To study the compatible mechanisms and compatible proportion of Shaoyao Gancao decoction, the intestinal absorption of main ingredients in Shaoyao Gancao decoction SG11 (Baishao-Zhigancao 1: 1) , SG31 (Baishao-Zhigancao 3: 1), Baishao water decoction S and Zhigancao (G) were investigated and compared using in vitro everted intestinal sac model and in situ single pass intestinal perfusion (SPIP) model. The concentration of paeoniflorin (PF), liquiritin (LQ) and mono-ammonium glycyrrhizinate (GL) in test samples and samples of intestinal sac and intestinal perfusion was determined by HPLC. The intestinal absorptive amount and absorption parameters were calculated. Results showed that in the everted intestinal sac model, three ingredients could be absorbed by duodenum, jejunum and ileum, and the absorption in the jejunum was best for all 3 ingredients. The absorption rate of three ingredients in SG11 was significantly higher than that in single decoction (P < 0.05), but had no significant difference compared with SG31. In SPIP model, the absorption rate constant K(a), the apparent absorption coefficient P(app) and the absorption rate of three ingredients in SG11 were significantly higher than those in single decoction. Parameters of PF and GL in SG11 were significantly higher than those in SG31, but had no differences of LQ. It proved that the compatibility of Baishao and Zhigancao could improve the intestinal absorption of PF, LQ and GL. The absorption of each ingredient in SG11 was better than that in SG31.
Animals ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; pharmacokinetics ; Intestinal Absorption ; drug effects ; Intestines ; blood supply ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVE:To optimize the extraction technology of Tibetan medicine Pedicularis kansuensis and compare con-tent of verbascoside and isoverbascoside differences in P. kansuensis from various habitats. METHODS:Using verbascoside and iso-verbascoside and dry paste yield as comprehensive evaluation indexes,single factor test and orthogonal test were used to investigate the extraction solvent,solvent dosage,extraction time and times to optimize extraction technology,and the verification test was conducted. Contents of the 2 constituents verbascoside and isoverbascoside in P. kansuensis from Gansu,Qinghai and Sichuan were compared. RESULTS:The optimal extraction technology was as follows as 8-fold 50% ethanol,extraction for 3 times,90 min each time. The verification results showed that the average contents of verbascoside and isoverbascoside were 3.49%(RSD=1.28%,n=3),1.26%(RSD=1.32%,n=3),and average dry paste yields were 37.99%(RSD=1.97%,n=3). The contents of verbascoside and isoverbascoside in P. kansuensis from Qinghai were relatively higher. CONCLUSIONS:Optimized extraction tech-nology is reasonable,stable,feasible;the contents of index constituents in P. kansuensis from different habitats have certain differ-ences. The study can provide scientific evidence for the development and utilization of extraction,and the in-depth study of quality evaluation for medicinal material.

BACKGROUND: Harmful stimuli induce increased production of calcitonin gene-related peptide(CGRP) in the spinal cord and dorsal root ganglion, causing also intense dilation of the microvessels. But it remains unknown whether vessel dilation and pain relief were accompanied by increased CGRP production when negative pressure is applied on the limbs for treatment of peripheral arterial occlusion diseases (PAOD).OBJECTIVE: To examine the changes of calcitonin gene-related peptide (GGRP) -immunoractive nerve fibers in the spinal cord and dorsal root ganglion in dogs with PAOD treated with negative pressure on the limbs.DESIGN: A randomized controlled retrospective study.SETTING: The department of general surgery of a military medical university.MATERIALS: This study was carried out at Xijing Hospital of the Fourth Military Medical University of Chinese PLA between January and August 2003. Seventeen adult male dogs weighing 12 - 18 kg, regardless of the gender, were selected.INTERVENTIONS: Seventeen dogs were randomly divided into three groups, namely the treatment group( n = 10), model group( n = 5), and the normal control group( n = 2). Posterior left leg ischemia was induced in dogs in the treatment and model groups, and those in the treatment group, but not the model group, were treated with negative limb pressure for 10 days 14days after model establishment. The spinal cord and dorsal ganglion at L1-5of these two groups were collected and stained immunohistochemically for observing the changes of GGRP-immunreactive nerve fibers. The dogs in the normal control group were also sampled in similar manner for immunohistochemical staining.MAIN OUTCOME MEASURES: Distribution of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions of the three groups of dogs.RESULTS: In the dogs of the model group, GGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions was significantly more numerous[ (75. 00 ±4. 30)%, (68.20 ± 2.60)% ] than those in the treatment and normal control groups[ (58. 20 ±5. 10)%, (52. 20 ±6.20)%; (37.00±4. 20)%, (34. 00 ± 1.40)%, P ＜ 0.01]. The positive nerve fibers were less strongly stained in the treatment group than those in the model group,but still stronger stained those in the normal control group, with significant difference between the three groups( P ＜ 0.01).CONCLUSION: Negative pressure on the limbs may attenuate the synthesis of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion and pain conduction following PAOD in dogs, so that harmful afferent stimuli are inhibited to relieve the pain in the limbs.

