Objective To assess the value of spiral and cine CT for the diagnosis of foreign body in trachea in children. Methods Fifty-one consecutive pediatric patients suspected of aspirating radiolucent foreign body underwent chest radiography, 12 of them underwent three-dimensional spiral CT and cine CT scan within 24 h before rigid bronchoscopy. Results Rigid bronchoscopy showed foreign bodies in the main bronchus or bronchus intermedius of 42 patients, while spiral CT localized airway foreign bodies in the same patients. In the remaining 9 patients without foreign body found by rigid bronchoscopy, 6 were true-negative and 3 were false-positive on CT, making the overall sensitivity, specificity, accuracy, and positive and negative predictive values of CT scans was 100% (95% confidence interval, 91%-100%), 66.67% (29%-92%), 94.12% (64%-99%), 93.33% (81%-98%) and 100% (54%-100%), respectively. The cine CT scan correctly diagnosed 9 of 12 patients as true-positive and 3 as true-negative with identification of air trapping and secondary lung changes. Conclusion CT may be used in airway foreign body management of pediatric patients, especially with diagnostic dilemmas, and further prospective evaluations should be considered to assess its overall efficacy.

To investigate the effects of aerobic exercise and resveratrol on janus kinase 2(JAK2) and transforming growth factor-β1(TGF-β1) in renal tissue of type 2 diabetes rats and its mechanism. Methods: The model of type 2 diabetic rats was established through SD rats fed high-fat diet for 5 weeks together with intraperitoneal infecting after a low dose of STZ. The rats were randomly divided into diabetic control group(DC), diabetic exercise group(DE), diabetic resveratrol group(DR), diabetic exercise and resveratrol group(DER), normal control group(NC), 12 rats in each group. Exercise-related groups performed 8 weeks treadmill exercise (20 m/min, 60 min/day). Resveratrol was administered to drug-related groups for 8 weeks (45 mg/kg, 7 day/week). Eight weeks later, we examined blood glucose concentrations, 24 h microalbuminuria(UA), serum creatinine(Scr), blood urea nitrogen(BUN), and the expressions of TGF-β1, janus kinase 2(JAK2) and JAK2 mRNA in renal tissue. After eight weeks of intervention, compared with NC group, the concentrations blood glucose, 24 h UA, Scr, BUN, the expressions of TGF-β1, JAK2 and JAK2 mRNA were increased significantly in DC group(P＜0.05). Compared with DC group, the concentrations of blood glucose, 24 h UA, Scr, BUN, the expressions of TGF-β1, JAK2 and JAK2 mRNA were decreased significantly in DE group, DR group and DER group(P＜0.05). Exercise, resveratrol and combined intervention may decrease the expressions of JAK2 mRNA, JAK2 and TGF-β1, which further attenuate renal injury for type 2 diabetes. The renal protective effect produced by exercise and resveratrol combined intervention is better than that produced by exercise or resveratrol intervention alone.

To observe the clinical efficacy of modified Chaiping decoction for HBeAg-negative chronic hepatitis B under DaBianZheng theory(syndrome differentiation theory) guidance with understanding of purgative detoxing and modern pharmacology research of traditional Chinese medicine. The patients with HBeAg-negative chronic hepatitis B(n=119) were randomly divided into treatment group(n=69) and control group(n=50). The patients in treatment group were treated with the modified Chaiping decoction(6 doses per week, one dose every day in two times by oral administration), and the patients in control group were treated with lamivudine(LAM) (100 mg/time, once a day). All of patients were treated for 48 weeks. The liver functions, levels of DNA of hepatitis B virus (HBV-DNA) and clinical symptoms were observed at weeks 12, 24, 36 and 48 in both groups. The levels of ALT and HBV-DNA in serum were also observed 24 weeks and 48 weeks after treatment in two groups. There was no significant difference in total effective rate between treatment group and control group at week 24, but the total effective rate in treatment group was higher than that in the control group at weeks 12, 36 and 48(P<0.05); the improvement of liver functions in the treatment group was superior than that in the control group at weeks 12, 36 weeks and 48(P<0.01 or P<0.05), but there was no significant difference at week 24; the improvement of serum HBV-DNA in the treatment group was significantly lower than that in the control group at week 12(P<0.01), but there was no significant difference at weeks 24, 36 and 48; the negative converse rate of serum HBV-DNA in the treatment group was lower than that in the control group at weeks 12, 24 and 36(P<0.01 or P<0.05), but there was no significant difference at week 48; the improvement of fatigue, lassitude, abdominal distension and hypochondriac pain in treatment group was significantly better than that in the control group at weeks 12 and 24(P<0.01 or P<0.05), but there was no significant difference in the improvement of fatigue and hypochondriac pain at weeks 36 and 48; the abnormal rate of ALT in treatment group was significantly lower than that in the control group 24 weeks and 48 weeks after drug withdrawal(P<0.01); there was no significant difference in abnormal rate of serum HBV-DNA 24 weeks after drug withdrawal, but it was significantly lower than that in the control group 48 weeks after drug withdrawal(P<0.05). Modified Chaiping decoction with combination of long term medication and intermittent administration showed better clinical efficacy on HBeAg-negative chronic hepatitis B. Its prescription compositions shall be further optimized and consummated under guidance of disease differentiation and syndrome differentiation, and its clinical research on hepatic fibrosis and living quality shall be carried out.

