ADAM Proteins ; blood ; ADAMTS13 Protein ; Adult ; Case-Control Studies ; Female ; Fluorescence Resonance Energy Transfer ; Humans ; Male ; Middle Aged ; Purpura, Thrombotic Thrombocytopenic ; blood ; diagnosis ; Young Adult

The Hazardous effect of Hippophae Rhamnoides L. juice was studied biologically. The results showed that the Hippophae rhamnoides L. juice has no teratogenic and mutagenic effect on the rat and mice germ cells.

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Objective With awareness, attitudes, and rice-intake behavior of Kaschin-Beck disease (KBD) and the analysis of the factors that influence KBD related rice-intake behaviors among resident's in Aba,this research could provide evidences for KBD-Control, and benefit the policy development related to KBD-Control.Methods Villages were chosen by proportional stratified random sampling from KBD monitoring villages among agriculture areas, pastoral areas, and farming & pastoral areas in Aba, Sichuan, in July 2009. Interview questionnaire of household survey, designed by research associates of this project, was used in this research for residents in endemic area of KBD in Aba. The questionnaire covered demographic and socio-economic characteristics, KBD knowledge and diet habits. Multi-level Variance Component Analysis was used to explore factors which would influence the KBD related rice-intake behaviors. Results A total of 1029 permanent residents were recruited in this research, among which the detection rate of KBD was 48.01％ (482/1004). Most of the patients lived in farming & pastoral areas(84.44％, 407/482). Pastoral residents had the least knowledge of KashinBeck disease, and the composition ratios ofGeneral andGood were 15.87％ (33/208)and 3.36％ (7/208),respectively. Still, people who were willing to have rice as staple food were 93.13％(935/1004). It indicated that only (50.40 ± 23.68)％ on average, of research subjects had the life style of rice intake. Ethnic, work status,language situation and attitudes to rice intake were influencing factors for rice-intake behavior. Conclusions The percentage of rice intake in Aba KBD epidemic areas is low. And to prevent KBD, the advocacy actions should be targeted at ethnic, work status, language situation, and attitudes to rice intake.

Abstract： Objective　To investigate and analyze the factors influencing the direct medical costs of tuberculosis patients in Hainan Province, so as to provide scientific reference for reducing the medical burden of patients and adjusting the medical insurance reimbursement policies in the local area. Methods　Using the total health expenditure accounting data of Hainan Province in 2020, including the outpatient and inpatient data of 14 provincial medical institutions, 235 city and county level medical institutions, and other relevant data from the 2020 Hainan Statistical Yearbook and Health Financial Yearbook, the direct medical costs of tuberculosis patients in the province in that year were calculated, and the influencing factors were explored using single factor analysis and multivariate generalized linear model. Results　The final number of cases included in this study was 11 979, including 7 526 males (62.83%) and 4 453 females (37.17%). The total direct medical costs of patients were 43.207 3 million yuan, of which the total outpatient costs were 2.733 9 million yuan (6.32%) and the total inpatient costs were 40.473 4 million yuan (93.67%). In the cost composition analysis, the drug cost was 17.971 million yuan (41.44%), the examination cost was 8.854 7 million yuan (20.49%), other costs were 16.445 5 million yuan (38.06%), and the median (quartile) M(P25,P75) direct medical cost of each patient was 177.50 (66.73,764.89) yuan. The multivariate generalized linear model analysis showed that hospitalization, new rural cooperative medical insurance (NRCMI) and urban employee medical insurance were the influencing factors of the increase in direct medical costs of tuberculosis patients the median (quartile) M(P25,P75) of direct medical costs are 10 425.04 (6 560.87,17 374.9), 10 246.5 (5 871.28,17 220.33), 3 177.2 (293.09,7 730.23) yuan respectively; the OR(95%CI) values were -3.505 (-3.499- -3.517), 1.559 (1.551-1.569) and 2.191 (2.188-2.207) respectively. Conclusions　The direct medical costs of tuberculosis patients in Hainan Province are high. Hospitalization, the new rural cooperative medical insurance and the medical insurance for urban workers are the influencing factors of the increase in costs.

On May 12,2008,a disastrous earthquake scaled 8.0 Richter hit Wenchuan,Sichuan province in China.Treating the acute kidney injury caused by crush syndrome in survivals of the earthquake has been a big challenge to the nephrologists.In this paper,we shared our experiences on the multi-disciplinary collaboration in management of acute kidney injury caused by crush syndrome.In addition to surgical therapy for crush injury and compartment syndrome and the renal replacement therapy for acute renal injury and its related complications,the early multi-disciplinary collaboration including rehabilitation,mental health care,infection control and ICU also contributed greatly to the successful treatment of the victims of the earthquake.

