Communicable Disease Control ; Global Health ; Humans ; Severe Acute Respiratory Syndrome ; prevention & control

ObjectiveTo study the impact of quercetin on LPS-stimulated macrophage inflammatory cytokine release.MethodsDetermined by MTT assay with different concentrations of quercetin on the activity of RAW 264.7 cells.Cells were divided into five groups:A (control group),B group (LPS intervention group),C (LPS+quercetin 50 μmol/L),D group (LPS+quercetin 150 μmol/L) and E group (LPS+quercetin 250 μmol/L).Cells expression of toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (Myd88) and NF-kappa B (p65) mRNA in each group was determined by real-time determination; Supematant IL-6 and TNF-α secretion level was tested by ELISA determination.ResultsThe quercetin at 0 to 250 μmol/L concentration range on the activity of RAW 264.7 cells did not significantly affect.Compared with the control group,quercetin can effectively reduce the level of LPS-induced TLR4 and of MyD88 and of NF-κB (p65) of rmRNA expression and supematant IL-6 and TNF-α secretion,and dose-dependent manner(P＜0.01).ConclusionQuercetin may reduce macrophage inflammatory cytokine secretion by inhibiting the activation of TLR-Myd88-NF-κB pathway.

AIM: To investigate the changes of serum angiogenic factors including vascular endothelial growth factor (VEGF) and basic fibroblast growth factor ( bFGF) in Mongolia patients with diabetic retinopathy ( DR) and to explore their roles in the progress of DR.
METHODS: Eighty - three patients with diabetes were divided into three groups according to the retinopathy, no DR group ( NDR, 25 cases), background DR ( NPDR, 31 cases) and proliferative DR group (PDR, 27 cases), and 36 age - matched healthy people ( control group) were selected. Serum concentrations of VEGF and bFGF were measured using ELISA method.
RESULTS: In Mongolia patients with diabetes, the serum concentrations of VEGF and bFGF were higher than those in control group; the serum concentrations of VEGF and bFGF in PDR group was higher than those of NDR and NPDR group (P< 0. 05); the concentrations of VEGF and bFGF in NPDR group was higher than that of NDR group (P<0. 05).
CONCLUSION: High level of VEGF and bFGF may be the important pathogenic factors for DR in Mongolia patients.

Clinical teaching and studying is suffering increasing hardship.This article analysises the present condition of clinical education problems and causes,and researches whether patients are obliged to coorperate clinical teaching and studying when they protect their rights.It also researches how to practice clinical teaching and studying in educational hospital and looks for effective pathway to go out of the clinical education problem.

Objective To explore predictive value of baseline red cell distribution width (RDW) determined in a routine blood count for severity of chronic heart failure (CHF) and mortality during hospitalization.Methods The study group comprised 135 patients hospitalized in the our hospital with CHF in the Ⅱ ～ Ⅳ class according to New York Heart Association (NYHA).The control group included 44 patients in class Ⅰ.Hematological and biochemical parameters were obtained and compared among groups.Receiver operator characteristic (ROC) curves were used for assessing predictive values.Results RDW increased significantly in class Ⅲ and Ⅳ compared to class Ⅰ [(14.3 ±2.3)％ and (14.3 ± 1.7)％ vs (12.9 ±0.8)％,P ＜0.01].Areas under ROCs (AUCs) of RDW,N-terminal prohormone brain natriuretic peptide (NT-proBNP) for class Ⅳ HF was 0.817 and 0.840,respectively.RDW was significantly elevated in mortality group compared to survival group [(15.8 ± 1.8)％ vs (13.7 ± 1.7) ％,P ＜ 0.01],predictive value of RDW was lower than that of NT-proBNP but was comparable to white blood cell (WBC),neutrophil (NEU),lymphocyte (L),and neutrophil/lymphocyte ratio (N/L) for mortality during hospitalization with AUCs (0.837,0.939,0.858,0.891,0.885,and 0.885,respectively).RDW and NT-proBNP showed low predictive values for repeated admission (≥3).RDW was an independent risk factor for mortality (OR =2.531,95％ CI:1.371 ～4.671).Conclusions RDW increased significantly in class Ⅲ and Ⅳ patients and death group.The predictive value of RDW is comparable to NT-proBNP for class Ⅳ and lower than that of NT-proBNP for mortality.Elevated RDW is an independent risk factor for mortality.

