Exploration and reform on education of applied talent in clinical laboratory technology in Guizhou Medical University under the background of "New Medicine" / 中华检验医学杂志

Objective:To explore the reform path of clinical laboratory technical talents training in local universities under the background of "New Medicine".Methods:The present situation of medical laboratory technical personnel training under the background of "New Medicine" was analyzed, and the teaching mode, teaching platform and practical teaching were reformed according to the reality of Guizhou Medical University.Results:An open education system of "healthcare-education collaboration and academia-industry alliances" and the talent training mode of "three-oriented drive, four-sided integration" had been formed, which improved the training quality and provided a large number of qualified medical laboratory technical undergraduate talents to the grass-roots of Guizhou Medical System.Conclusion:The reform and practice of applied talent training in Guizhou Medical University can be used as a reference for local colleges and universities to educate applied medical laboratory technical talents.

Aconite-isolated moxibustion at Yongquan (KI 1) combined with rivaroxaban for lower extremity venous thrombosis after total knee arthroplasty: a randomized controlled trial / 中国针灸

OBJECTIVE@#To investigate the clinical effect of aconite-isolated moxibustion at Yongquan (KI 1) combined with rivaroxaban for lower extremity venous thrombosis after total knee arthroplasty and the influence on hypercoagulation.@*METHODS@#Seventy-three patients of knee osteoarthritis with lower extremity venous thrombosis after total knee arthroplasty (KOA) were randomly divided into an observation group (37 cases, 2 cases dropped off) and a control group (36 cases, 1 case dropped off). The patients in the control group took orally rivaroxaban tablets, 10 mg a time, once a day. On the basis of the treatment as the control group, the aconite-isolated moxibustion was applied to Yongquan (KI 1) for the patients of the observation group, once daily and 3 moxa cones were used in each treatment. The duration of treatment was 14 days in both groups. Before treatment and 14 days into treatment, the ultrasonic B test was adopted to determine the conditions of lower extremity venous thrombosis in the two groups. Before treatment, 7 and 14 days into treatment, the coagulation indexes (platelet [PLT], prothrombin time [PT], activated partial prothrombin time [APTT], fibrinogen [Fib] and D-dimer[D-D]), the blood flow velocity of the deep femoral vein and the circumference of the affected side were compared between the two groups separately, and the clinical effect was evaluated.@*RESULTS@#Fourteen days into treatment, the venous thrombosis of the lower extremity was relieved in both groups (P<0.05), and that of the observation group was better than the control group (P<0.05). Seven days into treatment, the blood flow velocity of the deep femoral vein was increased compared with that before treatment in the observation group (P<0.05), and the blood flow rate in the observation group was higher than that in the control group (P<0.05). Fourteen days into treatment, PT, APTT and the blood flow velocity of the deep femoral vein were increased in the two groups compared with those before treatment (P<0.05); and PLT, Fib, D-D and the circumference of the limb (knee joint, 10 cm above the patella and 10 cm below the patella) were all reduced in the two groups (P<0.05). Compared with the control group 14 days into treatment, the blood flow velocity of the deep femoral vein was higher (P<0.05), PLT, Fib, D-D and the circumference of the limb (knee joint, 10 cm above the patella and 10 cm below the patella) were all lower in the observation group (P<0.05). The total effective rate was 97.1% (34/35) in the observation group, higher than 85.7% (30/35) in the control group (P<0.05).@*CONCLUSION@#Aconite-isolated moxibustion at Yongquan (KI 1) combined with rivaroxaban can effectively treat lower extremity venous thrombosis after total knee arthroplasty, relieve hypercoagulation, accelerate the blood flow velocity and alleviate swelling of the lower extremity in the patients with knee osteoarthritis.

