Thoughts on path of R&D and registration of innovative traditional Chinese medicine with synchronous transformation of "series prescriptions" / 中国中药杂志

Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of " one prescription for single drug". This model refers to the R&D and registration system of modern drugs, and approximates to the " law-abiding" medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to " establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research". Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of " one prescription for single drug" in the research and development of Chinese medicine. Additionally, a new type of " series prescriptions" was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.

Progress of research on disease-modifying osteoarthritis drugs / 中国药科大学学报

@#Osteoarthritis (OA) is a common chronic joint disease,whose main pathological changes are the degeneration of articular cartilage and secondary bone hyperplasia.The limitation of current treatment methods including pain relief and joint replacement surgery is that they cannot fundamentally improve the damage of articular cartilage.The emergence of disease-modifying osteoarthritis drugs (DMOAD) may break the above limitations.They fundamentally inhibit the structural degeneration of articular cartilage by participating in the regulation of cartilage metabolic balance, regulation of subchondral bone remodeling,and control of local inflammation.Thereby,OA patients will get symptom improvement including pain relief and joint function restoration,delay the artificial joint replacement surgery, and improve the quality of life. There are still no DMOAD drugs widely available on the market worldwide.This paper reviews the background of R&D,the classification of mechanisms of action and research progress of representative drugs under different inechanisms so as to provide reference for future research.

Simultaneous determination of macaenes and macamides in maca using an HPLC method and analysis using a chemometric method (HCA) to distinguish maca origin

ABSTRACT Macamides and Macaenes are the bioactive marker compounds in maca (Lepidium meyenii Walp., Brassicaceae) tuber. To simultaneously quantify these two types of compound, HPLC method was studied. To distinguish and group the growing regions of different maca samples, Hierarchical cluster analysis, a chemometric method, was applied to analyze the HPLC data. The calibration curves obtained using the HPLC method showed satisfactory linearity with determination coefficients >0.9998. The precision and repeatability relative standard deviation values were <4%, and the accuracy relative standard deviation value was <5%. The limits of detection was <0.1 µg/ml and the limit of quantification was <0.3 µg/ml. Our HPLC method was successfully used for the separation and determination of macamides and macaenes in Maca within 45 min, i.e., two macaenes (9-oxo-10E,12Z-octadecadienoic acid and 9-oxo-10E,12E-octadecadienoic acid) and five macamides (N-benzyl-9-oxo-10E,12Z-octadecadienamide, N-benzyl-9-oxo-10E,12E-octadecadienamide, N-benzyl-9Z,12Z,15Z-octadecatrienamide, N-benzyl-9Z,12Z-octadecadienamide and N-benzyl-hexadecanamide). The HPLC method was applied to analyze and quantify the seven compounds in thirty maca samples with different colors and origins. The origins of all the maca samples were distinguished and grouped using hierarchical cluster analysis of the HPLC data. Accordingly, the metabolism of macaenes and macamides in maca post-harvest processing has also been proposed. The HPLC method is efficient to simultaneously quantify the macamides and macaenes in maca. Analyzing the HPLC data using hierarchical cluster analysis can distinguish maca growing origins.

A randomized controlled study of erlotinib versus pemetrexed combined with cisplatin in neoadjuvant therapy of stage ⅢA EGFR-mutant lung adenocarcinoma / 中华肿瘤杂志

