Objective To explore the pertinence between the concentrations of seminal leptin (lep) and genital endocrine hormones, such as testosterone(T), follicle stimulating hormone( FSH), luteotropic hormone(LH) and insulin growth factor-1 (IGF-1), as well as the effect of Lep on sperm concentration,motility and genital function indexes.Methods 126 cases of infertility and 30 cases of normal fertility were randomly chosen.The contents of Lep, T, FSH and LH were detected by radioimmunoassay (RIA) and the IGF-1 content were detected by immunoradiometric assay (IRMA).The infertility group was divided into group A (sperm count ≥ 20×109 /L), group B (sperm count ＜ 20×109 /L) and group C of azoospermia.According to the number of white blood cell ( WBC ) in 10 high power fields (HPF), the infertility group was further divided into group WBC (WBC count ≥ 1×109 /L) and group Non-WBC(WBC count ＜ 1×109 /L).According to the sperm vitality and the rate of motility, group A was subdivided into the group of normal spermatic vitality (a + b≥50% ), the group of abnormal vitality( a + b ＜ 50% ) (a refers to the number of sperms with fast forward movement, and b refers to the number of sperms with slow or sluggish forward movement), the group of normal rate of spermatic motility( the rate ≥60% ) and the group of decreased rate of motility( the rate ＜60% ).According to the examination results of the normal contrast group, group A and group B were respectively divided into the following groups: the group of normal sperm penetrating power(≥40 mm), the group of decreased penetrating power( ＜ 40 mm), the group of normal intact acrosome rate(≥80% ), the group of decreased intact acrosome rate( ＜ 80% ), the group of normal terminal swelling rate( ≥60% ) and the group of decreased terminal swelling rate( ＜60% ).Results The concentration of Lep in the infertility group was (2.77±0.80) μg/L, significantly higher than the level of Lep [ (1.14 ± 0.31 ) μg/L ] in the contrast group ( t = 10.943,P ＜ 0.05 ).The contents of IGF-1 and T were ( 17.67±8.09) μg/L and (4.84±2.15) nmol/L respectively, significantly lower than the levels of IGF-1 [(24.79±9.32) μg/L] and T [(6.30±2.53) nmol/L] in the contrast group (t =4.205,3.228,P＜0.01).There existed no significant differences of the concentrations of FSH and LH between the two groups ( t = 1.655,1.378 ,P ＞ 0.05 ).The concentrations of FSH and LH were (32.61±9.14) U/L and (40.57 ± 12.40) U/L respectively in the infertility group and(29.63±7.56) U/L and (37.25±9.19) U/L respectively in the contrast group.The concentrations of Lep and IGF-1 and T showed negative correlation in the infertility group (r = -0.237, -0.316,P ＜ 0.01 ).The concentration of Lep had no correlation to the FSH and LH concentration (r = 0.104, 0.112, P ＞ 0.05 ).The concentration of Lep showed a gradual increase within group A, group B and group C (F = 115.93, P ＜ 0.01 ).The leptin contents in the above mentioned normal subgroups were found to be lower than the abnormal groups.Conclusions There exists pertinence between the Lep concentration and the concentrations of TGF-1, T, FSH and LH.Lep may decrease the sperm density and inhibit sperm vitality and the motility rate through inhibiting androgen secretion and sperm capacitation.

Objective To investigate the significance of MMP-9 and TIMP-1 test for assessing the occurrence and development of chronic heart failure.Methods One hundred and twenty-seven patients with chronic heart failure were enrolled in the observation group,and 40 cases community health people were selected for the control group. The levels of serum MMP-9 and TIMP-1 were detected and the LVEF and E/E ' were evaluated using endocardiography. Results Compared with the control group, the level of MMP-9 was significantly higher (<0.01) but the level of TIMP-1 had significantly decreased ( <0.05) in the observation group. And the ratio of MMP-9 and TIMP-1 had significantly increased compared with the control group ( <0.05) . There were statistically significant differences of LVEF and E/E' between the observation group and control group ( <0.05) . In the observation group,the level of MMP-9, MMP-9/TIMP-1,LVEF and E/E' were increased but the level of TIMP-1 decreased significantly in cases with cardiac functional class III compared with cardiac function class II (<0.05) . There were significant differences between the cases with class IV heart function and class II, III in the levels of MMP-9, TIMP-1 and MMP-9/TIMP-1 ( <0.05) . In the cases of class IV heart function, the LVEF and E/E' have significantly increased compared with the cases of class II ( <0.05) . MMP-9 + TIMP-1 +MMP-9/TIMP-1 combination has higher sensitivity and specificity than the MMP-9,TIMP-1 and MMP-9/TIMP-1 single indicator, and the joint diagnostic value of LVEF + E/E' was less than that of IL-18+ NT-ProBNP. Conclusion The levels of MMP-9 and TIMP-1 and their ratio may have contributed to the early detection and diagnosis for chronic heart failure,and help to determine the disease progression.

Objective To investigate the incidence of the nosocomial infection in patients of Shenzhen district polyclinic,provide solution for controlling the nosocomial infection and give precautionary measures for the future.Methods By prospective and retrospective combinative case-control methods,the incidence of nosocomial infection of the in-patients during May 2002 to December 2004 was investigated and analyzed.Results There were 237 patients and 251 cases of nosocomial infection from 10271 in-patients.The incidence of nosocomial disease was 2.31%.The infection rate was 2.44%.Conclusion In the basis of completely utilizing the third-class network management in nosocomial infection,the precautionary nosocomial infection can be effectually controlled by monitoring and enhancing staff training.

Objective To explore the protective effect of proliferator activated receptor-γ (PPAR-γ)activator pioglitazone on the expression of inflammatory cytokines in cultured cortical neurons after ischemia-reperfusion injury and its mechanism. Method The ischemie-reperfusion model was established by deprivating both glucose an oxygen in medium and then gave them back. Medium or that with pioglitazone was added at the beginning of reperfusion. The MTT values of neurons were determined in control or treatment groups, ANOVA was used to detect the expression of PPAR-γ. The expression of tumor necrosis factors-α(TNF-α) and interleukin-lβ(IL-lβ) were detected by Western Blotting. Results Compared to control group, the markedly reduction of MTT values and enhanced expression of PPAR-γ, TNF-a and IL-1β was observed in the ischemia-reperfusion neurons (P < 0.05). After they were treated by pioglitazone, the reduction of MTT values and enhanced expression of TNF-a and IL-1β were prominently reversed by the further activation of PPAR-γ ( P < 0.05). Conclusions Treatment of PPAR-γ activator pioglitazone has protective effect on neurons after ischemia-reperfusion injury. Its mechanism may be associated with the inhibition of inflammation after injury.

Objective To explore whether the inhibited expression of fibrocystin by RNA interference can increase epidermal growth factor (EGF)-induced cell proliferation and its possible mechanism . Methods A stable PKHD1-silenced HEK 293 cell line was established . Cell proliferation rate, intracellular Ca2+ concentration and extracellular signal-reguhted kinase 1/2(ERK1/2) activity were assessed after treatment with EGF, verapamil and Bay K8644 . Results The proliferation rate of PKHD1-silenced HEK-293 cells was found to be significantly higher after EGF stimulation compared to the control HEK 293 cell (231 .5% vs 152 .8%, P＜0 .01) . PKHD1-silencing lowered the intracellular Ca2+ concentration and caused EGF-induced ERK1/2 overactivation in the cells(P＜0 .01 ) . When cells were treated with verapamil for 4 hours to lower the intracellular Ca2+ concentration, the cell proliferation rate was significantly increased after 20 ng EGF for 24 hours . The verapamil treatment increased the level of activated ERK1/2 in EGF-treated cells . An increase of intracellular Ca2 + in PKHD1-silenced ceils repressed the EGF-dependent ERK1/2 activation and the hyperproliferative response to EGF stimulation . Conclusions Inhibition of fibrocystin can cause EGF-induced excessive proliferation through decreasing intracellular Ca2+ resulting in EGF-induced ERK1/2 activation . The loss of fibrocystin may lead to abnormal proliferation in kidney epithelial cells and cyst formation in ARPKD through modulation of intracellular Ca2+ concentration .

In order to lower the purchasing prices of drugs, prevent unhealthy tendencies that might arise in the process of drug circulation in the hospital, and reduce the financial burdens of patients, our hospital started from March 1997 the practice of purchasing drugs through open tender. The measures adopted include: ①establishment of a leading group in charge of drug purchases and a drug purchasing group; ②formulation and earnest implementation of the system of purchasing drugs through open tender, making “five checks”; ③standardization of the scope of routine drugs used in the hospital; and ④adherence to the system of examination and approval by the Drug Management Committee when introduction of new drugs is being considered. Since the adoption of the system of purchasing drugs through tender, the purc hasing prices of drugs have on the average dropped 14.7% and the drug expenses for single entity diseases have been lowered.

Objective To study the protective effect of removing inflammatory cytokines by hemoperfusion (HP)on acute kidney injury (AKI) in patients with sepsis. Method A total of 40 patients with sepsis and AKI were randomly divided into two croups: HP treatment group (n = 22) and control group (n = 18). Hemoperfusion carried out in patients of Hp group with HA330 filter once a day for 3 days and the procedure of each hemoperfusion was completed in 2 hours. The patients of control group were treated with routine treatment. Further, the hemodynamics, plasma IL-6, IL-10, C-reactive protein (CRP), serum creatinine (Scr), blood BUN and urine NAG, γ-GTP,α1-MG of patients in both groups were detected before treatment and 3 d,7 d and 14 days after treatment. Results Compared to control group, the levels of plasma interleukins-6, IL-10 and C-reactive protein were significantly lower (P ＜ 0.05), along with increase in urine output, lower levels of blood BUN and Scr, reduction in urine NAG,γ-GT and α1-MG (P ＜ 0.05). In addition, the patients at Ⅰ or Ⅱ stage of AKI treated with hemoperfusion had significantly lower level of Scr in 14 days and lower mortality in intensive care unit in comparison with control group (P ＜ 0.05). Conclusions Hemoperfusion employed in the earlier stage of AKI with the HA type filter may have protective effect on acute kidney injury by the removal of inflammatory cytokines in the setting of sepsis.

