The purity of 4,4′-dimethoxy-5,6,5′,6′-bis (methylenedioxy)-2′-morpholine methylenebiphenyl-2-methyl formate methanesulfonate (IMH), a new drug for fatty liver treatment, was determined through differential scanning calorimetry (DSC). Analysis of two-factor non repeatability method was performed in the investigation the effects of two factors (heating rate and sample weight) on purity determination. The DSC experimental parameters were optimized as follows: heating rate was 10 ℃·min^-1, temperature range was 150-300 ℃, sample weight was 2.0-4.1 mg, and N₂ flow rate was 80 mL·min^-1. The linear correlation coefficient (r) of this DSC method was 0.999 8. The RSD value (n = 6) of precision was 0.03%. The standard value and uncertainty of the purity results of the multiple batches of IMH drugs were (99.74 ± 0.29)%, (99.91 ± 0.28)%, (99.90 ± 0.28)%, and (99.81 ± 0.28)% with inclusion factor (K) of 2 and confidence probability (P) of 0.95. The results were basically consistent with the results of the mass balance method. The DSC mehod is a simple, rapid and accurate method, and provides a new reference method for determining the purity of IMH drugs, improves the accuracy and reliability of purity determination.

Objective To observe the effects of Dahuangfuzi decoction on the intestine barrier functional of acute necrotizing pancreatitis in rats. Methods The 60 rats were randomly divided into sham operation group ( n = 19 ), ANP group ( n = 21 ), and Dahuangfuzi treatment group ( n = 20). The rats of ANP group were induced by injecting 1 ml/kg of 4% sodium taurocholate into the pancreatiobiliary duct, and jejunal fistula was esablished. The rats of treatment group received Dahuangfuzi decoction (2 ml, repeated at 4 and 8 h)through jejunum distal stoma tube 0. 5 h after ANP induction. The other 2 groups received same amount of normal saline. Blood sample was collected through abdominal aorta, 24 h after ANP induction, and the serum amylase, endotoxin, D-lactate, plasma diamine oxidase (DAO) were detected. Pancreas, small intestine tissue was harvested for pathologic examination, index of intestinal epithelial damage was measured and ultrastructural changes in small intestinal mucosa was observed. Results The expression of serum amylase, endotoxin,D-lactate, DAO in sham operation group was ( 152 ± 32 ) U/L, (6.95 ± 2.10) pg/L, ( 3.96 ± 1.08 ) μg/mland ( 14.26 ± 2.67 ) μg/ml, while the corresponding values were ( 1549 ± 93 ) U/L, (40.48 ± 3.41 ) pg/L,( 12.34 ± 1.23 ) μg/ml and ( 80.28 ± 3.54) μg/ml in ANP group, and they were (655 ± 49 ) U/L, ( 19.55 ±2.50) pg/L, (6.75 ± 1.36 ) μg/mland ( 20.69 ± 7.53 ) μg/ml in treatment group. The values in ANP group were significantly higher than those in sham operation group. The values in treatment group were significantly lower than those in ANP group, but significantly higher than those in sham operation group ( P ＜ 0.05 or P ＜0. 01 ). The thickness and height of intestinal mucosa in ANP group were ( 389.44 ± 29.87 )μm and ( 16.52 ±3.73) μm, which were significantly lower than those in treatment group [(501.95 ± 45.38 )μm, (27.82 ±5.17)] μm, and in sham operation group [( 658.72 ± 57.49 ) μm, ( 35.49 ± 6.43 )μm, Index of intestional epitholial donage in ANP group was 3.72 ± 0.65 which is significently higher than those in theatment (2.12 ±0.37 ) and in sham operation group (0.85 ± 0.24). The intestinal mucosa histological and ultrastructural changes in Dahuangfuzi treatment group were better than those in ANP group. Conclusions Dahuangfuzidecoction can significantly decrease the damage of intestine barrier function in ANP rats.

OBJECTIVETo analyze the inpatient cost of AIDS related opportunistic infection in a high HIV epidemic area of China.

