OBJECTIVETo investigate the relationship among serum leptin, homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI) and dyslipidema in patients with nonalcoholic fatty liver disease (NAFLD).

METHODSEighty-two patients with NAFLD were divided into mild, moderate and severe NAFLD groups according histological examination results of the liver. Twenty healthy volunteers were chosen as the normal control (NC) group. Fasting insulin, glucose, leptin and lipid levels were measured in the 82 patients with NAFLD and the BMI calculated. IR index of the patients was calculated according to the HOMA method.

RESULTSLeptin, HOMA-IR index, BMI and dyslipidemia showed significant differences between NAFLD and NC groups (P<0.05 or 0.01). Leptin and HOMA-IR index increased with the exacerbation of NAFLD, both of which were positively correlated with the severity of NAFLD.

CONCLUSIONIncreased leptin level, HOMA-IR, BMI and dyslipidemia can be important risk factors of NAFLD, and serum leptin level and HOMA-IR are positively correlated with the severity of NAFLD.

Adult ; Aged ; Body Mass Index ; Dyslipidemias ; complications ; Fatty Liver ; blood ; etiology ; Female ; Humans ; Insulin Resistance ; Leptin ; blood ; Male ; Middle Aged ; Risk Factors

Adult ; Aged ; Decompression, Surgical ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Nerve Block ; methods ; Spinal Nerve Roots ; Spinal Stenosis ; surgery

BACKGROUNDCongestive heart failure (CHF) is associated with Cheyne-Stokes respiration (CSR), which may hasten CHF. Adaptive servoventilation (ASV) is a novel method of ventilatory support designed for removal of CSF in CHF patients. This study compares the efficacy of ASV in patients with CHF and CSR with the efficacy of oxygen therapy.

METHODSFourteen patients with CHF and CSR were recruited. During sleep, nasal oxygen therapy and ASV treatment were each performed for two weeks. Comparison before and after each treatment was made for the following items: a) parameters of sleep respiration, sleep structure and quality; b) left ventricle ejection fraction (LVEF) and 6-minute walk distance.

RESULTSCompared with the baseline levels of apnoea hypopnoea index of 34.5 +/- 6.1 before treatment, the apnoea hypopnoea index significantly decreased following oxygen therapy to 27.8 +/- 8.2, P < 0.05 and further reduced following ASV treatment to 6.5 +/- 0.8, P < 0.01. The minimal pulse oxygen saturation markedly increased following oxygen therapy from a baseline of (84.3 +/- 2.6)% to (88.6 +/- 3.7)%, P < 0.05 and further increased following ASV treatment (92.1 +/- 4.9)%, P < 0.01. Stages I + II sleep as percentage of total sleep time decreased from (81.9 +/- 7.1)% to (78.4 +/- 6.7)% following oxygen therapy and further to (72.4 +/- 5.0)% following ASV treatment. Stages III + IV sleep as percentage of total sleep time decreased from (8.4 +/- 5.5)% to (6.0 +/- 3.0)% following oxygen therapy and but increased to (11.9 +/- 5.4)% following ASV treatment. The arousal index of 30.4 +/- 8.1 before treatment significantly decreased following oxygen therapy to 25.6 +/- 5.7, P < 0.05 and further declined following ASV treatment to 18.2 +/- 6.1, P < 0.01. No significant difference was shown in above percentages between day 14 of oxygen therapy and before treatment (P > 0.05). LVEF was significantly higher on day 14 of ASV treatment (37.2 +/- 4.1)% than on day 14 of oxygen therapy (33.2 +/- 5.1)% and before treatment (30.2 +/- 4.6)% (all P < 0.05). Six-minute walk distance was the shortest before treatment (226 +/- 28) m, longer on day 14 of oxygen therapy (289 +/- 26) m, and the longest on day 14 of ASV treatment (341 +/- 27) m (all P < 0.01).

CONCLUSIONASV treatment is of better efficacy and greater clinical significance in improvement of CHF by eliminating CSR than oxygen therapy.

Adult ; Cheyne-Stokes Respiration ; physiopathology ; therapy ; Female ; Heart Failure ; complications ; physiopathology ; Humans ; Male ; Middle Aged ; Oxygen Inhalation Therapy ; Positive-Pressure Respiration ; methods ; Sleep ; physiology ; Stroke Volume ; Ventricular Function, Left

Taking Guangdong Province Traditional Chinese Medical Hospital as an example,the paper introduces the study idea of hospital IT intelligent operation maintenance and monitoring platform,expounds on design and realization of the platform,including general technical architecture,functional architecture and core business process,summarizes related practical experiences,and points out that application of the platform is able to enhance operation maintenance level and user satisfaction significantly.

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

ADP receptors on platelets are mainly divided into two categories: P2X and P2Y. The activation of P2Y receptor is closely related to the occurrence and development of cardiovascular diseases. It plays an important role in regulating platelet activation and aggregation, vascular inflammation, thrombosis and so on. It is the target of ADP receptor blockers. This kind of drugs is also a hot spot in the research and development of antiplatelet drugs. This article reviews the role of P2Y receptor in the occurrence and development of cardiovascular diseases, in order to provide new ideas and reference for the application of P2Y receptor antagonists in the treatment of cardiovascular diseases.

