Application status of electrical stimulation and repetitive transcranial magnetic stimulation in postherpetic neuralgia / 中华皮肤科杂志

For the treatment of postherpetic neuralgia, drugs have always played a major but unsatisfactory role. As auxiliary or alternative therapies for postherpetic neuralgia, non-pharmacological interventions, such as electrical stimulation and repetitive transcranial magnetic stimulation, not only have shown favorable efficacy, but also can decrease adverse reactions to drugs with high safety and patient acceptance, and are benificial for management of patients with postherpetic neuralgia.

A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

Association between family factors with dietary behaviors of left-behind children in rural China / 中国学校卫生

Objective@#To find out the association between family factors and left-behind children’s dietary behaviors in rural China.@*Methods@#This cross-sectional study was implemented in four counties of medium economic level were selected in Guizhou and Anhui province and four primary schools were chosen in each county and in total 16 schools were involved. Three classes from grades 5 and 6 each were selected randomly from included primary schools; all students in these classes, as well as their caregivers, were invited to participate. Self-designed questionnaire was adopted to collect intake frequencies of vegetable, fruit, meat, egg, milk, drink and fast food. Scores were calculated to evaluate these behaviors frequencies and multi-linear regression was used to explore the association between family factors and behavioral scores.@*Results@#The proportion of fruit, eggs and milk intake more than 4 times once a week in left-behind children were 44.9%, 35.1%, and 28.5%, while they were 57.2%, 38.5%, and 38.1% in non-left-behind children. It was found that statistical significant differences existed between scores of dietary behaviors of leftbehind children’s and non-left-behind children(t=-5.83, P<0.01). The results of multi-linear regression demonstrated that family cohesion (β=0.07, P=0.05) and caregivers’ behaviors (β=0.49, P<0.01) were protective factors for left-behind children’s behaviors, while taking care by single left-behind fathers was a risk factor(β=-1.21, P=0.03).@*Conclusion@#Primary caregivers play a critical role in offering guidance to children to help them develop health behaviors.

Preventive and therapeutic effects of common plant drugs on colon cancer and its mechanism / 国际肿瘤学杂志

It is shown that phytochemicals have a protective effect on colon cancer. Curcumin, polysaccharides (apple polysaccharides, mushroom glucans), saponins (paridis saponins, ginsenosides), resveratrol, quercetin and other plant drugs can inhibit colon cancer cell proliferation and promote cell apoptosis through different signaling pathways. In addition, it also has anti-inflammatory, antioxidant, anti-angiogenesis, reduce the toxic side effects of chemotherapy drugs, and reverse the drug resistance of tumor cells. Understan-ding the prevention and cure effect of plant medicine on colon cancer and its possible mechanism can provide more theoretical basis and therapeutic ideas for the clinical prevention and cure of colon cancer.

Effect of self-made traditional Chinese medicine decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy / 中国中西医结合急救杂志

