AIM: To study the quality standard of Compound Shencha Granuls (Radix et Rhizoma Glycyrrhizae, Radix Rehmanniae, etc.). METHODS: Radix et Rhizoma Glycyrrhizae and Rhizoma et Radix Polygoni Cuspidati in Compound Shencha Granule were distinguished by TLC. Ursolic acid was determinated by TLCS. RESULTS: The methods of TLC to distinguish Radix et Rhizoma Glycyrrhizae and Rhizoma Polygoni Cuspidati were feasible without negative inference. Ursolic acid content in three groups of samples was 1.24 - 1.58 mg?g -1 . CONCLUSION: The method is accurate and reproducible. It can be used for the quality control of Compound Shencha Granule.

Objective To study the cryoprecipitate effect of local external treatment of anal fistula surgical wound repair.Methods A total of 95 cases of low simple anal fistula patients was chosen, and was divided into three groups according to random number table method.The cryoprecipitate group (n =32 cases) began with cryoprecipitate dressing (2 layer) even to fill in a wound, once per day.The Kangfuxin group (n =32 cases) used Kangfuxin solution.The exposed burn ointment (MEBO) group (n =31 cases) used MEBO to cover the wound.The healing time, postoperative wound healing rate, the granulation tissue growth, new epithelial coverage, and adverse reactions were observed.Results The cryoprecipitate group in 14 d and 21 d had postoperative wound healing rate (60.97 ±4.20)％ and (97.69 ± 1.79)％ ,wound healing time (21.31 ±2.08)days;it had higher healing rate and shorter healing times compared to other two groups (P ＜0.05).Wound repaired more neatly;and 14d and 21d after the operation, wound granulation tissue growth rate [(61.06 ± 13.29) ％ and (97.63 ± 2.81) ％] and new epithelial coverage [(33.03 ±4.15)％ and (94.97 ±4.36)％] were more than the control groups (P ＜0.05) with less adverse reactions relative to control groups.Conclusions The cryoprecipitate contained in the composition has a strong biological activity.It can promote the wound tissue cell growth, and promote the wound repair.

Objective To compare the biomechanical pull-out strength (POS) of three different fixations in upper thoracic vertebras using translaminar screws (TLS), translaminar facet screws (TLFS), and transpedicle screws (TPS), respectively. Methods Nine fresh human cadaveric cervicothoracic junction spines specimens which including T1-T3 vertebras were harvested. The vertebras specimens were scanned using dual-energy radiograph absorptiometry for bone mineral density. Both of screw insertion techniques at each vertebrae was randomized. All the screw insertions were based on direct observation and the CT scan on the pedicles. The peak of insertional torque (IT) was recorded and axial pull-out testing was performed to simulate intraoperative failure of fixation. Results The mean peak IT of the TFLS, TPS and TLS were (0.43±0.01), (0.40±0.01), (0.35±).01) N·m, respectively. There was no statistically significant difference between the TFLS and TPS, and between the TPS and TLS was same. But the TFLS generated statistically greater peak 1T in comparison with the TLS(t=-13.86, P＜0.05). The mean POS of TLFS was (771±106) N,which had no statistically significant difference in comparison with the TPS(733±65) N. And the TLS (663±86) N was same. But the TFLS generated statistically greater POS in comparison with the TLS (t=9.907, P＜0.05). The peak IT showed a strong positive correlation with POS in three screw techniques. Bone mineral density correlation with POS in all methods of fixation. Conclusion It was not a significant difference to compare POS of TLS and TLFS to that of TPS respectively. TLS and TLFS appear to be a biomechanically sound alternative in the upper thoracic spine, and appear to be a safe and effective technique for instrumenting the upper thoracic spine.

