OBJECTIVETo explore the effect and mechanism of cinnabaris and realgar in promoting awake effect of endotoxin- induced brain injury rat applied with Angong Niuhuang Wan.

METHODNormal rats implanted cortical electrode in advance were divided into 6 groups: control, model, the Angong Niuhuang Wan (AGNH, 0.4, 0.2 g · kg(-1)), the Angong Niuhuang Wan without cinnabaris and realgar (QZX-AGNH, 0.32, 0.16 g · kg(-1)). Rats in the control and model groups were given distilled water. After three days of intragastric administration, the brain injury model was injected with endotoxin through tail vein. Then trace electro-corticogram (EcoG) 1-6 h after LPS injection, and compare the power and relative power of beta (β) and delta-waves (δ) at 6 h of these groups. The content of acetylcholine (Ach) and the affinity of M-receptor (M-R) in cortex and brainstem were detected by alkaline hydroxylamine colorimetric method and radioactive ligand binding assay, respectively.

RESULTAGNH (0.4, 0.2 g · kg(-1)) could increase the power and relative power of β and AGNH (0.4 g · kg(-1)) showed better action on brain electrical activation. QZX-AGNH showed weak effect on it. AGNH (0.4 g · kg(-1)) could increase the affinity of M-R in cortex and the content of Ach in brainstem. The action of QZX-AGNH was not obvious.

CONCLUSIONIn endotoxin-induced brain injury rats, AGNH can raise the cholinergic system function of cortex, and strengthen the uplink of cortex activation of brainstem cholinergic system, improve the level of cortical activity and enhance the activation of EcoG to promote the body's awakening. QZX-AGNH show weak effect. Cinnabaris and realgar play an important role in promoting awake effect in endotoxin-induced brain injury applied with Angong Niuhuang Wan. The mechanism may be related to cortical and brainstem cholinergic system function.

Animals ; Brain Injuries ; chemically induced ; drug therapy ; physiopathology ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; Endotoxins ; adverse effects ; Humans ; Male ; Rats ; Rats, Sprague-Dawley

Objective To investigate and eompare the diagnostic values of linear reference region model (LRRM) and Extended Tofts model in quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis of benign and malignant breast lesions under different temporal resolutions.Methods Eight five suspicious breast cancer women underwent bilateral DCE-MRI exam, 37 patients were benigns and 48 patients were malignants.Among those, 31 patients(15 malignant, 16 benign) were scanned with 18 s per phase, and 54 patients(33 malignant, 21 benign) were scanned with 7 s per phase, and they were assigned into breast cancer group, benign lesion group and healthy gland group proven by surgery or biopsies.For the same model, Ktrans values of the three groups under different time resolution were first analyzed using Kruskal-Wallis H rank sum test.Receiver operator curve (ROC) was used to analyse the diagnostic efficiency of K values.Results Under high and low temporal resolutions, K values of the healthy group were (0.048 ±0.022) and (0.090±0.040)/min for extended Tofts model,(0.301 ±0.197) and (0.287±0.225)/min for LRRM model respectively.K values of the benign group were (0.289±0.163) and (0.211 ± 0.080)/min for extended Tofts,(0.624 ± 0.358) and (0.593 ± 0.165)/min for LRRM respectively.K values of the malignant group were (0.959±0.451) and (0.524±0.285)/min for extended Tofts,(1.576±0.935) and (0.956±0.180)/min for LRRM respectively.There were significant differences among the three different groups(P＜0.05).Area under the ROC to differentiate benign and malignant breast lesions for Extended Tofts in high temporal, LRRM in high temporal, Tofts in low temporal and LRRM in low temporal were 0.941, 0.876, 0.850 and 0.933, with Ktrans cutoff values of 0.304, 0.917, 0.252 and 0.789/min,and sensitivity of 93.9％, 80.0％,80.0％, 80.0％;specificity of 85.7％, 90.5％, 81.2％, 87.5％ respectively.Conclusion Under low temporal resolutions, Ktrans of LRRM model had better sensitivities and specificities in differentiation of benign and malignant breast lesions than Extended Tofts model, which was the opposite in high temporal resolutions.

