Objective To study the application effect of day-parting appointment for elderly hypertensive contracted outpatients in community. Methods In May 2018 two groups (experiment and control) of 103 elderly hypertensive contracted outpatients, aged between 60 and 80 and looked after by the team of family doctors, who had been diagnosed with hypertension and with medication for at least one year were set up.The experimental group used self-made community hypertension visiting card for appointments, and the control group used the original way of treatment.Six months later, comparison was made in blood pressure control, the number of outpatients, the time consumed and the satisfaction between the two groups. Results It was found in comparison that the blood pressure standard-reaching rate of the experimental group was better than that of the control group (P < 0.05);outpatients′ visits and time consumed were less than those of the control group, the time used in the clinic room was longer than that in the control group; the differences in these aspects between the two groups were significant (P < 0.05);the satisfaction of the overall outpatient perception, attitude of family doctors, treatment technology, visits control, dosage, cost and safety of medication in the experimental group were better than in the control group; there were significant differences in these aspects between the two groups (P < 0.05). Conclusion Community day-parting appointment proves to be more convenient, more time-saving and safer for outpatients, greatly improving the medical quality and satisfaction for community outpatients.

OBJECTIVETo investigate the effect of Si' an Capsule combined Enalapril on hypertensive trough/peak ratio (T/P) and circadian rhythm of blood pressure in patients with essential hypertension (EH).

METHODSSixty patients with EH of stage II, III were randomly divided into two groups, the 30 patients in the treated group were treated with Si' an capsule combined Enalapril, and the 30 patients in the control group were treated with Enalapril alone. All patients were given 24-hour ambulatory blood pressure monitoring before and after 4 weeks treatment. T/P of systolic and diastolic blood pressure (SBP & DBP) of each group were calculated. Circadian rhythm of blood pressure was observed at the same time.

RESULTST/P of SBP and DBP in the treated group was 62.4 +/- 7.0% and 66.3 +/- 8.1% respectively, which was obviously higher than that in the control group, 53.3 +/- 6.7% and 60.1 +/- 7.2%, respectively (P < 0.05). The blood pressure circadian rhythm recovering rate in the treated group was 73.3% and in the control group 50%, the difference was insignificant.

CONCLUSIONThe combination therapy of Si' an capsule and Enalapril could lower the blood pressure smoothly and restore the circadian rhythm of blood pressure in EH patients.

Aged ; Antihypertensive Agents ; therapeutic use ; Blood Pressure Monitoring, Ambulatory ; Capsules ; Circadian Rhythm ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Enalapril ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Middle Aged ; Phytotherapy

Objective To compare and analyze the sensitivity,specificity of 4 domestic ELISA kits for detection of hepatitis B virus (HBV) markers (HBsAg,anti-HBs,HBeAg,anti-HBe,and anti-HBc).Methods Five hundred and ninety four serum samples collected from patients with chronic hepatitis B and abnormal blood donors were detected for HBV markers and by 4 domestic ELISA kits.Samples with conflicting results by different diagnostic kits were retested.Samples with the HBsAg values close to the cut-off point were detected by Abbott HBsAg confirmation kit (Architect HBsAg confirm).Sensitivity of the kits was determined,using the national sensitivity reference panels for HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc.Results The rates of sensitivity on 4 domestic kits for detection of HBsAg were 4 to 10 times lower,and on the 4 domestic kits for detection of anti-HBs,HBeAg,anti-HBc and anti-HBc were 4 to 16 times lower,as compared to Abbott Architect kits.In addition,the domestic HBV ELISA kits had some false positive results.The total coincidence rates of HBsAg,anti-HBs,HBeAg,anti-HBe,anti-HBc were 96.46%-98.15%,94.28%-98.15%,98.15%-99.49%,90.07%-96.30%,92.09%-96.80%,respectively.Conclusion Both sensitivity and specificity of the domestically produced HBV ELISA kits should be improved.

