Clinical analysis of 31 cases of fetal umbilical artery thrombosis / 中华妇产科杂志

Objective: To analyze the ultrasonic manifestations, clinical features, high risk factors and key points of pregnancy management in prenatal diagnosis of umbilical artery thrombosis (UAT). Methods: The data of 31 pregnant women of UAT diagnosed by prenatal ultrasonography and confirmed after birth from July 2017 to July 2022 at the Women's Hospital, Zhejiang University School of Medicine were retrospectively analyzed, including the maternal characteristics, pregnancy outcomes and fetal complications. In addition, the baseline data and pregnancy outcomes were compared in 21 patients who continued pregnancy after diagnosis of UAT. Of the 21 UAT cases that continued pregnancy, 10 cases were treated with low molecular weight heparin (LMWH; LMWH treatment group), while the other 11 patients had expectant treatment(expectant treatment group). Results: The age of the 31 pregnant women was (30.2±4.7) years, of which 5 cases (16%,5/31) were advanced age pregnant women. The gestational age at diagnosis was (32.9±4.0) weeks, and the gestational age at termination of pregnancy was (35.6±2.9) weeks. In 31 fetuses with UAT, 15 cases (48%) had fetal distress, 11 cases (35%) had fetal growth restriction, and 3 cases (10%) had intrauterine stillbirth. There were 28 cases of live births, including 26 cases by cesarean section and 2 cases by vaginal delivery. There were also 3 stillbirths, all delivered vaginally. Four neonates had mild asphyxia and two newborns had severe asphyxia. Among the 31 cases, 10 cases were terminated immediately after diagnosis, the gestational age at diagnosis was (35.9±2.9) weeks. Another 21 pregnancies continued, and their gestational age at diagnosis was (31.4±3.7) weeks. The median prolonged gestational age in LMWH treatment group was 7.9 weeks (4.6-9.4 weeks), and all were live births. The median prolonged gestational age in the expectant treatment group was 0.6 weeks (0.0-1.0 weeks), and 2 cases were stillbirths. There was a statistically significant difference in prolonged gestational age (P=0.002). Conclusions: Ultrasound is the preferred method for prenatal detection of UAT. Clinicians need to be vigilant for UAT when a newly identified single umbilical artery is detected by ultrasound in the second or third trimesters. The decision to continue or terminate the pregnancy depends on the gestational age and the condition of fetus. Attention should be paid to fetal movements as the pregnancy continues. The treatment of LMWH as soon as possible after diagnosis of UAT may improve the pregnancy outcome.

Clinical diagnosis and treatment of hereditary thrombocytopenia and purpura: a report of five cases and literature review / 中华血液学杂志

Objective: To report the clinical manifestations and laboratory features of five patients with congenital thrombotic thrombocytopenic purpura (cTTP) and explore its standardized clinical diagnosis and treatment along with a review of literature. Methods: Clinical data of patients, such as age of onset, disease manifestation, personal history, family history, and misdiagnosed disease, were collected. Treatment outcomes, therapeutic effects of plasma infusion, and organ function evaluation were observed. The relationship among the clinical manifestations, treatment outcomes, and ADAMTS13 gene mutation of patients with cTTP was analyzed. Additionally, detection of ADAMTS13 activity and analysis of ADAMTS13 gene mutation were explored. Results: The age of onset of cTTP was either in childhood or adulthood except in one case, which was at the age of 1. The primary manifestations were obvious thrombocytopenia, anemia, and different degrees of nervous system involvement. Most of the patients were initially suspected of having immune thrombocytopenia. Acute cTTP was induced by pregnancy and infection in two and one case, respectively. ADAMTS13 gene mutation was detected in all cases, and there was an inherent relationship between the mutation site, clinical manifestations, and degree of organ injury. Therapeutic or prophylactic plasma transfusion was effective for treating cTTP. Conclusions: The clinical manifestations of cTTP vary among individuals, resulting in frequent misdiagnosis that delays treatment. ADAMTS13 activity detection in plasma and ADAMTS13 gene mutation analysis are important bases to diagnose cTTP. Prophylactic plasma transfusion is vital to prevent the onset of the disease.

