Objective To evaluate the effects of dexmedetomidine on the hemodynamics and the heart rate variability(HRV)in patients under-going lower limbs operations with application of tourniquet. Methods Forty patients undergoing lower limbs operations with application of tourni-quet were randomized assigned to dexmedetomidine group(group D,n=20)or control group(group C,n=20). After combined spinal-epidural anesthesia,group D received a continuous infusion of dexmedetomidine(0.5μg/kg for 10 min for loading dose and followed by 0.2μg·kg-1·h-1) until tourniquet deflation. The control group received normal saline instead. Mean arterial pressure(MAP),heart rate(HR),saturation of pulse ox-imetry(SpO2),low frequency power(LF),high frequency power(HF)and LF to HF ratio(LF/HF)were recorded at regular time points:imme-diately before loading dose(T0),before tourniquet inflation(T1),15 min after tourniquet inflation(T2),30 min after tourniquet inflation(T3),45 min after tourniquet inflation(T4),60 min after tourniquet inflation(T5),1 min after tourniquet deflation(T6),5 min after tourniquet deflation (T7)and 10 min after tourniquet deflation(T8). Results Compared with T0,the MAP of group D significantly decreased at T6-T8(P<0.05). Compared with T0 and T1,the MAP of group C increased at T2-T5(P>0.05). Compared with T2-T5,the MAP of group C significantly decreased at T6(P<0.05). Compared with group C,the MAP of group D significantly decreased at T6 and T7(P<0.05). Compared with T0,the HR of group D significantly decreased at T1-T8(P<0.05). Compared with T0,the HR of group C had no significant change at T1-T5(P<0.05). Compared with T1-T5,the HR of group D and group C significantly increased at T6(P<0.05). Compared with group C,the HR of group D significantly decreased at T1-T4 and T6(P<0.05). Compared with T0,the SpO2 of group D and group C significantly decreased at T6(P<0.05). Compared with group C,the SpO2 of group D significantly decreased at T1-T3(P<0.05). Compared with T6,LF of group D and group C significantly increased at T7(P<0.05). LF were comparable between groups D and C(P>0.05). Compared with T0,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Compared with group C,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Conclusion The appropriate dose of dexmedetomidine(loading dose 0.5μg/kg and maintenance dose 0.2μg · kg-1 · h-1)can significantly increase vagal tone and improve cardiac sympathetic and parasympathetic balance during tourniquet appli-cation.

Objective To observe the clinical curative effect of Gubenzhike granule on cough variant asthma (CVA), and explore its mechanism. Methods A total of 140 cases of CVA were randomly divided into two groups, 70 cases for each group. The treatment group took Gubenzhike granule orally, and the control group inhaled Budesonide Powder for Inhalation and Salbutamol Sulphate Aerosol, respectively for 8 weeks, with 8 weeks follow-up after treatment. The same nursing intervention was implemented in two groups. Cough symptom scores of the two groups were observed after treatment and at the end of follow-up, the number of eosnophils (EOS) and content of immunoglobulin E (IgE) in peripheral blood were also observed. Results The treatment group completed 67 cases and the control group completed 66 cases. After treatment, the cough symptom scores, EOS and IgE in two groups were significantly reduced (P<0.01, P<0.05), and the cough symptom score of treatment group decreased more significantly than that of control group (P<0.01). The total effective rate and recurrence rate were 91.04%and 9.84%in treatment group, and 83.33% and 30.91% in control group. The total effective rate of treatment group was better than the control group (P<0.01), and the recurrence rate was lower than the control group (P<0.01). Conclusion Gubenzhike granule showed significant effect and low recurrence rate on CVA. Good anti-inflammatory and antianaphylaxis effects may be one of its mechanisms.

OBJECTIVETo observe the regulatory effect of Bushen recipe (BSR) on immune function in patients with chronic hepatitis B.

