BACKGROUND: Abnormal neuronal discharge arose from the activation of cell membrane ion channels and transmembrane ion transport. The electric activity of the cells is associated with cell metabolism fundamentally through adenosine triphosphate (ATP)-sensitive potassium(KATP) channels.Currently the involvement of KATP channels in the pathogenesis of epilepsy and the regulation of KATP channels by coriaria lacton (EL) remain unknown.OBJETCIVE: To investigate the changes of cell membrane KATP channels in rat hippocampal neurons in response to CL as an epilepsy-inducing agent, and explore the role of KATP channels in the pathogenesis of epilepsy.DESIGN: Randomized controlled experiment.SETTING: Department of Neurology, West China Hospital Affiliated to Sichuan University, and Teaching and Research Section of Physiology,West China College of Preclinical Medicine and Forensic Medicine of Sichuan University.MATERIALS: This experiment was carried out at Luzhou Medical College between May and December 2000. Hippocampus pyramidal neurons were obtained from neonatal Wistar rats and randomized into normal control group, tetraethylammonium chloride (TEA) group, DNP group, CL group, and electric conductance and dynamics group.METHODS: The hippocampus of newborn Wistar rats was separated under aseptic condition and cultured for 24 hours prior to treatment with 10 μmol/L cytarabine for selective cell culture for 7-10 days. The cells in good growth exhibiting typical morphology of pyramidal neurons were then selected for patch-clamp experiment. The cells in the normal control group were treated with normal saline, which was replaced by 5 mmol/L TEA in TEA group, by 30 μmol/L DNP then 0.5 mol/L ATP in DNP group, and by 1.0 mL/L CL then 1 μmol/L glibenclamide in CL group. In electric conductance and dynamics group, the clamp voltage was firstly adjusted to investigate the channel opening before CL was added to the cells.MAIN OUTCOME MEASURES: ① Activity and curve of neuronal KATP channels; ② Effects of various clamp voltages on the channels activity and the effects of interventions with DNP, ATP and TEA; ③ Activation of neuronal membrane KATP channels induced by CL and the influence of glibenclamide.RESULTS: The reversal potential of the channels approximated 0 mV in homologous high-potassium solution. The opening of KATP channels increased along with the absolute value of the clamp voltage in a voltage-dependent manner, which was blocked by TEA. The electric current-voltage (Ⅰ-Ⅴ)curve could be fitted to a straight line with the electric conductance of (78.23±12.04) pS. Administration of 30 μmol/L DNP enhances the opening of the channels, which could be suppressed by 0.5 mol/L ATP.Addition of 1.0 mL/L CL to the cells caused obviously increased channel opening, which was suppressed by 1 μmol/L glibenclamide. The channel opening time was (1.754±0.060) ms for epileptic neuron τ01and (1.733±0.046) ms for normal neurons, showing no significant difference between them (n=25, t=0.147, P ＞ 0.05), but compared with the channel opening time of (2.441±0.265) ms for τ02 normal neurons, and duration was significantly prolonged in the epileptic neurons to reach (10.446±0.579)ms (n=25, t=0.000, P ＜ 0.01).CONCLUSION: The opening of KATP channels is responsible for reducing the action potential frequency for neuronal protection, which might be a negative feedback mechanism.

Objective To observe the effect of treatment of the diabetide foot with the fresh skin of the bufo bufo gargarizans cantor. Methods 42 diabetic foot patients were randomized into the control group and the treatment group with 21 patients in each. In the control group the patients were treated with disinfection routinely and dressing changing. In the treatment group the patients were treated with the fresh skin of the bufo bufo gargarizans cantor covering the infected feet after routine disinfection treatment. The treatment effect, the healing time and the length of antibiotics treatment course were compared between the two groups. Results The treatment effect of the treatment group was 100.00%, significantly higher than 80.95% of the control group. The healing time of the treatment group was (9.05 ±4.09) days, shorter than (17.41±4.20)days of the control group. The length of the antibiotics treatment course of the treatment group was(9.33±4.73)days, shorter than (17.10±4.83) days of the control group. Conclusions The fresh skin of the bufo bufo gargarizans cantor can improve the recovery rate, shorten the healing time and the length of the antibiotics treatment course by covering the infected feet.

