Traditional Chinese medicine injections (TCMIs) originated in china, which was fast-acting with high bioavailability. TCMI is applied widely in clinic since it plays an important role for therapy severe and acute disease, such as cardiovascular diseases (CVD), infectious diseases, malignancy, and etc. However, the adverse reactions reported of TCMIs are increasing in recent years. For this, the review summarized systematically the reports and researches of adverse drug reactions (ADRs) of TCMIs according to about 100 literatures in the nearly five years. The ADR of TCMIs mainly includes allergic reaction, respiratory damage, digestive system damage, cardiovascular system damage and urinary system damage, and etc. The main causes are relative with complexity, uncertainty and instability of the drug material. Influence of excipients, pharmaceutical technologies, drug combination and application method was also discussed. There are many methods on adverse reactions of TCMIs, including descriptive studies, analytical epidemiology and experimental studies. This article provided necessary information for reasonable application of TCMIs in clinical practice.
Animals ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Humans ; Injections ; Medicine, Chinese Traditional

Aim To investigate the apoptosis of lung cancer cells A549 induced by quercetin and the regulation of survivin and Bcl-2 on A549 cells induced by quercetin.Methods MTT,fluorescence stain,flow cytometric analysis and immunocytochemistry stain were carried out.Results Quercetin had a significant inhibition on growth and proliferation of A549 cell in a concentration-and time-dependent manner.Evidence was provided that apoptosis occurred in A549 cells treated with quercetin using fluorescence microscopy.Quercetin arrested A549 cells at the G0/G1 phase by FCM analyses.Expression of survivin and Bcl-2 protein were decreased,and activity of caspase-3 were enhanced.Conclusion Quercetin could induce apoptosis of A549 cells.The arrested cell cycle and the down-regulation of survivin and Bcl-2 protein could activate caspase-3 resulting in cells apoptosis,which may contribute to the apoptosis mechanisms.The down-regulated survivin and Bcl-2 may play an important role in A549 cells apoptosis induced by quercetin.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.

Objective To evaluate the functional outcome after repair of zone V flexor tendon and to identify the relevant factors affecting the outcome.Methods A total of 52 patients ( 163 fingers) with wrist lacerations involving zone V flexor tendon from September 2003 to July 2009 were retrospectively studied.The average follow-up period was 32 months.The lacerated tendons were repaired by using three suture methods of different strands.Functional outcome was assessed by determining the active range of motion (AROM),and grip and pinch strength of the injured fingers,testing the independent flexor digitorum superficialis (FDS) action and employing the disability of arm,shoulder,and hand (DASH) questionnaire.Influencing factors for function of the repaired tendon including laceration section levels,repair methods,surgeons' experience,and injury severity were analyzed statistically.Results Functionally,146 out of 163 fingers (89.6％) achieved excellent or good range of motion and 103 out of 147 fingers with FDS injury (70.1％ ) obtained independent FDS action.Grip and pinch strength recovered to about two-thirds of the uninjured level.The mean DASH score was 11.9.Patients had adverse functional outcorme in tendons repaired with the 2-strand Kessler,in the tendons repaired by the surgeons with low level of expertise,or in the wrists with Spaghetti injuries,but levels of laceration section had no significant influence on the outcomes.ConclusionsFunctional recovery of zone V flexor tendon injuries is generally good,but repair methods,levels of expertise of surgeons,and injury severity have significant influences on the outcome.Thereby,advanced levels of expertise of surgeons can effectively improve the postoperative function.

Objective To explore the content change of Alpha Fetal Protein(AFP) and Alpha Fetal Protein Variants(AFP-L3) pre-and post-liver transplantation operation for liver cancer patients.Methods AFP-L3 was de-termined by micro centrifugal column from twelve cases of successive sera(For each case,one original shale pre-oper-ation,and mole shares post-operation successively),and preserved from patients who were diagnosed as fiver cancer and completed fiver transplantation operation.simultaneously the content of AFP and AFP-L3 in the original serum were also determined.and the ratio of AFP-L3 in AFP was calculated in order to compare the content change of AFP and the ratio of AFP-L3 pre-and post-liver transplantation operation.Results Compared with twelve cases of pre-and post-operation,the AFP in only five cases turned tO negative;The AFP in other cases keeped positive though AFP-L3%tumde to negative.and the content of AFP in some specific cases still keeped in a high level.Regarding AFP-L3,besides two casses turning to negative immediately after operation,the content of AFP-L3 in other patients de-creased gradually after operation,and it approached to negative(AFP-L3%<10%).Through statistical analysis,be-tween the half lives of AFP and AFP-L3%,there waa no statistic significance.Therefore,AFP-L3% could be considered as an independent reference item.Conclusion After a radical cure of liver resection or liver transplantation operation,AFP-L3%usually turned to negative in a rather short period (about 1 to 20 days).The ratio of AFP-L3 in AFP became be-low 10%,and it indicated that the operation would be quite complete,remaining liver would have hepatitis or hepatocirrho-sis.Otherwise,the ratio was not decrease during a long period,and it indicated the operation had not eliminated focuses completdy.