Objective@#To evaluate the feasibility, efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for neoadjuvant therapy.@*Methods@#Eighty-six patients with stage ⅢA EGFR-mutant lung adenocarcinoma were assigned to 2 groups (n=43 in each group) according to the random number table method: neoadjuvant targeted therapy group (single oral dose of erlotinib 150 mg per day, for 9 weeks) and neoadjuvant chemotherapy group (2 cycles of pemetrexed combined with cisplatin chemotherapy followed by 3- week discontinuation). Surgical treatment was underwent after imaging efficacy evaluation.@*Results@#In neoadjuvant targeted therapy group, 4 achieved complete response (CR), 25 achieved partial response (PR), giving an objective response rate (ORR) of 67.4%. In pathological response, 8 patients had grade Ⅰ, 20 patients had grade Ⅱ, giving a pathological response rate of 65.1%. The most frequent adverse events (AEs) were rash and diarrhea. In neoadjuvant chemotherapy group, 2 had CR and 17 had PR, giving an ORR of 44.2%. In pathological response, 3 patients had grade Ⅰ, 15 patients had grade Ⅱ, giving a pathological response rate of 41.9%. The main AEs were hematologic toxic effects. The ORR, histological efficacy and hematologic toxicity showed statistical significance between the two groups (P<0.05). The neoadjuvant targeted therapy group had 90.7% resection rate, (299.8±23.4) ml of hemorrhage volume during operation, (5.2±0.4) days of extubation time and 9.3% postoperative complication rate. Corresponding results were 83.7%, (308.9±22.7) ml, (5.4±0.6) days and 11.6% in neoadjuvant chemotherapy group, which showed no statistical significance (P>0.05).@*Conclusions@#Neoadjuvant targeted treatment for stage ⅢA lung adenocarcinoma harboring EGFR mutations. The regimen could be considered as a choice of neoadjuvant treatment for patients with stage ⅢA EGFR-mutant lung adenocarcinoma.

An Experimental Study Observing the Transient Expansion of Right Heart During Contrast-enhanced Echocardiography Post Bolus Injection of SonoVueTM / 中国循环杂志

Objectives: To observe the phenomenon of transient expansion of right heart during contrast-enhanced ultrasound (CEUS) by SonoVue?ultrasound contrast agent (UCA) in Chinese experimental mini-pig , and to explore the possible causes of this phenomenon. Methods: 24 healthy Chinese experimental mini-pigs were randomly divided into 3 groups according to the dose of injected contrast agent: 2 ml group (n=8), 1 ml group (n=8) and 0.5 ml group (n=8). Cardiac structure and function at baseline and during contrast procedure were determined by contrast-enhanced echocardiography. Pigs in each group received bolus contrast agent injection followed by 5ml saline flush with baseline concentration, 2, 4 and 6-fold serial dilutions, respectively. When the right heart enlargement appeared, stop the injection and next injection followed after the right heart returned its original size. The study protocols discontinued at the time when the right heart enlargement did not appear post injection. Results: In 2 ml group, the number of right heart enlargement with different injection concentrations was 7, 6, 4, 3, respectively; in 1 ml group, the number of right heart enlargement with different injection concentrations was 6, 5, 3, 1; in 0.5 ml group, the number of right heart enlargement with different injection concentrations was 5, 5, 2, and 0, respectively. Incidence of right heart enlargement decreased in proportion with lower contrast agent amount, and lower contrast concentration(P<0.001). The right heart enlargement phenomenon occurred at about (26±15) s after the injection and lasted for about (47±21) s. Conclusions:Transient expansion of right heart phenomenon is common by bolus injection of contrast agent during CEUS in the Chinese mini-pigs, which may be related to the injected concentration and dosage of the contrast agent, as well as the injection mode and animal species.

Mitochondria associated endoplasmic reticulum membranes in cisplatin induced ovarian cancer cell apoptosis / 中国病理生理杂志

AIM: To explore the structural change of mitochondria associated endoplasmic reticulum mem -branes(MAMs)in SKOV3 cells exposed to cisplatin.METHODS:The SKOV3 cells were treated with cisplatin at con-centration of 6 mg/L.The protein levels of active caspase-3,as well as the colocalization of B-cell receptor-associated pro-tein 31(BAP31)and voltage-dependent anion channel protein 1(VDAC1)in the SKOV3 cells were determined by the method of indirect immunofluorescence.The apoptotic rate of the SKOV3 cells was analyzed by flow cytometry.The struc-tural change of MAMs was observed under transmission electron microscope.RESULTS:Under the confocal microscope, we found that cisplatin increased the protein levels of active caspase-3 as well as colocalization of BAP31 and VDAC1 in the SKOV3 cells.The results of flow cytometry demonstrated that cisplatin increased the apoptotic rate of the SKOV 3 cells (P<0.05).The results of transmission electron microscopy showed that cisplatin induced increase in mitochondrial -asso-ciated membrane structures(P<0.05).CONCLUSION:Cisplatin induces SKOV3 cell apoptosis with increased MAMs contacts.MAMs may play a role in cisplatin induced SKOV3 cell apoptosis.

