Analysis of epidemiological and clinical characteristics of 1247 cases of infectious diseases of the central nervous system / 解放军医学杂志

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.

Study on the effects of AI reconstruction algorithm based on different tube voltages on CT imaging quality and radiation dose of chest phantom / 中国医学装备

Objective:To investigate the effects of different tube voltages combined with artificial intelligence reconstruction algorithm(CI)on the computed tomography(CT)imaging quality and radiation dose of chest phantom on the basis of the CT scan for an adult male simulated chest phantom(PH-N1).Methods:A 512-slice CT scanner of ultrahigh-end was adopted to conduct scan,and the images were divided into 70 kV group,80 kV group,100 kV group and 120 kV group according to different tube voltage.For 4 groups of CT scan images with different tube voltages,the 10%,30%,50%,70%and 90%CI were adopted to reconstruct 1mm thin layer image.The CT volume dose index(CTDIvol)and the dose-length product(DLP)of the scans of 4 groups were compared.The CT values and standard deviation(SD)values of the aorta,abdominal wall fat and erector spine muscle were measured.Two senior diagnostic physicians with more than 5 years of work experience independently and double-blindly evaluated the image quality by using 5-point scale.A Kappa consistency test was conducted.One-way analysis of variance was adopted to compare the differences of CT values and SD values of the tissues of image targets.The Friedman rank-sum test was adopted to compare the differences of subjective image qualities among different groups.Results:The differences of CTDIvol and DLP among 4 groups with different tube voltages were significant(F=1855.617,3996.118,P<0.05),respectively.Under 70 kV tube voltage,there were no significant differences in CT values of the aorta,abdominal wall fat and erector spine muscle,which were reconstructed by using 10%,30%,50%,70%and 90%CI(P>0.05),while the differences of SD values among them were statistically significant(F=32.267,53.327,14.873,P<0.05),respectively.Under the different tube voltages of 4 groups,which were reconstructed by 90%CI,the CT values of aorta,abdominal wall fat and erector spine muscle gradually decreased with decreasing of tube voltage,the differences were significant(F=139.899,2563.93,219.231,P<0.05),respectively.The consistency of subjective scores between two diagnostic physicians was better for each group of images(Kappa=0.712～0.869).Conclusion:Compared with 80 kV,90 kV and 120 kV images,the reconstructed images with 90%CI algorithm under 70 kV tube voltage can significantly reduce the radiation dose,and the images have a favorable signal-to-noise ratio at the same time.

Clinical diagnosis and prognostic value of serum TLR4 and VEGFA expression in diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the expression and clinical significance of Toll-like receptor 4(TLR4)and vascular endothelial growth factor A(VEGFA)in the serum of patients with diabetic retinopathy(DR).METHODS: A total of 183 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from January 2021 to January 2022 were collected as the study subjects. They were grouped into non diabetic retinopathy(NDR)group(n=54), proliferative diabetic retinopathy(PDR)group(n=68)and non proliferative diabetic retinopathy(NPDR)group(n=61). In the same period, 70 volunteers who underwent physical examination in our hospital were randomly stratified according to age and sex. After discharge, DR patients were followed up for 1a and grouped into a poor prognosis group(n=40)and a good prognosis group(n=89)based on whether they had visual impairment. Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of TLR4 and VEGFA in serum; Logistic regression was applied to analyze the influencing factors of DR; receiver operating characteristic(ROC)curve was applied to analyze the clinical value of serum TLR4 and VEGFA levels in diagnosing DR and predicting prognosis.RESULTS: There were statistical significance in TLR4 and VEGFA levels among the control group, NDR group, PDR group, and NPDR group(F=935.753, 516.936, all P&#x003C;0.05), and further pairwise comparisons showed statistical significance(P&#x003C;0.05); the expression levels of TLR4 and VEGFA in the serum of patients with poor prognosis were higher than those of patients with good prognosis(P&#x003C;0.01); the results of Logistic regression analysis showed that TLR4, VEGFA, course of disease, and HbA1c were all risk factors for the occurrence of DR(P&#x003C;0.05); the ROC results showed that the AUC of serum TLR4, VEGFA levels, and their combination for predicting DR was 0.869, 0.862, and 0.931, respectively, the AUC of serum TLR4, VEGFA levels, and their combined prediction of visual disability in DR patients was 0.864, 0.863, and 0.938, respectively.CONCLUSION: The expression of TLR4 and VEGFA in serum of DR patients is up-regulated, and the combined detection of TLR4 and VEGFA can be used as a potential indicator to evaluate the occurrence and poor prognosis of DR.

