Evaluation of protective effects of Chi-Zhi-Huang decoction on Phase I drug metabolism of liver injured rats by cocktail probe drugs

AIM OF THE STUDY: Chi-Zhi-Huang decoction (PGR) is one of the traditional Chinese medicine (TCM) preparations with unique effect on withdrawing jaundice and has been used to treat icteric patients in China for many years. In this research, we aim at to evaluate the potential activity of PGR in restoring hepatic drug metabolism in a damaged liver. MATERIALS AND METHODS: A cocktail approach with caffeine (10mg/kg), dapsone (10mg/kg) and chlorzoxazone (20mg/kg) respectively as probe drug of cytochrome P450 (CYP) isoform of CYP 1A2, 3A4 and 2E1 was used to evaluate its possible effects on Phase I oxidative metabolism. Pretreated with three dosages of PGR water extract (0.75, 1.5 and 3g/kg, po) for 5 days, male Wistar rats (220-240 g) were intoxicated by phenylisothiocyanate (PITC, 100mg/kg, po) 24h before probes intravenous injection. The pharmacokinetics of the probes in the blood was determined simultaneously by HPLC, and their non-compartmental parameters were used to evaluate the metabolic difference among the groups. Moreover, the levels of liver enzymes (ALT, AST, ALP) and bilirubins were also measured for insight of liver function. RESULTS: The findings in this study suggest that PGR induces CYP 3A4, does not have much effect on CYP 2E1, and inhibits CYP 1A2 at high dosage. CONCLUSION: The current pharmacokinetic approach allowed the protective effects of PGR on oxidative drug metabolism in damaged liver to be systemically examined and will certainly help in the explanation of synergistic effect of the composites formula.     

Proteomic studies of early-stage and advanced ovarian cancer patients

ObjectivesThe objectives of this study were to evaluate the diagnostic value for ovarian cancer using proteomic pattern established by surface-enhanced laser desorption/ionization (SELDI-TOF-MS) profiling of plasma proteins coupled with support vector machine (SVM) data analysis, and to investigate whether the proteomic pattern established by advanced ovarian cancer could be used for diagnosis of early-stage ovarian cancer patients.MethodsThe study included 44 ovarian cancer patients (11 early-stage and 33 advanced ovarian cancer patients) and 31 age-matched non-cancer controls. SELDI-TOF-MS coupled with SVM analysis was performed to establish a proteomic pattern to discriminate 33 advanced ovarian cancer patients from 31 non-cancer controls. A blind test, including 11 early-stage ovarian cancer cases, was performed to investigate whether proteomic pattern established by advanced ovarian cancer could be used for diagnosis of early-stage ovarian cancer patients.ResultsA seven-peak proteomic pattern was established which discriminated 33 advanced ovarian cancer patients from 31 non-cancer controls effectively. A sensitivity of 93.94% (31/33) and a specificity of 93.55% (29/31) were yielded from the proteomic pattern. Among the 7 protein peaks, 5 with mass charge ratio (m/z) 4099 Da, 5488 Da, 4144 Da, 4479 Da and 3940 Da were up-regulated, while 2 peaks, with m/z 13 783 Da and 8588 Da were down-regulated in the advanced ovarian cancer group compared with non-cancer control group. After blind test, 9 of 11 early-stage ovarian cancer patients were successfully diagnosed with the accuracy of 81.82% (9/11).ConclusionsThis study demonstrated that SELDI-TOF-MS coupled with SVM is effective in distinguishing protein expression between ovarian cancer and non-cancer plasma and it may be feasible to diagnose early-stage ovarian cancer using proteomic pattern established by advanced ovarian cancer. The gained and lost protein peaks in plasma may exist in both early-stage and advanced ovarian cancer plasma. Further studies should be performed using larger sample numbers.     

Fetal cardiac malposition: incidence and outcome of associated cardiac and extracardiac malformations

Cardiac malposition is a rare but important finding when detected on fetal ultrasound. The purpose of this study was to evaluate the incidence of fetal cardiac malposition, associated abnormalities, and clinical outcome in a tertiary-care medical center. Records of fetuses (1993 to 2006) with dextroposition, dextrocardia, mesocardia, ectopia cordis, or heterotaxy were reviewed. The presence of congenital heart disease (CHD), extracardiac anomalies, and outcome were noted. Cardiac malposition was present in 101 fetuses among a total of 3313 (3%) pregnancies. In 78 (78%) patients, the heart was positioned in the right hemithorax. Of those, 26 (33%) had dextrocardia (CHD = 21), and 52 (67%) had dextroposition (CHD = 14). Sixteen (16%) patients had mesocardia (CHD = 8), and 7 (7%) had ectopia cordis (CHD = 6). The majority (58%) of fetal cardiac malposition was caused by intrathoracic masses. Concomitant CHD occurred in 50%. Outcome was available in 97%. The perinatal and neonatal mortality rate was 30%; the elective termination rate was 4%. Patients with CHD had higher mortality rates. The highest mortality rates occurred in ectopia cordis and combined disease of diaphragmatic hernia and CHD.     