Automatic synthesis and myocardial imaging of 11C-meta-hydroxyephedrine / 中华核医学与分子影像杂志

Objective:To realize a fully automated synthesis of 11C-meta-hydroxyephedrine (mHED) and to perform imaging studies with it. Methods:11C-mHED was prepared by the 11CH 3-triflate method. The crude product was purified by semi-preparative high performance liquid chromatograph (HPLC) to obtain the final product. The radiochemical purity and specific activity were determined by radio-HPLC. The myocardial uptake and excretion process of the agent were monitored by microPET/CT imaging on 5 normal SD rats. The clinical imaging value was evaluated using PET/CT imaging in a patient (male, 42 years old) with myocardial infarction. Results:The automated synthesis of 11C-mHED was realized by a commercial synthesizer. The total synthesis time was about 30 min. The radiochemical yield was (15±2)% (non-decay corrected, n=10) and the radiochemical purity was greater than 98%. The specific activity was about 65 GBq/mmol. MicroPET/CT imaging in normal SD rats showed the myocardial uptake was highest at 10 min after the injection of imaging agent, and then the imaging agent was gradually excreted from the myocardium through the liver and gallbladder. PET/CT imaging of a patient with myocardial infarction showed an imaging agent defect near the apex in the inferior wall of the left ventricle, which was matched with results of ultrasound and electrocardiogram examination. Conclusions:11C-mHED can be successfully prepared automatically, with high radiochemical yield and specific activity. It can also highly concentrate in the myocardium, and the imaging effect with this agent is good in a patient with myocardial infarction.

Multiple components of Mahuang Shengma Decoction on prevention and treatment of acute lung injury based on RAGE/NF-κB signaling pathway / 中国中药杂志

To investigate the potential molecular markers and drug-compound-target mechanism of Mahuang Shengma Decoction(MHSM) in the intervention of acute lung injury(ALI) by network pharmacology and experimental verification. Databases such as TCMSP, TCMIO, and STITCH were used to predict the possible targets of MHSM components and OMIM and Gene Cards were employed to obtain ALI targets. The common differentially expressed genes(DEGs) were therefore obtained. The network diagram of DEGs of MHSM intervention in ALI was constructed by Cytoscape 3. 8. 0, followed by Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses of target genes. The ALI model was induced by abdominal injection of lipopolysaccharide(LPS) in mice. Bronchoalveolar lavage fluid(BALF) was collected for the detection of inflammatory factors. Pathological sectioning and RT-PCR experiments were performed to verify the therapeutic efficacy of MHSM on ALI. A total of 494 common targets of MHSM and ALI were obtained. Among the top 20 key active compounds of MHSM, 14 from Ephedrae Herba were found to be reacted with pivotal genes of ALI [such as tumor necrosis factor(TNF), tumor protein 53(TP53), interleukin 6(IL6), Toll-like receptor 4(TLR4), and nuclear factor-κB(NF-κB)/p65(RELA)], causing an uncontrolled inflammatory response with activated cascade amplification. Pathway analysis revealed that the mechanism of MHSM in the treatment of ALI mainly involved AGE-RAGE, cancer pathways, PI3 K-AKT signaling pathway, and NF-κB signaling pathway. The findings demonstrated that MHSM could dwindle the content of s RAGE, IL-6, and TNF-α in the BALF of ALI mice, relieve the infiltration of inflammatory cells in the lungs, inhibit alveolar wall thickening, reduce the acute inflammation-induced pulmonary congestion and hemorrhage, and counteract transcriptional activities of Ager-RAGE and NF-κB p65. MHSM could also synergically act on the target DEGs of ALI and alleviate pulmonary pathological injury and inflammatory response, which might be achieved by inhibiting the expression of the key gene Ager-RAGE in RAGE/NF-κB signaling pathway and downstream signal NF-κB p65.

Clinical observation of desmopressin in the treatment of 15 patients with DDAVP / 中华血液学杂志

Objective@#To assess the significance of DDAVP use in the diagnosis and treatment of VWD.@*Methods@#An analysis of 15 VWD cases who referred to Hematology Division of First affiliated Hospital of Soochow University and treated with DDAVP from March 2016 to August 2018 was conducted. Efficacy and treatment response of DDAVP were monitored by observations of changes in factor Ⅷ procoagulant (FⅧ∶C) and von Willebrand Factor (VWF) related indicators before and 2 h after DDAVP injection.@*Results@#Of 15 cases with VWD, 7 males and 8 females with a median age of 23 (6-46) years, 7 of 9 type I VWD patients achieved complete response (CR) , 1 type 2A VWD case CR, 5 type 3 VWD ones no response (NR) . The VWF multimer analysis in 5 patients combined with other plasma VWF values were in accordance with the known diagnosis.@*Conclusions@#DDAVP was effective in most type 1 patients, and ineffective in some type 2 and almost all type 3 cases. It was helpful for diagnosis and subsequent treatment planning.

