BACKGROUND: Buyanghuanwu decoction is a kind of commonly used Chinese herb in clinic for ischemic cerebrovascular disease, but its mechanisms have been unknown.OBJECTIVE: To observe effect of Buyanghuanwu decoction and its decomposed formulas on the levels of nerve apoptotic cells and expressions of Bcl-2 and Bax of brain in the ischemia/reperfusion model of SD rats and its mechanisms, study the significance of formula compatibility.DESIGN: Randomized controlled animal experiment.SETTING: Department of Neurology, First Affiliated Hospital, Henan College of Traditional Chinese Medicine.MATERIALS: The experiment was performed in 3rd Grade Laboratory of State Administration of Traditional Chinese Medicine, Henan Academy of Chinese Medicine. Totally 60 clean-grade SD rats aged 4-5 months, male and female (half and half), with the body mass of 260-310 g in females and 280-330 g in males were employed in the experiment, provided by Shanghai SIPPR/BK Experimental Animal Co., Ltd. In blood activation group, 120 g danggui (Radix Angelicae Sinensis), 60 g taoren (Semen Persicae), 60 g chuanxiong (Szechwan Lovage Rhizome) were selected, and then water 1 440 mL was added and volatile oil was extracted for reserving. 120 g chishao (Radix Paeoniae Rubra), 60 g dilong (Lumbricus), 60 g honghua (Flos Carthami) and 1 440 mL water were added to the gruffs and extract, and then filtered after 1 hour decoction, added 2 880 mL water to the gruffs again, decocted for 1 hour and filtered. The decocted liquid was merged and condensed to 1 200 mL, and then we get it by adding volatile oil and tween -80 3 mL and misce bene. In huangqi (Radix Astragaliseu Hedysary) group, 1 200 g huangqi was selected and 7 200 mL water was added, decocted twice, every time for one hour, and then filtered and the decoction was merged, concentrated to 600 mL, obtained by addition of tween-80 2 mL. In Buyanghuanwu decoction group, 60 g danggui (Radix Angelicae Sinensis), 30 g taoren (Semen Persicae), 30 g chuanxiong (Szechwan Lovage Rhizome) were selected, 720 mL water was added, and volatile oil was extracted for reserving. 1 200 g huangqi (Radix Astragali),60 g chishao (Radix Paeoniae Rubra), 30 g dilong (Lumbricus), 30 ghonghua (Flos Carthami) and 920 mL water were added in the gruffs and extract, and then filtered after 1-hour decoction. 8 640 mL water was added in the gruffs again, decocted for 1 hour and filtered, and then the decocted liquid was merged and condensed to 600 mL, then we get it by adding volatile oil and tween -80 3 mL and misce bene (huangqi group and blood activation group was the decomposed formulas of Buyanghuanwu decoction group). The 1 mL drug in blood activation group was equal to 0.4g raw herbs, 1 mL huangqi (Radix Astragali) in the huangqi group to 2 g raw herbs, and the drug in the general formula group to 2.4 g raw herbs.METHODS: A total of 60 SD rats of clean grade were randomly assigned into sham operation group, model group, blood activation group, huangqi group and general formula group with 12 in eachgroup. The medicine was applied by gastric perfusion at the dosages of 8 g/kg, 40 g/kg and 48 g/kg in blood activation group, huangqi group and general formula group successively; and 20 mL/kg saline was applied in both sham operation group and model group. The models of cerebral ischemia/reperfusion were prepared by four vessel ligature method. Apoptotic cells were determined with TDT-mediated dUTP biotin nick ending labeling (TUNEL). Expressions of Bcl-2 protein and Bax protein were measured with immunohistochenical method.MAIN OUTCOME MEASURES: ①Comparison of apoptotic levels of neurons in brain tissues of SD rats in each group; ②Comparison of expressions of Bcl-2 and Bax positive cells in neurons of brain tissue of SD rats in each group.RESULTS: ①Comparison of neuron apoptotic level of brain tissues in SD rats of each group: Compared with the sham operation group, the apoptosis increased in other groups (t=6.07-11.70,P＜0.01). Compared with the model group, the apoptosis decreased in the blood activation group and huangqi group (t=2.71, 2.06, P＜0.05), and decreased obviously in the general formula group (t=5.34, P＜0.01 ). ②Comparison of Bcl-2 and Bax positive cells in the neurons of brain tissues in SD rats of each group:Compared with the sham operation group, the expression of Bcl-2 staining positive cells increased in the blood activation group, huangqi group and general formula group (t=4.59-8.82,P＜0.01 ), and the expression of Bax positive cells became very significant (t=4.59-8.55,P＜0.01 ). Compared with the model group, the expression of Bcl-2 staining positive cells increased in the blood activation group, huangqi group and general formula group (t=3.48-7.75,P＜0.01 ), and the expression of Bax positive cells decreased (t=3.83-5.88,P＜0.01 ). There was no significant difference between the blood activation group and huangqi group (P＞0.05). There were significant differences in the drug effect of general formula group with huangqi group and blood activation group (P＜0.01).CONCLUSION: Buyanghuanwu decoction and its decomposed formulas act on being against the cerebral ischemia/reperfusion injury achieved by inhibiting cell apoptosis. Synergism of huangqi group and blood activation group leads to the strongest curative effect of general formula group.

