Through our pre-investigation and literature analysis, it was found that rhubarb could be categorized into two types, chrysophanol-type and rhein-type, based on the proportion of the two constituents in the total content of anthraquinones after acid hydrolysis. In this paper, the antimicrobial activities of chrysophanol-type and rhein-type rhubarbs against Staphylococcus aureus were compared with microcalorimetric analysis, in order to illustrate the bioactive differentiability between the two chemotypes. For the aim to display the distinction of chrysophanol and rhein percentage in total anthraquinones, the sampling volume was regulated to make the total anthraquinones equivalent, thus, the antimicrobial difference was only attributed to the difference of chemotypes. The results indicated that the antimicrobial difference between the two chemotypes was confirmable labeled at the biothermokinetic parameters of S. aureus growth affected by the rhubarb samples. The growth rate constant (k1) of the first exponential phase for the growth of S. aureus affected by the rhein-type rhubarb was significantly lower than that of chrysophanol-type (P<0.01), which suggested stronger antimicrobial activity of rhein-type rhubarb than that of chrysophanol-type. However, the antimicrobial activities of rhein-type rhubarbs were not positively correlated to the contents of rhein. It suggested that the antimicrobial activity of rhubarb might be related to some unknown components which were of same accumulating pattern of rhein. The findings in present study provided some experimental evidence on categorizing rhubarb into two chemotypes through the difference of antimicrobial activity on S. aureus by microcalorimetric analysis and, further, offered references to revision of the commercial specification of rhubarb from chemical view.

In this study the reliability and scientificity of organoleptic evaluation for the commercial specification of Chinese medicinal materials (CMM) was investigated with Delphi method, using rhubarb as an example. The consensus panel of panelists being expert in organoleptic evaluation for CMM was cogitatively selected, with high average authority index of 0.81. The average individual repeatability of selected panelists was 85%, while the group repeatability was above 70%. It was found that the career time of the expert had significant influence on the evaluation result (P < 0.05), which suggested that practice makes repeatability. Some panelists of different career type and education background concluded different results, but no statistical significance was found. Furthermore, four predominant organoleptic parameters, shape, color, texture and section characteristics, were selected based on statistics and panelists' discussion to judge the commercial specification of rhubarb. In conclusion, we firstly demonstrated the organoleptic evaluation is an objective and repeatable approach to judge the commercial specification of CMM; and we recommend Delphi method to do validation and standardization for the conventional experiences of traditional Chinese medicine.
Delphi Technique ; Rheum ; standards ; Sensation

The differences of 34 rhubarb samples collected on the market and at producing area were investigated by chemical analysis on the contents of anthraquinones and chromatographic fingerprints, in order to assess the rationality of the commercial specification of rhubarb. The results indicated that the commercial specification of rhubarb was not correlated to the contents of anthraquinones as well as the price. The chromatographic fingerprints of rhubarb samples from different producing area were dissimilar, while the commercial specifications were difficult to be separated. Generally, the rhubarb samples produced in famous-region contained more anthraquinones. This demonstrated rationality on the traditional records of the famous-region of rhubarb from a chemical view. In this study, it was firstly reported that rhubarb could be categorized into two types, chrysophanol-type and rhein-type, based on the proportion of the two constituents in the total anthraquinones after acid hydrohysis. It was found that the rhubarb samples of rhein-type were mostly produced in famous-regions, such as Qinghai, Xizang, West Sichuan and Gansu. The literatures reported that rhein was superior to chrysophanol at many pharmacological effects and pharmacokinetic properties. Hence, we primarily considered that rhein-type rhubarb might be high-quality. These results were helpful to improve the commercial specification of rhubarb from a view of chemical information.
China ; Drugs, Chinese Herbal ; analysis ; Quality Control ; Rheum ; chemistry

OBJECTIVETo probe into the influences of different granule sizes and to prepare procedures on rational clinical usage of rhubarb based on chemical equivalence.

METHODThe effects of particle size, extract solvent, extract time and repeat times, and pre-extract or pro-extract of rhubarb on the extract amounts of the anthraquinones (AQs) were compared.

