[Objective]To evaluate the effect of polysaccharide from Polygonatum sibiricum on Toll-like receptor 4(TLR4)activation and clarify its antigen specific response-enhancing effect on mice.[Methods]The HEK-BlueTM hTLR4 cell line which was stably transfected with genes of human TLR4 and secreted embryonic alkaline phosphatase(SEAP)was used to quickly evaluate the activation of four different types of polysaccharide from Polygonatum sibiricum,including Polygonatum kingianum NP H2O(PKNH),Polygonatum kingianum AP H2O(PKAH),Polygonatum kingianum NP 5%EtOH(PKNEt)and Polygonatum kingianum AP 5%EtOH(PKAEt)on TLR4.C57BL/10ScNJ(TLR4-/-)mice were used to determine the relationship between the drug effect and TLR4.Ovalbumin(OVA)immunized mouse model was used to evaluate the enhancement of drug on specific immune response.The serum immunoglobulin G1(IgG1)and the cytokines related to the TLR4 signaling pathways such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interferon-γ inducible protein-10(IP-10)levels were detected by enzyme-linked immunosorbent assay(ELISA),and lymphocyte proliferation was evaluated by 5-[3-(Aarboxymethoxy)phenyl]-3-(4,5-dimethyl-2-thiazolyl)-2-(4-sulfophenyl)-2H-tetrazolium innersalt(MTS)assay.The mRNA expression levels of cytokines related to the TLR4 signaling pathways was determined by reverse transcription-polymerase chain reaction(RT-PCR).[Results]TLR4 was activated most strongly by treatment of neutral polysaccharides from PKNH for 24 h(P<0.001).Compared with wild type,the cell proliferation and the expressions of TNF-α,IL-6 and IP-10 were significantly decreased in PKNH treated splenic lymphocyte from C57BL/10 ScNJ mice(P<0.001).Intragastric administration of PKNH significantly increased serum IgG1 level(P<0.01)and promoted splenic lymphocyte proliferation in OVA immunized mice(P<0.05).[Conclusion]The polysaccharide from Polygonatum sibiricum PKNH enhances the antigen specific immune response through activation of TLR4.

[Objective]To evaluate the effect of polysaccharide from Polygonatum sibiricum on Toll-like receptor 4(TLR4)activation and clarify its antigen specific response-enhancing effect on mice.[Methods]The HEK-BlueTM hTLR4 cell line which was stably transfected with genes of human TLR4 and secreted embryonic alkaline phosphatase(SEAP)was used to quickly evaluate the activation of four different types of polysaccharide from Polygonatum sibiricum,including Polygonatum kingianum NP H2O(PKNH),Polygonatum kingianum AP H2O(PKAH),Polygonatum kingianum NP 5%EtOH(PKNEt)and Polygonatum kingianum AP 5%EtOH(PKAEt)on TLR4.C57BL/10ScNJ(TLR4-/-)mice were used to determine the relationship between the drug effect and TLR4.Ovalbumin(OVA)immunized mouse model was used to evaluate the enhancement of drug on specific immune response.The serum immunoglobulin G1(IgG1)and the cytokines related to the TLR4 signaling pathways such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interferon-γ inducible protein-10(IP-10)levels were detected by enzyme-linked immunosorbent assay(ELISA),and lymphocyte proliferation was evaluated by 5-[3-(Aarboxymethoxy)phenyl]-3-(4,5-dimethyl-2-thiazolyl)-2-(4-sulfophenyl)-2H-tetrazolium innersalt(MTS)assay.The mRNA expression levels of cytokines related to the TLR4 signaling pathways was determined by reverse transcription-polymerase chain reaction(RT-PCR).[Results]TLR4 was activated most strongly by treatment of neutral polysaccharides from PKNH for 24 h(P<0.001).Compared with wild type,the cell proliferation and the expressions of TNF-α,IL-6 and IP-10 were significantly decreased in PKNH treated splenic lymphocyte from C57BL/10 ScNJ mice(P<0.001).Intragastric administration of PKNH significantly increased serum IgG1 level(P<0.01)and promoted splenic lymphocyte proliferation in OVA immunized mice(P<0.05).[Conclusion]The polysaccharide from Polygonatum sibiricum PKNH enhances the antigen specific immune response through activation of TLR4.

