Application of ultrasound-guided obturator nerve block combined with general anesthesia in transarethral resection of bladder fumors for elderly patients / 中华老年医学杂志

Objective:To explore the clinical value of ultrasound-guided obturator nerve block combined with general anesthesia in transurethral resection of bladder tumors(TURBT)for the elderly.Methods:A total of 84 elderly bladder tumor patients were randomly selected from those admitted to our hospital from November 2017 to August 2019, and were divided into the observation group(n=43)and the control group(n=41)according to whether obturator nerve block was performed.Patients in the observation group were given general anesthesia combined with ultrasound-guided obturator nerve block, and those in the control group were given general anesthesia alone.The surgical conditions, postoperative complications, and rates of adverse reactions were compared between the two groups.Results:Patients in the observation group had a significantly shorter duration of operation, shorter indwelling urinary catheter use, fewer days stayed in hospital and less intraoperative blood loss, compared with the control group(all P<0.05). Besides, the incidence of obturator nerve injury in the observation group was also significantly lower than in the control group(4.65% vs.19.51%, χ2=4.420, P=0.036). There were 2 cases of bladder hemorrhage and 1 case of bladder perforation in the control group, but no case of bladder hemorrhage or bladder perforation occurred in the observation group.A total of 2 cases of tachycardia, 2 cases of nausea and vomiting, and 1 case of hypotension were seen in the control group; and 3 cases of tachycardia, 1 case of nausea and vomiting, and 2 cases of hypotension occurred in the observation group.The total incidence of adverse reactions was similar between the two groups(12.16% vs.13.95%, χ2=0.057, P=0.811). Conclusions:The use of ultrasound-guided obturator nerve block combined with general anesthesia in TURBT surgery can effectively enhance the inhibitive effect on obturator nerve reflex, and reduce the risk of obturator nerve injury during surgery.Therefore, it can ensure smooth operation of the surgery and has a very positive effect on promoting successful postoperative rehabilitation.

Expert consensus on ShenqiJiangtang Granule in clinical application of type2 diabetes / 中草药

ShenqiJiangtang Granule is composed of Panax ginseng, Astragali Radix and other valuable Chinese herbal medicines and extract, which has the effect of replenishing qi and nourishing yin, nourishing spleen and kidney, and it is also widely used in the treatment of type 2 diabetes and complications. After more than 20 years of clinical application, abundant research data have been accumulated. In order to accurately locate the clinical position and promote the rational use of drugs, a project was established by the Chinese Society of Traditional Chinese Medicine and experts organized by the Diabetes Branch to compile this consensus. This consensus defines the application of ShenqiJiangtang Granule in the clinical treatment of prediabetes, type 2 diabetes and its complications. It is suitable for clinicians at all levels of hospitals and grass-roots medical and health institutions across the country (traditional Chinese medicine, Western medicine, integrated traditional Chinese and Western medicine).

Efficacy of perioperative management in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids / 中华老年医学杂志

Objective To investigate the efficacy of perioperative management in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids(PPH).Methods A total of 128 elderly patients treated with PPH in the Second Affiliated Hospital of Jiaxing University from February 2018 to January 2019 were enrolled and randomly divided into the routine group(n=64)and the intervention group(n=64).The routine group underwent routine postoperative management,and the intervention group received intervention postoperative management as add-on to routine postoperative management.Clinical efficacy was compared between the two groups.Results The frequency of constipation and hematoehezia was less and the hospitalization days were shorter in the intervention group than in the routine group(0.8 ± 0.6 times/d vs.1.2 ± 0.4 times/d,1.3 ± 0.8 times/d vs.2.0± 1.0 times/d,4.9± 1.1 days vs.7.4± 1.3 days,t =4.438,4.372 and 11.744 respectively,all P =0.000).The scores of visual analog scale(VAS) and geriatric depression scale (GDS) had no significant difference between the intervention and routine groups (5.0 ± 1.6 scores vs.5.2 ± 1.3 scores for VAS;22.2± 2.9 scores vs.22.5 ± 2.6 scores for GDS,t =0.776 and 0.616,P =0.220 and 0.269)before intervention,and had significant difference between the intervention and routine groups[2.7 ± 0.7 scores vs.3.2 ± 1.1 scores for VAS;17.2 ± 1.8 scores vs.19.0 ± 2.2 scores for GDS(t =3.068 and 5.066,P=0.001 and 0.000)]after intervention.The scores of quality of life,including physiological function,emotional function,social function,mental health and health status,were higher in the intervention group than in the routine group (all P ＜ 0.05).Conclusions Intervention perioperative management is effective in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids,It can not only effectively improve clinical symptoms and shorten treatment time,but also alleviate pain and improve prognosis and quality of life.

