Objective To observe the protective effect of sodium hyaluronate (Na-HA),and its effects on mRNA expression of peroxisome proliferators-activated receptor gamma (PPAR-γ) in cartilage of rabbit osteoarthritis (OA) model.Methods Forty eight white rabbits were divided into A,B,C groups randomly.Group A were normal controls,groups B and C were underwent unilateral anterior cruciate ligament transection (ACLT).The rabbits in group B were injected normal saline after ACLT;Group C rabbits received intra-articular 1% sodium hyaluronate (HA) injections 5 weeks after surgery,0.3 ml once a week.At week 11 after the surgery,all rabbits were sacrificed.The cartilage changes on the medial femoral condyles were graded.Cartilage sections were stained with safranin-O and HE,mRNA expression of PPAR-γ was detected by real time polymerase chain reaction (Real Time-PCR).Results Cartilage degeneration in group B was significantly more severe than in groups A and C.The grey value of Safranin-O of B group were higher than groups A and C.Expression of PPAR-γ mRNA in group B was higher than that in groups A and C.Conclusion NaHA has a protective effect on articular cartilage degeneration,and the inhibitory effect on PPAR-γ mRNA expression may be one of the therapeutic mechanism of Na-HA.

Objective To discuss the risks of hypertension development with relation to the level of lipid variables among populations who had normal blood pressure at baseline study. Methods In April 2000, under the support of project "prevention of metabolic syndrome and multi-metabolic disorders in Jiangsu province", a cohort study was performed to obtain the baseline data among 8685 persons from age 34 to 74. In June of 2006, a follow-up investigation was carried out among those who had been in the study for 5 years after the baseline study started. 2603 persons who met the selection criteria and showed normal blood pressure during baseline study, were recruited in this investigation. The interval from the baseline to the follow-up studies was 6.38 years on average. Relationship between the risk of developing hypertension and the baseline level of lipid variables were analyzed. Results Relations between baseline lipid levels and the incidence of hypertension during the follow-up was discovered. In gender and age adjusted model, the lipid variables were all associated with hypertension(Wend test, P<0.01). In multivariable-adjusted model, HDL-C [aRR=0.71 (95%CI: 0.61-0.99)], non-HDL-C [αRR=1.28 (95%CI: 1.14-1.83)], TC/HDL-C ratio[aRR=1.41 (95%CI: 1.25-2.03)] and TG [αRR=1.49(95%CI: 1.30-2.13)] were again associated with hypertension (trend test, P<0.05). Even the αRR was much weakened after the baseline SBP, DBP were adjusted with Cox model, the significant relation of hypertension to HDL-C, TC/HDL-C ratio and TG still existed. Excluding the two factors of obesity (BMI≥28) and diabetes which had been recognized in marked linking with hypertension, lipid variables were still associated with hypertension. Conclusion Dyslipidemia might occur before being hypertensive. Hypertension was associated with HDL-C, TC/HDL-C and TG or even exclusion of obesity, diabetes and factors of smoking and drinking or baseline level of SBP, DBP were adjusted.

Rupture of unstable atherosclerotic plaque is an essential pathogenetic mechanism of acute coronary syndrome (ACS), thereby, to stabilize the vulnerable plaque is of great importance for prevention and treatment of ACS. Recent study has shown the multi-target effects of traditional Chiese medicine intervention in stabilizing unstable atherosclerotic plaque is promising. The literatures involving this topic in recent years were reviewed in this paper.
Acute Coronary Syndrome ; complications ; drug therapy ; pathology ; Animals ; Coronary Artery Disease ; complications ; drug therapy ; pathology ; Coronary Vessels ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy

Objective To evaluate the dose of vancomycin for the treatment of central nervous system (CNS) infection after neurosurgery. Methods The information of hospitalized patients treated by vancomycin after neurosurgery from January 2011 to December 2015 at Beijing Tiantan Hospital, Capital Medical University was collected retrospectively. The patients with CNS infection were retrieved, the relevant data were extracted and systemized. A daily dose of 2 g or 30-60 mg/kg of vancomycin was thought as the standard, and the difference between the actual dose and the guidelines was analyzed. Results There were 5 816 patients used vancomycin for a total of 46 787 days. The number of patients with CNS infection after neurosurgery was 1 198 (20.6%), the total treatment course was 14 083 days (30.1%), the median treatment days was 9, the median daily dose was 26.0 mg/kg; and the percentage of male patient was 50.8%, the median age was 42.0 years, and the median body weight was 68.0 kg. The most commonly used dose and frequency of vancomycin was 1.0 g every 12 hours with 6 957 days (49.4%) and 60.3% daily dose of vancomycin reached the standard. 355 patients were treated to the target and 843 patients were treated empirically, the age of targeted treatment group was older than empirical treatment group [years: 44.0 (32.5, 54.0) vs. 41.0 (31.0, 52.0), P < 0.05]. The mean duration of targeted treatment group was obviously longer than empirical treatment group [days: 11 (6, 17) vs. 9 (6, 12), P < 0.01], but there was no difference in the total daily dose between the two groups [mg/kg: 25.4 (20.0, 30.3) vs. 26.1 (20.9, 31.0), g: 1.80 (1.50, 2.00) vs. 1.85 (1.50, 2.00), both P > 0.05], and daily dose of both groups did not reached the standard goal. 16.3% patients (195/1 198) received multi-courses therapy and there was no difference among the first course of dose. The clinical mortality of all patients was 1.5% (18/1 198). The targeted treatment and multi-courses had a higher proportion in the death group, and the treatment durations were longer than the non-death group [the targeted treatment proportion: 72.2% (13/18) vs. 29.0% (342/1 180), the multi-courses proportion: 83.3% (15/18) vs. 15.3% (180/1 180), the total treatment duration: 29.0 (17.8, 45.0) vs. 9.0 (6.0, 14.0), the days of the first course: 11.5 (7.5, 21.5) vs. 8.0 (6.0, 12.0), all P < 0.05]. Conclusions The dose of vancomycin to treat postoperative CNS infection was inappropriate in a majority of patients. Clinician's education regarding appropriate vancomycin dosing is recommended to achieve compliance with the guidelines.

Objective To investigate the effect of reptroperitoneal laparoscopic operation on the parameters of platelet, D-dimer and thrombomodulin(TM). Methods Forty cases were divided into two groups according to the operative way, retroperitoneal laparoscopic operation (n= 20) and open operation (n=20). Blood samples were taken preoperatively and at the end of the surgery. The following parameters were measured and compared within each group and between groups: platelet count (PLT), mean platelet volume (MPV), platelet distributionwidth(PDW), D-dimer, TM. ResultsThere were no significant differences for the PLT, PDW, MPV, TM and D-dimer between before and after operation in each group. There was no difference between 2 groups either for all these indicators.No patients from either group suffered thrombosis or abnormal bleeding as a pastoperative complication. Conclusion Compared with the conventional operation, retroperitoneal laparoscopic operation dioesd not induce more change on parameters of platelet, D-dimer and TM.

Objective To investigate the clinical value of high resolution ultrasound combined with radiological imaging in the diagnosis of Meckel′s diverticulitis (MD),and to analyze the causes of missed diagnosis as well as misdiagnosis by ultrasound.Methods The image data of 61 patients with MD were retrospectively analyzed,the essentials and the causes of missed diagnosis as well as misdiagnosis of ultrasound were summarized and compared with the results of operation,CT,gastrointestinal contrast,as well as radionuclide.Results The patients were divided into simple type(18,29.5%) and complex type(43,70.5%) according to ultrasonography.The simple type diagnostic accuracy rate was 100%,the ultrasonography showed the right lower abdominal tubular bowel shadow or cystic echo mass,and the structure of diverticulum could clearly showed by ultrasound.In another side,the complex type diagnostic accuracy rate was 55.8%,the ultrasonography showed the right lower abdominal mixed echo mass or concomitant with other alimentary tract malformation,while the diverticulum structure was difficult to be distinguished.The diagnostic accuracy rate of radionuclide imaging was 83.6%,CT was 37.0%,while gastrointestinal contrast was 30.0%.Among 19 cases of misdiagnosis by ultrasound,13 cases of MD were confirmed by radionuclide and CT examination,the diagnostic accuracy rate of ultrasound combined with radiological imaging diagnosis was 90.2%.Conclusions The sonographic features of MD are lack of specificity,especially in the complex type,while the patients with recurrent hemafecia or acute abdomen should be alert to the presence of MD.Patients who are suspected of MD by ultrasound diagnosis should also be examined by radiological imaging in order to make an early diagnosis and surgical treatment to improve the prognosis of patients.

