Objective To investigate the effect of transient receptor potential M4 (TRPM4) on autonomous regulation disorder of cerebral blood flow following subarachnoid hemorrhage (SAH) in rats.Methods A total of 120 clean grade male SD rats were selected.They were divided into sham operation,SAH,negative control,and treatment groups according to the random number table.The dead rats were excluded.A SAH model was induced by using the suprasellar cistern injection method with a stereotaxic apparatus.Isotonic saline 0.2 ml was injected into the rats of the sham operation group and negative control group respectively,and autologous tail arterial blood 0.2 ml was injected into the rats of the SAH group and the treatment group respectively.The isotonic saline solution was continuously pumped into lateral ventricle of rats via implantable micro-pump in the sham operation group and the SAH group respectively,and the concentration of 0.03 mol/L of TRPM4 blocking agent was continuously pumped into the lateral ventricles of rats in the control group and the treatment group respectively.The 4 groups of rats received the regional cerebral blood flow and whole cerebral blood flow detection on day 3,5,and 7,respectively.Results One hundred and six (88.3%) of the 120 SD rats survived to the time point of study,data analyses were performed in the 4 groups (with 21 rats in each group) respectively (n=7 in each time point).There were significant differences in cerebral cortex local and whole cerebral blood flow at day 3,5,and 7 in the sham operation,SAH and negative control groups (all P<0.05).Cerebral cortex local cerebral blood flow (141±18,148±24,and 168±19 PU,respectively at day 3,5,and 7) and whole cerebral blood flow (93±5,85±5,and 85±6 ml/[100 g·min],respectively at day 3,5,and 7 in the SAH group) were decreased significantly compared with the sham operation group (cortex local cerebral blood flow:235±17,220±24,and 224±20 PU),whole cerebral blood flow (141±10,147±8,and 143±8 ml/[100 g·min]),all P<0.05).Cerebral cortex local and whole cerebral blood flow (cortical local cerebral blood flow:183±26,173±26,and 187±15 PU,whole brain:114±10,104±9,and 119±5 ml/(100 g·min) in the treatment group were significantly increased compared with the SAH group (all P<0.05).Conclusion TRPM4 has an obvious effect on improving the autonomous regulation disorder of cerebral blood flow after SAH.

Objective To study the effect of dialysis adcquacy,microinflammation and residual renal function on nutritional status of hemodialysis patients.Methods One hundred and fourteen patients were enrolled in this study.Kt/V,?_2-MG and serum iPTH were measured as markers of hemodialysis adequacy.Nutritional evaluation included MQSGA,Alb,Hb,TF,IGF-1,IGFBP-3 and anthropometrics such as HGS,BSF,TSF,MAC,MAMC and AMA.Serum IL-6,TNF-?and CRP were detected to assess microinflammation.Urinary volume of 24 hours was measured to investigate the residual renal function (RRF).Results (1)There were different correlations and regressive associations of Kt/V,iPTH and?_2-MG with HGS,MAMC,AMA,Alb,Hb,nPCR,IGF-1 and MQSGA respectively.(2) There were significant correlations and regressive associations of RRF to HGS,TSF,MAMC,Alb,nPCR and IGF-1 within the first year of hemodialysis.(3) There were different correlations and regression relationships of IL-6,TNF-?and CRP with HGS、MAMC、AMA、Alb、TSF、Hb、nPCR、IGF-1 respectively.(4) Multivariate analysis showed that Kt/V,iPTH,IL-6, TNF-?,?_2-MG and RRF were influencing factors,among them,Kt/V,iPTH,IL-6 and TNF-?were independent predictors of nutritional status.Conclusions Hemodialysis adequacy and micruinflammation may impact on nutritional status.Residual renal function may be involved in nutritional status in the first year of hemodialysis.Kt/V,iPTH,IL-6 and TNF-?are independent factors affecting nutritional status.

