Expert consensus on Tongsaimai Tablets/Capsules in treatment of peripheral vascular diseases in clinical practice / 中国中药杂志

Tongsaimai Tablets/Capsules are composed of Lonicerae Japonicae Flos, Angelicae Sinensis Radix, Achyranthis Bidentatae Radix, Codonopsis Radix, Dendrobii Caulis, Astragali Radix, Scrophulariae Radix, and Glycyrrhizae Radix et Rhizoma, and are effective in promoting blood circulation, removing blood stasis, supplementing Qi, and nourishing Yin. It is widely used in the treatment of peripheral vascular diseases. With 40 years of clinical application, it has accumulated substantial research data and application experience. Its good clinical efficacy and pharmacoeconomic benefits in improving the clinical symptoms of peripheral vascular diseases have been confirmed by relevant research. Meanwhile, this drug has also been recommended by many expert consensus, guidelines, and teaching materials, serving as one of the most commonly used Chinese patent medicines in clinical practice. To further improve the understanding of the drug among clinicians and properly guide its clinical medication, the China Association of Chinese Medicine took the lead and organized experts to jointly formulate this expert consensus. Based on the questionnaire survey of clinicians and the systematic review of research literature on Tongsaimai Tablets/Capsules with clinical problems in the PICO framework, the consensus, combined with expert experience, concludes recommendations or consensus suggestions by GRADE system with the optimal evidence available through the nominal group technique. This consensus defines the indications, usage, dosage, course of treatment, medication time, combined medication, and precautions of Tongsaimai Tablets/Capsules in the treatment of peripheral vascular diseases, and explains the safety of its clinical application. It is recommended for clinicians and pharmacists in the peripheral vascular department(vascular surgery), traditional Chinese medicine surgery(general surgery), and endocrinology department of hospitals at all levels in China.

Classification, distribution and change of Uighur medicinal materials resources / 中国中药杂志

With the development and change of Uygur medicine, The sources,medicinal parts and producing area of some Uygur Medicine have changed. It is more important to master the classification, distribution and change of Uygur medicinal materials. These were more than 1 200 kinds Uygur medicine in history were resaerched by field investigation, philological research, and textual research, which main source of original plant were 140 families, 510 genera, 840 species; and source of original animal were 76 families, 107 genera, the original animal 141 species; 55 kinds of original mineral, which main producer were Xinjiang and Central Asia, West Asia, the Mediterranean, and North Africa, Southeast Asia and other provinces in China, there are individual medicinal materials from the Americas, Europe and other places. Through this study the classification, distribution, source and evolution of specific families and genera of Uygur medicine resources have mastered.It is hoped to provide theoretical basis for further research and development of Uygur medicinal materials.

Relationship Between the Systolic Blood Pressure Variability and Glomerular Filtration Rate in the Elderly / 中国循环杂志

Objectives:To investigate the correlation between the systolic blood pressure variability and glomerular filtration rate in the elderly. Methods:From retired employees who participated in the third time physical examination of Kailuan group to underwent 24-hour ambulatory blood pressure monitoring. A total of 3 064 subjects aged over 60 years were recruited by cluster sampling method. 2 464 participants who met the inclusion were included and tested the renal function, with estimated glomerular filtration rate (eGFR) as indicators of renal function evaluation. Finally, 1 382 cases up to the standard. Multiviate regression models were performed to analyze the correlataion beteen short-term MMD and eGFR. Results:The mean age of 1 382 participants was (67.16±5.86) years, and 905 individuals (65.5%) were male. Levels of eGFR decreased with the increased of MMD (P＜0.05). Pearson correlation analysis indicated that eGFR was positively correlated with 24 hr-MMD、day-MMD and night-MMD(P＜0.05). Multivarite linear regrsssion analysis indicated that 24 hr-MMD、day-MMD were correlated with eGFR. Conclusions:24 hr-MMD、day-MMD are correlated with eGFR.

