Objective]The article summarizes the H-hypertension's clinical experience by professor He Jia. [Methods]From following professor He Jia clinical studies, summarize professor He Jia from different ages, the treatment by applying the method of tonifying qi by stasis H-hypertension qi deficiency blood stasis syndrome differentiation thinking and clinical experience, and for proven cases.[Result]The professor He Jia considers the method of Buqi Zhuyu as the basic therapeutic principle, with pathogenesis of qi deficiency and blood stasis in the collaterals. And also to make up for points and syndromes differentiation from youthes and older, in the young and middle-aged people and see blood stasis into collaterals, the treatment of blood stasis by the main,the old people see more Qi deficiency into the network, to make up for the deficiency of Qi.Her clinical medicine is characterized in paying equal attention to the Qi and blood, Buqi Zhuyu, using opportunely insect medicine,Soufeng Tongluo,using the mineral medicine, Ziyin Qianyang along with the disease change, with good effect.[Conclusion]Professor He Jia for H-hypertension treatment of qi deficiency blood stasis unique insights, obtains good effect, often with fellow mutual information.

Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group (group A, n=10), epinephrine group (group B, n=6) and epinephrine plus adenosine group (group C, n=6). After a 3-min asphyxia without intervention, cardiopulmonary resuscitation (CPR) was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine (200 times/min). Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine (bolus of 90?g/kg) respectively, and in group C epinephrine (bolus of 90?g/kg) plus 70?g/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B (P

Recently, drug delivery materials have become the hotspot of medical study. Suitable delivery material plays an important role in constructing an excellent drug delivery system. Silk fibroin is a naturally occurring protein polymer with excellent biocompatibility, remarkable mechanical properties, biodegradability and outstanding processability. Due to its unique properties, silk fibroin has become a favorable carrier material for the incorporation and delivery of a range of therapeutic agents. Based on the structure and characteristics of silk fibroin, this article provides an overview of the recent research progress of silk fibroin used as drug delivery materials.
Biocompatible Materials ; Drug Delivery Systems ; Fibroins ; chemistry

Objective To discuss the diagnosis and surgical treatment of insulinoma. Methods The clinical data of 32 patients with insulinoma were analyzed retrospectively. Of the 32 patients, 19 patients were performed with simple tumor enucleation, 10 patients with pancreatic body and tail resection, 3 patients with pancreaticoduodenectomy. Results In this study, 20 cases were diagnosed and localized the tumor by type-B abdominal ultrasonic and enhanced spiral CT before operation and 12 cases by intraoperative type-B ultrasonic. Within all patients,9 tumors located in the head of pancreas, 15 tumors in the neck , 8 tumors in the tail. The clinical symptoms in 32 cases disappeared after operation with 2 cases followed by pancreatic leakage. Of all 32 cases with insulinoma,28 tumors were diagnosed as benign and the other 4 as malignant. Conclusions The mainly clinical manifestation of insulinoma is typical whipple triad. Preoperative qualitative diagnosis is practicable according to the clinical symptom and laboratory examination. Combined imaging examinations might be helpful in improving the positive test rates. Intraoperation exploration and ultrasonography are the chief methods for the tumor localization. Site, size, number and depth of the tumor are the key points determining the surgical method style.

Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.

AIM:To establish an HPLC method for determining cinnamaldehyde,costunolide and dehydrocostuslactone in the supercritical carbon dioxide extraction of Cinnamomum cassia and Aucklandia lapp.METHODS:The assay was performed on an Agilent HC-C_(18)(150 mm×4.6 mm,5 μm)column by UV detector at the wavelength of 210 nm with acetonitrile-water(gradient elutio)as the mobile phase at the flow rate of 1.0 mL/min,and the column temperature was 30℃.RESULTS:There were good relationships between peak area and sample size of cinnamaldehyde in the range of 148.5-1 732.5 ng,between peak area and sample size of costunolide in the range of 69.42-809.9 ng,and between peak area and sample size of dehydrocostuslactone in the range of 70.32 to 820.4 ng.Average recoveries of them were in turn 99.65%(RSD 0.72%)-99.57%(RSD 1.28%),and 98.90%(RSD 0.81%),respectively.CONCLUSION:The present method is convenient,sensitive and accurate with good reproducibility and can be used for the quality control of the supercritical CO_2 extract of Cinnamomum cassia and Aucklandia lapp.

Objective To detect the expression of extracellular-regulated kinase (ERK) and phosphatedextracellular-regulated kinase (P-ERK) in the hippocampus after pentylenetetrazoloe-induced status epilepsy and the effects of nimodipine on it.Methods Male Sprague-Dawley adult rats (200-250 g) were randomly divided into normal control group(NC,n =35),status epilepsy group (SE,n =40),nimodipine group (NIM,n =40).The rats were injected first with 40 mg/kg pentylenetetrazoloe(PTZ),followed 10 minutes later by 20 mg/kg PTZ,and subsequently,10 mg/kg PTZ ip every 10 minutes until SE occurred,apoint charactered by a loss of postural control and tonic-clonic seizures.Rats in control group received the same number of saline injections.Rats in NIM group were injected NIM(2.5 mg/kg) intraperitoneally 15 min before the injection of PTZ.Rats in every group were killed at 30 minutes,1 hour,3 hours,12 hours,24 horus,72 hours and 7 days after status epilepsy respectively and the hippocampus were dissected.The expression of ERK and P-ERK in the hippocampus were detected by Western blot.Results Nimodipine attenuated the convulsion of PTZ-induced status epilepsy.There was dynamic expression of P-ERK in SE group.In NIM group,the expression of P-ERK was markedly increased than that of SE group at 30 min,1h,3h,12h,24h,72h,and 7d (3.26 ±0.95 vs 2.56 ±0.82 at 30 min,P＜0.05).Conclusion Nimodipine attenuates the convulsion of PTZ-induced status epilepsy with increased expression of phosphated-ERK in the hippocampus of rats.

