Background Constipation is a common complication after stroke, and the results investigated overseas showed the incidence was about 30% ～60%. The difference of results is so significant because the time investigated and the diagnosis criterion used are different. There are less relative report about risk factors of constipation and no report about the impact of constipation on pragnosis. The study is to investigate the incidence and risk factors of new-onset constipation after stroke in the patients with acute stroke and to evaluate the impact of new-onset constipation occurrence on the prognosis in the patients.Methods A prospective cohort study of new-onset constipation was performed to investigate 154 cases of acute stroke patients who were hospitalized from December 2003 to October 2004 in the department of neurology, the first Affiliated Hospital of Sun Yat-sen University. We recorded the demographics, medical history,stroke severity and medication used. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI)and Modified Rankin Scale (MRS) were evaluated in the 1st week and 4th week after stroke to evaluate the neurological function and ability of an independent life. BI and MRS were recorded at the 12th week after stroke.Patients were then followed for the development of stroke, the event such as recurrence or death. Constipation was defined by Rome Ⅱ criteria.Results The incidence of new-onset constipation after stroke within 4 weeks was 55. 31%, and the highest risk was within seven days after onset of stroke. Cox regression showed that the incidence of constipation occurrence was strongly related to neurological functional status of patients in the 1st week assessed by BI and the transform of surrounding for defecation. In the 4th week and 12th week after stroke, the rates of poor prognosis in patients with constipation in middling state were both higher than patients without constipation, and the difference was statistically significant respectively(P ＜ 0. 01 ;P = 0. 012).Conclusions The new-onset constipation occurrence in acute stroke is very common and its main risk factor is functional status assessed by Barthel Index at the 1st week after onset and the transform of surrounding for defecation. The results indicate that the new-onset constipation occurrence after stroke has negative effects on the outcome of partial stroke patients.

Anticoagulants ; poisoning ; Humans ; Male ; Middle Aged ; Rodenticides ; poisoning

Objective To evaluate clinical significance of the grade of ischemia by QRS complex on the admission electrocardiogram(ECG)to predict severe arrithmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to emergency department from July 2003 to April 2008 were enrolled.A total of 223 patients met the criteria(ischemic chest pain ≥ 30 min,2 or more adjacent leads of ST segment elevation and onset time within 12 h).Exclusion criteria were bundle branch block and left ventricular hypertrophy.All enrolled patients were divided into two groups based on the enrollment electrocardiogram:grade 2 ischemia(ST elevation without terminal QRS distortion; n =134)and grade 3 ischemia(ST elevation with terminal QRS distortion; n =89).Patients of the two groups had comparable genderproportion,average age and coronary heart disease risk factors etc.All patients received thrombolytic therapy.The incidence rate of ST segment resolution(STR)and severe arrithmia in hospital stay were observed.Numerical variables were expressed mean ± standard deviation and compared by unpaired Student't test,Categorical variables were expressed percentage and compared by chi square test.Multiple logistic regression analysis was used to determine independent predictors of severe arrithmia.Results Patients with grade 3 ischemia had greater Σ ST on admission and 2 h after thrombolysis ECGs(P ＜ 0.01),the incidence rate of STR in patients with grade 3 ischemia was lower than that in patients with grade 2 ischemia(P ＜0.01).The peak creatine kinase MB fraction was higher in patients with grade 3 ischemia than that in patients with grade 2 ischemia(P ＜ 0.01).There was no significant difference of the incidence of severe arrithmia,such as ventricular premature beat,ventricular tachycardia or fibrillation,second-degree or third-degree atrioventricular block,and sinus arrest between the two groups(P ＞ 0.05),but there was a trend of higher incidence of severe arrithmia in patients with grade 3 ischemia compared with that in patients with grade 2 ischemia.Multiple logistic regression analysis demonstrated that the independent predictors of severe arrithmia were duration from symptom to thrombolysis and initial.Σ ST,whereas grade 3 ischemia remained a strong predictor of severe arrithmia.Conclusions Grade 3 ischemia on admission is associated with lower incidence of STR in patients with ST-segment elevation myocardial infarction(STEMI)after thrombolysis and a strong predictor of severe arrithmia.

