Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

Objective: To explore the relationship between platelet counts at admission and in-hospital mortality in patients with type A acute aortic dissection (AAD). Methods: We investigated 183 consecutive patients with CT conifrmed diagnosis of type A AAD treated in our hospital from 2012-02 to 2013-05. There were 126 (68.9%) male and the patients were divided into 3 sets of groups.①In-hospital surviving group,n=157 and In-hospital death group,n=26.②According to platelet counts, the patients were divided into 5 groups: Q1 group, platelet counts ≤ 119×109/L,n=36, Q2 group, platelet (120-149) ×109/L,n=37, Q3 group, platelet (150-173)×109/L, n=36, Q4 group, platelet (174-228)×109/L,n=37, Q5 group, platelet >228×109/L,n=37.③At admission, platelet ≤ 119×109/L,n=36 and platelet >119×109/L,n=147. In addition, the patients were further divided into another 4 groups based on operative condition: platelet ≤ 119×109/L with operation,n=18, without operation,n=18; platelet > 119×109/L with operation,n=96, without operation,n=51. The basic information at admission including platelet counts, WBC and D-dimer were studied in all groups, the primary endpoint was in-hospital mortality. Results: The overall in-hospital mortality was 14.3%. Compared with In-hospital surviving group, the In-hospital mortality group had decreased platelet counts, lower blood pressure and higher level of D-dimer. The mortality in Q1 group (38.9%) was higher than those in Q2, Q3, Q4 and Q5 groups (10.8%, 11.1%, 8.1% and 2.7%), allP<0.001. The risk of death in Q5 group was higher than Q1 group (HR=11.2, 95% CI 2.13-123.3,P=0.007). With adjusted age, gender and other relevant factors, when platelet counts ≤ 119×109/L, the risk of in-hospital mortality with Cox multivariate model I analysis was (HR3.90, 95% CI 1.67-9.09,P=0.002), with Cox model II was (HR=2.67, 95% CI 1.15 -6.19,P=0.023). Conclusion: AAD patients with admission platelet counts ≤ 119×109/L had the high risk of in-hospital death, even with operation, lower platelet counts was still related to in-hospital death.

AIMTo increase the solubility and bioavailability of all-trans retinoic acid (ATRA).

METHODSUsing the principle of lecthin/bile salt mixed micelle to prepared ATRA injection. The best formulation was obtained by the turbidity and three-phase figure.

RESULTSATRA mixed micelles injection is stable. The average size of the mixed micelle is 17.8 nm, poly. index 0.495, zeta potential -16.5 mV.

CONCLUSIONThe method can be used to prepare the stable injection.

Antineoplastic Agents ; administration & dosage ; chemistry ; Bile Acids and Salts ; Drug Stability ; Micelles ; Phosphatidylcholines ; Solubility ; Technology, Pharmaceutical ; methods ; Tretinoin ; administration & dosage ; chemistry

OBJECTIVEThe hypoxic-ischemic encephalopathy caused by asphyxia in peripartum is a serious disease in newborn infants, with a high disability and mortality rate. Lack of regenerative ability in central nervous system after injury is considered as the fundamental cause. However, in recent years many studies have revealed that there are myelin-associated neurite growth inhibitory factors that exert inhibiting effect through the Nogo receptor (NgR). This study aimed to investigate the expression level of NgR and the possible neuroprotective effect of NEP1-40 in newborn rats with hypoxic ischemic brain damage (HIBD).

METHODEighty healthy Wistar rats aged 7 days were randomly divided into 4 groups; 8 in control group, 24 in HIBD model group, 24 in GM-1 group and 24 in NEP1-40 group. The rats of the control group and HIBD group were injected with normal saline (0.25 ml/kg) intraperitoneally, while those in NEP1-40 group and GM-1 group with NEP1-40 12.5 microg/d, GM-1 10 mg/(kg.d) for continuous 3 days of 72-hour group or 7 days of 168-hour group, respectively. In situ hybridization was adopted for detecting the expression of NgR in the brain of the rats at the time point of 24 hours, 72 hours and 7 days. Meanwhile histopathological changes of neurons and axon were detected by transmission electron microscopy (TEM). The SPSS statistical software package for Windows, version 10.0, was used to run Chi-square tests and least significance difference (LSD-t) on the data presented, and P value of less than 0.05 was regarded as statistically significant.

