AIM To investigate the effect of Supplemented Buyang Huanwu Decoction (Astragali Radix,Angelica tail,Paeoniae Radix rubra,etc.) on blood glucose in diabetic rats and its antioxidant activity.METHODS The diabetic rat model induced by streptozotocin (STZ) was established,with metformin as positive control group.After intragastric administration with Supplemented Buyang Huanwu Decoction,the fasting blood glucose,superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in serum and tissues (heart,kidney and pancreas) in rats were detected.HPLC was used to determine the contents of antioxidant constituents (calycosin-7-O-β-D-glucoside and peoniflorin) in plasma,whose pharmacokinetic parameters were then calculated.RESULTS Compared with the model group,the hypoglycemic activity in the Supplemented Buyang Huanwu Decoction group was obvious (P ＜ 0.05),the SOD activity in serum and various issues (except for pancreas) was significantly enhanced,together with significantly reduced MDA level (P ＜ 0.05).The pharmacokinetic behavior of two constituents (calycosin-7-O-3-D-glucoside and peoniflorin) accorded with two-compartment open model,whose blood concentrations reached the highest within 50-70 min,and showed no obvious changes within 180-720 min.CONCLUSION Supplemented Buyang Huanwu Decoction can reduce the blood glucose in diabetic rats and improve the antioxidant activities in heart and kidney.The fast absorption and slow metabolism of calycosin-7-O-3-D-glucoside and peoniflorin in decoction are beneficial to related treatment.

Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.

Objective To study the effects of angiogenesis inhibitor SU5416 on the growth and metastasis of pancreatic cancer in SD rat model. Methods Dimethylbenzanthracine (9 mg) (DMBA),was implanted into the parenchyma of Sprague Dawley rat pancreas to induce pancreatic cancer. Rats with established pancreatic carcinoma were randomly divided into 4 groups (15 rats each) to receive every the other day for consecutive 13 weeks before sacrifice peritoneal cavity injection of: Normal saline (control),5-fluorouracil 30 mg?kg -1 (5-Fu group),SU5416 16 mg?kg -1 (SU5416 group),and both 5-Fu and SU5416(combined treatment group). Tumor weight,inhibition rates,intratumoral microvessel density (MVD),apoptotic index (AI) and metastasis were evaluated. Results Tumor weight was (1.15?0.21) g,(0.68?0.42) g,(0.31?0.11) g,(0.19?0.06) g respectively;the inhibition rate was 0,48%,80%,85% respectively;the intratumoral microvessel density (MVD) was (12.3?3.2),(11.4?3.8),(2.1?1.5),(1.8?1.1) respectively;The apoptotic index (AI) was (2.64?1.86)%,(5.71?3.14)%,(13.21?4.26)%,(21.12?7.15)% respectively. Peritoneal metastasis was significantly less severe in 5-Fu group,SU5416 group and combined group than that in control group(83% versus 46%,25% and 0) ( P

Objective To observe the therapeutic effects of the drugs alternation multiple stages and long term therapy in elderly patients with recurrent urinary tract infection.Methods The patients were divided into elderly group (age≥65 years,n=30) and non-elderly group (n=48).The multiple effective antibiotics were selected for alternate use.The treatment included four periods as follows:(1)Treatment period:the regular dose of antibiotic was maintained until the urine routine test result became normal;(2)Consolidation period:the dosage of antibiotic was reduced;(3)Maintenance period:the dosage of antibiotic was reduced to once every night and the treatment should be kept for three months;(4)Observation period:the patients were observed for six months after withdrawal of antibiotics.During the treatment,if the urine routine test became abnormal repeatedly,the patient should return to the previous treatment period.During the treatment and consolidation period,each medication should be applied for one week alternatively.Results Among 78 patients,69 cases (88.5%) were cured,7 cases (8.9%) were effective,and two cases (2.56%) were invalid.There were 28 cured cases,1 effective case and 1 invalid case in elderly group.The corresponding data were 41,6 and 1 in non-elderly group,respectively.There was no difference in cure rate between the two groups (F= 0.469).Compared with non-elderly group,the overall treatment time [(54.8± 16.2)weeks vs.(44.5± 13.7) weeks,t= 2.8467,P＜0.01],treatment period [( 34.3± 15.2) weeks vs.(26.2±14.8) weeks,t=2.2081,P＜0.05] and consolidation period [(5.7±2.6) weeks vs.(4.1±0.2) weeks,t=3.9369,P＜0.01] were all prolonged in elderly group.But there was no difference in maintenance period [(14.8±4.6) weeks vs.(14.2±3.1) weeks,t=0.6480,P＞0.05].There were no markedly changes in blood routine,liver and kidney function during the course of treatment.Conclusions For the elderly patients with recurrent urinary tract infection,the drugs alternation,multiple stages and long-term treatment has a high cure rate and no adverse effect on blood routine,liver and renal function.

