Evaluation of In Vitro Enzymatic and Non-Enzymatic Antioxidant Properites of Leaf Extract from Alpinia Purpurata (Vieill.) K. Schum.

Objective: To evaluate the enzymatic and non-enzymatic antioxidants of leaf extract from Alpinia purpurata. Methods: One gram of fresh leaf of Alpinia purpurata was grinded in 2 mL of 50% ethanol and centrifuged at 10,000×g at 4 ℃ for 10 min. The supernatant obtained was used within 4 h for various enzymatic antioxidants assays like superoxide dismutase(SOD), catalase(CAT), glutathione peroxidase(GPx), glutathione S-transferase(GST), ascorbate oxidase, peroxidase, polyphenol oxidase(PPO) and non-enzymatic antioxidants such as vitamin C, total reduced glutathione(TRG) and lipid peroxidation(LPO). Results: The leaf extract of Alpinia purpurata possess antioxidants like vitamin C 472.92±6.80 μg/mg protein, GST 372.11±5.70 μmol of 1-chloro 2,4 dinitrobenzene(CDNB)-reduced glutathione(GSH) conjugate formed/min/mg protein, GPx 281.69±6.43 μg of glutathione oxidized/min/mg protein, peroxidases 173.12±9.40 μmol/g tissue, TRG 75.27±3.55 μg/mg protein, SOD 58.03±2.11 U/mg protein, CAT 46.70±2.35 μmol of H_2O_2 consumed/min/mg protein in high amount whereas ascorbate oxidase 17.41±2.46 U/g tissue, LPO 2.71±0.14 nmol/L of malondialdehyde formed/min/mg protein and PPO 1.14±0.11 μmol/g tissue in moderate amount. Conclusion: Alpinia purpurata has the potential to scavenge the free radicals and protect against oxidative stress causing diseases. In future, Alpinia purpurata may serve as a good pharmacotherapeutic agent.     

Characterization of Wnt1-inducible Signaling Pathway Protein-1 in Obese Children and Adolescents

Wnt1-inducible signaling pathway protein-1 (WISP1), a member of the CCN family, is increasingly being recognized as a potential target for obesity and type 2 diabetes mellitus. Recent studies have shown that WISP1 can regulate low-grade inflammation in obese mice, and circulating WISP1 levels are associated with obesity and type 2 diabetes mellitus in adults. Herein, we measured serum WISP1 levels in obese youth and explored its relationships with pro-inflammatory cytokine interleukin 18 (IL-18) and other metabolic indexes. Totally, 44 normal-weight and 44 obese children and adolescents were enrolled. Physical and laboratory data were recorded, and then serum levels of WISP1 and IL-18 were determined by enzyme-linked immunosorbent assays. Results showed that serum levels of WISP1 were significantly higher in obese children and adolescents than in normal-weight healthy controls (1735.44±15.29 vs. 1364.08±18.69 pg/mL). WISP1 levels were significantly positively correlated with body mass index (BMI) and BMI z-score (r=0.392, P=0.008; r=0.474, P=0.001, respectively) in obese group; circulating IL-18 was increased in obese individuals (1229.06±29.42 vs. 295.87±13.30 pg/mL). Circulating WISP1 levels were significantly correlated with IL-18 (r=0.542, P<0.001), adiponectin (r=0.585, P<0.001) and leptin (r=0.592, P<0.001). The multivariate stepwise regression analysis showed that higher IL-18 levels represented the main determinant of increased WISP1 levels after adjusting for BMI, waist circumference, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and HbA1c in obese individuals (β=0.542, P=0.000). WISP1 can be involved in glucose/lipid metabolism in obese youth, which may be modulated by IL-18. Increased WISP1 levels may be a risk factor of obesity and insulin resistance, and WISP1 has a potential therapeutic effect on insulin resistance in obese children and adolescents.     