RESULTThe expression level of Nogo-A receptor in the control group was higher than that of the other groups at different time point (t value was 5.48, 6.11, 6.96, 8.24, 5.99 and 5.34, respectively, and all P values were less than 0.05). There were no significant differences in Nogo-A receptor level among the HIBD group, the GM-1 group and the NEP1-40 at 24 hours (t was 1.48, 2.76 and 1.29, respectively, and all P > 0.05), while the expression of Nogo-A receptor of NEP1-40 at 72 hours and 7 days was lower than that of the HIBD group and the GM-1 group at the same time point, respectively (all P < 0.05). Repair of neurons in damaged brain to some extent was found after GM-1 treatment and satisfactory repair of neurons and axon regeneration was obtained with NEP1-40 administration as shown by TEM.

CONCLUSIONHypoxic ischemic brain damage can down-regulate the expression of Nogo-A receptor in the central nervous system. NEP1-40 contributes to the regeneration of axon and repair of brain damage, thus exerts neuroprotective effect.

Animals ; Animals, Newborn ; Brain ; drug effects ; metabolism ; pathology ; GPI-Linked Proteins ; Hypoxia-Ischemia, Brain ; metabolism ; pathology ; Myelin Proteins ; pharmacology ; Nogo Receptor 1 ; Peptide Fragments ; pharmacology ; Rats ; Rats, Wistar ; Receptors, Cell Surface ; Receptors, Peptide ; metabolism

Adenovirus vectors are one of the most promising gene transfer systems. They are of great value for gene therapy because these vectors achieve temporal high-level transgene expression and high gene transfer efficiency. To meet increasing needs of adenovirus vectors for gene therapy programs, parallel development of efficient, scalable and reproducible production processes is required. Perfusion cultivation of 293 cells is one of the most commonly used methods to produce adenovirus vectors and it is suitable for industrialized production specially. Experimental studies had been carried out to produce recombinant adenovirus containing the green fluorescent protein gene (Ad-GFP) by perfusion cultivation of HEK-293 N3S cells in a 5L stirring bioreactors. Perfusion rate was 1-2 volume/day. To infect the 293 N3S cells with Ad-GFP at the density of (2-4) x 10(6) cells/ ml. The time of collecting cells was 48 hours post infection. After three rounds of freeze/thaw and centrifugation, the crude viral lysates were stored at--80 degrees C until use. Then to get the Ad-GFP products by 2 x CsCl-gradient purification. The purity of the products was determined by the A260/A280 ratio and a high performance liquid chromatography (HPLC) assay. The infective titer was determined by a TCID50 assay. The culture term was 10-12 days. The infectious titer, the number of virus particle and the ratio of infectious titer to virus particle for the product were 1.0 x 10(11) IU/mL, 1.68 x 10(12) VP/mL and 6.0% IU/VP respectively. The A260/A280 ratio was 1.33, and the purity determined by HPLC was 99.2%. The cell specific productivity was around 1000 IU/cell. By perfusion cultivation of 293 N3S cells in a 5L stirring bioreactors, we established the production process for Ad-GFP, which paves a way to produce other recombinant adenovirus for gene therapy.
Adenoviridae ; genetics ; growth & development ; isolation & purification ; Bioreactors ; microbiology ; Cell Line ; Gene Transfer Techniques ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Kidney ; cytology ; virology ; Recombinant Proteins ; biosynthesis ; genetics ; Recombination, Genetic ; Virus Cultivation ; instrumentation ; methods

OBJECTIVETo analyze the periodicity of pandemic influenza A (H1N1) in Changsha in year 2009 and its correlation with sensitive climatic factors.

METHODSThe information of 5439 cases of influenza A (H1N1) and synchronous meteorological data during the period between May 22th and December 31st in year 2009 (223 days in total) in Changsha city were collected. The classification and regression tree (CART) was employed to screen the sensitive climatic factors on influenza A (H1N1); meanwhile, cross wavelet transform and wavelet coherence analysis were applied to assess and compare the periodicity of the pandemic disease and its association with the time-lag phase features of the sensitive climatic factors.

