Objective: To understand the current status and characteristics of self-medication behavior in China and to analyze the determinants of self-medication behavior and willingness of Chinese residents. Methods: A total of 4 400 households from Beijing, Xi'an, Chengdu, and Kunming were chosen by multistage, stratified, and cluster sampling for a health survey. From a total 8 826 residents we selected 8 585 who aged over 15 years old and who gave a clear answer to whether had self-medication behavior and whether were willing to have self-medication. Logistic regression was used to analyze the relationship between self-medication behavior and self-medication willingness, and between residents' predisposing characteristics, enabling resources and need following Andersen health utilization model. Results: When other variables were controlled, the incidences of self-medication of residents at 25-44 years, 25-44 years, 45-64 years, and 65 years above were 1.52 folds (P = 0.000), 1.59 folds (P = 0.000), and 1.53 folds (P = 0.001) of the control group (15-24 years old). The incidence of self-medication of urban residents was significantly lower than that of the rural residents (P = 0.000). The incidence of self-medication behavior in residents with a common disorder in the last 6 months was 10.85 folds of those without common disease. The self-medication willingness of residents with chronic diseases was 1.22 folds (P = 0.035) of those without chronic diseases. The self-medication willingness of residents having a common disease in the last 6 months was 2.12 fold (P = 0.000) of those without common disorder. Conclusion: Age, urban-rural difference, knowledge of self-medication, and health status have different degrees of influence on the self-medication behavior and self-medication willingness of residents, while family income and health insurance have little influence.

Objective To evaluate the use of LigaSure vessel sealant system on hemorrhoidectomy for the patients with grade 3 and grade 4 hemorrhoids. Methods Sixty five patients with hemorrhoids (41 males and 24 females), among whom 46 cases were grade 3 and 19 cases were grade 4, underwent hemorrhoidectomy under local anesthesia with the use of LigaSure vessel sealant system. The time consumed for operation and the blood volume lost during and after operation were recorded. Postoperative pain was assessed by means of visual analog score (1-10). The patients were followed up for 2 months. Results The operations were performed successfully in all patients. The time consumed was 5-25 minutes (9.7?4.6 minutes). The pain scores at 4 hours and 24 hours after operation were 1-7 (2.7?1.7) and 0-5 (1.9?1.3), respectively. On the third day after operation, only 4 cases had a pain score of 3 to 5, in the remaining 61 cases the score was under 3. On the seventh day after operation, only 5 patients had pain scores of 1 to 3. No patients complained pain about 2 months later. The volume of blood loss in 9 cases was less than 15ml (15.8%), and in the remaining 56 cases there was no apparent blood loss during the operation. Only one patient was re-operated for bleeding after operation, and in 18 (27.7%) patients there was only oozing of blood. Mild incontinence occurred in 6 patients shortly after operation, and no severe complications occurred. Conclusions LigaSure vessel sealant system shows the advantage of good haemostatic effect, less time consuming for operation, and less pain after operation for the treatment of patients with Grade 3 and Grade 4 hemorrhoids.

Objective To explore the protective effect of ligustrazine on the apoptosis of PC12 cells induced by dopamine(DA) and its mechanisms. Methods Apoptosis of PC12 cell was induced by dopamine at the concentrations of 0, 0.30, 0.60 mM. Ligustrazine at the concentrations of 0, 30, 60, 90 ?g/ml was added to defect the effect of ligustrazine on apotosis. The subdiploid peaks showing cell apoptosis rate were detected by flow cytometry. The cell activity was determined by MTT. Concentration of nitric oxide(NO) was determined by the Griess reaction. Results Compared with those of the control, the apoptosis rate and the level of NO induced by 0.30 or 0.60 mmol/L DA were higher, but the activity of PC12 cells was lower. Compared with those of the groups without ligustrazine, the apoptosis rate and the level of NO increased, but the cell activity decreased in a dose dependent manner. Conclusion Ligustrazine can inhibit the apoptosis induced by DA, which might be correlated with the decrease of NO production.

