Aim To study the transport of geniposide and geniposide in Zhizi Bopi Decoction in MDCK cell membrane model. Methods The safety concentration of geniposide and Zhizi Bopi Decoction in MDCK cells were determined by MTT assay. Then the MDCK cell membrane model was used to investigate the transport of drugs. Firstly, the effects of time, drug concentra-tion, P-gp inhibitor and EDTA on the absorption and transport of geniposide were studied systematically. Secondly, the differences were compared between the transport of the same concentration of geniposide as single compound and that in Zhizi Bopi Decoction in MDCK cell model. The drug concentration was deter-mined by high performance liquid chromatography ( HPLC) to calculate the apparent permeability coeffi-cient (Papp). Results Geniposide transport in MDCK cell monolayer was time and concentration dependent. P-gp inhibitors had no significant effect on its transport and the transport of geniposide was enhanced by ED-TA. The absorption Papp of different concentrations of geniposide in Zhizi Bopi Decoction were ( 8. 96 ± 0. 35 ) × 10 -7 cm · s-1 , ( 8. 95 ± 0. 38 ) × 10 -7 cm · s-1 and (9. 16 ± 0. 30) × 10 -7 cm·s-1, significantly higher than the absorption Papp of geniposide as single compound(5. 85 ± 0. 44) × 10 -7 cm·s-1, (6. 88 ± 0. 38) × 10 -7 cm·s-1 and (6. 31 ± 0. 19) × 10 -7 cm ·s-1 ( P<0. 05 ) . Conclusion The transport of ge-niposide in MDCK cell membrane model is passive transport and is not affected by P-gp. Geniposide may transport via the paracellular route. The Zhizi Bopi De-coction can increase the absorption of geniposide.

OBJECTIVE To investigate the oropharyngeal bacterial carriage in hospitalized elderly patients without acute infections and the antimicrobial resistance,and the risk factors for the bacterial carriage.METHODS An oropharyngeal swab was taken from each patient after they rinsed their mouths with sterile saline.Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method.RESULTS The oropharyngeal bacterial carriage rate was 55.2% in elderly patients.Sixty two pathogens were isolated including 56(90.3%) strains of Gram-negative bacilli,5(8.1%) Gram-positive cocci and 1 Candida albicans.All of 34 strains of Haemophilus spp were susceptible to antimicrobials tested such as ampicillin and cefaclor,a few strains were resistant to gentamicin and ciprofloxacin.Of 10 strains of Klebsiella pneumoniae,4 strains were extended-spectrum ?-lactamases positive and resistant to cefotaxime.Logistic analysis indicated that denture-wearing was the risk factor for the oropharyngeal bacterial carriage in elderly.CONCLUSIONS Oropharyngeal bacterial carriage rate is high in hospitalized elderly patients.The major colonized bacteria are Gram-negative bacilli.Denture-wearing is the risk factor for the oropharyngeal bacterial carriage in elderly.

Objective To improve the orotracheal intubation verifying technique and reduce the complication of backflow in rat experiment.Methods A new position evaluation of anti-backflow device was designed and made of safety IV catheter and closed IV catheter system.60 adult male Sprague Dawley rats 216±20 g were randomly assigned to two groups: group A (n=40) for verifying placement, group B (n=20) for anti-backflow test.Group A was further divided into group A1 using self-designed positioning device, group A2 using aerosol, group A3 taking cotton fiber for positioning judgment.The group B was divided into two subgroups, B1 and B2, counting escaped bubbles as a means of positioning observation, the difference is that group B1 using frustum of a cone shape anti-backflow device, while the group B2 using common airway tube.Routine endotracheal intubation was performed to observe and record the time of positioning, the location of exhalation phase, and the length of inspiratory phase countercurrent water column.The group A1 further performed tracheotomy under direct vision clearly to confirm the anatomic positioning status.Results During the exhalation cycle,three or more bubbles were observed to escape continuously, indicating that the intubation tube was properly placed and open in the airway.Positioning time: It took 1.75±1.02 respiratory cycles in group A1,3.30±0.95 respiratory cycles in group A2 and 4.10±0.99 respiratory cycles in group A3 to complete the assessment the positioning status.There was no statistically significant difference between groups A2 and A3 (P> 0.05).The time needed for group A1 was significantly shorter than that of groups A2 and A3 (P < 0.01).The longest countercurrent water column length in group B1 was 3.23±0.53 cm, and 8.48±1.01 cm in the group B2.Conclusions The new designed anti-backflow positioning evaluation device is a simple and convenient appliance to evaluate the location of orotracheal intubation in rat experiment.It can effectively improve the positioning efficiency and has practical application value.

