Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups: group A (alprostadil),group B(Oza-grel),group C(Dan red injection),group D(Xuesaitong),the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio(C/E) were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio(△C/△E) were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme.

Objective To search for the specific biomarkers associated with local lymphatic metastasis of colorectal cancer in serum.Methods The serum protein profile of colorectal cancer patients was determined by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS),and the peak values of proteins were identified with the matched software,and then clustered to construct the classification tree model.Seventy colorectal cancer patients with local lymphatic metastasis and 75 patients in matched age and gender without local lymphatic metastasis were assigned as a training set to construct the classification tree model,and 35 colorectal cancer patients with local lymphatic metastasis and 30 patients in matched age and gender without local lymphatic metastasis were assigned as test set to make the independent sample double-blind test.Results Forty-six distinct proteins were identified from the two groups,and the classification tree model formed by 5 proteins (M/Z:3104,3781,5867,7970 and 9290) could be used to identify the two groups with a sensitivity of 94.3% (66/70) and a specificity of 100.0% (75/75).The double-blind test challenged the model with a sensitivity of 91.4% (32/35),a specificity of 96.7% (29/30),and a positive predictive value of 97.0% (32/33),respectively.ConclusionThe constructed classification tree model may distinguish colorectal cancer patients with or without local lymphatic metastasis correctly,and show a great potential for preoperatively screening the colorectal cancer patients with or without local lymphatic metastasis.

Objective To investigate the clinical value of mean channel of neutrophil volume (MNV), mean channel of neutrophil conductivity (MNC) and mean channel of neutrophil scatter (MNS) in predicting acute bacterial infection.Methods Peripheral blood samples from 112 patients with positive blood cultures for bacteria,70 healthy subjects and 45 non-infectious subjects with high white blood cell count(WBC) were studied using the Coulter LH 750 hematology analyzer.MNV, MNC, MNS and neutrophil volume distribution width (NDW) were retrospectively analyzed and compared with total WBC, percentage of neutrophils,neutrophil left-shift and CRP.112 blood bacterial infections were grouped according to WBC count (A:WBC ＜11.0×109 /L;B:11.0×109/L≤WBC＜15.0×109 /L;C:WBC≥15.0×109 /L) and neutrophil rate (NE ＜ 0.85 and NE ≥ 0.85 ).Results MNV and NDW increased significantly in septic patients (154.17 ± 10.08,24.36 ± 4.14 ) compared with those of healthy control group (142.09 ± 4.13,19.04 ± 1.97) and non-infectious patients with high WBC group ( 150.63 ± 8.14,20.19 ± 4.73 ).There was statistically significant difference (F value were 20.738 and 28.190 respectively,P ＜ 0.01 ). On the contrary, MNS decreased significantly in septic patients (137.15 ± 7.61 ) compared with that of healthy group (144.51±4.36) and nonspetic patients with high WBC group (142.45±7.11) ,there was significant statistical difference (F=5.217,P＜0.01).The MNV, NDW and MNS of A group were 148.09±5.76,22.39±1.97,140.07±6.11 respectively.The MNV, NDW and MNS of B group were 152.83±5.75,24.14±1.35,141.44±5.35 respectively.The MNV, NDW and MNS of C group were 164.28±6.49,29.42±5.93,134.27±9.61 respectively. There was statistically significant difference compared with healthy group (F value were 24.720,31.642,7.931, P ＜ 0.01).The MNV, NDW and MNS in the group with NE ＜0.85 were 149.17±9.06,22.59±2.73,141.19±4.34 respectively.The MNV, NDW and MNS in the group with NE≥0.85 group were 159.03±10.23,27.64±4.51,135.62 ± 8.95 respectively.There was statistically significant difference compared with healthy group ( F value was 23.970,51.309,19.792,P＜0.01).With a cut-off of 150 for the MNV, a specificity of 90% and sensitivity of 70% were achieved.NDW was associated with neutrophil left-shift (r=0.33,P＜0.01).With a cut-off of 23 for the NDW, a specificity of 100% and a sensitivity of 72% were achieved.The sensitivity of the MNV and NDW was better than total white blood cells count (with a cut-off≥ 11.0×109 /L, the sensitivity was 57% ), percentage of neutrophils( with a cut-off≥0.85, the sensitivity was 44% ) and neutrophil shift to left ( with a cut-off ＞5%, the sensitivity was 66% ) and CRP (with a cut-off ≥10 mg/L, the sensitivity was 65% ).Conclusions The MNV and NDW of the neutrophil can reflect the morphologic change of neutrophil sensitively and specificialy in acute infection. As quantitative, objective and more sensitive parameters, MNV and NDW may have a potential role for predicting the acute bacterial infection.

