Objective To evaluate the protective effect of large dose of ambroxol hydrochloride on lung ischemia reperfusion injury in rats and analyze the relationship between ambroxol hydrochloride and pulmonary vascular permeability mediators including EphrinAl, HIF-1α and VEGF at mRNA and protein levels.Methods Rats were operated by the thoracic posterolateral approach.The left lung is-chemia was induced by clamping the hilum of the left inflated lung for 60 minutes, and then followed by a 6-hour reperfusion.Forty rats were divided into ischemia-reperfusion group, ambroxol hydrochloride inter-vention group, sham operation group and blank control group.At the beginning of reperfusion, rats in am-broxol hydrochloride group were infused with ambroxol hydrochloride solution (3.75 mg ·kg~(-1) ·h~(-1)) via femoral vein for six hours.Then, PaO_2, wet-to-dry lung weight ratio, concentrations of IL-1β and TNF-a, activity of myeloperoxidase (MPO), mRNA and protein expressions of EphrinAl, HIF-1a and VECF were detected.Histopathological changes were observed under light microscope.Results (1) Histo-logical observation with light microscope showed significant decrease of diffuse alveolar damage consisting of septal edema, intraalveolar hemorrhage and exsudation in ambroxol hydrochloride group compared with ischemia-reperfusion group.The wet-to-dry lung weight ratio in ambroxol hydrochloride group was de-creased and PaO_2 was elevated significantly.(2) Compared with ischemia-reperfusion group, the concen-trations of IL-1β and TNF-α and activity of MPO in ambroxol hydrochloride group were decreased signifi-cantly.(3) The mRNA and protein expressions of EphrinAl, HIF-la and VEGF in ambroxol hydrochl-oride group did not recover to normal but were down-regulated significantly compared with ischemia-reper-fusion group.Conclusions (1) Large dose of ambroxol hydrochloride can alleviate the LJRI damage by down-regulating the expressions of IL-1β and TNF-α and the activity of MPO in the lung parenchyma.(2) The mRNA and protein expressions of EphrinA1, HIF-1α and VECF can be down-regulated by large dose of ambroxol hydrochloride, which contributes to alleviation of the LJRI damage.The results indicate possible role of gene regulation and fresh pharmacological effect of ambroxol hydrochloride during forma-tion of LIRI.

Objective To investigate the protective effects of ambroxol on lung during perioperation in elderly patients with myasthenia gravis.Methods 58 elderly patients diagnosed as myasthenia gravis combined with thymic disease were divided into treatment group and control group randomly.During the perioperation,the treatment group was treated with ambroxol,while the control group was not.Comparative analysis of pulmonary complications,pulmonary ventilation indexes,blood gas indexes,and serum concentration of C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),interleukin 1β (IL-1β) and IL-10 was performed.Results The incidence rate of postoperative pulmonary complications (pulmonary atelectasis,pneumonia and bronchitis) was significantly lower in the treatment group in the control group (9.4％ vs 15.6％,P＜0.05).Peak inspiratory pressure (PIP) and resistance of air way (RAW) were lower in treatment group than in control group [(22.32±3.43) cmH2O vs (26.54±4.81) cmH2O,(29.17±5.74) cmH2O· L-1s-1vs (34.47±7.94) cmH2O · L-1 · s-1 both P＜0.05],while compliance of lung (CL) washigher in treatment group than in control group [(106.04±-14.73)ml/cmH2O vs (95.11±9.50) ml/cmH2O,P＜0.05].Two days after operation,PaO2,SaO2 and PaO2/FiO2 were significantly higher in treatment group than in control group [(89.66 ±13.23) mmHg vs (70.94±12.75) mmHg,(96.95±2.65)％ vs (89.44±2.78)％,(219.47±54.05)mmHg vs (187.38±37.72) mmHg,respectively,all P＜0.05].Serum concentration of CRP,TNF-α,IL-1β were lower and serum level of IL-10 was higher in treatment group than in control group [(29.37 ± 14.87)mg/L vs (43.94 ±21.42) mg/L,(35.55±4.74)μg/L vs.(52.80±6.63) μg/L,(17.06±6.85)μg/L vs.(28.62±7.72) μg/L],[(132.84± 12.91)μg/L vs.(87.18± 16.37)μg/L,respectively,all P＜0.05].Conclusions Ambroxol hydrochloride can effectively reduce the incidence rate of postoperative pulmonary complications after thymectomy,improve the pulmonary ventilation function,and inhibit the inflammatory reaction in elderly patients with myasthenia gravis,which is worthy of wide application in the perioperation.

