Objective To investigate the epidemiology of drug-resistant tuberculosis (TB) in five rural counties of eastern China and analyze the biological,demographic and social risk factors.Methods Subjects of this study were all the diagnosed TB patients registered in the five study sites in Shandong Province,Jiangsu Province and Zhejiang Province during one year of 2008- 2009.Questionnaire interview was conducted in all the subjects to acquire the socio-demographic and clinical information.Sputum samples were collected for culturing and isolating of Mycobacterium tuberculosis (M.TB) strains.All the M.TB isolates were further tested for the susceptibility to first-line drugs including rifampin,isoniazid,ethambutol and strepomycin by proportion method.Mantel-Haenszel chi-square test,Fisher's exact test,ANOVA and nonconditional Logistic regression modeling were applied for data analysis.Results Among the total 380 M.TB isolates,105 were resistant to at least one of the first-line drugs.The total drug resistant TB prevalence was 27.6％.Multidrug-resistant tuberculosis (MDR-TB) was observed in 8.4％ of newly treated TB patients,whereas it was 23.3％in previously treated TB patients.After adjusted by county,gender and age of the subjects,multivariate analysis showed that previous treatment history (OR=3.900,95％CI: 1.737-8.704),tuberculosis cavity (OR - 1.987,95 ％ CI: 1.001 - 3.942) were independent factors influencing the occurrence of MDR-TB.Conclusions The prevalence of drug resistant TB in rural area of eastern China is relatively low compared with the average level in China,while it is still higher than the global average level.The present study highlights that TB patients with previous treatment history,cavitaryTB are correlated with MDR-TB,and elderly patients are at high risk of MDR-TB.

Objective To investigate the impact of isoniazid (INH)-resistant Mycobacterium tuberculosis (Mtb) on the prevalence and dissemination of multi-drug resistant tuberculosis (MDR-TB).Methods A total of 251 patients diagnosed with tuberculosis in designated hospitals of Guanyun,Jiangsu and Deqing,Zhejiang from 2010 to 2011 were included in the study.The drug susceptibility tests (DST) were performed on all the Mtb isolates available from the sputum cultures.Mycobacteral interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) was conducted for genotyping for all available Mtb isolates.Chi-square test,Fisher exact test,ANOVA and non-conditional Logistic regression modelling were applied for data analysis.Results Among 251 patients with Mtb isolates and DST results available,72 (28.7％) were resistant to INH,including 13 were INH mono-drug resistant.Of the remaining 59 INH-resistant Mtb,34 (13.5％) were resistant to rifampin TB and 25 were resistant to streptomycin and/or ethambutol.The clustering analysis based on MIRU-VNTR genotyping revealed 29 clustered genotypes (including 105 isolates) and 146 unique genotypes (including 119 isolates).Twentyfive clusters contained drug resistant Mtb and 16 clusters of them comprised by 37 INH-resistant isolates and 20 MDR-TB isolates,which accounted for 51.4％ of the INH-resistant isolates and 58.8％ of the MDR-TB isolates.Single factor analysis showed that sex,age,previous tuberculosis treatment history and sputum smear results were all related to INH-resistant tuberculosis and MDR-TB (all P ＜ 0.05).Multiple factors analysis showed that previous tuberculosis treatment history was risk factor of MDR-TB (OR=8.40,95 ％CI:3.342-21.105),while the risk factors of INH-resistant tuberculosis were previous tuberculosis treatment history (OR=3.52,95％CI:1.570-7.910),pulmonary caviry (OR=2.27,95％CI:1.075-4.799) and sputum smear results (OR=0.50,95％CI:0.275-0.892).Conclusions That INH-resistant strain may evolve to the MDR-TB after recent transmission is a possible trend.Patients with previous treatment history and advanced age are at high risk of INH-resistant tuberculosis and MDR-TB.

