Heart rate-corrected QT interval and QT dispersion in patients with pulmonary hypertension.

OBJECTIVE: Heart rate-corrected QT interval (QTc) and QTc dispersion (QTcd) are increased and associated with ventricular arrhythmia and an increase in sudden death in a variety of diseases. This study aimed to examine QTc and QTcd in pulmonary hypertension and assess their relationship with pulmonary arterial pressure. PATIENTS AND METHODS: A total of 201 patients who had undergone right heart catheterization for a preliminary diagnosis of pulmonary hypertension between December 2003 and July 2008 were included in the study. Resting 12-lead electrocardiogram was recorded. QT interval was measured manually and corrected using Bazett's formula. Patients were divided into groups with mild-to-moderate and severe pulmonary hypertension and a control group according to mean pulmonary arterial pressure. RESULTS: In all observed cases, mean QTc was higher in severe pulmonary hypertension than in controls (428.6 +/- 32.8 ms vs. 411.1 +/- 28.4 ms, P = 0.018) and QTcd was higher in mild-to-moderate (60.1 +/- 17.2 ms) and severe pulmonary hypertension (63.9 +/- 20.5 ms) than in controls (47.3 +/- 10.6 ms) (P = 0.031; P = 0.004). In men, there was no significant difference in mean QTc and QTcd. In women, mean QTc was higher in severe pulmonary hypertension than in controls (436.1 +/- 39.4 ms vs. 407.6 +/- 24.8 ms, P = 0.037) and QTcd was higher in severe pulmonary hypertension (68.5 +/- 20.9 ms) than in both the controls (45.1 +/- 12.6 ms) and patients with mild-to-moderate pulmonary hypertension (58.6 +/- 14.7 ms) (P = 0.002; P = 0.003). In addition, in women with pulmonary hypertension, mean QTc and QTcd were positively correlated to mean pulmonary arterial pressure (r = 0.207, P = 0.03; r = 0.236, P = 0.012). CONCLUSIONS: In women with pulmonary hypertension, mean QTc and QTcd are positively correlated to mean pulmonary arterial pressure and are significantly increased in patients with severe pulmonary hypertension.

Preparation and evaluation of sirolimus sustained release tablets based on mesoporous silicon loaded self-microemulsion / 药学学报

Sirolimus self-microemulsion-mesoporous silicon sustained release tablets were prepared in order to improve the dissolution of the insoluble drug sirolimus and reduce its side effects. Firstly, sirolimus self-microemulsion was prepared and cured with mesoporous silicon. Secondly, the suitable excipients were selected according to the appearance, hardness and in vitro release rate. The sustained-release tablets with hydroxypropyl methylcellulose (HPMC) as skeleton material were prepared by powder direct pressing method, and the formulation was optimized by central composite design-response surface method to investigate the drug release in vitro. Finally, the pharmacokinetics was carried out in beagle dogs using the commercial sirolimus tablets as references. The final formulation of sustained-release tablets is as follows: 162 mg of sirolimus self-microemulsion-mesoporous silica (1∶1, w/w), 80 mg of HPMC K4M and 80 mg of carboxymethyl starch sodium, the microcrystalline cellulose is 168 mg. The results of in vitro release test showed that the self-made sustained-release tablets released slowly within 12 h, which conformed to the Ritger-Peppas model. The in vivo test results showed that compared with the commercial sirolimus tablets, the Cmax of the sustained-release tablets decreased by 49.47%, the Tmax of the sustained-release tablets was prolonged by 5.1 times, and the relative bioavailability was 105.81%. Sirolimus self-microemulsion-mesoporous silicon sustained-release tablets have good sustained-release effects in vitro and in vivo, which provides a reference for the solubilization of other insoluble drugs and the research and development of sustained-release preparations. Animal experiments and welfare processes were reviewed and approved by the Animal Ethics Committee of the 900TH Hospital of the Joint Logistics support Force.

Nodular glomerular lesion: a later stage of diabetic nephropathy?

