OBJECTIVE:To study the potential of three kinds of Chinese medicines in combination with Ceftriaxone in inducing endotoxin release from Klebsiella for references of combined use of Chinese medicines and western medicines in the treatment of severe infections.METHODS:The amount of endotoxin released from Klebsiella after being treated in vitro by Ceftriaxone(high,medium and low concentrations)alone or in combination with 3 antibacterial Chinese medicines for 4 hours was compared.RESULTS:The amount of endotoxin released by Klebsiella in low concentration of Ceftriaxone either alone or in combination with Chinese medicines were the maximum but minimum in high concentration Ceftriaxone group.The amount of endotoxin released in low concentration group was larger than in blank group(without antibacterial treatment),and that released amount in Shuanghuanglian plus Ceftriaxone group was less than in Ceftriaxone alone group.CONCLUSION:Low concentration of Ceftriaxone can induce Klebsiella to release endotoxin,while Shuanghuanglian can reduce Ceftriaxone-induced release of endotoxin.

Objective To observe the effect of enhanced extracorporeal counterpulsation (EECP) on intraocular pressure (IOP). Methods 25 patients were measured their IOP bilaterally with Schoitz tonometer before and after EECP. Results The IOP decreased in both left and right eyes after EECP (P<0.01). Conclusion EECP can reduce intraocular pressure.

Objective To investigate the clinical manifestations and mortality related risk factors in patients with acute superior mesenteric artery embolism (ASMAE).Methods Clinical data of forty-three confirmed ASMAE patients in the PLA General Hospital from June 2002 to June 2012 were retrospectively analyzed.All patients were classified into the survival group (28 cases) and the death group (15 cases)according to the prognosis.The prognosis associated factors were further analyzed.Results The study group consisted of 31 men (72.1％)and 12 women (27.9％),with average age of (63 ± 11) years.The majority patients with ASMAE in our study had history of atherosclerotic diseases.The main clinical manifestationsincluded abdominal pain [100％ (43/43)],nausea and vomitting [55.8％ (24/43)],hematochezia [32.6％ (14/43)].Abdominal CT scan was performed in 74.4％ (32/43) patients with a high positive result of 96.9％ (31/32).Weight loss occurred more frequently in survival group than in death group [32.1％ (9/28) vs 6.7％ (1/15),P =0.001].Moreover,weight loss has been shown as a protective factor for ASMAE survival (OR =0.75,P =0.038) by logistic analysis.Compared with the death group,the incidence of either peritoneal irritation sign or ascites was significantly lower in survival group [respectively 7.1％(2/28) vs 66.7％ (10/15),14.3％ (4/28) vs 73.3％ (11/15),P ＜0.05],which were two independent risk factors of mortality(OR =8.51,P =0.014 ; OR =3.07,P =0.028).The incidence of main artery embolism of superior mesentery artery (SMA) in death group was higher than that in survival group [93.3％ (14/15) vs 60.7％ (17/28),P =0.023].Main artery embolism of SMA was also an independent mortality risk factor of ASMAE patients (OR =5.05,P =0.039).A total of 18 patients were treated with enterectomy.Intestine excision length was shorter in survival group than in death group [(82.8 ± 25.2) cm vs (141.0 ± 18.1)cm,P =0.017].The time from onset to operation in survival group was shorter than that in death group [(44.8 ±29.7) h vs (69.1 ±28.0) h,P =0.013].Conclusions Patients with ASMAE based on chronic ischemia have a relative good prognosis for survival.Peritoneal irritation sign,ascites and main artery embolism of SMA were independent risk factors for death in ASMAE.Intestine excision length and the interval from onset to operation may affect the mortality of ASMAE patients.

