Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method， it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth， leading to the production of phlegm and blood stasis， is an important pathogenesis. The invasion of external pathogenic toxins， deeply penetrating into the interior， is considered a triggering factor for the disease. The treatment focuses on supplementing the yang， consolidating the kidney， drawing fire back to its source， warming the yang， benefiting the kidney， and nourishing the spleen to generate metal. It also emphasizes unblocking the yang， transforming turbidity， and eliminating phlegm and blood stasis.

This article is based on ZHANG Jingyue's theory of yin-yang holism to explore the etiology， pathogenesis， and treatment of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease （RA-ILD）. It is believed that the foundation of acute exacerbation of RA-ILD lies in real yin insufficiency and yin fail to control yang； external pathogen attacking is a common cause of acute exacerbation of RA-ILD. For treatment， it is important to first suppress ministerial fire by prescribing modified Yinhuo Decoction （引火汤）； if ministerial fire submerged， focus should be on nourishing both yin and yang； if real yin deficiency is the main issue， modified Zuogui Pill （左归丸） should be used； if real yang deficiency is prominent as well， modified Yougui Pill （右归丸） can be chosen. When yin and yang balanced， the disease could be solved.

Alzheimer's disease （AD） is the most common form of dementia， and disease-modifying treatments are currently lacking. In traditional Chinese medicine （TCM）， it is believed that kidney-essence deficiency is the internal mechanism of AD， and invigorating kidney and nourishing essence is the basic principle of TCM treatment of AD， which runs through the whole treatment process. Bushen Yizhi formula is a prescription for the treatment of AD， with rich experience in clinical practice. There have been massive literature reports on the treatment of AD with Bushen Yizhi formula， but its clinical safety is seldom studied， and its basic research is weak， with the active components and multi-target mechanism unclear. To clarify the mechanism of Bushen Yizhi formula in the treatment of AD with multiple components， targets and pathways， this paper summarized the research progress of Bushen Yizhi formula in the treatment of AD. We further collected 16 main chemical components of Bushen Yizhi formula based on HPLC fingerprints， and evaluated their druggability and safety. By combining network pharmacology and literature review on the important pathophysiological process of AD， we analyzed the active components and possible mechanisms of Bushen Yizhi formula targeting the cholinergic system and neuropathological characteristics of AD. This paper provided potential lead compounds for AD drug research and development， and a theoretical basis for the clinical application of Bushen Yizhi formula.

Exosomes are vesicles with a double globular membrane of lipids that can be secreted by a variety of cells, including stem cells. Exosomes have unique biological characteristics and irreplaceable powerful functions which play an important role in intercellular communication. The various cytokines, signal proteins, lipids and regulatory nucleic acids contained in stem cell exosomes can play a protective role against the injury of kidney, liver, heart, blood vessels and nerves. Stem cell exosomes delay the process of intervertebral disc degeneration by inhibiting the apoptosis of nucleus pulposus cells and increasing the synthesis of extracellular matrix, etc. The mechanism of its role is mainly through miRNA and related signaling pathways. Exosomes contain complex components. Although the mechanism of action of exosomes in intervertebral discs has been preliminarily explored, the components contained in exosomes are complex and the specific situation has not been fully understood, which still needs further study. In this review, the characteristics and functions of stem cell exosomes, extraction, identification and storage methods, the impacttovarious other tissues, as well as the effects on intervertebral discs and their mechanisms were elaborated in order to provide a basis for the study of intervertebral disc degenerative diseases.

Objective To explore application effect of hierarchical management based on Intensive Care Nursing Scoring System ( ICNSS) in intensive care unit ( ICU) patients with brain injury .Methods A total of 65 ICU patients with brain injury from June 2013 to May 2014 were treated as control group;another 60 cases of ICU patients with brain injury from June 2014 to May 2015 were treated as observation group .Patients in the control group were implemented with routine nursing , while the observation group with hierarchical management based on ICNSS system.Prognosis, complications, nurse-patient disputes events, nursing risk events, and patient satisfaction of two groups were compared .Results In observation group, plant survival rate (3.33%), incidence of complications (6.67%), nurse dispute event rate (3.33%), incidence of nursing risk events (5.00%) were lower than those of the control group (χ2 =4.296,4.720,4.296,5.354;P<0.05).Among patient satisfaction of the observation group , scores of health education ( 3.85 ±0.45 ) points, medical environment(3.79 ±0.53)points, psychological nursing(3.65 ±0.78)points, service attitude(3.38 ±0.56) points, operational care(3.49 ±0.29)points were higher than those of the control group (t=40.821,36.362, 23.801,24.972,43.465;P<0.01).Conclusions Based on the ICNSS, hierarchical management model can allocate human resources in ICU reasonably and effectively , improve quality of care for patients with traumatic brain in ICU , reduce the incidence nursing risk events and elevate patient and family satisfaction .

OBJECTIVEThe aim of this study was to explore the molecular mechanism of apoptosis in esophageal cancer cells induced by Isodon rubescens.

METHODSThe DNA-damage effect of Jaridonin was detected by single cell gel electrophoresis (SCGE). The p53 protein was determined by Western blot. GSH assay kit was employed to determine the GSH content in human esophageal cancer EC-1 cells. Intracellular levels of hydrogen peroxide (H2O2) or superoxide (O(2).-) were determined using the redox-sensitive probes 2', 7'-dichlorodihydrofluorescein diacetate (DCF) or dihydroethidium (DHE), and the fluorescence signal was assayed by fluorescence microscopy and by flow cytometry.

RESULTSJaridonin induced DNA damage in EC-1 cells remarkably. The olive tail moments (OTM) of control and 20, 40 µmol/L Jaridonin were 3.2, 45.2 and 89.0, respectively. Compared with the control, the differences were significant (P < 0.01 for both). Jaridonin resulted in extensive p53 up-regulation in the EC-1 cells. More importantly, the p53 up-regulation occurred as early as 2 h after Jaridonin incubation, and in a time-dependent manner (P < 0.05). p53 siRNA transfection inhibited apoptosis in the EC-1 cells, and the Jaridonin-induced apoptosis rate was reduced from 38.5% to 8.8%. Intracellular level of H2O2 was increased by Jaridonin, whereas the level of O(2).- was barely changed. The GSH content in EC-1 cells was reduced from (10.3 ± 1.6) nmol/mg protein to (4.6 ± 2.1) nmol/mg protein after 20 µmol/L Jaridonin incubation for 8 h, and it was further reduced with the increase of Jaridonin concentration. Jaridonin induced DNA damage, H2O2 accumulation and apoptosis were significantly attenuated in the presence of GSH, but Jaridonin showed little effect on normal human liver L-02 cells.

CONCLUSIONSJaridonin selectively induces apoptosis in esophageal cancer EC-1 cells through H2O2-mediated DNA damage by depleting GSH.

Antineoplastic Agents ; pharmacology ; Apoptosis ; DNA Damage ; Diterpenes, Kaurane ; pharmacology ; Esophageal Neoplasms ; metabolism ; Humans ; Hydrogen Peroxide ; metabolism ; Up-Regulation

Aim To investigate Jaridonin′s selective killing of cancer cells and explore the related molecular mechanism. Methods After treatment by Jaridonin for 24 h, the effect of Jaridonin on the cell viability was examined using MTT assay. The effect of Jaridonin on cytomorphology and mitochondrial membrane poten-tial (Δψm) was observed by a fluorescence microsco-py. The apoptosis of cell lines treated with Jaridonin, as well as the level of reactive oxygen species ( ROS ) was analyzed by flow cytometry. Expression of the pro-teins related with mitochondria apoptosis pathways was detected by Western blot. Results Jaridonin caused strong antiproliferative and apoptotic effects on MGC-803 cells, but there were not remarkable effects on GES-1 cells. Furthermore, the expression of Bax was up-regulated, and the release of cytochrome c from mi-tochondria to cytosol was also promoted in MGC-803 cells treated by Jaridonin. The cleavage of caspase-3 in MGC-803 cells was also observed. Jaridonin increased persistently intracellular levels of ROS in MGC-803 cells, whereas the level of ROS in GES-1 rose in the first stage, and then decreased, and dropped to the basic level after 6 h. More interestingly, Jaridonin-in-duced ROS accumulation and the inhibition of MGC-803 cell proliferation were almost completely attenuated in the presence of GSH. Conclusions Jaridonin se-lectively kills cancer cells and induces apoptosis in MGC-803 through ROS-mediated mitochondrial dam-age.

ObjectiveTo study the diagnosis and therapy of circumcaval ureter.MethodsFifteen cases of circumcaval ureter were studied retrospectively.The cardinal symptoms include discomfort over the back and loins,nephrocolic and bloody urine.The diagnosis mainly depends on IVU and retrograde urography.12 patients underwent ureteroureterostomy,2 ureteropyeloneostomy and 1 nephrectomy.ResultsAll the patients have been follewed up from 1 to 15 years by IVU and ultrasonography,and no nephrohydrosis or stenosis of the anastomosis site has been noted.All the patients have been free from any complaints.ConclusionsIVU and retrograde urography are the cardinal means for the diagnosis of circumcaval ureter,and operation is indicated in order to improve the renal function.It is important to choose a proper time and an adequate surgical technique.

Objective To evaluate the diagnosis and treatment of pheochromocytoma in children. Methods Eighteen children with pheochromocytoma were diagnosed and treated from 1980 to 2000.The primary clinical manifestations included severe headache,blurring of vision,palpitation,excessive perspiration.Sustained hypertension occurred in 10 cases,sustained hypertension accompanied by episodic exacerbation in 7 and episodic hypertension in 1.The mean blood pressure was 185/130 mmHg(1 mmHg=0.133 kPa),with the highest up to 260/190 mmHg.VMA was increased in 89% (16/18) of the cases,and blood and urinary catecholamine was increased in 92% (12/13).Retroperitoneal pneumography was performed in 3 cases,CT in 14 cases and MRI in 2 cases,with all positive findings.B-ultrasonography showed positive in 94%(15/16). Results This series of 18 cases accounted for 11.6% of the pheochromocytoma cases admitted homochronously (18/155).All the 18 cases underwent surgery with the help of proper peir-operative management.The pheochromocytomas (comfired by pathology) were successfully extirpated with the tumor weight ranging from 40 to 150 g.All the cases were followed up for 1 to 20 years.Their blood pressure returned to normal in 94%(17/18).Only 1 case had relapse 2 years later with diagnosis of malignancy,and died in the following year. Conclusions Since the clinical manifestations of pheochromocytoma in children are atypical,endocrinological and imaging examinations are necessary to children with hypertension.Surgical excision is the best option,and oppropriate perioperative management is extremely important.The outcome of surgical management in children is better than that in the adults.