Table of Content

Volume 22 Issue 5
26 May 2017

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Preliminary study on mechanism of tricarboxylic acid cycle disruption in diabetic nephropathy cell model

YU Xiaoyi, ZHOU Zhiruo, XIE Yuan, SUN Runbin, FEI Fei, GAO Haoxue, HUANG Jingqiu, A Jiye, WANG Guangji

2017, 22(5):  481-489. 

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AIM: To explore the difference of tricarboxylic acid cycle (TCA) intermediates levels between diabetic nephropathy (DN) model cells and normal HK-2 cells and the metabolic disruption of DN model.  METHODS: HK-2 cells were cultured in vitro and were divided into normal group, glucose group, palmitic acid(PA) group, PA high glucose group. Kidney cell damage was observed by fluorescence microscopy after mitochondrial staining. Metabolic disruption was evaluated by a GC-MS based metabolomics method. Concentration of TCA intermediates was measured by a GC-MS based quantification method. Expressions of relative enzymes were measured by qPCR method. RESULTS:High glucose did not exert as strong an effect on cell damage or metabolic disruption as PA, which caused obvious cell damage or metabolic disruption in a short period. The combined inducement presented the strongest effect. TCA intermediates variation was the main change in PA caused HK-2 cells metabolic disruption. Further, PA could increase the level of citrate and succinate in HK-2 cells. And instead of SDH in model cell, the increase of succinate level was closely related to succinate-CoA ligase. CONCLUSION: Metabolic disruption of TCA induced by PA may be closely related to diabetic nephropathy.

17-DMAG inhibits cell growth and induces apoptosis of nasopharynx cancer cell HNE1

WANG Xiu, LIU Jian, ZHANG Jingjing, ZHU Na, WANG Qingqing, LI Jianchun

2017, 22(5):  490-494. 

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AIM: To explore the effect of 17-DMAG on nasopharynx cancer cell proliferation and apoptosis.  METHODS: Cell viability of HNE1 was detected by MTT assay. Cell apoptosis of HNE1 was evaluated by flow cytometry with propidium iodide staining. JC-1 staining was used to determine the effect of 17-DMAG on mitochondrial membrane potential of HNE1 cells. The expressions of Bcl-2 and Bax were detected by Western blot. RESULTS:17-DMAG inhibited the cell proliferation of HNE1 cells in a dose and time-dependent manner. PI staining revealed that 17-DMAG significantly induced HNE1 cell apoptosis（P<0.01）. JC-1 staining showed that 17-DMAG reduced the mitochondrial membrane potential of HNE1 cells. Western blot experiment showed that the expression of Bcl-2 decreased significantly (P<0.01). The expression of Bax increased significantly, especially in middle and high dose group after HNE1 cells being treated with 17-DMAG for 24 h (P<0.01). CONCLUSION: 17-DMAG inhibits the growth of HNE1 cells in a dose and time-dependent manner by inducing the apoptosis of HNE1 cells. The mechanism is related with reducing the mitochondrial membrane potential and the expression of Bcl-2, and increases the level of Bax.

Preparation and evaluation of inhaled dry powders based on folic acid-conjugated Docetaxel nanoparticles

ZHU Xiaojie, KONG Ying, LIU Qi, LU Yang, ZHAO Di, LI Ning, CHEN Xijing

2017, 22(5):  495-500. 

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AIM: To prepare docetaxel-loaded folic acid-conjugated nanoparticles (NPs-DTX-FA) for the treatment of lung cancer. METHODS: The NPs-DTX-FA were prepared by the solvent evaporation method and the nanoparticles (NPs) were then co-spray dried with excipients to obtain inhaled dry powders. The physiochemical properties of NPs and inhaled dry powders were evaluated. MTT assay was employed to study the cytotoxicity and tumor-targeting property of the NPs. RESULTS:The diameter of LPs-DTX-FA was （100.1±1.0） nm, the IC50 for NPs-DTX and NPs-DTX-FA were （2.09±0.82） μmol/L and （0.80±0.32） μmol/L, respectively. The fine particle fraction (FPF) and angle of repose (θ) of the inhaled dry powders were （21.10±0.18）% and （36.75±0.52）°, respectively. CONCLUSION: The preparation of NPs-DTX-FA based inhaled dry powders was successful and this formulation represented a possibility of clinical application by achieving higher anti-cancer activity in tumor site and lower damage to healthy organs.

