OBJECTIVETo study pharmacokinetic effect of Aikeqing Granule (AG) by different medication ways on zidovudine (AZT) in highly active antiretroviral therapy ( HAART) of rats.

METHODSTotally 36 rats were administered with corresponding medications by gastrogavage, group I [HAART: AZT 31.5 mg/kg +3TC 31.5 mg/kg + Efavirenz (EFV) 63.0 mg/kg], group II (HAART+AG525 mg/kg), group III (HAART and AG 525 mg/kg after a 2-h interval). Drug concentrations of AZT were determined by high performance liquid chromatography-mass spectroscopy (HPLC-MS) before HAART, and at 0.5, 1, 2, 3, 4, 6, 8, 10, 12 h after HAART, respectively. Pharmacokinetic parameters [such as t1/2, Tmax, Cmax, AUCo-t, plasma clearance rate (CL)] were calculated by DAS2.0 Software.

RESULTSThe-equation of linear regression of AZT was good, with the precision, coefficient of recovery, and stability definitely confirmed. AUC in group II and III was larger than that of group I. There was no statistical difference in t1/2, Tmax, Cmax, AUC0-12 h, or AUC0-∞ among groups (P > 0.05).

CONCLUSIONAG combined HAART could enhance the Cmax of AZT.

Animals ; Antiretroviral Therapy, Highly Active ; Benzoxazines ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; Mass Spectrometry ; Rats ; Zidovudine ; pharmacokinetics ; pharmacology

The epitope-G1 gene of Bovine ephemeral fever virus (BEFV) glycoprotein was synthesised by PCR and cloned into expression vector pPIC9K to construct recombinant plasmid pPIC9K-G1. Then the pPIC9K-G1 was linearized and transformed into Pichia pastoris GS 115. The recombinant P. pastoris strains were selected by a G418 transformation screen and confirmed by PCR. After being induced with methanol, an expressed protein with 26 kDa molecular weight was obtained, which was much bigger than the predicted size (15.54 kDa). Deglycosylation analysis indicated the recombinant G1 was glycosylated. Western blot and ELISA tests, as well as rabbit immunization and specificity experiments indicated that the target protein had both higher reaction activity and higher immunocompetence and specificity. The recombinant G1 protein could be used as a coating antigen to develop an ELISA kit for bovine ephemeral fever diagnosis.

BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insufficiency (CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit (ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group (n=32) and a control group (n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone (150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers of inflammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically significant. RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4％. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI (23.8％ vs. 8.7％, P<0.01). Kaplan-Meier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group (P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group (18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers of infection and inflammation (P<0.01), such as C-reactive protein (13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α (26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin (3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group (P<0.01). CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers of infection and inflammation.

Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were analyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.

Xiaoyao pills are a famous traditional Chinese medicine collected in Welfare Pharmacy, which is a classic prescription for treating liver depression and spleen deficiency. However, its composition is complex. In order to better control the quality of Xiaoyao pills, in this study, HPLC-ion-trap time-of-flight mass spectrometry (LC-IT-TOF/MS) was used to identify the main ingredients of Xiaoyao pills, paeoniflorin, albiflorin, glycyrrhizic acid, saikosaponin A and saikosaponin B2. Then a liquid chromatography tandem mass spectrometry (LC-MS/MS) was developed for simultaneous determination and quantification of the main compounds. Fragmentation pathways of five active components were obtained. The method was validated. Five active ingredients in Xiaoyao pills had a good linear relationship, and the values of RSD (%) of repeatability were all less than 5%, the recovery ranges were between 90% and 115%, and the values of RSD (%) of each substance were less than 10% after the sample solution is placed for 24 hours. Three batches of Xiaoyao pills (concentrated pellets) and two batches of Xiaoyao pills (water pellets) were determined, the contents of paeoniflorin in concentrated pills were more than 4.0 mg·g^-1, and those in water pills were more than 2.5 mg·g^-1, which was accordance with Chinese Pharmacopoeia. However, other compounds behave differently. This method has high sensitivity and reliable measurement results, which provides basis for quality control of Xiaoyao pills and material basis for pharmacology research.

Objective To review the techniques used in biliary reconstruction for adult-adult living donor liver transplantation using a right lobe graft. Methods The clinical data of 21 pairs of donor and recipient who underwent right lobe living donor liver transplantation from April 2007 to May 2009 at Beijing Youan Hospital were analyzed retrospectively. Biliary anastomoses consisted of 10 single right hepatic duct to common hepatic duct anastomoses, 5 donor double branched ducts to recipient double branched ducts anastomoses, 5 single anastomoses between a donor double branched duct which had been converted to a single duct by ductoplasty to a single recipient bile duct, and 1 hepaticojejunostomy. A T-tube was inserted through the anterior wall of the common hepatic duct and splinted across the anastomosis in 2 recipients and a Y-tube was used in 1 recipient. Results 4 recipients died during the first post-transplant month. Another recipient received a retransplantation for acute liver necrosis. The remaining recipients were alive. The 1-year survival rate of the recipients was 77.65 %.5 patients developed biliary leakage and 2 patients developed biliary stricture. The 7 biliary complications were treated and cured by further surgical procedures. There was no significant difference in the biliary complications among the three different types of biliary anastomotic groups (x2 = 0. 659,P=0. 719). Conclusion The different types of biliary anastomoses can be used in living donor liver transplantation depending on the situations found in the donors and recipients. Continuous suturing on the posterior wall of the bile duct, interrupted suturing on the anterior wall and microsurgical techniques in biliary reconstruction are effective modalities to minimize biliary complications.

Objective To investigate the epidemiological and molecular virological characteristics in HBV-infected patients with copositive HBsAg and anti-HBs.Methods HBV serological markers were analyzed in 52 070 specimens.The epidemiological characteristics of HBsAg and anti-HBs simultaneously positive patients (the experimental group) and HBsAg positive and auti-HBs negative patients (the control group) were compared.The S protein of HBV coding region was amplified by semi-nested PCR and sequenced.The statistical differences between the two groups were compared in different gene regions,genotypes and different clinical diagnosis.Results HBsAg was positive in 20.40％ (10 621/52 070) of all specimens.In the patients with positive HBsAg,2.48％ (263/10 621) was positive anti-HBs.The prevalence of co-positive HBsAg and auti-HBs was higher in aged 0 to 9 years and greater than or equal to 80 years than that in other age,and the prevalence of positive HBsAg and negative anti-HBs was completely opposite.The mutation rate of S protein in the experimental group was significantly higher than that in the control group (1.52％ vs 0.81％,P ＜0.01) with the mutation in the major hydrophilic region (MHR) (1.68％ vs 0.57％,P ＜0.01).The mutation rates of S protein of HBV carriers,chronic hepatitis B (CHB) patients and patients with liver cirrhosis (LC) in the experimental group were significantly higher than those in the control group (1.47％ vs 0.65％,1.28％ vs 0.84％,2.21％ vs 0.44％,P ＜0.05,respectively),except for the patients with hepatocellular carcinoma (HCC) (1.97％ vs 2.21％,P ＞ 0.05).Conclusion Co-positive HBsAg and anti-HBs in HBV-infected patients was more common in HBsAg positive patients aged 0 to 9 years and greater than or equal to 80 years than the others.Coexistence of HBsAg and anti-HBs in HBV-infected patients may relate to immune escape caused by mutation of S protein (mainly MHR).The mutation rates of S protein in the two groups of patients,co-positive HBsAg and anti-HBs and the positive HBsAg combined with negative anti-HBs,were associated with the stage of liver disease.

Objective To investigate technical skills on outflow reconstruction in right lobe graft adult-adult living donor liver transplantation for avoiding of venous congestion. Methods The clinical data of 21 donors and recipients who underwent right lobe living donor liver transplantation were analyzed retrospectively. Donor's standard liver volume was between 1150. 1 and 1629. 8 cm3,graft weight was between 585 and 920 g, the ratio of graft volume to recipient's estimated standard liver volume (GV/ESLV) was between 43 % and 67 %, graft-recipient weight ratio (GRWR) was between 0. 82 % and 1.59 %, the ratio of remnant liver volume to donor's standard liver volume(RLV/SLV) was between 32 % and 55 %, all graft macrosteatosis was less than 10 %. For graftwith middle hepatic vein (MHV), a triangle large orifice was made by joining MHV to right hepatic vein (RHV), then anastomosed to recipient' s enlarged orifice of RHV. For graft without MHV, if tributary of MHV＞5 mm, autologous or allogenic blood vessel was used as interposition graft to connect to IVC, and if no large MHV tributary, graft RHV was anastomosed to IVC directly. Graft's right portal vein was anastomosed to main trunk of recipient's portal vein, graft's right hepatic artery to recipient's hepatic artery, and graft's right hepatic duct to recipient's right hepatic duct. Results Among the 21 right lobe grafts, 4 right lobe grafts had MHV, 17 right lobe grafts had no MHV.Autologous greater saphenous veins were adopted in 2 cases, cryopreserved iliac arteries were adopted in 5 cases, and RHV was anastomosed directly to IVC in 10 cases. Outflow was all patent in 7 cases having reconstruction of MHV tributaries one month after operation. One-year survival rate was 75 %, 85. 7 % and 70 % respectively in MHV group, MHV tributaries reconstructed group and RHV directly anastomosed to IVC group with the difference being not significance among these three groups (P＞0. 05). Biliary complications occurred in 7 cases during the follow-up period. One case developed small-for-size syndrome, which was cured by splenic artery embolization. No severe complication occurred in donors. All donors returned to normal life during a follow-up period of 6 to 31 months. Conclusion If outflow tract was reconstructed properly, right lobe graft without MHV has equivalent clinical outcomes to right lobe graft with MHV. Using of autologous or allogenic blood vessel as interposition vessel graft for right lobe graft without MHV is an effective modality to prevent hepatic congestion and secure functional graft volume to meet recipients metabolic demand.

