OBJECTIVETo observe the effects of Pogostemon cablin (Blanco) Benth. (PCB), a Chinese aromatic herbal medicine, on serum levels of nitric oxide (NO), tumor necrosis factor-alpha (TNF-alpha), and membrane fluidity of intestinal epithelial cells (IMC) in rats undergoing lower limbs ischemic reperfusion (I/R), for exploring its action in protecting intestinal barrier and the possible mechanisms, and to seek a new way, viewing from Chinese medicine, for providing the experimental bases of gastrointestinal protection against trauma or surgical operation.

METHODSEighty adult Wistar rats were induced into lower limb I/R model and randomized equally into the model group, the three PCB water extract groups treated respectively with high- (4 g x kg(-1) x d(-10), middle- (3 g x kg(-1) x d(-1)), and low-dose (2 g x kg(-1) x d(-1)) of PCB water extract, and three PCB volatile oil groups treated respectively with high- (4 g x kg(-1) x d(-1)), middle- (3 g x kg(-1) x d(-1)), low-dose (2 g x kg(-1) d(-1) of PCB volatile oil. Besides, 10 healthy rats was allocated in a normal control group. PCB preparation was given via gastric infusion for 5 successive days just before modeling. The serum levels of NO and TNF-alpha were monitored, and the membranous fluidity of IMC at I/R region was determined by fluorescence polarization technique.

RESULTSCompared with the control group, both serum NO and TNF-alpha levels in model rats were significantly higher (P < 0.01), and the fluorescence polarization value (P) of IMC obviously increased at the same time (P < 0.05). As compared with the model group, the serum level of NO and TNF-alpha significantly reduced in all the PCB treated groups (P < 0.01 or P < 0.05). As for the membrane fluidity, significant difference was shown between the model group with low-dose of PCB water extract and middle-dose of PCB volatile oil (P < 0.05).

CONCLUSIONPCB could effectively protect the intestinal barrier function by way of maintaining the membrane fluidity of IMC through regulating the level of NO and TNF-alpha in serum.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Cells ; drug effects ; Extremities ; blood supply ; Intestinal Mucosa ; cytology ; Membrane Fluidity ; drug effects ; Nitric Oxide ; blood ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP) using instruments and drugs made in China, and to provide the data for the clinical application Methods Polymethylmethacrylate(PMMA) without adding contrast was classified into 3 groups according to the ratio of powder/liquid as 2∶1,3∶2,1∶1,PMMA with contrast was also classified into 3 groups according to the ratio of powder/liquid/contrast as 2∶1∶1,3∶2∶1,1∶1∶1 There were 6 groups totally The periods and temperature of polymerizing process were measured The PMMA specimens of different group were made,with the diameter of 1 0 cm, height of 3 0 cm The density was determined in X ray pictures and mechanical testing with universal testing machine was performed PVPwas performed in the spines of 3 human cadavers with transpedicular route under fluoroscopic control The PMMA was injected into vertebra at an interval of one vertebra from T4-L4, 7 vertebra were injected on each cadaver The injected volume was recorded The spines were dissected into 42 single vertebrae, with all soft tissues removed Overall,21 pairs of adjacent vertebrae were subjected to axial compression in an universal testing machine The cranial vertebra of each pair was injected with PMMA, the caudal one served as a control Results Lower temperature was observed in the PMMA groups with adding contrast than those without adding contrast during the polymerizing process, the average temperature in the PMMA group with the ratio of powder/liquid/contrast as 3∶2∶1 was 67 4℃ There was significant X ray density difference between the groups with contrast and corresponding groups without contrast ( t = 20 00, t = 20 00, t = 22 86, P 0 05) The group with ratio of power/liquid/contrast 3∶2∶1 was (127? 4 70) s in the period of the paste, and the ultimate compressive strength (mPa) was 47 23 The punctures were successfully reached in all vertebra The injected PMMA average volume was 5 ml in the thoracic vertebra and 7 5 ml in the lumbar vertebra PMMA leaking into adjacent paravertebral tissue was demonstrated in 3 of 21 vertebrae The ultimate compressive strength of the vertebrae without PMMA injection in the 3 groups was 3 28,3 63,and 3 69, respectively The ultimate compressive strength of the injected PMMA vertebrae in the 3 groups was 4 52,4 73,and 4 81, respectively The ultimate compressive strength was significantly higher in the injected PMMA vertebrae than that in the vertebrae without PMMA injection( t =3 17,3 55,3 99, P

OBJECTIVETo search for an effective therapy for depression.

