Effect of Sishenwan on Toll-like Receptor 4 and IRAK-M Expression in Colonic Tissue of Rats with Ulcerative Colitis of Spleen-kidney Yang Deficiency Type / 中国实验方剂学杂志

Objective:To observe the Toll-like receptor 4(TLR4)and its negative regulating factorInterleukin-1 receptor-associated kinase-M(IRAK-M)in colonic mucosa of rats with experimental ulcerative colitis(UC), and to discuss the mechanism of the Chinese medicine Sishenwan. Method:The 90 Wistar rats were randomly divide into six groups, blank group, model group, sulfasalazine group(0.36 g·kg-1), Sishenwan low, medium and high-dose group(2.5, 5, 10 g·kg-1), 15 cases in each group. A rat model of UC was prepared by using a solution of trinitrobenzenesulfonic acid/ethano.The histopathological changes of colon were observed by hematoxylin-eosin (HE) staining. The contents of serum free triiodothyroid acid (FT3), serum free thyroxine (FT4), immunoglobulin (Ig) E and interleukin (IL)-2 were determined by radioimmunoassay. The activity of superoxide dismutase (SOD) in rat serum was determined by xanthine oxidation method. The activity of malondialdehyde (MDA) in serum of rats was determined by thiobarbituric acid (TBA) colorimetry. Result:Compared with blank group, intestinal mucosal injury score of rats in model group was significantly increased (PP3, FT4, IL-2 and SOD were significantly decreased (PPPPPP3, FT4, IL-2, and SOD contents were significantly increased (PPPPPConclusion:The unbalanced expressions of TLR4 and its negative regulating factor IRAK-M are connected with the pathogenesis of UC.Sishenwan can cure UC and control the expression of TLR4 and promote the expression of IRAK-M.

Discussion on the problems and countermeasures of medical education in pediatrics after graduation / 中国实用儿科杂志

clinicians,which play a key role in the process of pediatricians becoming talented. Post-graduation medical education in China has been continuously institutionalized and standardized,and has achieved remarkable progress. However,there are still many problems in the implementation process. The author will carry out in-depth analysis concerning the national policy,base construction,teacher construction and students themselves,propose countermeasures and suggestions for existing problems,and provide ideas for the formation of an efficient and sustainable mechanism for pediatric talent training.

Identification of chemical constituents in Sinopodophylli Fructus by HPLC-DAD-ESI-IT-TOF-MSn / 中国中药杂志

This experiment was performed to analyze and identify the chemical constituents of Sinopodophylli Fructus by HPLC-DAD-ESI-IT-TOF-MSn. The analysis was performed on an Agilent Zorbax SB-C₁₈ (4.6 mm×250 mm, 5 μm) column.The mobile phase consisted of 0.1% formic acid was used for gradient at a flow rate of 1.0 mL·min⁻¹. Electrospray ionization ion trap time-of-flight multistage mass spectrometry was applied for qualitative analysis under positive and negative ion modes. The results indicated that 54 compounds consisted of 18 lignans and 36 flavonoids from Xiaoyelian had been detected by their HRMS data, the information of literature and reference substance. Among them, 27 compounds were reported in Sinopodophylli Fructus for the first time. In conclusion, an HPLC-DAD-ESI-IT-TOF-MSn method was established to qualitative analysis of Xiaoyelian in this study, which will provide the evidence for evaluating the quality of Xiaoyelian herbs, clarifying the mechanism, and guiding the development of pharmacological active ingredients.

N-acetylcysteine for treating women with clomiphene citrate resistant polycystic ovary syndrome: a systematic review / 中国药学杂志

OBJECTIVE: To evaluate the efficacy and safety of N-acetylcysteine (NAC) for treating women with clomiphene cit¬rate (CC) resistant polycystic ovary syndrome (PCOS).

