Objective To explore clinical and pathological characteristics of neurological lesions in primary Sj(o)gren's syndrome (pSS).Methods Ten patients diagnosed as pSS with nervous system involvement were analyzed retrospectively with autoimmune antibody test,cerebrespinal fluid examination and Schivmer's test,six pSS patients with peripheral nervous system lesions (PNS-pSS) were examined with electromyography and nerve conduction velocity and four pSS patients with central nervous system lesions (CNS-pSS) were examined with cranial MRI to analyze their clinical and pathological characteristics.Salivary gland biopsy was performed for all the ten patients,sural nerve biopsy for those with PNS-pSS and brain biopsy or spinal autopsy for those with CNS-pSS.Results Clinically,six patients with PNS-pSS presented symmetrical sensory-motor peripheral neuropathy or pure sensory peripheral neuropathy and four patients with CNS-pSS presented multiple sclerosis,subacute transverse myelitis,encephalitis,pituitary stroke and acute meningitis with varied lesions in the myelin sheath and axon by electromyography and motor nerve conduction velocity.Cranial MRI showed lesions in the white matter of the brain,spinal cord and abnormal signals in the pituitary.Pathologically,sural nerve biopsy showed typical vasculitis and nonvasculitis characterized as degeneration of the axon and myelin sheath,salivary acinar gland biopsy showed its atrophy and infiltration with lymphocytes,and brain biopsy showed demyelination of the brain and spinal white matter,as well as infiltration of lymphocytes surrounding the veins,typical vasculitis and bleeding and necrosis of the pituitary.Conclusions Both central and peripheral nervous systems can be involved in pSS,with complicated clinical manifestations.Electrophysiology,cerebrospinal fluid tests and histopathological examinations by biopsy are essential in diagnosis for neurological lesions in patients with pSS.Inflammatory reaction of the blood vessels and tissues mediated by cell immunity may be involved in mechanism of its neurological lesions.

OBJECTIVEThe changes of pain threshold and expression of 5-hydroxytryptamine(5-HT) and c-Fos in spinal dorsal horn of rats were observed after targetedly damaged the cerebraspinal fluid-contacting nucleus (CSF-contacting nucleus) to provide experimental evidence for the mechanism of regulating pain CSF-contacting nucleus involved in.

METHODSMale adult SD rats were divided into control, sham, choleratoxin subunit B conjugated with horse-radish peroxidase (CB-HRP)and damage groups randomly. The pain threshold using mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were recorded and analyzed. Immunofluorescence method was used to observe the expression of 5-HT and c-Fos in spinal dorsal horn.

RESULTSCompared with the control, sham and CB-HRP groups, the MWT and TWL of the damage group were significantly increased (P < 0.05). The results of immunofluorescence showed that 5-HT was detected in neurons of CSF-contacting nucleus. In the damage group, the number of neurons of CSF-contacting nucleus reduced gradually, and no survived neurons were observed at the 10th day. Meanwhile, both the expression of 5-HT and c-Fos in spinal dorsal horn increased gradually, and negatively correlated with the change of pain threshold.

CONCLUSIONThe method of targeted damaging CSF-contacting nucleus by cholera toxin subnit B conjugated with saporin(CB-SAP) is scientific and reliable, and it results in the changes of pain threshold and expression of 5-HT and c-Fos in spinal dorsal horn of rats. This study suggests that CSF-contacting nucleus participate in the regulation of pain, moreover, 5-HT and c-Fos play important roles in this regulation.

Animals ; Cerebrospinal Fluid ; Male ; Pain ; metabolism ; surgery ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism ; Spinal Cord Dorsal Horn ; metabolism

