Chinese Journal of Clinical Pharmacology and Therapeutics

Variation of CD₄^＋Foxp3^＋ regulatory T cells in sub-acute and chronic cigarette smoke exposure in mice

YU Wan-jun, WANG Hua-ying, WENG Yue-song, SONG Yan-jin, GU Xiao, YING Hua-juan

2014, 19(6): 601-606.

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AIM : To investigate the changes of Treg and related cytokines in cigarette smoke-induced mice model of chronic airway inflammation, and to explore the role of Treg in the pathogenesis of COPD.METHODS: Sixty male BALB/c mice were randomly divided into 3 groups: a 24 wk smoke chronic exposure group, a 4 wk sub-acute exposure group and control group(n=20 each). Cells in BALF were collected and analyzed by absolute and differential cell counts. IL-6, TGF-β and IL-10 levels in serum and BALF were tested by enzyme linked immunosorbent assay (ELISA). The proportion of CD₄^＋Foxp3^＋Treg in peripheral blood mononuclear cell (PBMC) and lung tissue were determined by flow cytometry. The mRNA expressions of Foxp3 in lung tissues were measured by real-time PCR.RESULTS:Ratio of Treg was higher in the sub-acute smoke-exposure group in lung tissue(5.24％±0.86%)and peripheral blood (5.24％±1.23%) compared with the control group[(2.52±0.62)%, (3.54±0.87)%]. But the ratio of Treg in the chronic exposure group in lung tissue (1.83％±0.39％) and peripheral blood (1.88％±0.25％)was lower compared with the control group, all P<0.01. The level of Foxp3 mRNA in lung tissue was increased in the sub-acute smoke-exposure (2.67±0.73) compared with the control groups (1.49±0.37).But it was remarkably decreased in the chronic exposure group (0.61±0.21) compared with the control groups, P<0.01. Levels of IL-6 and TGF-β were remarkably increased in the chronic exposure group in serum[(56.47±19.41) pg/mL, (144.22±43.19 pg/mL)] compared with the sub-acute smoke-exposure group[(6.22±2.06 pg/mL), (23.32±8.32 pg/mL)] and the control group[(5.12±1.48 pg/mL), (18.14±13.00 pg/mL)], all P<0.01. IL-10 in serum was significantly decreased in the chronic smoke-exposure group (4.04±2.57 pg/mL) compared with the control group(8.26±2.02 pg/mL), and it was increased in sub-acute smoke-exposure group (10.42±2.45 pg/mL) compared with the control group, all P<0.01.CONCLUSION: Our study thus reveals that the change of Treg and the related cytokines exists in mice with sub-acute and chronic cigarette smoke exposure, suggesting its potential role in the breakdown of immune self-tolerance in chronic airway inflammatory response. Further research on Treg change in airway inflammation of COPD may provide insights into the development of new therapeutic targets for this disease.

Sequential expression of nitirc oxide synthase positive neurons in post-embryonic development of cerebral cortex of the Chinese alligator

ZHENG Lan-rong, WANG Ren-ping, ZHOU Yong-kang, WU Xiao-bing

2014, 19(6): 607-611.

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AIM : To investigate sequential changes of nitirc oxide synthase expression in thepostembryonic development of cerebral cortex of the Chinese alligator.METHODS: Immunofluorescent technique was used to detect the temporal expression concerning its variation at location and content of NOS1 in the cerebral cortex of the Chinese alligator by postembryonic age of 0 mh(newly hatched), 3 mh, 6 mh, 12 mh, 24 mh and 120 mhs. RESULTS: Immunofluorescent experiments showed that NOS1-positive fluorescence reaction was not seen at the molecular layer of cerebral cortex from the alligator aged 0 mh, but seen at the other 3 layers. With increased ages, the layers of cerebral cortex gradually thickened, fluorescence reaction in the molecular layer appeared with enhanced positive reaction in the cell layer. By 120 mhs, NOS1-positive reaction amassed in the cell layer, which yellowish green and bright fluorescence increased and tailed out, while fluorescence of the outer and inner plexiform layers thickened. Yellowish green fluorescence were seen around vessels at all ages.Through analysis to its corresponding fluorescence density image, the result showed that the expression of various ages were discrepant (P<0.05) and gradually enhanced with increased ages. CONCLUSION: NOS1 is involved in the post-embryonic development of cerebral cortex of the Chinese alligator.

