OBJECTIVE: To observe the clinical effects of Xinfeng Capsules (XFC), a traditional Chinese medicine for invigorating the spleen to resolve dampness and dredging collaterals, on patients with rheumatoid arthritis (RA) and anemia, and to investigate its mechanism. METHODS: Forty patients with RA and anemia were divided into three groups: XFC-treated group (n=20), Tripterygium glycosides Tablets (TGT)-treated group (n=10) and methotrexate (MTX)-treated group (n=10). The patients in each group took corresponding medicine for three months. The response rates of the three groups were evaluated after treatment. The general symptoms and specific signs and symptoms of RA were observed before and after the treatment. The indexes of blood routine examination and some other laboratory indexes such as erythrocyte sedimentation rate (ESR), and blood levels of rheumatoid factor (RF), iron, C-reaction protein (CRP), immunoglobins (Ig), complements 3 and 4, tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10) and erythropoietin (EPO) were all examined and compared before and after treatment. RESULTS: The total response rate in the XFC-treated group was similar to those both in the TGT-treated and MTX-treated groups. The effects on relieving specific symptoms of RA in the three groups were also similar. The ESR and serum levels of RF, CRP, IgG, IgA and IgM were all decreased after treatment as compared with those before treatment in the three groups, and there were no significant differences among those laboratory indexes in the three groups after treatment. The XFC displayed more obvious effects on improving the general symptoms of patients with RA and anemia, increasing the blood levels of hemoglobin, iron and IL-10, while decreasing the serum level of TNF-alpha and regulating the serum EPO level, as compared with those in the TGT-treated and MTX-treated groups. CONCLUSION: The XFC for invigorating the spleen to resolve dampness and dredging collaterals was developed on the basic principle of regulating spleen. It can obviously improve the symptoms and laboratory indicators of RA. Such effects may be related to maintaining the balance of cytokines, regulating the serum level of EPO and increasing the serum iron level in patients with RA and anemia.

Objective: To observe the therapeutic effects on gout and the acute toxicity of Poecilobdella manillensis. Methods: The anti-gout effects of P. manillensis were studied by observing its effects on the hyperuricacidemia model and the level of blood uric acid. And we observed the effect of P. manillensis on gouty inflammation via injection of MSU to the foot of rats. The analgesic effect and toxicity of P. manillensis will be reported in this work too. Results: Comparing with the model group, P. manillensis could significantly reduce the level of the blood uric acid in the hyperuricemic and normal mice at 3.00 and 1.50 g/kg doses (P < 0.01), and acute gouty arthritis at 0.75 g/kg dose (P < 0.05, 0.01). It reduced the number of writhing in mice at 3.00 and 0.75 g/kg doses (P < 0.05, 0.01). Obvious toxic reaction was not observed and the maximum tolerant dose was 23.09 g/kg for mice in acute toxicity experiment. Conclusion: P. manillensis is proved to have the therapeutic effect on gout. Further research and development will be continued.

Objective: To investigate the anti-gout effect of hirudin and its mechanism. Methods: Hypoxanthine was used to replicate mouse model of hyperuricemia. Sodium uric induced acute gouty inflammation in rats to observe the effect of hirudin on the level of uric acid and inflammation induced by acute hyperuricemia. The serum uric acid, serum urea nitrogen, serum xanthine oxidase activity, and liver xanthine oxidase activity were observed in chronic hyperuricemia mouse model induced by potassium oxonate. The changes of renal pathology, the level of C-reactive protein (CRP) and the expression of glucose transporter 9 (GLUT9) were also be tested. Results: Hirudin could significantly reduce the serum uric acid level in hyperuricemia mice induced by hypoxanthine and significantly inhibit acute toe swelling induced by sodium uric acid in rats. It could significantly reduce the level of serum hyperuricemia, decrease the level of blood urea nitrogen (BUN), significantly inhibit the expression of GLUT9 and alleviate the pathological changes of kidney in chronic hyperuricemia mice induced by potassium oxazinate. Conclusion: Hirudin has significant anti-hyperuricemia and anti-gout effects, and its mechanism may be related to the protection of kidney and the regulation of GLUT9 expression.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Hematopoietic System ; drug effects ; Male ; Physical Conditioning, Animal ; Rats ; Rats, Wistar

