[Optimal processing technology of Zhangbang vinegar-processed Olibanum with multi-indicator-response surface methodology and anticoagulant effect evaluation].

This study first optimized the processing technology for Zhangbang vinegar-processed Olibanum and investigated its in vitro anticoagulant activity. A multi-index-response surface methodology was used, with yield, powder yield, and the relative percentage of the content of six non-volatile components [11-keto-boswellic acid(KBA), 3-acetyl-11-keto-boswellic acid(AKBA), ß-elemonic acid, α-boswellic acid(α-BA), ß-boswellic acid(ß-BA), and α-acetyl-boswellic acid(α-BA)] and three volatile components(octyl acetate, incensole, and incensole acetate) as evaluation indicators. Analytical hierarchy process(AHP) combined with coefficient of variation method was used to calculate the weight of each indicator and calculate the comprehensive score(OD). Furthermore, response surface methodology was used to investigate the effects of frying temperature(A), burning time(B), rice vinegar dosage(C), and steaming time(D) on the processing technology of vinegar-processed Olibanum. Vinegar-steamed Olibanum was prepared according to the optimal processing technology for in vitro anticoagulant experiments. The results showed that the weights of octyl acetate, incensole, incensole acetate, KBA, AKBA, ß-elemonic acid, α-BA, ß-BA, α-ABA, yield, and powder yield were 0.358 2, 0.104 5, 0.146 4, 0.032 9, 0.123 7, 0.044 4, 0.022 1, 0.042 2, 0.110 1, 0.012 2, and 0.0032, respectively. The optimal processing technology for Zhangbang vinegar-processed Olibanum was as follows. Olibanum(50 g) with a particle size of 1-5 mm was continuously stir-fried at a low heat of 150-180 ℃ until in a gel-like state, ignited for burning for 15 s, sprayed with 7.5 g of rice vinegar(15%), and steamed for 3 min without fire. Subsequently, the cover was removed, and the product was continuously stir-fried at 150-180 ℃ until in a soft lump shape, removed, cooled, and crushed. The results of the in vitro anticoagulant experiments showed that compared with the blank group, both Olibanum and vinegar-processed Olibanum significantly prolonged the activated partial thromboplastin time(APTT), thrombin time(TT), and prothrombin time(PT) of rat platelet-poor plasma(PPP), and the effect of vinegar-processed Olibanum was significantly better than that of Olibanum(P<0.05). The optimized processing technology for Zhangbang vinegar-processed Olibanum is stable, feasible, and beneficial for the further development and utilization of Olibanum slices. At the same time, using the content of volatile and non-volatile components, yield, and powder yield as indicators, and verifying through pharmacological experiments, the obtained results are more reasonable and credible, and have positive guiding significance for the clinical application of characteristic processed Olibanum products.

[Mechanism of Euodiae Fructus stir-fried with water decoction of Coptidis Rhizoma in treatment of chronic colitis based on UPLC-Q-TOF-MS, network pharmacology and experimental verification].

To elucidate the mechanism of Euodiae Fructus stir-fried with water decoction of Coptidis Rhizoma in the treatment of chronic colitis, this study employed ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS), network pharmacology, and experimental verification to predict the involved targets and signaling pathways. The chronic colitis mouse model was constructed to verify the core targets. A total of 48 compounds in the herbal medicine were identified by UPLC-Q-TOF-MS. SwissTargetPrediction was used to screen the potential active components and drug targets. GeneCards, OMIM, PharmGKB, and TDD were used to search for the disease targets. A total of 31 active ingredients, 453 targets of the herbal medicine, and 3 960 targets of chronic colitis were obtained. The common targets shared by the herbal medicine and chronic colitis were introduced into STRING to construct the protein-protein interaction(PPI) network, and CytoNCA plug-in was used to screen the key targets. A total of 90 key targets were obtained, and the key active components included isorhamnetin, quercetin, limonin, and oxyberberine. GO annotation and KEGG pathway enrichment for the key targets were carried out via DAVID. The targets were mainly involved in the positive regulation of protein phosphorylation, positive regulation of nitric oxide biosynthetic process, and negative regulation of apoptotic process. The medicine may treat chronic colitis through PI3 K-Akt, VEGF, HIF-1, and TNF signaling pathways. A mouse model of chronic colitis was established and then treated with Euodiae Fructus stir-fried with the water decoction of Coptidis Rhizoma. The experimental results demonstrated that the medicine can alleviate the pathological damage of colon, significantly reduce the levels of IL-1ß, IL-6, and TNF-α, inhibit the activation of PI3 K/Akt pathway, and down-regulate the expression of VEGFA in the treatment of chronic colitis.

Naoxintong Capsule Activates the Nrf2/HO-1 Signaling Pathway and Suppresses the p38α Signaling Pathway Via Estrogen Receptors to Ameliorate Heart Remodeling in Female Mice With Postmenopausal Hypertension.

ABSTRACT: Limited treatments are available for alleviating heart remodeling in postmenopausal hypertension. The cardioprotective effect of naoxintong (NXT) has been widely accepted. This study aimed to explore the effects of NXT on pathological heart remodeling in a postmenopausal hypertension mouse model in vivo and H9c2 cardiomyocytes in vitro. In vivo, ovariectomy combined with chronic angiotensin II infusion was used to establish the postmenopausal hypertension animal model. NXT significantly ameliorated cardiac remodeling as indicated by a reduced ratio of heart weight/body weight and left ventricle weight/body weight, left ventricular wall thickness, diameter of cardiomyocytes, and collagen deposition in the heart. NXT also significantly increased the expression of estrogen receptors (ERs) and downregulated the expression of nicotinamide adenine dinucleotide phosphate oxidase 2 (Nox2). In vitro, NXT treatment greatly suppressed angiotensin II-induced cardiac hypertrophy, cardiac fibrosis, and excessive oxidative stress as proven by reducing the diameter of H9c2 cardiomyocytes, expression of hypertrophy and fibrosis markers, intracellular reactive oxygen species, and oxidative enzymes. Mechanistically, NXT significantly upregulated the expression of ERs, which activated the Nrf2/HO-1 signaling pathway and inhibited the phosphorylation of the p38α pathway. Collectively, the results indicated that NXT administration might attenuate cardiac remodeling through upregulating the expression of ERs, which activated the Nrf2/HO-1 signaling pathway, inhibited the phosphorylation of the p38α signaling pathway, and reduced oxidative stress.

Laparoscopic approach for managing intussusception in children: Analysis of 65 cases.

BACKGROUND: Intussusception can be managed by pneumatic reduction, ultrasound-guided hydrostatic reduction, open or laparoscopic surgery, but laparoscopy in such cases remains controversial. AIM: To explore the clinical characteristics, effectiveness, and complications of surgical reduction for intussusception using laparoscopy in children. METHODS: This study was a retrospective case series of pediatric patients with intussusception who underwent surgical reduction by laparoscopy from May 2011 to April 2016 at Taizhou Hospital of Zhejiang Province. Clinical characteristics (operation time, intraoperative blood loss, conversion rate of laparotomy, reasons for conversion, postoperative hospital stay, and adverse events) were described. RESULTS: The 65 patients included 45 boys and 20 girls. The average age was 2.3 years (27.5 ± 24.5 mo). Of the 65 patients, 61 underwent surgical reduction by laparoscopy after a failed enema reduction of intussusception, and four underwent the procedure directly. All patients were treated successfully and 57 (87.7%) patients underwent successful laparoscopic surgery, two of which had a spontaneous reduction. Among the remaining cases, one was converted to open surgery via right upper quadrant incision, and seven required enlarged umbilical incisions. Intestinal resection was performed in 5 patients because of abnormal bowel lesions. There were no complications (intestinal perforations, wound infections, or intestinal adhesions) during the follow-up of 3 years to 8 years. Two patients experienced a recurrence of intussusception; one was resolved with pneumatic reduction, and the other underwent a second laparoscopic surgery. CONCLUSION: Laparoscopic approach for pediatric intussusception is feasible and safe. Bowel resection if required can be performed by extending umbilical incision without the conventional laparotomy.

