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2014年, 第12卷, 第1期 刊出日期:2014-01-10
综述
The role of central nervous system on hypoglycemia and the feasibility of the brain theory in traditional Chinese medicine on treatment of diabetes mellitus
​Hai-li Jiang, Jing-jing Ni, Wei-fei Zhang, Wen-jin Huang​, Ming-yue Zhou​, Wen-jun Sha​, Jun-yan Li​, Fu-feng Li​, Zhu Ting​​, Xin Xia, Jun Zhang​, Yuan-dong Shen​, Li-gang Zhou​
Journal of Integrative Medicine. 2014 (1):  1-6.  DOI: 10.1016/S2095-4964(14)60008-X
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The central nervous system (CNS) plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine (TCM) has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.
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临床论著
Medicine prescription practices of homeopathic undergraduate students in West Bengal, India
Journal of Integrative Medicine. 2014 (1):  7-12.  DOI: 10.1016/S2095-4964(14)60004-2
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Objective

To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students. 

Methods

A cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences. 

Results

A total of 328 forms were completed. Of these, 264 (80.5%) homeopathic undergraduate students admitted of prescribing medicines independently and most (40.5%) said that they did this 2-3 times a year. The most common reasons for this were ‘urgency of the problem’ (35.2%), ‘previous experience with same kind of illness’ (31.8%), and ‘the problem too trivial to go to a doctor’ (25.8%). About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital (odds ratio = 5.8; 95% confidence interval 2.247-14.972). Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses. 

Conclusion

Prescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.


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Developing the criteria for evaluating quality of individualization in homeopathic clinical trialreporting: A preliminary study
Subhranil Saha​, Munmun Koley​, Subhasish Ganguly​, Prasanta Rath​, Pulak Roy Chowdhury, Seikh Intaj Hossain
Journal of Integrative Medicine. 2014 (1):  13-19.  DOI: 10.1016/S2095-4964(14)60009-1
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Objective

This study describes the development of a preliminary version of an instrument that attempts to assess the quality of reports of individualized homeopathic prescriptions in clinical trials and observational studies. 

Methods

A multidisciplinary panel of 15 judges produced an initial version of the instrument through iterative Delphi rounds and pilot-tested the instrument on five clinical trials. Later they assessed, under blind conditions, the individualization quality of 40 randomly-selected research reports. The final version of the instrument included six criteria. These items were scored consistently by all the raters regardless of background. 

Results

The instrument appeared to have adequate face and content validity, acceptable internal consistency or reliability (Cronbach’s α 0.606-0.725), significant discriminant validity (F = 398.7; P < 0.000 1), moderate interrater reliability (Fleiss κ 0.533), agreeable test-retest reliability (Cohen’s κ 0.765-0.934), moderate sensitivity (0.4; 95% confidence interval 0.253-0.566), and high specificity (1.0; 95% confidence interval 0.891-1.000). 

Conclusion

The initial data suggest that this instrument may be a promising systematic tool amendable for further development.

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实验论著
Pristimerin enhances recombinant adeno-associated virus vector-mediated transgene expression in human cell lines in vitro and murine hepatocytes in vivo
Journal of Integrative Medicine. 2014 (1):  20-34.  DOI: 10.1016/S2095-4964(14)60003-0
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Objective

In the present study, we systemically evaluated the ability of two bioactive compounds from traditional Chinese medicine, celastrol and pristimerin, to enhance recombinant adeno-associated virus (rAAV) serotype vector-mediated transgene expression both in human cell lines in vitro, and in murine hepatocytes in vivo
Methods

Human cell lines were infected with rAAV vectors with either mock treatment or treatment with celastrol or pristimerin. The transgene expression, percentage of nuclear translocated viral genomes and the ubiquitination of intracellular proteins were investigated post-treatment. In addition, nonobese diabetic/severe combined immunodeficient gamma (NSG) mice were tail vain-injected with rAAV vectors and co-administered with either dimethyl sulfoxide, celastrol, pristimerin or a positive control, bortezomib. The transgene expression in liver was detected and compared over time. 

Results

We observed that treatment with pristimerin, at as low as 1 μmol/L concentration, significantly enhanced rAAV2 vector-mediated transgene expression in vitro, and intraperitoneal co-administration with pristimerin at 4 mg/(kg·d) for 3 d dramatically facilitated viral transduction in murine hepatocytes in vivo. The transduction efficiency of the tyrosine-mutant rAAV2 vectors as well as that of rAAV8 vectors carrying oversized transgene cassette was also augmented significantly by pristimerin. The underlying molecular mechanisms by which pristimerin mediated the observed increase in the transduction efficiency of rAAV vectors include both inhibition of proteasomal degradation of the intracellular proteins and enhanced nuclear translocation of the vector genomes. 

Conclusion

These studies suggest the potential beneficial use of pristimerin and pristimerin-containing herb extract in future liver-targeted gene therapy with rAAV vectors.
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Protective effect of diosmin against diabetic neuropathy in experimental rats
Dilpesh Jain​, Manish Kumar Bansal, Rahul Dalvi​, Aman Upganlawar​, Rahul Somani​
Journal of Integrative Medicine. 2014 (1):  35-41.  DOI: 10.1016/S2095-4964(14)60001-7
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Objective

The present study was undertaken to evaluate the effect of diosmin in diabetic neuropathy in type 2 diabetic rats. 

