This study was designed to validate the correlation between integrated pharmacokinetic and therapeutic effects of alkaloids using bile processed Rhizoma Coptidis (BRC). Rats were divided into three groups: normal, disease model, model+BRC. Rats were induced to have an excessive heat syndrome. Rectal temperatures were collected at 0, 3, 6 and 9 h after single oral administration of the drugs. The plasma concentrations of three alkaloids were quantified at different times by UPLC-MS/MS after the administration of BRC. An approach of self-defined weighting coefficiency was created to the holistic pharmacokinetic profiles of alkaloids in BRC. The classified and integrated synthetic concentrations were obtained, and then the pharmacokinetic parameters of alkaloids were calculated from non-compartmental model analysis. The potential relationship between the integrated mean concentration of alkaloids and the antifebrile efficacy was investigated. The holistic t(max) of alkaloids was 1.11 h, the antifebrile effect of BRC at 3 h was improved over the model group. Double peaking appeared in the integrated blood concentration-time curve, the second t(max) of alkaloids was 4.82 h. The antifebrile effects of BRC at 3-6 h were significant, and the antifebrile effects at 6-9 h was decreased significantly. Dynamic variation of alkaloids of BRC in the body exhibited the similarity to the pattern of its antifebrile effect.
Administration, Oral ; Alkaloids ; pharmacokinetics ; Animals ; Bile ; Coptis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Tandem Mass Spectrometry

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.

BACKGROUND:Experiments have shown that the col agen substrate has the capability of stimulating cartilage generation, but the stimulating role of different types of col agen substrates remains controversial. OBJECTIVE:To investigate the effect of type I and type II col agen on the biological characteristics of human chondrocytes cultured in vitro. METHODS:Human chondrocytes at passage were cultured onto the ordinary culture plates (ordinary plate), type I col agen-coated culture plates (type I plate), and type II col agen-coated culture plates (type II plate). cellgrowth curves were determined by MTT method after cells were cultured for 10 days. By ELISA, PCR, and 1,9-dimethyl methyleneblue technology, type I and type II col agen and glycosaminoglycan contents were quantitatively detected in cartilage cells 28 days after culture. RESULTS AND CONCLUSION:The number of cartilage cells was the highest in type II plate, which was twice of that in type I plate and five times of that in ordinary plate. Cartilage cells in type II plate secreted the least amount of type I col agen, which showed significant differences compared with the ordinary plate (P<0.01) and had no statistical y significant difference with type I plate (P>0.01). Cartilage cells in type II plate secreted the most amount of type II col agen and glycosaminoglycan, showing significant differences compared with the other two plates (P<0.01). The cartilage cells cultured in col agen plates are better than that cultured in ordinary culture plate, type II col agen culture plate is better than type I col agen culture plate in maintaining cellshape, extending the dedifferentiation pattern, and promoting celldifferentiation.

Objective To investigate the risk factors for severe and mild preeclampsia (PE) in women with irregular prenatal care,and to identify practical measures to reduce the occurrence of severe PE.Methods A retrospective study of 222 PE patients with irregular prenatal care,who delivered in Peking University Third Hospital from January 2007 to December 2011,was performed.The risk factors for PE and the status of prenatal care were analyzed.The non-parametric test,Chi-square test,Fisher's exact test,trendy Chi-square test and Logistic regression analysis were used for statistical analysis.Results There were 207 (93.2％) cases of severe PE and 15 (6.8％) cases of mild PE.In 207 severe PE patients,there were 95 cases (45.9％) of early-onset PE (diagnosed before 32 gestational weeks) and 112 cases (54.1％) of late-onset PE.In the 15 mild PE patients,there were two early-onset cases and 13 late-onset cases.The percentage of early-onset cases in severe PE patients was higher than that in mild PE patients [45.9％ (95/207) vs 2/15,x2=6.027,P=0.015].After excluding 9 cases without any prenatal care,213 PE patients were analyzed,and it was found that the proportion of severe PE diagnosed in hospitals of grade 3,2 and 1 were significantly different [5/9,94.2％ (131/139) vs 96.9％ (63/65),x2=8.600,P=0.003].Compared with mild PE patients,the prenatal care interval for PE diagnosis in severe PE patients was longer [M(Q),8.0(4.0) vs 4.8(4.4) weeks,Z=2.695,P=0.007];the frequency of prenatal care after 20 gestational weeks was less [1(1) vs 3(3) times,Z=-4.195,P=0.000];the gestational week of PE diagnosis and referral to grade 3 hospitals were earlier [32.4(5.6) vs 35.4(4.3) weeks,Z=-3.075,P=0.002;33.1(5.3) vs 35.4(3.9) weeks,respectively,Z=-2.608,P=0.009];and the interval between PE diagnosis and referral was longer [0.1 (0.7) vs 0.0(0.0) weeks,respectively,Z=2.904,P=0.004].Multivariate logistic regression showed that the frequency of prenatal care after 20 gestational weeks was an independent risk factor for severe PE (OR=0.115,95％CI:0.046-0.285,P=0.000).Conclusion In women without regular prenatal care,the onset of severe PE is related to low-level prenatal hospital care,lack of prenatal care after 20 gestational weeks and longer prenatal care intervals as well as referral to grade 3 hospitals.