Objective To investigate the effect of self-made traditional Chinese medicine(TCM) decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy. Methods A total of 124 pregnant hypertensive patients admitted to the Department of Critical Care of Guizhou Provincial People's Hospital from October 2016 to October 2018 were enrolled. The 62 patients who were treated with western medicine conventional method;62 patients who were treated with self-made TCM decoction on the basis of western medicine conventional method. The western medicine conventional treatment group was given magnesium sulfate combined with nicardipine; the self-made TCM treatment group was supplemented with TCM decoction on the basis of conventional western medicine treatment (composition: uncaria, raw oyster 20 g, gastrodia elata, eucommia, salvia miltiorrhiza, medlar rehmannia glutinosa each 15 g, rhizoma, mulberry parasitic, astragalus, ophiopogonis each 10 g. Severe headache and dizziness plus tortoise shell, gentian grass 15 g, anemarrhenae 10 g; severe edema plus cassia twig, aristolochiae 15 g, astragali, ginger skin 10 g), be decocted in water for oral dose, morning and evening oral, one dose a day, 1 week for a course of treatment, the two groups were continued for 4 weeks after the evaluation of clinical efficacy. The changes of blood pressure and blood coagulation parameters, placental bed arterial hemodynamics, pregnancy outcome index were observed before and after treatment; antihypertensive effects and adverse reactions after treatment were recorded. Results After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Fibrinogen (Fib), placental bed arterial pulsation index (PI), end-systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) and resistance index (RI) in both groups were lower than those before treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly longer than before treatment, and the time-averaged flow rate (TAV) increased than that before treatment; SBP, DBP, Fib, PI, S/D and RI were significantly lower in self-made TCM treatment group than those in western medicine conventional treatment group [SBP (mmHg, 1 mmHg = 0.133 kPa): 114.26±17.07 vs. 132.72±17.64, DBP (mmHg): 82.98±6.24 vs. 90.09±6.48, Fib (g/L): 3.21±0.45 vs. 3.64±0.31, PI: 0.59±0.14 vs. 0.75±0.15, S/D: 1.70±0.21 vs. 1.93±0.25, RI: 0.43±0.08 vs. 0.54±0.12, all P < 0.05], PT, APTT, TAV in self-made TCM treatment group were significantly higher than western medicine conventional treatment group [PT (s): 12.26±0.57 vs. 11.72±0.44, APTT (s): 27.11±1.34 vs. 25.69±1.48, TAV (cm/s): 15.64±2.88 vs. 12.49±2.76, all P < 0.05]. The rate of cesarean section, postpartum hemorrhage, fetal heart abnormality and neonatal asphyxia in self-made TCM treatment group were significantly lower than those in western medicine conventional treatment group [cesarean section rate: 9.84% (6/61) vs. 27.78% (15/54), postpartum hemorrhage rate: 1.64% (1/61) to 14.81% (8/54), fetal heart abnormal rate: 3.28% (2/61) vs. 16.67% (9/54), the incidence of neonatal asphyxia: 1.64% (1/61) vs. 12.96% (7/54), all P < 0.05]. The total effective rate of the self-made TCM treatment group was significantly higher than that of western medicine conventional treatment group [98.39% (61/62) vs. 87.10% (54/62), P < 0.05]. However, there was no significant difference in the incidence of adverse reactions between the self-made TCM treatment group and western medicine conventional treatment group [16.39% (10/61) vs. 16.67% (9/54), P > 0.05]. Conclusion Self-made TCM decoction can improve the maternal and infant outcomes by improving the hypercoagulable state and placental hemodynamics in hypertensive patients with hyperthyroidism, the antihypertensive effect is remarkable and the safety is good.

Changes of white matter in LDLR knockout hypercholesterolemic rats / 国际脑血管病杂志

Objective To investigate the difference between histopathological changes of brain white matter in low-density lipoprotein receptor (LDLR) homozygous mutation rats with hypercholesterolemia and wild-type rats.Methods Thirty LDLR-/-rats and 28 wild-type rats were selected.Plasma cholesterol levels were measured by enzyme-linked immunosorbent assay at 15,18 and 26 weeks old respectively.The axonal structure of the corpus callosum area was observed by transmission electron microscopy.The myelin basic protein (MBP) of the corpus callosum area was quantitatively analyzed by Western blotting.In addition,at 26 weeks old,the myelin sheaths were stained by fast blue staining.The expression level of MBP in white matter was further detected by immunofluorescence staining,and the morphological changes of glial cells were observed.Results Compared with the wild-type rats,the plasma cholesterol concentration in LDLR-/-rats increased significantly,and it could be as high as 3.3 times at 26 weeks.The results of electron microscopy showed that the LDLR-/-rats had axonal injury at 15 weeks and aggravated gradually over time.At 26 weeks,Western blot analysis of the LDLR-/-rats showed that the MBP expression level of the corpus callosum area decreased significantly.Fast blue staining showed loosening of nerve fibers,diffuse vacuole formation,and myelinated nerve fiber loss in the corpus callosum area.In addition,it was also found that the number of oligodendrocytes in LDLR-/-rats was significantly reduced,and large numbers of astrocytes and microglia were activated.Conclusions LDLR-/-rats will have spontaneous hypercholesterolemia.Axonal injury,demyelination,decreased oligodendrocytes,as well as the abnormal activation of astrocytes and microglia are present in the early adult brain white matter area.

