Objective To explore the clinical effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury.Methods Fifty elderly cardiac surgery patients with postoperative acute kidney injury were divided into control group and study group by random digit table method with 25 cases each.The 2 groups were treated with routine drug and blood purification,the study group was additionally given fasudil injection 30 mg + 0.9％ sodium chloride injection 50 ml vein pumping,1 time/12 h,for 7 d.The urine volume,urine N-acetyl-β-D-glucosaminidase (NAG),urine γ-glutamyl transpeptidase (γ-GTP),urine α 1-microglobulin (α 1-MG),serum creatinine (SCr),blood urea nitrogen (BUN) and creatinine clearance rate (CCr) were observed,and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was computed.Results There were no statistical differences in the indexes before treatment between the 2 groups (P＞ 0.05).The urine volume after treatment 3,5,7 d in study group was more than that in control group [(38.72 ± 2.68) ml/h vs.(31.68 ± 2.52) ml/h,(47.24 ±3.73) ml/h vs.(40.24 ± 2.52) ml/h、(63.80 ± 2.50) ml/h vs.(56.60 ± 3.30) ml/h],urine NAG,urine α 1-MG,urine γ-GTP,SCr and BUN were lower than those in control group [NAG:(25.05 ±5.44) U/L vs.(28.04 ± 5.21) U/L,(24.06 ± 3.43) U/L vs.(27.23 ± 6.43) U/L,(22.08 ± 3.25) U/L vs.(26.23 ± 4.41) U/L; α 1-MG:(24.05 ± 3.65) mg/L vs.(26.74 ± 6.74) mg/L,(22.98 ± 3.58) mg/L vs.(25.57 ± 3.58) mg/L,(20.95 ± 3.78) mg/L vs.(25.48 ± 3.45) mg/L; γ-GTP:(8.2 ± 0.4) U/L vs.(10.8 ± 3.8) U/L,(7.3 ± 0.2)U/L vs.(10.5 ± 2.5) U/L,(6.5 ± 1.4) U/L vs.(9.7 ± 2.6) U/L; SCr:(206.52 ± 6.72) μ mol/L vs.(255.16 ±6.75) μmol/L,(182.98 ±6.26) μmol/L vs.(252.23 ±9.53) μmol/L,(33.25 ±7.95) μmol/L vs.(170.75 ± 7.94) μ mol/L; BU N:(19.61 ± 3.23) mmol/L vs.(20.25 ± 3.25) mmol/L,(16.76 ± 2.06) mmol/L vs.(18.32 ± 4.84) mmol/L,(12.28 ± 2.26) mmol/L vs.(14.27 ± 4.54) mmol/L],CCr was higher than that in control group [(18.66 ± 3.89) ml/min vs.(13.28 ± 3.25) ml/min,(27.76 ± 4.36) ml/min vs.(16.23 ± 4.18)ml/min,(33.79 ± 5.58) ml/min vs.(22.12 ± 4.65) ml/min],there were statistical differences (P ＜ 0.05).The APACHE Ⅱ score before treatment and after treatment 5,7 d in control group were (32.20 ±4.51),(26.38 ±5.28) and (21.43 ±4.22) scores,in study group were (33.05 ±3.82),(22.15 ±3.42) and (13.25 ± 2.15) scores.There was no statistical difference in the APACHE Ⅱ score before treatment (P ＞ 0.05),the APACHE Ⅱ score after treatment was improved,furthermore APACHE Ⅱ score after treatment 5,7 d in study group were better than those in control group,there were statistical differences (P ＜ 0.05).Conclusions The treatment effect of blood purification combined with fasudil is remarkable in elderly cardiac surgery patients with postoperative acute kidney injury.At the same time,it has high security and very important clinical significance.

Calcinosis ; pathology ; surgery ; Child ; Diagnosis, Differential ; Humans ; Knee ; Male ; Skin Diseases ; pathology ; surgery

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Scaphoid Bone ; injuries ; surgery ; Wrist Injuries ; surgery ; Young Adult

OBJECTIVETo investigate the expression of retinoblastoma-associated protein 46 (RbAp46) or RbAp 46 mRNA in bone marrow mononuclear cells (BMMNC) of acute leukemia (AL) patients and determine whether the expression is related to the classification and prognosis of ALs.

