Analysis and evaluation on Paeoniae Radix Alba from different cultivars by UPLC-Q-TOF-MS and HPLC / 中国中药杂志

In this study, an established ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS) method was combined with multivariate statistical analysis to investigate the commonality and difference of main chemical components in the medicinal parts of Paeonia lactiflora from different cultivars; in addition, a high performance liquid chromatography(HPLC) method was established to simultaneously determine the content of eight active components in Paeoniae Radix Alba. Non-targeted analysis was carried out by UPLC-Q-TOF-MS on a Waters ACQUITY UPLC BEH C_(18)(2.1 mm×100 mm, 1.7 μm) column with a gradient elution of 0.1% aqueous formic acid(A)-acetonitrile(B) as the mobile phase at a flow rate of 0.2 mL·min~(-1). The column temperature was 30 ℃, and an electrospray ionization source was used to acquire mass spectrometry data in positive and negative ion modes. According to the accurate molecular weight and fragment ion information provided by multi-stage mass spectrometry and by comparison with reference substances and literature reports, thirty-six identical components were identified in Paeoniae Radix Alba from different cultivars with positive and negative ion modes. In the negative ion mode, two groups of samples were well separated; specifically, seventeen components with significant differences in content were screened and identified, and one component unique in "Bobaishao" was obtained. Quantitative analysis was conducted by high-performance liquid chromatography(HPLC) on an Agilent HC-C_(18)(4.6 mm×250 mm, 5 μm) column with a gradient elution of 0.1% aqueous phosphoric acid(A)-acetonitrile(B) as the mobile phase at a flow rate of 1.0 mL·min~(-1). The column temperature was 30 ℃ and the detection wavelength was at 230 nm. An HPLC method was developed for the simultaneous determination of eight active components(gallic acid, oxypaeoniflorin, catechin, albiflorin, paeoniflorin, galloylpaeoniflorin, 1,2,3,4,6-O-pentagalloylglucose, benzoyl-paeoniflorin) in Paeoniae Radix Albaa from different cultivars. Satisfactory linearity was achieved within the investigated linear ranges and with fine coefficients(r>0.999 0), and the methodological investigation showed that the method had good precision, repeatability and stability. The mean recoveries were 90.61% to 101.7% with RSD of 0.12% to 3.6%(n=6). UPLC-Q-OF-MS provided a rapid and efficient qualitative analytical method for the identification of the chemical components in Paeoniae Radix Alba, and the developed HPLC method was simple, rapid and accurate, which could provide a scientific basis for the evaluation of the germplasm resources and herbal quality of Paeoniae Radix Alba from different cultivars.

Case-control study on relationship between diet quality and thyroid nodules / 环境与职业医学

Background Both domestic and foreign studies on the diet quality of patients with thyroid nodules are rare at present, and the relationship between thyroid nodules and diet quality is still unclear. Objective This study aims to evaluate the diet quality of thyroid nodules with the China Healthy Diet Index (CHDI) and to explore the relationship between diet quality and thyroid nodules. Methods We conducted a hospital-based case-control study in which 387 patients with thyroid nodules were matched individually (1∶1) by gender and age (±3 years) to the controls who ordered a routine physical examine and with negative thyroid nodules reported by B-ultrasound in the same hospital. A structured questionnaire was applied to collect data on general characteristics and diet. CHDI was employed to evaluate the diet quality of the two groups. CHDI is based on the Dietary Guidelines for Chinese Residents and the recommended food intake in the balanced diet pagoda, combined with the dietary nutritional status of Chinese population. The index contains 13 scoring components, and the highest total score is 100, with a higher score representing better dietary quality. CHDI scores < 60, 60-<80, and ≥80 are recognized as unqualified, qualified, and good diet quality, respectively. Results The scores of the thyroid nodule cases were lower than the scores of the controls in total vegetables, dark vegetables, fruits, and fish/shrimps (all Ps<0.05). The nonparametric test results found that there were significant differences in the distributions of scores in total vegetables, dark vegetables, fruits, soybeans, and fish/shrimps between the case and the control groups (all Ps<0.05). The percentages reaching the full scores in food variety, meat and eggs, and empty calories in both groups exceeded 60%, while the percentages reaching the full scores in whole grains/beans/tubers, dairy, soybeans, and sodium were lower than 30% in the two groups. The median CHDI scores of the thyroid nodule cases and the controls were 69.1 and 72.9, respectively; the cases' CHDI score was lower than the controls' (P<0.05). The proportions of unqualified diet in the case and the control groups accounted for 23.0% and 13.7% respectively (P=0.001). After being adjusted for education level, marital status, occupation, monthly household income per capita, body mass index, hypertension/diabetes, energy, and iodine intake, the results of logistic regression analysis showed that the risk for thyroid nodules was negatively associated with CHDI score (CHDI qualified group vs. CHDI unqualified group, OR=0.484, 95%CI: 0.291-0.804; CHDI good dietary quality group vs. CHDI unqualified group, OR=0.414, 95%CI: 0.230−0.746). Conclusion The diet quality of patients with thyroid nodules is lower than that of the control group, as the former reported lower consumptions of total vegetables, dark vegetables, fruits, and fish/shrimps. Those who have good or qualified diet quality show a reduced risk of thyroid nodules than those with unqualified dietary quality.

