Objective: To observe the clinical efficacy of Nie-pinching the spine, puncturing Sifeng (EX-UE 10) plus Chinese herbs in treating pediatric anorexia due to dysfunction of spleen in transportation. Methods: A total of 64 kids were randomized into an observation group and a control group by the random number table method, with 32 cases in each group. Patients in both groups received Jian Pi Kai Wei (strengthening spleen and stomach) powder according to pattern differentiation of traditional Chinese medicine (TCM). In addition, patients in the observation group received Nie-pinching the spine and puncturing Sifeng (EX-UE 10). Nie-pinching the spine was applied twice a week, and puncturing Sifeng (EX-UE 10) was performed once a week, with 2 weeks counted as 1 course of treatment. After 2 courses of treatment, the body mass index (BMI), peripheral blood leptin level and the microelements Zn, Fe and Se were compared at different time points (before treatment, after the first and second courses of treatment), as well as the therapeutic efficacy and onset time. Results: After 2 courses of treatment, 31 cases in each group were evaluated. After the 1st course and the 2nd course, the BMI and serum Zn, Fe and Se levels in the observation group increased significantly (all P<0.05), the leptin level decreased substantially (both P<0.05); the BMI in the control group showed a substantial rise (P<0.05), while the Zn, Fe and Se levels slightly increased showing no statistical significance (all P>0.05), and the leptin level decreased but the difference showed no statistical significance (P>0.05). After the 1st and the 2nd courses of treatment, the BMI, serum Zn, Fe and Se levels increased more significantly (all P<0.05), and the serum leptin level decreased more significantly (both P<0.05) in the observation group than in the control group. After the 2nd course, the total effective rate and recovery rate in the observation group were both higher than those in the control group (both P<0.05), together with a quicker onset time (P<0.05). Conclusion: Nie-pinching the spine, puncturing Sifeng (EX-UE 10) plus Chinese herbs is effective for pediatric anorexia due to dysfunction of spleen in transportation. It can decrease leptin, increase Zn, Fe and Se levels, alleviate apositic symptoms and increase BMI in the kids.

Objective To investigate the expression pattern of Nrf2 in the lung of septic rat and preliminary analysis of the role of Nrf2 in the development of sepsis. Methods Wistar rats were used in this study, it was divided into 4 groups, including normal control group, pure burn group, burn with staphylococcus sepsis group, burn with pseudomonas sepsis group. According to the different time intervals such as 2 hours, 8 hours, and 24 hours, it was divided into three sub-group after injection of bacteria. The expression of Nrf2 in the lung at different time intervals was determined. Results Nrf2 mRNA in the lungs of normal rats was high expression （74.0±7.0）, Nrf2 mRNA in the lungs of pure burns rats obviously down-regulated, respectively as 34.5±1.9,50.4±2.2,32.1±1.4, （t＝5.69～14.63,P＜0.01）. Nrf2 mRNA in burn sepsis caused by Staphylococcus aureus in lung tissue of rats down-regulated expression, respectively as 53.1±5.0,14.4±1.6,48.5±1.9,and reached peak at 8 h（t＝5.59～29.3,P＜0.01）. Pseudomonas aeruginosa burn sepsis didn't induced Nrf2 mRNA in the lung tissue, but it showed a downward trend at 2h（71.0±8.1,P＞0.05）and markedly reduced after 8, 24 h（24.8±2.1,4.1±2.0,t＝21.33,68.1,P＜0.01）.Conclusions The distribution of Nrf2 mainly localized in immune organ, and it directly took part in the post burn immune response.

Objective: To establish a new method for determination of guaiacul in Succus Bambusa. Methods: The contents of guaiacul were determined by HPCG with sequential increase of temperature on a HP 6890 gas chromatograph. Results: The calibration curve showcd good linearity over the range of 0 ng～47.808 ng(r=0.99995). The average recovery was 99.64% and the relative standard deviation was 2.1%(n=6). Conclusion: The method is simple, and accurate with a good reproducibility and can be used as quantitative analysis method for Succus Bambusae.

Objective:To study how to guide the individual dose of clopidogrel in line with the genetic testing results. Methods:Clinical pharmacists decided how to optimize the prescription of clopidogrel according to the genotype combined with the drug metabolism and drug interactions for three patients respectively with slow clopidogrel metabolism,intermediary metabolism and super fast metabolism. Results:The slow clopidogrel metabolism patient with subacute stent thrombosis after half a month of coronary stenting was switched to orally administrate with ticagrelor. The super fast metabolism patient suffered from repeatedly subcutaneous hemorrhage with antiplatelet therapy was suggested to lower the dose of clopidogrel,temporarily withdraw Maixuekang capsules and conventionally administrate with vitamin C tablets orally. The intermediary metabolism patient with late stent thrombosis co-treated with lansoprazole was suggested to increase the dose of clopidogrel or use ticagrelor instead,and when it was necessary,panxitorazole,ray Bella or the other ranitidine acid suppression drugs such as ranitidine could be considered. Conclusion:Through genetic testing and drug interactions,clinical pharmacists guide the clinical use of clopidogrel and the optimization of antiplatelet therapy.

