Study on clinical efficacy and mechanism of Qingying Tang for treating psoriatic blood-heat syndrome based on IL-23/Th17 / 中国中药杂志

To observe the clinical curative effect of Qingying Tang in the treatment of psoriatic blood-heat syndrome and explore its intrinsic mechanism.In this study,we collected 72 patients with blood-heat syndrome psoriasis admitted to our dermatology clinic from January 2016 to December 2017 and divided into control group and observation group according to the random number table method,36 cases in each group.The patients in control group were given with Acitretin Capsules orally,10 mg/time,twice a day.The patients in observation group were given with Qingying Tang orally,150 mL/time,twice a day.The treatment period was 12 weeks in both groups.The traditional Chinese medicine(TCM) syndrome scores before and after treatment,psoriasis area and severity index(PASI) score,dermatology life quality index(DLQI) score,and the clinical efficacy of the two groups were compared between the two groups;flow cytometry was used to detect peripheral blood Th17 cell percentages before and after treatment in both groups;serum interleukin(IL)-17,IL-23,IL-22,and IL-21 levels in both groups before and after treatment were measured by ELISA;the expression levels of STAT3 and RORγt before and after treatment in patients were measured by using skin lesion immunohistochemical method.The results showed that the TCM symptoms were improved significantly in both groups(P<0.05),and the effect in observation group was significantly better than that in the control group(P<0.05).PASI and DLQI scores were decreased significantly after treatment in both groups(P<0.05),and the scores in observation group were significantly lower than those in the control group(P<0.05).The curative effect of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the percentage of Th17 cells,as well as IL-17,IL-23,IL-22 and IL-21 levels in peripheral blood were significantly decreased in both groups(P<0.05),and the levels in observation group were significantly lower than those in the control group(P<0.05).The expression levels of STAT3 and RORγt in both groups were significantly lower than those before treatment(P<0.01),and the levels in observation group were significantly lower than those in the control group(P<0.05).All of the results indicted that Qingying Tang can effectively improve the skin lesions and TCM syndrome in patients with psoriasis and blood-heat syndrome,and improve patient health quality,which may be related to regulation of peripheral blood IL-23/Th17.

Effect of hyperforin on learning and memory abilities and Aβ₁₋₄₂, βAPP and BACE1 protein expressions in hippocampus of Alzheimer's disease model mice / 中国中药杂志

To investigate the effect of the hyperforin (HF) on learning and memory function and Aβ₁₋₄₂, βAPP and BACE1 protein expressions in hippocampus of five-month-old APP/PS1 double transgenic mice, and discuss the underlying mechanism of HF. The five-month-old APP/PS1 double transgenic mice were randomly divided into the model group, rosiglitazone group (12 mg•kg⁻¹•d⁻¹) and HF high dose, middle dose and low dose groups (600, 300 and 150 mg•kg⁻¹•d⁻¹) in each group; in addition, 15C57BL/6J mice with the same months and background were selected as normal group. Drugs were diluted in the same volume before using, and then administrated by ig for 7 months, 1 time a day; the mice in normal group and model group received the same volume of distilled water. The learning and memory ability was tested by Morris water maze; Aβ₁₋₄₂, βAPP and BACE1proteinexpressionlevelswere tested by immunohistochemistry and Western blot. The Morris water maze results showed that as compared with the normal group, the learning and memory ability was significantly impaired in mice of model group (P<0.01); as compared with the model group, the learning and memory ability was improved in mice of rosiglitazone group and HF high, middle and low dose groups(P<0.01 or P<0.05). Immunohistochemistry and western blot results showed thatas compared with the normal group, the Aβ₁₋₄₂, βAPP and BACE1 protein expression levels in hippocampus were significantly increased in mice of model group (P<0.01);as compared with the model group, Aβ₁₋₄₂, βAPP and BACE1 protein expression levels in hippocampus were decreased in mice of rosiglitazone group and HF high, middle and low dose groups (P<0.01 or P<0.05). HF may improve the learning and memory ability of AD model mice via inhibition of βAPP and BACE1 protein expressions, thus reduced the generation of Aβ₁₋₄₂ proteins and amyloid plaque deposits in the brain.