Correlation between cerebral blood flow and infarct volume of the middle cerebral artery occlusion in mice

XIE Yuewu, ZHANG Fang, GUO Yan

2017, 22(5):  501-506. 

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AIM: To analyze the correlation between the two evaluation methods of middle cerebral artery occlusion and focal cerebral ischemia so as to explore a novel method and standard for the evaluation of the model.  METHODS: Twenty adult male kunming mice were randomly divided into the model group and the sham-operated group（n=10）.The focal cerebral ischemia reperfusion model was established by thread embolism method, and the changes of cerebral blood flow in each group were detected beforeischemia, the moment of ischemia, two hours after ischemia, immediately and 24 h after reperfusion. The rating system was employed to evaluate neurological function of mice at 24 h after ischemia reperfusion, the brain infract volume percentage was assessed after 2% TTC staining following the last neurological evaluation,and the correlation between the infarct volume and cerebral blood flow ratio was analyzed by correlation analysis. RESULTS:Compared with sham group, the mice in the model group exhibited obvious neurological abnormalities, the TTC staining showed obvious infarction, and the cerebral blood flow of the infarct side was significantly decreased（P<0.05). The correlation coefficient of the cerebral blood flow and the infarct volume at 24 h after reperfusion were 0.55 and 0.28（P<0.05）,respectively. CONCLUSION: There was a high linear correlation between cerebral infarct volume at 24 h reperfusion and cerebral blood flow immediately after ischemia in model group. Cerebral blood flow is a reliable indicator to confirm the establishment of mouse MCAO model besides monitoring theneurological function evaluation and infarct volume.

Effect of sesamin on learning-memory ability and expression of glutamate in hippocampus of rats with Alzheimer's disease

WANG Huan, YANG Jieren, ZHANG Junxiu,YAO Hai, MA Tongjun

2017, 22(5):  507-511. 

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AIM: To study the effect of sesamin on learning-memory ability and expression of glutamate (Glu) in hippocampus of rats with Alzheimer's disease.  METHODS: Forty normal SD rats were selected, ten for blank control group (NS 5.0 mL·kg^-1·d^-1). The rest were induced by intragastric administration of aluminium trichloride (AlCl3, 15 mg·kg^-1·d^-1) combined with intraperitoneal injection of D-galactose (D-gal, 180 mg·kg^-1·d^-1) for 20 weeks. After twelve weeks, rats were subsequently randomized into AD model group (NS 5.0 mL·kg^-1·d^-1), sesamin low dose group（80 mg·kg^-1·d^-1）, sesamin high dose group (160 mg·kg^-1·d^-1) (n=10). After eight consecutive weeks of drug administration, Morris water maze was used to test the learning-memory ability of rats. Immunohistochemical staining was used to determine the expression of Glu protein in hippocampal neurons. Western blot method was used to detect the expression of Glu in hippocampus. RESULTS: Sesamin can reduce the escape latency of AD rat, while increase the platform crossing numbers, improve their learning-memory ability, and reduce the positive cells and protein expression of Glu at the same time. CONCLUSION: Sesamin can reduce the expression of Glu by antagonizing Glu receptor and decrease neural excitatory toxicity, thus improving the learning-memory ability of alzheimer's disease rats.

Curcumin increases MDR1 expression in breast cancer MCF-7 and MCF-7/DOX cells through regulating histone acetylation

LI Xu, Dai Yi, HUANG Jiafeng, WEN Chunjie, ZOU Zhen, Wu Lanxiang, WANG Guo, ZHOU Honghao

2017, 22(5):  512-517. 

