Table of Content

Volume 19 Issue 4
26 April 2014

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Treatment of artesunate on the mouse model of acute pancreatitis induced by combining cerulean and lipopolysaccharide

YAN Zi-fei, CEN Yan-yan, LI Xiao-li, KUANG Mei, CAO Guan-qun, LI Pan, ZHOU Hong

2014, 19(4):  361-365. 

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AIM: To evaluate the effect of artesunate (AS) on rats with acute pancreatitis. METHODS: Sixty Kunming mice were randomly divided into five groups: control group, AP induction group and treatment group with AS. Then the treatment group was divided into three subgroups according to the concentration of AS. In the AP induction group and AS treatment group, cerulean (100 μg/kg) was intraperitoneal injected into animals every one hour for six times, then intraperitoneal injections of LPS (10 mg/kg). In the AS treatment group, AS was intramuscular injected at zero and four hours after the induction of pancreatitis. The animals were sacrificed at the 18 h hour after the first intraperitoneal injection. The levels of AMS, LPS, trypsin, SOD in serum were determined. HE staining was performed to evaluate the morphologic changes in animal pancreats. RESULTS: The amount of AMS, LPS and trypsin in serum and the pancreatic injury severity in AS treatment group were markedly lower than those in the AP induction group(P<0.05 or P<0.01). The amount of SOD was just the opposite. CONCLUSION: AS might ameliorate AP in this mouse model.

Effects of glucocorticoid and cyclophosphamide on the human umbilical vein endothelial cell proliferation and ICAM-1 and MCP-1 expression level

LI Zhi, ZHANG Meng-ying, LU Jin-ming, XU Liang, CHEN Lan-fang, MAO Tong-jun, XUAN Dan

2014, 19(4):  366-370. 

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AIM: To investigate the effects of combined use of dexamethasone and cyclophosphamide on the proliferation of human umbilical vein endothelialcells (HUVECs) and the expression of mRNA of intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1). METHODS: The HUVECs were respectively incubated for 24,48 or 72 h with dexamethasone or cyclophosphamide with different concentration. The proliferation of HUVECs was determined with methyl thiazolyl tetrazolium(MTT) in different time. The half maximal inhibitory concentration(IC₅₀) was calculated. The levels of mRNA of ICAM-1 and MCP-1 were measured after HUVECs being incubated with dexamethasone and cyclophosphamide respectively and collectively in the concentration of IC50 for 48 hours. RESULTS: Dexamethasone or cyclophosphamide inhibited the proliferation of HUVECs in a dose-and time-dependent manner. The IC₅₀ of dexamethasone and cyclophosphamide was 0.74 mg/mL and 1.87 mg, respectively. The levels of ICAM-1 and MCP-1 mRNA in HUVECs had no difference when HUVECs were incubated with either dexamethasone or cyclophosphamide, yet the levels were significantly decreased as compared with controls (P<0.05). ICAM-1 and MCP-1 mRNA levels in HUVECs were lower as HUVECs being collectively treated with dexamethasone and cyclophosphamide(P<0.05). CONCLUSION: Dexamethasone and cyclophosphamide can significantly inhibit the proliferation of vascular endothelial cells and expression of ICAM-1 and MCP-1, thus producing notable protective effect on the blood vessels. This findings may supply basis for clinical therapy strategy for vasculitis.

The interventive effects and mechanisms of erythropoietin postconditioning on celluar apoptosis of lung ischemia/reperfusion injury in rats

JIN Xiao-sheng, WU Li-feng, QIAN Xiao-ying, SHAO Mei-qin, WANG Wan-tie

2014, 19(4):  371-376. 

