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

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.

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: 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.

AIM: To explore the long-term efficacy of Q-factor guided laser epithelial keratomleusis ( LASEK ) for myopia and astigmatism with positive Q-factor.
METHODS: There were 158 eyes which were myopia and astigmatism with positive Q- factor taken in two groups randomly: 86 eyes accepted Q - factor guided LASEK as observation group and 72 eyes accepted routine LASEK as control group. The difference between the two groups about all data was similar. The uncorrected visual acuity ( UCVA ) and the best corrected visual acuity ( BCVA ) as well as diopter, ocular tension, corneal topography, Keratometry value K, aspherical factor Q, Higher-order aberrations ( HOA ) , corneal thickness by ultrasound and, contrast sensitivity ( CS ) , Haze were examined and compared before and after surgery. All the cased were followed up for 14d, 1, 3, 6, 12mo. And there were no statistical difference among the data before surgery.
RESULTS: After 12mo there were no statistical difference between the two groups about UCVA and BCVA. But the safety index of observation group was 1.10, that of control group was 1. 07. The validity index of observation group was 1. 06, that of control group was 0.99. The HOA of observation group was 0. 45±0. 17μm, and that of control group was 0. 72±0.25μm, there was statistically significant difference (t=-8. 193,P=0. 000). Q factor of observation group was 0. 41±0. 17, that of control group was 0. 77±0. 22, there was significant difference (t=11. 377,P = 0. 028). The contrast sensitivity of 3mo post surgery of patients in the observation group returned to the level of before surgery. But in the control group the contrast sensitivity of the patients did not returned until 6mo.
CONCLUSION:Q-factor guided LASEK for myopia and astigmatism with positive Q-factor is stable, safe and effective. The operation allow for reducing the high order aberrations, maintaining the most asphericity of cornea, saving more in corneal tissue, which cause faster recovery of contrast sensitivity, less haze and better visual quality.

Objective To evaluate the effect of endovascular embolotherapy treatment of carotid cavernous fistulas(CCF) via superior ophthalmic vein(SOV).Methods From June 1996 to June 2006,a total of 32 patients(16 female) with complex CCF underwent endovascular embolotherapy treatment through the SOV.All of the patients visited doctor due to ocular signs and symptoms.Nine patients with direct CCF had previously undergone partial arterial balloons embolotherapy.The other 23 patients were hard mater CCF,and of which 3 had underwent NBCA,embolotherapy with line section or PVA particle.In the angiographic suite all patients underwent general anesthesia,SOV was catheterized through the eyebrow incision.Cavernous sinus was packed with free coils,detachable coils or balloons and NBCA.Results Complete embolism of the arteriovenous shunt was achieved in 81.3%(26/32).A minor residual shunt(without cortical or ocular drainage) remained in 12.5%(4/32).Only SOV was occluded in 6.2%(2/32).All patients were clinical improvement without complications.No death and permanent disability occurred.No recurrence was observed during follow-up of mean time of 3.5 years in 22 outpatients.Conclusion The operative approach to SOV is straightforward and several kind of embolic materials can be used to embolize the cavernous sinus.Endovascular occlusion of cavernous sinus through the SOV is an efficient and safe treatment in CCF.

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 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 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 .