Comparison of Aspirin and Naoxintong Capsule () with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase.

OBJECTIVE: To compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (, NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1), who are at high-risk of thromboembolism. METHODS: A total of 151 patients, with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHA2DS2-VASc clinical risk score of 2 or above, were chosen for this study. Patients were randomized into two groups and orally treated with a combination of aspirin (100 mg/day) and NXT (1.6 g thrice a day) or adjusted-dose warfarin [international normalized ratio 2.0-3.0). The primary end points including ischemic stroke and death as well as the secondary end points including hemorrhage events were followed up for at least 1 year. RESULTS: Baseline clinical data and the rates of primary end points were similar between groups. However, the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%, odds ratio: 0.921, 95% confidence interval: 0.862-0.984, P=0.028). CONCLUSIONS: Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596).

Up-Regulation of CYP2C19 Expression by BuChang NaoXinTong via PXR Activation in HepG2 Cells.

BACKGROUND: Cytochrome P450 2C19 (CYP2C19) is an important drug-metabolizing enzyme (DME), which is responsible for the biotransformation of several kinds of drugs such as proton pump inhibitors, platelet aggregation inhibitors and antidepressants. Previous studies showed that Buchang NaoXinTong capsules (NXT) increased the CYP2C19 metabolic activity in vitro and enhanced the antiplatelet effect of clopidogrel in vivo. However, the underlying molecular mechanism remained unclear. In the present study, we examined whether Pregnane X receptor (PXR) plays a role in NXT-mediated regulation of CYP2C19 expression. METHODS: We applied luciferase assays, real-time quantitative PCR (qPCR), Western blotting and cell-based analysis of metabolic activity experiments to investigate the NXT regulatory effects on the CYP2C19 promoter activity, the mRNA/ protein expression and the metabolic activity. RESULTS: Our results demonstrated that NXT significantly increased the CYP2C19 promoter activity when co-transfected with PXR in HepG2 cells. Mutations in PXR responsive element abolished the NXT inductive effects on the CYP2C19 promoter transcription. Additionally, NXT incubation (150 and 250µg/mL) also markedly up-regulated endogenous CYP2C19 mRNA and protein levels in PXR-transfected HepG2 cells. Correspondingly, NXT leaded to a significant enhancement of the CYP2C19 catalytic activity in PXR-transfected HepG2 cells. CONCLUSION: In summary, this is the first study to suggest that NXT could induce CYP2C19 expression via PXR activation.

A randomized controlled trial of adjunctive Bunchang Naoxintong Capsule (步长脑心通胶囊) versus maintenance dose clopidogrel in patients with CYP2C19*2 polymorphism.

OBJECTIVE: To determine the impact of adjunctive Buchang Naoxintong Capsule (, NXT) on dual antiplatelet therapy in patients with cytochrome P450 2C19*2 (CYP2C19*2) polymorphism undergoing percutaneous coronary intervention (PCI). METHODS: Ninety patients with CYP2C19*2 polymorphism were enrolled, and their genotypes were confirmed by polymerase chain reaction (PCR). The patients were randomly assigned to receive either adjunctive NXT (triple group, 45 cases) or dual antiplatelet therapy (dual group, 45 cases) using a computer-generated randomization sequence and sealed envelopes. Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry. Subsequent major adverse cardiovascular events (MACE, including sudden cardiac arrest and acute coronary syndrome) were recorded during a 12-month follow-up. RESULTS: Baseline platelet function measurements were similar in both groups. After 7 days, percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group (42.3%±16.0% vs. 20.8%±15.2%, P<0.01, and 54.7%±18.3% vs. 21.5%±29.2%, P<0.01, respectively). During the 12-month follow-up, the rate of subsequent MACE (6/45) was significantly lower in the triple group compared with the dual group (14/45; P<0.05). CONCLUSION: Adjunctive NXT to maintenance dose clopidogrel (75 g) could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19*2 polymorphism undergoing PCI.