BACKGROUND: There are various mechanisms on the occurrence of cerebral vascular disorders,in which,free radical and lipid peroxidation have participated in the process of nerve cell injury after cerebral ischemia. Buyang huanwu tang is a kind of commonly used Chinese herb for the treatment of ischemic cerebral vascular disorders,but its mechanisms have been unknown.OBJECTIVE: To observe effect of buyang huanwu tang and its disassemble formulas on the levels of superoxide dismutase(SOD),malondialdehyde (MAD) and nitric oxide(NO) in serum and brain tissue in cerebral ischemic reperfusion model in rats,probe into its mechanisms and study on the significance of formula compatibility.DESIGN: Experimental study with randomized control based on experimental.animals.SETTING: Neurological internal department of one hospital affiliated to an institution of Chinese medicine.MATERIALS: The experiment was performed in 3rd Grade Experimental Room of State Administration of Traditional Chinese Medicine,Henan Academy of Chinese Medicine. Sixty clean-grade SD rats were employed in the experiment,provided by Shanghai SIPPR/BK Experimental Animal Co. Ltd.INTERVENTIONS: Sixty rats were randomized into sham-operation group,model group,huangqi(Radix Astragali seu Hedysari) group and general formula group. The model of cerebral ischemic reperfusion in SD rats were prepared by four vessel ligature method,in which,the medicine was applied at the dosages of 8 g/kg,40 g/kg and 48 g/kg in blood activation group,huangqi(Radix Astragali seu Hedysari) group and general formula group successively; and physiological saline 20 mL/kg was applied in both sham-operation group and model group. Serum and homogenate in brain tissue were collected to assay SOD with xanthine oxidase method,MAD with thiobarbituric acid method and NO with nitrate reductase method.MAIN OUTCOME MEARSURES: Levels of SOD,MAD and NO in serum and brain tissue of rats in every group.RESULTS: The levels of MAD and NO in serum and brain tissue in model group were remarkably increased(P ＜ 0.001-0.05) and SOD was remarkably decreased(P ＜ 0.05,P ＜ 0.01) .In general formula group,huangqi (Radix Astragali seu Hedysari) group and blood activation group of disassemble formulas,the levels of MAD and NO were reduced and SOD was increased,for which,the action of general formula group was the strongest ( P＜ 0.01).CONCLUSION: Buyang huanwu tang and disassemble formulas act on being against the cerebral ischemic reperfusion injury achieved by anti-free radical.

0.05).Compared with Radix Astragali and blood-activating drugs,Buyang Huanwu Decoction have notable effect(P