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AIM: To investigate the interventive effects and mechanisms of erythropoietin postconditioning on celluar apoptosis of lung ischemia/reperfusion injury in rats. METHODS: Adult male Sprague-Dawley rats were randomly divided into 5 groups based upon the intervention (n=8): control group (group C), lung ischemia reperfusion group (group I/R), I/R+EPO(group EPO), EPO+solvent control 1(0.4%DMSO of the PBS solution)(group D), EPO+U0126(group U). At the end of the experiment, the wet to dry wight ratio(W/D) of the lung tissue was tested; the pneumocyte apoptosis index(AI) was achieved by terminal deoxynucleotidyl transferase mediated dUTP nick end abeling(TUNEL) ; the content of Bcl-2 and Bax in cytoplasm was determined with immunohistochemistry, Bcl-2 mRNA and Bax mRNA in lung tissues were determined by RT-PCR. The pathological changes of lung tissue were observed under light microscope and the index of quantitative assessment(IQA) of histologic lung injury was counted by HE staining. RESULTS: Compared with group C, W/D, IQA and AI of lung tissue were increased in group I/R, the expression of Bcl-2 protein and Bcl-2 mRNA were decreased, the expression of Bax protein and Bax mRNA were increased, the ratio of Bcl-2/Bax was decreased.There were abnormal morphological changes under the light microscope; compared with group I/R, W/D, IQA and AI of lung were decreased in EPO, D and U groups, the expression of Bcl-2 protein and Bcl-2 mRNA were increased but the Bax protein and Bax mRNA were decreased, the ratio of Bcl-2/Bax was increased. The morphological changes under the light microscope markedly reversed in EPO, D and U groups;there was no statistical difference between group D and group EPO; compared with group EPO, W/D, IQA and AI of lung were increased in group U, the expression of Bcl-2 protein and Bcl-2 mRNA were decreased, the expression of Bax protein and Bax mRNA were increased, the ratio of Bcl-2/Bax was decreased. There were abnormal morphological changes under the light microscope in group U than group EPO. CONCLUSION: Erythropoietin postconditioning may attenuate pneumocyte apoptosis in LIRI by activating ERK1/2 signal transduction pathway, and up-regulating expression of Bcl-2/ Bax ratio.

The role of ginkgo biloba extract on the hepatic GRP78 and CHOP expression in rats with liver fibrosis

YE Lei, LI Jian-shuang, CHEN Zhi-yun, YAN Mao-xiang, HE Pei-hui

2014, 19(4):  377-380. 

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AIM: To observe the effect of ginkgo biloba extract (GbE) on expression of GRP78 and CHOP in endoplasmic reticulum (ER) stress-related pathway in rats with liver fibrosis, and to explore the mechanism of anti-hepatic fibrosis of GbE. METHODS: The model with liver fibrosis in rats were induced by intraperitoneal injection of 40% CCl₄。Meanwhile, all the rats were administrated with different doses of GbE (200, 100 and 50 mg·kg^-1·d^-1 body weight) by gavage. After the experiment, the mRNA and protein expressions of hepatic GRP78 and CHOP were detected with RT-PCR and immunohistochemical method. RESULTS: The mRNA and protein expression of hepatic GRP78 and CHOP in the rats of the model were more obviously enhanced than in the normal (P<0.05, P<0.01), which were obviously decreased after the treatment with GbE (P<0.05, P<0.01). CONCLUSION: ERS reaction occurs on the liver of rats with liver fibrosis. And that GbE down-regulate the mRNA and protein expressions of hepatic GRP78 and CHOP probably is one of its mechanism of anti-liver fibrosis.

Studies on the changes of chronic pelvic inflammatory disease(CPID) rat model of Penyankunhe liquor

LI Qin, LI Xiao-li, ZHAO Yin, ZHANG Ping-qing, ZHANG Xin-yue

2014, 19(4):  381-384. 

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AIM: To investigate the changes of Penyankunhe liquor on the CPID rat model. METHODS: The model was established with injection of phenol mucilage.Two weeks later the rats were randomly divided into Penyankunhe liquor low dose group,medium dose group and high dose group(66,33,16.5 g/kg).After the rats were treated 14 days with corresponding medicine intragastric administration, the rats body weight, the ratio value of the rats womb were observed,the pathological of endometrium was used to evaluate the effects of Penyankunhe liquor.The cotent of SOD and MDA in serum were also detected. RESULTS: The rats body weight was decreased and the ratio value of the rats womb was increased significantly,and the levels of SOD in serum were reducted while the MDA content was increased significantly.It was also found that each dose of Penyankunhe liquor had different digrees of protection against the indicators change.The pathologic examination results also showed that the Penyankunhe liquor had certain improvement effect on the degree of endometrial inflammation. CONCLUSION: Penyankunhe liquor is effective in treating CPID in experimental rats.

Effect of xuebijing injection on liver gene expression of NF-κB in septic rats

WANG Jin-ping, LI Wen, CHEN Jia-yi, LI Lu

2014, 19(4):  385-388. 

