The medical records of 197 patients on linezolid therapy were collected retrospectively.The prevalence and risk factors for linezolid-induced reduction of hemoglobin were identified.The incidence of linezolid-induced reduction of hemoglobin was 31.98％.The patients with reduction of hemoglobin had older age [(68 ± 14) vs.(59 ± 18) years,P =0.000] and lower creatinine clearance (CCr) [(72 ±42)vs.(98 ± 52) ml/min,P =0.000].Multivariate logistic regression analysis showed that age ≥65 years,treatment duration ≥ 15 days,CCr ＜ 65 ml/min and pre-treatment hemoglobin value ＜ 95 g/L were significant risk factors for linezolid-induced reduction of hemoglobin.

Objective To investigate the effect of Shuluo Injection on cerebral water volume,cerebral index ,LDH,NOS and SOD in the brain.Methods The model of cerebral ischemia-reperfusion in mice is set up by separating the bilateral common carotid artery (CCA) of the mice,blocking the blood stream by straining the thread and by reperfusion loosing the thread. After 3 times of ischemia-reperfusion,brain samples were prepared to observe the cerebral injury. Results High-dose Shuluo Injection significantly reduced the cerebral water volume and decreased the cerebral index and the activity of LDH and NOS(P

In order to analyze the correlation between critical residues in the catalytic centre of BSH and the enzyme substrate specificity, seven mutants of Lactobacillus salivarius bile salt hydrolase (BSH1) were constructed by using the Escherichia coli pET-20b(+) gene expression system, rational design and site-directed mutagenesis. These BSH1 mutants exhibited different hydrolytic activities against various conjugated bile salts through substrate specificities comparison. Among the residues being tested, Cys2 and Thr264 were deduced as key sites for BSH1 to catalyze taurocholic acid and glycocholic acid, respectively. Moreover, Cys2 and Thr264 were important for keeping the catalytic activity of BSH1. The high conservative Cys2 was not the only active site, other mutant amino acid sites were possibly involved in substrate binding. These mutant residues might influence the space and shape of the substrate-binding pockets or the channel size for substrate passing through and entering active site of BSH1, thus, the hydrolytic activity of BSH1 was changed to different conjugated bile salt.
Amidohydrolases ; genetics ; metabolism ; Bile Acids and Salts ; metabolism ; Escherichia coli ; metabolism ; Gene Expression ; Lactobacillus ; enzymology ; genetics ; Substrate Specificity

Objective To systematically assess the efficacy and safety of electroacupuncture for trigeminal neuralgia. Method Randomized controlled trials of a electroacupuncture treatment for trigeminal neuralgia were sought by a computer search of CNKI,Wan Fang Data,VIP,CBM,PubMed,EMbas and The Cochrane Library.The retrieval time limit was from March 1996 to March 2016. Two reviewers sifted the literature and extracted data independently according to the inclusion and exclusion criteria andthen assessed the riskofbias of the included literatureusing the Cochrane risk of bias assessment tool.Ameta-analysis was made using RevMan 5.3.Result Finally, 12 articles were included with atotal of 847 subjects.The results ofmeta-analysis showed that the total efficacy rate was higher in the electroacupuncture group than in the control group [OR=4.04,95%CI(2.67, 6.13),P<0.00001].There were no statistically significant differences in the VAS score [MD=﹣0.06,95%CI(﹣0.59, 0.47),P=0.82] and the recurrence rate [OR=0.64,95%CI(0.05,7.45),P=0.54] between the electroacupuncture and control groups.Conclusion The currentlimited evidenceshows that the total efficacy rate fortrigeminal neuralgiais higher in the electroacupuncture group than in the control group.There are no statistically significant differences in the VAS score and the recurrence rate of trigeminal neuralgia between the electroacupuncture and control groups of patients.But the conclusions need more high-qualitytrials for validation owing to the limitation of the sample size of the included studies.