RESULTSThe results of CART indicated that the daily minimum temperature and daily absolute humidity were the sensitive climatic factors for the popularity of influenza A (H1N1) in Changsha. The peak of the incidence of influenza A (H1N1) was in the period between October and December (Median (M) = 44.00 cases per day), simultaneously the daily minimum temperature (M = 13°C) and daily absolute humidity (M = 6.69 g/m(3)) were relatively low. The results of wavelet analysis demonstrated that a period of 16 days was found in the epidemic threshold in Changsha, while the daily minimum temperature and daily absolute humidity were the relatively sensitive climatic factors. The number of daily reported patients was statistically relevant to the daily minimum temperature and daily absolute humidity. The frequency domain was mostly in the period of (16 ± 2) days. In the initial stage of the disease (from August 9th and September 8th), a 6-day lag was found between the incidence and the daily minimum temperature. In the peak period of the disease, the daily minimum temperature and daily absolute humidity were negatively relevant to the incidence of the disease.

CONCLUSIONIn the pandemic period, the incidence of influenza A (H1N1) showed periodic features; and the sensitive climatic factors did have a "driving effect" on the incidence of influenza A (H1N1).

China ; epidemiology ; Climate ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; virology ; Regression Analysis ; Risk Factors ; Seasons ; Temperature

OBJECTIVETo explore the influence of landscape elements on the transmission of hemorrhagic fever with renal syndrome (HFRS) in Changsha.

METHODSA total of 327 cases of HFRS diagnosed between year 2005 - 2009 were recruited in the study. Based on the demographic data, meteorological data and the data of second national land survey during the same period, a GIS landscape elements database of HFRS at the township scale of Changsha was established. Spatial-temporal cluster analysis methods were adopted to explore the influence of landscape elements on the spatial-temporal distribution of HFRS in Changsha during the year of 2005 - 2009.

RESULTSThe annual incidences of HFRS in Changsha between year 2005 - 2009 were 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000(87 cases), 0.75/100 000(47 cases) and 1.02/100 000(65 cases) respectively. The results of poisson regression model analysis of principal component showed that the incidence of HFRS was positively correlated with farmland area (M = 29.00 km2) and urban and rural area (M = 6.12 km2; incidence rate ratios (IRR) = 1.34, 95% CI: 1.27 - 1.41); but negatively correlated with forestland area (M = 39.00 km2; IRR = 0.67, 95% CI: 0.55 - 0.81) and garden plot area (M = 0.99 km2; IRR = 0.74, 95% CI: 0.63 - 0.86). A significant cluster of the spatial-temporal distribution of HFRS cases was found in the study. The primary cluster (28.9 N, 113.37 E, radius at 22.22 km, RR = 5.23, log likelihood ratio (LLR) = 51.61, P <0.01, 67 cases of HFRS and incidence at 4.4/100 000) was found between year 2006 and 2007; and the secondary cluster (28.2 N, 113.6 E, RR = 10.77, LLR = 16.01, P < 0.01, 11 cases of HFRS and the incidence at 10.6/100 000) was found between year 2008 and 2009.

CONCLUSIONThe landscape elements were found to be closely related to the prevalence and transmission of HFRS.

China ; epidemiology ; Climate ; Geographic Information Systems ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; transmission ; Humans ; Regression Analysis ; Space-Time Clustering

The R (replicase) protein is the uniquely defined non-structural protein (NSP) responsible for RNA replication, mutation rate or fidelity, regulation of transcription in coronaviruses and many other ssRNA viruses. Based on our complete genome sequences of four isolates (BJ01-BJ04) of SARS-CoV from Beijing, China, we analyzed the structure and predicted functions of the R protein in comparison with 13 other isolates of SARS-CoV and 6 other coronaviruses. The entire ORF (open-reading frame) encodes for two major enzyme activities, RNA-dependent RNA polymerase (RdRp) and proteinase activities. The R polyprotein undergoes a complex proteolytic process to produce 15 function-related peptides. A hydrophobic domain (HOD) and a hydrophilic domain (HID) are newly identified within NSP1. The substitution rate of the R protein is close to the average of the SARS-CoV genome. The functional domains in all NSPs of the R protein give different phylogenetic results that suggest their different mutation rate under selective pressure. Eleven highly conserved regions in RdRp and twelve cleavage sites by 3CLP (chymotrypsin-like protein) have been identified as potential drug targets. Findings suggest that it is possible to obtain information about the phylogeny of SARS-CoV, as well as potential tools for drug design, genotyping and diagnostics of SARS.
Amino Acid Sequence ; Base Composition ; Base Sequence ; Cluster Analysis ; Computational Biology ; Conserved Sequence ; genetics ; Evolution, Molecular ; Gene Components ; Genome, Viral ; Molecular Sequence Data ; Mutation ; genetics ; Phylogeny ; Protein Structure, Tertiary ; RNA Replicase ; genetics ; SARS Virus ; genetics ; Sequence Analysis, DNA

OBJECTIVETo study the safety and immunogenicity of the Bilive combined hepatitis A and B vaccine produced by Sinovac Biotech Co., Ltd.