Background Research showed that transforming growth factor-β2 (TGF-β2) promotes scar formation.But its mechanism in scarring after glaucoma filtration surgery is worthy of studying.Objective This study was to investigate the effect of TGF-β2 on myofibroblast transition of human Tenon fibroblasts (HTFs) and scarring after glaucoma filtration surgery.Methods Tenon capsular tissue was obtained from 3 patients with strabismus during the surgery and was incubated in DMEM with 10％ fetal bovine serum (FBS).The cells were collected and passaged in the free-serum medium for 24 hours,and then 1,2,5,10,20 μg/L TGF-β2 was added into the medium respectively,to induce the transformation of HTFs,and 2 μg/L or 5 μg/L TGF-β2 was used to treat the HTFs for 6,24,48 and 72 hours.The control group was not treated with TGF-β2.The expressions of α-smooth muscle actin (α-SMA) and phosphorylation of the signaling proteins (pSmad2) in HTFs were detected by Western blot assay.The expressions of α-SMA and F-actin were located by cell immunofluorescine technique under the confocal immunofluorescence microscopy.Cell contractility was determined by collagen gel contraction assays.This study was approved by Ethic Committee of Institute of Surgery Research of Daping Hospital,and informed consent was obtained from each patient or custodian initial of the study.Results The expression of α-SMA protein in the HTFs was increased significantly after the treatment of TGF-β2 in comparison with the control group and reached a peak at 24-48 hours.The α-SMA expression was gradually weakened in the 10 μg/L TGF-β2 groups.Little of α-SMA and F-actin were expressed in the control group.However,strong staining for α-SMA and F-actin were observed in the 1,2 and 5 μg/L TGF-β2 groups and then the staining weakened at the concentration of 10 μg/L.In addition,pSmad2 showed a stronger expression in the 2 μg/L TGF-β2 group than that in the PBS group and FBS group,with the strongest expression in 30 minutes through 2 hours.The untreated gel contracted (78.00±3.13)％ from its initial size,and contraction in the 1,2,5,10 μg/L TGF-β2 group were (63.88±1.78)％,(20.69±0.65)％,(19.49-±0.54)％,(16.24±0.84) ％,respectively,TGF-β2 increased HTFs contraction significantly (Fgroup =859.400,P =0.000).Conclusions TGF-β2 can induce transdifferentiation of Tenon fibroblast into myofibroblast and increase cell contractility,with a concentration-dependent and time-dependent pattern to an extent.It may be the mechanism of scar formation after glaucoma filter surgery.

Objective: To explore the relationship between serum sodium level and early prognosis in patients with acute ST-elevation myocardial infarction (STEMI). Methods: A total of 7461 STEMI patients within 12h of onset who matched the diagnostic standard of European society of cardiology and American college of cardiology were retrospectively studied. According to serum sodium levels within 24h of admission, the patients were categorized into 3 groups: Serum sodium≥135 mmol/L group, Serum sodium 130-134 mmol/L group and Serum sodium<130 mmol/L group. The baseline condition, 30-day mortality with other adverse events and the effect of neuroendocriology inhibitor treatment were compared among 3 groups; their relationships to serum sodium level were analyzed. Results: Serum sodium<130 mmol/L group had the higher 7-day and 30-day mortality than the other 2 groups, both P<0.001; compared with Serum sodium≥135 mmol/L group, Serum sodium<130 mmol/L group presented the higher occurrence rates of 30-day cardiac shock, heart failure (HF) and life-threatening arrhythmia, P<0.001. With adjusted affecting factors of age, diuretic and reperfusion treatments, serum sodium<130 mmol/L was still related to 7-day and 30-day mortality (OR=1.69 and OR=1.57). Both single and multivariable analysis indicated that serum sodium<130 mmol/L was related to cardiac shock (OR=1.75 and OR=1.64), HF (OR=1.42 and OR=1.30) and life-threatening arrhythmia (OR=1.53 and OR=1.34). In all 3 groups, the patients using ACE inhibitor, β-blocker or both medications had reduced 30-day mortality than those without such medication, allP<0.001; the reduction was more obvious in Serum sodium<130 mmol/L group than the other 2 groups,P<0.001. Conclusion: Serum sodium level<130 mmol/L within 24h of admission was the risk factor for the early stage main adverse events as mortality, cardiac shock, HF and life-threatening arrhythmia in acute STEMI patients.

