Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Murine-Derived ; Antigens, CD20 ; immunology ; Antineoplastic Agents ; therapeutic use ; Child, Preschool ; Female ; Humans ; Lymphoma, B-Cell ; drug therapy ; Rituximab ; Treatment Outcome

Objective To evaluate the medical efficiency of sample hospitals in Sanming city before and after Sanming health care reform.Methods One tertiary hospital,two general county hospitals and two TCM county hospitals in Sanming were sampled for the study.Two dimensions(the intensity index of medical work and work efficiency index)were selected.In addition,six indexes were identified,namely the number of discharged patients,number of outpatients and emergency diagnostics,doctor′s daily workload per capita for inpatients,bed turnover times,bed utilization rate and average days of stay.Descriptive trend analysis and comprehensive index method were applied in turn to evaluate the longitudinal changes in medical efficiency at the sample hospitals before and after the medical reform.Results The five sample hospitals in Sanming were found with less days of stay in average,and three were found with year-by-year rise of medical efficiency index,with one of them rising from 1.57 to 2.42.Conclusions Sanming′s health care reform has effectively improved internal operational efficiency at the sample hospitals,and has well addressed the relationship of medical service efficiency and scale expansion.On the other hand,the relationship between work intensity and medical efficiency needs to be further balanced,resource allocation to be further optimized,and more priority to be put in the development of TCM hospitals.

Alzheimer Disease ; drug therapy ; genetics ; prevention & control ; Amyloid beta-Peptides ; genetics ; Animals ; Disease Models, Animal ; Mice ; Mice, Transgenic ; Phytotherapy ; Presenilin-1 ; genetics

BACKGROUND:It is crucial for us to find an objective and sensitive means for the assessment ofthe severitv and development of dementia,so as to make instant diagnosis and examination of therapeutic effect on patientswith vascular dementias(VD).Event related potential endogenetic eomponent P300 is proved closely correlated with the cognitive management of examinees but not with stimulus property,thereby considered as one of the most valuable and objective index for brain superior psychological activity.OBJECTIVE:To study the role and significance of events related potential P300,providing objective basis for clinical diagnosis and therapeutic assessment for patients with VD.DESIGN:Non-randomized simultaneous controlled explorative study based on patients. SETTING:Neurological department and electromyography department in aprovincial hospital and neurological department in a medical college hospital.PARTICIPANTS:Between February 2000 and June 2001,64 patients were of VD at neurological clinic and ward ofthe Second Affiliated Hospital of Chongqing Medical College,including 38 males and 26 females with theaverage age of(66.0±4.6)years(VD group).Culturallevel:19 cases re-ceiyed over senior school education,31 cases of junior school education and14 cases of illiteracy.Meanwhile 60 inpatients without VD were enrolled(non-VD group)including 35 males and 25 females withthe average age of(68.0±3.7)years.Culturallevel:senior school or above,15 cases,junior school, 29 cases and illiteracy,16 cases.METHODS:Mental sate of both VD and non-VD groups were assessed with mini-mental state examination(MMSE),and tested with P300 potential observing the variability of latency and amplitude of P300 in patients.Both methods were compared between VD group and non-VD group, moreover relationship between P300 latency and MMSE scores was also explored.MAIN OUTCOME MEASURES:Variability of P300 latency and amplitude Relationship between P300 latency and MMSE scores.RESULTS:P300 latency was found prolonged in 74% and 7% of VD group and non-VD group respectively,with obvious significance between them,meanwhile prolonged P300 latency was proved closely correlated with the MMSE scores(r=0.609 6,P＜0.05).CONCLUSION:P300 latency can be considered as an obiective predictor for the earlier diagnosis and the assessment of therapeutic effects in patients with VD.

Objective To understand the clinical characteristics of elderly patients aged 60 years and over in Anhui Province who receive maintenance hemodialysis (MHD).Methods Clinical data of MHD patients in hemodialysis centers of 26 hospitals in Anhui Province from March 31, 2014 to January 1, 2014 were collected.With non-elderly MHD patients (aged over 18 old and under 60) serving as controls, similarities and differences in the primary disease, vascular access, nutritional status, mineral and bone disorders (MBD), and other related aspects in MHD patients were compared.Results The top three original diseases for elderly patients were chronic glomerulonephritis (CGN) (32.8 ％), hypertensive nephrosclerosis (HNS) (27.7 ％) and diabetic nephropathy (DN) (26.2％).The proportion of patients with DN and HNS in the elderly was higher than in the control group (P ＜ 0.001).Vascular access types in elderly MHD patients were arteriovenous fistula (AVF) (89.4 ％), tunneled cuffed catheter (TCC) (8.9 ％), and temporary venous catheter (1.3％).The proportion of patients with AVF was lower (P＜0.001) and the proportion of patients with TCC was higher (P＜0.001) in the elderly group than in the control group.The incidence of anemia was higher in the elderly patients than in the control group (P＜0.05);the proportion of elderly patients with hemoglobin (Hb) levels was 30.3％, in which had no significant difference as compared with the control group (P ＞ 0.05).The incidence of hypoalbuminemia was 21.2％ in elderly patients, which was higher than in the control group.The proportions of elderly MHD patients with normal levels of adjusted serum calcium, serum phosphorus, and intact parathyroid hormone (iPTH) were 52.0％, 27.9％ (higher than in the control group, P＜0.001), and 47.9％, respectively, while there was no difference in adjusted serum calcium and iPTH between the two groups (P＞0.05).The treatment rates for low serum calcium,hyperphosphatemia and secondary hyperparathyroidism (SHPT) in elderly patients were 50.6％,51.6％ and 71.5％, respectively, which had no significant difference as compared with those in the control group (P＞0.05).Conclusions Elderly patients with MHD show distinct characteristics in primary diseases, vascular access types, and nutrition and MBD status, including higher proportions of HNS and DN as their primary diseases.The type of vascular access is still dominated by AVF, and the proportion of TCC is higher.The nutritional status is poor, with a lower incidence of high phosphorus and a higher incidence of low iPTH.Efforts should be made to promote compliance in elderly patients to better control MBD, improve nutritional status and increase safety and effectiveness of treatment.

