Objective To establish a rat model at the same time in accordance with the “hot sheng syndrome” of traditional Chinese medicine and primary immune thrombocytopenic purpura of peripheral blood platelet reduction. Methods Using back multi-point injection of 20% dry yeast suspension on SD rats and 1∶4 dilution of rabbit anti SD rats platelet serum (APS) by intraperitoneal injection to establish a primary immune thrombocytopenic purpura “heat sheng”rat model.And observing rats of TCM syndrome characteristics, hemogram, myelogram and serotonin (5-HT) level of the temperature regulating center in thalamus.Results After injection of 2 h ~6 h temperature and daily water of the model group rats increased significantly,toe purper showed in fourth day of modeling and intestinal mucosal bleeding in thirty day of modeling(P <0.05);Platelet count in peripheral blood decreased significantly, bone marrow megakaryocyte number reduced significantly((P <0.05);5-HT level of the temperature regulating center of brain increased significantly((P <0.05).Conclusions The study of the primary immune thrombocytopenic purpura heat sheng rat model of combination of disease and syndrome reflected basically the pathological characteristics of purpura caused by “heat sheng” in primary immune thrombocytopenic purpura rat mode.

Objective To investigate the related risk factors of the previous cemented vertebral body re-wedge after percutaneous kyphoplasty (PKP).Methods In this retrospective case-control study,clinical data of 617 patients treated by PKP from December 2008 to November 2014 were analyzed.According to whether the cemented vertebra wedged again,the patients were divided into cemented vertebral re-wedge group (n =12) and non-cemented vertebral re-wedge group (n =605).The data of age,preoperative bone density,preoperative vertebral osteonecrosis,intraoperative bone cement injection amount,postoperative bone cement leakage,postoperative bone cement filling,postoperative recovery rate of vertebral wedge angle,and presence or absence of adjacent old vertebral wedging were recorded in two groups.All patients were followed up for one year,and the data were summarized and statistically analyzed.Results Single factor analysis showed the factors of whether there were adjacent old vertebral wedge,preoperative vertebral osteonecrosis,cystic bone cement filling,different wedge angle recovery rate,and emergence of previous cemented vertebral body re-wedge after PKP were statistically significant between two groups (P ＜ 0.05).There was no obvious statistical difference in age,preoperative bone density,intraoperative bone cement injection amount,and intervertebral bone cement leakage between two groups (P ＞ 0.05).Multivariate Logistic stepwise regression analysis showed cystic bone cement filling,preoperative vertebral osteonecrosis,adjacent old vertebral wedging,and higher recovery rate of vertebral wedge angle were prone to appear previous cemented vertebral body rewedge (P ＜ 0.05).Conclusions Relatively higher recovery rate of vertebral wedge angle,previous adjacent old vertebral wedge,vertebral osteonecrosis,and cystic bone cement filling are risk factors closely related to cemented vertebral re-wedge after PKP,which gives a good reference to assess surgical risk,avoid risk factors and choose right surgical techniques.

A high-throughput three-dimensional (3D) hepatocyte culture model is constructed in this study. It is capable of replicating the 3D in vivo environment and offers the advantages of high throughput, enhanced reproducibility, low cost, and simplified operation, rendering a valuable tool for hepatotoxicity screening of traditional Chinese medicine (TCM). First, we constructed the 3D high throughput liver chip model using collagen hydrogel. The precision and its difference with traditional cell culture plates were assessed using acetaminophen, Tripterygium hypoglaucum, and Qili San as the references. The feasibility of this model was also investigated by comparing the hepatotoxicity among four batches of T. hypoglaucum and Qili San. The methodology verification shows that the 3D hepatocyte model is better than traditional two-dimensional (2D) cell culture model in precision and feasibility. Subsequently, we compared the hepatotoxicity of different samples over a period of three or seven days and found that the hepatotoxicity of TCM extracts increased over time. Finally, we compared the hepatotoxicity of T. hypoglaucum and its compound formula Kunxian capsule under equivalent concentration. The results showed that the compound Kunxian capsule could significantly reduce hepatotoxicity of T. hypoglaucum. Generally, we constructed a high-throughput, robust 3D liver-on-a-chip model with the potential of rapid assessing TCM-induced liver toxicity.

In China, the malignant tumor with the highest incidence and motality is lung cancer (LC). As screening and early detection and treatment are effective in reducing LC mortality, formulating a guideline in line with China′s national conditions for the screening and early detection and treatment of LC will greatly promote the homogeneity and accuracy of LC screening, and result in an improvement of the effectiveness of LC screening. Commissioned and directed by the Disease Prevention and Control Bureau of the National Health Commission of the People′s Republic of China, the guidline was initiated by the National Cancer Center of China and formulated with joint effort by experts from different disciplines. Following the principles and methods in WHO Handbook for Guideline Development, the guidline integrates the latest development in LC screening and early diagnosis and treatment worldwide while fully considering China′s national conditions and practical experience in LC screening. It provides detailed evidence-based recommendations for different aspects of LC screening, such as the targeted population, the technologies and the procedures, to regulate the practices of LC screening and early diagnosis and treatment and enhance the effectiveness of the prevention and control of LC in China.