Objective To assess the effects of limited hepatectomy on liver regeneration and function recovery of cirrhotic animal model.Methods Cirrhotic rat models were first prepared by intraperitoneal injection of CCL4.After that,the cirrhotic animal models underwent 20％ hepatectomy (n =30).The cirrhotic animals that underwent sham operation (n =30) and normal animals that underwent 20％ hepatectomy (n =30) were used as control groups.From the time when cirrhotic models were prepared to 3 months after 20％ hepatectomy,the hepatic function,coagulation function were tested regularly.Western blotting and real-time PCR were carried out to test the protein and gene expression of TGF-β,HGF and PCNA.Results Hepatic fibrosis and cirrhosis were observed during the preparation of cirrhotic rat models by intraperitoneal injection of CCL4.The hepatic function and coagulation function of cirrhotic models were partly recovered 3 month after 20％ hepatectomy.The gene and protein expression levels of TGF-β in the liver of animal model get higher during the preparation of cirrhotic rat models.However,the gene and protein expression levels of TGF-β get lower in cirrhotic model undergoing 20％ hepatectomy,when compared with that in cirrhotic animals (sham operation) and normal animals (20％ hepatectomy).Furthermore,the gene and protein expression levels of HGF and PCNA get higher in cirrhotic model undergoing 20％ hepatectomy,when compared with that in cirrhotic animals (sham operation) and normal animals (20％ hepatectomy).Conclusions Experimental limited hepatectomy facilitates the liver regeneration and function recovery of cirrhotic animal model,which may provide a novel method for the prevention and treatment of cirrhosis using limited hepatectomy technique.

Objective To evaluate the efficacy and safety of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy.Methods Sixty female patients aged 18-65 years, ASA grade Ⅰ or Ⅱ, undergoing elective unilateral modified radical mastectomy were enrolled.Patients were randomly divided into PECS group (group P, n=30) or control group (group C, n=30).Two groups of patients were given flurbiprofen axetil 1 mg/kg via intravenous injection before operation.After general anesthesia induction, patients in group P received ultrasound guided pectoral nerves block with 30 ml of 0.375% ropivacaine.Patients in group C didn`t receive nerve block.Anesthesia maintenance was performed by combined intravenous-inhalation Anesthesia.Postoperative VAS pain scores (at 0, 3, 6, 12, and 24 postoperative hours), does of intraoperative remifentanil, rescue analgesic requirements in the first 24 h after surgery, adverse reactions were recorded.Results VAS score in group P was lower than that in group C at 0, 3, 6 and 12 h after surgery (P<0.05), there was no difference at 24 h.The dose of remifentanil and the rescue analgesic requirements in group P were lower than those in group C (P<0.05).There was no significant difference in postoperative adverse reactions between the two groups.Conclusion As a supplementary mode of multimodal analgesia, PECS block is a safe and reliable technique that provide better analgesia effect for modified radical mastectomy.

Objective To investigate the efficacy and safety of fluid resuscitation with 75 g/L NaCl solution in traumatic hypovolemic shock using Meta-analysis. Methods Based on the inclusion criteria,the randomized controlled trials (RCTs) were identified by retrieving the databases including PUBMED,EMBASE,OVID,Cochrane library and EBSCO.The quality of studies was also evaluated.Indices including systolic blood pressure,hemoglobin,serum Na level and mortality were extracted from the enrolled RTCs and were comparatively analyzed between the 75 g/L NaCl group and the isotonic saline group for evaluating the safety and efficacy of 75 g/L NaCI solution.The extracted data were analyzed by using the Review Manager 5.0.25. Results Six RCTs were eligible for Meta-analysis.The 75 g/L NaCl group displayed remarkable increase in systolic blood pressure and decrease in hemoglobin level,compared with the isotonic saline group ( MD =6.23,95％ CI 2.78-9.69,P ＜ 0.01 ; MD =-6.11,95％CI -8.25-3.96,P ＜ 0.01,respectively).Short-term hyperosmolar state in 75 g/L NaCl group was increased significantly but was considered acceptable ( MD =7.97,95％ CI 7.55-8.38,P ＜ 0.01 ).No significant difference in mortality was found between 75 g/L NaCl group and isotonic saline group ( RR =0.96,95％ CI 0.84-1.10,P ＞ 0.05). Conclusion Fluid resuscitation with 75 g/L NaCl solution is safe and effective for traumatic hypovolemic shock.