Table of Content

Volume 23 Issue 11
26 November 2018

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Effects of ambroxol hydrochloride on pulmonary fibrosis in rats and its effect on TGF-β/Smad/ERK signal transduction pathway and Th17/Treg cell imbalance

MA Yuandong, HUANG Zuwei, AN Pei, XIE Xiaofei, LIU Xiaocai, MAO Lingzhe

2018, 23(11):  1201-1208.  doi:10.12092/j.issn.1009-2501.2018.11.001

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AIM: To study the effect of ambroxol hydrochloride on pulmonary fibrosis in rats and its effect on TGF-β/Smad/ERK signal transduction pathway and the imbalance of Th17/Treg cells. METHODS: Thirty male SPF-level Wistar male rats were selected from the Experimental Animal Center of our hospital and were randomly divided into five groups: normal group (10), model group (10), ambroxol low-dose group (10), ambroxol middle-dose(10) and ambroxol high-dose (10) goups. Pulmonary fibrosis model was prepared with 0.2 mL intratracheal perfusion of bleomycin (5 mg/kg). Rats in the low, medium and high dose groups were intraperitoneally injected with 10, 20, 40 mg/kg ambroxol hydrochloride from the first day after operation. Rats in the normal group and the model group were intraperitoneally injected with 3.33 mL/kg normal saline for 14 days. HE staining and Masson staining were performed to observe pathological changes. ELISA was applied to detect TGF-β1. The expression of TFG-β1 in fibroblasts was detected by real-time fluorescent quantitative PCR. The expressions of ERK1/2, p-ERK, Smad3, Smad4 and Smad7 in fibroblasts were detected by Western blot. The expressions of Treg and Th17 cells in the lung tissue of each group were detected by flow cytometry. RESULTS: Compared with normal group, content of TGF-β1 in the fibroblasts, expression of TGF-β1 gene in fibroblasts, expression of ERK1/2, p-ERK, Smad3 and Smad4 protein, and Th17 and Th17/Treg in the lung tissue of the model group were higher than those in the normal group (P<0.05), and those of the middle and high doses of ambroxol were lower than the model group (P<0.05). While the expression of Smad7 protein and Treg cell in the lung tissue in the model group was significantly higher than that in the normal group (P<0.05), and those of the middle and high doses of ambroxol were higher than the model group (P<0.05). CONCLUSION: Ambroxol hydrochloride has anti-pulmonary fibrosis effect by maintaining the balance of Th17/Treg in lung tissue of rats with pulmonary fibrosis and inhibiting the signal transduction of the major cytokines in the TGF-β/Smad/ERK signal transduction pathway in rats.

Protective effects of manganese superoxide dismutase mimic on liver injury in mice induced by carbon tetrachloride

WANG Yanhong, FENG Tiexin, PU Junfeng, ZHANG Lingfang, LI Hongling

2018, 23(11):  1209-1214.  doi:10.12092/j.issn.1009-2501.2018.11.002

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AIM: To investigate the effects of manganese superoxide dismutase mimic (MnSODm) on liver function and liver histological morphology in mice and to probe into its underlying mechanism. METHODS: Sixty mice were randomized into normal group, model group, bifendate group (50 mg/kg) and different doses of MnSODm (10, 20 and 40 mg/kg) group. Liver injury was induced by carbon tetrachloride (CCl₄) in mice. The serum and liver activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined. Liver tissue sections were examined under a light microscope. The activities of superoxide dismutase (SOD) and catcalase (CAT) and the level of glutathione (GSH) in liver homogenate were also detected. The contents of IL-1β, IFN-γ in liver homogenate were measured by ELISA. RESULTS: In the model of acute liver injury induced by CCl₄ in mice, MnSODm markedly decreased the elevated serum and liver activities of ALT and AST. MnSODm effectively improved the tissue lesion of liver. In addition, MnSODm significantly increased SOD activity and GSH level (P<0.05 or P<0.01), and decreased activity of CAT and content of IL-1β, IFN-γ in liver (P<0.05 or P<0.01). CONCLUSION: The MnSODm has protective effect on acute liver injury induced by CCl4 in mice. The mechanism may be related to inhibition of oxidative stress and inflammatory reaction.

