Hepatoprotective activity of cis-(trans)-emodin-emodin dianthrone from Polygonum multiflorum Thunb / 药学学报

The cis-emodin-emodin dianthrone (compound 1) and trans-emodin-emodin dianthrone (compound 2) were extracted from Polygonum multiflorum Thunb. The protective effect and mechanism of compound 1 and compound 2 (emodin-emodin dianthrones) on acute liver injury induced by concanavalin A (ConA) in ICR mice was first investigated. The results indicated that emodin-emodin dianthrones at 1 mg·kg-1 significantly reduced serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level (P < 0.05). Emodin-emodin dianthrones also improved liver histopathological damage in liver-injured mice. The level of Bcl-2-associated X protein (Bax) mRNA in liver was significantly reduced by 1 mg·kg-1 of emodin-emodin dianthrones, while the level of B-cell lymphoma-2 (Bcl-2) mRNA expression was significantly increased (P < 0.05). The protective activity of compounds 1 and 2 against hepatocyte injury was further evaluated by hydrogen peroxide (H2O2)-induced hepatocyte injury. Compounds 1 and 2 significantly inhibited H2O2-induced hepatocyte injury and reduced the levels of ALT, AST, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) in cell culture. Compounds 1 and 2 also significantly improved the cell survival rate and decreased H2O2-induced oxidative stress in hepatocytes. Compound 1 (0.5 µmol·L-1) significantly increased the enzymatic activity of superoxide dismutase (SOD) in hepatocytes (P < 0.01), and 0.5 µmol·L-1 of compound 2 significantly decreased the intracellular reactive oxygen species (ROS), increased SOD enzyme activity, and glutathione (GSH) content (P < 0.01). Compounds 1 and 2 at 0.5 µmol·L-1 also inhibited hepatocyte apoptosis by increasing the protein expression ratio of Bcl-2/Bax (P < 0.05) and decreasing the protein expression ratio of cleaved caspase-3 and pro caspase-3 (P < 0.05). This study indicates that the emodin-emodin dianthrones from Polygonum multiflorum Thunb. have liver-protective activity. Compounds 1 and 2 exerted hepatoprotective effects by inhibiting apoptosis and oxidative stress. The study provides an important material basis for the hepatoprotective effect of commonly used amounts of Polygonum multiflorum Thunb.

Establishment and Clinical Significance of Prognostic Nomogram Model for Diffuse Large B-Cell Lymphoma Based on Immunohistochemistry Markers and International Prognostic Index Scores / 中国实验血液学杂志

OBJECTIVE@#To retrospectively analyze clinical characteristics and survival time of patients with diffuse large B-cell lymphoma (DLBCL), detect prognosis-related markers, and establish a nomogram prognostic model of clinical factors combined with biomarkers.@*METHODS@#One hundred and thirty-seven patients with DLBCL were included in this study from January 2014 to March 2019 in the First Affiliated Hospital of Nanchang University. The expression of GCET1, LMO2, BCL-6, BCL-2 and MYC protein were detected by immunohistochemistry (IHC), then the influences of these proteins on the survival and prognosis of the patients were analyzed. Univariate and multivariate Cox regression analysis were used to gradually screen the prognostic factors in nomogram model. Finally, nomogram model was established according to the result of multivariate analysis.@*RESULTS@#The positive expression of GCET1 protein was more common in patients with Ann Arbor staging I/II (P =0.011). Compared with negative patients, patients with positive expression of LMO2 protein did not often show B symptoms (P =0.042), and could achieve better short-term curative effect (P =0.005). The overall survival (OS) time of patients with positive expression of LMO2 protein was significantly longer than those with negative expression of LMO2 protein (P =0.018), though the expression of LMO2 protein did not correlate with progression-free survival (PFS) (P >0.05). However, the expression of GCET1 protein had no significant correlation with OS and PFS. Multivariate Cox regression analysis showed that nomogram model consisted of 5 prognostic factors, including international prognostic index (IPI), LMO2 protein, BCL-2 protein, MYC protein and rituximab. The C-index applied to the nomogram model for predicting 4-year OS rate was 0.847. Moreover, the calibrated curve of 4-year OS showed that nomogram prediction had good agreement with actual prognosis.@*CONCLUSION@#The nomogram model incorporating clinical characteristics and IHC biomarkers has good discrimination and calibration, which provides a useful tool for the risk stratification of DLBCL.

