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

Objective To explore the impact of four different anesthetic drugs commonly used in animal experi-ments on cardiovascular system in rats.Methods Electrocardiogram ( ECG) and blood pressure were dynamically recor-ded by a BioPac MP150 system after anesthesia.In addition, the blood glucose at different time points and hepatic func-tion, kidney function, cardiac enzymes and electrolytes at the end of the test were collected.Rusults Chloral hydrate caused severe ventricular arrhythmia.Isoflurane had inhibitory effect on the heart rate.Pentobarbital sodium induced a in-crease of ECG P wave.Urethane caused J point elevation of ECG.Blood pressure in the urethane-and pentobarbital sodi-um-treated groups were increased.Chloral hydrate caused CK to be raised, while isoflurane showed the opposite effect on CK and CKMB.Alanine aminotransferase and aspartate aminotransferase in the pentobarbitol sodium and isoflurane groups were decreased.Creatinine in the chloral hydrate, pentobarbital sodium and isoflurane groups were lower, and the serum sodium and potassium were decreased in the four groups.Conclusions Chloral hydrate has obvious effect on the cardio-vascular system, and is not suitable for animal studies on cardiovascular diseases.Pentobarbital sodium, urethane, isoflu-rane can be chosen for animal studies on cardiovascular diseases.

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.

Objective To observe the acute pain service for analgesia effect and complications of postopera-tive analgesia and satisfaction after cesarean section.Methods 360 patients undergoing cesarean section and postop-erative continue analgesia were randomly divided into two groups.The control group (group C,n =178)was given with routine postoperative self -control analgesia give guidance.In the observation group (group A,n =182),a group for acute pain was founded,and the patients were explained about PCA self -control analgesia related knowledge before operation,together with the APS analgesia group people,the patients were given with postoperative pain management,observed self -control analgesia efficacy and side effects,and gives the corresponding treatment and guidance.The difference of analgesia incomplete and complication were observed such as nausea and vomiting,calm, itchy skin.Questionnaires that postoperative analgesia satisfaction survey were filled inafter discharged.The satisfac-tion of nurse with the APS were observed.Results Postoperative analgesia complication in group A were significantly lower than that in group C(P <0.01,P <0.05),APS analgesic incomplete in group C was significantly higher than groupA (χ2 =11,P <0.01).The satisfaction of PCA in group A were significantly higher than group C (P <0.01, P <0.05),ward nurses job satisfaction also increased significantly (t =2.63,P <0.05).Conclusion Acute pain service effectively improve analgesic quality and reduce related complications after cesarean section increase patients postoperative analgesia satisfaction,increase the ward nurses job satisfaction.

Background Corneal transplantation is the most reliable and effective means to treat the corneal blindness in the clinical,immune rejection is a major cause of corneal graft failure after the keratoplasty.Objective This study aimed to investigate the role of Tim-1 in the immune reaction following corneal transplantation in rats.Methods Forty clean female Wistar rats were randomized into normal control group,autologous corneal transplantation group and allogeneic corneal transplantation group.Penetrating corneal transplantation was performed with the Wistar rat donors and Wistar rat receipts in the autologous corneal transplantation group,while with the SD rat donors and Wistar rat receipts in the allogeneic corneal transplantation group.The corneal graft diameter was 3.5 mm and the plant bed diameter was 3.0 mm.The inflammatory response of the grafts was examined under the slit lamp microscope 7 days and 14 days after operation and scored based on the criteria of Larkin.Rejection index (RI),mean survival time and survival rate were calculated.The histopathological examination was performed 7 days and 14 days after surgery to evaluate the inflammatory manifestation,and the expressions of Tim-1 protein and mRNA were assayed by immnunochemistry and real-time fluorescence quantitative PCR (RT-qPCR)in the time points mentioned above.Results Mild edema of the grafts were found 7 days after operation in both the autologous corneal transplantation group and the allogeneic corneal transplantation group.In postoperative 14 days,the grafts were clear in the autologous corneal transplantation group,but the thickening,neovacularization and cloudy of the grafts were exhibited in the allogeneic corneal transplantation group.The survival rate of the grafts was 100％ in the autologous corneal transplantation group and that of the allogeneic corneal transplantation group was 0 with the survival time of (9.8±1.2) days.Histopathological examination revealed the stromal infiltration of inflammatory cells in both the autologous and allogeneic corneal transplantation groups in the seventh day,however,the inflammatory cells were obvious decreased in the autologous group but increased in the allogeneic corneal transplantation group in the fourteenth day.Immunochemistry showed a gradually declined positive cells for Tim-1 protein in the autologous corneal transplantation group,but the positive cells were exactly elevated in the allogeneic corneal transplantation group from 7 days through 14 days after operation;While only few positive cells were seen in the normal control group.The expression levels of Tim-1 mRNA in the grafts were 1.24 ± 0.03,5.85 ± 0.08 and 6.54 ± 0.20 in the normal control group,autologous corneal transplantation group and that of the allogeneic corneal transplantation group,respectively,in the seventh day,and in the fourteen day after operation,the expression level declined to 1.54 ±0.10 in the autologous corneal transplantation group and elevated to 8.62±0.24 in the allogeneic corneal transplantation group,showing significant differences among the different groups and various time points (Fgroup =3 277.590,P =0.000 ; Ftime =136.000,P =0.000).Conclusions Tim-1 may play an important role not only in the inflammatory response but also in the rejection reaction of the corneal transplantation.