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AIM: To study the effect of curcumin on histone acetylation and the expression level of MDR1 (multidrug resistance protein 1) in breast cancer cells MCF-7 and MCF-7/DOX.  METHODS: The effect of curcumin on the growth proliferation and sensitivities of doxorubicin against MCF-7 and MCF-7/DOX cells were evaluated by CCK-8 (Cell Counting Kit-8) assay. Real-time PCR and Western blot assays were used to detect the expression levels of MDR1 in MCF-7 and MCF-7/DOX cells. The acetylation levels of MDR1 promoter region related histone H3, H4 were detected by chromatin immunoprecipitation assay. RESULTS:Curcumin inhibited the growth of MCF-7 and MCF-7/DOX cells with the IC50 values of 22.03 μmol/L and 27.46 μmol/L, respectively. The doxorubicin sensitivity of MCF-7 and MCF-7/DOX cells were significantly increased after the treatment of 10 μmol/L curcumin for 72 h, and the values of IC50 were decreased by 57.14% and 54.52% (P<0.05), respectively. After curcumin treatment, MDR1 mRNA levels were (32.90±0.96) and (5.70±0.55) folds increased in MCF-7 and MCF-7/DOX cells (P<0.05), respectively; MDR1 protein levels were (2.26±0.18) and (2.90±0.21) folds increased in MCF-7 and MCF-7/DOX cells (P<0.05), respectively. The MDR1 promoter region related levels of histone H3 and H4 acetylation in MCF-7 and MCF-7/DOX cells were significantly induced by curcumin (P<0.05). CONCLUSION: Curcumin enhances the doxorubicin sensitivities in MCF-7 and MCF-7/DOX cells. Moreover, it induces the MDR1 expression via increasing the MDR1 promoter region related levels of histone H3 and H4 acetylation.

Establishment of rat model of type 2 diabetes induced by streptozotocin combined with cerebral ischemic reperfusion injury

LIU Chang, JIANG Daoli, LIU Xiaofang, XU Jia, WANG Lijue, WANG Qian, XU Ling, FANG Yi

2017, 22(5):  518-525. 

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AIM: To investigate an optimized rat model establishment of type 2 diabetes mellitus (T2DM) induced by streptozotocin (STZ) combined with cerebral ischemic reperfusion injury (T2DM-MCAO/R) so as to help the study of new drug for acute cerebral ischemia/reperfusion injury subjected to type 2 diabetes mellitus (T2DM).  METHODS: High-fat and high-sugar (HFG) diet for 4 or 5 weeks were administered to induce insulin resistance, and STZ of different doses were injected to induce T2DM model. Models of T2DM-MCAO/R were built through five methods (A, B, C, D, E) with different doses of streptozotocin (STZ). Method A, B and C developed T2DM-MCAO/R injury models by surgery with sutures into brain from CCA; Method D and E, sutures from ECA. Method A administered drugs along with reperfusion; Method B and C injected drugs every day from reperfusion to 72 h; Method D and E, drugs were injected every day for two weeks before surgery. Syndrome, weight and fasting blood glucose (FBG) were assessed in various stages, and neurological behavioral scores were measured after the surgery to assess the quantity and quality of successful models. RESULTS: With method A-E, 80%, 77.8%, 84.6%, 100%, 100% rats were successfully modeled. While 93.3% rats were successfully induced T2DM model by method E with the highest success rate and lowest death rate. Nimodipine and insulin could all improve the fasting blood glucose level, neurological deficits and reduced infarction volume percentage at the same time. CONCLUSION: Rat model of T2DM-MCAO/R injury established by two times injection of low dose STZ and MCAO/R surgery (introduced from ECA) present higher successful modeling rate, lower death rate and better stability. It is referential to investigate the effect and mechanism of new medicine for preventing and treating ischemia/reperfusion injury subjected to T2DM.

Effect of curcumin on the human colon cancer cells SW480

CHEN Yongcai, ZHOU Bin, CHEN Xuemin, WENG Jinyue

2017, 22(5):  526-530. 

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AIM: To study the effect of curcumin on human colon cancer cells SW480.  METHODS: Cell viability and the effects of curcumin on the activity of SW480 cells were detected by MTS method. Expressions of β-catenin and TCF4 were detected by Western blot. E-cadherin and Vimentin by real-time qPCR assay in human colon cancer cells SW480. RESULTS:Curcumin could significantly inhibit the proliferation of SW480 cells and the IC50 were (75.75±3.17) μmol/L（12 h）, (21.15±2.47) μmol/L（24 h）, (18.95±1.75) μmol/L（48 h）, (17.93±1.55) μmol/L（72 h）. Curcumin could up-regulate the expression of E-cadherin, and down-regulate the expression of Vimentin, β-catenin and TCF4 in SW480 cells. CONCLUSION: Curcumin can inhibit the the activity of SW480 cells through the Wnt/β-catenin signaling pathway.