RESULTThe different prepare procedures investigated in the paper revealed significant influence on the extract amounts of the AQs and those extracts were not chemical equivalent. Ethanol extracted more AQs than water did, when other conditions were same. When extracted with water, the rhubarb of piece size 0.8-1.2 cm could extract relatively high amount of AQs nearly equal to superfine grinded powders, and the former was cheap. The water extraction of AQs showed an increasing trend with the extraction time extended. And pro-extract manner with water could extract more AQs than pre-extract manner with a extraction time of 30, 60 min. The water extraction of AQs repeated two times exceeded half of the amount of totally six times. When extracted with ethanol, the rhubarb of fine powders could extract relatively high amount of AQs nearly equal to superfine grinded powders. And pre-extract manner with ethanol could extract more AQs than pro-extract manner. The ethanol extraction of AQs increased in 30 min and then increased slower. The ethanol extraction of AQs repeated two times exceeded 70% of the amount of totally six times. So, the optimal conditions for water extraction rhubarb were pro-extract, two times repeated and 30 min per time; and the optimal conditions for ethanol extract were pre-extract, two times repeated and 30 min per time.

CONCLUSIONThe different prepare procedures showed significant influence on the extraction of rhubarb AQs. There is great need to establish a good usage practice (GUP) for Chinese Materia Medica to maintain rational clinical usage.

Presepsin(sCD14-ST), is an soluble leukocyte differentiation antigen 14 subtype. It is a glycoprotein fragment and a marker of acute phase reaction. For diagnosis of adult sepsis, bacteremia and bacterial DNAaemia, the area under of ROC is 0.88,0.78 and 0.79, respectively. The levels of Presepsin increase earlier than procalcitonin, and have better clinical value for early diagnosis of sepsis. It is significantly correlated with disease severity and can be used to predict prognosis. One study mentioned that in the absence of organ dysfunction, the value was 235.0 (172.0-340.3) pg/ml, and for one, two, three or more organ dysfunction, were 403.5 (275.8-587.3) pg / ml, 844.5 (559.8-1259.5) pg / ml, 1412.5 (893.0-2675.8) pg/ml (P<0.01), respectively. Another study mentioned that Presepsin is an independent risk factor for 30-day death of sepsis, and it is effective to evaluate poor prognosis with a threshold of >927.5 pg/ml. Presepsin also has clinical value for neonatal and child sepsis. The Greece meta-analysis showed that the AUC for neonatal sepsis diagnosis was 0.9751, which was higher and more sensitive than that of CRP and procalcitonin. Turkish study on children showed a significant increase in sCD14-ST in sepsis patients compared with healthy controls. Its AUC was 0.98, the best threshold was 990 pg/ml. The reference range of this value was been studied, showing that 75％ and 95％ percentiles of full-term infants are 791 and 1178 pg/ml. Adults do not exceed 200 pg/ml of all age groups. It is affected by renal function. Prospective trials are expected to further clarify its diagnostic value, more therapeutic research to elaborate its therapeutic value, and corresponding clinical practice guideline.

Acute coronary syndromes (ACS) are clinical syndromes caused by the instability or rupture of coronary atheromatous plaques. The development and treatment of ACS are closely related to some ocular manifestations. Hypertensive retinopathy, retinal arteriovenous occlusion, diabetes retinopathy, and age-related macular degeneration are associated with a high risk of ACS. Retinal vascular occlusion may be a potential postoperative complication of the percutaneous coronary intervention for ACS. Ocular parameters such as the retinal vascular diameter and density, the blood flow velocity of the ophthalmic artery, and the choroidal thickness are expected to be markers for assessing or predicting the risk of ACS, which are of important value for the prevention of cardiovascular events such as ACS.