Freeze-dried rabies vaccine followed by death due to septic shock： a case report / 上海预防医学

ObjectiveTo analyze a case of death after inoculation of a freeze-dried rabies vaccine for human use so as to provide reference for the vaccination of the rabies vaccine and the process of investigation and diagnosis involving adverse events following immunization （AEFI） in the future. MethodsData on vaccination， clinical symptoms， treatments， investigation and diagnosis were collected and analyzed. ResultsRabies post-exposure prophylaxis and vaccination were in line with the protocols. On the 3rd day after the inoculation of the rabies vaccine， the patient developed fever， weakness， headache， dizziness， diarrhea and other symptoms. The white blood cell count and neutrophil count increased progressively. At about 17：00 on the same day， the patient suffered a sudden cardiac arrest and died clinically. Autopsy was not carried out. ConclusionThe cause of sepsis /septic shock of the patient is unknown. It is necessary to formulate detailed rabies immunization procedures as well as norms and expert consensus in the field of investigation and diagnosis of AEFI.

Freeze-dried rabies vaccine followed by death due to septic shock： a case report / 上海预防医学

ObjectiveTo analyze a case of death after inoculation of a freeze-dried rabies vaccine for human use so as to provide reference for the vaccination of the rabies vaccine and the process of investigation and diagnosis involving adverse events following immunization （AEFI） in the future. MethodsData on vaccination， clinical symptoms， treatments， investigation and diagnosis were collected and analyzed. ResultsRabies post-exposure prophylaxis and vaccination were in line with the protocols. On the 3rd day after the inoculation of the rabies vaccine， the patient developed fever， weakness， headache， dizziness， diarrhea and other symptoms. The white blood cell count and neutrophil count increased progressively. At about 17：00 on the same day， the patient suffered a sudden cardiac arrest and died clinically. Autopsy was not carried out. ConclusionThe cause of sepsis /septic shock of the patient is unknown. It is necessary to formulate detailed rabies immunization procedures as well as norms and expert consensus in the field of investigation and diagnosis of AEFI.

Combination of Geniposide and Eleutheroside B Exerts Antidepressant-like Effect on Lipopolysaccharide-Induced Depression Mice Model / 中国结合医学杂志

OBJECTIVE@#To study the antidepressant-like effect and action mechanism of geniposide and eleutheroside B combination treatment on the lipopolysaccharide (LPS)-induced depression mice model.@*METHODS@#Depression mice model was established by lipopolysaccharide (LPS) injection. Totally 48 mice were randomly divided into 6 groups (8 rats per group) according to a random number table, including normal, model, fluoxetine (20 mg/kg), geniposide (100 mg/kg) + eleutheroside B (100 mg/kg), geniposide + eleutheroside B + WAY 100635 (0.03 mg/kg), geniposide + eleutheroside B+ N-methyl-D-aspartic acid receptor (NMDA, 75 mg/kg) groups, respectively. After continuous administration for 10 days, autonomic activity tests after 30 min of administration were performed on the 10th day. On the 11th day, except for the normal group, the mice in the other groups were intraperitoneally injected with LPS (1 mg/kg), and the behavioral tests were performed 4 h later. Enzyme linked immunosorbent assay was used to detect tumor necrosis factor alpha (TNF- α) and interleukin-1 β (IL-1 β) levels in mice serum. The mRNA expression of indoleamine 2,3-dioxygenase (IDO) and nuclear transcription factor (NF- κB) were detected by real-time quantitative polymerase chain reaction. Western-blot analysis was used to detect IDO and NF- κB protein expressions in hippocampus tissue.@*RESULTS@#Compared with the normal group, a single administration of LPS increased the immobility time in the forced swimming test (FST) and tail suspension test (TST, P<0.01), without affecting autonomous activity. Compared with the model group, fluoxetine and geniposide + eleutheroside B administration significantly improved the immobility time of depressed mice in the FST and TST, decreased serum IL-1 β content, inhibited the expression levels of NF- κ B gene and protein in hippocampus tissues (P<0.05 or P<0.01). Compared with the model group, geniposide + eleutheroside B treatment significantly reduced serum TNF-α content and inhibited IDO mRNA and protein expressions in hippocampus (P<0.05 or P<0.01). In addition, NMDA partly prevented the inhibition of IDO mRNA expression by geniposide + eleutheroside B; NMDA and WAY-100635 also partly prevented the reduction of IL-1 ß content induced by geniposide + eleutheroside B treatment (P<0.05 or P<0.01).@*CONCLUSIONS@#The combination of geniposide and eleutheroside B showed a certain antidepression-like effect. Its main mechanism of action may be contributed to inhibiting the activation of NF- κB, decreasing the proinflammatory cytokines such as TNF-α, IL-1 β, and inhibiting in the neuroinflammatory reaction. Additionally, it also affects tryptophan metabolism, reduces the expression of a key enzyme of tryptophan metabolism, IDO. And this antidepressant-like effect may be mediated by 5-hydroxytryptamine and glutamate systems.

