By reviewing the research on patient reported outcomes (PRO) and the understanding of the theory of traditional Chinese medicine in coronary heart disease, the author found that the evaluation scale of PRO in coronary heart disease in traditional Chinese medicine should be guided by the theory of traditional Chinese medicine, including the theories of ‘heart-oriented, five internal organs correlation, internal injuries by seven emotions, unity of body and mind, correspondence between human and nature’ and other modern theoretical framework of PRO scale.It was believed that the physical, psychological, independence and social sphere constructed a special PRO efficacy scale of traditional Chinese medicine in coronary heart disease. The field of physiology on the scale was guided by ‘heart-based, five internal organs correlation' theory as the main line, and the scale was divided into various aspects in order to reflect all aspects of uncomfortable self-feeling of patients. Finally, 19 sides such as chest pain, chest tightness, heart palpitations, flank pain, insomnia, soreness and weakness of waist and knees, frequent urination at night, anorexia, weakness, spontaneous perspiration, shortness of breath, individual ability, daily life, positive feelings, negative feelings, personal relations and social support needed, level of social services, social intercourse and economy, healthy and medical care formed the theoretical structure model of the scale,which established the theory foundatio for the further development of PRO scale.

Objective The purpose of this study was to use diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) alone or in combination to observe the distribution of white matter lesions and cortical malfunctional areas in human immunodeficiency virus (HIV) infected patients with mild cognitive decline and to explore the relationship between the DTI and the rs-fMRI methods.Methods Twenty-six HIV infected patients with mild cognitive impairment and 30 healthy volunteers were selected by Montreal Cognitive Asessment (MoCA) scale evaluation.DTI data and rs-fMRI data were obtained,fractional anisotropy (FA) value images were obtained with voxel based analysis and the resting-state default mode network (DMN),functional connectivity images were obtained with cingulate gyrus as a seed point.Overlay images were obtained with FA,DMN and Ch2 standard images.Results Compared with the control group,the white matter FA values were significantly decreased in the left precuneus(t=4.0499,P＜0.005) and right precuneus (t=5.1553,P＜0.005),right superior frontal gyrus(t=5.1517,5.1484,P＜0.005),right middle frontal gyrus (t=4.1444,P＜0.005),right precentral gyrus (t=3.7395,P＜0.005),right occipital lobe (t=7.2236,P＜0.005),and right inferior parietal lobule (t=4.1450,P＜0.005) in acquired immunodeficiency syndrome (AIDS) patients.In resting-state default mode network,areas significantly related to cingulate gyrus seed point included the left cingulate gyrus (t =32.78,P＜0.005),left precuneus (t =4.51,P＜0.005),left superior frontal gyrus (t =14.33,4.53,P＜0.005),left middle temporal gyrus (t =10.01,5.72,P＜ 0.005),left inferior temporal gyrus (t =5.99,P＜0.005),left parahippocampal gyrus (t =7.63,P＜0.005),right posterior cingulate (t =34.81,P＜0.005),right precuneus (t=32.09,P＜0.005),right superior frontal gyrus(t =14.12,P＜0.005),right middle frontal gyrus (t=17.71,P＜0.005),right superior temporal gyrus (t=14.59,P＜0.005),and right middle temporal gyrus (t=11.83,P＜0.005); while areas not significantly related to the cingulate gyrus seed point included the left precuneus (t =5.39,P＜0.01),left anterior cingulate gyrus (t =3.66,P＜0.01),left cerebellar tonsils (t =7.51,P＜0.01),right superior parietal lobule (t=4.44,P＜0.01),right parahippocampa gyrus (t =3.69,P＜0.01),and right cerebellar tonsil (t=6.15,P＜0.01).Overlayed images showed that the white matter FA value of the left precuneus were decreased and the functional activitis of the corresponding cortex were significantly decreased; while the white matter FA values of the left precuneus,right precuneus,right superior frontal gyrus,right middle frontal gyrus were decreased without affection of the functional activity of the corresponding cortex in AIDS patients.Conclusion White matter nerve fiber disconnection of multiple brain regions and its corresponding cortical function decline with compensatory activity co-participated in the pathogenesis of AIDS mild cognitive decline.

