Objective:To investigate efficacy of paroxetine in the treatment of diarrhea-predominant irritable bowel syndrome(D-IBS).Methods:In a self-controlled trial,45 patients with D-IBS symptoms according to the Rome Ⅱ criteria were treated with paroxetine 10mg Qd for 12 weeks.The efficacy measures included D-IBS gastroin- testinal symptoms,abnormal frequency or consistency of defecation,Hamilton Depression Scale(HAMD)and Hamil- ton Anxiety Scale(HAMA).Results:42 cases completed 12 week therapy.The overall IBS symptoms,the Bristol stool consistency,stool frequency and abdominal pain were relieved significantly at week 2(P

Objective:To investigate the efficacy of mirtazapine in patients with anorexia nervosa.Methods: A randomized,controlled study was undertaken in 42 patients with anorexia nervosa.Subjects were treated with mir- tazapine or selective serotonin reuptake inhibitor(SSRIs)for 12 weeks and followed up to 12 weeks.The clinical out- come measures included body weight,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and the side effects of medications.Results:38 subjects completed the trial,20 in mirtazapine group,18 in SSRIs group. The weight gain in mirtazapine group was significantly more that that in SSRIs group at week 6 but the difference was not significant at week 12.The scores of HAMD and HAMA at endpoint were significantly lower than those at base- line(P0.05).No severe adverse events were observed in both groups.Common side effects of SSRIs were gastroenterological discomfort,while those of mir- tazapine included somnolence and weight gain.Conclusion:Mirtazapine can improve appetite and weight gain in pa- tients with anorexia nervosa in addition to relieve anxiety and depression.It is well tolerated and has ealier onset of effect than SSRIS.

Antiangiogenic therapy is an essential approach in the treatment of malignant tumors along with the development of preci-sion medicine. However, the occurrence of antiangiogenic therapy-induced hypertension, which is the most common toxicity of this agent, influences its broad clinical use (in some cases). Researches on its mechanisms, prevention, and management, have been con-ducted, but clinical guidelines or expert consensuses have not been reached. In this review, we presented the epidemiology, current re-search status, and systematic management of antiangiogenic therapy-induced hypertension.

Aged ; Coronary Disease ; Coronary Sinus ; pathology ; Female ; Heart Atria ; pathology ; Humans ; Middle Aged

Objective To investigate the effect of hydrogen sulfide (H2S) on brain injury and inflammatory response after cerebral ischemia/reperfusion in rats.Methods Forty-eight malc SD rats were randomly divided into four groups:sham operation group,ischemia/reperfusion (I/R) group,H2S-30 ppm group,and H2S-60 ppm group (n=12 in each group;1 ppm=1 mg/L).The middle cerebral artery occlusion method was used to induce a model of focal cerebral ischemia for 2 h and reperfusion for 24 h.After reperfusion for 24 h,the tape remove experiment was used to perform the nerve function evaluation.2,3,5-triphenyl-tetrazolium chloride staining method was used to measure the percentage of cerebral infarction volume.Enzyme-linked immunosorbent assay was used to measure the levels of interleukin (IL)-1 β and IL-6.Western blotting was used to detect the expression levels of inducible nitric oxide synthase (iNOS) and intercellular cell adhesion molecule-1 (ICAM-1),as well as the transposition activation of nuclear factor-κB (NF-κB).Results Inhalation of H2S could shorten the time required to remove the tape in a dose-dependent manner compared with the I/R group (I/R group vs.H2S 30 ppm group and H2S 60 ppm group:180 s vs.130 [113-157]s vs.110 [87-138] s;P＜ 0.05),reduced the cerebral infarct volume (48.8％ ± 9.1％ vs.23.3 ％ ± 5.1％ vs.17.3 ％ ± 3.5 ％;P ＜ 0.05),downregulated the expression levels of IL-1β (39.53± 6.02 pg/mg protein vs.30.17± 3.46 pg/mg protein vs.22.69± 6.09 pg/mg protein;P ＜0.05) and IL-6 (54.65 ± 10.68 pg/mg protein vs.37.89 ±4.54 pg/mg protein vs.27.00 ±3.08 pg/mg protein;P ＜ 0.05) in ischemic brain tissue,significantly decreased NF-κB nucleus/ cytoplasm ratio (4.40 ± 1.05 vs.3.07 ± 0.82 vs.2.30 ± 0.60;P ＜ 0.05),inhibited expressions of iNOS (4.22 ±0.67 vs.3.14 ±0.90 vs.2.08 ±0.35;P ＜0.05),and ICAM-1 (5.45 ± 1.08 vs.3.45 ±0.67 vs.2.21 ±0.39;P ＜0.05).Conclusions Inhalation of exogenous H2S can reduce cerebral infarct volume after cerebral ischemia/reperfusion in a dose-dependent manner and improve neurological function.Its mechanism may be associated with the inhibition of NF-κB activation,down-regulation of its downstream iNOS and ICAM-1 expression levels,and decrease of IL-1β and IL-6 levels.

