Acquired Immunodeficiency Syndrome ; blood ; pathology ; physiopathology ; Female ; Humans ; Infant

The establishment of quality evaluation of traditional Chinese medicine system that not only accords with Chinese medicine function characteristics but also is recognized as international medical circles, is an arduous task in urgent need of solving the current modernization of traditional Chinese medicine in the process of internationalization. It is difficult to evaluate atraditional Chinese medicine by detection of single active components in traditional Chinesemedicinewiththe western medicine quality controlmethod due to the overall effects of traditional Chinese drugs, the components of the overall diversity, targets, and the complexity of the interaction between components of unpredictable make the Long-term since, domestic and foreign scholars continue to explore and put forward a series of quality evaluation of traditional Chinese medicine to promote the development of traditional Chinese medicine. This article summarized the related academic ideas and developments to, providea new thought and perspective for the quality control of traditional Chinese medicine.
Drug Evaluation ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; standards ; Quality Control

Objective To explore establishment of indicator system to evaluate basic capacities of trainers of training for community general practitioners (GPs) to standardize their capacity building and management.Methods Questionnaire survey was conducted among 190 trainers of training for community health managers and GPs who were involved in community health-care and health-care service management in 12 districts of Shanghai to investigate what basic capacities the trainers should have.Delphi expert consultation method was used to construct an evaluation indicator system.Firstly, an evaluation form was formulated based on the preceding questionnaire.Then, two rounds of expert consultation were carried out with 28 experts specialized in general practice, training for GPs, public health and health management.The last step was to set up an evaluation indicator system based on experts' opinions with statistical analysis.Results The newly-established system consisted of five first-grade indicators including comprehensive performance, capacities and personal willingness, background of education and career, personal potential for professional development, capacity in general practice and capacity in training for GPs, and 57 second-grade indicators.Activity coefficient of the experts was all 100%, authority coefficients of the experts were 0.85,and harmonious coefficient of importance of the evaluation was 0.190 and 0.225 ( all P ＜ 0.01 ),respectively, in two rounds of Delphi consultation.Conclusions The preliminarily established indicator system to evaluate capacities of trainers of training for community GPs in diverse aspects can be used as reference for quality critria in selection of trainers of training for community GPs.

Objective To investigate the value of application of magnetic resonance imaging (MRI) in diagnosis and treatment of leptomeningeal metastases from malignant solid tumors.Methods A retrospective analysis was conducted depend on the radiological data of 63 patients who had been diagnosed as leptomeningcal metastasis of malignant solid tumors.Results All patients received brain MRI examination.26 patients underwent cervical or lumbar spine MRI examination.The MRI images showed nodular enhancement in the gyri and sulci,leptomeningeal linear enhancement,dura mater thickening and enhancement,ependymal enhancement,intraventricular metastasis,intraspinal metastatic nodules,communicating hydrocephalus,subdural hydroma and negative imaging.Ncuroimages of ependymal enhancenent,intraventricular metastasis and intraspinal implantation metastasis appeared in 5,7 and 9 patients with small cell carcinoma,respectively,which were higher than that of the other pathological types (P =0.002,P =0.009,P ＜ 0.000 1).Seizure occurred in 7 patients after intrathecal chemotherapy,of which 5 patients had pia mater linear enhancement.Among 33 patients treated with radiotherapy combined with intrathecal chemotherapy,3 patients had poor prognosis,of which 2 patients had negative imaging findings.The conditions of 25 patients were improved obviously after treatment,of which 21 patients showed different imaging remission in MRI re-examination.Conclusions The contrast MRI has an important assistant effect in diagnosis of leptomeningeal metastasis of malignant solid tumors.The MRI findings and clinical features are related with the pathological types.The pia mater linear enhancement indicates a high possibility of seizures after inthathecal chemotherapy,and it suggests that the preventive treatment should be given for such patients.MRI is not applicable to evaluate severity,prognosis and curative effect of the disease.

Objective To observe the clinical effect and safety of umbilical cord blood mesenchymal stem cell(UCB-MSC) transplantation in the treatment of diabetic foot. Methods UCB-MSC suspension (cell concentration (3 -7) × 107/L,0.3 -0.5 ml per point) was injected into multiple spots on affected lower limb with a 3 cm × 3 cm istance among each point. Demixing injection could be performed in regions with multilayer muscles. Clinical symptoms and related index were routinely observed from the first day to three months after operation. Results After three months of UCB-MSC transplantation, pain of patients was relieved, skin temperature increased, intermittent claudication ameliorated, ulcer healed, ankle-brachial index and transcutaneous partial pressure of oxygen increased. The lower extremity lesions showed an abundant collateral vessel formation after the treatment in 2 patients by angiography. Both patients had no severe complications and adverse reactions, none underwent amputation. Conclusions Umbilical cord blood mesenchymal stem cell transplantation is a safe and effective treatment of diabetic lower limb ischemic disease, which can exempt the patient from amputation and improve their quality of life.

