OBJECTIVE: To study the mechanism of Huoxue Qianyang Granule (HXQYG), a traditional Chinese compound medicine, in revising the left ventricular hypertrophy of hypertension. METHODS: Spontaneous hypertension rats (SHR) were randomly divided into seven groups: untreated group, Songling Xuemaikang (SLXMK)-treated group, captopril-treated group, high-, medium- and low-dose HXQYG-treated groups, and normal control group. The systolic blood pressure (SBP) and left ventricular mass index (LVMI) were measured. The content of angiotensin II (Ang II) in left ventricular tissue was determined by radioimmunoassay. The expressions of angiotensin converting enzyme (ACE) protein and mRNA in left ventricular tissue were analyzed separately by immunohistochemical method and RT-PCR. RESULTS: (1) SBP and LVMI were higher in the untreated group than those in the normal control group, and they were lower in the high- and medium-dose HXQYG-treated groups than those in the untreated group, but higher than those in the captopril-treated group, and without significant difference as compared to those in the SLXMK-treated group. (2) The content of Ang II and expressions of ACE protein and mRNA in the left ventricular tissue in the untreated group were higher than those in the normal control group, and they were lower in the HXQYG-treated groups than those in the untreated group, but higher than those in the captopril-treated group, and without significant difference as compared to those in the SLXMK-treated group. CONCLUSION: HXQYG can reverse the left ventricular hypertrophy of SHR, which may be due to decreasing the amount of Ang II and expressions of ACE protein and mRNA in the left ventricular tissue.

Adult ; Embolism, Amniotic Fluid ; blood ; diagnosis ; surgery ; Female ; Humans ; Hysterectomy ; Pregnancy ; Uterus ; pathology ; surgery

OBJECTIVE: To conduct an economic evaluation of Baofukang versus Langyi in the treatment of pregnancy with vulvovaginal candidiasis by means of cost-minimization analysis. Furthermore, provide reference for reasonable clinical prescription and decision-making. METHODS: Meta-analysis was conducted to support the safety data and effectiveness data of pharmacoeconomic evaluation based on literature review; guidelines and clinical experts' suggestion were used to find out treatment routes to calculate total direct medical costs. Cost-minimization analysis was conducted from the societal perspective. RESULTS: The total direct medical costs of group Baofukang was lower than group Langyi's. Sensitivity analysis indicated the results were robust. CONCLUSION: In contrast with Langyi, Baofukang is a more economic therapy in the treatment of pregnancy with vulvovaginal candidiasis.

Objective To evaluate catheter-directed thromlysis (CDT) through three different approaches in combination with intervention for acute deep venous thrombosis (DVT) of the lower extremities. Methods In this study 137 acute DVT cases were enrolled. CDT was performed through small saphenous veins in 107 cases,through the great saphenous veins in 21 and through popliteal veins in 9.Iliac vein balloon dilation was performed in 66 cases,and stents were placed in 60 cases. Results The limb edema reduction rates between small saphenous vein group and great saphenous vein group and popliteal vein group were of no significant difference (82.3％ ±7.6％ vs 81.6％ ±6.0％ vs 83.9％ ±6.1％,P＞0.05).The difference of rates of thrombolysis ( 63.5 ％ ± 7.7％ vs 66.9％ ± 8.4％ vs 66.1％ ± 2.7％ )between the 3 groups was not statistically significant (P ＞ 0.05 ). The mean time required for the cannulation was shorter in great saphenous vein group than the other two groups [ (7.3 ± 0.3 ) min vs (20.8 ± 1.1 ) min and (15.7 ±0.6) min,P ＜ 0.05 ].There were 12 cases complicating incision bleeding during thrombolysis in small saphenous vein group,in this group there were 5 cases complicating phlebitis and 8 complicating saphenous nerve injury.The complication rates in great saphenous vein group was lower (P ＜ 0.05).Follow-up made in 112 cases for 3 -25 months.There were 97 cases without limb edema.While test by venography or color Doppler,89 cases showed venous patency and rethrombosis developed in 8 cases. Conclusions Catheter-directed thrombolysis with iliac venous intervention was an effective method for the treatment of acute deep venous thrombosis.CDT through great saphenous vein is easier with less complications.

