Progress in Mechanism of Astragalus membranaceus and Its Chemical Constituents on Multiple Sclerosis / 中国结合医学杂志

The primary chemical components of Astragalus membranaceus include polysaccharides, saponins, flavonoids, and amino acids. Recent studies have shown that Astragalus membranaceus has multiple functions, including improving immune function and exerting antioxidative, anti-radiation, anti-tumor, antibacterial, antiviral, and hormone-like effects. Astragalus membranaceus and its extracts are widely used in clinical practice because they have obvious therapeutic effects against various autoimmune diseases and relatively less adverse reaction. Multiple sclerosis (MS) is an autoimmune disease of central nervous system (CNS), which mainly caused by immune disorder that leads to inflammatory demyelination, inflammatory cell infiltration, and axonal degeneration in the CNS. In this review, the authors analyzed the clinical manifestations of MS and experimental autoimmune encephalomyelitis (EAE) and focused on the efficacy of Astragalus membranaceus and its chemical components in the treatment of MS/EAE.

Animal Model Analysis of Multiple Sclerosis Based on Clinical Characteristics of Traditional Chinese and Western Medicine / 中国实验方剂学杂志

Based on the clinical characteristics of multiple sclerosis （MS） in traditional Chinese medicine （TCM） and western medicine and literature analysis， this paper aims to formulate the diagnostic criteria of TCM and western medicine for MS. Moreover， the modeling methods of experimental autoimmune encephalomyelitis （EAE）， animals for the modeling， and characteristics of the models were analyzed and summarized， and the consistency between the EAE models and the diagnostic criteria of TCM and western medicine was evaluated. The results showed that animal models had low consistency with the clinical characteristics in TCM （highest consistency 68%） and western medicine （highest consistency 60%）. Pathological models account for the majority of animal models for MS research， but there is a lack of intuitive performance indicators. Thus， it is difficult to comprehensively evaluate the models. The mental state， limb numbness， lack of strength， loss of muscle tone， tremor， and balance disorders of the mice are among the diagnostic criteria in western medicine. In TCM diagnostic criteria， the major symptoms which are reflected in animal behavior， such as physical fatigue， lack of strength， mental fatigue， distinclination to talk， and weak heavy numb limbs， are consistent with the western diagnostic criteria. The minor symptoms， including mental decline， bitter taste in mouth， frequent and urgent urination， fecal incontinence， and aggravated fever， are not well reflected in the models. According to TCM， MS is caused by deficiency of kidney essence and external contraction of pathogen， but no index is available for evaluating the external contraction of pathogen in existing animal models. The key to experimental research on MS is to establish an appropriate animal model based on the clinical pathogenesis and characteristics. However， there is a lack of MS animal model with TCM characteristics for syndrome classification. Therefore， renewed efforts should be made to prepare animal models with both TCM and western medicine characteristics that can be used in both basic experiments and clinical research.

Clinical outcomes of modified lateral advanced flap combined with tunnel technique for the treatment of maxillary isolated soft tissue defect / 上海交通大学学报（医学版）

Objective:To observe the clinical outcome of the modified laterally advanced flap combined with tunnel technique for the treatment of maxillary isolated soft tissue defects. Methods:Three of maxillary isolated soft tissue defects were selected, and the modified lateral advanced flap combined with tunnel technique and subepithelial connective tissue graft was performed to repair the soft tissue defects. Pocket depth (PD), clinical attachment loss (CAL), recession height (RD), recession weight (RW), gingiva thickness (GT), and keratinized tissue width (KTW) were measured at baseline and one-year follow-up after treatment and the root coverage rate (RC%) was calculated. Results:Totally three patients were treated, two Miller III and one Miller Ⅱ. The mean RC% at one-year follow-up was (78.89±18.36)%. The mean CALs at baseline and follow-up were (6.00±1.00) mm and (1.83±1.61) mm. The mean RHs at baseline and follow-up were (5.33±0.58) mm and (1.17±1.04) mm. The mean RWs at baseline and follow-up were (6.00±1.32) mm and (4.50±3.91) mm. The mean GTs at baseline and follow-up were (0.83±0.29) mm and (1.83±0.76) mm. The mean KTWs at baseline and follow-up were (0.83±0.76) mm and (5.50±0.50) mm. Conclusion:In the treatment of maxillary isolated soft tissue defect, the modified lateral advanced flap combined with tunnel technique has broad application and valid clinical outcome.