Objective To analyse protein tyrosine phosphatase 1B (PTP1B) gene mutation in myeloproliferative neoplasms (MPN).Methods DNA sequencing technology was used to detect DNA sequences of PTP1B in MPN patients (n =84) and normal controls (n =37).Results For Exon1-6,Exon9 and Exon10,84 cases of MPN patients and 37 cases of control group were not detected mutation.For EXON 8,18 of 84 MPN patients had Exon8 C/T heterozygous mutation and 10 of 37 normal controls were detected C/T heterozygous mutation.There was no significant difference between MPN patients and normal controls (x2 =0.453,P =0.501).Exon7 was detected in 38 MPN patients and 2 cases of patients were found C/T heterozygous mutation,while in the control group,1 case with G/C heterozygous mutation.All of the cases were not detected homozygous mutation.Conclusion Using DNA sequencing technology to detect gene mutations of PTP1B,there is no significant difference between MPN patients and normal controls.

Objective To study the inhibitory effect of panax notoginseng saponins (PNS) on 3-nitrotyrosine (3-NT) formation in brain induced by heme/NO2 -/H2O2 or ONOO - pathways in vitro. Methods According to the two major pathways of 3-NT formation in vivo, the models of protein nitration induced by heme/NaNO2/H2O2 or ONOO-system were established, respectively, in vitro. Bovine serum albumin (BSA)/rat plasma protein or rat brain homogenate protein were utilized as reactive substrates in both systems. Samples were divided into blank-control group, 3-NT group and PNS group (including low-, medium-and high-concentration subgroups). In 3-NT group, samples were exposed to heme/NaNO2/H2O2 or ONOO-system, respectively, at 37℃for 30 min, whereas in PNS group, samples were pre-incubated with PNS (at final concentrations of 50 mg/L, 100 mg/L, and 200 mg/L) at 37℃for 5 min before the nitrating system exposure. The 3-NT level in each group was detected by Western blot assy. Results Compared with the blank-control group, both heme/NaNO2/H2O2 and ONOO-system can induce significant 3-NT generation in BSA/rat plasma protein or rat brain homogenate protein (P<0.05). Compared with model group, PNS pre-treatment markedly inhibited 3-NT expression in BSA/rat plasma protein in a dose-dependent manner (P<0.05), the inhibitory effect of low intervention on the level of 3-NT in rat brain homogenate protein was not significant (P>0.05). Medium- and high-concentrations of PNS pre-treatment markedly inhibited 3-NT accumulation, with maximum effect at the concentration of 200 mg/L (P<0.05). Conclusion Medium- and high-concentrations of PNS can inhibit 3-NT formation in brain tissue mediated by either heme/NO2-/H2O2 or ONOO-pathways, implying that potential neuroprotective action against 3-NT involves pathological conditions, like trauma, stroke, and neurodegenerative diseases.

Objective To acknowledge the quality of life (QOL) in patients after lung transplantation and to explore related factors. Methods A cross- sectional study design and a convenience sampling were performed in this research. Totally 30 patients after lung transplantation were investigated. The questionnaires which used to explore the quality of life were Short Form 36 Health Survey Questionnaires (SF-36) and Revised Airways Questionnaires 20 (AQ20-R). Related state were surveyed by questionnaires consisted of demographic questionnaires, Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Medical Coping Mode Questionnaires (MCMQ). Statistical analysis was performed by SPSS 20.0 software. Correlation analysis and multivariate analysis were performed using Pearson linear correlation analysis and multi-linear regression. Results The scores among the 8 dimensions of SF-36 were(34.48±16.73)-( 71.63±22.83), lower than those of norms(Z=-9.684--2.817, P<0.05 or 0.01). Somatic pain scored the highest (71.63±22.83), while physiological function scored the lowest (34.48±16.73). The mean score of AQ20-R was 7.93±5.21. The major two problems that manifested QOL were: uncomfortable feeling of lung caused by strong scent, smog or perfume, exhausted feeling after having a cold. The mean scores of SAS and SDS were 44.33±9.33,48.05±9.80, higher than those of norms, which were 33.80 ± 5.90, 41.88 ± 10.57 (t=6.1833, 3.4458, P < 0.01). The scores among the 3 dimensions of MCMQ were 8.93 ± 2.08, 16.10 ± 2.28, 3.63 ± 1.33 and the differences were significant in 3 dimensions compared with those norms, which were 19.48±3.81, 14.44±2.97, 8.81±3.17(t=-27.7281, 3.9885,-21.3878, P<0.01). Conclusions In SF-36, role-physical of patients after lung transplantation was the worst dimension, while bodily pain was the best dimension of QOL. The QOL of patients after lung transplantation were almost worse than normal people. The related factors of QOL in patients after lung transplantation maybe:anxiety, depression and medical coping style.

