Chloral hydrate is a safe and effective sedative hypnotic medicine. Patients can usually calm down or fall asleep quickly after taking it. It has great clinical value and practical needs in children ’s sedation. However ，the nature of chloral hydrate itself and various factors such as ambient temperature and light affect its stability of the preparation ，most of chloral hydrate preparations are still used in clinic in the form of hospital preparations. Therefore ，developing chloral hydrate preparation with single dose ，long validity period and automatic mass production is the prospect and goal of its subsequent development. Based on it，this study collects and reviews the relevant literatures on various preparations of chloral hydrate and their clinical application by searching the Chinese and English databases.

OBJECTIVE：To investigate the effect of increasing efficacy and decreasing toxicity of Limax extract （LE）on cyclophosphamide（CTX）in the treatment of hepatocellular carcinoma. METHODS ：The mice were randomly divided into normal group，model group ，CTX group （0.02 g/kg），LE low-dose ，medium-dose and high-dose groups （LEL，LEM，LEH group ，0.6，1.2，2.4 g/kg），CTX+LE low-dose ，medium-dose and high-dose combination groups （CTX+LEL，CTX+LEM，CTX+ LEH group ，the same dose as single drug group ），with 10 huangrenbin518@163.com mice in each group. Except for normal group ，other groups were inoculated with hepatoma cells H 22 in the left ar mpit to establish tumor bearing models. After 24 h of inoculation ，normal group and model group were intragastrically given normal saline ， and administration groups were intragastrically given corresponding drugs ，once a day ，for 10 days. On the second day after the last administration ，the general conditions of mice in each group were observed ；the body mass ，thymus index （LI），spleen index （SI）were measured ；the tumor inhibition rate was detected. The effect （q）of combination therapy was evaluated by King ’s formula . The counts of WBC ，RBC and PLT ，serum contents of ALT ，ALT，Scr and BUN were detected in model group ，CTX group and combination groups ，and the contents of MDA，SOD and GSH ，the levels of VEGF ，TNF-α and IL-6 in the tumor tissue were detected by colorimetry and ELISA in above groups. The protein expression of oncogenes （p53，Bcl-2 and Bax ）were detected by immunohistochemical method in model group，CTX group and CTX+LEM group. RESULTS ：The mice in the model group were in poor spirit and had symptoms of excessive drinking and eating ；although the body weight ，TI and SI were not significantly abnormal compared with normal group （P＞0.05），WBC count and AST content were significantly increased ，ALT and BUN contents were significantly decreased （P＜ 0.05 or P＜0.01）. Compared with model group ，above symptoms of mice were all improved in administration groups. The tumor weight of administration groups ，TI and SI of CTX group and TI of combination groups were decreased significantly ，but tumor weight of LEL group and LEH group ，TI and SI of LE single groups and combination groups were significantly higher than CTX group；tumor weight of combination groups were significantly lower than CTX group （P＜0.05 or P＜0.01）. The tumor inhibition rates of administration groups were 29.58％-72.08％. The q values of CTX+LEL group ，CTX+LEM group and CTX+LEH group were 1.03，0.97 and 0.86，respectively. Compared with model group ，WBC count ，AST and BUN contents of CTX group ，MDA contents of combination groups ，VEGF，TNF-α and IL-6 levels of administration groups ，the protein expression of Bcl- 2 in CTX group and CTX+LEM group were decreased significantly ；the activities of SOD and GSH of administration groups ，the protein expression of p 53 in CTX+LEM group and Bax in CTX group ，CTX+LEM group were increased significantly （P＜0.05 or P＜ 0.01）；WBC counts and AST contents of administration groups ，ALT content of CTX+LEM group ，SOD activity of CTX+LEH group and GSH activity of CTX+LEM group were all significantly higher than those of CTX group ；MDA content of CTX+LEH group，VEGF and TNF-α levels of CTX+LEM group and CTX+LEH group，IL-6 levels of administration groups were all significantly lower than CTX group （P＜0.05 or P＜0.01）. CONCLUSIONS ：LE combined with CTX can increase the anti-tumor effect，and LE can reduce the toxicity of CTX induced immunosuppression and bone marrow suppression in mice ，with effect of increasing efficacy and decreasing toxicity. The effect may be related to antioxidant stress ，inhibition of angiogenesis and secretion of inflammatory factors ，and regulation of apoptosis protein expression.

