Objective To investigate the effect of continuous veno-venous hemofiltration (CVVH) on the peripheral blood levels of high mobility group box chromosomal protein 1 (HMGB-1) in patients with systemic inflammatory response syndrome (SIRS) or sepsis.Methods Thirty patients with SIRS or sepsis in Intensive Care Unit of our hospital were scheduled for treatment of CVVH.The replacement liquid was put in by the pattern of pre-dilution of 40％ and post-dilution of 60％.The flow-rate was 3 L/h.The blood flow-rate was from 200 to 300 ml/min.5 ml blood from right radial artery was got at the time points of preCVVH,CVVH 2 h,6 h,8 h and post-CVVH 12 h and the serum was stored at the temperature of-20 ℃ after high speed centrifugation,and 2 ml filter liquor was reserved at the time point of CVVH 6 h.The concentration of serum and filter liquor HMGB-1 was measured by ELISA,but that of TNF-α and IL-6 were measured by radioimmunity.Results 30 patients adept CVVH therapy within 24 h to the hospital,and their therapy time was 2 ～ 5(2.4 ± 1.5) d.Among them,17 cases survived and 13 cases died with a fatality rate of 43.3％.Serum concentration of HMGB-1 decreased from the baseline in patients,although this decrease was not statistically significant[(11.88 ± 6.06) ng/ml,(11.97 ± 5.66) ng/ml,(11.94 ± 5.94) ng/ml,(11.73 ± 5.19) ng/ml vs (13.87 ± 4.68) ng/ml,P ＞ 0.05],Serum concentration of both TNF-αand IL-6 after therapy significantly decreased compared to the baseline in patients [TNF-α: (0.28 ± 0.15)ng/ml,(0.30 ± 0.14) ng/ml,(0.29 ± 0.19) ng/ml,(0.33 ± 0.19) ng/ml vs (0.41 ± 0.12) ng/ml,IL-6:(408.20 ±92.18)pg/ml,(250.51 ± 107.34)pg/ml,(276.00 ± 126.20) pg/ml,(315.16 ± 130.97) pg/ml vs (513.35 ± 125.95) pg/ml,P ＜ 0.05].Conclusions CVVH could decrease the concentration of HMGB-1 in peripheral blood,which would be one of the mechanisms of action for CVVH on sepsis.

Objective To evaluate the effect of hydrogen-rich saline on the expression of phosphor-p38 mitogen-activated protein kinase (p-p38MAPK) during cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =20 each) using a random number table:sham operation group (group S),I/R group and hydrogen-rich saline group (group I/RH).Cerebral ischemia was induced in chloral hydrate-anesthetized rats by 2 h middle cerebral artery occlusion in I/R and I/RH groups.The artery was only exposed but not occluded in group S.At 3 days before operation and immediately after onset of reperfusion,hydrogen-rich saline (0.6 mmol/L) 10 ml/kg was intraperitoneally injected in group I/RH,while the equal volume of normal saline was given in S and I/R groups.Neurological deficits were blindly assessed and scored at the end of 24 h reperfusion.The animals were then sacrificed,and brains were removed for microscopic examination and for determination of the cerebral infarct size (by TTC),brain water content,cell apoptosis (by TUNEL),and expression of p38MAPk and phosphor-p38MAPK (p-p38MAPK) (by immunohistochemistry and Western blot).Apoptosis index was calculated.Results Compared with group S,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly increased,and the expression of p38MAPK and p-p38MAPK was up-regulated in I/R and I/RH groups.Compared with group I/R,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly decreased,and the expression of p38MAPK and p-p38MAPK was down-regulated in group I/RH.The pathological changes of cerebral tissues were significantly attenuated in group I/RH as compared with group I/R.Conclusion Hydrogen-rich saline can reduce cell apoptosis through inhibiting p-p38MAPK expression,thus attenuating cerebral I/R injury in rats.

Objective To evaluate the effect of hydrogen on the activation of caspase-3 in brain tissues during cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy adult male Sprague-Dawley rats,weighing 220-250 g,were divided into 3 groups (n=12 each) using a random number table:sham operation (group S),I/R group and hydrogen group (group H).Cerebral ischemia was induced by occlusion of the middle cerebral artery followed by reperfusion in I/R and H groups.In group H,hydrogen-rich saline 5 ml/kg (0.6 mmol/L) was injected intraperitoneally at 3 days before establishment of the model and immediately after the onset of reperfusion.At 24 h of reperfusion,the rats were sacrificed,and hippocampal tissues were obtained for determination of neuroapoptosis (by TUNEL),apoptotic neuron count and expression of activated caspase-3 (by Western blot).The brain tissues in the ischemic area were obtained and stained with haematoxylin and eosin for examination of the pathological changes.Results Compared with group S,the expression of activated caspase-3 was significantly up-regulated,and the apoptotic neuron count was increased in I/R and H groups (P<0.05).Compared with group I/R,the expression of activated caspase-3 was significantly down-regulated,the apoptotic neuron count was decreased (P<0.05),and the pathological changes of brain tissues were significantly reduced in group H.Conclusion The mechanism by which hydrogen inhibits neuroapoptosis during cerebral I/R is probably related to inhibited activation of caspase-3 in brain tissues of rats.