Objective: To investigate the clinical efifcacy of thoracic endovascular aortic repair (TEVAR) for treating the patients with complicated thoracic aortic dissection and to report the relevant clinical experiences. Methods: We retrospectively analyzed the records of 56 patients with complicated thoracic aortic dissection who received the operation of TEVAR in our hospital from 2011-02 to 2015-10 in order to analyze their operation methods with reasons. Results: There were 21 patients with complex anatomic conditions for aortic arch, 7 of them received TEVAR and 14 received TEVAR with covered left subclavian artery; 16 patients with complex shape of aortic dissection, 5 of them received TEVAR and 11 received TEVAR with covered left subclavian artery; 19 patients with aortic dissection involving aortic arch, 17 of them received hybrid procedures of aortic arch branch bypass surgery + TEVAR and 2 received TEVAR with fenestrated stent grafts. All operations were successful and no severe complications occurred. Conclusion: TEVAR is a fast and effective method for treating complicated thoracic aortic dissection, which may expand the application ranges as covering left subclavian artery, branch vessel bypass and modiifed stent grafting.

ObjectiveTo investigate the choice of graft,and transfusion and immunosuppressant regimen of a RhD negative recipient in liver transplantation.MethodsOne RhD negative patient with hepatocellular carcinoma who received a liver graft from a RhD positive donor was retrospectively studied,and related references were reviewed.During the operation,the patient received five units of RhD negative/O RBC,3000 ml positive/O plasma and 30 units cryoprecipitate.Tacrolimus and prednisone were used to prevent rejection,and prednisone was withdrawn 30d post transplant.Results The patient's liver function recovered smoothly,without any acute rejection or hemolytic reaction.Anti-D antibody was not detected.The patient suffered from cancer recurrence 9 months and died of brain metastasis 13 months after transplantation.ConclusionsA RhD negative recipient can receive a graft from a RhD positive donor in liver transplantation.The selection of RBC and platelet from RhD negative or positive donors should be based on the result of anti-D antibody test.Plasma and cryoprecipitate can be transfused regardless of Rh type.Enhanced immunosuppressant regimen was unnecessary for these patients.

ObjectiveTo establish a prognostic score model based on preoperative neutrophillymphocyte ratio (NLR) to predict recurrence of hepatocellular carcinoma (HCC) following liver transplantation.MethodsThe clinical data of 76 HCC patients undergoing liver transplantation were retrospectively analyzed.An NLR≥2.5 was considered to be elevated.A preoperative recurrence score was established by using three preoperative factors which significantly increased the risk of tumour recurrence after liver transplantation on multivariate analysis,namely,vascular invasion,tumour number＞3,and NLR≥2.5.We then evaluated the scoring system in predicting tumour recurrence of HCC after liver transplantation.ResultsArea under the receiver operating characteristic curve of preoperative recurrence score was 0.758,with scores of 2 and 3 having hazard ratios of 10.038 and 59.773,respectively.All ten patients with a score of 3 developed tumour recurrence in less than 6 months.The 1-,3- and 5-year tumour-free survival rates for patients with a score of 0,1 and 2 were 95.0％,78.4％,and 78.4％ vs.76.9％,66.9％,and 63.2％ vs.51.9％,8.7％,and 8.7％,respectively.Of 55 patients who had no gross vascular invasion,5 patients with both tumour number＞3 and NLR≥2.5 developed recurrence in less than 31 months.ConclusionsPatients with both preoperative NLR≥2.5 and tumour number more than 3 were at a high risk of tumour recurrence after liver transplantation for HCC.The preoperative recurrence score model strongly correlated with tumour recurrence,and may aid in the selection of patients with HCC for liver transplantation.

