Objective To investigate the effect of Panax notoginsenosides monomers ginsenoside Rg 1 in inhibiting hepatic fibro-sis .Methods The rat model of hepatic fibrosis was established by using 50% Ccl4 ,total 35 d .The different doses of Rg1was ad-ministered by hypodermical injection .At the end of the treatment ,the pathological changes of hepatic tissue were observed by light and transmission electron microscope .The stereological method was adopted to measure the volume density (Vvm) ,area density (Svm) ,specific surface(Qm) and surface number density (Nam) of liver cell mitochondria in various groups .Results The stereo-logical data of liver cell mitochondria showed that the statistical differences existed among various groups .Vvm in the Panax Notog-insenosides ,low dose Rg1 and isotonic saline groups were significantly increased compared with the normal control group with sta-tistical difference(P<0 .01);Vvm in the high dose Rg1 ,middle dose Rg1 and colchicine groups showed the increasing trend com-pared with the normal control group without statistical difference (P>0 .05);Vvm in the high ,middle and low dose Rg1 ,Panax No-toginsenosides and colchicine groups showed the decreasing trend compared with the isotonic saline group without statistical differ-ence(P>0 .05) .Svm in the low dose Rg1 ,Panax Notoginsenosides ,colchicine and isotonic saline groups were significantly increased compared with the normal group with statistical difference (P<0 .01);Svm in the high dose Rg1 ,middle dose Rg1 ,Panax Notogin-senosides and colchicine groups was significantly induced compared with the isotonic saline group with statistical difference (P<0 .01);Svm in the high dose Rg1 was reduced compared with the middle dose Rg1 group(P<0 .05) .Nam in the low dose Rg1 ,col-chicine and isotonic saline group was significantly increased compared with the normal group (P<0 .01);Nam in the high dose Rg1 , middle dose Rg1 and Panax Notoginsenosides groups were significantly reduced compared with the isotonic saline group with statis-tical difference(P<0 .01);Nam in the high dose Rg1 group was reduced compared with the middle dose Rg 1 group with statistical difference (P<0 .05) .Qm in all groups was reduced compared with normal group without statistical difference (P>0 .05) .Conclu-sion Rg1 has antifibrosis effects of Panax notoginsenosides ,even exceeds Panax notoginsenosides in some aspects ,and the above-mentioned effect is positively correlated with dose .Rg1 is an ideal drug for preventing and treating liver fibrosis .

Objective To simplify the calculation of T>MIC and evaluate meropenem regimens based on the simple mathematical model of T>MIC reported in literature for two-compartment model.Methods Six meropenem regimens were designed according to the recommended dose with the infusion duration of 0.5 h and 3 h.Four different MIC susceptibility breakpoint of meropenem against clinical microbiologic flora were used to formulate different T>MIC.Each T>MIC was calculated by both the simple and two-compartment model of T>MIC.Meropenem regimens were evaluated for different bacterial infections based on the simple model of T>MIC with 40%~100% of the T>MIC% as the target.The t-test suggested no significant difference between the pairs of T>MIC calculated by the two models.Results and Conclusion Simple model of T>MIC can replace the two-compartment model.Meropenem regimens can be optimized based on this simple model of T>MIC conveniently and quickly.

Objective To observe the treatment efficacy of piperacillin/tazobactam regime for P.aeruginosa infection formulated by the method of the ratio of T above MIC (T>MIC%).Methods 59 hospitalized patients with P.aeruginosa infection were diagnosed by etiological diagnosis which was sensitive to piperacillin/tazobactam from Jan.to April.2015.Before treatment, all patients were randomly divided into the control group and the test group.Patients in the control group were treated with 4.5 g piperacillin/tazobactam once and repeated every six hours.Patients in test group were treated with 4.5 g piperacillin/tazobactam once and repeated every twelve hours.The two groups were injected by 15 mg/kg amikacin once a day based on the above program.The other treatments were kept to be same.Results Between the two groups, the clinical efficiency rate and total hospital stay were equivalent, bacterial clearance rate and incidence of adverse reactions were similar, there were no difference between CRP and APACHE Ⅱ score before and after treatment.Conclusion The regime of piperacillin/tazobactam for P.aeruginosa infection formulated by the method of the ratio of T above MIC (T>MIC%)was safe, effective and feasible.