objective To examine nuclear transIocation of peroxisome proliferator-activated receptor γ(PPARγ)in rats following focal cerebral ischemia/reperfusion(I/R),and to explore the significance of altered PPARγ,nuclear translocation in ischemic brain injury.Methods Healthy adult male SD rats underwent 60-min cerebral artery occlusion followed by reperfusion of 4,8,or 24 h,respectively.The cytoplasmic-to-nuclear shuttling of PPARγ was characterized by Western blot,immunohistochemical and immunofluoreseence staining.The effects of PPARγ agonist rosiglitazone (Ros) and antagonist GW9662 on I/R-induced PPARγ nuclear translocation were also examined in the present study. Furthermore,TTC staining war adopted to determine the change in cerebral infarction volume. Results (1)Western blot analysis revealed an increase of PPARγ in the nucleus and a simultaneous reduction in the cytosol following ischemia and reperfusion for 4 h(tcytosol=9.03,tmuclear=27.19,P=0.00).Prolonged the reperfusion further enhanced this I/R induced PPARγ translocation in a time-dependent manner.Using immunohistochemistry and immunofluorescence,nuclear PPAR γ positive staining increased from 48.3%in the sham control to 80.3% following ischemia and reperfusion for 24 h.(2)Western blot analysis revealed that PPARγ agonist Ros further increased I/R-induced nuclear enrichment of PPARγ,whereas PPARγ antagonist GW9662inhibited I/R-stimulated change in PPARγ.(3)When compared to the L/R group using TTC staining,Ros treatment significantly decreased the infarction volume by 48.40%(15.46±4.94 versus 29.96±3.39,t=5.93.P=0.00),whereas GW9662 increased by 58.95%(47.62±4.93 versus 29.96±3.39,t=7.23,P=0.00).Conclusions Cerebral I/R injury induces PPARγ translocation from the cytosol to the nucleus.This change may represent an intrinsic neuroprotective response against brain I/R injury.

Objective To investigate neuroprotective function of peroxisome proliferator-activated receptor gamma (PPARγ) agonist, rosiglitazone against reperfusion injury after focal cerebral ischemia in mice model.Methods To establish cerebral isebemia-reperfusion injury mice model, adult male mice underwent 2 hours of middle cerebral artery occlusion followed by 22 hours reperfusion (MCAO/R). One hour before MCAO/R, mice were treated with either vehicle (MCAO/R group) or rosiglitazone (6 mg/kg, rosiglitazone group). 2,3,5-triphenyhetrazolium chloride (TIC) staining was applied to determine the volume of cerebralinfarction.TheneurologicaldeficitwasscoredatZeaLonga 5-pointscale. Myeloperoxidase (MPO) activity was measured in brain tissue as an index of neutrophil accumulation. RT-PCR, immunohistochemistry and Western blot were performed to examine the mRNA and protein expression of pro-inflammatory mediators (ICAM-1, IL-1β and COX-2).Results (1) The volume of cerebral infarction in rosiglitazone group was significantly decreased from that of MCAO/R group ( 29. 1 ± 6. 6 vs 57.8 ± 9. 7 ,t = 5. 980, P < 0. 01 ), and rosiglitazone markedly improved neurological function in treated mice than MCAO/R mice(1.2 +0.4 vs 3.3 ±0.8, t =5.812, P<0.01). (2) Compared with MCAO/R group, MPO activity in the rosiglitazone-treated group was significantly lower ((0. 049 + 0. 005 ) U/g vs (0. 083 ±0. 008) U/g,t =5. 904, P <0. 01 ). (3) The mRNA and protein expression of pro-inflammatory mediators (ICAM-1, IL-1β and COX-2) in rosiglitazone group were also significantly decreased from those in MCAO/R group, as demonstrated by RT-PCR (0.313 ±0.024, 0.205 ±0.007, 0.359 ±0.060, t = 7.464, 19.656, 29.319, P <0.01, respectively) and Western blot (0.274±0.014, 0.205±0.025, 0. 146±0.015, t=79.909, 21.392, 95. 105, P<0.01, respectively). ConclusionThe present study suggests that PPARγ agonist, rosiglitazone, has neureprotective properties to cerebral ischemia-reperfusian injury and that the protection is partially mediated via anti-inflarmmatory actions.