OBJECTIVE: To explore the effects of Shenfu Injection on prostacyclin, thromboxane A2 and the activities of ATPases in rats exposed to hepatic ischemia-reperfusion injury. METHODS: Twenty-four male Wistar rats weighing 200-250 g were randomly divided into two groups: Shenfu Injection (SF)-treated group (rats were treated with Shenfu Injection of 10 ml/kg through intraperitoneal injection) and untreated group (rats were administered with normal saline at the same dose and served as a control group). Hepatic ischemia was caused by Pringle's maneuver and lasted for fifteen minutes, and then one-hour or three-hour reperfusion was performed. Venous blood samples for the measurement of thromboxane B(2) (TXB(2)) and 6-keto-prostaglandin F(1 alpha)(6-keto-PGF(1 alpha)) were collected three hours after reperfusion. Liver tissue samples were collected one hour or three hours after reperfusion for the measurement of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase and for morphological studies. RESULTS: Plasma TXB(2) was lower in the SF-treated group than that in the untreated group after three-hour reperfusion (P>0.05), while 6-keto-PGF(1 alpha) was higher in the SF-treated group than that in the untreated group (P>0.05). The ratio of TXB(2) and 6-keto-PGF(1 alpha) was significantly lower in the SF-treated group than that in the untreated group (P<0.05). The activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase in the SF-treated group were improved obviously. A three-hour reperfusion after fifteen-minute ischemia caused important hepatic histological alterations. Marked structural abnormalities were observed in the untreated group, such as massive hepatocyte swelling, necrosis, mitochondria edema and vacuolar changes. In the SF-treated group, hepatic tissue injury was reduced significantly. CONCLUSION: Shenfu Injection protects hepatic tissue from ischemia-reperfusion injury, and such protective effects are achieved by decreasing the ratio of thromboxane A(2) and prostacyclin, and increasing the activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)- ATPase.

Objective To explore the activity and its possible neural mechanism of brain default mode network by using resting state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). Methods The 20 amnestic MCI patients and 25 healthy controls were included in this study, and all subjects underwent mini-mental state examination (MMSE), auditory verbal learning test (AVLT) and fMRI. The data were analyzed by amplitude of low frequency fluctuation (ALFF), and the enhanced and weakened regions of ALFF were observed and compared in both MCI patients and healthy controls. Results MMSE and AVLT tests showed that the memory function was seriously impaired in MCI patients compared with healthy controls, which is based on the short and long delayed episodic memory impairment (2.4±1.7 vs. 6.6±1.4, t=3.70, P＜0.01; 2.1±1.6 vs. 6.7±1.5, t=4.16, P＜0.01). The resting state fMRI showed that MCI patients had significant decreases of ALFF in hippocampal formation, parahippocampal cortex and lateral temporal cortex as compared with health controls (t=2.58, 2.43 and 1.75, all P＜0.01), which were closely relevant to the episodic memory. And they had significant increases in temporal-parietal joint and inferior parietal lobule (t=3.14 and 2.77, both P＜0.01). Conclusions MCI patients show significant decreased active intensity of some DMN nodes that is related to episodic memory in resting state. Increased active intensity in MCI patients would be some type of compensation.

Objective:To explore the feasibility and clinical efficacy of stratified suture of lateral pharyngeal wall(SSLPW) combined with soft palate radiofrequency coblation in the treatment of the patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:The clinical data of 21 severe OSAHS patients underwent lateral pharyngoplasty(LP) combined with soft palate radiofrequency coblation (LP group) and 39 severe OSAHS patients underwent SSLPW combined with soft palate radiofrequency coblation (SSLPW group) were selected.The apnea hypopnea index(AHI),lowest SaO2(LSaO2),Epworth sleepiness scale(ESS) scores,and related postoperative complications of the patients in two groups were analyzed before and after operation.The successful rates of operation of the patients in two were compared.Results:In LP group,1 patient was cured (5%),19 patients were improved markedly (90%),1 patient was effective (5%),and no patient was invalid;the successful rate was 95.2%(20/21).In SSLPW group,2 patients were cured (5.1%),33 patients were improved markedly (84.6%),4 patients were effective (10.3%),and no patients was invalid;the successful rate was 89.7%(35/39);there was no statistical difference in the successful rate of operation of the patients between two groups (P>0.05).There was statistically significant improvement of the subjective symptoms.All the patients returned to normal subjective swallowing functions without nasal pharyngeal reflux and dysphagia in one month follow-up after operation.Compared with before operation,the AHI and ESS scores of the patients in two groups after operation were decreased(P<0.05);the LSaO2 scores were increased(P<0.05).Conclusion:The AHI,LSaO2 and ESS scores are significantly improved in the OSAHS patients after treated with SSLPW combined with soft palate radiofrequency coblation.The method is a valid option for the severe OSAHS patients.

