Objective To study the effects of internal and external biliary drainage on inducible nitric oxide synthase (iNOS) mRNA expression of Kupffer cells and serum tumor necrosis factor-alpha (TNF-α) in rats with obstructive jaundice. Methods Forty-eight male Sprague-Dawley rats were randomly assigned to obstructive jaundice (OJ), sham operation (SH), internal biliary drainage (ID) and external biliary drainage (ED) groups with 12 each. Kupffer cells were isolated by in situ hepatic perfusion and digestion with collagenase type Ⅳ, and purified by cell culture attachment. The expression of iNOS mRNA of Kupffer cells was detected by reverse transcription polymerase chain reaction (RT-PCR) and the serum TNF-α concentration was measured using ELISA method. Results The serum TNF-α level was increased in OJ group[ (110.84±26.3) pg/ml ]compared with SH group [-(88.4±17.9) pg/ml, (P=0.045)]. The TNF-α level in ID group[ (89.8±28. 3) pg/ml ]was significantly lower than that in ED group[ (118.64±22.7) pg/ml, (P=0. 011) ]and OJ group (P=0. 059). Expression of iNOS mRNA of Kupffer cells was significantly higher in OJ group (0. 824± 0. 24) compared with SH group (0. 384±0.35,P=0. 005). After relieving the OJ, the iNOS mRNA expression in ED group (0. 974± 0.48) was not suppressed (P=0. 321). On the contrary, the iNOS mRNA expression in ID group was suppressed and significantly lower than that in ED group (0. 59±0. 35) (P=0. 016). Conclusions Internal biliary drainage is superior to external drainage in terms of reversing the elevated serum TNF-α and in suppressing the iNOS mRNA expression of Kupffer cells in rats with obstructive jaundice.

Objective To investigate the effect of an oral calcium load on serum electrolytes and PTH concentrations in healthy apheresis donors.Methods Forty-five apheresis donors were divided into two groups: calcium group(11 donors,taking oral calcium before apheresis) and no calcium group(34 donors).Serum parathyroid hormone(PTH),total calcium(Ca),phosphorus(P),potassium(K),sodium(Na) and magnesium(Mg) were measured before and after the apheresis process.Twenty-four whole blood donors served as controls.Results After the apheresis process,PTH concentrations in calcium group and mean P in no calcium group increased significantly(P

Gindenosides are the active ingredients of Panax ginseng. 20 (S) -protopanaxadiolocotillol type epimers are the main metabolites of 20 (S) -protopanaxadiol. The previous studies showed that there are stereoselectivity difference in pharmacodynamics and pharmacokinetics between 24R-epimer and 24S-epimer. The purpose of this study was to explore the excretion of the epimers in bile, feces and urine of rat. Liquid chromatography tandem mass spectrometry method has been performed for determination of 24R-epimer and 24S-epimer in bile, feces and urine. 24R-epimer or 24S-epimer was intragastric administered to rats at a single dose of 10 mg x kg(-1). Results showed that after administration the recovery of 24R-epimer and 24S-epimer in feces was 17.69% and 17.09%, respectively, while both of the two epimers were hardly detected in urine. The 48 h cumulative biliary excretion rate of 24R-epimer was 8.01% after administration, while only 1.47% for 24S-epimer. It indicated that there are stereoselectivity in biliary excretion of the epimers with intragastric administration.
Animals ; Bile ; chemistry ; metabolism ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Feces ; chemistry ; Ginsenosides ; chemistry ; pharmacokinetics ; Male ; Mass Spectrometry ; Panax ; chemistry ; Rats ; Rats, Sprague-Dawley ; Stereoisomerism ; Urine ; chemistry

Adolescent ; Adult ; Cyclophosphamide ; adverse effects ; Female ; Femur Head Necrosis ; etiology ; Humans ; Immunosuppressive Agents ; adverse effects ; Male ; Middle Aged ; Paraquat ; poisoning ; Young Adult

Objective To investigate the cause and related factors of hospitalization in patients with diabetic nephropathy with maintenance hemodialysis.Methods Fifty-six patients of diabetic nephropathy were enrolled in current study who hospitalized in Beijing Tongren Hospital affiliated to Capital Medical University from March 2009 to February 2012.All subjects were divided into hospitalized group (n =29) and non hospitalized group (n =27).The information including age,dialysis age,blood pressure,hemoglobin,blood glucose,serum creatinine,serum potassium,plasma albumin,serum calcium,serum phosphorus,albumin,intact parathyroid hormone (iPTH) and hemodialysis sufficienc (KT/V) were collected.Stepwise multiple regression analysis was applied to explore the main causes and related risk factor.Results Twenty-nine out of 56 patients were hospitalized and they had 56 hospitalization records during 24 months of observed period.Average hospitalization was 1.0 times per patient and hospitalized days were (29.62 ± 14.30) days per hospitalized patients.The main causes of hospitalization were cardiac vascular diseases (35.7％),vascular access stenosis (30.4％),and pulmonary infection (17.8％).Compare with non-hospitalization group,age of patient hospitalization group was older((66.97 ± 9.94) vs.(57.42 ± 11.77),t =2.917,P =0.02) and the level of albumin and Kt/V were lower(albumin:(34.02 ± 4.76) vs.(38.93 ± 3.82),t =-4.573,P =0.000 ; Kt/V:(1.16 ± 0.09) vs.(1.39 ± 0.18),t =6.503,P =0.000).Stepwise multivariate regression analysis showed plasma albumin and KT/V were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis (β =-1.724,-0.040 respectively,P =0.00,0.02 respectively) Conclusion Cardiovascular disease,vascular access stenosis and pulmonary infection were the important factors for hospitalization in hemodialysis patients with diabetic mellitus.Cardiovascular disease was the top reason of hospitalization in diabetic patients with maintenance hemodialysis.Hypoalbuminia and inadequacy dialysis were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis.

