Objective: To study the therapeutic effect of Com pound Biejia Ruangan prescription (CBRP) on rat model with pulmonary fibrosis in duced by bleomycin. Methods: Fifty four male Sprague Dawley rats were rando mly divide...Objective: To study the therapeutic effect of Com pound Biejia Ruangan prescription (CBRP) on rat model with pulmonary fibrosis in duced by bleomycin. Methods: Fifty four male Sprague Dawley rats were rando mly divided into 6 groups (9 rats in each group). From the first day to the 28th day of the experiment, except to those in the sham model control group that were treated with normal saline, the same amount of bleomycin injection as the n ormal saline given to the control group was given through endotracheal instillat ion to all the rats in all the other groups. From the 29th day of the modeling, CBRP solution of different dosages was respectively injected into the rats in th e high, moderate and low CBRP dose group, while equal volume of normal saline w as given to those in the sham model control group and the model control group , and an equal volume of prednisone solution was given to rats in the prednisone group. On the 80th day, the high resolution computerized tomographic (HRCT) images were observed on an equal footing, and HRCT pathology was correlativel y studied. Results: Different HRCT pathological changes were shown in th e rats with pulmonary fibrosis, such as lung consolidation, thickening of interl obular septum and interlobular mesenchyma as well as lobular deformation, nodule shadow, abnormal brochiovascular tract, thickened pleura with irregular junctio n and polished glass like dense shadows. Honeycomb lung was observed in some cases. Pathological sections showed fibrotic proliferation of lung tissues and noticeable pulmonary interstitial fibrosis. CBRP could improve HRCT images of rats with pulmonary fibrosis, and lower fibrotic p roliferation of the lung tissue.Conclusion: CBRP plays its therapeutic role possibly through its effect on the structure of the lung in rats with pulmonary fibrosis.展开更多
Background: In 2012, U.S. health care providers wrote more than 259 million opioid prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioids for pain management during pre...Background: In 2012, U.S. health care providers wrote more than 259 million opioid prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioids for pain management during pregnancy. The Centers for Disease Control and Prevention (CDC) estimated that between 2008 and 2012, 39% of reproductive-aged women on Medicaid had filled a prescription for opioid medication each year, as did 28% of women with private insurance. The opioid epidemic extends to the state of New Jersey (NJ);however, limited data is available regarding opioid prescriptions among Medicaid and private insurance patients within the state. Objective: Evaluate opioid prescriptions filled in reproductive-aged women presenting in labor at a community teaching hospital in suburban New Jersey. Methods: We performed a retrospective cohort study using data obtained from patient records and the New Jersey Prescription Monitoring Program (NJPMP) database. We enrolled 200 patients that were admitted in labor between May 2015 and May 2016. Data was collected from reproductive-aged women during the one year preceding labor admission. We compared our findings to national data reported by the CDC using Chi-square analysis. Maternal demographic data were extracted from patient records and included age, insurance status (private insurance, Medicaid, and no insurance), race, and ethnicity. The primary outcome was opioid prescriptions filled. Results: Of the 200 women admitted in labor, 129 had private insurance, 63 had Medicaid, and 8 had no insurance. We found that 5.4% (7/129) of patients with private insurance, 4.8% (3/63) of patients with Medicaid, and 12.5% (1/8) of patients with no insurance filled opioid prescriptions. Overall, 5.5% (11/200) of women filled opioid prescriptions during the study period. Opioid prescriptions confirmed via NJPMP were significantly lower than rates reported by the CDC in Medicaid (4.8% vs. 41.4%, p-value 0.001) and private insurance (5.4% vs. 29.1%, p-value < 0.001) patients, respectively. Conclusion: Rates of opioid prescriptions filled were lower among our suburban cohort of women in New Jersey than national rates reported by the CDC. We did not confirm that patients with Medicaid filled more prescriptions than patients with private insurance. These discrepancies raise the question of whether a federal prescription monitoring program would better capture data than state-wide programs. Further research is needed to ensure that prescription monitoring programs are actually capturing accurate data.展开更多
