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Welcome to Chinese Journal of Clinical Pharmacology and Therapeutics,Today is Chinese

Table of Content

    Volume 22 Issue 3
    26 March 2017
    LPS-induced chronic Parkinson's disease in mice α-synuclein in the emergence and metastasis
    GE Bobo,QU Hongdang,CHEN Yuhua,HU Caicai,LI Li,JIANG Mujun,XU Juanjuan
    2017, 22(3):  241-248. 
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    AIM: To establish a mouse model of chronic Parkinson's disease(PD) induced by lipopolysaccharide (LPS) and to investigate the behavioral changes of PD mice and the appearance and metastasis of α-synuclein(α-Syn) aggregates in the intestinal wall.  METHODS: 48 male C57BL/6J mice were randomly divided into normal saline control group and PD model group at 6 weeks of age. The PD mice model was established by intraperitoneal injection of LPS. Behavioral changes of the experimental mice were detected by the rotating bar test and field test. The dopaminergic neuron loss and α-Syn were observed by immunohistochemistry nuclear protein expression and metastasis. RESULTS:Behavioral changes of PD model mice exhibited significance difference (P<0.01). PD model mice's substantia nigra pars compacta α-Syn  aggregation first appeared in the gut, and over time, the α-Syn was transferred to the substantia nigra of the mesencephalon, and the dopaminergic neurons were severely damaged. CONCLUSION: In the LPS-induced PD model, the typical pathological changes (α-Syn aggregation) begin in the colon nerves, and gradually develop into the substantia nigra pars compacta, resulting in dopaminergic neuron damage and loss.

    Effect and mechanism of acute liver injury induced by volatile oil from folium artemislae argyi in mice
    LIU Hongjie, LI Tianhao, ZHAN Sha, CHEN Liang, CHEN Lingxiu, TANG Shujie
    2017, 22(3):  248-252. 
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    AIM: To explore the effect and mechanism of acute liver injury induced by volatile oils from artemislae argyi folium in mice. METHODS: Volatile oil from folium artemislae argyi was obtained through hydro-distillation extraction.52 SPF ICR mice (half male and half female) were randomized into five groups,i.e. control group, carbon tetrachloride group, different doses (1.9 g/kg, 2.3 g/kg and 2.7 g/kg) of volatile oils from folium artemislae argyi groups. Biological samples were obtained 6 hours after gavaging equal volume drugs or solvents to mice at a single dose. Alanine amino transferase (ALT), alkaline phosphatase (ALP) and total bilirubin (TB) in serum were detected. Morphologic changes of hepatic tissues were observed and analyzed by Ridit. Superoxide anion free radical, superoxide dismutase (SOD), malondialdehyde (MDA), reduced glutathione (GSH) and oxidized glutathione(GSSG) of hepatic tissues were examined. RESULTS: Compared to those of control group, ALT, ALP, MDA,GSSG, scores of Ridit and superoxide anion free radical of all volatile oil groups increased (P<0.05), while SOD and GSH decreased (P<0.05). Damage of hepatic tissues, such as degeneration, necrosis were observed in the poisoned groups. CONCLUSION:The acute liver injury induced by volatile oil from folium artemislae argyi might directly or indirectly relate to hepatic cells, and the mechanism may be related to oxidative stress.