METHODSInformation was collected and analyzed from 158 inpatients with AIDS related opportunistic infection, including demographic characteristics of patients, types of opportunistic infection and treatment cost (median) from 2008 to 2010 in a high HIV epidemic area.

RESULTSThe inpatient cost per visit for AIDS related opportunistic infection was 2935.7 yuan. The fee per visit for examination, laboratory test, medicine, diagnosis and treatment, nursing, bed was 132.5, 269.0, 1485.5, 367.3, 302.5 and 264.0 yuan, respectively. The inpatient cost per visit for AIDS related opportunistic infection was 4383.1 yuan for male and 3418.6 yuan for female inpatient (U = -1.279, P = 0.201). The cost per visit for AIDS related opportunistic infection was 4703.1 yuan for Han nationality and 3475.9 yuan for minority patient (U = -1.025, P = 0.305). The inpatient cost per visit for AIDS related opportunistic infection was respectively 3429.3, 5022.2, 6705.5 and 2396.7 yuan for farmers, individual businessmen, employees of enterprise and public institution and jobless (H = 28.633, P = 0.000). The cost per visit was lowest for illiteracy patients (2590.2 yuan), 3626.5 yuan for primary school, 4214.3 yuan for junior high school and 6865.8 yuan for high school and higher education (H = 10.828, P = 0.013). The cost per visit for AIDS related opportunistic infection was respectively 2873.6, 4534.3, 3077.8 and 3208.1 yuan for under the age of 29, 30-39 years old, 40-49 years old and beyond the age of 50 (H = 1.515, P = 0.679). The AIDS related opportunistic infection cost per visit for inpatients infected through sex (4621.3 yuan) was higher than that of intravenous drug users (3208.6 yuan, U = -2.588, P = 0.010). Among various types of opportunistic infections, the cost was highest for neurological diseases (5819.7 yuan), 4300.8, 2806.8, and 2083.9 yuan for respiratory diseases, digestive system diseases and skin and mucous membrane diseases, respectively (H = 15.142, P = 0.004).

CONCLUSIONThe study shows difference of inpatient cost per visit between subgroups, the cost of public institution was higher than that of other professions, the cost of illiteracy patients was lower than other education level, the cost of inpatients infected through sex was higher than that of intravenous drug users, the cost of neurological diseases was higher than that of other types of opportunistic infections.

AIDS-Related Opportunistic Infections ; economics ; Acquired Immunodeficiency Syndrome ; economics ; Adult ; Female ; Health Care Costs ; Hospitalization ; economics ; Humans ; Male ; Middle Aged

Objective To explore the infection and drug sensitivity of ureaplasma urealyticum(Uu)and mycoplasma hominis (Mh)in vaginal secretion of gynecological outpatients.Methods The infection and drug sensitivity test of Uu and Mh in va-ginal secretion samples of 1 800 patients collected from January 2015 to April 2016 were detected with mycoplasma culture i-dentification and counting drug sensitivity kit produced by Zhengzhou Antu Luke Bioengineering Co.,Ltd.Results The positive rate of Uu(57.27%)was significantly higher than that of Mh(2.78%,χ2=33.69,P<0.001).The positive rate of mycoplasma was highest in the age group of 31~35(77.09%),but that of Uu was highest in the age group of 21~25 (65.83%)and that of Mh in 36~40 years old group(9.09%),in addition that of multiple infection by Uu and Mh was highest in less than 20 years old group(20.51%).There were statistical difference for Un,Mh and co-infection by Un and Mh between age groups(χ2=15.505~36.574,P<0.01).The top three drugs sensitive for mycoplasma were josamycin, minocycline and doxycycline and that last three ones were clindamycin,thiamphenicol and sparfloxacin.The drug sensitive rates for 12 antibiotics against Uu were higher than those against co-infection by Uu and Mh,but those of erythromycin,gat-ifloxacin,azithromycin,clarithromycin and Luo Hongmei against Mh were lower than those against co-infecion of Uu and Mh.Conclusion The detection of mycoplasma and drug sensitivity in vaginal secretions provides the experimental basis for clinical diagnosis and treatment.