Effect of electroacupuncture on the expression of insulin signal pathway related proteins in hippocampus in mice with Alzheimer's disease / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the expression of insulin phosphatidylinositol-3 kinase/glycogen synthetase kinase-3α (PI3K/GSK3α) signal pathway related proteins in the hippocampus in mice with Alzheimer's disease (AD), and to explore the regulatory mechanism of EA on improving the pathological characteristics of AD.@*METHODS@#Twelve male APP/PS1 double transgenic mice were randomly divided a model group and a treatment group, 6 mice in each group; another 6 wild-type male mice were taken as the control group. The mice in the treatment group were treated with EA (continuous wave, 2 Hz of frequency) at "Baihui" (GV 20) and bilateral "Shenshu" (BL 23), once a day; 7-day treatment was taken as a course of treatment, and 2 courses of treatment were given. The immunohistochemistry method and Western blot method were used to detect the distribution and expression level of hippocampal PI3K/GSK3α signal pathway related proteins P85α, P110α, GSK3α and pSGSK3α, and the number of hippocampal senile plaques (SP) was observed.@*RESULTS@#The proteins of P85α, P110α, GSK3α and pSGSK3α were mainly distributed in the cytoplasm of hippocampal neurons, and the GSK3α was also distributed in the axons of neurons in the model group and the treatment group. The immunohistochemistry results showed that the distribution level of GSK3α in the hippocampus in the model group was significantly higher than that in the control group (<0.001), and the distribution level of pSGSK3α, P85α and P110α was significantly decreased (<0.01, <0.001); compared with the model group, the distribution level of GSK3α in the hippocampus in the treatment group was significantly decreased (<0.001), and the distribution level of pSGSK3α, P85α and P110α in hippocampus was significantly increased (<0.05, <0.001). The Western blot results showed compared with the control group, the expression of pSGSK3α, P85α and P110α as well as the ratio of pSGSK3α/GSK3α in the hippocampus in the model group were significantly decreased (<0.001), and the expression of GSK3α was increased (<0.05); compared with the model group, the expression of pSGSK3α, P85α, P110α and the ratio of pSGSK3α/GSK3α in the hippocampus in the treatment group were significantly increased (<0.01, <0.001), and the expression of GSK3α was decreased (<0.05). Compared with the control group, the number of hippocampal SP in the model group was significantly increased (<0.001); compared with the model group, the number of hippocampal SP in the treatment group was significantly decreased (<0.01).@*CONCLUSION@#EA could effectively regulate the expression of PI3K/GSK3α signal pathway related proteins in the hippocampus in mice with AD, so as to reduce the formation and deposition of SP.