Epigenetic role of N6-methyladenosine (m6A) RNA methylation in the cardiovascular system / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

As the most prevalent and abundant transcriptional modification in the eukaryotic genome, the continuous and dynamic regulation of N6-methyladenosine (m6A) has been shown to play a vital role in physiological and pathological processes of cardiovascular diseases (CVDs), such as ischemic heart failure (HF), myocardial hypertrophy, myocardial infarction (MI), and cardiomyogenesis. Regulation is achieved by modulating the expression of m6A enzymes and their downstream cardiac genes. In addition, this process has a major impact on different aspects of internal biological metabolism and several other external environmental effects associated with the development of CVDs. However, the exact molecular mechanism of m6A epigenetic regulation has not been fully elucidated. In this review, we outline recent advances and discuss potential therapeutic strategies for managing m6A in relation to several common CVD-related metabolic disorders and external environmental factors. Note that an appropriate understanding of the biological function of m6A in the cardiovascular system will pave the way towards exploring the mechanisms responsible for the development of other CVDs and their associated symptoms. Finally, it can provide new insights for the development of novel therapeutic agents for use in clinical practice.

A Prospective Randomized Multicenter Controlled Trial on Salvianolate for Treatment of Unstable Angina Pectoris in A Chinese Elderly Population / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris (UAP).@*METHODS@#A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group (160 patients) and a control group (158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as major adverse cardiovascular events (MACEs). Safety was assessed according to adverse events and serious adverse events.@*RESULTS@#Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angina attacks (2.92 vs . 4.08, P=0.025), the biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks (P<0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group (P<0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated.@*CONCLUSIONS@#Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP. [ClinicalTrials.gov identifier: NCT03037047].

Research progress in medicinal treatment of autism spectrum disorders / 药学学报

Autism spectrum disorders (ASD) are a group of behaviorally defined, etiologically heterogeneous neurodevelopmental disorders characterized by impairment in social reciprocity, disturbances in language and various types of repetitive behaviors. The etiology and pathogenic mechanism of ASD are still unclear and there is no effective treatment available yet. ASD treatment includes behavioral and medicinal interventions. Behavioral interventions are the first line of treatment for ASD, alleviating core symptoms. Medicinal treatments, exert limited effect towards the core symptoms, represent an aide to the behavioral intervention and mainly apply to the so-called associated behavioral symptoms, such as irritability, aggression, self-injury, anxiety, insomnia, hyperactivity, low attention and compulsive behavior. A wide range of different agents are currently being tested in the preclinical and clinical studies, which include antipsychotics, antidepressants, anticonvulsants, anxiolytics, anti-infective drugs, glutamate receptor modulators, GABA receptor modulators, mTOR inhibitors and neuropeptides, etc. The purpose of present review is to cover the research advances in drug development and medicinal treatment of autism spectrum disorders.

