Comparison of endoscopic therapy and TIPS in prophylaxis and treatment of variceal bleeding in decompensated portal hypertension / 临床肝胆病杂志

Esophagogastric variceal bleeding (EGVB) is one of the main complications of decompensated portal hypertension, especially in patients with liver cirrhosis, and it often has a high mortality rate. Medication combined with endoscopy is the main prevention and treatment method for EGVB, while transjugular intrahepatic portosystemic shunt (TIPS) combined with variceal embolization can also be selected for some high-risk patients, and individualized diagnosis and treatment of portal hypertension based on hepatic venous pressure gradient should become the latest consensus and the main strategy. This article mainly reviews endoscopic therapy and TIPS for the prevention and treatment of EGVB patients with decompensated portal hypertension in terms of selection of indications, incidence rate of complications, and respective advantages and disadvantages.

Effects and Mechanisms of Bone Marrow Mesenchymal Stem Cell Transplantation for Treatment of Ischemic Stroke in Hypertensive Rats

Background and Objectives@#Stroke is the most common cause of human death and functional disability, resulting in more than 5 million deaths worldwide each year. Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cell that are able to self-renew and differentiate into many types of tissues. Therefore, BMSCs have the potential to replace damaged neurons and promote the reconstruction of nerve conduction pathways and connective tissue. However, it remains unknown whether transplanted BMSCs promote angiogenesis or improve the tissue microenvironment directly or indirectly through paracrine interactions. This study aimed to determine the therapeutic effect of BMSCs on ischemic stroke with hypertension in a rodent model and to explore the possible mechanisms underlying any benefits. @*Methods@#and Results: Middle cerebral artery occlusion was used to establish the experimental stroke model. The area of cerebral infarction, expression of vascular endothelial growth factor (VEGF) and glial cell line-derived neurotrophic factor (GDNF), and increment of astrocyte were measured by TTC staining, western blot, real-time quantitative polymerase chain reaction (RT-qPCR) and immunocytochemistry. The results showed a smaller area of cerebral infarction and improved neurological function scores in animals treated with BMSCs compared to controls. The results of RT-qPCR and western blot assays showed higher expression of VEGF and GDNF in BMSC-treated animals compared with controls. Our study also showed that one round of BMSCs transplantation significantly promoted the proliferation of subventricular zone and cortical cells, especially astrocytes, on the ischemic side following cerebral ischemia. @*Conclusions@#Above findings support that BMSCs have therapeutic effects for ischemic stroke complicated with hypertension, which may occur via up-regulated expression of VEGF and GDNF and reduction of neuronal apoptosis, thereby promoting the recovery of nerve function.

Optimization of the Hot Sand Processing Technology for Alpinia officinarum by Central Composite Design-response Surface Method / 中国药房

OBJECTIVE：To optimize the hot sand processing technology of Alpinia officinarum，and to provide scientific evidence for the standardized processing of A. officinarum. METHODS：The contents of galangin and curcumin in processed A. officinarum were determined by HPLC. Based on single factor test，using processing temperature and processing time as factors，comprehensive score of galangin and curcumin contents as index，central composite design-response surface method was used to optimize hot sand processing technology of A. officinarum，and the processing technology was validated. RESULTS：The optimal processing technology included processing temperature of 200 ℃ and processing time of 5.5 min. In validation tests，average comprehensive score was 94.38 （RSD＝1.02％），relative deviation of which to predicted value 93.74 was 0.68％. CONCLUSIONS：The optimized processing technology is simple and predictable. It can be used for hot sand processing technology of A. officinarum.

Analysis of Curative Effect of LEEP Combined with Tremella Shu in Treating Cervical Precancerous Lesions with HPV Infection / 中国生化药物杂志

Objective To analyze the clinical efficacy of LEEP combined with Tremella Shu in the treatment of cervical cancerous lesions complicated with high-risk human papillomavirus (HPV) infection. Methods From March 2013 to May 2017, 88 patients with cervical precancerous lesions complicated with HPV infection selected from March 2013 to May 2017 in Beichen Hospital of Tianjin were randomly divided into experimental group and control group,44 cases in each group. The control group were treated with LEEP, the experimental group was treated with LEEP combined with Tremella Shu,The HPV viral load, clinical efficacy and quality of life score were compared between the two groups. Results The cure rate was 95.45％ in the experimental group higher than that in the control group(81.81％),the difference was statistically significant (P<0.05). The quality of life score of the experimental group was better than that of the control group,the difference was statistically significant(P<0.05). The HPV viral load in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion LEEP treatment combined with Tremella Shu on cervical precancerous lesions with HPV infection of clinical efficacy is significant, can effectively improve the quality of life of patients, reduce HPV viral load, worthy of clinical application.

