ve method of limb salvage.

BACKGROUND: Recent studies have demonstrated that ligustrazine removed oxygen-derived free radicals and protected vascular endothelial cells. Howerver, the effect of ligustrazine on skin flap ischemia-reperfusion injury was less reported. OBJECTIVE: To investigate the effect of ligustrazine on skin flap ischemia-reperfusion injury, and to analyze reaction pathway. METHODS: A total of 24 healthy SD rats were used to establish ischemia-reperfusion injured skin flap along superficial epigastric artery. All rats were randomly divided into sham-surgery, model control, and ligustrazine groups, with 8 rats per group. Ischemia-reperfusion injury was not induced in the sham-surgery group; saline (4 mL/kg) was given in the model control gorup 30 minutes prior to operation; an intraperitoneal injection of ligustrazine (4 mL/kg) was given in the ligustrazine group immediately after ischemia-reperfusion injury. Distal tissue was selected from skin flap in the model control group immediate after formation of skin flap, 8 hours after ischemia, and 1 hour after reperfusion, as well as in the sham-surgery group immediate after formation of skin flap, 8 and 9 hours after operation to measure superoxide dismutase (SOD) and malonaldehyde (MDA) contents. Histological morphology was observed under optic and electron microscopes.RESULTS AND CONCLUSION: At 8 hours after ischemia and 1 hour after reperfusion, SOD activity in the model control group was significantly less than in the sham-surgery group (P< 0.05-0.01), but the SOD activity in the ligustrazine group was significantly greater than in the model control group (P < 0.05-0.01). At 1 hour after reperfusion, MDA content in the model control group was significantly greater than sham-surgery group (P< 0.01), but the MDA content in the ligustrazine group was significantly less than in the model control group (P< 0.01). As compared with model control group, ultramicrostructure and vascular endothelial cell were mildly damaged in the ligustrazine group, suggesting that ligustrazine inhibited activation and adhesion of neutrophilic granulocytes, relieved inflammatory reaction, protected endothelial cells, resisted lipid peroxidation of free radicals, and prevented skin flap ischemia-reperfusion injury.

Objective To evaluate the changes in and the regularity of brainstem evoked potentials (BA-EPs) in Parkiuson's disease (PD) as an objective criterion for early diagnosis and assessment. Methods Thirty-five healthy SD rats were divided into two groups at random. Twenty-two rats were in the experimental group and 13 in the control group. The rats were injected with 8 μg of 6-OHDA solution in the right substantia nigra pars compacta (SNc) and the right ventral tegmentum area (VTA) to create a PD model. The BAEPs of the rats in the experimental group were recorded in a quiet shielded room before the 6-OHDA injection, and one week and two weeks after injec-tion. The control group rats were injected with saline (Ns) and their BAEPs were recorded at the corresponding times. One week and two weeks later, the model rats were injected with apomorphine (APO) and their rotating cycles were counted. Results The Ⅱ , Ⅳ, andV PLs and the Ⅲ-Ⅴ IPLs on the fight ears of the experimental group were prolonged significantly compared with the control group one week after APO injection. There was no significant differ-ence in the BAEPs of the left ears after the first week. After two weeks, the Ⅱ , Ⅳ, and Ⅴ PLs and the Ⅲ-Ⅴ, and Ⅰ-Ⅴ IPLs of the right ears in the experimental group were prolonged significantly compared with the controls and the Ⅳ, and Ⅴ PLs and the Ⅲ -Ⅴ , and Ⅰ-Ⅴ IPLs on their left ears were prolonged significantly. Conclusion In the early course of a PD model in rats, their BAEPs show abnormal changes, which indicates that BAEP could be an ob-jective criterion for early diagnosis and assessment of PD. BAEP may serve as one index of damage in PD. The Ⅲ-Ⅴ PL and Ⅰ-Ⅴ iPL are sensitive indices of PD.

Objective To dynamically the preparation process of Huangqi injection and to verify the rationality and existing problems of the process. Methods The preparation was made by the current standard (WS3-B-3335-98) issued by Ministry of Health, and the solid amount of the key processes were measured. The HPLC separation was performed on a Agilent Zorbax Bio-C18 reversed-phase column (250 mm × 4.6 mm, 5μm) in gradient mode of acetonitrile-water with UV detection at 254 nm. The column temperature was kept at 25 ℃, and the flow rate of mobile phase was 1.0 ml/min. Results Solid amounts of different operations of Huangqi injection were measured accurately. The content of the third water extracts was only 6.1%, and the changes of HPLC pointed the content of the 12 peaks of the second peaks decreased obviously. Conclusion The technological rationality of Huangqi injection need to be verified and optimized, the dynamic analysis of HPLC describes the changes of chemical constituents of Huangqi injection qualitatively, which also provides a reference value for establishing its fingerprint.

OBJECTIVE: To improve the dissolution rate of nitrendipine in vitro using co-grinding method.METHODS: Single-factor test was adopted to detect effect of phases of co-grinding,category of excipients (MCC,PVPk30,HPC,HPMC),time (0,10,20,30,40,50,60 min) of co-grinding and ratio of principal component to excipients (1 ∶ 1,1 ∶ 2,1 ∶ 3,1 ∶ 4,1 ∶ 5,1 ∶ 6,1 ∶ 7,1 ∶ 8,1 ∶ 9) on in vitro dissolution of nitrendipine power and tablet.RESULTS: The condition of co-grinding method was as follows: dual co-grinding phase,HPC or MCC as excipients,co-grinding time of 40 min,ratio of principal component to excipients was 1 ∶ 4.Accumulative dissolution rate of nitrendipine powder was more than 80% within 10 min and that of nitrendipine tablet was more than 80% within 40 min.CONCLUSION: Co-grinding method can improve the dissolution rate of poorly water-soluble nitrendipine in vitro under suitable condition.

