文化区系视野下的“毒药”疗法起源新探

《黄帝内经》"异法方宜论"记载的中医起源五方论的真实性在学术界备受质疑。文章试图以"中国考古学文化区系类型学说"为新视角,从西方羌族的始祖"炎帝神农"、农耕文明、医药传统、神话传说入手,通过分析炎帝神农与羌族的关系,西王母"不死药"的传说和羌族的医药文化,提出"毒药"疗法起源于西方羌族的新观点。

In vitro screening of traditionally used medicinal plants in China against Enteroviruses

AIM： To search for new antiviral agents from traditional Chinese medicine, specifically anti-enterovirosuses agents. METHODS： The aqueous extracts （AE） of more than 100 traditionally used medicinal plants in China were evaluated for their in vitro anti-Coxsackie virus B3 activities with a MTT-based colorimetric assay. RESULTS： The test for AE of 16 plants exhibited anti- Coxsackie virus B3 activities at different magnitudes of potency. They can inhibit three steps （inactivation, adsorption and replication） during the infection. Among the 16 plants, Sargentodoxa cuneata （Oliv.） Rehd. et Wils., Sophora tonkinensis Gapnep., Paeonia veitchii Lynch, Spatholobus suberectus Dunn. and Cyrtorniurn fortunei J, sm. also have activity against other enterovirus, including Coxsackie virus 135, Polio virus I, Echo virus 9 and Echo virus 29. Cell cytotoxic assay demonstrated that all tested AE had CC50 values higher than their EC50 values. CONCLUSION： The sixteen traditionally used medicinal plants in China possessed antMral activity, and some of them merit further investigations.

Assessment of drug-induced hepatotoxicity in clinical practice: A challenge for gastroenterologists

Currently, pharmaceutical preparations are serious contributors to liver disease; hepatotoxicity ranking as the most frequent cause for acute liver failure and post-commercialization regulatory decisions. The diagnosis of hepatotoxicity remains a difficult task because of the lack of reliable markers for use in general clinical practice. To incriminate any given drug in an episode of liver dysfunction is a step-by-step process that requires a high degree of suspicion, compatible chronology, awareness of the drug’s hepatotoxic potential, the exclusion of alternative causes of liver damage and the ability to detect the presence of subtle data that favors a toxic etiology. This process is time-consuming and the final result is frequently inaccurate. Diagnostic algorithms may add consistency to the diagnostic process by translating the suspicion into a quantitative score. Such scales are useful since they provide a framework that emphasizes the features that merit attention in cases of suspected hepatic adverse reaction as well. Current efforts in collecting bona fide cases of drug-induced hepatotoxicity will make refinements of existing scales feasible. It is now relatively easy to accommodate relevant data within the scoring system and to delete low-impact items. Efforts should also be directed toward the development of an abridged instrument for use in evaluating suspected drug-induced hepatotoxicity at the very beginning of the diagnosis and treatment process when clinical decisions need to be made. The instrument chosen would enable a confident diagnosis to be made on admission of the patient and treatment to be fine-tuned as further information is collected.

Efficacies of β-L-D4A against Hepatitis B virus in 2.2.15 cells

AIM： To investigate the antiviral effect of beta-L- enantiomer of 2;3＇-didehydro-2＇,3″-dideoxyadenosine （13-L-D4A） on 2.2.15 cells transfected with the hepatitis B virus （HBV） genome.METHODS： Lamivudine （3TC） as a positive control. Then, HBV DNA in treated 2.2.15 cells and the Hepatitis B surface antigen （HBsAg） in the culture supernatants were detected to determine the inhibitory effect of β-L- D4A. At the same time, 3-（4,5-dimethylthiazol-2-yl）-2,5- diphenyltetrazolium bromide （MTT） was used to detect the survival ratio of 2.2.15 cells.RESULTS： β-L-D4A has a dose-dependent inhibitory effect on HBV DNA replication; this effect was apparent when the concentration was above 1 mol/L. When β-L- D4A was at the highest concentration, 100 mol/L, the HBsAg inhibition ratio was above 50%. The Therapeutic index （TI） of β-L-D4A was above 2.1.CONCLUSION： β-L-D4A has a dose-dependent inhibitory effect on the replication of HBV DNA and the secretion of HBsAg at low toxicity,

