Objective To explore a new method for assessing the walking efficiency of the paraplegic patients assisted by functional electrical stimulation (FES). Methods The measurement system based on a standard walker was developed. During FES assisted walking of the paraplegic, the real time of the upper limb support were obtained and transformed into a 3 D center of gravity (CG) motion map with a paraplegic upper body mechanical model to describe the CG motion locus. Then the FES efficiency indicated by walking balance condition was assessed objectively and quantitatively. Results In this design, the pilot study of a paraplegic patient undergoing walking training with FES showed that the force accuracy was better than 1.01%, nonlinearity was less than 0.8%, and crosstalk was less than 3.2%. Conclusion The results showed that this system may be used as 1) an evaluation index of FES assisted paraplegic walking efficiency, 2) a balance control indicator during FES assisted paraplegic walking training and 3) a feed back signal to choose an efficient FES pattern and sequence.

Objective To identify the independent prognostic factors for femoral head avascular necrosis after internal fixation of femoral neck fractures.Methods A retrospective analysis was made on 246 patients (246 hips) with femoral neck fractures treated by internal fixation between January 2002 and January 2010.There were 111 male and 135 female patients aged 19-59 years.A total of 101 patients were injured in traffic accidents,79 patients in falls from the height and 66 patients in ground-level falls.Eight parameters were identified as the prognostic factors of femoral head avascular necrosis,including gender,fracture type,preoperative traction,interval from injury to surgery,reduction methods,quality of fracture reduction,time of weight bearing,and fixation removal.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative femoral head avascular necrosis.Results Period of follow-up was 1-13 years (mean,7.5 years).There were 38 patients (15.4％) with avascular necrosis of the femoral head.Multivariate analysis identified fracture type (95％ CI-3.41--2.43,P ＜ 0.01),preoperative traction (95％ CI-3.77--0.6,P ＜ 0.05) and quality of fracture reduction (95％ CI -3.33--0.94,P ＜ 0.01) as the independent predictors of avascular necrosis of the femoral head.Conclusion Fracture type,preoperative traction and quality of fracture reduction are the independent risk factors for avascular necrosis of the femoral head after internal fixation of femoral neck fractures.

Background:Gastric cancer (GC) is one of the most common malignancies,and intestinal-type GC is the main histopathologic type of GC in China.We previously reported that casein kinase 2 interacting protein 1 (CKIP-1) acts as a candidate tumor suppressor in intestinal-type GC.CKIP-1 participates in the regulation of multiple signaling pathways,including the Wnt/β-catenin pathway,of which caudal-related homeobox 1 (CDX1) may be a downstream target gene.The purpose of this study was to investigate the relationship between CKIP-1 and CDX1 in intestinal-type GC.Methods:Sixty-seven gastroscopy biopsy specimens and surgically resected gastric specimens were divided into four groups:gastric mucosa group,intestinal metaplasia (IM) group,dysplasia group,and intestinal-type GC group.The expression levels of CKIP-1 and CDX1 were detected in these groups and GC cell lines,and the correlations between these expression levels were analyzed.SGC7901 and BGC823 cells were divided into CKIP-1 shRNA groups and CKIP-1 over-expression groups,and CDX1 expression was detected.β-Catenin expression was detected in intestinal-type GC tissue samples and CKIP-1 shRNA and CKIP-1 over-expression SGC7901 cells,and its correlation with CKIP-1 expression in intestinal-type GC tissue was analyzed.The Wnt/β-catenin pathway inhibitor DKK-1 and activator LiCl were incubated with SGC7901 cells,BGC823 cells,and CKIP-1 shRNA and CKIP-1 over-expression SGC7901 and BGC823 cells,following which CDX1 and Ki-67 expression were detected.Results:The expression levels of CKIP-1 and CDX1 were lower in patients with intestinal-type GC than in patients with IM and dysplasia (both P ＜ 0.05).CKIP-1 and CDX1 expression levels were positively correlated in IM,dysplasia,and intestinal-type GC tissue and cell lines (r =0.771,P ＜ 0.01;r =0.597,P ＜ 0.01;r =0.654,P ＜ 0.01;r =0.811,P ＜ 0.01,respectively).CDX1 expression was decreased in the CKIP-1 shRNA groups and increased in the CKIP-1 over-expression groups of SGC7901 and BGC823 cells compared to that in the corresponding control groups (both P ＜ 0.05).CKIP-1 expression was negatively correlated with β-catenin expression in intestinal-type GC patients (r =-0.458,P ＜ 0.01).Compared to the control group,β-catenin expression was increased in the CKIP-1 shRNA SGC7901 cell group and decreased in the CKIP-1 over-expression SGC7901 cell group (P ＜ 0.05).CDX1 expression was increased in SGC7901 and BGC823 cells treated with DKK-1,DKK-1 increased CDX1 expression and decreased Ki-67 expression in the CKIP-1 shRNA group;the opposite result was observed in SGC7901 and BGC823 cells treated with LiCl,and LiCl decreased CDX1 expression and increased Ki-67 expression in the CKIP-1 over-expression group (both P ＜ 0.05).Conclusions:Through the Wnt/p-catenin signaling pathway,CKIP-1 may positively regulate CDX1 in intestinal-type GC.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

