Objective To observe liver functional lesion caused by combination chemotherapy containing or not containing oxaliplatin. Methods Data from 42 patients with liver functional lesion caused by chemotherapy between March 2005 and October 2007 were analyzed. All patients were diagnosed through histology or cytology detection and received chemotherapy only. Different drugs were. admitted,based on different tumors. Before chemotherapy, each patient had normal liver function without liver lesions such as liver metastasis, Hepatitis B and C, hepatic cirrhosis, etc. Furthermore, 22 received FOLFOX-4 in containing oxaliplatin group while the remaining 20 received chemotherapy excluding oxaliplatin. When liver functional lesion without the influence of any liver protectant was first observed, ALT, AST, TBIL, DBIL, IBIL, ALP, GGT and the WHO criteria of liver toxicity were analyzed. T test and Wilcoxon rank sum test were used for data analysis. Results All together 90 cycles, median 2.14 cycles, were given. According to WHO criteria of liver toxicity, 13 cases were in grade O, 21 in grade Ⅰ, 7 in grade Ⅱ, and 1 in grade Ⅲ. ALT and AST were significantly high after chemotherapy(P <0.05). Moreover, ALT and AST were significantly higher in containing oxaliplatin group than non oxaliplatin group after chemotherapy(P <0.05). Chemotherapy had no influence on bilirubin. The population distribution of accumulative chemotherapy cycles and WHO criteria of liver toxicity was similar between two groups. Conclusion Before the intervention of liver protectant, combination chemotherapy containing oxaliplatin is more likely to have liver functional lesion than other chemotherapy without oxaliplatin. It mainly presents an increase in transaminase.

OBJECTIVE: To study whether the effects of olanzapine on gastrointestinal motility is related to the serotonin antagonism and myosin light chain kinase. METHODS: Male Sprague-Dawley rats were randomly divided into four groups. Olanzapine gavage was performed for each treatment group during the course of 30 continuous days, while the same volume of saline was given to the rats in the control group. Defecation of the rats was observed on days 7 and 30 after olanzapine gavage. The effects of olanzapine on contraction of colonic smooth muscles were observed in ex vivo experiments. A Western blot was used to evaluate expression levels of the serotonin transporter (SERT) and MLCK in colon segments of the rats. RESULTS: ResultsaaCompared to the control group, 5-160 µM of olanzapine could inhibit dose-dependently the contraction of colonic smooth muscle ex vivo experiments. The maximum smooth muscle contraction effects of 5-HT and acetylcholine significantly decreased after treatment with 40-160 µM of olanzapine. Constipation was found in the olanzapine-treated rats on day 7 and have sustained day 30 after gavage. Expression of MLCK in olanzapine-treated rats was significantly decreased, whereas the expression of SERT significantly increased on the day 7, then significantly decreased on the day 30 after olanzapine gavage. CONCLUSION: SERT and MLCK may involve in the inhibition of colonic contraction induced by olanzapine.
Acetylcholine ; Animals ; Antipsychotic Agents ; Blotting, Western ; Colon* ; Constipation ; Defecation ; Gastrointestinal Motility ; Humans ; Male ; Muscle, Smooth ; Myosin Light Chains* ; Myosin-Light-Chain Kinase* ; Myosins* ; Rats ; Rats, Sprague-Dawley ; Serotonin Plasma Membrane Transport Proteins ; Serotonin*