Coronary heart disease （CHD） with atherosclerosis is a common chronic disease worldwide， and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang （CLMT）， first mentioned in the Shang Han Lun （《伤寒论》）， is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit， with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways， including regulating related signaling pathways， inhibiting the expression of inflammatory factors， improving oxidative stress damage， modulating neurotransmitter levels， suppressing the hypothalamic-pituitary-adrenal axis， promoting mobilization of mesenchymal stem cells from the bone marrow， and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression， effectively reduces negative emotions， improves traditional Chinese medicine （TCM） syndrome scores， and decreases levels of inflammatory factors. Furthermore， it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， and other databases in the past 15 years， in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.

ObjectiveTo investigate the therapeutic effects and difference in the effects of Arisaematis Rhizoma （AR） before and after processing （i.e.， Arisaematis Rhizoma Preparatum， ARP） with Zingiberis Rhizoma Recens-Alumen on allergic asthma in rats and to provide a basis for the theory of processing improving the efficacy. MethodA rat model of allergic asthma was established in 70 SD rats by intraperitoneal injection of ovalbumin （OVA）-aluminum hydroxide. The rats were administrated with the aqueous extracts of AR （1.2， 0.3 g∙kg^-1） and ARP （1.2， 0.3 g∙kg^-1） aqueous extracts by gavage， and montelukast sodium （0.001 g∙kg^-1） was used as the positive drug. The T helper cell type 1/type 2 （Th1/Th2） ratio in the serum and bronchoalveolar lavage fluid （BALF） and percentages of inflammatory cells in BALF were determined. Polymerase chain reaction （PCR） was employed to determine the mRNA level of mucin 5AC （MUC5AC） in the lung tissue. The pathological changes in the lung tissue were observed by hematoxylin-eosin （HE） staining and PAS staining. Immunohistochemical assay was employed to measure the expression of c-Jun amino-terminal kinase （JNK）， extracellular signal regulated protein kinase （ERK）， and p38 mitogen-activated protein kinase （p38 MAPK） in rat lung tissue. Western blot was employed to determine the protein levels of ERK， p-ERK， JNK， p-JNK， p38， p-p38 in the lung tissue. The effects of AR and ARP were compared based on overall desirability. ResultCompared with the blank group， the levels of interleukin-12 （IL-12） and γ interferon （IFN-γ） in serum and BALF of rats in the model group were significantly lower （P<0.05， P<0.01）， and the levels of interleukin-4 （IL-4）， interleukin-5 （IL-5） and interleukin-13 （IL-13） were significantly higher （P<0.05， P<0.01）. Compared with the model group， the serum and BALF contents of IL-12 and IFN-γ in rats in the montelukast sodium group， high-dose AR group and high-dose ARP group were significantly higher （P<0.05， P<0.01）， and the contents of IL-4， IL-5 and IL-13 were significantly lower （P<0.05， P<0.01）， and the serum contents of IFN-γ in rats in the low-dose AR group and low-dose ARP group were in BALF was significantly higher （P<0.05） and IL-4 and IL-13 were significantly lower （P<0.05， P<0.01）， the percentages of macrophages， lymphocytes， neutrophils， and eosinophils were reduced in BALF， and the expression of JNK/ERK/p38 MAPK signaling pathway and MUC5AC protein was inhibited in lung tissues. Overall assessment of the normalized analysis revealed that the ARP group was slightly more potent than the AR group after administration of the same dose. ConclusionAR and ARP can effectively treat allergic asthma by inhibiting JNK/ERK/p38 MAPK signaling pathway， and the effect is better after concoction， which can provide data support for its "concoction efficiency".

