AIM: Hematopoietic stem cell transplantation is the only method to cure hematologic disease. This article analyzes risky factors as to suffering and development of diabetes after hematopoietic stem cell transplantation for malignant hemopathy. METHODS: ①Sixteen patients who received hematopoietic stem cell transplantation were enrolled at the Wuhan Central Hospital from January 2003 to February 2007. They were divided into diabetic (n=6) and non-diabetic (n=11) groups with an average age of 45.2 years. ②The interrelationship between occurrences of diabetes after hematopoietic stem cell transplantation and patients' age, symptom before operations (times of chemotherapy, times of large amount of dosage for intensifying treatment, status of blood pressure, sugar tolerance), immunosuppressant, dosage and time of cortex incretion as well as effect of diabetes on patients. RESULTS: Sixteen patients were included in the final analysis ①5 cases of diabetes occurred after surgery; patients with abnormal sugar tolerance before surgery possessed a higher rates of occurrence of diabetes than those with normal sugar tolerance; ②Those patients of older than 40 years and who had taken in sugar-containing cortex incretion during chemotherapy also possessed a comparatively higher rates of occurrence of diabetes; Patients whose intake of cortex incretion have being cancelled after half a year of transplantation possessed an obviously lower rates of occurrence of diabetes than those intake of cortex incretion had being cancelled within half a year of transplanting operation. ③ Application of immunosuppressant and plasma drug concentration had no affect on occurrence of diabetes in both groups. ④No evident effect of infection rate of cytomegalovirus was detected in the diabetic group. CONCLUSION: Those patients that are older than 40 years and who have taken in sugar-containing cortex incretion during chemotherapy and with abnormal sugar tolerance as well as taking in sugar-containing cortex incretion to prevent occurrence of graft-versus-host-disease (GVHD) possess relatively higher rates of occurrence of diabetes.

Objective To evaluate the effect of lipoic acid on endothelial microparticles (EMP) in diabetic patients with peripheral artery disease (PAD) of the lower limbs. Methods Forty eight diabetic patients with PAD of the lower limbs were randomly divided into two groups: the therapeutic group and control group (each group has 24 cases). Patients of control group only received internal comprehensive medicine therapies for 3 weeks. Patients of therapeutic group were treated with both lipoic acid (600 mg lipoic acid injection in normal saline solution for intravenous drip, once daily for 3 weeks) and internal comprehensive medicine therapies at the same time. The levels of EMP in venous blood and Ankle-brachial index (ABI) were estimated before and after treatment by flow cytometry. Results Compared to the control group after treatment [(1 179. 8± 120. 1) per μL], EMP value showed a significant reduction in therapeutic group [(1 032. 4±117. 2) per μL] (P<0. 01). The levels of ABI of therapeutic group (0. 68 ±0. 10) was increased obviously as compared that before lipoic acid treatment (P<0. 01). Patients treated with lipoic acid showed the higher levels of ABI than the control group after treatment (0. 58±0. 11) (P<0. 01). Conclusion Lipoic acid injection significantly decreased the level of EMP in diabetic patients with PAD of lower limbs. Lipoic acid might be an effective drug for diabetic patients with PAD.

OBJECTIVETo observe the clinical efficacy of Compound Xiatianwu tablets in the treatment of active rheumatoid arthritis.

METHODOne hundred and eighty cases with active rheumatoid arthritis were randomly divided into the control group (60 cases) with leflunomide, sulfasalazine, and celecoxib; the treatment group (120 cases) given compound Xiatianwu tablets on the basis of the control group, 2 tablets each time, 3 times/day, with the course of treatment of 3 month. Patients of the two groups were observed for clinical symptoms, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and immunoglobulin changes before and after the treatment.

RESULTThe treatment group showed an overall efficiency of 94. 2% , the Xiatianwu group showed an overall efficiency of 80. 0%, while the control group showed an overall efficiency of 81.7%. The difference among the three groups was statistically significant (P <0. 05 or P <0. 01) , indicating that the treatment group was superior to the Xiatianwu group, while the Xiatianwu group was superior to the control group.

CONCLUSIONCompound Xiatianwu tablets has remarkable effect in the treatment of active rheumatoid arthritis.

