Objective To investigate the anti-inflammatory mechanism of the alkaloids in Dengtaiye Tablets (DTYT) based on the network pharmacology and chemomics. Methods The main indole alkaloids in the DTYT from Folium Alstoniae Scholaris were identified by UPLC-Q/TOF. The network pharmacology coupled with virtual docking technology and bioinformatics analysis were carried out for screening the key protein targets and pathways. Western blotting was utilized for evaluating the phosphorylation level of the primary node proteins in BEAS-2B cells inflammatory model induced by LPS. Results Twelve indole alkaloids were found in DTYT extract, which act on different protein targets, such as PDPK1 (PDK1), MAPK1 (ERK2), and MAPK8 (JNK1) respectively, and reduce the level of ERK2, JNK1, and IKK phosphorylation induced by LPS. Conclusion As the Q-markers of anti-inflammatory, the indole alkaloids contained in DTYT inhibited the PDK1/AKT/NF-κB and MAPK pathways, which present potential molecular mechanisms for the treatment of chronic bronchitis of DTYT.

Objective To investigate the expression and clinical significance of microRNA-93-5p (miR-93-5p) in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD). Methods A total of 60 patients with T2DM (T2DM group), 57 patients with T2DM complicated with CHD (T2DM with CHD group), and 60 healthy individuals (control group) were enrolled in this study from August 2019 to May 2021. The general information, serum miR-93-5p, and interleukin-6 (IL-6) levels were compared among the T2DM with CHD group, control group and T2DM group; the relationships of serum miR-93-5p and IL-6 levels with low-density lipoprotein cholesterol (LDL-C), fasting insulin (FINS), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglyceride (TG), glycated hemoglobin (HbA1c), and total cholesterol (TC) were analyzed in T2DM with CHD patients; the influencing factors of T2DM complicated with CHD were analyzed; the predictive value of serum miR-93-5p and IL-6 for T2DM complicated with CHD was evaluated. Results The levels of LDL-C, FINS, TG, FPG, TC, HbA1c, serum miR-93-5p, and IL-6 in the T2DM with CHD group and T2DM group were significantly higher than those in the control group, while the HDL-C level was significantly lower (P < 0.01); the levels of LDL-C, FINS, TG, FPG, TC, HbA1c, serum miR-93-5p, and IL-6 in the T2DM with CHD group were significantly higher than those in the T2DM group, while the HDL-C level was significantly lower (P < 0.01). The serum miR-93-5p and IL-6 levels in T2DM with CHD patients were positively correlated with LDL-C, FINS, HbA1c, TC and FPG (P < 0.01), and negatively correlated with HDL-C (P < 0.01); the expression level of miR-93-5p in serum was positively correlated with IL-6 (P < 0.05). LDL-C, FINS, FPG, HbA1c, TC, miR-93-5p, and IL-6 were the influencing factors of T2DM complicated with CHD (P < 0.05); the area under the curve (AUC) of serum miR-93-5p and IL-6 for predicting T2DM complicated with CHD was 0.888 and 0.898 respectively, with cut-off values of 2.59 and 77.98 ng/L respectively, sensitivity of 75.4% for both serum miR-93-5p and IL-6, and the specificity was 89.2% for miR-93-5p and 85.8% for IL-6; the AUC of the combined prediction of miR-93-5p and IL-6 for T2DM complicated with CHD was 0.939, with sensitivity and specificity of 91.2% and 83.3% respectively. Conclusion The serum miR-93-5p level is elevated in patients with T2DM complicated with CHD, and miR-93-5p together with IL-6 may participate in the process of T2DM complicated with CHD. The combined detection of IL-6 and miR-93-5p is expected to serve as an auxiliary method for prediction of T2DM complicated with CHD.

Based on the characteristics of clinical symptoms of psoriasis in traditional Chinese and Western medicine, and according to the coincidence between existing animal models and the characteristics of clinical symptoms of psoriasis in traditional Chinese and Western medicine, the evaluation criteria of psoriasis animal models are put forward, which can provide corresponding improvement ideas for psoriasis animal models. By listing the clinical manifestations and diagnostic criteria of psoriasis in traditional Chinese and Western medicine, this paper assesses the existing animal models of psoriasis, which accords with 8.3% of the clinical diagnostic criteria of Western medicine, 15% of the main symptoms and 8% of the secondary symptoms in traditional Chinese medicine. The results showed that imiquimod-induced model was found to be the best animal model with high coincidence. The rate of modeling was faster and the cost was lower, but it was reversible with the prolongation of withdrawal time. Allogeneic transplantation model and genotype model have high coincidence with Western medicine, but low coincidence with traditional Chinese medicine symptoms. Because psoriasis is a chronic, non-infectious skin disease that is prone to recurrence, there are many factors leading to psoriasis.The existing models can not simulate the clinical symptoms well. We should use multi-factor modeling method to establish a pathological model reflecting the characteristics of clinical symptoms of psoriasis in traditional Chinese and Western medicine combined with the main external pathogenic factors of psoriasis. Therefore, it is the main task for the future research of psoriasis traditional Chinese medicine to establish animal models that reflect the clinical characteristics of psoriasis and Western medicine and improve the evaluation criteria of psoriasis combined with syndrome animal models.

Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Radius Fractures ; therapy ; Splints

OBJECTIVETo determine the content of baicalin in Yinhuang granules fastly from different pharmaceutical factories with near-infrared spectroscopy.

METHODNear-infrared diffuse reflectance spectroscopy technology was used to collect NIR spectra of Yinhuang granules. With HPLC anilysis values as reference, the fast determination method of baicalin was established with partial least squares (PLS).

RESULTThe correlation coefficients (R2), the root-mean-square error of cross-validation and the root-mean-square error of calibration (RMSEC) of the calibration model for baicalin were 0.9982, 0.1899 and 0.0514, respectively; the root-mean-square error of prediction (RMSEP) and the average rate of recovery were 0.0802 and 104.27%.

CONCLUSIONThe method is accurate, fast and simple, and can be applied for the fast determination of large quantities of numbers of samples.

Objective: To analyze the safety and efficacy of intravenous thrombolysis(IVT) combined with emergency carotid artery stenting (eCAS) in acute ischemic stroke (AIS) patients with anterior circulation tandem occlusion and treated with mechanical thrombectomy. Methods: From January 2014 to September 2018, a total of 124 consecutive patients diagnosed with AIS with anterior circulation tandem occlusion and treated with mechanical thrombectomy were retrospectively enrolled from Department of Neurology in 5 comprehensive stroke centers. Patients were divided into 4groups according to IVT and eCAS:group A was without IVT and eCAS; group B was eCAS without IVT; group C was IVT without eCAS; group D was IVT combined with eCAS. Baseline and clinical characteristics were documented and compared among the 4 groups. Baseline characteristics included age, gender, risk factors for stroke, good collateral circulation ratio, National Institutes of Health Stroke Scale(NIHSS) score and Alberta stroke program early CT(ASPECT) score, etc. Clinical characteristics included occlusion site of intracranial artery, the degree of extracranial stenosis, etiology of extracranial stenosis, surgical strategy, femoral artery puncture to recanalization time (PTR).medication during hospitalization, etc. The safety and clinical outcomes of the 4 groups were evaluated, including recanalization, symptomatic intracranial hemorrhage, and prognosis. The modified thrombolysis in cerebral infarction score(mTICI) 2b or 3 was considered as successful recanalization. The modified Rankin scale (MRS) score 0-2 at 90 days was considered as favorable functional outcome and MRS score 0-1 was excellent functional outcome. Results: (1) There were no statistically significant differences in age, blood glucose level at admission, onset to femoral artery puncture time, gender, hypertension, diabetes, atrial fibrillation, smoking, good collateral circulation ratio, NIHSS score and ASPECT score among the 4 groups (all P >0. 05). (2) There were no statistically significant differences in occlusion site of intracranial artery, the degree of extracranial stenosis, extracranial stenosis etiology, priority treatment of distal or proximal lesion and PTR time among the 4 groups (all P > 0. 05). (3) In the total of 124 stroke patients with anterior circulation tandem occlusion and treated with mechanical thrombectomy, the rate of successful reperfusion (mTICI class 2b-3) was 75. 8% (94 cases);symptomatic intracranial hemorrhage was 15. 3% (19 cases); favorable functional outcome at 90 days was 48. 4% (60 cases) and excellent functional outcome was 29. 0% (36 cases);the overall mortality rate was 22. 6% (28 cases). The successful recanalization rate of group A, B, and C was 67.4% (31/46), 75. 8% (25/33), and 75. 0% (21/28), respectively. All patients in group D achieved recanalization (17/17). Compared to the group D, the difference was statistically significant in each group(X2 = 6. 831, P = 0. 009; X2 =4. 906, P = 0. 027; X2 =7. 410, P = 0. 006). The excellent functional outcome of group A.B.and C were 21.7% (10/46), 18.2% (6/33) and 35.7% (10/28).respectively. Compared with group D(10/17), the difference of group A or group B was statistically significant (X2 =7. 878, P = 0.005;X2 =8.517, P = 0.004). However.there was no significant difference between group C and group D(X2 =2.288, P=0. 130). There was no significant difference in symptomatic intracranial hemorrhage, favorable functional outcome and overall mortality rate among the 4 groups (all P > 0. 05). Conclusion: For patients with tandem lesion of the anterior circulation and treated with mechanical thrombectomy, IVT combined with eCAS appears to be feasible and safety.

AIM: To investigate the efficacy of intravitreal ranibizumab or conbercept combined with macular laser grid photocoagulation(MLG)for macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: Totally 120 patients(120 eyes)with BRVO were randomized into three groups, 40 patients(40 eyes)in each group. Group A received MLG alone; Group B: intravitreal injection of ranibizumab 0.05mL/0.5mg; Group C: intravitreal injection of conbercept 0.05mL/0.5mg. MLG were performed in Group B and Group A at 1wk after injection. At 1mo after injection, all the patients were examined with fundus fluorescein angiography and optical coherence tomography, repeated injections were given if necessary. Repeated injection rate of Group B and C was compared after a six-month follow-up. before and at 1wk, 1, 3, 6mo after treatment, best corrected visual acuity(BCVA)and central macular thickness(CMT)of the two groups were analyzed.