Relationship between cytochrome P450 2C19*17 genotype distribution, platelet aggregation and bleeding risk in patients with blood stasis syndrome of coronary artery disease treated with clopidogrel.

OBJECTIVE: To assess the impact of cytochrome P450 (CYP) 2C19*17 allelic variant on platelet aggregation and bleeding risk in Chinese patients with blood stasis syndrome undergoing percutaneous coronary intervention (PCI) and treated with clopidogrel. METHODS: A total of 520 patients with blood stasis syndrome undergoing PCI after pretreatment with 300 mg clopidogrel and aspirin were studied from July 2009 to April 2011 in Fujian Provincial Institute of Cardiovascular Diseases. CYP2C19*17 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Platelet aggregation induced by 5µmol/L of adenosine diphosphate (ADP) was analyzed with platelet-rich plasma and platelet-poor plasma by turbidimetry method before and after 10 d of treatment with clopidogrel. RESULTS: Bleeding events were observed in 5.96% of patients after thrombolysis for myocardial infarction, and the ratio of patients with CYP2C19*17 allele was 7.98%. The bleeding rate in patients carrying CYP2C19*17 allele, heterozygous (wt/*17) and homozygous (*17/*17), was higher than that in patients with wild-type homozygotes (wt/wt) (P<0.01). At baseline, ADP-induced light transmission at maximal aggregation, 5-min aggregation and disaggregation showed no significant difference among patients with the three different CYP2C19*17 genotypes. However, after 10-day administration of clopidogrel, values of ADP-induced platelet aggregation in *17/*17 and wt/*17 carriers were significantly decreased compared with the wild-type homozygotes (P<0.05, P<0.01); the inhibition rate of platelet aggregation was higher in patients carrying *17/*17 and wt/*17 than those only carrying wt/wt, and the same result was found in disaggregation of platelet after 10-day treatment (P<0.05, P<0.01). Patients with wt/*17 and *17/*17 allele of CYP2C19 showed a higher risk of bleeding than those with wild-type allele (P<0.01), and the occurrence of bleeding was highest in patients with CYP2C19*17 homozygotes. CONCLUSION: CYP2C19*17 allele is associated with enhanced response to clopidogrel and an increased risk of bleeding in patients with blood stasis syndrome of coronary artery disease treated by clopidogrel.

Efficacy of dual antiplatelet therapy combined with Naoxintong capsules [see text] following coronary microembolization induced by homologous microthrombi in rats.

OBJECTIVE: To evaluate the effificacy of dual antiplatelet therapy combined with Naoxintong Capsule ([see text], NXTC) in a rat model of coronary microembolization (CME). METHODS: A total of 95 rats were randomly divided into 6 groups: control, sham-operation, CME model, NXTC, dual antiplatelet (clopidogrel and aspirin) intervention (DA), and NXTC combined with DA (NDA) groups. The complete data in 69 rats were obtained. The number of CME, myocardial apoptosis rate, bleeding time, clotting time, and adensosine diphosphate (ADP)-induced platelet aggregation were assessed. RESULTS: Compared with the CME group, the number of CME and myocardial apoptosis rates were signifificantly decreased in the NXTC, DA, and NDA groups (P <0.01). Compared with other intervention groups, the number of CME and myocardial apoptosis rates were the least in the NDA group (P <0.01), and the incidence of surgical bleeding was the highest in the DA group (P <0.01). Compared with the CME group, ADP-induced maximum platelet aggregation rate was significantly inhibited in the NXTC, DA, and NDA groups (P <0.01), both bleeding time and clotting time were signifificantly increased in the NXTC, DA, and NDA groups (P <0.01), while the above parameters were the highest in the DA group (P <0.05). CONCLUSION: The combination therapy of NXTC and DA enhanced the anti-CME effect of either therapy alone and reduced the risk of the DA therapy-associated bleeding, demonstrating an improved benefifit/ risk ratio in the rat model of CME.