Danzhijiangtang capsule protects vasculopathy of T2DM: an evaluation based on the expression of Wnt/β-catenin

NI Yingqun, XIE Fengtao, FANG Zhaohui

2017, 22(5):  531-537. 

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AIM: To evaluate the protective effect of Danzhijiangtang capsule on vasculopathy of type 2 diabetes mellitus (T2DM) patients by observing the expression of Wnt/β-catenin, GSK-3β, and the change of carotid intima media thickness (IMT) and plaque area. METHODS: One hundred and two T2DM patients were randomly allocated into the control group and the treatment group (n=51). Both groups received conventional therapy (hypoglycemic drugs orally), while the treatment group was given extra Danzhijiangtang capsule. Therapy was conducted for 16 weeks.RESULTS:The total effective rate of the treatment group was significantly better than that of the control group (84.31% vs. 64.71%, P<0.05). Traditional Chinese Medicine (TCM) symptom scores, FPG, 2 hPG, HbA1c, TC, TG, LDL, HDL, carotid intima media thickness and plaque area were improved in both groups. Compared with the control group, TCM scores, 2 hPG, HbA1, TG and LDL decreased significantly (P<0.05  or P<0.01) in the treatment group, which also presented better improvement of IMT (P<0.05) though the comparison of plague area exhibited no significant difference (P＞0.05); The expressions of Wnt/β-catenin and GSK-3β also decreased significantly in the treatment group (P<0.05). CONCLUSION: Danzhijiangtang capsule can alleviate the clinical symptoms of T2DM, and can improve or even reverse carotid atherosclerosis to a certain extent.

Association study of NOS3 genetic polymorphism and the efficacy of anti-hypertensive drug treatment on patient with essential hypertension

JIN Yuelong, WANG Linhong, ZHU Lijun, LIANG Wei, DUAN Ying, YANG Song, CHEN Yanchun, ZHAO Xianghai, SHEN Chong, YAO Yingshui

2017, 22(5):  538-544. 

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AIM: To evaluate the effect of NOS3 gene polymorphism on anti-hypertensive drug treatment for patient with essential hypertension (EH). METHODS: General information and Clinical biochemical indicators of EH patients taking compound reserpine, hypertension pill and Zhenju hypertension pill were collected. RELP-PCR was used to test the polymorphism of NOS3 gene (rs4496877, rs1808593 and rs3918186).A quantitative trait analysis was performed to evaluate the relation between NOS3 genetic variation and blood pressure taking different anti-hypertensive drugs. RESULTS: Quantitative trait analysis showed significant differences in diastolic blood pressure (DBP) among the genotypes (TT,TG and GG) of rs1808593 in patients taking the hypertension pill after adjusting covariants (P=0.035). Stratification analysis indicated that DBP of male patients taking the hypertension pill significantly decreased with the variation (T＞G) of rs1808593 (P=0.046). For patients (age≥55) taking the hypertension pill, DBP of genotype TT was significantly higher than genotypes TG and GG of rs1808593(P=0.008). CONCLUSION: NOS3 gene rs1808593 mutation might relate to the anti-hypertensive effect of the hypertension pill.

Pharmacokinetics of cryptotanshinone and its metabolites between traditional decoction piece and ultrafine granular powder of salvia miltiorrhiza

ZHENG Lingjie, DENG Wen, XING Lu, ZHANG Wei, TAN Zhirong, ZHOU Honghao, CHENG Jinle

2017, 22(5):  545-550. 

