Objective To observe the changes in cytokines, oxygen free radicals, acidulous production in serum and to investigate the effectiveness of monitoring metabolism of cells and the method for evaluating cell injury in patients with severe trauma. Method The detailed data of 117 patients rescued and managed carefully from May 2005 to February 2007 were assessed and stratified with ISS and APACHE Ⅱ , and the serum levels of arterial blood lactate(ABL) ,base deficit(BD) ,superoxide(SOD) ,lipid peroxide(LPO) ,TNF-α and IL-6 were measured in real-time according to the condition of the patient. Results The monitoring biomarkers obviously changed with injury severity which endangered the situation of patients after trauma (P < 0.05) , especially in the patients with ischemia , hypoxia, shock, iniection, SIRS, and MODS (P < 0.01). The persistence of extremely elevated levels of biomarkers meant the organ failure and fatality of patients after trauma, and there was a obvious differece between those cases and cases without elevation of biomarkers ( P < 0.01). Conclusions The outcome of patients after trauma is closely correlated with injury severity,infection and MODS,and the levels of biomarkers including ABL, SOD, IPO, TNF-a and IL-6 are useful indicators of outcome measure.

Objective To evaluate the contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic renal insufficiency. Methods Correlation of CEUS indexes with glomerular filtration rate (GFR) detected by 99mTc-DTPA renography was examined. Thirty-three cases of clinical chronic renal insufficiency were enrolled in the study. They were 15 males and 18 females with average age of (43.33±6.78) years. After intravenous bolus injection of 1 ml SonoVue,CEUS of renal cortex blood perfusion was performed successfully, and a time-intensity curve (TIC)was created with PHILIPS iU22 system's QLAB software. A 148 to 222 MBq dose of 99mTc-DTPA was injected as a bolus from antecubital vein. Renal scintigraphic images were collected immediately and GFR was obtained. Results The significant correlation coefficients between GFR and CEUS quantitative indexes were as follows: rAUC (area under curve)=0.886 (P＜0.05), rA (slope rate of ascending curve, A) =0.804(P＜0.05). However, rDPI (derived peak intensity, DPI)=0.021 (P＞0.05), rTTP (time to peak, TTP) =0.043 (P＞0.05), rα (slope rate of descending curve,α)=0.039 (P＞0.05). Conclusion CEUS can precisely display the hemodynamic change of chronic renal insufficiency, which is well correlated with GFR by 99mTc-DTPA renography.

BACKGROUND:Posterior lamina resection often causes loss of spinal stability, so screw rod internal fixation technology is needed to maintain the stability of lumbar spine. Finite element analysis can be used to simulate the stress distribution of the spine and internal fixation system after spinal surgery. OBJECTIVE: To build three-dimensional finite element model of spinal L1 to L3, analyze the spinal stability and stress distribution after the total laminectomy and insertion of bilateral pedicle screw using finite element method. METHODS: L1-L3 CT data could be colected from an adult healthy male volunteer. Mimics14.01, 3-matic(V6.0) and Ansys 15.0 could be used to set up the intact lumbar spine finite element model of L1-L3 (group A), the L1-L3 finite element model after L2 total laminectomy (group B), and the finite element model of L2 total laminectomy and insertion of bilateral pedicle screw (group C). We used software to simulate flexion, extension, lateral bending and axial rotation, and three kinds of models received finite element analysis. RESULTS AND CONCLUSION: (1) Based on the maximum of Von Mises under different motion states, the maximum stress was significantly lower in group A than in group B (P< 0.05). The maximum stress was significantly lower in group B than in group C (P < 0.05). (2) Based on the total deformation under different motion states, the total deformation was significantly lower in group A than in group B (P < 0.05). The total deformation was significantly lower in group C than in groups A and B (P < 0.05). (3) After the total laminectomy, vertebral body stress increased, especialy in the lamina, pedicle and joints. The range of motion of the vertebral body increased, which influenced the stability of the vertebral body. Internal fixation could decrease range of motion. Stress concentrated on the screw. Stress on the vertebral plate and pedicle decreased. The stability of vertebral body increased. Excessive stress concentrated on screw system wil increase the risk of screw breakage.

Objective To explore serum caspase-3 activity in pulmonary tuberculosis patients.Methods 38 tuberculosis pa-tients in Infectious Disease Department in the First Affiliated Hospital of Guangxi Medical University were recruited and the peripheral venous blood was collected in December,2010.Among them,sputum smear-positive patients which were first treated were 13,sputum smear-negative patients which were first treated were 15,10 cases were drug resistance.In addition, 22 unrelated healthy individuals from a routine health survey were enrolled as controls.Spectrophotometry was used to de-tect serum caspase-3 activity in tuberculosis patients,which was absorbancy-A of 4-nitroaniline generated by caspase-3.Re-sults The activity of caspase-3 in sputum smear-positive patients,sputum smear-negative patients,drug resistance patients, and healthy controls were 37.15±5.06,50.38±6.29,45.32±3.32 and 23.89±2.29,respectively.The caspase-3 activity was significantly different from each other (F=10.68,P<0.01).Compared with the healthy controls,the caspase-3 activity in sputum smear-positive patients (q=3.51,P=0.016),sputum smear-negative patients (q=7.5,P<0.001),drug resist-ance patients (q=5.34,P=0.001)was significantly different.There was no statistical difference among sputum smear-posi-tive patients,sputum smear-negative patients and drug resistance pulmonary tuberculosis patients (P>0.05).In the same way,there was no significant difference in male/female ratio[χ2=0.38 (DL=3),P=0.94]and mean age (F=0.82,P=0.49)among the four group.Conclusion Caspase-3 closely associated with the development of tuberculosis occurrence, which might promote apoptosis of cells through the activation of caspase-3 and produce the body immune process of tubercu-losis.

