OBJECTIVETo explore the effect of the mixed liquor of danshen and magnesium sulfate injection on inflammatory reaction caused by autoimmune response of rabbits with lumbar intervertebral disc herniation.

METHODSSixty rabbits were divided into blank group (10 rabbits), sham operation group (10 rabbits), model group (40 rabbits) according to method of random digits table. Then model group was divided into made group (group A, 10 rabbits), normal saline group (group B, 10 rabbits), aescin natrium group (group C, 10 rabbits) and danshen and magnesium sulfate injection group (group D,10 rabbits). After model success of lumbar intervertebral disc herniation, different drugs were given to rabbits with lumbar intervertebral disc herniation by ear margin vein. The rabbits of the group C,B,D were respectively given aescin natriu (0.5 mg/kg), normal saline (5 ml/kg), danshen and magnesium sulfate injection (2.0 mg/kg). The rabbits of blank group, sham operation group and group A were not given any disposal. The IgG and IgM level in serum of different groups were determined with ELISA method in fourteen day after model success and drugs given.

RESULTSThe level of IgG and IgM in the group A was higher than that of blank group and sham operation group (P < 0.05). The level of IgG and IgM in the group D was lower than that of group B,C (P < 0.05).

CONCLUSIONThe mixed liquor of danshen () and magnesium sulfate injection could inhibit inflammatory reaction caused by autoimmune response of lumbar intervertebral disc herniation,which provides a new alternative for lumbar intervertebral disc herniation.

Animals ; Disease Models, Animal ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Injections ; Intervertebral Disc Displacement ; blood ; drug therapy ; immunology ; Magnesium Sulfate ; administration & dosage ; Male ; Phenanthrolines ; administration & dosage ; Rabbits ; Random Allocation ; Salvia miltiorrhiza ; chemistry

Objective To observe the effects of different doses of sinomenine on toll-like receptor (TLR) 2, TLR4 and myeloid differentiation factor 88 (Myd88) in cartilage of rabbit knee osteoarthritis model; To discuss its mechanism of action. Methods Knee osteoarthritis model was established by Hulth method. Experimental rabbits were randomly divided into control group, model group, sinomenine low-, medium-and high-dose groups. Blank group received no processing. Model group, sinomenine low-, medium-and high-dose groups received intra-articular injection of normal saline and sinomenine 0.2 mL (5 mg), 0.35 mL (8.75 mg) and 0.5 mL (12.5 mg) respectively, for 10 times. Real-time fluorescence quantitative PCR and Western blot were used to detect m RNA and protein expressions of TLR2, TLR4 and My D88 in cartilage. Results m RNA and protein expressions of TLR2, TLR4 and MyD88 in model group significantly increased compared with control group (P＜0.01); compared with model group, m RNA and protein expressions of TLR2, TLR4 and My D88 in sinomenine medium-and high-dose groups decreased significantly (P＜0.05, P＜0.01). Conclusion Sinomenine can inhibit the cartilage immune response of rabbit knee osteoarthritis by down-regulating expressions of key molecules in the TLR/My D88 pathway.

OBJECTIVETo study the effect of Xianlong granules (XLG) on immunological function in the rat of adjuvant arthritis (AA).

METHODRats were randomly divided into normal group, AA model group, prednisone group and low, middle and high dose XLG groups, 10 rats in each group. All rats were treated by intragastric administration from the 18 days after arthritis was induced by the complete Freud's adjuvant and the effect of XLG on toes swelling was observed. On the 30th days after modeling, proliferation of the splenic and thymic lymphocytes, and IgG secreted by splenocytes were detected respectively by MTT assay and ELISA.

RESULTCompared with the model group, both the high and middle dose XLG groups had significant therapeutic effects on toes dwelling in the rat of AA (P < 0.05 or P < 0.01); The low, middle and high dose XLG groups strengthened the PHAM-inhibited proliferation of splenic lymphocytes (P < 0.05), and inhibited the PHAM-augmented proliferation of thymic lymphocytes (P < 0.05); XLG did not significantly effect on IgG level secreted by splenocytes in rats of AA.

