BACKGROUND:Critical limb ischemia is difficult to be treated among the peripheral arterial occlusive diseases, and the application of transplanting autologous stem cells can bring a hope for the treatment of this disease.
OBJECTIVE: To review the autologous stem cells transplantation in the treatment of critical limb ischemia at present, and to study the mechanism and the existing problems.
METHODS:A computer retrieval of PubMed database, Wanfang database, and CNKI database was conducted to search the related articles with the keywords of“stem cell, transplant, critical limb ischemia”in English and Chinese. Final y, 47 articles were included in final analysis according to the inclusion criteria.
RESULTS AND CONCLUSION:Autologous stem cells transplantation for treatment of lower extremity ischemic disease is a latest and significantly effective treatment, but the mechanism is unclear and stil needs further study.

Thirty cases of rheumatoid arthritis were treated by the needle-warming method on bilateral Shenshu (BL 23), Zusanli (ST 36) and Quchi (LI 11), in combination with oral administration of Chinese herbal drugs, and 30 cases were treated by routine western medications for comparison.After treatment for three months, the effective rate was respectively 86.7% and 60.0% in the two groups and the difference of the therapeutic effect was statistically significant (P＜0.05).

The quality management of drug research,development,registration,production and marketing strengthened by good practice for pharmaceuticals ensure the drag safety,effectiveness and quality control.Teaching of new drug research and evaluation in compliance with good practice for pharmaceuticals will be of value in making teaching content close to actual work,extending the students'knowledge and training student's good habits in scientific study.

Objective To investigated the neuroprotective effect of PTEN inhibitor BPV on cerebral ischemia-reperfusion injury in rats and its mechanism. Methods Male Sprague-Dawley rats were used to induce a reperfusion model of middle cerebral artery occlusion for 1 h. During the reperfusion, the BPV solution (0. 2 mg/kg daily) or the equal volume of saline was injected intraperitonealy immediately. The neurological deficit scores were conducted at day 1, 3,5, and 7 after ischemia-reperfusion. At day 4, triphenyl tetrazolium chloride staining was used to assess cerebral infarction volume. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) in cortical ischemic border zones. Real-time quantitative polymerase chain reaction was used to detect the expression level of PTEN mRNA. Western blotting was used to detect the expression levels of PI3K, Akt, and p-GSK-3β. At day 7, Bielschowsky silver staining was used to detect the axonal distribution in the ischemic border zone of the striatum. Immunohistochemical staining was used to detect the expression of myelin basic protein (MBP). Results At day 4 after ischemia-reperfusion, the infarct volume (32. 27% ± 1. 71% vs. 45. 49% ± 2. 12% ; P < 0. 001), TNF-α concentration in the cortical ischemic border zones (134. 17 ± 10. 38 pg/ml vs. 264. 17 ± 24. 84 pg/ml; P < ), and PTEN mRNA level (1. 19 ± 0. 08 vs. 2. 50 ± 0. 06; P < 0. 001) in the rats of the BPV group were al significantly lower than those of the normal saline group. The IL-10 concentration (186. 83 ± 10. 83 pg/ml vs. 147. 83 ± 11. 62 pg/ml; P < 0. 001), and the expression levels of PI3K (0. 43 ± 0. 08 vs. 0. 26 ± 0. 06; P = 0. 004), Akt (0. 52 ± 0. 05 vs. 0. 40 ± 0. 04;P = 0. 001), and p-GSK-3β (0. 75 ± 0. 08 vs. 0. 38 ± 0. 06; P < 0. 001) were al significantly higher than those of the normal saline group. At day 7 after ischemia-reperfusion, the neurological deficit score (4. 83 ± 0. 41 vs. 6. 33 ± 0. 52; P < 0. 001) in the rats of the BPV group was significantly lower than that of the normal saline group. The axon densities in the ischemic border zones (35. 51% ± 2. 45% vs. 25. 31% ± 2. 79% ; P < 0. 001) and the expression level of MBP (32. 56% ± 3. 46% vs. 27. 81% ± 4. 18% ; P = 0. 037) were significantly higher than those of the normal saline group. Conclusions BPV has neuroprotective effect for cerebral ischemia-reperfusion injury in rats. Its mechanism may be associated with the up-regulation of PTEN downstream proteins PI3K, Akt and p-GSK-3β expression to regulate inflammatory mediators and reduce the inflammatory response.

Objective To investigate the therapeutic effect of ipratropium bromide on bronchial spasm of patients with asthma and chronic obstructive pulmonary disease (COPD).Methods 174 patients with asthma and COPD were selected and divided into two groups, 87 cases in the control group treated with budesonide and formoterol fumarate powder for inhalation , 87 cases in the experimental group received ipratropium bromide on the basis of the control group, pulmonary ventilation function, airway resistance and cytokine levels in induced sputum, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(81.61%)was lower than the experimental group (93.11%), with significant difference (P<0.05); compared with the control group, levels of peak expiratory flow (PEF), maximum midexpiratory flow (MMEF), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), forced vital capacity (FVC) were higher in the experimental group after treatment, levels of airway resistance (Raw), Raw% were lower, level of specific airway conductance (Gsp) was higher after treatment, induced sputum levels of vascular endothelial growth factor (VEGF), intercellular adhesion molecular-1 (ICAM-1), interleukin-13 (IL-13), IL-17 were lower after treatment, with significant difference (P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The clinical effect of ipratropium bromide in the treatment of asthma and COPD was exactly , ipratropium bromide can significantly improve the pulmonary ventilation function in patients, relieve bronchial spasm, reduce airway resistance, inhibit airway inflammation, and the safety is higher.

