Objective To investigate the effects and mechanisms of anal electrical stimulation (AES) with long pulses on anal sphincter pressure (ASP) in conscious dogs.Methods Nine healthy female hound dogs were used for the study,composed of 4 randomized sessions including AES with vari- ous stimulation parameters,20-min sustained AES to assess anal sphincter fatigue,atropine or phentolamine were used to block corresponding receptor.ASP was measured with manometry and the contractile area under the contraction curve.AES was performed via a pair of ring electrodes attached to the manometric catheter.The stimulation parameters in all sessions but the first session included a frequency of 20 ppm,width of 200 ms and amplitude of 3 mA.Results ASP was 55.7?6.0 at baseline and increased by 37% to 76.4?6.5 during AES (P

OBJECTIVETo investigate the prevalence and correlative factors of subclinical hepatic encephalopathy (SHE) in patients with cirrhosis in China by using psychometric tests with big sample size.

METHODS409 patients with cirrhosis and 416 patients with chronic hepatitis were investigated for the prevalence of SHE. In prevalence study questionnaire, psychometric tests (NCT and DST), laboratory data were used to estimate their liver function.

RESULTSAccording to age, the patients were divided into 5 groups (including<35, 35 to 44, 45 to 54, 55 to 64 and >65 groups). There was highly statistical significance on the results of NCT and DST, between the cirrhosis patients and the controls (t> or =4.108, P<0.01). The prevalence of SHE in cirrhosis patients was 51.3%. Highly statistical significance was found (chi 2=23.910, P<0.01) among the Child-Pugh A, B, C groups (39.9%, 55.2% and 71.8%). According to age, gender, smoking, etiology and education, no statistical significance was found. Logistic regression showed that there was a close relationship between the SHE prevalence and the Child-Pugh score only, and no relationship had been found between the SHE prevalence and other factors including age, gender, smoking, etiology and education.

CONCLUSIONThe SHE prevalence in hepatic cirrhosis patients is 51.3%, and the Child-Pugh score may be an important risk factor

Adult ; Age Distribution ; Aged ; Child ; China ; epidemiology ; Data Collection ; Female ; Hepatic Encephalopathy ; epidemiology ; etiology ; Humans ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Prevalence ; Risk Factors

It is now well established that inflammation plays an important role in the development of numerous chronic metabolic diseases including insulin resistance (IR) and type 2 diabetes (T2DM). Skeletal muscle is responsible for 75% of total insulin-dependent glucose uptake; consequently, skeletal muscle IR is considered to be the primary defect of systemic IR development. Our pre- vious study has shown that rutaecarpine (Rut) can benefit blood lipid profile, mitigate inflammation, and improve kidney, liver, pan- creas pathology status of T2DM rats. However, the effects of Rut on inflammatory cytokines in the development of IR-skeletal muscle cells have not been studied. Thus, our objective was to investigate effects of Rut on inflammatory cytokines interleukiri (IL)-1, IL-6 and tumor necrosis factor (TNF)-α in insulin resistant primary skeletal muscle cells (IR-PSMC). Primary cultures of skeletal muscle cells were prepared from 5 neonate SD rats, and the primary rat skeletal muscle cells were identified by cell morphology, effect of ru- taecarpine on cell proliferation by MTT assay. IR-PSMC cells were induced by palmitic acid (PA), the glucose concentration was measured by glucose oxidase and peroxidase (GOD-POD) method. The effects of Rut on inflammatory cytokines IL-1, IL-6 and TNF-α in IR-PSMC cells were tested by enzyme-linked immunosorbent assay (ELISA) kit. The results show that the primary skeletal muscle cells from neonatal rat cultured for 2-4 days, parallel alignment regularly, and cultured for 7 days, cells fused and myotube formed. It was shown that Rut in concentration 0-180. 0 μmol x L(-1) possessed no cytotoxic effect towards cultured primary skeletal muscle cells. However, after 24 h exposure to 0.6 mmol x L(-1) PA, primary skeletal muscle cells were able to induce a state of insulin resistance. The results obtained indicated significant decrease (P < 0.05 to P < 0.001) IL-1, IL-6 and TNF-α production by cultured IR-PSMC cells when incubating 24 hours with Rut, beginning from 20 to 180.0 μmol x L(-1). IL-1, IL-6 and TNF-α in the Rut treated groups were dose-dependently decreased compared with that in the IR-PSMC control group. Our results demonstrated that the Rut promoted glucose consumption and improved insulin resistance possibly through suppression of inflammatory cytokines in the IR-PSMC cells.
Animals ; Cell Proliferation ; drug effects ; Cytokines ; metabolism ; Female ; Glucose ; metabolism ; Indole Alkaloids ; pharmacology ; Inflammation ; metabolism ; Insulin Resistance ; Male ; Muscle, Skeletal ; cytology ; drug effects ; metabolism ; Quinazolines ; pharmacology ; Rats

Adiponectin ; blood ; Aged ; Fatty Liver ; blood ; metabolism ; Female ; Humans ; Insulin Resistance ; Male ; Middle Aged

OBJECTIVETo investigate leptin mRNA expressions in subcutaneous (SC) and omental (OM) adipose tissues of patients with nonalcoholic fatty liver disease (NAFLD), and their relationships with insulin resistance (IR), blood leptin, blood triglyceride, total blood cholesterol, blood glucose, body weight index and waist-hip ratio.

