。方法:筛选无明显诱因的男性非梗阻性无精及少精患者,首先排除染色体核型异常病例,进一步在AZFa、AZFb、AZFc和AZFd区域均匀选择缺失高发位点排除缺失,设130例正常男性与10例女性做对照,对DAZ1～4基因进行突变性研究。包括DAZ1～4共缺失性研究和基因内点突变研究。选择同时存在于DAZ1～4基因内部的STS位点sY587,结合其PCR扩增产物中DraI酶切位点的差异判断DAZ1～4共缺失情况;选择DAZ1～4高度同源保守的1～6外显子、接头以及上下游调控区域,采用PCR-SSCP、限制性酶切(RFLP)、PCR产物测序以及特异性基因型nest相结合方法对外显子进行突变检测;设sY14(SRY)基因作为阳性内参照。结果:经筛选得到80例先天非梗阻性无精与20例少精病例,所有患者及男性对照sY14(SRY)检测均为阳性,女性对照均为阴性;共发现16例DAZ共缺失患者,发生频率为20%;无精患者11例,DAZ1～4共缺失及DAZ1/DAZ2共缺失分别为1例和10例;少精患者5例,DAZ1～4共缺失及DAZ1/DAZ2共缺失分别为2例和3例;分别在3个不同患者的DAZ1的第2、4内含子发现3个变异位点,DAZ基因的调控序列、外显子及接头处未发现突变,而在130例正常对照中未见缺失及变异发生。结论:DAZ基因缺失是引起男性生殖异常的主要原因;共缺失的部位及长度与表型的严重程度未见相关性;基因组比较确定DAZ1第2内含子第64碱基处发杂合变异G→A为新的变异,是否是新的SNP位点、是否能够造成无精或少精需要进一步研究证实;DAZ基因突变发生情况也有待进一步探讨。