Diabetic cardiomyopathy occurs in diabetic patients and is different from hypertensive heart disease， coronary atherosclerotic heart disease， and other cardiac abnormalities. The main clinical symptoms are systolic and diastolic cardiac dysfunction， myocardial fibrosis， congestive heart failure， and angina pectoris. As one of the main complications of diabetes， its incidence and fatality rates have been on the rise year by year. However， modern medicine still fails to figure out its pathogenesis and no specific drug is available， which has seriously affected the survival and quality of life of patients. Cardiomyocytes contain a large number of mitochondria， which participate in cardiac energy metabolism and other biological activities and occupy an important position in the development of diabetic cardiomyopathy. Mitochondrial quality control mainly involves mitochondrial oxidative stress， mitochondrial dynamics， mitochondrial autophagy， and intracellular calcium regulation， which is an important condition for stabilizing the normal mitochondrial structure and exerting normal mitochondrial functions. In recent years， the efficacy of traditional Chinese medicine in intervening in mitochondrial quality control through multiple angles， pathways， and targets to affect the structure and function of myocardial mitochondria and significantly improve the clinical symptoms of patients with diabetic cardiomyopathy has attracted wide attention from scholars. Therefore， this paper reviewed the experimental studies and/or clinical observations concerning the treatment of diabetic cardiomyopathy with effective compounds of Chinese herbs and/or Chinese herbal compounds in the past ten years to further explain the pathogenesis of diabetic cardiomyopathy， clarify the regulatory mechanism of traditional Chinese medicine in mitochondrial quality control， and summarize the scientific connotations and shortcomings of traditional Chinese medicine in the treatment of diabetic cardiomyopathy， hoping to provide certain ideas and methods for further clinical application of traditional Chinese medicine in the treatment of diabetic cardiomyopathy.

OBJECTIVETo observe the difference for type 2 diabetes between acupoint injection of human placenta tissue fluid combined with oral administration of metformin and simple metformin.

METHODSSixty patients with type 2 diabetes were randomly assigned into a medication group and an injection group,30 cases in each one. In the oral medication group,metformin hydrochloride enteric-coated tablets was applied orally for continuous eight weeks,0.25 g a time,twice a day. In the injection group,based on the same oral administration,human placenta tissue fluid was injected into Diji(SP 8) and Yishu(EX-B 5) for two courses(four weeks as one course),once every other day and three times a week. Fast blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(HbAlc) and clinical effect were observed in the two groups before and after treatment.

RESULTSCompared with those before treatment,FBG,PBG and HbAlc were decreased in the two groups after treatment (all<0.05),with more apparent change in the injection group(all<0.05). The total effective rate of the injection group was 90.0%(27/30),which was obviously better than 63.3%(19/30) of the medication group (<0.05).

CONCLUSIONSAcupoint injection of human placenta tissue fluid combined with metformin hydrochloride enteric-coated tablets for type 2 diabetes can better lower blood glucose than simple metformin hydrochloride enteric-coated tablets.

With the development of urbanization and the change of lifestyle， people have gradually developed unhealthy living habits， such as high-fat diet and reduced physical activity， which promotes the increasing number of diabetes patients and becomes an escalating public health problem worldwide. Therefore， it is urgent to explore effective measures to prevent and treat diabetes. Recent studies have shown that intestinal flora is closely related to the occurrence and development of diabetes， making it a potential target for the treatment of diabetes. A healthy intestinal environment is an important internal environment for physiological and metabolic activities of the human body. Intestinal flora homeostasis is accompanied by physiological metabolic disorders of the body， such as induced metabolic endotoxemia， bile acid metabolism disorders and reduced production of short chain fatty acid （SCFA）， which leads to low-grade chronic inflammation and insulin resistance in the body that are important pathological processes of diabetes. Traditional Chinese medicine （TCM） has been used in the treatment of diabetes， with a remarkable curative effect. At present， there are extensive studies on the active ingredients of TCM and the compound of TCM for regulating structure of intestinal flora and improving symptoms of diabetes. A large number of studies have shown a dynamic two-way relationship between TCM and intestinal flora. Specifically， intestinal flora can transform TCM into polyphenols， alkaloids， saponins and other active substances with a pharmacological effect， in turn， these active ingredients can reverse the imbalance of intestinal microecology， and the recovery of intestinal flora imbalance can improve the symptoms of diabetes. It can be seen that intestinal flora is a bridge for TCM treatment of diabetes， which may be one of the mechanisms of TCM treatment of diabetes. This paper reviews the active ingredients of TCM and the compound of TCM in the treatment of diabetes， in order to provide reference for the exploration of prevention and treatment of diabetes.

