A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects

Objective To evaluate the application value of X-ray,echocardiogram,pulmonary perfusion scintigraphy,EBCT,Magnetic resonance Pulmonary angiography in diagnosis of PTE.Methods Twenty-five consecutive patients clinically diagnosed of having PTE were examined from july 2003 through March 2004. Patients underwent X-ray chest plain film, echoeardiogram, electronic beam computed tomographie (EBCT)angiography,ventilation-perfusion (V-P)seintigraphy,Magnetic resonance Pulmonary angiography (MRPA)and puhnonary angiography according to a strict diagnostic protocol.Two of the independent readers reviewed the pulmonary angiography and record all of the lobe and segmental involved in PTE and compared with other image method.Results Pulmonary angiography:all of the patients success underwent the technique,the pulmonary artery branch with PTE was in 556 of 775 branches (71.7%). Chest radiography had hints of diagnosis in 12 of 25 patients.Nine patients diagnosed with echocardiogram. Right heart enlargement was in 21,and pulmonary hypertension in 18.V-P scintigraphy revealed 247 segmental involved with PTE of 500 (52.0% ),and the sensitivity was 64.66% compare with the pulmonary angiography.There were 523 pulmonary branches involved PTE with EBCT pulmonary angiograpy of 775 branches,and the sensitivity was 94.06%.MRPA: 8 of 10 patients succeed in the technique, 155 branches of 248 were detected with PTE(62.5% ),the sensitivity was 81.29%.Conclusions EBCT is a high sensitivity method in diagnosis of PTE.Chest radiography and echocardiogram are the first-line modality of PTE.V-P scintigrapby is the valid compensation in diagnosis subsegmental pulmonary artery with PTE when EBCT miss diagnosis.Gd-CE-MRPA may be the second-line modality in diagnosis of PTE.

Objective To explore the mechanism of Zibu Piyin Recipe (ZBPYR) on spleen yin deficiency diabetes-associated cognitive disorder (DACD). Methods The rats were randomly divided into control group, diabetes mellitus (DM) group, spleen yin deficiency group, spleen yin deficiency DM group and spleen yin deficiency DM+ZBPYR group (treatment group). Type 2 DM models were established by high-fat food feeding and low dose STZ intraperitoneal injection for 4 weeks. Then the classical compound method was used to construct spleen yin deficiency rat models by improper diet, over exertion and yin fluids exhaustion. The treatment group was given ZBPYR by gavage for 15 days, and the other groups were given the same amount of normal saline. Then cerebral cortex, hippocampus, stomach and liver were obtained and the changes of protein expression of PDHE1α in them were observed by Western Blot. Results The protein expression of PDHE1αin cortex of DM group and spleen yin deficiency DM group were lower than control group (P<0.05). PDHE1α expression of treatment group in cortex and stomach increased more significantly than spleen yin deficiency DM group (P<0.05). The expression of PDHE1α protein showed no significant difference among all groups in hippocampus and liver. Conclusion ZBPYR improved spleen yin deficiency DACD by regulating PDHE1αin cortex and stomach.

Objective To investigate the feasibility and the efficacy of the Harmonic scalpel (HS)dissection compared with general electricoagulation(EC) in laparoscopic colorectal surgery.Methods In this nonrandomized prospective study，82 patients between May 2002 and December 2006 underwent elective laparoscopic colorectal resection.Laparoscopic right hemicolectomy(4)，left hemicolectomy(5)，sigmoidectomy(25)，or low anterior resection(48)were randomized to either electricoagulation or Harmonic scalpel dissection.The data for conversion to open surgery，operative time，blood loss，clips，complication rate，and hospital stay were compared.Results Intraoperative blood loss was significantly less in HS(180.6 ml)versus EC(229.6 ml)(P＜0.05).The number of clips was less in HS(2.3)versus EC(5.1)(P＜0.05).No differences were observed in postoperative time to recover bowl function and postoperative hospital stay.Postoperative complication rates in HS (2.3％)was significantly less as compared to EC(10.5％)(P＜0.05).Conclusion Harmonic scalpel in laparoscopic colorectal surgery can redues intraoperative blood loss，completes majority of laparoscopic procedures，and is technically easy，feasible，reliable.

Objective To investigate the feasibility and the efficacy of the Harmonic scalpel (HS)dissection compared with general electricoagulation(EC) in laparoscopic colorectal surgery.Methods In this nonrandomized prospective study，82 patients between May 2002 and December 2006 underwent elective laparoscopic colorectal resection.Laparoscopic right hemicolectomy(4)，left hemicolectomy(5)，sigmoidectomy(25)，or low anterior resection(48)were randomized to either electricoagulation or Harmonic scalpel dissection.The data for conversion to open surgery，operative time，blood loss，clips，complication rate，and hospital stay were compared.Results Intraoperative blood loss was significantly less in HS(180.6 ml)versus EC(229.6 ml)(P＜0.05).The number of clips was less in HS(2.3)versus EC(5.1)(P＜0.05).No differences were observed in postoperative time to recover bowl function and postoperative hospital stay.Postoperative complication rates in HS (2.3％)was significantly less as compared to EC(10.5％)(P＜0.05).Conclusion Harmonic scalpel in laparoscopic colorectal surgery can redues intraoperative blood loss，completes majority of laparoscopic procedures，and is technically easy，feasible，reliable.

