Objective To systematically review the efficacy of hypotensive resuscitation for traumatic-hemorrhagic shock.Methods Randomized controlled trails (RCTs) or quasi-Randomized controlled trails (qRCTs) were searched in Pubmed,Embase and the Corchrane Library from inception to August 2015.Two reviewers respectively picked out the useful data and performed quality evaluation.Metaanalysis was carried out with RevMan 5.3 software,risk ratio (RR) and its 95％ confidence interval (CI) were pooled to estimate the enumeration data,and GRADE 3.6.1 software was used to rate the level of evidence.Results The results of meta-analysis and GRADE rating system which included 4 studies showed that:compared with conventional resuscitation,hypotensive resuscitation was associated with lower total mortality [RR =0.77,95％ CI:0.62-0.95,P =0.01;n =984,GRADE rating:moderate],and 24-hour mortality [RR =0.47,95％ CI:0.24-0.91,P =0.03;n =281,GRADE rating:moderate],but the subgroup analysis of total mortality showed that there were no significant differences in mortality between the subgroup of blunt or penetrating trauma and the subgroup of penetrating trauma.Conclusions Hypotensive resuscitation reduced total mortality and 24-hour mortality,and the quality of the evidence was moderate.The future studies should do further research to explore the efficacy of hypotensive resuscitation for different types of trauma.

Objective To study the effect of aquaporin 1 on intestinal capillary endothelial barrier in rats with experimental acute necrotizing pancreatitis (ANP).Methods In this study,160 male Sprague-Dawley rats were randomly divided into five groups:Control group ( n =32),ANP group (n =32),NS group,Dexamethasone group,and Acetazolamide group.Eight rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models.Volume of ascites and levels of serum amylases were deternined at each time point.Pathological changes in intestine tissues were observed under electron microscope after HE staining.Capillary permeeabilities in intestine tissues were detected by Evans blue (EB) extravasation experiment.The mRNA and protein expressions of AQP1 in intestine tissue were determined by real-time PCR and Western blotting,respectively.Results Serum amylase level in ANP group was significantly higher than that in control group.Amylase level in dexamethasone group was lower than that in ANP group,and amylase level in acetazolamide group was higher than that in ANP group at 12 h (P ＜0.05 ) ; The concentration of EB in intestine tissues at each time point in ANP group was significantly higher than those in control group,and EB in dexamethasone group was lower than those in ANP group at 6,12 and 18 h.EB in acetazolamide group was higher than that in ANP group at 3 h ( P ＜ 0.05 ) ; The mRNA expression of AQPI in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group was higher than those in ANP group at 6,12 and 18 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3,6,12 h in intestine tissue ( P ＜ 0.05 ).Protein expression of AQPI in tissues in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group increased more than that in ANP group at 3,6,12 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3 h,6 h ( P ＜ 0.05 ).Conclusions The expression of AQP1 is down-regulated in intestine tissue in rats with acute necrotizing pancreatitis,and AQP1 could play an important role in the pathogenesis of capillary endothelial barrier dysfunction.

OBJECTIVETo explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.

METHODSFifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypotensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi (LI 11), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hematoma volume and neurological deficit score were compared at different time points between the two groups.

RESULTS(1) Blood pressure: from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [(164.3 +/- 21.6) mmHg vs (158.6 +/- 21.5) mmHg] and MAP [(113.4 +/- 4.9) mmHg vs (106.7 +/- 6.1) mmHg] were significant between the two groups (both P < 0.05). From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [(147.3 +/- 21.6) mmHg vs (158.4 +/- 23.5) mmHg, (97.2 +/- 5.3) mmHg vs (106.6 +/- 5.1) mmHg, both P < 0.05)]. (2) Hematoma volume: from the admission to 6 h after disease onset, the volume was increased by (4.15 +/- 0.73) mL in the convertional treatment group and (2.67 +/- 0.33) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). From the admission to 24 h after disease onset, it was increased by (5.57 +/- 1.26) mL in the convertional treatment group and (3.14 +/- 1.18) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). (3) Neurological deficit score: the score was increasing gradually in first 3 days after disease onset in the two groups. The score (38.39 +/- 6.84) in the acupuncture group on the first day was different significantly as compared with that (42.37 +/- 7.46) in the conventional treatment group (P < 0.05). On the 10th days, the score (24.68 +/- 5.42) in the acupuncture group was different significantly from that (29.74 +/- 7.36) in the convertional treatment group (P < 0.05).

CONCLUSIONThere is no peak of blood pressure rising, and the continuous hemorrhagic volume is less in 24 h and neurological deficit score is improved in the acupuncture group. Acupuncture brings the positive significance in the treatment of cerebral hemorrhage at the early stage.

Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Hemorrhage ; physiopathology ; therapy ; Female ; Hematoma ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

Plants in Ainsliaea genus, belongs to Compositae family, are traditional Chinese medicine and widely used in folk. These plants contain various types of chemical components, and main components are sesquiterpene lactone and its glycosides. In addition, there are triterpenoids, flavonoids, steroids, phenolic acid, long chain fatty acid and volatile oils. Recently, much attention has been payed to varlous research of A. fragrans. This paper reviewed and summarized the chemical components to provide the theoretical basis for the use of Ainsliaea.
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Molecular Structure

Objective To elucidate the association of the susceptibility for rheumatoid arthritis ( RA )and peptidylarginine deiminase 4(PADI4) genetic single nucleotide polymorphism (SNP) in Han population in Hebei province.Methods This hospital-based ease-control study included 105 untreated RA patients and 96 healthy controls.The genotypes and allele frequencies of padi4_92 gene polymorphisms were analyzed by PCR-RFLP method,and the analysis of linkage disequilibrium and haplotype construction were performed for padi4_92,padi4_94 and padi4_104 SNPs.The Peason Chi-square test and Woolf statistic method were used to analyze the odds ration (OR) and 95％ confidence interval (95％CI).Results Significant differences in the frequency of PADI4 alleles and genotypes between the cases and controls were observed.The combined effect of padi4_92,padi4_94 and padi4_104 SNPs was analyzed by SHEsis snd Genehunter software,and got three haplotypes,CCC,GTT and GCC.There was significant difference in haplotypes distribution of 3 SNPs of padi4 between the two groups.This analysis of haplotypes revealed that haplotype of PADI4 was a risk factor for RA The ORs for these three haplotypes for RA susceptibility were 0.634 (95％CI=0.425-0.946),1.306 (95％CI=0.864-1.975),4.286 (95％CI=1.274-14.424),respectively.Conclnsion The SNPs of PADI4 may contribute to genetic susceptibility to RA in Han population in Hebei Province.

Objective To demonstrate the relationship between Cdc20 mutation and the promotion of colon cancer via Cdc20loxp/+ APCmin/+ villin-cre+/-compound mutant mice.Methods Cdc20loxp/+ APCmin/+ villin-cre+/-compound mutant mice and APCmin/+ mutant mice were generated by mice mating strategy.The colon tumors of two group mice were compared by phenotypic analysis and histology analysis.Results Phenotypic analysis showed that the number of tumors in Cdc20loxp/+ APCmin/+ villin-cre+/-compound mutant mice group and APCmin/+ mutant mice group was 1.2±0.5 and 1.6±0.5, respectively (t =0.215, P =0.588), and the maximum diameter of tumors was (2.7±0.3) cm and (2.5±0.2) cm, respectively (t =0.568, P =0.575).Pathologic type of Cdc20loxp/+ APCmin/+ villin-cre+/-compound mutant mice was adenocarcinoma, while that of APCmin/+ mice was tubular adenoma.Conclusion Cdc20 carrying a null allele can accelerate the promotion of colon cancer in APCmin/+ mice without influence on the tumor number and size.

Objective To explore the effect of therapeutic hypothermia on the activation of inflammasome in the lung tissue of rats with hemorrhagic shock (HS).Methods Twenty-four male Sprague-Dawley rats were randomly (random number) divided into three groups:sham group,normothermia resuscitation (NR) group and hypothermia resuscitation (HR) group.Rats of each group were subjected to pressure-controlled (MAP 40 mmHg) HS for 1 h,then the NR group and the HR group were resuscitated with lactated Ringer and MAP was maintained at 90 mmHg for 1 h.Four hours later,the rats in each group were sacrificed by exsanguination.Hematoxylin eosin staining was used to observe the injury of lung tissue.The desiccation method was used to detect the edema of lung tissue.RT-PCR and western blot were employed to evaluate the mRNA and protein expression of NLRP-3,IL-1β,caspase-1.Analysis of variance was used for comparison among groups,and SNK-q test was used for comparison between two groups.Results (1) The injury of lung tissue in HR group was significantly milder than that in NR group;(2) Wet/dry (W/D) weight ratio of lung in HR group decrease compared with NR group [HR group 5.85 ± 0.102;NR group 6.471 ± 0.165 8 (t =3.14,P ＜ 0.05)];(3) NLRP-3 and of Caspase-1 protein expression in the HR group were lower than those in NR group.(4) The NLRP-3 mRNA expression in HR group was lower compared with NR group [(HR group 1.027 ± 0.143;NR group 1.3487 ± 0.163 (t =4.36,P ＜ 0.05)] and IL-1 mRNA expression in HR group was lower compared with NR group [HR group 162.3 ± 0.125;NR group 2.388 ± 0.229 (t =7.72,P ＜ 0.05)].Conclusions Therapeutic hypothermia attenuated ALI induced by HS in rats by modulation of signal way of inflammasome.