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AIM: To explore the effect of xuebijing injection on the liver injury and gene expression of nuclear factor kappa B (NF-κB) in septic rats. METHODS: 40 male rats were randomly divided into control group (n=10), sham operation group (n=10), model group (n=10) and xuebijing group (n=10). Before operation, the animals in all the groups were immediately given xuebijing 5 mL/kg or physiological saline 5 mL/kg intravenous push to caudal vein respectively for 3 days. The sepsis animal models were established with cecum ligation puncture method. The sham operation group was done the same anesthesia and midline laparotomy, the cecum was exteriorized and returned to the abdominal cavity. The levels of ALT and AST in serum were detected with automatic biochemistry analyzer, and TNF-α level were detected with ELISA, NF-κB gene expression were determined by Real-time PCR. RESULTS: The levels of ALT, AST, TNF-α and the gene expressions of NF-κB significantly increased in model group as compared to control group (P<0.05). Xuebijing injection markedly decreased the levels of ALT, AST, TNF-α and the gene expressions of NF-κB (P<0.05). CONCLUSION: Xuebijing injection was efficient to ameliorate liver dysfunction in septic rats and effectively lessen liver inflammatory reaction. The mechanism probably by its inhibition of gene expression of NF-κB.

Protective effects of proanthocyanidins on the endoplasmic reticulum stress in PC12 cells induced by H₂O₂

MA Yu-hong, ZHANG Meng-ying, SUO Qi-feng, ZHONG Min, LV Kun

2014, 19(4):  389-392. 

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AIM: To study the protective effects of the proanthocyanidins on the endoplasmic reticulum stress in PC12 cells induced by H₂O₂. METHODS: The models of alzheimer ' s disease were established by treating PC12 cells with H₂O₂ (100 μmol/L)for 18 h.Before modeling for 30 minutes proanthocyanidins 40 mg/L, SB203580 10 μmol/L,Tempol 800 μmol/L were administrated respectively. The level of BiP/GRP-78 mRNA was detected by RT-PCR. The formation rate of reactive oxygen species(ROS)positive cells was detected with flow cytometry,the mean fluorecence was calculated. RESULTS: The level of BiP/GRP-78 mRNA and the formation rate of ROS were decreased in PC12 cells treated with H₂O₂; the level of BiP/GRP-78 mRNA and the formation rate of ROS were decreased(P<0.01) with proanthocyanidins treatment(40 mg/L)in PC12 cells treated with H₂O₂. CONCLUSION: Proanthocyanidins can ameliorate endoplasmic reticulum stress in PC12 induced bywith H₂O₂.

Expression and significance of resistance genes in the gastrointestinal adenocarcinoma

HUAI Jian-guo, JIANG Yan, YANG Xiao-miao, XU Man, ZHU Yan-yan, SHEN Cheng-xiang, SI You-yi, WANG Mo-qing

2014, 19(4):  393-397. 

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AIM: To investigate the expression and significance of Topo Ⅱ, P-gp, MRP, LRP, TS and other resistance genes in the gastrointestinal adenocarcinoma, in order to provide a theoretical basis for the choice of chemotherapeutic drugs. METHODS: The study included 25 cases of gastrointestinal cancer cases as experimental group, each case adjacent tissues as a control group, we detected with pathology image analysis, immunohistochemistry SP method and literature review. RESULTS: Topo Ⅱ positive rate in moderately differentiated adenocarcinoma tissues was higher than poorly differentiated adenocarcinoma. P-gp, MRP1, MRP3, TS, GST-π, β-Tubulin Ⅲ in different types of gastric cancer and colorectal cancer have different levels of expression in cancer tissues were higher than in the adjacent tissues. MRP and β-Tubulin Ⅲ in Mucinous adenocarcinoma have higher rate. LRP rarely expressed in the gastrointestinal adenocarcinoma. CONCLUSION: TopoⅡ cancer drug target is one of the positive rate of the corresponding positive effects of chemotherapy drugs. Combined detection of P-gp, MRP1, MRP3, TS, GST-π, β-Tubulin Ⅲ in the gastrointestinal adenocarcinoma of clinical medicine has a certain reference value. The group of selected genes in colorectal and gastric carcinoma were in a similar, There was no significant difference.

Down-regulation of hyppocampal TH and TPH expression involved in CUMS-induced depressive behaviors of rats and interfering effects of venlafaxine

QIN Li-juan, LIU Dan, JIANG Xing-hui, QIU Hong-mei, WANG Li-jia, LIU Ren, FEI Hui-zhi, HU Xiao-ya, ZHOU Qi-xin

2014, 19(4):  398-403. 