Objective To observe the association between job stress (effort-reward imbalance model) and blood lipids among university staff in Yunnan province. Methods A cross-sectional survey was conducted among 1244 university staff in Yunnan province. The job stress was measured by the validated Chinese self-reported Effort-Reward Imbalance Questionnaire (ERI). Blood lipids were measured in all participated staff members. Results After adjustment for relevant confounding factors, it was found that the risk of increased serum triglyceride was 3.5 folds higher in male staffs with high extrinsic effort compared those with low extrinsic effort (OR = 3.45, 95% CI: 1.32-9.04) while the risk of increased serum low density lipoprotein-cholesterol was 2.9 folds higher in male staffs with high overcommitment compared those with low overcommitment (OR = 2.86, 95% CI: 1.03-7.96). The risk of elevated serum triglyceride increased in proportion to increasing job stress: 3.5 folds increase in male staffs with moderate job stress (OR = 3.43,95% CI: 1.24-9.53) and 4 folds increase in male staffs with high job stress (OR = 4.16, 95% CI: 1.42-12.17) compared those with low job stress. However, there was no significant association between job stress and lipid profile in female staffs. Conclusion Our results show that job stress (effort-reward imbalance) is positively associated with abnormal blood lipids in male university staffs.

The purpose of this study was to investigate the vasorelaxing effect and mechanism of idoxifene (a new estrogen receptor modulator) on human internal mammary artery (HIMA). HIMA segments were harvested from men during coronary artery bypass grafting surgery. Patients with diabetes mellitus, hypercholesterolemia, hypertension, or smoking habit were excluded. The vasorelaxing effect of idoxifene on artery rings from HIMA with and without endothelium was measured by means of perfusion in vitro. Cumulative dose-response to idoxifene in the range of 0.01-10 micromol/L was observed in the presence and absence of NO synthase inhibitor L-NAME. It was also studied whether the vasodilation effect of idoxifene on HIMA was blocked by methylene blue (MB), an inhibitor of guanylate cyclase (GC). The results obtained from idoxifene were compared with those from 17beta-estradiol (E(2)). It was found that idoxifene caused a concentration-dependent relaxation on HIMA. The dose range was from 0.03 micromol/L (minimal vasodilatory concentration) to 3 mmol/L (maximal vasodilatory concentration). It was also found that the vasorelaxation effect of idoxifene on HIMA was dependent on endothelium. E(2) (0.1-100 micromol/L) also resulted in an endothelium-dependent vasorelaxation, but the vessels were 15-fold less sensitive to E(2) than to idoxifene in their vasorelaxation responses. The EC(50) for E(2) was 4.65+/-0.34 micromol/L, compared with 0.32+/-0.02 micromol/L for idoxifene. The mean maximal vasodilatory value of E(2) was 88.3+/-5.7%, compared with 88.6+/-7.2% for idoxifene. Pretreatment with L-NAME (100micromol/L) abolished idoxifene-induced vasodilation virtually by blocking nitric oxide production. The vasorelaxing effect of idoxifene disappeared in the presence of MB (10 micromol/L). These findings demonstrate that idoxifene results in an endothelium-dependent vasorelaxation of HIMA, like estrogen. The effect of idoxifene is more potent than that of traditional estrogen, and is possibly mediated by NO-GC-cGMP pathway.
Estrogen Antagonists ; pharmacology ; Humans ; Mammary Arteries ; drug effects ; physiology ; Tamoxifen ; analogs & derivatives ; pharmacology ; Vasodilation ; drug effects