Therapy and prognosis of ventilator-associated pneumonia caused by multidrug-resistant organisms / 中国感染控制杂志

Objective To investigate the therapy and influencing factors for prognosis of ventilator-associated pneumonia(VAP) caused by multidrug-resistant organisms(MDROs).Methods 169 patients with VAP who were admitted to a hospital between January 2012 and December 2013 were included in analysis, 125 were in MDRO infection group and 44 in non-MDRO infection group.MDRO infection group was subdivided into MDR-A group(n=78, resistant to selected antimicrobial agents) and MDR-B group (n=47, sensitive to at least one kind of selected antimicrobial agent).Antimicrobial choice and prognosis between each group were analyzed and compared.Results 242 strains of pathogenic bacteria were isolated from airway secretion of VAP patients, 173(71.49％) were MDROs.The major pathogens causing VAP were Klebsiella spp.(n=66), Pseudomonas aeruginosa(n=64), Acinetobacter spp.(n=60), Staphylococcus aureus(n=27), and Escherichia coli (n=17), the percentages of MDROs of above pathogens were 68.18％, 50.00％, 91.67％, 88.89％, and 76.47％ respectively.The prognosis of MDRO infection group was poorer than that of non-MDRO infection group, MDR-A group had the worst prognosis(P0.05).Conclusion There is high incidence of MDRO infection in patients with VAP, effective antimicrobial therapy can improve the prognosis.

Human leptin gene overexpression enhances osteogenesis of bone marrow stromal cells from rats / 基础医学与临床

Objective To investigate the effects of human leptin ( hLEP) gene transfection on rat bone marrow stro-mal cells ( rBMSCs) .Methods rBMSCs were cultured and transfected with adenoviruses encoding hLEP ( Ad5-hLEP-EGFP) in vitro as experimental group while rBMSCs transfected with Ad 5-EGFP and non-transfected were control groups.The proliferation was detected by MTT and the expression of collagen type Ⅰ(Col-Ⅰ) and alkaline phosphatase ( ALP) were assessed by real-time PCR.The ability of mineralized nodule forming was also examined by Alizarin red staining .The combination of transfected rBMSCs and β-tricalcium phosphate (β-TCP ) was con-structed and the osteogenic ability of the construction was evaluated in nude mice .Results hLEP could be trans-fected into rBMSCs successfully by adenovirous .After transfection , the proliferation was not affected while Col-Ⅰand ALP expressions were more pronounced in rBMSCs transfected with Ad 5-hLEP-EGFP ( P<0.05 ) .Alizarin red staining showed the ability of mineralized nodule forming was also up-regulated in Ad5-hLEP-EGFP group (P<0.05).In addition, the transfected rBMSCs adhered to β-TCP and survived well and the combination showed more new bone like tissue formation in nude mice compared to control groups .Conclusions rBMSCs transfected with hLEP might be potently used in bone or periodontal tissue regeneration .

Analysis of clinic features of patients with axial spondyloarthritis complicated with uveitis / 中华风湿病学杂志

Objective To investigate the prevalence of uveitis associated with axial spondyloarthritis (ax-SpA), and analyze the features of patients with ax-SpA accompanying uveitis. Methods Two hundred and eighteen patients with ax-SpA were recruited. The differences in demographic factors, clinical features, the use of drugs and the quality of life were compared between uveitis group and non-uveitis group by using t-tests andχ2 tests. Results The prevalence of uveitis associated with ax-SpA was 24.3%. Uveitis group had longer disease duration [(156±140) month] compared to the non-uveitis group [(84±98) month] (t=-3.473, P=0.001), longer duration from disease onset to diagnosis [(90±105) month] compared to non-uveitis group [(47±65) month (t=-2.818, P=0.006), longer duration from first visit to diagnosis [(67±97) month] compared to non-uveitis group [(34 ±55) month] (t=-2.366, P=0.021). Patients with uveitis had higher rate of positive HLA-B27 (97.7%) compared to non-uveitis group (74.2%) (t=5.822, P=0.016), higher score of bath ankylosing spondylitis metrology index (BASMI) (3.3±2.0) compared to non-uveitis group (2.4±1.9) (t=-3.141, P=0.002), higher usage rate of biological agent (64.2%) compared to non-uveitis group (t=4.907, P=0.027). Conclusion In patients with acute anterior uveitis, the history should be carefully collected and HLA-B27 should be examined in order to make early diagnosis and treatment of ax-SpA, reducing uveitis flares and functional impairment.