Objective To study the influence of resolving phlegm and relaxing bowels decoction(Huatan Tongfu decoction)on plasma tissue type plasminogen activator(t-PA),plasminogen activator inhibitor(PAI)and homocysteine(Hcy)in patients with acute cerebral infarction. Methods With randomized and controlled clinical research,78 inpatients from 2010 to 2012 in Traditional Chinese Medicine(TCM)Department of Beijing Chaoyang Hospital,Capital Medical University were chosen,including 40 patients in observation group and 38 patients in control group. The patients in control and observation groups were treated by conventional treatment,and additionally the patients in observation group received Huatan Tongfu decoction(ingredients:Trichosanthis 30 g,Arisaema with bile 6 g,Magnolia bark 10 g,Fried rice sprout 15 g),and the rhubarb decoction was made alone,each 20 mL decoction containing crude drug 6 g. 1-4 days after the beginning of the study,the two decoctions were mixed,and the patients took the lukewarm mixture orally twice daily(once 1/2 the dosage);5-12 days after the start of the study, the patients took 200 mL lukewarm mixed decoction daily,being divided into 2 times to administer,and according to the patient defecation situation,the dosage of rhubarb decoction was adjusted individually,the therapeutic course being 12 days. The t-PA,PAI and Hcy were detected before treatment and on the 7th day after treatment. TCM syndrome scores(phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome)were recorded before and on the 12th day after treatment,and the scores of National Institute of Health Stroke Scale(NIHSS)were recorded at the same time. Results Before treatment,the differences in t-PA,PAI,Hcy levels and NIHSS score and phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome scores were not statistically significant;all the indicators improved significantly after treatment compared with those before treatment,and the changes in observation group were more remarkable〔t-PA(mg/L):13.03±2.15 vs. 12.95±2.16,PAI(mg/L):23.64±9.07 vs. 26.81±10.00, Hcy(μmol/L):9.13±1.15 vs. 11.52±3.17,phlegm syndrome:9.16±1.71 vs. 11.17±2.89,fire-heat syndrome:7.51±1.59 vs. 8.81±2.26, sthenic-fu syndrome:0.61±0.87 vs. 1.19±1.14, NIHSS score:5.70±3.16 vs. 5.90±2.97〕. Conclusion The mechanism of Huatan Tongfu decoction in treatment of patients with acute cerebral infarction accompanied by TCM syndromes of phlegm heat and sthenic-fu may be related to the reduction of plasma PAI and Hcy levels,protection of vascular endothelium and promotion of fibrinolysis,thereby the decoction can improve the clinical efficacy.

[Objective]Through the clinical investigation of the conversative treatment of undisplaced femoral necks,to analyze the occurrence of secondary displacement and femoral head necrosis.[Method]The medical records of 216 patients with undisplaced femoral neck fractures who were primarily treated conservatively from January,2000 to January,2004 were analyzed.Among that,186 cases is in accordance with the selected standard,which were consisted of 82 men and 104 women.(the average age 67.5).One hundred and forty-one fractures were given to bed rest in rotation-proof shoes,and walking on the crutches was followed after four weeks.Forty-five patients began to get out of bed with double crutches on the third day.When displacement happened,the operation was carried out.Once X-rays showed the fracture line unclearly,it is considered as bone healing.The early stage of femoral head necrosis was defined by sclerotic region or cyst in the femoral head.[Result]Sixty-eight fractures(36.6%) united and secondary considered displacement occurred in 118 cases(63.4%); the average time was 16 days (2～68 d) after injury when the displacement is found.In all primary healing patients,femoral head necrosis rate was 25%.The discovery time of necrosis was between 4 and 18 months,the most was 36 cases in the interval of 6 to 12 months.As for patients of secondary displacement,92 for closed reduction and hollow screws fixation,and the head necrosis happened in 55 patients(59.8%).The discovery time was from 4 to 18 months,the most in 6 to 12 months was 36 cases.The operation of open reduction and internal fixation with hollow screws was in 26 cases,73% of necrosis rate for it.The time was range from 3 to 12 months,11 case was the most in the period of 3 to 6 months.[Conclusion]Undispalced femoral neck fractures treated conservatively bear higher risk of secondary displacement and femoral head necrosis.In addition with more mortality and general complications,we therefore recommend primary operative stabilization of undisplaced femoral neck fractures.