Objective:To analysis the appearances and to evaluate the diagnostic value of X-ray CT and MR imaging in osteoid osteoma.Methods:22 cases 19 females and 3 males of osteoid osteoma proved by surgical pathology and their X-ray,CT and MRI were reviewed.The ability of X-ray,CT and MRI to demonstrate the nidus and surrounding reaction were analyzed.Results:The nidus were appeared as round or oval shape and the diameter was less than 2 cm.It was fomd in 17 cases of X-ray film，22 CT and 20 of MRI .There were different degree of bone sclerosis,periosteal reaction and soft tissues or bone marrow edema around the nidus.The diagnostic accuracy was 77.3% for X-ray，100% for CT and 90.9% for MRI.Conclusion:Most of osteoid osteoma have the typical appearances and is no difficult to make diagnosis.CT scan is the most accuracy method to demonstrate the nidus.It is possible to make misdiagnosis only with X-ray or MRI for the case that the hidus not be demonstodted.

Objective To detect anti-clinically amyopathic dermatomyositis (CADM)-140 antibody in patients with dermatomyositis (DM) or CADM,and to estimate its clinical correlation.Methods Serum samples were collected from 22 patients with DM,16 patients with CADM,46 patients with other connective tissue diseases complicated by interstitial lung disease(including 8 cases of polymyositis,15 cases of systemic lupus erythematosus,5 cases of systemic sclerosis,6 cases of Sj(o)gren syndrome,6 cases of mixed connective tissue disease,6 cases of idiopathic pulmonary fibrosis),and 5 normal human controls.Enzyme-linked immunosorbent assay (ELISA) was performed with the recombinant melanoma differentiation-associated gene 5(rMDA)as a substrate to measure the anti-CADM-140 antibody in these serum samples.Clinical manifestations were compared between patients with anti-CADM-140 antibody and those without.Results The anti-CADM-140antibody was found in 43.8% (7/16) of patients with CADM and 9.1%(2/22) of patients with DM(P<0.05),but absent in the patients with other connective tissue diseases and in the normal human controls.A significant incroase was observed in anti-CADM-140 antibody-positive patients with DM/CADM in the incidence of cutaneous ulceration and necrosis,interstitial lung disease and rapidly progressive interstitial lung disease (8/9 vs.6.9%,P<0.01;9/9 vs.48.3%,P<0.01;5/9 vs.0,P<0.05),serum lactate dehydrogenase level(328.3±104.2 vs 241.1±100.3 IU/L P<0.05),erythrocyte sedimentation rate(40.8±23.1 vs.22.5±16.8 mm/1 h,P<0.05),high resolution computed tomography score(122.9±54.8 vs.70.0±59.8,P<0.05)compared with anti-CADM-140 antibody-negative patients with DM/CADM.The ereatine kinase level was significantly lower(156.3±260.8 vs.1806.2±3737.1 IU/L P<0.05)in anti-CADM-140 antibody-positive patients with DM/CADM than in anti-CADM-140 antibody-negative patients with DM/CADM,while no significant difference was noted in the positivity rate of antinuclear antibodies or incidence of malignancies between the antibody-positive and-negative patients with DM/CADM.Conclusions Anti-CADM.140 antibody not only is useful for the diagnosis of interstitial lung disease in patients with DM/CADM,but also may serve as a serum marker for rapidly progressive interstitial lung disease.Monitoring of serum anti-CADM-140 antibody might help to predict the progression of interstitial lung disease in patients with DM/CADM.