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.

Objective To analyze the clinical risk factors of hemorrhagic transformation (HT) of cardiogenic cerebral embolism and the influence of HT on outcome. Methods The clinical data of 115 inpatients were reviewed from May, 2012 to December, 2015. They were di-vided into HT group (n=58) and non-HT group (n=57). The age, anticoagulant therapy, thrombolytic therapy, infarction diameter, diabetes, coronary heart disease, hyperlipidemia, the National Institutes of Health Stroke Scale (NIHSS) score and HAS-BLED score were compared. The risk factors for HT was screened with the multivariate Logistic regression. NIHSS score and Modified Rankin Scale (mRS) score as hos-pitalization, and one month and three months after stroke were compared. Results There were significant difference in NIHSS score (t=-2.991, P=0.003) and HAS-BLED score (t=-2.499, P=0.014), as well as infarction diameter (χ2=8.355, P=0.004) between HT group and non-HT group. NIHSS score (OR=1.127, P=0.027), HAS-BLED score (OR=1.783, P=0.03) and infarction diameter (OR=4.390, P=0.035) were the risk factors for HT. The incidence of HT was less in low-risk group (HAS-BLED score=0-2) than in high-risk group (HAS-BLED score≥3) (χ2=4.643, P=0.031). The NIHSS score as hospitalization, and one month and three months after stroke were all more in HT group than in non-HT group (t>2.387, P<0.05). The mRS score was more in HT group as hospitalization (t=-2.262, P=0.026), but not significant one and three months later (t<1.468, P>0.05). Conclusion HT tends to happen in the patients of cerebral embolism patients after atrial fibril-lation with severe neural function defect, large infarction diameter and high HAS-BLED score. The neural function is poor in those with HT.

Objective To explore the surgical management for arterial diseases. Methods The clinical data of 86 cases of arterial diseases were analysed retrospectively. These cases included:3 cases of thoracic aortic aneurysm,2 cases of descending aortic dissection with rupture and aneurysm formation,2 cases of abdominal aortic dissection with false aneurysm,1 case of abdominal aortic aneurysm(AAA)with duodenojejunal fistula and GI bleeding,5 cases of ruptured AAA with shock, 3 cases of traumatic rupture of abdominal aorta,21 cases of AAA combined with unilateral or bilateral iliac aneurysms,6 cases of iliac aneurysms,9 cases of popliteal aneurysms,21 cases of false aneurysm of iliac or popliteal artery,1 case of rupture of junction of subclavian and vertebral artery with false aneurysm,3 cases of rupture of subclavian artery with false aneurysm,2 cases of aneurysm of carotid artery and 7 cases of false aneurysm of carotid artery. Prosthetic vascular graft was performed in 71(cases),autologous vein graft in 3 cases and suture(repair) of arterial rupture in 12 cases.Results Operative (mortalty) was 3.5%(3/86)in this series.Seventy-one cases were followed-up for 1 month to 5 years, the results showed that all the patients were alive and well.Conclusions In the(management) of(appropriate) aortic diseases, the use of endoluminal technique is simple, microtraumtic, safe and has few complications. It also can shorten the hospital stay of the patient. Endovascular technique should be the first choice for patients with aortic diseases.

As a kind of commonly used traditional Chinese medicine, ginseng has a high reputation at home and abroad. The research of ginseng has been expanded to medicine, pharmacy, biology, food science and other fields, with great achievements in recent years. Ginseng contains ginsenosides, volatile oil, carbohydrates, amino acids, polypeptides, inorganic elements and othser chemical constituents. Each component has extensive physiological activity, and is the base of ginseng's effect. After processing, the complicated changes are taken place in the constituents of ginseng, and some new substances produced. This paper aims to review the studies on chemical constituents and their mechanisms during ginseng processing, and the ideas, methods and the direction of the development of traditional Chinese medicine processing in the future.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry