Objective To observe the change characteristics of serum prealbumin and cholinesterase in the liver cirrhosis pa-tients ,and to discusses the determination of these two indicators in diagnosis ,treatment and prognosis of clinical significance in pa-tients with liver cirrhosis .Methods A total of 45 liver cirrhosis patients diagnosis in our hospital from July to December 2013 were recruited into study group ,at the same time 98 healthy people were recruited into control group .The Hitachi 7170 automatic bio-chemical analyzer was used to detected serum prealbumin and cholinesterase ,the former was detected by immunoturbidimetry meth-od ,the latter was detected by butyryl glucosinolates choline bottom method .The levels and abnormal rates of the two indicators be-fore and after treatment in the study group were compared with those of the control group .Results The serum prealbumin and cho-linesterase at different stage in the study group were significant lower than those of the control group(P<0 .05) .The abnormal rate of serum prealbumin after treatment was significant different with those among and before treatment in patients with cirrhosis (χ2 =10 .08 ,P<0 .05) ,but there were no significant difference on cholinesterase(P>0 .05) .Conclusion The serum prealbumin is a sensitive indicator of liver cell damage ,its change could reflect the condition of treatment and development status ,which has im-portant clinical significance on judging the prognosis of patients with liver cirrhosis .

BACKGROUND: Astrocyte distributes the most widely in the central nerve system,but the role of astrocyte in the pathogenisis of neurodegenerative diseases is still unclear.OBJECTIVE :To investigate the effects of lipopolysaccharide (LPS) on the level of the free intracelluar calcium, the production of reactive oxygen species (ROS) and nitric oxide (NO), and the cell viability of astrocytes.DESIGN: Randomized grouping controlled experiment.SETTING: The Brain Circulation Research Laboratory, Second Affiliated Hospital of Suzhou University.MATERIALS: The experiment was carried out in the Brain Circulation Research Laboratory, Second Affiliated Hospital of Suzhou University from May 2005 to August 2005. The astrocytes were derived from the cerebral cortex of 8 Newborn SD rats aged 1-3 days provided by the Animal Experimental Center of Suzhou University. LPS was purchased from Sigma, MTT assay kit and NO assay kit were obtained from Beyotime Biotechnology.METHODS: The astrocytes were isolated and cultured using the method described by Kevin St. P. McNaught. The cells were purified by proliferation repeatedly. Astrocytes were divided into control group, LPS5, 10, 20,40 mg/L group according to different dosage of LPS added. The cell viability at 30 min and 60 min respectively was measured using MTT method.The NO accumulation in cultured cell supernatant at 30 min was assayed with Griess reagent after the treatment of LPS. Calcium and ROS accumulation in cultured astrocyte of rats stimulated by different dosage of LPS was measured at 30 min and 60 min respectively by confocal laser scan microscope (CLSM).MAIN OUTCOME MEASURES: Cell viability of astrocyte, the change of level of NO, calcium and reactive oxygen species of astrocyte.RESULTS: ① The cell viability 60 min after administration of LPS 5 mg/L,LPS 10 mg/L and LPS 20 mg/L was higher than that of control group(P ＜ 0.05). The cell viability of LPS 10 mg/L group was higher than that of LPS 5, 20 mg/L group.② NO production 30 min after LPS treatment of LPS 40 mg/L group was higher than control and the other 3 experimental groups (P ＜ 0.05 ). ③ The calcium of the LPS 5, 10 and 20 mg/L group was 200-400 times higher than that of the base state. The calcium of the LPS 40 mg/L group was 1 000 times than its baseline state; Absolute fluorescence intensity of ROS was superior than the detect range of CLSM, we could speculate that the relative fluorescence intensity of the group LPS 40 mg/L was at least 300-400 times higher than that of its base state.CONCLUSION: LPS could increase the level of the free intracelluar calcium and induce the production of ROS and NO in astrocytes.

Objective To observe the clinical efficacy of Zishen Pingchan Granules in treating non-motor symptoms (NMS) of Parkinson disease (PD). Methods A randomized, double-blind, placebo-controlled trial was used. 124 patients with PD were randomly divided into the treatment group (n=62) and the control group (n=62). Patients not yet taking Western medicine were suspended the application of Western medicine, receiving direct TCM treatment. Patients who had already taken Western medicine were added TCM on the basis of original medicine dosage and method. The treatment group was given Zishen Pingchan Granules, while the control group was treated with placebo granule, once a bag, twice a day. The treatment lasted for 12 weeks. The clinical efficacy was assessed by using unified PD rating scale (UPDRSⅡ–Ⅲ), the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT), Parkinson disease sleep scale (PDSS) and dosage of levodopa. Results The UPDRSⅡ and UPDRS Ⅲscores of the treatment group and the control group after 4, 8, and 12 week of treatment had no difference at each time point compared with before treatment (P>0.05). There was no statistical significance in scores of UPDRSⅡ and UPDRSⅢ after treatment (P>0.05). Efficacy of SCOPA-AUT in treatment group after treatment was significantly better than the control group; There was statistical significance in constipation, salivation, nocturia and sweating in SCOPA-AUT between the two groups after treatment (P<0.05). Compared with before treatment, PDSS scores in treatment group after 8 and 12 weeks of treatment increased significantly (P<0.05). After 4, 8, and 12 weeks of treatment, PDSS scores in treatment group were much higher than control group (P<0.01). By comparing PDSS score in the two groups before and after treatment, it showed that treatment group had better efficacy in extending the time to sleep, reducing nocturia, nightmares, and hallucinations (P<0.05). After 12 weeks of treatment, dosage of levodopa in control group increased significantly, which treatment group was much lower than the control group (P<0.05). Conclusion Zishen Pingchan Granules can improve the autonomic dysfunctionin and sleep quality of PD patients, and can significantly reduce the dosage of levodopa.

