OBJECTIVETo analyze the clinical characteristics of elderly patients with spinal tuberculosis and explore its clinical effects with anti-TB drugs alone.

METHODSFrom January 2008 to July 2010, the data of 36 patients with spinal tuberculosis underwent conservative treatment of anti-TB drugs alone were analyzed. There were 19 males and 17 females with an average age of 73.5 years (ranged, 60 to 85). All patients were in the active phase with high ESR and CRP levels and were treated with 3HRZE/6-9HRE (course from 9 to 12 months). According to clinical symptoms, chemical examination, radiological image to adjust drug and depending on VAS score to evaluate pain.

RESULTSAll the patients were followed up from 8 to 24 months with an average of 15 months. Tuberculose of 31 patients healed after chemotherapy from 9 to 12 months and ESR and CRP recovered normally. Levofloxacin and para-amino salicylic acid were used in 4 cases because of 4 cases occurred drug fast for RFP or INH, after 15 months, their obtained healing. Symptom of 1 case got worse during chemotherapy, and surgical treatment were performed, after 3 months, ESR and CRP recovered normally, X-ray and CT showed spinal osteosclerosis and fusion without significant kyphosis and internal fixation loosening. Cobb angle was respectively(17.6+/-2.3) degrees, (18.1+/-2.7) degrees before treatment and last follow-up (P>0.05). MRI showed abscess was absorbed and spinal inflammation subsidised. VAS score was respectively 6.5+/-1.7, 1.4+/-0.5 before treatment and last follow-up (P<0.05). Seven patients had complications relating with drug adverse reaction,after discontinuation and treated with clinical symptom,the patients recovered normally.

CONCLUSIONAnti-TB drugs alone can obtain satisfactory effects in treating early senile spinal tuberculosis, but strict supervision and individual administration should not be disregardful.

Aged ; Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Tuberculosis, Spinal ; diagnosis ; drug therapy

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.

OBJECTIVETo study the chemical constituents in fresh fleshyscaleaf of Lilium lancifolium.

METHODThe constituents were separated. by various kinds of chromatography and their structures were identified on the basis of spectral analysis.

RESULTTen compounds were identified regaloside A (1), regaloside C (2), methyl-a-D-mannopyranosid (3), methyl-ca-D-glucopyranoside (4), (25R, 26R) -26-methoxyspirost-5-ene-3p-yl-O-ca-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (5), (25R)-spirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (6), (25R, 26R)-17alpha-hydroxy-26-methoxyspirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyra nosyl-(1-->6)]-beta-D-glucopyranoside (7), daucosterol (8), adenoside (9), berberine (10).

CONCLUSIONAll compounds except 1 and 3 were isolated from this species for the first time, and berberine was first reported in genus Lilium.

Berberine ; chemistry ; isolation & purification ; Lilium ; chemistry ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Saponins ; chemistry ; isolation & purification

OBJECTIVETo investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing.

METHODSTwenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results.

RESULTSAll patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found.

CONCLUSIONAugmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.

Adult ; Bone Nails ; adverse effects ; Bone Plates ; Bone Transplantation ; Female ; Femoral Fractures ; complications ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; Fractures, Ununited ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the effect of compound Danshen Dripping Pill (DSP) on carotid arterial intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).

METHODSOne hundred and thirty T2DM patients were assigned to four groups, 32 in the Group A, the control group treated with blood glucose (BG) and blood pressure (BP) controlling; 32 in the Group B, with BG, BP and blood lipid (BL) controlling, 32 in Group C with BG, BP, BL controlling and vitamin E administration, and 34 in Group D with BG, BP, BL controlling and DSP administration. Patients in Group D were subdivided by Chinese medicine syndrome differentiation into four types, 8 of Yin-deficiency with flourishing heat type (YDFH), 5 of both qi-yin deficient type (BQYD), 8 of both yin-yang deficient type (BYYD) and 13 of blood-stasis and qi-stagnant type (BSQS). Fasting blood glucose (FBG), BP and BL in patients were observed periodically, and IMT in them were measured by ultrasonography before treatment, as well as at the end of the 1st, 3rd, and 5th year of treatment to dynamically observe the changes of IMT and condition of plaque formation, and analyze the relation between them with FBG, BP and BL.

RESULTSThe 5-year follow-up was performed in 105 patients. In the observation period, level of total cholesterol (TC) showed a decreasing trend and level of high density cholesterol (HDL-C) showed an increasing trend in all the 4 groups, the improvements in Group C and D were slightly better than those in Group B, while significantly superior to those in Group A; the changes of FBG and glycosylated hemoglobin (HbAlc) were insignificant in the 4 groups. IMT and numbers of atheroma plaque increased gradually in all groups in the observation period, however, the changes in Group D were lesser than those in other groups, showing significant difference (P < 0.01). It was showed that the increasing of cervical carotid IMT in T2DM patients was correlated with levels of HbAlc, HDL-C, LDL-C, triglyceride and TC, especially in Group D.

CONCLUSIONDSP might delay the occurrence and development of diabetic macro-vascular disease.

