Effect of Zhuchun Pill on Immunity and Endocrine Function of Senile Kidney-Yang Daficiency

TraditionalChineseMedicineholdsthatagingiscloselyrelatedwiththefunctionofKidney,thatKidney--Deficiencycouldinducedecrepitude('),andtheagingprocesscouldberetardedbysupplementingKidney.InordertoverifytheeffectofZhuchunPill(ZCP)onaging,fromMay1992toApril1993,agroupofelderlymalepatientswithKidney--YangDeficiencySyndromebutwithoutseriousorganicdiseasewastreatedbyZCP,andthemodernmedicalparametersrelatedwithKidlleyandagingwereobservedandcomparedwiththecontrolgroup.METHODSClinicalMaterials…     

基于TLR4/MyD88/MAPK信号通路探讨脉络舒通丸抗血栓性浅静脉炎的作用机制研究

[目的] 探讨脉络舒通丸抗血栓性浅静脉炎（STP）的作用机制。[方法] 将36只日本大耳白兔随机分为正常组、模型组、脉络舒通丸低、中、高剂量组、地奥司明组（阳性药对照），每组6只。除正常组外，其余各组均采用耳缘静脉注射20%甘露醇建立STP兔模型。造模同时各给药组连续灌胃给药14 d。苏木精-伊红（HE）染色法检测各组兔耳组织病理变化；酶联免疫吸附（ELISA）法检测各组血清中白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的水平；测定凝血4项；蛋白免疫印迹（Western Blot）法检测耳组织Toll样受体4（TLR4）、髓样分化因子88（MyD88）、细胞外信号调节激酶（ERK1/2）、p38丝裂原活化蛋白激酶（p38MAPK）和c-氨基酸末端激酶（JNK）蛋白表达及相关磷酸化水平。[结果] 与正常组比较，模型组病理损伤评分显著增加（P<0.01）；血清中IL-1β、TNF-α和IL-6的表达水平明显升高（P<0.05）；活化部分凝血酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）缩短，纤维蛋白原（FIB）含量升高（P<0.05）；TLR4、MyD88、丝裂原活化蛋白激酶（MAPK，包括p38MAPK、ERK1/2和JNK）蛋白及相关磷酸化水平均显著上调（P<0.01）。与模型组比较，脉络舒通丸低、中、高剂量组、地奥司明组兔耳组织病理损伤显著改善，病理损伤评分明显降低（P<0.05或P<0.01）；血清中IL-1β、TNF-α和IL-6的表达水平显著降低（P<0.05或P<0.01）；APTT、PT、TT明显延长，FIB含量明显降低（P<0.05或P<0.01）；TLR4、MyD88、MAPK（p38MAPK、ERK1/2和JNK）蛋白及相关磷酸化水平均显著下调（P<0.05或P<0.01）。[结论] 脉络舒通丸可能通过抑制TLR4/MyD88/MAPK信号通路，减轻炎症反应，改善凝血功能，从而发挥抗血栓性浅静脉炎作用。     

Contribution of Borneolum syntheticum to the Intervention Effect of Liuwei Dihuang Pill (六味地黄丸) on Experimental Retinal Degeneration

Objective: To observe the contribution of Borneolum syntheticum to the intervention effect of Liuwei Dihuang Pill (六味地黄丸, LDP) on experimental retinal degeneration, and initially investigate the mechanism of Borneolum syntheticum as meridian-lead-in drug. Methods: A total of 180 sodium iodate-induced retinital degeneration rats were randomly divided into three groups, including distilled water group, LDP group, and LDP+Borneolum syntheticum (LDP+BS) group. Twenty normal rats were fed regularly without any treatment as normal control. On day 7 and 14 after treatment, histopathological study and transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) test were performed to evaluate the retinopathy. Claudin-5 expression at blood-retina barrier (BRB) was detected by Western blot at different time points from 0.5 to 8 h after gavage. Results: On day 7 and 14 after treatment, the retinal lesion grades were significantly different among the three groups (P<0.05). The grade in the LDP+BS group was significantly less than the LDP and distilled water groups (both P<0.05), no significant difference was observed between the LDP and distilled water groups (P>0.05). The apoptosis rates in the LDP+BS group was significantly less than the distilled water and LDP groups (both P<0.05), while there was no significant difference between LDP and distilled water groups (P>0.05). Expression of claudin-5 in LDP+BS group was significantly less than the other two groups at 0.5, 1 and 2 h after gavage (P<0.05). There was no apparent difference among the three groups at 4 and 8 h after gavage (P>0.05). Conclusion: Borneolum syntheticum could strengthen the effect of LDP on experimental retinal degeneration, indicated that Borneolum syntheticum might play the role of meridian-lead-in drug in the formula. The mechanism may be due to Borneolum syntheticum could promote the physiologically openness of blood-retina barrier through transiently affecting the expression of claudin-5.     