NiCoP–CeO2 composites for efficient electrochemical oxygen evolution

In this study, a novel NiCoP–CeO₂ composite was constructed on a Ni foam by a simple hydrothermal method and thermal phosphating strategy. In the OER test, NiCoP–CeO₂ exhibited a low overpotential of 217 mV at 10 mA cm⁻², 45 mV dec⁻¹ of Tafel slopes. With the help of theoretical calculations and experimental characterization, the reason for performance improvement was analyzed in depth. The results show that CeO₂ leads to a confinement effect, maintaining the nanosheet morphology of NiCo-LDHs, which contributes to sustaining the catalyst in favourable contact with H₂O and minimizing the OER potential. Furthermore, by loading CeO₂ onto NiCoP, the hydrophilicity of the catalyst is significantly enhanced. Our work provides an ingenious synthesis strategy for the preparation of efficient and inexpensive electrocatalytic materials.

A NiCoP–CeO₂ composite was constructed by a simple hydrothermal method and thermal phosphating strategy. Benefiting from the confinement effect and optimized H₂O adsorption ability, NiCoP–CeO₂ exhibits superior OER performance than NiCoP.     

皮肤结核一例

患者,女,64岁.颈部斑块结节8年,逐渐增大.患者8年前患乳腺癌,手术切除治疗.曾诊断为毛囊炎、孢子丝菌病、乳腺癌皮肤转移等,给予相应治疗未愈.组织病理学检查:真皮内结核性肉芽肿,结节中央可见干酪样坏死,抗酸染色阳性,PAS染色阴性,真菌培养阴性,PPD(+++).抗结核治疗后皮疹明显消退.     

多层螺旋CT在骶管阻滞麻醉中的临床应用

目的 为骶管阻滞麻醉骶管裂孔穿刺点体表定位、进针方向及深度探索一种新的方法。方法 回顾性对8例盆腔扫描病人进行三维重建,测量骶管裂孔至拟注药点的距离及骶管裂孔大小;骶骨表面重建后对骶管裂孔、骶管的形状进行评估,确定进针方向。结果 全部病人经骶骨表面重建后能通过各种角度对骶管裂孔进行观察并测量骶管裂孔的大小,从骶正中嵴将骶骨切除一半后能对骶管的形状及走行进行精确的观察并准确测出了骶管裂孔至注药点的距离。利用上述数据术前在病人体表进行了准确定位,并成功实施了麻醉。结论 本方法可帮助医生对骶管裂孔进针方向、进针深度提供准确的数据。显著提高了麻醉手术的成功率,避免了给患者可能带来的副损伤,同时还可进行术前麻醉模拟训练。     

针灸加微波治疗肱骨外上髁炎100例

肱骨外上髁炎,俗称网球肘,属中医筋伤范畴,是常见的肘部筋腱慢性劳损性疾病。多见于从事前臂劳动强度较大的工作人员,如木工、银行点钞员及网球运动员。临床可见肘关节外侧酸痛、病侧手部无力握物、前臂旋转活动受限。中医认为与素体亏损、血不养筋、气滞血瘀有关。2004年5月至今我院理疗康复中心采用“针灸加微波疗法治疗肱骨外上髁炎100例,结果令人满意。现总结如下。1临床资料100例患者均为门诊病例,诊断均符合高等中医院校《中医骨伤科学》肘部筋伤的诊断标准。其中男性30例,女性7例;年龄最大65岁,最小30例,平均年龄45岁;病程最长年,最…     

Impact of National Centralized Drug Procurement Policy on Antiviral Utilization and Expenditure for Hepatitis B in China

Background and AimsThe National Centralized Drug Procurement (NCDP) policy was launched in mainland China in April 2019, with entecavir (ETV) and tenofovir disoproxil fumarate (TDF) being included in the procurement list. We conducted the current study to investigate the impact of the NCDP policy on the utilization and expenditures of antiviral therapy for chronic hepatitis B (CHB) in China.MethodsProcurement records, including monthly purchase volume, expenditure, and price of nucleos(t)ide analogs (NAs), were derived from the National Healthcare Security Administration from April 2018 to March 2021. The changes in volumes and expenditures of the first-line NAs and bid-winning products were calculated. The effects of price, volume, and structure related to drug expenditure were calculated by the Addis and Magrini (AM) Index System Analysis.ResultsThe purchase volume of NAs significantly increased from 134.3 to 318.3 million DDDs, whereas the expenditure sharply decreased from 1,623.41 to 490.43 million renminbi (RMB) or 241.94 to 73.09 million US dollars (USD). The proportions of first-line NAs rose from 72.51% (ETV: 69.00%, TDF: 3.51%) to 94.97% (ETV: 77.42%, TDF: 17.55%). AM analysis showed that the NCDP policy decreased the expenditure of all NAs (S=0.91) but increased that of the first-line NAs in the bid-winning list (S=1.13). Assuming the population size of CHB patients remains stable and a compliance rate of ≥75%, the proportion of CHB patients receiving first-line antiviral therapy would increase from 6.36–8.48% to 11.56–15.41%.ConclusionsThe implementation of the NCDP policy significantly increased the utilization of first-line NAs for CHB patients at a lower expenditure. The findings provided evidence for optimizing antiviral therapy strategy and allocating medical resources in China.