The fruit of Pandanus tectorius (PTF) has a long history of use as a folk medicine to treat hyperlipidemia in Hainan province, South China. Our previous studies have shown that the n-butanol extract of PTF is rich in caffeoylquinic acids and has an adequate therapeutic effect on dyslipidemic animals induced by high-fat diet. In this work, seven caffeoylquinic acids isolated from PTF were screened for the lipid-lowering activity in HepG2 hepatoma cells. Oil-Red O staining, microscopy and intracellular triglyceride (TG) and total cholesterol (TC) quantification showed that 3-O-caffeoylquinic acid (3-CQA), 3, 5-di-O-caffeoylquinic acid (3,5-CQA), and 3,4,5-tri-O-caffeoylquinic acid (3,4,5-CQA) significantly inhibited lipid accumulation induced by oleic acid and decreased intracellular levels of TC and TG in a dose-dependent manner. These three caffeoylquinic acids showed no significant cytotoxicity at concentrations of 1 -50 μmol x L(-1) as determined by MTT assay. Realtime quantitative PCR revealed that 3-CQA and 3, 5-CQA significantly increased the expression of lipid oxidation-related genes PPARα, CPT-1 and ACOX1 while 3-CQA, 3, 5-CQA and 3,4,5-CQA decreased the expression of lipogenic genes SREBP-1c, SREBP-2, HMGR, ACC, FAS. Overall, 3-CQA, 3, 5-CQA and 3, 4, 5-CQA may be the principal hypolipidemic components in PTF which can decrease intracellular lipid accumulation through up-regulating the expression of lipid oxidative genes and down-regulating the expression of lipogenic genes.
Carcinoma, Hepatocellular ; metabolism ; China ; Cholesterol ; metabolism ; Gene Expression Regulation ; Hep G2 Cells ; Humans ; Lipid Metabolism ; Liver Neoplasms ; metabolism ; Oleic Acid ; Pandanaceae ; chemistry ; Quinic Acid ; analogs & derivatives ; chemistry ; Sterol Regulatory Element Binding Protein 1 ; Triglycerides ; metabolism

Objective To observe the effect of Yang-warming and Qi-tonifying Recipe (YQP)on aquaporin 3(AQP3) and AQP8 in rats with slow transit constipation,and to explore its therapeutic mechanism. Methods Forty rats were randomly divided into modeling group(N=30)and normal control group(N = 10). After successful modeling by gastric gavage of loperamide,the modeled rats were randomly divided into model group,YQP group and Mosapride group,10 rats in each group,and were separately treated with corresponding medicine for 2 weeks. After treatment, the colonic transit function was measured by carbon propelling test. The protein levels of AQP3 and AQP8 were detected by immunohistochemistry and their mRNA expression levels were detected with real-time fluorescence polymerase chain reaction (qPCR). Results Compared with the normal control group,the propelling rate of carbon particle in the model group was decreased,and the protein and mRNA expression levels of AQP3 and AQP8 were significantly increased(P<0.05 or P<0.01). Compared with the model group,the propelling rate of carbon particle of YQP group and mosapride group was significantly increased, and the protein and mRNA expression levels of AQP3 and AQP8 were significantly decreased (P<0.05),but there was no significant difference between YQP group and mosapride group (P >0.05). Conclusion YQP had therapeutic effects on loperamide-induced constipation through decreasing the expression of AQP3 and AQP8 in the intestine,reducing the reabsorption of intestinal fluid, and increasing the fecal water content.

OBJECTIVETo evaluate the efficacy, safty and economical values of immunonutrition for clinical nutritional support.

METHODSThe following electronic databases were searched: Chinese Biomedicine database (CBM), MEDLINE, EMBASE, Cochrane Library and SCI. Data were extracted by two reviewers. RevMan 4.1 was applied for statistical analysis.

RESULTSSeventeen randomised trials comparing the use of immunonutrition which comprises nucleotides, omega-3 fatty acids and arginine with standard enteral nutrition in surgical, trauma/burn and critical illness patients. Combined analysis indicated that the use of immunonutrition decreased infectious events (pooled OR was 0.51, 95%CI [0.38, 0.67], P = 0.00001), length of hospitalization, and the cost. In sensitivity analysis for mortality, we found an increased tendency in immunonutrition (pooled OR was 1.94, 95%CI [1.05, 3.57], P = 0.03). Further sub-group analysis indicated that the effects of immunonutrition were various in different patient types.

CONCLUSIONSImmunonutrition is associated with decreasing of infectious rates, length of hospitalization and cost in selective operation patients. But current evidence can't affirm the role of immunonutrition on critical illness patients. Further studies are urgently needed to clarify the reliability of immunonutrition in this group.

Arginine ; administration & dosage ; Critical Illness ; Enteral Nutrition ; methods ; Fatty Acids, Omega-3 ; administration & dosage ; Food, Formulated ; Glutamine ; administration & dosage ; Humans ; Immune System ; drug effects ; Nucleotides ; administration & dosage ; Nutritional Support ; Outcome Assessment (Health Care)

OBJECTIVETo investigate the blood lead level in children aged 0-6 years in urban areas of China.