Objective: On the basis of typical cases, the objective of this study is to assess the service quality of primary healthcare institutions under the vertically integrated model from the perspective of demanding side.Methods: The vertical model between Renhe Hospital and Lixian Township Health Center was selected as the case study.Quantitative data were collected by exit review using Primary health-Care quality service Assessment Tool (PCAT)-Chinese version from the patients seeking services in Lixian.Quantitative data were analyzed by descriptive statistics and multiple linear regression equations while qualitative data were analyzed by thematic framework analysis.Results: Under the vertical model, the PCAT total score was 20.09.The scores on the first diagnosis, continuity of care, and comprehensiveness of care and coordination of care were 6.59, 3.27, 4.58 and 5.62 respectively.The scores on the three dimensional extensions, family-centered, community-oriented, medical culture were 3.07, 1.86 and 2.67 respectively.The difference was significant for the PCAT total score between a number of visits and the length of waiting time for services in Lixian.Conclusions: Under the vertical model, primary healthcare institutions did better in the first diagnosis while weaker in continuity and the three dimensional extensions.With the development of the integration, the primary healthcare institutions need to strengthen the continuity and downward referral in the future.Future researches and follow-up, analysis is needed to track the impact of the vertically integrated model.

Objective To analyze the clinical significance of modified thyroidectomy by trans-isthmus approach.Methods The clinical data of 5 751 patients who underwent thyroidectomy from Jan.1996 to Jan.2006 were retrospectively analyzed.All cases were divided into two groups.The modified operation group(n=3288) was treated by trans-isthmus thyroidectomy.Another group(n=2463) was treated by routine approach.The operation time,bleeding volume,and complications were observed and compared.Results In modified operation group,the mean operation time,bleeding volume,temporary injury of recurrent laryngeal nerve,tracheal discomfort,and hypocalcemia were significantly decreased than those in routine approach group(P

Objective To assess the clinical effect of tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints. Methods Thirty-seven patients with giant cell tumors of bone near the joints from January 1998 to January 2008 were reviewed. 18 were males and 19 were females. The ages ranged from 19 to 64 and the median age was 32 years old. The anatomic site of the lesions spreaded at distal femur(23 cases) , proximal tibia(10 cases),proximal humerus(3 cases) and proximal femur(1 case). According to Companacci's staging system: 9 patients were classified as grade II and 28 as grade Ⅲ. All patients had been treated with block excision and reconstruction with prosthesis. The functional outcomes were evaluated by MSTS 93 score. Results According to the follow-up for 2 -9 years,1 patient (4. 3% ) had local recurrence and underwent amputation of the diseased limb. As for the complications, periprosthesis infection occurred in 1 patient, prosthesis loosening in 2 patients. The average MSTS 93 score was 22. 49 ±5. 16 in 3 years after surgery. The evaluated functional result revealed excellent or good performance in 89. 2% of the patients. Conclusions Tumor-type prosthesis replacement is an effective procedure to reduce the local recurrence,and to restore joint function.

Objective:To explore the effect of red blood cell distribution width (RDW) on long-term follow-up study in patients with acute pulmonary thromboembolism (APE).
Methods:A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups:RDW≤15%group, n=202 and RDW>15%group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension (CTEPH). The independent predictor for CTEPH occurrence was studied by uni-and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve.
Results: All patients ifnished the follow-up study at the mean of (31±17) months. The overall occurrence rate of CTEPH was 7.5% (16/214), which was higher in RDW>15% group than that in RDW≤15% group (33.3% vs 5.9%, P=0.002). Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW>15%was still the strong predictor for CTEPH occurrence (OR=7.916, 95%CI 1.474-42.500, P=0.016). Adding RDW to the evaluating model, the predictive capability could be signiifcantly improved by ROC curve (AUC increased from 0.856 to 0.901, P<0.01).
Conclusion: Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.