Objective To investigate the management of pregnancy and cardiovascular complications in women with Marian syndrome(MFS).Methods From October 1994 to September 2006, 30 patients with MFS undergoing cardiovascular surgery were studied retrospectively.Results In the labor of 46 offsprings given birth by 30 women,5 cases(11%)were performed elective cesarean section because of the existence of aortic complication,and 12(26%)were diagnosed as MFS.The gestation in two patients was terminated due to deterioration of aortic abnormalities during their third trimester,and they received surgical treatment with Bcntall procedure.Two developed acute aortic dissection during labor and post delivery respectively.With the manipulation of anticoagulation peripartum,one who had the implantation with mechanical prosthesis went through pregnancy and delivery uneventfully.The average duration between delivery and cardiovascular surgery was(15?9)years.Conclusions Vaginal delivery can be done safely in patients with the MFS who do not have or have mild cardiovascular system abnormalities,aortic dissection,or other important cardiac abnormalities,cesarean section should be the preferred method of delivery.Women with MFS are at increased risk for dissection and congestive heart failure during pregnancy and should be counseled before pregnancy about these risks,as well as the inheritance of the condition.

AIM:To investigate the effects of DL-3-n-butylphthalidle (NBP) on angiogenesis of human um-bilical vein endothelial cells ( HUVECs) and the role of vascular endothelial growth factor ( VEGF)/VEGF receptor 2 (VEGFR2)-Notch1/Delta-like ligand 4 (Dll4) signaling pathway in this process. METHODS:The serum-free medium and anoxic tank were used to simulate the conditions of hypoxia and ischemia ( H/I). HUVECs were divided into control group, H/I group, H/I+NBPhigh group and H/I+NBPlow group. The HUVECs in control group were conventionally cul-tured, and those in H/I group were cultured under H/I intervention. The HUVECs in H/I+NBPhigh group were treated with NBP at 20 μmol/L under H/I intervention. The HUVECs in H/I+NBPlow group were treated with NBP at 5 μmol/L under H/I intervention. The cell viability of each group was measured by CCK-8 assay. The migration ability of the HUVECs in each group was detected by cell scratch test. The vessel formation ability of the HUVECs was examined by in vitro angiogenesis assay. The expression of VEGFR2, Notch1 and Dll4 at mRNA and protein levels was determined by qPCR and Western blot, and the expression of VEGF was determined by qPCR and ELISA. RESULTS:NBP increased the viability of HUVECs, and promoted the migration ability and the formation of blood vessels in vitro under H/I interven-tion. These effects of NBP at high dose were more significant than those at low dose. NBP increased the expression of VEGF, VEGFR2, Notch1 and Dll4 at mRNA and protein levels (P<0.05). CONCLUSION:NBP promotes HUVECs to form blood vessels under H/I intervention. The mechanism may be related to the activation of VEGF/VEGFR2-Notch1/Dll4 signaling pathway.

OBJECTIVETo study the new hydrolysate of aconitine using HPLC-MS(n) and quantum chemistry calculation.

METHODThe HPLC method was applied in gradient elution program and the mass spectrometry was in positive ion mode. Geometries of the possible hydrolysates were optimized at DFT/6-31G(d) level.

RESULTThe new hydrolysate was found and its protonated molecularions was at m/z 482. The quantum chemistry calculation results show that the product of elimination reations at C8 and C15 got the lowest energy conformation. The compound at m/z 482 was decluced to be the hydrolysate of carbony at C15.

CONCLUSIONDelydration aconine was detected for the first time and the new hydrolysis pathways of aconitine in water were deduced.

Aconitine ; chemistry ; Chromatography, High Pressure Liquid ; Hydrolysis ; Mass Spectrometry ; Models, Molecular ; Molecular Conformation

OBJECTIVETo establish the liver-depression and spleen-deficiency syndrome model in rats to screen the optimal extraction method of small compound Yueanjian on the basis of pharmacodynamic and chemical indicators.

METHODThe PMS liver-depression and spleen-deficiency syndrome model were established by the chronic restraint stress method and treatment with Yueanjian extracted by three methods: water-extraction, steam-distillation and alcohol-extraction. Behavioral performances and the contents of estradiol and progestin in serum were determined before and after the administration of the three extracts. The contents of salvianolic acid B in these three extracts were detected by HPLC. The optimal extraction method of Yueanjian was selected according to pharmacodynamic results.

