Referring to the rapid developed life science and the higher requirements for the approval of innovative Chinese drugs in recent years, this paper described systematically the discovery, research and development (R&D) approaches for the innovative Chinese drugs under the new situation from the following five aspects, i. e., active components discovered from TCMs, the discovery of effective fractions of TCMs and their formulae, the R&D of TCM innovative drugs based on famous classic prescriptions and famous Chinese patent drugs, and the transformation of clinical effective prescriptions, on the basis of analysing the advantages of innovative drugs derived from natural products based on TCM theories and the problems existed in current R&D of new TCM drugs. Moreover, five suggestions are also given for the rapid development of TCM innovative drugs in China. All these will provide reference for the R&D of TCM innovative drugs.
China ; Drug Discovery ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; Medicine, Chinese Traditional ; trends ; Research

Objective To compare the effect of intracoronary versus intravenous administration of tiroifban for acute coronary syndrome (ACS) patients during percutaneous coronary intervention (PCI). Methods A search was retrieved from Pubmed, EMbase, Chinese Biomedical Literature Database (CBM), Chinese Journal Full-text Database (CNKI), Chinese Science and Technology Periodical Database (VIP), Cochrane Library to systematically collect the randomized controlled trials of intracoronary versus intravenous administration of tirofiban for the patients with ACS undergoing PCI. The data was extracted from the included studies and analyzed by Cochrane Collaboration's RevMan5.2 software. Results Twenty-five studies involving 2516 patients met the inclusion criteria. The results of meta-analysis showed that thrombolysis in myocardial infarction (TIMI) grade 3 lfow (RR 1.15, 95%CI 1.07-1.23, P=0.0001) were signiifcantly more often achieved in the patients by intracoronary administration of tiroifban (IC group) than those by intravenous strategy (IV group). Left ventricular ejection fraction (LVEF) values in a week after PCI which were evaluated by Cardiac Ultrasound were statistically significant between the two groups (WMD 2.69, 95%CI 0.14-5.25, P=0.04). LVEF values in IC group were increased by an average of 2.69% compared with group IV. Intracoronary administration resulted in a reduced incidence of major adverse cardiovascular events (MACE) at 30-day follow-up (RR 0.51, 95%CI 0.38-0.69, P < 0.0001). However, the incidence of bleeding complications was not statistically signiifcant between the two groups (RR 0.95, 95% CI 0.76-1.19, P=0.64). Conclusions Compared with intravenous strategy, intracoronary administration of tiroifban can be more effective in increasing coronary blood lfow and microvascular perfusion, more signiifcantly in reducing the incidence of MACE at 30-day follow-up and improving the prognosis after PCI without increasing the risk of bleeding.

The levels of protein expressions o f insulin receptor substrate-1 and -2 (IRS-1 and IRS-2) in abdominal subcuta neous adipose tissue from type 2 diabetic patients were measured by Western blot technique. The expression of IRS-1 protein was reduced and the expression of I RS-2 protein was unchanged in adipose tissue of type 2 diabetic patients. IRS- 2 may be the main docking protein and one of the factors causing hyperinsulinemi a and insulin resistance in type 2 diabetes mellitus.

0.05). Conclusions The expression of angiotensinⅡincreases in BPH tissues in rats. It is suggested that angiotensinⅡmay affect cell proliferation but not significantly affect cell apoptosis of the rat prostate.

Objective To study the relationship between extraocular muscle thickness and exophthalmos degree in patients with thyroid-associated ophthalmopathy (TAO),so as to provide a scientific basis for guiding clinical treatment.Methods Forty seven patients diagnosed with TAO from May 2005 to May 2011,in the 451 Hospital of the People's Liberation Army were chosen in this study,and divided into TAO group(23 cases) and treatment group (24 cases).Meanwhile,another 32 healthy people were selected as control.Extraocular rectus muscles (including the medial rectus muscle,lateral rectus muscle,superior rectus muscle and inferior rectus muscle) of all participants were measured with B-scan ultrasonography,and exophthalmos degree with Hertel exophthalmometer.Results The thicknesses of medial rectus in control group,TAO group and treatment group were (3.35 ± 0.25),(4.38 ± 0.85),(3.58± 0.52)mm,respectively; the thicknesses of lateral rectus muscle were (2.95 ± 0.61),(4.24 ± 0.75),(3.65 ± 0.42)mm,respectively; the thicknesses of superior rectus muscle were (3.15 ± 0.20),(4.65± 0.68),(4.01 ± 0.15)mm,respectively; the thicknesses of inferior rectus muscle were (3.17 ± 0.72),(4.75 ± 0.52),(3.71 ± 0.91)mm,respectively; the sums of binocular rectus thickness in these three groups were (21.95 ± 0.65),(28.02 ± 1.51),(22.95 ± 0.65)mm,respectively; the difference between the three groups was statistically significant(F=2.32,2.43,2.25,2.17,5.63,all P ＜ 0.05),and TAO group was significantly higher than that in the control group and in the treatment group(all P ＜ 0.05),while there was no statistically significant between the control group and the treatment group(all P ＞ 0.05).The eyes exophthalmos degree in TAO group and treatment group were (16.82 ± 2.46),(14.52 ± 1.83)mm,respectively.The sum of the rectus muscle thickness and eyes exophthalmos was positively correlated(r =0.65,0.58,all P ＜ 0.05).Conclusions Extraocular muscle thickness in patients with TAO is positively correlated with exophthalmos degree,and using B-scan ultrasonography to detect the changes is practical for clinical diagnosis and treatment.