CONCLUSIONXLG can cure toes swelling in rats of AA, which is related with regulation of the abnormal immunlological function.

Animals ; Arthritis, Experimental ; immunology ; pathology ; prevention & control ; Cell Proliferation ; drug effects ; Colubridae ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Edema ; immunology ; pathology ; prevention & control ; Female ; Immunoglobulin G ; metabolism ; Lymphocytes ; drug effects ; pathology ; secretion ; Male ; Materia Medica ; isolation & purification ; pharmacology ; Medicine, Chinese Traditional ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Spleen ; pathology ; secretion ; Thymus Gland ; pathology ; Toes ; pathology

BACKGROUNDAs a time-dependent antibiotic, the time of cefazedone concentration exceeds the minimum inhibitory concentration (MIC) is the key pharmacokinetic-pharmacodynamic (PK-PD) variable associated with the killing of pathogens. The purpose of the study was to evaluate the clinical regimen rationality of intravenous cefazedone sodium in the treatment of community-acquired pneumonia (CAP) by PK/PD study.

METHODSTen patients with mild to moderate CAP were enrolled to receive intravenous cefazedone sodium (2 g q12 h) for 7-14 days. Blood samples were collected in any day during day 5-7. Sputum specimens were collected before treatment for bacteria isolated, and susceptibility to cefazedone determined. PK-PD analysis was performed using the noncompartmental analysis of Phoenix WinNolin software (version 6.1, Pharsight Corporation, CA, USA). The maximal time above MIC (ƒT > MIC) was calculated, and its correlation with clinical efficacy was analyzed.

RESULTSAll 10 patients completed the study and 8 of them were cured. Six strains were isolated from patients before treatment (one for each patient) and all susceptible to cefazedone. Five patients of six in culture positive group were cured. All pathogens were cleared at the end of therapy. The MICs were between 0.25 and 1 mg/L. The main PK parameters were C max 175.22 ± 36.28 mg/L; T½ 1.52 ± 0.23 h; AUC (0-∞) 280.51 ± 68.17 mg·L -1·h -1 ; CL 7.37 ± 1.84 L/h; Vd 16.06 ± 4.42 L. The average ƒT > MIC was 55.45 ± 8.12%.

CONCLUSIONSIntravenous injection of cefazodone sodium with 2 g q12 h dosage regimen is used in the treatment of CAP caused by sensitive bacteria, either ƒT > MIC or clinical efficacy shows that such dosing regimen is reasonable.

Administration, Intravenous ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; pharmacokinetics ; therapeutic use ; Cefazolin ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; therapeutic use ; Community-Acquired Infections ; drug therapy ; metabolism ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Young Adult

OBJECTIVETo evaluate the clinical efficacy of Gufusheng capsule (GFSC) in treating early stage Legg-Calve-Perthes disease.

METHODSAdopting randomized single controlled trial, 45 cases with Legg-Calve-Perthes disease in early stage were randomly divided into 2 groups, 23 patients in the control group were treated with arthrectomy hip synovial membrane excision of affected lateral, femoral head decompression and transplantation of muscle-bone flap from ileum, above treatment were also given to the 22 patients in the treated group but combined with orally taking of GFSC. The treatment course for both groups was 6 months.

RESULTSShort-term effect after 6 months' treatment showed that the total effective rate in the treated group and the control group was 90.9% and 78.3% respectively, and the excellent rate was 72.7% and 60.9% respectively. The pain visual analogue scoring, clinical symptom and syndrome scoring markedly decreased before and after treatment, showing significant difference between the two groups (P < 0.05, P < 0.01). Long-term effect after 1-year to 4-year follow-up showed that the total effective rate and excellent rate between the treated group and the control group was significantly different ( chi2 = 8. 5976, P < 0.05).

CONCLUSIONGFSC has marked effect in alleviating pain and ameliorating function of hip joint, being an effective compound recipe for treatment of early stage Legg-Calve-Perthes disease. Therefore, it is worthy of researching and developing furthermore.