Abstract: Our previous work revealed berberine can significantly enhance the susceptibility of fluconazole against fluconazole-resistant Candida albicans, which suggested that berberine has synergistic antifungal activity with fluconazole. Preliminary SAR of berberine needs to be studied for the possibility of investigating its target and SAR, improving its drug-likeness, and exploring new scaffold. In this work, 13-substitutited benzyl berberine derivatives and N-benzyl isoquinoline analogues were synthesized and characterized by 1H NMR and MS. Their synergetic activity with fluconazole against fluconazole-resistant Candida albicans was evaluated in vitro. The 13-substitutited benzyl berberine derivatives 1a-1e exhibited comparable activity to berberine, which suggested that the introduction of functional groups to C-13 can maintain its activity. The N-benzyl isoquinolines, which were designed as analogues of berberine with its D ring opened, exhibited lower activity than berberine. However, compound 2b, 2c, and 4b showed moderate activity, which indicated that berberine may be deconstructed to new scaffold with synergistic antifungal activity with fluconazole. The results of our research may be helpful to the SAR studies on its other biological activities.

Objective To investigate the risk factors of delayed hemolysis after treatment in patients with malaria .Methods Eighty-nine cases of malaria were retrospectively analyzed .The incidence rate , time from treatment to delayed hemolysis and clinical features of delayed hemolysis after treatment in patients with malaria were investigated .The characteristics of demography ,etiology and laboratory data were compared between delayed hemolysis group and non-delayed hemolysis group .The t test ,χ2 test and Fisher exact test were used for comparison between groups .Results A total of 89 cases of malaria infection were included and 8 cases were diagnosed with delayed hemolysis after treatment among them , with incidence rate of 8 .99% .Patients developed delayed hemolysis after anti-malarial treatment with a median of 7 .5 d and patients recovered from hemolysis after the usage of glucocorticoid with a median of 2 .5 d .The 8 cases were all infected with Plasmodium f alciparum ,and 4 of which had high parasitemia . None of the patients with delayed hemolysis came from epidemic area ,while 28 of the patients without non-delayed hemolysis came from epidemic area .The difference was statistically significant (P=0 .042 , Fisher unilateral exact test) .The average level of minimum hemoglobin was (44 .87 ± 11 .58) g/L in patients with delayed hemolysis ,which was significantly lower than that of non-delayed hemolysis group (108 .35 ± 19 .72) g/L (t= -8 .923 , P< 0 .01) .Conclusion Plasmodium falciparum infection , hyperparasitemia and having no immunity against malaria may be risk factors of delayed hemolysis after treatment .

Objective To observe the clinical effect of lumbar fixed-point pulling method combined with magnetic needling in the treatment of lumbar disc herniation(LDH).Methods Sixty LDH patients were randomly divided into treatment group and control group,30 cases in each group.The treatment group was treated with lumbar fixed-point pulling method combined with magnetic needling,and the control group was treated with Celecoxib Capsules.Two weeks as a course of treatment and both groups were treated for two courses.After 1 month of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Visual Analogue Scale(VAS)score and Japanese Orthopaedic Association(JOA)score were observed before and after treatment in the two groups.The changes of serum nuc lear factor-KB(NF-κB)p65,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were compared between the two groups before and after treatment.Results(1)After treatment,the JOA score and VAS score of the two groups were significantly improved(P＜0.05),and the improvement of JOA score and VAS score in the observation group was significantly superior to that in the control group,the differences were statistically significant(P＜0.05).(2)After treatment,the contents of NF-κB p65,serum IL-6 and TNF-α in the two groups were significantly improved(P＜0.05),and the improvement of NF-KB p65,serum IL-6 and TNF-α in the observation group was significantly superior to that in the control group,the differences were statistically significant(P＜0.05).(3)The total effective rate of the treatment group was 86.67％(26/30);the control group was 50.00％(15/30).The curative effect of the treatment group was significantly superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Lumbar fixed-point pulling method combined with magnetic needling in the treatment of LDH can effectively relieve the pain symptoms of patients,improve the lumbar function of patients,and effectively reduce the levels of serum NF-κB p65,IL-6 and TNF-α.The clinical effect is significant.

OBJECTIVETo investigate the effects of perioperative intestinal microecological treatment on postoperative complications and gastrointestinal function in patients with refractory functional constipation by nonrandomized controlled trial.

