BACKGROUND : Chitosan, derived from chitin, has a poor solubility which limits its application greatly. For improving its dissolubility, according to the feature that intramolecular hydroxy and amino group in chitosan are easy to be chemically modified, and functional groups are introduced to improve its solubility and functionality to widen the range of its application, which has become one of the new trend of development for investigating the application of chitosan. OBJECTIVE: To sum up the research advancements in the application and modification of chitosan in carboxylation,acylation, alkylation, etherification, etc.RETRTEVE STRATEGY: The relevant articles published in English between 1998 and 2007 were searched for in Pubmed database with the key words of "chitosan, modification", and the relevant articles published between 1998 and 2007 were searched for in Elsevier Science database with the key words "chitosan, modification" and search "derivate" within search results in English. Articles closely related to the structural modification and application of chitosan were involved, and repetitive and old studies were excluded.LTTERATURE EVALUATION: Totally 154 articles were selected, and 30 of them are accorded with the inclusive criteria,including 5 are reviews, and the others are clinical or experimental studies.DATA SYNTHESTS: The intramolecular hydroxy and amino groups in chitosan are mostly modified because they are easy to be chemically modified. Recently, reports lay particular emphasis on the modification in carboxylation, acylation,alkylation, etherification, etc. Functional groups are introduced to improve its solubility and functionality to widen the range of its application.CONCLUSTON: The water-solubility of chitosan can be improved through structural modification and introducing multifunctional group, which can also bring about much more special efficacies.

Objective To optimize an integration technique for extracting the liposoluble and water-soluble components of Salvia miltiorrhiza. Methods Salvianolic acid B and Tanshinone ⅡA were selected as marker components and determined by HPLC to optimize the integration extract process of Salvia miltiorrhiza by orthogonal test. Results The liposoluble and water-soluble active components of Salvia miltiorrhiza were efficiently extracted by the optimum integration technique. The integration technique for extracting was obtained:Salvia miltiorrhiza was added with 8 times alcohol of 70% and extracted 1 hour for 2 times. Conclusion The liposoluble and water-soluble active components of Salvia miltiorrhiza can be extracted simultaneously by the novel extraction process which was reasonable and feasible. This new technique can be employed to reduce time, working and energy, and be suitable for the morden production.

Objective To study the absorption and distribution of low molecular N-trimethyl chitosan chloride in mice.Methods Using tritium marking method to determine the concentrations of low molecular N-trimethyl chitosan chloride in serum after oral administration.Its pharmacokinetics were analysed by DAS ver1.0 program and the distributions in tissues were examined. Results The pharmacokinetics of low molecular N-trimethyl chitosan chloride were consistent with two-compartment model.The radioactive concentrations in liver,kidney,lung and spleen were higher than those in other tissues.And the radioactive concentration in cancer was higher. Conclusion Low molecular N-trimethyl chitosan chloride could be absorbed after oral administration.It was easily conjugate with cancer surface and could be developed as an anticancer drug for oral use in the future.

Objcetive To evaluate the clinical significance of bone biochemical metabolic markers in osteoporosis( OP),and investigate the clinical application value of the determination.Methods BMD at various skeletal sites was measured by XR-36 dual energy X-ray absorptiometry for 65 patients.Enzyme linked immunosorbent assay (ELISA) were used to determine bone biochemical metabolic markers in sera of 65 patients with osteoporosis and 62healthy controls.Results The levels of serum TRACP5b and 25-OH-VD3/25-OH-VD2 in OP group were higher than that in control group( P ＜0.05),meanwhile the level of BGP,BAP and Ca were varying degrees higher than that in control group,but the level of P was lower than that in control group.Conclusion TRACP5b,BGP,BAP,VD3/2 and other bone metabolic markers can be used as indicators of early detection of osteoporosis,in order to provide valuable data for early treatment of osteoporosis.