Objective To retrospectively study the clinical features in elderly patients with epilepsy.Methods Clinical data of 72 elderly patients with epilepsy aged over 60 years from outpatients and inpatients were studied.Results In the 72 cases,cerebrovascular disease associated with epilepsy occurred in 52 cases (72.2％),with partial seizures in 50 cases (69.4％),and with generalized seizures in 22 cases (30.6％).In 38 cases with epilepsy secondary to cerebral infarction,the cerebral cortex infarction occurred in 26 cases (68.4％).In 14 cases with epilepsy secondary to cerebral hemorrhage,cerebral cortex hemorrhage occurred in 11 cases (78.6％).In interictal electroencephalogram (EEG) of the 72 cases,8 cases had normal EEG (11.1％),64 cases had abnormal EEG (88.8％).31 cases (48.4％) presented with sharp wave,spikes wave or tip--slow composite wave,33 cases (51.6％) presented with low amplitude of slow wave activity,which were non-specific abnormalities.Conclusions The main cause of seizures in the elderly is cerebrovascular disease.Partial seizures is the main type of seizure.Most of seizures caused by cerebrovascular disease occur in the region near the cortex.

Objective:To study the effect of Rhizoma Coptidis apozem on expression of AMP-activated protein kinase(AMPK) in skeletal muscle of metabolic syndrome rats. Methods:The models were established by administering high fat diet. Rats were randomly divided into five group: normal control group, metabriolic syndome group, Rhizoma Coptidis apozem group, Berberine group, Metformin group. To estimate insulin resistance by euglycemic hyperinsulinemic glucose clamp(GC) tecchnique. To estimate expression of AMPK by using Western blot. Results: Compared with metabolic syndrome group, Rhizoma Coptidis apozem group had higher M-value, lower wet weight of innards fat, and higher protein level of p-AMPK-?. Conclusion: Rhizoma Coptidis apozem can improve insulin resistance, decrease innards fat, and regulate up expression of AMPK.

Aim To study the single nucleotide poly-morphism ( SNPs ) of AMP-activated protein kinase ( AMPK) ?2 subunit gene PRKAA2 ( rs2051040 and rs17848595) and its relationship with metformin response. Methods A total of 32 patients with type 2 diabetes( T2DM) were enrolled. All patients were required to take metformin for 1 week. The serum levels of FPG,TG,TC,LDL-C,HDL-C were assayed before and after therapy. The gene polymorphism of PRKAA2 was analyzed by PCR-DGGE,the effects of metformin were compared between patients with different phenotypes. Results FPG,TG,TC,LDL-C were significantly improved after therapy in wild genotype carriers( P 0. 05) . Conclusion The results of this study suggest that PRKAA2 polymorphism may be associated with metformin treatment effects in T2DM patients.

Objective To test the protective effect of a new Ringer's malate solution on intestine's apoptosis caused by hemorrhagic shock in rats.Methods Forty-eight Sprague-Dawley male rats, weighing 280-320 g, were randomly assigned into four groups: sham shock group (group SS), normal saline group (group NS), Ringer's lactate group (group RL) and Ringer's malate (group RM), n=12 each.The group SS was served as control group, the other groups were subjected to 60 min of hemorrhagic shock followed by crystalloid resuscitation.Those rats were sacrificed 3 h after resuscitation.Intestinal tissue was harvested to detect Bcl-2/Bax protein level, the bioactivity of superoxide dismutase (SOD) and malondialdehyde (MDA) level.The level of intestinal cell apotosis was measured using TUNEL method and apoptosis index was calculated.The intestinal histopathology was examined.Results Compared with group SS, the expression of Bcl-2 and the bioactivity of SOD were lower, the level of Bax protein, MDA and apoptotic index were higher in groups NS, RL and RM (P<0.05).Compared with groups NS and RL, the expression of Bcl-2 and the bioactivity of SOD was higher, the level of Bax protein, MDA and apoptotic index were lower in group RM (P<0.05).Histopathological examination showed that group RM was better than group NS and group RL.Conclusion Ringer's malate alleviated intestinal apoptosis caused by hemorrhagic shock in rats.The study suggests that Ringer's malate solution could be a potential new therapeutic agent for fluid resuscitation.

