BACKGROUNDEstrogen deficiency causes atrophic changes within the urogenital tract, and is associated with urinary symptoms. The purpose of this study was to investigate the effects of estrogen and tibolone on bladder histology, and the changes of estrogen receptor alpha and beta (ERalpha and beta) protein expression in the detrusor muscle.

METHODSForty female rats were separated into four groups of ten each. They received a sham operation (Sham), ovariectomy (Ovx), ovariectomy plus estrogen replacement (Ovx + E), or ovariectomy plus tibolone treatment (Ovx + T). After 12 weeks each rat was anesthetized and the bladders were removed. The bladders' ultra structure, collagen fiber (CF) to smooth muscle (SM) ratio and ER subtypes were studied. Statistical analyses were performed using the one-way analysis of variance test.

RESULTSOvx resulted in significant degeneration in bladder ultra structure; however, estrogen and tibolone reversed those changes. Ovx increased the CF/SM ratio, estrogen and tibolone resulted in an increase. Two estrogen receptors (ERs) were expressed in the bladder detrusor, with ERbeta the main subtype. Ovx resulted in up-regulation of ERalpha and down-regulation of ERbeta. With estrogen and tibolone treatment, ERbeta showed a significant increase but ERalpha showed no significant difference compared with Ovx.

CONCLUSIONSEstrogen deficiency deteriorates bladder ultra structure and histology. Supplementary estrogen can improve bladder function which may be due to inhibition of collagen hyperplasia and increased SM density. ERbeta has an important role in mediating estrogen function in the bladder. Tibolone has a mild estrogenic action and has an effect on bladder function and structure to some degree.

Animals ; Estrogen Receptor Modulators ; pharmacology ; Estrogens ; pharmacology ; Female ; Immunohistochemistry ; Microscopy, Electron, Transmission ; Norpregnenes ; pharmacology ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Receptors, Estrogen ; metabolism ; Urinary Bladder ; drug effects ; metabolism ; ultrastructure

Objective:To construct and verify a prognostic model based on Necroptosis genes(NEGs)in liver cancer.Methods:Through unsupervised clustering analysis in liver cancer patients from TCGA and ICGC databases,67 NEGs were grouped into two clusters.The differ-ences in prognosis between clusters were explored.Prognosis-related genes were selected through single-factor Cox regression analysis.A prognostic model was built using clustering analy-sis and multi-factor Cox regression,and the model's accuracy and predictive ability were validated.Results:The 67 NEGs were divided into two subtypes,namely NEGclusterA and NEGclusterB.Survival analysis indicated a better prognosis for patients in B compared to A(P＜0.05).Single-factor Cox analysis identified 133 prognosis-related genes,further classified into genecluster A and genecluster B,the prognosis of A was better than B(P＜0.001).Three genes(SLC1A5,MYBL2,and CFHR3)were determined to construct the prognostic risk scoring model.In both TCGA training and validation cohorts,patients in the high-risk group exhibited poorer prognosis(P＜0.05).Conclu-sion:This predictive model can independently forecast the prognosis of liver cancer and provides initial insights into the differences in immune cell infiltration among different liver cancer clusters.

OBJECTIVETo identify the relationship of body mass index (BMI) and blood pressure in 7 - 15 years children and adolescents of Beijing so as to provide scientific basis for early prevention of hypertension and to provide evidence for verification on the category criterion of overweight and obesity in children and adolescents of China, recommended by the Working Group on Obesity in China (WGOC) to sensitively distinguish the blood pressure in normal weight, overweight and obesity populations.

METHODSA cross-sectional survey on epidemiological characteristics of obesity with stratified cluster sampling method carried out in Beijing in April and May, 2000. 5155 students aged 6 - 15 years were selecte das research subjects. The category criterion of overweight and obesity in children and adolescents of China was recommended by WGOC, the diagnostic criterion of hypertension in children was recommended by CDC in the USA. Statistics analysis system (SAS 8.1) including partial person correlation analysis, t-test, chi(2) test and logistic multi-factors regression analysis was used to analyses the data from 4982 subjects aged 7 - 15 years.

