Objective Combined with the patients arthritis symptoms and signs,TCM syndrome differentiation of rheumatoid arthritis was undertaken to investigate TCM syndrome distribution.Methods A total of 656 patients of rheumatoid arthritis from October 1st 2010 to January 1st 2012 hospitalized in Shandong Qingdao Combine Traditional Chinese and Western Medicine hospital were untaken TCM syndrome differentiation according to their symptoms and signs.Results The main syndromes of rheumatoid arthritis patients were cold-dampness blockage syndrome and liver and kidney deficiency syndrome,followed by cold-wind blockage syndrome,deficiency of Qi and blood syndrome,and dampness-heat blockage syndrome.The highest scores of ESR and C reactive protein appeared in dampness-heat blockage syndrome group,with ESR being (56.23 ± 13.87) ram/h,CRP being (69.49± 21.56) mg/L.These values showed significant difference than other syndrome group (P ＜ 0.05).There was no significant difference of rheumatoid factor,immunoglobulin IgG,IgA,IgM values among these syndrome groups (P＞0.05).Comparison of age,course of disease showed the liver and kidney deficiency syndrome group (age was 59.3± 12.15,duration was 7.98 ± 3.76)and Qi and blood deficiency syndrome group (age was 52.5± 11.5,duration was 6.56±3.12) were significant higher than cold-dampness blockage syndrome,damp-heat blockage syndrome group and cold-wind blockage syndrome group with the age of (46.2± 11.12) and (45.8± 11.60),(43.5± 12.50) respectively and course of (5.56±2.76),(5.78±2.98),(5.12±2.32) respectively (P＜0.05).Conclusion The main TCM syndromes of rheumatoid arthritis patients in Qingdao area were cold-dampness syndrome,liver and kidney deficiency syndrome,followed by cold-wind blockage sydrome,Qi and blood deficiency syndrome,damp-heat blockage syndrome.Among all syndromes,relatively high age and disease course of patients appeared in liver and kidney deficiency syndrome and Qi and blood deficiency syndrome.

OBJECTIVE:To provide reference for prescriptions audit before payment in hospital pharmacy. METHODS:The management measures of prescriptions audit and intervention before payment in our hospital were introduced. 1 200 outpatient pre-scriptions within 1 year before and after management were subjected to a statistical analysis. The effects of prescriptions audit be-fore payment were evaluated through analyzing and comparing qualification rate of prescription and unqualified prescriptions. RE-SULTS:Our hospital adopted a series of measure to realize prescriptions audit and intervention before payment by clinical pharma-cists,such as using information audit system,formulating audit standard,educating pharmacists,establishing audit job system, prescriptions review and feedback system,setting up communication system,etc. Of the total audited 189 665 prescriptions, 14 581(7.69%)failed to audit and 606 prescriptions hadn’t been revised after 1 year management,with effective intervention rate of 95.84%. Compared with before management,the prescription qualification rate increased from 88.83% to 98.67% after manage-ment(P<0.01). The quantity of overdose,inconformity with medical insurance,overload and other conditions reduced to 0. CON-CLUSIONS:It is feasible for pharmacists to audit and intervent prescriptions before payment in hospital pharmacy to improve pre-scription qualification and promote rational drug use in the clinic.

Objective To analyze the plasma free fatty acid (FFA) composition in patients with T2DM. Methods All subjects were from Zhongnan hospital of Wuhan university, and they were divided into three groups: normal control ( n = 94 ), T2DM ( n = 101 ) and T2DM with hyperlipidemia ( n = 77 ). Fasting blood samples were taken from the participants, and plasma FFA were separated using a modified Doles method with the bromoacetophenone, pre-column-derivative. The quantitation of FFA was performed on were (355.63 ± 100. 35) μmol/L, (421.21 ± 200. 83 ) μ mol/L, ( 473.04 ± 213.40 ) μmol/L in healthy controls, T2DM group and T2DM with hyperlipidemia group, respectively. The significant differences were observed among the 3 groups(x2 = 13.08, P <0.01 ). However, there was no significant difference of UFA concentrations among the 3 groups [(206.29± 61.94) μ mol/L, (218.11 ± 110.28) μmol/L and ( 240.94 ± 116.79 ) μmol/L, x2 = 2.17, P > 0.05]. Compared to normal control [( 355.63 ± 100.35 )μmol/L], the FFA concentration[(421.21 ±200.83) μmol/L] in T2DM has significantly increased (x2 =FFA concentrations were higher in T2DM with hyperlipidemia [(473.04 ±213.40) μmol/L] (x2 =27.93,P <0.01 ). The RSD values for intra- and inter-day precision were less than 5%, and the minimal detection limits ranged from 0.05 μmol/L to 0.35 μmol/L The recoveries of high, intermediate and low-level materials were 96.4% -104.8%. Conclusions The total FFA concentration in T2DM has increased, most of which are saturated FFA. The unsaturated FFA has not significantly increased. They seem to be related to the development of T2DM, and might be a new biomarker for clinical monitoring of metabolic disorder of T2DM.

