Curcumae Rhizoma comes from Curcuma genus,functional breaking blood stasis,detumescence and acesodyne for treatment of Zhengjia accumulation,amenorrhea,traumatic injury and bruising pain.Modem pharmacological studies have shown that the main monomer composition of zedoary turmeric has a good anti-inflammatory and anti-tumor effects.The main monomer composition of zedoary turmeric copies of curcumol,beta etemene,curcumin anti-inflammatory anti-tumor mechanism of review,provide the basis for the further research progress and clinical application of zedoary turmeric.

ObjectiveTo investigate the effect of vitamin D supplementation on the outcome of acute ischemic stroke in young patients with vitamin D deficiency.MethodsThe prospective controlled study was used to select the consecutive young patients with acute ischemic stroke.Vitamin D deficiency was defined as 25-hydroxyvitamin D (25(OH)D) ≤50 nmol/L.The Patients with vitamin D deficiency were randomly divided into an intervention group and a routine treatment group according to the random number table method.Routine treatment group didn't receive the drug intervention for vitamin D deficiency, and the intervention group received daily oral alfacalcidol 0.5 μg.After 1 year of treatment, the 25(OH)D levels were examined again;the adverse reactions during the drug treatment were monitored;the modified Rankin Scale (mRS) was used to evaluate the functional outcome and 0-2 was defined as good outcome.ResultsThere are 94 patients (53.41%) with vitamin D deficiency among 176 young patients with acute ischemic stroke.They were randomly divided into either an intervention group or a routine treatment group (n=47 in each group).At the end of the follow-up, the good outcome rate (82.98% vs.63.83%;χ2=4.414, P=0.036) and serum 25(OH)D level (85.83±10.53 nmol/L vs.39.10±11.18 nmol/L;t=20.860, P<0.001) in the intervention group were significantly higher than those in the routine treatment group.During the follow-up period, there was no loss to follow-up or death events in both groups.Only 2 cases of nausea and 1 case of dizziness were observed, and the incidence of adverse reaction was 6.38% in the intervention group.ConclusionsVitamin D supplement can increase the vitamin D levels and improve functional outcome in young patients with acute ischemic stroke and vitamin D deficiency.

Objective To analyze the efficacy of epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in young.Methods Two hundred and fifty-eight cases(age was 18-50 years old) with PC-BPPV were randomly divided into maneuver group(86 cases),betahistine group(86 cases) and vertigo calming group(86 cases).The maneuver group was treated by epley maneuver associated with placebo,2 pills per time,3 times daily for one month and follow up one month.The betahistine group and vertigo calming group were treated by epley maneuver with betahistine(12 mg/ time,Tid) or vertigo calming(2 piles/time,Tid),the same dose,period of treatment and follow-up as maneuver group.Results After one time treatment,199 cases were cured in 258 patients,including 68 cases in maneuver group,66 cases in betahistine group,65 cases in vertigo calming group,and the difference between groups was not statistically significant(x2 =0.308,P＞0.05).After treatments and followed up for one month,72 cases were cured,3 cases were effective,11 cases were invalid in maneuver group;74 cases were cured,3 cases were effective,9 cases were invalid in betahistine group;81 cases were cured,4 cases were effective,1 cases were invalid in vertigo calming group.Efficient of betahistine group,maneuver group and vertigo calming group were 89.5％,87.2％ and 98.8％,and the difference between maneuver group and betahistine group was not statistically significant(x2=58.65,P＞0.05),the difference of vertigo calming group between with other groups was statistically significant(P＜0.05).Conclusion The effects of vertigo calming in addition to Epley maneuver is significantly better than both Epley maneuver and Epley maneuver combined with betahistine in young PC-BPPV,while the effects of Epley maneuver combined with betahistine isn't better than Epley maneuver.