Objective To investigate the level and value of serum uric acid (UA) in patients with multiple system atrophy (MSA).Methods One hundred and one MSA patients were selected as the MSA group and 101 age and sex-matched healthy controls as control group.The UA concentrations and other biochemical indexes were measured by an enzymatic method and carefully analyzed.By comparing the UA concentrations for different genders, subtypes, and different levels of certainty of the MSA group with their counterparts in the control group, we obtained the differences between these two groups and also discussed possible reasons and factors.Results The serum UA levels of MSA patients ((283.74 ± 87.76) μmol/L) were significantly lower than the controls ((317.86 ± 76.95) μmol/L;t =-2.94, P ＜ 0.05).In addition, when the male and female groups were investigated separately, the decrease of serum UA was more significant in the male group compared to the female group (t =-3.88, P ＜ 0.01).Furthermore, by comparing different subtypes of the MSA patients with the control group, we found that the serum UA levels in both P-type or C-type MSA patients were significantly lower than in controls (t =2.92, 2.02;all P ＜ 0.05).By comparing different levels of MSA with the control group, we obtained that UA levels in both probable MSA patients and possible MSA patients were significantly lower than in controls (t =3.13, 2.09;all P ＜ 0.05).By adjusting for the confounding factors, such as age, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatinine, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol, the multiple Logistic regression analysis showed that the numbers of MSA patients in the lowest level UA group (UA ＜ 263.0 μmol/L) were higher than the high level UA group (UA ＞ 370.5 μmol/L), though the difference did not reach statistical significance (P ＞ 0.05).Nevertheless, the numbers of male MSA patients in the lowest level and the lower level UA groups (UA =263.0-309.0 μmol/L) were 11.5 and 10.8 times that in the high level UA group (P =0.001, P =0.003).No obviously linear relation between the level of UA and disease progression was found.Conclusions The level of serum UA is significantly decreased in MSA patients, especially in the male patients.The UA, as an antioxidant, may be beneficial to the neurodegenerative diseases.

Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.