Prevention and Treatment of KSHV-associated Diseases with Antiviral Drugs

Kaposi’s sarcoma-associated herpesvirus (KSHV) was first identified as the etiologic agent of Kaposi’s sarcoma (KS) in 1994. KSHV infection is necessary,but not sufficient for the development of Kaposi sarcoma (KS),primary effusion lymphoma (PEL),and multicentric Castleman disease (MCD). Advances in the prevention and treatment of KSHV-associated Diseases have been achieved,even though current treatment options are ineffective,or toxic to many affected persons. The identification of new targets for potential future therapies and the randomized trial to evaluate the efficacy of new antivirals are required.

N-acetyl cysteine therapy in acute viral hepatitis

AIM: To investigate the effect of N-acetyl cysteine (NAC)on acute viral hepatitis (AVH).METHODS: We administered 200 mg oral NAC three times daily (600 mg/day) to the study group and placebo capsules to the control group. All patients were hospitalized and diagnosed as AVH. Blood total and direct bilirubin, ALT, AST,alkaline phosphatese, albumin and globulin levels of each patient were measured twice weekly until total bilirubin level dropped under 2 mg/dl, ALT level under 100 U/L, follow up was continued and then the patients were discharged.RESULTS: A total of 41(13 female and 28 male) AVH patients were included in our study. The period for normalization of ALT and total bilirubin in the study group was 19.7±6.9 days and 13.7±8.5 days respectively. In the control group it was 20.4±6.5 days and 16.9±7.8 days respectively (P＞0.05).CONCLUSION: NAC administration effected neither the time necessary for normalization of ALT and total bilirubin values nor duration of hospitalization, so we could not suggest NAC for the treatment of icteric AVH cases. However, our results have shown that this drug is not harmful to patients with AVH.

Development of Novel Antiviral Therapies for Hepatitis C Virus

Over 170 million people worldwide are infected with hepatitis C virus (HCV), a major cause of liver diseases. Current interferon-based therapy is of limited efficacy and has significant side effects and more effective and better tolerated therapies are urgently needed. HCV is a positive, single-stranded RNA virus with a 9.6 kb genome that encodes ten viral proteins. Among them, the NS3 protease and the NS5B polymerase are essential for viral replication and have been the main focus of drug discovery efforts. Aided by structure-based drug design, potent and specific inhibitors of NS3 and NS5B have been identified, some of which are in late stage clinical trials and may significantly improve current HCV treatment. Inhibitors of other viral targets such as NS5A are also being pursued. However, HCV is an RNA virus characterized by high replication and mutation rates and consequently, resistance emerges quickly in patients treated with specific antivirals as monotherapy. A complementary approach is to target host factors such as cyclophilins that are also essential for viral replication and may present a higher genetic barrier to resistance. Combinations of these inhibitors of different mechanism are likely to become the essential components of future HCV therapies in order to maximize antiviral efficacy and prevent the emergence of resistance.

Recent Ⅳ-drug users with chronic hepatitis C can be efficiently treated with daily high dose induction therapy using consensus interferon:An open-label pilot study

AIM： To investigate the use of high dose consensusinterferon in combination with ribavirin in former iv drug users infected with hepatitis C. METHODS： We started, before pegylated （PEG）interferons were available, an open-label study to investigate the efficacy and tolerability of high dose induction therapy with consensus interferon （CIFN） and ribavirin in treatment of naiive patients with chronic hepatitis C. Fifty-eight patients who were former iv drug users, were enrolled receiving 18 μg of CIFN daily for 8 wk, followed by 9 μg daily for up to wk 24 or 48 and 800 mg of ribavirin daily. End point of the study was tolerability and eradication of the virus at wk 48 and sustained virological response at wk 72. RESULTS： More than 62% of patients responded to the treatment with CIFN at wk 24 or 48, respectively, showing a negative qualitative PCR [genotype 1 fourteen patients （56%）, genotype 2 five （50%）, genotype 3 thirteen （87%）, genotype 4 four （50%）]. Forty-eight percent of genotype 1 patients showed sustained virological response （SVR） six months after the treatment. CONCLUSION： CIFN on a daily basis is well tolerated and side effects like leuko- and thrombocytopenia are moderate. End of therapy （EOT） rates are slightly lower than the newer standard therapy with pegylated interferons. CIFN on a daily basis might be a favourable therapy regimen for patients with GTI and high viral load or for non-responders after failure of standard therapy.

