Objective: To identify the chemical constituents in Akebiae Fructus by UFLC-Q-TOF/MS method. Methods: The separation was performed on an Acquity UPLC BEH C18 Column (100 mm × 2.1 mm, 1.7 μm), with a mobile phase using 0.1% formic acid-acetonitrile and water containing 0.1% formic acid (B) for gradient elution. The flow rate was 0.3 mL/min, the temperature of column was 40°C with injection volume of 1 μL. TOF/MS and electrospray ion (ESI) source were applied for the qualitative analysis under the negative ion mode, and the full mass scan range was m/z 100-1500. Results: According to MS principle, twenty-five triterpenoids were identified from the methanol extract of Akebiae Fructus and the chemical structures of other nine unknown compounds were deduced. Conclusion: UFLC-Q-TOF/MS method could identify the main chemical constituents in Akebiae Fructus rapidly and accurately, which lays a foundation for the quality control of Akebiae Fructus.

OBJECTIVETo investigate the effect of 8-aminolevulinic acid (ALA) photodynamic therapy (PDT) on the cell proliferation, apoptosis and collagen secretion in keloid fibroblasts and to provide the theoretical base for ALA-PDT treatment of keloids.

METHODSFibroblasts from keloid patients were cultured to the third generation in vitro and incubated in 0, 1, 3, 6, 9 mmol/L of δ-aminolevulinic acid for 3 h in the darkness. Then they were exposed to 635 nm wavelength red light ( 30 J/cm2 ) and continued incubation 24 h after irradiation. CCK-8 assay was used to detect proliferation inhibition rate of fibroblasts. The content of hydroxyproline was measured by colorimetric method. The expression of p-Akt and programmed cell death 4 ( PDCD4) were detected by Western blot.

RESULTSThe inhibition rate of keloid fibroblasts were respectively 0, (8.30 ± 1.01)%, (29.48 ± 3.27)%, (52.01 ± 5.34)%, (79.99 ± 5.85)% with the presence of difference concentrations (0, 1, 3, 6, 9 mmol/L) of ALA. The content of hydroxyproline were respectively (9.540 0 ± 0.352 42), (6.242 5 ± 0.224 85 ), (5.107 5 ± 0.534 88), (3.490 0 ± 0.623 48), (2.945 0 ± 0.514 10) μg/mg. The relative expression of p-Akt were respectively 1, 0.75 ± 0.12, 0.52 ± 0.14, 0.41 ± 0.18, 0.32 ± 0.09. The relative expression of PDCD4 were respectively 1, 1.18 ± 0.19, 1.51 ± 0.22, 0.15 ± 0.30, 2.44 ± 0.22. The difference was statistically significant when compared the group of 1, 3, 6, 9 mmol/L with 0 mmol/L (P < 0.05).

CONCLUSIONSIn concentration within the range of 1-9 mmol/L, ALA could inhibit the proliferation of fibroblasts significantly, promote fibroblasts apoptosis and reduce the content of hydroxyproline in a dose-dependent manner, indicating that 8-aminolevulinic acid photodynamic therapy may be a potential treatment for keloid.

Aminolevulinic Acid ; pharmacology ; Apoptosis ; drug effects ; Cell Culture Techniques ; Cell Proliferation ; drug effects ; Collagen ; secretion ; Fibroblasts ; cytology ; drug effects ; secretion ; Humans ; Keloid ; drug therapy ; pathology ; Light ; Photochemotherapy ; methods ; Photosensitizing Agents ; pharmacology

Recent studies show that autophagy ont only plays an important role in maintaining homeostasis in cells,but also palys a double role in the tumorigenesis and development of cancer.Studying the molecular mechanisms of autophagy and the relationship between autophagy and cancer have great significance for cancer treatment and prevention.

