Abstract: Fifteen novel ligustrazine-tetrahydroisoquinoline derivatives were designed and synthesized according to the association principle of pharmaceutical chemistry. The structures were identified by IR, NMR and ESI-MS. The inhibitory activities of platelet aggregation induced by ADP and AA have been measured by Bron method. Preliminary pharmacological results showed that compounds 7g, 7h and 7n had potent inhibitory activity against platelet aggregation induced by AA, and the compound 7o showed significant inhibitory activity against platelet aggregation induced by ADP.

Objective To observe the influence of Ligustrazine on the hemodynamic effects and prognosis in elderly patients with early cerebral ischemia following intracranial aneurysm operation ,and explore the therapeutic value .Methods 43 elderly patients with ECI following intracranial aneurysm operation were randomly divided into the Ligustrazine group (20 cases) ,and the conven-tional treatment group(23 cases)according to the table of random numbers .The patients in the Ligustrazine group were given intra-venously Ligustrazine injection and combined with conventional therapy ,whereas ,other patients were given conventional treat-ments .Results The clinical effective rate in Ligustrazine group was significantly higher than conventional treatment group (P<0 .05) .Patients recovered well in conventional treatment group were 7 cases(30 .43% ) ,mild disability 8 cases(34 .78% ) ,severe dis-ability 4 cases(17 .39% ) ,plant survival 1 case(4 .34% ) ,3 cases died(13 .06% ) ,data peer-based in the Ligustrazine group were 12 cases(60 .00% ) ,5 cases(25 .00% ) ,2 cases(10 .00% ) ,0 case and 1 case(5 .00% ) ,which were significantly lower than that of con-ventional treatment group .The prognostic scores in Ligustrazine group were apparently higher than conventional treatment group by using Glasgow outcome scale and Chinese stroke scale(P<0 .05) .Meanwhile ,the indicators of hemodynamic effects also reflec-ted that the Ligustrazine improved the blood circulation of patients with ECI ,which was better than the conventional treatment group(P<0 .05) .Conclusion The Ligustrazine Phosphate for injection showed better curative effect and prognosis in elderly pa-tients with ECI following intracranial aneurysm operation .

Objective To investigate the effects of acupoint therapy on inflammatory factors and its clini-cal efficacy in relieving bronchial asthma. Methods Selected patients with bronchial asthma which was in remis-sion were randomly divided into a treatment group that was treated with acupoint therapy and a control group that was given Seretide. Each group had 30 cases. The treatment period was 4 weeks. Both groups were evaluated in terms of Asthma Control Test ( ACT) scores and the serum content of interleukin-5 ( IL-5) and interleukin-10 ( IL-10) before and at one month ( short-term) , as well as three months after the end of the treatment ( long-term) . The asthma control situation ( fully controlled, partially controlled or uncontrolled) was evaluated. Results Before treatment the average ACT scores of the two groups were not significantly different. After the treatment both the short-term and long-term average ACT scores of the treatment group were significantly higher than those of the con-trol group. The total effectiveness rate of asthma control in the treatment group in the short term ( 93%) was signifi-cantly higher than that in the control group ( 70%) . After the treatment the IL-5 and IL-10 levels in the treatment group were improved to a significantly greater extent than those in the control group. Conclusion Acupoint thera-py can reduce airway inflammation, control bronchial asthma symptoms and show good clinical efficacy, probably by regulating IL-5 and IL-10 levels.

Objective To study the effects of repeated hypoxic exposures (HEs) on glycolysis, mitochondrial oxi-dative phosphorylation and energy charge in mouse brain. Methods Adult BALB/c mice were repeatedly exposed to hypoxia for 5 times and the standard tolerant time and body temperature were recorded. The activities of PFK, PK and mitochondrial complex Ⅰ in the brain were assayed. Phosphoadenosines and energy charge were measured. Results Repeated HEs prolonged the hypoxic tolerance and reduced the body temperature. The activities of PFK and PK experienced regular changes, with an increase in 1st and 3rd HEs and a decline to control levels in 5th HE. The complex Ⅰ activity continued to decrease during HEs. The energy charge was stable. Conclusion HEs lead to a regular change of glycolysis, a continued inhibition of mitochondrial oxidative phosphorylation, and a main-tained energy charge in the brains of mouse.

