Objective To investigate the interference effect of calcium dobesilate on serum creatinine levels by Sarcosine oxidase-based assay.Methods 1.Interference test in vivo:Ten patients with chronic renal diseases from Huangshi second hosptial were recruited.Serum creatinine (sarcosine oxidase method,Scr1 ; deiminase method,Scr2),urea,and cystatin C were detected and compared before and after one week administration of calcium dobesilate; 2.Interference test in vitro:to detect whether 100 mg/L calcium dobesilate has any interference with Scr1 and Scr2; 3.Dose-dependent interference test:To detect the interference effect of different concentrations of calcium dobesilate (1.25-20.0 mg/L) on different creatinine concentrations (404.5 μmol/L or 65.9 μmoL/L) measured by sarcosine oxidase assay.Bias within 3.5％ or 6.63 μmol/L of creatinine levels was clinically acceptable.Statistical comparisons were made using Wilcoxon rank-sum test.Results There was significant difference of sarcosine oxidase-based serum creatinine levels between before and after one week administration of calcium dobesilate (P ＜ 0.05),while no significant differences were observed for deiminase-based serum creatinine levels,urea and estimated GFR values (P ＞ 0.05).Interference test showed that 95％ confidence interval of interventional value (Dobs) of calcium dobesilate (100 mg/L) was (-173.9 ± 2.86) μmol/L for the sarcosine oxidase assay and (1.21 ± 3.14) μmol/L for deiminase method,indicating that calcium dobesilate caused a significant negative effect on the former enzymatic assay but not the latter one.In the dose effect interference test of calcium dobesilate,the regression equations were:Y =-2.7649X-0.0782 (R2 =0.998,F =7943.4,P =0.000) for high creatinine levels and Y =0.0263X2-1.6394X-0.2754 (R2 =0.996,F =2546.7,P =0.000) for low creatinine levels.The interference effect was less than the predetermined d with the calcium dobesilate concentrations of 4.4 mg/L in high concentration specimen and 3.5 mg/L in low concentration specimen.Conclusions Calcium dobesilate has a significant negative interference with serum creatinine detected by the sarcosine oxidase method,which leads to the bias of creatinine in patients with renal insufficiency.Hence,sarcosine-oxidase-based creatinine levels should be cautious when calcium dobesilate was used,and further check with another assay is necessary if possible.

Age-related macular degeneration (AMD) is the leading cause of visual impairment among older population worldwide,and wet AMD is more threatened to vision because of the choroidal neovascularization.Some physical therapies are thought to destroy the lesions but can not improve the visual acuity.Therefore,anti-VEGF drug therapy is becoming a new approach to the management of wet AMD.Vascular endothelial growth factor(VEGF) is thought to play an important role in the complicated pathogenesis,which can be addressed by disease reduction strategies.Among the anti-VEGF drug therapies,anti-VEGF monoclonal antibodies are proved to maintain and improve visual acuity.Other therapies have been or now being developed for the treatment of neovascular AMD with the goal of inhibiting VEGF.These inhibitors include VEGF receptor decoy aflibercept,small interfering RNA-based therapies (bevasiranib) and tyrosine kinase inhibitors (vatalanib),which could offer the potential for further advances.To completely realize the active mechanism of VEGF in wet AMD is helpful for the rational use of anti-VEGF drugs.

Objective: To observe the effect of Weixikang apozema on growth factor of acetic acid gastric ulcer rats.Methods: The rats were divided into blank control group(abbreviated as blank group),model group,ranitidine group,Weixikang low dosage group(abbreviated as low dosage group) and Weixikang high dosage group(abbreviated as high dosage group) at random,each group has 8 rats.The content of epidermal growth factor(EGF) and transforming growth factor-?(TGF-?) were measured with radioimmunoassay.The protein expression of EGF,TGF? and EGFR were measured with immunohistochemical method.Results: The content of EGF and TGF-? and the protein expression of EGF,TGF-? and EGFR in low dosage group and high dosage group have increased(P

Objective To analyse the effect of endoscopic thoracic sympathectomy of palma-plantar hyperhidrosis. Methods Between January 2006 and January 2009,77 cases with palma-plantar hyperhidrosis were operated by thoracoscope. Fifty-two cases of palma-axillary-plantar hyperhidrosis were performed sympathectomy of T2-T4 and 25 cases of palma-plantar were performed sympathectomy of T2-T3.Bilateral procedures were completed in the same position. Results After operation palmar hyperhidrosis and armpits hyperhidrosis all were cured. Of soles, 7 cases were completely dry, 34 cases nearly dry, 32 cases unchanged and 4 cases worse. There was no significant difference in the change of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4 (P ＞ 0.05). Conclusions Bilateral single port for endoscopic thoracic sympathectomy produces slighter trauma and patients easily accept it. Plantar sweating can be relieved or nearly relieved in partial patients after thoracic sympathectomy. There is no difference in the effect of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4.

Objective To understand the features of cognitive impairment in patients with subclinical hypothyroidism. Methods The cognitive function of the patients with subclinical hypothyroidism and the healthy controls was tested using Mini-Mental State Examination (MMSE) and Wechsler Memory Scale (WMS). The change in cognitive function was observed and analyzed before and after L-T4 treatment. Results Fifty-seven patients with subclinical hypothyroidism and the same number of healthy controls were enrolled in this study. There were no significant differences between two groups in biochemical indexes and MMSE score (all P＞0.05). But there were significant differences between two groups in WMS score, including pictures, memories, learning, touch, understanding memory and back several test scores (all P＜0.05). There existed certain degree of cognitive dysfunction mainly displayed in memory, attention, etc. After three months of L-T4 treatment, all had significant improvement (all P＜0.05). Conclusions Patients with subclinical hypothyroidism have cognitive dysfunction, when the thyroid stimulating hormone is restored to normal level, cognitive function is also improved.