Derris eriocarpa, a traditional Chinese medicine belonging to the family of Leguminosae, is widely distributed mainly over Yunnan, Guangxi and Guizhou of China. Modern pharmacological researches on this herb showed that it had extensive bioactivities, such as promoting urination, removing dampness and cough and reducing inspissated mucus and other biological activities. The extensive studies on the chemical constituents of this plant have resulted in the isolation of triterpenoids, steroids, fatty acid and others, but the flavone compounds haven't reported before. In our further research on the ethyl acetate of this plant, nine flavone compounds were obtained by column chromatography on silica gel, Sephadex LH-20, semi-prep HPLC, polyamide column chromatography and recrystallization for separation and purification. The structures were determined on the basis of extensive spectroscopic analysis, including MS, NMR experiments and comparison with spectroscopic data in the literature, respectively, as diosmetin (1), 3, 3'-di-O-methylquercetin (2), afromosin (3), 6, 3'-dihydroxy-7, 4'-dimethoxyisoflavone (4), odoratin (5), 7, 3'-dihydroxy-8, 4'-dimethoxyisoflavone (6), 6, 4'-dihydroxy-7, 3'-dimethoxyisoflavone (7), 5, 7, 4'-trihydroxy-3, 3', 5'-trimethoxyflavone (8), and alpinumisoflavone (9). All these compounds were isolated from Derris eriocarpa How for the first time. And the in vitro assays showed that compound 2 possessed moderate inhibitory activity against human cancer cells K562 and HEL.
Derris ; chemistry ; Flavonoids ; chemistry ; isolation & purification ; pharmacology ; Humans ; K562 Cells

OBJECTIVETo investigate the differentiation of bone marrow mesenchymal stem cells (BMSCs) and the effects of BMSCs on the proliferation of cirrhotic fat-storing cells (CFSC) and hepatocytes in vitro.

METHODSBMSCs and hepatocytes were isolated and harvested from the bone marrow and livers of rats. A co-culture system was set up by transwell inserts in which the two chambers were separated by a semipermeable membrane. BMSCs labeled with PKH26 were cultured with hepatocytes/CFSC in the co-culture system and also in a cell-cell direct contact culture system. Anti-albumin and anti-smooth muscle alpha-actin (alpha-SMA) antibodies were tested by using fluorescence immunocytochemistry. BMSCs and hepatocytes/CFSC cultured alone served as controls. The proliferation level of hepatocytes in the co-culture system was measured. CFSC were cultured with the conditional medium of BMSCs, and their quantities were measured microscopically.

RESULTSExpression of albumin was observed in the hepatocytes of the two culture systems after they were cultured for 72 h but the albumin levels were higher in the cell-cell direct contact culture system (P<0.01). As compared to the controls, the number of hepatocytes was larger in the co-culture system (P<0.01). No expression of alpha-SMA in CFSC was observed in either culture system. The proliferation of CFSC was inhibited by the conditional medium of BMSCs. The longer the time of the co-culturing the more significant was the CFSC growth suppression (P<0.01).

CONCLUSIONSBMSCs can be induced into hepatocytes by a local micro-environment formed by hepatocytes. BMSCs may promote proliferation of hepatocytes and inhibit proliferation of CFSC.

Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Female ; Hepatocytes ; cytology ; Liver Cirrhosis, Experimental ; metabolism ; Mesenchymal Stromal Cells ; cytology ; Pregnancy ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the usefulness of serum alpha-fetoprotein (AFP) in clinical diagnosis and screening for hepatocellular carcinoma (HCC).

METHODSTotally 290 HCC patients, 48 liver cirrhosis patients, and 49 healthy subjects were enrolled in this study. Serum AFP analysis was performed to investigate the correlation between the serum AFP level in HCC and the clinical or biochemical parameters of the disease, which included the size and number of tumor and the TNM stage. Sensitivities and specificities of AFP in HCC prediction at different cut-off levels were determined.