Value of visual analysis and SUVR during 18F-AV45 PET/CT imaging in the diagnosis of mild cognitive impairment and Alzheimer′s disease / 中华核医学与分子影像杂志

Objective:To evaluate the value of visual analysis and standardized uptake value ratio (SUVR) during 18F-florbetapir (AV45) PET/CT brain imaging in diagnosis of β-amyloid (Aβ) deposition in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and to explore the clinical ancillary value of the two indexes. Methods:From December 2018 to July 2019, a total of 47 subjects, including 5 (3 males, 2 females, age (58±13) years) normal controls (NC), 8 (2 males, 6 females, age (66±10) years) patients with AD and 34 (16 males, 18 females, age (70±7) years) patients with MCI were enrolled. All subjects underwent 18F-AV45 PET/CT scan. All images were evaluated by visual analysis and SUVR were calculated. The diagnostic efficiencies of visual analysis and SUVR were compared by McNemar test and Kappa test. One-way analysis of variance and Welch test were used to compare data differences. The best threshold value of SUVR was obtained by receiver operating characteristic (ROC) curve analysis. Results:The positive rate of Aβ deposition for all subjects was 46.81%(22/47) by SUVR analysis, and 38.30%(18/47) by visual analysis. There was no significant difference between the two methods ( χ2=33.15, P>0.05), and the consistency was good ( Kappa=0.83). Considering the clinical diagnosis as the"gold standard", the Aβ deposition obtained by visual analysis and SUVR analysis can effectively distinguish AD from NC, and the sensitivities were 7/8 vs 8/8, respectively, both specificities were 5/5( χ2=9.48, P>0.05), with good consistency ( Kappa=0.84). SUVR quantitative analysis could distinguish AD from NC, AD from MCI ( F values: 3.99-8.79, all P<0.01), but could not distinguish NC from MCI (all P>0.05). ROC curve analysis showed that the best threshold value of precuneus′ SUVR was 1.08 for the differential diagnosis of AD and NC; for the differential diagnosis of AD and MCI, the best threshold value of lateral temporal′s SUVR was 1.06. Conclusion:Visual analysis was consistent with SUVR′s qualitative determination during 18F-AV45 PET/CT imaging for brain Aβ deposition, while SUVR quantitative analysis could assist in the differential diagnosis of AD and NC, AD and MCI.

Food and nutrients intake among 223 residents in Yangpu District from 2011 to 2015 / 上海预防医学

Objective To analyze the intake and changes of food and nutrients in 223 residents of Yangpu District from 2011 to 2015. Methods From the China Nutritional Transition Cohort Study in 2011 and 2015, the data in the study was obtained on Yangpu District′s residents aged 2 and above.A dietary survey was conducted using the 3-day 24-hour dietary recall and condiment weighing method to obtain data on food and nutrients intake per reference man per day and the nutrient source of energy, and to analyze the intake status of different years. Results The intake of vegetables, fruits, livestock and poultry, aquatic products, eggs, milk and dairy products, soybeans and nuts, edible oil and salt per reference man per day was lower in 2015 than in 2011.The insufficient intake proportions of cereals and tubers, vegetables, fruits, aquatic products, eggs, milk and dairy products, soybeans and nuts, and edible oils were 56.0%, 84.0%, 98.2%, 56.0%, 70.2%, 97.8%, 85.3% and 91.1%, respectively, the excessive intake proportion of livestock and poultry meat was 51.6%;the intake of energy, protein, fat and micronutrient per reference man per day in 2015 was lower than in 2011, and the insufficient intake proportion of energy, protein, vitamin A, vitamin B1, vitamin B2, vitamin C, and calcium were 84.0%, 56.4%, 97.3%, 93.8%, 93.3%, 90.2% and 91.6%, respectively.In 2011 and 2015, it was found that residents who had the proportions of energy supply from carbohydrate lower than 50% accounted for 64.6% and 49.8%, those who had the proportions of energy supply from protein higher than 15% accounted for 76.2% and 40.4%, and those who had the proportions of energy supply from fat higher than 30% accounted for 76.7% and 72.9%. Conclusion In 2011-2015, the food and nutrients intakes among community residents in Yangpu District generally decrease, showing the coexistent problems of insufficient and excessive food intake, and the insufficient intake is serious.The insufficient intake of energy, vitamins and calcium is still a severe problem.And the dietary structure is not rational; the proportions of energy supply from three major nutrients are unbalanced.It is suggested that nutrition education for residents should be enhanced.

