Objective To explore factors associated with emergency room(ER)length of stay and provide basis for the emergency managers about the development of relevant measures.Methods Data of critically ill patients from the emergency room in a tertiary teaching hospital from January 2010 to June 2011 were retrospectively studied.Binary Logistic regression analysis was used to determine possible factors and further compare the clinical characteristics of the patients.Results(1)From January 2010 to June 2011 a total of 11 468 patients were seen in the emergency department,the median ER length of stay was 11 h,a number of 6 525 patients(56.9％)stayed in ER more than 6 h.(2)Binary Logistic regression analysis showed that the main factors contributing to length of stay more than 6 hours were types of wards,green channel,treatment time,followed by admitted to ICU,traffic,sent by 120,the number of initial diagnosis,destinations of disposition,sex,holiday visit,visit month.While age,occupation,residence were not factors.Conclusions The patients in this hospital has a prolonged length of stay.The associated factors included types of wards,green channel,treatment time deserves a further study.

This study is to investigate the protective effect of rosiglitazone (RSG) against learning and memory impairment of APP/PS1/tau transgenic mice. AD mice model was replicated by using 6-month APP/PS1/tau transgenic mice. The learning and memory ability of mice was evaluated by Morris water maze and Western blotting assays was applied to measure the phosphorylation and O-glycosylation of Tau and neurofilaments (NFs) protein. The results demonstrated that RSG could reverse the learning and memory deficits of 3 x Tg mice significantly. It was also found that RSG could suppress the hyperphosphorylation of Tau and NFs protein levels and increase the glycosylation expression of Tau and NFs proteins in 3 x Tg mice brain. Together, RSG ameliorates cognitive impairments of 3 x Tg mice via the alleviation of the hyperphosphorylated Tau and NFs proteins burden in the brain.
Alzheimer Disease ; Amyloid beta-Peptides ; Animals ; Brain ; drug effects ; Disease Models, Animal ; Glycosylation ; Learning ; drug effects ; Memory ; drug effects ; Memory Disorders ; drug therapy ; Mice ; Mice, Transgenic ; Neurofilament Proteins ; metabolism ; Phosphorylation ; Thiazolidinediones ; pharmacology ; tau Proteins ; metabolism

OBJECTIVETo observe the changes in Aβ40, Aβ42 and ADDLs in brains of 3 month-old APPswe/PS1dE9 double transgenic mice after six-month intervention with curcumin, in order to discuss the neuroprotective effect of curcumin.

METHODAPPswe/PS1dE9dtg mice were randomly divided into the model group, the Rosiglitazone group (10 mg x kg(-1) x d(-1)) and curcumin high (400 mg x kg9-1) x d(-1)), medium (200 mg x kg(-1) x d(-1)) and low (100 mg x kg(-1) x d(-1)) dosage groups, with C57/BL6J mice of the same age and the same background in the normal control group. After 6 months, the immunohistochemical staining (IHC) and the Western blot method were used to observe the changes in positive cell of Aβ40, Aβ42 and ADDLs in hippocampal CA1 area, their distribution and protein expressions.

RESULTBoth of the immunohistochemical staining and the Western blot method showed more positive cell of Aβ40, Aβ42 and ADDLs in hippocampal CA1 area and higher protein expressions in the model group than the normal group (P < 0.01). IHC showed a lower result in the Rosiglitazone group than the model group (P < 0.05), while Western blot showed a much lower result (P < 0.01). The number of Aβ40, Aβ42 and ADDLs positive cells and the protein expressions decreased in the curcumin high group, the medium group showed a significant decrease (P < 0.01), and the low dose group also showed reductions in the protein expressions of Aβ40 and Aβ42.

CONCLUSIONThe six-month intervention with curcumin can significantly reduce the expressions of hippocampal Aβ40, Aβ42 and ADDLs in brains of APPswe/PS1dE9 double transgenic mice. Whether curcumin can impact Aβ cascade reaction by down-regulating expressions of Aβ40, Aβ42 and ADDLs and show the neuroprotective effect needs further studies.