Chinese herbal medicine Naoxintong capsule combined with dual antiplatelet therapy in a rat model of coronary microembolization induced by homologous microthrombi.

OBJECTIVE: In the present study, the efficacy of Naoxintong capsule (NXT), a compound Chinese herbal medicine, combined with dual antiplatelet therapy (DA) in a rat model of coronary microembolization (CME) was evaluated. METHODS: CME in rats was developed by injecting a suspension of microthrombotic particles into the left ventricle when the ascending aorta was obstructed. Microthrombotic particles were generated from the clots of rats sized by filtration through a screen (aperture diameter, 38 µm). A total of 95 rats were randomly divided into six groups, including control group, sham-operation (sham) group, CME model (CME) group, and NXT, DA, and NDA (NXT plus DA) groups. Rats in treatment groups were administered intragastrically with NXT, DA, and NDA, respectively, from 3 d before to 7 d after operation. All rats were sacrificed on day 7 post-operationally, and samples of blood and heart were collected. The complete data of 69 rats were obtained. The incidence of CME (CME%) was evaluated by hematoxylin-eosin staining. Bleeding time (BT) and clotting time (CT) were measured by means of tail cutting and glass slide methods, respectively. Adenosine diphosphate-induced maximum platelet aggregation rate (PAR) was assessed with turbidimetry. Platelet counts were examined by an automated hematology analyzer. The levels of serum P-selectin, interleukin (IL)-6, IL-10, endothelin (ET-1) and endothelial nitric oxide synthase (eNOS) were all detected by enzyme-linked immunosorbent assay. RESULTS: Compared with control and sham groups, CME group had an increase in CME%, PAR, P-selectin, IL-6 and ET-1 (P<0.01, P<0.01), and a decrease in BT, CT, IL-10 and eNOS (P<0.01, P<0.01); compared with CME group, the groups receiving medications had an increase in BT, CT, IL-10 and eNOS (P<0.05 or P<0.01), and a decrease in CME%, PAR, P-selectin, IL-6 and ET-1 (P<0.05 or P<0.01), with DA group increasing most in BT and CT and decreasing most in PAR and P-selectin, and with NDA group increasing most in IL-10 and eNOS and decreasing most in CME%, IL-6 and ET-1. In terms of platelet counts, there was no statistically significant difference among groups (P>0.05). CONCLUSION: NXT combined with DA can decrease CME%. The probable mechanism is that this therapy can appropriately inhibit platelet aggregation, balance the pro- and anti-inflammatory cytokines as well as serum ET-1 and eNOS. This therapy can also reduce risk of intraoperative bleeding during DA therapy.

[Relationship between gene polymorphism and haplotype of SLC6A2 promoter and blood-stasis pattern in patients with essential hypertension].

OBJECTIVE: To explore the relationship between the genetic variants of the norepinephrine transporter gene solute carrier family 6 member 2 (SLC6A2) and blood stasis pattern (BSP) in patients with essential hypertension (EH). METHODS: DNA was extracted from the peripheral blood of 830 EH patients (532 were typed as BSP and 298 as non-BSS) and 512 persons with normal blood pressure (for control), to detect the polymorphisms of SLC6A2 promoter-3 and 2 by PCR-RFLP, and estimate the haplotype frequency adopting SHEsis program. RESULTS: Chi2 partition showed that frequency of promoter-2-GG genotype in EH patients of BSP was lower than that in the EH patients of non-BSP and the normal control (P = 0.001); while that of promoter-3-GG/GA in the EH patients with severe BSP was the highest (P < 0.001). Logistic regression analysis showed that after the miscellaneous factors being rectified, with the reference category of EH-non-BSP, the relative odds ratio (OR) of promoter-2-GC/CC genotype for EH-BSP was 1.535 (95% CI: 1.094-2.155, P = 0.013); that of promoter-3-AG/GG genotype for EH with severe BSP was 1.925 (95% CI: 1.199-3.091, P = 0.007); while OR of G-C haplotype (promoter-3-promoter-2) for EH-BSP was 2.127 (95% CI: 1.202-3.765, P = 0.010), showing the strongest intensity. CONCLUSION: SLC6A2 promoter-3-GA/GG genotype may be a susceptibility gene for patients of EH with severe BSP; promoter-2-GC/CC and G-C haplotype might be the susceptible factors to EH-BSP.