An overview of the removal of algal toxins by water treatment process / 军事医学

The environmental and health problems caused by the frequent occurrence of cyanobacteria blooming and its secondary metabolites,algal toxins, have become a hot spot in environmental science research.This article reviews the production and contamination status of algal toxins, and the removal effects of microcystins(MCs), anatoxin-a(ANTX) and other algal toxins by different water treatment processes, including coagulation and sedimentation, ozone oxidation, activated carbon adsorption,membrane treatment, chlorination and UV irradiation.Furthermore, the factors affecting the removal effect are analyzed,and the advantages and limitations of each water treatment process are summarized.Finally, some feasible proposals are presented regarding the future research of removing algal toxins.

Age distribution and infection types of human papillomavirus cervical infection in patients in Wuhan region / 中国感染控制杂志

Objective To investigate the age distribution and types of human papillomavirus (HPV) cervical infection in patients in Wuhan region, so as to provide scientific basis for the prevention and treatment of HPV infection and cervical cancer.Methods 9 915 exfoliated cervical cell specimens from patients in Wuhan Medical and Health Center for Women and Children between January 2015 and March 2016 were performed HPV genotyping (21 subtypes), clinical data of 1 732 HPV positive cases were statistically analyzed.Results HPV-positive rates in ≤25, 26~, 36~, 46~, and ≥56 age groups were 22.15%, 15.90%, 17.04%, 19.97%, and 17.57%,respectively (χ2=36.587,P<0.01),HPV-positive rates in ≤25 and 46~ age groups were both higher than other age groups.There were significant differences in single infection and multiple infection rates among different age groups respectively(χ2=14.39, 36.51,respectively, both P<0.05),single infection rate was highest in 46~ and ≤25 age groups (15.41% and 15.24% respectively);multiple infection rates was highest in ≤25 and ≥56 age groups (6.90% and 5.86% respectively).The percentage of single infection and multiple infection were 75.58% and 24.42% respectively, the major single infection type was HPV high-risk subtype (84.34%),the major multiple infection types were high-risk and high-risk compound subtype as well as high-risk and low-risk compound subtype, accounting for 60.52% and 38.77% respectively.The main single infection types were HPV high-risk subtypes 33, 68, 31 and 16, as well as and low-risk subtype 11, the ratios of single infection to multiple infection were 3.13, 2.03, 1.71, 1.67 and 2.00 respectively.Conclusion Cervical infection rates in women in Wuhan region is high in ≤25 and 46~ age groups, there are differences in the distribution of different HPV subtypes of single infection and multiple infection.

Comparison of RECIST1.1, PERCIST1.0, WHO and EORTC in the evaluation of treatment response in colorectal liver metastases after neoadjuvant chemotherapy / 中华核医学与分子影像杂志

Objective To compare treatment response according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria in patients with colorectal liver metastases (CLM) who received neoadjuvant chemotherapy.Methods A total of 41 CLM patients (27 males,average age 68.48 years;14 females,average age 62.43 years) from January 2010 to September 2013 were included in this retrospective study.PET/CT scan was performed before chemotherapy and after 4-6 cycles′ chemotherapy.The baseline and the sequential follow-up 18F-FDG PET/CT of each patient were evaluated according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria.The response was categorized into 4 levels including CR,PR,SD,PD.PET/CT images were used for both metabolic and anatomic evaluation.The concurrent diagnostic CT or MRI images (performed within 1 week of PET/CT) were also utilized when needed.The agreements of criteria were analyzed using Kappa test.The response rate (RR) and disease control rate (DCR) were compared using χ2 test.Results The RR and DCR according to the PERCIST1.0,EORTC and RECIST1.1 criteria were 31.71％(13/41) and 63.41％(26/41),31.71％(13/41) and 60.98％(25/41),17.07％(7/41) and 68.29％(28/41),respectively.The general comparison of PERCIST1.0 and RECIST1.1,EORTC and RECIST1.1 criteria showed good agreements (κ values: 0.711,0.689).Significant difference was not found in the DCR(χ2=2.000,P>0.05) but found in the RR(χ2=6.000,P0.05),while the RR had significant difference(χ2=6.000,P0.05) but found in the RR(χ2=8.000,P<0.05) between PERCIST1.0 and WHO criteria.Conclusions In evaluating CLM treatment response,anatomical criteria and metabolic criteria have a good consistency.But metabolic criteria are more sensitive for RR evaluating.

