Objective To explore the effectiveness and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treatment of C and D level of COPD in stable period .Methods According to the digital table,255 cases of C and D level in patients with stable COPD were randomly divided into the study group and control group,the patients in study group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day,and give tulobuterol patch(2mg/paste),one time every day.The control group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day.The changes of lung function were observed before and after treatment,the clinical symptom score and inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation condition.Results The patients in the two groups after treatment ,pulmonary function ,clinical symptoms score,inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation compared with statistical significance(all P<0.05).Subgroup analysis in study group ,emphysema phenotype visible persistent effect ,chronic bronchitis phenotype ,ACOS phenotype early effective treatment ,decreased efficacy after half a year .The adverse reac-tion of two groups of drugs were respectively 19.7%and 21.0%,there was no significant difference in the incidence of adverse reaction between the two groups (χ2 =0.071,P>0.05).Conclusion Tiotropium bromide inhalation agent with tulobuterol patch can improve clinical symptoms and pulmonary function in patients with C and D level part of the stable phase of COPD .

Callicarpa Linn.(beautyberry) is one of the major genera in Verbenaceae,about 20 of which are medicinal plants.Beautyberty,called Zizhu in China,is a generic name of those species and largely used as hemostatic medicine.The Chinese Pharmacopoeia 2010 has admitted three new crude drugs from the genus of Callicarpa Linn.including Callicarpae Macrophyllae Folium,Callicarpae Caulis et Folium,and Callicarpae Forraosanae Foliam for the first time since the 1977 version of the Chinese Pharmacopoeia.In order to better understand these new crude drugs,we systematically described their bibliography,admission reasons,botanical identification,chemistry,and pharmacology.Several other species,out of national regulations but intensively studied and widely used,are also covered in this review.

Objective To prepare a new-type acellular dermal matrix (ADM) and research on its relevant performance,which would provide theoretical evidence for clinical application.Methods Skin of Bama suckling pig was taken as resource of skin,and technologies of physics,chemistry and biology were selected to prepare new-type ADM.To detect the external structure,physical and chemical property as well as biological property of the prepared new-type ADM,hematoxylin-eosin (HE) staining observation,scanning electron microscope observation,amino acid analysis,material porosity and hydrophilicity test,tensile strength and in vitro degradation experiment,cytotoxicity test,and animal experiment have been conducted.Results New-type ADM cells have been thoroughly removed and dermal matrix remains intact with collagen content of 95.55％,connective three-dimensional pore structure,(85.03 ± O.99) ％ of porosity,(24.56 ± 0.57) ° of contact angle implying new-type ADM was hydrophilic substance,(5.48 ± 0.44) Pa of tensile strength implying its moderate level of pulling force,in vitro degradation period reduced to (28.7 ± O.76) h,and ＞75％ relative growth rate (RGR).Cells grew and proliferated on new-type ADM and could be replaced by original tissue after degradation.Conclusions New-type ADM have overcome disadvantages of traditional preparation method in sabotaging dermal matrix structure and incompletely removing cells from matrix,which is qualified with higher level of collagen content and porosity.With improved biological property,greatly reduced inflammation immunoreactions,and accelerated degradation rate,new-type ADM is of higher level of clinical application value.

Spontaneous isolated superior mesenteric artery dissection (SISMAD) is an uncommon but potentially catastrophic pathology. Multiple classification schemes have been proposed for this occurrence. Although no consensus has emerged regarding which classification should be used, Li's classification scheme is more precise and complete compared to other classification systems and can be used to guide the treatment of SISMAD. Initial conservative treatment is promising, with favorable early and long-term outcomes for most patients; endovascular treatment is recommended for patients with persistent/recurrent symptoms after conservative treatment; surgical treatment should be performed without delay for patients with arterial rupture, intestinal necrosis, or failed endovascular treatment.
Classification* ; Consensus ; Humans ; Mesenteric Artery, Superior* ; Necrosis ; Pathology ; Rupture

The prepared slices of Chinese crude drugs are growing important in recent years, and faced with new developments and opportunities. The author analyzed the importance of formulate national processing procedures of prepared slices of Chinese crude drugs combined actual work, proposed the overall objectives and tasks for the formulation, and emphasized to need to correctly deal with several important factors during the process of formulate "National processing procedures of prepared slices of Chinese crude drugs", unified the national standards of prepared slices, solved the real problems that the prepared slices of Chinese crude drugs industry faced.
Chemistry, Pharmaceutical ; methods ; standards ; China ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; methods ; standards

Pancreas arises from dorsal and ventral anlagen,and there is an embryological fusion plane between them.The embryological fusion plane can be discriminated by immunohistochemical staining for an anti-pancreatic polypeptide or computed tomography.The embryological fusion plane can not only guide the management of benign or low malignant potential tumors,but also determine the clinicopathological characteristics of pancreatic head cancer and patients'survival,and the embryological fusion plane plays an important role in the management of pancreatic disease.In this review,the research progressions and clinical significance in the embryological fusion plane of dorsal and ventral pancreas are described.