MiR-145 regulating SOD activity mediated brain protection of ginsenosides Rb1 in rats with cerebral ischemia-reperfusion injury

XU Hui，ZHANG Minyuan, DAI Qinxue

2018, 23(11):  1215-1220.  doi:10.12092/j.issn.1009-2501.2018.11.003

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AIM: To explore whether ginsenosides Rb1 can increase the activity of SOD in the brain tissue of rats with cerebral ischemia reperfusion injury by reducing the miR-145 content, and play the role of brain protection. METHODS: Sixty SD rats were randomly divided into five groups: model group, normal saline control group, ginsenosides Rb1 group, ginsenosides Rb1+miRNA-145 mimics group and ginsenosides Rb1+miRNA-145 mimics NC group, 12 rats in each group. The rats' cerebral ischemia reperfusion injury models were established by thread embolism method to form middle cerebral artery occlusion (MCAO). After modeling, the rats in ginsenosides Rb1 and saline control group were given ginsenosides Rb1 and normal saline respectively. Two days before modeling, the rats in ginsenosides Rb1+miRNA-145mimics and ginsenosides Rb1+miRNA-145 mimics NC group received miRNA-145 mimics and miRNA-145 mimics NC through lateral ventricle, and other operations were same to ginsenosides Rb1 group. Twenty-four hours after cerebral ischemia reperfusion injury, the cerebral tissues were taken and the volume of cerebral infarction was measured in 6 rats in each group. The cerebral cortex was taken from another 6 rats in each group after execution to detect the contents of miR-145 and superoxide dismutase (SOD). RESULTS: Compared with model group, the rats' behavior score was lowered obviously（P＜0.05）, the infarct volume was markedly decreased（P＜0.05）,the content of miR-145 was remarkably decreased （P＜0.05）, and the content of SOD was significantly increased（P＜0.05）in the ginsenosides Rb1 group. Compared with ginsenosides Rb1 group, the rats' behavior score was obviously increased （P＜0.05）, the volume of cerebral infarction was markedly increased（P＜0.05）, the content of miR-145 was obviously increased (P＜0.05), and the content of SOD was significantly decreased (P＜0.05) in ginsenosides Rb1+miRNA-145 mimics group. CONCLUSION: Ginsenosides Rb1 can increase the activity of SOD in the brain tissue of rats with cerebral ischemia reperfusion injury by reducing the miRNA-145 content, and protect the brain.

Effects of sesamin combined with vitamin E on the cardiomyocyte apoptosis of spontaneously hypertensive rats

HAO Wei, SHEN Yuanyuan, ZHANG Junxiu, YANG Jieren

2018, 23(11):  1221-1227.  doi:10.12092/j.issn.1009-2501.2018.11.004

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AIM: To observe the inhibitory effect and mechanism of sesamin (Ses) combined with vitamin E (Vit E) on the cardiomyocyte apoptosis of spontaneously hypertensive rats (SHR). METHODS: Thirty-two spontaneously hypertensive rats (SHR) were randomly divided into SHR group, Ses combined with Vit E group (160 mg·kg^-1·d^-1+ 10 mg·kg^-1·d^-1), Vit E group (10 mg·kg^-1·d^-1), Ses group (160 mg·kg^-1·d^-1), 8 in each group. Another 8 Wistar-Kyoto rats were included as control group (0.5% CMC-Na 5 mL/kg). The animals were in tragastrically administrated with Vit E, sesamin and CMC-Na once a day for consecutive 10 weeks. After 10 weeks, the cardiomyocyte apoptosis was detected by TUNEL assay; The expression of Bax, Bcl-2 protein was detected with immunohistochemistry staining; The expression of Bax, Bcl-2, PUMA protein and the phosphorylation of p53 was detected by Western blot. RESULTS: The combination of sesamin with vitamin E significantly reduced the cardiomyocytes apoptosis rate of SHR, down-regulated the expression of Bax, Bcl-2, PUMA protein and the phosphorylation of p53, up-regulated the ratio of Bcl-2/Bax (P<0.01). CONCLUSION: Sesamin combined with vitamin E can synergistically inhibit the cardiomyocytes apoptosis of SHR, of which the potential mechanism may be related to the downregulation of PUMA protein expression and p53 phosphorylation, the regulation of the ratio of Bcl-2/Bax, and the regulation of the balance between Bax and Bcl-2 protein expression.