OBJECTIVETo study the effect of Tongluo Xingnao effervescent tablets on learning and memory capacity and expression of Na(+)-K(+)-ATPase in hippocampus of rats with chronic cerebral ischemia-induced learning and memory dysfunction model.

METHODThe 2-VO method was used to establish sd rat model learning and memory dysfunction induced by chronic cerebral ischemia. The 50 rats in the successfully established model were randomly divided into the model control group, the Dihydroergotoxine Mesylate tablets group (0.7 mg x kg(-1), Tongluo Xingnao effervescent tablets high dose (7.56 g x kg(-1)), middle dose (3.78 g x kg(-1)) and low dose (1.59 g x kg(-1)) groups and the sham operation group (n = 10) as the control group. The groups were orally given 10 ml x kg(-1) x d(-1) drugs for consecutively 90 days. On the 86th day, Morris water maze was adopted for them. On the 90th day, a leaning and memory capacity test was held. The brain tissues were fixed with 10% formaldehyde and observed for pathomorphism after routine slide preparation and staining. The expression of hippocampal Na(+)-K(+)-ATPase was detected with immunohistochemistry and image quantitative analysis.

RESULTCompared with the model group, all of Tongluo Xingnao effervescent tablets groups showed significant decrease in the escape latency at the 5th day in the Morris water maze, and notable increase in the frequency of the first quadrant dwell, the frequency passing the escape platform and the frequency entering effective area (p < 0.05). According to the pathomorphological detection, the control group showed a significantly higher pathological score than the sham operation group (p < 0.01), the middle dose group showed a significantly lower pathological score than the model group (p < 0.05). According to the immunohistochemistical detection, the model control group showed a remarkably lower mean OD value of Na(+)-K(+)-ATPase than the sham operation group (p < 0.05), high and middle dose groups showed a significantly higher mean od value than the model control group (p < 0.01).

CONCLUSIONTongluo Xingnao effervescent tablets can improve the learning and memory capacity, reduce pathological changes of hippocampal tissues of rats with chronic cerebral ischemia-induced learning and memory dysfunction model, and promote the expression of Na(+)-K(+)-ATPase in hippocampus.

Animals ; Brain Ischemia ; drug therapy ; enzymology ; genetics ; psychology ; Chronic Disease ; drug therapy ; psychology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hippocampus ; drug effects ; enzymology ; Humans ; Learning ; drug effects ; Male ; Memory ; drug effects ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase ; genetics ; metabolism ; Tablets ; administration & dosage

