Objective:To investigate the efficacy of lanthanum carbonate versus calcium acetate in the treatment of hyperphosphatemia in patients receiving maintenance hemodialysis. Methods:A total of 202 patients with chronic renal failure who received maintenance hemodialysis in Department of Nephrology, Yiwu Central Hospital from March 2016 to January 2017 were included in this study. These patients were on dialysis for ≥ 6 months with blood phosphorus level > 1.78 mmol/L before dialysis. They were randomly divided into the lanthanum carbonate ( n = 100) and calcium acetate ( n =102) groups. Two patients in the lanthanum carbonate group withdrew from the study due to intolerance of vomiting. All patients were treated for 9 months. During the study period, low calcium dialysate was rationally used, and strict dietary phosphate restriction was applied. The changes in serum phosphorus, calcium and parathyroid hormone contents before and after treatment were compared between the two groups, and they were compared between before and after treatment in each group. Results:During the treatment, the average dose of phosphate binder was 1 500 mg/d in the lanthanum carbonate group and 3 335 mg/d in the calcium acetate group. There were no significant differences in general demographic data and biochemical indexes between the two groups (both P > 0.05). No significant differences in dietary phosphorus content and dialysate calcium concentration were observed between the two groups (both P > 0.05). In the calcium acetate group, blood phosphorus content decreased from (2.12 ± 0.35) mmol/L before treatment to (1.55 ± 0.24) mmol/L after treatment ( t = 13.43, P < 0.01). In the lanthanum carbonate group, blood phosphorus content decreased from (2.14 ± 0.3) mmol/L before treatment to (1.45 ± 0.17) mmol/L after treatment ( t = 20.01, P < 0.01). In the lanthanum carbonate group, the difference in blood phosphorus content between before and after treatment was (0.69 ± 0.29) mmol/L, which was significantly higher than that in the calcium acetate group [(0.57 ± 0.37) mmol/L, t = 2.553, P < 0.01]. Hypercalcemia did not occur in both groups, and there were no significant differences in carotid intima thickening and presence of calcified plaque between the two groups (both P > 0.05). Conclusion:Under the premise of effectively implementing rational low calcium dialysate use and strict dietary phosphate restriction, both calcium acetate and lanthanum carbonate can effectively reduce the blood phosphorus level in patients undergoing maintenance hemodialysis. Lanthanum carbonate has better effect in reducing serum phosphorus level than calcium acetate, but it is likely to produce gastrointestinal reactions. Neither treatment method bears the risk of hypercalcemia.

Sixty four patients undergoing endoscopic sinus surgery were randomly divided into two groups.In nimesulide group (n=32) patients were given nimesulide capsule 100 mg after surgery and 32 patients in control group were given 100 mg vitamin C as placebo.The visual analogue scale (VAS) was used to evaluate the degree of pain during withdrawing nasal packing.The VAS value of the nimesulide group was 2.8±1.1 3 h after surgery and 2.7±1.2 during with drawing nasal packing,that of control group was 6.7±0.6 and 8.3±0.6,respectively (both P<0.01).The results revealed that nimesulide had a siguificant analgesic effect in endoscopic sinus surgery.

Fifty four patients with chronic sinusitis (without nasal polyps) were randomly divided into two groups. Thirty patients in experimental group were treated with dirithromycin and 24 patients in control group were treated with clarithromycin. The doses was both 250 mg q. d. and the duration of treatment was 3to 6 months. The VAS scores of subjective symptoms (nasal obstruction, purulent nasal discharge,headache, smell worse ) and Lund-Mackay scores of objective signs (sinus CT ) in both groups were improved significantly compared with the baseline(P ＜0.05), and there were no statistical significances between two groups ( P ＞ 0. 05 ). The curative effect was positively correlated with the duration of treatment.The total effective rates were 73% and 67% and adverse reaction rates 7% and 21% in two groups,respectively (P ＞ 0. 05 ); but the adverse reactions in control group were more serious than those in experimental group. During the six-month follow-up, no recurrence and aggravation were observed. The results suggest that low-dose dirithromycin may be more suitable for long-term treatment of chronic sinusitis.