Anti-inflammatory Therapy Progress in Major Adverse Cardiac Events after PCI: Chinese and Western Medicine / 中国结合医学杂志

Acute coronary syndrome (ACS) is one of the leading causes of death in cardiovascular disease. Percutaneous coronary intervention (PCI) is an important method for the treatment of coronary heart disease (CHD), and it has greatly reduced the mortality of ACS patients since its application. However, a series of new problems may occur after PCI, such as in-stent restenosis, no-reflow phenomenon, in-stent neoatherosclerosis, late stent thrombosis, myocardial ischemia-reperfusion injury, and malignant ventricular arrhythmias, which result in the occurrence of major adverse cardiac events (MACE) that seriously reduce the postoperative benefit for patients. The inflammatory response is a key mechanism of MACE after PCI. Therefore, examining effective anti-inflammatory therapies after PCI in patients with ACS is a current research focus to reduce the incidence of MACE. The pharmacological mechanism and clinical efficacy of routine Western medicine treatment for the anti-inflammatory treatment of CHD have been verified. Many Chinese medicine (CM) preparations have been widely used in the treatment of CHD. Basic and clinical studies showed that effectiveness of the combination of CM and Western medicine treatments in reducing incidence of MACE after PCI was better than Western medicine treatment alone. The current paper reviewed the potential mechanism of the inflammatory response and occurrence of MACE after PCI in patients with ACS and the research progress of combined Chinese and Western medicine treatments in reducing incidence of MACE. The results provide a theoretical basis for further research and clinical treatment.

Pharmacokinetic characteristics of psoralen,isopsoralen,psoralenoside and isopsoralenoside in rats after oral administration of Psoraleae Fructus extract / 中国中药杂志

Coumarins are the main active components in Psoraleae Fructus. To study the multi-component pharmacokinetics of Psoraleae Fructus, this study established a sensitive and rapid ultra-pressure liquid chromatography coupled to tandem mass spectrometry(UPLC-MS/MS) method for simultaneous determination of psoralen, isopsoralen, psoralenoside, and isopsoralenoside in rat plasma. After validation, the method was applied to the investigation of pharmacokinetics of psoralen, isopsoralen, psoralenoside, and isopso-ralenoside in rats after single and multiple administration of Psoraleae Fructus extract. The results revealed that the exposure of psoralen and isopsoralen in rat plasma was high after a single intragastric administration of Psoraleae Fructus extract, with an AUC_(0-∞) of 443 619-582 680 and 167 314-276 903 ng·mL~(-1)·h~(-1), respectively. Compared with these two compounds, the exposure of psoralenoside and isopsoralenoside was lower with marked gender difference. After 7-day administration of Psoraleae Fructus extract to rats, the AUC_(0-∞) of psoralen and isopsoralen was 29 701-81 783 and 39 234-89 914 ng·mL~(-1)·h~(-1), respectively, which was significantly lower than that at the first day(P<0.05), and that of psoralenoside and isopsoralenoside was 7 360-19 342 and 8 823-45 501 ng·mL~(-1)·h~(-1), respectively. There was no significant gender difference in exposure of psoralenoside and isopsoralenoside in male and female rats. However, the exposure of psoralenoside and isopsoralenoside in male rats was reduced(P<0.05), and the t_(1/2) and mean residence time(MRT) were shortened, suggesting that the removal of these two compounds from the body was accelerated.

Effects of medium and long-term insulin pretreatment on the activity of main oxidase and antioxidant enzyme in the myocardium of burned rats with delayed fluid resuscitation / 中华危重病急救医学

