Objective To investigate the value of C- reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-?) in early diagnosis of neonatal sepsis. Methods Sixty- five newborns were divided into experiment group and control group, experiment group was also divided into sure group and doubtful group by blood culture We assessed the level of serum CRP, IL-6 and TNF-? in 24 hours and after 24 hours of clinical diagnosis of sepsis in experiment group, and examined the blood culture before antibiotic treatment Serum CRP, IL-6 and TNF-? were also examined in 3 to 6 days old. Results 1 The levels of serum CRP, IL-6 and TNF-? in experiment group were significantly higher than that in control group 2. The sensitivity of IL-6 and TNF-? were higher than CRP in 24 hours in experiment group. 3. After 24 hours, the sensitivity of CRP was elevated,and there was no statistical difference compared with the IL-6. Conclusion IL-6 and TNF-? are the credible marker in the early diagnosis of neonatal sepsis, and are more sensitive than the CRP, the IL-6 is the first sensitive marker.

OBJECTIVE:To systematically review the efficacy and safety of glipiaide versus repaglinide in treatment of type 2 diabetes and provide evidence-based reference for the clinical treatment. METHODS:PubMed,EMBase,Medline,Cochrane Li-brary,CJFD,VIP and WanFang database were retrieved to collect the randomized controlled trials(RCT)of the efficacy and safety of glipizide(test group)versus repaglinide(control group)in the treatment of type 2 diabetes. After the quality evaluation and in-formation collection of clinical studies with inclusion criteria,Rev Man 5.2 software was conducted for Meta-analysis. RESULTS:There were totally 10 RCTs,involving 1 022 patients. Meta-analysis results showed that the HbA1c levels [MD=0.43,95%CI (0.20,0.65),P<0.001],2 h postprandial plasma glucose levels [MD=0.49,95% CI(0.04,0.94),P=0.03] and hypoglycemia inci-dence [OR=2.99,95%CI(1.83,4.88),P<0.001] in test group were significantly higher than control group. There was no signifi-cant difference in the fasting plasma glucose level in 2 groups[MD=-0.14,95%CI(-0.44,0.16),P=0.35]. CONCLUSIONS:Re-paglinide has better efficacy and safety than glipizide in the treatment of type 2 diabetes. Limited by the methodological quality and sample amount of included studies,it remains to be verified by RCT with large sample,strict design and long-term follow-up.

Objective To evaluate the methods for the prevention of internal jugular vein malposition of peripherally inserted central catheter (PICC) in patient with limited neck motion.Methods 210 patients who underwent PICC placement using ultrasound-guided modified Seldinger technique were divided into observation group (n =106) and control group (n =104) with a random number table.Ultrasound probe compression on the internal jugular vein was used in the observation group,while finger compression was used in the control group.The 2 groups were compared in terms of incidence of internal jugular vein malposition,accuracy of PICC tip position in X-ray,and incidence of complications.Results Incidence of PICC malposition was significantly lower in the observation group than the control group [3 (2.8％) vs.36 (34.6％),P =0.000].The accuracy of PICC tip position in both groups was 100％.No complication was observed in the observation group,while the rate of complication in the control group was 4.8％,with a statistically significant difference (P =0.022).Conclusion The ultrasound probe compression method can significantly lower the incidence of internal jugular vein malposition of PICC and is safer than the finger compression method.

AIM: To determine the optimized intranasal powders formulation of Panax Notoginseng Saponins(PNS). METHODS: According to the indexes of the in vitro release rate in 1h and 12h of Rb1 and Rg1, bioadhesive intensity and the ciliary toxicity in situtoad palatal mucosa of the preparations, the optimized formulation was determined by the central composite design-response surface methodology. RESULTS: When the correspondent percentage of PNS, microcrystalline cellulose (MCC) and moderate viscosity hydroxypropyl cellulose (H-HPC) was 31%, 60% and 9%, respectively, the release rate in 1h and 12h of Rb1 and Rg1 was 6.82%, 53.25% and 83.4%, 95.09%, respectively. The adhesive time was 78min, and the lasting time of ciliary movement after the rinsing of the PNS powders was 94.84% to the physiological saline group which suggested the powder was almost no toxicity. CONCLUSIONS: The optimized formulation of the PNS intranasal powder was obtained quickly and conveniently by the central composite design-response surface methodology.

OBJECTIVE:To promote standard management of drugs in ICU area. METHODS:The change of work mode in ICU area of our hospital was analyzed and compared after the application of automated drug dispensing system(ADDS)as well as the change of related indicators 3 months before and after the application of ADDS;the effect of ADDS was evaluated. RESULTS& CONCLUSIONS:After the application of ADDS,the management of base drugs changed from open management to intelligent, closed-off and authority management;drug storage and cost management became more scientific,and staff allocation became more optimal. Under the condition of zero difference in the number of medical orders,initial medication time shortened from 170 min to 131 min (P<0.05),time of daily drug preparation and drug repercussion shortened from (81.20 ± 3.56)min to (30.04 ± 7.55) min,and (9.18 ± 2.79)min to (6.47 ± 4.66) min (P<0.05). The application of ADDS can improve work efficiency,standardize drug management,promote medical safety,and provide reference for initiating a new mode of drug management in wards.