Pharmacodynamics effects of APPS Liposome on acute liver injury induced by D-galactosamine in experimental mice

LI Xiao-li, DAI Wen-yun, SHI Sen-lin, WU Jin-jin, ZHU Yu-qing

2014, 19(6): 611-614.

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AIM : To study the preventive and therapeutic effects of APPS Liposome on mice acute liver injury induced by D-galactosamine.METHODS: D-galactosamine was given to establish the acute liver damaged mouse models. ALT, AST in mice blood were examined as indexes to study on the anti-acute liver injury effect of APPS Polyphase liposome oral liquid, with bifendate as a control drug.RESULTS:High dosage of APPS Polyphase liposome(200 mg/kg)have a significant effect on the acute liver damaged mice models(P<0.05 or P<0.01), low dosage(50 mg/kg)has no significant effect on the models(P>0.05).CONCLUSION: The results indicated that preventive and therapeutic effects of APPS Polyphase Liposome on mice acute liver injury are significant.

Study on specific binding between cyclic peptide and MDA-MB-231 cells of human breast cancer

XIE Yan, LIU Lu, ZHANG Jun, ZHOU Huan, WU Qing-hua, ZHONG Ying, SUN Jin, CHEN Dao-zhen, WANG Ying-ying , CHENG Guang-hua

2014, 19(6): 615-619.

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AIM : To investigate the specific binding between ⁹⁹Tc^m radiomarked molecular probe and MDA-MB-231 cells of human breast cancer and biodistribution in mice in vivo.METHODS: The different expression of IL-11R in MDA-MB-231 tumor cells and normal mammary epithelial cells(MCF-10A) were examined by Western blot. The specific binding of ⁹⁹Tc^m-DTPA-c(CGRRAGGSC)and binding site with MDA-MB-231 cells were observed by a fluorescence microscope. Eighteen tumor-bearing nude mice were randomly divided into 6 groups(n=3), biodistribution in vivo in the nude mice were observed in different times after intravenous injection 0.74 MBq (0.1 mL) of the molecular probe.RESULTS:The expression of IL-11R in MDA-MB-231 tumor cells group was 6.7 times as MCF-10A cells group. Fluorescent staining confirmed that ⁹⁹Tc^m-DTPA- c(CGRRAGGSC)-FITC was located in the cell membrane and cytoplasm of MDA-MB-231. The combination between molecular probe ang IL-11R in MDA-MB-231 cells possessed saturability.The radioactive molecular probe was rapidly, continually concentrated in the tumor tissue of the mice, and peaked (17.63±1.73)% ID/g 4 h later. But the radioactive molecular probe was not obviously observed in other vital organs (P<0.05).CONCLUSION: The IL-11R is highly expressed in MDA-MB-231 cells and has high affinity with the cyclic peptide. The ⁹⁹Tc^m labelled cyclic peptide, which is the radioactive molecular probe, has the specific targeted binding ability with MDA-MB-231 cells in vivo and in vitro.

Effects of docetaxel on the radiation sensitivity and expression of invasion and metastasis relative factors of human Nasopharyngeal Cancer CNE-2 cells

LIN Su-fang

2014, 19(6): 620-625.

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AIM : To investigate the role of docetaxel on the radiosensitivity of human nasopharyngeal cancer CNE-2 cell, and the effect on expression of invasion and metastasis relative factors MMP-2 and MMP-9.METHODS: The effects of docetaxel on cell proliferation abilities of CNE-2 cells were detected by CCK-8. The radiosensitivity of cells to docetaxel was examined by clone formation assay. The dual luciferase reporter assay was used to observe the activity of MMP-2 promoter after transduction 48 h later. Expressions of MMP-2 and MMP-9 mRNA in cells were detected by Real-time PCR and protein expressions of MMP-2 and MMP-9 were assayed by Western blot.RESULTS:Docetaxel had obvious inhibition on proliferation of CNE-2 cells, the 50% inhibiting concentration (IC₅₀) was respectively 30.6, 25.4, 12.8 μmol/L in 24, 48, and 72 h, and innocuity dose in 24 h was 5 μmol/L. The radiosensitivity of CNE-2 cells was enhanced obviously and activity of MMP-2 promoter was decreased after administration with docetaxel in 5 μmol/L (P<0.05). Expressions of MMP-2 and MMP-9 mRNA and protein in cells were down-regulated compare to untreated groups.CONCLUSION: Docetaxel administration with radio- therapy can increase the radiation sensitivity of CNE-2 cells. This mechanism may be related to the inhibiting genetic transcription of MMP-2 and MMP-9 in cells, and down-regulation protein expression of MMP-2 and MMP-9.

