Objective To explore the efficacy and safety of tocilizumab in combination with disease-modifying anti-rheumatoid drugs (DMARDs) for the treatment of rheumatoid arthritis (RA) patients with moderate to severe activity and inadequate response to DMARDs. Methods Thirty-two RA patients with inadequate response to DMARDs were treated with tocilizumab along with stable dose of DMARDs for 12 weeks, adverse reactions were recorded, clinical laboratory and physiological indices were recorded 4, 8, and 12 weeks after treatment. The routine blood, liver and kidney function tests, morning stiffness, rest pain, tender joint count, swollen joint count, overall evaluation of the patient and physician to disease and health assessment questionnaire, blood sedimentation, C-reactive protein (CRP), Disease activity score 28 (DAS28), simplified disease activity index (SDAI) score, clinical disease activity index (CDAI). Repetitive measure analysis of variance wase used for statistical analysis. Results The clinical laboratory indices and DAS28, SDAI, CDAI scores observed in all of the patients were significantly improved (P<0.05). After 8 and 12 weeks of treatment, disease activity was further improved with statistical significance (P<0.05). The levels of IL-6 were downregulated obvious compared with before [(26±14) pg/ml vs (76±39) pg/ml, t=-6.925, P<0.01], and no obvious adverse reactions were observed. Conclusion Tocilizumab can quickly improve the symptoms and the control disease activity of refractory active RA within a few weeks.

Objective To study the clinical effects of shortening the drainage time for patients with dural tears after posterior spinal sur -gery.Methods A total of 120 patients with dural tears after posterior spinal surgery were randomly divided into study group and control group,60 patients in each group .Patients in control group had wound drainage tubes removed after 5 days and patients in study group had wound drainage tubes removed after 3 days.The disappearance time of leakage ,incision healing time and complication rate were compared between two groups.Results The disappearance time of leakage in study group was (13.7 ±3.8)days which was significantly less than (20.0 ±5.1)days in control group(P<0.05).The incision healing time in study group was (22.7 ±4.9)days which has no significant difference with (23.9 ± 5.7)days in control group.The postoperative infection rate was 3.3%(2/60) which was significantly less than 20.0%(12/60) in control group(P<0.01).Conclusion Shortening drainage time can decrease the disappearance time of leakage and postoperative infection rate .

Objective To evaluate therapeutic effects of simvastatin on serum expressions of cytokines and synovial tissue aspartic protease-3 (Caspase-3) in collagen induced arthritis (CIA) in rats, and the mechanism thereof. Methods The rat model of CIA was established by injecting bovine Ⅱ collagen. Sixteen model rats were randomly divided into two groups:CIA model group (sterile water 5 mL·kg-1·d-1 by gavage) and simvastatin group (2.0 mg·kg-1·d-1 by gavage). Seven normal rats were included in control group (sterile water 5 mL·kg-1·d-1 by gavage). The arthritis index (AI) and hind paw vol-umes were recorded once a week. The serum levels of cytokine, tumor necrosis factor (TNF)-αand interleukin (IL)-6 were measured by ELISA 42 days after the initial immunization. The expression of Caspase-3 in ankle synovial tissue was detect-ed by immunohistochemical method, and pathological results of HE staining in rat ankle were compared between three groups. Results Values of AI were decreased on the 24-d of the initial immunization in simvastatin group and CIA model group, which was significantly decreased on the 35-d of the initial immunization in simvastatin group than that of CIA model group (P＜0.05). The values of hind paw volumes were decreased on the 14-d of the initial immunization in simvastatin group and CIA model group, which was still significantly higher than those of control group (P＜0.05). The values of hind paw volumes were decreased on the 35-d and 42-d of the initial immunization in simvastatin group than those of CIA model group (P＜0.05). The serum levels of TNF-αand IL-6 on the 42-d of the initial immunization were significantly lower in simvastatin group than those of CIA model group, but which were significantly higher than those of control group ( P＜0.05). There were more synovial hyperplasia in simvastatin group than those of CIA model group. Only a small amount of inflamma-tory cell infiltration was found in simvastatin group. The expression of Caspase-3 was significantly higher in simvastatin group than that of CIA model group. Conclusion Simvastatin can significantly inhibit the serum levels of TNF-αand IL-6 in CIA model rats, and can up-regulate the expression of Caspase-3 in ankle of model rats.

