Objective To compare the efficacy and safety of nicardipine versus urapidil in blood pressure (BP) management during the acute phase of intracerebral hemorrhage (ICH).Methods ICH patients admitted in Emergency Intensive Care Unit of Shenzhen People's Hospital from March,2013 through March,2016 were retrospectively studied.Patients were enrolled as nicardipine group or urapidil group depending on the initial antihypertensive drug given at admission.The differences in rate of patients reached the goal BP within the first 24 h,time required for getting goal BP,blood pressure variability (BPV),rebleeding or hematoma expansion during the first 24 h,cerebral state index (CSI) within 7 days and 28-day mortality were compared between the two groups.The differences in adverse events including bradycardia,tachycardia and hypotension were also compared between two groups.An independent t test and x2 test were performed to compare different variables.An analysis of variance of repeated measurement was performed to compare CSI within 7 days between two groups.Results Seventy-seven patients were included with 42 in nicardipine group and 55 in urapidil group.Rate of patients getting goal BP in nicardipine group was (94±5)％ and (86±11)％ in urapidil group (P＜0.01).Time required to get goal BP was (35 ± 28) min in nicardipine group and (52 ± 37) min in urapidil group (P =0.02).BPV was (11.23 ± 2.38) in nicardipine group and (13.16 ± 3.15) in urapidil group (P =0.003).Rebleeding or hematoma expansion rate during the first 24 h and 28-day mortality rate were comparable between the two groups (P ＞ 0.05).Through analysis of variance of repeated measurement,CSI in nicardipine group improves more rapidly than that in urapidil group (F =1 581.115,P =0.000).Hypotension,bradycardia and tachycardia were also comparable between groups (P ＞ 0.05).Conclusion Compared with urapidil,nicardipine produces effect more rapidly with more stable BP and higher rate of patients with ICH getting goal BP.Moreover,the application of nicardipine may be better to improve the CSI of ICH patients.

A rare strain of actinomycetes, with broad-spectrum antimicrobial activity, was isolated from the soil samples from the farmland in the area of Yaohu lake in Nanchang. The information about the taxonomic identification, such as the morphology, physiological properties, cell components and 16S rRNA gene se-quences, suggested that the rare strain of actinomycetes was identified as Micromonospora carbonacea.

Based on the strain of Micromonospora carbonacea JXNU-1 with board-spectrum antimicrobial activity, the technology for the isolation and purification of antibiotic from the fermentation broth of the Micromonospora carbonacea, and its physical-chemical properties were studied. The results showed that, the antibiotic was stable under the condition of high temperature and alkali, but not in acid solution. After the pretreatment of centrifugation and filtration to remove the cells and lipids, the antibiotic was absorbed to negative exchange resin, and the impurity was excluded when 2 mol/L NaCl was used as primary eluent. The antibiotic could be eluted with 20% alcohol as eluent, and the eluting speed of the antibiotic was greatly accelerated as 2 mol/L NaCl was added into 20% alcohol as final eluent. Aqueous solution of the antibiotic was yielded from the alcohol-salt eluant by decompression concentration to wipe off alcohol and by dialysis to exclude salt. One active component was detected in antibiotic solution by paper chromatography, and theHPLC purity was over 99%. As the antibiotic shows positive color-forming reaction to Molish reagents, Benedict’s reagents and Diohenvlamine reagents, combined with the characteristics of absorption spectra, it is deduced that the antibiotic belongs to nucleoside antibiotics.

OBJECTIVETo evaluate the efficacy and safety of Xinmailong Injection (XI) in treatment of chronic heart failure (CHF) patients with qi-yang deficiency and blood stasis resistance syndrome (QY-DBSRS).

METHODSTotally 238 CHF patients with QYDBSRS were assigned to the treatment group (118 cases) and the control group (120 cases) by randomized, double-blind, placebo parallel controlled method. Patients in the treatment group received routine therapy and XI (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days), while those in the control group received routine therapy and XI mimetic agent (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days). The heart function classification of New York Heart Association (NYHA), 6-min walking distance, left ventricular ejection fraction (LVEF), scores for Chinese medical symptoms were observed before and after treatment, and safety assessed.

RESULTSTotally 235 patients actually entered full analysis set (FAS), including 120 cases in the control group and 115 cases in the treatment group. The total effective rate of heart function, 6-min walking distance and increased post-pre-treatment distance in the experimental group were superior to those of the control group with statistical difference (all P < 0.05). Compared with the control group, increased value of post-pre-treatment LVEF, the total effective rate of Chinese medical syndrome efficacy, scores for Chinese medical symptoms and decreased post-pre-treatment value of Chinese medical syndrome scores were obviously improved (all P < 0.05). There was no significant difference in the incidence of adverse events between the two groups (P > 0.05).

CONCLUSIONSXI could improve the heart function of CHF patients, improve Chinese medical symptoms, elevate exercise tolerance, and improve LVEF. It had no obvious toxic and side effects.

Chronic Disease ; Double-Blind Method ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Heart Failure ; drug therapy ; Humans ; Injections ; Medicine, Chinese Traditional ; Phytotherapy ; Qi ; Syndrome ; Yang Deficiency

OBJECTIVETo study the protective effect of carbon monoxide (CO) inhalation on the serious limb ischemia/reperfusion (I/R) injury, and which effects caused to shock in rats.

METHODS36 SD rats were randomly divided into I/R, I/R + CO (RC), sham operation (S) groups. I/R injury models were made by the occlusion of the femoral artery for 8 h and the reperfusion for 12 h, 10 d. Before reperfusion of 2 h, RC group started to breathe medical air containing CO (the volume fraction of CO: 0.075%) continuously, until after reperfusion for 4 h, a total of inhalation 6 h. S, I/R groups exposed to air, breathe freely. Caudal artery pressures (CAP), ten days survival rate, serum lactate dehydrogenase (LDH) and creatine kinase (CK) activity, limb wet - to - dry weight ratio (W/D) and the pathologic changes of limb were observed.

RESULTSOnce the reperfusion started, the CAP decreased rapidly in I/R group, and the mean reduced to(5.3259 +/- 0.3832) kPa when reperfusion for 8 h. Compared to I/R group, the CAP decreased slower and smaller in RC group, moreover, its mean reduced to (8.3300 +/- 0.4224) kPa when reperfusion for 8 h. The 10 d survival rate in I/R group was that 8 rats died all between reperfusion for 13 - 20 h. Only 1 rat died in RC group and the other 7 rats were still alive when reperfusion for 10 d. Compared to I/R group, the pathological features of the ischemic limb were significant ly improved, and the figures of W/D, serum LDH and CK value were remarkable lower in RC group (P < 0.05).

CONCLUSIONInhaling exogenous low-dose CO has a reverse regulation in the blood pressure decline caused by serious limb I/R injury in rats. And at the same time, it can effectively prevent the occurrence of shock, reduce physical damage, significantly increase the survival rate of animals.

Administration, Inhalation ; Animals ; Carbon Monoxide ; administration & dosage ; pharmacology ; Creatine Kinase ; blood ; Extremities ; blood supply ; L-Lactate Dehydrogenase ; blood ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology ; prevention & control ; Shock ; etiology ; prevention & control

Objective: To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity. Methods:A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table, with 28 cases in each group. The tuina group was treated mainly with tuina at the head and abdomen, while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang(Pinellia, Atractylodes Macrocephala and GastrodiaDecoction). The course of treatment was 30 d. The scores of headache index, traditional Chinese medicine syndrome scale, and the therapeutic efficacy were observed. Results:There were 2 dropouts in each group during treatment. The total effective rate was 92.3％ in the tuina group, significantly higher than 76.9％ in the Chinese medicine group (P<0.05). The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment (bothP<0.05), and scores in the tuina group were lower than those in the Chinese medicine group (bothP<0.05). Conclusion:Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity, and has a better effect than Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and GastrodiaDecoction).

AIMTo develop a pharmacokinetic model for the enterohepatic circulation of mycophenolic acid (MPA).

METHODSTwenty healthy volunteers were orally given a single dose of 500 mg mycophenolate mofetil. Plasma samples were collected during 48 hours and MPA concentration was measured by HPLC method. Pharmacokinetic (PK) model was established based on physiological and biopharmaceutical consideration and PK parameters were obtained using nonlinear mixed effect model.

RESULTSThe proposed model included an intestinal compartment and gall bladder compartment in addition to the central compartment. The predicted time-concentration curve and AUC0-t, Cmax, Tmax estimated by the established model were in agreement with the observations.

CONCLUSIONThe established model was well defined for the MPA disposition and could afford a useful approach for the further clinical investigation.

Adult ; Area Under Curve ; Enterohepatic Circulation ; physiology ; Glucuronides ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; pharmacokinetics ; Male ; Models, Biological ; Mycophenolic Acid ; administration & dosage ; analogs & derivatives ; blood ; pharmacokinetics

Objective To observe nerve conduction blocking effects of magnetic curve cutting. Methods Twenty-four male SD rats were randomly assigned to 2 groups: experiment group and control group. In the former, rats were anesthetized and hung over a alum plate in which 20 pieces of magnet were embedded. The alum plate was rotated so as to the lumbar spine of the rat could cut magnetic curve passively at a speed of 60 m/s. The control group received the same treatment except that the magnets had no magnetism. The right paw of rat was clamped with a 100 g force for 1 s, and the withdrawal reflex was observed. Results During magnetic curves cutting, the paw withdrawal reflex disappeared in 91.67% rats of experimental group, whereas it existed in all rats of control group. The difference was statistically significan (P＜0.05). Withdrawal reflex was recovered in 83.33% of rats in experimental group as soon as the cutting stopped, and the control group still remained the reflex; there was no significant difference between the 2 groups (P＞0.05). The rats whose reflex failed to recover at first in experimental group, rcovered 5 minutes later. Conclusions When the lumbar spine of a rat cuts magnetic curve passively, the hindlimb withdrawal reflex will be blocked.

