Objective To systematically evaluate the curative effect of continuous positive airway pressure (CPAP) on treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and hypertension. Methods The data were retrieved of randomized controlled trials (RCTs) about the curative effect of CPAP on treatment of patients with OSAHS and hypertension from PubMed, Cochrane Library, CNKI, VIP, CBM and WanFang database from inception to Oct. 2015. Literature screening, data extraction and risk bias assessment were performed by two independent reviewers, and meta-analysis was then carried out by using RevMan 5.3 software. Results A total of 16 RCTs involving 2101 patients were included. Meta-analysis revealed that, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy significantly reduced the daytime systolic pressure [MD=–12.60, 95%CI(–17.68 to –7.52), P<0.00001], nighttime systolic pressure [MD=–21.90, 95%CI(–25.94 to –17.86), P<0.00001] and nighttime diastolic pressure [MD=–11.90, 95%CI(–15.44 to –8.36), P<0.00001], while created no significant difference in daytime diastolic pressure, 24-h mean systolic pressure and 24-h mean diastolic pressure in a followingup less than 12 weeks. Whereas in the following-up no less than 12 weeks, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy significantly reduced the 24-h mean systolic pressure [MD=–7.88, 95%CI(–12.09 to –3.66), P=0.00002], 24-h mean diastolic pressure [MD=–5.14, 95%CI(–6.00 to –4.28), P<0.00001], daytime systolic pressure [MD=–5.89, 95%CI(–8.79 to –2.98), P<0.0001], daytime diastolic pressure [MD=–4.34, 95%CI(–6.32 to –2.36), P<0.0001]; nighttime systolic pressure [MD=–7.06, 95%CI(–11.12 to –2.99), P=0.0007] and nighttime diastolic pressure [MD=–4.49, 95%CI (–7.39 to –1.58), P=0.006]. Conclusions The current evidences suggest that on the basis of antihypertensive drug therapy, CPAP may effectively reduce the systolic pressure and diastolic pressure of OSAHS patients with hypertension at long-term follow-up, but the effect in a short-term follow-up is not obvious. For the quality and quantity of included studies limited, more high quality and larger sample studies are needed to verify the above conclusion

Tripterygium wilfordii has exihibited multiple pharmacological activities, such as anti-inflammatory, immune modulation, anti-tumor and anti-fertility. T. wilfordii have been used for the therapy of inflammation and autoimmune diseases including rheumatoid arthritis, immune complex nephritis and systemic lupus erythematosus clinically. However, it is well known that T. wilfordii has small margin between the therapeutic and toxic doses and could cause serious injury on digestive, reproductive and urogenital systems. Among all the organs, liver is one of the most remarkable targets of T. wilfordii-induced toxicities, and the damage is more serious than others. It is generally accepted that T. wilfordii-induced liver injury is a result of the combined effects of toxic elements of T. wilfordii. It is reported in several studies that the mechanism of T. wilfordii-induced liver injury may be related to lipid peroxidation, cell apoptosis and immune damage, and so on. Licorice is one of the most commonly used Chinese herbal medicine, with effects of heat- clearing and detoxicating, anti-inflammatory and hepatoprotective, reconciling various drugs, and so on. Licorice often accompany T. wilfordii in clinical application which can significantly reduce the liver injury induced by T. wilfordii. The attenuated effect is exact, but the mechanism is still a lack of in-depth study. This paper reviews the studies on T. wilfordii-induced liver injury and the related mechanism as well as licorice and other traditional Chinese medicine accompany T. wilfordii to reduce the injury in recent years, so as to provide reference for related research in the future.
Animals ; Chemical and Drug Induced Liver Injury ; etiology ; prevention & control ; Glycyrrhiza ; Humans ; Inactivation, Metabolic ; Medicine, Chinese Traditional ; Tripterygium

A field demonstration of reduction of lead availability in a soil and cabbage (Brassica Chinensis L.) contaminated by mining tailings, located in Shaoxing, China was carried out to evaluate the effects of applications of phosphorus fertilizers on Pb fractionation and Pb phyto-availability in the soil. It was found that the addition of all three P fertilizers including single super phosphate (SSP), phosphate rock (PR), and calcium magnesium phosphate (CMP) significantly decreased the percentage of water-soluble and exchangeable (WE) soil Pb and then reduced the uptake of Pb, Cd, and Zn by the cabbage compared to the control (CK). The results showed that the level of 300 g P/m(2) soil was the most cost-effective application rate of P fertilizers for reducing Pb availability at the first stage of remediation, and that at this P level, the effect of WE fraction of Pb in the soil decreased by three phosphorus fertilizers followed the order: CMP (79%)>SSP (41%)>PR (23%); Effectiveness on the reduction of Pb uptake by cabbage was in the order: CMP (53%)>SSP (41%)>PR (30%). Therefore our field trial demonstrated that it was effective and feasible to reduce Pb availability in soil and cabbage contaminated by mining tailings using P fertilizers in China and PR would be a most cost-effective amendment.
Biodegradation, Environmental ; drug effects ; Brassica ; drug effects ; metabolism ; Chemical Fractionation ; methods ; Fertilizers ; Industrial Waste ; analysis ; prevention & control ; Lead ; analysis ; chemistry ; pharmacokinetics ; Mining ; Phosphates ; administration & dosage ; chemistry ; Soil Pollutants ; analysis ; pharmacokinetics