Objective To evaluate the clinical significance of quantitative sensory testing (QST) in screening diabetic peripheral neuropathy of the early stage. Methods One hundred patients with type 2 diabetes mellitus were examined by nerve conduction velocity (NCV) and QST examination. With the NCV positive as the gold criterion for screening diabetic peripheral neuropathy of the early stage, the sensitivity and specificity of QST was further analyzed for diagnosis of the early stage diabetic peripheral neuropathy. Results Among the 100 patients with type 2 diabetes mellitus,there were 41 cases positive and 59 cases negative in NCV examination. On the other hand,there were 74 cases positive,and 26 cases negative in QST. The sensitivity and specificity of QST for the diagnosis of early stage diabetic peripheral neuropathy was 97.56% (40/41) and 42.37% (25/59). Conclusions In the screening of early stage diabetic peripheral neuropathy,QST shows higher detection sensitivity,but lower specificity than NCV examination. Therefore, QST may be an examination for the supplement of the routine electromyography.

Objective To investigate the expression changes of macrophage migration inhibitory factor( MIF) and C-Jun N-terminal kinase ( JNK) in the liver of rat with abnormal glucose metabolism and explore the pathological mecha-nism of abnormal glucose metabolism with non-alcoholic fatty liver disease ( NAFLD) .Methods Sixty SD rats were ran-domly divided into impaired glucose tolerance (IGT) model group (n=20), type 2 diabetes mellitus (T2DM) model group (n=20), IGT control group (n=10) and T2DM control group (n=10).IGT models were produced by feeding high-fat diet, T2DM models were produced by feeding high-fat diet for 4 weeks and intraperitoneally injected streptozotocin. Liver cell apoptosis was detected by TUNEL staining.The expression of MIF mRNA in liver tissue was determined by real-time PCR.The expressions of MIF, caspase-3, JNK proteins and phosphorylated JNK(p-JNK)in the liver tissue were de-termined by Western blotting.Results Apoptotic cells were obviously increased in the IGT and T2DM groups.Expression of MIF mRNA in the IGT and T2DM groups was markedly higher than that in the control group, respectively (P<0.01). The expressions of MIF, caspase-3, JNK proteins and phosphorylated JNK were markedly higher than that of the control group, respectively (P<0.05 or P<0.01).The expressions of MIF, caspase-3, JNK proteins in the T2DM group were significantly decreased compared with those of the IGT group, while the expression of phosphorylated JNK was significantly higher ( P<0.01) .Conclusions Abnormal glucose metabolism accompanied with NAFLD is probably related to the in-crease of MIF, Caspase-3, JNK and phosphorylated JNK expression.

Objective To investigate the regulatory effect of calcitonin gene-related peptide (CGRP) on the mRNA and protein expression of neuronal nitric oxide synthase (NOS), as well as the release of nitric oxide (NO) in cultured human keratinocyte line HaCaT. Methods NO level in the supernatant of cell culture medium was detected with an enzymatic NO detecting kit, the mRNA expression of neuronal NOS was studied with reverse transcription polymerase chain reaction(RT-PCR), and the protein expression of neuronal NOS was studied with immunochemical technique(SP). Results Compared with that in normal culture condition, the mRNA and protein expression of neuronal NOS and the release of NO was significantly upregulated by CGRP in HaCaT cells. Whereas, the expression of neuronal NOS and the release of NO in HaCaT cells induced by CGRP was inhibited by CGRP-8-37, an inhibitor of CGRP receptor. Conclusion The expression of neuronal NOS in keratinocytes and the release of NO from keratinocytes could be upregulated by CGRP.

Objective To investigate the relationship between renal vascular resistance index( RI) and serum Apelin level in type 2 diabetic mellitus ( T2DM )?Methods Seventeen cases newly diagnosed T2DM patients with RI increased but without microalbuminuraia in Minhang Hospital Affiliated to Fudan University from December 2011 to December 2014 were selected as observation group,17 newly diagnosed T2DM patients with RI normal during the same period were selected as control group?Fasting plasma glucose(FPG),glycosylated hemoglobin A1C(HbAlC),blood lipids and fasting insulin(FINS),hepatic functional and renal function were tested in all the subjects?Serum Apelin level was detected by enzyme?linked immunosorbent assay?Results Compared with control group,serum Apelin level was significantly higher in observation group((179?2±122?4)μg/L vs?(56?7±50?6) μg/L,t=3?814,P<0?05)?Partial correlation analysis showed that the RI was positive correlated with Apelin ( r= 0?364, P= 0?040 )?Conclusion The serum Apelin levels elevated in newly diagnosed T2DM patients with RI increased, and RI is positively correlated with Apelin, which indicate that Apelin play an important role in the pathophysiology of early renal damage in patients with TsDM.

