A HPLC method was established to determine the contents of the five anthraquinones and rhaponticin in the different varieties of Rhei Radix et Rhizoma. The difference existed in different varieties. The results showed that rhein and rhaponticin were marker substances which could be used to distinguish palm leaf groups rhubarb and wave leaf groups rhubarb. Authentic rhubarb didn't contain rhaponticin. Falsify rhubarb contains trace amounts of rhein. Rheum tanguticum contains abundant rhein. The ratio value of the content of rhein to chrysophanol could be used to distinguish R. tanguticum from the other two authentic varieties (R. palmatum and R. officinale). The content of rhaponticin varied largely in different varieties of wave leaf groups rhubarb.
Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; Quality Control ; Rheum ; chemistry ; classification ; Rhizome ; chemistry ; classification

OBJECTIVETo assess the efficacy and safety of Tangzu Yuyang Ointment (TYO) for treatment of chronic diabetic foot ulcers.

METHODSFifty-seven patients with chronic diabetic foot ulcers of Wagner's ulcer grade 1 to 3 were randomly assigned to the control group (29 cases) and the treatment group (28 cases). Patients in the control group received the standard wound therapy (SWT), while those in the treatment group received SWT plus TYO. The ulcer healing rate, the ulcer improvement rate and the incidence of adverse events were compared between the two groups. Totally 48 patients finished the final follow-ups and entered the data analysis.

RESULTSThe ulcer improvement rate was 79.2% in the TYO group and 41.7% in the SWT group (P=0.017) at the 12th week, and 91.7% vs. 62.5% (P=0.036) at the 24th week. There was no statistical difference in the ulcer healing rate and the incidence of adverse events between the two groups at week 4, 12, and 24, respectively. The ulcer healing time was 96 +/- 56 days in the TYO group and 75 +/- 53 days in the SWT group, showing insignificant difference (P=0.271).

CONCLUSIONTYO plus SWT was more safe and effective than SWT alone in the treatment of chronic diabetic foot ulcers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diabetic Foot ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Phytotherapy ; Treatment Outcome ; Wound Healing ; Young Adult

In order to explore the influence of purified donor regulatory T cells (T(Reg) cells) infused after allogeneic bone marrow transplantation (allo-BMT) on GVHD and hematopoietic reconstitution of mice, an allo-BMT model of C(57)BL/6-->BALB/c mice was established. CD4(+)CD25(+)T(Reg) cells were purified through bead-magnetic activated cells separated from donor mice peripheral blood. The recipient mice were randomly divided into three groups: CD4(+)CD25(+) T cells, CD4(+)CD25(-) T cells and RPMI 1640 culture medium. These cells and RPMI 1640 were infused into recipient mice by caudal veins at about 6 to 8 hours after allo-BMT respectively. Incidence of GVHD, pathological lesion of liver, spleen, small intestine, survival time and hematopoietic reconstitution in the recipients were observed after allo-BMT. The results showed that the time for WBC > 1.0 x 10(9)/L was (8.14 +/- 3.26) days, (17.62 +/- 5.71) days, (19.81 +/- 6.77) days and the time for Plt > 20.0 x 10(9)/L was (5.29 +/- 1.34) days, (8.97 +/- 3.44) days, (9.52 +/- 3.92) days in T(Reg) positive cell group, T(Reg) negative cell group and the blank control group respectively, and the recovery times of WBC and Plt in T(Reg) positive cell group were faster than that in T(Reg) negative cell group and the blank control group (P < 0.05). The scores of GVHD were (1.33 +/- 0.58), (1.80 +/- 0.27), (1.93 +/- 0.45) in three groups of mice at about 15 days after allo-BMT, respectively, the GVHD in T(Reg) positive cell group was slighter than that in T(Reg) negative cell group and the blank control group (P < 0.05). It was found that GVHD pathologic manifestations of the liver, spleen and small intestine in T(Reg) positive cell group were slighter in a certain extent than those in other two groups at about (25 - 30) days after allo-BMT. The mean survival time in three groups was (41.45 +/- 17.88) days, (18.75 +/- 14.39) days and (25.67 +/- 16.84) days after allo-BMT, respectively, which in the T(Reg) positive cell group was significantly longer than that in other two groups (P < 0.05). It is concluded that donor-T(Reg) cell infusion can mitigate the GVHD so as to reach hematopoietic reconstitution and prolong survival time after allo-BMT in mice.
Animals ; Female ; Graft vs Host Disease ; immunology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Random Allocation ; T-Lymphocytes, Regulatory ; immunology ; transplantation