    Mechanism of apoptosis of mucoepidermoid carcinoma MEC-1 cells induced by ethanol extract of Lamiophlomis rotate
    MA Chenghua, ZHOU Haijing, SHI Wen, WANG Zhiqiang, YANG Lan, CHEN Ping, ZHENG Xueli, MA Rui, MA Lijuan
    2017, 22(3):  253-259. 
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    AIM: To investigate the pro-apoptotic of ethanol extract of Lamiophlomis rotate (EELR) on human mucoepidermoid cancer cells (MEC-1). METHODS: Sulforhodamine B (SRB) colorimetric method, cell clone formation experiment, Hoechst33258/PI staining and flow cytometry instrument technique were used to determine cell apoptosis, and Western blot analysis was used to detect alterations in cell apoptosis pathway-related proteins.RESULTS:EELR dose- and time-dependently exhibited anti-proliferation. With the increase of EELR concentration, the pro-apoptotic effect on MEC-1 was increased gradually. Moreover, Western blot analysis indicated that the expression of Bcl-2 was reduced and Bax and Casepase-3 were increased with the increasing of EELR concentration. CONCLUSION: EELR can induce MEC-1 cells apoptosis, which may be associated with the down-regulation of the Bcl-2 expression and up-regulation of the Bax and Casepase-3 expressions.

    Effect and mechanism of cytokine levels in mice systemic inflammation of dexmedetomidine
    CONG Haitao, LI Zhonghua, HEN Bin, DING Jinfeng, WANG Huiqin, CHEN Lingyang
    2017, 22(3):  260-266. 
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    AIM: To elucidate the anti-inflammatory mechanism of dexmedetomidine through the cholinergic anti-inflammatory pathway.  METHODS: BALB/c mice were selected as the experimental animals and were intraperitoneally injected with LPS (10 mg/kg, injection time longer than 2 min) to establish the mouse model of endotoxemia. Dexmedetomidine was applied to intervene. 60 mice were divided into three groups (20 in each)in the behavioural performance and living conditions experiment, i.e. the dexmedetomidine group (Dex group), normal saline group (Saline group) and blank control group (C group). Behavioural performance and survival rate of the three groups were observed 120 hours after drug intervention. Mice were divided into four groups with 16 in each group in the detection of serum inflammatory factors and observation of the pathological morphology, i.e. physiological saline (Saline group) and dexmedetomidine group (Dex group) alpha bungarotoxin+dexmedetomidine group (alpha BGT+Dex group) and blank control group (C group) . Enzyme linked immunosorbent assay was used to detect the concentration of serum TNF-a, IL-1β and IL-6. Pathological examination was performed thereafter. Mice were divided into two groups with 16 in each group for the cervical vagectomy experiment, i.e. sham operation group (SHAM+Dex group) and cervical vagectomy group (VNX+Dex group). Concentration of serum TNF-a, IL-1 and IL-6 three hours after LPS injection were detected.RESULTS:In the survival analysis experiment, the survival rate of dexmedetomidine group was significantly higher than that of the endotoxemia group (P<0.01). Pre-emptive administration of dexmedetomidine significantly attenuated the cytokine response after endotoxin-induced endotoxemia (P<0.01). Moreover, there were significant differences in changes of heart tissue, liver tissue, kidney tissue and lung tissue. Expression levels of TNF-a, IL-1β, IL-6 in the VNX+Dex group were significant higher than those in the SHAM + Dex group (P<0.01). CONCLUSION:Pre-emptive administration of dexmedetomidine increases the activity of cervical vagus nerve and can improve survival rate in experimental endotoxemia by inhibiting the inflammatory cytokines release.