Clinical phenotype and genetic analysis of MED13L syndrome / 中国当代儿科杂志

A boy aged 4 years and 2 months was found to have delayed language and motor development, instability of gait, poor eye contact, stereotyped behavior, and seizure at the age of 3 years. Physical examination showed special facial features, including plagiocephaly, blepharoptosis, wide nasal bridge, down-turned mouth corners at both sides, and low-set ears. There were only two knuckles at the little finger of the left hand. The anteroposterior and lateral films of the spine showed scoliosis; echocardiography showed ventricular septal defect; the Gesell Developmental Scale showed delayed language development and moderate intellectual disability; there were no abnormalities in the karyotype; genome-wide SNP arrays found a duplication in 12q24.21 region with a size of 1.03 Mb in chromosome 12, while this was not seen in his parents. The boy was diagnosed with MED13L syndrome. Point mutation, deletion, and duplication in the MED13L gene can lead to MED13L syndrome. The patients with different genotypes may have different phenotypes. Genome-wide SNP arrays may help with the diagnosis of this disease.

Application of automatic tube current modulation combined with iterative reconstruction in CT scanning of neck / 中华放射医学与防护杂志

Objective To explore application of automatic tube current modulation combined with iterative reconstruction in CT scanning ( non-enhanced and enhanced) of neck. Methods A total of 80 patients with CT scanning of neck were randomly divided into test group(n=40, automatic tube current modulation, iterative reconstruction ) and control group ( n = 40, 200 mAs, filtered-back-projection reconstruction ) . Subjective scores and objective evaluation of two groups were evaluated. Evaluation included image noise ( SD ) of thyroid gland, trapezius muscle, sternocleidomastoid muscle, submandibular gland, lateral pterygoid muscle and brain tissue. Effective dose ( E ) was compared. Results The E of non-enhanced and enhanced scanning in test group was lower than that of control group with the statistically significant difference(t = -2. 451, -2. 451, P <0. 05). The subjective scores of non-enhanced and enhanced scanning in test group were higher than those of control group with the statistically significant difference (Z = - 1.969, - 2.056, P < 0.05), while SD of thyroid gland, trapezius muscle, sternocleidomastoid muscle, submandibular gland in test group were lower than that of control group with the statistically significant difference ( t =2. 400,2. 516,2. 120,2. 411,4. 134,4. 674, 2. 711,2. 892, P<0. 05). There were no significant differences in SD of lateral pterygoid muscle, brain tissue of non-enhanced and enhanced scanning between two groups (P>0. 05). Conclusions Automatic tube current modulation combined with iterative reconstruction in CT scanning of neck could improve image quality, and reduce effectively radiation dose.

Clinical tests of huatan Huoxue Jiangqi prescription in treatment of chronic obstructive pulmonary disease / 实用医学杂志

Objective To investigate the Huatan Huoxue Jiangqi prescription in treating AECOPD clinical curative effect. Methods 123 patients with AECOPD were randomly divided into the treatment group and the control group. The two groups were treated with western medicine, and the treatment group added with Chinese herbal medicine treatment with Huatan Huoxue Jiangqi prescription. The syndrome effect, clinical symptom score, CAT score, mMRC classification, lung function, the serum FIB and CRP levels were obtained to evaluate the efficacy of the two groups before and after treatment. Results The syndrome effect of the treatment group was significantly better than that of the control group. Compared with the control group, there was significant difference between traditional Chinese medicine syndrome score, CAT score (P < 0.05); Lung function (including FEV1, FEV1%, FEV1/FVC) was significantly improved in the treatment group after treatment (P < 0.05). The serum FIB and CRP levels decreased significantly in the treatment group compared with the control group (P < 0.05). Conclusion Huatan Huoxue Jiangqi prescription has reliable effets on treating AECOPD.

