Cyclooxygenase (COX) is a crucial enzyme in the biosynthesis of prostaglandins.There are two COX isoforrns:COX-1 and COX-2.Recently it is demonstrated that there is a close relationship of COX-2 with the occurrence,development and metabasis of tumor; COX-2 inhibitor is hoping to be a new target in tumor therapy.The article overviews many progresses of COX-2 about its expression,modulation and mecha-nism of carcinogenesis in cholangiocarcinoma in order to explore the prospect of the COX-2 inhibitors in cholangioearcinoma treatment.

4-Hydroxycoumarins ; poisoning ; Acute Disease ; Adult ; Humans ; Male ; Poisoning ; diagnosis ; Prothrombin Time

OBJECTIVETo study the relationship between Chinese medical syndrome types and metabolomics of non-small cell lung cancer (NSCLC) patients.

METHODSTotally 120 NSCLC patients were assigned to asthenia syndrome group and sthenia syndrome group, 60 in each group. Meanwhile, 60 cases of benign pulmonary nodules in physical examinations were recruited as the control group. Tumor tissues or benign pulmonary nodules tissues were obtained by thoracoscope. Changes of their metabolites were observed using gas chromatography-mass spectrometry (GC-MS). Their differences were studied using principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA). ROC curve analysis was performed in different metabolic compounds of sthenia and asthenia syndromes groups. The area under the curve (AUC) was calculated to evaluate the sensitivity of diagnosing syndrome types.

RESULTSCompared with the control group, difference existed in 16 compounds. Of them , contents of citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, linoleic acid, oleic acid, lactic acid, inositol were more in the two tumors group than in the control group. Difference existed in 10 compounds between the sthenia syndrome group and the asthenia syndrome group. Of them, citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, lactic acid, and inositol were more in the asthenia syndrome group than in the sthenia syndrome group. Contents of valine, glucose, and glutamine were more in the sthenia syndrome group than in the asthenia syndrome group. ROC curve analyses of different compounds indicated that AUC of lactic acid and glucose was more than 0.8 (P < 0.01); AUC of inositol, choline phosphate, and glycerol phosphate choline was more than 0.7 (P < 0.01); AUC of valine, citric acid, glutamine, alanine, and pyruvic acid was more than 0.6 (P < 0.05).

CONCLUSIONSThere existed certain correlation between CM syndrome types and metabolomics of lung cancer. Lactic acid, glucose, inositol, choline phosphate, glycerol phosphate choline, valine, citric acid, glutamine, alanine, pyruvic acid were sensitive diagnostic compounds, and the first four kinds were most sensitive compounds.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Gas Chromatography-Mass Spectrometry ; Humans ; Lactic Acid ; Least-Squares Analysis ; Metabolomics ; methods ; Principal Component Analysis ; Pyruvic Acid

Adult ; Chlorine ; poisoning ; Humans ; Male ; Middle Aged ; Phosgene ; poisoning ; Respiratory Distress Syndrome, Adult ; chemically induced

Biomedical Research ; Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods

Clinical pathway (CP), as a standardized approach and clinical management process for disease diagnosing and treating, is being widely used with more relevant publications reported gradually. But different forms of CP reports may prevent the evaluation and spreading of CP. The authors recommend guidelines for evidence-based Chinese medicine CP report, including 18 items which form 5 big sections, by precise item selection and rigorous expert consensus. All these items can embody the principles of Chinese medicine and comply with the requirements of the clinical practice of Chinese medicine. All above are based on synthesizing the published literature systematically and analyzing the current status in this field, also according to the characteristics of Chinese medicine and methodology requirement of evidence-based medicine.

Objective To explore the rehabilitation outcome and influencing factors of functional recovery in patients with nontraumatic spinal cord injury (NTSCI). Methods A retrospective analysis was done on 49 cases suffering from NTSCI who recepted rehabilitation therapy from December 2014 to November 2016. The main indicator of the rehabilitation effect was Modified Barthel Index (MBI). A total of 49 cases were divided into two groups, effective group (31 cases) and ineffective group (18 cases) according to whether their MBI on discharge had beated the target setted on admission. The following factors:ages, gender, injury causes, injury level, injury grade, injury severity, the types of paralysis, hospitalization time, sick time, complications number, MBI on admission and discharge, operation, early rehabilitation were evaluated by Univarite analysis and Logistic stepwise regression to assess how they influenced rehabilitation outcome. Results After systematically rehabilitation training, MBI had apparent improvement, from (38.98 ± 24.90) score on admission to (56.35 ± 22.69) score on discharge and had statistical significance(Z=-4.95, P=0.00), which showed that rehabilitation training can effectively improve patients′ self-care ability of daily living. Regression analysis found that the MBI on admission (OR=1.044, P=0.010) and hospitalization time(OR=1.044, P=0.039) had a noticeable effect on the rehabilitation outcome, while all the other factors, such as age, sex, injury grade, injury level, injury severity, complications number hadn′t show concrete effect on rehabilitation outcome. Conclusions Patients with NTSCI should have early rehabilitation, medical staff should assess their admission MBI, make a strict rehabilitation training plan to improve rehabilitation efficiency, shorten hospitalization time, improve the patients quality of life.