BACKGROUND: Two typical pathological changes can develop in the type 2 diabetic nephropathy: one is diffuse glomerulosclerosis (DIF) and the other is nodular glomerular lesion (NOD). The aim of this study is to retrospectively investigate these two types of diabetic nephropathy and compare the characteristics of clinical findings and prognosis. METHODS: One hundred and twenty-four patients with biopsy-proven diabetic nephropathy, including 58 DIF and 66 NOD were investigated in this study. Clinical data were registered for each patient: age, sex, diabetes duration, hypertension duration, body mass index (BMI), and laboratory tests included: glycosylated hemoglobin, plasma albumin, plasma cholesterol and triglycerides, serum creatinine, proteinuria, urine osmole, urine N-acetyl-beta-D-glucosaminidase (NAG) enzyme and creatinine clearance rate (Ccr). Furthermore, the 1- and 5-year renal survival rates were analysed and compared. RESULTS: (1) Compared with DIF patients, NOD patients had a longer duration of diabetic mellitus, and higher levels of proteinuria and NAG enzyme, along with lower BMI, Ccr and plasma albumin levels (p<0.01). (2) In the NOD cases, there were 90% presented diabetic retinopathy; while in the DIF cases, there were 14% presented diabetic retinopathy. (3) In the DIF patients, the 1- and 5-year renal survival rates were 96 and 78%, respectively, while in the NOD patients, the rates were 86 and 18%, respectively (p<0.01). CONCLUSION: The NOD patients had longer diabetic durations, more severe renal damage, and exhibit a poorer renal prognosis. Furthermore, the NOD patients revealed more frequently evidence of diabetic retinopathy.

Construction of China Occupational Skills Standard of Assistive Technology Consultants / 中国康复理论与实践

Objective:To explore national standard of occupational skills for assistive technology consultants in China based on the study of relevant international standards. Methods:After analyzing the international and some other national job content, work requirements, professional education and vocational training, and vocational standards of assistive technology consultants, the national occupational skills standard for assistive technology consultants in China was established referring to the compiling rules of national occupational skills standard. Results:According to the compiling rules of national occupational skills standard, the national occupational skills standard for assistive technology consultants in China included career situation, basic requirements, job requirements, and weight table, etc. Conclusion:The vocational development, structural framework and content of professional capacity for assistive technology consultants are studied. The draft of national occupational skills standard for rehabilitation assistive technology consultants has been compiled.

Gegen Qinliantang Alleviates Ulcerative Colitis via Cell Signaling Pathways： A Review / 中国实验方剂学杂志

Gegen Qinliantang， a classic traditional Chinese medicine（TCM） compound， has been verified in modern research to possess various pharmacological effects such as anti-inflammation，anti-oxidative stress，protecting intestinal mucosal barrier， and regulating intestinal flora and immune response. Ulcerative colitis （UC） is a chronic idiopathic inflammatory disease involving the colorectal mucosa， which mainly results from genetic susceptibility， intestinal mucosal barrier damage， abnormal immune response， intestinal flora disturbance， and bile acid metabolism disorders. By reviewing the literature published in recent years， this paper sorted out the relevant pathways and mechanisms involved in the treatment of UC by Gegen Qinliantang to provide ideas for further clinical and basic research. This literature review uncovered that Gegen Qinliantang exerted the therapeutic effects against UC mainly via interleukin-6（IL-6）/Janus tyrosine kinase 2（JAK2）/signal transducer and activator of transcription 3（STAT3） signaling pathway， Toll like receptor 4（TLR4）/nuclear transcription factor-κB（NF-κB） signaling pathway，Notch signaling pathway， and matrix metalloproteinase-9（MMP-9）/p38 mitogen-activated protein kinase（p38 MAPK） signaling pathway. Gegen Qinliantang regulates the intercellular molecular transmission in multiple pathways to protect the intestinal mucosal barrier， adjust the immune response and anti-oxidative stress， and relieve UC， demonstrating the multi-target， multi-mechanism， and multi-pathway advantages of TCM compounds.

The mechanism of enriched environment repairing the learning and memory impairment in offspring of prenatal stress by regulating the expression of activity-regulated cytoskeletal-associated and insulin-like growth factor-2 in hippocampus