Objective To explore the curative efficacy of astragalus injection on blood lipids and bone mineral density in patients with hemiplegia after ischemic stroke. Methods From January, 2014 to June, 2015, 116 patients with hemiplegia after ischemic stroke were col-lected and radomly divided into control group (n=54) and observation group (n=62). The control group received acupuncture based on con-ventional treatments, while the observation group received astragalus injection in addition. National Institutes of Health Stroke Scale (NI-HSS) and Ability of Daily Living Scale (ADL) were used to assess the neurologic impairment and the ability of daily living. The curative ef-ficacy and the levels of blood lipids and bone mineral density were observed. Results Compared with the control group, the curative efficien-cy increased (χ2=3.960, P<0.05). The score of NIHSS decreased (t=3.490, P=0.001), and the score of ADL increased (t=2.820, P=0.006). The levels of total cholesterol, triglyceride, low density lipoprotein cholesterol significantly decreased (t>4.190, P<0.001), however, the lev-el of high density lipoprotein cholesterol did not change (P>0.05). The densities in forearm, femur and Ward's area in the hemiplegia side in-creased (t>2.060, P<0.05). Conclusion Astragalus injection is effective on hemiplegia after ischemic stroke, which can increase the curative efficacy, alleviate the neurologic impairment, promote the ability of daily living, improve the blood lipids and increase the bone mineral den-sity.

ObjectiveTo observe the effect of donor liver pretreated by breviscapine on liver transplantation ischemia/reperfusion injury in rats. Methods SD rats served as liver donors and recipients (n =48 each).The recipients were divided into four groups by random number table.The donors in groups A and C were not pretreated with breviscapine,but those in groups B and D were pretreated with 20 mg/L Breviscapine.The cold ischemia time in donor livers of groups A and B was 30-40 min,and that in groups C and D was 12 h. Clotting function, liver function, serum thrombomodulin,caspase3,and relative activity of NF-kB after liver transplantation were assessed,and the pathological changes and TUNEL apoptosis staining were observed.ResultsThe mortality in groups C and D was 40.0％ (8/20) and 29.4％ (5/17),respectively (P＞0.05).There were no significant changes in coagulation function in all groups after operation. The liver function was improved,pathological lesions were alleviated,and apoptosis rate,serum TM,caspase3 expression and activity of NF-kB in the liver tissues of group D were significantly decreased as compared with group C at 3rd day after operation (P＜0.01),but all these parameters in group B had no significant change compared to group A.ConclusionPretreatment of donor livers with breviscapine can reduce the ischemia/reperfusion injury and apoptosis after liver transplantation in rats probably by inhibiting the apoptosis-related pathway and alleviating the damage to the endothelial cells of the liver microcirculation.

Objective Ventriculoperitoneal shunt (VPS)is preferable in treatment for normal pressure hydrocephalus (NPH). In this study, the factors related to the motor recovery after VPS were analysed.Method Twenty-six patients were treated with VPS, and four factors, that are duration of symptoms, open lumbar puncture(LP) pressure, improvement after LP ,and motor recovery of twelve months after operation,were assessed. Results Twelve months after VPS, the better motor recovery after VPS was related to shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP. Conclusion The patients with shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP are often responsive to VPS.