OBJECTIVETo discuss whether asiaticosides could effectively reduce the endothelial cell damage as a biochemical modulator, so as to further inhibit the post-stenting intima-media membrane hyperplasia.

METHODHuman aortic smooth muscle cells and aortic fibroblasts were selected and divided into the blank group, the rapamycin group and the asiaticoside group and the rapamycin and asiaticoside group. The expressions of muscle cells and fibroblasts TGF-beta1, Smad7 and I-collagen gene were determined by RT-PCR. The expression quantity of I-collagen protein was assayed by ELISA. The coefficient of drug interaction (CDI) between rapamycin and asiaticoside was calculated. Additionally, 16 Chinese mini-swines were randomly divided into group A and group B. One sirolimus drug-eluting stent of the same type was implanted after the high-pressure pre-expansion of anterior descending artery balloon. After the operation, the group A was intravenously injected with normal saline 30 mL x d(-1). Whereas the group B was intravenously injected with asiaticoside 30 mg x kg(-1) x d(-1)(diluted to 30 mL). The expressions of plasma vWF of the two groups were measured at the 7th and 14th days after the operation. At the 28th day after the operation, tissues of the stented vessel segments were sliced and stained to calculate the vessel area, inner stent area, lumen area and neointima area

RESULTCompared with the control group, the combination group showed significant up-regulation in smooth muscle cells and fibroblast Smad7 gene, down-regulation in TGF-beta, and obvious inhibition of I-collagen gene expression (P < 0.01). As for smooth muscle cells, there was no difference in the expression of I-collagen between the combination group and the rapamycin group, with CDI at 0. 83. As for fibroblasts, there was a significant difference in the expression of I-collagen between the combination group and the rapamycin group (P < 0.05), with CDI at 0.77. Plasma vWF of the group B was significantly lower than that of the group A (P < 0.05) at the 7th and 14th days after the operation. At the 28th day after the operation, no difference was observed in vessel area and stent area between the two groups. However, the lumen area in the group B was significantly larger than that of the group A(P < 0.05), and the neointima area of the group B was significantly smaller than that of the group A (P < 0.05).

CONCLUSIONAs an effective biochemical modulator for rapamycin, asiaticosides could inhibit TGF-beta expression, significantly decrease the synthesis and secretion of extracellular matrix, further inhibit the post-stenting intima-media membrane hyperplasia and reduce the endothelial cell damage by effectively up-regulate the expression of Smad7 protein.

Animals ; Collagen ; genetics ; metabolism ; Coronary Restenosis ; drug therapy ; prevention & control ; surgery ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Hyperplasia ; drug therapy ; genetics ; metabolism ; prevention & control ; Smad7 Protein ; genetics ; metabolism ; Stents ; adverse effects ; Swine ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Triterpenes ; administration & dosage

Objective To observe the effect of acyl-CoA carbrolase (ACC) antisense oligonucleotide (ASODN) on steatosis of HL-7702 hepatocytes.Methods The specific phosphorothioate modified ACC targeting ASODN were designed and synthesized by a computer software.Normal HL-7702 hepatocytes were cultured in vitro using intravenous lipid emulsions,a large number of triglyceride was induced in hepatocytes within 48 h,and a model of fatty liver cells in vitro was successfully formed.ACC-ASODN was transfected into the hepatocyte model by liposome method.The blank group (HL-7702 cells),model group (fatty liver cells of model) and low and high concentrations of the two experimental groups (5,10 μmol · L-1 ACC-ASODN) were set up.ACC-ASODN was transfected into fatty liver cell model 24 h later.ACC activity was determined by radioisotope technology.The malonyl coenzyme A content was determined by HPLC.The carnitine palmitoyltransferase Ⅰ (CPT Ⅰ) activity was determined by radioisotope technique.The level of triacylglycerol(TG) was determined by automatic analyzer.Results The value of the liver cell ACC activity (U) in blank group,model group and experimental-L,-H groups were respectively 0.74,0.33,0.20,0.18.The value of the intracellular content (nmol · L-1) of malonyl CoA in above four groups were respectively 14.3,12.4,7.5,6.8.The value of CPT Ⅰ (U) in above four groups were respectively 1.33,1.47,3.85,3.95;the value of TG conten(mmol · L-1) in above four groups were respectively 0.20,0.52,0.37,0.28.Compared with blank group,the factors in model group had significant differences(all P ＜ 0.05).Compared with model group,the factors in experimental-L,-H groups had significant differences (all P ＜ 0.01).Conclusion ACC-ASODN acts on hepatocytes,and by inhibiting the activity of ACC,the content of TG is decreased,and the steatosis of hepatocytes is alleviated.

