Objective To observe the clinical efficacy and safety ofZhilou Lotion combined with modified Sihuang Ointment in treatment of anal cryptitis.MethodsOne hundred patients with anal cryptitis were randomly divided into observation group and control group, with 50 cases in each group. The control group was given propylene dispersible tablets oral and topicalHuazhi embolism. The observation group received steaming and hip bath with Zhilou Lotion combined with modifiedSihuang Ointment topical external application treatment, 7 days as a course of treatment and 2 courses successive. The TCM syndrome scores of two groups were compared before and after treatment to evaluate the clinical efficacy. The remission time of symptoms, hospitalization time, recurrence rate in 6 months and adverse reactions were observed.Results After treatment, the TCM syndrome scores of two groups were improved (P<0.01), and the scores in the observation group was lower than those in the control group (P<0.01). The total effective rate was 96.0% (48/50) in the observation group, and 80.0% (40/50) in the control group, with statistical significance (P<0.01). The remission time of anal edema, anal dampness, anal pain and anal fall-swell in observation group was obviously shorter than that in the control group, with statistical significance (P<0.01). The average hospitalization time was (15.25±2.78) days in the observation group and (18.46±3.41) days in the control group, the difference was significant (P<0.01). In the observation group, the recurrence rate was 0, 0 and 2.0% in 2, 4, 6 months follow-up, while that was 4.0%, 12.0% and 16.0% in the control group, respectively. The recurrence rates of the control group in 4 months and 6 months were higher than those of the observation group (P<0.05). No significant adverse reactions occurred in the two groups.Conclusion Zhilou Lotion combined with modifiedSihuang Ointment has good clinical efficacy in treatment of anal cryptitis, with low recurrence rate and high safety.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; In Vitro Techniques ; Mice ; Myocarditis ; drug therapy ; virology ; Phytotherapy ; methods ; Virus Diseases ; drug therapy

OBJECTIVETo prepare the quercetin self-emulsified formulation and evaluate its quality.

METHODThe quercetin self-emulsified formulation was optimized based on the quercetin solubility in different oils, and the self-microemulsified efficiency of various combinations of emulsifier and co-emulsifier evaluated using the pseudo-ternary phase diagram. The microemulsion of morphology, size and zeta potential were examined. The quercetin of solubility in self-emulsified system was tested and the formulation stability was investigated by accelerated experiment.

RESULTThe blank self-emulsified system was composed of ethyl oleate/Cremophor EUL/butanol with weight ratio of 10: 54: 36. After being dilutied with water, the morphology of microemulsion was homogeneous small spherical drops observed under the electro-microscopy. The particle size and the zeta potential were 16.3 +/- 4.6 nm and 2.1 +/- 0.8 mV, respectively. The solubility of quercetin in self-emulsifing system was (62.42 +/- 0.11) mg x mL(-1), increased 2 229 folds compared with that of in water. The quality of quercetin self-emulsified formulation was stable during the 3 months storage at 40 degrees C.

CONCLUSIONThe solubility of quercetin is significantly increased in self-emulsified system and the formulation is stable and easy to prepare.

Antioxidants ; administration & dosage ; chemistry ; Butanols ; chemistry ; Chromatography, High Pressure Liquid ; Drug Delivery Systems ; Drug Stability ; Emulsions ; Glycerol ; analogs & derivatives ; chemistry ; Oleic Acids ; chemistry ; Particle Size ; Quercetin ; administration & dosage ; chemistry ; Solubility ; Solvents ; Technology, Pharmaceutical ; methods