METHODSThe expression of RbAp46 protein in BMMNC was detected by Western blot in 46 AL patients and the expression of RbAp46 mRNA in BMMNC by semi-quantitative RT-PCR in 22 AL patients. The indirect immunofluorescence staining technique was applied to the localization of RbAp46 protein in BMMNC both in leukemia patients and control subjects.

RESULTS(1) Both RbAp46 protein and mRNA were expressed in AL BMMNC and no significant difference was found among different leukemia types. (2) The expression of RbAp46 protein was lower in AL patients with high-degree tumor burden than in those with low-degree tumor burden (mean A, 93.4 +/- 37.2 vs 127.2 +/- 15.8, P < 0. 05). (3) The expression of RbAp46 protein was lower in refractory leukemia than those in non-refractory leukemia (mean A, 87.1 +/- 33.8 vs 126.6 +/- 21.2, P < 0. 05). (4) The expression of RbAp46 mRNA was lower in AL patients with high-degree tumor burden than in those with low-degree tumor burden (mean A R, 0.19 +/- 0.08 vs 0.31 +/- 0.12, P < 0. 05). (5) RbAp46 protein was mainly localized in nucleus of BMMNC in both AL patients and control subjects.

CONCLUSIONBoth RbAp46 protein and mRNA are expressed in AL patients BMMNC. The downregulation of RbAp46 expression is associated with high leukemic burden and refractory to treatment. RbAp46 gene might be a tumor suppressor gene for leukemia.

Acute Disease ; Adolescent ; Adult ; Aged ; Blotting, Western ; Bone Marrow Cells ; metabolism ; Carrier Proteins ; genetics ; metabolism ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Leukemia ; blood ; pathology ; Male ; Middle Aged ; Nuclear Proteins ; genetics ; metabolism ; Prognosis ; RNA, Messenger ; genetics ; metabolism ; Retinoblastoma Protein ; genetics ; metabolism ; Retinoblastoma-Binding Protein 7 ; Reverse Transcriptase Polymerase Chain Reaction ; Young Adult

OBJECTIVETo detect the expression of PSF1 (partner of Sld five 1) in colon cancer specimens, and to explore the effect of RNA interference targeting PSF1 on the proliferation of colon cancer cells and its mechanism.

METHODSExpression level of PSF1 protein in colon cancer specimens was detected by Western blot in 40 patients with colon cancer from May 2004 to December 2006. The short hairpin RNA (shRNA) plasmid targeting PSF1 was transfected into LOVO, HT-29 and HCT116 cells with liposome, then the expression level of PSF1 protein was measured by Western blot, the effect of PSF1 shRNA plasmid transfection on cell proliferation by MTT assay, anchorage-independent growth by soft agar colomy-formation assay, and PSF2, PSF3 and SLD5 mRNA expression by quantitative reverse transcription polymerase chain reaction.

RESULTSThe relative expression level of PSF1 protein in colon cancer tissues was 0.485±0.113, which was significantly higher than that in adjacent normal mucosa tissues (0.056±0.014, P<0.01). Western blot showed that the expression level of PSF1 protein was significantly decreased in colon cancer cells transfected with PSF1 shRNA plasmid. After PSF1 shRNA plasmid transfection, cell proliferation was significantly suppressed, the soft agar colony-forming rates of LOVO, HT-29 and HCT116 cells were significantly lower than those in control groups (P<0.05), meanwhile the expression levels of PSF2, PSF3 and SLD5 mRNA were significantly decreased (P<0.05).

CONCLUSIONSPSF1 is significantly up-regulated in colon cancer tissues compared with adjacent normal mucosa tissues. ShRNA plasmid targeting PSF1 can inhibit the expression of PSF1 gene, suppress the proliferation of colon cancer cells, suggesting that it may be a new therapeutic target for colon cancer.

ATP-Binding Cassette Sub-Family B Member 2 ; ATP-Binding Cassette Transporters ; genetics ; metabolism ; Adult ; Aged ; Cell Line, Tumor ; Cell Proliferation ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Middle Aged ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.

