Traditional Chinese medicine (TCM) is an important part of modern medicine. Application of modern ana-lytical techniques to identify the authenticity of TCM and evaluate its quality is an important and critical content in the process of the modernization and internationalization of TCM. This paper described the development and charac-teristics of a 1H-NMR-based metabolomics technology, and reviewed its application in the species identification, quality evaluation of Daodi Y aocai (i.e., genuine medicinal materials), processing theory and the best harvest time of TCM. Besides, based on previous work, further discussion was given on technical methods and key question of the 1H-NMR metabolomics method. This paper provided a methodological reference for the species identification and quality evaluation of TCM and other herbal medicines.

This study is aimed to establish a high-performance liquid chromatography (HPLC) method for simultaneous determination of skimmin, scopolin and umbelliferone in Saussurea hieracioides. Samples were analyzed on a Wondasil C18-WR column (4.6 mm x 250 mm, 5 microm) with methanol (A) and water containing 0.1% phosphate (B) as mobile phases for gradient elution at a flow rate of 1.0 mL x min(-1). The detection wavelength and column temperature were set at 325 nm and 35 degrees C, respectively, and the sample size was 10 microL. The results showed that skimmin, scopolin and umbelliferone were simultaneously achieved within 40 min under the above conditions. A good linearity was observed in the range of 0.18-5.6 microg (r = 1.000 0), 0.060-1.8 microg (r = 0.999 9), 0.032-0.97 microg (r = 0.999 8) for skimmin, scopolin and umbelliferone, respectively, with the average recoveries of 99.16% (RSD = 0.41%), 100.3% (RSD = 0.79%), 102.2% (RSD = 0.87%). The method is simple, accurate and reproducible and can be used for the quality control of S. hieracioides.
Chromatography, High Pressure Liquid ; Coumarins ; analysis ; Glucosides ; analysis ; Medicine, Tibetan Traditional ; Reproducibility of Results ; Saussurea ; chemistry ; Umbelliferones ; analysis

This study was aimed to investigate the comprehensive ecological factors of Hippophae rhamnoides L. and their regional suitability in China. Based on field survey, specimen examination and literature investigation, ecologi-cal factors and appropriate production areas were analyzed by Traditional Chinese Medicine Geographic Information System (TCMGIS-II). The results showed that the proper region (with similarity of 95%~100%) of H. rhamnoides L. accounts for 737 994.71 km2, including 15 provinces/municipalities and 387 counties/cities. The largest area among them is Tibet autonomous region with area of 313 857.73 km2 (42.53%), followed by Sichuan province (223 987.02 km2, 30.35%), Gansu province (66 314.43 km2, 8.99%) and Shanxi province (4 237.79 km2, 0.57%). There are also certain appropriate production areas distributed in Liaoning province, Beijing, Chongqing and Hubei province. It was concluded that this system is much valuable to the recognition of the formation of the producing area, the division of adaptive area, introduction and acclimatization of medicinal materials. It also provided a scientific reference for the introduction and cultivation of H. rhamnoides L. Through further field study and experiments, these new areas have the potential to be developed into suitable production region of H. rhamnoides L. in the future.

