Objective : To construct an appropriate technology catalogue for general practice based on Delphi method,and to provide reference for promoting appropriate techniques and training general practitioners. Methods : The catalogue was briefly constructed based on literature reviews and the data of the top twenty diseases diagnosed in out-patient department of Sir Run Run Shaw Hospital and two community health service centers in Hangzhou. Two-round Delphi consultation was conducted by fourteen general practitioners coming from upper first-class hospitals and community hospitals. The final catalogue was established according to evaluation of the degree of involvement,authority coefficient and Kendall's W values of the fourteen specialists. consultations : Results Of the fourteen specialists,nine had bachelor's degrees and five had master's degrees or above;twelve were deputy chief physicians or chief physicians and two were physicians. They were engaged in general practice for 17.21 years in average. The positive coefficients of the two rounds of were both 100.00%. The authority coefficient of the specialists was 0.891. After the first round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.170 and 0.244,and the ones of 56 second-class indicators were 0.236 and 0.250（all P<0.05）. Six of second-class indicators were excluded because their coefficent of variation（CV）for importance and feasibility were more than 0.25. After the second round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.245 and 0.247,and the ones of 50 second-class indicators were 0.355 and 0.370（all P<0.05）. The CV for each indicator was less than 0.25. Finally,an instructional catalogue was defined,consisting of 6 first-class indicators（basic diagnosis and treatment skills,first aid skills,symptomatic diagnosis and treatment skills,chronic disease management skills,common disease diagnosis and treatment skills,and common manipulative skills）and 50 second-class indicators. Conclusion The degrees of involvement,authority and consistency of the specialists were relatively high. The catalogue of appropriate technology for general practitice had good reliability and feasibility,which was worthy of promotion and application.

OBJECTIVETo explore the effects of Xingnaojing injection on cerebral edema and blood-brain barrier (BBB) in rats following traumatic brain injury (TBI).

METHODSA total of 108 adult male Sprague-Dawley rats were used as subjects and randomly assigned to three groups: sham-operation, TBI and Xingnaojing injection groups (10 ml/kg/d, intraperitoneal injection). TBI in rats was set up by the improved device of Feeney's weight-dropping model with the impact of 600 g.cm. Brain water content and BBB permeability expressed as Evans blue content were measured at 1, 3, 5 and 7 days after surgery.

RESULTSIn sham-operation group, brain water content and Evans blue content in brain tissue were 78.97%+/-1.22% and 5.13 microgram+/-0.71 microgram. Following TBI, water content in brain tissue was increased significantly at 1, 3, 5 and 7 days (83.49%+/-0.54%, 82.74%+/-0.72%, 80.22%+/-0.68%, 79.21%+/-0.60%), being significantly higher than that in sham operation group (P less than 0.05). Evans blue content was increased in TBI group (16.54 microgram+/-0.60 microgram, 14.92 microgram+/-0.71 microgram, 12.44 microgram+/-0.92 microgram, 10.14 microgram+/-0.52 microgram) as compared with sham-operation group(P less than 0.05). After treatment with Xingnaojing injection, brain water content decreased as compared with TBI group (81.91%+/-1.04%, 80.38%+/-0.72%, 79.54%+/-0.58%, 78.60%+/-0.77%, P less than 0.05). Xingnaojing injection also reduced the leakage of BBB as compared with TBI group (15.11 microgram+/-0.63 microgram, 13.62 microgram+/-0.85 microgram, 10.06microgram+/-0.67 microgram, 9.54 microgram+/-0.41 microgram, P less than 0.05).

CONCLUSIONXingnaojing injection could alleviate cerebral edema following TBI via reducing permeability of BBB.

Animals ; Blood-Brain Barrier ; drug effects ; Brain ; pathology ; Brain Edema ; drug therapy ; Brain Injuries ; drug therapy ; pathology ; Drugs, Chinese Herbal ; administration & dosage ; Injections ; Male ; Medicine, Chinese Traditional ; Permeability ; Rats ; Rats, Sprague-Dawley

Brain edema leading to an expansion of brain volume has a crucial impact on morbidity and mortality following traumatic brain injury as it increases intracranial pressure, impairs cerebral perfusion and oxygenation, and contributes to additional ischemic injuries. Classically, two major types of traumatic brain edema exist: "vasogenic" and "cytotoxic/cellular". However, the cellular and molecular mechanisms contributing to the development/resolution of traumatic brain edema are poorly understood and no effective drugs can be used now. Aquaporin-4 (AQP4) is a water-channel protein expressed strongly in the brain, predominantly in astrocyte foot processes at the borders between the brain parenchyma and major fluid compartments, including cerebrospinal fluid and blood. This distribution suggests that AQP4 controls water fluxes into and out of the brain parenchyma. In cytotoxic edema, AQP4 deletion slows the rate of water entry into brain, whereas in vasogenic edema, AQP4 deletion reduces the rate of water outflow from brain parenchyma. AQP4 has been proposed as a novel drug target in brain edema. These findings suggest that modulation of AQP4 expression or function may be beneficial in traumatic brain edema.
Animals ; Aquaporin 4 ; analysis ; antagonists & inhibitors ; chemistry ; physiology ; Brain ; metabolism ; Brain Edema ; drug therapy ; etiology ; Brain Injuries ; complications ; Humans ; Mice