Objective:To investigate the effect of Astragaloside Ⅳ-mediated Endothelial progenitor cells derived exosomes (EPC-Exos) on the biological function of EPC-Exos damaged by high glicose.Methods:EPCs from human umbilical cord blood were isolated and cultured in vitro. the EPC-Exos secreted by EPCs were extracted by ultracentrifugation combined with ultrafiltration, and identified by specific markers CD9, CD63 and CD81, respectively. After the cells were cultured for 24 hours with AS-IV at 100 mg/L and PBS at the same volume, the morphological characteristics of EPC-Exos were observed by transmission electron microscope. Human endothelial cells were isolated, cultured and identified in vitro. The identified endothelial cells were pretreated with 30 mmol/L glucose for 120 h and randomly divided into experimental group and control group, at the same time set the normal group. The cells were cultured for 24 hours, the effects of EPC-Exos on proliferation, adhesion, migration and angiogenesis of endothelial cells damaged by high glucose were observed by using cell counting kit-8 (CCK-8) Cell Proliferation Assay Kit, cell scratch test, adhesion assay and in vitro angiogenesis assay by Matrigel. Results:Compared with the normal group, the proliferation, migration, adhesion and tubulogenesis of human endothelial cells in the control group were significantly lower ( t=24.35, 6.80, 10.65, 9.62, P<0.05). Compared with the control group, the proliferation, adhesion, migration and tubulogenesis of human endothelial cells in the experimental group were significantly enhanced ( t=30.68, 5.99, 5.40, 8.25, P<0.05). Conclusions:EPC-Exos mediated by AS-Ⅳ can significantly improve the biological function of human endothelial cells damaged by high glucose and has the potential to modulate endothelial neovascularization in diabetic rats.

Gallbladder-duodenal fistula is a rare disease in clinical practice, and difficult to diagnosis. One patient with high suspicion of gallbladder-duodenal fistula in preoperative examination was performed with percutaneous transhepatic gallbladder drainage due to could not tolerate surgical operation, and gallbladder-duodenal fistula was diagnosed with the gastric and intestinal fluids extracted from the drainage tube. In the later of fistula repair and the patient′s nutritional support management, the jejunal nutrition tube is inserted through the bile duct, and then the nutrition support was performed through this jejunal nutrition tube. This patients was recovered well.

AIM:To study the regulation of endoplasmic reticulum stress(ERS)using the glucose regulated protein 78(GRP78)/CCAAT/enhancer binding protein homologous protein(CHOP)pathway and explore the related mech-anism of Wenyang-Shengji ointment in facilitating the repair of diabetic refractory wounds.METHODS:To establish a rat model of diabetic refractory wound repair,Sprague-Dawley(SD)rats were fed a high-fat diet and intraperitoneally in-jected with streptozotocin.Subsequently,full-thickness skin defects were induced in the dorsal region of the rats.The ex-periment included 4 groups:normal,model(diabetic refractory wounds),Wenyang-Shengji ointment,and Beifuxin(re-combinant bovine basic fibroblast growth factor gel)groups.The normal and model groups were treated with normal saline after disinfection.In the Wenyang-Shengji ointment and Beifuxin groups,the wounds were topically treated with the re-spective ointments once daily.After 14 d of treatment,wound healing was assessed and quantified using the wound healing rate.Hematoxylin-eosin(HE)staining was employed to examine the micromorphology of the wound tissue.Western blot analysis was performed to measure GRP78,CHOP and caspase-12 levels in the wound tissue.Immunohistochemical analy-sis was used to detect the expression and distribution patterns of GRP78,CHOP and caspase-12 in the wounds.Transmis-sion electron microscopy was used to observe reticulum numbers and swelling.Enzyme-linked immunosorbent assay was used to determine interleukin-1β(IL-1β)level as a pro-inflammatory factor within the wound.RESULTS:Indexes of each group were assessed 14 d after the corresponding intervention.Compared with normal group,the rats in model group exhibited a significant decrease in the wound healing rate(P＜0.01),accompanied by increased inflammatory exudation and poor granulation tissue growth.Additionally,there were increases in the expression levels of GRP78,CHOP and cas-pase-12 proteins(P＜0.01),as well as a significant elevation in the content of inflammatory factor IL-1β(P＜0.01).In contrast,compared with model group,treatment with Wenyang-Shengji ointment resulted in a significant improvement in wound healing rate(P＜0.01),reduction in inflammatory exudation,and enhanced granulation tissue growth(P＜0.01).Furthermore,there was a notable decrease in the protein expression of GRP78/CHOP/caspase-12 within the wound tissue following treatment with Wenyang-Shengji ointment(P＜0.01).The levels of inflammatory factor IL-1β also showed a sig-nificant decrease(P＜0.01).CONCLUSION:Wenyang-Shengji promotes the healing of diabetic refractory wounds,which may be associated with the downregulation of the GRP78/CHOP pathway,inhibition of excessive ERS,and reduc-tion in the level of wound cell apoptosis.

Objective:To detect serum Col2-3/4 C-terminal cleavage product of type Ⅱ collagen (C2C) and pyridinoline (PYD) among brucellosis patients at early period, and to provide a better understanding of the changes of bone and joint collagen metabolism in the early stage of brucellosis.Methods:From 2013 to 2016, 61 cases of brucellosis patients at early period (within 6 months) from brucellosisout patient of Qinghai Institute for Endemic Disease Prevention and Control were selected as case group, and 67 cases of healthy volunteers were selected as control group. Serum C2C and PYD levels in all samples were measured simultaneously with enzyme linked immunosorbent assay (ELISA).Results:The median serum C2C of patients with early brucellosis was 83.45 ng/ml and that of the control group was 73.35 ng/ml. There was significant difference in serum C2C between the case group and the control group ( Z = 5.027, P < 0.05). The median serum PYD of patients with early brucellosis was 278.45 nmol/L and that of the control group was 212.75 nmol/L. There was significant difference in serum PYD between the case group and the control group ( Z = 6.967, P < 0.05). Conclusion:Serum C2C and PYD levels of brucellosis patients at early period are increased.