Objective To explore the effects of estrogen on oxidative stress of the lung tissue induced by acute paraquat (PQ) poisoning. Methods Thirty-two male adult New Zealand rabbits were randomly divided into model group and estrogen intervention group, 16 rabbits in each group. The model of lung injury induced by PQ poisoning was reproduced by feeding 16 mg/kg of 20% PQ through gastric tube. The rabbits in estrogen intervention group received intravenous infusion of 5 mg/kg estrogen after PQ challenge for 7 days, and the rabbits in model group received an equal volume of normal saline. Three rabbits in each group were sacrificed at 1, 2 and 3 days respectively after exposure. The lung tissue was harvested, the levels of reactive oxygen species (ROS) was determined by 2',7'-dichlorofluorescin diacetate (DCFH-DA), malondialdehyde (MDA) was determined by thiobarbituric acid (TBA), the mRNA expression of manganese-containing superoxide dismutase (MnSOD) was determined by reverse transcription-polymerase chain reaction (RT-PCR), and adenosine triphosphatase (ATP) content in mitochondrion was determined by enzyme linked immunosorbent assay (ELISA). The pathological changes in lung were observed under light microscopy using hematoxylin and eosin (HE) staining, and the lung injury was evaluated with lung injury score. Results The contents of ROS and MDA in lung within 3 days after PQ poisoning were gradually increased, and MnSOD mRNA expression and ATP content were gradually decreased. Estrogen intervention could significantly reduce the production of ROS and MDA after PQ poisoning [3-day ROS (fluorescence intensity): 161.05±30.04 vs. 188.30±31.80, 3-day MDA (mmol/L): 98.71±0.92 vs. 122.12±1.24], up-regulate MnSOD mRNA expression (integral A value: 3.05±0.90 vs. 1.22±0.24), and increase ATP content in mitochondrion (ng/L: 3.75±0.92 vs. 2.28±0.29) with statistically significant differences (all P < 0.01). In lung tissue after PQ poisoning, congestion, edema, focal pulmonary consolidation, pulmonary interstitial and alveolar space were infiltrated by a large number of neutrophil, alveolar interval were thickened obviously and the above phenomenon were most serious at 3 days after poisoning as shown under optical microscope. Estrogen intervention could significantly improve lung injury as compared with that of model group, and the lung injury score at 3 days was significantly lower than that of model group (11.8±0.7 vs. 13.5±1.0, P < 0.01). Conclusions The oxidative stress indicators in the lung tissue after PQ poisoning were obviously abnormal, the pathological damage was serious with time dependence. The administration of estrogen can reduce acute lung injury after PQ poisoning by reducing the oxidative stress.

