Diabetic nephropathy ( DN) is one of the complications of diabetes, which is closely related to the pathogenesis of in-flammation. This article summarized the relevant literatures on the correlation between MCP-1 , TNF-α and DN, and the intervention of traditional Chinese medicine with DN. In kidney tissues, oxidative stress and NF-κB-dependent signal pathways induced the increase of monocyte chemoattractant protein-1 (MCP-1) expression, which could induce macrophage accumulation, proteinuria increase, renal fibrosis and renal clearance capacity decrease, and further leading to kidney damage. The clinical and experimental trails showed tumor necrosis factorαmRNA and protein levels in serum, urine and renal tissues were closely related with DN, which could be used as a bio marker to provide clinical guidance. As the therapeutic targets,MCP-1 and TNF-αcould give a novel insight into the clinical treatment of DN. Some traditional Chinese medicines or monomer could ameliorate DN by inhibiting MCP-1 and/or TNF-α. Thus, further verifi-cation or clinical application of those traditional Chinese medicines is worth trying.

With the increment of the workload,high stability is required by hospital information system.When the amount of client exceeds the limit,we must reconstruct the Oracle server in order to meet the needs of workload increment.This article describes the principle of shared server and the reconstructed method from dedicated server to multithreaded server.

Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

Objective To evaluate the clinical efficacy and safety of modified anti -tuberculosis scheme in the treatment of tuberculous meningitis.Methods 60 cases with tuberculous meningitis were randomly divided into two groups.We enrolled 30 patients in each group.The traditional anti -tuberculosis group used traditional anti -tuberculosis scheme with isoniazid,rifampicin,pyrazinamide,streptomycin,and the modified anti -tuberculosis group was given isoniazid,rifampicin,pyrazinamide,levofloxacin,the treatment course of tuberculous meningitis was 12 months.The efficacy and safety through clinical manifestations and laboratory examinations,the dynamic changes of cerebrospinal fluid were evaluated by statistical methods.Results The total effective rate of the modified anti -tuberculosis group was significantly higher than the traditional anti -tuberculosis group(86.6% vs.63.3%,χ2 =4.36,P <0.05).The cerebrospinal fluid routine and biochemical index in the modified anti -tuberculosis group were obviously superior to the traditional anti -tuberculosis group after treatment(all P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups(26.6% vs.16.7%,χ2 =0.88,P >0.05).Conclusion Levofloxacin combined with other first -line anti -tuberculosis drugs,glucocorticoids,dehydration and other comprehensive measures improved brain function for the treatment of tuberculous meningitis is recommended.

Objective:To investigate the therapeutic effect of tannins from pomegranate rind on passive Heymann nephritis ( PHN) in rats. Methods:Rabbits were with intradermal immunization for many times to obtain anti-Fx1A serum, and then PHN model in rats was established by tail intravenous injection of anti-Fx1A serum. The experimental rats were randomly divided into six groups, the nor-mal control group, model group, benazepril group, and tannins from pomegranate rind group respectively at high, medium and low dose. After the success of modeling, each rat was received intragastric administration for five weeks, and then the total of urine was collected once a week for the detection of 24-hour urine protein. At the end of treatment, serum was collected for the detection of serum albumin, blood urea nitrogen, creatinine, total cholesterol and triglyceride. The pathological changes of the renal tissue were observed using hematoxylin-eosin and Masson staining to observe the effect of tannins from pomegranate rind on PHN rats. Results:After the in-tragastric administration for five weeks, tannins from pomegranate rind could obviously reduce the level of 24-hour urine protein in PHN rats(P<0. 01), significantly reduce the levels of serum creatinine (P<0. 01), urea nitrogen (P<0. 01,P<0. 01,P<0. 05), total cholesterol (P<0. 01) and triglyceride (P<0. 01,P<0. 01,P<0. 05) in PHN rats, and increase the level of serum albumin (P<0. 01,P<0. 05,P>0. 05). HE and Masson staining results indicated that tannins from pomegranate rind could improve the pathologi-cal damage in PHN rats. Conclusion:Tannins from pomegranate rind has notable improvement for PHN in rats.

Objective; To explore mechanism of Zhongjiling tablet treats experimental autoimmune myasthenia gravis on rats. Methods:Normal mice, immunosuppressive mice and EAMG rats were used to investigate the mechanism. Results:Zhongjiling tablet enhanced T and B cells proliferation of normal mice and immunosuppressive mice induced by ConA or LPS, and increased the production of IL-2. T cell proliferation of EAMG rats was improvement stimulated by AChR and decline by ConA. Zhongjiling tablet inhibited the improvement by AChR and enhanced the decline by ConA, and reduced the expression of IFN-? and IL-4 mRNA. Zhongjiling tablet also induced the apoptosis of CD4 + T lymphocyte stimulated by AChR. Conclusion: Zhongjiling tablet increased immunity of normal mice, immunosuppressive mice and EAMG rats. But it suppressed specific T lymphocyte proliferation induced by AChR and reduced the expression of IFN-? and IL-4 mRNA. It was probably one of mechanisms Zhongjiling tablet induced the apoptosis AChR specific CD4+T lymphocyte.

