OBJECTIVE:To evaluate the cost-effectiveness of three drug regimes for infection of Helicobacter Pylori (Hp).METHODS:150 patients with peptic ulcer infected by positive Hp were randomly assigned to three groups.They were treated with Lansoprazole,Clarithromycin and amoxicillin (group A,n=50),Rabeprazole,amoxicillin and metronidazole (group B,n=50) or omeprazole,Clarithomycin and amoxicillin (group C,n=50),respectively with course of treatment as 7 days.The observation of clinical efficacy and analysis of cost-effectiveness were conducted.RESULTS:In group A,B,C,the costs were 120.19,62.02,120.75 yuan;the eradication of Hp was 82%,92%,80%;ratio of cost-effectiveness was 146.57,67.41,150.94,respectively;incremental costs were 523.50,440.50.CONCLUSION:The regime for Hp in group B is the best one among 3 groups.

Objective To observe protective effects of parthenolide ( PTN) in rats with doxorubicin-induced nephropathy and its mechanims. Methods 48 male rats were randomly divided into six groups: blank group, model group, vehicle group, and parthenolide-treated group (1.5, 3, 6 mg/kg).The models of doxorubicin-induced nephropathy were established by tail vein injection of 5 mg/kg doxorubicin for one time.After consecutive treatment of PTN for seven days, the BUN and Cr in serum, and nitricoxide (NO), malondialdehyde (MDA), nitricoxidesynthase (NOS), glutathione peroxidase (GSH), superoxide dismutase (SOD) in renal tissues were detected.The pathological changes of renal tissue was observed by HE method. ResuIts There was significant pathological changes of renal tissue in model group, that showed basophilic change, interstitial inflammatory hyperplasia and inflammatory infiltratio, after PTN 6 mg/kg treatment, the above changes significant improved.The serum BUN and Cr levels in PTN 1.5 mg/kg, PTN 3 mg/kg and PTN 6 mg/kg group were lower than those in model group (P<0.05);there were no significant differences of above indexes between PTN 3 mg/kg, PTN 6 mg/kg group and blank gorup.Compared with model group, the SOD and GSH activity were higher and MDA level was lower in three different dosage of PTN groups (P<0.05); there were no significant differences of SOD activity between PTN 3 mg/kg, PTN 6 mg/kg group and blank gorup; there were no significant differences of GSH activity and MDA level between PTN 6 mg/kg group and blank gorup.The NO level and NOS activity in three different dosage of PTN groups were higher (P<0.05);there were no significant differences of NO level and NOS activity between PTN 6 mg/kg group and blank gorup.ConcIusion Parthenolide has protective effects on doxorubicin-induced nephropathy, and its mechanism might be antioxidative effects.

Objective To investigatc the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases (Akt) signal pathway in ginsenoside Rb1 pretreatment-induced attenuation of myocardial ischemiareperfusion (I/R) injury in diabetic rats.Methods Male SD rats weighing 250-300 g were used in this study.Diabetes mellitus was induced by intraperitoneal streptozotocin and confirmed by fasting blood glucose ≥ 16.7mmol/L.Eight weeks after diabetes mellitus was induced,48 rats were randomly divided into 4 groups ( n =12each):group myocardial I/R (group I/R); group ginsenoside Rb1 (group R); group ginsenoside Rb1 + wortmannin (PI3K inhibitor) (group RW) and group wortmannin (group W).Myocardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion.Ginsenoside Rb1 40 mg/kg was injected iv at 10 min before ischemia in groups R and RW,while in groups RW and W wortmannin 15 μg/kg was injected iv at 20 min before ischemia.Arterial blood samples were collected at the end of 120 min reperfusion for determination of creatine kinase (CK) and lactate dehydrogenase (LDH) activities.The rats were then sacrificed.The infarct size was measured by tetrazolium method.Myocardial apoptosis was detected by TUNEL and apoptotic index (the number of apoptotic myocardial cells/the total number of myocardial cells) was calculated.The expression of Akt and phosphorylated Akt (p-Akt) was determined by Western blotting.Results Ginsenoside Rb1 pretreatment significantly reduced the infarct size,myocardial cell apoptotic index and serum CK and LDH activities and up-regulated p-Akt expression in group R as compared with group I/R.The protective effects of ginsenoside Rbl against myocardial I/R injury were significantly attenuated by wortmannin pretreatment in group RW compared with group R.Conclusion PI3K/Akt signal pathway is involved in the protective effects of ginsenoside Rb1 against myocardial I/R injury in diabetic rats.

