A prospective multicenter randomized controlled study on the efficacy and safety of pharyngeal spraying recombinant human interferon alpha 2b in the treatment of children with herpangina / 中华实用儿科临床杂志

Objective:To evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children.Method:s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated.Result:s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant( χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed ( χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P<0.05). Before treatment, the serum levels of tumor necrosis factor α(TNF-α) [(13.02±4.41) ng/L vs.(13.57±9.27) ng/L], interleukin-6(IL-6) [(26.48±11.31) ng/L vs.(30.15±15.55) ng/L] and C-reactive protein(CRP)[(19.34±14.11) mg/L vs.(19.83±14.57) mg/L]were not significantly different between the two groups (all P>0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P<0.05), but no significant difference in serum levels of CRP between the two groups was observed ( P>0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (1/90 cases) in the treatment group and 5.6% (5/90 cases) in the control group.In addition, the serum hemoglobin level of children in the control group after treatment was significantly lower than that before treatment and that in the treatment group (all P<0.05). Conclusions:Compared with pharyngeal spraying ribavirin, pharyngeal spraying rhIFNα2b can greatly improve the clinical efficiency, accelerate the disappearance of clinical symptoms and signs, and shorten the total course of disease, and is more safe and worthy of clinical application.

Applied anatomy of the first metatarsal proximal perforator-based neurocutaneous vascular flap / 中华显微外科杂志

Objective To explore the anatomical characteristics of mediate dorsal pedal cutaneous nerve and its nutritional vessels to provide anatomical basis of the perforator pedicle flap based on the medial dorsal pedal neurocutaneous vessels for repairing the forefoot soft-tissue defects.Methods From December,2016 to April,2017,the following contents were investigated in 30 adult feet specimens perfused with red latex:①The course,branches and distribution of the medial dorsal pedal cutaneous nerve.②The origin,course,branches and distribution of the nutrient vessels of the medial dorsal pedal neurocutaneous vessels.Mimic operation was performed on 1 fresh specimen.Results ①The mediate dorsal pedal cutaneous nerve mainly arose from the medial branch of the superficial peroneal nerve and processed forward for a distance of (2.5±0.4) cm under the surface of the inferior extensor retinaculum,and then divided into the mediate dorsal branch,the 1st and 2nd dorsal metatarsal branch over part of the dorsal pedal and digital skin.②The medial dorsal pedal neurocutaneous vessels were multiple segmental and polyphyletic,mainly include dorsalis pedis artery proximal perforator,the first metatarsal proximal perforator,the tibial proper plantar digital artery of the great toe and the perforater of the second toe web artery,of which the first metatarsal proximal perforator was most associated with operating methods.The first metatarsal proximal perforator perforate through the deep fascia to the subcutaneous area within the range of 1.0-2.0 cm near the proximal first plantar gap,the piercing point of which on deep fascia was constant,and the anatomical plane of the first metatarsal proximal perforator was higher than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator divide into a large number of branches,which closely anastomose with adjacent perforators and other medial dorsal pedal neurocutaneous vessels.③Simulated surgery showed that the first metatarsal proximal perforation pedicle flap to meet the forefoot soft tissue defect repair.Conclusion The first metatarsal proximal perforator is constant in piercing point and reliable in blood supply,and it have a higher anatomical plane than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator-based medial dorsal pedal neurocutaneous vascular flap can be transferred to repair the soft-tissue defects of forefoot.

Preventive effect of Guizhi decoction on myocardial injury after chemical sympathectomy / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the preventive effect of Guizhi decoction on myocardial injury after chemical sympathectomy induced by 6-hydroxydopamine (6-OHDA).METHODS:Wistar rats (n=54) were randomly divided in-to 6 groups.Methycobal and Guizhi decoction ( with different proportions between Ramulus Cinnamomi and Radix paeoniae Alba at 2∶1, 1∶2 or 1∶1) were pre-administered to the rats.Immunohistochemical method was used to observe the cardiac sympathetic nerve distribution.The contents of tyrosine hydroxylase (TH), choline acetylaminotransferase (ChAT) and growth-associated protein 43 (GAP-43) in the left ventricle were measured by ELISA.The serum levels of myocardial en-zymes and morphology of myocardial tissues were also observed.RESULTS:6-OHDA successfully induced cardiac sympa-thetic denervation as the contents of TH and GAP-43 in the left ventricle declined significantly.Compared with model group, the content of TH was elevated in both methycobal group and Guizhi decoction groups, while the content of GAP-43 was elevated only in Guizhi decoction groups.The serum levels of myocardial enzymes and the histopathological changes of the cardiac tissues were deteriorated after injection of 6-OHDA, indicating that the myocardial injury was established. Methycobal and Guizhi decoction normalized the abnormal change.Guizhi decoctions at 2∶1 and 1∶1 showed the best effi-cacy.CONCLUSION:6-OHDA-induced sympathetic denervation causes myocardial injury.Guizhi decoction with the proportions between Ranulus Cinnamomi and Radix paeoniae Alba at 2∶1 and 1∶1 effectively alleviate the myocardial injury after cardiac sympathetic denervation induced by 6-OHDA.