Objective:To explore the occurrence of rashes in healthy subjects caused by efavirenz in drug clinical trials.Methods:The occurrence of rashes related to efavirenz, which was used as an enzyme inducer, in healthy subjects in 2 clinical trials conducted by the Phase I Clinical Research Center of the Department of Pharmacy, Xuanwu Hospital, Capital Medical University (our hospital) in November 2020 and October 2021 was retrospectively analyzed. The relevant databases at home and abroad (up to November 30, 2022) were searched, and the literature, in which efavirenz was applied as trial drug or enzyme inducer in healthy subjects, were collected. The cases of efavirenz-related rashes reported in the literature were reviewed. The clinical characteristics of the cases in the literature and above 2 clinical trials in our hospital were summarized and analyzed by descriptive statistics.Results:A total of 40 healthy subjects were included in the 2 clinical trials, and 5 (12.5%) developed efavirenz-related rashes. The average time from taking the medicine to the appearance of rashes was 8 days. The initial symptom was skin itching. The rashes occurred mainly on the limbs and back, and mainly presented as maculopapular rashes, without other symptoms or laboratory abnormalities. Four subjects withdrew from the trial and the rashes subsided after 5-7 days of anti-allergic and symptomatic treatments; one subject was given calamine lotion for external use because of mild rashes, and continued to participate in the trial. His rashes subsided 17 days later (5 days after stopping efavirenz). Eighteen literature in which efavirenz was used as a trial drug or enzyme inducer in healthy subjects were retrieved. A total of 403 healthy subjects collected from 18 literature and our trials were included in the analysis. Of them, 19 subjects developed rashes, with a incidence of 4.7%. According to the daily dose of efavirenz, the incidence of rashes in the subjects of the 600 mg/d group was higher than that of the <600 mg/d group, but the difference was not statistically significant [5.5% (18/329) vs. 1.4% (1/74), P=0.131]. According to the course of drug, the incidence of rashes was similar in subjects between the single dose group and the continuous dose group [4.1% (4/97) vs. 4.9% (15/306), P=0.753]. Conclusion:Rashes are common adverse reactions in healthy subjects after taking efavirenz, which is generally mild and can subside after timely detection and treatment.

Objective:To explore the occurrence of rashes in healthy subjects caused by efavirenz in drug clinical trials.Methods:The occurrence of rashes related to efavirenz, which was used as an enzyme inducer, in healthy subjects in 2 clinical trials conducted by the Phase I Clinical Research Center of the Department of Pharmacy, Xuanwu Hospital, Capital Medical University (our hospital) in November 2020 and October 2021 was retrospectively analyzed. The relevant databases at home and abroad (up to November 30, 2022) were searched, and the literature, in which efavirenz was applied as trial drug or enzyme inducer in healthy subjects, were collected. The cases of efavirenz-related rashes reported in the literature were reviewed. The clinical characteristics of the cases in the literature and above 2 clinical trials in our hospital were summarized and analyzed by descriptive statistics.Results:A total of 40 healthy subjects were included in the 2 clinical trials, and 5 (12.5%) developed efavirenz-related rashes. The average time from taking the medicine to the appearance of rashes was 8 days. The initial symptom was skin itching. The rashes occurred mainly on the limbs and back, and mainly presented as maculopapular rashes, without other symptoms or laboratory abnormalities. Four subjects withdrew from the trial and the rashes subsided after 5-7 days of anti-allergic and symptomatic treatments; one subject was given calamine lotion for external use because of mild rashes, and continued to participate in the trial. His rashes subsided 17 days later (5 days after stopping efavirenz). Eighteen literature in which efavirenz was used as a trial drug or enzyme inducer in healthy subjects were retrieved. A total of 403 healthy subjects collected from 18 literature and our trials were included in the analysis. Of them, 19 subjects developed rashes, with a incidence of 4.7%. According to the daily dose of efavirenz, the incidence of rashes in the subjects of the 600 mg/d group was higher than that of the <600 mg/d group, but the difference was not statistically significant [5.5% (18/329) vs. 1.4% (1/74), P=0.131]. According to the course of drug, the incidence of rashes was similar in subjects between the single dose group and the continuous dose group [4.1% (4/97) vs. 4.9% (15/306), P=0.753]. Conclusion:Rashes are common adverse reactions in healthy subjects after taking efavirenz, which is generally mild and can subside after timely detection and treatment.