The application research of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion.@*METHOD@#We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively.@*RESULT@#In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P 0.05).@*CONCLUSION@#This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.

Comparative analysis of serum proteomic profiles between patients with silicosis and chronic bronchitis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze the differences in serum proteomic profiles between patients with silicosis and chronic bronchitis and to investigate the pathogenesis, clinical diagnosis, and treatment of these two disease.</p><p><b>METHODS</b>Serum samples from patients with stage I silicosis and chronic bronchitis were collected. Two-dimensional gel electrophoresis was performed and protein plots with expression differences higher than 2-fold were identified and further analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.</p><p><b>RESULTS</b>Compared with the silicosis group, the chronic bronchitis group had 11 up-regulated proteins and 23 down-regulated proteins. The chronic bronchitis group had high expression of proteins such as interferon beta precursor, apolipoprotein precursor, and transforming growth factor beta1 precursor. The silicosis group had high expression of proteins such as interleukin-6, granzyme A, cathepsin G, and glycoprotein precursor.</p><p><b>CONCLUSION</b>The differentially expressed proteins are mainly involved in the activity of serine enzymes, cytotoxicity, inflammation response, and apolipoprotein transfer and play different roles in silicosis and chronic bronchitis.</p>

Changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer.</p><p><b>METHODS</b>Serum samples of patients with silicosis, tuberculosis, and lung cancer were collected. The variation trends of the expression of granzyme A, cathepsin G, apolipoprotein A, and interferon-β (IFN-β) were analyzed using enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>The concentration of apolipoprotein A of the silicosis group was 200 µg/ml, significantly higher than those of the tuberculosis and lung cancer groups (P < 0.05), and the lung cancer group had a significantly higher concentration of apolipoprotein A compared with the tuberculosis group (P < 0.05). The silicosis group had significantly higher expression of cathepsin G compared with the tuberculosis and lung cancer groups (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in the concentration of cathepsin G (P > 0.05). The tuberculosis group had a significantly higher concentration of granzyme A than the silicosis and lung cancer groups (P < 0.05), and the silicosis group and lung cancer group had similar protein concentration trends (P > 0.05). The tuberculosis group and lung cancer group had significantly higher concentration of IFN-β compared with the silicosis group (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in IFN-β concentration (P > 0.05).</p><p><b>CONCLUSION</b>This study may offer diagnostic markers for the clinical diagnosis of silicosis, tuberculosis, and lung cancer, and could provide a basis for the research, as well as potential molecular targets for the diagnosis and treatment of these diseases.</p>

A clinical observation on therapeutic effect of traditional Chinese medicine granules made by formula of ;Shegan Mahuang decoction for treatment of patients with asthma / 中国中西医结合急救杂志

Objective To observe the therapeutic effect of traditional Chinese medicine(TCM)granules made by the formula of Shegan Mahuang decoction for treatment of patients with asthma. Methods A prospective study was conducted,51 cases of light to moderate asthma(cold type)patients were randomly divided into treatment group (25 cases)and control group(26 cases). Conventional symptomatic treatments were of the same in two groups. The patients in control group were given salbutamol aerosol inhalation,100μg each time,4 times per day;based on the treatment of the control group,additionally the above mentioned TCM granules dissolved in water was administered orally 1 dose/day taken twice once in the morning and another once in the evening in treatment group. The therapeutic course was 12 weeks in both groups. Before and after treatment,the asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1)and peak expiratory flow(PEF)were observed. The therapeutic effect,adverse reaction and compliance were evaluated. Results The number of patients with asthma completely controlled in the treatment group was significantly higher than that in the control group(16 cases vs. 9 cases,χ2=4.82,P=0.028). In the patients of two groups,FEV1,PEF and ACT scores were significantly improved after treatment,and in the treatment group,they were obviously higher than those in control group〔FEV1(L):2.67±0.46 vs. 2.32±0.47,PEF(L/min):327.6±49.4 vs. 273.1±42.8,ACT score:22.8±2.0 vs. 21.1±2.6,all P<0.05〕. After treatment,FEV1%predicted value was increased in the treatment group but decreased in control group,there was significantly statistical difference〔(0.68±0.07)% vs.(0.80±0.11)%,P<0.05〕,no significant adverse reaction was found,compliance was good. Conclusion TCM granules made by formula of Shegan Mahuang decoction can improve the clinical symptoms, pulmonary function and control level in patients with asthma,so it is an effective medicine for the control of asthma.

