Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22％).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age ＞65 year (OR =1.123,95％ CI:1.013-1.244,P =0.027),lesion size ＞ 3.5 cm (OR =1.173,95％ CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 ％ CI:1.460-8.379,P =0.005),hospital stay ＞ 10 d (OR =2.480,95％ CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95％ CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.

Objective To detect levels of serum platelet activating factor(PAF),thrombomodulin(TM) and white blood cell(WBC),platelet count(PLT) in neonates with meconium aspiration syndrome(MAS),and observe changes of mediators of inflammation and function of endotheliocute.Methods All cases were taken vein blood in 24 h and 72-96 h after birth.Surm PAF and TM were detected by EILSA technique,at the same time,blood cell counts were determined.Results PAF and WBC in neonates with MAS increased,which were relevant to the patients′ condition.TM of neonates with MAS increased significantly,especially in 72-96 h after birth and(aggrava)-ted with the patients′ condition.Conclusion Neonates with MAS have inflammatory reaction and injured endotheliocyte,which are(inte)-raction.

OBJECTIVETo study the effect of Aconiti Radix Cocta and Pinelliae Rhizoma with different matching proportions and doses on their analgic, anti-inflammatory, phlegm eliminating and cough relieving efficacies in mice.

METHODThe two-factor, seven-level uniform design method was adopted to observe the effect of the oral administration with the combined decoction on the analgic, anti-inflammatory, phlegm eliminating and cough relieving efficacies, with frequency of body torsions induced by acetum, ear swelling degree induced by dimethylbenzene, secretion of phenol red in tracheas and frequency of coughs induced by aqueous ammonia as indexes. Significant matching proportions and doses were collected for verification.

RESULT(1) The effect on the frequency of body torsions and ear swelling degree. The combined decoction could effectively reduce the frequency of body torsions and ear swelling degree. According to a regression analysis, Aconiti Radix Cocta and Pinelliae Rhizoma had the antagonism, which was maximized at the ratio of 10: 1, and minimized at the ratio of less than or equal to 1: 1. The frequency of body torsions and ear swelling degree increased first and then decreased along with the rise in the total dose; and a higher proportion of Aconiti Radix Cocta resulted in a faster speed in decrease or increase. (2) The effect on the secretion of phenol red in tracheas and frequency of coughs. The combined decoction could effectively increase the secretion of phenol red in tracheas and decrease the frequency of coughs. According to a regression analysis, Pinelliae Rhizoma and Aconiti Radix Cocta had the synergistic effect in the secretion of phenol red in tracheas, which was maximized with a total dose of more than 5 g x kg(-1) and a ratio of 1: 1.

CONCLUSIONThe compatible application of Pinelliae Rhizoma and Aconiti Radix Cocta can decrease the analgesic and anti-inflammatory effects of Aconiti Radix Cocta and promote the cough-relieving effect of Pinelliae Rhizoma, which vary according to different matching ratio and dose. This study provides experimental basis for indepth studies on the combined effect of Aconiti Radix Cocta and Pinelliae Rhizoma--two of eighteen incompatible pairs.

Aconitum ; Animals ; Cough ; drug therapy ; Drug Therapy, Combination ; Male ; Mice ; Mice, Inbred ICR ; Pinellia ; Plant Extracts ; administration & dosage ; Research Design

