Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) in severe cardiopaths with crisis. Methods Fourteen cases of severe eardiopaths with crisis were treated by ECMO with V A- ECMO technique, whose pump was centrifugal pump and whose tubes was spread byheparin. The cases included 8 fulminating myocarditis (FM) cases with ventricular arrhythmias or/and acute heart failure or/and cardiac shock and 6 acute myocardial infarction cases with pump failure or cardiac shock,in whom 10 cases with cardiorespiratory resuscitation. Haemodynamics and blood gas analysis, and so on were measured before and after treatment. Results The support time of ECMO was 3-106 h, mean (32.4±27.6) h. After ECMO mean arterial blood pressure (MAP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), partial pressure of arterial oxygen, saturation of blood oxygen improved (P < 0.05 or < 0.01 ), negative value of base excess decreased significantly( P < 0.01 ). MAP had notchanged before and after stopping ECMO [ (80.02±10.20) wan Hg (1 mm Hg = 0.133 kPa) vs (76.34±9.15) mm Hg] (P > 0.05), however, LVEF and LVEDd improved continually (P <0.05). Conclusion ECMO can provide oxygen supply and stable circulation volume for severe cardiopaths with crisis to recover cardiorespiratory function or save valuable time to treat primary disease.

Aim To evaluate the inhibitive and induc-tive effects of Polygonum capitatum water extract on main cytochrome P450 isoforms in human and liver mi-crosomes of mouse in vitro for predicting the herb-drug interactions in clinical application. Methods The in vitro inhibitory effect was evaluated by incubating Po-lygonum capitatum water extract with the probe sub-strates of main phase I metabolic enzymes in human liver microsomes, including CYP1A2, CYP2E1, CYP2C9,CYP2C19 and CYP3A4. Mice were adminis-tered with Polygonum capitatum water extract at dosage of 0 . 58 g · kg-1 and 1 . 16 g · kg-1 by gastric lavage for successive 7 days and 14 days, then the cocktail-LC-MS/MS method was applied to assess the inductive effect of main CYP450 isoforms in mouse liver micro-somes. Results The IC50 values of Polygonum capita-tum water extract on main CYP450 isoforms in human liver microsomes were from 849 . 6 mg · L-1 to 2 287 mg·L-1 . Compared with the blank control group, the activites of CYP2C9 and CYP3A4 in 1. 16 g·kg-1 7 d group were about 49 . 9 % and 21. 1 % higher ( P <0. 01, P < 0. 05 ) respectively, the activities of CYP2C9 and CYP3A4 in 0. 58 g·kg-1 7 d group were 27. 6 % and 15. 5 % higher ( P <0. 01 , P <0. 05 ) respectively, the activities of CYP2C9 and CYP3A4 in 1. 16 g·kg-1 14 d group were 67. 5 % and 32. 1 %higher (P<0. 01) respectively, while the activities of CYP1 A2 , CYP2 E1 and CYP2 C19 were not increased significantly in Polygonum capitatum treatment group. Conclusions Polygonum capitatum water extract do not show the inhibitory effect on main CYP450 in hu-man liver microsomes. There is induction on CYP2C9 and CYP3 A4 in mouse liver microsomes by Polygonum capitatum water extract.

Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P ＜ 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.

OBJECTIVE:To study the effect and thepossible mechanism of low molecular weight heparin(LMWH)on immunocytes' adhesion to fibroblast-like synovocytes(FLS)isolated from patients with rheumatoid arthritis(RA)and to study LMWH'S possible anti-inflammatory effect on RA.METHODS:LMWH's interference on the adhesion of peripheral blood monouclear cells(PBMC)isolated from healthy volunteers to FLS of RA patients was determined by quantitative counting using flow cytometry.The expression of CYR61 in the in vitro cultured FLS of RA patients was detected using real-time PCR technology.RESULTS:When FLS culture system was added with PBMC,PBMC were obviously found to adhere to FLS,but the number of adhered PBMC decreased after LMWH treatment,which manifested as increase of deciduous PBMC,increased more with the increase of LMWH dose.There was a high expression of CYR61 in synovium tissue in RA patients.CONCLUSION:LMWH inhibited the adheresion of PBMC to FLS from RA patients in a dose-dependent manner,which might be attributed to its competitive combination with heparin sulfate sites on CYR61.