METHODSA total of 198 patients with refractory functional constipation who underwent Jinling procedure in our department from 2014 to 2015 were prospectively enrolled, and were divided into conventional treatment group (n=100, routine intestinal preparation was used before operation; probiotics and prebiotics were applied if diarrhea or abdominal distention occurred after operation) and microecological treatment group (n=98, routine perioperative management was applied; probiotics, prebiotics and enteral nutrition were administered since 2 weeks before operation; probiotics and prebiotics were given again when exhaust and defecation recovered after operation). The general clinical data, postoperative complications, gastrointestinal quality of life index (GIQLI), Wexner constipation score, the incidence of abdominal distension and diarrhea during follow-up were collected.

RESULTSThe baseline information was not significantly different between two groups (all P>0.05) as well as the morbidity of postoperative complication [27.6% (27/98) vs 37.0% (37/100), P=0.155]. Compared with conventional treatment group, microecological treatment group had obviously lower incidence of enteritis [2.0%(2/98) vs. 9.0% (9/100), P=0.034] and shorter postoperative hospital stay [(7.2±3.1) d vs. (9.8±3.6) d, P=0.040]. The incidences of diarrhea and abdominal distension in microecological treatment group were obviously lower than those in conventional treatment group [30.9% (29/94) vs. 46.9% (45/96), P=0.024; 44.7%(42/94) vs. 60.4%(58/96), P=0.030] at postoperative 1-month. Compared with conventional treatment group, microecological treatment group had obviously higher GIQLI (52.36 vs. 43.55, P=0.026) at postoperative 1-month. At postoperative 12-month, the incidences of diarrhea and abdominal distension decreased obviously in both two groups but without significant differences [diarrhea: 3.4% (3/89) vs. 3.3%(3/90), P=0.989; abdominal distention: 6.7% (6/89) vs. 5.6% (5/90), P=0.742]. GIQLI and Wexner score were improved but without significant differences as well (all P>0.05).

CONCLUSIONPerioperative intestinal microecological treatment can obviously reduce the incidences of postoperative enteritis, early abdominal distension and early diarrhea, improve the postoperative early GIQLI, and shorten postoperative hospital stay.

Objective To observe the changes in tear quantity and tear break-up time(BUT) before and after wearing overnight orthokeratology (OK),and investigate the influence of OK on tear film in young adolescents.Methods Prospective clinic study was conducted in 60 adolescents,aged 8-16 years,who met the inclusion criteria during November 2016 and May 2017 in the Second Hospital of Dalian Medical University were chosen and fitted with OK (OK group).At the same time,60 adolescents who met the same requirement were fitted with spectacle (spectacle group).The two groups were both divided into three subgroups according to the age (subgroup of 8-10 years old,11-13 years old,and 14-16 years old).The BUT,Schirmer' s I test score,and corneal fluorescent (FL) were measured and recorded before wearing and 1 week,1 month,3 months,6 months and 12 months after wearing.Results Totally 57 patients in the OK group (114 eyes) and 59 patients in the spectacle group (118 eyes) completed the follow-up study.No significant difference in Schirmer' s Ⅰ test scores was observed between the OK group and spectacle group (all P＞0.05).The BUT in OK group was significantly lower than that in the spectacle group at all the time points (all P ＜ 0.05).Of all subgroups,the subgroup aged from 8-10 years exhibited the sharpest and most rapid reduction in BUT.Conclusion Based on our findings,long-term OK wearing has no effect on tear volume but reduces the stability of tear film.The results suggest that OK should be considered to be a good alternative for children and adolescents with spectacle;however,it may influence the quality of tear film.In addition,special attention should be paid to younger adolescents,and regular follow-up is needed.

Abstract: Our previous work revealed berberine can significantly enhance the susceptibility of fluconazole against fluconazole-resistant Candida albicans, which suggested that berberine has synergistic antifungal activity with fluconazole. Preliminary SAR of berberine needs to be studied for the possibility of investigating its target and SAR, improving its drug-likeness, and exploring new scaffold. In this work, 13-substitutited benzyl berberine derivatives and N-benzyl isoquinoline analogues were synthesized and characterized by 1H NMR and MS. Their synergetic activity with fluconazole against fluconazole-resistant Candida albicans was evaluated in vitro. The 13-substitutited benzyl berberine derivatives 1a-1e exhibited comparable activity to berberine, which suggested that the introduction of functional groups to C-13 can maintain its activity. The N-benzyl isoquinolines, which were designed as analogues of berberine with its D ring opened, exhibited lower activity than berberine. However, compound 2b, 2c, and 4b showed moderate activity, which indicated that berberine may be deconstructed to new scaffold with synergistic antifungal activity with fluconazole. The results of our research may be helpful to the SAR studies on its other biological activities.
Antifungal Agents ; pharmacology ; Berberine ; pharmacology ; Candida albicans ; drug effects ; Drug Resistance, Fungal ; Drug Synergism ; Fluconazole ; pharmacology ; Isoquinolines ; pharmacology ; Microbial Sensitivity Tests