Objective To explore the effect of lactulose oral solution in the treatment of patients with chronic functional constipation and its influence on the level of MTL and NO.Methods 54 cases of patients were selected with primary glaucoma who were treated in our hospital from June 2013 to October 2014 as research objective,and they were randomly divided into research group(29 cases)and control group(25 cases)according to the number table method.All of the patients were given treatment as diet adjusting,defecating exercise and so on.The research group got extra treatment as taking lactulose oral solution 10 g,2 to 3 times per day,for 6 weeks.Results MTL in the research group before treatment was 203.71ng/mL,and it was 371.03ng/mL after treatment for 6 weeks,there was statistically significance on difference of MTL levels between before treatment and after treatment(P <0.05).NO in the research group before treatment was 120.52ng/mL,andit was 69.01ng/mL after treatment for 6 weeks,there was statistically significance on difference of NO levels between before treatment and after treatment(P <0.05).MTL in the control group before treatment was 206.21ng/mL,which was 279ng/mL after treatment for 6 weeks,there was statistically significance on difference of MTL levels between before treatment and after treatment(P <0.05).NO in the control group before treatment was 123.92ng/mL,which was 98.75ng/mL after treatment for 6 weeks,there was statistically significance on difference of NO levels between before treatment and after treatment(P <0.05 ).MTL levels in the research group after treatment was higher than that in the control group when NO levels was lower than that in the control group,the difference was statistically significant(P <0.05).Conclusion Lactulose can improve the secretion of gastrointestinal hormones in plasma such as promoting the secretion of MTL and reducing the synthesis of NO.

0.05),12 h(96.33?76.09),24 h(98.63?75.73),48 h(100.77?69.48) post-CPB were significantly lower than that of pre-CPB(125.53?70.85)(t=2.316,2.139,2.058 Pa0.05).Conclusions The early damage of lung function after CPB is obviously in infants.Accurate management of circulation and respiration are important for reducing acute lung injury and improving pulmonary function.

Objective To investigate the correlation between plasma brain natriuretic peptide (BNP) ,central aortic systolic pres-sure with the degree of coronary artery lesion .Methods One hundred and fifty patients with coronary artery disease ,positive coro-nary angiographic results and without heart failure in the cardiological department of this hospital from March to June 2011 were selected and divided into the hypertension group (n=90) and the non-hypertension group(n=60) according to the blood pressure . The plasma BNP before angiography was detected by ELISA .The coronary lesion vessels and clinical scores were assessed after an-giography .The central aortic pressure before angiography was measured by the noninvasive measurement method and the diastolic blood pressure(DBP) ,systolic blood pressure(SBP) and pulse pressure(PP)were recorded .The correlation between PP and BNP was analyzed by Logistic regression .Results The plasma BNP concentration in the hypertension group was significantly higher than that in the non-hypertension group(P<0 .05) .The SBP level in 2 vessels ,3 vessels was significantly higher than that in the momal coronary group(P<0 .05) ,the PP in 3 vessels was significantly higher than that in the momal coronary group (P<0 .05) . The BNP level in 3 vessels ,2 vessels and single vessel of coronary artery lesion was significantly higher than that in the normal cor-onary artery group(P<0 .05) .The Logistic regression analysis on the PP influencing factors found that PP was closely related with the number of coronary artery lesion vessels ,lesion score ,LVEF and BNP ;the multiple correlation coefficient between PP with the number of coronary artery lesion vessels ,lesion score and BPN was 0 .91 ,its linear model was PP=0 .543 lesion vessels number +0 .656 lesion score + 0 .864 BNP .Conclusion PP of the central aortic pressure is a risk factor for the development and progress of coronary artery stenosis occurrence .BNP may be used as a plasma marker of the degree of coronary artery stenosis .

