Objective To explore the effects of andrographolide(AD) on proliferation inhibition ,cells cycle distribution and the expression of Bax and Bcl‐2 mRNA in human tongue squamous cell carcinoma Tca8113 cells .Methods MTT was used to measure the levels of the proliferation of Tca8113 cells cultured with different concentraions of AD .Cell cycles were analyzed by flow cytom‐etry .RT‐polymerase chain reaction(RT‐PCR)technique was used to evaluate Bcl‐2 mRNA and Bax mRNA expression .Results An‐drographolide inhibited Tca8113 cells growth in a time and dose‐dependent manner ,the IC50 was 74 .66 μg/mL .A feature of apop‐tosis was observed under microscope .With a increase in concentration and increase in time ,the cells in G0/G1 phase increased from (39 .45 ± 0 .65)% to (63 .70 ± 0 .65)% ,the cells in S phase decreased from (56 .55 ± 0 .64)% to (32 .28 ± 0 .54)% .Statistics showed tha the cells arrested in G0/G1 phase .It was statistially significant in comparison with the control group (P< 0 .01) .AD could up‐regulate the experssion of Bax mRNA ,and AD could down‐regulate the experssion of Bcl‐2 mRNA .Conclusion An‐drographolide inhibited the growth of Tca8113 cells and increased the cell apoptosis .It may be promising as a new drug for treat‐ment of tongue squamous cell carcinoma .

Objective:To see the influence of different antiplatelet therapies on stroke patients’ readmission by performing a deep data-mining into Beijing Healthcare Insuring Database,based on a large sample size.Methods:Aretrospective cohort study,was adopted to extract patients primarily diag-nosed as ischemic stroke from healthcare database.The first hospital records were considered as the pa-tient’s baseline in this study,who were divided into MAPT (aspirin)and DAPT (aspirin and clopi-dogrel)according to the patient’s baseline medications.A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication.The major re-sult events,included:(1 )recurrence of ischemic stroke;(2)hemorrhagic transformation of ischemic stroke;(3)myocardial infarction;(4)the digestive hemorrhage.The Kaplan-Meier figure was used to compare the survival situations between these two groups,the log-rank test was used to test the difference of the survival curve,and 1 ∶1 propensity score matching was calculated from the patients’baseline da-ta.Cox proportional hazards model was used to calculate the hazard ratio (HR).Results:A total of 27 695 patients From January 201 0 to September 201 3 were included,4 047 with DAPT,and 23 648 with MAPT.Because the baseline characteristics of the patients was disequilibrium,so we used 1 ∶1 pro-pensity score matching,after which,the number of the two groups was 4 046 each.Adjusted for the gen-eral demographic characteristics such as age,sex,nationality,complication and drug combination,no statistical significance was observed between the survival curves of the two groups (P =0.06).HR value of major result events between the groups was 0.91 (0.82 -1 .01 ,P =0.07),which was not statistically significant.The covariate gender HR =1 .36 (1 .20 -1 .55,P <0.05),accompanied by diabetes HR =1 .36 (1 .20 -1 .54,P <0.05 ),dyslipidemia HR =1 .1 3 (1 .00 -1 .27,P =1 .1 3),heart disease HR =1 .39 (1 .22 -1 .58,P <0.05)was statistically significant.Drug combination with other antiplate-let agents HR =1 .05 (0.95 -1 .1 7,P >1 .05)did not increase the risk of readmission.Conclusion:There was no difference in prevention of readmission between patients with DAPT and MAPT.Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

Objective To analyze the diagnostic procedures and treatment strategies in the mycotic aneurysm caused by Salmonella enterica serotype choleraesuis infection in a single medical center. Methods From January 2000 to December 2008, clinical data of 8 cases with infected aneurysm caused by Salmonella enterica serotype choleraesuis were analyzed. Results All cases were treated with endovascular stent-graft treatment, including abdominal aortic aneurysm in six cases, thoracic aortic aneurysm in one, and popliteal artery aneurysm in one case. Six bifurcated stent-graft and two tube stent-graft were used. The surgical success rate was 100% with no perioperative or 30-day mortality nor major morbidity. All of the patients recovered uneventfully and were discharged with oral antibacterial agents. During mid-term follow up (range 15-36 months), four patients are alive and well with no signs of persistent or recurrent infection, three cases with recurrent infection were cured by drainage of local abscess and debridement, one case died of rupture of the abdominal aortic aneurysm. Conclusion Endovascular grafting combined with antibiotic therapy and careful surveillance program represent an alternative to conventional surgery in mycotic aneurysms caused by Salmonella enterica serotype choleraesuis.