Effect of sequoyitol on the expression of NADPH oxidase p22phox, p47phox and iNOS protein in myocardium of type 2 diabetic rats

XU Wen-qi, LI Xian-wei, HAO Wei, LIU Yan, YANG Jie-ren

2014, 19(6): 626-631.

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AIM : To investigate the effect of sequoyitol on the expression of NADPH oxidase p22phox, p47phox and iNOS protein in myocardium of type 2 diabetic rats.METHODS: Diabetic rats were induced by high-fat diet and low dose streptozotocin (30 mg/kg) and were administered with sequoyitol (12.5, 25 and 50 mg/kg) for 6 weeks. The changes in blood glucose (BG) and left ventricular mass index were calculated. Morphological change was observed by HE staining. We also measured nitric oxide (NO), hydrogen peroxide (H₂O₂), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC) in myocardial tissue. In addition, the expression of NADPH oxidase p22phox, p47phox, and inducible nitric oxide synthase (iNOS) protein in myocardium were determined by Western Blot.RESULTS:Compared with the normal control group, the BG and left ventricular mass index were significantly increased. The levels of NO and H₂O₂ were significantly increased and the vitalities of SOD and T-AOC were obviously decreased. The expression of p22phox, p47phox, and iNOS were also significantly increased (P<0.01).Compared with the diabetic group, all above indexes of sequoyitol or acarbose treatment groups had been improved by gavage 6 weeks (P<0.05, P<0.01).CONCLUSION: These results showed that sequoyitol may be lessen the myocardial damage of diabetes by decreasing the expression of NADPH oxidase p22phox, p47phox and iNOS and reducing the sources of oxidative stress.

Prevention by caveolin-1 of the proliferation of the asthmatic airway smooth muscle cells is most likely mediated by ERK1/2 signal pathway and regulation of roxithromycin

ZENG Wei-xian, DAI Yuan-rong

2014, 19(6): 632-638.

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AIM : To explore the effect of caveolin-1 on ERK signal pathway in ariway smooth muscle cells (ASMCs) of asthmatic rats and observe regulation of roxithromycin to expression of caveolin-1.METHODS: Asthmatic rats were copied. Morphological of the caveolae in airway smooth muscle cells (ASMCs) were observed by electron microscopy [EM]. The histopathology change of pulmonary tissues were observed by light microscope. The smooth muscle cells were isolated by adherent from the bronchial tree in vitro, which were divided into five groups: control group (group A), asthmatic airway smooth muscle cells group (group E), MAPKs signal pathway's blocking agent (PD98059) group (group C), roxithroymcin group (group D), methyl-β-cyclodextrin (MβCD) to disrupt caveolae group (group E).SMCs proliferation of each group were examined by CCK-8. The protein expressions of caveolin-1and pERK were detected by western blot and the mRNA expressions of ERK were detected by RT-PCR. RESULTS:Compared with the control group B, the ASMCs was pretreated with PD98059 and roxithroymcin for an hour, the proliferation on ASMC were weakened, P<0.05; in group E, after the ASMCs was pretreated with MβCD, the proliferation on ASMCs were increased, P<0.05. The expressions of protein of caveolin-1 was significantly increased in group C and group D (P<0.01), while the expressions of protein or mRNA of ERK were significantly decreased in group C and group D (P<0.01), but decreased in group E. CONCLUSION: Caveolin-1 maybe prevent the proliferation of the asthmatic ASMCs, which is most likely mediated by ERK1/2 signal pathway. ROX may increase the expression of caveolin-1 and inhibit the proliferation in cultured ASMCs from chronic asthmatic rats.

