OBJECTIVETo optimize the prescription dose of Mahuang decoction in a multi-target manner, in order to provide reference for the quantitative optimization of the prescription dose of the traditional Chinese medicine compound.

METHODThe number of diaphoretic spots in rats, the tracheal antispasmodic rate in guinea pigs and the writhing times by acetic acid in mice were taken as the indexes for evaluating the diaphoretic, antispasmodic and analgesic effects. According to the experimental results of the 16 orthogonal combination prescriptions, a mathematical dose-effect model was built by support vector regression (SVR) and quadratic response surface regression (RSR) respectively. The multi-target optimization was achieved by elitist non-dominated sorting genetic algorithm (NSGA-II) and entropy weight TOPSIS method.

RESULTThe optimal dose of Mahuang decoction after being optimized by SVR modeling contained 17.71 g of Ephedrae Herba, 9.57 g of Cinnamomi Ramulus, 11.75 g of Armeniacae Semen Amarum and 4.39 g of Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle. The optimized result by RSR modeling contained 13.37 g of Ephedrae Herba, 11.61 g of Cinnamomi Ramulus, 11.98 g of Armeniacae Semen Amarum and 5.67 g of Glycyrrhizae Radix et Rhizoma Praeparate Cum Melle. SVR was superior to RSR in both of the forecast capacity and optimization results.

CONCLUSIONSVR-NSGA-II-TOPSIS method could be adopted for the multi-target optimization for the dose of Mahuang decoction and other traditional Chinese medicine compounds. It is proved to be the optimal prescription with the best efficacy, and could provide scientific quantitative basis for determining the dose of traditional Chinese medicine compound prescriptions and developing new traditional Chinese medicines.

Animals ; Cinnamomum ; chemistry ; Drug Compounding ; methods ; Drug Dosage Calculations ; Drug Prescriptions ; Ephedra ; chemistry ; Ephedra sinica ; chemistry ; Glycyrrhiza ; chemistry ; Guinea Pigs ; Mice ; Rats

OBJECTIVETo establish a chiro chromatography for studying the stereoselective metabolism of propranolol (PL) in S(9) incubates prepared from transgenic cell lines expressing human cytochrome P450.

METHODSThe concentration of each enantiomer in S(9) incubates was determined through precolumn derivatization with GITC, followed by RP-HPLC assay using S-(+)-propafenone as internal standard.

RESULTSBaseline separations among the diastereomers of S(-)-P, internal standard and R(+)-PL were achieved on Shimpack CLC C(18)ODS column, with UV detection and methanol:water:glacial acetic acid (67/33/0.05,v/v/v) as mobile phase. The assay was simple, accurate, precise and specific. The linear range was from 5 to 500 micromol/L for each enantiomer. The limit of quantitation (LOQ) for the method was 5 micromol/L for the S(-)-and R(+)-PL, respectively (n=5, RSD<10%). The analytical method afforded average recoveries of 98.7 and 98.1% for S(-)- and R(+)-PL, respectively. The reproducibility of the assay was good (RSD<10%). The time-dependent studies showed that PL had the stereoselectivity of S-(-)-isomer in metabolism via CYP2C18 and the stereoselectivity of R-(+)-isomer in metabolism via CYP2C9.

CONCLUSIONThe method allows to study of stereoselective metabolism of PL in vitro.

Chromatography, High Pressure Liquid ; Cytochrome P-450 Enzyme System ; genetics ; physiology ; Humans ; Propranolol ; analysis ; metabolism ; Reproducibility of Results ; Stereoisomerism ; Transgenes

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the therapeutic effect of Triamcinolone Acetonide and Pingyangmycin on lymphatic malformations in oral and maxillofacial regions.

METHODS29 patients with lymphatic malformations in oral and maxillofacial regions were divided into two groups to receive intra-lesion injection with Triamcinolone Acetonide and Pingyangmycin in experimental group, or with Pingyangmycin only in control group. The lesions involution and facial appearance were observed.

RESULTS2 years after treatment, the volume of small cyst and micro-cyst type mass shrank to (3.7 +/- 0.3)% and (4.2 +/- 0.4)%, respectively in experimental group, while (15.4 +/- 1.3)% and (24.1 +/- 3.1)% in control group. The lesion involution was markedly obvious in experimental group. Compare with control group, the facial asymmetry was greatly improved in experimental group.

CONCLUSIONSIntra-lesion injection with Triamcinolone Acetonide and Pingyangmycin is an effective method for the treatment of lymphatic malformations in oral maxillofacial regions. The mass can be shrank markedly to improve facial symmetry.

