1.Analyzing the Impact of Applying Clinical Pathway on the Hospitalization Costs of Total Knee Replacement
Kai WANG ; Dandan PENG ; Jianhao LIN
Chinese Health Economics 2013;(11):30-32
Objective: Through comparing the hospitalization costs of total knee replacement (TKR) in People’s Hospital of Peking University in 2005 and 2010, to investigate the changing status of hospitalization costs on this operation and the impact of clinical pathway ( CP ) on controlling the hospitalization costs during 5 years , and provide references for controlling medical treatment cost reasonably. Methods: The patients are grouped into undergoing unilateral and bilateral TKR. The total hospitalization cost and cost of each category during 5 years are compared, and SAS 9.2 statistic software is applied to deal the data. Results: Compared with 2005, the total cost for TKR in 2010 decreased. All the charging items decreased, except implant material increased, especially the cost of surgery, hospital room, nursing and pharmacy. Specific to one knee replacement group and both knees replacement, the changing trend of cost is coincident with the total cost. Conclusion: The total cost for TKR in 2010 was lower than that of 2005, which might be the result of adopting CP since 2010. Nevertheless, the implant material cost accounted large proportion of hospitalization cost in 2010, and it has obvious increasing trend compared to 2005. This result is related the increasing application of the new edition of Artificial knee joint prosthesis. Controlling implant material cost is the effective method of decreasing medical costs for TKR.
2. N-Butanol-Soluble Chemical Constituents from Bamboo Juice
Chinese Pharmaceutical Journal 2020;55(16):1325-1330
OBJECTIVE: To study the chemical constituents of bamboo juice. METHODS: The compounds were isolated and purified by column chromatography on silica gel, ODS, macroporous resin, MPLC and HPLC. Their structures were elucidated by NMR spectroscopic evidence and compared with those in literature. RESULTS: Fifteen compounds were isolated and identified as (+)-lyoniresinol-3α-O-β-D-glucopyranoside (1), 5, 5'-dimethoxylariciresinol-4'-O-β-D-glucopyranoside (2), syringaresinol 4'-O-β-D-glucopyroside (3), (-)-4-epi-lyoniresinol (4), (-)-lyoniresinol -2α-O-β-D-glucopyranoside (5), (+)-lyoniresinol (6), 8, 8'-bisdihydrosiringenin glucoside (7), 2, 4, 6-trimethoxyphenyl-1-O-β-D-glucopyranoside (8), threo-8S-7-meth-oxysyringylglycerol (9), salidroside (10), (7S, 8R)syringoylglycerol (11), syringaldehyde (12), 2, 6-dimethoxy-1, 4-benzoquinone (13), n-butyl-β-D-fructopyranoside (14), and n-butyl pyroglutamate (15).CONCLUSION: Compounds 1-11 and 14-15 are isolated from bamboo juice for the first time. Compounds 14 and 15 are β-D-fructopyranoside and pyroglutamic acid artifacts produced during the extraction.
5.Effect and Mechanism of Helix B Surface Peptide on Reducing Myocardial Ischemia Reperfusion Injury in Experimental Mice
Wei YOU ; Yingfeng LIU ; Fei MIAO ; Lin LIN ; Jiebo ZHANG ; Long WANG ; Kai ZHU ; Yongluan LIN ; Peng LIU
Chinese Circulation Journal 2015;(10):996-999
Objective: To investigate the effect and mechanism of helix B surface peptide (HBSP) on myocardial ischemia reperfusion injury (MIRI) in experimental mice.
Methods: The MIRI model was established by ligation of anterior descending coronary artery of the mice for 45 min and followed by corresponding treatment at 5 min before reperfusion. A total of 64 male ICR mice were randomly assigned to 4 group:①Sham group,②MIRI group, the mice received normal saline at 5 min before reperfusion,③HBSP group, MIRI mice received HBSP at 5 min before reperfusion and④HBSP+PD98059 group, MIRI mice received PD98059 (a speciifc blocker of ERK1/2) at 20 min before reperfusion and followed by HBSP at 5 min before reperfusion.n=16 in each group, all animals were treated for 2 hours. The area of myocardial infarction (MI) was detected by TTC-EB double staining method, the myocardial apoptosis rate was examined by TUNEL method, the levels of protein expression of ERK1/2 and phosphorylation of ERK1/2 were measured by Western blot analysis.
Results: Compared with MIRI group, HBSP group presented decreased MI area, decreased myocardial apoptosis rate and increased phopsphorylation level of ERK1/2, allP<0.05. Compared with HBSP group, HBSP+PD98059 group showed decreased phopsphorylation level of ERK1/2, increased myocardial apoptosis rate and increased MI area, allP<0.05.
Conclusion: HBSP may reduce the MI area via inhibiting myocardial apoptosis and therefore, protecting the experimental mice from MIRI; the mechanism might be related to the activation of ERK1/2 pathway.
