Objective To assess the clinical efficiency , safety and potential advantages of autologous blood transfusion (ABT) drains compared with the closed-suction/no drainage. Methods Pubmed, Embase, Cochrane Library, CBMdisc, CNKI, VIP and WANGFANG were searched comprehensively. The statistical anal-ysis was conducted by using the Cochrane Collaboration review Manager 5.3.5. Results The pooled data of seventeen RCTs including a total of 1 993 patients showed that the patients in the ABT drainage group might benefit from the low rate of blood transfusion [ 16 . 59% and 37 . 47%, OR: 0 . 28 ( 0 . 14 ~ 0 . 55 ); 13 . 05% and 16.91%, OR: 0.73 (0.47 ~ 1.13), respectively]. The ABT drainage and the closed-suction drainage/no drainage have the similar clinical efficiency and safety length of hospital stay and wound infection on days 3 post-operative haemoglobin. Conclusion This systematic review provides the evidence that the ABT drainage offers a safe and efficient alternative to CS/no drainage with the lowered blood transfusion rate.

Deflazacort (DFZ, a prodrug) is well absorbed and rapidly metabolized into the active metabolite 21-hydroxydeflazacort (21-OH DFZ) after oral administration. The aim of this study is to evaluate the pharmacokinetic properties of 21-OH DFZ in healthy Chinese volunteers after a single and multiple oral administration of DFZ tablets under fed condition. Twelve volunteers (six males and six females) were administered a single dose of 6 mg or 12 mg or 24 mg of DFZ in three different periods separately, according to the 3 x 3 Latin square design. Between each administration period there was a washout period of one week. The multiple-dose study of 12 mg dose DFZ per day for 7 consecutive days was started after a 1 w washout period when the single-dose study completed. The pharmacokinetic parameters of 21-OH DFZ after the single oral administration of 6 mg, 12 mg and 24 mg DFZ tablets were as follows: (37.7 +/- 11.6), (61.5 +/- 17.7) and (123 +/- 23) ng x mL(-1) for C(max); (1.90 +/- 0.32), (1.96 +/- 0.27) and (2.13 +/- 0.34) h for t1/2; (96.6 +/- 25.9), (190 +/- 44) and (422 +/- 107) ng x h x mL(-1) for AUC(0-14 h), respectively. After the multiple dose administration, the mean plasma concentration at steady-state C(av) was (7.00 +/- 1.66) ng x mL(-1) and the degree of plasma concentration fluctuation DF was 7.7 +/- 1.2. The results showed that the pharmacokinetic characteristics of 21-OH DFZ in healthy Chinese volunteers were linear over the dose range of 6 to 24 mg. No significant gender differences were found in the pharmacokinetics of 21-OH DFZ in healthy Chinese volunteers. After the multiple dose administration of 12 mg DFZ for 7 d, no accumulation of 21-OH DFZ in healthy Chinese volunteers was observed.
Administration, Oral ; Area Under Curve ; Asian Continental Ancestry Group ; Female ; Healthy Volunteers ; Humans ; Male ; Pregnenediones ; pharmacokinetics ; Tablets