RESULTSThe serum AFP level was significantly higher in HCC patients than in liver cirrhosis patients (P = 0.0274) and healthy subjects (P = 0.0001). Among 290 HCC patients, 95 patients (32.8%) were AFP-negative (AFP < 20 microg/L), 195 (67.2%) were AFP-positive (AFP > or =20 microg/L). Sensitivity and specificity of AFP at 20 microg/L cut-off was 67.2% and 29.2%, respectively, and the positive and negative predictive value was 85.2% and 12.8%, respectively. Sensitivity of AFP at 400 microg/L cut-off was only 42.8%. Serum AFP levels were significantly different among HCC with different tumor size (P = 0.0009), tumor number (P = 0.0001), and TNM stage [TNM I vs. TNM III-IV (P = 0.0001); TNM II vs. TNM III-IV (P = 0.0003)].

CONCLUSIONSIncreased serum AFP level is highly suggestive in HCC diagnosis. Combined with other imaging examinations, AFP level can be used for the screening of high risk population and for the follow-up of AFP-positive patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Carcinoma, Hepatocellular ; blood ; diagnosis ; Diagnostic Techniques and Procedures ; Female ; Humans ; Liver Neoplasms ; blood ; diagnosis ; Male ; Middle Aged ; Sensitivity and Specificity ; Young Adult ; alpha-Fetoproteins ; analysis

OBJECTIVETo understand the correlation between CD4+ cell count, HIV viral load (VL) and clinical characteristics among patients when HIV-1 was tested positive and initial AIDS diagnosis was made.

METHODS690 HIV-infected cases from Beijing Di-Tan Hospital were included and under a cross sectional study while SPSS statistical method was used.

RESULTSThe 690 HIV-infected cases would include 458 males and 232 females with age range from 2-72 years (mean age as 35.3). The modes of transmission showed that: homosexual contact taking up 17.5% while heterosexual was 16.7%. Most of the homosexual-infected ones lived in Beijing and most of them had bachelor or master's degrees. 19.4% of the transmission happened between heterosexual/bisexual couples, suggesting that HIV was transmitted through the "bridge population" while the rest were infected by contaminated blood/plasma. Many of the cases were identified when they lately visited the pre-operation surveillance point in the hospital. Serious immunodeficiency symptoms or signs were discovered as: CD4+ count < 50 cell/microl, serious opportunistic infections including pneumocystosis pulmonary, cerebral toxoplasmosis and cryptococcal meningitis. Higher frequencies of diseases seen were dermotosis, pneumonia, upper respiratory tract infection, hepatitis and digestive tract moniliasis.

CONCLUSIONBecause of the late identification of the disease, serious immuo-suppression situation often appeared, suggesting that there was an urgent need to improve STD/AIDS knowledge on those HIV (+) people so they might have an early access to accept medical care.

AIDS-Related Opportunistic Infections ; diagnosis ; Adolescent ; Adult ; Aged ; CD4 Lymphocyte Count ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; HIV Infections ; complications ; diagnosis ; transmission ; Humans ; Male ; Middle Aged ; Viral Load ; Young Adult

Objective To evaluate the multiplex nucleic acid testing (NAT) assays for HBV,HCV and HIV in detecting HBV DNA in plasma samples. Methods 534 plasma samples collected form several areas were detected with Abbott Architect i2000 HBsAg, ani-HBs, HBeAg, anti-HBe, anti-HBc and anti-HBc IgM diagnostic kits. HBV DNA levels of those samples were detected with Roche COBAS AmpliPrep/ COBAS TaqMan HBV Test. Two kinds of multiplex NAT assays for HBV, HCV and HIV were used to test HBV DNA of those 534 samples. Results of serology-markers and quantitative HBV DNA levels with results of NAT were compared. Results HBV DNA was positive in all 81 HBsAg, HBeAg and anti-HBc positive samples,detected by both of NAT assays. HBV DNA was positive in 11 and 19 of 200 HBsAg negative samples when detected with the two kinds of NAT assays separately. Compared with the quantitative results detected by Roche COBAS AmpliPrep/COBAS TaqMan HBV Test, the HBV DNA positive rates were 96.9% and 94.3% in 193 samples of HBV DNA levels over 500 IU/ml while 40.2% and 45.3% in 117 samples of HBV DNA levels below 500 IU/ml while 99.3% and 96.0% in 151 samples of DNA negative HBV. Conclusion There are some occult low level HBV DNA carriers with HBsAg negative results in China. NAT assays for HBV, HCV and HIV may be useful to improve the transfusion safety.