[ ABSTRACT] AIM:To observe the changes of perilipin and adipose differentiation-related protein ( ADRP) du-ring the development of diabetes mellitus and to explore the effect of perilipin and ADRP on abnormal glucose metabolism with non-alcoholic fatty liver disease ( NAFLD) .METHODS:The rat model of impaired glucose tolerance ( IGT) was in-duced by feeding high-fat diet, and the type 2 diabetes mellitus (T2DM) model was induced by feeding high-fat diet for 4 weeks and intraperitoneally injecting streptozotocin.The morphological change of the liver tissue was observed under optical microscope.The serum contents of perilipin and ADRP were measured by ELISA.The mRNA expression of perilipin and ADRP in the liver tissues was detected by real-time PCR.The protein expression of ADRP in the liver tissues was deter-mined by Western blotting.RESULTS:HE staining showed steatosis in the liver of the rats in IGT group was more serious than that in T2DM group.The biochemical and the pathological processes of rat models were consistent with the clinical feature of related diseases.The serum content of perilipin had no difference among various groups.The mRNA expression of perilipin in IGT group and T2DM group was significantly higher than that in control group.Compared with IGT group, the mRNA expression of perilipin in T2DM group was significantly increased.The serum content of ADRP in T2DM group was significantly lower than that in control group.The mRNA and protein expression of ADRP in model groups was signifi-cantly lower than that in control group.Compared with IGT group, the mRNA expression of ADRP in T2DM group was sig-nificantly reduced.CONCLUSION: The serum content of ADRP plays a role in the development and progression of T2DM.It is negatively correlated with HOMA-IR.NAFLD occurs during progression of abnormal glucose metabolism in-duced by feeding high-fat diet.The development of abnormal glucose metabolism with NAFLD is probably related to the in-creased expression of perilipin and the reduced expression of ADRP.

Objective To observe and analyze the effect of different external fixation methods on catheter related urinary tract infection (CAUTI).Methods The clinical data of 86 patients suffered from indwelling catheters were retrospectively analyzed .According to the different external fixation of indwelling catheter , the patients were divided into observation group (n=43) and control group (n=43).The control group received drainage tube fixed in the bedside the legs go below ,the observation group received drainage tube fixed on the bed after upper thigh walking . The incidence of complications was analyzed in the two groups .Results The incidence rates of CAUTI ,leakage of urine,skin indentation of the observation group were 13.95％,6.98％ and 2.33％,respectively,which were lower than those of the control group (34.88％,30.23％ and 23.26％),there were statistically significant differences between the two groups (χ2 =11.869,17.848,19.630,all P<0.05).The incidence rates of 2,3 degree pain and pain in the observation group were 0.00％,4.65％,6.98％,respectively,which in the control group were 2.33％, 6.98％,9.30％,respectively,the differences were not statistically significant (χ2 =2.357,0.495,0.359,all P>0.05).Conclusion For the patients of indwelling catheter ,drainage tube is fixed on the bed by the upper thigh walking is helpful to reduce skin pressure , reduce catheter infection and urine leakage rate , and can improve the comfort degree of patients ,it is worthy of clinical popularization and application .

OBJECTIVETo compare the effects of Atractylodes lancea from different producing area on collagen-induced arthritis (CIA) in rats.

METHODWistar rats were induced by type II bovine collagen. CIA rats were treated daily with oral administration of A. lancea from the geo-authentic and non-authentic producing area of Maoshan, Jiangsu province, and non-geo-authentic and non-authentic producing areas of Yingshan, Hubei province and Huayin, Shanxi province from day 7 after the day of the first immunization to day 35. Clinical symptoms as well as clinical scores and incidence were observed. All rats were sacrificed on day 35 after immunization to observe histopathologic and radiologic changes. Antibody to type II collagen in sera was measured by enzyme-linked immunosorbent assay (ELISA), the levels of pro-inflammatory cytokines tumor necrosis factor alpha (TNF-alpha), interleukin-1beta (IL-1beta), and interleukin-6 (IL-6) in sera and article-homogenated supernants by radiommunoassay, and inflammatory mediator of PGE2 in sera using ELISA.

RESULTA. lancea from Jiangsu province can ameliorate clinical symptom, reduce arthritis index and arthropathy of inflammatory joints, inhibit the production of IgG and IgM in sera, directly suppress the production of exogenous and endogenous cytokines of IL-1beta, TNFalpha and IL-6 and PGE2. A. lances from Hubei and Shanxi provinces can inhibit the production of IgM in sera, and A. lanceas from Hubei province also depress the production of IL-1beta in sera and IL-6 in supernants.

CONCLUSIONA. lancea from Jiangsu province is effective in CIA rats through inhibiting the production of pro-inflammatory cytokines and the inflammatory mediators.

Animals ; Arthritis, Experimental ; drug therapy ; immunology ; Atractylodes ; Cytokines ; blood ; Dinoprostone ; blood ; Male ; Phytotherapy ; Plant Extracts ; therapeutic use ; Rats ; Rats, Wistar