Objective:To observe whether 10.6 μm infrared laser moxibustion provides greater pain and stiffness relief and improves joint function in patients with knee osteoarthritis(KOA)compared with sham laser moxibustion. Methods:A total of 178 patients with KOA were randomly divided into a CO2 laser moxibustion group and a sham laser moxibustion group by block randomization method.Patients in the two groups received 10.6 μm infrared laser moxibustion or sham laser moxibustion treatment symmetrically at bilateral Dubi(ST35),respectively.Patients in both groups received 20 min of treatment,3 times per week for 4 weeks.Treatment effects were assessed by changes in the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)before treatment,at mid-treatment(2 weeks),at the end of treatment(4 weeks),and 4 weeks after treatment.Completion time for walking 50 yards was evaluated as a secondary measurement. Results:There were no statistical differences in the WOMAC scores for pain,stiffness,and function between the two groups before treatment(P>0.05).Patients in the CO2 laser moxibustion group experienced greater improvement in WOMAC pain,stiffness,and function scores at mid-treatment,the end of treatment,and 4 weeks after treatment(P<0.05).No significant inter-group difference was found at each assessment of the 50-yard walking time(P>0.05). Conclusion:Compared with the sham laser moxibustion,10.6 μm laser moxibustion can significantly reduce pain and improve knee joint stiffness and function in patients with KOA.

BACKGROUND:Bilateral-sagitta-split-ramus-osteotomy (BSSRO) has become a conventional method to correct facial deformities, and the finite element method is a significant way to study biomechanics of the mandible and temporomandibular joint (TMJ) after BSSRO. OBJECTIVE: To establish a precise and high simulation model of mandible containing TMJ after BSSRO with internal fixation, which is the base to study the biomechanics of the mandible and TMJ after BSSRO. METHODS: Spiral CT scan was used to get the data of DICOM that were input into MIMICS to establish the three-dimensional model of the mandible. The three-dimensional model was wrapped into a single closed shel for mesh generation and conversion in ANSYS. Then, the model was input into the ANSYS software for temporomandibular joint reconstruction and simulation of BSSRO and internal fixation. RESULTS AND CONCLUSION: The three-dimensional finite element model of mandible containing TMJ after BSSRO was established using MIMICS and ANSYS. This model had biological similarity and geometric similarity in comparison with the human tissues. The model could undergo various internal fixations through antedisplacement, retroposition and rotational movement of the distal end. Based on different experimental purposes, the established model can apply a load to al parts to study changes in stress and displacement of different tissues after BSSRO and internal fixation, and it also can be used to study the effect of different fixation materials on the rear stability after internal fixation.

Objective To observe the clinical effect of myofascial release on treatment of patients with chronic tention headache. Methods A total of 100 patients with chronic tention headache, admitted to our hospital from January 2012 and January 2014 and met the inclusion criteria, were chosen in our study; According to the will of the patients, they were divided into treatment group (n=50) using myofascial release and control group (n=50) with traditional massage. The treatment time was 30 min per day for 5 days as a therapeutic cycle, interval for 2 days to continue the next cycle, and they received treatment for a total of 8 weeks. The headache index, syndrome improvement, changes of headache times and headache impact scale-6 scores were recorded and analyzed;the clinical efficacies of these two treatment methods were compared. Results The treatment efficacy of treatment group was significantly better as compared with that of control group in the aspects of total effective rate (96%vs. 76%, x2=4.757, P=0.004), changes of headache index (11.11±10.28 vs. 19.37±10.56, t=3.963, P=0.000), changes of headache times at three months after treatment (12.06±5.86 vs. 15.35±6.02, t=2.770, P=0.007) and changes of headache impact-6 scores (44.58±6.50 vs. 52.81±8.02, t=5.637, P=0.000). Conclusion Myofacial release has better efficacy than traditional massage in treating chronic tention headache; the method of myofacial release is simple and easy to apply, with good value of clinical applications.