Early surgical treatment of multi-segmet intramedullary cervical spinal cord ependymoma / 北京大学学报(医学版)

Objective:To investigate the early clinical treatment and prognosis of multi-segment intramedullary cervical ependymoma.Methods:Twenty patients with multi-segment (more than 3 segments) intramedullary spinal ependymoma (McCormic grade Ⅰ) were microsurgically treated with assistance of intraoperative neuroelectrophysiological monitoring.None of them received postoperative radiotherapy.Preoperatively all the patients underwent MRI examination and their neurologically function was assessed by McCormic classification method.They were followed up for an average of 2.7 years (The follow-up ranged from 3 months to 4 years).All the patients underwent review of the MRI examination and their postoperative neurological function was assessed by McCormic classification method again.Evaluation was accomplished according to the results of the follow-up.Results:All tumors were intramedullary.The length of the tumor body varied from 3 to 8 vertebral segments with an average of 4.2 vertebral segments.Gross total removal was achieved in all the 20 patients through one-stage operation.The pathology of these patients was ependymoma (WHO grades Ⅰ to Ⅱ).Two cases were lost during the follow-up due to the change of contact,but the hospital records of them showed that they recovered well at discharge.Eighteen cases were followed up constantly after operation.A case which ran through the whole cervical spinal cord had short-term mild motor dysfunction after operation,which manifested as weakness of the left side muscle strength to grade Ⅳ (which recovered to grade Ⅴ during the follow-up period).Results of the follow-up showed that these 18 patients recovered well.Preoperative symptoms,such as limb numbness and painness were significantly alleviated.There was no obvious motor dysfunction.The bowel and bladder function of these 18 patients were almost normal.The McCormic scores of these 18 patients remained in grade Ⅰ.No recurrence was found on review of the MRI examination.The main complications were a certain degree of deep sensory disturbance of lower extremities.The operation did not significantly affect the patient's life and work.Conclusion:Aggressive surgical therapy is a good treatment strategy for early multi-segment intramedullary cervical ependymoma.There is nearly no recurrence after operation and no postoperative radiotherapy is needed after gross total removal of tumors.

The Application of Comprehensive Performance Evaluation Model in the Evaluation Department Based on the DRG / 中国卫生经济

Objective:Introducing the Diagnosis Related Groups(DRGs) to build the evaluation system of cardiovascular internal medicine based on Delphi + AHP method.Methods:The detailed indexes of DRGs,quality efficiency indexes,financial efficiency indexes and teaching technology research were applied to construct performance evaluation system.Delphi+AHP was applied to certain the weight allocation.Results and Conclusion:The performance of 4 cardiovascular internal hospitals in Wenzhou ranked as:the First Hospital of Wenzhou University,the Secord Hospital of Wenzhou University,Ruian Hospital and the Center Hospital of Wenzhou.The Cardiovascular Medicine of hospital achievements appraisal system was more reasonable and objective based on Delphi+ AHP,which had good operability.

Effects of heat shock protein 70-2 gene polymorphisms on the transcription of HSP 70-2 mRNA and the translation of HSP 70 protein in lung cancer / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the effects of gene polymorphism of heat shock protein 70-2 (HSP 70-2) 1267A/G on the mRNA level HSP 70-2 mRNA and the protein level HSP 70 in human lung cancer.</p><p><b>METHODS</b>Forty six lung cancer patients diagnosed histopathologically between February and August 2008 from a hospital in zhengzhou were enrolled as the subjects in this study. Gene polymorphism of HSP 70-2 1276A/G in 46 patients with lung cancer was detected by PCR-RFLP. The mRNA levels of HSP 70-2 mRNA and the protein levels of HSP 70 in lung tissue and para-cancerous tissues of these subjects were determined by RT-PCR and Western blotting respectively.</p><p><b>RESULTS</b>The expression levels of HSP 70-2 mRNA (1.02 ± 0.30) and HSP 70 protein (0.44 ± 0.12) in the lung cancer tissues was significantly higher than that in para-cancerous tissues (0.19 ± 0.04, 0.12 ± 0.02). The relative levels of HSP 70-2 mRNA in the subjects with AA genotype (1.32 ± 0.22) were significantly higher than the patients with AG genotype or GG genotype (0.95 ± 0.17, 0.70 ± 0.16) at the site of 1267 (A/G) (P < 0.01); however, the relative protein levels of HSP 70 were 0.47 ± 0.13 (AA genotype), 0.42 ± 0.11 (AG genotype), 0.45 ± 0.11 (GG genotype), respectively, which showed no statistically significant difference (P > 0.05).</p><p><b>CONCLUSION</b>The polymorphism of HSP 70-2 1267 (A/G) is highly associated with the transcription level of HSP 70-2 mRNA, but not with the expression level of HSP 70 protein.</p>

