Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

ObjectiveTo provide references for the selection of Zingiberis Rhizoma Recens on the research of famous classical formulas and the reasonable uses for medicines and foods through herbal textural research and quality analysis of Zingiberis Rhizoma Recens from main producing areas in China. MethodBy consulting the ancient and modern literature， the name， origin， producing areas， harvest time， processing methods of Zingiberis Rhizoma Recens were summarized. According to the 2020 edition of Chinese Pharmacopoeia， the contents of 6-gingerol， 8-gingerol， 10-gingerol， and volatile oil in Zingiberis Rhizoma Recens samples were determined. ResultHerbal textural research indicated that medicinal Zingiberis Rhizoma Recens originated from the fresh rhizome of Zingiber officinale. Before Tang dynasty， Zingiberis Rhizoma Recens produced in Sichuan was the best. In the Song dynasty， Zingiberis Rhizoma Recens produced in Sichuan， Zhejiang， and Anhui was of excellent quality. The cultivation of Zingiberis Rhizoma Recens in Shandong developed during the Ming and Qing dynasties. From ancient times to the present， the harvest period extended from the autumnal equinox to the winter solstice. Quality evaluation standards of Zingiberis Rhizoma Recens were essentially the same in ancient and present documents， as those with little gluten or gluten-free and strong pungency were preferred. After determination， the contents of 6-gingerol， 8-gingerol， and 10-gingerol in 44 samples were qualified in 27 samples， with a qualified rate of 61.4%. Among them， 17 samples were unqualified in the total contents of 8-gingerol and 10-gingerol. Among these qualified samples， the content of 6-gingerol ranged from 0.067% to 0.255%， and the total contents of 8-gingerol and 10-gingerol ranged from 0.040% to 0.131%. The content of volatile oil in 36 samples were qualified in 33 samples， with a qualified rate of 91.7%. Among the qualified samples， the content of volatile oil ranged from 0.175% to 0.410%. ConclusionZingiberis Rhizoma Recens has been used as medicines and foods since ancient times， and the genuine producing areas are consistent in ancient and present times， while the quality of the products， especially the medicinal Zingiberis Rhizoma Recens， should be monitored. Medicinal Zingiberis Rhizoma Recens planted in Leshan city of Sichuan province contains high contents of effective components， followed by Qujing and Wenshan cities of Yunnan province. Zingiberis Rhizoma Recens planted in Shandong and other places is mostly edible.

To analyze the effectiveness and safety of intermittent lung inflation combined with rigid ureteroscopy in the treatment of upper ureteral stones that were not fully visible. The clinical and imaging data of 56 patients with upper ureteral stone undergoing rigid ureteroscopic lithotripsy combined with intermittent lung inflation in Zhejiang Quhua Hospital from March 2016 to October 2017 were retrospectively analyzed.Intermittentt lung inflation was used to change and stabilize the position of ureteral calculi during the operation,so as to ensure the visual field of ureteroscopy.Holmium laser lithotripsy was performed to remove the stones.Urinary tract abdominal plain X-ray or CT urography was performed 1 and 3 months after the operation to evaluate the residual stones and the clinical efficacy. Stones were successfully removed after a single attempt in 48 patients.In 5 patients,stones escaped into the kidney during ureteroscopic lithotripsy,and thus flexible ureteroscopy were performed.In 3 patients,a second session of auxiliary procedure was required,among whom 2 patients received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy+ureteroscopic lithotripsy.The stone-free rates 1 and 3 months after surgery were 94.6%(53/56)and 100%(56/56),respectively.No severe complication such as ureter perforation,gross hematuria,septic shock,or pneumothorax occurred during and after surgery. Intermittent lung inflation in tracheal intubation under general anesthesia in patients with proximal ureteral stones that can not be fully visible during rigid ureteroscopic lithotripsy was feasible and reliable.It can effectively change the location of stones and thus enable safe and effective lithotripy.It expands the indications of rigid ureteroscopy for treating upper ureteral stones.
Humans ; Lithotripsy, Laser ; Retrospective Studies ; Ureteral Calculi ; diagnostic imaging ; Ureteroscopes ; Ureteroscopy