Adult ; Coronary Aneurysm ; complications ; Endocarditis, Bacterial ; complications ; Fistula ; complications ; Humans ; Male

BACKGROUNDSpinal anesthesia is considered as a reasonable anesthetic option in lower abdominal and lower limb surgery. This study was to determine the dose-response of intrathecal ropivacaine in patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia.

METHODSSeventy-five patients with scarred uterus undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized, double-blinded, dose-ranging study. Patients received 6, 8, 10, 12, or 14 mg intrathecal hyperbaric ropivacaine with 5 μg sufentanil. Successful spinal anesthesia was defined as a T4sensory level achieved with no need for epidural supplementation. The 50% effective dose (ED50) and 95% effective dose (ED95) were calculated with a logistic regression model.

RESULTSED50and ED95of intrathecal hyperbaric ropivacaine for patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia (CSEA) were 8.28 mg (95% confidence interval [CI]: 2.28-9.83 mg) and 12.24 mg (95% CI: 10.53-21.88 mg), respectively.

CONCLUSIONWhen a CSEA technique is to use in patients with scarred uterus for an elective cesarean delivery, the ED50and ED95of intrathecal hyperbaric ropivacaine along with 5 μg sufentanil were 8.28 mg and 12.24 mg, respectively. In addition, this local anesthetic is unsuitable for emergent cesarean delivery, but it has advantages for ambulatory patients.

Adult ; Amides ; administration & dosage ; therapeutic use ; Anesthesia, Epidural ; methods ; Anesthesia, Spinal ; methods ; Cesarean Section ; methods ; Cicatrix ; Dose-Response Relationship, Drug ; Female ; Humans ; Pregnancy ; Sufentanil ; administration & dosage ; therapeutic use ; Uterus ; pathology

OBJECTIVETo examine the relationship between effect of vascular endothelial growth factor (VEGF) on epithelial-myofibroblast transition (EMT) of HK-2 cells and changes in expressions of bone morphogenetic protein-7 (BMP-7) and inhibitor of DNA binding/differentiation (Id) 2, Id3.

METHODSThe cultured HK-2 cells were co-treated with transforming growth factor-beta1 (TGF-beta1) (5 ng/ml) and VEGF165 (0.1, 1, 10, 100 ng/ml), or with TGF-beta1 (5 ng/ml) and VEGF receptor-1 neutralized antibody (10 microg/ ml), and were also co-treated with TGF-beta1 (5 ng/ml) and VEGF165 (100 ng/ml) with or without activin receptor-like kinase 6 (Alk6)/Fc Chimera (2 microg/ml, to neutralize endogenous BMP-7) for 48 hours. mRNA and protein expressions of alpha-smooth muscle actin (alpha-SMA), E-cadherin, BMP-7, Id2 and Id3 of HK-2 cells were assessed with double-stain immunocytochemistry, real-time PCR and Western blot respectively.

