Objective To evaluate the efficacy and safety of repeated endoscopic sclerotherapy injection(ESI) and endoscopic variceal ligation(EVL) in eradication of esophageal varices among patients who survive an episode of first variceal hemorrhage with a high risk of rehaemorrhagia and death. Methods The correlated literatures were identified from Medline,Embsae,the Library Cochrance,PubMed and CNKI.RevMan 4.2 Software provided by the Library Cochrance was used for data analysis. Results A total of 4 randomized controlled trials were included.It was demonstrated that there was no significant difference in the esophageal varices eradication rate between repeated ESI and EVL(OR=0.75,95%CI: 0.48-1.15;P=0.19).However,the rehaemorrhagia rate of EVL after emergency hemostasis was significantly lower than that of ESI(OR=2.19,95%CI:1.44-3.31;P=0.000 2).Meanwhile,there was no significant difference in mortality between ESI and EVL(OR=1.34,95%CI:0.82-2.17;P=0.24).Little publication bias was found with funnel plot analysis. Conclusion EVL outperforms ESL in prevention of rehaemorrhagia in treatment of esophageal varices,while does no better than ESL in eradication of esophageal varices and mortality.

Objective To investigate the correlation between the mutation in serum lipoprotein-associated phospholipase A2(Lp-PLA2) Ile198Thr, Val279Phe and cerebral infarction in Chinese Han population of Jiangsu Province. Methods One hundred fifty patients with cerebral infarction and 100 healthy controls in Chinese Han population of Jiangsu Province were recruited. The correlation between Val279Phe and Ilel98Thr mutation in Lp-PLA2 gene and cerebral infarction was analyzed using polymerase chain reaction and denaturing high performance liquid chromatography. Results The Val279Phe genotype and the mutant allele frequency in the cerebral infarction group were significantly higher than those in the control group (χ2 were 6. 31and 5. 32, respectively, all P ＜0. 05), and there was no significant difference between the Ile198Thr genotype and the mutant allele frequency in the control group (χ2 were 0. 039 and 0. 037, respectively, all P ＞0. 05). Conclusions The Val279Phe mutation in Lp-PLA2 gene may be a genetic risk factor for cerebral infarction in Chinese Han population of Jiangsu Province.

OBJECTIVETo explore the nerve regeneration mechanism of electroacupuncture (EA) combined with polysaccharide of gastrodia elate blume (PGB) for secondary thalamic damage of focal cerebral ischemia.

METHODSForty Sprague-Dawley adult rats were randomly divided into a normal control group, a model group, an EA group, a PGB group and an EA + PGB group, 8 rats in each group. The rat model of right middle cerebral artery occlusion was prepared by suture-occluded method. Two weeks after model establishment, rats in the normal control group and model group received no treatment; rats in the EA group were treated with EA at "Baihui" (GV 20) and left "Zusanli" (ST 36), 30 min per treatment, once a day for 14 successive days; rats in the PGB group were treated with intragastric administration of PGB (100 mg/kg) , once a day for 14 days; rats in the EA + PGB group were treated with EA and PGB treatment, once a day for totally 14 days. The expressions of nestin and stem cell factor (SCF) in thalamic ventroposterolateral nucleus (VPL) were detected by immunohistochemical method.

RESULTSThere were positive cells of nestin in ischemia VPL in the model group, and the number of SCF positive cells was increased compared with that in the normal control group (P<0.05). The number of positive cells of nestin and SCF in ischemia VPL in the EA group, PGB group and the EA + PGB group was increased compared with that in the model group (all P<0.05), and the average gray value of immune positive product was all reduced (all P<0.05). The number of positive cells of nestin and SCF in the EA + PGB group was higher than that in the EA group or the PGB group (all P<0.05).

CONCLUSIONEA combined with PGB can significantly increase the SCF expression in ischemia VPL and promote the proliferation of neural stem cells, which is likely to be one of the nerve regeneration mechanism of acupuncture and medication tor secondary thalamic damage of local cerebral isctemia.