OBJECTIVE:To systematically review the effect of Danhong injection on hemorhelogy in patients with angina pec-toris in coronary heart disease(CHD),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Medline,Cochrane Library,CJFD,VIP database,Wanfang database,and retrieved relevant literatures manual-ly,the randomized controlled trials (RCT) about the effect of Danhong injection on hemorhelogy in patients with angina pectoris in CHD were collected. After the quality evaluation and information collection of clinical studies with inclusion criteria,Meta-analy-sis was conducted by using Rev Man 5.2 software. RESULTS:A total of 12 RCT were enrolled,involving 1 160 patients. Results of Meta-analysis showed the conventional treatment of Danhong injection could more effectively improve the high blood viscosity [MD=-0.87,95%CI(-1.24,-0.50),P<0.001],low blood viscosity[MD=-2.43,95%CI(-3.99,-0.87),P=0.002],hemato-crit value[MD=-0.05,95%CI(-0.10,-0.00),P=0.04],plasma viscosity[MD=-0.58,95%CI(-0.78,-0.38),P<0.001] and fibrinogen level[MD=-1.06,95%CI(-1.65,-0.47),P<0.001],compared with convertional treatment,there were significant dif-ferences. CONCLUSIONS:Based on the conventional treatment,Danhong injection has improvement effect on the related indica-tors of hemorhelogy in patients with angina pectoris in CHD. Due to the limit of methodological quality and sample size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.

Objective To investigate the effect of cocaine and amphetamine-regulated transcript (CART ) peptides on cortical synaptic plasticity in ischemia-reperfusion (I/R ) injury mice. Methods A total of 288 healthy male specific pathogen free(SPF)grade Kunming mice aged 0 to 12 weeks were selected. They were divided into four groups:I/R group (n =81 ),I/R +CART group (n =81),sham operation group (n=63),and sham operation+CART group (n=63)according to the random number table method. A model of middle cerebral artery occlusion (MCAO)for 2 h and reperfusion was induced. Before reperfusion,the mice of the I/R+CART group were injected CART via tail vein (0. 5μg, 200μl)and the those of the sham operation+CART group were injected equal CART;repeated administration once every 24 hours. 2,3,5-Triphenyl tetrazolium chloride assay was used to detect cerebral infarction volume of the I/R group and the I/R+CART group at different time points (24 h,72 h,and day 7 )after achieving reperfusion. The transmission electron microscope was used to observe the ultrastructural changes of synapses at different time points,and the synaptic morphological parameters were analyzed quantitatively. Western blot was used to observe the expression level of postsynaptic density 95 (PSD-95)proteins in the surrounding area of cortical infarct at 72 h after reperfusion. Results (1 )Compared with the sham operation group,the number of synapses was significantly decreased in the cortical slices in the I/R group (3. 37 ± 0. 38μm2 vs. 7. 04 ± 0. 55μm2 ,2. 89 ± 0. 22μm2 vs. 6. 89 ± 0. 04μm2 ,3. 25 ± 0. 18μm2 vs. 6. 78 ± 0. 42μm2;all P<0. 05). The density of PSD was significantly decreased (24. 4 ± 2. 8 nm vs. 47. 3 ± 6. 1 nm,23. 8 ± 3. 7 nm vs. 46. 5 ± 7. 5 nm,24. 6 ± 2. 2 nm vs. 48. 1 ± 5. 1 nm;all P <0. 05). The width of synaptic cleft was increased (25. 2 ± 2. 1 nm vs. 21. 5 ± 1. 6 nm,25. 2 ± 1. 4 nm vs. 21. 3 ± 1. 0 nm,23. 7 ± 2. 6 nm vs. 21. 6 ± 1. 6 nm;all P<0. 05). The expression level of PSD-95 protein was decreased at 72 h after reperfusion (P<0. 05). (2)Compared with the I/R group,the infarction volume of the I/R+CART group was significantly reduced at 24 h,72 h,and day 7 after reperfusion (29. 0 ± 1. 9% vs. 36. 3 ± 1. 4%,38. 1 ± 1. 4% vs. 47. 6 ± 2. 7%,and 36. 0 ± 2. 8% vs. 42. 5 ± 2. 0%,respectively;all P<0. 05). The number of synapses was significantly increased (4. 32 ± 0. 35 μm2 )and the expression level of PSD-95 protein was increased at 72 h after reperfusion (P<0. 05). The PSD density (33. 8 ± 3. 4,34. 2 ± 4. 6,38. 2 ± 4. 0 nm)was thickened at 24 h,72 h,and day 7 after reperfusion (all P <0. 05),and there were no significant differences in the width of synaptic cleft at each time point(allP>0.05).Conclusion CART can reduce cerebral infarct volume of I/R in mice and improve synaptic plasticity of cortical neurons in mice after ischemic injury.

Objective To explore the change of activin A(ACT A) in umbilical artery blood of newborns with fetal distress and its clinical significance.Methods Forty healthy pregnant women(control group)and 35 pregnant women with fetal distress (experimental group)were collected.The levels of ACT A of umbilical artery blood in both groups were determined by a solid quantitative biotin-avidin system enzyme-linked immunosorbent assay(BAS-ELISA),umbilical artery blood gas were also measured.Results The level of ACT A of umbilical artery blood in fetal distress group was (1 235.89?178.78)ng/L,and that in control group was (627.28?75.24)ng/L,and the level of ACT A of umbilical artery blood in fetal distress group was significantly higher than that in control group(P