Objective To explore the therapeutic effects of human glial cell line-derived neurotrophic factor (GDNF)-engineered rat neural stem cell (NSC) transplantation in rat model of Parkinson's disease ( PD) . Methods SD rats received a single injection of 24 μg of 6-hydroxydopamine (6-OHDA) at two sites in right striatum. Then 10 days after surgery, the successful animal models of PD were divided into 3 groups: PD model group ( 2 μl transplantation media was injected in right striatum), NSC group (transplanted were 2×10~5 NSCs infected by bare lentivirus) and GDNF group (transplanted were 2×10~5 GDNF-engineered NSCs). The rotation scores were assessed 5 weeks, 7 weeks and 9 weeks after transplantation. The dopaminergic neurons in substantia nigra ( SN ) were analyzed quantitatively using immunohistochemistry for tyrosine hydroxylase (TH), and the dopamine and its metabolites, dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were analyzed 9 weeks after transplantation by high performance liquid chromatography ( HPLC) . Results GDNF-engineered NSC transplantation could effectively improve the behavioral performance in rats. At the 5th week after cell transplantation, the rotation turns within 90 min were (993. 9±159. 1) turns, (956. 7±136. 3) turns and (433. 6±100. 9) turns in PD model group, NSC group and GDNF group respectively (F=95. 694, P = 0. 000). At the 7th week, the rotation turns within 90 min were (964. 2 ± 152.0) turns, (909. 2 ± 136. 3) turns and (399. 4±84. 4) turns in PD model group, NSC group and GDNF group respectively (F = 106. 134, P=0. 000). At the 9th week, the rotation turns within 90 min were (909. 5±152. 2) turns, (865. 5± 129. 1) turns and (312. 2±63. 7) turns in PD model group, NSC group and GDNF group respectively (F= 151. 100, P = 0.000). GDNF-engineered NSC transplantation could significantly increase the levels of dopamine and its metabolites in injured striatum. The concentrations of dopamine in injured striatum was higher in GDNF group than that in PD model group and NSC group C(7. 5±0. 8) ng/mg vs. (3.3±0.3) ng/mg and (3. 7±1. 3) ng/mg, F=59. 543, P = 0. 0003. The level of DOPAC was higher in GDNF group than that in PD model group and NSC group C(0. 9±0. 1) ng/mg vs. (0. 5± 0. 1) ng/mg and (0. 6±0. 2) ng/mg, F= 17. 293, P=0. 000]. The concentration of HVA in injured striatum was higher in GDNF group than that in PD model group and NSC group [(0. 9±0. 1) ng/mg vs. (0.5±0. 1) ng/mg and (0. 6±0. 2) ng/mg, F=35.175, P = 0.000]. Conclusions engineered NSC transplantation improves the function of dopamine system in SN and striatum, and GDNF gene therapy has potential clinical value.

Humans ; Sialorrhea ; etiology ; therapy

To develope a 5 lipoxygenase inducible expression system for further understanding the function and signal transduction pathway of 5 lipoxygenase, providing information for drug screening.The 2 kb 5 LO cDNA sequence containing HindⅢ site was generated by PCR using pEGFP 5LO as a template. Full length 5LO cDNA was subsequently cloned into the corresponding Pst Ⅰ and Sal Ⅰ sites of the plasmid pBI G to generate the mammalian expression vector pBI 5LO. HeLa Tet On cell line was co transfected with pBI 5LO and pTK Hyg plasmids. Inducible expression of target gene was detected using X gal histochemical staining of cell monolayers for ? galactosidase after incubating the transfected cell line with 1 ?g/ml doxycycline for 48 h.The HindⅢ restriction digest site was inserted into polyclonal site of pBI G and recombinant vector pBI 5LO was constructed. The desired recombinant plasmid pBI 5LO was identified by restriction analysis, and orientation and junctions were confirmed by sequencing. Induction of the target gene expression by doxcycline treatment was demonstrated by X gal histochemical staining and nuclei of the cells that have expressed the pBI 5LO expression vector were brilliant blue.The 5LO inducible expression system is established successfully and it works well in cell model.

