OBJECTIVETo observe the therapeutic effect of a drug pair of Radix Astragali and Rehmanniae Radix combined with glucocorticoid (GC) in treating lupus nephritis (LN) patients and its influence on some experimental indices.

METHODSTotally 52 LN patients were randomly assigned to the treatment group (treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix, 25 cases) and the control group (treated by Western medicine, mainly by GC and cyclophosphamide, 27 cases). All patients received 6-month therapy. The GC dosage, the withdrawal and reduction dosage of GC, clinical efficacy, systemic lupus erythematosus disease activity index (SLEDAI) score, adverse reactions, and laboratory indicators were recorded.

RESULTS(1) All patients got relieved to some degree with the dosage of GC reduced. The total withdrawal and reduction dosage of GC was slightly higher in the treatment group than in the control group [(50.23 +/- 12.43) mg vs (48.76 +/- 13.61) mg, P > 0.05]. Besides, the prednisone dosage in the treatment group was lower than that in the control group, but without statistical difference (P > 0.05). The ratio of patients in need of adding prednisone for aggravating disease was 24.0%, significantly lower than that in the control group (44.44%, P < 0.05). (2) There was no statistical difference in the SLEDAI score, inflammatory indicators, liver and renal functions, blood electrolytes, blood glucose, blood and urine routines between the two groups (P > 0.05). The 24-h urinary protein count was (1.06 +/- 0.22) g/L in the treatment group, obviously lower than that in the control group (1.43 +/- 0.55 g/L, P < 0.05). (3) There was no statistical difference in the incidence rate of infection, gastrointestinal hemorrhage, psychoneuroses, Cushing's syndrome, cardiovascular anomalies, and femoral head necrosis between the two groups (P > 0.05). But the incidence of adverse reactions such as insomnia, tidal fever, spontaneous sweat, and obesity was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONSUsing a drug pair of Radix Astragali and Rehmanniae Radix combined with GC in treating LN could withdraw the dosage of GC and relieve symptoms it induced. It was advantageous in reducing the dosage of GC and stabilizing patients' conditions.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Lupus Nephritis ; drug therapy ; Treatment Outcome ; Young Adult

Objective To compare the effectiveness and safety of raltitrexed and fluorouracil(FU)/leucovorin (LV) combined with oxaliplatin for advanced colorectal cancer. Methods Fifty patients with advanced colorectal cancer diagnosed by histopathology or cytology were randomly divided into two groups with 25 cases each by envelope, but 1 case lost. Patients in experimental group were treated with raltitrexed (3 mg/m2, ≥ 15 min intravenously) combined with oxaliplatin (130 mg/m2 on day 1 ), patients in control group were treated with FU/LV combined with oxaliplatin:LV 100 mg/m2 infusion (over 2 h, from day 1 to day 3 ) followed by FU (400 mg/m2 infusion in 2 h and 600 mg/m2 continuous infusion from day 1 to day 3 ),combined with oxaliplatin ( 130 mg/m2 on day 1 ), 3 weeks were as one cycle. Patients received 6 or less cycles until disease progressed or toxicity could not be tolerated. Results Effective rate was 37.50%(9/24)and 33.33%(8/24) in experimental group and control group respectively (P＞ 0.05). Disease control rate in experimental group was 83.33% (20/24) while in control group was 70.83% ( 17/24 ) (P ＞ 0.05 ). The median time of progression-free survival (PFS) in experimental group and control group was 11.0 months and 9.0 months respectively (95%CI 8.643-11.357,P =0.015). Main adverse effects were anorexia, vomiting, neutropenia, thrombopenia, anemia, neurotoxicity, fatigue, aminotransferase abnormality, and so on. There was no statistic difference between two groups in side effects(P ＞ 0.05). Conclusions Raltitrexed combined with oxaliplatin is an effective regimen for the advanced colorectal cancer. Compared with traditional FU-based regimen, it is more convenient. Patients will have less venous exposure time and hospital days.Effective rate and mean survival time are superior or not inferior in raltitrexed treatment to that of FU-based regimen. Raltitrexed combined with oxaliplatin is worthy to be recommended in treating colorectal cancer.