[Relationships of blood stasis syndrome, CYP2C19 gene polymorphism with clopidogrel resistance and post-PCI prognosis].

OBJECTIVE: To study the relationships of blood stasis syndrome (BSS), CYP2C19 gene polymorphism with clopidogrel resistance (CR) and post-PCI prognosis. METHODS: Materials of 415 patients (Han nationality) with coronary atherosclerotic heart disease (CAHD) hospitalized between January 2008 and July 2009 were collected. The CYP2C19*2 gene distribution in patients with different degrees of BBS was observed, and the relationships of BSS, CYP2C19*2 with the laboratory CR [LCR, percentage of patients with ADP-induced maximal platelet aggregation (MPA) rate reduced for < or = 10% after a 10-day clopidogrel treatment] were analyzed. Besides, an assay on the relations of maximal platelet aggregation suppressive rate (MPAS), LCR, recurrent cardiovascular events (RCEs) with BSS and CYP2C19*2 gene mutation was performed in a 7-month (in median) follow-up study on 180 post-PCI patients who received conventional treatment by clopidogrel and aspirin. RESULTS: (1) The frequency of 681G>A mutation in patients with severe BSS and in those who received PCI was higher than that in those with mild BSS (P<0.01); (2) After clopidogrel treatment, LCR was 45.06% (187/415) in total patients, 61.63% (143/232) in patients with severe BSS, 53.24% (115/216) in patients carrying 681A allele; (3) The MPA was less decreased and the LCR was higher in patients with severe BSS than in those with mild BSS (P<0.01); (4) After clopidogrel treatment, the MPA was less decreased and the LCR was higher in carrying CYP2C19 681A allele than in those carrying 681 GG type gene (P<0.01); (5) Follow-up study showed that not only the MPA suppressive rate was lower, LCR was higher in patients with severe BSS or those carrying CYP2C19 681A allele, but a higher RCEs was also shown in them (P<0.01). Moreover, after the various risk factors had been adjusted, the RCEs in patients with severe BSS or carrying CYP2C19 681A allele was higher than in those with mild BSS (OR: 4.01; 95% CI: 1.79-8.99) or carrying GG type gene (OR: 6.89; 95% CI: 2.97-15.97). CONCLUSION: Severe BSS and CYP2C19*2 gene mutation are associated with LCR, and could increase the risk of post-PCI cardiovascular events recurrence in patients with CAHD.

Sequential defunctionalization followed by thyroxine supplementation as preoperative preparation of hyperthyroid patients undergoing thyroidectomy.

BACKGROUND: Preparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment "sequential thyroid defunctionalization followed by thyroxine supplementation." METHODS: Four hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with "sequential thyroid defunctionalization followed by thyroxine supplementation". Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications. RESULTS: Compared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group (326 +/- 163) ml in the control group; (196 +/- 57) ml in subgroup A; (230 +/- 71) ml in subgroup B; (240 +/- 80) ml in subgroup C; and (312 +/- 97) ml in subgroup D). The postoperative complication rate of the experimental group was 8.64% (21/243) whereas that of the control group was 17.54% (40/228). CONCLUSIONS: Sequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected hyperthyroid patients undergoing thyroidectomy.

