To investigate icariin’s regulation of marrow fatty acid metabolism and stearoyl-CoA desaturase (SCD) indices in preventing ovariectomy-induced osteoporosis. Thirty-six female Sprague-Dawley rats underwent sham surgery or ovariectomy and were treated with either icariin (125 mg/kg/day) or vehicle via oral gavage for 12 weeks, 6 days per week. Bone marrow was collected from tibias for fatty acid profiling via gas chromatography–mass spectrometry. Serum levels of bone-specific alkaline phosphatase (BALP) and tartrate-resistant acid phosphatase 5b (TRACP-5b) were measured using Enzyme-Linked Immunosorbent Assay. Tibial trabecular microstructure was assessed by micro-CT. Ovariectomy significantly altered marrow fatty acid composition, marked by increased palmitic acid (C16:00) and palmitoleic acid (C16:1 n-7), decreased stearic acid (C18:00) and arachidonic acid (C20:4 n-6), and elevated SCD indices. These changes were associated with deteriorated bone microarchitecture and impaired bone turnover. Icariin treatment effectively normalized marrow fatty acid levels, suppressed SCD indices, and consequently attenuated bone loss by improving bone volume fraction, trabecular number, and thickness, while reducing trabecular separation. Additionally, icariin restored the balance of bone turnover markers, increasing BALP and decreasing TRACP-5b. Significant correlations were identified between specific fatty acids and both bone structural parameters and remodeling markers. Icariin attenuates osteoporotic bone loss by preventing ovariectomy-induced disturbances in marrow fatty acid metabolism, particularly through the suppression of SCD indices and normalization of C16:00, C16:1 n-7, and C18:00 levels. This study highlights the critical role of lipid homeostasis in bone integrity and identifies icariin as a promising lipid-modulating candidate for postmenopausal osteoporosis.

Stellera chamaejasme L., a traditional Chinese medicinal herb used for treating skin disorders such as psoriasis, was investigated to identify its bioactive antipsoriatic components and elucidate its underlying mechanisms of action. In an imiquimod (IMQ)-induced psoriasis-like skin lesion mouse model, the ethyl acetate (Et) fraction exhibited the most significant therapeutic effect among various solvent-partitioned extracts, as demonstrated by hematoxylin-eosin (H&E), immunohistochemistry (IHC), and immunofluorescence (IF) analyses. The bioassay-guided fractionation of the Et extract led to the isolation of eleven compounds (1-11), whose structures were characterized using nuclear magnetic resonance (NMR) spectroscopy and X-ray crystallography. Among them, wikstroelide J (WJ, compound 11) exhibited the most potent activity, inhibiting M5-induced hyperproliferation of HaCaT keratinocytes (IC₅₀ = 9.4 μM) and alleviating psoriasis-like skin lesions in vivo. Mechanistically, WJ modulated T-cell subsets and downregulated the JAK2/PI3K/AKT signaling pathway, with pathway involvement further supported by the use of the JAK2 inhibitor AG490. These findings highlight WJ as a promising antipsoriatic agent that targets the JAK2/PI3K/AKT pathway. Future studies will aim to improve its pharmacological properties and assess its efficacy in clinical settings, although current limitations, such as a lack of pharmacokinetic and clinical data, remain to be addressed.

BACKGROUND:Skin disorders are a collection of prevalent and frequent illnesses that have significant impacts on daily life. Currently, a limited number of effective therapeutic drugs are available that fall far short of the clinical needs; most medications usually offer chronic alleviation instead of treatment. Diterpenoids are the main components of many plant essential oils, such as lemon oil, turpentine, peppermint oil and camphor oil. Most of these compounds are water insoluble, volatile, aromatic, and oily substances. PURPOSE:This paper systematically introduces major skin illnesses in regular life, lists related diterpenoids and their clinical applications, and summarizes the current status of clinical research on related diterpenoids and their structural formulas. This review may increase the research focus on dermatological illnesses by providing helpful knowledge for individuals involved in drug research on this subject. METHODS:A thorough review of the literature was conducted using the search parameters "diterpenoid," "skin diseases," "structure" and "pharmacological activity" to retrieve articles from the PubMed, Web of Science, ACS, Elsevier Science and Scopus databases.