Objective To study the change of estrogen in patients with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD). Methods A total of 144 patients with CHD including 36 patients with normal pulmonary arterial pressure as control group, and 108 with PAH were investigated as PAH group. Their pulmonary artery pressure was measured by right heart catheterization and the serum concentrations of estradiol, progesterone, prolactin and follicle stimulating hormone (FSH) were detected by chemiluminescence immunoassay. Results The serum concentrations of estradiol, progesterone, prolactin and FSH in PAH group were significantly higher than those in control group (P<0.05). Multiple regression analysis showed that the concentrations of estradiol, progesterone and prolactin were not correlated with the site of shunt but significantly correlated with physiologic factor including sex, age and menstrual cycle, and the level of mean pulmonary arterial pressure. The correlation coefficient of mean pulmonary arterial pressure to them was 0.607,0.531 and 0.518 respectively. The concentration of FSH was positively correlated with the prolactin and estradiol with a related coefficient of 0.917 (P=0.012) and 0.759 (P= 0.000). Conclusion The estrogen plays an important role in modification of the pulmonary arterial pressure in patients with CHD and PAH.

Objective To explore the relationship among psychological flexibility,anxiety and depression in postoperative thyroid carcinoma patients.Methods A total of 184 postoperative thyroid carcinoma patients selected randomly were measured with Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ),Cognitive Fusion Questionnaire (CFQ),Self-Rating Anxiety Scale (SAS),Self-rating depression scale (SDS),and the Meaning in Life Questionnaire-the presence of meaning(MLQ-P).Variance analysis,pearson correlation analysis and stepwise multiple regression analysis were conducted in 157 questionnaires which were effective.Results The scores of AAQ-Ⅱ,CFQ,SAS,SDS,MLQ-P were(17.62±7.63),(27.37± 11.00),(32.38±6.99),(34.73±7.87),(28.55±5.09) respectively.The MLQ-P scores were negatively correlated with other scales(r=-0.278 ～-0.427,P＜0.01).The correlations among AAQ-Ⅱ,CFQ,SAS,SDS were positive(r=0.359～0.784,P＜0.01).The SAS scores and SDS scores in postoperative thyroid carcinoma patients were higher than that in norm group(z=72.28,P＜0.01;z=2.25,P＜0.05).When stepwise multiple regression analysis was conducted on SAS and SDS scores,AAQ-Ⅱ,MLQ-P,CFQ could explain 24.2％ variance in anxiety,and AAQ-Ⅱ,MLQ-P could explain 24.4％ variance in depression.Conclusion The level of anxiety and depression in postoperative thyroid carcinoma patients is much higher than that in norm.The higher the psychological flexibility,the lower the depression level.Psychological flexibility has significant explanatory power on anxiety and depression.

Objective To investigate the clinical characteristics and risk factors for healthcare-associated infection (HAI)in patients with severe chronic hepatitis B (CHB),and provide theoretical basis for preventing and controlling HAI.Methods Retrospective survey was used to investigate the occurrence of HAI in hospitalized patients with severe CHB in a hospital between January 2012 and January 2015,risk factors for HAI were analyzed. Results A total of 126 patients with severe CHB were investigated,49 patients developed 106 times of HAI, incidence of HAI was 38.89%.The main HAI site was respiratory tract (n=47,44.34%),the next was abdominal cavity (n=34,32.08%).A total of 76 isolates of pathogens were detected,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 53.95%(n =41 ),43.42%(n =33),and 2.63%(n =2)respectively.Risk factors for HAI in patients with severe CHB were patients ’ age ≥ 60 years, length of hospital stay ≥ 30 days, complications,invasive operation,serum albumin < 35 g/L,and white blood cell count (WBC)< 4 × 109/L. Conclusion Incidence of HAI in patients with severe CHB is high,the majority are respiratory tract and abdominal cavity infection,risk factors are old age,long length of hospital stay,invasive operation,hypoalbuminemia,and low WBC count.

