Objective To observe the symptoms,short and long term effects of body gama-knife in treatment of obstructive jaundice caused by cholangiocarcinoma.Methods 76 patients with obstructive jaundice caused by cholangiocarcinoma were treated with OUR-QGD body gamma-knife.The single therapeutic dose was 3.0-4.0 Gy,isodose curves was 50.0 ％-65.0 ％,the total treatment time was 10-12 times.The liver function,blood routine and adverse effects were monitored.Results Among 76 patients,the jaundice symptoms of 69 cases were significantly reduced,the TBIL and ALT levels were significantly lower than that before treatment (P ＜ 0.05),the ORR was 88.16 ％ (67/76),DCR was 90.79 ％ (69/76).The median TTP was 8.8 months and the median OS was 13.4 months.Conclusions Body gamma-knife treatment for obstructive jaundice caused by cholangiocarcinoma can significantly improve symptoms of patients,and improve their life quality.This treatment has less adverse effects and satisfaction short-time and long-term effects.

Objective To analyze the effect of different medical insurance payments on medical expenses so as to provide some suggestions for Guangdong Provincial Department of Offsite Medical Insurance Administration in its future policy-making.Methods An statistic analysis was conducted of medical expenses among patients who chose different medical insurance payments and their average length of stay.Results Medical expenses and average length of stay were statistically different among patients who chose different payments.Conclusion The medicare reimbursement′s inclusion of prevention and diagnosis should be recommended to establish a flexible referral system, reinforce the payments reform and increase the efficiency of social security funds.

OBJECTIVETo reveal the quality variation of polysaccharides, triterpenoids and proteins in spores and fruiting bodies of Ganoderma lucidum from producing areas, different varieties, harvesting parts and periods, and wall-breaking treatments.

METHODSpores and fruiting bodies from varieties of Longzhi No. 1 and Hunong No. 1 were collected as test samples, together with wall-broken spores sold in domestic main producing areas. The anthrone-sulfuric acid colorimetric method was used to determine the content of total polysaccharides. The vanillin-glacial acetic acid-perchloric acid colorimetric method was used to determine the content of total triterpenoids. The Lowry method was used to determine the content of total proteins.

RESULTThe content ranges of total polysaccharides, total triterpenoids, and total proteins from 6 domestic main producing areas were 0.40% - 2.25%, 1.36%-3.15% and 0.74% -1.91% respectively. The content ranges of total polysaccharides, triterpenoids, and proteins in the fruiting bodies from 2 varieties cultured in Zhejiang were 0.25% -1.42%, 0.44% -1.42% and 1.82% -3.67% respectively. In addition, the ranges of samples from wall-unbroken spores were 0.41% - 0.91%, 0.09% - 0.12%, 0.78% - 0.90% respectively and wall-broken spores are 1.03% - 2.25%, 1.89% - 3.15%, 0.96% - 1.04% respectively.

CONCLUSIONThere are significant differences in the contents of main chemical ingredients of wall-broken G. lucidum spores saled in the markets. The samples from Zhejiang contain high content of total polysaccharides and triterpenoids, and samples from Fujian contains more proteins. Between the 2 major varieties cultured in Zhejiang, Longzhi No. 1 contains higher content of triterpenoids, but Hunong No. 1 has more polysaccharides. Contents of triterpenoids and polysaccharides from wall-broken spores are much higher than those of fruiting bodies. The stipes from fruiting bodies contains more polysaccharides than those of the pileus, while the triterpenoids contents are higher in the pileus than stipes. The pileus and stipes collected in the second year contain higher content of polysaccharides than the first year's samples, but the contents of triterpenoids are lower. Wall-breaking treatment would significantly improve the extraction and dissolution rate of total triterpenoids and polysaccharides.

Fungal Proteins ; analysis ; Polysaccharides ; analysis ; Reishi ; chemistry ; Spores, Fungal ; chemistry ; Triterpenes ; analysis

OBJECTIVETo compare the difference of Euphorbia Pekinensis Radix before and after being processed with vinegar in the toxicity on rat small intestinal crypt epithelial cells IEC-6, and make a preliminary study on the mechanism of detoxication of Euphorbia Pekinensis Radix processed with vinegar.

METHODWith rat small intestinal crypt epithelial cells IEC-6 as the study object, the MTT method was adopted to detect the effect of Euphorbia Pekinensis Radix before and after being processed with vinegar on IEC-6 cell activity. The morphology of cells were observed by the inverted microscope. The down-regulated mitochondrial apoptosis pathway of enterocytes caused by the vinegar processing was analyzed by using the high content screening.

