[Management of antithrombotic agents for endoscopic procedures in elderly Chinese patients: a retrospective study].

OBJECTIVE: To investigate the peri-endoscopic management of antithrombotic drugs and adverse events in elderly patients un-dergoing gastrointestinal endoscopy in order to provide clinical guidance of peri-endoscopic management of antithrombotic drugs for elderly pa-tients. METHODS: Between January 1st 2008 and December 31st 2014, clinical data of 3 747 patients (aged 46~99 years, 96.1% male) who were hospitalized for elective gastrointestinal endoscopy were analyzed retrospectively. The general clinical data, cardiovascular disease and re-lated risk factors, medication, management of peri-endoscopic antithrombotics and adverse events were recorded. The differences of peri-endo-scopic adverse events including thromboembolism and bleeding between patients with different management strategies of peri-endoscopic an-tithrombotics were analyzed. RESULTS: The overall incidences of peri-endoscopic thromboembolism and bleeding were 2.24% and 1.89%, re-spectively. The incidences of thromboembolism and bleeding when stopping antithrombotics at 0~7 days pre-procedure were 1.87% and 2.38% respectively. The incidences of thromboembolism and bleeding when resuming antithrombotics at 2~7 days after endoscopy were 2.07% and 0.63% respectively. When discontinuing antithrombotics, the differences in peri-endoscopic thromboembolism and bleding be-tween patients who did and did not undergo low-molecular-weight heparin (LMWH) bridging therapy were not significant. The incidence of bleeding in patients who underwent LMWH bridging therapy was higher than that in patients who didn't undergo LMWH bridging therapy, but the diference was not significant. CONCLUSIONS: Our findings suggest that cessation of antithrombotics < 7 days pre-procedures and resumption of antithrombotic agents after 2-7 days post-porcedures is optimal in elderly Chinese patients undergoing endoscopy.

Anti-Fatigue and Antioxidant Activity of the Polysaccharides Isolated from Millettiae speciosae Champ. Leguminosae.

Millettiae speciosae Champ. Leguminosae (MSC), is a well-known Chinese herb traditionally used as food material and medicine for enhancing physical strength. Our preliminary study found that the aqueous extract of this herb (MSE) had an anti-fatigue effect. In this paper, we further separated MSE into total polysaccharides (MSP) and supernatant (MSS) by alcohol precipitation, and explored which fraction was active for its anti-fatigue effect. Mice were orally administered with MSP or MSS at the doses of 200, 400, and 800 mg/kg for 20 days and the anti-fatigue effect was assessed by exhaustive swimming exercise (ESE). The biochemical parameters related to fatigue after ESE and the in vitro antioxidant activity of active fraction were determined. Our results showed that MSP, instead of MSS, significantly extended the swimming time to exhaustion (p < 0.05), indicating that MSP is responsible for the anti-fatigue effect of MSE. In addition, MSP treatment increased the levels of glucose (Glu) and muscle glycogen, whereas it decreased the accumulations of blood urea nitrogen (BUN) and lactic acid (Lac). Moreover, ESE increased the levels of creatine phosphokinase (CK), lactic dehydrogenase (LDH), and malondialdehyde (MDA) but reduced superoxide dismutase (SOD) and glutathione (GSH) in plasma. In contrast, MSP inhibited all the above changes relating to fatigue. Furthermore, an in vitro antioxidant test revealed that MSP dose-dependently scavenged ·OH and DPPH free radicals. Taken together, these findings strongly suggested that MSP was able to alleviate physical fatigue by increasing energy resources and decreasing accumulation of detrimental metabolites. The antioxidant activity may crucially contribute to the observed anti-fatigue effect of MSP.

Anti-Inflammatory Effect of Supercritical-Carbon Dioxide Fluid Extract from Flowers and Buds of Chrysanthemum indicum Linnén.