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AIM: To study the pharmacokinetics and bioequivalence of cryptotanshinone and its metabolites tanshinone IIA between traditional decoction piece and ultrafine granular powder of salvia miltiorrhiza.  METHODS: Twenty-four healthy volunteers, half male and half female were orally administrated with a single dose of subject drug (ultrafine granular powder of salvia miltiorrhiza) and reference drug (traditional decoction piece of salvia miltiorrhiza). Plasma concentrations of cryptotanshinone and tanshinone IIA were determined by a validated LC-MS method. Collected data were calculated and analyzed by DAS Ver3.2.2 and SPSS software. After logarithmic transformation of AUC _0-60 and C _max, one-sided t-test was performed and 90% confidence interval was calculated. RESULTS: The main pharmacokinetics parameters of cryptotanshinone and tanshinone IIA in subject drug and reference drug including T _max, C _max, AUC _0-60 and t _1/2 exhibited no significant difference (P>0.05) between different periods and different genders, while significant difference was observed between different preparations (P<0.05). The relative bioavailability of subject drug and reference drug were as follow:（4 456.8±3 706.8）%，(4 690.3±3 416.7) %. CONCLUSION: The bioavailability of cryptotanshinone and tanshinone IIA in ultrafine granular powder is significantly higher than traditional decoction piece, which is referential for reducing dosage in clinical application.

Expression of CD73 in breast cancer and the correlation with its clinicopathological features

YU Kun, NI Chao, SONG Xiangyang, YUAN Hongjun, SUN Kewang

2017, 22(5):  551-555. 

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AIM: To investigate the expression of CD73 in breast cancer and the correlation with its clinicopathological features.  METHODS: Biopsy of the tumor tissue specimens from 100 cases of breast cancer from April 2015 to October 2016 were included; Paraffin sections were obtained from 60 normal breast tissues; CD73 staining was used to detect the sections by immunohistochemistry; Immunohistochemical method was used to detect the expression of Ki-67, P53, ER, PR and HER-2 in breast tissues. The expression of CD73 and its correlation with Ki-67, P53, ER, PR and HER-2 as well as correlation with clinicopathological features were analyzed. RESULTS:The high expression occurrence rate of CD73 in breast cancer tissues was 76%, while in normal breast tissue was 21.7% (P<0.05);There was no significant correlation between CD73 expression and age, histological grade, tumor size and tumor location (P>0.05);The high expression of CD73 was correlated with TNM stage, lymph node metastasis, PR positive expression, ER positive expression, HER-2 positive expression, Ki-67 positive expression and P53 positive expression (P<0.05);The positive expression of Ki-67, P53, PR and HER-2 was the influencing factor of the high expression of CD73(OR:8.233,5.091,4.670,3.000); The positive expression of ER was a protective factor of high expression of CD73 (OR: 0.291). CONCLUSION: The high expression of CD73 in breast cancer and TNM staging, lymph node metastasis, the positive expression of PR, HER-2, Ki-67 and P53 are referential for clinical treatment and prognosis.

Efficacy and safety of vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis

YU Huajun, HUANG Kai, ZHANG Zhan, GUO Qiaofeng, ZHANG Xiaowen, ZHANG Chun

2017, 22(5):  556-559. 

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AIM: To evaluate the efficacy and safety of vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis. METHODS: Severty-four cases of traumatic osteomyelitis were randomly divided into control group and treatment group (37 cases each).The control group was given hydrochloric acid (0.8 g/d) for 3 days (2 times a day) before surgery.Selection of calcium sulfate bone graft substitute (5-10 g) and hydrochloric acid (1 g) were added to make paste. Hydrochloric acid (0.8 g/d) was given after the operation.The treatment group received ultra-short wave therapy after operation and all patients were treated for 28 days.The clinical effects, hemorheology index,the serum C- reactive protein (CRP), serum tumor necrosis factor (TNF-α),nuclear factor kappa B (NF-κB),and adverse reactions were compared between the two groups. RESULTS: After treatment, the total effective rate in the control group was (78.38%),which was significantly lower than that in the experimental group (97.30%) (P<0.05). After treatment, the erythrocyte aggregation index of the experimental group was higher than that of the control group (P<0.05).Plasma viscosity, whole blood viscosity and ESR level were lower than the control group(P<0.05).Levels of serum CRP,TNF-α and NF-κB in the experimental group were significantly lower than those in the control group (P<0.05).Levels of serum CRP,TNF-α and NF-κB were significantly lower than control group (P<0.05).The adverse reaction rate of control group was 13.51%,the treatment group was 8.11%,and the difference was not statistically significant (P> 0.05). CONCLUSION: Vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis is effective and safe.