Objective To explore the efficacy of endoscopic sphincterotomy with small incision combined with balloon dilatation (sEST+EPBD)in the treatment of patients with choledocholithiasis and juxtapapillary duodenal diverticula (JPDD).Methods From January 2011 to January 2015 ,149 patients with choledocholithiasis and JPDD who underwent endoscopic retrograde cholangio-pancreatography (ERCP)were enrolled.Among them,60 patients were in sEST+EPBD group and 89 were in endoscopic sphincterotomy (EST)group.Success rate of ERCP and first-time stone removal,changes of total bilirubin (TBil)and direct bilirubin (DBil)levels,as well as the incidence of postoperative complications between the two groups were compared.Chi-square test or t-test was performed for statistical analysis. Results The ERCP success rate sEST+EPBD group was 100.0% (60/60),and the first-time success rate of stone removal was 91 .7%(55/60);correspondingly,ERCP success rate of EST group was 98.9%(88/89),and the success rate of first-time stone removal was 77.5 %(69/89).There was no statistically significant difference in success rate of ERCP between the two groups (χ2 =0.19,P =0.410).The first-time success rate of stone removal of sEST +EPBD group was higher than that of EST group,and the difference was statistically significant (χ2 =5 .53,P =0.020).After operation,the TBil level of sEST+
EPBD group was (152.62 ±109.04 )μmol/L,which was lower than that before operation ((266.02 ± 143.31)μmol/L),and the difference was statistically significant (t =4.88,P <0.01 ).After operation, the DBil level of sEST +EPBD group was (87.13 ±65 .90)μmol/L,which was lower than that before operation ((175 .70 ± 100.53 )μmol/L),and the difference was statistically significant (t = 5 .71 ,P <0.01).After operation,the TBil level of EST group was (251 .90 ±247.90)μmol/L,which was lower than that before operation ((340.20 ±176.20 )μmol/L),and the difference was statistically significant (t=2.74,P <0.05).After operation,the DBil level of EST group was (168.10±140.60)μmol/L,which was lower than that before operation ((228.40 ±139.60 )μmol/L),and the difference was statistically significant (t = 2.87,P = 0.005).The complication rate of sEST + EPBD group after operation was 8.3%(5/60),which was lower than that of EST group (20.2%,18/89 ),and the difference was statistically significant (χ2 =3.88,P =0.049 ).Conclusion sEST+EPBD could increase the first-time success rate of stone removal in patients with choledocholithiasis and JPDD,and it is a safe and effective treatment.

Objective To evaluate PICCO (pulse indicator continuous cardiac output) to predict fluid responsiveness in patients with acute lung injury secondary to septic shock.Methods We conducted a prospective study on 42 patients with acute lung injury secondary to septic shock.global end-diastolic volume index (GEDVI),pulse pressure variation (PPV),stroke volume variation (SVV),central vein pressure (CVP) and other haemodynamic data were recorded before and after fluid administration of 500 mL of 6％ hydroxyethyl starch.Responders were defined as patients with an increase in stroke volume index of at least 15％ after fluid loading.Performance of variables was analyzed using receiver operator characteristics analysis.Results GEDVI and PPV,but not SVV and CVP,were able to predict fluid responsiveness in patients with acute lung injury secondary to septic shock 1 hrs after admission to intensive care unit (ICU).The best area under the ROC curve (AUC) was found for GEDVI (AUC 0.802,P ＜0.01) and PPV (AUC 0.752,P ＜0.01) ; the optimal cut-off of GEDVI and PPV were 643.5 mL/m2 and 13.5％,respectively.At this cut point,the sensitivity was 90.9％,the specificity was 91.9％,however,only GEDVI was able to predict fluid responsiveness in patients with acute lung injury secondary to septic shock 6hrs afteradmission to ICU.The best area under the ROC curve (AUC) was found for GEDVI (AUC 0.788,P ＜ 0.01).the GEDVI ＜ 559 mL/m2 during loading were found to predict volume responsiveness with a sensitivity of 100％,specificity of 62.5％.Conclusions GEDVI and PPV predict fluid responsiveness in patients with acute lung injury secondary to septic shock in the early hours.

Sulfur , a major component of gunpowder , has been widely used in the engineering and military in-dustries since ancient times . In fact , the application of sulfur in traditional Chinese medicine ( TCM ) has a long history , which indicated the uniqueness of TCM theory and practice . Besides , sulfur has played an impor-tant role for the development of TCM in the history . In order to scientifically analyze the role of sulfur in TCM , this paper focused on the application and evolution of sulfur in the development process of TCM , which aimed to provide a reference for the study of the value and role of sulfur in TCM .