Neonatal group B streptococcus infection in the Children's Hospital of Gansu Province through PCR array / 中华儿科杂志

<p><b>OBJECTIVE</b>To study neonatal Streptococcus agalactiae (GBS) infection in The Children's Hospital of Gansu Province through Polymerase Chain Reaction(PCR) Array.</p><p><b>METHOD</b>After obtaining the informed consent from parents or guardians, blood samples of 286 neonates were collected and studied in The Children's Hospital of Gansu Province from June 2011 to January 2012. DNA of the selected samples was extracted through the method of 5% Chelex-100 + 0.5% NP40 solution. Twenty-five genes were ultimately selected and then 25 pairs of primers were designed respectively through primer-BLAST tool of NCBI database.For every primer, PCR conditions were optimized through the identified GBS, and 25 pairs of primers were arrayed as to be used to study neonatal GBS infection.</p><p><b>RESULT</b>The results of PCR Array showed that the 14 samples were detected positive, accounting for 4.90% of all the selected specimens. As for neonatal GBS infection, the positive rate was 4.55% within 7 days after birth and 5.19% in those older than 7 days. The positive rate of 53 preterm infants was 5.66%. The follow-up survey showed that none of the cases died.</p><p><b>CONCLUSION</b>In the Children's Hospital of Gansu Province neonatal GBS infection rate was 4.90%, which is similar to the previous domestic reports, but is lower than the reports from Europe and the United States.Studies have shown that the gene expression related to immune evasion has a higher frequency. The present study suggests that the strategy of GBS immune adaptation may play an important role in neonatal GBS infection.</p>

Z scores for growth and development, physical fitness, and the relationship between them in 362 preschool children in Yantai City, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the Z scores for growth and development, physical fitness, and the relationship between them in preschool children in Yantai City, China, and to provide scientific evidence for health care in children.</p><p><b>METHODS</b>A total of 362 children aged 3 to 4 years, whose data were recorded in the National Physical Fitness Survey in Yantai in 2010, were included in the study. Z scores for weight-for-age, height-for-age and body mass index-for-age were calculated. The relationship between Z scores and physical fitness was determined by Pearson's correlation analysis.</p><p><b>RESULTS</b>The mean Z scores were all positive numbers. The prevalence rates of underweight and growth retardation were very low, but that of obesity was relatively high (up to 16.5% in 4-year-old boys). There were differences in physical fitness between children of different ages and between boys and girls (P<0.05). The Z scores showed correlation with some physical fitness indices (P<0.05), but they were not closely correlated as the value of r was not more than 0.30.</p><p><b>CONCLUSIONS</b>Z scores for growth and development remain at relatively high levels in preschool children in Yantai. The physical fitness is associated with age and gender in these children. There are weak correlations between Z scores and some physical fitness indices. Effective measures should be taken to adjust dietary habits and promote exercise for children, thus preventing obesity and improving physical fitness.</p>

Research on chemical fingerprint chromatograms of Sinopodophyllum hexandrum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the HPLC fingerprint of Sinopodophylli Fructus, compare the major chemical differences in fruit of Sinopodophyllum hexandrum as well as the roots and rhizomas of S. hexandrum, and provide scientific evidence for clinical application and quality control.</p><p><b>METHOD</b>HPLC fingerprint method was used to analyze 12 fruits of S. hexandrum. A total of 20 common peaks were confirmed, and 12 peaks in the HPLC fingerprint were identified. Furthermore, similarity evaluation method and clustering analysis method were introduced to compare HPLC chromatograms, between fruits and underground parts.</p><p><b>RESULT</b>In this paper, quercetin-3-O-beta-D-glucopyranosid, kaempferol-3-O-beta-D-glucopyranoside, 8-prenylquercetin and 8-prenylquercetin 3-methyl ether were firstly reported in Sinopodophylli Fructus. Among the existing fingerprint research, a total of 11 peaks were identified for the first time, containing 9 flavonoids and 2 lignans. The chemical constituents differed significantly in different medicinal parts of S. hexandrum. Prenylflavonoid compounds were the main constituents of Sinopodophylli Fructus. However, podophyllotoxin, flavonoids with simple substituent groups and flavonoid glycosides were the major ingredients in the roots and rhizomas of S. hexandrum.</p><p><b>CONCLUSION</b>This method can be used for the quality control of Sinopodophylli Fructus and the roots and rhizomas of S. hexandrum. It has provided a reference for the pharmacodynamic differences of the two different parts.</p>