Objective To evaluate the role of different nicotinic acetylcholine receptor ( nAChR) subtypes in skeletal muscles in sepsis-related nerve-muscle dysfunction in septic rats by neuroelectrophysiol-ogy. Methods SPF adult male Sprague-Dawley rats, weighing 200-220 g, aged 2-3 months, were stud-ied. Sepsis was induced by cecal ligation and puncture in chloral hydrate-anesthetized rats. Twelve portions of sciatic nerve-tibialis anterior muscles taken at day 3 after successful establishment of the sepsis modelserved as group S. Another 12 portions of sciatic nerve-tibialis anterior muscles of normal rats served as group C. The endplate potential ( EPP ) was monitored by intracellular microelectrode recording. Six por-tions of nerve-muscle samples were incubated with the adult nAChR (ε-nAChR ) specific antagonist wa-glerin-1 at a concentration of 1 μmol∕L, the fetal nAChR (γ-nAChR) specific antagonist αA-OIVA at a concentration of 250 nmol∕L and neuronal nAChR (α7-nAChR) antagonist methyllycaconitine ( MLA) at a final concentration of 6 nmol∕L. The amplitude of EPP was recorded at 15 min of incubation, and the differ-ence in the amplitude of EPP (ΔEPP) and changing rate of EPP (ΔEPP％) were calculated. Another 6 portions of samples were incubated for 15 min with the Kreb mixture of waglerin-1 and 250 nmol∕LαA-OIVA at a final concentration of 1 μmol∕L, the Kreb mixture of waglerin-1 and 6 nmol∕L MLA at a final concen-tration of 1 μmol∕L, and the Kreb mixture of αA-OIVA and 6 nmol∕L MLA at a final concentration of 250 nmol∕L, and then the amplitude of EPP was recorded. Washout was performed with antagonist free Kreb so-lution for 15 min between treatments with different blockers. Results Compared with group C, ΔEPP andΔEPP％ were significantly decreased after antagonizing ε-nAChR, ΔEPP％ was decreased after antagoni-zing γ-nAChR, ΔEPP and ΔEPP％ were increased after antagonizing α7-nAChR, the amplitude of EPP was increased after antagonizingε-nAChR+γ-nAChR andε-nAChR+α7-nAChR, and the amplitude of EPP was decreased after antagonizing γ-nAChR+α7-nAChR (P<0. 05). ΔEPP and ΔEPP％ were significantly higher after antagonizing α7-nAChR than after antagonizingγ-nAChR in group S ( P<0. 05) . The EPP was significantly lower after antagonizingε-nAChR+α7-nAChR than after antagonizingε-nAChR+γ-nAChR ( P<0. 05) . Conclusion Weakened function of ε-nAChR and enhanced function of α7-nAChR in the mem-brane of the end-plate in skeletal muscle are the main reasons for sepsis-related nerve-muscle dysfunction in septic rats, and the role is comparable between them.

Studies have suggested that the nucleus accumbens (NAc) is implicated in the pathophysiology of major depression; however, the regulatory strategy that targets the NAc to achieve an exclusive and outstanding anti-depression benefit has not been elucidated. Here, we identified a specific reduction of cyclic adenosine monophosphate (cAMP) in the subset of dopamine D1 receptor medium spiny neurons (D1-MSNs) in the NAc that promoted stress susceptibility, while the stimulation of cAMP production in NAc D1-MSNs efficiently rescued depression-like behaviors. Ketamine treatment enhanced cAMP both in D1-MSNs and dopamine D2 receptor medium spiny neurons (D2-MSNs) of depressed mice, however, the rapid antidepressant effect of ketamine solely depended on elevating cAMP in NAc D1-MSNs. We discovered that a higher dose of crocin markedly increased cAMP in the NAc and consistently relieved depression 24 h after oral administration, but not a lower dose. The fast onset property of crocin was verified through multicenter studies. Moreover, crocin specifically targeted at D1-MSN cAMP signaling in the NAc to relieve depression and had no effect on D2-MSN. These findings characterize a new strategy to achieve an exclusive and outstanding anti-depression benefit by elevating cAMP in D1-MSNs in the NAc, and provide a potential rapid antidepressant drug candidate, crocin.