Objective To observe the clinical efficacy of Santeng Tongbi pills on rheumatoid arthritis (RA),evaluate the safety and explore its mechanism. Methods Double-blind and double dummy design method was used. 107 cases of RA were randomly divided into Santeng Tongbi pills group (the treatment group,53 cases) and Zhengqing Fengtongning group (the control group,54 cases). The Ritchie index,health assessment questionnaire (HAQ),arthritis influenced index (AIMS),patinents' assessment to pain (VAS form),acute phase reactant,Chinese medical pattern grade,the hemorheology state and so on were retrospectively analyzed. Results There was significantly difference between RA patients and healthy people on the hemorheology state (P

BACKGROUND:It is an important and complex issue for the incidence of bacterial infection and complications after transplantation. The monitoring and care after transplantation can improve the success rate of transplantation. OBJECTIVE:To search the database of China National Knowledge Infrastructure, North American Clinical Trial Register and Thomson Reuters Web of Science database, and to perform literature metrological analysis and clinical trials registration project analysis on the published literatures of the monitoring and care after transplantation. METHODS:A total of 138 literatures were searched with the key words of“intensive care, transplantation”in the database of China National Knowledge Infrastructure on the intensive care after transplantation. 23 literatures were used for further analysis by reading titles and abstracts and 115 papers were excluded; the Thomson Reuters Web of Science database was searched with the key words of“intensive care, transplantation”for the literatures on the intensive care after transplantation published from 2008 to 2013;the North American Clinical Trial Register was searched with the key words of“intensive care, transplantation”for the related clinical trials, and a total of 50 registered projects were obtained, only 10 interventional studies. RESUTLS AND CONCLUSION:In recent years, the literatures on the intensive care after transplantation show a gradual increase trend. Compared with international research, fewer researches in this field emerge in China, literature quantity and quality need to be improved. There have been 1 693 papers published in the Thomson Reuters Web of Science database regarding the intensive care after transplantation. United States published the most literatures than other countries, total 532 papers, accounting for the largest proportion, 31.424%of total literatures. Transplantation Proceeding published the most literatures, total 144 papers, accounting for 8.506%of total literatures. There are 50 clinical trial registration projects related to the intensive care after transplantation in the North American Clinical Trial Register, 10 of them were interventional study, accounting for the majority, fol owed by observational study. Diagnostic study had no related registration projects. The surgery of transplantation was complex with trauma. The early monitoring and care post-transplantation are directly related to the success of surgery. Strengthening the monitoring and care of patients’ vital signs, rejection, bacterial infections and other aspects can reduce the complications and improve patients survival rate and quality of life.

Objective To investigate the effects of different doses of angiotensin Ⅱ(Ang Ⅱ) on hepa tic stellate cells(HSC) proliferation and collagen synthesis in rats. Methods The pronase E and collagen Ⅰ were used to isolate HSC, 3H TdR, 3H Leu and 3H Pro incorporation methods were used to evaluate the effects of different doses of AngⅡ on HSC DNA, protein and proline synthesis. Results It showed that 10 -9 ～10 -6 mol/L AngⅡ could significantly increase the 3H TdR incorporation rate of HSC ( P