Investigation of Decoction Process of Digda-4 Decoction / 中国实验方剂学杂志

Objective:To optimize the decoction process of Digda-4 decoction(DGD-4D), and provide reference for the standardization study of decoction of Mongolian medicine decoction. Method:Taking DGD-4D as model drug, different decoction methods of Mongolian medicine were compared, HPLC was used to determine contents of aesculetin, geniposide, picroside Ⅰ and picroside Ⅱ.On the basis of single factor tests, central composite design-response surface methodology was adopted to optimize the decoction process of DGD-4D with transfer rates of 4 components and dry extract rate as indexes, regression model fitting was carried out by Design-Expert 8.0.6 software, prediction model of process parameters was established, and the optimal process was verified. Result:The optimal decoction condition of DGD-4D was determined to be adding 40 times the amount of water and decocting for 17 min, decocting once.Transfer rates of aesculetin, geniposide, picroside Ⅰ, picroside Ⅱ and dry extract rate were 70.01%, 94.11%, 61.23%, 92.32%, 32.89%, respectively. Conclusion:The optimum decoction process of DGD-4D is established, it has important reference significance for excavating, sorting, improving the level of Mongolian medicine preparations and ensuring the consistency of their clinical efficacy.

Diagnostic value of 18F-FDG PET/CT and tumor markers (CEA, CA19-9, CA24-2) in recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value of 18F-FDG PET/CT and tumor markers (CEA,CA19-9,CA24-2) in detection for recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma.@*METHODS@#Fifty-five patients were enrolled in this study. All of the patients were tested with serum CEA within 2 weeks when they underwent 18F-FDG PET/CT scan, and some patients were tested with serum CA19-9 and CA24-2 simultaneously. According to the pathology and clinical results of their follow-up, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT and tumor markers were calculated based on different divided groups, respectively.@*RESULTS@#According to the pathology and the results of their clinical follow-up, the sensitivity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 68.09%, 28.57%, 40.00% and 74.47%, respectively. The specificity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 50.00%, 66.67%, 71.43% and 50.00%, respectively. The positive predictive valueof 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 88.89%, 85.71%, 88.89% and 89.74%, respectively. The negative predictive value of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 26.67%, 11.42%, 17.24%, 25.00%, respectively. The accuracy of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 92.73%, 65.47%, 32.65%, 44.68% and 70.91%, respectively. There were 2 cases of false positive and 2 cases of false negative in 18F-FDG PET/CT.@*CONCLUSION@#18F-FDG PET/CT has high value in detecting recurrence and metastasis of postoperative colorectal carcinoma. Tumor markers have the positive value to imply the recurrence and metastasis of postoperative colorectal carcinoma and are useful to indicate when to perform the 18F-FDG PET/CT. The combination of tumor markers could improve the diagnostic efficiency to some extent.

Fingerprinting and multi-indicator quantitative analysis of Mongolian drug Digeda-4 decoction / 中国中药杂志

To establish the high performance liquid chromatography (HPLC) fingerprint for Digeda-4 decoction (DGD-4D), determine the contents of aesculetin, geniposide, picroside Ⅰ, picroside Ⅱ and ellagicacid in DGD-4D, and provide the scientific foundation for quality control of DGD-4D. The analysis was performed on Diamonsil(2) C₁₈ (4.6 mm×250 mm,5 μm) column, with methanol-0.1% phosphoric acid aqueous solution as mobile phase for gradient elution. The flow rate was 1.0 mL·min⁻¹; injection size was 10 μL; temperature was maintained at 30 °C, and the detection wavelength was set at 254 nm. The common mode of DGD-4D HPLC fingerprint was established, and the hidden information was analyzed by Chemometrics. Chromatographic peaks for DGD-4D were identified by HPLC and quantitative analysis was conducted for characteristic peaks. There were 17 common peaks in the fingerprints and the similarity of the fingerprints was over 0.9 in all 15 batches. The samples were broadly divided into four kinds by principal component analysis and clustering analysis. Four marker compounds were verified by partial least squares discriminant analysis, and No. 9, 12 and 14 peaks were identified as geniposide, picroside Ⅱ, and picroside Ⅰ respectively. The average recoveries were in the range of 95.91%-97.31%. The HPLC fingerprint method for content determination is reliable, accurate, rapid, simple, and reproducible, and can be used as one of the effective methods to control the quality of DGD-4D.