RESULTThe contents of estradiol and progestin in groups treated with steam distillations and alcoholic extraction were higher than the model group. In the open field test, the group treated with steam distillations showed much higher scores than the model group. HPLC showed that the content of salvianolic acid B extracted by steam-distillation was higher than the other two extracts.

CONCLUSIONOn the basis of pharmacodynamic and chemical results, the steam-distillation was proved to be best extraction method of Yueanjian.

Animals ; Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; Distillation ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; therapeutic use ; Estradiol ; blood ; Female ; Premenstrual Syndrome ; blood ; drug therapy ; Progestins ; blood ; Rats ; Rats, Wistar

Objective To study the video-electroencephalography (vEEG) background activities of very premature infants within the first 7 days after birth.Method The inclusion criteria were gestational age (GA) within 31 weeks and bedside vEEG monitoring within first 7 days of birth.Those with severe cranial ultrasound (CUS) findings,refused treatment,dead and with seizures on vEEG were excluded.The clinical information of included cases were reviewed and the continuity and sleep-wake cycle (SWC) on their EEG background activities were analysed.Result From June 2017 to April 2018,a total of 56 cases were included.Their GA were (29.4 ± 1.6) weeks,and birth weight were (1 306 ± 316) g.A total of 31 cases were diagnosed with asphyxia(1 min Apgar score less than 8),and no one with 5 min Apgar score below 5.Their umbilical artery blood pHs were 7.29 ± 0.07.Their first CUS and the CUS at corrected gestational age (cGA) full term were all within the normal range.The Gesell neurological assessment at cGA 6 months were all within the normal range.As the cGA increased,the continuity of EEG background activities became more continuous as the normal continuous/discontinuous pattern.The 95％ confidence interval of max interburst interval was 95 s.The SWC first occurred at GA 26 w,but was immature,then became mature as the cGA increased.Conclusion The EEG background activity analysis of relatively normal very premature infants within first week shows that interburst interval can be longer than the previous report,and the SWC first appear at GA 26 w.

Objective To improve the diagnosis accuracy and treatment quality of juxtaglomerular cell tumor.Methods The clinical data of 2 female patients(20 and 36 years,respectively)with juxtaglo- merular cell tumor were presented and discussed in combination with review of the literature,including the onset characteristics,imaging features,treatment,pathology and prognosis.Case 1 presented with hyperten- sion of 180/110 mm Hg.The laboratory examinations showed that in decubitus and standing position,the plasma rennin activity(PRA)was 3.2?g - L~(-1)?h~(-1)and 36.5?g?L~(-1)?h~(-1);angiotensinⅡwas 54.3 pg/ml and 183.5 pg/ml;aldosterone was 193.5 prnol/L and 489.4 pmol/L,respectively;serum kalium was 2.6 mmol/L.Case 2 presented with hypertension of 210/120 mm Hg.The laboratory examination results were as follows:in decubitus and standing position,PRA was 4.3?g?L~(-1)?h~(-1)and 37.0?g?L~(-1)?h~(-1);angio- teusinⅡwas 55.6 pg/ml and 200.4 pg/ml;aldosterone was 162.4 pmol/L and 506.3 pmol/L,respectively; serum kalium was 3.0 mmol/L.On CT scan,both cases had renal tumor,with the diameter of 3.0 cm and 3. 5 cm,respectively.Results Case 1 underwent laparoscopic partial nephrectomy.Case 2 who had artery stricture and severe functional injure of the right kidney underwent laparoscopic right nephrectomy.The oper- ative time was 3.0 h and 2.0 h,and the blood loss was 175 ml and 112 ml,respectively.There was no mor- tality or postoperative complication.In 1 or 2 postoperative weeks,Case 1 had blood pressure(BP)of 120/70 mm Hg;in deeubitus and standing position,PRA was 1.5?g ~ L~(-1)?b~(-1)and 12.8?g?L~(-1)?h~(-1);angio- tensinⅡwas 30.6 pg/ml and 97.5 pg/ml;aldosterone was 78.5 pmol/L and 192.2 pmol/L,respectively ;se- rum kalium was 4.2 mmol/L.Case 2 had BP of 125/75 mm Hg;in decubitus and standing position,PRA was 1.6?g.L~(-1)?h~(-1)and 12.3?g.L~(-1)?h(-1);angiotensinⅡwas 34.3 pg/ml and 83.5 pg/ml;aldoste- rone was 62.6 pmol/L and 292.5 pmol/L,respectively;serum kalium was 4.8 mmol/L.Pathology showed that the juxtaglomerular cell tumor had intact envelop.Light microscopically,the tumor was very much like a hemangiopericytoma,showing active proliferation and nuclear atypia.The immunohistochemical staining showed positive Vimentin,CD_(34)expression,and negative MSA,EMA,Bcl-2,?-SmA,AG/AG3,34?En, CD_(117),CD_(31),Iv glue,Ki-G~-(＜2%)expression.Ultrastructural changes of the nuclei and some organelles in the cytoplasm were observed under electron microscope.The conspicuous ultrastructural feature was the pres- ence of secretion granules and rhomboid-shaped,crystal-like structures in the dilated cisternae of rough endo- plasmic reticulum and vesicles of Golgi complex.The follow-up was 14 and 6 months,respectively;the renal function was normal and no tumor recurrence was found.Conelusions Juxtaglomerular cell tumor is a rare tumor which can produce renin.It is characterized by severe hypertension and low serum potassium.La- boratory examination results are helpful for the diagnosis:PRA and angiotensinⅡincrease obviously ;aldoste- rone is 1-10 times more than normal;serum kalium is commonly between 2.1-3.5 mmol/L.The definite diagnosis depends on clinical presentations,immunohistochemistry,light and electron microscopic examina- tions.Laparoscopie operation is the first choice of surgical treatment.