Objective To evaluate the possibility and safety of balloon kyphoplasty for the aged osteoporotic thoracolumbar burst fractures. Methods From October 2007 to December 2012, 78 patients with aged osteoporotic thoracolumbar burst fractures were treated by balloon kyphoplasty. The inflatable balloon was inserted through pedicle of vertebal arch to make fracture reduction, then the centrum was stuffed with bone cement. The whole procedure was pinpointed and detected by C-arm x-ray machine. Results All operations were completed successfully. The lumbar and back pain of the patients relieved obviously. The quality of patients' life was significantly improved. Imaging examinations revealed that the vertebrae altitude was recovered and the kyphosis was corrected obviously. Conclusion Balloon kyphoplasty is effective to treat the aged osteoporotic thoracolumbar burst fractures. But the operation had certain risk, we must do a good job in preoperative preparation, strictly handle surgical indication and accurately operate.

Objective To evaluate the clinical efficacy of infliximab (IFX) in Crohn′s disease (CD) and its effects on mucosal healing and promoting fistula closure.Methods Between September 2007 and February 2011,relevant clinical data of CD patients treated with IFX in the Department of Gastroenterology,Ruijin Hospital were collected and the efficacy and safety of IFX were retrospectively analyzed.After IFX therapy,the efficacy evaluation included laboratory index,clinical efficacy,efficacy of fistula closure and mucosal healing.The data were analyzed using t test and Wilcoxon signed-rank test.Results A total of 22 patients were enrolled in this study,11 males and 11 females; the mean age was 29.3 years.The dosage of IFX was 5 mg/kg to 10 mg/kg at week 0,2,6to induce remission,and every 8 weeks on maintenance therapy.Of 22 patients,16 patients were active CD.One case dropped out.At week 14,of the remaining 15 cases,11 cases achieved clinical remission,two cases achieved clinically effective and two cases were ineffective.Crohn′s disease activity index (CDAI) (112±80) and ESR [(13±11) mm/1 h] of week 14 decreased compared with that of week 0 [(186±88),(21± 15) mm/1 h,P=0.04 and 0.007].Two cases of 10 patients with fistula dropped out as a result of ineffective,while eight cases had a partial response and six patients sustained response during the maintenance therapy,but no fistula closed and completely disappear.Seven patients reviewed by endoscopy after five times IFX therapy (24 weeks),after therapy the simple endoscopic score for Crohn′ s disease (SES-CD) ( 3.21 ± 2.89 ) decreased compared with that before treatment (5.86±3.02) (Z＝-2.38,P＝0.018).Eleven times of adverse events were found in nine patients,infusion reaction and respiratory tract infection were more common and no severe adverse effect was observed.Conclusions IFX can rapidly improve clinical symptoms and with good safety.The effects in mucosal healing and fistula closure may occur at early medication.

Developmental changes in children can affect drug disposition and clinical effects. A physiologically-based pharmacokinetic (PBPK) model is a mathematical model that can be used to predict blood drug concentrations in children and gain insight into age-dependent physiological differences in drug disposition impact. Pediatric PBPK (P-PBPK) models have attracted attention over the past decade. With the concerted efforts of academia, pharmaceutical companies, and regulatory agencies, there are more and more examples of pediatric clinical studies using PBPK models. Nevertheless, the number of P-PBPK models and their predictive performance still lag behind adult models. By referring to the literature, we study the process of children adapting to adult absorption, distribution, metabolism, and excretion (ADME) parameters and analyze the general principles of P-PBPK model establishment. In addition, we summarize the functions and application examples of commonly used P-PBPK modeling software to provide a basis for the rational application of modeling software.