Objective Recently, a series of studies demonstrated that activation of local renin angiotensin system (RAS) may be related to tissue fibrosis, but the role of RAS in hepatic fibrogenesis has not been evaluated. The present study was designed: (1) to assess the effect of angiotensin converting enzyme (ACE) inhibitor and angiotensin Ⅱ type 1 (AT1) receptor antagonist in preventing hepatic fibrosis induced by CCl 4 administration in rats; (2) to investigate whether or not there are expression of AT1 receptors on hepatic stellate cells. Methods Study was conducted in male Sprague Dawley rats. Except for control group, three treated groups, either enalapril (10 mg/kg), losartan (10 mg/kg) or a combination of enalapril and losartan were given to the fibrotic rats (daily gavage), and saline vehicle was given to the control rats. After 6 weeks, liver fibrosis was assessed directly by hepatic morphometric analysis, which have been considered the gold standard for the quantitative measurement of fibrosis. The expression of AT1 receptors and ? smooth muscle actin (? SMA) in liver tissue were detected by immunohistochemical techniques. Results Compared to the rats of control groups, either enalapril or losartan, or a combination of two drugs can limit the expansion of the interstitium ( P 0.05). Expression of AT1 receptors was found in abundance in hepatic fibrotic interstitium of fibrotic rats, whereas only limited in vasculature in rats of control group to a very slight degree. Conclusions The present results demonstrated that: (1) activation of RAS is related to hepatic fibrosis induced by CCl 4; (2) angiotensin converting enzyme inhibitor and AT1 blocker might slow the propression of hepatic fibrosis; (3) activated hepatic stellate cell expresses AT1 receptors.

Objective To explore the possible role of NROB1 gene played in regulating hypothalamic-pituitary-gonad axis(HPGA) by analyzing the clinical and molecular characteristics in a case of central precocious puberty(CPP) with NROB1 gene mutation. Methods Clinical characteristics and direct sequencing of NROB1 gene in the patient were analyzed. Results A 11-month-old boy with manifested premature puberty, enlargement of penis/testes, and penile erection, but without manifestations of adrenal insufficiency was reportd. Clinical diagnosis was adrenal hypoplasia congenita( AHC) with CPP. The NR0B1 gene sequencing revealed a novel mutation in exon 1 (913C> T). Conclusion NR0B1 gene mutation may lead to the development of CPP in the patient with AHC. However, the mechanism remains unclear and thus deserves further exploration.

Objective To discuss the surgical management of von Hippel Lindau(VHL) syn drome.Methods The clinical data of four VHL patients who were clinically diagnosed from March1999 to October 2006 were reviewed.The first patient was a 56 year old man with the chief complaintof hypodynamia and low serum glucose as 2.37 mmol/L.CT scan showed three masses in the the leftkidney.He had a history of cerebral haemangioblastoma ten years before.The second case was a 57 year old woman with the chief complaint of lumbago in the left side.CT scan showed masses in theleft kidney,adrenal gland and panerease.The third case was a 39 year old woman with the chief com plaint of an accident mass in the left adrenal gland.She had the history of cerebellar hemangioblastoma9 years before,spinal hemangioblastoma resection 7 years before.The fourth case was a 41-year oldwoman,she was found brain tumors and cured by gamma radiation abalation.Bilateral renal masseswere found by B ultrasound one month later,CT scan showed four masses in the both kidneys,leftadrenal gland and pancreas.Results All 4 cases underwent surgical approach.The first case under went radical nephrectomy which pathological report was PEComa of kidney.The blood glucose wasnormal one week later.The second case underwent resection of the left adrenal gland,kidney,pancre atic body and tail and spleen.Pathological report was clear cell carcinoma,islet cell tumor and adrenal cyst.Three months later she was found spinal hemangioblastoma and refused treatment.The thirdcase underwent adrenalectomy in the left side and pathologieal report was adrenal pheoehromocytoma.There was not tumor reeurrenee during 2 years' follow up.The nephrectomy and adrenalectomy wasperformed for the last ease whose pathological report was clear celt carcinoma and pheochromoeytoma.Three weeks later,tumor enueleating of the right kidney was undertaken; the result was clear cellcancer.During the follow up for one year there was no relapse of tumor.Conclusions For VHL ac companied with multiple organ tumors,surgery resection is the proper approaeh when tumors of centralnervous system is large.Different approaches could be taken to deal with multiple tumors of VHL such aswatchful waiting,nephron sparing surgery.