Curcumin mitigates the changes of cognitive function by sevoflurane anesthesia in aged rats

ZUO Lei, LIU Dan-yan, LI Qi-ying

2014, 19(6): 638-643.

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AIM : To investigate the curcumin effect on cognitive function after sevoflurane anesthesia with high concentration and the expression of Cyclooxygenase-2 in aged rats.METHODS: Forty-six male Sprague Dawley SD rats aged 18 months weighing 490-590 g were randomyly divided into three groups: Blank control group (n=16), sevoflurane group (n=16), 3% sevoflurane and curcumin group (curcumine group, n=16) ; sevoflurane group and curcumine group received anesthesia for 6 h. The cognitive function was tested with Morris Watermaze. Aβ, COX-2 and BACE-1 expressions in the hippocampus were determined with enzyme-linked immunosorbent assays and Western-Blot.RESULTS:Compared with the control group, both latency and the number of seeking for hidden-platform has significant difference in sevoflurane and curcumine groups (P<0.05), there were significant differences between the sevoflurane group and curcumine group(P<0.05).Compared with blank control group, the expression of Aβ in the hippocampus had significant differences in curcumine group (P<0.05), but no significant differences between the blank control and curcumine groups(P>0.05).Compared with the blank control group, the expression of BACE-1 in hippocampal was significant increased in sevoflurane and curcumine groups (P<0.05).There were no significant differences among the sevoflurane group, curcumine group and blank control group(P<0.05).CONCLUSION: Curcumin might mitigate cognitive function impairment induced by sevoflurane with high concentration.Possibly by suppress APP, Aβ generation and caused down-regulation of BACE-1.

Updating the evidence for the effect trimetazidine and shexiang baoxin pills on chronic heart failure: a Meta-analysis

YANG Liu, GUO Yi

2014, 19(6): 644-650.

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AIM : To review the therapeutical effect of trimetazidine and shexiang baoxin pill on chronic heart failure.METHODS: The literature of randomized and controlled trialls(RCT) about treatment of chronic heart failure with trimetazidine and shexiang baoxin pill were retrieved from Cochrane Library, ProQuest Central, MEDLINE, EMbase, PEDro, OpenSIGLE, NTIS, ScienceDirect, CNKI, VIP, Wanfang Data and CBM(by Apri 30, 2013), and then 2 reviews independently chose RCT , extracted materials, checked crossly and gave methodological quality evaluation. Meta analysis was conducted by using Revman 5.2 software.RESULTS:A total of 7 trials and 451 patients were discovered .Meta-analyses showed that at the end of the study , compared with routine remedy alone, the extra remedy of trimetazidine and shexiang baoxin pill on chronic heart failure got abvious amelioration on the improvement of clinical efficacy, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter(LVEDD), left ventricular end diastolic volume(LVEDV) and the walking range of 6 minutes [WMD=(95%CI)3.09(2.07, 4.59), WMD=(95%CI)5.81(4.69 to 6.93), WMD=-5.31(-7.19 to -3.43), WMD=-4.6(-8.59 to -0.64)], WMD=42.73(32.48 to 52.97).CONCLUSION: The existing evidence shows that the therapy of trimetazidine and shexiang baoxin pill is effective to on chronic heart failure and can ameliorate clinical efficacy , left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter(LVEDD), left ventricular end diastolic volume(LVEDV) and the walking range of 6 minutes. There were not any adverse reactions .As the limitation of the quality of enclosed literature, the review on the curative effect of chronic heart failure expects more randomized controlled double-blin-ded trials with high quality.

A Meta-analysis of modafinil pharmacokinetics and gender

LI Ya-dong, WANG Tian-xiao, HONG Zong-yuan

2014, 19(6): 651-655.