Alzheimer Disease ; drug therapy ; genetics ; metabolism ; Amyloid beta-Peptides ; genetics ; metabolism ; Animals ; Brain ; drug effects ; metabolism ; Curcumin ; administration & dosage ; Disease Models, Animal ; Hippocampus ; drug effects ; metabolism ; Humans ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Neuroprotective Agents ; administration & dosage ; Plant Extracts ; administration & dosage

Objective To study the damage propagation and evolution mechanism of cartilage under compressive loads.Methods The fiber-reinforced porous elastic model of cartilage with micro-defect was established by using finite element method,and the process of damage evolution under compressive loads was simulated and analyzed with parameters.The patterns of stress and strain distributions on cartilage matrix and collagen fiber at different damage extension stages were obtained.Results The strain in the surface and forefront of cartilage damage increased significantly with the increase of compression displacement,and they were obviously in positive correlation;in the process of damage evolution,there was a trend that cartilage extended to the deep and both sides simultaneously;cracks and damage in cartilage extended preferentially along the fiber tangent direction.With the aggravation of cartilage damage,the lateral extension speed was significantly faster than the longitudinal extension speed.Conclusions The process of cartilage damage extension has a close relationship with the distribution of fibers.The damages in matrix and fiber promote each other.The evolution speed and degree of cartilage vary constantly in different layers and at different stages.These results can provide the qualitative reference for prediction and repair of cartilage damage,as well as the theoretical basis for explaining pathological phenomena of damage degeneration and its clinic treatment.

The payment methods,such as Diagnosis Related Group(DRG)for hospitalization and capitation for outpatient treat-ment,have achieved positive results in protecting the rights and interests of insured persons and improving the efficiency of the use of medical insurance funds.However,for patients with chronic diseases and rehabilitation nursing,the hospitalization period is long and the conditions complicated,and the payment method of DRGs is not reasonable.It analyzes the experiences of paying for long-term hospital cases in the US.and Germany from the aspect of reform process,payment method and regulatory measures.In order to pro-vide references for the reform of per-diem payment in rehabilitation nursing and other long-term hospitalized cases,it puts forward suggestions from aspects of realizing value care,reflecting individual differences,exploring complex payment methods,improving data quality and establishing constraint mechanism.

OBJECTIVETo evaluate and compare the efficacy and safety of titanoreine cream with compound carraghenates suppository in the treatment of mixed hemorrhoids.

METHODSTwo hundred and fifty-two patients with mixed hemorrhoids were enrolled in this randomized,open, multicentral trial. Patients applied titanoreine cream (study group, n=133) or compound carraghenates suppository (control group, n=119). The symptomatic relief including pain,bleeding and edema was evaluated by scoring system at 30 minutes, 3 hours, 6 hours, 1 day, 2 days, 3 days, 4 days, 6 days after administration.

RESULTSSymptoms were significantly improved in both groups (87.3%, 94.8%, respectively) excepting symptom of pain relief, but there was no significant difference between two groups (P > 0.05). The pain scores were lower at every observing point in the study group than those in the control group (P< 0.05). The proportions of the patients with pain relief and all symptoms relief were both higher in the study group than that in the control group at 30 min, 3 h after drug used (both P< 0.01). No side effect was found during the triad.

CONCLUSIONTitanoreine cream has predominance of relieving pain and response time compared with compound carraghenates suppository, but other effects on mixed hemorrhoid are similar between the two groups.

Adult ; Carrageenan ; adverse effects ; therapeutic use ; Drug Combinations ; Female ; Hemorrhoids ; drug therapy ; Humans ; Male ; Middle Aged ; Ointments ; therapeutic use ; Safety ; Suppositories ; therapeutic use ; Titanium ; adverse effects ; therapeutic use ; Zinc Oxide ; adverse effects ; therapeutic use

BACKGROUNDInternal metallic stents have been widely used in clinical practice, but a high postoperative restenosis rate limits its application. The purpose of this study was to determine the effect of intrabiliary radiation on muscle formation and biliary duct remodeling after biliary duct balloon injury in dogs.

