Objective To investigate the clinical efficacy of domestic terlipressin in the treatment of type II hepatorenal syndrome (HRS -II).Methods A total of 25 HRS -II patients admitted to our hospital from November 2011 to June 2014 were recruited into the treatment group,and 28 HRS -II patients treated with dopamine before 2011 were recruited into the control group.Patients in the treatment group were randomly divided into two subgroups:one subgroup (n =12)was given terlipressin once every 8 h,and the other subgroup (n =13) was given terlipressin once every 12 h.Both groups received albumin (Alb)infusion to expand the blood volume before treatment with terlip-ressin or dopamine,and the course of treatment was 7 days.The improvement in clinical symptoms,levels of blood urea nitrogen (BUN), serum creatinine and electrolytes,urine volume,changes in liver function,and ascites disappearance in the two groups before and after treat-ment were compared.Comparison of categorical data between the two groups was made by χ2 test,and comparison of continuous data was made by t test.Results Patients in the control group showed no obvious symptom relief,but those in the treatment group had varying de-grees of improvement in clinical symptoms.Neither group had significant changes in liver function and serum sodium level after treatment. The treatment group had significantly more patients whose ascites volume had decreased from large to medium than the control group (χ2 =5.705,P <0.05).There was a slight but not significant decrease in the levels of BUN and serum creatinine in the control group after treat-ment with dopamine (all P >0.05),whereas the urine volume showed significant difference after the treatment (t =15.534,P <0.01). The treatment group showed significant differences in the levels of BUN and serum creatinine and urine volume after terlipressin treatment (t=11.535,9.941,and 19.685,respectively;all P <0.01),and significant differences in those levels were also observed compared with the control group after dopamine treatment (t =7.317,9.284,and 9.839;all P <0.01).Larger changes in BUN,serum creatinine,and urine volume were observed in the subgroup receiving terlipressin every 8 h than in that receiving terlipressin every 12 h,but the differences were not significant (all P >0.05).Patients treated with terlipressin had mild and tolerable adverse reactions.Conclusion The domestic terlipressin combined with albumin infusion has good clinical efficacy and mild adverse effects in treating HRS -II.Its clinical application is highly recommended.

Objective To explore the effect of transcranial magnetic stimulation (TMS) on gross motor function for children with cerebralpalsy. Methods 80 children with cerebral palsy treated in our hospital during July 2009 to January 2010 were divided into control group(n=40) and observation group (n=40). The control group received conventional treatment, including physical therapy, massage, scalp acupuncture,body acupuncture, point injection, physiotherapy and medication. The observation group received TMS in addition. The therapeuticeffects were compared using the Gross Motor Function Measure-88 (GMFM-88) after 3 months. Results The percent scores of all the domainssignificantly increased in both groups (P<0.05) after treatment, the increased percent scores of observation group in B domain, D domain,E domain and total were higher in the observation group than in the control group (P<0.05). Conclusion TMS can further improve thegross motor function of children with cerebral palsy.

Objective To evaluate the role of clinical features,radiography and histopathology in differential diagnosis between chronic necrotizing pulmonary aspergillosis(CNPA)and aspergilloma.Methods Thirty-four patients including 8 cases of CNPA and 26 of aspergilloma comfirmed by operation and histopathology in First Affiliated Hospital,Zhejiang University were investigated retrospectively.The clinical manifestations,radiological and pathological findings of all the patients were analyzed and related references were reviewed. Results The age of onset was not significantly different between CNPA and aspergilloma.Obsolete pulmonary tuberculosis and lung abscess were predisposing factors of them.Productive cough was presented in all 8 cases of CNPA,haemoptvsis in 7,and 5 were presented with constitutional symptoms.The most common symptom of aspergilloma was haemoptysis, which was presented in 25 cases.The less common symptoms were cough and sputum,which was presented in 17 cases.Only two cases were presented with constitutional symptoms."Air crescent"sign at radiography was typical and suggestive of diagnosis in both CNPA and aspergilloma,but the wall of cavity in CNPA was thicker and irregular,infiltrates were often to be seen around the cavity.Histologically,CNPA and aspergilloma both showed septate fungal hyphae branching at an acute angle.CNPA was characterized with the presence of tissue invasion by aspergillus,tissue necrosis and granulomatous inflammation. Fungal hyphae ware only found in a preexistent cavity or ectatic bronchus without tissue invasion in aspergilloma.Conclusions Histopathology is gold standard of differential diagnosis of CNPA and aspergilloma. Meanwhile, clinical features and radiological findings appear to be valuable for the diagnosis.