Adult ; Arthritis, Rheumatoid ; drug therapy ; immunology ; metabolism ; pathology ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Erythrocytes ; drug effects ; Female ; Humans ; Immunoglobulins ; metabolism ; Male ; Middle Aged ; Tablets ; Treatment Outcome ; Young Adult

Objective To optimize the extraction process of total phenolic acids from Cibotii rhizoma using Box-Behnken design-response surface methodology and evaluate antioxidant activity of total phenolic acid in vitro.Methods Taking the liquid-solid ratio,ethanol concentration and extraction temperature as influencing factors,and the extraction rate of total phenolic acids as evaluation indicator,the extraction process of total phenolic acids from Cibotii rhizoma was optimized using a three-factor and three-level Box-Behnken design-response surface methodology on the basis of single factor tests.Meanwhile,the scavenging effects of total phenolic acid extract from Cibotii rhizoma on ABTS·+and DPPH· was determined.Results The optimized extraction process for total phenolic acids from Cibotii rhizoma was as follows:the ethanol concentration of 55％,the extraction temperature of 88℃ and the liquid-solid ratio of 60∶1 mL/g.Under these conditions,the extraction rate could reach 8.67％.When the mass concentration of total phenolic acids extract were 2 mg/mL and 1 mg/mL,the clearance rates of ABTS·+and DPPH·were 92.76％and 88.66％,respectively.Conclusion The theoretical values obtained from the response surface optimization method are consistent with the actual measured values,and the extraction process of total phenolic acids from Cibotii rhizoma was simple and feasible.The total phenolic acids extract from Cibotii rhizoma exhibit strong antioxidant activity in vitro.

Objective? To explore the effects of perioperative nursing care after stage I surgical treatment for scoliosis complicated with intraspinal lesion. Methods? Totally 12 patients with scoliosis complicated with intraspinal lesion who received stage I surgical treatment from October 2016 to December 2017 were selected by retrospective analysis. These patients received targeted nursing care and functional exercise guidance perioperatively to prevent the incidence of surgical complications. Results? The stage I surgical treatment for the 12 patients with scoliosis complicated with intraspinal lesion was successful. Their lower limb muscle strength improved and their muscular tension reduced; and urination disorder was mitigated post operation. The length of hospital stay was (14.91±2.90)d, ranging from 9 to 20 d. No perioperative infection, cerebrospinal fluid leakage or other surgical complications were found in any patient. The duration of postoperative follow-up visits was (11.75±3.42) months, ranging from 3 to 17 months. No loss or deterioration of neurological function, delayed infection, pseudarthrosis or orthopaedic loss was found. Conclusions? Stage I surgical treatment for scoliosis complicated with intraspinal lesion can improve the treatment effects in patients. Better perioperative observation and specialized nursing care can help to reduce the incidence of relevant complications.

Cibotii Rhizoma has a long history of folk usage and clinical applications,which is commonly used to treat symptoms such as waist and knee soreness,numbness of hands and feet.Its chemical components mainly include sugars and glycosides,aromatics,volatile oils,pterosins,flavonoids,steroids,pyranones,amino acids and inorganic elements.Pharmacological studies have shown that Cibotii Rhizoma has antioxidant,anti-inflammatory,anti-osteoporosis,gastrointestinal protection,antibacterial,liver protection,anticancer,analgesic and other effects.This paper systematically reviews the research status of chemical constituents,pharmacological effects and quality control of Cibotii Rhizoma,which provides reference for the development and rational use of Cibotii Rhizoma.