PurposeDiffusion weighted imaging (DWI) can significantly improve the diagnosis of non-enlarged lymph node metastasis. This study aims to evaluate the correlation between the DWI findings and the prognosis, and to identify prognostic factors.Materials and Methods Forty-seven patients with colorectal cancer underwent MRI scan including DWI sequence before surgery. Imaging ifndings were compared with the pathologic results to determine the metastatic lymph nodes (DWI positive) or non-metastatic lymph nodes (DWI negative). Postoperative disease-free survival and overall survival for 5 years of the patients with DWI positive and DWI negative lymph nodes were compared. Correlation between the prognosis and the related factors were investigated including regional DWI-positive lymph nodes, short axis diameter and long axis diameter of the largest DWI-positive lymph node, and number of DWI-positive nodes.Results Of 47 patients,10 (21%) patients had regional DWI-positive lymph nodes showed high signal intensity on diffusion-weighted images. The patients with regional DWI negative lymph nodes had a signiifcant better ifve-year disease-free survival and overall survival (P<0.05). The short axis diameter of the largest DWI-positive lymph node was correlated with distant metastasis (AUC=0.77,P<0.05). The short axis diameter and long axis diameter of the maximum metastatic lymph nodes were correlated with overall survival (AUC=0.84 and 0.75,P<0.05). Five-year disease-free survival and overall survival of the patients with short axis diameter of the largest DWI-positive lymph node ≤9 mm were higher than the patients with lymph node short axis diameter >9 mm (P<0.05). Five-year disease-free survival and overall survival of the patients with long axis diameter of the largest DWI-positive lymph nodes ≤11 mm were higher than the patients with long axis diameter >11 mm (P<0.05). Five-year disease-free survival of the patients with all DWI positive lymph nodes resected was higher than the patient without DWI-positive lymph nodes resected (P<0.05).Conclusion The patients with regional DWI-negative lymph node had a better prognosis. Of the patients with DWI-positive lymph nodes, the patients with smaller lymph nodes have better prognosis than who have larger lymph nodes.

Toll-like receptor 4 (TLR4), the natural receptor of lipopolysaccharide(LPS), plays an important role in the regulation of acute inflammation, intracellular signal transduction and cell apoptosis. TLR4 over expresses in both acute inflammation and fibrotic tissues, which suggests that TLR4 may be essential in acute inflammation and subsequent fibrosis. Nowadays, some progress has been made in the exploration of TLR4 in pathogenesis and treatment of liver cirrhosis and pulmonary fibrosis. TLR4 may become a new target in the treatment of human fibrotic diseases including liver cirrhosis and pulmonary fibrosis. The research status of TLR4 in human fibrotic diseases and its future development are reviewed in this paper.

Public cardiopulmonary resuscitation(CPR)is an important strategy and method to deal with sudden cardiac death outside hospital by relying on the wisdom and strength of the whole society in China. The article summarizes the definition of public CPR, the subject of implementation, the core of construction and the implementation steps. With the support and guidance of the government, the public should join together,with the construction of the first responder, automatic external defibrillator and comprehensive prevention and control system as the core, and promote the implementation of training,practice and scientific research to achieve the ultimate goal.

Objective To discuss and to compare the curative effects of interventional embolization with different embolic agents in treating giant hepatic cavernous hemangiomas. Methods From 2008 to 2010, a total of 30 cases with clinically proved hepatic cavernous hemangioma were treated with interventional embolization. According to the embolic agents used , the patients were divided into pingyangmycin-lipiodol emulsion mixed with sodium alginate microspheres group(PLE+KMG, group A, n=15) and pingyangmycin-lipiodol emulsion group (PLE, group B, n=15). CT scanning was performed one, 3, 6, 12 months after the treatment to evaluate the curative effect. Results The technical success rate was 100%in both groups. The mean PLE dose used in group A and B was (10.9 ± 5.2) ml and (11.4 ± 4.9) ml respectively, the difference between the two groups was not significant (P > 0.05). CT reexamination performed one, 3, 6 months after the treatment showed that a reduction in tumor volume over 50%in group A was seen in 9, 11 and 14 cases respectively, while in group B it was 0, 3 and 5 cases respectively (P <0.05). One week after the procedure, the degree of pain in patients of group A was more severe than that in patients of group B, the difference between the two groups was statistically significant (P < 0.05). Slight abnormal hepatic function was seen in some patients of both groups, which presented mainly as an elevation of aminotransferase, which returned to normal after symptomatic medication. Follow-up with questionnaire indicted that patients of group A were more satisfied with the treatment than the patients of group B. Conclusion Transhepatic infusion of pingyangmycin-lipiodol emulsion is a safe and effective treatment for giant cavernous hemangioma of the liver. Combination use of pingyangmycin-lipiodol emulsion and sodium alginate microspheres can obviously reduce the tumor size mainly in the first and the third month after the treatment, besides it produces instant clinical effect although the pain is more severe than in patients treated with pure pingyangmycin-lipiodol emulsion.

Objective To investigate the situation of the activities of daily living(ADL)for elderly people in Changsha,and analyze the influencing factors. Methods Questionnaire survey on ADL was held in 2239 elderly people(ranging from 60 to 91 years old),and the influencing factors including age,sex,family structure,marital status,education level,occupation,common chronic diseases and medical care consciousness were analyzed. Results Going to the toilet irregularly hadthe highest injury rate in physical self-maintenance viability(18.2%).But in instrumental ADL,the highest injury rate occurred while shopping(26.3%).Advanced age,living alone,losing spouse,sickness and the lack of medical care awareness were the major factors that influenced the ADL of the elderly people. Conclusions The ADL is an important indicator which reflects the health condition of elderly people.Advanced age,living alone,losing spouse,having many chronic diseases and lacking in medical care awareness are risk factors.