Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Phytotherapy ; Radiation Pneumonitis ; drug therapy

AIM: To develop a HPLC method to determine emodin and chrysophanol in Shierwei Chiyinkang Powder (Gypsumseu Calcitum, Radix et Rhizoma Rhei, Herba Asari, Rhizoma Chuanxiong, Rhizoma et Radix Notopterygii, Radix Gentianae, Pericarpium Zanthoxyli, etc.). METHODS: The sample was made referring to China Pharmacopoeia(2000) and determined by HPLC. The separation was performed on a Shim pack CIC ODS column (150mm?5mm, 4.5?m) with a mobile phase of methanol 0.1% H 3PO 4 solution (40∶9). The flow rate was 1.3mL?min -1 and the detective wavelength was set at 254nm. RESULTS: The emodin and chrysophanol in sample were separated. The square linear ranges were 0.52～5.28?m?mL -1 ( r =0.9999) and 0.96～9.60?m?mL -1 ( r=0.9999 ), respectively, and the average recoveries were 98.62% and 98.57% for emodin and chrysophanol, respectively. CONCLUSION: This method is sensitive and accurate for the determination of emodin and chrysophanol in the sample.

ObjectiveTo evaluate the clinical application of endovascular treatment for severe Takayasu's arteritis (TA).MethodsIn this study,35 target lesions in 32 patients [28 women,mean age (30 ±8) years] with severe Takayasu's arteritis were treated with endovascular merthod.The average length of lesion was 3.1 cm( range 2.7 -5.3).The overall average degree of diameter stenosis was 90％ ± 11％ (range 70- 100)in which 15 lesions were completely occlusive.There were 10 patients whose ESR were higher than 20 mm/h( range 25 -37).Follow-up included physical examination and patency evaluated by color duplex souography/computed tomography angiography/angiography at 6 months and then annually.ResultsRecanalization was unsuccessful in 3 completely occlusive lesions,with a successful rate of 80％(12/15).There was one case in which embolization leading to acute thrombogenesis developed during interventional procedure and resulting in severe stroke.The technical successful rate ( residual stenosis ＜ 50％ ) was 88.6％ ( 31/35 ).The transient cerebral ischemia attack ( TIA ) symptoms disappeared in 31 cases.26 cases were followed up for an average of (19 ± 10) months (range 13 -40).Occipital infarction following severe in-stent restenosis developed 13 months later in one case.Symptomatic in-stent restenosis18monthslaterwasfoundin2cases. Patencyratewas88.5％( 23/26 ).ConclusionsEndovascular treatment is safe and effective for severe TA.Strict indication and accurate targeting the lesions help ensure the success of management.

ObjectiveTo evaluate the clinical safety and efficacy of SilverHawk directional atherectomy for femoropopliteal occlusive lesions. MethodsEighteen ischemia occlusive lesions in 11 patients of the lower extremity were treated with SilverHawk directional atherectomy.The mean lesion number was 1.6 ± 1. 1 per patient. The mean lesion length was ( 3.4 ± 2. 2 ) cm. The average degree of diameter stenosis was 96％ ± 14％. 9 lesions were totally occlusive. Clinical symptoms included claudication in 4 cases ( Rutherford classes: 3) and critical limb ischemia ( Rutherford classes: 4) in 7 cases. Lesions characteristics were divided by TASC classification: TASC B in 7 cases; TASC C in 1 case (in-stent occlusion); TASC D in 3 cases.Mean ABI was 0. 5± 0.4. Patency was evaluated with color duplex sonography or CTA besides clinical examination during follow-up.ResultsNine totally occlusive lesions were recanalizated successfully via intraluminal approach. 18 lesions achieved technical success (residual stenosis ＜50％ ) leaving 15％ ±7％ mean residual stenosis in mean (8 ±3)min, predilation was needed in one lesion ( in-stent occlusion) prior to atherectomy. Clinical symptoms improved or disappeared with mean ABI 1.07 ±0. 12 and Rutherford grades: 0 (n =9) and 1 (n =2). Patency rate was 100％ with mean 0. 93 ± 0. 14 ABI and Rutherford grades remain unchanged after follow-up of mean ( 9 ± 4 ) monthes.ConclusionsSilverHawk directional atherectomy is safe and effective for the treatment of lower extremity ischemia.

Sodium houttuyfonate (SH) is a derivative of effective component of a Chinese material medica, Houttuynia cordata, which is applied in anti-infection of microorganism. But, the antimicrobial mechanisms of SH still remain unclear. Here, we firstly discovered that SH effectively inhibits the three types of virulence related motility of.Pseudomonas aeruginosa, i.e., swimming, twitching and swarming. The plate assay results showed that the inhibitory action of SH against swimming and twitching in 24 h and swarming in 48 h is dose-dependent; and bacteria nearly lost all of the motile activities under the concentration of 1 x minimum inhibitory concentration (MIC) (512 mg x L(-1) same as azithromycin positive group (1 x MIC, 16 mg x L(-1)). Furthermore, we found that the expression of structural gene flgB and pilG is down-regulated by SH, which implies that inhibitory mechanism of SH against motility of P. aeruginosa may be due to the inhibition of flagella and pili bioformation of P. aeruginosa by SR Therefore, our presented results firstly demonstrate that SH effectively inhibits the motility activities of P. aeruginosa, and suggest that SH could be a promising antipseudomonas agents in clinic.
Alkanes ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; metabolism ; Biofilms ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fimbriae, Bacterial ; drug effects ; genetics ; metabolism ; Houttuynia ; chemistry ; Pseudomonas aeruginosa ; cytology ; drug effects ; genetics ; pathogenicity ; Sulfites ; pharmacology ; Virulence ; drug effects

Objective To investigate the predictive value of left ventricular diastolic function on mechanical ventilation weaning in patients with left ventricular ejection fraction (LVEF) > 0.50.Methods A retrospective case control study was conducted. Sixty-five patients with LVEF > 0.50 undergoing mechanical ventilation for more than 48 hours admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from June 2014 to December 2016 were enrolled. The clinical data and parameters of echocardiography before spontaneous breathing trial (SBT) were collected. The possible relationship between left ventricular diastolic function and the results of weaning was analyzed according to analysis of blood flow filling parameters of mitral valve orifice. According to the grading standard of left ventricular diastolic function, the patients were divided into normal, mild (level 1) and moderate to severe (level 2-3) groups, and the outcomes of weaning were compared among the groups. Then patients were also divided into two groups of weaning successfully and weaning failure, and the clinical data and left ventricular diastolic function parameters of patients were compared between the two groups. The predictive value of left ventricular diastolic function on results of weaning was evaluated with receiver operating characteristic curve (ROC).Results Sixty-five patients were enrolled and 28 patients (43.1%) failed weaning, 22 patients failed the first SBT and 6 required reintubation within 48 hours, 31 of the patients presented normal left ventricular diastolic function, 9 of patients presented mild diastolic dysfunction, and 25 of them presented moderate to severe diastolic dysfunction. So with the gradual increase of the severity of diastolic dysfunction, the rate of weaning failure was gradually increased, which was 16.1%, 44.6% and 76.0% respectively (χ2 = 20.240,P = 0.001). Patients who failed weaning presented evidence of increased left ventricular filling pressures at pre-SBT, by demonstrating decreased deceleration time of E (DTE, s: 180.4±5.1vs. 196.8±4.0,t = 2.567,P = 0.013), increased left ventricular mitral valve diastolic early and late filling velocity ratio (E/A: 1.47±0.08 vs. 1.14±0.05, t = 3.827,P = 0.000), increased lateral, septal and averaged left ventricular mitral valve diastolic early velocity and maximal velocity of mitral annulus in early diastolic velocity ratio (E/Em: 10.26±0.52 vs. 7.28±0.41,t = 4.535, P = 0.000; 10.08±0.58 vs. 8.16±0.40,t = 2.797,P = 0.007; 10.17±0.48比7.72±0.35,t = 4.231,P = 0.000), and the rapid shallow breathing index (RSBI) was also increased significantly (61.7±3.6 vs. 50.6±2.7,t = 2.507, P = 0.015). It was shown by ROC curve analysis that the basic left ventricular diastolic function at pre-SBT had the diagnostic performance in predicting the outcome of weaning from mechanical ventilation, especially E/A and lateral E/Em. Pre-SBT values of E/A greater than 1.2 and lateral E/Em greater than 7.9 predicted weaning failure with an area under the ROC curve (AUC), sensitivity, and specificity of 0.81±0.06 and 0.85±0.06, 82.6% and 91.3%, 81.4% and 80.7%, respectively, and the AUC was higher than RSBI (0.70±0.07). The AUC of combination of E/A > 1.2 and lateral E/Em > 7.9predicting weaning failure was 0.86±0.05 with a sensitivity of 78.3% and a specificity of 93.6%.Conclusions The results suggest that left ventricular diastolic dysfunction is significantly associated with weaning outcome in critical patients with LVEF > 0.50. The combination of E/A ratio greater than 1.2 and E/Em ratio greater than 7.9 may identify patients at high risk of weaning failure.