Objective To evaluate the efficacy and safety of photodynamic therapy(PDT)combined with intravitreaIinjection of bevacizumab for choroidal neovascularization(CNV)caused by agerelated macular degeneration(AMD). Methods A total of 21 eyes of 21 patients with AMD,which was diagnosed by examination of visual acuity,intraocular pressure,ocular fundus,fundus color photography,fundus fluoreseein angiography(FFA),indocyanine green angiography(ICGA)and optic coherence tomography(OCT),were underwent PDT combined with intravitreal injection of Bevacizumab.The patients,15 males(15 eyes)and 6 females(6 eyes),aged from 56 to 78 years,with the average of 68.6years.The best corrected visual acuity:counting fingers/10cm-0.9,logMAR was 1.04±0.41.CNV located in below or side central fovea of macula.There was obvious leakage of fluorescein which examined by FFA and ICGA.The average of retinal thickness of macular foveal was(258.91±78.66)μm.The treatment method of PDT has to according to the way of PDT for TAP and Verteporfin PDT for VIP.Intravitreal infeetion with 1.5mg bevacizumab was performed after three days under surface anesthesia.Follow-up time was 1,3,6,12 months after the treatment. Resuits At last visit,the best corrected visual acuity:counting fingers/10 cm-1.5,logMAR was 1.04±0.41,and the differences are statistically significant compared with before.The BCVA improved four or more lines in 6 eyes(28.57%),improved two to four lines in 9 eyes(42.86%),stabilized(±1 line or no change)in 6 eyes(28.57%)and decreased in none.The average intraocular pressure was(15.20±2.41)mmHg after surgery,and the differences was not statistically significant compared with before(P＞0.05).FFA and lCGA showed CNV complete closure in 13 eyes(61.90%).partial closure in 8 eyes(38.10%).The average of retinal thickness of macular foveal was(127.38±20.14)μm(P＜0.01). Conclusion Combining treatment with PDT and intravitreal injection of Bevacizumab is safe and effective for CNV which caused by AMD.It has significant improvement in BCVA.1eakage of CNV and retinal edema.

OBJECTIVETo evaluate effectiveness therapeutic regimens for obstructive sleep apnea hypopnea syndrome (OSAHS) children at an acceptable cost.

METHODThis study was performed at Yuying Children's Hospital of Wenzhou Medical University from Mar. 2008 to Dec. 2010. Prospective random number table method was used for the analysis; 60 children with mild OSAHS were divided into Mild OSAHS Montelukast Treatment (MM) group and Mild OSAHS Adenotonsillectomy Treatment (MAT) group. 32 children in MM group were treated with leukotriene receptor antagonists (LTRAs), while 28 children in MAT group were treated with adenotonsillectomy. Also, 58 children with moderate and severe OSAHS were divided into severe OSAHS Montelukast Treatment (SM) group and severe OSAHS Adenotonsillectomy Treatmen (SAT) group. Twenty-two children in SM group were treated with LTRAs, while 36 children in SAT group were treated with adenotonsillectomy. All selected children were evaluated by polysomnography (PSG) and Obstructive Sleep Apnea-18 (OSA-18) items before and after a six-month treatment. Both records were taken and analyzed, surgical complications and the reason for non-remission after operation were also analyzed. Two therapies were compared based on economic consideration and therapeutic effect. Result (1) PSG: A significant change of a significant change of Apnea Hypopnea Index (AHI) was observed in MM group after the treatment (before receiving the treatment 4.56 ± 1. 26, and after receiving the treatment 3. 48 ± 1. 52, t =3. 50, P <0. 05). But for oxygen desaturation Index (ODI) (MM group 2. 18 ± 2. 19, and MAT group 1. 80 ± 2. 34) and Lowest Oxygen satuation (LSaO2) (MM group 91. 66 ± 2. 34, and MAT group 92. 79 ± 2. 18), there was no significant difference in MM group and MAT group after the treatment (ODI, t =0. 65, and LSaO2 t = - 1. 93, P >0. 05). (2) OSA-18 scores: Significant differences were found in sleeping disorder (before 14. 81 ± 6. 28, and after 10. 56 ± 3. 57), the degree of familial stress (before 13. 56 ± 3. 54, and after 8. 97 ± 2. 96), and OSA-18 total scores (before 52. 66 ± 1. 11, and after 42. 56 6. 48) in MM group after the treatment (sleeping disorder Z - 3. 14, the degree of familial stress Z = -4. 50, and OSA-18 total scores Z= -4. 01, P <0. 05). (3) In addition to the cost of drugs, groups with surgical treatment had a larger economic burden than those with LTRAs treatment. (4) Treatment was totally effective for 28 children (88%) in MM group, and 28 children (100%) in MAT group. Meanwhile, treatment also achieved an obvious effect on 2 children (9%) in SM group, and in 35 children (97%) in SAT group. In MAT group, 3 children improved (11%). And in SAT group, 7 children improved (19%), but treatment was found to be ineffective in 1 case (3%). Among those effective and ineffective cases in groups with surgical treatment, there were 9 children with nasal diseases.

CONCLUSION(1) Surgical treatment is recommended as the first choice for children with moderate and severe OSAHS. And for those who also suffer from nasal diseases, treatment combining drugs with surgery is necessary. (2) LTRAs therapy has a good effect for mild OSAHS. Surgery is also recommended when drugs could not achieve any obvious improvement in clinical symptoms of children with mild OSAHS.

