Objective To investigate the prognostic value of National Early Warning Scores (NEWS) combined with arterial lactate level in elderly patients with critical illness in emergency department.Methods A total of 413 elderly patients with critical illness randomly (random number) selected from resuscitation room in emergency department from September 2013 to July 2015 were enrolled in this study.NEWS system was employed to determine the patients' condition.Arterial lactate level was detected.The patients were followed for the 30-day death by telephone calls and patients were divided into survival group and death group.Multivariate logistic regression analysis and receiver operating characteristic curve (ROC) were used to evaluate the prognostic values of NEWS score,arterial lactate level,and NEWS score combined with arterial lactate level in patients without survival.Results There were significant differences in NEWS score and arterial lactate level between the death group and the survival group.The results of multiple factor regression showed that NEWS score,arterial lactate level,and NEWS score combined with arterial lactate level were all independent predictors of 30-day death (P ＜ 0.05,OR ＞ 1).The AUCs of the three evaluation modalities were 0.721,0.746 and 0.762,respectively.There was a significant difference in the area under the ROC curve between NEWS score and NEWS score combined with arterial lactate level.The optimal cut-off point of NEWS score was 7,and arterial lactate level was 2.7 mmol/L.Conclusions NEWS score,arterial lactate level,and NEWS score combined with arterial lactate level were independent predictors of 30-day death in elderly patients with critical illness in emergency department.They all had some predictive value,and NEWS score combined with arterial lactate level had higher capability to predict 30-day death in elderly patients with critical illness in emergency department than NEWS score alone.

Objective To culture human pituitary adenoma cells to provide some useful experimental foundations to practice pituitary adenoma cells as donor cells in the extracranial implantation. Methods Human pituitary adenoma cells obtained by operation were cultured in vitro, and their growth state was dynamically observed. Immunohistochemical staining and RIA were used to evaluate their functional status. Results The cultured pituitary adenoma cells still had secretory function in vitro. 6 cases of GH adenoma cells secreted a large amount of GH, 5 cases of PRL adenoma cells secreted a large amount of PRL, and 3 cases of pituitary adenoma cells without function could also secrete a small quantity of FSH, LH and PRL. Conclusion 14 cases of cultured human pituitary adenoma cells had secretory function in vitro, which provides the useful experimental data to perform extracranial implantation with pituitary adenoma cells as donor cells.

The relationship between probiotics and host intestinal immune system was reviewed. Then, as a new immunomodulator, the mechanisms and clinical uses of probiotics were discussed.

Objective To investigate the the effect of long-term glucocorticoid on bone mineral density (BMD) and bone turnover makers in patients with glomerular diseases. Methods The dual-energy x-ray absorptiometry (DXA) was used to measure the bone mineral density of lumbar spine (L1~L4), femoral neck and trochanter of the 97 patients treated with glucocorticoid and the 20 patients in the control group. In addition , ELISA assay was used to measure the concentrations of bone turnover makers including serum PINP and CTX-I. Results (1)Compared with the control group, the BMD of lumbar spine (L1 ~ L4), femoral neck and trochanter and the concentrations of PINP were significantly lower, while the concentration of CTX-I was increased (P < 0.05);(2) Following up the passage of time and the accumulation of the amount of GC application , the BMD of lumbar spine , femoral neck and trochanter , and the concentrations of PINP decreased , while the concentration of CTX-I steadily increased (P<0.05);(3)Multiple linear regression analysis indicated that the BMD of lumbar spine and trochanter were negatively correlated with the time of GC application (P<0.01),and the concentrations of PINP and CTX-I were correlated with the cumulative doses of GC (r = -0.310 vs 0.221, P < 0.05);(4)The incidence of bone abnormalities in patients received vitamin D and calcium was markedly reduced (P<0.05). Conclusion The long-term glucocorticoid treatment for the patients with glomerular diseases can lead to bone mass reduction or osteoporosis , it can be helpful for early prevention and treatment of glucocorticoid osteoporosis with bone mineral density and bone turnover makers.