BACKGROUND: Total knee arthroplasty is a procedure for treatment of knee osteoarthritisa with standardized, mature technology and affirmative efficacy. Total knee arthroplasty can result in overt excessive bleeding, decreased hemoglobin levels, patient mouth infection and other complications. As a new technology, autologous blood transfusion device can effectively reduce the rate of blood transfusion through reinfusing the unwashed and filterable drainage blood after operation. Up to now, no systematic reviews incorporating meta-analyses have found directly sufficient evidence to compare autologous blood transfusion drainage and no drainage after primary total knee arthroplasty. OBJECTIVE: To study the clinical efficacy, safety and potential advantages of the application of autologous blood transfusion device/no drainage based on the meta-analysis. METHODS:PubMed, Embase, the Cochrane Library, CBMdisc, China HowNet, VIP, Wanfang database were searched comprehensively by computer. The search strategies were developed by the way of MeSH terms combining with free words: “total knee replacement” OR “total knee arthroplasty” OR “total knee prosthesis” OR “unicompartmental” OR “unicondylar” OR “unicompartmenta” OR “arthroplasty, replacement, knee” [MeSH terms] AND “autologous blood transfusion” OR “Autotransfusion” OR “blood transfusion, autologous” [MeSH Terms] OR “Intraoperative Blood Salvage” OR “Intraoperative Blood” OR “Postoperative Blood Salvage” OR “Intraoperative Blood Cel Salvage” OR “Operative Blood Salvage” [MeSH Terms]. Data included in the final literature were analyzed using RevMan 5.3.5 software recommended by Cochrane. The main outcome measure was the rate of transfusion. The secondary outcome measures were the average change in hemoglobin, hemoglobin levels at the 3rd day, hospitalization time and intraoperative mouth infection rate. RESULTS AND CONCLUSION:Five randomized controlled trials, a total of 667 patients were enroled. Meta-analysis results showed that there were no significant differences in the transfusion rate (OR=0.73, 95%CI: 0.47-1.13;Z=1.41,P=0.16), average change in hemoglobin (WMD=0.20, 95%CI:-0.28-0.68;Z=0.82,P=0.41), the hemoglobin levels at the 3rdday (WMD=0.41, 95%CI:-0.26-1.09;Z=1.20,P=0.23), hospitalization time (OR=1.01, 95%CI: 0.06-16.27;Z= 0.01,P=1.00), intraoperative mouth infection rate (OR=1.01, 95%CI: 0.06-16.27;Z=0.01,P=1.00) between the postoperative use of autologous blood transfusion and no drainage. These results suggest that the meta-analysis of outcome measures has not provided the evidence-based medical support for the clinical efficacy of autologous blood transfusion device (including blood transfusion rate, the average change in hemoglobin, average hemoglobin change at the 3rd day, hospitalization time). Given the inherent limitations of the quality of the included studies and the publication bias, future high-quality, large-volume, multi-center randomized controled trials are awaited to confirm and update the findings of this analysis.

Objective To assess the effective length of jejunal graft when the 3~(rd) intestinal artery is u- tilized as vascular pedicle and afford a reliable theoretic base for clinical esophageal reconstruction.Methods In 32 formalin preserved and 21 fresh cadaver specimens,the diameter of 1st to 5th intestinal arteries and diameter of arterial arches are measured with linear calibre.Measure the length of jejunum that can be harves- ted as graft when the arches are extended.In the 21 fresh specimens,the 1st,2nd,4th and 5th intestinal ar- teries are ligated,acetic ester stained with red dye were injected into the lumen of 3rd intestinal artery via catheter.Extent of distribution of the arteries to the jejunum was observed.And then red ABS solution was in- jected into the 3rd intestinal artery to make into cast specimen.The blood supply distribution of jejunum through 3rd intestinal artery-arterial arch and communicating system were observed again.Results The di- ameter of the 3rd intestinal artery was the largest among the 1st to 5th intestinal arteries.The length of jejunum vascularized by 3rd intestinal artery can be as long as (142.2?62.3) (69.0～206.60cm) in acetic ester in- filtrated specimens.While in ABS east specimen,the average available extent of donor jejunum was(30.8?7.3) (23.0～37.3cm).Conclusion As observed by this applied anatomy study,the jejunum graft vascu- larized by 3rd intestinal artery alone has sufficient length to meet the need of esophageal reeonstrution.

Diabetic rats were induced by intraperitoneal injection of streptozotocin.TUNEL and immunohistochemistry results showed that the renal tubular cell apoptosis index(AI)and Bax protein expression were significantly reduced,and the Bcl-2 protein expression in glomeruli was significantly increased in diabetic rats with stable hyperglycemia treated by benazepril compared with diabetic rats with stable hyperglycemia treated by vehicle(all P

OBJECTIVETo explore the effects of the exogenous and endogenous reactive nitrogen metabolites (RNM) as NK cell inhibitors on NK cell-mediated killing of K562 cells and the influence of Tiopronin (TIP), glutamylcysteinylglycine (GSH) and histamine dihydrochloride (DHT) as RNM scavengers on reversing the suppressing effect of RNM.

METHODSThe exogenous ONOO(-) was administered in the NK+K562 culture system, then the RNM scavengers were added in the NK+K562+ONOO(-) culture system, respectively. The concentrations of RNM, TNF-beta and IFN-gamma, K562 cell inhibition rate (KIR) and the percentage of living NK cells were examined. IL-2+PHA were used as monocyte (MO) activators in the culture system of MO+NK+K562. Then TIP, GSH and DHT were administered and the parameters of NK cell activity were analyzed.

