Objective To analyze the association of the morbidity,the management of blood glucose,and the prognosis of patients with hyperglycemia in the medical intensive care units(ICU).Methods Medical records of ICU patients of Renji Hospital from 2002 to 2009 were reviewed using Medical Record Inquiry System,and the data were retrospectively analyzed.Results(1)2631 subjects were included in the present study,blood glucose was determined at least once during hospitalization in 2168 of them.The incidence of hyperglycemia was 26.3%,in which 12.9% presented a known history of diabetes and 13.4% without.In the patients with diabetes history,93.2% of them received anti-diabetic treatment during hospitalization.mainly with oral anti-hyperglyeemic agents (53.0%)or subcutaneous insulin injection(24.9%).However,in the patients without diabetes history,84.4% were not treated against hyperglycemia.The mortality was increased in the latter group(30.4% vs13.9%,P<0.01).(2)In the patients with diabetes history,the mortality in patients whose blood glucose>10 mmol/L was higher than those with blood glucose≤7.0 mmol/L(20.5% vs 9.9%,P<0.05):while in the patients without diabetes history,the mortality began to rise as blood glucose>7.0 mmol/L(P<0.01).(3)Multiple stepwise regression analysis revealed that the average blood glucose level was an independent risk factor for death(OR=1.26).Conclusions The ICU patients showed a high prevalence of hyperglycemia,the management of hyperglycemia should be emphasized.Hyperglycemia in critically ill patients might be an independent risk factor of increased mortality.

BACKGROUND:Mongolian Pharmaceutical Betel Shisanwei Ingredients Pil has achieved good clinical efficacy, but the underlying mechanism remains unclear. OBJECTIVE: To study the effects of Mongolian Pharmaceutical Betel Shisanwei Ingredients Pil on the hypothalamic-pituitary-adrenal axis negative feedback function in the chronic depressed rats, and to explore anti-depression mechanisms of Mongolian Pharmaceutical Betel Shisanwei ingredients pil. METHODS: Eighty male Wistar rats were randomly divided into ten groups according to the sugar consumption test (with eight rats in each group): normal control group, model group, fluoxetine group, high-, medium- and low-dose Betel Shisanwei Ingredients Pil groups, RU486 group, high-, medium- and low-dose Betel Shisanwei Ingredients Pil plus RU486 groups. Except normal control group, the other groups were treated with the chronic unpredictable mild stress stimulation combined with lonely rising, to establish depression models. In the meantime, rats of the high-, medium- and low-dose Betel Shisanwei Ingredients Pil groups were given oral gavage of Betel Shisanwei Ingredients Pil (0.2, 0.4, 0.8 g/kg) for 28 days; rats of the normal control group and model group were intragstricaly administered with sodium carboxymethyl celulose; rats of RU486 group were given abdominal subcutaneous injection of RU486 from day 21 after modeling; rats of the high-, medium- and low-dose Betel Shisanwei Ingredients Pil plus RU486 groups were intragstricaly administered with Betel Shisanwei Ingredients Pil (0.2, 0.4, 0.8 g/kg) and subcutaneous injection of RU486 from day 21. RESULTS AND CONCLUSION:Compared with normal control group, cortisone content increased significantly (P < 0.05), the expression of glucocorticoid receptor mRNA in hippocampus, hypothalamus and pituitary gland decreased significantly, and hypothalamic corticotrophin releasing hormone mRNA expression increased significantly in the model group and RU486 group. Compared with model group, cortisone content decreased, the expression of glucocorticoid receptor mRNA in hippocampus, hypothalamus and pituitary gland increased significantly, and hypothalamic corticotrophin releasing hormone mRNA expression decreased significantly in rats treated with Betel Shisanwei Ingredients Pil. Compared with RU486 group, Betel Shisanwei Ingredients Pil administration led to changed in cortisone content, glucocorticoid receptor mRNA expression in hippocampus, hypothalamus and pituitary gland, as wel as hypothalamic corticotrophin releasing hormone mRNA expression. Experimental findings indicate that, Betel Shisanwei Ingredients Pil can directly regulate excessive secretion of glucocorticoid, and improve the dysfunction of hypothalamic-pituitary-adrenal axis central negative feedback through increasing glucocorticoid receptor mRNA expression and decreasing corticotropin releasing hormone mRNA expression. After the hypothalamic-pituitary-adrenal axis negative feedback pathway is blocked, the effect of Betel Shisanwei Ingredients Pil is weakened.

