王道坤基于圆运动之天人一气论治“交节病”

阳性善动,阴性则静,静则沉,动则浮。由静而动谓之升,由动而静谓之降,升降浮沉一周,则中气升。中气者,生物之生命也。由是人与自然界是一个有机整体,因脏腑之气升降相因,协调平衡为用,五行之气更迭有序,交节和平为顺,故五脏特性外象于五行之性,五行之气内应于五脏之气。气的运动生成变化或节气交替,均会导致人体机能变化,若协调相应失常,从而可致"交节病"。王道坤教授善从中医整体观念出发,倡导"平阴阳,调六气",重视天人一气论,在临床上解决"交节病"疑难杂症,效果显著。     

Carthamus tinctorius L. extract activates insulin‐like growth factor‐I receptor signaling to inhibit FAS‐death receptor pathway and suppress lipopolysaccharides‐induced H9c2 cardiomyoblast cell apoptosis

Carthamus tinctorius L. (Compositae) is used in Chinese medicine to treat heart disease and inflammation. In our previous study, we found that C. tinctorius L. inhibited lipopolysaccharides (LPS)‐induced tumor necrosis factor‐alpha (TNF‐α) activation, JNK expression, and apoptosis in H9c2 cardiomyoblast cells. The present study was performed to investigate the protective effect of C. tinctorius extract (CTF) on LPS‐challenged H9c2 myocardioblast cell and to explore the possible underlying mechanism. Cell viability assay showed that LPS treatment decreased the cell viability of H9c2 cell, whereas CTF treatment reversed LPS cytotoxicity in a dose‐dependent manner, especially in the LPS + CTF 25 (μg/mL) group. LPS treatment‐induced apoptosis was determined by transferase‐mediated dUTP nick end labeling assay, and by Western blot. LPS‐induced apoptotic bodies were decreased following CTF treatment. Expression of TNF‐α, FAS‐L, FAS, FADD, caspase‐8, BID, and t‐BID was significantly increased in LPS‐treated H9c2 cells. In contrast, it was significantly suppressed by the administration of CTF extract. In addition, CTF treatment activates antiapoptotic proteins, Bcl‐2 and p‐Bad, and downregulates Bax, cytochrome‐c, caspase‐9, caspase‐3, and apoptosis‐inducing factor expression. Furthermore, CTF exerted cytoprotective effects by activating insulin‐like growth factor‐I (IGF‐I) signaling pathway leading to downregulation of the apoptotic proteins involved in FAS death receptor pathway. In addition, AG1024 and IGF‐I receptor (IGF‐IR) inhibitor and siRNA silencing reverses the effect of CTF implying that CTF functions through the IGF‐IR pathway to inhibit LPS‐induced H9c2 apoptosis. These results suggest that treatment with CTF extract prevented the LPS‐induced apoptotic response through IGF‐I pathway.     

药用炭剂治疗慢性肾功能不全的随机对照多中心临床研究

目的 观察国产药用炭剂片与胶囊（肠道毒素吸附剂）治疗慢性肾功能不全的疗效和安全性。方法 用多中心临床对照试验，187例患者口服治疗8周，比较治疗前后血肌酐、尿素水平和临床症状评分，并评价其安全性；对照药为包醛氧淀粉。结果 肌酐：治疗有效率分别为炭片组：33．3％，炭胶囊组：33．3％，包醛氧淀粉组：29．4％。尿素：治疗有效率分别为炭片组：50．0％，炭胶囊组：46．0％，包醛氧淀粉组：59．4％。经治疗后，3组患者临床症状评分较治疗前有显著改善。药用炭剂片、胶囊与包醛氧淀粉的药物不良反应发生率分别为4．8％，3．1％，1．5％。结论 国产药用炭剂作为肠道吸附剂，用于治疗慢性肾功能不全安全、有效。     