BACKGROUND: Previous studies have demonstrated that Yiqihuoxue recipe (Buyanghuanwu decoction) can inhibit cell apoptosis and antagonize free radical injury in cerebral ischemia/reperfusion models. However, there have been few reports regarding the effects of Yiqihuoxue recipe on stem cell differentiation. OBJECTIVE: To observe the effects of Yiqihuoxue recipe on the differentiation of rat bone marrow mesenchymal stem cells (MSCs) towards neurons. DESIGN, TIME AND SETTING: The present controlled observational expedment based on cells was performed at the Henan University of Traditional Chinese Medicine, i.e., the Third-Grade Laboratory of the State Administration of Traditional Chinese Medicine between March 2006 and February 2008.MATERIALS: Twenty clean Sprague-Dawley (SD) rats, aged 1-2 months, weighing 100-150 g, of either gender, were included in this study. The Chinese medicine compound Yiqihuoxue recipe was made in the Manufacturing Laboratory of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine as follows. 60 g Danggui (Radix Angelicae Sinensis), 30 g Taoren(Semen Persicae), 30 g Chuanxiong(Szechwan Lovage Rhizome) were selected and mixed in 720 mL water for extract volatile oil for later use. The remaining gruffs and extract were supplemented with 1 200 g Huangqi(Radix Astragali), 60 g Chishao (Radix Paeoniae Rubra), 30 g Dilong(Lumbricus), 30 g Honghua(Flos Carthami) before 920 mL water was added. After I hour of decoction and filtering, the gruffs were decocted for another 1 hour after adding 8 640 mL water. Then all decocted liquid was merged and condensed to 600 mL and mixed with 3 mL of volatile oil and tween-80. After high-temperature and high-pressure stedlization, the products were preserved for future use. 1 mL of drug was equal to 2.4 g raw herbs. METHODS: Bone marrow mononuclear cells were isolated by density gradient centrifugation. After culture, bone marrow MSCs were amplified and purified. Passage 10 cell suspension was inoculated into a 40 mm-diameter plastic culture dish. Dulbecco's modified eagle's medium supplemented with 0.1 volume fraction of fetal bovine serum and basic fibroblast growth factors was added for 24 hours of culture when adherent cells reached 60%-90% confluence in each group. Thereafter, the "Yiqihuoxue" group was incubated for 5 hours using medium containing DMSO, butylated hydroxyanisole, 13-mercaptoethanol, and Yiqihuoxue recipe; simultaneously, the control group was treated for 5 hours with fluid containing DMSO, butylated hydroxyanisole, and β- mercaptoethanol.MAIN OUTCOME MEASURES: Identification of bone marrow MSCs by flow cytometry; Detection of Nestin-, and neuron specific enolase(NSE)-, and glial fibrillary acidic protein(GFAP)-positive expression by immunohistochemistry. RESULTS: Flow cytometery results demonstrated that cell surface marker CD90 and CD106 expression was positive, while CD45 and CD34 expression was negative. Immunohistochemistry results showed that the numbers of Nestin-positive cells (1 and 3 hours after induction) and NSE- and GFAP-positive cells (5 hours after induction) were significantly greater in the Yiqihuoxue group than in the control group (P < 0.01). CONCLUSION: Yiqihuoxue recipe can induce the differentiation of bone marrow MSCs towards neurons in vitro.

BACKGROUND:When acute cerebral ischemia attacks, matrix metaloproteinases (MMPs) lead to the occurrence of cerebral edema through degrading the extracelular matrix, breaking the close connection between endothelial cels, increasing the permeability of capilaries, and destroying the blood brain barrier.
OBJECTIVE: From the aspects of MMPs and extracelular matrix, to discuss the therapeutic effects ofbuyang huanwu decoction combined with bone marrow mesenchymal stem cel (BMSCs) transplantation on cerebral ischemia-reperfusion injury.
METHODS:A total of 96 Sprague-Dawley rats were randomly divided into model group, tissue inhibitor of MMPs-1 (TIMP-1) group, TIMP-1+BMSCs group (BMSCs group) andbuyang huanwu decoction+BMSCs+TIMP-1 group (combined group that was divided into four subgroups, 12-, 24-, 36-, 48-hour groups). Rat models of cerebral ischemia-reperfusion were constructed, and TIMP-1 and BMSCs were injected to the brain of rats by a microinjector in a stereotaxic apparatus. Rats in the combined group were given buyang huanwu decoction (10 mL/kg), and rats in the other groups were given the same volume of normal saline at 7 days before surgery. After 10 days of administration, serum samples and brain tissues were colected to determine MMP-2 and MMP-9 levels using ELISA and to detect MMP-9 activity using gelatinases spectrometry method.
RESULTS AND CONCLUSION:Compared with the model group, the levels of MMP-2 and MMP-9 in the serum and MMP-9 activity in the brain were decreased in the other groups to different extents, especialy the levels of MMP-9 (P < 0.05). Compared with the BMSCs group, the levels of MMP-2 and MMP-9 in serum as wel as activities of MMP-9 and pro-MMP-9 in the brain were decreased significantly in the combined group at 36 and 48 hours after treatment (P< 0.01). The results show that thebuyang huanwu decoction can be mutualy cooperated with TIMP-1 to inhibit the degradation of extracelular matrix induced by MMP-2 and MMP- 9, repair the damaged blood brain barrier, prevent and cure cerebral edema after ischemia.