Objective: To observe the clinical effect of early intervention of combined tuina with medicated bath for neonatal brain injuries.Methods: Brain-benefiting tuina manipulations,medicated bath and music plus exercise therapies were employed in 60 infants with medium or severe brain injuries.The Gesell measurement methods were adopted prior to and 3 months after treatment to evaluate the development quotient(DQ).In addition,the long-term follow-up was made after one and a half years.Result: The scores of DQ prior to treatment,3 month after treatment and 1.5 years after treatment were(34.98±28.94),(66.17±14.91)and(75.40±14.69)respectively,showing a marked improvement after 3months and 1.5 years of treatment(P=0.000).Conclusion: Early intervention using tuina manipulations could enhance the brain development,repair the nerve injury,improve the motion and cognitive ability and prevent the sequela of the nervous system.

Aim To observe the protective effects of epigallocatechin gallate(EGCG)on cortical neurons of embryonic mice the injury by FeSO4/H2O2 in vitro.Methods The cell injury model was established with FeSO4/H2O2 for 24 h.The process of the growth and morphology of the neurons were observed under phase contrast microscope in vitro.The cell survival was analyzed using colormetric neutral red assay.The cortical neuronal viability was analyzed using MTT assay.TBARS method was performed to detect the levels of Malondialdehyde(MDA).The composing capacity of total protein was measured by BCA method.Results As compared with FeSO4/H2O2,EGCG enhanced the mouse cortical neuronal survivality and viability,decreased the levels of MDA and increased the composing capacity of total protein.Conclusion EGCG exerted protective effects on cortical neurons the injury induced by FeSO4/H2O2,which may be related to free radial scavenging activity and lipid peroxidation process being inhabited.

Objective: To explore the effects of thiazolidinediones pioglitazone on the mRNA expressions of adiponectin and its receptor in human adipocytes.Methods: We obtained omental adipose tissue biopsies from patients undergoing elective open-abdominal surgery,performed primary culture and differentiation induction of the human preadipocytes,treated them with pioglitazone at different concentrations,and detected the mRNA expressions of adiponectin and its receptor in them by RT-PCR.Results: The mRNA expressions of adiponectin and its receptor were higher in the pioglitazone groups than in the non-pioglitazone control.Conclusion: Pioglitazone promotes the mRNA expressions of adiponectin and its receptor in human adipocytes.

AIM: To study the difference in glucose and lactate levels between brain extracellular fluid (ECF) and plasma in rabbits in the different blood glucose levels. METHODS: Using intracerebral microdialysis technology, brain ECF levels of glucose and lactate were measured in every 10 min under basal conditions and during a hyperglycemia-hypoglycemia clamp study. RESULTS: Under basal condition, brain ECF glucose levels were markedly lower than ambient plasma levels (30% of plasma), whereas ECF lactate levels were substantially higher (165% of plasma). During the hyperglycemia-hypoglycemia clamps, the relationship between plasma and ECF levels of glucose remained similar, but changes in ECF glucose lagged about 30 min. There were no substantially changes in ECF levels of lactate during dynamical study. CONCLUSION: There are striking differences in glucose and lactate levels between brain ECF and plasma. Lactate may involve in the metabolic process of central nervous system.

