Objective To summarize the clinical features and transsphenoidal microsurgical experiences of pituitary adenomas in the elderly patients over 70 years old Methods Twenty four elderly patients accepted transsphenoidal microsurgery were conductded a retrospective review,whose clinical data including clinical main presentation,histological types,surgical conditions,perioperative treatment and outcome were also analyzed Results There were 16 non functional adenomas (66 7%) and 18 giant macroadenomas(75%) respectively Visual deterioration was the commonest complain in 20 (83 3%) Despite the majority of patients having coexisting medical conditions,we had no mortality and no postoperative adjunctive morbidity with an average hospital stay of 17 8 days For an average follow up of 3 5 years,we did observe major patients(79 2%) vision had improved Conclusions Pituitary adenomas in the elderly are most frequently non functional macroadenomas that present with visual deterioration and hypopituitarism If special care is devoted to the perioperative treatment,in particular to fluid and electrolyte balances,transsphenoidal microsurgery is safe and effective in hands of an experienced team

Objective:To study the clinical effect of herba Houttuyniae Injection by aerosol inhalation for respiratory tract infection. Methods: 107 patients with respiratory tract infection (the main symptoms were cough and expectoration) were treated with Herba Houttuyniae Injection by aerosol inhalation. The conditions of symptom improvement and bacteria in sputum before and after treatment were observed. The case control studies on parts of patients in acute attack and delayed peroids of chronic bronchitis were carried out. The treatment processes patients were given 25mL Herba Houttuyniae Injection and 25mL normal saline by aerosol inhalation for 30 minutes, twice a day. Results: The effective rates were 91.59% for cough symptom, 85.06% for expectoration symptom. 98.13% patients experienced comfort of pharyngeal and thoracic protions after treatment. Among 55 patients whose cough symptom wasn't improved after they were treated with anti inflammatory agent and antitussive the effective rate was 72.72% after treatment with Herba Houttuyniae Injection by aerosol inhalation. The 45 case control studies of acute attack and delayed periods of chronic brochitis showed no statistically difference between them. The clearance rate of bacteria in sputum after treatment was 80.39%. Conclusions: Herba Houttuyniae Injection by aerosol inhalation is effective for respiratory tract infection with the main symptoms of cough and expectoration.

Objective To investigate the relationship among interstitial infiltrating inflammatory cells (including CD4+, CD8+, CD25+, MAC387+ and 27E10+), renal function and pathological changes in IgA nephropathy (IgAN). Methods This study included 36 IgAN patients. PAS and immunohistochemistry method were applied to stain paraffin sections. The surface of interstitial tubules, the amount of CD4+, CD8+, CD25+, MAC387+, 27E10 + cells per unit were counted(cells/mm2), together with pathological changes (including glomerulosclerosis, tubular atrophy and interstitial sclerosis) and renal function during and after biopsy were determined by using image analysis system and SPSS software pack. Results In the renal tubulointerstitium, the number of CD4+ cells correlated with interstitial fibrosis (r=0.38 ,P

