Objective To investigate the level of the red blood cell (RBC) distribution width and other related indicators to predict the prognosis in patients with chronic heart failure elderly.Methods Retrospective analysis was performed in the patients with chronic heart failure elderly which died in our hospital (experimental group) and 100 patients were selected randomly that with heart failure elderly being improved by treatment (control group).The difference was compared in the level of the RBC distribution width (RDW),high-sensitivity C-reactive protein (hs-CRP),homocysteine (Hcy),D-dimer (DD),and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in two groups.Results The level of RDW,hsCRP,Hcy,DD,and NT-proBNP in experimental group were significantly higher than that in control group (P ＜0.01).Conclusions Chronic heart failure was common clinical critically ill in the elderly.There were important clinical significance and important predictors to detect the levels of RDW,hs-CRP,Hcy,DD,and NT-proBNP in predicting prognosis and evaluating the effect of treatment.

OBJECTIVE: To observe the effects of Xinmailong (XML), Xiangdan (XD) and Shenmai (SM) Injection on early kidney damage induced by toxin of grass carp bile (GCB) and provide experimental evidence for Chinese medicine in treating toxication of GCB. METHODS: GCB (6ml/kg) was administered orally to adult SD rats to induce the model of GCB intoxication and a single intraperitoneal injection of XML, XD or SM was administered 10 min later. RESULTS: It was found that the levels of blood creatinine and blood urea nitrogen were decreased and the creatinine clearance rate was increased by XML, XD or SM. Degenerated epithelial cells of proximal convoluted tubules and glomeruli containing red blood cells in saccular cavities were decreased as compared with the normal group (P<0.01). CONCLUSION: The Chinese medicine XML, XD and SM Injection have therapeutic effects on early kidney damage induced by toxin of GCB.

Objective To investigate the effect of PBL combined with EBM applied in the teaching of fever of unknown origin. Methods PBL combined with EBM teaching was applied in fever of unknown origin course for 30 clinical medicine specialty(eight years) students of Tongji class of grade 2009(experiment group), while PBL teaching was applied in fever of unknown origin course for 30 clinical medicine specialty (eight years) students of Tongji class of grade 2008 (control group). After teaching, the theory examination for both basic knowledge and case analysis was organized for all students of both groups. At the same time the questionnaire survey was conducted to 30 students of grade 2009 to evaluate the teaching effect. The results were assessed by using SPSS 18.0 statistical software for the T-test of the experimental group and the control group.Inspection level was α=0.05. Results The theory test score of students in the experimental group was (93.5±3.2) point, signifi-cantly higher than that of the students in the control group(84.7±2.8). There was statistically signifi-cant difference between the scores of the two groups of students (P=0.00). Survey results showed 19 students ( 63 . 33%) thought that the development of PBL teaching combined with evidence-based medicine teaching had its necessity, and 16 students(53.33%) thought that the teaching method im-proved their clinical thinking ability of logical reasoning. Conclusion The concept of PBL combined with EBM has achieved significant resultsinthe teaching offever of unknown origin, and it is necessary to carry out this teaching mode in medical colleges with certain teaching strength.

Objective To evaluate the influence of cytochrome P450 (CYP2C9 and CYP4F2) polymorphisms on anticoagulant intensity of warfarin after cardiac valve replacement.Methods A total of 136 patients tak ing warfarin after cardiac valve replacement were identified and classified into 4 groups:CYP2C9 wild type group (CYP2C9*1*1),CYP2C9 mutated type group (CYP2C9*3),CYP4F2 rs2108622 wild type group (CC) and CYP4F2 rs2108622 mutated type group (CT or TT).The patients' baseline data,initial dose of warfarin and base INR measurement resuhs were recorded and then the follow-up was conducted.The initial administration of warfarin to INR standard time for the first time,total amount of warfarin and the average daily amount were recorded.Results Patients carrying CYP2C9* 1* 1 had increased time to reach INR target value for the first time (P ＜ 0.05);and the total warfarin doses and average daily dose when INR reached target value were higher than those carrying CYP2C9*3 (P ＜ 0.05).When compared with those in two wild type groups,patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type needed the shortest time when INR reached target value for the first time,and the total warfarin doses and average daily dose when INR first reached target value was the lowest,which showed significant difference (P ＜ 0.05).And when compared with CYP2C9 mutated type group,the INR average time to reach the first target was shortened and the total warfarin dose of patients carrying CYP2C9 and CYP4F2 rs2108622 mutated type was lower (P ＜ 0.05).Conclusion The gene polymorphisms of CYP2C9 and CYP4F2 are significant hereditary factors influencing warfarin dose.Detection of CYP2C9 and CYP4F2 genotypes prior to medication and predicating warfarin dosage may result in lower incidence of over-anticoagulation and reduce the dosage-adjusting time of warfarin.