Influencing factors on depression among medical staff in Hunan province under ordinal regression analysis / 中华流行病学杂志

Objective To understand the situation of depression and its related influencing factors among medical staff in Hunan province.Methods Data were collected through random sampling with multi-stage stratified cluster.Wilcoxon rank sum test,Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software.Results This survey was including 16 000 medical personnel with 14 988 valid questionnaires and the effective rate was 93.68％.Results from the single factor analysis showed that factors as:level of the hospital grading,gender,education background,age,occupation,title,departments,the number of continue education,income,working overtime every week,the frequency of night work,the number of patients treated in the emergency room etc.,had statistical significances (P＜0.05).Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR=1.58,95％ CI:1.30-1.92).The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR=2.19,95％CI:2.05-2.35).The higher the numbers of days with working overtime every week,the frequencies of night work,and the numbers of patients being treated at the emergency room,with more probabilities of the people with depression seen in our study.Conclusion Depression seemed to be common among doctors and nurses.We suggested that the government need to increase the monthly income and to reduce the workload and intensity,lessen the overworking time,etc.

Nilotinib treatment for imatinib resistant or intolerant chronic myelogenous leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of nilotinib in chronic myelogenous leukemia (CML) patients with resistance or intolerance to imatinib.</p><p><b>METHODS</b>Thirty-five CML patients after imatinib failure or intolerance received oral administration of 400 mg nilotinib twice daily. The overall survival, hematologic and cytogenetic responses, as well as adverse events were evaluated.</p><p><b>RESULTS</b>The median duration of nilotinib therapy was 11 (1 - 23) months, with a median follow-up of 19 months. Nonhematologic adverse events were mostly of grade 1-2. The most common ones possibly related to nilotinib were increase of bilirubin (76%) and rash (46%). Grade 3-4 hematologic adverse events includes thrombocytopenia (37%), neutropenia (26%) and anemia (26%). Nilotinib was proved to be well-tolerated in this study. Grade 3-4 hematologic adverse events happened more frequently in advanced phase CML. The rate of major cytogenetic response in chronic phase (CP) CML was much higher than those in advanced CML (38.5% vs 22.2%). The median time to major cytogenetic response was 3 months. The estimated overall survival at 18 months was (93.5 +/- 1.0)%.</p><p><b>CONCLUSION</b>Nilotinib is a more effective and safe treatment option for imatinib-resistant or -intolerant CML-CP patients.</p>

Efficacy and safety of imatinib in treatment of 151 chronic myeloid leukemia patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of imatinib in treatment of chronic myeloid leukemia (CML) patients.</p><p><b>METHODS</b>From December 2003 to March 2007, 151 patients entered Glivec International Patient Assistance Program (GIPAP) in our center and received imatinib therapy. The overall and progression free survival, hematologic, cytogenetic and molecular response, and adverse events were evaluated. The factors associated with outcome of imatinib therapy were also analysed.</p><p><b>RESULTS</b>One hundred and forty-two patients were evaluable with a median follow-up duration of 21.5 (6 -78) months. (1) The rate of cumulative complete hematologic response (CHR), major cytogenetic response (MCyR), complete cytogenetic response (CCyR) and complete molecular response (CMoR) in chronic phase (CP) CML patients were 96.9%, 82.6%, 76.1% and 29.4%, respectively. These rates were significantly higher in patients with CP than in those with accelerated phase (AP) and blast crisis (BC) (P < 0.0001). (2) The overall survival (OS) rates at 1, 2 and 3 year were 100%, (97.3 +/- 1.9)% and (95.8 +/- 2.4)% for CP patients, they were (84.7 +/- 8.2)%, (77.0 +/- 10.4)% and (69.3 +/- 11.9)% for AP patients, and (62.9 +/- 8.9)%, (41.9 +/- 9.2)% and (28.5 +/- 9.1)% for BC patients, respectively (P < 0.0001). The progression-free survival (PFS) rates at 1, 2 and 3 year were (98.9 +/- 1.1)%, (93.9 +/- 2.7)%, (93.9 +/- 2.7)% for CP patients, (68.9 +/- 10.6)%, (61.3 +/- 11.9)%, (61.3 +/- 11.9)% for AP patients, (36.4 +/- 8.8)%, (25.4 +/- 8.1)%, (10.1 +/- 8.2)% (P < 0.0001) for BC patients respectively. (3) Among 92 CP patients, the rates of MCyR and CCyR in newly diagnosed patients were significantly higher than those in interferon therapy failure patients (P = 0.015, P = 0.010). Patients obtained CCyR at 12 months after the initiation of imatinib treatment were associated with longer PFS (P = 0.0099). According to the Sokal scoring system, the rates of MCyR and CCyR in low-risk patients were significantly higher than those in intermediate-risk and high-risk patients (P = 0.0013, P = 0.0024). Sokal score was also significantly associated with disease progression (P = 0.0467). (4) The adverse events of imatinib were moderate and tolerable.</p><p><b>CONCLUSIONS</b>Treatment of CML patients in CP with imatinib can induce high hematologic, cytogenetic and molecular response and overall survival, but can not do satisfactorily for patients in AP and BC.</p>

