Objective To observe the clinical efficacy of low-dose erythromycin combined with salmeterol-fluticasone in the treatment of stable COPD, focus on the quality of life and respiratory function of patients.Methods 87 patients with stable COPD admitted to Hangzhou Red Cross Hospital from January 2014 to January 2016 were selected.Patients were divided into two groups by therapeutic methods, observation group ( salmeterol-fluticasone+erythromycin) 46 cases and control group (salmeterol-fluticasone) 41 cases.Six months of treatment, the quality of life of two groups of respiratory function assessment, acute COPD and peripheral inflammatory factor and other indicators of change.Results After treatment, both of the two groups got significantly decreased in SGRQ and MMRC scores, while the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05).After treatment, FEV1/FVC%levels were significantly increased in both groups, but the observation group was significantly higher than the control group, the difference was statistically significant(P <0.05).The cumulative incidence of acute exacerbation of COPD was 10.87%(5/46) in the observation group, which was significantly lower than that in the control group 29.27%(12/41), the difference was statistically significant(Log-rankχ2 =4.833, P=0.028).After treatment, the levels of IL-1βand TNF-αin the peripheral blood of the patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05).Conclusion In the treatment of stable COPD, low-dose erythromycin could significantly improve the clinical efficacy, improve the quality of life and respiratory function.

Objective:To compare the content of polydatin and emodin between polygonum cuspidatum pieces and dispensing gran-ules to provide theoretical basis for the improvement of preparation process of the granules. Methods:An HPLC method with linear gra-dient elution was used to determine the content of polydatin and emodin in the pieces and dispensing granules, and the difference in the two contents was compared. Results: The content of polydatin and emodin in polygonum cuspidatum pieces met the requirement de-scribed in China pharmacopoeia, which was lower than that in the dispensing granules, and the contents of the two components in the commercial dispensing granules were not equivalent to the labeled amount, which was 1/15 and 1/27 of that in the pieces. Conclu-sion:The transport rate of the traditional preparation process of dispensing granules is with poor efficiency, which should be improved.

Objective To construct a recombinant plasmid pLEGFP-mIFN? for developing the genetical therapy of tumor by stem cells.Methods PCR was used to amplify the mIFN? gene from plasmid pcDNA3.1-mIFN? in which the mIFN? was cloned.A new plasmid,pLEGFP-mIFN?,was then constructed by inserting the amplified mIFN? gene into pLEGFP-C1.Restriction analysis and sequencing were used to confirm the structure of pLEGFP-mIFN?.Neural stem cells were transfected by supernatant of PA317.Results A DNA fragment in size of 500 bp was amplified.Restriction analysis showed that the amplified gene was inserted into pLEGFP-C1 correctly.(Conclusion The) plasmid pLEGFP-mIFN? is constructed successfully,and it can transfect neural stem cells.

Objective To investigate the mechanism of liver X receptor(LXR)signal pathway in regulating glucose metabolism by observing the variety of LXR expression and its impacts on regulating the mRNA expression of PEPCK and GCK, the key enzyme of hepatic glucose metabolism in various glucose metabolic status in rats. Methods SD rats were chosen and divided into four groups:the CON group, the induced DM group, the OB group, and the induced OB+DM group. For each group of rats, body weight, blood glucose, serum triglycerides, and cholesterol were measured. Then the rats were sacrificed and the livers were collected and studied. Real-time PGR was used to measure the expressions of LXR mRNA, PEPCK mRNA, and GCK mRNA in the livers. Finally, the Western Blot assay was used to measure the liver LXR protein expression. Results The expression of LXR mRNA was significantly higher in DM,OB, and OB+DM groups than in CON group(P＜0.05).The Western blot results showed that the levels of protein were in accordance with the mRNA expression. Comparing to the CON and the OB groups, the PEPCK mRNA expression of the OB+DM and the DM groups was significantly higher, while the GCK mRNA expression of these two groups was significantly lower(P＜0.05). Comparing to the CON group, the PEPCK mRNA expression of the OB group was significantly lower, while the GCK mRNA expression of OB group was significantly higher(P＜0.05).Conclusions During non-diabetic phase, LXR could act as a protective receptor for glucose metabolism and keep glucose homeostasis by regulating the key enzymes of the hepatic glucose metabolism. While in the diabetic phase, the protective receptor LXR failed to reverse the change of the related enzymes caused by insulin deficiency, and finally the plasma glucose level was raised.

OBJECTIVE:To establish the quality standard for Xiaoer Zhike oral liquid(XZOL).METHODS:The Herba Ephedrae,Pericarpium Citri Reticulatae and Radix Glycyrrhizae in XZOL were identified by TLC.The chlorogenic acid in the liquid was determined by HPLC,The mobile phase was methanol-water(10∶90)with a flow rate of1ml/min,the detection wavelength was254nm.RESULTS:The Herba Ephedrae,Pericarpium Citri Reticulatae and Radix Glycyrrhizae in XZOL could be identified on TLC chromatograms.The linear range of chlorogenic acid was0.2?g～1.2?g(r=0.9996),the average recov?ery was96.67%,RSD was1.04%.CONCLUSION:The method is simple,reliable and accurate.The method can be used for quality control of XZOL.