SRPX2 promotes HUVEC angiogenesis via macrophages

LI Nanshan, LIU Kuiliang, LI Qian, LAO Yueqiong, WANG Yadan, SU Hui, LIU Hong, WU Jing

2018, 23(11):  1228-1234.  doi:10.12092/j.issn.1009-2501.2018.11.005

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AIM: To investigate whether sushi repeat-containing protein X-linked 2 (SRPX2) can influence angiogenesis via macrophages, and its potential mechanism. METHODS: After transferring shRNA-SRPX2 and vacant shRNA vector into HCT116 cells, culture medium supernatant was extracted from three types of cells (HCT116-KD, HCT116-NC and HCT116-BC) as the conditioned medium. After culturing THP-1 induced macrophages in the conditioned medium, the macrophages were co-cultured with HUVECs for Transwell migration assay and Matrigel tube formation assay to verify the migration ability and tube formation ability of HUVECs. In addition, focal adhesion kinase (FAK) and phosphorylated FAK expression level in macrophages were measured by Western blot after activated by SRPX2 recombinant protein for 4 h. RESULTS:In migration assay, the number of HUVECs migrating to the lower chamber was significantly diminished in HCT116-KD group（P<0.01）. In tube formation assay, numbers of junctions, meshes and nodes also decreased in the HCT116-KD group（P<0.05）. As for the FAK expression, the expression of FAK as well as the phosphorylated level of FAK in macrophages elevated after interacted with SRPX2 recombination protein.CONCLUSION: SRPX2 can affect angiogenesis via macrophages, which is probably depends on FAK related signal pathways.

Analgesic effect and mechanism of the active component of cobras venom in southern Anhui province

YU Ling，ZHANG Genbao，SUN Shuping

2018, 23(11):  1235-1239.  doi:10.12092/j.issn.1009-2501.2018.11.006

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AIM: To explore the effect of topical analgesia of cobra venom analgesic factor (CVAF) in southern Anhui province and its possible mechanism. METHODS: Male SD rats were divided into normal saline control group (NS group), complete Freund's adjuvant pain group (CFA group), diclofenac sodium analgesic positive control group (CFA+SL group), flurbiprofen analgesic positive control group (CFA+FB group), CVAF analgesia group (CFA+CVAF group). The analgesic effect of CVAF gel, the active component of cobra venom was observed and compared. The pain thresholds of rats in each group were measured with a thermal tingling tester and mechanical tenderness tester. The content of IL-1 and TNF-α in the homogenate of spinal cord in each group was detected by using ELISA, the pathological changes of rat toe tissue was observed by using HE staining.RESULTS:Compared with CFA group, the weight loss of CVAF analgesia rats on the 7th and 14th day after administration was improved (P<0.05, P<0.01). The mechanical pain threshold and the thermal pain threshold of the CVAF group were all improved (P<0.01). The concentrations of IL-1 and TNF-α in the homogenate of spinal cord were relatively low (P<0.01). In HE staining, the toe tissue edema in the CVAF group was significantly reduced, and the inflammatory infiltration was relatively insignificant. CONCLUSION: The CVAF gel, the active ingredient of Cobra venom in southern Anhui province, can improve the inflammatory pain in rats hot pain threshold and mechanical pressure threshold; its mechanism may be related to reduce the release of inflammatory mediators, inhibiting the inflammatory response.

Preparation of piperine liposomes and its antitumor activity of gastric cancer cells in vitro

GUO Li, HAN Chenyang

2018, 23(11):  1240-1245.  doi:10.12092/j.issn.1009-2501.2018.11.007

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AIM: To study the preparation method of piperine liposomes and the mechanism on anti-tumor activity of gastric cancer cells in vitro.  METHODS: Piperine liposomes were prepared by freezing and thawing method. The morphology of liposomes was observed by transmission electron microscopy (TEM). Particle size analyzer and Zeta potential analyzer were used to analyze the particle size and Zeta potential of piperine liposomes, and to investigate the stability of liposomes and the special release of drug in vitro. Human gastric cancer cell MKN45 cells were cultured in vitro and divided into normal group, control group and experimental group. The control group was treated with 50 μmol/L piperine, the experimental group was treated with the liposomes of piperine, the cell viability was detected by CCK-8, the level of apoptosis was detected by flow cytometry, the expression level of apoptosis related protein Bcl-2, Bax, Caspase-3, Caspase-9 was detected by protein immunoblotting, and Hoechst 33342 staining was used to observe the details. RESULTS: The morphology of piperine liposomes was spheroid, the average particle size was （92.32+2.10）nm, and the Zeta potential was（-49.8+3.5）mV. The release rate of piperine liposomes was significantly higher than that of piperine raw material in vitro. The results of cell test showed that the cell viability of the control group and the experimental group was significantly lower than that in the normal group in time dependent manner (P<0.05), the experimental group had statistical significance compared with the control group (P<0.05). The apoptosis rate of the control group and the experimental group was higher than that of the normal group, but the experimental group was significantly higher than that of the control group (P<0.05). The levels of Bcl-2 in the control group and the experimental group were significantly decreased, while the expressions of Bax, Caspase-3 and Caspase-9 were significantly increased. Compared with the normal group, it was statistically significant (P<0.05). CONCLUSION: The release rate of piperine liposomes is higher than that of the drug, which shows that liposomes increase the solubility of piperine, and the ability of piperine liposome to induce MKN45 apoptosis in vitro is higher than that of the drug.