Objective:To compare the pharmacokinetics consistence of baicalin between traditional slice decoction and dispensing granule decoction of Huanglianjiedu decoction. Methods:After the gastric administration of the two decoctions at low, middle and high dose in rats, an HPLC method was used to detect the content of baicalin in the plasma, and then DASS 2. 1. 1 software was used to cal-culate the pharmacokinetic parameters. Results:After the administration of the two decoctions at low, middle and high dose, the phar-macokinetic parameters were as follows:Cmax of 0. 25 and 0. 27μg·ml-1 ,0. 30 and 0. 31 μg·ml-1 ,0. 40 and 0. 45 μg·ml-1;AUC of 2. 48 and 2. 59μg·ml-1 ·h,3. 59 and 3. 71μg·ml-1 ·h,5. 71 and 6. 16μg·ml-1 ·h;Tmax of 3. 0 and 3. 0 h,3. 0 and 3. 0 h, 4.0 and 4.0 h;Vd of (2 822.4 ±118.2) and (2 998.9 ±255.6) L·kg-1,(3 102.6 ±176.3) and (3 405.3 ±213.8) L·kg-1, (4 231.2 ±155.4) and (4 486.0 ±187.0) L·kg-1;CL of (2 923.3 ±215.6) and (2 767.5 ±184.6)L·h-1·kg-1,(4 921.7 ± 225.4) and (4 040.8 ±246.7)L·h-1·kg-1,(5 255.9 ±189.7) and (4 868.7 ±260.4)L·h-1·kg-1;and t1/2 of (3.88 ± 0.41) and (3.71 ±0.37)h,(4.19 ±0.36) and (3.73 ±0.51)h, (5.54 ±0.38) and (5.80 ±0.54)h. Conclusion: The pharma-cokinetic parameters of baicalin have no significant difference between traditional slice decoction and dispensing granule decoction of Huanglianjiedu decoction.

Animals ; Hypertension ; metabolism ; physiopathology ; Male ; Myocardium ; metabolism ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Receptors, G-Protein-Coupled ; genetics ; metabolism

Objective To study the inhibition of tumor necrosis factor-alpha(TNF-α)cytokine expression of BV-2 cells induced by hypoxia-reoxygenation injury by siRNA targeting TLR4 gene via the RNAi mechanisms.Method BV-2 mouse microglial cell line was cultured in six-well plates and randomly divided into group N(nor-mal group),group H(hypoxia-reoxygenation),group T(hypoxia-reoxygenation+TLR4-siRNA transfected group),group C(hypoxia-reoxygenation+pEGFP-H1/control-siRNA transfected group)and group B(hypox-ia-reoxygenation+pEGFP-H1 transfected group).Group H,group T,group C and group B were cultured in hy-poxia condition for 3 h followed by reoxygenation for 24 h.The plasma was transfected into BV-2 cells mediated by lipofectamine 2000.The efficiency of transfection were detected by flow cytometry to observe the expression of EGFP.RT-PCR method was used to detect the level of mRNA of TLR4 or NF-кB p65.Westem blot methed was used to test the expression of TLR4 protein.and ELISA was used to test the level of TNF-α in the supernatants.Analysis of variances was used for statistical analysis.Results The expression of EGFP gene waa;(67.58±7.16)% after transfection by flow cytometry analysis.Compared to group N,the TLR4 mRNA,NF-кB p65 mR-NA,TLR4 protein level and the TNF-α quantity in group H,group T,group C and group B increased after the hy-poxia-reoxygenation treatment(P＜0.01).While the expression of the TLR4 mRNA,NF-кB p65 mRNA,TLR4 protein level and the TNF-α quantity in the group T down-regulated compared to group H,group C and group B(P＜0.01).And there were no changes in group C,group B and group H about observation index(P＞0.05).Conclusions The siRNA targeting TLR4 mRNA could inhibit the inflammatory reaction released by BV-2 cells in-duced by hypoxia-reoxygenation stimulation.

