Objective To get new more sensitive signs reflecting cartilage degeneration,which were added to the present ARA differential criteria of knee osteoarthritis and to compare the sensitivity and specificity before and after new items.Methods Through review analysis of the clinical feature,radiography and operative presentation of 115 adult patients,the new signs reflecting cartilage degeneration as items were found,which were added to the present ARA differential criteria of knee osteoarthritis as new criteria.Then the 112 patients who have received either knee joint replacement or arthroscopy were re diagnosed with both the present ARA criteria and the new criteria.Sensitivity and specificity were calculated and compared.Results "Extensive knee joint tenderness" with cartilage degradation and "lockage on motion or a positive Apler test" were significantly related to the meniscus degradation.A 39 7% sensitivity of these patients was obtained using the present ARA clinical criteria,while it reached 70 6% using the new clinical criteria ( P 0 05).Conclusion The two new items added to the present ARA criteria help to increase the sensitivity for diagnosis of knee osteoarthritis without influence on the specificity.

Child ; Humans ; Tuberculosis, Renal

Objective To explore the corrective role of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on the bacteria overgrowth in small intestinal (SIBO)and assess the efficacy and possible mechanism of it in the treatment of diarrhea predominant irritable bowel syndrome (IBS-D).Methods From May to August 2013,IBS-D patients were collected.Screened by lactulose hydrogen breath test (LHBT),and a total of 60 SIBO positive patients were enrolled in the study and divided into experimental group and control group.Live combined Bacillus subtilis and Enterococcus faecium enteric were given to the experimental group and starch given to the control group,both were capsules,each 250 mg,three times per day,two capsules each time,and the treatment course was four weeks.Before and after administration a questionnaire was conducted in the study objects,including basic information (age,gender,disease type,family history and accompanied diseases) and the severe degree of the symptoms (abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust).Fasting peripheral venous blood was taken from the study individuals before and after administration.The level of interleukin (IL)-1β,IL-6,IL-10,IL-12 and tumor necrosis fator-α(TNF-α) in serum were detected by enzyme linked immunosorbent assay(ELISA).t-test was performed for measurement data comparison between two groups,and chi-square test was for count data comparison.Results Among 60 SIBO positive IBS-D patients,30 patients were in experimental group and 30 in control group.The SIBO negative conversion rate of experimental group and control group was 63.3 ％(19/30) and 30.0％ (9/30),the difference was statistically significant (x2 =6.696,P＜0.05).Before and after administration,in control group there were no significant differences in severe degree scoring of abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust or the level of TNF-α,IL-1β,IL-6,IL-10 and IL-12 (all P＞0.05).In experimental group,before and after administration there were statistically significant differences in severe degree scoring of abdominal floating (2.97 ± 1.45 vs 2.61±1.28),level of IL 1β ((1390.81±103.95) ng/L vs (1209.76±113.26) ng/L)and IL-10/IL-12 (4.94±0.74 vs 5.30±0.43),the differences were statistically significant (t=2.052,5.279 and 2.282,all P＜0.05).There were no signinficant differences in other items (all P＞0.05).Conclusions Lived combined Bacillus subtilis and Enterococcus faecium enteric coated capsules could alleviate the symptoms of abdominal floating.The possible mechanism may related with correcting SIBO,inhibiting low degree of inflammation reaction and regulating the inflammatory cytokines.

OBJECTIVE：To introduce pharmacogenomics and its applications in establishing clinical pharmacotherapeutic schemes.METHODS：Based on the analysis of the related literatures,the development and contents of pharmacogenomics and their relationship with individualized medication were summarized.RESULTS：Pharmacogenomics studies the association between gene polymorphisms and the variance of drug effects.CONCLUSION：Pharmacogenomics provides a theoretical basis for medication with safety,effectiveness and rationality.

