Adult ; Causality ; Death, Sudden ; epidemiology ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Retrospective Studies ; Young Adult

ObjectiveTo investigate the expression levels of the red blood cell surface receptors and oxidative stress of patients with hemodialysis,evaluate the immune function of the red blood cells,and identify the cause of infection and high prevalence of tumor in patients with hemodialysis.MethodsForty-five long-term hemodialysis patients from our blood purification center was chosen as the treatment group.Forty-five healthy individuals conducting physical examination at the same period was chosen as the control group.The flow cytometric method was used to detect CD35 surface receptors numbers of the red blood cell.The red blood cells wreath experiments were used to measure the adhesive function.The ELASA method was used to test the changes of oxidative stress index:SOD,MDA,CAT and GSH-PX.ResultsCompared to the normal control group,the treatment group had significantly lower levels of CD35 [ ( 28.62 ±6.95 ) AU vs.( 19.71 4.89) AU,t =5.441,P ＜0.01 ],impaired adhesive function red blood cells[ (0.63 ±0.07) vs.(0.44 ±0.04),t =0.41,P ＜0.05].For the levels of oxidative stress index,MDA [ ( 6.18 ± 0.16 ) μmol/L vs ( 13.47 ± 0.39 ) μmol/L ] was significantly higher in the treatment group than in the normal control group( t =13.14,P ＜ 0.05 ),and SOD( 34 202.00 ± 1634.00) U/( g · Hb),CAT ( 21.70 ± 0.84 ) U/ml and GSH-PX ( 444.00 ± 10.31 ) U/ml were significantly lower in the treatment group than in the normal control group [ SOD:(24 652.00 ± 2179.00)U/( g · Hb),CAT:( 14.80 ± 1.13 ) U/ml,GSH-PX:( 217.89 ± 13.70 ) U,t =20.246,9.496,27.195,P ＜0.05 ].ConclusionPatients with hemodialysis had lower numbers of red blood cell surface receptors CD35 and impaired immune function of adhesion,and higher oxidative stress levels.This may be the cause of infection and tumor of patients with hemodialvsis.

Objective To analyze the impacts of early enteral nutrition (EN) and parenteral nutrition (PN) on the prognosis of acute pancreatitis.Method By searching relevant literature between January 1996 and August 2013 in Chinese and English databases including Wanfang,VIP,CNKI,PubMed,the Cochrane Library,CBM,and EMABSE,we compared the prognosis of acute pancreatitis after EN or PN in terms of casefatality rate,infections,multiple organ failure,and other complications.Result Compared with PN,early EN significantly reduced the case-fatality rate [OR =0.37,95％ CI (0.23,0.58),P ＜ 0.000 1],decreased the infection rate [OR =0.24,95％ CI (0.15,0.39),P ＜0.000 01],shortened hospital stay [MD =-9.87,95％ CI (-10.84,-8.89),P ＜ 0.000 01],and reduced complications [OR =0.26,95％ CI (0.12,0.58),P =0.001 0] in patients with acute pancreatitis,although the incident of multi-organ failure showed no significant difference [OR =0.35,95％ CI (0.10,1.19),P =0.09].Conclusions For patients with acute pancreatitis,early EN is superior than PN in terms of case-fatality rate,infection rate,hospital stay,and complications.Therefore,it should be applied in such patients whenever condition allows.

A total of 120 medical students were surveyed to investigate the current status of communication between medical students and old patients and the awareness of medical laws. The questionnaire shows many students don't have enough knowledge of communication skills and medical laws. Furthermore, the most important reason of the medical disputes is the lack of communication between doctors and patients so the cultivation of communication skills and legal knowledge should be strengthened.

Holistic education is an important philosophy of medical education.Medical graduate students can show their skills of medical specialties,improve their abilities of communication and cooperation,and promote their sense of social responsibility through social practice.Through conducting questionnaire among medical graduate students of Peking University Third Hospital who major in internal medicine,we have got to know the effect of social practice on holistic education philosophy.Meanwhile,social practice is a crucial approach to implementing holistic education.

