It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

Objective To study the relationship between Poly(ADP-ribose) glycohydrolase(PARG) and Poly(ADP-ribose) polymerase(PARP) in colorectal carcinoma.MethodsImmunohistochemical S-P staining was used to examine the expressions of PARG and PARP in 44 specimens human colorectal carcinoma.The positive rate of PARG and PARP in murine colon carcinoma CT26 cells was detected by flow cytometry before and after the treatment of PARG inhibitor Gallotannin.ResultsPARG and PARP expressed in colorectal carcinoma specimens was of positive correlation(r=0.300 01,P

Adult ; Aged ; Humans ; Male ; Papilloma, Inverted ; Paranasal Sinus Neoplasms ; Sphenoid Sinus ; pathology

OBJECTIVETo verify the clinical efficacy on chronic fatigue syndrome of qi deficiency syndrome treated with acupuncture at selective time and explore the effect mechanism.

METHODSEighty patients were randomized into a selective-time-acupuncture group and an acupuncture group, 40 cases in each one. Qihai (CV 6), Guanyuan (CV 4), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36) were selected in the two groups. In the selective-time-acupuncture group, acupuncture was used at 9:00am to 11:00am. In the acupuncture group, acupuncture was used at any time except in the range from 9:00am to 11:00am. No any manipulation was applied after the arrival of needling sensation. The treatment was given once every day, 10 day treatment made one session and two sessions of treatment were required. The fatigue scale was adopted to evaluate the efficacy before and after treatment in the patients of the two groups. The ratios among CD3+, CD4+ and CD8+ T cells in the peripheral blood were detected before ad b a after treatment.

RESULTSIn the acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment (all P<0.05). In the selective-time -acupuncture group, the total score of fatigue, the s core of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those hefore treatment (all P<0. 01). The improvements in the scores of the selective-time-acupuncture group were superior to the acupuncture group (all P<0. 05). The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in the two groups (all P<0. 05) and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group (P<0. 05), which was better than that in the acupuncture group (all P<0.05). The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the acupuncture group (P<0.05).

CONCLUSIONThe acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome of qi deficiency syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Fatigue Syndrome, Chronic ; immunology ; therapy ; Female ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Qi ; T-Lymphocyte Subsets ; cytology ; immunology ; Treatment Outcome ; Young Adult

Objective To study the changes of umbilical blood lactate,pH, blood sugar(BS),bilirubin, electrolyte, osmotic pressure (OP) in the newboms with fetal distress.Methods Thirty-five newborns with fetal distress (distress group) and 40 healthy new-borns (control group) were studied. Distress group were divided into distress group Ⅰ and distress group Ⅱ respectively, based on without or with neonatal asphyxia. Concentration of umbilical blood lactate was determined with enzyme method, pH, BS,serum total bilirubin (BIL), serum electrolyte (Na+ ,K+ ,Ca2+ ) and OP were analyzed respectively. Results 1. The difference of incidence of newborn asphyxia between distress groups (29.03%) and control group (2.50%) was statistically significant. 2. Compared with the controls and distress group Ⅰ, the umbilical blood lactate concentration significantly increased in distress group Ⅱ (P 0.05).The incidence of hyperglycemia was significantly elevated in distress groups than that in the control group. 4. Lactate concentration in distress I and distress fl group showed negative correlation with pH. Conclusion The concentration of umbilical blood lactate can provide the proof for diagnosis and prognosis of fetal distress.

