Objective To explore the early predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive disease and its significance for the decision of exploratory laparotomy.Methods This retrospective study enrolled 29 patients diagnosed with acute superior mesenteric artery embolism or thrombosis in Peking University People's Hospital between July 1995 and June 2015.Results 12 patients developed intestinal necrosis.Patients with intestinal necrosis had a poorer prognosis than those who did not develop intestinal necrosis (x2 =14.867,P =0.000).In univariate analysis,the early predictive factors for intestinal necrosis were D-Dimer ≥ 600 μg/L (x2 =11.455,P =0.002),INR≥1.2 (x2 =3.948,P =0.047),pH values ＜7.4 (x2 =8.191,P =0.004),BE ＜ -1.0 mmol/L (x2 =8.191,P =0.004),blood lactate ≥ 2.2 mmol/L(x2 =7.535,P =0.006),BUN ≥ 6 mmol/L (x2 =10.076,P =0.002),CK ≥ 80 U/L (x2 =8.191,P =0.004),LDH ≥ 210 U/L (x2 =13.079,P=0.000),AST ≥25 U/L (x2 =10.076,P =0.002),SIRS (x2 =10.076,P =0.002).Multivariate logistic regression analysis found no independent predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive diseases.Conclusion Intestinal necrosis in acute mesenteric arterial occlusive diseases indicates a poor prognosis.Coagulation abnormalities,liver or kidney dysfunction,metabolic acidosis and SIRS necessitates an immediate exploration.

Objective:To analyze the effects of essential medicine system on revenue structures at primary med-ical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results:Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medi-cine revenue to pharmaceutical revenue rose from 20 . 45% in 2009 to 97 . 03% in 2013 , though the percentage of pharmaceutical revenue to total revenue dropped by 18 . 43%. The percentage of fiscal subsidy revenue in total reve-nue rose from 25 . 77% in 2009 to 54 . 16% in 2013 , though the percentage of business revenue to total revenue dropped in general. Conclusions:The essential medicine system requires the government’s financial support. Essen-tial medicine lists and primary financial aid policies should be further improved;doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed.

To observe the protective effect and mechanism of Sailuotong capsule in focal cerebral ischemia/reperfusion. The 90 min middle cerebral artery occlusion (MCAO) reperfusion model was established. The expressions of dynamin-related protein 1 ( Drp1) and optic atrophy 1 (Opa1) were tested by Western blot. The transmission electron microscope was used to observe the changes in the mitochondrial ultra-structure. The pathological morphological changes were observed through the HE staining. The immunohistochemical method was used to test Drp1 and Opa1 expressions. Sailuotong capsule (33, 16.5 mg x kg(-1), ig) can inhibit the abnormal mitochondrial fission and fusion in the cortical area on the ischemia side and the mitochondrial fission gene expression and promote the mitochondrial fusion gene Opa1 expression, so as to alleviate the energy metabolism disorder caused by ischemia/reperfusion. Sailuotong capsule can inhibit the abnormal mitochondrial dynamics in peri-ischemic regions and maintain the normal morphology of mitochondria, which may be the mechanism of Sailuotong capsule in promoting the self-recovery function in the ischemic brain region.
Animals ; Brain ; drug effects ; metabolism ; Brain Ischemia ; drug therapy ; genetics ; metabolism ; surgery ; Drugs, Chinese Herbal ; administration & dosage ; Dynamins ; genetics ; metabolism ; GTP Phosphohydrolases ; genetics ; metabolism ; Humans ; Male ; Mitochondria ; drug effects ; metabolism ; Rats

The excipient processing is an essential part of traditional Chinese medicine processing, and understanding its scientific connotations is a critical scientific issue that urgently needs resolution. Building upon a foundation where the composition of traditional Chinese medicine substances is fundamentally clear, this paper applies the techniques and methods of chemoinformatics to the study of the excipient processing mechanism. Relevant information on traditional Chinese medicines processed with four kinds of excipients (wine, vinegar, salt and honey) was collected, including properties, taste, meridian tropism, chemical components, etc. Molecular descritors and skeletons corresponding to each chemical component were calculated using chemoinformatics to characterize the properties and structural features of the components. Characteristic components associated with the four excipients (wine, vinegar, salt and honey) were explored through multivariate statistical analysis and Murcko skeleton analysis. Further analysis, taking honey-processed Astragali Radix as an example, the focus was on the impact of the processing excipient honey on the solubility and permeability of its characteristic pharmacologically active components (isoflavones). It was discovered that the excipient honey can increase their solubility and permeability, emphasizing that the impact of processing excipients on the pharmacological classification properties is a key breakthrough in elucidating the mechanism of excipient processing. In summary, this study analyzed the characteristic components associated with the processing excipients "wine, vinegar, salt and honey" based on their composition characteristics, providing data support for the research on the mechanism of excipient processing from a biopharmaceutical perspective.

OBJECTIVETo determine the effect of neostigmine on antagonizing atracurium-induced neuromuscular blockage with sulfate magnesium pretreatment.

