AIM To observe the effects of ZMS and ZMR(isomer of ZMS),two active components of Zhimu on learning and memory ability and muscarinic subtype M 1 receptor density in aged rats. METHODS 24 month-old SD rats were randomly divided into aged control group, ZMS and ZMR treatment group. Young rats were used as normal control group. The learning and memory ability was detected by Y-maze method. The muscarinic subtype M 1 receptor density in the brain was detected by 3H-QNB binding tests. RESULTS It was found that daily oral administration of ZMS and ZMR for 40 d significantly enhanced the learning and memory ability and the muscarinic subtype M 1 receptor density in the brain of the aged rats. CONCLUSION These results suggested that ZMS and ZMR probably have potential preventive and curative action for the progressive deterioration of the cholinergic system in Alzheimers disease (AD).

Objective To observe the changes in serum vancomycin trough concentration,and explore its optimal dosage in critical patients.Methods A retrospective study was conducted.Data of 66 patients who used vancomycin during July 2010 to May 2012 in surgical intensive care unit (SICU) of the First Affiliated Hospital of Sun Yat-Sen University were collected and analyzed.According to the endogenous creatinine clearance rate (CCr),the patients were divided into two groups:CCr normal group (≥ 70 mL/min) and CCr lowered group (＜70 mL/min).The distribution of vancomycin serum trough concentration between two groups,relationship between vancomycin serum trough concentrations and CCr,and the influence of vancomycin serum trough concentrations on the prognosis was analyzed.The difference between actual dosage and the recommended dosage in guideline was compared between two groups.Results 119 times of vancomycin serum trough concentration in 66 patients were enrolled,and it was found that only 20.17％ (24/119) reached the target concentration (15-20 mg/L),45.38％ (54/119)＜ 15 mg/L and 34.45％ (41/1 19) ＞20 mg/L.Vancomycin serum trough concentration in CCr normal group (55 cases) was (13.11 ± 6.84) mg/L,among them 65.5％ (36/55) attained lower trough concentrations (＜ 15 mg/L).In the subgroup with 15-20 mg/L trough serum concentrations,vancomycin doses were significantly lower than that of recommendation (g/d:1.95 ± 0.61 vs.2.73 ± 0.32,F=1.739,P=0.001).Vancomycin serum trough concentration in CCr lowered group (64 cases) was (20.49 ± 8.12) mg/L,with 51.5％ (33/64) of them showed higher trough concentrations (＞20 rag/L).In the subgroup with 15-20 mg/L vancomycin trough serum concentration,vancomycin doses were higher than that of recommendation (g/d:1.08 ±0.49 vs.0.78 ±0.19,F=11.294,P=0.062).There was no significant difference in 28-day mortality between patients with targeting trough serum concentrations and those without [22.2％ (4/18) vs.18.8％ (9/48),x2=0.009,P=0.924].Serum creatinine [odds ratio (OR)=1.001,95％ confidence interval (95％CI):0.990-1.012,P=0.000],vancomycin doses (OR=0.600,95％CI:0.251-1.434,P=0.003),age (OR=0.985,95％CI:0.955-1.015,P=0.015) and body mass index (OR=1.013,95％CI:0.967-1.062,P=0.022) were found to be correlated to serum trough concentrations by multiple linear regression analysis.Conclusions The rate of vancomycin serum trough concentrations reaching the standard is low in critical patients,so constant monitoring is necessary.Creatinine,vancomycin dosage,age and body mass index show a relatively significant influence on the serum trough concentrations,and they should be taken into consideration in dosage to be given.

OBJECTIVETo investigate the role ofCD4+CD25+ T regulatory (Treg) cells, T helper (Th)17cells and interleukin (IL)-6 in the progression of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and determine their value as prognostic markers.

METHODSThe Chinese National Knowledge Infrastructure (CNKI), WanFang, Chinese Scientific Journals (VIP), PubMed, Embase and Web of Science databases were searched for English language case-control studies on the relationship between regulatory T lymphocytes and ACLF.The quality of included studies was assessed using the Newcastle-Ottawa scale. The meta-analysis was designed according to the PICOS approach recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. RevMan software, version 5.1, was used to perform the meta-analysis.

RESULTSNine case-cohort studies were selected for inclusion in the metaanalysis.The results of the meta-analyses showed that the level of CD4+CD25+ Treg cells was not significantly different between patients with HBV-related ACLF and patients with chronic hepatitis B (CHB) (mean difference (MD)=0.59, 95% confidence interval (CI)-1.68, 2.85, P=0.61) nor between patients with HBVrelated ACLF and healthy controls (MD=1.12, 95% CI:-1.42, 3.66, P=0.39). Thus, it appears that ACLF patients do not have a higher level of CD4+CD25+ Treg cells than CHB patients or healthy controls. However, the ACLF patients did appear to have a significantly higher level of Th17 cells than both the CHB patients (MD=1.73, 95% CI:0.21, 3.26, P=0.03) and the healthy controls (MD=1.62, 95% CI:(0.52, 2.72, P=0.004). In addition, the ACLF patients also had significantly higher level than both the CHB patients (MD=11.69, 95%CI:1.98, 21.40, P=0.02) and the healthy controls (MD=13.17, 95% CI:1.38, 24.95, P=0.03).

CONCLUSIONCD4+CD25+ Treg cells may be an important protective factor in the progression and prognosis of HBV-related ACLF, while Thl7 cells and IL-6 may be risk factors for further progression and worsened prognosis.

Acute-On-Chronic Liver Failure ; diagnosis ; immunology ; CD8-Positive T-Lymphocytes ; Case-Control Studies ; Disease Progression ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; Humans ; Interleukin-6 ; immunology ; Prognosis ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology