Objective To study the toxicity and its mechanism of Radix Aconitii from genetic and molecular levels.Methods According to the requirements of ICH,the acute toxicity experiment was carried out under the condition of SPF by ig administration of the decoction of Radix Aconitii to mice.Gene expression profiling was used to describe whole-genome of five organs in mice,the related data were analyzed by using bioinformatics statistics,such as Cluster,GO,and Pathway,and the results were validated through quantitative PCR.Results The effects of Radix Aconitii on the key genes of the Focal adhesion pathway of mice,such as ECM,FAK,Cdc42,were remarkably.Conclusion The reason why Radix Aconitii produces the toxicity is probably that Radix Aconiti could cause the toxicity of Focal adhesion signal pathway through influencing the key genes.

Objective To investigat the symptom burden of patients with maintenance hemodialysis (MHD) and explore the influencing factors of them,in order to provide the basis for improving the quality of life of these patients.Methods A total of 230 patients with MHD were enrolled in Xiangtan Central Hospital from January 2016 to December 2016,the general condition and disease-related data of them were collected,and the symptom burden of them over the past week was assessed by improved symptom burden scale.Results ① The average age of these patients were (56.8 ± 14.1)years,the sex ratio for men and women was 1.37∶ 1,the median time of dialysis was 24 months,and the frequency of dialysis was (9.16 ± 2.36)times;② The symptom score in MHD patients was (65.72 ± 28.46)points,the top 5 symptoms which had higher incidence were fatigue (72.2％),dry mouth (63.5％),itching (61.3％),falling asleep difficultly (54.3％),drying (49.2％),the top 5 symptoms which were more troubling were restless legs syndrome (2.54 ± 0.73),falling asleep difficultly (2.48 ± 0.83),bone/joint pain (2.45 ± 0.69),fatigue (2.31 ±0.77),easy to wake up (2.16 ±0.78);③ Age,sex,occupation,dialysis age,inorganicphosphorus and serum calcium had an effect on the symptom burden of MHD patients (P ＜ 0.05).Condusions We should focus on patients who are older,female,retired or no occupation,longer dialysis age,calcium or phosphorus metabolism disorders,provide targeted care and treatment,in order to reduce the symptom burden and improve the life quality of them.

Objective To study the clinical effect of triethanolamine cream in treatment of traumatic wounds and its effect on level of interleukin-2 (IL-2), interleukin-8 (IL-8) and tumor necrosis factor-α(TNF-α).Methods 88 patients with traumatic wounds were selected in our hospital from February 2015 to January 2016, those patients were divided into observation group and control group according to coin method.The control group was treated with alginate dressing, observation group were given triethanolamine cream for treatment.The levels of IL-2, IL-8, TNF-αand visual analogue scale(VAS) between the two groups were compared.The clinical curative effect of the two groups was evaluated.Results After treatment, the total effective rate of the observation group(90.91%) was significantly higher than the control group (68.18%).There were no significant differences in VAS scores between the two groups before treatment, 5, 10,20 days after treatment, the VAS scores of the two groups were significantly lower than before treatment (P<0.05), at 5,10,20 days after treatment, the VAS scores in the observation group were significantly lower than the control group (P<0.05).The level of IL-2 in the observation group were significantly higher than the control group, the levels of IL-8,TNF-αwere significantly lower than the control group (P<0.05).Conclusion Triethanolamine cream can increase the level of IL-2 and decrease the levels of IL-8 and TNF-αin patients with traumatic wounds, it can relieve the pain of patients and has good clinical curative effect.

Objective:To study the dynamic changes of serum AFP before and after cryosurgery for liver cancer.Methods:The dynamic changes of serum AFP in 46 cases of liver cancer before and after cryosurgery were analyzed.Results:In those with a negative AFP before operation,the value of AFP increased rapidly 3 days after operation,kept positive for half a month,and was difficult to be turned negative.In those with a positive AFP before operation,there were no evident changes 3 days after operation,and the value of AFP decreased to normal half a month after operation.Conclusion:The change of AFP had some characteristic in the cryosurgery of liver cancer.Detection on the changes of AFP value is helpful in judging the curative effect and prognosis of cryosurgery for liver cancer patients.