Objective:To observe the effects of medium and long-term insulin pretreatment on the activity of main oxidase and antioxidant enzyme in the myocardium of burned rats with delayed fluid resuscitation.Methods:According to random number table method, forty male Sprague-Dawley (SD) rats were divided into pseudo-burn group, burn delayed resuscitation group, insulin glargine pretreatment group and neutral protamine hagedorn (NPH) insulin pretreatment group, with 10 rats in each group. 30% total body surface area (TBSA) as Ⅲ degree scald model was prepared by bathing the back of rats in 95 ℃ hot water for 15 s; the rats in the pseudo-burn group were immersed in 37 ℃ warm water for 15 s as control. Insulin glargine pretreatment group, NPH insulin pretreatment group and burn delayed resuscitation group were injected subcutaneously with insulin glargine, NPH insulin, and normal saline 1.0 U·kg -1·d -1 2 hours after injury, and intraperitoneal injection of normal saline 40 mL/kg simulated delay resuscitation 6 hours after injury. The pseudo-burn group didn't receive medicine and delayed resuscitation. Abdominal aortic blood samples and heart tissue were collected immediately after simulating scald in the pseudo-burn group, and 24 hours after scald in three burn groups. Blood glucose, xanthine oxidase (XOD), myeloperoxidase (MPO), CuZn-superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) of the heart tissue were determined by spectrophotometry. Results:Compared with the pseudo-burn group, the burn delayed resuscitation group have significantly higher blood glucose level and the XOD and MPO in the heart tissue, while significantly lower CuZn-SOD, CAT, and GSH-Px in the heart tissue. Compared with the burn delayed resuscitation group, insulin glargine pretreatment group and NPH insulin pretreatment group have lower blood glucose level and heart tissue XOD [blood glucose (mmol/L): 6.37±1.22, 6.66±1.45 vs. 9.47±0.80; XOD (U/g): 271.93 (261.59, 275.91), 285.32 (251.96, 297.29) vs. 363.37 (354.12, 377.76), all P < 0.05], while significantly higher heart tissue CuZn-SOD, CAT, and GSH-Px [CuZn-SOD (U/g): 0.13±0.01, 0.14±0.01 vs. 0.10±0.01; CAT (U/g): 29.17±7.28, 27.16±7.37 vs. 18.36±4.53; GSH-Px (U/g): 0.33 (0.16, 0.41), 0.30 (0.17, 0.41) vs. 0.07 (0.04, 0.11), all P < 0.05]. MPO activity in insulin glargine pretreatment group was significantly lower than that in burn delayed resuscitation group (U/g: 0.016±0.002 vs. 0.020±0.002, P < 0.05), but there was no significant difference between insulin pretreatment group and NPH insulin pretreatment group (U/g: 0.019±0.003 vs. 0.020±0.002, P > 0.05). There was no significant difference in the blood glucose, and activities of XOD, MPO, CAT, GSH-Px between insulin glargine pretreatment group and NPH insulin pretreatment group, but the activity of CuZn-SOD in NPH insulin pretreatment group was further higher than that in insulin glargine pretreatment group (U/g: 0.14±0.01 vs. 0.13±0.01, P < 0.05). Conclusions:Medium and long-term insulin pretreatment can improve the antioxidant capacity of myocardium in delayed resuscitation rats after burns, inhibit the production of reactive oxygen species and improve the scavenging capacity of reactive oxygen species. However, only CuZn-SOD activity is different between the two groups, and further study needs to be carried out to determine whether it is related to the type if insulin.

Rapid and simultaneous determination of 10 active components of Psoraleae Fructus in beagle dog plasma using UPLC-MS/MS and its application in pharmacokinetic study / 中国中药杂志

An UPLC-MS/MS method for rapid and simultaneous determination of psoralen, isopsoralen, apigenin, genistein, bavaisoflavone, neobavaisoflavone, bavachin, bavachinin, psoralenoside, and isopsoralenoside of Psoraleae Fructus in beagle dog plasma was established, and then the method was applied in the pharmacokinetic study after oral administration of Psoraleae Fructus extract to beagle dogs. The pharmacokinetic parameters were calculated by the software of WinNonlin. A Waters HSS-T3 column(2.1 mm×100 mm,1.8 μm)was used for liquid chromatography separation with acetonitrile-water(containing 0.004% formic acid) as the mobile phase for gradient elution.The mass spectrometry was detected using electrospray ion source(ESI) under multi-reaction monitoring mode(MRM), as well as positive ion mode. Analysis time only takes 8.5 min. The methodological study in terms of specificity, accuracy, precision, linear range, recovery, matrix effect, and stability, was validated. The LC-MS analysis method established in this experiment was simple, specific, accurate, reliable, and meet the requirement of pharmacokinetic study in plasma after administration of Psoraleae Fructus extract to beagle dogs. Six beagle dogs received intragastric administration of Psoraleae Fructus extract, T_(max) of 10 chemical components is 1.92-5.67 h; among them, C_(max) of psoralen, isopsoralen, psoralenoside and isopsoralenoside is 383-3 613 ng·mL~(-1), and AUC_(0-∞) is 3 556-18 949 ng·h·mL~(-1), t_(1/2) is 2.45-4.83 h. C_(max) of the remaining six compounds is 0.81-19.9 ng·mL~(-1), AUC_(0-∞ )is 6.54-178 ng·h·mL~(-1), t_(1/2) is 2.95-7.29 h. The UPLC-MS/MS analysis method established in this study was proved to be accurate and sensitive that it can be applied to the pharmacokinetic study of beagle dogs after oral administration of Psoraleae Fructus extract.

