Metabolomics study on the therapeutic effect of traditional Chinese medicine Xue-Fu-Zhu-Yu decoction in coronary heart disease based on LC-Q-TOF/MS and GC-MS analysis

The present study aims is to investigate the metabolic mechanism of Xue-Fu-Zhu-Yu decoction (XFZYD) in the treatment of blood-stasis syndrome in Coronary Heart Disease (CHD). To that end, 30 CHD patients with Blood-Stasis Syndrome (BSS) and 20 healthy subjects were enrolled. LC-Q-TOF/MS analysis determined that in comparison between CHD with BSS patients (Group A) and healthy subjects (Group C), 59 significantly differential metabolites in the positive mode and 18 significantly differential metabolites in the negative mode. The metabolite constituents in the plasma of 30 CHD with BSS patients before (group A) and after 30 days of treatment (Group B), and 20 healthy subjects (Group C) were analyzed using LC-Q-TOF/MS and GC-MS. Based on multivariate statistical analysis (PCA, PLS-DA and OPLS-DA), we determined 69 differential metabolites. The levels of hemorheology indexes were significantly down-regulated after treatment. Metabolic pathway attribution analysis showed that lipid metabolism, amino acid metabolism and bile acid metabolism pathways are involved. Our study identifies the metabolic networks of CHD and demonstrates the efficacy of this metabolomics approach to systematically study the therapeutic effect of XFZYC on CHD.     

新型防旋支具在中西医结合保守治疗胫腓骨骨折中的应用

[目的]探讨新型防旋支具在中西医结合保守治疗胫腓骨骨折中的临床应用效果。[方法]2015年9月—2017年1月行保守治疗的胫腓骨骨折患者64例,随机分为试验组(32例)和对照组(32例)。两组患者入院后均行跟骨牵引术,中医正骨手法复位联合小夹板固定,辅以中药外敷内服。试验组术后采用新型防旋支具固定患肢,防止足部外旋;对照组术后采用传统的方法防止足部外旋。定期进行疼痛视觉模拟评分法(VAS法)评分,应用Kolcaba舒适状况量表(GCQ)检测舒适度改善状况,计算机断层扫描(CT)检查测量骨折旋转移位角度,随访记录骨折愈合时间及并发症情况,采用Johener-Wruhs评分系统对患肢功能进行评价。[结果]试验组骨折旋转移位角度小于对照组,牵引术后第1、3、7天的VAS疼痛评分均低于对照组,舒适度GCQ总分和其中的生理、心理精神维度单项得分均高于对照组,骨折愈合时间短于对照组,肢体功能Johner-Wruhs评分优良率高于对照组。两组间差异具有统计学意义(P0.05)。[结论]中西医结合保守治疗胫腓骨骨折过程中应用新型防旋支具,可以有效维持足部中立位,纠正成角及旋转畸形,辅助复位,减轻疼痛,提高患者舒适感受,缩短骨折愈合时间,有利于患肢功能恢复,且不增加并发症的发生,便于护理,安全可靠。     

从"醒脑开窍"针刺疗法探讨国医大师石学敏院士对中医脑病的贡献

"醒脑开窍"针刺疗法是我国著名中医药学家和教育家、中国工程院院士、国医大师、石学敏中医发展基金会理事长石学敏教授于1972年为治疗中风病创立的针刺疗法。该疗法临床应用已达40余年，在中风病等多种疾病治疗中确实显示出其卓越的疗效。通过大量的临床观察和基础实验研究，对机体多系统疾病均有良好的调节作用。该疗法不仅限于中风病的应用，一切脑性麻痹或瘫痪(如小儿脑瘫、一氧化碳中毒和脑外伤后等)；严重的疼痛(如神经痛、内脏痛、创伤痛和癌瘤痛等)；精神疾病(如癫狂痫、抑郁症、百合病和癔病等)；还有部分其他系统(如尿崩症、遗尿和二便失控等疾病)均有非常好的疗效。从脑主神明的认识；"醒脑开窍"针刺疗法的提出与确立；创立中风病机新理论等方面，并探讨中国工程院院士、国医大师石学敏教授对中医脑病的新贡献。     

