With the increasing trade of traditional Chinese medicine(TCM),the issue of excessive levels of toxic heavy metals metals in TCM has raised worldwide concerns. Some countries and re?gions have set strict limits on the heavy in TCM. There are currently no uniform limits on heavy metals, partly for lack of a good understanding of heavy metals in TCM. The toxicity of heavy metals varies with their chemical forms so that it is not rational to evaluate safety in terms of total contents. Cinnabar and realgar are widely used TCM containing heavy metals in clinical practice. Because of the potential toxicity of heavy metals such as mercury or arsenic,and the related adverse reactions reported occa?sionally,the safety of cinnabar,realgar and their preparations has also attracted public attention. In the present paper,the progress in toxicological studies on cinnabar,realgar as well as commonly used preparations was reviewed while priorities of future research were proposed.

BACKGROUND:Transplantation of bone marrow mesenchymal stem cells can promote repair of brain injuries in animals. OBJECTIVE:To summarize the research progress in intranasal delivery of bone marrow mesenchymal stem cells to the brain. METHODS:A computer-based online retrieval of PubMed and Wanfang databases was performed to search papers published during January 1999 to January 2014 with the key words of“bone marrow mesenchymal stem cells, brain injury, transplantation”in English and Chinese. Thirty-eight papers were included in the final analysis. RESULTS AND CONCLUSION:Nowadays, many studies have been certified that the transplantation of bone marrow mesenchymal stem cells can significantly ameliorate the function of cranial nerve in animal models of brain injury. Many researchers have searched for the transplantation methods and approaches and have made progresses in many aspects. In this article, we compare the different transplantation ways of bone marrow mesenchymal stem cells to the brain. We focus on the intranasal transplantation route in the fol owing aspects:processing of the nasal mucosa;delivery route to the brain;labeling and intracranial observation of stem cells;animal experiments. We conclude that the intranasal delivery of bone marrow mesenchymal stem cells to the brain has a wide clinical application as a noninvasive transplantation.

ObjectiveToevaluatelaparoscopiccholecystectomy(LC)versusopen cholecystectomy (OC) in compensated cirrhotics and model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP)classification in predicting perioperative morbidity.MethodsBetween January 1998 and June 2011,128 cirrhotic patients of symptomatic innocuous gallbladder disease at CPT class A or B liver function were prospectively and randomly divided into LC group (64 patients) and OC group (64 patients ). Data were analyzed by T test, Mann-Whitney U test and Pearson x2 test.ResultsThere was no statistical differences in operation time between the two groups ( t =1.761,P =0.081 ).The intraoperative blood loss ＞ 200 ml occurred in 15 ( 26％ ) LC patients and 35 ( 55％ ) OC patients ( x2 =4.467,P =0.035 ).LC patients had earlier up and about,earlier oral intake,short hospital stay ( t =5.424,t =8.573,t =15.634; P =0.000,respectively) and lower complication rate [ CTP:24％ (14/58) vs 38％ (24/64),x2 =4.582,P =0.032; MELD scores 21％ (12/58) vs 34％ (22/64),x2 =4.238,P =0.040] compared with OC patients.LC patients' VAS- fatigue and VAS-pain scores on first 3 days were lower than OC according to the VAS (visual analogue scale) (Mann-Whitney U =473.0,MannWhitney =6.0,Mann-Whitney =22.5,Mann-Whitney =24.0,Mann-Whitney =46.0; P =0.000,respectively),and the VRS-cosmetic score was higher in LC group than in the OC group according to the VRS ( verbal rating scale) ( Mann-Whitney =145.0,P =0.000).MELD score ＞ 14 predicted higher blood loss and complication rate regardless of LC or OC,while CPT classification did not seem to predict intraoperative bleeding volume and morbidity.ConclusionsLC can be performed safely in cirrhotic patients with CPT class A and B.LC has less,blood loss lower postoperative complication rate,and quicker postoperative recovery.MELD score system is more valuable than CPT classification system in predicting blood loss and postoperative complication rate in cirrhotics undergoing cholecystectomy.