To reduce the problems of poor solubility, high in vivo dosage requirement, and weak targeting ability of paclitaxel (PTX), a hyaluronic acid-octadecylamine (HA-ODA)-modified nano-structured lipid carrier (HA-NLC) was constructed. HA-ODA conjugates were synthesized by an amide reaction between HA and ODA. The hydrophobic chain of HA-ODA can be embedded in the lipid core of the NLC to obtain HA-NLC. The HA-NLC displayed strong internalization in cluster determinant 44 (CD44) highly expressed MCF-7 cells, and endocytosis mediated by the CD44 receptor was involved. The HA-NLC had an encapsulation efficiency of PTX of 72.0%. The cytotoxicity of the PTX-loaded nanoparticle HA-NLC/PTX in MCF-7 cells was much stronger than that of the commercial preparation Taxol®. In vivo, the HA-NLC exhibited strong tumor targeting ability. The distribution of the NLCs to the liver and spleen was reduced after HA modification, while more nanoparticles were aggregated to the tumor site. Our results suggest that HA-NLC has excellent properties as a nano drug carrier and potential for in vivo targeting.

Objective To investigate the effect of RablA on proliferation and apoptosis of multiple myeloma (MM) cell line 8226. Methods The siRNA interference was used to knockdown RablA gene. The multiple myeloma cell line 8226 was divided into blank control group, negative control group and RablA siRNA group. In the blank control group, the multiple myeloma cells were not treated. Multiple myeloma cells 8226 in the negative control group were transfected with negative control siRNA. The RablA siRNA group was transfected with Rabl A-targeted siRNA. The effect of RablA on multiple myeloma cell 8226 proliferation was analyzed by colony forming test and cell counting kit-8 (CCK-8) assay. The apoptosis of multiple myeloma cell 8226 was detected by flow cytometry. Western blotting and Real-time PCR were used to observe the effect of RablA siRNA on the expression of c-Myc, cyclin D1, Bcl-2 and Bax. Results The expressions of RablA mRNA and RablA protein in the RablA siRNA group were significantly down-regulated compared with those in the negative control group. The result of colony formation and CCK-8 assay showed that RablA siRNA inhibit the proliferation of multiple myeloma cells 8226. The early and late apoptosis ratio of multiple myeloma cell 8226 in RablA siRNA group increased significantly compared with the negative control group (P<0.05). The expression of cyclin D1 and Bcl-2 in the RablA siRNA group were significantly down-regulated compared with the negative control group (P<0.05), and the expression of c-Myc and Bax were significantly up-regulated compared with the negative control group (P<0.05). Conclusion RablA may promote the proliferation of multiple myeloma cells 8226 by regulating the expression of c-Myc, cyclin Dl, Bcl-2 and Bax, while RablA siRNA can effectively inhibit the expression of RablA in rpmi-8226 cells, thereby inhibiting its proliferation and promoting apoptosis.

OBJECTIVETo study the effect on the corrosion resistance of Cr alloy in the artificial saliva with different pH value in vitro.

METHODSCompared to Ti alloy, electrochemical technique was used to measure the electric potential of corrosion (E(corr)), current density of corrosion (I(corr)) Cr alloy in the artificial saliva with different pH value. The corrosion and corrosion resistance mechanism on Cr alloy in the artificial saliva with different pH value had been investigated by the EIS curves.

RESULTSThe corrosion resistance of Co-Cr alloy was better than Ti alloy. The value of I(corr) was lower and the value of R(p) was larger than Ti alloy. The corrosion resistance of Ni-Cr alloy was worse than Ti alloy. The value of I(corr) was larger and the value of R(p) was lower than Ti alloy. The pH value in the artificial saliva was decreased, the I(corr) value of three types of alloy increased, the R(p) value of three types of alloy decreased. But the changes of Co-Cr alloy was smaller than that of Ti alloy or Ni-Cr alloy.

CONCLUSIONThe corrosion resistance of Co-Cr alloy was superior to that of Ni-Cr alloy and Ti alloy. In the acid artificial saliva, the corrosion resistance of three types of alloy descended evidently.

Corrosion ; Dental Alloys ; Electrochemistry ; Saliva, Artificial ; Surface Properties ; Titanium

OBJECTIVETo observe the distribution of HBV variants resistant to lamivudine and their relation to clinical manifestations of chronic hepatitis.

METHODSUsing direct sequencing, YMDD (tyrosine-methionine-aspartate-aspartate) variants in patients with chronic HBV were detected before and during treatment with lamivudine. A statistical analysis of the distribution of HBV strains resistant to lamivudine was performed.