Blastic plasmacytoid dendritic cell neoplasm: a case report and literature review / 白血病·淋巴瘤

Objective To provide new information for treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Through one case report and literature review of 48 BPDCN cases were reviewed retrospectively.The clinical characteristics,treatment choices and prognosis were analyzed.Results BPDCN patients were mainly elderly males,mostly presented as skin rash and bone marrow infiltration.Immunophenotype was characteristically expressed as CD4,CD56 and CD123.Lymphoid-like regimens could induce higher response rate,lower relapse rate and longer overall survival compared with myeloid-like regimens.Allogeneic hematopoietic stem cell transplantation may provide long-term survival.At the onset of the disease,The counts of white blood cells (WBC) and blood platelet (Plt) may be correlated with inferior overall survival.Conclusions BPDCN is a disease with distinct clinical characteristics and immunophenotype.Lymphoid-like regimen may be the better treatment of choice,while allogeneic hematopoietic stem cell transplantation should be taken into account in the first complete remission for longterm survival.

Effects of Difference Chinese Medicinal Herbs for Tonifying Spleen on Obesity Degree and Insulin Resistance in Diet-induced Obesity Rats / 中国中医药信息杂志

Objective To observe the effects of Chinese medicinal herbs with the efficacy of invigorating spleen, upbearing the clear, and tonifying spleen on the obesity degree, fat hormones, and insulin resistance in diet-induced obesity (DIO) rats;To choose better anti-obesity herbs from different Chinese medicinal herbs that can tonify spleen. Methods Among the 130 Wistar rats, 10 were chosen as the blank control group (fed with basal forage), and the remaining 120 were administered with high-fat high-nutrition forage for 13 weeks. According to weight, 50 DIO rats and 10 diet-induced obesity resistance (DIO-R) rats were obtained. DIO rats were divided into model group (normal saline), sibutramine group, invigorating spleen group (Atractylodix Rhizome and Magnoliae Officinalis Cortex), upbearing the clear group (Bupleuri Radix and Aurantii Fructus Immaturus) and medicine for tonifying qi and spleen group (Astragali Radix). All groups received gavage with corresponding drugs. Rats in the blank control group and the DIO-R group received gavage with normal saline. The basal forage was administered to rats in the blank control group, while high-fat forage was continually given to rats in the other six groups. Insulin resistance index (IRI), blood glucose, triglycerides, cholesterol, tumor necrosis factor α (TNF-α) and adiponectin were detected after blood withdrawing. TNF-α and adiponectin in the fat homogenate were examined. Results Compared with the blank control group, body weight, IRI, and cholesterol of rats in the model group significantly increased (P<0.01);adiponectin in homogenate reduced (P<0.01);serum and adipose homogenate TNF-α increased (P<0.01). Compared with model group, body weight, IRI, cholesterol of rats in DIO-R group significantly decreased (P<0.01);adiponectin in fat homogenate increased (P<0.01). Body weight and cholesterol of rats in the sibutramine group significantly decreased (P<0.01), while serum and adipose homogenates TNF-αdecreased (P<0.05, P<0.01). Body weight, IRI and cholesterol of rats in upbearing the clear group decreased (P<0.05, P<0.01);serum and adipose homogenate TNF-α decreased (P<0.05, P<0.01);adiponectin increased in fat homogenate (P<0.05). IRI, cholesterol and serum TNF-αof rats in the invigorating spleen group decreased (P<0.05, P<0.01);adiponectin in serum and adipose homogenate increased (P<0.05). BMI, blood glucose, IRI and cholesterol of rats in Astragali Radix group decreased (P<0.05, P<0.01);TNF-α decreased and adiponectin increased in serum and adipose homogenate (P<0.05, P<0.01). Conclusion Astragali Radix could reduce obesity induced by high-fat forage, and its effects on improving glucose and lipid metabolism disorder and IR are better than the other TCM groups. Its mechanism is related to decreasing TNF-α and increasing adiponectin level.

Inhibition effect of Guizhi decoction on cardiac sympathetic sprouting / 中国药理学通报

Aim To investigate the preventive effect of Guizhi decoction on cardiac sympathetic sprouting induced by 4-Methylcatechol (4-MC) . Methods The rat models of cardiac sympathetic sprouting were in-duced by 10 mg · L-1 4-MC ( 10μg · kg-1 body weight, i. p. ) . Guizhi decoctions ( with different pro-portion between Ramulus Cinnamomi and Radix Paeon-iae Alba, 1 : 1, 1 : 2 and 2 : 1) and metoprolol were administered to the rats. Heart rate and electrocardio-gram ( ECG ) were observed, the content of norepi-nephrine (NE), growth associated protein (GAP-43), tyrosine hydroxylase ( TH ) and acetylcholine transfer-ase enzyme ( CHAT) in myocardial homogenate of left ventricular and right atrial were determined by ELISA method, and immunofluorescence assay was used to observe cardiac nerve sprouting and sympathetic distri-bution. Results 4-MC caused cardiac sympathetic sprouting and parasympathetic was not influenced. Heart rate of the model group was improved significant-ly and higher than that of the other groups . Compared with the model group, the content of NE, GAP-43 and TH in left ventricle and right atrium of the metoprolol group and Guizhi decoction group were decreased( P<0.05 ) , and the immunofluorescence result showed that the distribution of TH positive nerve was reduced sig-nificantly(P<0.05). It was demonstrated that Guizhi decoction of the proportion between Ramulus Cinnamo-mi and Radix Paeoniae Alba 1 : 1 and 1 : 2 had the best efficacy, which was similar to the efficacy of meto-prolol. Conclusion Guizhi decoction ( with the pro-portion between Ramulus Cinnamomi and Radix Paeon-iae Alba 1 : 1 and 1 : 2 ) effectively inhibits the cardi-ac sympathetic sprouting induced by 4-MC.