AIM: To investigate the clinical effect for treating bullous keratopathy ( BK ) by anterior corneal stromal acupuncture combined with amniotic membrane transplantation.
METHODS: Totally 35 patients ( 35 eyes ) with bullous keratopathy were treated by corneal stromal acupuncture combined with amniotic membrane transplantation. All patients preoperative and postoperative underwent anterior segment OCT, corneal topography, corneal sensitivity and confocal microscopy. To observe postoperative ocular symptoms in patients with BK, recurrence of bulla, changes in corneal thickness, corneal sensitivity and changes in the organizational structure of the layers of the cornea.
RESULTS: Thirty-five were followed up for 6-18mo. The symptom of pain disappeared in 32 cases ( 91%) in the first day after operation and did not recur during follow-up. The symptom of pain relieved in 3 cases (9%) in the first day after operation and disappeared in 3 days. Corneal epithelium of 9 cases ( 26%) were all healed within 1wk, 21 cases (60%) were all healed within 2wk, and 5 cases (14%) were all healed within 3wk. Following up for 6-18mo, there was no recurrence of symptoms or bulla. A small amount of tiny bubbles in the surrounding area appeared in 2 cases after 3 and 4wk. All patients had no neovascularization, and had smooth corneal surface. The amnions of 30 cases (86%) were thinning after 2mo, partially dissolved and absorped, not seen with the naked eye after 3mo. Thirty-four cases (97%) had no changes in vision, one case (3%) was from the light to front of the manual. After 2mo, corneal sensation decreased in 30 cases ( 86%) , corneal thickness increased from preoperative 788±35μm to 940±43μm. After 12mo, corneal thickness increased to 1060±27μm. Results of confocal microscopy: after 3mo, the number density of the trigeminal nerve fibers under corneal basement membrane reduced, shallow stromal cells became into fibrotic stroma, deep stroma was more loose, and cells swelled significantly. The number of endothelial cells reduced and form swelled more obviously compared with preoperatively.
CONCLUSION: Corneal acupuncture combined with amniotic membrane transplantation can effectively control the symptoms of BK, prevent the recurrence of BK, and especially it is a simple, safe and practical way for patients with poor visual function.

Based on the infrared spectra of Lophatheri Herba and Commelinae Herba, one-dimensional infrared spectra, second derivative spectra and two-dimensional correlated spectra were used to find out the differences between Lophatheri Herba and its imitations, respectively. The common peak ratio and variant peak ratio dual-indexes sequential were calculated and established according to infrared spectra of eleven batches of herbs. Infrared spectral data of Lophatheri Herba cluster analysis was applied to explore the similarity between each sample. The grouping results trend of sequential analysis of dual-indexes and cluster analysis was accordant. The results showed that the differences could be found by multi-level identification, and the source and the quality of the herbs could be effectively distinguished by the two analysis methods. Infrared spectroscopy, used in the present work exhibited some advantages on quick procedures, less sample required, and reliable results, which could provide a new method for the identification of traditional Chinese medicine with the imitations and adulterants, and the control of quality and origin.
Drugs, Chinese Herbal ; analysis ; chemistry ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Reproducibility of Results ; Spectrophotometry, Infrared ; methods ; Spectroscopy, Fourier Transform Infrared ; methods

OBJECTIVETo evaluate the impact of luteinizing hormone-releasing hormone (LHRH) on the protection of thymic function after allogenic hematopoietic stem cell transplantation (allo-HSCT).

METHODSMurine model of MHC mismatched allogeneic HSCT (C57BL/6-->BALB/c) was established. The severity of acute graft-versus-host-disease (GVHD) was assessed according to a clinical scoring system. The intra-cellular levels of IFN gamma, TNFalpha and IL-1 beta in thymocyte were analyzed by protein array and thymic function by quantification of signal-joint TCR rearrangement excision circles (sjTRECs).