BACKGROUND@#Prenatal stress can cause neurobiological and behavioral defects in offspring; environmental factors play a crucial role in regulating the development of brain and behavioral; this study was designed to test and verify whether an enriched environment can repair learning and memory impairment in offspring rats induced by prenatal stress and to explore its mechanism involving the expression of insulin-like growth factor-2 (IGF-2) and activity-regulated cytoskeletal-associated protein (Arc) in the hippocampus of the offspring.@*METHODS@#Rats were selected to establish a chronic unpredictable mild stress (CUMS) model during pregnancy. Offspring were weaned on 21st day and housed under either standard or an enriched environment. The learning and memory ability were tested using Morris water maze and Y-maze. The expression of IGF-2 and Arc mRNA and protein were respectively measured by using RT-PCR and Western blotting.@*RESULTS@#There was an elevation in the plasma corticosterone level of rat model of maternal chronic stress during pregnancy. Maternal stress's offspring exposed to an enriched environment could decrease their plasma corticosterone level and improve their weight. The offspring of maternal stress during pregnancy exhibited abnormalities in Morris water maze and Y-maze, which were improved in an enriched environment. The expression of IGF-2, Arc mRNA, and protein in offspring of maternal stress during pregnancy was boosted and some relationships existed between these parameters after being exposed enriched environment.@*CONCLUSIONS@#The learning and memory impairment in offspring of prenatal stress can be rectified by the enriched environment, the mechanism of which is related to the decreasing plasma corticosterone and increasing hippocampal IGF-2 and Arc of offspring rats following maternal chronic stress during pregnancy.

Influencing factors of work-related musculoskeletal disorders among civil aviation flight attendants / 中国职业医学

OBJECTIVE: To analyze the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) in civil aviation flight attendants. METHODS: A total of 810 flight attendants from three civil aviation airlines in China were selected as research subjects using the convenient sampling method. The revised Musculoskeletal Disorders Investigating Questionnaire was used to investigate the prevalence of WMSDs in various parts of the body in the past year. RESULTS: The total prevalence of WMSDs in flight attendants in this survey was 64.4%(522/810). The prevalence of WMSDs in various parts of the body from high to low was: neck(48.0%), shoulder(38.6%), lower back/waist(26.0%), upper back(19.8%), feet(15.1%), knee(14.0%), hip and leg(11.0%), hand and wrist(9.0%) and elbow(5.1%). The results of multivariate logistic regression analysis showed that working with an uncomfortable posture and the shortage of staff in the work sector were risk factors for neck WMSDs(all P<0.05). The protective factors were sufficient rest time and voluntary decision when to take a break during work(all P<0.05). Carrying heavy objects >20 kg, working in uncomfortable posture and shortage of staff were risk factors for shoulder WMSDs(all P<0.05). Working in uncomfortable posture and repeated an operation every minute were risk factors for lower back/waist WMSDs(all P<0.05), and sufficient rest time was its protective factor(P<0.05). CONCLUSION: The prevalence of WMSDs in civil aviation flight attendants is high, and the neck, shoulder and ower back/waist are the most commonly affected part of the body. The main influencing factors are poor ergonomics and work organization.

A novel splicing mutation identified in a Chinese family with Alport syndrome and analysis of its pathogenicity / 医学研究生学报

Objective The purpose of this study was to identify a pathogenic variant in a Chinese family with Alport syndrome and analyze the pathogenicity of the variant. Methods Using targeted region capture and high-throughput sequencing technology, we identified the genetic variant of the proband with Alport syndrome, verified the variant in the family members by Sanger sequencing, and analyzed its influence on the pre-mRNA splicing process by in vitro minigene assay. Results A heterozygous variant c.2767G>T (p.Gly923Cys) was identified as a novel variant in exon 32 of the COL4A5 gene in the proband, which was confirmed by Sanger sequencing to be cosegregated with disease in the family. The minigene assay demonstrated that the c.2767G>T variant induced deletion of exon 32 of the COL4A5 gene. Conclusion A novel COL4A5 mutation was identified by targeted region capture and high-throughput sequencing, which has enriched the gene mutation spectrum of Alport syndrome. The exonic mutation c.2767G>T confirmed to be a splicing mutation by in vitro minigene assay, which may lead to a deeper insight into the molecular pathogenesis of Alport syndrome.

First line nucleos(t)ide analog monotherapy is more cost-effective than combination strategies in hepatitis B e antigen-positive chronic hepatitis B patients in China / 中华医学杂志(英文版)

BACKGROUND@#Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed "functional cure," based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective.@*METHODS@#A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively.@*RESULTS@#In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA - PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results.@*CONCLUSION@#Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

First line nucleos(t)ide analog monotherapy is more cost-effective than combination strategies in hepatitis B e antigen-positive chronic hepatitis B patients in China / 中华医学杂志(英文版)

Background@#Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed "functional cure," based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective.@*Methods@#A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively.@*Results@#In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA - PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results.@*Conclusion@#Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

CD20+ B-cell infiltration is related to the time after transplant and poor prognosis of acute cellular rejection in renal transplant.

