The recipe-analgesic compound decoction composed of herbs according to the theory of Traditional Chinese Medicine and the author's clinical experience of treating painful diseases. The experimental studies showed that the pain threshold of mice in hot-plate test was raised (p

Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were compared in 299 cases,including DEF group 44 cases and early feeding group 255 cases,in which cure or improvement were achieved and hospital stay ＞ 14 d.The perinatal risk factors were subjected to univariate and multivariate logistic regression analysis.Results The incidence of DEF was 16.05％ (57/355) in VLBWI.The time to regain birth weight in DEF group was significantly longer than early feeding group [(11.86 ± 3.86) d vs (9.76 ± 3.83) d,P ＜ 0.01],and the incidences of parenteral nutrition associated cholestasis [27.27％ (12/44)] and extrauterine growth retardation at discharge [79.55 ％ (35/44)] in DEF group were also significantly higher than early feeding group respectively [11.76％ (30/255) and 61.57％ (157/255),P ＜ 0.05].Multivariable logistic regression analysis showed that infants born to mother with placental abruption had higher risk of exposure for DEF than those without placental abruption (OR =2.74,95％ CI 1.06 ～7.05,P ＜ 0.05).Similarly,infants with mechanical ventilation had also higher odds of DEF than those with-out mechanical ventilation (OR =3.51,95 ％ CI 1.92 ～ 6.42,P ＜ 0.01).Conclusion Placental abruption and mechanical ventilation are independent risk factors for DEF in VLBWI.Improving neonatal outcome through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to reduce DEF in VLBWI.

BACKGROUND: It is manifested in epidemiology and clinical observation that lipoprotein (a) is a new risk factor of cerebrovascular disease and is closely related to cerebral ischemic stroke.OBJECTIVE: To discuss the relationship between levels of high serum lipoprotein (a) and stroke.DESIGN: Case controlled analysis.SETTING: Neurological Institute of Xiangya Hospital of Central South University.METHODS: Totally 294 patients with stroke were selected from Neurological Department of Xiangya Hospital of Central So, uth University between September 1999 and March 2002. Of them, 159 cases were regarded as cerebral infarction group and other 135 cases as acute hypertensive cerebral hemorrhage group. In cerebral infarction group, 109 patients had atherosclerotic cerebral infarction and 50 patients had lacunar cerebral infarction, and 94patients with contimuous health examination were regarded as health examination group. Serum lipoprotein (a) in each group was assayed with "sandwich enzyme-linked immuno-sorbent assay". According to whether the value of lipid was normal or not, patients with atherosclerotic cerebral infarction and acute hypertensive cerebral hemorrhage were divided into two groups. Comparisons between the two groups were assayed with single sample t test, and multiple liner regression was used to assay whether sex, hypertension and value of lipid were related to the level of serum lipoprotein (a).MAIN OUTCOME MEASURES: ① Comparisons of serum lipoprotein (a)among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group. ② Correlated analysis between serum lipoprotein (a) and lipid.RESULTS: Among 294 patients, 94 cases in control group entered the final analysis. ① Comparisons of serum lipoprotein (a) among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group: Levels of serum lipoprotein (a) in atherosclerotic cerebral infarction group and cerebral hemorrhage group were higher than those in health control group (P ＜ 0.05), and concentration of lipoprotein (a) in atheroosclerotic cerebral infarction group was increased as compared with that in acute hypertensive cerebral hemorrhage group (P ＜ 0.05). Also, level of lipoprotein (a) in lacunar cerebral infarction group was a little higher than that in control group,but the difference was not significant (P ＞ 0.05). ② Correlated analysis between serum lipoprotein (a) and lipid: Levels of lipoprotein (a) in both normal lipid group and abnormal lipid group were assayed with single sample t test, and the results showed that levels in the two groups were similar (P ＞ 0.05). Multiple liner regression was used to assay whether sex,hypertension and value of lipid were related to level of serum lipoprotein (a).CONCLUSION: Levels of lipoprotein (a) may be an independent risk factor for cerebral hemorrhage and atherosclerotic cerebral infarction.

Objective To investigate the short- and mid-term outcomes of after off-pump coronary artery bypass grafting (OPCABG) in patients with severe elevation of preoperative serum creatinine levels (SEPSC). Methods The perioperative data of SEPSC patients undergoing OPCABG were investigated based on the perioperative CABG database from Feb. 2012 to Jul. 2016. The patients were also followed up for the perioperative complication, short and medium-term survival were estimated. Results The mean age of the patients was 65.4(45-85) years. The in-hospital mortality was 4.4% and the CRRT rate was 19.6%(9 case). Survival analyses revealed a survival ratio of 100% at one year, 97.6% at two years. Short-Form Mini Nutritional Assessment was used to show that 13(28.3%) patients had malnutrition. Conclusions SEPSC patients can be candidates for OPCABG procedure. The mortality in hospital and 2-year survival rate of SEPSC patients after OPCABG procedure are both considered within an acceptable range. OPCABG may be performed in these patients with a satisfactory survival rate with the development of surgical instruments and medical treatment.