Alcoholic liver disease ( ALD ) , a chronic progres-sive disease, threatens human health seriously. An increasing number of studies have shown that gut flora dysbiosis plays an important role in the development of ALD. Intestinal microbiota maintains a steady state under normal conditions, regulating gut flora normal physiological function. However, chronic alcohol consumption produces intestinal bacteria overgrowth and dysbio-sis, including the alteration of the composition of intestinal mi-croflora, the increment of gut permeability and bacterial translo-cation. Subsequently, the host immune is activated, promoting the production of inflammatory cytokines in liver, which plays a central role in the development of ALD. Notably, the supple-ment of prebiotics or probiotics reverses the intestinal flora disor-der,ameliorating the clinical symptoms effectively in ALD pa-tients. The evidence impies that the modulation of dysbiosis may be effective in the prevention and treatment of ALD. This review summarizes the research progress on the mechanism of the devel-opment of dysbiosis-mediated ALD, to provide a theoretical basis for the research on intestinal flora and ALD.

BACKGROUND: Triiodothyronine (T3) is an important regulation factor at the critical period of brain development. It maybe control the successive differentiation during the development of central nervous system (CNS).OBJECTIVE: To monitor the differentiation of neural stem cells (NSCs) induced by T3 and the thyroid hormone receptor (TR) mRNA expression changes.DESIGN: Open experiment.SETTING: Department of Pathology, Tianjin Medical College of Chinese People's Armed Police Force; Institute of Endocrinology of Tianjin Medical University.MATERIALS: This study was carried out in the Tianjin Medical University between January 2003 and March 2005.Ten-to-twelve-week-old aborted fetuses were obtained from the General Hospital of Tianjin Medical University with the approval of the local ethical committee. Informed consents were obtained from the mothers and their relatives.METHODS: ①Under the aseptic condition, the bilateral cortex of human fetal brain was removed and dissociated by brief mechanical trituration in D-Hanks. Then, 20 μg/L bFGF and 30 nmol/L T3 were used to induce the proliferation of NSCs and inoculated to poly-L-lysine-coated 24-well plate and 25 mL culture flask for routine culture at 1 ×109 L-1. The culture medium was DMEM/F12 serum-free complemented with N2. Half of the culture medium was changed every 48 hours.Seven days later, bFGF was discarded, only T3 was used for induction and differentiation. ② At 1, 2 and 3 weeks of culture, cells were collected, and RT-PCR was semiquantitatively used to detect TR mRNA expression changes at different stages of differentiation of NSCs. Isoforms were identified by immuocytochemistry.MAIN OUTCOME MEASURES: ①Cellular morphology observation and isoforms identification before and after differentiation of NSCs induced by T3. ② TR mRNA expression changes during the differentiation of NSCs.RESULTS: ①The hNSCs were round and had a smooth surface and gradually gathered to neurospheres. The proliferative hNSCs were nestin-positive and incorporated BrdU. When NSCs were induced by T3 for one week, most of the cells took on monopole or double poles, and had long and thin processes. The differentiated cells were neurofilament protein (NFP)-positive, galactocerebroside (GC)-positive or glial fibrillary acidic protein (GFAP)-positive. When NSCs were induced by T3 for three weeks, most of the cells were big, with unclear cell membrane, round nucleus, many thick processes which had many branches. The spider-like cells were scattered, and 80% of the cells were myelin basic protein-positive. ② TRα1 mRNA expression level was the highest before inducing NSCs. With the induction of T3, the expression level was decreased gradually, and was the lowest at 2 weeks, and then was rebounded gradually, but the final level was still lower than that of NSC (F =32.49, P =0.008). The tendency of TRα2 mRNA expression alteration was identical with that of TRα1 mRNA. TRβ1 mRNA expression level was the lowest in NSC, was increased gradually with the induction of T3 and attained the highest level at 2 weeks of induction of T3. Furthermore, the expression level of TRβ1 mRNA was also higher than that of TRα1 at the same time (t =15.64,P =0.001), and it reached the lowest level at 3 weeks of the induction. TRα3 expression level was firstly decreased after the differentiation induced by T3, and was close to the expression level of NSC at 2 weeks of induction (F =51.94, P =0.378), then was decreased to lower lever.CONCLUSION: T3 can induce NSC to differentiate into neurons, oligodendrocyte and astrocytes. TR mRNAs are expressed in different time intervals during the differentiation of NSCs.