Objective To explore the causes of acute renal failure resulted from tacrolimus in the treatment of nephrotic syndrome. Method The clinical data of acute renal failure caused by tacrolimus in treatment of nephrotic syndrome in 3 children during January 2012 and December 2015 were retrospectively analyzed. Results There were 2 male and 1 female aged 3, 11,and 13 years respectively. Clinical manifestations were consistent with simple type of primary nephrotic syndrome. One child was frequently recurrent and another two were secondary steroid resistant. The renal pathology showed minimal changes. Acute renal failure occurred within 4 weeks after treatment with tacrolimus on the basis of hormone therapy in all patients who had infection within one week. Renal function recovered to normal within 2 weeks after discontinuation or reduction of tacrolimus combined with anti-infection and diuresis treatment. Two children continued with tacrolimus, but the other one was replaced with cyclosporin A. The renal function of all patients remained normal during the follow-up for 10-42 months. Conclusion In the first 4 weeks of tacrolimus therapy in children with nephrotic syndrome, infection may lead to reversible acute renal failure.

Depression is a common emotional disorder that seriously affects people's life and health all over the world. The pathogenesis of depression is complex, and traditional Chinese medicine (TCM) for antidepressants has a good therapeutic effect because of its multi-component, multi-pathway, and multi-target action mode. At present, the anti-depressive mechanism of TCM has not been fully clarified, but it is clear that depression is closely related to metabolic health. Therefore, in order to further explore the anti-depressive mechanism of TCM, this paper proposes research strategies on the anti-depressive mechanism of TCM based on functional metabolomics from the perspective of metabolism, the potential biomarkers of depression are analyzed with the help of multi-omics combined analysis technology, and the functional molecules of TCM for antidepressant are studied. Molecular biology techniques are used to accurately capture the molecular interactions between biomarkers of depression and functional compounds, which identify effective drug targets and further elucidate the biochemical functions and related mechanisms involved in depression metabolic disorders. This paper systematically reviews the research strategies and applications of functional metabolomics in the anti-depressive mechanisms of TCM, expounds on the core value of functional metabolomics, and summarizes the current research status and hot issues of TCM for antidepressants in recent years, providing new methods and new ideas for the study of mechanisms of TCM with the help of functional metabolomics.

Glioma is the most common form of brain cancer. Despite recent advances in the treatment of solid tumors, there are few effective treatments for malignant gliomas due to its infiltrative nature. It has important significance to improve the treatment of glioma through in-depth understanding the intracerebral metabolic characteristics and pharmacokinetics of chemotherapeutics. Brain microdialysis (B-MD), an effective method to monitor central nervous system anticancer drug disposition, conditions of drugs through the blood-brain barrier, basic pathophysiologic metabolism, bioactive compounds and the changes of neurotransmitter in brain, provides the unique opportunity to allow the simultaneous determination of unbound concentrations of drugs in several tissues, and directly measure gliomas biochemistry continuously. B-MD has been able to monitor the change of brain drugs, metabolites and neurotransmitters, dynamic analysis of the drug concentration and pharmacological effect after administration, pharmacodynamic interaction between drugs, receptor mechanism of drug transport, as well as feedback information of internal environment. B-MD is expected to provide reference for clinical individual chemotherapy of glioma, but also provide powerful tools for the evaluation of new anticancer drugs in vivo. In this review, a comprehensive overview of B-MD for studies on glioma is elucidated with special emphasis on its application to neurochemistry and pharmacokinetic studies.
Animals ; Antineoplastic Agents ; pharmacokinetics ; Blood-Brain Barrier ; Brain Neoplasms ; metabolism ; Glioma ; metabolism ; Humans ; Magnetic Resonance Spectroscopy ; Metabolomics ; methods ; Microdialysis ; methods ; Neurotransmitter Agents ; pharmacokinetics ; Pharmaceutical Preparations ; metabolism ; Positron-Emission Tomography

