Objective To evaluate the effect of Danshen Chuanxiongqin injection combined with Xuesaitong capsule on blood viscosity in patients with pulmonary heart disease.Methods 80 patients with pulmonary heart disease who were admitted to our hospital between January 2013 and November 2015 were studied,the patients were randomly divided into the combined group and the control group according to the order of admission,40 cases in each group.Control groups were treated with Xuesaitong capsule,and the combined group were treated with Danshen Chuanxiongqin injection on the basis of the control group.The clinical efficacy,blood viscosity(whole blood viscosity,plasma viscosity,whole blood viscosity ratio),blood indexes(blood platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index),cardiac function and safety were observed.Results There were no significant differences in blood rheological indexes,LVEF,MAP and HR between the two groups before treatment.After treatment,the whole blood viscosity,plasma viscosity,whole blood viscosity ratio,platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index,MAP and HR in the two groups were significantly lower than those before treatment,while LVEF was significantly higher,and the changes in the combined group were more significant than those in the control group(P<0.05).After treatment,the clinical total effective rate of treatment in the combined group(88.89％)was significantly higher than that in the control group(62.50％).Conclusion Danshen Chuanxiongqin injection combined with Xuesaitong capsule is effective in the treatment of pulmonary heart disease.It can significantly reduce blood viscosity,blood related indexes and improve cardiac function.

Guinea pigs were given orally with a daily dose of 0.5 mg ascorbic acid per 100 g body weight 20 days before and 4 days after a whole-body r-irradiation and then injected subcutaneously with 10 mg ascorbic acid at 24 hours intervals. During the injection period, the daily urinary output of total ascorbic acid in the animals irradiated with 500 or 1000 r was significantly higher than that in controls, but the difference of 24 hours excretions of total ascorbic acid between the group irradiated with 150 or 250 r and the control group was not statistically significant.As shown in the urinary output of dehydroascorbic acid and diketo- gulonic acid estimated by our modified Roe's method, r-irradiation has no effect on its excretion in guinea pigs and rats.The levels of ascorbic acid in plasma, spleen and adrenals were significantly lower in the irradiated group than in the control group, but might increase with the increase of the injected dose of ascorbic acid.

Abstract: Objective　To analyze the epidemiological characteristics of 151 cases of melioidosis and the drug resistance of Burkholderia pseudomallei (BP), in order to provide the basis for diagnosis, treatment and reasonable prevention of melioidosis. Methods　A total of 151 inpatients and outpatients from the Second Affiliated Hospital of Hainan Medical University from January 1, 2013 to August 31, 2022 were collected, and clinical specimens were submitted for examination to isolate and identify BP strains. The clinical data of 151cases of melioidosis and the drug resistance characteristics of pathogenic bacteria were retrospectively analyzed, and using SPSS26.0 software for statistical analysis. Results　Among 151 cases with BP infection, there were 138 males (91.4%) and 13 females (8.6%); the most patients were aged from 45-<60 years old, accounting for 74 cases (49.0%); melioidosis incidence was concentrated in October (19.2%), November (19.2%), August (9.9%) and July (8.6%), and; the number of confirmed cases showed an increasing trend and the time for confirmation was <10 d; Internal medicine system (31.1%), surgery system (26.5%) and intensive care department (20.5%) were the common departments for treating melioidosis; blood (49.0%), sputum (9.9%) and wound secretion (8.6%) were the main clinical specimens for detecting BP; pulmonary infection (68.2%), sepsis (35.1%) and local suppurative infection (23.8%) were the top clinical manifestations in patients with BP infection; the effective rate of treating melioidosis was 74.8%; abnormal liver function was a risk factor for the curative effect of melioidosis (χ2=5.010, P<0.05); the sensitivity rates of BP strains to sulfamethoxazole-trimethoprim (SXT), doxycycline (DOX), imipenem(IPM), ceftazidime (CAZ), amoxicillin/clavulanate (AMC) and tetracycline (TCY) were generally more than 90%, with sensitivities of 98.7%, 97.2%, 96.7%, 94.0%, 93.2% and 90.7%, respectively. Conclusions　It can be concluded that misdiagnosis or missed diagnosis of melioidosis is easy to occur, and the understanding of the epidemiological characteristics and risk factors in this area should be strengthened. The sensitivity of BP to commonly used antibiotics has shown a certain downward trend, clinical use should be standardized, and drug resistance monitoring should be strengthened to improve the efficacy of melioidosis treatment.