An exploration into the therapeutic effects and molecular mechanisms of paeoniflorin in the treatment of adjuvant-induced arthritis rats by a network pharmacology-based research strategy / 药学学报

Paeoniflorin (PAE), the major active compounds of Chinese herbs Radix Paeoniae Alba andChinese patent drug "Total Glucosides of Paeony Capsules", which is effective in the treatment of rheumatoid arthritis (RA), exerted multi-pharmacological activities, such as anti-inflammatory, immune-regulatory, etc. However, its potential action mechanisms remain unclear. Herein, we predicted the putative targets of Radix Paeoniae Alba and constructed an interaction network of putative targets of Radix Paeoniae Alba and known RA-related genes. A list of key putative targets was identified by calculating their topological features (degree, node betweenness and closeness) in the above pharmacological network. Importantly, pathway enrichment analysis revealed that these key putative targets were significantly enriched in several RA-related pathways, including cartilage damage-related IL1B-TNF-TLR2-JUN-MMP1-MMP3 signaling pathway. Further molecular docking simulation showed that PAE, the major active compounds of Radix Paeoniae Alba, has strong binding affinity with MMP1 and MMP3 proteins. Next, in vivo experiments based on the adjuvant-induced arthritis (AIA) animal models showed that PAE significantly alleviated the disease severity and the syndromes of severe redness or swelling in hind limbs of AIA rats, including decreasing the arthritis score, the diameter of the limbs, and elevating body weight and pain thresholds (all P<0.05). ELISA assay indicated that PAE obviously suppressed the abnormal up-regulation of serum inflammatory factors including IL-1β, TNF-α, IL-6, IL-17 and IFN-γ in AIA rats (all P<0.001). Western blot analysis found that PAE simultaneously modulated the abnormal up-regulation of MMP1 and MMP3 proteins in the ankle tissues of AIA rats (all P<0.001) (all procedures in the current study were performed in accordance with the ethical standards of the Center for Laboratory Animal Care, China Academy of Chinese Medical Sciences). In conclusion, PAE alleviated the cartilage damage and disease severity in the progressive process of RA via regulating the IL1B-TNF-TLR2-JUN-MMP1-MMP3 pathway. This study provided the theoretical basis of the PAE for its immune-regulatory effects, and as well provided references for the action mechanism study of extract compounds of Chinese herbs.

Efficacy of the herbal cake-separated moxibustion with new-type moxibustion device on urinary retention after spinal cord injury / 中国针灸

OBJECTIVE@#To compare the clinical effect of the herbal cake-separated moxibustion with new-type moxibustion device combined with bladder function exercise and simple bladder function exercise on improving urinary retention after spinal cord injury.@*METHODS@#Sixty-eight patients were randomly divided into a control group and an observation group, 34 cases in each group. The bladder function exercise was given in the control group. On the basis of the treatment in the control group, herbal cake-separated moxibustion with new-type moxibustion decice was applied at Shenque (CV 8), Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3) for 30 min, once a day in the observation group. The two groups were treated for 4 weeks as a course, 2 courses of treatment were needed. Bladder maximum volume, bladder residual urine volume and urinary tract infection before and after treatment were compared, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#The total effective rate in the observation group was 88.2% (30/34), which was better than 64.7% (22/34) in the control group (<0.05). The increase of bladder maximum volume and decrease of bladder residual urine volume in the observation group were significantly better than those in the control group (<0.01). At the 4th, 6th and 8th weeks for treatment, the improvement of urinary tract infection in the observation group was better than that in the control group (<0.05).@*CONCLUSION@#At the same time of bladder function training, herbal cake-separated moxibustion with new-type moxibustion device could improve urinary retention after spinal cord injury.

's experience in treating dry eye syndrome with fire needling / 中国针灸

Professor - is the representative inheritor of fire needling therapy. He proposed that the clinical application of fire needling is mainly based on pattern differentiation according to eight priciples, as well as in coordination with the theories of meridians and - organs. He believes that dry eye syndrome can be treated from the aspects of deficiency of liver and kidney, heart deficiency, and and deficiency. Through deeply digging the connotation of ancient classics, and combined his clinical practice using fire needling, professor created a unique therapy that select "Neichengqi"as the main acupoint combined with Xialeidian, Dagukong (EX-UE 5), Xiaogukong (EX-UE 6) and Shaoze (SI 1) in the treatment of dry eye syndrome. In this paper, from the etiology and pathogenesis of dry eye syndrome and therapeutic characteristics of fire needling, the thoughts of syndrome differentiation and characteristics of acupoints selection of professor were analyzed by a typical case, and it is expect to enrich the clinical treatment plan for dry eye syndrome.