RESULTSAll recipients in group A (allogeneic mice), B (allogeneic LHRH castrated-mice) and C (syngenic mice) achieved hematopoietic reconstitution. White blood cell (WBC) over 1.0 x 10(9)/L in groups A, B and C were on day (11.2 +/- 1.4), day (9.8 +/- 0.6) and day (9.7 +/- 0.7), respectively (P = 0.003, 0.002). The onset of acute GVHD in group B was (14.1 +/- 0.7) d and in group A was (11.4 +/- 1.2) d (P = 0.000). All mice in groups A and B developed acute GVHD. No mice occurred aGVHD in group C. The average scores of acute GVHD in groups A and B were (9.1 +/- 0.7) and (5.1 +/- 1.0), respectively (P = 0.000). The levels of IFN gamma, TNFalpha and IL-1 beta in control group were (2.3 +/- 2.5) ng/ml, (1.7 +/- 1.1) pg/ml and (1.8 +/- 1.2) pg/ml, respectively. The IFN gamma levels in groups A, B and C were (10.5 +/- 2.1) ng/ml, (6.7 +/- 2.1) ng/ml and (5.2 +/- 3.3) ng/ml, TNFalpha levels were (7.0 +/- 2.6) pg/ml, (4.3 +/- 0.8) pg/ml and (3.0 +/- 1.8) pg/ml, and IL-1 beta levels were (24.9 +/- 9.0) pg/ml, (17.4 +/- 3.9) pg/ml and (10.8 +/- 3.1) pg/ml, respectively. There were significant differences in the levels of cytokines between group A and the control group (P = 0.000, 0.000, 0.000). The levels of cytokines in group B were significantly higher than those in control group (P = 0.000, 0.003, 0.000). The levels of IFN gamma and IL-beta in group C were significantly higher than those of in control group (P = 0.015, 0.013), and so did in group A than in group B (P = 0.002, 0.002, 0.004), and in group A than in group C (P = 0.000, 0.000, 0.000). The analysis of linear regression showed that the average levels of IFN gamma and TNFalpha paralleled with aGVHD scores (r(2) = 0.359, P = 0.045; r(2) = 0.228, P = 0.019). The average sjTRECs copies/1000 PBMNCs were (39.4 +/- 44.7) in the control group and (12.3 +/- 13.0), (58.0 +/- 71.8) and (19.6 +/- 14.6) in groups A, B and C, respectively. There was no significant difference in the multiple comparisons of peripheral blood levels of sjTRECs among these four groups (P = 0.468).

CONCLUSIONIFN gamma, TNFalpha and IL-1 beta might be involved in the damage to the thymus by acute GVHD. Sex steroid inhibitor can not only reduce the severity of thymic damage after allo-HSCT, but also reduce the severity of aGVHD and the mechanism might be associated with the reduction of intra-cellular levels of IFN gamma in thymocyte.

Animals ; Castration ; methods ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Graft vs Host Disease ; pathology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Interferon-gamma ; metabolism ; Interleukin-1beta ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Thymus Gland ; immunology ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo evaluate the role of human leukocyte antigen G (HLA-G) in the better effect of allogenetic bone marrow transplantation than that of peripheral blood stem cell transplantation.

METHODSFlow cytometry was used to detect the expression of membrane-bound HLA-G (mHLA-G) on donor peripheral blood (PBC) or bone marrow (BM) mononuclear cells. The levels of soluble HLA-G (sHLA-G) in the plasma and bone marrow fluid were determined using enzyme-linked immunosorbent assay (ELISA) before and after granulocyte colony-stimulating factor (G-CSF) mobilization.

RESULTSThe mean levels of mHLA-G after G-CSF mobilization in the PBC and BM were significantly higher than that before G-CSF mobilization (P=0.001 and 0.000), but the plasma levels of sHLA-G showed no significant changes after the mobilization (P=0.279). The mean levels of sHLA-G in the BM fluid significantly increased (P=0.002) to a level higher than that in the PBC after G-CSF mobilization (P=0.004).

CONCLUSIONHLA-G plays an important role in immune tolerance after hematopoietic stem cell transplantation with G-CSF mobilization.

Adult ; Bone Marrow Transplantation ; immunology ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; HLA Antigens ; immunology ; metabolism ; HLA-G Antigens ; Hematopoietic Stem Cell Mobilization ; methods ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Antigens Class I ; immunology ; metabolism ; Humans ; Immune Tolerance ; Male ; Middle Aged

OBJECTIVETo develop a protocol for the rapid detection of Salmonellae.

METHODSA mono-antibody-based direct-ELISA and PCR methods for the detection of Salmonella were developed previously. This study assessed the accuracy of both direct-ELISA and PCR methods for the rapid detection of Salmonella and set up a new detection protocol.

RESULTSThe sensitivity of the PCR method was higher than that of direct-ELISA method. In the 2002 spring physical examination for employees, 1 546 human fecal samples were examined by the combination of direct-ELISA and PCR method. Compared with the results of national standard method, the sensitivity and specificity of direct ELISA was 100% and 97.14%, respectively, while those of PCR method reached both 100%. It also indicated that combination use of two methods could give positive report within 40 hrs, and also achieve high sensitivity and specificity.

CONCLUSIONSBased on the results obtained, a protocol for the rapid detection of Salmonella was developed. The first step is to us direct-ELISA method to screen the large number of samples, and then use PCR method to validate the ELISA positive samples, and the final step is, if needed, is to use the national standard method to determine the serotypes of Salmonellae.