The value of measuring cysC, β2-microglobulin and neutrophil gelatinase-associated lipocalin as a test panel for detection of early renal damage in lung cancer patients receiving chemotherapy / 中华老年医学杂志

Objective To compare the value of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil gelatinase-associated lipocalin (NGAL) as a test panel with that of traditional indicators,serum Cr and urea,for detection of early renal damage in lung cancer patients after chemotherapy.Methods This prospective study collected data at our hospital on levels of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil-gelatinase associated lipocalin (NGAL) from 63 lung cancer patients aged 60 and over.In addition,levels of traditional indicators including serum Cr and urea were also measured.Participants were divided into three groups:a prechemotherapy group,an under chemotherapy group,and a post-chemotherapy group.Results Levels of serum CysC,urine β2-MG,and NGAL in the post-chemotherapy group markedly increased,whereas levels of serum Cr and urea had no significant increase;furthermore,levels of serum CysC,urine β2-MG,and NGAL went up steadily as the time of exposure to chemotherapy drugs increased.Pearson's test showed that the sensitivity of CysC,beta 2-MG and NGAL as a panel was statistically significant for both the under chemotherapy group and the post-chemotherapy group (x2 =31.32,P=0.00;x2 =60.38,P=0.00).Conclusions Serum CysC,urine β2-MG and NGAL as a panel have good diagnostic value for early renal function damage in lung cancer patients after chemotherapy and are superior to traditional renal function indicators such as serum creatinine and urea.

Evaluation of efficacy and safety of different doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding / 药物评价研究

Objective To evaluate the efficacy and safety of different doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding.Methods Eighty hepatocirrhosis patients with upper gastrointestinal bleeding during May.2013 to May.2016 were treated with Octreotide combined with Lansoprazole,and were divided into high dose group (40 cases) and low dose group (40 cases) according to different doses Octreotide.Before and after treatment,portalvenousmaximumvelocity (PVV) and portalveindiameter (PVD) were detected by color Doppler ultrasound respectively,and haemostatic time,blood transfusion cases and volume,rehaemorrhagia cases were recorded,and adverse reactions were observed.Results After treatment,PVV and PVD of the two groups were significantly ameliorative (P ＜ 0.05),and there were no significantly different between two groups.Haemostatic time,blood transfusiorate,blood transfusiorate volume and rehaemorrhagia rate of the high dose group were significantly less than the low dose group (P ＜ 0.05).The clinical effective rate of the high dose group was significantly higher than that of the low dose group (P ＜ 0.05).The rate of adverse reactions of the high dose group was not significantly different from that of the low dose group.Conclusions High doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding have a gain on hemostatic effect,and cannot increase adverse reactions significantly.

Therapeutic effect of nicorandil for treatment of patients with acute respiratory distress syndrome / 中国中西医结合急救杂志

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.

Late-course and concurrent radiochemotherapy for advanced esophageal carcinoma / 中国医师进修杂志

Objective To compare the efficacy and toxicity of late-course concurrent radiochemotherapy and sequential chemoradiotherapy for advanced esophageal carcinoma. Methods Eighty-two patients with advanced esophageal carcinoma were randomized into two groups: 41 cases in late-course concurrent radiochemotherapy (LCRC) group were received two cycles chemotherapy and then underwent concurrent radiochemotherapy;41 cases in sequential chemoradiotherapy (SCR) group were received four cycles chemotherapy and then underwent radiotherapy. The regimen of chemotherapy in all cases:cisplatin 25mg/m2, 1-3 d;calcium folinate (CF) 150 mg/m2, 1-5 d;fluorouracil 375 mg/m2, 1-5 d, 21 d was one cycle. All patients were received the three-dimensional conformal radiation therapy, the total dose of radiation was same as 64 Gy. Results The short-term response rate was 85.4%(35/41) in LCRC group and 65.9%(27/41) in SCR group, they had significant difference ( P0.05). The l year, 2 years, 3 years survival rate were 68.3%(28/41) and 65.9%(27/41), 56.1%(23/41) and 51.2%(21/41), 46.3%(19/41) and 36.6%(15/41) respectively,the median survival time were 30.0 months and 26.0 months, there had no significant difference ( P>0.05). Conclusion The short-term efficacy of advanced esophageal carcinoma could be improved by the late-course concurrent radiochemotherapy.