Objective To study the effects of selenium deficiency,iodine deficiency and combined selenium and iodine deficiency on bone and cartilage growth in the parental and the first filial generation rats. Methods Forty-eight weanling healthy SD rats were randomly divided into selenium deficieney, iodine deficiency, combined selenium and iodine deficiency and control groups according to their body mass. These rats were fed with selenium deficiency, iodine deficiency, combined selenium and iodine deficiency, and normal fodder, respectively. The parental rats (about 3 months old) were mated in each group 8 weeks after the beginning of the experiment. Right tibias and left knee joints were collected when the parental generation rats were about 6 months and the first filial generation rats were about 3 months old. Tibial length, mid-shaft tibial diameter, and articular cartilage diameters of the right tibias were measured by vernier caliper. Left knee joints were embedded and cut into sections and the thickness of the growth plate cartilage, layers of proliferative and hypertrophic chondrocytes in growth plate cartilage were observed under the light microscope. Results The selenium deficiency had significant effect on serum selenium level of the parental and the first filial generation rats(F value were 239.56,232.68, P< 0.01), and also on serum T4 level of the first filial generation rats(F value were 6.95, P < 0.05). The iodine deficiency had significant effect on serum T3 and T4 level in the two generations rats(F value were 14.11,14.05,30.29,34.53, P < 0.01 ). There were interactions between selenium deficiency and iodine deficiency on serum T4 level in the first filial generation rats (F= 5.99, P< 0.05). The serum selenium of selenium deficiency group[ (30.28 ± 6.34), (43.95 ± 9.75)μg/L],combined selenium and iodine deficiency group[ (30.33 ± 5.18), (35.40 ± 3.16)μg/L] were significantly lower than iodine deficiency group[(345.83 ± 29.55), (245.24 ± 9.95)μg/L] and the controls[ (358.64 ± 30.50), (236.50 ±9.75) μg/L] in the two generations. The serum T3 of combined selenium and iodine deficiency group [(0.55 ± 0.05 ),(0.88 ± 0.14)nmol/L] were significantly lower than the controls[(0.75 ± 0.08), (1.26 ± 0.26)nmol/L] in the two generations. The serum T4 of iodine deficiency [ (24.11 ± 2.29), (42.10 ± 8.92) nmol/L ] and combined selenium and iodine deficiency group[ (20.66 ± 1.93), (26.55 ± 5.98)nmol/L] were significantly lower than the controls[ (36.15 ±2.74), (52.79 ± 8.84)nmol/L] and selenium deficiency group[ (28.12 ± 3.33), (52.02 ± ll.99)nmol/L] in the two generations. The selenium deficiency and iodine deficiency had significant effect on tibial length, thickness of the growth plate cartilage, layers of proliferative and hypertrophic chondrocytes in first filial generation rats(F values were 24.31,6.98,40.76,56.15,25.24,82.82, 10.07,5.57, P <0.05 or <0.01). There were interactions between selenium deficiency and iodine deficiency on tibial length, thickness of the growth plate cartilage, layers of proliferative and hypertrophic chondrocytes (F values were 5.68,24.86,41.82,9.12, P <0.05 or <0.01 ). The tibial length of the selenium deficiency group[ (33.17 ± 0.34)mm] and combined selenium and iodine deficiency group[ (31.30 ± 0.87)mm] were significantly lower than the controls[ (34.12 ± 0.32)mm, P< 0.05]. Thickness of the growth plate cartilage [ (1.60 ± 0.18)mm ], layers of proliferative chondrocyte (8.54 ± 0.81), and hypertrophic chondrocyte (4.95 ± 0.37)of the combined selenium and iodine deficiency group were significantly decreased when compared to the selenium deficiency group[ (3.03 ± 0.10)mm, 14.68 ± 0.84,6.60 ± 0.31], iodine deficiency group[ (2.90 ± 0.09)mm, 13.75 ±0.33,6.61 ± 0.84 ] and the controls [ (3.19 ± 0.09) mm, 14.94 ± 0.36, 6.64 ± 0.26, P <0.05]. Thickness of the growth plate cartilage, layers of proliferative chondrocyte of the iodine deficiency group were lower than the controls(P<0.05). Conclusions Selenium deficiency impair tibial growth in first filial generation rats, iodine deficiency retarded the chondroncyte proliferation and decreases the thickness of growth plate cartilage in first filial generation rats, and combined selenium and iodine deficiency significantly impair the growth of bone and cartilage in first filial generation rats.