Danshen,an efficacious agent for cardiovascular diseases,has been found to play an essential role in kidney injury.In the present study,the effect of Danshen on cisplatin-induced renal dysfunction was investigated in a mouse model.Danshen was administered to mice at a dose of 3 g/kg 4 days before and 3 days after cisplatin treatment.A single intraperitoneal injection of 20 mg/kg cisplatin was used to induce nephrotoxicity.The mice were sacrificed 72 h after cisplatin intoxication.Biochemical parameters including serum creatinine and blood urea nitrogen were analyzed.Histopathological changes of kidney tissues were detected using HE staining.Antioxidant enzymes (GSH-Px and SOD) and peroxidative product (MDA) were detected.Protein expressions of Nrf2 and its target genes including HO-1 and NQO1 were measured by Western blotting.The results showed that pretreatment with Danshen significantly reduced serum creatinine and blood urea nitrogen in the cisplatin-treated mice.Histopathological examination showed that Danshen mitigated the renal damage induced by cisplatin.Moreover,Danshen restored the activities of antioxidant enzymes (GSH-Px and SOD) and normalized the MDA contents in renal tissues.Western blotting revealed that Danshen enhanced the expressions of Nrf2 and its target genes in cisplatin-exposed mice.It was suggested that Danshen protects against the cisplatin-induced renal impairment in the mice,which is potentially associated with the upregulation of Nrf2-mediated signaling pathway.

Objective:Iron accumulation is related to the occurrence of postmenopausal osteoporosis. Meanwhile, autophagy abnormality of bone marrow hematopoietic cells is observed in hip osteoporotic fracture. This study is performed to investigate correlation between iron accumulation induced bone loss and hematopoietic autophagy dysfunction to explore the new risk factor of osteoporosis.Methods:Male iron accumulation mice model was established by intraperitoneally injecting ferric ammonium citrate. Serum ferritin and osteogenic indicator P1NP were tested by ELISA. Bone mineral density was measured by micro-CT. Femur and tibia bone marrows were collected for hematopoietic stem and progenitor cells proportion and cell apoptosis analysis. Autolysosome formation was measured by image flow cytometry. We used conditional mouse model Atg7 flox/flox; Vav-Cre(Atg7 -/-) in which Atg7 had been genetically deleted in the hematopoietic system. Bone marrow hematopoietic stem and progenitor cells were collected for RNA sequence. micro-CT scan was conducted for Atg7 -/- femur. Results:Ferritin level of iron accumulation mice was significantly higher than control group( P<0.05). Iron accumulation inhibited P1NP and induced decreased bone mineral density( P<0.05). Iron accumulation bone marrow displayed enhanced hematopoietic stem and progenitor cells proportion( P<0.05), with more cell apoptosis( P<0.05). Hematopoietic autophagy was deteriorated in iron accumulation bone marrow. Transcriptomic profiling showed up-regulation of iron activity in Atg7 -/- mice, with increased iron homeostasis and iron membrane transporter genes, including Lcn2, Tfr2, Slc40a1(Fpn1), Steap3, and Cpox. micro-CT revealed severe bone loss and decreased bone mineral density in Atg7 -/- mice( P<0.05). Conclusion:Iron accumulation induced bone loss is related to inhibition of hematopoietic cells. Hematopoietic autophagy dysfunction is associated with bone loss.

Objective To probe into the way for relieving pains irrelevant to incision but associated with the event of pneumoperitoneum by means of physiotherapy, wherein the said pains occur after a gynecologic celioseope operation.Methods Random option of 207 patients after the gynecologic operation was conducted and the patients were divided into 3 groups at random that were on the man-care,instrument and ordinary basis.Each group consists of 69 cases.In man-care group,artificial massage at the points (hereafter called mann-care group)Was adopted.The instrument group adopted microwave devices to heal (hereafter called instrument group).And the ordinary group adopted regular care of post operation (hereafter called ordinary group).We observed and compared three methods,to see whether they may relieve the pains irrelevant to incision.Results The point massage and microwave therapy can relieve the complicated pains irrelevant to incision after a gynecologic operation,and the effect thereof is obviously better than that of the ordinary care.Conclusions As to the complications such as pains irrelevant to incision after gynecologic operation,the point massage,microwave and relevant physiotherapy can function well and are comparatively ideal.