Betel Shi-San-Wei Ingredients Pill(BSSWIP) was first recorded in the 19th century writings Meng-Yi Jin-Gui with the name of Gao-Y ou-13. The name of BSSWIP was first recorded in the book of the 1977 edition of the Drug Standard of the Jilin Province, which was formerly known as Tai De Hu Ran Gu Lu Ge Qi Nai Ran Ta, Se Me Ji De Ji De, and etc. Although in the book of Tong-Wa-Ga-Ji-De, Se Me Ji De Ji De was documented, it was the same name of different compositions. It had no original relation with BSSWIP. In different periods, the BSSWIP was consisted of 13, 14 or 15 kinds of herbs. There were at least five different types of herbs appeared in the Gao-Y ou-13. The evolution of prescription was mainly from the 19th century to the first half of the 20th century. There was no major change on prescription composition and proportion since 1971. Among them, 10 kinds of herbs, which were Bing-Lang, Guang-Zao, Mu-Xiang, Ding-Xiang, Rou-Dou-Kou, Zi-Nao-Sha, Gan-Jiang, Bi-Ba, Hu-Jiao, and Chen-Xiang were fixed. The ratio of single herbal medicine changed the most was Zhi-Cao-W u, which was followed by Mu-Xiang, Ding-Xiang and Chen-Xiang. There were no marked sources of BSSWIP in the recording of the Drug Standard of the Jilin Province and the Mongolian Medicine V olume·Ministry of Health of the People's Republic of China. The composition and proportion were considered to be from the book Meng-Y i Jin-Gui according to notes of Standards on Mongolian Patent Medicine in Inner Mongolia. Recordings of three standards are in consistence with the Meng-Y i Jin-Gui on Gao-Y ou-13 except for Y e-Mao-Niu Xin and the different ratio of Zhi-Cao-W u. In the appendix of the Standards on Mongolian Patent Medicine in Inner Mongolia, it marked the differences from the original prescription. Therefore, the other two criteria should also mark the similarities and differences compared with the original prescription properly.

Objective:To explore the effect of prostaglandin E2 (PGE2) on the expression of high mobility group box-1 protein (HMGB1) in peritoneal macrophages of septic mice and its possible mechanisms.Methods:Ihe mouse peritoneal macrophages were isolated and cultured by conventional methods.The model of inflammation was established by using lipopolysaccharide (LPS) to incubate with mouse peritoneal macrophages.The PGE2,prostaglandin E receptor (EP) 4 agonist,EP4 RNAi,and DN.CREB inhibitory plasmid were used to interfere with the LPS-treated mouse peritoneal macrophage.The levels of HMGB 1 was determined by Western blot.Results:Compared with LPS alone treatment,the expression of HMGB 1 in peritoneal macrophages was increased obviously after 24 h by treatment with PGE2 and LPS,and it was also increased after the combined treatment of EP4 receptor agonist with LPS for 24 h (both P<0.05);compared with the PGE2+LPS treatment,the level of HMGB1 was decreased after knockdown of EP4 receptor expression (P<0.05);compared with EP4 receptor agonist +LPS treatment,there was no difference in HMGB1 levels in mice after the treatment with DN.CREB plasmid to suppress CREB function (P>0.05);compared with LPS alone treatment,the combined treatment of EP4 receptor agonist with LPS for 24 h could up-regulate the phosphorylation of epidermal growth factor receptor (EGFR) and protein kinase B (Akt) thr308 (P<0.05),which were blocked by EGFR inhibitor.Once Akt specific inhibitor was used before EP4 and LPS treatment,the expression of HMGB1 was declined (P<0.05).Conclusion:PGE2 can up-regulate the expression of HMGB1 in sepsis of peritoneal macrophages through EP4 receptor,which may be related to the activation of EGFR/PI3K/Akt signaling pathway.

Objective To evaluate the efficacy of Lianhua Dingchuan Tablets in bronchial asthma.Methods Fifty BALB/C mice were randomly and equally divided into control (Con) group,ovalbumin (OVA) group,dexamethasone (DEX) group,high-dose Lianhua group,low-dose Lianhua group.The mice were sensitized and challenged with OVA plus aluminium hydroxide to establish asthmatic model and were pre-treated 30 minutes before challenge.Specific airway resistance (sRaw) was used to evaluate airway hyperresponsiveness,and airway inflammatory changes were measured.ELISA and Magnetic Luminex(R) were used to quantified the levels of IL-4,IL-13 and INF-γ.Results Airway resistance significantly decreased in DEX group and High-dose Lianhua group (P＜0.05).Levels of inflammatory cells and IL-13 in BALF evidently reduced in DEX group,high-dose Lianhua group and low-dose Lianhua group (P ＜ 0.05),while IL-13 level in serum only decreased in DEX group.There was no significant changes in the levels of IL 4 and INF γ among those groups.Conclusions Lianhua Dingchuan Tablets might relieve the symptoms of asthma by reducing IL-13 level and inhibiting the airway inflammation.