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AIM: To investigate if chronic unpredictable mild stress (CUMS)-induced anxiety-depression-like behaviors of rats is associated with the expression changes of hyppocampal TH and TPH and interfering effects of venlafaxine. METHODS: Sixty-four male SD rats were randomly divided into normal group (NG), model group (MG), Venlafaxine -treated normal group (WNG), and Venlafaxine -treated model group (WMG).CUMS with solitary condition was taken to establish rat depression model.The open field test (OFT) and Forced swim test (FST) were used to evaluate depressive behaviors, biochemistry kit, real-time PCR, and western blot were used to determine SOD activity and MDA level of cortex, as well as mRNA and protein expressions of hippocampus TPH and TH. RESULTS: Compared with corresponding control, the open field score (ambulation and rearing), cortex SOD activity, as well as mRNA and protein expression of hippocampus TPH and TH significantly were decreased with obviously increasing cortex MDA and immobility time of FST in MG. The treatment of Venlafaxine obviously blunted the changes above caused by CUMS, but failed to affect normal rats. CONCLUSION: CUMS-induced depression of rats is associated with down-regulation of hyppocampal TH and TPH expression, which can be blunted by administration of Venlafaxine.

Mechanisms and protective effect of procyanidins on the aortal injury in rats induced by D-galactose combined with aluminum trichloride

YAO Hai, WANG Huan, MA Yu-hong, ZHANG Jun-xiu, YANG Jie-ren

2014, 19(4):  404-409. 

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AIM: To observe the protective effect of procyanidins on the aortal injury in rats induced by D-galactose combined with aluminum trichloride and explore its conceivable mechanisms. METHODS: The model of aortal injury rats were established by D-galactose(180 mg·kg^-1·d^-1,i.p.)combined with aluminum chloride(15 mg·kg^-1·d^-1,i.g.). 12 weeks later, aortal injury rats(40) were randomized into blank control group (NS i.p., NS i.g.), aortal injury group (D-gal i.p.+ AlCl₃ i.g.), procyanidins with low and high dosages (PC 20,40 mg/kg; D-gal i.p.+ AlCl₃ i.g.), vitamin E group (VitE 10 mg/kg; D-gal i.p.+ AlCl₃ i.g.) (n=8 for each group). The animals were intragastrically administrated with procyanidins once a day for consecutive 8 weeks.After the last administration, blood pressure was measured by tail cuff. The thoracic aortic ring of rats was mounted on a bath system, and the relaxation induced by acetylcholine was measured. The primary pathologic changes of aorta were observed by HE staining. T-AOC,H₂O₂ and NO in serum were measured by colorimetric analysis. The expression of eNOS protein were measured by immunohistochemistry. RESULTS: With the increase dose of procyanidins, the blood pressure was gradually decreased, the aortic endothelium-derived diastolic function had been improved,the aortal pathological damage had been improved. The levels of serum T-AOC and NO were gradually increased while the level of serum H₂O₂ was gradually decreased. The expression of eNOS protein upregulated inch by inch. CONCLUSION: Procyanidins can significantly decrease the blood preasure,improve the aortic endothelium-derived diastolic function, ameliorate the aortal injury,suggesting this medicine may protect the aorta from injury through increasing the level of serum NO and the expression of eNOS protein expression.

Study of adjuvant treatment of alendronate sodium in human chondrosarcoma cells

LE Fang-hua, LOU Xing-fa, FANG Qin-hua

2014, 19(4):  410-414. 

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AIM: To observe the effect of alendronate sodium (fosamax) on inhibition of invasion and migration of human chondrosarcoma cells. METHODS: Human chondrosarcoma cells were treated with 100 μmol/L of alendronate sodium. Matrix metalloproteinase (MMP-2) activity and invasion ability were observed by gelatin zymography and stromal invasion experiment, respectively. RESULTS: The data showed, the degree of inhibition in migration and invasion of chondrosarcoma cells closely was related to the alendronate sodium treated dose and time. In addition, detected with gelatin zymography and RT-PCR, alendronate sodium significantly reduced mRNA levels and enzyme matrix metalloproteinase activity in a concentration related manner. CONCLUSION: Alendronate sodium can reduce the matrix metallo- proteinases in transcription and translation level, and inhibit the invasion of chondrosarcoma cells. Therefore, alendronate sodium, an adjuvant therapy agent, can be used as a systemic treatment for chondrosarcoma and other malignant tumour.

