Acupuncture Analgesia ; Animals ; Central Nervous System ; metabolism ; Electroacupuncture ; Nitric Oxide ; metabolism ; Pain Threshold ; physiology ; Rats ; Rats, Wistar

Objective To investigate the expressions of intermedin /adrenomeduliin 2 (IMD/AM2) and its receptor calcitonin receptor-like receptor (CRLR) in the kidney of rats after renal ischemia reperfusion injury(IRI). Methods Male Wistar rats were divided randomly into two groups: sham group and operation group. Renal IRI model was induced by clamping both renal arteries. Blood and kidney were harversted at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after reperfusion, respectively. Renal histological changes were semi-quantitated. Expressions of IMD and CRLR in the kidney were detected by Western blot, and the content of IMD in serum was measured by radioimmunity at 12 h, 48 h, 72 h after repeffusion. Results Kidneys of renal IRI model rats displayed significant pathologic changes, and the changes were much severer at 48 h after reperfusion. The expressions of IMD and CRLR in kidney were significantly up-regnlated at 12 h, 48 h, 72 h after renal IRI (P<0.01). The level of IMD in serum increased at 12 h, 48 h, 72 h after renal IRI (P<0.05). Conclusion The expressions of IMD and its receptor are up-regulated in the kidney after renal IRI, which may participate in the pathophysiological changes induced by renal IRI.

Objective:To explore the amplitude of normal kidney motion in the 3D direction and its influencing factors under free-breathing condition.Methods:Clinical data of 28 patients with a KPS score≥80 who received 4D CT scan from March 2018 to March 2019 were collected. All patients were diagnosed with liver, pancreatic or lung tumors. The kidney was outlined and the geometric center and 3D coordinate values were recorded. The motion of bilateral kidneys in each direction and the 3D direction was calculated. The volume of kidney and surrounding organs, age, sex, height and body mass index (BMI) were recorded. Clinical data were statistically compared by t-test or nonparametric test. Results:The motion of the left and right kidneys in the the sup-inf (SI) direction were the largest up to (8.39±3.18) mm and (7.71±3.55) mm. The motion amplitudes of bilateral kidneys in male patients were significantly larger than those of the female counterparts in the left-right (LR), SI and 3D directions (all P<0.05). The motion amplitudes of bilateral kidneys in patients taller than 165 cm were significantly larger than those of their counterparts with a height of ≤165 cm (all P<0.05). Patients with a BMI≥25 kg/m 2 had significantly larger motion amplitudes of the left kidney in the LR and ant-post (AP) directions compared with those of normal weight counterparts (all P<0.05). The motion amplitude of the left kidney in the AP direction in patients with the left kidney volume of >180 cm 3 was significantly larger than that of patients with smaller left kidney volume ( P=0.014). Age was not significantly associated with kidney motion in each direction ( P>0.05). Conclusions:Kidney motion mainly occurs in the SI direction. The kidney motion amplitudes in male and taller patients are larger. Special attention should be paid to the use of breath motion control device to decrease the normal tissue damage.

Objective To investigate the relationship between calcific aortic valve stenosis and inflammatory cells in peripheral blood and dyslipidemia in elderly patients(age ≥65 years).Methods A total of 76 elderly patients(≥65 years old)diagnosed as calcific aortic stenosis in our hospital from June 2015 to June 2017 were selected as the case group,and 78 seniors(excluding valvular heart disease)hospitalized due to chest discomfort were selected as the control group.The white blood cell count (WBC), neutrophil ratio (N%), neutrophil count (N), lymphocyte count (L), neutrophil lymphocyte ratio (NLR),hypersensitive C-reactive protein(hs-CRP),N-terminal B-type natriuretic peptide(NT-pro BNP),total cholesterol (TC),triglyceride(TG),apo-α,high-density lipoprotein(HDL),low-density lipoprotein(LDL),very low-density lipoprotein (VLDL)and other indicators were tested on admission.All these indicators were compared between the two groups. Results The levels of WBC, N%,N,NLR, hs-CRP, NT-pro BNP,VLDL were higher in the case group than those in the control group.The levels of L and HDL were significantly lower in the case group than those of the control group(P<0.05).Multiple regression analysis showed that smoking, the increased hs-CRP and NT-pro BNP levels were independent risk factors for senile calcific aortic stenosis.Conclusion Senile calcific aortic stenosis is not a simple degenerative disease.It is closely related to systemic inflammatory response and abnormal lipid metabolism.

OBJECTIVETo analyze hepatotoxicity of Polygonum multiflorum and clinical character- istics of drug-induced liver injury (DILI) caused by Polygonum multiflorum and its preparations.

METHODSA retrospective study was performed in 158 patients treated at 302 Military Hospital between January 2009 and January 2014. All of them had used Polygonum multiflorum and its preparations before the onset of DILI, and their clinical characteristics and prognoses were analyzed.