Enzyme-Linked Immunosorbent Assay ; methods ; Feces ; microbiology ; Humans ; Polymerase Chain Reaction ; methods ; Salmonella ; classification ; genetics ; isolation & purification ; Serotyping

OBJECTIVETo optimize primarily acupuncture program for dysphagia after cerebral infarction.

METHODSSixty-three patients with pseudobulbar palsy dysphasia after cerebral infarction were selected as the subjects. Water swallow test was adopted for observation index. Orthogonal design was used to study the different combinations of treatment programs among four factors and three levels, named acupuncture opportunity (factor A: A1: 1-10 d, A2: 11-20 d, A3: 21-40 d), point combination (factor B: B1: points in the neck, B2: points in the neck + points in the glossopharyngeal part, B3: points in the neck + points in the glossopharyngeal part + differentiating point), needling depth (factor C: C1: shallow puncture, C2: moderate puncture, C3: deep puncture), and treatment session (factor D: D1: 2 sessions, D2: 4 sessions, D3: 6 sessions); as well as the influences on pseudobulbar palsy dysphagia after cerebral infarction so as to determine primarily the optimized acupuncture program for dysphagia after cerebral infarction.

RESULTSThe direct analysis of orthogonal design indicated that the best level and the combination of four factors and three levels were A1 (or A2), B3, C3 and D3. It meant that for the patients less than 20 days for sickness, the points in the neck, points in the glossopharyngeal part and points selected according to syndrome differentiation were selected for deep puncture and the treatment lasted for 6 sessions. This program achieved the best improvement in water swallow test. The comparison between the primary effect and secondary effect among four factors (variance analysis) showed that factor A and C were the significant factors (P < 0.05), factor B and D were not significant (P > 0.05). It was suggested that acupuncture opportunity and needling depth played the significant roles in clinical efficacy. The comparison among different levels in terms of the significant factors A and C (multiple comparison) presented that A1 and A2 were superiorly significant than A3 (P < 0.001), A1 was not different in significance from A2 (P > 0.05). C3 was superiorly significant than C2 and C1 (P < 0.001, P < 0.01) and C2 was superiorly significant than C1 (P < 0.05).

CONCLUSIONBy the comprehensive summarization of direct analysis, variance analysis and multiple comparison combined with actual clinical situation, the optimal program of acupuncture treatment for pseudobulbar palsy dysphasia after cerebral infarction is that in terms of the four factors and three levels, for the patients within 1 to 20 days for sickness, acupuncture is applied to the points in the neck or combined with points in the glossopbaryngeal part or the points se-i lected according to syndrome differentiation, with deep puncture, for 4 to 6 sessions of treatment.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Cerebral Infarction ; complications ; Deglutition ; Deglutition Disorders ; etiology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged

Fatigue is a common complication of type 2 diabetes mellitus (T2DM). We examined the relationship between T2DM fatigue and the skeletal muscle 5-hydroxytryptamine (5-HT) system. In animal experiments, a T2DM model was established in mice by feeding a high-fat diet with intraperitoneal injection of streptozotocin. The mice were treated with the 5-HT_2A receptor antagonist sarpogrelate hydrochloride (SH) and the 5-HT synthesis inhibitor carbidopa (CDP) (separately and in combination). In cell culture experiments, C2C12 cells were stimulated with D-glucose, palmitic acid or 5-HT. 5-HT_2AR, 5-HT synthesis and 5-HT degradation were inhibited by SH, CDP, or monoamine oxidase A (MAO-A) inhibitor. The animal experiments were in accordance with the regulations of the Animal Ethics Committee of China Pharmaceutical University. The results showed that 5-HT_2AR, 5-HT synthase and MAO-A were expressed in mouse skeletal muscle and C2C12 cells. The expression of these proteins was significantly up-regulated in T2DM mice or when C2C12 cells were exposed to palmitic acid and D-glucose; palmitic acid was a stronger stimulant of their expression than D-glucose. Rotating rod experiments and biochemical index tests have shown that T2DM fatigue is associated with an increase in skeletal muscle 5-HT_2AR, 5-HT synthesis and 5-HT degradation. 5-HT_2AR mediates the expression of MAO-A and the synthesis of 5-HT, which indirectly regulates the degradation of 5-HT. MAO-A regulates cell inflammation, mitochondrial ROS production and membrane potential depolarization by mediating 5-HT degradation. MAO-A also inhibits the expression of peroxisome proliferator-activated receptor γ coactivator-1 (PGC-1), carnitine palmitoyltransferase-1 (CPT1) and ATP synthase-6 (ATP6), thus inhibiting mitochondrial functions such as fatty acid β oxidation and ATP synthesis. SH and CDP can effectively treat T2DM fatigue, and can also reduce blood glucose and blood lipid, and the combination of SH and CDP has a clear synergistic effect.