ObjectiveTo study the regulatory effect of Tripterygium wilfprdii polyglycoside (TWP) on the expression of EGFR and ErbB-2 induced arthritis rats.The effect of TWP on arthritis was also explored.MethodsAfter the model of CIA rats were established,the expression of EGFR and ErbB-2 in the synovium and articular cartilage were tested by immunohistochemical stain and real time PCR.ANOVA was used for statistical analysis.ResultsThe protein and mRNA expression of EGFR and ErbB-2 in the synovium (EGFR 0.268±0.059,ErbB-2 0.25±0.04,EGFR mRNA:14.2±0.55,ErbB-2 mRNA 23.46±3.64) and articular cartilage (EGFR 0.193±0.018,ErbB-2 0.217±0.033,EGFR mRNA:4.16±0.50,ErbB-2 mRNA 9.23±0.66) of the model group were significantly higher than those of the control group(P＜0.01).After being treated with TWP and MTX,the protein and mRNA expression of the EGFR and ErbB-2 decreased markedly (P＜0.01).Conclusion EGFR and ErbB-2 may play an important role in the pathogenesis of arthritis development.The molecular mechanism that TWP can treat synovitis and bone destruction of RA is related to the inhibition of EGFR and ErbB-2.

Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope,and to determine the CTV in radiotherapy target delineation.Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital,PLA from 2013 to 2014 were analyzed.In 15 patients,the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples,respectively.In 19 patients,the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated.The paired t-test was applied to analyze the differences in the results of different measurement methods.Results In the 15 patients,the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm,respectively (P=0.000),and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm,respectively (95％ CI 1.2-6.0).In the 19 patients,the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm,respectively (P=0.000),and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm,respectively.The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm,with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50± 0.88 mm (95％ CI 2.19-5.06).Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer,and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient.It is recommended to extend another 1-3 mm outside GTV as CTV.

Objective:To evaluate the safety and efficacy of antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary in-tervention. Methods:In the study, 96 patients suffering from acute ST segment elevation myocardial infarction onset within 12 h undergoing primary percutaneous coronary intervention from May to October in 2013 were randomly divided into ticagrelor group (n=48) and clopidogrel group (n=48) by using the method of random number table. Ticagrelor and clopidogrel antiplatelet treatment were used before and after operation. Their baseline data, coronary artery disease characteristics, platelet count, adenosine diphosphate(ADP)-induced platelet inhibition rate by thrombelastograph after 5 days of treatment, the major adverse cardiovascular events of the follow up for 6 months and bleeding complications were observed and compared in the two groups. Re-sults:The differences between the two groups of patients with their baseline data, the features of coronary ar-tery lesions, platelet count before and after 5 days of treatment had no statistical significance (P>0. 05). ADP induced platelet inhibition rate [(80. 2 ± 10. 7)%] after 5 days of treatment in ticagrelor group was sig-nificantly higher than that in clopidogrel group [(75. 3 ± 12. 1)%, P<0. 05]. The two groups of patients were followed up for 6 months, 8 cases of major adverse cardiovascular events occurred in clopidogrel group, 2 ca-ses of major adverse cardiovascular events occurred in ticagrelor group, and there was significant difference between the two groups (P<0. 05). The two groups (7 cases of 48 patients in ticagrelor group vs. 3 cases of 48 patients in clopidogrel group ) had no statistically significant difference in bleeding complications ( P>0. 05). Conclusion: Antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing emergency PCI has good efficacy and safety.

Objective To investigate the effects of intrathecal morphine remote preconditioning (MRPC) on protein-serine-threonine kinases-endothelial nitric oxide synthase (Akt/eNOS) signaling pathways and cardiac myocyte apoptosis in rats.Methods Male SD rats weighing 280-320 g were used in this study.A needle was inserted through a surgically created hole into the sub-dural space of spinal cord.Thirty-six rats in which intrathecal needle was successfully placed without complication were randomly divided into 3 groups (n =12 in each).In group Ⅰ sham operation was performed (Sham).In group Ⅱ myocardial I/R was produced (I/R).In group Ⅲ morphine was given intrathecally in 3 repeated doses of 1 μg/kg at 5 min intervals before ischemia (MRPC).Myocardial I/R was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion.The animals were then sacrificed and hearts removed for measurement of area at risk (AAR) and infarct size area (IS).IS/AAR ratio was calculated.Myocardial apoptosis was detected by TUNEL and apoptotic index (the number of apoptotic myocardial cells/the total number of myocardial cells) was calculated.The levels of Akt,phosphorylated Akt (p-Akt) and eNOS was determined by Western blot.Results The infarct size,myocardial cell apoptotic index and pAkt level were higher and eNOS level was significantly lower in I/R group than those in group Sham (P ＜ 0.01).MRPC significantly reduced the infarct size and myocardial cell apoptotic index,and pAkt and eNOS level up-regulated in group RMPC compared with group I/R (P ＜ 0.01).Conclusions Akt/eNOS signaling pathways probably participate in the protective effects of intrathecal morphine remote preconditioning against myocardial I/R injury and myocardial cell apoptosis in rats.

