In this paper , the causes of patients in emergency ICU were analyzed .The authors used classical theory of ethics to illuminate and put forward the ethical principles that both doctors and patients should follow and the conception of patients′moderate right , as well as the relevant suggestions and strategies , with the aim to make the application of emergency ICU medical resources more reasonable and make the treatment and cure of the emer -gency and critical patients more conform to the requirement of the ethics .

AIM:To observe the effect of Tianbing Tiaodu Capsule on learning and memory,and expression of BDNF in brains of picrotoxin-kindled epilepsy rats. METHODS: The epilepsy rat model was established by picrotoxin in jection.The effects of Tianbing Tiaodu Capsule were observed on the model groups and compared with sodium valproate group and piracetam group.The behavior and emotion of epilepsy rats were observed by Action Observing Box.Its reactions were assessed by snatching rats with the gloves.The learning and memory abilities were tested after Morris water maze training.The brains were made into paraffin sections,processed for HE staining and Nissl staining.The expression levels of BDNF were measured by immunohistochemical S-P techniques. RESULTS: Taking Tianbing Tiaodu Capsule,the behavior and emotion of epilepsy rats were markedly improved.The escape latency of searching the platform were shortened and times of rats acrossing the original platform were increased.Tianbing Tiaodu Capsule could reduce neuron impairment and necrosis on the cordex and Hippocampus of epilepsy rats,improve the loss of Nissl bodies,increase BDNF positive remarks. CONCLUSION: Tianbing Tiaodu Capsule can markedly improve impairment of learning and memory in picrotoxin-kindle epilepsy rats,which might be the result of increaseing BDNF expression,the protection of Nissl bodies,making protein synthesize,improving neuron function.

Objective To judge method performance of routine biochemistry parameters on Roche Modular PPI testing system by using westgard's method evaluation decision chart.Methods We assessed imprecision(CV)from internal quality control and inaccuracy(bias)from external quality control evaluation.Combined estimates of imprecision and inaccuracy by plotting imprecision as the x-coordinate and inaccuracy as the y-coordinate to locate an expected operating point of every item on the chart.By comparing this operating point with allowable total errors(TEa),we can decide whether the performance is acceptable or not.Results In the 27 different parameters tested,imprecision and bias of calcium were 0.08 mmol/L and 0.06 mmol/L respectively,its performance was marginal.The imprecision of creatinine,urea,glucose, sodium,chloride and phosphorus were 3.20%,2.13%,1.52%,0.89 mmol/L,1.10% and 1.55%,the bias were 4.79%,0.96%,4.63%,0.80 mmol/L,1.74% and 4.13% respectively,their performance was good.M1 other 20 items were of excellence performance.Conclusions Routine biochemistry parameters on Roche Modular PPI testing system possessed good precision and accuracy,and their performance were acceptable.To judge method performance of biochemistry testing system by using westgard' s method evaluation decision chart was easy to do and suited for clinical laboratory.

Objective To investigate the potential of adult mesenchymal stem cells (MSCs) derived from human bone marrow to undergo cardiomyogenic differentiation after exposure to 5-azacytidine (5-aza) in vitro. Methods A small bone marrow aspirate was taken from the iliac crest of human volunteers, and hMSCs were isolated by 1.073g/mL Percoll and propagated in the right cell culturing medium as previously described. The phenotypes of hMSCs were characterized with the use of flow cytometry. The hMSCs were cultured in cell culture medium (as control) and medium mixed with 5-aza for cellular differentiation. We examined by immunohistochemistry at 21 days the inducement of desmin, cardiac-specific cardiac troponin I (cTnI), GATA 4 and connexin-43 respectively. Results The hMSCs are fibroblast-like morphology and express CD44+ CD29+ CD90+ / CD34- CD45- CD31- CD11a. After 5-aza treatment, 20-30% hMSCs connected with adjoining cells and coalesced into myotube structures after 14days. Twenty-one days after 5-aza treatment, immunofluorescence showed that some cells expressed desmin,GATA4, cTnI and connexin-43 in 5,10 μmol/L 5-aza groups, but no cardiac specific protein was found in neither 3μmol/L 5-aza group nor in the control group. The ratio of cTnI positively stained cells in 10 μmol/L group was higher than that in 5 μmol/L group (65.3 ± 4.7% vs 48.2 ± 5.4%, P ＜ 0.05). Electron microscopy revealed that myofilaments were formed. The induced cells expressed cardiac-myosin heavy chain (MyHC) gene by reverse transcription-polymerase chain reaction (RT-PCR). Conclusions Theses findings suggest that hMSCs from adult bone marrow can be differentiated into cardiac-like muscle cells with 5-aza inducement in vitro and the differentiation is in line with the 5-aza concentration. (J Geriatr Cardiol 2004;1(2) :101-107. )