Patients with inflammatory bowel disease (IBD) frequently experience osteoporosis (OP) due to factors such as chronic inflammation, malnutrition, and corticosteroid use. However, there is currently a lack of effective pharmacological interventions for the prevention and treatment of IBD-associated OP. Xanthohumol (XAN), a natural flavonoid compound isolated from hops, has shown beneficial effects on both inflammation and osteoporosis. This study aimed to explore the therapeutic effects and potential mechanisms of XAN from hops on IBD-associated OP based on gut microbiota. The IBD-associated OP model was constructed by free drinking of dextran sulfate sodium (DSS). Therapeutic effects of XAN were investigated through disease activity index (DAI) scoring, colon pathology, mucosal barrier function, inflammatory factors, bone metabolism indicators, and femoral Micro-CT. Mechanisms of XAN regulating gut microbiota were preliminarily elucidated by 16S rDNA sequencing and non-targeted metabolomics. XAN could effectively alleviate colonic tissue inflammation and protect the intestinal mucosal barrier, further improve colonic pathological damage, and reduce the DAI scoring in DSS mice. It also exerted anti-IBD-associated OP effects by reducing serum inflammatory factors IL-6, IL-17A, and TNF-α, inhibiting serum CTX-I expression, promoting serum OPG expression, regulating calcium-phosphorus balance, and improving bone density and morphology. More importantly, 16S rDNA sequencing and untargeted metabolomics showed that XAN increased the abundance and diversity of the gut microbiota in DSS mice. By altering the abundance of specific bacterial taxa such as Turicibacter, norank_f__norank_o__Clostridia_UCG-014, norank_f__Muribaculaceae, and Faecalibaculum, XAN changed the metabolites of gut microbiota, thereby regulating the tryptophan (Trp) metabolism pathway, as well as improving the intestinal mucosal barrier and bone metabolism. XAN can improve the pathological injury of the colon and bone loss caused by IBD. The mechanism is to regulate Trp metabolism by intervening in gut microbiota, thereby protecting intestinal mucosal barrier function and promoting bone formation.

BACKGROUND AND PURPOSE:Psoriasis is a multisystem inflammatory disease with a significant impact on quality of life. Stellera chamaejasme, a medicinal plant used in traditional Chinese medicine, shows promise for the treatment of psoriasis. We identified diterpenoids in S. chamaejasme, including a new compound, stellchamain A (SA, 1), with notable antipsoriasis properties. This study explored the effects of SA on psoriasis to determine the mechanisms underlying the therapeutic efficacy of S. chamaejasme. EXPERIMENTAL APPROACH:Compounds isolated by column chromatography were structurally identified using NMR spectroscopy. The effects of SA on IL-17A-treated HaCaT cell viability and apoptosis were assessed using CCK-8 and TUNEL assays. In vivo anti-psoriasis activity of SA was evaluated in a mouse model of imiquimod (IMQ)-induced psoriasis. Network pharmacology, surface plasmon resonance (SPR), drug affinity responsive target stability (DARTS), and cellular thermal shift assays (CETSA) were elucidated the interactions between SA and the targets. KEY RESULTS:SA was isolated from S. chamaejasme along with nine known analogues (2-10). In vivo, SA reduced IMQ-induced epidermal thickness, hyperkeratosis, and perivascular inflammatory cell infiltration. Network pharmacology indicated that SA may function via the interleukin IL-17A/STAT1/S100A9 pathway. The results of SPR assays and molecular docking showed that SA binds to STAT1 with a KD value of 9.24 nM. DARTS and CETSA analyses confirmed a direct and relevant interaction between SA and STAT1. CONCLUSION AND IMPLICATIONS:SA modulates the immunological microenvironment to treat psoriasis by targeting the IL-17A/STAT1/S100A9 axis, representing a potential new treatment for psoriasis and other IL-17A-mediated skin disorders.