Exploration on the Interactive Mode of Ethical Review and Quality Management in Clinical Trials / 中国医学伦理学

Interactive mode of ethical review and quality management in clinical trials consists of several parts, which includesconstructing a scientific platform of interactive information management, interactive achievement in the process of informed consent,and interactive management of following review and quality control. It aims to rem-edy the existing defects in the ethical review of clinical trials and quality management system, to guarantee the quality of clinical trials, and to achieve the full coverage of ethical codes in clinical trials.

Phosphorylation of Atg31 is required for autophagy

Autophagy is an evolutionarily conserved cellular process which degrades intracellular contents. The Atg17-Atg31-Atg29 complex plays a key role in autophagy induction by various stimuli. In yeast, autophagy occurs with autophagosome formation at a special site near the vacuole named the pre-autophagosomal structure (PAS). The Atg17-Atg31-Atg29 complex forms a scaffold for PAS organization, and recruits other autophagy-related (Atg) proteins to the PAS. Here, we show that Atg31 is a phosphorylated protein. The phosphorylation sites on Atg31 were identified by mass spectrometry. Analysis of mutants in which the phosphorylated amino acids were replaced by alanine, either individually or in various combinations, identified S174 as the functional phosphorylation site. An S174A mutant showed a similar degree of autophagy impairment as an Atg31 deletion mutant. S174 phosphorylation is required for autophagy induced by various autophagy stimuli such as nitrogen starvation and rapamycin treatment. Mass spectrometry analysis showed that S174 is phosphorylated constitutively, and expression of a phosphorylation-mimic mutant (S174D) in the Atg31 deletion strain restores autophagy. In the S174A mutant, Atg9-positive vesicles accumulate at the PAS. Thus, S174 phosphorylation is required for formation of autophagosomes, possibly by facilitating the recycling of Atg9 from the PAS. Our data demonstrate the role of phosphorylation of Atg31 in autophagy.

Expressions of IL-16, IFN-γ and CXCR3 in plasma of patients with chronic obstructive pulmonary disease and their clinical significance / 实用医学杂志

Objective Toexplore the expressions of interleukin-16 (IL-16), interferon-γ (IFN-γ), CXC chemokine receptor 3 (CXCR3), and CRP and their clinical significance in acute exacerbation chronic obstructive pulmonary disease by observing the changes in these factors in patients with AECOPD. Methods 103 patients with AECOPD and 20 healthy controls were collected. According to the 2013 GOLD guideline, all the patients with AECOPD were divided into4 groups(group A of 21 patients, B of 30, C of 27, andD of 25). Results As compared withthe control group, plasma concentrations of IL-16, IFN-γ, CXCR3. and CRP were significantly increased in the patients with AECOPD (P < 0.01), and as the severity of the disease was elevating, these expression levels were significantly increased.While the expression levels of IL-16, IFN-γ, CXCR3, and CRP levels were significantly reduced after treatment, but they were still higherthan those in the control group (P < 0.05). The expression levels of serum IL-16, IFN-γ, CXCR3, and CRP were significantly correlated in patients with AECOPD. Conclusions Expressions of IL-16, IFN-γ and CXCR3 are significantly increased in AECOPD, which is correlated with disease severity and decreased after treatment, suggesting that these three factors may be associated with the occurrence and development of COPD.