To study the transport mechanisms of drugs for transplacental treatment of fetal tachyarrhythmia, MDCKII-BCRP and MDCKII cell models was used. MDCKII-BCRP and MDCKII cell monolayer model was used to investigate the bi-direction transport of sotalol, propranolol, propafenone, procainamide and flecainide. Drug concentrations were measured by HPLC-UV or chemiluminescence. The apparent permeability coefficient (P(app)), efflux rate (R(E)) and net efflux rate (R(net)) were calculated. Drugs with R(net) greater than 1.5 were further investigated using cellular accumulation experiments with or without a BCRP inhibitor. The R(net) of sotalol, propranolol, propafenone and procainamide were less than 1.5, while R(net) of flecainide with concentrations of 20 and 5 μmol x L(-1) were 1.6 and 1.9, respectively. The results showed that the transport of flecainide on MDCKII-BCRP cell monolayer could be mediated by BCRP; and the affinity increased when the concentration of flecainide decreased. Cellular accumulation experiments further suggested that accumulation of flecainide in MDCKII-BCRP cells was significantly lower than that in MDCKII cells in a concentration-dependent manner. BCRP inhibitor quercetin (50 μmol x L(-1)) significantly increased the accumulation of flecainide in MDCKII-BCRP cells (P < 0.05). Our preliminary data showed that flecainide but not sotalol, propranolol, propafenone or procainamide can be a substrate of BCRP. Thus the effect of flecainide may be affected by the BCRP in the maternal placental trophoblast membrane layer when treating fetal tachyarrhythmia.
Animals ; Biological Transport ; Cell Membrane Permeability ; Dogs ; Female ; Flecainide ; metabolism ; Madin Darby Canine Kidney Cells ; metabolism ; Placenta ; physiology ; Pregnancy ; Tachycardia ; drug therapy

Objective To investigate the influence of ethanol on the toxicokinetic profiles of ketamine and its main metabolite norketamine in rabbits.Methods Ketamine hydroehloride Wills administered orally to the rabbits at a dose of 15mg/kg in the ketamine-treated group.Ketamine hydrochloride combined with ethanol at a dose of 15 mg/kg and 3.0g/kg respectively was administered orally to those of the ethanol-coadministration group.The serum and urine samples were collected before administration and at different time points after drug delivery.The concentrations of ketamine and norketamine were determined by GC and GC/MS.Compartment model and toxicokinetics parameters were assessed by WinNorLin program.Results The mean serum concentration-time profile of ketamine after oral administration was fitted to a two-compartment open model with first order kinetics and not affected by ethanol.The K_(10),AUC and β of ketamine in rabbits of ethanol-coadministration group increased as compared with those of ketamine-treated rabbits,while T_(1/2K_(10)),T_(1/2β),A and C_(max)decreased(P＜0.05).Meanwhile,the K01,A,B and C_(max) of norketamine,the metabolite of ketamine increased in ethanol-coadministration group and T_(1/2K01) and Tmax were lowered than those in ketaminetreated group(P＜0.05).Difference of the other toxicokinetics parameters including V/F,K_(10),K_(12),K_(21),AUC,T_(1/2K_(10)),T_(1/2α),T_(1/2β) and β were not statistically significant between two groups(P＞0.05).Conclusion Ethanol may accelerate elimination of ketamine and the metabolism of ketamine to norketamine and has little effect on the absorption of ketamine,suggesting that interaction between ethanol and ketamine should be considered in cases of co-abuse of the two drugs.

Objective To identify the possible alterations of brain function in prefrontal lobes and hippocampus in the first-episode patients with positive symptoms of schizophrenia using magnetic resonance spectroscopy. Methods 20 patients were selected to perform MRI and HMRS examination. Proton multi-voxel spectroscopy imaging(1 H-MRSI)was obtained from two sides of the hippocampus and frontal lobes regions. The metabolites included N-acetylaspartate (NAA), and choline-containing compounds (Cho), creatine and phosphocreatine (Cr).The ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. Results (1)The Cho/Cr ratio was significantly reduced in left frontal white matter of patients compared to right(1. 178 ± 0.210 vs 1.437 ± 0. 337). (2) There was no statistically significant difference in metabolite levels in between left anterior cingulate gray matter and right (N AA. Cr: 1. 339 ± 0.452 vs 1. 748 ± 0. 147;Cho/Cr: 1. 406 ± 0. 394 vs 1. 761 ± 0.362) (P ＜ 0.05). (3) The NAA/Cr, Cho/Cr were significantly reduced in left hippocampus of patients compared to right. Conclusion The results implicate that the metabolic abnormalities might exist in the left hippocampus and frontal lobe of schizophrenic patients with positive symptoms.