Dynamic changes of 2.8 mm clear corneal incisions architecture with different angles and comparison of safety / 中华实验眼科杂志

Background In recent years,the relationship between transparent corneal incision and endophthalmitis is attracting more and more attention.Transparent corneal incision configuration become a research hotspot.Objective This study was to analyze dynamic architectural changes of 2.8 mm clear corneal incisions with different angles using anterior segment optical coherence tomography (AS-OCT) and safety.Methods A retrospective cases-control study was performed.Seventy-three eyes of 63 patients who received phacoemulsification combined with implantation of intraocular lens (IOL) were included in Ordos Central Hospital from January to October 2015.The patients were divided into incision ≤ 45° group and incision ＞45° group according to the angle of incision revealed by OCT.Thirty-eight eyes of 32 patients was in incision≤45° group and 35 eyes of 31 patients was in incision ＞ 45° group.Corneal incision quality was analyzed preoperative 1 day and postoperative 1 day,1 week and 1 month by AS-OCT.The corneal thickness at the incision,the length of the healed incision,the opening of the outer incision and inner incision and the detachment of the posterior elastic layer were observed.Written informed concent was obtained from each patient before surgery.Results The mean angle of the incisions in the incision ≤45 ° group was 31.6°-±5.4°,and that in the incision＞45° group was 54.3°±5.5°.The corneal thickness in the incision ≤45° group was significantly thicker than that in the incision＞45° group at postoperative 1 day and 1 week (t=5.96,P=0.00;t =4.69,P=0.00).The ratio of incision length without coaptation was higher in the incision ≤45° group than that in the incision＞45 ° group at postoperative 1 day,1 week and 1 month,respectively (Z =-5.14,P =0.00;Z =-5.46,P =0.00;Z =-3.52,P =0.00).The incidence of endothelial gaping was significantly lower in the incision ≤ 45° group than that in the incision＞45° group at 1 day,1 week and 1 month after surgery (x2 =6.88,P=0.01;x2 =14.87,P=0.00;x2 =9.07,P=0.00).The closure rates of outside incision were 100％ in both two groups.There were no statistically significant differences in Descemet detachment at 1 day,1 week and 1 month after surgery between two groups (x2 =0.15,P =0.70;x2 =1.29,P =0.36;x2 =0.02,P =0.89).Lip recession and contracture were observed in 3 eyes in the incision group.Conclusions At the early stage after phacoemulsification,when the intraocular pressure is changing constantly,small angle clear corneal incision appears to be a good closure and therefore is safer.

Gene silencing of indoleamine 2,3-dioxygenase 2 influences proliferation,migration and invasion of B16-BL6 melanoma cells / 中国病理生理杂志

AIM:To investigate the effects of indoleamine 2,3-dioxygenase 2 (IDO2) silencing on proliferation,migration and invasion of B16-BL6 melanoma cells.METHODS:IDO2-siRNA was transfected into the B16-BL6 melanoma cells in vitro.The expression of IDO2 or IDOl at mRNA and protein levels was detected by real-time PCR and Western blot.Colony formation assay was performed to analyze the proliferation of IDO2-silencing tumor cells.The migration ability of B16-BL6 cells after silencing of IDO2 was measured by wound healing assay and Transwell cell migration assay.The invasion ability of the tumor cells was detected by Transwell cell invasion assay.RESULTS:IDO2-siRNA significantly down-regulated IDO2 expression in B16-BL6 melanoma cells,and did not affect IDO1 expression.Compared with control group,the colony formation ability,the migratory distance measured by wound healing assay,and the migration and the invasion cell numbers detected by Transwell assay all remarkably decreased in the IDO2-silencing cells.CONCLUSION:IDO2 silencing affects the proliferation,migration and invasion abilities of the R16-BL6 melanoma cells.