He Hongfang(何鸿舫),a medical scholar in the Qing Dynasty,was the 24th descendant of He’s family in Jiangnan Region.He was famous in Shanghai during the reign of Tongzhi and Guangxu for his medicine and calligraphy.T...He Hongfang(何鸿舫),a medical scholar in the Qing Dynasty,was the 24th descendant of He’s family in Jiangnan Region.He was famous in Shanghai during the reign of Tongzhi and Guangxu for his medicine and calligraphy.This article introduces two frames of prescriptions of He Hongfang in the Shanghai Museum of Traditional Chinese Medicine for appreciation。展开更多
The handicapped, a special group in society, usually encounter many difficulties in employment, marriage, and daily life.Some difficulties are what they cannot conquer by themselves. It is also not easy for them to in...The handicapped, a special group in society, usually encounter many difficulties in employment, marriage, and daily life.Some difficulties are what they cannot conquer by themselves. It is also not easy for them to integrate into society. However, if there is a person who helps the hand- icapped find a job, build up confidence and make their life worth; if there is a person who helps them set up their families and incorporate in a harmonious community;展开更多
Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Met...Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.展开更多
Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older p...Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older patients are frequently suboptimal or potentially inappropriate and often result in negative outcomes such as adverse drug events, hospitalisation and increased healthcare resource utilisation. Several factors influence the appropriateness of medication selectionin older patients including age-related changes in pharmacokinetics and pharmacodynamics, high numbers of concurrent medications, functional status and burden of co-morbid illness. With ever-increasing therapeutic options, escalating proportions of older patients worldwide, and varying degrees of prescriber education in geriatric pharmacotherapy, strategies to assist physicians in choosing appropriate pharmacotherapy for older patients may be helpful. In this paper, we describe important age-related pharmacological changes as well as the principal domains of prescribing appropriateness in older people. We highlight common examples of drugdrug and drug-disease interactions in older people. We present a clinical case in which the appropriateness of prescription medications is reviewed and corrective strategies suggested. We also discuss various approaches to optimising prescribing appropriateness in this population including the use of explicit and implicit prescribing appropriateness criteria, comprehensive geriatric assessment, clinical pharmacist review, prescriber education and computerized decision support tools.展开更多
During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positivel...During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positively the agitation of demented patients aged ≥ 65 years.To gather information on the utilization of pain killers in demented patients a preliminary survey has been conducted in collaboration with the Calabrian Pharmacovigilance Territorial Service of the health district of Catanzaro（Italy）.The study has taken into consideration the prescriptions of acetylcholinesterase inhibitors and memantine during the period ranging from July 2015 to June 2016 and the percentage of patients treated against pain with non steroidal antinflammatory drugs,opioids,and anticonvulsants have been monitored.The latter have been evaluated statistically for difference between the treatment before（pre） and after（post） the settlement of acetylcholinesterase inhibitors（ACh EI） or memantine therapy.The results do support accuracy in painkillers utilization in the course of dementia in the regional population of Calabria（Italy）.展开更多
目的:本研究旨在通过Meta分析方法,系统评估经典名方一贯煎在干燥综合征、慢性胃炎、肝纤维化与肝硬化等临床疾病中的治疗效果。方法:全面检索知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、Web of S...目的:本研究旨在通过Meta分析方法,系统评估经典名方一贯煎在干燥综合征、慢性胃炎、肝纤维化与肝硬化等临床疾病中的治疗效果。方法:全面检索知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、Web of Science与PubMed共6个数据库,检索时间为各平台建库至2024年2月18日。纳入一贯煎干预干燥综合征、慢性胃炎、肝纤维化与肝硬化的临床研究,对各病种纳入的结局指标进行数据提取和Meta分析。同时,采用Egger检验评估潜在的发表偏倚,并通过逐一剔除法进行敏感性分析。结果:共纳入26项研究,其中干燥综合征12项研究,病例898例;慢性萎缩性胃炎2项研究,病例159例;肝纤维化与肝硬化14项研究,病例1018例。Meta分析结果表明,一贯煎对干燥综合征的泪液分泌[SMD=1.08,95%CI(0.30,1.85),P=0.0158]及其他血清学指标有改善作用;能降低慢性萎缩性胃炎的内镜评分[MD=-1.66,95%CI(-2.22,-1.10),P<0.0001];降低肝纤维化血清学指标Ⅲ型前胶原[MD=-40.34,95%CI(-71.40,-9.29),P=0.0191]与层黏连蛋白[MD=-53.12,95%CI(-87.14,-19.09),P=0.0088]水平以及肝硬度[MD=-2.61,95%CI(-2.80,-2.41),P=0.0003]。结论:一贯煎临床用于干燥综合征、慢性萎缩性胃炎与肝纤维化具有较好的临床效果。当前研究对于其安全性评价尚不充分,仍然需要进一步的验证。展开更多
Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescripti...Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.展开更多