METHODSOne hundred and twenty cases were randomly divided into two groups. The acupuncture group (60 cases) was treated with acupuncture at Zhong wan (CV 12) and Si-guan points [Taichong (LR 3) and Hegu (LI 4)] selected as main acupoints, combined with Baihui (GV 20), Sishencong (EX-HN 1), etc. , meanwhile, the reinforcing-reducing manipulation of respiration was adopted. The western medicine group (60 cases) was treated with oral administration of Fluoxetine Hydrochloride at the dosage of 20 mg every day. These treatments lasted for 8 weeks in both groups. The depression severities were assessed with Hamilton Depression Scale (HAMD) before treatment and at the 8th week of the treatment and adverse reactions were appraised respectively with Treatment Emergent Symptom Scale (TESS).

RESULTSThe total effective rate was 95.0% in the acupuncture group and 91.7% in the western medicine group with no significant difference between the two groups (P > 0.05). After treatment, the HAMD score had very significant changes in the two groups as compared with those before treatment (both P < 0.01), but there was no significant difference between the two groups (P > 0.05). After treatment, there was a significant difference between two groups in TESS score (P < 0.01). There was almost no adverse reaction in the acupuncture group, while the main clinical manifestations in the western medicine group were nausea, anorexia, diarrhea, etc.

CONCLUSIONAcupuncture at Zhongwan (CV 12) and Si-guan points combined with reinforcing-reducing manipulation of respiration can significantly improve symptoms of depression patients with a similar therapeutic effect to oral administration of Fluoxetine Hydrochloride and it is a safe method for depression without adverse reactions.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Depression ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Respiration ; Treatment Outcome ; Young Adult

Objective To evaluate the quality of the portal images acquired by computed radiography(CR)system and conventional screen-film system,respectively.Methods imaging plates (IP)and X-ray films of a home-devised lead phantom with a leakage of 6.45% were acquired,and modulation transfer function(MTF)curves of the both images were measured using edge method.Portal images of 40 nasopharyngeal cancer patients were acquired by IP and screen-film system respectively.Two doctors with similar experience evaluated the damage degree of petrosa] bone,the receiver operating characteristic(ROC)curve of CR images and general images were drawn according to two doctors evaluation results.Results The identification frequency of CR system and screen-film system were 1.159 and 0.806 Lp/mm respectively.For doctor one,the area under ROC curve of CR images and general images were 0.802 and 0.742 respectively.For doctor two,the area under ROC curve of CR images and general images were 0.751 and 0.600 respectively.The MTF curve and ROC curve of CR are both better than those of screen-film system.Conclusion The image quality of CR portal imaging is much better than that of screen-film system.The utility of CR in linear accelerator for portal imaging is promising in clinic.

OBJECTIVESTo evaluate the effect of percutaneous vertebroplasty on vertebral tumor metastasis using instruments and drugs made in China and to explore the technique of percutaneous vertebroplasty.

METHODSThirty-two patients with vertebral metastasis were treated with percutaneous vertebroplasty with instruments and drugs made in China. Anterolateral approach for cervical vertebrae and transpedicular approach for thoracic and lumbar vertebrae were used. The volume of disease focus and the amount of polymethy methacrylate (PMMA) injected were calculated with formula V = 4/3pi (D/2)(3) preoperatively. PMMA with contrast was mixed according to the ratio of powder/liquid/contrast of 3:2:1. The procedures were monitored under fluoroscopy. PMMA was injected in the polymerization time. CT scanning was performed before and after the operation.

RESULTSThe percentage of lesion PMMA fill was more than 50% as demonstrated by CT. Clinical data were obtained from the cases followed up for 7 - 12 months, and the rate of pain relief was 90.6% (29/32) at one week, 71.8% (23/32) at six months, and 58.6% (17/29) at 12 months after operation. There were no cases of PMMA leakage that affected clinical performance.

CONCLUSIONSPercutaneous vertebroplasty for vertebral tumor metastasis using instruments and drugs made in China was effective. It is important to prevent paravertebral leaks of PMMA and to ensure that PMMA is injected within the polymerization time.

Aged ; Aged, 80 and over ; China ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Polymethyl Methacrylate ; administration & dosage ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Spinal Neoplasms ; secondary ; surgery ; Spine ; surgery ; Thoracic Vertebrae ; surgery

OBJECTIVETo evaluate the hemodynamic response to passive leg raising (PLR) indicates fluid responsiveness in patients with septic shock.

METHODSTwenty patients with septic shock, considered for fluid challenge (FC), were enrolled in the study from June 2009 to May 2010. Hemodynamic changes were determined by pulse-contour derived cardiac index at baseline, before and after PLR, return to baseline for 10 min, before and after fluid challenge (250 ml saline for 10 min). An increase of SV after fluid challenge (FC-ΔSV) ≥ 10% were defined responders.