RESULTS(1) after the age and gender were adjusted, the BMI positive correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found independent in 7 - 15 years children and adolescents (P < 0.0001) and the partial relation coefficients(r) between BMI and SBP and DBP were 0.323 87 and 0.245 88 respectively. (2) the means of SBP and DBP in obesity group were significantly higher then overweight, while overweight was significantly higher then normal weight group (P < 0.0001). (3) the prevalence rates of hyper-SBP, hyper-DBP and hypertension were significantly different (P < 0.0001). When compared with the normal weight group, the relation risk (RR) for hypertension in overweight group and obesity group were 2.96 and 4.85 respectively. The prevalence rates of hypertension in overweight and obesity group were 19.70% and 24.22% respectively. (4) the results of logistic multi-factors regression analysis showed that both age and weight were effecting on hyper-SBP, hyper-DBP and hypertension (P < 0.0001). After age was adjusted, the RR for hypertension was 2.62, and their confidence interval (CI) was 2.36 - 2.91 in obesity or overweight, between overweight and normal weight.

CONCLUSION(1) the BMI positive correlation with SBP and DBP was found independent in 7 - 15 years children and adolescents of Beijing, and the risk for hypertension maybe increased when these people with overweight and obesity, it is very important for hypertension prevention and control that overweight and obesity prevention and control in children and adolescents. (2) the sensitivity of the category criterion of overweight and obesity in children and adolescents of China, recommended by WGOC have been verified on distinguish the blood pressure in normal weight, overweight and obesity populations.

Adolescent ; Age Factors ; Blood Pressure ; Body Mass Index ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; etiology ; Logistic Models ; Male ; Risk Factors ; Sex Factors

OBJECTIVETo investigate the effects of short-term forest bathing on human health.

METHODSTwenty healthy male university students participated as subjects and were randomly divided into two groups of 10. One group was sent on a two-night trip to a broad-leaved evergreen forest, and the other was sent to a city area. Serum cytokine levels reflecting inflammatory and stress response, indicators reflecting oxidative stress, the distribution of leukocyte subsets, and plasma endothelin-1 (ET-1) concentrations were measured before and after the experiment to evaluate the positive health effects of forest environments. A profile of mood states (POMS) evaluation was used to assess changes in mood states.

RESULTSNo significant differences in the baseline values of the indicators were observed between the two groups before the experiment. Subjects exposed to the forest environment showed reduced oxidative stress and pro-inflammatory level, as evidenced by decreased malondialdehyde, interleukin-6, and tumor necrosis factor a levels compared with the urban group. Serum cortisol levels were also lower than in the urban group. Notably, the concentration of plasma ET-1 was much lower in subjects exposed to the forest environment. The POMS evaluation showed that after exposure to the forest environment, subjects had lower scores in the negative subscales, and the score for vigor was increased.

CONCLUSIONForest bathing is beneficial to human health, perhaps through preventive effects related to several pathological factors.

Baths ; China ; Cytokines ; metabolism ; Humans ; Hydrocortisone ; blood ; Life Style ; Lymphocyte Subsets ; Male ; Nature ; Recreation ; Stress, Physiological ; Testosterone ; blood ; Trees ; Young Adult

Objective To understand the occurrence of healthcare-associated infection (HAI),distribution of pathogens,and drug resistance in a general hospital in 2014-2016,provide basis for prevention and control of HAI.Methods Clinical data of hospitalized patients from January 2014 to December 2016 were collected by prospective and retrospective investigation,distribution and drug resistance of pathogens causing HAI were statistically analyzed.Results From 2014 to 2016,4 750 patients had 5 352 cases of HAI,incidence and case incidence of HAI were 2.19％ and 2.46％ respectively.Incidences of HAI in three years were 2.47％,2.07％,and 2.05％ respectively,showing a decreased tendency,difference was statistically significant (x2 =36.217,P＜0.01).Incidences of HAI were high in intensive care unit,department of neurosurgery,as well as department of burn and plastic surgery,the common HAI sites were respiratory tract,urinary tract,and surgical sites.The main pathogens causing HAI were gram-negative bacteria (76.10％).Resistance rates of Escherichia coli to cephalosporins and fluoroquinolones were relatively higher (＞60％);resistance rates of Klebsiella pneumoniae to carbapenems were relatively higher;resistance rates of Pseudomonas aeruginosa to carbapenems showed a increased tendency year by year (x2 =15.175,P =0.001);antimicrobial resistance rates of Acinetobacter baumannii were all＞50 ％.Methicillin-resistant Staphy lococcus aureus (SA) accounted for about 60％ of SA,methicillin-resistant coagulase negative Staphylococcus(CNS) accounted for more than 80％ of CNS,vancomycin-and linezolid-resistant Staphylococcus spp.were not found.Conclusion The common pathogens causing HAI in this hospital are higher.Scientific monitoring on HAI and regular analysis of clinical data are of great significance for guiding rational use of antimicrobial agents,controlling multidrug-resistant organisms,and reducing the occurrence of HAI.

OBJECTIVETo investigate the anti-angiogenic effects of Pien Tze Huang in vivo and in vitro.