Objective To identify the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle in patients who had oral mucositis after allogeneic hematopoietic stem cell transplantation. Methods A total of 134 patients were enrolled in this study from 2014 to 2015. They were randomly divided into two groups:the experimental group (n=65) and the control group (n=69). Both groups received preventive measures for oral mucositis. But once oral mucositis occurred, the control group continued with the routine nursing measure, while the experimental group added GM-CSF gargle based on previous routine nursing measure. The effective rate and healing time were compared between two groups. Results The effective rate of the experimental group (81.54%, 53/65) was significantly higher than that of the control group (24.64%,17/69) (χ2=43.434, P=0.000). The median healing time in the experimental group was 4.5 days, shorter than 9.0 days in the control group (Z=-5.379, P< 0.01). Conclusions GM-CSF gargle can control the oral mucositis after allogeneic hematopoietic stem cell transplantation.

OBJECTIVE To observe prenatal nicotine exposure (PNE) induced high sensitivity of hypo?thalamic-pituitary-adrenal (HPA) axis in offspring rats which were fed with a high-fat diet, and to explore the mechanism. METHODS Nicotine (2 mg·kg-1 per day) was injected subcutaneously to preg?nant Wistar rats from gestational day (GD) 9 to GD20,and then the young rats were naturally delivered. After weaning, half of the offspring was fed with a high-fat diet until postnatal weeks (PW) 20. The others were exposed to unpredictable chronic stress (UCS) from PW17 to PW20. The pathological changes in the hippocampus were analyzed by HE staining. The blood concentration of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) was detected by RIA kits and ELISA kits, respectively. Meanwhile, real-time PCR was used to detect the mRNA expression of ACTH releasing hormone (CRH), arginine vasopressin (AVP), vesicular glutamate transporter 2 (VGluT2), glutamic acid decarboxylase 65 (GAD65), mineralocorticoid receptor (MR),glucocorticoid receptor (GR) and glutamic acid decarboxylase 67 (GAD67). RESULTS In the normal control group,UCS treatment increased the level of serum ACTH and CORT 1.96 and 3.24 times in female rats,but 1.63 and 3.54 times in male rats. In the PNE group, UCS treatment increased the level of serum ACTH and CORT 3.96 and 5.98 times in female rats, but 3.04 and 5.22 times male rats. PNE increased the mRNA expression of AVP in the female and male rats 2.04 and 1.13 times in UCS treatment control group, and the mRNA expression of hypothalamus CRH and the ratio of VGLuT2/ GAD65 were increased 2.49 and 1.14 times in female rats, respectively. Furthermore, the nicotine group exhibited histological changes to different degrees in the hippocampus and dentate gyrus area of the hippocampus. In the female and male nicotine groups, the mRNA ratio of hippocampal MR/GR decreased by 88.0% and 86.0% in comparison with the normal control group without UCS, and the mRNA expression of GAD67 was enhanced 1.38 and 1.97 times in female and male rats without UCS. In the female UCS treatment nicotine groups, the mRNA expression of GAD67 was increased 2.17 times compared with the UCS treatment control group. CONCLUSION PNE can induce a high sensibility of HPA axis in offspring rats fed with a high-fat diet. The imbalance of hippo?campus MR/GR and the enhanced expression of GAD67 mRNA may be involved.