[In vitro effect of medicinal scorpion on the larvae of Ancylostoma caninum].

Five gram stool sample from dog infected with Ancylostoma caninum was smeared on filter paper for routine cultivation under 35 degrees C with moist condition for 24 hours. Hookworm larvae were separated and divided into 3 bottles through precipitation-washing method. Traditional Chinese medicine scorpion (2 ml), albendazole (10 mg) and normal saline (2 ml) (control) were added respectively into the 3 bottles, which were cultured for another 24 hours. The growth and development of the larvae were observed under microscope. In scorpion group, the larva body shrank, development stopped, and with an unclear internal structure. Treated with albendazole, the larvae became rigid and shriveled with rough body surface and vague internal structure. The results indicate that both medicinal scorpion and albendazole have considerable effect in inhibiting the development of hookworm larvae and the effect of albendazole is stronger.

[Study on thyroid defunctionalization method for the preoperative preparation of hyperthyroid operation].

OBJECTIVE: To set up and publicize the thyroid defunctionalization method for the preoperative preparation of hyperthyroid operation. METHODS: 476 hyperthyroid patients admitted in our hospital from March 1990 to February 2005 were studied by groups. They were divided randomly into a test group (244 patients), in which "preoperative preparation method of sequential thyroid defunctionalization" was applied to hyperthyroid patients, and based on the different drug dosages and treating terms used, further 4 subgroups (A, B, C and D) were divided to observe the treatment efficiency; And a control group (232 patients), in which antithyroid drugs and iodine preparation were applied preoperatively to cases. Thyroid functions in every stage of treatment were tested by radioimmunoassays (RIA), and operative bleeding volumes and postoperative complications were observed. RESULTS: Compared to the control group, the thyroid congestion and surface varices were alleviated in the test groups, in which the thyroid tissue of subgroup A most closed to euthyroidism histologically. The mean operative bleeding volume of test group was less than that of the control group. The bleeding volumes were (324.76 +/- 163.26) mL for the control group, (195.74 +/- 57.07) mL for the subgroup A, (230.00 +/- 70.81) mL for the subgroup B, (240.47 +/- 80.29) mL for the subgroup C and (314.75 +/- 96.46) mL for the subgroup D. There was no significant difference between the control group and subgroup D, but compared with the subgroup A, B, and C, there was the significant difference between control and treated subgroup (P < 0.05). The postoperative complication rate of the test group was 8.61% (21/244), while that of the control group was 17.24 (40/232). There was statistic difference between two groups (P < 0.005). CONCLUSION: The key to "preoperative preparation method of sequential thyroid defunctionalization" is as follows: the synthesis of thyroxin should be fully inhibited to thyroid defunctionalized; sufficient exogenous thyroxin should be supplemented; the term of thyroid function compensation should be long enough. The "preoperative preparation method of sequential thyroid defunctionalization" can decrease perioperational complications effectively and operation risks.

[Clinical analysis on high-sensitivity C-reactive protein in hypertensive patients with blood-stasis syndrome].

OBJECTIVE: To study the correlation of serum high-sensitivity protein (hs-CRP) level and the clinical score of blood-stasis syndrome as well as the clinical indexes in hypertensive patients. METHODS: Levels of serum hs-CRP, blood lipids, fasting blood glucose (FBG), body mass index (BMI), left ventricular mass index (LVMI), fibrinogen (Fg), urinary albumin (UA), and score of blood-stasis syndrome (SBSS) in 117 patients were measured, and the relationship between hs-CRP and the other indexes was analyzed. RESULTS: Spearman rank correlation analysis showed that hs-CRP level was significantly positively correlated with SBSS, triglyceride (TG), FPG, BMI, LVMI, Fg, and UA, while negatively correlated with high density lipoprotein cholesterol (HDL-C). CONCLUSION: Hs-CRP is closely related with the formation and development of blood-stasis syndrome in hypertensive patients.