Expression of long-chain non-coding RNA FOXN3-AS2 in hepatocellular carcinoma and its effect on proliferation and invasion of hepatoma cells

CAI Min, XU Liu, SHEN Lan, ZHANG Jie

2018, 23(11):  1246-1251.  doi:10.12092/j.issn.1009-2501.2018.11.008

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AIM: To observe the expression levels of FOXN3-AS2 in hepatocellular tissues and cells, and its effect on proliferation and invasion of hepatoma cells. METHODS: The expression levels of FOXN3-AS2 in 12 hepatocellular carcinoma tissues and 5 hepatocellular carcinoma cell lines were detected by real-time quantitative PCR (qRT-PCR). Transfection of plasmid in the hepatocellular carcinoma cell line with the lowest expression level of FOXN3-AS2 was used to increase the expression of FOXN3-AS2. The cell counting kit (CCK-8) and Transwell invasion assay were used to detect the effect of overexpressed FOXN3-AS2 on proliferation and invasion of hepatoma cells. Bioinformatics was used to predict the miRNA that FOXN3-AS2 could complement and related genes, qRT-PCR detected the expression levels of miRNA and related gene mRNA, and Western blot was used to detect the expression level of related proteins. RESULTS: The expression level of FOXN3-AS2 in hepatocellular carcinoma tissues was significantly lower than that in adjacent tissues (P<0.01). The expression level of FOXN3-AS2 in hepatocellular carcinoma cell lines was significantly lower than that in human normal liver cells (P<0.05). FOXN3-AS2 has the lowest expression level in HepG2 cells (P<0.01). High expression of FOXN3-AS2 significantly inhibited the proliferation activity (P<0.05) and invasive ability (P<0.05). FOXN3-AS2 could complement the miR-34a-5p, and miR-34a-5p can complement the KLF4 gene. FOXN3-AS2 can complementarily pair with miR-34a-5p, and miR-34a-5p can complementarily pair with KLF4. High expression of FOXN3-AS2 decreased the expression of miR-34a-5p (P<0.01) and increased the expression of KLF4 mRNA (P<0.01). The expression of KLF4, β-catenin and E-cadherin proteins were increased, while the expression of CDK4 and Cyclin D1 proteins were decreased. CONCLUSION: The expression of FOXN3-AS2 is down-regulated in HCC tissues and cells. The high expression of FOXN3-AS2 can inhibit the proliferation and invasion of HepG2 cells. The mechanism may be related with regulating the expression of miR-34a-5p and KLF4 genes.

Population pharmacokinetics of vancomycin in post-operative neurosurgical patients

DING Zhirong, CAI Xiaozhen, ZENG Haiwen, LIN Tianlai

2018, 23(11):  1252-1257.  doi:10.12092/j.issn.1009-2501.2018.11.009

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AIM: To establish the population pharmacokinetic model of vancomycin in post-operative neurosurgical patients and to provide information for precision medicine. METHODS: A total of 56 neurosurgical patients with external ventricular drainage were enrolled in this study. Vancomycin was intravenously administered into the patients and blood and cerebrospinal fluid samples were obtained at the scheduled time. Nonlinear mixed-effects modeling method was applied to develop population pharmacokinetic model. Goodness-of-fit, bootstrap and visual predictive check were employed to test the final model.RESULTS:Three-compartmental model (central, peripheral and cerebrospinal fluid compartments) was applied to describe the vancomycin model. The cerebrospinal fluid cell count could significantly affect the clearance between central and cerebrospinal fluid compartments (Qcsf), and the positive relationship was observed between the drainage amount and clearance of cerebrospinal fluid compartment (CLcsf). The estimated values of the model were similar to the median of bootstrap, and they are included in the 95% confidence interval. Bootstrap and visual predictive check demonstrated the stability and performance of the proposed population model. CONCLUSION: The proposed final model can be used to guide clinicians with vancomycin dosing in this specific patient population.