Objective To investigate the clinical effects of different dosages of Shenfu injection for treatment of elderly patients with refractory chronic congestive heart failure (CHF).Methods A prospective study was conducted, 360 patients with CHF from Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled, and they were randomly divided into low dose, middle dose and high dose Shenfu injection groups. In the three groups, the patients received the same conventional medicine therapy, and additionally they were treated by low, medium and high dose Shenfu injection (60, 80, 100 mL/d, respectively), once a day. The therapeutic course was 10 days in the three groups. After treatment, the clinic therapeutic effect, left ventricular diastolic end diameter (LVEDD), left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) and plasma B type natriuretic peptide (BNP) were observed in the three groups.Results The total therapeutic effective rate in middle dose Shenfu injection group was significantly higher than that in low dose and high dose Shenfu injection groups [82.5% (99/120) vs. 54.2% (65/120), 60.0% (72/120), bothP < 0.05]. In high dose Shenfu injection group, increase of blood pressure occurred in 15 cases (12.5%), but no such phenomenon appeared in low and middle dose Shenfu injection groups. In the three groups, no cardiac arrhythmia, liver function abnormality, myocardial enzymogram abnormality, etc. adverse reactions occurred. Compared with those before treatment, after treatment in three groups the LVEDD and BNP were significantly decreased, while LVEF, SV, CO and CI were markedly increased. The changes of above index in middle dose Shenfu injection group were more significant [LVEDD (mm): 46.1±6.3 vs. 58.3±4.4; LVEF: 0.561±0.056 vs. 0.324±0.044, SV (mL): 58.1±6.3 vs. 35.7±5.4, CO (L/min): 5.78±0.60 vs. 4.21±0.78, CI (mL·s-1·m-2): 81.85±7.33 vs. 53.01±9.00, BNP (ng/L): 355.4±76.6 vs. 3 263.2±65.7, allP < 0.05]. Conclusion Shenfu injection 80 mL/d is the best effective dosage for treatment of elderly patients with refractory CHF and its incidence of adverse events is low.

BACKGROUND:Under certain conditions, bone marrow mesenchymal stem cels can be differentiated into hepatocytes, which are an important source of liver cels. Moreover, multiple factors can be involved in this induced differentiation process. OBJECTIVE:To investigate the inducible effect of cholestatic serum on the differentiation of bone marrow mesenchymal stem cels into hepatocytes. METHODS:Cholestatic animal model was prepared in rats to extract cholestatic serum. Bone marrow mesenchymal stem cels isolated from rats were divided into three groups and cultured in serum-free hepatocyte medium, serum-free hepatocyte medium plus cholestatic serum, serum-free hepatocyte medium plus normal serum, respectively. RESULTS AND CONCLUSION:The positive expression of alpha fetoprotein and keratin 18 and mass concentration of albumin were significantly higher in the serum-free hepatocyte medium plus cholestatic serum group than the other two groups (P < 0.05). These findings indicate that cholestatic serum has a certain inducible role in the differentiation of bone marrow mesenchymal stem cels into hepatocytes.

OBJECTIVE:To observe clinical effects and safety of sequential therapy of Ginkgo biloba extract preparation for elderly acute cerebral infarction,and to evaluate its pharmacoeconomics. METHODS:Totally 98 patients with acute cerebral infarc-tion selected from neurology department of our hospital during Aug. 2014-Aug. 2015 were divided into control group and test group according to random number table,with 49 cases in each group. Both groups received routine therapy of antiplatelet aggregation, microcirculation improvement. Control group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for consecutive 21 d. Test group was additionally given Shuxuening injection 10 mL,ivgtt,qd,for 7-10 d;and then given G. biloba tablet instead,1 tablet,po ,tid,for 21 d in total. Clinical efficacies of 2 groups were compared as well as ESS score,ADL score,blood flow in-dexes and blood lipid indexes before and after treatment,and adverse drug reaction. Cost-minimization analysis was used for phar-macoeconomic evaluation. RESULTS:After treatment,total response rate of control group and test groups were 87.23% and 83.33%,without statistical significance (P>0.05). Before treatment,there was no statistical significance in ESS score,ADL score,blood flow indexes and blood lipid indexes between 2 groups (P>0.05). After treatment,ESS score and ADL score of 2 groups were increased significantly,and whole blood viscosity,plasma viscosity,hematocrit,fibrinogen content,TC and TG were decreased significantly;there was statistical significance with before treatment(P<0.05);there was no statistical significance be-tween 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The average cost of control group and test group were (7060.9 ± 234.8) yuan and (5800.7 ± 149.5) yuan,with statistical significance (P<0.01). CONCLUSIONS:The sequential therapy of G. biloba extract preparation is similar to intravenous dirpping in the treatment of elderly acute cerebral infarction in therapeutic efficacy and safety. The sequential therapy is better in economics field.