Objective To investigate the curative effect of perioperative strengthened health education to hip joint replacement patients.Methods Applied the perioperative strengthened health education to 80 hip joint replacement patients, then had 6 ～ 57 months follow-up after operation.Results Harris graded standard was used to assess the results: excellent 65 cases, good 14 cases, passable 1 case.Conclusions To give perioperative strengthened health education to hip joint replacement patients can improve their knowledge level,make them cooperate with doctors to rehabilitate.It can also increase success rate of operation, reduce the complications and improve the quality of life.

OBJECTIVETo study and summarize the etiology of children patients with chronic kidney disease (CKD) stage 2 to 5 seen in Children's Hospital of Fudan University from Jan. 2004 to Dec. 2013.

METHODBy complying with the NKF-K/DOQI guidelines, we collected data of 264 cases of children patients with CKD stage 2-5 from Jan. 2004 to Dec. 2013 in the medical record system of Children's Hospital of Fudan University. And we retrospectively analyzed their age and CKD stage at first diagnosis, primary diseases, complications, etc.

RESULTIn the collected 264 cases, 52 cases (19.7%) were diagnosed at stage 2, 67 (25.4%) at stage 3, 52 (19.7%) at stage 4 and 93 (35.2%) at stage 5. For disease causes, 116 cases (43.9%) had congenital anomalies of the kidney and urinary tract (CAKUT), 61 cases (23.1%) had glomerular disease, 15 (5.7%) had hereditary kidney disease, 14 (5.3%) had other diseases and in 58 cases (22.0%) the causes of disease were unknown. In the group with age between 0 and 3.0 and 3.1 and 6.0 years, 57.1% (24 cases) and 60.0% (30 cases) had primary disease with CAKUT. In the group with age older than 10 years, 49.2% (30 cases) had primary disease with glomerular disease and 32.0% (32 cases) with unknown causes.

CONCLUSIONThe major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT (43.9%), followed by glomerular disease (23.1%). The primary diseases of CKD were significantly different between the 2 age groups. CAKUT was more common in infants and preschool children while for adolescents, glomerular disease was the major cause.

Child ; Child, Preschool ; China ; Humans ; Infant ; Infant, Newborn ; Kidney ; physiopathology ; Renal Insufficiency, Chronic ; etiology ; Retrospective Studies

Mild cognitive impairment (MCI), as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer's Disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Beijing United Study Group on MCI funded by the Capital Foundation of Medical Developments (CFMD) proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to: (1) cognitive complaints coming from the patients or their families; (2) reporting of a relative decline in cognitive functioning during the past year by the patient or informant; (3) cognitive disorders evidenced by clinical evaluation; (4) activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and (5) absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI (aMCI), single non-memory MCI (snmMCI) and multiple-domains MCI (mdMCI). Finally, the subtype causes could be identified commonly as Alzheimer disease (AD), vascular dementia (VaD), and other degenerative diseases such as frontal-temporal dementia (FTD), Lewy body disease (LBD), semantic dementia (SM), as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin B12 and folic acid, plasma insulin, insulin-degrading enzyme, Abeta40, Abeta42, inflammatory factors. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE epsilon4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.

In order to provide the "guiding principles of clinical research on mild cognitive impairment (MCI) (protocol)" edited by Beijing United Study Group on MCI of the Capital Foundation of Medical Developments (CFMD) with evidence support, clinical criteria, subtypes, inclusion and exclusion of MCI, and use of rating scales were reviewed. The authors suggested that MCI clinical criteria and new diagnosis procedure from the MCI Working Group of the European Alzheimer's disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Diagnostic rating scales including Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Instrumental Activities of Daily Living (IADL) are very useful in definition of MCI but can not replace its clinical criteria. Absence of major repercussions on daily life in patients with MCI was emphasized, but the patients may have minimal impairment in complex IADL. According to their previous research, the authors concluded that highly recommendable neuropsychological scales with cut-off scores in the screening of MCI cases should include Mini-Mental State Examination (MMSE), logistic memory test such as Delayed Story Recall (DSR), executive function test such as Clock Draw Test (CDT), language test such as Verbal Category Fluency Test (VCFT), etc. And finally, the detection of biological and neuroimaging changes, including atrophy in hippocampus or medial temporal lobe in patients with MCI, was introduced.