Methods

Type 2 diabetes was induced in male Sprague-Dawley rats by single intraperitoneal injection of streptozotocin (35 mg/kg) and high-fat diet. Four weeks after the confirmation of diabetes, diabetic rats were treated with diosmin (50 and 100 mg/kg, p.o.) for next 4 weeks. Rats were evaluated for biochemical, behavioral and oxidative stress parameters. Eddy’s hot plate and tail immersion test were performed on 6th, 7th, 8th, 9th and 10th weeks of experiment to assess thermal hyperalgesia and cold allodynia respectively. Further, the walking function test was performed for assessing the motor responses at the end of the treatment schedule. 

Results

Rats were fed with high-fat diet throughout the experiment schedule and administration of low-dose streptozotocin induced significant elevation in blood glucose level and insulin resistance which was confirmed by oral glucose tolerance test. Treatment with diosmin at doses of 50 and 100 mg/kg significantly restored the reduced body weight, elevated blood sugar and lipid profiles. Further the dose-dependent improvement was observed in thermal hyperalgesia, cold allodynia and walking function in diabetic rats treated with diosmin. Elevated levels of malondialdehyde, and nitric oxide and decreased glutathione levels and superoxide dismutase activity in diabetic rats were restored significantly after the 4 weeks of diosmin treatment. 

Conclusion

Diosmin has shown beneficial effect in preventing the progression of early diabetic neuropathy in rats.

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Gastric antisecretory and cytoprotective effects of hydroalcoholic extracts of Plumeria alba Linn. leaves in rats
Manjusha Choudhary​, Vipin Kumar​, Surender Singh​
Journal of Integrative Medicine. 2014 (1):  42-51.  DOI: 10.1016/S2095-4964(14)60002-9
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临床论著
In-house preparation and characterization of an Ayurvedic bhasma: Praval bhasma
Amrita Mishra, Arun K. Mishra, Om Prakash Tiwari, Shivesh Jha
Journal of Integrative Medicine. 2014 (1):  52-58.  DOI: 10.1016/S2095-4964(14)60005-4
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Objective

To prepare the Praval bhasma (PB) and to perform its characterization. 

Methods

The preparation was performed strictly as per method prescribed in Ayurvedic formulary of India followed by preliminary tests including Nischandratva, Rekhapurnatvam, Varitaramtavm, Nisvadutvam and Amla pariksha. The physicochemical characterization was done with the use of instrumental techniques such as Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), X ray diffraction (XRD), and energy dispersive X-ray (EDAX). 

Results

The FTIR bands appearing in final product spectra showed a significant shift in infrared vibration frequency as well as intensity when compared with the raw material, which was indicative of formulation of bhasma. The XRD analysis revealed that raw material contained CaCO3 whereas in case of final product of bhasma, CaO was identified. SEM analysis revealed the difference in particles size of bhasma (10-15 μm) and raw material (100-150 μm). The EDAX analysis showed presence of different concentration of carbon in both the samples. 

Conclusion

It may be concluded that modern analytical techniques may be involved to evaluate the quality aspects of PB. The findings of the present research work may be helpful for further formulation and standardization of PB in routine analysis.

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实验论著
Anti-fatty liver effects of oils from Zingiber officinale and Curcuma longa on ethanol-induced fatty liver in rats
Sarah Onyenibe Nwozo, Damilola Adeola Osunmadewa, Babatunji Emmanuel Oyinloye
Journal of Integrative Medicine. 2014 (1):  59-65.  DOI: 10.1016/S2095-4964(14)60006-6
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Objective

The present study is aimed at evaluating the protective effects of oils from Zingiber officinale (ginger) and Curcuma longa(turmeric) on acute ethanol-induced fatty liver in male Wistar rats. 

Methods

Ferric reducing antioxidant power activity and oxygen radical absorbance capacity of the oils were evaluated ex vivo. Rats were pretreated for 28 d with standard drug (Livolin Forte) and oils from Z. officinale and C. longa before they were exposed to 45% ethanol (4.8 g/kg) to induce acute fatty liver. Histological changes were observed and the degree of protection was measured by using biochemical parameters such as alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase activities. Serum triglyceride (TG) level, total cholesterol (TC) level and the effects of both oils on reduced gluthatione (GSH), glutathione-S-transferase (GST), superoxide dismutase (SOD) and hepatic malondialdehyde (MDA) levels were estimated. 

Results

Oils from Z. officinale and C. longa at a dose of 200 mg/kg showed hepatoprotection by decreasing the activities of serum enzymes, serum TG, serum TC and hepatic MDA, while they significantly restored the level of GSH as well as GST and SOD activities. Histological examination of rats tissues was related to the obtained results. 

Conclusion

From the results it may be concluded that oils from Z. officinale and C. longa (200 mg/kg) exhibited hepatoprotective activity in acute ethanol-induced fatty liver and Z. officinale oil was identified to have better effects than C. longa oil.

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读者来信
Nigella sativa is a safe herbal product
Abdullah Bamosa
Journal of Integrative Medicine. 2014 (1):  66-66.  DOI: 10.1016/S2095-4964(14)60007-8
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