ObjectiveTo evaluate the effect and safety of Jiuxin Pill （救心丸） on exercise tolerance and quality of life in patients with stable angina pectoris （SAP）. MethodsA randomised， double-blind， placebo-controlled， multicentre study design was used to enroll 170 patients of SAP from nine centres， which were divided into 85 patients each in the trial group and control group with 1∶1 ratio. Both groups maintained the original western medicine treatment plan， and added Jiuxin Pill or placebo respectively， 2 pills （0.05 g） each time twicely for 28 days. The main outcomes were total exercise time （TED） in the exercise treadmill test and Seattle Angina Questionnaire （SAQ） scores including physical limitation （PL）， angina stability （AS）， angina frequency （AF）， treatment satisfaction （TS）， and disease perception （DP）. The secondary outcomes were exercise treadmill test indicators including heart rate recovery in 1 min （HRR1）， metabolic equivalents （METs）， maximum magnitude of ST-segment depression， and the Borg rating of perceived exertion scale， the average number of angina attacks per week， withdrawal and reduction rate of nitroglycerin， traditional Chinese medicine syndrome scores， incidence of major adverse cardiovascular events. Safety indicators were evaluated and the occurrence of adverse events during the trial was recorded. Data was collected before treatment， day 28±2 in treatment period， and follow-up at day 56 which is 28±2 days after treatment period finished. ResultsEighty-four and eighty-five patients respectively from trial group and control group were included to the full analysis set （FAS） and safety analysis set （SS）. Compared with the group before treatment and with the control group after treatment， the trial group had higher TED， HRR1， and METs， and lower maximum magnitude of ST-segment depression and Borg rating of perceived exertion scores after treatment （P＜0.01）. Compared with the group before treatment and with the control group after treatment and at follow-up， the total SAQ score and scores of AS， AF， TS and DP of the trial group after treatment and at follow-up elevated， while the average number of angina attacks per week and traditional Chinese medicine syndrome scores reduced （P＜0.01）. There was no statistically significant difference in the withdrawal and reduction rate of nitroglycerin between groups （P＞0.05）. Major adverse cardiovascular events occurred in 1 case （1/84， 1.19%） in the trial group and 1 case （1/85， 1.18%） in the control group， and the difference between groups was not statistically significant （P＞0.05）. A total of 3 cases of adverse events occurred in the trial group （3/84， 3.57%）， and a total of 6 cases of adverse events occurred in the control group （6/85， 7.06%）， and there was no statistically significant difference in the incidence of adverse events between groups （P＞0.05）. ConclusionIn the treatment of SAP， Jiuxin Pill combined with conventional western medicine can further enhance exercise tolerance， improve quality of life， and demonstrate great safety.

OBJECTIVE To study the improvement effect and possible mechanism of N-butylphthalide on inflammatory injury of bone marrow mesenchymal stem cells （BMSCs） in rats. METHODS BMSCs of rats were divided into control group， model group， N-butylphthalide low-concentration， medium-concentration and high-concentration groups （10， 20， 50 μmol/L）. BMSCs were cultured in vitro and lipopolysaccharide （the final concentration of 10 mg/L） was used to establish the inflammatory injury model. After the intervention of N-butylphthalide， the survival rate， apoptotic rate， the contents of tumor necrosis factor α （TNF- α）， interleukin 1β （IL-1β） and IL-6 in cell culture medium， the mRNA expression of nuclear factor-κB（NF-κB） p65， and the protein expressions of caspase-3， B-cell lymphoma 2 （Bcl-2）， Bcl-2 related X protein （Bax） and NF-κB p65 in cells were detected. RESULTS Compared with control group， the survival rate and protein expression of Bcl-2 were decreased significantly in model group （P＜0.05）； the apoptotic rate， contents of TNF-α， IL-1β and IL-6， the mRNA expression of NF-κB p65， and the protein expressions of caspase-3， Bax and NF-κB p65 were increased significantly （P＜0.05）. Compared with model group， above indexes were significantly reversed in all concentration groups of N-butylphthalide （P＜0.05）， in concentration-dependent manner. CONCLUSIONS N-butylphthalide can ameliorate the inflammatory injury of BMSCs induced by lipopolysaccharide， and its mechanism may be related to the inhibition of NF-κB signaling pathway.

A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

Objective To analyze the clinical features, laboratory findings, electroencephalography (EEG) and neuroimaging of the neurosyphilis presented with parkinsonism as the principal manifestation to improve the diagnosis of neurosyphilis. Methods Eight eurosyphilis patients were from department of neurology of Hainan provincial people’s hospital from early July 2010 to December 2014. We retrospectively analyzed the clinical manifestation, laboratory exami?nations, neuroimaging examinations, diagnosis and treatment outcomes of 8 cases neurosyphilis who presented with par?kinsonism as principal manifestation. Results Myotonia and bradykinesia were principal symptoms in these 8 cases. Limb tremor, posture disorder, abnormal mental behavior and cognitive impairment occurred in some patients. Serum treponema pallidum particle agglutination (TPPA) and toluidine red untreated serum test (TRUST)were positive in 8 cas?es. Cerebrospinal fluid (CSF) protein and cell counts were elevated in all the patients. CSF-TPPA and TRUST were posi?tive in all the patients. The MRI showed that cerebral infarction in basal ganglia, cerebral atrophy in temporal lobe and hippocampus and ventricular enlargement in all the patients. EEG showed abnormal activity in all the patients. After treatment with a large dose of penicillin, clinical symptoms were obviously improved;the titer of serum and CSF TRUST decreased;and scores of UPDRS decreased in all the patients. Conclusions There is a wide variation in the clinical man?ifestation of the neurosyphilis. When patients present with Parkinsonism, we should comprehensively analyze the laborato?ry examinations, EEG and neuroimaging to rule out the possibility of neurosyphilis.