Objective To observe the correlation between the changes of neural cell apoptosis arid caspase-3 gene expression in brain tissues following acute severe traumatic injury to brain(TIB).Method A total of 120 adult Spraque-Dawley rats were divided into a control group(n=8)，TIB group(n=56)and TIB with administration of caspase-3 inhibitor group(n=56).TIB models of rats were made with Feeney's method.The z-DEVDfmk(5 μg)，caspase-3 inhibitor，was administered by intracerebral infusion，and the rats were sacrificed 1，6，24，48 hours and 3，7，14 days postinjury(n=8 for each interval).The specimens of the injured cerebral cortex，suhcerticai white matter，hippocampus，dentate gyrus and contrahteral corresponding brain tissues were taken for detecting apoptesis of neural cells by the terminal deoxynucleotidyl transferase mediated DUTP nick end labeling (TUNEL)methods and flow cytomeay.Caspase-3 mRNA and protein expression were detected by using RT-PCR，immunohistochemistry and western blot analysis.The caspase-3 activity was detected by using caspase-3 fluorescent assay kit.Student t-test and Spearman correlation analysis were used to analyze the data with SPSS version 10.1 software package.Results Apoptesis indexes(AI)and the apoptesis percentage(AP)of neural cells in the injured brain regions increased quickly after injury，and reached its peak 24 to 48 hours later，then decreased slowly,but it remained at higher level above that of normal till 14 days later(P＜0.01).The levels of caspase-3 mRNA,eastme-3 protein and caspase-3 activity were increased significantly post injury，and reached its peak at 24 to 48 hours，then it gradually decreased.Compared with control group，the levels ofoptical density of caspase-3 proteins in the injured hippocampus and subcortical white matter at 24 and 48 hours post injury increased 1484% and 1690%，caspase-3 mRNA expressiom increased 1043%and 1180%，and the degreas of caspase-3 activity increased 148% and 183%，respectively.The expression of caspase-3 proenzyme and its P17 subarrit increased.After trealment with caspase-3 inhibitor z-DEVD-fmk，the levels of caspase-3 mRNA，protein expression and caspase-3 activity were significantly decreased.and AI and AP were significantly decreased as well.The correlation between caspase-3 mRNA and level of neural apoptesis was positive(r=0.821，P＜0.01)，and it was likewise between caspase-3 protein and level of neural apoptosis(r=0.638.P＜0.01).Interestingly enough，a positive correlation was found between caspase-3 mRNA and easpase-3 proteins(r=0.945，P＜0.01).Conclusions The activation of caspase-3 leads to apoptosis of neural cells after acute TIB.The expression of caspase-3 are consistent with apoptosis of neural cells following TIB.The regulation of caspase-3 induced by TIB occurs at a ceriain critical link before transduction.Caspase-3 inhibitor can efficiently inhibit apoptosis of neural cells following TIB.

Objective To evaluate the clinical significance of detecting urinary natural killer(NK) cells in patients with general types of glomerulonephritis. Methods The contents of urinary NK cells from 54 patients with glomerulonephritis were measured by flowcytometry,while all patients were classified into two groups including acute proliferation group and none-acute proliferation group by renal biopsy results. The content of urinary NK cells was compared between the two groups. Results The content of urinary NK cells in acute proliferative glomerular disease group were( 14. 8 ±3. 3)% (30 cases) ,which was significantly higher than that of(21. 6 ±2. 9)% (24 cases) in the non-acute proliferative glomerular patients(P<0.05). Conclusions Decreasing of the contents of NK cells in urine may be an indirect indicator of the activity of glomerulonephritis.

BACKGROUND:The therapeutic effect of traditional Chinese drug on myocardial ischemia and reperfusion has been increasingly attached importance to. The tongxinluo, a Chinese paten drug taking insect medicine as its major gradients, has been achieved satisfactory effect in anti-myocardial ischemia clinicallyOBJECTIVE: To investigate the effect of tongxinluo on myocardial apoptosis induced by ischemic reperfusion.DESIGN:A randomized controlled trialSETTING: Department of Traditional Chinese Medicine (TCM) of the First Affiliated Hospital, Sun Yat-sen UniversityMATERIALS:The experiment was conducted from November to December 2002 at the Molecular Medicine Research Center of Sun Yat-sen University.METHODS:Totally 72 Kunming mice were at random divided into 6groups with 12 in each group: 2 g/kg tongxinluo, 1.5 g/kg tongxinluo, 1.0g/kg tongxinluo group (The mice were administrated by gavage, once a day, on the day 5, one hour after administration, pituitrin and nitroglycerin were in combination used for building the myocardial ischemic reperfusion model), isosorbide dinitrade group (The dose was 3.9 g/kg, and the rest treatment was the same as the above), model group and blank control group(Normal saline was taken as substitute for the drug). At the end of trial the myocardia of the mice were taken for investigating the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) of myocardia in mice with ischemic reperfusion, analyzing the myocardial apoptosis index, and determining the expression levels of apoptosis-relevant proteins bcl-2 and bax.MAIN OUTCOME MEASURES: [1] Comparison of SOD activity and MDA level in mice of each group. [2] Comparison of myocardial apoptosis and apoptosis relevant proteins.RESULTS:Totally 72 mice involved were good for the trial and no one died. [1] SOD activity and MDA level: Compared with the model and isosorbide dinitrade groups, SOD activity in 2 g/kg tongxinluo, 1.5 g/kg tongxinluo, 1.0 g/kg tongxinluo group was increased [( 1379.28±140.03 ),(1223.91 ±109.02), (1789.19 ±155.20), (2267.79 ±216.04), (2387.55±229.71 )nkat/L]; MDA level was decreased [(16.58±2.59), (20.40±2.66),(12.73±1.98), (9.65±2.03), (7.56±1.67)nmol/L], and the effect was increased as the dose was raised [2] myocardial apoptosis and apoptosis relevant proteins: Compared with the model and isosorbide dinitrade groups, the myocardial apoptosis index and Bax expression index in 2 g/kg tongxinluo,1.5 g/kg tongxinluo, 1.0 g/kg tongxinluo group were obviously decreased[(13.84±1.97)%, (11.56±1.43 )%, ( 334±0.96)%, (0.82±0.12 )%, (0.42±0.06)%;(17.44±6.18)%, (15.45±3.72)%, (10.85±2.73)%, (6.46±1.88)%, (5.57±1.49)% ]; Bcl-2 expression index was obviously increased [(6.22±0.50)%, (8.73 ±0.63)%, (11.38 ±1.38)%, (16.22 ±2.36)%, (19.45±2.92)%], and with a dose-effect relationship.CONCLUSION:Tangible capsule had the effects of. resisting oxygen free radical injury, anti-myocardial apoptosis and protecting ischemic reperfusion myocardial cells, and with a dose dependence.