Chemical Constituents of Psoraleae Fructus and Its Main Toxic Ingredients / 中国实验方剂学杂志

Psoraleae Fructus (Buguzhi) is dried mature fruit of Psoralea corylifolia. It is spicy and bitter in favor and warm in nature, and distributed to kidney and spleen meridians. Psoralea Fructus has the effects of warming kidney and tonifying Yang,absorbing Qi and relieving asthma,warming spleen and stopping diarrhea; for external use,it can remove beverage. It is mainly used to treat impotence and nocturnal emission cold and knee pain,kidney deficiency and asthma caused by kidney Yang deficiency; for external use, it can treat vitiligo and alopecia areata. Its principle chemical components are coumarins,monoterpene phenols,flavonoids,with an estrogen-like effect as well as anti-inflammatory,antibacterial,antifungal,anti-oxidation,anti-tumor and immunomodulatory activities, and can be used for the prevention and treatment of osteoporosis,bacterial infections,asthma and osteoarthritis. However,the long-term administration with large doses of psoralen have the potential risk of causing liver damage,with phototoxicity,nephrotoxicity and reproductive toxicity,which restricts its application in clinical therapy. Therefore,it is essential to fully understand the chemical composition and mechanism of psoralen. Through the review and summarization of literatures about psoralen at home and abroad,this article systematically reviews the chemical constituents and toxicity of Psoralea Fructus, provides Chinese and English names,structural formulas,molecular formulas,molecular weights,CAS numbers of the compounds and the toxicity information about psoralen reported in recent years, in order to provide a reference for further study on the compositional spectrum and pharmacokinetics,toxic kinetic studies and clinical medication safety of psoralen.

Qualitative characterization of flavonoids in Scutellariae Radix by using PREC-IDA-EPI / 中国中药杂志

Flavonoids are the most abundant constituents and induce these the rapeutic effects against inflammation, gastrointestinal infections, cardiovascular diseases, and respiratory. Most of these flavonoids have low content in Scutellarie Radix. It was difficult to detect some minor compounds by using LC-MS method with full scan. Based on the review of flavonoids that had been extracted from Scutellariae Radix, a method with PREC-IDA-EPI technique was developed and applied to Scutellariae Radix by using UPLC-MS/MS. A total of 97 flavonoids were identified, including 29 aglycones and 68 -glycosides. This study laid the foundation for pharmacodynamicss of Scutellariae Radix.It is believed that an individual detection scheme based on the PREC-IDA-EPI technique could be used to identify unknown compounds.

The study of DCE-MRI quantitative parameters for the pathologic characteristics and clinical stage of cervical cancer at 3.0T / 实用放射学杂志

Objective To evaluate the value of 3.0T dynamic contrast-enhanced MRI (DCE-MRI)quantitative parameters for the diagnosis,pathological classification,clinical staging and lymph node status of cervical cancer.Methods The DCE-MRI data of 41 cases with cervical cancer and 1 5 cases with normal cervix were analyzed retrospectively.The quantitative parameters including Ktrans,Kepand Ve were obtained by Siemens Tissue 4D software.Statistical analysis was performed by SPSS 22.0.Results The Ktransand Kepvalues of cervical cancer group were significantly higher than normal cervix group(P<0.001),and there was no statistical difference in Vevalue between the two groups(P>0.05).The Ktransvalue of squamous carcinoma was significantly higher than adenocarcinoma(P<0.05),while Kep and Vevalues showed no statistical differences(P>0.05).The Ktransvalue of International Federation of Gynecology and Obstetrics (FIGO)for early cervical cancer was significantly lower than that for advanced cervical cancer(P<0.05),while Kepand Vevalues showed no statistical differences (P>0.05).There were no statistically significant differences in Ktrans,Kepand Vevalues between cervical cancer with or without lymph node metastasis(P>0.05).Conclusion The quantitative parameters of 3.0T DCE-MRI can be used for the diagnosis, pathological classification and clinical staging of cervical cancer,and it is also of great significance for the rational formulation of the clinical treatment plan.