Objective:To identify the essential quality, expected quality and charm quality of outpatient doctors based on Kano model.Methods:The Kano model quality attribute questionnaire for outpatient doctors was designed from 4 dimensions and 18 indicators of service, quality, safety and cost. 220 outpatients were investigated in a tertiary hospital. The reliability and validity of 212 valid questionnaires were tested and the questionnaire data were analyzed.Results:Both the Cronbach α coefficient and the KMO value were higher than 0.7, which indicated that the reliability and validity were good. Nine of the 18 survey indicators were essential quality, focusing on the quality dimension and service dimension; 4 items were expected quality; 4 items were charm quality, focusing on disease cognition, prevention and drug safety; 1 item was indifferent quality.Conclusions:The essential quality of outpatient doctors is to provide basic and standardized medical services to patients. Studying the quality attribute can provide behavior guidance for outpatient doctors, improve patient satisfaction and quality of outpatient medical services.

OBJECTIVE：To study the imp rovement effects of 2-dodecyl-6-methoxycyclohexa-2，5-diene-1，4-dione（DMDD） from Averrhoa carambola on H 9c2 myocardial cell injury induced by high glucose and its mechanism. METHODS ：H9c2 myocardial cells were divided into normal group ，high glucose group ，osmotic pressure control group ，DMDD high ，medium and low concentration groups （8，4，2 μmol/L）. Normal group and high glucose group were treated with low glucose DMEM medium （containing 5.5 mmol/L glucose ，similarly hereinafter ） and high glucose DMEM medium （containing 33.3 mmol/L glucose ， similarly hereinafter ）for 48 h，respectively. The cells in osmotic pressure control group were cultured in low glucose DMEM medium containing 27.5 mmol/L mannitol for 48 h. In DMDD groups ，cells were cultured in high glucose DMEM medium for 24 h， and then in high glucose DMEM medium containing corresponding concentration of DMDD for 24 h. At the end of cell culture ，MTT metho d was used to detect the cell survival rate. The activities of ROS ， GSH-Px and LDH in cellsupernatant were detected by using related kits. ELISA assay was used to detect the levels of TNF-α and IL-6 in cell supernatant. Cell apoptosis was d etected by acridine orange/ethidium bromide （AO/EB）staining. Western blot assay was used to detect the expression of apoptosis related proteins （cleaved caspase- 3，Bcl-2，Bax）and the phosphorylation level of nuclear factor κB （NF-κB）/NF-κB suppressor protein α（IκBα）signaling pathway related proteins （NF-κB p65，IκBα）. RESULTS ：Compared with the normal group ，survival rate ，the activity of GSH-Px and protein expression of Bcl- 2 in high glucose groups were decreased significantly（P＜0.01）；the activities of ROS and LDH ，the levels of TNF-α and IL-6，the protein expression of Bax and cleaved caspase-3，and the phosphorylation level of NF-κB p65 and IκBα were increased significantly（P＜0.01）；the cells showed orange yellow fluorescence ，and the number of cells with fuzzy morphology increased significantly ，showing an obvious apoptotic state. There was no statistical significance in above indexes of osmotic pressure control group compared with normal group. Compared with high glucose group ，the activities or levels of above indexes （except for cell survival rate an LDH activity in low concentration group ）were reversed significantly in DMDD groups （P＜0.05 or P＜0.01）；the orange yellow fluorescence in the cells decreased significantly ，and the cell morphology was relatively complete. CONCLUSIONS ：DMDD can significantly improve H9c2 myocardial cell injury induced by high glucose ；the mechanism of which may be associated with suppressing oxidative stress and inflammatory response ，regulating the expression of apoptosis related protein and NF-κB/IκBα pathway related protein.