BACKGROUND: In the evaluation on the effects of intervention on the patients with angina pectoris,whether the quality of life is improved or not is a very important factor while the symptoms and physical signs are benefited.OBJECTIVE: To probe into the intervention effects of sini tang,the classic formula,on angina pectoris of coronary heart disease and compare the effects of simple Chinese herbs,western medicine and integrated traditional Chinese and western medicine on quality of life.DESIGN:Prospective observation and control study in which the patients with angina pectoris of coronary heart disease were taken as the objects.SETTING: Department of Traditional Chinese Medicine of a Hospital Affiliated to a University.PARTICIPANIT : The 88 cases in total were the patients with angina pectoris of coronary heart disease in the clinic of Department of Traditional Chinese Medicine of First Hospital Affiliated to Sun Yat-sen University from February to August 2003. Inclusion criteria: those compiled with "Guide Principles of Pharmaceutical Clinical Study in Cardiac Vascular System" and "Standards on Differentiation of Coronary Heart Disease with Chinese Medicine". Exclusion criteria: those complicated with various severe diseases. All the patients were randomized into sini tang group,isosrbide dinitrate group and allied medication group of 29,30 and 29 cases successively.METHODS: In sini tang group,isosrbide dinitrate group and allied medication group,sini tang,isosrbide dinitrate and sini tang allied with isosrbide dinitrate were prescribed successively. At the beginning and the end of treatment, it was to observe the attack frequency,condition, severity and persistent duration of angina pectoris and to record electrocardiogram (ECG).The evaluation on quality of life was carried on before and two weeks after medication with the unified inventory and determination device.MAIN OUTCOME MEASURES: Comparisons of therapeutic effect on angina pectoris control,ECG and evaluation on life quality in every group.RESULTS: Both isosrbide dinitrate and sini tang relieved remarkably angina pectoris, improved ECG and quality of life in physical symptoms, health pleasure and depression level(P<0.01) . The result of sini tang on improving the quality of life in above-mentioned three aspects was better than that of isosrbide dinitrate(P<0.01) . But the allied medication improved clinical therapeutic effects and quality of life (health pleasure and depression level) best(P<0.01).CONCLUSION: Sini tang benefits the improvement of quality of life of patients with angina pectoris. But during clinical medical intervention,the advantages of integrated traditional Chinese and western medicine should be adopted.

This study was aimed to observe the clinical efficacy of Ju-Hong Tan-Ke (JHTK) liquid in the treatment of patients with anemofrigid (or mixing with damp) cough.A total of 70 patients with anemofrigid (or mixing with damp) cough admitted to Chinese medicine clinic in our hospital were selected and randomly divided into the treatment group (n =50) and the control group (n =20).Patients in the treatment group were treated with 2 JHTK liquid (Guangzhou Xiangxue Pharmaceutical Co.,Ltd.,20 ml),3 times a day.Two She-Dan Chen-Pi (SDCP) liquid (20 ml) was used in the control group,3 times a day.The treatment course was 1 week.Differences of the clinical efficacy of cough and expectoration symptoms between two groups after treatment were compared.The effect of JHTK liquid on different degrees of cough and expectoration was also compared.The results showed that the total effective rate of cough in the treatment group was 92.00％,which was obviously higher than 70.00％ of the control group with statistical difference (P＜ 0.05).The total effective rate of expectoration symptoms in the treatment group was 94.00％,which was obviously higher than 75.00％ of the control group with statistical difference (P＜0.05).The curative effects of JHTK liquid in the treatment of mild,moderate and severe cough were 90.00％,93.75％,and 87.50％,respectively.The curative effects of JHTK liquid on mild,moderate and severe expectoration were 100％,96.77％,and 80.00％,respectively.It was concluded that JHTK liquid can effectively improve cough and expectoration symptoms of patients with anemofrigid (or mixing with damp) cough,especially the clinical curative effect of mild and moderate cough with expectoration was obviously and the effect of severe cough and expectoration was excellent.Its curative effect was superior to SDCP liquid,which is worthy of clinical application.