METHODSSC and OM adipose tissues were obtained from 10 obese and 11 nonobese NAFLD patients and from 11 obese and 13 nonobese patients without NAFLD, who served as controls. Leptin mRNA expression levels in the subcutaneous and omental adipose tissues were measured using SYBR Green I quantitative real-time PCR. IR was estimated using homeostasis assessment (HOMA). The levels of plasma leptin and insulin were measured using ELISA.

RESULTSThe relative mRNA expression of leptin, HOMA-IR and blood leptin levels in NAFLD differed significantly from those of the controls (P < 0.05). The leptin/GAPDH ratio of the obese and nonobese NAFLD and control cases were 1.32 +/- 0.12, 0.99 +/- 0.05, 1.10 +/- 0.09, 0.87 +/- 0.13 respectively. The expression levels of SC and OM adipose leptin mRNA in NAFLD patients were positively correlated with HOMA-IR (r=0.72, P < 0.05), blood leptin (r=0.69, P < 0.05), blood triglyceride (r=0.32, P < 0.05), body weight index (r=0.57, P < 0.05) and waist-hip ratio (r=0.50, P <0.05).

CONCLUSIONThe primary reason for high levels of blood leptin is high leptin mRNA expression in adipose tissues; in both obese and nonobese patients with NAFLD; high levels of blood leptin and the leptin mRNA expression in adipose tissues and IR exist. These findings suggest that leptin resistance exists in patients with NAFLD and leptin resistance is positively correlated with NAFLD, the same as in insulin resistance.

Adipose Tissue ; metabolism ; Adult ; Aged ; DNA, Complementary ; Fatty Liver ; genetics ; metabolism ; Female ; Gene Expression ; Humans ; Leptin ; genetics ; metabolism ; Male ; Middle Aged ; RNA

OBJECTIVETo evaluate the effect of the treatment of congenital hypertrophic pyloric stenosis (CHPS) with endoscopic pyloromyotomy.

METHODNine consecutive infants (7 boys, 2 girls; age range 26 - 70 days; weight range 2.65 - 6.10 kg), with a diagnosis of CHPS according to typical clinical manifestations, transabdominal ultrasound (US), gastroenterography and gastroscope. All the cases had accompanying malnutrition, anaemia, metabolic alkalosis, and some were complicated with congenital heart disease. In gastroscope operating room, all the patients were given pentobarbital and midazolam intravenously. A gastroscope with an outer diameter of 5.9 mm was passed through mouth, stomach, pylorus to the descending segment of duodenum. Under gastroscopy, two incisions were made along the anterior and posterior wall of pylorus from the duodenal bulb to the antrum by using endoscopic electrosurgical needle knife and an arch sphincter sarcosome. Incisions were deepened by 2 to 3 procedures until the longitudinal muscle was exposed, about 2 to 4 mm according to transabdominal US performed before operation. The incision depth was 2 - 3 mm if pylorus wall was 4 - 6 mm in thickness; or 3 - 4 mm when the wall was thicker than 6 mm.

RESULTThe endoscope was easily passed through the pylorus to the duodenum post-operation. The transabdominal US and gastroenterography showed that liquid easily flew through pylorus. All patients were able to have regular feeding about 2 to 10 hours after the operation. Vomiting in all patients was significantly decreased in frequency and amount, and in 8 infants vomiting stopped within 1 week, in one case it did not stop until 1 month after the treatment. Some cases showed slight adverse reaction, no perforation or massive haemorrhage in stomach or intestines occurred in any of the patients during and post-operation. Eight infants were doing well at follow-up (range 2 to 9 months). One girl had recurred vomiting at normal feeding after a period of 1 month postoperation without vomiting. This case was cured by second endoscopic pyloromyotomy.

CONCLUSIONSEndoscopic pyloromyotomy is effective, safe, simple, and offers several advantages: no need for open-abdomen surgery, feeding can be initiated rapidly.

Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pyloric Stenosis, Hypertrophic ; congenital ; surgery ; Pylorus ; surgery ; Sphincterotomy, Endoscopic ; ethics ; methods

OBJECTIVETo investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies.

