Brain ; metabolism ; Brain Chemistry ; Creatine ; deficiency ; Humans ; Syndrome

The liver is an important organ of the body, which has many functions, such as metabolism and detoxification. Due to the rapid change of lifestyle and the improvement of public health, the incidence rate of non-communicable diseases has increased significantly, which fundamentally changed the disease characteristics in most parts of the world. At present, the global prevalence of non-alcoholic fatty liver disease (NAFLD) is about 25%. Moreover, about 59.10% of NAFLD patients progress to non-alcoholic steatohepatitis (NASH) within 5 years, and about 41% of NASH patients progress to fibrosis. NAFLD has become one of the most important liver diseases in the world and may become the main cause of end-stage liver disease in the next few decades. In addition, NAFLD and related cirrhosis will bring huge economic burden to patients, health care system and society. Since there are currently no medications available that have been approved by Food and Drug Administration (FDA), NAFLD is still treated mainly through lifestyle changes such as exercise and diet. Oxidative stress and inflammation are the most important pathological processes in the occurrence and development of liver diseases. Nuclear factor erythroid-2-related factor 2 (Nrf2) is a key regulator of the body's antioxidant stress system, with anti-inflammatory, antioxidant and other functions. Many studies have shown that Nrf2 pathway significantly affects the progression of liver diseases. In this review, we aimed to summarize the regulatory role of the Kelch-like ECH-associating protein 1 (Keap1)-Nrf2-antioxidant response element (ARE) signaling pathway in the pathogenesis of NAFLD, and to reveal the potential of Nrf2 as a therapeutic target for NAFLD.

ObjectiveTo detect the neuropsychological performances of vascular dementia(VD) and the varied patterns when the severity of VD progressed. Methods39 patients who fulfilled with National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Diseases and Related Disorders Association(NINDS AIREN) criteria for "probable vascular dementia"were assessed with the neuropsychological scales, including Mini Mental State Examination (MMSE), Blessed Dementia Scale (BDS), Clinical Memory Scale, Wechsler Adult Intelligence Scale Revised China (WAIS-RC) and Clinical Dementia Rating (CDR), to measure the change of orientation to time and place, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. Patients were divided into mild, moderate and severe categories according CDR scores.ResultsAmong mild, moderate and severe categories, significant differences (P<0.05) were detected in the following subtests: orientation to time of MMSE, digit span, block design, object assembly, arithmetic of WAIS-RC, memory quotient, the activities of social and daily living and self maintenance of BDS. In moderate/severe and mild/severe categories, significant differences (P<0.05) were detected in the MMSE language subtest, WAIS-RC comprehension subtest and verbal intelligence quotient. Significant differences were detected in MMSE orientation to time subtest and WAIS RC similarities subtest only between mild/severe categories (P<0.05). In the MMSE immediate or delayed recall, drawing, simple calculation subtests, and BDS personality subtest, no significant differences were detected among mild, moderate and severe categories (P>0.05). Conclusions Patients with mild VD showed general deterioration of orientation, memory, language, visuospatial skills, cognitive function, personality characteristics, the activities of social and daily living and self maintenance. However, the speed of deterioration of each item was different when the severity of VD progressed. No close correlation was observed between personality characteristics alteration and the severity of VD. From mild to moderate and moderate to severe VD, the speed of deterioration of part of the cognitive function, especially the knowledge ever acquired, was slow relatively. The other aspects continued deteriorating in all stages of VD.

ATP-binding cassette (ABC) transporters are a family of proteins that mediate multi-drug resistance (MDR) via ATP-dependent drug efflux pumps. Abnormally expression and function would result in tumor MDR. That is the most important mechanism of MDR. The inhibition of ABC transporters as a strategy to reverse MDR in cancer has been studied extensively. In this review, we reviewed the structure and function of ABC transporters, and focused on the research advances in the mechanism of tumors MDR mediated by ABC transporters and the development of their modulators and reversal strategies.

