OBJECTIVETo assess the clinical efficacy, safety and compliance of tianwang buxin decoction (TWBXD) combined with dormancy hygiene education (DHE) and TWBXD alone in treatment of sub-healthy insomnia patients of yin deficiency fire excess syndrome.

METHODSThe multi-centered, single blinded randomized clinical trial design was adopted. One hundred and one sub-healthy insomnia subjects of yin deficiency fire excess syndrome were randomly assigned to two groups. The 50 in the treatment group were treated by combined treatment with TWBXD and DHE, while the 51 in the control group were treated with TWBXD alone. The therapeutic efficacy, Pittsburgh sleep quality index (PSQI) score, clinical global impression-improvement (CGI) score, quality of life made by WHO (WHOQOL-BREF) score, and safety in the two groups were compared.

RESULTSThe effective rate in the treatment group was 68.08%, lower than that in the control group (75.00%), but the difference between them was statistically insignificant. The PSQI score in the treatment group were reduced from 12.00 +/- 2.25 to 7.55 +/- 2.91 (P < 0.01). It was reduced from 11.68 +/- 2.21 to 7.16 +/- 3.13 in the control group (P < 0.01). The improvement of CGI score and WHOQOL-BREF score was also shown in the two groups after treatment (P < 0.01). No significant difference was shown in each index between the two groups. There was no significant difference in CGI between two weeks after drug withdrawal and by the end of the therapeutic course in the same group (P > 0.05). There was no statistical significance in inter-group comparison (P > 0.05).

CONCLUSIONSignificant effect was achieved by TWBXD combined with DHE and by TWBXD alone. Their efficacies were equivalent, with high compliance and safety.

Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hygiene ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Patient Education as Topic ; Single-Blind Method ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome ; Yin Deficiency ; therapy

Epidemiology is a discipline characterized by complicated theory and practice.How to make the practice course function better is a topic worthy of exploring in educational reform for clinical students.The article explored the‘Student-Dominated’ Model based on ‘Problem-Based Learning ’ and ‘Team Based Learning ’ in teaching process and compared the model with the traditional one ( Teacher-Dominated Model) .Suggestions were given to further improve effectiveness of epidemiology practice courses.

Objective To detect the internal arteriovenous fistulas (AVF) in 73 maintenance hemedialysis patients, as to explore the recirculation, blood flow and cardiac output of the internal AVF and provide basis for the hemodialysis project. Methods Internal AVF of 73 maintenance hemodialysis patients was detected 30 minutes after the initiation and 30 minutes before the end of the hemodialysis. Patients with low blood flow ( AF < 600 ml/min) were followed up. Results Fistula function was successfully monitored in 73patients, in which 1 case ( 1. 4% ) was found to have recirculation rate > 50%. 15 patients (20. 5% ) had AF <600 ml/min and 18 patients (24.7%) had AF > 1 600 ml/min. During 12 months follow up with the 15 patients (AF <600 ml/min), 6 cases (40%) had occlusion, 7 cases (46.7%) maintained unobstructed and 2 cases underwent kidney transplant. There was statistical significance in terms of internal fistula flow, cardiac output, cardiac index and center blood volume between 30 minutes after the initiation and 30 minutes before the end of the hemodialysis. Conclusions AVF detection plays an important role in the monitor of AVF function in hemodialysis patients. The possibility of AVF occlusion increases in patients with lower blood flow. The recirculation rate is low when AVF obtains enough blood flow and the internal fistula interval is not a major factor.

OBJECTIVETo assess the effect of perioperative glucose-insulin-potassium (GIK) infusions on the prognosis in patients undergoing coronary artery bypass grafting.

METHODSElectronic databases including Cochrane library (Issue 3, 2011), Pubmed, EMbase, Highwire, CBM and CNKI were searched. A meta-analysis of all randomized controlled trials (RCTs) comparing GIK with control in coronary artery bypass grafting was performed. Study selection and meta-analysis were conducted which according to the Cochrane Handbook for systematic reviews. Date were extracted from these trials by 3 reviewers independently and analyzed by RevMan5.0 software.

RESULTSA total of 9 RCTs including 1029 patients were assessed in this study. GIK infusion was associated with significantly fewer perioperative myocardial infarctions (RR = 0.59, 95%CI: 0.38 - 0.91, P = 0.02), less inotropic support requirement (RR = 0.44, 95%CI: 0.35 - 0.56, P < 0.01), and increase the incidence of postoperative atrial fibrillation (RR = 1.23, 95%CI: 1.05 - 1.43, P = 0.009).

CONCLUSIONSGIK significantly reduces myocardial injury and improves cardiac function in patients undergoing coronary artery bypass grafting, but also increases the incidence of postoperative atrial fibrillation.

