Thirty cases of rheumatoid arthritis were treated by the needle-warming method on bilateral Shenshu (BL 23), Zusanli (ST 36) and Quchi (LI 11), in combination with oral administration of Chinese herbal drugs, and 30 cases were treated by routine western medications for comparison.After treatment for three months, the effective rate was respectively 86.7% and 60.0% in the two groups and the difference of the therapeutic effect was statistically significant (P＜0.05).

BACKGROUND:Critical limb ischemia is difficult to be treated among the peripheral arterial occlusive diseases, and the application of transplanting autologous stem cells can bring a hope for the treatment of this disease.
OBJECTIVE: To review the autologous stem cells transplantation in the treatment of critical limb ischemia at present, and to study the mechanism and the existing problems.
METHODS:A computer retrieval of PubMed database, Wanfang database, and CNKI database was conducted to search the related articles with the keywords of“stem cell, transplant, critical limb ischemia”in English and Chinese. Final y, 47 articles were included in final analysis according to the inclusion criteria.
RESULTS AND CONCLUSION:Autologous stem cells transplantation for treatment of lower extremity ischemic disease is a latest and significantly effective treatment, but the mechanism is unclear and stil needs further study.

Objective To investigated the neuroprotective effect of PTEN inhibitor BPV on cerebral ischemia-reperfusion injury in rats and its mechanism. Methods Male Sprague-Dawley rats were used to induce a reperfusion model of middle cerebral artery occlusion for 1 h. During the reperfusion, the BPV solution (0. 2 mg/kg daily) or the equal volume of saline was injected intraperitonealy immediately. The neurological deficit scores were conducted at day 1, 3,5, and 7 after ischemia-reperfusion. At day 4, triphenyl tetrazolium chloride staining was used to assess cerebral infarction volume. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) in cortical ischemic border zones. Real-time quantitative polymerase chain reaction was used to detect the expression level of PTEN mRNA. Western blotting was used to detect the expression levels of PI3K, Akt, and p-GSK-3β. At day 7, Bielschowsky silver staining was used to detect the axonal distribution in the ischemic border zone of the striatum. Immunohistochemical staining was used to detect the expression of myelin basic protein (MBP). Results At day 4 after ischemia-reperfusion, the infarct volume (32. 27% ± 1. 71% vs. 45. 49% ± 2. 12% ; P < 0. 001), TNF-α concentration in the cortical ischemic border zones (134. 17 ± 10. 38 pg/ml vs. 264. 17 ± 24. 84 pg/ml; P < ), and PTEN mRNA level (1. 19 ± 0. 08 vs. 2. 50 ± 0. 06; P < 0. 001) in the rats of the BPV group were al significantly lower than those of the normal saline group. The IL-10 concentration (186. 83 ± 10. 83 pg/ml vs. 147. 83 ± 11. 62 pg/ml; P < 0. 001), and the expression levels of PI3K (0. 43 ± 0. 08 vs. 0. 26 ± 0. 06; P = 0. 004), Akt (0. 52 ± 0. 05 vs. 0. 40 ± 0. 04;P = 0. 001), and p-GSK-3β (0. 75 ± 0. 08 vs. 0. 38 ± 0. 06; P < 0. 001) were al significantly higher than those of the normal saline group. At day 7 after ischemia-reperfusion, the neurological deficit score (4. 83 ± 0. 41 vs. 6. 33 ± 0. 52; P < 0. 001) in the rats of the BPV group was significantly lower than that of the normal saline group. The axon densities in the ischemic border zones (35. 51% ± 2. 45% vs. 25. 31% ± 2. 79% ; P < 0. 001) and the expression level of MBP (32. 56% ± 3. 46% vs. 27. 81% ± 4. 18% ; P = 0. 037) were significantly higher than those of the normal saline group. Conclusions BPV has neuroprotective effect for cerebral ischemia-reperfusion injury in rats. Its mechanism may be associated with the up-regulation of PTEN downstream proteins PI3K, Akt and p-GSK-3β expression to regulate inflammatory mediators and reduce the inflammatory response.

The quality management of drug research,development,registration,production and marketing strengthened by good practice for pharmaceuticals ensure the drag safety,effectiveness and quality control.Teaching of new drug research and evaluation in compliance with good practice for pharmaceuticals will be of value in making teaching content close to actual work,extending the students'knowledge and training student's good habits in scientific study.

Objective To investigate the therapeutic effect of ipratropium bromide on bronchial spasm of patients with asthma and chronic obstructive pulmonary disease (COPD).Methods 174 patients with asthma and COPD were selected and divided into two groups, 87 cases in the control group treated with budesonide and formoterol fumarate powder for inhalation , 87 cases in the experimental group received ipratropium bromide on the basis of the control group, pulmonary ventilation function, airway resistance and cytokine levels in induced sputum, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(81.61%)was lower than the experimental group (93.11%), with significant difference (P<0.05); compared with the control group, levels of peak expiratory flow (PEF), maximum midexpiratory flow (MMEF), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), forced vital capacity (FVC) were higher in the experimental group after treatment, levels of airway resistance (Raw), Raw% were lower, level of specific airway conductance (Gsp) was higher after treatment, induced sputum levels of vascular endothelial growth factor (VEGF), intercellular adhesion molecular-1 (ICAM-1), interleukin-13 (IL-13), IL-17 were lower after treatment, with significant difference (P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The clinical effect of ipratropium bromide in the treatment of asthma and COPD was exactly , ipratropium bromide can significantly improve the pulmonary ventilation function in patients, relieve bronchial spasm, reduce airway resistance, inhibit airway inflammation, and the safety is higher.

