OBJECTIVETo observe the efficacy and safety of Qizhi Jiangtang Capsule (QJC) in treating stage 3b diabetic kidney disease (DKD) patients with macroalbuminuria.

METHODSPatients who conformed to the diagnostic criteria of stage 3b DKD were randomly assigned to two groups according to random digital table, the experiment group and the control group, 84 in each group. All patients received a two-week elution period, and then were treated with basic Western therapy. Patients in the experiment group took QJC, 5 pills per time, 3 times a day, while those in the control group took Valsartan Capsule 160 mg each time, once daily. The observation period of follow-ups was limited within 6 months, and the time points were set as the baseline, 1st month, 3rd month, and 6th month. Systolic blood pressure (SBP), diastolic blood pressure (DBS), 24 h urine protein quantitative (24 h UPQ), plasma albumin (ALB), and serum creatinine (SCr) were detected and recorded, and estimated glomerular filtration rate (eGFR) was calculated. The occurrence of hypoglycemic reaction, coagulation disorder, gastrointestinal tract reaction, allergy, hyperkalemia, doubling of creatinine, and overall adverse events were observed and recorded at same time.

RESULTSFinally 81 patients in the experiment group and 80 patients in the control group were effectively included. Compared with the baseline level, SBP and DBS obviously decreased in the control group at month 1 of treatment (P < 0.05), and more significantly decreased at month 6 of treatment (P < 0.01). SBP at month 1, 3, and 6 of follow-ups; DBS at month 6 of follow-ups was lower in the control group than in the experiment group (P < 0.05). At month 1, 3, and 6 of follow-ups, 24 h UPQ of the experiment group was significantly lower than the baseline level (P < 0.01). It was also significantly lower than the level of the control group at the same time point (P < 0.05). There was no significant difference in 24 h UPQ at month 1, 3, and 6 of follow-ups between the control group and the baseline level (P > 0.05). ALB of the experiment group showed an increasing trend. It was significantly higher than the baseline level at month 6 (P < 0.05), which was also higher than that of the control group at same period (P < 0.05). There was no significant difference in the ALB level in the control group (P > 0.05). SCr of two groups showed an increasing trend. SCr of the experiment group was significantly higher at month 1, 3, and 6 follow-ups than the baseline level (P < 0.05). But the increment of SCr was higher in the control group than in the experimental group, and obviously higher than the baseline levels (P < 0.05). eGFR of both groups showed a decreasing trend. The decrement was higher in the control group than in the experimental group (P < 0.05). The proportion of progression of renal functions at month 1, 3, and 6 of follow-ups in the experimental group was 0.0% (0 case), 9.55% (8 cases), and 21.4% (18 cases), while they were 8.3% (7 cases), 21.4% (18 cases), and 40.5% (34 cases) in the control group. There was no statistical difference in the proportion of progression of renal functions between the two groups at month 3 and 6 of follow-ups (P < 0.05). There was no statistical difference in the incidence of adverse reactions between two groups (P > 0.05).

CONCLUSIONQJC could effectively reduce urinary protein of patients with stage 3b DKD, and delay the progression of renal functions.

Adult ; Albumins ; analysis ; Albuminuria ; drug therapy ; Blood Pressure ; drug effects ; Creatinine ; blood ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Tetrazoles ; therapeutic use ; Treatment Outcome ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

OBJECTIVETo explore the effects of high altitude on cognitive flexibility.

METHODSSimulated hypoxia at an altitude of 3 600 m was performed in a hypobaric chamber. Twenty-three volunteers without hypoxic experience were selected and the mean age was about 25.1 years. The physiological parameters (heart rate, blood pressure and oxygen saturation) were measured. Task switch paradigm was used to explore the cognitive flexibility in each phase, and the changing anxiety state was evaluated simultaneously.

RESULTSReaction time (RT) switch cost in hypoxia phase showed a significant increase compared with the baseline; anxiety level in hypoxia phase was higher than the adaptation phase; a remarkable negative correlation between anxiety level and RT switch cost was found in adaptation phase, whereas a positive correlation was found in landing phase.

CONCLUSIONHigh altitude (3 600 m) affects cognitive flexibility and anxiety state. Anxiety before the hypoxia exposure improves the cognitive flexibility performance, while anxiety after the hypoxia exposure hampers the performance because of the post-hypoxia effect.