RESULTSTwenty patients with septic shock were included in the study. PLR and fluid challenge were performed 46 instances, among which 15 instances were defined as response group. SV and pulse pressure induced by PLR (PLR-ΔSV and PLR-ΔPP) were increased significantly in response group [(76 ± 19) ml vs. (65 ± 18) ml, (73 ± 20) mmHg vs. (62 ± 20) mmHg (1 mmHg = 0.133 kPa), P < 0.05], while in nonresponse group there were no significant change. PLR-ΔSV and PLR-ΔPP were correlated with FC-ΔSV (r = 0.51, P = 0.001; r = 0.45, P = 0.006), central venous pressure (CVP) were unrelated with FC-ΔSV. Area under curve (AUC) for PLR-ΔSV, PLR-ΔPP and stroke volume variation (SVV) were 0.846, 0.791 and 0.708. PLR-ΔSV ≥ 12.5% predicted fluid responsiveness with sensitivity of 80% and specificity of 93.5%. PLR-ΔPP ≥ 9.5% predicted fluid responsiveness with sensitivity of 73.3% and specificity of 83.9%.

CONCLUSIONSPLR-ΔSV and PLR-ΔPP can predict fluid responsiveness in patients with septic shock. PLR-ΔSV and PLR-ΔPP have a greater ability in predicting volume responsiveness than CVP and SVV.

Adult ; Aged ; Aged, 80 and over ; Female ; Hemodynamics ; physiology ; Humans ; Leg ; Male ; Middle Aged ; Posture ; Sensitivity and Specificity ; Shock, Septic ; physiopathology

OBJECTIVESTo understand the value of measuring neonatal cerebral regional oxygen saturation (rSO2) using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation, to establish the normal range of neonatal cerebral rSO2 and to collect data of the changes of cerebral rSO2 under certain disease status.

METHODSNine large hospitals participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008. Using the NIRS human tissue oximeter (TSAH-100) independently developed in China, the cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any special disease, was detected at 1, 2 and 3 days after birth, respectively. The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation, was also detected during the severe phases. The pulse oxygen saturation (SpO2) measured at the finger tip, and also the arterial oxygen saturation (SaO2) measured by blood gas analysis, which could indicate the oxygen supply of the whole body, were obtained simultaneously. The correlations among cerebral rSO2, pulse SpO2 and arterial SaO2 were analyzed.

RESULTS(1) The cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral hypoxia was defined as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F=0.610, P>0.05). The cerebral rSO2 of the neonates with diseases was (55+/-7)%, which was significantly lower than that of the normal full-term neonates (t=15.492, P<0.05). (2) The cerebral rSO2 was positively correlated with the SpO2 (r=0.74, P<0.01) and the SaO2 (r=0.71, P<0.01). (3) Under some special diseases, the changes of cerebral rSO2 was asynchronous with those of the SpO2: (1) For 18 cases under severe cerebral damages or under relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%-58%), but the SpO2 was still normal (above 90%). (2) During the recovery of some critically ill neonates, the increase of cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%-80% for SpO2, and 44%-50% for cerebral rSO2); when the diseases were alleviated, although the SpO2 recovered to above 85%, the cerebral rSO2 was still significantly low (around 50%). (3) In 3 cases, during the severe phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%-72%, which was significantly higher than the normal value (62%).

CONCLUSIONSThe range of cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIRS, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.

Birth Weight ; Brain ; metabolism ; Female ; Humans ; Hypoxia, Brain ; diagnosis ; Infant, Newborn ; Male ; Oximetry ; methods ; Oxygen ; analysis ; Spectroscopy, Near-Infrared

OBJECTIVETo evaluate the correlation between the lactate in artery blood and lactate clearance rate and prognosis in patients with septic shock in intensive care unit (ICU).

METHODSProspectively studied 221 consecutive patients with septic shock from December 2005 to December 2007, the diagnosis of septic shock was made based on the criteria of 2001 ACCP/SCCM. For inclusion in the study, we required admission of the patients within 24 h of septic shock diagnosed. The criteria for exclusion from the study were an age of less than 18 years, pregnancy, serious inadequacy of liver and renal, needing blood purification, or acidosis result of biguanides drugs, or do-not-resuscitate. The eligible patients assigned to early goal-directed therapy. The 6-, 24- and 72-hour lactate clearance rate were calculated, the relationship between the level of lactate, lactate clearance rate, the APACHE II score, the number of failed organ and the 28-day mortality were evaluated.