Expression of astrocyte elevated gene-1 (AEG-1) in uveal melanoma and its relationship with clinical histopathology / 眼科新进展

Objective To investigate the relationship between the expression of astrocyte elevated gene-1 (AEG-1) and its clinical pathological features in uveal melanoma.Methods Paraffm tissue specimens of 50 patients (50 eyes) with confirmed diagnosis of uveal melanoma (UM) were collected as experimental group,and samples from 11 patients (11 eyes) who underwent ocular excision due to trauma,still with largely intact uveal tissue,were selected as control group in the Department of Ophthalmology of Beijing Tongren Hospital from January 2013 to May 2017.Then the expression of AEG-1 in paraffm-embedded specimens was detected by immunohistochemical methods,and the correlation of AEG-1 expression with the clinical pathological data was analyzed.Results AEG-1 protein staining presented accurate pink or red granules,mainly located in UM nucleus,cytoplasm,cell membrane.In the experimental group,negative expression of AEG-1 was in 21 eyes (42.0％),and positive expression was in 29 eyes (58.0％),while AEG-1 were negatively expressed in the control group,and the difference in the two groups was statistically significant (P =0.000),suggesting that the expression of AEG-1 was upregulated in UM.In the experimental group,AEG-1 positive expression rate in patients with clinical pathological risk factors was significantly higher than that in patients without high risk factors (all P ＜ 0.05),and the positive expression rate of AEG-1 in UM with involvement of the ciliary body and iris neovascularization,the maximum diameter of tumor base ＞ 16 mm,tumor thickness ＞ 8 mm,tumor cell type belonging to mixed cell type and epithelioid/mixed cell type,and extra ocular tumor growth was 73.1％,73.9％,95.2％,82.4％,83.3％,74.1％ and 69.4％,respectively.However,there was no significant difference in AEG-1 expression among general clinical data including gender,eyes,age,optic disc involvement,secondary retinal detachment,epithelioid cell type and scleral duct invasion (all P ＞ 0.05).Conclusion AEG-1 is overexpressed in UM and has a significant correlation with multiple clinical risk factors,suggesting that high expression of AEG-1 may be one of the important prognostic indicators for UM.

Effects of psychological stress and social support on quality of life of patients with ulcerative colitis / 中华消化杂志

Objective To explore effects of psychological stress and social support on quality of life of patients with ulcerative colitis (UC ) .Methods From February 2017 to February 2018 ,at the First Affiliated Hospital of Zhengzhou University ,the data of 167 patients with UC were collected ,which included education levels ,monthly per capita income of the family ,course of the disease ,Mayo score and Montreal classification .Psychological stress was evaluated by perceived stress scale (PSS) .Social support was assessed by social support rate scale (SSRS) .Quality of life was measured by the inflammatory bowel disease questionnaire (IBDQ) .Chi square test was performed for univariate correlation analysis ,Pearson or Spearman correlation analysis was performed for the correlationship ,and two classification logistic regression method was used for multivariate analysis .Results The PSS score was 23 (19 ,31) ,and the SSRS score was 33 .0 (29 .0 ,37 .0) ,and the IBDQ score was 168 .0(154 .0 ,183 .0) .The PSS score was negatively correlated with IBDQ scores (r= -0 .590 ,P<0 .01) .SSRS score were positively correlated with the IBDQ score (r=0 .329 ,P<0 .01) .The results of univariate correlation analysis indicated that the quality of life was higher in patients with high education ,high monthly per capita income of the family , high medical insurance reimbarsement rate ,clinical remission period and mild active period (χ2 =4 .338 , 12 .311 ,9 .896 and 25 .159 ,all P<0 .05) .The results of multivariate analysis demonstrated that quality of life of patients with UC was correlated with psychological stress (odds ratio (OR)= 0 .871 ,95％ confidence interval (CI) 0 .815 to 0 .932) ,type of medical insurance (OR= 2 .024 ,95％ CI 1 .168 to 3 .507) ,social support (OR=1 .065 ,95％ CI 1 .002 to 1 .132) and clinical disease activity (OR=0 .362 , 95％ CI 0 .193 to 0 .679) (all P<0 .05) .Conclusion The quality of life of patients with UC is not only correlated with clinical activity of the disease ,but also correlated with psychological stress ,social support and type of medical insurance .