RESULTSOf the 158 DILI patients who used Polygonum multiflorum or its preparations, 92 (58.2%) combined with Western medicine or Chinese herbal preparations without Polygonum multiflorum; 66 patients (41.8%) used Polygonum mult florum and its preparations alone. In 66 DILI patients induced by Polygonum multiflorum or its preparations alone, 51 cases (77.3%) were induced by Polygonum multiflorum compounds and 22.7% by single Po- lygonum multiflorum; 4 cases (6.1%) were caused by crude Polygonum multiflorum and 62 (93.9%) by processed Polygonum multiflorum and its preparations. Clinical injury patterns were hepatocellular 92.4% (61 cases), cholestatic 1.5% (1 case), and mixed 6.1% (4 cases). Pathological examination was per- formed by liver biopsy in 32 cases (48.15%), manifested as hepatocellular degeneration and necrosis, fibroplasia, Kupffer cells with pigment granule, and a large number of eosinophil infiltration, were ob- served. Four patients were developed into liver failure, 4 into cirrhosis, and 1 died.

CONCLUSIONPolygo- num multiflorum and its preparations could induce DILI, but clinical diagnosis of Polygonum multiflorum induced hepatotoxicity should be cautious.

Asian Continental Ancestry Group ; Chemical and Drug Induced Liver Injury ; diagnosis ; Cholestasis ; Drugs, Chinese Herbal ; adverse effects ; Fallopia multiflora ; Humans ; Liver Cirrhosis ; Liver Failure ; Plant Preparations ; adverse effects ; Polygonum ; Retrospective Studies

OBJECTIVETo analyze how the infection of human papillomavirus 16 (HPV16) affects expression of DNA polymerase beta (DNA polB) with the aim of probing the mechanism of over-expression of DNA polB in human cancers.

METHODSFour fragments of human DNA polB promoter were amplified and constructed into luciferase reporter vector pGL-Basic, generating pGL-BP, pGL-BMH, pGL-BMS, and pGL-BAT constructs respectively, and co-transfected with HPV16 or HPV6 into Hep2 cells. Luciferase activity was assayed 48 hours after transfection. Semi-quantitative RT-PCR was used to measure mRNA expression of endogenous DNA polB. Immunohistochemistry and in situ hybridization were used to analyze DNA polB expression and HPV16 or HPV6 infection in 38 cases of cervical lesions respectively.

RESULTSWith co-transfection of HPV16 and DNA polB promoter-driving reporters into Hep2 cells, pGL-BP reporter in full-length DNA polB promoter presented markedly elevated luciferase activities (P < 0.05). However, the other three mutant reporters: pGL-BMH, pGL-BMS, and pGL-BAT, generated no reporting activities in the presence of HPV16 (P > 0.05). On the contrary, all of polB promoter reporters were little stimulated in co-transfection of HPV6 (P > 0.05). The transfection of HPV16 could enhance the endogenous polB mRNA expression compared with that of HPV6 (3.42 vs. 0.80, P < 0.05). The DNA polB expression was found in 8 of 10 HPV16-positive cervical intraepithelial neoplasia grade III (CIN III) cases, while was only found in 3 of 11 HPV6-positive condyloma accuminatum cases, but was negative in all chronic cervicitis cases. The correlation of DNA polB expression with HPV16 infection in cervical lesions was significant (P < 0.05).

CONCLUSIONSHPV16 is able to specifically stimulate the expression of DNA polB in human epithelial cells through interaction with the core upstream regulatory sequences of DNA polB promoter. Over-expression of DNA polB might be an explanation for the molecular mechanism underlying HPV-related human cancers.

Cell Line ; DNA Polymerase beta ; genetics ; metabolism ; Female ; Gene Expression Regulation, Enzymologic ; Human papillomavirus 16 ; genetics ; metabolism ; Human papillomavirus 6 ; genetics ; metabolism ; Humans ; Papillomavirus Infections ; Promoter Regions, Genetic ; Uterine Cervical Neoplasms ; genetics ; pathology ; virology

