Objective To analyze the cost-effectiveness of integrated pharmaceutical care (IPC) in community-based patients with chronic obstructive pulmonary disease (COPD).Methods The COPD patients were divided randomly into intervention group (group A,n =79) and control group (group B,n =71).Group A received the IPC intervention measures,including serial lectures of pharmaceutical knowledge,home supervision and web-based communications for while group B group had none.Results As compared with group B,group A obviously improved on the knowledge of pharmaceutical treatment effect and side effect (95.1％,67.4％ vs.63.1％,21.9％,x2 =12.445,P=0.000 vs.x2 =55.557,P=0.000).There were notable differences between two groups [ ( 1.77 ± 1.23 ) vs.( 2.42 ± 1.66 ) s,t =2.583,P=0.011],pulmonary rales [ (0.01 vs.0.01)s,Z =2.370,P=0.018],6-min walk distance (6 MWD) [ (457 ± 67 ) vs.(425 ± 72) m,t =2.760,P =0.007 ],vital capacity ( VC ) [ ( 1.60 ± 0.25 ) vs.( 1.49 ± 0.23 ) L,t =2.718,P =0.007 ) ] andquality-of-life items ( 48 ± 10 vs.52 ± 11,t =2.624,P =0.010) after intervention.Analyze of cost-effectiveness show that groupA was superior to group B [ total effect total cost(TE/TC =764.6/4936,15.49％ )vs.(TE/TC =1509.4/4708),32.06％,x2 =6.183,P ＜ 0.01 ].Conclusion IPC can improve the disease condition and achieve excellent cost-effectiveness for community-based COPD patients.

Drug reservation wag investigated in 2077 community residents.We found that most drugs were obtained from the hospitals(83.78%),kept at a relatively lower place(69.23%),packed in box(75.25%),and did not meet the storage requirement(72.60%).Half of the overdue drugs(median time,12 months)were used for internal treatment.This study suggests that there might be unsafe drug storage in communities.

OBJECTIVETo investigate the susceptibility gene of type 2 diabetes mellitus (T2DM) through a novel strategy.

METHODSFirstly, the common feature of the putative susceptibility genes in the reported susceptibility loci was searched by using NCBI BLAST, and a functional L1 retrotransposon in the loci was found. Secondly, the mRNA expression level of the functional L1 retrotransposon in 25 Han T2DM patients and 22 normal controls was investigated by reverse transcription-polymerase chain reaction, and statistical analysis was implemented in statistical package SPSS10.0. Thirdly, L1 retrotransponson genome mutation screening was performed via sequencing.

RESULTSScreening the human genome for the retrotransposon genome via alignment with the L1 genome using NCBI BLAST showed the functional L1 retrotransposons distribute on most chromosomes except for chromosomes 19, 21 and Y on which rare type 2 diabetes susceptibility loci were reported to reside, and their distribution sites are consistent with the locations of the reported candidate type 2 diabetes susceptibility loci. The mRNA expression level of the functional L1 retrotransposon in the T2DM patients was significantly lower than that in normal subjects (P<0.001). Nonsense mutations including deletion and/or point mutations were observed in all of the 6 T2DM patients tested, but no mutation was observed in all of the 4 normal controls tested.

CONCLUSIONThe functional L1 retrotransposon may be a candidate susceptibility gene of type 2 diabetes or a key regulator of the susceptibility genes, and it may be an ideal candidate biomarker for screening type 2 diabetes.

Adult ; Chromosomes, Human ; genetics ; Databases, Genetic ; Diabetes Mellitus, Type 2 ; genetics ; Genetic Predisposition to Disease ; genetics ; Genome, Human ; genetics ; Genotype ; Humans ; Polymerase Chain Reaction ; Retroelements ; genetics

OBJECTIVETo evaluate the effects of nasal continuous positive airway pressure (nCPAP) on serum leptin concentration and the metabolic parameters in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).

METHODSSerum leptin levels and true insulin (TI) levels were measured before and after one night nCPAP therapy in 18 patients. Eight patients received regular nCPAP treatment and had no change of body weight (BMI change < or = 1.5 kg/m2 from baseline) were recruited to the reassessment study 7.5 months after therapy.

RESULTSAfter one night use of nCPAP, there was a significant decrease in serum leptin [(8.47 +/- 0.62) microg/L vs (7.32 +/- 0.64) microg/L, P = 0.022] without change in other parameters. After 7.5 months of nCPAP treatment, serum leptin levels continued to decrease significantly without changes in BMI [(8.35 +/- 0.83) microg/L vs (6.05 +/- 0.78) microg/L; P = 0.036), and fast blood glucose (FBG) and true insulin (TI) also decreased significantly (P = 0.036) in OSAHS patients. However, triglyceral (TG) and cholesterol (Chol) maintained the pretreatment level (P > 0.05).

CONCLUSIONSOSAHS may have significant effects on the serum leptin levels and the correction of sleep disordered breathing by nCPAP can reduce the serum leptin levels. Decrease of leptin was independent of BMI change. The glucose metabolic disturbance and insulin resistance in OSAHS were improved after 7.5 months of nCPAP treatment.