Aged ; Biopsy, Needle ; methods ; Coal Mining ; Humans ; Lung ; pathology ; Lung Neoplasms ; complications ; diagnosis ; Middle Aged ; Pneumoconiosis ; complications

BACKGROUND:The intestine is not only the main target attacked by sepsis but also the vital organ which mediated sepsis. The recovery of the damaged intestinal barrier structure and function is related to the occurrence and outcome of multiple organ dysfunction syndrome (MODS). How to protect and reduce the damage of the intestinal mucosa and how to promote the reconstruction of the intestinal mucosa have been the important topics in sepsis for many years. This study aimed to investigate the influential factors of intestinal mucosal reconstruction after intestinal epithelial injuryin vivo in a mouse model of sepsis.METHODS:Mice were subjected to cecal ligation and puncture (CLP) for induction of sepsis to assess intestinal mucosal damage, epithelial cell apoptosis, and transformed number of goblet cells, and to detect the concentration of TNF-α, IL-1 and TGF-β1 and TFF3 (trefoil factor 3) expression in the small intestinal mucosa. All above were performed by HE staining, western blot, ELISA and immunohistochemistry respectively. The experimental animals were divided into a sepsis group and a sham-operation group. The animals with sepsis were separately killed at 6 (7 animals), 24 (7 animals) and 48 hours (7 animals) after CLP.RESULTS:Injured intestinal mucosa was observed in the 3 groups under a light microscope, in which damage scores in the 24-hour and 48-hour groups were higher than in the 6-hour group and no difference was found between the two groups. Moreover, less of goblet cells or other epithelial cells adjacent to the injured surface migrated into the wound to cover the denuded area. The number of goblet cells was substantially decreased in the three CLP groups compared with the sham-operation group. Protein levels of IL-1 and TNF-α were significantly increased by 3-4 fold at all time points when compared with the sham-operation group, and cleaved caspase-3 by 4 fold. Although TFF3 expression was modestly increased for 6 hours after the onset of CLP, it appeared to decline at 24 hours and 48 hours as shown by Western blot. A similar tendency was observed upon TGF-β1, i.e. the protein level was not elevated at 24 hours and 48 hours, but increased modestly at 6 hours.CONCLUSIONS:Sepsis from CLP shows less restitution on the surface of injured intestinal mucosa. There is evidence that both constant inflammatory reaction and epithelial cell apoptosis may affect mucosal reestablishment of the intestine at the onset of sepsis. Mucosa after severe sepsis showed the state of high inflammation, and declined goblet cell function and mucosal reconstruction, which affected the repair of damaged intestinal barrier. Constant inflammatory reaction, and declined goblet cell function and mucosal reconstruction ability may affect the reestablishment of intestinal mucosa at the onset of sepsis.