OBJECTIVETo explore the role of Compound Danshen Injection (CDI) in regulating the expression of aquaporin 3 (AQP3) in human amnion epithelium cells (hAECs), and to study the relation between c-Jun N-terminal kinase (JNK) signal pathway and AQP3.

METHODShAECs were isolated and primarily cultured from term pregnancy with normal amniotic fluid volume and from term pregnancy with oligohydramnios, and then hAECs were further divided into four groups, i.e., the blank control group (A), the SP600125 group (B), the CDI group (C), and the SP600125 +CDI group (D). The cell viability was measured by cell counting kit-8 assay (CCK-8). The expression of total JNK, phosphorylated JNK, and AQP3 were determined by Western blot.

RESULTS(1) In hAECs with normal AFV or with oligohydramnios: There was no statistical difference in the cell viability or the expression of total JNK among the 4 groups (P > 0.05). But there was statistical difference in the expression of p-JNK (P < 0.05). Compared with A group, the expression of p-JNK was obviously down-regulated in B group, but obviously up-regulated in C group (P < 0.05). The expression of p-JNK was significantly lower in D group than in C group, but higher than that in A group or B group (P < 0.05).The AQP3 expression in the hAECs with normal amniotic fluid volume of C group and D group were higher than that in the A group (P < 0.05). However, there was no statistical difference in the AQP3 expression between C group and D group (P > 0.05). In hAECs with oligohydramnios, the expression of AQP3 obviously decreased in B group, but up-regulated in C group (both P < 0.05). The expression of AQP3 was lower in D group than in C group, but higher than in B group (P < 0.05).

CONCLUSIONCDI could regulate the AQP3 expression in hAECs with oligohydramnios via activating the JNK signal pathway.

Amnion ; cytology ; drug effects ; Aquaporin 3 ; metabolism ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Cells ; drug effects ; metabolism ; Female ; Humans ; JNK Mitogen-Activated Protein Kinases ; metabolism ; MAP Kinase Signaling System ; physiology

Objective To investigate the effect of different volume of fresh gas on postoperative analepsia period of general anesthesia with sevoflurane in patients undergoing abdominal surgery. Methods 181 ASAⅠ-Ⅱpatients aged 20 - 70 undergoing elective abdominal surgery were divided into group A (112 patients) and group B (69 patients). Both groups received sevoflurane general anesthesia during surgery. At the end of surgery , group A received fresh gas for no more than 2L/min , and group B received the gas for more than 2L/min. The recovery time of spontaneous breathing, eye-opening time (from the end of surger to eye opening), and time of endotracheal extubation (from the end of surgery to endotracheal extubation ) were recorded. Results There were no significant differences in the recovery time of spontaneous breathing ,eye-opening time and time of endotracheal extubation between group A and group B (P > 0.05); Gender and time of intraoperative continuous uses of sevoflurane had effects on the recovery time of spontaneous breathing , which showed statistical significances (P < 0.05). Conclusions Uses of fresh gas for no more than 2L/min or more than 2L/min after surgery have no marked effects on the recovery time. However , gender and time of intraoperative continuous uses of sevoflurane may have effects on the recovery time of spontaneous breathing.