Many studies have shown that chronic inflammation occurs in the brain of patients with Alzheimer's disease (AD). It is well known that long-term administration of non-steroidal anti-inflammatory drugs (NSAIDs) can alleviate the cognitive decline of AD patient and elderly. Several inflammatory cytokines produced in the metabolism of arachidonic acid (AA) are closely related to inflammatory diseases. Lipoxygenases (LOXs) and cyclooxygenases (COXs) play a crucial role in the AA network, the products eicosanoids have an important impact on the progression of AD. Although there are many arguments and conflicting evidence, currently LOXs and COXs are still the hot topics in the research on AD pathogenesis and drug development. Here, we review the progress in research on COXs and LOXs, including their actions on CNS and their association with AD, and explore the feasibility of LOXs and COXs as targets for the drugs to prevent and/or treat AD.
Alzheimer Disease ; drug therapy ; enzymology ; prevention & control ; Amyloid beta-Peptides ; metabolism ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; therapeutic use ; Arachidonic Acid ; metabolism ; Brain ; metabolism ; Cyclooxygenase 1 ; metabolism ; Cyclooxygenase 2 ; metabolism ; Cyclooxygenase Inhibitors ; therapeutic use ; Humans ; Lipoxygenase Inhibitors ; therapeutic use ; Lipoxygenases ; metabolism ; Prostaglandin H2 ; metabolism ; Prostaglandin-Endoperoxide Synthases ; metabolism

Objective To investigate the protective effects of propofol against acute lung injury(ALI) induced by oleic acid.Methods Forty adult male SD rats weighing 250-290 g were anesthetized with intraperitoneal(i.p.)20% urethrane 6 ml?kg~(-1) and tracheostomized.Left common carotid artery and right internal jugular vein were cannulated for BP monitoring and fluid and drug administration.The animals were randomly divided into 5 groups (n=8 each):Ⅰ control group;Ⅱ ALI group in which ALI was induced by oleic acid 250 mg?kg~(-1) i.v.;Ⅲ,Ⅳ and Ⅴ ALI+propofol group in which propofol was continuously infused i.v.at 4, 8 and 16 mg?kg~(-1)?h~(-1) for 4 h immediately after i.v.oleic acid.The animals were killed at 4 h after oleic acid administration.The lungs were immediately removed for(1)examination of ultrastructure of the lung with transmission electron microseope and(2)determination of SOD and MPO activity,content of MDA,level of IL-10 and IL-18 and expression of NF-kB in lung tissue.Results In group Ⅱ intravenous oleic acid produced damage to mitochondria,rough endoplasmic reticulum and osmiophilic multi-lamellar body in type Ⅱ alveolar epithelial cells. Propofol infusion in group Ⅲ,Ⅳ and Ⅴ attenuated the damage to different degrees.In group Ⅱi.v.oleic acid produced significant decrease in MPO and SOD activity and significant increase in MDA content,IL-10,IL-18 and NF-kB expression in lung tissue.Intravenous propofol infusion attenuated the decrease in MPO and SOD activity, increase in IL-18 expression and MDA content and NF-kB expression in lung tissue produced by i.v.oleic acid, but increased IL-10 expression in lung tissue further.The best protective effect was seen in group Ⅳ.Conclusion Propofol i.v.infusion at 4-16 mg?kg~(-1),h~(-1) can inhibit the oxidative response and inflammatory response and down-regulate NF-kB expression in lung tissue.Propofol infusion at 8 mg?kg~(-1)?h~(-1) provides best protective effects.