Objective To study the analytical sensitivity on 31 HBsAg enzyme immunoassy (EIA) test kits.Methotis Thirty one HBsAg EIA kits produced by domestic or overseas manufactories and applied for approval during May 2007 to May 2008,were evaluated using the national reference panels.The hyperbolic curve of the log A value and log concentration for the national sensitivity standards was established.The cut-off value of each kit was substituted into the curvilinear equation to determine the analytical sensitivity which was compared between different HBsAg EIA kits.Results Twenty seven(351 lots) domestic and 4(27 lots) overseas kits were compared.Among 378 lots of the 31 HBsAg EIA kits,only 2 lots of the domestic kits had a lower sensitivity when tested with the national HBsAg reference panels,with an average approvalr ate of 99.43%(349/351).The mean analytical sensitivity of the domestic kits for adr,adw,ay serotypes were 0.307,0.419,0.513 ng/ml,respectively.There was a significant difierence between serotypes (F=97.30,P<0.01).The mean analytical sensitivity of the overseas kits for adr,adw,ay serotypes were 0.054,0.066,0.050 ng/ml respectively,with no significant difference between serotypes(F=0.65,P>0.05).The analytical sensitivity of the overseas kits for all the three serotypes was higher than that of the domestic kits(P<0.01).There was no significant difference found between the analytical sensitivities of the kits produced by the same manufactory using 30- or 60- minute incubation of detection(P>0.05).In contrast,there was significant diffefence noticed between the analytical sensitivities of the kits produced by the same manufactory when tested for 10 or 15- minute coloration of the results(P<0.01).Conclusion Analytical sensitivity of the HBsAg EIA domestic kits should be further improved,especiatry for detecting adw and ay serotypes.

OBJECTIVETo explore the mechanism of oxymatrine in preventing hepatic fibrosis formation in patients with chronic hepatitis B (CHB).

METHODSA total of 80 CHB patients receiving routine therapies for liver protection and support were divided into two groups. Oxymatrine at the daily dose of 150 mg was injected intravenously in the therapeutic group (n=40), and gluthion (1.2 g daily) was injected in the control group (n=40) for 8 weeks. The liver functions, indexes of hepatic fibrosis and the levels of transforming growth factor-beta1 (TGF-beta1), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) were measured in these patients before and after the therapy.

RESULTSLiver functions was obviously improved after therapy in both groups, showing no significant difference between them (P>0.05). The indexes of hepatic fibrosis such as HA, LN, PCIII and C-IV were significantly lower in the therapeutic group than in the control group (P<0.01). The serum levels of TGF-beta1 and TNF-alpha decreased while IL-10 increased significantly after the treatment in the therapeutic group (P<0.05).

CONCLUSIONThe effect of oxymatrine against hepatic fibrosis is mediated by lowering the levels of TGF-beta1 and TNF-alpha and increasing the level of IL-10 in CHB patients.

Adult ; Alkaloids ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; pathology ; Humans ; Interleukin-10 ; blood ; Liver Cirrhosis ; drug therapy ; pathology ; prevention & control ; Male ; Middle Aged ; Quinolizines ; therapeutic use ; Transforming Growth Factor beta1 ; blood ; Tumor Necrosis Factor-alpha ; blood