重拳出击,打击非法行医

在5月30日召开的全国卫生监督工作会议上,国家卫生部副部长陈啸宏透露:中国打击非法行医取得阶段性成效,已吊销1700家医疗机构执业许可证,660人的医师执业证书;暂停机构执业1.2万户,暂停人员执业2.7万人,追究刑事责任157人。

岛苏秀续骨酊治疗闭合性骨折疗效观察

用白族民间草药岛苏秀为主药配制的复方制剂治疗闭合性骨折89例,与习用的中草药包敷法治疗的69例作对照,经X线摄片证实:局部症状解除时间,试验组明显优于对照组(P<0.01);骨痂形成时间,两组间有显著性差异(P<0.05)。表明岛苏秀续骨酊具有良好的活血化瘀、消肿止痛、接骨续筋的作用,其剂型及给药方法,有稳定固定、使用方便舒适、经济实惠等特点。

Experimental Study on Apoptosis in Leukemia Cells Induced by Econazole

To investigate apoptosis in mouse leukemia cell (WEHI-3) induced by Econazoleand its mechanism. Methods: Apoptosis induced by Econazole was examined by flow cytometry. Freecalcium ([Ca^(2+])i) was determined by Fura-2 fluorescein load technique. The protein was isolatedfrom endoplasmic reticulum of WEHI-3 cells, and then the expression of caspase-12 and caspase-7 wasdetected by Western blot. Results: WEHI-3 cells exhibited typical change of apoptosis when they weretreated by Econazole. [Ca^(2+)]i was significantly higher in Econazole-treated group than incontrol group. The expression of caspase-12 and caspase-7 was increased with the increase ofEconazole concentration. Conclusion: Caspase-12 may play a key role in WEHI-3 apoptosis induced byEconazole.

Lactobacilli inhibit interleukin-8 production induced by Helicobacter pylori lipopolysaccharide-activated Toll-like receptor 4

AIM： To investigate the effect of Lactobacillus bulgaricus （LBG） on the Toll-like receptor 4 （TLR4） pathway and interleukin-8 （IL-8） production in SGC-7901 cells treated with Helicobacter pyloriSydney strain 1 lipopolysaccharide （HpyloriSS1-LPS）. METHODS： SGC-7901 cells were treated with HpyloriSS1-LPS in the presence or absence of pretreatment for 1 h with viable LBG or supernatant recovered from LBG culture MRS broth （LBG-s）. Cellular lysates were prepared for Western blot with anti-TLR4, anti-transforming growth factor β-activated kinase 1 （TAK1）, anti-phospho-TAK1, anti-nuclear factor κB （NF-κB）, anti-p38 mitogen-activated protein kinase （p38MAPK）, and anti-phospho-p38MAPK antibodies. The amount of IL-8 in cell culture medium was measured by ELISA. RESULTS： H pyloriSS1-LPS up-regulated the expression of TLR4, stimulated the phosphorylation of TAKI, subsequently enhanced the activation of NF- κB and the phosphorylation of p38MAPK in a time- dependent manner, leading to augmentation of IL-8 production in SGC-7901 cells. Viable LBG or LBG-s pretreatment attenuated the expression of TLR4, inhibited the phosphorylation of TAK1 and p38MAPK, prevented the activation of NF-κB, and consequently blocked IL-8 production.CONCLUSION： H py/oriSS1-LPS induces IL-8 production through activating TLR4 signaling in SGC-7901 cells and viable LBG or LBG-s prevents H pyloriSS1-LPS-mediated IL-8 production via inhibition of the TLR4 pathway.

Why do we have so much trouble treating anal fistula?

Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.

How albumin administration for cirrhosis impacts on hospital albumin consumption and expenditure