Progress of external beam radiotherapy combined with 89Sr in the treatment of bone metastases / 中华核医学与分子影像杂志

Skeleton is one of the most common metastasis sites of malignant tumor.Bone metastases can cause bone pain,pathologic fractures,spinal cord compression and other bone related events,which seriously affect the quality of life of patients.The treatment modalities of bone metastases are diverse.External beam radiotherapy and 89 Sr are commonly used in the treatment of bone metastases,however,a single treatment cannot achieve satisfactory results.This review summarizes the advances of 89Sr combined with external beam radiotherapy for bone metastases.

α1-antitrypsin Pittsburg mutations: report of two cases in the same family / 中华血液学杂志

Objective@#To analyze the clinical and laboratory abnormalities of two patients with α1-antitrypsin (α1-AT) Pittsburgh in a family and review the literatures.@*Methods@#Both plasma clotting time and factor activities were performed using clotting or substrate methods. Platelet aggregation was evaluated using an optical aggregometer. The serum protein electrophoresis was performed on Sebia HYDRASYS by using Agarose gel. The exons of α1-AT were amplified by using polymerase chain reaction (PCR) and then sequenced and compared with NCBI GenBank records.@*Results@#The proband had several ruptures of corpus luteum and bleeding after operation, while her daughter had no bleeding history. Both of them showed prolonged coagulation tests which could not be corrected by mixing with the normal plasma. They also showed low levels of plasma coagulation factors, undetected protein C and S activity and abnormal bands of α1-globulin. The results of gene sequencing demonstrated that they were heterozygous for g.T17132G (p.Met358Arg) mutation of α1-antitrypsin gene (NG_008290.1) .@*Conclusions@#Comparing with the data of previously reported cases, our results confirmed the obvious abnormality of coagulation test and the discrepancy of bleeding tendency of α1-antitrypsin Pittsburgh patients, and suggested that the rupture of corpus luteum would be a specific characteristic in women of child-bearing age.

Detection and analysis of plasma VWF levels in healthy Chinese by automatic standardized assay / 中华血液学杂志

Objective@#To explore the normal range of plasma VWF levels of healthy Chinese and to analyze the influencing factors to VWF level.@*Methods@#To detect the levels of von Willebrand factor antigen (VWF∶Ag) , von Willebrand factor ristocetin cofactor activity (VWF∶Rco) , von Willebrand factor collagen binding activity (VWF∶CB) , and the factor Ⅷ coagulation activity (FⅧ∶C) by using fully automatic and standardized testing instruments and matching reagent in 70 healthy Chinese. The effects of age, ABO blood type, gender and region were also analyzed. Meanwhile, 8 standard plasma samples (2 normal subjects, 6 cases of type 2 VWD) confirmed by NIBSC were tested for VWF values.@*Results@#① In 70 cases of healthy Chinese, the mean value of plasma VWF∶Ag, VWF∶Rco and VWF∶CB were (95.4±44.9) %, (105.9±35.4) % and (89.8±28.4) %, respectively; the ratio of VWF∶Rco/VWF∶Ag and VWF∶CB/VWF∶Ag was 1.18±0.25 and 1.03±0.29, respectively. ②There was no statistical significance in plasma VWF values between the age ≥30 years and <30 years group (P>0.05) . ③The VWF∶Rco, VWF∶CB of type O blood group were lower than that of non-O group (t=2.074, P=0.042; t=3.949, P=0.001) , but there was no statistical significance in VWF∶Ag, VWF∶Rco/VWF∶Ag, VWF∶CB/VWF∶Ag between the two groups (P>0.05) . ④There was no significant difference in VWF values between male and female groups (P>0.05) . ⑤The VWF∶Ag, VWF∶CB of the northern population (North area of Huaihe River) group were higher than that of southern population (Suzhou area) group (t=4.525, P=0.001; t=3.214, P=0.002) , but VWF∶Rco/VWF∶Ag, VWF∶CB/VWF∶Ag were lower than that of southern population group (t=6.373, P=0.001; t=2.902, P=0.005) , and there was no significant difference in VWF∶Rco between the two groups (t=1.598, P=0.115) . ⑥The VWF values of 8 standard plasma samples were in accordance with the known diagnosis.@*Conclusions@#A more integrate plasma VWF levels of healthy Chinese people were obtained for the first time by using fully automatic and standardized testing instruments. It was also found that ABO blood group and region had a significant impact on the level of VWF, while the age and gender had no significant effect.

