OBJECTIVE: To explain the current situation of the study on Chinese herb nephropathy (CHN), clarify the concept of CHN and investigate the pathogenesis, also suggest the measures for the prevention and treatment of CHN.DATA SOURCES: Articles about kidney impairment induced by Chinese herbal medicine containing aristolochic acid (AA) published in English between January 1994 and April 2006 were searched in Pubmed database by using the keywords of "kidney impairment induced by Chinese herbal medicine containing aristolochic acid (AA), nephropathy induced by aristolochic acid (AA), Chinese herb nephropathy (CHN)". Other articles were collected by the specific name of journals and title of papers by retrieving VIP database.STUDY SELECTION: The original articles were checked primarily, those about kidney impairment induced by Chinese herbal medicine containing AA were selected, those obviously irrelevant ones were excluded, and the full-texts of the involved articles were searched manually.DATA EXTRACTION: Totally 86 articles were collected, 20 of them were involved, and the other 66 repetitive studies or reviews were excluded:DATA SYNTHESIS: At present, kidney impairment induced by Chinese herbal medicine has not attracted enough attentions in Chinese, and effective monitoring system should be established. The diagnosis and pathogenesis of nephropathy induced by AA are still unclear, and the prevention is the main treatment. Therefore, we should realize its harmfulness, and reinforce its basic and clinical researches.CONCLUSION: The main damage in kidney caused by AA focuses on the renal tubulointerstitial matrix. Renal glomerulus is rarely involved in the toxic process. Clinical manifestations also reflect the impairment of renal tubules and interstitium such as interstitial fibrosis. A more effective diagnosis monitoring and screening system should be set up in order to mesh the patients at the early stage. A more stringent method for classification of the species in fourstamen stephania root family will be established to avoid confusion and error. More valid therapeutic channels should investigate for its remedy.

Objective To study the relationship between serum high sensitive C-reactive protein(Im-CRP) and acute coronary syndrome(ACS). Methods We detected and analyzed the levels of hs-CRP in 38 clinical deft-trite patients with ACS. Results Patients with ACS had significantly higher serum hs-CRP levels than the control group(P < 0.05). Conclusion Serum hs-CRP level has high correlation with ACS, and the hs-CRP maybe a arthero-sclerosis marker,which reflected the process of coronary artery disease.

Objective To observe the effects of intensive insulin therapy on IL-10 level and NF-ΚB activity in peripheral blood mononuclear cells in patients undergoing cardiopulmonary bypass.Methods The non-diabetic patients undergoing cardiopulmonary bypass in our department were selected and assigned to intensive therapy group (group A,n=40) and received strict glycemic control after the initiation of surgery.And those who undergoing cardiac surgery but without strict glycemic control were assigned to routine therapy group (group B,n=40) as controls.The blood glucose in group A was maintained at 4.4～8.3mmol/L,whereas the glucose in group B was below 11.lmmol/L.The concentration of serum IL-10 and NF-ΚB activity in peripheral blood mononuclear cells was measured at different time points.Results There were no significant differences in general data between two groups.The concentration of IL-10 in group B was significantly lower than that in group A(P<0.05).compared with group B,strict glycemic control markedly suppressed NF-KB activation (P<0.05).Conclusion Intensive insulin therapy could reduce the activity of NF-ΚB and then reduce the expression of IL-10.Strict glycemic control could significantly mitigate the systemic inflammatory response.

OBJECTIVETo observe the effect of sodium ferulate on the hemodynamics of hepatic cirrhosis patients.

METHODSEighty-two hepatic cirrhosis patients were randomly assigned to two groups, the 27 patients in the control group were treated by conventional liver protecting therapy, and the 55 patients in the treated group were treated with sodium ferulate besides the conventional therapy. The therapeutic course for both groups was two weeks. The following indexes were measured before treatment and two weeks after treatment respectively: inner diameter of portal vein (PV), inner diameter of splenic vein (SPV), maximum portal vein flow rate (PVX), maximum splenic vein flow rate (SPVX), portal vein blood flow (QPV) and endothelin-1 (ET-1) concentration. The adverse effect was observed meanwhile.

RESULTSIn the treated group after treatment, levels of PV, SPV and ET-1 decreased (P < 0.01), PVX and SPVX increased significantly (P < 0.01), but QPV was unchanged; while no significant change of all the indexes was found in the control group (P > 0.05). Further analysis showed that in the treated group, PV, SPV and ET-1 decreased significantly in patients of Child grade A and B (P <0. 01), but QPV changed insignificantly (P > 0.05, and all indexes were unchanged in patients of Child grade C (P > 0.05).

CONCLUSIONSodium ferulate can effectively lower the pressure of portal vein in hepatic cirrhosis patients without any influence on the blood flow of portal vein, the effect is more significant on patients of Child grade A and B.

Adult ; Aged ; Coumaric Acids ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Hypertension, Portal ; drug therapy ; physiopathology ; Liver Cirrhosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Treatment Outcome

Objective To analyze the ischemia degree of initial electrocardiogram in the patients of acute ST-segment elevation myocardial infarction (STEMI) and investigate its value in the predicting cardiogenic shock (CS) after percutaneous coronary intervention (PCI).Methods Three hundred and ninety patients with STEMI from the onset of symptoms to admission within 12 h were divided into two groups based on grade Ⅱ ischemia (group A,248 cases) or grade Ⅲ ischemia (group B,142 cases) in the initial electrocardiogram.Clinical data,TIMI risk score,ST-segment resolution (STR),CS and cardiovascular events (hospital mortality,ventricular arrhythmias,reinfarction) were recorded in all patients.Results The gender,time from onset to balloon opening,smoking,hypertension,type 2 diabetes,hyperlipidemia,stroke,postoperative TIMI flow 3 grade,coronary artery lesions and lesions in the left main stem between two groups was not statistically significant (P ＞0.05).In group B,the rate of ST segment resolution ＞ 50％ was significantly lower than that in group A [53.2％ (132/248) vs.29.6％ (42/142)] (P ＜ 0.01).The incidence of CS,in-hospital death,malignant ventricular arrhythmias in group B was higher than that in group A,and the difference was statistically significant (P ＜ 0.05).The age,left ventricular ejection fraction,TIMI risk score ＞ 3 points,Killip grade ＞ 1 grade,anterior myocardial infarction between two groups was statistically significant (P ＜ 0.05 or ＜ 0.01).The indicators that were statistically significant in the univariate analysis were included into Logistic regression model and analyzed,with CS-related factors as independent variables and CS as the dependent variable and found that age (P =0.008),Killip class ＞ 1 grade (P =0.049),ST segment resolution rate (P =0.008) and grade Ⅲ ischemia (P =0.001) as independent predictors of CS after PCI.Conclusions Grade Ⅲ ischemia is an independent predictor of CS after PCI in STEMI patients.And it has predictive value for hospital mortality and ventricular arrhythmias.

Objective To discuss the protective effects and mechanisms of dexamethasone and Shenfu sepa-rate and joint administration of flap after ischemia-reperfusion injury. Methods 40-month-old fairly healthy rats were randomly divided into 4 group as A, B, C, D, and to product the abdominal island flap, then blocking the flow of blood of the pedicle artery respectively before 30 minutes when injecting with normal saline (1 ml/kg), dexametha-sone (1 ml/kg), Senate (10 ml/kg), joint injection with dexamethasone (1 ml/kg) and Shenfu (10 ml/kg). 4 groups of animals' blood samples were collected from the pedicle vein before the time of I hour when blocking vascu-lar pedicle and reperfusion after the time of 1 h, 6 h, 12 h, 24 h, respectively. Then the plasma concentration of TNF-α was measured. Results The concentration of TNF-α in the treatment group was significantly lower than the blank group(P <0.01). And the group D and the group B、C has significant differences either(P <0.01). Conclu-sion Using Dexamethasone, Shenfu injection in early can reduce the concentration of TNFα in repeffusion injury of flap and has a protective effect on the flap, but make better effect in combined.

Adult ; Back Muscles ; physiopathology ; Fasciitis ; physiopathology ; therapy ; Female ; Humans ; Male ; Moxibustion ; Muscular Diseases ; physiopathology ; therapy

Aged ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Humans ; Male

Animals ; Cells, Cultured ; Interleukin-1beta ; pharmacology ; Male ; Neurons ; drug effects ; metabolism ; Nitric Oxide ; metabolism ; Nitriles ; toxicity ; Pyrethrins ; toxicity ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase ; metabolism

Objective To explore the value and advantage of intracranial pressure (ICP) monitoring in the treatment of hypertensive intracerebral hemorrhage (HICH) through minimally invasive surgery. Methods Seventy-three HICH cases were randomly selected and then divided into control group and treatment group. Thirty-four of them in control group received soft-channel minimally invasive hematoma removal. The head of the soft-channel was placed in the center of the hematoma. One third to half of the initial hematoma was extracted during the operation. Urokinase was injected into the soft channel to dissolve the hematoma. Thirty-nine of them in treatment group underwent the same operation procedure but with ICP monitoring to control aspirating hematoma during the operation. The target ICP was 15 mmHg. The aspiration of hematoma may stop once the ICP down to the target. Treatment such as urokinase injection was adjusted according to the value of ICP monitoring throughout the operation. The incidence of rebleeding, hematoma evacuation time and the average length of stay between two groups were compared. Results The results showed that one fifth of hematoma extracted was enough for a desired ICP. There found no rebleeding case in treatment group while 4 cases in control group and the difference had statistical significance. The hematoma evacuation time and the average length of stay between two groups had statistical significance. Conclusion Continuous ICP monitoring combined with directional software channel minimally invasive surgery changes the concept of empirically intraoperative hematoma evacuation and postoperative drug injection and proposes the idea of controlling drainage. It can shorten the course, provide sensitive and objective indicators and basis, reduce the secondary brain injury and improve prognosis.