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AIM : Modafinil is a potent wake-promoting compound with low abuse potential used in the treatment of narcolepsy and day time sleepiness. This paper was to evaluate the difference of modafinil pharmacokinetics between females and males for developing more reasonable clinical dosing regimens.METHODS: A systematic review and Meta-analysis of pharmacokinetic studies that administered a single oral dose of modafinil were performed. Pharmacokinetic parameters of modafinil were from 8 papers selected from Pubmed, Medline, Ovid, springer link, CNKI, VIP and CBM etc. databases for January of 1994 to February of 2013. The three pharmacokinetics parameters:t_1/2β, AUC_0-∞, Tmax were analysised using Revman 5.0 software.RESULTS:Pooled analysis (n=207) demonstrated that the elimination half-life (t_1/2β) of modafinil in females was shorter than that in males (Mean difference =1.13, 95% CI=0.31-1.96, P=0.007), while the area under the concentration-time curve (AUC_0-∞) in females was increased significantly, compared with that in males (Mean difference =-6.37, 95% CI =- 9.20--3.53, P<0.0001). However, the peak plasma modafinil concentration (t_max) was no difference between females and males (Mean difference=-0.11, 95% CI=-0.32-0.10, P=0.32).CONCLUSION: This study indicates a marked effect of gender factor on modafinil pharmacokinetics, which provides a reference for reasonable administration in clinic.

A systematic review of low-dose and routine-dose colchicine regimen in the treatment of acute gout flare

MENG Long, LI Juan, LONG Rui, JIA Yun-tao

2014, 19(6): 656-662.

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AIM : To investigate the efficacy and safety of low-dose colchicine regimen compared with routine-dose colchicines for acute gout flare.METHODS: We searched MEDLINE, Sciencedirect, CNKI and WanFang database systematically. RevMan5 was used for meta-analysis.RESULTS:A total of 11 randomized controlled trials matched our inclusion and exclusion criteria. Meta-analysis found that low-dose colchicine regimen showed no significant difference compared with routine-dose colchicine regimen in the proportion of at least a 2-unit reduction in target joint pain score(RR 1.04, 0.95%CI 0.77-1.40, P=0.81), proportion of pain relief(RR 1.06, 95%CI 0.85-1.31, P=0.62) and proportion of clinical efficacy(RR 0.89, 95% CI 0.71-1.11, P=0.29). In addition, gastrointestinal adverse reaction(RR 0.25, 95% CI 0.19-0.34, P<0.000 01) and overall adverse reaction rate(RR 0.36, 95% CI 0.26-0.50, P<0.000 01) were lower in low-dose colchicine group. Similarly, there was no significant difference concerning clinical efficacy rate(RR 1.46, 95% CI 0.42-5.08, P=0.55)between low-dose colchicines + non-steroid anti-inflammtory drugs group compared with routine-dose colchicine group. However, fewer patients experienced overall adverse reaction(RR 0.16, 95% CI 0.08-0.29, P<0.000 01), withdrawal due to adverse reaction(RR 0.14, 95% CI 0.07-0.28, P<0.00001)and gastrointestinal adverse reaction(RR 0.17, 95% CI 0.11-0.27, P<0.000 01)in low-dose colchicines + non-steroid anti-inflammtory drugs group.CONCLUSION: Our meta-analysis indicated that routine-dose colchicine regimen showed no significant superior to low-dose colchicine regimen, and routine-dose colchicine regimen increased the risk of adverse reaction significantly.

ED₅₀ of sufentanil combined with bupivacaine for spinal anesthesia in cesarean section

XIANG Xiao-bing, FANG Jun, JIN Xiao-ju, LIU Zhao-fang

2014, 19(6): 663-665.

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AIM : To study the minimal effective dose of sufentanil spinal anesthesia in cesarean section.METHODS: Forty patients undergoing cesarean section were enrolled in this study and L3/4 was chosen for lumbar puncture.The solution used for spinal anesthesia was sufentanil and bupivacaine, in which the dose of bupivacaine was fixed 7.5 mg. While the initial dose of sufentanil was 1.2 μg, according to 1.2 times increase or decrease the administration. If the level of spinal anesthesia reached to T6 and up to 1 hour, the dose decreased 1 grade for next patient. On the contrary, the dose increased 1 grade in the next one. The ED₅₀ of sufentanil was calculated by Dixon-Massey sequential method.RESULTS:Twenty-one patients had the good effect of spinal anesthesia. The ED₅₀ of sufentanil for cesarean section was 0.84 μg, and its 95% confidence interval was 0.78-0.90 μg.CONCLUSION: The minimal effective dose of sufentanil combined with bupivacaine 7.5 mg for spinal anesthesia in cesarean section was 0.84 μg.