Objective To investigate the effect of levodopa on melanogenesis in Penicillium mameffei (PM),and to determine if melanization affects the antifungal drug susceptibility of PM.Methods A clinical isolate of PM,GXMU121011,was inoculated onto Sabouraud's dextrose agar (SDA) containing different concentrations (0.1-10 mmol/L) of levodopa at an inoculum density of 1.0 × 106 cfu/ml,or onto SDA containing 1 mmol/L levodopa at three inoculum densities (1.0 × 105,1.0 × 106,1.0 × 107 cfu/ml),and cultured at 37 ℃ for 7 days.Subsequently,melanization of PM colonies was observed.The paper-disk method was used for antifungal susceptibility testing,and the diameter of inhibition zones of itraconazole,fluconazole and amphotericin B against 8 clinical strains of PM was determined on SDA with or without levodopa.Results The melanization of PM colonies increased when the concentration of levodopa increased from 0.1 to 1.0 mmol/L,peaked when that reached 1.0 and 3.0 mmol/L,but mildly decreased when that continuously increased beyond 3.0 mmol/L,and a slight shrinkage was observed in PM colonies when that was 10.0 mmol/L.The color of colonies deepened along with the increase in inoculum density of PM.The average diameters of inhibition zones of itraconazole,fluconazole and amphotericin B against PM were all significantly lower on SDA with levodopa than on SDA without levodopa (all P ＜ 0.05).Conclusions Levodopa concentration and inoculum density both affect melanogenesis in PM.Melanization may decrease the susceptibility of PM in yeast phase to itraconazole,fluconazole and amphotericin B in vitro.

The trophoblast is fetal-derived and in direct contact with maternal tissues. The expression of the various types of MHC antigen in trophoblast cells is very important for successful pregnancy. Among nonclassical MHC class Ⅰ antigens, HLA-G is expressed specifically on cytotrophoblast cells and its expression protects the fetal from maternal immune attack. The expression of the distinct subtypes of classical MHC class Ⅰ antigen is different in different subtypes of trophoblast cells. The expression of MHC class Ⅱ antigen is inhibited in trophoblast during pregnancy. It is suggested that C Ⅱ TA plays an important role in regulation of MHC class Ⅱ gene expression.

Objective To investigate the effect of tetramethylpyrazine injection on serum ion and β2-GPI/ox-LDL in patients with IgA nephropathy.Methods 58 IgA nephropathy patients were randomly divided into two gorups with 29 cases in each group.The control group were treated by benazepril and conventional treatment of dipyridamole, the experiment group were treated on the basis of the control group with tetramethylpyrazine injection.10 days of 1 courses, 2 courses of treatment.The serum ion,β2-GPI/ox-LDL and renal function related indexes were tested.Results Compared with before treatment, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower( P<0.05), the blood calcium level were higher(P<0.05).Compared with the control group, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower(P<0.05), the blood calcium level were higher(P<0.05), the clinical effect were higher (P<0.05).Conclusion Tetramethylpyrazine injection can effectively decrease the serum phosphorus, β2-GPI/ox-LDL, SCR, BUN, CysC levels and urinary protein amount of patients with IgA nephropathy, elevate blood calcium levels, significantly improve renal function and with less adverse reactions.

Articular cartilage repair is limited. Current treatments for cartilage defect are less satisfactory, and rarely restore full function or return the tissue to its native normal state. The rise of tissue engineering holds great promise for the generation of functional cartilage tissue substitutes. The history of cartilage tissue engineering and highlights the applications and advantages of various kinds of scaffolds in cartilage tissue engineering, such as native scaffolds, synthesis scaffolds, composite scaffolds and nanometer scaffolds had been introduced. But native scaffolds have weak strength and immunogenicity insufficiency, synthesis scaffolds degrade quickly, whose degrading products have cytotoxicity,which need further improvement. The application of superficial decoration overcomes the disadvantage of some scaffolds to an extend. Composite scaffolds possess the advantages of several scaffolds, it points out the direction of future scaffolds research. The development of Nanometer technique endows newly-synthesis scaffolds with nano-grade, thus it has some advantages and give a new way for the development of tissue engineering. At the end, the problems of these scaffolds, their trend of development and perspective studies were discussed.