At present,the unrealistically high drug prices become an indisputable fact to cause the chaos in the medical field.They are the main reasons of "difficult and too expensive to see doctors".And they are deeply loathed by the people in the country.In addition,the unrealistically high drug prices have become the shackles in deepening medical and health reform.Therefore,a determined effort must be made to resolve the serious problems.Through analyzing the status of high drug prices,the main reasons of the unrealistically high drug prices,and the hazards of high drug prices,the article puts forward countermeasures of state monopoly in national essential drugs to solve the unrealistically high drug prices problems for structural reform of supply side.

BACKGROUND5-dihydroxyanthraquinone-2-carboxylic acid (rhein) inhibits oxidoreduction induced by reducing nicotingamide adenine dinucleotide in the mitochondria and reducing reactive oxygen species, it also suppresses lipid peroxidation in rat brain homogenates. This study was to assess the effects of anthraquinone derivatives, rhein on synaptic transmission in the rat hippocampal CA1 pyramidal cell layer by intracellular recording.

METHODSThe excitatory postsynaptic potential (EPSP) evoked by stimulation of the Schaffer collaterals in the presence of bicuculline (15 micromol/L) was depressed by application of rhein (0.3 - 30 micromol/L). The amplitude of the EPSP was restored within 20 minutes after removal of rhein from the supernatant. At a concentration of 30 micromol/L, rhein reduced the amplitude of the EPSP to 42% +/- 3.7% (n = 24) of the control. Subsequently, wavelet spectral entropy was used to analyze the EPSP.

RESULTSA strong positive correlation was observed between the wavelet spectral entropy and other parameters such as amplitude, slope of rising phase and slope of descending phase of the EPSP. The paired-pulse facilitation (PPF) of the EPSP was significantly increased by rhein (30 micromol/L). The inhibitory postsynaptic potential (IPSP) recorded in the presence of CNQX (20 micromol/L) and APV (40 micromol/L) is not altered by rhein (30 micromol/L).

CONCLUSIONSRhein (30 micromol/L) can decrease the frequency but not the amplitude of the miniature EPSP (mEPSP). It is suggested that rhein inhibits excitatory synaptic transmission by decreasing the release of glutamate in rat hippocampal CA1 pyramidal neurons.

Animals ; Anthraquinones ; chemistry ; pharmacology ; Entropy ; Excitatory Postsynaptic Potentials ; drug effects ; Hippocampus ; drug effects ; physiology ; In Vitro Techniques ; Male ; Rats ; Rats, Wistar ; Synaptic Transmission ; drug effects

OBJECTIVETo evaluate the value of serum procalcitonin (PCT) for the guidance of antibiotic therapy in children with lower respiratory tract infection (LRTI).

METHODSA prospective randomized controlled study was conducted in 396 children with LRTI who visited Weifang Maternity and Child Care Hospital. The participants were randomly assigned into a PCT group in which the antibiotic therapy was guided by serum PCT level and a control group in which the standard therapy was given according to clinical guidance. Afterwards, a subgroup analysis was performed according to whether the patient was diagnosed with community-acquired pneumonia (CAP). After 14-day treatment, antibiotic prescription rate, duration of antibiotic treatment, and side events were compared between the groups.

RESULTSA total of 396 cases were recruited and equally assigned into the PCT group and the control group, among whom the numbers of the children with CAP were 125 and 123, respectively. The mean duration of antibiotic treatment was significantly shorter in the PCT group than in the control group (P<0.05). The subgroup analysis showed that the duration of antibiotic treatment in both CAP and non-CAP PCT subgroups was significantly shorter than in the control subgroups (P<0.05), however, the antibiotic prescription rate in the non-CAP PCT subgroup was significantly higher than that in the non-CAP control subgroup (P<0.05). There were no differences in the rate and duration of side events from antibiotic therapy, hospitalization rate, the length of hospital stay, and safety between the PCT and control groups.

CONCLISOPNSSerum PCT-based guidelines on antibiotic use can shorten the duration of antibiotic therapy in children with LRTI.