    Effect of preemptive analgesia with dezocine+ketorolac tromethamine complex on postoperative pain thresholds and inflammatory reaction in rats
    CHANG Yongli, XU Yinhong, WEN Xuemin, GUO Zhennan, ZHANG Lihui, HAN Ying, GUO Xiaoshu
    2017, 22(3):  267-271. 
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    AIM: To explore the effects of preemptive analgesia with dezocine+ketorolac tromethamine complex on postoperative pain thresholds and inflammatory reactions in rats.  METHODS: A total of 60 adult Sprague Dawley rats were randomized into the control group, the preemptive analgesia (CZ) group and the postoperative analgesia (SZ) group, each with 20 rats. The rats were subjected to an abdominal midline incision followed by sterile suturing. In each group, 5 rats were taken, and the pain thresholds were determined at 0, 6, 12 or 24 h after operation, respectively, using BL-420 biological and functional experimental system. Then, blood samples were collected from the inferior vena. After isolation, the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in serum were determined using enzyme-linked immunosorbent assays. The expression of substance P (SP) were observed using western blot analysis. RESULTS:There was no significant difference in the pain threshold, the levels of TNF-α, IL -1β and SP of the three groups at 0 h (P>0.05). But at 6,12 or 24 h, the pain threshold of N group was significantly lower than that of CZ and SZ group (P<0.01). The levels of TNF-α and IL -1β of N group were significantly higher than those of CZ and SZ group (P<0.01) at 6,12 or 24 h, and although the levels of the CZ group and the SZ group did not show significant difference at 6 h (P>0.05), the levels of SZ group were significantly higher than the CZ group at 12 and 24 h (P<0.01). The levels of SP of N group were significantly higher than those of CZ and SZ group (P<0.01) at 6,12 or 24 h, and although the levels of the CZ group and the SZ group did not show significant difference at 6 and 12 h (P>0.05), the levels of SZ group were significantly higher than the CZ group at 24 h (P<0.01). CONCLUSION:Dezocine+ketorolac tromethamine inhibited the expression of the inflammatory factor TNF-α, IL -1β, and the pain factor SP after operation, showing a exact analgesic effect. Compared with postoperative application, the preemptive had a better effect. 

    Development and validation of a sensitive LC-MS/MS method for the determination of para-aminosalicylic acid in different tissues in rats
    YUAN Yawen, LI Yan, YANG Jin
    2017, 22(3):  272-280. 
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    AIM: To develop a novel HPLC-ESI-MS/MS method to determine P-aminosalicylic acid (PAS) in different rat tissues to overcome the weaknesses of the conventional complicated pretreatment process and its low sensitivity.  METHODS: The assay was performed with a one-step pre-column process of protein precipitation for extraction and the use of a Phenomenex Synergi 4u Polar-RP 80A (150 mm×4.6 mm; 4 μm) column with gradient elution for separation. Chlorzoxazone was selected as an internal standard (IS). LC-MS/MS (API4000) was applied for determination. PAS and IS were detected by tandem mass spectrometer using multiple reaction monitoring mode (MRM) with negative electrospray ionization. The ion transitions recorded in multiple reaction monitoring mode were m/z 152.0→108.1 for PAS and m/z 167.9→131.9 for the internal standard. RESULTS: The total analytical run time was short of 6.5 min. Calibration curve was linear over the range of 0.05-50 μg/mL and the lower limit of quantification (LLOQ) was low up to 0.05μg/mL. All validation criteria were fulfilled in compliance with the guidelines of the United States Food and Drug Administration (FDA). CONCLUSION: This HPLC-MS/MS method is accurate and reliable. The described assay method has been successfully applied for the measurement of PAS in preclinical distribution study.

    Effect of fasudil combined with sildenafil in the treatment of pulmonary hypertension in rats
    XU Jing, JIN Xiaojie
    2017, 22(3):  281-286. 
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    AIM: To investigate the curative effect of fasudil combined with sildenafil in the treatment of pulmonary hypertension in rats.  METHODS: 100 rats were randomly divided into A, B, C, D and E group.Group A was control group, group B was set for the model of pulmonary hypertension, group C was given fasudil treatment on the basis of modeling. Group D received sildenafil treatment on the basis of modeling, group E was given fasudil combined with sildenafil treatment on the basis of modeling. The blood pressure, right ventricular function, right ventricular hypertrophy and vascular reconstruction were compared between the 5 groups. RESULTS:The RVSP of C group, D group and E group were significantly lower than that of B group;the RVSP of E group was significantly lower than that of rats in the C group (P<0.05); RVEDD and RVESD of group E were significantly lower than those in the C group, and right ventricular fractional shortening of D group and E group were significantly higher than that in the B group (P<0.05); RV/LV+S and RV/BW of the rats in group E were significantly lower than that of C group and group D (P<0.05); pulmonary artery intimal thickening in rats of group E was significantly lower than that of B group, C group and D group (P<0.05).Rho kinase activity in pulmonary artery of E group was significantly lower than that of B group, C group and D group (P<0.05). CONCLUSION: Fasudil combined with sildenafil treatment can significantly improve the hemodynamics of rats with pulmonary hypertension and right ventricular function as well as relieve right ventricular hypertrophy.It is beneficial to microvascular reconstruction, and there is a cooperative relationship between the two drugs in the regulation of Rho kinase activity and the treatment of pulmonary artery.