Reliability of Amsterdam Preoperative Anxiety and Information Scale score in evaluating preoperative anxiety of Chinese people / 中华麻醉学杂志

Objective To evaluate the reliability of Amsterdam Preoperative Anxiety and Information Scale (APAIS) score in evaluating the preoperative anxiety of Chinese people.Methods One hundred sixty Chinese patients of both sexes, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective surgery, were enrolled.Preoperative anxiety of the patients was assessed with APAIS score and Spielberger's State-Anxiety Inventory (S-AI) questionnaire during the preoperative interview.Cronbach's alpha of total anxiety and need for information scores was calculated.Four thresholds of total anxiety score in identifying preoperative severe anxiety was set as 10, 11, 12 and 13.S-AI questionnaire was considered as the standard, and the correlation between total anxiety score and S-AI questionaire was tested.Results The Cronbach's alpha of total anxiety and need for information scores was 0.84 and 0.71, respectively.When the threshold of total anxiety score in identifying preoperative severe anxiety was 12, the total anxiety score was highly correlated with S-AI questionnaire, the Kappa value was 0.62, 95％ confidence interval was 0.46-0.78, the sensitivity was 0.71, the specificity was 0.90, and the positive predictive value was 0.78.Conclusion APAIS score can be used to assess the preoperative anxiety of Chinese people.

The Challenge and Countermeasure of Pharmacy Automation Construction in Public Hospital / 中国药房

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.

Effect of repeated hypoxic preconditioning on renal ischemia-reperfusion-induced hepatic dysfunction in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the effect of repeated hypoxic preconditioning (RHP) on renal ischemia-reperfusion-induced hepatic dysfunction in rats and the underlying mechanism.</p><p><b>METHODS</b>A total of 120 normal SD rats were randomly divided into 4 groups (n=40), namely RHP surgical group, RHP sham-operated (RHPS) group, nonhypoxic surgical group (IRI group), and nonhypoxic sham-operated group (S group). The rats in the hypoxic groups were exposed to hypoxia in a hypoxic chamber for 5 days prior to establishment of renal ischemia-reperfusion model by resection of the right kidney and clamping the left renal hilum. Serum alanine aminotransferase (ALT), IL-17 A, TNF-a, liver superoxide dismutase (SOD) and nitric oxide (NO) were detected at 2, 8 and 24h after reperfusion, and Western blotting was used to determine the expression of p-PI3K and p-AKT;HE staining was used to observe the structural changes in the liver.</p><p><b>RESULTS</b>Compared with IRI group, RHP group showed significantly milder hepatic damage, lower ALT levels and higher NO levels at 2, 8, and 24 after reperfusion (P<0.05); TNF-a levels were lowered at 24 h (P<0.05) and SOD increased at 8 h after the reperfusion (P<0.05). Compared with S group, IRI group and RHP group showed significantly higher IL-17A levels (P<0.05) but without significant difference between the latter two groups (P>0.05). The expressions of p-PI3K and P-Al<t in RHP group were significantly higher than those in IRI group (P<0.05), especially at 8 h after reperfusion (P<0.05).</p><p><b>CONCLUSION</b>Repeated hypoxic preconditioning can attenuate hepatic injury induced by renal ischemia-reperfusion injury in rats.</p>

