[Optimization Study on the Nitrogen and Phosphorus Removal of Modified Two- sludge System Under the Condition of Low Carbon Source].

This paper explored the method of resolving insufficient carbon source in urban sewage by comparing and analyzing denitrification and phosphorus removal (NPR) effect between modified two-sludge system and traditional anaerobic-aerobic-anoxic process under the condition of low carbon source wastewater. The modified two-sludge system was the experimental reactor, which was optimized by adding two stages of micro-aeration (aeration rate 0.5 L · mm⁻¹) in the anoxic period of the original two-sludge system, and multi-stage anaerobic-aerobic-anoxic SBR was the control reactor. When the influent COD, ammonia nitrogen, SOP concentration were respectively 200, 35, 10 mg · L⁻¹, the NPR effect of the experimental reactor was hetter than that of thecontrol reactor with the removal efficiency of TN being 94.8% vs 60.9%, and TP removal being 96.5% vs 75%, respectively. The effluent SOP, ammonia, TN concentration of the experimental reactor were 0.35, 0.50, 1.82 mg · L⁻¹, respectively, which could fully meet the first class of A standard of the Pollutants Emission Standard of Urban Wastewater Treatment Firm (GB 18918-2002). Using the optimized treatment process, the largest amounts of nitrogen and phosphorus removal per unit carbon source (as COD) were 0.17 g · g⁻¹ and 0.048 g · g⁻¹ respectively, which could furthest solve the lower carbon concentration in current municipal wastewater.

Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials.

BACKGROUND: Low-level laser therapy (LLLT) has been applied in the treatment of carpal tunnel syndrome (CTS) for an extended period of time without definitive consensus on its effectiveness. This meta-analysis was conducted to evaluate the effectiveness of low-level laser in the treatment of mild to moderate CTS using a Cochrane systematic review. METHODS: We conducted electronic searches of PubMed (1966-2015.10), Medline (1966-2015.10), Embase (1980-2015.10), and ScienceDirect (1985-2015.10), using the terms "carpal tunnel syndrome" and "laser" according to the Cochrane Collaboration guidelines. Relevant journals or conference proceedings were searched manually to identify studies that might have been missed in the database search. Only randomized clinical trials were included, and the quality assessments were performed according to the Cochrane systematic review method. The data extraction and analyses from the included studies were conducted independently by 2 reviewers. The results were expressed as the mean difference (MD) with 95% confidence intervals (CI) for the continuous outcomes. RESULTS: Seven randomized clinical trials met the inclusion criteria; there were 270 wrists in the laser group and 261 wrists in the control group. High heterogeneity existed when the analysis was conducted. Hand grip (at 12 weeks) was stronger in the LLLT group than in the control group (MD = 2.04; 95% CI: 0.08-3.99; P = 0.04; I = 62%), and there was better improvement in the visual analog scale (VAS) (at 12 weeks) in the LLLT group (MD = 0.97; 95% CI: 0.84-1.11; P < 0.01; I = 0%). The sensory nerve action potential (SNAP) (at 12 weeks) was better in the LLLT group (MD = 1.08; 95% CI: 0.44-1.73; P = 0.001; I = 0%). However, 1 included study was weighted at >95% in the calculation of these 3 parameters. There were no statistically significant differences in the other parameters between the 2 groups. CONCLUSION: This study revealed that low-level laser improve hand grip, VAS, and SNAP after 3 months of follow-up for mild to moderate CTS. More high-quality studies using the same laser intervention protocol are needed to confirm the effects of low-level laser in the treatment of CTS.

Delayed drainage versus autotransfusion drainage and routine drainage after total knee arthroplasty: a comparative study.

