Objective To study the pathology mechanism of vascular dementia(VD)rats and study the effect of Bushenxingnao(BSXN)prescription on cerebral neurocyte apoptosis.Method Experimental VD model rats were caused by clipping two side of total artery in neck repeatedly and to examine cerebral neurocyte apoptosis with TUNEL.Results Both the high and low dose BSXN abated excitatory toxic infury and inhibit neurocyte apoptosis after ischemia-refusion.Conclusion BSXN prescription can repress cerebral neurocyte apoptosis,to abate its excitatory nerotoxicity,to protect cerebral neurocyte,which may be one of the mechanisms of to treating the lesion.

Blood Glucose ; metabolism ; Female ; Glycogen Storage Disease ; diagnosis ; Humans ; Infant, Newborn ; Liver ; pathology

OBJECTIVETo systematically assess the efficacy and safety of Rhodiola in treating chronic stable angina pectoris.

METHODSOur group searched the Cochrane library, PubMed, Embase, Chinese biomedical literature database (CBM), VIP database (VIP), Chinese Journal Full-text Database (CNKI) for the literature published in English and Chinese till April 2013. Randomized controlled trials (RCTs) were included on the therapeutic effect of Rhodiola or Rhodiola plus conventional Western medicine in comparison with the conventional Western medicine treatment on stable angina. Data were extracted according the data extraction form. The literature methodological quality was assessed by using the Cochrane handbook, and data analyzed by Rev-Man 5.2 Software for Meta-analysis. The effect indicators of outcomes was expressed by odds ratio (OR) and 95% CI.

RESULTSA total of 7 randomized controlled trials, 662 cases of stable angina pectoris patients met the inclusion criteria and all published in Chinese, without one scientific design and high quality literature. Compared with the conventional Western medicine treatment, combined with oral administration of Rhodiola could improve the efficiency of anti-angina (OR = 2.49, 95% CI: 1.02 - 6.09). Combined with intravenous infusion of Rhodiola could also improve the efficacy of angina pectoris (OR = 4.86, 95% CI: 2.4 - 9.82). Oral administration of Rhodiola couldn't improve ECG efficacy (OR = 1.25, 95% CI: 0.67 - 2.34). Intravenous infusion of Rhodiola could improve the clinical efficacy (OR = 2.94, 95% CI: 1.61 - 5.35). Combined with the conventional treatment, intravenous infusion of Rhodiola could improve the whole blood viscosity (low and high shear rates) and inverse variance (IV) (-1.36 and -0.99, 95% CI: -1.65 - 1.07 and -1.26 - 0.71), but could not reduce serum fibrinogen and D-dimer level. The incidence rate of adverse reactions was higher than that of the conventional treatment combined with Rhodiola (OR = 0.1, 95% CI: 0.02 - 0.51).

CONCLUSIONSOn the basis of routine treatment, Rhodiola could further improve patients' symptoms. Combined with intravenous medication, Rhodiola could increase the ECG improvement rate, and reduce adverse reactions. But the methodological quality of included studies was poor, the number of samples was small, and influence factors such as the intervention period was short. This conclusion needs scientific and rational design in a larger sample, multicenter clinical trial to verify.

