Adrenergic beta-Agonists ; therapeutic use ; Aged ; Albuterol ; analogs & derivatives ; therapeutic use ; Bronchi ; drug effects ; physiopathology ; Bronchodilator Agents ; therapeutic use ; Coal Mining ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; drug therapy ; physiopathology ; Respiratory Function Tests ; Salmeterol Xinafoate ; Treatment Outcome

The levels of triglyceride(TG)and free fatty acid(FFA)in serum,liver,skeletal muscle,and pancreas of lipoprotein lipase gene knockout heterozygous(LPL+/-)mice and C57 mice were determined.Intraperitoneal glucose tolerance test(IPGTT)was performed to evaluate insulin sensitivity and β-cell function.The results showed that the Iipid content in 16 weeks LPL+/- group did not increase significantly.The TG and FFA contents in 28 weeks LPL+/- group were significantly higher than those in control and 16 weeks LPL+/-group(all P<0.05).In 50 weeks LPL+/- group,FFA levels in serum and pancreas,and TG content in pancreas increased significantly compared with other three groups(all P<0.05).The IPGTT result showed that the blood glucose levels increased from 15 to 120 min,not at 0 and 5 min.The blood glucose levels during 30-120 min increased significantly in 50 weeks LPL+/- group compared with other three groups(P<0.05).Fasting insulin(FINS),homoestasis assessment of insulin resistance(HOMA-IR)and pancreatic β cell function also increased gradually with age.FINS and HOMA-IR in 28 weeks LPL+/- group were higher than those in control and 16 weeks LPL+/- group.These results suggest that LPL is a key enzyme in lipid metabolism and plays a crucial role in the development of insulin resistance and diabetes.

OBJECTIVETo explore the difference in the efficacy and effect mechanism of subcortical ischemic vascular disease (SIVD) complicated with depression between acupuncture and medication.

METHODSSixty patients were randomized-into an acupuncture group and a medication group, 30 cases in each one. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Shuigou (GV 26), Fengfu (GV 16), Fengchi (GB 20) and the others, once a day, 6 times a week. The treatment of 4 weeks made one session and totally 2 sessions were required. In the medication group, nimodipine 30 mg, three times a day and fluoxetine 20 mg, once a day were prescribed for oral administration, for 8 weeks totally. Before treatment, at the end of the 4th week and at the end of the 8th week of treatment, cerebral blood flow velocity (CBFV) and solubility CD40 ligand (sCD40L) were determined respectively. The scores in Montreal cognitive assessment (MoCA) and Hamilton' s depression scale (HAMD) were evaluated in the two groups. The efficacies on cognitive function and depression symptoms were compared in the patients between the two groups. Results Compared with the outcome before treatment, mean blood flow velocity (Vm) of middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was increased significantly at the end of the 4th week of treatment in the two groups (all P<0.05). At the end of the 8th week, Vm was increased much significantly (all P<0.01). The differences were not significant in comparison between the two groups (all P>0.05). Compared with the expression before treatment, sCD40L was reduced significantly after treatment in the patients of the two groups (all P<0.01), but the differ- ence was not significant between the two groups (all P>0.05). Compared with that before treatment, MoCA score was increased significantly after treatment in the two groups (all P<0.01), HAMD score was reduced sig- nificantly (all P<0.01), the differences were not significant in comparison between the two groups (all P>0.05). The total effective rate of cognitive improvement was 86.7% (26/30) in the acupuncture group and was 80.0% (24/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05). The total effective rate of the improvement in depression was 93.3% (21/30) in the acupuncture group and was 86.7% (26/30) in the medication group, the differences were not significant in comparison of the two groups (P>0.05).

CONCLUSIONAcupuncture could significantly increases CBFV and reduces serum sCD40L expressions in the patients of SIVD complicated with depression, and significantly improves cognitive function and relieves depression symptoms. The efficacy of it is similar to that of western medication. The increase of serum sCD40L expression is possibly involved in the occurrence and development of SIVD. Reducing sCD40L expression contributes to the alleviation of damage induced by cerebral ischemia and reperfusion.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; drug therapy ; therapy ; Depression ; drug therapy ; etiology ; therapy ; Female ; Fluoxetine ; administration & dosage ; Humans ; Male ; Middle Aged ; Nimodipine ; administration & dosage ; Treatment Outcome

