Correlation of the Desialylation of Platelets with Efficacy of the First-line Therapy for ITP / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect desialylation of platelets in primary immune thrombocytopenia(ITP) patients with FITC-labelled ECL and RCA-1, and compare the correlation of the desialylation level and the efficacy of first-line therapy for ITP.</p><p><b>METHODS</b>Before treatment, 48 ITP patients were selected and their levels of ECL and RCA-1 were detected with flow cytometry.</p><p><b>RESULTS</b>The desialylation level in the different efficacy groups by using the first-line therapy of corticosteroids and (or) intravenous immunoglobulin G (IVIG) had a statistically significant difference (P<0.05). The correlation analysis showed negative relation of the therapeutic efficacy with desialylation level, that is to say, the more high of desialylation level, the more poor therapeutic efficacy of the first-line therapy.</p><p><b>CONCLUSION</b>The desialylation level of platelets in ITP patients is related with the first-line therapeutic efficacy, the efficacy for patients with high desialylation level is poor, suggesting that the FcR-independent pathway exists in clearance of platelets in ITP patients. Therefore, the desialylation level of platelets may suggest the first-line therapeutic efficacy for ITP patients to a certain degree, and may be used as a potential target for the treatment of refractory ITP.</p>

Effect of extracts from Panax ginseng, Panax notoginseng, and Ligusticum chuanxiong on vascular smooth muscle cells of aging and hypertension rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe and compare the effects of aging and hypertension on rats' aortic vascular smooth muscle cells (VSMCs) and the effects of the extracts from Panax ginseng, Panax notoginseng and Ligusticum chuanxiong.</p><p><b>METHODS</b>The rat aortic VSMCs model was established using the method of primary cell culture. Of them, the rats of the aging experiment were divided into 5 groups, i.e., the young control group (as Yon), the old group (as Old), the old + probucol group (as Old+Pro), the old +low dose extracts group (as Old+Pro), and the old+high dose extracts group (as Old+High). The rats of the hypertension experiment were divided into 5 groups, i.e., the Wistar-Kyoto control group (as WKY), the spontaneously hypertensive rat group (as SHR), the SHR +Valsartan group (as SHR+Val), the SHR+low dose extracts group (as SHR+Low), and the SHR+high dose extracts group (SHR+High). The proliferation of VSMCs was detected using MTT. The expression of MMP-9 was detected by immunocytochemical assay. The mRNA and protein expressions of peroxisome proliferator activated receptor-gamma (PPAR-gamma) were detected using RT-PCR and Western blot respectively.</p><p><b>RESULTS</b>Compared with the Yon group, the proliferation of VSMCs and the MMP-9 expression increased, the mRNA and protein expressions of PPAR-gamma decreased in the Old group, all showing statistical difference (P < 0.05). Compared with the Old group, the proliferation of VSMCs and the MMP-9 expression obviously decreased, the mRNA expression of PPAR-gamma obviously increased in the Old+Pro group, the Old+High group, and the Old+Low group (all P < 0.05). The PPAR-y protein expression obviously increased in the Old+Pro group and the Old+Low group (P < 0.05). Compared with the WKY group, the proliferation of VSMCs and the expression of MMP-9 obviously increased, the mRNA and protein expressions of PPAR-gamma obviously decreased in the SHR group (all P < 0.05). Compared with the SHR group, the proliferation of VSMCs and the expression of MMP-9 obviously decreased, the mRNA and protein expressions of PPAR-gamma obviously increased in the SHR+Val group, the SHR+High group, and the SHR + Low group (all P < 0.05).</p><p><b>CONCLUSIONS</b>Both aging and hypertension could result in excessive proliferation of rat aortic VSMCs and the expression changes of correlated cytoactive factors. The extracts from Panax ginseng, Panax notoginseng (Burk.) and Ligusticum chuanxiong can lower their proliferation levels and reduce the expressions of negative cytokines, thus reducing aging and hypertension induced injury of VSMCs and delaying angiocellular aging.</p>

