Effect of gender factor on efficacy of remimazolam combined with alfentanil in patients undergoing gastrointestinal endoscopy / 中华麻醉学杂志

Objective:To evaluate the effect of gender factor on efficacy of remimazolam combined with alfentanil in the patients undergoing gastrointestinal endoscopy.Methods:Two hundred patients, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classificationⅠor Ⅱ, scheduled for elective gastrointestinal endoscopy, were divided into 2 groups ( n=100 each) according to gender: male group (group M) and female group (group F). Remimazolam 0.2-0.3 mg/kg and alfentanil 5-7 μg/kg were intravenously injected, remimazolam 0.5-0.7 mg·kg -1·h -1 was continuously infused during operation to maintain the modified observer′s assessment of alert/sedation score<3 points, and alfentanil 2 μg/kg was administered when necessary. The consumption of remimazolam and alfentanil, examination time, recovery time and time of post-anesthesia care unit stay were recorded. The satisfaction scores of examination physicians and patients were recorded. The occurrence of adverse reactions such as injection pain, intraoperative body movement, respiratory depression, hypotension, bradycardia and hiccups and postoperative dizziness, nausea, vomiting, fatigue, abdominal pain and abdominal distension were recorded. Results:There was no significant difference in the consumption of remimazolam and alfentanil, examination time, recovery time, satisfaction scores of examination physicians and patients between the two groups ( P>0.05). There was no significant difference in the incidence of respiratory depression, hypotension, bradycardia, injection pain, body movement, hiccups, abdominal pain, abdominal distension, and fatigue between the two groups ( P>0.05). Compared with group M, the time of post-anesthesia care unit stay was significantly prolonged, and the incidence of postoperative dizziness, nausea and vomiting was increased in group F ( P<0.05). Conclusions:Remimazolam combined with alfentanil provides better efficacy in male patients than in female patients undergoing gastrointestinal endoscopy.

Efficacy of remimazolam combined with propofol for sedation in pediatric patients undergoing outpatient dental root canal treatment / 中华麻醉学杂志

Objective:To evaluate the effect of remimazolam combined with propofol for sedation in the pediatric patients undergoing outpatient root canal treatment.Methods:Seventy pediatric patients of either sex, aged 2-6 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with an expected treatment time<1 h, scheduled for elective outpatient root canal treatment, were divided into 2 groups ( n=35 each) using a random number table method: propofol group (P group) and remimazolam plus propofol group (RP group). Induction of anesthesia was as follows: propofol 1-3 mg/kg was intravenously injected until BIS value was less than 60 in group P, and remimazolam 0.2 mg/kg and propofol 1-3 mg/kg were intravenously injected until BIS value was less than 60 in group RP.Anesthesia maintenance was as follows: propofol 6-12 mg·kg -1·h -1 was intravenously infused in group P, and remimazolam 0.3 mg·kg -1·h -1 and propofol 6-12 mg·kg -1·h -1 were intravenously infused in group RP.The BIS value was maintained at 50-70 during operation.Spontaneous breathing was kept, and oxygen was inhaled through a nasal catheter with oxygen flow rate of 2-3 L/min in both groups.The amount of propofol consumed during induction and maintenance periods and the total consumption were recorded.The onset time of sedation, duration of operation, emergence time and duration of post-anesthesia care unit stay were recorded.The adverse reactions such as intraoperative respiratory depression, hypotension, bradycardia, coughing and body movement, emergence agitation and postoperative nausea and vomiting were recorded. Results:Compared with group P, the amount of propofol consumed during induction and maintenance periods and the total consumption were significantly reduced, the onset time of sedation was prolonged, the emergence time and duration of post-anesthesia care unit stay were shorted, the incidence of respiratory depression was decreased ( P<0.05), and no significant change was found in the incidence of duration of operation, hypotension, bradycardia, body movement or emergence agitation in group RP ( P>0.05). No intraoperative coughing or postoperative nausea and vomiting was found in two groups. Conclusions:The combination of remimazolam and propofol provides better efficacy than propofol alone when used for sedation in the pediatric patients undergoing outpatient dental root canal treatment.