The coding sequence for the mature peptide of porcine lactoferrin (Plf) was synthesized according to the codon usage of lactobacillus, to establish optimized porcine lactoferrin Lactobacillus expression system. The gene was ligated into the Xho I/BamH I site of Lactobacillus expression vector pPG612.1 and the recombinant plasmid pPG612.1-plf was transformed individually into Lactobacillus casei ATCC393, Lactobacillus pentosus KLDS1.0413, Lactobacillus plantarum KLDS1.0344 or Lactobacillus paracasei KLDS1.0652 by electroporation. After induction with xylose, expression of the recombinant proteins was detected by Western blotting and confocal laser scanning microscopy. Secretion of recombinant Plf proteins from four recombinant species was determined quantitatively by ELISA. The antibacterial activities of recombinant proteins were measured by agar diffusion method. The result shows that Plf was correctly expressed in four species of recombinant lactobacillus, with molecular weight of about 73 kDa. The expression levels in recombinant Lactobacillus casei, Lactobacillus pentosus, Lactobacillus plantarum, Lactobacillus paracasei were 9.6 μg/mL, 10.8 μg/mL, 12.5 μg/mL and 9.9 μg/mL, respectively. Antimicrobial activity experiment shows that the recombinant proteins were active against E. coli, Staphylococcus aureus, Salmonella typhimurium, Listeria, Pasteurella. The recombinant Plf expressed by recombinant Lactobacillus plantarum showed the best antibacterial activity among all recombinant lactobacillus species. These data represent a basis for the development and application of porcine lactoferrin from recombinant lactobacillus.
Animals ; Anti-Bacterial Agents ; biosynthesis ; Lactobacillus ; metabolism ; Lactoferrin ; biosynthesis ; Recombinant Proteins ; biosynthesis ; Swine

Objective To investigate the predictive factors of outcome in young patients with mild acute ischemic stroke treated with intravenous thrombolysis. Methods Consecutive young patients with mild acute ischemic stroke ( age 18- 45 years ) treated with intravenous thrombolysis were enrol ed retrospectively. According to the modified Rankin Scale (mRS) score at day 90 after onset, they were divided into either a poor outcome group ( mRS ≥2 ) or a good outcome group ( mRS 0- 1 ). The demographic and baseline clinical characteristics were compared. Multivariate logistic regression analysis was used to identify the independent predictive factors of poor outcome in young patients with mild acute ischemic stroke treated with intravenous thrombolysis. Results A total of 57 young patients with acute mild ischemic stroke treated with intravenous thrombolysis were enrol ed, including 41 patients (71. 93%) had good outcome and 16 (28. 07%) had poor outcome. There were significant differences in the proportion of the patients with previous stroke or transient ischemic attack (TIA) (25. 00% vs. 4. 88%; P=0. 046), smoking (56. 25% vs. 19. 51%; P=0. 010 ), atrial fibril ation (31. 25% vs. 7. 32%; P=0. 032 ), diabetes (62. 50% vs. 21. 95%;χ2 =8. 515, P=0. 004), large artery atherosclerotic stroke (68. 75% vs. 21. 95%;χ2 =11. 067, P=0. 001 ), and receiving antiplatelet therapy before symptom onset (6. 25% vs. 34. 15%;P=0. 044) and the age (Z=2. 396, P=0. 020) between the poor outcome group and the good outcome group. Multivariate logistic regression analysis showed that the age (odds ratio [OR] 2. 64, 95% confidence interval [CI] 1. 28-5. 36;P=0. 038), history of previous stroke or TIA (OR 2. 25, 95% CI 1. 22-4. 31;P=0. 042), atrial fibril ation (OR 5. 12, 95% CI 1. 58-19. 23; P=0. 032), and large artery atherosclerotic stroke (OR 5. 89, 95% CI 1. 78-19. 92; P=0. 002) were the independent risk factors for poor outcome after mild acute ischemic stroke thrombolytic therapy. Conclusions Age, history of stroke or TIA, atrial fibril ation, and large artery atherosclerotic stroke were the predictive factors of poor outcome at day 90 in young patients with mild acute ischemic stroke treated with intravenous thrombolysis.

Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.

Objective To assess the association of synovial cyclic citrullinated peptide(CCP)expression with T helper 17(Th17) cells/Regulatory T cells (Treg) imbalance,the histological and clinical features of synovitis in rheumatoid arthritis (RA).Methods CCP expression in synovial specimens from 39 patients with RA and 35 controls was detected by immunohistochemistry assay(IH) using 6×His tagged anti-CCP single chain fragment V (ScFv) antibodies,which were generated by pHEN2 phagemid recombinant antibodies display system.The frequencies of Th17/Treg cells in the peripheral blood mononuclear cells (PBMCs) were determined by flow cytometry (FCM).Th17/Treg cells associated cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA).The histological scores and clinical features of synovitis were included in the study.Chi-square test and ANOVA were used for statistical analysis.Results ① The prevalences of synovial C CP expression were significantly different between RA group and the control(76.9％ and 11.4％ respectively,X2=31.9,P＜0.01).② The frequencies of Th17 cells,Th17/Treg ratio,Th17 cells associated cytokines as IL-6,IL-17a,IL-23,TNF-α,and the Treg cells associated cytokines TGF-31,the serum and synovial fluid anti-CCP antibodies in the RA patients with synovial CCP positive expression were significantly higher in RA patients with CCP positive than those with CCP negative.Disease activity score DAS28 index and histological features quantified variations of the synovial biopsy specimens (synoviocyte hyperplasia,focal aggregates of lymphocytes,and diffuse infiltrat(e)s of lymphocytes) in RA were higher in synovial CCP positive expression patients than in the negative.Conclusion Synovial CCP expression is strongly associated with the Th17/Treg imbalance and synovitis,which may play a crucial role in the pathogenesis of RA.

Objective To investigate the effect of Chinese rhubarb and ephedra prescription on the pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease (COPD) in remission stage. Methods One hundred and fifty-two patients with COPD were admitted to Harrison International Peace Hospital from March 2014 to December 2016, and they were divided into a western medicine control group (72 cases) and a rhubarb and ephedra prescription group (80 cases) by random number table method, the conventional therapy was given to both groups, and in the rhubarb and ephedra group, additionally Chinese rhubarb and ephedra prescription (rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g) was applied, one dose orally taken daily, once 1/2 dose, 2 times a day, the therapeutic course being 3 months. The blood gas analysis, pulmonary function, 6-minute walking distance (6MWD) were detected, and modify medical research committee (mMRC) questionnaire for dyspnea score, the change of ambulatory blood pressure level monitoring and clinical effect were observed before and after treatment for 1, 2, 3 months. Results Compared with those before treatment, the blood gas indexes, the arterial partial pressure of oxygen (PaO2), arterial blood oxygen saturation (SaO2), and pulmonary function indexes, the percentage of one second forced expiratory volume (FEV1) in predictive value (FEV1%), the ratio of FEV1/forced vital capacity (FEV1/FVC) and 6MWD levels in both groups were continuously increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were persistently decreased after treatment in the two groups. After treatment for 2 months, compared with before treatment, the statistical differences appeared in the western medicine control group, while in the rhubarb and ephedra group, the statistical differences turned up after 1 month of treatment. After 3 months of treatment,the PaO2, SaO2, FEV1%, FEV1/FVC and 6MWD in the rhubarb and ephedra group were significantly higher than those in the western medicine control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 95.42±14.88 vs. 88.28±13.38, SaO2:0.97±0.02 vs. 0.96±0.02, FEV1%: 77.35±11.57 vs. 72.63±10.66, FEV1/FVC (%): 71.01±9.47 vs. 69.28±10.04, 6MWD (m): 318.0±40.1 vs. 306.6±35.7], PaCO2and mMRC were obviously lower in the rhubarb and ephedra group than those in the western medicine control group [PaCO2(mmHg): 40.35±7.58 vs. 43.57±7.85, mMRC score: 1.09±0.65 vs. 1.23±0.69], the differences of the two groups were statistically significant (all P < 0.05). After 3 months of treatment, in the western medicine control group, the percentage of patients with abnormal blood pressure rhythm was reduced to 44.4% (32/72), while in the rhubarb and ephedra group, was decreased to 32.5% (26/72), and the decrease amplitude of the rhubarb and ephedra group was greater than that of the western medicine control group (P > 0.05). The ratio of blood pressure morning peak in the rhubarb and ephedra group was significantly lower than that in the western medicine control group [23.8% (19/80) vs. 31.9% (23/72), P < 0.05], and the total effective rate in rhubarb and ephedra group was significantly higher than that in the western medicine control group [92.5% (74/80) vs. 73.6% (53/72), P < 0.05]. Conclusion Chinese rhubarb and ephedra prescription can improve indexes of blood gas analysis, pulmonary function and blood pressure rhythm in COPD patients in remission phase, and its clinical efficacy is significant.

