[Efficacy and safety of Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension].

Objective: To study the efficacy and safety of Balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Patients who were diagnosed CTEPH in China-Japan Friendship Hospital from Feb 2018 to Sep 2019 were evaluated. The ineligibility for pulmonary endarterectomy (PEA) and the indication for BPA were decided on the basis of a consensus among the multidisciplinary team for all CTEPH patients. 6-min walk distance (6MWD), the plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP), mixed venous oxygen saturation, mean pulmonary artery pressure (mPAP), cardiac index (CI) and pulmonary vascular resistance (PVR) were collected and analyzed before the first and the last BPA session. Results: A total of 67 BPA sessions were performed for 302 subsegmental pulmonary arteries in 25 inoperable CTEPH patients. 10 males (40.0%) and 15 females (60.0%), with the age of (57.8±7.1) years old. The median interval between CTEPH diagnosis and first BPA was 20.0 (9.0, 48.5) months. 18 patients were received more than 2 BPA sessions, the median follow-up time was 5.0 (3.5, 8.3) months. 6MWD, CI and the mixed venous oxygen saturation were significant improved after BPA [(425±74) vs (345±109) m, (1.99±0.45) vs (1.62±0.35) L·min(-1)·m(-2), (68.1%±6.5%) vs (61.2%±6.3%)](all P<0.05). The plasma level of NT-proBNP, mPAP and PVR were significantly decreased after BPA [259 (93, 739) vs 806 (148, 2 159) ng/L, (40.6±8.3) vs (47.3±10.7) mmHg (1 mmHg=0.133 kPa), (11.9±4.9) vs (17.2±6.5) WU (1 WU=80 dyn·s·cm(-5))](all P<0.05). Hemoptysis occurred in 5 sessions (7.5%) and reperfusion pulmonary edema (RPE) occurred in 2 sessions (1.5%), 1 patient needed non-invasive mechanical ventilation because of RPE, 1 patient died from right heart failure caused by hemoptysis during perioperative period. Conclusions: BPA can significantly improve the exercise tolerance and hemodynamic parameters for inoperable CTEPH patients, the risks of BPA are acceptable. BPA is an effective and relatively safe treatment for inoperable CTEPH patients.

[Noninvasive diagnostic and predictive value in renal transplant recipients with acute rejection by measurement of urine Fractalkine].

Objective: To investigate the relationship between early-stage renal acute rejection(AR) and the level of Fractalkine in urine, explore the diagnostic and noninvasive monitoring value in early stage after transplantation by measurement of urine Fractalkine. Methods: Urine samples were examined from renal transplant patients between January 2006 and October 2009. A total of 155 patients were enrolled, including 49 with biopsy-proved AR, 58 patients with stable renal function and no abnormal histological findings, 10 patients with subclinical rejection in protocol biopsy, 9 patients with biopsy-proven acute tubular necrosis and 29 patients with biopsy-proven chronic allograft nephropathy. Additionally, urine samples were also collected from 40 healthy controls. Fractalkine was measured in urine samples using a commercial human Fractalkine enzyme-linked immunosorbent assay (ELISA) kit. Immunohistochemistry for Fractalkine expression was performed on biopsies from renal transplant patients with AR and non-AR. Results: Forty-nine patients with AR excreted urinary Fractalkine at a significantly higher level than levels in patients with stable renal function and healthy controls[(429.1±56.1)vs (94.6±8.4), (84.5±8.9)ng/mmol creatine, both P<0.001]. Patients with AR excreted urinary Fractalkine at a significantly higher level than levels in patients with acute tubular necrosis and chronic allograft nephropathy[(429.1±56.1)vs(133.0±9.8), (183.0±18.9)ng/mmol creatine, both P<0.001]. Receiver operating characteristic(ROC)curve was constructed to determine the discriminatory power of Fractalkine levels for diagnosis of AR. The area under ROC curve was 0.920(95% CI: 0.875-0.969, P<0.001), which showed that Fractalkine was a suitable marker for the diagnosis of AR. At a cut-off point of 157.5 ng/mmol creatinine, the sensitivity was 83.7% and the specificity was 84.5% (P<0.001). The dynamic level of urinary Fractalkine in AR patients within 3 weeks after transplantation fluctuated above 300 ng/mmol creatine, which is remarkably higher than patients with stable renal function (below 200 ng/mmol creatinine). Conclusions: As a noninvasive monitoring method, Fractalkine in urine may be a new approach for detection of AR as well as useful to predict response to antirejection therapy. It has good sensitivity and specificity. Besides, measurement of Fractalkine in urine is a simple, inexpensive method for the routine clinical monitoring after kidney transplantation.