Objective To analyze risk factors of continuous renal replacement therapy (CRRT) in patients with severe serum creatinine levels elevation undergoing off-pump coronary artery bypass grafting (OPCABG).Methods The perioperative data of 45 patients with severe elevation of preoperative serum creatinine levels undergoing OPCABG were investigated based on the perioperative CABG database from Feb, 2012 to Jul, 2016.The postoperative treatment rates of CRRT were recorded and the risk factors were identified by multivariate logistic regressions.Results There were 9 patients (20%) who suffered from CRRT after OPCABG in all 45 recruitment patients.Compared with non-CRRT patients, there were higher levels of serum creatinine (Cr) and blood urea nitrogen (BUN) before surgery, a lower volume of urine during surgery, a higher level of serum creatinine at postoperative 12 hour and 24 hour, longer ICU staying time and higher in-hospital mortality after surgery in patients with CRRT (P＜0.05 or P＜0.01).Multivariate logistic regression analysis demonstrated that preoperative level of serum creatinine (OR=1.05, 95% CI 1.05-1.10, P=0.046) was the independent risk factor of postoperative CRRT in patients with severe serum creatinine levels elevation undergoing OPCABG.At the value of postoperative 12 hour serum creatinine up to 166 μmol/L, the incidence of postoperative CRRT in patients increased 5% by postoperative 12 hour serum creatinine increasing 1 μmol/L(OR=1.05, 95% CI 1.01-1.08, P=0.013).However at the value of postoperative 12 hour serum creatinine above 350 μmol/L, ceiling effect was apparent.Conclusion This study shows that 20% patients with preoperative severe serum creatinine level elevation are suffered from CRRT after OPCABG procedure and preoperative level of serum creatinine is predominant factor of postoperative CRRT.

BACKGROUND: Alginic sodium diester (ASD) possesses neuroprotective function because of its selective calcium antagonist effects.OBJECTIVE: To compare the influences of ASD on intraneuronal Ca2+content and nerve cell apoptosis before and after reperfusion in focal cerebral ischemic rats.DESIGN: Randomized controlled observation.SETTING: Neurological Department of Xiangya Hospital Affiliated to South China University; Laser Orthopedic Surgery of the First Hospital Affiliated to Southern China University.MATERIALS: This experiment was carried out between November 2003and April 2004 at the Neurological Department of Xiangya Hospital Affiliated to South China University. A total of 65 male SD rats were recruited and randomized into 6 groups; 17 got lost during the experiment, and the other 48 rats completed the experiment with 8 rats in each group.METHODS: In sham operation group, an incision was made on rats' cervical skin and sutured. Right cerebral middle artery was occluded in rats of ischemic group, ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group, and ASD 10 mg/kg postischemic group. After that, rats in all but ischemic group were subjected to intraperitoneal injection of various dosage of ASD or excipient 30minutes before reperfusion and 5 hours after reperfusion. FCM was used to determine intraneuronal Ca2+ content and rate of nerve cell apoptosis;meanwhile, neurological dysfunction was scored.MAIN OUTCOME MEASURES: [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia. [2]Correlation of behavioral obstacle score with intraneuronal Ca2+ fluorescence intensity and neuronal apoptosis in rats with right cerebral middle artery ischemia.RESULTS: Totally 65 rats were enrolled in this study, 17 of which got lost and the other 48 rats entered the result analysis. [1] Influence of ASD on the score for neurological dysfunction, intraneuronal Ca2+ fluorescence intensity, and neuronal apoptosis in rats with right cerebral middle artery ischemia: The score was obviously reduced in ASD 5 mg/kg preischemic group, ASD 5 mg/kg postischemic group, ASD 10 mg/kg preischemic group and ASD 10 mg/kg postischemic group as compared with ischemic group (1.80±0.21, 2.20±0.23, 1.20±0.11, 2.00±0.22, 3.40±0.65); moreover,functional improvement was more obvious due to pre-reperfusional administration than post-reperfusional administration. Intraneuronal Ca2+ concentration was reduced after ASD administration at different degrees and lower than that of ischemic group. Decrement of intraneuronal Ca2+ concentration was found most obvious due to 10 mg/kg ASD administration 30 minutes before reperfusion, approximately reduced by 70%; moreover, neuronal apoptosis rate on the ischemic side was obviously suppressed by ASD administration, displaying time-dependent manner, with apoptotic suppression effect more obvious in pre-reperfusional group than in post-reperfusional group (5.68%, 10.03%; 4.00%, 9.91%). [2] Correlation of behavioral obstacle score of right cerebral middle artery ischemic rats with intraneuronal Ca2+ fluorescence intensity and membrane associated protein/propidium iodide apoptosis: Obvious positive correlation was found between behavioral obstacle score and intraneuronal Ca2+ fluorescence intensity and detection rate of membrane associated protein/propidium iodide apoptosis (r=0.51,0.62, P ＜ 0.05); intraneuronal Ca2+ fluorescence intensity was also positively correlated with the detection rate of membrane associated protein/propidium iodide apoptosis (r=0.84, P ＜ 0.05).CONCLUSION: [1] ASD can exert anti-apoptosis effect by suppressing the increment of intraneuronal Ca2+ concentration, thus having neuroprotective function and ultimately improving neurological dysfunction. [2] Its effect displays time-dependent manner, and neurological functional improvement is more obvious by pre-reperfusional administration than by post-operational administration.