Cardiac neuroceptor imaging on acute myocardial ischemia model using 11C-methyldopamine / 中华核医学与分子影像杂志

Objective To evaluate 11C-MDA,a cardiac sympathetic nerve presynaptic molecular probe,in acute myocardial ischemia (AMI) and to compare with 13N-Ammonia myocardial perfusion imaging.Methods Twelve Bama miniature pigs were used to establish AMI models.11C-MDA and 13N-Ammonia PET/CT were performed before and after model establishment.The defect fraction,ratio of defect to normal region,defect volume of 11C-MDA and 13N-Ammonia PET/CT were calculated.Paired-t test and twosample t test were used.Results Eight models were established successfully and 4 pigs died.The defect fractions on 11C-MDA and 13N-Ammonia myocardial imaging were significantly different (13.4±3.3 vs 7.4±1.0,18.8±4.4 vs 4.8±1.0,10.5±4.2 vs 4.4±0.9;t values:4.901,8.864,4.030,all P＜0.001) at the first,third and sixth month post-model establishment.The ratios of defect to normal region on 11C-MDA and 13N-Ammonia PET/CT myocardial images were significantly different (0.47±0.14 vs 0.59±0.10,0.43±0.13 vs 0.61±0.09;t values:-2.166,-3.415,both P＜0.05) at the first and third month post-model establishment.The defect volumes on 11C-MDA and 13N-Ammonia PET/CT were significantly different ((4.20±0.34) vs (2.55±0.11) cm3,(10.66±0.71) vs (2.46±0.12) cm3,(5.95±0.50) vs (2.44±0.11) cm3;t values:12.925,32.149,19.440,all P＜0.001) at the first,third and sixth month post-model establishment.Conclusions Myocardial ischemia-reperfusion and cardiac sympathetic restoration might occur at different times.The recovery of myocardial ischemia-reperfusion is earlier than that of the cardiac sympathetic nerve.

Lignans-rich extract from Herpetospermum caudigerum alleviate physical fatigue in mice / 中国结合医学杂志

<p><b>OBJECTIVE</b>To ascertain anti-fatigue constituents and mechanisms of Herpetospermum caudigerum.</p><p><b>METHODS</b>The 80% ethanol extracts of Herpetospermum caudigerum were partitioned with chloroform, ethyl acetate and n-butanol, respectively. Male Kunming mice were divided into 13 groups with 16 mice in each group: a control group fed with water, 9 groups treated with 3 fractions of Herpetospermum caudigerum (chloroform fraction, ethyl acetate fraction and n-butanol fraction) at dose of 80, 160 and 320 mg/kg for the low-dose group, medium-dose group and high-dose group, 3 herpetrione (HPE) treated groups fed with HPE at dose of 15, 30, and 60 mg/kg for the low-dose group, medium-dose group and high-dose group. All animals were treated once per day for 30 days. Anti-fatigue activity was assessed through the forced swimming test and serum biochemical parameters including blood lactic acid (BLA), blood urea nitrogen (BUN), malondialdehyde (MDA), hepatic glycogen (HG), lactic dehydrogenase (LDH), superoxide dismutase (SOD) and glutathione peroxidase (GPx) determined following the recommended procedures provided by the commercial kits.</p><p><b>RESULTS</b>Compared with the control group, the lignans extract (ethyl acetate fraction) of Herpetospermum caudigerum and HPE could signifificantly prolonged the exhaustive swimming time (P<0.05 or P<0.01), and also increased the HG levels (P<0.05 or P<0.01) and the activities of antioxidant enzymes (SOD, GPx and LDH, P<0.05 or P<0.01); BLA and MDA levels were decreased considerably in lignans extract and HPE treated groups (P<0.05 or P<0.01). HPE also could significantly decrease the BUN contents compared with the control group (P<0.05). The chloroform and n-butanol fraction showed no effect on swimming time and biochemical parameters.</p><p><b>CONCLUSIONS</b>The lignans extract had antifatigue activities and HPE may be partly responsible for the anti-fatigue effects of Herpetospermum caudigerum. The possible mechanisms of anti-fatigue activity were related to the decrease of BUN and BLA, the increase of the HG storage and protecting corpuscular membrane by preventing lipid oxidation via modifying several enzyme activities.</p>

