Objective: To screen the active compounds in Sini Decoction showing the potential to inhibit tumor necrosis factor α (TNFα) to alleviate Doxorubicin (DOX)-induced heart failure. Methods: A chemical database of Sini Decoction was constructed from literature research. The generated pharmacophore models based on TNF-α used to screen active ingredients of Sini Decoction in the database by Discovery Studio 2.5. Molecular docking by Autodock 4.2 was adopted to demonstrate the hit compounds' affinities with TNFα. Furthermore, DOX-induced heart failure model on H9c2 cell line was constructed and cell viability was detected by CCK-8 to validate the therapeutic effect of potential active compounds. Results: The higenamine showed potential cardiovascular protective effect through virtual screening. And the activity was identified in vitro. Conclusion: In this study, we found that higenamine may inhibit TNF-α through virtual docking and validated that higenamine may have the potential of treatment for heart failure in the model of doxorubicin-induced myocardial toxicity to H9c2 cells.

Objective To investigate the effects of a novel standardized training program on the satisfaction and training quality of general practitioners (GPs). Methods 114 GPs trained in Wuxi People's Hospital between 2009 and 2013 were included, 52 GPs and 62 GPs were trained before and after the reform respectively. The measures of teaching reform included improvements in curriculum provision, theory teaching, learning modality and skills training. The evaluation indexes of satisfaction questionnaire and examination were confirmed by literature method and small-group discussion. Self-report satisfaction ques-tionnaire were distributed to graduate GPs and valid questionnaires were collected, while the results of entrance examination and graduation examination of GPs were recorded before and after the teaching reform. The research data were analyzed by chi-square test using SPSS 16.0 software. Results The basic characteristics of GPs and results of entrance examination before and after the teaching reform were compa-rable (P>0.05), however, GPs' satisfaction with curriculum, theoretical education, study form and skill training were increased significantly after teaching reform (P<0.05). Besides that,the results of graduation examination of GPs after the teaching reform, both the theory and skill examination, were improved signifi-cantly (P<0.05). Conclusion The study showed that GPs satisfaction with training modality and the results of graduation examination were improved greatly through our innovative teaching reform.

Objective To study the clinical characteristics which are related to malignancy in pancreatic intraductal papillary mucinous neoplasm (IPMN) with an aim to provide evidence for clinical practice.Methods Using PubMed,all pancreatic IPMN related articles with positive pathologic results before July 30th,2011 were studied.A pooled analysis was carried out on the morphological features of the disease.The analysis included gender,diameter of main pancreatic duct,diameter of cystic lesion,mural nodules and histological types (benign/malignant) of the neoplasm.Results 98 articles (including 1902 cases) were collected and analyzed.1025 cases were benign (53.89％) and 877 cases (46.11 ％) were malignant.Morphologically,there were a correlation between main pancreatic duct dilatation (≥5 mm),cystic lesion of large size (≥30 mm),presence of mural nodules and malignancy.The OR (95％ CI) were 5.591 (3.657-8.548),3.633 (2.626-5.027) and 4.983 (3.872-6.412) respectively.Conclusions A main pancreatic duct dilatation (≥5 mm),cystic lesions of large size (≥30 mm) and presence of mural nodules prompt the tumor to be malignant.In clinical work,the management of pancreatic IPMN should be made prudently based on comprehensive analysis of clinical features and the patient's status and intent.

ObjectiveTo analyse the clinical characteristics of pancreatic intraductal papillary mucinous neoplasm (IPMN) which coexists with extrapancreatic malignancy (EPM),with an aim to provide strategies for clinical diagnosis and treatment.MethodsThe PubMed was used to search for the pancreatic IPMN related articles with positive pathologic results.A pooled analysis was then performed.The ratio ofpancreatic IPMNs coexisting with EPMs and the locations (or the type) of EPMs were analyzed.ResultsAfter a strict process of screening,18 articles met the pre-determined standardsand were accepted.Of the 1327 patients,363 had coexisting EPMs (27.35％).There were 392 EPMs in these 363 patients.The EPMs occurred in almost all the systems of the body,especially in the digestive tract and its related organs,which accounted for 63.06％ of the EPMs. Conclusions There is a tendency for patients with pancreatic IPMN to have coexisting EPM. More than half of these EPMs are malignant tumors in the digestive system. When pancreatic IPMN is diagnosed,the clinician should be aware of the possible coexistence of an EPM and should look for the possibility of a new EPM developing in a patient after treatment of pancreatic IPMN.