    Polymorphism distribution of rs316019 of SLC22A2 in the Uygur population of Xinjiang
    ZHOU Yuan, LU Xueling, ZHAO Jun, ZHANG Li, YANG Huanjie,WANG Ning
    2017, 22(3):  287-293. 
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    AIM: To study the polymorphism distribution of SLC22A2 gene rs316019 loci in Uygur of Xinjiang, and to analyze the racial differences in different populations.  METHODS: The genotypes of rs316019 loci(G808T,A270S)in 276 unrelated healthy Uygur male were detected by the techniques of SNaP shot, and the genotype and allele frequency were subsequently compared with different populations,  and analyzed  the racial differences in their distribution. RESULTS:The genotypes distribution of rs316019 loci was in the Hardy-Weinberg equilibrium (P>0.05). The frequencies of genotypes (CC, CA, and AA) were 79.7%,18.1% and 2.2% in Xinjiang Uygur, the frequency of minor allele A was 11.2%, the allele G or T were not observed. It's polymorphism distribution showed significant differences between Xinjiang Uygur and the Han, the African, the American and European populations etc. (P<0.05). CONCLUSION: There was national difference in polymorphism of SLC22A2 rs316019 loci among different populations, and it may bring the difference to drugs' pharmacogenetics  and related diseases' development  etc. accordingly.

    Comparison of the pharmacokinetics of levetiracetam injection and levetiracetam tablets in human
    LIU Shijia, CHEN Du, YIN Jungang, CHU Jihong, XU Meijuan, LIU Fang, DAI Guoliang, XIONG Ningning, JU Wenzheng
    2017, 22(3):  294-298. 
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    AIM: To compare the pharmacokinetic parameters of levetiracetam with those of levetiracetam tablets in fasting condition, and to observe the safety and tolerability of them in healthy subjects.  METHODS: The concentrations of levetiracetam in plasma samples of healthy subjects before and after two cycles of administration were determined using established high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) analysis. RESULTS: The main pharmacokinetic parameters of levetiracetam after intravenous injection and oral administration of levetiracetam were as follows:t1/2 were (7.70±0.85), (7.81±0.88) h;Tmax were(0.70±0.10) , (0.90±0.80)h, Cmax were (51.64±9.59) , (40.83±9.13) ng/mL and AUC0-t were (385.69±65.45) , (394.24±64.68) ng·mL-1·h, and AUC0-∞ was (390.85±66.40), (400.13±65.89) ng·mL-1·h, respectively. The average relative bioavailability of the test preparation was (98.1±9.4)% with levetiracetam AUC0-t. No severe adverse events were observed during the trial. CONCLUSION: The pharmacokinetic parameters of levetiracetam and levetiracetam tablets are not significantly different, and the safety is better in healthy subjects.

