Objective To investigate the treatment of pronation external rotation ankle injuries and to evaluate its outcomes. Methods 58 cases of severe ankle injuries of pronation external rotation type who had been hospitalized between October, 2001 and October, 2003 were retrospectively analyzed. They were 42 males and 16 females, with an average age of 32.4 years old (16 to 61 years old). According to Lauge Hansen classification, 39 cases were grouped as grade Ⅲ, while other 19 cases as grade Ⅳ. Most cases were surgically managed, and routine examinations were done. Results The average follow up period was 16.4 months (from 10 to 36 months). The satisfactory outcome was 89.7%. 2 cases of osteoarthritis were observed. Conclusions In treatment of pronation external rotation ankle injuries, the key points are to correct the fibular shortening and external rotation and to take great care of technical details.

there are abundant products and fierce competitions in the market of skin-care products,which on the one hand provide customers with multiple choices,but on the other hand also make it difficult for customers to choose proper products.Under this circumstance,it is quite possible to create a new career of skin-care-consultant,which serves as a communication bridge between customers and skin-care products.This paper aims to clarify the ethical significance of the new-rising career of skin-care-product consultant.

With the wide application of Chinese herbal medicine, herb-drug interaction (HDI) has become increasingly prominent. Metabolic enzymes and transporters are the main targets of HDI, because the changes in expression and function of enzymes and transporters can influence the disposition of drugs. Metabolic enzymes are responsible for the metabolic clearance of drugs, including cytochrome P450 (CYP), UDP-glucuronyl transferase (UGT) and sulfotransferases (SULT); transporters widely expressed in the intestine, kidney, liver and brain are involved in the oral absorption, distribution and excretion of drugs. Pueraria, ginkgo, ginseng, St. John's wort and other Chinese herbal medicine often induce a HDI because those herbal medicines combined with chemical medicine are widely used in clinic. The components of herb medicines mentioned above are prone to interact with enzymes and transporters, which often induce a HDI. This paper reviews the advances in the study of enzymes and transporters-mediated pharmacokinetic mechanism of HDI.
Biological Products ; Biological Transport ; Cytochrome P-450 Enzyme System ; physiology ; Drugs, Chinese Herbal ; Ginkgo biloba ; Glucuronosyltransferase ; physiology ; Herb-Drug Interactions ; Humans ; Membrane Transport Proteins ; physiology ; Oxidation-Reduction ; Panax ; Plants, Medicinal ; Pueraria

Objective To investigate the effects of Qiliqiangxin capsule on serum concentration of adiponectin (APN) and heart function in patients with uremia combined with heart failure. Methods Uremia patients combined with heart failure were randomly divided into treatment group and control group , both of which were given anti-failure routine therapy. The patients in treatment group were treated with Qiliqiangxin capsule for 8 weeks and those in control group with placebo. The New York Heart Association (NYHA) heart function classi-fication, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction(LVEF), and the levels of APN were observed before and after treatment. Results The level of APN in uremic patients combined with heart failure was significantly higher than that in normal subjects. With the increase in the class of NYHA heart function, the serum concentrations of APN increased, but the difference was not significant(P > 0.05). After 8 weeks′ treatment, the effective rate in treatment group was higher than that in control group (P < 0.05). LVEDD and LVESD in both groups decreased significantly. LVEF in both groups increased, but serum concentration of APN decreased significantly. More obvious effects were observed in treatment group (P < 0.05). Conclution Qiliqiangxin capsule could significantly reduce the level of APN and improve heart function in patients with uremia combined with heart failure.

Objective To evaluate the expression of Gadd45α and p38 MAPK in placentas and the correlations of Gadd45α protein and serum soluble vascular endothelial growth factor receptor-1 (sFlt-1) and soluble endoglin (sEng) in preeclampsia(PE). Methods Fifty-four pregnant women who delivered from September 2009 to March 2010 in the First Affiliated Hospital of Chongqing Medical University were chosen as the subjects. They were classified into mild preeclampsia group (n=20),severe preeclampsia group (n=16) and the control group (normal pregnant women underwent elective cesarean sections at term without labor and perinatal complications, n=18). Western blot and immunohistochemistry were employed to determine the expression and localization of Gadd45α and p-p38 MAPK protein respectively. Gadd45α mRNA level was determined by quantitative real-time PCR. The levels of seum sFlt-1 and sEng were measured by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA and LSD-t test were applied for statistical analysis. Results (1)Immunohistochemistry identified that the positive stained cells were mostly located in trophoblast cells in normotensive placentas, whereas in preeclamptic placentas Gadd45α protein and p-p38 MAPK protein were detected in trophoblast and endothelial cells, as well as a few stromal cells at increased levels.(2)The mRNA levels of Gadd45α was significantly elevated in mild and severe preeclampsia groups compared to the control group (2.10±0.11 and 3.33±0.13 vs 1.01±0.18, P＜0.05), and Gadd45α mRNA level in severe group was significantly higher than in mild group (P＜0.05).(3)The data of Western blot revealed that the Gadd45α protein levels in each group were 0.22±0.11, 0.65±0.15 and 1.34±0.17, respectively, with significant differences between each group(P＜0.05). The p-p38 MAPK protein levels in each group were 0.32±0.08, 0.72±0.12 and 1.45±0.21, respectively, with significant differences between each group (P＜0.05). p38 MAPK protein levels in the total groups showed no difference(P＞0.05).(4)Compared with the control group, sFlt-1 and sEng concentrations in maternal circulation were significantly increasing in mild and severe preeclampsia groups, and concentrations in severe group were significantly higher than those in mild group (P＜0.05).(5) There were positive correlations between Gadd45α protein levels and the concentrations of serum sFlt-1 and sEng in each group( r=0.88 and 0.87, respectively all P＜0.05). Conclusions Upregulation of Gadd45α in preeclampsia placentas may play an important role in the pathogenesis of preeclampsia. It may induce the increased maternal serum levels of sFlt-l and sEng by activating p38 MAPK signaling pathway, leading to deficient cytotrophoblastic invasion and abnormal placental vascular reconstruction during pregnancy.

Objective T o observe the therapeutic effect of Radix Astragali Injectio on psoriasis and it s possible pharmaceutical mechanism. Methods Two groups of patients with psoriasis vulgaris were treated with either comprehensive regi men or comprehensive regimen plus Radix Astragali Injectio. The clinical respons es in both groups were compared. Meanwhile, the effects of Radix Astragali Decoc tion and Injectio on proliferation of vaginal epithelium, PCNA expression, diffe rentiation of tail scale epidermis and plasma ET－1 were assessed in mouse mode l. Results It was shown that psoriatic lesions began to fade significantly earli er in Radix Astragali group than in routine comprehensive treatment group. The c linical cure rate was significantly higher in Radix Astragali group also. Animal experiment indicated that Radix Astragali Injectio had effects on all 4 indices mentioned above and the effects of the Injectio was stronger than that of the D ecoction. Conclusions Radix Astragali Injectio is effective for psoriasis vulgar is. Its therapeutic effects may be explained by blocking multiple pathogenetic l inkage.

Objective To evaluate the expression and location of the growth arrest and DNA damage 45 alpha(Gadd45α)gene in human placenta and explore the relationship between Gadd45α and preeclampsia(PE).Methods Thirty-six women with preeclampsia who delivered from September 2009 to March 2010 in the First Affiliated Hospital of Chongqing Medical University were chosen as the study objects.They were classified into mild group( n = 20), severe group( n = 16) and elective term cesarean sections group without previous onset of labor and perinatal complications ( control group, n = 18 ).Placentas were collected after they delivered and immunohistochemical streptravidin-biotin peroxidase(SP) method and histoscore were employed to detect the expression and localization of Gadd45α protein.Gadd45α mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR) technique and western blot analysis was used to quantify Gadd45α protein expression level.Results (1)Gadd45α protein was detectable in placenta tissues of the mild and severe groups, mostly located in cytoplasm and nuclei of trophoblast, plus nuclei of vascular endothelial cells and a few stromal cells; whereas placenta tissues of control group showed weak staining, and only detectable in trophoblast, undetectable in vascular endothelial cells.(2)The Gadd45α mRNA levels in placenta tissues of the severe and mild groups were 0.75 ±0.07 and 0.44±0.13, respectively, significantly higher than that in control group (0.18 ±0.04, P ＜0.05);compared with mild group, Gadd45α mRNA level was significantly higher in severe group( P ＜ 0.05 ).(3)The Gadd45α protein levels in placenta tissues of the severe and mild groups was 1.34 ±0.17 and 0.65 ±0.15, respectively, compared with mild group, Gadd45α protein level was higher in severe group (P ＜0.05); they were both significantly higher than that in control group ( 0.22 ± 0.11, P ＜ 0.05 ).Conclusions Gadd45α mRNA and protein levels in placenta tissues of patients with preeclampsia are higher than that of normotensive women, and up-regulated with aggravation of preeclampsia; the Gadd45α protein is located in trophoblast cells, which are closely related to pathogenesis of preeclampsia.These results indicate that Gadd45α plays an important role in the pathogenesis and progression of preeclampsia.