Objective To study the incidence of stroke among elderly people in China's longevity area and its association with diseases such as hypertension,diabetes and heart disease.The differences in the following common hematological indicators in subjects with stroke and non-hypertension,diabetes,heart disease and stroke were studied:superoxide dismutase (SOD),malondialdehyde (MDA),hypersensitive c-reactive protein (hsCRP),albumin (propagated) glucose (GLU),cholesterol (CHO),triglyceride (TG),high-density lipoprotein cholesterol (HDLC),glycosylated serum protein (GSP) urea nitrogen (BUN),creatinine (CREA) and uric acid (UA).Methods Residents who participated in the project of biomedical research of aging population conducted in 2014 were selected from 8 longevity Areas in China.2 315 people aged 40 and over attended the study,including 22 aged 40 and over,238 aged 60 and over,490 aged 70 and over,629 aged 80 and over,518 aged 90 and over,418 aged 100 and over.Using the self-designed questionnaire to collect information about the characteristics of social demographics,the clinical doctors used the unified inspection tool to examine the subjects.The fasting blood samples were collected by vacuum tube at early morning.The contents of plasma SOD,MDA,hsCRP,ALB,GLU,CHO,TG,HDLC,GSP,BUN,CREA and UA were detected and compared among these elderly who were classified into different genders and different age groups and different healthy groups.Results The prevalence of high blood pressure,diabetes,heart disease and stroke increased with age,reaching a peak and then slowly decreasing.The age of peak was 90 ～ 99,60 ～ 69,70～ 79 and 80～ 89.The prevalence of hypertension was 71.62 ％ and 60.54 ％ respectively for stroke subjects and non-cerebral apoplexy subjects,and the difference was statistically significant.The prevalence of diabetes was 18.92％ and 11.35％ respectively,and the difference was statistically significant.The prevalence of heart disease was 20.98％ and 5.26％,respectively,and the difference was statistically significant.The rates of non-hypertension,non diabetic and non-heart disease were 4.73％ and 33.41％ respectively,and the difference was statistically significant.In the groups of Stroke subjects and Non-high blood pressure,nomdiabetic,non-heart disease subjects the following indicators were Compared,values of SOD were 55.76±8.27 and 57.16±8.00 U/ml respectively,the difference between groups were not statistically significant (t=0.341,P=0.053),values of MDA were 5.81 ± 3.82 and 5.67± 3.16 μmol/L respectively,the difference between groups were not statistically significant (t=0.329,P =0.661),values of hsCRP were 4.15 ± 12.33 and 2.94 ± 6.25 mg/L,respectively,the difference between groups were not statistically significant (t=0.026,P=0.080),values of ALB were 41.60±4.51 and 42.08±3.94 g/L respectively,the difference between groups were not statistically significant (t=0.032,P=0.194),values of ALB were 41.60 ± 4.51 and 42.08± 3.94 g/L respectively,the difference between groups were not statistically significant (t =0.032,P=0.194),values of ALB were 41.60 ± 4.51 and 42.08 ± 3.94 g/L respectively,the difference between groups were not statistically significant (t =0.032,P=0.194),values of GLU were 5.89 ± 2.67 and 4.90 ± 0.90 mmol/L respectively,the difference between groups showed statistically significant (t=0.000,P=0.000)),values of CHO were 4.81 ± 1.00 and 4.71±1.02 mmol/L respectively,the difference between groups were not statistically significant (t =0.670,P=0.318),values of TG were1.33±0.69 and 1.14±0.57 mmol/L respectively,the difference between groups showed statistically significant (t=0.012,P=0.000),values of HDLC were 1.29±0.35 and 1.41±0.40 mmol/L respectively,the difference between groups showed statistically significant (t=0.004,P=0.001),values of GSP were 259.10±60.90 and 246.75±24.52 μmol/L respectively,the difference between groups showed statistically significant (t =0.000,P =0.000),values of BUN were 6.84±± 3.53 and 6.62 ± 2.20 mmol/L respectively,the difference between groups were not statistically significant (t=0.110,P=0.338),values of CREA were 84.92 ± 33.00 and 80.14 ± 24.64 μmol/L respectively,the difference between groups showed statistically significant (t=0.013,P=0.044),values of UA were 296.73±91.34 and 288.12±80.47 μmol/L respectively,the difference between groups were not statistically significant (t=0.123,P=0.247).Conclusion Diabetes,hypertension,and heart disease are risk factors for stroke.Abnormal blood glucose and lipid metabolism:the increase of GLU,TG and the decrease of HDLC are important common biochemical index of stroke.Patients with cerebral apoplexy have certain renal impairment.