Background: Acute aortic dissection is known as the most dangerous aortic disease, with management and prognosis determined as the disruption of the medial layer provoked by intramural bleeding. The objective of this study was to evaluate the safety and necessity of antiplatelet therapy on patients with Stanford Type B aortic dissection (TBAD) who underwent endovascular aortic repair (EVAR). Methods: The present study retrospectively analyzed 388 patients with TBAD who underwent EVAR and coronary angiography. The primary outcomes were hemorrhage, death, endoleak, recurrent dissection, myocardial infarction, and cerebral infarction in patients with and without aspirin antiplatelet therapy at 1 month and 12 months. Results: Of those 388 patients, 139 (35.8%) patients were treated with aspirin and 249 (64.2%) patients were not treated with aspirin. Patients in the aspirin group were elderly (57.0 ± 10.3 years vs. 52.5 ± 11.9 years, respectively, χ2 = 3.812, P < 0.001) and had more hypertension (92.1% vs. 83.9%, respectively, χ2 = 5.191, P = 0.023) and diabetes (7.2% vs. 2.8%, respectively, χ2 = 4.090, P = 0.043) than in the no?aspirin group. Twelve patients (aspirin group vs. no?aspirin group; 3.6% vs. 2.8%, respectively, χ2 = 0.184, P = 0.668) died at 1?month follow?up, while the number was 18 (4.6% vs. 5.0%, respectively, χ2 = 0.027, P = 0.870) at 12?month follow?up. Hemorrhage occurred in 1 patient (Bleeding Academic Research Consortium [BARC] Type 2) of the aspirin group, and 3 patients (1 BARC Type 2 and 2 BARC Type 5) in the no?aspirin group at 1?month follow?up ( χ2 = 0.005, P = 0.944). New hemorrhage occurred in five patients in the no?aspirin group at 12?month follow?up. Three patients in the aspirin group while five patients in the no?aspirin group had recurrent dissection for endoleak at 1?month follow?up (2.3% vs. 2.2%, respectively, χ2 = 0.074, P = 0.816). Four patients had new dissection in the no?aspirin group at 12?month follow?up (2.3% vs. 3.8%, respectively, χ2 = 0.194, P = 0.660). Each group had one patient with myocardial infarction at 1?month follow?up (0.8% vs. 0.4%, respectively, χ2 = 0.102, P = 0.749) and one more patient in the no?aspirin group at 12?month follow?up. No one had cerebral infarction in both groups during the 12?month follow?up. In the percutaneous coronary intervention (PCI) subgroup, 44 (31.7%) patients had taken dual?antiplatelet therapy (DAPT, aspirin + clopidogrel) and the other 95 (68.3%) patients had taken only aspirin. There was no significant difference in hemorrhage (0% vs. 1.1%, respectively,χ2 = 0.144, P = 0.704), death (4.8% vs. 4.5%, respectively, χ2 = 0.154, P = 0.695), myocardial infarction (2.4% vs. 0%, respectively,χ2 = 0.144, P = 0.704), endoleak, and recurrent dissection (0% vs. 3.4%, respectively, χ2 = 0.344, P = 0.558) between the two groups at 12?month follow?up. Conclusions: The present study indicated that long?term oral low?dose aspirin was safe for patients with both TBAD and coronary heart disease who underwent EVAR. For the patients who underwent both EVAR and PCI, DAPT also showed no increase in hemorrhage, endoleak, recurrent dissection, death, and myocardial infarction.

AIMTo isolate triterpene saponins of polygalacic acid type from the roots of Platycodon grandiflorum (Jacq.) A. DC and to identify their structures.

METHODSThe compounds were separated by means of extraction, chromatography on silica gel, MPLC and HPLC, and their structures were elucidated on the basis of spectral analyses (FAB-MS, IR, 1H NMR, 13C NMR etc.).

RESULTSThree triterpene saponins were isolated from the roots of Platycodon grandiflorum. They were identified as 3-O-beta-D-laminaribiosyl polygalacic acid (I), 3-O-beta-D-glucopyranosyl polygalacic acid (II), polygalacin D (III), separately.

CONCLUSIONCompound I is a new compound, compounds II, III are known triterpene saponins. The compound I and II were isolated from the plant for the first time, which is also the monodesmoside from the plant for the first time.

Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Platycodon ; chemistry ; Saponins ; chemistry ; isolation & purification

OBJECTIVETo analyze the styryllactone components in Goniothalamus cheliensis Hu (Annonaceae).

METHODUPLC-Q-TOF-MS was used to identify the main styryllactone components in G. cheliensis. The chromatographic separation was performed on ACQU ITY UPLC BEH C18 column and eluted by actonitrile and 0.1% acetic acid in water gradiently. The mass spectrometer equipped with electrospray ionization souce was used as detector under the positive ion modes.

RESULTTwelve styryllactons were identified based on their MS data and published literatures, and the MS fragmentation regularity of the styryllactones was also proposed.

CONCLUSIONIt is an accurate and effective method to obtain the structural information of styryllactones.