ObjectiveTo study the role of micafungin in the treatment of invasive fungal infection after liver transplantation.MethodsWe retrospectively studied the clinical data of 32 patients who developed invasive fungal infection after liver transplantation treated in our center between December 2008 and June 2010.The therapeutic effect,adverse effect,and the blood concentration/dose ratio of tacrolimus (tacrolimus concentration per dose.kg-1) before and after micafungin treatment were analysed.ResultsThe curative rate was 93.7％.There were no obvious toxicity and sideeffect.The blood concentration/dose ratio in the triazoles treatment group [(1031± 634.2) ng·ml-1/mg · kg-1] was markably higher than the micafungin treatment group [(172.6±39.45) ng·ml-1/mg · kg-1] and the control group (ceasing antifungal agents) [(183.8±47.08) ng· ml-1/mg · kg-1] (P＜0.05).However,there was no significant difference in the blood concentration/dose ratio between the micafungin treatment group and the control group (P＞0.05).ConclusionsMicafungin did not significantly affect the blood concentration/dose ratio of tacrolimus,and effectively treated invasive fungal infection in patients after liver transplantation.

Objective To investigate the feasibility and effect of intentional occlusion of the left subclavian artery (LSA) in endovascular aortic repair EVAR of thoracic aortic disease.Methods The cases,who needed occlusion of the LSA in EVAR of thoracic aortic disease,were examined cerebral circulation,carotid artery,vertebral basilar artery and circle of Willis.If the vertebral artery had a good blood pathway,and carotid artery and circle of Willis had no stenotic,we occluded the LSA directly in EVAR,and observed the brain and upper limb ischemia complications postoperation.Results Among 40 cases who were occluded the LSA directly in EVAR,28 cases were successful with no neurological complications and left upper limb ischemia symptoms postoperation,12 patients with mild symptoms of subclavian steal syndrome and neurdogical complications,but none required and secondary surgical intervention.Conclusions Prior to intentional LSA occlusion,attention must be paid to potential supraaortic variants and pathologies.Only in this way,it was safe and effective to occlude the LSA in EVAR of thoracic aortic disease.

Objective This study aims to analysis in the clinical features of Stanford type B thoracic aortic dissection with multiple tears,and to explore the clinical methods of thoracic endovascular aortic repair (TEVAR) treating this disease.Methods From February 2011 to May 2015,the cases that diagnosed with multiple tears (≥ two tears) Stanford type B thoracic aortic dissection and accepted operations with TEVAR at department of Thoracic Cardiovascular Surgery,Wuhan General Hospital of Guangzhou Command,were retrospective analyzed their clinical data.Except the first tear of proximal,cases were named for the treatment group whom used surgical methods treating distal aortic dissection tears.Otherwise,the cases were named non-treatment group.We compared the incidence of chest and back pain,the progress of distal aortic dissection,the changes of false lumen with aortic dissection,and the benefit of distal tears in two groups after 6 months after TEVAR.Results A total of 67 cases were recruited this retrospective study,successful operations with TEVAR were conducted in all patients,and no serious complications occurred postoperatively in all patients.7 cases with treatment group,60 cases with non-treatment group,no deaths within two groups in 6 months after TEVAR.There were no significance statistically in complained of the incidence of chest and back pain,and the rate of progress with distal aortic dissection (P ＞ 0.05).There was statistically significant in the rate of changes with false lumen with aortic dissection false lumen (P ＜ 0.05).Some cases with abdominal visceral artery blood flow from the distal tears of aortic dissection in the non-treatment (n =19).Conclusions TEVAR is an effective method for treating multiple tears Stanford type B thoracic aortic dissection.Distal tears should be individualized treatment according to the characteristics of Stanford type B thoracic aortic dissection or try not to deal with.