OBJECTIVE:To investigate the role of clinical pharmacists in anti-infective treatment for the patient with septic shock. METHODS:Clinical pharmacists participated in anti-infective treatment for a patient with septic shock,assisted physicians to formulate individual regimen based on empirical anti-infective treatment,ESBLs producing Escherichia coli and anti-fungal treat-ment. Clinical pharmacists suggested using Itraconazole injection 200 mg,ivgtt,qd,for anti-fungal treatment;Itraconazole cap-sules 200 mg,po,bid,instead of fusidinic for anti-fungal treatment;meropenem 0.5 g,ivgtt,q6 h,for anti-infective treatment. RESULTS:Physicians adopted the suggestion of clinical pharmacists;the infection had been controlled after 16 d treatment and then the patient discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in clinical treatment,and assist phy-sicians to make a decision and formulate individual regimen,so as to promote rational drug use.

Objective To investigate the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome.Methods The data of 10 patients with central nervous system hemangioblastoma in our hospital since 2013 were analyzed retro-spectively,and the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome were summarized. Results The macroexamination result showed that most tumor lesions were found in the cerebellum and medulla oblongata,with cystic chan-ges,size from 1 cm to 5 cm,the average size was (3.1 ±0.2)cm,clear boundary,intracapsular yellow cyst fluid.The microscopy result showed tumor foci with a rich blood supply,endothelial cell proliferation and hypertrophy in vascular,which arranged in nests or lobulated mesenchymal cells,the cytoplasm of stromal cells was abundant and lightly stained,a rich lipid was seen,with vesicular or foam.Conclusion The von Hippel-Lindau syndrome is usually cystic lesion,the microscopic examination shows tumor foci with rich blood supply,endothelial cell proliferation,hypertrophy and other changes in vascular.

Objective:To investigate the clinical efficacy and safety of compound carraghenates suppositories in the treatment of wounds after anal fissure operation. Methods:Eighty-eight cases of patients with anal fistula post-operation wounds were diagnosed from June 2011 to June 2014 and randomly divided into the observation group (n=44) and the control group (n=44). The control group was treated with the conventional treatment and the observation group was treated with external compound carraghenates suppositories additionally. The efficacy, average healing time, growing time of granulation tissue and removal time of necrotic tissue, pain disappear-ance time and wound edema disappearance time after the operation and the area of wound surface in the two groups were observed and compared. Results:After the 14-day treatment, the time of wound healing, granulation growth and cure in the observation group was shorter than that in the control group (P<0. 05). In the observation group, the total effective rate (93. 18%) was higher than that in the control group (77. 27%, P<0. 05). After the 7-day and 14-day treatment, the pain score and wound edema score in the observa-tion group were significantly lower than those in the control group (P<0. 05), and the wound area was significantly smaller than that in the control group (P<0. 05). Conclusion:The clinical efficacy of external compound carraghenates suppositories in the treatment of wounds after anal fissure operation is significant, safe and reliable.

Objective To discuss the indication, technique, effect, and safety of endoscopic treatment of SMT in gastrointestinal tract. Methods Endoscopic therapy was performed in 94 patients with gastrointestinal diagnosed by endoscopy. 22 cases underwent EMR; 61 cases were treated with ESD; MBM was exercised on 7 cases; and nylon endoloop ligature were carried out on 4 cases. Results Complete resection was achieved on 86 cases, and 1 case was excised partially. 1 patient with SMT was transferred to open surgery. Lumps of 4 SMT cases treated by nylon endoloop ligature were found disappeared at subsequent visit after a month. All patients were followed up for one year, and no recurrence was found. Conclusions Gastrointestinal SMT can be completely resected by EMR, ESD and MBM. Nylon endoloop ligature can be used for the treatment of SMT in position difficult to deal with. Endoscopic therapy is relatively safe, effective, and minimal invasion for SMT.

Objective To explore the appearance of CT angiography(CTA)and magnetic resonance angiography (MRA)in persis-tent carotid-basilar artery anastomoses,and discuss its clinical significance.Methods 1 7 patients of persistent carotid-basilar artery anastomoses diagnosed by CT and MR angiography were retrospectively reviewed.10 patients were examined by craniocervical CTA, 7 patients were examined by cranial and cervical MRA,and 3 patients were examined by CTA and MRA.Results 10 patients had persistent trigeminal arteries (PTA).Based on Saltzman type:6 cases were Saltzman type Ⅰ,2 cases were Saltzman typeⅡ,and 2 cases were Saltzman type Ⅲ.1 case of 3 persistent hypoglossal arteries(PHA)originated from the right carotid artery,and 2 cases originated from the left external carotid artery.2 cases of 4 proatlantal intersegmental artery(PIA)were right ipsilateral,and 2 cases were left ipsilateral.1 case of PTA and 1 case of PHA associated with an aneurysm.6 cases of PTA,2 cases of PHA and 1 case of PIA complicated with ipsilateral vertebral arteries artopied or hypoplasia of the contralateral vertebral artery.Conclusion CTA and MRA can demonstrate clearly the course of persistent carotid-basilar artery anastomoses and its complicating intracranial coexisting abnormalities.Diagnosis of this anatomic variation may be helpful for providing reliable data to the guidance of surgery and interven-tional treatment.