Objective To explore the curative effect of percutaneous cavity injection for the treatment of drug resistant pulmonary tuberculosis guided by color Doppler ultrasound.Methods Ninety-six bacterial culture positive patients with drug resistant pulmonary tuberculosis were randomly divided into treatment group(n =48) and control group (n =48).Patients in both groupswere given systemic anti tuberculosis therapy,and those who in the treatment group were given extra percutaneous cavity injection guided by color Doppler ultrasound.Results After 3 months of treatment,the sputum negative conversation rate,X-ray absorption rate,cavity closure rate,and cavity efficiency rate of the treatment group were 56.3％ (27/48),81.3％ (39/48),58.3％ (28/48) and 75.0％ (36/48) respectively,higher than those of the control group 35.4％ (17/48),62.5％ (30/48),37.5％ (18/48) and 50.0％ (24/48) respectively),and the differences were statistically significant(x2 =4.20,P =0.02 4 ; x2 =4.17,P =0.041; x2 =9.58,P =0.004 ; x2 =6.40,P=0.020).After 12 months of treatment,the sputum negative conversation rate,cavity closure rate,cavity efficiency rate of the treatment group were 93.8％ (45/48),83.3％ (40/48),95.8％ (46/48) respectively,higher than those of control group(77.1％ (37/48),62.5％ (30/48) and 81.3％ (39/48)),and there were significant differences between two groups (x2 =5.35,5.27,5.03 ; P =0.040,0.038,0.025) ; the X-ray absorption rate of the treatment group was 93.8％ (45/48),higher than that of ciontrol group (83.3％ (40/48)),but there was no significant difference between two groups(x2 =2.56,P =0.199).Conclusion It is very effective to treat drug resistant pulmonary tuberculosis using percutaneous cavity injection guided by Color Doppler Ultrasound.No obvious complications or adverse reactions have been observed so far.

Objective To investigate the effects of N - acetylcysteine (NAC) on apoptosis and the expressions of Fas/FasL mRNA in lung tissue of rats with paraquat - induced acute lung injury.Methods Forty five male SD rats were randomly (random number) divided into normal control group,paraquat (PQ) group,and NAC treatment group.The rat model of acute lung injury was made with 2％ PQ induction in dose of 25 mg/kg injected,and NAC was injected into the PQ poisoning rats (200 mg/kg) 30 minutes after PQ administration in NAC treatment group.In the control group,equal amount of saline instead was injected into the rats.Apoptosis was detected by using TUNEL method and the expressions of Fas/FasL mRNA were evaluated by using reverse transcription polymerase chain reaction (RT- PCR),and the levels of Fas/FasL protein were detected by using western blot analysis.Results Compared with control group,cell apoptosis and expressions Fas/FasL mRNA in PQ group were significantly different ( P ＜ 0.05 ).Compared with PQ group,cell apoptosis and expressions Fas/FasL mRNA in NAC group were significantly decreased,were significant lower (P ＜ 0.05).Conclusions NAC inhibited apoptosis in lung tissue of rats with paraquat induction by regulating the activation of Fas/FasL systems.

Objective To establish a method for quality control of xinshuaining mixture. Methods The herbal contents including red ginseng,milk veteh,root of red rooted salvia were identified by thin layer chromatography ( TLC) and the content of ginsenoside Rb1 in xinshuaining mixture was determined by high performance liquid chromatography ( HPLC ) . Results The herbs can be overtly identified by TLC. Ginsenoside Rb1 had a linear relationship in the range of 1. 095-5. 475μg, and the average recovery was 97. 3%(RSD 1. 98%). Conclusion The method is simple and rapid,and can be used for the quality control of xinshuaining mixture.

Rheumatic diseases often involve the musculoskeletal system, including rheumatoid arthritis (RA), spondyloarthritis (SpA), gouty arthritis, systemic sclerosis (SSc) and polymyalgia rheumatica (PMR), which are difficult to cure and have a high disability rate, thus seriously affect patients′work and life. A simple, convenient and effective means is needed for disease′s diagnosis and activity monitoring in clinic. Musculoskeletal ultrasound (MSUS) scans the superficial joints and muscles, and can detect the inflammation in disease′s early stage. It has the advantages of safety, high sensitivity and repeatability, and is widely applied in rheumatic diseases.