Anti-Bacterial Agents ; therapeutic use ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child, Preschool ; Community-Acquired Infections ; drug therapy ; Female ; Humans ; Infant ; Male ; Pneumonia ; drug therapy ; Prospective Studies ; Protein Precursors ; blood ; Respiratory Tract Infections ; blood ; drug therapy

Objective To explore the association between total cholesterol and type 2 diabetes ( T2DM) ． Methods Non－diabetic people who aged 20 to 90 years at the baseline and who had physical examination more than 2 times were screened． Comparisons of the baseline characteristics were conducted with Student－t test or Pearson chi－square test． Generalized estimating equation ( GEE) was used to analyze the effect of total cholesterol of quantiles groups ( 2．10－ mmol /L，4．16－ mmol /L，4．76－ mmol /L and 5．42 －13．29 mmol /L) to type 2 diabetes． Results The cohort with an average age of 3．53 years per person in- cluded 12 928 subjects and 45 626 person－years． During the follow－up，447 cases of new－onset diabetes occurred and the incidence density was 9. 80‰． The high incidence of type 2 diabetes increased with the increase of total cholesterol． After adjusting the factors including age，high density lipoprotein，hypertension and obesity，based on the 2. 10－ mmol /L group，the relative risk ( RR) of the 4. 16－ mmol /L，4. 76－ mmol/L and 5. 42－13. 29 mmol /L group were 1. 24( 95% CI: 0. 83－1. 86) ，1. 75 ( 95% CI: 1. 19－2. 56) and 3. 60( 95% CI: 2. 51－5. 17) ，respectively． Conclusions Total cholesterol is associated with type 2 diabetes，and as the total cholesterol increases，the risk of developing type 2 diabetes increases．

OBJECTIVETo examine the association of the Thr394Thr polymorphism of PPARGC1A gene with type 2 diabetes (T2DM), insulin resistance (IR) and other metabolic disorders in a Chinese population.

METHODSThree hundred and seven subjects including 151 T2DM patients and 156 normal glucose tolerant controls (NC) were enrolled in this study. The Thr394Thr G/A polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Glucose, insulin, lipids levels were determined in all subjects. Body mass index (BMI), waist circumferences, index of homeostasis model assessment-insulin resistance (HOMA-IR) and blood pressure were also measured.

RESULTSThe diabetic subjects had higher levels of BMI, waist circumferences, blood systolic pressure, triglycerides and lower levels of high density lipoprotein-cholesterol (HDL-C) compared with those of control subjects (P<0.05). About 43.7% (66/151) of the T2DM subjects had the AG genotype, while 37.2% (58/156) in the NC group. The frequency of the A allele was 0.225 in T2DM, and 0.186 in the NC subjects. There were no significant differences either in genotype or allelic distribution of G/A polymorphism between the two groups. In the T2DM group, subjects with AA and GA genotypes had significantly higher levels of HOMA-IR, waist circumferences and lower levels of HDL-C (P<0.05) than those carrying GG genotype. HOMA-IR in subjects with AA and AG were significantly higher than those with GG genotype in both groups.

CONCLUSIONThe A allele of the Thr394Thr (G-->A) polymorphism of the PPARGC1A gene was associated with insulin resistance, and may be related to central obesity and decreased HDL-C levels in Chinese population. The relationship between this polymorphism and T2DM needs further investigation.

Aged ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; genetics ; metabolism ; Heat-Shock Proteins ; genetics ; metabolism ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Polymorphism, Single Nucleotide ; Transcription Factors ; genetics ; metabolism

Objective To evaluate the clinical safety and efficacy of GuidezillaTM guide extension catheter during complex coronary percutaneous coronary intervention(PCI). Methods A total of 13 patients were included in the studywho presented with complex coronary lesions during PCI. Stents or balloons could not be delivered to these complex lesions with conventional approach and GuidezillaTM guide extension catheters were used. Results Among these 13 patients,there were 7 CTO lesions,7 calcified lesions, 6 tortuous lesions,8 diffuse lesions,8 distal lesions and 8 lesions with pre-existing stents. PCI success rate was 100% .In one patient,GuidezillaTM guide extension catheter was obstructed which were relieved after stent implantation. There was no major adverse cardiac event(MACE) during follow-up.Conclusions The GuidezillaTM guide extension catheter was safe and effective for PCI of complex coronary artery lesions.