Prenatal diagnosis of X-linked adrenoleukodystrophy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To make prenatal dignosis of X-linked adrenoleukodystrophy (ALD) for the prevention of the disease.</p><p><b>METHODS</b>Eighteen amniocenteses were performed on 17 suspected carriers of X-ALD during 18-30 gestation weeks. The very long chain fatty acids (VLCFAs) levels of cultured amniocytes were tested by gas chromatography-mass spectrometry (GC/MS). The plasma VLCFAs levels were measured in 8 of the 18 prenatal diagnosed children when they were born or after abortion. ABCD1 gene mutation analysis was carried out in 8 cases by PCR and sequencing. ALDP of amniocytes was tested by Western blotting in 2 cases from a family, one female, another male, and the VLCFAs of cultured amniocytes were increased in both of them.</p><p><b>RESULTS</b>Among the 18 fetuses, 10 were males and 8 were females. The VLCFAs levels of the cultured amniocytes were increased in 3 males and 4 females. The postnatal plasma VLCFAs were normal in 5 cases with normal VLCFAs levels of amniocytes, and increased in 3 cases with high VLCFAs levels of amniocytes. ABCD1 gene mutations were found in 4 cases with high VLCFAs levels of amniocytes, no mutation was found in other 4 cases with normal VLCFAs levels of amniocytes. ALDP of amniocytes could be detected in the female with high VLCFAs levels of amniocytes, and it could not be detected in the male with high VLCFAs levels of amniocytes. Three male fetuses with high VLCFAs levels of amniocytes were aborted. The others who were born were normal clinically so far.</p><p><b>CONCLUSION</b>The prenatal diagnosis is very important for the prevention of ALD. Amniocyte VLCFAs level analysis combined with ABCD1 gene mutation analysis and ALDP test could make a proper prenatal diagnosis.</p>

EEG, CT and MRI findings in hepatic encephalopathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To describe the clinical manifestation and the EEG, CT and MRI findings of hepatic encephalopathy (HE).</p><p><b>METHODS</b>The clinical manifestations and the plasma ammonia levels were analyzed in 17 patients with HE, who underwent EEG, CT and MRI examinations.</p><p><b>RESULTS</b>Fifteen patients had abnormal EEG findings characterized by lowered basic rhythm, moderate to high amplitude theta wave activity, and sporadic delta wave and triphasic wave. Fourteen patients had abnormal MRI findings, including increased signal in the bilateral globus pallidus (14/17), putmen(4/17) and tegmentum of the midbrain (7/17) in T1WI without corresponding alterations in the signal intensity in T2WI. T2 FLAIR demonstrated increased signal in the bilateral white matter of the cerebral hemispheres. CT identified no corresponding alterations in the signal intensity.</p><p><b>CONCLUSION</b>Abnormal EEG findings or MR signals in the brain are common in patients with HE. EEG allows detection of abnormal waves, and MRI may help identify such lesions, which all help in the diagnosis of HE.</p>