Efficacy and Safety of Qiaoshao Formula(翘芍方) on Patients with Lifelong Premature Ejaculation of Gan(Liver) Depression and Shen(Kidney) Deficiency Syndrome:A Randomized Controlled Trial

Objective: To observe the efficacy and safety of Qiaoshao Formula(翘芍方, QSF) on patients with lifelong premature ejaculation(LPE) of Gan(Liver) depression and Shen(Kidney) deficiency syndrome. Methods: A total of 60 LPE patients were randomly divided into treatment(QSF) and control(dapoxetine) groups. The treatment group received QSF twice a day and the control group received dapoxetine 1 to 2 h prior to planned sexual intercourse for 4 weeks. The outcomes included intra-vaginal ejaculation latency time(IELT), premature ejaculation diagnostic tool(PEDT), clinical global impression of change(CGIC), scores of Chinese medicine symptoms(CMSS), sex life satisfaction(SLS) and adverse events(AEs). Results: In the treatment group, the median IELT was 3 min vs. 1.5 min before and after treatment(P0.05). PEDT in the treatment group was reduced to 11.76±1.68 from 15.83±2.30 after treatment(P0.05). Besides, patient's SLS was improved from 1.30±0.05 to 6.30±0.04(P0.05), and spouse's SLS was increased from 1.30±0.08 to 6.10±0.06(P0.05); CMSS was decrease from 14.86±3.02 to 9.62±2.87(P0.05). In addition, no significant AE was observed in both groups. Conclusion: QSF may be effective and safe on LPE patients with Gan depression and Shen deficiency syndrome.     

Differences in pathological characteristics and laboratory indicators in adult and pediatric patients with Henoch-Schönlein purpura nephritis

We aimed to investigate the differences in renal histopathological changes and laboratory parameters between adult and pediatric patients with Henoch-Schönlein purpura nephritis (HSPN), and to analyze the correlation between laboratory parameters and renal histopathological grading. A total of 139 patients diagnosed with HSPN between September 2010 and December 2014 at the First Hospital of Jilin University, China, were retrospectively reviewed. The clinical and pathological characteristics were examined and compared between the adult and the pediatric patients. A majority of adult (75.0%) and pediatric (66.2%) patients were categorized as pathological grade III HSPN. Adults having crescent lesions, interstitial fibrosis and renal artery involvement significantly outnumbered child counterparts (all P<0.05). Pathological grading showed a positive correlation with 24-h urine protein (r=0.307, P=0.009), microalbuminuria (r=0.266, P=0.000) and serum globulin (r=0.307, P=0.014), and a negative correlation with serum albumin (r=0.249, P=0.037) in pediatric patients with HSPN. Among adult patients with HSPN, histopathological grading showed a positive correlation with 24-h urine protein (r=0.294, P=0.015), microalbuminuria (r=0.352, P=0.006), α1-microglobulin (r=0.311, P=0.019) and immunoglobulin G (r=0.301, P=0.023) in urine, and serum creatinine (r=0.292, P=0.018). Further, a negative correlation between serum albumin and pathological grading was also observed (r=0.291, P=0.018). In conclusion, the severity of renal pathological lesions in HSPN patients is well reflected by the levels of proteinuria. Adult patients have more severe renal histopathological changes than pediatric patients.     

Pretreatment of Shaoyao Gancao Decoction (芍药甘草汤) Alters Pharmacokinetics of Intravenous Paclitaxel in Rats