To investigate the protective effects and underlying mechanisms of Qin-Zhu-Liang-Xue decoction (QZLX) in atopic dermatitis (AD) and glucocorticoid resistance, we conducted a single-blinded, randomized controlled clinical trial to evaluate the efficacy and safety of this concoction. Network pharmacology analysis was performed and validated through clinical studies. The efficacy, safety, and mechanism of action of QZLX and glucocorticoid receptor (GR) α recombinant protein were assessed in AD mice induced by 2,4-dinitrofluorobenzene (DNFB). Correlation analysis was performed to determine the clinical relevance of GRα. The trial demonstrated that patients who received QZLX showed considerable improvements in their Scoring Atopic Dermatitis (SCORAD) and Dermatology Life Quality Index (DLQI) scores compared with those who received mizolastine at week 4. Network pharmacological analysis identified GRα as a key target for QZLX in AD treatment. QZLX administration increased the serum GRα expression in AD patients, alleviated AD symptoms in mice, decreased inflammatory cytokine expression, and increased GRα expression without affecting liver or kidney function. In addition, GRα recombinant protein improved AD-like skin lesions in DNFB-induced mice. A negative correlation was observed between GRα expression and clinical parameters, including SCORAD, DLQI, and serum IgE levels. QZLX alleviates AD symptoms through the upregulation of GRα and thus presents a novel therapeutic strategy for the prevention of glucocorticoid resistance in AD management.

Daphne genkwa, as a traditional medicine, is widely distributed in China, Korea and Vietnam. In China, the dried flower buds of this plant are named "Yuanhua". It has the ability to effectively promote urination, eliminate phlegm and alleviate cough, eliminate parasites and cure of scabies, with a broad spectrum of pharmacological effects and considerable clinical efficacy. This paper provides a summary and classification of the main chemical constituents of D. genkwa based on a review of relevant domestic and foreign literature. It also outlines the current research status of traditional clinical usage, pharmacological effects, and toxicity of D. genkwa. The aim is to provide a theoretical basis for further study of D. genkwa and its potential new clinical applications.

目的 建立LC-MS/MS测定大鼠血浆样品中夏枯草消瘤合剂有效成分浓度的方法,并进行药动学研究.方法 采用C18 色谱柱正离子模式下流动相为甲醇-水(0.1%甲酸)体系,梯度洗脱,流速为 0.3 ml/min.负离子模式下流动相为乙腈-水(0.1%甲酸)体系,梯度洗脱,流速为 0.4 ml/min.分别对正离子模式下咖啡酸、迷迭香酸、丁香酸、芦丁及负离子模式下白术内酯Ⅱ、白术内酯Ⅲ进行测定.正常大鼠灌胃给予夏枯草消瘤合剂 7.8 ml/kg,给药后在不同的时间点眼眶取血,采用经过验证的LC-MS/MS法测定血药浓度并采用 DAS2.0 软件的非房室模型计算大鼠给药后的药动学参数.结果 夏枯草消瘤合剂药效成分咖啡酸等的药动学参数属于非房室模型,夏枯草消瘤合剂大鼠给药后体内咖啡酸、迷迭香酸、丁香酸及白术内酯Ⅲ等4种主要抗癌活性成分与文献报道单体给药后药动学特征相比,均存在明显差异.结论 本研究建立的UPLC-MS/MS法快速、灵敏、准确,适用于测定大鼠血浆中夏枯草消瘤合剂主要活性成分,为其主要抗癌活性物质研究提供科学依据.