BACKGROUND:Restoring the stability of the spine has become the consensus of spinal surgery. The canaloplasty technology has been continuously improved, but how can we get the good clinical effect of the canaloplasty, and the price affordable, many domestic scholars have to try al kinds of the improved operation methods. OBJECTIVE:To evaluate the clinical application value of cannulated screws fixation in canaloplasty. METHODS:From February 2011 to February 2013, total y 24 patients with spinal disease treated by canaloplasty using cannulated screw were retrospectively analyzed, of which 12 cases of cervical stenosis, 2 cases of intraspinal tumor in thoracic and 10 cases of intraspinal tumor in lumbar. Al patients were fol owed up after treatment. Postoperative CT and MRI were done in al patients. Clinical symptoms and radiographic changes were observed after treatment. The Japanese Orthopaedic Association score and the spinal canal cross-sectional area measurement were conducted in the patients with cervical stenosis between the preoperation and postoperation. Visual analog scale score was evaluated in patients who have the tumor in the thoracolumbar spine between the preoperation and postoperation. RESULTS AND CONCLUSION:Al patients had no complications such as nerve or blood vessel damage. Al patients were fol owed up 12 to 24 months. Imaging evaluation showed that internal fixator was stable without the hol ow screw loss or displacement. The bone grafting in groove reached bone fusion. There was no occurrence of lamina col apse or“re-close of door”. The Japanese Orthopaedic Association score and spinal canal cross-sectional area of patients with cervical stenosis during the fol ow-up after 12 months of treatment were significantly superior to those in preoperation (P<0.01). After 12 months of treatment, Japanese Orthopaedic Association scores showed that the excel ent rate of classification assessment was 92%. During the fol ow-up after 12 months of treatment, the visual analog scale of patients with thoracolumbar tumor improved from (8.2±1.6) points before treatment to (2.3±1.3) points at the first year after discharge (P=0.004 2). These results suggest that the application of cannulated screws in the canaloplasty can not only enhance the stability of the rear pil ar, and can improve the healing rate of osteotomy, and has the characteristics of inexpensive, easy to operate, and repair effect is good.

Objective To investigate the relationship between the neuroprotective effect of epigallocatechin gallate ( EGCG ) for PC12 cells induced by 1-methyl-4-phenyl-pyridinium ( MPP+ ) and activating nuclear factor-related factor 2 ( NRF2 ).Methods Well differentiated PC12 cells treated with MPP+ were used as the in vitro cell models,and PC12 cells were pretreated with different concentrations of EGCG.MTT assay was used to investigate the cell viability.Western blot was used to observe the expression of NRF2 in cells and distribution in the nucleus and the cytoplasm.Real-time PCR was used to observe the antioxidant enzymes,HO-1 and NQO1 mRNA expression.Results Pretreatment of PC12 cells with different concentrations of EG CG for an hour could restore cell viability.Western blot showed that expression of NRF2 in cells treated with MPP+ for 24 hours was increased 148％ +5％ compared with the control group (t =6.102,P ＜0.01 ).The level of NRF2 in EGCG pretreated group was 188％ + 6％ compared with the control group(t =11.172,P ＜0.01 ).Moreover the NRF2 protein level in the nuclear was also increased.Western blot showed that the NRF2 protein level in the nuclear was 258％ +2％ compared with the control group (t =21.995,P ＜ 0.01 ).Further research found U 120,an inhibitor of ERK,could inhibit the effect of EGCG.The levels of NRF2 in both samples were 148％ ± 15％ and 158％ ± 1％ compared with their respective control groups(t =6.118,8.058,both P ＜0.01 ).In accordance with the NRF2 data,real-time PCR indicated that the levels of HO-1 and NQO1 mRNA expression increased obviously in the group pretreated with EGCG.Likewise,U120 could also inhibit HO-1 and NQO1 mRNA expression induced by EGCG.Conclusions EGCG can repair oxidative damage to PC12 cells induced by MPP+.The protective effect may be related through the ways to activate ERK-NRF2 and induce downstream of antioxidant enzyme expression,such as HO-1 and NQO1.