AIM:To assess the impact of guidelines for albumin prescription in an academic hospital,which is a referral center for liver diseases.METHODS:Although randomized trials and guidelines support albumin administration for some complications of cirrhosis,the high cost of albumin greatly limits its use in clinical practice.In 2003,a multidisciplinary panel at Sant'Orsola-Malpighi University Hospital(Bologna,Italy)used a literature-based consensus method to list all the acute and chronic conditions for which albumin is indicated as first-or second-line treatment.Indications in hepatology included prevention of post-paracentesis circulatory dysfunction and renal failure induced by spontaneous bacterial peritonitis,and treatment of hepatorenal syndrome and refractory ascites.Although still debated,albumin administration in refractory ascites is accepted by the Italian health care system.We analyzedalbumin prescription and related costs before and after implementation of the new guidelines.RESULTS:While albumin consumption and costs doubled from 1998 to 2002,they dropped 20%after 2003,and remained stable for the following 6 years.Complications of cirrhosis,namely refractory ascites and paracentesis,represented the predominant indications,followed by major surgery,shock,enteric diseases,and plasmapheresis.Albumin consumption increased significantly after guideline implementation in the liver units,whereas it declined elsewhere in the hospital.Lastly,extra-protocol albumin prescription was estimated as<10%.CONCLUSION:Albumin administration in cirrhosis according to international guidelines does not increase total hospital albumin consumption if its use in settings without evidence of efficacy is avoided.

In vitro porcine brain tubulin assembly inhibition by water extract from a Chinese medicinal herb,Tripterygium hypoglaucum Hutch

AIM： To investigate the effect of Tripterygium hyp-oglaucum Hutch （THH） on the assembly and disassembly process of tubulin and its possible mode of action.METHODS： In vitro porcine brain tubulin assembly assay was employed to analyze the inhibitory effects of THH at different concentrations （0.05 μg/L, 0.07 μg/L, 0.09μg/L）. Colchicine （0.0025 mmol/L, 0.0050 mmol/L, 0.0075 mmol/L） was used as a positive control.RESULTS： THH could significantly inhibit the assembly of isolated porcine brain tubulin at all tested concentrations.CONCLUSION： THH is capable of inducing aneuploidy in mammals via tubulin polymerization inhibition pathway and may pose a genetic risk to human beings.

Impact of Pharmacist Insulin Management on Hemoglobin Alc in Outpatient Hospital Clinic Setting

To assess the efficacy of pharmacist lead insulin management in improvement of HbAlc. Patients were referred to the LMttS （Licking Memorial Health Systems） Outpatient Medication Therapy Insulin Clinic by their physician during the time periods of July 2012 through March 2013 and August 2014 through December 2014. Physician authorization permitted pharmacists to provide clinical monitoring in order to evaluate and adjust insulin, GLP-I agonist and amylin mimetic doses by adhering to approved dosing guidelines and policy and procedures. Hemoglobin Atc values were obtained from the patients electronic medical records. Patients achieved an average decrease in HbAlc of 0.8 percentage points over a mean of 83 days. Pharmacist insulin management is an innovative pharmacy service through which clinical pharmacists can have an impact on patients＇ HbAtc.

EVALUATION OF SEQUEST RESULT FILTER-XCORR AND UNIFIED SCORE

Objective To estimate the effect of two simple filters, two or more positive peptide filter and Unified Score filter on the true positive rate of protein and peptide. Methods Twenty-two LC-MS/MS datasets were from 18 known protein mixture. Two or more positive peptide filter and Unified Score filter were applied to the 22 datasets. The filters effect was evaluated according to the true positive rate of protein and peptide for each filter. Results The positive rates of protein and peptide from two or more peptide filter raised from 56.49% to 92.86%-99.12% (for protein) and from 90.67% to 97.74%-99.62% (for peptide), but many positive proteins were filtered out. The positive rates of protein and peptide from Unified Score (ThermoFinnigan value 2400) were only about 35.51% and 82.99%, but after adjusted the value (3900) according to the number of false positive peptide, those positive rate raised to 63.61% (for protein) and 91.97% (for peptide). Conclusions Two or more peptides requirement could significantly decrease false positive rate, but it also may filter out many true positive proteins especially low molecular weight and less abundant proteins. Unified Score may be a better filter than Xcorr and DeltaCn combination and the value of 3900 is found to be more suitable for this particular datasets.

P2X7 Receptor Mediated Growth-Inhibitory Effect in KG1a Cell Line

OBJECTIVE This study was conducted to investigate ATP- induced growth inhibition in human leukemic cells KG1a. METHODS ATP inhibited cell growth was analyzed by MTS assay. Externalization of phosphatidylserine could be detected by Annexin-V-FITC apoptosis staining after activation of the P2X7 receptor. P2X7 mediated pore formation was detected in KGla cells by Yo-Pro-1 uptake assay. RESULTS ATP inhibited cell growth in a dose-dependent manner. The cytotoxic effect could be blocked by P2X7 antagonists, oxidized ATP （oATP） and KN62. Externalization of phosphatidylserine could be detected in a time-dependent manner. P2X7 mediated pore formation could be detected in KG1a cells. These effects could not be observed in P2X7 null Ramos cells. CONCLUSION The results and our previously reports that mRNA, protein expression and calcium response of the P2X7 receptor in KGla cells, suggested that extracellular ATP effectively induces growth inhibition through apoptosis in KGla cells by activation of P2X7 receptor, and that may be mediated by extracellular Ca^2＋ in ux and pore formation.

