HH 4R, a novel histamine receptor, was found in recent years. HH 4R posses unique pharmacological character and special tissue distribution,which has high homology compared with the H 3 receptor.In this article,we review various aspects of HH 4R,such as gene formation, tissue distribution, homologous analysis, signal transduction pathway, histamine ligand affinity,and so on, and preview future study on HH 4R.

Cancer-related fatigue (CRF) is associated with tumor and (or) anti-tumor treatment,which has a high incidence and seriously affects the life quality of patients.The etiology of CRF involves psychology,physiology and social factors.There are various hypothesis of pathogenesis and the inflammatory system may play an important role in the generation and development of CRF.A variety of inflammatory cytokines such as IL-1β,IL-6,TNF-α,CRP are significantly correlated with CRF.

Objective To review our surgical treatment experience and analyze the surgical methods and efficacy of Stanford type A acute aortic dissection in elderly patients.Methods We recruited 24 patients aged over 60 years with Stanford type A acute aortic dissection treated surgically with deep hypothermic circulatory arrest and selective cerebral perfusion from June 2013 to September 2016.Depending on the patients` conditions, we selected different surgical methods, including Bentall operation in 3 cases, David operation in 1 case, partial aortic arc replacement+Bentall operation in 3 cases, total aortic arch replacement+stented elephant trunk implantation technique+Bentall operation in 12 cases, total aortic arch replacement+stented elephant trunk implantation technique+ascending aorta replacement in 5 cases, and concomitant coronary artery bypass grafting (CABG) in 3 cases.Results Surgical operation was successful in all the 24 patients.The average CPB time of the all patients was (192.9±37.1)min, the aortic cross-clamp time was (120±28.72)min, deep lower temperature of cerebral perfusion time was (36.2±11.3)min, and operation time was (544.8±91.2)min.Soon after the operation, two patients died of multiple organ dysfunction syndrome and renal failure complicated with infection, respectively.Postoperative complications included brain nerve dysfunction in 2 cases;renal insufficiency in 4 cases, which werelater treated with CRRT;pulmonary infection and tracheotomy in 3 cases;dysfunction in lower extremities in 1 case;hyoxemia in 3 cases;and incision infection in 2 cases.All the patients were followed up for 2-38 months, one patient was hospitalized because of hydropericardium and another one died of sudden death with unclear cause.Conclusion Surgical treatment of Stanford type A acute aortic dissection can obviously decrease the mortality and improve the quality of life.Total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta is a classic clinical surgical treatment.Precise diagnosis, suitable surgical treatment and post-operative care are all important factors contributing to patients` recovery.

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: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.

AIM: To investigate 1) the role of transforming growth factor-?_1(TGF-?_1) and macrophage infiltration during the development of myocardial fibrosis(MF) in rats after myocardial infarction(MI);and 2) mechanisms of MF post-MI and the inhibitory effect of angelica.METHODS: Sprague-Dawley(SD) rats were subjected to MI by ligating the left anterior descending coronary artery.The animals were randomly divided into three groups: sham,MI and MI+angelica.After 24 hours of ligation,rats received angelica(20 mL?kg~(-1)?d~(-1),ip) or saline.Left ventricular hemodynamics were measured and rats were killed at week 1,week 2 and week 4, respectively.Collagen content,macrophage infiltration and TGF-?_1 expression were examined in the non-infarcted area.RESULTS: ① In MI group,the numbers of macrophage and TGF-?_1 expression were significantly upregulated compared to sham at week 1 post-MI and remained elevated at week 4(P

Objective: To detect ED1 gene mutation in three hypohidrotic ectodermal dysplasia (HED) nuclear families. Methods: Peripheral blood samples were obtained from three different families of hypohidrotic ectodermal dysplasia. Genomic DNA was extracted. Polymerase chain reaction, direct sequencing and restriction enzyme reaction were performed to identify the mutations. Results: Different missense mutation in ED1 gene were found in each family: C412G, A1201G and C1375T. Two of the mutations had not been previously reported. Conclusion: Mutations in the ED1 gene are responsible for the phenotypes of HED of the patients in the family.

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.

