中药醋炙增效减毒机理的现代研究进展

醋炙法多用于具有疏肝解郁、散瘀止痛、攻下逐水功效的中药。醋炙可引药入肝,增强疏肝解郁、散瘀止痛中药的作用,降低峻下逐水中药的毒性。本文在查阅大量文献的基础上,从化学、药理和毒理角度对醋炙增效减毒的机理进行总结论述,为醋炙中药的临床合理应用提供参考。     

心外膜脂肪厚度、CT值及Syntax评分与冠心病的关系

目的探讨心外膜脂肪厚度、CT值及心脏外科与介入治疗狭窄冠脉研究(Syntax)评分与冠心病的关系。 方法选取2017年2月至2018年10月就诊于临沂市兰陵县人民医院心血管内科,经冠状动脉造影检查确诊的冠心病患者,共69例作为研究组,另选同期正常健康体检者60例作为对照组。两组均行冠状动脉CT血管成像(CTA)检查,比较心外膜脂肪厚度及CT值。分析冠心病患者造影结果,计算Syntax评分,比较不同水平Syntax评分冠心病患者心外膜脂肪厚度及CT值差异。 结果研究组患者甘油三酯[(1.62±0.68)mmol/L]、总胆固醇[(5.12±1.83)mmol/L]水平明显高于对照组[(1.50±0.53)mmol/L,(4.90±1.20)mmol/L](t＝4.60,3.82;均P<0.05);研究组高密度脂蛋白胆固醇[(1.49±0.43)mmol/L]和低密度脂蛋白胆固醇[(2.45±0.63)mmol/L]水平与对照组[(1.50±0.55)mmol/L,(2.50±0.55)mmol/L]比较,均差异无统计学意义(t＝0.55,0.34;均P>0.05)。研究组心外膜脂肪厚度[(12.30±2.66)mm]高于对照组[(9.50±1.85)mm](t＝8.60,P<0.01);研究组心外膜脂肪CT值[(-98.60±15.66)HU]高于对照组[(-70.55±9.82)HU](t＝19.36,P<0.01);低积分组冠心病患者心外膜脂肪厚度[(11.30 ± 2.20)mm]、心外膜脂肪CT值[(-90.60±9.55)HU]、平均Syntax评分[(-17.32±8.42)分]低于高积分组冠心病患者[(14.50±2.76)mm、(-115.30±13.36)HU、(-30.44±9.19)分],均差异有统计学意义(t＝6.42,9.58,21.15;均P<0.01)。 结论心外膜脂肪厚度、CT值可能影响冠心病患者Syntax评分结果,可作为患者病情评估的参考指标,有推广价值。     

Spectrum of activity,mutation rates,synergistic interactions,and the effects of pH and serum proteins for fusidic acid (CEM-102)

Fusidic acid (CEM-102) is a steroidal antimicrobial agent with focused Gram-positive activity that acts by preventing bacterial protein synthesis via interacting with elongation factor G. A collection of 114 wild-type isolates (>80 species) was used to define the contemporary limits of fusidic acid spectrum against Gram-positive and Gram-negative species. Reference broth microdilution and anaerobic agar dilution methods were performed. Modifications of standardized test methods included adding 10% human serum and adjusting the medium pH to 5, 6, and 8. Synergy was assessed by the checkerboard method and time-kill studies. Mutational rates to resistance were determined at 4×, 8×, and 16× MIC. Against Gram-positive pathogens, fusidic acid MIC values ranged from 0.06 to 32 μg/mL with the greatest potency against Staphylococcus aureus, Corynebacterium spp., and Micrococcus luteus (MIC results, 0.25, ≤0.12, and ≤0.5 μg/mL, respectively). Enterococci and streptococci were less susceptible (MIC ranges, 2–8 and 16–32 μg/mL, respectively). Fusidic acid activity against Gram-negative species was more limited (all MIC values, ≥2 μg/mL) except for Empedobacter brevis, Moraxella catarrhalis and Neisseria meningitidis. A 4-fold increase in fusidic acid MIC results was observed when 10% serum was added to the broth. Decreasing medium pH to 5.0 to 6.0 negated the protein binding effects. Among the 8 antimicrobial combinations tested, gentamicin and rifampin enhanced the activity when combined with fusidic acid (no antagonism). Fusidic acid in vitro activity was most improved when combined with rifampin. Single-step mutational rates ranged from 1.2 × 10⁻⁶ for 4× MIC to 9.8 × 10⁻⁸ for 16× MIC. In conclusion, these in vitro results for fusidic acid tested against contemporary strains confirm a persisting antimicrobial spectrum, especially against staphylococci and some other Gram-positive species.     

Synergy matrices to estimate fluid wrist movements by surface electromyography

Although many efforts have been undertaken to develop an interface using surface electromyography (sEMG) to connect the gap between a human and a wrist prosthesis, most of these efforts have offered only static positioning (ON/OFF) of the prosthesis. This study introduced synergy matrices to extract fluid wrist movement intents by sEMG to allow individuals with wrist amputations to use wrist prostheses. A non-negative muscle synergy matrix was used to map muscle activities in the forearm into four predefined wrist movement intents (flexion/extension and radial/ulnar deviation). The directions of the predefined intents were constrained to two perpendicular axes, so each movement spanned only a one-dimensional space. A joint synergy matrix was used to span the whole two-dimensional space by combining the four wrist movement intents. Ten healthy subjects volunteered for a validation experiment, which was built as a virtual environment in which people with wrist amputation could receive myoelectric control training. The results showed that proportional two-degree-of-freedom (DOF) movements could be estimated by sEMG. This work could be useful not only for wrist prostheses but also for alternative computer interfaces and studies to examine motor adaptation by sEMG.     