Objective To analyse the survival time and related factors of patients with brain stem glioma who received 3DCRT.Methods Thirty-six patients with brain stem tumor were admitted from October 2004 to December 2008 and all received 3D-CRT with the dosage (50-54 Gy,25-30 f,5-6 weeks).During treatment,the patients’ outcomes were analyzed by observing the changes of symptoms,signs and adverse radiotherapy reaction and all of them were followed-up in the next 3 years.The survival data were analyzed by Kaplan-Meire method.Results The median survival time was 9 months in the 23 pediatric patients and 15 months in 13 adult patients.One-,two-and three-year survival rates between pediatric group and the adult group were 43.5 ％ (10/13) vs 76.9 ％ (10/13),26.1％ (6/23) vs 46.2 ％ (6/13),8.7 ％ (2/23) vs 38.5 ％ (5/13).Karnofsky performance scale score at admission (x2 =20.059,P =0.000),tumor site (x2 =17.585,P =0.000),growth pattern (x2 =21.247,P =0.000) were associate with survival time.Conclusion 3DCRT is an effective therapy to brain stem glioma,childhood onset,pontine glioma,diffusion style and Karnofsky performance scale less than 80 are risk factors of poor prognosis.

BACKGROUND:Previous studies have found that combined use of Buyang Huanwu decoction and bone marrow mesenchymal stem cel (BMSC) transplantation can play a synergic role against cerebral ischemia injury. OBJECTIVE:To analyze the effect of Buyang Huanwu decoction combined with BMSC transplantation to promote angiogenesis after cerebral ischemia. METHODS:Ninety-six Sprague-Dawley rats were randomly divided into four groups, and used to make middle cerebral artery occlusion models. In combined group, rats were given intragastrical administration of Buyang Huanwu decoction 10 mL/kg once a day, beginning at 3 days prior to modeling, and then given intragastrical administration of Buyang Huanwu decoction once at 2 hours after modeling, fol owed by its intragastrical administration every 12 hours. In BMSC and combined groups, BMSC suspension was injected into the rat ventricle after 2-hour cerebral ischemia/2-hour reperfusion, and then 30 minutes later, CD34 and CD45 antibodies were injected. In antibody group, CD34 and CD45 antibodies were injected. In model group, only normal saline was given. SerumαVβ3 level detection, immunohistochemical observation, Q-PCR and western blot tests were performed in the combined group at 12, 24, 36, 48 hours after reperfusion, while these indices were detected in the other three groups at 36 hours after reperfusion. RESULTS AND CONCLUSION:(1) The level of serumαVβ3 was lower in the antibody group than the model group (P<0.05), higher in the BMSC and combined groups than the antibody group (P<0.05), and higher in the combined group than the BMSC group (P<0.05). (2) Immunohistochemical findings showed that compared with the antibody group, the number of CD34 positive cel s was higher in the model, BMSC and combined groups (P<0.05). (3) Results from the Q-PCR and western blot assay showed that compared with the model group, the pFAK protein expression level was lower in the antibody and BMSC group, but FAK gene expression level had no overt changes;while the protein levels of FAK (24 hours after reperfusion) and pFAK (12 hours after reperfusion) were significantly increased in the combined group than the antibody and BMSC groups (P<0.05, P<0.01). Moreover, this increase exhibited a gradual y rising trend with the extension of reperfusion time. To conclude, the combined use of BMSC transplantation and Buyang Huanwu decoction can reverse the effect of CD34+CD45 antibodies that lead to the decrease in the number of vascular endothelial cel s and levels of integrinαVβ3 and downstream signaling molecules, thereby to promote angiogenesis in the MCAO model.