Adult ; Altitude ; Anxiety ; Cognition ; physiology ; Humans ; Hypoxia ; psychology ; Male ; Reaction Time

Imatinib mesylate has been commonly used in the treatment of patients with chronic myeloid leukemia (CML). However, a significant number of CML patients treated with imatinib developed thrombocytopenia. Platelet-derived growth factor (PDGF)/platelet-derived growth factor receptor (PDGFR) plays a significant role in the regulation of thrombopoiesis. It is suggested that imatinib may block the PDGF/PDGFR and PI3-K/Akt pathway, then inducing the apoptosis of megakaryocytes and developing thrombocytopenia in these patients. In this review, the potential molecular mechanism of imatinib-induced thrombocytopenia in the treatment of CML patients is discussed, including imatinib and thrombocytopenia, PDGF/PDGFR and thrombopoiesis, potential mechanism of imatinib-induced thrombocytopenia in treatment of patients with CML and so on.
Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzamides ; Caspase 3 ; metabolism ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; genetics ; metabolism ; Piperazines ; adverse effects ; therapeutic use ; Platelet-Derived Growth Factor ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Pyrimidines ; adverse effects ; therapeutic use ; Signal Transduction ; Thrombocytopenia ; chemically induced ; Thrombopoiesis

OBJECTIVETo explore the role of hypoxia in skeletal myoblasts proliferation and related mechanism.

METHODSThe numbers and proliferous indexes of skeletal myoblasts were detected by flow cytometer under 20%, 3%, and 10% oxygen concentration. Hypoxia inducing factor 1alpha (HIF-1alpha) mRNA expression was determined by reverse transcriptase-polymerase chain reaction (RT-PCR). HIF-1alpha proteinum in endochylema and intranucelus were respectively detected by Western blot.

RESULTSThe numbers and proliferous indexes were higher (P < 0.05) in hypoxia group than those of control group. The expression HIF-1alpha mRNA had no difference in hypoxia and in normal groups. The level of HIF-1alpha proteinum in endochylema under normoxia was more than that in intranucelus and it was opposite under hypoxia.

CONCLUSIONHypoxia can promote the proliferation of skeletal myoblasts. The possible mechanism of hypoxia promoting the proliferation of skeletal myoblasts might be that low oxygen concentration regulates HIF-la nuclear translocation.

Animals ; Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Male ; Myoblasts, Skeletal ; cytology ; metabolism ; Oxygen ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

16 and the distribution of severe trauma more than 2 anatomic parts.They were randomly divided into two groups:intensive insulin treatment group(n=31)and control group(n=31).Intensive insulin treatment group received insulin with insulin pump in order to maintain blood glucose levels at 4.0-6.1 mol/L,while the control group received routine insulin treatment in order to mmaintain blood glucose levels at 10.0- 11.0 mol/L.Plasma levels of TNF-?,IL-1,IL-6, CRP,APACHEⅡscores and cure rate were analyzed before and after the treatment.Data was expressed as mean?standard deviation.Two- tailed T test and ANOVA were used for comparison in SPSS 10.0,and changes were considered as statistically significant if P value was less than 0.05.Results After the intensive insulin treatment, patient's hemodynamic parameter apparently improved,APACHEⅡscores descended,and the levels of TNF-?, Ib-1,IL-6,CRP all declined,in comparison with control group,there were significant differences. Intensive insulin treatment might improve patient's general condition and decrease complications and mortality of severe multiple trauma.

Objective To study the clinical features and to improve the treatment on the elderly patients with brain tumor.Methods Retrospective analysis of 163 cases with brain tumor which had been confirmed by CT,MRA or pathology.Results Of all the 163 cases,121 were located in supratentorium,most of which were meningiomas and gliomas.Most patients(129 cases)had comorbidity.After operation,symptoms disappeared or obviously improved in 126 cases,moderately improved in 19 cases,and did not changed in 6 patients.Twelve cases died after operation in a month, in which 9 patients were over 75 years old.The death rate of operation was 6.1%.Conclusions It is important to know the atypical manifestation of brain tumor in the elderly,which may prevent clinical misdiagnosis and mistherapy.The perioperative management is indispensable to the prognosis of the patients.The choice of operation and medication should be in individualized.