OBJECTIVE To investigate the bacterial distribution and antibiotic resistance situation with urinary tract infection(UTI) for the guidance of rational use of antibiotics.METHODS The antibiotic resistance of clinical isolates from urinary tract infection from Mar 2005 to Jul 2006 was analyzed. RESULTS The most common pathogens in urinary tract infection were Escherichia coli(50.2%),Enterococcus(14.4%),Staphyloccus aureus(8.7%),Klebsiella pneumoniae(7.3%),and Proteus mirabilis(3.9%).E.coli,K.pneumoniae,and P.mirabilis were found to be highly resistant to ampicillin,quinolones and SMZ(70.6-100.0%).Enterococcus were highly resistant to penicillin and quinolones(81.0-96.8%).41.4% of E.coli and 31.3% of K.pneumoniae isolates produced ESBLs.HLGR-Enterococcus were 79.4%.78.9% S.aureus isolates were resistant to oxacillin.CONCLUSIONS The high antibiotic resistance of commonly encountered pathogens is a serious problem and much attention should be paid to detect pathogens and their antibiotic resistance.

Objective To investigate the protective effects and molecular mechanism of peroxisome proliferate-activated receptor α(PPARα) activation on acute myocardial damage induced by isoproterenol (Iso) in rats. Methods Thirty male Wistar rats, weighting 160～180 g, were randomly divided into control group, Iso group, fenafibrate(FF) group(each n=10) according to physique quantity. Acute myocardial injury caused by Iso abdomen cavity injection induced ischemia was established and the protective effects of peroxisome proliferate-activated receptor α activation were accessed by the level of ereatine kinase(CK), lactic dehydrogenase(LDH) in serum as well as the activities of myoperoxidase(MPO) in myocardium, and the protein expressions of PPABα in myocardium by Western blot. Results The level of serum CK in control group, lso group and FF group, was (62.41±9.47),(101.71±11.05),(75.64±11.73)kU/L, respectively(F= 34.34, P<0.01). Whereas the level of serum CK in Iso group and FF group was higher than that in control group(P<0.01 or<0.05), the level of serum CK in FF group was lower than that in Iso group(P<0.01). The levels of LDH in these three groups were (5912.20±204.44), (6365.78±137.10), (6089.76±169.60) U/L, respectively(F= 17.54, P<0.01). Compared with the control group, the levels of LDH in Iso and Fir groups were significantly increased(P<0.01 or<0.05). But the level of LDH in FIr group was decreased compared with that in Iso group(P<0.01). The activities of myocardial MPO in these three groups were (1.95±0.10),(3.89±0.17),(2.49±0.19)U/g, espectively(F=391.68,P< 0.01). The activities of myocardial MPO in Iso and FF groups were higher than that in the control group (all P< 0.01), while the activities of myocardial MPO in FIr group were lower than that in lso group(P<0.01). The protein expressions of PPARα in myocardium of these three groups were 251.57±10.95,191.97±10.74,215.08±9.61, respectively(F=82.69, P<0.01). Conclusion PPARα activation by its actor FF can exert protective effects on the acute myocardial ischemia injury induced by lso in rats through inhibiting the release of inflammatory cell factors.

0.05),but that MFI and/or PPC of CAR in the 2 types cells markedly increased compared with lymphocytes in the same group(Pa

Objective To evaluate the effect ofcytochrome P450 isoenzyme subfamily 2C19 (CYP2C19)gene polymorphism on the clopidogrel antiplatelet therapy in cirrhosis patients after receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods The clinical data of 171 cirrhosis patients,who were treated with TIPS during the period from January 2013 to December 2014,were retrospectively analyzed.During operation both the portal vein and the elbow vein blood samples were collected and sent for CYP2C19 gene testing.After TIPS,clinical follow-up checkup was made once every 3 months.The gene detection results and clinical follow-up findings were comparatively analyzed.Results A total of 110 patients,who had not received blood transfusion before TIPS and who had regularly taken clopidogrel antiplatelet therapy after TIPS were enrolled in the study.The mean time to take clopidogrel was 192.4 days (31-517 days),and the gene detection results of portal vein and elbow vein were quite consistent.CYP2C19 genotype of *1/*1 was found in 49 patients (44.5％),CYP2C19 genotype of *1/*2 in 27 patients (24.6％),CYP2C19 genotype of *1/*3 in 18patients (16.4％),CYP2C19 genotype of *2/*2 in 11 patients (10.0％),CYP2C19 genotype of *2/*3 in 3patients (2.7％),and CYP2C 19 genotype of *3/*3 in 2 patients (1.8％).Following-up examinations showed that the incidence of shunt dysfunction in patients carrying slow metabolic gene was 87.5％ (14/16),which was significantly higher than that in patients carrying moderate metabolic gene (20.0％,9/45;x2=22.9,P=0.006)as well as in patients carrying fast metabolic gene (8.2％,4/49;x2=37.91,P=O.O00 1).Multivariate analysis of Cox regression model indicated that CYP2C19 slow metabolic gene variation was an important predictive factor for shunt dysfunction (95％CI:1.80-9.03,P=O.O00 7).Conclusion CYP2C19 slow metabolic gene variation,including genotype of *2/*2,*2/*3 and *3/*3,is an important factor that can influence the efficacy of clopidogrel treatment after TIPS.Preoperative CYP2C19 gene detection results can provide useful information,which is very helpful in making an effective and reliable anti-platelet treatment plan for patients after TIPS.