Objective To observe the effect of Shenmai injection on congestive heart failure(CHF) and the effect on thyroid hormone as well as medicine security. Methods 52 patieits with CHF were enrolled,Shenmai injection was used with regular western medicine in the treatment. And observed its effect and test serum thyroid hormone: TSH,T3 ,T4 ,rT3. Another 50 CHF patients were enrolled as a control. Results The results of observation were that 25 cases were very effective,23 were effective,4 had no effect and the total effective rate was 92%. The results of control group were that 21 were very effective, 16 were effective, 13 had no effect and the total effective rate was 74%. The differences between the two groups were significant (P > 0.05). By comparing two thyroid hormone T3, T4, rT3, the observation T3 and T4 was obviously higher than the control. rT3 was lower than the control. Conclusion Shenmai injection could efficiently improve the heart function of CHF,cure arrhythmin and correct the illness caused by thyroid hormone.

Due to unknown onset time, patients with wake-up stroke and unknown onset stroke areoften excluded from thrombolytic therapy. However, many clinical studies have shown that multimodal imaging techniques can effectively guide wake-up stroke and unknown onset stroke for intravenous thrombolysis. Its endovascular treatment has also made some progress. This article mainly reviews the imaging findings, intravenous thrombolysis, and endovascular therapy in patients with wake-up stroke and unknown onset stroke.

Objective To determine the solubility and apparent oil/ water partition coefficient of sitafloxacin in different solvents. Methods High performance liquid chromatography (HPLC) was used. The column was Dikma Diamonsil C18 (2) (4. 6 mmí250 mm,5 μm). The mobile phase was 0. 05 mol·L-1 KH2 PO4 solution (pH was adjusted with H3 PO4 to 2. 4)-acetonitrile (7030). The column temperature was set at room temperature. The flow rate was 1. 0 mL·min-1 . The detection wavelength was 295 nm and the injection volume was 10 μL. The solubility of sitafloxacin and the apparent oil/ water partition coefficient at pH 2. 0,4. 3,5. 8,6. 6,7. 4,8. 0,10. 0 and 11. 2 were determined. Results The equilibrium solubility of sitafloxacin in water was 0. 44 mg·mL-1 and the apparent oil/ water partition coefficient was 0. 23 (lgP= -0. 64) at (37±2) ℃ . Sitafloxacin has the lowest equilibrium solubility (0. 13 mg·mL-1 ) and the highest apparent oil/ water partition coefficient in pH7. 4 buffer solution system. At pH>10 and pH<5. 8,the solubility of sitafloxacin increased obviously and apparent oil/ water partition coefficient decreased. Conclusion Sitafloxacin is insoluble in water and also poorly soluble in oil,but its solubility could be improved significantly in acidic or alkaline solution.

Objective To study the effects of rhubarb on the mitogen-activated protein kinase (MAPK) sig-naling transducfon pathway in rats with severe acute pancreatitis (SAP),and to investigate the treatment mecha-nism of rhubarb on SAP. Method One hundred SD rats were provided by from the Animal Center of Nanjing Uni-versity. All animals were randomly divided into sham operation (n=33), SAP (n=33) and rhubarb groups (n=34). SAP model was induced by retrograde injection of 5% sodittm taurocholate. Rhubarb was given with 10% rhubarb decoction (2 mi/100 g) at the time of pancreafitis induction in the rhubarb groups. At 1, 3, 6, and 12 h after the models were established,animals were killed. MAPK activity in pancreatic tissue was examined by West-em blotting and the mRNA levels of TNF-α and IL-6 in pancreatic tissues were detected by RT-PCR. All data were analyzed by SPSS statistical software and statistical differences between values from two sroups were determined by the Student's t -test. Results MAPK activity, TNF-α and IL-6 mRNA levels in pancreatic tissues were signifi-cantly enhanced in the SAP group compared with the sham operation group (all P<0.01). Rhubarb treatment markedlyinhibited MAPK activation,TNF-α,IL 6 mRNA (all p<0.01). Conclusions Rhubarb can alleviate the inflammatory response of SAP by down-regulating MAPK activity.