Differentially Expressed Serum Protein Profiling in Esophageal Squamous Cell Carcinoma Patients with Different Chinese Medicine Syndromes

Objective:Esophageal carcinoma is the eighth most common malignant tumor and ranked the sixth cause of death in the worldwide careinoma.To find out effective serum markers for early diagnosis and targeted treatment is important to improve esophageal carcinoma survival rate.The aim of this study was to screen differ-entially expressed serum protein profiling in esophageal squamous cell careinoma(ESCC)patients with differ-ent Chinese medicine syndrome and establish ESCC syndrome diagnosis model,to explore the signifcance of ESCC serum differential protein in traditional Chinese medicine(TCM)syndrome diagnosis and provide exper-imental and theoretical basis for the diagnosis,clinical treatment of ESCC.Methods:Serum specimens of 80 ES-CC patients with different syndrome and 20 healthy people were selected according to distribution of their sex and age.Magnetic beads based weak cation exchange combined w ith matrix-assist ed laser desorption/ionization time-of-flight mass spectrometry prot eomic technology and Autoflex Analysis and ClinProTools software were applied to screen differentially expressed serum protein profiling.Then establishing each syndrome group diag-nosis model and verifying with new samples to evaluate the diagnosis value of each syndrome group diagnosis model.Results:18 significantly differential expression protein peaks were screened between the whole ESCC patients sera and the healthy control group.Compared with normal control group,among which,ten were signif-cant down-regulation with m/z values of4210,4267,4054,4248,2106,4091,2991,5337,3952,822,and eight were significant up-regulation with m/z values of 2900,2883,1467,1617,2862,2600,895,811.There were 16,12,11,15 differentially expressed protein peaks in phlegm and qi stagnat ion syndrome(Group P),fluid insufficiency and heat agglomeration syndrome(Group F),blood stasis syndrome(Group B),qi and yang deficiency syndrome(Group Q),respectively.Protein with m/z of4210,4091,4054 and 5337 presen-ted obviously low expression in all syndrome groups,while protein with m/z of2883,1617 presented obvious-y high expression.Protein with m/z of 4644 is an obvious and significative biomarker in the comparison of dif-ferent syndrome of ESCC.Establishing ESCC each syndrome serum different ial protein profiling diagnosis mod-el showed that the specificity and veracity in four syndrome groups were all≥80.00%.Conclusion:Our study achieved differentially expressed protein profiling in ESCC patients with different TCM syndromes,established relatively high sensitivity and specificity of different syndrome of ESCC serum differential protein profiling diag-nosis model,which implied the screened syndrome related serum differential expression protein in TCM syn-drome differentiation and diagnosis had great clinical meaning,could be the assistant diagnosis biomarker of ESCC.

Lack of Association between fbe Gene with Adherence and Biofilm Formation in Staphylococcus epidermidis Clinical Isolates

Biofilm formation plays a major role in the pathogenesis of nosocomial infections caused by Staphylococcus epidermidis ( S.epidermidis ). It has been suggested that protein encoded by the fbe (fibrinogen binding protein) gene of S.epidermidis enhances bacterial adherence to medical devices and biofilm formation by binding to host fibrinogen (Fg). In this study, a 1.7 kb fbe gene fragment was amplified in 111 of 115 strains of S.epidermidis clinical isolates using PCR. Contrary to expectations, only 14 strains showed marginally increased adherence to Fg-coated polystyrene wells compared with BSA coated wells. Quantitative real-time PCR revealed no statistically significant difference in Fbe expression between Fg binding strains and Fg non-binding strains. Furthermore, in the presence of soluble Fg, S.epidermidis biofilm formation decreased in a dose-dependent manner. In contrast, the Staphylococcus aureus ( S.aureus ) strain Cowan Ⅰ and other 5 S.aureus clinical isolates showed a substantial increase in both adherence and biofilm formation in the presence of Fg. The results suggest that in S.epidermidis the fbe gene may not be associated with bacterial adherence and biofilm formation.