Objective To research the effects of drought stress on activity of key enzyme in saikosaponin biosynthesis and saponins content in Bupleurum chinense; To reveal response of Bupleurum chinense to drought stress from protein level. Methods Bupleurum chinense was cultivated in potted water control experiment with 70%–80%, 60%–70%, 40%–50% and 20%–30% saturated soil water contents. The enzyme activities of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGR), isoprenyl-based coke (IPPI), farnesyl pyrophosphate synthase (FPS) and β-carotenoid synthase (β-AS) of six months and one year old Bupleurum chinense were measured. The contents of saikosaponins a and d in samples of different soil water contents were determined by HPLC. Results When the saturated moisture was 40%–50%, the enzymatic activities of HMGR, IPPI, FPS and β-AS were the highest, followed by saturated moisture 60%–70%、70%–80% and 20%–30%. The trend of saikosaponin was similar to that of the activity of key enzyme. Conclusion 40%–50% soil saturated water content can significantly increase the activity of the key enzymes in the saikosaponin synthesis pathway. The saponin content and enzyme activity show a significant positive correlation, indicating that under drought stress, Bupleurum chinense regulates the synthesis of saikosaponin by regulating the key enzyme activity of saikosaponin synthesis pathway to respond drought stress.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Objective To explore the combined effects of fluoride and arsenite on the expression of Runx-related transcription 2 (Runx2) mRNA in bone of Sprague Dawley (SD) rats.Methods Fifty four SD rats were selected[body mass(109.71 ± 10.52)g,half male and half female].3 × 3 Factorial experimental design was used to evaluate the combined effects of fluoride and arsenite on the expression of Runx2 mRNA by random number talbe.Rats were exposed to NaF,NaAsO2 and NaF plus NaAsO2 for 6 months by oral perfusion at gradient doses,respectively:the control group(0 mg/kg NaF + 0.0 mg/kg NaAsO2),the low fluoride group(5 mg/kg NaF),the high fluoride group(20 mg/kg NaF),the low arsenite group(2.5 mg/kg NaAsO2),the high arsenite group(10.0 mg/kg NaAsO2),the low fluoride low arsenite group(5 mg/kg NaF + 2.5 mg/kg NaAsO2),the high fluoride low arsenite group(20 mg/kg NaF + 25 mg/kg NaAsO2),the low fluoride high arsenite group(5 mg/kg NaF + 10.0 mg/kg NaAsO2) and the high fluoride high arsenite group(20 mg/kg NaF + 10.0 mg/kg NaAsO2).The expression of Runx2 mRNA was determined by quantitative real-time RT-PCR.Results The expressions of Runx2 mRNA in the control,low fluoride,high fluoride,low arsenite,high arsenite,low fluoride low arsenite,low fluoride high arsenite,high fluoride low arsenite and high fluoride high arsenite groups were 1.024 ± 0.015,1.377 + 0.014,1.587 ± 0.012,1.182 ± 0.015,1.343 ± 0.010,1.444 ± 0.019,1.504 ± 0.013,1.608 ± 0.013 and 1.714 + 0.009,respectively.The expressions of Runx2 mRNA in experimental groups were higher than those in control group (all P ＜ 0.05),fluoride and arsenite were positively correlated with the expression of Runx2 mRNA(all P ＜ 0.01),and there was a dose-response relationship between Runx2 mRNA and fluoride-arsenite levels.Factorial analysis showed that fluorine or arsenic alone could affect the expression level of Runx2(F =46.967,8.317,all P ＜ 0.05),and there was a interaction between fluorine and arsenic to the expression of Runx2 mRNA (F =105.271,P ＜ 0.01).Conclusion Fluoride or arsenic could promote the expression of Runx2 mRNA in bone of rats; there is an interaction between fluorine and arsenic to the expression of Runx2 mRNA.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

[Summary] According to the cutpoint of plasma triglycerides concentration ≥ 1.7 mmol/L,waist circumference ≥85 cm in men or ≥80 cm in women,459 patiens with type 2 diabetes mellitus were divided into four groups:normal waist circumference and triglycerides,normal waist circumference and hypertriglyceridemia,abdominal obesity and normal triglycerides,and hypertriglyceridemic-waist (HTWC) group.The results showed that body mass index,waist circumference,systolic blood pressure,triglycerides,microalbuminuria,and homeostasis model assessment insulin resistance index (HOMA-IR) in HTWC group were higher than those in non-HTWC groups (all P＜0.01),as well as higher diabetic nephropathy incidence (P＜0.05).Multiple logistic regression analysis revealed that HTWC was an independent risk factor of diabetic nephropathy (OR =2.070,95 ％ CI 1.195-3.586).