Effect of Dexmedetomidine on postoperative impairment of cognitive function in elderly patients undergoing thoracoscopic surgery under wireless analgesia / 中华老年医学杂志

Objective To investigate the effect of Dexmedetomidine on postoperative impairment of cognitive function in elderly patients undergoing thoracoscopic surgery under wireless analgesia.Methods Eighty elderly patients undergoing thoracoscopic surgery in our hospital from May 2017 to April 2018 were randomly divided into the S group(n=40)receiving Sufentanil under wireless analgesia,and the DS group receiving Dexmedetomidine as add-on to the therapy for S group.The mini-mental state examination(MMSE) score,postoperative pain degree,and serum levels of interleukin(IL)-1,IL-6 and tumor necrosis factor(TNF)-α,as well as adverse reactions were compared between the two groups,preoperatively and postoperatively.Results MMSE score was higher in the DS group than in the S group at 1 and 3 days after operation[(26.85±1.20)vs.(26.33±1.33),(26.65± 1.16)vs.(26.00± 1.29),t =1.795 and 2.370,P =0.038 and 0.010].Pain visual analog scale(VAS)score was lower in the DS group than in the S group at 6 and 12 hours after operation[(4.32±0.64)vs.(4.65±0.77),(4.01±0.45)vs.(4.23±0.59),t=2.138 and 1.875,P=0.018 and 0.032,respectively].At 1 and 3 days after operation,IL-1,IL-6 and TNF-α levels were higher in SD group than in S group (P ＜ 0.05).But,at 5 and 7 days after operation,there was no significant difference in the expression levels of IL-1,IL-6 and TNF between the two groups (P ＞0.05).The incidence of nausea was lower in DS group than in S group(2.5％ vs.15.0％,x2 =3.914,P=0.048),while the incidence of bradycardia was higher in the DS group than in the S group(17.5％ vs.2.5 ％,x2 =5.000,P =0.025).Conclusions Dexmedetomidine not only effectively alleviates the postoperative pain and improves cognitive function in elderly patients undergoing thoracoscopic management under wireless analgesia,but also reduces postoperative inflammatory levels.

Neurobiological mechanisms of conditioned fear memory reconsolidation / 中国病理生理杂志

Post-traumatic stress disorder (PTSD) is a reactive mental disorder that occurs after an individual was exposed to a traumatic event,and the core of the treatment is the extinction of conditioned fear memory caused by stress.Fear memory is an incentive mechanism based on external stimuli that occupy a central position in the defense system.Traditional memory concept convinced that the original memory traces were in an unstable state when the memory was activated.This process is called memory reconsolidation.The research has proved the existence of the fear memory reconsolidation,but the specific mechanism of reconsolidation has not been clarified.The animal studies show that many brain sites and molecular mechanisms are involved in the process of fear memory reconsolidation.Understanding the underlying mechanisms of fear memory reconsolidation is conducive to the treatment of specific phobias and PTSD.This review summarized the brain structure and molecular mechanism of conditioned fear memory reconsolidation,providing a new direction for the in-depth study of conditioned fear memory reconsolidation and PTSD.