Chromatography, High Pressure Liquid ; methods ; Goniothalamus ; chemistry ; Lactones ; chemistry ; isolation & purification ; Mass Spectrometry ; methods ; Plant Extracts ; chemistry ; isolation & purification

To prepare transdermal drug delivery system (TDDS) of felodipine and metoprolol and to study its pharmaceutical characteristics, pharmacokinetics and bioavailability in rabbits, an HPLC assay was established for the simultaneous determination of felodipine and metoprolol in the permeation receptor and patch. The permeation rate and permeation mechanism of felodipine-metoprolol-TDDS through rabbit skin in vitro was examined. The determination of drug content, the examination of content uniformity and stability of the TDDS were carried out. GC-ECD assays were established for the determination of felodipine and metoprolol in plasma separately and then employed to study the pharmacokinetics and bioavailability of felodipine and metoprolol after a single dose of oral or transdermal administration in rabbits. The results indicated that the permeation of flodipine and metoprolol from the patch through excised rabbit skin exhibited zero-order kinetic characteristics. The determination of drug content and the quality control of content uniformity of the patch accorded with Pharmacopoeia of the People's Republic of China of 2005 edition and the pharmaceutical characterization showed good stability. In contrast to oral delivery, relatively constant, sustained blood concentration with minimal fluctuation and prolonged peak time were observed over a long period after transdermal administration. The relative bioavailability of felodipine and metoprolol were 275.37% and 189.76% versus oral administration respectively. It was evident that the felodipine-metoprolol-TDDS exhibited good controlled release properties that satisfied the demands of original design that enhancing bioavailability and maintaining appropriate blood levels for a prolonged time without adverse effects associated with frequent oral administration.
Administration, Cutaneous ; Animals ; Antihypertensive Agents ; administration & dosage ; blood ; pharmacokinetics ; Area Under Curve ; Azepines ; chemistry ; Biological Availability ; Cyclohexanols ; chemistry ; Delayed-Action Preparations ; Drug Delivery Systems ; Drug Stability ; Felodipine ; administration & dosage ; blood ; pharmacokinetics ; Female ; Male ; Metoprolol ; administration & dosage ; blood ; pharmacokinetics ; Monoterpenes ; chemistry ; Propylene Glycols ; chemistry ; Rabbits ; Skin Absorption

OBJECTIVETo investigate therapeutic effects of minimally invasive arthroscopic internal fixation with plates and screws in treating tibial plateau fractures.

METHODSA retrospective study from December 2006 to June 2010 was done on 69 patients with tibial plateau fractures. According to Schatzker classification, 5 patients were type I, 5 patients were type II, 25 patients were type III, 20 patients were type IV, 9 patients were type V and 5 patients were type VI. Thirty-six patients were treated with arthroscopy-assisted reduction and internal fixation, including 21 males and 15 females, ranging in age from 17 to 59 years (averaged, 34.2 years); another 33 patients were treated with small incision and fixed with plates and screws,including 19 males and 14 females, ranging in age from 18 to 62 years (averaged, 35.4 years). The operation time, blood loss during operation,drainage volume of blood, healing time, weight-bearing time and function of effected knee were compared between the two groups.

RESULTSAll the patients were followed up,and the duration ranged from 6 to 12 months (averaged, 10.3 months). All the patients had no complications such as infection, articular collapse, re-fracture and joint stiffness. There were no significant differences in weight-bearing time, complications and Rasmussen scores between two groups (P>0.05); but there were significant differences in the operative time, blood loss, drainage volume of blood, hospital stay time, the healing time between two groups (P<0.05). The results showed that arthroscopy-assisted technique was better than minimally invasive internal fixation in operation duration, blood loss during operation and the healing time.

CONCLUSIONDifferent types of fracture of tibial plateau should be treated with different surgical treatments. Arthroscopic technique for reduction of fractures, which has less influence on bony union and minimally invasive, and can provide a good clinical outcome.

Adolescent ; Adult ; Arthroscopy ; methods ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tibial Fractures ; surgery ; Young Adult