Error analysis and experience summary in setting up the retroperitoneal cavity for peritoneoscopy / 天津医药

Objective To explore errors and their causes in setting up the retroperitoneal cavity for peritoneoscopy. Methods The clinical data of 450 patients who were performed the laparoscopic surgery in our hospital from May 2009 to December 2016 were collected. According to the trocar puncture points, patients were divided into lumbar group (n=193) and iliac flap group (n=276). The problems were summarized and analyzed in the process of setting up the retroperitoneal cavity. Results The mistakes existed in setting up the retroperitoneal cavity including peritoneum rupture (10 cases), error in balloon expansion clearance (5 cases), homemade balloon rupture and fall off (7 cases), poor position of puncture port (34 cases), bleeding of puncture channel (6 cases), leaking around the trocar and subcutaneous emphysema. After peritoneal patching, re-establishment of the expansion of the gap, adjusting the trocar position and other appropriate measures for treatment, the operations were successfully in 450 patients. Conclusion We should choose the appropriate method for building cavity according to different conditions of patients, and know well the anatomy of the peritoneal cavity. All details should be emphasized in the process of building cavity to reduce the occurrence of errors.

Distribution of HPV infection in laryngopharyngeal squamous cell carcinoma and laryngeal papilloma / 医学研究生学报

Objective Human papillomavirus (HPV) is presumed to be the cause of the development of head and neck squamous cell carcinoma.However,the current research results are not very sure.The article was designed to study the distribution of HPV infection in the tissues of laryngopharyngeal squamous cell carcinoma and laryngeal papilloma and its significance.Methods We collected samples of tissues from 67 patients who were treated in our hospital,including 41 cases of laryngeal papilloma,26 cases with laryngeal carcinoma,hypopharyngeal carcinoma,and oropharyngeal carcinoma.In the same period,20 cases of benign vocal cord polyps were treated as control group.PCR was applied in HPV typing test of fresh tumor tissues from operations,followed by the analysis on HPV infection type and distribution.Results In research group,44/67 cases was HPV-positive (65.7％),among which the HPV types of the laryngeal papilloma were HPVll (36/41) and HPV6 (4/41),and HPVI6 (6/26) in laryngeal carcinoma,hypopharyngeal carcinoma,and oropharyngeal carcinoma.While in control group,vocal cord polyps were HPV-negative without any multitype infection.Conclusion HPV16 may be a risk factor for the occurrence of laryngeal cancer and oropharyngeal cancer (non-alcoholic-induced or non-tobacco-induced cancer).HPV has high prevalence in Chinese laryngeal papilloma people,but HPV has low prevalence in Chinese laryngeal or hypopharyngeal carcinoma people.HPV testing of head and neck cancer is worth promoting.

Report of three death cases of imported falciparum malaria in Wenzhou City / 中国血吸虫病防治杂志

The three death cases of falciparum malaria in Wenzhou City were all imported from Africa. One patient died on 10 January 2007 because of severe clinical symptoms after hospitalization. The second case was initially misdiagnosed as influen-za in primary health and medical institution. The patient's condition quickly worsened and died of Plasmodium falciparum infec-tion on 5 March 2011. The third patient belonged to"non-identity"person,and there were no detailed information and epidemio-logical history on admission,which resulted in the delayed diagnosis,disease exacerbation and death. In conclusion,the health education should be provided to the people who return from Africa and also to medical workers in order to reduce the mortality of falciparum malaria.

Curcumin Attenuates Allergic Airway Inflammation of Young Mice through Inhibiting the Activation of p38 MAPK and AKT / 中山大学学报(医学科学版)

[Objective]To investigate the effects of dietary curcumin on the prevention and treatment of allergic airway inflamma?tion in young mice for simulating the allergic airway inflammation of 3-12 years old children.[Methods]The 4 weeks young female BALB/c mice were randomly divided into three groups (n=8): Control group, Model group and curcumin group (800 mg curcumin/ kg diet). 24 h after the last OVA challenge, the symptoms of mice in each group were observed, the inflammatory cells in the bronchoalve?olar lavage fluid (BALF) were measured, various kinds of blood cells were detected, the inflammatory cells around the peribronchial ar?eas stained by H&E and the goblet cell hyperplasia in the lungs stained by PAS were analyzed. Additionally, the IL-4, IL-5, IL-13 in the BALF and the total IgE level in the plasma were detected by ELISA, and the activation of p38 MAPK and AKT was measured by western blot.[Results]The mice of model group showed the symptoms of allergic airway inflammation, such as repeatedly scratched the noses, showed nodding breath, notably, the weight of model mice was decreased significantly during the OVA challenge phase, while the symptoms mentioned above were alleviated in curcurmin group. The blood cells test found that the curcumin could in?hibit the elevation of the eosinophils significantly (P<0.05). Dietary curcumin treatment significantly decreased the inflammatory cells in the BALF and peribronchial areas, and the IL-4, IL-5, IL-13 levels in the BALF were significantly inhibited (P<0.05). The goblet cell hyperplasia was attenuated by curcumin treatment, and the dietary curcumin inhibited the activation of p38 MAPK and AKT sig?naling.[Conclusions]Dietary curcumin can alleviate the allergic airway inflammation of young mice, which may through inhibiting the transduction of p-38 MAPK and AKT signaling.