Objective To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors. Methods Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant′s demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia. Results (1)The total prevalence of macrosomia was 7.069%(1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36%(89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95%CI: 1.114-1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95%CI: 1.559-2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m2 (24.0-27.9 kg/m2:adjusted OR=1.696, 95%CI: 1.426-2.018; p-BMI≥28.0 kg/m2:adjusted OR=2.393, 95%CI: 1.831-3.127), gestational weight gain (GWG)≥15.9 kg (adjusted OR=2.462, 95%CI: 2.125-2.853), gravidity>1 (adjusted OR=1.408, 95%CI: 1.224-1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI:1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI:1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m2 and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all P<0.01). Conclusions The prevalence of macrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.

This article introduces the progress about study of lipid mdeiating action of chitosan. It was found that chitosan could mediate blood lipids and modification of chitosan could improve its lipid mediating activity in animal and human.

OBJECTIVETo understand childhood asthma from age 0 to 14 in Kaifeng city and the relevant risk factors, effects of therapy and costs.

METHODSEleven thousand children aged 0 to 14 were chosen in Gulou area, Shunhe area using cluster sampling.

RESULTS(1) The overall prevalence of childhood asthma was 1.16% sex ratio 1.72:1. Significant difference was found among every age group (P < 0.001), with the highest from 0 to 3, the prevalence rate in industrial area was significantly higher than that of residential area, with a ratio of 2.13:1 (P < 0.001). (2) Major relevant factors were found to be: history of hypersensitivity, upper respiratory infection and family history; while nationalities, history of contact with pets were not found to be related to childhood asthma (P > 0.05). (3) The expenditure was significantly different between non-specific therapy and specified therapy (P < 0.001). Among those children with asthma, 89.8% did not get specified treatment and the average expenditure was 2,375.2 Yuan per year, which was 10.2% of accepted specified therapy, namely under GINA program, with average expenditure 653.68 Yuan every year.

CONCLUSIONThe result of this study provided scientific basis for child asthma prevention and cure in this area.

Adolescent ; Asthma ; economics ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Prevalence

OBJECTIVETo investigate the value of dual-energy computed tomography (DECT) in the diagnosis of gouty arthritis.

METHODSSixty-one patients with gout, 30 with ankylosing spondylitis and 30 with rheumatoid arthritis were included in the study. DECT scans of the hands, wrists, elbows, feet, ankles, knees, lumbar, pelvis and sacroiliac joint were performed. For post-processing, a color-coding gout software protocol was used. The demographic data and blood uric acid levels were recorded. For 3 gout patients, the findings of puncture biopsy and DECT were compared. Ten gout patients with urate crystal deposition upon recruitment underwent DECT scans again after a 6-month urate-lowering therapy.

RESULTSThe positivity rates of DECT scan differed significantly among the patients with gout, ankylosing spondylitis and rheumatoid arthritis [98.4% (60/61), 13.3% (4/30), and 6.7% (2/30), respectively; χ² =95.522, P<0.05). Of the 21 patients with acute gouty arthritis, 20 (95.2%) showed positive DECT finding, and all the 40 patients with chronic gouty arthritis showed positive findings. In the patients with patients with gout, ankylosing spondylitis and rheumatoid arthritis, the positivity rates of hyperuricemia were 97.3% (36/37), 44.4% (4/9), and 28.6% (2/7), respectively (χ² =24.197, P<0.05). A total of 344 urate deposition sites were detected in the gout patients, involving most commonly the first metatarsophalangeal joint (22.1%), the middle and distal end of the first phalanges of the toes (19.8%), the calcaneus (17.4%), and the inferior extremity of the tibia (13.4%). Seventeen and 5 urate deposition sites were found in ankylosing spondylitis patients and rheumatoid arthritis patients, respecitvely. The 10 gout patients receiving a 6-month urate-lowering therapy showed decreased urate deposition on DECT scan.

CONCLUSIONSDECT scan can detect urate deposition to allow differentiation diagnosis and follow-up in gout patients.