Gene silencing of indoleamine 2,3-dioxygenase 2 influences proliferation,migration and invasion of B16-BL6 melanoma cells / 中国病理生理杂志

AIM:To investigate the effects of indoleamine 2,3-dioxygenase 2 (IDO2) silencing on proliferation,migration and invasion of B16-BL6 melanoma cells.METHODS:IDO2-siRNA was transfected into the B16-BL6 melanoma cells in vitro.The expression of IDO2 or IDOl at mRNA and protein levels was detected by real-time PCR and Western blot.Colony formation assay was performed to analyze the proliferation of IDO2-silencing tumor cells.The migration ability of B16-BL6 cells after silencing of IDO2 was measured by wound healing assay and Transwell cell migration assay.The invasion ability of the tumor cells was detected by Transwell cell invasion assay.RESULTS:IDO2-siRNA significantly down-regulated IDO2 expression in B16-BL6 melanoma cells,and did not affect IDO1 expression.Compared with control group,the colony formation ability,the migratory distance measured by wound healing assay,and the migration and the invasion cell numbers detected by Transwell assay all remarkably decreased in the IDO2-silencing cells.CONCLUSION:IDO2 silencing affects the proliferation,migration and invasion abilities of the R16-BL6 melanoma cells.

Magnetic Resonance Imaging for Ischiofemoral Impingement Syndrome / 中国医学影像学杂志

Purpose To explore the diagnostic value of quantitative measurements of magnetic resonance images (MRI) in transverse and coronary sections in patients with ischiofemoral impingement (IFI) syndrome.Materials and Methods The data of 70 patients (127 hips) in the Affiliated Hospital of Chengde Medical College from 2013 June to 2016 April who were performed hip MRI examination was analyzed retrospectively.39 patients (67 hips) with clinical diagnosis of IFI syndrome were selected as case group,while the other 31 patients (58 hips) with clinical exclusion of IFI syndrome were selected as control group.Ischiofemoral space (IFS),quadratusfemoris space (QFS),ischial angle,femoral neck angle (FNA) and lesser trochanter angle (LTA) were measured on axial MR image with PDWI FS sequence.The cervicodiaphyseal angle (CCD) was measured on coronary section MR image with T2WI TIRM sequence.The above measurements of two groups were analyzed.Results IFS,QFS and LTA in patients of case group were 12.2 (10.2-13.9) mm,8.5 (6.9-10.4) mm and (13.8±0.7) °,while these measurements were 26.3 (22.9-30.4) mm,21.6 (19.5-25.4) mm and (19.9± 1.0) ° in patients of control group.Compared with control group,these measurements were significantly lower in case group (P＜0.01).Ischial angel,FNA were significantly higher in case group compared with control group [(131.2±0.4) ° vs.(127.1±0.6) °,29.2 (22.8-34.1) ° vs.22.7 (19-28.3) °,P＜0.01].CCD showed no significant difference between the two groups (P＞0.05).QFS,LTA have positive correlation with IFS in case group (r=0.870 and 0.653,P＜0.05),while FNA,ischial angel have significant negative correlation with IFS in case group (r=-0.623 and-0.655,P＜0.05).The cut-offvalues ofQFS,FNA,ischial angel and LTA were ≤ 12.7 mm,≥ 21.75 °,≥ 131.65 °,≤ 9.3°,respectively.Conclusion The reduction ofIFS and QFS is the main imaging signs of IFI syndrome.

Changes in electrocardiographic parameters in children with complete left bundle branch block early after transcatheter closure of ventricular septal defect / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe the changes in electrocardiographic parameters in children with complete left bundle branch block (CLBBB) after the transcatheter closure of simple ventricular septal defect (VSD).</p><p><b>METHODS</b>A total of 21 children with CLBBB early after transcatheter closure of perimembranous VSD were recruited. Another 21 children without any type of arrhythmia after transcatheter closure of perimembranous VSD were enrolled as the control group. The sex, age, and the size of occluder were matched between the two groups. The changes in the following indices were compared between the two groups: left ventricular voltage, QT interval, corrected QT interval (QTc), QT dispersion (QTd), corrected QT dispersion (QTcd), JT dispersion (JTd), and corrected JT dispersion (JTcd) on the electrocardiogram before transcatheter closure and at 1, 3, 5, 30 days after transcatheter closure.</p><p><b>RESULTS</b>Left ventricular voltage and JTcd changed with operation time in the CLBBB and control groups (P<0.05). There were interaction effects between time and grouping in the changes in left ventricular voltage and QTd (P<0.05). There was a significant difference in JTcd between the CLBBB and control groups (P<0.05). There was also a significant difference in left ventricular voltage between the CLBBB and control groups at 3 and 5 days after the transcatheter closure (P<0.05).</p><p><b>CONCLUSIONS</b>There are significant differences in electrocardiographic left ventricular voltage and JTcd between VSD children with and without CLBBB early after transcatheter closure. JTcd might be useful in predicting the development of CLBBB early after transcatheter closure of VSD.</p>