Effect of stanozolol on the nitrogen balance,grip strength and clinical outcomes of critical patients with high nutrition risk / 重庆医学

Objective To investigate the effect of stanozolol on nitrogen balance ,grip strength and clinical outcomes of criti‐cal patients with high nutrition risk .Methods We enrolled patients who were admitted to the ICU of Guizhou provincial Hospital during the time period from January 2014 to June 2014 and ,as patients with high nutrition risk .Patients ,who received same base nutritional support program ,were divided into two groups .Treatment group who were treated with stanozolol administrated with gastric or jejunal tube for 7 days by 4 mg Tid .The control group whose members underwent placebo simultaneously with the treat‐ment group .The nitrogen balance ,grip strength of both groups was measured when at admitted and 4th as well as 7th day .Prealbu‐min ,total bilirubin ,alanine aminotransferase ,and aspartate aminotransferase were measured when at the same time and before leave hospital .The duration of the mechanical ventilation ,ICU stays ,hospital stays and mortality within 28 days were recorded .Results There was no statistical significance in the differences between all the indicators of the two groups at admission(P>0 .05) .The du‐ration of mechanical ventilation ,ICU stays ,hospital stays were decreased significantly in the treatment group (P0 .05) .Nitrogen bal‐ance ,prealbumin ,grip strength and liver function parameters in the treatment group were significantly higher than they were been at admitted and control group at 4th and 7th day (all P<0 .05) .Liver function parameters of treatment group gradually decreased to the normal range before discharge .Conclusion In critically ill patients treated with anabolic steroid stanozolol ,can promote protein synthesis ,reduce muscle and other lean tissue decomposition ,improve clinical symptoms ,short the length of hospital stay and ICU stay .But we should pay more attention on liver function in critically ill patients who treated with stanozolol .

Protective effects of grape polyphenol on pancreatic tissues of mice with caerulein-induced acute pancreatitis / 中国病理生理杂志

AIM:To investigate the effects of grape polyphenol ( GP) on caerulein-induced acute pancreatitis (AP) in mice.METHODS:Two-month-old female mice of ICR strains (n=21) were randomly divided into 3 groups:normal control ( NC) group, AP group, and GP-treated AP group.Before AP induction, the mice in GP-treated AP group were continuously administrated with 1.5 g/kg GP aqueous solution by gavage for 7 d, while those in NC group and AP group were treated with saline as a vehicle control.On the 7th day, the mice in AP group and GP-treated AP group were in-traperitoneally injected with caerulein (50μg/kg) in 1 h interval for 7 serial injections in total.The mice in NC group were treated with saline according to the same procedure in experimental group.All the mice were sacrificed 24 h after AP induc-tion, and the pancreatic tissues and lung tissues were harvested for further investigation of the pathological changes, macro-phages infiltration, myeloperoxidase ( MPO ) activity and expression of inflammatory and oxidative stress factors.RE-SULTS:Compared with AP group, the mice in GP-treated AP group showed milder morphological changes and lower path-ological scores, including the scores of edema, inflammation and vacuolization (P<0.05), but the necrosis scores and to-tal scores showed no statistical difference between these 2 groups.Besides, the mice in GP-treated AP group had fewer macrophage infiltration, lower lung MPO activity (P<0.01), and lower expression of inflammatory factors, tumor necrosis factor α(TNF-α)and monocyte chemotactic protein 1 (MCP-1) (P<0.05), and oxidative stress factors, superoxide dis-mutase (SOD)-1, SOD-2 and NADPH oxidase 2 (NOX-2) (P<0.01).CONCLUSION:Grape polyphenol has remark-able protective effect on pancreatic tissues of mice with caerulein-induced acute pancreatitis, and the mechanisms may be related to down-regulation of inflammatory and oxidative stress factors.

Comparison of different stylet angulation and endotracheal tube camber on time to intubation with the Tosight?? / 临床麻醉学杂志

Objective To compare the effect of different stylet angulation and endotracheal tube camber on time to intubation with Tosight?? video laryngoscope.Methods One hundred and twenty patients of 18 to 55 years old,ASA Ⅰ or Ⅱ,with no difficult airway signs and history,were random-ized into three groups with different endotracheal tube bending angle:group A(angle 40°),group B (angle 60°)and group C(angle 80°).For patients in all three groups,after rapid sequence induction, the Tosight?? oral intubation were applied.The Cormack-Lehane grading,glottic exposure time, times of tracheal intubation,hemodynamic response and complications were recorded.Results Tra-cheal intubation with the Tosight were successfully completed for all three groups.The success rate of first time intubation in groups A,B and C were 37 (92.5%),39 (97.5%)and 40(100.0%),respec-tively.3 patients in group A and 1 patient in group B finished the intubation with the second try after the stylet angle was changed.The mean time to glottic exposure had no significant difference in groups A,B and C.The time to complete tracheal intubation in group C was significantly shorter than that in groups A and B (P < 0.05 ).There was no significant hemodynamic changes for all three groups,and no serious complications were detected.Conclusion When the Tosight?? is used for adult endotracheal intubation 40°,60°,80°angled stylets can all well assist endotracheal intubation.Among which 80°angled slylet has obvious advantages in intubation success rate and shortest intubation time.