Objective To investigate the influence of the physiological conditions and kidney function of the donors on their recipients ’ myco-phenolic acid ( MPA) and mycophenolic acid glucuronide ( MPAG) levels in the early period after renal transplantation.Methods Forty-two pa-tients receiving mycophenolate mofetil ( MMF) and 23 patients receiving enteric-coated mycophenolate sodium ( EC-MPS) , as well as their do-nors were included in this study.For patients who recieving MMF , MPA and MPAG concentrations were detected by HPLC , then AUCMPA and AUCMPAG were calculated by the limited sampling strategy (LSS) model es-tablished by our lab previously.For the patients receiving EC -MPS, AUCMPA and AUCMPAG were calculated by linear trapezoidal rule.Results Spearman test showed significant correlation between recipients ’ AUCMPAG and the age of donors in MMF group , EC-MPS group and the total cohort (P<0.05).Moreover, AUCMPAG in the recipients of elder group (>55 years old) was significantly higher than that in the younger group (≤55 years old) in both MMF group and the total cohort (P<0.05).In addition, AUCMPAG was siginificantly associated with the urea levels of donors before renal transplanta-tion in MMF group and the total cohort ( P<0.05 ).Patients were divided into tacrolimus ( FK506 ) or cyclosporin A ( CsA) group according to their comedication.AUCMPAG was significantly higher in CsA group than that in FK 506 group ( P<0.01 ).AUCMPAG in the recipients of elder group was significantly higher than that in the younger group ( P<0.05), and AUCMPAG was siginificantly associated with the urea levels of donors in FK 506 group (P<0.05).In CsA group, significant correlation between AUC MPAG and the age of donors was showed (P<0.05).Conclusion Our data suggested that the age and the urea level of donors might play roles in the recipients ’ MPAG exposure in the early period after renal transplantation .

Adult ; Female ; Hamartoma ; complications ; diagnosis ; surgery ; Humans ; Kidney Calculi ; complications ; Spleen ; pathology ; surgery ; Splenectomy ; methods ; Splenic Diseases ; complications ; diagnosis ; surgery

This study was aimed to explore the influence of staphylokinase derivative (SAKD) on the hemoagglutinative and fibrinolytic systems, and to determine the safety of the staphylokinase derivative in application. The normal and model rats each 30 were divided into normal saline, SAKD and rSAK groups. The hemorrhage, bleeding time (BT), blood platelet count (BPC), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), D-dimer (D-D), plasminogen (PLG) and plasmin inhibitor activity (PI) were detected before and after the administration with staphylokinase derivative 0.5 mg/kg body weight, once three days for consecutive 15 days. The results indicated that one case of normal rats with SAKD and two cases of high fat diet model group had mild hemorrhage, all of which showed automatic hemostasis; and 3 cases in rSAK group had mild hemorrhage. And the platelet counting, D-D, PLG and PI in all groups did not significantly change. The rats of high fat diet group treated with SAKD showed the significant extension of APTT, PT and TT times, and the decrease of Fg time (p < 0.05). All the experimental results demonstrated that the influence of SAKD on the hemagglutination of the normal animals was lower, however, which can improve the high-hemagglutination status of the rats with high fat diet. It is concluded that the SAKD at the dosage of this study has the higher safety, which can alleviate the high hemagglutination symptoms of the rats with high fat diet.
Animals ; Dietary Fats ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; drug effects ; Fibrinolytic Agents ; adverse effects ; pharmacology ; Hemagglutination ; drug effects ; Hemostasis ; Male ; Metalloendopeptidases ; pharmacology ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Rats ; Rats, Wistar ; Recombinant Fusion Proteins ; adverse effects ; pharmacology ; Thrombin Time ; Thrombolytic Therapy

OBJECTIVETo survey the dose of glucocorticosteroids administered in patients with severe acute respiratory syndrome (SARS) and assess the effect of glucocorticosteroid doses in improving the patients' lung function.

METHODSA retrospective analysis was conducted among 225 SARS patients treated in our in 2003. Oxygenation index was used as the effectness index, and the criteria for effectiveness was defiend as increase of the value of OI by 20% or above.

RESULTSGlococoticostecoids were used in 59.56% of the SARS cases. The average value of OI before intravenous use of glucocorticosteroids was 237.08 mmHg, and that after the administration was 335.08 mmHg. The glucocorticosteroid doses that produce better effects were 1-3 mg/kg and 160-240 mg daily, with the total accumulative dose of 1000-2000 mg. The optimal duration of glucocorticosteroid use was 8-14 days.

CONCLUSIONSFor SARS treatment, Glucocorticosteroids can effectively ameliorate the SARS patients' lung symptoms and improve the lung function. The appropriate daily dose of glucocorticosteroids is 1-3 mg/kg or 160-240 mg/d for a duration of 8-14 d; the accumulative dose should be controlled around 1500 mg.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Glucocorticoids ; administration & dosage ; Humans ; Male ; Methylprednisolone ; administration & dosage ; Middle Aged ; Respiratory Function Tests ; Respiratory Insufficiency ; prevention & control ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; drug therapy ; Young Adult