Objective To analyze the relationship between the catheter to vein ratio and the formation of peripheral insertion of central venous catheter (PICC) related upper extremity deep venous thrombosis (PICC-UEDVT) in cases having undergone PICC in patients at intensive care unit (ICU) and further identify the best optimal ratio cut-off point to reduce the incidence of PICC-UEDVT.Methods A retrospective study was conducted, including 69 patients having undergone PICC with complete clinical data admitted to the Department of Critical Care Medicine of the First Affiliated Hospital of Nanchang University from August 2013 to December 2016; their ages were > 18 years old and catheter indwelling times were > 1 week; the patients' basic information, disease related laboratory parameters and catheter insertion situation were collected. According to the occurrence of PICC-UEDVT, they were divided into PICC-UEDVT group and non PICC-UEDVT group; the receiver operating characteristic (ROC) curve of the catheter to vein ratio versus the incidence ofPICC-UEDVT was plotted to assess the optimal ratio to reduce the incidence of PICC-UEDVT.Results In the 69 patients, there were 7 patients in the PICC-UEDVT group and 62 patients in the non PICC-UEDVT group, the incidence of PICC-UEDVT being 10.14%. Four, 5 and 6 French (Fr) catheters were indwelled in 43, 23 and 3 cases respectively, and the range of catheter to vein ratio was 20% - 67%. The comparisons between PICC-UEDVT group and non PICC-UEDVT group in various aspects were as follows: the incidence of DVT in the PICC-UEDVT group was significantly higher than that in non PICC-UEDVT group [42.9% (3/7) vs. 6.5% (4/62)], the rate of using vasopressor drugs [57.14% (4/7) vs. 17.74% (11/62)], D-dimer level [mg/L: 9.0 (3.0, 12.3) vs. 1.8 (1.0, 3.6)], patients of indwelling 5Fr catheter [71.4% (5/7) vs. 29.0% (18/62)] and the percentage of patientsapplying catheter to vein ratio 45%-67% [57.14% (4/7) vs. 17.74% (11/62)] in PICC-UEDVT group were all higher than those in the non PICC-UEDVT group, the differences being statistically significant (allP < 0.05). ROC analysis showed that the catheter to vein ratio 44% was the optimal cut off or critical point, the area under the ROC curve (AUC) at that point was 0.755, 95% confidence interval (95%CI) = 0.554-0.955, sensitivity = 71.4% and specificity = 79.0%; compared with the patients using 45%-67% catheter to vein ratio, the incidence of PICC-UEDVT was 6.182 times higher than those using the ratio 20%-44% [odds ratio (OR) = 6.182, 95%CI = 1.208-31.634,P = 0.036]; however, there was no significant difference in incidence of PICC-UEDVT between 20%-32% and 33%-44% (P = 1.000).Conclusion It is found that the 44% catheter to vein ratio was the optimal critical point to reduce the incidence of PICC-UEDVT, possessing relatively high sensitivity and specificity; applying <44% catheter to vein ratio can decrease the risk of PICC-UEDVT occurrence in patients at ICU.

OBJECTIVETo study the correlation between apparent diffusion coefficient (ADC) and Ki-67, a marker of tumor activity, in the diagnosis of gliomas.

METHODSConventional magnetic resonance imaging (MRI), enhanced scanning, and diffusion-weighted imaging were performed in 76 patients with pathologically confirmed gliomas. The ADC values were measured at tumor parenchyma and the corresponding contralateral normal brain. The relatively ADC (rADC) values of the tumor parenchyma were calculated. The correlation of the ADC values with tumor grades was analyzed. The expression of Ki-67 was detected by immunohistochemical staining. The correlation between ADC value and Ki-67 in the diagnosis of gliomas was analyzed.

RESULTSThe ADC values and rADC values of high-grade gliomas were significantly lower than those of low-grade gliomas. The ADC values of tumor parenchyma were inversely associated with the degree of malignancy of the gliomas (r=-0.898, r=-0.868; P<0.01). The expression of Ki-67 was significantly higher in high-grade gliomas than that in low-grade gliomas. The Ki-67 labeling index in grade 3 and 4 gliomas were (29.48 ± 19.78)% and (31.21 ± 17.50)%, respectively. Both of them were significantly higher than Ki-67 labeling index in low-grade (grade 1 and 2) gliomas [(2.33 ± 2.20)%] (P<0.01). Nevertheless, the Ki-67 labeling index showed no significant difference between grade 3 and 4 gliomas (P>0.05). The expression of Ki-67 was negatively correlated with the ADC values and rADC values in tumor parenchyma (r=-0.627, r=-0.607; P<0.01).

