Diabetic peripheral neuropathy is one of the common chronic complications of diabetes, and TCM has unique advantages in the treatment of diabetic peripheral neuropathy. The article summarized the experimental research progress in the TCM intervention in treatment of diabetic peripheral neuropathy in recent years from the aspects of oxidative stress, metabolic disorders, neurological nutrition factor and neural microvascular dysfunction, with a purpose to provide better efficacy in clinical treatment.

The effects of DHAA-urea,a novel dehydroabietylamine(DHAA) derivatives,on cell viability and glucose metabolism,in hypoxia and normoxia human hepatoma HepG2 cells were investigated.Hypoxia cells were achieved using DMEM containing high concentration of glucose without serum and pre-incubating of CoCl_2 (final concentration 150 μmol/L) for 24 h.The antiproliferation effect of DHAA-urea was measured by colorimetric MTT assay.The cellular ATP concentration,the lactate dehydrogenase(LDH) and glucose-6-phosphate dehydro genase (G6PD) activity were detected by their kits.It was shown that DHAA-urea markedly inhibited cell viability,cellular ATP level,LDH and G6PD activity in either aerobic or anaerobic circumstance in a dose-and time dependent manner.This suggested that DHAA-urea possibly inhibited HepG2 cells growth via the inhibition of glucolysis and glucolysis-dependent ATP depletion.DHAA-urea could be a promising candidate in the development of a novel class of agents used for human hepatocellular carcinoma.

OBJECTIVE:To observe the efficacy of Methyl Carboprost-NEGPF administered per rectum at different time in preventing postpartum hemorrhage in patients with vaginal delivery.METHODS:A total of 300 parturients undergoing vagi-nal delivery with possible postpartum hemorrhage were enrolled:Methyl Carboprost-NEGPF 1 granule(1mg) per rectum (with a suitable inserting depth of 6 cm) were administered in Group A(n=100) when their uterine orifices were fully open and Group B(n=100) after fetal delivery,while Group C(n=100) were injected i.m with oxytocin 10IU after fetal delivery. The three groups were compared in respect of third stage labor duration,postpartum blood loss amount at 2h and 24h and case numbers with postpartum hemorrhage.RESULTS:As compared with Group A and Group B,Group C was significantly different in the duration of third stage of labor and postpartum blood loss amount at 2h and 24h(P

Objective To investigate the maternal-fetal transmission of human papillomavirus (HPV).Methods Samples of exfoliated cervical cells were obtained from 73 pregnant women on their third-trimester examinations. Samples of fetal membranes, amniotic fluid and nasopharyngeal swab were obtained from the parturients and their neonates. The presence of HPV types 16, 18 and 35 deoxyribonucleic acid was detected by polymerase chain reaction (PCR) and endonuclease method.Results HPV types 16, 18 and 35 deoxyribonucleic acid were found in 26 (35.6%) of 73 specimens of cervical cells obtained from the parturients, and in 31 (42.5%) of 73 specimens of fetal membranes, 6 (15.4%) of 39 specimens of amniotic fluid, and 5 (14.7%) of 34 neonatal nasopharyngeal swabs obtained from the neonates. The restriction endonuclease analysis of the amplified products showed that HPV types 16, 18 and 35 were positive in 24.7%, 9.6% and 1.4% respectively of parturients, and 11.0%, 4.1% and 0 respectively of neonates. The maternal-fetal transmission rate of HPV was 50% (7/14) for spontaneous vaginal delivery, and 33.3% (4/12) for cesarean section.Conclusion HPV can be transmitted from mothers to their babies not only through the placenta during pregnancy, but also through the genital tract during delivery.

Objective.To determine whether malariotherapy (an old therapy for treatment of neurosyphilis)improves some clinical and laboratory parameters of HIV-positive patients without iatrogenic complications.Methods.Total 8 asymptomatic HIV-1 positive subjects whose CD4 cell counts were over 250×106 cells/L were selected for the phase-1 studies of malariotherapy and were intravenously injected Plasmodia vivax to induce artificial malaria.Malaria was terminated with chloroquine after 10～20 malarial fever episodes.Cell-bound CD4 levels were measured by APAAP (a solid-phase enzyme essay)and levels of neopterin (NPT),beta-2-microglobulin (B2M),soluble tumor necrosis factor receptor-2(sTNF-RII),interleukin-2(IL-2)and HIV P24 antigen were measured by ELISA. Patients were followed up to 24～30 months.Results.CD4 levels increased in 5,NPT decreased in 7 of 8 patients;IL-2 increased in 5 of 6 patients after malariotherapy.The total trends of B2M and sTNF-RII basically remained stable.HIV P24 antigen remained undetectable in 6, remained detectably low level in 1 and experienced increase in 1 of 8 patients after malariotherapy.No any severe complications occurred in all 8 patients.Conclusions.The results indicate that malariotherapy basically is safe for HIV infection and it seems that the therapy improves some immunological parameters of HIV patients.