Objective To investigate the value of quantitative dynamic contrast-enhanced MRI (DCE-MRI)in diagnosis of breast adenosis.Methods 54 patients with breast glandular lesions diagnosed as 4th or 5th grade in BI-RADS and proved by pathology un-derwent routine 3.0T quantitative DCE-MRI.Quantitative parameters including volume transfer constant (Ktrans ),plasma volume fraction (Vp )were measured.According to the pathological findings and MRI morphological characteristics,the lesions were divided into breast cancer group,adenosis group and control group.The contralateral healthy side of the adenosis group was regarded as control group.The quantitative parameters of the three groups were statistically analyzed.Results Pharmacokinetic parameters of Ktrans and Vp were (0.289±0.1 63)min-1 and 0.042 8±0.045 respectively in adenosis group (n=21),(0.959±0.45 1)min-1 and 0.057±0.079 in breast cancer group (n=33),and (0.048±0.022)min-1 and 0.01 6 ±0.01 9 in control group (n=21).Ktrans and Vp between adenosis and control group had statistical significance(Z =-5.733,-2.844,all P <0.05),Ktrans between breast cancer group and adenosis group had statistical difference (Z =-5.421,P =0.000 ).Vp between breast cancer and adenosis group had no statistical difference (Z=-0.009,P =0.993).Area under curve (AUC)of the receiver operator curve (ROC)to differentiate benign and malignant lesions of Ktrans were 0.941.When the cutoff were 0.304 min-1 ,the sensitivities and specificities were 93.9%,85.7%. Conclusion Quantitative DCE-MRI shows good diagnostic value in differentiation of breast glandular lesions and cancer.

Objective To investigate the potential and early effect of hypertonic saline resuscitation on Tlymphocyte subpopulations in patients with traumatically hemorrhagic shock.Method Eighty-two patients with acute traumatically hemorrhagic shock admitted from Department of Emergency，Beijing Tongren Hospital，from De cember 2006 to July 2008 were randomly divided into：hypotonic saline(HS)group(n=43)and Lactated Ringer's solution(LR)group(n=39).The criteria of eligible patients were systolic blood pressure＜90mm Hg at admission with definite evidence of blood loss.Patients with immune system diseases and those who died within 24 hours of admission were excluded.Patients in HS group received intravenous administration of 200 mL of 7.5% sodium chloride withhin 15～20 minutes，and LR group received routine therapy with Lactated Ringer's solution.Blood pressure and heart rate were recorded 10，20，and 60 minutes after the start of resuscitation and compared between two groups.Before and 24 hours after treatment，peripheral blood levels of T-lymphocyte subpopulations including CD3+，CD4+，and CD8+ were measured by using direct immunofluorescence test and compared between two groups.The inter-group comparison was carried out by using independent sample t-lest and intragroup comparison using paired t-test.The numabers of operation，complication cases and death cases were conducted by using X2 test.SPAS version 11.0 software was used for statistical analysis.Results The volume of solution infused in HS group was(3820±623)mL and in LR group was(5430±1254)mL(P＜0.05).At 10 and 20 minutes after the sdministration of solution.the mean blood pressures in HS group were both significantly higher than those in LR group(P＜0.01).The levels of CD3+and CD4+lymphocytes in peripheral blood in HS group 24 hours after treatment were sinificantly higher than those in LR group(P＜0.01).Totally，63(76.8%)patients were cured and 19(23.2%)patients died.ARDS occurred in 10 patients and MODS occurred in 14 patiellts.The mortality，and the rates of ARDS and MODS in HS group were sinificantly higher than those in LP group(P＜0.05).Conclusiom In patients with acute traumatically hemorrhagic shock.HS can increase the effective circulating vol. ume，ameliorate the perfusion of tissues and organs，improve the immune fuction of T-lymphocytes，decrease the rats of ABDS and MODS，mad decrease the morality.HS is more effective than routine solution used for resuscitation.