Involvement of TLR4 in the protective effect of intra-articular administration of curcumin on rat experimental osteoarthritis

Abstract Purpose In view of the principal role of Toll-like receptor 4 (TLR4) in mediating sterile inflammatory response contributing to osteoarthritis (OA) pathogenesis, we used lipopolysaccharide (LPS), a known TLR4 activator, to clarify whether modulation of TLR4 contributed to the protective actions of intra-articular administration of curcumin in a classical rat OA model surgically induced by anterior cruciate ligament transection (ACLT). Methods The rats underwent ACLT and received 50μl of curcumin at the concentration of 1 mg mL-1 and 10 μg LPS by intra-articular injection once a week for 8 weeks. Morphological changes of the cartilage and synovial tissues were observed. Apoptotic chondrocytes were detected using TUNEL assay. The concentrations of IL-1β and TNF-ɑ in synovial fluid were determined using ELISA kits. The mRNA and protein expression levels of TLR4 and NF-κB p65 were detected by real-time PCR and Western blotting, respectively. Results Intra-articular administration of curcumin significantly improved articular cartilage injury, suppressed synovial inflammation and down-regulated the overexpression of TLR4 and its downstream NF-κB caused by LPS-induced TLR4 activation in rat osteoarthritic knees. Conclusion The data suggested that the inhibition of TLR4 signal might be an important mechanism underlying a protective effect of local curcumin administration on OA.

Surgical repair of complex aortopulmonary window: a case study

Abstract Aortopulmonary septal defect, also known as the aortopulmonary window, is a rare congenital macrovascular malformation. This case involves a 9-year-old boy with aortopulmonary septal defect (type I combined with type IV). Before surgery, milrinone and alprostadil were used to counteract high lung pressure. Surgery was performed under cardiopulmonary bypass, following which the pulmonary pressure decreased. The aorta was cut, and the right pulmonary artery opening was connected with the main pulmonary artery septal defect using polyester patch. An internal tunnel was made, and the deformity correction was completed. The child exhibited normal postoperative recovery with no discomfort. A complex aortopulmonary window is a rare condition that can be treated successfully with appropriate preoperative and surgical management.

Low triiodothyronine syndrome can predict poor prognosis in peritoneal dialysis patients / 上海交通大学学报（医学版）

Objective· To investigate the prevalence of low triiodothyronine syndrome (LT3S) in peritoneal dialysis (PD) patients and to evaluate the predictive value of long-term prognosis. Methods · From Jan. 2009 to Dec. 2015, all patients who started PD for 3 months were enrolled. According to thyroid hormone levels, there were classified into LT3S group (218 cases) and normal T3group (259 cases). The association between FT3and mortality in PD patients was estimated using Cox risk regression model. Results · Compared to the patients in normal T3group, patients with LT3S had lower hemoglobin[(97.90±23.71)g/L vs(105.54±22.94)g/L],adjusted serum calcium[(2.06±0.35)mmol/L vs(2.17±0.27)mmol/L](all P<0.01).Patients with LT3S had higher BNP{[311.00(134.59,776.00)pg/mL]vs[159.00(58.28,378.75)pg/mL]},hrCRP{[2.85(0.95,6.81)mg/L]vs[1.34(0.54,3.32)mg/L]}and serum total cholesterol[(3.18±1.29)mmol/L vs(2.76±0.93)mmol/L]than that in patients with normal T3group(all P<0.01).LVMI of LT3S group [(154.16±58.15)g/m2] vs (125.24±42.67)g/m2] was much higher than that of normal T3group (P<0.01). Cox risk regression model indicated that FT3 was significantly associated with all-cause mortality(HR 0.51,95% CI 0.41-0.63;P<0.01)and cardiovascular mortality(HR 0.60,95% CI 0.45-0.81;P<0.01). Conclusion·LT3S is common in PD patients.Lower FT3was an independent risk factor of all-cause and cardiovascular mortality in PD patients.