OBJECTIVE This study aimed to investigate the role and mechanism of Astragaloside IV (AS-IV)in rats with myocardial infarction.METHODS The myocardial infarction model was established by ligation of the left anterior descending artery. The rats were randomly divided into sham, DMSO, model group, AS-IV and CID755673 groups. The rats were sacrificed 4 weeks later, and segmental heart samples were used for hematoxylin and eosin staining and masson staining. The expression of PKD1, HDAC5 and VEGF were analyzed using immunohistochemistry, reverse transcription poly-merase chain reaction and western blot. RESULTS Compared with the sham operation and DMSO groups,morphology of myocardium in model group was disordered,accompanied with necrotic myocar-dial cells and obvious collagen tissues. After treatment with AS-IV, the morphology of myocardium was obviously improved, and the number of new blood vessels increased significantly. However, after treatment with CID755673, the myocardial tissue of rats became disordered again, the necrotic cells increased, and some vessels closed. The expression levels of PKD1, HDAC5 and VEGF mRNA and protein in myocardial tissue of model group were significantly lower than the other four groups(P<0.05), whereas these levels in the AS-IV group were significantly higher than those in the other four groups (P<0.01). Additionally, the CID755673 group had significantly higher levels of PKD1, HDAC5 and VEGF mRNA and protein than the sham group, DMSO group and model group (P<0.05). CONCLUSION AS-IV may partly promote the angiogenesis of myocardial tissue in rats with myocardial infarction via the PKD1-HDAC5-VEGF pathway.

Objective:To explore the effect of the wearing time of cervical collar on the rehabilitation of patients with anterior cervical discectomy and fusion (ACDF) .Methods:The data of 97 patients with cervical spondylosis who were admitted to the Neurosurgery Spine Group of Xuanwu Hospital of Capital Medical University and underwent 1-2 segment ACDF from January 2016 to December 2017 were retrospectively analyzed. According to the wearing time of cervical collar after operation, the patients were divided into 1-4 weeks group (39 cases) , 5-8 weeks group (22 cases) , and 9-12 weeks group (36 cases) .The scores of the Japanese Orthopaedic Association Score (JOA) , Axial Symptom Score (AS) , and Neck Disability Index (NDI) were compared among the three groups before operation and 3 months after operation.Results:The postoperative JOA scores of the three groups were improved compared with those before the operation, and the differences were statistically significant ( P<0.05) ; however, there was no significant difference among the three groups before operation and 3 months after operation ( P> 0.05) . Compared with preoperative, the postoperative AS scores in 1-4 weeks group and 5-8 weeks group has no significant difference ( P> 0.05) , but the AS score of the 9-12 weeks group decreased compared with that before operation, and the difference was statistically significant ( P< 0.05) . After operation, the difference of AS scores among three groups was statistically significant ( P< 0.05) . The postoperative NDI scores of the three groups were improved compared with those before operation, and the differences were statistically significant ( P<0.05) . The improved effect of NDI in the 5-8 weeks group was better than that in the 1-4 weeks group, and the difference was statistically significant ( P<0.05) . Conclusions:The incidence of axial symptoms in patients with 1-2 segment ACDF increases with the wearing time of cervical collar. The cervical collar wearing time for 5 to 8 weeks has the best effect, the patients have the lowest disability index, and did not significantly increase the patients ' axial symptoms.

Esophageal cancer has a high morbidity and mortality worldwide， and the burden of esophageal cancer is still heavy in China. The conventional treatments such as radiotherapy and chemotherapy fail to yield a satisfactory outcome， implying that the safe and effective treatments are not available for the majority of patients. At present， esophageal cancer is mainly treated by Chinese medicine combined with radiotherapy and chemotherapy. The retrieval of related papers in Chinese and English reveals that Kang'ai injection， Compound Kushen injection， Kanglaite injection， Xiaoaiping injection， Aidi injection， Bruceae Fructus Oil Emulsion， Cinobufotalin injection， and Shenmai injection have been commonly used in esophageal cancer treatment. These eight injections are either single medicinal or compound preparations， involving 11 Chinese medicinals， which synergize the effects of radiotherapy and chemotherapy and reduce their adverse reactions in the treatment of esophageal cancer. Due to the complexity of Chinese medicinal components， a series of adverse reactions such as phlebitis， phlebosclerosis， and hemolysis may be caused by irrational dosage， administration speed， and compatibility in the use of injection. There are many clinical studies on Chinese medicine injections for anti-esophageal cancer but few studies on their active components and molecular mechanism. This paper reviewed the active components， effectiveness， safety， and mechanism of Chinese medicine injections frequently employed for treating esophageal cancer， in order to provide reference for their clinical application as well as the development of new Chinese drugs.