OBJECTIVE:To evaluate clinical efficacy of Angong niuhuang pill combined with chemical drug in the treatment of severe craniocerebral injury and its effect on the concentration of Mg2+ in peripheral blood,and to provide evidence-based reference in clinic.METHODS:Retrieved from Chinese Journal Full-text Database,China Science and Technology Journal Database,China Bxdxiology Medicine disc,Wanfang Database,Chinese Clinical Trial Registry,PubMed,Excerpta Media Database,The Cochrane Library,Web of Science,Clinical Trials,and related literatures of intemet searched by Google Scholar,randomized controlled trials (RCT) about Angong niuhuang pill combined with chemical drug (trial group) vs.chemical drug (control group) in the treatment of severe craniocerebral injury and its effects on the concentration of Mg2+ in peripheral blood were collected.After literature screening,data extraction,quality evaluation with modified Jadad scale,meta-analysis of Glasgow Coma Scale (GCS) scores and Mg2+ concentration in peripheral blood were conducted by using Rev Man 5.3 statistical software after 7 d of treatment.RESULTS:A total of 6 RCTs were included,involving 773 patients.Results of meta-analysis showed that GCS [MD=2.87,95％CI (1.64,4.10),P＜0.01] and Mg2+ concentration in peripheral blood [MD=0.11,95％CI(0.06,0.16),P＜0.01] of trial group were significantly higher than those of control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Angong niuhuang pill combined with chemical drug is better than that of chemical drug alone in the treatment of severe craniocerebral injury,can improve clinical symptom and prognosis.

Objective To establish a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs with high repeatability and stability. Methods Twelve Bama miniature pigs were randomly divided into the donor group (n=6) and recipient group (n=6). Pigs underwent non-venous bypass orthotopic liver transplantation. The time of anhepatic phase during operation was shortened, blood pressure during anhepatic phase was stably maintained, and management of anesthesia and body fluid during operation were strengthened. The operation time, anhepatic phase and survival status of the recipients were observed and recorded. The intraoperative heart rate, mean arterial pressure (MAP) and changes in arterial blood gas analysis were monitored. The perioperative liver function was evaluated. Results Among 6 Bama miniature pigs, 1 died from transplantation failure intraoperatively. The operation time of the remaining 5 pigs was (247±27) min and the time of anhepatic phase was (46±4) min. Three animals survived for more than 2 weeks. Compared with the preanhepatic phase, the heart rate of the animals was significantly faster, MAP was considerably reduced to (46±6) mmHg, blood pH value, base excess (BE) and HCO₃^- level were all significantly decreased and serum level of K⁺ was significantly elevated during the anhepatic phase (all P < 0.05). In the neohepatic phase, MAP of Bama miniature pigs was significantly increased, heart rate was dramatically slower.Blood pH value, BE, HCO₃^- level were significantly increased and serum level of K⁺ was significantly declined (all P < 0.05). During abdominal closure, MAP, blood gas indexes and serum level of K⁺ were almost recovered to those in the preanhepatic phase. Compared with preoperative levels, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)were significantly increased after operation (all P < 0.05), the change in AST was the most obvious, and it gradually decreased at postoperative 2 d. The level of γ-gutamyl transferase(GGT) did not significantly elevated. The level of total bilirubin (TB) was evidently elevated at postoperative 5 d. Compared with the preoperative levels, the levels of total protein (TP) and albumin (ALB) were significantly decreased after operation (both P < 0.05), and began to gradually increase at postoperative 1 d. Conclusions The non-venous bypass orthotopic liver transplantation model of Bama miniature pig is convenient, with highly reproducible and survival rate, which can be utilized as a standardized liver transplantation model.