Objective:To investigate the effect of Shaoyao Gancao Decoction(芍药甘草汤,SGD) on the pharmacokinetics of intravenously administered paclitaxel in rats.Methods:Paclitaxel was intravenously administered to rats(3 mg/kg) with or without the concomitant administration of SGD(752 mg/kg,a single day or 14 consecutive days pretreatment).The paclitaxel in the serum was quantified using a simple and rapid ultra performance liquid chromatography(UPLC) method for the pharmacokinetic study.The pharmacokinetic parameters were calculated via a non-compartment model using the computer program DAS 2.0.Results:The pharmacokinetic parameters of paclitaxel were significantly altered in response to 14 consecutive days of pretreatment with SGD.The area under the curve(AUC_(0-t),from 4 820 ± 197 to 4 205 ± 186 ng·mL~(-1)·h~(-1))and AUC_(0-∞)(from 5 237 ±280 to 4 514 ± 210 ng·mL~(-1)·h~(-1)) significantly decreased in response to the 14-day pretreatment with SGD.The values of V_(dss)(L/kg) were 10.74 ±1.08 and 9.35 ±0.49,those of CL(L/kg) were0.67 ±0.03 and 0.57 ±0.03 and the t_(1/2)(h) values were 11.17 ±0.84 and 11.32 ±0.93,respectively,for the14-day SGD pretreatment and intravenous paclitaxel alone.The AUC_(0-t) and AUC_(0-∞) values decreased by13%and 14%(P0.01),respectively.The area under the curve decreased significantly(P0.01),and the total clearance increased by 1.2-fold(P0.01),after 14 consecutive days of pretreatment with SGD.A single-day pretreatment with SGD did not significantly affect the pharmacokinetic parameters of paclitaxel.Conclusions:SGD administration for 14 consecutive days increased the metabolism of paclitaxel,while a 1-day pretreatment had little effect.The results would contribute important information to the study on interaction between Chinese medicines and chemotherapy and also help to utilize SGD better in the adjunctive therapy of cancer patients.     

Endoscopic Surgery <Emphasis Type="Italic">versus</Emphasis> External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage

The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventricular hemorrhage (IVH) were explored and compared. From Jan. 2015 to Dec. 2016, the clinical data of 42 cases of IVH were retrospectively analyzed, including 18 patients undergoing endoscopic hematoma evacuation (group A), and 24 patients receiving EVD (group B). The hematoma clearance rate was calculated by 3D Slicer software, and complications and outcomes were compared between the two groups. There were no significant differences in age, sex and Graeb score between groups A and B (P>0.05). The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05). The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27 min, respectively (P<0.05). The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A, and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05). The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05). The GOS scores at 6 months after surgery were 3.83±1.12 in group A, and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate, fewer complications and better outcomes in the treatment of severe IVH, indicating it is a safe, effective and promising approach for severe IVH.     

Carbon monoxide inhibits the nuclear-cytoplasmic translocation of HMGB1 in an <Emphasis Type="Italic">in vitro</Emphasis> oxidative stress injury model of mouse renal tubular epithelial cells

Carbon monoxide (CO), as a vital small molecule in signaling pathways, is found to be involved in ischemia-reperfusion injury (IRI) in renal transplantation. CO-releasing molecule-2 (CORM-2), a CO-releasing molecule, is a type of metal carbonyl complexes which can quickly release CO in vivo. In this study, an in vitro oxidative stress injury model was established to examine the effect of CORM-2 pretreatment on the nuclear-cytoplasmic translocation of high mobility group box 1 protein (HMGB1) in mouse primary renal proximal tubular epithelial cells (RPTECs). Immunofluorescence staining showed that HMGB1 in the medium- and CORM-2-treated groups was predominantly localized in the nucleus of the cells, whereas higher amounts of HMGB1 translocated to the cytoplasm in the H₂O₂- and inactive CORM-2 (iCORM-2)-treated groups. Western blotting of HMGB1 showed that the total amounts of cytoplasmic HMGB1 in the H₂O₂-treated (0.59±0.27) and iCORM-2-treated (0.57±0.22) groups were markedly higher than those in the medium-treated (0.19±0.05) and CORM-2-treated (0.21±0.10) groups (P<0.05). Co-immunoprecipitation showed that the levels of acetylated HMGB1 in the H₂O₂-treated (642.98±57.25) and iCORM-2-treated (342.11±131.25) groups were markedly increased as compared with the medium-treated (78.72±74.17) and CORM-2-treated (71.42±53.35) groups (P<0.05), and no significant difference was observed between the medium-treated and CORM-2-treated groups (P>0.05). In conclusion, our study demonstrated that in the in vitro oxidative stress injury model of primary RPTECs, CORM-2 can significantly inhibit the nuclear-cytoplasmic translocation of HMGB1, which is probably associated with the prevention of HMGB1 acetylation.     