Hepatoprotective activity of Zha Xun and its different solvent-eluting components / 药学学报

A pharmacophore-based study was conducted to investigate the therapeutic activity of the traditional Tibetan medicine Zha Xun (ZX) in liver diseases. In the present study, the protective effect of ZX on the acute liver injury induced by concanavalin A (ConA) and 0.15% carbon tetrachloride (0.15% CCl4) in ICR mice was evaluated, and the results showed that ZX significantly reduced serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the ConA-induced acute immune liver injury model and the CCl4-induced acute oxidative liver injury model (P < 0.05). Subsequently, the protective effects of aqueous, 95% ethanol, 60% ethanol and 30% ethanol eluting fractions of ZX, and fulvic acid, the main water-soluble constituent of ZX, were evaluated against acute oxidative liver injury induced by 0.15% CCl4 in mice. The results showed that different solvent-eluting fractions of ZX showed certain hepatoprotective activities, among which the aqueous extract of ZX and 30% ethanol extract of ZX significantly reduced the serum levels of ALT, AST, and lactate dehydrogenase (LDH) in mice (P < 0.05), and the serum levels of LDH in mice were significantly reduced by fulvic acid (P < 0.05), which showed significant hepatoprotective activity. The protective activities and preliminary mechanisms of the total extract of ZX, the aqueous extract of ZX, the 30% ethanol extract of ZX, and fulvic acid against hepatocellular injury in vitro were further evaluated by using the H2O2-induced hepatocellular injury model. The results showed that the components could significantly inhibit H2O2-induced hepatocellular injury, reduce the levels of ALT, alkaline phosphatase (ALP), and LDH, improve the survival rate of hepatocellular cells, and reduce the content of intracellular reactive oxygen species (ROS) in cell culture. At the same time, it can inhibit hepatocyte apoptosis by increasing the expression ratio of Bcl-2/BAX protein and decreasing the expression ratio of cleaved caspase-3/pro caspase-3 protein. The present study showed that ZX has clear hepatoprotective activity in vitro and in vivo, and the different solvent elution fractions of ZX showed certain hepatoprotective activity, among which the aqueous extract of ZX, 30% ethanol extract of ZX had better hepatoprotective activity, and the activity of 60% ethanol extract of ZX was stronger than that of 95% ethanol extract of ZX. The activity of ZX and its water-soluble elution site exerted hepatoprotective effects by inhibiting hepatocyte apoptosis and oxidative stress. The animals used in this experiment and related disposal meet the requirements of animal welfare, and have been reviewed and approved by the Laboratory Animal Management and Use Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences (approval number: 00004018).

Zinc finger and BTB domain-containing protein 46 is essential for survival and proliferation of acute myeloid leukemia cell line but dispensable for normal hematopoiesis / 中华医学杂志(英文版)

BACKGROUND@#Zinc finger and BTB domain-containing protein 46 (Zbtb46) is a transcription factor identified in classical dendritic cells, and maintains dendritic cell quiescence in a steady state. Zbtb46 has been reported to be a negative indicator of acute myeloid leukemia (AML). We found that Zbtb46 was expressed at a relatively higher level in hematopoietic stem and progenitor cells (HSPCs) compared to mature cells, and higher in AML cells compared to normal bone marrow (BM) cells. However, the role of Zbtb46 in HSPCs and AML cells remains unclear. Therefore, we sought to elucidate the effect of Zbtb46 in normal hematopoiesis and AML cells.@*METHODS@#We generated Zbtb46 and Zbtb46Mx1-Cre mice. The deletion of Zbtb46 in Zbtb46Mx1-Cre mice was induced by intraperitoneal injection of double-stranded poly (I). poly (C) (poly(I:C)), and referred as Zbtb46 cKO. After confirming the deletion of Zbtb46, the frequency and numbers of HSPCs and mature blood cells were analyzed by flow cytometry. Serial intraperitoneal injection of 5-fluorouracil was administrated to determine the repopulation ability of HSCs from Zbtb46 and Zbtb46 cKO mice. The correlation between Zbtb46 expression and prognosis was analyzed using the data from the Cancer Genome Atlas. To investigate the role of Zbtb46 in AML cells, we knocked down the expression of Zbtb46 in THP-1 cells using lentiviral vectors expressing small hairpin RNAs targeting Zbtb46. Cell proliferation rate was determined by cell count assay. Cell apoptosis and bromodeoxyuridine incorporation were determined by flow cytometry.@*RESULTS@#The percentages and absolute numbers of HSPCs and mature blood cells were comparable in Zbtb46 cKO mice and its Zbtb46 littermates (Zbtb46vs. Zbtb46 cKO, HPC: 801,310 ± 84,282 vs. 907,202 ± 97,403, t = 0.82, P = 0.46; LSK: 86,895 ± 7802 vs. 102,210 ± 5025, t = 1.65, P = 0.17; HSC: 19,753 ± 3116 vs. 17,608 ± 3508, t = 0.46, P = 0.67). The repopulation ability of HSCs from Zbtb46Mx1-Cre mice was similar to those from Zbtb46 control (P = 0.26). Zbtb46 had elevated expression in AML cells compared to total BM cells from normal control. Knockdown of Zbtb46 in THP-1 cells led to a significant increase in cell apoptosis and reduced cell growth and proliferation.@*CONCLUSION@#Collectively, our data indicate that Zbtb46 is essential for survival and proliferation of AML cells, but dispensable for normal hematopoiesis.