    Efficacy of Zhenyuan capsule as adjuvant therapy for chronic heart failure: a Meta-analysis
    WU Changjuan, TANG Tiansheng
    2017, 22(3):  299-304. 
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    AIM: To systematically review the efficacy of Zhenyuan capsule combined with western medicine for chronic heart failure.  METHODS: Databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP, Wanfang were searched to collect randomized controlled trials about Zhenyuan capsule in treating chronic heart failure. Valid data were selected for a Meta-analysis by document screening and quality evaluation. RESULTS: A total 11 RCTs involving 1 006 cases were included. The results of Meta-analysis showed that the combination of Zhenyuan capsule and western medicine were superior in clinical effect[OR=4.35, 95% CI ( 2.97, 6.36), P<0. 000 01], left ventricular ejection fraction[MD=7.89, 95% CI (4.24, 11.54), P<0. 000 1], N-terminal pro brain natriuretic peptide[MD=572.24, 95% CI (427.16, 717.32), P<0. 000 01], cardiac output[MD=0.79, 95% CI (0.61, 0.98), P<0. 000 01], compared with the pure western medicine treatment. CONCLUSION: Current results indicated better clinical efficacy of the combination of Zhenyuan capsule and western medicine in the treating chronic heart failure compared with the pure western medicine treatment. Yet, due to the limited results of the included studies, it still needs to be verified by more researches.

    Therapeutic effect of human umbilical cord-derived mesenchymal stem cells for severe knee osteoarthritis
    YANG Xiaobing, JIANG Feng, ZHANG Fan, SHI Xingfen, LIU Limin, XU Zhiguo
    2017, 22(3):  305-311. 
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    AIM: To explore the therapeutic effect of two methods of knee joint cavity injection in treating sodium hyaluronate and human umbilical cord-derived mesenchymal stem cells for severe knee osteoarthritis by evaluating pain degree, clinical effect, radiological change, and safety.  METHODS: In this semi-blind parallelling study, 44 severe knee osteoarthritis patients were randomly divided into 3 groups. 16 patients in group A were injected with sodium hyaluronate 5 times individually. 15 patients in group B were injected with human umbilical cord-derived mesenchymal stem cells twice. 13 patients in group C were injected with human umbilical cord-derived mesenchymal stem cells 4 times. VAP scores, American Knee Society Knee scores, and Kellgren-Lawrence radiographic evaluation were evaluated. Follow-up were conducted 3, 6 and 12 months after treatment for recording clinical examination, evaluating observed indicators and safety assessment. Laboratory tests and X-ray examination of the knee were checked 6 and 12 months after treatment independently. RESULTS: VAP scores: significant difference were found in three groups before and 3, 6, 12 months after treatment; results showed that there were significant difference in group A 12 months after treatment comparing with group B and group C. AKS scores: significant difference were found in group B and group C before and 3, 6, 12 months after treatment; AKS Function: significant difference were found in group B and group C before and 3, 6, 12 months after treatment; Kellgren-Lawrence radiographic evaluation: no significant difference were found during the study. CONCLUSION: Comparing with sodium hyaluronate injection, the therapeutic effect of human umbilical cord-derived mesenchymal stem cells for severe knee osteoarthritis was more effective in relieving pain and improving joint function. Four times injections are better than two times injection.

    Therapeutic effect of fluorouracil coated with interferon injection combined with liquid nitrogen cryotherapy in the treatment of verruca plantaris and influence on immune function in patients
    WU Miao, LIU Yonglin, CAI Yunya
    2017, 22(3):  312-315. 
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    AIM: To evaluate the clinical efficacy of fluorouracil coated with interferon injection combined with liquid nitrogen cryotherapy in the treatment of verruca plantaris and influence on immune function in patients.  METHODS: 78 cases of verruca plantaris were divided into two groups, each group of 39 cases. In the control group, the liquid nitrogen was used as the control group, and on the basis of the control group, the observation group was given intramuscular interferon. Changes of skin lesions in the two groups were observed. Changes of T lymphocyte levels before and after treatment were compared between the two groups. DLQL method was used to assess the quality of life of patients. RESULTS: The curative effect of the observation group was significantly better than that of the control group. The difference was statistically significant (Z=2.312,P<0.05). CD3, CD4, CD4/CD8 of observation group were significantly increased after treatment (P<0.05). After treatment, the CD3, CD4 and CD4/CD8 in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). After treatment, the skin lesion score and DLQL score of the observation group were significantly lower (P<0.05) than that of the control group. After treatment, the skin lesion score and DLQL score of the observation group were significantly lower than that of the control group. The difference was statistically significant (P<0.05). CONCLUSION: The therapeutic effect of fluorouracil coated with interferon injection combined with liquid nitrogen cryotherapy in the treatment of verruca plantaris is effective, and can significantly improve the immune function of patients.