Objective To investigate the effect of gastrointestinal environment on fecal occult blood test.Methods Mixed peripheral venous blood (45 ml) of 25 healthy volunteers from medical examination center of China-Japan Friendship Hospital in 2015 were collected to establish an in vitro gastrointestinal digestion model.The model was used to study the effects of different digestion time and concentration of digestive juice on the immunochemical fecal occult blood test using two kinds of occult blood detection reagents.Results When the amount of bleeding was over 5 ml,fecal occult blood test still showed positive after artificial stomach liquid digestion for 2 hours and artificial intestinal liquid digestion for 5 hours.The fecal occult blood test turned negative after artificial stomach liquid digestion for 0.5-3 hours and artificial intestinal liquid digestion for 3 hours.The positive rate of fecal occult blood test was closely related to the amount of bleeding.When the amount of bleeding was large and bleeding was acute,false negative could be caused by postzone phenomenon.The upper detection limit of two reagents was more than 3 165 ng/L,and the lower detection limit was0.2 ng/L.Conclusions Higher positive rate was detected not only in lower digestive tract bleeding but also in upper gastrointestinal bleeding with immunoassay method.Immunochemical fecal occult blood reagent had a wide detection range and could meet the clinical requirements for detection of gastrointestinal bleeding.

Objective: To investigate the effects of dexmedetomidine (DEX) on oxidative stress and systemic inflammatory response syndrome(SIRS) during cardiopulmonary bypass (CPB).Methods: Totally 62 patients scheduled for mitral valve replacement surgery were enrolled in this study and randomly assigned to DEX group with constant infusion of DEX (0.5 μg·kg-1 ·h-1 , n =31) and the control group with the same amount of 0.9% sodium chloride injection(n =31).A volume of 4 ml of jugular vein blood was respectively withdrawn before the induction of anesthesia (T0), at 10 min after aortic-off clamping(T1), the end of bypass(T2), 4h after bypass(T3),12h after bypass(T4) and 24h after bypass(T5).The serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6(IL-6), interleukin-8(IL-8) and interleukin-10(IL-10) were determined.Results: The serum CRP in both groups increased remarkably at T1-T5 , while the serum CRP in DEX group was significantly lower than those in the control group at T3-T5.The serum TNF-α increased remarkably in control group at T2-T4, while the serum TNF-α increased remarkably in DEX group at T2-T3;the serum TNF-α in DEX group was significantly lower than those in the control group at T3-T4.The serum IL-6, IL-8, IL-10 in both groups were increased remarkably at T2-T5, T1-T5,T1-T3, respectively.The serum IL-6 and IL-8 in the DEX group were significantly lower than those in the control group at T2-T4 while the serum IL-10 in the DEX group was significantly higher than that in the control group at T1-T3.The serum WBC in both groups at T3-T5 were higher than those at T0, while the serum WBC in the control group was significantly higher than that in the DEX group at T3-T5.However, the differences between the two groups at mechanical ventilation time, ICU observation time, the incidence of postoperative SIRS after 24h, hospitalization days, and the adverse reactions were not statistically significant.Conclusion: DEX has notable protective effects on systemic inflammatory response syndrome during extracorporeal circulation.

Objective:To establish the quality standard for Kechuanning granules. Methods: A TLC method was used for the qualitative study on the main ingredients, Radix stemonae,ephedra and bitter almond. An HPLC method was used to determine the con-tents of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin. The separation of targeted compounds was performed on a Tech Mate C18-ST column (250 mm × 4. 6 mm,5 μm) . The mobile phase consisted of methanol(A) and 0. 1% phosphoric acid (B) with gradient elution at a flow rate of 1. 0 ml·min-1. The detection wavelength was 207nm and the column temperature was 35℃. Results:The spots in TLC were quite clear without any interference from negative control. The linear relationship of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin was 1. 826-182. 600μg·ml-1( r=0. 9997),1. 848-184. 815μg·ml-1 (r=0. 9997) and 2. 981-298. 069 μg·ml-1(r=0. 9996),respectively. The average recovery was 97. 00%,97. 40% and 98. 30%(RSD=3.7%,2.5%,1.6%)(n=9),respectively. Conclusion: The method is sensitive,accurate,simple and reproducible,which can be used for the quality control of Kechuanning granules.