Effects of intramuscular and oral mecobalamin in elderly patients with vitamin B12 deficiency / 中国综合临床

Objective To investigate the effect of intramuscular and oral mecobalamin on hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.Methods One hundred and twenty-six patients with vitamin B12 deficiency who fulfilled the inclusion criteria were randomly divided into 3 groups,42 cases in each,including the intramuscular group (to receive mecobalamin therapy intramuscularly),the oral group ( to receive mecobalamin therapy orally) and the control group ( without mecobalamin therapy).The changes of hematologic markers including hemoglobin (Hb,g/L),mean corpuscular volume (MCV,fl),serum levels of vitamin B12 (ng/L),folate and total homocysteine (Hcy,μmol/L),and neurological signs before and after treatment were compared among these groups.Results Baseline characteristics among the three groups were similar.After a 6-month therapy,there were no differences in any markers in control group patients in comparison to baseline;for patients in the intramuscular group,the blood vitamin B12 levels increased from (139.13 ± 31.57)ng/L to (328.10 ± 42.35 )ng/L (P ＜ 0.001 ).Hcy levels decreased from (36.29 ± 16.23 )μmol/L to ( 18.23 ± 9.85 ) μmol/L ( P ＜ 0.001 ).Hb rose from ( 125.34 ± 16.21 ) g/L to ( 132.79 ± 15.98 )g/L (P =0.037).MCV reduced from (92.98 ±5.35)fl to (87.65 ±5.74)fl (P ＜0.001 ) ;For patients in the oral administration group,the blood vitamin B12 levels increased from ( 138.19 ± 29.95) ng/L to (487.79 ±32.21 ) ng/L ( P ＜ 0.001 ).Hcy levels decreased from ( 33.27 ± 11.51 ) μmol/L to ( 17.49 ± 10.13 ) μmol/L( P ＜ 0.001 ).Hb rose from ( 125.89 ± 17.65 ) g/L to ( 133.46 ± 16.26) g/L ( P =0.041 ).MCV reduced from (93.08 ± 5.10 ) fl to ( 89.29 ± 5.37 ) fl ( P =0.001 ).After the 6-month therapy,there were somewhat improvement in MMSE scores of the intramuscular ( 28.24 ± 3.89 vs.27.85 ± 3.56,P =0.633 ) and the oral groups (27.97 ± 3.77 vs.27.34 ± 3.15,P =0.408 ) compared with baseline,but the differences were not significant.The achilles tendon reflex of the intramuscular ( 1.86 ± 0.67 vs.1.56 ± 0.61,P =0.035 ) and the oral groups ( 1.79 ± 0.64 vs.1.43 ± 0.51,P =0.006 ) were enhanced compared with baseline.Foot vibration sensation of the intramuscular ( 1.35 ± 0.37 vs.1.06 ± 0.41,P =0.001 ) and the oral groups ( 1.24 ± 0.52vs.1.01 ± 0.43,P =0.03) were improved compared with baseline.After treatment,the serum VitB12 concentration in the oral group were higher than that of the intramuscular group ( P ＜ 0.001 ).There were no significant differences in other indexes between the two groups.Conclusion Mecobalamin,administered either intramuscularly or orally,may improve the hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.

Epithelial-to-mesenchymal transdifferentiation of renal tubular epithelial cells mediated by oxidative stress and intervention effect of probucol in diabetic nephropathy rats / 中华肾脏病杂志