Bioequivalence study of atorvastatin calcium tablets in Chinese healthy volunteers

YANG Yanan, CHEN Limei, TAO Chunlei

2018, 23(11):  1258-1264.  doi:10.12092/j.issn.1009-2501.2018.11.010

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AIM: To study human bioequivalence between atorvastatin tablets and original preparation Lipitor. METHODS: Sixty-four healthy subjects participated in the fasting test and 64 healthy subjects participated in the postprandial test. Both were designed using a randomized two-way crossover study. They were orally administered with 10 mg of the test preparation or reference preparation. The plasma concentration of atorvastatin and its two active metaboliteswere determined by LC-MS/MS. By means of WinNonlin 7.0 software, pharmacokinetic parameters were calculated.RESULTS:The pharmacokinetic parameters for atorvastatin of the two preparations under fasting condition were as follow: C _max of test and reference preparations were （4.31±2.24）, （4.64±2.73） ng/mL, T _max were （0.58±0.36）, （0.58±0.35） h，t _1/2 were （9.10±2.67）, （9.16±3.13） h，AUC _0-t were （23.79±10.73）,（21.93±9.29） ng·h·mL ^-1，AUC _0-∞ were （24.87±10.88）, （23.04±9.29） ng·h·mL ^-1. The pharmacokinetic parameters for atorvastatin of the two preparations under fed condition were as follow: C _max of test and reference preparations were（2.41±1.37）,（2.39±1.21） ng/mL，Tmax were （2.38±1.43）,（2.15±1.54） h，t _1/2 were （10.86±8.77）,（9.59±2.81） h，AUC0-t were （19.03±9.26）, （19.25±9.20） ng·h·mL ^-1，AUC _0-∞ were （20.25±9.30）, （20.39±9.27） ng·h·mL ^-1. CONCLUSION: The atorvastatin calcium test formulation and the reference formulation were both bioequivalent in both fasting and postprandial conditions.

Comparison of the effects of general laryngeal mask anesthesia combined with iliofascial block and lumbar epidural anesthesia in elderly patients undergoing hip surgery

LU Xuewen, LIU Yuejiang

2018, 23(11):  1265-1269.  doi:10.12092/j.issn.1009-2501.2018.11.011

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AIM: To compare the effects of general laryngeal maskanesthesia combined with iliofascial block（GLB）and combined spinal-epidural anesthesia（CSEA） in the operation of elderly patients with hip surgery. METHODS: A total of 100 elderly hip patients undergoing elective surgery admitted from January 1, 2016 to December 31, 2016 in our hospital were randomly divided into GLB group and CSEA group, with 50 cases in each group. The changes of oxygen saturation, heart rate and blood pressure were compared between the two groups before anesthesia (T0), 5 min after anesthesia (T1), during the main procedure (T2), 8 h after operation (T3), 12 h after operation (T4). VAS score after operation and the times of analgesia pump were used to observe the pain; postoperative 24 h adverse reactions (nausea and vomiting, headache, urinary retention, fever, drowsiness, delirium) occurred and patient's satisfaction were also compared between the two groups. RESULTS: There was no significant difference in oxygen saturation between the two groups during the whole process (P>0.05). There was no significant difference in heart rate and blood pressure between two groups at T0 (P>0.05), but compared with GLB group, the fluctuation amplitude of heart rate, blood pressure were significantly lower than CSEA group during T1-T4（P<0.05）, the postoperative VAS score and the times of analgesia pump used were significantly lower than CSEA group（P<0.01）, postoperative 24 h adverse reactions were also lower than CSEA group（P<0.05）, the patient's satisfaction in GLB group was higher than CSEA group（P<0.01）. CONCLUSION: Compared with lumbar epidural anesthesia, the general laryngeal mask anesthesia combined with iliofascial block can effectively improve the hemodynamics fluctuation, reduce the incidence of postoperative adverse reactions, optimize postoperative pain management and improve patients ' satisfaction in the operation of elderly patients undergoing hip surgery.

Effects of hydrotalcite combined with PPI on COPD combined with laryngology reflux and its preventive effect on AECOPD 