Animals ; Brain Ischemia ; drug therapy ; genetics ; metabolism ; therapy ; Combined Modality Therapy ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Electroacupuncture ; Gastrodia ; chemistry ; Humans ; Male ; Nestin ; genetics ; metabolism ; Polysaccharides ; administration & dosage ; Rats ; Rats, Sprague-Dawley ; Stem Cell Factor ; genetics ; metabolism ; Thalamic Nuclei ; metabolism

This study is to establish an UPLC fingerprint of Resina Draconis from different manufacturers, which can provide a comprehensive evaluation for its quality control. The analysis was performed on a Phenomenex Kinetex 2.6 μ C18 100A column by agradientelution program with acetonitrile-water as mobile phase at a flow rate of 1.7 mL x min(-1). The column temperature was 40 degrees C and the detection wavelengthwas 280 nm. The fingerprints of 18 batches of Draconis Resina were further evaluated by chemometrics methods including similarity analysis (SA), hierarchical clustering analysis (HCA) and principal component analysis (PCA). As a result, there were 15 common peaks, 13 of which had been identified by LC-Q-TOF MS, and the similarity degrees of 15 batches of the samples was more than 0.9, and the samples were divided into 4 clusters by their quality difference. The method is reproducible, simple and reliablethat it can be used for quality control and evaluation of Resina Draconis from different manufacturers.
Chromatography, High Pressure Liquid ; methods ; Dracaena ; chemistry ; Drugs, Chinese Herbal ; analysis ; Principal Component Analysis ; Quality Control

A reliable method for simultaneous determinition of eleven representative components (neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C, shanzhiside, geniposidic acid, genipin-1-β-D-gentiobioside, geniposide and secoxyloganin) in combination of chromatographic fingerpint analysis for Reduning injection was developed by ultra high-performance liquid chromatography (UPLC). The method was performed on an Agilent ZORBAX SB-C18 anlytical column (3. 0 mm x 100 mm, 1. 8 µm) with a guard column of Agilent UPLC Guard ZORBAX SB-C18 (3.0 mm x 5 mm) at the column temperature of 30 °C. The gradient mobile phase consisted of acetonitrile (A)-0. 1% phosphoric acid (B) with a flow rate of 0. 4 mL . min-1. The injection volumn was 2 µL. The detection wavelengths were set at 324 nm and 238 nm for quantit tive analysis and 225 nm for fingerpint chromatography. Neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C, shanzhiside, geniposidic acid, genipin-1-β-D-gentiobioside, geniposide and secoxyloganin were baseline seperated with good linearity relationships (r >0. 999) between concentration and peak areas over the linear ranges. The average recoverys of the investigated compounds were 103.5%, 100. 2%, 103. 3%, 102. 8%, 101. 3%, 102. 8%, 97. 36%, 99. 62%, 98. 16%, 102. 8%, 99. 27%, respectively. Reduning injection of forty-five batches was analyzed by UPLC finge print chromatography. Thirty batches were selected to generate the reference fringerprint chromatography with fourteen common peaks. The similarity values between the reference fringerprint chromatography and the remaining fifteen batches were higher than 0. 99. The developed method was fast, accurate and sensitive. It could be used as a reference for the quality control of multiple components determination and fingerprint chromatography for Reduning injection in future.
Chlorogenic Acid ; chemistry ; isolation & purification ; standards ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Glucosides ; chemistry ; isolation & purification ; standards ; Iridoids ; chemistry ; isolation & purification ; standards ; Quality Control ; Reference Standards ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors

Acetates ; pharmacology ; Animals ; Disease Models, Animal ; Diving ; adverse effects ; Ear Canal ; injuries ; Nitrogen ; Oxygen ; Protective Agents ; pharmacology ; Rabbits

Objective To investigate the ipratropium bromide combined with Ambroxol Aerosol Inhalation on preventive effect of pulmonary complications after thoracotomy. Method 115 patients undergoing thoracic operation were randomly divided into 2 groups, 2 groups were given routine nursing before operation, the control group on the basis of Mucosolvan atomization inhalation, the observation group in the conventional nursing combined with ipratropium bromide and atomization inhalation of ambroxol. Results the curative effect of therapeutic group was signiifcantly better than the control group (P<0.05); lung infection in the observation group was significantly lower than that of the control group (P<0.05). Conclusion ipratropium bromide and Mucosolvan aerosol inhalation signiifcantly on the prevention of pulmonary complications after thoracotomy and effect, will help the patient restore.

Objective To evaluate the value of neutrophil gelatinase - associated lipocalin (NGAL) for diagnosis of acute kidney injury (AKI) after cardiopulmonary bypass established. Method 120 children undergoing cardiopulmonary bypass were enrolled in this prospectively study. Serial urine samples were analyzed by ELISA for NGAL expression. The primary outcome measure was AKI, which was defined as a 50% or greater increase in serum creatinine from baseline. Result 21 children ( 17.5% ) developed AKI. Urine concentrations of NGAL increased after cardiopulmonary bypass had been established for 2 hours. The concentration of NGAL in urine after cardiopulmonary bypass had been established for 2 hours was used to diagnose AKI. The area under the receiver-operating characteristic curve was 0. 96, the sensitivity was 92%, and the specificity was 91% for the cutoff value of 100ng/mg Cr. Conclusion Concentrations of NGAL in urine might be used as a sensitive and specific biomarker for early prediction of AKI after cardiopulmonary bypass had been established.