AIM:To detect the myeloid-derived suppressor cells(MDSCs )in peripheral blood from the pa-tients with Parkinson disease(PD)and its clinical significance.METHODS:The patients(n=80)diagnosed PD from January 2016 to March 2017 in our hospital and 20 healthy volunteers were selected as the subjects.According to the Hoehn-Yahr staging,80 PD patients were staged,of whom 22 were Ⅰ,24 were Ⅱ,20 were Ⅲ,14 were Ⅳ,and 0 was Ⅴ. Peripheral blood(5 mL)samples from the patients with PD and the healthy volunteers were collected and the mononuclear cells were isolated.The levels of CD14 +CD11b+cells and CD14 -CD11b+cells in the peripheral blood were detected by flow cytometry.The two populations of the cells were sorted by magnetic beads.The mRNA levels of arginase 1(ARG1),interleukin-10(IL-10)and cyclooxygenase 2(COX-2)were detected by qPCR.The expression of surface membrane pro-teins CD14 and CD11b,and immunosuppressive factors ARG1,IL-10 and COX-2 was determined by Western blot and ELISA.RESULTS:No significant change of CD14 +CD11b+cells between the patients with PD and normal controls was observed,but the cells with CD14 -CD11b+increased significantly in the patients with PD compared with the control peo-ple(P<0.05).The CD14 -CD11b+cells in peripheral blood of the patients were related to the stage of Hoehn-Yahr.The CD14-CD11b+and CD14+CD11b+cells showed high levels of IL-10 and COX-2,and the high level of ARG1 was only expressed in the CD14 -CD11b+cells.The expression of ARG1 in the CD14 -CD11b+population from PD patients was significantly different from that of CD14+CD11b+population and normal subjects(P<0.05).CONCLUSION:The CD14-CD11b+cells and ARG1 expression level in peripheral blood of the PD patients can be used to evaluate the patho -genesis and staging.Immunosuppression may play an important role in the pathogenesis and development of PD.