Objective:To elucidate the changes in apparent diffusion coefficients(ADC)by quantify diffusion weighted (DW)magnetic resonance imaging(MRI)in patients with Alzbeimer's disease(AD),and the relationship between micro-structure changes of white matter(WM)and the cognitive impairment thereof.Methods:The DW-MRI was performed in 30 probable AD patients and 30 normal controls with normal-appearing white matter(NAWM).The ADC was measured in different WM areas.The neurologic and neuropsychological assessments were examined with mini-mental state examination(MMSE)in patients.The ADC were determined in standard regions of the frontal,temporal,occipital and parietal white matter,genu,splenium of the corpus callosum.Results:The value of ADC was higher in frontal,splenium corpus callosum,temporal,and parietal white matter of AD group than that of control(P ＜ 0.01).There was no significant difference in the ADC value of genu and occipital white matter between AD and control groups(P＞ 0.05).The score of MMSE was 24.1±0.8 in AD group.The ADC values of parietal,splenium of the corpus callosum and frontal white matter were significantly negatively correlated with MMSE scores in AD group(P ＜ 0.05 or P ＜ 0.01).There was no correlation between the ADC values of genu of the corpus eallosum,temporal and occipital white matter with the MMSE score(P ＞ 0.05).Conclusion:The quantitative DWI analysis of MRI DWI may be helpful in assessing WM abnormalities in AD.The parietal WM abnormalities may play an important role in the development of dementia.It was showed that Alzheimer's cognitive decline with ADC value and micro-structure of white matter was closely related.

Objective To investigate the effect of emphysema and intermittent hypoxia (IH) on the hepatic oxidative stress and inflammatory injury in rats. Methods Sixty male Wistar rats were randomly assigned to 4 groups, control group (A), emphysema group (B), IH group (C) and emphysema+IH group (D). Group A was normally fed. Group B was exposed to smoke, 30 min per time, twice everyday. Group C was exposed to 5%O2 30 s/Air 90 s for 8 h/d. Group D was exposed to smoke twice, about 30 min each time, and exposed 5%O2 30 s/Air 90 s for 8 h/d. After continues exposure for 8 weeks, five rats in each group were randomly selected for arterial blood gas analysis. The tissue blocks of liver was obtained for pathologi-cal scoring and measurements of liver oxidative stress in the rest 10 rats of each group. HE staining was used to calculate the mean lining interval (MLI) and mean alveolar number (MAN). The hepatic inflammatory factor interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), superoxide dismutase (SOD) activity, catalase (CAT) activity and malondialdehyde (MDA) con-centration were measured in four groups. Results Characteristics of emphysema were found in group B and group D. The values of MLI were significantly higher in Group B and group D than those of group A and group C (P<0.05). The values of MAN were significantly lower in group B and group D than those of group A and group C (P<0.05). The levels of SOD and CAT were significantly lower in group B, group C and group D than those of group A (P<0.05). And the levels of SOD and CAT were significantly lower in group D than those of group B and group C (P<0.05). The values of liver MDA were signifi-cantly higher in group B, group C and group D than those of group A, and the values were significantly higher in group D than those of group B and group C (P<0.05). The liver histological scores and the levels of IL-6 and TNF-αwere signifi-cantly higher in group B, group C and group D than those of group A, and the values were significantly higher in group D than those of group B and group C (P<0.05). Conclusion Emphysema and IH have synergistic action in causing hepatic oxidative stress and inflammation.

Objective To investigate the adverse effects of nano-titanium dioxide (TiO2 )on kidney tissues in healthy rats and rats with oxidative stress (OS).Methods Thirty-six healthy male SD rats were randomly divided into control group, alloxan-treated group, nano-TiO2 treated (NM) group, and alloxan and nano-TiO2 dual treatment (OS-NM)group.Nano-TiO2 of three concentrations (0.5,5 and 50 mg/kg body weight)was injected intraperitoneally.The level of OS biochemical factors and blood urea nitrogen (BUN)and pathological changes of kidney were determined.Results Compared with those in NM and OS groups,the levels of O2 -· and superoxide dismutase (SOD)in OS-NM group were significantly increased after exposure to nano-TiO2 of 5 mg/kg body weight (P <0.05).Nano-TiO2 of 50 mg/kg body weight led to significant changes of O2 -·,SOD,and glutathione (GSH) levels in OS-NM group in comparison with OS and NM groups (P <0.01).The levels of O2 -· and GSH between OS group and NM group changed significantly (P < 0.05 ).Compared with healthy rats,OS rats showed significant increased BUN level (P <0.01),cell number and edema of renal tubular epithelial cells after nano-TiO2 exposure.A synergic effect between OS condition and nano-TiO2 level was shown on the increased level of O2 -·.Conclusion Nano-TiO2 induced more adverse effects on the kidney in OS rats,suggesting a synergistic effect between nano-TiO2 and OS.This result provides experimental evidence for patients’safe use of nano-TiO2 .