OBJECTIVE: To study the changes of the center of cellular immune thymus and the interference of Jinhong Tablet, a compound traditional Chinese herbal medicine, during the course of cholangitis. METHODS: Twenty-four male Wistar rats were randomly divided into three groups. Ligation group, simple ligation of bile duct without producing infection and fed with normal saline; untreated group, reproduce acute cholangitis and fed with normal saline; Jinhong Tablet-treated group, reproduce cholangitis and treated with Jinhong Tablet. Five days after modeling, the rats were sacrificed and the thymus were sampled to observe the morphological changes with an electronic microscope, count the index of thymus and apoptosis and assay the expressions of Bcl-2 gene coding protein and Fas gene coding protein. RESULTS: The frequency of apoptosis of thymus in the untreated group was higher than that in the Jinhong Tablet-treated group and the ligation group, and the frequency of apoptosis of thymus in the Jinhong Tablet-treated group was higher than that in the ligation group. Compared with the Jinhong Tablet-treated group and the ligation group, the weight and index of thymus were lower and the index of apoptosis of thymus was higher significantly in the untreated group (P<0.01). The expression of Bcl-2 gene coding protein in the ligation group and the Jinhong Tablet-treated group were much higher than that in the untreated group (P<0.01), but there were no significant differences of the expression of Fas gene coding protein among the three groups. CONCLUSION: There exists a promotion of non-physiological apoptosis of cellular immune center such as decrease of the weight and the index of thymus and increase of the index of apoptosis of thymus during acute cholangitis, which may be inhibited by up-regulation of Bcl-2 gene coding protein with antipyretic and purgative herbs Jinhong Tablet.

Acupuncture Therapy ; Deglutition Disorders ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications

Objective: This present study is to establish a rat model of intravenous heroin self-administration and observe the effect of electro-acupuncture on the heroin-seeking behavior of the heroin self-administrating rat. Methods: Six Male Wistar rats were surgically implanted with an intra-jugular intravenous catheters under sodium pentobarbital anesthesia,following a minimum recovery of 7 days, the rats were trained by nose-poke response with one daily 4-hour session for 14 consecutive days to self administer heroin (50 μg /kg / per injection), the session ended after 25 infusions were earned or 4 hours had passed, whichever came first, the reinforcement schedule was fixed ratio 1 (FR1) that the rat received a heroin injection for each nose poke response. And then the rats were given electro-acupuncture treatment daily 30min prior to each session and then were trained with one daily 4-h session for 7 consecutive days. Results: Stable intravenous heroin self-administration behavior of rats was established after 7-8 days' drug training, electro-acupuncture given to the stable heroin self-administrating rat 30 min prior to each session could reduce the drug self-administration behavior, namely the total heroin intake in each session was reduced, especially the 1st hour heroin intake, the initiation of first nose-poke response in each session was relayed, and the haste heroin-seeking behavior also became slower. Conclusions: The above results suggested that the electro-acupuncture had better detoxification effect.

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

Abstract: Objective　To analyze the clinical characteristics of Chlamydia psittaci pneumonia and improve the diagnosis and treatment skills of clinicians on this disease. Methods The clinical data of thirty-nine Chlamydia psittaci pneumonia cases detected by metagenomic next-generation sequencing (mNGS) from September 2020 to January 2022 at the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. Results There was a history of poultry exposure in 89.7%(35 cases) of the patients. The most common clinical manifestations were high fever (92.3%, 36), cough (76.9%,30), muscle soreness (48.7%,19), headache (38.5%,15), etc. Laboratory examinations showed 76.9% of patients had a normal leukocyte count, and 76.9% had decreased lymphocyte count, often accompanied by elevated C-reactive protein (100%), procalcitonin (97.4%), interleukin-6 (95.8%), interleukin-10 (95.8%), alanine aminotransferase (74.4%), and aspartate aminotransferase (84.6%). Univariate analysis indicated that there were statistically significant differences in the levels of aspartate transaminase, blood urea nitrogen, C-reactive protein, and procalcitonin between severe pneumonia patients and non-severe pneumonia patients（P<0.05）. Multivariate logistic regression analysis showed that an elevated blood urea nitrogen (OR=4.899) had guiding significance for predicting the occurrence of severe pneumonia. Bronchoscopy examination showed no abnormalities in 53.6% of the patients. The imaging manifestations of pulmonary lesions were mainly lobar pneumonia (61.5%) and air bronchograms (94.9%). Therapeutically, it was sensitive to tetracyclines, macrocyclic lactones, and fluoroquinolones. A total of 84.6%(33 cases) of the patients were cured and discharged from the hospital at the end of the treatment. Conclusion Chlamydia psittaci pneumonia is a zoonotic disease that can be detected by mNGS. An elevated blood urea nitrogen level has guiding significance for predicting the occurrence of severe pneumonia. Empirically-selected regimens based on doxycycline are effective for the treatment of Chlamydia psittaci pneumonia.