RESULTFour variant strains existed in patients before lamivudine treatment, 128 variant resistant strains were noted after 6 mouths of lamivudine treatment including 42 YVDD (valine) variants, 20 YIDD (isoleusine) variants and 66 non-YMDD variants. According to the hepatitis severity, 8 patients were mild, 108 moderate and 12 severe. Viral loading was higher and clinical types were more severe in no-YMDD variants.

CONCLUSIONVariant strains including strains resistant to lamivudine exist naturally before lamivudine treatment, but lamivudine-resistant ones become more dominant after treatment. Liver inflammation is more severe in non-YMDD group.

Antiviral Agents ; pharmacology ; Drug Resistance, Viral ; Genetic Variation ; Hepatitis B virus ; drug effects ; genetics ; Lamivudine ; pharmacology

OBJECTIVETo construct a recombinant adenovirus vector containing bone morphogenic protein-7 (BMP-7) gene and to identify its biological activities in proximal tubule epithelial cells (PTECs).

METHODSForty-six fragments of BMP-7 gene were obtained by PCR method and then were ligated to the full-length gene. The full length sequence of BMP-7 was subcloned into pBluescript II(+) vectors, and confirmed by sequencing. Double digested with Not I and Hind III, BMP-7 gene was inserted into pShuttle-CMV. EcoR I pre-linearized pShuttle plasmid was transformed into competence bacterium BJ5183 to obtain the recombinant adenovirus-BMP-7 by efficient homologous recombination. Then the AdBMP-7 was obtained by packaging Pac I linearized in 293 cells. Adenoviral titer was determined by adenovirus fluorescent detection kit. The protein expression of BMP-7 in PTECs was respectively detected by ELISA and Western blot. RT-PCR method was used for analyzing the alpha-smooth muscle action (alpha-SMA) expression in PTECs, which was treated consecutively with TGF-beta and AdBMP-7.

RESULTSThe recombinant plasmid AdBMP-7 was successfully generated, which increased BMP-7 protein expression levels in PTECs, and down-regulated TGF-beta-induced alpha-SMA expression.

CONCLUSIONThe bioactive recombinant adenovirus AdBMP-7 has been successfully constructed, which may be effective in inhibition of chronic renal fibrosis.

Adenoviridae ; genetics ; metabolism ; Animals ; Base Sequence ; Bone Morphogenetic Protein 7 ; biosynthesis ; genetics ; Cells, Cultured ; Epithelial Cells ; metabolism ; Genetic Vectors ; genetics ; Kidney Tubules, Proximal ; cytology ; metabolism ; Molecular Sequence Data ; Rats ; Recombinant Proteins ; biosynthesis ; genetics

Recently, we treated a patient with pulmonary vein sarcoma. The patient was a 41-year-old woman, had cough, short of breath and apsychia, with obvious jugular venous distention, rales in both lungs and a diastolic murmur at the apex. CT and Echo revealed a tumor in the left atrium. She received an emergency surgery to remove the mass in the heart. The pathological diagnosis demonstrated it as leiomyosarcoma. Though the patient accepted radiotherapy and chemotherapy, she still died of recurrence and metastasis of the sarcoma 10 months after operation.
Adult ; Fatal Outcome ; Female ; Humans ; Pulmonary Veins ; pathology ; surgery ; Sarcoma ; diagnosis ; drug therapy ; surgery ; Vascular Neoplasms ; diagnosis ; drug therapy ; surgery

OBJECTIVETo evaluate the efficacy and safety of adefovir dipivoxil in treatment of decompensated liver cirrhosis patients with YMDD motif mutation during lamivudine therapy.

METHODSThe disease relapsed in 14 hepatitis B patients with decompensated liver cirrhosis during lamivudine treatment due to the YMDD motif mutation. All 14 patients had positive HVBDNA and active hepatitis, and were evaluated as Child-Pugh Score C (CPS-C). The patients were treated with lamivudine 50 mg/d and adefovir dipivoxil 10 mg/d for 6 months.

RESULTSOne patient signed off due to non-hypoxemic hyperlactacidemia; other 13 patients showed decreased serum HBVDNA. All patients had serum HBVDNA < or =10(5) copies/ml and 7 patients had HBVDNA < or =10(4) copies/ml. Six patients regained normal serum ALT level and Child-Pugh scores decreased in all patients.

CONCLUSIONAdefovir dipivoxil has satisfied efficacy and safety in treatment of decompensated liver cirrhosis patients with YMDD motif mutation during lamivudine treatment.

Adenine ; adverse effects ; analogs & derivatives ; therapeutic use ; Adult ; Aged ; Amino Acid Motifs ; genetics ; Antiviral Agents ; therapeutic use ; DNA-Directed DNA Polymerase ; genetics ; Female ; Hepatic Encephalopathy ; drug therapy ; genetics ; virology ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy ; genetics ; virology ; Male ; Middle Aged ; Mutation ; Organophosphonates ; adverse effects ; therapeutic use ; Protein Structure, Tertiary ; genetics ; Recurrence ; Reverse Transcription ; genetics