OBJECTIVETo compare the hybrid between species of Dendrobium huoshanense and its parents on growing, physiologic indexes and content of medicinal components, and provide theoretical basis for species quality improvement.

METHODThe chlorophyll content, the photosynthesis rate, the polysaccharides content and the alkaloids content were measured by anhydrous ethanol method, Cl-310 photosynthesis determination system, colorimetry of concentrated sulphuric acid-phenol and acid dyes colorimetry respectively.

RESULTThe growth of hybrid was close to D. moniliforme, and apparently higher than D. huoshanense. The chlorophyll content and the photosynthesis rate of one-year-hybrid were markedly higher than its parents. The content of polysaccharides and alkaloids in two-year-stem and three-year-stem of hybrid were close to that of D. huoshanense.

CONCLUSIONThe hybrid integrates superiority of parents on growth and accumulation of medicinal components opens vast vistas for development and utilization.

Alkaloids ; analysis ; Chlorophyll ; analysis ; Dendrobium ; chemistry ; classification ; genetics ; growth & development ; Hybridization, Genetic ; Photosynthesis ; Plants, Medicinal ; chemistry ; classification ; genetics ; growth & development ; Polysaccharides ; analysis

OBJECTIVETo investigate the distribution of hepatitis B virus (HBV) genotype B subgenotype in China.

METHODSA cohort of 511 patients with chronic HBV genotype B infection, collected from 7 centers across China, were analyzed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or nucleotide sequencing.

RESULTSFor the 511 patients, only subgenotype Ba was identified and subgenotype Bj was not found.

CONCLUSIONIn China, subgenotype Ba was the most prevalent HBV strains, while subgenotype Bj was very rarely found.

China ; DNA, Viral ; genetics ; Genotype ; Hepatitis B ; virology ; Hepatitis B virus ; classification ; genetics ; isolation & purification ; Humans ; Phylogeny ; Polymorphism, Restriction Fragment Length

OBJECTIVETo investigate the relationship between the excitotoxicity and serum-inducible kinase (SNK) and spine-associated Rap GTPase-activating protein (SPAR) pathway in primary hippocampal neuron injury induced by glutamate and furthermore, to explore the molecular mechanism of neuroprotection of Zibu Piyin Recipe (ZBPYR) and the relationship between ZBPYR and the morphological regulation of dendritic spines.

METHODSThe serum containing ZBPYR was prepared by seropharmacology. Reverse transcription and polymerase chain reaction (RT-PCR) was used to detect the expression of mRNA for SNK, SPAR, postsynaptic density protein 95 (PSD-95) and N-methyl-D-aspartate (NMDA) receptor subunits (NR1, NR2A and NR2B) in primary rat hippocampal neuron cultures after pretreatment with 10 micromol/L glutamate and ZBPYR serum.

RESULTSZBPYR serum pretreatment resulted in a significant down-regulation of glutamate-induced SNK mRNA expression (P<0.05). Significant up-regulation was seen on the mRNA expression of SPAR and PSD-95 (P<0.05). All these changes were dose-dependent. The mRNA expression of NR1, NR2A and NR2B was down-regulated to different degrees (P<0.05).

CONCLUSIONThe mechanism of effect of ZBPYR on glutamate-induced excitotoxicity may be related to the regulation of SNK-SPAR signal pathway. ZBPYR may play a role in protecting and maintaining the normal morphology and structure of dendritic spines, which may be achieved by inhibiting the excessive activation of NMDA receptors.

Animals ; Cells, Cultured ; Disks Large Homolog 4 Protein ; Drugs, Chinese Herbal ; pharmacology ; GTPase-Activating Proteins ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Glutamic Acid ; toxicity ; Hippocampus ; drug effects ; enzymology ; pathology ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Membrane Proteins ; genetics ; metabolism ; Neurons ; drug effects ; enzymology ; pathology ; Protein Kinases ; genetics ; metabolism ; Protein-Serine-Threonine Kinases ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Serum

To investigate the chemical constituents of the roots of Aconitum taipaicum, silica gel column chromatography was used for the isolation and purification of compounds. A new norditerpenoid alkaloid, isodelelatine (1), along with five known alkaloids, atisine (2), delfissinol (3), liangshanine (4), hypaconitine (5) and delelatine (6) were isolated and identified. The structure of the new compound was elucidated on the basis of spectral data.
Aconitine ; analogs & derivatives ; chemistry ; isolation & purification ; Aconitum ; chemistry ; Alkaloids ; chemistry ; Diterpenes ; chemistry ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVETo compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.

METHODSA retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.

RESULTSThere were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.

CONCLUSIONSThe influence of PJ and PG on the postoperative nutritional status are comparable.

Adult ; Aged ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Postoperative Period ; Retrospective Studies