OBJECTIVETo demonstrate the side effects of malariotherapy and to explore safe procedures in conduct of malariotherapy for human immunodeficiency virus (HIV) infected patients.

METHODSTwenty HIV/acquired immunodeficiency syndrome (AIDS) patients were selected for the study of malariotherapy and were intravenously infected with Plasmodia vivax to induce therapeutic malaria. Malaria was terminated with chloroquine after 10 - 20 malarial febrile episodes. Clinical assessments were made before (baseline), during (malarial phase) and after (post) termination of malaria. The density of Plasmodia in peripheral blood from the HIV/AIDS patients were compared to that from HIV-negative naturally infected malarial patients who donated the blood for the therapeutically induced malaria. CD(4) cell baseline levels were correlated to the severity of malarial symptoms and parasitemia.

RESULTSThere were no significant differences of Plasmodium density between the HIV/AIDS patients injected with P. vivax and the HIV-negative blood donors. However, it was found that the HIV-positive patients had milder malarial symptoms and parasitemia with progressively lower CD(4) cell baseline levels. All patients developed every day or every other day fever episodes with headache and shaking chill. These symptoms were well tolerated with the aid of anti-pyretic medications. Spleen and liver enlargement were seen in 15 of 20 and 4 of 20 patients respectively. Transitory liver effects with increase of serum glutamic-pyruvic transaminase were seen in 2 of 20 during malarial phase. Most patients experienced mild to medium anemia and 6 of 20 patients developed thrombocytopenia during malarial phase. All these side effects disappeared after termination of malaria or within one month thereafter. No complications occurred in these patients.

CONCLUSIONSTherapeutically induced acute vivax malaria was well tolerated in 20 HIV-positive subjects who represented a range of CD(4) cell levels from 1868/ micro l to 15/ micro l. Malariotherapy did not induce complications while increasing CD(4) cell levels in most treated HIV/AIDS patients (results published elsewhere).

Adult ; Animals ; CD4-Positive T-Lymphocytes ; Female ; HIV Infections ; therapy ; Humans ; Immunotherapy ; adverse effects ; methods ; Lymphocyte Count ; Malaria, Vivax ; immunology ; Male ; Plasmodium vivax ; immunology

Objective To explore the clinical characteristics of acute calculous cholecystitis in over 80 years old patients.Methods A retrospective study was made on the clinical data of 71 cases diagnosed as acute calculous cholecystitis and receiving surgical treatment from Sep 2006 to Sep 2016.Patients were divided into three groups:Early LC group (25 patients),PTGD group (29 patients),the staged LC group (17 patients) after PTGD.Results There was statistically significant difference in the gallbladder wall thickness,operation time and blood loss between the two LC groups.There was no statistically significant difference between the two LC groups in other baseline data and hospital stay,hospital cost,rate of postoperational complication,rate of conversion to open procedure between the two LC groups.There was statistically significant difference between the early LC group and PTGD group in the baseline data.Logistic regression analysis indicated that the TG13 grade was an important influence factor for treatment selection of PTGD (OR=3.957,P=0.015,95％CI:1.30-12.043).Conclusion Laparoscopic cholecystectomy was safe for good risk over 80 years old patients.For poor risk patients,PTGD is recommended before a LC attempt.

OBJECTIVETo explore the mechanisms of malariotherapy for human immunodeficiency virus (HIV)-infected patients and to identify which stage(s) of HIV infection is suitable for the treatment of malariotherapy.

METHODSTherapeutic acute vivax malaria was induced and terminated after 10 fever episodes in 12 HIV-1-infected subjects: Group 1 (G1) had 5 patients with CD(4) T-cell counts >or=500/ micro l at baseline, Group 2 (G2) had 5 patients with CD4 at 499 - 200/ micro l and Group 3 had 2 patients with CD(4) < 200/ micro l (not included in statistical analysis). Enzyme-Linked-Immuno-Sorbent Assay (ELISA) was used to measure plasma levels of cytokines and soluble activation markers. Flow cytometry was used to measure levels of lymphocyte subsets and phenotypes and CD(4) cell apoptosis. Bayer bDNA assay was used to test plasma levels of HIV-1 RNA (viral load). Samples were taken and tested twice before malaria (baselines), three times during malaria and seven times after termination of malaria (at day 10 and 1, 3, 6, 12, 18 and 24 months).