Objective To evaluate the clinical value of noninvasive positive-pressure ventilation (NPPV) treatment in acute respiratory distress syndrome caused by acute pancreatitis. Methods A retrospective study of 27 cases, with acute respiratory distress syndrome (ARDS) caused by acute paucreatitis,who were admitted to our department from Jan 2007 to May 2010 and treated with NPPV, was performed. The changes of heart rate, respiratory rate, PaO2, oxygenation index (OI) and PaCO2 before and after treatment were compared. Results The heart rate, respiratory rate of 25(92.6％ ) patients decreased from (118.4 ±13.4)/min, (32.1 ± 1.7)/min to ( 81.9 + 8.5 )/min, ( 19.9 ± 2.1 )/min; PaO2, OI and PaCO2 increased from (74.1 ±5.0)mmHg, (148.2 +10.0)mmHg, (28.7 ±1.6)mmHg to (110.4 ±20.8)mmHg, (204.5±71.1)mmHg, (38.4 +3.6)mmHg 48 h after NPPV, respectively, and they recovered and were transited to oxygen supply by Venturi mask. 2 (7.4％) patients deteriorated and were transited to invasive positive-pressure ventilation support. Conclusions NPPV could effectively improve oxygenation of patients with ARDS caused by acute pancreatitis. The procedure of NPPV is relatively easy to use and to learn with few complications, and worth of clinical application.

Objective To investigate the relationship between the immunohistochemical types and the pathological types of pancreatic intraductal papillary mucinous neoplasms (IPMN).Methods Literatures on the diagnosis and treatment of pancreatic IPMN published before June 30,2011 in the PubMed database were retrieved.The literatures adopted were scored by the case reports quality assessment list.The correlation analysis between the immunohistochemical types and the gender,pathological types,characteristics of benign or malignant tumor and morphological types were analyzed.All data were analyzed using the Pearson chi-square test or multiple regression analysis.Results Thirteen literatures were adopted,the scores were 31-45 (full mark:50),and the mean score was 37.The clinical data of 826 pancreatic IPMN patients who were comfirmed by pathological examination were collected,and there were 4 immunohistochemical types:(1) The gastric type (363 patients).Of the 271 patients who underwent gender analysis,there were 195 males and 76 females,with the median age of 65.6 years.Of the 225 patients who underwent pathological types analysis,there were 146 cases of adenoma,34 cases of borderline tumor,24 cases of carcinoma in situ,21 cases of invasive carcinoma,the benign tumor was accounted for 86.68％ (293/338).Of the 215 patients who underwent morphological type analysis,there were 34 cases of main pancreatic duct type,151 cases of branch duct type and 30 cases of mixed type.(2) The intestinal type (327 patients).Of the 269 patients who underwent gender analysis,there were 184 males and 85 females,with the median age of 64.5 years.Of the 262 patients who underwent pathological types analysis,there were 28 cases of adenoma,43 cases of borderline tumor,91 cases of carcinoma in situ,100 cases of invasive carcinoma,the benign tumor was accounted for 29.21％ (85/291).Of the 151 patients who underwent morphological type analysis,there were 63 cases of main pancreatic duct type,54 cases of branch duct type and 34 cases of mixed type.(3) The pancreatobiliary type (92 patients).Of the 78 patients who underwent gender analysis,there were 41 males and 37 females,with the median age of 69.2 years.Of the 81 patients who underwent pathological types analysis,there were 4 cases of adenoma,1 case of borderline tumor,21 cases of carcinoma in situ,55 cases of invasive carcinoma,the benign tumor was accounted for 5.75％ (5/87).Of the 34 patients who underwent morphological type analysis,there were 7 cases of main pancreatic duct type,18 cases of branch duct type and 9 cases of mixed type.(4) The oncocytic type (44 patients).Of the 37 patients who underwent gender analysis,there were 24 males and 13 females,with the median age of 60.3 years.Of the 33 patients who underwent pathological types analysis,there were 18 cases of carcinoma in situ,15 cases of invasive carcinoma,and all of them were with malignant tumors.Of the 36 patients who underwent morphological type analysis,there were 9 cases of main pancreatic duct type,16 cases of branch duct type and 11 cases of mixed type.The immunohistochemical type of pancreatic IPMN was correlated with gender,pathological type and characteristics of maglignant or benign tumors (x2=10.626,281.839,333.212,r =0.097,0.569,0.625,P ＜ 0.05).The result of the chi-square test between the immunohistochemical types and the morphological types was statistically significant (x2 =50.732,P ＜ 0.05),but there was no correlation between them (r =0.010,P ＞ 0.05).Conclusion The immunohistochemical type of pancreatic IPMN is correlated with gender,pathological type and the characteristics of maglignant or benign tumors,which provide references for the diagnosis and prognosis evaluation of pancreatic IPMN.

