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Cordyceps， a unique precious Chinese herbal medicine in China， has the effects of tonifying the kidney and lungs， stopping bleeding， and resolving phlegm. It has definite clinical effects on diabetes， respiratory diseases （such as chronic obstructive pulmonary disease）， chronic kidney diseases， slow arrhythmia， and hyperlipidemia. We searched China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， SpringerLink （Biomedical Sciences）， Embase， Proquest （Life Sciences）， PubMed， Cochrane Library， and SinoMed for the research on the arsenic content in Cordyceps. According to statistical analysis， arsenic in Cordyceps mainly exists in the non-toxic or low-toxic form. The arsenic-containing compounds in Cordyceps may be an arsenic-sugar compound with anticancer effect. The inorganic arsenic content in Cordyceps is lower than the arsenic standard stipulated by the State Food and Drug Administration. It remains uncertain whether different measurement methods can affect the results. The total arsenic content varies in Cordyceps from different producing areas， and the general rule of total arsenic content in Cordyceps produced in different provinces， districts， and counties cannot be obtained from the results of the existing studies. The arsenic content in Cordyceps is mainly concentrated in the insect part， which is significantly different from that in stroma， and no arsenic is detected in the mycelia. The soil arsenic content in the growing areas is generally high， which may be a main reason for the high arsenic content in Cordyceps. As a valuable medicinal material for tonifying and nourishing， Cordyceps still plays an irreplaceable role in disease prevention， health care， chronic disease management， and rehabilitation.
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Objective:To develop an ex vivo normothermic mechanical perfusion(NMP)and compare the effect of different portal perfusion pressures on attenuating hepatic injury from donor after cardiac death(DCD).Methods:All rat livers were subjected to in situ warm ischemia for 30 min after cardiac attest and thereafter stored for 8 h under cold preservation. Six livers were harvested and regarded as static cold storage(group CS, n=6). In experimental group, liver received an ex vivo dual NMP with oxygenated perfusion via hepatic artery for 2 h after cold storage. Hepatic injury was assessed and compared from perfused livers with full portal vein pressure(group M1, n=6)and low portal vein pressure(group M2, n=6). The evaluation parameters included perfusion flow, liver enzymes of perfusate, pathological changes by hematoxylin-eosin staining, Suzuki histological criteria, expression of activation markers of polymorphonuclear neutrophils and macrophages, myeloperoxidase (MPO)and CD68 by immunohistochemistry, level of malondialdehyde(MDA)and activity of superoxide dismutase(SOD). Results:In experimental group during NMP, perfusion flows tended to increase when portal pressures were stabilized in groups M1 and M2.Perfusion flow during NMP 60~120 min was significantly higher than during NMP 0~20 min.After NMP with full portal pressure, hepatic sinusoidal congestion, hepatocyte necrosis, steatosis and Suzuki criteria were lower in group M1 than those in group CS( P<0.05). Compared with group M1, lower hepatic injury was characterized with a lower change of liver enzymes in perfusate( P<0.05), a better histological evaluation( P<0.05), a lower level of MDA and a higher activity of SOD( P<0.05), lower expressions of CD68 and MPO ( P<0.05)and lower levels of TNF-α and IL-6( P<0.05)in perfused liver. Conclusions:The ex vivo dual NMP with oxygenated perfusion via hepatic artery mimics liver perfusion under the physiological conditions.NMP with a lower portal pressure can attenuate hepatic ischemia-reperfusion injury and confer a better protection against liver damage from DCD.
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OBJECTIVES@#To investigate the effectiveness and safety of Xingnaojing Injection (XNJ, ) compared with naloxone for the treatment of acute alcohol intoxication (AAI), and provide the latest evidence through evidence-based approach.@*METHODS@#Seven electro-databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure Databases, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database (VIP) and Wanfang Database were searched from the inception to January 2018. Randomized controlled trials (RCTs) comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included: patients' conscious recovery time, stay length in emergency department, disappearance time of the ataxia symptom, the severity of the symptoms, the blood alcohol content as well as the adverse events. Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Collaboration. Meta-analysis was conducted by Review Manager 5.3 software.@*RESULTS@#Totally 141 trials with 13,901 patients were included in this review, all of them were assessed as unclear or high risk of bias. Results showed that on the basis of routine therapy, standard dose XNJ (10-20 mL) may have similar results with naloxone on the recovery time of consciousness (MD 12 min, 95% CI 7.2-17.4 min) and disappearance time of symptoms (MD 6 min, 95% CI-13.8-25.8 min) for patients with AAI. Larger dose of XNJ Injection (21-40 mL) may speed up the time (almost 1 h earlier). Combination of XNJ and naloxone seemed superior to the naloxone alone for all the relevant outcomes. The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50% the combination group than in the control group (RR 1.42, 95% CI 1.29 to 1.56). No severe adverse events or adverse reactions of XNJ were reported in the included trials.@*CONCLUSIONS@#Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI. We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review. Registration number. in PROSPERO (No. CRD42018087804).