METHODSForty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine, and the control group (20 patients) treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.

RESULTSHAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05). The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%). No significant difference of TESS scores was found between the two groups.

CONCLUSIONEA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.

Adult ; Combined Modality Therapy ; Depression ; drug therapy ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Paroxetine ; adverse effects ; therapeutic use ; Serotonin Uptake Inhibitors ; adverse effects ; therapeutic use ; Treatment Outcome

OBJECTIVETo evaluate the effect of a 10-day course of triptolide (TP) on rat cytochrome (CY) P3A4 activity, and on the pharmacokinetics of cyclophosphamide (CPA).

METHODSIn the pharmacokinetics experiment, rats were orally given 0.9% NaCl solution (n=5) and TP [1.2 (mg/kg·d)] for 10 days and a single dose of CPA was administered intravenously (100 mg/kg) to rats on day 11. Blood samples were collected up to 4 h at predetermined time intervals, the plasma concentration of CPA was determined by high performance liquid chromatography (HPLC) and pharmacokinetic parameters were determined. In the in vitro CYP3A4 activity inhibition research, rat blank liver microsomes were divided into 3 groups: a control group, a TS (5 μL, 200 μmol/L) with TP (5 μL, 12.5 μmol/L) group, a TS with ketoconazole (5 μL, 1 μmol/L) group. Concentration of 6β-hydroxylated testosterone (6β-OHT) in liver microsomes was measured by HPLC and the activity of CYP 3A4 was calculated through the following formula: Einhibitor/Econtrol × 100%=Cinhibitor/Ccontrol × 100%.

RESULTSCompared with the control group, the area under the plasma concentration-time curve (AUC0-∞) of CPA was significantly increased by 229.05% pretreated with TP (P<0.01). Peak plasma concentrations (Cmax) of CPA was significantly increased and plasma half-life was correspondingly extended. The CYP3A4 activity was significantly inhibited by ketoconazole 93.5%±0.2% and TP 84.6%±0.3% compared with the control group (P<0.01 and P<0.05, respectively).

CONCLUSIONOur results strongly suggested that long-term oral intake of TP can distinctly inhibit the CYP3A4 activity and this inhibition evidently decrease the formation of toxic metabolites of CPA.

Animals ; Cyclophosphamide ; pharmacokinetics ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; pharmacology ; Diterpenes ; pharmacology ; Epoxy Compounds ; pharmacology ; Herb-Drug Interactions ; Hydroxytestosterones ; metabolism ; Immunosuppressive Agents ; pharmacokinetics ; Injections, Intravenous ; Ketoconazole ; pharmacology ; Male ; Microsomes, Liver ; drug effects ; metabolism ; Phenanthrenes ; pharmacology ; Rats, Sprague-Dawley

BACKGROUNDAspermia caused by exogenous testosterone limit its usage in late-onset hypogonadism (LOH) patients desiring fertility. Saikokaryukotsuboreito (SKRBT) is reported to improve serum testosterone and relieve LOH-related symptoms. However, it is unclear whether SKRBT affects fertility. We aimed to examine the effects of SKRBT on spermatogenesis and fertility in aging male mice.

METHODSThirty aging male mice were randomly assigned to three groups. Mice were orally administered with phosphate-buffer solution or SKRBT (300 mg/kg, daily) or received testosterone by subcutaneous injections (10 mg/kg, every 3 days). Thirty days later, each male mouse was mated with two female mice. All animals were sacrificed at the end of 90 days. Intratesticular testosterone (ITT) levels, quality of sperm, expression of synaptonemal complex protein 3 (SYCP3), and fertility were assayed.