Effect of obesity on dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy / 中华麻醉学杂志

Objective:To evaluate the effect of obesity on the dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy.Methods:American Society of Anesthesiologists physical status Ⅰor Ⅱ patients of both sexes, scheduled for elective painless gastroscopy, aged 18-64 yr, were divided into 2 groups according to the body mass index (BMI): normal (BMI 19-24 kg/m 2) group and obese (BMI≥28 kg/m 2) group.Alfentanil 5 μg/kg combined with remimazolam was given intravenously in all the patients, and the dose of remimazolam was determined by the modified Dixon′s up-and-down method.The initial dose of remimazolam was 0.25 mg/kg, and each time the dose was increased or decreased by 0.05 mg/kg based on the sedative effect.The response was defined as positive when the responses that affected the operation of examination developed during insertion of the gastroscope and within the first 2 min of examination such as swallowing, bucking or body movement.This process was repeated until the seventh intersection occurred.The 50% effective dose (ED 50), 95% effective dose (ED 95), and 95% confidence interval ( CI) of remimazolam were calculated by probit method. Results:There were 26 patients in normal group and 18 patients in obese group.The ED 50 (95% CI) of remimazolam was 0.196 (0.087-0.274) mg/kg, and the ED 95 (95% CI) was 0.322 (0.256-1.397) mg/kg in normal group.The ED 50 (95% CI) of remimazolam was 0.125 (0.102-0.148) mg/kg, and the ED 95 (95% CI) was 0.161 (0.141-0.242) mg/kg in obese group.The ED 50 and ED 95 were significantly lower in obese group than in normal group ( P<0.001). Conclusions:Obesity increases the potency of remimazolam when combined with alfentanil 5 μg/kg in the patients undergoing painless gastroscopy.

Overview of systematic reviews on Shenmai Injection in prevention and treatment of diseases / 中国中药杂志

To summarize and evaluate the efficacy and safety of Shenmai Injection in the treatment of viral myocarditis, shock, pulmonary heart disease, coronary heart disease, neutropenia and tumor chemotherapy, so as to provide supportive evidences for clinical rational use of Shenmai Injection. By searching literatures about studies on the systematic reviews on Shenmai Injection in treatment of viral myocarditis, shock, pulmonary heart disease, coronary heart disease, neutropenia and tumor chemotherapy from the main Chinese and English databases. Primary efficacy and safety outcome measures were selected for comparative analysis and summary, and the appraisal tool of AMSTAR 2 was used to evaluate the included studies.A total of 36 systematic reviews(published from 2005 to 2020) were included, involving viral myocarditis, shock, pulmonary heart disease, malignant tumor and coronary heart disease. The number of cases included in each type of the above diseases was 3 840, 2 484, 12 702, 28 036 and 27 082, respectively. The comparison results showed that, Shenmai Injection combined with conventional/western medicine treatment groups had better efficacy than conventional/western medicine groups alone in the prevention and treatment of the above five diseases. The main adverse reactions of Shenmai Injection reported in the included studies were facial flushing, rash, palpitation, etc., but the incidence was low and the general symptoms were mild, so no special treatment was needed. Therefore, the application of Shenmai Injection on the basis of conventional treatment or western medicine treatment had better prevention and treatment efficacy of the diseases. It was suggested that more multi-center and larger sample-size randomized controlled trials should be carried out in the future, and the relevant reporting standards should be strictly followed in systematic reviews, so as to improve the scientificity and transparency of the study.

Identification of Panax notoginseng and Its Processed Products Based on HPLC and IR Spectrum / 中国药房

OBJECTIVE：To identify Panax notoginseng and its processed products . METHODS ：The fingerprint was established by HPLC. Using ginsenoside Rb 1 as reference ，HPLC fingerprints of 15 batches of P. notoginseng and its processed products were drawn and the similarity evaluation was conducted by using the Similarity Evaluation System for TCM Chromatographic Fingerprints（2012 edition）. The common peaks were confirmed by comparing with substance control. SPSS 21.0 and SIMCA 14.1 software were used to perform cluster analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis；taking the variable importance projection （VIP）value greater than 1 as the standard ，the differential marker components causing the quality difference between P. notoginseng and its processed products were screened. IR fingerprints of P. notoginseng and its processed products were established by OMNIC 8.2.0 software，and the spectral similarity was evaluated ；double index sequence analysis was used to analyze absorption peaks of IR fingerprints of 15 batches of P. notoginseng and its processed products. RESULTS ：There were 16 common peaks in the fingerprints of 15 batches of P. notoginseng ， and the similarities were 0.911-1.000；there were 25 common peaks in the fingerprints of processed products ，and the similaritieswere 0.862-1.000. They had 12 identical common peaks ，and wang668@sina.com three of them were ident ified as sanchinoside R 1，ginsenoside Rg1 and ginsenoside Rb 1. Results of cluster analysi s showed that when the distance was 10，15 batches of P. notoginseng could be clustered into two categories ，SW1-SW5 into one category ，SH1-SH5 and SQ 1-SQ5 into one category ，ZW1-ZW5，ZH1-ZH5 and ZQ1-ZQ5 of 15 batches of processed products could be clustered into one category. When the distance was 5，15 batches of P. notoginseng could be clustered into three categories ，SW1-SW5 into one category ，SH2-SH5 and SQ 2 into one category ，SQ1， SQ3-SQ5 and SH 1 into one category. Fifteen batches of processed products could be clustered into two categories ，ZW1-ZW5 into one category ，ZH1-ZH5 and ZQ 1-ZQ5 into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first two principal components was 80.104％ . The results of orthogonal partial least squares-discriminant analysis showed that the VIP values of the five peaks were greater than 1，which were peak H ，peak G ，peak J，peak F （ginsenoside Rg 1）and peak I. The similarity of IR fingerprints of 15 batches of P. notoginseng and its processed products were 0.889 7-1.000 0 and 0.972 8-1.000 0；the common peak rates were 80％-100％，and the variation peak rates were 0-17.65％ and 0-18.75％，respectively. By comparing the wave numbers of absorption peaks ，it was found that there were differences between P. notoginseng at 3 440 and 1 450 cm－1 and processed products at 1 530 and 575 cm－1. CONCLUSIONS ：Established HPLC fingerprint and IR fingerprint have good similarity ，and could effectively distinguish P. notoginseng and its processed products. P. notoginseng and its processed products from different habitats have high common peak rate and low variation rate ，and their chemical components are different ；peak H ，peak G ，peak J ，ginsenoside Rg 1 and peak I are differential marker components causing the quality difference between P. notoginseng and processed products.

Sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients / 中华麻醉学杂志

Objective:To evaluate the sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients.Methods:One hundred children of both sexes, aged 1-6 yr, weighing 10-30 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, who underwent MRI from February to June 2021, were selected and divided into 2 groups ( n=50 each) by a random number table method: propofol group (P group) and S-ketamine plus propofol group (K+ P group). Anesthesia induction: propofol 2.5 mg/kg was intravenously injected in group P, and S-ketamine 0.5 mg/kg and propofol 1.5 mg/kg were intravenously injected in group K+ P.Anesthesia maintenance: propofol 100 μg·kg -1·min -1 was intravenously infused, and the infusion rate of propofol was adjusted to maintain Ramsay sedation score ≥5.Propofol 0.5-1.0 mg/kg was intravenously injected and/or increasing the infusion rate of propofol when moderate and severe movement occurred.The quality of MRI images was evaluated during the examination, and the occurrence and degree of movement, airway-related adverse events (hypoxemia, apnea, upper airway obstruction, hypersalivation), hypotension and bradycardia were recorded.The average infusion rate, consumption of additional propofol for intravenous administration and total consumption of propofol were recorded.The emergence time and time of anesthesia recovery room stay were recorded.The occurrence of adverse events (vomiting, diplopia and agitation) and the parents′ satisfaction with sedative efficacy and recovery were recorded during observation in the recovery room. Results:Compared with group P, the average infusion rate of propofol, total consumption of propofol, airway-related adverse events and incidence of hypotension and bradycardia were significantly decreased ( P<0.05), and no significant change was found in the incidence and degree of body movement, quality of MRI images, emergence time and time of anesthesia recovery room stay and incidence of adverse events during recovery from anesthesia in group K+ P ( P>0.05). Conclusion:S-ketamine combined with propofol can be safely and effectively used in MRI examination in pediatric patients.

Comparison of efficacy of mivacurium versus cisatracurium in patients undergoing painless fiberoptic bronchoscopy / 中华麻醉学杂志

Objective:To compare the efficacy of mivacurium versus cisatracurium in patients undergoing painless fiberoptic bronchoscopy.Methods:A total of 100 patients of both sexes, aged 18-64 yr, of American Society of Anesthesiology physical status I or Ⅱ, scheduled for elective fiberoptic bronchoscopy were divided into 2 groups ( n=50 each) using a random number table method: mivacurium group (M group) and cisatracurium group (C group). Mivacurium 0.15 mg/kg was injected intravenously in group M, and cisatracurium 0.1 mg/kg was injected intravenously in group C. The onset time of neuromuscular block (ThD95), the duration of neuromuscular block (TOFR25), recovery index (RI), recovery time of autonomous respiration, extubation time and time of discharge from postanesthesia care unit (PACU) were recorded.The occurrence of intraoperative and postoperative adverse reactions and complications were recorded.The mean arterial pressure (MAP), heart rate (HR) and SpO 2 at restlessness at 10 min after entering the operating room (T 1), at loss of consciousness (T 2), when laryngeal mask airway was inserted (T 3), at the end of surgery (T 4), when laryngel mask airway was removed (T 5), and when the patients left the operating room (T 6). Results:Compared with group C, TOFR25, RI, recovery time of autonomous respiration, extubation time and time of discharge from PACU were significantly shortened, the total incidence of adverse reactions was decreased ( P<0.05), and no significant change was found in ThD95 in group M ( P>0.05). There was no significant difference in MAP, HR and SpO 2 at each time point between the 2 groups ( P>0.05). Conclusion:Mivacurium provides better efficacy than cisatracurium when used for painless fiberoptic bronchoscopy.

