Objective To assess the effect of anti- Helicobacter pylori (Hp) treatment on patients with chronic idiopathic thrombocytopenic purpura (cITP). Methods Fifty-nine patients with cITP and positive-Hp were divided into two groups by random digits table:Hp eradication group (30 cases,given a standard anti-Hp treatment) and placebo controlled group (29 cases,received a placebo). The platelet response of two groups was compared after three months' follow-up. Result The platelet response in Hp eradication group (63.3%, 19/30) was significantly higher than that in placebo controlled group (27.6%,8/29 )(χ2 = 7.59, P ＜ 0.05 ), and the increasing level of platelet count in Hp eradication group [ (33.5 ± 21.6)× 109/L] was higher than that in placebo controlled group [(12.6 ± 19.5) × 109/L] (t = 5.52,P ＜0.05).Conclusion Hp eradication treatment can promote the platelet recovery in mild and moderate cITP patients with positive-Hp.

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.

ObjectiveTo observe the effect of transcutaneous electric nerve stimulation (TENS) and physical therapy on shoulder pain after stroke. Methods60 patients of shoulder pain after stroke were randomly divided into treatment group (30 cases) and control group(30 cases). The patients in the treatment group were treated with TENS and physical therapy. The cases in the control group were treated with TENS only. All patients were evaluated with visual analogous score of pain (VAS) and Fugl-Meyer measure (FM) before and after treatment. ResultsThe scores of VAS and FM improved more significantly in treatment group than in control group(P<0.01).ConclusionTranscutaneous electric nerve stimulation combined with physical therapy showed more effective on shoulder pain after stroke.

Akt1 is a serine-threonine protein kinase that has been implicated in the control of cellular metabolism,survival and growth.Elevated expression of Akt1 has been noted in a significant percentage of human tumors,promoting cellular metastasis.Conversely,some studies have revealed hyperactivated Akt1 inhibited the invasiveness and metastasis of breast cancer cells.To clarify the definite effect of Akt1 on tumorigenesis and development,Akt1 was silenced by RNAi in the highly metastatic murine breast cancer 4T1 cells.Akt1 silencing didn't affect the proliferation of breast cancer cells in MTT assay,while reduced the migration in Transwell assay.Consistent with the above results,Akt1 silencing didn't change the primary tumor weight,but significantly suppressed lung metastasis of 4T1 cells.These observations indicated Akt1 plays an important role in murine breast cancer metastasis,and suggested that Akt1 might be a therapeutic target for breast cancer metastasis.

With the advance of drug development and research techniques, the drug metabolic processes and mechanism can be more deeply achieved. As the drug metabolism and pharmacokinetics process are mediated by drug metabolizing enzymes and transporters, study of drug metabolizing enzymes and transporters has become an important part for drug development. The traditional immunoassays with low sensitivity and poor specificity can not reflect the accurate expression level of drug metabolizing enzymes and transporters. We now give a brief review on the quantitative study of drug metabolizing enzymes and transporters by mass spectrometry-based proteomic approach.
Enzymes ; chemistry ; Humans ; Inactivation, Metabolic ; Mass Spectrometry ; Membrane Transport Proteins ; chemistry ; Pharmacokinetics ; Proteomics

Objective To study the effect of different concentration of 1,25-dihydroxyvitamin D3[1,25(OH)2D3] on cell proliferation,differentiation and the expression of vitamin D receptor (VDR) in mouse MC3T3E1 osteoblast.Methods Osteoblast were cultured in medium with different concentrations of 1,25(OH)2D3.Incubated for 48 h,cell proliferation of osteoblast were examined by MTT reduction assay (mono-nuclear cell direc cytotoxicity assay),the osteocalcin (OC) levels in cell medium were detected by ELISA,and the expression of VDR mRNA and protein were examined by using SYBR Green real-time PCR and Western blot,respectively.Results 1.After incubation with 1,25(OH)2D3 for 48 h,the number of MC3T3E1 osteoblast was significantly less than that in control group(P0.05).3.SYBR Green real-time PCR and Western blot results showed that the expression of VDR mRNA as well as VDR protein of osteoblast in 10-8,10-9 mol/L experimental groups were significantly higher than those in control group (Pa0.05).Conclusions Cell proliferation of mouse osteoblast can be inhibited,while the cell differentiation was promoted by 1,25(OH)2D3.1,25(OH)2D3 up-regulated the expression of VDR in mouse osteoblast,which suggested that the VDR signal pathway may play some role in proliferation and differentiation of osteoblast.

BACKGROUNDAcute renal failure following coronary artery bypass grafting (CABG) surgery is associated with high morbidity and mortality. Approximately half of all patients who develop acute kidney injury (AKI) subsequently develop acute renal failure (ARF). The purpose of the study was to compare early transient changes in renal function within the first post-operative week following CABG in patients that were either off-pump or on-pump.

METHODSEight hundred and forty-nine consecutive patients with isolated CABG in a single institution between January 1990 and August 2006 were retrospectively analyzed, including 518 off-pump and 331 on-pump patients. A multivariate Logistic regression model was constructed to identify risk factors for the development of AKI.

RESULTSSixty-one off-pump patients and 63 on-pump patients developed AKI. Risk factors for the development of post-operative AKI included an ejection fraction > or =50% or < or =30%, a pulse pressure > or =60 mmHg, peripheral vascular disease, diabetes, emergent procedure, triple-vessel disease, body mass index, peri-operative and post-operative. intra-aortic balloon pumping, NYHA class III and IV, and cardiopulmonary bypass. An ejection fraction > or =50% and peri-operative and post-operative intra-aortic balloon pumping were protective (OR <1). Peak serum creatinine for post-operative AKI was noted 12 hours and 24 hours in the off-pump and on-pump patients, respectively. Serum creatinine kinetics revealed rapid recovery in the 24th to 48th hour (off-pump) and the 48th to 72nd hour (on-pump).

