OBJECTIVE:To observe the clinical efficacy of Shenkang injection,a new compound preparation for chronic renal failure(CRF).METHODS:A total of 84 CRF patients were randomly divided into two groups:the treatment group(n=54)was given routine antihypertensive therapy and infused(iv gtt)with Shenkang injection 60～ 100mL(dissolved in 10% GS 300mL or NS 300mL)q.d for 30d;the control group(n=30)was infused(iv gtt)with Compound danshen injection 250mL q.d for 30d.RESULTS:As compared with the control group,serum levels of creatinine and urea nitrogen(UN)in treatment group had a greater reduction(P

Objective: To investigate the relationship between arterial stiffness and variability of blood pressure (BPV) in senile patients with hypertension.
Methods: A total of 234 senile patients with hypertension were enrolled. The patients were examined by 24h ambulatory blood pressure monitoring (ABPM), BPV was identified by the standard deviation (SD) of blood pressure value. Based on increased percentage of baPWV, the patients were divided into 4 groups: Normal artery group, n=44, Mild arterial stiff group, n=72, Moderate arterial stiff group, n=78 and Severe arterial stiff group, n=40. The 24h ABPM results, BPV, biochemical indexes and their relationship to baPWV were compared among different groups.
Results:①The HDL-C level and 24hDBP, dDBP, 24hSBPSD, 24hDBPSD, dSBPSD, dDBPSD, nDBPSD were significantly different among each group, all P<0.05.②The increased percentage of baPWV was positively related to the age and 24hSBPSD, 24hDBPSD, dSBPSD, dDBPSD, nDBPSD, while negatively related to HDL-C level, all P<0.05.③The age and 24hSBPSD, 24hDBPSD, dSBPSD were the independent risk factors for baPWV elevation.
Conclusion: The arterial stiffness was closely related to BPV in senile patients with hypertension.

Objective To discuss the protective effect of doxofylline on radical surgery for esophageal cancer.Methods Under elective general anesthesia, 60 cases, 35 males and 25 females, aged 45-70 years, BMI 20-30 kg/m2, ASA physical status Ⅰ or Ⅱ, FEV1%>50%, underwent radical surgery for esophageal cancer at middle and distal parts.Random number table was employed to divide these patients into two groups: doxofylline group (group D) and control group (group C) with 30 cases in each.After a routing intravenous induction in the two groups, mechanical ventilation was conducted after bronchial intubation with double channel catheter on the right side.The intravenous injection of doxofylline 4 mg/kg in group D was administrated 30 min after bronchial intubation with double channel catheter.Equal normal saline was instilled to the patients in group C.Blood samples were taken from radial artery to detect the levels of TNF-α, IL-6, IL-10, MDA and SOD at four time points: 10 min (T0) before the one-lung ventilation, 60 min after OLV (T1), after two-lung ventilation (T2) and the end of the operation (T3).Meanwhile, the blood and breath at these time points were tested.The occurrence of OLV, blood loss volumes, fluid input quantities, urine volumes, postoperative hyoxemia and pulmonary inflammation were observed.Results Compared with T0, the activity of SOD in serum and PaO2 in the two groups at T1-T3 decreased (P＜0.05).The concentrations of TNF-α, IL-6, IL-10 and MDA increased significantly (P＜0.05).Compared with group C, the activity of SOD activities and PaO2 in group D at T1-T3 increased while concentrations of TNF-α, IL-6, IL-10 and MDA decreased significantly (P＜0.05).The occurrence rates of postoperative hyoxemia and pulmonary inflammation in group D were obviously lower than those in group C (P＜0.05).Conclusion Doxofylline can suppress patients' inflammatory response and oxidative stress response after OLV and reduce the incidence rates of postoperative hyoxemia and pulmonary inflammation as well as alleviate lung injury triggered by radical surgery for esophageal cancer.

Objective To explore the signal-to-noise ratio loss (SNR loss) of the people with normal pure-tone audiograms .Methods A group of 10 patients were recruited into the study ,who complained they could not hear speech clearly in the real world environment but had normal pure-tone audiograms ,immittance and word rec-ognition score (WRS) results .The Mandarin hearing in noise test (M-HINT ) was administered to them and the results were compared to the normal ranges published in the journal .Results All of them had SNR loss when noise (speech spectrum) came from front of them ,but 9 patients had SNR loss when noise came from 90 degree left or 90 degree right of them .Conclusion The current study showed the patients had speech hearing loss in the noisy envi-ronment ,regardless of whether they had normal audiograms ,immittance and WRS results .So we should pay atten-tion to such patients and adopt some special tests (eg M-HINT) .It is better for us to communicate and counsel with them .

