Objective To analyze dialectical thinking and medication laws of TCM master LI Ji-ren in treating rheumatoid arthritis (RA); To provide references for clinical medication. Methods Medical cases of RA in outpatient department of the First Affiliated Hospital of Wannan Medical College during January 2014 to June 2015 treated by Professor LI Ji-ren. SPSS18.0 statistical software was used to carry out frequency analysis, correlation analysis, and cluster analysis. Results The included medical cases covered 123 cases, 199 prescriptions and 211 kinds of medicine. The total medication frequency was 3503, with 52 kinds of high frequency medicine (>10%), including Astragali Radix, Angelicae Sinensis Radix, Scorpio, Spatholobi Caulix, and Sargentodoxae Caulix. 36 kinds of medicine belonged to Liver Meridian of Foot-Jueyin (69.2%); 21 kinds of medicine belonged to Kidney Meridian of Foot-Shaoyin (40.4%); 20 kinds of medicine belonged to Spleen Meridian of Foot-Taiyin (38.5%); 16 kinds of medicine belonged to Heart Meridian of Hand-Shaoyin (30.8%). High frequency medicine was mainly to be sweet, spicy and bitter. High frequency medicine was mainly to be medicine with the functions of clearing heat, tonifying (tinifying qi, blood, yang and yin), activating blood and expelling stasis, and expelling rheumatism. 127 pairs of high frequency medicine was in positive correlation, among which 36 pairs showed the correlation coefficient >0.9. High frequency cluster analysis could be mainly divided into 6 categories. Conclusion The medication laws in this study and Professor LI Ji-ren's treatment for RA emphasize consolidating basis, and are in accordance with the ideas of expelling wind and humidity, activating blood and expelling stasis and stopping pain, which can provide references for clinic.

Objective Compared with different decellularization procedures for their potential of cell removal and the ability to preserve the matrix. Methods Specimens of bovine pericardiums were treated by 3 approaches (detergent and enzyme extraction、trypsin 、Triton-X 100 and sodium-deoxycholate). Tissue samples were then observed by HE staining and scanning electron microscopy to confirm the removal of cells. Von Gieson(VG) staining and Gomori staining were used for showing the integrity of collagen and elastin. DNA content was examined by the method of DNA extraction. Tissue shrinkage temperature and mechanical properties were also studied. Results Completely decellularization were achieved in 3 groups. While trypsin、Triton-X 100 and sodium-deoxycholate caused severe structural destruction and declined of mechanical properties of the matrix. In contrast, detergent and enzyme extraction achieved completely deeellularization and effectively preservation the matrix structure. Conclusion This research demonstrated detergent and enzyme extraction could achieve both complete decellularization and preservation of the matrix structure. This approach may provide an ideal platform for the construction of tissue-engineering heart valves.

Objective To sum up the experience of position nursing of patients with ankylosing spondylitis and severe kyphosis. Methods Eleven patients with ankylosing spondylitis and severe kyphosis underwent surgery. The patients′spine and head were kept in a line during anesthesia to avoid spinal cord injury. The eye mask was used to make sure the eyelid close, so the bulbar conjunctiva and corneal did become dry. The angle of operation bed in time during operation was adjusted. The crushed area was observed and the position was changed to avoid pressure sores and edema. After surgery, they were keep inactive to make sure the spine stable and relieve the pressure. Results The 11 patients′surgery were successful. There were no pressure ulcer, fracture, spinal cord injury or eye injury occurs. The operation time was 9.3 ± 2.9 h. Conclusion Position nursing is very important to improve the success rate of surgery and reduce complications.

