Calomel is a common traditional Chinese medicine (TCM) containing mercury in clinical external application. Although the toxicity of calomel has attracted concern, there is no unified standard yet in clinical external application. Risk assessment is used for evaluating the potential health effects of hazardous substances. The purpose of this article was to evaluate the health risk of calomel in clinical external application on the basis of toxicity data, to ensure safe and rational application of TCM containing calomel. The toxicity data of transdermal administration of calomel or mercurous chloride were collected by searching the literature. The daily maximum exposure dosage of calomel in clinical external application was estimated by following the four procedures of risk assessment, and Margin of Safety (MOS) as an evaluation indicator was then calculated to evaluate the safety of calomel on clinical application. It has been reported that the adult in single transdermal administration of calomel at 1. 5 g was lethal. Based on the LOAEL of calomel for long-term transdermal exposure (1 month) in rats was 0.096 g · kg(-1) · d(-1), the NOAEL of calomel for patients (about 60 kg) by external application within 2 weeks was estimated to be 1.46 mg · kg(-1) · d(-1). When MOS value equals to 1, the daily maximum exposure of calomel in clinical external application within 2 weeks was calculated to be 1.1 g. The results suggest that daily single dose of calomel in clinical external application should be lower than 1.5 g for adults, and more attention should be paid to changes in hepatic and renal function of patients when repeated dose more than 1.1 g within 2 weeks. The approach of risk assessment could be helpful in rational application of TCM containing mercury.
Animals ; Humans ; Medicine, Chinese Traditional ; Mercury Compounds ; toxicity ; No-Observed-Adverse-Effect Level ; Rats ; Risk Assessment

Animals ; Atherosclerosis ; blood ; drug therapy ; pathology ; Dehydroepiandrosterone ; blood ; physiology ; therapeutic use ; Dehydroepiandrosterone Sulfate ; blood ; therapeutic use ; Hormone Replacement Therapy ; Humans

AIM: To analyze curative effect of four regulating-intestines prescriptions (Wumei Wan, Baitouweng Tang, Shenling Baizhu San and Tongxie Yao-fang) on the treatment of ulcerative colitis (UC) through summing up the previous animal experimental results.METHODS: We collected the conclusions in the papers related to four regulating-intestines prescriptions for the treatment of UC which were published recently, made comparisons from the aspectsof symptoms, physical sign, pathological change, cytokine and its protein expression, blood adhesion molecule, cell apoptosis and controlling gene and analyzed the pathogenesis of UC and action mechanism of four regulating-intestines prescriptions. Four regulating-intestines prescriptions included Wumei Wan,Baitouweng Tang, Shenling Baizhu San and Tongxie Yaofang. Wumei Wan is from Treatise on Exogenous Febrile Diseases and Synopsis of the Golden Chamber, which consists of dark plum, asarum herb, dried ginger, Chinese goldthread, Chinese angelica root, aconite root, pricklyash peel, cassia twig,ginseng (sun-dried ginseng) and bark of cork tree and has marked effect in treating colic caused by ascariasis and persistent dysentery. Baitouweng Tang, from Treatise on Exogenous Febrile Diseases, consists of medicinal herbs such as pulsatilla root, Chinese goldthread, bark of cork tree and ash bark, which has functions of clearing away the heat-evil, expelling superficial evils and relieving dysentery. In addition, it has marked effect in treating heat-type dysentery. Shenling Baizhu San, from Prescriptions of Peaceful benevolent Dispensary, consists of medicinal herbs such as pulp of lotus seed, coix seed, amomum fruit, balloon flower root, white hyacinth bean, poria, ginseng (sun-dried ginseng), glycyrrhiza, bighead atractylodes and rhizoma dioscoreae, which has the nature of replenishing qi to invigorate the spleen and eliminate wetness to arrest diarrhea and has marked effect on treating diarrhea due to the hypofunction of spleen. Tongxie Yao-fang which is from The Complete Works of Zhang Jingyue consists of four herbals of agehead atractylodes, root of herbaceous peony, dried tangerine peel and ledebouriella root and has the functions of soothing liver and invigorating spleen and stopping diarrhea, and has marked effect on treating liver sthenia and deficient spleen, borborygmus and abdominal pain and diarrhea.RFSULTS: ① Because UC is a chronic protracted dysentery with deficiency of vital energy and existing of evil energy, the vital energy will be harmed if its treatment is specialized in removing and dissolving the stagnation, evil energy will continue to exist and stagnation will continue to accumulate if its treatment is specialized in strengthening vital energy and inducing astringency. Only supporting healthy energy and expelling evil energy is the correct therapy method. This is in accordance with the main treatment of Wumei Wan ②Eliminating dampness and pathogenic heat from the blood to treat diarrhea is the main treatment method of Baitouweng Tang, and this is incompletely suitable for the treatment of UC.③Shenling Baizhu San had the effect on soothing liver and invigorating spleen and stopping diarrhea, and this is also incompletely suitable for the treatment of UC. ④ The prescription of Tongxie Yaofang is used for treating diarrhea caused by deficient spleen and liver sthenia, and spleen controlled by liver, and abnormal ascent and descent. It accords with main pathogenesis of UC, deficient spleen, excessive dampness of deficient spleen and it is weaker in invigorating the spleen in catabasis of UC than Shenling Baizhu San. Therefore, Wumei Wan has the best curative effect,Baitouweng Tang the second, Shengling Baizhu San the third and Tongxie Yaofang a little poor.CONCLUSION: UC belongs to recurrent dysentery, and its pathogenesis is in accordance with the main treatment of Wumei Wan, but not the other three prescriptions, so Wumei Wan is the most efficient prescription in treating ulcerative colitis. Diagnosis and treatment based on an overall analysis of signs and symptoms of TCM is the premise of obtaining the best curative effect. Modeling of animal tests must be consistent with the type of syndrome of the traditional Chinese medicine. Ating ulcerative colitis (UC) from aspects such as symptom, physical sign, pathological changes, adherence factor, cytokine and its protein expression, apoptosis and its controlling gene by means of modeling, which proves their functions and effects are different and their curative effect are also different due to their different ingredient though they all have the functions of treating. Results of this test show Wumei Wan has the best curative effect, Baitouweng Tang the second, Shenling Baizhu San the third and Tongxie Yaofang a little poor[1-11] Mechanism of four regulating-intestines prescription in the treatment of ulcerative colitis is discussed from the viewpoints of traditional Chinese medicine as follows.

Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.

Objective To search for the methods preventing nephrotoxic injury of amikacin,Methods Case-control research was used in this study. There were 50 normal children in control group The urine routine, the ?2-microglobulin (?2 -M), mosmol and THP in urine and blood, the AIb, rGT and NAG in urine, the renal function and serum concentration of amikacin were determined respectively.The 43 patients with serious illness childten in study group, were divided into 2 groups (Group 1 and group 2 ). Group 1 (23 cases) was treated only with amikacin for 7 days, and group 2 (20 cases) was treated with vitaminC, vitamin E and amikacin for 7 days. Before treatment, the 3rd and 7th day during the treatment, all the items mentioncd above were examined in gtoup 1 and 2.Results The incidences of nephrotoxic injury of amikacin are 87 per cent (20/23)and 55 per cent (11/20) respectively in group 1 and 2. There is significant difference (P

Objective:To approach the status quo and characteristics of traditional Chinese medicine(TCM) in intefering the related cardiovascular risk factors in obese type 2 diabetes mellitus(T2DM).Methods:The recent 10 years documents about nitric oxide(NO),endothelin(ET),C reactive protein(CRP),and etc.,eight cytokines which are involved in T2DM and its cardiovascular complications were retrieved and statistically analyzed and all related TCM were pykno-analyzed.Results:① CRP was the focal point at home and abroad,adiponectin(APN) was the hot spot in recent years.② The documents of ET at home was greatly more than that abroad,it may hint some diversity between different races.③ The related TCM were mainly characterized by cleaning heat,enriching yin and qi,activating blood circulation and removing stasis.④ ET and NO were the hot spots in the TCM fi eld.Conclusion:TCM had certain effect on the cardiovascular risk factors above in obese T2DM.

Objective:To develop health-related physical fitness measurement scale and assess its reliability and validity among older adults.Methods:The health-related physical fitness measurement scale was developed through Delphi method and field investigation method.And the authority coefficient, Kendall's coefficient and variation coefficient were analyzed.A multi-stage random sampling technique was adopted to select 410 older adults to investigate the reliability and validity of health-related physical fitness measurement scale with test-retest reliability, Cronbach's α coefficient and Guttman Split-Half coefficient and structural validity by IBM SPSS 20.0 and AMOS 22.0.Results:The health-related physical fitness measurement scale consisted of 3 dimensions (organic function, motor function, physical adaptive capacity) and 15 indexes.The Cronbach's α coefficient was 0.84.The Spearman-Brown correlation coefficient and Guttman Split-Half coefficient were both 0.82.The test-retest reliability between the first measurement and retest after 1 week was 0.84.Three factors were extracted by exploratory factor analysis, which were basically consistent with the theoretical concept of the scale, but the items of the theoretical conception were different from the actual ones.Confirmatory factor analysis based on the theoretical conception showed that all the indexes met the requirements of reference value as well(χ 2/ df=2.38, GFI=0.94, AGFI=0.91, CFI=0.92, TLI=0.91, TFI=0.92, RMSEA=0.06). Conclusion:The health-related physical fitness measurement scale has good reliability and validity in measuring the health fitness level of the elderly population in Guangzhou.