Coronary Artery Bypass ; Glucose ; administration & dosage ; Humans ; Insulin ; administration & dosage ; Myocardial Infarction ; prevention & control ; Postoperative Period ; Potassium ; administration & dosage ; Prognosis ; Randomized Controlled Trials as Topic

OBJECTIVETo investigate the modulatory effects of morphine on the susceptibility to pentylenetetrazole-induced seizures, and the involvement of endogenous histamine in this process.

METHODSBoth the wild-type (WT) mice and histidine decarboxylase (a key enzyme for histamine biosynthesis) deficient (HDC-KO) mice were subcutaneously injected with different doses of morphine, and 1 hour later the pentylenetetrazole solution (1.5 %) was infused into the tail vein at a constant rate of 0.3 ml/min. The minimal dose of pentylenetetrazole (mg/kg) needed to induce myoclonic jerks and clonus convulsion was recorded as the thresholds of seizures.

RESULTIn WT mice, morphine dose-dependently decreased the thresholds of both myoclonic jerks and clonus convulsion. In HDC-KO mice, morphine at 10 mg/kg only significantly decreased the threshold of myoclonic jerks from (38.6 +/-2.9)mg/kg to (32.5 +/-0.7)mg/kg, but had no significant effect on the threshold of clonus convulsion [from (51.8 +/-2.1)mg/kg to (47.6 +/-1.2)mg/kg]. In addition, the value of decreased myoclonic jerks (15.8 +/-1.4)% and clonus convulsion (8.3 +/-0.9)% thresholds were much lower in HDC-KO mice than in WT mice [(26.1 +/-2.5)% and (20.8 +/-2.4)%, respectively].

CONCLUSIONMorphine can decrease the thresholds of pentylenetetrazole in induction of seizure, and the endogenous histamine may be involved in this process.

Animals ; Disease Susceptibility ; chemically induced ; metabolism ; physiopathology ; Dose-Response Relationship, Drug ; Histamine ; metabolism ; physiology ; Histidine Decarboxylase ; genetics ; metabolism ; Male ; Mice ; Mice, Knockout ; Morphine ; pharmacology ; Myoclonus ; chemically induced ; metabolism ; physiopathology ; Narcotics ; pharmacology ; Pentylenetetrazole ; Random Allocation ; Seizures ; chemically induced ; genetics ; physiopathology ; Sensory Thresholds ; drug effects

OBJECTIVE Tissue plasminogen activator (tPA) is the only approved pharmaco-logical therapy for acute brain ischaemia;however,a major limitation of tPA is the haemorrhagic trans-formation that follows tPA treatment. Here, we determined whether nicotinamide mononucleotide (NMN), a key intermediate of nicotinamide adenine dinucleotide biosynthesis, affects tPA-induced haemorrhagic transformation. METHODS Middle cerebral artery occlusion (MCAO) was achieved in CD1 mice by introducing a filament to the left MCA for 5 h.When the filament was removed for reperfusion, tPA was infused via the tail vein.A single dose of NMN was injected i.p.(300 mg·kg-1).Mice were killed at 24 h post ischaemia, and their brains were evaluated for brain infarction, oedema, haemoglobin content, apoptosis, neuroinflammation, blood-brain barrier (BBB) permeability, the expression of tight junction proteins(TJPs)and the activity/expression of MMPs. RESULTS In the mice infused with tPA at 5 h post ischaemia, there were significant increases in mortality, brain infarction, brain oedema, brain haemoglobin level, neural apoptosis, Iba-1 staining (microglia activation) and myeloperoxidase staining (neutrophil infiltration). All these tPA-induced alterations were significantly prevented by NMN administration. Mechanistically, the delayed tPA treatment increased BBB permeability by down-regulating TJPs, including claudin-1, occludin and zonula occludens-1,and enhancing the activities and protein expression of MMP9 and MMP2. Similarly, NMN administration partly blocked these tPA-induced molecular changes. CONCLUSION Our results demonstrate that NMN ameliorates tPA-induced haemorrhagic transformation in brain ischaemia by maintaining the integrity of the BBB.

With retrieval of MEDLINE database (from Jan 2006 to Dec 2010) and supplementary search on other important literatures, 29 overseas articles that were in accord with inclusive criteria were included. The results showed that the overseas scholars issued the international standard on human acupoint locations and proposed the localization system of animal acupoint model; discovered the new acupoint structure, characteristic of acupoint microcirculation, the states of the diseases could be specifically reflected through acupoint temperature, electric resistance, pressure and pain threshold, and the specific brainstem reaction could be induced by electroacupuncture at acupoints; verified initially the effect on nausea and vomiting with the related acupuncture methods at acupoints and explained the mechanisms on the local analgesia of acupuncture at acupoints; suggested that a further study should be expected on the low electric resistance property of acupoints and the effect specificity in the treatment of disease. Additionally, they were proposed that the domestic study should focus on the symptom treatment, correct application of logic reasoning, the secondary literature study and international exchange and cooperation. It is indicated that the overseas study has made the great progression on the acupoint locations, morphological structure, biological and physical properties, pathological reaction, stimulation effect, therapeutic effect and mechanism, and it provides the references for the domestic study in terms of study clues and methods.
Acupuncture ; trends ; Acupuncture Points ; Acupuncture Therapy ; trends ; Humans ; MEDLINE ; Publications

