Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing

Objective

The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds.

大黄对重症急性胰腺炎患者血清高迁移率族蛋白B1影响的临床研究

目的 观察大黄灌肠对重症急性胰腺炎(SAP)患者血清高迁移率族蛋白B1 (HMGB1)的影响.方法 选取2014年10月至2016年10月该院收集SAP患者60例,分为观察组和对照组,各30例,对照组给予常规治疗,观察组加用大黄治疗,分别在入院后第1、3、5天动态监测患者血清HMGB1水平,对患者进行急性生理功能和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分,观察患者胃肠功能恢复时间、连续性肾脏替代疗法(CRRT)治疗时间.结果 入院第1天,两组患者血清HMGB1水平比较,差异无统计学意义(P＞o.05);第5天观察组患者血清HMGB1水平较第1天明显降低,且低于对照组,差异均有统计学意义(P＜0.05).观察组第3天与第1天血清HMGB1水平的差值与第3天APACHEⅡ评分呈明显负相关(r=-0.604,P＜0.05).观察组腹痛、腹胀缓解时间,排气、排便时间及CRRT治疗时间均较对照组短,差异均有统计学意义(P＜0.05).结论 大黄可能通过有效抑制晚期炎性因子HMGB1的表达,改善SAP患者的症状和转归.     

Rhubarb-based Chinese herbal formulae for hepatic encephalopathy: a systematic review and Meta-analysis

Objective

To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae (RCHF), which are widely used to treat hepatic encephalopathy (HE) in China.

大黄对老年Ⅱ型糖尿病尿蛋白排泄率的影响

目的 :观察大黄对老年Ⅱ型糖尿病尿白蛋白排泄率的改变。方法 :94例年龄≥ 60岁的NID DM患者伴微量白蛋白尿 ,分为三组 ,分别应用captopril、大黄及两药联合治疗 ,比较治疗前、治疗 2W和4W尿白蛋白排泄率。结果 :应用captopril 2W即发挥降低UAER作用 ( 95.1± 9.8比 82 .7± 8.8,P <0 .0 5) ,大黄治疗 2W对UAER无明显改变 ,4W与captopril效果相似 ( 72 .3± 9.6比 73.3± 9.2 ,P >0 .0 0 1 ) ,两药联合应用效果最佳 ( 4 2 .3± 1 1 .6,P <0 .0 0 1 )。结论 :大黄有降低老年NIDDM患者尿白蛋白排泄的作用 ,与aptopril联用效果最好。     

大黄游离蒽醌的制备与纯化

从中药大黄中提取总蒽醌（结合和游离２类）,经水解后用水化学试剂或大孔树脂制备总游离蒽醌（含大黄素、大黄酸、芦荟大黄素、大黄酚和大黄素甲醚）,进一步纯化得大黄酸和大黄素。     

藏边大黄的化学成分研究

目的研究藏边大黄的化学成分。方法用硅胶、聚酰胺柱色谱分离结合重结晶方法进行分离纯化。用MS、1H-NMR、13C-NMR谱学方法结合化学方法确定化合物的结构。结果从藏边大黄干燥根与根茎的乙醇提取物中分得18个化合物,鉴定了其中16个化合物的结构,分别为大黄酚(1)、大黄素甲醚(2)、β-谷甾醇(3)、大黄素(4)、芦荟大黄素(5)、波叶素(6)、胡萝卜苷(7)、d-儿茶素(8)、反式-3,5,3′,4′-四羟基茋(9)、反式-3,5,3′,4′-四羟基茋-4′-O-β-D-吡喃葡萄糖苷(10)、反式-3,5,3′,4′-四羟基茋-4′-O-β-D-(6″-O-p-香豆酰)-吡喃葡萄糖苷(11)、大黄酚-8-O-β-D-吡喃葡萄糖苷(12)、大黄素甲醚-1和8-O-β-D-吡喃葡萄糖苷(13a和13b)、大黄素-8-O-β-D-吡喃葡萄糖苷(14)、蔗糖(15)。同时得到一种大黄酸类似物,因量少未得到最终的结构确定。结论化合物11为一新化合物,命名为波叶苷(rheoside),化合物13a和13b系首次从该植物中分得。     

Potential ex vivo immunomodulatory effects of San-Huang-Xie-Xin-Tang and its component herbs on mice and humans

Aim of the study

San-Huang-Xie-Xin-Tang (SHXXT), an important Chinese medicine formula, contains Rhei Rhizoma (RR), Scutellariae Radix (SR) and Coptidis Rhizoma (CR). RR and SR are abundant in anthraquinone and flavonoid polyphenols. Pharmacokinetic study of SHXXT indicated that glucuronides were the predominant forms of polyphenols in rats.

Materials and methods

As an extension of pharmacokinetic study, the serum metabolites of SHXXT, RR, SR and CR were prepared from rats and quantitated, then the immunomodulation effects were examined by culturing these serum metabolites with murine and human immune cells.

Results

The results indicated that the inhibitions on nitric oxide (NO) and cytokine production from mitogen-activated peritoneal macrophages by the serum metabolites of SHXXT, RR, SR and CR were through reducing the protein expression of inducible NO synthase (iNOS) and the IC₅₀ were 0.8%, 1.5%, 3.0% and 0.8% of their blood concentrations, respectively. In addition, the serum metabolites of SHXXT, RR, SR and CR significantly decreased the ratios of interferon-gamma (IFN-γ) to interleukin (IL)-4 in mitogen-stimulated mice spleen cells and human peripheral blood mononuclear cells (PBMCs). Moreover, the serum metabolites of SHXXT and SR significantly arrested the mitogen-stimulated mice spleen cells at G2/M stage.

Conclusions

In conclusion, the serum metabolites of SHXXT and the component herbs exerted promising modulation activities on the immune functions and the cell cycle distribution of mice and human immune cells. We suggest that SHXXT is a promising remedy for immunomodulation through Th1/Th2 regulation.     

大黄醇提液抗乙肝病毒作用

目的研究评价大黄醇提液的抗乙肝病毒作用。方法体内实验采用先天感染鸭乙肝模型,检测血清DHBV—DNA动态变化,体外实验采用2、2．15细胞为模型,检测用药后对细胞培养上清中HBsAg和HBeAg的抑制作用。结果在体内抗乙肝病毒实验中,大黄醇提液20g／kg和10g／kg剂量组于给药5d(T5)、10d(T10)和停药3d(P3)时体内均有显著抑制DHBV-DNA的作用。体外实验显示：大黄醇提液对2．2、15细胞分泌HBsAg的治疗指数为16、96,对分泌HBeAg的治疗指数为12．06。结论大黄醇提液在体内外实验中均具有明显的抗乙肝病毒作用。     

When and How to Treat Agitation in Alzheimer's Disease Dementia With Citalopram and Escitalopram

Agitation is a common neuropsychiatric symptom (NPS) in the early and middle stages of Alzheimer's disease (AD) dementia, which is difficult to treat and causes much distress. The U.S. Food and Drug Administration (U.S. FDA) issued black box warnings against the use of antipsychotics in dementia in 2005 and 2008 due to the increased risk of morbidity and mortality, resulting in the reduction in antipsychotic use for treating dementia-related NPS and spurring the quest for safer and more effective pharmacological options. The data favoring the use of citalopram for treating agitation in AD dementia is particularly compelling, and this may be a class effect for all selective serotonin reuptake inhibitors. However, concerns about the cardiac side-effects of citalopram have limited its widespread use for this indication. In this article, available efficacy and safety data for the use of citalopram and escitalopram in treating agitation in AD dementia is reviewed, using a composite case to illustrate key points. Practical recommendations are made to facilitate the use of these medications in routine clinical practice, risk mitigation strategies are discussed and salient issues for future clinical research are emphasized.