METHODSThirty patients with HBeAg+ and abnormal alanine transaminase (ALT) level were treated with BSR for 6 months. The following parameters before treatment, 3 months and 6 months after treatment were tested: (1) HBV DNA by fluorescence quanitiative PCR; (2) Levels of interleukin-10 (IL-10) and interferon-gamma in supernatant of cultured peripheral blood mononuclear cell (PBMC) after had been cultured with HBeAg, HBcAg and phytohemagglutinin (PHA) for 48 hrs; (3) Blood levels of T-cells, including CD4+ , CD8+ , CD8+ CD28+ , CD8+ CD28- and CD28+ , and their ratio, as well as the percentage of CD8+ CD28+ in the cell culture after being co-cultured with PHA for 48 hrs.

RESULTSIn patients effectively treated by BSR, after 3 months treatment, level of IFN-gamma in PBMC culture significantly increased, CD8+ CD28+ , CD28+ T-cells significantly enhanced and IL-10 and CD8 + CD28+ T-cells significantly decreased (P < 0.05, P < 0.01).

CONCLUSIONBSR could significantly strengthen the expression of Th1 type cytokine, decrease the expression of Th2 type cytokine and promote the expression of CD8+ cytotoxic T-lymphocyte, which may be one of mechanisms in suppressing HBV DNA replication.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; isolation & purification ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interleukin-10 ; blood ; Male ; Middle Aged ; Phytotherapy ; T-Lymphocyte Subsets ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Virus Replication ; drug effects

OBJECTIVETo evaluate the ability of Biopure MTAD in removing smear layer in vitro.

METHODSForty extracted single-rooted human teeth were randomly divided into five groups: Distilled water in group A, 5.25% NaClO and 17% EDTA in group B, 1.3% NaClO in group C, 1.3% NaClO and Biopure MTAD in group D, 1.3% NaClO and 3% EDTA in group E. The canals were prepared and irrigated with one of the five different irrigating agent respectively. The amount of smear layer and erosion on the surface of the root canal walls were examined with scanning electron microscope.

RESULTSThe whole surfaces of root canals in group A and C were covered by smear layer. The surfaces of root canals in the coronal and middle thirds of samples in group B, D, E were free of smear layer (P>0.05) and the apical third of canals in the group D were significantly cleaner (P<0.05) than that in group B and E. The coronal and middle sections were significantly eroded in group B compared with group D and E (P<0.05). The degree of erosion in the apical section was not statistically different among group B, D and E (P>0.05).

CONCLUSIONBiopure MTAD and 1.3% NaClO are effective irrigating agents for removal of the smear layer on the surface of root canal. There is no significant change in the structure of the surface of root canal.

Citric Acid ; Doxycycline ; Edetic Acid ; Humans ; In Vitro Techniques ; Microscopy, Electron, Scanning ; Polysorbates ; Root Canal Irrigants ; Root Canal Preparation ; Root Canal Therapy ; Smear Layer ; Tooth Root

Objective To explore the efficacy of non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma (T-LL). Methods 3 T-LL patients achieving complete remission received haploidentical bone marrow stem cell transplantation with granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow grafts from related donor without T-cell depletion. Two of them received a myeloablative conditioning regimen consisting of high-doses of cyclophosphamide and cytarabine with total body irradiation, whereas the other was preconditioned with busulfan, cyclophosphamide and cytarabine. All patients received strengthened phophylaxis regimen including rabbit anti-thymocyte globulin against acute graft-versus-host disease. Results All patients had rapid hematopoietic engraftment with the median time for neutrophil and platelet recovery being 12 days and 13 days, respectively. They are still alive without relapse at a median follow-up of 24 months (range: 9-75 months). Conclusion Treatment related toxicity can be acceptable in non-T cell depletion haploidenfical hematopoietic stem-cell transplantation for T-LL and the patients may achieve long term survival.

