Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

This study was aimed to explore the effect of total flavonoids and saponins from Huang-Qi Ge-Gen (HQGG) decoction on blood glucose (BG), serum lipid, interleukin-12 (IL-12) and interleukin-15 (IL-15) of liver in diabetes mellitus (DM) rats, in order to investigate their interactions in regulating DM processes. A total of 66 SD rats were randomly divided into 6 groups, which were the normal group, model group (A1B1), control group, total flavonoids group (A2B1), total saponins group (A1B2), and total flavonoids and saponins group (A2B2), with 11 rats in each group. Except the normal group, other groups were intraperitoneal injected with streptozotocin (STZ). And the experiment was according to 2×2 factorial design experiment scheme. The BG was determined before STZ injection and 7 days after the STZ injection. After 30 days, BG, serum lipid, IL-12 and IL-15 of liver were tested. Related indexes were calculated to the weighted composite score. Main and interactive effect of total flavonoids and saponins were studied according to the factorial design experiment scheme. The results showed that compared with the normal group, all indexes of model group showed statistical differences (P<0.05). Total flavonoids and saponins from HQGG decoction can effectively reduce BG, without any interactions between them. Both the total flavonoids and total saponins can reduce serum cholesterol (CHO), triglyceride (TG), liver IL-12 and IL-15. And there were interactive effects. The single use of herb achieved better effects than the combination. It was concluded that total flavonoids and saponins from HQGG decoction can reduce BG, CHO, TG, and liver IL-12 and IL-15 levels in rats. However, the regulation of total flavonoids and saponins on indexes mentioned above showed no additive effect.

(3S)-Linalool synthase (LIS) is a key enzyme involved in the monoterpene biosynthetic pathway. Based on our previous transcriptome study, the expression level of LIS gene was exceedingly related to glycyrrhizic acid (GA) biosynthesis. Therefore, we used hairy root culturing to further investigate the effect of LIS on the GA biosynthesis. A LIS gene (GenBank accession number: MZ169552) was cloned from Glycyrrhiza uralensis. The plant binary overexpression vector pCA-LIS was constructed by gene fusion. G. uralensis hairy roots overexpressing LIS were induced by the Agrobacterium rhizogenes ATCC15834. The expression levels of LIS were analyzed by real-time quantitative PCR (RT-qPCR) and the contents of GA in hairy root lines were determined by UPLC. It was found that in the hairy root lines overexpressing LIS, the expression levels of LIS were significantly higher than that in the wild type, while the contents of GA were remarkably lower than those in the wild type and negative control. These findings indicate that the expression level of LIS is negatively correlated with the accumulation of GA. In this study, LIS was cloned from G. uralensis for the first time and the negative regulatory effect of LIS on GA biosynthesis was confirmed by reverse genetics. This work provides support for further improvement of the molecular regulatory network of GA biosynthesis in G. uralensis.

OBJECTIVEThe aim of the present study was to prepare uniform-sized silybin loaded poly (lactic-co-glycolic acid) (PLGA) microspheres in study of silybin with stainless steel membrane.

METHODSilybin PLGA microspheres were prepared by stainless steel membrane emulsification. The preparation conditions were optimized by single-factor test and orthogonal experiment, and evaluating the mean diameters, the particle size distribution, drug loading, entrapment efficiency and morphology of microsphere.

RESULTPrepared microspheres were round and surface was smooth. The mean diameter was (4.961 +/- 0.56) microm. The span was (1.75 +/- 0.18). The entrapment efficiency was (54.997 +/- 4.05)% and the average drug loading was (23.6 +/- 1.70)%.

CONCLUSIONThe stainless steel membrane emulsification can be used to prepare the silybin PLGA microspheres. The mean diameters of the silybin PLGA microspheres can be controlled in certain level. Stainless steel membrane emulsification has great potentiality exploitation and utilization.