Pharmaceutical care for clinical therapy in a patient with bacteremia

WANG Yu, HU Xiao-lei, TANG Min

2014, 19(4):  415-418. 

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Clinical pharmacists participate in the treatment of one case of bacteremia, thought designing of the formulation individualized drug treatment and carrying out effective pharmaceutical care, we can better analyze the infection of the patient and control it. As a result, clinical pharmacists in clinical team can promote the clinical medication more secure, effective and reasonable.

Pharmacokinetics of fosphenytoin sodium injection in Chinese healthy volunteers

HUANG Xiao-yan, GUO Xin, YU Peng, LIU Zhi, HUANG Zhi-jun, YANG Guo-ping, CHENG Ze-neng

2014, 19(4):  419-423. 

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AIM: To investigate the pharmacokinetics of fosphenytoin sodium injection at single dose in Chinese healthy volunteers. METHODS: The pharmacokinetics of intravenous infusing fosphenytoin sodium injection at different dose levels (600 mg and 900 mg) was studied in 24 healthy volunteers.The drug concentrations in plasma samples were assayed by HPLC, and the pharmacokinetic parameters were calculated by DAS 2.0 software. RESULTS: Among 24 healthy subjects, the main pharmacokinetic parameters of fosphenytoin after single dose of 600 mg and 900 mg were as follows: C_max were (89.3±14.9), (110.5±17.2) mg/L; t_max were (0.46±0.08), (0.46±0.08) h; AUC_0-t were (56.5±11.3), (71.2±13.8) mg·h·L^-1; for phenytoin, they were C_max (8.36±0.92), (11.98±1.07) mg/L; t_max (1.1±0.3), (1.3±0.3) h; AUC_0-t(222.7±47.8), (355.9±72.6) mg·h·L^-1, respectively. CONCLUSION: After 600-900 mg single dose infusion of fosphenytoin sodium injection, the pharmacokinetic results show that both fosphenytoin and phenytoin exhibit first order kinetic characteristics in such a dose. And the pharmacokinetic characteristics of fosphenytoin sodium injection are consistent with foreign reports.

Pharmacokinetics of tolvaptan tablets in healthy Chinese volunteers

XIA Zhi-gao, YANG Guo-ping, LIU Shi-kun, TAN Hong-yi, WANG Yan, WAN Qian, YANG Liu, YANG Shuang, YANG Xiao-yan, PEI Qi

2014, 19(4):  424-429. 

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AIM: To investigate the pharmacokinetics of Tolvaptan tablets at single doses and multiple doses in healthy Chinese volunteers. METHODS: A single oral doses of tolvaptan tablets (15,30,60 mg) were given to 12 healthy volunteers (half male and half female) according to an open, random 3×3 latin design. Another 12 healthy volunteers (half male and half female) received multiple doses. The concentrations of tolvaptan in plasma were determined by liquid chromatography/tandem mass spectrometry (LC-MS/MS) and the pharmacokinetic parameters were calculated using NCA method of WinNonlin program. RESULTS: The main pharmacokinetic parameters of tolvaptan after single doses (15,30,60 mg) were as follows: C_max were (129±36.6), (250±105), and (418±166) μg/L,t_max were (2.30±0.48), (2.30±0.89), and (2.45±0.60) h,AUC_last were (758±217), (1570±494), and (3360±1420) μg·h·L^-1,AUC_inf were (768±215), (1590 ± 490), and (3400±1410) μg·h·L^-1,t_1/2 were (7.08±3.78), (6.77±1.60), and (7.02±1.89) h. The parameters of tolvaptan after multiple doses(30 mg) were as follows: C_max was (254±90) μg/L,t_max was (2.63±1.25) h,AUC_last was (1760±709) μg·h·L^-1,AUC_inf was (1790±711) μg·h·L^-1,t_1/2 was (6.92±2.58) h. CONCLUSION: Over the single dose range of 15-60 mg, the exposure measured as AUC and C_max were found to be proportional with dosage. After 30 mg multiple doses administration, tolvaptan showed no accumulation at steady status.

Prevalence and risk factors for chronic kidney disease in Wuhu

YANG Yan-lang, ZHONG Zheng-ling, WANG Yu-wei, GAO Chao-qing, JING Yue-long, ZOU He-qun

2014, 19(4):  430-436. 

