基于大黄不同炮制方法和煎煮时间治疗慢性肾衰竭患者的理论探讨

中药大黄在慢性肾衰竭（CRF）患者的治疗中发挥着重要的作用,能有效延缓肾脏病的进展。通过讨论大黄通腑降浊在慢性肾衰竭的运用,探讨大黄治疗CRF的作用机制,大黄不同炮制方法和煎煮时间对有效成分及功效的影响,名老中医使用大黄治疗CRF的经验,大黄对CRF肾小球硬化信号通路的影响。生大黄、熟大黄、酒大黄、大黄炭哪一种是治疗CRF的最佳药物;不同炮制方法和煎煮时间对大黄有效成分的影响;煎煮多长时间才能发挥最大疗效;大黄治疗CRF的作用机制。现研究大黄不同炮制品不同煎煮时间有效成分的变化规律和大黄不同炮制品不同煎煮时间对CRF大鼠转化生长因子-β1/P13K/Akt信号旁路的影响,为大黄的临床应用提供理论依据。     

中国成年居民就餐行为及其与肥胖的关系

目的 了解中国成年居民就餐行为及其与肥胖的关系。方法 利用2013年中国慢性病及其危险因素监测数据,经过数据清理,本研究共纳入171 040名调查对象。采用复杂抽样设计的Rao-Scott χ²检验比较不同特征调查对象的就餐行为及肥胖率的差异。以是否肥胖为因变量,使用基于复杂抽样设计的二分类logistic回归模型分别探讨早、午、晚餐就餐行为与肥胖的关系。结果 我国成年居民一日三餐中不吃早餐的比例最高,为3.3%。早、午、晚餐在外就餐比例分别为16.4%、21.4%、11.7%。午餐在家就餐、在外就餐和不吃午餐的男性肥胖率分别为13.2%、16.1%、15.9%,女性肥胖率分别为14.5%、9.8%、19.6%。多因素logistic回归结果显示,在男性中,午餐或晚餐在外就餐者和不吃午餐或晚餐者发生肥胖的风险均高于在家就餐者;女性不吃午餐或晚餐者发生肥胖的风险高于在家就餐者,女性午餐在外就餐与是否肥胖的关联无统计学意义,晚餐在外就餐发生肥胖的风险低于在家就餐者。结论 我国成年居民不同餐次就餐行为存在差异,午餐在外就餐比例最高,晚餐在外就餐比例最低。男性午餐和晚餐在外就餐者发生肥胖的风险较高;无论男性还是女性,不吃午餐或晚餐者发生肥胖的风险均较高。     

痰瘀互结证病证结合研究疗效评价指标回顾分析

目的：探讨痰瘀互结证病证结合疗效评价指标分布特征。方法：通过检索中国期刊全文数据库,对其1982-2016年间病证结合治疗痰瘀互结证的临床随机对照试验进行资料提取并建立数据库。经过资料规范统一化处理后,对痰瘀互结证疗效评价指标进行频次、频率统计分析。结果：①纳入108个痰瘀互结证病证结合临床研究中,95.4%的Jadad评分≤3分,高质量文献只有5篇（≥4分）。②痰瘀互结证病证结合临床疗效评价指标中,理化指标出现频率最高（81.5%）,其次是总体疗效（67.6%）、症状或证候计分（63.9%）、生存质量（13.9%）。③2011-2016年的临床研究中总体疗效出现频率较2000-2010年增加,其它指标呈下降趋势。④痰瘀互结证病证结合疗效评价指标种类数多为2种或3种,分别占52.8%和28.7%。⑤高脂血症和脂肪性肝病痰瘀互结证的全部临床研究都将理化指标作为评价指标之一。症状或证候计分在冠心病、脂肪性肝病痰瘀互结证临床研究中出现的频率较乳腺增生病和高脂血症高。结论：目前痰瘀互结证病证结合临床研究质量较低,疗效评价指标主要以替代指标为主。亟需提高临床研究质量控制意识,同时积极探索更符合临床实际的,操作性和可行性更高的观察终点指标的方法。     