METHODSForty patients who undertook elective gynecologic laparoscopic examinations and treatments under general anesthesia were randomized into four groups (group A, B, C, and D, group A paired with group C, and group B paired with group D). Before induction of general anesthesia, patients in group A and group C received MgSO4 30 mg/kg in saline intravenously within 5 min, while patients in group B and group D received the same volume of saline. Anesthesia was induced with fentanyl and propofol; subsequently tracheal intubation was performed with 0.5 mg/kg atracurium after stabilization of the electromyography recording, and neostigmine (0.02 mg/kg) and atropine (0.01 mg/kg) were infused in group C and group D when neuromuscular recovery (T1/T(C)) reached 10%. T1/T(C) changes after neostigmine infusion as well as haemodynamic changes and other responses during induction and neostigmine and atropine infusion were recorded.

RESULTSThe neuromuscular recovery speed had no significant difference between group A and group B after the neuromuscular recovery reached 10%, but it was lower in group C than in group D (P < 0.05). Significant difference existed between group AC and group BD (P < 0.05). No haemodynamic changes and other responses were found during induction and neostigmine and atropine infusion.

CONCLUSIONNeostigmine-induced neuromuscular recovery can be attenuated in patients pretreated with magnesium sulfate.

Adolescent ; Adult ; Anesthesia, General ; Atracurium ; antagonists & inhibitors ; Cholinesterase Inhibitors ; pharmacology ; Female ; Humans ; Laparoscopy ; Magnesium Sulfate ; pharmacology ; Middle Aged ; Neostigmine ; pharmacology ; Neuromuscular Blockade ; Neuromuscular Nondepolarizing Agents ; antagonists & inhibitors

OBJECTIVETo investigate the effects of pioglitazone on transforming growth factor beta1 (TGFbeta1) expression in ischemia/reperfusion injury myocardium of rats.

METHODSThirty SD rats were randomly divided into five groups (n = 6): ischemia/reperfusion group, pioglitazone 5 mg/(kg x d) group, pioglitazone 10 mg/(kg x d) group, pioglitazone 20 mg/(kg x d) group and pioglitazone 20 mg/(kg x d) + peroxisome proliferator-activated receptor gamma (PPARgamma) specific antagonist GW9662 group. Left anterior descending coronary artery of rats were ligated for 30 min and reperfused for 120 min to establish the model of ischemia/reperfusion in vivo. RT-PCR was performed to detect the expression of TGFbeta1 mRNA. Western blot was performed to detect the expression of TGFbeta1 protein.

RESULTSMyocardial apoptosis was significantly suppressed by pioglitazone. Pioglitazone upregulated TGFPbeta1 expression both in mRNA and protein level. GW9662 reversed the inhibition of myocardial apoptosis and the upregulation of TGFbeta1 expression by pioglitazone.

CONCLUSIONPioglitazone can inhibit the myocardial apoptosis induced by ischemia/reperfusion. Pioglitazone may protect the myocardium from ischemia/reperfusion via upregulation of TGFbeta1. This protection may be mediated by PPARgamma.

Anilides ; pharmacology ; Animals ; Apoptosis ; Male ; Myocardial Reperfusion Injury ; metabolism ; Myocardium ; metabolism ; PPAR gamma ; antagonists & inhibitors ; Rats ; Rats, Sprague-Dawley ; Thiazolidinediones ; pharmacology ; Transforming Growth Factor beta1 ; metabolism

beta-CIT was labeled with 131I by the peracetic acid method. Cat model of Parkinsonism was set up with MPTP. Each of normal and PD model cats was given an injection of 74 MBq/0.5 ml 131I-beta-CIT into the femur vein. Then the blood samples were obtained at 4 h and 20 h, the radioactivity was counted with calibrator. The biodistribution data of 131I-beta-CIT in cat body was calculated (ID%/g). The cats were subjected to imaging at 0.5 h, 1 h, 2 h, 4 h, 20 h after the administration of radiopharmaceutical. The radioactivity in striatum and cerebellum was measured and striatal specific binding ratios were calculated. The Results showed that the radio chemical purity of 131I-beta-CIT was 97.62% +/- 0.31%. The 131I-beta-CIT remained stable for at least 4 h after incubation with water and serum respectively. Following intravenous administration in cats, 131I-beta-CIT showed high accumulation in striatum. The study of imaging in cats showed that striatal specific uptake of 131I-beta-CIT at 20 h after injection was 4.83 +/- 0.82 in normal cats and 2.92 +/- 0.66 in PD cats. There was a significant reduction of striatal tracer uptake in PD cats, compared to the controls. The results of biodistribution study was in agreement with the results of imaging study. These results suggest that beta-CIT is an ideal agent for dopamine transporter imaging and can be used for the diagnosis of Parkinson's disease.
Animals ; Brain ; metabolism ; Cats ; Cocaine ; analogs & derivatives ; metabolism ; Disease Models, Animal ; Dopamine Plasma Membrane Transport Proteins ; Female ; Male ; Membrane Glycoproteins ; metabolism ; Membrane Transport Proteins ; metabolism ; Mice ; Mice, Inbred Strains ; Nerve Tissue Proteins ; metabolism ; Parkinson Disease ; diagnostic imaging ; metabolism ; Tomography, Emission-Computed, Single-Photon

OBJECTIVETo validate the hypothesis that the phenotypic transformation occurs in the smooth muscle cells in the corpus cavernosum of hypertensive rat and explore its impact on the erectile function of rats.