RESULTCompared with the negative control group, the proliferation inhibition experiment showed that Euphorbia Pekinensis Radix showed a relatively high intestinal cell toxicity (P < 0.01). The results of HCS analysis showed that Euphorbia Pekinensis Radix could significantly reduce the cell nucleus Hoechst fluorescence intensity and mitochondria membrane (P < 0.05, P < 0.01), and increase Annexin V-FITC and PI fluorescence intensity and membrane permeability (P < 0.01, P < 0.01, P < 0.01). After being processed with vinegar, compared with Euphorbia Pekinensis Radix groups with different doses, Euphorbia Pekinensis Radix processed with vinegar could significantly decrease the cell proliferation inhibition effect on enterocytes, increase the cell nuclear Hoechst fluorescence intensity and mitochondria membrane (P < 0.05, P < 0.05), and decrease Annexin V-FITC and PI fluorescence intensity and membrane permeability (P < 0.01, P < 0.01, P < 0.05), and showed a certain dose-effect relationship.

CONCLUSIONThe vinegar processing can further reduce the toxicity of Euphorbia Pekinensis Radix on enterocytes. Its possible mechanism can decrease the effect of Euphorbia Pekinensis Radix on the permeability of IEC-6 cell membrane, so as to provide a basis for further explanation of the detoxication mechanism of Euphorbia Pekinensis Radix processed with vinegar.

Acetic Acid ; chemistry ; Animals ; Apoptosis ; drug effects ; Cell Line ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Epithelial Cells ; cytology ; drug effects ; Euphorbia ; chemistry ; Intestine, Small ; cytology ; Rats

Child, Preschool ; Echocardiography, Transesophageal ; methods ; Heart Septal Defects, Ventricular ; diagnostic imaging ; therapy ; Humans ; Male

OBJECTIVE: To synthesize low molecular weight chitosan-acetylcysteine (LMWC-NAC) conjugate and investigate its renal targeting profile and the rapeutic effects in model mice with acute kidney injury (AKI).METHODS: NAC was conjugated to LMWC by EDC/NHS reaction and the LMWC-NAC conjugate was identified by 1H-NMR. The cellular uptake of LMWC-NAC conjugate and megalin receptor involved in this process was investigated in vitro. In addition, the tissue distribution of ICG-labelled LMWC-NAC conjugate was investigated in nude mice. AKI were induced by LPS intraperitoneal injection (20 mg·kg-1).The parameters including Scr, BUN, inflammatory factors (TNF-α and IL-1β), and oxidative stress (MDA) were determined and renal histology was observed. RESULTS: LMWC-NAC conjugate was successfully synthesized by the amide interaction.The in vitrostudies demonstrated that the uptake of LMWC-NAC conjugate was mediated by the megalin receptor on HK-2 cells, and the tissue distribution experiment indicated that LMWC-NAC conjugate was mainly accumulated in the kidney.LMWC-NAC conjugate significantly suppressed Scr, BUN, inflammatory factors and oxidative stress (P<0.01) and improved kidney injury. CONCLUSION: LMWC-NAC conjugate showed good renal targeting profile and effect in recovering renal functions, which indicates the potential of LMWC-NAC conjugate as a safe and efficient drug delivery system for the treatment of AKI.

To investigate and step in the compliance of clinician hand hygiene, we used vari-ous management tools of the quality control circle (QCC), and then compared the change of the com-pliance before and after any operations. Firstly, we followed this 5 steps: selecting themes, drafting plans, grasping current situations, setting goals and analyzing objectives. Then, we formulated and im-plemented the interventions pertinently. All of the QCC members participated actively in the whole process. The compliance of clinician hand hygiene was improved from 41.11%to 57.59%. The realiza-tion rate was 115.97%, the progress rate was 40.99%, and the hand hygiene compliance of hand hy-giene in different time was significantly improved with the average value 1.25. Standardized result formed by quality control circle activity had a comprehensive promotion in the hospital and promoted the management of hospital infection and the development of hospital.