Objective To explore the effects of intra-jugular vein dual lumen catheter lock heparin in different concentrations on the coagulation function,hemorrhagic tendency and catheter thrombosis risk in hemodialysis patients,and to investigate the reasonable lock heparin cuncentration. Method Ninety end stage renal disease (ESRD)patients receiving regular hemodialysis were enrolled and randomly assigned into 3 groups(n=30):Group A(pure heparin lock solution,6250 U/m1),GrouP B(medium heparin lock solution,1040 U/ml)and Group C(low hepafin lock solution,625 U/ml).The coagulation indexes were determined in short term.Complications such as bleeding,thrombosis,infection and thrombocytopenia were monitored.Results Prothrombin time(PT),actiwtted partial thromboplastin time(APTT)and thrombin time (TT)were significantly prolonged in Group A(P＜0.01);only APTT was signifieanlly prolonged in Group B:however,no significant changes were observed in Group C.Hemorrhage risk was much higher in Group A than that in Group B and C (26.7%vs 10%and 0.P＜0.05).Catheter thrombosis incidence was significantly higher in Group C than that in Group A and B(23.3%vs 0and 10%,P＜0.05).Only 1 suspected catheter related infection was found in Group C,and 2cases of moderated thrombocytopenia in Group A. Concltrsion Moderate concentration of lock heparin solution has the best balance of hemorrhagic and thrombotic risk,and should be recommended to most of regular hemodialysis patients.

Chronic viral hepatitis B (CHB) is a major infectious disease greatly harmful to the health of Chinese people. Chinese medicine has its speciality and advantages in treating it depending syndrome-differentiation. The objectified researches regarding Chinese medical syndromes in CHB heretofore were reviewed in this article. Moreover, aiming at existing problems and taking the angle of "disease-syndrome combining" study, authors put forward research approach, and approaches for studying systemic biology based biological basis of Chinese medical syndrome in hepatitis B with reductionism and holism, cybernetics and system theories in combination.
Hepatitis B, Chronic ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

Objective To study whether the organs besides digestive system of musca domestica Ⅲ instar larvae have the capability of produceing musca β-glucosidase.Methods Tissues of malpighian tubules,trachea,epiploon and body wall of musca domestica Ⅲ instar lar-vae were dissected under anatomic microscope,and the expression of β-glucosidase gene in these dissected tissues were detected by reverse transcription PCR.And the tissue localization of β-glucosidase mRNA was further identified by in situ hybridization.Moreover,anti-cellulase was used to determinate the tissue distribution with immunohistochemical staining.The relative mRNA expression levels of musca domesticaβ-glucosidase gene in these organs were tested by real-time quantitative PCR.Results The reverse transcription PCR showed that the ampli-fication products of β-glucosidase gene were observed in tissues of malpighian tubules,trachea and body wall.β-glucosidase mRNA was shown in the epithelium cells of malpighian tubules,trachea and body wall by in situ hybridization,and it was almost the same in the results of im-munohistochemical staining.The real-time quantitative PCR showed that the relative expression quantity of β-glucosidase gene in malpighian tubules and body wall were higher than that in foregut,while it was lower in itrachea than that in foregut.And it was of statistical difference in gene expression level of β-glucosidase among these organs (P <0.05).Conclusion Malpighian tubules,trachea and body wall of musca domestica Ⅲ instar larvae have the function of secreting β-glucosidase.Combining with the characteristics of secreting β-glucosidase in most organs of digestive system,it may provide a new biological method for the prevention and treatment of human diseases transmitted by musca domestica with the use of taget gene β-glucosidase.

This study was aimed to explore clinical effect on treatment of rheumatoid arthritis (RA) of cold-dampness syndrome by the combination of Wen-Jing San-Han Tong-Luo (WJSHTL) decoction and acupuncture. A total of 88 RA patients were selected and randomly divided into the control group and the treatment group. All 44 cases in the control group were orally administrated with diclofenac sodium, sulphasalazine (SASP) and methotrexate (MTX). All 44 cases in the treatment group were treated with the combination of WJSHTL decoction and acupuncture on the ba-sis of western medication the same as the control group. Each group was treated for three months. Improvements of clinical symptoms, body signs and laboratory indexes were observed. The results showed that clinical symptoms, body signs and laboratory indexes were greatly improved in the comparison before and after treatment in both groups with statistical significance (P < 0.05). Compared to the control group, the treatment group had no statistical significance in the improvement of rest pain, swelling numbers and index, tenderness numbers and index, morning stiffness time, liver and kidney function. Compared with the control group, the treatment group had more obvious advantages in the improvement of joint function, hand grip strength, erythrocyte sedimentation rate (ESR) decreasing, C-reactive protein (CRP) and rheumatoid factor (P< 0.05). It was concluded that compared with single western medication, the combi-nation of WJSHTL decoction and acupuncture with western medication had certain advantages in the improvement of joint function of RA and management of patient's disease condition.