1.Summary of best evidence for target temperature management in stroke patients
Jiumei CAI ; Wei CHEN ; Li WU ; Xiaoqing ZHAN ; Chunmei YIN ; Minmin REN ; Xilan ZHENG
Chinese Journal of Modern Nursing 2023;29(34):4650-4657
Objective:To retrieve, evaluate, and sum up the evidence on target temperature management in stroke patients, and summarize the best evidence.Methods:Based on the "6S" pyramid model, clinical practice guidelines, expert consensus, evidence summary, and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center, Guidelines International Network, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Heart Association, American Stroke Association, European Stroke Organization, Medlive, Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP and China Biology Medicine Disc. The search period was from database establishment to October 7, 2022. Two researchers received evidence-based nursing training independently evaluated the quality of the article, extracted, integrated, and summarized the best evidence.Results:A total of 12 articles were included, including three clinical practice guidelines, four systematic reviews, and five expert consensuses. 24 best pieces of evidence were summarized from five aspects, involving target temperature population, target temperature implementation, complication monitoring, nutritional support, and prognosis evaluation.Conclusions:This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients, which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients, further standardize temperature monitoring and management, and offer scientific basis for future research and practice.
2.Optimization of the extraction and separation process of chebulagic acid and chebulinic acid
Jiumei CHEN ; Qizhen ZHU ; Chengguo JU ; Qiang ZHANG ; Wei WANG
China Pharmacy 2022;33(22):2733-2737
OBJECTIVE To optimize the extraction and separation process of chebulagic acid and chebulinic acid from Terminalia chebula. METHODS Based on single factor experiment, with particle size, liquid-solid ratio, extraction time and extraction times as factors, using the contents of chebulagic acid and chebulinic acid as indexes, orthogonal experiment was designed to optimize the extraction process of chebulagic acid and chebulinic acid. Taking sample concentration, elution solvent and the ratio of eighteen-group bonded silicone reverse phase (ODS) to the amount of raw medicine as factors, the separation processes of chebulagic acid and chebulinic acid were optimized. RESULTS The optimal extraction process of chebulagic acid and chebulinic acid included ethanol volume fraction of 70%, ultrasonic extraction, particle size of 120 mesh, liquid-solid ratio of 25∶1 (mL/g), extraction time of 20 min, and extracting for 2 times. After 3 experiments, the average comprehensive score was 99.33 (RSD= 0.68%, n=3), and the average contents of chebulagic acid and chebulinic acid were 107.05 and 58.32 mg/g, respectively. The optimal separation process of the two components included the concentration of sample loading solution was 0.5 g/mL (1 mL was equivalent to 0.5 g of medicinal materials), the ratio of ODS to the amount of raw medicine was 10∶1.5 (g/g), methanol-water (1∶4, V/V) eluted chebulagic acid, methanol-water (3∶7, V/V) eluted chebulinic acid. After 3 experiments, the average total yields of the two components were 53.33%, 39.23%. After recrystallization, the purity of both components was 100%. CONCLUSIONS Established extraction and separation process of chebulagic acid and chebulinic acid is simple and feasible.
3.Content changes of chemical constituents and comparison of the anti-ulcerative colitis effect of processed products of Terminalia chebula at different temperatures
Yueyan AN ; Chengguo JU ; Qiang ZHANG ; Ji HAO ; Jiumei CHEN ; Wei WANG
China Pharmacy 2022;33(3):332-337
OBJECTIVE To study the content changes of ch emical constituents of processed products of Terminalia chebula at different temperatures ,and to compare its anti-ulcerative colitis effect. METHODS Processed products of T. chebula at different temperatures(160,180,200,220,240,260,280,300 ℃)were prepared by sand scalding technology. HPLC method was adopted to determine the contents of gallic acid ,chebulagic acid ,chebulinic acid and ellagic acid in crude drug and processed products of T. chebula at different temperatures. The mice were divided into blank group ,model group ,Mesalazin enteric-coated tablets group (positive control ,0.4 g/kg),crude drug and processed products groups of T. chebula at different temperatures (1.3 g/kg),with 10 mice in each group. Except for blank group ,other groups were given 6% acetic acid 0.1 mL via anus to induce ulcerative colitis model. After modeling ,blank group and model group were given water intragastrically ,and other groups were given relevant drug intragastrically ,20 mL/kg,once a day ,for consecutive 7 days. The general physical signs of mice in each group were observed and the body weight was recorded. The colorectal length and index ,serum levels of related inflammation indexes [superoxide dismutase (SOD),malondialdehyde (MDA),interleukin-10 (IL-10),IL-1 β ,tumor necrosis factor α (TNF-α)] were detected. The pathomorphological changes of colon and rectum were observed ,and the comprehensive score of pharmacodynamics was performed. RESULTS With the increase of processing temperature ,the contents of chebulagic acid and chebulinic acid decreased gradually ,the content of gallic acid increased first and then decreased ,and the content of ellagic acid increased. Compared with model group ,the general physical signs ,body weight ,colorectal length ,colorectal index and related inflammation indexes were all improved significantly in crude drug and processed products groups of T. chebula at different temperatures(P<0.05 or P<0.01). The glandular recess structure of colorectal tissue was repaired ,the infiltration of inflammatory cells was reduced ,and the comprehensive score of efficacy of processed products prepared at 260 ℃ was the highest. CONCLUSIONS The contents of chemical components in T. chebula processed at different temperatures change significantly and their anti-ulcerative colitis effects are different. The processed products of T. chebula prepared at 260 ℃ show the best anti-ulcerative colitis effect.