Tetrandrinehasawiderangeofpharmacologicaleffectssuchasanti-inflammation,analgesiceffect,anti-tumor,anti-silicosis, lowering blood pressure and anti-arrhythmia. Up till now, only tablets and ordinary injections are on the market, which is hard to meet the clinical requirements. The paper reviewed the research progress in the new technology and dosage forms of tetrandrine to provide the basis for new dosage form development of tetrandrine.

Background and purpose:A large number of studies have showed that retinoblastoma gene 1 (RB1) can inhibit the occurrence and development of many tumors, including neuroblastoma, small cell lung cancer, osteosar-coma, pancreatic cancer, breast cancer and so on. RB1 is also closely related to the regulation of cell cycle, differentia-tion, senescence, apoptosis, growth inhibition, etc. The goal of this article is to elucidate whether miR-222 promotes cell proliferation and invasion by targeting RB1, further to explore the molecular mechanism that miR-222 functions as an oncogene in retinoblastoma cells.Methods:miR-222 (miR-222 mimics) and RB1-wt, miR-NC and RB1-wt, miR-222 and RB1-mut, miR-NC (a controlled miR-222 mimics) and RB1-mut were co-transfected into Y79 cells, and luciferase activity was detected by single photon. Retinoblastoma cells were transfected with miR-222 mimics and miR-NC, and the expressions of RB1 protein were detected by Western blot. Retinoblastoma cell proliferation assays were performed by MTS assay when miR-222, miR-NC, RB1 (pcDNA3.1-RB1), vector (pcDNA3.1), miR-222+RB1 and miR-NC+vec-tor were transfected into Y79 cells. The growth and invasion ability of Y79 cells with ectopic expression of miR-222 were evaluated by MTS and Transwell invasion assays.Results:This study demonstrated that miR-222 could promote the luciferase activity of RB1-wt. The expression levels of luciferase reporter gene activity in Y79 cells after transfection with miR-222+RB1-wt were higher than those in the negative control cells (miR-NC+RB1-wt) (P<0.05). The protein expression levels of RB1 in Y79 cells after transfection with miR-222 were lower than those in miR-NC (P<0.05). Overexpression of RB1 inhibited the proliferation of retinoblastoma cells. miR-222 promoted the prolifera-tion of retinoblastoma cells through targeting RB1 (P<0.05). Moreover, there was no signiifcant difference between the cell survival rates of Y79 which were transfected with miR-222+pcDNA3.1-RB1 and miR-NC+pcDNA3.1 (P>0.05). After transfection with miR-222 mimics for 48 h, Transwell invasion assay showed that the number of cells through the basement membrane was (193±10). Compared with the control group (144±11), it could signiifcantly accelerate the invasion of Y79 cells (P<0.01). There was no signiifcant difference between the number of cells through the basement membrane which were transfected with miR-222+pcDNA3.1-RB1 and miR-NC+pcDNA3.1 (P>0.05).Conclusion:miR-222 promotes cell proliferation and invasion by targeting RB1 expression in retinoblastoma cells.

Objective To compare postoperative complications between endoscopic thyroidectomy via breast areola approach and open thyroidectomy.Methods From June 2011 to June 2014,475 patients underwent thyroidectomy.Patients were divided into traditional open group (251 cases) and endoscopic thyroidcctomy group (224 cases).Postoperative complications were recorded and compared.Results All operations were successfully completed.There was no case in endoscopic thyroidectomy group converted to traditional open surgery.There was no serious postoperative complication occurred,including injury to trachea,mediastinal emphysema,intraoperative massive hemorrhage and cardiopulmonary accidents.The difference of postoperative complication between two groups had no statistical significance (all P ＞0.05) as to permanent recurrent laryngeal nerve injury,Homer syndrome,permanent hypoparathyroidism,chyle leakage,postoperative hemorrhage and infection of incision.However,postoperative ecchymosis was more often in endo group (P ＜0.05).Conclusions Compared to traditional open thyroidectomy,endoscopic thyroidectomy via breast areola approach has significant cosmetic advantages without increasing the incidence of major postoperative complications.

Objective To study the constituents in water-extracts from Flos Lonicerae. Methods Compounds were isolated and purified by using various column chromatography such as D101, Sephadex LH-20, and silica gel, etc. Their structures were identified on the basis of physical and spectral data. Results Seven secoiridoid glycosides were obtained and identified as vogeloside (Ⅰ), 7-epi-vogeloside (Ⅱ), secologanic acid (Ⅲ), sweroside (Ⅳ), secoxyloganin (Ⅴ), secologanoside (Ⅵ), (E)-aldosecologanin (Ⅶ). Conclusion Among them, compounds Ⅲ and Ⅵ are firstly obtained from the plants in Lonicera L. The structure of compound Ⅶ is rare in nature so far.