Workspace location influences joint coordination during reaching in post-stroke hemiparesis

The purpose of this study was to determine the influence of workspace location on joint coordination in persons with post-stroke hemiparesis when trunk motion was required to complete reaches beyond the arm’s functional reach length. Seven subjects with mild right hemiparesis following a stroke and seven age and gender matched control subjects participated. Joint motions and characteristics of hand and trunk movement were measured over multiple repetitions. The variance (across trials) of joint combinations was partitioned into two components at every point in the hand’s trajectory using the uncontrolled manifold approach; the first component is a measure of the extent to which equivalent joint combinations are used to control a given hand path, and reflects performance flexibility. The second component of joint variance reflects the use of non-equivalent joint combinations, which lead to hand path error. Compared to the control subjects, persons with hemiparesis demonstrated a significantly greater amount of non-equivalent joint variability related to control of the hand’s path and of the hand’s position relative to the trunk when reaching toward the hemiparetic side (ipsilaterally), but not when reaching to the less involved side. The relative timing of the hand and trunk was also altered when reaching ipsilaterally. The current findings support the idea that the previously proposed “arm compensatory synergy” may be deficient in subjects with hemiparesis. This deficiency may be due to one or a combination of factors: changes in central commands that are thought to set the gain of the arm compensatory synergy; a limited ability to combine shoulder abduction and elbow extension that limits the expression of an appropriately set arm compensatory synergy; or a reduction of the necessary degrees-of-freedom needed to adequately compensate for poor trunk control when reaching ipsilaterally.     

Enhanced Anti-tumor Efficacy of Aspirin Combined with Triptolide in Cervical Cancer Cells

Background: The non-steroidal anti-inflammatory drug (NSAID) aspirin (acetylsalicylic acid) is an inhibitor ofcyclooxygenase enzymes. Recent studies have shown that aspirin could be used as an anti-tumor drug. Triptolide,the major compound extracted from the Chinese herb Tripteryglum wilfordii Hook.f, has now been shown that itcan inhibit tumor growth. The aim of this study was to analyze the anti-tumor efficiency of aspirin and triptolidein cervical cancer cells. Methods: Viability of cervical cancer cell lines was assessed by the MTT method atvarious concentrations of aspirin and triptolide. Siha and HeLa cell apoptotic analysis was performed by flowcytometry. Real time-PCR and Western Blotting were used to analyze the expression of Bcl-2/Bax, Cyclin D1 andp16. Results: Viability in the combination group was significantly decreased as compared with either drug usedalone. Expression change of Bcl-2/Bax, CyclinD1 and p16 appeared to play an important role in the synergistickilling effect on cervical cancer cell apoptosis. Conclusion: Aspirin and triptolide combination treatment mayhave synergistic anti-tumor effects on cervical cancer cells.     

Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: Evidence from 260,061 Australians

Objective

While many studies report that green spaces promote mental health, some suggest the psychological benefits of physical activity are amplified if participation occurs within greener environs. We investigated whether this relationship could be observed among adults in middle-to-older age.

Method

Multilevel logit regression was used to investigate association between green space and psychological distress (Kessler scores of 22 +) among 260,061 Australians over 45 years old living in New South Wales (2006–2009). Physical activity was measured using the Active Australia survey. Percentage green space was estimated within a 1-kilometre of residence.

Results

In comparison to residents of the least green areas, those in the greenest neighbourhoods were at a lower risk of psychological distress (Odds Ratio 0.83, 95% CI: 0.76, 0.92) and were less sedentary (0.81: 0.77, 0.87). An interaction was observed between physical activity and green space (p = 0.0028). More green space did not appear to benefit mental health among the least active (0.99: 0.85, 1.15), but there was a protective association for the more physically active (0.82: 0.67, 0.99).

Conclusion

For adults in middle-to-older age, green spaces are not only important for promoting physical activity, but the mental health benefits of greener environs appear contingent upon those active lifestyles.     

Neuro-rehabilitation robot-assisted assessments of synergy patterns of forearm,elbow and shoulder joints in chronic stroke patients

Background

Abnormal synergy is one of the major motor deficits in stroke patients. Abnormal muscle synergies, in conjunction with weakness and spasticity, interfere with voluntary movements and restrict the range of motion. This study aimed to quantify abnormal synergies in the affected upper limbs of chronic stroke patients by using a neuro-rehabilitation robot.

Methods

Twelve chronic stroke patients and eight age-matched control subjects were recruited to perform rectilinear tracking movements in four horizontal directions (back–forth, two oblique directions at 45°, and right–left). Kinematic, kinetic and electromyogram data were recorded and used to develop two biomechanical indices and one electromyogram assessment index based on principal component analysis.

Findings

Significant differences between upper limbs of control subjects and the affected side of stroke patients were observed in all three assessment indices. Higher correlation between the elbow joint angle and the forearm pronation/supination torque, higher variation of the forearm torque, and abnormal co-contraction of the elbow and shoulder muscles were observed in the affected limbs of stroke patients. The difference was more prominent in the right–left direction and the oblique direction contra-proximal to ipsi-distal.

Interpretation

The proposed assessment indices could be employed to quantify the abnormal synergies in stroke patients. Rectilinear tracking along the right–left direction and the oblique direction of contra-proximal to ipsi-distal is more suitable for assessing abnormal synergies.