Objective Through detecting the expression of chemokine CCL21 and its receptor CCR7 in thyroiditis of NOD mice induced by excessive iodine and thyroglobulin (Tg) immunization,to explore the mechanism of lymphocytic infiltration.Methods Seven to eight weeks old female NOD (non-obese diabetic) mice were used,the mice were divided into four groups by random number table,7 mice for each group.Control group:intoke distilled water;,Tg group:intoke'distilled water,use pig Tg emulsified in Freund's complete adjuvant subcutaneous injection to immunization,0.10 mg Tg for each mouse at 8 weeks old,strengthened immunity at 11 and 15 weeks old (0.05 mg Tg for each mouse,and emulsified by Freund's incomplete adjuvant); iodine excess (HI) group:intoke 0.05％ NaI water; iodine excess combined with Tg (HI + Tg) group:intoke 0.05％ NaI water,Tg immunization method was same to Tg group; all mice were raised in specific pathogen free (SPF) environment.All mice were executed at 16 weeks old,and removed the thyroid tissue.Morphologic change in thyroid was observed by HE staining.Immunofluorescence (IF) staining was used to observe CD3,CD22,CCL21 and CCR7 expression in thyroid.Real-time PCR was used to detect CCL21 mRNA expression in thyroid.Results The morphologic change of thyroid was observed under the light microscope,in HI group,thyroid follicle distended,colloid accumulation,lymphocytes accumulate together and disorganization was seen; Tg group thyroid had scatted lymphocytes; HI + Tg group enhanced inflammation response and disorganization.IF staining showed that lymphocytes infiltrated in thyroid were almost CD3+ T cells,only few scatted CD22+ B cells; CCL21 and CCR7 were negative in control group,CCR7 positive cells were scatted in Tg group but no CCL21 expression,in HI and HI + Tg groups,we could see CCL21 strong positive expression in inflammation area and also had CCR7 positive cells there.CCL21 mRNA relative expression in thyroid:Tg group (3.20 ± 0.18),HI group (1.72 ± 0.31),and HI ± Tg group (9.94 ± 0.32) increased compared to control group (1.00 ± 0.17,all P ＜ 0.01).Conclusion CCL21 and its receptor CCR7 have improved lymphocytic infiltration in autoimmune thyroiditis

AIM:To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS:Female,32 NOD mice were randomly divided into 4 groups:(1) control; (2) high iodine; (3) poly (I:C); (4) high iodine+poly (I:C). Nine weeks after administration,mice were sacrificed. The following parameters were determined:body weight,thyroid weight and anatomic form. Thyroid hormone (T4) in serum was measured by radioimmunoassay,the thyroid morphology was observed through HE staining,apoptosis was detected by TUNEL,the mRNA expression levels of TRAIL,TRAIL-sR1,ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS:Compared to control group and poly (I:C) group,the thyroid absolute weight and relative weight in high iodine group were increased (P0.05). CONCLUSION:Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.