OBJECTIVETo observe the effects of Mongolian pharmaceutical Betel shisanwei ingredients pill on AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depressive rats.

METHODSixty male Wistar rats were randomly divided into six groups according to the sugar consumption test (10 rats in each group), normal control group,model group,fluoxetine group (3.3 mg x kg(-1)) and low dose, medium dose and high dose group (0.25, 0.5, 1 g x kg(-1)) of Betel shisanwei ingredients pill. Except the normal control,the other groups were treated with the chronic unpredictable mild stress stimulation combined with lonely raising for 28 days. 10 mL x kg(-1) of drugs were given to each rat once daily,continuously for 28 days. The AC activity of the hippocampus and prefrontal cortex were determined by radiation immunity analysis (RIA), while cAMP and PKA quantity were determinated by Enzyme-linked immunosorbent (ELISA).

RESULTThe AC activity, cAMP and PKA quantity of hippocampus and prefrontal of mouse model of Chronic stress depression decreased significantly than those of control group (P < 0.05 or P < 0.01). However, the AC activity, cAMP and PKA quantity of rat hippocampus and prefrontal cortex in the fluoxetine group and the Mongolian pharmaceutical Betel shisanwei ingredients pill group indecreased significantly than those of model group (P < 0.01 or P < 0.05). Especially for the high dose group of Mongolian pharmaceutical Betel shisanwei ingredients pill.

CONCLUSIONThe AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depression model of rats is down-regulated, whereas Mongolian pharmaceutical Betel shisanwei ingredients pill could up-regulated it to resist depression.

Adenylyl Cyclases ; genetics ; metabolism ; Animals ; Cyclic AMP ; metabolism ; Cyclic AMP-Dependent Protein Kinases ; genetics ; metabolism ; Depression ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Hippocampus ; drug effects ; metabolism ; Humans ; Male ; Mice ; Prefrontal Cortex ; drug effects ; metabolism ; Rats ; Rats, Wistar ; Signal Transduction ; drug effects

OBJECTIVETo analyze the stress distribution on cast retentive clasp arms in dislodging denture, and to discuss the deepest undercuts of the second mandibular premolar (abutment) for cobalt-chromium alloy cast clasps with different widths.

METHODSThree-dimensional finite element models of the abutment with different depths of undercuts and retentive arms with different widths were set up. Dynamic displacement load (3 mm/s) was exerted on the middle of the retentive arms to analyze the stress in retentive arms while they were being removed from the abutment.

RESULTSThe peak stress in retentive arms was positively correlated to the undercuts displaced by clasp tips, and those were not obviously related to the undercuts displaced by the middle of retentive arms. When width/thickness of retentive arms was 3, the increase of peak stress of retentive arms with similar locations of clasp tips was significantly related to the increase of the arm width. The deepest undercuts of the second mandibular premolar for cobalt-chromium alloy cast retentive arms with different widths of 1.8 mm, 1.6 mm, and 1.4 mm were 0.25 mm, 0.30 mm, and 0.35 mm respectively.

CONCLUSIONSWhen width/thickness of the retentive clasp arm is fixed, the wider the arm is, the smaller depth it should be placed on the undercut of abutment. Retentive clasp arms with different widths should be placed on different depths of undercuts in order to prevent their permanent deformation.

Chromium Alloys ; Dental Casting Technique ; Dental Clasps ; Dental Prosthesis Design ; Dental Stress Analysis ; Denture Retention ; Finite Element Analysis ; Humans

OBJECTIVETo observe the effect of different needling manipulation in improvement of swallow-period obstacle of dysphagia after stroke.

METHODSOne hundred and eleven cases were randomly divided into a single Lianquan RN 23 shallow needling group (group A ), single Lianquan (RN 23) deep needling group (group A2) and Lianquan (RN 23) and para-Lianquan deep multi-needling group (group B). The therapeutic effect was investigated after continuous treatment for 14 days.