Objective To explore the application of evaluation of measurement uncertainty in routine coagulation assays based on the data of internal quality control (IQC) and results of external quality assessment (EQA) .Methods Data of clinical coagulation assays of clinical laboratory of Xiangyang city hospital were collected ,Which came from six months of IQC and 3 times of EQA of ministry of health clinical laboratory center from 2012 to 2013 .The combined and expanded uncertainties of 3 measurements(PT , APTT and Fbg) were evaluated according to CNAS top-downapproach .Results When PT were in 12 .72 s and 21 .04 s ,its ex-panded uncertainty were 1 .06 s and 1 .96 s ,and APTT in 36 .6 s and 50 .6 s were 2 .59 s and 5 .30 s ,and Fbg in 3 .32 g/L was 0 .30 g/L .Conclusion Evaluation of measurement uncertainty by using internal quality control data and EQA results for routine coagula-tion detection index is economical and practical and acceptable way ,with good clinical practice .

OBJECTIVETo study immunomodulating activity of Lonicera Japonica flavone by investigating immune enzymatic activity of serum and antoxidized activity of lymphoid organs in mice.

METHODSFifty KM mice were randomly divided into control group, model group, low dose group, middle dose group and high dose group(n = 10), respectively. And low dose group, middle dose group and high dose group were given Lonicera Japonica flavone with 100 mg/kg, 200 mg/kg and 400 mg/kg every day, respectively, while control group and model group were administered with NS. After continuously giving drug 7 weeks, other groups were injected with Dexamethasome (Dex: 25 mg /kg) for 3 days by subcutaneous injection, but the control group were treated with NS. And after giving Lonicera Japonica flavone 1 week simultaneously, organ indexes , the activity of acid phosphatase (ACP), alkaline phosphatase (AKP) and lysozyme (LSZ) in serum , and the content of monoamine oxidase (MAO), total antioxidant capacity (T-AOC), total superoxide dismutase (SOD) and malondialdehyde (MDA) in lymphoid organs in mice were tested, respectively.

RESULTSLonicera Japonica flavone could significantly improve the organ indexes, and significantly improve the activity of ACP, AKP and LSZ in serum, and significantly improve the contents of T-AOC and SOD, but reduce that of MAO and MDA in lymphoid organs in immunosuppressed mice.

CONCLUSIONIonicera Japonica flavone can significantly improve the activity of immune enzyme in serum and the antioxidized activity of lymphoid organs in mice. It suggests that Ionicera Japonica flavone has a good immunomodulatory effects.

Acid Phosphatase ; blood ; Alkaline Phosphatase ; blood ; Animals ; Antioxidants ; metabolism ; Flavones ; pharmacology ; Immunomodulation ; Lonicera ; chemistry ; Malondialdehyde ; metabolism ; Mice ; Monoamine Oxidase ; metabolism ; Muramidase ; blood ; Superoxide Dismutase ; metabolism

As a part of the project for the Chinese Pharmacopoeia (2015 edition), the quality standard of Sophora flavescens root extract was investigated and established. According to the methods described in the Appendix of Chinese Pharmacopoeia (2010 edition), the water and ash inspections were carried out. The marker components trifolirhizin, sophoraflavanone G, oxymatrine and oxysophocarpine in the samples were identified by qualitative TLC. The determination of oxymatrine, matrine, oxysophocarpine and sophocarpine was conducted by HPLC and the total flavonoids were measured by ultraviolet spectrophotometry, using sophoraflavanone G as reference substance. The results indicated the spots on the plate were clear with good resolution and the contents of oxymatrine, matrine, oxysophocarpine and sophocarpine in the 13 batches of the samples were 3.87% - 11.1%, 0.970% - 4.33%, 1.30% - 2.59% and 0.260% - 1.14%, respectively. The total flavoids in the 13 batches of the samples were 3.88% - 7.93%. In the study, the validated methods were reproducible and the established quality standard was feasible, which could be used for the quality control of S. flavescens root extract and related preparations.
Chromatography, High Pressure Liquid ; Flavonoids ; analysis ; Plant Extracts ; analysis ; Plant Roots ; chemistry ; Sophora ; chemistry