Efficacy of remimazolam-alfentanil-mivacurium for fiberoptic bronchoscopy / 中华麻醉学杂志

Objective:To evaluate the efficacy of remimazolam-alfentanil-mivacurium for fiberoptic bronchoscopy.Methods:A total of 100 patients of both sexes, aged 18-64 yr, with body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective fiberoptic bronchoscopy, were divided into 2 groups ( n=50 each) using a random number table method: remimazolam-alfentanil-mivacurium group (group R) and propofol-alfentanil-mivacurium group (group P). Oxygen was inhaled by mask, and alfentanil 10 μg/kg was slowly injected intravenously in advance.One minute later, remimazolam 0.2 mg/kg was injected intravenously in group R, propofol 1.5-2.0 mg/kg was injected in group P until loss of consciousness, and mivacurium 0.14 mg/kg was then injected intravenously in 2 groups.When the bispectral index value was 40-60, mechanical ventilation was performed after laryngeal mask was placed by the same anesthesiologist.During the maintenance of anesthesia, remimazolam 1 mg·kg -1·h -1 was infused intravenously in group R, propofol 4-6 mg ·kg -1·h -1 was infused intravenously in group P, and mivacurium was intermittently injected in both groups to maintain muscle relaxation.Before induction (T 0), when the laryngeal mask was placed (T 1), immediately when fiber bronchoscope reached juga (T 2), at 10 min after the surgery (T 3), at the end of the surgery (T 4) and when patients regained consciousness (T 5), blood pressure (BP), (HR), pulse oxygen saturation (SpO 2), breathing at the end of the CO 2 partial pressure (P ETCO 2), BIS values and Modified Observer's Assessment/Alertness and Sedation (MOAA/S) score were recorded.The time from beginning of anesthesia to beginning of examination, total examination time, the time from the end of administration to laryngal mask airway removal, the time to recovery of spontaneous breathing and the time from emergence to discharge from postanesthesia care unit (PACU) were recorded.The occurrence of intraoperative and postoperative adverse reactions was recorded. Results:There was no significant difference in SpO 2, P ETCO 2, BIS values and MOAA/S score at each time pint and the time from beginning of anesthesia to beginning of examination, the time to recovery of spontaneous breathing and the time from emergence time to discharge from PACU between the 2 groups ( P>0.05). Compared with group P, systolic blood pressure and diastolic blood pressure were significantly increased at T 1, T 3 and T 4, the time from the end of administration to laryngal mask airway removal was prolonged, the incidence of intraoperative hypotension, postoperative cough and total adverse reactions were decreased in group R ( P<0.05). Conclusion:Remimazolam-alfentanil-mivacurium produces better efficacy than propofol-alfentanil-mivacurium for fiberoptic bronchoscopy.

Study on Isolation ，Purification and in vitro Antioxidant Activity of the Polysaccharides from Cucumis satiuus / 中国药房