This study is to explore the amelioration of piperine on chronic acute combining stress rat with depression-like behavior, visceral sensitivity, and its effect on the expression of serotonin (5-HT) and synaptophysin. Forty two SD rats were divided into seven groups: blank group, model group, piperine (12.5, 25, 50 and 100 mgkg-1, ig) and imipramine (10 mgkg-1, ip) groups. The rat model of irritable bowel syndrome was established by chronic acute combining stress, and then to evaluate depression-like behavior and visceral sensitivity. The expressions of 5-HT and synaptophysin in the hippocampus and colon were determined by high performance liquid chromatography (HPLC) and Western blotting, respectively. The duration of immobility of IBS rat in the forced swimming test had been significantly increased, the sucrose consumption of IBS rat had been reduced and visceral sensitivity was obviously elevated in the IBS model group as compared with those in the normal control group (P<0.05, P<0.01). As compared with those in the normal control group, the expression of 5-HT significantly decreased, 5-HIAA/5-HT ratio significantly increased in the hippocampus of IBS model group (P<0.05), but opposite presentations were noted in the colon (P<0.05). As compared with that in the normal control group, the synaptophysin expression in the hippocampus decreased significantly but obviously increased in the colon (P<0.05). Piperine improved the behavior of IBS rats, and reversed the levels of 5-HT and 5-HIAA, and 5-HIAA/5-HT proportion in the hippocampus and colon (P<0.05); besides, they significantly reverse the synaptophysin level in the hippocampus and colon (P<0.05). The presence of depression and visceral sensitivity had been changed in IBS rats, with abnormal expression of 5-HT and synaptophysin in the brain-gut system. Piperine can ameliorate the changes of the behavior and regulation of serotonin and synaptophysin expression in IBS rat model.
Alkaloids ; isolation & purification ; pharmacology ; Animals ; Benzodioxoles ; isolation & purification ; pharmacology ; Colon ; metabolism ; Hippocampus ; metabolism ; Hydroxyindoleacetic Acid ; metabolism ; Irritable Bowel Syndrome ; metabolism ; physiopathology ; Male ; Motor Activity ; drug effects ; Piper nigrum ; chemistry ; Piperidines ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Polyunsaturated Alkamides ; isolation & purification ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism ; Synaptophysin ; metabolism

Objective To study the construction and function of platelet (PL) and the protection of PL by blood anesthesia during the eardiopulmonary bypass (CPB). Methods Bovine serum albumin (BSA) was immobi-lized on the surface of polyethylene terephthalate(PET) which was used as artificial vascular materials,to obtain the samples of PET-BSA. (1) The quantity of PL adhesion of PET and PET-BSA samples were investigated by lactate de-hydrogenase(LDH) test. (2) The quantity of PL activation was investigated by a-granule membrane protein-140 (GMPI40) test. (3)PL adhesion test was conducted on the surface of the samples and the morphology of the adhered PL was examined by scanning electron microscopy (SEM). (4)30 patients undergoing cardiac surgery under CPB were randomly divided into aprotinin group and control group,quantities of FDP, PK, PLG and thromboxance B2 (TXB2) in the blood were measured in various time, PLs were observed by electron microscopy, and postoperative blood loss from chest and medium were recorded during first 24 hours. Results Compared with the control group,the quantity of PL adhesion on the PET-BSA samples significantly decreased and the quantity of PL activation of the PET-BSA group was only 20% of the control group. The results of SEM showed PL on PET-BSA surface was few,whereas on the PET sur-face overlaped and had pseudopodium. The decomposition of PLG is fewer in blood anaesthesia group,indicated the fi-brinolytie system was inhibited and construction of PL was protected. Conclusion During CPB,plasma proteins com-pete against each other to adhere on the tube of CPB,then PL interact to the adhered proteins,and PL combine with conformation changed fibrin at its C extreme of γ chain. At the same time,PL is activated and its GPⅡb/Ⅲa point is ex-posed. The function of blood anesthesia of aprotinin is to inhibit the activation of PIg; and PK,protect the GPⅡb of PL from being destroyed, and protect the coagulation funeion of PL of postoperation.