Objective To establish a nursing performance evaluation indicator system in military hospitals,so as to provide reference for standardized nursing performance management. Methods Based on literature review,group discussion and qualitative interviews,two rounds of consultation were conducted among 19 experts using Delphi method. Results The nursing performance evaluation indicator system in military hospitals included 3 first-level in-dicators,13 second-level indicators and 60 third-level indicators. Experts' authority coefficient,judgment coefficient and familiarity coefficient were 0.930,0.960,0.900,respectively. The coordination coefficients of the first-level,sec-ond-level and third-level were 0.517,0.490 and 0.459. Variation coefficients were 0~0.113. Conclusion The nurs-ing performance evaluation indicator system in military hospitals based on Delphi method is scientific and reliable, which provides references for nursing performance in clinical units and makes significant contributions to nursing performance management in military hospitals.

OBJECTIVETransplantation of adipose-derived stem cells (ADSCs) is associated with potential risks of late complications including tumorigenesis due to the active proliferation of the cells. We aimed to test the effect of transplantation of ADSCs with suppressed proliferation by gamma irradiation in the treatment of thin endometrium in rats.

METHODSADSCs were isolated from female SD rats and identified by detecting the surface antigens with flow cytometry. After exposure to gamma irradiation at 0, 5 Gy and 10 Gy, the cells were examined for changes in colony-forming ability. Twenty-four female rats with chemically induced thin endometrium were randomized into 4 equal groups and at 6-8 h after modeling, the rats received intrauterine injection of non-irradiated ADSCs (group I), 5 Gy irradiated ADSCs (group II), 10 Gy irradiated ADSCs (group III), or PBS only (group IV). Endometrial pathology was analyzed with HE staining in these rats in the third estrus phase following the cell transplantation.

RESULTSThe ADSCs showed a complete loss of proliferative capacity after exposure to 10 Gy irradiation. After the cell transplantation, the endometrium thickness was thicker in group I and II than in group IV (P<0.01), but there was no significant difference between groups III and IV.

CONCLUSIONSGamma irradiation impairs the proliferative capacity of ADSCs in vitro. Exposure to 10 Gy irradiation causes a total loss of proliferation capacity of the ADSCs, which have no therapeutic potential; 5 Gy irradiation causes partial loss of proliferation capacity of the cells, which still retain the activity to promote endometrial cell regeneration.

Objective To observe the efficacy difference between different needling manipulations in treating acute stroke with point-toward-point needling at scalp acupoints, for seeking the optimal treatment protocol. Method Ninety patients with acute stroke were randomized into a manual needling group, an electroacupuncture group, and a needle-retaining group, 30 cases each. In addition to the neurological treatment, the three groups were all given point-toward-point needling from Baihui (GV20) to Taiyang (EX-HN5) on the affected side, respectively with manual twisting, electroacupuncture and needle retaining methods. Before and after 14-day treatment, the Neurological Deficit Score (NDS), level of neuron specific enolase (NSE) and total efficacy were compared among the three groups. Result The NDS dropped significantly in the three groups after the intervention (P<0.05); the manual needling group showed the most significant improvement, better than the electroacupuncture group and needle retaining group. The level of NSE declined significantly in the three groups after the intervention (P<0.05); the decrease in the manual needling group was the most significant compared to that in the electroacupuncture group and needle retaining group. The total effective rate in the manual needling group (90.0%) was significantly higher than that in the electroacupuncture group and needle retaining group (P<0.05). Conclusion Point-toward-point needling at scalp acupoints with manual operation can effectively improve the neurological deficit in stroke patients, and the application of needling manipulations can further enhance the therapeutic efficacy, which is specific.

Objective To measure the level of microglia TRPC6 in mouse MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)-induced neuroinflammation model and investigate its role in cytokine production and dopaminergic neuron damages. Methods Microglia were sorted by magnetic beads labeled with CD11b antibody and the level of TRPC6 in MPTP-induced neuroinflammation models was measured by western blotting. The proliferation of microglia and damages of dopaminergic neurons induced by MPTP were analyzed by immunofluorescence in CD11b-TRPC6 -/ - mice. Meanwhile, the expression of cryαB and cytokines in microglia was measured by western blotting and real-time quantitative PCR, respectively. Results The level of microglia TRPC6 in MPTP-induced neuroinflammation model was up-regulated. The expression of cryαB was increased and the cytokine level was down-regulated in the microglia in MPTP-injected CD11b-TRPC6 -/ - mice. Moreover, the dopaminergic neuron survival was improved in the MPTP-induced neuroinflammation model after TRPC6 knock-out in the microglia. Conclusions The expression of TRPC6 in microglia is up-regulated after MPTP injection, while in CD11b-TRPC6 -/ - mice the MPTP-induced cytokine expression is reduced, contributing to the improvement of dopaminergic neuron survival.