Objective To examine the metabolic variations in liver after 30 min warm ischemic injury,and the effect of hypothermic machine perfusion on the metabolism in rats.Methods 40 SD male rats were randomly divided into 4 groups:Group A,the liver underwent warm ischemia for 0 min and cold storage (CS) for5 h; Group B,the liver was treated by warm ischemia for0 min,CS for4 h and then machine perfusion (MP) for 1 h; Group C,the liver suffered from warm ischemia for 30 min and CS for 5 h; and Group D,the liver was treated by warm ischemia for 30 min plus CS for 4 h plus MP for 1 h.During the MP process,the perfusion resistance index was recorded every 10 min,and the liver glycogen content and malondialdehyde (MDA) value were also detected.Results The hepatic glycogen content decreased after MP treatment,but there was no statistical significance (P ＞ 0.05).No differences on MDA contents was found between Group A and B (P ＞ 0.05),while MDA in Group D was significantly higher than that in Group C (P ＜ 0.05).After hypothermic MP treatment,the liver resistance index value was significantly reduced.Conclusion MP could reduce the resistance index but increase metabolic rate in liver undergoing warm ischemic injury,thus producing more lipid peroxides.

Objective To determine the prevalence of metabolic syndrome ( MS) in women who had gone through natural menopause, and to provide basic data for developing effective prevention and intervention of metabolic syndrome in Taixing area Jiangsu province. Methods A cluster sample of natural postmenopausal women aged 45 to 64 years were sampled and assessed by questionnaires, physical measurements, and biochemical tests; and analyzed according to the International Diabetes Federation ( IDF, 2005) diagnostic criteria for MS. Results The crude prevalence of metabolic syndrome was 35. 25% and the standardized prevalence rate was 31. 47% after age being adjusted. The prevalence of metabolic syndrome was increased with age ( P < 0. 01). The constituent ratio of the combinations of 3, 4, and 5 components in MS was 21. 45% , 10. 73% , and 3. 07% , respectively. Conclusion The prevalence of the metabolic syndrome among older women after menopause is high and increasing with aging. Public education should be strengthened to improve the quality of life in postmenopausal women and prevention and intervention should be adopted earlier as well.

Objective To investigate the expression of CD133 and CD44 proteins in gastric stromal tumors (GST) and their clinical significances. Methods The expression of CD44 and CD133 proteins in the GST tissues of 112 patients was detected by immunohistochemical staining. The relation between the expression of CD44 and CD133 proteins and the clinicopathological characters was analyzed. The survival and prognosis of GST were also analyzed. Results Both CD44 and CD133 were expressed on the cell membranes. The expression rates of CD44 and CD133 were 58.04 % (65/112) and 42.86 % (48/112) separately; the co-expression rate of CD44 and CD133 was 27.68 % (31/112). CD44 and CD133 were negative in normal peritumoral tissues. No correlation was found between CD44 and CD133 and the clinicopathological parameters including gender, age and lymphatic vessel invasion (all P>0.05), but the expression levels of CD44 and CD133 in patients with the mitotic count ≥ 5/50 high-power field, large diameter and vascular invasion were significantly higher (all P<0.05). No correlation was found between co-expression of CD44 and CD133 and the clinical clinicopathological parameters including gender, age, the mitotic count ≥ 5/50 high-power field and vascular invasion (all P>0.05), but the co-expression level of CD44 and CD133 in patients with tumor diameter ≥5 cm was significantly higher than that in patients with tumor diameter < 5 cm (χ2=5.040, P=0.025). The overall survival rate of the patients with co-expression of CD44 and CD133 was shorter than that in other groups (χ2 = 8.758, P= 0.001). No correlation was found between CD44 and CD133 expression (r=0.126, P=0.210). Multivariate analysis with the Cox regression models showed that the tumor diameter ≥5 cm (P=0.042) and co-expression of CD44 and CD133 (P=0.003) were significantly associated with poor prognosis. Conclusion CD44 and CD133 as robust cancer stem cell markers in GST might be the prognostic factors.