BACKGROUND: The purpose of this research is to compare the clinical results of different drainage methods in total knee arthroplasty (TKA). METHODS: This retrospective comparative study included 55 patients who accepted primary unilateral TKA between October 2010 and November 2012. The patients were classified according to the drainage method used: 25 patients in the autotransfusion drainage group, 12 patients in the delayed drainage group, and 18 patients in the routine drainage group. Otherwise, the same operative procedures and postoperative care were applied to all patients. The variables recorded included total amount of postoperative drainage (including intraoperative blood loss); cases of allogenic blood transfusion; body temperatures on postoperative days 1, 3, and 7; and pre- and postoperative hemoglobin level. Some other elements such as postoperative swelling, range of motion, and wound healing were also compared. RESULTS: Patients who underwent autotransfusion were found to have an amount of drainage (799.2 ± 196.7 mL) significantly greater than that in the routine drainage group (666.1 ± 155.0 mL), which in turn was significantly greater than that in the delayed drainage group (381.7 ± 129.2 mL). The postoperative hemoglobin level in the delayed drainage group (91.5 ± 7.9 g/L) was similar to that in the autotransfusion group (92.0 ± 9.6 g/L), while that in the routine drainage group (81.3 ± 9.9 g/L) was significantly lower. The patients in the autotransfusion group were observed to have higher body temperatures than those in the other two groups. In the routine drainage group, eight cases accepted allogenic blood transfusion, and the percentage (44.4%) was significantly higher than that in the other two groups. There were no significant between-group differences in swelling, healing qualities, and range of motion. CONCLUSIONS: Delayed postoperative drainage may reduce blood loss and the chance of allogenic blood transfusion compared with routine drainage and may also reduce the chance of postoperative fever and extra costs compared with autotransfusion.

[Study of traditional Chinese medicine syndrome on multiple organ dysfunction syndrome in the elderly].

OBJECTIVE: To statistically analyze the clinical data from patients with multiple organ dysfunction syndrome in the elderly (MODSE), and to investigate the distribution pattern of traditional Chinese medicine (TCM) syndromes. METHODS: TCM data of 200 patients with MODSE was collected on 1, 3 and 7 days after diagnosis. Using 134 symptoms as observation indexes, clustering analysis was used to analyze the TCM symptoms and syndromes of these patients. RESULTS: In accordance with Diagnostic efficacy of standard TCM Syndrome, Diagnostics of TCM, State Standard of the People's Republic of China: clinical diagnose and treat Terminology of TCM, expert group differentiate on the professional knowledge and clinical manifestation and 7 types of TCM syndrome were selected. Among all syndrome types, there were 134 (22.3%) cases of phlegm stagnation with the largest population, 113 cases (18.8%) of toxic heat flourishing, 97 cases (16.2%) of damp-heat accumulation, 85 cases (14.2%) of qi-deficiency, 67 cases (11.2%) of both yin and yang deficiency, 55 cases (9.2%) of fu being filled and substances could not pass through, and 48 cases (8.1%) of qi stagnation and blood stasis. CONCLUSIONS: This preliminary study found 7 primary types of TCM syndrome in patients with MODSE, including syndrome of phlegm stagnation, toxic heat flourishing, accumulation of damp-heat, qi-deficiency, both yin and yang deficiency, fu being filled and substances could not pass through and qi stagnation and blood stasis. The most common syndrome is phlegm stagnation and deficiency, phlegm, blood stasis, toxic are the main etiology and pathology of the disease.

Reduced hepatotoxicity by total glucosides of paeony in combination treatment with leflunomide and methotrexate for patients with active rheumatoid arthritis.

Combination use of methotrexate (MTX) and leflunomide (LEF) has been proved effective in the treatment of active rheumatoid arthritis (RA). However, previous trials have documented that both are associated with increased incidence of liver toxicity. As active compounds extracted from the roots of the traditional Chinese herb Paeonia lactiflora Pall, total glucosides of paeony (TGP) have been shown to have anti-inflammatory, hepatoprotective and immuno-regulatory activities, without evident toxicity or side effects. In this 24-week, open label, randomized multicenter clinical trial, we investigated the efficacy of TGP and the protective effect on hepatotoxicity in the combination treatment with LEF and MTX for patients with active RA. A total of 204 patients with active RA (DAS28>3.2) recruited from 3 regional referral centers were enrolled and received MTX and LEF combination therapy (MTX 10 mg/week plus LEF 20 mg/day) with or without TGP for up to 24 weeks by randomization. Hepatotoxicity was defined as an increase of at least 1.5-fold the upper limits of normal (ULN) of alanine aminotransferase (ALT) or aspartate aminotransferase (AST). Significantly less frequent hepatotoxicity was observed in patients with TGP than those without (9.5% vs 34.8%, p < 0.001) at 12 weeks. The proportion of patients whose ALT or AST levels were > 1.5 to ≤2 times and >2 to ≤3 times the ULN were lower in TGP group than the control (1.9% vs 10.1%, 2.9% vs 12.4%, p < 0.05 respectively). More patients in the TGP group achieved a European League Against Rheumatism (EULAR) good response or moderate response at 12 weeks, although there is no statistical significance. Similar results were observed at 24 weeks. Our preliminary study demonstrates the hepatoprotective and additive role of TGP in combination with MTX and LEF in the treatment of active RA.