Taxa-4(5),11(12)-diene is the precursor for paclitaxel biosynthesis. The diterpenoid paclitaxel (marketed as Taxol), a plant secondary metabolite isolated from yew, is an effective drug widely used in the treatment of numerous cancers. However, further application of taxol has been restricted due to its low yield in plants and the difficulties in extraction. To increase the intact isoprene flux, we constructed the fusion gene plasmid pBgGGTS and individual cassette plasmid pBgGGgTS to enhance the expression levels of geranylgeranyl diphosphate synthase gene (ggpps) and a taxadiene synthase gene (ts) in Coprinopsis cinerea. These two plasmids were separately transformed into C. cinerea LT2 strain, resulting in several putative transformants. Putative transformants were determined by PCR technique, indicating that 5 out of 13 putative transformants transformed by pBgGGTS and 6 out of 13 putative transformants transformed by pBgGGgTS, respectively. Additionally, the Southern blotting analysis of these 10 transformants confirmed that both ggpps and ts gene were stably integrated into the genome of C. cinerea. Crude extracts from each of the transformants were analyzed. There is no difference in the mycelium extracts among the wild-type LT2 and two types of transformants. However, analysis of culture filtrates indicated that an additional GC peak was found at the retention time of 16.762 min which was absent in the wild type control. The mass fragmentation pattern of this peak had the same diagnostic ions with taxa-4(5),11(12)-diene. According to peak area, the amounts of taxa-4(5),11(12)-diene in each fermented broth were 44 ng/L (transformed with pBgGGgTS) and 30 ng/L (transformed with pBgGGTS), respectively. In conclusion, co-expression of the ggpps and ts gene could increase the taxadiene production in C. cinerea.
Agaricales ; metabolism ; Alkenes ; metabolism ; Diterpenes ; metabolism ; Farnesyltranstransferase ; genetics ; metabolism ; Genetic Engineering ; Isomerases ; genetics ; metabolism ; Paclitaxel ; Plasmids

OBJECTIVE:To explore the new model and feasibility of the combination of ward round conducted by business president and pharmaceutical administration.METHODS:The organization form,procedures,content and experience of ward round conducted by business president were introduced based on the practice of our hospital.RESULTS & CONCLUSIONS:The pharmaceutical ward rounds conducted by business president are carried out once a month in our hospital to intervene irrational medication by means of medication survey,administration intervention and education with guidance and supervision of rational use of drug as core.Multi-disciplinary cooperation is effective measure for improving rational use of drug.It can strengthen public perception on rational use of drug in all areas by enhancing experience at key point which is worth of spreading.

This study was designed to disclose the specific changes of distortion product otoacoustic emission (DPOAE), including DP-gram and I/O-gram in guinea pigs treated with GM for 10 and 17 days. Forty guinea pigs were divided into four groups:group I (treated with GM for 10 days), group II (treated with normal saline for 10 days), group III (treated with GM for 17 days), group IV (treated with normal saline for 17 days). DPOAE including DP-gram and DP-I/O was recorded by use of CELESTA 503 Cochlear Emission Analysis and the out hair cell loss was numerated. (1) The amplitude in group I showed significant reduction at frequencies of 4, 6, 8 kHz. There were significant differences, compared to group II (t=2.52, 1.92, 2.10, P<0.05). The amplitude in group III also decreased at frequencies of 3, 4, 6, 8 kHz. There were also significant differences compared to group IV (t=3.27, 2.81, 2.92, 3.13, P<0.01). The amplitude of DP-I/O in group I and group III at different frequencies and stimulus levels showed reduction. (2) At the level L1 <60 dB SPL, the stimulus levels to elicit a 0 dB response in group I and group III were higher than those in corresponding control groups, respectively. (3) The mean of threshold shift was 5.0+/-3.8 dB in group I and 25.0+/-6 dB in group III at 8 kHz frequency. (4) The out hair cell loss was 22.16% in group I and 48.36% in group III, both showed significant difference as compared to controls, respectively (P<0.01). The employment of DPOAE can be a useful tool in monitoring ototoxicity of GM for its sensitivity and specificity in guinea pigs treated with GM. The changes in DPOAE were consistent with those in histology.
Acoustic Stimulation ; methods ; Animals ; Cochlea ; drug effects ; physiopathology ; Female ; Gentamicins ; administration & dosage ; adverse effects ; Guinea Pigs ; Hair Cells, Auditory, Outer ; drug effects ; pathology ; Male ; Otoacoustic Emissions, Spontaneous ; physiology ; Perceptual Distortion ; drug effects ; physiology ; Random Allocation