Adenoidectomy ; Blood Gas Analysis ; Child ; Cost of Illness ; Humans ; Oxygen ; Polysomnography ; Prospective Studies ; Sleep Apnea, Obstructive ; surgery ; Sleep Wake Disorders ; Tonsillectomy ; Treatment Outcome

Animals ; DNA Damage ; Dose-Response Relationship, Drug ; Isotope Labeling ; Male ; Phosphorus Radioisotopes ; analysis ; Rats ; Rats, Sprague-Dawley ; Trichloroethylene ; toxicity

Objective To investigate the neuroprotective effect and possible mechanism of nicorandil in mice under deep hypothermic low flow (DHLF). Methods A total of 105 3-week-old male C57/BL-6 mice were randomly divided into 7 groups: sham operation, model, nicorandil (5, 10, and 20 mg/kg), nicorandil 20 mg/kg + LY294002, and LY294002 groups (n = 15 in each group). A DHLF model was induced. At 24 h after reperfusion, the brain tissues of mice were taken out for HE and TUNEL staining. The pathological changes of cerebral cortical neurons and apoptosis were observed. Western blot was used to detect the expression levels of the total Akt, phospho-Akt (p-Akt), Bcl-2, and Bax. Results HE pathological staining showed that cortical neuronal injury was reduced, the phenomena of cel membrane depression, nuclear condensation, concentrated dye, and the blurring of the nucleus were decreased significantly in nicorandil group. The morphology of neurons was basicaly restored to normal. TUNEL staining showed that the apoptosis index in various dose groups of nicorandil was decreased significantly compared with the model group (al P < 0. 05). Western blot analysis showed that the expression levels of p-Akt and Bcl-2 proteins increased significantly in various dose groups of nicorandil compared with the model group (al P < 0. 05), and the expression level of Bax protein was decreased significantly (al P < 0. 05 ). After adding the phosphatidylinositol 3-kinase (PI3K) specific inhibitor LY294002, there was no significant difference in neurons pathological injury in the cortex compared with the model group. There was no significant difference in the apoptosis index, and the expression levels of p-Akt, Bcl-2, and Bax compared with the model group. Conclusions Nicorandil has a certain neuroprotective effect in mice under DHLF. Its mechanism may be associated with the activation of PI3K/Akt signaling pathway, and then further regulation of the downstream protein Bcl-2 and Bax expression.

Objective To investigate the effect of tube voltage and iodine concentration of contrast medium (CM) on abdominal dynamic enhanced CT image quality.Methods Six miniature pigs underwent repeated upper abdomen dynamic contrast-enhanced CT scans in 4 scanning protocols with different concentration of CM and tube voltage,namely,protocol 1,CM with iodine concentration of 270 milligrams iodine per milliliter (mg/ml) and 80 kV tube voltage;protocol 2,270 mg/ml and 120 kV;protocol 3,370 mg/ml and 80 kV and protocol 4,370 mg/ml and 120 kV.The same iodine dose (600 mg/ml) and iodine delivery rate (IDR) (920 mg/s) were used in all protocols.The CM with iodine concentration of 270 mg/ml were injected at a flow rate of 3.4 ml/s,and 370 mg/ml CM injected at 2.5 ml/s.Image reconstruction was performed with iterative reconstruction (iDose4) in protocol 1 and 3,filtered back projection (FBP) was used in protocol 2 and 4.A subjective scoring system for image quality,image noise and sharpness was conducted by 2 radiologists independently.The measured values (peak of enhanced CT values,image noise of aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma) as well as the calculated values [their time-to-peak,signal-to-noise (SNR) and contrast-to-noise (CNR) ratios] were compared between among 4 protocols.The CT volume dose index (CDTIvol) and dose length product (DLP) were recorded from the CT console after each scanning.Factorial designed ANOVA was used for comparison of enhanced CT values of vessels and liver parenchyma,noise,SNR and CNR.The Kruskal-Wallis test was used for comparison of values among the 4 protocols,including the time-to-peak enhancement of vessels and liver parenchyma,the subjective scores of image quality indices.Result There was no significant differences in subjective scores of the image quality,image noise and image sharpness (P＞0.05).The scored were more than 3,and the images with 4 scanning protocols were all acceptable for diagnosis.There was no significant differences between protocol 1 and 3,protocol 2 and 4 in the peak enhancement CT values of aorta [(729±46) HU vs.(707±59)HU,(515±84)HU vs.(513±53)HU],inferior vena cava [(366±95)HU vs.(368±92)HU,(282±39)HU vs.(262 ± 67)HU],portal vein [(213± 18)HU vs.(201 ±29)HU,(180±21)HU vs.(176±27)HU],hepatic vein [(207±18)HU vs.(193±10)HU,(179±24)HU vs.(170±14)HU] and liver parenchyma [(128±7) HU vs.(127±4) HU,(135±5)HU vs.(135±6)HU] (P＞0.05).But the CT values of vessels (aorta,inferior vena cava,portal vein and hepatic vein) in protocol 1 and 3 were significantly higher than those in protocol 2 and 4 (P＜0.05),the CT values of liver parenchyma in protocol 1 and 3 were significantly lower than values in protocol 2 and 4 (P＜0.05).The image noises of vessels were higher in protocol 1 and 3 than noises in other protocols (P＜0.05),but there was no significant difference in liver parenchyma noise among protocols (P＞0.05).No significant differences were observed on the peak times,SNR and CNR in aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma among 4 protocols (P＞0.05).The CDTIvol and DLP were 199.67 mGy,1 597.4 mGy· cm respectively in protocol 1 and 3,585.12 mGy and 4 680.9 mGy· cm in protocol 2 and 4 (scanning with 120 kV).Conclusions CM with different iodinated concentration could achieve the same enhancement in the abdominal vessels and liver parenchyma by using the proper scan protocols,which have the same IDR and iodine dose per kilogram body weight.Higher vessel enhanced peak values were achieved when using the protocols with 80 kV tube voltage than 120 kV.By using a low dose protocol of 80 kV tube voltage with the iterative reconstruction algorithm,the quality of image can be warranted.