To explore influence of Xinmailong injection on cardiac function and vascular endothelial func‐tion in advanced aged patients with acute myocardial infarction (AMI) heart failure (HF).Methods : A total of 122 advanced aged AMI‐HF patients treated in our hospital from Mar 2015 to Jul 2017 were selected ,randomly and e‐qually divided into routine treatment group (received routine anti‐HF medication ) and Xinmailong group (received Xinmailong injection based on routine treatment group ) ,both groups were treated for 10d and then followed up for six months .LVEF ,wall motion score index (WMSI) ,serum levels of BNP , hsCRP , cTnI ,nitric oxide (NO) ,en‐dothelin (ET)‐1 and inner diameter of brachial artery were observed and compared between two groups before and after treatment .Results : Compared with before treatment ,there were significant rise in LVEF [routine treatment group : (35.42 ± 5.11)% vs. (44.62 ± 5.88)%;Xinmailong group : (36. 13 ± 5.64)% vs. (49.75 ± 6. 18)%] and serum NO level [routine treatmentgroup : (108. 35 ± 21.67) μmol／L vs. (129.68 ± 25. 83 ) μmol／L ; Xinmailong group : (110.26 ± 22.71) μmol／L vs. (156.82 ± 24. 19) μmol／L] ,and significant reductions in WMSI [routine treatment group : (2.49 ± 0.51) score vs. (1.45 ± 0.34) score ; Xinmailong group : (2.51 ± 0.42) score vs. (1. 12 ± 0.27) score] ,NYHA class (routine treatment group :3.19 ± 0. 44 vs. 2.65 ± 0.36 ;Xinmailong group :3. 21 ± 0.42 vs. 2.11 ± 0.28) ,serum levels of BNP [routine treatment group : (986. 72 ± 245.63 ) pg／ml vs. (764.42 ± 217.33) pg／ml ; Xinmailong group : (989.99 ± 243. 54 ) pg／ml vs. (607. 82 ± 198. 65 ) pg／ml ] , hsCRP [routine treatment group : (24.31 ± 3.82) mg／L vs. (14.52 ± 1. 69 ) mg／L ; Xinmailong group :(24.93 ± 3.74) mg／L vs. (7. 81 ± 0. 96) mg／L] ,cTnI [routine treatment group :(5.29 ± 0.43) μg／L vs. (3.01 ± 0. 27) μg／L ;Xinmailong group :(5.37 ± 0.64) μg／L vs. (1.42 ± 0.33) μg／L ] and ET‐1 [routine treatment group :(95. 67 ± 16. 32) ng／L vs. (76. 34 ± 17.82) ng／L ;Xinmailong group :(96.13 ± 17.21) ng／L vs. (57.29 ± 14. 63) ng／L] in two groups ;and LVEF and serum NO level of Xinmailong group were significantly higher than those of routine treatment group , WMSI ,NYHA class ,serum levels of BNP ,hsCRP ,cTnI and ET‐1 of Xinmailong group were significantly lower than those of routine treatment group , P＝0.001 all.Compared with before treatment ,there were significant rise in reactive hyperemia brachial diameter (Dhyperemia ) , fore brachial artery endothelium dependent diastolic‐systolic function (FMD) in Xinmailong group after treatment , and they were significantly higher than those of routine treatment group , P＜0. 05 or ＜0. 01 .Conclusion : Xinmailong injection can significantly improve cardiac function and vascular endothelial function in AMI‐HF patients ,which is worth extending .

Four impurities were isolated from raw material of clindamycin phosphate (CP), and their structures have been determined. LC-MS was used to determine the molecular weights of the impurities in the raw material of CP. Reversed-phase preparative HPLC was used to prepare them, and their chemical structures were identified by HR-MS and NMR. The four unknown impurities were determined as clindamycin-B-phosphate (1), clindamycin-2,4-diphosphate (2), 3',6'-dehydro clindamycin phosphate (3), epi-clindamycin phosphate (4). Impurity 1 has been included in BP and EP, while 2, 3 and 4 have not. The impurities 2, 3, 4 are first separated from raw material of CP.
Anti-Bacterial Agents ; chemistry ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Clindamycin ; analogs & derivatives ; chemistry ; Drug Contamination ; Molecular Structure ; Molecular Weight ; Spectrometry, Mass, Electrospray Ionization