AIM: To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS: Female, 32 NOD mice were randomly divided into 4 groups: (1) control;(2) high iodine;(3) poly (I:C);(4) high iodine+poly (I:C). Nine weeks after administration, mice were sacrificed. The following parameters were determined: body weight, thyroid weight and anatomic form. Thyroid hormone (T_4) in serum was measured by radioimmunoassay, the thyroid morphology was observed through HE staining, apoptosis was detected by TUNEL, the mRNA expression levels of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS: Compared to control group and poly (I:C) group, the thyroid absolute weight and relative weight in high iodine group were increased (P<0.01), the level of total T_4 in serum was decreased (P<0.05), inflammation and apoptosis were obviously observed, the mRNA expressions of TRAIL, TRAIL-sR1, CXCL10 and ICAM-1 were upregulated (P<0.05). Compared to high iodine group, thyroid absolute weight and relative weight in high iodine+poly (I:C) group were further increased, the level of total T_4 in serum was further decreased (P<0.05), the ratio of inflammatory degree Ⅳ increased to 50.0%, the numbers of apoptosis cells were further enhanced, the mRNA expressions of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were further upregulated (P<0.05). Otherwise, the tendency of all parameters in poly (I:C) group was similar to that in control group (P>0.05). CONCLUSION: Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.

Objective:To discuss the reconstuctive strategy of the defect of anterior rectus fascia and rectus abdominus muscle in the clinical practice.Methods:Between November 2009 and Janurary 2020, clinical data of 24 female patients that underwent 29 anterior rectus fascia and rectus abdominus muscle reconstructions of defect were reviewed retrospectively. The median age was 42.5 years (range, 35-60 years), including 20 breast reconstructions, 2 pelvic reconstructions, 1 thoracic defect after tumor resection and 1 abdominal defect after tumor resection. According to the location and size of the anterior rectus fascia and rectus abdominus muscle defect, three reconstructive methods were applied: 6 direct clousres were applied if the width of defect was less than half of the anterior rectus fascia, 21 polypropylene mesh onlay reconstructions were applied for which the width of defect was or more than half of the anterior rectus fascia, and 2 direct suture closure were applied for the simple rectus abdominus muscle defect.Results:All the patients healed eventfully without abdominal wound complications, such as infection, hematoma, dehiscence. The patients were followed up for a median period of 30 months (range, 5-126 months). 1 patient died of breast cancer recurrence and matastasis at 36 months postoperatively. No patient developed a mesh infection or required mesh removal secondary to infection or foreign body reaction. There was no abdominal wall hernia, 1 patient developed abdominal bulge without further treatment because of no abdominal wall discomfort.Conclusions:The key of successful operation is different reconstructive methods applied to reconstruct the integrity and stability of abdominal wall, based on the location and size of the anterior rectus fascia and rectus abdominus muscle defect.

Objectives:To observe the effect of metabolic intervention of anti TNF antibody on the hypermetabolism occurred in intra abdominal infection(IAI) complicated by multiple organ dysfunction syndrome(MODS). Methods:Twenty rabbits were operated on with cecal ligation plus puncture(CLP) inducing IAI and MODS and were randomly divided into two groups, one receiving the anti TNF serum raised against TNF ?(anti TNF group) at 0.5?h after CLP and another receiving the non specific serum (control group). All animals were placed in metabolic cages and maintained with intravenous infusion for the observation period of one week. Serum levels of cytokines(TNF, IL 6), hormones (cortisol, insulin, glucagon), biochemical indexes (glucose, cholesterol, triglyceride, albumin) and daily excretions of urea nitrogen (UN),creatinine (Cr) and 3 methylhistidine (3 MH) were dynamically determined for 7 days. The death of animals was also recorded. Results:Compared with the control group, the levels of serum TNF, IL 6 and cortisol were significantly decreased and the levels of insulin and glucagon were kept normal after the injection of immune serum in anti TNF group, with significant improvements of biochemical indexes and decreased excretions of UN, Cr and 3 MH in urine. The survival rate was significantly increased in the anti TNF group. Conclusions:The anti TNF antibody can attenuate the metabolic abnormalities of IAI and MODS, being of the metabolic intervention on the hypermetabolism.