RESULTSAfter exogenous ONOO(-) was administered in NK+K562 culture system, the percentage of living NK cells was decreased from (93.17 +/- 2.57)% to (71.87 +/- 1.02)% (P < 0.01) and KIR was decreased from (67.47 +/- 2.64)% to (43.44 +/- 2.87)% (P < 0.01). When TIP, GSH and DHT were administered into the systems, the percentage of living NK cells was increased to (91.13 +/- 3.67)% (P < 0.05), (88.03 +/- 1.46)% (P < 0.05), (73.60 +/- 2.76)% (P > 0.05), respectively; KIR was increased to (61.58 +/- 1.89)% (P < 0.05), (60.68 +/- 2.07)% (P < 0.05) and (45.26 +/- 3.31)% (P > 0.05), respectively. When IL-2/PHA were administered in the NK+K562+MO culture system, RNM products was increased from (82.10 +/- 6.60) micromom/L to (193.65 +/- 5.95) micromom/L(P < 0.01);KIR was decreased from (90.64 +/- 3.06)% to (61.29 +/- 2.22)% (P < 0.01). When the TIP, GSH and DHT were administered in the systems, RNM products were decreased to (91.32 +/- 6.81) micromom/L (P < 0.05), (84.66 +/- 5.99) micromom/L (P < 0.05) and (188.92 +/- 5.00) micromom/L (P > 0.05), respectively; KIR was increased to (84.31 +/- 4.56)%(P < 0.05), (81.65 +/- 3.09)% (P < 0.05) and (72.20 +/- 4.10)% (P < 0.05), respectively.

CONCLUSIONNK Cell-mediated killing of K562 cells can be suppressed by exogenous and endogenous RNM administration. Both of TIP and GSH can protect NK cells by scavenging RNM and enhance the antineoplasmic activity of NK cells.

Cells, Cultured ; Coculture Techniques ; Glutathione ; pharmacology ; Histamine ; pharmacology ; Humans ; Interferon-gamma ; metabolism ; Interleukin-2 ; immunology ; pharmacology ; K562 Cells ; Killer Cells, Natural ; cytology ; immunology ; metabolism ; Lymphotoxin-alpha ; metabolism ; Monocytes ; cytology ; Peroxynitrous Acid ; pharmacology ; Reactive Nitrogen Species ; antagonists & inhibitors ; metabolism ; Tiopronin ; pharmacology

Objective To evaluate the safety and efficacy and summarize the initial experience of transcatheter mitral valve repair (TMVR) for treating Chinese patients with severe mitral regurgitation.Methods In May 2012,TMVR using MitraClip system was applied in 3 patients with severe mitral regurgitation.One patient suffered from with mitral valve prolapse and two with functional mitral regurgitation.The efficacy and complications of the procedure were analyzed.Results TMVR procedure was successful in all 3 cases.NYHA classification improved by 1 grade in 2 patients and 2 grades in one patient.The mean operation time was (105 ± 38) minutes and X-ray exposure time was (10 ± 4) minutes.Mean arotic pressure was increased from (62 ± 18)mm Hg (1 mm Hg =0.133 kPa) to (75 ± 14)mm Hg,and mean left atrial pressure was significantly reduced from (15 ± 10)mm Hg to (9 ±5)mm Hg immediately after the deployment of MitraClip.Three days after the procedure,left ventricular diastolic dimension decreased from (63 ± 11) mm to (59 ± 10) mm,left atrial dimension declined from (59 ± 11)mm to (51 ± 8) mm,and NT-ProBNP was reduced from (4292 ± 1137) mmo]/L to (1187 ± 489) mmol/L.No complications occurred in all three cases.Conclusions Our initial experience showed that TMVR using MitraClip system is safe and effective for patients with severe mitral regurgitation.However,the long term benefit of the procedure should be validated through follow up.