Objective To explore the anti-inflammatory action of Heshi Yangshen Recipe on rat model of nephrotic syndrome induced by adriamycin. Methods Rat model of nephrotic syndrome was established by tail venous injection of one-dose of adriamycin. SD rats were divided into normal group(N = 10),model group(N =11), positive control group (N = 12), and high-, middle- , low-dose Chinese medicine groups (N = 12, respectively). Two weeks after modeling,rats in the normal group and model group were given gastric gavage of same volume of normal saline, rats in positive control group were given gastric gavage of benazepril aqueous solution at a dose of 10 mg·kg-1·d-1 in the former period of 15 days and at 10 mg·kg-1·d-1 in the later period of 20 days, and rats in high-,middle- ,low-dose groups were given gastric gavage of Heshi Yangshen Recipe at a dosage of 33.26, 16.63, 8.32 g·kg-1·d-1 respectively, for 30 continuous groups. During the treatment period, the general situation of rats was observed. After the completion of medication, the levels of 24-hour urinary protein, urine total proteins, urine creatinine were measured by biochemical analyzer, serum high-sensitivity C-reactive protein (Hs-CRP) level was detected by enzyme-linked immunosorbent assay(ELISA),and the expression levels of intercellular adhesion molecule 1 (ICAM-1)and vascular cell adhesion molecule-1 (VCAM-1)in rat renal tissue of various groups were determined by immunohistochemistry. Results The increase of body mass in all of the modeled rats was significantly slowed down (P < 0.01 as compared with the normal group). Compared with the normal group, the levels of 24-hour urinary protein, serum hs-CRP, and the expression of ICAM-1 and VCAM-1 in rat renal tissue were increased in the model group (P < 0.05 or P <0.01). Compared with the model group, the level of 24-hour urinary protein in the positive control group and high-dose Chinese medicine group was decreased (P < 0.05), and the levels of serum Hs-CRP, and the expression of ICAM-1 and VCAM-1 in rat renal tissue of the positive control group and high-,middle-,low-dose Chinese medicine groups were decreased (P < 0.05 or P < 0.01). Conclusion Heshi Yangshen Recipe exerts certain anti-inflammatory action, and its mechanism may be related with the decrease of ICAM-1 and VCAM-1 expression. High dosage of Heshi Yangshen Recipe has the strongest therapeutic effect.

Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease.

OBJECTIVETo study the oxidative damage and apoptosis of renal tubular epithelial cells (NRK-52e cell line) induced by ethylbenzene.

METHODSNRK-52e cells were exposed to 30, 60, 90, 120 μmol/L ethylbenzene for 24 hours. Cell viability were measured using MTT, the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT), the contents of malondialdehyde (MDA) and glutathione (GSH) were detected respectively. PI fluorescent staining assay was applied to detect percentage of apoptosis in ethylbenzene-treated groups.

RESULTSCompared with control group, cell outline became clear, cell diopter increased, cell became smaller and shrinkage, some cells broke in 60 μmol/L ethylbenzene-treated group. Plenty of cells died, suspension cells increased significantly in 90 μmol/L ethylbenzene-treated group. Compared with control group, cell viability the activities of SOD and CAT and the content of GSH were significantly decreased in 60 and 90 μmol/L ethylbenzene-treated groups (P<0.05). The MDA content were remarkably elevated in 90 μmol/L ethylbenzene-treated groups (P<0.05).

CONCLUSIONEthylbenzene can induce oxidative stress and apoptosis in NRK-52e cells (P<0.05).

Animals ; Apoptosis ; drug effects ; Benzene Derivatives ; toxicity ; Cell Line ; Epithelial Cells ; drug effects ; metabolism ; Kidney Tubules ; cytology ; Oxidation-Reduction ; Oxidative Stress ; drug effects ; Rats ; Reactive Oxygen Species ; metabolism

OBJECTIVETo establish a predictive scoring system which may serve for the prediction of sustained response to conventional interferon-alpha (IFN-alpha) treatment on chronic hepatitis B.