Objective： To observe the effect of Huannao Yicong Prescription （还脑益聪方, HNYC, a Chinese medical compound） extract on β-amyloid precursor protein （APP） metabolic signal transductionrelated protein kinase C ...Objective： To observe the effect of Huannao Yicong Prescription （还脑益聪方, HNYC, a Chinese medical compound） extract on β-amyloid precursor protein （APP） metabolic signal transductionrelated protein kinase C （PKC）, tyrosine amyloid protein kinase （TrKA）, and glycogen synthase kinase-3 （GSK-3） in brain tissue of transgenic mouse dementia model induced by APP. Methods： Sixty dementia model transgenic 3-month-old mice induced by APP695V7171 were randomly allocated in four groups： the model group （A）, the Donepezil （0.65×10^-3 g.kg-1.d-1）-treated group （B）, and the two HNYC-treated groups （C and D） with high dosage （2.8 g.kg^-1.d^-1） and low dosage （1.4 g.kg^-1.d^-1） of HNYC extract, respectively, 15 mice in each group. Besides, a normal control group was set up with 15 C57BL/6J mice with the same age and genetic background as the model mice. The drugs for treatment were administered once a day by dissolving in equal-volume distilled water through gastric infusion, continued for 6 months, to mice in group A and to normal control group equal-volume distilled water was administered instead. Spatial learning and memory capacity of mice were observed by Morris water maze; their one-time escape response memory capacity was tested by diving platform; and changes of PKC, TrkA, and GSK-3 levels in hippocampus and cortex of brain were detected by Western blotting. Results： HNYC extract showed significant effects on increasing the time of model mice for swimming through the flat roof and the swimming time and path in the fourth quadrant （P〈0.05 or P〈0.01）. Diving platform test showed that the latent times in Groups B and C were longer than that in Group A significantly （P〈0.05 and P〈0.01）. Compared with the normal control group, PKC and TrkA protein expression levels in hippocampus and cortex of model mice＇s brain lowered significantly （P〈0.01）, while GSK-3 protein expression increased significantly （P〈0.01）; compared with Group A （the model group）, hippocampal and cortical levels of PKC protein expression in the intervened groups （B-D） as well as those of TrkA in Group C were higher （P〈0.01 or P〈0.05）, while hippocampal levels of GSK-3 in intervened groups were lower （P〈0.01）. Conclusion： HNYC extract could obviously increase the protein expressions of PKC and TrkA and decrease the expression of GSK-3 protein in brain tissue of transgenetic mice model of dementia, and regulate APP metabolic signal transduction path, and thus to suppress the production of A β, which is one of the dominant mechanisms for improving learning/memory capacity of dementia model animals.展开更多
基金This study was supported by National Funds of Natur al Science (No.30130220)and Administration of Education against SARS(No.15)
文摘Objective: To study the therapeutic effect of Com pound Biejia Ruangan prescription (CBRP) on rat model with pulmonary fibrosis in duced by bleomycin. Methods: Fifty four male Sprague Dawley rats were rando mly divided into 6 groups (9 rats in each group). From the first day to the 28th day of the experiment, except to those in the sham model control group that were treated with normal saline, the same amount of bleomycin injection as the n ormal saline given to the control group was given through endotracheal instillat ion to all the rats in all the other groups. From the 29th day of the modeling, CBRP solution of different dosages was respectively injected into the rats in th e high, moderate and low CBRP dose group, while equal volume of normal saline w as given to those in the sham model control group and the model control group , and an equal volume of prednisone solution was given to rats in the prednisone group. On the 80th day, the high resolution computerized tomographic (HRCT) images were observed on an equal footing, and HRCT pathology was correlativel y studied. Results: Different HRCT pathological changes were shown in th e rats with pulmonary fibrosis, such as lung consolidation, thickening of interl obular septum and interlobular mesenchyma as well as lobular deformation, nodule shadow, abnormal brochiovascular tract, thickened pleura with irregular junctio n and polished glass like dense shadows. Honeycomb lung was observed in some cases. Pathological sections showed fibrotic proliferation of lung tissues and noticeable pulmonary interstitial fibrosis. CBRP could improve HRCT images of rats with pulmonary fibrosis, and lower fibrotic p roliferation of the lung tissue.Conclusion: CBRP plays its therapeutic role possibly through its effect on the structure of the lung in rats with pulmonary fibrosis.