METHODSFourteen cities were selected as sites under surveillance. A total of 44 045 peripheral blood specimens were collected from 2004 to 2006, during which 15 727, 14 737, and 13 584 specimens were tested in 2004, 2005, and 2006, respectively. Tungsten atomizer absorption spectrophotometer was employed to determine blood lead level.

RESULTSThe geometric mean blood lead level in the tested children was 47.10 microg/L with 10.10% > or = 100 microg/L, 46.17 microg/L with 7.78% > or = 100 microg/L, and 47.03 microg/L with 7.30% > or = 100 microg/L in 2004, 2005, and 2006, respectively. The blood lead levels seemed to tend to rise in parallel with the increase of age of the children and were higher in boys (48.84 microg/L, 47.56 microg/L, and 47.78 microg/L in the 3 respective years) than in girls (45.00 microg/L, 44.53 microg/L, and 46.13 microg/L).

CONCLUSIONThe blood lead levels in children in cities of China are lower than those in previous national studies, but higher than those in developed countries. Childhood lead poisoning remains a public health problem in China.

Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Cities ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Lead ; blood ; Lead Poisoning ; blood ; diagnosis ; epidemiology ; Male ; Population Surveillance ; Sex Characteristics

OBJECTIVETo investigate the blood lead status and influencing factors among preschool children in the sampling city.

METHODStratified-clustered-random sampling was used. Standardized questionnaire and peripheral blood samples were obtained from 69 968 children aged 0-6 years in fixed kindergartens and communities of Yinchuan, Xi'an, Chengdu, Wuhan, Hefei, Beijing, Harbin, Zhengzhou, Huhhot, Shijiazhuang, Haikou, Dalian, Qingdao, Guangzhou, Nanning and Changsha from 2004 to 2008, respectively. Tungsten atomic absorbtion spectrophotometry was employed to determine the blood lead level of children.

RESULTThe proportion of children with blood lead level ≥ 100 µg/L was 7.57% (among which the proportion of high blood lead level, mild lead poisoning, moderate lead poisoning, severe lead poisoning were 91.0%, 2.76%, 3.32%, 2.93%, respectively) and the blood lead level was lower than those of the past studies. The proportion of high blood lead level has steadily declined from 2004 to 2008 [the proportions were 10.03%, 7.85%, 7.40%, 6.91% and 4.78%, respectively (χ(2) = 297.36, P < 0.0001)]. The proportion of children with blood lead level ≥ 100 µg/L in Haikou, Zhengzhou, Guangzhou, Shijiazhuang, Changsha, Xi'an, Wuhan, Hefei, Chengdu, Yinchuan, Harbin, Beijing, Dalian, Huhhot, Nanning and Qingdao were 12.15%, 10.49%, 10.37%, 9.69%, 9.53%, 9.46%, 9.40%, 8.50%, 7.99%, 7.98%, 7.51%, 6.10%, 3.25%, 2.89%, 2.46% and 2.39%, respectively (χ(2) = 768.21, P < 0.0001). By multiple regression method, the risk factors which influenced blood lead status of children were education status of mother, older children, behavior and dietary habit of children, boy, stay for long time in traffic busy areas, the type of housing, taking traditional Chinese and herbal medicine. The protective factors against lead poisoning in children mainly included scattered living, the nutritional status of calcium, iron, zinc, frequent intake of milk, and older mother.

CONCLUSIONThe blood lead level of children has decreased, but is still higher than those in developed countries. Lead exposure remains a public health issue which affects children most. The blood lead level of children is affected by multiple factors. Government and the whole society should pay attention to interrupt the lead pollutant and to promote nutritional health education. With all these efforts, it is possible to stop the progress of lead exposure and reduce its hazardous effects on the growth and development of children.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Lead ; blood ; Lead Poisoning ; epidemiology ; Male ; Risk Factors ; Surveys and Questionnaires ; Urban Population

In recent years, the treatment strategy of mid-low rectal cancer has changed from surgical resection alone to multidisciplinary treatment. In order to offer the greatest benefits to the mid-low rectal cancer patients, it is necessary to carry out the preoperative TNM staging for appropriate therapeutic strategies. Total mesorectal excision (TME), preoperative TNM staging and neoadjuvant chemoradiotherapy together may achieve a breakthrough in the therapeutic outcome of mid-low rectal cancer.
Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms ; surgery

Laparoscopic proctocolectomy is a safe and feasible but complicated procedure, which is widely used clinically. Fully understanding of surgical plane and vascular anatomy is important for operation. The anastomosis methods, the type of ileal reservoir pouch and whether or not performing protective ileostomy should be considered preoperatively. Many details should be paid attention to.
Colorectal Surgery ; methods ; Humans ; Laparoscopy ; methods

OBJECTIVETo assess the short-term outcomes of staged hybrid coronary revascularization performed using robotic-assisted off-pump coronary bypass grafting followed by percutaneous coronary intervention (PCI) in a non-left anterior descending (LAD) coronary artery lesion.