A comparative study on the medium-long term results of endovascular repair and open surgical repair in the management of ruptured abdominal aortic aneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm (rAAA) obtain the greatest benefit from endovascular repair (EVAR), convincing evidence on the medium-long term effect is lacking. The aim of this study was to compare and summarize published results of rAAA that underwent EVAR with open surgical repair (OSR).</p><p><b>METHODS</b>A search of publicly published literature was performed. Based on an inclusion and exclusion criteria, a systematic meta-analysis was undertaken to compare patient characteristics, complications, short term mortality and medium-long term outcomes. A random-effects model was used to pool the data and calculate pooled odds ratios and weighted mean differences. A quantitative method was used to analyze the differences between these two methods.</p><p><b>RESULTS</b>A search of the published literature showed that fourteen English language papers comprising totally 1213 patients with rAAA (435 EVAR and 778 OSR) would be suitable for this study. Furthermore, 13 Chinese studies were included, including 267 patients with rAAA totally, among which 238 patients received operation. The endovascular method was associated with more respiratory diseases before treatment (OR = 1.81, P = 0.01), while there are more patients with hemodynamic instability before treatment in OSR group (OR = 1.53, P = 0.031). Mean blood transfusion was 1328 ml for EVAR and 2809 ml for OSR (weighted mean difference (WMD) 1500 ml, P = 0.014). The endovascular method was associated with a shorter stay in intensive care (WMD 2.34 days, P < 0.001) and a shorter total postoperative stay (WMD 6.27 days, P < 0.001). The pooled post-operative complication rate of respiratory system and visceral ischemia seldom occurred in the EVAR group (OR = 0.48, P < 0.001 and OR = 0.28, P = 0.043, respectively). The pooled 30-day mortality was 25.7% for EVAR and 39.6% for OSR, and the odds ratio was 0.53 (95% confidence interval (CI) 0.41-0.70, P < 0.001). There was not, however, any significant reduction in the medium-long all-cause mortality rate (HR = 1.13, P = 0.381) and re-intervention rate (OR = 2.19, P = 0.243) following EVAR. In EVAR group, nevertheless, incidence of type I endoleak was significantly lower than type II endoleak (OR = 0.33, P = 0.039) at late follow-up period.</p><p><b>CONCLUSIONS</b>On the basis of this systematic review, rAAA EVAR results in less blood use for transfusion, shorter operation time, shorter intensive care unit and hospital stays, and lower 30-day mortality. However, in the medium-long term, it is not associated with a reduction in all-cause mortality.</p>

Expression of carbonic anhydrase II in cultured rat osteoclasts after stress stimulation / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To test expression of carbonic anhydrase II (Ca II) mRNA in osteoclasts which were applied with fluid shear stress.</p><p><b>METHODS</b>The bone marrow cells of Sprague-Dawley rats were cultured with the presence of 1,25-(OH)2D3 and dexamethasone. The osteoclast-like cells were identified by tartrate-resistant acid phosphatase(TRAP) staining and scanning electron microscope (SEM) observation, then purified with trypsin/ethylenediamine tetraacetic acid (EDTA). Different values and lasting time of steady fluid shear stress were exerted on the osteoclasts with parallel plate flow system. The Ca II expression of osteoclasts were detected by real time reverse transcription-polymerase chain reaction(RT-PCR) and nested polymerase chain reaction(PCR).</p><p><b>RESULTS</b>The levels of Ca II mRNA were down-regulated correspondingly with the increase of stress and time (P < 0.05).</p><p><b>CONCLUSION</b>It's indicated that steady fluid shear stress within a certain range may down-regulate the expression of Ca II in osteoclasts.</p>