Objective To evaluate the toxicity and efficacy of thermotherapy used with a streptococcus A preparation (OK-432) and cisplatin for treating malignant pleural effusion (MPE),and to assess patients' tolerance.Methods A total of 158 MPE patients were randomized into experimental and control groups.Closed drainage of the thoracic cavity was conducted with all the patients using a central venous catheter,and systematic chemotherapy was administered individually on the basis of each patient's condition.Patients in the control group were treated with intrapleural administration of OK-432 (0.5 mg) and cisplatin (40-60 mg) weekly for a maximum of 4 weeks,while those in the experimental group were given 60min of high frequency electrical thermotherapy 30-60 min after the administration of the drugs.The thermotherapy was at 40-43.5 ℃ and administered twice a week.Efficacy,quality of life and toxicity were compared between the two groups.Results The overall response rate in the experimental and control groups was 90.6% and 79.5% respectively;and grade I-II toxicity was similar.No grade Ⅲ or more serious toxicity was observed.The life quality scores in both groups were significantly improved after treatment.Conclusions Thermotherapy combined with intrapleural OK-432 and cisplatin can improve the effectiveness of therapy and life quality in MPE patients without increased toxicity.

BACKGROUND: Acute renal failure following heart failure assisted circulation have been extensively reported. However, little data have been available concerning morphological analysis of kidney tissues under that condition.OBJECTIVE: To observe morphological change of ischemia/reperfusion kidney in a sheep pulsatile catheter (PUCA) pump short-term support for heart failure model and explore causes of acute renal failure in assisted circulation patients.DESIGN, TIME AND SETTING: Self-contrast animal experiment was performed at the laboratory of Department of Cardiothoracic Surgery, Renji Hospital of Shanghai Second Medical University between July 2003 and April 2004.MATERIALS: PUCA pump was provided by Gerhard Rakhorst, Professor of Biomedical Engineering, University of Groningen.METHODS: After ischemic heart failure in 10 sheep was induced successfully and subsequently ischemia/reperfusion kidney was developed, PUCA pump was activated to support the hemodynamics for 3 hours.MAIN OUTCOME MEASURES: Hemodynamic parameters were monitored and recorded before thoracotomy, heart failure, and every 45 minutes after the support. Kidney biopsy specimens for light and electron microscopy were obtained 3 hours after support.RESULTS: PUCA pump support was successful in 7 of 10 sheep for 3 hours. During support with the PUCA pump,Hemodynamic parameters gradually restored to normal and stable condition, and blood pressure was close to baseline at the end of experiment. On both light and electron microscopy examination, mild acute kidney change was observed after ischemia/reperfusion. Cytosis in renal glomerulus associated with vasodilatation hyperemia, endepidermis in renal tubules hydropic degeneration, vasodilatation hyperemia and Interstitial edema in renal medulla were the main findings.CONCLUSION: PUCA pump could successfully maintain the hemodynamics for 3 hours in a sheep acute heart failure model,but pathological change in ischemia/reperfusion kidney was remained. It is impossible to predict prognosis of renal function on hemodynamic data alone during support.

Objective To assess the effect of the pulsatile catheter (PUCA) pump support on cardiac resuscitation in sheep,and to provide a new approach for saving cardiac arrest patients. Methods Cardiac arrest was induced by ventricular fibrillation in 11 sheep. These sheep were divided into three groups including no support (n=3), delayed support (n=2) and immediate support (n=6). Time for cardiac resuscitation and the ratio of success to failure in each group were recorded. Hemodynamic parameters including heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure(CVP),right ventricular end-diastolic pressure (RVEDP),left atrial pressure (LAP), and left ventricular end-diastolic pressure (LVEDP) were monitored and recorded at 5, 60 and 180 min after cardiac resuscitation with PUCA pump. Results Time for cardiac resuscitation in no support group, delayed support group and immediate support group was (38.3±5.8),(43.5±9.2) and (48.7±23.8)minutes, respectively(P＞0.05),and the ratio of success to failure was 0/3,0/2 and 5/1, respectively ( P＜0.05). After cardiac resuscitation with the PUCA pump support, MAP, SBP and DBP increased gradually(P＜0.05).Conclusions PUCA pump can maintain the hemodynamic stability in a sheep model of cardiac arrest,and can thus increase the success rate of cardiac resuscitation. It may be suitable for resuscitating cardiac arrest patients.