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AIM: To investigate the prevalence and risk factors associated with chronic kidney disease (CKD) in Wuhu, China. METHODS: To investigate the prevalence and risk factors associated with chronic kidney disease (CKD) in Wuhu, China. RESULTS: The result showed the prevalence of CKD in Wuhu city was 6.71%. The prevalence of proteinuria, hematuria, and eGFR of less than 60 mL·min^-1·1.73 m^-2 were 1.83%, 2.07%, and 3.4% respectively, all of which were increased expectedly with age. multivariate analysis demonstrated hyperuricemia, diabetes, anemia, age,gemdre and hypertension (OR 2.28, 1.70, 1.65, 1.48, and 1.29, respectively) to be independent risk factors for CKD. CONCLUSION: CKD in Wuhu city is lower than the average CKD prevalence in China as a whole. The risk factors for CKD outlined above should considered as a potential strategy for the early identification and prevention of CKD.

Study of Chonglou Shenghua Tang on preventing lochiorrhagia after caesarean section

JIANG Yan-jiao, HUANG Yi-ping, YE Hui-jun, YING Ming

2014, 19(4):  437-441. 

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AIM: To evaluate the efficacy and safty of Chonglou Shenghua Tang for preventing lochiorrhagia after caesarean section (CS). METHODS: Using prospective and single blind methods, 584 women underwent caesarean section (CS) were divided into three groups randomly : Chonglou Shenghua Tang group(198 cases), Classical Shenghua Tang group (198 cases), placebo group (184 cases),and were administered by Chonglou Shenghua Tang, Classical Shenghua Tang and placebo 100 mL, per 12 hours 14 days after CS respectively. The following clinical parameter were collected and analyzed: (1) Uterine instauration: fundus height, the average drop speed of fundus;the sum of the three paths of uterus and uterine cavity hematocele, uterine incision healing by ultrasound monitoring 42 days after CS; (2)The lochia: the amount and duration of lochia rubra, duration of lochia. (3) The time of anus exhaust, adverse reaction. RESULTS: (1)Uterine instauration: On the height of fundus from the 2nd day to the fifth day after CS and the average drop speed of fundus, there were significant differences between groups, and Chonglou Shenghua Tang group was significantly better than the classical Shenghua Tang group and placebo group (P＜0.05). On the sum of the three paths of uterus, Chonglou Shenghua Tang group was significantly less than the Classical Shenghua Tang group group and placebo group(P＜0.05).Chonglou Shenghua Tang group was significantly better than the other two groups about uterine incision healing rate(P＜0.05). (2) On the amount and duration of lochia rubra, Chonglou Shenghua Tang group was significantly superior to the classical Shenghua Tang group and placebo group(P＜0.05).(3) Chonglou Shenghua Tang group was shorter than the control group significantly on the time of average anal exhaust(P＜0.05).4 cases with mild diarrhea at the beginning with the drug had been observed. CONCLUSION: It is efficacious and safe of using Chonglou Shenghua Tang to prevent lochiorrhagia after caesarean section.

Effect of Dengzhan shengmai capsules on the secondary prevention of atherosclerotis cerebral infarction

MA Ling-song, CHU Zhao-hu, ZHAO Shou-cai

2014, 19(4):  442-445. 

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AIM: To investigate the effect of Dengzhan Shengmai capsules on the secondary prevention of atherosclerotic cerebral infarction. METHODS: 110 patients with cerebral infarction from June 2009 to June 2012 in the hospital were randomly divided into observation group and control group. Conducting the secondary prevention treatment measures, the control group was treated with atorvastatin (10 mg, Qn) and aspirin enteric-coated tablets(100 mg, q.d.). The observation group was given Dengzhan Shengmai(540 mg, Tid). Lipoprotein-a and C-reactive protein levels were detected respectively before and after treatment. Neurological deficit situation in patients of two groups were assessed respectively by the U.S.National Institutes of Health Stroke Scale(NIHSS score) before and after treatment,and stroke recurrence situation within 6 months of two groups were observed respectively. RESULTS: After treatment,the change of lipoprotein-a and C-reactive protein levels were different from that of before treatment, the differences were both statistically significant(P<0.01) and so did NIHSS score (P<0.05).Before treatment, lipoprotein-a and C-reactive protein levels and NIHSS score showed no-statistical significance(P>0.05);after treatment, lipoprotein-a and C-reactive protein levels and NIHSS score in observation group and control groups, the difference was significant (P<0.05). CONCLUSION: Dengzhan Shengmai capsules for secondary prevention of cerebral infarction, not only can reduce the levels of lipoprotein -a and C-reactive protein levels, but also help to improve neurological function in patients with cerebral infarction and reduce the recurrence of stroke and play an important role in secondary prevention of cerebral infarction.

Effects of dexmedetomidine on myocardial ischemia-reperfusion injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass

ZHANG Chang-feng, ZHENG Xian-he, LI Yu-hong, HU Shuang-yan, CHEN Nian-ping

2014, 19(4):  446-449. 

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AIM: To investigate the effect of dexmedetomidine on myocardial ischemia-reperfusion injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). METHODS: Forty ASAⅡ or Ⅲ patients of both sexes, aged 40-65 yr, scheduled for elective cardiac valve replacement under CPB, were randomly divided into 2 groups (n=20 each): contral group (group C) and dexmedetomidine group (group D). Dexmedetomidine 0.6 μg /kg was injected intravenously over 15 min before induction of anesthesia, followed by infusion at 0.2 μg·kg^-1·h^-1 until the end of operation in group D. While the equal volume of normal saline was given in group C. Blood samples were obtained from the vein before induction of anesthesia (T₀) and at 30 min, 6, 12, 24 and 48 h after aortic unclamping (T_1-5) for determination of plasma concentrations of cardiac troponin-I(cTnl) and creatine kinase isoenzyme-MB (CK-MB) and serum concentrations of TNF-α and IL-6. The duration of CPB, time of operation, time of aortic calmping, extubation time, duration of stay in ICU, and the rate of restoration of spontaneous heart beat were recorded. RESULTS: Compared with T₀, the plasma concentrations of cTnI and CK-MB and the serum concentrations of TNF-α and IL-6 were significantly increased at T_1-4 in group C and D (P<0.05). Compared with group C, the plasma concentrations of cTnI and CK-MB and the serum concentrations of TNF-α and IL-6 were significantly decreased at T_1-4 in group D, while the extubation time and duration of stay in ICU were decreased in group D (P<0.05). CONCLUSION: Dexmedetomidine can reduce the myocardial ischemia-reperfusion injury in patients undergoing cardiac valve replacement under CPB, and the mechanism may be related to inhibition of the release of proinflammatory cytokines.

Clinical research on the bleeding in ERCP and EST

JIA Yu-liang, JIANG Hua, HAN Zhen, ZOU Xiao-ping

2014, 19(4):  450-453. 

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AIM: To analyze the concurrent bleeding-related causes and identify effective prevention measures of common bile duct stones by ERCP and EST. METHODS: 299 cases of common bile duct stones underwent ERCP and EST lithotomy clinical data of Digestive Endoscopic Center in Yijishan Hospital of Wannan Medical College from January 2012 to December 2012 were researched and analyzed. RESULTS: The 299 patients,52 cases of less bleeding and 50 cases of significant bleeding in surgery, the difference of the time inserting nipple by analysis of variance (F=3.713) was statistically significant (P=0.026); in the bleeding cases, 21 cases of diverticulum, the difference of the relationship between the amount of bleeding and diverticula by the chi-square test (χ² =5.314) was statistically significant (P<0.05); the Fisher exact test showed that hemostasis titanium clips under endoscopic was more efficient than electric coagulation therapy (P<0.05); in 11 cases of postoperative bleeding, 6 cases treated by drugs,4 cases were invalid, 4 cases treated by endoscopic hemostasis treatment, all cases were effective, the Fisher exact test showed that the postoperative bleeding under endoscopic was more efficient than therapy of drugs (P<0.05). CONCLUSION: The concurrent bleeding of common bile duct stones by ERCP and EST is related to the time of successfully inserting the nipple, and the exist of diverticulitis, endoscopic hemostasis treatment is the effective measure of preventing and treating bleeding.

Clinical application of pulmonary surfactants to full term infants with pulmonary hemorrhage

PAN Rong-hua, ZHANG Shi-fa, TAI Hai-fu, HU Fang, CHENG Ai-bin, MAO Shuang-gen

2014, 19(4):  454-458. 