微波等离子体化学气相沉积合成TiN超细颗粒

热力学计算表明，Ｈ２，Ｎ２的过量有助于提高ＴｉＮ的产率，但能耗也相应增加。为此考察了温度，流量，ＴｉＣｌ４携带量，混合方式对产物性能的影响。结果表明，流量增加，温度升高，ＴｉＣｌ４携带量增加，混合愈好，则产物粒径愈小。在此基础上采用微波等离子体化学气相沉积法，合成了粒径为１２３－２８４ｎｍ的ＴｉＮ超细颗粒     

HPLC-UV法同时测定羌活酚酸和香豆素类成分含量

[目的]建立同时测定羌活酚酸(新绿原酸、绿原酸和阿魏酸)和香豆素(羌活醇和异欧前胡素)两类成分的高效液相色谱-紫外分析法(HPLC-UV),为羌活药材的质量评价提供技术支撑。[方法]Agilent Zorbax SB-C18反相色谱柱(4.6 mm×250 mm,5μm),流动相为乙腈-0.2%磷酸水,检测波长330 nm,进样量5μL,流速1 m L/min。[结果]两类成分具有良好的线性关系,方法学验证均符合要求。[结论]该方法简单易行,重复性好,专属性强,可用于羌活药材的质量控制。     

Study on clinical effect and mechanism of Jianpi Qingre Huayu Recipe (健脾清热化瘀方) in treating patients with gastric ulcer

Objective： To study the effects of Jianpi Qingre Huayu Recipe （健脾清热化瘀方, JQH） in curing gastric ulcer and to preliminarily probe into its pathogenic mechanism, Methods： Fifty patients with gastric ulcer of Pi （脾）-insufficiency and stasis-heat syndrome type were assigned to the treated group （30 patients） and the control group （20 patients）. They were treated respectively with JQH and Ranitidine. At the same time, another group consisting of 20 healthy persons was set up for normal control. The clinical effect on gastroscopic figure and traditional Chinese medicine （TCM） syndrome were observed. Changes of T-cell subsets and interleukin-8 （IL-8） in serum as well as IL-8 in mucosa around the gastric ulcer were determined before and after treatment by flow cytometry and ELISA. Results： Comparison of the total effective rate on gastroscopic figure in the treated group and the control group （86.7% vs 80.0%） showed insignificant difference, but the cure rate and markedly effective rate in the former （50.0% and 20.0%） was higher than that in the latter （40.0% and 15.0%） respectively. Comparison of the total effective rate on TCM syndrome in the treated group and in the control group （96.7% vs 70.0%） showed insignificant difference, but the cure rate and markedly effective rate in the former （63.3% and 23.3%） was higher than that in the latter （50.0% and 20.0%） respectively. Serum levels of CD3^＋, CD4^＋, CD8^＋ got restored to normal range in the treated group after treatment but it was not so in the control group. IL-8 level in gastric mucosa was improved in both groups but the improvement in the treated group was better. Cenclusien： JQH could effectively treat gastric ulcer and partly reduce its recurrence through improving patients＇ immune function.     

阿尔茨海默病社区中医适宜干预技术及其应用策略

目的：总结适宜于社区阿尔茨海默病（AD）的中医干预技术,并探讨其在社区应用的策略。方法：通过对中国知网（CNKI）、中文科技期刊数据库（VIP）、万方数据库（WANFANG dATA）、PubMed检索AD社区中医干预相关文献报道（检索时间均从建库至2013年1月）,对AD社区中医干预的现有及可能的手段进行回顾性分析,在此基础上探讨AD社区中医适宜干预技术及应用策略。结果：相关研究证据表明中药内服疗法、针灸推拿疗法、药膳食疗、气功、太极拳等运动疗法、情志疗法、五音疗法等中医适宜干预技术可以应用于社区轻度认知损害（MCI）及轻、中度AD的防治,建立健全的社区医疗机构-患者-社区老年人监护人员的AD社区中医干预模式是值得探索的。结论：社区医务人员指导、AD患者自我管理和监护人员协助的AD社区中医综合干预管理策略尚需在具体社区实践中不断完善和规范。     

Influencing factors on efficacy of summer acupoint application treatment for allergic rhinitis: a retrospective study

Objective

Allergic rhinitis (AR) is a common health problem. Summer acupoint application treatment (SAAT) is reported to effectively treat and prevent AR from seasonal onset. In the present study, we aimed to evaluate its effects, especially on the course of AR, through a retrospective study.