METHODSTwenty male dogs (15 - 20 kg) were randomly divided into treatment group (n = 10) and control group (n = 10). Balloon overstretching injury was induced using a balloon catheter placed across the biliary duct. Subsequently, a 103Pd radioactive stent was positioned at the target site in each animal in the treatment group, providing the injured biliary duct with a radiation dose of 12.58 x 10(7) Bq. Dogs in the control group received Ni-Ti stents. All the dogs were killed one month after initial injury. The injured sections were dissected free from the dogs, and were processed for histological and morphological study. Cross-sections were stained with hematoxylin-eosin, Masson's trichrome, and Verhoef-van Giesen. Muscle formation area and lumen area were determined using a computer-assisted image analysis system.

RESULTSCompared with the control group, 103Pd radioactive stents significantly reduced muscle formation area (78.3%, P < 0.01), and percentage area of stenosis [control stents: (60.0 +/- 21.6)%, 103Pd radioactive stents: (31.6 +/- 9.5)%]. In addition, in the treatment group, the biliary duct lumen area was significantly larger than that in the control group (P < 0.01).

CONCLUSIONS103Pd radioactive stents providing a radioactive dose of 12.58 x 10(7) Bq are effective in reducing muscle formation and biliary duct remodeling after balloon overstretching injury.

Animals ; Bile Ducts ; pathology ; physiology ; radiation effects ; Catheterization ; adverse effects ; Dogs ; Male ; Muscle Development ; radiation effects ; Muscle, Smooth ; radiation effects ; Palladium ; administration & dosage ; Radioisotopes ; administration & dosage ; Random Allocation ; Stents ; adverse effects

OBJECTIVETo explore the feasibility of a dual-energy computed tomographic angiography (DECTA) protocol using test-bolus injection with reduction of contrast material (CM) dose in second generation dual-source CT system.

METHODSTotally 57 consecutive patients underwent CT angiography scan covering the cervical and cerebral arteries. CT was performed with second generation dual-source CT system. The time to peak (T) using a test-bolus injection was calculated. The patients were divided into three groups (A, B, and C) with different CM doses (40, 45, and 50 ml) and different delay time points [ (T+1) , (T+1) , and (T+2) s] . All the patients were followed by a 48 ml saline flush. Arterial enhancements were quantified by measuring attenuation values of the aortic arch, bifurcation of common carotid artery, contralateral internal jugular vein of the CM injection, superior vein cava, proximal middle cerebral artery, basilar artery, and straight sinus on source images. Visualizations of intracranial artery and ipsilateral venous effect of the CM injection were rated on a four-point grading scale on CTA images for qualitative assessment.

RESULTSAlthough the attenuation of internal jugular vein and straight sinus were significantly lower in group A than in groups B and C (P<0.05) , the attenuation of aortic arch, superior vein cava, common carotid artery, middle cerebral artery, and basilar artery vessels showed no significant differences among these three groups. The scores of the visualizations of intracranial artery and ipsilateral venous effect of the CM injection were also not significantly different among these three groups.

CONCLUSIONBased on the delay time calculated by a test-bolus injection, a reduced-dose contrast material may provide an equal degree of arterial attenuation and a lower attenuation of vein for dual-energy CTA covering the craniocervical region in second generation dual-source CT system.

Adult ; Aged ; Angiography ; methods ; Contrast Media ; administration & dosage ; Feasibility Studies ; Female ; Head ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Radiation Dosage ; Tomography, X-Ray Computed ; methods

OBJECTIVETo establish a duplex nested PCR assay system which is capable for detecting O1 and O139 groups of Vibrio cholerae simultaneously, and is applicable to environmental specimens from routine cholera surveillance.