OBJECTIVETo investigate the feasibility of reconstruction of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with hamstring tendons knot implant fixation.

METHODSFifty-two cases of ACL and PCL old injury were reconstructed under the arthroscopy with double bundles hamstring tendons knot implant fixated in the bottle-necked femoral tunnel. The tibia side were fixated by tendon weave suture cross tied a knot at the bone bridge of tibia. In this group reconstruction of ACL was in 25, PCL and ACL at the same time reconstruction in 15, PCL in 12. The failure test and displacement evaluation were used to study the biomechanics of reconstruction of ACL by hamstring tendon knot implant fixation (n = 13) in porcine knees. The control group were reconstructed with bone-patellar tendon-bone B-PT-B and interference screw (n = 11). The tibia side tendon weave suture immobility by cross tied a knot at the tibia bone bridge (n = 7) and interference screw in the tibia tunnel (n = 8).

RESULTSForty-nine cases were followed up, average 14.6 months. The results of Lanchman test was negative in 46 cases, positive in 3 cases. Preoperative Lysholm score was 56.7, and postoperative was 92.8. According to the knee joint effective evaluate standard, 46 were excellent and 3 good. The maximal pull-out force of hamstring tendons knot implanted fixation had been greater than B-PT-B fixation by interference screw. There were similar displacement in 100 N and 400 N load between hamstring tendons knot implant fixation and B-PT-B (P > 0.05). Peak force test maximal displacement evaluation and failure energy absorption measurement showed that hamstring tendons knot implant fixation was significantly greater than B-PT-B (P < 0.01). The failure test and displacement evaluation of tendon fixation by weave suture knot at the tibia bone bridge cross tie were greater than B-PT-B fixation by interference screw.

CONCLUSIONThe methods of reconstruct of ACL and PCL by hamstring tendons knot implant fixation are feasible. The advantages include: it is biological fixation, not machine fixation; it may benefit for tendons with bone tunnel healing and decrease medical cost. Decreasing or eliminating displacement is helpful to prevent relaxation after reconstruction of ACL and PCL.

Animals ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; surgery ; Male ; Orthopedic Procedures ; methods ; Posterior Cruciate Ligament ; injuries ; surgery ; Swine ; Tendons ; surgery

Primate placentation involves a series of cell proliferation, immigration and apoptosis which account for the progressive tissue remodelling at the implantation site. p53 is an important proto-oncogene involved in the regulation of cell-cycle and apoptosis. To study the effect of RU486 on apoptosis and expression of p53 at the fetal-maternal interface, the location of apoptotic cells and expression of p53 were examined using in situ 3'-end labeling method, immunohistochemistry and Western blot assay at the fetal-maternal interface of normal and RU486 treated rhesus monkey. Western blot analysis showed the specificity of the anti-human antibody used with the monkey tissue. In the placental villi, the apoptotic nuclei were observed mainly in the syncytiotrophoblast and part of the cytotrophoblast within the cell column; p53 protein was detected mainly in the cytotrophoblast. In the endometrium, positive signals for apoptosis and p53 were detected in some stromal cells. After two days of mifepristone treatment, the apoptotic cells increased significantly in both placental villi and endometrium. In the villi, the increased apoptotic nuclei were mainly localized to the cytotrophoblast. At the same time, p53-positive nuclei also increased in both villous cytotrophoblast cells and endometrial stromal cells, after the treatment of RU486. These results suggest that apoptosis and expression of p53 are essential in regulating trophoblastic homeostasis by controlling its proliferation in normal placenta, whereas the up-regulation of p53 protein may play an important role in apoptosis that happens at the fetal-maternal interface induced by RU486.
Abortifacient Agents, Steroidal ; pharmacology ; Animals ; Apoptosis ; drug effects ; Chorionic Villi ; pathology ; Female ; Macaca mulatta ; Mifepristone ; pharmacology ; Placentation ; drug effects ; physiology ; Pregnancy ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics