BACKGROUND:The number of patients in need of organ transplantation in China is increased by more than 10%per year. Due to the lack of voluntary donations, China is facing a more severe donor shortage than other countries. What are the specific reasons for the shortage of donor organs in China? What is the attitude toward organ donation in Chinese citizens? What factors are affecting the implementation of organ donation in Chinese citizens?
OBJECTIVE:To investigate the influence of traditional Chinese ideas on the wil ing of Chinese citizens toward organ donation after death.
METHODS:By random cluster sampling, 900 persons selected from different social classes as research objects received questionnaire survey. Self-made questionnaire consisted of cognition, attitude and behavior of the public in face of organ donation.
RESULTS AND CONCLUSION:(1) 55.16%of persons thought that the main purpose of organ donation was to help others, 24.22%thought that the main purpose of organ donation was a manifestation of social morality, 11.94%thought that organ donation was the continuation of their lives. (2) There were 70.00%who said donations should be used for the cause of organ transplantation, in order to save more lives, and the average score was 2.53 points;while the number of persons who proposed donor organs would be applied in medical teaching was similar to that in pathological anatomy, and the average score was 1.72 and 1.75, respectively. (3) 65.01%of the public supported cardiopulmonary death standard to judge death, 24.33%supported brain death standard to judge death, and moreover, 10.66%of people did not know what to take. (4) 50.52%of people thought that the main factors affecting the organ donation was traditional Chinese culture and ideas, fol owed by the donation program and family feelings. The study found that traditional Chinese culture and ideas are the main factor affecting organ donation in the public, most people think that cardiopulmonary death standard is better to judge death and that the main purpose of organ donation is to help others that organ donation should be applied firstly to organ transplantation in order to save more lives.

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

Objective To investigate the potential role of angiotensinⅡ(AngⅡ)-angiotensinⅡreceptor 1 (ATRI) pathway on inflammatory activation in the lung of rats. Method Twenty four Sprague-Dawley rats were randomly divided into four groups: control group, Ang II group, AngⅡ+losartan group and losartan group. Lung wet/dry weight (W/D) was recorded to assess lung injury. The total lung homogenates were prepared to detect nuclear factor-kappa B (NF-?B) activation by electrophoretic mobility gel shift assary (EMSA), tumor necrosis factor (TNF)-?mRNA expression by reverse transcription polymerase chain reaction (RT-PCR), myeloperoxidase (MPO) and malondialdehyde (MDA) by colorimetry. Plasma yon Willebrand Factor (vWF) were assessed by enzyme-linked immunosorbent assay (ELISA). Meanwhile, pathological changes were examined under optical microscope. Results Histologically, alveolar edema, hemorrhage, and massive inflammatory cell infiltration were observed in AngⅡgroup, but not in control group and losartan group. Compared with AngⅡgroup, histological injury was lesser in AngⅡ+ losartan group. In AngⅡgroup, lung W/D, NF-?B activation, TNF-?mRNA expression, MPO, MDA and vWF were markedly higher than those in the other three groups. There were not significant differences of lung W/D, NF-?B activation, TNF-?mRNA expression, MPO, MDA and vWF in control group, AngⅡ+ losartan group and losartan group. Conclusions Systemic infusion of AngⅡcould up- regulate inflammatory mediator expression and induce lung injury in rats. AngⅡ, acting mainly through ATRI, induced inflammatory activation in the lung of rats.

Objective To explore possible associations between host polymorphism of HLA classⅡgenotypes and advanced hepatosplenic schistosomiasis japonica.Methods 45 advanced schistosomiasis patients(experimental group) and 44 age,and sex,matched patients with chronic schistosomiasis(control group) from the same area were investigated for their HLA class II gene DRB genotypes by genotyping the alleles using microarray DNA chip.The correlation of allele frequencies to advanced hepatosplenic schistosomiasis was compared for the two groups.Results HLA,DRB1*04x exhibited markedly higher frequency in advanced patients than that in control group(P

Cinobufacino injection is a significant anti-tumor medicine for the treatment of various tumors in clinic, which was made from water extraction of the skin of Bufo bufo gargarizans. In present paper, HPLC-DAD-FT-ICR-MS method was used to identify the major bufadienolides in cinobufacino for the first time. Solid-phase extraction with dichloromethane and silica was used to enrich the total bufadienolides in cinobufacino. Based on the UV and high resolution MS/MS data, 33 bufadienolides were analyzed and characterized. Among them, eight compounds were identified by comparing with standard references unambiguously. This study elucidated the major bufadienolides in cinobufacino, which provided material foundation of cinobufacino and will be benefit for the further pharmacological research.
Amphibian Venoms ; chemistry ; Animals ; Bufanolides ; analysis ; chemistry ; Bufo bufo ; Chromatography, High Pressure Liquid ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

As an important part of traditional Chinese medicine (TCM), mineral medicine plays an irreplaceable role. However, little has been reported on its species and valence state of heavy metals and deleterious elements, and also the relevance to pharmacological effect and toxicology. The present paper, in a new perspective, summarized the determination of the species and valence state of heavy metals and deleterious elements in recent years, discussed the progress of the pharmacological effect and toxicology, and prospected for future study which might provide reference for mineral medicine.
Animals ; Drug Contamination ; statistics & numerical data ; Drug Therapy ; Humans ; Medicine, Chinese Traditional ; Metals, Heavy ; analysis ; toxicity ; Minerals ; analysis ; pharmacology

OBJECTIVETo clarify drug properties of components in Euodiae Fructus.