Objective To establish the methods of three-dimensional eonformal(3DCRT) and intensity-modulated radiotherapy(IMRT) for whole pelvic irradiation in post-hysterectomy cervical carcinoma, And to optimize the methods for clinical practice. Methods Between 2004 and 2005,10 patients with cervical carcinoma who underwent hysterectomy with high risk of recurrence were selected for this study. The following observations and measurements were used for the study: Set-up errors with supine or prone position were measured to determine appropriate immobilization position. Influence of full and empty bladder on irradiated normal tissue volume was measured. Treatment errors were detected and CTV/PTV were then delineated. 3DCRT and IMRT planning and comparison were applied. Results The set-up error was within 5 mm of three dimensions in prone position and more than 5 mm in supine position, the difference of which was statistically significant. The percentage of irradiated volume of the bladder and bowel was smaller when the bladder was full comparing with empty bladder. In prone position and with full bladder,portal films showed the movement of isocenter in three directions. The total uncertainty was [7.4±1.6]mm. For 95% confidence interval,the margin from CTV to PTV was 1 cm. CIPTV for 3,4,5,and 6 fields 3DCRT was 0.46,O. 67, O. 68, and O. 68, respectively. When beyond 4 fields, the advantage of adding fields was not significant.Four fields planning was feasible for clinical practice. CI for 5,7,9,11 ,and 13 fidds IMRT was 0.75,0.83, 0.84,0.85 ,and 0.85 ,respectively. When beyond 9 fields,the advantage of adding fields was not significant. Nine fields planning was feasible for clinical practice. Conclusions For whole pelvic radiotherapy for post-hysterectomy cervical carcinoma,prone position was better than supine position for immobilization due to smaller set-up errors. The full bladder is recommended during radiotherapy, planning,For clinical practice,4 fields planning is feasible in 3DCRT while 9 fields planning is feasible in IMRT.

Objective To study the CT features of nasal bone foramen and nasal bone fracture,and investigate the differential key points of them.Methods visual observation was performed for 30 selected skull specimens of adults(60 nasal bones)(specimens group),then CT imaging was obtained for them with volume redering(VR)reconstruction(imaging group).The frequency of the nasal bone foramens,their size,shape and location were statistical analysed.Ferthermore,CT features of nasal bone foramen and nasal bone fracture were analyzed in 30 patients who were suspected having nasal bone fractures by clinicians.Results Forty foramen shape nasal bone foramens were found in observation group,while 37 were obtained in imaging group.For patients,19 cases were diagnosed as single fracture of nasal bone by non-spiral axial high-resolution CT images.When using both axial and multi-plane reformation(MPR)and VR images,8 of 19 cases were diagnosed as single fracture,5 were multiple fractures,4 were normal nasal bone foramen,and 2 were normal variation.The other 11 cases that were diagnosed as multiple fractures by non-spiral axial HRCT images were demonstrated as 6 cases multiple fractures and 5 single fracture by combining axial images with MPR and VR images.The frequencies of foramen shape nasal bone foramen in specimens group and imaging group were 66.7% and 61.7%,respectively,and there were no significant differences between them(χ2=1.33,P＞0.05).Conclusion The nasal bone foramen is the normal anatomy,and to recognize the imaging findings of it can improve the diagnostic accuracy of nasal bone fracture.