AIM: To explore the activative effect of water extract from cultured mycelium of Paecilomyces cicadae (P. cicadae) on peritoneal macrophages (PM?) and alveolar macrophages (AM?) of rats.METHODS: The rats were randomly divided into four groups: normal control group(Ⅰ), cyclophosphamide (Cy) group (Ⅱ), P. cicadae group(Ⅲ), Cy+ P.cicadae group(Ⅳ).The rats were bred in the same circumstance and were administered with corresponding drugs by subcutaneous injection for 26 days. PM? and AM? of rats were irrigated by normal saline and collected by centrifuge and incubated in a humidified incubator for 2 h at 37 ℃. The activities of acid phosphatase (ACP) and lactate dehydrogenase (LDH) in the PM? and AM? were determined by biochemical methods, and the capability of PM? and AM? in phagocytosis of neutral red were measured by colorimetric method too. RESULTS: After administering P. cicadae to rats, the activities of ACP and LDH in PM? and AM? of normal rats were elevated significantly,and the reduction of the activities of ACP and LDH in PM? and AM? of rats due to Cy was notably antagonized, and the capability of PM? and AM? phagocytizing the neutral red were strengthened significantly.CONCLUSION: P. cicadae can activate the PM? and AM? of rats.

BACKGROUND: Chinese medicine xinmailong (XML) injection is a kind of new nucleoside compound which comes from American giant cockroach of insects. A lot of studies show that XML has obvious effect on cardiovascular activity which can treat acute or chronic congestive heart failure and shock and improve microcirculation.OBJECTIVE: To observe the effect of XML on anti-aging of mice.DESIGN: Controlled observational study.SETTING: Department of Physiology and Pathology, Basic Medical College of Dali College.MATERIALS: The experiment was carried out at the Functional Laboratory of Basic Medical College between July 2002 and September 2004. A total of 40 ICR mice of both sexes were provided by Kunming Medical College,Yunnan Naturally Occurring Drugs Key Laboratory. XML injection was provided by Yunnan Tengchong Pharmacy Factory [batch number: 94 (ZL) 03].METHODS: A total of 40 ICR mice were randomly divided into 4 groups:young control group, aging control group, XML group at high dosage and XML group at low dosage with 10 in each group. All mice were fed routinely with standard feed. Mice in young control group aged 3 months and weighed (20±2) g; meanwhile, mice in other groups aged 20 months and weighed (40±3) g. From the 20th month, mice in XML groups were intraperitoneally injected with 6 mg/kg and 8 mg/kg, respectively, for 30 days with once every day. Mice in young and aging control groups were intraperitoneally injected with the same volume of saline. On the 31st day,heads of mice were cut off to obtain blood which was maintained at hepalean anti-coagulated tube. Brains and livers were obtained rapidly for homogenate with 10% saline. Activities of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in serum, content of malondialdehyde (MDA) in brain tissue and content of lipofuscin in cerebral and hepatic tissue were measured according to introduction of kits.MAIN OUTCOME MEASURES: ① Activities of CAT, SOD and GSHPx in serum; ② content of MDA in brain tissue and contents of lipofuscin in cerebral and hepatic tissues.RFSULTS: A total of 40 animals were involved in the final analysis without any loss. ① Activities of CAT, SOD and GSH-Px in serum of mice were lower in aging control group than those in young control group; however,activities of CAT, SOD and GSH-Px in serum of mice were increased in the two XML dosage groups, and there was significant difference from those in aging control group (P ＜ 0.05 or P ＜ 0.01). ② Content of MDA in brain tissue and contents of lipofuscin in cerebral and hepatic tissues of mice in aging control group were higher than those of mice in young control group, but those in the two dosage groups were decreased, which was significant difference from those of mice in aging control group (P ＜ 0.01). However, there was no significant difference between the two dosage groups.CONCLUSION: XML has an effect on anti-aging through improving metabolism of free radicals.

Objective To evaluate thetherapeutic effect of sodium deoxyribonucleotide injection at Zusanli point for chemotherapy-induced leukopenia in patients with lung cancer.MethodsA total of 116 chemotherapy-induced leukopenia patients with lung cancer were randomly divided into a therapy group and a control group, 60 in the treatment group and 56 in the control group. The patients in the treatment group were treated with sodium deoxyribonucleotide injection atZusnlipoint, and those in the control group were treated with vein injection of sodium deoxyribonucleotide.Results The total effective rate in the treatment group was significant higher than that in the control group (91.7%vs.76.8%;χ2=4.890,P=0.032). The effective rates on days 3,5,7 and 10 in the treatment group were also significant higher than those in the control group (on day 3: 51.7%vs. 32.1%,χ2=4.530,P=0.036; on day 5: 76.7%vs. 53.6%,χ2=6.840,P=0.018; on day 7: 85.0%vs. 67.9%,χ2=4.770,P=0.026; on day 10: 78.3%vs. 53.6%,χ2=7.960,P=0.011).Conclusion Sodium deoxyribonucleotide injection atZusanlipoint has definite efficacy for chemotherapy-induced leukopenia in patients with lung cancer.