OBJECTIVE：To isolate and purify the polysaccharides from Cucumis satiuus ，and to investigate its in vitro antioxidant activity. METHODS ：The crude polysaccharides （CCL）were extracted from C. satiuus by water extraction and alcohol precipitation. CCL was separated and purified on Amberlite FPA 90Cl anion and Amberlite FPC 3500H cation exchange resin column and DEAE cellulose 52 column，so as to obtain 3 kinds of polysaccharides as CCL-M 2，CCL-M3，CCL-M6. The purity ， molecular weight ，structure and monosaccharide composition of 3 kinds of polysaccharides were analyzed by HPLC-ELSD ， UPLC-QTOF/MS，UV and IR. Using vitamin C （VC）as positive control ，the scavenging activity of CCL-M 2，CCL-M3 and CCL-M6（0.4，0.8，1.2，1.6，2.0 mg/mL）to 1，1-dibenzene-2-trinitrobenzene free radicals （DPPH·），hydroxyl free radicals （·OH） and superoxycyclic anion free radicals （O2－·）were investigated ，and IC50 was calculated. RESULTS ：CCL-M2，CCL-M3 and CCL-M6 were homogeneous polysaccharides in the form of pyranose ，with molecular weights of 9.614×106，2.024×107 and 3.343× 107 Da，respectively. CCL-M 2 monosaccharides were composed of rhamnose ，semi-lactose aldehyde acid ，glucose， semi-lactose and arabic sugar ，with a molar ratio of 5.1∶2.6∶1.7∶1.4∶31.6. CCL-M 3 and CCL-M 6 monosaccharides were composed of mannose， rhamnose，glucose，semi-lactose，arabic sugar ，with a molar ratio of 1.7 ∶ 3.8 ∶ 6.4 ∶ 3.3 ∶ 1.3 and 1.3 ∶ 3.0 ∶ 3.2 ∶ 4.4 ∶ 8.9. The results of antioxidant activity in vitro showed that 3 kinds of homogeneous polysaccharides had certain scavenging activity on DPPH ·，·OH and O 2－·；the order of scavenging activity to DPPH ·was VC ＞CCL-M2＞CCL-M3＞CCL-M6（IC50 was 0.309， 1.240， 1.489 and 1.713 mg/mL）； the order of scavenging activity to ·OH was VC ＞CCL-M2＞CCL-M6＞CCL-M3（IC50 was 0.968，1.032，1.233，1.356 mg/mL）；the order of scavenging activity to O 2 －· was VC ＞CCL-M2＞CCL-M3＞CCL-M6 （IC50 was 0.335， 0.379， 0.812， 1.662 mg/mL）. CONCLUSIONS：3 kinds of monosaccharides in the form of pyranose are isolated from C. satiuus ，and all of them have antioxidant activity in vitro ，and CCL-M 2 is the best.

Effects of Decitabine Combined with Bortezomib on the Proliferation of Mantle Cell Lymphoma Cell Lines and Its Underling Mechanisms / 中国实验血液学杂志

OBJECTIVE@#To investigate the effects of decitabine combined with bortezomib on the proliferation of mantle cell lymphoma cell lines (Jeko-1 and Grante519) in vitro and explore the underlying mechanisms.@*METHODS@#Jeko-1 and Grante519 cells were treated with different concentrations of decitabine and/or bortezomib alone and their combination.The cell proliferation was determined by CCK-8 assay. the cell apoptosis were detected by flow cytometry, the mRNA and protein expression levels of genes related with the cell cycle and apoptosis were analyzed by RT-PCR and Western blot respactively.@*RESULTS@#Low dose DAC could significantly inhibit the proliferation and induce apoptosis of Jeko-1 and Grante519 cells which shows a dose-and time-dependent manner. After DAC treatment, caspase 3, BAX and PCDH8 expression levels increased, while BCL-2 and CCND1 expression levels decreased in Jeko-1 and Grante519 cells, but there was no significant difference in NF-κB expression. High dose BTZ could significantly inhibit the proliferation and induce apoptosis of Jeko-1 and Grante519 cells which shows a dose-and time-dependent manner; single drug BTZ could increase the expression level of Caspase 3 and BAX, and decrease the expression level of NF-κB, BCL-2 and CCDN1 in Jeko-1 and Grante519 cells, but there was significant difference in PCDH8 expression level. Compared with single-drug treatment group, DAC combined with BTZ significantly increased the inhibitory rate and apoptotic rate of Jeko-1 and Grante519 cells; PCDH8, Caspase 3 and BAX expression levels significantly increased, and the expression levels of NF-κB, BCL-2 and CCND1 significantly decreased in Jeko-1 and Grante519 cells.@*CONCLUSION@#The combination of DAC and BTZ has obviously synergistic effects on the growth inhibition of Jeko-1 and Grante519 cells which maybe relates with enhancing inbibitory effect on NF-κB signal pathway, down-regulating BAX expression, up-regulating BAX expression as well as increasing cospase 3 expression. This study provides a novel therapeutic approach for mantle cell lymphoma.

Progress in Research on Effect of Processing on Chemical Constituents and Pharmacological Effect of Notoginseng Radix et Rhizoma / 中国实验方剂学杂志

Notoginseng Radix et Rhizoma, one of precious and important traditional Chinese medicinal herb, has the functions of dispersing blood stasis and stopping bleeding, detaching swelling and alleviating pain, and invigorating Qi and blood. It is a traditional Chinese medicine for promoting blood circulation and removing blood stasis. After processing, the efficacy of Notoginseng Radix et Rhizoma was obviously different, the raw products mainly dispersed blood stasis and hemostasis, while the main effect of processed products was to replenish blood and Qi. In recent years, more attention has been paid to Notoginseng Radix et Rhizoma research, mainly focusing on the chemical constituent, pharmacological action and clinical application of the raw products. Although the research on processed Notoginseng Radix et Rhizoma has been increasing in these years, the mechanism of processing and the changes of bioactive constituents before and after processing are still unclear. This paper systematically summarized the modern processing methods of Notoginseng Radix et Rhizoma and compared the changes in chemical constituent and pharmacological action before and after processing through literature search. It is proposed that modern technologies should be put forward to study the correlation between the chemical constituent transformation and enriching blood as the breakthrough point, in order to explain the processing mechanism of Notoginseng Radix et Rhizoma, improve the quality evaluation system of this decoction pieces, and provide guarantee for the safety and effectiveness of its clinical medication.