Effects of Short-term High Dose Atorvastatin on Left Ventricular Remodeling in Patients with First Time Attack of Anterior Acute Myocardial Infarction / 中国医学科学杂志(英文版)

Objects The aim of this trial was to evaluate the effect of short-term high-dose atorvastatin therapy on levels of high-sensitivity C-reactive protein (hs-CRP), malonaldehyde (MDA), endothelin-1(ET-1), matrix metalloproteinases (MMPs), and left ventricular (LV) remodeling in patients with first time attack of acute anterior myocardial infarction (AAMI) .Methods A hundred and three patients with first time attack of AAMI who underwent successful primary percutaneous coronary intervention were randomized to receive atorvastatin 40 mg once daily for 1 week followed by 20 mg once daily (intensive treatment group, IT group, n=49), or atorvastatin 20 mg once daily (standard treatment group, ST group, n=54). Plasma levels of hs-CRP, MDA, ET-1, MMP-2 and MMP-9 were measured on admission, at 1 week, 2 weeks and 6 months follow up and compared between the IT group and ST group. Echocardiography was performed on admission, at 2 week, and 1 year follow up. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured at each echocardiographic examination and compared between the IT group and ST group.Results Plasma levels of hs-CRP (F=7.718, P=0.009), ET-1 (F=7.882, P=0.006), MMP-9 (F=4.834, P=0.028) and pro-BNP (F=4.603, P=0.032) were significantly lower at 1 week after initial onset of AAMI in the IT group compared with the ST group. The changes of LVEDV, LVESV, and LVEF at the 1 year follow-up from the admission did not differ between the IT group and the ST group (t=0.722, P=0.444; t=1.228, P=0.221; t=1.354, P=0.187, repectively).Conclusions Short-term high-dose atorvastatin treatment for AAMI was associated with lower hs-CRP, ET-1 and MMP-9 levels compared to the standard dose treatment. However, this beneficial effect is not likely to related to the left ventricular remodeling.

Optimization of the Soxhlet Extraction Technology of Atractylodes macrocephala Formula Granules by Or-thogonal Test / 中国药房

OBJECTIVE:To optimize the soxhlet extraction technology of Atractylodis macrocephalae,and to provide evi-dence for research and preparation of its formula granules. METHODS:Using the contents of atractylenolide Ⅰ,Ⅱ,Ⅲ as index, based on single factor test,the Soxhlet extraction technology of A. macrocephalae formula granules was optimized and verified by L9(34)orthogonal test with extraction time,solid-liquid ratio,extraction times as factors,and then compared with other technolo-gies (normal temperature extraction method,ultrasonic extraction method,reflux extraction method). RESULTS:The optimal ex-traction technology was as follows as 6-fold ethanol,extracting for 3 times,lasting for 8 h. Results of validation test showed that the extraction amounts of atractylenolide were 0.769,0.752,0.781 mg/g (RSD=1.99%,n=3) for 3 times,which were higher than the extraction amounts of other 3 methods(0.683,0.489,0.693 mg/g). CONCLUSIONS:The optimized extraction technolo-gy possesses high extraction rates of atractylenolide Ⅰ,Ⅱ,Ⅲ,and can be used for the extraction of internal ether from A. macro-cephalae formula granules.

Scientific Evaluation of TCM Clinical Outcomes Rating Scale for Heart Failure Based on Patients Report / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the reliability, validity, and responsiveness of traditional Chinese medicine (TCM) clinical outcomes rating scale for heart failure (HF) based on patients' report.</p><p><b>METHODS</b>TCM clinical outcomes rating scale for HF (TCM-HF-PRO) were evaluated based on 340 HF patients' report from multiple centers. The completion of the investigation was recorded. Cronbach's α coefficient and split-half reliability were used for reliability analysis, and factor analysis was used to assess the construct validity of the rating scale. Pearson correlation analysis was then used for criterion validity analysis. Discriminant analysis was used to assess the responsiveness of the scale. All 340 HF patients having complete TCM-HF-PRO data were assigned to the treatment group and the control group by central randomization. The total TCM-HF-PRO scores of the two groups were compared using paired t-test to reflect the longitude responsiveness of the scale before treatment and at week 2 after treatment.</p><p><b>RESULTS</b>(1) The recycling rate of the scale was 100.0%. One of them was not filled completely, which was rejected thereby. So the completion rate was 99.7%. The completion time for TCM-HF-PRO scale ranged 15 to 25 min. (2) The Cronbach's α coefficient of rating scale was 0.903, split-half reliability was 0.844 and 0.849. (3) Confirmatory factor analysis showed that 7 factors and items formed according to maximum load factor basically coincided with the construct of the rating scale, 7 factors accumulated contribution rate was 43.8%. TCM clinical outcomes rating scale for HF based on patients' report was relatively better correlated with the Minnesota living with HF questionnaire (r = 0.726, P < 0.01). (4) Discriminant analysis showed that the rating scale correctly classified more than 78.8% of case studies having confirmed initial differential diagnosis by experts. The total scale of the rating scale decreased more in the two group after treatment, with significant difference as compared with before treatment (P < 0.01.</p><p><b>CONCLUSION</b>TCM clinical outcomes rating scale for HF based on patients' report had good reliability, validity and responsiveness, hence it could be used to assess clinical efficacy for HF patients.</p>