OBJECTIVE:To investigate the role of clinical pharmacists in anti-infective treatment for the patient with septic shock. METHODS:Clinical pharmacists participated in anti-infective treatment for a patient with septic shock,assisted physicians to formulate individual regimen based on empirical anti-infective treatment,ESBLs producing Escherichia coli and anti-fungal treat-ment. Clinical pharmacists suggested using Itraconazole injection 200 mg,ivgtt,qd,for anti-fungal treatment;Itraconazole cap-sules 200 mg,po,bid,instead of fusidinic for anti-fungal treatment;meropenem 0.5 g,ivgtt,q6 h,for anti-infective treatment. RESULTS:Physicians adopted the suggestion of clinical pharmacists;the infection had been controlled after 16 d treatment and then the patient discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in clinical treatment,and assist phy-sicians to make a decision and formulate individual regimen,so as to promote rational drug use.

Objective To investigate the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome.Methods The data of 10 patients with central nervous system hemangioblastoma in our hospital since 2013 were analyzed retro-spectively,and the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome were summarized. Results The macroexamination result showed that most tumor lesions were found in the cerebellum and medulla oblongata,with cystic chan-ges,size from 1 cm to 5 cm,the average size was (3.1 ±0.2)cm,clear boundary,intracapsular yellow cyst fluid.The microscopy result showed tumor foci with a rich blood supply,endothelial cell proliferation and hypertrophy in vascular,which arranged in nests or lobulated mesenchymal cells,the cytoplasm of stromal cells was abundant and lightly stained,a rich lipid was seen,with vesicular or foam.Conclusion The von Hippel-Lindau syndrome is usually cystic lesion,the microscopic examination shows tumor foci with rich blood supply,endothelial cell proliferation,hypertrophy and other changes in vascular.

Objective To study the curative effect of combing montelukast with inhaled corticosteroids in the treatment of cough variant asthma .Methods According to diagnosis standard guideline for diagnosis and treatment of cough in CVA,84 cases of CVA patients were chosen and divided into the treatment group (n=42)and the control group(n=42).The control group were treated with inhaled corticosteroid Budesonide .The treatment group was given monelukast based on the treatment in control group .And the clinical effects of two groups ,recurrence and the lung function index were observed .Results The total efficiency of treatment of the control group was 73.8%,and the treatment group was 95.0%.The total effective rate of observation group was apparently higher than that of the control group(χ2 =6.46,P<0.05).The lung function of the treatment group compared to the control group was significantly increased(t=2.873,P<0.05).Conclusion Montelukast combined with Glucocorticoid in the treatment of CVA can effectively improve the cure rate ,reduce the recurrence ,which can be widely used in clinical treatment .

Objective To investigate the effect of calcium channel antagonist verapamil upon coronary vessel disease of allograft heart transplant rat model.Methods 160 SD rats weighing 220 to 300 g were randomly allocated to control group (group 1, n=40) and experiment groups (group 2, n=40; group 3, n=40, group 4, n=40). The hearts of all donor rats were implanted into the recipient rats. From the day after operation, the rats in each group were fed routinely and injected intraperitoneally (ip) with Cyclosporin (5 mg?kg~ -1?d~ -1 for 10 days). In experiment groups, the rats were individually injected (ip) with verapamil by 0.1 mg/kg,0.5 mg/kg,1.0 mg/kg twice every day for 3 months, but the rats in control group were not subjected to injection. At 60th and 90th day after grafting, 10 of each group were selected randomly and transplanted hearts were cut. The specimens were stained with HE and histochemistry.Result The degree of intimal hyperplasia in the control group was more severe than in the experiment groups.Conclusion Calcium channel antagonist verapamil can effectively inhibit the intimal hyperplasia of coronary arteries in heart transplant model.

[Objective]To study the evaluation method for total ankle replacement.[Method]According to anterior-posterior and lateral Xray films of ankle joint pre-and postoperatively,the level of osteotomy and method of bone grafting were confirmed and the correct position of total ankle replacement and its complication were evaluated.Forty-six cases of total ankle replacement were followed up 2~8 years and 4 months with average 5 years and 5 months.With author's radiographic evaluation method and Ko-foed's system,results of ankle function were evaluated.[Result]The foot dorsiflexion was 6?~16? and plantoflexion 8?~28?,movement range of foot dorsiflexion and plantoflexion was 14?~38?(average 21.4?).The function results showed excellent(85~100) in 32 ankles,good(75~84) in 9,and poor(60~74) in 2,no failure case.The complication included necrosis of incision border skin of 3 ankles and intraoperative fractures of both melleola of one ankle;no foot inversion and eversion,no radiographic loosenning were seen.[Conclusion]Radiological evaluation is a critical and useful measure to enhance the quality and function of total ankle replacement,to prevent and to early find its complications.