The efficacy of combined l-carnitine and l-acetyl carnitine in men with idiopathic oligoasthenoteratozoospermia: A systematic review and meta-analysis

The purpose of our analysis is to identify the effect of l -carnitine (LC) and l -acetyl carnitine (LAC) on the semen parameters of men with idiopathic oligoasthenoteratozoospermia (iOAT). We performed a comprehensive search to ascertain all the trials about LC and LAC in the treatment of iOAT and compared the results, including percentage of total sperm motility, sperm concentration, percentage of forward sperm motility, semen volume, percentage of atypical forms, total motile spermatozoa, forward motile spermatozoa and the number of pregnancies between the two groups that treated with LC + LAC or placebo respectively. Seven randomised controlled trials (RCTs) involving 693 patients were included in our analysis. We found that patients who treated with LC and LAC had significantly increased the percentage of forward sperm motility (MD 6.98; 95% CI 1.06–12.90; p = .02), total motile spermatozoa (MD 16.45; 95% CI 8.10–24.79; p = .0001), forward motile spermatozoa (MD 13.01; 95% CI 11.08–14.94; p < .00001) and the number of pregnancies (OR 3.76; 95% CI 1.66–8.50; p = .002). However, no significant differences were found in other semen indicators between the two groups. LC and LAC can significantly increase part of the semen parameters. The combination therapy of LC and LAC is effective in the men with iOAT.     

针药结合治疗特发性震颤病案举隅

特发性震颤,又名原发性震颤,属于常见的锥体外系疾病,在震颤病症患者中多见,约60%患者有家族史,为单一症状性疾病,姿势性震颤为本病的唯一临床表现,罕见静止性震颤,其震颤常见于手,其次为头部,极少为下肢,西医多认为本病与小脑橄榄核节律紊乱有关,治疗尚无特效方法。中医学认为特发性震颤属“颤证”范畴,多因肝肾不足,肝风内动,筋脉失养所致,因肝主风,风为阳邪,阳主动,肝木气太过克脾土,脾主四肢,四肢者诸阳之末,木气鼓之,故动,治疗当滋补肝肾、抑木扶土、益气养血、调补阴阳为主,兼以熄风通络。本例在临床上运用针刺结合三甲复脉汤加减治疗,短期内取得明显疗效。     

Meloxicam emulgels for topical management of rheumatism: Formulation development,in vitro and in vivo characterization

PurposeThe study designed, formulated and evaluated meloxicam emulgels as a potential alternative topical treatment option for rheumatism.MethodsA 3² factorial design was employed to formulate nine preliminary meloxicam emulgels (Formulations F1 ? F9). The influences of carbopol-934 and menthol as gelling agent and drug release enhancer, respectively, were correlated with four pharmaceutical properties of the formulated emulgels namely viscosity, spreadability, and cumulative drug release at one hour and at eight hours. Using the generated data and applying the Design Expert® modelling software, two optimized meloxicam emulgels (Formulations F10 and F11) were designed, formulated and evaluated. In vivo anti-inflammatory efficacy was conducted using carrageenan-induced rat paw oedema method. Drug release kinetics was modelled using DDSolver® dissolution software.ResultsAll formulations were homogenous with no observable grittiness or phase separation. The optimized Formulations F10 and F11 had pH 6.5 and 6.4, viscosity of 23656 and 24524 mPa.s, spreadability of 9.9 and 9.5 cm, and drug content of 90.4% and 92.9%, respectively, all within optimal values. The cumulative percentage of drug released was 21.0% and 22.9% after one hour and 50.1% and 55.8% after eight hours for Formulations F10 and F11, respectively. Drug release kinetics exhibited Fickian diffusion best described by Korsmeyer-Peppas model. Paw volume inhibition by Formulation F11 at two and three hours after carrageenan injection was statistically significant (p < 0.05).ConclusionThe optimized meloxicam emulgels had high pharmaceutical quality and were pharmacologically active. Further optimization could potentially provide a safe and efficacious alternative treatment option for rheumatism.     