Objective To investigate the change in the phosphorylation of vanilloid receptor 1 (VR1) in dorsal root ganglion (DRG) in rats with inflammatory pain (IP)-morphine tolerance. Methods Twenty 8-12 months old male SD rats in which intrathecal (IT) catheters were successfully implanted without complication were randomly divided into 4 groups (n =5 each): group NS, IP + normal saline (NS) 10 μl IT twice a day ×7 days; group M0 ,intact rats + morphine 10 μg/kg ( 10 μl) IT twice a day × 7 days; group M1 , IP + morphine 10 μg/kg (10 μl) IT once; group M2 ,IP + morphine 10 μg/kg(10 μl) IT twice a day × 7 days. IP was induced by injecting complete Freund's adjuvant (CFA) into the ankle joint of the left hindlimb. IT morphine or NS was started on the 3rd day after induction of IP. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL)were measured after catheterization, before and at 1-7 days of IT consecutive administration. The rats were sacrificed after last pain threshold measurement. The phosphorylated VR1 (p-VR1) protein expression in DRG was determined by Western blot. Results There was no significant difference in the baseline PWL measured before induction of IP among the 4 groups. Morphine tolerance developed in group M0 and M2. The expression of p-VR1 in DRG was highest in group M2. Conclusion The phosphorylation of VR1 in DRG in rats with IP tolerance is increased, which is involved in the development of morphine tolerance.

Objective To observe changes in hippocampal network electrical activities in electroacupuncture regulation of abnormal cardiovascular activities and explore the central mechanism of the regulation. Method Experimental rats were randomized into three groups: normal urethane anesthesia without electroacupuncture (n=15), urethane enhanced deep anesthesia (n=9) and normal anesthesia plus anal canal pressurization (n=15). Femoral arterial pressure, cardiac electricity, hippocampal field potentials and cellular discharge were recorded in the three groups. The normal anesthesia group did not receive intervention measures. The other two groups received acupuncture intervention after successful induction of abnormal blood pressure. Result In rats with normal urethane anesthesia, sleep-like periodic hippocampal electrical activity occurred with periodic cardiovascular activities and theta oscillations was corresponding to increased heart rates. In rats with deep anesthesia and hypotension, theta oscillations appeared in hippocampal network with increased blood pressure and heart rates after electroacupuncture (P<0.001). Anal canal pressurization induced increases in blood pressure and heart rates and caused theta oscillations in hippocampal network. During that time, electroacupuncture could still activate theta-related cells, reduce blood pressure and decrease heart rates (P<0.001). Conclusion Theta oscillations in hippocampal network are involved in the bidirectional regulating effect of electroacupuncture on abnormal cardiovascular activities.

Twenty-seven male SD rats were assigned to 3 groups: control, obese, and obese with diabetes groups. Serum corticosterone was determined and euglycemic-hyperinsulinemic clamp was carried out. Expressions of liver X receptor ( LXR), 11 β-hydroxysteroid dehydrogenase 1 ( 11 β-HSD1 ), and glucocorticoid receptor (GR) were determined by real-time PCR. Both groups of obese rats were insulin-resistant, with up-regulated LXR mRNA and down-regulated 11 β-HSD1 mRNA( both P＜0.05 ).

Objective To investigate the antihyperglycemic effect and the most effective com-ponent of Momordica charantia L. and its mechanism. Method Water-extracted and alkali-extracted Momordica charantia L. polysaccharides with different molecular weight on streptozotocin induced diabetes mellitus mice were carried out. The antihyperglycemic mechanism was preliminarily analyzed. Results Alkali-extracted Momordica charantia L. polysaccharides could lower blood sugar,improve glucose tolerance and increase the content of hepatic glycogen significantly at the dose of both 200 and 400mg/kg bw. The content of fructosamine was also lowered. Conclusion The component of alkali extracted Momordica charantia L polysacchaides with maximal molecular weight possessed the best antihyperglycemic effect.

Neuro-ophthalmological emergencies are some ocular manifestations, which are associated with the sight or life-threatening diseases if not promptly treated, including acute visual loss, sudden diplopia or anisocoria.Some severe nerve system or orbitocranial inflammatory diseases frequently present neuro-ophthalmological symptoms at the early stage.Acute visual loss is the common complaint of optic neuritis, arteritic anterior ischemic optic neuropathy, rhino-orbital-cerebral mucormycosis, and pituitary apoplexy.Diplopia usually occurs in cavernous sinus thrombosis or intracranial aneurysm because of cranial nerve palsies.Additionally, intracranial aneurysms and carotid artery dissecting aneurysm often present anisocoria initially.The clinical symptoms, signs, diagnosis and management of these disorders were reviewed from the point of emergency medicine, and the role of neuro-ophthalmological signs in the diagnosis was highlighted in this review, aiming to help ophthalmologists improve the awareness of these conditions, and emphasize the urgency of these signs.