CONCLUSIONThe ADC and rADC values of tumor parenchyma can indirectly reflect the proliferation and malignancy of gliomas and therefore can be useful for the grading of glioma.

Adolescent ; Adult ; Brain Neoplasms ; diagnosis ; metabolism ; pathology ; Child ; Child, Preschool ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Glioma ; diagnosis ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Young Adult

Objective:This study aimed to present the time trend of suicide rate in people aged 5 years and over in China from 2002 to 2015,and to describe the rural and urban distribution,and population characteristics of suicide rate in recent 13 years.Methods:The data of suicide rate were based on the China Health Statistics Yearbook published by the National Health and Family Planning Commission (formerly as the Ministry of Health) of the Peoples Republic of China.Poisson regression models were used to test the time trend of the general suicide rate,and region-,gender-and age-specific suicide rates.Results:Since 2002,the suicide rates in urban population,rural population,male and female have decreased significantly.Urban population had higher decreasing trend than rural population,and female had higher decreasing trend than male.Suicide rates in women of reproductive age (15 -49 years) both in rural and urban areas had significantly decreasing trends,and were lower than male with same ages in recent years.There was no statistical difference of the decreasing trend in rural population aged 85 years and over,or young male population in rural area.The annual average suicide rate from 2012 to 2015 was 6.75/100 000.Rural population,male and the older persons had higher suicide rate.Conclusion:The overall suicide rate decreased over the period of 2001-2015.However,it is still important to carry out suicide prevention program,especially in rural area,and in older persons and young male.

OBJECTIVETo study the clinical manifestations and neuroimaging characteristics of pediatric moyamoya disease.

METHODSThe clinical data of 17 children with moyamoya disease were retrospectively studied.

RESULTSThe onset age was between 3 and 14 years. The main clinical manifestations included motor weakness of extremities or hemiplegia, sensory disturbance and headache. Cranial CT or/and MRI examinations predominately showed cerebral infarct. Magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) showed stenosis or occlusion at the terminus of the siphon portions of internal carotid arteries and proximal portions of anterior or middle cerebral arteries, and abnormal vascular networks at the base of brain.

CONCLUSIONSCerebral ischemia is main clinical manifestations in children with moyamoya disease, presenting motor weakness of extremities or hemiplegia, sensory disturbance and headache. DSA is essential to the diagnosis of the disease.

Adolescent ; Angiography, Digital Subtraction ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Moyamoya Disease ; complications ; diagnosis ; therapy ; Tomography, X-Ray Computed

Objective:To understand the seroepidemiological characteristics of pertussis in healthy population in Ningbo, and estimate the overall incidence of pertussis.Methods:A cross-sectional survey method was used in this study. A total of 1 206 healthy residents in 9 age groups were stratified randomly selected from 3 counties of Ningbo. Serum samples were collected from the subjects, and the pertussis toxin immunoglobulin G antibody (PT-IgG) levels were measured quantitatively by enzyme-linked immunosorbent assay (ELISA).Results:The mean PT-IgG seropositive rate in the subjects was 0.91% (95% CI:0.45%-1.63%) with a geometric mean titer (GMT) of 3.10 (95% CI:2.86-3.36) IU/ml. The seropositive rates ranged from 0.00% to 1.68%, and the GMTs ranged from 2.08 IU/ml to 5.28 IU/ml in 9 age groups. The incidence rate of pertussis was estimated to be 4 572.81 per 100 000 in age group ≥5 years (95% CI:1 807.30 per 100 000-9 348.12 per 100 000), and the peak of estimated incidence rates were found in age group 5- years (9 301.62 per 100 000, 95% CI:1 121.77 per 100 000-33 154.68 per 100 000) and age group ≥50 years old (8 967.02 per 100 000, 95% CI: 1 059.45 per 100 000-31 845.94 per 100 000). Conclusions:The actual incidence of pertussis was high in Ningbo in 2019. As a result of waning immunity after vaccination, pertussis can occur in adolescents and adults. The pertussis surveillance should be strengthened and the pertussis vaccination strategy should be improved.