ObjectiveTo investigate the effect of clinical pathway teaching methord in nursing practice teaching. Methods80 junior college nursing students were randomly divided into control and experimental groups. Traditional clinical teaching method was given to control group, while the clinical pathway teaching method was given to observation group. Scores of comprehensive quality after departmental rotation and satisfaction rates of nursing students to teaching method in these two groups were evaluated. ResultsThe experimental group was significantly better than the control group ( P＜0.05 ), and the difference was statistically significant. ConclusionThe clinical pathway can significantly improve the quality of nursing practice teaching.

Objective: To explore the clinical characteristics of ST elevation and non-ST elevation acute myocardial infarction (AMI) related with left circumflex artery (LCX) occlusion. Methods: Clinical data of 86 consecutively enrolled patients with LCX occlusion -related AMI undergoing percutaneous coronary intervention (PCI) were retrospectively analyzed. According to manifestations of electrocardiography, the patients were divided into ST elevation myocardial infarction (STEMI) group (n=32) and non STEMI (NSTEMI) group (n=54). Clinical features and prognosis were compared between two groups. Results: Compared with NSTEMI group, there were significant increase in serum level of creatinine [(80±23) μmmol/L vs. (100±30) μmmol/L], in rates of intra-aortic balloon counterpulsation （IABP）support (3.7% vs. 18.8%), usage of invasive respiratory machine (1.9% vs. 15.6%), ischemic mitral reflux (13.0% vs. 40.6%), complete atrioventricular block (0 vs. 9.4%), proportion of left coronary artery dominant type (7.4% vs. 28.1%) and left ventricular end-diastolic diameter [LVEDd,（46±4）mm vs.（48±5）mm?]; And significant decrease in percentage of triple-vessel coronary disease (72.2% vs. 46.9%) in STEMI group, P<0.05 or <0.01. There was no significant difference in mortality rate during admission (3.1% vs. 0, P>0.05) between STEMI group and NSTEMI group. Conclusions: Compared with patients with NSTEMI, patients with STEMI have poorer heart function in patients with left circumflex artery occlusion, which may be related to more left coronary dominance.

Pulmonary fibrosis is a common pathological change in many chronic lung diseases, and its pathogenesis and characteristics are mainly caused by repeated lung alveolar injury leading to abnormal activation of fibroblasts and the accumulation of large amounts of extracellular matrix (ECM) deposition. Fibroblasts are not only responsible for constituting the interstitial structure of the lung but are also involved in the post-injury repairment in healthy lung tissue. In contrast, fibroblasts show a typical pro-fibrotic metabolic phenotype after differentiation into myofibroblasts during the development of pulmonary fibrosis. To synthesis large amount of collagen, the myofibroblasts have a strong metabolism characteristic of serine/glycine, glutamine, proline, and arginine. At the same time, the myofibroblast get the ability to resist cell apoptosis. As an important cell type for collagen degradation, fibroblasts reuse the amino acids of collagen to maintain cell metabolism. However, the myofibroblasts cannot degrade the ECM due to the suppression of autophagy activity, thus accelerating the progression of pulmonary fibrosis. This review attempts to summarize how amino acid metabolism of fibroblasts influence the pulmonary fibrosis.

Objective To explore the relationship between micresatellite alterations of RASSF1A gene and the development of cervical carcinoma, and HPV16 infection. Methods Two sites of microsatellite polymorphism of RASSF1A gene were selected, we used polymerase chain reaction(PCR) technique to detect the LOH and MSI of cervical tissues, and to detect the infection state of HPV16. Results There were significant differences of LOH rates at the two sites between clinical stage and pathological grade(P ＜ 0.05). Significant differences were noted between the cervical carcinomas with lymph node metastasis and those without lymph node metastasis in regard to their LOH and MSI at the two sites(P＜0.05). The incidence of LOH of RASSF1A gene was higher in HPV16 (+) than that in HPV16(-) (P＜0.05). Conclusion The change of RASSF1A gene is a relatively late event in cervical carcinomas. The detection of the LOH and MSI of RASSF1A gene might be helpful to the early diagnosis and the screening of cervical carcinoma. It might also be useful for predicting the prognosis of cervical carcinoma. Infection of HPV16 and LOH of RASSF1A gene had reacted together in the development of cervical carcinoma.