Objective : To investigate the influencing factors for depression and anxiety in patients with dysphagia after stroke. Methods: From May 2017 to June 2018,patients with post-stroke dysphagia in the Department of Rehabilitation Medicine of Zhejiang Hospital were recruited to collect their height,weight,education level,serum nutritional indicators and feeding patterns. Self-Rating Anxiety Scale and Self-Rating Depression Scale were employed to assess the incidence of anxiety and depression. Multivariate logistic regression model was used to analyze the influencing factors for depression and anxiety. Results : Among 96 patients enrolled,43 suffered from anxiety and depression,with the incidence of 44.79%. The results of multivariate logistic regression analysis showed that normal albumin（OR=0.208,95%CI：0.054-0.800）was a protective factor for anxiety,while indwelling gastric tube（OR=5.789,95%CI：1.654-20.260）was a risk factor. Normal transferrin（OR=0.189,95%CI：0.042-0.860）was a protective factor for depression,while indwelling gastric tube（OR=13.977,95%CI：1.472-132.667）was a risk factor. Conclusion Normal albumin and transferrin are the protective factors for anxiety and depression in patients with dysphagia after stroke,and indwelling gastric tube is the risk factor for anxiety or depression.

Objective To provide a basis for clinical diagnosis,a serum metabonomic dynamic study was carried out on the Tg2576 mouse model at different stages of Alzheimer's disease(AD) whose pathological progress is similar to that of human AD patients.Methods Serum samples of Tg2576 mice were collected at the early(6 months) and late(12 months) stages of Alzheimer's disease.The 1H NMR spectra of the serum samples were collected and the metabolic characteristics were analyzed by multivariate analysis.Results Significant differences in serum metabonomics were found in the transgenic Tg2576 mice and C57 mice at 6 and 12 months of age,and there were significant metabolic changes in Tg2576 mice at different stages of Alzheimer's disease.Compared with C57 mice,the Tg2576 mice at early stage of Alzheimer's disease showed higher levels of serum lactate,myo-inositol and amino acids(such as leucine,isoleucine,alanine),and lower levels of lipids,choline,phosphorylcholine,glycerol phosphorglcholine,betaine,glycine and glucose.At the late stage of Alzheimer's disease,the transgenic Tg2576 mice had higher levels of lactate,myo-inositol and alanine,while the serum levels of lipids,choline,phosphorylcholine,glycerophosphorylcholine,betaine,and glycine continued to drop.Meanwhile glutamine and creatine levels started to decline.By comparing the early and late serum metabolites of Alzheimer's disease,serum metabonomic profiles of the late stage of Alzheimer's disease indicated an up-regulation of lactate,myo-inositol and alanine,and a down-regulation of lipids,choline,phosphorylcholine and glycerophosphorylcholinelevels.Moreover,the levels of lactate,lipids,choline,phosphorylcholine and glycerophosphorylcholine showed statistical significance at the early stage of AD,and they were closely correlated with the severity of Alzheimer's disease.Conclusions The above results show that the changes of lactate,myo-inositol and alanine are positively-correlated with the development of AD,while the serum levels of lipids,choline,phosphorylcholine and glycerophosphorylcholine are inversely-proportional to the severity of AD.These metabolites are dynamically and progressively changed along with the disease progression,which hopefully may serve as early metabolic markers for the diagnosis of AD in clinical practice.

Objective:To explore the effect of ulinastatin on prevention of acute respiratory distress syn-drome (ARDS).Methods:A prospective multicentral cohort study was conducted.The patients from three intensive care units (ICUs)of grade A tertiary hospitals in Beijing and a ICU of grade A tertiary hospitals in Cangzhou from January 2012 to December 2014,included 77 ARDS at-risk patients with uli-nastatin treatment and 108 ARDS at-risk patients without ulinastatin treatment (control)were eligible. Both groups received normal treatment;additionally,the intervention group received 600 000 units of uli-nastatin via intravenous infusion for 5 days.The control group received the same amount of saline via in-travenous infusion for 5 days.Venous blood human neutrophil elastase (HNE)and peptidase inhibitor 3 (PI3)levels were measured on days 1,3,and 7,respectively.Other outcomes included acute physiolo-gy and chronic health evaluation scoring Ⅱ (APACHE Ⅱ),body temperature,respiratory rate,heart rate,mean arterial pressure,white blood cell counts,PaO2 /FiO2 ,ARDS incident,mechanical ventila-tion time,ICU treatment and hospitalization duration,28 days mortality.Results:The PI3 levels showed no statistical difference on day 1,but significant differences on day 3 and day 7 between the two groups (P <0.01).HNE /PI3 ratio showed no statistical difference on day 1,but significant differences on day 3 and day 7 (P <0.05).PaO2 /FiO2 was significantly higher in ulinastatin group on day 3 and day 7 (P <0.05).The incident rate for ulinastatin group was 15.58%,lower than that for the control group (33.33%),and the difference was statistically significant (P <0.05).The mechanical ventilation time and ICU treatment time in ulinastatin group was shorter than that in the control group,and the difference was statistically significant (P <0.05).There were no significant effects in other factors.Conclusion:Increased dose of ulinastatin can recover the balance of HNE and its antagonist,lower the HNE’s damage to lungs,and further reduce the ARDS incident rate.