Analysis of single nucleotide polymorphisms at IL-6-174 and TNF-β NcoI in Chinese Han children in Guangzhou, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the single nucleotide polymorphisms (SNPs) at interleukin 6 (IL-6)-174 and TNF-β NcoI in Chinese Han children in Guangzhou, China and to provide basic information for study on the association between IL-6-174 and TNF-β NcoI polymorphisms and systemic inflammatory response syndrome (SIRS).</p><p><b>METHODS</b>Allele-specific polymerase chain reaction and polymerase chain reaction-restriction fragment length polymorphism were used to determine the SNPs at IL-6-174 and TNF-β NcoI in 481 children selected from the Han population in Guangzhou in 2012. Genotype analysis and comparison with other populations were made with reference to relevant literature.</p><p><b>RESULTS</b>Chinese Han children in Guangzhou had only GG genotype at IL-6-174, and the SNP at this locus was rare or not seen in the Han population in Guangzhou. At TNF-β NcoI, the frequencies of TNF-β 1*1, TNF-β 1*2, and TNF-β 2*2 genotypes were 24.7%, 49.7%, and 25.6%, respectively. The sample distribution was in accordance with Hardy-Weinberg equilibrium. The TNF-β 1 allele frequency was significantly higher in Guangzhou Han population than in European and American white population (P<0.05).</p><p><b>CONCLUSIONS</b>TNF-β NcoI SNP is prevalent in the Han population in Guangzhou, and the distribution of alleles is significantly different from that in the white population. The sample from an Hardy-Weinberg equilibrium population can be further used for study on the association between TNF-β NcoI SNP and SIRS in Chinese Han children in Guangzhou. IL-6-174 SNP is rare or not seen in the Han population in Guangzhou, so SNP at this locus cannot be selected for disease association analysis.</p>

Cyanidin-3-O-galactoside and blueberry extracts supplementation improves spatial memory and regulates hippocampal ERK expression in senescence-accelerated mice / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate whether the antioxidation and the regulation on the Extracellular Regulated Protein Kinases (ERK) signaling pathway are involved in the protective effects of blueberry on central nervous system.</p><p><b>METHODS</b>30 Senescence-accelerated mice prone 8 (SAMP8) mice were divided into three groups and treated with normal diet, blueberry extracts (200 mg/kg•bw/day) and cyaniding-3-O-galactoside (Cy-3-GAL) (50 mg/kg•bw/day) from blueberry for 8 weeks. 10 SAMR1 mice were set as control group. The capacity of spatial memory was assessed by Passive avoidance task and Morris water maze. Histological analyses on hippocampus were completed. Malondialdehyde (MDA) levels, Superoxide Dismutase (SOD) activity and the expression of ERK were detected.</p><p><b>RESULTS</b>Both Cy-3-GAL and blueberry extracts were shown effective functions to relieve cellular injury, improve hippocampal neurons survival and inhibit the pyramidal cell layer damage. Cy-3-GAL and blueberry extracts also increased SOD activity and reduced MDA content in brain tissues and plasma, and increased hippocampal phosphorylated ERK (p-ERK) expression in SAMP8 mice. Further more, the passive avoidance task test showed that both the latency time and the number of errors were improved by Cy-3-GAL treatment, and the Morris Water Maze test showed significant decreases of latency were detected by Cy-3-GAL and blueberry extracts treatment on day 4.</p><p><b>CONCLUSION</b>Blueberry extracts may reverse the declines of cognitive and behavioral function in the ageing process through several pathways, including enhancing the capacity of antioxidation, altering stress signaling. Cy-3-GAL may be an important active ingredient for these biological effects.</p>

Experience of endovenous radiofrequency combined with TriVex in treatment of chronic venous insufficiency in lower extremity / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.</p><p><b>METHODS</b>One hundred and fifty patients with chronic venous insufficiency (150 limbs) were randomly assigned to Group A (75 limbs) and Group B (75 limbs). Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex. Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex. The postoperative pain, average hospital stay and short-term results in hospital were compared between the two groups. Self-assessment of the operation 4 weeks after, changes of CEAP classification, venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ) score were compared between the two groups.</p><p><b>RESULTS</b>The operation time in Group A was (67 +/- 11) min, compared with (59 +/- 9) min in Group B (P > 0.05). Postoperative pain and average hospital stay in Group A were significantly lower than those in Group B (P < 0.05). The scores of self-assessment of the operation in Group A was higher than that in Group B 4 weeks after operation (P < 0.05). The change of CEAP classification, VCSS and quality of life were significant after operation in both groups. The VCSS of Group A decreased by 4.6 +/- 2.5 compared with 4.3 +/- 2.7 in Group B (P > 0.05).</p><p><b>CONCLUSIONS</b>Endovenous radiofrequency combined with TriVex for treatment of venous insufficiency in lower extremity is available, effective and with less trauma and faster recovery. CEAP classification, VCSS and CIVIQ are useful tools for assessing outcomes after radiofrequency in these patients.</p>

