Objective To investigate the potential therapeutic effects of trifolin on hypertension-induced renal injury,as well as the key targets and pathways involved.Methods The mRNA transcriptional profiles of peripheral blood clinical samples from hypertensive patients were analyzed using Gene Expression Omnibus(GEO),a high-throughput gene expression database.The network pharmacology method was employed to screen key targets of trifolin in treating hypertension-induced renal injury.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were conducted.NRK-52E cells,a rat renal proximal tubular cell line,were used to construct an angiotensin Ⅱ(Ang Ⅱ)-stimulated cell model.Flow cytometry was performed to assess cell apoptosis rates and Western blotting was performed to determine the expression levels of apoptosis-related proteins,including Bax,Bcl-2,cleaved caspase-3,and caspase-3,and the phosphorylation and total protein levels of the key MAPK pathway proteins,including ERK,p38 MAPK,and JNK.Results Analysis of the dataset GSE75360 revealed that,compared with healthy controls,3 331 genes were upregulated and 3 197 genes were downregulated in peripheral blood mononuclear cells of hypertensive patients.According to network pharmacology analysis,472 potential targets of trifolin were identified,including CASP3 and MAPK1.Protein-protein interaction network analysis showed that these targets were closely associated with apoptosis regulatory signaling pathways.GO and KEGG pathway enrichment analyses indicated that trifolin was significantly enriched in pathways associated with negative regulation of apoptosis,apoptotic signaling pathways,and the MAPK signaling pathway.The in vitro experiments confirmed that,compared with the Ang Ⅱ group,trifolin intervention inhibited apoptosis in Ang Ⅱ-stimulated NRK-52E cells,suppressed the expression of Bax and cleaved caspase-3,promoted Bcl-2 expression,and inhibited the phosphorylation of p38 MAPK,ERK,and JNK(P<0.05).Conclusion Trifolin may exert its protective effect against hypertension-induced renal injury by inhibiting Ang Ⅱ-induced NRK-52E cell apoptosis and regulating the MAPK signaling pathway,representing an important mechanism underlying its therapeutic action.

To evaluate effects of reinfusion of the remaining blood filtered by leukocyte depletion filter on postoperative cellular immune function after cardiopulmonary bypass (CPB). Methods Forty patients who underwent selective cardiac valve replacement surgery with CPB in department of anesthesiology of Haikou Municipal Hospital from January to June in 2018 were enrolled. All the patients were divided into the control group and experimental group according to the random number table method, with 20 patients in each group. In the experimental group, patients received residual pump blood transfusion which had been filtered by leukocyte depletion filter and stored in sterile blood collection bags. In the control group, patients received residual pump blood transfusion which was stored in sterile blood collection bags without being filtered. The remaining blood was reinfused after CPB in two groups. Blood samples were taken before CPB (T1), 2 hours following CPB (T2), and 1, 3, 5 days after reinfusion of the remaining blood (T3, T4, T5), the levels of T lymphocyte subsets CD3+, CD4+, CD8+ and natural killer cells (NK cells) were detected by flow cytometer, and CD4+/CD8+ ratio was calculated. The levels of plasma tumor necrosis factor-α (TNF-α), interleukins (IL-2, IL-6, IL-8) were measured by enzyme linked immunosorbent essay (ELISA). The duration of mechanical ventilation, the length of intensive care unit (ICU) stay, the length of hospital stay, and incidence of wound and pulmonary infection after surgery were compared between two groups. Results Among 40 patients, there were 22 males and 18 females; with an age of (47.88±12.29) years old; and with 25 cases of American Society of Anesthesiologists (ASA) physical status Ⅱ, and 15 cases of ASAⅢ. There was no statistical difference in the volume of the remaining blood between the two groups (mL: 959.00±116.84 vs. 971.50±115.68, P > 0.05). Compared with T1, the levels of T lymphocyte subsets CD3+, CD4+, CD8+, NK cells and plasma levels of IL-2 were significantly decreased from T2, the CD4+/CD8+ ratio was significantly decreased from T3 in two groups, but there was no statistical difference in CD3+, CD4+, CD8+, NK cells, CD4+/CD8+ ratio or plasma level of IL-2 at each time between the two groups. Compared with T1, the plasma levels of TNF-α, IL-6 and IL-8 were significantly increased at T2 in two groups and then decreased gradually. The plasma levels of TNF-α, IL-6 and IL-8 from T3 in experimental group were lower than those in control group [TNF-α (ng/L): 28.49±4.66 vs. 33.82±4.30, IL-6 (ng/L): 25.98±4.51 vs. 31.38±5.42, IL-8 (ng/L):38.98±4.67 vs. 45.76±5.33, all P < 0.05], they restored to the level of T1 at T5. In addition, compared with control group, the duration of mechanical ventilation, the length of ICU stay in experimental group were significantly decreased (hours: 8.07±1.30 vs. 9.16±1.52, 28.22±2.78 vs. 31.25±3.18, both P < 0.05), and there was no statistical difference in the length of hospital stay (days: 20.65±2.76 vs. 22.45±3.22), incidence of wound and pulmonary infection (25.0% vs. 15.0%, 5.0% vs. 15.0%) between the two groups (all P > 0.05). Conclusion Reinfusion of the remaining blood filtered by leukocyte depletion filtercan inhibit inflammatory responses and don't affect the function of cellular immunity, and don't increase the incidence of infection.

