Objective To investigate the effects of nuciferine on hyperlipidemia in mice and to clarify the molecular mechanism. Methods Mice were divided into three groups according to the diet: normal control group ( n=10 ) , model control group (n=10), and the intervention group (n=10). The normal control group was treated with common diet (ANI-76A feed:12. 4% fat, 68. 8% carbohydrate, 18. 8% protein). The model control group was induced with high fat diet (37. 1% fat, 42. 4% carbohydrate, 20. 5% protein). The intervention group was supplemented with 0. 5% nuciferine based on high fat diet. The mice were allowed free access to food and water for a total of 10 weeks. Several indices were analyzed in the 3 groups, including the body weight, serum lipid, lipid metabolism key enzyme, oxidative stress and metabolic pathway. Results Our results suggested that the high-fat diet-induced animal models developed obesity and dyslipidemia (P<0. 05). The body weight [(33.97±3.46) g vs. (27. 62±2. 87) g] and the serum lipid[(2. 73±0. 26) g vs. (1. 91±0. 21) g] were significantly decreased in the intervention group compared to the model control group (P<0. 05), except for the hypertriglyceridemia (P>0.05).Theactivityofhepaticlipidmetabolismkeyenzymes[(4.15±1.26) U·mL-1vs.(9.01±1.34) U·mL-1] andthe activity of hepatic lipase and lipoprotein lipase[(8.12±3.07) U·mL-1 vs.(13.48±3.75) U·mL-1] were elevated.Oxidative stress was also affected by nuciferine (P<0. 05). Mechanism study suggested that lipid synthesis genes (like SREBP-1c, FAS, SCD-1 and PPAR gamma mRNA) were up-regulated by high fat diet (P<0. 05), and the lipid oxidation metabolism genes, PPARαand CPT-1a mRNA, were down-regulated (P<0. 05), while the intervention group treatment reversed these changes (P<0. 05). Conclusion Nuciferine can improve hyperlipidemia, which might be related to the regulation of enzyme activity, oxidative stress and the changes of lipid synthesis and oxidative metabolism.

OBJECTIVE To study the distribution of pathogens and their antibiotic resistance in systemic lupus erythematosus(SLE)patients with gram-negative bacterial infections,for guiding the rational use of antibiotics therapy.METHODS The identification was analyzed by ATB Expression automatic microbiology analytical instrument system.The bacterial susceptibility test was done by Kirby-Bauer agar diffusion method.RESULTS Among 346 patients included,112(32.4%)had bacterial infections.A total of 181 pathogens strains had been isolated.Among 181 isolates,Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,Proteus mirabilis,and Enterobacter cloacae were the main pathogens.The ESBLs producing rates in E.coli and K.pneumoniae were 27.5% and 28.1%.Piperacillin/tazobactam and cefepime had less activity against A.baumannii and low resistant to other Gram-negative bacilli(0-46.2% and 13.0-33.3%).Meropenem,imipenem and cefoperazone/sulbactam showed greater activity against Gram-negative bacilli,their resistant rates were 0-17.1%,0-22.9% and 0-38.5%,respectively.CONCLUSIONS The clinical features of SLE patients with bacterial infections are lack of specificity.The data will be useful for reasonably choosing antimicrobial agents in the treatment of SLE patients with bacterial infections.

Diabetic gastroparesis (DGP) is one of the most common complications of diabetes. Acupuncture is an ef-fective treatment for DGP in recent years. Literatures on acupuncture therapy for DGP treatment were screened for the past 10 years. Statistical analysis was made on acupoints used in the literatures in order to find the most com-monly used acupoints and combinations. This article was aimed to explore and summarize the use of the acupuncture law for the better service of clinical practice.

