Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods

Objective To explore the early clinical characteristics of multiple system atrophy (MSA) in the elderly,and provide the basis for early diagnosis.Methods Totally 102 cases with probable MSA in elderly patients were retrospectively analyzed to understand the beginning symptom,clinical features and assistant examination results,combined with the literature review.Results Among the 102 cases diagnosed as probable MSA (61 cases were male and 41 cases were female),57cases (55.9％) were diagnosed as parkinsonism dominant MSA (MSA-P) subtype and 45 cases (44.1％) as cerebellar dominant MSA (MSA-C)subtype.In the beginning symptom,27 cases appeared autonomic dysfunction,including 15 cases (26.3％) in MSA P subtype and 12 cases (26.6％) MSA-C subtype; 14 cases manifested as dysuresia,11 cases as orthostatic hypotension,and 8 cases as sexual dysfunction.Parkinsonism as the beginning symptom was in 49 cases,among whom 24 cases were of abnormal gait,3 cases of resting tremor,16 cases of muscle rigidity,and 15 cases of slowed movement.Cerebellar symptoms as the beginning symptom were in 33 cases,with gait and limb ataxia of 27 cases,dysarthria of 6 cases,nystagmus of 2 cases.Pyramidal tract signs as the beginning symptom were in 2 cases.There was early misdiagnosis of 36 cases (35.3％).Conclusions As wide variety of early clinical features,MSA can be easily misdiagnosed.The clinical features and assistant examination should be paid attention to improvement of the accuracy of early diagnosis.

AIM: To investigate the change of estrogen receptor (ER) in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress, and to illuminate the mechanism of dysfunction on ovarian reproductive endocrine function. METHODS: Sound, light and electricity were combined into a psychological stressful stimulus to induce female rat dysfunction on ovarian reproductive endocrine function. Immunohistochemical technique and image analysis were used to assess the expression levels of ER in hippocampus, hypothalamus and pituitary. RESULTS: When exposed to compound stressful stimulus of sound, light and electricity for 20 days in female rats, the expression levels of ER in hippocampus, hypothalamus and pituitary dropped. CONCLUSION: The decrease in estrogen receptor expression in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress may be one of the mechanisms of ovarian reproductive endocrine dysfunction.

Objective To investigate and dispose an outbreak of seasonal influenza in hospital,so as to provide reference for the prevention and control of influenza outbreak in hospital.Methods Eight cases of influenza-like in-fection occurred in the department of neurosurgery at a hospital between July 29 and August 7,2014,epidemiologi-cal investigation was conducted,throat swabs of infected persons were collected for laboratory detection.Results Of 8 infected persons,6 were health care workers (HCWs)in department of neurosurgery,1 was a family member of HCW,and 1 was a patient,the major symptoms of the infected persons were low-grade fever,sore throat,and ma-laise,there were 67 patients and HCWs in this department,the attack rate of influenza was 11.94%,there was no similar infection in other departments of the hospital during the same period.The throat swabs from 6 infected HCWs were positive in influenza virus nucleic acid detection.Office for healthcare-associated infection (HAI)man-agement participated the investigation,after active isolation and antiviral treatment,the outbreak was effectively controlled.Conclusion This HAI outbreak is a seasonal influenza H3 outbreak,ventilation and environmental dis-infection in wards should be strengthened when central air conditioning is running,anti-influenza vaccination among HCWs should be performed during the epidemic season of influenza,and surveillance should be strengthened to pre-vent influenza outbreak in hospital.

More attentions have been paid to the development of evidence-based clinical practice guidelines (ECPGs) of Chinese medicine (CM). International guideline evaluation instruments such as Appraisal of Guidelines for Research and Evaluation (AGREE I) has been gradually applied in ECPGs quality evaluation of CM. Nowadays, there are some certain methodological defects in partial ECPGs of Chinese medicine, with relatively low applicability and slowly update. It is suggested to establish technical specifications of CM-ECPGs in accordance with the characteristics of CM and international general specification, strengthen the quality evaluation of CM-ECPGs, attach great importance to the regularly update as well as popularization and application of CM-ECPGs.
Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Practice Guidelines as Topic

Designer Drugs ; Drug Design ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Tablets

Objective To explore the relation between the infection of Helicobacter pylori (H .pylori)and colorectal tumor.Methods From January 2012 to January 2013,the medical data of 152 patients with colorectal tumor were collected.According to the findings of colonoscopy examination, the patients were divided into the colorectal adenoma group (84 cases)and the colorectal carcinoma group (68 cases).A total of 88 healthy individuals were also enrolled as control.The differences of H .pylori infection were compared among the colorectal adenoma group,the colorectal carcinoma group and the healthy control group.The distribution of H .pylori infection in different age,gender and nation was analyzed in colorectal tumor group.According to the location,maximum diameter,number,type of pedicle and pathological type of adenoma,the colorectal adenoma group was divided into subgroups and the condition of H .pylori infection was compared among the subgroups.Chi-square test was used in the statistical analysis.Results The positive rates of H .pylori infection of colorectal adenoma group, colorectal carcinoma group and healthy control group were 70.2% (59/84),72.1 % (49/68)and 53.4%(47/88),respectively,where the former two groups were both higher than that of the healthy control group,and the differences were statistically significant (χ2 =5 .147 and 5 .637,both P <0.05).Regarding the H .pylori infection,there was no difference in age,gender and ethnicity among 152 patients with colorectal tumor (all P > 0.05 ).Among 84 patients with colorectal adenoma,there was no statistical difference in the positive rate of H .pylori infection in different location,maximum diameter,number, type of pedicle and pathological type of adenoma (all P > 0.05).Conclusion H .pylori may have promoting effects on the genesis and development of colorectal tumor.