Objective To investigate the expression of musashi-1(msi-1)and its significances in small intestinal mucous severely damaged by high close 5-FU.Methods Total 40 adult C57BL/6J mice were divided into control group(n= 8,group D)and experimental group(n=32).Mice in control group received intraperitoneal injection of PBS as control,and mice in experimental group were intraperitoneally injected high dose 5-FU(150 mg per kg of body weigh for five days).After treatment 1 day(group A),3 days(group B)and 5 days( group C),the dying mice were killed,HE straining and immunohistochemical technique were carried out for detecting the expression of putative marker of intestinal epithelial stem cells——musashi-1(msi-1)in the samples of the meddle intestine,and the percentage of the msi-1 positive cells from the intestinal mucosal cells of the mice in group A was detected by flow cytometry.Results After the treatment of high dose 5-FU,the intestinal mucous was damaged severely;the number of msi-1 positive cells increased markedly;The intestinal mucosal cells can be divided into two groups by flow cytometry,and in the group in which the value of FSC was higher,the percentage of msi-1 positive cells increased to 67.75 %.Conclusions After the treatment of high dose of 5-FU,the percentage of intestinal stem cells increased significantly;this model may be useful for further isolation and enrichment of intestinal epithelial stem cells.

Objective To evaluate the risk of the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer in the oral HPV carriers through a population-based investigation in Shanghai.Methods A total of 1200 cases of outpatients who attended the annual cervical examination and 50 preoperational cases of inpatients with CIN Ⅲ or invasive cervical cancer were enrolled from three clinical centers in Shanghai.The oral HPV infection was determined by real-time PCR.In 1200-case cross-sectional study,the incidence rate of CIN was compared between the oral HPV positive and negative cohort.In 1250-case case-control study,the positive rate of oral HPV DNA test was compared among normal control group,CIN Ⅰ-Ⅲ,and invasive cancer case groups,and all odds ratio (OR) values were calculated,respectively.The HPV transmission-related demographic and behavioral characters of the oral HPV carriers were also analyzed.Results The oral HPV carriers accounted for 5.9％ (71/1200) of the investigated outpatients.The oral HPV DNA positive rates were gradually increased with the cervical disease grades,which were 5.8％ (68/1182,normal),2/13 (CIN Ⅰ),1/5 (CIN Ⅱ),31.4％ (11/35,CIN Ⅲ) and 5/15 (invasive cancer).In cross-sectional cohort studies,the relative risks (RR) of CIN Ⅰ,Ⅱ were 2.9 and 4.0 for oral HPV carriers,respectively.In case-control study,the OR values for CIN Ⅰ-Ⅲ and invasive cervical cancer were 3.1(95％CI:1.6-10.1),4.2(95％CI:1.7-28.4),7.1(95％CI:4.8-19.8) and 10.1 (95％ CI:3.2-32.1),respectively.The oral sex and multi-sexual partner were two major risk factors for the oral and cervical HPV co-infection,HPV-related cervical cancer and precancerous diseases according to behavioral analysis.Conclusions There are complicated transmission pathways between oral and cervicalHPV.Oral HPV carriers should be intensively followed up and their oral HPV infection and HPV-related cervical diseases should be treated together.

OBJECTIVE:To study the bioequiavailability of two sertraline hydrochloride formulations in healthy volunteers.METHODS:A randomized, crossover study of 22 healthy volunteers receiving single oral dose of 50mg sertraline hydrochloride solution(test preparation) or sertraline hydrochloride tablets(comparator preparation) was conducted and the blood concentrations determined by LC/MS/MS.RESULTS: The pharmacokinetic parameters for the test sertraline and the comparator sertraline were as follows:t1/2 were (27.3?5.2)h and (26.3?3.0)h,respectively;Cmax were(9.56?2.49)?g?L-1 and(9.43?2.91)?g?L-1,respectively;tmax were(5.18?1.47)h and(6.00?1.07)h,respectively;AUC0～108 were(329?112)?g?h?L-1 and (297?111)?g?h?L-1,respectively;AUC0～∞ were(354?127)?g?h?L-1 and (316?122)?g?h?L-1,respectively.There were no significant differences in main pharmacokinetics parameters between the 2 preparations,except in tmax from analysis of variance and one-side & two-sides t tests.The relative bioavailability of the test sertraline was(115.5?26.7)%.CONCLUSION:These two sertraline hydrochloride formulations are bioequivalent.