Role of poly( ADP-ribose) polymerase-1 on lung ischemia-reperfusion injury in rats: the relation-ship with autophagy / 中华麻醉学杂志

Objective To evaluate the role of poly( ADP-ribose) polymerase-1 ( PARP-1) in lung ischemia-reperfusion ( I/R ) injury in rats and the relationship with autophagy. Methods Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 8-12 weeks, weighing 200-240 g, were divided into 3 groups (n=8 each) using a random number table method: sham operation group (S group), lung I/R group ( I/R group) and lung I/R plus PARP-1 inhibitor PJ34 group ( I/R+PJ34 group) . The chest was only opened without clamping the left hilum of lung in group S. Lung I/R injury model was established by clam-ping the left hilum of lung for 45 min followed by 120 min reperfusion in I/R and I/R+PJ34 groups. PJ3410 mg/kg was intraperitoneally injected at 30 min before ischemia in group I/R+PJ34, while the equal volume of normal saline was injected in S and I/R groups. The rats were sacrificed at the end of reperfusion, and lungs were removed for microscopic examination of the pathological changes ( with a light microscope) which were scored and for determination of wet to dry weight ratio ( W/D ratio) , cell apoptosis ( by TUNEL) , ex-pression of PARP-1 activity markers ( PAR) , Bcl-2, Bax, microtubule-associated protein 1 light chain 3Ⅰ ( LC3-Ⅰ) , LC3-Ⅱ and Beclin-1 ( using Western blot ) . The apoptosis index, Bcl-2/Bax ratio and LC3-Ⅱ/LC3-Ⅰ ratio were calculated. Results Compared with S group, the W/D ratio, pathological scores, apoptosis index and LC3-Ⅱ/LC3-Ⅰ ratio were significantly increased, the expression of PAR and Beclin-1 was up-regulated, and Bcl-2/Bax ratio was decreased in I/R and I/R+PJ34 groups (P＜0. 05). Compared with I/R group, the W/D ratio, pathological scores, apoptosis index, and LC3-Ⅱ/LC3-Ⅰratio were significantly decreased, the expression of PAR and Beclin-1 was down-regulated, and Bcl-2/Bax ratio was increased in I/R+PJ34 group ( P＜0. 05) . Conclusion PARP-1 activation is involved in lung I/R inju-ry in rats, and the mechanism may be related to increasing autophagy and inducing cell apoptosis.

Effect of Montelukast on T-lymphocyte subsets and advanced oxidation protein products in immune thrombopenic purpura model mice / 中国免疫学杂志

Objective:To investigate the effect of Montelukast on T-lymphocyte subsets, cytokines and advanced oxidation protein products ( AOPP ) in immune thrombopenic purpura ( ITP ) model mice. To analyze the principle of the treatment by Montelukast. Methods: Forty ITP mice were randomly divided into control group,model group,Montelukast low dose group(3 mg/kg) and Montelukast high dose group(12 mg/kg). ITP model mice were successive administration for 14 days after building models for 7 days. Platelet counts,the index of thymus and spleen were calculated. T-lymphocyte subsets were detected by flow cytometry. IL-6,TNF-α,AOPP were detected by enzyme linked immunosorbent assays. Results: Comparison with control group,the PLT,thymus index and spleen index,CD8+,IL-6,TNF-α,AOPP of model group mice were significantly increased (P＜0. 05) while CD3+,CD4+,CD4+/CD8+were significantly decreased (P＜0. 05). Comparison with model group,PLT,thymus index and spleen index,CD8+,IL-6,TNF-α,AOPP of low dose group and high douse group mice were significantly decreased (P＜0. 05) while CD3+,CD4+,CD4+/CD8+were significantly increased (P＜0. 05). Conclusion: Montelukast can cure ITP regulate immune disorders,eliminate accumulation of AOPP and reduce level of IL-6 and TNF-α.