朱砂安神丸薄层扫描鉴定

本文研究了朱砂安神丸的定性鉴别方法。采用均匀设计试验法选取最佳展开剂和展距,以双波长薄层扫描指纹谱进行定性鉴别,是一种迅速而有效的方法。     

参乌益智胶囊治疗血管性痴呆的临床研究

目的 观察参乌益智胶囊治疗血管性痴呆的临床疗效.方法 将80例血管性痴呆患者数字表法随机分为对照组和治疗组,每组40例.在常规治疗基础上,对照组予吡拉西坦片口服,治疗组予以参乌益智胶囊口服.60d为1个疗程.比较治疗前后简单智力状况检查(MMSE)量表积分、Blessed行为量表积分变化.结果 两组治疗前后MMSE积分、Bcessed行为量表积分均明显改善(均P＜0.05);治疗后治疗组MMSE积分、Bcessed行为量表积分分别为(19.83±5.24)分、(7.18±4.21)分,均优于对照组的(20.01±4.89)分、(7.23±3.99)分(t=4.148,2.141,均P＜0.05).结论 参乌益智胶囊能改善轻、中度血管性痴呆患者认知功能,提高患者记忆力、计算力、定向力,增强患者行为能力,减轻痴呆症状,取得较好近期疗效.     

Estimation of brain receptor occupancy for trazodone immediate release and once a day formulations

Trazodone is approved for the treatment of major depressive disorders, marketed as immediate release (IR), prolonged release, and once a day (OAD) formulation. The different formulations allow different administration schedules and may be useful to facilitate patients’ compliance to the antidepressant treatment. A previously verified physiologically‐based pharmacokinetic model based on in vitro and in vivo information on trazodone pharmacokinetics was applied, aiming at predicting brain receptor occupancy (RO) after single and repeated dosing of the IR formulation and repeated dosing of the OAD formulation in healthy subjects. Receptors included in the simulations were selected using static calculations of RO based on the maximum unbound brain concentration (C_max,brain,u) of trazodone for each formulation and dosing scheme, resulting in 16 receptors being simulated. Seven receptors were simulated for the IR low dose formulation (30 mg), with similar t _onset and duration of coverage (range: 0.09–0.25 h and 2.1–>24 h, respectively) as well as RO (range: 0.64–0.92) predicted between day 1 and day 7 of dosing. The 16 receptors evaluated for the OAD formulation (300 mg) showed high RO (range: 0.97–0.84 for the receptors also covered by the IR formulation and 0.73–0.48 for the remaining) correlating with affinity and similar duration of time above the target threshold to the IR formulation (range: 2–>24 h). The dose‐dependent receptor coverage supports the multimodal activity of trazodone, which may further contribute to its fast antidepressant action and effectiveness in controlling different symptoms in depressed patients.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

The antidepressant efficacy of trazodone has been shown to be significantly correlated to its steady‐state plasma levels, and previous work has shown some understanding of trazodone range of affinity for different receptors, at different doses, but without considering the different available formulations. Trazodone is commonly available as: immediate release (IR), prolonged release (PR), and once a day (OAD) tablets. The IR formulation has a rapid onset and short duration of action, whereas the PR formulation is characterized by an absorption boost as soon as it is administered and has a comparatively delayed maximum concentration (C_max). Conversely, the OAD formulation provides a controlled release of trazodone over 24 h without the early high peak plasma concentration seen with the IR and PR formulations.

• WHAT QUESTION DID THIS STUDY ADDRESS?

This work aims to identify the brain receptors reaching a threshold occupancy of 50% through static predictions and determine the occupancy versus time profile for those of interest following administration of short‐ and long‐acting trazodone formulations.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

Brain receptor occupancy (RO) for key targets were predicted based on free drug concentrations, allowing for a physiologically relevant assessment of the different pathways affected by each formulation and dose.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

The presented physiologically‐based pharmacokinetic approach to assess RO can be used to guide formulation selection and dosing in clinical studies.     