RESULTSCompared with normal controls, alpha-SMA expression significantly increased, while E-cadherin, BMP-7, Id2, and Id3 mRNA and protein expressions markedly decreased in HK-2 cells treated with TGF-beta1 (5 ng/ml) (P < 0.05). VEGF165 interrupted TGF-beta1 induced alpha-SMA expression in a dose-dependent manner and upregulated BMP-7, Id2 mRNA and protein expressions of the cells (P < 0.05). alpha-SMA expression increased, while E-cadherin, BMP-7, and Id2 expressions decreased further in HK-2 cells co-treated with TGF-beta1 and VEGFR1 antibody compared with normal controls (P < 0.05). When endogenous BMP-7 was neutralized with Alk6/Fc Chimera in the cells co-treated with TGF-beta1 and VEGF165, alpha-SMA expression upregulated (P < 0.05), while Id2 was not changed.

CONCLUSIONSVEGF165 may partially inhibit TGF-beta1-induced EMT of HK-2 cells in vitro. This effect is related to the upregulated expressions of BMP-7 and Id2. Id2 may be upregulated directly by VEGF165, but not related to BMP-7.

Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Cell Differentiation ; Cell Line ; Epithelial Cells ; cytology ; metabolism ; Gene Expression Regulation ; Humans ; Inhibitor of Differentiation Protein 2 ; genetics ; metabolism ; Inhibitor of Differentiation Proteins ; genetics ; metabolism ; Neoplasm Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVETo prevent and manage frequent complications after endovascular repair of infrarenal abdominal aortic aneurysm (AAA).

METHODSThe data of 71 cases of infrarenal abdominal aortic aneurysm (AAA) treated by endovascular repair were analysed retrospectively. The reasons, managements, results and prognosis of frequent complications were investigated.

RESULTSSeventy-one cases of infrarenal AAA were treated by endovascular repair with 100% success rate. There was no surgical conversion to open aneurysm repair. There were 8 cases of primary endoleak, 1 case of nervous complication and acute thrombosis. An average follow-up period was 26 +/- 5 months. Three persistent endoleaks and 4 secondary endoleaks were found during the follow-up period. The endoleak rate was 9.8% (7/71) within 1 month postoperatively and mortality rate was 1.3% (1/71). Total mortality rate was 4.2% (3/71). Two patients died from acute myocardial infarction and one from acute heart failure.

CONCLUSIONSEndovascular treatment of abdominal aortic aneurysm is technically feasible and can effectively exclude aortic aneurysms from the circulation. Endoleak is a chief complication after endovascular repair of infrarenal AAA.Additional procedures and follow up are very important. Endoleak with enlarged aneurysm should be treated actively.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; therapy ; Prognosis ; Retrospective Studies ; Stents ; Treatment Outcome ; Vascular Fistula ; etiology ; prevention & control ; therapy

OBJECTIVETo observe the effect of donor CD4+;CD25+; regulatory T cells (TReg) on hematopoietic reconstitution, immune reconstitutuion and graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSThirty patients were divided into high TReg group (TReg> or =10.0 x 10(6) cells/kg, n=13) and low TReg group (TReg<10.0 x 10(6) cells/kg, n=17) according to the number of TReg in the grafts. Flow cytometry (FCM) was used to detect the TReg percentage in the grafts and recipients peripheral blood T lymphocyte subsets and TReg at different time points after allo-HSCT. The hematopoietic reconstitution, immune reconstitution, TReg reconstitution, incidence of GVHD and disease-free survival were compared between the two groups.

RESULTSThe high and low TReg groups showed similar WBC reconstitution time (+8.62-/+2.29 vs +8.88-/+2.71 days, P=0.778) and platelet reconstitution time (+12.69-/+5.74 vs +15.18-/+6.71 days, P=0.613). In high TReg group, the reconstitutions of CD4+;CD3+; and CD45RO+;CD4+; T cells on day 15 and CD3+; and CD4+;CD3+; T cells on day 30 were significantly accelerated in comparison with those of the low TReg group (with P values of 0.039, 0.024, 0.014, 0.020, respectively). TReg reconstitution 15 and 180 days following the surgery was significantly faster in high TReg group than in low TReg group (P=0.013, 0.005, respectively). The incidence of acute GVHD in high TReg group (61.54%) was obviously lower than that in low TReg group (94.12%, P=0.027). A negative correlation was found between the number of infused donor TReg and the severity of acute GVHD (rs=-0.393, P=0.032). The one-year disease-free survival rates of the high and low TReg groups were (60.40-/+16.10)% and (72.00-/+12.00)%, respectively, showing no significant difference between the two groups (P=0.818).