Effect of glucosamine sulfate combined with Shenmai injection on knee osteoarthritis

MAO Hongxia, JIN Lingqing, LIU Shuangchun

2017, 22(5):  560-564. 

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AIM: To investigate the effect of glucosamine sulfate combined with Shenmai injection on knee osteoarthritis.  METHODS: One hundred and twenty patients with knee osteoarthritis were randomly divided into combined group and control group, 60 cases in each. The control group was treated with glucosamine sulfate only, while the combined group was given glucosamine sulfate (0.5 g per time, 3 times per day) plus Shenmai injection (5 mL per knee, 1 time per week). Both groups were treated for 6 weeks, and the clinical efficacy of the two groups was observed. RESULTS: The total effective rate of combined group (91.67%) was significantly higher than that of the control (78.33%) (P<0.05). After treatment, the improvement of The Western Ontario and McMaster Universities Arthritis Index (WOMAC) in the combined group was significantly higher than that in the control group (P<0.05). No significant difference was observed with respect to the incidence of adverse reactions between the two groups (P>0.05). Levels of serum IL-17 and IL-18 in both groups were significantly decreased, yet the combined group exhibited more significant decrease than the control group (P<0.05). Levels of TGF-β, IGF-1 and FGF-2 were significantly increased, yet the combined group exhibited more significant increase than the control group (P<0.05). CONCLUSION: Glucosamine sulfate combined with Shenmai injection demonstrate better effect on knee osteoarthritis with low incidence of adverse reactions. Its mechanism may be related to the decrease of serum levels of IL-17, IL-18 levels and the increase of TGF-β, IGF-1 and FGF-2 concentrations.

Chemotherapy compliance of patients with digestive system cancer and its influencing factors

LI Xiu, JI Zhaoning

2017, 22(5):  565-569. 

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AIM: To investigate the relationship between the chemotherapy compliance and general status, symptoms of chemotherapy, emotional experience and resilience of patients with digestive system cancer.  METHODS: The Connor-Davidson Resilience Scale (CD-RISC), MD Anderson Symptom Inventory (MDASI) and chemotherapy compliance questionnaire were used to assess the 165 digestive system cancer patients. RESULTS:The score of chemotherapy compliance was (15±7) points, which was influenced by such factors as age of patients, mode of payment and participation in exercise (P<0.05). Score of chemotherapy compliance was significantly positively correlated with score of MDASI (r＝0.812), while significantly negatively correlated with CD-RISC (r＝-0.177). The scores of CD-RISC and MDASI as well as two factors of MDASI were applied to the multiple regression equation. CONCLUSION:Patient's symptoms during chemotherapy, emotional experience and resilience are important factors influencing chemotherapy compliance. Medical staff and relevant departments are required to take effective measures to improve the chemotherapy compliance of patients.

Application of serum B type natriuretic peptide precursor and blood pressure variability in patients with non-cardiogenic ischemic stroke

CHEN Tao, YAN Yongxing, SHEN Yonghui

2017, 22(5):  570-573. 

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AIM: To discuss the application of serum B type natriuretic peptide precursor and blood pressure variability in patients with non-cardiogenic ischemic stroke. METHODS:Eighty-six patients with non cardiogenic acute cerebral infarction were selected as the case group, and 40 healthy volunteers were selected as control group. The serum levels of pro-BNP and blood pressure variability were compared between the two groups. RESULTS:The level of serum pro-BNP in the case group was (984.63±148.67) ng/L, which was significantly higher than that of the control group（138.44±30.75）ng/L (P<0.01). The 24 h systolic pressure variation coefficient (24 h SBPCV), 24 h diastolic pressure variation coefficient(24 h DBPCV), 24 h systolic pressure standard deviation(24 h SBPSD), 24 h diastolic pressure standard deviation(24 h DBPSD) and comparison of blood pressure variability coefficients independent of mean(VIM) between the two groups were statistically significant (P<0.01). Serum pro-BNP was positively correlated with 24 h SBPCV, 24 h DBPCV, 24 h SBPSD, 24 h DBPSD. The serum pro-BNP level in the death group was （1 326.36±156.85）ng/L, which was significantly higher than that of the survival group （910.28±118.47）ng/L (P<0.01). The difference of 24 h SBPCV, 24 h DBPCV, 24 h SBPSD, 24 h DBPSD,VIM between the two groups was statistically significant (P<0.05). CONCLUSION:The level of serum pro-BNP and the variation of blood pressure are closely related to the prognosis of patients with non- cardiogenic acute cerebral infarction.