AIM: To explore the pathogenic mechanism of high altitude pulmonary edema(HAPE). METHODS: Haemodynamic changes and effects of 100 percent oxygen breathing were measured by Swan-Ganz thermistor catheters, high altitude healthy volunteers were served as controls. RESULTS: The important features of haemodynamic changes in HAPE: (1)Pulmonary arterial pressure was raised; (2)Pulmonary arterial resistance and cardiac output were raised; (3)Pulmonary artery wedge pressures and right atrial pressure were normal; (4)Pulmonary arterial pressure and resistance were induced by oxygen breathing. CONCLUSIONS: The normal pulmonary artery wedge pressures with a high cardiac output indicated that HAPE was recognized as a form of noncardiogenic pulmonary edema. The pulmonary hypertension may play an important role in the development of HAPE.

This study investigated the effect of epigenetic modification of maspin on extravillous trophoblastic function. The mRNA expression of maspin in placentae from normotensive and preeclamptic pregnant women was detected by RT-PCR. TEV-1 cells, a human first-trimester extravillous trophoblast cell line, were cultured and treated with CoCl(2) (300 μmol/L) to induce chemical hypoxia and with 5-aza (500 nmol/L) to induce demethylation. The mRNA expression of maspin in TEV-1 cells subjected to different treatments was determined by RT-PCR, and the proliferative and migratory abilities of TEV-1 cells were assessed by cell counting kit-8 (CCK-8) and Transwell assays. Our results showed that the maspin mRNA expression level in placentae from preeclamptic women was much higher than that from normotensive women. CoCl(2) or 5-aza could up-regulate the mRNA expression of maspin and significantly suppress the proliferation and migration of TEV-1 cells. It was concluded that the epigenetic modification in promoter region of maspin contributes to incomplete trophoblast invasion, which offers a novel approach for predicting and treating placental dysfunction.

Objective To review the prevention and treatment strategies for complications after carotid artery stenting in a single medical center. Methods From December 2004 to December 2009,clinical data of 118 cases of carotid artery stenting with the use of cerebral protective device were analyzed retrospectively. Results The surgical success rate was 100% with no perioperative 30- day mortality or severe complications such as disabling stroke. The overall perioperative complication rate was 32. 20% (38/118), including carotid artery spasm in 10.17% (10/118), bradycardia in 11.02% (13/118), hypotension in 2.54% (3/118), transient ischemic attack in 5.93% (7/118) and false aneurysm of femoral artery in 2. 54% (3/118) cases. The average follow-up time was (28 ± 15) months. The mortality was 2. 38% (2/84) and the overall complication rate was 10. 71% (9/84) , including ischemic stroke in 3. 57% (3/84) , in-stent restenosis in 1. 19% ( 1/84) , stent deformation in 4. 66% (4/84) and stent fracture in 1. 19% (1/84) cases. Conclusion Death or ischemic stroke and other severe complications after carotid artery stenting under cerebral protective device were low. A careful selection of patients and strict indication for surgery is the key to reduce the complication rate.

In 2012, USA Food and Drug Administration (FDA) approved 39 new drugs, however, there are only two botanical drugs (one topical and one oral) approved by FDA since the publication of the FDA's industry guidelines for the botanical drug product in June 2004. The approval shows the Western guideline can be used for herbal medicines, authors investigate current regulation on herbal medicine clinical research, identify challenges conducting clinical trials, and seek to produce some guidance for potential investigators and sponsors considering a clinical trial in this area. Key words were formulated for searching on Medline and FDA website to locate relevant regulations for clinical research in herbal medicines to understand current environment for herbal medicine usage and examine the barriers affecting herbal medicine in clinical trials. Authors critically explore case study of the 1st FDA approved botanical drugs, Veregen (sinecatechins), green tea leaves extract, a topical cream for perianal and genital condyloma. In consideration of current regulation environment in USA, based on the findings and analysis through the literature review and Veregen case study, authors produce and propose a Checklist for New Drug Application of Herbal Medicines for potential investigators and sponsors considering in a herbal medicine clinical trial.
Biomedical Research ; legislation & jurisprudence ; Clinical Trials as Topic ; Herb-Drug Interactions ; Herbal Medicine ; legislation & jurisprudence ; Humans ; Plants, Medicinal ; adverse effects ; United States