Association of serum 25-hydroxyvitamin D levels with aterial stiffness and left ventricular hypertrophy in elderly hypertension patients / 中华老年医学杂志

Objective To examine the association of serum 25-hydroxyvitamin D levels with arterial stiffness and left ventricular hypertrophy (LVH) in elderly hypertension patients.Methods We recruited 166 elderly patients [mean age,(80.8 ± 6.2) years] with primary hypertension.Arterial stiffness was assessed by carotid femoral pulse wave velocity (cfPWV).Left ventricular mass index (LVMI) was determined according to the Devereux formula.Based on serum 25-hydroxyvitamin D levels,the patients were divided into two groups,the low 25-hydroxyvitamin D group (＜20 μg/L)and the high 25-hydroxyvitamin D group (≥20 μg/L).Results Faster cfPWV and larger LVMI values were observed in the low 25-hydroxyvitamin D group as compared with the high 25-hydroxyvitamin Dgroup [(15.00±3.04) m/s vs.(11.26±3.09) m/s;(120.14±25.82) g/m2 vs.(96.74±23.10) g/m2 ; t=-6.79,-5.16,respectively; both P=0.000].Multiple liner regression analysis showed that the 25-hydroxyvitamin D level was independently associated with LVMI (β=0.215,P=0.001) and cfPWV (β=-0.469,P＜0.001).Conclusions Serum 25-hyroxyvitamin D is independently associated with arterial stiffness,LVH Vitamin D may play an important role in the pathogenesis of arterial stiffness and LVH in elderly hypertension patients.

Structural insights into the assembly of the 30S ribosomal subunit in vivo: functional role of S5 and location of the 17S rRNA precursor sequence

The in vivo assembly of ribosomal subunits is a highly complex process, with a tight coordination between protein assembly and rRNA maturation events, such as folding and processing of rRNA precursors, as well as modifications of selected bases. In the cell, a large number of factors are required to ensure the efficiency and fidelity of subunit production. Here we characterize the immature 30S subunits accumulated in a factor-null Escherichia coli strain (∆rsgA∆rbfA). The immature 30S subunits isolated with varying salt concentrations in the buffer system show interesting differences on both protein composition and structure. Specifically, intermediates derived under the two contrasting salt conditions (high and low) likely reflect two distinctive assembly stages, the relatively early and late stages of the 3' domain assembly, respectively. Detailed structural analysis demonstrates a mechanistic coupling between the maturation of the 5' end of the 17S rRNA and the assembly of the 30S head domain, and attributes a unique role of S5 in coordinating these two events. Furthermore, our structural results likely reveal the location of the unprocessed terminal sequences of the 17S rRNA, and suggest that the maturation events of the 17S rRNA could be employed as quality control mechanisms on subunit production and protein translation.

Antidiarrheal properties of different extracts of Chinese herbal medicine formula Bao-Xie-Ning / 中西医结合学报

Bao-Xie-Ning (BXN), a traditional Chinese herbal medicine (CHM) formula composed of Fructus Evodiae, Flos Caryophylli and Cortex Cinnamomi, and used for the treatment of infant diarrheal illness, was subject to systematic assessment for its putative multiple pharmacodynamic effects and pharmacological antidiarrheal mechanisms.

Antidiarrheal properties of different extracts of Chinese herbal medicine formula Bao-Xie-Ning / 中西医结合学报

<p><b>OBJECTIVE</b>Bao-Xie-Ning (BXN), a traditional Chinese herbal medicine (CHM) formula composed of Fructus Evodiae, Flos Caryophylli and Cortex Cinnamomi, and used for the treatment of infant diarrheal illness, was subject to systematic assessment for its putative multiple pharmacodynamic effects and pharmacological antidiarrheal mechanisms.</p><p><b>METHODS</b>High-performance liquid chromatography-diode array detector-electrospray ionization-mass spectrometric/mass spectrometry was developed and validated for identification and quantification of the main constituents in different extracts of BXN. Male Kunming mice weighing 20 to 25 g were used for detecting the antidiarrheal activity of the extracts. Ethanolic extract (EE), volatile oil extract (VOE), and aqueous extract (AE) of BXN were respectively subjected to pharmacodynamic and pharmacological comparison in assessing antidiarrheal effects with senna-induced diarrhea, castor oil-induced diarrhea, acetic acid-induced writhing assay, and isolated duodenum test.</p><p><b>RESULTS</b>The highest yields of three detected components of BXN, rutaecarpine, eugenol and cinnamaldehyde were observed in EE. EE showed the most remarkable antidiarrheal activity in dose-dependent and time-dependent manners in both senna- and castor oil-induced diarrhea models, and presented dose-dependent analgesic activity in acetic acid-induced algesthesia model. In addition, EE extract of BXN also exhibited strong antimobility action on the intestine and strongest depression on spontaneous contraction of isolated duodenum.</p><p><b>CONCLUSION</b>Ethanol extraction is an efficient method to extract the active constituents of BXN. BXN extract demonstrated multiple pharmacological activities affecting the main mechanisms of diarrhea, which validated BXN's usage in the comprehensive clinical treatment of diarrhea.</p>