Status of hemodialysis and qualified status of dialysis water and dialysate in a city / 中国感染控制杂志

Objective To investigate current status of hemodialysis,and qualified status of dialysis water and dia-lysate in a city. Methods Status of hemodialysis in 36 medical institutions in a city which conducted blood purifica-tion programme was surveyed,dialysis water and dialysate were collected to perform microbial detection(including conventional and low temperature culture methods)and on-site ATP detection.Results 13.89% of equipments for water treatment were used less than 1 year,5.56% were used for more than 10 years. 77.78% of medical institu-tions didn't replace sand filtration which had been used for more than 1 year,the replacement time of 72.22% of fil-ter core was less than 3 months,2.78% of reverse water supply pipeline was used for more than 10 years.77.78%of medical institutions used finished A solution,72.22% used finished B solution,22.22% used centrally provided A solution,19.44% used centrally provided B solution,and 8.34% used self-made B solution. Routine microbial detection in 36 medical institutions were qualified,but 80.56% of detection results were"0" value for long period;ATP detection of on-site collected dialysis water and dialysate were all qualified. One specimen for microbial detec-tion under normal temperature exceeded the standard,2 reached the intervention value;4 specimens for microbial detection under low temperature exceeded the standard,6 reached the intervention value;qualified rates of 3 kinds of detection methods among different levels of medical institutions weren't significantly different(all P>0.05).Con-clusion The overall quality of hemodialysis water and dialysate in this city is good,the majority of medical institutions pay attention to the routine maintenance of water treatment equipment,detect the quality of hemodialysis water and dialysate regularly,but microbial detection technique needs to be improved,causes for abnormal results or intervention value of rou-tine detection needs to be analyzed and improved continuously.

Effect of HLA-DPB1 locus match on clinical outcomes of unrelated donor hematopoietic stem cell transplantation: a Meta-analysis / 器官移植

Objective To systematically evaluate the effect of HLA-DPB1 mismatch on the clinical outcomes of unrelated donor hematopoietic stem cell transplantation. Methods Relevant studies analyzing the effect of HLA-DPB1 mismatch upon the clinical outcomes of unrelated donor hematopoietic stem cell transplantation published from January 1995 to December 2016 were retrieved from the PubMed, Embase, Center of International Bone Marrow Transplant Registration, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Chinese BioMedical Literature Database and China National Knowledge Infrastructure database. The survival rate, the incidence of implantation failure, graft-versus-host disease (GVHD), recurrence rate, transplantation-related mortality rate and other adverse events were analyzed by Review Manager 5.3 software. Funnel plot was utilized to assess the publication bias. Results A total of 19 literatures consisting of 26634 patients were retrieved. Meta-analysis demonstrated that compared with the recipients in the HLA-DPB1 match group, those in the HLA-DPB1 mismatch group had lower disease-free survival rate and overall survival rate in non-T cell-depleted transplantation. In the HLA-DPB1 mismatch group, the incidence of severe GVHD and transplantation-related mortality(TRM) rate were higher. And the TRM rate of two loci mismatch was more evident than that of one locus mismatch. Conclusions HLA-DPB1 locus exerts significant effect on the survival rate and incidence of adverse events after unrelated donor hematopoietic stem cell transplantation. The status of HLA-DPB1 match should be considered when selecting the unrelated donors.

Knockdown of the M2 Isoform of Pyruvate Kinase (PKM2) with shRNA Enhances the Effect of Docetaxel in Human NSCLC Cell Lines In Vitro

PURPOSE: The aim of our study was to explore the relationships between the M2 isoform of pyruvate kinase (PKM2) and the sensitivity of human non-small cell lung cancer (NSCLC) cells to docetaxel in vitro. MATERIALS AND METHODS: With the method of plasmid transfection, we silenced the expression of PKM2 successfully in A549 and H460 cells. Western blotting and real-time PCR were applied to detect PKM2 expression at protein and gene levels. Cell viability was examined by CCK8 assay. Cell cycle distribution and apoptosis were examined by flow cytometry. P21 and Bax were detected. RESULTS: Expression of PKM2 mRNA and protein were significantly decreased by shRNA targeting PKM2. Silencing of PKM2 increased docetaxel sensitivity of human NSCLC A549 and H460 cells in a collaborative manner, resulting in strong suppression of cell viability. The results of flow cytometric assays suggested that knockdown of PKM2 or docetaxel treatment, whether used singly or in combination, blocked the cells in the G2/M phase, which is in consistent with the effect of the two on the expression of p21. Cells with PKM2 silencing were more likely to be induced into apoptosis by docetaxel although knockdown of PKM2 alone can't induce apoptosis significantly, which is in consistent with the effect of the two on Bax expression. CONCLUSION: The results suggest that PKM2 knockdown could serve as a chemosensitizer to docetaxel in non-small lung cancer cells through targeting PKM2, leading to inhibition of cell viability, increase of cell arrest of G2/M phase and apoptosis.

