Objective To investigate the ultrasound measured inferior vena cava (IVC) caliber used as an objective indicator to assess water retention of patients with acute heart failure (AHF).Methods A total of 72 consecutive patients with acute heart failure admitted in the emergency department between December 2013 and April 2014 were enrolled.Acute heart failure was defined by the presence of symptoms such as asthmatic embarrassment and nocturnal paroxysmal dyspnea with or without signs of tracheobronchchial rale and edema of lower limbs,and by objective evidence of cardiac dysfunction as well,either a left ventricular ejection fraction (LVEF) ≤ 45％ or the combination of both left atrium dilation (≥ 4 cm diameter in the parasternal long axis) and a plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) ＞ 450 pg/mL (patients under 50 years old) or ＞ 900 pg/mL (patients over 50 years old and under 75 years old) or ＞ 1800 pg/mL (patients over 75 years old) or ＞ 1200 pg/mL (patients with renal dysfunction,glomerular filtration rate ＜ 60 mL/min).Exclusion criteria were chronic hepatic disease and acute myocardial infarction.Another 22 patients were enrolled as control.Independent t tests were used to compare normally distributed continuous variables between two groups,while nonparametric tests were used to compare non-normally distributed continuous ones,and chi-squared tests were used for categorical variables.The relations between IVC inner diameter and other normally distributed variables were assessed by Pearson correlation coefficients.A 2-sided P value ＜ 0.05 was considered statistically significant.Results The congestion score and IVC inner diameter were significantly higher in patients with AHF (P ＜ 0.05 ; P ＜ 0.01).The IVC inner diameter was correlated with NT-proBNP concentration (r =0.339,P =0.01 3) and congestion score (r =0.431,P =0.002).There was no relation between IVC inner diameter and LVEF (r =-0.241,P =0.102).IVC inner diameter had significantly positive correlations with pulmonary artery pressure and tricuspid regurgitation (r =0.414,P =0.004 ; r =0.359,P =0.015).Creatinine,blood urea nitrogen,and bilirubin were independently associated with increasing IVC inner diameter (r =0.313,P =0.032 ; r =0.379,P =0.009 ; r =0.385,P =0.007),while IVC inner diameter had negative relation with glomerular filtration rate (r =-0.337,P =0.021).Conclusions The IVC inner diameter can be used as a measurable and objective indicator to estimate the magnitude of access water retention in patients with AHF.

Objective To observe the clinical efficacy of puncturing Tianshu (ST 25) alone in treating intractable constipation in the elderly.Method Totally 193 senile subjects with intractable constipation were randomized into group A of 57 cases, group B of 73 cases, and group C of 63 cases. Group A was intervened by acupuncture at Tianshu (ST 25), group B was by Lactulose oral solution, and group C was by retention enema. The clinical efficacies and effect-lasting time of the three groups were compared. Result The total effective rate was 89.3% in group A, versus 88.6% in group B and 92.1% in group C, and the between-group differences were statistically insignificant (P>0.05). Of the markedly effective and improved cases, the effect-lasting time in group A was significantly different from that in group B and C (P<0.01).Conclusion Acupuncture at Tianshu (ST 25) alone is an effective method in treating senile intractable constipation.

OBJECTIVE: To study the efficacy of probiotics in preventing late-onset sepsis (LOS) in very low birth weight (VLBW) infants. METHODS: Databases including PubMed, Web of Science, Cochrane Library, Wanfang Data, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database were searched for randomized controlled trials (RCTs) of probiotics in preventing LOS in VLBW infants. LOS was classified as clinical LOS and confirmed LOS. RevMan 5.4 was used to perform the Meta analysis. RESULTS: A total of 31 RCTs were included, with 3 490 VLBW infants in the probiotics group and 3 376 VLBW infants in the control group. The Meta analysis showed that compared with the control group, the probiotics group had significantly lower risks of clinical LOS ( CONCLUSIONS Current evidence indicates that probiotics may reduce the risk of clinical LOS and clinical/confirmed LOS in VLBW infants, and the risk of confirmed LOS in VLBW infants who are exclusively breastfed.
China ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Probiotics/therapeutic use* ; Sepsis/prevention & control*

The roots of Corydalis decumbens are used in Chinese folk herbal medicine for treatment of a variety of diseases. In this article, developments of chemical composition, pharmacology, clinical application and recent stud-ies on pharmacokinetics of C. decumbens were reviewed and summarized for its further development and utilization.