METHODSEighteen 16-week-old male spontaneously hypertensive rats (SHR) and 10 syngeneic normotensive rats (WKY) were used in this experiment. After measurement of systolic blood pressure of the caudal artery and examination of the erectile function with subcutaneous injection of apomorphine (APO), the rats were divided into 3 groups, namely hypertensive with erectile dysfunction (HBP-ED) group (n=6), hypertensive (HBP) group (n=12) and control group (n=10). Immunohistochemical staining and color image analysis system were used to observe expression of calponin 1 and osteopontin (OPN) in rat corpus cavernosum. Real-time quantitative RT-PCR was used to determine the expression of calponin 1 and OPN mRNAs in different groups.

RESULTSThe expressions of calponin 1 protein and mRNA were the highest in the control group and the lowest in HBP-ED group, while the expressions of OPN protein and mRNA were the highest in HBP-ED group and the lowest in the control group.

CONCLUSIONThe smooth muscle cells may transform from the contractile phenotype into synthetic phenotype in the corpus cavernosum of the hypertensive rats, resulting ultimately in erectile dysfunction.

Animals ; Calcium-Binding Proteins ; genetics ; metabolism ; Erectile Dysfunction ; etiology ; pathology ; Hypertension ; complications ; pathology ; Male ; Microfilament Proteins ; genetics ; metabolism ; Myocytes, Smooth Muscle ; pathology ; Osteopontin ; genetics ; metabolism ; Penis ; pathology ; Phenotype ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR

Objective:To explore the curative effect of the "domino" sequential method with prosthesis preservation in the treatment of infection around the prosthesis after limb salvage surgery for bone tumors.Methods:A retrospective analysis of 11 patients with peripheral prosthetic infections after limb salvage surgery with prosthesis preserving "domino" from January 2016 to January 2020 was retrospectively analyzed, including 8 males and 3 females; age 21-74 years old, with an average of 51.8 years old. There were 6 cases of knee prosthesis for distal femoral tumor, 2 cases of proximal tibia knee prosthesis, 2 cases of pelvic prosthesis infection, and 1 case of middle femoral prosthesis. Before the operation, 8 cases had fever, and 2 cases had sinus. Sequential treatment failure is defined as: recurrence of infection. The treatment method is the debridement and lavage of the prosthesis and the systemic combined local application of drug-sensitive antibiotics to evaluate the patient's blood routine, C-reflective protein, erythrocyte sedimentation rate and other indicators, X-ray and CT of the surgical site, and the Musculoskeletal Tumor Society (MSTS) score.Results:The positive rate of microorganism culture was 72.7% (8/11), including 2 cases of Staphylococcus aureus, 1 case of Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus aureus, abalone There were 2 cases of Acinetobacter mannifolia and 1 case of Streptococcus degalactiae. The MSTS score before treatment and at the last follow-up after treatment increased from 10.91±2.31 points to 20.73±3.52 points, the difference was statistically significant ( t=7.162, P<0.05). A total of 3 cases of sequential treatment failed to control infection, and the operation success rate was 72.7% (8/11). One case was amputation, one case was long-term replacement of wound dressing, and one case was switched to antibiotic bone cement combined with intramedullary nail reverse double insertion technique to control infection. Conclusion:For bone tumors with clinical infection symptoms less than one month after limb salvage surgery, the use of prosthesis-preserving "domino" sequential method for treatment of prosthetic infections is desirable for early and mid-term clinical efficacy.

Background and Objective:Cytokine-induced killer(CIK)cells have high anti-tumor activity for hepatocellular carcinoma(HCC).Whether CIK cell therapy can eradicate residual cancer cells and prevent or postpone tumor relapse after transcatheter arterial chemoembolization(TACE)should be testified.This study was to evaluate the efficacy of CIK cell therapy combined with TACE on HCC.Methods:A total of 146 consecutive patients with unresectable HCC were divided into combination group (72 patients trealted with CIK cell therapy combined with TACE) and TACE group(74 patients treated only with TACE).The progression-free survival(PFS)and overall survival(OS)were analyzed.Results:The 6-month,1-year,and 2-year PFS rales were 72.2%, 40.4%, 25.3%in combination group, and 34.8%,7.7%,2.6%in TACE group.The median time to progression was 11 months[95%confidence interval(CI),8-1 4 months]in combination group and 5 months(95% CI,4-7 months)in TACE group.The estimated 6-month, 1-year, and 2-year OS rates were 90.3%, 71.9%. 62.4%in combination group,and 74.6%,42.8%,18.8%in TACE group.The median OS was 31 months(95%CI,27-35 months)in combination group and 10 months(95% CI,7-13 months)in TACE group.The times of TACE,ECOG performance status, and CIK cell therapy were independent prognostic factors for PFS and OS.Conclusion:Adjuvant immunotherapy with CIK cells could greatly improve the efficacy of TACE on HCC,and plays an important role in prolonging the PFS and OS of HCC patients after TACE.