Inhibition effect of Chinese herbal medicine on transcription of hepatitis C virus structural gene in vitro

AIM: To investigate the inhibitory effect of Chinese herbal medicine on the transcription of hepatitis C virus (HCV) structural gene in Hela D cells.METHODS: Hela cell line was transfected with recombinant pBK-CMV-HCV containing HCV structural gene by Lipofectamine. RT-nested-PCR and Western blot assay were used to testify the HCV gene expression in Hela cells. The Hela cells expressing HCV structural protein were named Hela D cells. Prescriptions of Xiao chaihu Decoction (XCHD),Fufang Huangqi (FFHQ) and Bingganling (BGL) wererespectively added to Hela D cells in various concentrations. Semi-quantitative RT-nested-PCR product analysis was performed according to the fluorescent density between HCV DNA band and GAPDH DNA band in gel electrophoresisafter screened. RESULTS: Recombinant pBK-CMV-HCV could correctly express the HCV structural gene in Hela D cells. After coculture of Hela D cells with three prescriptional different concentrations for 48 h respectively, the transcription of HCVgene decreased with increasing of the concentration of each prescription. The lightness ratio of HCV product bands to GAPDH product bands was 0.24, 0.10 and 0.12 in Hela D cells incubated with 0.1 g/mL of XCHD, FFHQand BGL respectively and the lightness ratio HCV product bands to GAPDH product bands was 0.75, 0.67 and 0.61respectively in the control cells. CONCLUSION: The prescriptions of XCHD, FFHQ and BGL partly inhibit the transcription of HCV structural gene inHela D cells.

THE ROLE OF RECOMBINANT HUMAN FUSION PROTEIN IL－6／IL－2（CH925） IN HEPADNA VIRUS INFECTION TREATMENT

The effects of CH925, a novel immune modulator, on hepadna virus infection was evaluated. Day-old ducklings were inoculated intravenously with LJ-76 DHBV containing serum. Infected ducklings were then treated with the CH925 and the mixture of IL-2 and IL-6 intravenously and the control ducklings received equivalent normal saline (NS). Blood and liver samples were taken and assayed for DHBV DNA and /or DHBsAg. At the completion of the experiment there was a inhibition of viremia with the CH925 and IL-2 + IL-6. Serum DHBV DNA was detected in 6 of 10 ducks in 100 000 unit/kg dosage group, 7 of 10 ducks in 50 000 unit/kg dosage group and 6 of 10 ducks in IL-2 + IL-6 dosage group, compared with 9 of 10 NS control, and it showed a similar result in circulating DHBsAg. When samples of liver DNA were processed for hybridization, a little difference in the DHBV DNA replication was noted between ducks receiving CH925, IL-2 + IL-6 or NS placebo. It is suggested that CH925 might be a potential remedy in HBV infection treatment.

Localization of Auricular Projection Area of the Liver and Its Use in the Monitoring of Viral Hepatitis

