Xixin [Asarum heterotropoides Fr. Schmidt Var mandshuricum ( Maxim ) kitag] is a Chinese drug which has a little toxicityas recorded in ancient Chinese medical books. It was demon-strated in this article that the toxicity of Xixin was caused by itsessential oil. When the mice were administered with Xixin oil and its decoction without oil in equal doses separately, the mortality rate for the oil group was 70%, whereas no death was observed in the group of decoction without oil. By synchronous recording the EKG and EEG of cerebral cortex, hippocampus and reticular formation of midbrain in the rabbits, it was revealed that the EKG underwent following changes after the administration of Xixin oil: fast wave of low amplitude→slow wave of high amplitude→slow wave of low amplit ude→burst-suppression pattern→electrical silence. EEG vanished after the electrical silence of cerebral cortex,hippocampus and midbrain reticular formation.The LD50 and ED50 of Xixin oil was calculated 27.0?0.4ml/kg and 18.3?0.8ml/kg respectively,safety coefficient 1.47, being significantly less than control drug sodium amytal.

OBJECTIVE:To provide reference for the medication safety in elderly patients with chronic diseases. METHODS:Elderly inpatients with chronic diseases and nursing staff in affiliated hospital of shaoyang medical college,from Mar. 2014 to May 2015 were randomly selected for a questionnaire survey to analyze the influential factors of drug safety and health education de-mand,and the difficulty sources of nursing staff in developing health education was explored. RESULTS:Totally 500 questionnaire was sent out to elderly patients with chronic diseases,500 were effectively received with effective recovery of 100%;and totally 200 were sent out to nursing staff,200 were effectively received with effective recovery of 100%. In the 500 surveyed patients, 193 had ADR,which was affected by age,educational background,monthly income,disease course,whether received health edu-cation,etc.(P<0.05),patients with older age,lower educational background and monthly income,longer disease course and no receiving health education showed higher incidence of ADR;the influential factors for health education demands included education-al background,occupational status,disease course,quality evaluation of nursing staff,etc.(P<0.05),patients with higher educa-tional background,lower disease course,higher occupational status and quality evaluation of nursing staff showed stronger health education demands. The difficulty sources of surveyed nursing staff in developing health education were busy work,being afraid of misunderstanding,embarrassing,cognitive and skill deficits. CONCLUSIONS:The drug safety of elderly patients with chronic dis-eases is related to many influential factors,as well as the health education demands. Nursing staff should continuously improve their ability and quality,combined with the above influential factors,carry out health education with physicians and pharmacists to ensure the medication safety.

Objective To compare the postoperative follow-up indexes of femoral popliteal artery bypass grafts and evaluate the sensitivity of vessel function test methods for the early detection of grafts restenosis.Methods 84 cases were followed-up after femoral popliteal graft bypass,using ankle brachial index (ABI),ABI decrease amplitude,and Duplex ultrasound to detect peak systolic velocity (PSV) and peak systolic velocity ratio (PSVR).All patients were divided into mild stenosis group (0-49％),moderate stenosis group (50％-74％) and severe stenosis group (75％-99％).Results ABI was 0.88 ±0.12,0.81 ± 0.10 and 0.52 ± 0.13;ABI decrease amplitude was 0.13 ± 0.06,0.12 ± 0.06 and 0.36±0.06;PSV(m/s) was 0.89 ±0.23,0.91 ±0.31 and 1.70 ±0.85,respectively.There was remarkable difference for ABI,ABI decrease amplitude and PSV between severe stenosis and mild to moderate stenosis group (P ＜0.05).PSVR was 1.00 ±0.08,2.14 ±0.31 and 3.58 ±0.31 respectively,in the three groups (P ＜ 0.05).Conclusion PSVR was more sensitive to detect grafts restenosis early than ABI,ABI decrease amplitude and PSV.

Objective To observe the pain behavioral performance of rats that different sensory nerve fibers were transected,and examine the expression of brain-derived neurotrophic factor(BDNF) in these models.Methods Twenty-four rats were divided into three groups according to random number table method:SUR group,GS group and SHAM group, which received sural nerve transection, gastrocnemius-soleus nerve transection or sham operation respectively.There were 8 rats in every group.The expression of BDNF in the lumbar 5 DRG and spinal dorsal horn were detected,and the types of damaged cells were also observed.Results In GS group, 50% paw-withdrawal thresholds were significantly decreased on the ipsilateral hind paw compared with baseline and with those in SHAM group,and the paw-withdrawal durations in response to the thermal stimulus increased significantly (P＜0.01 ＝.In contrast, no change was found in SUR group(P＞0.05 ).The expression of BDNF in the lumbar 5 DRG ( (37.87 ± 4.23 ) % ) and spinal dorsal horn ( (21.9 ± 3.1 ) % ) was significantly higher in GS group than in SHAM group( ( 17.31 ± 2.12 ) %, ( 12.6 ± 1.3 ) % ), and no significant difference was found between SUR and SHAM groups(P＞0.05 ).FG opposite cells which also expressed BDNF in GS group were more than those in SUR group ( (47.7 ± 1.8) % and (26.7 ± 2.3 ) % ) (P ＜ 0.01 ＝.The percentage in N200 and FG double positive cells to N200 positive cells in GS group was significantly increased in GS group than those in SUR group ( (47.7 ±1.8 ) %, (26.7 ± 2.3 ) % ) (P ＜ 0.01 ＝.Conclusion The data suggest that injury of the sensory nerve innervating skin does not produce hyperalgesia, but injury of the sensory nerve innervating muscle does.Different kinds of neuron were damaged and the differences of BDNF expression is essential for this difference.