Objective:To evaluate the validity and reliability of the Problem Area in Diabetes Scale (PAID) for assessing diabetes-related distress in patients with type 2 diabetes. Methods:Totally 203 outpatients with type 2 diabetes from a tertiary hospital in Beijing were selected. They were assessed with PAID,Hamilton Depression Scale (HAMD-17),Patient Health Questionaire-9(PHQ-9),World Health Organization Five item Well-Being Index (WHO-5 ),Mini-International Neuropsychiatric Interview (MINI)and HbA1 C. Item analysis and exploratory factoranalysis were conducted to test constructive validity. Concurrent validity was evaluated by the correlation coeffi-cients with the other instruments mentioned above. Totally 3 1 subjects were retested 4 weeks later to obtain the test-retest reliability. Results:Exploratory factor analysis produced 4 factors,including emotional,therapeutic,diet and perceived society support problems specific to diabetics. The total variance contribution ratio was 64. 33%. Except i-tem 7 and 20,no item was across two factors. The correlation coefficients of each item with relevant subscale score ranged from 0. 67 to 0. 86. The PAID scores were positively correlated with the scores of HAMD-17,PHQ-9 and HbA1C (r=0. 48,0. 43,0. 21,P<0. 001 or 0. 01),and negatively correlated with WHO-5 scores (r=-0. 46,P<0. 001). The Cronbach's αcoefficients were 0. 94 for the total scale and 0. 81 -0. 88 for the 4 subscales. The test-retest reliability coefficient was 0. 65 for the total scale and 0. 53-0. 73 for the 4 subscales. Conclusion:The validi-ty and reliability of the Problem Area in Diabetes Scale are acceptable in Chinese mainland,and can be available to assess the stress related to diabetics.

Objective: To observe the clinical effect of treating remission-stage cerebral infarction with mind-refreshing and orifice-opening needling method. Method: Six hundred cases of cerebral infraction were randomized on the basis of disease phase. The 234 cases in remission stage were randomized into treatment group (116 cases) and control group (118 cases). Besides routine Western therapies, the cases in the treatment group were combined mind-refreshing and orifice-opening needling method and the cases in the control group were combined with conventional needling method. The treatment was done once every day for 4 weeks. The follow-up was done for six months. Result: the baseline material in the two groups has good compatibility (P>0.05) and the treatment group is better than the control group (P<0.05). Conclusion: the mind-refreshing and orifice-opening method is safe and act to improve symptoms of patients during remission stage, reduce disability, prevent disease progression and improve quality of life.

Objective To summarize the diagnosis and treatment of one case of combined heart liver transplantation. Methods On November 24, 2011, one case of combined heart-liver transplantation was performed on a patient with Ebstein's anomaly and tricuspid valve replacement after 5 years,complicated with congestive cirrhosis,liver failure dccompensation,preoperative heart failure Ⅲ degree and B grade of liver function Child-Pugh score. The operation was done with the graded cardiopulmonary bypass assisted mode:first creating the vena cava-aortic bypass to complete heart transplantation, second creating the femoral vein-ascending aorta bypass to complete liver transplantation,and third stopping and neutralizing.The aortic cross-clamping time was 54 min and the an hepatic phase was 38 min.The total time of three times of cardiopulmonary bypass was 199 min and the total time-consuming of operation was 517 min. The patient was given basiliximab +methylprednisolone for immune induction therapy, and tacrolimus + mycophenolate mofetil +prednisone solution for anti-rejection. After operation, liver protecting treatment, anti-infection therapy and nutrition support therapy were given.Results The recipient died of multiple organ failure after 78 days.The mechanical ventilation treatment duration for this recipient was 78 days and ECMO adjuvant therapy for postoperative hypoxemia time lasted 63 days.Conclusion The combined heart liver transplantation is an effective measures for treatment of heart and liver failure.

OBJECTIVETo study the effect of butenolide (BUT) on cultured chondrocytes differentiation and the possible protective effects of selenium (Se).

METHODSEx-vivo cultured chondrocytes were divided into six groups: (1) Control group (without BUT and Se); (2) Se 0.1 microg/ml control group; (3) BUT 0.1 microg/ml group; (4) BUT 1.0 microg/ml group; (5) BUT 5.0 microg/ml group; and (6) BUT 1.0 microg/ml + Se 0.1 microg/ml group. The expression of collagen II (Col II), collagen X (ColX), basic fibroblast growth factor (bFGF), and parathyroid hormone-related peptide (PTHrP) in (or around) chondrocytes in all groups were analyzed by immunohistochemistry.