The aim of this study was to analyze the chemical composition and investigate the anti-inflammatory property of the supercritical-carbon dioxide extract from flowers and buds of C. indicum (CISCFE). The anti-inflammatory effect was evaluated in four animal models including xylene-induced mouse ear edema, acetic acid-induced mouse vascular permeability, carrageenan-induced mouse hind paw edema, and cotton pellet-induced rat granuloma formation. The results indicated that CISCFE significantly attenuated xylene-induced ear edema, decreased acetic acid-induced capillary permeability, reduced carrageenan-induced paw, and inhibited the cotton pellet-induced granuloma formation in a dose-dependent manner. Histopathologically, CISCFE abated inflammatory response of the edema paw. Preliminary mechanistic studies demonstrated that CISCFE decreased the MDA level via increasing the activities of anti-oxidant enzymes (SOD, GPx, and GRd), attenuated the productions of NF- κ B, TNF- α , IL-1 ß , IL-6, PGE2 and NO, and suppressed the activities of iNOS and COX-2. In phytochemical study, 35 compounds were identified by GC-MS, and 5 compounds (chlorogenic acid, luteolin-7-glucoside, linarin, luteolin and acacetin) were reconfirmed and quantitatively determined by HPLC-PAD. This paper firstly analyzed the chemical composition by combining GC-MS with HPLC-PAD and explored possible mechanisms for the anti-inflammatory effect of CISCFE.

Screening cellular proteins binding to the core region of hepatitis C virus RNA genome with digoxin-labeled nucleic acids.

OBJECTIVE: To screen and identify cellular proteins binding to the core region of hepatitis C virus (HCV) RNA genome. METHODS: The plasmid pHCV core was constructed to generate in vitro transcripts of the core region of HCV RNA genome. Ultraviolet (UV) cross-linking experiment and competition analysis were performed to screen HepG2 cellular proteins, which interact with digoxin-labeled transcripts of the core region of HCV RNA genome. RNA-binding proteins were separated by immunoprecipitation, analyzed by electrophoresis on SDS-PAGE and detected by immunoblotting with anti-digoxingenin-AP. After being excised from SDS-PAGE, the proteins bands were analyzed by MALDI-TOF-MS. RESULTS: Several cellular proteins of hepG2 cell specifically bound to the core region of HCV RNA genome. The binding of cellular proteins to digoxin-labeled HCV core RNA was competed out in proportion to the increasing amount of unlabeled RNA. One of the HCV RNA-binding proteins was the B (brain) isozyme of human phosphoglycerate mutase (PGAM-B) identified by MALDI-TOF-MS. CONCLUSION: PGAM-B could specifically bind to the core region of HCV RNA genome in vitro.

Effective protection of Terminalia catappa L. leaves from damage induced by carbon tetrachloride in liver mitochondria.

The protective effects of chloroform extracts of Terminalia catappa L. leaves (TCCE) on carbon tetrachloride (CCl4)-induced liver damage and the possible mechanisms involved in the protection were investigated in mice. We found that increases in the activity of serum aspartate aminotransferase and alanine aminotransferase and the level of liver lipid peroxidation (2.0-fold, 5.7-fold and 2.8-fold) induced by CCl4 were significantly inhibited by oral pretreatment with 20, 50 or 100 mg/kg of TCCE. Morphological observation further confirmed the hepatoprotective effects of TCCE. In addition, the disruption of mitochondrial membrane potential (14.8%), intramitochondrial Ca2+ overload (2.1-fold) and suppression of mitochondrial Ca2+-ATPase activity (42.0%) in the liver of CCl4-insulted mice were effectively prevented by pretreatment with TCCE. It can be concluded that TCCE have protective activities against liver mitochondrial damage induced by CCl4, which suggests a new mechanism of the hepatoprotective effects of TCCE.

[Screening of cellular proteins binding to the core region of hepatitis C virus RNA by ultraviolet cross-linking assay].

OBJECTIVE: To screen cellular proteins binding to the core region of hepatitis C virus (HCV) from human hepatoma cells. METHODS: Unlabeled and labeled RNA transcripts were prepared by in vitro transcription. Cytoplasmic extracts were prepared from human hepatoma cells HepG2. Ultraviolet (UV) cross-linking was used to screen the cellular proteins that would bind to the core region of HCV. Competition experiment was performed to confirm the specificity of the binding in which excess unlabeled RNA of HCV core region and plasmid RNA were used as competitors. RESULTS: Two cellular proteins of 6.6 x 10(4) and 5.5 x 10(4) were found binding to the core region of HCV RNA by UV cross-linking assay. The unlabeled core region of HCV RNA could compete out this binding whereas the unlabeled plasmid RNA could not. CONCLUSION: The cellular proteins from HepG2 cells could bind to the core region of HCV RNA.

[CK20 mRNA expression in peripheral blood of patients with gastrointestinal carcinoma and its clinical significance].