Objective To investigate risk factors for postoperative delirium in elderly patients with hip fractures and determine whether the delirium can influence the outcome of hip fracture.Method A retrospective case control study was performed for 521 patients (≥60 years) with hip fractures treated surgically from January 2012 to December 2014.There were 170 males and 351 females, with the age of (79.3±8.3)years.Confusion assessment method (CAM) was applied to diagnose delirium after surgery, and the subjects were divided into delirium group (n=159) and control group (n=362) according to the presence of delirium.Univariate and multivariate analyses were performed to identify the riks factors for postoperative delirium, including age, gender, comorbidities, body mass index, American Society of Anesthesiologists (ASA) classification, type of fracture, haemoglobin, PaO2, albumen, type of anesthesia, type of anesthesia, amount of bleeding, time between admission to surgery, length of operation, type of operation and amount of blood transfusion.Perioperative complications and mortality within 1 year after operation were compared between the two groups.Results Univariate analysis revealed dementia, ASA classification, haemoglobin, PaO2, albumen, interval between admission to surgery, anesthesia method, operation time, and surgery methods were risk factors for postoperative delirium incidence (P<0.05).While multivariate analysis showed only dementia (OR=6.211, 95%CI 2.482-23.498), long interval between admission to surgery (OR=3.505, 95%CI 1.478-6.342), arthroplasty (OR=2.015, 95%CI 1.783-3.481), and PaO2≤60 mmHg (OR=2.766,95%CI 1.783-5.039) were the significant risk factors for postoperative delirium after hip surgery in the elderly.Incidences of lung infection, wound infection, cardiovascular events, cerebrovascular events and deep venous thrombosis in delirium group were higher than those in control group, but only incidences of lung infection and wound infection reached significant differences (P<0.05).Mortality in delirium group was higher than that in control group within 1 year after operation, but there was significant difference only within 3 months after operation (P<0.05).Conclusions Incidence of delirium is high after hip fracture surgery in the elderly.Dementia, long interval between admission to surgery, arthroplasty and PaO2≤60 mmHg are significant risk factors for postoperative delirium incidence, and the delirium patients are associated with high early mortality.

Objective:To discuss the therapeutic effect of blood purification on hemorrhagic fever with renal syndrome combined with acute renal failure.Methods:60 patients with hemorrhagic fever with renal syndrome combined with acute renal failure were selected,and they were divided into two groups according to the odd and even number of hospitalization.The observation group (31 cases) received hemodialysis therapy.The control group (29 cases) received veno-venous hemofiltration therapy.The renal function,serum ion,blood routine indexes and the incidence of adverse reactions during treatment was detected and compared between two groups.Results:There were no statistical significance on K+,HCO3-,BUN,Cr between two groups (P＞0.05).After treatment,the K+,BUN,Cr levels were decreased in two groups (P＜0.05).The values of observation group were lower than those of the control group (P＜0.05).The level of HCO3-was increased in two groups,and it was higher in observation group than that of the control group (P＜0.05).Before treatment,there was no statistical significance on Hb,Hc,PLT between two groups (P＞0.05).After treatment,the Hb,Hc,PLT levels were increased in two groups (P＜0.05),but there were no statistical significance between two groups (P＞0.05).During 1 year of follow-up,the 6 months and 12 months survival rate of observation group was higher than that of the control group (P＜0.05).During treatment,there were no statistical significance on the incidence of adverse reactions between two groups (P＞0.05).Conclusions:The hemofiltration therapy has a good therapeutic effect on blood purification on hemorrhagic fever with renal syndrome combined with acute renal failure,and it can regulate the electrolyte balance,improve the renal function and increase the survival rate,which is equivalent to veno-venous hemofiltration therapy in amelioration of blood state.