Advances in pre-hospital recognition and cooling treatment of exertional heat stroke / 中华危重病急救医学

Heat stroke (HS) is a life-threatening illness characterized by an altered level of consciousness with an elevated core body temperature 40 ℃, which may be further classified as exertional heat stroke (EHS) or classical heat stroke (CHS) according to the etiology of the condition. In recent years, the morbidity of EHS increases year by year. The severity and clinical outcome for an EHS casualty have a strong correlation with the area under the time and temperature curve for heat exposure. The early recognition and rapid cooling body core temperature ≤38.9 ℃ within 30 minutes of EHS results in the best clinical outcome and minimize severe multiple organ dysfunction and death for patients. Cold water immersion (CWI) is considered as an optimum cooling method for the reversal of hyperthermia in EHS. Some alternative modalities have also shown acceptable cooling rate, for example, the subjects immersed in a circulated water bath controlled below 20 ℃, tarp-assisted cooling with oscillation, body cooling unit, undressed, air-conditioned room, the whole body and large vessels placed ice packs, massaging the extremities; cold intravenous saline applied to dehydrated one. It is necessary to monitor body core temperature for hypothermia and/or recurrent hyperthermia, and to provide physical care for shivering, agitation, or concerns with the potential discomfort combativeness that may occur during cooling process. In this paper, pre-hospital recognition, care, monitoring and rapid cooling treatment measures of EHS have been reviewed to provide references for early identification of EHS and scientific, reasonable and effective cooling treatment.

Research progress of LCZ696 in patients with chronic heart failure / 中国综合临床

Chronic heart failure(CHF)is the performance of end-stage cardiovascular disease and the leading cause of death in recent years.With the rapid development of medical care,the mortality rate of heart failure is still high.This is one in the two major challenges in the cardiovascular field in the 21st century.The new drug LCZ696 is a dual inhibitors of angiotensin receptor blockers(ARB)and neprilysin(NEP),which may lead to new hope for patients with heart failure.In order to determine the efficacy and safety of LCZ696 in the treatment of heart failure,foreign countries have carried out some large-scale trials,such as PARAMOUT, PARADIGM,TITRATION and so on.The results of these studies reflected the superiority of LCZ696 compared with enalapril,valsartan and other drugs in the treatment of chronic heart failure.ARB/antiotensin converting enzyme inhibitors(ACEI)targets the angiotensin receptor to dilate blood vessels and inhibits the sympathetic nerve,but their effects on sodium withdrawal and diuresis are weak.The sacubitril in LCZ696 prevents natriuretic peptide from degrading,strengthens the natriuretic diuretic and further expansion of blood vessels.Thereby it improves water and sodium retention and cardiac function.It can play a better synergistic role combined with valsartan.

Effects of Yunnan BaiYao on the Expressions of c-fos and C-jan mRNA in Periodontal Ligament Cells in Vitro / 昆明医科大学学报

Objective To study the effects of Yunnan BaiYao on the expressions of c-fos and c-jun mRNA in HPDLFs and explore the potential mechanism that Yunnan BaiYao promotes the proliferation and differentiation of HPDLFs.Methods The HPDLFs tissue was obtained from the extracted healthy premolar.The HPDLFs used underwent four to six passages.Cells were divided into untreated group,positive control group and treated group.In treated group,HPDLFs were co-cultured with Yunnan BaiYao solution for 4h with gradient concentration.The expressions of c-fos and c-jun mRNA were determined by RT-PCR.Results The results showed that the expressions of c-fos and c-jun mRNA were up-regulated significantly in treated group compared with control group (P＜0.05) Conclusion Yunnna BaiYao can upregulate the expressions of c-los and C-jun mRNA in HPDLFs.Through upregulating the expressions of c-fos and c-jun mRNA in hPDLs,Yunnan BaiYao can promote proliferation and differentiation of ossification of HPDLFs to induce bone formation.

Effects of rosiglitazone on cholesterol contents and scavenger receptor class B type I expression in RAW264.7 foam cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of rosiglitazone on the content of cholesterol and expressions of Acy-coenzyme A: cholesterol acyltransferase 1 (ACAT-1) and scavenger receptor class B type I (SR-BI) in RAW264.7 macrophage-derived foam cells and explore the anti-atherosclerotic mechanism of rosiglitazone.</p><p><b>METHODS</b>RAW264.7 macrophages were incubated with oxidized low-density lipoproteins (ox-LDL) or with both ox-LDL and rosiglitazone (5, 10, or 20 µmol/L). Oil red O staining was used to observe the formation of foam cells, and cholesterol oxidase was used to determine the content of cellular cholesterol contents. Western blotting was used observe the expressions of ACAT-1 and SR-BI in RAW264.7 foam cells.</p><p><b>RESULTS</b>Compared with the control cells, RAW264.7 macrophage-derived foam cells showed significantly increased contents of total cholesterol and free cholesterol (P<0.01) and ACAT-1 expressions (P<0.05) with mildly increased SR-BI expression (P>0.05). Rosiglitazone treatments significantly lowered the contents of total cholesterol and free cholesterol (P<0.05), decreased the expression of ACAT-1 (P<0.05), and increased SR-BI expression (P<0.05) in the foam cells in a dose-dependent manner.</p><p><b>CONCLUSION</b>Rosiglitazone can decrease the contents of total and free cholesterol, down-regulate ACAT-1 expression and up-regulate SR-BI expression in the foam cells produce the anti-atherosclerotic effect.</p>

Correlation research of myeloperoxidase and the severity of coronary lesions in patients with acute coronary syndrome / 中国医师进修杂志

ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.