Objective To evaluate the effects of gestational weight gain(GWG) in different prepregnant body mass index (BMI) women on perinatal outcomes and to provide evidences for gestational weight management protocol.Methods Totally,2409 healthy singleton pregnant women accepted regular prenatal examinations in Nanjing Drum Tower Hospital from January 2009 to April 2010 were recruited in this study.They were divided into three groups according to pre-pregnant BMI,which were low BMI group (BMI＜18.5),normal BMI group (BMI 18.5-) and high BMI group (BMI≥24.0).According to GWG,the difference between pre-delivery maximal weight and prepregnant weight,the low and normal BMI women were divided into ＜10 kg,10 kg-and ≥15 kg GWG subgroups,and the high BMI women were divided into ＜5 kg,5 kg-,10 kg and ≥15 kg GWG subgroups.Data including gestational age,delivery modc,newborns' birth weight,Apgar score and incidences of gestational complications,such as hypertensive disorders complicating pregnancy (HDP),gestational diabetes mellitus (GDM),macrosomia,fetal growth restriction (FGR) and preterm birth,were recorded.Analysis of variance,Student-Newman Keuls,Chi-square test and Fisher exact test were applied for statistics.Results (1) Among the 2409 women,the percentages of low,normal and high BMI groups were 18.5％ (n=445),69.9％ (n=1685) and 11.6％ (n=279),respectively.The incidences of HDP,GDM,macrosomia and caesarean delivery in high BMI group were 12.9％ (n=36),17.9％ (n=50),13.6％ (n=38) and 52.3％ (n=146),respectively,higher than those in low BMI group [3.4％ (n=15),4.3 ％ (n=19),3.8％ (n=17) and 25.8％(n=115),x2 =23.8,37.1,23.5 and 50.2,P＜0.05] and those in normal BMI group [5.5％ (n=92),7.8％ (n=132),7.8％ (n=132)and 31.6％ (n=532),x2=21.8,29.0,10.1 and 3.4,P＜0.05].(2) In normal BMI group,the rates of FGR and preterm birth in GWG ＜10 kg subgroup were 3.5％ (4/115) and 8.7％ (10/115),higher than those in GWG 10 kg-subgroup [0.7％(4/548) and 3.3％(18/548),x2=6.0 and 6.9,P＜0.05] and GWG ≥15 kg subgroup [(0.8 ％ (8/1022) and 3.6％ (37/1022),x2=7.2 and 6.7,P＜0.05].The rates of macrosomia and cesarean delivery in GWG ≥15 kg subgroup were 10.7％ (109/1022) and 34.5％ (353/1022),higher than those in GWG＜10 kgsubgroup [3.5％ (4/115) and 32.2％ (37/115),x2=6.0 and 63.0,P＜0.05] and GWG 10 kg subgroup [3.5％ (19/548) and 25.9％ (142/548),x2=24.7 and 31.0,P＜0.05].(3) In high BMI group,the incidences of all pregnancy complications and perinatal outcomes did not show statistical significance among the four GWG subgroups (P＞0.05).Conclusions High prepregnant BMI is a high risk factor of pregnancy complications.It is suggested that normal BMI women should control GWG at 10-15 kg to lower the incidences of pregnancy complications.

Objective To investigate the contribution of single nucleotide polymorphisms (SNP)variation in folate metabolism pathway genes and its interaction with environmental risk factors to the etiology of NTD. Methods In 275 families from central China, a total of 278 aborted fetal tissues or blood samples were collected from NTD individuals, 478 maternal and/or paternal blood samples were also obtained as controls. Folate supplementation, maternal diabetes mellitus and medication before pregnancy and during the first trimester of pregnancy were investigated. SNP analyses of all samples were performed by CEQ 8800. Case-parent control study and transmission/disequilibrium tests (TDT) were performed according to environmental cofactors stratification to evaluated 28 SNP in 12 folate pathway genes associated with human NTD. Results Only gene MTHFR rs1801133 was significantly associated with NTD, and synergistic effects of environmental risk factors (no folate supplementation and maternal diabetes) were shown on the occurrence of NTD. Linkage disequilibrium between BHMT rs3733890 and NTD existed in case of no folate supplementation,whereas the genotype alone did not contribute to the etiology of NTD. Other SNP were not significantly associated with NTD. Conclusions MTHFR rs1801133 is a risk factor of NTD, but BHMT rs3733890 is not an independent risk factor. Further investigations in folate and methionine cycle genes are requird in larger scale to enclose the interactions between gene and gene, or gene and environmental factors.