BACKGROUND: Most of hematopoietic growth factor regulates proliferation and differentiation of blood cells through JAKs-STATs signal transduction pathway. Total saponins of Panax ginseng (TSPG) can promote in vitro differentiation of CD34+ hematopoietic progenitor cells into erythroid cells, with similar effectiveness of hematopoietic growth factor.Erythropoietin receptor (EpoR) expression on the cell membrane of progenitor cells is critical during the erythroid differentiation process.OBJECTIVE: To investigate the molecular mechanism of TSPG to induce erythroid cells through erythropoiesis and its receptor-mediated JAK2/STAT5 signal transduction.DESIGN, TIME AND SETTING: An in vitro cytological observation. The study was performed at the Department of Histology and Embryology, Institute of Basic Medicine, Chongqing Medical University from May 2006 to October 2008.MATERIALS: Umbilical cord blood of normal full-term pregnancy was provided by the First Hospital of Chongqing Medical University. TSPG, purity＞95%, provided by Chongqing Institute of Traditional Chinese Medicine, was diluted in RPMI-1640 for work concentration of 1 g/L and degermed by positive pressure filtration.in RPMI-1640 culture solution containing horse serum, with various dilutions of TSPG (0 as blank control, 10, 25, 50, 75,100 mg/L). The MNCs were cultured on 96-well culture plate, with 0.2 mL in each well. Early erythroid cells were counted on were harvested and cultured separately in RPMI-1640 culture solution containing 10% horse serum as control group and in TSPG (25 mg/L)- conditioned culture system as experimental group. 5 U/mL Epo was added for 0, 2, 5 and 30 minutes.Immunoprecipitation of JAK2/STAT5 was used for the effect of TSPG on Epo/EpoR-induced tyrosine phosphorylation of JAK2/STAT5.MAIN OUTCOME MEASURES: Effect of TSPG on proliferation of erythroid progenitor cells from human umbilical cord blood;Effect of Epo on the proliferation of hematopoietic cells; Effect of TSPG on EpoR expression of the umbilical blood cells; tyrosine phosphorylations of JAK2 and STAT5.RERULTS: TSPG (10-75 mg/L) promoted the colony formation of BEU-E, CFU-E, and the preferential differentiation into erythroid lineage cells was most induced from 25 mg/L of TSPG. Using the colorimetric MTT assay, MNCs exhibited proliferative responses to Epo (2-50 U/mL) reaching maximum at 5 U/mL Epo. The addition of TSPG did not increase the expression of EpoR after MNCs were incubated in the presence of with or without TSPG for 24 hours. The pretreatment with TSPG for 24 hours enhanced Epo-induced tyrosine phosphorylation of JAK2 and STAT5 (STAT5a and STAT5b).

Objective To understand the existing deficiency in the work of preventing HIV transmission from mother to child.Methods The diagnostic occasions of 179 HIV positive pregnant women(189 pregnant times)in some counties in Hubei,Shanxi,and Hebei were collected,including measures for prevention.The reasons for the missing prevention for HIV positive pregnant women were analyzed.Results The HIV positive rate in pregnant women in the counties enrolled in this study was 0.26‰.Percentage of HIV pregnant women who were found in antepartum,intrapartum,and postpartum were 66.7%,7.4%,and 25.9% respectively.Some HIV positive pregnant women missed the prevention in all of three periods.In HIV positive pregnant women found antepartum,some rejected prevention.The missing reason for HIV positive pregnant women found intrapartum failed to get ARV drug.HIV positive pregnant women found postpartum missed the prevention.Conclusions There is some progress in the work of preventing HIV transmission from mother to child in China,but some HIV positive pregnant women can not be detected in time,and the percentage of HIV pregnant women who have received comprehensive measures is low.The work of PMTCT therefore needs to be improved.

Aim To investigate whether capacitative Ca~(2+) entry involved in excitation-contraction coupling in rat distal colon smooth muscle.Methods Changes of isolated organ's tension were monitored with force-displacement transducer and Powerlab 4/25T recording system.Results Thapsigargin(10 nmol?L~(-1)～1 ?mol?L~(-1))produced slowly developing sustained contractions in isolated distal colon smooth muscle strips of rats.The timed contractile responses to thapsigargin(10 n mol?L~(1)-1 ?mol?L~(-1)) were significantly different.The contractile response to Ca~(2+) reintroduction following incubation of strips in a Ca~(2+)-free Krebs in the presense of thapsigargin was significantly higher than in its absence(99%?28% vs 70%?8%).Contractile responses to Ca~(2+)reintroduction following depletion of sarcoplasmic reticulum Ca~(2+) stores with thapsigargin were attenuated by La~(3+),while unaffected by verapamil.Conclusion Contractile responses to Ca~(2+)reintroduction following depletion of sarcoplasmic reticulum Ca~(2+)stores with thapsigargin,are mediated by capacitative Ca~(2+)entry.The results suggested that CCE provided activator Ca~(2+)for the contraction and participated in excitation-contraction process in rat distal colon smooth muscle.