PURPOSE: Laparoscopic cholecystectomy (LC) has been accepted as one of the best methods for treatment of patients with gallbladder (GB) disease. Diagnosis of malignant gallbladder disease by radiologic finding is possible; however, some cases can be diagnosed incidentally as cancer of the gallbladder after a LC. Prognosis of GB cancer is very poor; however, a complete recovery can be achieved with early detection and resection. This study was performed in order to determine incidence and clinical features of incidentally detected GB cancer after LC. METHODS: A retrospective analysis of 10 Patients diagnosed as GB polyp prior to surgery, but diagnosed incidentally as GB cancer after LC from January 2002 to February 2011 was conducted. RESULTS: Of 124 cases of GB polyp, 10 patients were diagnosed as incidental GB cancer, with incidence rate of approximately 8%. Mean age was 60.9. Mean diameter of polyps was 1.1 cm, with six cases of pedunculated polyps, and four cases of sessile polyps. GB stones were diagnosed by radiologic study prior to surgery in four patients. Four patients had pT1a tumors (limited to mucosa) and six patients had pT2 (invaded perimuscular tissue) or pT3 (perforated serosa, direct invasion into liver). CONCLUSION: Malignancy potential of GB polyps was 8%. Surgeons should be aware of the possibility of malignancy and frozen section biopsy should be performed for examination of suspected GB tissue. If needed, radical cholecystectomy should be performed.
Biopsy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Frozen Sections ; Gallbladder ; Gallbladder Diseases ; Gallbladder Neoplasms ; Humans ; Incidence ; Polyps ; Prognosis ; Retrospective Studies ; Serous Membrane

Objective To evaluate the clinical application and safety of CT-guided pereutaneous transthoracic biopsy in the diagnosis of mediastinal masses.Methods Thirty three cases were undertaken CT- guided percutaneous transthoraeie biopsy with automatic biopsy gun and then the sampling specimens were undergone histological examination.The accuracy of puncture,diagnostic correctness and complications were analyzed.Results The operations were performed successfully in all 33 cases(100%),the definite pathologic diagnosis were made in 28 out of 33 cases(85%)and no complications occurred.Conclusion As for midiastinal masses,CT-guided percutaneous transthoracic biopsy is a feasible,successful,efficient interventional diagnostic method with high accuracy in localization,puncture,diagnosis and few complications, which should he recommended in clinical use more widely.(J Intervent Radiol,2007,16:852-854)

Objective To determine the incidence, clinical manifestation and part of lymphokines which represent the balance of Th1 and Th2 in the role of the immunologic mechanisms for IRIS(immune restoration inflammatory syndromes)in patients initiating HAART(Highly Active Antiretroviral Therapy).Methods A prospective study of all patients initiating HAART was performed. A period of six months tracking initiating HAART was performed. The incidence of IRIS, time of occurrence and clinical disease spectrum were recorded. The main T lymphokines including IL-2, INF-γ, IL-4, IL-10 which on behalf of the balance of Th1 and Th2 were detected. To explore the immunopathologic mechanisms for IRIS, the levels of T lymphokines at pre-HAART, initiating HAART for 1 month, 3months and 6 months were compared in IRIS group and non-IRIS group, healthy group. Results A total of 212 patients were enrolled in this study. 59 patients were diagnosed as IRIS at a median of 21 days after HAART initiation (QR 19 days).The main disease spectrum included tuberculosis, herpes virus infections, pneumocystis jirovecii pneumonia. No matter in the IRIS group or non-IRIS group, the main lymphokines baseline of IL-2, INF-γ reduced and IL-4, IL-10 increased before HAART compared to healthy group (P ＜ 0. 05), which had the tendency to restore balance relations initiating HAART. The lymphokines levels had significant difference between baseline and 6 months initiating HAART (P ＜ 0. 05). The changed levels of lymphokines between IRIS group and non-IRIS group before HAART had significant difference compared to healthy group. IL-2, INF-γ increased level[(11.68 ± 2. 89) pg/ml vs (8.52 ±2.26) pg/ml; (22. 19 ± 6. 22) pg/ml vs (18.34 ±5. 35) pg/ml] and IL-10 decreased level [(19. 21 ± 4. 03) pg/ml vs (23. 19 ± 5.92) pg/ml] had significant difference between IRIS group and non-IRIS group initiating HAART I month(P ＜0. 05). Conclusions The incidence of IRIS during 6 months initiating HAART in HIV/AIDS was 27. 8%, IRIS usually occurred in 1 month initiating HAART. The most common disease spectrum was infectious disease, including tuberculosis and herpes virus infection. Lymphokine of Th1 and Th2 existed unbalance in IRIS group and non-IRIS group before HAART. The unbalance tendency in IRIS group was more obvious. All lymphokines had the trend to recover balance. IL-2, INF-γ significantly increased and IL-10 significantly decreased, which might involve the occurrence of the IRIS.