Diagnosis of early ovarian cancer by combination use of tran svaginal color doppler sonography and HE4,CA125 detection / 上海预防医学

Objective To estimate the clinical value of diagnosing early ovarian cancer by using transvaginal color doppler sonography (TVCDS ) , combined with the levels of serum tumor markers HE 4 and CA125. Methods A total of 151 patients with adnexal masses admitted for elective surgery were selected .According to the postoperative pathologic results , they were divided into ovarian cancer group (group A, 48 cases) and ovarian benign lesions group (group B, 103 cases).All patients were examined by TVCDS and the determination of serum HE 4 and CA125 level before surgery . The results were compared with pathological diagnosis after surgery . Results Serum HE4 and CA125 levels of the patients in group A were higher than those in group B .TVCDS parameters S/D, PI and RI were significantly lower in group A than in group B .The accuracy , sensitivity , specificity , positive predictive value, negative predictive value of TVCDS and HE 4+CA125 in ovarian cancer diagnosis were 94 .70%, 93 .75%, 95 .15%, 90 .00%, 97 .03%, respectively .The values were higher than the value of the sepa -rate checks .Con clusion TVCDS combined determination of serum HE 4 and CA125 level is helpful to the improvement of clinical diagnosis in ovarian cancer .

A single-center clinical study of 22 patients with acquired hemophilia / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the feature of underlying disorders, clinical symptoms, diagnosis and treatment strategies of patients with acquired hemophilia(AH).</p><p><b>METHODS</b>The clinical data and laboratory tests results of 22 patients with AH from March 2010 to June 2014 were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 22 patients with AH were enrolled in our study, including 20 patients diagnosed as acquired hemophilia A (AHA) and 2 as acquired hemophilia B (AHB). Among the AHA patients, there were 10 males and 10 females with the median age of 37.5 (range, 2-95) years old. The median activity of FVIII (FVIII:C) of the 20 AHA patients was 1.9% (0.5%-39.0%). Soft tissue hematoma (80.0%) and subcutaneous bleeding (75.0%) were the most common clinical symptoms. Two male children were diagnosed as AHB (age 1 and 3 years old, respectively) with mild bleeding symptoms, and the activities of FIX (FIX:C) were 5.0% and 16.0%, respectively. In addition, an underlying disorder was found in 7 patients (31.8%). In laboratory testing, all patients had prolonged APTT, normal PT, decreased FVIII:C or FIX:C, positive antibody screening test or antibody titer (2-32 BU), and negative for lupus anticoagulant and anticardiolipin antibody. Nineteen out of 20 patients were treated with blood products to stop acute bleeding episodes. Corticosteroid alone was applied to 7 patients, corticosteroid combined with other immunosuppressive agents to 11 patients, rituximab to 3 patients. Nineteen patients responded well to hemostatic treatment, except 1 patient who died of fatal bleeding. The FVIII:C of 8 patients increased to a normal level with the median time of 42.5(21-145) days. After treatment, the activity of FIX:C of the 2 AHB patients achieved 35% and 24% in 48 and 60 days, respectively.</p><p><b>CONCLUSION</b>Acquired hemophilia is not an uncommon disease in clinical practices, which can occur in people of all ages. AH is a bleeding disorder with heterogeneous characteristics. Compared with adult, the clinical symptoms of children patients were mild, which lead to underdiagnosis.</p>

Nanostructured lipid carrier based topical gel of Ganoderma Triterpenoids for frostbite treatment / 中国天然药物