Objective:To evaluate the nutritional status of patients in intensive care unit (ICU) by using nutritional risk screening 2002 scale (NRS2002), subjective general assessment (SGA) and critical illness nutritional risk score (NUTRIC), and to compare the characteristics and applicability of three scoring tools.Methods:A cross-sectional survey was conducted. 315 patients admitted to the comprehensive ICU of Affiliated Qingdao Municipal Hospital of Qingdao University from April 2018 to July 2019 were enrolled. Basic information of patients was collected, and patients were divided into two groups with 65 years old as the standard to compare the nutritional status of patients among different genders and ages. The nutritional status of patients were assessed by NRS2002, SGA, and NUTRIC. Height, weight, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC), leg circumference (LC), and other related parameters of human nutrition were measured. Total protein (TP), albumin (Alb), prealbumin (PA), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglyceride (TG), total number of lymphocytes (LYM), hemoglobin (Hb), C-reactive protein (CRP) and other blood biochemical indicators were performed. Spearman rank correlation analysis was used to analyze the correlation between the three nutrition evaluation scales and other objective nutrition parameters. Binary multivariate Logistic regression analysis was used to evaluate the influencing factors of nutritional status with three scales of patients in ICU.Results:Among 315 patients in ICU, 183 were male and 132 were female. There were 143 patients < 65 years old and 172 ≥ 65 years old. In male patients, the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, age and BUN of patients aged ≥ 65 years old were significantly increased, and the height, weight, BMI, TSF, AC, LC, Alb and PA were significantly lowered as compared with those aged < 65 years old, while the difference in other indicators was not statistically significant. In the female patients, the APACHEⅡ score, age, SCr and BUN of the patients aged ≥ 65 years old were significantly increased, the height, Alb, PA and Hb were significantly decreased as compared with those aged < 65 years old, and the difference in other indicators was not statistically significant. The proportion of patients with nutritional risk evaluated by NRS2002 (NRS2002 score ≥ 3) was 87.62% (276/315). SGA showed that the proportion of malnourished patients (SGA was grade B or C) was 62.86% (198/315). NUTRIC showed 66.03% of patients (208/315) in high nutritional risk (NUTRIC score ≥ 5). Spearman rank correlation analysis showed that there were significant correlations among NRS2002, SGA and NUTRIC of patients in ICU ( rNRS2002 with SGA = 0.522, rNRS2002 with NUTRIC = 0.392, rSGA with NUTRIC = 0.442, all P < 0.01). Among the three assessment tools, SGA had the best correlation with blood biochemical indicators and body measurements to assess nutritional status, followed by NRS2002, and NUTRIC had the worst correlation. Binary multivariate Logistic regression showed that APACHEⅡ score, BMI, AC, BUN and TG were factors influencing NRS2002 assessment of nutritional status in ICU patients [odds ratio ( OR) were 2.535, 0.404, 1.438, 0.858, and 2.391, respectively, all P < 0.05]; APACHEⅡ score, age, weight, TP, BUN, LYM and CRP were influence factors of SGA for evaluating the malnutrition of patients in ICU ( OR values were 1.074, 1.038, 0.921, 0.947, 1.077, 1.625 and 0.991, respectively, all P < 0.05); APACHEⅡ score, age, LYM and CRP were the influence factors of NUTRIC assessment for malnutrition of patients in ICU ( OR values were 1.159, 1.049, 0.715 and 0.995, respectively, all P < 0.05). Conclusions:The nutrition status of ICU patients evaluated by NRS2002, SGA and NUTRIC was simple and easy to operate, and the positive screening rate of NRS2002 was the highest, which was suitable for patients with mild conditions in ICU. SGA is the most valuable tool to evaluate the nutritional status of ICU patients. NUTRIC has a poor correlation with objective indicators reflecting nutritional status, while its indicators are objective and easy to obtain, which is suitable for ICU patients with critical condition and unclear consciousness. Nutritional assessment tools should be integrated with the patient's gender, age, anthropometric and biochemical indicators.