BACKGROUND:The hedgehog pathway has paid an important role in the progress of chondrogenesis from bone marrow mesenchymal stem cells. However, the definite signal transduction pathway and cross-talking relationship with other common signal pathways are stil poorly understood and the researches related to this field is to continue as a hotspot in the future study. OBJECTIVE:To investigate the research progress of hedgehog signal pathway on the regulation of the chondrogenesis from bone marrow mesenchymal stem cells and the relationship between hedgehog and other signal pathways in the process. METHODS:A computer-based online search in CNKI, PubMed and Google Scholar databases was performed using key words of“Hedgehog, IHH, SHH, bone marrow mesenchymal stem cells, cartilage, chondrogenesis”in English and Chinese, respectively. Literatures related to the process of chondrogenesis from bone marrow mesenchymal stem cells were included and 36 articles were extensively summarized for review. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells are currently accepted optimal cellseeds for the cartilage tissue engineering, and hedgehog is a critical signal molecule in the development of skeletal system. The IHH and SHH in hedgehog signal closely participate in control ing the processes of bone marrow mesenchymal stem cellproliferation and chondrogenesis, chondrocyte phenotype maintenance and cooperation with other common single pathways. However, the specific signal transduction mechanism and cross-talking contact with other signal pathways stil need to be further studied, and it stands for the future research directions.

BACKGROUND:Lung invasive fungal infection is the main reason for the failure in renal transplant recipients. Caspofungin has specific anti-fungi mechanism, and can effectively prevent the candida fungus that is resistant to Fluconazol and Itraconazole. Caspofungin exerts good tolerance, without dose-or time-dependent toxicity.
OBJECTIVE:To evaluate the efficacy and safety of Caspofungin in treatment of pulmonary invasive fungal infection fol owing kidney transplantation.
METHODS:A retrospective analysis was performed in renal transplant patients who were diagnosed pulmonary invasive fungal infection in Department of Respiratory Medicine, Sanmenxia Central Hospital between January 2013 and December 2013. The patients were then treated with Caspofungin as antifungal therapy. The initial dose was 70 mg per day and then changed to 50 mg per day, via intravenous drip. After drug intervention, liver function was evaluated twice per week. The severity of liver functional impairment or emergency of new impairment indicated the adjustment of Caspofungin dose or withdrawal. The treatment was given for 10-14 days. The curative effect and adverse reaction of patients were observed.
RESULTS AND CONCLUSION:Total 12 patients were treated, and the percentage of fungi microbiology evidence was 66.7%. Among these evidenced patients, candida fungus was the dominant, accounting for 75.0%, accompanying bacterial infection was found in 58.3%, accompanying cytomegalovirus infection was found in 25.0%. The effective treatment rate was up to 91.67%(11/12), the mortality was 8.33%(1/12), and the incidence of adverse reactions was 25%. Caspofungin effectively prevented pulmonary invasive fungal infection fol owing kidney transplantation, as empirical antifungal therapy, with low incidence of adverse reactions. Therefore Caspofungin is the preferred drug against pulmonary invasive fungal infection in renal transplant recipients.

Hearing Loss ; epidemiology ; Humans

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Scalp ; Sleep Initiation and Maintenance Disorders ; therapy ; Young Adult

We report a case of symptomatic bradycardia caused by consumption of a Chinese herbal medicine which was initially undisclosed to the attending emergency physician. The scientific name of the herb is Panax japonicus. Electrocardiogram revealed sinus bradycardia. Laboratory tests were normal except for the detection of a high serum digoxin level. Further interrogation of the patient eventually disclosed ingestion of the herb which, however, did not contain any digoxin. Other active ingredients in the herb include various types of ginsenoside. These are digoxin-like substances that had caused the observed false-positive detection of digoxin by fluorescence polarization immunoassay due to cross-reactivity. Our case-report provides an important insight about a blind-spot in the field of laboratory medicine (clinical pathology), namely, the false positive detection of digoxin due to crossreactivity in the immunoassay when we come across digoxin-like substances in clinical scenarios, which has barely received attention in the medical literature. It also conveys a clear educational message that with full understanding of the laboratory methodology and its mechanistic rationale there are actually some tricks-of-the-trade that allow us to optimize the specificity of the biochemical tests and the treatment of digoxin-like substances overdose.