Background Optic neuropathy is one of the diabetic eye complications.Rosiglitazone,a peroxisome proliferator activated receptor γ(PPARγ) agonist,plays a very important role in arresting the pathogenesis and development of diabetes.However,the role of PPARγ in diabetic optic neuropathy is unclear.Objective This study was to investigate the protective effect of rosiglitazone against diabetic optic neuropathy and its mechanism.Methods Male Sprague-Dawley rats were randomly divided into the control group,diabetic group and rosiglitazone group,with 10 rats for each group.Diabetic models were induced by injecting 50 mg/kg of streptozotocin via the caudal vein,and rosiglitazone(5 ng/[kg· d])was used in the rats of the rosiglitazone group by intragastric administration every day for four weeks.At the end of the experiment,the fasting blood sugar(FBS) was tested in all the animals.The level of vascular endothelial growth factor(VEGF) in the blood plasma was detected by ELISA.Optical neural tissues were obtained from the rats of each group,and Lauck fast Blue myelin stain was used to examine the morphology of the optical myelin.The expression of neural cell adhesion molecule (NCAM) mRNA and protein in the optic nerve was detected by real time PCR and Western blot,respectively.Results The levels of FBS,blood plasma VEGF,NCAM mRNA and protein in the optic nerve were significantly different among the control group,diabetic model group and the rosiglitazone group after the administration of 5 nmg/(kg · d) rosiglitazone for 4 weeks (F =6.12,P＜0.01 ; F =5.14,P＜0.05 ; F =4.75,P＜0.05 ; F =4.87,P＜0.05).Compared with the control group,the level of FBS significantly increased in the diabetic model group(t =2.26,P＜O.05),and that in the rosiglitazone group significantly declined in comparison with the diabetic model group(t=2.08,P＜0.05).The optic nerve exhibited a normal morphology in the control group as revealed by the Lauck fast Blue myelin staining;however,severe demyelination of the optic nerve and proliferation of glial cells were found in the diabetic model group,and mild demyelination of the optic nerve and proliferation of glial cells were seen in the rosiglitazone group.Blood plasma VEGF was(28.76±4.21)ng/L in the control group and(134.28±11.36)ng/L in the diabetic model group,showing a significant difference between them (t=2.36,P ＜ 0.05).Compared with the model group,the blood plasma VEGF was significantly lower in the rosiglitazone group ([42.67 ± 5.83] ng/L) than that in the diabetic model group (t =2.17,P＜ 0.05).Expression of NCAM mRNA and protein in the optic nerve significantly decreased in the diabetic model group compared with the control group(t =2.21,t =2.58,both at P＜0.05);while those in the rosiglitazone group were significantly elevated in comparison with the diabetic model group(t =2.19,t =2.67,both at P＜O.05).Conclusions Rosiglitazone can protect optic nerve from damage in diabetic rats mainly by downregulating blood plasma VEGF level and upregulating NCAM expression.

Radiology is an important adjunct to clinical practice, but for many clinicians, requesting X-rays was something that was learnt on the job. This article provides guidelines on when and how to request X-rays for acute conditions such as head and cervical spine trauma, suspected rib and extremity fractures, low back pain and acute abdominal pain. We also highlight what to write in the request form, in order to obtain maximum value from the examination and allow the radiologist to generate a useful, accurate report.
Ankle Injuries ; diagnostic imaging ; Cervical Vertebrae ; diagnostic imaging ; Emergency Service, Hospital ; standards ; Fractures, Bone ; diagnostic imaging ; Health Care Costs ; Hospitals ; Humans ; Medical Errors ; prevention & control ; Neck Pain ; diagnostic imaging ; Radiology ; methods ; organization & administration ; standards ; Spinal Injuries ; diagnostic imaging ; Tomography, X-Ray Computed ; X-Rays

The 1H-NMR fingerprints of three different species tibetan medicine sea buckthorn were established by 1H-HMR metabolomics to find out different motablism which could provide a new method for the quality evaluation of sea buckthorn. The obtained free induction decay (FID) signal will be imported into MestReNova software and into divide segments. The data will be normalized and processed by principal component analysis and.partial least squares discriminant analysis to perform pattern recognition. The results showed that 25 metabolites belonging to different chemical types were detected from sea buckthorn,including flavonoids, triterpenoids, amino acids, carbohydrates, fatty acids, etc. PCA and PLS-DA analysis showed three different varietiest of sea buckthorn that can be clearly separated by the content of L-quebrachitol, malic acid and some unidentified sugars, which can be used as the differences metabolites of three species of sea buckthorn. 1H-NMR-based metabonomies method had a holistic characteristic with sample preparation and handling. The results of this study can offer an important reference for the species identification and quality control of sea buckthorn.
Hippophae ; metabolism ; Magnetic Resonance Spectroscopy ; methods ; Medicine, Tibetan Traditional ; Metabolomics

Objective To explore caregiver burden and coping strategies of primary caregivers of patients with stroke and their correlation. Methods 120 primary caregivers of patient with stroke from four provincial hospitals of Guangzhou were included in this study. The Chinese version of Zarit Burden Interview (ZBI) and Simplified Coping Style Questionnaire (SCSQ) were applied to assess caregiver burden and coping strategies. Results The total score of caregiver burden of the primary caregivers was (39.54 ± 13.88), 86.7%primary caregivers' burden were in the mild and middle level. Positive coping was used more often than the negative coping among primary caregivers. Positive coping was negatively related to the caregiver burden (P ＜0. O1) and negative coping was positively related to the burden (P ＜ 0. 01). Conclusions Care burden were prevalent in the caregivers of patient with several extent and burden was related with coping style closely. Nurses should guide caregivers to take proper coping style and alleviate disease burden.