Adult ; Continuous Positive Airway Pressure ; Female ; Humans ; Leptin ; blood ; Male ; Sleep Apnea, Obstructive ; blood ; therapy

Actins ; metabolism ; Animals ; Brain ; cytology ; metabolism ; Cell Culture Techniques ; methods ; Cells, Cultured ; Immunohistochemistry ; Pericytes ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Platelet-Derived Growth Factor beta ; metabolism ; Staining and Labeling

OBJECTIVETo perform an comparative proteome analysis of human papillomavirus-infected cervical specimens and to investigate different expressions between high- and low-risk genotypes.

METHODSThe cervical specimens were divided into two groups (cervical intraepithelial neoplasia group and condyloma acuminatum group) according to their genotypes. Using comparative proteome technology, high-risk human papillomavirus-infected cervical intraepithelial neoplasia, low-risk human papillomavirus-infected condyloma acuminatum, and normal cervical intraepithelial tissue were compared. The differential expression protein spots were identified by mass spectrometry.

RESULTSTotally 26 differential spots were selected and analyzed, and 22 peptide mass fingerprints (PMF) maps were obtained by MALDI-TOF-MS. Eighteen proteins were preliminarily identified after searching the NCBInr database. The function information of these 18 proteins mainly involved cell metabolism, signal transduction, cell secretion, cell cytoskeleton construction, cell proliferation, and apoptosis.

CONCLUSIONThe proteomic expressions after the cervical infection of high- or low-risk genotype of human papillomavirus are obviously different.

Cervical Intraepithelial Neoplasia ; metabolism ; virology ; Cervix Uteri ; metabolism ; Condylomata Acuminata ; metabolism ; virology ; Female ; Genotype ; Humans ; Papillomaviridae ; genetics ; pathogenicity ; Papillomavirus Infections ; metabolism ; virology ; Proteome ; metabolism ; Risk ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Uterine Cervical Diseases ; metabolism ; virology

BACKGROUNDThe production of neural stem cells (NSCs) derived from embryonic stem (ES) cells was usually very low according to previous studies, which was a major obstacle for meeting the needs of clinical application. This study aimed at investigating whether astrocytes could promote production of NSCs derived from ES cells in vitro.

METHODSMouse ES cells line-D3 was used to differentiate into NSCs with astrocytes as inducing stromal cells by means of three-stage differentiation procedure. Another group without astrocytes served as control. The totipotency of ES cells was identified by observation of cells' morphology and formation of teratoma in severe combined immunodeficiency disease (SCID) mice. The quantity and purity of NSCs derived from ES cells were analyzed using clonogenic assay, immunohistochemical staining and flow cytometry assay. The plasticity of NSCs was detected by differentiating test. Octamer-binding transcription factor 4 (Oct-4) and nestin, the specific marker genes of ES cells and NSCs respectively, were detected continuously using reverse transcription-polymerase chain reaction (RT-PCR) method to monitor the process of cell differentiation.

RESULTSThe ES cells of D3 line could maintain the ability of differentiating into cellular derivations of all three primary germ layers after continuous passage culture. At the end of two-stage of inducing process, 23.2 +/- 3.5 neurospheres per plate formed in astrocyte-induced group and only 0.8 +/- 0.3 per plate in the control group (clonogenic assay, P < 0.01), and the ratio of nestin positive cells was (50.2 +/- 2.8)% in astrocyte-induced group and only (1.4 +/- 0.5)% in the control group (flow cytometry, P < 0.01). With the induction undergoing, the expression of Oct-4 gradually decreased and then disappeared, while the expression of nestin was increased step by step, and the ratio of nestin positive cells was up to 91.4% by the three-stage differentiation. The nestin positive cells could be further induced into neurons, astrocytes, and oligodendrocytes in differentiating medium supplemented with fetal calf serum. The results of differentiating test showed that the ratio of NF-200 and NSE positive cells was (42.7 +/- 2.6)% in astrocyte-induced group and only (11.2 +/- 1.8)% in the control group (P < 0.01).

CONCLUSIONSAstrocytes can not only increase the production of NSCs derived from ES cells but also promote the differentiation of NSCs toward neuronal lineage.

Animals ; Astrocytes ; physiology ; Cell Differentiation ; Cell Lineage ; Cells, Cultured ; Embryo, Mammalian ; cytology ; Mice ; Neurons ; cytology ; Stem Cells ; cytology

OBJECTIVETo explore the effective therapy for maintenance hemodialysis patients in dificiency syndrome in end-stage renal disease.

METHODSNinety-seven cases were divided into an observation group (51 cases) and a control group (46 cases) randomly, and routine western medicine was used in both of them. On this base, moxibustion was used in Zusanli (ST 36) and Sanyinjiao (SP 6) in paper-tube-moxibustion equipment in the observation group. Evaluate the therapeutic effect on symptoms by comparing the symptom scores in two groups before and after treatment.