Objective To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). Methods A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled. Thirty-six healthy cases were enrolled as control during the same time. The levels of serum complement C3, C4 and C5b-9 on 1, 3 and 7 days after admission and myocardial function indicators were analyzed. Major adverse cardiovascular events (MACE) and readmission rate were analyzed after 1 year follow-up. The correlation between serum complement levels and myocardial function indicators was analyzed by Pearson correlation analysis. Results ① The levels of serum C3, C4 and C5b-9 on the first day in NSTE-ACS group and STEMI group were significantly higher than control group [C3 (g/L): 1.04±0.33, 1.26±0.35 vs. 0.39±0.21, C4 (g/L): 0.31±0.14, 0.33±0.10 vs. 0.19±0.07, C5b-9 (g/L): 575.46±197.26, 659.26±160.77 vs. 501.40±141.51, all P < 0.05]. There were no changes of serum C3, C4 in NSTE-ACS group, but C5b-9 decreased after a peak (g/L: 700.63±218.42) at 3 days. Serum complements in STEMI group reached peak on the third day [C3 (g/L): 1.37±0.33, C4 (g/L): 0.42±0.12, C5b-9 (g/L): 754.72±136.22]. The levels of serum C4 and C5b-9 in STEMI group were higher than NSTE-ACS group on the third and seventh day. ② The levels of troponin T (TnT), creatine kinase-MB (CK-MB), solution intercellular adhesion molecule-1 (sICAM-1), global registry of acute coronary events (GRACE) scores and percutaneous coronary intervention (PCI) numbers in STEMI group were significantly higher than those in the NSTE-ACS group, which were as opposite as left ventricular ejection fraction (LVEF). However, there were no significant differences in levels of serum N-terminal pro-brain nitric peptide (NT-proBNP), Fibrinogen (Fib), readmission rate and incidence of MACE between STEMI and NSTE-ACS groups. ③ According to GRACE, patients with ACS were divided into low risk group (≤ 108 scores, 26 cases), intermediate risk group (109-140 scores, 61 cases) and highest group (> 140 scores, 83 cases). TnT and sICAM-1 in intermediate risk group were significantly increased as compared with low risk group. Levels of TnT, sICAM-1, C3, C4 and C5b-9 in the highest group were significantly higher than the low and intermediate risk groups, however the lowest LVEF was found in the highest group. ④ It was shown by Pearson correlation analyses that levels of serum C3, C4, C5b-9 were positively correlated with TnT (r value was 0.481, 0.367, 0.292, respectively, all P <0.01), sICAM-1 (r value was 0.298, 0.249, 0.365, respectively, all P < 0.01), but negatively correlated with LVEF (r value was -0.384, -0.260, -0.200, respectively, all P < 0.01). In addition sICAM-1 positively correlated with TnT (r = 0.536, P = 0.000), but negatively correlated with LVEF (r = -0.341, P = 0.001). Conclusions Serum complements activation was found in the acute phase of ACS patients. Serum complement C3, C4 and C5b-9 are involved in the process of myocardial injury, and may reflect severity of myocardial injury and cardiac dysfunction.

Objective:To express and purify recombinant human collagen type Ⅲ and evaluate its properties.Methods:The recombinant genetic engineering strain pET30a(+)-1880/pACYCDuet-hy726/bL21(DE3) was constructed to stably co-express recombinant human type Ⅲ collagen (rhCol) and prolyl hydroxylase. rhCol was prepared and purified by E. coli high-density fermentation, salting out and column chromatography protein purification technology. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was used to determine the purity of rhCol. The N-terminal amino acid sequences of rhCol were determined by automatic protein polypeptide sequencing instrument. The hydroxyproline content of rhCol was determined by ultraviolet spectrophotometry. The cellular compatibility of rhCol was evaluated by MTT assay. Results:The final wet weight of high-density fermentation was about 200 g/L. The expression level was about 3 g/L. The purity of rhCol by affinity chromatography was over 95%. The results showed that the hydroxyproline content of rhCol was 11.44%, and the rhCol products have good water solubility and cell compatibility.Conclusions:RhCol can be widely applied to the field of skin care and biomedicine as an excellent biological material.

Objective To analyze the expression of C-reactive protein(CRP)in 2-12-year-old children with acute otitis media(AOM),we can use CRP as a strong evidence for the usage of antibiotics in the diagnosis and treatment of otitis media.Methods 250 children with AOM were selected as the research subjects.52 cases refused to test,CRP was detected in 198 children(231 ears).CRP was examined in all patients before treatment,they were followed up for 1 month.After treatment,CRP was reviewed in three days,one week and one month,respectively.Results In 198 children(231 ears),71 ears were recovered,33 ears improved,and 127 ears were ineffective in three days,the effective rate was 45.0%(104/231).100 ears were recovered,45 ears improved,and 86 ears were ineffective in one week,the effective rate was 62.8%(145/231).121 ears were recovered,56 ears improved,and 54 ears were ineffective in one month,the effective rate was 76.6%(177/231).The effective rate were significantly different among the three groops(x2=14.643、48.406,10.494,all P<0.05).Among 198 children,188 ears were in the low expression group,43 ears were in the high expression group.After three days of treatment,the composition ratio of group B and group C was changed(x2 =5.979,P=0.014),while group A had a significant change(x2 =13.948,P=0.000).Therefore,early use of antibiotics was effective in reducing CRP,so as to reduce the clinical symptoms in children.Conclusion CRP can be used to guide antibiotic monitoring.