Objective To evaluate the effect of hydrogen-rich saline on inflammatory responses during transient cerebral ischemia-reperfusion (I/R) in rats.Methods Forty-five male Sprague-Dawley rats,aged 5-6 yr,weighing 180-250 g,were randomly divided into 3 groups (n =15 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H).The rats were anesthetized with intraperitoneal 10％ chloral hydrate 0.3 ml/100 g.Transient cerebral ischemia was induced by bilateral common carotid artery occlusion with hypotension for 15 min,followed by reperfusion.Five rats were randomly chosen from each group,and Morris water maze was used to assess the cognitive function starting from 5 days before establishment of the model.Place navigation test lasted for 5 consecutive days.The escape latency,swimming speed and swimming distance were recorded.Spatial probe test was carried out on 1 and 3 days after establishment of the model.The time of staying at the target platform quadrant,frequency of crossing the original platform and swimming speed were recorded.The rats were sacrificed after the end of spatial probe test on 3 days after the model was established,and hippocampi were removed to examine the morphology of neurons in hippocampal CA1 region with light microscope.Five rats randomly chosen from each group were sacrificed on 1 day after the model was established,and hippocampi were removed to detect the contents of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β).The rest 5 rats in each group were sacrificed,and hippocampi were removed for determination of nuclear factor kappa B (NF-κB) activity (by immuno-histochemistry).Results In place navigation test before the model was established,the escape latency and swimming distance were gradually shortened with the prolonging training time,and no significant change was found in the swimming speed with the prolonging training time in the three groups.Compared with group S,the time of staying at the target platform quadrant was significantly shortened,and the frequency of crossing the original platform was reduced on 1 and 3 days after establishment of the model,and the contents of TNF-α and IL-1β and NF-κB activity were increased on 1 day after establishment of the model in group I/R.Compared with group I/R,the time of staying at the target platform quadrant was significantly prolonged,and the frequency of crossing the original platform was increased on 1 and 3 days after establishment of the model,and the contents of TNF-α and IL-1β and NF-κB activity were decreased on 1 day after establishment of the model in group H.There was no significant change in the swimming speed during spatial probe test on 1 and 3 days after establishment of the model.Conclusion The mechanism by which hydrogen-rich saline reduces transient cerebral I/R injury may be related to inhibition of inflammatory responses in rats.

Objective To retrospectively investigate the incidence of accidental awareness during general anesthesia in selective operation and analyze the influence factors of accidental aware-ness.Methods Patients scheduled for elective surgery requiring general anesthesia with artificial air-way during April 2013-July 2015 were collected.The incidence was obtained from postoperative fol-low-ups.Perioperative data and anesthetic drugs were collected to analyze influence factors. Results A total of 141 294 patients were enrolled.Eighty patients (0.06%)were definitely identified as awareness.Multiple regression analysis showed that awareness during operation was associated with total intravenous anesthesia (OR=5.181,95% CI 3.032-8.853),using laryngeal mask airway (OR=2.478,95% CI 1.544-3.977)and ASA Ⅲ or Ⅳ (OR=9.202,95% CI 5.475-15.466).Pre-medication of midazolam (OR=0.125,95% CI 0.080-0.196)and combination of sevoflurane (OR=0.193,95% CI 0.113-0.330)had lower incidence of awareness during operation.Conclusion Total intravenous anesthesia,using laryngeal mask airway and ASA Ⅲ or Ⅳ are risk factors of accidental awareness during general anesthesia.Premedication of midazolam and combination of sevoflurane may prevent awareness during operation.

Epmedii Folium is a commonly used traditional Chinese drug, and is beneficial for the "liver" and "kidney" s function in Chinese medicine. Recently, the origin of this drug is more complex. Most of the identification studies are emphasized on the species certified by the pharmacopoeia and other related species from the same genus of Epimedium, but few was emphasized on the counterfeit. In this paper, one counterfeit of Epmedii Folium, identified as the dried leaf of Quercus variabilis (Fam. Fagaceae), has been reported based on field investigation, comparing specimen of Epmedii Folium and Q. variabilis,using the macroscopic, microscopic and TmC methods. It is resulted that they could be identified clearly not only by the macroscopic features, such as the vein character and the tooth apex, but also by the microscopic features, such as the vascular bundles of the midrib, the non-glandular hair, the anticlinal wall of the epidermis cell and the calcium oxalate crystal. Furthermore their TLC chromatograms showed also difference. This study will give reference for the identification of Epmedii Folium and the related supervision and inspection work.
China ; Discriminant Analysis ; Epimedium ; anatomy & histology ; chemistry ; Plant Leaves ; anatomy & histology ; chemistry ; Plants, Medicinal ; anatomy & histology ; chemistry ; Quercus ; anatomy & histology ; chemistry

Objective To study the scientificity and rationality in data management of the project of Chinese Chronic Disease Clinical Research System and its Achievements Application Mode;To provide evidence and reference for the improvement of follow-up work. Methods According to the relevant management regulations, guidelines, and other relevant documents of national and international clinical research data,“Questionnaire for Research Data Management Assessment of Chinese Chronic Disease Prevention” was designed. The questionnaires were used in 10 clinical topics during the on-site inspection survey, and 20 valid questionnaires were retrieved and analyzed statistically. Results 50-60 percentage of subjects in data management and statistics were performed by the third party;70 percentage of subjects were performed by their own central monitoring;50 percentage of the subjects adopted a cooperative manner with others to develop appropriate data management systems;7 centers had system and plan for data management;Data management was carried out;implementation degree of training, database, CRF tracing, and others 7 aspects was low. Conclusion Improving the quality of data management of TCM clinical research still needs to be perfected from many aspects, and quality mode of large-scale clinical trials should be improved.