OBJECTIVES: This study sought to determine the relation between CD20+ B-cell infiltration and time after transplant and outcome of acute cellular rejection in renal allografts. MATERIALS AND METHODS: Fifty-five patients with acute cellular rejection were categorized into 3 groups: very early, early, and late rejection. The density of CD4+, CD8+, CD20+, and CD68+ cells and HLA-DR expression were characterized and quantified using immunohistochemical staining. Histologic changes were compared between high-density and low-density CD20+ B-cell groups. Poor prognosis factors were analyzed with Cox proportional regression. RESULTS: Density of CD20+ cells in the very-early rejection group was lower than it was in the early- and late-acute rejection groups (P = .03); the density of CD4+, CD8+, and CD68+ cells and HLA-DR expression did not differ between the groups. Mesangial matrix increase, tubular atrophy, arteriolar hyaline thickening, and tubulitis were more prevalent in the high CD20+ density group. Cox regression analysis demonstrated that HLA-DR expression on the tubules, arteriolar hyaline thickening, and CD20+ cell density were associated with an elevated risk of acute cellular rejection. CONCLUSIONS: Expansion aggregation of CD20+ B cells occurred mostly after 2 weeks. When combined with HLA-DR expression and arteriolar hyaline thickening, these influence the outcome of acute cellular rejection in renal allograft.

Effect of baicalein on pancreas insulin secretion in rats and its mechanism / 中国药理学通报

Aim To investigate the effect of baicalein on insulin secretion from rat islets and the underlying mechanism. Methods Pancreatic islets were obtained from the pancreas of male Wistar rats by collagenase P digestion and histopaque-1077 density gradient separa-tion. Single islet cells were dispersed from pancreatic islets by Dispase II digestion. Insulin secretion experi-ment was applied to observe insulin release after baica-lein stimulation. To study the potential mechanism, calcium imaging technique and patch-clamp experiment were applied to measure intracellular Ca2+ concentra-tion and voltage-dependent potassium channel currents (Kv). Results In 16. 7mmol·L-1 glucose, baica-lein accelerated insulin secretion in a dose-dependent manner. Baicalein promoted the intracellular Ca2+ con-centration. The patch-clamp experiment showed that baicalein inhibited Kv current in a dose-dependent manner. Conclusion Baicalein can increase the in-tracellular Ca2+ concentration by inhibiting Kv chan-nels and eventually promoting insulin secretion.

Preparation of silymarin solid dispersions and dissolution rates of five constituents / 中成药

AIM To prepare silymarin solid dispersions and to evaluate the dissolution rates of five constituents.METHODS Taking F68 and PVPk30 as a combined carrier,the solid dispersions were prepared by solvent fusion method.Then the effects of combined carrier ratio and drug-carrier ratio on dissolution rates of silybin,isosilybin,silydianin,silycristin and taxifolin were investigated.RESULTS The optimal conditions were determined to be 1 ∶ 3 for combined carrier ratio,and 1 ∶ 5 for drug-carrier ratio.These five constituents displayed much higher dissolution rates in solid dispersions than those in raw medicine and physical mixture (silymarin-carrier).CONCLUSION Solid dispersions can significantly increase the dissolution rates of effective components in silymarin.

Clinical Feature Analysis for Respiratory Disease and/or Hypoxia Related Pulmonary Hypertension in 31 Patients / 中国循环杂志

Objective: To investigate the clinical features in patients with respiratory disease and/or hypoxia related severe pulmonary hypertension. Methods: Our research included in 2 groups: Hypoxia related pulmonary hypertension group, the patients with respiratory disease and/or hypoxia combining severe pulmonary hypertension, n=31 and Severe idiopathic pulmonary hypertension group, n=41. The diagnosis was confirmed by right heart catheterization; the patients treated in our hospital from 2016-01 to 2017-01 were consecutively enrolled and studied. Clinical features and treatment were compared between 2 groups. Results: Compared with Severe idiopathic pulmonary hypertension group, the patients' mean age, BMI and blood pressure were higher in Hypoxia related pulmonary hypertension group, while the majority clinical features were similar between 2 groups. In Hypoxia related pulmonary hypertension group, more patients had obstructive sleep apnea-hypopnea syndrome (OSAHS) with the higher AHI and the lower mean blood oxygen pressure at night, increased diameters of left atria and ventricle, elevated NT-proBNP level and reduced 6 minutes walking distance; some patients tried target drug therapy, calcium channel blocker therapy or continuous positive airway pressure therapy. Conclusion: Respiratory disease especially OSAHS should be screened from the patients with severe pulmonary hypertension. In addition to basic respiratory and hypoxia medication, further investigation is needed to confirm whether the prognosis could be improved by calcium channel blocker therapy and target drug therapy.