Objective To study the clinical efficacy of naloxone combined with edaravone on acute alcoholism. Methods One hundred and twenty-five patients with acute alcoholism were randomly divided into the control and treatment groups. The control group accepted conventional treatment and taking naloxone, while the treatment group accepted edaravone on the basis. Before and after treatment,the treatment recovery time,recovery respiratory rate time and symptom disappearance time were recorded. The malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), neuron-specific enolase (NSE), S-100βand vascular cell adhesion points-1 (VCAM-1) were detected. Results After treatment,the recovery time and recovery respiratory rate time of the treatment group were significantly shorter than those of the control group ( <0.05) . In the control group, S-100β was significantly improved after treatment ( <0.05) . NSE, S-100β, VCAM-1 and MDA have significantly decreased ( <0.05) after treatment in the treatment group. Compared with the control group, there were significant differences of S-100β,VCAM-1 and MDA in the treatment group before and after treatment (<0.05) . While SOD and GSH have significantly increased ( <0.05) after treatment and showed significant differences compared with the control group ( <0.05) . Conclusion Naloxone and edaravone combination therapy can improve oxidative stress and nerve damage, which help early rehabilitation in patients with acute alcoholism.

Objective To initially observe the antitumor immune of PVAX1-HPV58mE6E7FcGB composite DNA vaccine.Methods Before detecting immune effect of the vaccine,the B16-HPV58E6E7 tumor cell line was built which could steadily express HPV58E6E7 fusion gene.Then,HPV58E6E7-GST fusion protein as an antigen was expressed and purified.Before or after immunized with the vaccine,the C57BL/6 mice were challenged by B16-HPV58E6E7 cells.Anti-tumor transplantation and tumor growth inhibition experiment were performed to observe prevention and treatment effects on the vaccine.Specific humoral and cellular immune responses in the immunized mice were detected by ELISA,enzyme linked immunospot assay (ELISPOT) and cytotoxic T lymphocyte (CTL) method.Results In the anti-tumor transplantation experiment,tumor formation rate was only 9/15 in the mice which were immunized by PVAX1-HPV58mE6E7FcGB vaccine,time before tumor formation was the longest [(13.6 ± 1.7) days] and tumor growth was the slowest in the vaccine group.In tumor growth inhibition experiment,inhibition rate reached 81.4％ in the vaccine group.Except tumor formation rate,all data in the vaccine group was superior to the pure antigen PVAX1-HPV58mE6E7Fc group (P ＜ 0.05).Humoral immune effect showed that both the vaccine and the pure antigen could induce specific antibody in the immunized mice,and the highest titer were 1 ∶ 25600 and 1 ∶ 12800,respectively.Although there was not significant difference of antibody titer between the vaccine and the pure antigen group (P ＞ 0.05),the number of activated T cells in the vaccine group was almost four times as that in the pure antigen group [(219 ±34)/4 × 105 spleen lymphocytes versus (55 ±25)/4 × 105 spleen lymphocytes,P ＜ 0.05],and the highest specific CTL that vaccine induced was significantly higher than that of pure antigen (43.3％ versus 31.3％,P ＜ 0.05).Conclusions Humoral and cellular immune response could be effectively stimulated by PVAX1-HPV58mE6E7FcGB composite DNA vaccine.Growth of B16-HPV58E6E7 cells was significantly inhibited in the immunized mice.The cellular immune effect on the vaccine was superior to the pure antigen.Therefore,PVAX1-HPV58mE6E7FcGB could be used as a candidate vaccine for immune therapy to the HPV58 positive tumors and precancerous lesions.

Objective: To evaluate the feasibility and safety of postoperative patient-controlled epidural analgesia (PCEA)in children. Methods: Forty postoperative pediatric patients(5-11 years old)were divided into two groups. A and B. Both wereinstituted with postoperative PCEA with LCP model (loading dose 2.05 + 0.13ml), continuos infusion rate 0.82 + 0.15mi/h, PCA dose 0.81 + 0.16ml)by Graseby-9300 PCA pump. The PCEA solution of group A was 0.075% bupivacaine plus0.0012 % buprenorphine, that of group B was same while 0. 005% droperidol was added as an adjuvant. Results:The volumeof PCEA sdution consumption in group B was significantly less than that in group A on the first and second postoperative day (P< 0.01-0.05). Good analgesic efficiency with little side effects was obtained, as evaluated by the VASF emasay or D/D score and complications in two groups, but the analgesic effect of group B was better than that of group A. Conclusion: Thepediatric PCEA with low concentration of bupivaeaine plus buprenorphine is feasible and safe. Droperidol may enhance theanalgesic effects of PCEA.