Objective To examine the association of arteriovenous fistula (AVF) blood flow (Qa) dynamics with inflammation state and its effect on cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients.Methods Thirty MHD patients with AVF and twelve healthy people were enrolled in the study.Qa and cardiac output (CO) were measured by Transonic Hemodialysis Monitor HD 02.In MHD patients,pre-dialysis blood samples were taken before Qa monitoring.High-sensitivity C-reactive protein (hsCRP) was measured by immunoturbidimetry (Kyoma,Japan).Inflammatory factors IL-2,IL-6,IL-10,TNF were measured by Cytometric Bead Array (BDTM).Cardiovascular diseases morbidity was monitored prospectively within nineteen months follow-up period.Results There were no significant differences in age and sex between MHD patients and healthy people.The serum IL-6,IL-10,TNF and hsCRP were significantly higher in MHD patients than those in healthy controls [2.38 (1.86-4.69) vs 1.14 (0.27-1.18) ng/L,P＜0.01; 1.47 (1.19-2.10) vs 1.04 (0.00-1.23) ng/L,P＜0.01; 1.33 (1.05-1.56) vs 0.54 (0.00-1.24) ng/L,P＜0.05; 4.90 (1.58-7.45) vs 1.50 (0.63-1.90) mg/L,P=0.01].During the follow-up period,6 patients (20.0％) developed at least one episode of cardiovascular event.Qa,serum IL-6 and hsCRP levels were significantly higher in patients with CVD as compared to those without CVD [(1120±192) vs (893±189) ml/min,P＜0.05; 4.86 (2.96-7.85) vs 2.20 (1.80-3.10) ng/L,P＜ 0.01;11.75 (3.83-31.53) vs 4.45 (1.05-6.68) mg/L,P＜0.05].Binary Logistic regression analysis demonstrated that serum IL-6 was an independent and stronger risk factor for CVD morbidity [HR=1.943,95％CI (1.110-3.402),P=0.02].Spearman rank correlation analysis and liner regression analysis showed that Qa was positively correlated with serum IL-6 (β=0.492,P＜0.01).Path analysis suggested that Qa contributed to CVD mortality via the increase of serum IL-6.Conclusions AVF blood flow monitoring is important for MHD patients.IL-6 is an independent risk factor of CVD in MHD patients.AVF blood flow increases cardiovascular diseases morbidity in MHD patients via its promotion of IL-6 production.

Objective To establish diagnostic models for pancreatic carcinoma(PC)and to find out the biomarkers related to PC.Methods Serum samples obtained from subjects including PC patients,pancreatic benign disease patients and normal controls were examined with strong anionic exchange chromatography(SAX2)chips for protein profiling using surface enhanced laser desorption/ionization-time of flight-mass spectrometry(SELDI-TOF-MS).The decision tree models and logistic regression models for evaluating the value of serum biomarkers were assessed.SELDI immunoassay and ELISA were used to identify the biomarker and its level in serum respectively.Results Twentysix mass peaks were different between PC patients and normal controls(P＜0.0 1)and 16 mass peaks were different between patients with PC and with pancreatic benign disease(P＜0.05).The decision tree model had a sensitivity of 83.3%and a specificity of 100.0%in differentiation of PC,which was better than that of CA19-9 by ROC curve.There were significant differences in 6 mass peaks among different stages of PC(P＜0.01).Logistic regression model showed a sensitivity of 81.6%and a specificity of 80.6%in diagnosis of early PC.The M/Z 28068 protein was identified as C14orf166 with a sensitivity of more than 82%and a specificity of more than 88%in diagnosis of PC.Conclusions The diagnostic models based on SELDI-TOF-MS were superior to CA19-9 in diagnosis of PC.The identified biomarker C14orf166 is expected to play a role in the diagnosis of PC.

Objective To assess value of contrast enhanced ultrasonography(CEUS)in diagnosis of extracranial carotid stenosis.Methods Baseline ultrasonography and CEUS were performed in 108 patients with extracranial carotid stenosis.The location and degree of stenosis were judged and compared with the results of digital subtraction angiography(DSA).Results Of 108 patients,DSA diagnosed 81 vessels in 62 cases of mildintermediate stenosis which consisted of 33 common carotid arteries(CCAs),43 internal carotid arteries(ICAs)and 5 external carotid arteries(ECAS),51 vessels in 39 cases Of severe stenosis(46 ICAs and 5 CCAs)and 7vessels in 7 cases of complete occlusion(7 ICAs).The surface of intima and the interface of media-adventitia were depicted clearly by CEUS.The consistent rates in diagnosis on mild-intermediate stenosis,severe stenosis and complete obstruction by baseline ultrasonography and CEUS were 76.5%and 9 1.4%(P＜0.05).60.8%and94.1%(P＜0.001),28.6%and 100%(P＜0.05)respectively when judged by DSA as the golden standard.CEUS and DSA were correlated significantly on calculating the stenosis rate(r=0.975,P＜0.001).Conclusions CEUS can assess the degree of extracranial carotid stenosis accurately and non-invasively which is superior to baseline ultrasonography and correlated significantly with DSA.

This study is to explore the effect of ginkgolide B (BN52021) on the production of nitric oxide (NO), interleukin (IL)-6 and regulated upon activation normal T cell expressed and secreted (RANTES) from astrocytes induced by stimulators. Primary cultured rat astrocytes were stimulated with lipopolysaccharides (LPS), the production of NO was assayed using Griess reaction; U251 cells were stimulated with IL-1 beta, the contents of IL-6 and RANTES in the supernatant were measured using ELISA. The mRNA expressions of IL-6 and RANTES were detected using RT-PCR. LPS (10 ng mL(-1) to 10 microg mL(-1)) could stimulate rat astrocytes to produce NO in a dose-dependent manner. Ginkgolide B at the concentrations of 0.1-10 micromol L(-1) were shown to decrease NO production significantly. IL-1 beta could induce the mRNA expression and protein secretion of IL-6 from U251 cells, as well as RANTES. Ginkgolide B at concentrations of 0.1-10 micromol L(-1) were shown to inhibit RANTES secretion, and to inhibit mRNA expression of IL-6 and RANTES at concentration of 10 micromol L(-1). Ginkgolide B has inhibitory effect on the production of NO, IL-6 and RANTES from astrocytes treated with inflammatory stimulators.