Objective To explore pathogenesis and influencing factors of poor outcome in patients with wake-up stroke.Methods In this prospective study,patients with acute ischemic stroke who were hospitalized in the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from October 2016 to December 2017 were continuously collected.All patients were divided into wake-up stroke group and non-wake-up stroke group according to the onset time.The clinical data of demographics,vascular risk factors,imaging examination,laboratory examination of the two groups were collected to identify the pathogenesis of wake-up stroke.Followed up to six months of onset,the patients were divided into poor outcome (modified Rankin Scale (mRS) score ＞2) and good outcome (mRS score 0-2) subgroups according to mRS score.Multivariate Logistic regression analysis was used to determine the influencing factors of poor outcome in patients with wake-up stroke.Results A total of 178 patients with acute ischemic stroke were enrolled in the study,including 42 patients (23.60％) in the wake-up stroke group and 136 patients (76.40％) in the non-wake-up stroke group.Followed up to six months of onset,11 patients lost,and 167 patients were followed up finally.There were 40 patients (23.95％) in the wake-up stroke group,including 17 patients (42.50％) with poor outcome and 23 patients (57.50％) with good outcome.There were 127 patients (45.64％) in the non-wake-up stroke group,including 32 patients (25.20％) with poor outcome and 95 patients (74.80％) with good outcome.The difference of poor outcome between the two groups was statistically significant (x2=4.393,P=0.036).Comparison of the demographic and baseline data of the wake-up stroke group and the non-wake-up stroke group showed that the differences between variables such as atrial fibrillation and double-dose hypertension were statistically significant.Univariate analysis showed that there were statistically significant differences in vascular risk factors,Trial of Org 10172 in Acute Stroke Treatment etiology,stroke severity,number of stroke lesions,treatment patterns,and number of cerebral microbleeds between the poor and good outcome subgroups.Multivariate Logistic regression analysis showed that the moderate to severe stroke (odds ratio (OR)=3.838,95％ confidence interval (Co 2.162-5.890,P=0.018),the number of lesions in cerebral microbleeds (OR=2.113,95％CI 1.291-2.868,P=0.049) were independent risk factors for poor outcome of wake-up stroke.Intravenous thrombolysis (OR=0.427,95％CI 0.242-0.615,P=0.036) was an independent protective factor for poor outcome of wake-up stroke.Conclusions The onset of wake-up stroke is closely related to atrial fibrillation and reverse scoop hypertension with higher incidence of poor outcome.Early adequate imaging screening and stroke severity assessment have important reference to guide clinical treatment and predict outcome.

Objective To investigate the correlation between post-stroke depression(PSD) and cerebral microbleeds(CMBs)in elderly patients with ischemic stroke.Methods In the prospective study,220 elderly patients with ischemic stroke were enrolled and followed up to one month after onset.Finally a total of 214 elderly patients performed a follow-up.According to DSM-Ⅳ Diagnostic and Statistical Manual of Mental Disorders,patients were divided into the PSD group and non-PSD group.The degree of depression was evaluated by17-item Hamilton Depression Scale(HAMD-17)score,and patients were divided into mild depression,moderate depression and severe depression group.The loci number,distribution and location of CMBs lesions were assessed by SWI.Patients were divided into brain lobe type,deep lobe type and mixed type according to the CMBs lesion location.The influence of CMBs or not,loci number and location of CMBs lesions on PSD were compared.Results A total of 214 elderly patients with ischemic stroke were enrolled,in whom 84(84/214,39.3％)had PSD with 29(34.5％)males and 55(65.5％)females.According to the HAMD scale,there were 51 patients (60.7 ％) with mild depression,25 (29.8 ％) with moderate depression,and 8 (9.5 ％) with severe depression.The prevalence rate of CMBs was 62.5 ％ (32/51) in mild depression group,71.0 ％ (22/25) in moderate depression group,81.8 ％ (6/8)in severe depression group and 45.4 ％ (49/108)in non PSD group(all P=0.008).The number of CMBs lesions were(4.5±1.2)in mild depression group,(7.8± 2.0)in moderate depression group,(12.6±2.7)in severe depression group and(1.8±0.5)in non-PSD group,with the statistically significant differences between groups (F =2.79,P =0.041).The proportions of CMBs lesions location(brain lobe type,deep lobe type and mixed type)were 40.6 ％ (13/32),34.4％(11/32) and 25.0％ (8/32) in mild depression group,36.4％(8/22),40.9％(9/22) and 22.7％(5/22) in moderate depression group,33.3％ (2/6),50.0％ (3/6) and 16.7％ (1/6) in severe depression group,40.8％ (20/49),12.2％ (6/49) and 46.9％ (23/49) in non-PSD group,respectively (Fisher exact test,P =0.043).The proportions of CMBs lesions distribution(left side,right side and double side)were 37.5％(12/32),43.8％(14/32) and 18.8％(6/32) in mild depression group,36.4％ (8/22),40.9％ (9/22) and 22.7％ (5/22) in moderate depression group,50.0％ (3/6),33.3％ (2/6)and 16.7％(1/6) in severe depression group,36.7％(18/49),40.8％(20/49) and 22.5％(11/49) in non-PSD group,and the difference was not statistically significant (Fisher exact test,P =0.998).Conclusions The prevalence rate of CMBs,number of CMBs lesions and deep lobe type of CMBs are closely related to the degree of post-stroke depression in the elderly.The distribution of CMBs lesions has no relevance with the degree of post stroke depression in the elderly.Elderly patients with ischemic stroke at high risk of post-stroke depression can be identified by evaluating CMBs for early intervention,which is worthy of promotion in clinical work.