Neurobiological mechanisms of conditioned fear memory reconsolidation / 中国病理生理杂志

Post-traumatic stress disorder (PTSD) is a reactive mental disorder that occurs after an individual was exposed to a traumatic event,and the core of the treatment is the extinction of conditioned fear memory caused by stress.Fear memory is an incentive mechanism based on external stimuli that occupy a central position in the defense system.Traditional memory concept convinced that the original memory traces were in an unstable state when the memory was activated.This process is called memory reconsolidation.The research has proved the existence of the fear memory reconsolidation,but the specific mechanism of reconsolidation has not been clarified.The animal studies show that many brain sites and molecular mechanisms are involved in the process of fear memory reconsolidation.Understanding the underlying mechanisms of fear memory reconsolidation is conducive to the treatment of specific phobias and PTSD.This review summarized the brain structure and molecular mechanism of conditioned fear memory reconsolidation,providing a new direction for the in-depth study of conditioned fear memory reconsolidation and PTSD.

Correlation of oxidative stress with sperm DNA integrity and semen parameters in infertile men with varicocele / 中华男科学杂志

<p><b>Objective</b>To investigate the relationship of oxidative stress with DNA integrity and semen parameters in infertile men with varicocele (VC).</p><p><b>METHODS</b>This prospective study included 98 infertile males with VC. According to the levels of reactive oxygen species (ROS) in the semen, we divided the patients into a high ROS group (n=44) and a low ROS group (n=54), determined the sperm DNA fragmentation index (DFI), motility and morphology, and analyzed their correlation with ROS in the two groups of patients.</p><p><b>RESULTS</b>Compared with the patients of the low ROS group, those of the high ROS group showed a significantly higher DFI (27.38±8.10 vs 34.49±6.05, P=0.039) and a higher concentration of seminal leukocytes (［0.65±0.15］×10⁶/ml vs ［0.86±0.41］×10⁶/ml, P=0.022), but lower sperm motility (［36.16±22.83］% vs ［18.22±25.21］%, P=0.017), percentage of progressively motile sperm (［23.34±11.53］% vs ［16.34±9.22］%, P=0.041), sperm curvilinear velocity (［27.03±6.21］ vs ［20.62±4.38］ μm/s, P=0.013), and sperm linearity (［29.75±8.24］% vs ［18.30±7.93］%, P=0.024). Spearman correlation analysis indicated that the ROS level was correlated positively with the concentration of seminal leukocytes (r=0.41, P<0.01) and DFI (r=0.21, P=0.006), but negatively with sperm curvilinear velocity (r=－0.24, P=0.017), linearity (r=－0.24, P=0.021), motility (r=－0.31, P=0.002), and the percentage of progressively motile sperm (r=－0.41, P=0.012). Additionally, the sperm DFI manifested a significant negative correlation with sperm motility (r=－0.29, P<0.01) and the percentage of progressively motile sperm (r=－0.34, P<0.01).</p><p><b>CONCLUSIONS</b>The level of seminal ROS is positively correlated with the sperm DFI in infertile men with varicocele, and both the ROS level and DNA integrity are associated with semen parameters.</p>

Chemical constituents from the roots of Angelica polymorpha Maxim / 药学学报

Angelica polymorpha Maxim. is a plant of the Angelica genus (Umbelliferae). The root and stem of this plant is a folk medicine known to have the actions of relieving rheumatism and cold and subsiding swelling and pains. To investigate the chemical constituents in the root of A. polymorpha Maxim., seven compounds were isolated from an 80% ethanol extract by column chromatography. Their structures were elucidated according to the spectroscopic analysis. Compound 1 is a new sesquiterpene, named as bisabolactone. Its absolute configuration was determined by 1D NOESY and CD analysis. The others were identified as 5-hydroxymethylfurfural (2), hycandinic acid ester 1 (3), ferulic acid (4), isooxypeucedanin (5), noreugenin (6) and cimifugin (7). Compound 2 and 3 were isolated from this genus for the first time and compound 4 was isolated from this plant for the first time.