Objective:To investigate the safety and reliability of endoscopic mucosal resection (EMR) in the treatment of gastrointestinal neuroendocrine tumors (GI-NETs) with a diameter of ≤10mm.Methods:From February 2015 to June 2019, 40 cases of gastrointestinal neuroendocrine tumors with a diameter of ≤10mm underwent EMR in Yantaishan Hospital of Yantai City were retrospectively analyzed to evaluate the safety and reliability of EMR surgery.Results:All 40 cases were performed endoscopically by EMR. The en bloc resection rate and RO resection rate reached 100%. The lesions were all confined to the submucosa and did not infiltrate the muscularis propria. Postoperative pathological classification: NET G1: 35 cases, NET G2 grade: 5 cases, no NET G3 grade cases. There were no complications such as bleeding and perforation during and after the operation. Follow-up: 1 case was lost to follow-up, 1 patient died of other diseases, and the remaining 38 cases were followed up for an average of 27.8 months (5-46 months) without local recurrence or distant metastasis.Conclusion:For well-differentiated G1 and G2 gastrointestinal neuroendocrine tumors with a diameter ≤10mm, EMR is a safe and reliable treatment.

Objective To analyze the relationship between collateral status and clinical manifestations or prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.Methods 181 patients with acute cerebral infarction in internal carotid arterial were selected.According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) standard,the degree of carotid stenosis was divided into 5 grades.All patients were divided into 3 subgroups according to the status of collateral circulation formation evaluated with the Regional Lepomeningeal Score(rLMC).The correlations were observed between the degree of carotid stenosis and the compensation level of collateral circulation,and the compensation level of collateral circulation and cerebral infarct volume,and the National Institute of Health Stroke Scale(NIHSS) on admission and the Activity of Daily Living(ADL) score at 3 months after stroke onset.Results The degree of carotid stenosis positively correlated with the compensation level of collateral circulation (r=0.724,P<0.01).The compensation level of collateral circulation negatively correlated with infarct volume (r=-0.313,P<0.01) and NIHSS score on admission (r=-0.504,P<0.01),but positively correlated with ADL score at 3 months after stroke onset (r=0.370,P<0.01).Diabetes was risk factor for the formation of moderate (OR=1.361,95%CI=1.145-1.902,P=0.029) collateral circulation,and hyperlipemia was risk factor for the establishment of moderate (OR=1.050,95%CI=1.011-1.219,P<0.01) or poor (OR=1.048,95%CI=1.010-1.225,P<0.01) collateral circulation.Conclusion The compensation level of collateral circulation positively correlates with the severity of carotid stenosis.Diabetes and Hyperlipemia are risk factors for the formation of collateral circulation.The improvement in the status of collateral circulation can significantly reduce infarct volume and improve prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.

Objective To investigate the role of nitric oxide (NO) in the protective effects of morphine postconditioning against ischemia-reperfusion (I/R)-induced myocardial apoptoais. Methods Sixty pathogen-free SD rats were randomly divided into 4 groups ( n = 15 each) : group Ⅰ sham operation (S) ; group Ⅱ I/R; group Ⅲ morphine postconditioning ( M ) and group Ⅳ M + L-NAME ( non-selective NOS inhibitor). The animals were anesthetized with intraperitoneal pentobarbital 60 mg/kg, tracheostomized and mechanically ventilated. ECG was monitored. Right carotid artery was cannulated for BP monitoring and left jugular vein was cannulated for drug and fluid administration. Myocardial ischemia was induced by 45 min occlusion of left anterior descending coronary artery (LAD) followed by 120 min reperfusion. In group S LAD was exposed but not occluded; in group M morphine 1.25 mg/kg was injected iv over 5 min from 3 min before reperfuaion to 2 min of repeffuaion and in group M + L-NAME L-NAME 10 mg/kg was injected iv at 20 min before myocardial ischemia. Hemodynamic changes were monitored. The animals were killed at the end of 120 min reperfusion and their hearts removed. Myocardial apoptosis was determined by TUNEL technique. The expression of Akt phosphorylation was assessed by Western blotting. The NO content in myocardium was measured by a chemiluminescence detector.Results A large number of TUNEL positive cells (18.4 ± 1.1 ) % were observed in group I/R. Morphine postconditioning exerted a significant anti-apoptotic effect. The number of TUNEL positive cells was reduced to (10.8 ± 1.2)%. The myocardial eNOS phosphorylation expression and NO content were significantly increased in group M as compared with group I/R. The anti-apoptofie effect and increased NO production were significantly reversed by L-NAME. However, pretreatment with L-NAME did not inhibit the phosphorylation of eNOS in group L + M. Conclusion In vivo, morphine postconditioning can significantly reduce I/R-induced myocardial apoptosis through phosphorylation of eNOS and increase in NO production.