OBJECTIVETo observe the effect of natural type ginsenoside Rg2 (Rg2) and its stereoisomers [20 (R)-Rg2 and 20 (S)-Rg2] at different concentrations on oxygen-glucose deprivation/ reperfusion (OGD/R) induced cortical neuronal injury model in vitro, and to explore the mechanism, and compare their differences of action.

METHODSCortical neurons after 7-day culture were randomly divided into 5 groups, i.e., the control group, the model group, the Rg2 group, 20 (R) -Rg2 group, and 20 (S) - Rg2 group. Cortical neurons in the Rg2 group, 20 (R)-Rg2 group, and 20(S)-Rg2 group were pretreated with 20, 40, and 80 μmol/L Rg2, 20 (R) -Rg2, and 20 (S) -Rg2 for 24 h to prepare OGD/R model. The cell survival rate, the activity of Caspase-3, the intracellular Ca2+ concentration, contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected 24 h later.

RESULTSCompared with the control group, cell survival rates and activities of SOD obviously decreased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly increased with statistical difference (P < 0.05). Compared with the model group, cell survival rates and activities of SOD obviously increased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly decreased in 20 μmol/L Rg2 group, 40 μmol/L 20 (R) -Rg2 group, and 80 μmol/L 20 (S) -Rg2 group (P < 0.05). Compared with 20(S)-Rg2 group, cell survival rates increased and contents of MDA significantly decreased in 20, 40, and 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). The activity of Caspase-3 decreased and contents of SOD increased in 80 μmol/L 20 (R)-Rg2 group, and 40, 80 μmol/L Rg2 groups (P < 0.05). Ca2+ fluorescent optical gray value decreased in 40, 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). Compared with 20 (R)-Rg2 group, Ca2+ fluorescent optical gray value decreased in 80 μmol/L Rg2 group (P < 0.05); contents of SOD increased in 40 and 80 μmol/L Rg2 groups (P < 0.05); contents of MDA decreased in 20, 40, and 80 μmol/L Rg2 groups (P < 0.05).

CONCLUSIONSRg2 and its stereoisomers could improve cell vitality of cortical neurons against OGD/R induced injury. This might be related to improving anti-apoptotic capacities and antioxidant abilities, and reducing Ca2+ inflow. Besides, the neuroprotective effect of 20 (R) -Rg2 was better than that of 20 (S) -Rg2, but inferior to that of Rg2.

Antioxidants ; metabolism ; Apoptosis ; Calcium ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glucose ; Humans ; Malondialdehyde ; metabolism ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Oxygen ; Random Allocation ; Reperfusion Injury ; Stereoisomerism ; Superoxide Dismutase ; metabolism

OBJECTIVETo study the constituents from roots of Euphorbia hylonoma.

METHODColumn chromatographic techniques were used for isolation and purification of the chemical constituents and their structures were identified by spectral analysis (IR, 1H-NMR, 13C-NMR, 2D-NMR and MS).

RESULTSix compounds were isolated and elucidated as nonane (1), bis (2-ethylhexyl) phthalate (2), euphol (3), beta-sitosterol (4), acalyphol (5) and daucosterol (6) respectively.

CONCLUSIONCompounds 1, 2, 3, 5 and 6 were isolated from the plant for the first time.

Alkanes ; chemistry ; isolation & purification ; Diethylhexyl Phthalate ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Lanosterol ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Sitosterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo observe therapeutic effect of acupuncture at acupoints selected according to rehabilitation medical theory on upper limb spasticity in the patient of poststroke.