This study was aimed to evaluate the quality ofYuan-Hu Zhi-Tong (YHZT) tablet from different manufacturers by high performance liquid chromatography (HPLC) fingerprint. An HPLC method was developed to establish the fingerprint of 12 batches of YHZT from 10 manufacturers. The common peaks were confirmed by mass spectrometric analysis. Similarity analysis (SA), hierarchical cluster analysis (HCA) and principal component analysis (PCA) were applied to analyze the fingerprint chromatography. The results showed that there were 15 common peaks in which 12 components were from Corydalis Rhizoma and 3 from Radix Angelicae Dahuricae. The similar degrees of 12 batches of YHZT tablet were between 0.498 and 0.999. Based on the values, they could fall into three groups. The result of HCA showed that 12 batches of samples could be divided into 3 classes. The results of PCA indicated that the first three principal components (PCs) could represent the 15 common peaks. According to the scores of 3 PCs, 12 batches of samples could be divided into three categories. The classification result was mainly affected by the components of Corydalis Rhizoma. The classification results of three methods were basically the same. Based on the combination of three methods, 12 samples can be divided into three grades in the aspect of quality. It was concluded that the quality differences of YHZT tablet from different manufacturers were obvious. The combining application of three methods can be used in the evaluation on fingerprint of samples from different sources and influence factor analysis. It can be used as an effective method for quality evaluation.

Objective To investigate the high mobility group box chromosomal protein-1 (HMGB1) levels in patients with acute pancreatitis (AP); and to study the relationship between the serum level of HMGB1 and the severity of AP. Methods The patients' serum HMGB1 concentrations were determined right after admission, 24, 48 hour after admission. The levels of HMGB1 were measured by ELASA kit and its relationship with the severity of AP was analyzed. 20 healthy adults were treated as the control group. Results At the time of admission, and 24, 48 hours after admission, the serum HMGB1 levels in AP patients were (8.05 + 1.60 ), ( 8.04 ± 1.39 ), ( 8.25 ± 1.56) ng/ml, respectively, which were significantly higher than that in the healthy control [ ( 2.20 + 0.57 ) ng/ml, P ＜ 0. 01]. There were 35 patients with severe acute pancreatitis (SAP) and 27 patients with mild acute pancreatitis (MAP). The HMBG1 levels in patients with SAP were (7.99 + 1.69) ,(8.12 ± 1.40), (8.13 ± 1.34) ng/ml, and they were (8.12 + 1.52), (7.92 +1.40), (8.39 ± 1.81 )ng/ml in patients with MAP, and the difference between the two groups was not statistically significant. Conclusions The serum HMGB1 level in AP patients was significantly higher than that in healthy controls, but it was not related with the severity of AP.