Objective:To observe the differences in clinical efficacy of Jieyu Anshen Decoction combined with auricular points and oral tibolone in the treatment of patients with perimenopausal sleep disorders, and provide effective treatment for patients with contraindications to hormone supplement therapy in clinicalMethods:Using a randomized trial design, from July 2018 to August 2020,102 perimenopausal insomnia patients in International Peace Maternity and Child Health Hospital of China Welfare Institutewith kidney deficiency and liver depression who met the inclusion criteria were randomly divided into a treatment group and a control group with 51 cases each. The treatment group took Jieyu Anshen Recipe. At the same time, unilateral auricular point pressing treatment was given, and the opposite ear was changed in 5 d. The control group was treated with tiburon for a period of 3 months. The changes in the scores of each scale were observed in the two groups after 1 month and 3 months treatment. The scale included Pittsburgh sleep quality index (PSQI), modified Kupperman score (KMI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire Depression Screening Scale (PHQ-9). Its effectiveness and differences were evaluated and analyzed comprehensively through the above scale.Results:PSQI, KMI, GAD-7, PHQ-9 scores decreased significantly in the control and treatment groups after 1 month and 3 months of treatment, and the difference were statistically significant: PSQI: (8.58 ± 1.94) and (5.81 ± 1.93) scores vs. (13.10 ± 2.53), (9.15 ± 2.59) and (6.33 ± 1.98) scores vs.(13.52 ± 2.27) scores; KMI: (19.92 ± 2.16) and (14.67 ± 4.11) scores vs. (28.54 ± 7.65) scores, (19.02 ± 5.92) and(14.10 ± 4.37) scores vs. (27.42 ± 7.34) scores; GAD-7: (4.54 ± 2.03) and (3.81 ± 1.63) scores vs. (5.69 ± 2.95) scores, (3.71 ± 2.48) and (3.32 ± 1.73) scores vs. (4.90 ± 3.17) scores; PHQ-9:(6.90 ± 2.52) and (4.98 ± 1.96) scores vs. (9.83 ± 3.71) scores, (6.15 ± 2.62) and (4.44 ± 1.81) scores vs. (9.02 ± 3.73) scores ( P<0.01). PSQI, KMI, PHQ-9, and GAD-7 scores declined between the two groups, but there were no significant differences between the two groups ( P>0.05). After 1 month and 3 months of treatment, using PSQI scale and KMI score, the total efficiency of patients in the control group was slightly higher than that of the treatment group, but the difference was not statistically significant ( P>0.05); after 1 month and 3 months of treatment, using PHQ-9 score and GAD-7 score, the total efficiency of patients in the treatment group was slightly higher than that of the control group, but the difference was not statistically significant ( P>0.05). Conclusions:Traditional Chinese medicine combined with ear acupoint pressing has similar effects to tibolone in treating perimenopausal insomnia with kidney deficiency and liver depression. It can significantly improve the quality of sleep and quality of life of patients, and has good safety. For patients who are not suitable for hormone, Chinese medicine can be used as an alternative. The therapies are worthy of clinical application.

Objective To observe the effect of pre-intervention with electroacupuncture at Neiguan (PC 6) plusα2-adrenoceptor (α2AR) agonist on peri-operative heart rate variability (HRV).Method A total of 120 patients going to receive lower limb orthopedic surgery were randomized into four groups by using the random number table, namely a control group (group A), an electroacupuncture group (group C), anα2AR agonist group (group D) and an electroacupuncture plus medication group (group N), 30 cases in each group. The indicators of heart rate variability (HRV), including the standard deviation of normal-to-normal (N-N) intervals (SDNN), standard deviation of the average of N-N intervals (SDANN), root mean square successive differences (rMSSD), percentage of adjacent N-N intervals>50 ms apart (pNN50), low-frequency power (LF), high-frequency power (HF), LF/HF and total power (TP) were recorded 1 d prior and 1 d after the operation; meanwhile, the mean arterial pressure (MAP) and heart rate (HR) were recorded before incubation (T0), right after incubation (T1), 5 min after incubation (T2), right afterextubation (T3), 5 min after extubation (T4), 60 min after extubation (T5), and 180 after extubation (T6).Result In group N, the HR and MAP at the other time points were insignificantly different from those at T0 (P>0.05); in group A, the HR and MAP at T1-T6 were significantly different from those at T0 (P<0.05); in group C and D, the HR and MAP at T1-T4 were significantly different from those at T0 (P<0.05); the HR and MAP in group N were significantly lower than those in group A at T1-T6 (P<0.05) and were significantly lower than those in group C and D at T1-T4 (P<0.05); the HR and MAP in group C and D were significantly lower than those in group A at T5 and T6 (P<0.05). In group A, the LF, HF, LF/HF and TP 1 d after the operation were significantly increased compared to those 1 d prior to the operation (P<0.05); in group A and D, the SDNN, SDANN, rMSSD, and pNN501 d after the operation were significantly lower than those 1 d prior to the operation (P<0.05); the LF, HF, LF/HF, and TP in group C, D and N were significantly lower than those in group A 1 d after the operation (P<0.05); the SDNN, SDANN, rMSSD, and pNN50 in group C and N were significantly higher than those in group A and D 1 d after the operation (P<0.05). Conclusion Pre-intervention electroacupuncture plusα2AR agonist can improve the balance of cardiac sympathetic and vagus nerves, and better maintain the peri-operative hemodynamic stability.