[Clinical observation of flupentixol and melitracen combined with specific immunotherapy for treatment of allergic rhinitis patients with anxiety and depression].

Objective:To explore the clinical effects of Flupentixol/Melitracencombined with specific immunotherapy in allergic rhinitis patients with anxiety and depression. Method:Totally ninetynine moderate to severe persistent allergic rhinitis patients with anxiety and depression from October 2014 to Sepetember 2015 were randomly divided into two groups: 45 patients in experimental group (Flupentixol/Melitracen 10.5 mg，QD,treatment last 4 months)and 44 patients in control group.All patients were treated with specific immunotherapy for 1 years. The nasal symptoms score, mini Rhinoconjunctivitis Quality of life questionnaire(MiniRQLQ), Medication score, SAS and SDS score and the clinical curative effect were observed before treatment, after 4 months or one year treatment. The drug reactions were also recorded. Result:The VAS scores, MiniRQLQ scores, medication scores, SAS and SDS scores of patients in two groups who were treated after 4 months and 1 year were significantly reduced than that of patients before treatment.The differences were statistically significant(P<0.05).Compared with the control group, nasal symptom scores, MiniRQLQ scores, medication scores, SAS and SDS scores in experimental group were decreased after 4 month or 1 year treatment(P<0.05).After 4 months of treatment, the total effective rate of the experimental group was 84.4%, while the control group was 56.8%.After 1 years of treatment, the experimental group excellence rate was 57.8%, while the control group was 22.7%.The differences were statistically significant(P<0.05). During the course of treatment, there were thirteen cases of mild adverse reactionsin experimental group (17.7%) and control group(11.4%). There was no significant differences(P>0.05). Conclusion:Flupentixol and melitracen combined with specific immunotherapy could sifnificantlly relieve clinical symptom, quality of life and mental depression.is a safe and reliable therapeutic regimen for further improving clinical symptoms,quality of life,mental statusand the clinical efficacy in moderate to severe persistent with anxiety anddepression.

Anxiolytic effect of seed of Ziziphus jujuba in mouse models of anxiety.

The aim of the present study was to investigate the ethanolic extract of Semen Ziziphi jujuba (SZJE) induced anxiolytic effect. The SZJE was orally administered to male ICR mice, at 0.5, 1.0 and 2. 0 g/kg, 30 min before the behavioral evaluation in the black and white test (BWT) and elevated plus maze (EPM). The SZJE at the dosage 0.5-2.0 g/kg increased the first time entry, total changes and times spent in the white chamber of the BWT. The SZJE at the dosage 0.5-1.0 g/kg increased the percentage of time-spent and the percentage of arm entries in the open arms of the EPM and decreased the percentage of time-spent and the percentage of arm entries in the closed arms of the EPM. Furthermore, the SZJE at the dosage of 1. 0 g/kg prolonged the hexobarbital-induced sleeping time in mice and decreased the locomotor activity in rats. These results suggested that SZJE possessed anxiolytic effect at lower dose and sedative effect at higher dose.

The ameliorating effects of the cognitive-enhancing Chinese herbs on scopolamine-induced amnesia in rats.

Ameliorating effects were investigated of the cognitive-enhancing Chinese herbs administered orally for 1 week-Panax ginseng (PG), Panax notoginseng (PNG), Dioscorea opposita (DO), Gastrodia elata (GE), Salvia miltiorrhiza (SM), Acorus gramineus (AG), Coptis chinensis (CC), Polygonum multiflorum (PM), Cyperus rotundus (CR) and Psoralea corylifolia (PC)-on the scopolamine (SCOP)-induced amnesia by using a passive avoidance task in rats. Of ten Chinese herbs, only PG, PNG, GE and CC prolonged the SCOP-shortened STL. These results revealed that PG, PNG GE and CC administered orally for 1 week improved the SCOP-induced learning and memory deficit in rats.