Mechanism of beryllium sulfate-induced apoptosis in human embryonic lung fibroblast / 中国职业医学

OBJECTIVE: To investigate the effect of beryllium sulfate( BeSO_4) on apoptosis of human embryonic lung fibroblast( MRC-5 cell). METHODS: MRC-5 cells were cultured in vitro and randomly divided into 6 groups: a control group,a low-,medium- and high-dose BeSO_4 group,an antagonist group,and an activator group. The former 4 groups were given final concentrations of 0,1,10 and 100 μmol / L of BeSO_4,respectively. The combined treatment of BeSO_4and2-aminoethoxydiphenyl borate( 10 μmol / L final concentration) was used in the antagonist group. The combined treatment of BeSO_4 and inositol triphosphate( IP3)( 10 μmol / L final concentration) was used in the activator group. After 24 and48 hours of culture,the cells were harvested. The apoptosis of MRC-5 cells was detected by flow cytometry. The intracellular calcium ion( Ca~(2+)) was detected using laser scanning confocal microscope. Quantitative real-time polymerase chain reaction was used to detect the relative expression of IP_3RⅢ and B-cell lymphoma-2( BCL-2) mRNA and the protein expression of IP_3RⅢ and IP3 were detected by enzyme-linked immunosorbent assay. RESULTS: The apoptosis rates of cells in the 3 BeSO_4 dose groups at the time points of 24 and 48 hours were lower than those in the control group at the same time points( P < 0. 05). The apoptosis rate of the antagonist group was lower than those in medium-dose BeSO_4 group and control group at the same time points( P < 0. 05). At the time point of 48 hours,the apoptosis rate of the activator group was lower than that of control group( P < 0. 05) and higher than that of the medium-dose BeSO_4group( P < 0. 05). As for the Ca~(2+)concentration at time point of 24 hours,the low-dose BeSO_4 group was lower than the control group( P < 0. 05),and the high-dose BeSO_4 group was higher than the control group( P < 0. 05). The Ca~(2+)concentrations at time point of 48 hours in the medium- and high-dose BeSO_4 groups were lower than that in the control group( P < 0. 05). Compared with the medium-dose BeSO_4 group and control group at time points of 24 and 48 hours,the Ca~(2+)concentrations in the antagonist group decreased( P < 0. 05),while thoes of the activator group increased( P < 0. 05). The expression of BCL-2and IP_3RⅢmRNA in the 3 BeSO_4 groups,the activator and antagonist group were higher than those of the control group( P <0. 05). The expression of IP3 R Ⅲ protein at the time point of 24 hours in the medium-dose BeSO_4 group,the activator group and the antagonist group were lower than that of control group( P < 0. 05). The expression of IP_3RⅢ protein at the time point of 48 hours,the high-dose BeSO_4 group was lower than the control group( P < 0. 05); the activator and antagonist groups were higher than the medium-dose BeSO_4group( P < 0. 05). The expression of IP3 protein in the lowand medium-dose BeSO_4 groups and the activator group were higher than that in the control group( P < 0. 05). The expression of IP3 protein in activator group was higher than the medium-dose group( P < 0. 05). CONCLUSION: BeSO_4 might change the Ca~(2+)concentration and inhibite the apoptosis of MRC-5 cell through regulating the IP3 R / Ca~(2+)pathway,IP3 can improve the decrease of Ca~(2+)concentration in MRC-5 cells induced by BeSO_4.