Objective:By comparing preoperative high resolution magnetic resonance imaging (MRI) examination with postoperative pathologic results, to investigate the effects of MRI examination evaluation on the anatomical level and clinical outcome.Methods:We conducted a retrospective study on 72 patients who underwent resection of rectal cancer at the Second Affiliated Hospital of Wenzhou Medical University between Apr 2017 and Nov 2018, including 35 patients undergoing laparoscopic resection and 37 patients doing open resection. All cases received high resolution MRI examination before operation. The diagnostic accuracy of MRI, operation safety, and the short-term outcomes were analyzed.Results:There were no postoperative tumor recurrence. The accuracy rate of preoperative MRI evaluation of T stage was 85%, and positive N+ was 74%. There were no difference in postoperative complications between the open resection group and laparoscopic resection group (29% vs. 22%, χ 2=0.463, P=0.496). The proximal and distal margin was negative, postoperative circumferential resection margin and preoperative mesorectal fascia was consistent, the distance between the lower margin of the tumor and the anal right angle measured by MRI were consistent with the distance between the tumor from the dentate line. Conclusion:High resolution MRI with a good tissue resolution, has a high preoperative diagnosis accuracy for T and N staging of the low rectal cancer, with decisive role in the evaluation on the anatomical level, improving the quality and safy of surgery.

Objective:To investigate the changes in plasma ET-1 and ANF in IDDM and its microvascular complication.Methods:The plasma levels of ET-1 and ANF were measured by radioimmunoassy in 31 patients with IDDM and 25 normal controls.Results:The plasma levels of ET-1 and ANF significantly increased in IDDM compared with the normal controls (P<0.01);and the levels were also markedly higher in diabetics with microangiopathy complications than in those withou the complications (P<0.01).The more kinds of microangiopathey complications,the higher level of the plasma ET-1 and ANF,which suggests that the elevation of plasma ET-1 and ANF may be concerned with the microangiopathy and ET-1 may reflect the degree of vascular endothelial cell damage.There were no significant correlation between plasma ET-1 or ANF and blood glucose,fructosamine and C-peptide,but the plasma levels of ET-1 and ANF both correlated with the duration of diabetes mellitus.And the plasma level of ET-1 positively correlated with ANF1 (P<0.01).Conclusion:The results of study suggest that ET-1 and ANF are both associated with the development,progress and severity of microvascular complications.

0.05).The concentration of IL-6 in sputum of multi-virus infection group(122.51?39.86)ng/L was higher than in single virus infection group(65.30?34.92)ng/L.The concentration of IL-6 in sputum of bacteria-virus mixed infection group(120.31?46.62)ng/L was higher than in bacteria or virus single infection group(83.61?47.83)ng/L.Conclusion Streptococcus pneumonia and influenza virus A infection are important factors in AECOPD at early stage.Virus infection would prolong recovery time,increase inflammation of the airway and even induce bacteria infection.Therefore,we should pay more attention to the virus infection in COPD patients,especially A-type influenza virus.