Objective To investigate the intervention effect of Qingxin-Ⅱ Recipe on myocardial cell apoptosis and its fibrosis in viral myocarditis mice and its mechanism.Methods A total of 120 Balb/c mice were randomly divided into the model group (n=50),the treatment group (n=50) and the control group (n =20).Mice in the model and treatment groups were given intraperitoneal injection of CVB3 to establish the experimental model of viral myocarditis.The control and model groups were treated with normal saline and water by intragastric administration respectively and the treatment group was given Qingxin-Ⅱ Recipe.The expression level of nuclear factor-κB (NF-κB),tumor necrosis factor (TNF-α),interleukin-1β(IL-1β),collagen type Ⅰ-A1 (COL1-A1),collagen type Ⅲ-A1 (COL3-A1),matrix metalloproteinase-9 (MMP-9),tissue inhibitor of metallproteinase-1 (TIMP-1),myocardial interstitial collagen volume fraction (CVF) and apoptosis rate (Rapo) were assessed after treatment.Results The levels of NF-κB,TNF-α,IL-1 in cardiomyocytes,serum levels of COL1-A1,MMP-9,TIMP-1,the mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 in cardiomyocytes,CVF and Rapo were lower in the treatment and control groups than in the model group (F=21.541,12.146,32.583,4.212,6.863,4.868,9.089,8.662,7.307,6.646,4.324,41.237,respectively,all P＜0.05).No significant differences in the levels of NF-κB,TNF-α,IL-1 of cardiomyocytes,in serum levels of COL1-A1,TIMP-1 and in mRNA expression levels of COL1-A1,COL3-A1,MMP-9,TIMP-1 of cardiomyocytes between the control group and the treatment group (all P＞0.05) were found,but serum MMP-9 level was higher in the treatment group than in the control group (P =0.033).Conclusions Qingxin-Ⅱ Recipe can effectively reduce inflammatory cytokines levels,protect myocardial cells from inflammatory damages and inhibit myocardial fibrosis in viral myocarditis.

Objective: Analyze the impact of NCMS(new cooperative medical scheme) on rural medical institutions,and give suggestions for the sustainable development of medical institutions and the NCMS.Methods: Collect and analyze the efficiency and the account materials of the county-level healthcare departments and the town-level health centers of Zhen'an County in 2003 and 2006.Results: The implementation of NCMS produced an effect on the increase of the outpatient medical service;the service quality of the county-level medical institutions and the town-level health centers needs to be enhanced in spite of the increase of in-patient medical service;the medical institutions' income increased,and the medical service fees increased rapidly;the expenditure per person and time rose sharply.Conclusions: Management mechanism of NCMS should be further developed,construction and supervision of the county-level medical sectors and the town-level health centers,especially supervision of the quality of medical sectors be enhanced;the payment system be changed to control the growth rate of medical expenses.

Objective To explore the feasibility of quantitative hemodynamics measurement of inferior vena cava (IVC) in healthy volunteers with phase-contrast sequence on 3.0 T MR system (3.0 T PC-MRI),and to evaluate the relationship between IVC lumen area,blood flow,and velocity.Methods Fifty healthy adult volunteers prospective underwent IVC PC-MRI at 3.0 T MR system.All volunteers were from our hospital for the routine chest or abdomen examinations,no heart disease and lung disease always,heart rate,blood pressure,electrocardiogram was in normal range,no abnormalities were found in clinical and abdominal imaging examinations,and IVC disease was excluded by ultrasonic examination.The area (A),mean velocity (MV),mean flux (MF),regurgitant fraction (RF) and time-flow curve of upper and middle segments of IVC during one cardiac cycle were observed.Independent samples t test was used to compare IVC lumen area and blood flow,velocity between different genders,different age groups (18 to 30 years old group,more than 30 years old group) and different phase velocity encoding value of IVC middle segment,one-way ANOVA was used to compare different phase velocity encoding value of IVC upper segment [(60,80,100)cm/s].Pearson correlation coefficient and regression equation were used to evaluate the relationships between area,blood flow,and velocity.Results Among 50 patients with successful completion of the examination,significant difference was found in A,MV,MF and RF between the different IVC segments.MF of the IVC middle segment were (37.94 ± 7.32) and (33.68 ± 6.65) ml/s in male (n =24) and female (n =26),respectively ; significant difference was found in different genders (t =2.49,P =0.017).MF of upper segment and middle segments of IVC were (54.89 ± 10.98)and (38.29 ± 7.54)ml/s in 18 to 30 years old group(n =27),while MF of upper segment and the middle of IVC were (44.96 ± 8.49) and (32.65 ± 5.59) ml/s in older than 30 years old group (n =23) with significant difference(t =3.34,2.15,P ＜ 0.01).Peak positive velocity were (55.36 ± 6.30),(61.30 ± 12.42),(62.55 ± 13.09) cnm/s in different phase velocities (60,80 and 100 cm/s),while peak negative velocity (PNV) were (42.37 ± 19.18),(32.79 ± 24.67),(24.61 ± 21.20) cm/s with significant differences (F =4.258,7.794,P ＜ 0.05).The overall image quality was good for quantitative measurement between different phase velocity encoding values of upper segment and the middle IVC (image evaluation are greater than or equal to 3,11 patients were three points,24 patients were four points,15 patients five points).The relation between the PC flow image of IVC and the cardiac cycle was sine wave,the area and the velocity of upper and middle segments of IVC was negative (r =-0.466 and-0.765,P ＜ 0.01),and no linear correlation between the area and the flow of upper and middle segments of IVC (r =0.259,0.046,P ＞ 0.05).There were slight reverse flow during systolic and diastolic cycle.Conclusion The area,flow and velocity of IVC can be rapidly,accurately and noninvasive measured with PC-MRI,and different ages,different genders and different anatomical parts of IVC had obvious hemodynamic differences.