Relevant Features Selection for Automatic Prediction of Preterm Deliveries from Pregnancy ElectroHysterograhic (EHG) records

In this study, we proposed an approach able to predict whether a pregnant woman with contractions would give birth earlier than expected (i.e., before the 37 ^{t h} week of gestation (WG)). It only processes non-invasive electrohysterographic (EHG) signals fully automatically without assistance of an expert or an additional medical system. We used term and preterm EHG signals of 30-minutes duration collected between the 27 ^{t h} and the 32 ^{n d} WG. Preterm deliveries (<?37W G) had occurred in average 4.00 ± 1.88 weeks since recording dates. Each recording contains three bipolar channels. Using the Huang-Hilbert transform (HHT), we obtained up to twelve intrinsic mode functions (IMFs) for each signal. We found that the most relevant IMFs for both term and preterm records were IMF3 and IMF6. From these two IMFs, we extracted 8 most relevant features targeting EHG signal specificities. We investigated features classifications using support vector machine (SVM) for the 3 single-channels and for all their possible combinations. High discrimination power between term and preterm EHG records was obtained with linear-SVM classifiers. For almost all the cases, mean areas under curves (AUC) exceeded 0.92. A two-channel combination (7 features) achieved the best mean results with A c c u r a c y =?95.70%, S e n s i t i v i t y =?98.40%, S p e c i f i c i t y =?93.00% and A U C =?0.95. Results of the three-channel combination (9 features) were A c c u r a c y =?92.30%, S e n s i t i v i t y =?93.00%, S p e c i f i c i t y =?91.60% and A U C =?0.96. The best single-channel (8 features) gave the mean values: A c c u r a c y =?90.40%, S e n s i t i v i t y =?93.60% and A U C =?0.94. Thus, the advantage of our approach is the high diagnostic performance at low computational cost.     

Effects of Electro-Acupuncture at Zusanli, Guanyuan for Sepsis Patients and Its Mechanism through Immune Regulation

Objective:To evaluate the effect of electro-acupuncture on Zusanii(ST 36),Guanyuan(RN 4)in patients with sepsis,and explore its mechanism in term of immune regulation.Methods:In this prospective randomized controlled trial,60 patients with sepsis were randomly assigned to the control group and the intervention group equally by block randomization.Patients in the control group received routine treatment and those in the intervention group received electro-acupuncture at bilateral Zusanii and Guanyuan in addition to routine treatment,respectively.The mortality at 28 days,Acute Physiology and Chronic Health Evaluation(APACHE)-Ⅱ score were compared to evaluate the effect,and the levels of T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+) and monocytes of human leukocyte antigen(HLA)-DR using flow cytometry were compared to explore the mechanism of this combined treatment.Results:Fifty-eight patients completed the trial with29 in each group.There was no significant difference of mortality in the 28 th day between the two groups,with 5 death of 29 patients in the intervention group(17.2%) and 9 of 29 in the control group(31.0%).After treatment,APACHE- II score of both groups was significantly decreased,however,score of the intervention group was lower than the control group(13.28 ±7.07 vs.17.10 ±5.83;P0.01).The levels of CD3+,CD4+,CD8+ and CD4+/CD8+ ratio of the intervention group improved after treatment and were higher than the control group(59.71%±11.94%vs.52.54%± 11.86%;36.46%±7.60%vs.31.58%±10.23%;18.40%±8.82%vs.23.07%±7.30%;2.38±1.14 vs.1.54±0.80,respectively;all P0.05).The expression of HLA-DR significantly increased after treatment in the intervention group than that in the control group(7.28%± 9.26%vs.1.27%±7.00%;P0.01).Conclusion:Electro-acupuncture at Zusanii and Guanyuan could improve clinical curative effect in patients with sepsis,which might be achieved by regulation of the immune system.     