Objective: The aim of this paper is to identify the basic organizational structure and the key elements of integrated healthcare model of patients with Chronic Obstructive Pulmonary Disease (COPD) and propose an appropriate development strategy.Methods: Based on the literature review of research articles about integrated care on patients with COPD, an analysis was conducted with the help of the Chronic Care Model (CCM) which is a chronic disease management model.Results: From of a total 16 articles about 13 case studies were found.An integrated healthcare of COPD was carried out in 10 hospital-based or community-based care programs.Most of the patients were the elderly and health status were moderately severe or more severe.The components of healthcare programs varied from 4 to 12 included at least two CCM dimension.A coordinator or a case manager was appointed in all healthcare programs and a follow-up plan was made as well.Decision making was supported by clinic guideline and specialist resource in 9 integrated healthcare programs which community facilities involved.All programs included self-management with health education and individualized behavioral support was in 10 programs.The action plan was applied in 8 studies.8 studies using a clinical information system connected health care provider and patients.Conclusions: COPD integrated care program can be constructed according to the management model of chronic disease, and it is suggested that we can organize the COPD integrated care program based on CCM and the program comprises 4 organizational components of at least two CCM dimensions.The key elements of COPD integrated healthcare are to appoint a coordinator, to make a follow-up plan, and the necessity of community participation to support decision making, support self-management by education and individualized behavioral management with an action plan.

In traditional clinical application, Coptidis Rhizome and Evodiae Fructus have been combined to treat various stomach heat and cold syndromes, gastritis, gastric ulcer and the like. With the application of modem instruments and the development of molecular pharmacologic theory, their chemical constituents and pharmacological effects have been sufficiently studied. In this paper, literatures from Pubmed were adopted, with particular emphasis on findings of international counterparts and studies on compatibility of main chemical components in Coptidis Rhizoma and Evodiae Fructus, in order to elaborate on the scientific comparability of Coptidis Rhizoma and Evodiae Fructus through chemical analysis, and pharmacological and biopharmaceutics studies and introduce the future development trend of the studies.
Animals ; Drug Interactions ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Evodia ; chemistry ; Fruit ; chemistry ; Humans ; Ranunculaceae ; chemistry ; Rhizome ; chemistry

OBJECTIVETo explore the mechanism of the aging deformity of tear trough through the anatomic study of the tear trough region.

METHODS13 adult cadaveric heads (26 sides), including 9 male heads (18 sides) and 4 female heads (8 sides), aged 22-78 years old, were used. Anatomic study was performed around the orbital, especially tear trough region, with microsurgery instrument under microscope( x 10 times). The lower orbicularis retaining ligament was dissected and exposed. The anatomic location was recorded and photographed.

RESULTS(1) The anatomic layers of the tear trough region contains skin, subcutaneous tissue, orbicularis oculi muscle, periosteal membrane. There is no subcutaneous fat above the tear trough, while it exists below the tear trough, called malar fat pad. (2) There is a natural boundary between the septal and the orbital portions of the orbicularis oculi muscle of lower eyelid at surface of the orbital bone. The natural boundary, projected on the body surface corresponds to tear trough. The width of boundary is (2.06 +/- 0.15) mm on the vertical line through inner canthus and (3.25 +/- 0.12) mm on the vertical line through the lateral margin of the ala. The septal portion and the orbital portion of the orbicularis oculi muscle began to merge in (16.56 +/- 0.51) mm to inner canthus. (3) There is ligament attachment in the medial, upper and lower orbital and no ligament attachment in the lateral orbital. Orbicularis retaining ligament of lower eyelid is divided into two layers. (4) The medial of the upper layer of the orbicularis retaining ligament in lower eyelid originates from orbital margin and from preorbital walls laterally in (16.10 +/- 0.43) mm to the medial of lateral orbital margin, through orbicularis oculi muscle and ends at the skin. The lower layer of the orbicularis retaining ligament of lower eyelid originates from preorbital walls through orbicularis oculi muscle and its superficial fat, then ends at the skin.

CONCLUSIONSThe length of tear trough is (16.56 +/- 0.51) mm, the width of tear trough is (2.06 +/- 0.15) mm and (3.25 +/- 0.12) mm on the vertical line through inner canthus and the lateral margin of the ala nasi respectively. The main reason of the aging deformity of tear trough attributes to the increased distance between the upper and lower layers of the orbicularis retaining ligament in lower eyelid, which is caused by loose of the orbicularis retaining ligament and its underlying fat atrophy or decline.

Adult ; Aged ; Aging ; Cheek ; anatomy & histology ; Eyelids ; anatomy & histology ; Facial Muscles ; anatomy & histology ; Female ; Humans ; Lacrimal Apparatus ; anatomy & histology ; Male ; Middle Aged ; Young Adult