前列舒颗粒对湿热瘀阻型慢性前列腺炎症状改善研究

目的:研究观察前列舒颗粒对湿热瘀阻型前列腺炎的治疗情况。方法:采用以安慰剂为对照药的临床随机和双盲研究。结果:对照组与治疗组有显著性差异。结论:前列舒颗粒能显著改善患者的症状。     

Does Systemic Chemotherapy Influence Skeletal Growth of Young Osteosarcoma Patients as a Treatment-Related Late Adverse Effect?

The aim of this study was to investigate the influence of systemic chemotherapy on the skeletal growth of young osteosarcoma patients as a treatment-related late adverse effect. We reviewed the height data of 20 osteosarcoma patients (13 males and 7 females) aged ≤18 years. The average (±SD) age at diagnosis was 14.5 (±3.3) years. The average follow-up interval was 89.6 months. After wide resection of the affected bones, reconstruction with tumor prostheses and auto-bone grafting was carried out in 11 and 9 cases, respectively. Pearson’s correlation coefficient was calculated to evaluate the association between actual and predicted (using Paley’s multiplier method) heights. Z-scores were used to compare the initial and final heights with the Japanese national growth curve. Actual and predicted heights were correlated according to Pearson’s correlation coefficient (R = 0.503). Z-analysis showed that statistical significance (p = 0.04) was noted for the height data Z-scores of patients between ≤10 years and >10 years at the final follow-up. Systemic chemotherapy did not reduce skeletal growth in young osteosarcoma patients as a late adverse effect based on two different evaluation methods. However, patients aged ≤10 years at diagnosis may develop a short stature after systemic chemotherapy.     

Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia

Objective Peripherally inserted central catheters (PICCs) are widely used in patients with hematologic malignancies. However, the risks of PICC-related complications during chemotherapy for acute myeloid leukemia (AML) are not fully understood. Methods We conducted a retrospective review of 128 adult patients with AML who received induction therapy by way of PICC insertion between 2012 and 2019. Results The median duration of PICC insertion was 30 days. The incidence rate of catheter-related bloodstream infection (CRBSI) was 2.4% at 30 days, and women were more likely to suffer from CRBSI than men. Local reactions at the insertion site were observed in 56 patients; however, these events did not predict CRBSI. The incidence rates of catheter-related thrombosis (CRT) were 1.6% at 30 days. Obesity put patients at an increased risk for CRT. Unexpected PICC removal occurred in 59 patients, and women were at a higher risk of catheter removal than men. Conclusion Low PICC-related complication rates, possibly associated with high rates of catheter removal, were observed during intensive chemotherapy for AML. Women and obese patients require careful monitoring of their PICC. Procedures to achieve appropriate PICC removal without increasing the complication rate need to be considered.     

Effect of Robusta (Coffea canephora P.) coffee cherries quantity put out for sun drying on contamination by fungi and Ochratoxin A (OTA) under tropical humid zone (Côte d‘Ivoire)

The effect of coffee cherries quantity put out for sun drying on the kinetics of the drying, chemical components variation, fungal growth and ochratoxin A production was evaluated. The results showed that the more coffee cherries quantity on the drying area was important, the slower they dried. Indeed, the drying durations were 12, 17, 21, 26, 31 and 32 days respectively for the lots of 10 kg, 20 kg, 30 kg, 40 kg, 50 kg and 60 kg of cherries by square meter of drying area. The slowness of the drying led to the increasing of fungal development and ochratoxin A production in the cherries. Indeed, samples more contaminated were those from the lots of 50 kg and 60 kg of cherries by square meter of drying area with between 10% and 100% of infected beans and with levels of ochratoxin A ranging from 0.92 to 118.47 and 1.4 to 131.33 μg kg⁻¹ respectively. The slowness of the drying led also to the acidification of the cherries (pH = 5.55–4.54) and the degradation of their chlorogenic acids content (13.03–11.69) while for their caffeine content (2.52–2.54), any significant difference was observed whatever the drying duration.