METHODSFrom January, 2007 to May, 2013, 35 patients (32 male and 3 female patients, mean age 56.7 ± 9.6 years) underwent staged hybrid coronary revascularization. Ten patients had double-vessel and 25 patients had triple-vessel coronary diseases, and the lesions involved an average of 2.7 ± 0.5 coronary vessels. Coronary artery bypass grafting was completed in robotic-assisted left internal thoracic artery (ITA) harvesting and LITA to LAD bypass. Coronary angiography or 64-MSCT was performed to evaluate the patency of the ITA and stents at 6 months and at 1 to 5 years postoperatively. The patients were followed for major adverse cardiac events (MACE) including cardiac death, acute myocardial infarction and target lesion revascularization.

RESULTSStaged hybrid revascularization was completed successfully in all the patients without complications. The LITA to LAD anastomosis was completed in minimally invasive direct coronary bypass grafting (MIDCAB) or totally robotic coronary bypass grafting on beating heart (TECAB) with the assistance of da Vinci Surgical System. The mean artery graft flow was 36.0 ± 22.5 ml/min, and the graft had a 100% patency before discharge. A total of 49 stents were deployed in 35 patients within 2 weeks after robotic coronary bypass grafting, with a mean of 1.34 ± 0.6 stents per case (1 stent in 23 cases, 2 stents in 11 cases, and 3 stents in 1 case). The patients were followed up for 17.5 ± 11.6 months, and 1 patient had artery graft occlusion and another had in-stent occlusion at 6 months. All the other 33 patients had patent LITA-to-LAD anastomosis without angina or MACE.

CONCLUSIONStaged hybrid revascularization strategy has acceptable angiographic patency results for both LITA-LAD grafts and PCI interventions.

Aged ; Coronary Angiography ; Coronary Artery Bypass ; methods ; Coronary Artery Disease ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Mammary Arteries ; Middle Aged ; Percutaneous Coronary Intervention ; Robotic Surgical Procedures ; Stents ; Treatment Outcome

OBJECTIVETo observe blood lead level and related risk factors among children aged 0-6 years old living in cities in China and to provide data for policy development to the prevention on environmental lead pollution.

METHODSA stratified-clustered-random sampling method was used. 17 141 peripheral blood samples of 0-6 years old children from 15 cities in China were tested. Tungsten atomizer absorption spectrophotometer was employed to determined the blood lead level. Related factors were also studied using a standardized questionnaire. Data were analyzed on related risk factors that affecting blood lead levels through multiple regression method.

RESULTSThe mean blood lead level of 0-6 years old children from 15 cities in China was 59.52 microg/L including 10.45% of those > or =100 microg/L, and 0.62% > or = 200 microg/L. However, the blood lead levels seemed to have had a trend of increase parallel to age among 0-6 years-old children and were higher for boys (59.50 microg/L) than girls (54.95 microg/L). The risk factors which influenceing children's blood lead levels would include the type of housing, parent's education levels, social status and hobby, children's behavior habit, dieting habit and nutritional condition.

CONCLUSIONThe blood lead levels of children in China were lower than data gathered from former national studies but higher than those from developed countries, suggesting that the. Government and the whole society should be aware of the problem on lead poisoning among children during their childhood.

Child ; Child, Preschool ; China ; Female ; Health Policy ; Humans ; Infant ; Infant, Newborn ; Lead ; blood ; Logistic Models ; Male ; Quality Control ; Risk Factors ; Sampling Studies ; Urban Population ; statistics & numerical data

Objective To understand the status on AIDS awareness,AIDS-related behaviors,risk factors on HIV infection status among 15-90 years or older men at the sexually transmitted disease clinics.Methods Data from the 2009 and 2010 national sentinel surveillance system,regarding men attending sexually transmitted disease clinics was collected from Guangdong,Guangxi,Henan,Sichuan,Yunnan and Jiangxi provinces,where the AIDS epidemic among 15-90 years or older population was serious.Data was uploaded to National Center for AIDS/STD Control and Prevention (NCAIDS) through the comprehensive AIDS control and prevention information system.Data was then analyzed by SPSS 18.0.Results A total of 64 003 pieces of data were collected.Among them,8783 ( 13.7％ ) were related to men at ≥ 50 years or older,and to men 15-49 years older were 55 220.The rates on the awareness of AIDS knowledge were from 69.6％ vs.80.1％,on frequently having had commercial sexual contacts in the last three months were between 34.1％vs.36.6％,on having had casual sexual contact in the last three months were 18.7％ vs.28.4％,on having had homosexual anal intercourse as 0.7％ vs.1.4％.The rates of taking HIV antibody testing in the last year (14.3％ vs.17.1％ ) among this population were all significantly lower than the rate among the 15 to 49 years age group.However,the HlV-positive rate among the older age group (fifty years of age or older) was significantly higher than the rate among 15 to 49 year age group ( 1.1％ vs.0.7％ ).Regard the fifty years of age or older men.Data from the multivariate logistic regression analysis demonstrated that factors as:having regular partner (OR=0.588,P=0.034),having homosexual anal intercourse (OR=5.226,P=0.006) were associated with positivities of HIV antibody.Conclusion High-risk sexual behaviors,including homosexual anal intercourse were the major risk factors for men at ≥50 years or older age,related to the infection of HIV.