AIM: The phagocytotic function and morphological changes of pulmonary alveolar macrophages (AM) of rat in high glucose or high glucose and high insulin conditions were studied. METHODS: AM were harvested from Wistar rats by bronchoalveolar lavage and were activated by Bacille Calmette - Guerin (BCG), interferon a - 2b (IFNa - 2b)or BCG and IFNa - 2b. The adherent rate, nitroblue retrazolium (NBT). reduction function and the concentrations of NO and TNF-a in culture rat AM were evaluated. The ultrastructure of AM was Observed by using transmission elects microscopy and scanning electron microscopy. RESULTS: In high glucose or high glucose glucose and high insulin conditions, the adherence of AM postponed(P＜ 0.01 ), NBT reduction of AM significantly decreased(P＜0.01); the volume of NO and TNF-a produced by AM after stimulation with BCG and IFNa-2b + BCG was significantly lower in high glucose groups than in the controls (P ＜ 0.01); their surface pseudopodia was reduced and shortened and the numbers of Golgi apparatus and rough endoplasmic reticulum decreased. CONCLUSIONS:The impaired phagocytotic function and ultrastructure of activated rat AM were much the same regardless of high glucose or high glucose and high insulin level in a short time. Diabetic subjects were predisposed to infection of the lung, which was frequently recurrent or even fatal.

AIM:To investigate the relationship between trace elements and oxidative stress in diabetic diaphragm. METHODS: Contents of copper(Cu), manganese(Mn), zinc(Zn), iron(Fe),cadmium(Cd),chromium(Cr),cobalt(Co),molybdenum(Mo) and lithium(Li) in the alloxan-induced diabetic rat diaphragm muscles were measured by atomic absorption spectrophotometer, and their superoxide dismutase(SOD) activities and malondiadehyde(MDA) contents were detected. RESULTS: The contents of Cu, Zn, Cr and Li were lower and the Fe and Cd were higher in diabetic rat diaphragm muscles than that of the control group, but there were no significant differences in Mn, Co and Mo, between control and diabetic group. SOD activities decreased significantly and MDA contents increased significantly in diaphragm of diabetic rats as compared with the control group.In addition,in diabetic rats diaphragm, there was a positive correlation between Zn and SOD, and negative correlation between Zn and MDA, and Cd and SOD. CONCLUSION: Changes of the contents of Cu, Zn, Fe, Cd, Cr, Li and the increase of oxidative stress in diaphragm were found in the early diabetes, and Zn, Cd play an importment role in oxidative stress of diabetic diaphragm.

AIM: To evaluate the changes of diaphragm contractile properties and morphologic features in experimental diabetic rats. 糤THZ]METHODS: METHODS: Diaphragm contractility was assessed by twitch kinetics, maximal tetanic force (P 0) , tension-frequency relationship and fatigue index (FI) in vitro diaphragm strip preparations of 4th week diabetic Wistar rats, and compared with that of the control group. The structure of diaphragm was analysed in diabetic rats and control with Hematoxyline and eosin staining, Heidenhain staining and enzymatic histochemistry. RESULTS: The twitch (Pt), contraction time (CT), half relaxation time (RT 1/2 ) and FI decreased significantly in diabetic group as compared with the control group. There was no difference in Po between the two groups. The tension of diabetic diaphragm at frequencies of 25,50,75,100 and 125 Hz was significantly decreased compared with that of the normal rats. After diaphragm bundles were subjected to fatiguing stimulations and incubated with aminophylline at 250 mg/L for 30 minutes, the tension of diabetic diaphragm decreased remarkably at both high and low frequencies in comparison with that of the normal rats. In addition, the activity and optical density of ?-phosphoglycerol dehydrogenase in diaphragm from diabetic rats were significantly lower than that from control rats ( P

AIM: The pathological changes in inducible nitric oxide synthase (iNOS) and vasoactive intestinal peptide (VIP) in diabetic rat lung were investigated.METHODS: Using immunohistochemical method and imaging analysis, the changes in iNOS and VIP were observed in normal and diabetic rat lung. RESULTS: In diabetic rats, the iNOS positive or weak positive staining was localized in epithelial cells of bronchi, epithelial cells of alveolar ducts, alveolar sacs, and arteries, but negative in endothelial cells of vein and capillary. Image analysis showed the area, the integral absorbance(IA) and relative contents of iNOS were significant lower than that of control (P

ObjectiveTo evaluate the change of extracellular matrix (ECM) in diabetic rat lungs.MethodsUsing special staining,immunohistochemical method and imaging analysis,the changes of distribution,area,integral optial density and relative contents of lung ECM in diabetic rats were studied.ResultsThe distributions of elastic fibres,collagenic fibres and reticular fibres increased and roughened.The type Ⅳ collagen strong staining was localized in alveolar septum,the basement membranes of bronchiole and capillary,and distributed in cordal,plexiform.Laminin was strong stained and found in alveolar septum,epithelial cells of alveolar,and the basement membranes of bronchiole and pulmonary vessels in cordal and linear distribution.Image analysis showed the area,integral optical density and relative contents of elastic fibres,collagenic fibres,reticular fibres,type Ⅳ collagen and laminin were larger in diabetic rat lungs than in control groups.ConclusionThese results showed that the changes of ECM in early diabetic rat lungs were abnormal.