Objective To investigate the relationship between plasma concentration of B type natri uretic peptide (BNP) and the severity and prognosis of patients with acute spontaneous intracerebral hemorrhage (ICH).Methods Review of 86 cases of patients with spontaneous intracerebral hemorrhage analysis in our hospital Department of Emergency/Surgical Intensive Care Unit (ED/S1CU) were admitted within 6 hours of admission to collect blood samples,head CT,biochemical index,Glasgow Coma Scale (GCS) score and other clinical data,and detected within 6 hours after admission,the admission of third days and 7 days of plasma BNP concentration.The blood volume of cerebral hemorrhage was computed.The GCS was used to evaluate nerve function after admission.The survival of 28 days was observed.Results The concentration of BNP detected at 3 time points increased with the increase of the amount of bleeding in patients with acute cerebral hemorrhage and increased with the decrease of GCS score at admission (P ＜0.01).The BNP concentration was mild higher in the small amount of bleeding group than that of the control group (P =0.094),while that of the other two groups were significantly higher (P ＜ 0.01).Concentration of BNP detected within 6 hours of admission was positively correlated with cerebral hemorrhage (r =0.551).The a mount of BNP in the 6 hours after admission of the GCS ＞ 8 group was significantly higher than those of the control group (P ＜ 0.05),and the GCS ≤ 8 group was significantly higher than that of the control group and GCS ＞ 8 group (P ＜ 0.01).The BNP concentration was negatively correlated with GCS score at admission (r =-0.532).The 28-day mortality was predicted by BNP ＞ 168 pg/ml for 6 hours,AUC was 0.814,the sensitivity was 75.0％ and the specificity was 81.4％.Conclusions The concentration of BNP in patients with acute spontaneous intracerebral hemorrhage increased with the increase amount of bleeding and the decrease of GCS score at admission.The concentration of BNP in the 6 hours after admission was correlated with the severity and the prognosis of the disease,which can be used as the important reference indicators for evaluating severity and prognostic prediction.

Communicable diseases are the major threats to the health and security of all the people living in Liberia, including UN peacekeepers from China. The most prevalent communicable diseases in Liberia include malaria, HIV/AIDS, acute respiratory infection, sexual transmitted disease, schistosomiasis, onchocerciasis, tuberculosis, cholera, pertussis, hepatitis, meningococcal disease, typhoid fever, Lassa fever and yellow fever. An insight into the profiles and epidemiology of the above epidemics in Liberia would greatly help peacekeepers with disease diagnosis and epidemic prevention. According to the profiles of epidemics in Liberia and the authors' experience in epidemic prevention in Liberia, the authors recommend that peacekeepers strengthen their epidemic prevention as follows. Firstly, a combined vector control strategy is suggested for the prevention and control of vector-borne diseases. Secondly, water safety should be highlighted by water disinfection and regular water quality testing. Thirdly, vaccines, diagnostic reagents and medications should be accordingly outfitted. Then, the awareness of epidemic prevention and individual hygiene should be improved by education and strict management. Finally, the daily life management for peacekeepers is also very important. The epidemic overviews and strategies for epidemic prevention described in this paper are also useful for all the other peacekeepers deployed in Africa.