DPP-4 inhibitors are new oral hypoglycemic drugs and hot spots developed and launched in recent years, and they pro-vide new choices for the clinical treatment of type 2 diabetes. In China, DPP-4 inhibitors that are approved to use in the treatment of type 2 diabetes are all imported products currently. In the paper, the current intellectual property situation of DPP-4 inhibitors that are developed and approved at home and abroad is researched and analyzed. Reasonable use of the patent information of DPP-4 inhibitors that is about to expire or have failed can provide good guidance for the subsequent development of DPP-4 inhibitors in domestic with promising curative effect and good market prospects, and can generate new patents in order to enhance the market competitiveness.

AIM: To evaluate the potential acylation stimulating protein (ASP) resistance in both adipocytes and preadipocytes under the conditions by which insulin resistance is produced by the stimulation of free fatty acids (FFA), and to explore the mechanism of ASP resistance on post-receptor level. METHODS: 3T3-L1 preadipocytes were induced to differentiate. Then the cells were treated with oleate or palmitate at concentration of 0 mmol/L (FFA-free DMEM/F12), 0.125 mmol/L, 0.5 mmol/L or 1.0 mmol/L overnight. Glucose transport was assessed by [~3H] 2-deoxyglucose uptake to evaluate insulin resistance and ASP resistance. Both non-FFA treated and FFA treated 3T3-L1 cells were cultured with ASP at concentration of 5.0 μmol/L for 4 h, then the cell proteins were extracted, and the expressions of guanine nucleotide binding protein beta (Gβ), guanine nucleotide-binding protein alpha-q/11(Gαq/11), phosphorylated-protein kinase Cα (p-PKCα) and phosphorylated-protein kinase Cζ (p-PKCζ) were measured by Western blotting. RESULTS: Both adipocytes and preadipocytes were responsive to ASP. ASP stimulation increased glucose transport by 198% in adipocytes and by 287% in preadipocytes (P<0.01 vs PBS). FFA at concentration of 0.125 mmol/L did not change ASP-stimulated glucose transport significantly, but high dose of oleate or palmitate effectively reduced the ASP response with a significant reduction by 47% (P<0.05 for oleate) and 34% (P<0.05 for palmitate) at 1 mmol/L FFA in adipocytes. Similarly in preadipocytes, glucose uptake rates were decreased by 43% (P<0.05 for oleate) and 62% (P<0.01 for palmitate) at 1 mmol/L FFA. Effects were comparable to those obtained with insulin. After overnight incubation with oleate or palmitate in adipocytes and preadipocytes, Gβ, Gαq/11, p-PKCα and p-PKCζ were downregulated both in the absence of ASP treatment and in the presence of ASP treatment in adipocytes. At concentration of 1.0 mmol/L, oleate inhibited the expressions of ASP-induced Gβ, Gαq/11, p-PKCα and p-PKCζ in adipocytes by 47%, 44%, 39% (P<0.05, P<0.01) and 20% (P>0.05), respectively. Palmitate also effectively blocked the expressions of ASP (at concentration of 1.0 mmol/L)-induced Gβ, Gαq/11, p-PKCα and p-PKCζ by 50%, 43%, 44% and 43% (P<0.05, P<0.01) in adipocytes. In preadipocytes, oleate only inhibited ASP-induced p-PKCα and p-PKCζ significantly by 39% and 19%, respectively (P<0.05). However, overnight exposure of 3T3-L1 preadipocytes to 1 mmol/L palmitate leaded to 45%, 50%, 52% and 21% (P<0.05, P<0.01) inhibition of ASP-induced expressions of Gβ, Gαq/11, p-PKCα and p-PKCζ, respectively. CONCLUSION: Oleate and palmitate inhibit ASP-mediated stimulation of glucose transport both in adipocytes and preadipocytes. The study provides direct evidence of ASP resistance under the condition of insulin resistance induced by FFA in a cellular model. The mechanism of action involves both changes in expression of C5L2 as well as signaling parameters. Fatty acid-induced ASP resistance may contribute to the physiological abnormalities associated with insulin resistance and obesity phenotype.

OBJECTIVETo observe the effect of external application of Zhuangshenling Recipe (ZR) combined with Western medicine (WM) on the heart function of chronic heart failure (CHF) patients of Xin-Shen yang deficiency, interior retention of water-fluid syndrome (XSYDIRWFS).