Clinical features and genotype-phenotype studies of 89 Chinese patients with X-linked adrenoleukodystrophy / 中华儿科杂志

<p><b>OBJECTIVE</b>X-linked adrenoleukodystrophy (X-ALD) is the most common inherited disorder of peroxisomal metabolism which is characterized by demyelination of central nervous system, impaired adrenal cortex and abnormal accumulation of very long chain fatty acids in body fluid and tissues. In this study, the clinical features and the genotype-phenotype relationship were investigated so as to help early diagnosis.</p><p><b>METHODS</b>Clinical data of 89 Chinese patients with X-ALD were analyzed and mutation spectrums in 53 of the patients were investigated by polymerase chain reaction and DNA sequencing.</p><p><b>RESULTS</b>Of the 89 cases, 60 (67.4%) had childhood cerebral ALD (CCALD, mean age of onset was 6.5 years, range 2 - 10 years), 18 (20.2%) had adolescent cerebral ALD (ACALD, mean age of onset 12.1 years, range 11 - 19 years), 7 (7.9%) had adrenomyeloneuropathy (AMN, mean age of onset 23 years, range 6 - 39.5 years), and two cases were asymptomatic and another 2 had simple Addison's disease only. CCALD was the most common and severe phenotype, visual impairment was the most common initial symptom in CCALD and ACALD patients. Twenty four cases (63%) in whom hydrocortisone and ACTH were measured showed adrenal insufficiency. Forty five different mutations were identified in 53 patients. Missense mutations were the most common. No hotspot mutation was found in these patients and 1415delAG, the most frequent mutation found worldwide seemed not to be the real "hotspot" in these Chinese patients. The same phenotype may be due to diverse genomic mutations. A single mutation may result in different phenotypes even within a family.</p><p><b>CONCLUSION</b>The phenotype distribution, initial symptom and gene mutation spectrum of Chinese patients may not be completely consistent with those in other countries. The clinical phenotype of the disease had no definite relationship with the nature of gene mutations.</p>

Screening for carrier and prenatal diagnosis of X-linked adrenoleukodystrophy / 中华儿科杂志

<p><b>OBJECTIVE</b>X-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder characterized by progressive demyelination of the central nervous system, adrenal cortex insufficiency and accumulation of saturated very long chain fatty acids (VLCFAs) in tissues and body fluids due to the impaired beta-oxidation in peroxisomes. X-ALD shows a wide range of phenotypic variation. Childhood cerebral form (CCER) is the most common phenotype with severe neurological symptoms and often the average interval from onset to total disability or death is 3 years. So far no effective treatment is available for the underlying defect. Screening for carriers of mutated relevant gene and prenatal diagnosis are very important for the prevention of the disease. In this study, the authors explored the method of carrier screening and prenatal diagnosis of X-ALD.</p><p><b>METHODS</b>The plasma VLCFAs levels of 83 suspected carriers for ALD were determined by using GC/MS and ABCD1 gene mutational analysis was performed in 31 of them. Amniocentesis was performed in 9 suspected carriers for ALD during 18 - 30 gestational weeks. The VLCFAs level of cultured amniocytes was tested with GC/MS. ABCD1 gene mutational analysis was performed on two cases (one was a male and the other a female) whose VLCFAs levels of amniocytes were found elevated. The plasma VLCFAs levels were measured in five of the nine prenatally diagnosed children when they were 1 day to 3.5 years old.</p><p><b>RESULTS</b>Fifty-one of 83 suspected carriers had high plasma VLCFAs levels; 29 of 31 suspected carriers showed ABCD1 gene mutation. Among the nine fetuses, four were males and five were females. The VLCFAs levels of the cultured amniocytes were high in two cases, one was female and the other a male. ABCD1 gene mutational analysis of these two cases showed a 871G > A (E291K) mutation and a 726G > A (W242X) mutation, respectively, which confirmed the biochemical result. The VLCFAs levels were normal in the rest of cases and five of them were confirmed by postnatal plasma VLCFAs assay.</p><p><b>CONCLUSION</b>The carrier screening and prenatal diagnosis are very important for prevention of the X-ALD. Only the combined use of plasma VLCFAs level analysis and ABCD1 gene mutational analysis could detect X-ALD carriers correctly. ABCD1 gene mutational analysis and postnatal plasma VLCFAs level test verified that amniocytes VLCFAs level analysis is a reliable prenatal diagnostic method for this disease.</p>