Objective To explore whether major depressive disorder（MDD）and the therapeutic effect of fluoxetine are related to a functional polymorphism-1019C/G in the promoter region of the 5-HT1A receptor（HTR1A）gene.Methods Genotype and allele frequencies of HTR1A receptor gene-1019C/G polymorphism in MDD patients and healthy subjects（control）were examined by PCR-RFLP technique.Before and after the MDD patients accepted fluoxetine treatment for 6 weeks,17-item Hamilton depression rating scales（HAMD）were made to determine the severity of the symptoms,the outcome and remission status.Results There were significant differences in-1019C/G gene genotypes and alleles distribution between the patients and the healthy control,G allele frequency of the MDD patient was higher than that of the healthy control（P 0.05）.There were significant differences in HAMD scores among the patients with different genotypes in MDD group（P 0.05）,the score of C/C genotype patient was especially higher than that of C/G genotype（P 0.05）and G/G genotype patient（P =0.008）.There was no statistical difference in the therapeutic effect of fluoxetine among the patients with different genotypes in MDD group（P =0.761）.Conclusion HTR1A gene-1019C/G genetic polymorphism might related to MDD,especially G allele might be the possible risk factor of MDD.C allele might be correlated with the degree of pathogenetic severity,especially patients with the-1019C/C carriers.-1019C/G genetic polymorphism was not related to the clinical outcome of MDD patients treated with fluoxetine.

OBJECTIVETo observe the therapeutic effect of calming the liver and restraining the Yang formula in treating patients with mild or moderate degree of essential hypertension (syndrome of hyperactivity of liver-Yang), and to explore its mechanism in lowering blood pressure.

METHODThe 348 patients with EH of stage I , II were randomly divided into two groups, the 174 patients in the treated group were treated with the calming the liver and restraining the Yang formula, and the 174 patients in the control group were treated with amlodipine. The treatment course for them all was 12 weeks. The related clincial symptoms score and quality of life score estimated before and after treatment at 4th week, 8th week and 12th week were observed. Before and after treatment, the ambulatory blood pressure (AMBP), heart rate, blood lipid, serum livels of high-sensitivity C-reactive protein (Hs-CRP), Angiotensin-II (Ang II) and calcitonin gene-related peptide (CGRP) were measured respectively in 40 patients of the treared group and 40 patients of the control group.

RESULTAfter treatment, the treatment in the treated group showed an effect better than that in the control group in terms of nigh-time blood pressure reducing rate (P < 0.05). The reducing blood pressure variability and total effective rate in the treated group were no significant than that in the control group. In respect of reducing symptomatic scores on dizzy, soreness and weakness of the waist and knees, disturbed and dry and bitter of mouth, ameliorating quality of life score, decreasing the levels of heart rate, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol(HDL-C) in the treated group were showing marked improvement as compared with that in the control group (P < 0.05 or P < 0.1). The improvement in the level of Ang II , Hs-CRP and CGRP before treatment in two groups were more significant than that after treatment (P < 0.05). However There were no difference in after treatment between the treated group and the control group.

CONCLUSIONThe calming the liver and restraining the Yang formula shows favorable efficacy in lowering blood pressure on the patients with mild or moderate degree of essential hypertension. It can reduce the clincial symptoms, improve the quality of life, regulate blood lipid metabolism. Its mechanism may be related to the functional relieving inflammatory reaction and inhibition the activity of renin-angiotensin-aldosterone system (RAAS).

Adult ; Aged ; Amlodipine ; therapeutic use ; Antihypertensive Agents ; therapeutic use ; Anxiety ; chemically induced ; physiopathology ; Blood Pressure ; drug effects ; Cholesterol ; metabolism ; Cholesterol, HDL ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Rate ; drug effects ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Triglycerides ; metabolism

Objective:To study the clinical characteristics and risk factors for hypertriglyceridemia-induced severe acute pancreatitis (HTG-SAP) complicated by acute kidney injury.Methods:The clinical data of HTG-SAP patients admitted to the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2014 to July 2022 were retrospectively collected, and divided into an AKI group and a non-AKI group according to whether AKI occurred. The general condition, laboratory data and clinical characteristics of the two groups were compared. Factors with statistically significant differences were screened for logistic regression analysis and a predictive model was constructed. We plotted the receiver operating characteristic curve and used the area under the curve (AUC) to evaluate the predictive ability of each predictor for HTG-SAP complicated with AKI.Results:A total of 91 patients were included, including 37 (40.7%) with AKI and 54 (59.3%) without AKI. The proportions of extrapancreatic infection, sepsis and multiple organ dysfunction syndrome, requiring mechanical ventilation, continuous renal replacement therapy (CRRT), retroperitoneal puncture, and surgical intervention were higher in the AKI group than in the non-AKI group (all P<0.05). The length of ICU stay, total length of hospitalization, and mortality rate in the AKI group were higher than those in the non-AKI group (all P<0.05). Multivariate logistic regression analysis showed that acute physiology and chronic health status scoreⅡ (APACHEⅡ) ( OR=2.069, 95% CI: 1.286-3.417, P=0.003), abdominal pressure ( OR=1.469, 95% CI: 1.108-1.958, P=0.007), and lactic acid ( OR=3.156, 95% CI: 1.013-9.831, P=0.047) were independent risk factors for AKI in HTG-SAP patients. The AUCs of the APACHEⅡ score, abdominal pressure, lactic acid level and combined prediction model were 0.951, 0.918, 0.837 and 0.986, respectively. Conclusions:Patients with HTG-SAP complicated with AKI were more likely to have complications related to extrapancreatic infection, sepsis and multiple organ dysfunction, and the proportion of mechanical ventilation, CRRT, retroperitoneal puncture and surgical intervention required during hospitalization was greater, the lengths of ICU stay and total hospital stay were longer, and the mortality rate was higher. APACHEⅡ score, abdominal pressure and lactic acid were independent risk factors for HTG-SAP concurrent AKI, and the prediction model established based on these three factors had higher value in predicting HGT-SAP concurrent AKI