This study was aimed to investigate the effects of high-dose strictosamide injection on cardiovascular sys-tem of anesthetized beagle dogs and to examine the inhibition of strictosamide on ion channels in vitro. Indexes such as changes of systolic blood pressure (Sys), diastolic blood pressure (Dia), mean blood pressure (MBP), heart rate (HR), PR, QRS, QT, QTcb and QTcv at different time points before and after strictosamide injection in dogs were monitored by the polygraph system. The inhibition of strictosamide at different concentrations on hERG potassium channel in CHO-hERG cells and Nav1.5 sodium channel in HEK-293-Nav1.5 cells were measured by whole-cell patch-clamp method. The results showed that compared with the blank control group, Sys, Dia, MBP and HR were obviously declined 15 min after medication in the strictosamide (60, 18 mg·kg-1) group and the vehicle-control group (containing tween-80) (P < 0.05). After medication, all indexes were recovered. Compared to the vehicle-control group, there were no significant differences at different time points in each medication groups. Compared with the blank control group and before medication, the QT interval, QTcb and QTcv were significantly prolonged 15 min af-ter medication in the strictosamide (60, 18, 6 mg·kg-1) group and the vehicle-control group (P< 0.05). When medi-cation stopped, indexes were recovered at certain level. Compared with the vehicle-control group, there were no sig-nificant differences of QT interval, QTcb and QTcv of each medication group at different time points (P> 0.05). The inhibition of strictosamide on hERG potassium channel and Nav1.5 sodium channel were weak with IC50 values of 560.8 μM and > 900 μM, respectively, which were far greater than the positive controls. It was concluded that sin-gle, high-dose intravenous injection of strictosamide may lead to a lower blood pressure, a slower heart rate and a prolongation on the QT interval in beagle dogs, which returned to basal levels when medication stopped. It was spec-ulated that the reduction of blood pressure and the slowing of heart rate were related to tween-80 contained in the vehicle control group. No significant inhibitory effects were detected on hERG potassium channel and Nav1.5 sodium channel in vitro, which suggested that other mechanisms may be involved in strictosamide-induced QT interval pro-longation in animals.

This study was aimed to analyze differences of chemical compounds of Ginseng and Radix Puerariae be-fore and after compatibility using HPLC. Hypersil ODS column (4.6 mm × 250 mm, 5μm) was adopted. The mobile phase was acetonitrile-water for gradient elution. The detection wavelength was set at 203 nm. The column tem-perature was 25℃. The flow rate was 1 mL/min. The results showed that through the study of all main peaks in the finger print spectra, there was no obvious influence on extract before and after compatibility of Ginseng and Radix Puerariae. It was concluded that there were no obvious chemical changes of Ginseng and Radix Puerariae before and after compatibility. The synergistic mechanism of compatibility might mainly come from the interaction between the pharmacological actions and the absorption or the metabolism of effective constituents of the medicinal plants.

This article was aimed to study the stability of hesperidin in alkaline solution, in order to provide experi-ment evidences for quality control of extraction and purification as well as formulation development. RP-HPLC was applied to determinate content changes of hesperidin in alkaline solution by changing the temperature, pH and heat-ing time. The results showed that hesperidin was degraded in alkaline solution by heating. The content of hesperidin decreased along with the increasing of heating temperature and heating time. The hesperidin appeared to be more stable in a weak base. It was concluded that for the purpose of ensuring of the stability of hesperidin in alkaline so-lution, it should be kept at low temperature (below 50℃), weak base conditions and shorten the heating time during the preparation process.

Objective To evaluate the clinical significance of sentinel lymph nodes biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy. Methods SLNB was performed in sixty primary breast cancer patients after neoadjuvant chemotherapy using a combination of 99mTc- Rituximab and patent blue. SLN was examined by routine pathologic examination and immunohistochemistry. Routine axillary lymph node resection was performed after SLNB. Results The successful rate of SLNB was 95% (57/60). Twenty-three cases of SLN (40% ) were metastasis positive, including 18 positive cases detected by HE staining and 5 by immunohistochemistry. SLN was the only metastasis lymph nodes in 14 out of 23 cases. One case was of false negative metastasis by SLN. The sensitivity and accuracy of SLNB were 96% (23/24) and 98% (56/57), respectively. The specificity was 100% (33/33) , the false negative rate was 4. 3% (1/23) with the negative predictive value being 97% (36/37). The positive predictive value was 100% (24/24). Internal mammary sentinel lymph node lymphoscintigraphy were positive in 11 cases but all the cases were negative in metastases by pathologic examination. Conclusion The combination of isotope imaging agent and patent blue is suitable for primary breast carcinoma after neoadjuvant chemotherapy. Internal mammary sentinel lymph node biopsy is less clinically important.