Abstract? AIM: To investigate changes of anterior chamber parameters after posterior chamber phakic implantable collamer lens ( ICL ) surgery and its correlation with intraocular pressure ( IOP) .?METHODS: This was a retrospective case series study. Seventy four eyes in 43 myopia patients were examined by Allegro Oculyzer anterior segment tomography to obtain the changes of anterior chamber volume ( ACV ) , anterior chamber angle ( ACA) , central anterior chamber depth ( ACD) and vault, meanwhile, to measure the IOP to analyze the correlation with anterior chamber parameters.?RESULTS: Compared with preoperative, ACV, ACA, ACD all decreased apparently ( P <0.01 ) in the postoperative period of 1, 3, and 6mo.ACV, ACA and ACD showed their stability in each period after the surgery.There were changes of vault in 1 and 6mo ( t=27.66, P=0.01).IOP had not altered when compared with the preoperative.This research revealed that IOP had no relation with ACV, ACA, ACD and vault in every phase( all P>0.05).?CONCLUSION:For patients underwent ICL, the anterior chamber parameters all decreased which included ACV, ACA, ACD, and had stabilized since early postoperative period. Correspondingly, IOP was stable and had not correlate with ACV, ACA, ACD and vault, however the long-term observation is still necessary.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; immunology ; pathology ; Cytokines ; blood ; Esophageal Neoplasms ; immunology ; pathology ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-12 ; blood ; Interleukin-4 ; blood ; Interleukin-5 ; blood ; Lymphatic Metastasis ; Male ; Middle Aged ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Tumor Necrosis Factor-alpha ; blood

Objective To investigate the relationship between retinal nerve fiber layer thickness and peripheral neuropathy in elderly patients with type 2 diabetes.Methods Clinical data of elderly patients with T2DM in Endocrinology Department in Beijing Hospital were retrospectively collected.Global and sectorial retinal nerve fiber layer(RNFL)thicknesses were measured by using optical coherence tomography(OCT),and never conduction velocity measurements were performed in all patients.Diabetic peripheral neuropathy was diagnosed by the criteria in diabetic neuropathies update(2010,American Diabetes Association).RNFL thickness was compared between diabetic nonperipheral neuropathy group (control group,n =30)and diabetic peripheral neuropathy group (DPN group,n=17)and between different sub-groups.Results The RNFL thicknesses of temporal,nasal,superior and inferior visual fields and the mean RNFL thickness were less in DPN group than in control group,among which there were significant differences in the RNFL thicknesses of superior,inferior visual fields and the mean RNFL thickness [(107.7±27.4)μm vs.(128.1±17.3)μm,(112.9 ±20.8)μm vs.(130.8±21.8)μm,(88.2±15.5)μm vs.(100.5± 11.3)μm,F=7.446,7.468,7.988,respectively,P=0.009,0.009 and 0.007].RNFL thickness was decreased along with the aggravation of DPN from the control group,the subclinical DPN group to the DPN group successively(all P＜ 0.05).Conclusions Retinal nerve fiber layer thickness is associated with diabetic peripheral neuropathy in elderly patients with type 2 diabetes,and the relationship is more significant in patients with serious DPN.