Short-term results of open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation / 中国骨伤

OBJECTIVE@#To investigate short-term clinical efficacy of open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation.@*METHODS@#From August 2014 to August 2017, 13 patients with Chopart joint dislocation were treated by open reduction and percutaneous Kirschner wire fixation, including 7 males and 6 female aged from 13 to 58 years old. American Orthopaedic Foot and Ankle Society(AOFAS)criteria system and visual analogue scale (VAS) were applied to evaluate function of foot and ankle at 12 months after operation.@*RESULTS@#All patients were followed up from 8 to 24 months. AOFAS score at 12 months after operation ranged from 65 to 99; 8 cases got excellent results, 4 good and 1 moderate. VAS score ranged from 0 to 4. All wounds were primary healed from 12 to 16 days, and no skin necrosis, infection, Kirschner broken, or other complications occurred. One patient occurred Kirschner's wire loosening at 4 weeks after operation.@*CONCLUSIONS@#Open reduction and percutaneous Kirschner wire fixation for Chopart joint dislocation could relieve pain and improve functional activities and obtain satisfactory short-term clinical results.

Clinical Characteristics of Liver Dysfunction in Patients with Hemophagocytic Syndrome / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical feature of liver injury in patients with hemophagocytic syndrome (HPS).@*METHODS@#The clinical data of 92 patients with HPS in our hospital were analyzed retrospectively, and the characteristics of hepatic lesion and its relationship with prognosis in HPS patients were explored.@*RESULT@#92 cases of HPS showed different degrees of liver dysfunction from mild to moderate. The clinical parameters of liver dysfunction included the increased level of LDH (89.13%), AST (64.13%), TBIL (59.78%) and decreased level of ALB (90.22%). Moreover, 76.09% and 67.39% of the patients had the prolonging of APTT and PT respectively. The ALB level of patients in rheumatoid immune group were higher than that in infection, maglinancy and unexplained groups, all with statistically and significant difference (P＜0.05, P＜0.05 and P＜0.01), the ALB level of patients in infection group were statistically and significantly higher than that in unexplained group (P＜0.01). The Fbg level of patients in infection group were lower than that in maglinancy group, unexplained group and rheumatoid immune group, all the differences were statistically significant (P＜0.05, P＜0.01 and P＜0.05). Child-Pugh grading was further carried out in HPS patients with liver disfunction. Survival time of the patients grade A was significantly higher than that of grade B and C of patients. Univariate analysis showed that the patients with LDH≥2000 U/L, ALB＜30 g/L and PT≥15.1 s had a survival time inferior to control patients (P＜0.05, P＜0.01 and P＜0.01, respectively). Multivariate analysis showed that ALB＜30 g/L was an independent adverse prognostic factor for these patients (P＜0.01).@*CONCLUSION@#Patients with HPS generally have impaired liver function mainly manifested with elevated LDH and AST levels, and declined ALB level, which may correlate with the disease cause and prognosis. Patients with LDH≥2000 U/L, ALB＜30 g/L and PT≥15.1 s have a poorer prognosis and should be treated as soon as possible.

Efficacy and Safety of Tofacitinib in Chinese Patients with Rheumatoid Arthritis / 中华医学杂志(英文版)

Background@#Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This study assessed the efficacy and safety of tofacitinib in Chinese patients with RA enrolled in Phase 3 and long-term extension (LTE) studies.@*Methods@#ORAL Sync was a 1-year, randomized, placebo-controlled, Phase 3 trial. Patients received tofacitinib 5 or 10 mg twice daily (BID) or placebo advanced to tofacitinib 5 or 10 mg BID at 3 or 6 months. All patients remained on ≥1 background conventional synthetic disease-modifying antirheumatic drug. ORAL Sequel is an open-label LTE study (data-cut: March 2015; data collection and analyses were ongoing, and study database was not locked at the time of analysis; study was closed in 2017). Efficacy outcomes: American College of Rheumatology (ACR) 20/50/70 response rates and Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-4 [ESR]). Patient- and physician-reported outcomes: Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient and Physician Global Assessment of Arthritis, and pain (visual analog scale). Safety was assessed throughout.@*Results@#ORAL Sync included 218 patients; 192 were subsequently enrolled into ORAL Sequel. In ORAL Sync, more patients achieved ACR20 (tofacitinib 5 mg BID, 67.4%; 10 mg BID, 70.6%; placebo, 34.1%) and DAS28-4 (ESR) <2.6 (tofacitinib 5 mg BID, 7.1%; 10 mg BID, 13.1%; placebo, 2.3%) with tofacitinib versus placebo at Month 6. Mean changes from baseline in HAQ-DI were greater with tofacitinib versus placebo at Month 6. In ORAL Sequel, efficacy was consistent to Month 48. Incidence rates for adverse events of special interest in tofacitinib-treated patients were similar to the global population.@*Conclusions@#Tofacitinib significantly reduced signs/symptoms and improved physical function and quality of life in Chinese patients with moderate-to-severely active RA up to Month 48. The safety profile was consistent with the global population.@*Clinical Trial Identifier@#NCT00856544 and NCT00413699.