Comparability evaluation of dissolution curve of esomeprazole magnesium enteric tablets / 国际药学研究杂志

Objective To evaluate the similarity of dissolution behavior in vitro of self-made and reference listed drug (RLD) of esomeprazole magnesium enteric tablets. Methods The dissolution test method and HPLC method were established according to Chinese pharmacopoeia. The HPLC method was validated according to ICH guidance. The dissolution behavior of the 3 batches of the self-made drug and RLD were compared in dissolution medium of pH 1.2 HCl solutuion, pH 4.5 phosphate buffer, pH 6.8 phosphate buffer, pH 1.2 HCl solutuion (2 h) and pH 6.0 phosphate buffer, pH 1.2 HCl solutuion (2 h) and pH 6.8 phosphate buffer, and purified water with different rotation rates. Results The HPLC validation results for linearity, repeatability, recovery, etc. all met the requirement. The similarity factors F2 between the self-made drug and RLD were greater than 50 in different dissolution mediums. Conclusion The dissolution behaviors of the self-made drug and RLD are similar.

Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is important to choose an appropriate antiepileptic drug (AED) to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ) and valproate (VPA), have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy.</p><p><b>METHODS</b>This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM), oxcarbazepine (OXC), lamotrigine (LTG), or levetiracetam (LEV), were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated.</p><p><b>RESULTS</b>A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64-44.07). CBZ exhibited the highest 12-month remission rate (85.55%), which was significantly higher than those of TPM (69.38%, P = 0.006), LTG (70.79%, P = 0.001), LEV (72.54%, P = 0.005), and VPA (73.33%, P = 0.002). CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%), rashes (7.76%), abnormal hepatic function (6.24%), and drowsiness (6.24%).</p><p><b>CONCLUSION</b>This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first seizure, 12-month remission rate, and retention rate.</p>

Regulatory effect of compound Coptidis Rhizoma capsule on unbalanced expression of renal tissue TGF-β1/BMP-7 and Smad signaling pathway in rats with early diabetic nephropathy / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of compound Coptidis Rhizoma capsule (CCRC) on unbalanced expression of renal tissue TGF-β1/BMP-7 and Smad signaling pathway in rats with early diabetic nephropathy (DN), and discuss CCRC's effect on DN rats with early diabetic nephropathy and its possible mechanism.</p><p><b>METHOD</b>DN model rats were established by injecting streptozotocin (STZ). The rats were randomly divided into seven groups: the normal group, the model group, the enalapril treatment group, the xiaoke pill treatment group and three CRCC treatment groups. They were orally administered once a day for five weeks. The fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Scr), insulin (Ins), 24 h urinary protein (24 h Upro) and 24 h urinary microalbumin (24 h UmAlb) were tested. The pathological changes in renal tissues were examined by optical microscopy. Immuno- histochemical measures were used to detect the expressions of TGF-β1, BMP-7, Smad2/3, Smad1/5, and Smad7 protein, and RT-PCR was used to detect TGF-β1 mRNA and BMP-7 mRNA in renal tissues.</p><p><b>RESULT</b>Compared with model group, BUN, Scr, Ins, 24 h Upro and 24 h UmAlb levels decreased at different degrees in CCRC treatment groups; the abnormal pathomorphology in renal tissue was improved; immunohistochemistry results showed that the expression of TGF-β1 and Smad2/3 were reduced, while the expression of BMP-7, Smad1/5 and Smad7 increased in CRCC treatment groups; the expression of TGF-β1 mRNA were reduced, but the expression of BMP-7 mRNA had no obvious change in CRCC treatment groups.</p><p><b>CONCLUSION</b>CRCC can improve the early renal function, delay the progression of chronic renal pathology and maintain the dynamic balance of TGF-β1/BMP-7 expression in renal tissues of DN rats. The mechanism may be related to down-regulation of renal TGF-β1 and up-regulation of BMP-7 through Smad signaling pathway.</p>