Identification and Treatment of the Early Form of Neurogenic Pulmonary Edema in Emergency Room / 中国医学科学院学报

<p><b>OBJECTIVE</b>To improve the management of the early neurogenic pulmonary edema(NPE)in patients with non-traumatic cerebral hemorrhage.</p><p><b>METHODS</b>Totally 140 eligible patients with non-traumatic cerebral hemorrhage who were treated in the emergency department of our hospital from October 2008 to October 2014 were divided into two groups:NPE group(n=25)and non-NPE group(n=115). The clinical data were analyzed and compared.</p><p><b>RESULTS</b>Although the mean arterial pressure was similar between these two groups,the median pH and the bicarbonate ion(HCO(3)(-))were significantly lower in the NPE group than in the non-NPE group(pH:7.32 vs.7.39,P=0.002;HCO(3)(-),20.6 mmol/L vs.22.7 mmol/L,P=0.01). Multivariate regression analysis indicated that younger age and higher glucose level were significantly correlated with the early onset of NPE in the NPE group than in the non-NPE group(age:50.1 years vs.65.1 years,P=0.0008;glucose,15.4 mmol/L vs.10.78 mmol/L,P=0.001).There were only 3 patients in all with non-traumatic cerebral hemorrhage happened the fulminant NPE in 1 hour. Within 24 hours after patients visited the emergency room,the condition was improved in 20 of 25 patients in the NPE group. However,5 patients died,among whom 3 patients with fulminant NPE(onset within 1 hour)died due to acute respiratory distress syndrome and complicated with multiple organ failure,and 2 died of cerebral hernia.</p><p><b>CONCLUSIONS</b>NPE is a rare and severe complication in patients with non traumatic cerebral hemorrhage. The possibility of NPE should be considered in relatively young patients with higher glucose and lower blood pH value. Timely prevention and treatment can improve the outcomes.</p>

Association of the TRAF1/C5 gene polymorphism with rheumatoid arthritis in Han population of Guizhou Province / 国际检验医学杂志

Objective To explore the association between the tumor necrosis factor receptor-associated factor 1(TRAF1)/com-plement component 5(C5)single nucleotide polymorphism and rheumatoid arthritis patients.Methods Two groups of people were included in the study:300 rheumatoid arthritis(RA)patients(RA group)and 300 healthy individuals(control group).Real-time PCR was used to test the single nucleotide polymorphisms rs3761847 and rs10818488 of TRAF1/C5.Results There was no signifi-cant difference (P >0.05)of TRAF1/C5 rs3761847 and rs10818488 polymorphism between the two groups.The linkage disequilib-rium analysis results showed that there was strong linkage disequilibrium between rs3761847 and rs10818488.For the RF,anti-CCP and anti-Sa negative RA patients,the difference in the frequency of A allele of rs3761847 between the RA patients and matched con-trols was statistically significant(P =0.001,OR =0.57,95%CI :0.41 -0.79;P =0.001,OR =0.51,95%CI :0.35 -0.76;P =0.02,OR=0.72,95%CI :0.55-0.94).Significant difference for the frequency of G allele of rs10818488 between RF positive RA patients and control groups was observed(P =0.01,OR=1.40,95%CI :1.09-1.81).Conclusion TRAF1/C5 gene polymorphism may not associate with susceptibility of RA patients in Han population in Guizhou.