Effects of Fructus schizandrae on cycloheximide-induced amnesia in rats.

The effects of Fructus Schisandrae (Schizandra Chinensis, (FS) on cycloheximide (CXM)-induced amnesia by using a passive avoidance task were studied in rats. FS at 0.25 and 0.75 g/kg administered for 1 week significantly prolonged the CXM-shortened step-through latency (STL). Of the fractions (n-hexane, chloroform and water), only the water fraction at 25 mg/kg administered for 1 week prolonged the CXM-shortened STL. These results suggest that the water fraction is the main active fraction of FS.

Effect of long-term administration of berberine on scopolamine-induced amnesia in rats.

The effect of berberine (BER) on scopolamine (SCOP)-induced amnesia was investigated in a step-through passive avoidance task in rats. It was observed that BER at the doses of 0.1 and 0.5 g/kg after 7-day or 14-day administration significantly improved SCOP-induced amnesia. The anti-amnesic effect of BER after 14-day administration on the SCOP-induced amnesia was significantly augmented by physostigmine or neostigmine, and completely reversed by scopolamine N-methylbromide. These results suggest that the antiamnesic effect of BER after 14-day administration may be related to the increase in the peripheral and central cholinergic neuronal system activity.

Biphasic effects of pu-chung-i-chi-tang on sedation and excitation.

The biphasic effects of Pu-Chung-I-Chi-Tang (PCT) on sedation and excitation in acute treatment or after one-week consecutive treatment were studied. The results indicated that PCT produces sedation in acute treatment and excitation after one-week consecutive treatment. The sedative mechanism of PCT in acute treatment might be due to an increase in serotonergic activity and a decrease in dopaminergic activity. However, the excitatory mechanism of PCT after one-week consecutive treatment might involve the increase in dopaminergic activity and the decrease in serotonergic activity.

Effects of Gastrodia elata and its active constituents on scopolamine-induced amnesia in rats.

The effects of the rhizome of Gastrodia elata Blume (Orchidaceae) (abbreviated as GE) and its active constituents on learning and memory by using the one-trial passive avoidance task were studied in rats. At the 1.0 g/kg dose administered for one week, the methanol extract of GE significantly prolonged the shortened step-through latency induced by scopolamine in the passive avoidance task. Furthermore, at the 50.0 mg/kg dose administered for one week, the ethyl acetate and n-butanol fractions of the methanol extract prolonged the shortened step-through latency induced by scopolamine in rats. Gastrodin, isolated from the n-butanol fraction of the methanol extract, and p-hydroxybenzyl alcohol, isolated from the ethyl acetate fraction of the methanol extract, also significantly prolonged the shortened step-through latency induced by scopolamine on the passive avoidance task. These results suggested that gastrodin and p-hydroxybenzyl alcohol may be the active constituents of GE.

Effects of Hemerocallis flava on motor activity and the concentration of central monoamines and its metabolites in rats.

In this study, we used behavioral and biochemical methods to investigate the effects of Hemerocallis flava (Liliaceae) (abbreviated as HF) on motor activity and the concentration of monoamines in rats. The water fraction of the resuspended HF extract was most active in reducing the motility in rats. The water fraction of the HF extract enhanced the reduction of locomotor activity produced by alpha-methyl-p-tyrosine and 5-hydroxytryptophan, but it reduced the increase of locomotor activity produced by L-dopa plus benserazide and p-chlorophenylalanine. Furthermore, the water fraction of the HF extract significantly decreased the concentration of norepinepherine in the cortex and the concentration of dopamine and serotonin in the brain stem. It also increased the concentration of vanilylmandelic acid in the cortex, homovanillic acid and 5-hydroxyindole-acetic acid in the brain stem. These results suggest that the reduction of locomotor activity produced by the water fraction of HF extract may be related to the decrease in the concentration of norepinepherine in the cortex and the concentration of dopamine and serotonin in brain stem.

Study of the external counterpulsation (ECP) therapy for senile dementia of the Alzheimer's type (SDAT).