Objective To compare several methods for the rapid detection of methicillin resistant StaphylOCOCCUS aureus(MRSA).Methods Forty-four Staphylococcus aureus isolates from Tianjin Medical University Cancer Institute and Hospital(TMUCIH)were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method,Oxacillin micro-broth dilution method,E tests and PBP2a Latex agglutinaltion assay.These above results were compared with PCR analysis.Results PCR analysis showed that 36 MRSA strains containing mecA was identified.Thirty-two MRSA strains were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method and Oxacillin micro-broth dilution method.Compared with PCR analysis,the sensitivity and specificity is 88.9%and 100%respectively.Thirty-three MRSA strains were identified by E test,with the sensitivity of 88.9%and specificity of 87.5%.Twenty-nine MRSA strains were identified by PBP2a latex agglutination assay with the sensitivity of 80.5%and specificity of 100%.Conclusions The turnaround time of PBP2a Latex agglutination assay could be reduced 24 h compared with other methods for detection of MRSA.This rapid,convenient and specific method could be applied in clinical laboratories for MRSA detection.

Objeetive To investigate the effects of nimodipine combined with edaravone on cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH).Methods The consecutive patients with aSAH who underwent microsurgical clipping were included retrospectively.All patients received intravenous prophylaxis with nimodipine,and some patients also used edaravone (30 mg,twice a day for 2 weeks).They were divided into either a CVS group or a non-CVS group according to the findings of transcranial Doppler.They were also divided into a DCI group and a non-DCI group according to the findings of CT reexamination and clinical examination.The demographics,baseline clinical data,Glasgow Coma Scale (GCS) score,Fisher grade,Humt-Hess grade,and aneurysm location of all patients were collected.The multivariate logistics regression analysis was used to identify the independent risk factors for CVS and DCI.Results A total of 220 patients with aSAH were enrolled in the study,132 (60.0％) had CVS and 106 (48.2％) had DCI.One hundred twenty-three patients (55.9％)were treated with nimodipine + edaravone,97 were treated with nimodipine alone,none of them died.The incidences of CVS (51.2％ vs.71.1％;x2 =8.962,P =0.003) and DCI (35.0％ vs.65.0％;x2 =19.535,P ＜0.001) in patients receiving nimodipine + edaravone therapy were significantly lower than those receiving nimodipine alone.The proportions of hypertension,hyperlipidemia,diabetes,smoking,high Fisher grade in the CVS group were significantly higher than those in the non-CVS group (all P ＜0.05),while the proportion of patients receiving nimodipine + edaravone therapy (47.7％ vs.68.2％;g2 =8.962,P =0.003) and the GCS score (11.2 ±3.1 vs.13.4 ±2.6;t =5.492,P＜0.001) were significantly lower than those in the non-CVS group.Multivariate logistic regression analysis showed that low GCS score (odds ratio [OR] 6.57,95％ confidence interval [CI] 1.04-12.96;P=0.001),high Fisher grade (OR 5.39,95％ CI 4.09-20.15;P =0.004),hyperlipidemia (OR 4.39,95％ CI 2.97-34.15;P =0.004),hypertension (OR 3.24,95％ CI 1.06-13.47;P=0.016) were the independent risk factors for CVS,while received nimodipine + edaravone was the independent protective factor for CVS (OR 0.39,95％ CI0.13-0.91;P =0.039).The proportions of patients with hypertension,hyperlipidemia,diabetes,smoking,and high Fisher grade in the DCI group were significantly higher than those in the non-DCI group (all P ＜0.05),while the proportion of patients received nimodipine + edaravone (40.6％ vs.70.2％;x2 =19.535,P ＜ 0.001) and the GCS score (10.2 ± 2.4 vs.13.8 ± 2.6;t =10.648,P ＜ 0.001) were significantly lower.Multivariate logistic regression analysis showed that low GCS score (OR 8.92,95％ CI 2.48-26.94;P =0.001),high Fisher grade (OR 7.49,95％ CI 1.96-20.47;P =0.001) were the independent risk factors for DCI,while.received nimodipine +edaravone was an independent protective factor for DCI (OR 0.27,95％ CI 0.08-0.97;P =0.020).Conclusions Compared with nimodipine alone,nimodipine combined with edaravone can significantly reduce the incidences of CVS and DCI.The GCS score,high Fisher grade,and hypertension are the independent risk factors for CVS and DCI in patients with aSAH,and nimodipine combined with edaravone is the independent protective factor for CVS and DCI.