To identify adulterants from medicinal plants of Bletilla H. G. Reichenbach, the suitable candidate DNA barcoding of Bletilla was evaluated. In this study, the internal transcribed spacer (ITS) of nuclear ribosomal DNA, the LFY homologous gene intron 2 and chloroplast ycfl gene were amplified and sequenced from forty-one samples. The intra-specific and inter-specific divergences of Bletilla were calculated, and the identification efficiency was assessed using Barcoding Gap, NJ tree by K2P distance and BLAST1 method. The result showed the intra-specific divergence of nrDNA ITS and ycJfl (0.022-0.106 and 0.017-0.106) were obviously higher than the inter-specific divergence (0-0.012 and 0-0.015), and four species of Bletilla were also accurately distinguished in NJ trees. Whereas, there was no Barcoding Gap on LFY homologous gene intron 2, thus it cannot effectively identify species of Bletilla. Using NJ tree of nrDNA ITS and ycfl gene, powdery medicine and the adulterants of Bletilla were successfully unidentified. In conclusion, nrDNA ITS and ycfl can be used as a potential DNA barcoding to identify the medicinal plants in Bletilla and its adulterants. There were only three basic differences on nrDNA ITS between "Jujing baiji" and Bletilla striata of Lu'an in Anhui province, and two basic differences in ycfl. Based on morphological and molecular data, "Jujing baiji" could be recognized as the species of Bletilla striata.

Objective To investigate the clinical efficacy of a needle knife in treating knee meniscus injury. Methods One hundred patients with knee meniscus injury (112 knee joints) were randomly allocated to treatment and control groups, 50 cases each. The treatment group received needle knife therapy and the control group, an injection of sodium hyaluronate injectio into knee joint cavity. The main clinical symptoms and signs around the knee joint were observed and the knee function score was recorded in the two groups before and after treatment. the clinical therapeutic effects were evaluated in the two groups. Results There were statistically significant differences in pre-/post-treatment main clinical symptom and sign index (pain score, swelling score, activity score and tenderness index score) difference values between the two groups (P<0.05). There were statistically significant differences in the main clinical symptom and sign index difference values at follow-up compared with before treatment between the two groups (P<0.05). There was a statistically significant differences in the knee function score after treatment and at follow-up compared with before treatment in the two groups (P<0.01,P<0.05). There was a statistically significant differences in the knee function score between the treatment and control groups after treatment and at follow-up (P<0.05). Post-treatment excellence rate and total efficacy rate were 94.0%and 100.0%, respectively, in the treatment group and 72.0%and 98.0%, respectively, in the control group. There was a statistically significant differences in post-treatment excellence rate between the two groups (P<0.05). Follow-up excellence rate and total efficacy rate were 96.0% and 100.0%, respectively, in the treatment group and 76.0% and 98.0%, respectively, in the control group. There was a statistically significant differences in follow-up excellence rate between the two groups (P<0.05). Conclusion Needle knife therapy is an effective way to treat knee meniscus injury.

ObjectiveTo observe andanalyze the clinical efficacy of needle knife treatment for knee meniscus injury from improving knee biomechanical balance and to provide a therapeutic basis and method for clinical practice.MethodOne hundred patients (112 knees) with knee meniscus injury meeting the inclusion criteria were allocated, in order of visits, to observation and control groups, 50 cases each. They were treated with a needle knife and an injection of sodium hyaluronate injectio into knee joint cavity, respectively. Changes in the indices were observed and assessed in the two groups by recording the plantar pressure analysis score and the knee function score before and after treatment and at follow-up. The clinical therapeutic effects were evaluated in the two groups.ResultThemaximum load, time integral difference value and load ratio around the knee joint decreased significantly in both observation and control groups after treatment and at follow-up (P<0.05). The regulating effect on knee joint force balance was better in theneedle knife group than in the control group (P<0.05). The improving effect on knee joint function was significantly better in the observation group than in the control group (P<0.01). The excellence rate was significantly higher in the observation groupthan in the control group after treatment and at follow-up (P<0.05).ConclusionNeedle knife treatment restores the function of the knee joint by loosing focal soft tissues around the knee joint, improving knee joint load imbalance and correcting the mechanical equilibrium around the knee joint in patient with knee meniscus injury. It has a definite curative effect on the disease.

About 80％ of the patients with pancreatic cancer have glucose metabolism alterations,which suggests an association between diabetes and the occurrence and development of pancreatic cancer.Studies have shown that diabetes and hypoglycemic agents are closely related to the occurrence risk,clinical manifestation and prognosis of pancreatic cancer.Recent findings demonstrate that insulin resistance,hyperinsulinemia,the expression level of insulin-like growth factor related protein and inflammatory reaction are the possible mechanisms of the interaction between diabetes and pancreatic cancer.However,the definite mechanism still remains unclear,and further researches are still needed.