Ten patients with SDAT received the ECP therapy. The examination of Hasegawa's Dementia Scale (HDS), single photor emission computed tomography (SPECT) brain imaging, and some biochemical parameters in blood and CSF were selected to evaluate the effect of ECP for SDAT. After ECP treatment, the average HDS score of the patients increased, the value of P was close to 0.05; and the cortical cerebellar ratios of SPECT brain scan, the superoxide dismutase (SOD) activity and the concentrations of somatostatin-like immunoreactivity (SLI), dynorphin AL-13 (Dyn Al-13) in blood and/or CSF were significantly elevated. The results indicated that ECP could not only improve cerebral blood flow, but also make a notable impact on biological active substances in blood and CSF. It is suggested that ECP is beneficial to SDAT patients.

Effects of DL-tetrahydropalmatine on motor activity and the brain monoamine concentration in rats.

Behavioral and biochemical methods were used in this study to investigate the effect of DL-THP on motor activity and the concentration of monoamines in rats. Experimental results indicated that DL-THP significantly decreased the motor activity of rats and showed a dose-response pattern; in addition, it produced rigidity at a higher dosage. DL-THP also enhanced the hypomotility induced by haloperidol, but reduced the hypermotility produced by apomorphine. Furthermore, DL-THP significantly decreased the concentration of norepinephrine (NE), dopamine (DA) in the cortex and brain stem at lower and higher dosages, and the concentration of serotonin (5-HT) in the cortex at higher dosages. DL-THP also increased the concentration of homovanillic acid (HVA) in the cortex and brain stem at lower and higher dosages, and the concentration of 5-hydroxyindole acetic acid (5-HIAA) in the cortex at higher dosages. These results suggest that the hypomotility produced by DL-THP may be due to the increase in the turnover rate of dopamine in the cortex and brain stem at lower and higher dosages, and of serotonin in the cortex at higher dosages.

Effects of palmatine on motor activity and the concentration of central monoamines and its metabolites in rats.

We used behavioral and biochemical methods to investigate the sedative effect of palmatine on locomotor activity and the concentration of monoamine in rats. It was found that palmatine enhanced the hypomotility induced by alpha-methyl-p-tyrosine, reserpine and 5-hydroxytryptophan, but reduced the hypermotility produced by L-dopa plus benserazide and p-chlorophenylalanine. Furthermore, palmatine significantly decreased the concentration of dopamine and homovanillic acid in the cortex and the concentration of serotonin in the brain stem, and it increased the concentration of 5-HT in the cortex and 5-hydroxyindole acetic acid in the brain stem. These results suggest that the sedative mechanism of palmatine may be related to the decrease in the concentration of catecholamine in the cortex and serotonin in brain stem and the increase in the concentration of 5-HT in the cortex.

Studies on the anticonvulsive, sedative and hypothermic effects of Periostracum Cicadae extracts.

The anticonvulsive, sedative and hypothermic effects of water and ethanol extracts of Periostracum Cicadae (PC), the cast off skin of Cryptotympana atrata were studied. The water-extract of whole Periostracum Cicadae (PCws) had anticonvulsive, sedative and hypothermic effects in rats. Orally, it decreased carrageenin-induced hyperthermia. The hypothermic effect of PCws was potentiated by 5-hydroxytryptophan and antagonized by p-chlorophenylalanine. PCws enhanced the decrease in locomotor activity induced by alpha-methyl-p-tyrosine or 5-hydroxytryptophan and reduced the increase in locomotor activity produced by levodopa plus benserazide or p-chlorophenylalanine. From these results, it was concluded that the sedative and hypothermic effect of PCws may be due to an increase in central serotonergic activity.

Unstable phalangeal fractures: treatment by A.O. screw and plate fixation.

A prospective study of fifty-two fresh traumatic unstable fractures of the proximal or middle phalanges of the hand in forty-seven patients was reviewed. All the fractures were fixed with A.O. miniature screws and plates. The overall results were not satisfactory and complications were frequent. Only 26.9% of the fractures had good results. Fractures associated with significant soft tissue injuries had very poor results. When the present series was compared with a comparable group of fractures fixed with Kirschner wires, there was no significant improvement in the results. The unsatisfactory outcome of this group of unstable fractures may be largely due to the frequent association with poor prognostic factors.