RESULTSOne hundred and five patients with septic shock were admitted, 74 male and 31 female, the mean age was 70 +/- 12 years. The 28-day mortality was 54.3%. The average APACHE II score at baseline was 20 +/- 8, the number of failed organs was 3.0 +/- 1.1 and the average concentration of lactate in artery blood at baseline was (3.8 +/- 3.6) mmol/L. Significant differences of the lactate at 0-, 6-, 24- and 72-hour were found between death group and survival group. There were 69 patients whose lactate in artery blood at baseline was > 2 mmol/L, 24 survived. The lactate clearance rate of 6- and 24-hour in survival group were significantly higher than death group (P < 0.01, P < 0.05, respectively), but the lactate clearance rate of 72-hour was not (P > 0.05). By using a multivariate logistic regression analysis, it showed that the lactate clearance rate of 6-hour was the independent predictive factor of survival. The area under the receiver operating characteristic curve (ROC) was 0.564, 0.649, 0.754, 0.784, respectively according to the level of the lactate at 0-, 6-, 24-hour and the 6-hour lactate clearance rate. The cutoff of 6-hour lactate clearance rate was >or= 30.0%, resulting in a sensitivity of 60.0% and a specificity of 77.3%.

CONCLUSIONSDynamic observation of lactate level is very important for the survival in the patients with septic shock. Patients with elevated lactate and not decreased rapidly have a worse outcome. The 6-hour lactate clearance rate might be the indicator for predicting the prognosis of patients with septic shock.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lactic Acid ; blood ; Male ; Middle Aged ; Monitoring, Ambulatory ; Prognosis ; Prospective Studies ; Shock, Septic ; blood ; Young Adult

In order to study the roles of integrin beta6 in Foot-and-Mouth Disease Virus infection, pig integrin beta6 was firstly molecularly cloned from RNA of the tongue and lung of recovered pig infected experimentally with foot-and-mouth-disease virus (FMDV), and was compared with the beta6 gene of other animals available in GenBank at nucleotide and amino acid leves. GeneBank association number of the beta6 gene is EF432729. Pig integrin beta6 gene (2367bp) encodes a polypeptide of 788 amino acids consisting of 9 potential N-linked glycosylation sites, 3 Glycosaminoglycan attachment sites, a cGMP-dependent protein kinase phosphorylation site, 10 Protein kinase C phosphorylation sites, 2 EGF-like domains and 2 cysteine-rich regions. Pig integrin beta6 subunit has a 26-residue putative signal peptide, a 681-residue ectodomain, a 29-residue transmembrane domain, and a 52-residue cytoplasmic domain. 11 mutant nucleotides were found in beta6 gene coding region and 9 amino acids were changed. The nucleotide sequence similarity of integrin beta6 gene between rheses monkey, mouse, Norway rat, dog, guinea pig, human, bovine, sheep is 79.5%, 84.9%, 85.4%, 85.2%, 88.7%, 90.1%, 91.9% and 91.9%, and the amino acid sequence similarity is 93.5%, 88.2%, 88.5%, 88.3%, 91.0%, 92.8%, 93.3% and 93.4% respectively. This study will lay a foundation for understanding the interactions of FMDV with receptors.
Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; DNA, Complementary ; Foot-and-Mouth Disease Virus ; pathogenicity ; Integrin beta Chains ; genetics ; metabolism ; Molecular Sequence Data ; Mutation ; Receptors, Virus ; genetics ; metabolism ; Sequence Analysis ; Swine ; genetics

OBJECTIVETo investigate the relationship between the HLA-DQB1 allele polymorphisms and the clinical features of 15 familial myasthenia gravis (MG) cases in north China.

METHODSBy polymerase chain reaction-sequence specific primers (PCR-SSP), the HLA-DQB1 gene polymorphisms were determined in 64 MG patients (15 familial and 49 sporadic) and 52 healthy individuals as control group. The clinical characteristics of 15 familial MG patients and 49 sporadic were analyzed. The measurement data was analyzed by t test and enumeration data by chi-square test.

RESULTSThe frequency of DQB1*0501 was significantly increased in familial MG, especially in the ocular type, compared with sporadic MG (P<0.05, OR=3.08) and healthy controls (P<0.01, OR=4.439). Comparing with healthy controls, the frequency of DQB1*0301/4 was increased (P<0.05, OR=2.56), while the frequency of DQB1*0601 was significantly decreased (P<0.05, OR=0.33) in sporadic MG. The familial patients had an early age of disease onset, but less severity and good prognosis.

CONCLUSIONThe familial MG has distinctive clinical features. DQB1*0501 allele is positively related to the genetic susceptibility to familial MG patients in north China, especially to the ocular type. DQB1*0301/4 allele is positively related to the pathogenesis of sporadic MG. DQB1*0601 may be a protecting allele for sporadic MG. The phenotype of MG may be the result of interaction of hereditary defects and environmental factors. The familial MG may be different from sporadic patients in genetic immune mechanism.

Adolescent ; Adult ; Aged ; Alleles ; Child ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; HLA-DQ Antigens ; genetics ; HLA-DQ beta-Chains ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Young Adult