Epilepsy is a chronic neurological disorder with different etiologies. Despite of many antiepileptic drugs (AEDs) used in clinical treatment, about 30% of the patients have uncontrolled onset, and combined use of different AEDs or new AEDs are needed. The new AEDs should have satisfactory clinical efficacy, tolerability and pharmacokinetic properties, and minimal adverse effects. By now there have been about 20 novel AEDs; most of them are derivatives or analogues of current AEDs. Brivaracetam (BRI) is the derivative of levetiracetam (LEV). This review summarizes the mechanisms of action, pharmacokinetic profiles, tolerability, pharmacology and toxicology, and side effects of LEV and its derivative BRI.

Intestinal microbiota is closely related to the human health. The unhealthy state is often associated with disorders in intestinal microbiota. Intestinal microbiota modulators such as probiotics, prebiotics and synbiotics, which can restore and improve intestinal microbiota balance, are thus drawing wide attention. This paper reviewed the research progress of modulators of intestinal microbiota.

Bile acids (BAs) are a major component of bile salt, which plays a vital role in the metabolism of lipids in humans. Ninety-five percent of bile acids are recycled by the enterohepatic circulation (EHC), and therefore EHC is essential for bile acid homeostasis. There are four transporters that mediate the transmembrane transport of bile acids, each of which plays an important role in the enterohepatic circulation. Gene defects in bile acid transporters can lead to disorders of the enterohepatic circulation, ultimately leading to clinical phenotypes such as metabolic diseases and even death. Bile transporter expression is altered in patients with various metabolic disease states, suggesting that disruption of bile acid transporters may be a pivotal pathological mechanism for the development of metabolism diseases. Thus, many drugs targeting bile acid transporters are being developed. We provide a concise overview of the progress of bile acid transporters research, discuss the relationship between different bile acid transporters and disease development, and summarize the current progress in drug development targeting bile acid transporters.

Objective To study the clinical and pathologic features,histological criteria and pathologic factors contributing to diagnosis of mixed epithelial and mesenchymal tumors(mixed m?llerian tumors,MMT)of the uterus.Methods A retrospective study of 102 cases of MMT of the uterus (74 adenofibromas including 9 recurrent cases,3 atypical polypoid adenomyomas,2 carcinofibromas,10 adenosareomas and 13 carcinosarcomas)was undertaken.Clinical records,gross features and tissue slices were reviewed.The follow-up data were analysed.Results The most common symptom was vaginal bleeding.Clinical signs included pelvic mass,uterine polyps,and enlarged uterus.Benign MMT usually presented as exophytic polypoid masses extending into the uterine cavity or protruding through the external os,often broad-based,lobulated and papillary.It was hard to distinguish low-grade malignant MMT from the benign ones by gross appearance.High-grade malignant MMT had the common gross features of carcinoma and sarcoma.Histologically,MMT showed a biphasic differentiation of mesenchymal and epithelial components.MMT were classified according to whether these elements were benign or malignant.Nine cases of adenofibroma without unique features for the diagnosis of adenosarcoma recurred at postoperative intervals of 3 to 96 months.Recurrent tumors were almost always confined to the original site.Conclusions Uterine MMT tumors according to WHO diagnostic criteria are not rare.The differential diagnosis depends on a multifactorial analysis.The recurrent adenofibromas may be a kind of borderline tumors with benign appearances and malignant behavior.