METHODSA total of 474 IFN-alpha treated hepatitis B virus e antigen (HBeAg)-positive patients were enrolled in the present study. The patients' baseline characteristics, such as age, gender, aminotransferases, activity grading (G) of intrahepatic inflammation, score (S) of liver fibrosis, hepatitis B virus (HBV) DNA and genotype were evaluated; therapy duration and response of each patient at the 24th wk after cessation of IFN-alpha treatment were also recorded. A predictive scoring system for a sustained complete response (CR) to IFN-alpha therapy was established based on genetic algorithm. About 10% of the patients were randomly drawn out as the test set. Responses to IFN-alpha therapy were divided into CR, partial response (PR) and non-response (NR). The mixed set of PR and NR was recorded as PR + NR.

RESULTSFor the scoring system, the sensitivity and specificity were 78.8% and 80.6%, respectively.

CONCLUSIONThis SCR scoring system has satisfying prediction efficiency and is easily employed in clinical practice. With this scoring system, practitioners can propose individualized decisions that have an integrated foundation on both evidence-based medicine and personal characteristics.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Child ; Dose-Response Relationship, Drug ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Sensitivity and Specificity ; Treatment Outcome ; Young Adult

Objective To evaluate the efficacy and safety of risperidone long-acting injectable (LAIR) for the treatment of schizophrenia in a large sample size in Chinese population.Methods This was an open-label, multi-center and prospective study in naturalistic treatment.Patients suffering from schizophrenia and schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria were treated with LAIR for 12 weeks, every two weeks a time.The PANSS total score, positive and negative symptom scores, Clinical Global Impressions-Severity and Clinical Global Impressions-Improvement were evaluated at baseline, and the 4th, 6th, 8th, 12th week treatment respectively.The adverse events were recorded.Results Altogether 251 patients from 17 hospitals across China were enrolled in the study.From the end of 4th week to the end of 12th week, the PANSS total score,positive and negative symptom scores, general psychopathology score significantly decreased compared with the baseline score (P<0.01).The effective rate, improvement rate and the percentage of patients who met the criteria of clinical relief were 57.4%, 79.9% and 76.6%, respectively.At the end of 4th week, the better decline level on PANSS score were in patients with illness duration of 2 years or shorter than that in ones with duration of longer than 2 year, and this trend persisted into the end of treatment.The total adverse events rate was 12.4%, and most were mild and moderate.Conclusions LAIR is effective and safe for treatment of schizophrenia and schizoaffective disorder, with better effect in patients with shorter illness duration.

Objective To evaluate the efficacy and safety of risperidone long-acting injectable (LAIR) for the treatment of schizophrenia in a large sample size in Chinese population.Methods This was an open-label, multi-center and prospective study in naturalistic treatment.Patients suffering from schizophrenia and schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria were treated with LAIR for 12 weeks, every two weeks a time.The PANSS total score, positive and negative symptom scores, Clinical Global Impressions-Severity and Clinical Global Impressions-Improvement were evaluated at baseline, and the 4th, 6th, 8th, 12th week treatment respectively.The adverse events were recorded.Results Altogether 251 patients from 17 hospitals across China were enrolled in the study.From the end of 4th week to the end of 12th week, the PANSS total score,positive and negative symptom scores, general psychopathology score significantly decreased compared with the baseline score (P<0.01).The effective rate, improvement rate and the percentage of patients who met the criteria of clinical relief were 57.4%, 79.9% and 76.6%, respectively.At the end of 4th week, the better decline level on PANSS score were in patients with illness duration of 2 years or shorter than that in ones with duration of longer than 2 year, and this trend persisted into the end of treatment.The total adverse events rate was 12.4%, and most were mild and moderate.Conclusions LAIR is effective and safe for treatment of schizophrenia and schizoaffective disorder, with better effect in patients with shorter illness duration.