a mygdalin ex isting the pro blem of exce ssive sulfurd ioxide evenw ithout sulfur smoked thro ugh “distill-io dometry”. M ethods Hea dspace gas ch romatograph y-flame phot ometric metho d was compa red with dist ill-iodometry method to d etect the con tent of sulfur dioxide in Se men Armeni acae Amarae, and silver ni trate titration and iodometr ic titration w ere used to determine th e pure amygd alin and sam ple through conventional sulfur dioxid e determinati on device. R esults In th e process ofd etermination of sulfur dio xide residues in Chineseh erbal medicin e and decoc tion pieces c ontaining am ygdalin, som e iodine cons umption was caused bya mygdalin dec omposing. C onclusion Co nventional i odometric m ethod and so dium hydrox ide titrationm ethod cann o longer be used for dete ction of sulf ur dioxide r esidue amoun t of Chinese herbal medici ne and decoc tion pieces co ntaining amy gdalin. Objective To explore th e causes ofs ome Chinese herbal medi cine and deco ction pieces containing.

Objective To systematically evaluate the role of laparoscopic living donor hepatectomy in living donor liver transplantation (LDLT).Methods A systematic literature search was conducted on Medline-Pubmed,Embase,Cochrane Library to find studies on laparoscopic living donor hepatectomy for LDLT.All extracted data were analyzed using the RevMan 5 software.Results Ten studies with a total of 1 059 participants were included in this analysis.Laparoscopic donor hepatecomy (LDH) was associated with significantly less intraoperative blood loss [SMD =-0.39,95％ CI (-0.73,-0.05),P ＜ 0.05],lower peak level of postoperative total bilirubin [SMD =-0.24,95％ CI (-0.47,-0.01),P ＜ 0.05]and longer operative time [SMD =0.50,95％ CI (0.04,0.96),P ＜0.05] when compared with those operated with open surgery.On subgroup analyses,hospitalization stay decreased in patients who underwent LDLT with grafts obtained by complete living donor hepatectomy (LDH) and left lateral sectionectomy (both P ＜ 0.05).LDH was comparable to open surgery in donor complication rates and in-hospital cost (P ＞ 0.05).There were no differences on the harvested liver graft size,ischemic time,recipient postoperative liver function and complications between the two groups (P ＞ 0.05).Conclusions Laparoscopic hepatectomy in living donor is a safe procedure for graft-harvesting,which improved the clinical outcomes of the donor,liver graft and recipient in LDLT.It has also the advantages of reduced blood loss,low peak levels of postoperative total bilirubin and short hospitalization stay.

OBJECTIVETo investigate the significance, effects and precautions of enteral nutritional support in patients with short bowel syndrome (SBS).

METHODSClinical data of 40 SBS patients who were maintained on enteral nutrition (EN) for more than 2 years were retrospectively summarized. The cost of EN and parenteral nutrition (PN), the PN-free duration, and the current nutritional status of these patients were analyzed.

RESULTSThe mean length of the remnant small bowel was (50.8 +/- 29.4) cm. All the patients currently lived on high-carbohydrate low-fat diet supplemented with EN (3284.0 +/- 1408.8) kJ/d, the cost was significantly lower than that of PN (P < 0.01). Mean PN-free duration was (29.1 +/- 9.2) months for these patients. The current defecation frequency and volume were (3.4 +/- 1.7) times/d and (720.2 +/- 350.3) ml/d, respectively. As for the patients' nutritional index, mean BMI, blood hemoglobin and serum albumin level were (17.8 +/- 3.2) kg/m(2), (113.3 +/- 14.8) g/L and (35.0 +/- 4.1) g/L, respectively.

CONCLUSIONSEnteral nutrition is a cost-effective method for maintaining the nutritional status in patients with short bowel syndrome, but proper management in clinical practice to avoid diarrhea or other complications should be ensured.

Adolescent ; Adult ; Enteral Nutrition ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Parenteral Nutrition ; Retrospective Studies ; Short Bowel Syndrome ; therapy ; Treatment Outcome

Primary pigmented nodular adrenal disease (PPNAD) is a kind of autosomal dominant inherited disease. Patient in the study presented with Cushing's syndrome, and clinical and pathological diagnosis of PPNAD was confirmed. It is now confirmed that there are two relevant genes and their mutations may lead to PPNAD. This study showed no mutations in the patient, surpecting if there would be an alternative mechanism or a new gene in playing the role.