ObjectiveTo detect the concentration and distribution of fluoride ions in osteoblasts exposed to fluoride in vitro culture,and to provide basic information for studying the effect of fluoride on osteoblast injury.MethodsIn vitro cultured osteoblasts were exposed to 0,5,10,20,40 mg/L fluoride for 3,10,30 d (n =6),respectively.Concentration and distribution of fluoride ions in the cytoplasm and the nucleus of these osteoblasts were determined by nuclear magnetic resonance spectroscopy.Results(①) After cultured for 3 d,fluoride ion content of the bone cytoplasm exposed to different concentrations of fluoride 0,5,10,20,40 mg/L were (0.83 ±0.65),(0.54 ± 0.23),(0.65 ± 0.77),(0.59 ± 0.87),(3.64 ± 1.21 )mg/L,respectively,and the values of exposed to 40 mg/L fluoride group was significantly higher than that of exposed to 0,5 mg/L groups (all P ＜ 0.05).(②)after cultured for 10 d,the composition of the fluoride ion in cytoplasm of exposed to fluoride 10,20,40 mg/L groups were (4.03 ± 1.23),(3.66 ± 0.98),(6.26 ± 2.10)mg/L,respectively,which were higher than that of exposed to 0,5 mg/L groups [(0.78 ± 0.75),(2.69 ± 0.89)mg/L,respectively,all P ＜ 0.05].Of fluoride 20,40 mg/L groups,the composition of the fluoride ion in nucleus were (1.63 ± 1.19),(2.17 ± 1.21 )mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.65 ± 0.46),(1.57 ± 0.33) mg/L,all P ＜ 0.05].(③)After cultured for 30 d,of the exposed to fluoride 10,20,40 mg/L groups,the composition of the fluoride ion in cytoplasm were (3.99 ± 0.84),(4.33 ± 1.67),(5.80 ± 1.38)mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.88 ± 0.44),(2.84 ± 0.43)mg/L,all P ＜ 0.05].The composition of the fluoride ion in nucleus of the fluoride 20,40 mg/Lgroups were (3.33 ± 1.46),(3.53 ± 1.22)mg/L,respectively,which were significantly higher than that of 0,5mg/L groups [(0.70 ± 0.66),(1.99 ± 0.76)mg/L,all P ＜ 0.05].ConclusionsWhen osteoblasts are exposed to fluoride environment,fluoride ions enter into the osteoblasts quickly,and quickly accumulate in the nucleus,showing a special affinity between fluoride and bone tissue.Intracellular fluoride ions increase with the increase of contact time and exposure dose.

OBJECTIVEReview and discuss anesthesia and operative approach of resection of the trachea for different tracheal diseases, especially for the resection of long-segment of trachea. At the same time to introduce the method of reconstruction of long-segment of trachea with Zhao's (two-stage procedure with memory-alloy mesh) artificial trachea.

METHODSRetrospective study of 18 cases of tracheal resection, analysis of the relation between the choice of anesthetic and operative approach.

RESULTSGeneral anesthesia through cut open the trachea with local anesthesia in 2 cases, general anesthesia through previous tracheotomy in 2 cases, extracorporeal circulation in 2 cases, general anesthesia through endotracheal tube in 12 cases. There were no anesthetic or operative death. Local resection in 3 cases, segmental resection in 15 cases. The longest segmental resection was 8.0 cm. Primary anastomosis after segmental resection in 8 cases, Reconstruction with Zhao's artificial trachea in 7 cases. Postoperative follow-up was 5 months to 8 years. Four cases died from systemic metastasis or other reasons at 4, 11 and 12 months, respectively.

CONCLUSIONSDifferent methods of anesthetic and operative procedures should be used for different patients. Extracorporeal circulation used for patient with highest dangerous condition, or, for which could be inserted endotracheal tube by tracheotomy with local anesthesia. Conservative local resection performed only for patients with very bad general condition. Segmental resection less than 5 cm long could be reconstructed with primary reanastomosis. Resection longer than 5.5 cm could be reconstructed with Zhao's artificial trachea.

Adolescent ; Adult ; Aged ; Anesthesia, General ; methods ; Anesthesia, Local ; Artificial Organs ; Extracorporeal Circulation ; Female ; Humans ; Intubation, Intratracheal ; Male ; Middle Aged ; Prosthesis Implantation ; Retrospective Studies ; Thoracotomy ; Tracheal Diseases ; surgery ; Tracheotomy ; methods