    Clinical efficacy and safety of chaihu shugan powder in the treatment of post-cholecystectomy syndrome
    WEI Feng,WANG Dayu,WEI Yunhai
    2017, 22(3):  316-320. 
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    AIM: To evaluate the clinical efficacy and safety of chaihu shugan powder combined with danshu capsule and xiaoyan lidan tablet in the treatment of post-cholecystectomy syndrome.  METHODS: Ninety patients with post-cholecystectomy syndrome were divided into control group (45 cases) and treatment group (45 cases) according to random number table method. The control group was given danshu capsule, 2 capsules /time, 3 times/d, and xiaoyan lidan tablet, 6 pills/time, 3 times/d, and the control group was given chaihu shugan powder, 1dose/d, on the basis of control group. After one month therapy, the clinical efficacy, clinical symptoms such as abdominal pain, abdominal distention, anepithymia, nausea and adverse reactions were observed in two groups, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the patient's bad mood. RESULTS:The total effective rate 97.78% (44/45) in treatment group was higher than that of the control group 77.78%(35/45) (P<0.05). The scores of abdominal pain(0.94±0.52),abdominal distension(0.86±0.45),anepithymia(0.73±0.47)and nausea(0.72±0.41)in treatment group were significantly lower than the control group(2.62±0.51),(1.71±0.43),(1.51±0.52) and(1.41±0.45)(P<0.05).The scores of SAS(42.64±7.35)and SDS(32.37±7.09)in treatment group were significantly lower than the control group(50.31±8.62)and (48.41±7.11)(P<0.05). No obvious adverse reactions were found in two groups. CONCLUSION:Chaihu shugan powder combined with danshu capsule and xiaoyan lidan tablet in the treatment of post-cholecystectomy syndrome have better clinical curative effect, can improve clinical symptoms, increase patients' enthusiasm and bad no adverse reactions. It was worthy of clinical popularization and application.

    Clinical effect of paroxetine hydrochloride combined with Danzhi xiaoyao pills in the treatment of depression associated with anxiety
    XU Daoxiang, SHI Huimin, LIN Xiaodong
    2017, 22(3):  321-325. 
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    AIM: To investigate the clinical effect of paroxetine hydrochloride combined with Danzhi xiaoyao pills in the treatment of depression associated with anxiety.  METHODS: Between March 2014 and March 2016, 160 patients with depression and anxiety in our hospital were selected as study subjects, randomly divided into experimental group and control group, each of 80 cases, the experimental group was given Pa Rossi Dean hydrochloride (20 mg/times, 1 times/d, according to the state of the disease gradually increased by 10mg per week to step by step, the therapeutic dose range of 20-60 mg/d) and Danzhi xiaoyao pills (oral, 6-9 g/time, 2 times/d) treatment, 8 weeks of continuous treatment, treatment effect, HAMA score, HAMD score, CGI score and adverse reactions of two groups were compared. RESULTS: The clinical total effective rate of the experimental group was 92.5%, significantly higher than that of 81.2% of the control group, the difference was statistically significant (P<0.05), there was no significant difference in recurrence rate between the two groups (P>0.05); 2 weeks, 4 weeks and 8 weeks after the treatment, HAMA, HAMD scores of the experimental group were significantly lower than the control group, the differences were statistically significant (P<0.05); There was no significant difference between the two groups before treatment (P>0.05), there was significant difference in CGI score 2 weeks, 4 weeks and 8 weeks after treatment (P<0.05); During the 8 week treatment, 24 patients (12.5%) in the experimental group were significantly lower than those in the control group (30%), and the difference was statistically significant (P<0.05), no significant difference was found between nausea, dry mouth, constipation, sweating, fatigue, palpitation, headache and other items (P>0.05). CONCLUSION: Clinical effect of paroxetine hydrochloride combined with Danzhi xiaoyao pills in the treatment of depression associated with anxiety show good tolerance to drugs, which is of high clinical value.

