We reported the discovery of six novel coumarins, toddasirins A-F (1-6), each endowed with modified isoprenyl or geranyl side chains, derived from the roots of Toddalia asiatica. Comprehensive structural elucidation was achieved through multispectroscopic analyses, single-crystal X-ray diffraction experiments, and advanced quantum mechanical electronic circular dichroism (ECD) calculations. Furthermore, the anti-inflammatory activity of these compounds was assessed. Notably, compounds 1-3 and 6 demonstrated notable inhibitory effects on nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW 264.7 cells, with 50% inhibitory concentration (IC₅₀) values of 3.22, 4.78, 8.90, and 4.31 μmol·L^-1, respectively.
Mice ; Animals ; Coumarins/chemistry* ; Rutaceae/chemistry* ; Anti-Inflammatory Agents/pharmacology* ; Plant Extracts/chemistry* ; RAW 264.7 Cells ; Nitric Oxide ; Molecular Structure

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.
Child ; Female ; Humans ; Australia ; Massage ; Mastitis/therapy* ; Mastodynia ; Medicine, Chinese Traditional

The relevant provisions of bloodletting for expelling pathogens are collected from the works of the medical representative scholars in Jin-Yuan Dynasties and Ming-Qing Dynasties respectively to construct the databases of bloodletting for expelling pathogens of Jin-Yuan Dynasties and Ming-Qing Dynasties. Using frequency analysis, the bloodletting device, bloodletting location, bloodletting volume, the related pathogens and indications are compared between these two times so that the evidences could be provided for the inheritance and development of the academic thought of bloodletting for expelling pathogens. It is found that the three-edge needle is the most commonly used device for bloodletting in Jin-Yuan Dynasties and Ming-Qing Dynasties and
Acupuncture Points ; Bloodletting ; China ; Medicine, Chinese Traditional ; Meridians ; Needles

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective To investigate the effect of asymptomatic hyperuricemia after renal transplantation on renal function of the grafts.Methods The follow-up data were retrospectively collected and analyzed in 144 patients with renal transplantation from January 2010 to March 2015.The patients were classified into three groups according to the level of serum uric acid (SUA):group A (normal group),group B (asymptomatic hyperuricernia with average SUA less than or equal to 360 μmol/L after treatment),and group C (asymptomatic hyperuricemia with average SUA greater than 360μmol/L after treatment).The renal function indexes such as serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were compared among three groups from 12 to 48 months after transplantation.Results The SCr and eGFR showed no significant difference between group A and group B at 12th month (P＞0.05),but ther are superior than Group Ⅲ (P＜0.05).Conclusion After renal transplantation,asymptomatic hyperuricemia can lead to impaired renal function,and there are no significant differences in renal function between renal transplant recipients with normal SUA levels after treatment and those without hyperuricemia.

The paper analyzes the current problems of medical students'humanistic quality and the causes,points out the necessity of strengthening the humanistic quality of medical students,and puts forward the countermeasures to be taken by libraries of medical colleges in the humanistic quality education for college students,including strengthening the construction of medical humanistic resources,doing well of medical humanistic reading guide and entrance education for new students,and strengthening reading promotion activities,etc.

Objective To comprehensively analyze the nursing measures of early thrombolytic therapy for acute myocardial infarction. Methods 140 patients with acute myocardial infarction admitted in our hospital from October 2013 to October 2016 were randomly divided into control group (70 cases) and experimental group (apply early thrombolytic care on the basis of routine nursing method, 70 cases) according to different nursing methods. SPSS20.0 statistical software was used to analyze the incidence of complications, mean hospitalization time, average bedridden time and total satisfaction. Results The average hospital stay and the average length of stay in the experimental group were much shorter than those in the control group (P<0.05). The total score of the experimental group was much higher than that of the control group (P<0.05). The complication rate of the experimental group was much lower than that of the control group (P<0.05). Conclusion Nursing measures for early thrombolytic therapy in patients with acute myocardial infarction can significantly reduce the incidence of complications in patients.

Objective To study the protective effect of nuclear factor erythroid 2-related factor 2 (Nrf2)activation by curcumin against lead-induced toxicity and apoptosis in SH-SY5Y human neuroblastoma cells and its impact on expression of apoptosis-related proteins.Methods After the cells were treated with 0,0.5,1,5,or 10 μmol/L curcumin for 24 hours,nucleoprotein was extracted and electrophoretic mobility shift assay was used to measure Nrf2-antioxidant responsive element (ARE) binding capacity.The optimal concentration of curcumin was figured out for treating cells.After pretreatment with 5 μmol/L curcumin for 24 hours,cells were exposed to lead acetate at different concentrations (0,5,25,and 125 μmol/L for control,low-dose,mediumdose,and high-dose groups).The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay,flow cytometry,and Western blot were used to evaluate cell viability,apoptosis,and expression of apoptosisrelated proteins,respectively.Results Curcumin of 5 μmol/L caused significantly increased cell viability in low-,medium-,and high-dose groups exposed to lead acetate for 12 hours(98.42％±1.12％ vs 92.92％±0.14％,P＜0.05;95.30％±1.17％ vs 91.15％±0.67％,P＜0.05;94.50％±1.45％ vs 85.98％±0.45％,P＜0.05).Curcumin of 5 μmol/L also caused significantly increased cell viability in medium-and high-dose groups exposed to lead acetate for 24 hours (93.10％±1.63％ vs 88.40％±4.13％,P＜0.05;90.13％±2.03％ vs 83.63％±3.42％,P＜0.05).The high-dose group had a significantly higher apoptotic rate than the control group 6.17％ ±1.31％ vs 3.30％±0.53％,P＜0.05).Curcumin of 5.0 μmol/L significantly reduced the apoptotic rate in the high-dose group (2.97％±0.15％ vs 6.17％±1.31％,P＜0.05).Exposure to lead acetate elevated the expression of Bax,cytochrome C,and caspase-3 and reduced Bcl-2 expression.Curcumin of 5.0 μmol/L significantly reduced the expression of Bax,cytochrome C,and caspase-3 in the high-dose group (P＜0.05).Conclusion Nrf2 activation by curcumin has a protective effect against lead-induced toxicity and apoptosis in SH-SY5Y cells.The protective effect of Nrf2 against apoptosis may be associated with the regulation of apoptosis-related proteins.