Objective To investigate the effect of nuclear-transcription factor-κB signal transduction pathway on differentiation of rat marrow mesenchymal stem cells (MSCs) into neurons.Methods The MSCs were purified at least four generations in vitro.And then,the MSCs were assigned into three groups:non-serum control group (group A),fasudil treatment group (group B) and fasudil and lipopolysaccharide treatment group (group C).Cells in group A were added serum-free DMEM,those in group B were added induced liquid (DMEM 900 μL+fetal bovine serum 100 μL that contains final concentration of 200 μmol/L of fasudil),and those in group C were added induced liquid (DMEM 900 μL+fetal bovine serum 100 μL that contains final concentration of 200 μmol/1 of fasudil and final concentration of 1000 μg/L of lipopolysaccharide).All the MSCs were induced into neurons for 6 h.The morphology of MSCs was observed under inverted fluorescence microscope.The expressions of neuronspecific enolase (NSE),microtubule-associated protein (MAP)-2,cyclin D1 and glial fibrillary acidic protein (GFAP) in neurons were detected by immunocytochemical method.The mRNA expressions ofcyclin D1 and MA P-2 in neurons were detected by real time-PCR.The protein expressions ofcyclin D1 and MAP-2 were detected by Western blotting.Results (1) The MSCs of group A kept flat and the neurites were scarce;the MSCs of group B and C could differentiate into neurons,and the speed of MSCs of group B differentiating into neurons was faster than that in group C;there was typical neural network in group B and the neural network in group C was scarcer than group B.(2) As compared with those in group A,higher expression levels of NSE and MAP-2,and lower cyclin D1 expression level in group B and group C were noted (P＜0.05);the expression percentage of GFAP was lower than 1％ in both three groups.(3) As compared with group A,group B and group C had significantly lower cyclin D1 protein and mRNA expressions and significantly higher MAP-2 protein and mRNA expressions (P＜0.05).Conclusion The NF-κB signal transduction pathway,by regulating the expression of cyclin D1,participates in the neuronal differentiation of rat marrow mesenchymal stem cells induced by fasudil.

Objective To explore the effect of Xiongbiyihao mixture in the treatment of coronary heart disease with angina pectoris.Methods 90 coronary heart disease patients with angina pectoris were divided into the treatment group( 60 cases) and control group( 30 cases).The control group was given routine westerm medicine therapy,and the treatment group was administered with Xiongbiyihao mixture at the base of the control group.Ater treatment,the heart disease attack frequency,duration,and degree,clinical symptoms and electrocardiogram changes of the two groups were observed.Results The total efficiency symptoms of and electrocardiogram of the treatment group was 95.0％,90.0％,respectively,and was higher than that of the control group(76.7％,73.3％ ) ( x2 =9.7,x2 =7.8,all P ＜ 0.05).Conclusion Xiongbiyihao mixture could effectively improve the coronary blood,reduce myocardial ischemia,and alleviate the symptoms of angina pectoris,chest tightness,chest pain.It is safe and effective in the treatment of angina pectoris,and worthy of clinical application.

Objective To establish a HPLC method for the simultaneous determination of campanulin, paeoniflorin and hydrox-ysafflor yellow A in Buyang Huanwu Decoction. Methods A Kromasil C18(4. 6 mm × 250 mm, 5 μm) column was adopted. The mobile phase consisited of methanol and acetonitrile(26 : 2) (A), and 0. 7 % phosphoric acid solution(B), in gradient e-lution (0～10 min, 25 % →35 % A; 10～25 min, 35 %→40 % A). The flow rate was at 1.0 mL·min-1. The column tem-perature was 35 ℃;, and the detection wavelengths were set at 260nm for campanulin, 230 nm for paeoniflorin and 403 nm for hydroxysamor yellow A. Results The linear ranges of campanuliu, paconiflorin and hydroxysafflor yellow A were 0. 0539～1. 078 μg (r=0. 999 5), O. 4160～8. 320μg (r=0. 999 8), and 0. 0418～0. 8352 μg (r=0. 999 5) respectively; the av-erage recovery was 99. 4 % (RSD=1.5 %), 100. 6 % (RSD=1.7 %), and 101.0 % (RSD=1.9 %) respectively. Conclu-sion The method is simple, feasible and reproducible, and can be used for the quality control of Buyang Huanwu Decoction.