    Application of closed-loop muscle relaxant injection system in upper abdominal laparotomy
    GUO Wenjun, CHEN Guodong, HOU Guiting, JIN Xiaoju
    2017, 22(3):  326-331. 
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    AIM: To study the feasibility of closed-loop muscle relaxant injection system(CLMRIS) in traditional laparotomy.  METHODS: 90 ASA I-II patients undergoing traditional laparotomy under total intravenous anesthesia were randomly divided into three groups: group E(administration by CLMRIS), group C(administration by experience) and group EC (administration combined CLMRIS with experience) using the random number table method. The TOF value at different points, the onset time of muscle relaxant, the time from induction to intubation, induced dosage, intubation condition score, total dosage of muscle relaxant, duration of surgery and anesthesia, recovery time and recovery index, the intraoperative frequency of body movement, extubation agitation score, PACU retention time and the satisfaction scores of anesthesiologist and operation doctor were all detected and recorded. RESULTS: No significant difference was observed between the general situation, operation time, anesthesia time, recovery index, onset time of muscle relaxant and the frequency drug delivery (P>0.05).All groups were able to meet the requirements of muscle relaxation during operation. During induction of anesthesia, intubation time of group E and group EC were longer than group C, but with higher intubation score and smoother intubation process (P<0.05). During the maintenance of anesthesia, group E consumed more vecuronium and demonstrated faster average infusion speed of vecuronium than the other two groups, but presented with fewer body movement (P<0.05). During the anesthesia recovery stage, group E was faster than the other two groups recovering from anesthesia with higher value of TOF and shorter retention time in PACU (P<0.05). CONCLUSION: The CLMRIS can accurately recognize the intubation time and provide better conditions to intubation in the course of anesthesia induction. It can also provide good muscle relaxation condition with less body movement during operation while shorten the recovery time and the time stay in PACU postoperative as well. Therefore, the CLMRIS can be safely and effectively used in patients on upper abdominal open surgery under anesthesia, and muscle relaxation monitoring is referential for clinical application.

    Study on asthmatic children serum cytokine levels and saccharomyces boulardii intervention
    ZHANG Peihong, CHEN Xiaohong, CHEN Bingrong, LI Huajun
    2017, 22(3):  332-336. 
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    AIM: To investigate the serum cytokine levels in children with asthma and saccharomyces boulardii intervention. METHODS: 184 cases of children with asthma were randomly divided with routine treatment (90 cases) and observation group with saccharomyces boulardii intervention (94 cases). Two groups were treated with GINA regimen. The observation group received another saccharomyces boulardii 1.0/ times, 2 times a day orally for 4 weeks. The IL-10, IL-17, IL-5 and IFN-γ in peripheral blood of 3 groups (the third group includes another 80 healthy cases) before treatment and 2 groups (observation group and control group) after treatment were detected by ELISA method. The clinical effect, serum cytokine and lung function were observed. RESULTS: The total effective rate of the observation group (91.49%) was significantly higher than that of the control group (72.22%) (P<0.01). Levels of IL-17 and IL-5 before treatment in two groups were higher than those of the healthy group and Levels of IL-10 and IFN-γ were lower than those in the healthy group. After treatment, levels of IL-17 and IL-5 in two groups decreased (P<0.01 or P<0.05), levels of IL-10 and IFN- γ increased (P<0.01or P<0.05) , but the observation group increased or decreased significantly better than the control group (P<0.01). After treatment, the lung function of the two groups were improved, but the improvement degree of the observation group was significantly higher than that of the control group (P<0.01). CONCLUSION: Levels of IL-10 and IFN- γ in peripheral blood from children with asthma are negatively correlated with the concentrations of IL-17, IL-5. Saccharomyces boulardii can be effective in treating asthma in children, the mechanism may be related to the migration of Thl/Th2 cytokines.