LU Yajun, HUANG Xiaoying, FU Zhongming

2018, 23(11):  1270-1275.  doi:10.12092/j.issn.1009-2501.2018.11.012

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AIM: To investigate the efficacy of magnesium aluminium carbonate combined with proton pump inhibitor (PPI) on the treatment of chronic obstructive pulmonary disease(COPD) complicated with laryngopharyngeal reflux and its preventive effect on acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS: Ninety-eight COPD patients with laryngopharyngeal reflux from June 2015 to June 2017 were divided into research group and control group by the random number table.Both groups were given conventional COPD medication, and the patients in the control group were treated with PPI, while the study group was given extra hydrotalcite combined PPI therapy. The patients were followed up for 12 months.The clinical efficacy, 24-hour continuous pH monitoring, lung function and laryngopharyngeal reflux were compared between the two groups. The survival curve was drawn by Kaplan-Meier method, and the differences of AECOPD attack and death risk between the two groups were analyzed. RESULTS: There were significant differences in clinical efficacy between the two groups (Z=-1.976，P=0.048), and the treatment efficiency of the study group was significantly higher than that of the control group (97.96% and 79.59%, χ ²=8.295, P=0.004). After treatment, the levels of acid reflux,Ryan index and total acid reflux time of the two groups were significantly reduced, and the study group was significantly lower than the control group (P<0.05). After treatment,the FEV1% and FEV1/FVC were significantly increased, CAT score, RSI and RFS were significantly decreased, among which, the FEV1% and FEV1/FVC in the study group were significantly higher than those in the control group, CAT score, RSI and RFS were significantly lower than those in the control group (P<0.05). The acute onset rate within 12 months after discharge was 69.39% (34/49) and 46.94% (23/49), respectively.The risk of acute onset in the study group was significantly lower than that in the control group (HR=0.513, 95% CI［0.318,0.904］, P=0.015). And there were 2 and 1 deaths in the control group and the study group within 12 months after discharge,respectively. There was no significant difference in risk (HR=0.489, 95% CI［0.050, 4.709］, P=0.551). CONCLUSION: Magnesium aluminium carbonate combined with PPI in the treatment of COPD with laryngopharyngeal reflux can significantly improve the clinical efficacy, lung function and laryngopharyngeal reflux symptoms, while reduce the risk of acute attack of COPD. It is worthy of clinical promotion.

Effects of propofol combined with sevoflurane on kidney function and immune function in patients with cirrhosis after splenectomy

ZHAO Pengcheng, ZHANG Chao

2018, 23(11):  1276-1281.  doi:10.12092/j.issn.1009-2501.2018.11.013

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AIM: To explore the effects of propofol combined with sevoflurane on kidney function and immune function in patients with cirrhosis after splenectomy. METHODS: Seventy-two cases in our hospital from May 2015 to May 2016 were divided into two groups: control group (36 cases) and observation group (36 cases) according to random number table method. Control group received propofol anesthesia, while observation group received sevoflurane combined with propofol. Liver function, renal function, immune function, stress reaction and anesthetic effects of two groups were observed and compared at before anesthesia, 2 h after anesthesia induction and 1 d after surgery. RESULTS: The spontaneous breathing recovery time, speech response time, orientation recovery time, blink time and extubation time in observation group were significantly shorter than those of control group (P＜0.01). After induction of anesthesia for 2 hours and after operation for 1 day, the level of ALT of observation group was much lower than that of control group, and ALB was much higher than that of control group (P＜0.05). The levels of BUN and Cr in observation group was much lower than these in control group (P＜0.05). The levels of CD4+ and CD4+/CD8+ in observation group was much higher than those in control group (P＜0.05). The levels of NE, NA and COR in control group was significantly increased after anesthesia (P＜0.05), while no differences were found in observation group (P＞0.05). The levels of NE, NA and COR in control group were much higher than those in observation group at 2 h after anesthesia induction and 1 d after surgery (P＜0.05) ［(241.43±22.15) ng/L vs. (196.74±18.47) ng/L, (230.86±20.28) ng/L vs. (191.13±17.59) ng/L; (352.38±29.47) ng/L vs. (247.84±21.23) ng/L, (341.65±27.87) ng/L vs. (241.64±20.52) ng/L; (253.13±25.95) ng/L vs. (131.37±15.53) ng/L, (231.91±19.97) ng/L vs. (128.93±15.15) ng/L］. CONCLUSION: The effects of sevoflurane combined with propofol on liver function, renal function and immune function in patients with liver cirrhosis is relatively mild, and the mechanism may be related to the reduction of stress response. The combination therapy is suitable for patients with cirrhosis.