Objective:To investigate the effects and mechanisms of Xuebijing injection on early sepsis induced acute lung injury and explore a new therapy.Methods:Thirty healthy male Sprague-Dawley rats were randomly divided into 3 groups:Sham group(n=10),NS group (NS 4mL/kg n=10),Xuebijing Group(Xuebijing 4mL/kg n=10).Cecal ligation and puncture (CLP) was used to duplicate severe sepsis model.At 6h after CLP,the rats were sacrificed,the lungs were resected and histopathological characteristic was observed by transmission electron microscopy technique.The change of the lung wet/dry (W/D) weight ratio were studied.Meanwhile,the lungs were resected for detection of ET-1,iNOS,MMP-9,TIMP-1 mRNA with reverse transcription-polymerase chain raction (RT-PCR).Results:The changes of pulmonary alveoli and the interstitial edema as well as lung tissue in Xuebijing group were better than those of NS group.The change of lung wet/dry (W/D) weight ratio in septic rats showed was significantly increased at 6 h after CLP (vs Sham group:5.37± 0.12 vs 4.33± 0.06,P＜0.01).The lung W/D was significantly decreased in XBJ group (vs NS group:4.67± 0.09 vs 5.37± 0.12,P＜0.05).The expressions in XBJ group lung tissue of ET-1 (0.511 ± 0.111 vs 0.705± 0.122,P＜0.01),iNOS(0.45610.075 vs 0.548± 0.098,P＜0.05)、MMP-9 (0.617± 0.079 vs 0.732± 0.131,P＜0.05),TIMP-1 (0.438± 0.043 vs 0.515± 0.049,P ＜0.01) mRNA were significantly decreased than those in NS group.And the expressions of ET-1 (0.705± 0.122vs 0.400± 0.033,P＜0.01),iNOS (0.548± 0.098 vs 0.334± 0.027,P＜0.01),MMP-9(0.732± 0.131 vs 0.352± 0.061,P＜0.01),TIMP-1(0.515± 0.049 vs 0.365± 0.068,P＜0.01) mRNA in NS group were significantly increased compared with those in the sham group.Conclusions:Xuebijing could protect against sepsis induced acute lung injury,which might be related with the decrease ofET-1,iNOS,MMP-9 and TIMP-1 mRNA expressions.

Objective To explore the protective effect of Xuebijing on the endothelium and extracellular matrix in sepsisinduced acute kidney injury (AKI) rats for providing a new clinical treatment strategy.Methods The method of cecal ligation and puncture (CLP) was used to duplicate severe sepsis model.Thirty healthy male SD rats were randomly divided into 3 groups:Sham group (n=10),NS group (normal saline 4ml/kg,n=10),Xuebijing group (Xuebijing 4ml/kg,n=10).6h after CLP,the rats were sacrificed and their kidneys were resected and histopathological characteristic was observed by light microscopic and transmission electron microscopic techniques.The expressions ofET-1 mRNA,iNOS mRNA,MMP-9 mRNA,TIMP-1 mRNA in the renal tissues were measured semiquantitatively by reverse transcription-polymerase chain reaction (RT-PCR).Results The histopathological changes in renal tissue were observed by light microscope.The changes of renal glomerulus and renal tubuli in Xuebijing group were better than NS group.The ultrastructural changes in renal tissue were observed under electron microscope.Compared with NS group,ultrastructural changes of renal glomerulus and proximal convoluted tubule were smaller in Xuebijing group.The expressions of ET-1mRNA (0.631 ± 0.169vs 0.770 ± 0.154,P＜0.05),iNOS mRNA (0.507 ± 0.071 vs 0.587 ± 0.073,P＜0.05),MMP-9mRNA (0.641 ± 0.082 vs 0.742 ± 0.116,P＜0.05) and TIMP-1 mRNA (0.434 ± 0.052 vs 0.520 ± 0.049,P＜0.01) were significantly lower in XBJ group renal tissues than in NS group.The expressions of ET-1 mRNA(0.770 ± 0.154 vs 0.394 ± 0.105,P＜0.01),iNOS mRNA (0.587 ± 0.073 vs 0.326 ± 0.085,P＜0.01),MMP-9 mRNA (0.742 ± 0.116 vs 0.356 ± 0.055,P＜0.01) and TIMP-1 mRNA (0.520 ± 0.049 vs 0.351 ± 0.041,P＜0.05) in renal tissues were more significantly increased in NS group compared with sham group.Conclusions Xuebijing could reduce the levels of ET-1,iNOS,MMP-9 and TIMP-1 mRNA,protect the stability of endothelium and extracellular matrix,and reduce tissue injury in septic rats.