Drug Compounding ; methods ; Emulsions ; chemistry ; Lactic Acid ; chemistry ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Silymarin ; chemistry ; Stainless Steel ; chemistry

To study the effect of Gegen Qinlian decoction and its major effective components on five hepatic microsomal CYP450 isozymes in rats. The in vitro hepatic microsomal incubation technique was used to co-culture Gegen Qinlian decoction and its major effective components together with each probe substrate. HPLC-MS/MS was used to establish the analytical method for metabolites of the five isoform probe substrates of CYP450 isozymes, detect the linearity among micoromal protein concentration, incubation time and metabolite formation amount. And HPLC-MS/MS was applied to determine the formation rate (V) of corresponding metabolites (acetaminophen, 4-OH-chlorzoxazone, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone) specific probe substrates of the five isoform probe substrates of CYP450 isozymes (phenacetin, polbutamide, dextromethorphan, chlorzoxazone, testosterone), in order to determine the activity of each isozyme. The result showed good linearity among acetaminophen, 4-OH-tolbutamide, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone, satisfactory precision, stability and average recovery, suggesting the method was feasible. The optimized in vitro microsomal incubation conditions conformed to the requirements in the guideline of drug-drug interaction. Gegen Qinlian decoction showed different degrees of inhibitor effect on 5 CYP450 isoforms (CYP1A2, CYP2C11, CYP2D2, CYP2E1, CYP3A1/2). Its major effective component berberine could inhibit each CYP450 isoform at high concentrations (except for CYP1A2, CYP3A1/2).
Animals ; Chromatography, High Pressure Liquid ; methods ; Cytochrome P-450 Enzyme Inhibitors ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Isoenzymes ; antagonists & inhibitors ; Liver ; enzymology ; Rats ; Tandem Mass Spectrometry ; methods

Zwittermicin A was purified by ion exchange resin and HPLC from supernatants of Bacillus thuringiensis.subsp.kurstaki strain D1-23 cultivation.2.89mg pure Zwittermicin A was acquired,proved by HPLC-MS.Results show that the optimized wash concentration of NH_ 4 H_ 2 PO_ 4 is 5mmol/L at first step.Next step CH_ 3 COONH_ 4 concentration is 30 mmol/L,the gradient pH is 8.0～9.5.Totally 93% Zwittermicin A can be reserved with ion exchange resin.The temperature and pH stability experiments show the half life of Zwittermicin A is 48.22 minutes in 100℃,and it is more stable in lower pH in pH 2.0～12.0.

Objective:To identify the risk factor for prolonged post-anesthesia care unit (PACU) stay in elderly patients after painless gastrointestinal endoscopy.Methods:The elderly patients received painless gastrointestinal endoscopy from March to June 2021 in our hospital were included in this study. The information such as preoperative interview, patient′s general condition, current and past medical history, intraoperative conditions, and conditions in the PACU was collected. Patients were divided into non-prolonged group (group N) and prolonged group (group D) based on whether PACU stay was prolonged, and the risk factors for prolonged PACU stay were identified by logistic regression analysis.Results:There were 257 patients in group D and 716 cases in group N, and the incidence of prolonged PACU stay was 26.4%. Compared with group N, the proportion of preoperative frailty, smoking, intraoperative hypotension, and ratio of hypotension, somnolence and dizziness in PACU were significantly increased in group D ( P<0.05). The results of logistic regression analysis showed that preoperative frailty, smoking, intraoperative hypotension, and hypotension, somnolence and dizziness in PACU were independent risk factors for prolonged PACU stay( P<0.05). Conclusions:Preoperative frailty, smoking, intraoperative hypotension, and hypotension, somnolence and dizziness are independent risk factors for prolonged PACU stay in elderly patients after painless gastrointestinal endoscopy.