Objective To evaluate the clinical characteristics and surgical treatment of renal stenosis resulting from fibromuscular dysplasia ( FMD ). Methods 16 cases from 1998 to 2011 were reviewed,the average age was (28 ± 13 ) years old. Among them, all patients suffered refractory hypertension and only one presented renal dysfunction. Aorto-renal bypass was performed in 2 cases.Resection and reconstruction was performed in 2 cases,balloon angioplasty in 10 and stent implantation in 3.Results There was 1 death peri-operatively.13 out of 15 cases were followed-up with no death.Significant decline of blood pressure [ (134 ± 14 )/( 83 ± 8 ) mm Hg vs.( 151 ± 17 )/( 96 ± 16 ) mm H g ( P ＜ 0.01 ) ]and 100％ effective rate were observed.The creatine level were preserved after surgical treatment [ (61 ±22) μmol/L vs.(69 ± 22) μmol/L,(P ＞ 0.05 ) ] with 4 cases improved and the other 9 stable.12 patients received ultrasound surveillance with only one case of 20％ restenosis. Conclusions Renal stenosis due to FMD are most common in children and the youth with hypertension as major presentation. Balloon angioplasty is the first choice of surgical treatment with positive efficacy.

Objective To retrospectively analyze the geometrical characteristics of abdominal aortic aneurysms undergoing endovascular treatment in a single medical center.The long-term effects as well as the strategies for the prevention and treatment of complications have been reviewed.Methods From January 2003 to December 2010,clinical data and geometrical parameters of 344 cases undergoing endoluminal repair of abdominal aortic aneurysms were analyzed retrospectively.Results The diameter and length of proximal neck was (23 ± 3 )mm and ( 26 ± 12) mm respectively.The angle between the neck and the abdominal aortic aneurysm was (25 ± 28) degree.The surgical success rate was 99.7％.The average follow-up time was 32.9 months (3 -84 months) with follow-up rate 81.8％ (279/341).The mortality was 1.1％ (3/279),the re-intervention rate was 10.4％ (29/279) and the overall complication rate was 12.9％ ( 36/279),including endoleak of 5.7％ ( 16/279 ),stent-graft migration of 1.1％ ( 3/279 ),aneurysm expansion or rupture of 5.4％ ( 15/279 ),and other complications like limb occlusion.Severe infrarenal aortic neck angulation ( ＞ 60 degree) was associated with type Ⅰ endoleak ( P =0.010 ).Conclusions A careful preoperative case selection and evaluation is the key for a successful endovascular aneurysm repair.Endoleak continues to be the major long-term complication of the endoluminal grafting technique,and the major cause for re-intervention.Life-long follow-up is extremely important.

OBJECTIVE:To investigate the clinical efficacy of Bacterial lysates capsule in the treatment of acute attack of asthma in children,and its effects on inflammatory factors and respiratory mechanics indexes.METHODS:A total of 87 children with acute attack of asthma in our hospital were divided into observation group (44 cases) and control group (43 cases).Control group was given glucocorticoid Beclomethasone dipropionate aerosol 0.05 mg,tid;observation group was additionally given Bacterial lysates capsule 3.5 mg,qd,on the basis of control group.Both groups received 120 days of treatment.Peripheral Thl/Th2 cell factor levels (IFN-γ,IL-2,IL-4,IL-5,IL-10,IL-13),lung function indexes (FVC,FEV1,PEF),respiratory mechanics indexes (mean airway pressure,respiratory resistance,static compliance,measured plateau pressure) and clinical efficacies were observed in 2 groups.RESULTS:Before treatment,there was no statistical significance in Th1/Th2 cell factors,lung function indexes or respiratory mechanics indexes between 2 groups (P＞0.05);after treatment,the levels of IFN-γ,IL-2,IL-10,FVC,FEV1 and PEF were increased significantly,while the levels of IL-5 and IL-3 were decreased significantly;IL-4 level of control group was decreased significantly;the levels of IL-2,IL-4,IL-10,FVC,FEV1 and PEF in observation group were significantly better than control group,with statistical significance (P＜0.05).Mean airway pressure,respiratory resistance and measured plateau pressure of observation group were significantly lower than those of control group,while static compliance was significantly higher than control group,with statistical significance (P＜0.05).Response rate of clinical control in observation group was 77.27％,which was significantly higher than 55.81％ of control group,with statistical significance (P＜0.05).CONCLUSIONS:Bacterial lysates capsule shows significantly therapeutic efficacy for acute attack of asthma,relieves airway inflammation and improves the immunity level of the body so as to improve airway respiratory mechanics parameters.