A case of adrenal ganglioneuroblastoma is presented here. This adrenal ganglioneuroblastoma was found in a 27-year-old female 7 months after delivery. CT clarified that the tumor originated retroperitoneally and was large in size (11.4 cm x 9.4 cm). The tumor was surgically removed together with pancreatic body and tail, left kidney and spleen, and pathological diagnosis was adrenal ganglioneuroblastoma-intermixed. Adrenal ganglioneuroblastoma is extremely rare in adults, with only about 9 cases documented including this case.
Adrenal Glands ; Adult* ; Diagnosis ; Female ; Ganglioneuroblastoma* ; Humans ; Kidney ; Spleen ; Tail

BACKGROUNDFolic acid is very important for embryonic development and dihydrofolate reductase is one of the key enzymes in the process of folic acid performing its biological function. Therefore, the dysfunction of dihydrofolate reductase can inhibit the function of folic acid and finally cause the developmental malformations. In this study, we observed the abnormal cardiac phenotypes in dihydrofolate reductase (DHFR) gene knock-down zebrafish embryos, investigated the effect of DHFR on the expression of heart and neural crest derivatives expressed transcript 2 (HAND2) and explored the possible mechanism of DHFR knock-down inducing zebrafish cardiac malformations.

METHODSMorpholino oligonucleotides were microinjected into fertilized eggs to knock down the functions of DHFR or HAND2. Full length of HAND2 mRNA which was transcribed in vitro was microinjected into fertilized eggs to overexpress HAND2. The cardiac morphologies, the heart rates and the ventricular shortening fraction were observed and recorded under the microscope at 48 hours post fertilization. Whole-mount in situ hybridization and real-time PCR were performed to detect HAND2 expression.

RESULTSDHFR or HAND2 knock-down caused the cardiac malformation in zebrafish. The expression of HAND2 was obviously reduced in DHFR knock-down embryos (P < 0.05). Microinjecting HAND2 mRNA into fertilized eggs can induce HAND2 overexpression. HAND2 overexpression rescued the cardiac malformation phenotypes of DHFR knock-down embryos.

CONCLUSIONSDHFR plays a crucial role in cardiac development. The down-regulation of HAND2 caused by DHFR knock-down is the possible mechanism of DHFR knock-down inducing the cardiac malformation.

Animals ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; physiology ; Female ; Heart ; embryology ; Heart Defects, Congenital ; etiology ; Tetrahydrofolate Dehydrogenase ; genetics ; physiology ; Zebrafish ; Zebrafish Proteins ; genetics ; physiology

Objective To investigate the efficiency and safety of allogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 yeas of age. Methods From May 2002 to January 2010, 35 patients (＞ 50 years) with malignant hematological diseases received allogeneic hematopoietic cell transplantation. In 35 patients, 18 patients were conditioned with non-myeloablative regimen and 17 patients with myeloablative regimen. The outcome,engraftment and prognosis of allogeneic hematopoietic cell transplantation were analyzed. Results The hematopoetic reconstitution was achieved in 32 of 35 patients. The median time of granulocyte count exceeding 0. 5 × 109/L was 12 days and the that of platelet count exceeding 20 × 109/L was 17days. The cumulative incidence of aGVHD was 48. 6 %, and 37. 9 % patients developed cGVHD.The estimate probability of cumulative survival at 5 years was 48. 5 %, The estimate probability of cumulative mortality rate was 51.5 %, and the estimated transplant-related mortality was 22. 9 %.The relapse rate was 11.4 %. There was significant difference except for the incidence of cGVHD.Conclusion Allogeneic hematopoietic cell transplantation may be appropriate for older patients with malignant hematological diseases.