RT-PCR was conducted with one degenerate primer designed according to repetitive regions' amino acid sequence of major ampullate spidroin (MaSp) in spiders and adaptor primer in the SMART cDNA Library Construction Kit. By cloning and sequencing of amplified products, one cDNA clone (GenBank Accession No. AY365017) of Argiope amoena MaSp gene was obtained. The deduced amino acid sequence can be distinctly divided into two regions: (1) Repetitive region that consists of an alternating alanine-rich and glycine-rich domain in which many prolines are present; and (2) C-terminal non-repetitive region. The region coding for 272 amino acids of MaSp gene was subcloned into prokaryotic expression vector pET28b(+) and an about 26kD recombinant protein was expressed at high levels in Escherichia coli BL21 (DE3) after induction of IPTG. After being purified with metal-affinity chromatography on Ni(2+) -IDA-Sepharose columns as well as gel filtration chromatography, the recombinant protein was confirmed to be predicted MaSp by means of amino acid composition analysis and N-terminal amino acid sequence analysis. The solubility behavior of recombinant MaSp with C-terminal non-repetitive region in the present study is similar to that of recombinant dragline silk proteins without C-terminal non-repetitive region expressed by bacteria and yeast in the other studies. The result shows that absence or presence of C-terminal non-repetitive region is not a crucial factor affecting the solubility of the recombinant MaSp.
Amino Acid Sequence ; Animals ; Base Sequence ; Chromatography, Affinity ; Cloning, Molecular ; DNA, Complementary ; chemistry ; genetics ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; genetics ; Fibroins ; genetics ; metabolism ; Gene Expression ; Molecular Sequence Data ; Molecular Weight ; Plasmids ; genetics ; Recombinant Proteins ; chemistry ; isolation & purification ; metabolism ; Sequence Analysis, DNA ; Sequence Analysis, Protein ; Sequence Homology, Amino Acid ; Spiders ; genetics ; metabolism

OBJECTIVETo screen the optimum formulation and prepare O/W sinomenine microemulsion and investigate its in vitro transdermal delivery ability.

METHODThe microemulsions were prepared with the formulation containing oleic acid-tween 80-dehydrated alcohol-water by the pseudo-ternary phase diagram. The permeation flux of sinomenine was determined in vitro by Franz diffusion cell fitted with rat skin. The sinomenine was determined by HPLC. The transdermal characteristics of sinomenine microemulsion were compared with that of sinomenine gels.

RESULTThe steady state flux of sinomenine microemulsion was significantly higher than that of sinomenine gels. The average permeation rate of sinomenine microemulsion was 116. 44 microg x cm(-2) x h(-1) in vitro.

CONCLUSIONThese results indicated that the studied microemulsion system with high permeation rate may be a potential vehicle for the transdermal delivery of sinomenine.

Administration, Cutaneous ; Animals ; Drug Compounding ; methods ; Drug Delivery Systems ; Emulsions ; Ethanol ; chemistry ; Male ; Morphinans ; administration & dosage ; isolation & purification ; pharmacokinetics ; Oleic Acid ; chemistry ; Particle Size ; Plants, Medicinal ; chemistry ; Polysorbates ; chemistry ; Rats ; Sinomenium ; chemistry ; Skin ; metabolism ; Skin Absorption ; Surface-Active Agents ; chemistry

Aim To investigate the effects of dihydromyricetin on the apoptosis in AGZY-83-a tumor cells and its relevant mechanisms.Methods The survival rate of AGZY-83-a cells was assayed by MTT dye reduction.The cellular apoptosis was analyzed by TUNEL method and caspase-3 activity.The intracellular free calcium i was detected to explore the apoptotic mechanism of dihydromyricetin.Results In the MTT assay,dihydromyricetin 50?mol?L-1 significantly inhibited survival ratios of AGZY-83-a cells at dose-and time-dependent manner.It was demonstrated in TUNEL assay that dihydromyricetin could induce the apoptosis of AGZY-83-a cells in a concentration-dependent manner.The examination of Caspase-3 activity indicated that the dihydromyricetin could induce the apoptosis of AGZY-83-a cells,which was dose-dependent activation of Caspase-3 in AGZY-83-a cells.The detection of the intracellular i showed that the average FI of the i could be markedly increased to 20-fold as the basic condition.Conclusions Dihydromyricetin can induce the apoptosis in AGZY-83-a cells,which is associated with the overload of the intracellular i.