Objective To study the protective effect of nuclear factor erythroid 2-related factor 2 (Nrf2)activation by curcumin against lead-induced toxicity and apoptosis in SH-SY5Y human neuroblastoma cells and its impact on expression of apoptosis-related proteins.Methods After the cells were treated with 0,0.5,1,5,or 10 μmol/L curcumin for 24 hours,nucleoprotein was extracted and electrophoretic mobility shift assay was used to measure Nrf2-antioxidant responsive element (ARE) binding capacity.The optimal concentration of curcumin was figured out for treating cells.After pretreatment with 5 μmol/L curcumin for 24 hours,cells were exposed to lead acetate at different concentrations (0,5,25,and 125 μmol/L for control,low-dose,mediumdose,and high-dose groups).The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay,flow cytometry,and Western blot were used to evaluate cell viability,apoptosis,and expression of apoptosisrelated proteins,respectively.Results Curcumin of 5 μmol/L caused significantly increased cell viability in low-,medium-,and high-dose groups exposed to lead acetate for 12 hours(98.42％±1.12％ vs 92.92％±0.14％,P＜0.05;95.30％±1.17％ vs 91.15％±0.67％,P＜0.05;94.50％±1.45％ vs 85.98％±0.45％,P＜0.05).Curcumin of 5 μmol/L also caused significantly increased cell viability in medium-and high-dose groups exposed to lead acetate for 24 hours (93.10％±1.63％ vs 88.40％±4.13％,P＜0.05;90.13％±2.03％ vs 83.63％±3.42％,P＜0.05).The high-dose group had a significantly higher apoptotic rate than the control group 6.17％ ±1.31％ vs 3.30％±0.53％,P＜0.05).Curcumin of 5.0 μmol/L significantly reduced the apoptotic rate in the high-dose group (2.97％±0.15％ vs 6.17％±1.31％,P＜0.05).Exposure to lead acetate elevated the expression of Bax,cytochrome C,and caspase-3 and reduced Bcl-2 expression.Curcumin of 5.0 μmol/L significantly reduced the expression of Bax,cytochrome C,and caspase-3 in the high-dose group (P＜0.05).Conclusion Nrf2 activation by curcumin has a protective effect against lead-induced toxicity and apoptosis in SH-SY5Y cells.The protective effect of Nrf2 against apoptosis may be associated with the regulation of apoptosis-related proteins.

To study the in vitro anti-angiogenesis effect of three curcumin pigments (curcumin, demethoxycurcumin, bisdemethoxycurcumin). In the study, the inhibitory effect of the three curcumin pigments on proliferation of HUVEC cells induced by OX-LDL and the effect on migration of HUVEC cells were detected. The effect on neovascularization was observed by chorioallantoic membrane (CAM) test. The effect on cell adhesion factors ICAM-1 and VCAM-1 of HUVECs were tested by Real-time RT-PCR. It was found that the three curcumins could inhibit the proliferation of HUVEC cells induced by OX-LDL within the dosage range 4, 8, 16 mg x L(-1), with a dose-dependence. The proliferative effect of curcumins on HUVECs was greater than the other two derivatives (P < 0.01). All of the three curcumin pigments inhibited the migration of HUVEC cells and the angiogenesis of chick chorioallantoic membrane (CAM). The migration inhibition rate of curcumins at middle and high concentrations was greater than the other two (P < 0.01). All of the three curcumin could down-regulate the expression of VEGF and ICAM-1, and curcumins showed more obvious effect in down-regulating VEGF than demethoxycurcumin and bisdemethoxycurcumin(P < 0.01); Bisdemethoxycurcumin showed the most significant effect in down-regulating ICAM-1 (P < 0.01). All of the three showed no remarkable effect on expression of VCAM-1, and only bisdemethoxycurcumin showed the down-regulating effect (P < 0.05). According to the findings, all of the three curcumin pigments could resist angiogenesis by inhibiting proliferation and migration of endothelial cells and down-regulating the expression of VEGF and adhesion molecules ICAM-1.
Angiogenesis Inhibitors ; pharmacology ; Animals ; Cell Movement ; drug effects ; Cells, Cultured ; Chorioallantoic Membrane ; drug effects ; Curcumin ; analogs & derivatives ; pharmacology ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; RNA, Messenger ; analysis ; Vascular Cell Adhesion Molecule-1 ; genetics ; Vascular Endothelial Growth Factor A ; genetics