Objective To study the incidence and risk factors of retinopathy of prematurity (ROP) in a single tertiary center during different times(Phase 1:2009 to 2011;Phase 2:2012 to 2014). Methods From 2009 to 2014, fundus examinations were performed on premature infants admitted to NICU of our hospital. The incidence and risk factors of ROP were compared between the two phases. Results During Phase 1,68 (11. 1% ) cases were diagnosed with ROP among 614 premature infants. During Phase 2, 121 (15. 2% ) cases were diagnosed with ROP among 794 premature infants. The incidences of ROP between the two phases were significantly different (P <0. 05). During Phase 1 and 2, 10 (14. 7% ) infants and 12 (9. 9% ) infants were diagnosed with Grade 3 and above or threshold ROP, respectively. The incidence of Grade 3 and above or threshold ROP between the two phases were also significantly different (P < 0. 05). Logistic analysis demonstrated that gestational age(GA), birth weight (BW), duration of oxygen therapy and mechanical ventilation(MV) were independent risk factors during hase 1, whereas GA, MV and blood transfusion were independent risk factors during Phase 2. Pulmonary surfactant (PS) was protective factor of ROP in both two groups. GA in Phase 2 was significant lower than Phase 1 (P <0. 05), while duration of oxygen therapy, incidence of MV, PS and blood transfusion were higher in Phase 2 ( P < 0. 05) . Conclusions The incidence of ROP has increased. Reducing the incidence of preterm delivery, duration of oxygen therapy, incidence of MV and blood transfusion has important role in preventing ROP. Reducing the use of MV and the oxygen concentrations, appropriate PS therapy and focusing on early ophthalmic screening are important preventing severe ROP.

Objective To develop a genetically modified fetal liver cells (FLC) based transplantation system that can release therapeutic levels of hematopoietic growth factors into the system circulation which can facilitate treatment of patient receiving cytokine therapy following chemotherapy. Method Examine adeno virus mediated gene transfer to isolated murine FLC and evaluate the biocharacterization of intrasplenic transplantation of gene modified murine FLC. Results Substantial transfection rate of 80%～85% were achieved at a ratio of 50 for 2 hr of exposure. Gene modified FLC (FLC GM) labeled with 111 In were injected into the allogenic mice, spleen, the %ID/g of liver was 20%～25% at 24 hr and 50%～55% at 48 hr after transplantation. In addition, serum concentration of GM CSF in mice with intrasplenic transplantation reached its maximum at 48 hr [(356 ?58 ) pg/ml]. Conclusion Intrasplenic transplantation of FLC GM can be predominantly localized in liver and spleen, and engraft rapidly and maintain normal function, which represent a critical step toward successfully accomplishing liver directed gene therapy.

OBJECTIVETo reveal the quality variation of polysaccharides, triterpenoids and proteins in spores and fruiting bodies of Ganoderma lucidum from producing areas, different varieties, harvesting parts and periods, and wall-breaking treatments.

METHODSpores and fruiting bodies from varieties of Longzhi No. 1 and Hunong No. 1 were collected as test samples, together with wall-broken spores sold in domestic main producing areas. The anthrone-sulfuric acid colorimetric method was used to determine the content of total polysaccharides. The vanillin-glacial acetic acid-perchloric acid colorimetric method was used to determine the content of total triterpenoids. The Lowry method was used to determine the content of total proteins.

RESULTThe content ranges of total polysaccharides, total triterpenoids, and total proteins from 6 domestic main producing areas were 0.40% - 2.25%, 1.36%-3.15% and 0.74% -1.91% respectively. The content ranges of total polysaccharides, triterpenoids, and proteins in the fruiting bodies from 2 varieties cultured in Zhejiang were 0.25% -1.42%, 0.44% -1.42% and 1.82% -3.67% respectively. In addition, the ranges of samples from wall-unbroken spores were 0.41% - 0.91%, 0.09% - 0.12%, 0.78% - 0.90% respectively and wall-broken spores are 1.03% - 2.25%, 1.89% - 3.15%, 0.96% - 1.04% respectively.

CONCLUSIONThere are significant differences in the contents of main chemical ingredients of wall-broken G. lucidum spores saled in the markets. The samples from Zhejiang contain high content of total polysaccharides and triterpenoids, and samples from Fujian contains more proteins. Between the 2 major varieties cultured in Zhejiang, Longzhi No. 1 contains higher content of triterpenoids, but Hunong No. 1 has more polysaccharides. Contents of triterpenoids and polysaccharides from wall-broken spores are much higher than those of fruiting bodies. The stipes from fruiting bodies contains more polysaccharides than those of the pileus, while the triterpenoids contents are higher in the pileus than stipes. The pileus and stipes collected in the second year contain higher content of polysaccharides than the first year's samples, but the contents of triterpenoids are lower. Wall-breaking treatment would significantly improve the extraction and dissolution rate of total triterpenoids and polysaccharides.