OBJECTIVETo study the effects of kneepad on expression of Bcl-2 and p53 mRNA of chondrocyte in white rabbits with knee osteoarthritis, so as to explore and treatment mechanism of OA kneepad on apoptosis of chondrocytes of rabbits with knee osteoarthritis in molecular degree.

METHODSForty-four Japanese healthy 6-month-old rabbits (equal male and female,the weight ranging from 2 to 2.2 kg) were used to establish knee osteoarthritis models by modified Hulth method. The rabbits were randomly divided into 6 groups: normal group, model group, control group (microwave), experimental group 1 (electricity), experimental group 2 (thermal), experimental group 3 (kneepad). Ten rabbits in the normal group were breed with conventional method; 9 rabbits in the model group were breed with conventional method after model made; 9 rabbits in the control group were treated with microwave for 30 minutes, one time daily; 9 rabbits in the experimental group 1 were treated with electricity (density wave) for 30 minutes,one time daily;8 rabbits in the experimental group 2 were treated with hot (hot soft membrane) for 30 minutes, one time daily; 9 rabbits in the experiment group 3 were treated with electrothermal (OA knee pad) for 30 minutes, one time daily. All the rabbits were treated for 16 weeks and then sacrificed. The expressions of Bcl-2 and p53 mRNA of chondrocytes in knee joint were detected by using fluorescence quantitative RT-PCR method.

RESULTSAt the 16 hthek,th e OD260/OD280 value range of total RNA extracted from rabbit articular cartilage tissue in each group were all at 1.80 to 2.00,wh ich indicates high RNA purity. The p53 relative mRNA in articular cartilage cells of model group,th e control group,th e experimental group 1 ,r oup 2,gr oup 3 were overexpressed,an d Belc2 mRNA expression levels of articular cartilage cells were low expression,an d compared with the normal group there were significant differences (P < 0.01). Belc2, p53 mRNA expression in articular cartilage cells,th ere were significant differences (P < 0.01) between the control group, experimental group 1, group 2, group 3 and model group. The results between the control group, experimental group 1 ,group 2 and group 3 had significant differences (P < 0.01).

CONCLUSIONOA-kneepad can up-regulate the mRNA expression of Bcl-2 as well as down-regulate the mRNA expression of p53, thereby to inhibit the apoptosis of cartilage cells and delay the degeneration of articular cartilage changes.

Animals ; Apoptosis ; physiology ; Disease Models, Animal ; Female ; Knee Joint ; metabolism ; pathology ; Male ; Osteoarthritis, Knee ; genetics ; pathology ; therapy ; Protective Devices ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; Rabbits ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Protein p53 ; genetics

Objective To assess the value of procalcitonin(PCT)measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy.Methods A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009.Patients were divided into the infection group and the non-infection group and their PCT levels were compared.Results A total of 103 patients (65 women)were enrolled in this prospective study[aged(47.9 ± 21.9)years old]with 84 in the infection group and 19 in the non-infection group.The baseline level of PCT was significantly higher in infection than in non-infection patients[2.58(0.08-44.65)pg/L vs 0.62(0.15-6.00)pg/L,P =0.002].Different levels of PCT were manifested in different pathogen groups with 3.41(0.45-44.65)pg/L in bacteria infection,0.99(0.28-6.67)pg/L in fungus infection,0.11(0.08-0.20)pg/L in virus infection group(P =0.018).The AUCROC of PCT was 0.867 for diagnostic bacterial infection.By multivariate analysis,the factors associated with the level of PCT were bacteria infection(OR 5.1,P =0.031)and septic shock(OR 7.5,P =0.027),while the factors not associated with the level of PCT were age,renal function,infection site and prognosis(P ＞ 0.05).Conclusions The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.