Development of special einbrand / 医疗卫生装备

Objective To develop a kind of special einbrand for clinical sputum suction. Methods The einbrand was composed of two parts: a body penetrating the mouth and an external wing, which was made of self-lubrication paraformaldehyde. The body was small in size and easy to be put in the patient's mouth, and could effectively press the tongue.The bite surface was divided into two sections of plane and elliptic surface,the plane section facilitated the biting of the patient while the elliptic surface assisted to discharge the einbrand. The external wing executed positioning while the einbrand was put into the mouth,which could be held by one single hand for manipulation.Results Clinical trials proved that the einbrand was embedded into the mouth easily with the mouth opened 10 mm,that the einbrand was bitten by the patient in case the bite force was existent,that the einbrand was discharged when it was drawn out 35 mm or so,and that the einbrand could withstand the pressure higher than 12 kg/cm2(1 200 kPa)with no deformation.Conclusion The einbrand designed can be satisfactorily used for clinical sputum suction.

Expression of LI-cadherin in advanced gastric cancer and its effect and mechanism on human gastric cancer cell line MKN28 / 临床与实验病理学杂志

Purpose To investigate the expression of LI-cadherin in advanced gastric cancer and its effect and mecha-nism on human gastric cancer cell line MKN28. Methods Im-munohistochemical staining was performed on advanced gastric cancer to examine the LI-cadherin protein expression. CCK8, colony formation assay, transwell assay, flow cytometry were used to detect the changes in the biological behavior of MKN28 cells after LI-cadherin gene interference. Dual-luciferase report-er assay and Western blot were used to detect the activity of the NF-κB after the interference of LI-cadherin gene. Results LI-cadherin in chronic gastritis was negative, in well- and moder-ately-differentiated advanced gastric cancer was significantly in-creased, in poorly-differentiated was decreased. Cell prolifera-tion, colony formation, and invation ability were inhibited in the group of knockdown expression of LI-cadherin ( P ＜ 0. 05 ). Flow cytometry results showed that knockdown expression of LI-cadherin resulted in a significant increase in the proportion of cells in G1 phase, while the proportion of cells in S phase was significantly lower ( P ＜0. 05 ). Knockdown expression of LI-cadherin resulted in the decreased activation of NF-κB and re-stricted its translation. Conclusion LI-cadherin in well- and moderately-differentiated advanced gastric cancer is significantly increased. Knockdown of LI-cadherin can strongly decrease the malignant biological characteristics of human gastric cancer cell line MKN28. Its mechanism may be associated with the NF-κB pathway.

Study on the risk factors for the misdiagnosis of femoral head osteonecrosis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the status and risk factors for the misdiagnosis of femoral head osteonecrosis, providing the basis for accurate diagnosis of osteonecrosis of femoral head.</p><p><b>METHODS</b>The data of 314 hospitalized patients were collected from March 2015 to March 2016, and the risk factors for osteonecrosis of femoral head were analyzed by Logistic regression model. Misdiagnosis was defined that the diagnosis given on the first time was different from that on the second time or that given by expert group with the same symptoms and signs. The general data, predisposing factors, time of onset, hospital visits, clinical manifestations, X-ray film of hip joint, MRI and other data were statistically analyzed.</p><p><b>RESULTS</b>Total 127 patients experienced misdiagnosis (up to 40.8%). Among them, the patients with osteonecrosis of femoral head misdiagnosed as other diseases accounted for 77.2% and the patients with other diseases misdiagnosed osteonecrosis of femoral head accounted for 22.8%. Statistical analysis showed that the predisposing factors, history of glucocorticoid and alcohol intake, diseased lower limb, pained lower limb, hidden disease attack, the level of first reception hospital and expert were significantly related with the misdiagnosis of femoral head osteonecrosis based on the logistic regression model (<0.05) . The relationship between misdiagnosis and gender, age, primary disease taking glucocorticoid, approach and time of glucocorticoid use, the type of alcohol, drinking time had no statistical significance(>0.05). The Logistic regression analysis showed that the hidden disease attack(OR=3.059) and level of first reception expert(OR=2.778) were the high risk factors associated with the misdiagnosis in which the femoral head necrosis was misdiagnosed as other diseases(<0.01), and glucocorticoid intake history was the low risk factors(OR=0.387)(<0.05). The Logistic regression analysis showed that the level of first reception expert (OR=3.573) was the high risk factor associated with the misdiagnosis in which the other diseases were misdiagnosed as necrosis of femoral head.</p><p><b>CONCLUSIONS</b>Misdiagnosis rate of femoral head necrosis is high. Hidden disease attack and low level of first reception expert are the high risk factors associated with the misdiagnosis in which the femoral head necrosis was misdiagnosed as other diseases, however, glucocorticoid intake history is the protective factor of misdiagnosis. Low level of first reception expert is the high risk factor associated with the misdiagnosis in which other diseases were misdiagnosed as necrosis of femoral head.</p>