Electrical Signal Propagated across Acupoints along Foot Taiyang Bladder Meridian in Rats

Objective: To investigate the electrical signals propagated along Foot Taiyang Bladder Meridian(BL) in a rat model. Methods: The experiments were performed on Dark-Agouti(DA), DA.1U and Sprague Dawley(SD) rats. The antidromic electrical stimulation was applied on the nerve innervating "Pishu"(BL 20) to mimic the acupoint electro-acupuncture(EA). The activities recording from adjacent nerve innervating acupoint "Danshu"(BL 19) or "Weishu"(BL 21) were recorded as indics for acupoint, including the mechanical threshold and discharge rate. Results: After mimic EA on BL 20, C and Aδ units from adjacent BL 19 or BL 21 were sensitized including the decrease in mechanical threshold and increase in discharge rates in DA, DA.1U and SD rats, especially in DA rats. The average discharge rate increased from 2.40±0.26 to 6.06±0.55 and from 1.92±0.42 to 6.17±1.10 impulse/min(P0.01), and the mechanical threshold decreased from 0.52±0.12 to 0.24±0.05 and from 0.27±0.02 to 0.16±0.01 mmol/L(P0.01) in C(n=15) and Aδ(n=18) units in DA rats. The net change in discharge rates from C units were 152.5%, 144.7% and 42.4% in DA, DA.1U and SD rats, respectively, among which DA rat's was the highest(P0.05). In Aδ units, the net change in DA rats were also the highest(221.5%, 139.2% and 49.2% in DA, DA.1U and SD rats). Conclusions: These results showed that mimic acupoint EA activated adjacent acupoints along BL in three rat strains, which might be related to propagated sensation along meridians(PSM). In addition, DA rats were more sensitive and might be a good model animal for PSM research.     

Hot Compress with Chinese Herbal Salt Packets Reducing PICC Catheter Complications: A Randomized Controlled Trial

Objective: To explore the preventive effect of applying hot compress with Chinese herbal salt packets(CHSP) to puncture vessels under aseptic conditions during peripherally inserted central catheter(PICC) on postoperative phlebitis. Methods: A total of 720 hospitalized patients undergoing first PICC were assigned to treatment and control groups(360 cases each group) according to a random number table. The control group received conventional catheterization and nursing care. The treatment group was first given hot compress with CHSP(which consisted of honeysuckle 30 g, Semen brassicae 30 g, Salvia miltiorrhiza 30 g, Angelica dahurica 30 g, Semen raphani 30 g, Evodia rutaecarpa 30 g, and coarse salt 20 g) on the punctured vessel under aseptic conditions for 5–10 min before conventional catheterization. The main efficacy indices were the vessel diameters before and during catheterization and the success rate of a single catheter, and the secondary efficacy indiex was the incidence of superficial phlebitis within 1 week after catheterization. Results: The vessel diameter during catheterization of the treatment group was remarkably increased compared with the control group [(7.96±0.42) mm vs.(4.39±0.54) mm, P0.01]. The success rate of the single catheter of the treatment group was significantly higher than that of the control group [94.00%(329/350) vs. 73.72%(244/329), P0.01]. The incidence of superficial phlebitis within 1 week after catheterization in the treatment group was lower than that in the control group(P=0.007). There was no adverse event with CHSP. Conclusion: Hot compress with CHSP during PICC is applicable as it can effectively improve the success rate of a single catheter and reduce the incidence of superficial phlebitis after catheterization(Trial registration No. ChiCTR-ONC-17010498).     