Objective To evaluate the effect of transcatheter arterial chemoembolization (TACE) and delayed surgery for infant hepatoblastoma.Methods TACE was performed with the initial digital subtractive angiography (DSA) under general anesthesia 1-3 times in 8 infants with huge hepatoblastoma, whose age was 2 to 12 months. DSA was done via arterials in hepatoblastoma each time before chemoembolization. The arterials were perfused with chemodrugs and suspensions in ultrasome iodized oil , and were blocked with spring rings. DSA findings indicated that the tumor shrank without new tumorous arterials after 1 month in 6 cases, and 4 of them showed no tumorous staining, and the delayed surgery was performed successfully 1 week later in 6 infants. One boy underwent systemic chemotherapy alone during 6 months after 3 times of TACE. Results TACE therapy did not encounter any major technical problem or toxic reaction caused by chemotherapy. The following DSA test 4 weeks later did not detect any new tumorous vessels in 6 cases. Six children received TACE and surgery had been followed-up with no tumor recurrence for months averagely. The boy underwent TACE and venous chemotherapy for 6 months , without surgery , had been followed-up for 48 months until the present report. CT, AFP and DSA did not show any hints of tumor recurrence. Six cases receiving 3 times TACE combined with surgery survived without tumor recurrence. Conclusions TACE is a very effective, safe and helpful therapy for hepatoblastoma, which stressed the repeated use of spring ring to block tumor vessels lastingly if necessary. If surgery is required, DSA test is needed beforehand to detect new tumorous vessels or neoplasm. If there is any , TACE is repeated. TACE combined with surgery may provide an additional promising choice in the treatment of hepatoblastoma, and repeated TACE alone may cure hepatoblastoma in infants.

OBJECTIVE: To investigate a nwe, simple technique for preparation of interferon-alpha-liposomes, which may be suitable for industrial use. METHODS The uniform design coupled with computerized optimization was utilized to screen the formulation and preparation procedure of interferon-alpha-liposomes. Pro-liposomes were prepared by the powder bed grinding method and combined with interferon-alpha-solution to form interferon-alpha-liposomes. Liposome size was determined by the particle size analyzer. Free interferon-alpha and interferon-alpha-liposome were separated by gel filtration. Then the recovered activity of interferon-alpha was analyzed by enzyme-linked immunosorbent assay. RESULTS The result demonstrated that the best interferon-alpha-liposome formulation was as follows: the protectant was sorbitol; weight ratio of protectant to lipid was 5:1; weight ratio of octadecytamin to lipid was 1:9; weight ratio of sobey phosphatidylcholine to cholesterol was 9:1 respectively. Interferon-alpha-liposome size determined by the particle size analyzer was 80.8+/-36 nm and the encapsulation efficiency was 59.0+/-3.3%. CONCLUSION The powder bed grinding method can be used to prepare pro-liposomes which can be easily combined with interferon-alpha-solution to form interferon-alpha-liposomes.