Objective To observe the clinical efficacy and safety of citicoline sodium tablets combined with edaravone injection in the treatment of cerebral ischemic stroke. Methods A total of 100 patients with cerebral ischemic stroke were randomly divided into control group (n = 48 cases) and treatment group (n = 52 cases) . Control group was given edaravone injection 30 mg per time, bid, intravenous drip. Treatment group received citicoline sodium tablets 0. 2 g per time, tid, orally, on the basis of control group. Two groups were treated for 14 days. The clinical efficacy, the levels of serum calmodulin (CAM) , growth differentiation factor 15 (GDF-15) and pentraxin-3 (PTX-3) , the scores of national institutes of health stroke scale (NIHSS) and modified Barthel index (MBI) , and adverse drug reactions were compared between twogroups. Results After treatment, the total effective rates of treatment and control groups were 88. 46％ (46 cases/52 cases) and 70. 82％ (34 cases/48 cases) with significant difference (P < 0. 05) . After treatment, the main indexes of treatment and control groups were compared: CAM were (102. 45 ± 14. 59) and (136. 58 ± 14. 55) mg ·m L-1, GDF-15 were (443. 59 ± 49. 34) and (567. 36 ± 55. 20) pg·m L-1, PTX-3 were (0. 40 ± 0. 05) and (0. 56 ± 0. 08) ng·m L-1, NIHSS scores were (9. 19 ± 1. 67) and (11. 13 ± 1. 65) , MBI scores were (58. 37 ± 3. 17) and (49. 75 ± 3. 43) , the differences were statistically significant (all P < 0. 05) . The adverse drug reactions of treatment group were gastrointestinal discomfort and fever, which in control group were fever and elevated blood pressure. The total incidences of adverse drug reactions in treatment and control groups were 5. 77％ and 4. 17％ without significant difference (P> 0. 05) . Conclusion Citicoline sodium tablets combined with edaravone injection have a definitive clinical efficacy in the treatment of cerebral ischemic stroke, which can effectively reduce the levels of serum CAM, GDF-15 and PTX-3, improve the nerve function, without increasing the incidences of adverse drug reactions.

Fecal Microbiota Transplantation (FMT) has achieved significant therapeutic effects in the treatment of various diseases such as Clostridium difficile infection, irritable bowel syndrome, inflammatory bowel disease et al. Researches have shown that FMT may affect the occurrence and development of malignant tumors by remodeling the composition of patients′ intestinal flora, which has potential therapeutic value. In recent years, key techniques of FMT such as washed microbiota transplantation, transendoscopic enteral tubing, spore transplantation, and manually prepared transplantation, provide more possibilities for diseases treatment of FMT. This review introduces the development status of FMT, the pivotal techniques of FMT, and summarizes the applicational advantages and disadvantages. We also focus on the applied researches of FMT in the treatment of malignant tumor diseases, such as adjuvant immunotherapy, chemotherapy, surgical treatment and endocrine therapy, so as to provide theoretical basis for the future clinical application of FMT in this field.

Objective To identify the impact of age and gender on cardiac structure and left ventricular function in normal Chinese by echocardiography. Methods Cardiac structure, valve flow velocity and cardiac function were measured by echocardiography in 15 692 healthy volunteers. Subjects were grouped by age at 5 years interval in population older than 5 years. Children under 5 years were divided into 3 age groups(<1 years,1-3 years,4-5 years). Hierarchical cluster analyses were performed for ages, based on indexes of cardiac structure and function respectively. Results Six groups (< 1 years, 1-3 years,4-5 years, 6-10 years, 11-20 years, ≥21 years) were generated after the age hierarchical cluster analyses based on index of cardiac structure. Four groups (≤30 years, 31-50 years, 51-80 years,≥81 years) were generated based on spectral current flow. Six groups (< 1 years,1-3 years,4-5 years, 6-10 years, 11-15 years, ≥16 years) were generated baaed on left ventricular systolic function and five groups (≤15 years, 16-30 years, 31-50 years, 51-80 years, ≥81 years) were generated based on left ventricular diastolic function. Cardiac structure index were similar between male and female in age groups ≤ 10 years and significantly lower in females than males in age groups ≥ 11 years (P < 0.05). Valve flow velocity was similar between male and female in various age groups (P >0.05). Left ventricular systolic function was similar between male and female in age groups ≤10 years but was significantly higher in males than females in age groups ≥11 years(all P <0.05). Left ventricular diastolic function was similar between female and male in various age groups (P > 0.05) and equally decreased with aging in both female and male subjects. Conclusions The cardiac development in Chinese population can be divided in 6 phases and becomes stable in subjects older than 21 years, left ventricular systolic function becomes stable in subjects older than 16 years and the left ventricular diastolic function declines physiologically with aging.