Adolescent ; Bleomycin ; analogs & derivatives ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Infant, Newborn ; Lymphatic Abnormalities ; drug therapy ; Male ; Maxillofacial Abnormalities ; drug therapy ; Treatment Outcome ; Triamcinolone Acetonide ; therapeutic use ; Young Adult

Cholelithiasis is one of the clinically common and frequently encountered diseases. In this paper, the Chinese Meteria Medica and prescriptions utilized to treat cholelithasis were discussed in four aspects. In addition, we discussed the clinical effect and mechanism of actions of these drugs in order to provide some reference for future drug development in this area.
Animals ; Cholelithiasis ; drug therapy ; prevention & control ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Humans ; Phytotherapy ; Plants, Medicinal ; chemistry

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

Hilar cholangiocarcinoma is one of the most difficult malignant tumors to treat in the biliary system. In Japan, 5-year survival rate of the disease has increased from 32.5% to 67.1% during the past 30 years. The impressive progress reflects the solid efforts in preoperative endoscopic diagnosis, innovation in surgery such as PTPE as well as hepato-pancreatoduodenectomy and perioperative treatment including replacement of the bile and synbiotic treatment, which have finally formed a set of standardized diagnosis and treatment systems. The present review intends to report the history, current status and remaining bottlenecks of the diagnosis and treatment system of hilar cholangiocarcinoma in Japan as follows.

Perihilar biliary diseases have a wide spectrum of diseases including stones, inflammation, tumors, injuries and congenital malformations. Because of their characteristics such as anatomic variability, pathophysiological complexity, high operative difficulties, more postoperative complications and high operative risk, the perihilar biliary surgery is a high difficulty area in biliary surgery. For common clinical features ,common surgical methods and common technical difficulties of perihilar biliary diseases, the perihilar surgical technique system adequately evaluates hilar anatomy and its variations,liver function and volume of residual liver relying on threedimensional digital medical imaging technology, completely exposes hepatic hilum via combining anterograde and retrograde route from extra and intra-hepatic direction to hepatic hilum, then re-evaluates the relationship between the lesion and the hepatic artery and portal vein, and ultimately sets the surgical procedure . It is developed to improve the R0 resection rate, quality of cholangiojejunostomy, quality of vascular resection and reconstruction and safety of operation,eventually for the purpose of reducing postoperative complication rate and perioperative mortality and improving the prognosis. So surgeons should pay attention to the comprehensive system involving multiple disciplines in order to improve the effectiveness and safety in diagnosis and treatment of perihilar biliary diseases.

OBJECTIVE: To investigate the outcome of the kidney transplant recipients with different grades and stages of chronic hepatitis B virus after receiving renal transplantation for 3 years. METHODS: Thirty nine cases of kidney transplant recipients with hepatitis B virus and 20 cases of kidney transplant recipients (control group) between August 2000 and February 2002 were studied. Before the transplantation, the patients were divided into 4 groups: the mild hepatitis group (Group A, n = 8), the middle hepatitis group (Group B, n = 6), the severe hepatitis group (Group C, n =5) according to pathological diagnosis by percutaneous liver biopsy, and the control group (Group D). During the 3 year follow-up, the serum creatinine, alanine aminotransferase, g-Glutamyl transferase (GGT), total bilirubin, direct bilirubin, prothrombin time, cyclosporine trough concentration, urinary protein excretion, the HBV markers, HBV-DNA, albumin (A), globulin (G), the hepatic fibrosis markers and Child-Pugh score were studied at intervals. All patients received ultrasound examination every year. Two patients received repeated liver biopsy at the end of the follow-up in the hepatitis groups. RESULTS: The outcome of Group A and Group D was fine. In Group B, GGT level was significantly elevated (P < 0.05) sixth months after the operation, the Child-Pugh score of 2 patients were B, the liver pathohistological changes in another 2 patients were in severe stage in the endpoint. In Group C, GGT values had higher base-line (P <0.01) during the follow-up. Albumin were lower and globulin were higher than normal at the beginning of the 24th month. At the end of the follow-up, the Child-Pugh scores of all patients were B or C (B = 3, C = 2), 4 patients had end-stage cirrhosis, one died of hepatic cancer and the survival rate was 40% in Group C. CONCLUSION The outcome of the 3 groups is different. The pathohistological diagnosis by liver biopsy is important for patient selection receiving renal transplantation.
Adult ; Aged ; Female ; Follow-Up Studies ; Hepatitis B, Chronic ; complications ; surgery ; Humans ; Kidney Failure, Chronic ; complications ; surgery ; Kidney Transplantation ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

Objective To explore the significance of urine deoxypyridinoline to diagnosis on osseous metastasis of lung neoplasms.Methods.182 cases with lung carcinoma was divided into two groups.One group was case with osseous metastasis,the other group was case without osseous metastasis,uDPD/uCr, uCa/Cr,sCa and sAKP in two groups were respectively compared.Sensitivity and specificity of these indexes to diagnosis on osseous metastasis of lung cancer were also acalculated and compared.80 cases without osseous metastasis were follow-up for 6 months.Results The ratio of uDPD/uCr with osseous metastasis group[(12.35?2.65)nmol/mmol]was significantly higher than that of without osseous metastasis group [(7.76?2.11)nmol/mmol](t=2.46,P