Objective To analyze clinical pathologic characteristics of patients with primary biliary cirrhosis autoimmune hepatitis overlap syndrome (PBC AIH OS),the incidence of extrahepatic autoimmune disease,malignant tumor and the abdominal lymph node enlargement.Methods From January 2000 to January 2012,the clinical data of 49 patients with PBC AIH OS were retrospectively analyzed,which included general information,clinical manifestations,biochemical parameters,immunological parameters,liver histopathological features,the incidence of extrahepatic autoimmune disease and malignant tumor,imaging findings and the efficacy.Results Among 49 PBC-AIH OS patients,the percentage of patients between 51 and 60 years old was 59.2％ (29/49),and the mean age of onset was (57.2±8.9) years old.Female was 83.7％ (41/49).The percentage of jaundice and pruritus in the main symptoms of initial visit was 42.9％ (21/49).The serum level of alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptadase (GGT) and total bilirubin (TBil) of 49 patients all increased.Among 31 patients who accepted IgA,IgG and IgM level test,the level of IgM increased in 58.1％ (18/31) of patients,and the level of IgG increased in 61.3％ (19/31) of patients.Ninety-eight percent of patients were antinuclear antibody (ANA) positive,6.1 ％ (3/49) were anti-smooth muscle antibody (SMA) positive,89.8％ (44/49) of patients were anti mitochondrial antibody (AMA) and or AMA-M2 positive.All patients had interface hepatitis.Forty-nine percent (24/49) of patients had both histological features of autoimmune hepatitis (AIH) and primary biliray cirrhosis (PBC).After being treated with ursodeoxycholic acid (UDCA) and immunosuppressant,the percentage of remission,incomplete response and failure was 65.3％ (32/49),26.5％ (13/49) and 8.2％ (4/49),respectively.After remission,five of six patients with medicine withdrawal relapsed.Among 49 patients,40.8％ (20/49) with extrahepatic autoimmune disease and the percentage of Sjogren's syndrome,autoimmune thyroid disease,interstitial pneumonia,systemic lupus erythematosus,psoriasis,sarcoidosis and membranous nephropathy was 16.3％ (8/49),12.2％ (6/49),4.1％ (2/49),2.0％ (1/49),2.0％ (1/49),2.0％ (1/49) and 2.0％ (1/49),respectively.Among 49 patients,14.3％ (7/49) with malignant tumor and the percentage of endometrial cancer,breast cancer,thyroid cancer and lymphoma was 4.1％ (2/49),4.1％ (2/49),4.1％ (2/49) and 2.0％ (1/ 49).Among 49 patients,abdominal ultrasound showed abnormality in 93.9％ (46/49) of patients.Abdominal lymph nodes enlargement was found in 91.8％ (45/49) of patients.Conclusions Autoimmune disease and malignant tumor should be screened when patients with PBC-AIH OS were assessed.Abdominal lymph nodes enlargement found by imaging examination may have guiding significance to the diagnosis.

Objective:To explore the effect of humanistic care in patients with hematopoietic stem cell transplantation.Methods:Totally 51 patients with hematopoietic stem cell transplantation were recruited from the First Affiliated Hospital of Xi'an Jiaotong University,between September 2014 and July 2016,and were randomly divided into two groups.Patients in the intervention group (n =25) received humanistic care,while those in the control group (n =26) received routine nursing.The incidence of adverse psychological status and nursing satisfaction were compared between the two groups.Results:The incidence rate of adverse psychological state in the intervention group (16％) was significantly lower than that in the control group (53％),while the nursing satisfaction in the interventiongroup (92％) was significantly higher than that in the control group (69％),P ＜0.05.Conclusion:Application of humanistic care in the patients with hematopoietic stem cell transplantation can significantly improve nursing satisfaction and reduce the incidence of adverse psychological state,which will improve the confidence of the patients and the quality of nursing satisfaction.Consequently,it will promote the relationship between the nurses and patients.

Objective To explore the security and the short term efficacy of VIABAHN stents in the treatment of branching area lesions in lower extremity arterial diseases. Methods The data of 16 patients (11 male and 5 female, aged 59.0 to 81.0 with median of 71.6) with lower extremity arterial occlusive disease from November 2014 to June 2015 were analyzed retrospectively. All lesions were located around the branching area of the lower extremity artery (3 cases in the internal iliac artery orifice, 6 cases in the deep femoral artery orifice and 7 cases in the vascular net around the knee). The short?term effects on these patients in the follow-up period, such as the success rate of surgical technique, the improvement of symptoms and the incidence of complications were summarized. Results Revascularization was technically successful in all 16 patients, and ischemic symptoms relieved significantly after the operation. The ABI were 0.36±0.12 before and 0.89±0.10 after the operation. The patients were followed up for 3 to 9 months (median 5.5 months). All the patients were achieved limb salvage and no complication occurred. Conclusions VIABAHN stent is safe and effective for the treatment of lower extremity arterial occlusive disease. The branches around the lesion can be covered with VIABAHN stents.

A plasmids of continuous expressing shRNAs targeting the NDV NA-1 Phosphoprotein (P) gene was designed.Virus titration,Real Time RT-PCR,CPE indicated that P-specific siRNA could inhibit virus replication at 36 h post-virus infection.In future studies,a combination of siRNAs targeting the NP and L gene may be used as a tool to study NDV replication and antiviral therapy.