Correlation analysis between nonalcoholic fatty liver disease and metabolic syndrome

JI Xue-lei, GE Yi-dong, AN Min-min, LIU Lei, DING Jun, XIE Yu-xin, LI Chun-yun

2014, 19(6): 666-670.

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AIM : To investigate the correlation between nonalcoholic fatty liver disease(NAFLD) and metabolic syndrome (MS) by detecting the index of enzyme and metabolism. METHODS: 122 employees who receive physical examination in Physical Examination Center of the No'2 people' hospital of Wuhu were involved in the group, and the index of enzyme, metabolism, and complication were detected all of them. RESULTS:Compared with the pure NAFLD group, the levels of weight index, TG, systolic blood pressure, diastolic blood pressure and the fasting blood glucose in NAFLD with MS group were increased, there was statistically significant difference (P<0.05). the levels of TC, HDL-C, LDL-C, UA and the complications in two groups were similar, there was no statistically significant difference (P>0.05). CONCLUSION: The rate of abnormal index of metabolism and the complications of patients of NAFLD with MS were higher, and physician should pay attention to it and give some suggestion about it to patients of NAFLD with MS.

Acyclovir in the treatment of facial paralysis clinical and prognostic analysis

ZHAO Xiao-yan

2014, 19(6): 670-673.

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AIM : To observe the curative effect of Acyclovir in the treatment of facial paralysis, and to use the blink reflex to measure the incubation period of the ipsilateral R1, R2 and the contralateral stimuli R2' wave to determine the curative effect of facial paralysis peripheral in the treatment group and control group around.METHODS: 68 cases of patients with clinical diagnosis of facial paralysis were randomly divided into two groups. The control group with 33 cases was given routine therapy and the other 35 cases in the treatment group were given the treatment which is on the basis of conventional treatment combined with Acyclovir. The Portmann simple scoring and blink reflex were used to measure the incubation period of the ipsilateral R1, R2 and the contralateral stimuli R2' wave before the treatment. After two weeks' and four weeks' comprehensive treatment, the Portmann simple scoring and blink reflex test were executed respectively, and then compare the treatment effect of two groups.RESULTS:The improvement after two weeks in Portmann simple scoring of treatment group was significant compare with the control group, in which the treatment group and control group cure rates were 68.5% and 48.4% (P<0.05), and the treatment group and control group cure rates after 4 weeks were 88.6% and 71.4% (P<0.05) with statistical significance. After 2 weeks' treatment, the blink reflex abnormal rate in treatment group and control group were 45.7% and 57.6% (P<0.05). After four weeks' treatment, the blink reflex abnormal rates in treatment group and control group were 11.4% and 21.2% (P<0.05).CONCLUSION: The routine therapy plus the Acyclovir in the treatment of facial paralysis the is more safe and effective than the conventional treatmant, and can shorten the period of treatment. The prognosis is good, before and after treatment with blink radiation can effectively judge the curative effect and prognosis of facial paralysis.

Short-term survival analysis of predictive factors associated with mortality in 92 patients with polymyositis and dermatomyositis

SHENG Jun, LU Jin-ming, XUAN Dan, QIANG Fu-yong, XU Liang

2014, 19(6): 674-679.