Transcriptomics of therapeutic effect of Huangqi Liuyi decoction in treating type 2 diabetes / 中国中药杂志

In this study, Illumina sequencing platform was applied in sequencing rat pancreas, counting expression of target points, analyzing expression differences among blank group, model group and Huangqi Liuyi decoction group and exploring the therapeutic effect and mechanism of Huangqi Liuyi decoction on type 2 diabetes mellitus. According to the result, 24.25% of these genes belonged to the unknown functional class, which was the largest classification unit according to the classification analysis of genes by eggNOG. The rest were classified as energy conversion, amino acid transport and metabolism, nucleotide transport and metabolism, carbohydrate transport and metabolism, coenzyme transport and metabolism, and lipid transport and metabolism, etc.Huangqi Liuyi decoction may play a therapeutic role in the treatment of type 2 diabetes mellitus through four metabolic pathways, namely environmental information processing, cellular process, organismal system and human diseases according to KEGG enrichment analysis. This study shows that, Huangqi Liuyi decoction can significantly improve the fasting blood glucose and glycosylated hemoglobin in type 2 diabetic rats.

In silico cloning and bioinformatics analysis of cyclophilin from Lotus corniculatus / 中草药

Objective: Using electronic cloning technology to predict cyclophilin gene of Lotus corniculatus. Methods: Using glycine max cyclophilin sequence as probe sequence, based on EST sequence from NCBI and assembled by CAP3 sequence assembly programme, using bioinformatic database and related software, the structure prediction and function analysis were performed. Results: The full length of cyclophilin gene was 1 346 bp, it contained a 771 bp ORF, encoding 256 amino acids, and the protein was a hydrophilic protein. Conclusion: The study is intended to further explain the molecular genetic function theory and experimental basis.

Down-regulation of AnnexinⅡExpression in NB4 Cells Induced by all-trans Retinoic Acid and Its Mechanisms / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore effect of all-trans retinoic acid(ATRA) on annexin Ⅱ expression in NB4 cells and to analyze the luciferase activity of annexinⅡ promoter in condition of ATRA-induced treatment.</p><p><b>METHODS</b>NB4 cells were cultured in vitro, the transcriptional or translational expression levels of Annexin Ⅱ in NB4 cells treated with 1 µmol/L ATRA at different time points were detected by RT-PCR or Western blot respectively. Annexin Ⅱ-promoter was constructed, the recombinant plasmids pGL4.15 -Annexin Ⅱ -promoter were transfected into NB4 cells with electroporation, and after being treated with 1 µmol/L ATRA for 24 hours the luciferase acttivity of Annexin Ⅱ promoter was determined by luciferase activity assay.</p><p><b>RESULTS</b>The transcriptional expression of Annexin Ⅱ was down-regulated after 48 h. The translation expression of Annexin Ⅱ was slowly weakened after 24 h, and it was seriously reduced after 48 h. Further, Luciferase activity of AnnexinⅡ promoter in NB4 cells treated with 1 µmol/L ATRA was down-regulated, and showed a decreased tendency at indicated time points.</p><p><b>CONCLUSION</b>All-trans retinoic acid can induce the down-regulation of AnnexinⅡ expression on the membrane of NB4 cells, and the activity of Annexin Ⅱpromoter is down-regulated too. This study provide a basis for further study of molecular mechanism.</p>

The effect of clindamycin on preventive infection after knee replacement / 中国基层医药