ObjectiveTo investigate whether aldosterone infusion induces glomerular or podocyte injury in rats and to evaluate the effects of eplerenoen (EPL), andodipine (CCB) and telmisartan (ARB) on aldosterone- induced injury. MethodsThirty male Sprague-Dawley rats were divided into 5 groups: control, subcutaneous infusion of aldosterone (1.5 μg/h, ALD group) and aldosterone infusion plus eplerenone (100 mg·kg-1·d-1, EPL group), amlodipine(10 nag·kg-1·d-1 CCB group), telmisartan (3 mg·kg-1·d-1, ARB group), respectively. Systolic blood pressure(SBP) and urinary albumin excretion ratio(UAER) were measured at day 0, 7, 14, 21, 28. Blood samples were harvested to detect plasma angiotensin Ⅱ, plasma aldosterone, serum sodium, serum potassium and serum creatinine at day 28. Glomerular damge was quantified by morphological glomerular injury score (GIS). Immunohistochemistry and RT-PCR were performed to evaluate podocyte lesion, and apoptosis ratio of pedocyte (ARP) in a glomerular cross section was analyzed by TUNEL. ResultsALD infusion progressively increased SBP and UAER compared with CTL (P＜0.01). SBP was significantly reduced in EPL, CCB or ARB-treated animals, meanwhile, UAER was decreased in EPL and ARB group, but not in CCB group. The ALD-infused rats exibited hypernatremia and hypopotassaemia, which were blocked by EPL adminstration but not by CCB or ARB treatment. ARB group had a significant increase in plasma angiotensin Ⅱ compared with ALD, CCB and EPL groups(P＜0.01). The ALD-infused animals developed hyperaldosteronemia compared with CTL, but with no difference of plasma aldosterone among ALD, EPL, CCB and ARB-treated rats. Treatment with EPL prevented an increase of GIS and ARP compared with CCB and ARB (P＜0.05, P＜0.01). Protein and mRNA expression of nephfin was up-regulated in ALD group (P＜ 0.01), but was significantly prevented by EPL treatment(P＜0.01), whereas CCB and ARB therapy had no such effect. Conclusion ALD infusion significantly induces glomerular and pedocyte injury which is blocked by EPL but not by CCB or ARB independently on systemic hemodynamics.

To investigate the inhibitory effects of Ginsenoside Rb1 (GRb1) on apoptosis caused by Herpes Simplex Virus-1 (HSV-1) in Human Glioma Cells (U251),U251 cells were infected by HSV-1 at a multiplicity of infection of 5 and GRb1,GRb1+HSV-1,HSV-1 and control groups.MTT and cell apoptosis assays were used to detect the inhibitory effects of GRbl on the apoptosis of U251 cells that caused by HSV-1 infection for various concentrations of drug and virus treatments by MTT assay.We found that in the 400 μg/mL GRbl and 400 μg/mL GRbl+HSV-1 groups,MTT values were higher than control group at all times (P＜0.05).Moreover,the apoptosis rate in the 400 μg/mL GRb1+HSV-1 group was lower than the HSV-1 group (P＜0.05).These results confirmed that,at appropriate concentrations,GRb 1 could inhibit nerve cell apoptosis in HSV-1 infections.

Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.

Objective:This paper aims to analyze the related effects of the low price medicine policy, and prob-lems in the implementation process. Methods:To retrieve an official website of the state food and medicine supervi-sion and administration, collect the package supplements of the low-price medicines and analyze their varieties according to their situations, and calculate he highest and lowest average daily use indicators for the medicine, etc. from January 2009 to August 2014. Results:(1) The low-price medicine list contains 533 kinds of standard medi-cines, and the coincidence rate with the essential medicines list is 51. 59%. Results also show that 96. 82% of the low-price medicines are incorporated into the national medical insurance directory. ( 2 ) The daily medicine cost difference of the maximum and minimum bidder price to the same medicine produced by different manufacturers ran-ges from 0. 01 to 30. 96 Yuan with 94. 76% of the western medicine dosage constituting the existing price rise space. (3) The daily medicine cost difference ranges from 0. 01 to 19. 35 Yuan with 92. 13% of the proprietary Chinese medicine varieties constituting the existing price rise space. Discussions:The low-price medicine varieties lack in the strict proof, the fact of low pricing the medicine has a two-way effect, and the connection between the low-price medi-cine administration policy and other policies is unclear.