Objective To systematically review the efficacy of bispectral index (BIS) monitoring for prevention of intraoperative awareness in patients under general anesthesia.Methods The Cochrane Central Register of Controlled Trials (Central),PubMed,Medline,and EMBASE were searched for randomized controlled clinical trials involving detection of intraoperative awareness in patients in whom BIS was used or not under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidence of intraoperative awareness.Meta-analysis was conducted using RevMan 5.1 software.Results Five randomized controlled clinical trials involving 34181 patients were included in this meta-analysis.There were 17432 cases in whom BIS was applied and the incidence of intraoperative awareness was 0.132％.There were 16749 cases in whom BIS was not used and the incidence of intraoperative awareness was 0.245％.There was no significant difference in the incidence of intraoperative awareness between the two groups (P ＞0.05).Further analysis was performed according to the method of anesthesia.In inhalational anesthesia,there were 13288 cases in whom BIS was applied and the incidence of intraoperative awareness was 0.128％,and there were 13202 cases in whom BIS was not applied and the incidence of intraoperative awareness was 0.113％.There was no significant difference in the incidence of intraoperative awareness between the two groups (P ＞ 0.05).In total intravenous anesthesia,there were 4144 cases in whom BIS was applied and the incidence of intraoperative awareness was 0.145％,and there were 3547 cases in whom BIS was not applied and the incidence of intraoperative awareness was 0.733 ％.The incidence of intraoperative awareness was significantly lower in the patients in whom BIS was applied than those in whom BIS was not applied (P ＜ 0.01).Conclusion BIS monitoring can effectively prevent the development of intraoperative awareness in patients under total intravenous anesthesia,but can not prevent the development of intraoperative awareness in patients under inhalational anesthesia.

AIM: To study the roles of Toll-like receptor 4 ( TLR4 ) and TLR4 activator lipopolysaccharide ( LPS) in colonic inflammation recovery .METHODS:Normal intestinal epithelial cells were cultured with LPS in vitro. The subgroups of the intestinal epithelial cells with differential expression of TLR 4 ( low, normal and high ) were construc-ted by the technique of lentivirus transfection .The cells with normal and high expression of TLR 4 were induced by LPS for 0 h, 2 h and 4 h.Inflammatory cytokines TNF-α, IL-6 and IL-8 in the culture supernatant were detected by ELISA .The mRNA levels of TNF-α, IL-6, IL-8, IL-10 and IL-1βwere detected by qPCR .The cell mobility was also monitored by wound healing assay .RESULTS:The protein expression of TLR 4 was significantly higher after LPS treatment than that in control groups of both cells with TLR4 normal and high expression (P<0.05).The inflammatory cytokines TNF-α, IL-6, IL-8 and IL-1βat mRNA and protein levels were also significantly increased after LPS treatment compared with control group (P<0.05).The protein levels of TNF-α, IL-6 and IL-8 between the 2 groups were also different with statistical sig-nificance ( P<0.05 ) .Higher mobility was observed in the cells with TLR 4 high expression compared to control cells . CONCLUSION:LPS induction might play a role in the activation of TLR 4-mediated inflammatory pathways by up-regula-ting the expression of inflammatory cytokines at both transcriptional and translational levels .

Objective To evaluate the effect of dexmedetomidine on spinal purinergic receptor 2X-4 (P2X4)/nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) pathway in a rat model of diabetic neuropathic pain (DNP).Methods Twenty-four pathogenfree adult male Sprague-Dawley rats,weighing 200-220 g,aged 8 weeks,were allocated into 3 groups (n =8 each) using a random number table:control group (C group),DNP group and DNP plus dexmedetomidine group (DNP+D group).Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.In group DNP+D,dexmedetomidine 50 μg/kg was intraperitoneally injected once a day for 6 consecutive weeks starting from 3 days after the model was successfully established.The mechanical paw withdrawal threshold (MWT) and sciatic nerve conduction velocity (SNCV) were measured at 2,4 and 6 weeks after injection of dexmedetomidine.The rats were sacrificed at 6 weeks after injection of dexmedetomidine,and the L4-6 segments of the spinal cord were removed for examination of the pathological changes (with a light microscope) and for determination of P2X4,NLRP3 and interleukin-lbeta (IL-1β3) expression (by Western blot).The sural nerve was obtained for examination of the ultrastructure by electron microscopy.Results Compared with group C,the MWT was significantly decreased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was decreased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was up-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were marked in DNP and DNP+D groups.Compared with group DNP,the MWT was significantly increased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was increased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was down-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were significantly attenuated in group DNP+D.Conclusion The mechanism by which dexmedetomidine mitigates DNP is probably related to inhibition of P2X4/NLRP3 pathway in rats.

AIM:To investigate the type of chloride channel activated by cisplatin in poorly differentiated na -sopharyngeal carcinoma cells (CNE-2Z cells).METHODS:The technique of whole-cell patch-clamp was used to investi-gate the role of Ca 2+in the activation of cisplatin-activated chloride currents and to analyze the effect of hypertonic stress on these currents in CNE-2Z cells.RESULTS:Chloride currents were induced when the cells were exposed to the calcium -free cisplatin solution , showing the similar density to the currents induced by cisplatin with the presence of extracellular cal -cium.However , the latency and the peak time of cisplatin-activated currents in the absence of extracellular calcium were prolonged.The activation of cisplatin-activated chloride currents was insensitive to the depletion of intra-and extracellular calcium.Calcium channel antagonist nifedipine had no effect on the cisplatin -activated chloride currents , while hypertonic solution completely inhibited those currents .CONCLUSION:The cisplatin-activated chloride currents are independent on intra/extracellular calcium .The chloride channels activated by cisplatin are not calcium-activated chloride channels , but are probably volume-sensitive chloride channels .