PURPOSE: The data on the differences between sputum autoantibodies (Sp-Abs) and serum autoantibodies (Se-Abs) in reflection of autoimmune responses to lungs is still lacking. METHODS: Ten types of Abs were investigated in matched Se and Sp samples collected from recruited subjects. Correlations between Ab levels and airway inflammatory parameters and measures of pulmonary function were assessed. The network-based and inter-correlated analysis was performed to explore the patterns of Sp- and Se-Ab profiles. RESULTS: Fifty stable asthmatic patients and 24 healthy volunteers were recruited for our study, 15 with mild asthma, 18 with moderate asthma and 17 with severe asthma. The concentrations of Sp-Ab against U1 small nuclear ribonucleoprotein (Sp-anti-U1-SnRNP), Sp-Ab against Smith antigen and Se-Ab against thyroid peroxidase (anti-TPO) in severe asthmatics and Sp-anti-U1-SnRNP in moderate asthmatics were significantly higher compared to healthy controls and mild asthmatic subjects (P < 0.05). Sp-anti-U1-SnRNP levels were positively correlated with the dose of inhaled corticosteroids, Sp eosinophil counts and fractional exhaled nitric oxide (r = 0.326, P = 0.022; r = 0.356, P = 0.012; r = 0.241, P = 0.025, respectively) and negatively correlated with Sp neutrophil counts (r = −0.308, P = 0.031) with adjustment for age. Spearman's correlation matrix showed multiple inter-correlations among Sp-Abs and Se-Abs (P < 0.05) while only the levels of Ab against DNA topoisomerase and anti-TPO in Se were correlated with those Sp-Ab counterparts (P < 0.05). The network-based analysis defined 2 clusters: clusters 1 and 2 contained 10 Sp-Abs and 10 Se-Abs, respectively. CONCLUSIONS: This study observes that Sp-Abs are more associated with clinical parameters and the severity of disease in asthma compared to Se-Abs. Targeting on Sp-Abs which are the hallmark of the localized autoimmune event might help us better understand the role of autoimmunity in the pathological mechanism of asthma.
Adrenal Cortex Hormones ; Asthma ; Autoantibodies ; Autoimmunity ; DNA Topoisomerases, Type I ; Eosinophils ; Healthy Volunteers ; Humans ; Iodide Peroxidase ; Lung ; Neutrophils ; Nitric Oxide ; Ribonucleoproteins, Small Nuclear ; Sputum

Aim To investigate the effect of the extract of Averrhoacarambola L.root (EACR)on renal func-tion in diabetic mice and its anti-oxidative action. Methods Diabetic mice were established by tail vein injection with 120 mg·kg-1 streptozotocin (STZ)and were divided into 5 groups:model control group,val-sartan control group,and low-,middle-,high-dose of EACR groups (300,600,1 200 mg·kg-1 ).And 10 normal mice consisted of normal control group.The fasting blood glucose (FBG)of mice was detected be-fore and after administration of drugs.After last admin-istration,the blood and urine samples were collected for creatinine (Cr),urea nitrogen (BUN),urine and 24 h urinary protein determination.The activities of superoxide dismutase (SOD ),glutathione peroxidase (GSH-Px)and malonaldehyde (MDA)content were determined using kits.HE staining was conducted to observe the pathological changes of kidney tissues. ELISA method was utilized to detect the contents of catalase (CAT)and reactive oxygen species (ROS ). The expressions of Cyto-C,AIF and caspase-3 proteins in kidney tissues were analyzed by Western blot.Re-sults Compared with model group,the serum bio-chemical indexes and 24 h urinary protein of valsartan and moderate-,high-dose of EACR groups were de-creased with statistical significance (P<0.05 ).After the treatment, the MDA content was decreased by EACR treatment,and SOD,GSH-Px and CAT activities were enhanced.Meanwhile the expressions of ROS, Cyto-C,AIF and caspase-3 were down-regulated.The pathological changes of kidney tissues were ameliorated by EACR through HE results.Conclusions The ex-tract of Averrhoacarambola L.root can decrease the se-rum levels of Cr and BUN,reduce the MDA and ROS contents in kidney tissue and enhance the activities of SOD,GSH-Px and CAT,down-regulate the expres-sions of Cyto-C,AIF and caspase-3 proteins in kidney tissues,elevate the anti-oxidative effect of kidney. Therefore,the renal function of diabetic mice is melio-rated.

Objective To study the neuroprotective role of TFP5 in a MPTP-induced mouse model of Parkinson's disease (PD).Methods C57BL/6 mice were used as experimental animals.Briefly, 5 consecutive days of intraperitoneal injection of 25 mg/Kg 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was applied to induce mouse PD model.The mice were randomized into 5 groups including control group,model group, scrambled TFP5 peptide (Scb) group, TFP5 group and roscovitine group.On the 7th day after the first injection of MPTP,behavior tests were performed, and then western blot method was employed to detect the expression of p25 and phosphorylated MEF2D in substantia nigra.Tyrosine hydroxylase (TH) immunohistochemical staining was performed to observe the apoptosis of dopaminergic neurons in substantia nigra pars compacta (SNpc) 28 days after the first injection of MPTP.Results MPTP increased the expression of p25 (0.48±0.10 vs 0.26±0.02, P＜0.05) and phosphorylated MEF2D (0.81±0.10 vs 0.22±0.02, P＜0.05) in substantia nigra, but decreased the number of dopaminergic neurons in SNpc (348.67±24.40 vs 463.29± 19.61, P＜0.05),resulting in motor impairment in the model mice (P＜0.05).Intraperitoneal injection of 30mg/Kg of TFP5 for 3 days effectively reduced the excessive phosphorylation of MEF2D (0.25 ± 0.12 vs 0.81 ± 0.10, P＜ 0.05) in substantia nigra, rescued dopaminergic neuron reduction of SNpc (422.92±8.41 vs 348.67±24.40, P＜0.05), and improved the motor ability of the model mice (P ＜0.05).Roscovitine exerted almost same neuroprotective role as TFP5 ,while Scb had no protective effect.Conclusion TFP5 can rescue MPTP-induced damage of dopaminergic neurons in substantia nigra, and thus improve motor impairment of model mice,which may be mediated by the inhibition of Cdk5/p25 activity.