Objective To explore the role of oxidative stress in the epithelial-tomesenchymal transition (EMT) of tubular epithelial cells and the protective effect of probucol in rat model with diabetic nephropathy (DN). Methods Thirty SD rats were randomly divided into normal control group, DN group, probucol treatment group (supplemented 1% probucol dietary). Twentyfour hours urinary protein excretion (UTP) was measured at the 3rd, the 8th and the 12th week respectively. The biochemical indicators including blood glucose (BG), lipids [triglyceride (TG), total cholesterol (TC)], low-density lipoprotein (LDL), serum creatinine (Scr), creatinine clearance rate (Ccr),kidney tissue malondialdehyde (MDA) level and glutathione peroxidase (GSH-Px) activity were assessed at the end of the 12th week in all groups. The renal pathological changes were evaluated by hematoxylin & eosin (HE) and Masson staining. The protein expression of specificity protein 1 (Sp1), α-smooth muscle actin (α-SMA) and E-cadherin was also detected and analyzed by immunohistochemistry and Western blotting. Results Compared with the normal control group,the BG, TC, LDL, Scr, 24 h UTP and MDA level of renal tissue increased significantly and the Ccr reduced in the rats of DN group (all P＜0.01). The pathological scores and the expression of Sp1 and α-SMA in renal tissue were higher in the DN animals than that in the other animals (all P＜0.01), the expression of E-cadherin downregulated significantly in the DN animals (P＜0.01). The MDA level of renal tissue was positively correlated to the expression of α-SMA and Sp1 protein in DN group (r=0.896, P＜0.01; r=0.862, P＜0.01, respectively), and negatively correlated to the expression of E-cadherin protein (r=-0.673, P＜0.01). In the diabetic animals treated with probucol, the Scr, 24 h UTP, pathological scores, MDA content,expression of Sp1 and α-SMA in renal tissue were lower than those in the diabetic animals (all P＜0.01). The Ccr and the expression of E-cadherin upregulated obviously (all P＜0.01). Conclusion Oxidative stress plays an important role in the EMT process of tubular epithelial cells. Probucol can slow down renal disease progression in DN rats through anti-oxidant, downregulating the expression of Sp1 protein and inhibiting the renal tubular EMT.

Determination of the localization of rupture aneurysms in patients with multiple cerebral aneurysms and spontaneous subarachnoid hemorrhage / 中国综合临床

Objective To discuss the reasons of false judgments of localization of the rupture aneurysms and find the way to fix this problem in patients with multiple intracranial aneurysms. Methods The clinical data of 25 consecutive patients, who presented with their first spontaneous subarachnoid hemorrhage and had multiple intracranial aneurysms from 2003 to 2009 in our hospital, were analyzed retrospectively. The rupture aneurysms were determined according to Nehls' method that reported before, and the supposed responsible rupture aneurysms w0ere clipped within 48 hours after hemorrhage in all patients. More aneurysms that could not be accessed in the same surgical session were surgically terated later. Results The location of the rupture aneurysm was verified at the time of surgery in all 25 patients. The concordance rate of the prediction and the reality of the rupture aneurysm was 80% (20/25). Four patients ( 16% ) ,in whom the ruptured aneurysm was not correctly identified,rebled after surgery,and 2 patients died as a result of the rebleeding One patients had no clear diagnosis at the end. Conclusion In the reported cases, about 80% rupture aneurysms could be correctly diagnosed before treatment according to the CT and DSA examinations. If clear diagnosis couldn't be made,additional examinations should be considered, such as CTA or MRI. Rupture aneurysms must be confirmed during the operation and the other aneurysms should be checked to exclude additional responsible aneurysms in all cases.

Epithelial-to-mesenchymal transdifferentiation of peritoneal mesothelial cells mediated by oxidative stress in peritoneal fibrosis rats / 中南大学学报(医学版)

Objective To investigate the role of oxidative stress in the epithelial-to-mesenchymal transdifferentiation (EMT) of peritoneal mesothelial cells in rat model of peritoneal fibrosis and the effect of probucol on peritoneal fibrosis. Methods The rat model of peritoneal fibrosis was induced by 4.25% high glucose peritoneal dialysis fluid (PDF). The rats were randomly divided into 4 groups:the control group, the saline group, the peritoneal fibrosis group, and the probucol group. A 4 hour peritoneal equilibration test (PET) was performed 4 weeks later. The peritoneal function and net ultrafiltration (UF) volume were determined. The level of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) in peritoneal tissue were examined. The histology of peritoneal membrane was evaluated by light microscopy. E-cadherin and α-smooth muscle actin (α-SMA) protein expression was evaluated by immunohistochemical method and Western blot.Results The mesothelial cells were detached from peritoneal membrane in peritoneal firbosis rats. Comparing with the control rats, the thickness of visceral peritoneum, the level of MDA, and the-SMA protein expression were increased while the net ultrafiltration volume, the level of GSH-Px and E-cadherin protein expression were decreased in peritoneal firbosis rats. All these changes were reversed in the rats treated with probucol.Conclusion Oxidative stress plays an important role in transdifferentiation of peritoneal mesothelial cell in the peritoneal fibrosis rats. Probucol can improve structure and function of peritoneum, and partially reverse the EMT by reducing the oxidative stress.