AIM:To evaluate the changes of lung morphologic features and oxidative stress in experimental diabetic rats. METHODS: The pulmonary structure of alloxan-induced diabetic rats were quantitatively studied with stereological methods. Changes of ultrastructure, activities of superoxide dismutase (SOD) and contents of malondialdehyde(MDA) of diabetic lung and serum were observed. RESULTS: The volume proportion of alveolar air and mean linear intercept of diabetic rats decreased remarkably in comparison with controls while the volume proportion of alveolar wall, the surface density of alveolar, the numerical density of alveolic area, the numerical density of alveolar and specific surface of alveolar increased significantly. The major change of the type II pneumocyte of diabetic rats was dilation of the rough endoplasmic reticulum (RER). The other findings in diabetic rats had included the presence of thickened alveolar epithelial, pulmonary capillary basal laminae and blood- air barrier, the volume density, the surface density, the mean profile area and the mean perimeter of RER in type Ⅱ pneumocyte of diabetic rats increased remarkably. And the specific surface of RER was significantly lower as compared with controls. SOD activity decreased and MDA content increased significantly in serum of diabetic rats as compared with the control group. SOD activity in the diabetic lung was not different from that of the control lung. However, the content of MDA obviously increased in diabetic lung. CONCLUSION: The morphologic features and oxidative stress in early diabetic rats are abnormal thus the lung should be considered as one of the “target organ”in diabetes mellitus.

AIM: The aim of this research is to study the earlier enzyme activity changes of the diaphragm in diabetic rats. METHODS: An enzyme histochemical method was used to observe the changes in the enzyme activities of dehydrogenases,hydrolases and oxidases in 4th week diabetic rat diaphragm. RESULTS: The activites of enzymes including SDH(Succinate dehydrogenase),MDH(Malate dehydrogenase), GDH(Glutamate dehydrogenase), ICDH(Isocitrate dehydrogenase), NADHD(NADH diaphorase), G-6-PD(Glucose-6-phosphate dehydrogenase), ACP(Acid phosphatase) and ANAE(Acid ?-naphtyl acid esterase) were increased in diabetic diaphragm compared with the control. LDH (Lactate dehydrogenase)and CCO(Cytochrome oxidase) activities were decreased, whereas NADPHD(NADPH diaphorase) showed no changes in diabetic rats. Eleven kinds of enzyme were analysed with image analysis.Optical density (A) of SDH, MDH, GDH, ICDH, NADHD, G-6-PD, ACP and ANAE in diaphragm of diabetic rats were significantly higher than that of control rats (P0.05). CONCLUSION: Increase in the aerobic capacity, decrease in the glycolytic capacity, and disturbance of lipid and energy metabolism were found in diaphragm of 4th week diabetic rats.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

Objective Measuring job satisfaction level of community health workers,providing on the evidences for the design of the relevant policy and the evaluation of job effect.Methods 57 Community Health Service centers and 54 stations were randomly selected in 12 cities in Anhui province,and all staff on the job were investigated.The questionnaires were delivered to the working staff and anonymously filled in by them.Results The total job satisfaction average score of the staff is 110.84± 18.18.The average score of pay(10.05±2.99),welfare(10.35±3.17)and promotion(10.85±3.00)are rather low.The average score of coworkers(14.78±2.11),nature of work(14.60±2.69)and supervision (13.90±3.00)are quite high.Logistic regression analysis shows the staff's duration and title are the main factors affecting their overall job satisfaction.Conclusion The overall job satisfaction level of community health workers is not high.Establishing the reasonable system of pay,welfare mechanism and the predictable promotion space are feasible choices to promote job satisfaction of community health workers

OBJECTIVE To study the distribution and drug resistance of the cancer patient′s pathogenic bacteria.METHODS The clinical nosocomial infection of 1451 cancer patients was analyzed by using the soft WHONET-5.RESULTS Of 955 strains isolated from sputa,the G-bacilli were 31.2%,and their main bacteria were Pseudomonas aeruginosa and Klebsiell pneumoniae,the G+ coccis were 31.2%,and their main bacteria were Staphylococcus epidermidis,and the fungi were 43.3%,and their main molds were Candida.albicans.Of 284 strains isolated form stool,the G-bacilli were 64.4%,and their main bacteria were Eschericha coli,the G+ cocci were 10.2% and their main bacteria were S.epidermidis,and fungi were 25.5%.Of 72 strains isolated from blood,the G-bacilli were 62.5%,and their main bacteria were E.coli,the G+ cocci were 30.5% and the fungi were 7.0%.Of 140 strains isolated from pharyngeal swab,the G-bacilli were 15.0%,and the G+ cocci were 43.0% and the fungi were 42.0%.The results of sensitivity tests showed as followed: The G-bacilli had a highly sensitive to imipenem,and had a high drug resistance against the first and second generation cephalosporin,ampicillin,piperacillin.The G+ cocci were highly sensitive to vancomycin and had a high drug resistance against oxacillin,penicillin,and erythromycio,the fungi had an obvious drug resistance against azoles.CONCLUSIONS It is high prevalence of ESBLs among MRS,and Staphylococcus.The application and selection of antibiotics must be based on the results of sensitivity tests,and the drug resistance of pathogenic bacteria must be controlled.