The muscarinic receptor family expressed in smooth muscle throughout the body is thought to be composed of five subtypes coupling to distinct signaling systems,respectively.The population in smooth muscle is composed of mainly M 2 and M 3 subtypes in a 80% to 20% mixture. The muscarinic receptor, mainly M 3 receptor, play an important role in regulating gastrointestinal smooth muscle contraction. Selective muscarinic M 3 antagonist should have therapeutic utility in the treatment of gastrointestinal disease.

OBJECTIVE: To observe the protective effects of ginkgo leaf extracts on spinal cord after ischemia-reperfusion (IR) injury in rabbits and to find out its possible mechanism. METHODS: Twenty-seven New Zealand white rabbits were randomly divided into three groups, which were sham-operation group, untreated group and ginkgo leaf extracts-treated group. The locomotor scores of hindlimbs in rabbits after 24 and 48 h of reperfusion were evaluated, and the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in ischemia spinal cord were examined. The apoptotic index (AI) of neurons in spinal cord was detected by terminal deoxyribonucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) method. The expressions of Bcl-2 and Bax proteins were examined by streptavidin-biotin peroxidase method. RESULTS: The locomotor scores of hindlimbs in rabbits after 24 and 48 h of reperfusion in the ginkgo leaf extracts-treated group were obviously elevated as compared with those in the untreated group (P<0.05). The activity of SOD was higher and the level of MDA was lower in ischemia spinal cord in the ginkgo leaf extracts-treated group than those in the untreated group (P<0.01). The decreased neuron AI and the expressions of up-regulated Bcl-2 protein and down-regulated Bax protein were also observed in the ginkgo leaf extracts-treated group. CONCLUSION: The protective effects of the ginkgo leaf extracts against spinal cord injury induced by IR may be related to scavenging oxygen free radicals, reducing lipid peroxidation injury and inhibiting apoptosis.

Objective To analyse the diagnosis and treatment of the single tubular type of diastematomyelia. Methods Clinical scoring and posterior tibial nerve cortical somatosensory evoked potential (PTNCSEP) were performed in 23 cases to define surgical indications and investigate the results of treatment. Results Seven cases without clinical symptoms and 11 cases without progressive neural deficit showed no significant change in terms of clinical scoring and PTNCSEP P40 latent period; while other 5 cases with progressive neural deficit improved after the surgical intervention, and operative findings confirmed that there were fibrous septum or band and other malformations. Conclusion Patients with progressive neural deficit need surgical intervention while those without progressive neural deficit and clinical symptoms only need conservative treatment and routine follow-up.

OBJECTIVE:To observe the occurrence of severe myelosuppression after chemotherapy and to improve its therapeutic effects. METHODS:A total of 288 cases of 268 patients with grade Ⅳ bone marrow suppression induced by chemotherapy treatment were analyzed. RESULTS:Of the 288 cases,The median day when absolute neutrophil coun(tANC)

Aromatase inhibitors(AIs) are standard therpy for postmenopausal women with estrogen responsive breast cancers.By inhibiting the aromatase enzyme,causing decreases in endogenous estrogens,the treatment of Als is responsible for lower bone mineral density(BMD) and increased fractures.Therefore,early recognition, prevention,and/or treatment of AI-induced bone loss is needed.Zoledronic acid is specific inhibitors of osteoclasts and extensively used in bone metastasis patients.Recently, there are several trials evaluating the use of in- travenous zoledronic acid as prevention and treatment of AI-induced bone loss in postmenopausal women with breast cancer.In this article, we aim to review the use of zoledronic acid in this population including the response and safety.

Objective To compare clinical effects between totally video-assisted thoracoscopic surgery and conventional median sternotomy for mitral valve replacement . Methods From March 2012 to October 2013, patients with simple mitral valve disease underwent mitral valve replacement through either right chest port -access totally video-assisted thoracoscopy ( thoracoscopy group, n=110) or conventional median sternotomy (conventional group, n=128).The time of operation, cross-clamp ascending aorta, cardiopulmonary bypass , postoperative mechanical ventilation , intensive care unit stay , postoperative hospital stay , and volume of postoperative chest drainage were compared between the two groups .All the patients were followed after 6 months postoperatively for evaluating the condition of valve regurgitation under echocardiography . Results Between the thoracoscopy group and the conventional group, no significant differences were found in time of operation [(256.2 ±28.5) min vs.(251.2 ±30.0) min, t=1.312, P=0.191], cross-clamp time of the ascending aorta [(40.0 ±2.7) min vs.(39.4 ±2.7) min, t=1.709, P=0.089], and cardiopulmonary bypass time [(74.2 ±4.1) min vs.(73.7 ±4.9) min, t =0.846, P =0.399].As compared to the conventional group, the thoracoscopy group had significantly shorter time of postoperative mechanical ventilation [(716.4 ±79.1) min vs.(811.9 ±58.8) min, t=-10.657, P=0.000], shorter length of intensive care unit stay [(26.2 ±3.6) h vs.(29.3 ±4.7) h, t=-5.640, P=0.000], shorter length of postoperative hospital stay [(9.6 ±1.2) d vs.(10.9 ±2.5) d, t=-4.982, P=0.000], and less volume of postoperative chest drainage [(328.1 ±83.2) ml vs.(561.3 ±143.9) ml, t=-14.978, P=0.000], respectively .No death happened in the two groups . No mitral valve regurgitation was seen during follow-ups at 6 months postoperatively . Conclusion For patients undergoing mitral valve replacement , totally video-assisted thoracoscopic surgery is superior to conventional median sternotomy with respect to surgical trauma .