RESULTS: In Group B, there were 4 eyes with 2 consecutive injections, 7 eyes with 3 consecutive injections, and the repeated injection rate was 27.5%. Patients in Group C received injection only once. The repeated injection rate of Group B was higher than that of Group C with significant difference(P<0.05). BCVA of the three groups were improved after treatment, CMT was less than those before treatment. BCVA of Group B and C after treatment was better than those of Group A and CMT was less. BCVA of Group C was better than that of Group B, and CMT was less without significant difference(P>0.05). After the follow-up, there were no significant adverse reactions in three groups. The recurrence rate of group A was 25%, no recurrence in Group B and C and the difference was statistically significant(P<0.05).

CONCLUSION: Intravitreal ranibizumab or Conbercept combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion is effective. But injection times of Conbercept is less.

Knee osteoarthritis(KOA) is a common orthopedic disease. Its main symptoms include pain in the medial knee, aggravated knee pain during walking, limited movement, and joint deformity, which seriously affect the daily life of patients. The replication of animal models consistent with clinical symptoms is the premise of KOA-related experimental research. Based on the clinical characteristics of KOA and Western medicine, this paper discusses the existing KOA animal model, and analyzes the clinical anastomosis of the existing model based on the clinical diagnostic criteria of KOA. Through analysis and comparison, it can be seen that most of the existing modeling methods are single-factor animal models, which have a certain gap with the characteristics of KOA caused by clinical multi-factors and interaction. Moreover, modeling methods are mostly guided by Western medicine, and traditional Chinese medicine pathogenic factors are absent in the modeling process. Only cold stimulation method takes cold and wet into account. In the evaluation of the model, knee swelling, pain and articular rickets were the main evaluation criteria, which were different from the diagnostic criteria of Chinese and Western medicine in KOA. In terms of syndrome differentiation and classification, KOA is divided into kidney vacuity and deficiency of marrow, Yang vacuity and cold coagulation, and blood stasis and arrest in traditional Chinese medicine. The exis-ting animal models often confuse KOA with each other. Only cold stimulation method is used to establish KOA of Yang vacuity and cold coagulation. Therefore, in this paper, based on KOA clinical symptoms between Chinese and Western medicine features, analysis of the existing animal models, for further improving KOA animal models, the standardization of the model to evaluate suggestions, in order to improve the animal models and clinical inosculation between Chinese and Western medicine, the KOA animal model to better serve the scientific research work, promote the related mechanism, pathological changes and drug screening.
Animals ; Disease Models, Animal ; Humans ; Medicine, Chinese Traditional ; Osteoarthritis, Knee

With the rapid rise of modern drug-derived diseases, the external treatment has received extensive attention at home and abroad, due to its small adverse reactions, convenient application and accurate efficacy.At present, although there are many clinical applications of Chinese medicine external treatment, there are few unified norms and strong arbitrariness in related external treatment techniques, for example, external methods, dosage forms, means, dosage, time, etc.As a result, the development of Chinese medicine external treatment is slow and chaotic, and it can not serve the clinic well.It also hinders the development and expansion of external treatment techniques.This paper discusses the current status of external treatment techniques, and clarifies the development trend of Chinese medicine external treatment, in order to pointing out the direction for the development of Chinese medicine external treatment, it will promote the standardization of Chinese medicine external treatment techniques, and it will be better servicing the clinical practice.

The pathogenesis of chloasma is complex and diverse. Traditional Chinese medicine （TCM） believes that it is mostly related to liver, spleen and kidney, with hematogenous impassability as the standard and pigmentation on the face or body surface as the main symptom. Western medicine believes that it is closely related to family inheritance, ethnic differences and ultraviolet radiation. At present, there are various clinical therapies, mainly including prevention of ultraviolet radiation, local whitening agent and chemical skin. In addition, TCM plays an important role in the treatment of chloasma, often involving internal use, topical use, acupuncture and moxibustion. Modern studies have shown that TCM therapies mainly regulate the metabolism of antioxidant, endocrine and melanin in vivo. Although the mechanism of action could not explained to some extent, there are still some restriction in the discussions on the mechanism of external use of TCM in controlling chloasma. As the skin nerve-endocrine-immune (NEI) network is proposed and further studied, the role of NEI network in realizing overall functional regulation with cytokines, hormones and neurotransmitters as information molecules has been widely verified and recognized. This paper symmetrically reviewed the pathogenesis of chloasma and the progress of the regulatory effect of TCM, and proposed the possible local efficacy of TCM for external use in treating chloasma by regulating surface NEI network. This is worth further study and exploration in the expectation of providing new ideas for the treatment of chloasma and the studies on the mechanisms of action of TCM for external use.