Objective:To establish the quality control of Zhiqikang capsules. Methods:TLC was used to identify Gastrodia tuder halimasch, rhubarb and Astragalus mongholicus in the preparations. A spectrophotometry method with 3, 5-dinitrosalicylic acid (DNS) was used to measure the polysaccharide content in Zhiqikang capsules. A spectrophotometry method with Forint phenol method ( Low-ry) was used to measure the peptide content in the capsules. Results:The linear range of polysaccharide was obtained between 6. 412 and 32. 060μg·ml-1(r=0. 999 5), the average recovery was 95. 86% and RSD was 0. 86%. The linear range of peptide was ob-tained between 0.059 7 and 0.298 4 mg·ml-1(r=0.999 0), the average recovery was 100.3% and RSD was 1.88%(n=6). Conclusion:The assay method is simple and accurate in the quality control of the preparations.

Objective To investigate the clinical manifestations and risk factors related to ulcer in patients with ischemic colitis(IC).Methods Clinical data of sixty-three IC patients with definite diagnosis from June 2002 to June 2012 in the PLA General Hospital were retrospectively analyzed.All patients were classified into ulcer group (23 cases) and non-ulcer group (40 cases) according to the presence of ulcer or not.Clinical manifestations and risk factors related to ulcer lesions were compared in the two groups.Logistic regression model was used for statistical analysis.Results There were 50 men and 13 women enrolled,with an average age of 70 years old.The main clinical manifestations included abdominal pain [85.7％ (54/63)],diarrhea [54.0％ (34/63)],hematochezia [41.3％ (26/63)].In comparison with non-ulcer group,the ulcer group showed higher incidences of chronic constipation[34.8％ (8/23)vs 12.5％ (5/40),P =0.03],enteric-coated aspirin intake [52.2％ (12/23) vs 25.0％ (10/40),P =0.03] and abdomen tenderness[82.6％ (19/23) vs 52.5％ (21/40),P =0.02].Chronic constipation and entericcoated aspirin intake were independent risk factors related to ulcer lesions (OR =3.38,P =0.04 ; OR =5.91,P =0.03).Patients with abdomen tenderness had higher incidence of ulcer lesion(OR =3.12,P =0.04).The most common location of IC was left colon[69.8％ (44/63)].No difference of site distribution was found in ulcer and non-ulcer group(P =0.066).Splanchnic atherosclerosis in the ulcer group was more common than in non-ulcer group [88.2％ (15/17) vs 58.3％ (14/24),P =0.038].The duration of hospitalization was significantly longer in ulcer group [(14.3 ± 7.1) d vs (6.2 ± 4.1) d,P ＜ 0.01].Higher white blood cell (WBC) count and lower hemoglobin (Hb) were seen in ulcer group than those in non-ulcer group [(10.17 ±3.32) × 109/L vs (7.25 ±3.15) × 109/L,P =0.018; (98 ±27)g/L vs (126 ±35)g/L,P=0.041].Conclusions Chronic constipation,enteric-coated aspirin intake and splanchnic atherosclerosis are risk factors related to ulcer in IC patients.Abdomen tenderness,high WBC and low Hb strongly indicate possible IC with ulcer.

Objective:To study the surface structure and antibacterial property of Ag-containing coating(AgCC)on casting cobalt chromium alloy(Co-Cr).Methods:Plasma spraying technique was adopted to prepare AgCC on Co-Cr.Scanning electron microsco-py,energy dispersive analysis and X-ray diffraction analysis were used to evaluate the surface properties.The antibacterial effects of AgCC against staphylococcus aureus and candida albicans were examined by film attachment method.Fluorescence microscope was a-dopted to evaluate the bacteria adhesion property.Results:AgCC surface was uniform and compact,combined perfectly with sub-strate material.The content of the surface was mainly Ag,Cr and a small amount of Ag2 O and Cr2 O3 .The results of antibacterial as-say showed that on AgCC the number of bacterial colony was fewer(P<0.05)and bacterial adhesion was less than those on Co-Cr(P<0.05).Conclusion:AgCC surface was stable and has antibacterial property.