AIM:To study the pharmacological action of Zhikang Capsule (Herba et Radix, Paederiae scandentis, etc.) METHODS: To establish the model of anus injury in the rectal position on rabbit, anti-inflammation and analgesia effect in rats and mice were observed by carrageen and hot-plate method, and inflammatory mediator PGE_2 of rat paw edema was analysed. RESULTS: Zhikang Capsule had the obvious effect to help heal and recover the anus injury in the rectal position and it could inhibit rats’ thorax leukocytoplania and rat paw edema of Garrageenan-induced and cotton pellet-induced granuloma formation in mice. The exudation of blood capillaryies and the contents of inflammatory medium PGE_2 were lowered and improved in the pain threshold. CONCLUSION: Zhikang Capsule has the obvious effect on the healing and recovery of the anus injury in the rectal position, its anti-inflammiting effect is related to the decrease in the exudation of blood capillaries and the contents of inflammatory medium PGE_2.

Objective To explore the role of the PI3K/Akt signaling pathway in the calvarial osteolysis induced by TCP wear particles in mice model.Methods Thirty-six male ICR mice were randomly divided into a sham group (n=12),TCP group (n=12)and a LY294002-treated group (n=12).A murine calvarial model of osteolysis was established through implanting 30 mg of TCP particles onto the surface of bilateral parietal bones following the removal of the periosteum.On the second postoperative day,LY294002 (5 mg·kg-1)was locally injected to the calvarium under the periosteum three times a week;mice in the sham group received local injection of normal saline (N.S.)in the calvarium,and the injection time was consistent with that of LY294002.Two weeks later,the calvaria and periostea were obtained after the mice were executed.The calvarial osteolysis,bone mineral density (BMD)and bone mineral content(BMC)were analyzed using Micro-CT,Hematoxylin-Eosin (HE)staining was conducted to observe the inflammatrory response and formation of osteoclasts.Real-time PCR was applied to detect the mRNA level of tartrate-resistant acid phosphatase (TRAP),the marker of osteoclasts formation,cathepsin K (CstK),receptor activator for nuclear factor-κB kigand (RANKL)and c-Fos.The release of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6)and IL-1β were measured using enzyme-linked immumsorbent assay (ELISA).Results Micro-CT and histological analysis indicated that LY294002,the specific inhibitor of PI3K,significantly prevented TCP wear particles-induced osteolysis and osteoclastogenesis,and increased BMD and BMC in the calvaria of mice.Real-time PCR data revealed LY294002 significantly suppressed the increase in mRNA level of osteoclastogenic genes such as TRAP,CstK,RANKL and c-Fos in the calvaria of TCP wear particles-implanted group.ELISA assay showed that TCP wear particles-induced release of TNF-α,IL-1β and IL-6 was significantly inhibited by LY294002 treatment.Furthermore,LY294002 significantly attenuated TCP wear particles-triggered activation of Akt,and down-regulated the level of p-AktSer473 and p-AktThr308.Conclusion PI3K/Akt signaling pathway contributes to TCP wear particle-induced osteolysis,and can be developed as a new therapeutic target for the prevention and treatment of bone destruction diseases caused by wear debris.

Objective To explore the correlation of traditional Chinese medical syndrome elements with plasma connective tissue growth factor ( CTGF) and platelet-derived growth factor ( PDGF) in early liver cirrhosis induced by type B hepatitis. Methods The distribution of traditional Chinese medical syndrome elements in early liver cirrhosis induced by type B hepatitis was analyzed, plasma contents of CTGF and PDGF were detected by enzyme-linked immunosorbent assay ( ELISA) , and the correlation of syndrome elements with CTGF and PDGF was discriminated. Results ( 1) The distribution of traditional Chinese medical syndrome elements in early liver cirrhosis induced by type B hepatitis showed as follows: the syndrome elements involved the viscera of liver and spleen, and the pathogenesis was characterized as dampness, heat, qi stagnation, and yin deficiency. ( 2) CTGF was closely related with spleen, gallbladder and dampness, with OR value being 1.598, 1.567, 2.797, respectively. PDGF was closely related with heat, with OR value being 1.134. Conclusion Early liver cirrhosis induced by type B hepatitis mainly affects the viscera of liver and spleen, the pathogenesis is characterized by dampness, heat, qi stagnation, and yin deficiency. The patients with higher CTGF are apt to show the pathological changes of spleen, gallbladder, dampness, and have the syndrome el-ements of spleen, gallbladder, dampness. The patients with higher PDGF are apt to show the pathological changes of heat, and have the syndrome element of heat.