BACKGROUND:Bone marrow mesenchymal stem cells transplantation can change the surrounding microenvironment through paracrine mechanisms, and can be employed for treatment of serious damage to lung function through the promotion of angiogenesis, inhibition of apoptosis and maintaining functional stability of autonomic nervous system. OBJECTIVE:To observe the inflammatory reaction in experimental emphysema and inhibition of apoptosis through bone marrow mesenchymal stem cells transplantation.
METHODS:Twenty-four Wistar female rats were randomly divided into three groups:healthy control group, model group and experimental group. In the latter two groups, smoking and endotracheal instil ation of porcine pancreatic elastase were performed to establish emphysema models. After modeling, bone marrow mesenchymal stem cells were injected via tail vein in the experimental group. Pathological changes of the lung, the level of tumor necrosis factor-alpha and cellnumber in the bronchoalveolar lavage fluid as wel as apoptotic index in lveolar wal s were detected after celltransplantation.
RESULTS AND CONCLUSION:In the model and experimental groups, pathological changes of lung tissues were observed to different extent. The lung pathological changes were slighter in the experimental group than the model group (P<0.01). The level of tumor necrosis factor-alpha and apoptotic index in lung tissue were lower in the experimental group than the model group (P<0.01). These findings indicate that bone marrow mesenchymal stem cells can improve emphysema pathological y through inhibition of inflammatory response and apoptosis in experimental emphysema.

BACKGROUND:Bone marrow mesenchymal stem cel s transplantation can inhibit experimental emphysema inflammatory reaction and apoptosis, and has been experimental y confirmed to treat severe lung function impairment. OBJECTIVE:To explore the inhibitory effects of bone marrow mesenchymal stem cel s transplantation via different ways on inflammatory reaction and apoptosis due to experimental emphysema. METHODS:Female Wistar rats were randomly divided into control group, intravenous group and endotracheal group fol owing model establishment using fumigation plus intratracheal instil ation of porcine pancreatic elastase. In the latter two groups, bone marrow mesenchymal stem cel s from male rats were injected via the tail vein and the trachea, respectively. In the control group, rats were given PBS via he tail vein and trachea. At 14 days after transplantation, pathological changes of rat lung tissues were observed, cel apoptotic index in alveolar wal cel s and tumor necrosis factorαlevel in the bronchoalveolar lavage fluid were detected. RESULTS AND CONCLUSION:Compared with the control group, in the intravenous and endotracheal groups,the pathological changes of lung tissues were relieved, tumor necrosis factorαlevel and apoptosis index were reduced significantly (P<0.01);but there were no differences between the intravenous and endotracheal groups (P>0.05). These findings indicate that bone marrow mesenchymal stem cel s transplantation via the tail vein and trachea both can exert obvious therapeutic effects on emphysema. Moreover, cel transplantation via the tail vein is more convenient and easier than that via the trachea in the treatment of emphysema.

Objective To investigate the relationship between acute radiation proctitis and radiation dose,volume as well as radiation time,in the process of intensity-modulated radiation therapy (IMRT) for the cervical cancer patients.Methods A total of 51 patients with locally advanced cervical cancer were enrolled from January 2011 to December 2013.Those patients were then classified into grade 1 to 4 groups,according to the RTOG/EORTCtoxicity grading standard.The exposure dose volume and the average dose of rectum under the standard plan were evaluated with dose-volume histogram (DVH).The ANOVA test was used for analyzing Dmax,D mean,D1 cm3,D2cm3,D40 and V40 values of rectum and the average exposure dose of rectum.Results The average time of acute radiation proctitis with clinical symptoms was (23.06 ± 12.01) d after radiotherapy.Dmaxvalues of rectum in grade 2 group was lower than those in grade 3 and 4 groups (F =5.268,P ＜ 0.05).Moreover,D1 cm3 and D2 cm3 values of rectum in grade 1 and 2 groups were also lower than those in grade 3 and 4 groups (F =4.893,4.406,P ＜ 0.05).There was no statistically significant difference between D40 and V40 values.Conclusions The acute radiation proctitis could be frequently found around 20 days during the IMRT for cervical cancer patients.Mild and moderate acute radiation proctitis are more common,while severe acute radiation proctitis is rare.Minimizing Dmax,D1 cm3 and D2 cm3 values of rectum might reduce the incidence of severe acute radiation proctitis in cervical cancer patients receiving IMRT.