Anti-Bacterial Agents ; poisoning ; Education, Veterinary ; Ethers ; poisoning ; Veterinary Drugs ; poisoning

Objective To explore the medical characteristics of end of-life care in elderly inpatients for improving their quality life and distributing appropriately the end-of-life medical expenditure.Methods The historical cohort study was used to survey the characteristics of admission disease,diagnosis and treatment and hospitalization expenditure.The patients were divided into the elderly group (age 60 years and over,228 cases) and control group (age ＜60 years,156 cases).Results There was a statistically significant difference in the admission disease proportion between elderly group and control group (x2 =91.345,P ＜ 0.0001),but the malignant tumor proportion had no differences between the two groups (x2 =9.761,P=0.082); the operation proportion in elderly group (16 cases,7.0％) was lower than in control group (28 cases,17.9％) ; the hospital stay time was longer in elderly group (12.5 days) than in control group (5 days),and the salvage times of elderly group (3 times)was more than that of control group,but the usage of medical device had no differences between the two groups (x2 =0.029,P =0.864).The hospitalization expenditure,medicine expenditure,western medicine expenditure,traditional Chinese medicine expenditure,and medicine proportion were higher in elderly group (15356.0 yuan,6448.3 yuan,5070.0 yuan,895.5 yuan,40.2％,respectively) than in control group.Conclusions Most of the elderly patients with chronic diseases at the end of life have no indication of operation and rely on medicine to maintain life for a long time,and the end-of-life medical expenditure is higher.

Type 1 diabetes mellitus ( T1DM),arising through a complex interaction of immune,genetic and environmental factors,results from autoimmune destruction of insulin-producing β cells.In up to one third of patients the autoimmune attack is not limited to β cells,but expands into autoimmune polyendocrine syndromes(APS).APS are characterized by functional insufficiency of multiple endocrine organs due to an immunologically mediated destructive process.APS can commonly be divided into three types,including APS type Ⅰ,APS type Ⅱ and immune dysregulation,polyendocrinopathy,enteropathy,X-Linked syndrome (IPEX).Here,we discuss the susceptible factors,clinical manifestation,screening and treatment of APS,with the perspective of the clues they can offer to the pathogenesis and treatment of type 1 diabetes mellitus.

The concentration of 5 nucleosides, uracil, uridine, guanidine, adenine and adenosine in culture of Paecilomyces hepialid was determined by the developed method of HPLC. The HPLC method was performed on a Waters SunFire C18 (4.6 mm x 250 mm, 5 μm) column with methanol-water gradient elution as the mobile phase. The detection wavelength was 260 nm and the colunmn temperature was controlled at 30 °C. The linear range was 10.00-200.00 mg · L(-1) (r = 0.9994) for uracil, 10.10-202.00 mg · L(-1) (r = 0.9992) for uridine, 10.00-200.00 mg · L(-1) (r = 0.9991) for guanidine, 10.30-206.00 mg · L(-1) (r = 0.9992) for adenine and 10.45-209.00 mg · L(-1) (r = 0.9991) for adenosine, respectively. The RSD of precision was 0.032%, 0.035%, 0.039%, 0.049%, 0.00080%, respectively. The average recoveries of uracil, guanidine, adenine, and adenosine were 97.34%, 99.10%, 101.6%, 98.61% and 100.2% with RSD of 1.3%, 2.1%, 0.96%, 0.95%, and 1.3% respectively. The method showed high sensitivity, good selectivity, linearity and repeatability, which was suitable for the content analysis of 5 nucleosides components in P. hepialid and its extracts.
Chromatography, High Pressure Liquid ; methods ; Nucleosides ; analysis ; Paecilomyces ; chemistry

Purpose　To study myocardial pathology and its pathogenesis in diabetes. Methods　Myocardial structure of alloxan induced diabetic rats was observed under light microscopy (LM)and transmission electron microscopy(TEM).Activity of superoxide dismutase(SOD),glutathione peroxidase (GSH-Px)，nitric oxide synthase(NOS)and content of malondialdehyde (MDA),nitric oxide(NO) were detected biochemically in myocardial homogenate. Results　Atrophy and degeneration of myocardium and interstitial fibrosis were found under LM and expansion of mitochondria and smooth endoplasmic reticulum, destruction of myofibril and interstitial proliferation of collogen fiber under TEM. Activity of SOD and GSH-Px decreased significantly, while content of NO and MDA and activity of NOS increased significantly in diabetic rats. Conclusion　Atrophy of myocardium, expansion of mitochondria,destruction of myofibril and interstitial fibrosis are the main morphological changes of diabetic cardiomyopathy, and lipid peroxidation and NO may be involved in it.