Objective To evaluate the value of blood coagulation biomarkers in orthopaedic traumatic patients after surgery and analyze its diagnostic values for venous thrombosis embolism.Methods In thiscase control study, we consecutive enrolled 108 traumatic patients after surgery.54 patients have thrombosis and other 54 patients have no thrombosis.Blood was taken 3 -4 days after surgery.Routine coagulation screening test , FDP(fibrinogen/fibrin degradation products) , D dimer and new item such as TM( thrombomodulin) , TAT( thrombin-anti-thrombin complex) , t-PAIC( tissue-type plasminogen activator-plasminogen activator inhibitor complex),PIC(plasmin-anti-plasmin complex) were tested.The difference between groups of these biomarkers was compared, and then the receiver operation curve ( ROC) was drew to determine the diagnostic cut-off point and diagnostic performance.Results ALL blood coagulation biomarkers in orthopaedic traumatic patients after surgery were significantly increased.The group of patients with thrombosis have higher TM(9.04 ±2.06) IU/ml,t-PAIC(10.15 ±4.23) ng/ml, PIC(1.15 ±0.70)μg/ml, D dimer(5.31 ±5.10) ng/ml than group without thrombosis TM(7.50 ±1.70) IU/ml, t-PAIC (6.97 ±2.56)ng/ml, PIC(0.93 ±0.84)μg/ml,D dimer(2.35 ±2.12)ng/ml,and P=0.000 2,<0.000 1,<0.000 1,<0.000 1, respectively.However, TAT(4.79 ±4.32)ng/ml, (6.51 ±5.92)ng/ml, FDP (8.87 ±7.68 )μg/ml, ( 4.91 ±4.67 )μg/ml showed no difference between thrombosis groupand no thrombosis group, (P=0.212 3,0.050 8; respectively).The area under the ROC curve of TM, t-PAIC, PIC and D-dimer were 0.718 5,0.741 6,0.648 0,0.670 0, respectively; P values were <0.000 1,<0.000 1, 0.009 3,0.004 1, respectively; cut-off values were 11.15 IU/ml, 10.65 ng/ml, 1.36 μg/ml, 7.69 ng/ml, respectively;positive likelihood ratios were 9.00,11.29,3.66,14.60, respectively;specificity were 98.15%,96.23%, 90.20%, 97.96%, respectively; the diagnostic rates were 20.3%, 46.3%, 35.8%, 25.9%, respectively.Conclusions There were coagulation and fibrinolysis system activated in orthopaedic traumatic patients after surgery.TM, t-PAIC, PIC, D dimer were good biomarkers for the diagnosis of thrombosis after trauma surgery.TAT was not fit for screening thrombosis after surgery because of influence of anti-coagulation.

Objective To study the effect of public hospitals vertical integration on scale economy in Shanghai. MethodsA total of 401 samples of 67 hospitals from 1999 to 2004 in Shanghai were collected.Median regression was performed to estimate the multi-output cost function and marginal cost of discharge patients,and scale economies were calculated.Results The independent variables Beds,W,X1,X23,Region,Level,Y03,and Y04 were all predictors of cost.Conclusion Both integrated tertiary and secondary hospitals had scale economy before and after integration.Integration enhanced the output and improved the efficiency of integrated secondary hospitals.To some extent,patients were dispersed to secondary hospitals.

Objective To explore the differences in health care quality,scale,output,efficiency,cost and financial condition between freestanding secondary hospitals and system-affiliated secondary hospitals in Shanghai,and analyse the determinants of hospital integration. Methods Eleven upper secondary hospitals in Shanghai integrated between 2000 and 2004 were selected,and another 40 secondary hospitals (including 30 upper secondary hospitals and 10 middle secondary hospitals) without integration were served as controls. Using related data of 1999,Mann-Whitney U test was performed to analyse the differences between these two groups,and Logistic regression analysis was conducted to explore the determinants of hospital integration. Results There were significant differences in health care quality,scale,and output between these two groups (P0.05). It was revealed by Logistic regression analysis that health care quality,scale,output,and financial condition were determinants of integration. Conclusion System-affiliated secondary hospitals have advantages over freestanding hospitals in health care quality,scale,output and financial condition,and those with better health care quality,larger scale,larger output and better financial condition are more likely to be integrated by tertiary hospitals.

AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy.METHODS: A retrospective study was designed.160 patients(160 eyes) with diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract.74 patients(74 eyes) were operated on vitrectomy,and 86 patients(86 eyes) on vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular lens.To record the change of corneal endothelial cells density,average cellular area,coefficient of variation and percentage of hexagonal endothelial cell before and after treatment with Topcon corneal specular microscope.RESULTS: Before and after surgery,the results of corneal endothelial cells density,average cellular area,coefficient of variation and percentage of hexagonal endothelial cell in simple vitrectomy group were no significant difference(P>0.05);After treatment corneal endothelial cells density and percentage of hexagonal endothelial cell were changed with statistical difference as the same as average cellular area and coefficient of variation(P<0.05);There were significantly differences in corneal endothelial cells between two groups(P<0.05).CONCLUSION: It has certain influence on the corned endothelial cells when using vitrectomy combined with cataract surgery in diabetic retinopathy.For patients with indications,it should be paid attention to protecting the corneal endothelial cells.

China ; epidemiology ; Communicable Diseases ; epidemiology ; Disease Notification ; methods ; Humans ; Mandatory Reporting ; Rural Health Services