Objective To investigate the clinical effects of lactobacillus acidophilus combined with glutathione in the treatment of nonalcoholic fatty liver disease.Methods 120 patients with nonalcoholic fatty liver disease were selected,and they were randomly divided into control group (60 patients used glutathione alone) and observation group (60 patients received lactobacillus acidophilus on the basis of control group).The clinical efficacy,liver function index,blood lipid index and the ultrasonography grading of fatty liver before and after treatment of the two groups were compared.Results The clinical total effective rates of the control group and the observation group were 76.67％,91.67％,respectively.The total effective rate of the observation group was significantly higher than that of the control group(x2 =10.52,P ＜ 0.05).The levels of AST,ALT and GGT of the observation group after treatment were significantly lower than those of the control group and before treatment [(36.89 ± 7.14) U/L,(36.89 ± 7.14) U/L,(36.89 ±7.14) U/L vs.(49.36 ± 11.08) U/L,(45.91 ± 10.24) U/L,(90.28 ± 20.70) U/L;(36.89 ± 7.14) U/L,(36.89 ± 7.14) U/L,(36.89 ± 7.14) U/L vs.(92.90 ± 24.3) U/L,(81.11 ± 17.37) U/L,(147.27 ± 34.19) U/L,t =2.88,2.54,2.91;3.01,3.36;3.18,3.48;3.41,3.87;all P ＜0.05).The levels of TG,TC,HDL-C and LDL-C of the observation group after treatment were significantly better than those of the control group and before treatment [(1.66 ± 0.42) mmol/L,(4.05 ± 0.77) mmol/L,(1.69 ± 0.60) mmol/L,(2.44 ± 0.38) mmol/L vs.(2.13 ± 0.80) mmol/L,(4.64 ± 0.94) mmol/L,(1.45 ± 0.48) mmol/L,(2.97 ± 0.57) mmol/L;(1.66 ± 0.42) mmol/L,(4.05 ± 0.77) mmol/L,(1.69 ± 0.60) mmol/L,(2.44 ± 0.38) mmol/L vs.(2.71 ± 1.33) mmol/L,(5.42 ± 1.27) mmol/L,(1.08 ± 0.36) mmol/L,(3.49 ± 0.71) mmoL/L,t =2.43.2.13,2.55,2.07;3.02,3.41;3.11,3.65;2.81,3.30;2.87,3.15;all P ＜ 0.05).In the control group,normal in 6 cases,mild in 24 cases,moderate in 21 cases and severe in 9 cases as fatty liver degree;in the observation group,normal in 13 cases,mild in 30 cases,moderate in 13 cases and severe in 4 cases as fatty liver degree.The ultrasonography grading of fatty liver of the observation group after treatment were significantly better than those of control group and before treatment (U =3.74,5.20,all P ＜ 0.05).Conclusion Lactobacillus acidophilus combined with glutathione in the treatment of nonalcoholic fatty liver disease can efficiently promote the recovery process of liver function,regulate blood lipid levels and is helpful to improve the imaging grading.

Objective To measure the mRNA expression of immediate-early gene c-fos in endothelial cells by the use of different intermittent hypoxia (IH) protocols. Methods A gas control delivery system was homemade, which pro-duced IH/re-oxygenation(ROX) environmental exposure. The endothelial cells were exposed to IH/ROX cycles, and were di-vided into three groups (A, B and C). There were five sub-groups in each group. Group A included intermittent normoxia group, standard incubator control group, continuous hypoxia group (CH), 1.5%O2 IH group and 10%O2 IH group. There were different frequency IH of 1.5%O2 and 10%O2 sub-groups in group B and group C. Hypoxia time was 15 s. The intermittent hypoxia cycle was 60 and the ROX time was different. The total cycle time was different, including 1.5 h group, 3 h group, 5 h group, 6.5 h group and 9.5 h group. The mRNA expression of immediate-early gene c-fos was measured by real-time PCR. Results There was no significant difference in the level of c-fos mRNA between intermittent normoxia group and CH group. The expression of c-fos mRNA was significantly higher in 1.5%O2 IH group and 10%O2 IH group than that of intermit-tent normoxia group, and there was a higher expression level of c-fos mRNA in 1.5%O2 IH group than that of 10%O2 IH group (P＜0.01). It was found that the mRNA expression of c-fos increased gradually at first, and then gradually decreased. The expression of c-fos mRNA was significantly higher in 5 h group than that of other groups (P＜0.01). Conclusion The mRNA expression of immediate-early gene c-fos is increased after exposing to IH/ROX in endothelial cells, which is closely related with IH extents and frequencies.