葡萄籽提取物与柳氮磺吡啶联合用药对实验性溃疡性结肠炎的作用

目的 研究葡萄籽提取物（GSPE）与柳氮磺吡啶（SASP）联合用药治疗葡聚糖硫酸钠（DSS）诱导的小鼠溃疡性结肠炎的效果及作用机制。方法 将SPF级C57小鼠随机分为对照组、模型组、GSPE （250 mg/kg）组、SASP （250 mg/kg）组、联合用药（SASP 250 mg/kg+SASP 250 mg/kg）组,对照组给予正常饮用水,其他组均自由饮用3% DSS水溶液,连续饮用7 d,诱发小鼠溃疡性结肠炎模型;造模第1天同步开始ig给药,每天记录小鼠体质量、便血、便型等症状变化;7 d后断头取血,收集结肠和脾脏,记录结肠长度、脾脏质量变化情况。HE染色评估小鼠结肠黏膜组织病理变化,ELISA法检测血清和结肠组织中炎症因子肿瘤坏死因子（TNF-α）、白细胞介素（IL）-1β、IL-6和NO的表达变化以及丙二醛（MDA）、超氧化物歧化酶（SOD）细胞因子的含量变化,免疫组化分析结肠组织上皮细胞中NF-κB-p65、Nrf2、HO-1和Keap-1含量的变化。应用金氏Q值法分析联合用药的作用效果。结果 与模型组比较,各给药组的小鼠体质量下降幅度显著降低（P<0.01）,小鼠腹泻、便血症状改善明显,其中联合用药组小鼠体质量较单独给药组下降更缓,小鼠腹泻、便血程度改善更明显（P<0.05）。各给药组小鼠血清及结肠组织中IL-1β、IL-6、TNF-α、NO、MDA含量较模型组显著降低,SOD含量则显著升高（P<0.01）;病理组织切片分析发现,各给药组小鼠结肠黏膜病理损伤较模型组显著减轻,其中联合用药组小鼠结肠黏膜病理损伤较单独给药组降低更为显著（P<0.05）。免疫组化分析结果也显示,各给药组小鼠的NF-κB-p65、Keap-1蛋白表达与模型组比较显著下调（P<0.01）,Nrf2、HO-1蛋白表达显著上调（P<0.01）。联合给药组与单独给药组比较,NF-κB-p65、Keap-1蛋白表达显著降低（P<0.05）,Nrf2、HO-1蛋白表达显著升高（P<0.05）。金氏Q值法评价两药合用后对IL-1β、IL-6、TNF-α、NO、MDA、NF-κB-p65、Keap-1的作用效果均大于1.15,说明GSPE与SASP具有协同作用。结论 GSPE与SASP联合用药治疗实验性溃疡性结肠炎效果优于单独给药,联合用药增强GSPE和SASP的抗氧化和抗炎作用,GSPE与SASP配伍治疗溃疡性结肠炎可进一步发挥协同增效的作用。     

他克莫司联合透明质酸凝胶治疗面部脂溢性皮炎的效果

目的探究他克莫司软膏联合透明质酸凝胶应用于面部脂溢性皮炎患者治疗中的临床效果及其价值。方法选取2017年1月—2018年11月时间段到本院就诊的75例面部脂溢性皮炎患者作为此次研究的研究对象。并以不同的治疗方式将患者分为单一组(共37例,外用他克莫司软膏治疗)和联合组(共38例,他克莫司软膏联合透明质酸凝胶治疗)。治疗一个月后,对比两组患者的皮肤屏障功能以及总治疗效果。结果联合组皮肤含水量、pH值明显高于单一组,皮质分泌率以及皮肤经皮水丢失(TEWL)水平明显优于单一组,差异具统计学意义(P<0.05)。联合组治疗有效率(94.74%)明显高于单一组(70.27%),差异具统计学意义(P<0.05)。结论与单一他克莫司软膏治疗相比,他克莫司软膏联合透明质酸凝胶应用于面部脂溢性皮炎患者治疗中能更好的改善患者的脸部皮肤屏障,提高整体疗效。     