The objective of this study was to prepare nanostructured lipid carrier (NLC)-based topical gel of Ganoderma Triterpenoids (GTs) and evaluate their effects on frostbite treatment. GT-NLCs was prepared by the high pressure homogenization method and then characterized by morphology and analyses of particle size, zeta potential, entrapment efficiency (EE), and drug loading (DL). The NLCs was suitably gelled for skin permeation studies in vitro and pharmacodynamic evaluation in vivo, compared with the GT emulgel. The GT-NLC remained within the colloidal range and was uniformly dispersed after suitably gelled by carbopol preparation. Transmission electron microscopy (TEM) study showed GT-NLCs was spherical in shape. The EE (%) and DL (%) could reach up to (81.84 ± 0.60)% and (2.13 ± 0.12)%, respectively. The result of X-ray diffractograms (XRD) showed that GTs were in an amorphous state in the NLC-gel. In vitro permeation studies through rat skin indicated that the amount of GTs permeated through skin of GT-NLCs after 24 h was higher than that of GT emulsion, and GT-NLCs increased the accumulative amounts of GTs in epidermis 7.76 times greater than GT emulsion. GT-NLC-gel was found to possess superior therapeutic effect for frostbite, compared with the GT emulgel. The NLC based topical gel of GTs could improve -their therapeutic effect for frostbite.

Clinical studies of 162 patients with von Willebrand disease / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyse the epidemiological feature, clinical characters and therapeutic regimens for von Willebrand disease(VWD).</p><p><b>METHODS</b>The clinical data and laboratory tests results of 162 VWD patients in our center were analyzed.</p><p><b>RESULTS</b>There were 76 males and 86 female among these patients with the mean age of 7.2(2.0-41.0) and 20.7(5.0-48.0) years, respectively. 86 patients (53.1%) were identified to be type 1 VWD, 34 patients (21.0%) type 3 VWD and 42 patients (25.9%) type 2 VWD. Among type 2 VWD patients, 33 patients were type 2A, 4 patients type 2M, 5 patients type 2B. Eighty-seven patients (53.7%) had a definite family history of bleeding tendency. The most common and specific bleeding symptoms were easy bruising (61.7%), epistaxis (53.7%), prolonged bleeding after surgery or minor injury (53.1%). Menorrhagia (66.3%) was common in female patients. The analysis of Vicenza bleeding scores in all patients showed that only 56(34.6%) patients had abnormal bleeding scores. FVIII/VWF concentrates and cryoprecipitate were applied to 45 patients (27.8% ), Desmopressin (DDAVP) to 8 patients. Eight female patients need oral contraceptives jointly to control menorrhagia. Hysterectomy had to be performed in 2 female patients with VWD.</p><p><b>CONCLUSION</b>VWD was a common congenital bleeding disorder with heterogeneous characters, it was necessary to screen, identify, classify accurately this disease in order to supply to effectively individualized treatment.</p>

Characterization and evaluation in vivo of baicalin-nanocrystals prepared by an ultrasonic-homogenization-fluid bed drying method / 中国天然药物

AIM@#To improve the absorption and bioavailability of baicalin using a nanocrystal (or nanosuspension) drug delivery system.@*METHODS@#A tandem, ultrasonic-homogenization-fluid bed drying technology was applied to prepare baicalin-nanocrystal dried powders, and the physicochemical properties of baicalin-nanocrystals were characterized by scanning electron microscopy, photon correlation spectroscopy, powder X-ray diffraction, physical stability, and solubility experiments. Furthermore, in situ intestine single-pass perfusion experiments and pharmacokinetics in rats were performed to make a comparison between the microcrystals of baicalin and pure baicalin in their absorption properties and bioavailability in vivo.@*RESULTS@#The mean particle size of baicalin-nanocrystals was 236 nm, with a polydispersity index of 0.173, and a zeta potential value of -34.8 mV, which provided a guarantee for the stability of the reconstituted nanosuspension. X-Ray diffraction results indicated that the crystallinity of baicalin was decreased through the ultrasonic-homogenization process. Physical stability experiments showed that the prepared baicalin-nanocrystals were sufficiently stable. It was shown that the solubility of baicalin in the form of nanocrystals, at 495 μg·mL(-1), was much higher than the baicalin-microcrystals and the physical mixture (135 and 86.4 μg·mL(-1), respectively). In situ intestine perfusion experiments demonstrated a clear advantage in the dissolution and absorption characteristics for baicalin-nanocrystals compared to the other formulations. In addition, after oral administration to rats, the particle size decrease from the micron to nanometer range exhibited much higher in vivo bioavailability (with the AUC(0-t) value of 206.96 ± 21.23 and 127.95 ± 14.41 mg·L(-1)·h(-1), respectively).@*CONCLUSION@#The nanocrystal drug delivery system using an ultrasonic-homogenization-fluid bed drying process is able to improve the absorption and in vivo bioavailability of baicalin, compared with pure baicalin coarse powder and micronized baicalin.