Aim To investigate the effects of the alco-hol extract from Coreopsis tinctoria Nutt. on urinary metabolomics of spontaneous hypertension rats ( SHR) . Methods SHR were fed with normal diet for 1 week and then, they were randomly divided into six groups:untreated control, the high, middle, low dos-age group of the alcohol extract(3.2 g·kg-1 ,1.6 g· kg-1,0.8 g·kg-1) , captopril group(4 mg·kg-1) and Duzhong tablet group(187.5 mg·kg-1). The u-rine of normal rats and SHR hypertension model rats was collected on 1,2,3,4 weeks. The metabolic pro-files were analyzed using 1 H-NMR. PLS-DA methods were used to discriminate the difference and the bio-markers. Results Compared with model group, the blood pressure of all groups was significantly lowered after 4 weeks ( P <0.01 ) . The alcohol extract from Coreopsis tinctoria Nutt. could significantIy reduce blood pressure, and the urinary metabolic profiles trea-ted with Coreopsis tinctoria Nutt. were changed signifi-cantly such as IIL,creatine,β-glucose,etc. Conclusion The alcohol extract from Coreopsis tinctoria Nutt. could significantIy reduce blood pressure and change the urinary metabolomics profiles of SHR rats.

BACKGROUND:Previous tudies have shown that the anti-aging effects of stem cel s with lycopene are more significant, and can also significantly improve the aging body immune function.
OBJECTIVE:To investigate the anti-aging effects of human umbilical cord mesenchymal stem cel s combined with lycopene on the aging beagles.
METHODS:Sixteen aging beagles (6-7 years old) were randomly divided into two groups:aging control group and aging treatment group;young beagles (3-4 years old) were chosen as young control group. In the aging treatment group, human umbilical cord mesenchymal stem cel s combined with lycopene was given;while in the other two group, an equal amount of DMEM/F12 cel culture medium and sunflower oil was given. Each dog's general conditions were observed regularly during the whole progress. The changes of superoxide dismutase,
malondialdehyde, glutathione peroxidase in the serum were detected at regular time of the whole process, and the structure changes of each organ were observed at 24 weeks of treatment.
RESULTS AND CONCLUSION:(1) Before treatment, the levels of superoxide dismutase and glutathione peroxidase in the aging control and treatment groups were lower than those in the young control group (P<0.05), while the malondialdehyde content was higher than that in the young control group (P<0.05). However, there was no significant statistical difference between aging control and treatment groups (P>0.05). (2) For the aging treatment group at 24 weeks of treatment:the beagle fur became clearer and smoother, motility was strengthened, appetite became better;and the activity of superoxide dismutase in serum at 8 to 24 weeks of treatment increased significantly compared with before treatment (P<0.05), the activity of glutathione peroxidase significantly increased from 6 weeks (compared with treatment before, P<0.05), the malondialdehyde content decreased significantly from 4 weeks of treatment to the completion of the experiment (compared with before treatment, P<0.05). (3) After the experiment, the microscopic observation showed that compared with the aging control group, the tissues and organ structures of the aging treatment group were al clear, had no inflammatory infiltrates, no obvious necrosis and fibrosis lesions. These results were mainly consistent with the observations of young control group. The above results show that umbilical cord mesenchymal stem cel s combined with lycopene therapy on the natural aging beagles may enhance the activities of antioxidant enzymes, reduce malondialdehyde content, and their combination also can repair tissue structures and promote the functions, which has obvious anti-aging effects.