Systematic review on safety of Salvianolate injection / 中国中药杂志

To systematically evaluate the safety of salvianolate injection in clinical medication. A systematic literature search was performed in the databases of Cochrane Library, Medline, Embase, the Web of Science, Clinical Trials, CNKI, VIP, WanFang Data and CBM. Literature screening was done according to inclusion and exclusion criteria, and quality was assessed according to internationally recognized quality evaluation criteria. Then the data were reviewed for analysis. 148 papers were included, consisting of 122 randomized controlled trials(RCTs), 10 non-randomized controlled trials(NRCTs), 4 case series studies, and 12 case reports. In the analysis of 135 studies, totally 7 300 patients used salvianolate injection. There were a total of 419 adverse drug reactions(ADRs), and 12 cases of serious adverse drug reactions. In the patients with Salvianolate injection, there were 176 cases of adverse drug reactions(ADRs) and 1 case of adverse cardiac event. The ADRs included 17 cases of rash, 9 cases of gastrointestinal reaction, 38 cases of headache, dizziness, heaviness in head, 1 case each of drug fever, hypotension, bleeding gums, chills, lip numbness, body jitter, slightly elevated ALT, 3 cases of palpitation, 4 cases of breath shortness, and 25 cases of other unkonwn ADRs. In the present study, a large number of rare, serious adverse events were not seen in clinical application of Salvianolate injection, but future long-term monitoring is needed to obtain evidence for the safety of the drug. In addition, the clinical application of Salvianolate injection is seriously beyond the instruction, so relevant departments shall urgently develop the medication specifications for salvianolate injection to provide better guidance for its clinical medication.

Study on optimization of a fewest layer measuring method of osteonecrotic area in femoral head / 中国骨伤

<p><b>OBJECTIVE</b>To optimize a measuring method of osteonecrotic area by analyzing the average osteonecrotic areas and osteonecritic volume using multi layer MR images.</p><p><b>METHODS</b>The MRI images of 87 cases (120 hips) of ONFH(ARCO II) were collected retrospectively from January 2011 to January 2012 in Wangjing Hospital of China Academy of Chinese Medicine Science. PHILIPS Achieval 1.5T MR was used to obtain coronal TSE T1 weighted (T1W) images. The scanning parameters were shown as follows:slice thickness, 3.5 mm; gap, 0.3 mm; images repetition time(TR), 500 ms;echo time(TE), 20 ms;field of view (FOV), 374 mm;total 12 layers. According to the distribution rule of osteonecrotic lesion, the layer of coronal T1-weighted imaging showing most of femoral neck was marked as layer 0(L0). The layers before L0 were marked in sequence L1, L2, L3, L4... , and the layers after L0 were marked in sequence L-1, L-2, L-3, L-4... . Auto CAD 2007 was used to measure the percentage of osteonecrotic area and calcu late the average data, and then decreased the layer from low to high layer successively based on frequency of osteonecrotic occurrences. First, the layer with lowest frequency of osteonecrotic occurrenoses L3 was removed, then calculated the average osteonecrotic area of the ramaining 8 layers. L5, L4, L-2, L-1, L3 layers were gradually removed, resulting in the calculation of avereage osteonecrotic areas in 7, 6, 5, 4, 3 layers. These areas were compared to the osteonecrotic volume in MR imagings, leading to the optimization of the fewest layer measuring method of osteonecrotic area using a statistical analysis.</p><p><b>RESULTS</b>The percentage of osteonecrotic volume in 120 hips was 0.333±0.151. The average osteonecrotic areas of 9 to 3 layers were 0.321±0.117, 0.317±0.136, 0.312±0.147, 0.333±0.153, 0.348±0.172, 0.365±0.174, 0.377±0.202 respectively. There were no statistical differences of the average osteonecrotic areas and osteonecrotic volume in 9 to 3 layers(>0.05), but when the osteonecrotic layers were reduced to 3, there were statistical differences(<0.05). Total 120 hips were grouped according to osteonecrotic volume based on ARCO staging criteria, among them, 12 hips were grade A, 43 were B, 65 were C. According to average osteonecrotic areas of 4 layers, 10 hips were A grade, 32 were B, 78 were C. There were no statistical differences between two methods(>0.05). There was a high degree of concordance among two methods.</p><p><b>CONCLUSIONS</b>The results of 4(L0, L1, L2, L3) layers measuring method and osteonecrotic volume measuring method are similar. The 4 layers measuring method is an accurate, convenient, valuable method measuring the esteonecrotic area with the fewest layers, which is worth to be popularized in clinical application.</p>