Endovascular repair vs conservative therapy for the treatment of acute type B aortic dissection / 中华普通外科杂志

Objectives To compare endovascular aortic repair (EVR) and medical therapy for acute type B aortic dissection (AD) in terms of treatment results.Methods From January 2004 to October 2010 116 cases were collected and were divided into two groups,with treatment of EVR (n =60)and medical therapy (n ＝ 56).Treatment outcomes were assessed.Results Clinical manifestations of AD are complex and variable,with the most common symptom being pain on chest and back (74.1％).CTA is the most valuable method in confirming the diagnosis of aortic dissection.In conservative group of 56 patients admitted to hospital,30-day mortality rate was 16.1％.In EVR group of 60 patients with grafts successfully released,the 30-day mortality was 1.7％.There is significant difference between the two groups on mortality rate during 30-day(P ＜0.05).Follow-up rate in conservative group and the EVR group was 71.4％ and 86.7％,with average follow-up time of (38 ± 16) months and (35 ± 14) months.The 5-year survival rates were 87.5％ and 88.5％ respectively in conservative group and EVR group (P ＞ 0.05).Conclusions EVR is considered to be the first choice for acute Stanford type B dissection.EVR can improve patients' 30-day survival,though long term result is comparable with that of conservative treatment.

Surgical and interventional management of splenic artery aneurysms / 中华普通外科杂志

Objective To assess the treatment of splenic artery aneurysms (SAA) and prognosis.Methods Clinical data of 18 SAA patients treated in our hospital from 1999 to 2011 were retrospectively analyzed. Results There were 18 patients diagnosed as SAA,including 7 males and 11 females.The average age was 53.8 ± 7.3 years.8 patients were asymptomatic found by routine physical examination,7 patients complained upper left abdominal pain,3 cases suffered from aneurysm rupture. Diagnosis was established by three-dimensional computed tomography angiography (3DCTA) in 14,Digital subtraction angiography (DSA) in 3 and magnetic resonance angiography (MRA) in 1 patient.Three patients with ruptured splenic artery aneurysm underwent emergent operations,11 patients underwent elective surgery or interventional therapy.Surgical procedures included aneurysmectomy and splenectomy in 4 patients,distal pancreatectomy in 5 cases; aneurysmectomy and splenic artery ligation in one patient; and aneurysmectomy with splenectomy and colon resection in 1 case.Interventional embolization by coils of the splenic aneurysm in 3 patients.The remaining 4 being asymptomatic and with tumor diameter less than 2 cm were put on a close follow-up.There was no perioperative mortality.Two were lost to follow-up.16 cases were followed-up for averaging 3.2 years. 1 patient died of cerebral hemorrhage after four years. Conclusions Splenic artery aneurysms was a rare disease and with usually occult symptoms,but rupture can leads to abdominal apoplexy.Open surgery and minimally invasive endovascular treatment is effective and offers a good prognosis.

Effect of different prone time/supine time ratios to pathology of mini-pig with acute lung injury / 中国实用护理杂志

Objective To compare the effects of different prone and supine position duration within 24-hour period on mini-pig acute lung injury (ALI)models. Methods Fifteen female mini-pigs,mean weight (30.2±3.2) kg, length (76.5±5.9) cm were anesthetized and ventilated. Hydrochloric acid (pH 1.0)was aspirated intratracheally to create ALI model. Mini-pigs were assigned randomly into three groups: p rone 8 h group, prone 8h then supine 16 h; 16 h group, prone 16 h then supine 8 h; 24 h group, prone 24 h continuously. Min-pigs were euthanasia at the end of the experiment to take out the lung, examine the tissue change and calculate the wet to dry weight ratio of lung (W/D). Sample was cut into slices and carried on hematoxylin and eosin (HE) stain which was intended to calculate injury score by semi ration score criteria. Results W/D, and injury score were lower in 16 h group and 24 h group than the 8 h group,whereas no significant differences among the three groups. Conclusions Prone position for 16 hours or longer could decrease oxygenation by decreasing inflammation in acute lung injury(ALI)animal models.