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AIM : To investigate the risk factors on survival and prognosis of polymyositis/dermatomyositis(PM/DM).METHODS: The clinical and laboratory data of 101 PM/DM patients from July 2006 to July 2013 in Yijishan Hospital were collected, 9 cases were lost. The 92 patients were divided into a death group and a non-death group. The clinical feature and prognosis were analyzed retrospectively. The clinical and laboratory data were analyzed by using the SPSS 16.0 software. Survival analysis and COX regression were performed to analyze the prognosis and related risk factors for 92 patients followed up.RESULTS:The 92 patients with PM/DM comprised 29 males and 63 females. The idiopathic DM was 51 cases, PM was 41cases. During the follow-up period, 15 patients died, 4 patients with PM, 11 patients with DM. Compared with the non-death group, the age in the death group was markedly older [ (59.1±10.6) years vs (44.3±12.9) years], the median duration [9(3-123) months vs 46(4-174)months, χ² =-3.251, P=0.001] was significantly shorter. The serum levels of ALB [(31.9±4.3) g/L vs (37.4±6.1) g/L, t=2.712, P=0.008], ESR [(46.1±32.6) mm/h vs (30.61±24.9) mm/h, t=2.031, P=0.045] and the serum levels of CRP [(32.5±25.4) mg/L vs (18.0±11.7) mg/L, t=2.263, P=0.026] were statistically different between the two groups. The incidence of ILD [11/15 vs 29/77, χ²=6.56, P=0.010], heart impairment (9/15 vs 24/77, χ²=4.53, P=0.033) and lung infection(10/15 vs 24/77, χ²=5.35, P=0.021)were significantly higher in the death group. Survival estimates in the whole group at 1, 5 and 10 years was 88.7%, 82.3%, 59.5%, respectively.The unfavourable prognostic factors were increased age(χ²=14.128, P<0.001, RR=1.102, 95%CI 1.048-1.160), ILD(χ²=4.642, P=0.031, RR=0.284, 95%CI 0.090-0.893), low ALB level(χ²=7.543, P=0.006, RR=0.890, 95%CI 0.819-0.967), heart impairment(χ²=4.980, P=0.026, RR=0.306, 95%CI 0.108-0.866) and lung infection (χ²=5.451 P=0.020, RR=0.277, 95%CI 0.095-0.140) by multivariate COX regression analysis.CONCLUSION: Patients in the death group showed older age, shorter duration, lower ALB level and higher incidence of ILD , heart impairment and lung infection than in the non-death group. Increased age, low ALB level and complicated ILD, heart impairment, lung infection were poor prognosis factors of PM/DM patients.

Research on the value of Mosapride in bowel preparation before colonoscopy in elderly patients

WANG Wei-feng, ZHENG Pei-fen, CHEN Xin-yu, FENG Yu-liang, CHENG Lin

2014, 19(6): 680-682.

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AIM : To investigate the efficacy of oral administration of polyethylene glycol-electrolyte powder combined with mosapride in bowel preparation before colonoscopy in elderly patients.METHODS: One hundred and sixty-four patients undergoing colonoscopy examination were randomly divided into A, B and C three groups. Before colonoscopy examination, the patient took orally polyethylene glycol-electrolyte powder 2 L in group A , besides method as mentioned above, while the patients in group B took mosapride 10 mg 6.5 hour ago. Besides method as mentioned in group B, the patients in group C took mosapride 5 mg three times a day for 6 days before colonoscopy examination. Then, the time of the first stool, stool frequency, adverse reactions of the patients as well as the quality of the bowel cleanness and so on were recorded and compared.RESULTS:The time of the first stool in group B and C showed earlier than group A with statistical significance (P<0.05), but this was no difference between group B and group C(P>0.05). Compared with the group A and group B, the stool frequency was significantly increased in the group C (P<0.05), but this was no difference between group A and group B(P>0.05).The group C showed a positive efficacy on the quality of the bowel cleanness(P<0.05), whereas this was no difference between group A and group B(P>0.05).CONCLUSION: Compared with single-use polyethylene glycol electrolyte powder and combined with mosapride one time, oral administration of polyethylene glycol-electrolyte powder combined with mosapride for one week before colonoscopy can increase the stool frequency and the quality of the bowel cleanness in elderly patients.

Effect observation of rehabilitation training combined with drug in the treatment of children with cerebral palsy

XU De-he, ZHAO Qun-feng, ZHANG Xi-hong, CHEN Qian-qian

2014, 19(6): 683-686.

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AIM : To investigate the clinical value of botulinum toxin type A in the treatment of children with cerebral palsy.METHODS: The 86 cases of lower limb spasticity in children with cerebral palsy were randomly divided into two groups, treatment group (n=43) and control group (n=43). The control group was given Vojta training, and the treatment group was also given botulinum toxin type A. The muscle spasms, motor function and activities of daily living in 2 groups were observed and compared. RESULTS:The score of composite spasticity scale in the treatment group after treatment was significantly lower than the control group (P<0.05); the D district E district scores of gross motor function measure in the treatment group after treatment were significantly higher than the control group(P<0.05); the score of activities of daily living in the treatment group after treatment was significantly higher than the control group (P<0.05). CONCLUSION: Botulinum toxin type A can efficiently relieve muscle spasms, and promote recovery of their motor function.