METHODSSixty cases were randomly divided into an acupuncture group and an electro-stimulation group, 30 cases in each group. The acupuncture group were treated by acupuncture at the contralateral scalp motor region of the affected limb, Jiquan (HT 1), Chize (LU 5), Daling (PC 7) on the flexor side and Jianyu (LI 15), Tianjing (TE 10), Yangchi (TE 4) on the extensor muscle side of the affected limb; the electro-stimulation group were treated by electric stimulation. The two groups also were treated with necessary medical treatment and anti-spasm rehabilitation motor training. The course was 3 weeks. Modified Ashworth Scale for muscle spasm (MAS), modified Fugl-Meyer Assessment (FMA) for upper limb motor function, and Modified Barthel Index (MBI) for ability of daily living were used for assessment of the therapeutic effect.

RESULTSAfter treatment, the spasm was significantly alleviated, the motor function of the upper limb and daily living ability were significantly increased (P<0.01) in the two groups; after treatment, BMI scores in the acupuncture group was very significantly superior to that in the electro-stimulation group. The total effective rate was 93.3% in the acupuncture group and 86.7% in the electro-stimulation group, with no significant difference between the two groups.

CONCLUSIONProper acupuncture is an effective method for upper limb spasm in the patient of poststroke, and the therapeutic effect is better for mild-moderate spasm of the upper limb.

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Muscle Spasticity ; therapy ; Stroke Rehabilitation

Background Infective keratopathy is a key cause of corneal blindness in China,and fungal keratitis is proved to have a higher incidence and bigger threats in infective keratitis.Researches showed that topical immunology plays an important effect during the development of fungal keratitis,but its mechanism is still studying.Objective This experiment was to explore the critical immunocyte during the process of fungal keratitis.Methods Forty-eight SPF 12-week-old male C57BL/6J mice were included and randomized into the control group and model group.The fungal keratitis model closely mimicking human cornea infections was established in the mouse using scratch followed by incubation of fusarium solani on the cornea,and the mice in the control group scratched on the cornea only.Cornea was examined under the slit lamp at 0,6,9,12,24,72 and 120 hours after operation.The severity of keratomycosis was clinically scored based on the literature criteria.The inflammatory cells were identified using immnofluorescence label,and the number of the inflammatory cells was calculated and compared among different groups and time points.This study complied with the Statement of ARVO in the use of experimental animal.Both Experimental Animal Ethic Commission in Zhengzhou University and Life Science Management Commission approved this study proposal.Results After inoculation of fusarium solani,typical fungul keratitis signs were seen on the cornea.Severe corneal opacifieation occurred within 24 hours and peaked at 72 hours.However,only mild edema of cornea was exhibited and gradually recovered normal in the control group within 24 hours.The clinical score of inflammation was higher in the model group in various time points than that in the control group,and it was seen that 24-72 hours after operation,the score attached peak in the model group with a significant difference in comparison with the control group(P＜0.01).In 9,12,24,72 and 120 hours after operation,the number of neutrophil cells was significantly increased in the model group compared with control group (P＜0.05),and that in 12,24,72 hours after operation was significantly higher than the 6 hours(P=0.004,0.000,0.001).However,no significant differences were seen in the number of neutrophil cells between 9 or 120 hours and 6 hours after operation(P=0.772,0.323).The number of T lymphocytes in cornea was significantly increased in 72 and 120 hours in comparison with 6 hours in the model group(P=0.000,0.000),and from 72 to 120 hours after operation,the number of T lymphocytes was significantly higher than that of the contral group (P＜0.01).The neutrophil cell number was positive correlated with the inflammatory score in the early phase (r =0.593,P =0.000).T limphocyte emerged in late phase but no significant correlation with the clinical score (r＝0.315,P=0.062).Conclusions Neutrophil cells play a critical role in the development of fungal keratitis in early stage.