Objective To observe the effect of clindamycin for preventive infection in arthroplasty prophylac-tic.Methods 108 knee replacement patients were injected by 600mg intravenous clindamycin preoperation and con-tinue to use 1 -2 days after operation.The average postoperative hospitalization,postoperative outcome,body tempera-ture and blood after WBC changes of CRP and ESR in the fall of superficial infection trend,the average postoperative day,take out stitches after operation and the number of cases,postoperative deep infection early after infection (2 weeks)and delayed infection cases (within one year)were observed in order to evaluate the efficacy of preopera-tive antibiotics.Results 2 cases had superficial infection due to wound dehiscence (two times after suture recover-y),there was no complications of surgical wound in the other cases.In all cases,after operation,body temperature and blood WBC became to the normal level in seventh days,postoperative patients'CRP,ESR monitoring were significantly higher than those before operation (CRP:F =105.32,P =0.045;ESR:F =118.47,P =0.039),but on the 5 day after operation they were started to decline,CRP in the 21 postoperative day gradually returned to normal,and ESR gradually returned to normal after 6 months of operation.Preoperative HSS score was significantly lower than the post-operative score[(46.8 ±9.7)points vs.(91.7 ±3.4)points,t =6.38,P <0.05].Conclusion Clindamycin plays a definite role in prevention of infection,especially in the beta lactam antibiotic allergy cases,it can be preoperative antibiotic prophylaxis instead of cephalosporins.

Role of epithelial sodium channel in rat osteoclast differentiation and bone resorption / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of epithelial sodium channel (ENaC) in regulating the functional activity of osteoclasts.</p><p><b>METHODS</b>Multinucleated osteoclasts were obtained by inducing the differentiation of rat bone marrow cells with macrophage colony-stimulating factor (M-CSF) and RANKL. The osteoclasts were exposed to different concentrations of the ENaC inhibitor amiloride, and the expression of ENaC on osteoclasts was examined using immunofluorescence technique. The osteoclasts were identified with tartrate-resistant acid phosphatase (TRAP) staining, and the positive cells were incubated with fresh bovine femoral bone slices and the number of bone absorption pits was counted by computer-aided image processing. RT-PCR was performed to analyze the expression of cathepsin K in the osteoclasts.</p><p><b>RESULTS</b>s Exposure to different concentrations of amiloride significantly inhibited the expression of ENaC and reduced the number of TRAP-positive osteoclasts. Exposure of the osteoclasts to amiloride also reduced the number of bone resorption pits on bone slices and the expression of osteoclast-specific gene cathepsin K.</p><p><b>CONCLUSION</b>s ENaC may participate in the regulation of osteoclast differentiation and bone resorption, suggesting its role in functional regulation of the osteoclasts and a possibly new signaling pathway related with ENaC regulation for modulating bone metabolism.</p>

Relationship between regulation effect of salvia miltiorrhiza on AQP2 in kidney and promoting blood circulation and diuresis / 中国中药杂志

Partial nature of "promoting blood circulation and dieresis" of Salvia Miltiorrhizain was initially demonstrated by investigating the regulation effect of AQP2 expression in kidney of trauma blood stasis model rats with the Salvia Miltiorrhizain so as to provide guidance for its clinical deployment of administration. Random allocation was taken to averagely divide 30 SD rats into two groups: 10 rats in normal group and 20 rats in blood stasis syndrome group. Trauma blood stasis rat model was established by quantitatively beating. Then the rat model group was divided into model group and salvia group. After 7 days of treatment, the rat kidney AQP2 expression was detected, the content of urine AQP2 was compared and the damaged local muscle and kidney pathological changes were observed by immunohistochemical method and western blot method. Compared with that of the normal group, rats in model group had inflammatory cells infiltration, blood stasis and edema of the injured local muscles and up-regulated AQP2 expression, decreasing urinary output, and kidney tissues blood stasis and edema (P < 0.05). On the other hand, compared with that of the model group, those parameters of rats in salvia group were all decreasing except urine output (P < 0.05). Such result indicated that Salvia Miltiorrhiza can reduce trauma blood stasis rat content of urine AQP2 and down-regulated AQP2 expression in kidney tissue, so as to reduce the reabsorption of water by renal tubular and increase urine output. The promoting blood circulation effect of Salvia Miltiorrhizain can alleviate the degree of the damaged tissue edema and encourage urine drainage. This therapy is closely related to the effect of regulating AQP2 in kidney by salvia, so the purpose of this study by verifying "promoting blood circulation and diuresis" as the mechanism for the regulation effect of the salvia on AQP2 expression.