RESULTSThe expressions of Col II in 1.0 microg/ml BUT group and 5.0 microg/ml BUT group were significantly lower than those in the control group (P < 0.05). The expression of Col II in 1.0 microg/ml BUT + Se group were significantly higher than those in the 1.0 microg/ml BUT group and 5.0 microg/ml BUT group (P < 0.05). The expressions of bFGF and PTHrP of BUT groups were significantly higher than those in the Se and control groups (P < 0.05). No expression of ColX was observed in all groups.

CONCLUSIONBUT can affect the collagen II synthesis of the chondrocytes. Selenium supplementation may play a protective role.

4-Butyrolactone ; analogs & derivatives ; pharmacology ; Cell Differentiation ; Cells, Cultured ; Chondrocytes ; cytology ; Humans ; Protective Agents ; pharmacology ; Selenium ; pharmacology ; T-2 Toxin ; toxicity

OBJECTIVETo investigate the role of Caspase-8 and Bcl-2 in the formation of loose bodies in Kashin-Beck disease (KBD).

METHODSSpecimens of cartilage loose bodies were collected from 50 adult patients with KBD, and the samples of articular cartilage were collected from 10 healthy adults to serve as control. Avidin-biotin alkaline phosphatase immunohistochemistry was employed to examine Bcl-2 and Caspase-8 positivities in the chondrocytes in the loose bodies.

RESULTSIn KBD loose bodies, the percentage of chondrocytes positive for Bcl-2 and Caspase-8 [(18.40∓8.78)% and (67.54∓12.29)%, respectively] were significantly higher than those of the control group [(12.25∓1.58)% and (24.70∓4.35)%, respectively]. Caspase-8 was found to promote chondrocyte apoptosis in the loose bodies, and this effect overrode the apoptosis-suppressing effect of Bcl-2. Bcl-2 and Caspase-8 positivities were found mainly in the deep hypertrophic chondrocytes in the cartilage or in cells adjacent to the bone tissues.

CONCLUSIONKBD loose bodies contain an increased percentage of apoptotic chondrocytes positive for Bcl-2 and Caspase-8. The apoptosis-inducing effect of Caspase-8 was a dominant feature in the cartilage pathology of KBD compared to the apoptosis-suppressing effect of Bcl-2.

Adult ; Apoptosis ; Cartilage ; pathology ; Case-Control Studies ; Caspase 8 ; metabolism ; Female ; Humans ; Joint Loose Bodies ; metabolism ; Kashin-Beck Disease ; metabolism ; pathology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism

AIMTo investigate the chemical constituents of the rhizomes of Anemarrhena asphodeloides Bunge.

METHODSThe compounds were separated by means of solvent extraction, chromatography on absorbent resin SP825 and silica gel C18 repeatedly, and their structures were elucidated on the basis of chemical methods and spectral analyses (FAB-MS, 1H NMR, 13C NMR, 1H-1H COSY).

RESULTSSix steroidal saponins were isolated from the rhizomes of Anemarrhena asphodeloides Bunge. They were identified as (25S)-26-O-beta-D-glucopyranosyl-22-hydroxy-5beta-furostane-2beta, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (timosaponin N, 1), timosaponin E1 (2), (25S)-26-O-beta-D-glucopyranosyl-22-methoxy-5beta-furostane-2beta, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (timosaponin O, 3) , timosaponin E2 (4), (25R) -26-O-beta-D-glucopyranosyl-22-hydroxy-5alpha-furostane-2alpha, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-[beta-D-xylpyranosyl-(1 --> 3)]-beta-D-glucopyranosyl-(1 --> 4)-beta-D-galactopyranoside (purpureagitosid, 5) and marcogenin-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (6).

CONCLUSIONCompound 1 and compound 3 are new compounds, and compound 5 was isolated from the rhizomes of Anemarrhena asphodeloides Bunge for the first time.

Anemarrhena ; chemistry ; Molecular Conformation ; Molecular Structure ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Saponins ; chemistry ; isolation & purification