Comparative study on Chinese medical syndrome typing and treatment combined different surgical methods for treating clomiphene-resistant polycystic ovary syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic efficacy of Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique under laparoscope for treating clomiphene-resistant polycystic ovary syndrome (PCOS).</p><p><b>METHODS</b>Forty infertility patients with clomiphene-resistant PCOS were assigned to two groups using stratified random sampling method according to age, infertility time, and body mass index, 20 in each group. Patients in Group A were treated with Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation, while those in Group B were treated with Chinese medical syndrome typing and treatment combined unipolar electrocoagulation drilling technique. After operation Chinese herbal treatment was administered to all patients according to syndrome typing. The serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), androgen (T), estradiol (E2), and prolactin (PRL) were determined before and after operation. The ovulation was monitored. The pregnancy rate and the pregnancy outcomes were recorded after operation.</p><p><b>RESULTS</b>There was no statistical difference in the 3-month spontaneous ovulation rate or the 1-year pregnancy rate (P > 0.05). The levels of LH, T, and PRL were significantly lower after operation than before operation in the two groups (P < 0.05). The menstruation and ovulation were obviously improved after operation. The total ovulation rate was 95% (19/20) in Group A. Successful pregnancy occurred in 15 cases of Group A. Ovarian hyperstimulation syndrome (OHSS) occurred in 1 case of Group A. The total ovulation rate was 90% (18/20) in Group B. Successful pregnancy occurred in 13 cases of Group B. Hypovaria occurred in 1 case of Group B. Luteinized unruptured follicle (LUFS) occurred in 2 cases of Group A and 1 case of Group B.</p><p><b>CONCLUSIONS</b>Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique could effectively promote the ovulation. The two methods showed similar therapeutic effects.</p>

Etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Appropriate antimicrobial therapy of community-acquired pneumonia (CAP) is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China.</p><p><b>METHODS</b>Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution.</p><p><b>RESULTS</b>A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae (79/242, 32.6%) was the most frequently isolated pathogen, followed by Haemophilus influenzae (55/242, 22.7%) and Klebsiella pneumoniae (25/242, 10.3%). Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 (38.9%) and 60 (11.4%) patients respectively. Legionella pneumophila infections were identified in 4.0% (13/324) of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% (6/533).</p><p><b>CONCLUSIONS</b>The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.</p>

Effect of extracts from Radix Ginseng, Radix Notoginseng and Rhizoma Chuanxiong on delaying aging of vascular smooth muscle cells in aged rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of extracts from Radix Ginseng, Radix Notoginseng and Rhizoma Chuanxiong (EXT) on delaying vascular smooth muscle cells (VSMCs) aging in aged rats.</p><p><b>METHODS</b>VSMCs were obtained by the modified tissue explants technique and were shown to be positive for smooth muscle α-actin (SM-α-actin) by immunohistochemistry staining. VSMCs obtained from the young rats were served as the young control group; VSMCs obtained from the old rats were treated with no drug (the old group), with low dose extracts (20 mg/L, the EXT low-concentration group) and high dose extracts (40 mg/L, the EXT high concentration group), and with Probucal (10(-6) mol/L, the Probucal group) as a positive control. All groups were cultured for 24 h in the medium with 10% serum for 24 h followed by another 24 h in the serum-free medium. At the end of the 48-h culture, the following analyses were performed including determination of senescence-associated β-galactosidase (SAβ-Gal) activity, flow cytometry analysis of cell cycle, real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) analyses of p16, Cyclin D1, cyclin-dependent kinase 4 (CDK4) and retinoblastoma (Rb) mRNA expression, and Western blotting analyses of p16, cyclin D1, CDK4 and phosphoretinoblastoma (pRb) protein expressions.</p><p><b>RESULTS</b>(1) In comparison to the younger rats, VSMCs from aged rats had significantly more SAβ-Gal positive cells (P<0.01) and more cells in S phase (P<0.05). VSMCs from the all treated groups showed a significant decrease in both SAβ-Gal positive cells (P<0.05) and S phase (P<0.05) compared to the old rats. (2) Compared with the young group, VSMCs in the old group had a significant decrease in p16 and Rb mRNA expression and a significant increase in Cyclin D1 and CDK4 mRNA expression. Compared with the old group, VSMCs in the treated groups had a significant increase in p16 and Rb mRNA expression and a significant decrease in Cyclin D1 and CDK4 mRNA expression (P<0.05). (3) Compared with the young group, VSMCs in the old group had a significant decrease in p16 protein expression and a significant increase in Cyclin D1, CDK4 and pRb protein expressions (P<0.05). Compared with the old group, VSMCs in the treated groups had a significant increase in p16 protein expression and a significant decrease in cyclinD1, CDK4 and pRb protein expressions (P<0.05).</p><p><b>CONCLUSIONS</b>VSMCs obtained from old rats showed typical signs of cellular senescence and vascular aging. EXT had an effect on delaying senescence of VSMCs in vitro by altering the p16-cyclinD/CDK-Rb pathway.</p>