The level of circulating endothelial progenitor cells may be associated with the occurrence and recurrence of chronic subdural hematoma

OBJECTIVES: The onset of chronic subdural hematoma may be associated with direct or indirect minor injuries to the head or a poorly repaired vascular injury. Endothelial progenitor cells happen to be one of the key factors involved in hemostasis and vascular repair. This study was designed to observe the levels of endothelial progenitor cells, white blood cells, platelets, and other indicators in the peripheral blood of patients diagnosed with chronic subdural hematoma to determine the possible relationship between the endothelial progenitor cells and the occurrence, development, and outcomes of chronic subdural hematoma. METHOD: We enrolled 30 patients with diagnosed chronic subdural hematoma by computer tomography scanning and operating procedure at Tianjin Medical University General Hospital from July 2009 to July 2011. Meanwhile, we collected 30 cases of peripheral blood samples from healthy volunteers over the age of 50. Approximately 2 ml of blood was taken from veins of the elbow to test the peripheral blood routine and coagulation function. The content of endothelial progenitor cells in peripheral blood mononuclear cells was determined by flow cytometry. RESULTS: The level of endothelial progenitor cells in peripheral blood was significantly lower in preoperational patients with chronic subdural hematomas than in controls. There were no significant differences between the two groups regarding the blood routine and coagulation function. However, the levels of circulating endothelial progenitor cells were significantly different between the recurrent group and the non-recurrent group. CONCLUSIONS: The level of circulating endothelial progenitor cells in chronic subdural hematoma patients was significantly lower than the level in healthy controls. Meanwhile, the level of endothelial progenitor cells in recurrent patients was significantly lower than the level in patients without recurrence. Endothelial progenitor cells may ...

Robotic anterior resection of rectal cancer: technique and early outcome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The Da Vinci system is a newly developed device for colorectal surgery. With advanced stereoscopic vision, lack of tremor, and the ability to rotate the instruments surgeons find that robotic systems are ideal laparoscopic tools. Since conventional laparoscopic total mesorectal excision is a challenging procedure, we have sought to assess the utility of the Da Vinci robotic system in anterior resections for rectal cancer.</p><p><b>METHODS</b>Between November 2010 and December 2011, a total of 22 patients affected by rectal cancer were operated on with robotic technique, using the Da Vinci robot. Data regarding the outcome and pathology reports were prospectively collected in a dedicated database.</p><p><b>RESULTS</b>There were no conversions to open surgery and no postoperative mortality of any patient. Mean operative time was (220 ± 46) minutes (range, 152 - 286 minutes). The median number of lymph nodes harvested was (14.6 ± 6.5) (range, 8 - 32), and the circumferential margin was negative in all cases. The distal margin was (2.6 ± 1.2) cm (range, 1.0 - 5.5 cm). The mean length of hospital stay was (7.8 ± 2.6) days (range, 7.0 - 13.0 days). Macroscopic grading of the specimen was complete in 19 cases and nearly complete in three patients.</p><p><b>CONCLUSIONS</b>Robotic anterior resection for rectal surgery is safe and feasible in experienced hands. Outcome and pathology findings are comparable with those observed in open and laparoscopy procedures. This technique may facilitate minimally invasive radical rectal surgery.</p>

Analysis of treatment and prognosis in 34 patients with anorectal malignant melanoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the prognostic factors of anorectal malignant melanoma (ARMM).</p><p><b>METHODS</b>Medical records and follow-up data of 34 patients with ARMM treated in the Chinese PLA General Hospital from March 1993 to November 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>There were 26 abdominoperineal resections(APR) and 8 wide local excisions (WLE). Twenty patients underwent postoperative adjuvant therapy, including chemotherapy in 14 cases, radiotherapy in 2 cases, traditional Chinese medicine therapy in 4 cases and immunotherapy in 16 cases. Postoperative follow-up was carried out in all the patients and the mean follow-up period was 27 months. The 1-, 3- and 5-year overall survival rates were 76.3%, 39.6% and 20.6% respectively, while the 1-, 3- and 5-year disease-free survival rates were 60.6%, 30.8% and 12.8% respectively. APR and postoperative immunotherapy could significantly reduce the local recurrence rate. According to the Kaplan-Meier method, gross type of tumor, mural involvement, lymph metastasis, and clinical staging had significant effects on overall survival, while lymph metastasis and postoperative immunotherapy on disease-free survival. Cox proportional hazards model indicated that the clinical staging and postoperative immunotherapy were significant predictive factors.</p><p><b>CONCLUSIONS</b>Early diagnosis and correct choice of surgical method are the keys to the treatment. Postoperative immunotherapy can prolong disease-free survival.</p>