Objective To establish a method performance verification project and experimental method for the clinical chemiluminescence immunoassay.Methods Referring to CLSI evaluation protocols and pertinent literature,and by combining our actual works,we designed a verification procedure and experimental method.By Using these above,the precision,accuracy,analytical sensitivity,analytical measurement range,clinical reportable range and biotic interval of AFP on the Bayer Centaur 240 chemiluminescence immunoassay system were verificated.Results would be compared with the declaration of the manufacturer or desirable specifications derived from biologic variation.Results The results showed that the between-day inaccuracy on AFP levels at 77.4 ng/ml and 168.0 ng/ml was 5.70% and 4.84% respectively,these were consistent with manufacturer's inaccuracy claimed.The relative bias between the results measured for calibrator at four levels and target value was less 5.0%,and the relative bias between the results measured for EQA control sample at five levels and target value was-3.4% to 11.9%.Lower limit of detection was 1.04 ng/ml,lower slightly manufacturer's analytical sensitivity claimed.Biologic limit of detection was 2.65 ng/ml-3.53 ng/ml,functional sensitivity was 3.53 ng/ml.Analytical measurement range was 3.53-912.00 ng/ml,within manufacturer's liner range claimed.Clinical reportable range was 3.53-182 400.00 ng/ml.Reference interval was 0.6-7.7 ng/ml,within manufacturer' s claimed.Conclusions The main performances of the detection system are accorded with the declaration of the manufacturer.The performance verification procedure and experimental method of our research ars simple and practical,which has important significations for building medical laboratory and laboratory accreditation, improving quality of the chemiluminescence immunoassay.

OBJECTIVETo evaluate the association between vasectomy and prostate cancer.

METHODSWe searched comprehensively the databases, CBMDisc, CMCC, CMAC, CNKI (from 1978 to January 6, 2009), and PubMed (from 1965 to January 6, 2009) using the key words "vasectomy" and "prostate cancer", screened the retrieved literature according to the inclusion and exclusion criteria, performed a Meta-analysis with the software RevMan 4.2 after identification of the relevant data, and calculated the overall pooled OR (95% CI) as well as that of the association of prostate cancer with <20 and > or =20 yr vasectomy.

RESULTSA total of 20 088 cases and 232 506 controls in 27 reports (7 cohort and 20 case-control studies) were included in this investigation. The overall pooled OR (95% CI) was 1.10 (0.97-1.24), and those of <20 and > or =20 yr vasectomy were 0.94 (0.83-1.06) and 1.05 (0.90-1.23), respectively.

CONCLUSIONNo existing literature show any positive association between vasectomy and prostate cancer.

Humans ; Male ; Prostatic Neoplasms ; epidemiology ; etiology ; Risk Factors ; Vasectomy ; adverse effects

OBJECTIVETo investigate the relationship of seminal plasma levocarnitine with sperm concentration, vitality and motility.

METHODSEnrolled in this study were 64 infertile men, who were divided according to the results of routine sperm tests into a normozoospermia (n = 12), an oligozoospermia (n = 16), an asthenozoospermia (n = 20) and an oligoasthenozoospermia group (n = 16). The level of seminal plasma levocarnitine was detected by LC-MS-MS, the concentration of seminal plasma testosterone measured by chemiluminescence immunoassay, the correlation of seminal plasma levocarnitine with sperm concentration, motility and vitality determined by bivariate correlation analysis with SPSS15.0, and so was the correlation between the carnitine and sperm concentration by partial correlation analysis with seminal plasma testosterone as a control variable to exclude the influence of testosterone.

RESULTSThe concentrations of total seminal plasma levocarnitine, free seminal plasma levocarnitine and seminal plasma acetolevocarnitine were (91.33 +/- 40.49) mg/L, (40.89 +/- 24.13) mg/L and (50.44 +/- 21.90) mg/L; the Pearson coefficients of correlation of the levocarnitine level with sperm motility, vitality and concentration were 0.161 (P = 0.235), 0.114 (P = 0.370) and 0.637 (P < 0.001), those of free seminal carnitine with sperm motility and vitality were 0.325 (P = 0.024) and 0.316 (P = 0.029), respectively, with the oligozoospermia group excluded, and that of partial correlation between the concentrations of seminal levocarnitine and sperm was 0.641 (P < 0.001).

CONCLUSIONThe level of seminal plasma levocarnitine is positively correlated with sperm motility and vitality, and more significantly with sperm concentration.

Adult ; Carnitine ; analysis ; Humans ; Infertility, Male ; physiopathology ; Male ; Semen ; chemistry ; cytology ; Sperm Count ; Sperm Motility ; physiology ; Spermatozoa ; cytology ; physiology ; Young Adult

OBJECTIVETo investigate the effect of the different immunosuppression therapy on CD4(+)Foxp3(+)regulatory T cells (CD4(+)Foxp3(+)Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.