Objective To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter.Methods A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test. The catheter was withdrawn step by step and the injection test was repeated until the presence disturbance wave presented, which indicated that the balloon had just entered the esophagus. The position where disturbance wave appears was named 0 cm. End-expiratory occlusions were performed at the positions of+15,+10,+5, 0, -5, -10 and -15 cm, respectively, and the changes of esophageal pressure (Pes) and airway pressures (Paw) were measured in the spontaneous breathing and passive ventilation, and the ratio between the changes (ΔPes/ΔPaw) was calculated.Results A total of 20 patients were enrolled, of which 15 patients finished both the spontaneous and the passive ventilation parts, and 2 patients finished only the spontaneous part and 3 patients finished only passive part. ① Disturbance waves could be induced by injection test in all patients. The average depth of disturbance wave in spontaneous breathing was deeper than that in passive ventilation (cm: 42.4±3.8 vs. 41.8±3.3), but there was no significant difference between the two ventilation settings (P = 0.132). No adverse events occurred during the study period. ② Pes increased with the stepwise withdraw of esophageal catheter, reached the maximal value at+5 cm, and then decreased when the catheter was further withdrawn, no matter in the spontaneous or the passive ventilation. In spontaneous breathing, the ΔPes/ΔPaw was within the ideal range (0.8-1.2) at the positions of 0, -5 and -10 cm. The ΔPes/ΔPaw was closest to unity at the positions of 0 cm (0.98±0.15). The ΔPes/ΔPaw at -15 cm (0.66±0.26) was significantly lower than that at 0 cm (P < 0.05). For passive ventilation, the ΔPes/ΔPaw was within the ideal range at the positions of -5 cm and -10 cm, and the ΔPes/ΔPaw was closest to unity at the positions of-10 cm (0.94±0.12). The ΔPes/ΔPaw at 0 cm and -5 cm was significantly higher than that at -10 cm (1.43±0.31 and 1.12±0.14, respectively); while the ΔPes/ΔPaw at -15 cm (0.68±0.23) was significantly lower than that at -10 cm (allP < 0.01).Conclusions Ideal position of the esophageal balloon catheter could be determined quickly and easily by using injection test. The method is safe and clinically feasible.Clinical Trial Registration Clinical Trials, NCT02446938.

Objective To evaluate the effect of early continuous renal replacement therapy(CRRT)on patients with acute kidney injury(AKI)induced by severe sepsis. Methods A prospective study was conducted. 160 patients with AKI induced by severe sepsis admitted to intensive care unit(ICU)of Qingyuan People's Hospital between October 2009 and June 2013 were enrolled. According to the starting time of CRRT,the patients were randomly divided into two groups:an earl y treatment group and a regular treatment group(each,80 cases). All patients were treated in accordance with the principle of the cluster of severe sepsis. In early treatment group,the patents began to receive CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment over 6 hours,but the curative effect was not ideal. In the regular treatment group,the patients began to apply CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment persistently over 24 hours or difficultly corrected acidosis or heart failure developed. The changes in urine output,creatinine,saturation of blood oxygen,and albumin,and 28-day survival rate,length of ICU stay,time of organ support were measured and compared between the two groups to evaluate the therapeutic significance of the early CRRT. Results The mean length of ICU stay(day:6.5±1.7 vs. 8.2±1.6),length of organ support(day:5.3±1.8 vs. 6.0±1.4),the recovery time of urine amount(day:3.4±0.9 vs. 4.8±0.5)in early treatment group were significantly shorter than those in regular treatment group(all P<0.01);recovery ratio of urine in 1 week in early treatment group was significantly higher than that in regular treatment group(46.2%vs. 28.8%,P<0.05). The creatinine recovery ratio in 1 week in early treatment group was lower than that in regular treatment group(55.0%vs 78.8%),but there was no statistically significant difference(P>0.05). Early treatment group and regular treatment groups of creatinine recovery time were similar(day:5.1±1.3 vs. 5.2±1.2). 28-day survival rate in early treatment group was higher than that in regular treatment group(41.2%vs. 35.0%),but there was no statistically significant difference(P>0.05). Conclusion It is found that there is no evidence to suggest that early CRRT may improve the prognosis of the patients with AKI induced by severe sepsis,but it may be in favor of shortening the time of urine recovery,length of stay in ICU,length of organ support and length of dialysis.

Objective:To explore the diagnosis and treatment of ketamine-associated urinary system dysfunction. Methods:Total-ly 56 cases of urinary tract symptoms with the history of ketamine abuse in recent years were retrospectively analyzed. The routine ex-amination and the examination related to the urinary system were given, and individual treatment was undertaken according to different situation. Results: The main symptom of ketamine-asscociated urinary tract dysfunction was lower urinary tract symptom (LUTS). Bladder pathologic biopsy showed different degree of inflammatory change. Imaging examination showed various degree of pathological changes, including reduced bladder capacity, thickened bladder wall, bladder contracture, ureteral stricture and hydronephrosis. Three patients had increased serum creatinine level. Conclusion: Ketamine-asscociated urinary system dysfunction is a disease with LUTS as the main clinical symptom. At the early stage, the disease is reversible with promising treatment outcome. In the progression of the disease, some patients develop irreversible histological changes in the urinary tract, which should be brought to the forefront.