Objective To assess the role of helical CT in the long-term follow-up of patients with malignant hepatic tumors treated with RFA. Methods CT findings of patients with liver malignant tumors (29 hepatocellular carcinomas and 7 metastases) were reviewed retrospectively, who underwent percutaneous ultrasound-guided radiofrequency ablation (RFA). CT images consisted of nonenhanced and dual-phase contrast-enhanced helical CT scan, the effect of ablation therapy and tumor recurrence were detected. Results The major patterns of tumor residual or local recurrence were the lesions with thick rim or nodular peripheral enhancement in arterial phase or the lesions with gross enlargement on follow-up CT images. The complete necrosis lesions in 28 cases (77.8%) were seen on the initial postablation CT scans after a single session RFA. On the subsequent follow-up CT examination, the local intra-hepatic tumor recurrences were seen in 2 cases (5.6%) as well as the remote intra-hepatic tumor recurrences were seen in 4 cases (11.1%).Conclusion For certain patients with hepatic malignant tumors, RFA is an effective therapeutic method, and dual-phase contrast enhanced helical CT scans play a important role in long-term assessment and follow-up of patients.

Objective To investigate the effect of stress level on blood coagulation and fracture healing in fracture patients.Methods The clinical data of 50 fracture patients (fracture group) and 50 healthy volunteers (control group) were analyzed retrospectively.The oxidative stress indexes [superoxide dismutase (SOD) and malondialdehyde (MDA)] and blood coagulation indexes [plasma fibrinogen (Fib),activated partial thromboplastin time (APTT),thronbin time (TT),and prothrombin time (PT)] were compared between the 2 groups.Correlation between stress level and coagulation indexes in the fracture patients was analyzed by Spearman correlation coefficient.The correlation between stress level and the progress of fracture healing in fracture patients was analyzed.Results There were no significant differences in APTT,TT,PT or other blood coagulation indexes between the 2 groups (P ＞ 0.05).The fracture group had a significantly lower SOD level but significantly higher MDA and Fib levels than the control group (P ＜ 0.05).Spearman analysis showed that the SOD level was negatively correlated to the Fib level (P ＜ 0.05) while the MDA level was positively correlated to the Fib level in the fracture group (P ＜ 0.05).The MDA level was negatively correlated to the process of fracture healing (P ＜ 0.05) while the SOD level was positively correlated to the process of fracture healing in the fracture group (P ＜ 0.05).Conclusions Traumatic fracture can cause stress reaction.It should be kept in mind that the severity of stress reaction is closely related to the Fib level and the process of fracture healing.

Objective To identify the thromolysis rate in patients with ischemic ccrebrovascular disease in Qingdao area and to analyze the causes of influcncing thrombolytic therapy and investigate their influencing factors. Methods We adopted a unified questionnaire about the status of diagnosis and treatment of stroke in Qigndao. The patients with acute stroke in the 11 departments of neurology of Qingdao municipal and county hospitals (all with thrombolytic conditios) from October 1,2008 to October 31,2009 were collected retrospectively. A face to face questionnaire survey was performed, their clinical data were collected and the factors of influencing thrombolytic therapy were analyzed. Results Actually 864 patients with ischemic eerebrovascular disease were investigated. Only 10 patients received thrombolytic therapy. The thrombolysis rate was 1.16%, and the thrombolysis rate within a 4.5-hour time widow was 6. 33 %. Logistic regression analysis showed that in addition to thrombolytic contraindications,the factors that influencing thrombolytic therapy in patients with acute ischemic stroke included the treatment in different level-hospitals (OR =0.061,95% CI O. 006-0. 703, P =0. 040) and the United States National Institutes of Health Stroke Scale (NIHSS) score (OR = 0.810,95% CI 0. 729-0.900, P = 0.000) at presentation. Conclusions The thrombolysis rate in patients with cerebrovascular disease in Qingdao area was relatively lower. In addition to thrombolytic contraindications, the factors that influencing thrombolytic therapy in ptients with acute ischemic stroke included the treatment in different level-hospitals and NIHSS score at presentation.