METHODSHuman umbilical vein endothelial cells (HUVECs) were treated with 0 mg/mL, 0.25 mg/mL, 0.5 mg/mL, and 1 mg/mL of PZH for 24 h, 48 h and 72 h, respectively. Chicken embryo chorioallantoic membrane (CAM) model was used to evaluate in vivo angiogenesis. An ECMatrix gel system was used to evaluate in vitro angiogenesis by examining the tube formation of HUVECs. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was performed to determine HUVEC viability. Cell density of HUVECs was observed by phase-contrast microscopy. HUVEC migration was determined by wound healing method. The mRNA and protein expression of vascular endothelial growth factor A (VEGF-A) and basic fibroblast growth factor (bFGF) in both HUVEC and human colon adenocarcinoma cells (HT-29) was examined by reverse transcription polymerase chain reaction (RT-PCR) and enzyme linked immune sorbent assay (ELISA), respectively.

RESULTSPZH treatment significantly reduced the total number of blood vessels compared with the untreated control in the chicken embryos and resulted in a significant decrease in capillary tube formation and cell density of HUVECs (P<0.05). In addition, treatment with 0.25-1 mg/mL of PZH for 24 h, 48 h, and 72 h respectively reduced cell viability by 9%-52%, 24%-87% or 25%-87%, compared with the untreated control cells (P<0.05). Moreover, PZH treatment decreased the migration of HUVECs. Furthermore, PZH dose-dependently suppressed the expression of VEGF-A and bFGF on both mRNA and protein levels (P<0.05).

CONCLUSIONPZH could inhibit angiogenesis in vivo in CAM model and in vitro on HUVECs, suggesting that inhibiting tumor angiogenesis might be one of the mechanisms by which PZH treats cancer.

Animals ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Chick Embryo ; Chorioallantoic Membrane ; blood supply ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fibroblast Growth Factor 2 ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; HT29 Cells ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; metabolism ; Humans ; Neovascularization, Physiologic ; drug effects ; genetics ; RNA, Messenger ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

BACKGROUNDThe socio-economic burden of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing is not fully understood. The study investigated the hospitalization cost in patients with AECOPD and the associated factors.

METHODSA multi-center, retrospective study was conducted in the four hospitals in Beijing including two level III hospitals and two level II hospitals. Patients with AECOPD admitted to the hospitals between January and December in 2006 were enrolled. The hospitalization cost and its relationship with disease severity and treatment were analyzed.

RESULTSTotally 439 patients were enrolled with 294 men (67.0%) and a mean age 73.4 years. The mean hospital stay was 20.7 days. A total of 204 patients (46.5%) had respiratory failure, 153 (34.9%) with cor pulmonale, 123 (28.0%) with coronary artery disease, 231 (52.6%) with hypertension, 70 (15.9%) with cerebrovascular disease and 32 (7.3%) with renal failure. The percentage of drug cost to total cost was the highest (71.2%), followed by laboratory cost (16.7%), therapy cost (9.7%), oxygen cost (7.3%), radiology cost (4.5%), examination cost (4.5%), bed cost (4.1%). Correlation analysis showed that cost was positively correlated with age, hospitalization days, co-morbidities such as respiratory failure and cor pulmonale, hypertension. Three hundred and twenty-one patients were further analyzed. The hospitalization cost increased in patients with non-invasive ventilation (P < 0.01), invasive mechanical ventilation (P < 0.01), ICU stay (P < 0.01), antibiotics (P < 0.05), systemic steroids (P < 0.01), and poor prognosis (P < 0.05). Correlation analysis showed that the hospitalization cost was negatively correlated with percentage forced expiratory volume in 1 second (FEV(1)%) (r = -0.149, P < 0.05), pH (r = -0.258, P < 0.01), and PaO(2) (r = -0.131, P < 0.05), positively correlated with PaCO2 (r = 0.319, P < 0.01), non-invasive positive pressure ventilation (r = 0.375, P < 0.01) and duration (r = 0.463, P < 0.01), invasive mechanical ventilation (r = 0.416, P < 0.01) and duration (r = 0.511, P < 0.01), ICU stay (r = 0.390, P < 0.01) and duration (r = 0.650, P < 0.01), antibiotics (r = 0.140, P < 0.05) and systemic steroids (r = 0.202, P < 0.01).

CONCLUSIONSAECOPD had a great impact on healthcare resources utilization. Disease severity, use of non-invasive or invasive ventilation, ICU stay and usage of antibiotics and systemic steroids were the major determinants of hospitalization cost. Long-term regular treatment aimed at reducing the frequency of acute exacerbation will lower the social and economic burden of chronic obstructive pulmonary disease (COPD).