Jinmaitong(筋脉通)Alleviates the Diabetic Peripheral Neuropathy by Inducing Autophagy

Objective:To observe the deregulation of autophagy in diabetic peripheral neuropathy(DPN) and investigate whether Jinmaitong(筋脉通i,JMT) alleviates DPN by inducing autophagy.Methods:DPN models were established by streptozotocin-induced diabetic rats and Schwann cells(SCs) cultured in high glucose medium.The pathological morphology was observed by the improved Bielschowsky's nerve fiber axonal staining and the Luxol fast blue-neutral red myelin staining.The ultrastructure was observed by the transmission electron microscopy.Beclinl level was detected by immunohistochemistry and Western blot.The proliferation of cultured SCs was detected by methylthiazolyldiphenyl-tetrazolium bromide.Results:Diabetic peripheral nerve tissues demonstrated pathological morphology and reduced autophagic structure,accompanied with down-regulation of Beclinl.JMT apparently alleviated the pathological morphology change and increased the autophagy[in vivo,Beclinl integral optical density(IOD) value of the control group 86.6±17.7,DM 43.9±8.8,JMT 73.3 ±17.8,P0.01 or P0.05,in vitro Beclinl IOD value of the glucose group 0.4710.25 vs the control group 0.88 ±0.29,P0.05].Consequently,inhibition of autophagy by 3-methyladenine resulted in a time- and concentrationdependent decrease of the proliferation of SCs(P0.05,P0.01).Conclusions:Down-regulation of autophagy in SCs might contribute to the pathogenesis of DPN.JMT alleviates diabetic peripheral nerve injury at least in part by inducing autophagy.     

(a,k)-Anonymous Scheme for Privacy-Preserving Data Collection in IoT-based Healthcare Services Systems

The widely use of IoT technologies in healthcare services has pushed forward medical intelligence level of services. However, it also brings potential privacy threat to the data collection. In healthcare services system, health and medical data that contains privacy information are often transmitted among networks, and such privacy information should be protected. Therefore, there is a need for privacy-preserving data collection (PPDC) scheme to protect clients (patients) data. We adopt (a,k)-anonymity model as privacy pretection scheme for data collection, and propose a novel anonymity-based PPDC method for healthcare services in this paper. The threat model is analyzed in the client-server-to-user (CS2U) model. On client-side, we utilize (a,k)-anonymity notion to generate anonymous tuples which can resist possible attack, and adopt a bottom-up clustering method to create clusters that satisfy a base privacy level of (a₁,k₁)-anonymity. On server-side, we reduce the communication cost through generalization technology, and compress (a₁,k₁)-anonymous data through an UPGMA-based cluster combination method to make the data meet the deeper level of privacy (a₂,k₂)-anonymity (a₁?≥?a₂, k₂ ≥?k₁). Theoretical analysis and experimental results prove that our scheme is effective in privacy-preserving and data quality.     

Shen-Fu Injection(参附注射液) Alleviates Post-resuscitation Myocardial Dysfunction by Up-regulating Expression of Sarcoplasmic Reticulum Ca2~+ -ATPase

Objective: To compare the effect of Shen-Fu Injection(SFI) and epinephrine on the expression of sarcoplasmic reticulum Ca2~+ ATPase 2a(SERCA2a) in a pig model with post-resuscitation myocardial dysfunction. Methods: Ventricular fibrillation(VF) was electrically induced in Wu-zhi-shan miniature pigs. After 8 min of untreated VF and 2 min of cardiopulmonary resuscitation(CPR), all animals were randomly administered a bolus injection of saline placebo(SA group, n=10), SFI(0.8 mg/kg, SFI group, n=10) or epinephrine(20 μg/kg, EPI group, n=10). After 4 min of CPR, a 100-J shock was delivered. If the defibrillation attempt failed to attain restoration of spontaneous circulation(ROSC), manual chest compressions were rapidly resumed for a further 2 min followed by a second defibrillation attempt. Hemodynamic variables were recorded, and plasma concentrations of catecholamines were measured. Adenylate cyclase(AC), cyclic adenosine monophosphate(c AMP) and the expressions of β1-adrenoceptor(AR) and SERCA 2a were determined. Results: Cardiac output, left ventricular dp/dt_(max) and negative dp/dt_(max) were significantly higher in the SFI group than in the SA and EPI groups at 4 and 6 h after ROSC. The expression of β1-AR and SERCA2 a at 24 h after ROSC were significantly higher in the SFI group than in the SA and EPI groups(P0.05 or P0.01). Conclusions: The administration of epinephrine during CPR decreased the expression of SERCA2 a and aggravated postresuscitation myocardial function(P0.01). SFI attenuated post-resuscitation myocardial dysfunction, and the mechanism might be related to the up-regulation of SERCA2 a expression.     