Objective To evaluate the diagnostic value of one-stop cardiac CT (stress dynamic CT-MPI combining with CTA) in CAD. Methods Thirty patients underwent CCTA combined with stress dynamic CT-MPI and stress SPECT-MPI including 16 patients underwent ICA were retrospectively enrolled. All procedures were performed within 2 weeks without related treatment. CT-MPI and SPECT-MPI were evaluated visually and MBF was quantified according to dynamic CT-MPI which was compared through paired t test. The diagnostic value of CT-MPI for myocardial ischemia was evaluated with SPECT-MPI as the reference standard. The consistency between the two techniques was determined by Kappa test. With SPECT combined with ICA as the reference standard, we evaluated the value of CT-MPI and its combination with CCTA in the diagnosis of CAD with hemodynamic stenosis. Results On stress CT-MPI, 19 of 30 patients and 52 segments were evaluated with myocardial perfusion defects. There was a significant difference in MBF values between normal[(117.61±29.82)ml·100 ml-1·min-1] and hypoperfused [(80.60±22.15)ml·100 ml - 1 · min - 1] segments (t=15.764,P<0.001). With SPECT as reference standard, the sensitivity, specificity were 94.12% (32/34), 95.80% (456/476) on the vessel basis. The Kappa value of the two examinations was 0.772(P<0.001). As for the 16 patients who also underwent ICA, 15 patients with 22 vessel-areas had hemodynamic stenosis on CT-MPI. Compared with SPECT combined with ICA, the sensitivity, specificity for detecting hemodynamic stenosis were 92.31% (12/13), 71.43% (25/35) for CT-MPI;100%(13/13), 51.43%(18/35) for CTA and 92.31%(12/13), 82.86%(29/35) for CT-MPI combined with CTA, respectively. Moderate correlation was observed between the combination of CT-MPI and CCTA and reference standard (r=0.690,P<0.001). Conclusion Stress dynamic CT-MPI can detect myocardial perfusion defects and hemodynamic changes and improves the diagnostic ability of functional stenosis of CAD combined with CTA, which can finally achieve the one-stop mode of cardiac CT in CAD.

Objective To study the effects of traditional Chinese medicine Panax notoginoside(PNS,血塞通) and Tetramethylpyrazine(TMPz,川芎嗪) on different subtypes of cytochrome P450(CYP450),based on that,to forecast the inter-reaction between these two drugs and between each one of them and another drug,and also to estimate the safety assessment of them.Methods The metabolic changes of caffeine and dapsone which are the specific probe drugs for subtypes of CYP450,CYP1A2 and CYP3A4,were studied in vitro to estimate the inhibition or induction effects of PNS and TMPz.Results The concentrations of caffeine and dapsone,the probe drugs in liver cytochrome P450,in control group,PNS group and TMPz group were all declined with time prolongation,and there were no significant differences among the three groups.The half life time(t1/2) of caffeine in PNS group was obviously shorter than that in control group((19.24?2.37) minutes vs.(25.15?2.02) minutes, P0.05).It was suggested that TMPz have no effect on both CYP1A2 and CYP3A4.Conclusion Different drugs have different effects on different CYP450 subtype enzymes.When PNS is used in combination with other drugs which are related to the metabolism of CYP1A2 enzyme,its induction effect on CYP1A2 should be considered fully to avoid toxic effect or the potential adverse reactions.