Effect of Xuesaitong soft capsule on acute lacunar cerebral infarction combined with cerebral microbleeds

WANG Meihua, WENG Qiuyan, ZHA Qin, NIU Yanfang

2017, 22(5):  574-579. 

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AIM: To evaluate the clinical efficacy of Xuesaitong soft capsule in the treatment of acute lacunar cerebral infarction combined with cerebral microbleeds and its influence on S100B and soluble receptor for advanced glycation end products (sRAGE) in serum.  METHODS: Eighty-six patients with acute lacunar cerebral infarction and cerebral microbleeds were randomly divided into control group and treatment group, 43 cases in each group. Control group received basic treatment. Treatment group were treated with Xuesaitong soft capsule additionally for a course of 8 weeks. Clinical efficacy, scores of CSS, NIHSS and MRS, levels of S100B and sRAGE in serum and adverse reactions were compared between the two groups. RESULTS:The effective rate in treatment group was 90.70%, significantly higher than 74.42% in control group (P<0.05). After treatment, scores of CSS and NIHSS in treatment group were significantly lower than those in control group (P<0.01). The level of S100B in serum in treatment group was significantly lower than that in control group (P<0.05), and the level of sRAGE in serum in treatment group was significantly higher than that in control group (P<0.05). During treatment, no significant adverse reactions were exhibited. CONCLUSION: Xuesaitong soft capsule has obvious curative effect on acute lacunar cerebral infarction combined with cerebral microbleeds, which is referential for clinical application.

Application of dexmedetomidine in elderly patients during ESD operation

DENG Yingfeng

2017, 22(5):  580-583. 

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AIM: To investigate the effects of dexmedetomidine in elderly patients with endoscopic submucosal dissection (endoscopic submucosal dissection, ESD) used in operation.  METHODS:Sixty elderly patients who underwent ESD operation in our hospital were divided into study group and control group, each group included 30 cases. The study group was given 0.5 μg/kg infusion of dexmedetomidine. The control group was given the same amount of saline. During operation, two groups weregiven continuous infusion of propofol. The operation time, anesthesia time, recovery time, propofol dosage were compared between the two groups. Post-operative cognitive function(POCD) was assessed by mini mental state examination (MMSE) before and 6 hours after operation, on the postoperative day 1 and day 3 after operation, and the incidence of POCD was assessed. RESULTS:Comparison of operation time, anesthesia time in two groups. The difference was not statistically significant (P>0.05). The recovery time and propofol dosage in the study group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). Postoperative 6 hours, postoperative day 1, postoperative day 3, the observation group MMSE score was significantly higher than that of the control group. The difference was statistically significant (P<0.05). Postoperative 6 hours, postoperative day 1, postoperative day 3, the study group POCD was significantly lighter than that of the control group. The difference was statistically significant (P<0.05). The incidence of adverse reactions in the study group (6.67%) was significantly lower than that in the control group (30%). The difference was statistically significant (P<0.05). CONCLUSION: Dexmedetomidine has a protective effect on cognitive function in elderly patients after ESD surgery.

Application of tranexamic acid combined with acute normovolemic hemodilution in off-pump coronary artery bypass grafting

LI Yan, ZHANG Song, ZHOU Ying, QI Yong, GUO Jianrong

2017, 22(5):  584-588. 