柴胡桂枝干姜汤治疗失眠的功效网络研究

目的运用网络药理学分析方法,明确柴胡桂枝干姜汤治疗失眠的作用机制。方法运用TCMSP、TCMID数据库锁定柴胡桂枝干姜汤7味药的药物靶标,TTD、DrugBank、PubMed数据库查找失眠的疾病靶点,构建"疾病-方剂-靶点"网络,用STRING和Cytoscape分析软件对其关键靶点进行富集分析,明确作用机制。结果柴胡桂枝干姜汤蛋白质-蛋白质相互作用(PPI)网络包含靶标640个,失眠的PPI网络包括靶标175个,富集分析得29个关键靶标和其间80条互作关系;GO富集分析及KEGG途径分析结果显示柴胡桂枝干姜汤中柴胡皂苷a、柴胡皂苷d、槲皮素、碳酸钙、6-姜辣醇、山柰酚、汉黄芩素等171个活性成分主要通过CACNA1C、GABRA1、GABRA2、GABRB3、GABRA3等29个关键靶标及突触信号传导、膜电位的调节、G蛋白偶联受体信号通路等生物过程,神经递质受体活性、离子门控通道活动、GABA-A受体活性等分子功能,质膜、突触等细胞组成作用于神经活性配体-受体相互作用、逆行内源性大麻素信号传导、5-羟色胺能突触等多条作用通路发挥治疗失眠作用。结论柴胡皂苷a、柴胡皂苷d等171个活性成分是柴胡桂枝干姜汤治疗失眠的药效物质基础,神经活性配体-受体相互作用等通路和CACNA1C等29个靶标构成了其发挥"疏肝健脾、调和阴阳"的功效作用网络,为临床合理运用柴胡桂枝干姜汤治疗失眠提供了网络药理学证据。     

金元四大家消渴类方药分析之新见

金元四大家在诊治消渴方面即借鉴了前人的经验又各有创新,对后世在辨证论治消渴类疾病影响巨大,对于消渴病的辨证论治逐渐形成体系。用现代数学方法分析四大家用药频率,根据《内经》及其他经典中记载消渴病分析的内容,提出上焦辨证消渴的方法。     

Pacifiplex: an ancestry-informative SNP panel centred on Australia and the Pacific region

The analysis of human population variation is an area of considerable interest in the forensic, medical genetics and anthropological fields. Several forensic single nucleotide polymorphism (SNP) assays provide ancestry-informative genotypes in sensitive tests designed to work with limited DNA samples, including a 34-SNP multiplex differentiating African, European and East Asian ancestries. Although assays capable of differentiating Oceanian ancestry at a global scale have become available, this study describes markers compiled specifically for differentiation of Oceanian populations. A sensitive multiplex assay, termed Pacifiplex, was developed and optimized in a small-scale test applicable to forensic analyses. The Pacifiplex assay comprises 29 ancestry-informative marker SNPs (AIM-SNPs) selected to complement the 34-plex test, that in a combined set distinguish Africans, Europeans, East Asians and Oceanians. Nine Pacific region study populations were genotyped with both SNP assays, then compared to four reference population groups from the HGDP-CEPH human diversity panel. STRUCTURE analyses estimated population cluster membership proportions that aligned with the patterns of variation suggested for each study population’s currently inferred demographic histories. Aboriginal Taiwanese and Philippine samples indicated high East Asian ancestry components, Papua New Guinean and Aboriginal Australians samples were predominantly Oceanian, while other populations displayed cluster patterns explained by the distribution of divergence amongst Melanesians, Polynesians and Micronesians. Genotype data from Pacifiplex and 34-plex tests is particularly well suited to analysis of Australian Aboriginal populations and when combined with Y and mitochondrial DNA variation will provide a powerful set of markers for ancestry inference applied to modern Australian demographic profiles. On a broader geographic scale, Pacifiplex adds highly informative data for inferring the ancestry of individuals from Oceanian populations. The sensitivity of Pacifiplex enabled successful genotyping of population samples from 50-year-old serum samples obtained from several Oceanian regions that would otherwise be unlikely to produce useful population data. This indicates tests primarily developed for forensic ancestry analysis also provide an important contribution to studies of populations where useful samples are in limited supply.     

Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine

Clinical trial outcome reporting differs between studies integrating traditional Chinese medicine (TCM) and Western medicine, so that some clinical trials are not eligible for inclusion in a systematic review. The excluded studies are therefore less widely disseminated, and even valid studies are less likely to yield impact. This problem may be addressed by developing core outcome sets (COSs) for integrative medicine in specific healthcare areas. The first stage of development is to define the scope of the COS for integrative medicine, the second stage is to establish the need for such a COS, and the third stage is to develop a protocol and register the COS. The final stage involves three steps: (i) development of a comprehensive list of outcomes (including efficacy outcomes and safety outcomes and TCM syndromes) using systematic review, qualitative or cross-sectional research, and reviews of package inserts and medical records; (ii) merging and grouping of outcomes within domains; (iii) conducting two rounds of Delphi survey and consensus meetings with a range of stakeholders. The final COS will include a general COS and core TCM syndrome- set. Development of COSs for clinical trials of integrative medicine may help to standardize outcome reporting and reduce publication bias in the future.     

运脾化浊法治疗脾虚型高尿酸血症回顾性研究

目的 评价运脾化浊法治疗脾虚型高尿酸血症患者的临床疗效。方法 使用回顾性研究的方法，检索天津市中医药研究院附属医院的电子病历系统，收集近5年住院的脾虚型高尿酸血症患者，选择接受运脾化浊法治疗的45例患者为运脾化浊组，采用倾向性评分匹配法匹配以接受常规西医治疗的45例患者为常规治疗组，疗程均为2周。比较两组患者治疗前后血尿酸水平、脾虚证症状评分。结果 治疗后两组患者血尿酸水平均较治疗前降低（P＜0.05），两组患者降尿酸达标率（运脾化浊组40%、常规治疗组55.56%）以及降尿酸疗效相近（P＞0.05）。治疗后运脾化浊组脾虚证症状评分较治疗前降低（P＜0.05），且降低幅度较常规治疗组更大（P＜0.05）；两组中医症状疗效比较，差异有统计学意义（P＜0.05）。结论 采用运脾化浊法治疗脾虚型高尿酸血症，可降低患者的血尿酸水平且明显改善其脾虚证症状。     

Strengthening medical radiation technologist recognition through advanced practice in Canada: A narrative review

BackgroundLack of professional recognition from the public and other healthcare professionals has been a long-standing issue for medical radiation technologists (MRTs) in Canada. This situation was further highlighted by the pandemic when several provinces refused to recognize MRTs as essential workers. In addition to continued advocacy to develop interprofessional awareness of the MRT discipline, prioritizing the creation of advanced practice opportunities will increase the perceived value of MRTs to healthcare.MethodsLiterature for this review was found by searching the electronic databases of PubMed, CINAHL, Google Scholar, and Athabasca University. Relevant reports from credible Canadian organizations, global MRT professional association websites, frameworks for advanced practice, and one dissertation were also reviewed.DiscussionThe implementation of advanced practice radiography roles present a tremendous opportunity to increase the visibility and recognition of the MRT profession in both clinical and research domains. In Canada, role extension in radiography has underscored the significance and need for advanced practice.ConclusionTo keep pace with growing demand for medical imaging, the use of human health resources must be re-evaluated to optimize care delivery and capitalize on the full skill set of MRTs.