ObjectiveTo evaluate the association between Pro12Ala polymorphism in peroxisome proliferator activated receptorγ2 (PPARγ2) gene and gestational diabetes mellitus(GDM).Methods Publications on genetic association studies of PPARγ2 and GDM were searched using the PubMed database, The HuGE Navigator, China National Knowledge Infrastructure (CNKI), Wanfang database and VIP Science from the inception of the databases to December 1, 2014. Two reviewers independently selected literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the data using the Newcastle-Ottawa Scale (NOS) standard. Meta-analysis was performed using RevMan 5.3 software.ResultsOverall, 13 eligible articles were identified, including seven in English and six in Chinese, with a total of 2 787 GDM cases and 5 408 healthy controls. Quality assessment showed that the quality of the 13 articles was all good, with NOS≥5. (1) Pro12Ala polymorphism in PPARγ2 (allele Ala or genotype Ala/Ala or Pro/Ala) was shown to be highly associated with GDM occurrence on general evaluation, with anOR(95%CI) of 0.74(0.60-0.93) in the allele model and 0.79(0.65-0.96) in the dominant genetic model (P<0.05, respectively). (2) Pro12Ala polymorphism in PPARγ2 was shown to be highly associated with GDM occurrence in Asians in a stratification analysis of ethnicity in the populations included in the studies, with anOR(95%CI) of 0.61(0.48-0.79) in the allele model and 0.64(0.50-0.82) in the dominant genetic model (P<0.01, respectively). No correlation was found between the Pro12Ala polymorphism in PPARγ2 and GDM in the Caucasian population. (3) A meta-analysis of six Chinese studies showed that the Pro12Ala polymorphism in PPARγ2 was associated with the risk of GDM in the Chinese population, with anOR(95%CI) of 0.52 (0.36-0.73) in the allele model and 0.55(0.39-0.80) in the dominant genetic model (P<0.01, respectively). (4) No significant association was observed in the TaqMan allelic discrimination assay with anOR(95%CI) of 0.96(0.83-1.10) in the allele model and 0.95(0.81-1.11) in the dominant genetic model (P>0.05, respectively), although there was still a significant correlation in polymerase chain reaction-restriction fragment length polymorphism with anOR(95%CI) of 0.58(0.43-0.79) in the allele model and 0.62(0.45-0.85) in the dominant genetic model (P<0.01, respectively).ConclusionsThe Ala allele and the Ala/Ala or Pro/Ala genotypes of the Pro12Ala polymorphism in PPARγ2 can decrease the risk of GDM. However, there are differences in the results which are affected by the genotype analysis method or races.

BACKGROUND:Domestic and international studies have confirmed that human umbilical cord mesenchymal stem cel s could be induced to differentiate into islet-like cel s, but little is reported about the changes of insulin and nestin expressions during the differentiation phase. OBJECTIVE:To observe the changes of insulin and nestin expressions during the differentiation of human umbilical cord mesenchymal stem cel s into islet-like cel s. METHODS:Human umbilical cord mesenchymal stem cel s were cultured using UltraCULTURE medium in vitro. Stem cel s were cultured for three generations to observe cel morphological changes under an inverted microscope, to test immunophenotype by flow cytometry, and to identify the capacity of osteogenesis and adipogenic differentiation. Induction protocol was divided into two stages. In stage 1, stem cel s were induced for 14 days in the UltraCULTURE medium with 4 nmol/L activin A, 25μg/L epidermal growth factor, 100μg/Lβ-nerve growth factor, 10 mmol/L nicotinamide. In stage 2, the cel s were cultured in the UltraCULTURE medium with 1%insulin-transferin-selenium, 10 mmol/L nicotinamide, 10μg/L basic fibroblast growth factor for an additional 14 days. The expressions of nestin and insulin in those differentiated cel s were tested by flow cytometry, and zinc ion expression in the islet-like cel clusters was identified by dithizone staining. RESULTS AND CONCLUSION:During the differentiation process, the insulin level was increased gradual y in the induction group and reached a higher level on day 28, but the insulin expression showed negative in the control group. In addition, on day 14 of induced differentiation, the nestin expression reached the peak and then gradual y reduced along with the prolonged inductive time. On day 28 of induction, islet-like cel clusters formed and were positive for dithizone staining. In this experiment, the umbilical cord mesenchymal stem cel s were successful y induced and differentiated into islet-like cel s, accompanied with the variation of insulin and nestin expression.