Xuebijing Injection (血必净注射液) Increases Early Survival Rate by Alleviating Pulmonary Vasopermeability in Rats Subjected to Severe Burns

Objective: To investigate the effects of Xuebijing Injection(血必净注射液, XBJ) on survival rate and pulmonary vasopermeability in a rat model of severe scald injury. Methods: Rats were divided into two experiments: experiment 1 was monitored for 12 h post-injury for survival analysis after severe burns; in experiment 2, rats were killed for determination of pulmonary vascular permeability and pro-inflammatory mediators. In both experiments, rats were subject to third-degree 50% total body surface area(TBSA) burns or sham injury followed by XBJ or normal saline(NS) treatment. In addition, rat pulmonary microvascular endothelium cells(PMECs) were pretreated with either XBJ or phosphate buffer saline(PBS), and then subjected to sham serum or scald serum stimulation for 2 or 6 h, followed by transwell examination for the permeability of PMECs. Meanwhile, pro-inflammatory mediators in PMECs culture supernatant were also investigated. Results: The average survival time in the scald+XBJ group was 582.1±21.2 min, which was significantly longer than that in the scald + NS group(345.8±25.4 min, P0.01). Plasma levels of tumor necrosis factor-alpha(TNF-α), E-selectin, interleukin-6(IL-6), vascular permeability and water content of lung tissues were significantly increased in animals after severe burns(P0.01). However, administration of XBJ significantly decreased these levels in plasma and lung tissue. In in vitro cell experiments, XBJ markedly attenuated permeability in PMECs monolayer and reduced the levels of TNF-α, IL-6 and soluble E-selectin after stimulation with scald serum(P0.01). Conclusions: XBJ increases early survival rate by alleviating pulmonary vasopermeability and inhibiting pro-inflammatory mediators in rats subjected to lethal scald injury. XBJ may be a potent drug in treatment of severe burns.     

Salvianolate Reduces Murine Myocardial Ischemia and Reperfusion Injury via ERK1/2 Signaling Pathways in vivo

Objective

To analyze the effects of salvianolate on myocardial infarction in a murine in vivo model of ischemia and reperfusion (I/R) injury.

Methods

Myocardial I/R injury model was constructed in mice by 30 min of coronary occlusion followed by 24 h of reperfusion and pretreated with salvianolate 30 min before I/R (SAL group). The SAL group was compared with SHAM (no I/R and no salvianolate), I/R (no salvianolate), and ischemia preconditioning (IPC) groups. Furthermore, an ERK1/2 inhibitor PD98059 (1 mg/kg), and a phosphatidylinositol-3-kinase (PI3-K) inhibitor, LY294002 (7.5 mg/kg), were administered intraperitoneal injection (i.p) for 30 min prior to salvianolate, followed by I/R surgery in LY and PD groups. By using a double staining method, the ratio of the infarct size (IS) to left ventricle (LV) and of risk region (RR) to LV were compared among the groups. Correlations between IS and RR were analyzed. Western-blot was used to detect the extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (AKT) phosphorylation changes.

Results

There were no significant differences between RR to LV ratio among the SHAM, I/R, IPC and SAL groups (P>0.05). The SAL and IPC groups had IS of 26.1%±1.4% and 22.3%±2.9% of RR, respectively, both of which were significantly smaller than the I/R group (38.5%±2.9% of RR, P<0.05, P<0.01, respectively). Moreover, the phosphorylation of ERK1/2 was increased in SAL group (P<0.05), while AKT had no significant change. LY294002 further reduced IS, whereas the protective role of salvianolate could be attenuated by PD98059, which increased the IS. Additionally, the IS was not linearly related to the RR (r=0.23, 0.45, 0.62, 0.17, and 0.52 in the SHAM, I/R, SAL, LY and PD groups, respectively).