Objective To evaluate the breakthrough varicella infection rate and varicella vaccine effectiveness(VE) among children who received 1-dose varicella vaccine. Methods A total of 57 180 subjects for the consecutive 4-year birth cohorts were selected from the local children born between 2007 and 2010 in Yinzhou District, Ninghai County and Yuyao City.And they were followed up for varicella from 2008 to 2013. The recipients of the vaccinations were identified through Ningbo Immunization Information System and data on breakthrough infections among the recipients were collected by using China Information System for Disease Control and Prevention. The breakthrough varicella rate and the VE were calculated and the trends of them were described from 2008 to 2013 among 4-year birth cohorts.The cumulative incidence of varicella was compared between vaccinated and unvaccinated children among the consecutive 4-year birth cohorts. Results The rate of varicella vaccine coverage, vaccine cumulative incidence among the cohorts was 96.74%(55 317/57 180)and 0.56%(321/57 180). The breakthrough varicella infection for 4-year birth cohorts was 0.44%(244/55 317), and for each birth cohort was 0.95%(142/14 928),0.44%(61/13 855), 0.22%(29/13 433)and 0.09%(12/13 101), respectively. It was on the rise from 2008 to 2013 and the 2007 birth cohort of it increased fastest from 0.04%(6/14 928)in 2007 to 0.32%(48/14 834)in 2013.The vaccine cumulative incidence of these who vaccinated 1-dose varicella(the breakthrough varicella infection) was lower than these who were unvaccinated(the incidence:6.25%(37/592),3.52%(15/426),3.69%(17/461) and 2.08%(8/384))by each birth cohort(χ2=130.27,P<0.001 for 2007 birth cohort;χ2=74.11,P<0.001 for 2008 birth cohort;χ2=162.80,P<0.001 for 2009 birth cohort;χ2=100.01,P<0.001 for 2010 birth cohort) .The vaccine effectiveness for 4-year birth cohorts was 89.33%(95%CI:86.7%-92.1%) and for each birth corhort was 84.78%(95%CI:77.94%-89.50%),86.82%(95%CI:77.82%-92.95%),93.99%(95%CI:89.27%-96.81%)and 95.60%(95%CI:89.18%-98.21%), respectively. The effectiveness of each birth cohort declinedgradually from 2008 to 2013 and the 2009 birth cohort of it decreased fastest from 98.86%in 2010 to 66.83% in 2013. Conclusions The 1-dose varicella vaccine effectiveness was good, but breakthrough varicella infection rate was on the rise with time and the VE declined gradually from 2008 to 2013.

Objective To evaluate the breakthrough varicella infection rate and varicella vaccine effectiveness(VE) among children who received 1-dose varicella vaccine. Methods A total of 57 180 subjects for the consecutive 4-year birth cohorts were selected from the local children born between 2007 and 2010 in Yinzhou District, Ninghai County and Yuyao City.And they were followed up for varicella from 2008 to 2013. The recipients of the vaccinations were identified through Ningbo Immunization Information System and data on breakthrough infections among the recipients were collected by using China Information System for Disease Control and Prevention. The breakthrough varicella rate and the VE were calculated and the trends of them were described from 2008 to 2013 among 4-year birth cohorts.The cumulative incidence of varicella was compared between vaccinated and unvaccinated children among the consecutive 4-year birth cohorts. Results The rate of varicella vaccine coverage, vaccine cumulative incidence among the cohorts was 96.74%(55 317/57 180)and 0.56%(321/57 180). The breakthrough varicella infection for 4-year birth cohorts was 0.44%(244/55 317), and for each birth cohort was 0.95%(142/14 928),0.44%(61/13 855), 0.22%(29/13 433)and 0.09%(12/13 101), respectively. It was on the rise from 2008 to 2013 and the 2007 birth cohort of it increased fastest from 0.04%(6/14 928)in 2007 to 0.32%(48/14 834)in 2013.The vaccine cumulative incidence of these who vaccinated 1-dose varicella(the breakthrough varicella infection) was lower than these who were unvaccinated(the incidence:6.25%(37/592),3.52%(15/426),3.69%(17/461) and 2.08%(8/384))by each birth cohort(χ2=130.27,P<0.001 for 2007 birth cohort;χ2=74.11,P<0.001 for 2008 birth cohort;χ2=162.80,P<0.001 for 2009 birth cohort;χ2=100.01,P<0.001 for 2010 birth cohort) .The vaccine effectiveness for 4-year birth cohorts was 89.33%(95%CI:86.7%-92.1%) and for each birth corhort was 84.78%(95%CI:77.94%-89.50%),86.82%(95%CI:77.82%-92.95%),93.99%(95%CI:89.27%-96.81%)and 95.60%(95%CI:89.18%-98.21%), respectively. The effectiveness of each birth cohort declinedgradually from 2008 to 2013 and the 2009 birth cohort of it decreased fastest from 98.86%in 2010 to 66.83% in 2013. Conclusions The 1-dose varicella vaccine effectiveness was good, but breakthrough varicella infection rate was on the rise with time and the VE declined gradually from 2008 to 2013.