Objective:To investigate the clinical effect of locking plate combined with large autologous iliac bone implantation in treatment of complex proximal humeral fractures with comminuted proximal humerus and bone defect.Methods:A retrospective case-control study was conducted to analyze the clinical data of 52 elderly patients with proximal humeral fracture accompanied by comminuted and bone defect admitted to General Hospital of Jizhong Energy Xingtai Mining Group from January 2014 to March 2017. including 24 males and 28 females, aged 65-79 years, with an average age of 69 years. There were 36 patients with Neer's three-part fracture and 16 four-part fracture. Twenty-two patients were treated using locking plate combined with large autologous iliac bone graft (plate+ bone graft group), and 30 patients were treated using locking plate alone (plate group). The deltoid-pectoralis major approach was used in both groups. Operation time, bleeding volume and bone healing time were recorded. neck-trunk angle and shoulder joint range of motion were measured at the last follow-up . MOS 36-item short-form health survey (SF-36) score and visual analog scale (VAS) score were used to evaluate shoulder joint function and pain at last follow-up. Complications were observed as well.Results:All patients were followed up for 6-24 months, with an average of 17. 8 months. Operation time was (120.3±12.5)minutes in plate+ bone graft group, and (115.6±5.8)minutes in plate group ( P<0.01). Intraoperative bleeding volume was (400.8±15.8)ml in plate+ bone graft group and (300.2±16.2)ml in plate group ( P<0.05). Bone healing time was (2.2±0.5)months in plate+ bone graft group and (2.5±0.5)months in plate group ( P>0.05). At last follow-up, the neck-trunk angle was (132.3±10.6)°in plate+ bone graft group and (121.1±4.5)° in plate group ( P<0.01); the uplift and external rotation of shoulder joint was (149.2±3.7)° and (35.2±2.9)° in plate+ bone group, better than that in plate group [(135.1±2.1)°, (27.8±4.5)°] ( P<0.05). Meanwhile, the abduction and extension of shoulder joint was (118.4±13.9)°and (36.1±1.8)°in plate+ bone graft group, not significantly different from that in plate group [(110.8±21.9)°, (32.8±1.3)°] ( P>0.05). SF-36 score and VAS score in plate+ bone graft group was (87.3±4.7)points and (1.3±0.6)points, with significant difference from that in plate group [(70.9±7.2)points, (2.1±0.7)points]( P<0.05 or 0.01). One year after operation, 3 patients with humeral head varus and 1 patient with humeral head necrosis were observed in plate group, with the complication incidence of 13% (4/30); while 1 patient with absorption of humeral greater tuberosity in plate+ bone graft group, with complication incidence of (5%, 1/22) ( P<0.05). Conclusion:For complex proximal humeral fractures with comminuted proximal humerus and bone defect, locking plate combined with large autologous iliac bone implantation can maintain intraoperative reduction, avoid loss of neck-shaft angle, improve shoulder joint range of motion, promote function recovery, attenuate pain and reduce incidence of complications.

Objective: To evaluate the effect of transcatheter aortic valve replacement(TAVR) using Venus-A valve for treating patients with severe aortic stenosis. Methods: In this prospective study, 101 consecutive severe aortic stenosis patients with high surgical risk(Society of Thoracic Surgeon(STS) score ≥4%) or at prohibitive surgical risk were enrolled from 5 academic cardiovascular centers in China(Fuwai hospital, the second affiliated hospital of Zhejiang university school of medicine, West China hospital of Sichuan university, the first affiliated hospital of Nanjing medical university, Ruijin hospital of Shanghai Jiaotong university school of medicine) from September 2012 to January 2015, and Venus-A valves were used in TAVR for these patients. The primary endpoints were death from any cause and major stroke in 1 year. The secondary endpoints included efficacy and safety of TAVR in 1 year. Results: TAVR success rate was 97.9%(98/101), and 3 patients were transferred to receive surgical AVR. There were 85 patients using 1 Venus-A valve, and 13 patients underwent valve-in-valve implantation using 2 Venus-A valves. There were 1 case(1.0%) of stroke, 2 cases(2.0%)of acute myocardial infarction, 5 cases(5.0%) of pericardial effusion, 6 cases(5.9%) of severe vascular complication, and 2 cases(2.0%) of death after 7 days of TAVR. Meanwhile, aortic pressure gradient derived from echocardiography was significantly reduced when compared with pre-procedure level(11(8, 15) mmHg (1 mmHg=0.133 kPa) vs. 59(45, 71)mmHg, P<0.01), and there was no aortic root rupture or leaflets thrombosis. Rate of NYHA functional class ≤Ⅱ improvements were observed at 6 months follow-up when compared with pre-procedure(94.4%(84/89)vs. 21.3%(21/89), P<0.01). The primary endpoint was 7.9%(8/11), and the incidence of all cause death and stroke was 5.9%(6/101) and 2.0%(2/101) respectively at 1 year after the procedure. Kaplan-Meier survival analysis showed that cumulative survival rate was 94.1% at 1 year after the procedure. Conclusion TAVR using Venus-A valve for treating patients with severe aortic stenosis is effective and safe in the early and medium term post procedure.

Anoctamin 1 (ANO1) is a kind of calcium-activated chloride channel involved in nerve depolarization. ANO1 inhibitors display significant analgesic activity by the local peripheral and intrathecal administration. In this study, several thiophenecarboxylic acid and benzoic acid derivatives were identified as novel ANO1 inhibitors through the shape-based virtual screening, among which the 4-arylthiophene-3-carboxylic acid analogues with the best ANO1 inhibitory activity were designed, synthesized and compound