Laparoscopic surgery for complex choledochal cysts / 中华普通外科杂志

Objective To summarize our experience of laparoscopic surgery for complex choledochal cysts (type Ⅳ-A). Methods The clinical data of 65 children of choledochal cyst undergoing laparoscopic choledochal cyst resection were retrospectively reviewed from 2002 to 2009 in our institute.Among those type Ⅳ-A cyst was found in 16 patients. Hepaticojejunostomy was performed using a Roux-en-Y jejunal loop after extrahepatic cyst excision and ductoplasty. Results Laparoscopic procedures were successfully performed in 16 patients with type Ⅳ-A cysts. The stenotic segment was splited or excised and a wide hepaticojejunostomy was completed at the porta hepatis in 8 patients with a stricture extending to the level of common hepatic duct. The constrictive confluence of the bilateral hepatic duct was incised and the bi-ductal cystojejunostomy was achieved at the bifurcation in 4 cases. A septum was found at the orifice of right hepatic duct and was excised through the hilar stoma in 2 cases. A downstream stricture of the left hepatic duct was incised from the hilum to the dilated segment along the lateral wall in 2 patients, so that a long intrahepatic cystojejunostomy was completed in an oblique course. Postoperative complications developed in 2 cases including temporary bile leakage in one case and anastomotic stricture in another. The intrahepatic cysts were remarkably reduced in size during the follow-up. Conclusions With the magnified laparoscopic view, the radical resection of extrahepatic cyst and correction of the intrahepatic bile ductal stenosis can be easily performed. Laparoscopic hepaticojejunostomy and/or intrahepatic cystojejunostomy is effective and safe for children with type Ⅳ-A choledochal cysts.

Suitable oxygen concentration for rat model's hypoxic preconditioning / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study the suitable oxygen concentration in hypoxic preconditioning.</p><p><b>METHODS</b>Short-term and long-term intermittent hypoxia modes were designed and the effects of various oxygen concentrations on body weight, blood oxygen saturation, swimming capability were analyzed.</p><p><b>RESULTS</b>The rate of body weight gain in rat model decreased gradually when exposed to hypoxia environment for long time. When the concentration of oxygen changed from 15% to 8%, accompanied with the decreasing of oxygen concentration, a platform was observed in blood oxygen saturation of rat model after hypoxic preconditioning training. Rat swimming capability improved significantly. After trained in 10% hypoxia environment, the swimming capability of kunming mice improved obviously.</p><p><b>CONCLUSION</b>Proper level of hypoxic preconditioning training could improve hypoxia tolerance and enhance the rat sport capability significantly. 15%-10% oxygen concentration range could be regarded as a helpful effective area for hypoxic preconditioning, 10% oxygen concentration might be the eligible concentration for hypoxic preconditioning training.</p>

Clinical and pathological features of the 5 Limb-girdle muscular dystrophy 2A patients / 中华神经科杂志

Objective To investigate the clinical and molecular pathological features of limb-girdle muscular dystrophy 2A (LGMD2A) of Chinese patients. Methods Thirty cases of LGMD with excluding LGMD2B were included in this study. The muscle specimens were performed by a standard series methods of histochemistry, enzymohistochemistry, immunohistochemistry and Western blot. The clinical and molecular pathological features of LGMD2A were retrospective analyzed. Results Five cases with no or only trace expression of calpain-3 protein were diagnosed as calpainopathy (LGMD2A) by Western blot analysis. The age of onset of these 5 patients ranged from 10 to 45 years and the duration of the disease were about 2-10 years. Proximal muscles weakness and atrophy of lower limbs were predominantly involved. In all patients,symptoms progressed slowly. The ambulation could be retained for many years but running and jumping were impaired early. The serum creatine kinase level was elevated moderately to markedly. Electromyography showed myopathic patterns in all cases. Two siblings had similar symptoms indicating autosomai recessive inherited pattern. Pathologically, there was marked variation in fibre size and most small fibres were round. Some necrotic and regenerating fibers were seen. Fibres with centrally placed nuclei can be found frequently. No infiltrations of inflammatory cells were seen. Lobulated fibers were observed in 2 patients by NADH-TR stain. The expression of dystrophin, caveolin-3, α-, β-, γ- and δ-sarcoglycan protein were normally staining of 5 LGMD2A patients' specimens by immunohistochemistry. Two patients had reduced staining of dysferlin by immunohistochemistry study. Conclusions Clinical and pathological characteristics of our 5 LGMD2A patients are consistent with typical muscular dystrophy features reported in other countries. Identification of calpian-3 deletion by Western blot is essential for the diagnosis of calpainopathy.