Newer antifungal agents micafungin and voriconazole for fungal infection prevention during hematopoietic cell transplantation: meta-analysis / 中国医师杂志

Objective To compare the newer antifungal agents micafungin and voriconazole for prophylaxis effects on the clinical outcomes.Methods We electronically searched the database of Cochrane Central Register of Controlled Trials,Pubmed,EMbase,China Biology Medicine (CBM),China National Knowledge Infrastructure(CNKI),and relevant database articles (1996.01-2014.12).Comparative studies were carried out on proved fungal infections,mortality,and adverse effects.Meta-analysis was performed by Review Manager 5.3 software.Results We found 1 564 records and 16 studies totaling 4 234patients included in analyses.Pooled comparisons of studies found that antifungal prophylaxis with the new agents did reduce the incidence of invasive fungal infections and transplant related mortality than fluconazole or itraconazole [OR =0.41 (0.21 ～ 0.80) and OR =0.40 (0.24 ～ 0.66),respectively,P ＜ 0.01].Voriconazole had higher rates of liver dysfunction,lower gastrointestinal side effects over fluconazole,and lower rates of nephrotoxic effects than amphotericin B.Voriconazole had significant decrease in adverse events requiring drug discontinuation compared to itraconazole [OR =0.43 (0.27 ～ 0.68),P ＜ 0.01].Conclusions This analysis indicated the 2 agents appear to be well tolerated with manageable side effects and beneficial in the prophylaxis of invasive fungal infection (IFI).

Recent progress of potential effects and mechanisms of chlorogenic acid and its intestinal metabolites on central nervous system diseases / 中国中药杂志

Chlorogenic acid displays several important roles in the therapeutic properties of many herbs, such as antioxidant activity, antibacterial, antiviral, scavenging free radicals and exciting central nervous system. Only about one-third of chlorogenic acid was absorbed in its prototype, therefore, its gut metabolites play a more important role in the therapeutic properties of chlorogenic acid. It is necessary to consider not only the bioactivities of chlorogenic acid but also its gut metabolites. This review focuses on the potential activities and mechanisms of chlorogenic acid and its gut metabolites on central nervous system diseases.

Isolation, purification, and structural elucidation of polysaccharide CALB-1 from Aurantii Fructus and study on its immunoregulatory activity / 中草药

To separate and purify the crude polysaccharide from Aurantii Fructus to obtain CALB-1 and to study the structure of CALB-1 and immunoregulatory activity. A refined CALB-1 was obtained from F. aurantii by hot water extraction, then separated and purified by ion exchange resin and ion exchange agarose gel. The molecular weight of CALB-1 was measured by HPLC. The chemical structure and molecular morphology of CALB-1 were determined by IR, periodate oxidation, methylation analysis, scanning electron microscopy (SEM), and atomic force microscope (AFM). The immunoregulatory activity of CALB-1 was evaluated by splenocyte proliferation and mononuclear-macrophage phagocytic function in hypo-immunologic mice. CALB-1 was a homogeneous polysaccharide measured by HPLC and the molecular weight of CALB-1 was estimated to be 3.28 × 107. Chemical and spectroscopic analyses illustrated that CALB-1 was highly branched acidic polysaccharides, contained Ara, Man, and Gal as monosaccharide constitutes, and it consisted of backbone chain of 1→ and 1→4 linkages. Through SEM and AFM observations, we indicated that the molecular morphology of CALB-1 was amorphous solid. Besides, CALB-1 significantly stimulated the splenocyte proliferation in vitro and improved the K value of expurgation index and α value of phagocytic index in hypo-immunologic mice. CALB-1 is highly branched acidic polysaccharides and uniform relative molecular mass. Moreover, CALB-1 could present the certain immune regulation in vivo and in vitro. Our study provides a theoretical basis for the development and utilization of CALB-1.

Clinical evaluation of reliability of autologous blood withdrawal during cesarean section / 中华麻醉学杂志

Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and∕or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at≥36 weeks of gestation, were enrolled in the study. Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell?salvage machine and then filtered using a leukocyte depletion filter during cesarean section. The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood. The fetal squamous cells were counted using papanicolaou staining. The concentrations of a?fetoprotein, tissue factor, endothelin?1 and histamine were measured by enzyme linked immunosorbent assay. The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a?fetoprotein and endothelial?1, and fetal red blood cells were decreased in the washed samples. Compared with washed samples, the fetal squamous cell count, concentrations of a?fetoprotein and fetal red blood cells were significantly decreased in filtered samples. Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a?fetoprotein and endothelial?1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section.