METHODSWork reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%.

RESULTSBy the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year.

CONCLUSIONA national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified doctors.

Accountable Care Organizations ; standards ; China ; Occupational Diseases ; diagnosis ; Physicians ; standards

Objective To investigate the effects of functional magnetic resonance imaging (fMRI)with acute ischemic stroke (AIS) patients,and to evaluate the relationship between brain reorganization and motor recovery.Methods Nine AIS patients and 9 healthy volunteers were assessed by fMR1 during passive finger clenching at a pace of 1 Hz.The fMRI results were analyzed using SPM2 software.Lateral indices (LIs) and activated regions were calculated,and the relationship between LI and muscle strength was examined.Results In the control group,activation was observed in the contralateral sensorimotor cortex (SMC) and the bilateral supplementary area (SMA) during the passive movement.In the AIS group,similar results were recorded dur- ing unaffected hand movement,but the ipsilateral activation areas were greater than those on the eontralateral side during movement of the affected hand.LI results confirmed that movement of the affected hand mainly elici- ted activation in the ipsilateral hemisphere.Conclusion The different fMRI manifestations of patients and nor- mal subjects reflect brain compensation,and fMRI is valuable for studying the correlation between motor function and brain reorganization.

Objective:To analyze the reason which cause the different change of airway appearance after laparoscopic radical resection and transabdominal radical resection for cervical cancer.Methods:Patients with ASAⅠ-Ⅱ,twenty undergoing laparoscopic radical resection of cervical cancer and twenty with transabdominal radical resection of cervical cancer were enrolled.The parameters of Mallampati class,class of upper-lip-bite test,and neck circumference were measured pre-surgery, 1 h after and 24 h after surgery.The correlation between these three parameters and airway pressure or central venous pressure were analyzed.Results:The parameters of Mallampati class,class of upper-lip-bite test,and neck circumference showed no statistical significance between laparoscopic group and transabdominal group at each time.The statistical significances were found between the parameter of Mallampati class (P= 0.001)and class of upper-lip-bite test (P= 0.003)1 h after surgery and before surgery,while no parameters significantly changed between 24 h after surgery and before surgery.The parameter of neck circumference in laparoscopic treatment group statistically changed 1 h ([34.18 ± 2.50 ]cm)and 24 h ([32.98 ± 2.30]cm)after surgery than before surgery ([32.48 ± 2.58 ]cm,P<0.05 ).In transabdominal group,no statistical difference was found in the parameters of Mallampati class ,class of upper-lip-bite test and neck circumference at 1 h or 24 h after surgery.In the group of laparoscopic treatment,Mallampati class 1 h after surgery was positively related to the airway pressure at 1 h and 2 h after beginning of surgery and central venous pressure at 1 h after beginning of surgery(P<0.05). There were also positive correlation of class of upper-lip-bite test 1 h after surgery and airway pressure at 1 h,2 h and 3 h after beginning of surgery and central venous pressure at 2 h after beginning of surgery (P<0.05).Conclusions:Compared with the transabdominal radical resection,in laparoscopic radical resection,there are significant changes of airway at 1 h after surgery, which related to the airway pressure and central venous pressure at the beginning of surgery.

Objective:To explore the effect of patient-controlled intravenous analgesia (PCIA) using oxycodone combined with sufentanil on cesarean section patients.Methods:Sixty elective cesarean section patients were randomly divided into two groups:SF group (sufentanil 100 μg and ramosetron 0.3 mg),OS group (sufentanil 50 μg,oxycodone 50 mg,and ramosetron 0.3 mg).All patients were received combined spinal-epidural anesthesia,and applied with PCIA after surgery.Making 0.9％ sodium chloride solution to 100 mL,continuous dosage 1 mL/h,pulse dosage 2 mL,the time was 10 min.Numerical pain scores of somatalgia at rest(NRS-R) or movment(NRS-M),numerical pain scores of uterine contraction (NRS-U),patient-controlled intravenous analgesia doses,and side effects were assessed at 6 h,12 h and 24 h after the operation.Results:At the time points of 6,12 and 24 h after surgery,the scores of NRSM,NRS-R,and NRS-U in OS group were lower than those in SF group.Times of bolus and accumulated drugs consumption in OS group were less than those in SF group (P＜0.05).The incidence of nausea in SF group was higher than that in OS group (P＜0.05).There was no significant difference in the incidences of vomiting,dizziness,pruritus or respiratory depression between the two groups.Conclusions:Oxycodone combination with sufentanil in patient-controlled intravenous analgesia may be more effective and without increasing side effects compared with sufentanil alone after cesarean section.