This study is to elucidate the immunoregulation mechanisms of artesunate (AST) on allergic contact dermatitis (ACD). Pharmacodynamics analyses, HE staining, semi-quantitative RT-PCR and Western blotting were used to explore the effects of AST on the related cytokines, transcription factor and signaling molecule of ACD respectively. The results indicated that topical administration of AST not only reduced the increase of ear swelling, spleen index and inflammatory cells infiltration in ACD mice, but also inhibited remarkably the expression of IFN-gamma, T-bet and NF-kappaB p65. It's suggested that AST could exhibit suppressive effects on inflammatory response and immune function of ACD, which indicates the possibility of developing AST as a novel immunoregulatory agent in the treatment of ACD and other immune-related diseases.
Administration, Topical ; Animals ; Artemisinins ; administration & dosage ; chemistry ; pharmacology ; Dermatitis, Allergic Contact ; immunology ; metabolism ; pathology ; Ear ; pathology ; Female ; GATA3 Transcription Factor ; genetics ; metabolism ; Hypersensitivity, Delayed ; drug therapy ; Immunosuppressive Agents ; administration & dosage ; chemistry ; pharmacology ; Interferon-gamma ; genetics ; metabolism ; Interleukin-4 ; genetics ; metabolism ; Mice ; Mice, Inbred ICR ; Molecular Structure ; NF-kappa B ; metabolism ; RNA, Messenger ; metabolism ; T-Box Domain Proteins ; genetics ; metabolism

Objective To investigate the basic distribution of endemic areas in the type of drinking water arsenism and in Xiantao City,Hubei Province,and to offer a scientific basis for control and prevention.Methods According to"the Chinese Scheme of Implementing Surveillance of Distribution of Endemic Arsenism",considering with the special geography feature of Xiantao,both sampling and overall survey were used in 7 towns chosen.The water arsenic content was determined by half quantitative fast reagent-box method.We began to search for clues and patients according to the endemic areas and the families with high arsenic wells.Results High endemic arsenic water sources were distributed in 7 the towns(districts or farms).In 81 villages of Xiantao City,35 villages had drinking water arsenic content exceeding 0.05 mg/L,accounting for 43.21%(35/81).In 4020 screened wells,269 had arsenic content higher than the national standard,the detective rate of high arsenic wells(more than 0.05 mg/L)was 6.69%(269/4020),with the highest rate in Shahu Seed Plant being 13.56%(115/848).The population exposed to high arsenic was 1091,in a rate of 5.75%(1091/18 975),in which 281 children were exposed in a rate of 5.82%(281/4826).In Shahu Seed Plant,467 people including 129 children were exposed to high arsenic, accounting for 13.26%(467/3522)and 12.91%(129/999),respectively.Conclusions High arsenic sources widely exist in Xiantao City,especially in Shahu Seed Plant,where arsenic content,the exposed rate of population and children are high.Therefore,prevention and control should be carried out in the southeast as soon as possible,as well as in other places where situation is less serious.

Objective To explore the association between patatin-like phospholipase domaincontaining protein 3 (PNPLA3) gene rs738409 polymorphism and the susceptibility of non-alcoholic fatty liver disease (NAFLD).Methods Data bases were comprehensively searched to retrace all the related studies on the association between PNPLA3 gene rs738409 polymorphism and susceptibility.Of NAFLD,the pooled OR with 95％ CI of the association between PNPLA3 gene rs738409 polymorphism and NAFLD susceptibility were performed using different genetic models.Subgroup analysis based on the source of population and sensitivity analysis was performed to detect the stability of results.Results 28 original studies with 6 216 patients and 8 218 controls were involved in the final combination of data.Findings from the meta-analyses showed that there were strong associations between PNPLA3 gene rs738409 polymorphism and the susceptibility of NAFLD,under different genetic model comparisons [GG vs.CC:OR=2.42,95％CI:1.83-3.21,P＜0.001 ;CG vs.CC:OR=1.28,95％CI:1.15-1.43,P＜0.001 ; CG+GG vs.CC:OR=1.31,95％CI:1.17-1.46,P＜ 0.001 ; GG vs.CC + GC:OR=2.26,95％CI:1.76-2.90,P＜0.001].Similar results were found in both Asian and Caucasian populations.Conclusion Results from the Meta-analysis strongly suggested that there appeared significant association between PNPLA3 gene rs738409 polymorphism and the susceptibility of NAFLD.

Objective To observe the clinical efficacy of fluticasone propionate aerosol in children with allergic rhinitis and its effect on osteopontin (OPN),interleukin-4 (IL-4) and intedeukin-5 (IL-5)expression.Methods Sixty children with allergic rhinitis were randomly divided into control group and treatment group,30 cases in each group.Control group was treated with ketotifen 1 mg,twice daily.The treatment group was treated with fluticasone propionate aerosol,100 μg each time,twice a day for 2 months.The levels of interleukin (IL)-4,IL-5 and integral optical density (IOD) of immunohistochemical staining of osteopontin in two groups were observed.The clinical effect and the number of eosinophils,neutrophils and lymphocytes in peripheral blood of 1,3,6 months after operation were observed.Results Mter treatment,the levels ofIL-4,IL-5 and OPN in treatment group were (66.31 ± 18.00) ng· mL-1,(62.12 ± 0.33) ng· mL-1,5589.71 ± 267.00,had significant difference with those in control group,which were (85.32 ± 12.34) ng · mL-1,(30.24 ± 0.30) ng · mL-1 and (15.00 ±0.26) + 103(P ＜0.05).The number of eosinophils,neutrophils and lymphocytes in 6 month after treatment in treatment group were (0.21 ±0.01) × 109/L,(0.10 ±0.01) × 109/L,(0.14 ±0.01) + 109/L.The number of eosinophils,neutrophils and lymphocytes in control group at 6 months after treatment were (0.21 ±0.02) + 109/L,(0.10 ±0.01) + 109/L,(0.14 ±0.01) + 109/L respectively,all had significant difference with those in 1 month after treatment (P ＜ 0.05),with no significant between the two groups (P ＞0.05).The total effective rate was 93.33％ (28/30 cases) in treatment group and 36.67％ (11/30 cases) in control group (P ＜0.05).The incidence of adverse drug reaction in treatment group was 3.33％ (1/30 cases).In control group,there were 4 cases of skin allergy,3 cases of thrush,3 cases of bronchospasm with asthma,theincidence of adverse drug reactions was 33.33 ％ (10/30 cases,P ＜ 0.05).Conclusion Fluticasone propionate aerosol treatment of children with allergic rhinitis have significant clinical efficacy.

INTRODUCTIONAntimicrobial stewardship programmes (ASP) can reduce antibiotic use but patient safety concerns exist. We evaluated the safety of prospective carbapenem review and feedback and its impact on carbapenem use and patient outcomes.

MATERIALS AND METHODSAfter 3 months implementation of our ASP, we compared patients with and without acceptance of ASP recommendations on the use of carbapenems. Primary outcome was 30-day mortality. Secondary outcomes included duration of carbapenem use, length of hospitalisation, clinical response, microbiological clearance, 30-day readmission and mortality at discharge.

RESULTSOf 226 recommendations for 183 patients, 59.3% was accepted. De-escalation, switching to oral antibiotics and antibiotic cessation comprised 72% of recommendations. Patients with acceptance of ASP recommendations had lower 30-day mortality and higher end-of-therapy clinical response despite shorter carbapenem duration (P <0.05). Predictors of 30-day mortality were Pitt bacteraemia score (adjusted odds ratio [aOR] 1.39, 95% confidence interval [CI], 1.11 to 1.74; P = 0.004) and non-acceptance of ASP recommendations (aOR 2.84, 95% CI, 1.21 to 6.64; P = 0.016).

CONCLUSIONOur prospective carbapenem review and feedback mainly comprising of reducing carbapenem use is safe.

Carbapenems ; therapeutic use ; Drug Utilization ; standards ; Feedback ; Guideline Adherence ; statistics & numerical data ; Humans ; Patient Safety ; Pharmaceutical Services ; Treatment Outcome

OBJECTIVETo study the analgesic, expectorant and antitussive effects of the compatible use of Aconiti Radix Cocta and Fritillaria cirrhosa or F. thunbergii with different matching ratio or dose in mice.