Objective To investigate the effects of early hemofiltration combined with traditional Chinese medicine on nasal feeding on severe acute pancreatitis (SAP) patients. Methods Seventy four patients were divided into traditional Chinese medicine group (group A, 35 cases) and traditional Chinese medicine+hemofiltration group (group B, 39 cases). In group A, patients were given a serious of procedure including fasting, gastrointestinal decompression, fluid resuscitation, inhi-bition of pancreatic secretion, antibiotic prophylaxis, parenteral nutrition and traditional Chinese medicine on nasal feeding;In group B, patients received continuous veno-venous hemofiltration treatment(also called Continuous Renal Replacement Therapy,CRRT) in addition to the procedures receiving by group A. On admission and the first, 3rd, 7th days post-treatment, the scores of acute physiology and chronic health evaluation (APACHEⅡ), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels were recorded. Length of hospital stay, local and systematic complications, surgical inter-vention, mortality and hospitalization expenses were compared between two groups. Results On admission, no statistical significance was seen in the hematocrit, white blood cell count, lactic acid dehydrogenase, blood urea nitrogen, blood glu-cose, APACHEⅡscore, Ranson’s score and classification of etiology between these two groups (P>0.05). But APACHEⅡ, TNF-α, IL-6, IL-8 were decreased significantly in group B than in group A, after the first, 3rd, 7th days post-treatment (P＜0.05). Compared with group A, the length of hospital stay, local complications, systemic complications, surgical interven-tion, mortality and hospitalization expense were lower in group B. Conclusion Traditional Chinese medicine on nasal feed-ing combined with early hemofiltration could effectively reduce complications, incidence of organ dysfunction and could im-prove the prognosis of SAP patients.

Objective To study the changes of behavior and depression-like classic indicators after hippocampal microinjection of K252a,and to establish a new animal model of depression.Methods SD rats were randomly divided into five groups,namely the control group,sham group,chronic stress depression model group,hippocampal of K252a microinjection group,and hippocampal microinjection K252a plus chronic stress group.Open field experiments,sucrose consumption test,and Morris water maze behavioral assay were used to assess the behavioral changes in the rats.ELISA was used to detect the plasma monoamine neurotransmitter,radioimmunoassay was used to determine the plasma CRH,ACTH,CORT contents,and western-blotting was performed to observe the protein expression of BDNF,CREB,ERK1/2,and BCL-2 in the hippocampus.Results Compared with the control group,the amount of activity,sugar consumption,learning and memory abilities were decreased(P<0.05 or P<0.01),also the serum monoamine neurotransmitters were decreased (P<0.01),HPA axis function was improved (P<0.01),and the expression of BDNF,CREB,ERK1/2,BCL-2 decreased in the CUMS group(P<0.05 or P<0.01),but there was no significant difference in the DMSO group.Compared with the DMSO group,the activity,consumption of sucrose,learning and memory ability were significantly decreased(P<0.05 or P<0.01),while the HPA axis function was increased (P<0.05 or P<0.01),the serum monoamine neurotransmitters decreased(P<0.05 or P<0.01),and the BDNF,CREB,ERK1/2,BCL-2 expressions in the hypocampus were significantly decreased(P<0.05 or P<0.01) in the K252a group and K252a + CUMS group.Compared with the CUMS group,the K252a group and K252a + CUMS group did not show significant changes in these parameters.Compared with the K252a group,these indicators were not significantly changed in the K252a + CUMS group.Conclusions The results of behavior,hematology,and molecular biology analysis show that this model has a great similarity to the classical model of CUMS in surface validity,construct validity,and functional validity.It may provide an alternative investigative technology platform for basic research and antidepressant drug screening.

Objective To study the efficacy of rituximab in the treatment of pemphigus vulgaris (PV) and its underlying mechanism. Methods A 38-year-old female with PV presented with refractory, painful oral ulcers and erosions. Since she was poorly responsive to prednisone 80 mg daily, intravenous ritu-ximab of 500 mg once a week was given for successive 3 weeks followed by 5 successive days of intra-venous gamma globulin at a dose of 400 mg/kg per day, and a total of two treatment sessions were conducted. ELISA was used to detect the serum titer of anti-Dsg3 antibodies and their IgG subtypes (IgG1 and IgG4) as well as serum level of interferon-gamma (IFN-gamma), interleukin-4 (IL-4), interleukin-10 (IL-10). Results Three months after the end of two treatment sessions, the symptom was obviously improved, and lesions subsided; alter another 1 month, clinical symptom fully disappeared. During the 1-year follow-up, no lesions recurred. The anti-Dsg3 antibody titer was 253.33 U/mL before treatment, plateaued at 250 U/mL within 4 weeks after the initial infusion, decreased till 3 months after the withdrawal, and reached 26.06 U/mL 7 months after the withdrawal, and remained within normal range till the time of this writing. The serum titer of IgGl subclass of anti-Dsg3 antibodies dropped dramatically fight after the first infusion, but that of IgG4 subclass remained at a high level at early stage of medication, began to decline until 3 months after the with-drawal, and finally reached the normal range following clinical remission. Also, serum level of IFN-garnma and IL-10 correlated with the severity of PV. Conclusions Combined rituximab is effective for the control of PV, likely by eliminating Dsg3-specific antibodies, especially IgG4 subclass of them.