Clinical observation of the short-term efficacy of the treatment with combination of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) in newly diagnosed acute promyelocytic leukemia (APL) / 中华血液学杂志

<p><b>OBJECTIVE</b>To study whether all-trans retinoic acid (ATRA) combined with arsenic trioxide (As(2)O(3)) in acute promyelocytic leukemia (APL) treatment could further improve the clinical and molecular remission rate.</p><p><b>METHOD</b>Thirty one newly-diagnosed APL patients of whom 15 were males, 16 females and median age 35.4 years entered into the study. They were treated with ATRA 25 mg x m(-2) x d(-1) combined with As(2)O(3) 0.16 mg x kg(-1) x d(-1) until complete remission (CR). The doses were adjusted according to white blood cell (WBC) counts, occurrence of RA syndrome and the status of liver function. CR rate, time of reaching clinical and molecular remission and side effects were observed.</p><p><b>RESULT</b>Two patients died 2 approximately 3 days after the treatment due to intracranial hemorrhage, and 29 (93.5%) achieved CR. The average time for achieving CR was 25.1 +/- 3.9 days. Hyperleukocytosis emerged in 66.5% and hepatic damages in 65.5% of the patients, they were ameliorated within one week after reduction of the As(2)O(3) dose or its suspension. The PML/RAR alpha fusion gene that was positive in all 29 patients before treatment turned negative only in 3 cases (10.3%) after obtaining CR (CR1) and in 10/13 cases (77%) after consolidation treatment. Up to now (1-8 months follow-up), all 29 patients remain in CR1.</p><p><b>CONCLUSION</b>ATRA combined with As(2)O(3) in de novo APL treatment can yield a high CR rate without intolerable side effects. Long term effect needs further observation.</p>

Analysis of HBV precore 1896 site mutation and its HBV genotype and other laboratory features / 第二军医大学学报

Objective:To analyze the relationship between hepatitis B virus(HBV)gene mutation at 1896 in precore region with genotype and replication of HBV and the liver function of patients.Methods:HBV precore 1896 site mutation,the genotype of HBV and serum content of HBV DNA were determined by PCR in 60 patients positive of HBV DNA.Chemiluminescence miacropaticle immunoassay(CMIA)was used for detection of serum HBeAg and HBeAb.Liver function parameters were ob- tained by routine biochemistry method.Results:The alanine aminotransferase(ALT)level in HBV with 1896 site mutation was significantly higher than that in the wildtype virus.Site mutation at 1896 had no correlation with HBeAg,HBV genotype and HBV DNA content.HBV DNA content in patient with genotype C was significantly higher than that with genotype B(P

Effect of Sodium Valproate on Weight,Body Mass Index,Serum Glucose,Serum Insulin in Children with Epilepsy / 实用儿科临床杂志

Objective To explore the changes of weight,body mass index(MBI),serum glucose,serum insulin in sodium valproate(VPA)-treated children with epilepsy.Methods The study was carried out in 30 epileptic children treated with VPA for 3 months.Weight,height,serum glucose and insulin levels were conducted before and after VPA treatment.Serum insulin levels were detected by radioimmunoassay.Results After 3 months' treatment,body weight [(15.68?3.82)kg vs(19.64?4.75)kg,t=3.56 P0.05].Conclusions VPA therapy can make insuline weight,BMI,serum insulin increased and may lead to insulin resistance.Insulin resistance may be one of the reasons for weight gain in VPA-treated patients.