Objective To investigate the effect on and mechansm by which prostaglandin E_1(PGE_1)protects liver functions after hepatectomy.Methods In this study,82 cases undergoing hepatectomy were divided randomly into control group with conventional therapy(41 cases),and PGE_1 treatment group(41 cases)treated with liposomal prostaglandin E_1 in addition to conventional therapy.Postoperative hospital days,urinary volume and abdominal drainage volume were observed.Pre-and postoperative liver functions were measured.Results Postoperative hospital days(median time 22 days)in PGE_1 treatment group were significantly shorter than those(median time 26 days)in control group.The postoperative levels of alanine transaminase,aspartic transaminase,total bilirubin and albumen in PGE_1 treatment group recovered to preoperative levels more quickly,than control group.Postoperative urinary volume in patients of PGE_1 treatment group was significantly more than that in control group,while abdominal drainage volume was markedly less,although there was no significant difference in prothrombin time between the two groups.Conclusion In patients undergoing hepatectomy,PGE_1 is very useful and safe to protect and improve hepatic function,decreasing the level of bilirubin,preventing ascites,formation shortening hospital days,without causing prolongation of prothrombin time remarkably.

Objective To observe the effect of stageⅢdiabetic nephropathy(DN)treated by Qizhi Jiangtang capsule and explore its potential mechanism. Methods According to digital table method,the patients who conformed to the diagnostic criteria of stageⅢDN were randomly divided into two groups:an experiment group and a control group. All the patients in the two groups took elution treatment for 2 weeks,and then were treated with western basic therapy. The patients in the experiment group were administered orally with Qizhi Jiangtang capsule(2.5 g once, 3 times a day),while those in the control group treated with valsartan 80 mg,once a day. Urine microalbumin(mALB), mALB/urine creatinine(UCr),β2-microglobulin(β2-MG),α1-microglobulin(α1-MG)were observed in the two groups,endothelin-1(ET-1),nitric oxide(NO),thromboxane B2(TXB2),6-keto prostaglandin F1α(6-keto-PGF1α) were also determined. Serum creatinine(SCr),blood urea nitrogen(BUN),serum cystatin-C(Cys-C),retinol-binding protein(RBP),β2-MG were detected in the blood biochemistry automatic analyzer. These laboratory markers were inspected before treatment and at the 4th,8th and 12th week after treatment. Results Ninety-six patients in the experiment group and 95 patients in the control group were effectively included in the end. Before treatment,there were no statistic significant differences in urine mALB,mALB/UCr,β2-MG,α1-MG and blood ET-1,NO,TXB2, 6-keto-PGF1α between two groups(all P>0.05). Along with the prolongation of treatment,urine mALB,mALB/UCr,β2-MG,α1-MG and ET-1,TXB2 were significantly reduced,while NO,6-keto-PGF1α were significantly raised in the two groups after treatment,and the above changes in the experimental group were more obvious. There were statistic significant differences of mALB,mALB/UCr,β2-MG,α1-MG and TXB2,6-keto-PGF1αbetween two groups at the 12th week after treatment〔mALB(mg/L):36.6±9.2 vs. 78.6±16.5,mALB/UCr(mg/mmol):3.90±1.97 vs. 9.70±2.90,β2-MG(mg/L):0.25±0.10 vs. 0.40±0.12,α1-MG(mg/L):8.40±2.26 vs. 12.50±3.21,TXB2 (ng/L):75.8±18.7 vs. 94.7±21.7,6-keto-PGF1α(ng/L):73.4±15.2 vs. 65.2±11.5,P<0.05 or P<0.01〕. But there were no statistic significant differences of ET-1 and NO between experimental group and control group at the same time-points〔ET-1(ng/L):57.6±6.9 vs. 59.1±6.2,NO(μmol/L):68.9±11.6 vs. 65.4±10.7,both P>0.05〕. In each of the two groups,the comparisons of the levels of SCr,BUN before and after treatment,there was no statistical significant difference at any time point;the same comparisons between the two groups,there was also no statistic significant difference before treatment and at each of the same time-point after treatment(all P>0.05). The levels of Cys-C,RBP andβ2-MG of the control group after treatment had the tendency of decreasing,but no statistic significant differences were found(all P>0.05). The levels of Cys-C,RBP,β2-MG of the experimental group at the 12th week after treatment were significantly lower than those before treatment〔Cys-C(mg/L):0.72±0.07 vs. 0.89±0.12,RBP (mg/L):53.0±14.2 vs. 66.1±16.5,β2-MG(mg/L):1.86±0.71 vs. 2.79±0.82,all P<0.05〕. Conclusions Qizhi Jiangtang capsule can significantly reduce the levels of urine mALB and mALB/UCr of patients with stageⅢDN and stabilize their renal functions;its therapeutic effect is better then that of valsartan. Its mechanisms are related to the reduction of ET-1,elevation of NO,maintenance of dynamic equilibrium of thromboxane A2/prostacycline(TXA2/PGI2) and protection of vascular endothelial cells.