Effects of Sangbailishi decoction on post infection cough (lung heat damp syndrome) and the level of substance P and calcitonin gene related peptide in induced sputum

LI Xianchao, MA Xiaodong, ZHENG Qingxiu, LIU Gang

2018, 23(11):  1282-1286.  doi:10.12092/j.issn.1009-2501.2018.11.014

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AIM: To explore Sangbailishi decoction in the treatment of post infection cough (lung heat damp syndrome) and the effect on the level of substance P (SP) and calcitonin gene related peptide (CGRP) in induced sputum. METHODS: Sixty patients with post infection cough (lung heat damp syndrome) were divided into the treatment group and the control group. The control group received dextromethorphan chlorpheniramine pseudoephedrine. The treatment group was treated with Sangbailishi decoction. The time of cough remission and the frequency of coughing recurrence were recorded and compared between two groups. Cough symptom score was used to evaluate the change of patients' cough symptoms. The severity of coughing was assessed by visual imitative score (VAS). The symptoms of the patients were evaluated by the score of the syndrome. The levels of SP and CGRP were detected and compared betweeen the two groups before and after treatment. RESULTS:The total effective rate of the treatment group was higher than that of the control group (P<0.05). The time of cough remission and the number of coughing recurrences in the treatment group were lower than those in the control group (P<0.05). After treatment, The score of day cough score, night cough score, VAS score and syndrome effect score of the two groups were significantly reduced (P<0.05), and those of the treatment group were lower than those in the control group (P<0.05). After treatment, SP and CGRP were significantly decreased (P<0.05) and those of the treatment group were lower than those in the control group (P<0.05). CONCLUSION: Sangbailishi decoction is effective in the treatment of post infection coughing (lung heat damp syndrome), and can significantly reduce the level of SP and CGRP in induced sputum.

Application and effect of intrauterine injection of human chorionic gonadotropin in frozen-thawed embryo transfer cycle for endometriosis patients

XU Zhihui, ZHOU Jiechun, CHEN Huinan, WANG Anlan

2018, 23(11):  1287-1291.  doi:10.12092/j.issn.1009-2501.2018.11.015

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AIM: To investigate the effect of intrauterine injection of human chorionic gonadotropin (hCG) upon pregnancy outcomes following frozen-thawed embryo transfer (FET) for endometriosis (EMs) patients. METHODS: We retrospectively collected 228 FET cycles of EMs patients, and divided them into intrauterine injection group (50 cycles) and control group (178 cycles). Age, infertile duration, body mass index, hormone profile, endometrial thickness, embryo quality, clinical pregnancy rate and live birth rate were compared, the related factors affecting live birth were further analyzed. RESULTS: No significant difference was detected when baseline character, hormone change, endometrial thickness and embryo quality were compared between two groups, while live birth rate was found statistically higher and miscarriage rate was remarkably lower in intrauterine injection group. Age and intrauterine injection of hCG were two independent factors affecting live birth in EMs following FET. CONCLUSION: Intrauterine injection of hCG prior to FET can improve the live birth rate and reduce the miscarriage rate for EMs patients.

Association analysis of low dose olanzapine in controlling mental symptoms of NMDAR encephalitis

ZHANG Xiaoying, WANG Kang, WU Sha, GUO Peng

2018, 23(11):  1292-1296.  doi:10.12092/j.issn.1009-2501.2018.11.016

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AIM: To analyze the effect of low-dose olanzapine on the association of psychiatric symptoms in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: Twenty-six adults with anti NMDAR encephalitis treated in our hospital from March 2014 to March 2018 were divided into two groups randomly. The control group (13 cases) was treated with routine immunotherapy. The observation group (13 cases) was given low dose olanzapine on the basis of the above. The clinical efficacy and adverse reactions of the patients were observed. Negative and positive symptom scale (PANSS), explicit aggressive behavior scale (MOAS), nurse observation scale (NOSIE), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the improvement of mental symptoms in patients 1 and 2 weeks after treatment. RESULTS: The total effective rate was 92.31% in the observation group, which was higher than 76.92% in the control group. The difference was statistically significant (P<0.05). Before treatment, difference of the MOAS and NOSIE scores of the two groups were not statistically different (P>0.05). At 1 and 2 weeks after treatment, the MOAS and NOSIE scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant (P<0.05). The scores of MOAS and NOSIE in the observation group were significantly lower than those in the control group at 1 and 2 weeks after treatment (P<0.05). Before treatment, difference of the HAMA and HAMD scores of the two groups were not statistically significant (P>0.05). At 1 and 2 weeks after treatment, the HAMA and HAMD scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant (P<0.05). At 1 and 2 weeks after treatment, the HAMA and HAMD scores of the observation group were significantly lower than those of the control group (P<0.05). CONCLUSION: Continuous low-dose olanzapine can significantly improve the psychiatric symptoms of patients with anti-NMDAR encephalitis with fewer adverse reactions, but it requires more clinical validation.