Objective Based on the mathematical models established in Department of Thoracic Surgery of Peking University People's Hospital for predicting malignant probability for solitary pulmonary nodules ( SPN),another continuous 145 patients with SPN were assessed to verify the accuracy of the model comparing with foreign models (Mayo model and VA model).Methods A retrospective cohort study in our institution included 145 patients with definite pathological diagnosis of SPN from Oct 2009 to Aug 2011,72 males and 73 females,average age (59.4 ± 12.2 ) years old.Clinical data included age,gender,course of disease,symptoms,history and quantity of smoking,time of smoking cessation,history of tumor,family history of tumor,tumor site,diameter,calcification,speculation,border,lobulation,traction of pleural,vascular convergence sign,and cavity.These raw data were incorporated into our model,Mayo model and VA model,the probability of malignant in every patient was calculated separately according to methods described before.The sensitivity and specificity of these 3 models were evaluated then.Afterwards,calibration of the 3 models was assessed by the Hosmer-Lemeshow (H-L) test.Discrimination was tested by calculating the area under curve ( AUC ) after the receiver operating characteristic (ROC) curve was drawn.Results 32.4％ (47 in 145 patients) of the nodules were malignant,and 67.6％ (98 in 145 patients) were benign in this group.Verified the accuracy of our model with sensitivity of 94.9％,specificity of 66.0％,positive predictive value of 85.3％ and negative predictive value of 86.1％.The H-L test showed good fitting in all models ( P ＞0.05 ).The AUC for our model was 0.874 ±0.035,and 0.784 ± 0.041 in Mayo model (P =0.004 compared to our model),0.754 ± 0.041 in VA model (P =0.002 compare to our model).And,there was not significant statistical difference between Mayo model and VA model (P ＞0.05 ).Our model has the best precision indexed by AUC,which were statistically significant differential compared with Mayo model and VA model.Conclusion The model established by our center has superior value than foreign counterparts in predicting the probability of malignant or benign in patients with SPN.

Objective To investigate the possible pathogenesis of type 2 diabetes mellitus (T2DM) combined with Alzheimer's disease (AD). Methods Wistar rats were randomly divided into control, T2DM, AD and T2DM +AD groups. The blood glucose levels were assayed, and the behavior changes were tested by Morris water maze. The glycogen synthase kinase-3β (GSK-3β) and hyperphosphorylation of tau protein were detected by immunohistochemistry staining. Results Compared with the control rats, the learning and memory abilities were weakened significantly in the model rats (F=28. 65, P<0.001). The expression of GSK-3β was higher in T2DM + AD group (4319. 02±653. 24) than in AD group (304. 39 ± 175. 83), T2DM group (540.43 ± 558.49) and control group (315. 56 ± 91. 64, H=19. 335, all P<0. 01). The level of hyperphosphorylation of tau protein was significantly increased in T2DM + AD group (8583. 81 ± 2236. 11) and AD group (2799. 61±1070. 02) than in control group (252. 02 ± 58. 37) and T2DM group (287. 75 ± 192. 53, H=32. 950, P< 0.001). There was no significantly difference of hyperphosphorylation of tau between T2DM group and control group (H = 32. 950, P>0. 05). Conclusions The increasing of GSK-3β activity in T2DM may be caused by hyperphosphorylation of tau.

Objective To explore the changes of the serurn cardiac enzymes in patients with acute massive pulmonary thromboembolosm(PIE),sub-massive PTE and non-massive FIE between pre-therapy and past-therapy and its relationship.Method The prospective multi-centres trial included 519 patients with confirmed PTE from 24 joint hospitals in Beijing,consisting of 54 massive FIE,195 sub-massive PTE and 270 non-massive PIE.Thrombolytic treatment was used in massive and sub-massive PTE patients with employment of urokinase and recombinant tissue plasminogen activator(rt-PA),and anti-coagulative therapy with unfractionated heparin and low molecular heparin was used in non-massive PTE.Results(1)The values of serum CPK and LDH in massive PTE patients before therapeutical intervention were obfiously higher than those in sub-massive and non-massive PTE patients(P<0.01);(2)Of 45 patients with high pulmonary pressure,24(54.4%)patients had high serum LDH(P<0.01).Of 169 patients with right ventrieular dysfunction,68(40.2%)ones has high serum LDH(P=0.049).Of 48 patients suffered from poor prognosis,15(30.8%)ones had high serum.LDH(P=0.039).Conclusions ①The vMues of serum CPK and LDH in acute PTE patients increase without elevation of CK-MB.②Serum LDH associates with pulmonary presure,right ventrieular function and prognosis.

Adult ; Aged ; Arsenic Poisoning ; drug therapy ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male ; Middle Aged

Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinolysis ; drug effects ; Glycoproteins ; blood ; Humans ; Injections ; Male ; Middle Aged ; Phytotherapy ; Plasminogen Activator Inhibitor 1 ; blood ; Platelet Aggregation ; drug effects ; Pulmonary Heart Disease ; blood ; drug therapy ; Tissue Plasminogen Activator ; blood