[Routine western medicine treatment plus qishen yiqi dripping pill for treating patients with chronic heart failure: a systematic review of randomized control trials].

OBJECTIVE: To systematically review the safety and efficacy of Qishen Yiqi Dripping Pill (QYDP) as a complementary treatment for chronic heart failure (CHF) patients. METHODS: CNKI, VIP, Wanfang Data, PubMed and Cochrane Library were retrieved for papers on randomized control trials of treating CHF patients by routine western medical treatment plus QYDP. The quality of inclusive literatures was assessed by methods from Cochrane Handbook. Valid data were extracted and analyzed by Meta-analysis using RevMan 5.1.0 Software. RESULTS: Totally 17 trials and 1840 patients in line with standard were included. Results of Meta-analysis showed, compared with the routine Western medical treatment group, additional use of QYDP could decrease re-admission rate [RR = 0.52, 95% CI (0.33, 0.81), P = 0.004] and the mortality rate, improve the clinical efficacy [RR = 1.18, 95% CI (1.12, 1.25), P < 0.01] and cardiac function [RR = 1.18, 95% CI (1.10, 1.27),P < 0.01], increase left ventricular ejection fraction (LVEF) [WMD = 5.57, 95% CI (4.16, 6.97), P < 0.01] of CHF patients. Subgroup analysis of LVEF showed that additional use of QYDP could further improve LVEF [ WMD = 8.34, 95% CI (6.23, 10.45), P < 0.01] of CHF patients and increase the distance of their 6-min walk test [WMD = 94.39, 95% CI (71.89, 116.89), P < 0.01]. But there was no statistical difference in plasma brain natriuretic peptide (BNP) between the two groups. No obvious adverse reaction and liver or kidney damage was reported during the trial. CONCLUSIONS: Compared with the Western medical treatment, additional use of QYDP was safe and could further improve clinical efficacy. However, larger and high-quality clinical trials are necessary for further evidence.

[Effect of prostaglandin E1 combined with Xuebijing injection on transforming growth factor-ß1 in rats with pulmonary interstitial fibrosis].

OBJECTIVE: To investigate the effect of prostaglandins E1 combined with Xuebijing injection on the expression of transforming growth factor-ß1 (TGF-ß1) and tumor necrosis factor-α (TNF-α) in rats with acute pulmonary interstitial fibrosis. METHODS: A rat model of pulmonary interstitial fibrosis was established by intratracheal injection of bleomycin (1 ml/kg). One hundred and eight Wistar rats were randomly divided into six groups with 18 in each group, which were normal control group, model group, hormone (methylprednisolone) treatment group, Xuebijing treatment group, prostaglandin E1 treatment group and combination treatment group (prostaglandin E1 and Xuebijing injection). Except for those in the normal control group, the rats in each group were sacrificed on the 7th, 14th and 28th day after treatment. The TGF-ß1 expression in lung tissue was measured by immunohistochemical staining. The TNF-α concentration in bronchoalveolar lavage fluid (BALF) of rat model was determined by enzyme-linked immunosorbent assay. RESULTS: The combination treatment group showed significantly more macrophages with TGF-ß1 expression in lung tissue at each time point, as compared with the model group, Xuebijing treatment group, methylprednisolone treatment group and prostaglandin E1 treatment group (P < 0.05). On the 7th day, the TNF-α concentration in BALF in the combination treatment group was significantly lower than those in the model group, methylprednisolone treatment group and prostaglandin E1 treatment group (P < 0.05); on the 14th day, the TNF-α concentration in BALF in the combination treatment group was significantly lower than that in the model group (P < 0.05); on the 28th day, the levels of TNF-α in the prostaglandin E1 treatment group and combination treatment group were significantly lower than that in the model group (P < 0.05). CONCLUSION: Prostaglandin E1 combined with Xuebijing injection may significantly inhibit TGF-ß1 expression in the lung tissue of rats with acute pulmonary interstitial fibrosis, which reduces alveolar inflammatory response.

[Effects of Xue-Bi-Jing combined with forsythia suspension on the liver gene expression levels of rats with sepsis model].