CONCLUSIONDonor TReg may promote immunological reconstitution and TReg reconstitution, and decrease the incidence of acute GVHD after allo-HSCT.

Blood Donors ; CD4-Positive T-Lymphocytes ; immunology ; Disease-Free Survival ; Graft vs Host Disease ; etiology ; immunology ; Hematopoiesis ; immunology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo explore the role of monitoring sex chromosome chimeric status by fluorescence in situ hybridization (FISH) in the identification of leukemic extramedullary relapse and post-transplant lymphoproliferative disease (PTLD) in acute lymphocytic leukemia (ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSSix ALL patients who received sex-mismatched allo-HSCT and manifested extravisceral lymphadenectasis or local lump were investigated. The sex chromosome chimeric status in tumor tissues and bone marrows (BM) were monitored by FISH, and EBV-RNA in the tumor tissues were detected by in situ hybridization (ISH).

RESULTSThe sex chromosomes in BM of all 6 patients were 100% donor-derived. Among the sex chromosome chimeric status of tumor tissues, three patients were mainly recipient-derived, and the percentage of sex chromosomes derived from recipients were 100%, 100% and 98.0%, respectively, and then they were diagnosed leukemic extramedullary relapse. The other 3 patients were donor-derived, the percentage was 98.5%, 96.0% and 91.5%, respectively, and were diagnosed PTLD. EBV-RNA and latent membrane protein (LMP-1) were positive in 2 patients with PTLD and negative in the other 4 patients. One patient with extramedullary relapse obtained partial remission, one with PTLD gained complete remission, and the others died eventually after therapy.

CONCLUSIONMonitoring the sex chromosome chimeric status by FISH is an effective method to distinguish leukemic extramedullary relapse from PTLD in ALL received sex-mismatched donor HSCT.

Adolescent ; Adult ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Lymphoproliferative Disorders ; pathology ; surgery ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; physiopathology ; surgery ; Recurrence ; Sex Chromosomes ; genetics ; physiology ; Transplantation Conditioning ; Young Adult

OBJECTIVETo evaluate the role of human leukocyte antigen G (HLA-G) in the better effect of allogenetic bone marrow transplantation than that of peripheral blood stem cell transplantation.

METHODSFlow cytometry was used to detect the expression of membrane-bound HLA-G (mHLA-G) on donor peripheral blood (PBC) or bone marrow (BM) mononuclear cells. The levels of soluble HLA-G (sHLA-G) in the plasma and bone marrow fluid were determined using enzyme-linked immunosorbent assay (ELISA) before and after granulocyte colony-stimulating factor (G-CSF) mobilization.

RESULTSThe mean levels of mHLA-G after G-CSF mobilization in the PBC and BM were significantly higher than that before G-CSF mobilization (P=0.001 and 0.000), but the plasma levels of sHLA-G showed no significant changes after the mobilization (P=0.279). The mean levels of sHLA-G in the BM fluid significantly increased (P=0.002) to a level higher than that in the PBC after G-CSF mobilization (P=0.004).

CONCLUSIONHLA-G plays an important role in immune tolerance after hematopoietic stem cell transplantation with G-CSF mobilization.

Adult ; Bone Marrow Transplantation ; immunology ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; HLA Antigens ; immunology ; metabolism ; HLA-G Antigens ; Hematopoietic Stem Cell Mobilization ; methods ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Antigens Class I ; immunology ; metabolism ; Humans ; Immune Tolerance ; Male ; Middle Aged