文摘Background: In 2012, U.S. health care providers wrote more than 259 million opioid prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioids for pain management during pregnancy. The Centers for Disease Control and Prevention (CDC) estimated that between 2008 and 2012, 39% of reproductive-aged women on Medicaid had filled a prescription for opioid medication each year, as did 28% of women with private insurance. The opioid epidemic extends to the state of New Jersey (NJ);however, limited data is available regarding opioid prescriptions among Medicaid and private insurance patients within the state. Objective: Evaluate opioid prescriptions filled in reproductive-aged women presenting in labor at a community teaching hospital in suburban New Jersey. Methods: We performed a retrospective cohort study using data obtained from patient records and the New Jersey Prescription Monitoring Program (NJPMP) database. We enrolled 200 patients that were admitted in labor between May 2015 and May 2016. Data was collected from reproductive-aged women during the one year preceding labor admission. We compared our findings to national data reported by the CDC using Chi-square analysis. Maternal demographic data were extracted from patient records and included age, insurance status (private insurance, Medicaid, and no insurance), race, and ethnicity. The primary outcome was opioid prescriptions filled. Results: Of the 200 women admitted in labor, 129 had private insurance, 63 had Medicaid, and 8 had no insurance. We found that 5.4% (7/129) of patients with private insurance, 4.8% (3/63) of patients with Medicaid, and 12.5% (1/8) of patients with no insurance filled opioid prescriptions. Overall, 5.5% (11/200) of women filled opioid prescriptions during the study period. Opioid prescriptions confirmed via NJPMP were significantly lower than rates reported by the CDC in Medicaid (4.8% vs. 41.4%, p-value 0.001) and private insurance (5.4% vs. 29.1%, p-value < 0.001) patients, respectively. Conclusion: Rates of opioid prescriptions filled were lower among our suburban cohort of women in New Jersey than national rates reported by the CDC. We did not confirm that patients with Medicaid filled more prescriptions than patients with private insurance. These discrepancies raise the question of whether a federal prescription monitoring program would better capture data than state-wide programs. Further research is needed to ensure that prescription monitoring programs are actually capturing accurate data.
文摘He Hongfang(何鸿舫),a medical scholar in the Qing Dynasty,was the 24th descendant of He’s family in Jiangnan Region.He was famous in Shanghai during the reign of Tongzhi and Guangxu for his medicine and calligraphy.This article introduces two frames of prescriptions of He Hongfang in the Shanghai Museum of Traditional Chinese Medicine for appreciation。
文摘The handicapped, a special group in society, usually encounter many difficulties in employment, marriage, and daily life.Some difficulties are what they cannot conquer by themselves. It is also not easy for them to integrate into society. However, if there is a person who helps the hand- icapped find a job, build up confidence and make their life worth; if there is a person who helps them set up their families and incorporate in a harmonious community;
文摘Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.
文摘Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older patients are frequently suboptimal or potentially inappropriate and often result in negative outcomes such as adverse drug events, hospitalisation and increased healthcare resource utilisation. Several factors influence the appropriateness of medication selectionin older patients including age-related changes in pharmacokinetics and pharmacodynamics, high numbers of concurrent medications, functional status and burden of co-morbid illness. With ever-increasing therapeutic options, escalating proportions of older patients worldwide, and varying degrees of prescriber education in geriatric pharmacotherapy, strategies to assist physicians in choosing appropriate pharmacotherapy for older patients may be helpful. In this paper, we describe important age-related pharmacological changes as well as the principal domains of prescribing appropriateness in older people. We highlight common examples of drugdrug and drug-disease interactions in older people. We present a clinical case in which the appropriateness of prescription medications is reviewed and corrective strategies suggested. We also discuss various approaches to optimising prescribing appropriateness in this population including the use of explicit and implicit prescribing appropriateness criteria, comprehensive geriatric assessment, clinical pharmacist review, prescriber education and computerized decision support tools.
文摘During the clinical course of dementia,beside cognitive impairment and memory loss,a very complex challenge is posed by the neuropsychiatric symptoms（NPSs）.Accurate evaluation and treatment of pain impacts positively the agitation of demented patients aged ≥ 65 years.To gather information on the utilization of pain killers in demented patients a preliminary survey has been conducted in collaboration with the Calabrian Pharmacovigilance Territorial Service of the health district of Catanzaro（Italy）.The study has taken into consideration the prescriptions of acetylcholinesterase inhibitors and memantine during the period ranging from July 2015 to June 2016 and the percentage of patients treated against pain with non steroidal antinflammatory drugs,opioids,and anticonvulsants have been monitored.The latter have been evaluated statistically for difference between the treatment before（pre） and after（post） the settlement of acetylcholinesterase inhibitors（ACh EI） or memantine therapy.The results do support accuracy in painkillers utilization in the course of dementia in the regional population of Calabria（Italy）.