Effects of DNA methylation of thymocyte differentiation antigen-1 in beryllium sulfate induced human fetal lung fibroblast fibrosis / 中国职业医学

OBJECTIVE: The change of DNA methylation of thymocyte differentiation antigen-1( Thy-1) was observed in beryllium sulfate( Be SO4) stimulated human fetal lung fibroblast( MRC-5 cell) to explore the effects of Thy-1 in Be SO4 induced lung fibrosis. METHODS: MRC-5 cell culture in vitro model was used. The final concentrations of Be SO4were1. 0,10. 0 and 100. 0 μmol / L( low-,medium- and high-dose groups). The control was untreated. Other 2 intervention groups were the 5-azacytidine( AZC) intervention group( 10. 0 μmol / L of AZC and 10. 0 μmol / L Be SO4) and the trichostatin A( TSA) intervention group( 0. 5 μmol / L of TSA and 10. 0 μmol / L Be SO4). The cells were collected 24,48 and 72 hours after exposure. Real-time quantitative polymerase chain reaction( PCR) was used to determine the relative expression of collagen typeⅠ( Col Ⅰ),collagen type Ⅲ( Col Ⅲ),α-smooth muscle actin( α-SMA) and Thy-1 mRNA.The nested landed methylation specific PCR was used to detect the Thy-1 DNA methylation level. RESULTS: At 24 hours,the relative expression level of Col Ⅲ mRNA in MRC-5 cells showed an increasing trend with increasing dose( P < 0. 05);at 48 and 72 hours,the relative expression levels of Col Ⅰ,Col Ⅲ and α-SMA mRNA in MRC-5 cells increased with the increasing dose( P < 0. 05). All these 3 indicators in MRC-5 cells of 3 dose groups increased with the increase of expose time( P < 0. 05). The relative expression level of Thy-1 mRNA in MRC-5 cells of all 3 dose groups were lower than that in control( P < 0. 05). The relative expression level of Thy-1 mRNA of the high-dose group was lower than that of the lowdose group( P < 0. 05). The Thy-1 DNA methylation levels in the medium- and high-dose groups were both higher than that of the control( P < 0. 05). The Thy-1 DNA methylation levels of the 3 dose groups increased with the increasing dose( P < 0. 05). The Thy-1 DNA methylation levels of MRC-5 cells in the 2 intervention groups were higher than that of the control( P < 0. 05),but there was no significant difference when compared with the medium-dose group( P > 0. 05).CONCLUSION: Be SO4 stimulation can induce the fibrosis of MRC-5 cells. In this process,the Thy-1 DNA methylation level increases,while the Thy-1 mRNA expression level decrease. Thy-1 DNA methylation might be one of the important mechanisms of lung fibrosis induced by Be SO4.

Treatment of Refractory Rheumatoid Arthritis by Huayu Tongbi Recipe Combined Methotrexate / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of Huayu Tongbi Recipe (HTR) combined methotrexate (MTX) in treating refractory rheumatoid arthritis (RRA).</p><p><b>METHODS</b>Totally 167 RRA patients were assigned to the treatment group (73 cases) and the control group (94 cases) according to different therapeutic methods. Patients in the treatment group were treated with HTR combined MTX, while those in the control group were treated with leflunomide (LEF) combined MTX. Clinical signs and symptoms, RF, CRP, ESR, disease activity score 28 (DAS28), and safety indicators were compared between the two groups before treatment, at week 12 and 24 after treatment. The efficacy and safety indices were also evaluated.</p><p><b>RESULTS</b>At week 12 after treatment the total effective rate was 82.2% (60/73 cases) in the treatment group and 79.8% (75/94 cases) in the control group, showing no statistical difference between the two groups (chi2 = 0.15, P > 0.05). At week 24 after treatment the total effective rate was 78.1% (57/73 cases) in the treatment group and 755% (71/94 cases) in the control group, showing no statistical difference between the two groups (chi2 = 0.15, P > 0.05). There was statistical difference in the total effective rate between week 24 and week 12 in the control group (chi2 = 0.49, P < 0.05). Clinical signs and symptoms, RF, CRP, ESR, and DAS28 were significantly improved in the two groups after 12- and 24-week treatment (P < 0.01). There was no statistical difference in the improvement at week 12 after treatment between the two groups (P > 0.05). There was statistical difference in time of morning stiffness, tender joint numbers, swollen joint numbers, patient global assessment, RF, CRP, and DAS28 at week 24 after treatment between the two groups (P < 0.05). Besides, adverse reactions occurred less in the treatment group than in the control group (P < 0.01).</p><p><b>CONCLUSION</b>The efficacy of HTR combined MTX was equivalent to that of LEF (10 mg per day) combined MTX, but with more stable therapeutic effects and less adverse reactions.</p>

Isolation, purification and identification of polysaccharides from Gynura divaricata / 中国中药杂志