Objective As members of CNEDERT, we were trusted to take the mission of medical rescue in April of this year in Yushu area of Qinghai province. As soon as we heard of the news of earthquake with shock of 7.1 on Richter scale happened on 14th April 2010, our team of 32 members from the General Hospital of Armed Police Force rapidly rushed to get there at 19 o'clock on 14th April. It is a cold plateau with 4000 meters in average above sea level. Of course, they would face many difficult problems and some of them could not be figured out in advance. It was really a new and big challenge. First of all, we had to bear the very low barometric pressure,threatening lives of team members. In order to fulfill the mission of medical rescue, and to prevent the acute mountain sickness (AMS) ,we monitored the physiological changes of every member. Method A total of 32 members aged from 27 - 42 years old with average age of (33.26 + 12.54) years, 6 male and 6 female, gathered at Peking, 50 meters above sea level, 6 hours ahead of getting to Yushu and received physical examination with measurements of SaO2, HR, Hb and breath holding test. The team worked in Yushu area for 13 days and returned back to Peking on 27th April at 13 o'clock. The measurements of SaO2, HR and He were kept on from 14th April to 4th May, 21 days in total. The occurrence of AMS was surveyed by questionnaire from 18 to 48 hours after arrival,and the AMSA was diagnosed and scored according to the Lake Louise consensus on the definition and quantification of altitude illness. When the score was equal or above 3, it was considered to be AMS. Our work activities included searching the victims under the collapsed building, carrying out treatment and operation as soon as possible in the mobile hospital, doing medical round visiting, public health and disease prevention, work of joint rescue of multiple professions and psychological counseling. Results Of them 26 (81.25%) members suffered from AMS of various severities and few of them had pulmonary edema and hematuria, and those with SaO2 below 60% were sent down to the plain of low level above sea. The average level of SaO2 at Peking was ( 98.21 + 2.63) %, and it suddenly dropped to (66.31 ± 4.24)% on the first day of entering Yushu area, and from the 2nd day on, it gradually increased to (84.80 ± 4.20)% on the 13th day of stay in Yushu. On the 14th day, we returned back to Peking, the average SaO2 gradually went up from ( 85.57 + 2.73) % to (85.70 + 3.11 ) % on the 15th day,(87.93±2.63)% on the 17th day, (92.21 ±3.62)% on the 18th day, and (98.2333 ± 1.78)% On the 21st day (5th May ). At plain the average HR was (78 ± 11 ) beats/min, and it went up abruptly to ( 121 ± 18) beats/min on the first day of arrival to Yushu, and from the 2nd day on, it slowly lowered down to (99± 12) beats/min at the end day of stay in Yushu area. When we got back to Peking, the average HR gradually normalized from (91± 18) beats/min to (77 + 16) beats on the 5th May. The average Hb in Peking was ( 118 ± 32) g/L, and it gradually increased to ( 137 ± 18) g/L on the 5th day and to ( 161 ± 27) g/L on the 11th day after arrival, and it gradually dropped to (127:± 13) g/L on the 17th day and to (120± 13) g/L on the 21st day. Various measures were taken to treat and prevent the AMS with Chinese herbal medicines such as hongjingtian (Rholiola sacra [Prain ex Hamet] Fu), droplet-sized pill of danshen (salva miltiorrhiza Bge), slice of xiyangshen (Panax quinquefolium L)for lozenge which had some effect of minimizing the symptoms of AMS, and with easily digestible diet catered for in less amount of food in each meal and more meals every day, and diet was composed of mainly carbohydrate and vitamins. Large amount of fluid was required at least 4000 - 6000 mL daily guided by the number of urination at least once or twice a day. For the severe case with shortness of breath and sense of oppression over chest, the oxygen inhalation and intravenous glucose saline with small dose of hydrocortisone were given. Conclusions There were great changes in SaO2, HR and Hb of individuals rushed into high altitude area from plain of low level above sea in a short length of time. But those individuals had the capability of adaptation to ameliorate bit by bit those changes day by day until 13 days of stay, the end of stay at high altitude. On that day, the levels of SaO2, HR and He were still far away from normal. And those changes took 6 days to resume the original levels after the members retumed to the plain. Of them, 81.25% (26/32) members suffered from AMS of various severities. Various measures taken to treat and prevent the AMS are very important. In addition, working at high altitude area, the medical equipment and facilities should be miniaturized for easy portability on the rugged and narrow footpath in order to preserve the energy of medical members.