METHODThe rat cold syndrome model was induced by cold water stress method. The content of neurotransmitters sand hormones such as DA, 5-HT, NE, AChE and 17-OHCS in serum of model rats were taken as the indexes to evaluate drug properties of components in Euodiae Fructus.

RESULTEuodiae Fructus and its components could correct or relief the content of energy metabolism and substance metabolism-related neurotransmitters sand hormones in serum of model rats with water-stressed cold syndrome.

CONCLUSIONEuodiae Fructus and its components are proved to show hot property.

Animals ; Cold Temperature ; adverse effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gastric Mucosa ; drug effects ; pathology ; Male ; Medicine, Chinese Traditional ; Neurotransmitter Agents ; blood ; Rats ; Rats, Wistar ; Stomach Ulcer ; blood ; drug therapy ; physiopathology ; Stress, Physiological

AIM: To study the chemical constituents of the roots of Achyranthes bidentata Bl. METHODS: The chemical constituents were isolated and purified by macroporous adsorptive resin D101, silica gel, and ODS column chromatographies and preparetive HPLC. Their structures were elucidated on the basis of 1D and 2D NMR analyses. RESULTS: Two feruloyl tyramine glycosides and seven triterpenoid saponins were obtained and identified as N-trans-feruloyl-3-methoxytyramine-4'-O-β-D-glucopyranoside (1), N-trans-feruloyl-3-methoxytyra mine-4-O-β-D-glucopyranoside (2), PJS-1 (3), chikusetsusaponin IVa (4), oleanolic acid 3-O-[β-D-glucuronopy ranoside-6-O-methyl ester]-28-O-β-D-glucopyranoside (5), oleanolic acid 3-O-[β-D-glucuronopyran-oside-6-O-ethylester]-28-O-β-D-glucopyranoside (6), oleanolic acid 3-O-[β-D-glucuronopyranoside-6-O-butyl ester]-28-O-β-D-glucopyranoside (7), ginsenoside R(0) (8) and hederagenin-28-O-β-D-glucopyranosyl ester (9). CONCLUSION Compound 1 is a new feruloyl tyramine glycoside, while compounds 2 and 9 are reported from A. bidentata for the first time.
Achyranthes ; chemistry ; Glucosides ; chemistry ; isolation & purification ; Molecular Structure ; Plant Extracts ; chemistry ; Plant Roots ; chemistry ; Saponins ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification ; Tyramine ; analogs & derivatives ; chemistry ; isolation & purification

OBJECTIVETo evaluate the effect of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients.

METHODSRandomized controlled trials (RCTs) that studied the effect of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients were searched from Pubmed, Embase, The Cochrane Library, CBM during January 1990 to June 2010. The quality of the RCTs was evaluated. Meta-analysis of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients were conducted using the methods recommended by the Cochrane Collaboration. Definition of early tracheotomy was the patients performed tracheotomy during 10 days after admission to hospital or ICU, mechanical ventilation or intubation. Late tracheotomy was defined tracheotomy performed beyond 10 days of admission to hospital or ICU, mechanical ventilation or intubation; or those mechanically ventilated through intubation all the time.

RESULTSEight hundred and twenty eight patients, 411 in early tracheotomy group and 417 in late tracheotomy group, from 6 RCTs were included in the analysis of data. The meta-analysis showed that early tracheotomy could reduce mortality of patients (RR: 0.81, 95%CI: 0.66 - 0.99, P = 0.04); but it didn't significantly alter the incidence of pneumonia (RR:0.89, 95%CI: 0.68 - 1.17, P = 0.41), mechanical ventilation days (mean difference: -2.19, 95%CI: -9.86 - 5.49, P = 0.58) and length of ICU stay (mean difference: -5.65, 95%CI: -17.11 - 5.81, P = 0.33).

CONCLUSIONSIn critically ill adult patients who require prolonged mechanical ventilation, early tracheotomy performed at an earlier stage reduces the mortality, but doesn't reduce the incidence of pneumonia and shorten the mechanical ventilation days and ICU length of stay. But more high quality RCTs are required to confirm it.

Humans ; Prognosis ; Randomized Controlled Trials as Topic ; Respiration, Artificial ; Time Factors ; Tracheotomy

Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191 ), followed by homosexual transmission ( 19.4%, or 37/191 )and injection drug use (5.8%, or 11/191 ). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and malesex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.