Effect of Suanzaoren decoction on acute hepatic failure in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of Suanzao nacute hepatic failure in mice.</p><p><b>METHOD</b>Acute liver failure was induced in male Kunming strain mice by enterocoelia injecting the animals with D-Gal-N and LPS. The mice in treatment groups were given corresponding drug 2 h before administration of D-Ga1-N and LPS, and the mice in control group were given the same dose of distilled water. The 24 h survival rate, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels were compared. Serum the levels of TNF-alpha and IL-1 and the levels of SOD, MDA, GR, GSH, NO and NOS in the liver were determined.</p><p><b>RESULT</b>Treatment with suanzaoren decoction could increase the survival rate and improve the liver histological feather. Suanzaoren decoction inhibited the serum the levels of ALT, AST, TNF-alpha and IL-1, and reduced the levels of MDA, NO and NOS and increased the levels of GR and SOD in the liver.</p><p><b>CONCLUSION</b>Treatment with Suanzaoren decoction can suppress the D-Gal-N/LPS-induced acute hepatic failure. It may be the mechanism that Suanzaoren decocotion regulate the production of inflammatory cytokines and free radicals.</p>

Expression of angiotensin II type 1 receptor in cervical squamous cell carcinoma and its clinical significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of Angiotensin II type 1 receptor (AT1R) in tissue and cell lines of squamous cervical carcinomas and its clinical significance, and to explore the molecular mechamisms of angiotensin II and AT1R activity in the process of cervical carcinogenesis.</p><p><b>METHODS</b>(1) The levels of AT1R mRNA were examined by quantitative reverse transcriptase-polymerase chain reaction( RT-PCR) in paraffin-embedded tissues from 35 cases of cervical squamous cell carcinoma, 15 cases of cervical intraepithelial neoplasia (CIN), and 15 cases of normal cervix, and in Siha and C33a cells. The expression of AT1R protein in 65 specimens of cervix tissue sections was evaluated by immunohistochemistry. The corelation between the expressions of AT1R and its clinicopathologic features was analyzed accordingly. (2) After the Siha and C33a cells were treated at different concentrations of Angiotensin II (0, 10(-10) mol/L, 10(-9) mol/L, 10(-8) mol/L, 10(-7) mol/L, 10(-6) mol/L, 10(-5) mol/L) for different time in culture, the cell proliferation was determined by methylthiazolyl tetrazolium (MTT) assay. The vascular endothelial growth factor (VEGF) expression was examined by enzyme-linked immuno-absordent assay (ELISA).</p><p><b>RESULTS</b>(1) AT1R mRNA expression was detected in the two cervix cancer cell lines. The positive rate of ATIR mRNA was 77.1%, 40.0% and 0, respectively, in squamous cell carcinomas, cervical intraepithelial neoplasia and normal cervical tissues, while their mRNA quantities were 0.3863 +/- 0.041, 0.0768 +/- 0.035 and 0, respectively. There was statistically a significant difference between them (P < 0.01). The average staining intensity of AT1R protein was stronger in invasive carcinoma cells than that in dysplasia tissues and normal ones (P < 0.01). Among 65 cases of squamous cell carcinomas, the expressions of AT1R mRNA and protein increased with pathological grading (P < 0.05), while it was neither correlated with clinical stage nor pelvic lymph node metastasis (P > 0.05). The level of AT1R protein expression corresponded to that of its mRNA. (2) Angiotensin II promoted the cell growth of cervical cancer cell lines Siha and C33a and induced secretion of VEGF from cells in a dose-dependent manner (P < 0.01), and the expression of VEGF was reversed by the addition of valsatan (an antagonist of angiotensin II type 1 receptor) (P < 0.01).</p><p><b>CONCLUSION</b>Angiotensin II is involved in the progression of cervical carcinoma, since it may increase the proliferation activity of cancer cells, induce secretion of VEGF through AT1R synchronously, and results in an increase of angiogenesis in tumors. It suggests that use of AT1R antagonists may be an useful therapeutic strategy for cervical carcinoma.</p>