Fasudil inhibits HSC adhesion, migration and proliferation via Rho/ROCK pathway / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To observe the effects of fasudil, a Rho/ROCK signaling pathways inhibitor, on adhesion, migration and proliferation of hepatic stellate cells (HSCs).</p><p><b>METHODS</b>Cultured HSCs were divided into 5 groups. Fasudil was added to 4 groups in a concentration of 12.5, 25, 50, and 100 micromol/L, respectively. A group without fasudil added served as untreated controls. The adhesive inhibition effect of fasudil on HSCs was examined by toluidine blue colorimetric assay, the inhibition of migration of HSCs was evaluated by a modified Boyden chamber, and cell proliferation was assessed by MTT assay. The protein levels of RhoA, p-MLC (Thr18/Ser19) and alpha-SMA were assayed by Western blot.</p><p><b>RESULTS</b>Fasudil inhibited HSC adhesion, proliferation and LPA-induced migration in a concentration-dependent manner; the protein expressions of alpha-SMA and p-MLC (Thr18/Ser19) were significantly decreased in the presence of fasudil.</p><p><b>CONCLUSION</b>Fasudil can inhibit HSC adhesion, migration and proliferation by suppressing the cytoskeleton regulation function of Rho/ROCK signaling pathways.</p>

Lipids disorder, macrovascular diseases, and insulin resistance in Chinese diabetic patients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the types of lipid disorder and its relationship with macrovascular diseases and insulin resistance in Chinese diabetic patients.</p><p><b>METHODS</b>2,430 diabetic patients finished the diabetes complications assessment and were surveyed on their blood lipids, insulin level and macrovascular diseases. The insulin resistance (HOMA-IR) was calculated based on HOMA model.</p><p><b>RESULTS</b>Prevalence of lipids disorder was as high as 63.8% in this group, including 23.9% with both hypercholesterolemia and hypertriglyceridemia (HY-C-T), 16.1% with hypercholesterolemia only (HY-C), 15.0% with hypertriglyceridemia only (HY-T), 5.5% with lower HDL level (L-HDL), 3.3% with hypercholesterolemia, hypertriglyceridemia and lower HDL level together. Compared with the patients with normal lipid level (control group), no duration differences existed among these groups. There were more female patients in HY-C and HY-C-T groups. BMI and WHR were higher in all groups with lipid disorder except in HY-C group. Macrovascular diseases were more common in HY-C-T patients than in control group (33.6% vs 24.0%, P < 0.001). Average blood pressure and the prevalence of hypertension were significantly higher in HY-C-T, HY-C, HY-T groups than in control group (139/79, 138/76, 134/77 vs. 132/75 mmHg; 53.2%, 50.1%, 46.2% vs. 39.2%). Fasting insulin level was significantly higher in HY-C-T and HY-C-T-L-LDL groups than in controls. Insulin resistance was more severe in all patients with lipid disorder except in L-HDL group, particularly in the HY-C-T-L-HDL group.</p><p><b>CONCLUSIONS</b>(1) BMI, WHR increased significantly with the severity of lipid disorder. (2) Nearly two thirds of Chinese diabetic patients have lipid disorder, which is the strong risk factor of macrovascular diseases and aggravates insulin resistance. (3) There was severe insulin resistance in patients with hypertriglyceridemia or with hypertriglyceridemia plus other lipid disorder.</p>