Objective To investigate the effect of frequency on osteoblast apoptosis induced by tensile strain.Methods MC3T3-E1 cells were applied with 1％ biaxial tensile strain at the frequency of 1,2,3,4,5 Hz,re spectively for 1 hour per day in 8 days.The survival rate of the cells was determined by activity of lactate dehydrogenase (LDH).Annexin V-FITC/ PI Flow cytometry was used to test cell apoptosis.Real-time RT-PCR was used to detect the gene level of apoptosis markers caspase-3,-9 as well as Bcl-2 and Bax,and Western blotting was used to test protein expressions of caspase-3,-9.Results Different loading frequencies had no effect on osteoblast activity of LDH.There was no significant difference in the total apoptosis rate of flow cytometry at different frequencies.However,the frequency of 2 Hz could induce early osteoblast apoptosis.Tensile strain at the frequency of 2 Hz could significantly increase the expression of caspase-3,-9 gene and protein,and induce cell apoptosis with the up-regulation of the Bax/Bcl-2.Conclusions Osteoblast apoptosis and death cannot be induced by 1％ biaxial tensile strain at the frequency of 1-5 Hz,but the frequency of 2 Hz can induce the early apoptosis of osteoblasts by up-regulating the expression of Bax/BCI-2.

Objective To determine whether the susceptibility to ischemia-reperfusion injury in aged heart is higher than that in adult heart and,if so,to clarify the mechanisms underlying this change.Methods Wister rats(5-or 20-month-old)were randomly divided into 4 groups(6 animals in each group).The rats were subjected to 30 minutes of myocardial ischemia via ligating the left anterior descending coronary artery,followed by 3 hours of reperfusion(Young-MI/R group and Old-MI/R group);A silk suture around the left anterior descending coronary artery was not ligated in young and old rats(Young-sham group and Old-sham group).Myocardial apoptosis was detected by terminal deoxynueleotidyl transferase biotin-d UTP nick end labeling(TUNEL)staining and caspase-3 activity was detected by using a caspase-3 colorimetrie assay.Nitrotyrosine content,a footprint of in vivo ONOO~-formation,and total NO content were determined by ELISA and chemiluminescence method respectively.Results A significantly exacerbated cardiac reperfusion injury was found in Old-MI/R group as evidenced by increased TUNEL positive myocytes[(19.0?2.1)% vs.(14.6?1.7)%],and increased myocardial caspase-3 activity[(436?35)?mool/mg vs.(340?32)?mol/mg] compared with Young-MI/R group(P＜0.05).Aged hearts had a markedly increased basal NOx level compared with young adult hearts.Marked higher myocardial nitrotyrosine content was found in OId-MI/R group[(7.25?0.18)nmol/g]than that in Young-MI/R group[(4.68?0.15)nmol/g] (P＜0.05).Conclusions In aged hearts,high levels of NO might form highly toxie derivant, ONOO~-,and its subsequent nitrified protein.This may attribute to the increased susceptibility of the aged heart to isehemic-reperfusion injury.

Objective Effectiveness of two kinds of thermochemotherapy infusion from intraarterial approach were studied in the grafted liver VX2 tumors of rabbit.Methods VX2 tumor model was established in 30 Newzland rabbit's livers.Percutaneous transfemoral hepatic arterial catheterization with fixation of the cathether tip inside the feeding vessel was carried out under DSA guidance.All 30 rabbits were divided into three groups(n=10 in each group),normal temperature 100 ml saline+Adriamycin(ADM)infusion(group 1),60℃100 ml saline+ADM continuous perfusion(group 2)and 60℃100 ml saline+ADM intermittent perfusion(group 3).After the perfusion,the lasting time periods of 43-45℃for tumor tissue of group 2 and 3 together with the concentrations of ADM within tumor's tissue were measured.Results Concentrations of ADM were shown as(12.013?2.237)?g/ml,(17.622?1.368)?g/ml,and(11.519?1.225)?g/ml for group 2, group 3 and group 1 respectively.60℃intermittent perfusion vs 60℃continuous perfusion showed P＜0.05, 60℃continuous pefusion vs normal temperature perfusion also showed P＞0.05. 43-45℃period lasting time (min)for 60℃continuous pefusion vs 60℃intermittent pefusion were(4.1?2.7)min and(11.3?3.3)min respectively,the latter was three times more than the former.There were no differences shown betwen the temperature,respiration and heart rate of group 2 and group 3.Conclusion Intermittent intraarterial perfusion thermochemotherapy is a more effective interventional management among all thermochemotherapies.