Objective:To study the clinical effect of different application times of antibiotics in patients with hypertriglyceridemic severe acute pancreatitis(HTG-SAP).Methods:The clinical data of 92 patients with HTG-SAP who were treated at the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2016 to February 2022 were analyzed retrospectively. There were 65 males and 27 females, aged (40.82±10.55) years old. These patients were divided into three groups based on the time of prophylactic use of antibiotics: the early prevention group (used within 72 h after admission, n=39), the delayed prevention group (used after 72 h after admission, n=30) and the nonprevention group ( n=23). The clinical data such as the general data, length of stay and all cause mortality rate of the three groups of patients were analyzed. Results:Compared with patients in the nonprevention group, the incidence rate of pancreatic/peripancreatic infection [10.0%(3/30) vs. 39.1%(9/23)] and the incidence rate of bloodstream infection [6.7%(2/30) vs. 34.8%(8/23)] in the delayed prevention group were significantly decreased (pancreas/peripancreatic infection: χ 2=6.31, P=0.012; bloodstream infection: χ 2=6.72, P=0.010). The infection rate of multiple/pan resistant bacteria in the early prevention group [23.1%(9/39)] was significantly higher than the nonprevention group [4.3%(1/23)] (χ 2=4.49, P=0.034). There were no significant differences in the all cause mortality rate, length of stay, duration of intensive care, hospitalization cost, incidence of intestinal fistula and retroperitoneal hemorrhage, and the proportion of patients requiring surgery among the 3 groups (all P>0.05). Conclusions:Pophylactic use of antibiotics within 72 h of hospital admission significantly reduced the incidence of pancreatic/peripancreatic infection and bloodstream infection in patients with HTG-SAP. There were no significant differences in the final prognosis among these patients with HTG-SAP treated with antibiotics at different times.

OBJECTIVETo discuss the feasibility of terminal intestinal exteriorization (exteriorization without ileostomy) in laparoscopic anterior resection for rectal cancer.

METHODSClinicopathological data of 77 patients undergoing laparoscopic anterior resection for low rectal cancer in our department from January 2011 to December 2013 were retrospectively analyzed. After laparoscopic rectal resection, 32 patients received terminal intestinal exteriorization (exteriorization group) and 45 patients received preventive ileostomy (ileostomy group). Anastomosis-related, stoma-related and intestinal stoma closure-related morbidity was compared between the two groups.

RESULTSThere were no significant differences in operative time, blood loss and overall hospital stay between the two groups (all P>0.05). The total hospital cost was (5.39±1.74)×10(4) yuan in the exteriorization group, and (6.98±1.37)×10(4) yuan in the ileostomy group(P<0.01). The incidences of postoperative anastomotic fistula was not significantly different between the two groups(P>0.05). Three patients(9.4%) developed anastomotic leak in the exteriorization group and 2(4.4%) in the ileostomy group. The anastomotic leak was managed by opening the external intestinal wall and maturating an ileostomy under local anaesthesia. All these 5 patients were cured with nutritional support, antibiotics, continuous local drainage. In the exteriorization group, 5 patients had complications related to stoma and intestinal stoma closure operation(15.6%), which was lower than(42.2%) in the ileostomy group(P=0.013).

CONCLUSIONTerminal intestinal exteriorization in laparoscopic anterior resection is a safe and feasible surgical procedure with little trauma and less hospital cost, which can be an alternative as a prophylactic treatment for patients with high risk of anastomotic leak.

Anastomosis, Surgical ; Anastomotic Leak ; Drainage ; Humans ; Ileostomy ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Rectal Neoplasms ; Retrospective Studies ; Surgical Stomas

Since the proposal of the concept of the gut-liver axis， a large number of studies have focused on exploring the connection between gut microbiota and liver disease； however， the idea of using pyroptosis as a hub to explore the intrinsic mechanism of gut-liver crosstalk is still in its infancy. This article mainly describes the process by which gut microbiota dysbiosis affects the integrity of mucosal barrier and bile acid metabolism， induces pyroptosis， and thereby affects the development and progression of liver diseases， and it also concludes that gut microbiota dysbiosis affects liver diseases by inducing NLRP3/AIM2/Caspase-1-dependent， Caspase-4/11/GSDMD-dependent， and Caspase-3/GSDME-dependent pyroptosis. In summary， this study aims to provide new ideas and targets for the future diagnosis and treatment of liver diseases by establishing the connection between pyroptosis and intestinal-liver immune crosstalk.