RESULTSLevels of plasma tumor necrosis factor-alpha (TNF-alpha), soluble TNF-alpha receptor-2 (sTNF-RII), neopterin (NPT) and soluble IL-2 receptor (sIL-2R) significantly increased during malaria and sharply reduced to baselines post malaria in all groups. Stronger responses of the aforementioned factors were seen in G2 than in G1 during malaria (P = 0.081, 0.001, 0.013, 0.020). CD4 count and percentage; CD(4)/CD(8) ratio and CD(25)(+) and CD(4)(+)CD(25)(+) percentages increased but HLA-DR+ percentage decreased either during or post malaria in G2. Most G2 patients experienced sustained increase but most G1 patients underwent natural history decline of CD(4) counts and percentages during 2-year follow-up. Percentage of apoptotic CD(4) cells decreased post malaria in all groups. G3 patients had weaker immune responses, however, one advanced AIDS patient in this group experienced clinical improvement after malariotherapy. Most of the 12 patients experienced increase of HIV viral load during malaria but the viral load returned to baseline levels 1 - 3 months after cure of malaria and remained near baseline levels for up to two years.

CONCLUSIONSPart of the mechanisms of malariotherapy is to induce high levels of cytokine activities and subsequently the changes of T-lymphocyte subsets and phenotypes in HIV-infected patients. These findings suggest that malariotherapy may treat HIV-1-infected patients whose CD4 baselines are in the range of 500 - 200/ micro l.

Acute Disease ; Adult ; CD4 Lymphocyte Count ; Cytokines ; blood ; Female ; HIV Seropositivity ; immunology ; therapy ; virology ; HIV-1 ; isolation & purification ; Humans ; Malaria, Vivax ; immunology ; Male ; Viral Load

Objective To evaluate the role of spinal astrocytes in posttraumatic stress disorder (PTSD)-induced hyperalgesia in rats. Methods Forty pathogen-free healthy male Sprague-Dawley rats, aged 6-8 weeks,weighing 200-250 g, were divided into 4 groups(n=10 each)using a random number table:control group(group C), group PTSD, normal saline group(group NS)and fluorocitrate group (group FC).The rats were exposed to single prolonged stress for establishment of the PTSD model in PTSD, NS and FC groups. At 30 min before establishment of the model and 1-7 days after establishment of the model,normal saline 10 μl was intraperitoneally injected in group NS, and 1 nmol∕10 μl fluorocitrate 10 μl, an inhibitor of astrocyte activation, was intraperitoneally injected in group FC. The mechanical paw withdrawal threshold(MWT)was measured at 24 h before establishment of the model and on 1, 2, 3, 5 and 7 days after establishment of the model. Four rats were sacrificed after measurement of pain threshold on 1 and 7 days after establishment of the model, and the lumbar segment(L3-5)of the spinal cord was re-moved for determination of the expression of glial fibrillary acidic protein(GFAP, an astrocyte marker)u-sing Western blot. Results Compared with group C, the MWT was significantly decreased at each time point after establishment of the model,and the expression of spinal GFAP was up-regulated on 1 and 7 days after establishment of the model in PTSD,NS and FC groups(P<005). Compared with group PTSD, no significant change was found in the MWT at each time point in group NS(P>005),and the MWT was sig-nificantly increased at each time point after establishment of the model,and the expression of spinal GFAP was down-regulated on 1 and 7 days after establishment of the model in group FC(P<005).Conclusion Activation of spinal astrocytes is involved in PTSD-induced hyperalgesia in rats.

Objective To investigate the effect of percutaneous endoscopic transforaminal discectomy(PETD)on L5-S1 lumbar disc herniation(LDH)and the influence of iliac crest height on the clinical efficacy.Methods A total of 86 patients treated with PETD for LDH(L5-S1 segment)from February 2019 to February 2018 were selected and grouped according to the relationship between the highest point of the iliac crest and the position of the L4-5 pedicle.Forty-eighty patients with the highest point of the iliac crest located below the upper edge of the L5 pedicle were included in group A;thirty-three patients with the highest point of the iliac crest located between the lower edge of the L4 pedicle and the upper edge of the L5 pedicle were included in group B,and five patients with the highest point of the iliac crest located above the lower edge of the L4 pedicle were included in group C.The operation indexes of the three groups were compared.The visual analogue score(VAS)and Oswestry Disability index(ODI)before and after surgery[preoperative(T0),1 week after surgery(T1),1 month,6 months and 12 months after surgery(T2,T3,T4)]were compared among the three groups.Results There was no difference in operation time and blood loss among the three groups(P>0.05).At T0,there was no difference in VAS score and ODI among the three groups(P>0.05).At T1-T4,when VAS score and ODI of the three groups were lower than that at T0,VAS in group A and B was lower than that in group C(P<0.05),but there was no difference between group A and B(P>0.05).Conclusion PETD has significantly clinical efficacy in the treatment of L5-S1 LDH,and whether the iliac crest height is higher than the level of the lower edge of the L4 pedicle will affect its clinical efficacy.