RESULTSThe total effective rate was 95. 0% in the group B, 65. 7% in the group A1 and 83. 3% in the group A2, with significant difference or very significant difference when the group B compared with the group A, and the group A, (P<0. 01 or P<0. 05); the cured and markedly effective rate was 82. 5% in the group B, 20. 0% in the group Al and 52. 8% in the group A2, with a very significant difference as the group B compared with the group A, and A2 (both P

CONCLUSIONDeep needling with multi-needles can significantly improve swallow-period obstacle of dysphagia after stroke with higher safety and rapid effect.

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

Background Corneal neovascularization (CNV) is an important cause of visual impairment and graft rejection after allograft corneal transplantation in inflammatory corneal diseases. The mechanisms and therapy relating to CNV are intensely investigated at all times. Objective This study was to evaluate the effect of eicosapentaenoic acid (EPA) on CNV induced by alkali cauterization and its mechanism. Methods The animal models of corneal neovasculation were induced in the right eyes in 72 Sprayue-Dawley rats by putting a piece of 3 mmfilter paper with 1 mol/L NaOH at the center of the cornea for 30 seconds. The rats were then divided randomly into the 0.02 mg EPA treatment group (24 rats) ,0.03 mg EPA treatment group (24 rats) ,model group (24 rats) and normal group (6 rats). EPA of 0.04 ml with doses of 0.02 mg or 0. 03 mg or saline solution of 0. 04 ml was injected subconjunctivally in model rats and immediately after cauterization. The presence of CNV and corneal edema were observed daily by slit lamp biomicroscope. 1,4,7 and 14 days after operation, corneal histopathological examination was performed by hematoxylin and eosin staining. The vascular endothelial cells were stained with CD34 by immunohistochemistry,and the expression of IL-1α,IL-6 mRNA and the nuclear factor-κBp65 ( NF-κBp65 ) proteins was measured by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. The use of animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by Hebei Province( version 1998 ). Results Under the slit lamp, CNV grew slowly from days 2-4 with obvious corneal edema and defect of epithelium. Larger CNV area and less edema were seen from days 7-10. Maximal vessel growth was observed 14 days after injury with thinner vessels in the model group. Histological examination showed that part of the corneal epithelium was damaged;serious corneal edema, more inflammatory cells and a lot of CNV in the stroma were presented in the model group. However, repairing of the corneal epithelium without CNV ,light corneal edema and less inflammatory cells were found in both the 0. 02 mg EPA and 0. 03 mg EPA treatment groups 7 days after alkali cauterization. The relative area of CNV in the 0. 02 mg EPA treatment group was ( 15.80±6.43 )% and ( 11.06±2. 14)% ,and that in the 0. 03 mg EPA treatment group was (16. 10±7.41 )% and (11.06±2. 51 )%, showing significant reduction in comparison with the model group [ (84. 74±7.77)% and (89.63±7.50) % ] 7 days and 14 days after operation ( P＜0. 05 ). Stronger expression of CD34 in the vascular endothelial cells of the cornea stroma was observed in the model group and an absence of CD34 was observed in the EPA-treated groups on the 7th day. RT-PCR revealed that the expression of IL-1α mRNA and IL-6 mRNA was lower in the EPA treatment groups than the model group ( P＜0. 05 ), and Western blot analysis showed that the expression of NF-κB/p65 in the corneas in the EPA treatment groups was significantly lower than that in the model group on the 4th day after operation (P＜0.05).Conclusion Topical application of EPA suppresses CNV induced by alkali burn possibly by inhibiting the expression of NF-κB,IL-1α and IL-6.

OBJECTIVETo study the change of Ca2+ density in cultured osteoclast-like cells in response to fluid shear stress.

METHODSLaser scanning confocal microscope and fluorescent probe were used to detect the free Ca2+ in osteoclast-like cells before and after undergoing fluid shear stress. The images were analyzed and compared with image software.

RESULTSAt 37 degrees C the free Ca2+ in osteoclast-like cells could be labelled effectively with 10 micromol/L Fluo-3/AM. Compared with contol group, the average intensity of Ca2+ fluorescent signal in osteoclast-like cells undergoing fluid shear stress increased significantly.

CONCLUSIONThe Cal2+ concentration in bone-marrow derived osteoclast-like cells is sensitive to fluid shear stress, which suggests osteoclast-like cells modulate their function in response to fluid shear stress through the change of free Ca2+ concentration.

Aniline Compounds ; Bone Marrow ; Bone Marrow Cells ; Calcium ; Cells, Cultured ; Osteoclasts ; Stress, Mechanical ; Xanthenes