Objective To investigate the protective effect of Yulangsan polysacharide ( YLSPS) and mechanism against ibuprofen-induced liver injury in mice. Methods The mice were randomly divided into the blank control(NC), the model control,YLSPS at 150 mg·kg-1 , 300 mg·kg-1 ,600 mg·kg-1 groups and biphenyldicarboxylate (150 mg·kg-1 BPDC) group. The mice were orally administered with corresponding agents once per day for consecutive 14 days, whereas the blank control group and model control group were orally administered with saline. Except the blank control group, all the other mice were orally administered IBU 200 mg·kg-1 body weight 2 h after last lavagedof medicimes. The mice were fasted and watered ad lib for 20 h after model establishment. Activities of ALT,AST and ALP,content of T-BiL,TNF-α,IL-6 in serum;activities of SOD,GSH-Px and content of MDA in liver tissue were detected. The morphological pathology test was used to examine degrees of hepatic injury. Results Compared with the model control, YLSPS could obviously reduce activities of ALT,AST and ALP,content of T-BiL, MDA,TNF-α and IL-6, and increase SOD,GSH-Px and CAT (P<0. 05), and then lessen the hepatic injury. Conclusion YLSPS showed potential protective effect against ibuprofen-induced liver injury in mice, the mechanism may be related to attenuating free radical injury and inhibiting lipid peroxidation and lowering release of inflammatory factors.

Aim To investigate the effects of 1 7-me-thoxyl-7-hydroxyl-benzofuran chalcone(YLSC)on my-ocardial ischemia /reperfusion injury(MI /RI)by mod-ulating PI3K/Akt signaling pathway and the possible mechanisms.Methods Male SD rats were randomly
divided into sham group,model group,YLSC group, wortmannin(WM)group and YLSC +WM group(n =8).The rat model of MI /RI was established by ligation of the left anterior descending artery for 30 min fol-lowed by loosening the ligature for 2 h.After reperfu-
sion,blood samples were obtained to determine serum contents of CK-MB,LDH,NO and TNF-α.The pro-tein levels of total (t)-Akt,phosphorylated (p)-Akt and LC3-Ⅱ were detected by Western blot.Caspase-3,Beclin1 and eNOS mRNA expression was evaluated by FQ-PCR.Results YLSC pretreatment greatly re-duced serum levels of CK-MB,LDH and TNF-α,and elevated NO content.It also inhibited the expression of
caspase-3,Beclin1 and LC3-Ⅱ,while enhanced p-Akt and eNOS expression.Conclusion YLSC protects the heart against MI /RI via inhibition of apoptosis and excessive autophagy,in which protective effect is regu-lated by activation of the PI3K/Akt pathway.

Objective To investigate the protective effects of ethanol extract of calonyction acculeatum beans( CABE) on rats with acute lung injury ( ALI ) . Methods The ALI model was induced via intravenous injection with 5 mg · kg-1 lipopolysaccharide(LPS). The expression of nuclear factor-кB p65(NF-кB65) was determind by immunohistochemistry(IHC), and the content of interleukin-1β( IL-1β) in the lung tissue was detected by enzyme-linked immunosorbent assay ( ELISA ) . Meanwhile,lung tissue histopathology,the wet-dry weight ratio of lung and the activity of myeloperoxidase(MPO) in the lung tissues were observed. Results Compared with the model group, CABE lessened the lung injury, decreased IL-1β level, reduced the lung dry-wet weight ratio and activity of MPO,and down-regulated the expression of NF-кB/p65(P<0. 05). Conclusion CABE has remarkedly protective effect on ALI induced by LPS in rats. One of the mechanisms may be related to reducing the secretion of IL-1β and interfering with the activity of NF-кB.