The purpose of this study was to investigate the vasorelaxing effect of vasonatrin peptide (VNP) on human intramammary artery (HIMA).The vasorelaxing effect of VNP on HIMA was measured by means of perfusion in vitro. The effects of HS-142-1, TEA, 8-Br-cGMP and methylene blue (MB) were also observed. It was found that VNP caused a concentration-dependent relaxation in HIMA which was independent of the endothelium. 8-Br-cGMP (0.1-1000 micromol/L) also caused a concentration-dependent relaxation in HIMA. The vasorelaxing effect of VNP disappeared in the presence of HS-142-1 (20 micromol/L), an antagonist of the natriuretic peptide guanylate cyclase (GC) receptor. MB (10 micromol/L), an inhibitor of GC, not only blocked completely the relaxation of HIMA, but also enhanced the vascular contraction induced by norepinephrine. TEA (1 mmol/L), an antagonist of calcium activated potassium channels (K(Ca)), reduced but not completely blocked the vasorelaxing effect of VNP. These findings suggest that VNP can relax HIMA, which is independent of the endothelium. This effect is possibly achieved by the binding of VNP with the natriuretic peptide GC receptors in the smooth muscle cells (SMCs), leading to an increase in intracellular cGMP level. Moreover, the vasorelaxing effect of VNP is associated with K(Ca).
Aged ; Atrial Natriuretic Factor ; pharmacology ; Dose-Response Relationship, Drug ; Humans ; In Vitro Techniques ; Mammary Arteries ; drug effects ; physiology ; Middle Aged ; Potassium Channels, Calcium-Activated ; metabolism ; Receptors, Guanylate Cyclase-Coupled ; metabolism ; Vasodilation ; drug effects ; physiology

BACKGROUND: The clinical experience of the treatment of the sternoclavicular joint dislocation and peripheral fracture is relatively lacking, but its incidence is increasing yearly. At present, there are few studies on the anatomy and biomechanics of the sternoclavicular joint in and outside China, and no systematic anatomical measurements of the sternoclavicular joint are reported. OBJECTIVE: To provide a biological reference for the clinical diagnosis and treatment of sternoclavicular joint dislocation or peripheral fractures by studying the anatomy and biomechanics of the sternoclavicular joint. METHODS: (1) A total of 16 specimens (32 sides) of adult antiseptic and moist cadaveric specimens were selected. The complete manubrium, bilateral clavicle and surrounding tissues of sternoclavicular joint were anatomically separated, and repair to bone-ligament-bone specimen models. (2) The areas of manubrium articular surface and the medial clavicular articular surface of all specimens were measured by the ink pattern combined with grid counting method. (3) The morphological features of the anterior and posterior sternoclavicular ligaments of the specimens in this group were observed, and the length, width and thickness were measured and analyzed statistically. (4) The left and right sternoclavicular joints of each specimen were randomly paired into A and B groups. Group A received simply cutting of anterior sternoclavicular ligament. Group B received simply cutting of posterior sternoclavicular ligament. Before and after cuting off the ligament, the anterior and posterior load experiments were performed on the anatomical sites with the same force arm length and perpendicular to the distal clavicle. The angles of joints and load-angle regression line slopes were compared between the two groups in the anterior and posterior directions load. RESULTS AND CONCLUSION: (1) The area of articular surface of manubrium (239.00±28.78 mm2) was smaller than the area of medial articular surface of the clavicle (482.56±44.89 mm2), and the difference was statistically significant (t=-40.105, P < 0.001). (2) The length, width and thickness of the anterior sternoclavicular ligament were (17.56±1.94 mm), (15.54±1.42 mm) and (1.93±0.32 mm), and the length, width and thickness of the posterior sternoclavicular ligament were (17.21±1.86 mm), (15.97±1.17 mm), and (2.07±0.29 mm) respectively;there was no significantly statistical difference in the length, width and thickness between them (P > 0.05). (3) Before cutting the ligaments, when the loads were 2, 4, 6, 8, and 10 N, the angle backwards of joint caused by loads in the forward direction was less than the angle of forwards of joints caused by loads in the backward direction, but only when the loads were 6, 8, and 10 N, the difference between them was statistically significant (P < 0.05). The slope of the regression line of load-angle for the loads in the forward direction was less than the slope of the regression line of load-angle for the loads in the backward direction, with statistical difference (F=31.413, P < 0.001). After the ligaments were cut, when the loads were 2, 4, 6, 8 and 10 N in the forward direction in group A and group B, the backward angulation of joint in group A was less than that in group B (P < 0.05). The slope of the load-angled regression line in group A was less than that in group B (F=52.224, P <0.001). When the loads in the backward direction in group A and group B were 2, 4, 6, 8 and 10 N, the forward angulation of joint in group A was greater than that in group B (P < 0.05), and the slope of the load-angled regression line in group A was greater than that in group B (F=12.503, P=0.008). (4) These results suggest that contact area between the articular surface of the medial clavicle and the articular surface of the manubrium is narrow, which determines the instability of the joint itself. The sternoclavicular ligament is extremely important for maintaining the joint stability. The forward angulation of joint restriction effect of sternoclavicular ligament was weaker than that of the backward angulation, also because of the joint in the anatomical position of the natural forward angulation, so the sternoclavicular joint was prone to anterior dislocation. It is necessary to pay attention to the repair and reconstruction of sternoclavicular ligament when sternoclavicular joint dislocation or peripheral fractures are treated by operations.