METHODSTotally 140 CHF patients of XSYDIRWFS were randomly assigned to two groups, the treatment group and the control group, 70 in each group. All patients received WM therapy. Those in the treatment group were applied with ZR at Xinshu (BL15) and Shenshu (BL23), while those in the control group were applied with placebos at Xinshu (BL15) and Shenshu (BL23). The therapeutic course for all was 12 weeks. The integrals of TCM syndrome, grading of cardiac function, brain natriuretic polypeptide (BNP), and 6 min walking distance were observed before and after treatment.

RESULTSAfter twelve weeks of treatment, the effective rate of improved grading of cardiac function, the total effective rate of TCM syndrome efficacy, and the BNP level were obviously better in the treatment group (P < 0.05). There was no statistical difference in 6 min walking distance between the two groups (P > 0.05).

CONCLUSIONExternal application of ZR combined with WM could improve the heart function of CHF patients of XSYDIRWFS.

Aged ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; drug therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Yang Deficiency ; drug therapy

OBJECTIVE:To optimize the extraction technology of total flavonoids for Bone healing formulation in order to use it for preparation research. METHODS:With the content of total flavonoids as the index,L9(34)orthogonal test was employed to investigate the effects of volume fraction of the solvent ethanol,the amount of solvent,extraction times and extraction time on the extraction of total flavonoids for Bone healing formulation to determine the optimal levels of the factors,and verification tests were conducted. RESULTS:The optimal extraction technology of total flavonoids was 1 h reflux extraction for 3 times,with 70% etha-nol 10 times as much as the amount of medicinal materials. Verification tests showed the average content of total flavonoids was 62.03 mg/ml(RSD=0.84%,n=3),that is to say,6.20 g total flavonoids might be extracted from 100 g medicinal materials for the formulation. CONCLUSIONS:The optimal technology is stable and feasible and can be used for the extraction of total flavo-noids for Bone healing formulation and provide a experimental basis for the preparation of Bone healing liniment.

OBJECTIVE:To investigate transdermal behavior in vitro of total flavonoids and its monomer components in Guyu liniment. METHODS:Vertical Franz diffusion cell was adopted to perform a test on excised mouse skin as transdermal barrier. UV spectrophotometry was used to determine the content of total flavonoids,and HPLC to determine the content of monomer flavo-noid hydroxysafflor yellow A(HSYA)to observe transdermal absorption in vitro within 12 hours. RESULTS:The accumulative per-meation quantity Q of the total flavonoids and HSYA in Guyu liniment increased with time(t),demonstrating a significant correla-tion with t1/2,and transdermal absorption was in conformity with Higuchi equation (r=0.995 6,0.999 5);permeate flux of total flavonoids and HSYA were 126.24,47.516μg/(cm2·h). CONCLUSIONS:The transdermal behavior of total flavonoids in Guyu lin-iment is similar to that of HSYA. Both belong to matrix diffusion-type transdermal drug delivery system,with the characteristic of long-term sustained release.

Aim To research the protective effects of specnuezhenide, an active compound of traditional Chinese medicine, against CCl4-induced hepatic dam-age in mice. Methods The model of acute hepatic damage caused by CCl4 intraperitoneal injection on mice was obtained. The levels of ALT, AST, TNF-α, IL-1β, and IL-6 in serum, the activities of MDA, SOD, and GSH-Px in liver homogenates, and the his-topathological organization of liver sections were also examined to observe the protective effects of specnu-ezhenide. Results Specnuezhenide markedly de-creased the CCl4-induced elevation of serum ALT and AST activities, and improved hepatic histopathology changes. Specnuezhenide also significantly decreased the content of MDA in liver tissues, meanwhile in-creased the activities of antioxidant enzymes SOD and GSH-Px. In addition, specnuezhenide reduced the lev-els of TNF-α, IL-1β and IL-6 . Conclusions Specnu-ezhenide has significant protective effects against CCl4-induced hepatic damage in mice, and the possible un-derlying mechanisms of the activity could be due to its antioxidant and anti-inflammatory effects.