Objective To evaluate the safety and efficacy of mechanical thrombectomy in treating in-stent restenosis of lower extremity arteriosclerosis obliterans. Methods From May 2015 to Sep 2016, the clinical data of 9 cases of lower extremity arteriosclerosis obliterans who were with in-stent restenosis(3 were stent graft)were retrospectively collected, and of which 7 were males and 2 were females with a mean age of (75.4 ± 6.3)years old. All the cases were treated by mechanical thrombectomy of Rotarex catheter. All the patients were diagnosed via low-extremity artery CTA, and treated by means of the Rotarex catheter, combined with angioplasty and stent if necessary. All patients received antiplatelet therapy. Doppler ultrasonography was taken during the followed-up. Results All the 9 cases were successed in technology, without complications in hospital. All patients received Rotarex mechanical thrombectomy. Six of which used balloon and 1 stent implanted. The ABI increased from 0.29 ± 0.07 to 0.88 ± 0.07 after treatment, the difference was statistically significant(t=28.875,P<0.05). All the patients were followed up for 3—18 (median time, 11.5)months. No death and symptoms recurrence appeared during the follow-up. Conclusions Mechanical thrombectomy using Rotarex catheter is a safe and effective treatment for in-stent restenosis in lower extremity arterial diseases.

[ ABSTRACT] AIM:To investigate the preventive effects of Clostridium butyricum ( C.butyricum) on the type of pylorus ligated gastric ulcer ( GU) in mice and the underlying mechanisms.METHODS:ICR mice were randomly divided into 4 groups:sham operation group, model group, C.butyricum pretreatment group and omeprazole pretreatment group. Gastric pyloric ligation was adopted to establish GU model in mice.The gastric juice was collected to measure the content of gastric free mucus, the pH of gastric juice and the activity of pepsin.The gastric tissues were collected for routine HE stai-ning to observe the pathological changes.The content of glycogen was detected by PAS staining.The protein expression of Bax and Bcl-2 in the gastric mucosa was also assessed by immunohistochemical staining.RESULTS: The HE and PAS staining showed that the C.butyricum pretreatment obviously attenuated the mucosa lesion induced by ligation.Compared with model group, the pH of gastric juice was significantly raised.The activity of pepsin fell off in C.butyricum group, which was lower than that in omeprazole group.In comparison with model group, the content of gastric free mucus was dra-matically increased and PAS staining showed a significant rise in C.butyricum group, but not in omeprazole group.The protein expression of Bax was decreased and the protein expression of Bcl-2 was upgraded in C.butyricum group than those in model group.CONCLUSION:C.butyricum protects gastric mucosa against the challenge of pylorus ligation in mice and its mechanism may be related to inhibiting gastric acid secretion and the activation of pepsin, increasing the production of gastric free mucus, strengthening the expression of bcl-2 gene and inhibiting the expression of bax gene.

Objective: To investigate the possible mechanisms of tumor-associated macrophages (TAMs) in regulating epithelia-mesenchymal transition (EMT) of Hep3B hepatoma cells, since EMT is closely associated with the malignancy of hepatoma cells and tumor microenvironment plays an important role in regulating EMT of hepatoma cells, and to provide new regimens for the clinical studies and treatment of liver cancer. Methods: Human monocytic leukemia THP-1 cells were successfully induced to TAMs. With TAMs as target cells, they were co-cultured with the supernatant of Hep3B hepatoma cells or Hep3B hepatoma cells, and Western blot and RT-PCR were used to measure the change in the expression of Toll-like receptor 4 (TLR4) in TAMs. The expression of TLR4 in TAMs was downregulated by transient plasmid transfection with shRNA. With Hep3B hepatoma cells as target cells, the supernatants of TAMs and TAMs transfected with shRNA TLR4 plasmid were used for intervention, and Western blot was used to measure the protein expression of E-cadherin, N-cadherin, and vimentin. The two-sided t-test was used for comparison of the means of two independent samples. Results: THP-1 cells were successfully induced to TAMs. According to the results of Western blot, compared with the control-CM group, the TAM-CM group had a significant reduction in the protein expression of E-cadherin and significant increases in the protein expression of N-cadherin and vimentin in Hep3B cells. After the expression of TLR4 in TAMs was downregulated, the culture solution of TAMs was used for the intervention of Hep3B cells (shRNA group), and compared with the TAM-CM group, the shRNA group had a significant increase in the expression of E-cadherin and significant reductions in the protein expression of N-cadherin and vimentin in Hep3B cells. Western blot and RT-PCR showed that the expression of TLR4 in TAMs was influenced by Hep3B cells. Conclusion TAMs can promote EMT of Hep3B hepatoma cells, and downregulation of the expression of TLR4 in TAMs may reduce EMT of Hep3B hepatoma cells, suggesting that TLR4 on the surface of TAMs may be a key molecule involved in the interaction between TAMs and Hep3B hepatoma cells.