Objective To evaluate the clinical and pathological feature,as well as risk factors of lymph node metastasis (LNM) and high-volume LNM (hvLNM) in papillary thyroid microcarcinoma (PTMC) with di ameter ≤0.5 cm.Methods PTMC patients who received surgical treatments in Peking Union Medical College Hospital from Nov.2013 to Nov.2014 were reviewed.Patients were allocated into the ≤0.5 cm group and (0.5-1)cm group according to tumor diameter.Clinical and pathological features were assessed and compared.Risk factors of LNM and hvLNM were also assessed through univariate and multivariate analysis.Results 1414 patients were enrolled,of which 315 patients (22.3％) were in the ≤0.5 cm group.76 LNM (24.1％) and 9 hvLNM (2.9％) were detected in the ≤0.5 cm group.There was significantly less capsule invasion (14.3％ vs 25.0％,P＜0.05),LNM (24.1％ vs 39.8％,P＜0.05) and hvLNM (2.9％ vs 7.9％,P＜0.05) in ≤0.5 cm group than in (0.5-1)cm group.In univariate analysis,patients aging ＜40 years old were more likely to have LNM than those older than 40(38.0％ vs 20.1％,P＜0.05),while male patients tended to have more LNM than female (32.4％ vs 21.9％,P=0.073).No risk factors were identified for hvLNM.In multivariate analysis,multifocality and younger than 40 years old were the independent risk factors of LNM (OR=2.082 and 2.899,P＜0.05),while male tended to be the independent risk factors of LNM (OR=l.807,P=0.058).No independent risk factors was identified for hvLNM.Conclusions A certain proportion of PTMC patients are with tumor diameter ≤0.5 cm,who have lower risk of LNM and hvLNM.Dynamic observation may be an option,especially in older ≥40 years old),unifocal and female patients.

OBJECTIVETo explore the transmembrane transport and metabolism of diammonium glycyrrhizinate in intestines of rats.

METHODAn Ussing Chamber model were used to investigate the transmembrane transport of diammonium glycyrrhizinate (GZ), the concentrations of diammonium glycyrrhizinate and its two metabolites were determined by HPLC.

RESULTThe permeability coefficients of GZ in difference intestinal mucous membranes were ranged from 0.3 x 10(-6) cm x s(-1) to 1.1 x 10(-6) cm x s(-1). The metabolism of GZ in enterocytes during its transport process was negligible. The concentration of diammonium glycyrrhizinate and pH had limit effects on the transport amount and the permeability coefficients of GZ.

CONCLUSIONGZ is a low permeability drug, but it can be absorbed at all segments of the small intestine in rats. Ileum is the major absorption region of GZ.

Animals ; Biological Transport ; Cell Membrane Permeability ; Glycyrrhizic Acid ; metabolism ; pharmacokinetics ; Hydrogen-Ion Concentration ; Intestine, Small ; chemistry ; drug effects ; metabolism ; Male ; Models, Biological ; Rats ; Rats, Sprague-Dawley

Objective To learn the needs of family physicians for tertiary hospital support in the hierarchical medical system. Methods In July 2017 cluster sampling was made to 135 family physicians of Changning district of Shanghai for a " Family physicians needs questionnaire" . It covered such aspects as their demographic characteristics and their needs. The data so acquired were subject to descriptive and logical analysis. Results 99.3% of them need preferential appointment of specialists at tertiary hospitals;93.3% of them need preferential appointment of examinations; 82.2% of them need preferential outpatient visits; while 83.7% of them need preferential hospitalization and surgery scheduling. In terms of the approaches for preferential appointment of specialists, 84.4% of them prefer specialist appointment at short notice, and 73.3% of them need direct online appointment for large-scale device examinations at tertiary hospitals. In terms of mentoring scenarios, 62.2% of them prefer mentoring during outpatient rounds at fixed schedules of specialists in their community. Conclusions Tertiary hospitals are recommended to establish green pathways for referrals and priority measures in order to improve capabilities of family physicians and the shared platform in the hierarchical medical network. They are also expected to guide family physicians in their research paper writing, thus fully supporting the hierarchical medical system.

Taking the application of logistics robots in intravenous drug distribution at our hospital as an example, this paper discussed the application effect of hospital logistics robots in actual operation, and discussed how to use data analysis to carry out a comprehensive scientific evaluation of the work effect of hospital logistics robots. The results showed that the hospital logistics robots can take charge of the daily heavy workload by using of unmanned technology. And at the same time, the transportation of medical materials by such means ensures the safety of transportation. It can also realize the whole process monitoring and closed-looping of transportation information. Analysis of operational data proves that the use of hospital logistics robots conforms to the expectation of higher quality requirements in hospital logistics, thus strengthening and improving the level of modern management of hospital logistics.