Objective To investigate the value of bispectral index and intracranial pressure monitoring in evaluation of postoperative consciousness and short-term prognosis in patients with severe traumatic brain injury.Methods A simple random sampling method was used in 30 cases of brain trauma coma patients in the People's Hospital of Northern Jiangsu Province from January 2014 to December 2014.Glasgow coma scale (GCS) were evaluated at intervals of 8 hours,GCS were recorded for 3 days after surgery,The bispectral index value and intracranial pressure value are recorded at the same time.According to GCS,the patients were divided into two groups,group A (3≤GCS≤5) and group B(5 ＜ GCS≤8).The 21-days natural survival rate was counted.The Kaplan-Meier Method and Log-rank test were used to analyze the relationship between Bispectral index and intracranial pressure.Results The bispectral index value of group A was 45.3 ± 3.8,the intracranial pressure value of group A was (18.6 ± 2.8) mmHg,The bispectral index value of group B was 32.2 ± 8.2,the intracranial pressure value of group B was (33.4 ±4.6) mmHg.The 21-days survival rate of group A was 55％,and 21-days survival rate of group B was 30％.The Spearman rank correlation method was used to analyze the values.Bispectral index value was positively correlated with coma degree after operation in patients with severe traumatic brain injury,and was negatively correlated with intracranial pressure value (r =0.532,P ＜ 0.05;r =0.521,P ＜ 0.05).The more severer the patient's craniocerebral injury.,the more severer the condition,the higher the intracranial pressure,the lower the bispectral index value,the worse the prognosis is.Conclusion Combined monitoring of bispectral index and intracranial pressure has high application value in evaluating the coma degree and prognosis of patients with severe craniocerebral injury after operation.

OBJECTIVEThis study was designed to evaluate the inhibitory effect of nimesulide in combination with oxaliplatin on tumor growth, expression of COX-2, VEGF-C, VEGFR-3, survivin and β-catenin, and lymphatic metastasis in lung cancer xenograft in nude mice, and to discuss the possible synergistic effect of nimesulide in combination with oxaliplatin.

METHODSHuman lung cancer A549 cells were injected into BALB/c nude mice subcutaneously. Thirty-three healthy male nude mice were randomly divided into 4 groups: the control group, nimesulide group, oxaliplatin group and nimesulide combined with oxaliplatin group. Transplanted tumor tissues were collected and the expressions of COX-2, VEGF-C, VEGFR-3, survivin, β-catenin protein were detected by immunohistochemistry, and RT-PCR assay was used to assess the expression of tumor COX-2, VEGF-C, VEGFR-3, survivin and β-catenin mRNA. SPSS 16.0 was used for statistical analysis. Data were present as (x(-) ± s), and the means were compared by analysis of variance test.

RESULTSTumor inhibition rates of the nimesulide group, oxaliplatin group and nimesulide + oxaliplatin group were 39.73%, 48.04% and 65.94%, respectively. Immunohistochemical and RT-PCR analysis showed that compared with the control group, the expression levels of COX-2, VEGF-C, VEGFR-3, survivin and β-catenin of the nimesulide group were significantly reduced (all P < 0.05). Compared with the control group, statistical analysis of variance showed that the expression levels of COX-2, VEGF-C and VEGFR-3 of the oxaliplatin group were significantly increased (P < 0.05), the expression levels of survivin and β-catenin protein and mRNA of the oxaliplatin group were significantly reduced (P < 0.05). Compared with the control group, the expression levels of COX-2, VEGF-C, VEGFR-3, survivin and β-catenin of the nimesulide + oxaliplatin group were significantly reduced (all P < 0.05).

CONCLUSIONSBoth nimesulide alone or in combination with oxaliplatin can significantly inhibit the growth of lung cancer xenografts in nude mice and the expression levels of COX-2, VEGF-C, VEGFR-3, survivin and β-catenin. Oxaliplatin can significantly inhibit the growth of lung cancer xenografts in nude mice, and the expression of survivin and β-catenin. Nimesulide in combination with oxaliplatin enhances the antitumor effect of oxaliplatin.