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AIM: To evaluate the efficacy and safety of the exogenous pulmonary surfactants(PS) in the treatment of full term neonates with pulmonary hemorrhage. METHODS: Forty full-term newborns with pulmonary hemorrhage were equally randomized into PS group (mechanical ventilation+PS and instillation of hemocoagulase via endotracheal tube,n=20) and control group(mechanical ventilation+ hemocoagulase instillation via endotracheal tube,n=20).The blood was obtained in the two groups via radial artery respectively at 6, 12,24 h after intervention for blood gas analysis.Other data were maintained concerning the indexes of respiratory mechanics(PIP and Crs), oxygen kinetic(PaCO₂,PaO₂ and PaO₂/FiO₂), case fatality rate, mean time for stoppage of pulmonary hemorrhage and withdrawal of the breathing apparatus. RESULTS: In PS group, 18 cases were cured and 2 cases died, and in the controls, 17 cases were cured and death occurred in 3 cases. The case fatality rate was 10% vs 15% for the two groups, there was no statistically significant difference (P>0.05).The time for hemorrhage stoppage and withdrawal of the ventilator was significantly reduced in PS group, and the indexes of PIP at each time point were lower, whereas the levels of Crs, PaO₂ and PaO₂/FiO₂ were elevated; compared with the controls,there were statistically significant difference (all P<0.05), while there was no statistically significant difference about the PaO₂ at each point (all P<0.05) had no difference. CONCLUSION: The exogenous PS is safe and effective in treatment of full-term neonates with pulmonary hemorrhage.

Clinical research of new type P2Y12 Receptor inhibitor ticagrelor

ZHANG Xia, KE Yong-sheng

2014, 19(4):  459-464. 

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Antiplatelet drug is the cornerstone for CHD (coronary heart disease) treatment, which is beneficial to the myocardial ischemia prevention and treatment as well complication intervention. At present, the CHD (coronary heart disease) and PCI (percutaneous coronary intervention) treatment manual recommends to use oral antiplatelet drugs including clopidogrel, ticagrelor, trasugrel together with aspirin dual antiplatelet therapy for recurrent ischemic events prevention. This article introduces the pharmacokinetics and pharmacodynamics features of new type P2Y12 receptor inhibitor ticagrelor, as well as evidence-based medical evidence in patients with coronary artery disease.

Advances in luminal breast cancer

JIANG Yan, ZHANG Fan

2014, 19(4):  465-469. 

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We use the immunohistochemical techniques to be parting from breast cancer at the genetic level, not only to determine the prognosis of the tumor, but also be able to predict tumor response to treatment, provide the basis for individualized treatment of cancer. In this study, the research direction of luminal breast cancer, from six aspects discussed: the process of luminal breast cancer awareness; molecular luminal breast cancer; morphological features of luminal breast cancer; luminal breast cancer immune phenotype; gene expression of luminal breast cancer genetics; clinical features and prognosis of luminal breast cancer, providing a basis for further study of luminal breast cancer.

Advancement in pharmacokinetic mechanisms of herb-drug interaction

HE Ji-chao, ZHOU Fang, ZHANG Jing-wei, YAN Ting-ting, WANG Guang-ji

2014, 19(4):  470-475. 

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Recently, there is a dramatic increase in the combination use of traditional Chinese medicine and western drug, causing various drug interactions and adverse effects. This combination can not only change physiochemical properties of the related drugs and physiological nature of human body, but regulate expression and function of drug metabolizing enzymes and transporters, which a play key role in drug metabolism and disposition in vivo. Pharmacokinetic interaction then takes place frequently, together with alteration in clinical outcome. The paper summarizes the pharmacokinetics and assessment approaches of herb-drug interaction, acting as a reference for practical use and research.

Phase 0 clinical trial of innovative drugs

WANG Jin, CHEN Gang, ZHANG Tong, WANG Xing-he

2014, 19(4):  476-480. 

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In order to expedite development and reduce risk of drug innovations, the United States Food and Drug Administration (FDA) published “The Exploratory Investigational New Drug Guidance” in 2006 and introduced the concept of early clinical studies prior to traditional Phase I clinical trials, also known as Phase 0 clinical trials. This study model has shown certain advantages in clinical trials conducted in the United States. With the development of innovative drugs in China, new investigational models intended to enhance the drug development process by reducing risk and cost are receiving growing attention. However, Phase 0 clinical trials are still in its nascence in China and lack sufficient government guidance, trial design and experienced research personnel. In this paper, we will discuss the benefits and disadvantages of Phase 0 clinical trials through close analyses of its concept, research methods, assessment, suitable drug types, and differences from traditional clinical trials.