The dosage-efficacy/toxicity relationship of the 50% alcohol extracts of Polygonum multiflorum was comparatively investigated on either normal or CCl4-induced chronic liver injury rats, by determining the general condition, serum biochemical indices and liver histopathology, coupled with the factor analysis. The dosages were 10 and 20 g raw materials per kg body weight. Compared with the normal control group, the normal high dose group showed significant increases of the serum alanine transaminase (ALT), total bilirubin (TBIL), high mobility group box 1 (HMGB-1) and interleukin-1β (IL-1β) (P < 0.05 or P < 0.01), as well the frequent incidences of inflammatory cell infiltration, hepatic sinus enlargement and fiber stripes formation in histopathological sections. Compared with the model control group, the model low dose group showed significant declines of serum ALT, aspartate transaminase (AST) and total bile acid (TBA) (P < 0.05), as well the alleviation of vacuoles of hepatocytes, but no amelioration of the inflammatory cell infiltration and fibrous tissue hyperplasia; moreover, the model high dose group showed significant degeneration declines of serum HMGB-1, tumor necrosis factor-α (TNF-α) and IL-1β (P < 0.05, P < 0.01), as well the evident alleviation of vacuoles degeneration of hepatocytes, inflammatory cells infiltration and fibrosis degree. The factor analysis showed that the low dosage treatment had almost neither injuring effect on the normal rats nor protective effect on the model rats; while the high dosage treatment showed observable injuring effect on the normal rats, expressed by the significant increases of the factor-1 (HMGB-1, TNF-α and IL-1β as the main contributors) and factor-2 (TBIL, ALT and TBA as the main contributors) relative to the normal control group. The liver protective effect of the high dosage treatment could be observed with the significant reduction of the factor-1, indicating the effective alleviation of the expression of inflammatory cytokines. In conclusion, it could illustrated the phenomenon of symptom-based prescription theory of Polygonum multiflorum on rat livers: the high dosage of the herb had either an injuring effect on normal rats, or a therapeutic effect on the rats with chronic liver injury.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Bile Acids and Salts ; metabolism ; Bilirubin ; blood ; Chemical and Drug Induced Liver Injury ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; Fallopia multiflora ; chemistry ; HMGB1 Protein ; metabolism ; Hepatocytes ; drug effects ; Interleukin-1beta ; metabolism ; Liver ; drug effects ; pathology ; Plant Extracts ; pharmacology ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

The clinical application of Chinese patent medicines has suffered sever problems and required guidelines for clinical practices. Currently, the expert consensus method is more suitable for formulating clinical practice guidelines of Chinese patent medicines than the evidence-based method. However, there remain problems in the application of the expert consensus method. This study proposed a derivative expert consensus method--a method for formulating clinical practice guidelines of common Chinese patent medicines based on clinical practices, and introduced the method in terms of research thought, methodology and implementation procedure.
Evidence-Based Medicine ; standards ; Humans ; Nonprescription Drugs ; standards

Objective To evaluate treatment strategies for fungal endocarditis after heart prosthetic valve surgery. Methods Two cases of severe fungal infection after heart prosthetic valves surgery were analyzed retrospectively, related literatures were reviewed.Results Two patients had fungal endocarditis after surgery,the valve function was affected,patients were hospitalized repeatedly after surgery.In case 1 ,fever occurred 45 days after cardiac sur-gery and patient was returned to the hospital for re-examination,emergency mitral valve replacement was performed under cardiopulmonary bypass,the postoperative vegetation culture suggested Aspergillus flavus.In case 2,the aortic wall vegetation was removed 5 months after heart surgery under cardiopulmonary bypass,pathology of post-operative vegetation suggested mucor.Two patients were promptly removed infection foci through surgery and trea-ted with standard antifungal agents,patient with Aspergillus infection died after rescue,and patient with mucor in-fection was cured,the latter was more powerful in antifungal therapy.Conclusion Prevention is the key to fungal endocarditis after heart prosthetic valve surgery,treatment should be prompt and effective,antifungal agents should be given in sufficient dose and course.

To explore the effects of extract of selenium-enriched Astragalus membranaceus(ESAM)on insulin resistance(IR)in streptozotocin(STZ)diabetic rats. In this study, type 2 diabetes mellitus(T2DM)was established; ESAM and pioglitazone were used to intervene T2DM model rats; the general condition of rats in each group was observed, and body weight and fasting blood glucose(FBG)were recorded before modeling and after modeling. At the end of the fourth week, the blood and liver tissues of each group were collected. The total cholesterol(CHOL), triglyceride(TG), high-density lipoprotein(HDL), low-density lipoprotein(LDL)in blood were detected by biochemical detector; ELISA was used to detected content changes of blood fasting insulin(FINS), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), C-reactive protein(CRP), interleukin-1β(IL-1β); Western blotting was used for the detection of insulin receptor substrate protein 1(IRS1), phosphorylated IRS1(p-IRS1), nuclear factor κB inhibitor kinase β(IKKβ), phosphorylated IKKβ(p-IKKβ), c -Jun N-terminal kinase(JNK), phosphorylated JNK(p-JNK)protein changes. Results showed that compared with the blank group, the body weight of the model group was significantly decreased. FBG, CHOL, TG, LDL, TNF-α, IL-6, CRP, IL-1β in the blood and p-IRS1, p-IKKβ, p-JNK in the liver was increased significantly; after intervention, pioglitazone, ESAM can reverse the body weight of the model rats and the changes of the above cytokines and proteins. In conclusion, ESAM can reduce the expression of inflammatory cytokines in T2DM rats, inhibit the increase of free fatty acids(FFA), decrease the activation of IKKβ and JNK phosphorylation in surrounding tissues, activate insulin pathway and improve the IR effect of T2DM.