Conclusion

Salvianolate could reduce myocardial I/R injury in mice in vivo, which involves an ERK1/2 pathway, but not a PI3-K signaling pathway.

     

No Additional Cholesterol-Lowering Effect Observed in the Combined Treatment of Red Yeast Rice and Lactobacillus Casei in Hyperlipidemic Patients: A Double-Blind Randomized Controlled Clinical Trial

Objective

To observe the effect of combining red yeast rice and Lactobacillus casei (L. casei) in lowering cholesterol in patients with primary hyperlipidemia, the later has also been shown to remove cholesterol in in vitro studies.

Methods

A double-blind clinical trial was conducted to evaluate the cholesterol-lowering effect of the combination of red yeast rice and L. casei. Sixty patients with primary hyperlipidemia were recruited and randomized equally to either the treatment group (red yeast rice + L. casei) or the control group (red yeast rice + placebo). One red yeast rice capsule and two L. casei capsules were taken twice a day. The treatment lasted for 8 weeks, with an extended follow-up period of 4 weeks. The primary endpoint was a difference of serum low-density lipoprotein cholesterol (LDL-C) level at week 8.

Results

At week 8, the LDL-C serum level in both groups was lower than that at baseline, with a decrease of 33.85±26.66 mg/dL in the treatment group and 38.11±30.90 mg/dL in the control group; however, there was no statistical difference between the two groups (P>0.05). The total cholesterol was also lower than the baseline in both groups, yet without a statistical difference between the two groups. The only statistically signifificant difference between the two groups was the average diastolic pressure at week 12, which dropped by 2.67 mm Hg in the treatment group and increased by 4.43 mm Hg in the placebo group (P<0.05). The antihypertensive activity may be associated with L. casei. Red yeast rice can signifificantly reduce LDL-C, total cholesterol and triglyceride.

Conclusion

The combination of red yeast rice and L. casei did not have an additional effect on lipid profifiles.

     

The usefulness of left atrial volume index and left ventricular mass index in determining subclinical cardiac involvement in patients with early-stage sarcoidosis

Background and aim

Sarcoidosis is a multi-systemic granulomatous disease of unknown etiology. The present study has been designed to evaluate the importance of diastolic dysfunction with left atrial volume index (LAVi) and left ventricular mass index (LVMi) in determining subclinical cardiac involvement in subjects with stage I–II pulmonary sarcoidosis.

Methods

A total of 54 patients under follow-up for sarcoidosis without cardiac involvement and 56 healthy subjects were included in the study. The echocardiographic assessment of the patients revealed no significant difference between the two groups regarding left ventricular end-systolic and end-diastolic diameters, ejection fraction (LVEF) and annular velocity determined by tissue Doppler evaluation.

Results

The LVEF calculated was 61.8 ± 7.8 % in the sarcoidosis group versus 64.1 ± 2.7 % in the control group (p = 0.04). Left ventricular interventricular septum thickness, posterior wall thickness, and relative wall thickness were significantly higher in the sarcoidosis group compared to the control group (p < 0.001). The sarcoidosis group had higher LVM and LVMi values compared to the control group (145 ± 18.1 and 79 ± 14 g/m², 135 ± 27.7 and 74 ± 14.2 g/m²; p = 0.020 and p = 0.021, respectively). Left atrial end-systolic volume and LAVi were higher in the sarcoidosis group (28.7 ± 18.5; 15.6 ± 10.2) compared to the control group (16.6 ± 10.9; 8.9 ± 5.5) with a statistically significant difference (p < 0.001).

Conclusion

The present study indicates diastolic dysfunction and increased LVMi despite normal systolic function in patients with early-stage sarcoidosis without cardiac involvement. Also, the diastolic parameters were normal without showing any significant difference compared to the control group while there was a statistically significant increase in LAVi. This finding suggests that LAVi may be the earliest marker of diastolic dysfunction in patients with early-stage sarcoidosis without cardiac involvement.