复可托联合玉屏风颗粒治疗儿童哮喘合并反复呼吸道感染的临床效果

目的 探讨复可托联合玉屏风颗粒治疗儿童哮喘合并反复呼吸道感染临床疗效。方法 选取2017年2月—2017年7月本院诊治哮喘合并反复呼吸道感染患儿75例行回顾性分析,根据患儿用药方案分为干预组(常规治疗+复可托+玉屏风颗粒治疗,43例)和常规组(常规治疗+玉屏风颗粒治疗,32例),比较2组患儿症状改善情况、免疫功能、疗效及不良反应发生率。结果 干预组患儿哮喘发作次数、呼吸道感染次数、咳嗽时间、发热时间及抗生素使用时间均低于常规组(P<0.05)。治疗前,2组患儿CD3+、CD4+、CD8+、IgA、IgG水平比较差异无统计学意义(P>0.05);治疗后6月,干预组患儿CD3+、CD4+、CD8+、IgA、IgG均高于常规组,且高于治疗前(P<0.05)。干预组患儿治疗总有效率高于常规组(97.44% vs 75.86%,P<0.05)。2组患儿治疗期间不良反应发生率差异无统计学意义(12.82% vs 24.14%,P>0.05)。结论 复可托联合玉屏风颗粒治疗儿童哮喘合并反复呼吸道感染可提高患儿免疫功能、改善临床症状和体征,具有显著疗效和较高用药安全性。     

用夏变夷融西贯中

干祖望教授的学术思想体系中渗透了中西医结合的思维方式,本文试从他的中西医结合学术思想形成的根源,以及在辨证论治方面的探索加以分析,阐明了他“用夏变夷”的中西医结合思想核心,就是立足发扬光大中医的立场,吸收西医理论要素,将其融入中医理论之中。     

Adenylate cyclase in the Drosophila memory mutant rutabaga displays an altered Ca2+ sensitivity

Adenylate cyclase in washed, crude membrane fractions prepared from the Drosophila conditioning mutant, rutabaga, displays an altered responsiveness to Ca2+. The results are of interest since the modulation of adenylate cyclase activity by Ca2+ has recently been suggested to play a role in molecular events that underlie memory formation.     

Studies with the azoxymethane-rat preclinical model for assessing colon tumor development and chemoprevention

During recent years, multidisciplinary studies in epidemiology and molecular biology have contributed to our understanding of the etiology of colorectal cancer; more importantly they have enabled us to approach its prevention. An impressive body of epidemiological data suggests an inverse relationship between colorectal cancer risk and consumption of diets rich in omega (omega)-3 fatty acids (n-3 PUFAs) or the regular use of nonsteroidal antiinflammatory drugs (NSAIDs), including aspirin. The development of strategies for the chemoprevention of colorectal cancer have been facilitated by the use of relevant animal models mimicking the neoplastic processes that occur in humans, including similarities in histopathology and molecular and genetic lesions during both the early and promotion/progression stages of carcinogenesis. Studies with the azoxymethane-F344 rat model indicate that diets rich in n-3 PUFAs, NSAIDs, selective cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS) inhibitors, and curcumin can reduce the incidence of colon cancer. Advances in the knowledge of the mechanisms by which chemopreventive agents act offer opportunities to use combinations of specific chemopreventive agents, having clinically beneficial aggregate activity with minimal toxicity. This approach is extremely important when a promising chemopreventive agent demonstrates apparent efficacy but may produce toxic effects at high doses. Our studies show that a combination of very low doses of piroxicam (NSAID) and difluoromethylornithine, a specific inhibitor of ornithine decarboxylase, or very low doses of COX-2 and HMG-CoA reductase inhibitors are more effective in inhibiting colon carcinogenesis than administration of these compounds as single agents even at higher levels. The natural history of colorectal cancer, from dysplastic aberrant crypts to adenomas and adenocarcinomas, offers multiple opportunities for assessment and intervention. Of further importance is to identify whether the molecular targets that are critical in the growth and survival of the malignant colorectal cell are modulated by n-3 PUFAs, NSAIDs, or COX-2 and iNOS inhibitors.