Objective To assess the value of procalcitonin (PCT) for the differential diagnosis between infectious and non-infectious systemic inflammatory response syndrome (SIRS) after cardiac operation.Methods Patients diagnosed with SIRS after cardiac surgery and admitted to Department of Cardiovascular Surgery of Tokyo Medical and Dental University Graduate School between April 1st,2011 and March 31st,2013 were retrospectively studied.A total of 142 patients with SIRS were included,and they were divided into infectious group (n =47) or non-infectious group (n =95) according to the diagnostic criteria of the Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock:2012 (SSCG2012).The patients with infectious SIRS were included,and there were 11 with sepsis,12 with severe sepsis without shock,and 24 with septic shock respectively.The clinical data of patients were compared,and the receiver operating characteristic curve (ROC curve) was plotted to assess the diagnostic value of infection and non-infectious diseases for PCT,C-reactive protein (CRP) and white blood cell count (WBC),as well as the diagnosis of the severity of sepsis.Results PCT,CRP,and WBC were significantly higher in the infectious SIRS group than those in the non-infectious SIRS group [PCT (μg/L):2.80 (1.24,10.20) vs.0.10 (0.06,0.21),Z=-9.020,P=0.001; CRP (mg/L):158.0 (120.0,199.0) vs.58.0 (25.0,89.0),Z=-7.264,P=0.001; WBC (× 109/L):15.5 (11.0,22.6) vs.9.3 (7.2,12.6),Z=-5.792,P=0.001].PCT had the highest sensitivity (91.5％) and specificity (93.7％) for differential diagnosis,with a cut-off value for infectious SIRS of 0.47 μg/L,and the cut-offvalue of CRP and WBC were 119.5 mg/L and 10.85 × 109/L,respectively.There was no significant difference in WBC among sepsis group,severe sepsis group,and septic shock group [× 109/L:12.40 (9.10,24.20),13.30 (9.93,16.93),20.40 (13.45,28.6),x2=5.638,P=0.060],while PCT,CRP had significant difference [PCT(μg/L):1.37 (0.72,1.85),3.16 (0.48,13.24),3.68 (1.67,20.96),x2=7.422,P=0.024; CRP (mg/L):120.0(74.0,180.0),135.7 (81.7,181.3),171.1 (151.5,306.0),x2=9.524,P=0.009].PCT was more reliable than CRP in diagnosing severe sepsis without shock,but it was ineffective for diagnosing septic shock.The cut-off value of PCT for diagnosing severe sepsis without shock was 2.28 μg/L,and the sensitivity was 66.7％,specificity was 90.9％.Cut-off value of CRP for the diagnosis of septic shock was 149.5 mg/L,with the sensitivity of 83.3％,and the specificity of 66.7％.Conclusions PCT was a useful marker for the diagnosis of infectious SIRS after cardiac operation as compared with WBC and CRP.The optimal PCT cut-off value for diagnosing infectious SIRS was 0.47 μg/L.

AIM: To study the activation and the immune regulation of paecilomyces cicadidae total polysaccharides on macrophages in old rats. METHODS: The ability of devouring neutral red and stimulating index in the alveolar macrophages (AM) and peritoneal macrophages (PM) were observed. The activities of lactate dehydrogenase (LDH), acid phosphatase (ACP) and arginase (Arg) were detected by automatic biochemistry analyzer. The shape and structure of spleen macrophages were observed by electron microscope. RESULTS: Compared with control group, the activity of the LDH/ACP/Arg in the AM or PM and in the culture fluid of the AM or PM were significantly increased (P

AIM: To study the effects of paecilomyces cicadidae total polysaccharides on the immune function and free radical scavenging of tissues in immunosuppressed rats.METHODS: The activities of lactate dehydrogenase(LDH) and arginase(Arg) in liver,kidney,spleen,thymus of immunosuppressed rats were detected by automatic biochemistry analyzer.The content of lipid peroxide(LPO) and the reduced glutathione(GSH) level in liver,kidney,spleen,thymus of immunosuppressed rats were observed.RESULTS: The activity of the LDH,Arg and GSH level were significantly increased,and the LPO content were significantly declined in liver,kidney,spleen,thymus of immunosuppressed rats induced by cyclophosphamide.CONCLUSION: Paecilomyces cicadidae total polysaccharides promote immune function and the ability of free radical scavenging of tissues in immunosuppressed rats.