文摘目的:本研究旨在通过Meta分析方法,系统评估经典名方一贯煎在干燥综合征、慢性胃炎、肝纤维化与肝硬化等临床疾病中的治疗效果。方法:全面检索知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、Web of Science与PubMed共6个数据库,检索时间为各平台建库至2024年2月18日。纳入一贯煎干预干燥综合征、慢性胃炎、肝纤维化与肝硬化的临床研究,对各病种纳入的结局指标进行数据提取和Meta分析。同时,采用Egger检验评估潜在的发表偏倚,并通过逐一剔除法进行敏感性分析。结果:共纳入26项研究,其中干燥综合征12项研究,病例898例;慢性萎缩性胃炎2项研究,病例159例;肝纤维化与肝硬化14项研究,病例1018例。Meta分析结果表明,一贯煎对干燥综合征的泪液分泌[SMD=1.08,95%CI(0.30,1.85),P=0.0158]及其他血清学指标有改善作用;能降低慢性萎缩性胃炎的内镜评分[MD=-1.66,95%CI(-2.22,-1.10),P<0.0001];降低肝纤维化血清学指标Ⅲ型前胶原[MD=-40.34,95%CI(-71.40,-9.29),P=0.0191]与层黏连蛋白[MD=-53.12,95%CI(-87.14,-19.09),P=0.0088]水平以及肝硬度[MD=-2.61,95%CI(-2.80,-2.41),P=0.0003]。结论:一贯煎临床用于干燥综合征、慢性萎缩性胃炎与肝纤维化具有较好的临床效果。当前研究对于其安全性评价尚不充分,仍然需要进一步的验证。
基金This study was supported by grants for National Key Clinical Disciplines to the Shanghai Mental Health Center(Office of Medical Affairs,Ministry of Health,2011–873,OMA-MH,2011–873)the Shanghai Clinical Center for Mental Disorders(2014),Shanghai Science&Technology Committee(No.15411961400).
文摘Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.
基金Supported by the National Natural Science Foundation of China(No.30873338)the Major New Drug Projects of the Ministry of Science and Technology of P.R China(No 2009ZX09103-391)
文摘Objective： To observe the effect of Huannao Yicong Prescription （还脑益聪方, HNYC, a Chinese medical compound） extract on β-amyloid precursor protein （APP） metabolic signal transductionrelated protein kinase C （PKC）, tyrosine amyloid protein kinase （TrKA）, and glycogen synthase kinase-3 （GSK-3） in brain tissue of transgenic mouse dementia model induced by APP. Methods： Sixty dementia model transgenic 3-month-old mice induced by APP695V7171 were randomly allocated in four groups： the model group （A）, the Donepezil （0.65×10^-3 g.kg-1.d-1）-treated group （B）, and the two HNYC-treated groups （C and D） with high dosage （2.8 g.kg^-1.d^-1） and low dosage （1.4 g.kg^-1.d^-1） of HNYC extract, respectively, 15 mice in each group. Besides, a normal control group was set up with 15 C57BL/6J mice with the same age and genetic background as the model mice. The drugs for treatment were administered once a day by dissolving in equal-volume distilled water through gastric infusion, continued for 6 months, to mice in group A and to normal control group equal-volume distilled water was administered instead. Spatial learning and memory capacity of mice were observed by Morris water maze; their one-time escape response memory capacity was tested by diving platform; and changes of PKC, TrkA, and GSK-3 levels in hippocampus and cortex of brain were detected by Western blotting. Results： HNYC extract showed significant effects on increasing the time of model mice for swimming through the flat roof and the swimming time and path in the fourth quadrant （P〈0.05 or P〈0.01）. Diving platform test showed that the latent times in Groups B and C were longer than that in Group A significantly （P〈0.05 and P〈0.01）. Compared with the normal control group, PKC and TrkA protein expression levels in hippocampus and cortex of model mice＇s brain lowered significantly （P〈0.01）, while GSK-3 protein expression increased significantly （P〈0.01）; compared with Group A （the model group）, hippocampal and cortical levels of PKC protein expression in the intervened groups （B-D） as well as those of TrkA in Group C were higher （P〈0.01 or P〈0.05）, while hippocampal levels of GSK-3 in intervened groups were lower （P〈0.01）. Conclusion： HNYC extract could obviously increase the protein expressions of PKC and TrkA and decrease the expression of GSK-3 protein in brain tissue of transgenetic mice model of dementia, and regulate APP metabolic signal transduction path, and thus to suppress the production of A β, which is one of the dominant mechanisms for improving learning/memory capacity of dementia model animals.