ICH GCP requires that all information of clinical trial should be recorded, processed, and stored in a way that allows the accurate reporting, interpretation and verification. A trial master file (TMF) contains all paper or electronic records/documentations related to a clinical trial. As a tool of the retrospective analysis, the TMF profile should be able to reproduce the full procedure of the trial completely. As a part of TMF profiles, both the accuracy and completeness of clinical data management documentation are important in data integrity. It is helpful to learn the workflow of clinical data management in different stage of a clinical trial, to understand which documents are essential, and why the documentation of clinical data management is important for data integrity. This paper elaborates how to perform the good documentation practice of clinical data management, and suggests that both the precise and efficient document management and regular quality control may ensure the high quality of clinical data documentation management on the basis of an intensive awareness of the overall process of clinical data management.
Clinical Trials as Topic ; Data Curation ; standards ; Information Storage and Retrieval ; methods ; standards

Objective To assess the predictive value of plasma level of calcitonin gene related peptide for cardiovascular events and operational stent restenosis after coronary stent implantation in 6 months.Methods Plasma level of CGRP was measured in 53 cases of coronary stent implantation before and after the operation.The cardiovascular events and the stent restenosis were observed and recorded in 6 months after the procedure.Results The plasma level of CGRP was significantly lower in patients with cardiovascular events and stent restenosis(166.36?10.18,182.5?11.36,P

Objective To evaluate the clinical value of 64-slice spiral computed tomography(CT) in detecting coronary artery disease. Methods Twenty-three patients with suspected coronary artery stenosis were analyzed by 64-slice spiral computed tomography coronary angiography and catheter coronary angiography. Results Two hundred and ninety -one segments of the two hundred ninety-nine coronary artery segments in twenty-three patients could be visualized by 64-slice spiral CT,eight segments couldn't be visualized because of calcification and exercising shadow. According to gold standard of selective coronary arteriongraphy,the sensibility,specificity,positive predictive value and negative predictive value to diagnose coronary artery stenosis by 64-slice spiral CT were 88.7%,98.2%,94.0% and 96.4%.Conclusion The coronary artery stenosis diagnosis by 64 -slice spiral CT is a potential detecting method and good clinical value but could not replace selective coronary arteriongraphy.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.

Aim To investigate the effects of Shaoqiduogan(SQDG)on immunological hepatic fibrosis induced by human albumin in rats as well as its possible mechanisms.Methods The model of immunological hepatic fibrosis induced by human albumin was prepared.The rats were randomly divided into 6 groups,namely normal control group,liver fibrosis model group,SQDG(42.5,85,170 mg·kg~(-1))treated groups and colchicine(0.1 mg·kg~(-1)) treated group.HE staining was used to examine the histopathological change.The activities of transaminase in serum,malondiadehyde(MDA)content,superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)activities,hydroxyproline(Hyp)content in liver homogenate were assayed byspectrophotometry.The levels of hyaluronic acid(HA)and procollagen Ⅲ (PCⅢ)in serum were determined by radioimmunoassay.In vitro,the collagen production of hepatic stellate cell(HSC)-T6 stimulated with transforming growth factor beta1(TGF-β1)was measured with 3H-Proline uptake.Results SQDG had obvious protective effects on human albumin induced hepatic fibrosis in rats.The results showed that the serum ALT and AST decreased by SQDG treatment,but had no significant difference compared with model group.Pathological examination showed that SQDG could remarkably alleviate the hepatic fibrosis.SQDG not only decreased the Hyp content in liver homogenates,but also the elevated level of HA,PCⅢ in serum.SQDG also ameliorated the oxidative stress state of hepatic fibrosis rats,decreased the production of MDA and enhanced the activities of antioxidative enzyme including SOD and GSH-Px.Furthermore,SQDG(20～160 mg·L~(-1))inhibited the collagen production of HSC stimulated with TGF-β1 in vitro.Conclusion sSQDG has protective effect on liver fibrosis rats induced by human albumin.The mechanisms of its anti-fibrotic effects may be associated with its action of ameliorating the oxidative stress in liver,and inhibiting the production of collagen in HSC.

Objective To build a simulation model for outpatients queuing,using data from a general outpatient cardiovascular clinic of a general hospital in Shanghai and different rules in the process.The study employs time-interval controlled mode for appointment registration,for the purpose of analyzing characteristics of different queues.Methods Extraction of data of the clinic in a given month by means of HIS system to determine the parameters of the queuing models.Building the simulation model with Matlab to develop the plan of mixed queues and that of discrete queues,for analyzing the waiting time variations,with different number of doctors on duty and different number of appointments in one time interval.Resnlts In the Monday mornings for example,the mean waiting time of appointments or no-appointments are calculated by simulation with different queuing rules,different number of doctors on duty and different appointment quantities of one time interval.Conclusion The mean waiting times of appointments and no-appointments can be both sizably cut short by means of time-interval controlled appointment; different queuing plans are recommended for different departments; the simulation model should be further verified and optimized in practice.