Acute pancreatitis in mice with lipoprotein lipase deficiency / 中华胰腺病杂志

Objective To establish an experimental animal model of hypertriglyceridemic(HTG)panereatitis by using special lipoprotein lipase(LPL)deficient HTG heterozygous mice.Methods LPL deficient HTG heterozygous mice and wild type mice were divided into experiment group and control group,then each group was subdivided into 12 h,24 h subgroup.Acute pancreatitis(AP)was induced by caerulein intra-abdominal injection for 7 times(50μg/kg)at the interval of 1 h;the mice in the control group received same amount of normal ssline.The serum level of TG,amylase was determined,and morphologic changes were scored.Results The serum level of TG in LPL deficient HTG heterozygous mice was(3.55±0.27)mmol/L,which was significantly higher than that of wild type mice[(0.94±0.18)mmol/L,P＜0.05].The serum level of TG and amylase in heterozygous mice at 12 h was(3.55±0.27)mmol/L and(3685±484)U/L,which was significantly higher than those in wild type mice[(0.92±0.11)mmol/L and(2501±410)U/L,P＜0.05].The pancreatic tissue edema,necrosis,bleeding and inflammatory cell infiltration score was 3.94 ±0.21,3.94±0.21,1.84±0.25 and 1.84±0.25 in heterozygous mice,which was significantly higher than that of wild type mice(3.06±0.01,2.52±0.51,0.46±0.22 and 0.58±0.38,P＜0.05).Conclusions The serum level of TG was moderately and stably elevated in heterozygous mice.The mice developed more severe panereatitis after caemlein induction.which was an ideal experimental model for study of mechanism of HTG pancreatitis.

Nephrotoxicity of X-ray contrast media and protective effect of pentoxifylline in rats with hypercholesterolemia / 中华肾脏病杂志

Objective To evaluate the nephrotoxicity induced by radiographic contrast media with different osmolality in rats with hypercholesterolemia, and to explore the protective effect of pentoxifylline. Methods Forty-eight healthy SD male rats were randomly divided into normal dietary group (NN, n =8) and high cholesterol supplemented dietary group (H, 4% cholesterol and 1% cholic acid, n=40). At the end of 8th week, the rats with high cholesterol diet were randomly divided into five subgroups (n=8, respectively): high cholesterol diet group(HN), high cholesterol plus iso-osmolar contrast media (iodixanol, IOCM) group (HI), high cholesterol plus low-osmolar contrast media (iohexle, LOCM) group (HL), high cholesterol diet plus high-osmolar contrast media (diatrizoate, HOCM) group (HH) and high cholesterol plus HOCM plus pentoxifylline group (HHP). Forty-eight hours after contrast media injection, the rats were executed and blood samples were prepared to determine total cholesterol, triglyceride, serum creatinine, creatinine clearance(Ccr), fractional excretion of sodium and potassium(FeNa, FeK), and angtension Ⅱ (Ang Ⅱ) levels. The renal injury was assessed by HE staining and TUNEL staining, respectively. The expression of NF-κB protein in the renal tissue was detected by using immunohistocbemical method. Results An increase of cholesterol was observed in all the rats with high cholesterol diet. Scr, FeNa%, FeK% and Ang Ⅱ levels of rats in HH group were obviously higher than those in HL and HI groups respectively. Ccr in HH group [(0.11±0.02) ml·min-1·(100 g)-1] was significantly lower than that in HHP group [(0.43±0.03) ml·min-1·(100 g)-1], HL group [(0.25±0.02) ml·min-1·(100 g)-1] or HI group [(0.27±0.03) ml·min-1,(100 g)-1] (P<0.05). TUNEL staining showed that the pewentage of apoptotic cells in HH group [(89.60±6.40)% ] was higher than that of the other groups [NN (2.40±0.77)%, HN (5.60±1.08)%, HHP (8.91±1.44)%, HL (63.34±11.97)% and HI (61.50±9.40)%]. Immunohistochemistry staining showed that the average gray value of NF-κB positive cells in HH group decreased (P<0.05). There were no significant differences of all indices between HL and HI groups (P0.05). Conclusions Contrast media can cause kidney injuries in the rats with hypercholesterolemia. PTX can protect the renal tissue from nephrotoxicity induced by HOCM in hypercholesterolemia.