Expert survey for Chinese medicine syndrome characteristics of different clinical types of coronary artery disease based on the Delphi method / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To carry out expert survey for traditional Chinese medicine (TCM) syndrome characteristics of different clinical types of coronary artery disease (CAD).</p><p><b>METHODS</b>By using Delphi method, we carried out two rounds of nationwide expert surveys for modern TCM characteristics of syndrome elements and syndrome types of CAD.</p><p><b>RESULTS</b>Based on expert consensus, qi deficiency, blood stasis, phlegm turbidity, qi deficiency blood stasis, and intermingled phlegm and blood stasis are common TCM syndromes for different clinical types of CAD. Of them, qi stagnation, blood stasis, phlegm turbidity, heat accumulation, cold coagulation, yang deficiency, deficiency of both qi and yang were more often seen in patients with unstable angina than in those with stable angina. Qi deficiency, yin deficiency, and deficiency of both qi and yin were less seen. We could see more excess syndrome and less deficiency syndrome (such as qi deficiency, yin deficiency, etc.) in acute ST-segment elevation myocardial infarction (STEMI) than acute non-ST-segment elevation myocardial infarction (NSTEMI). Qi deficiency, blood stasis, water retention, yang deficiency, phlegm turbidity, yin deficiency, Xin-qi deficiency, and qi deficiency blood stasis induced water retention are the most common TCM syndrome types of CAD heart failure (HF). Blood deficiency, yin deficiency, heat accumulation, deficiency of both Xin and Pi, deficiency of both qi and blood, deficiency of both qi and yin, yin deficiency and fire hyperactivity were more often seen in CAD arrhythmias.</p><p><b>CONCLUSIONS</b>TCM syndrome distributions of different clinical types of CAD have common laws and individual characteristics. Results based on the expert consensus supplied evidence and support for clinical diagnosis and treatment of CAD.</p>

Prevention of procedural pain in dressing changes of burn wounds by auricular injection of small-dose fentanyl / 中国针灸

<p><b>OBJECTIVE</b>To explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds.</p><p><b>METHODS</b>Ninety patients of burn injury were randomized into 3 groups, 30 cases in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, jiaogan (AH6a, sympathetic nerve), fei (CO14, lung), neifenmi (CO18, endocrine) on ear, 0.25 mL at each point. In the group B, fentanyl citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale (VAS) was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately.</p><p><b>RESULTS</b>It was not different in VAS score before dressing change among the three groups (P> 0.05). Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A (both P>0.05), but the score in the patients of the group B and C was different significantly (all P<0.05). The VAS score during and after dressing change in the group A was lower than that in the group B and C (all P<0.05), and the score in the group B was lower than that in the group C (P<0.05).</p><p><b>CONCLUSION</b>Fentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.</p>

Cultivation and identification of colon cancer stem cell-derived spheres from the Colo205 cell line

Our group established a method to culture spheres under serum-free culture condition. However, the biological characteristics and the tumorigenicity of spheres are unknown. Here, we demonstrate that sphere cells expressed high levels of the putative colorectal cancer stem cell markers CD133 and CD44. The CD133-positive rates were 13.27 ± 5.62, 52.71 ± 16.97 and 16.47 ± 2.45 percent in sphere cells, regular Colo205 cells and differentiated sphere cells, respectively, while the CD44-positive rates were 62.92 ± 8.38, 79.06 ± 12.10 and 47.80 ± 2.5 percent, respectively, and the CD133/CD44-double-positive rates were 10.77 ± 4.96, 46.89 ± 19.17 and 12.41 ± 2.27 percent, respectively (P < 0.05). Cancer sphere cells formed crypt-like structures in 3-D culture. Moreover, cells from cancer spheres exhibited more tumorigenicity than regular Colo205 cells in a xenograft assay. The cancer sphere cells displayed much higher oncogenicity than regular Colo205 cells to initiate neoplasms, as assayed by H&E staining, Musashi-1 staining and electron microscopy. Our findings indicated that the sphere cells were enriched with cancer stem cells (CSCs), and exhibited more proliferation capacity, more differentiation potential and especially more tumorigenicity than regular Colo205 cells in vitro and in vivo. Further isolation and characterization of these CSCs may provide new insights for novel therapeutic targets and prognostic markers.