6.Low intensity pulsed ultrasound can help protect chondrocytes co-cultured with the infrapatellar fat pad through the integrin-FAK-p38 MAPK pathway
Yanping QU ; Kai CHENG ; Qiang LIN ; Mingxia GAO ; Peng XIA ; Shasha REN ; Tingting ZHANG ; Xueping LI
Chinese Journal of Physical Medicine and Rehabilitation 2017;39(4):241-246
Objective To observe the effect of low intensity pulsed ultrasound (LIPUS) on chondrocytes co-cultured with infrapatellar fat pads.Methods Twenty-four infrapatellar fat pads and cartilages from female knee trauma patients aged between 25 and 35 were cut and stained using hematoxylin-eosin staining.Chondrocytes were isolated from part of the integrated surface of the cartilages to be cultured in vitro.They were then randomly divided into a normal chondrocyte group (the control group),a normal chondrocyte+FCM (fat conditioned medium) group (the model group),a normal chondrocyte+ FCM + LIP US group (the treatment group),and a normal chondrocyte+ FCM + LIPUS + GRGDSP (an integrin inhibitor) group (the inhibited group).The treatment group and inhibited group received LIPUS at 40 mW/cm2 for 20 min once a day,while the other groups received sham LIPUS treatment.Five days later,the cells were collected and western blotting was used to examine the expression of type Ⅱ collagen (COL2),aggrecan (Acan),matrixmetalloproteinase (MMP)-13,integrin β1,phosphorylation-focal adhesion kinase (p-FAK) and phosphorylation p38 (p-p38).Results Western blotting showed that compared with the control group,the expression of COL2 and Acan was significantly lower in the model group,but that of MMP-13,integrin β1,p-FAK and p-p38 was significantly higher.As compared with the model group,the expression of COL2,Acan,integrin β1 and p-FAK was significantly higher,and that of MMP-13 and p-p38 was significantly lower in the treatment group.The expression of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 showed no significant difference between the inhibited and model groups,but that of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 was significantly different between the control and treatment groups.Conclusions LIPUS provides a protective effect on chondrocytes through inhibiting the expression of MMP-13 induced by adipokines and the degradation of COL2 and Acan through activating the integrin-FAK-p38 MAPK pathway.
7.The effects of cranial electrotherapy stimulation therapy combined with psychological intervention in treating post-stroke depression
Xiaoju WANG ; Peng XIA ; Qiang LIN ; Kai CHENG ; Anliang CHEN ; Ting YANG ; Xueping LI
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(9):680-682
Objective To evaluate the effects of cranial electrotherapy stimulation therapy combined with psychological intervention for treating depression after cerebral infarction.Methods Eighty persons diagnosed with depression after cerebral infarction were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation training and psychological intervention, but the treatment group also received microcurrent transcranial electrical stimulation treatment.All the patients were evaluated with Hamilton's depression scale (HAMD) and the mini-mental state exam (MMSE) and given Barthel index (BI) scores before and after 4 weeks of treatment.Results There was no significant difference between the 2 groups in terms of any of the measures before treatment.After 4 weeks of treatment, both groups had improved significantly, but the improvements on all measures were significantly better in the treatment group.Conclusion Cranial electrotherapy combined with psychological intervention can significantly improve symptoms of depression and cognitive function in patients with post-stroke depression, and play an important role in improving their daily life.
8.The effects of low intensity pulsed ultrasound on expression of mechanochemical transduction pathway-related protein of integrin-focal adhesion kinase-mitogen-activated protein kinases in the chondrocytes of rabbits with knee osteoarthritis
Peng XIA ; Xueping LI ; Qiang LIN ; Kai CHENG ; Shihao SHEN ; Shasha REN ; Mingxia GAO
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(3):165-170
Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.
9.The safety of Habib VesOpen bipolar radiofrequency ablation catheter used in the treatment of portal vein tumor thrombus:an experimental study in miniature pig models
Lin ZHANG ; Jinxin FU ; Peng SONG ; Kai YUAN ; Jieyu YAN ; Feng DUAN ; Maoqiang WANG ; Fengyong LIU
Journal of Interventional Radiology 2015;(6):515-519
Objective To explore the safety of Habib VesOpen bipolar radiofrequency ablation (RFA) catheter used in the treatment of portal vein tumor thrombus (PVTT). Methods A total of 10 miniature pigs were randomly divided into 3 groups. Group A(n=6):RFA of normal portal vein was directly performed;group B (n=2): balloon obstruction of the portal vein was performed first, which was followed by RFA for the fresh thrombus in the portal vein; group C (n=2): PVTT model was established first, and RFA of the portal vein was carried out when the portal thrombus became organized. MRI examination was employed at one, 3 and 4 weeks after RFA; the animals were sacrificed 4 weeks after RFA and pathological examination of portal vein was performed. Results Pigs of group A received portal vein RFA under the condition of 5 W power for 0.6-3.6 min. No obvious abnormality was detected by MRI and pathological examination , which were performed one month after the treatment. In the pigs of group B , MRI performed after RFA showed that the damage of portal vein area was more serious than that in the pigs of group A;abdominal MRI examination performed at one, 3 and 4 weeks after RFA showed that the portal venous edema was gradually decreased;pathological examination at one month after RFA demonstrated serious injury of adjacent liver tissue. Pigs of group C received portal vein RFA under the condition of 7 W power for 1.5 min; no obvious edema of the ablated area was observed on MRI performed after RFA , and pathological examination revealed organized thrombus necrosis and va scular endothelial cell damage. Conclusion When Habib VesOpen bipolar RFA catheter is used for the treatment of PVTT, the RFA power and time should be properly selected according to the severity of PVTT. In order to ensure a safer procedure, high power and short ablation time should be used when the severity of PVTT is mild, while low power and longer ablation time are recommended when the PVTT is more severe.