40/h) and non-severe group(n=15,AHI 5-40/h).Anthropometric measurements,fasting plasma glucose,insulin,blood fat,and CT quantitative measurement of abdominal adipose tissue were recorded. Results Insulin resistance index(HOMA-IR) in patients with OSAS was related to hypoxia independently of obesity variables.The severe group was characterized by more serious metabolic disorders and higher prevalence of metabolic syndrome than the non-severe group.OSAS was positively associated with an increased metabolic disorders risk for the severe group versus the non-severe group(OR=8.8).Using the receiver operating characteristic(ROC) curve analysis,waist circumference had the greatest areas under the ROC curves compared with body mass index and neck circumference.The results of multiple stepwise regression of lowest pulse oxygen saturation(LSpO2)during overnight sleep indicated that neck circumference followed by epworth sleepiness score(ESS) entered the equation(P

Aged ; Biopsy ; Bone Marrow Examination ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, B-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

The paper introduces an overview of Shanghai medical security system, analyzes its effectiveness and challenges, and put forward overall goals and key tasks in the future. Shanghai has formed a multiple, medical security system and basically achieved the short-term goal of medical security system establishment which was requested to put forward in national health system reform. Shanghai medical insurance system has played a positive role in promoting economic and social development and reducing the burden of medical expenses. To further implement requirements of national health system reform, Shanghai will be conducting the integration of different schemes , narrow down the gap of benefit packages, improvement of health care management and the initiatives of nursing care insurance to further improve the medical security system, and strive to cover 98% of household population and 90% resident population in 2012.

OBJECTIVETo explore the clinical roles of Jiawei Shentong Zhuyu Decoction (JSZD) in preventing the occurrence of failed back surgery syndrome (FBSS), and to observe its effect on serum tumor necrosis factor-alpha (TNF-alpha).

METHODSTotally 100 patients prepared for surgical operation due to lumbar intervertebral disc herniation were randomly assigned to the treatment group and the control group according to random number table, 50 cases in each group. Patients in the treatment group additionally took JSZD, one dose per day, taken in two portions, once in the morning and once in the evening. Those in the control group took Celecoxib Capsule (200 mg each time, once per day) and Mecobalamin Tablet (0.5 mg each time, 3 times per day). They only took Mecobalamin Tablet from the 11th day. All patients were treated for 30 days. Japanese Orthopaedic Association (JOA) score was performed before treatment, at week 1, after treatment, at 6 months of followed-ups, and at 12 months of followed-ups. And the levels of TNF-alpha in the peripheral blood were observed before treatment and at one month after treatment.

RESULTSTotally 93 patients completed the followed-up study. The JOA scores were improved after treatment, at 6 and 12 months of followed-ups (P < 0.05, P < 0.01). The JOA score at 6 months of followed-ups was superior in the treatment group to that of the control group (P < 0.05). Five patients (accounting for 10.6%) suffered from FBSS in the treatment group, while 9 (accounting for 19.6%) suffered from FBSS in the control group. The treatment group was superior to the control group (P < 0.05). The TNFalpha level was improved after treatment in the two groups. Of them, the improvement of TNF-alpha in the treatment group was better than that of the control group (P < 0.05).

CONCLUSIONThe application of JSZD was effective for preventing the occurrence of FBSS, and improved the serum TNF-alpha level.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Failed Back Surgery Syndrome ; prevention & control ; Female ; Humans ; Intervertebral Disc Displacement ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; blood ; Young Adult

BACKGROUND: Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration (CVVH). Hence blood hemoperfusion with resin adsorption combined CVVH (HP+CVVH) has higher ability of mediator clearance, and can improve clinical outcomes in theory. This study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration (HP+CVVH) on plasm cytokines like TNF-α, IL-1β, IL-6, cellular immunity and prognosis in patients with multiple organ dysfunction syndrome (MODS). METHODS: This was a prospective, randomized clinical trial. A total of 30 patients who had been diagnosed with MODS were enrolled in this study. Patients were randomly allocated to routine treatment+HP+CVVH group (treatment group) and routine treatment+only CVVH group (control group). In the treatment group, patients received blood hemoperfusion with resin adsorption for 2 hours, and then received CVVH for 10 hours every day. In the control group, patients received CVVH for 12 hours only every day. The patients in the two groups received blood purification therapy for three days. The plasma of patients in the treatment group was obtained at 0, 2, 12, 24, 26, 36, 48, 50, 60 hours, 5th day, 7th day and 10th day, respectively. The plasma of patients in the control group was obtained at 0, 12, 24, 36, 48, 60 hours, 5th day, 7th day and 10th day, respectively. APACHE II score, T-lymphocytes subpopulations, blood lactate acid concentration, heart rate, breathing rate, and oxygenation index were observed. RESULTS: Plasma cytokines like TNF-α, IL-1β, IL-6 decreased markedly after HP (P<0.01);T-lymphocytes subpopulations CD3+, CD4+, CD8+, CD4+/CD8+ increased after HP+CVVH or only CVVH. The plasma concentrations of TNF-α, IL-1β and IL-6 in the two groups were not markedly different at 12, 36, and 50 hours. But on the 5th day, the plasma concentrations of TNF-α, IL-1β and IL-6 in the treatment group were lower than those in the control group (P<0.05). On the 28th day, 5 patients died in the treatment group, and 6 patients in the control group. CONCLUSIONS: Both HP+CVVH and CVVH can clean plasma cytokines like TNF-α, IL-1β, and IL-6, and improve cellular immunity and clinical symptoms and signs of patients. Compared with only CVVH, the plasma concentrations of TNF-α, IL-1β and IL-6 were lower on the 5th day, and patients have an increased survival rate on the 28 day in the HP+CVVH group.