Treatment of Radical Resected NSCLC by Chinese Medicine Combined with Adjuvant Chemother- apy: a Clinical Study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of Chinese medicine (CM) combined adjuvant chemotherapy in postponing relapse and metastasis of radical resected Ib-IIIa stage non-small cell lung cancer (NSCLC) patients, and to explore its effect in improving their quality of life (QOL) and clinical symptoms.</p><p><b>METHODS</b>We designed a cohort study of 336 radical resected Ib-IIIa NSCLC patients by analyzing disease free survival (DFS) using Log-rank test. They were randomly assigned to the control group (155 cases, treated by adjuvant chemotherapy group) and the test group (181 cases, treated by adjuvant chemotherapy combined CM). By using controlled method, 60 radical resected NSCLC patients undergoing NP/NC program in 2012 (vinorelbine 25 mg/m2, combined with cisplatin 75 mg/m2 on day 1 and day 8/on day 1 or on day 1, 2, and 3; or carboplatin AUC = 5 on day 1) were assigned to the control group (29 cases) and the test group (31 cases). QOL scores (using EORTC QLQ-LC43 questionnaire) and TCM symptoms scores were compared between the two groups before chemotherapy, peri-chemotherapy (one day before the 2nd course of chemotherapy) , and after chemotherapy (20 days after ending the 4th course of chemotherapy).</p><p><b>RESULTS</b>(1) The median DFS was longer in the test group than in the control group, but with no statistical difference between the two groups (42.73 months vs 35.57 months , P = 0.179). In the subgroup analysis, there was statistical difference in IIIa stage DFS. The median IIIa stage DFS of was longer in the test group than in the control group with statistical difference (27.87 months vs 19. 93 months, P = 0.047). (2) In the control study, repeated measured data indicated there was significant difference in physical functions between the two groups (P < 0.05). Total scores for health states decreased more in the test group than in the control group, but with no statistical difference (P > 0.05). Scores for constipation and CM syndrome scores were higher in the test group than in the control group (P < 0.05).</p><p><b>CONCLUSIONS</b>CM had advantages in postponing DFS of radical resected NSCLC patients, especially in IIIa stage. CM could improve their QOL and clinical symptoms during adjuvant chemotherapy.</p>

HPLC enantioseparation, absolute configuration determination and anti-HIV-1 activity of (±)-F18 enantiomers / 药学学报

Racemic (±)-F18 (10-chloromethyl-11-demethyl-12-oxo-calanolide A), an analog of nature product (+)-calanolide A, is a new anti-HIV-1 nonnucleoside reverse transcript inhibitor (NNRTI). A successful enantioseparation of (±)-F18 offering (R)-F18 and (S)-F18 was achieved by a chiral stationary phase prepared HPLC. Their absolute configurations were determined by measurement of their electronic circular dichroisms combined with modem quantum-chemical calculations. Further investigation revealed that (R)-F18 and (S)-F18 shared a similar anti-HIV activities, however, (R)-F18 was more potent than (S)-F18 against wild-type virus, K101E mutation and P225H mutation pseudoviruses.