This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy.The study was carried out from April 2014 to December 2015,during which 70 patients with complete previa and 113 with incomplete previa between 20+0 weeks and 25+6 weeks of gestation were included.Maternal demographics and pregnancy outcomes were compared between the two groups.Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test.Resolution ofprevia occurred in 87.43％ of the studied women.The mean gestational age at resolution was 32.1±4.4 weeks.Incidence of maternal age ≥35 years and incidence of prior uterine operation ＞3 were high in women with complete previa (28.6％vs.8.8％,P=0.003;28.6％ vs.8.8％,P=0.003).Resolution of previa occurred less often in complete previa group (74.3％ vs.95.6％,P=0.001).Women with complete previa admitted earlier (37.3±2.0 weeks vs.38.1±1.4 weeks,P=0.011) and delivered earlier (37.7±1.2weeks vs.38.3±1.4 weeks,P=0.025).Maternal age ≥35 years and prior uterine operation ＞3 increase the risk of complete previa in mid-pregnancy.Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in midpregnancy.What is more,women with complete previa in mid-pregnancy deliversearlier.

The gut microbiota of intensive care unit (ICU) patients displays extreme dysbiosis asso-ciated with increased susceptibility to organ failure, sepsis, and septic shock. However, such dysbio-sis is difficult to characterize owing to the high dimensional complexity of the gut microbiota. We tested whether the concept of enterotype can be applied to the gut microbiota of ICU patients to describe the dysbiosis. We collected 131 fecal samples from 64 ICU patients diagnosed with sepsis or septic shock and performed 16S rRNA gene sequencing to dissect their gut microbiota compo-sitions. During the development of sepsis or septic shock and during various medical treatments, the ICU patients always exhibited two dysbiotic microbiota patterns, or ICU-enterotypes, which could not be explained by host properties such as age, sex, and body mass index, or external stressors such as infection site and antibiotic use. ICU-enterotype I (ICU E1) comprised predominantly Bac-teroides and an unclassified genus of Enterobacteriaceae, while ICU-enterotype Ⅱ(ICU E2) com-prised predominantly Enterococcus. Among more critically ill patients with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores > 18, septic shock was more likely to occur with ICU E1 (P = 0.041). Additionally, ICU E1 was correlated with high serum lactate levels (P = 0.007). Therefore, different patterns of dysbiosis were correlated with different clinicaloutcomes, suggesting that ICU-enterotypes should be diagnosed as independent clinical indices. Thus, the microbial-based human index classifier we propose is precise and effective for timely mon-itoring of ICU-enterotypes of individual patients. This work is a first step toward precision medicine for septic patients based on their gut microbiota profiles.