Objective To explore the relationship between illness perceptions and medication adherence of patients undergoing percutaneous coronary intervention (PCI).Methods The Illness Perception Questionnaire-Revised(IPQ-R) and Medication Adherence Questionnaire were used to investigate 95 patients undergoing PCI.Results (1)Illness perception status of patients undergoing PCI:average score of identity was (4.87 ± 3.50).Subscales of illness representation were listed according to scores from high to low as follows:timeline (acute/chronic) (3.68 ± 1.1 0),personal control (3.59 ± 0.83),treatment control (3.54 ± 0.65),illness coherence (3.02 ± 1.04),consequences (2.79 ± 0.87),emotional representation (2.24 ± 0.86),timeline cyclical (1.92 ± 1.06).In the part of causes,diet or eating habit scored highest (3.35 ± 1.83).(2)The average total score of medication adherence of patients undergoing PCI was (14.52 ± 1.99) and rate of complete adherence was 35.8％.(3) Identity of patients undergoing PCI was positively correlated with medication adherence (r =0.203,P ＜ 0.05).And personal control (r =-0.236,P ＜ 0.05) and emotional representation (r =-0.228,P ＜ 0.05) were negatively correlated with medication adherence.Conclusions Health care workers should improve symptom identity of patients undergoing PCI,emphasize the importance of adherence to medication,and help them relieve negative emotion in time to enhance their medication adherence.

Adult ; Carbimazole ; therapeutic use ; China ; Cholestyramine Resin ; therapeutic use ; Female ; Graves Disease ; drug therapy ; Humans ; Hyperthyroidism ; drug therapy ; Patient Admission ; Sepsis ; complications ; Thyroid Gland ; drug effects ; Treatment Outcome

INTRODUCTIONSubclinical hyperthyroidism (SH, grade 1, thyrotropin (TSH) ≥0.1 mU/L and grade 2, TSH <0.1 mU/L) is a common disorder with increased prevalence in older subjects. There is evidence for increased morbidities in SH, such as atrial fibrillation and osteoporosis. We aim to study the natural history and comorbidities of SH from patients referred to a tertiary endocrine clinic in Singapore as they are currently unknown.

MATERIALS AND METHODSRetrospective evaluation of SH subjects for natural progression and comorbidities.

RESULTSOne hundred and thirteen SH subjects (male/female: 24/89, mean age: 67.2 years, grade 1/grade 2: 60/53) were identified from the endocrine clinic. The aetiology of SH include 52 multinodular goitre, 15 Graves' disease, 7 toxic adenoma and 39 unclassified. A minority of SH patients (5.3 %) progressed to overt hyperthyroidism while 13% remitted to euthyroid state (1 to 3 years with a mean follow-up of 18 months) in the total cohort. Most of the patients remained in SH state during follow-up (50/60 in grade 1 SH and 42/53 in grade SH). However, no single predictive factor could be identified for progression or remission of SH. The prevalence of morbidities in SH subjects include ischaemic heart disease (16.8%), heart failure (8.9%), tachyarrhythmias (13.3%), any cardiovascular disease (28%), cerebrovascular disease (28%), osteoporosis (28%), and any fracture (15.9%).

CONCLUSIONMost of SH cases in our cohort remain in subclinical state with very few progressing to overt hyperthyroidism. Significant proportion of SH subjects have vascular disease, but this association needs to be confirmed in prospective controlled studies.

Aged ; Disease Progression ; Female ; Humans ; Hyperthyroidism ; complications ; diagnosis ; Male ; Prospective Studies ; Tertiary Care Centers