Clinical analysis of healthcare-associated pneumonia / 中国感染与化疗杂志

Objective To study the clinical characteristics of healthcare-associated pneumonia (HCAP).Methods A retrospective cohort study was conducted on consecutive hospitalized pneumonia cases from January 2007 through April 2008.Results HCAP group of 75 patients was compared with 133 patients of community-acquired pneumonia (CAP) and 76 patients of hospital-acquired pneumonia (HAP). Most of HCAP patients had a history of recent hospitalization (47 cases), clinical IV infusion (27 cases), and prior chemotherapy or antibiotic therapy (27 cases). Underlying diseases were identified in 71 (94.7%) of HCAP patients, significantly higher than that in CAP group (37.6%, P<0.01). Positive sputum culture in CAP, HCAP and HAP was 22.6%, 56.9%, 77.6% respectively. Antibiotic resistance of bacteria in HCAP (71.43%) and HAP (80%) was comparable (P>0.05). Initial antibiotic therapy was effective in 47 (62.6%) cases of HCAP. Only 52.9% of the identified pathogens were sensitive to initial antibiotic therapies. The mortality of HCAP (12%) was similar to HAP (23%, P>0.05), but significantly higher than CAP (3%, P<0.05).Conclusions HCAP is a common type of pneumonia, which is characterized by more resistant pathogens, higher mortality, more comorbidities and poor outcomes. Antibiotic therapy should cover the hospital acquired bacterial pathogens.

Monitoring and Analysis of Drug Utilization in In-patients of Our Hospital by PASS / 中国药房

OBJECTIVE:To investigate the drug use in the inpatients of our hospital and evaluate its rationality.METHODS:By using PASS-nested "Army Health No.1" hospital information system,the drug utilization in these patients was analyzed.RESULTS:Among 32 834 medication orders for 586 inpatients,732(1.50%)were warning ones.CONCLUSION:The drug utilization in the inpatients of our hospital was rational on the whole.PASS satisfies clinical doctors' needs,and the physicians feel satisfied with the system.Nevertheless,there are some problems remain to be tackled.

Considerations on Unlicensed and Off-Label Drug Uses / 中国药房

OBJECTIVE: To provide reference for dealing with the problems arose from unlicensed and off-label drug uses.METHODS: The rationality of unlicensed and off-label drug uses and the possible problems induced by which were analyzed.RESULTS: The existence of unlicensed and off-label drug used has its rationality,and it also in line with the international practices,but it may cause some problems related to policy,laws and regulations and medication safety etc.CONCLUSION: The concerned department and trade association should attach great importance to unlicensed and off-label drug uses and establish a generally accepted principle and strategies to tackle the problems.

Effects of mental state on patients with high altitude pulmonary edema / 第二军医大学学报

Objective: To investigate the effects of psycholog ical factors on treatment and outcome of patients with high altitude pulmonary e dema(HAPE). Methods: In the present study, one hundred and fifty -two patients with HAPE were tested by hospital anxiety and depression scale. Results: The results showed that there were 61 patients (40.13%) with anxiety and 29 patients (19.08%) with depression. The important factors on mental state of patients were preventive education, the first time suffering HA PE, characters of patients, degree of the disease and the medical fee, the less w ere age, sex, occupation and education of patients. Duration of rales of lung an d course of illness were significantly prolonged in HAPE patients with mental di sorders compared to the patients without mental disorder. Conclusion:The study suggests that anxiety and depression might aggravate the state of HAPE.

Preliminary Study on Implementation of Standardized Management of Dispensing in Our Hospital / 中国药房

OBJECTIVE: To probe into the standardized management of dispensing in the pharmacy METHODS: To introduce the idea of standardization in dispensing, to establish and implement SOP(standard operating procedure), to carry out networking management, to setup the modern facility, and to introduce the new open and divisional mode for dispensing drugs and to put dispensing and supply of drugs in over - inclusive standardized management .RESULTS: The standardized management of dispensing and supply of drugs was achieved on the whole and the aim of precise dispensing and scientific management was fulfilled. CONCLUSION: The establishment and implementation of SOP, the networking management of drugs and mord-ernization of facility are the basis of standardization of dispensing of drugs.