BACKGROUND & OBJECTIVE: Detecting expression levels of cytokeratin 19 (CK19), CK20, MUC1, and carcinoembryonic antigen (CEA) in peripheral blood,lymph node,and bone marrow is a major method for diagnosing micro-metastasis in patients with gastrointestinal carcinoma of early stages. This study was to examine the expression, before and after operation, of CK20 mRNA in peripheral blood of patients with gastrointestinal carcinoma, to further explore hematogenous-spread micro-metastasis status of these patients, and significance of CK20 mRNA detection in treatment during perioperation period. METHODS: Peripheral blood samples were collected before, and 2 weeks after operation from 62 patients with gastrointestinal carcinoma,and 22 controls (12 patients with benign gastrointestinal disease, and 10 healthy volunteers). CK20 mRNA expression in the blood samples was specifically detected by nested reverse transcriptase-polymerase chain reaction (RT-PCR). Pathologic examination of all cases was done by conventional methods. RESULTS: Of 62 patients with gastrointestinal carcinoma, 34 (54.3%) have positive CK20 mRNA expression before operation,and so did 31 (50.0%) postoperatively, but no CK20 mRNA expressed in 22 controls. In patients of stageI-IV, CK20 mRNA positive rates were 37.5% (3/8), 36.3% (8/22), 66.7% (18/27), and 100% (5/5), respectively, difference between stage I+II (36.9%) and stage III+IV (83.3%) was significant (P< 0.05). Among 35 patients with local lymph node metastasis, 27 (77.1%) were positive for CK20 mRNA; among 27 patients without lymph node metastasis, 7 (25.9%) have positive CK20 mRNA expression (P< 0.01). CK20 mRNA expression was not correlated with tumor cell differentiation,and cancer embolus existance. There was no significant difference in CK20 mRNA expression before and after operation (P >0.05). CONCLUSIONS: CK20 mRNA may be a sensitive marker for detecting micro-metastasis,and recurrence of patients with gastrointestinal carcinoma. It may be helpful for the correct clinical staging,and reasonable treatment for patients.

Inhibitory effect of TCCE on CCl4-induced overexpression of IL-6 in acute liver injury.

Terminalia catappa L. leaves have been shown to protect against acute liver injury produced by some hepatotoxicants, but the active components and mechanisms are not clear. This study was designed to characterize the protective effects of the chloroform fraction of the ethanol extract of T. catappa leaves (TCCE) against carbon tetrachloride (CCl4)-induced hepatotoxicity in mice, and analyze the changes in expression level of interleukin-6 (IL-6) in the process. It was found that TCCE pretreatment (10 or 30 mg/kg, ig) protected mice from CCl4 toxicity, as evidenced by the reversed alterations in serum alanine aminotransferase (sALT) and serum aspartate aminotransferase (sAST) activities. Additionally liver tissues were subjected to RT-PCR, Western blot and immunohistochemistry to analyze changes in IL-6 expression. It was found that TCCE markedly suppressed the CCl4-induced over-transcription of IL-6 gene. Consistent with the result, the expression of IL-6 protein was also blocked by TCCE in CCl4-stimulated mice, especially in the area around central vein on liver tissue section. In conclusion, TCCE is effective in protecting mice from the hepatotoxicity produced by CCl4, and the mechanisms underlying its protective effects may be related to the inhibition on the overexpression of IL-6 mainly around terminal hepatic vein.

[Hepatoprotective effects of chloroform extract from leaf of Terminalia catappa in relation to the inhibition of liver IL-6 expression].

OBJECTIVE: To study the hepatoprotective effects of Terminalia catappa chloroform extract (TCCE) and its effects on IL-6 gene over expression in liver of CCl4-treated mice. METHOD: Mice were orally pretreated with TCCE (20, 50, 100 mg x kg(-1) x d(-1)) for 5 days, and the sALT activity of mice was detected 24 hours after the intraperitoneal injection of CCl4 on the 5 th day. Meanwhile, IL-6 mRNA level was determined by using the method of RT-PCR. And the liver morphological changes were also observed. RESULT: sALT activity was remarkably increased (5.6 fold) after the injection of CCl4. However, with oral pretreatment of TCCE, changes in sALT were dose-dependently reversed. On the other hand, significant increase in IL-6 mRNA level induced by CCl4 was remarkably decreased. The level of IL-6 mRNA in 100 mg x kg(-1) TCCE treated mice was reversed to that of control. In addition, histological changes such as the infiltration of numerous inflammatory cells and hepatocyte swelling in injured mice were effectively lessened by the pretreatment of TCCE. CONCLUSION: TCCE has hepatoprotective activity and the mechanisms underlying its protective effects may be related to the inhibition on the over expression of IL-6 gene in liver.