Referring to ZHANG Xichun's experience in treating dysentery from cold-fire accumulation， the treatment of ulcerative colitis （UC） in this paper can be divided into three stages including cold-fire accumulation stage， excessive heat and putrid intestine stage， and healthy qi deficiency and pathogen lingering stage. For people with slippery and excess pulse in the cold-fire accumulation stage， Xiaochengqi Decoction （小承气汤） added with Baishao （Radix Paeoniae Alba） and Gancao （Radix et Rhizoma Glycyrrhizae） can be used for purgation， while those with deficient pulse， Huazhi Decoction （化滞汤） or Xieli Decoction （燮理汤） can be used. In the excessive heat and putrid intestine stage， Tongbian Baitouweng Decoction （通变白头翁汤） and Jiedu Shenghua Elixir （解毒生化丹） are suggested. In the healthy qi deficiency and pathogen lingering stage， it is advised to use Jiedu Shenghua Elixir added with Shanyao （Rhizoma Dioscoreae）， and Sanbao Porridge （三宝粥）. Additionally， the medication rules， dosage and administration characteristics of Huanglian （Rhizoma Coptidis）-Rougui （Cortex Cinnamomi）， Yadanzi （Fructus Bruceae）， Diyu （Radix Sanguisorbae）， Shanyao and Liuhuang （Sulphur） by ZHANG Xichun have been summarized with the help of modern pharmacological research， so as to provide new ideas for the treatment of UC by TCM.

OBJECTIVETo observe the therapeutic effect and mechanism of nux vomica total alkali gel (NVTAG) on adjuvants arthritis (AA) rats.

METHODSD rats were randomly divided into nine groups: the normal group, the AA model group, NVTAG high, middle and low-dose (25, 12.5, 6.25 mg x kg(-1)) groups and the Votalin control (diclofenac diethylamine emulgel, 50 mg x kg(-1)) group. Except for the normal group, the remaining groups were transcutaneously administered with 0.1 mL freund's adjuvant complete (FCA) for inflammation in left rear feet and then evenly treated with medicine and packed with oilpapers. The foot volume method was adopted to determine foot swelling degree, with pain scoring and polyarthritis scoring. HE staining was used to observe arthro-pathologic injury. The content of prostaglandin E2 (PGE2), interleukin-1 (IL-1), IL-6, tumor necrosis factor (TNF-alpha) and vascular epidermal growth factor (VEGF) in synovium homogenates were measured by enzyme-linked immuno-absorbent assay (ELISA) respectively.

RESULTCompared with the model group, NVTAG and control gel can obviously reduce the foot swelling degree, polyarthritis indicators and relieve arthro-pathologic injury in AA rats (17-21 d). The levels of IL-1, PGE2, IL-6, VEGF and TNF-alpha in synovial homogenates of AA rats were also reduced by NVTAG significantly.

CONCLUSIONNVTAG shows an antergic effect on AA progress in rats, which is closely related to inhibition of development of inflammatory mediator.

Alkalies ; Animals ; Arthritis, Experimental ; drug therapy ; immunology ; pathology ; Cytokines ; analysis ; Gels ; Male ; Phytotherapy ; Rats ; Rats, Wistar ; Strychnos nux-vomica

OBJECTIVETo observe the therapeutic effect of TCM syndrome-typing based therapy (TCM-STBT) combined with cyclosporin on myelodysplastic syndrome (MDS) and investigate the correlation of efficacy with TCM syndrome type and MDS type.

METHODSFifty-eight MDS patients were classified into refractory anemia (RA) and RA with excess blast (RAEB) by FAB standard and randomly divided into the cyclosporin group (the treated group) and the alltransretinoic acid group (the control group), and both were subjected to STBT additionally. The therapeutic effect and changes of peripheral hemogram were observed and compared.

RESULTSThe total effective rate and the total remission rate was 73% and 33% in the treated group, higher than that in the control group (39% and 0) respectively. Hemoglobin level, white blood cell and blood platelet count increased significantly in the treated group after treatment (P < 0.05), while only hemoglobin level rose obviously in the control group (P < 0.05). The total effective rate and markedly effective rate in patients with qi-blood deficiency syndrome type were higher than those with other syndrome types.