ObjectiveTo observe the clinical efficacy ofTong Du Tiao Shen(unblocking the Governor Vessel and regulating spirit) needling method plus Nimodipine in treating vascular dementia.MethodSixty patients with vascular dementia were randomized into a treatment group and a control group, 30 in each group. The control group was intervened by oral administrationof Nimodipine, while the treatment group was additionally intervened byTong Du Tiao Shenneedling method. Two weeks were taken asa treatment course, and the intervention lasted 2 courses. The Mini-Mental State Examination (MMSE) and Activities of Daily Life (ADL) were evaluated and compared before and after intervention, and the therapeutic efficacy was determined.Result After intervention, there were significant differences in comparing MMSE and ADL scores between the two groups (P<0.05). ConclusionTong Du Tiao Shenneedling method plus Nimodipine is effective in treating vascular dementia, and worth promotion in clinic.

OBJECTIVETo evaluate the quality and clinical applicability of pyrosequencing assay kit for detecting hepatitis B virus resistance (HBV DRT).

METHODSSerial dilutions of the International Standard for HBV DNA were used to test the detection limit of the PCR for HBV DRT. Plasmids containing the either a wild-type (WT) copy or one of 10 mutant (MT) copies of the HBV RT gene were used to prepare a series of samples with various mutation ratios. To construct the linear relationship between the true mutation rate and the detected mutation rate, each sample was repeated at least 10 times. A total of 102 clinical samples were analyzed by Sanger sequencing and retested by the PCR for HBV DRT to determine the concordance of these two methods.

RESULTSThe lower detection limit of the PCR for HBV DRT was 50 IU/ml. Except for the RT236 MT, the correlation between the true mutation rate and the detected mutation rate for the other nine resistance-related mutation sites were excellent, with R² more than 0.98 (P less than 0.001). Among the 102 clinical samples, four were not amplified successfully by PCR. The results were significantly different between the PCR for HBV DRT method and the Sanger sequencing method (x² = 71.2, P less than 0.001), and concordance was observed for 897/969 (92.6%) amino acid positions in 98 samples. Concordant results were achieved in 46/98 (46.9%) samples at all 10 mutation sites. For detection of a single mutation site, concordance rates ranged from 71.5% to 100% at the 10 mutation sites, respectively. Analysis of discordant samples showed that in 87.5% (63/72), Sanger sequencing detected WT and the PCR for HBV DRT detected WT/MT. In 5.6% (4/72) of samples, Sanger sequencing detected WT/MT and the PCR for HBV DRT detected WT. In the remaining 6.9% (5/72) of samples, Sanger sequencing detected WT but PCR for HBV DRT detected MT.

CONCLUSIONThe PCR for HBV DRT showed high sensitivity and accuracy in detecting antiviral drug-resistant mutations. The method is superior to Sanger sequencing for detecting minor mutations and can be used for early detection of a resistance mutation.

Antiviral Agents ; Base Sequence ; Drug Resistance, Viral ; Hepatitis B virus ; Humans ; Mutation ; Plasmids ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Pictet-Spenglerases (P-Sases) catalyze the Pictet-Spengler (P-S) reactions and exhibit high stereoselectivity and regioselectivity under mild conditions. The typical P-S reaction refers to the condensation and recyclization of β-arylethylamine with aldehyde or ketone under acidic conditions to form tetrahydroisoquinoline and β-carboline alkaloid derivatives. The related enzymatic products of P-Sases are the backbones of various bioactive compounds, including clinical drugs: morphine, noscapine, quinine, berberine, ajmaline, morphine. Furthermore, the activity of P-Sases in stereoselective and regioselective catalysis is also valuable for chemoenzymatic synthesis. Therefore, this review summarizes the research progress in the discovery, functional identification, biological characteristics and catalytic applications of P-Sases, which provide the useful theoretical reference in future P-Sases research and development.
Alkaloids/chemistry* ; Catalysis ; Enzymes/metabolism* ; Research/trends* ; Tetrahydroisoquinolines/chemistry*