Fungal Proteins ; analysis ; Polysaccharides ; analysis ; Reishi ; chemistry ; Spores, Fungal ; chemistry ; Triterpenes ; analysis

The oil content and fatty acid composition of Ganoderma lucidum collected from different producing areas, varieties, tissue types and growth periods were measured and analyzed. The results showed that the oil content was 23. 61%-34.17% in different domestic producing areas of China; the oil content of fruiting bodies from major varieties cultured in Zhejiang province were 0.81%-1.87%, wall-unbroken spores were 0.07%-0.24%, wall-broken spores were 27.54%-34.17%, so the oil content of wall-unbroken spores were much higher than fruiting bodies, and wall-breaking treatment would increase the oil extraction rate 150-340 times. G. lucidum spores oil was mainly composed of unsaturated fatty acid composition. oleic acid and linoleic content were 53.26%-58.16% and 10.69%-16.87% respectively. Fatty acid composition ratio of spores and fruiting bodies were significantly different by PLS-DA. Determining the composition of fatty acid, especially the content of oleic acid, stearic acid and palmitic acid, could identify the tissue types of G. lucidum products' sources. In addition, the study result showed that the spores and fruiting bodies collected in the first year contained richer oil and fatty acid than second year's samples from the same variety of G. lucidum.
Fatty Acids ; analysis ; Oils ; analysis ; Reishi ; chemistry

ObjectiveTo observe the effects of mild hypothermia on post-resuscitation myocardial dysfunction in rabbits in order to elucidate the underlying mechanism of hypothermia.Methods After setting up rabbit model of cardiopulmonary resuscitation,20 rabbits were randomly ( random number)divided into two groups,namely normothermic resuscitation group (group A,n =10 ) and post-ROSC hypothermia group ( group B,n =10).In the group A,animals wore treated with standard CPR after cardiac arrest.In post-ROSC hypothermia group,the body temperature of animals was cooled to 32 ～ 34°C after successful ROSC.The left ventricular end-diastolic pressure (LVEDP),left ventricular pressure rise and fall rates ( ± dp/dtmax,serum concentrations of heart-type fatty acid-binding protein (H-FABP) and 8-isoprostaglandin F2a (8-iso-PGF2a) and Cyclooxygenase-2 (COX-2) were observed. Results Compared with the A group,the B group had significantly better hemodynamics,and lower serum H-FABP,8-isoPGF2a and COX-2 levels in the early stage of post-resuscitation ( both P ＜ 0.05 ).ConclusionsMild hypothermia attenuated post-resuscitation myocardial dysfunction during the early period of postresuscitation.The cryoprotective effect on myooardium is likely associated with the reduction of 8-iso-PGF2a and COX-2.

BACKGROUND:Fentanyl transdermal system has analgesic effect similar to oral sustained-release morphine and has been widely used in advanced cancer pain management in several years. However, recent literatures about some serious adverse events associated with fentanyl transdermal system have been published, and the long-term safety of fentanyl transdermal system treatment is stil chalenged. OBJECTIVE:To observe the long-term clinical efficacy and safety of fentanyl transdermal system for pain management in patients with advanced cancer. METHODS:A total of 309 patients with advanced cancer pain were enroled, including 166 females and 143 males. The age ranged from 26-72 years old. Patients received oral sustained-release morphine for 2 weeks, and then were subject to fentanyl transdermal system for pain management at the 3rd week until the 12th week. A prospective study with self-contrast method was conducted to compare the analgesic effects of these two drugs, as wel as patient's acceptability, adverse events and toxicity in the administration course. RESULTS AND CONCLUSION: Stable pain relief was harvested throughout the oral administration of both sustained-release morphine and fentanyl transdermal system therapy. During the use of oral sustained-release morphine, adverse reactions appearing in sequence were constipation, nausea, fatigue and anorexia. After converting to fentanyl transdermal system, the symptoms of constipation (χ2=5.22,P=0.02) and nausea (χ2=4.38, P=0.04) significantly reduced, and vomiting was abated but showed no significant difference (χ2=2.7,P=0.10). 2.3% of patients had skin reactions to the patches, and regressed after replacing the patch area. Skin reactions were aleviated at 2-10 weeks after oral administration of fentanyl transdermal system. Some uncommon adverse events including headache, diarrhea, dyspnoea, excessive sweating or other symptoms often occurred at the time of the initial dosage increase. Preference or strong preference for fentanyl transdermal system in comparison to previous oral sustained-release morphine was reported by 91% of patients. These results demonstrate that fentanyl transdermal patches can provide stable pain relief for advanced cancer patients with good acceptability, and mitigate the incidence of adverse events due to oral drugs.