Objective To study the effect of granulocyte-macrophage colony-stimulating factor(GM-CSF)on angiogenesis of rat with acute myocardial injury induced by isoproterenol(Iso). Methods A total of 60 adult male Wistar rats were randomly divided into 3 groups: normal control group, GM-CSF pretreatment group (GM-CSF group), and lso injury group, 20 rats in each group. GM-CSF group was administered recombinant human(rh)GM-CSF(5.0 μg/kg), through tail intravenous injection once a day for three days. Then the GM-CSF group and the Iso injury group were anesthetized by intraperitoneal injection of lso( 15.0 mg/kg) once a day for three days. The same dose of saline was administered in the same way to the control rats. Ten days after injection, pathological changes of myocardial damage and infarct area were examined by immunohistochemistry. The mRNA expression levels of polypeptide antigen (CD34), vascular endothelial growth factor (VEGF) and its receptor KDR/flk- 1 were measured by RT-PCR. Results The difference of myocardial necrosis area between groups was statistically significant(F=10.07, P < 0.01), in which GM-CSF group[(37.37 ± 12.98)%] was significantly less than Iso injury group[(45.51 ±14.96)%, P < 0.05]. The difference of myocardial neovascularization density index of rats between groups was statistically significant ( F = 25.54, P < 0.05 ), in which GM-CSF group [(3980.05 ± 477.22) No/mm2] was significantly higher than Iso injury group((2605.93±361.49)No/mm2,P<0.01).The differences of myocardial CD34,VEGF,KDR/flk-1 mRNA expression between groups were statistically significant(F=17.83,4.29,4.10,all P<0.01).Compared to Iso mjury group[CD34(23.85±6.06),VEGF(31.80±8.05),KDR/flk-1(30.16±8.01)]were higher in the GM-CSF group[CD34(44.04±10.13),VEGF(49A±11.59),and KDR/flk-1(46A9±7.90),all P<0.01].The expressions of myocardiM VEGF mRNA and its receptor KDR/flk-1 mRNA was positively correlated(r=0.725,R2=0.526,P<0.01).Conclusions GM-CSF prelreatmcnt increases the density ofnew blood vessels in myocardium,and reduces the Iso-induced myocardial injury in rats.

Objective To explore epidemic characteristics and trend of livestock brucellosis in Zibo,and to provide a scientific basis for development of prevention strategies to brucellosis.Methods Epidemiology statistical analysis and forecast was made based on related information such as the active immunization data of human brucellosis,the infection data between people and livestock,and the active immunization data among livestock over the years since 1954.Results From 1954 to 2011,37 years had brucellosis cases reported in Zibo City,with accumulative reports of 380 cases,and the average incidence rate was 0.2512/100 000,distributed in 118 villages 56 counties 3 towns 5 districts of the whole city.From 1954 to 1988,only 14 years had brucellosis cases reported,with accumulative reports of 94 cases,and the average incidence rate was 0.1573/100 000.From 1989 to 2011,each year had brucellosis cases reported,with accumulative reports of 283 cases,and the average incidence rate was 0.3158/100 000,of which the highest incidence was in 2011 (45 cases).From 1958 to 2011,there were a total of 140 154 livestock went through serology monitoring,1162 positives,and the positive rate was 0.83％,while the total immunization number of sheep was 884 900,of which 28 years did not carry out immunization work.Conclusions The incidence rate has decreased year by year since the seventies of last century.But the epidemic is on the rise since 1989,while new epidemic areas are emerging and the history affected areas are still serious,therefore the brucellosis prevention and control situation is still grim.