Objective To evaluate prescribing antibiotics in medical patients visiting the polyclinic at 2008 Beijing Olympic Village for its further reasonable use. Methods Clinical prescriptions for all the medical patients at the polyclinic were reviewed retrospectively. Consistency between antibiotics prescriptions and their indications formulated before 2008 Beijing Olympic Games was evaluated, as well as related factors for their overuse. Results In total, 1537 patients visited the polyclinic and 1233 recipes were prescribed,with 956 patients (62. 2% ) with infections, including 809 (52. 6% ) of respiratory infections. One hundred and forty-nine of 1537 patients (9. 7% ) were treated with antibiotics, accounting for 12. 1 percent of all prescriptions, and 43 cases (28.9%) were identified as antibiotics overuse, including 39 cases with respiratory infections. Prevalence of antibiotics overuse was significantly more for patients of domestic employees than that for non-employees (34. 6% vs. 14.3% , P <0. 01 ), with art independent association between them (OR 3.07, 95% CI 1.11 - 8. 50). Conclusions Although the polyclinic has successfully reduced unnecessary antibiotics use, their overuse remains to be reduced, and physicians' strict adhesion to indications for antibiotics use and patient education are essential for their rational use in primary care of China.

Objective To evaluate the effect of autophagy-related factors LC3 and Bnip-3 and apoptosis related factors Bcl-2 and Bax on brain damage in experimental diabetic rats .Methods Thirty SD rats were randomly divided into diabetic group and control group .The diabetic group was injected with 1% streptozotocin ( 60 mg/kg body mass ) and the control group with citrate buffer .The rats were sacrificed after 12 weeks feeding and brain tissues were obtained .Pathological chan-ges were observed and the expression of LC 3, Bnip-3, Bcl-2 and Bax in brain tissues of the rats was detected by immuno-histochemical SP method .Results Compared with the control group ,the diabetic rat brain pathology showed that the cell arrangment was more disorderly and distributed more unevenly , the cell body was smaller , cytoplasm was lighter red , and the number of nerve cells of normal morphology was smaller .The positive number of LC3, Bnip-3 and Bax in brain tissues of diabetic rats was significantly larger than in the control group ,and the difference was statistically significant (P<0.05). However ,the positive number of Bcl-2 was significantly smaller than in the control group ,and the difference was statistically significant (P<0.001).In diabetic rats, LC3 and Bnip-3 showed a weak positive correlation(P<0.05), Bcl-2 and Bax were irrelevant, Bnip-3 and Bax were positively weakly-correlated(P<0.05),Bcl-2 was not correlated;and Bcl-2 and Bax were irrelevant.Conclusion LC3,Bnip-3 and Bax in the brain tissue of diabetic rats are overexpressed , while Bcl-2 shows weak expression , indicating that autophagy factors and apoptotic factors are involved in the process of brain injury in diabet -ic rats, which may be one of the mechanisms of brain tissue damage .

OBJECTIVE:To systematically evaluate the efficacy of mecobalamin,ganglioside,mixture of calcium and magne-sium,reduced glutathione,mixture of calcium and magnesium combined with reduced glutathione in the prevention of chronic neu-rotoxicity induced by oxaliplatin, and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,clinicltrials.gov and CJFD,randomized controlled trials (RCT) about efficacy of 5 interventions in the prevention of chronic neurotoxicity induced by oxaliplatin were collected,and network Meta-analysis were performed by using ADDIS 1.16.5 af-ter extracting data and evaluating quality. RESULTS:A total of 34 studies were included,involving 3 236 patients. 4 studies were three-arm studies,30 studies were two-arm studies,totally 42 arms. Compared with placebo,the incidence of CIPN by 5 interven-tions was significantly reduced. Mixture of calcium and magnesium combined with reduced glutathione was the most effective and the followed by mecobalamin,reduced glutathione,ganglioside and mixture of calcium and magnesium,however,there were no significant differences among 5 interventions(P>0.05). CONCLUSIONS:5 kinds of interventions are all effective in the preven-tion of chronic neurotoxicity induced by oxaliplatin. Mixture of calcium and magnesium combined with reduced glutathione is the most effective. Duo to the low quality of included studies,large-scale and high quality RCTs are required for further validation of the conclusions.