Clinical study on effect of qingxuan tiaoya recipe in treating menopausal women with hypertension / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect and mechanism of Qingxuan Tiaoya Recipe (QXTYR) on depressing blood pressure in menopausal women with hypertension.</p><p><b>METHODS</b>Patients were randomly assigned to two groups, the 44 patients in the test group were administered with perindopril tablet and QXTYR granule, while the 43 in the control group were administered with the same program, but a simulator of QXTYR was used to replace for the real one. The treatment course for them all was 2 months. Before and after treatment, the ambulatory blood pressure (ABMP), heart rate, related clinical symptoms, blood lipids, serum estradiol (E2), high-sensitivity C-reactive protein ( Hs-CRP), homocysteine (HCY) and angiotensin II (Ang II) were measured.</p><p><b>RESULTS</b>The treatment in the test group showed an effect better than that in the control group in terms of reducing blood pressure variability and night-time blood pressure decrease rate (P <0.05), with the total effective rate and markedly effective rate in lowering blood pressure superior to the control group (P<0.05), alleviating symptoms as headache, soreness and weakness of the waist and knees, and insomnia (P <0.05), and decreasing levels of heart rate, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), Hs-CRP and Ang II (P <0.05), The plasma level of endogenous E2 was elevated after treatment in the test group (P< 0.05), but showed no statistical difference in the control group.</p><p><b>CONCLUSIONS</b>QXTYR shows favorable effect in depressing blood pressure of menopausal women with hypertension, it can reduce blood pressure variability, improve the symptoms of the menopause syndrome, blood lipid metabolism and plasma levels of Hs-CRP, E2, and Ang II in patients, suggesting that its mechanism may be related to the functional regulation of sympathetic-vagus nerve and neuro-endocrine-immune system, and also the inhibition on the circulatory renin-angiotensin-aldosterone system activity.</p>

Effects of modified longdan xiegan decoction on hyperandrogenism in patients with polycystic ovary syndrome of stagnant fire in Gan channel type / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of modified Longdan Xiegan Decoction (LXD) on hyperandrogenism in patients with polycystic ovary syndrome (POS) of stagnant fire in Gan channel type.</p><p><b>METHODS</b>Forty-eight patients were divided into two groups: the LXD group (25 cases) treated with LXI) for 3 months, and the Diane-35 group (23 cases) with Diane-35. Condition of menstruation, acne, hairiness were observed, basal body temperature (BBT) was measured, and the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), free testosterone (FT), and androstenedione (A) were detected before and after 3 months' treatment. Meanwhile, adverse reaction was observed.</p><p><b>RESULTS</b>After treatment, the condition of menstrual disorder, acne and single-phase BBT were improved significantly, and serum levels of LH, LH/FSH, FT and A decreased in both groups (P < 0.05), showed insignificant difference between them (P > 0.05). The PRL level dropped in the LXD group (P < 0.05), which significantly lower than that in the Diane-35 group (P < 0.05). There were 3 cases with adverse reaction of irregular colporrhagia and 5 cases with nausea and vomiting in the Diane-35 group, while no adverse reaction in the LXD group occurred.</p><p><b>CONCLUSION</b>Modified LXD could significantly improve the condition in hyperandrogenism patients with POS of stagnant fire in Gan channel type.</p>

Role of area postrema of medulla in regulation of rat cardiovascular activity / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To explore the role of area postrema (AP) of medulla in control of cardiovascular functions in rat.</p><p><b>METHODS</b>(1) Sprague Dawley rats were anaesthetized with urethane and pentobarbital and the AP was stimulated by electrical stimulus with intensity of 0.1 mA and frequencies ranged 10 approximate, equals 80 Hz. (2) Excitatory amino acid L-glutamate (L- Glu, 0.1 approximate, equals 0.5 mol/L) was microinjected into AP in urethane anaesthetized rats and the changes of mean arterial pressure (MAP) and heart rate (HR) were recorded.</p><p><b>RESULT</b>(1) When the frequencies of 10 Hz, 20 Hz and 40 Hz were used, the electrical stimulation of AP caused decrease of MAP and HR (P<0.001),while the electrical stimulation with the frequencies of 60 Hz and 80 Hz caused an increase of MAP (P<0.05) but a decrease of HR (P<0.001). (2) Microinjection of L-Glu at 0.1 mol/L had no effect on MAP and HR (P>0.05), but it decreased MAP and HR at 0.15 mol/L (P<0.001, P<0.05). The MAP was increased (P<0.001) but HR (P<0.05) was decreased at the concentrations of 0.2 mol/L and 0.5 mol/L, respectively.</p><p><b>CONCLUSION</b>Alterations of MAP and HR induced by electrical or chemical stimulation on AP of medulla are related to the frequency of electrical stimulation or concentration of L-Glu.</p>