Effects of hydrocortisone sodium succinate continuous intravenous infusion in the treatment of severe septic shock

YANG Yong, DENG Xianghui, HE Runzhi, HUANG Jia

2018, 23(11):  1297-1301.  doi:10.12092/j.issn.1009-2501.2018.11.017

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AIM: To investigate the effects of continuous intravenous microinfusion of hydrocortisone sodium succinate on hospitalization time, dynamic glycemic index and some vital signs in patients with severe septic shock. METHODS: A total of 142 cases of severe septic shock were selected in our hospital from January 2017 to February 2018 and were randomly divided into the study group and the control group, with 71 cases in each group. The study group was given hydrocortisone sodium succinate intravenous micro pump based on routine treatment, while control group received hydrocortisone sodium succinate intravenous drip treatment, the total hospitalization time, ICU hospitalization time and duration of shock, part of vital signs index, dynamic blood glucose index, blood lactate clearance etc. were observed and compared between two groups. RESULTS: After treatment, the total hospitalization time, ICU hospitalization time and duration of shock of the study group were less than those of the control group (P<0.05); and the heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) and other indicators were significantly better than those of the control group (P<0.05). And the blood glucose fluctuation coefficient, maximum blood glucose fluctuations and high blood glucose level time window of the study group were significantly better than those of the control group; After treatment, blood lactate clearance rate of patients in the study group was significantly higher than that of the control group (P<0.05). CONCLUSION: Continuous intravenous microinfusion of hydrocortisone sodium succinate is effective in treating severe septic shock. Micropump can improve the metabolism level and blood glucose stability of patients, and it can be widely applied in clinic.

Pharmacology progress on the main bioactive components of Ligusticum chuanxiong hort

LI Haigang, HU Shaiping, ZHOU Yi, XU Dandan, MA Ning, TANG Jing, BAO Meihua, ZHENG Xiahui

2018, 23(11):  1302-1308.  doi:10.12092/j.issn.1009-2501.2018.11.018

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Ligusticum chuanxiong hort contains more than 100 kinds of pharmacological active ingredients. This study summarized its main bioactive components in pharmacology progress based on pharmacokinetics, and explained the pharmacokinetics and pharmacodynamics of ferulic acid, ligustilide, senkyunolide A, senkyunolide I and tetramethylpyrazine in detail. It will provide some new ideas and methods to the clinical application, deep development and utilization of Ligusticum chuanxiong hort.

Relevance of CYP1B1 genetic polymorphism and individual therapy

CHEN Binyao, LI Ling, ZHAO Huijia, LIU Xiaohong, QI Zhenhua, SUN Gongpeng, HAO Zhuowen, FAN Zhipeng, DONG Li, YUE Jiang, YE Qifa

2018, 23(11):  1309-1316.  doi:10.12092/j.issn.1009-2501.2018.11.019

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CYP1B1 is a member of the cytochrome P450 (CYP450s) family. As a phase I metabolizing enzyme, CYP1B1 is involved in the maintenance of normal structure and physiological function in the human body through catalyzing the metabolism of hormones, fatty acids, vitamins, exogenous chemicals and drugs. It has been found that CYP1B1 gene polymorphism can affect its protein expression and enzyme activity, thus having an impact on the metabolic processes that it catalyzes, especially the changes in the metabolic processes of sex hormones and exogenous substances which are closely related to the occurrence and treatment of glaucoma, various types of cancer and other diseases. Studying on the metabolic pathways involving CYP1B1 and on the influence of its gene polymorphisms will help us understand the role of metabolic pathway changes in the development of related diseases and in the medical treatment, deepen our understanding of diseases such as cancer and glaucoma, and facilitate the detection and assessment of the risk of diseases at the genetic level, so as to achieve early detection and prevention of the diseases, to provide evidence for personalized medicine, thus improving the quality of life and prolonging the survival period. This article reviews the research progress of metabolic pathways involving CYP1B1 and the impact of genetic polymorphisms in recent five years.

Application of immunosuppressive agents in pregnancy after organ transplantation

YAN Lin, WANG Jingjing, HUANG Hua, YAO Qin, LI Qian, ZHANG Jun

2018, 23(11):  1317-1320.  doi:10.12092/j.issn.1009-2501.2018.11.020

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Immunosuppressive agents are widely used in patients after organ transplantation, including calcineurin inhibitors, azathioprine, mycophenolate mofetil, glucocorticoids, etc. However, the safety of immunosuppressive agents in pregnancies is not well defined, which limits the use of these drugs. Therefore, safe and effective immunosuppressant during pregnancy has received much attention. This article will review the current commonly used immunosuppressive agents during pregnancy after organ transplantation.