The aim of this study is to prepare hyaluronic acid (HA) modified core-shell liponanoparticles (pHA-LCS-NPs) as gene delivery system and investigate its gene transfection efficiency in human retinal pigment epithelium (ARPE-19) cells in vitro. The pHA-LCS-NPs was prepared by firstly hydrating dry lipid film with CS-NPs suspension to get LCS-NPs, then modifying the lipid bilayer with HA by amidation reaction between HA and dioleoyl phosphatidylethanolamine (DOPE). Its morphology, particle size and zeta potential were investigated. XTT assay was used to evaluate the cell safety of different vectors in vitro. The gene transfection efficiency of pHA-LCS-NPs modified with different contents of HA was investigated in ARPE-19 cells with green fluorescent protein (pEGFP) as the reporter gene. The results showed that the obtained pHA-LCS-NPs exhibited a clear core-shell structure with the average particles size of (214.9 +/- 7.2) nm and zeta potential of (-35 +/- 3.7) mV. The 24 h cumulative release of gene from pHA-LCS-NPs was less than 30%. After 48 h incubation, gene transfection efficiency of pHA-LCS-NPs/pEGFP was 1.81 times and 3.75 times higher than that of CS-NPs/pEGFP and naked pEGFP, respectively. Also no obvious cytotoxicity was observed on pHA-LCS-NPs. It suggested that the pHA-LCS-NPs might be promising non-viral gene delivery systems with high efficiency and low cytotoxicity.

The purpose of this study is to prepare galactosyl modified lipid bilayer-coated mesoporous silica nanoparticles (GPEM) to enhance the antitumor efficacy against hepatocellular carcinoma cells. The irinotecan (CPT-11) loaded mesoporous silica nanoparticles (MSNs) was coated with the Gal-P123 modified functional lipid bilayer by thin-film dispersion method. Nanoparticles were characterized with particle size, zeta potential, morphology and drug release in vitro. Afterwards, the cell uptake, intracellular concentration of CPT-11, cell apoptosis rate and cytotoxicity were evaluated on human hepatocellular carcinoma cell line Huh-7. The results showed that MSNs were coated with intact lipid bilayers and the nanoparticles had clear core-shell structure. GPEM is stable with the mean particle size of (78.01 +/- 2.04) nm. The low leakage rate in normal physiological conditions in vitro is contributed to the protection of stable lipid bilayer, and the fast drug release in acid environment due to the destruction of the lipid bilayer. On the cell level, the vector could improve the intracellular CPT-11 concentration by 4 times because of the functional lipid bilayer. The high CPT-11 concentration led to the increasement of apoptosis rate by 48.6%, and the reduction of half maximal inhibitory concentration (IC50) values of CPT-11 by 2 times, indicating stronger cell cytotoxicity.

The aim of this study is to prepare hyaluronic acid (HA) modified core-shell liponanoparticles (pHA-LCS-NPs) as gene delivery system and investigate its gene transfection efficiency in human retinal pigment epithelium (ARPE-19) cells in vitro. The pHA-LCS-NPs was prepared by firstly hydrating dry lipid film with CS-NPs suspension to get LCS-NPs, then modifying the lipid bilayer with HA by amidation reaction between HA and dioleoyl phosphatidylethanolamine (DOPE). Its morphology, particle size and zeta potential were investigated. XTT assay was used to evaluate the cell safety of different vectors in vitro. The gene transfection efficiency of pHA-LCS-NPs modified with different contents of HA was investigated in ARPE-19 cells with green fluorescent protein (pEGFP) as the reporter gene. The results showed that the obtained pHA-LCS-NPs exhibited a clear core-shell structure with the average particles size of (214.9 +/- 7.2) nm and zeta potential of (-35 +/- 3.7) mV. The 24 h cumulative release of gene from pHA-LCS-NPs was less than 30%. After 48 h incubation, gene transfection efficiency of pHA-LCS-NPs/pEGFP was 1.81 times and 3.75 times higher than that of CS-NPs/pEGFP and naked pEGFP, respectively. Also no obvious cytotoxicity was observed on pHA-LCS-NPs. It suggested that the pHA-LCS-NPs might be promising non-viral gene delivery systems with high efficiency and low cytotoxicity.
Cell Survival ; Gene Transfer Techniques ; Genes, Reporter ; Genetic Vectors ; Green Fluorescent Proteins ; metabolism ; Humans ; Hyaluronic Acid ; chemistry ; pharmacology ; Lipids ; Nanoparticles ; Particle Size ; Phosphatidylethanolamines ; chemistry ; pharmacology ; Retinal Pigment Epithelium ; drug effects ; Transfection