METHODThe two-factor, seven-level uniform design method was adopted to observe the analgesic, expectorant and antitussive effects of the oral administration with the two combined decoctions in rats, with frequency of body torsions induced by acetum, secretion of phenol red in tracheas and frequency of coughs as indexes. Significant matching proportions and doses were collected for verification.

RESULTThe effect on the frequency of body torsions: The combined decoctions could effectively reduce the frequency of body torsions. According to a regression analysis, Aconiti Radix Cocta and F. cirrhosa had the synergistic effect, which was maximized with a ratio of 1: 1. The 1: 1 combined decoction played the least role in reducing the frequency of body torsions with a total dose of more than 5 g x kg(-1). The effect on the secretion of phenol red in tracheas. The combined decoctions could effectively increase the secretion of phenol red in tracheas. According to a regression analysis, Aconiti Radix Cocta and F. thunbergii had the antagonism, which was maximized at the ratio of 1: 1, and minimized with a total dose of less than 10 g x kg(-1) and a ratio of 5: 1 between F. thunbergii and Aconiti Radix Cocta. The effect on the frequency of coughs. The combined decoctions could effectively reduce the frequency of coughs. According to a regression analysis, Aconiti Radix Cocta and F. cirrhosa had the antagonism, which was maximized at the ratio of more than 1: 5 and less than 10: 1. There was no interaction between Aconiti Radix Cocta and F. thunbergii. F. thunbergii could reduce the frequency of coughs, whereas Aconiti Radix Cocta showed no effect.

CONCLUSIONThe compatible application of Aconiti Radix Cocta and F. cirrhosa could enhance the analgesic effect of Aconiti Radix Cocta and reduce the expectorant and antitussive effects of F. cirrhosa, which vary according to different matching ratio and dose. The compatible application of Aconiti Radix Cocta and F. thunbergii shows no effect on the antitussive effect of F. thunbergii. This study provides experimental basis for in-depth studies on the combined effect of Aconiti Radix Cocta and Fritillaria--two of eighteen incompatible pairs.

Aconitum ; chemistry ; Analgesics ; pharmacology ; Animals ; Antitussive Agents ; pharmacology ; Behavior, Animal ; drug effects ; Drug Synergism ; Drugs, Chinese Herbal ; pharmacology ; Expectorants ; pharmacology ; Fritillaria ; chemistry ; Male ; Mice ; Phenolsulfonphthalein ; metabolism ; Trachea ; drug effects ; metabolism

To investigate the effects of matrine on apoptosis and expression of adhesion molecules in human multiple myeloma cell line RPMI8226 cells, RPMI8226 cells were incubated with indicated concentrations of matrine. The growth of RPMI8226 cells was observed by CCK-8 colorimetric assay and apoptosis was detected by flow cytometry using Annexin V-FITC/PI staining. The cell cycles were analyzed by PI staining. Flow cytometry using Annexin V-FITC/PI staining was used to detect the expression of cell adhesion molecules, including CD44, CD44v6, CD54 and CD106. The results showed that RPMI8226 cell viability in presence of matrine decreased markedly in a dose- and time-dependent manners. The apoptosis could be induced by matrine and its level increased following the augmentation of the drug concentration. After treated by matrine for 48 hours, a concentration-dependent increase of cells in G(0)/G(1) phase and a decrease in S phase could be detected, but no obvious change of cell count was found in G(2)/M phase. Treatment of RPMI8226 cells with matrine for 48 hours resulted in decrease of expression levels of CD44 and CD54, while expressions of CD44v6 and CD106 had no significant change. It is concluded that matrine induces in vitro apoptosis, suppresses proliferation in multiple myeloma cells and depresses expression of some adhesion molecules.
Alkaloids ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Hyaluronan Receptors ; metabolism ; Intercellular Adhesion Molecule-1 ; metabolism ; Multiple Myeloma ; pathology ; Quinolizines ; pharmacology