METHODSSamples were selected from first year students of a senior high school (adults group) and first to fifth grade 1-5 students of 3 primary schools (children group). Those who were susceptible to both hepatitis A virus (HAV) and hepatitis B virus (HBV), HAV only or HBV only were assigned to group AB, A and B respectively and were vaccinated with three doses (0, 1 and 6 month schedule) of Bilive combined hepatitis A and B vaccine, inactivated hepatitis A vaccine and recombined hepatitis B vaccine respectively. The dosage for adult group was 500 U hepatitis A antigen and/or 10 micro g hepatitis B surface antigen and the dosage for children group was half the dosage of adult group. The potential adverse effects were observed within 72 hours after vaccination. Serum samples were collected for testing anti-HAV and anti-HBs at month 2 and 7 after the initial dose.

RESULTSThe rates of local adverse effects were 0.58% and 2.56% in children AB group and adults AB group and the general adverse effects rates were 9.88% and 5.45% respectively. Both local and general adverse effect rates were not significantly different to the control group. The sero-conversion rate of anti-HAV in children and adults AB group reached 100%, one month after 3 doses. The geometric mean titer (GMTs) reached 33,910 mIU/ml and 23,435 mIU/ml respectively, significant higher than that in control group (group A). The sero-conversion rates of anti-HBs were 97.30% and 96.63%, and GMTs were 103 mIU/ml and 102 mIU/ml in children and adults AB group respectively. No significant difference on sero-conversion and GMT was observed when compared with control group.

CONCLUSIONThe Bilive combined hepatitis A and B vaccine had good safety profile, and the immunogenicity both on anti-HAV and anti-HBs was similar to that of separated components.

Adolescent ; Adult ; Child ; Female ; Hepatitis A ; prevention & control ; Hepatitis A Antibodies ; blood ; Hepatitis A Vaccines ; administration & dosage ; adverse effects ; immunology ; Hepatitis Antibodies ; blood ; Hepatitis B ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; administration & dosage ; adverse effects ; immunology ; Humans ; Male ; Safety ; Vaccines, Combined ; administration & dosage ; adverse effects ; immunology ; Vaccines, Synthetic ; administration & dosage ; adverse effects ; immunology

OBJECTIVETo evaluate the clinical efficacy of electroacupuncture(EA) for apoplectic urinary incontinence.

METHODSTwo hundred and four cases of apoplectic urinary incontinence were randomized into an EA group (136 cases) and an indwelling catheter group (68 cases). The EA was applied at Qugu (CV 2), Zhongji (CV 3), Shuidao (ST 28), Qihai (CV 6) and Guanyuan (CV 4), etc. in the EA group,5 times a week. Indwelling catheter was applied in the indwelling catheter group at intervals of 2-4 hours, and periodic bladder irrigation along with bladder rehabilitation training were also given. The efficacies were evaluated after 4 weeks of treatment. Before and after treatment, the urination diary (including the interval of urination, nocturia frequency, urination difficulty, urinary incontinence severity), bladder capacity, patients' satisfaction of the two groups were observed and the efficacy was evaluated.

RESULTSThe total effective rate was 96.2% (125/130) in the EA group, which was apparently superior to 87.5% (56/64) in the indwelling catheter group (P < 0.05); except for nocturia frequency in the indwelling catheter group, the total score and the subitem score in the urination diary were all improved significantly after treatment in both groups (all P < 0.001), which were more obvious in the EA group (P < 0.001, P < 0.05); the patients' satisfaction and bladder capacity were all improved significantly after treatment in both groups (all P < 0.001), which were more obvious in the EA group (both P < 0.001).

CONCLUSIONThe EA has an obvious effect for apoplectic urinary incontinence in urinary incontinence alleviation and bladder capacity increase, which has better efficacy than indwelling catheter therapy.

Acupuncture Points ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome ; Urinary Incontinence ; therapy