Animals ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cyclooxygenase 2 ; genetics ; metabolism ; Cyclooxygenase Inhibitors ; pharmacology ; Drug Synergism ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Organoplatinum Compounds ; pharmacology ; RNA, Messenger ; metabolism ; Random Allocation ; Sulfonamides ; pharmacology ; Tumor Burden ; drug effects ; Vascular Endothelial Growth Factor C ; genetics ; metabolism ; Vascular Endothelial Growth Factor Receptor-3 ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism

OBJECTIVETo investigate the incidence of nosocomial infections of newborn infants in neonates and to explore the risk factors and strategies of infection control.

METHODSThere were 433 confirmed cases of nosocomial infection in the neonatal ward of the authors' hospital from January 2007 to December 2009. Their data of epidemiological and clinical characteristics, results of etiological examinations and antibiotic resistance were retrospectively analyzed.

RESULTSDuring the study, the number of hospitalizations were 6437. Nosocomial infection occurred in 433 patients 513 times. The overall nosocomial infection rate was 6.82%. The overall hospitalization days were 73 663 and nosocomial infection patient-day rates were 6.96‰. The VAP infection rate was 28.7‰. The CRBSI rate was 3.5‰. Gestational age (OR = 1.049), mechanical ventilation (OR = 1.810), umbilical vein catheter (OR = 1.106), hospitalization days (OR = 1.081), premature rupture of membrane (OR = 1.433) were the risk factors for the development of nosocomial infection. There were 197 (38.4%) cases of pneumonia, which was the most common nosocomial infection in Neonatal Ward. There were 129 cases of ventilator-associated pneumonia (VAP), which accounts for 65.5% of pneumonia and 24.4% of cases treated with ventilator. The next was sepsis, 124 cases (24.2%) and 64 cases of diarrheal disease (12.7%). One hundred and eighty two (54.4%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion. The predominant pathogens of Gram-negative bacteria were Klebsiella pneumoniae (19.6%), followed by Acinetobacter baumannii (8.1%), Pseudomonas aeruginosa (7.2%), Stenotrophomonas maltophilia (4.8%) and Escherichia coli (4.8%). The isolation rates of Klebsiella pneumoniae and Escherichia coli with positive extended-spectrum beta-lactamases (ESBLs) were 91.4% and 75%, respectively. Those two bacteria were universally resistant to cephalosporins. The rate of resistance to imipenem of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa were 1.5%, 11.1% and 41.7%. The isolation rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus were 28.6% and 95.5%.

CONCLUSIONIt is important to identify the high risk factors for nosocomial infections in newborn infants. To shorten time for mechanical ventilation and hospitalization days, removal of the central venous catheter as early as possible would be conducive to reducing the morbidity of nosocomial infection. The main pathogens were Gram-negative bacteria. The multidrug resistance of Enterobacteriaceae and Non-fermenters is serious.

Cross Infection ; epidemiology ; microbiology ; Female ; Humans ; Incidence ; Infant, Newborn ; Intensive Care Units, Neonatal ; Retrospective Studies ; Risk Factors

Development of the disease is the result of several factors involved in biological network changes. The nature of drug intervention is to regulate these pathological changes to the normal range. Advantages of traditional Chinese medicine (TCM) are to integrally and systematically regulate this biological networks and systematic pathology through multi-targets, multi-levels, multi-channels. Structural components TCM provides the controlled and precise basis "substance" for this regulation and also to clarify the "truth" of the nature of the regulation by the network pharmacology. Network pharmacology provides new strategy for the research on mechanism of structural components TCM. This study not only reflects the overall characteristics of the development of the disease, but also fully embodies the essence of TCM for preventing and treating diseases through changing traditional model on "one drug, one gene, one disease". This paper explores systematically the integration essence, features and research strategies of structural components TCM and the network pharmacology, understand the interaction of structural components TCM and body from the perspective of the overall concept of improving or restoring the balance of.biological networks. It is effective measure to reveal the structure of a multi-component for regulating biological networks mechanisms, and also provide new ideas and methods for further scientific research and innovation of structural component TCM.
Drug Interactions ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Gene Regulatory Networks ; drug effects ; Humans ; Medicine, Chinese Traditional