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Objective To survey the awareness and knowledge of Helicobacter pylori (Hp) infection among medical staff in Shanghai.Methods A questionnaire survey was conducted among 316 medical staff in Shanghai,including 74 gastroenterologists (GI),158 general practitioners (GP),and 68 gastroenterology nurses(GN),from October 2014 to September 2015.The questionnaire was designed according to the Fourth Helicobacter Pylori Infection Treatment Consensus Report of China (the Consensus).There were 4 parts and 29 questions in the questionnaire,including the knowledge and performance of the Consensus (8 questions),the indications of Hp eradication (8 questions),detection methods of Hp infection (7 questions)and the therapy of Hp eradication (6 questions).Results Total 300 valid questionnaires were received with a response rate of 94.9％ (300/316).The awareness rate of the Consensus in GI,GP and GN groups was 81.1％ (60/74),57.6％ (91/158) and 26.4％ (18/68),respectively (χ2 =43.67,P=0.001).GI had higher awareness rate than GP and GN in indications of Hp eradications (for peptic ulcer,mucosa-associated lymphoid malignancies,post-resection patients of early gastric cancer,and family history of gastric cancer,the χ2 values were 16.68,35.60,33.46 and 39.22,respectively;all P ＜0.05).In part of Hp infection detection methods,the responses of GI,GP and GN groups in C14 or C13 urea breathing test were 97.3％ (72/74),47.5％ (75/158) and 82.1％ (55/68),respectively (χ2 =72.38,P =0.001);in gastric mucosa tissue rapid urease test were 70.3％ (52/74),13.9％ (22/158) and 25.4％ (17/68),respectively (χ2 =78.22,P =0.001);in serological test were 58.1％ (43/74),20.9％ (33/158)and 44.8％ (30/68),respectively (χ2 =40.30,P =0.001);in gastric mucosa tissue section staining were 56.8％ (42/74),13.3％ (21/158) and 22.4％ (15/68),respectively (χ2 =50.35,P =0.00).In part of Hp eradication therapy the responses of GI,GP and GN groups in recommended bismuth quadruple therapy were 71.6％ (53/74),47.5％ (75/158) and 40.3％ (25/62),respectively (χ2 =15.93,P =0.001);in triple therapy were 27.0％ (20/74),51.6％ (81/158) and 42.0％ (26/62),respectively (χ2 =12.42,P =0.002);in 10 or 14 d for treatment duration were 78.4％ (58/74),78.5％ (124/158)and 67.6％ (46/68),respectively (χ2 =3.36,P =0.186).Conclusion Gastroenterologists are more likely to adhere with the Consensus than general practitioners and gastroenterological nurses in the management of Hp infection.The survey suggests that more attention should be paid for popularization and implementation of Hp infection guidelines and consensus among Shanghai medical staff,especially for GP and nurses.
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Objective: To investigate the regulating effect of Krüppel-like transcription factor 8 (KLF8) on the expression of vascular endothelial growth factor A (VEGFA) in hepatocellular carcinoma (HCC) and its potential mechanism. Methods: The expressions of KLF8 and VEGFA proteins and their correlation in paired HCC and adjacent paracancerous tissues were detected by immunohistochemistry staining. The KLF8 expression plasmid pcDNA3.1-KLF8 and the control plasmid were transfected into HCC SMMC7721 cells, respectively. The expressions of VEGFA and phosphoinositide-3-kinase (PI3K)/Akt pathway-related molecules including phospho-Akt (p-Akt), phospho-phosphoinositide-dependent kinase 1 (p-PDK1) and phospho-phosphatase and tensin homolog deleted on chromosome 10 (p-PTEN) in SMMC7721 cells were detected by real-time fluorescent quantitative PCR and Western blotting. The effect of PI3K/Akt pathway inhibitor LY294002 on the expression of VEGFA protein in SMMC7721 cells with KLF8 overexpression was detected by Western blotting. Chicken chorioallantoic membrane (CAM) model was used to detect the inducing effect of SMMC7721 cells with up-regulation of KLF8 expression on angiogenesis in chicken embryos. Results: The expression levels of KLF8 and VEGFA proteins were much higher in HCC tissues than those in the adjacent paracancerous tissues (P < 0.01). KLF8 protein expression was positively correlated with VEGFA protein expression in HCC tissues (r = 0.622, P < 0.01). The expression levels of KLF8, VEGFA, p-Akt, p-PDK1 and p-PTEN proteins were up-regulated in SMMC7721 cells transfected with pcDNA3.1-KLF8 plasmids (P < 0.05). LY294002 inhibited VEGFA expression in SMMC7721 cells with KLF8 overexpression (P < 0.05). The SMMC7721 cells with KLF8 overexpression had a higher potential in inducing angiogenesis in chick embryos (P < 0.01). Conclusion: KLF8 gene induces VEGFA expression and angiogenesis in HCC via PI3K/Akt signal pathway.