Objective To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE ). Methods Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. Results All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. Conclusion Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.

ObjectiveTo investigate the mechanism of protective effect of Xuebijing injection on vascular endothelial cells in rats with heat stress.Methods Ninety Sprague-Dawley(SD) rats were randomly divided into control, model and Xuebijing injection treatment groups, 30 rats in each group. Heat stress model was reproduced by placing rats in constant temperature box at 40℃, 60% relative humidity for 1 hour, Xuebijing injection group was treated by intraperitoneal injection of Xuebijing 2.5 g/kg, while the control and model groups were treated by intraperitoneal injection of normal saline 2 mL/kg, once a day only in 1 day for both groups. After model establishment, the rectum temperature, heart rate and the mean arterial pressure(MAP) were recorded at 2, 6, 12 hours in each group. At the same time, the rat abdominal aortic blood was collected and serum was separated, the enzyme-linked immunosorbent assay(ELISA) was used to determine the aortic serum levels of lipopolysaccharide(LPS), nuclear factor-κB(NF-κB) and p53, and the prothrombin time(PT), activated partial thromboplastin time(APTT) and D-dimer of venous blood were detected by automatic blood coagulation analyzer(ACLTOP).Results Compared with those in control group, the rectum temperature, heart rate, LPS, NF-κB, p53, PT, APTT, D-dimer were significantly increased, and MAP was obviously decreased in model group(P<0.05 orP<0.01). Compared with model group, the above indexes were improved significantly in Xuebijing injection treatment group at 2 hours〔rectum temperature(℃): 38.02±0.22 vs. 39.32±0.33, heart rate(bpm): 507±14 vs. 562±35, MAP(mmHg, 1 mmHg=0.133 kPa): 98±6 vs. 87±13, LPS(ng/L): 0.65±0.03 vs. 0.82±0.05, NF-κB(ng/L): 1.10±0.04 vs. 1.33±0.05, p53(ng/L): 1.33±0.03 vs. 1.73±0.02, PT(s):15.47±1.03 vs. 20.28±2.01, APTT(s): 40.26±2.46 vs. 47.46±3.51, D-dimer(μg/L): 238.54±8.32 vs. 323.12±8.14,P<0.05 orP<0.01〕.Conclusion Xuebijing injection can correct the disorders of blood PT, APTT, D-dimer via decreasing the secretion of the levels of NF-κB, p53 from vascular endothelial cells in rats with heat stress, thus the integrity of the vascular endothelium can be protected, and LPS entering into the blood stream can be inhibited.

Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Phytotherapy ; Radiation Pneumonitis ; drug therapy

Adolescent ; Child ; Humans ; Male ; Neuroectodermal Tumors, Primitive, Peripheral ; pathology ; Sarcoma, Ewing ; pathology

Objective To explore the effectiveness of ω-3 fatty acids in intervening rat models of chronic obstructive pulmonery disease (COPD).Methods The rat COPD models were established by cigarette smoking and intratracheal lipopolysaccharide instillation.Totally 90 rats were randomly divided into 3 groups:normal control group (treated with normal saline),COPD group,and intervention group (the COPD rat models treated with ω-3 fatty acids).Lung tissues were obtained on the 7th,21st,and 28th day.The left lower lobes were analyzed to determine the expressions of nuclear factor-kappa beta (NF-κB) and interferon-γ (IFN-γ)and the right lung lobes were sliced for detecting the cell apoptosis.Double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) was used to detect the serum IFN-γ and interleukin-6 (IL-6).Results (1) The pathological changes of lung tissue:there were a large number of inflammatory exudation,alveolar wall thickening,hyperplasia of vascular smooth muscle and the alveolar structure destruction in the COPD model group,but the lung tissue were part of alveolar cavity and a little inflammatory exudate in ω-3 fatty fish acids treatment group,control rats were almost no alveolar inflammation on the 28th days.(2) On the 28th day,NF-κB protein expression of the lung tissue (18.91 ± 3.07) in rats of COPD model group was significantly higher than the control group and the intervention group (5.47 ±4.86 and 7.23 ±2.21) (P ＜0.01).On the 28th day,IFN-γ protein expression in lung tissue of the rats in the model group was 7.12 ±3.37,significantly lower than the intervention group (18.74 ± 2.65),the difference was statistically significant (P ＜ 0.01).(3) The IL-6 levels of the blood-serum of model group rats were (13.43 ± 2.47) ng/L,significantly higher than the control group and the intervention group [(4.78 ± 1.93) and (4.98 ± 1.89) ng/L],the differences were statistically significant (P ＜ 0.01) on the 28th day,,but the IFN-γ level [(2.23 ± 0.63) ng/L] in COPD group was more poorer than ω-3 fatty acids group and the intervention group [(4.51 ± 0.71) and (7.05 ± 0.52) ng/L] (P ＜ 0.01).Conclusions The ω-3 fatty acids can lower NF-κB protein expressions in lung tissues and serum and IL-6 levels in COPD rats; aslo,it can increase the IFN-γ protein expression in lung tissue and serum.Thus,it can prevent the lung inflammation in COPD rats.