Objective To investigate the characteristic MRI features of sporadic inclusion?body myositis(sIBM). Methods Clinical and MR imaging data of 6 patients with sIBM diagnosed by muscle biopsy from May 2013 to November 2014 were retrospectively analyzed. All patients showed insidious onset of lower limb muscle weakness and diagnosed as sIBM by muscle biopsies. All patients were evaluated by the score of the severity of fatty infiltration, inflammation and atrophy in MRI. Results All patients were observed fatty infiltration with different degrees. The fatty infiltration in thighs was characterized in a decreasing order of frequency:gluteus maximus (6 cases), vastuslateralis (6 cases), vastusintermedius (6 cases), vastusmedialis (6 cases), sartorius (5 cases), adductor magnus (5 cases), rectus femoris (4 cases), semi?membranosus (4 cases), semi?tendinosus (4 cases), biceps femoris (4 cases), gracilis (3 cases), adductor longus(2 cases).The fatty infiltration in thighs was characterized in a decreasing order of severity:vastuslateralis (3.2 points), vastusintermedius (3.2 points), vastusmedialis (3.0 points), adductor magnus (3.0 points), gluteus maximus (2.7 points), bicepsfemoris (2.2 points), semi?membranosus (2.1 points), semi?tendinosus (2.1 points), rectus femoris (1.5 points), sartorius (1.3 points), gracilis (0.8 points), adductor longus (0.7 points). All patients showed the features of distal distribution andsymmetry. Inflammation was observed in 3 patients. 1 patient only involved the vastuslateralis, the other 2 patients were observed muscle inflammation with different degrees in 12 muscles. Atrophy was observed in 5 patients. The atrophy in thighs was characterized in a decreasing order of frequency:vastuslateralis (5 cases), vastusintermedius (5 cases), vastusmedialis (4 cases), adductor magnus (4 cases), semi?membranosus (2 cases), rectus femoris (1 cases), sartorius (1 cases) and gluteus maximus;there was no atrophy in adductor longus, gracilis,semi?tendinosus, biceps femoris. Conclusion The MRI characteristic manifestations of sIBM is fatty infiltration and atrophy in the distal portion, particularly involving the vastuslateralis, vastusintermedius, vastusmedialis and adductor magnus.

In recent years, polysaccharides have received much attention because of their high safety and good immunological activity. The study of polysaccharide in vivo process is a key scientific problem that needs to be solved for polysaccharide drug development. Some progress has been made in the field of polysaccharide pharmacokinetics and immunomodulation. However, due to the lack of both chromogenic and light-absorbing groups and the complex molecular structure of polysaccharides, the in vivo processes and immunomodulatory mechanisms of polysaccharides have been slow to be investigated. The effective combination of multiple techniques can break the bottleneck of difficult tracing and unknown immunomodulatory mechanism of polysaccharides in vivo, and promote the development and utilization of polysaccharides. In this paper, we systematically summarize the key techniques in the study of polysaccharide in vivo processes and immunomodulatory mechanisms in order to provide technical references and research ideas for the study of polysaccharide in vivo processes and immunomodulatory mechanisms.

This paper is to report the study of the metabolism of forscolin in plasma and liver microsomes for guiding clinical therapy. Forscolin was quantified by HPLC-MS/MS. The metabolic stability of forscolin in rat, Beagle dog, monkey and human plasma and liver microsomes, mediated enzymes of forscolin and its inhibition on cytochrome P450 isoforms in human liver microsomes were studied. Results showed that forscolin was not metabolized in plasma of the four species but metabolized in liver microsomes of the four species. The t1/2 of forscolin in rat, Beagle dog, monkey and human liver microsomes were (52.0 +/- 15.0), (51.2 +/- 5.9), (6.0 +/- 0.2) and (11.9 +/- 1.8) min; CL(int) were (75.6 +/- 18.7), (60.9 +/- 6.8), (513.8 +/- 14.3) and (176.2 +/- 25.6) mL x min(-1) x kg(-1); CL were (34.8 +/- 4.5), (23.3 +/- 1.0), (40.3 +/- 0.5) and (17.9 +/- 0.3) mL x min(-1) x kg(-1), respectively. Forscolin was metabolized by CYP3A4 in human liver microsomes. There was definite inhibition on CYP3A4 at the concentrations of forscolin between 0.1 ng x mL(-1) and 5 microg x mL(-1). Therefore, forscolin is rapidly excreted from liver microsomes. Attention should be paid to the drug interaction when forscolin was used along with other drugs metabolized by CYP3A4 in clinics.
Animals ; Chromatography, High Pressure Liquid ; Coleus ; chemistry ; Colforsin ; blood ; isolation & purification ; metabolism ; Cytochrome P-450 CYP3A ; metabolism ; Dogs ; Humans ; Macaca ; Metabolic Clearance Rate ; Microsomes, Liver ; metabolism ; Plants, Medicinal ; chemistry ; Rats ; Tandem Mass Spectrometry