[ ABSTRACT] AIM:To investigate the effect of combined treatment with gonadotropin-releasing hormone analogue ( GnRHa) and growth hormone ( GH) on the linear growth in mid-and late pubertal girls at great bone ages with central precocious puberty ( CPP) or early and fast puberty ( EFP) , and to determine the relation between C-type natriuretic pep-tide ( CNP) signaling pathway and the accelerative effect of GH on long bone growth in these girls.METHODS:Twenty-two girls were diagnosed as CPP or EFP, whose bone ages were older than 11.5 years with impaired predicted adult height ( PAH) , and divided into GnRHa treatment group ( treated with GnRHa alone, slow-release of triptorelin 60~80 μg/kg every 4 weeks, im) and combined treatment group ( treated with GnRHa and GH, 1 U/kg GH every week for 6~7 times, sc) .The height, weight and pubertal stage were determined every 3 months.At the beginning and after 6 months of the treatment, the bone age was evaluated and the serum concentrations of amino-terminal pro-C-type natriuretic peptide ( NT-proCNP), insulin-like growth factor 1 (IGF-1) and procollagen type 1 amino-terminal propeptide (P1NP) were measured. Height velocity ( HV) , height SD score for bone age ( HtSDSBA ) , PAH and the serum indexes mentioned above were com-pared at the beginning and the end of the treatment.RESULTS: After 6 months of the treatment, HV, ΔHtSDSBA andΔPAH of the girls treated with GnRHa +GH were statistically higher than those of the girls given GnRHa alone ( P <0.01).Serum concentrations of NTproCNP, P1NP and IGF-1 were not significantly different between the beginning and the end of the 6-month combined treatment.The girls treated with GnRHa alone showed a significant decrease in both serum NTproCNP and P1NP levels (P<0.05) and no significant change of serum IGF-1 level after 6 months of the treatment. CONCLUSION:In the CPP or EFP girls who are in mid-and late puberty and at great bone ages, the combined treatment with GnRHa and GH may accelerate linear growth and improve predicted adult height.This effect of GH is not attributed to the change of serum IGF-1 level, and may be related in part to the acceleration of CNP-mediated long bone growth.

Objeetive To investigate the effectiveness and safety of agomelatine for the treatment of elderly patients with post-stroke depression.Methods A total 80 elderly patients with post-stroke depression were randomly divided into either an agomelatine group or a sertraline group.The Hamilton Depression Scale (HAMD),National Institutes of Health Stroke Scale (NIHSS) and Barthel Index were used to evaluate the patients before and after 1,2,4,and 6 weeks,respectively.Results HAMD,NIHSS,and Barthel index scores were improved significantly after treatment in the agomelatine group (n =38) and the sertraline group (n =42).There were significant improvement in the scores of HAMD,NIHSS and Barthel Index with time in both groups (all P ＜0.001).There were no significant difference in the scores of HAMD and NIHSS at different time points after treatment between the agomelatine group and the sertraline group,and the Barthel Index scores began to have significance difference from the fourth week after treatment (all P ＜ 0.05).Conclusions The efficacy of agomelatine for the treatment of PSD is almost the same as sertraline,and the effect of improving activities of daily living is better than sertraline.The safety of both agomelatine and sertraline is good.