Objective To evaluate the lung protection of residual pump blood processed by microaggregate blood filter-reinfusion in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB).Methods A total of 40 patients,aged 28-55 yr,weighing 46-66 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with New York Heart Association of Ⅱ or Ⅲ,with left ventricular ejection fraction＞50％,scheduled for elective cardiac valve replacement under general anesthesia,were divided into 2 groups (n =20 each) using a random number table method:residual pump blood reinfusion group (group C) and residual pump blood processed by microaggregate blood filter-reinfusion group (group M).Residual pump blood was collected immediately after the end of CPB.The residual pump blood was stored in sterile blood collection bags without being filtered in group C.The residual pump blood was stored in sterile blood collection bags after being processed by microaggregte blood filter in group M.Residual pump blood was intravenously reinfused after the CPB pipe was removed.At 10 min before CPB (T1),immediately after the end ofCPB (T2),immediately after processing (T3) and at 12 and 24 h after residual pump blood reinfusion (T4,5),blood samples were collected to measure blood components and serum tumor necrosis factor-alpha and intedeukin-6 concentrations (by enzyme-linked immunosorbent assay).Airway plateau pressure was recorded,arterial blood samples were collected for blood gas analysis,and static lung compliance,oxygenation index and respiratory index were calculated at T1.5.The postoperative mechanical ventilation time,duration of intensive care unit stay,length of hospital stay,and incidence of hypoxemia and pulmonary infection were recorded.Results Compared with group C,white blood cell count was significantly decreased at T3-5,and static lung compliance and oxygenation index were increased,respiratory index was decreased,serum tumor necrosis factor-alpha and interleukin-6 concentrations were decreased,postoperative mechanical ventilation time and duration of intensive care unit stay were shortened,and the incidence of hypoxemia was decreased at T4.5 in group M (P＜0.05).Conclusion Residual pump blood proccessed by microaggregate blood filter-reinfusion can reduce systemic inflammatory responses and exerts lung protection to some extent in the patients undergoing cardiac surgery under CPB.

OBJECTIVE To study the diagnostic and therapeutic conditions in a general hospital,and try to find out the measures to decrease cross infection in hospital. METHODS From Dec 2003 to Nov 2004,2 037 cases of infectious diseases were diagnosed and treated in our hospital.All these cases were analyzed. RESULTS Among the 2037 cases,the most common diseases were viral hepatitis and pulmonary tuberculosis.And others were infectious diarrhea,gonorrhea,syphilis,typhoid,paratyphoid,epidemic parotitis,bacillary dysentery,epidemic encephalitis B,measles,tetanus of newborn and rabies. CONCLUSIONS To control cross infection in hospital effectively,we must pay more attention to standardized management of infections diseases,strengthen the isolation and protective conciousness of medical personnel for infectious diseases,and tighten up the management of sterilization and isolation.

【Objective】The chemical constituents of Viscum liquidambaricolum Hayata.were studied to screen the constituents with antitumor activity.【Methods】Chromatography was used for the isolation and purification of chemical constituents of Viscum liquidambaricolum Hayata..And their structures were identified on the basis of spectroscopic evidences and physiochemical properties.Meanwhile,the in-vitro antitumor activities of two kinds of triterpenoids and one kind of sitosterol were investigated.【Results】Four compounds were isolated from Viscum liquidambaricolum Hayata.and their structures were identified as genkwanin(1),?-amyrin acetate(2),erythrodiol(3) and ?-sitosterol(4).Compounds 2 and 3 had an inhibitory effect on mice sarcoma 180(S180),Ehrlich ascites carcinoma(EAC) and ascties hepatoma(HeAP),and compound 4 had an inhibitory effect on mice S180 and EAC,their half-inhibitory concentrations being less than 400??g/mL.【Conclusion】Compounds 1～4 are isolated from Viscum liquidambaricolum Hayata.for the first time,and compound 1 is isolated from Loranthaceae for the first time.Triterpenoids and steroids from Viscum liquidambaricolum Hayata.exert certain antitumor activity.