ACUPUNCTURE-MOXIBUSTION, HEAT SHOCK PROTEIN 70 AND CYTOPROTECTION

Pleat shock protein 70 （HSP70） is a kind of non-specific cytoprotective protein, and its generation can be induced by acupuncture and moxibustion. In the present paper, the authors review the protective actions of HSP70 on the heart, gastric mucosa, liver, brain tissues, kidney, etc., and the relationship among acupuncture/moxibustion, heat shock protein and the cytoprotective actions. It is worth studying the cytoprotective effect of acupuncture and moxibustion by way of the resultant generation of HSP70 in the organism.

Medicine Referred in Poetries in Tang Dynasty In the Case of Li Bai, Du Fu and Bai Juyi

Poetry is an important part of traditional culture, which reached the zenith in Tang dynasty. Li Bai, Du Fu and Bai Juyi are famous poets, and there are much about medicine in their works, such as disease, pathogeny, herbs and life cultivation. Some poets described their feelings about getting sick in their poetries, which showed their psychologic status, social conditions and helped us to learn the development of medicine.

Progress in the expression of P-glycoprotein in brain metastases of lung cancer andrelated TCM research

Brain metastases are common intracranial tumors, and their occurrence not only represents a high degree of malignancy, but also often is the major factor in treatment failure and poor prognosis. Primary site of brain metastases often occur in lung. P-glycoprotein is a member of the （ATP binding cassette） transporter superfamily,which is closely related to the development of lung metastases. It is the main reason for influencing the drug through the blood_brain barrier into the brain tissue, and it also is an important factor affecting the treatment of brain metastases. According to the theory of traditional chinese mddicine, the pathogenesis of brain metastases is due to phlegm, poison, stasis, virtual and so on. The principle of treatment is to promote blood circulation, remove phlegm turbidity. In recent years, the impact of Chinese herbal medicine on P-glycoprotein is increasing. This paper analyzes the mechanism and components of the relevant Chinese medicine on P-glycoprotein. It provides a reference for clinical rational drug use.

TCM Differential Treatment of IgA Nephrosis

IgA nephrosis, with an incidence of 38%-49% in the primary glomerulopathy in China, is one of the main causes for the late renal failure. In view of the fact that there are no specific Western remedies for IgA nephrosis characterized by hematuria, the researches on TCM differential treatment of IgA nephrosis have been listed in the major projects of 'the Scientific Technologies in thel0th 5-year plan of China'.

EFFECT OF HERB-MEDICINE-CAKE-SEPARATED MOXIBUSTION ON SERUM LIPOPROTEIN CONTENTS AND RATIO OF HDL-Ch AND LDL-Ch IN HYPERLIPEMIA RABBITS

Objective: To observe the effect of herb-medicine-cake-separated moxibustion on serum lipoprotein in hyperlipemia rabbits. Methods: 55 New-Zealand rabbits were randomly divided into control group (n=13), model group (n=14), direct moxibustion group (n=14) and herb-medicine-cake-separated moxibustion (indirect moxibustion) group (n=14). Hyperlipemia model was established by feeding the animals with specialized forage (15% vitellus powder, 5% lard, 0.5% cholesterol and common forage) for 6 weeks. Moxibustion was applied to “Juque”(CV 14), “Tianshu”(ST 25), “Fenglong”(ST 40), etc., 4 moxa-cones for every acupoint, once daily and continuously for 40 days. Serum high density lipoprotein-cholesterol (HDL-Ch), low density lipoprotein-cholesterol (LDL-Ch) and total cholesterol (TCh) contents were assayed with colorimetric method. Results: Compared with control group, serum LDL-Ch content, HDL-Ch/LDL-Ch and HDL-Ch/TCh of model group were significantly higher (P<0.05～0.01), while compared with model group, LDL-Ch contents of two moxibustion groups were strikingly lower (P<0.01). No significant differences were found between two moxibustion groups in all the 4 indexes. Conclusion: Both direct and indirect moxibustion can effectively lower serum LDL-Ch, raise HDL-Ch, HDL-Ch/LDL-Ch and HDL-Ch/TCh, and regulate lipoprotein metabolism in hyperlipemia rabbits.