肠道菌群是定植在人体内复杂而庞大的微生物群落,肠道菌群及其代谢物短链脂肪酸在参与人体代谢、抵御外来致病菌以及调节免疫机制等方面发挥重要作用.近年来,不少研究发现肠道菌群与骨骼代谢密切相关.肠道菌群可通过营养吸收、短链脂肪酸生成、调节机体免疫、影响机体代谢等多种途径调控骨代谢,影响骨量变化.本文综述了肠道菌群影响骨代谢中骨量变化的潜在途径及作用机制,以及中药干预肠道菌群调控骨代谢的相关进展,以期为骨代谢相关疾病骨质疏松症的防治提供新思路.

BACKGROUND:Diabetic ulcer is a common complication of diabetes. It is characterized by a long-term disease course and high recurrence rate. Shengji Huayu Formula (SHF) is an effective formula for treating diabetic ulcers. However, the specific effective parts of SHF remain unclear. Clarifying the active polar site of SHF would be helpful to refine research on the components in SHF that promote wound healing. This research aims to focus on evaluating the activity of polar fractions.METHODS:A diabetic rat model was established by intraperitoneally injecting streptozotocin (STZ) and was adopted to confirm the therapeutic effect of SHF. Four different polarity parts were extracted from SHF and prepared into a cream to evaluate the activity. High-performance liquid chromatography (HPLC) was used to detect chemical constituents in chloroform extracts.RESULTS:It was discovered that dracorhodin, aloe-emodin, rhein, imperatorin, emodin, isoimperatorin, chrysophanol, physcion, and tanshinone IIA were the main components of the chloroform extract from SHF. The results revealed that chloroform extract could effectively accelerate diabetic wound healing by promoting collagen regeneration and epidermal repair. Chloroform extract of SHF could stimulate the generation of vascular endothelial growth factor (VEGF). The results are also indicated that the effective active fraction was the chloroform part, and the method of detecting the main chemical constituents in the active part was successfully established.CONCLUSION:SHF could improve diabetic ulcers by promoting granulation tissue synthesis. In this study, four polar parts (petroleum ether, chloroform, ethylacetate, n-butanol) were extracted from a 95% ethanol extract. In contrast, chloroform polar parts showed a higher wound closure rate, stimulated more collagen regeneration and promoted more production of vascular endothelial cells. In conclusion, the chloroform extract of SHF was the effective polar part in ameliorating diabetic wound healing.

海派膏方作为上海的"明星产品",无论是在治疗疾病方面,还是滋补养生方面都发挥了无可取代的作用.通过查阅相关文献,结合实际应用经验,介绍了海派文化、海派中医和海派膏方的概念.在此基础上,总结梳理了海派膏方的发展历史,以期更全面地了解海派膏方,为海派膏方的传承与创新提供历史和经验依据.

目的 观察中药膏方联合八段锦治疗经皮椎体成形术(PVP)术后骨质疏松性椎体压缩骨折(OVCF)患者的疗效.方法 前瞻性选取 120例 2016年 1月至 2017年 9月于我院行PVP治疗的OVCF患者为研究对象,按随机数字表法将其分为观察组(60例),对照组(60例).对照组予以碳酸钙D3 咀嚼片口服,同时进行常规指导;观察组在对照组疗法的基础上予以中药膏方口服,同时进行八段锦锻炼.两组均治疗 6个月,并随访 3年.观察两组治疗 6个月后的疗效及治疗 1、3、6个月的腰背疼痛情况,比较两组治疗前、治疗 6个月后的骨密度(BMD)、椎体后凸角度(Cobb角)、椎体前壁高度(AVBH)变化情况及骨代谢指标水平,记录两组随访时间及随访期间PVP术后推体再骨折发生率.结果 治疗 6个月后,观察组临床治愈率为 73.33%,高于对照组的 53.33%(P<0.05).与治疗前比较,治疗 3、6个月后两组视觉模拟评分法(VAS)评分逐渐降低,且观察组低于对照组(P<0.05).与治疗前比较,治疗 6个月后两组腰椎、股骨颈BMD及AVBH均升高,且观察组高于对照组(P<0.05);两组Cobb角及血清I型原胶原降解产物(β-Cross I)、N端中段骨钙素(N-MID Ost)、甲状旁腺素(PTH)水平均降低,且观察组低于对照组(P<0.05).两组随访时间、随访 1年内、1～3年内PVP术后推体再骨折发生率比较,均无统计学意义(P>0.05);随访 3年内,观察组 PVP术后推体再骨折发生率为 3.33%,低于对照组的 20.00%(P<0.05).结论 中药膏方联合八段锦治疗PVP术后OVCF可降低其血清β-Cross I、N-MID Ost、PTH水平,调节机体骨代谢,有助于提高腰椎、股骨颈BMD及AVBH,降低Cobb角,促进腰部功能的恢复,进而缓解患者腰背疼痛,显著降低PVP术后推体再骨折发生率.