Objective:To evaluate the efficacy and mechanism of continuous blood purification(CBP) in the treatment of severe sepsis in children.Methods:A total of 42 patients with severe sepsis were enrolled in the study.According to the parents undefined desire to treatment, on the basis of the same treatment condition, 30 cases in the blood purification group were treated with CBP, and 12 cases in the control group were given the routine treatment without CBP treatment.The difference of each index between the two groups at the baseline(before treatment) and 72 hours after treatment were observed.Results:The differences of heart rate, mean arterial pressure and brain natriuretic peptide before and after treatment in the blood purification group were significantly higher than those in control group( P<0.05), and the differences of oxygenation index, 24-hour average urine volume, blood urea nitrogen, creatinine and Glasgow coma score in the blood purification group were significantly higher than those in control group( P<0.05). The difference of capillary refill time, lactic acid and central venous oxygen saturation in blood purification group were significantly higher than those in control group( P<0.05). The level of white blood cell count, C-reactive protein, procalcitonin and interleukin-6 in blood purification group were significantly higher than those in control group, with all significant difference( P<0.05). There was significant difference in critical illness score between two groups after treatment and before treatment.The mortality rate of the blood purification group was significantly lower than that in control group( P<0.01). Conclusion:CBP can improve cardiovascular function, brain function, renal function, tissue perfusion, inflammation index, internal environment, and improve the score of children with severe sepsis.

Objective To explore the effect of Xiangpi Shengji Ointment on wound healing and apoptosis-related Fas/Fas L pathway in model rats after anal fistula operation.Methods Thirty-six SD rats were used to construct the anal fistula model by using steel wire hanging line and indwelling for 30 days.After successful modeling,27 rats with anal fistula were randomly selected for"fistulectomy"to construct a postoperative wound model.After operation,the wound model rats were randomly divided into three groups,9 rats in each group,which were Xiangpi Shengji Ointment Group,Vaseline Group and Model Group,and the remaining 9 rats with anal fistula were sham operation group.The rats in the Xiangpi Shengji Ointment group were externally applied with Xiangpi Shengji Ointment gauze,while those in the Vaseline group were externally applied with Vaseline gauze.The rats in the model group were only disinfected and rinsed.No special treatment was given to the rats in the sham operation group.The wound healing was observed on the 3rd,5th,7th and 10th day after medication intervention,and the wound healing rate was calculated.After 10 days of continuous intervention,wound tissues were taken from each group,and the histopathological changes,the number of apoptosis,the expressions of Fas,Fas L,caspase-8 and cyto-c in wound tissues were observed by HE staining,TUNEL staining and immunohistochemistry respectively,and the mRNA expressions of Fas,Fas L and cyto-c in wound tissues were detected by RT-PCR.Results Compared with the model group,Xiangpi Shengji ointment group and Vaseline group significantly promoted wound healing at 7 and 10 days after intervention(P<0.01),and the wound healing rate of Xiangpi Shengji ointment group was significantly higher than that of Vaseline group(P<0.01).After 10 days of drug intervention,compared with sham operation group,the apoptosis rate of Xiangpi Shengji ointment group,Vaseline group and model group increased significantly(P<0.01),and the relative expressions of Fas,Fas L and cyto-c mRNA and the expression levels of Fas,Fas L,caspase-8 and cyto-c protein in wound tissue increased significantly(P<0.05,P<0.01).Compared with the model group,the apoptosis rate,the relative expression of Fas,Fas L and cyto-c mRNA and the expression level of Fas,Fas L,caspase-8 and cyto-c protein in Xiangpi Shengji ointment and Vaseline groups decreased significantly(P<0.05,P<0.01).Compared with Vaseline group,the apoptosis rate of Xiangpi Shengji ointment group decreased significantly(P<0.01),and the relative expression of Fas,Fas L and cyto-c mRNA and the expression level of Fas,Fas L,caspase-8 and cyto-c protein decreased significantly(P<0.05,P<0.01).Conclusion Xiangpi Shengji Ointment can inhibit the activation of Fas/Fas L pathway,reduce the apoptosis of wound tissue cells and promote wound healing after anal fistula operation.