Objective To detect the levels of serum bilirubin and uric acid as well as their relationship with cognitive function in patients with subcortical ischemic vascular disease (SIVD).Methods Serum direct bilirubin (DBIL),indirect bilirubin (IBIL),total bilirubin (TBIL),uric acid (UA) and vascular risk factors were analyzed in 238 individuals comprising 161 patients with SIVD and 77 controls with normal cognitive function.SIVD patients were divided into two subgroups:those with cognitive impairment (SVMCI) and those with dementia (SVaD).All of them were subject to the cognitive assessment including Mini-mental State Examination(MMSE),the Cambridge Cognitive Examination-Chinese Version (CAMCOGC) and Clinical Demential Rating (CDR).Leukoaraiosis was graded according to the severity by their MRI scan appearances.Results MMSE and CAMCOG scores were significant lower in SVMCI and SVaD groups (17.9 ± 5.01,59.87 ± 12.89 ; 24.84 ± 1.57,83.66 ± 4.79) when compared to those in the controls (28.19 ± 1.03,91.66-± 4.93 ; Z =197.63,P =0.000 ; Z =186.54,P =0.000).In comparison with the controls,serum levels of DBIL,IBIL,and TBIL in SVaD group were significant lower ((2.85 ± 1.09) μmol/L vs (3.24 ± 1.30) iμmol/L; (7.50 ±3.27) μmol/L vs (9.06 ±3.52) μmol/L; (10.37 ±4.10) μ mol/L vs (12.31 ±4.64) μmol/L; P =0.035,P =0.005,P =0.006).Also,serum IBIL level was significant lower in SVMCI group compared to the controls ((7.86 ± 3.28) μmol/L vs (9.06 ± 3.52) μmol/L,P =0.034).While serum level of UA was significantly higher in SVMCI ((341.47 ± 92.80) μmol/L) and SVaD ((356.34 ±80.89) μmol/L) groups as compared to those in controls((310.52 ±79.85) μmol/L;P =0.025 ;P =0.001).The UA level was negatively correlated with MMSE scores and CAMCOG-C scores (r =-0.180,P =0.005; r =-0.203,P =0.002),while the bilirubin level was positively correlated with language (r =0.130,P =0.045) and recent memory (r =0.160,P =0.014) scores in CAMCOG-C.The UA level remained associated with MMSE after controlling for age,sex,education,hypertension,diabetes,smoking,and BMI (β =-0.121,P =0.044).While,after adjusting grading of a leukoaraiosis,UA has no significant association with MMSE.Conclusions The bilirubin level is decreased while the UA level is elevated in SIVD patients.The serum TBIL is negatively correlated with cognition dysfunction,while UA is strongly related to cognition dysfunction in SIVD patients.Cognitive dysfunction resulting from UA might have close association with leukoaraiosis.

OBJECTIVETo observe the clinical efficacy of comprehensive Western medical treatment plus Compound Yindan Decoction (CYD) in treatment of acute cholestatic hepatitis (ACH).

METHODSUsing randomized controlled study, 60 ACH patients in line with inclusive criteria were randomly assigned to the treatment group (treated by comprehensive Western medical treatment plus CYD) and the control group (treated by comprehensive Western medical treatment alone), 30 in each group. Scores for symptoms and levels of liver functions [total bilirubin (TBIL), direct bilirubin (DBIL), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), total biliary acid (TBA)] were observed before and after treatment.

RESULTSCompared with before treatment in the same group, total scores for symptoms decreased in the treatment group and the control group at the end of the 1st and the 4th week after treatment (all P < 0.05). Compared with the control group, total scores for symptoms decreased in the treatment group at the end of the 1st week (P < 0.05). Compared with before treatment, serum levels of TBIL, DBIL, ALP, GGT, and TBA all decreased in the two groups at the end of the 4th week after treat- ment (P < 0.01). Compared with the control group, serum levels of TBIL, DBIL, ALP, GGT, and TBA all decreased in the treatment group at the end of the 1st and the 2nd week after treatment (P < 0.05). Compared with the control group, the average time for TBIL and DBIL decreasing to the level less than five times the normal value was significantly shorter in the treatment group (P < 0.05).

CONCLUSIONCYD could significantly improve clinical symptoms of ACH patients, decrease serum levels of TBIL and DBIL, reduce serum levels of ALP, GGT, and TBA, obviously improve cholestasis, and promote the recovery.

Alkaline Phosphatase ; Bilirubin ; Cholestasis ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis ; drug therapy ; Humans ; gamma-Glutamyltransferase

OBJECTIVE: To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis. METHOD: The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P<0. 05). Similarly, after SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 46; 3. 63], 4. 23[3. 65; 4. 96], respectively) and TMS (0. 42[0. 36; 0. 58], 0. 50[0. 34; 0. 72], respectively) in the polyallergen sensitized group were lower than that before the treatment (TNSS: 9. 00[8. 00; 10. 00], TMS: 2. 18[1. 95; 2. 37]), which have showed a statistically significant difference(P<0. 05). No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2 years after treatment, respectively. However, a statistically significant finding could be observed between two groups in the drug discontinuance for 3 years (P<0. 05). Eleven patients suffered local adverse effects, and the incidence of adverse effects showed no significantly difference (P>0. 05). CONCLUSION SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.
Administration, Sublingual ; Animals ; Antigens, Dermatophagoides ; therapeutic use ; Humans ; Pyroglyphidae ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Skin Tests ; Sublingual Immunotherapy ; Treatment Outcome