OBJECTIVE To find the infla mmation bio markers induced by coke oven e missions (COE),we investigated the changes of T helper 17 (Th17 )cytokines in hu man bronchial epithelial (16HBE)cells.METHODS 16HBE cells were exposed to organic extracts of COE collected fro m co-king plant at the concentrations of 5,10 and 20 mg·L -1 for 24 h or 5 d to establish short-term and long-term cell models,respectively.Cell viability was measured by MTT assay and infla mmatory da mage was assessed by lactate dehydrogenase assay (LDH).The cytokines in culture supernatant sa mples was detected by co mmercial hu man Th17 cytokine panel kit.RESULTS COE Can induce infla mmation in COE 20 mg·L -1 group and no expression on IL-17 F and IL-1 β.The concentration of IL-10 was 1 .25 ± 0.54,1 .39 ±0.13 and (1 .90 ±0.73)pg·mL -1 in COE 5,10 and 20 mg·L -1 group showing good con-centration-effect relationship (r=0.98,P <0.05 ).IL-23 expression was found only higher at 10 and 20 mg·L -1 and the concentrations were 3.38 ±3.90 and (1 .74 ±2.00 )pg·mL -1 ,respectively.In 16HBE cells treated by COE for 5 d,elevated expression of IL-17A was found in COE 5 and 10 mg·L -1 group,and there was statistically sigificant difference between COE 10 mg·L -1 and DMSO group (P<0.05).Elevated concentration of IL-17F of 10.2 ±1 1 .78 and (6.79 ±7.84)pg·mL -1 was found in COE 5 and 10 mg·L -1 group.The concentration of IL-10 was 1 .71 ±0.02,1 .49 ±0.25 and (2.82 ± 0.33)pg·mL -1 in COE 5,10 and 20 mg·L -1 group,respectively.We found increased IL-1 βexpression with concentration of 2.72 ±0.62,2.25 ±0.33 and (0.93 ±0.21 )pg·mL -1 in COE 5,10 and 20 mg·L -1 group with negative dose-response relationship.We also found more elevated TNF-αlevels in the 5 d than in the 24 h model with no COE specific relationship.CONCLUSION COE induces expression changes of Th17 cytokines profile in 16HBE cells,including IL-23 and IL-1 βfor early and long-term infla mmation,respectively.IL-10 may be a candidate marker for population study on COE induced infla mmatory injury.

In order to solve the adhesion and the softening problems of traditional Chinese medicine extract during spray drying, a new method of adding dehumidified air into spray drying process was proposed, and the storage stability conditions of extract powder could be predicted. Kouyanqing extract was taken as model drug to investigate on the wet air (RH = 70%) and dry air conditions of spray drying. Under the dry air condition, the influence of the spray drying result with different air compression ratio and the spray-dried powder properties (extract powder recovery rate, adhesion percentage, water content, angle of repose, compression ratio, particle size and distribution) with 100, 110, 120, 130, 140 °C inlet temperature were studied. The hygroscopic investigation and Tg value with different moisture content of ideal powder were determined. The water activity-equilibrium moisture content (aw-EMC) and the equilibrium moisture content-Tg (EMC-Tg) relationships were fitted by GAB equation and Gordon-Taylor model respectively, and the state diagram of kouyanqing powder was obtained to guide the rational storage conditions. The study found that in the condition of dry air, the extract powder water content decreased with the increase of air compression ratio and the spray drying effect with air compression ratio of 100% was the best performance; in the condition of wet air, the extract powder with high water content and low yield, and the value were 4.26% and 16.73 °C, while, in the dry air condition the values were 2.43% and 24.86 °C with the same other instru- ment parameters. From the analysis of kouyanqing powder state diagram, in order to keep the stability, the critical water content of 3.42% and the critical water content of 0.188. As the water decreased Tg value of extract powder is the major problem of causing adhesion and softening during spray drying, it is meaningful to aid dehumidified air during the process.
Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Humidity ; Medicine, Chinese Traditional ; Plant Extracts ; chemistry ; Powders ; Temperature

Objectives To compare prospective memory (PM) deficits with retrospective memory (RM) deficits and to explore the correlation between PM and RM in chronic schizophrenia. Methods Fifty chronic schizophrenia pa?tients and fifty healthy controls were recruited. The PM performance [event-based PM (EBPM) and time-based PM (TB?PM)] were evaluated by the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT); working memory (WM) was evaluated by the digital span subtest (DS);immediate auditory logical memory (IALM), delayed audito?ry logical memory (DALM), immediate visual reproduction memory (IVRM) and delayed visual reproduction memory (DVRM) were evaluated by the logical memory and visual reproduction subtest. The score of each test was transformed to comparable standard score. Results Patients performed significantly worse on EBPM [(7.9 ± 3.4) vs. (13.7 ± 2.9)], TBPM [(6.9±3.6) vs. (13.0±3.2)], DS [sequence:(5.8±2.0) vs. (7.5±2.2);backward:(6.5±1.9) vs. (8.2±2.8)], IALM [(8.3±3.1) vs. (11.9 ± 2.5)], DALM [(7.4 ± 3.7) vs. (11.8 ± 2.6)], IVRM [(8.0 ± 2.7) vs. (11.2 ± 3.8)], and DVRM [(7.7 ± 3.5) vs. (10.8 ± 2.7)] scores than controls (P<0.05). The extent of deficits of EBPM and TBPM were greater than those of DS (sequence and backward), IALM, DALM, IVRM and DVRM (P<0.05), but not DALM (P>0.05). The performance of PM in chronic schizophrenia was significantly related to DS (sequence and backward), IALM, DALM and DVRM (P<0.05), but not IVRM (P=0.155). Conclusion:There are greater prospective memory deficits than retrospective memory deficits in chron?ic schizophrenia and the prospective memory deficits are correlated with the retrospective memory deficits in chronic schizophrenia.