Ping-tang Recipe () improves insulin resistance and attenuates hepatic steatosis in high-fat diet-induced obese rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of Ping-tang Recipe (, PTR) on high-fat diet (HFD)-induced insulin resistance and non-alcoholic fatty liver disease (NAFLD), and to elucidate the underlying mechanisms.</p><p><b>METHODS</b>Forty male SD rats were included in the study. Ten rats were fed on normal diet as normal control, and thirty rats were fed on HFD for 8 weeks to induce obesity, followed with low dose (0.42 g/kg) or high dose (0.84 g/kg) of PTR or vehicle for 8 weeks with 10 animals for each group. Glucose metabolism and insulin sensitivity were evaluated by oral glucose tolerance test and insulin tolerance test. Hepatic steatosis was measured by immunohistochemistry. Liver lipid metabolic genes were analyzed by quantitative real-time polymerase chain reaction, while AMP-activated protein kinase (AMPK) expression was examined by Western blot.</p><p><b>RESULTS</b>Rats fed on HFD developed abdominal obesity, insulin resistance and NAFLD. PTR treatment reduced visceral fat (peri-epididymal and peri-renal) accumulation, improved glucose metabolism, and attenuated hepatic steatosis. The expressions of the key lipolytic regulating genes, including peroxisome proliferators-activated receptor γ co-activator 1α (PGC-1α), peroxisome proliferator-activated receptor γ (PRAR-γ) and α (PRAR-α), were up-regulated (P<0.05 or P<0.01), while the expressions of lipogenic genes such as sterol regulatory element-binding protein 1c (SREBP-1c), fatty acid synthase (FAS) and liver fatty acid-binding protein (L-FABP) were down-regulated (P<0.05 or P<0.01). In addition, PTR activated AMPK and promoted acetyl-CoA carboxylase phosphorylation in the liver.</p><p><b>CONCLUSIONS</b>PTR improves insulin resistance and reverse hepatic steatosis in the rat model of HFD-induced obesity through promotion of lipolysis and reduction of lipogenesis, which involves the AMPK signaling pathway, thus representing a new therapeutic intervention for obesity related insulin resistance and NAFLD.</p>

Chemical constituents of Ligularia duciformis / 药学学报

Ligularia duciformis is a plant of the Ligularia genus (Compositae) which has been reported to have therapeutic effects of treating diseases such as bronchitis and coughing. In order to find out the bioactive components, the 85% ethanol extract of the root and rhizome of L. duciformis was treated by solvents extraction and column chromatography on silica gel and Sephadex LH-20. Six compounds were obtained from the ethyl acetate fraction and identified as 3-methoxy-4-hydroxyphenylpropyl caffeate (I), 6beta, 8beta-dihydroxyeremophil-7 (11)-en-12, 8alpha-olide (II), 6beta, 8alpha-dihydroxyeremophil-7 (11)-en-12, 8beta-olide (III), 6beta-hydroxyeremophil-7 (11)-en-12, 8alpha-olide (IV), stigmasterol (V) and beta-daucosterol (VI) by analysis of their physic-chemical constants and spectral data. Compound I is a new compound and compounds II - V were isolated from L. duciformis for the first time. The antitussive effect of the compounds is under evaluation.