Background Subretinal transplantation of retinal pigment epithelium (RPE) cells for the treatment of age-related macular degeneration (AMD) have accelerated the drive to develop xeno-free cultivation system that support the rapid differentiation of human embryonic stem cells (hESCs) into ES-RPE cells.Objective This study was to report a modified xeno-free culture system and method for accelerating derivation of hESCs to differentiate into RPE cells.Methods This study was approved by Ethic Committee of Zhongshan Ophthalmic Center.HESC H1 line was cloned and cuhured in Vitronectin XFTM-coated 6-well dish with xenogenetic-free medium.Cells were cultured in 50 ng/ml noggin,10 ng/ml DKK-1 and 10 ng/ml insulin like growth factor-1 (IGF-1) medium for 2 days,and then the concentration of noggin was decreased to 10 ng/ml and 5 ng/ml basic fibroblast growth factor (bFGF) and cultured for the following 2 days.Sequentially,noggin and bFGF were removed and cultured for 2 days.Finally,1 μmol/L CHIR99021 was added in medium for 6 days.Morphological changes in the progress of ESCs differentiation into RPE were observed by Living Cell Imaging System.The expression of Mitf and RPE65,RPE cellsspecific markers,in the cells were detected by immunofluorescence technique,and the relative expression levels of RPE cells-specific marker mRNA were assayed using real time fluorescent quantitation PCR.Results Polygonalshape monolayer cells which contained pigments were initially observed at day 14 after cultured with the cobblestonelike arrangement.Mitf and RPE65 were strongly expressed in the hES-derived RPE cells 35 days after induced,showing red fluorescence,and the cells presented hexagonal shape at cultured day 60 with numerous pigment granules in cytoplasm.Compared with before differentiation,the expression levels of Mitf mRNA in hES-RPE cells increased by (3.43±2.77) folds and (8.91 ± 2.83) folds,and the expression levels of RPE65 mRNA increased by (14.60 ± 3.94) folds and (87.16 ±9.32) folds at day 7 and day 14 after differentiation,respectively (all at P＜0.05).Conclusions A defined xeno-free culture system is successfully established by adding niacinamide,DKK-l,noggin,IGF-1 and CHIR99021 in xeno-free medium,and this system can accelerate the derivation and differentiation of hESCs into RPE-like cells.

Objective To evaluate the value of CT perfusion imaging (CTP)for solitary pulmonary nodule (SPN)by Meta-analysis.Methods Literatures about SPN diagnosed by CTP were filtered.PubMed,EMBASE,CNKI,VIP and WANFANG databases were searched for the relevant articles.The retrieved studies were screened according to the criteria for diagnostic research published by the cochrane methods group on screening and diagnosis.The quality of the articles was accessed and the basic data in the articles was extracted.Review Manager 5.3 software was used to compare the blood volume (BV)among different nodules,to perform heterogeneity test and analyze publication bias.Results A total of 1 7 studies with 877 lesions were included in the study.The random effect model was used for the existence of heterogeneity.The result showed the BV value of malignant SPN was higher than that of benign ones.Conclusion The result indicates that there exists significant difference in BV between malignant and benign SPN.The BV value,as one of the hemodynamic parameters of CTP,can be used as the diagnostic basis of SPN.

Objective To analyze monitoring results of iodized salt and distribution characteristics of problem areas with non-iodized salt in Gansu province during 2001 - 2009 and to provide a basis to develop countermeasures to iodine deficiency disorders. Methods According to the criterion of "The National Scheme of Iodized Salt Surveillance", two levels of monitoring were carried out on production and wholesale-level(during 2001 -2007) and household-level(during 2001 - 2009). Salt iodine was determined by direct titration method (GB/T13025.7-1999), and Sichuan salt or special salt was determined with an arbitration method. Criteria for qualified iodized salt was (35 ± 15)mg/kg(20 - 50 mg/kg), and for non-iodized salt was ＜ 5 mg/kg. Results During 2001 - 2007, a total of 4900 salt samples at production and wholesale-levels were examined, with a qualification rate of 97.80% (4792/4900). Non-iodized salt rates were all below 5% in Gansu province, consumption rate of qualified iodized salt was higher than 90% after 2003. During 2001 - 2009, cities(states) with non-iodized salt problems appeared 23 times, with Linxia accounting for 39.1%(9/23), Wuwei accounting for 21.7%(5/23). During 2001 -2009, counties(districts) with non-iodized salt problem appeared 123 times, including 68 times of ethnic minorities and state poverty counties, accounting for 55.3%(68/123). During 2001 - 2005 and 2006 - 2009, ethnic minorities and state poverty counties were accounting for 49.4%(44/89) and 70.6%(24/34) in counties with non-iodized salt problem. Conclusions The quality of iodized-salt at production and wholesale level is satisfactory in Gansu province, household consumption rate of qualified iodized salt have reached national standard for eliminating iodine deficiency disorders. But ethnic minorities and state poverty counties are main regions with non-iodized salt problem,these areas will be the key areas of prevention of iodine deficiency disorders in Gansu province in the future.