Objective To evaluate the diagnosis and treatment for the patients infected with Candida species.Methods A total of 47 patients with persistent fever,pathology of pulmonary infection,no response to the antibiotic therapy,Candida species found in sputum after long time hospitalization were retrospectively analyzed.Results The 47 patients were 24 males and 23 females.The mean age was 57.0?16.1.The mean temperature was(38.4?0.6)℃ and all lasted for over 6 days.Pulmonary infections with Candida species was diagnosed at the(17.7?5.2)th day after admission.The species isolated were 38 strains Candida albicans,5 strains Candida glabrata,2 strains Candida kruseic,1 strain Candida tropicalis,and 1 strain Candida lusitaniae.Fluconazole was given to 28 patients(2 with voriconazole as sequential therapy),itraconazole to 9(2 with voriconazole too),voriconazole in 7(including the 4 patients mentioned above),Casfungin aceate to 7,Amphotericin B to 1(Casfungin aceate was given alone later for serious adverse reactions).Results two patients infected with C.albicans and Candida glabrata separately had no improvement in the 28 patients treated with fluconazole,but voriconazole showed good effect on the 2 patients.Two patients infected with C.albicans and Candida glabrata separately had no improvement to itraconazole in the 9 patients treated with Itraconazole,but voriconazole showed good effect on them too.The 7 patients treated with voriconazole all had good effect,including 3 infected with Candida glabrata,1 with Candida lusitaniae,3 with C.albicans.Conclusion Candida albicans is the main pathogen in this group of invasive pulmonary infections with Candida species.All the patients have fever and long-time hospitalization.The currently used antifungal drugs,such as voriconazole,Casfungin aceate,are reliable.Caspofungin is generally better tolerated than other antifungal drugs.

Objective:To investigate the clinical value of total parenteral nutrition for patients with tetanus. Methods:TPN was used in 13 tetanus patients. The nutrition parameters were recorded in these patients and compared with those in 25 tetanus patients without TPN. Results:Compared with the control, body weight, albumin, Hb, peripheral lymphocyte count in TPN group were higher and the complication and mortality were less. Conclusions:Total parenteral nutrition can improve nutrition parameters and prognosis of tetanus patients.

Objective: To study the chemical constituents of Limonium sinense. Methods: Eleven compounds were isolated by extraction, preparation-TLC, repeat-silicagel column, Sephadex-LH20, and opened-ODS column chromatography, and identified on the basis of physicochemical constant and spectra analysis. Results: Eleven compounds were isolated and their structures were identified as isorhamnetin (1), mannitol (2), β-sitosterol (3), oleanolic acid (4), quercetin (5), quercetin-3-O-β-D-glucoside (6), ethylgallate (7), kaempferol (8), kaempferol-3-O-α-L-rhamnopyranoside (9), (+)-catechin (10), and isorhamnetin-3-rutinoside (11). Conclusion: Compounds 4, 6, 7,10, and 11 are obtained from L. sinense for the first time.

Objective:To evaluate the efficacy and safety of elbasvir/grazoprevir (EBR/GZR) in patients with genotype 1 chronic hepatitis C in the real-world.Methods:This was an open-label, single-center, retrospective real-world study. A total of 103 genotype 1 chronic hepatitis C patients who were treated with EBR/GZR in Henan Provincial People′s Hospital from May 2018 to October 2019 were enrolled.And the clinical baseline characteristics of patients and the effectiveness and safety of antiviral therapy were respectively evaluated.Results:A total of 103 patients were enrolled in the study with an age of (47.6±13.9) years. Fifty-five (53.4%) patients were male and 48(46.6%) were female. One point nine percent (2/103) patients were genotype 1a hepatitis C and 98.1%(101/103) were genotype 1b hepatitis C. Seventeen genotype 1b hepatitis C patients were previously treated with interferon, and three patients co-infected with hepatitis B virus (HBV). Among the 103 cases, 35 had underlying diseases and 26 had combined medication. Ninty-eight cases completed 12-week treatment and 89 cases completed 12-week follow-up after treatment.Overall, 89 cases achieved sustained virological response. The overall incidence of adverse reactions was 20.4%(21/103), and the main adverse reactions were fatigue, insomnia and anxiety. No serious adverse event occurred. The three patients with HBV co-infection had no hepatitis B activation after treatment.Conclusion:EBR/GZR is effective and safe in the patients with genotype 1 chronic hepatitis C in China.

In this paper, optimization of the conditions of microwave technique in extraction process of Guizhi Fuling capsule in the condition of a pilot scale was carried out. First of all, through the single factor experiment investigation of various factors, the overall impact tendency and range of each factor were determined. Secondly, L9 (3(4)) orthogonal test optimization was used, and the contents of gallic acid in liquid, paeoniflorin, benzoic acid, cinnamic acid, benzoyl paeoniflorin, amygdalin of the liquid medicine were detected. The extraction rate and comprehensive evaluation were calculated with the extraction effect, as the judgment basis. Theoptimum extraction process of Guizhi Fuling capsule by microwave technology was as follows: the ratio of liquid to solid was 6: 1 added to drinking water, the microwave power was 6 kW, extraction time was 20 min for 3 times. The process of the three batch of amplification through verification, the results are stable, and compared with conventional water extraction has the advantages of energy saving, time saving, high efficiency advantages. The above results show the optimum extracting technology of high efficiency, stable and feasible.
Capsules ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; isolation & purification ; Microwaves ; Technology, Pharmaceutical ; methods