Analysis of distribution, drug resistance and risk factors of pathogens isolated from septicemic patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate distribution, drug resistance and risk factors of pathogens isolated from septicemic patients in a hospital in the past 6 years.</p><p><b>METHODS</b>Most of the bacterial isolates were identified with BD Phoenix, and a few isolates were identified manually and with K-B method. Candida isolates were identified with color display plates and K-B method. WHONET5.4 software was used for analysis.</p><p><b>RESULTS</b>The common bacteria isolated form the blood included E. coli, P. aeruginosa, K. pneumoniae, and S. aureu. The gram-negative bacillus from the blood exhibited relatively low resistance to such antibiotics as cefoperazone/sulbactam, imipenem, amikacin, piperacillin/tazobactam, and ceftazidime, and the incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) ranged between 33.3% and 34.9% and between 32.9% and 36.0%, respectively. The gram-positive coccus from blood showed a sensitivity rate of 100.0% to vancomycin and low resistant rates to amikacin and chloramphenicol; the methicillin-resistant rates of S. aureu and coagulase-negative staphylococcus were 26.9%-35.5% and 72.7%-74.3%, respectively. The risk factors of septicemia included hospital stay for over 5 days, venous catheterization, surgeries, puncture, oxygen therapy, urine tract catheterization, and chemotherapy.</p><p><b>CONCLUSION</b>Blood culture can be of importance in patients with septicemia, and the use of antibiotics should be carefully weighed according to the results of bacterial culture and sensitivity tests of the pathogens isolated from the blood.</p>

Distribution and drug resistance spectrum analysis of 2478 clinical bacterial and Candida isolates / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the distribution and drug resistance spectrum of clinical bacterial and Candida isolates.</p><p><b>METHODS</b>Most of the bacterial isolates were identified using automated BD Phoenix, and a few with K-B method carried out manually. Candida isolates were identified by color-display plate and K-B method.</p><p><b>RESULTS</b>The most common isolates in the 2478 strains were P. aeruginosa (15.6%), E. coli (11.5%), C. albicans (9.6%), K. pneumoniae (9.3%), S. aureu (8.2%), and S. epidermidis (7.5%). In gram-negative isolates, the antibiotics with the lowest resistance rate were meraopenem (14.4%), cefoperazone/Sulbactam (14.8%), Imipenem (21.9%), piperacillin/tazobactam (27.4%), ceftazidime (30.0%), amikacin (31.1%), and cefepime (33.1%). The detection rate of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) were 47.4% and 37.3% respectively. In gram-positive isolates, the antibiotics with the lowest resistance rate were vancomycin (0.9%), teicoplanin (1.1%), nitrofurantoin (6.9%), amikacin (20.1%), chloramphenicol (30.7%), and cefoperazone/sulbactam (31.5%). The methecillin-resistant rates of S. aureu , S. epidermidis, and S. haemolyticus were 57.1%, 65.0%, and 66.0%. For Candida isolates, the most sensitive antibiotics were amphotericin B (0.3%), nystain (0.3%), itraconazole (5.6%), fluconazole (9.4%), and fluorocytosine (9.4%).</p><p><b>CONCLUSION</b>The results suggest high rate of ESBL production and oxacillin resistance of the bacteria isolated in the hospital. More rational use of antimicrobial agents is crucial for reducing the drug-resistance of the bacteria, and effective measures must be taken to reduce dissemination of multidrug-resistant bacteria.</p>

Surgical Treatment and Etiology Explorement of Axillary Tuberculous Lymphadenitis in Infant / 实用儿科临床杂志

Objective To present the experience in surgical treatment method and clinic application of axillary tuberculous lymphadenitis in infant.and discuss its etiology.Methods From 1995 to 2003, axillary tuberculous lymphadenitis mass in 14 hospitalized cases were resectioned.Results The incision healing was better in 3 cases of regional lymphadenectomy and 11 cases of axillary lyphoidectomy.The tuberculous lymphadenitis was not relapse during patients were followed-up.All discharge patients were not suffer from extrapulmonary and intrapulmonary tuberculosis.Conclusions The prompt regional lymphadenectomy and axillary lyphoidectomy are preferred to axillary tuberculous lymphadenitis and suspicious tuberculous lymphadenitis.It is effective to avoid the patients suffering from tuberculosis in other organs of human body and eliminate antituberculous drugs lesion to important organs of body.