    Investigation and analysis of the off-label drug use in outpatient department of rheumatic immunology
    SHEN Bin,ZHANG Bin,XU Liang,YANG Yanying
    2017, 22(3):  337-341. 
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    AIM: To investigate the application of the off-label drug in rheumatic immunology department so as to provide reference for establishing the standard for evaluation and management.   METHODS: Statistical data of the surrogate prescriptions of rheumatic immunology department in our hospital from April to June in 2016 were collected and were analyzed from the indications, the intended group, the dosage, the frequency, the route of administration and contraindication according to the instructions of the drug. Guideline of evidence-based medicine, relevant literature, clinical guidance and expert consensus were referred to evaluate their rationality.  RESULTS: 3 501 prescriptions from the outpatient clinic of the department of rheumatic immunology were included, 9 889 records involved. According to the prescription and medication record, the incidence rates were 47.50% and 27.69%, respectively. The specific drug use types included over-indication (87.73%), over-dosage (6.54%), over frequencies (5.08%), no usage information for children (0.55%) and usage exceed certain age (0.11%). Hydroxychloroquine sulfate tablets (1 091 records), methotrexate tablets (713 records) and thalidomide tablets (147 records) ranked the top 3 of the over-indications. Guideline of evidence-based medicine, and relevant literature could be selected to support the over-indication, but the quality of evidence remains difference. CONCLUSION: Off-label drug use in rheumatic immunology is common, which on one hand shows the development and information update of drug for rheumatic immune disease lags behind the development of medicine, on the other hand suggests that relevant laws, regulations or guidelines for off-label drug use should be formulate to regulate such behavior so as to protect the safety of patients as well as to avoid physician occupation risk.

    Research progress of TERT promoter mutation in thyroid cancer
    TANG Xinyue, SHI Feng, LI Cuilin, LIU Jianqiu, LI Zhi
    2017, 22(3):  350-354. 
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    Thyroid cancer is a common endocrine malignancy and its morbidity raised rapidly in recent years. The association between TERT promoter mutations (C228T,C250T) and clinical outcomes have been investigated since they were confirmed in thyroid cancer (including differentiated thyroid cancer and anaplastic thyroid cancer) in 2013. Most studies suggest the mutations are associated with thyroid cancer, the clinical outcomes and poor prognosis. The two mutations are considered to be oncogenic mutations. In order to provide a new sight into the research of TERT promoter mutation, diagnosis and treatment of thyroid cancer, we summarized the incidence of TERT promoter mutation in different types of thyroid cancer and the clinical relevance of these mutations.

    Progress of the study of anticancer and anti-inflammatory bioactive compounds of Tripterygium wilfordii
    LIU Wencheng, TAN Buzhen,FANG Yuting, ZHAN Xinlu, WANG Yu
    2017, 22(3):  355-360. 
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    Tripterygium wilfordii (TW) is a Chinese medicine herb which has been used widely and successfully for centuries in treating immunological disorders and inflammatory diseases. Up to now more than 46 diterpenoids, 20 new triterpenoids, 26 alkaloids and other small molecules have been isolated and identified from this plant. The diterpenoid epoxide triptolide, the quinone triterpene celastrol and the triptolide derivative tripchlorolide are amomg the bioactive compounds of TW with potent anti-inflammatory and anticancer effects.This review discusses mechanistic studies into these three bioactive compounds and illustrates their potential clinical use in the treatment of cancer and inflammatory diseases.