OBJECTIVE: To study the effects of "XUE BI JING plus LIANQIAO" injection on gene expression levels of rats with sepsis model. METHODS: One hundred and twenty rats were randomly divided into sham operation group, sepsis model group, Te-neng group and "XUE BI JING plus forsythia suspension" group. The sepsis model of rats was prepared by "CLP" method. Tai neng group was treated by peritoneal injection Imipenem/ Cilastatin (0.18 g/kg); "XUE BI JING plus LIANQIAO" group was treated by peritoneal injection Imipenem/ Cilastatin (0.18 g/kg) plus "xue-bi-jing" (10 ml/kg) and "liang ge san" (18 g/200 g) by intragastric administration 2 times a day; the sham operation group and model group were treated by peritoneal injection of normal saline (10 ml/kg). The survival rates at 48h and 72h were observed for all groups. The gene expression levels of livers in all groups were detected by BiostarR-40s chip. The NCBI database was used to inquest Gene function and class. RESULTS: The survival rates at 48h and 72h in "XUE BI JING+ forsythia suspension" group were 83.3% and 76.7% which were significantly higher than those (30.0% and 16.7%) in sepsis model group and those (60.0% and 33.3%) in Te-neng group (P < 0.01). Model group/control group have 305 differential expression genes with 159 up-regulation genes and 146 down-regulation genes. Tai-neng group/model group have 386 differential expression genes with 206 up-regulation genes and 180 down-regulation genes. "XUE BI JING plus forsythia suspension" group/model group have 342 differential expression genes with 102 up-regulation genes and 240 downregulation genes. The genes with up-regulation in model group/ control group and with down-regulation in"XUE BI JING plus forsythia suspension" group/model group were 24. The genes with down-regulation in the model group/ sham operation group and with up-regulation in "XUE BI JING plus forsythia suspension"group/model group were 16. CONCLUSION: "XUE BI JING plus forsythia suspension" can reduce the mortality of rats with sepsis, which could be due to the expression of relative regulation genes.

[A gene chip study of "Jun Du Yan Bingzhi" on liver in a sepsis model of rat].

OBJECTIVE: To study the effect of "Jun Du Yan Bingzhi" on genic change in liver of a sepsis rat model by gene chip technique, in order to study the mechanism of the action of the drug on the gene level. METHODS: Ninety rats were randomly divided into normal control group, model group and "Jun Du Yan Bingzhi" group, with 30 rats in each group. Sepsis was reproduced by cecal ligation and puncture (CLP) method. In "Jun Du Yan Bingzhi" group the rats were treated with intraperitoneal injection of imipenem/cilastatin (0.18 g/kg), Xuebijing injection (10 ml/kg) and gavage of "Liangge San" (15 ml/kg). In the control group and model group intraperitoneal physiological saline (10 ml/kg) was given; Survival time, and 48-hour and 72-hour survival rates of every group were observed, and changes in liver genes were examined with BiostarR-40 s chip. The ratio of Cy3/Cy5 > or =2.0 or < or =0.5 was used to screen differential genes, and NCBI database was used to identity the function of differential genes. RESULTS: The 48-hour and 72-hour survival rate of "Jun Du Yan Bingzhi" group was significantly higher than that of model group (83.3% vs. 30.0%, 76.7% vs. 17.7%, both P<0.01), 305 differential genes were found in model/control groups, with up-regulation in 159, down-regulation in 146, 500 differential genes were found in "Jun Du Yan Bingzhi" group/model group, with up-regulation in 292, down-regulation in 208, model group/control group up-regulation and "Jun Du Yan Bingzhi" group/model group down-regulation were 48, model group/control group down-regulation and "Jun Du Yan Bingzhi" group/model group up-regulation were 63. CONCLUSION: "Jun Du Yan Bingzhi" can degrade the 48-hour and 72-hour death rate of sepsis rat, through control immunization related, inflammation, signal transduction transcription regulation, cell cycle, apoptosis, substance metabolism, translation/processing/modify/degradation of protein, differentiation/proliferation/growth of cell related gene, promote multisystem function of sepsis rat to recover normal.

[Study on the effect of mild moxibustion combined with cupping therapy on serum creatine kinase in gym-athletes].

OBJECTIVE: To probe into eliminating action of mild moxibustion combined with cupping therapy on athletic fatigue. METHODS: Observe changes of serum creatine kinase activity in gym-athletes with once great intensity training or periodic great intensity training, and the interfering effect of mild moxibustion combined with cupping therapy. RESULTS: The mild moxibustion combined with cupping therapy has a significant promoting action on recovery of the increased serum creatine kinase activity induced by once great intensity training or periodic great intensity training in gym-athletes. CONCLUSION: The method has a better action of eliminating athletic fatigue.

Progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of acute pancreatitis.