Objective To investigate the impacts of phillyrin on exudates and lung injury in rats with acute pleurisy by regulating the NLRP3 inflammatory pathway.Methods Ninety rats were randomly divided into the control group,the model group,the low-dose phillyrin(PH-L,5 mg/kg)group,the medium-dose phillyrin(PH-M,10 mg/kg)group,the high-dose phillyrin(PH-H,20 mg/kg)group and the NLRP3 pathway inhibitor(PJ34,10 mg/kg)group.FVC,FEV 0.1 and FEV 0.3 were detected by lung function analyzer.Electronic balance was used to weigh the mass of chest exudate.The number of white blood cells in exudate was detected by Wright staining.Contents of prostaglandin E2(PGE2),monocyte chemoattractant protein-1(MCP-1),interleukin(IL)-6 and tumor necrosis factor-α(TNF-α)in exudate were detected by ELISA.Automatic blood gas analyzer was used to detect p(CO2)and p(O2)of rats.HE staining was used to observe pathological changes of lung tissue.The expression levels of NLRP3 and Caspase-1 protein were detected by immunohistochemistry.Western blot assay was used to detect the expression of NLRP3 pathway protein.Results Compared with the control group,the quality of pleural exudate and the number of white blood cells,the contents of PGE2,MCP-1,IL-6,TNF-α,the expression of p(CO2)and NLRP3 pathway proteins in exudate of the model group increased obviously,FVC,FEV 0.1,FEV 0.3 and p(O2)decreased obviously,and the lung tissue showed obvious pathological damage(P＜0.05).Compared with the model group,the quality of pleural exudate and the number of white blood cells,the contents of PGE2,MCP-1,IL-6,TNF-α,the expression of p(CO2),NLRP3 pathway proteins in the exudate of rats decreased obviously in the PH group and the PJ34 group,FVC,FEV 0.1,FEV 0.3 and p(O2)increased obviously,the pathological injury of lung tissue was obviously improved(P＜0.05).Compared with the PH-H group,there were no significant differences in the above indexes in the PJ34 group(P＞0.05).Conclusion PH can improve lung injury induced by acute pleurisy in rats by inhibiting the activation of NLRP3 pathway and inhibiting inflammatory reaction.

Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C ＜ 7.0％ at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21％ ± 1.65％ to 6.69％±0.83％,P＜0.001),69.7％ of the patients achieved HbA1C ＜7.0％ at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P＜0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2％,and the incidence of confirmed hypoglycemia was 3.8％.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.

OBJECTIVETo investigate the effects of acetamide at different doses on the expression of inhibitory amino acids (gamma-aminobutyric acid, GABA) and excitatory amino acid (glutamate, Glu) in the cerebral cortex of rats with acute tetramine (TET) poisoning.

METHODSEighty Sprague-Dawley rats (SPF) were randomly divided into five groups, with 16 rats in each group: saline control group, dimethyl sulfoxide (DMSO) control group, TET exposure group, high-dose (2.8 g/kg/d) acetamide treatment group, and super-high-dose (5.6 g/kg/d) acetamide treatment group. Rats in the exposure group and treatment groups were exposed to TET by intragastric administration after fasting, and were then intramuscularly injected with saline or different doses of acetamide in the following 5 days. The cortex of the temporal lobe was collected at 3 h, 12 h, 48 h, or 7 d after treatment. The expression levels of GABA and Glu in the cortex of the temporal lobe were determined by average optical density (OD) values in immunohistochemistry.

RESULTS1) Expression of GABA: The OD value of GABA in TET exposure group started to increase at 12 h after treatment, reached the peak at 48 h, and decreased to the normal level at 7 d. In the high-dose acetamide treatment group, the increase in OD at 12 h was not so significant as that in the TET exposure group, OD value decreased to the normal level at 48 h and was lower than that in the exposure group, and the changes were more like those in the control groups. In the super-high-dose acetamide treatment group, OD value began to increase significantly at 3 h and was significantly higher than that in the TET exposure group (P < 0.01), it reached the peak at 12 h, and was restored to the normal value at 48 h. 2) Expression of Glu: The OD value of Glu in TET exposure group at 3 h after treatment was significantly lower than those in the two control groups, it increased gradually from 12 h to 48 h, and recovered to the normal level at the 7th d. The changes in the high-dose acetamide treatment group were similar to those in the TET exposure group, but became more like those in the control groups after 48 h; the OD value in super-high-dose acetamide treatment group was significantly higher than that in the TET exposure group at 3 h after treatment (P < 0.01), while no significant difference was found at 12 h; it was significantly lower than those of all other groups at 48 h and 7 d (P < 0.01).

CONCLUSIONSTreatment with high dose of acetamide has some curative effect on TET poisoning-induced central nervous lesion, while the effect of super-high-dose acetamide on expression of neurotransmitters is too complex to evaluate.

Acetamides ; pharmacology ; Animals ; Bridged-Ring Compounds ; poisoning ; Cerebral Cortex ; drug effects ; metabolism ; Female ; Glutamic Acid ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; gamma-Aminobutyric Acid ; metabolism