Arthritis, Gouty ; diagnosis ; Arthritis, Rheumatoid ; diagnosis ; Color ; Diagnosis, Differential ; Humans ; Hyperuricemia ; diagnosis ; Spondylitis, Ankylosing ; diagnosis ; Tomography, X-Ray Computed ; Uric Acid ; analysis

OBJECTIVETo investigate the role of natural killer-22 (NK-22) cells in the synovial fluid in the proliferation of fibroblast-like synoviocytes (FLS) in patients with rheumatoid arthritis (RA) and explore the possible signal pathway involved.

METHODSNK-22 cells in the SF of RA patients were sorted by flow cytometry. NK-22 cells were cultured for two weeks and the purity was detected by flow cytometry before stimulation with 20 ng/ml phorbol 12-myristate 13-acetate and 0.5 µmol/L ionomycin for 4 h. The level of interleukin-22 (IL-22) in the culture medium supernatant was then measured with ELISA. The proliferation of FLS in the presence of the culture supernatant of NK-22 cells was assessed with MTT assay at 24, 48 and 72 h, and the effect of IL-22 antibody on FLS proliferation was also observed. Real-time PCR and Western blotting were used to detect Stat3 mRNA and p-Stat3 protein levels, respectively, in the FLS exposed to rhIL-22 and AG490.

RESULTSNK-22 cells were successfully sorted by flow cytometry with a purity exceeding 90%. The levels of IL-22 in the supernatant of NKp44(+)NK cell culture averaged 1273.42∓254.48 pg/ml. The FLS proliferated rapidly 24, 48, and 72 h after the addition of culture supernatant of NK-22 cells (P<0.05). IL-22 antibody obviously inhibited the proliferation of FLS induced by NK-22 cell culture supernatant (P<0.05). Exposure of the FLS to rhIL-22 obviously increased cellular Stat3 expression levels, which were significantly lowered by the addition of AG490 (P<0.05).

CONCLUSIONNK-22 cells in the SF of RA patients can produce high concentrations of IL-22 to promote the proliferation of FLS through the STAT3 signal pathway.

Arthritis, Rheumatoid ; metabolism ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; cytology ; Humans ; Interleukins ; metabolism ; Killer Cells, Natural ; cytology ; metabolism ; STAT3 Transcription Factor ; metabolism ; Signal Transduction ; Synovial Fluid ; cytology ; Synovial Membrane ; cytology

Objective To investigate the immune status characteristics of primary ITP patients with abnor-mal auto-antibodies. Methods A total of 110 patients were enrolled in our study,who were admitted in Fu-Xing Hospital affiliated to Capital Medical University from January 2001 to July 2015.According to whether the patients have autoimmune diseases and the presence of auto-antibodies,we divided the patients into 3 groups,including the primary ITP with abnormal auto-antibodies(PITP-ANA)group,the primary ITP(PITP)group and the second-ary ITP(SITP)group.We compared the T-cell subsets,regulatory T cells,B lymphocytes,changes of immunoglob-ulin and bone marrow biopsy and cytology of patients among the three groups,retrospectively. Results The per-centage of CD3+T cells(61.72 ± 10.60)% in PITP-ANA group was lower than that in PITP group(69.57 ± 11.99)%. The percentage of CD8+T lymphocyte(24.00 ± 7.67)% was significantly lower than that of PITP group (30.59 ± 11.08)%(P<0.05).The proportion of Treg in PITP group,PITP-ANA group and SITP group were(6.12 ± 1.41)%,(7.50 ± 2.76)% and(8.49 ± 2.47)%,respectively,with statistically significant differences.The ra-tio of CD19+T cell in PITP-ANA group(25.75 ± 9.98)%was significantly higher than that in PITP group(16.16 ± 8.19)%(P < 0.01). The concentration of IgG、IgA、κ light chain and λ light chain in PITP group,PITP-ANA group and SITP group showed an upward trend and the highest level was in the SITP group,with statistically signifi-cant differences among the three groups. A variety of abnormal auto-antibodies could be found in both PITP-ANA group and SITP group. Conclusions We consider that the immune function abnormity of patients in PITP-ANA group were worse than that in PITP group,because the concentration of immunoglobulin,the percentage of B lym-phocyte and Treg ratio are higher in than those in PITP group.