BACKGROUND: Acute pancreatitis (AP) is a common acute abdomen with high mortality, multiple complications and complicated causes. There is no effective therapy for AP. Radix salviae miltiorrhizae (Danshen), a traditional herbal medicine, has a low price and a wide range of clinical applications. It is effective to promote blood flow, eliminate stagnancy, and relieve pain. It is also found to be effective in treating AP. We reviewed the progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of AP. DATA SOURCES: An English-language literature search was conducted using MEDLINE (1988-2005) on Radix salviae miltiorrhizae (Danshen) and acute pancreatitis. RESULTS: The mechanisms of Danshen in the treatment of AP include improvement of microcirculatory disturbances; elimination of oxygen free radicals; modulation of the metabolism of lipid inflammatory mediator; and blocking of calcium inflow and prevention of calcium overload. CONCLUSION: Danshen can effectively reduce the mortality and complications of AP.

[Experimental study of protective effects of Xuebijing injection on stress-induced organ damage in rabbit].

OBJECTIVE: To investigate the protective effects of the integrated traditional Chinese and western medicine Xuebijing injection on stress-induced organ damage in rabbits. METHODS: Forty rabbits were randomly divided into four groups: the control group, the model group, the western medicine group, and the Xuebijing group. The stress-induced organ damage model was replicated by soak the rabbits in water, the animals in the western medicine group and Xuebijing group received injection of lytic cocktail and Xuebijing, respectively. The changes in cortisol (Cor), thromboxane A(2) (TXA(2)), endothelin (ET), nitric oxide synthase (NOS) were determined at different time points in all the groups. The pathologic changes of the gastric mucosa, the adrenal gland and the cardiac muscle cell were observed. RESULTS: The content of Cor increased significantly in model group (P<0.01). The content of Cor decreased in the western medicine group and Xuebijing group, the changes showed no significant difference between two groups (P>0.05). The contents of ET, TXA(2) decreased and NOS increased in Xuebijing group compared with the western medicine group, the differences were significant (all P<0.05). The pathological changes of the gastric mucosa, the adrenal gland and the cardiac myocyte were less marked in Xuebijing group, compared with the western medicine group, the difference was significant (P<0.05). CONCLUSION: Xuebijing has better protective effects on stress-induced organ damage.

[Clinical observation on treatment of 18 patients with pulmonary infection after renal transplantation by integrative traditional Chinese and Western medicine].

OBJECTIVE: To observe the therapeutic effect of integrative traditional Chinese and Western medicine in treating patients with pulmonary infection after renal transplantation. METHODS: Thirty-four inpatients were randomly divided into the treated group (n=18) and the control group (n=16). They were treated with conventional therapy, including corticosteroid, anti-viral, anti-bacterial, symptomatic and supporting therapy, to the treated group, the modified qingwen baidu decoction (MQBD) was administered additionally. RESULTS: Fifty of the 18 patients in the treated group were cured, 2 improved and 1 died, the cure rate being 83.3% and the total effective rate 94.4%; while 8 of the 16 patients in the control group were cured, 2 improved and 6 died, the cure rate being 50.0% and the total effective rate 62.5%, comparison between these two groups showed significant difference (P < 0.05). CONCLUSION: Promising effect could be obtained for treatment of patients with pulmonary infection after renal transplantation by adding MQBD, a Chinese herbal medicine for clearing heat and detoxication, cooling blood and removing fire, on the basis of conventional western medical treatment.

[Determination of catechins and caffeine in tea and tea beverages by high-performance liquid chromatography].

OBJECTIVE: A high-performance liquid chromatography method was developed for the determination of total tea catechin and caffeine. METHODS: The catechins needed to be determined are: (-)-catechin, (-)-epigallocatechin, (-)-epigallocatechin gallate, (-)-epicatechin, (-)-epicatechin gallate, (-)-gallocatechin, (-)-gallocatechin gallate, (-)-catechin gallate and caffeine. The catechins in the tea was extracted with water:ethanol (3:7) by sonication for 20 min. After the extraction solution was centrifuged, it was analyzed by HPLC. The column used was a CAPCELL PAK C18 MG (4.6mm I.D. x 150mm) and gradient elution at constant column temperature with 30 degrees C under UV detector with 210nm. Mobile phase A was 0.1% H3PO4 in water, mobile phase B was 0.1% H3PO4 in methanol with the flow rate 1ml/min. RESULTS: The results showed that the concentration of the catechins and caffeine and their peak areas achieved good linear relation, r > 0.999. The recoveries were between 61.7%-117.3%. RSD was below 10%. With this method, some tea samples were determined, the results were favorable. CONCLUSION: The method can be applied for determination of catechin and caffeine in tea and tea beverages.