Carotid Arteries ; pathology ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2 ; drug therapy ; pathology ; Diabetic Angiopathies ; pathology ; prevention & control ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Salvia miltiorrhiza ; chemistry ; Tunica Intima ; pathology ; Tunica Media ; pathology

The relevant literatures of Siwu series decoctions--Taohong Siwu decoction for treating primary dysmenorrea of gynecology blood stasis syndrome were summarized including the clinical application, pharmacological effects, bioactive components and metabolic characteristics. On this basis,research on the bioactive components and formulation rule were discussed, to provide reference for modern traditional Chinese medicine formula study.
Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Dysmenorrhea ; drug therapy ; Female ; Humans

To explore the effect of different processing methods and conditions of coumarin and volatile compounds in Angelica Dahuricae Radix and their change regularity, in order to optimize and establish appropriate drying methods and conditions. After being cleaned, fresh Angelica Dahuricae Radix herbs were baked, sun-dried, shade-dried, sun-dried after sulfur-fumigation, dried by quick-lime embedding, freeze-dried, microwave-dried. Finally, 24 groups of samples were obtained after being mashed and passing through the 60-mesh screen. The HPLC-PDA method was adopted to simultaneously determine the content of coumarin compounds. The GC-MS method was used to determine the content of volatile compounds. The principal component analysis (PCA) was made on the standardized analysis results for the 24 groups of samples processed with different drying methods. According to the PCA results, the comprehensive scores of coumarin and volatile compounds in Angelica Dahuricae Radix herbs processed with different methods in the order from high to low were that unpeeled and dried by quicklime embedding > unpeeled and dried with hot-air at 100 degrees C > unpeeled and dried with hot-air at 40 degrees C > peeled and infrared-dried > peeled and dried with hot-air at 60 degrees C > peeled and dried with hot-air at 40 degrees C > peeled and sun-dried > peeled and dried with hot-air at 60 degrees C > peeled and dried with hot-air at 100 degrees C > peeled and microwave-dried > peeled and dried with hot-air at 80 degrees C > unpeeled and sun-dried > unpeeled and dried with sulfur-fumigation > peeled and dried with sulfur-fumigation > unpeeled and dried with hot-air at 120 degrees C > unpeeled and freeze-dried > unpeeled and infrared-dried > peeled and dried with hot-air at 120 degrees C > peeled and freeze-dried > peeled and dried by quicklime embedding > unpeeled and dried with hot-air at 80 degrees C > peeled and shade-dried > unpeeled and shade-dried > unpeeled and microwave-dried. According to the findings, different drying processing methods have certain impacts on the content coumarin and volatile compounds in Angelica Dahuricae Radix herbs. The traditional method of drying by quicklime embedding is recommended as the optimum origin processing method of Angelica Dahuricae Radix, which is followed by the method for being peeled and dried with hot-air at 100 degrees C.
Angelica ; chemistry ; Coumarins ; analysis ; Desiccation ; methods ; Gas Chromatography-Mass Spectrometry ; Hot Temperature ; Principal Component Analysis ; Volatile Organic Compounds ; analysis

BACKGROUND:Intertrochanteric fracture showed shattered state of different degrees in the clinic. The medial cortex is often a lack of continuity. Indentation and lesser trochanter displacement often cause destruction of biomechanics of femoral calcar to different degrees. Under this condition, it is very important to perform detailed classification of fractures and to strictly master indication of dynamic hip screw. OBJECTIVE:To further analyze the reasons for failure of internal fixation with dynamic hip screw for intertrochanteric fracture. METHODS:Data of 82 patients with intertrochanteric fracture repaired by internal fixation with dynamic hip screw, who were treated at the Department of Orthopedics, Kangtai Branch of the Second Hospital of Lanzhou University from March 2004 to December 2013, were retrospectively analyzed. The reason for failure of internal fixation and prevention method were explored. RESULTS AND CONCLUSION:Al patients were fol owed up for 4-48 months. Time of fracture healing was 12-38 weeks. Fixation failure was found in 12 cases, with an incidence of 15%. Of 12 failure cases, 7 cases affected hip screw cutting out femoral head neck (including 1 case combined with avascular necrosis of the femoral head), 1 case suffered from compression screw slipping out of the tube, 3 cases experienced screw pul ing out and breaking, plate loosening, and 1 case affected steel plate breakage. There were 1 case of Evans II type (8%), 3 cases of type III (25%), 5 cases of type IV (42%), and 3 cases of type V (25%). Lesser trochanter was not completely reset in 5 cases (42%). There were tip-apex distance>25 mm in 7 cases (58%) and early weight loading (3 weeks after fixation) in 1 case (8%). These data confirmed that the selection of indications, the degree of stability after reduction, accuracy of implant position and postoperative unreasonable exercise wil cause fixation failure of dynamic hip screw. Preoperative careful and comprehensive analysis, intraoperative precise operation and postoperative reasonable functional exercise are the keys to ensure success of fixation.

This study is to establish the methods for determination of iridoid glycosides and triterpenic acids in Corni Fructus and provide technical support for the quality control of Corni Fructus. Morroniside, loganin and sweroside were determined by HPLC-UV method with acetonitrile and 0.1% formic acid as the mobile phase, and the detective wavelength was set at 240 nm. Oleanolic acid and ursolic acid were determined by HPLC-ELSD method with methanol-0.5% ammonium acetate (87:13) as the mobile phase. The results showed that the linear ranges of morroniside, loganin and sweroside were 5.335-213.4 mg · L(-1) (r = 0.9999), 5.515-220.6 mg · L(-1) (r = 1.0000), 1.992-79.68 mg · L(-1) (r = 1.0000), respectively. The average recoveries of the above three iridoid glycosides were 98.49%-99.28% with RSDs of recoveries being less than 2%. The linear ranges of oleanolic acid and ursolic acid were 7.74-154.8 mg · L(-1) (r = 0.9964), 10.82-216.4 mg · L(-1) (r = 0.9996), respectively. The average recoveries of the above two triterpenic acids were 98.11%-99.27% with RSDs of recoveries being less than 3%. The method established in this research is simple, rapid and reliable, and can be used for quality control of Corni Fructus. Furthermore, the research provided experimental data for the improvement of present quality standard of Corni Fructus, which has important significance to guarantee its quality and clinical curative effect.
Cornus ; chemistry ; Drug Stability ; Oleanolic Acid ; analysis ; Quality Control ; Triterpenes ; analysis