To investigate the function of exogenous unsaturated fatty acids in hyposmotic membrane stretch enhancement of muscarinic current (ICCh) in antral circular smooth muscle cells of guinea pig, we recorded the membrane current with the conventional whole cell patch-clamp technique. I(CCh) elicited by 50 micromol/L carbachol (CCh) at the holding potential of 20 mV under isosmotic condition was taken as control. Hyposmotic membrane stretch increased I(CCh) to 226.0+/-21.0%. When the cells were pretreated with 5 micromol/L arachidonic acid (AA), linoleic acid (LA) or oleic acid (OA), I(CCh)was inhibited to 3.8+/-0.6%, 35.2+/-0.8% and 66.6+/-0.6% respectively. Hyposmotic membrane stretch increased I(CCh) to 106.0+/-2.5%, 173.2+/-6.8% and 222.1+/-11.0% of the control respectively. Five micromol/L AA inhibited hyposmotic membrane stretch-enhanced I(CCh) by 51.2+/-3.8%, while the control I(CCh) under isosmotic condition was inhibited by 96.2+/-1.6%. The results suggest that unsaturated fatty acids inhibited I(CCh) and the inhibitory effect is more significant when the unsaturation degree is increased. However, the unsaturated fatty acids are not involved in the increase of I(CCh) induced by hyposmotic membrane stretch.
Animals ; Fatty Acids, Unsaturated ; pharmacology ; Guinea Pigs ; Membrane Potentials ; drug effects ; Myocytes, Smooth Muscle ; cytology ; physiology ; Osmotic Pressure ; Patch-Clamp Techniques ; Pyloric Antrum ; cytology ; physiology ; Receptors, Muscarinic ; physiology ; Sodium Chloride

Objective We used blood oxygenation level dependent-functional MR imaging(BOLD- fMRI)to explore the characteristics of deactivation patterns in patients with anxiety disorders and the underlying neural mechanism of this disease.Methods Ten patients and ten healthy controls participated the experiments.All subjects performed the trait portion of the State-Trait anxiety Inventory(STAI-T)prior to the fMRI scans.The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to emotionally neutral words alternating with no words(experiment 1)and threat related-words alternating with emotionally neutral words(experiment2).During fMRI scanning,subjects were instructed to closely listen to each stimuli word and to silently make a judgment of the word's valence.Data were analyzed with statistical parametric mapping(SPM 99).Individual and group analysis were conducted.Results Mean STAI-T score was significantly higher for patients group than that of controls(58?8 for patients group and 33?5 for controls,t=8.3,P

Objective To establish cell strain expressing the genes of HIV vpr and mutant HIV vpr-FS, and to explore cell apoptosis ability by HIV Vpr and Vpr-FS. Methods The recombinant plasmids were constructed by cloning HIV vpr and HIV vpr-FS genes into the eukaryotic expression vector pcDNA3.1respectively. To determine the primary structures of HIV vpr and HIV vpr-FS, plasmids were cleaved by restriction enzymes. After the plasmids were transfected into HeLa cells by liposome, the HeLa cells were selected with G418 selective medium, mRNA expression of HIV vpr or HIV vpr-FS of transfected cells was detected by RT-PCR, and Vpr and Vpr-FS protein expression were detected by Western blot assay respectively. The DNA content and the percentage of apoptosis in HeLa HIV vpr cell, HeLa HIV vpr-FS cell and HeLa pcDNA3.1 cell were monitored by flow cytometry and the DNA fragmentation was analyzed by agarose gel electrophoresis. Results BamH Ⅰ and Hind Ⅲ cleavaged products of pcDNA3.1-vpr and pcDNA3.1-vpr-Fincluded 342 bp length fragments suggesting that the length of DNA sequence containing HIV vpr (HIV vpr-FS) within pcDNA3.1 was the same as theoretical length. The HeLa cells transfected by pcDNA3.1-vpr or pcDNA3, l-vpr-FS and selected with G418 could express HIV vpr or HIV vpr-FS by RT-PCR, and express HIV Vpr or HIV Vpr-FS protein by Western blot. The results of flow cytometry and DNA fragmentation showed that there was significant different in the number of apoptotic cells between HeLa HIV vpr cell and HeLa HIV vpr-FS cell, but the difference between HeLa HIV vpr-FS cell and control group was not obvious. Conclusion Recombinant plasmids pcDNA3.1-vpr and pcDNA3. 1-vpr-FS were constructed successfully, and the cell strain expressing HIV Vpr and HIV Vpr-FS proteins was established. The HIV Vpr could induce host cell apoptosis, while the mutant of Vpr did not or weakened this ability. This study provides foundation for further study on HIV vpr gene.