METHODSBased on nucleic acid sequences available in GenBank, six sets of primers were designed by PrimerSelect program of DNAStar, targeting the rfb gene that encodes the O antigens of O1 and O139 V. cholerae, respectively. The specificity of several primer combinations was tested. A duplex nested PCR assay system for simultaneously detecting O1 and O139 V. cholerae was established, subsequently, its sensitivity, specificity, reproducibility and field evaluation were tested. The sensitivity of this assay was evaluated by comparing detection limits of nested PCR and conventional PCR. Its reproducibility was tested by 32 positive samples (11 samples positive for O1, 21 samples positive for O139) from environmental surveillance. In addition, the selected amplicons from positive samples were sequenced and analyzed with relevant sequences.

RESULTSThis newly-established duplex nested PCR assay might distinguish O1 V. cholerae from O139 V. cholerae, based on fragment lengths of amplicons, with reliable reproducibility, and no specific amplification was observed as compared with other vibrio species. The sensitivity of this nested PCR was (15 000) higher than conventional PCR, and there was no interference observed with multiple primers and complicated templates in the same vial. In its field evaluation, 32 positive DNA samples were detected and be further confirmed with double or triple tests, implying reliable reproducibility and consistency of this system. These results indicated that this assay had reliable reproducibility. No amplification was observed in all negative specimens and also suggested the acceptable specificity of this assay. Sequence analysis of the selected amplification products revealed 100% homogeneous with relevant genes from V.cholerae, indicating that these amplicons were originated from V. cholerae.

CONCLUSIONThis duplex nested PCR assay system should be rapid, sensitive and especially applicable to small laboratories, and be suitable for dynamic environmental surveillance.

DNA, Bacterial ; Environmental Monitoring ; methods ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA ; Vibrio cholerae O1 ; genetics ; isolation & purification ; Vibrio cholerae O139 ; genetics ; isolation & purification

OBJECTIVEThrough the dynamic detection of the concentration change of the urine Alzheimer-associated neuronal thread protein (AD7C-NTP) in the curcumin treated Alzheimer's disease (AD) model (APP/PS1 double transgenic) mice, the therapeutic effect of curcumin in AD was determined.

METHODThirty three-month-old APP /PS1 double transgenic mice were randomly divided into 5 groups, 6 in each group, the model group, rosiglitazone group(10 mg . kg-1 . d-1) , high(400 mg . kg -1 . d-1) , medium(200 mg . kg-1. d-1) and low(100 mg . kg-1 . d-1) dose curcumin groups. Six C57BL/6J mice in the same age and genetic background were used as normal control group. All the 6 groups of mice were intragastrically administered for 6 months. Urine samples were collected on 4 month, 5 month and 6 month after intragastric administration, respectively. The changes of urinary AD7C-NTP concentration were detected by enzyme-linked immunosorbent assay (ELISA).

RESULTThe concentration of AD7C-NTP of each group was compared at the same time point, the concentration of model group is higher than normal control group (P <0.05) ; the concentration of other groups is lower than model group. The concentration of high curcumin dose group with 4 months treatment, has no statistical difference compared with model group. The AD7C-NTP concentration of each group was elevated with the age growth, and all concentrations of the treatment groups were lower than the model group at the same period. With the treatment of 4, 5 and 6 months, the concentration of the normal control group has significant difference with the treatment groups(P <0. 01). There have no statistical difference between all the groups with the treatment of 6 months compared with 5 months.

CONCLUSIONWith the progression of the disease in AD mice, there are fluctuations in urinary AD7C-NTP concentration, the compound curcumin from traditional Chinese medicine can delay the progression of AD.

Alzheimer Disease ; drug therapy ; urine ; Animals ; Curcumin ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Mice ; Mice, Transgenic ; Nerve Tissue Proteins ; urine ; Thiazolidinediones ; therapeutic use