Effects of total paeony glucosides on mRNA expressions of Toll receptors and interleukin-33 in the brain tissue of D-galactose induced aging rats: an experimental research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate effects of total paeony glucosides (TPGs) on the expressions of Toll receptors (TLR4) and interleukin-33 (IL-33) in the brain tissue of D-galactose-induced aging rats. METHODS; Fifty SD rats were randomly divided into 5 groups, i.e., the blank control group, the model group, the high dose TPG group, the middle dose TPG group, and the low dose TPG group, 10 in each group. Equal volume of normal saline was subcutaneously injected to rats in the blank control group, while 10% D-galactose was subcutaneously injected to rats in the rest groups at 0.125 mL/g, once a day for 8 successive weeks to induce the aging rat model. TPG was administered at 300 mg/kg, 150 mg/kg, and 75 mg/kg to rats in the high, middle, and low dose TPG groups while injecting D-galactose from the 5th week of model preparation, once daily for 4 successive weeks. Equal volume of normal saline was administered to rats in the blank control group and the model group, once daily. The capability for learning and memory was detected using Morris water. The mRNA expressions of TLR4 and IL-33 in the brain tissue were detected using ELISA.</p><p><b>RESULTS</b>Compared with the blank control group, the capability for learning and memory decreased in the model group with statistical difference (P < 0.05). Compared with the model group, the capability for learning and memory was obviously improved in all the medicated groups in a dose-dependent manner, showing statistical difference (P < 0.05). Compared with the blank control group, mRNA expressions of TLR4 and IL-33 in the brain tissue obviously increased after medication in the model group, showing statistical difference (P < 0.05). Compared with the model group, mRNA expressions of TLR4 and IL-33 in the brain tissue obviously decreased after medication in all the medicated groups in a dose-dependent manner, showing statistical difference (P < 0.05).</p><p><b>CONCLUSION</b>TPGs improved D-galactose induced aging rats' capability for learning and memory through regulating changes of TLR4 and IL-33 expressions.</p>

In vitro meniscal culture of juvenile porcine / 中国骨伤

<p><b>OBJECTIVE</b>To observe the histological changes of juvenile porcine menisci in an in vitro organ culture system. It was hoped that the experiment can provide evidence for the study of menisci in an in vitro organ culture model.</p><p><b>METHODS</b>Eight juvenile swines of one month old were involves in the study. Thirty-two meniscal specimens with 8 mm in width were obtained from each meniscus in the two posterior extremities. The specimens were incubated in an in vitro organ culture model. At 0, 2, 4 and 6 weeks after culture, 8 specimens were observed. Hematoxylin eosin staining: the cell density of the inner 1/3 zone was measured. Safranin-O staining:the degree of staining in the inner zone was measured and semi-quantitative scores were obtained.</p><p><b>RESULTS</b>At 0, 2, 4 and 6 weeks, the cell density were (285.3 +/- 12.0)/HPF, (182.8 +/- 11.2)/HPF, (129.7+/- 9.9)/HPF, (92.3 +/- 9.3)/HPF respectively. Statistically significant differences were found between different time points (P < 0.05), Paired comparison showed statistical differences (P < 0.05). At 0, 2, 4 and 6 weeks, the semi-quantitative scores of Safranin-O staining were 2.0 +/- 0.0,1.5 +/- 0.5, 1.0 +/- 0.0, 0.5 +/- 0.5, statistically differences were found between different time points (P < 0.05). Paired comparison showed statistical differences (P < 0.05).</p><p><b>CONCLUSION</b>In the juvenile meniscus in vitro organ culture model, the cell density and viability diminished along with the cultural time. In vitro organ culture model is suitable for the study of menisci in short-term.</p>

Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers

To evaluate the clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. A retrospective study was carried out at the Department of Orthopedics, the First Hospital affiliated to Nanhua University, Hengyang, China from March 2005 to December 2011. Seventeen cases of anterior impingement syndrome of the ankle joint were confirmed, and treated through arthroscopy. All these patients conformed to regular follow-up postoperatively, and clinical details, as well as postoperative prognosis were retrieved and analyzed retrospectively. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society [AOFAS] hindfoot-ankle scoring system, and pain relief was assessed by visual analogue scoring [VAS]. Anterolateral impingement syndrome was found in 11 patients, anteromedial impingement syndrome in 4, while anterior impingement syndrome in 2 via arthroscopic examination. The VAS was reduced from 5.2-1.1, and the AOFAS score was elevated from 76.4-95.8 postoperatively; both of which demonstrated statistical differences when compared to preoperative scores. It was also found that concomitant cartilage damage was an indicator of poor prognosis in arthroscopic treatment of impingement syndrome of the ankle joint. Satisfactory results could be achieved for physical workers with anterior impingement syndrome treated by arthroscopy. As the cartilage damage is an indicator of poor prognosis, an early operation is advocated when the prognosis of anterior impingement syndrome is confirmed