Objective: To explore the relationship between the changes of plasma levels of resistin with the contemporary body weigh changes in the same population. Methods: The community based epidemiological surveys were carried out in the same population in Shijingshan district of Beijing at the year of 2005 and year of 2010. A total of 943 subjects with the entire information of cardiovascular related risk factors were enrolled including 316 male with the mean age of (58.2 ± 8.5) years and 627 female with the mean age of (59.3 ± 7.5) years. Plasma levels of resistin in both year of 2005 and year of 2010 in all subjects were recorded, and the subjects were divided into 4 groups based on the quartile levels of resistin. Group①, the subjects with plasma level of resistin ≤ (-0.66) mmol/L,n=239, Group②, resistin level (from -0.67 to 0.25) mmol/L,n=233, Group③, resistin level (0.26-1.24) mmol/L, n=235 and Group④, resistin level ≥1.25 mmol/L,n=236. Pearson correlation study with uni- and multi- regression analysis were conducted to investigate the relationship between the changes of plasma levels of resistin with the contemporary body weight changes in the same population.Results: The uni-variate analysis showed that in female subjects, plasma levels of resistin were obviously related to the percentage (%) of body weight changes (correlation coefifcient: 0.1173), body weight index (kg/m2) changes (0.1521), the% of body weight index changes (0.1412), the waist circumference (cm) changes (0.1228) and the % of waist circumference changes (0.1057) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Multi-regression analysis indicated that with adjusted baseline variables, in female subjects, the plasma levels of resistin were obviously related to body weight (kg) changes and the % of body weight changes (regression coefifcient: 0.0261 and 0.2916), body weight index (kg/m2) changes and % of body weight index changes (0.2157 and 0.3072), the waist circumference (cm) changes and the% of waist circumference changes (0.0532 and 0.2738) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Conclusion: The changes of plasma levels of resistin are signiifcantly related to contemporary body weight changes in female subjects, but not in male subjects.

Objective: To explore the prevalence and risk factors of mitral regurgitation (MR) in the population ≥35 years in China in order to provide prevention reference for high risk crowd. Methods: The residents ≥35 years were taken by a stratified multistage sampling method. General information of crowd was collected by predesigned questionnaire and physical examination including life style, disease history, body weight and height. Echocardiography was conducted, fasting blood glucose and blood lipid levels were measured. Results: A total of 28814 subjects were enrolled. The overall MR detection rate was 18.4%, the detection rate in male and female were both 18.4%. The detection rates of moderate and severe MR were 0.3% in the paticipants at (35-50) years, 0.9% at (51-64) years and 2.2% at ≥65 years. MR prevalence showed an increasing trend with aging. Multivariate Logistic regression analysis indicated that age, systolic blood pressure, urban and rural, district, left atrial front and back diameter, left ventricular end diastolic front and back diameter, left ventricular ejection fraction, stroke, atrial fibrillation and heart failure were the risk factors for MR occurrence. Conclusion: MR detection rate was rather high in China. Specific prevention action should be taken for those with theabove risk factors.