Objective To evaluate the clinical application of embolization therapy using N-butyl 2-cyanoacrylate(NBCA)for hepatocellular carcinoma(HCC)complicated with arterio-portal fistula(APF).Methods Eighty patients with HCC and APF underwent embolothempy with NBCA(NBCA group,26 patients)or absolute alcohol(alcohol group,54 patients).The APF wag first treated with liquid embolic agent during the TACE procedure.We used NBCA-Lipiodol mixtures in concentration of 20%-50% according to tlle different circulation times of these APF in NBCA group,Absolute alcohol plus gelfoam or other materisis were used for embolization of APF in alcohol group.The pain reaction during the procedure,influence for liver function(X2 test).occlusive suceessfxil rate after single embolization(Fisher's exact test)and the survival rate of 1 year(log-rank analysis)between two groups were compared after the embolotherapy.Results Four patients in NBCA group and 52 patients in alcohol group felt painful during the pmcedures.There wag statistically significant difference between two groups(x2=58.86,P＜0.001).The APF disappeared after only sin~e embolization in 24(92.3%,24/26)cages of NBCA group and in 37(68.5%,37/54)patients of alcohol group.There wag also significant difference between two groups (P=0.024).There were no statistical ditierence in the post.embolization liver function change and 1 year survival rate between two groups.Conclusions The embolization therapy using NBCA for HCC complicated with APF is safe.effective and more accurate.It can be used as a new technique for these patients.

Objective Acute massive pulmonary embolism(PE)is a clinical emergency requiring rapid and supportive measures.With the development of interventional technology and devices,percutaneous mechanical thrombectomy(PMT)is considered to be an alternative for the treatment of PE,though there is still relative lack of clinical experience.The purpose of this study is to evaluate the clinical efficacy and safety of PMT in the management of acute massive PE.Methods The clinical data of massive PE patients treated with interventional methods were collected and analyzed in a retrospective way.From Jan.2003 to Jan.2008,6 patients(5 males and one female,with a mean age of 62 years)with acute massive PE,which was initially diagnosed by computed tomography and finally confirmed by pulmonary angiography,were treated with percutaneous catheter fragmentation and/or Straub Rotarex thrombectomy device.Results The improvement of clinical status and restoration of blood flow in the main branches of pulmonary artery were obtained in all patients.Oxygen saturation(SaO2)increased from preoperative(79.5±5.3)%to postoporative (92.8±3.4)%,with P＜0.01.Partial arterial oxygen pressure(PaO2)increased from preoperative(58.0±9.8)mmHg to postoperative(88.7±4.1)mmHg(P＜0.01).After PMT treatment,the mean pulmonary artery pressure(PAP)decreased from preoperative(40.8±7.8)mmHg to postoperative(29.8±8.0)mmHg (P＜0.01).Miller index decreased from preoperative 0.54±0.03 to postoperative 0.18±0.07(P＜0.01).During a clinical follow-up period ranged from 1 to 5 years,four patients showed no recurrence of PE,the other two patients lost touch with the authors.Conclusion The preliminary experience in onr series suggests that PMT is an easy,effective and safe therapy in the clinical management of acute massive PE,especially when thrombolysis is contraindicated.

Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.

Objective To investigate the effect of soluble endothclial protein C receptor(sEPCR) on natural killer(NK) cells and Th17 cells of epithelial ovarian cancer(EOC) patients and further to study the mechanism of the occurrence and development of epithelial ovarian cancer.Methods 35 cases with epithelial ovarian cancer were selected as the experimental group,and 35 healthy women were chosen as the control group.Peripheral venous blood sample(8 ml)was extracted from each subject.Plasma,serum and peripheral blood mononuclear cells(PBMCs) were obtained from the blood sample.ELISA was used to detect the level of plasma sEPCR and serum IL-17 and IL-21.Flow cytometry was used to detect proportions of NK cells and Th17 cells in PBMCs.Results Compared to the control group,the level of plasma sEPCR in the experimental group increased significantly(P ＜ 0.05).The level of serum IL-17,IL-21 and proportion of NK and Th17 cells in PBMCs significantly decreased(P ＜ 0.05).Correlation analysis showed that sEPCR was negatively correlated with IL-17,IL-21,Th17 cells and NK cells,and the correlation coefficient r was-0.71,-0.62,-0.68 and-0.79,respectively.Conclusion sEPCR in epithelial ovarian cancer patients possibly promotes the proliferation of tumor cells through inhibition of NK and Th17 cells.