Antidepressant-like effects of the ethanolic extract of Xiaobuxin-Tang, a traditional Chinese herbal prescription in animal models of depression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Xiaobuxin-Tang, a traditional Chinese herbal prescription recorded in a silk scroll unearthed from Mogao Caves of Dunhuang has been indicated that it can remit depressive disorder. The present study was designed to investigate its antidepressant effects in various animal depression models.</p><p><b>METHODS</b>Xiaobuxin-Tang was extracted by 70% alcohol, and then three behavioral despair models and 5-Hydroxytryptophan (HTP)-induced head twitch response model were adopted to assess the antidepressant effects of the ethanolic extract of Xiaobuxin-Tang with the study on spontaneous motor activity. Groups of mice and rats received oral treatment with Xiaobuxin-Tang (150 - 1200 mg/kg) only once acutely in all tests. The duration of immobility was measured during the last 4 minutes of the 6-minutes test period in mice forced swimming test, rats forced swimming test and mice tail suspension test. In 5-HTP-induced head twitch response, the mice were intraperitoneally administered with 120 mg/kg of L-5-HTP, and then the cumulative number of head twitches was counted in 20 minutes. Spontaneous motor activities of mice were recorded automatically in 10 minutes by VIDEOMEX-V image analytic system.</p><p><b>RESULTS</b>The extract at doses of 300 mg/kg (p.o.) and 600 mg/kg (p.o.) significantly decreased the duration of immobility time in a dose dependent manner in mice forced swimming test; also, the extract at dose of 1200 mg/kg (p.o.) significantly decreased the duration of immobility time in rat forced swimming test. Furthermore, the extract at a dose of 600 mg/kg had the same effect in mice tail suspension test. Meanwhile, the extract at the effective doses for behavioral despair models, had no effect on spontaneous motor activity in mice. The extract (300 - 1200 mg/kg, p.o.) also increased the accumulative number of the 5-HTP-induced head twitch response in mice in 20 minutes.</p><p><b>CONCLUSION</b>Our results suggested that the ethanolic extract of Xiaobuxin-Tang exerts antidepressant-like effect.</p>

Detection of pim-1 mRNA in prostate cancer diagnosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pim-1 plays an important role in the apoptosis, proliferation, differentiation of cancer cells and progression of cancer. In this study we detected the expression of pim-1 mRNA in normal prostate, benign prostatic hyperplasia (BPH), and prostate cancer (PCa) and explored its diagnostic value for PCa.</p><p><b>METHODS</b>The prostate tissues were collected from 23 patients with PCa, 37 patients with BPH, and 3 healthy volunteers. Pim-1 mRNA expression levels in these samples were determined by the quantitative real-time PCR (QRT-PCR). The differences of expression were calculated based on a standard curve.</p><p><b>RESULTS</b>The ratio of pim-1 mRNA to beta-actin in the normal prostate, BPH, and PCa were 1.05 +/- 0.04, 2.57 +/- 0.74 and 4.45 +/-0.63, respectively. The differences among PCa, BPH and NT were significant (P < 0.05, respectively).</p><p><b>CONCLUSION</b>Detecting pim-1 mRNA expression by QRT-PCR provides a reliable metric for the diagnosis of PCa.</p>

Study on chemical constituents of bark of Paeonia suffruticosa / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of the bark of Paeonia suffruticosa.</p><p><b>METHOD</b>The 95% ethanol extract was re-extracted with EtOAc, and then separated and purified by column chromatography using silica gel, Sephadex LH -20 and RP-18 as packing materials. The structures were identified on the basis of spectral analysis and physico-chemical characters.</p><p><b>RESULT</b>Six compounds were isolated and identified as (+)-catechin (1), paeonidanin (2), paeoniflorigenone (3), 2, 5-dihydroxy-4-methoxyacetophenone (4), paeonol (5), gallic acid (6).</p><p><b>CONCLUSION</b>The compound 1 was isolsted from the genus Paeonia for the first time. The compounds 2, 3 were isolated from this plant for the first time.</p>

Studies on second metabolites of an endophytic fungus (II) / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents from the cultured mycelia of a fungus Cephalosporium which accelerate the growth of plant.</p><p><b>METHOD</b>The constituents were isolated by column chromatography and identified by advanced physical and spectral analysis.</p><p><b>RESULT</b>Eleven compounds including 3-isopropyl-6-(1-methylpropyl) piperazine-2,5-dione(I), choline sulfate(II), 2-[(2-hydroxy tetracosanoyl) amino]-1,3,4-octadecatriol(III) were isolated and identified.</p><p><b>CONCLUSION</b>Compound I, II were isolated from Cephalosporium genus for the first time.</p>