Background： Pathology of an internal organ causes significant rectification of electrical currents （diode phenomenon） in related skin areas once the resistance ＇breakthrough effect＇ has been induced in the skin. Objective： Localization of auricular projection area of the liver and evaluation of its usefulness in the monitoring of viral hepatitis. Design, Patients and Setting： Comparative study of the degree of electrical rectification measured at various spots in the auricular concha region, in 19 inpatients with hepatitis B and 15 clinically healthy volunteers, at the Department of Infectious Diseases, Provincial Teaching Hospital, Tychy, Poland. Intervention： Evaluation of electrical rectification at various spots on the auricular concha using a ＂rectification ratio＂ that quantifies the degree of rectification （normal range： 0-60%）. Main outcome measure： The location of the skin area where a statistically significant difference existed between the rectification ratios was observed in patients （82±12% at the time of the ＇peak period＇） versus controls （42±8%）. Results： A location was identified on the ear auricle where the electrical rectification phenomenon demonstrated a dependence on the presence of hepatitis. Conclusions： Liver projection area exists on the ear auricle which is located within the region of cymba conchae, next to anthelix and the cavity of concha. The existence of viral hepatitis causes this skin area to show a higher degree of electrical rectification once the skin resistance ＇breakthrough effect＇ has been induced. Evaluation of the rectification phenomenon of the liver proiection area provides a method of non-invasive monitoring of viral hepatitis.

Antiretroviral Therapy through Barriers： A Prominent Role for Nanotechnology in HIV-1 Eradication from Sanctuaries

Abstract： In HIV-1 management, eradication of the virus from sanctuaries represents a major and challenging goal. The genital tract, gut associated lymphoid tissue, lymph nodes, central nervous system, macrophages and latently infected CD4＋ T lymphocytes are typical sites where H1V-1 compartmentalizes. To circumvent this problem, a consistent number of studies have focused on improving ARVs （antiretroviral drugs） delivery into sanctuary sites and different nanoteehnological approaches have been developed. Cellular HIV-1 sanctuaries （i.e. macrophages） can be reached by nanoformulation of ARVs or by activation of latently infected cells. Anatomical sanctuaries （i.e. brain or male genital tract） can be addressed by increasing the permeation of ARVs across tissue barriers, such as the blood-brain barrier or the blood-testis barrier, while ARVs concentration in lymph nodes can be enhanced by drug encapsulation in CD4-targeted nanoparticles.

慢性乙型肝炎临床治愈的破晓晨晖

乙型肝炎病毒(HBV)的发现为慢性乙型肝炎(CHB)的诊断、预防和治疗提供了科学基础。新生儿乙型肝炎疫苗的普种极大地降低了我国人群乙型肝炎表面抗原(HBsAg)阳性率,基于干扰素和/或核苷(酸)类似物的抗病毒治疗,可有效抑制HBV复制、改善肝脏炎症坏死和肝纤维化,从而减少肝硬化和肝细胞癌的发生。然而,现有治疗手段很难实现到HBsAg转阴的临床治愈目标。近年来,针对HBV生命周期的直接抗病毒药物及针对机体抗病毒应答的免疫调节药物进入研发活跃期。设计良好、执行规范、分析正确、解读恰当的临床试验,是决定乙型肝炎临床治愈新药能否研发成功的关键。希望肝脏病学、临床药理学及方法学专家通力合作,采用新型临床试验设计、新型终点指标、新型数据管理和质控技术,共同促进乙型肝炎临床治愈新药研发进程。

Effects of Moxibustion Therapy on Preventing and Treating Side Effects from Chemotherapy of Malignant Tumor Patients

Objective： To observe the clinical effects of moxibustion therapy on preventing and treating toxic and side effects of chemotherapy in malignant tumor patients. Methods： A total of 63 cases were randomly divided into three groups. Twenty-three cases in the moxibustion group were treated by moxibustion, and 22 cases in the hydro-acupuncture group were treated by acupoint injection, and 18 cases in the control group were treated by oral administration of Batilol tablets. The changes of the white blood cell count and the content of immunoglobulin before and after the treatments were observed. Results： After treatments, the total leukocyte count and the content of immunoglobulin were all elevated in the moxibustion group and the hydro-acupuncture group, with statistical difference when compared with the control group （P〈0.05, P〈0.01）. In the elevation of the white blood cell count, the hydro-acupuncture group was better than the moxibustion group （P〈0.05）. Conclusion： Moxibustion and hydro-acupuncture can be used to treat and prevent toxic and side effects of chemotherapy. From this aspect, the different needling techniques possess different effects.