OBJECTIVETo evaluate the efficacy and the relevant effect factors of acupuncture for type 2 diabetes mellitus (T2DM) in females.

METHODSOf 83 female patients of T2DM, 49 cases were deficiency of kidney yin syndrome and 34 cases were yin and yang deficiency syndrome. Acupuncture was adopted and the acupoints were selected according to the syndrome differentiation. In kidney yin deficiency syndrome, Taixi (KI 3), Shenmen (HT 7), Taichong (LR 3) and Sanyinjiao (SP 6), etc. were selected. In yin and yang deficiency syndrome, Shenshu (BL 23), Pishu (BL 20), Yishu (Extra) and Jingmen (GB 25), etc. were selected. In 3 courses of treatment, the changes in fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistace index (Homa-IR), index of islet beta-cell function (Homa-beta), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared before and after treatment between the two groups. The relationship of the efficacy was analyzed in terms of the syndrome differentiation, age, duration of sickness, obesity and hereditary factors.

RESULTSAfter the treatment, the levels of FPG, FINS, Homa-IR, TC, TG and LDL-C were reduced obviously (all P < 0.01) and the levels of ISI, Homa-beta and HDL-C were increased apparently (all P < 0.01). The total clinical effective rate was 80.7% (67/83), in which, that of kidney yin deficiency syndrome was 83.7% (41/49) and that of yin and yang deficiency syndrome was 76.5% (26/34). The efficacy was not different significantly between the two syndromes. But, the younger the age was, the better the efficacy was.

CONCLUSIONAcupuncture positively regulates the glucose and lipid metabolism in the patients of T2DM. This therapy improves insulin resistance, enhances the body sensitivity to insulin and improves insulin beta-cell function. The efficacy is related to the patient's age.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

Adolescent ; Gene Rearrangement ; Humans ; Leukemia, Myeloid, Acute ; etiology ; genetics ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; genetics ; Receptor, Platelet-Derived Growth Factor beta ; genetics

Objective To investigate the role of M3 receptor in the effect of penehyclidine hydrochloride(PHC) upregulating β-arrestin-1 expression in lipopolysaccharide(LPS)-induced human pulmonary microvascular endothelial cell(HPMVEC) injury.Methods.M3 shRNA transfected HPMVEC and normal HPMVEC cells were randomly divided into LPS group(A),LPS+pHC group(B),LPS+ M3 shRNA transfection group(C) and PHC+ LPS+ M3 shRNA transfection group(D).The cytoskeleton change was observed by laser scanning confocal.The LDH level in cellular supernate was detected.The VCAM 1 protein expression was examined by immunofluorescence chemistry.β-arrestin-1 protein expression was determined by Western blot and β-arrestin-1mRNA expression was measured by real-time PCR.Results Compared with the group A or C,F-actin cytoskeleton arrangement in the group B or D was neat,the LDH level and VCAM-1 protein expression were decreased,and β-arrestin-1 expression was increased;compared with group A or B,F-actin cytoskeleton arrangement in the group C or D was neat,the LDH level and VCAM-1 protein expression were decreased,while the β-arrestin-1 expression had no obvious change.Conclusion Silence M3 receptor is conducive to reduce LPS-induced HPMVEC injury.But the role of PHC up-regulating β-arrestin-1 expression has no necessary connection with M3 receptor.

The monocarboxylate transporters (MCTs) family, especially MCT1, plays an important role in tumor metabolism.MCT1 mediates a variety of monocarboxylic acids across the plasma membrane, and determines to take in or export lactic acid according to the metaboliuc state, thus maintaining the special tumor cells metabolism model.Considering the emerging evidence for the role of MCT1 in the tumor genesis, metabolism, invasion and metastasis, MCT1 is expected to be a new target for cancer therapy.