Clinical study on wendantang combined non-invasive positive pressure ventilation in patients with severe obstructive sleep apnea hypopnea syndrome

ZHANG Ying, ZHOU Ying

2014, 19(6): 686-690.

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AIM : To observe the impact of wendantang combined non-invasive ventilation on the number of clinical symptoms, apnea, the longest apnea time, the number of low hypopnea, average oxygen saturation finger, lowest oxygen saturation finger and leptin in the patients of severe OSAHS.METHODS: Total 50 severe cases of OSAHS as test group were chosen, and divided into treatment group and control group randomly, that was to say 25 cases each group. The treatment group peros wendantang day one of each serving 28 for a course, combined non-invasive positive pressure ventilation therapy 8-14 hours a day, while the control group used non-invasive ventilation only. Then the level of sleep monitoring indicators and leptin by polysomnography and radio-immunity assay was tested to compare the changes of these indexes before and after the treatment in one month, two months and three months.RESULTS:The level of the number of apnea, the number of low hypopnea, leptin obviously decreased while the level of average oxygen saturation finger, lowest oxygen saturation finger significantly increased by taking wendantang combined non-invasive ventilation in treatment group after three months. Moreover, the level of the clinical symptoms and the number of apnea, the number of low hypopnea, leptin obviously decreased as compared with the control group. The relative analysis indicated that the level of the number of apnea, the number of low hypopnea in the patients of severe OSAHS had positive correlation with leptin.CONCLUSION: Wendantang combined non-invasive ventilation can cut down the level of leptin in the patients of severe cases OSAHS obviously, thereby reducing the number of apnea and low hypopnea , and improve the prognosis in the patients of OSAHS accordingly.

Effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis

LI Dong, XIA Chen-mei, CHEN Xia, YAN Hai-fan, FENG Chong-zhi

2014, 19(6): 691-694.

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AIM : To explore the effects of calcitriol on bone mineral density and bone metabolic markers in male patients with alcoholic cirrhosis.METHODS: 112 male patients with alcoholic cirrhosis were randomly divided into the observe group(n=56)and the control group(n=56). They all accepted the conventional treatment, but the patients in the observed group were given the treatment of calcitriol (0.25 μ g/d). The difference of the bone mineral density, beta-isomerized C-telopeptide(β-CTx), 25- hydroxy vitamin D (25-OHD), serum calcium, serum phosphorus and parathyroid hormone (PTH) were compared between the two group after 6 months treatment.RESULTS: The serum phosphorus and PTH in the observed group after treatment were significantly lower than that before treatment(P<0.05), and the 25-OHD and serum calcium in the observed group after treatment were significantly higher than that before treatment(P<0.05); the 25-OHD in the control group after treatment were significantly lower than that before treatment(P<0.05). After treatment, the serum calcium and the 25-OHD in the observation group were significantly higher than that in the control group(P<0.05), the serum phosphorus and PTH in the observation group were significantly lower than that in the control group(P<0.05). After treatment, there is no significant difference of bone mineral density, T score, β-CTx and liver function both in the observation group and in the control group(P＞0.05).CONCLUSION: Supplement of vitamin D for 6 months could improve vitamin deficiency in male patients with alcoholic cirrhosis, but can't stop the destruction of bone and increase bone mineral density.

Pathogenesis, clinical diagnosis and treatment for CKD-MBD

PAN Hai, LIU Jin-xin, ZHANG Yan

2014, 19(6): 695-700.

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The abnormal levels of calcium, phosphorus, parathyroid hormone, vitamin D, fibroblast growth factor-23 in the blood of patients with chronic kidney disease (CKD) will not only cause long-term systematic complications, but also lead to bone mineral metabolism imbalance and bone injury, and finally increase the risk of morbidity and mortality with CKD-MBD. In this review, we summarize the pathogenesis, clinical diagnosis and treatment strategy for CKD-MBD.

Advances in Research on Interactions between Amlodipine and Other drugs

CHEN Shen-Jue, KUANG Ze-Min, YUAN Hong, HUANG Zhi-Jun, ZUO Xiao-Cong

2014, 19(6): 701-0.

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