ObjectiveTo investigate the feasibitity of detecting S100A6 expression at mRNA level in endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) pancreatic ductal adenocarcinoma (PDA) specimens and its diagnostic value in PDA.MethodsA total of 18 PDA specimens and 22 normal pancreatic specimens were collected. RNA was extracted for reverse transcription.The expression of S100A6 gene was examined by real-time polymerase chain reaction.The cut-off value of S100A6 expression at mRNA level in PDA diagnosis was established through receiver operating characteristic (ROC) analysis. 28 patients with pancreatic head masses were selected for EUS-FNA examination,and the value of S100A6 mRNA expression level in PDA diagnosis was prospectively evaluated. The expression of S100A6 protein in PDA tissue was determined by immunohistochemistry staining.ResultsS100A6 mRNA expression in EUS-FNA and surgical PDA specimens (0.05023±0.10120,0.02083 ± 0.02848) was significantly higher than that of normal pancreatic tissues (0.00164±0.00202),both P＜0.01.The expression of S100A6 in 22 EUS-FNA PDA specimens was significantly higher than that of 6 pancreatic benign disease biopsy specimens (0.00193 ± 0.00278,P =0.0009). There was no significant difference in S100A6 expression between 6 pancreatic benign disease biopsy specimens and normal surgical pancreatic samples (P=0.6143).When S100A6 mRNA expression in EUS-FNA specimens over 0.00525 was taken as positive diagnostic value,the sensitivity,specificity and accuracy in prospective pancreatic cancer diagnosis were 90.01％,100 ％ and 92.85 ％,respectively.ConclusionThe high expression of S100A6 mRNA in EUS-FNA specimens of PDA has good preoperative diagnostic value.

Objective To discuss the value of double-row allograft bone suture anchor in repair of rotator cuff injury. Methods Under assistance of arthroseope, 16 cases of rotator cuff lesions were repaired by using double-row allograft bone suture anchors. There were 10 males and 6 females at average age of 44 years (32-58 years). According to Bigliani classification, there were 6 cases of small ruptures, 8 medial ruptures and 2 large ruptures. After rotator cuff was trimmed and acromial bone was re-shaped under arthroscopy, 2 bone anchors attached to suture lines were implanted in the attachment point of rotate cuff of humerus greater tuberosity side by side. Then, the 4 ends of the 2 suture lines were vertically sutured through tendon of supraspinatus mnscle and tied separately, crossing the 4 ends of 2 knots and penetrated each 2 ends into one bone anchor. Finally, these 2 bone anchors were embedded into 2 predrilled bone holes which were parallel to the former 2 anchors and lower in humerus greater tuberosity. Thus, a web was formed and overlapped on the ruptured rotator cuff. The number of bone anchors was according to the size of rupture. Results All cases were followed up for average 14 months (6-23 months). The mean UCLA score was (21.30±5.6) points preoperatively and (32.4±5.8) points postoperatively. The function of shoulders recovered well, with no pain, recurrence or pulling out of bone anchor. Function was excellent in 10 cases, good in 5 and fair in 1. Conclusions As for repair of rotator cuff injury, double-row bone-anchors under arthroscope can provide a tendon-bone interface better suited for biologic healing of rotator cuff. Bone suture anchor can not leave any foreign object residual and costs less.

Objective To express and purify the pneumococcal surface adhesin A(PsaA) protein,discuss its application as a protein carrier in conjugates vaccine. Methods The gene encoding for the PsaA protein was amplified from the genomic DNA of Streptococcus pneumoniae using PCR. The PCR product was then cloned into the prokaryotic expression vector pET-28a and the recombinant was transformed into host cell E. coli BL21 (DE3). The expression of the recombinant protein(rPsaA) was induced by IPTG and purifled by using DEAE anion-exchange chromatography. The rPsaA was successfully conjugated with group A meningococcal polysaccharide(GAMP). The mice were immunized subcutaneously with the conjugate and the immune responses against GAMP and PsaA were detected by ELISA. Results The recombinant PsaA was expressed as a 37 × 103 soluble protein without His-Tag. The rPsaA was successfully conjugated with GAMP. In addition to the immune response against PsaA, The antibody response against GAMP was significant improved in the mice immunized with conjugate vaccine in comparison with those immunized with GAMP alone. Conclusion The recombinant protein PsaA without His-Tag was obtained and conjugated with GAMP. The strong antibody responses against PsaA and CAMP were obtained in the immunized mice at the same time which may provide the protection against pneumonia and meningitis simultaneously.