In the present study, the specifically knockdown models of P-gp or MRP2 were constructed by using a series of chemically synthesized small interfering RNA (siRNA) in vitro. The expression of P-gp and MRP2 was measured by real-time PCR and Western blot, and the function was evaluated by applying P-gp and MRP2 substrate, rhodamine and methotrexate. The results showed that MRP2 siRNA-3 or P-gp siRNA-2 significantly decreased the mRNA expression of MRP2 or P-gp, the inhibition ratio was 68% or 84%; MRP2 siRNA-3 or P-gp siRNA-2 at a dose of 80 nmol x L(-1) significantly reduced the protein expression of MRP2 or P-gp at 48 h after treatment, the inhibition ratio was 62% or 70%. Meanwhile, other transporters were not influenced by siRNA. When pretreatment with MRP2 siRNA-3 or P-gp siRNA-2, the efflux of methotrexate or rhodamine decreased significantly and the intra-cellular concentration increased. The results suggested that chemically synthesized siRNA could significantly inhibit the expression and function of MRP2 and P-gp, and the model of RNAi in vitro could be used to evaluate the role of efflux transporters in transportation of drugs.

Objective:To study the detection value of platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis.Methods:40 patients with hepatitis B-induced cirrhosis in our hospital from November 2015 to August 2016 were selected as the observation group.40 healthy subjects went through physical examination during the same period were chosen as the control group.The platelet activation indexes and platelet parameters of subjects with same age in two groups were detected and compared.The detection results of the two items in patients with different stages of hepatitis B-induced cirrhosis were compared,too.Results:The PLT of observation group was lower than that of control group,while the other platelet parameters and platelet activation indexes were all higher than those of control group.The detection results of two items in patients with different stages of hepatitis B-induced cirrhosis were with significant differences,all P＜0.05.Conclusion:The platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis are obviously abnormally expressed.There are significant differences among the detection results in patients with different stages.Therefore,surveillance of those indexes in patients with hepatitis B-induced cirrhosis should be strengthened.

Effects of different drying methods including sun drying, steamed, boiled, constant temperature drying (at 40, 50, 60 °C) on appearance, hardness, rehydration ratio, dry rate, moisture, total ash, extractive and polysaccharides contents were studied to provide the basis of standard processing method for Tulipa edulis bulbus. The results showed that the treatments of sun drying and 40 °C drying showed higher rehydration ratios, but lower dry rate, higher hardness, worse color, longer time and obvious distortion and shrinkage in comparison with other drying methods. The treatments of 60 °C constant temperature drying resulted in shorter drying time, lower water and higher polysaccharides content. Drying time is shorter and appearance quality is better in the treatment of steaming and boiling compared with other treatments, but the content of extractive and polysaccharides decreased significantly. The treatments of 50 °C constant temperature drying led to similar appearance quality of bulb to commercial bulb, and it resulted in lowest hardness and highest dry rate as well as higher rehydration ratio, extractive and polysaccharides content, moderate moisture and total ash contents among these treatments. Based on the results obtained, 50 °C constant temperature drying is the better way for the processing of T. edulis bulbus.
Color ; Desiccation ; methods ; Plant Stems ; chemistry ; Polysaccharides ; analysis ; Quality Control ; Tulipa ; chemistry ; Water ; analysis

OBJECTIVEUse propensity score methods to explore the effect of Shenqi Fuzheng injection (SQFZ) on ALT and AST lever of real worlds.

METHODHIS data from 18 hospitals was analyzed. Patients ranging from 18 to 80 years, it were divided into the cases group was used Shenqi Fuzheng injection > 21 days under the instruction, and control group used SQFZ ≤ 21 days. A large number of confounding biases are taken into account through the generalized boosted models (GBM) and multiple logistic regression model to estimate the treatment effects of SQFZ on abnormal changes in ALT and AST index and to explore possible influencing factors.

RESULTSventy and one confounding factors had been counterpoised, stratified analysis showed that the abnormal changes of cases group lower than control group, but not statistically significant.

CONCLUSIONAnalysis of HIS database showed that significant effects of SQFZ on abnormal changes in ALT and AST have not been found. The results of this study form the retrospective data, for the purpose of validating its clinical safety should be have a prospective clinical study of large sample.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hospital Information Systems ; Humans ; Injections ; Liver ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.