The Australian emergency medical system has transformed over the last thirty years with the development of pre-hospital care services, hospital Emergency Departments and the development of new professional roles of Emergen-cy Physician and Paramedic. This transformation which has reflected those in many other countries has occurredbecause of increasing accountability by health services for the quality of emergency health care and increased pro-fessional commitment.

BACKGROUND: This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China. METHODS: An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals. RESULTS: There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4％ of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7％ were treated for poisoning; 3) 1.4％ for cerebral vascular disease; 4) 1.7％ for cardiac disease; and 5) 42.6％ for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5％ of all ED presentations. Among ED patients in China, 6.7％ arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7％ were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9％ for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7％ for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3％ for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population. CONCLUSIONS: Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.

BACKGROUND: Immigrants with language barriers are at high risk of having poor access to health care services. However, several studies have indicated that immigrants tend to use emergency departments (EDs) as their primary source of care at the expense of primary care. This may place an additional burden on already overcrowded EDs and lead to a low level of patient satisfaction with ED care. The study was to review if immigrants utilize ED care differently from host populations and to assess immigrants' satisfaction with ED care. DATA SOURCES: Studies about immigrants' utilization of EDs in Australia and worldwide were reviewed. RESULTS: There are conflicting results in the literature about the pattern of ED care use among immigrants. Some studies have shown higher utilization by immigrants compared to host populations and others have shown lower utilization. Overall, immigrants use ED care heavily, make inappropriate visits to EDs, have a longer length of stay in EDs, and are less satisfied with ED care as compared to host populations. CONCLUSIONS: Immigrants might use ED care differently from host populations due to language and cultural barriers. There is sparse Australian literature regarding immigrants' access to health care including ED care. To ensure equity, further research is needed to inform policy when planning health care provision to immigrants.

BACKGROUND: Despite the fact that traditional Chinese medicine (TCM) has been developed and used to treat acute and urgent illness for many thousands of years. TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases. The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential. METHODS: Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) were searched using the terms: Traditional Chinese Medicine/ Chinese Medicine, Emergency Medicine, China. In addition, three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles (published from 1990—2012). Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care. RESULTS: TCM is a systematic traditional macro medicine. The clinical practice of TCM is guided by the TCM theoretical framework – a methodology founded thousands of years ago. As the methodologies between TCM and Biomedicine are significantly different, it provides an opportunity to combine two medicines, in order to achieve clinical efficacy. Nowadays, combined medicine has become a common clinical model particular in TCM hospitals in China. CONCLUSIONS: It is evident that TCM can provide some assistance in emergency although to combine them in practice is still its infant form and is mainly at TCM hospitals in China. The future effort could be put into TCM research, both in laboratories and clinics, with high quality designs, so that TCM could be better understood and then applied in emergency medicine.

OBJECTIVETo observe the absorption and concentration of berberine hydrochloride (BH) in gastric, entric, colonic tissue after intragastric administration of BH-containing carboxymethyl konjac glucomannan pellets for evaluating colon-specific drug delivery characteristics of the pellets.

METHODBH-containing carboxymethyl konjac glucomannan pellets (pellets group) and BH-containing carboxymethyl cellulose suspension (control group) were intragastric administrated to rats at the dose of 50 mg x kg(-1), respectively. A high performance liquid chromatography method determinated BH concentration in rat plasma and tissue. Drug delivery index (DDI) was calculated.

RESULTThe range of BH in plasma and tissue in rats were 0.025 2-2.52 mg x L(-1) (r = 0.999 2) and 0.126-25.22 mg x L(-1) (R > 0.99),respectively. The detection of BH in plasma and tissue were 10 microg x L(-1) and 8 microg x L(-1), respectively. The area under the curve (AUC(0 --> infinity)) in the plasma samples of pellets group was 0.477 times that of the control group; in the gastric, entric, colonic tissue, the AUC(0 --> infinity) of pellets group was as much as 0.187, 0.228, 2.00 times that of the control group, respectively. The DDI of the pellets was 0.392 4, 0.478 6, 4.193 in the gastric, entric, colonic tissue of the rat, respectively.

CONCLUSIONCarboxymethyl konjac glucomannan pellets may be a useful carrier of BH for colon-specific delivery.

Absorption ; Animals ; Berberine ; metabolism ; Calibration ; Chromatography, High Pressure Liquid ; Drug Implants ; Female ; Intestines ; metabolism ; Male ; Mannans ; administration & dosage ; pharmacokinetics ; Organ Specificity ; Rats ; Sensitivity and Specificity