METHODSA Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008, who had been followed up for 1 year. The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients, including cyclosporin group 10 recipients and tacrolimus group 9 recipients), rapamycin group (RAPA + MMF + Pred) (31 recipients). Twenty end-stage renal disease patients were in control group. The frequency of CD4(+)Foxp3(+)Treg cells in total CD4(+)T cells was analyzed by flow cytometry in peripheral blood from three groups, results were compared.

RESULTSThe clinical variables of recipients such as age, sex, cold ischemia time, human leucocyte antigen mismatch, panel reaction antibody, rejection episode were no significant difference. The percentage of CD4(+)Foxp3(+)Treg cells in total CD4(+) cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group (P < 0.01). The level of CD4(+)Foxp3(+)Treg cells between cyclosporin group and tacrolimus group was no significant difference (P > 0.05).

CONCLUSIONThe level of CD4(+)Foxp3(+)Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred, which suggested that RAPA may be play a more important role in immune tolerance induction.

Adult ; Female ; Follow-Up Studies ; Forkhead Transcription Factors ; Humans ; Immunosuppression ; methods ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; immunology ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; T-Lymphocytes, Regulatory ; drug effects ; immunology

OBJECTIVEFMS-like tyrosine kinase 3 (FLT3) is a receptor tyrosine kinase that is constitutively activated in (70-90)% pediatric patients with acute myeloid leukemia (AML) and appears to confer an adverse prognosis. Although several FLT3-selective small molecule inhibitors and antibodies were developed with varied degrees of success, to address the specificity and resistance, new approaches for specifically targeted FLT3 are needed and RNA interference is a promising choice. The aim of the present study was to investigate the efficacy of suppression of FLT3 induced by small hairpin interfering RNA (shRNA) on myeloproliferation and apoptosis in an acute monocytic leukemia (AMOL) cell line THP-1.

METHODSFLT3-targeted small hairpin interfering RNA (FLT3-shRNA) was designed and synthesized by transcription system in vitro was transfected into THP-1 cells. Firstly FLT3 mRNA level was detected by semi-quantitative RT-PCR and FLT3 protein level was detected by flow cytometry (FCM) to verify the efficacy on FLT3-shRNA interference at 48 h after transfection. Cell growth viability was measured at 24 h, 48 h and 72 h after treatment with CCK-8. The distribution of cell cycle was assayed by FCM, and apoptosis was analyzed by DNA Ladder and Annexin V-FITC Staining at 48 h.

RESULTSFLT3 targeted shRNAs was synthesized successfully and the concentration of 15 nmol/L for 48 h could obtain desirable downregulation of FLT3 expression, the inhibitory percentages of FLT3 mRNA and protein were (72.95 +/- 2.07)% and (65.39 +/- 5.57)%, respectively. The suppression of FLT3 induced by FLT3-shRNA resulted in marked inhibition of cell growth and the inhibitory percentages were (36.66 +/- 3.67)% at 48 h, (35.56 +/- 0.73)% at 72 h. FLT3-shRNA induced the inhibition of cell cycle from G(0)/G(1) phase to S phase, the percentage of sub-G(0)/G(1) phase (65.71 +/- 4.47)% was higher than those in the PBS-control group (52.23 +/- 2.98)%, NC-shRNA control group (51.81 +/- 1.44)%, P < 0.01; the percentage of S phase (25.11 +/- 2.70)% was lower than those in the PBS-control group (34.41 +/- 4.07)% and NC-shRNA control group (32.50 +/- 1.46)%, P < 0.05. Furthermore treatment with FLT3-shRNA for 48 h resulted in clear apoptosis ladder, the percentage of early apoptosis detected by Annexin V-FITC was (18.59 +/- 2.07)% which was significantly higher than that in the PBS-control group (4.00 +/- 0.50)% and the NC-shRNA control group (6.06 +/- 0.70)%, P < 0.001.

CONCLUSIONThe suppression of FLT3 induced by the shRNA can effectively inhibit cell proliferation, and apoptosis induction on THP-1 cells, which indicates that this approach may bear the therapeutic potential on childhood AMOL.

Apoptosis ; drug effects ; genetics ; Cell Proliferation ; drug effects ; Child ; Humans ; Leukemia, Monocytic, Acute ; enzymology ; pathology ; Protein-Tyrosine Kinases ; metabolism ; RNA Interference ; physiology ; RNA, Small Interfering ; pharmacology ; Receptor Protein-Tyrosine Kinases ; metabolism ; fms-Like Tyrosine Kinase 3 ; metabolism