CONCLUSIONTCM-STBT combined with cyclosporin has good efficacy in treating MDS and there is well correlation between the therapeutic efficacy and type of TCM syndrome or of MDS, indicating the STBT is necessory for TCM therapy.

Adult ; Aged ; Cyclosporine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; Phytotherapy ; Treatment Outcome

Chinese arsenic drugs have been applied in Chinese medicine for several centuries. Beginning from 1970s, arsenic containing drugs have been generally used for the treatment of malignant hematologic diseases including acute promyelocytic leukemia, myelodysplastic syndrome, and multiple myeloma. No matter what ingredients of arsenic drugs were applied, either arsenic trioxide, arsenic disulfide, or arsenic containing Chinese herbal compositions including Qinghuang Powder and Realgar-Indigo naturalis formula, they all provided the distinct approaches for the management of malignant hematologic diseases, and good clinical efficacy was obtained with mild adverse reactions. Moreover, the mechanisms of action have been continually elucidated.
Arsenicals ; therapeutic use ; China ; Drugs, Chinese Herbal ; therapeutic use ; Hematologic Neoplasms ; drug therapy ; Humans ; Oxides ; therapeutic use

OBJECTIVETo observe the clinical efficacy of Qinghuang Powder combined with Chinese herbs for reinforcing Shen and strenghening Pi in treating myelodysplastic syndrome (MDS).

METHODSfifty-five patients with diagnosis fitting to MDS were treated with Qinghuang Powder and decoction for strengthening Pi and reinforcing Shen, in combination with Stanozololum.

RESULTSEleven patients (20.0%) out of the 55 were completely remitted (CR), the total effective rate being 74.5% (41/55 cases). By FAB typing, 9 (26. 5%) in the 34 patients of type RA/RAS were CR, with the total effective rate of 82.4% (28/34 cases), and in the 21 patients of type RAEB, 9.5% (2/21 cases) were CR with the total effective rate of 61.9% (13/21 cases), showing insignificant statistical difference between the two types (P > 0.05). By international prognostic scoring system (IPSS), the treatment was evaluated as CR in 10 patients, effective in 25 and ineffective in 11 in 36 patients of moderate risk group I , the responding numbers were 1, 4, 2 in 7 patients of moderate risk group II and 0, 3, 3 in 6 patients of high risk group, respectively, also showing insignificant difference between groups (P > 0.05). Levels of Hb, WBC and platelet significantly increased after treatment (P < 0. 05). By cytogenetics, the effective rate was 68.8% (11/16 cases) in patients with abnormal chromosome and 72.7% (24/33 cases) in those with normal chromosome, with insignificant difference (P > 0.05).

CONCLUSIONThe comprehensive therapy with TCM treatment for reinforcing Shen and dissolving stasis in dominance has a definite clinical effect in treating MDS, it was not significantly associated with FAB typing, IPSS score, and chromosome abnormality of patients.

Adolescent ; Adult ; Aged ; Anemia, Refractory ; drug therapy ; Arsenicals ; therapeutic use ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; drug therapy ; physiopathology ; Phytotherapy ; Stanozolol ; therapeutic use ; Treatment Outcome ; Young Adult

Atherosclerosis is a vascular disease characterized by arterial occlusion formed by the pathological accumulation of pathological vascular cells and apoptotic cell debris. Atherosclerotic vulnerable plaque is an important pathological basis for inducing severe thrombotic cardiovascular events， and the study of its etiology and pathogenesis has always been a hot issue in the field of cardiovascular research. Efferocytosis is a new type of programmed death cell removal， which refers to the process of macrophages phagocytosing and degrading apoptotic cells to prevent secondary necrosis. It is a key homeostatic mechanism in the body's physiological process. In the pathological state， the dysfunction of efferocytosis causes the pathological accumulation of apoptotic cells and necrotic debris， leading to the occurrence of secondary cell necrosis and the continuous release of intracellular toxic content and inducing inflammatory regression disorders and cholesterol metabolism disorders， which are closely related to the occurrence and development of atherosclerotic vulnerable plaques. The theory of ''blood stasis and toxin'' is an important theory of traditional Chinese medicine （TCM） to explain the occurrence and development of atherosclerosis. Atherosclerosis starts from the pathological state of blood stagnation. Prolonged blood stagnation leads to blood stasis and toxic substances. Blood stasis and toxic pathogens interact with each other in blood vessels and eventually form plaques in blood vessels. The theory of ''blood stasis and toxin causing a catastrophe'' is an important understanding of the occurrence and development of acute cardiovascular events. From the perspective of TCM theory， the pathophysiological mechanism of efferocytosis is similar to the etiology and pathogenesis of the ''blood stasis and toxin'' in TCM. Therefore， this paper took the theory of ''blood stasis and toxin'' as the breakthrough point to explore the mechanism of efferocytosis in atherosclerotic vulnerable plaques， and proposed a detoxification and blood circulation method to regulate cell burial to prevent and treat atherosclerotic vulnerable plaques. The research strategy aims to provide new ideas and theoretical basis for the prevention and treatment of atherosclerosis by detoxification and blood circulation.