Objective To investigate the effect of morphine postconditioning on myocardial ischemiarepedusion(I/R)injury and the role of PI3K/Akt signaling pathway in the effect.Methods Seventy male SD rats weighing 280-330 g aged 16-17 weeks Were randomly divided into 5 groups(n=14 each):group Ⅰ sham operation(S);group Ⅱ I/R;group Ⅲ morphine postconditioning(M);group Ⅳ morphine postconditioning+ wortmannin(W+M);groupV wortmannin(W).Myocardial I/R injury wa.g produced by occlusion of anterior descending branch of left coronary artery for 45 min followed by 120 min reperfusion.In group M and W+M (groupⅢ,Ⅳ)morphine 1.25 mCkg was given iv at 3 min before and 2 min after reperfusion.In group W+M and W(groupⅣ,Ⅴ)wortmannin(a specific PDK inhibitor)15μ/gkg Was given iv at 20 min before ischemia. The animals were sacrificed at the end of 120 min repedusion for assessment of ischemic and infarct area and determination of total and phosphorylated Akt expression in myocardium by Western blot.Results There were no significant differences in the size of ischemic area and total Akt expression among the 5 groups. The infarct area was significantly smaller in group M than in group I/R. The were no significant differenees in the size of infarct area between group 1/R, W + M and W (group Ⅱ , Ⅳ,Ⅴ ). The phosphorylated Akt expression was significantly upregulated in group I/R and M as compared with group S, and was significantly higher in group M than in group I/R.Conclusion The PI3K/Akt signaling pathway activation is involved in the protective effect of morphine posteondifioning on myocardium against I/R injury.

Objective To explore the correlation between mutations in the promoter region of TBX1 gene and conotruncal heart defects. Methods A total of 621 children with conotruncal heart defects were recruited. Multiplex ligation-dependent probe ampliifcation (MLPA) was used to detect the copy numbers of chromosomal region 22 q 11 . 2 . Children with 22 q 11 . 2 deletion were excluded. Polymerase chain reaction ampliifcation (PCR) and gene sequencing were applied to analyze promoter region of TBX 1 (-2000 ..+1 ) in 605 children with conotruncal heart defects without 22 q 11 . 2 deletion and 588 healthy children. Bioinformatics software was used to predict and analyze the function of the variable loci. Results There were mutations in the promoter region of TBX 1 gene in children with conotruncal heart defects, including 3 single nucleotide polymorphisms (SNP) sites and 7 rare loci. The incidence of mutation was 1 . 7%. The analysis of 7 rare loci by AliBaba 2 . 1 to showed that 3 of them may inlfuence the combination of trans-acting factors and cis-acting elements of the promoter of TBX 1 gene. Conclusion The mutation in the TBX 1 promoter region may be related to the occurrence of conotruncal heart defects.

AIM:To investigate the effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced injury of the mouse podocyte cell line MPC5.METHODS: The cultured MPC5 cells were randomly divided into 4 groups: HG group, normal glucose (NG) group, NG+DL-propargylglycine (PPG) group, and HG+NaHS group.After treated for a certain time, the cells were collected for further detection .The expression of zonula occludens-2 (ZO-2), nephrin,β-cate-nin and cystathionine γ-lyase ( CSE) was determined by Western blotting .RESULTS:High glucose significantly reduced the expression of nephrin, ZO-2 and CSE (P<0.05), while the level of β-catenin was elevated obviously (P<0.05), all in a time-dependent manner.NG+PPG inhibited the levels of ZO-2 and nephrin significantly (P<0.05), and increased the level of β-catenin (P<0.05), all in a PPG concentration-dependent manner.HG+NaHS induced a more significant increase in the levels of ZO-2 and nephrin as compared with HG group (P<0.01), whereas a severe reduction of β-cate-nin in HG+NaHS group was observed as compared with HG group .Compared with NG group , the expression of ZO-2 and nephrin was decreased obviously , and the level of β-catenin was increased in HG +NaHS group.CONCLUSION:Down-regulation of CSE contributes to hyperglycemia-induced podocyte injury .Exogenous H 2 S protects against hyperglycemia-in-duced podocyte injury , possibly through up-regulation of ZO-2 and subsequent suppression of Wnt/β-catenin pathway .