Aged ; Female ; Hospitalization ; economics ; Humans ; Length of Stay ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; economics ; Respiration, Artificial ; Retrospective Studies

Objective:To compare the clinical outcomes between percutaneous Kirschner wire leverage plus plaster fixation and elastic intramedullary nailing in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 60 children with radial neck fracture who had been treated by percutaneous Kirschner wire leverage plus plaster fixation at Department of Pediatric Orthopedics, Children's Hospital of Soochow University from January 2016 to July 2023 (set as an internal fixation-free group). They were 30 males and 30 females (34 left and 26 right sides) with an age of (7.7±3.0) years. At the same time, another cohort of 60 patients were chosen as an intramedullary nailing group who had been treated by percutaneous Kirschner wire leverage plus elastic intramedullary nailing and matched in age and gender with those in the internal fixation-free group. The preoperative fracture angulation, operative time, hospitalization time, fracture angulation on the first postoperative day, fracture angulation at 1 month postoperatively, rate of angulation loss after reduction, Mayo elbow performance score (MEPS) at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P<0.05). The 120 pediatric patients were followed up for (7.5±3.2) months. The operative time [(27.4±15.0) min] and hospitalization time [(3.4±1.9) d] in the internal fixation-free group were significantly shorter than those in the intramedullary nailing group [(45.4±13.5) min and (4.4±1.3) d] ( P<0.05). The preoperative fracture angulation (50.8°±1.9°), fracture angulation on the first postoperative day (11.3°±1.2°), fracture angulation at 1 month postoperatively (12.1°±1.3°), rate of angulation loss after reduction (2.9%±0.5%), and MEPS at the last follow-up [(90.4±2.0) points] in the internal fixation-free group showed no significant differences from those in the intramedullary nailing group [49.5°±1.7°, 11.1°±1.2°, 13.3°±1.5°, 3.9%±1.4%, and (90.2±2.3) points] ( P>0.05). None of the patients in the internal fixation-free group developed pin-tail irritation sign or premature epiphyseal closure after surgery, whereas 3 patients in the intramedullary nailing group developed pin-tail irritation sign and 2 ones premature epiphyseal closure after surgery, showing a significant difference in the complication rate between the 2 groups [0 (0/60) versus 8.3% (5/60)] ( P<0.05). Conclusions:Percutaneous Kirschner wire leverage plus plaster fixation and close elastic intramedullary nailing can both achieve satisfactory outcomes in the treatment of radial neck fractures in children. However, percutaneous Kirschner wire leverage plus plaster fixation needs shorter operative time and hospitalization time, leads to fewer complications, and requires no reoperation to remove internal fixation.

OBJECTIVETo assess the characteristics and daily treatment compliance of non-alcoholic fatty liver disease (NAFLD) patients in China.

METHODSNAFLD adult patients from 21 clinics of 12 cities in China were enrolled in this registry. Physical examination such as demographic characteristics (height, weight, waist circumference measurement), blood pressure and clinical laboratory and ultrasonographic examination of liver were undertaken. Daily practice including life style and medication were recorded and assessed in accordance with 2006 Chinese NAFLD treatment guidelines.

RESULTSA total of 1656 patients were enrolled (1146 male and 510 female), mean of 45.8 ± 12.6 years old, mean duration of NAFLD history was (47.2 ± 47.7) months. 44.9% of NAFLD were suffering from metabolic syndromes. Patients with central obesity have higher incidence of hypertension and lower level of high-density lipoprotein cholesterol (HDL-C) than those without central obesity, P < 0.05. Body mass index (BMI), waist circumference, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in ALT abnormal group were higher than those in ALT normal group (P < 0.05), HDL-C was lower in ALT abnormal group (P < 0.05). Significant differences existed between the BMI, female waist circumference, TG, fast insulin, HOMA index, ALT, AST and HDL-C among subgroups with mild, moderate and severe steatosis. Majority of the patients did not follow recommendations of NAFLD treatment guidelines. Among targeted population only 15.3% of patients used insulin sensitizers and 23.8% took lipid lowering medicine according to the guideline.

CONCLUSIONData indicated that nearly half of NAFLD patients co-morbid with metabolic disorders. Therapy compliance was unsatisfactory and the gap between current practice and Chinese NAFLD treatment guidelines was not optimal.

Adult ; Asian Continental Ancestry Group ; China ; epidemiology ; Fatty Liver ; diagnosis ; epidemiology ; therapy ; Female ; Humans ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Risk Factors ; Waist Circumference