ObjectiveTo examine the relationship between ankle brachial index (ABI) and the extent of coronary stenosis and evaluate the usefulness of ABI to predict the extent of coronary stenosis in old patients.Methods118 patients with coronary angiography were examined by ABI and hemostatic factors evaluation in addition to history collection.ResultsABI was inversely and significantly associated with Gensini score. ABI reduced significantly (P<0.001) in the patients with 3-vessel or left main coronary artery disease (CAD). But there were no significant differences in ABI among the patients with no CAD, 1-vessel or 2-vessel CAD. The corresponding area under the ROC curve was 0.75±0.045, with 95% CI=0.67～0.84 (P<0.001) in ABI in 3-vessel or left main CAD. When ABI≤0.9, it had a relatively high specificity (89.1%) and sensitivity (55.6%) for predicting the presence of 3-vessel disease or left main CAD.ConclusionIn the old patients, ABI is inversely and significantly associated with the extent of coronary stenosis, and ABI≤0.9 has a relatively high specificity and sensitivity for predicting the presence of 3-vessel or left main CAD.

OBJECTIVE: To analyze the main causes of medical dispute and the main types of medical malpractice. The related problems were discussed in forensic expertise. METHODS: Forty cases of medical dispute from 2006 to 2008 in our institute were analyzed retrospectively. RESULTS: In 40 cases of medical dispute, city-level hospitals, county-level hospitals, town-level hospitals and private clinics were 11 (27.5%), 24 (60.0%), 2 (5.0%) and 3 (7.5%) cases respectively. The internal medicine departments, surgical departments, gynaecological and obstetric departments, pediatric departments and outpatient center were 16 (40.0%),10 (25.0%), 9 (22.5%), 2 (5.0%) and 3 (7.5%) cases, respectively. The amount of cases from city-level hospitals, county-level hospitals diagnosed by the medical experts as the medical malpractice showed less than that from town-level hospitals and private clinics. CONCLUSION The amount of cases of medical dispute from city-level and county-level hospitals were more than that of town-level hospitals. But the amount of cases diagnosed by the medical experts as medical malpractice from city-level and county-level hospitals were less than that of town-level hospital and private clinics.
Expert Testimony ; Female ; Forensic Medicine ; Hospitals, County ; Hospitals, Urban ; Humans ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies

OBJECTIVETo observe the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) on inflammatory injury induced by intestinal ischemia/reperfusion (I/R) in rats.

METHODSForty-eight Wistar rats were randomly divided into a sham injury group, a model group, an EA group and a sham EA group, 12 rats in each group. Intestinal I/R rat models were established by method of clamping with occlusion of superior mesenteric artery (SMA) for 45 min followed by reperfusion. The EA group was treated with EA (2.5 mA, 2 Hz/100 Hz, 0.5 h) at "Zusanli" (ST 36) 30 min before reperfusion, and at the same time, the sham EA group was treated with fast insertion at two non-meridian acupoints on skin surface (2 cm horizontally away from linea alba abdominis and about 5 cm paralleled to cartilago ensiformis downward). No interventions were added on the sham injury group and the model group. The degree of pathological injury in intestines, water rate of intestines, diamine oxidase (DAO) activity and intestinal mucosal blood flow (IMBF) were examined at 1 h and 3 h after reperfusion.

RESULTSAt 1 h and 3 h after reperfusion, the intestinal pathological injury in EA group was significantly attenuated compared with that in model group, and the intestinal water rate of (74.00 +/- 2.11)% and (78.78 +/- 0.80)% in EA group were significantly lower than (80.69 +/- 1.66)% and (83.17 +/- 2.08)% in model group (both P < 0.01), but DAO of (68.83 +/- 4.31) U/L and (47.84 +/- 5.57) U/L as well as IMBF of (152 +/- 5.8) PU and (139.8 +/- 6.1) PU in EA group were significantly higher than DAO of (32.86 +/- 4.72) U/L, (17.01 +/- 2.96) U/L as well as IMBF of (124.7 +/- 8.3) PU and (89.4 +/- 13.2) PU in model group (all P < 0.01). Meanwhile, the above mentioned changes in sham EA group showed no significant differences compared with those in model group (all P > 0.05).

CONCLUSIONElectroacupuncture can not only reduce the inflammatory injury induced by intestinal IR but also increase intestinal blood supply so as to protect the intestine function.

Acupuncture Points ; Amine Oxidase (Copper-Containing) ; metabolism ; Animals ; Electroacupuncture ; Inflammation ; therapy ; Intestines ; blood supply ; metabolism ; pathology ; Male ; Rats ; Rats, Wistar ; Reperfusion Injury ; therapy

An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECC, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers ( significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.