Clinical efficacy of Yiqi Qushi Recipe in treating myasthenia gravis and observation of its immunomodulatory effects / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the efficacy of Yiqi Qushi Recipe (YQR) in treating myasthenia gravis (MG) patients and its effects on their immune functions.</p><p><b>METHODS</b>Recruited were 40 type I and II MG patients from clinics and wards of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2009 to June 2011. They were randomly assigned to the treatment group (20 cases) and the control group (20 cases). Patients in the treatment group took YQR, one dose daily, while those in the control group took pyridostigmine 60 mg, three times a day. The therapeutic course consisted of eight weeks. The clinical efficacy, immunization indicators before and after treatment were observed. Meanwhile, the safety evaluation was performed.</p><p><b>RESULTS</b>The cured and effective rate was 75% and the total effective rate was 95% in the treatment group. They were 45% and 85% in the control group. Better results were obtained in the treatment group. Compared with the same group before treatment, IgA, IgG, and CD8 increased, IgM, CD4, and CD4/CD8 decreased in the treatment group, showing statistical difference (P < 0.05). There was no obvious change in each index of the control group after treatment (P > 0.05). Compared with the control group after treatment, IgA, IgG, and CD8 increased, CD4 and CD4/CD8 decreased in the treatment group, showing statistical difference (P < 0.05). During the course of treatment, mild diarrhea, nausea, and vomit occurred in two patients of the control group, while no adverse reaction occurred in those of the treatment group.</p><p><b>CONCLUSION</b>YQR could significantly improve clinical symptoms of MG patients, regulate their immune functions, with no obvious adverse reaction.</p>

Regulatory effect of berberine on unbalanced expressions of renal tissue TGF-beta1/SnoN and smad signaling pathway in rats with early diabetic nephropathy / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of berberine (BBR) on unbalanced expression of renal tissue TGF-beta1/SnoN and Smad signal pathway in rats with early diabetic nephropathy (DN), and discuss BBR's effect on DN rats with early diabetic nephropathy and its possible mechanism.</p><p><b>METHOD</b>DN rat model were established by injecting streptozotocin (STZ). The rats were divided into six groups: the control group, the model group, three BBR (50, 100, 200 mg x kg(-1)) treatment groups and the enalapril treatment group. They were orally administered once a day for five weeks. The fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Scr), urinary protein (24 h Upro) and urinary microalbumin (24 h UmAlb) were tested. The pathological changes in renal tissues were examined by optical microscopy. Immunohistochemical measures were used to detect the expressions of TGF-beta1, SnoN, Smad2/3 and Smad7 protein, and RT-PCR was used to detect TGF-beta1 mRNA in renal tissues.</p><p><b>RESULT</b>Compared with the model group, BBR-treated groups showed significant decrease in FBG, BUN, Scr, 24 h Upro, 24 h UmAlb, TGF-beta1 protein, mRNA and Smad2/3 protein, abnormal morphological improvement in renal tissues, and notable increase in the expressions of SnoN and Smad7 protein.</p><p><b>CONCLUSION</b>BBR can maintain the dynamic balance in TGF-beta1/SnoN expression in renal tissues through Smad signaling pathway, so as to mitigate renal functional disorder in DN rats and delay DN and its development.</p>

Synthesis and analgesic activities of phenyl piperazinyl aralkyl ketone derivatives / 药学学报

To explore novel non-opioid analgesic agents, 16 compounds were synthesized and their structures were confirmed by 1H NMR and HR-MS. YX0611-1 was treated as the leading compound. The results of mice writhing model and hot plate model showed that compounds 2, 7, 8, 9, 11 and 15 had obvious analgesic activities in vivo. The test of affinity to mu, delta, kappa receptor displayed that active compounds didn't act on opioid receptor. The results of preliminary toxicity and pharmacokinetic tests showed that compound 7 had better safety and pharmacokinetic properties than that of YX0611-1, and it deserved further development.

Late recurrent high degree atrioventricular block after percutaneous closure of a perimembranous ventricular septal defect / 中华医学杂志(英文版)

High degree atrioventricular block (HDAVB) is a serious complication of transcatheter closure of a perimembranous ventricular septal defect (PMVSD). We report one patient who developed transient HDAVB seven days after transcathter closure of PMVSD and had recurrent HDAVB 42 months after the procedure.