Adolescent ; Capsules ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Legg-Calve-Perthes Disease ; drug therapy ; Male ; Phytotherapy

OBJECTIVETo evaluate the clinical outcomes of improvement technique of double Endobutton plate for the treatment of Tossy III acromioclavicular joint dislocation.

METHODSFrom June 2008 to June 2009, 18 patients with Tossy III acromioclavicular joint dislocation were treated with improvement technique of double Endobutton plate. There were 11 males and 7 females, with an average age of 35 years old ranging from 28 to 55 years. The time from injury to operation was 2 to 5 days (means 3.5 days). All patients were followed and the clinical outcomes were recorded.

RESULTSThese 18 patients were followed up from 4 to 8 months (averaged 6 months). All acromioclavicular joint dislocation were reduced. According to the scales of Karlsson, the post-operation function 1 of shoulder-joint in 16 patients were A grade and 2 patients were B grade.

CONCLUSIONThe improvement technique of double Endobutton plate is an effective ideal treatment methods for Tossy III acromioclavicular joint dislocation due to its less invasion and convenience and good biocompatibility.

Acromioclavicular Joint ; injuries ; Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged

Objective To determine the audiological characteristics in 832 deaf children with biallelic causative mutations in GJB2 ,SLC26A4 gene .Methods The 832 patients received deafness gene screening ,553 were GJB2 gene biallelic causative mutations ,279 were SLC26A4 gene biallelic causative mutations .Patients were divided into four groups according to ages of hearing loss onset :<1 ,1~3 ,3~6 ,6~12 years old ,and the audiological character-istics and prevalence of GJB2 ,SLC26A4 gene mutations at different ages of onset .Results The prevalence of GJB2 gene mutations at four groups was 37 .97% (210/553) ,38 .34% (212/553) ,16 .27% (90/553) ,7 .41% (41/553) ,re-spectively ;the prevalence of SLC26A4 gene mutations at four groups was 25 .45% (71/279) ,44 .80% (125/279) , 20 .07% (56/279) ,9 .67% (27/279) ,respectively .The difference between GJB2 and SLC26A4 gene was significant(P=0 .001) .The prevalence of profound hearing loss with GJB2 gene mutations at four groups were 66 .67% (140/210) ,61 .32% (130/212) ,47 .78% (43/90) ,41 .46% (17/41) ,respectively .The difference was significant (P=0 .004) ,while the difference in 279 patients with SLC26A4 gene mutations was not statistically significant (P= 0 . 083) .Conclusion The age of hearing loss onset in patients with biallelic causative mutations in GJB 2 or SLC26A4 gene refers to 0~3 years -old ,hearing loss in patients with GJB2 ,SLC26A4 gene mutations gives priority to pro-found .The age of hearing loss onset is smaller ,the ratio of profound hearing loss is higher .Patients with severe and profound hearing impairment should be performed the genetic testing when the age of onset under 12 .