Effects of flavones of buckwheat flower and leaf on insulin resistance and liver PTP1B in type 2 diabetic rats / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the effect and mechanism of flavones of buckwheat flower and leaf (FBFL) on lowering blood glucose and improving insulin resistance in type 2 diabetic rats.</p><p><b>METHOD</b>Seventy healthy male Wistar rats were used in this trial. Ten of them were selected randomly as normal group; the others were given fat milk by intragastric administration daily, from the 14th day on, low dose tetraoxypyrimidine was added by intraperitoneal injection every other day for three times. Rats with fasting (72 hours after the last injection) blood sugar > or = 16.7 mmol x L(-1) and K(IPT) < 60% of normal group were selected as type 2 diabetic model with insulin resistance, which were randomly divided into 5 groups: model group. LGLT group; low, moderate and high dosage FBFL groups (L-FBFL; M-FBFL; H-FBFL). Every rat was treated accordingly for 4 weeks; then FBG, FFA, INS were detected and ISI was calculated to evaluate the degree of insulin resistance. Liver PTP1B expression was determined by immunohistochemistry method. staining were observed by light microscopy.</p><p><b>RESULT</b>FBFL could dose-dependently inhibit the rising of FBG, FFA, INS, improve the state of insulin resistance and reduce the expression level of liver PTP1B.</p><p><b>CONCLUSION</b>FBFL could effectively improve insulin resistance in type 2 diabetic rats induced by tetraoxypyrimidine and fat milk and showed dose-dependence relationship.</p>

Comparison of Efficacy of Valsartan,Benazepril and Felodipine on Left Ventricular Hypertrophy in Essential Hypertension and Aldosterone Escape During Therapy / 中华高血压杂志

Objective To compare the efficacy of valsartan,benazepril and felodipine on reversal of left ventricular hypertrophy(LVH)in patients with hypertension and the relevant "aldosterone escape phenomena".Methods One hundred eleven patients with hypertension-related LVH were randomly to receive valsartan(80-160 mg/d,n=36),benazepril(10-20 mg/d,n=39)and felodipine(5 mg/d,n=36).Plasma angiotensin Ⅱ(Ang Ⅱ)and aldosterone(Ald)were determined before and 10-14 weeks 20-26 weeks after treatment.Echocardiographic examinations and blood routine,urine routine,blood glucose,blood lipid,liver function and renal function were conducted in all subjects before and after treatment.Results Blood pressure was significantly decreased in all three groups(P0.05).Valsartan increased plasma Ang Ⅱ at 10-14 weeks and furthermore at 20-26 weeks;benazepril decreased plasma Ang Ⅱ initiatively with trend of rebound at 20-26 weeks;however,plasma Ang Ⅱ was kept constantly in felodipine group.Valsartan decreased Ald and sustained during the all treatment period.On contrary,benazepril initiatively decreased Ald which was rebound to baseline level at 20-26 weeks.No change in Ald by felodipine was found during the treatment.After treatment plasma Ald level was significantly related to the reduction of LVH in both valsartan and benazepril groups.36% patients in benazepril group was found to have "aldosterone escape".Conclusion The antihypertensive effect was similar between valsartan,benazepril and felodipine.Although three medications all reversed LVH,but valsartan,benazepril was more effective than felodipine.There was no evidence of aldosterone escape in the long-term treatment with valsartan.Valsartan might have more advantages in reversal of LVH than benazepril.Felodipine had no effect on the plasma level of aldosterone.

Inhibitory effect of total flavones of buckwheat flower on the non-enzymatic glycation of protein in vivoand vitro / 中国药理学通报

Aim To investigate the influence of total fl avones of buckwheat flower (TFBF) on the productivity of the non-enzymatic advanced glycation end products (AGEs) in vivoand vitro. Methods TFBF in different dosages (0.1 g?kg -1?d -1,0.2 g?kg -1?d -1,0.4 g?kg -1?d -1) was taken orally by streptozotocin-induced diabetic rats for 12 wk. After the treatment, blood glucose, fructosamine and AGEs in plasma and kidney were measured. Meanwhile, glucose and bovine serum albumin (BSA) were incubated with TFBF at different concentrations (0.01 mg?L -1,0.05 mg?L -1,0.10 mg?L -1) respectively for 4,8,12 wk.The fluorescence intensity of glycated BSA was detected by a spectrophotometer BSA was detected spectrophotometer.Results TFBF significantly lowered the level of blood glucose in diabetic rats (P