Spontaneous rupture of hepatocellular carcinoma: a retrospective study of 87 patients in a teaching hospital

Objective: The aim of the study was to review the management of ruptured hepatocellular carcinoma (HCC) in a single teaching hospital over 13-year period; to determine the prognostic factor of in-hospital mortality and evaluate the safety and efficacy of liver resection. Methods: A retrospective collection of medical records of 87 patients with spontaneous ruptured HCC was carried out. The 28 patients underwent emergency intervention including transarterial chemoembolization (TACE) and laparotomy with/without liver resection. Conservative treatment was performed in 59 patients and 16 of which underwent delayed hepatectomy or TACE. Results: The overall in-hospital mortality and median survival time was 54% and 22 days respectively. Albumin level (OR = 0.874, 95% CI: 0.778-0.973, P = 0.024), number of tumors (OR = 5.011, 95% CI: 1.015-24.750, P = 0.048) and laparotomy (OR = 0.069, 95% CI: 0.012-0.406, P = 0.003) were all independent factors affecting overall in-hospital mortality, but for patients undergone laparotomy, only total bilirubin level (OR = 1.138, 95% CI: 1.024-1.264, P = 0.016) was independent factor affecting overall in-hospital mortality. Age, total bilirubin level, maximum tumor size, number of tumors, portal vein tumor thrombosis and extra-hepatic metastasis were all significantly different between groups with laparotomy and without. There were no significant differences between emergency and delayed liver resection groups in in-hospital mortality (0 vs. 0), median survival time (788 vs. 750 days respectively) as well as 1-year and 3-year survival rates (66.7%, 44.4% vs. 70%, 30%, respectively) (P = 0.763, log-rank test). Conclusion: Both underlying chronic liver disease and tumor stage can affect the in-hospital mortality, but for patients undergone laparotomy, only total bilirubin level is independent factor. Surgeons are more prone to choose patients with younger age, better liver function and earlier tumor stage to do surgery. In well selected patients, both emergency and delayed liver resections are safe and could achieve prolonged survival.

A traditional Chinese medicine Huaier triggers G1 cell cycle arrest and apoptosis through cyclins-CDKs-CKIs machinery in MOLT4 cells

Objective: The purpose of the study was to study the effect of Huaier, a traditional Chinese medicine, on the cell cycle adjustment in MOLT4 cells in vitro. Methods: We used MTT assay to test cell viability, flow cytometry to detect cell cycle and apoptosis and western blot to examine the expression of cell-cycle and apoptotic proteins in MOLT4 cells induced by Huaier. Results: Huaier could reduce the viability of MOLT4 cell by inducing G1 arrest and apoptosis. The induction of apoptosis after treatment with Huaier for 24 h was demonstrated in a dose- and time-dependent manner by flow cytometry analysis. G1 arrest induced by Huaier was modulated through the increased expression of Cdki proteins(p21cip/waf1 and p27kip1) with a simultaneous decrease in Cdk2, Cdk4, Cdk6, cyclin D1 and cyclin E expression. Huaier also induced Bax and Bcl-2 expression and activation of Caspase-3. Conclusion: It is firstly demonstrated that Huaier can inhibit proliferation of MOLT4 cells via G1 arrest and apoptosis. These results suggest that Huaier is a cell-cycle anti-cancer drug.

Traditional Chinese Medicine syndrome-related herbal prescriptions in treatment of malignant tumors

OBJECTIVE： To investigate the distribution characteristics of TCM syndromes and the related herbal prescriptions for malignant tumors （MT）. METHODS： A clinical database of the TCM syndromes and the herbal prescriptions in treatment of 136 MT patients were established. The data were then analyzed using cluster and frequency analysis. RESULTS： According to the cluster analysis, the TCM syndromes in MT patients mainly included two patterns： deficiency of both Qi and Yin and internal accumulation of toxic heat. The commonlyprescribed herbs were Huangqi （Astraglus）, Nuizhenzi （Fructus Ligustri Lucidi）, Lingzhi （Ganoderma Lucidum）, Huaishan （Dioscorea Opposita）, Xiakucao （Prunella Vulgaris）, and Baihuasheshecao （Herba Hedyotidis）. CONCLUSION： Deficiency of Qi and Yin is the pri- mary syndrome of MT, and internal accumulation of toxic heat is the secondary syndrome. The herbs for Qi mainly heat-cl supplementation and Yin houris used, with earance and the assistance of detoxification. hment are herbs for