Objective By using digital three-dimensional (3D) model of abdominal and pelvic vessels to investigate the relationship between the angle/position of the bifurcation of bilateral common iliac arteries and the length of the common iliac artery, thus to guide the endovascular interventional catheterization manipulation. Methods A total of 439 patients, who received abdominal and pelvic CTA at authors’ department during the period from Sep. 2011 to May 2013, were included in this study. By using digital 3D reformation technique, the 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was established in all patients. With the help of mimics and geomagic software the angles between the left and right common iliac arteries and the lengths of common iliac arteries were determined, and the lumbar vertebra corresponding to the bifurcation of common iliac arteries was recorded. Using statistical software, the relationship between the bifurcation angle of bilateral common iliac arteries and the corresponding lumbar vertebra as well as the length of common iliac arteries was analyzed. Results The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was successfully reconstructed in all 439 patients. Both the angle between the left and right common iliac arteries and the corresponding lumbosacral level of bifurcation angle were clearly demonstrated on the model. The average angle was 49.1° ± 12.4°. The bifurcation was located at L3 -L4 level in 38 cases, at upper one-third level of L4 in 63 cases, at middle one third level of L4 in 89 cases, at lower one-third level of L4 in 135 cases and at L4 -L5 level in 114 cases. The average length of the left and right common iliac artery was (45.6 ± 15.6) mm and (43.3 ± 15.4) mm respectively. Pearson correlation analysis indicated that a negative correlation existed between the angle and the position level of the left and the right common iliac artery (r = -0.172, P< 0.05), and a negative correlation also existed between the angle and the length of the common iliac artery (left: r = -0.171, P<0.05; right: r = -0.164, P < 0.05). Conclusion The lower the opening position of the left and right common iliac artery is, and the bigger the intersection angle is, the shorter the length of corresponding common iliac artery will be. In this case, catheterization via femoral artery to contralateral iliac artery is a short path, and the catheterization procedure is easy to manipulate with higher success rate. On the contrary, the catheterization will be difficult, and the use of loop-technique will be needed. The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae can help select the optimal catheterization path.

Pancreatic ductal adenocarcinoma (PDAC) is one of the five most malignant cancer. ZX-1201 is one of the active constituents in Alismatis Rhizoma,a well-known traditional Chinese medi-cine with a wide variety of pharmacological properties including diuretic,anti-hyperlipidemic,anti-atheroscle-rotic,anti-cancer,anti-inflammatory and anti-oxidative activities.We investigated the inhibitory effect of ZX-1201 on pancreatic cancer and the relevant molecular mechanism in vitro and in vivo. ZX-1201 inhibited the growth and metastasis of PANC-1 cells in BALB/c nude mice significantly.ZX-1201 inhibited the function of AQP1 via directly interaction and involved in the reversion process of ZX-1201 on TGF-β1. CTGF was an important protein in the reversion process of ZX-1201 on TGF-β1.ZX-1201 inhibited the migration of PANC-1 and CPFAC-1 cells induced by TGF-β1in vitro.ZX-1201 reversed the down-regu-lated of epithelial markers and up-regulated of mesenchymal markers, as well as the up-regulated of Snail and p-Smad2/3 induced by TGF-β1.And ZX-1201 reversed Epithelial-Mesenchymal Transition by down-regulating AQP1 and inhibiting translocation of β-catenin, the promotor of CTGF. According to these,ZX-1201 inhibited the migration of pancreatic cancer cells.We concluded that ZX-1201 inhibited the growth and metastasis of PANC-1 cells in vivo significantly.And AQP1,β-catenin and CTGF were the pivotal proteins in the process of ZX-1201 inhibiting PANC-1 cells migration induced by TGF-β1.