RESULTSIn the SKRBT-treated group, ITT, quality of sperm, and expression of SYCP3 were all improved compared with the control group (ITT: 85.50 ± 12.31 ng/g vs. 74.10 ± 11.45 ng/g, P = 0.027; sperm number: [14.94 ± 4.63] × 106 cells/ml vs. [8.79 ± 4.38] × 106 cells/ml, P = 0.002; sperm motility: 43.16 ± 9.93% vs. 33.51 ± 6.98%, P = 0.015; the number of SYCP3-positive cells/tubule: 77.50 ± 11.01 ng/ml vs. 49.30 ± 8.73 ng/ml, P < 0.001; the expression of SYCP3 protein: 1.23 ± 0.09 vs. 0.84 ± 0.10, P < 0.001), but fertility was not significantly changed (P > 0.05, respectively). In the testosterone-treated group, ITT, quality of sperm, and expression of SYCP3 were markedly lower than the control group (ITT: 59.00 ± 8.67, P = 0.005; sperm number: [4.34 ± 2.45] × 106 cells/ml, P = 0.018; sperm motility: 19.53 ± 7.69%, P = 0.001; the number of SYCP3-positive cells/tubule: 30.00 ± 11.28, P < 0.001; the percentage of SYCP3-positive tubules/section 71.98 ± 8.88%, P = 0.001; the expression of SYCP3 protein: 0.71 ± 0.09, P < 0.001), and fertility was also suppressed (P < 0.05, respectively).

CONCLUSIONSKRBT had no adverse effect on fertility potential in aging male mice.

Aging ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Fertility ; drug effects ; Hypogonadism ; drug therapy ; Male ; Mice ; Nuclear Proteins ; analysis ; Sperm Count ; Sperm Motility ; drug effects ; Spermatogenesis ; drug effects ; Testis ; drug effects ; pathology ; Testosterone ; blood

【Objective】To investigate the sleep status of patients with chronic HBV infection【Methods】From January 2019 to June 2019 ，353 patients with chronic hepatitis B virus infection in the outpatient department of the Third Affiliated Hospital of Sun Yat-sen University，using the sleepiness scale，insomnia scale，sleep quality scale，anxiety self- rating form and depression self- evaluation ，patients were scored and grouped according to sleep grading criteria. Patients were collected for gender，age，disease diagnosis，antiviral therapy，and educational level. Chi-square correlation test and multivariate logistic regression were applied to analyze the influencing factors of sleep. 【Results】 The overall sleepiness rate was 47.88%. The overall insomnia rate was 53.26%. There were 6.8% patients who had poor sleep quality. The risk factor of lethargy was the degree of anxiety（P = 0.000，OR = 3.076，95% CI 1.706~5.545）. The risk factor of insomnia was anxiety（P = 0.000，OR = 14.693，95% CI 5.046~42.782）and depression（P = 0.002，OR = 2.279，95% CI1.340~3.877）. The risk factor of sleep quality was anxiety（P = 0.000，OR = 9.990，95% CI 4.031~24.758）.【Conclusions】 Patients with chronic HBV infection have a high proportion of subjective sleep disorders. The main influencing factor is mental state of the patient. A full understanding of the patients′ sleep status will help the patients′ treatment.

BACKGROUNDPrevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus (T2DM) remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs (OAD) alone and to determine factors associated with inadequate glycaemic control in this population.

METHODSAn observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers. People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were ≥ 30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin A(1C) (HbA(1C)) ≥ 6.5% detected on the index visit.

RESULTSIn this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean (SD) HbA(1C) was 6.7% (1.3). Multivariate Logistic regression showed that physical inactivity, disease duration > 10 years, body mass index (BMI) ≥ 24 kg/m(2), low homeostasis model assessment of β-cell function (HOMA-β) index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience (47.1% vs. 34.8%, P = 0.008) and more fear of hypoglycemia quantified by Worry subscale of the Hypoglycaemia Fear Survey (HFS) II were happened in subjects with good glycemic control.

CONCLUSIONApproximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and therapeutic approaches on management of hypertriglycemia, enhancing physical exercise and weight control, and at the same time, lowering the hypoglycemic risk and diminishing the hypoglycemic fear of patients.

Aged ; Asian Continental Ancestry Group ; Blood Glucose ; drug effects ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; metabolism ; Female ; Glycated Hemoglobin A ; Humans ; Hypoglycemic Agents ; therapeutic use ; Logistic Models ; Male ; Middle Aged