OBJECTIVETo evaluate the short-term outcomes and complication management of submucosal tunneling endoscopic resection(STER) for esophageal submucosal tumors (SMTs) originating from the muscularis propria(MP) layer.

METHODSClinical data of 48 patients with esophageal SMTs from MP layer undergoing STER in the Department of Gastroenterology, the First People's Hospital of Xiangshan, Zhejiang, and the Endoscopy Center of Zhongshan Hospital, Fudan University, Shanghai between September 2013 and August 2014 were retrospectively analyzed. The clinicopathological features, complication management, and short-term outcomes were evaluated.

RESULTSAll the patients underwent STER successfully. The complete resection rate was 100%. The mean maximum diameter of the lesions was (22.9±12.1) mm (range 9.0-60.0 mm), and the mean operation time 41.8 min (range 15.0-140.0 min). Intraoperative mucosal injury occurred in 5 patients (10.4%), which was successfully clipped, pneumoperitoneum in 2 patients (4.2%) and subcutaneous emphysema in 3 patients(6.3%), which were successfully controlled with conservative treatments. Five patients (10.4%) had postoperative severe chest pain. Seven patients (14.6%) developed fever, among them, 5 were managed by conservative therapy, and 2 were submucosal tunnel infection, who were successfully treated after reclosing the ruptured tunnel entry with clips. All the removed tumors had tumor-free resection margins. The average length of postoperative hospital stay was 2.4 days (range 1-13 days). Local recurrence and distant metastasis did not occur during mean 6.8 months (range 2-12 months) follow up.

CONCLUSIONSSTER appears to be a safe and effective option for esophageal SMTs originating from MP layer. Common complications related to STER often can be successfully controlled with conservative treatments.

China ; Esophageal Neoplasms ; Esophagoscopy ; Humans ; Mucous Membrane ; Muscle, Smooth ; Operative Time ; Retrospective Studies

OBJECTIVETo explore whether microRNA-200a (miR-200a) could be used as a novel biomarker of liver cancer using a rat model system.

METHODSDiethylnitrosamine abdominal injection was applied to induce liver cancer in the F344 rat strain (n =40); ten unmodeled rats served as controls. In addition, human subjects with normal healthy liver (n =10), liver cirrhosis (n =10), and liver cancer (n =10) were enrolled in the study. Blood samples from both rats and patients and rats' livers were collected for analysis. Real-time quantitative PCR and enzyme-linked immunosorbent assay were used respectively to measure the expressions of serum miR-200a and alpha-fetoprotein (AFP) for all rat and human subjects. In situ hybridization was used to detect the miR-200a expression in the rats' livers.

RESULTSComparison of normal rats and the liver cancer modeled rats showed that the latter had significantly lower expression of miR-200a (P less than 0.05), with decreasing expression following the progression of liver injury to cancer (liver cirrhosis rats less than early liver cancer rats less than advanced liver cancer rats); in contrast, the AFP levels were significantly higher in the liver cancer modeled rats only at the early and advanced stages of the liver cancer (P less than 0.05). These

RESULTSsuggested that miR-200a expression decreases during the developmental process of liver cancer, while AFP expression increases distinctly at the stage of tumor formation. Analysis of the human subjects' clinical samples showed that miR-200a expression was decreased in both liver cirrhosis patients and liver cancer patients (vs. normal liver subjects, P less than 0.05), while AFP showed abnormal expression only in the patients with liver cancer. Comparison of the normal rats and modeled rats using in situ hybridization showed the positive rates for miR-200a expression were 1.00% +/- 0.01% in rats with normal liver, 0.37% +/- 0.03% in rats with fibrotic liver, 0.14% +/- 0.01% in rats with cirrhotic liver, 0.05% +/- 0.00% in rats with early stage liver cancer, and 0.01% +/- 0.00% in rats with advanced stage liver cancer.

CONCLUSIONMiR-200a may play an important role in liver cancer development and may have diagnostic value for indicating early liver cancer.

Adult ; Aged ; Animals ; Case-Control Studies ; Female ; Humans ; Liver ; metabolism ; Liver Neoplasms ; blood ; metabolism ; Male ; MicroRNAs ; blood ; metabolism ; Middle Aged ; Rats ; Rats, Inbred F344 ; Young Adult ; alpha-Fetoproteins ; metabolism

Objective:To investigate the characteristics, contents and effects of outpatients′ telephone counseling during COVID-19 pandemic, and to promote the development of outpatient service.Methods:Frequency Retrospective analysis was made on contents of such consultations ranging from February to April 2020, to learn their medical consultation, epidemic consultation, outpatient registration and non-attendance consultation, inspection consultation and other 5 aspects.Results:72 525 cases of outpatient telephone consultations were received, and 98.48 percent of the problems had been solved. The evaluation of outpatient satisfaction was as high as 4.60 points. The quantity of consultation at 8-11 am and 14-17 pm on weekdays was the largest. The highest proportion of information content was about COVID-19.Conclusions:Telephone consultation during COVID-19 can not only effectively reduce outpatient visits, but also effectively diverse patient flow and prove conducive to extension services of outpatients in the future.

Exosomes are extracellular vesicles released from various cellular sources and are widely present in body fluids. Bioactive substances such as microRNAs, mRNAs, and proteins are encapsulated in exosomes, which can activate various signaling pathways and play important roles in early warning of stroke and neurovascular unit repair. This article reviews the signal transduction of exosomes in cerebral ischemia.