Gaofang (medicated paste), also known as gaoji in Chinese, is one of the eight dosage forms of traditional Chinese medicine. Originated in the Han and Tang dynasties, it is widely used in Shanghai, Jiangsu, Zhejiang, and Guangdong of China at present. It is generally believed that Gaofang can help reinforce deficiency, delay aging, and regulate the overall health status. Currently, Gaofang has been extensively used in the treatment of cardiovascular disease. Based on the relevant literature and clinical experience, this article reviews the general situation and the clinical application of Gaofang as well as the common Chinese medicines in Gaofang for cardiovascular diseases.

中成药是我国医疗卫生体系中药品的一大特色和优势,其剂型多样,品种繁多,临床应用十分广泛.据相关统计,我国获批国产中药批文共59 474个,共涉及中成药品种9 629个,剂型42种.综合性医院中,西医所开出的中成药占医疗机构全部售出中成药的84％[1-2].随着中成药临床使用范围的扩大,安全性问题也日趋严峻,除中成药的质量状况外[3],临床合理应用方面更为明显,如用药过量,重复用药、联合用药不当,超用药禁忌、功效及毒副作用考虑不周等[4-5].近年来发生的"鱼腥草注射液事件""双黄连注射液事件""茵栀黄注射液事件"等中成药安全性事件,对中成药的临床应用产生了巨大的不良影响,其中重要的原因就是中成药临床使用缺乏科学的、符合中成药特点的、实用性强的规范性文件.国家发布了《中成药临床应用指导原则》(2010版),但从实施效果来看,中成药临床合理使用仍需进一步规范,亟需制定具有实用性、针对性、科学性的中成药临床使用规范.

目的:探讨酒石酸美托洛尔与厄贝沙坦联合应用在老年高血压患者中的疗效及对生活质量指标的影响.方法:选择笔者所在医院2019年5月-2020年4月确诊并治疗的122例老年高血压患者作为研究对象,按照随机数字表法标记,将患者分为对照组与观察组,每组61例.对照组患者采用酒石酸美托洛尔片口服治疗,观察组患者在对照组口服药物基础上加用厄贝沙坦片口服治疗,14 d为1个周期,连续治疗4个周期.观察两组患者治疗后的临床总有效率,统计分析治疗后生活质量相关指标(认知功能、情感、角色功能、躯体功能、社会功能)变化,治疗前后两组患者血压(收缩压、舒张压)变化.结果:观察组患者的临床总有效率为91.80％(56/61),对照组临床总有效率为77.05％(47/61),两组比较差异有统计学意义(P<0.05);治疗前两组患者的血压水平比较差异无统计学意义(P>0.05),治疗后两组舒张压及收缩压均降低,观察组降低程度更加明显,与对照组比较差异有统计学意义(P<0.05);治疗后观察组生活质量各项指标评分均高于对照组,差异有统计学意义(P<0.05).结论:酒石酸美托洛尔片与厄贝沙坦片联合用于治疗老年高血压患者中,临床疗效确切,可提高生活质量水平,降低血压水平,是临床上可以采用的治疗老年高血压疾病的口服药物.