OBJECTIVETo observe the expression profiles of osteoblast-related genes in human mesenchymal stem cells (MSCs) derived from bone marrow during osteogenic differentiation.

METHODSMSCs were induced to differentiate with MSC osteogenic differentiation medium for 7, 14, 21 and 28 days respectively. Alizarin Red staining was used to detect matrix mineralization. Expression of osteoblast-related genes, including osteocalcin, osteopontin, Runt-related transcription factor 2 (Runx2), alkaline phosphatase and collagen type 1, was assessed with quantitative reverse transcription-polymerase chain reaction.

RESULTSOn day 14 after induction of differentiation, cells were stained positively with Alizarin Red. The expression levels of these genes exhibited an upward trend as induction time was prolonged. Exposure to osteogenic differentiation medium less than 21 days did not significantly induce osteocalcin expression; osteocalcin expression levels in the differentiated cells induced for 21 and 28 days were 1.63 and 2.46 times as high as the undifferentiated cells respectively (all P<0.05). Stimulation with MSC osteogenic differentiation medium over 14 days significantly enhanced bone marrow-derived MSCs to express osteopontin and Runx2 genes (all P<0.05). Osteogenic differentiation medium could significantly induce the expressions of alkaline phosphatase and collagen type1 genes (all P<0.05). Their expressions reached the peak levels on day 21, which were increased more than 4- and 3-fold respectively.

CONCLUSIONHuman bone marrow-derived MSCs could exhibit the sequential expression pattern of osteoblast marker genes during osteogenic differentiation in vitro.

Alkaline Phosphatase ; genetics ; Cell Differentiation ; Cells, Cultured ; Collagen Type I ; genetics ; Core Binding Factor Alpha 1 Subunit ; genetics ; Genetic Markers ; Humans ; Mesenchymal Stromal Cells ; metabolism ; Osteocalcin ; genetics ; Osteogenesis ; Transcriptome

Objective To determine effect of endurance training on the expression of fatty acid translocase FAT/ CD36 in skeletal muscle of rats and the correlation between the expression and insulin sensitivity index (ISI). Methods Male Sprague-Dawley rats were randomly assigned to two groups:training group(T,n=13) and control group (C, n=10). Rats in group T were trained on treadmill six days a week for 7 weeks. Fat pads around testes and kidneys were weighted for calculating the percentage of fat pads vs body weight. Serum total cholesterol (TC), triglyceride (TG),nonesterified fatty acids(NEFA) and fasting insulin(FINS) were measured. Western blot was used to detect FAT/ CD36 protein expression in quadriceps homogenate. The relation of FAT/CD36 expression to the ISI was analyzed. Results Markedly lower body weight,percentage of fat pads, TC,NEFA, and FINS were seen in group T after 7-week endurance training comparing to that in group C(P<0.01 ,P<0.01 ,P<0.01 ,P<0.05,and P<0.05,respectively). The FAT/CD36 protein expression and ISI were significantly higher in group T than in group C(P<0.01and P<0.05). A significant correlation between FAT/CD36 and ISI were found in group T(r=0.823,P<0.01 ),nut not in group C. Conclusion Seven-week endurance training improved insulin sensitivity and up-regulated the expression of FAT/CD36 for adapting the requirement of fatty acid transportation in skeletal muscle induced by enhanced lipid catabolism after endurance exercise.

The traditional fermentation engineering experiment requires a reform on the experimental con-tents and teaching pattern. According to the production process of industrial enzymes, we set up a two-week comprehensive experiment. The students designed and prepared the experiment by themselves. Moreover, the pattern of self-management was used in the process and the experiment scores included the self-assess-ment and objective assessment. It was proved that the new teaching pattern increased the study interesting of students, inspired their initiative and trained their spirits of team cooperation. The teaching effect was im-proved markedly and good ideas are also put forward to solve the possible problem.

Objective To investigate the axonal lesion in chronic inflammatory demyelinating polyneuropathy(CIDP).Methods Eighteen patients had undergone sural nerve biopsy.The clinical and electrophysiological distinction based on the different pathological changes were analyzed.Results Five patients with demyelination predominance which presented myelinated fiber with thin myelin.Three of them showed also mild axonal degeneration.Eight patients with axonal lesion predominance which presented Wallerian degeneration and regeneration of myelinated fibers.Three patients with mixed myelin and axon lesion of myelinated fibers and two with mild lesion.There was no significant difference between CIDP predominantly with axonal lesion and demyelination.Electrophysiological examination shows both axonal lesion and demyelination feature in some of the 2 types patients at the same time.Conclusions Axonal lesion is a common pathological change in CIDP and should not be considered as an exclusive criterion in diagnosis of the disease.Infiltration of macrophages is a common change.

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.