Acupuncture Therapy ; Adolescent ; Humans ; Male ; Superior Mesenteric Artery Syndrome ; therapy

Objective To investigate the changes of intestinal blood flow and motility and their effects on intestinal mucosa barrier in rats with acute cerebral ischemia. Methods 64 male Wistar rats were assigned randomly into cerebral ischemia group (n=32) and control group (n=32).The two groups were divided into four subgroups according to timepoints of 6 h,12 h,24 h and 48 h after operation (8 rats for each subgroup).The intestinal mucosa blood flow,intestinal transmit index and endotoxin level in porlal vein were detected.The displacement ratio of E.coli was marked and counted with fluorescent microscope in tissue homogenate from organs. Results The intestinal blood flow in cerebral ischemia group at 6 h,12 h,24 h and 48 h after operation [(34.5±3.2)PU,(22.7±1.9)PU,(26.2±4.3) PU and (30.5± 4.1) PU] were significantly lower than control group[(46.8 ±5.4) PU,(50.1±3.6) PU,(45.4±4.1) PU and (48.7±7.3) PU] (t=2.650,2.875,2.639 and 2.507,all P＜0.05).The intestinal transmit index in cerebral ischemia group at 6 h,12 h,24 h and 48h after operation[(0.59±0.07),(0.48±0.06),(0.50±0.08)and (0.57±0.04)] were decreaesd as compared with control group [(0.73±0.04),(0.75=0.02),(0.74±0.06) and (0.76±0.03)] (t=2.409,2.758,2.649 and 2.807,all P＜0.05). The levels of endotoxin in cerebral ischemia group started to increase at 6 h and arrived to peak at 24 h,and the levels at four timepoints were (0.382 ± 0.014) Eu/ml, (0.466 ± 0.018) Eu/ml,(0.478 ± 0.029) Eu/ml and (0.412±0.036)Eu/ml,respectively,that were higher than those in control group[(0.102±0.007)Eu/ml,(0.114±0.021)Eu/ml,(0.112±0.018)Eu/ml and (0.108±0.011)Eu/ml] (all P＜0.05).The total E.coli detection rates in multiple organs in cerebral ischemia group (11.4％,18.8 ％,25.0％and 12.5％) were higher than in control group (2.1％,4.2％,2.1％ and 0.0％) at four rime points (all P＜0.05). The level of endotoxin was negatively related with the intestinal blood flow and intestinal transmit index( r =- 0.861 and - 0.796,both P＜ 0.05). Conclusions The higher intestinal mucosa blood flow and intestinal motility play important roles in the increase of intestinal mucosa permeability at early stage after acute cerebral ischemia.

Clinicians monitor the gastric residual volume(GRV) of critical ill patients to minimize or prevent side effect of EN.Nevertheless,recommendations about the threshold GRV in critically ill patients treated with EN are not uniform.Many recent clinical studies had demonstrated that increasing the limit of GRV was associated with the increase in the diet volume ratio of ICU patients receiving EN,and it was not associated with adverse effects in gastrointestinal complications.This review summarizes the influence factors of GRV monitoring to evaluate the feasibility and necessity of increasing the threshold of GRV.

Objective To investigate the effect of aerosol inhalation of iloprost on pulmonary arterial pressure and hypoxic pulmonary vasoconstriction (HPV)during one-lung ventilation (OLV) in rats.Methods Thirty male rats were randomly divided into three groups,10 in each group. Models of lung perfusion were established,100% FiO 2 was ensured under the condition of OLV and the atomizers were opened.Atomization inhalation with normal saline was performed in group A,ilo-prost at a concentration of 0.05 μg·kg-1 ·min-1 in group B and iloprost at a concentration of 0.1μg·kg-1 ·min-1 in group C.Mean pulmonary artery pressure (MPAP)and PaO 2 of drainage-fluid from left atrium were recorded at time points of perfusion for 10 min (T1 ),aerosol inhalation for 10 min (T2 )and OLV for 1 h (T3 ).Oxygenation index (OI)was calculated with PaO 2 at each time point.Both lungs were harvested for electronic microscope detection.Results MPAPs at T2 and T3 were higher in contrast with that at T1 (P <0.05).A decrease of MPAP at T2 and T3 showed in group B and C when compared with those in group A (P <0.05).Group C had lower MPAP in comparison with group B at each time point.Considering the time span,we found that OIs at T2 and T3 were lower than that at T1 .In addition,OIs at T2 and T3 in group C were higher than those in group B,respectively.Under elec-tronic microscope,nuclear membranes typeⅡ alveolar epithelial cells of both lungs in group A and of non-ventilated lungs in group B and C bulged out or invaginated and lamellar bodies were evacuated,especially when compared to those in ventilated lungs in groups B and C.Conclusion In rat models of lung perfusion, atomization inhalation with iloprost can decreased MPAP,reduce intrapulmonary shunt and increase oxygen-ation.