本文从教学方法 和教学效果深度剖析以往中药房实训教学中存在的利与弊,采用新的教学模式 — — 理论实践一体化教学模式开展教学.该模式强调在整个教学环节中理论和实践交替进行,突出学生的动手能力和专业技能的培养,充分调动学生的学习积极性.学生通过学习中药饮片的辨识、不同炮制品的应用和处方的规范性及常见药材的真伪鉴别等,取得了良好的实训教学效果.

中药膏方是以中医药理论为基础的传统中药剂型,临床应用广泛.在促进健康和养生保健等方面,中药膏方正在发挥着越来越积极的作用.通过查阅近几年中药膏方相关文献,结合工作实践中的经验,从膏方的渊源、制备的工艺要点及3个质量控制参考指标进行综述研究,以期为中药膏方将传统与创新相结合,形成一套规范化、科学化和合理化的制备工艺和质量标准体系提供参考,适应现代化发展的需要.

随着中医临床药师规范化培养的推进,急需寻找一种适合其特色的教学模式.本文总结传统教学法(Lecture-based Learning,LBL)与案例为基础的教学(Case based learning,CBL)在上海中医药大学附属岳阳中西医结合医院中医临床药师培训基地的带教经验,结果显示LBL与CBL相结合的教学方法能将中医理论学习和临床实践进一步有机结合,能更好地启发学习者的积极性和兴趣,较好地培养其发现问题、解决问题的临床思维和决策能力,适合一线中药师转型期的培养教学.

目的:探讨用厄贝沙坦联合恩格列净治疗糖尿病肾病(DKD)的效果及安全性.方法:将上海长征医院收治的80例DKD患者纳入本研究.采用信封法将其分为试验组和对照组.对两组患者均进行常规治疗,在此基础上用厄贝沙坦对对照组患者进行治疗,用厄贝沙坦联合恩格列净对试验组患者进行治疗,然后比较两组患者的疗效及各项临床指标.结果:试验组患者治疗的总有效率高于对照组患者,P<0.05.治疗后,试验组患者血清内皮素(ET)、尿酸(UA)、尿素氮(BUN)、肌酐(Cr)的水平均低于对照组患者,血清白蛋白(ALB)的水平和肾小球滤过率(eGFR)均高于对照组患者,P<0.05.用药后,两组患者不良反应的发生率相比,P>0.05.结论:在对DKD患者进行常规治疗的基础上,用厄贝沙坦联合恩格列净对其进行治疗能显著改善其肾功能,提高其疗效,且用药的安全性较高.

目的:探讨使用辣椒碱软膏联合保湿霜治疗神经性皮炎的效果.方法:选取2018年1月至2020年1月期间上海中医药大学附属岳阳中西医结合医院收治的100例神经性皮炎患者作为研究对象.随机将这些患者分为对照组(n=50)和观察组(n=50).为对照组患者使用辣椒碱软膏进行治疗,为观察组患者使用辣椒碱软膏联合保湿霜进行治疗.然后观察两组患者皮损组织中P物质的水平、临床症状积分、临床体征积分、治疗的效果、病情复发的情况、皮损的面积及临床症状改善的时间.结果:治疗后,观察组患者病情的复发率、皮损组织中P物质的水平、临床症状积分及临床体征积分均低于对照组患者,其治疗的总有效率高于对照组患者,其治疗1周后及治疗2周后的皮损面积均小于对照组患者,其临床症状改善的时间短于对照组患者,P<0.05.结论:使用辣椒碱软膏联合保湿霜治疗神经性皮炎的效果显著,可快速减轻患者的临床症状及体征,减小其皮损的面积,且用药后其病情的复发率较低.