Objective To investigate the expression levels of Interleukin(IL)?6 and matrix metalloproteinases(MMP)?13 in synovial fluid by in?vigorating kidney and activating blood formulae in treating rabbit knee osteoarthritis model. Methods A total of 30 New Zealand rabbit were ran?domly divided into blank group,model group,invigorating kidney group,activating blood group and invigorating kidney and activating blood group. Rabbits model with knee osteoarthritis were established by improved Hulth method. To give corresponding respectively the medicinal broth,model group was given saline,knee joint synovial fluid was collected after 4,8 and 12 weeks. Enzyme linked immunosorbent assay(ELISA)was used to measure the levels of IL?6 and MMP?13. Results The levels of IL?6 in rabbit knee osteoarthritis were obviously higher than that of normal control group at both 4 weeks and 8 weeks(P<0.001). But there was no statistical difference on the levels of IL?6 compared with controls in 12 weeks. In addition,the level of MMP?13 at 4 weeks,8 weeks and 12 weeks were significantly higher than the blank control group(P<0.001). After 8 weeks of Chinese medicine administration,the levels of IL?6 in synovial fluid were significantly decreased in invigorating kidney group,activating blood group and invigorating kidney and activating blood group(P<0.001),but there was no statistical difference among groups in 12 weeks. The MMP?13 levels of synovial fluid was significantly lower than the model group(P<0.001). Conclusion Our results indicate that IL?6 and MMP?13 par?ticipate in the pathological development of the rabbit knee osteoarthritis. Invigorating kidney and activating blood formulae could reduce the expres?sion of IL?6 and MMP?13 and alleviate osteoarthritis progression,and which is superior to the pure invigorating kidney formulae and activating blood formulae.

Objective To explore the relationship between diameter of liver hemangioma and operation risk.Methods The clinical data of 362 patients with liver hemangioma who were admitted to the PLA General Hospital from January 2006 to January 2014 were retrospectively analyzed.All patients were divided into the 3 groups according to diameter of gross specimen,217 with tumor diameter≥5 cm and ≤ 10 cm in the large hemangioma group,119 with tumor diameter ＞ 10 cm and ≤20 cm in the giant hemangioma group and 26 with tumor diameter≥20 cm in the extremely large hemangioma group.The operation method included open surgery and laparoscopic surgery.Hepatectomy and enucleation of liver hemangioma were major operation procedures.The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay were evaluated.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s,and comparison among groups was analyzed using the ANOVA.Skewed distribution data were described as M (P25,P75),comparison among groups was analyzed by Kruskal-wallis test and pairwise comparison was done by the MannWhitney U test.Results All patients underwent operation successfully without perioperative death,including 315 receiving open surgery (175 in the large hemangioma group,114 in the giant hemangioma group and 26 in the extremely large hemangioma group) and 47 receiving laparoscopic surgery (42 in the large hemangioma group and 5 in the giant hemangioma group).The operation time,volume of intraoperative blood loss,number of patients with blood transfusion,number of patients with postoperative complications and duration of hospital stay were 160 minutes (125 minutes,205 minutes),300 mL (100 mL,500 mL),31,5 and 8 days (7 days,9 days) in the large hemangioma group,220 minutes (175 minutes,275 minutes),500 mL (300 mL,1 000mL),36,5 and 9 days (8 days,10 days) in the giant hemangioma group,330 minutes (280 minutes,420 minutes),1 975 mL (800 mL,4 000mL),20,7 and 11 days (9 days,13 days) in the extremely large hemangioma group,respectively,with significant differences (x2 =84.24,80.94,53.65,31.54,47.67,P ＜ 0.05).The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion and duration of hospital stay were compared,showing significant differences between large hemangioma group and giant hemangioma group (Z =6.39,6.51,x2 =11.29,Z =4.73,P ＜ 0.05),with significant differences between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (Z =7.28,6.91,x2=51.22,Z =5.57,P ＜ 0.05;Z =5.33,4.86,x2=17.69,Z =3.5 1,P ＜ 0.05).Seventeen patients had postoperative complications with an incidence of 4.70％ (17/362),intra-abdominal hemorrhage were detected in 7 patients,perihepatic effusion in 4 patients,pleural effusion in 3 patients,bile leakage in 2 patients and fat liquefaction of abdominal incision in 1 patient.There was no significant difference in the number of patients with postoperative complications between large hemangioma group and giant hemangioma group (x2 =0.41,P ＞ 0.05).There were significant differences in the number of patients with postoperative complications between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (x2 =24.96,11.67,P ＜ 0.05).Conclusions Diameber of liver hemangioma is associated with operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay,and there is a high risk in the surgical treatment of patients with liver hemangioma diameter≥20 cm.