Objective:To evaluate role of Ras homolog gene family member A (RhoA)/Rho-associated coiled-coil protein kinase 2 (ROCK2) signaling pathway in trilobatin-induced reduction of cerebral ischemia-reperfusion (I/R) injury in rats.Methods:Eighty clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 230-280 g, were divided into 4 groups ( n=20 each) using a random number table method: sham operation group (group S), cerebral I/R group (group IR), cerebral I/R plus trilobatin group (group T) and cerebral I/R plus trilobatin plus RhoA/ROCK2 signaling pathway agonist AA group (group A). The model of focal cerebral I/R injury was developed by middle cerebral artery occlusion in anesthetized animals.Trilobatin 15 mg/kg was given by gavage twice a day for 3 consecutive days in T and A groups.RhoA/ROCK2 signaling pathway agonist AA 10 mg/kg was intraperitoneally injected before each administration by gavage in group A. Neurobehavioral score was assessed at 24 h of reperfusion, then the rats were sacrificed, and the hippocampal tissues were isolated for determination of the apoptosis rate of hippocampal neurons (by flow cytometry), cerebral infarction volume (by TTC staining), and expression of phosphorylated RhoA (p-RhoA), ROCK2 and cleaved caspase-3 (by Western blot) and for microscopic examination of ultrastructure of hippocampal neurons (with a transmission electron microscope). Results:Compared with group S, the neurobehavioral score, apoptosis rate of hippocampal neurons, and cerebral infarction volume were significantly increased, the expression of p-RhoA, ROCK2 and cleaved caspase-3 was up-regulated ( P<0.05), and the pathological damage to hippocampal neurons was aggravated in group IR.Compared with group IR, the neurobehavioral score, apoptosis rate of hippocampal neurons and cerebral infarction volume were significantly decreased, the expression of p-RhoA, ROCK2 and cleaved caspase-3 was down-regulated ( P<0.05), and the pathological damage to hippocampal neurons was alleviated in group T. Compared with group T, the neurobehavioral score, apoptosis rate of hippocampal neurons, and cerebral infarction volume were significantly increased, the expression of p-RhoA, ROCK2 and cleaved caspase-3 was up-regulated ( P<0.05), and the pathological damage to hippocampal neurons was aggravated in group A. Conclusions:RhoA/ROCK2 signaling pathway is involved in trilobatin-induced reduction of cerebral I/R injury, which may be related to inhibition of apoptosis in hippocampal neurons of rats.

Objective To explore the efficacy and safety of endoscopic retrograde appendicitis therapy (ERAT) for pediatric acute appendicitis. Methods Thirty-five pediatric patients with acute simple appendicitis admitted between June 2021 and November 2023 were selected as study subjects. Relevant perioperative data including clinical manifestations, diagnostic and therapeutic processes, as well as treatment and follow-up outcomes were collected. Results All 35 patients successfully underwent ERAT with an operation time ranging from 24 to 75 min. Intubation of the appendiceal lumen was successful in all patients, with pus flushed out or stones removed. After contrast administration and flushing, 16 patients were found to have pus only in the appendiceal lumen with no appendicoliths, while 19 patients had both pus and visible appendicoliths with diameters ranging from 2 to 5 mm. Of 19 patients, 17 appendicoliths were loose and 2 were well-formed. Abdominal pain symptoms were alleviated within a short period, with the average VAS score decreasing from 6.6 preoperatively to 1.7 at 3 hours postoperatively and to 0.2 at 24 hours postoperatively. There was a statistically significant difference in Visual Analogue Scale(VAS) scores before and after surgery (P < 0.05). During follow-up ranging from 3 to 11 months postoperatively, appendicitis recurred in one patient one week after ERAT, while no surgery-related complications occurred in the other patients during follow-up. Conclusion ERAT is a safe and effective endoscopic treatment for pediatric acute appendicitis, with advantages including reduced trauma and shorter recovery time. It is particularly suitable for pediatric patients with acute simple appendicitis complicated by appendicoliths, appendiceal lumen stenosis, or intra-appendiceal abscesses.