The purpose of this study was to isolate and purify polysaccharide from Gynura divaricata and analyze its monosaccharide composition. A water-soluble crude polysaccharide was obtained by hot water extraction, ethanol precipitation and deproteinization after degreasing. The crude polysaccharide then purified with DEAE-Sepharose Fast Flow column chromatography and dialysis. The monosaccharide composition and structure were analyzed by HPLC, UV spectrophotometer and 1H-NMR. The results showed that the purity and molecular weight of GDPS-2 and GDPS-3 were 87.3%, 2.03 x 10(4) Da and 90.9%, 4.29 x 10(4) Da, respectively. The UV spectrophotometer and 1H-NMR data suggested that glycosidic bond of GDPS-2 and GDPS-3 were a type. Both GDPs-2 and GDPs-3 were homogeneous polysaccharides, and GDPs-2 was mainly composed of glucuronic acid and xylose at a molar ratio of 1.1:0.63. GDPs-3 was mainly composed of rhamnose, glucuronic acid, galactose, xylose and galacturonic acid at a molar ratio of 0.32:6.0:0.21:1.75:4.3.

Fingerprint and spectrum-effect relationships on Tripterygium glycosides preparation / 中国中药杂志

Tripterygium glycosides preparation which extracted from the traditional Chinese herb Tripterygium wilfordii (TWHY), was widely used to treat the autoimmune diseases. Previous works demonstrated that TWHF had potent anti-inflammatory and immunosuppressive properties. But the different quality and high incident rate of side effects of different manufactures inhibited its clinical application. Since TWHF had been generally known to play a therapeutical effect by synergism of multiple constituents, it was necessary to build the relationship between the HPLC fingerprint and bioactivity so as to ensure the quality safety and efficacy. The HPLC fingerprint showed that description and content of peaks from different manufactures were diverse. Only 11 common peaks were found. In this study, mice spleen cells stimulated by Con A were used to test the proliferation inhibition bioactivity of TWHF preparations, which were incubated with 30, 15, 7.5, 3.75, 1.88 and 0.94 mg x L(-1) TWHF preparations for 48 h. The results showed that mice spleen cells proliferation was inhibited by all TWHF preparations significantly compared with the control group, which suggested the TWHF preparations showed immune suppress activity. The TWHF preparations from 7 manufacture showed different IC50 value, which might belong to different contents which showed in the HPLC fingerprint. Moreover, a relationship between the HPLC fingerprint and the bioactivity were established to identify important constituents by grey relational analysis (GRA). The result showed that all the contents were relative with the IC50, especially No. 5 and 10 peaks, but No. 1 peak, which was proved to be triptolide, had few contribute to the inhibition of mice spleen cells proliferation. The study of relationship between the HPLC fingerprint and the IC50 by GRA could help to investigate mechanism of bioactive and provide an evidence for the quantification of multi-constituents.

Percutaneous transluminal angioplasty and stenting for pulmonary stenosis due to Takayasu's arteritis: clinical outcome and four-year follow-up.

BACKGROUND: Percutaneous transluminal angioplasty and stent implantation for stenotic lesions of renal arteries and other branches of the aorta in Takayasu's arteritis have been reported to show good outcomes. However, this form of therapy has been reported in few cases with pulmonary artery involvement. HYPOTHESIS: The aim of this study was to evaluate the role of this interventional treatment for pulmonary stenosis due to Takayasu's arteritis. METHODS: A total of 4 patients (3 female and 1 male, ages 30-40 yrs) with Takayasu's pulmonary arteritis underwent percutaneous transluminal balloon angioplasty and stent implantation and were followed up for 1 to 4 years. RESULTS: One patient underwent balloon angioplasty alone, 3 patients underwent balloon angioplasty and stent implantation. The stenoses were relieved acutely, oxygen saturation improved immediately due to improvement in lung perfusion and relief of dyspnea. The pressure gradient fell from 58.3 +/- 8.7 mm Hg to 14 +/- 3.2 mm Hg and mean pulmonary arterial pressure decreased from 48.5 +/- 12.0 mm Hg to 37.3 +/- 6.0 mm Hg. At a follow-up period of 34.5 +/- 15.8 months, the patient with balloon angioplasty alone developed a recurrence of symptoms 18 months after the procedure. The other 3 patients continued to be asymptomatic and the stent remained patent without restenosis after the procedure. CONCLUSION: Percutaneous transluminal angioplasty and stent implantation is a safe and effective treatment in patients with pulmonary stenosis caused by Takayasu's arteritis.