objective To evaluate the therapeutic efficacy of endovenous radiofrequency ablation in combination with TriVex for the treatment of chronic venous insufficiency (CVI)of the lower extremity.Methods One hundred and fifty CVI cases(150 limbs)were randomly assigned to Group A(75 limbs)and Group B(75 limbs).Patients in Group A were treated with greater saphenous vein radiofrequency ablation procedures in combination with TriVex.Patients in Grpup B were treated with greater saphenous vein traditional stripping operation in combination with TriVex.The short-term results in hospital and patient self-assessment for the operation at postoperative 4 week were compared with each other:The changes of CEAP classification and venous clinical severity score(VCSS)were compared. Results Operation time was(67±11)min in Group A versus(69-4-9)min in Group B(P＞0.05).Postoperative pain,average hospital stay in Group A were significantly less and shorter than in Group B(P ＜0.05).The scores of selfassessment for the operation were(11.21±2.00)in Group A versus(10.52±2.08)in Group B(P＜0.05).The change of CEAP classification and VCSS were statistically significant after operation in both groups(P＜0.01).The VCSS decreased 4.6 ±2.5 in Group A versus 4.3±2.7 in Grpup B(P＞0.05).Conclusions Endovenous radiofrequency ablation in combination with TriVex for treatment of CVI are effective,less traumatic,of fast recovery.CEAP classification and VCSS are useful tools for assessing outcomes after the operation.

Objective To investigate the genotypic frequency of glucose-6-phosphate dehydrogenase (G6PD) (1376G ＞ T),G6PD 1311C ＞ T and G6PD IVS11-93T ＞ C in 50 newborns with G6PD deficiency in Guangdong region.Methods To identify G6PD deficiency in the patients of neonatal ward in Guangzhou First People's Hospital during 2010,detected by methemoglobin reduction test and measurement of G6PD/6-phosphate dehydrogenase (6PGD) ratio.Fifty G6PD deficiency subjects were classified into the experimental group,20 neonatal jaundice subjects were classified into the control group.Genomic DNA was extracted by standard method from the peripheral blood of each subject.PCR-direct DNA sequence analysis was used to identify G6PD 1376G ＞ T,1311C ＞ T and 11 intron 93T ＞ C mutations.Results The overall results of mutation analysis in the 50 G6PD deficiency subjects showed the existence of 3 different alleles:G6PD 1376G ＞T,1311C ＞T,11 intron 93T ＞ C(including 1311C ＞ T/IVS11-93T ＞ C and 1376G ＞T/1311C ＞T/IVS11-93T ＞ C complex mutations).The different genotypic frequency in the experimental group was G6PD 1376G ＞T 26.0％ (13/50 cases),1311C ＞ T 4.0％ (2/50 cases),11 intron 93T ＞ C 4.0％ (2/50 cases),1311C ＞ T/IVS11-93T ＞ C 2.0％ (1/50 cases),1376G ＞ T/1311C ＞ T/IVS11-93T ＞ C 2.0％ (1/50 cases).The G6PD enzyme activity of the subjects with 1311C ＞ T/IVS11-93T ＞ C and 1376G ＞ T/1311C ＞ T/IVS11-93T ＞ C complex mutation were reduced.These G6PD mutations were not found in the controls.Conclusions G6PD 1376G ＞ T is one of the commonest mutation in G6PD deficiency newborn in Guangdong region.A novel complex mutation 1376G ＞ T/1311C ＞ T/IVS11-93T ＞ C in this study was found.

Glioma is the most common form of brain cancer. Despite recent advances in the treatment of solid tumors, there are few effective treatments for malignant gliomas due to its infiltrative nature. It has important significance to improve the treatment of glioma through in-depth understanding the intracerebral metabolic characteristics and pharmacokinetics of chemotherapeutics. Brain microdialysis (B-MD), an effective method to monitor central nervous system anticancer drug disposition, conditions of drugs through the blood-brain barrier, basic pathophysiologic metabolism, bioactive compounds and the changes of neurotransmitter in brain, provides the unique opportunity to allow the simultaneous determination of unbound concentrations of drugs in several tissues, and directly measure gliomas biochemistry continuously. B-MD has been able to monitor the change of brain drugs, metabolites and neurotransmitters, dynamic analysis of the drug concentration and pharmacological effect after administration, pharmacodynamic interaction between drugs, receptor mechanism of drug transport, as well as feedback information of internal environment. B-MD is expected to provide reference for clinical individual chemotherapy of glioma, but also provide powerful tools for the evaluation of new anticancer drugs in vivo. In this review, a comprehensive overview of B-MD for studies on glioma is elucidated with special emphasis on its application to neurochemistry and pharmacokinetic studies.