Objective To evaluate the therapeutic effects of thymectomy in myasthenia gravis (MG) patients with thymoma.Methods A total of 178 MG patients with thymectomy between July 2008 and December 2010 were included.All the subjects were received either cyclophosphamide alone or in combination with radiotherapeutic treatment after surgery.The MG absolute and relative clinical scores were used to assess the effectiveness of long-term trcatments.Clinical evaluations were conducted before,and at 1,6,12 and 24 months after operation.A comparative analysis on the inter-relationships among MG clinical presentation,WHO histology aud Masaoka stage was also conducted.Results (1) Of the 178 thymomapatients,103 were male and 75 were female,with a mean age of (43.7 ± 12.5)-years old.One hundred and twelve cases were taken cyclophosphamide,and 58 cases with invasive thymoma (stages Ⅱ,Ⅲ and Ⅳ or WHO type B3) were taken cyclophosphamide in combination with radiotherapy.Five patients refused cyclophosphamide or radiotherapy and 3 did not finish treatment.(2) The muscular strength improved obviously in 32.8％ (58/177) of the patients after 1 month after thymectomy,and 59.8％ (101/169),69.7％ (115/165) and 81.5％ (132/162) after 6 months,1 year and 2 years,respectively with MG score for disease severity decreased significantly with time.(3) No significant differences of the improvement rates were observed in patients within different WHO histology category.However,the rates were much higher in patients with Masaoka stage Ⅰ (91.4％) and stage Ⅱ (89.8％) than those in patients with stage Ⅲ (45.5％) and Ⅳ(28.6％) (all P＜0.001).Conclusions The remission rate of MG patients with thymomas increase after thymectomy plus cyclophosphamide or in combination with radiotherapy and reached 81.5％ after 2 years.The remission rate is associated with Masaoka stagc,but not with WHO histology.

Objective To survey the anxiety status of university students in Xuzhou city ,and to analyze its influence factors to propose the effective improvement strategy .Methods The stratified cluster random sampling method was adopted to conduct the questionnaire survey on 1931 college students from 2 colleges in Xuzhou City .The statistical analysis was performed by using SPSS 16 .0 .Results The average score of anxiety in college students was (42 .23 ± 9 .70) points ,the total detection rate was 21 .4% .The main influencing factors of anxiety included the home ranking ,character ,specialty ,school record ,getting scholarship ,plan to partici-pate in graduate entrance examination ,employment prospect ,sleep quality ,physical condition ,relationship with classmates and ro-ommates ,love status ,work-study programs or go out to work situation ,family type ,communication with parents ,family income . Conclusion The anxiety status of college students in Xuzhou City is in middle level .So improving the college students′anxiety sta-tus needs the joint efforts of school ,family and students themselves .

Objective To observe the clinical characteristics in schoolchildren diagnosed with allergic rhi-nitis(AR)and nonallergic rhinitis(NAR)three years ago,and to compare the prevalence of asthma and chronic cough among them and the impacts of AR and NAR on the quality of life. Methods Totally 146 AR children and 108 NAR ones diagnosed between September 2013 and March 2014 were surveyed using a questionnaire by tele-phone and all the children were not complicated with chronic cough and asthma. The statistical analysis was per-formed by a professional statistician using SPSS 12.0 statistical software. Results A total of 111 questionnaires were completed in AR group and 76 in NAR group. The prevalence of asthma was 11.7%(13/111)in AR group while 6.6%(5/76)in NAR group and there was no statistically significant difference(χ2=1.366,P=0.242). The prevalence of chronic cough was 26.1%(29/111)in AR group and 13.2%(10/76)in NAR group and there was sta-tistically significant difference(χ2=4.596,P=0.032). The score of rhinitis visual scale(VAS)and rhinoconjunc-tivitis quality of life questionnaire(RQLQ)was significant higher in AR group than that in NAR group(t = 2.570 and 2.467,P=0.012 and 0.016). Conclusions Children with NAR may also have the risk for the development of asthma as those with AR. The prevalence of chronic cough is higher in children with AR than in those with NAR. AR might bring more impacts on children′s quality of life than NAR.