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AIM: To investigate the effect of tranexamic acid plus acute normovolemic hemodilution (ANH) in off-pump coronary artery bypass grafting (OPCABG) patients.  METHODS: Sixty ASA physical status II-III patients，aged 45-70 years，with body mass index of 20-23 kg/m², scheduled for elective undergoing OPCABG were randomly divided into 3 groups (n=20): control group (group C), tranexamic acid group ( group T), tranexamic acid combined with ANH group (group T+A). Group C received no treatment. After induction of anesthesia, tranexamic acid 20 mg/kg was intravenously infused in 30 min followed by continuous infusion at 10 mg·kg^-1·h^-1 until the end of operation in group T. Tranexamic acid was intravenously infused combined with ANH in group T+A. Coagulation parameters such as Hb, Hct, Plt, PT, INR and D-dimer were recorded before operation, after operation and 24 h after operation, respectively. The volume of chest tube drainage was collected and recorded at 6 h and 24 h after operation. The transfusion of allogeneic red blood cells and fresh frozen plasma within 24 h were also recorded. RESULTS:Compared with group C, the D-dimmer level decreased significantly in group T and group T+A right after the operation and 24 h after the operation, and the volume of chest tube drainage as well as the requirement for transfusion of allogeneic red blood cells were reduced (P<0.05). No significant changes were found in Hb, Hct, Plt and INR at each time point between all groups (P>0.05). Compared with group T, the volume of chest tube drainage and the requirement for transfusion of allogeneic red blood cells were reduced (P<0.05) in group T+A. No development of death and complications during days of hospitalization was observed in the three groups. CONCLUSION: Tranexamic acid combined with ANH exhibit a synergistic effect of blood-saving and has no significant effect on coagulation function of patients undergoing OPCABG surgery.

Effects of splicing factor SRp40 on the expression of GRα/β mRNA and on glucocorticoid therapy for nephrotic syndrome

ZHANG Jun, XIE Yanyun, LI Zhi, TAO Lijian

2017, 22(5):  589-593. 

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AIM: To determine the expression of glucocorticoid (GC) receptor GRα/GRβ and splicing factor SRp40 in peripheral blood mono-nuclear cells (PBMC) of nephrotic syndrome (NS) patients so as to investigate the regulating effect of splicing factor on GC and differential expression of GC receptor on GC therapy. METHODS: Twenty healthy volunteers and 46 NS patients were included. The NS patients were divided into GC-sensitive (n=24) and GC-resistant group (n=22) according to the response to GC therapy. Quantitative Real-time PCR was performed to investigate the mRNA expression of GRα/GRβ and SRp40 in healthy volunteers and NS patients before and after glucocorticoid treatment. The expression level of GRα/GRβ and SRp40 mRNA were compared between groups and analyzed to assess the relevance of GC receptor and slicing factor and their effect on clinical outcomes. RESULTS: The expression of GRα and GRβ mRNA were detected both in control and NS patients with the GRα as the domination sub-type, and no significant difference was observed between GC-sensitive and GC-resistant group. While the expression of SRp40 mRNA on PBMC in GC-resistant group was significantly higher than that in GC-sensitive group and in health control (P=0.035). The expression level of GR  in GC-resistant group was significantly increased after GC treatment （P<0.001）, but no significant difference of the GRα mRNA expression was observed between NS groups.  And the expression of GRβ mRNA level was found positively associated with SRp40 level through linear regression method. CONCLUSION:The over expression of SRp40 can induce the over expression of GRβ mRNA through modulating alternative splicing, which may be a risk factor in the resistance of GC in NS patients. And levels of GRβ and SRp40 mRNA may be predictors for GC resistance in NS patients.

Research progress of traditional Chinese medicine for the invasion and metastasis of hepatocellular carcinoma

ZHANG Ying, ZHOU Yuanfeng, HU Min

2017, 22(5):  594-600. 

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Hepatocellular carcinoma (HCC) is a common cancer worldwide. Its morbidity and mortality remain significantly high. HCC invasion and metastasis are key factors affecting the efficacy of therapy to patients; they also are the indicators to evaluate the prognosis and survival of patients. Therefore, finding ways to repress HCC invasion and metastasis is a popular area of research. In this article, we introduce how traditional Chinese medicine comprehends the progress of HCC invasion/ metastasis in the aspects of: theory investigation, experimental study, and clinical study, and provide the summary of research progress of traditional Chinese medicine for the invasion and metastasis of hepatocellular carcinoma.