Method

A cross-sectional multicenter study was performed based on patients treated between 2008 and 2009 in 13 clinical centers in China. A total of 1058 outpatients aged ≥2 years with documented AR and ≥1 year SAAT were eligible for enrollment. A case report form (CRF) was completed by both patient and doctor. The CRF was designed to collect data on the patient's history of SAAT, AR condition, and self-reported health condition. The outcomes (dependent variables) were incidence and intensity of AR and concomitant medications used. Data were analyzed with ordinal logistic regression (OLR).

Results

Treatment course and seasonal pattern of AR were related to all dependent variables positively. After controlling for sample bias and confounding factors, the findings suggested that a 3-year treatment course had better efficacy (OR/incidence of AR: 2.57, 95% CI: 1.76–3.76; OR/intensity of AR: 2.17, 95%CI: 1.50–3.17; OR/concomitant medications: 2.20, 95% CI: 1.50–3.23) compared with a 2-year or less treatment course.

Conclusion

The results showed that: 1) the length of treatment course was positively associated with the efficacy of SAAT (the longer the treatment course, the better the efficacy); and 2) SAAT was more efficacious in treating seasonal AR than non-seasonal AR.     

Hepatoprotective and antiviral properties of isochlorogenic acid A from Laggera alata against hepatitis B virus infection

Ethnopharmacological relevance

The aim of this study was to determine the anti-hepatitis B effect of isochlorogenic acid A isolated from Laggera alata (Asteraceae), a traditional Chinese herbal medicine.

Materials and methods

The anti-hepatitis B activity of isochlorogenic acid A was evaluated by the d-galactosamine (D-GalN)-induced HL-7702 hepatocyte damage model and the HBV-transfected HepG2.2.15 cells.

Results

Isochlorogenic acid A significantly improved HL-7702 hepatocyte viability and markedly inhibited the productions of HBsAg and HBeAg. The inhibitory rates of isochlorogenic acid A on the HBsAg and HBeAg expressions were 86.9% and 72.9%, respectively. In addition, isochlorogenic acid A declined markedly the content of hepatitis B virus covalently closed circular DNA (HBV cccDNA) and induced significantly the heme oxygenase-1 (HO-1) expression in HepG2.2.15 cells.

Conclusions

Isochlorogenic acid A was verified to possess the potent anti-hepatitis B activity. The anti-HBV target of isochlorogenic acid A is probably associated with blocking the translation step of the HBV replication. Overexpression of HO-1 may contribute to the anti-HBV activity of isochlorogenic acid A by reducing the stability of the HBV core protein and thus blocking the refill of nuclear HBV cccDNA. Additionally, the hepatoprotective effect of isochlorogenic acid A could be achieved by its antioxidative property and induction of HO-1.     

PERIPHERAL AND AUTONOMIC NERVE FUNCTION. TESTS IN EARLY DIAGNOSIS OF DIABETIC NEUROPATHY CORRELATION BETWEEN MOTOR NERVE CONDUCTION VELO- CITY AND FASTING PLASMA GLUCOSE

This paper reports the application of peri- pheral motor ne'rve conduction velocity (MNCV) determination and 6 noninvasive autonomic functional tests for the early diagnosis of dia- betic neuropathy. Among the 150 cases of new- ly discovered diabetics investigated during ex- tensive survey in Sha.nghai, 135 cases of tlia.- betic neuropathy were diagnosed. In this group, patients with both neurologic symptoms and signs were found in 56 cases, only symptoms with no signs in 50, only sign.s with no symp- toms in 8 and both symptoms and signs absent but diagnosis. based on special tests in 21. The motor nerve conduction velocity of the median n., ulnar n., and fibular n. were ascer- tained on JD Type II electromyography. The velocity was found to be significantly slower in diabetics with neuropathy than the control group. H-reflex and tibial n. Iatency were found to be prolonged in diabetics as compared with the control group. There is negative cor- relation 'oetween the MNCV and fa.sting plas- ma glucose and positive correla.tion between the H-reflex and fasting plasma glucose, indicating that hyperglycemia may be closely related to the pathogenesis of diabetic neuropathy. No correlation was found between the MNCV, age and duration of d[iabetes. For early diagno,sis of diabetic neuropathy, besides the symptoms and signs, motor nerve conduction velocity and 4 0f the 6 noninvasive autonomic ne'rve function test are valuable and reliable diagnostic procetlures. Differential diagnosis from other causes of neuropathy is also emphasized.