Objective To compare intrarenal pelvic pressure or endoureteral pressure and infection index between perfusion pump and low pressure of gravity drip during percutaneous nephrolithotomy (PCNL). Methods From 2015 April to 2017 June, 107 patients with ureteral or renal calculus were randomly divided into two groups, among whom 46 cases underwent perfusion pump PCNL and 61 cases underwent low pressure gravity drip PCNL. No statistical significance of preoperative variables was found between the two groups such as age, gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P＞0.05).A 5Fr ureteral catheter was positioned into the renal pelvic or ureter,and the intrarenal pelvic or endoureteral pressure was measured by anesthesia monitor during PCNL for all patients.We recorded and compared removing calculus time, postoperative hemoglobin changing, fever rate, procalcitonin abnormal rate, white blood cell counts and calculi clearance rate.Results The average pelvic or endoureteral pressures in the group undergoing perfusion pump and the one undergoing low pressure gravity drip were (22.7±4.6) mmHg VS (29.8±5.3) mmHg and the maximum pressure were (28.8 ±6.56) mmHg VS (50 ±9.25) mmHg.The statistics was significantly different (P＜0.05).Compared with perfusion pump group, the group undergoing low pressure gravity drip had significant differences in fever rate [4.9%(3/61) VS.17.3%(8/46) ], procalcitonin abnormal rate [3.2%(2/61) VS. 15.2%(7/46) ] and white blood cell counts abnormal rate[9.8%(6/61) VS.28.26%(13/46) ] (P＜0.05). However,no significant difference was seen in postoperative hemoglobin changing[(8.3±3.7) g/L VS.(7.2 ± 3.3) g/L] (P＞0.05) and the time of removing calculus [(42.4 ±14.5) min VS (43.6 ±13.5) min] (P＞0.05) .Conclusions Compared with perfusion pump, low pressure gravity drip PCNL maintains lower renal pelvic or endoureteral pressure, which is less than reflux limit during calculi fragmentation. It might be contributed to reduce the postoperative fever rate, white blood cell counts abnormal rate and procalcitonin abnormal rate. Hemoglobin changing and the time of removing calculus show no obvious disadvantage.

Objective To elucidate the electrophysiological features of POEMS syndrome. Methods We retrospectively analyzed the electrophysiological findings of 22 patients of POEMS, and compared their results with those of 22 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Results Compared with the CIDP group, the motor nerve conduction velocity was decreased in the POEMS group, but the difference was not significantstatistically (P>0.05); whereas, distal motor latency (DML) was significantly decreased (P<0.05), and terminal latency index (TLI) was significantly increased (P<0.05). The incidence rate of the nerve conduction block in the POEMS group was lower than that in the CIDP group (P<0.05). Compound muscle action potential (CMAP) of the tibial nerve was decreased significantly in the POEMS group as compared with the CIDP group (P<0.05), whereas CMAP of the median nerve was not significantly different (P>0.05). Abnormal electrophysiology was frequently observed in muscles of lower limbs in the POEMS group, and in comparison of upper limbs, the difference was not significant statistically (P<0.05).Conclusion In POEMS syndrome, slowing of nerve conduction velocity is more predominant in the intermediate segments of the peripheral nerve, and conduction block is rare. Abnormal nerve conduction may be correlated with limbs.

BACKGROUNDDifferentiating intracerebral hemorrhage (ICH) from cerebral infarction as early as possible is vital for the timely initiation of different treatments. This study developed an applicable model for the ambulance system to differentiate stroke subtypes.

METHODSFrom 26,163 patients initially screened over 4 years, this study comprised 1989 consecutive patients with potential first-ever acute stroke with sudden onset of the focal neurological deficit, conscious or not, and given ambulance transport for admission to two county hospitals in Yutian County of Hebei Province. All the patients underwent cranial computed tomography (CT) or magnetic resonance imaging to confirm the final diagnosis based on stroke criteria. Correlation with stroke subtype clinical features was calculated and Bayes' discriminant model was applied to discriminate stroke subtypes.

RESULTSAmong the 1989 patients, 797, 689, 109, and 394 received diagnoses of cerebral infarction, ICH, subarachnoid hemorrhage, and other forms of nonstroke, respectively. A history of atrial fibrillation, vomiting, and diabetes mellitus were associated with cerebral infarction, while vomiting, systolic blood pressure ≥180 mmHg, and age <65 years were more typical of ICH. For noncomatose stroke patients, Bayes' discriminant model for stroke subtype yielded a combination of multiple items that provided 72.3% agreement in the test model and 79.3% in the validation model; for comatose patients, corresponding agreement rates were 75.4% and 73.5%.

CONCLUSIONSThe model herein presented, with multiple parameters, can predict stroke subtypes with acceptable sensitivity and specificity before CT scanning, either in alert or comatose patients. This may facilitate prehospital management for patients with stroke.

Aged ; Cerebral Hemorrhage ; classification ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Stroke ; classification ; diagnosis ; Tomography, X-Ray Computed