ObjectiveTo observe the effect of Shenling Baizhusan on the intestinal inflammatory reaction in the rat model of Crohn's disease （CD） and study its relationship with p38 mitogen-activated protein kinase （MAPK） signaling pathway， so as to provide an experimental and theoretical basis for the clinical application of this prescription. MethodA total of 72 SD rats （36 males and 36 females） were randomized into a normal group （n=12） and a modeling group （n=60）. The rats in the modeling group were treated with 2，4，6-trinitrobenzene sulfonic acid （TNBS， 3 mL·kg^-1） and then randomized into model， mesalazine （0.21 g·kg^-1·d^-1）， and low-， medium-， and high-dose （5.88， 11.76， 23.59 g·kg^-1·d^-1， respectively） Shenling Baizhusan groups. The rats in the drug intervention groups were administrated with corresponding agents by gavage for 14 days， and those in the normal and model groups with an equal volume of distilled water. The disease activity index （DAI） score of inflammatory bowel disease （IBD） and the colon mucosal damage index （CMDI） score of rats in each group were assessed after gavage. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes in the colon， and enzyme-linked immunosorbent assay （ELISA） to measure the levels of tumor necrosis factor alpha （TNF-α）， interleukin-1 （IL-1）， and interleukin-6 （IL-6） in the serum. Western blotting was employed to determine the protein levels of p38 MAPK， phosphorylated p38 MAPK （p-p38 MAPK）， p65 nuclear factor （NF）-κB， and phosphorylated-p65 NF-κB （p-NF-κB p65） in the colon tissue. Quantitative real-time polymerase chain reaction was conducted to determine the miRNA levels of p38 MAPK and NF-κB p65 in the colon tissue. ResultThe model group had higher DAI and CMDI scores than the normal group （P<0.01） and showed damaged epithelial cells in the colon mucosa， disarrangement of glands， damaged simple tubular glands， local necrosis， infiltration of a large number of inflammatory cells and lymphocytes in each layer， and presence of ulceration. Compared with the normal group， the model group showed elevated levels of TNF-α， IL-1， and IL-6 in the serum （P<0.01） and up-regulated protein levels of p-p38 MAPK and p-NF-κB p65 and miRNA level of p38 MAPK in the colon tissue （P<0.01）. Compared with the model group， mesalazine and high- and medium-dose Shenling Baizhusan decreased the DAI and CMDI scores （P<0.05， P<0.01）， repaired the mucosal epithelium of the colon tissue， increased the glands and goblet cells， lowered the levels of TNF-α， IL-1， and IL-6 in the serum （P<0.05， P<0.01）， and down-regulated the protein levels of p-p38 MAPK and p-NF-κB p65 and the miRNA level of p38 MAP in the colon mucosa （P<0.01， P<0.05）. ConclusionShenling Baizhusan can reduce intestinal inflammation of CD rats and promote the repair of colon mucosa by down-regulating the protein levels of p-p38 MAPK and pNF-κB p65 and the miRNA level of p38 MAPK to inhibit the p38 MAPK pathway.

As coronavirus disease 2019 (COVID-19) pandemic poses a substantial global public health threat, traditional Chinese medicine (TCM) was used in 91.50% of the COVID-19 cases in China, showing encouraging results in improving symptom management and reducing the deterioration, mortality, and recurrence rates. A total of 166 modified herbal formulae consisting of 179 single herbal medicines were collected for treating COVID-19 in China. Glycyrrhizae Radix et Rhizome, Scutellariae Radix, and Armeniacae Semen Amarum are the most frequently utilized in clinics, most of which are antipyretic (47, 26.26%), expectorant and cough-suppressing (22, 12.29%), and dampness-resolving (21, 11.73%) from traditional descriptions. A total of 1212 chemical components containing -sitosterol, stigmasterol, and quercetin were primarily selected. Additionally, using complex system entropy and unsupervised hierarchical clustering, 8 core herbal combinations and 10 new formulae emerged as potentially useful candidates for COVID-19. Finally, following scaffold analysis, self-organizing mapping (SOM) and cluster analysis, 12 clusters of molecules yielded 8 pharmacophore families of structures that were further screened as pharmacological targets in human metabolic pathways for inhibiting coronavirus. This article aims to make more easily accessible and share historical herbal knowledge used in contemporary treatments in a modern manner to assist researchers contain the global spread of COVID-19.