OBJECTIVE: To observe the impacts of electroacupuncture (EA) on neurological function, the pathological morphology in brain tissue, apoptosis level and the protein expressions of apoptosis-related cytochrome C (Cyt-C) and cysteine aspartic acid protease-9 (Caspase-9) in the rats with traumatic brain injury (TBI) and explore the potential mechanism of EA in treatment of TBI. METHODS: A total of 70 clean-grade SD mice were randomized into a blank group (8 rats), a sham-operation group (8 rats), a model group (27 rats) and an EA group (27 rats). In terms of interventions of 3, 7 and 14 days, 3 subgroups were divided in the model group and the EA group successively, 9 rats in each subgroup. The modified Feeney free-fall percussion method was adopted to establish TBI models of rats. In the sham-operation group, only the skull was exposed and drilled and no free-fall percussion was exerted. One day after modeling, EA was given in the rats of EA group at "Shuigou" (GV 26), "Baihui" (GV 20) and "Neiguan" (PC 6) and "Zusanli" (ST 36) on the affected side, with intermittent wave, 2 Hz in frequency, once daily, 10 min each time, for 3, 7 and 14 days successively. Separately, on the day 3, 7 and 14 of intervention, the modified neurological severity scale (mNSS) was used to evaluate the degree of neurological function injury in the rats, HE staining and Nissl staining were to observe the pathological and morphological changes in brain tissue, TUNEL method was to observe the level of apoptosis in brain tissue and immunohistochemistry (IHC) method and Western blot were to determine the protein expressions of Cyt-C and Caspase-9 in brain tissue. RESULTS: Compared with the sham-operation group, on the day 3, 7 and 14 of intervention, mNSS scores were increased obviously in the rats of the model group respectively (<0.01). Compared with the model group, on the day 3, 7 and 14 of intervention, mNSS scores were reduced in the rats of the EA group respectively (<0.05). On day 3 of intervention, in brain injury region of the rats in the model group and the EA group, gross tissue necrosis, nuclear fragmentation, consolidation and obvious vacuolar changes, reduced Nissl bodies and scattered arrangement were found. On day 7 and 14 of intervention, in the model group and the EA group, the new connective tissue filling and normal cells were visible and Nissl bodies increased. The overall repair and Nissl body quantity in the EA group were better than the model group. Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the numbers of apoptotic cells were increased obviously in the model group (<0.01) and they were reduced in the EA group as compared with the model group (<0.05). Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue were all increased obviously in the model group (<0.01) and they were all reduced in the EA group as compared with the model group successively (<0.05). CONCLUSION Electroacupuncture remarkably improves the condition in the neurological function injury and reduces apoptosis degree in TBI model rats, which is likely related to the down-regulation of the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue and further to bring the impacts on mitochondria mediated apoptosis process.
Animals ; Apoptosis ; Brain Injuries, Traumatic ; therapy ; Caspase 9 ; metabolism ; Cytochromes c ; metabolism ; Electroacupuncture ; Random Allocation ; Rats ; Rats, Sprague-Dawley

The incidence of psycho-cardiological diseases， i.e.， cardiovascular diseases combined with psychological disorders， is increasing year by year. Brain-derived neurotrophic factor （BDNF） plays a role in the pathogenesis of such diseases. According to the theory of collateral diseases， our team innovates the concept of regulating mental activity by dredging collaterals in the treatment of psycho-cardiological diseases and summarizes the concepts of "heart of Qi and collaterals" and "heart of vessels and collaterals". We believe that obstructed collaterals and disturbed mental activity run through the whole course of psycho-cardiological diseases， being the core pathogenesis. BDNF closely related to the core pathogenesis can regulate nerve and vascular inflammation， alleviate oxidative stress， and mediate a variety of signaling pathways， thereby promoting the survival and repair of nerve cells and vascular endothelial cells to regulate emotion and protect the heart. Therefore， BDNF is one of the potential biomarkers for clinical treatment of psycho-cardiological diseases. Collateral obstruction caused by blood stasis is specifically manifested as collateral deficiency， blood stasis， and Qi stagnation in collaterals. It can easily lead to inflammation， free radical generation， and antioxidant system changes in the patients with psycho-cardiological diseases， which can cause oxidative stress damage， affect the BDNF level， and result in mental disorders， such as anxiety and depression. Disturbed mental activity is mainly caused by the disturbance in the heart of Qi and collaterals， which is specifically manifested as the disturbance of the mind and liver soul. It is prone to cause anxiety or depression symptoms， which is closely related to the BDNF-mediated abnormal activation of neural circuits， nerve injury， and inflammation. This article elaborates on the theoretical connotation and pathological mechanism of regulating mental activity by dredging collaterals in the treatment of psycho-cardiological diseases from the perspective of BDNF， aiming to provide new ideas for the prevention and treatment of psycho-cardiological diseases and collateral diseases.