Objective To investigate the scope of application of precise hepatectomy and its value.Methods The clinical data of 112 consecutive patients with liver neoplasm who received hepatectomy at Renji Hospital from November 2006 to March 2009 were retrospectively analyzed.Precise hepatectomy technique was applied to 88 patients(precise group),whereas pringle maneuver was applied to the rest 24 patients(prince group).Patients in precise group had undergone lobectomy,segmentectomy or local resection,while patients in pringle group received segmenteetomy or local resection.The perioperative conditions of patients in the 2 groups were compared via Fisher exact probability and l test.Results No perioperative mortality,hepatic failure,reoperation due to massive hemorrhage or bile leakage was observed.The blood transfusion rate,blood loss,postoperative total bilirubin(Tbil),prothrombin time(PT)were 7%(2/29),220 ml,20 μmol/L,13 seconds in patients who received segmentectomy and local resection in precise group,and were 4%(1/24),210 ml,19μmol/L and 13 seconds in patients who received segmentectomy and local resection in pringle group,with no significant difference(t=0.248,0.263,0.246,P>0.05).The operation time,postoperative white blood cell (WBC)count.alanine aminotransferase(ALT)value and fever incidence were 60 minutes,7.5×10~9/L,66 U/L,10%(3/29)in patients who received segmentectomy and local resection in precise group,and were 15 minutes,14.0×10~9/L,335 U/L and 42%(10/24)in patients who received segmentectomy and local resection in pringle group,with significant difference(t=4.962,4.961,4.959,P<0.05).In precise group,the blood transfusion rate,postoperative WBC count,ALT value.PT and fever incidence were 9%(4/45),8.3×10~9/L,153 U/L,17 seconds and 13%(6/45)in patients who received Iobectomy,and were 12%(5/43),8.2×10~9/L,133 U/L,14 seconds and 14%(6/43)in patients who received segmentectomy or lncal resection,with no significant difference (t=1.652,1.225,1.236,P>0.05);the blood loss,operation time and postoperative Tbil level were 350 ml,250 minutes and 32μmol/L in patients who received lobectomy.and were 240 ml,150 minutes and 21 μmol/L in patients who received segmentectomy or local resection(t=4.915,4.967,4.829,P＜0.05).Conclusions Precise hepatectomy can decrease damage to patients,but it should be applied in selected patients according to the tumor location and the excision range.Precise hepatectomy is recommended to be applied in lobeetomy.

This paper presents the detail methods which innovation activities are in harmony for fundamental medical physics ex- periment teaching without increasing course period and new equipment.

Objective To evaluate the efficacy of living donor liver transplantation in the treatment of infants with end-stage liver diseases. Methods The clinical data of 33 infants who received living donor liver transplantation at the Renji Hospital of Shanghai Jiaotong University from October 2006 to September 2009 were retrospectively analyzed. The median age of the infants was 10.9 months, and the mean body weight was 8.2 kg.All of the grafts were left lateral lobes. Tacrolimus (or cyclosporine A) + steroid or tacrolimus (or cyclosporine A)+ steroid + mycophenolate mofeti] were applied to the infants to suppress the immune reaction. Operative techniques, perioperative management and results of follow-up were analyzed. Results The mean operation time,blood loss and blood transfusion of the donors were (384±108)minutes, (183±35) ml and O, and the three indexes of the recipients were (500± 103) minutes, (296±163) ml and (292 ± 159) ml , respectively. The cold preservation time of the grafts was (64 ±23)minutes, the mean weight of the grafts was (249 ±52)g, and the mean graft to recipient weight ratio was 2.1% ± 0.4%. All donors recovered smoothly and no complication occurred. Of the recipients, three were complicated with hepatic artery thrombosis, two with portal vein thrombosis,nine with biliary complications, 11 with infection, two with acute rejection and five infants died perioperatively.The one-year cumulative survival rate of the infants was 85% (28/33). Conclusions Infants with end-stage liver diseases could be treated by living donor liver transplantation. The development of surgical techniques and perioperative managements improves the success rate of operation and the long-term survival rate.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; radiotherapy ; Esophageal Neoplasms ; metabolism ; pathology ; radiotherapy ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Inhibitor of Apoptosis Proteins ; Lymphatic Metastasis ; Male ; Microtubule-Associated Proteins ; metabolism ; Middle Aged ; Neoplasm Staging ; Paraffin Embedding ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism

To statistically study the patients with asplenia syndrome combining complex congenital heart disease (CHD) for their common cardiac malformation, frequency of occurrence and to explore the anatomical features with possible mechanism. Methods: A total of 47 patients with asplenia syndrome were analyzed including 27 male and 20 female at the age from 23 days to 32 years. The common cardiac malformation and frequency of occurrence were statistically studied. Results: ① The cardiac malformations were mainly with the following types: abnormal position of heart in 16 (34.0%) cases, a wide range of septal tissue defect in 47 (100%) cases, abnormal atrio-ventricular valve in 42 (89.4%) cases, abnormal aortic origin in 47 (100%) cases, abnormal position of 2 grate arteries in 46 (97.8%) cases, right ventricular outflow obstruction/pulmonary arterydysplasiain 45 (95.7%) cases, anomalous systemic venous drainage in 44 (91.5%) cases and anomalous pulmonary venous drainage in 28 (59.6%) cases. ② The cardiac malformations were usually involved in several positions as 1 (2.1%) patient with 4 kinds of abnormal structures, 5 (10.6%) patients with 5 kinds of abnormal structures, 13 (27.7%) patients with 6 kinds of abnormal structures, 23 (48.9%) patients with 7 kinds of abnormal structures and 7 (14.9%) patients with 8 kinds of abnormal structures. Conclusion: Asplenia syndrome combining cardiac malformation has been complex while with specificity. Laterality dysfunction might be the primarycause for series malformations.