麝香保心丸预防桡动脉痉挛的疗效研究

目的：对经桡动脉冠脉介入诊疗术患者进行硝酸甘油和麝香保心丸干预,观察两组药物及联合干预预防桡动脉痉挛的疗效。方法：选择经桡动脉行冠脉介入诊疗的患者636例,随机分为3组(A组、B组、C组)：A组予硝酸甘油200μg;B组予舌下含服麝香保心丸67.5mg(3丸);C组予硝酸甘油200μg联合麝香保心丸67.5mg。观察各组之间桡动脉痉挛发生率。结果：桡动脉痉挛发生率分别为：A组(13.1%),B组(14.2%),C组(8.5%),其中A组与B组之间比较无统计学差异(P >0. 05),C组与A组、B组比较有统计学差异(P <0. 05)。结论：经桡动脉冠脉介入诊疗术前予麝香保心丸降低桡动脉痉挛发生率与硝酸甘油疗效相当,与硝酸甘油合用效果更佳。     

逍遥丸联合氟西汀治疗卒中后抑郁疗效及对血清5-羟色胺水平的影响

目的 观察逍遥丸结合氟西汀治疗卒中后抑郁患者的临床疗效及对血清5-羟色胺(serotonin,5-HT)水平的影响。方法 采用随机对照的方法,将医院收治的符合卒中后抑郁的86例患者分成试验组（43例）和对照组（43例）,试验组患者采用逍遥丸+氟西汀治疗,对照组患者应用氟西汀治疗,疗程4周。观察指标包括：治疗前后的汉密尔顿抑郁量表（HAMD）评分和血清5-HT浓度。结果 试验组总有效率（90.7%）高于对照组总有效率（76.7%）(P＜0.05)。治疗前试验组、对照组的HAMD评分分别为（21.02±2.84）、（20.75±4.17）,治疗后试验组、对照组的HAMD评分分别为（9.18±2.87）、（12.63±3.74）。两组患者经治疗后,HAMD评分较治疗前均有改善（P＜0.05）,且治疗后试验组HAMD评分明显低于对照组（P＜0.05）。治疗前试验组、对照组的血清5-HT浓度分别为（85.02±6.42）ng/ml、（83.97±5.90）ng/ml,治疗后试验组、对照组的血清5-HT浓度分别为（146.29±6.78）ng/ml、（121.82±4.73）ng/ml。治疗后两组血清5-HT浓度均有升高（P＜0.05),试验组较对照组升高更为明显（P＜0.05）。治疗中均未发生严重不良反应。结论 逍遥丸联合氟西汀能有效改善卒中后抑郁患者的抑郁症状,其机制可能与逍遥丸调节体内5-HT水平相关。     

基于网络药理学和分子对接的补肾固齿丸治疗肾虚血热型牙周病物质基础与作用机制研究

[目的] 通过网络药理学及分子对接分析,揭示了补肾固齿丸治疗肾虚血热型牙周病的有效物质基础及作用机制。[方法] 通过中药系统药理学数据库与分析平台（TCMSP）等数据库及平台检索补肾固齿丸复方中各味药材的所有有效成分及相应靶标,在人类基因数据库（Gene Cards）及在线《人类孟德尔遗传》（OMIM）平台检索疾病相关靶基因,构建补肾固齿丸“活性成分-成分对应靶标-牙周病靶标”网络,进一步筛选进行网络拓扑学分析,并对有效核心成分及关键靶标进行分子对接,分析小分子配体与受体的结合能力。[结果] 筛选出12个活性成分,25个靶标,关键靶标3个,分别为雌激素受体（ESR1）、表皮生长因子受体（EGFR）、磷酸肌醇3-激酶α（PIK3CA）。这些成分及靶标基因通过对核受体活性、蛋白激酶活性、酶激活剂活性、生长因子结合、血红素结合、内肽酶活性、蛋白质同二聚活性等的调节,参与细胞肿瘤抗原（P53）及核因子κB（NF-κB）信号通路的调控过程对牙周病的治疗起到重要作用。分子对接分析发现,3个关键靶标与12个活性成分（Quercetin、Aureusidin、Physcion等）均具有一定的亲和力。[结论] 补肾固齿丸通过复杂的网络调控对肾虚血热型牙周病的起到有效治疗作用,该研究为更进一步探索其治疗相关证候的作用机制及临床应用提供了研究思路和理论基础。     