OBJECTIVE:To establish the HPLC fingerprints for Herba clematidis in northeast. METHODS:HPLC was per-formed on the column of Hedera ODS-2 C18 with mobile phase of acetonitrile-0.5% phosphoric acid solution(gradient elution)at a flow rate of 1.0 mL/min,detection wavelength was 338 nm,column temperature was 30 ℃,and the injection volume was 20 μL. Using rutin as as a reference,the HPLC profiles of 10 batches of H. clematidis were determined,Similarity Evaluation Software for Chromatographic Fingerprint of Traditional Chinese Medicine(2004A edition) was used for the common peaks identification and similarity evaluation. RESULTS:There were 16 common peaks in the 10 batches of H. clematidis,similarity degree was higher than 0.9. It was proved that the HPLC profiles and control fingerprint profile of 10 batches of H. clematidis had good consistency. CONCLUSIONS:The established fingerprints can provide reference for the identification and quality evaluation of H. clematidis in northeast.

Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

BACKGROUND:Bone loss to different degrees may appear within 1 year after hip replacement in the femoral or acetabular sides, and severely affect long-term stability of the prosthesis and bone strength. Thus, to reduce bone loss around the prosthesis stem after total hip replacement is significant to prolong the use time of the prosthesis and to prevent fractures surrounding the prosthesis.
OBJECTIVE:To observe the preventive effect of zoledronic acid on bone loss surrounding the prosthesis stem after hip replacement.
METHODS:A total of 80 patients after total hip replacement in the People’s Hospital of Shenxian from February 2011 to September 2014 were enrol ed in this study. They were divided into two groups (n=40). At 4 days after replacement, patients in the observation group received treatment with zoledronic acid, but those in the control group did not give zoledronic acid. The rest medication was identical between the two groups. Bone mineral density in the hip was measured before replacement and at 1 year after replacement in both groups. Serum calcium and
phosphorus levels and alkaline phosphatase activities were observed before replacement, 3 days and 1 year after medication in the two groups. Adverse reaction during medication was recorded in the observation group.
RESULTS AND CONCLUSION:The average bone mineral density was significantly decreased in both groups at 1 year after replacement, and significant differences were found as compared with before replacement (P<0.05). The average bone mineral density was significantly higher in the observation group than in the control group at 1 year after
replacement (P<0.05). Calcium and phosphorus levels were significantly diminished at 3 days after medication as compared with that before replacement (P<0.05). Calcium and phosphorus levels maintained at the level before replacement at 1 year after medication. Alkaline phosphatase activities were slightly reduced within a short time after replacement in both groups, but no significant difference was found as compared with before replacement (P>0.05). Alkaline phosphatase activities were low in the observation group at 1 year after medication, and significant difference was detected as compared with the control group and that before replacement (P<0.05). No significant difference in alkaline phosphatase activities was detectable in the control group between 1-year post medication and pre-replacement (P>0.05). Within two or three days after medication, nine patients suffered from varying degrees of muscle aches and fever in the observation group, and above symptoms were lessened after taking acetaminophen. These results verify that after total hip replacement, zoledronic acid injection can effectively prevent bone loss around the prosthesis in early stage after replacement, but fever symptoms may occur within a week after replacement. Thus, it is recommended that zoledronic acid injection can be given at 1 week after replacement. If fever and other symptoms appear, acetaminophen can be given.