Treatment of Sanders type III and IV calcaneal fractures with open reduction and internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the surgical techniques and results of open reduction and internal fixation for the treatment of Sanders type III, IV calcaneal fractures.</p><p><b>METHODS</b>From January 2004 to January 2010, 58 feet of Sanders type III, IV in 51 patients were treated with open reduction and plate fixation through L incision. There were 29 males and 22 females,the age ranged from 17 to 58 years with an average of 29.5 years old. The time between injury and operation ranged from 7 to 14 days (mean, 10 days). All the patients underwent systematic CT scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 26 feet of type III, 32 feet of type IV. The Böhler angle and Gissane angle were compared before and after operation. The clinical results were evaluated with the Maryland foot score: pain (45 scores), function (55 scores: distance walked 10 scores, stability 4, support 4, limp 4, shoes 10, stairs 4, terrain 4, cosmesis 10, motion 5).</p><p><b>RESULTS</b>All 58 feet in 51 patients were followed up,and the duration ranged from 6 to 24 months,with an average of 13 months. The incidence of complications was 13.8% (8/58). Incision superficial necrosis in 2 feet,choronicity pain in 4 feet,subtalar joint arthrositis of advanced stage in 2 feet. According to Maryland foot score, the results were excellent in 23 feet, good in 27, fair in 5, poor in 3.</p><p><b>CONCLUSION</b>The surgical techniques and results of internal fixation to fractures are related to anatomic features of calcaneus and their injury mechanism. It is an effective method for the treatment of calcaneal fractures with Sanders type III, IV.</p>

Clinical features and correlation research of fever in systemic lupus erythematosus patients / 中华风湿病学杂志

ObjectiveTo investigate the clinical features of systemic lupus erythematosus (SLE) patients with fever and find out the related factors.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu province and then the data wereretrospectively analyzed.The potentially possible risk factors of fever in SLE were selected and then analyzed by chi-square test,Wilcoxon rank sum test and Logistic regression analysis.ResultsAll 1762 patients were investigated.Seven hundred and twenty-nine had active fever.Age at hospitalization,initially treated patients,photosensitivity,serositis,nervous system involvement,generalized lymphadenopathy/hepatosplenomegaly,white blood cell count (WBC),haemoglobin (HB),erythrocyte sedimentation rate (ESR),C-reaction protein (CRP),alanine aminotransferase(ALT),albumin(ALB),serum creatinine (Scr),complement C3,anti-dsDNA antibodies positive rate,anti-Sm antibodies positive rate,SLEDAI score and past therapies were factors associatedwith SLE fever.Logistic regression analysis showed that abnormal WBC count (OR=1.396,95％CI 1.114-1.711,P=0.004),CRP(OR=1.005,95％CI 1.002-1.009,P=0.002),ALT(OR=1.003,95％CI 1.001-1.005,P=0.005),Scr (OR=0.997,95％CI0.995-0.999,P=0.007),HB (OR=0.986,95％CI 0.981-0.992,P=0.000),age (OR =0.984,95％ CI 0.974-0.993,P=0.001 ) and past usage of cyclophosphamide (CTX) (OR =0.557,95％CI 0.382-0.813,P=0.002) were correlated with SLE fever.ConclusionFever is one of the most common clinical manifestations of SLE patients.Leucopenia,elevated CRP levels,liver function abnormalities,anemia,younger age are risk factors for SLE fever,while renal impairment and past usage of CTX are protective factors.

Erlotinib as a salvage treatment for patients with advanced non-small cell lung cancer after failure of gefitinib treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several clinical trials showed that erlotinib was effective after the failure of gefitinib in advanced non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the feasibility of erlotinib treatment after the failure of gefitinib based on the data from our hospital.</p><p><b>METHODS</b>The clinical data of 20 patients with advanced NSCLC who were admitted to Shanghai Chest Hospital from August 2007 to December 2008 were retrospectively analyzed. All of the patients were given erlotinib treatment after the failure of gefitinib. Survival analysis was made by Kaplan-Meier method. The Cox regression model was performed to analyze the relationship between the influential factors and the erlotinib progression-free survival (PFS).</p><p><b>RESULTS</b>Five patients had a partial response (PR), nine patients had stable disease (SD) and six patients had progressive disease (PD) with gefitinib treatment. The median PFS was 277 days (95% CI 0- 566). No patient had a PR, seven had SD and fourteen PD with the erlotinib therapy. The median PFS was 31 days (95% CI 9.1- 52.9). The response rate (RR) was 0, and the disease control rate (DCR) was 35% (7/20). Cox regression analysis demonstrated that sex (P = 0.96), age (P = 0.89), smoking history (P = 0.78), performance status (PS) (P = 0.98), gefitinib efficacy (P = 0.90) and whether chemotherapy was applied between using the two drugs (P = 0.45) had no significant correlation with erlotinib PFS. Fifteen patients had epidermal growth factor receptor (EGFR) mutation status determined. There were five cases got SD with the erlotinib treatment in ten mutation negative (wild-type) patients. No SD was recorded in the five mutation positive patients.</p><p><b>CONCLUSIONS</b>The efficacy of erlotinib treatment after gefitinib failure was limited. However, the patients who are EGFR mutation negative can probably benefit from erlotinib treatment after gefitinib failure.</p>