止骨增生丸对兔膝骨关节炎组织形态学改变实验研究

目的：探讨止骨增生丸对兔膝骨性关节炎模型组织形态学的影响。方法：选取大耳白兔24只,按照组间均衡一致的原则,将24只健康大耳兔随机分为4组,每组6只,分别为：正常组、模型组、对照组（壮骨关节丸）组、治疗组（止骨增生丸）组。采用改良的＂Hulth＂经典造模法复制家兔膝骨性关节炎模型。造模成功后按体型系数换算法,计算出家兔用药量。给予对照组：含壮骨关节丸0.756g/kg的生理盐水10mL/次,3次/d,给予治疗组：含止骨增生丸0.756g/kg的生理盐水10mL/次,3次/d药物灌胃,用药4周后取材,采用普通光学显微镜观察关节软骨的层次、软骨细胞及软骨下骨的变化。结果：肉眼观察见正常组关节软骨表面光滑,呈极淡蓝色。对照组（壮骨关节丸）关节软骨表面呈淡黄色。治疗组（止骨增生丸）软骨颜色淡白。模型组关节软骨表面略显粗糙,呈黄色,可见滑膜充血。治疗组（止骨增生丸组）：软骨组织表面光滑,表浅层：组织细胞有部分消失。以上实验结果结果显示止骨增生丸可以维持机体软骨细胞的正常组织形态,改善骨性关节炎的滑膜充血肿胀情况以及维持软骨细胞组织的正常形态。结论：表明止骨增生丸对骨性关节炎有比较显著的防治效果,其临床效果优于壮骨关节丸。     

金匮肾气丸治疗牙周病的临床疗效观察

目的初步评价金匮肾气丸治疗牙周病的临床疗效。方法选取120例牙周病病例,经中医辩证诊断为肾气亏损;随机分为两组各60例,A组采用中医辨证治疗,进行一次全口龈上、龈下超声波洁治后,先以金匮肾气丸汤剂每日1剂,2次/d,煎服2周,后以丸剂桂附地黄丸口服,每次8丸,2次/d,2周为一疗程,3个疗程结束后统计疗效。B组单纯进行一次全口龈上、龈下超声波洁治。疗效测定分别于治疗前（基线）、疗程结束后4周、12周复诊分别检查记录每个受检位点的①菌斑指数（plaque index,PLI）、②龈沟出血指数（sulcus bleeding index,SBI）、③牙周探诊深度（periodontal probing depth,PD）、④附着丧失（attachment loss,AL）、⑤探诊出血（bleeding onp robin,BOP）牙周检测临床指标。结果 A组疗程结束后4周、12周的PLI、SBI、PD、AL、BOP疗效测定分别与治疗前（基线）对比明显改善,差异有统计学意义;B组差异无统计学意义;A组与B组比较,差异有统计学意义。结论金匮肾气丸治疗牙周病短期疗效良好,但长期疗效仍有待观察研究。     

Associations between pain clinic density and distributions of opioid pain relievers,drug-related deaths,hospitalizations, emergency department visits,and neonatal abstinence syndrome in Florida

Background

Community-level associations between pain clinics and drug-related outcomes have not been empirically demonstrated.

Methods

To explore these associations we correlated overdose death rates, hospital-discharge rates for drug-related hospitalizations including neonatal abstinence syndrome, and emergency department rates for drug-related visits with registered pain clinic density and rate of opioid pills dispensed per person at the county-level Florida in 2009. Negative binomial regression was used to model the crude associations and associations adjusted for exposure measures and county demographic characteristics.

Results

An estimated 732 pain clinics operated in Florida in 2009, a rate of 3.9/100,000 people. Among the 67 counties in Florida, 23 (34.3%) had no pain clinics, and three had 90 or more. Adjusted negative binomial regression determined no significant association between pain clinic rate and drug-related outcomes. However, rates of drug-caused, opioid-caused, and oxycodone-caused death correlated significantly with rates of opioid and oxycodone pills dispensed per person in adjusted analyses. For every increase of one pill in the rate of oxycodone pills per person, there was a 6% increase in the rate of oxycodone-related overdose death.

Conclusions

Although pain clinics, some of which are “pill mills,” are clearly a source of drugs used nonmedically, their impact on health outcomes might be difficult to quantify because the pills they prescribe might be consumed in other counties or states. The impact of “pill mill” laws might be better measured by more proximal measures such as the number of such facilities.     

木香顺气丸薄膜包衣工艺研究

目的研究用薄膜包衣技术改进木香顺气丸的质量稳定性。方法采用薄膜包衣工艺技术,选取3种包衣液处方对本品素丸进行包衣,考察包衣前后丸子的相关质量指标。结果本品素丸包薄膜衣对溶散时限影响较小,对含量测定几无影响,稳定性试验表明包衣丸比未包衣素丸的吸湿率低。结论本品可以采用胃溶型薄膜包衣预混剂进行包衣,对提高其防吸湿性有明显效果,且工艺操作简单。