CONCLUSIONRenal protection strategies are indicated from general anesthesia induction until 48 and 72 hours post-operatively in off-pump and on-pump patients, respectively.

Acute Kidney Injury ; etiology ; Aged ; Coronary Artery Bypass ; adverse effects ; Coronary Artery Bypass, Off-Pump ; adverse effects ; Creatinine ; blood ; Female ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the effect of maternal vitamin D deficiency on lung morphogenesis and platelet-derived growth factor-A (PDGF-A) expression in rat offspring.

METHODSSprague-Dawley (SD) female rats were randomly divided into two groups: normal control and vitamin D deficiency, with 6 rats in each group. The vitamin D deficiecy group was kept away from light and fed with the forage without vitamin D. After 2 weeks, the rats were mated with normal SD male rats. The morphological changes of fetal rat lungs on day 20 of gestation and 1-day-old neonatal rat lungs were observed by light microscope and electronic microscope. The levels of PDGF-A mRNA and protein in fetal and neonatal rat lungs were measured by reverse transcriptase-polymerase chain reaction (RT-PCR) technique and Western blot method respectively.

RESULTSUnder the light microscope, smaller alveolar space, smaller diameter of the respiratory membrane and thicker alveolus mesenchyma were observed in lungs of fetal and neonatal rats from the vitamin D deficiency group compared with the controls (P<0.05). Under the electronic microscope, fewer lamellar bodies but more glycogen deposition in intracytoplasm were observed in the lungs of fetal rats from the vitamin D deficiency group compared with the controls. There was an increased number of empty lamellar bodies in neonatal rats from the vitamin D deficiency group. The levels of PDGF-A mRNA and protein in lungs of fetal and neonatal rats from the vitamin D deficiency group were significantly lower than the controls (P<0.05).

CONCLUSIONSMaternal vitamin D deficiency during pregnancy may inhibit the development of lung morphogenesis and PDGF-A expression in late fetal and neonatal rats. The low expression of PDGF-A may be involved in the inhibitory effect of vitamin D deficiency on the lung development.

Animals ; Calcifediol ; blood ; Female ; Lung ; embryology ; pathology ; ultrastructure ; Platelet-Derived Growth Factor ; analysis ; genetics ; metabolism ; Pregnancy ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Vitamin D Deficiency ; embryology ; metabolism

Objective To evaluate the safety and efficacy of single and local use of a China-made compound betamethasone injection in the treatment of lichen simplex chronicus. Methods A multi-center,randomized, parallel controlled study was conducted. Patients with lichen simplex chronicus were divided into test and control groups to receive a single dose of intralesional compound betamethasone injection made in China or Schering-Plough Labo N.V. Belgium. Patients were visited for the evaluation of efficacy and safety of the China-made injection at the beginning of the treatment (DO), on week 2 (D14) and 4 (D28) after the initiation of treatment. Results A total of 144 patients were enrolled, among which, 68 in the control group and 71 in the test group completed the trial. FAS analysis on week 4 revealed that the response rate and healing rate were 86.11% and 59.72% in the control group, respectively, 86.11% and 54.17% in the test group, respectively (χ2=0.00,0.45,respectively,both P>0.05).There was no severe adverse event in either group after the treatment, and only mild atrophoderma occurred in one patient in the control group, which was improved spontaneously within several weeks of follow-up. There was no statistically significant difference in the occurrence of side reactions between the two groups (P> 0.05). Conclusion The China-made compound betamethasone injection is effective and safe for the treatment of lichen simplex chronicus.

OBJECTIVETo evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbi- dity postoperatively.

METHODSFifty-four octogenarians and nonagenarians patients were enrolled in the study, receiving surgical repair of hip fracture in our hospital from January 2006 to January 2010. High risk factors were recorded preoperatively in detail. Complications and survival state were followed up by telephone for 2 years postoperatively. All the data were analyzed by Chi-square test with SPSS 13.0.

RESULTSTwenty-six males (48.1%), aged from 80 to 94 years with a mean age of 84.2 years, and twenty-eight females (51.9%), aged from 80 to 95 years with a mean age of 83.4 years, were presented in the cohort study. The hip traumas were caused by daily slight injuries (52 cases) and car accidents (2 cases), respectively. Twenty-eight patients (51.9%) with femoral neck fracture while 26 patients (48.1%) with intertrochanteric fracture were diagnosed through an anterior-posterior pelvic radiophotograph. In this series, 39 patients (72.2%) suffered from one or more comorbidities preoperatively. The morbidity was 48.1% and the major cause was urinary tract infection, while a significant difference was noted between females and males. The mortality was 20.4% with a predominant cause of acute renal failure.

CONCLUSIONSThe gender should be considered as a critical high risk factor in octogenarians and nonagenarians with hip trauma postoperatively. Females are more likely to suffer complications postoperatively, which is especially obvious in senile patients over 80 years (P less than 0.05). Urinary tract infection is the most frequent complication after hip surgery, followed by low limb embolism and malnutrition. The mortality is dramatically greater in patients over 80 years old than those below, and major causes are acute renal failure, multiple organ dysfunction syndrome and mental deterioration. Multidisciplinary consultations and mental assessment are encouraged in patients over 80 years old after hip trauma and surgery. Hip fractures in octogenarians and nonagenarians deserve special attention because of their advanced age and comorbidities.

Aged, 80 and over ; Cohort Studies ; Femoral Neck Fractures ; surgery ; Hip Fractures ; surgery ; Humans ; Risk Factors ; Treatment Outcome