Objective To evaluate the clinical value of tube-sealing with norvancomycin and heparin saline mixture for prevention of central venous catheter-related infection (CRI).Methods A prospective randomized controlled trial was performed.120 patients who were admitted to department of critical care medicine from January 2012 to January 2014 were included,with their subclavian vein catheterization installation time longer than 48 hours,age over 18 years and younger than 80 years,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score reaching 10-29.The patients were divided into two groups using a random number table,and finally 116 patients were enrolled.Norvancomycin and heparin saline mixture were used for tube sealing in the intervention group (n=56),while only heparin saline was used in the control group (n=60).The incidence of CRI,catheter correlated spectrum of pathogens,adverse events,mortality,hospital day,catheter retention time,and hospital costs were compared between two groups.Results ① There was no significant difference in the incidence of CRI between intervention group and control group [7.14％ (4/56) vs.8.33％ (5/60),x2=0.058,P=1.000].There was no catheter pathogenic colonization in the intervention group,but there were 2 cases of catheter pathogenic colonization in control group.② A total of 7 pathogens were found in two groups.Three cases with pathogenic bacteria was found in the intervention group,with 1 case of Pseudomonas aeruginosa,1 case Acinetobacter baumannii,and 1 case fungi.Staphylococcus aureus,Staphylococcus epidermidis,fungi,and Acinetobacter baumannii was found in the control group,with 1 case of each.There was no significantly statistical difference between two groups (all P＞0.05),but there was a decreasing trend of Gram-positive cocci infection in the intervention group.③ There was no significant difference in the catheter thrombosis,local bleeding or hematoma,catheter dislocation and other adverse events between intervention group and control group [21.43％(12/56) vs.23.33％ (14/60),x2=0.060,P=0.806].④ There were no significant differences in mortality [7.14％(4/56) vs.8.33％ (5/60),x2=0.058,P=1.000],hospital day (days:35.9 ± 15.2 vs.34.1 ± 16.3,t=16.330,P=0.620),catheter retention time (days:25.0 ± 4.5 vs.24.5 ± 5.1,t=26.427,P=2.560) and cost of hospitalization (10 thousand Yuan:3.42 ± 1.22 vs.3.72 ± 1.30,t=13.215,P=1.560) between intervention group and control group.Conclusions For patients with central venous catheter,application norvancomycin with heparin saline mixture for tube sealing did not reduce the incidence of CRI,the incidence of adverse events and mortality,does not reduce hospitalization time,catheter retention time and hospital costs,but may reduce the catheter colonization and infection of Gram-positive bacteria.

Objective To explore the technology and curative effect of thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection.Methods The clinical data of 85 patients with Stanford type B aortic dissection,who were admitted to authors' hospital during the period from January 2010 to April 2016 to receive TEVAR,were retrospectively analyzed.Conventional left brachial artery puncture and straight incision of right femoral artery were employed in all 85 patients,and DSA of ascending aorta was performed to find out the position of rupture,the position of the true and false lumens,and their relationship with the vascular openings of important organs.Endovascular covered stent was implanted to seal off the primary rupture;reexamination of ascending aorta angiography was adopted to check the sealing-off condition of the proximal rupture and the changes of blood flow in the aortic branches as well as in the true and false lumens.Results Successful TEVAR was accomplished in 84 patients.One patient died of sudden rupture of aortic dissection during preoperative anaesthesia.The technical success rate was 100％.In 9 patients the covered stent partially overlapped the left subclavian artery,in one patient the left subclavian artery “chimney” stem completely obstructed both the left common carotid artery and the left subclavian artery,and bypass surgery between left common carotid artery and left subclavian artery was carried out in 2 patients.After the treatment,internal leakage of type Ⅰ was detected in 2 patients.No death occurred during hospitalization period.After the surgery the patients were followed up for 3 months to 3 years,and all patients survived.New rupture at the distal site occurred in 2 patients.Conclusion For the treatment of Stanford type B aortic dissection,TEVAR is safe and effective.Strict observance of surgical indications,careful operative manipulation,and strengthening postoperative management after discharge from hospital are the key points to ensure a successful surgery as well as to improve the long-term survival rate.