RESULTSAll the symptom scores in the observation group were improved after treatment, and the differences were significant (all P < 0.05). Among all symptoms, the most improved ones included lassitude and fatigue, short breath and aversion to talk, poor appetite, soreness and softness of waist and knees, aversion to cold, cold extremities and so on. In the aspect of therapeutic effect on symptoms, the total effective rate in observation group (64.7%, 33/51) was higher than that in control group (23.9%, 11/46), and the difference was significant (P < 0.05).

CONCLUSIONMoxibustion can improve the clinical symptoms of maintenance hemodialysis patients in end-stage renal disease, and can generate some therapeutic effect to the dificiency syndrome of this disease.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic ; therapy ; Male ; Middle Aged ; Moxibustion ; Renal Dialysis ; Young Adult

Objective To observe the absorption, excretion and retention of fluoride and aluminum after drinking brick tea in healthy adults. Methods The study was conducted in ten healthy volunteers by drinking brick tea solution in which the fluoride and aluminum concentrations were 5.97, 7.53 mg/L, respectively. The concentrations of fluoride and aluminum were determined in serum samples collected before and at 0.5,1.0,2.0,3.0,and 24.0 h, and in urine samples collected before and during the periods 1.0,2.0,4.0, ＞ 4.0 - ＜ 24.0 h and 24 h after drinking brick tea solution by ion-selective electrode, inductively coupled plasma atomic emission spectrometry (ICP-AES) and inductively coupled plasma atomic mess spectrometry. The total amounts of intake and excretion of fluoride and aluminum in healthy volunteers during 24.0 h were calculated from their corresponding fluoride and aluminum ingesting from brick tea and excreting from urine. Results Before and during the periods 1.0,2.0,4.0,＞ 4.0 - ＜ 24.0 h and 24.0 h after drinking brick tea solution, the urinary fluoride concentrations were (0.50 ±0.14), (2.14 ± 0.90), (1.57 ± 0.93), (2.43 ± 1.49), (1.91 ± 0.69), (0.58 ± 0.20)mg/L, respectively, and the aluminum concentrations in the urine samples were (0.35 ± 0.15), (0.65 ± 0.37), (0.50 ± 0.25), (0.52 ± 0.21 ),(0.50 ± 0.23), (0,46 ± 0.27)mg/L, respectively; the 24.0 h excreting rates of fluoride and aluminum from urine were 52.90%(4.64/8.77) and 12.38% (1.37/11.07), respectively. The fluoride concentrations in serum samples collected before and at 0.5,1.0,2.0,3.0,24.0 h after drinking brick tea solution were (0.06 ± 0.02), (0.14 ± 0.01 ), (0.21 ±0.04), (0.17 ± 0.04), (0.10 ± 0.03), (0.04 ± 0.01 )mg/L, respectively, and aluminum in those were (0.30 ± 0.05),(0.27 ± 0.01 ), (0.30 ± 0.12), (0.34 ± 0.19), (0.30 ± 0.10), (0.27 ± 0.09)mg/L, respectively. Conclusions Fluoride in brick tea is easyly to be absorbed and excreted through kidney, and the kidney excretory capacity of aluminum in brick tea is limited. Levels of fluoride and aluminum in urine could be taken as the indicators for monitoring the prevalent extent and evaluating preventive experiment's effect on the brick tea fluoride-aluminum toxicity; and fasting serum fluoride and aluminum levels could be taken as indicators for estimating the toxic condition of the brick tea fluoride-aluminum toxicity.

OBJECTIVETo evaluate the method and effectiveness of rigid-bronchoscopic cryosurgery for advanced central lung cancer.

METHODSForty-eight patients were enrolled in this study from June 2002 to December 2008, including 33 male and 15 female. The average age was 70 years (ranged from 45 to 83 years old). For the 48 patients, 38 cases were patients with advanced central lung cancer who were not suitable for surgery, and the remaining 10 cases were patients with local recurrence in trachea or main bronchus postoperatively. Cryosurgery was performed 120 times for all patients, 2.5 times per patient on average. The trachea or bronchus station, symptom such as dyspnea, hemoptysis, respiratory function and quality of life were observed.

RESULTSThe unblocked ratio of trachea and bronchi was 97%. All patients got satisfied improvement ratio of symptoms, 87.5% for dyspnea, 72.9% for cough, 93.8% for hemoptysis and 62.5% for chest pain. Respiratory function tests showed that both the mean forced expiratory volume in first second and forced vital capacity got an improvement from (1.03+/-0.05) L to (1.85+/-0.13) L and from (1.69+/-0.18) L to (2.96+/-0.14) L respectively (P<0.01). Karnofsky score also got no less than 20 scores improvement. The Follow-up time was 6 to 62 months. The longest survival was 62 months. The median survival time was 20 months. There was no severe perioperative complications and mortality except for 3 cases of moderate exeduation.

CONCLUSIONSCryosurgery is easy to perform with minimal complications. Not only could it provide an effective and rapid control of symptoms caused by central lung cancer, it could also unobstructed bronchus promptly and improve patients' quality of life.

Aged ; Aged, 80 and over ; Bronchoscopy ; Cryosurgery ; methods ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome