Objective To evaluate a model of management for chronic pain disease coordinated community health services and district hospital. Methods The epidemiology of chronic pain disease was surveyed in Haotao community of Zhongshan, before and after the establishment of the model of management. Results The prevalence rate of chronic pain disease was 51.83%, in which it was 47.06% in men, and 57.32% in women. After the establishment of the model, the efficacy of good to excellent improved from 30.22% to 67.08%, the cost for medicine reduced 36.16%, time for rest reduced from 32.42 d to 15.25 d (P<0.05). Conclusion The model of management that coordinated community health services and district hospital, including demonstration diagnosis and treatment through internet, tele-consultations and health education, is effective on chronic pain disease.

Clinical guideline is of important significance to standardize clinical practice. Clinical guideline of evidence-based medicine puts stress on the classification and evaluation of evidences, especially in randomy controlled trial and gives recommendation based on the different grades and intensities of evidences. Since Chinese medicine has its own theoretical system in diagnosis and treatment, and the integrative Western and Chinese medicine (ICWM) is characterized by complicated intervention, making up a clinical guideline for Chinese medicine or ICWM based on the evidence obtained from modern medical research is apparently not so suitable. In this paper, the authors offered to develop a practice-based ICWM clinical guideline, which could be used in complementation with the evidence-based medical clinical guideline, and have a discussion on our preliminary research, looking forward to provide a new thinking path for constructing clinical guideline for Chinese medicine, ICWM and modern medicine.
China ; Data Collection ; Evidence-Based Medicine ; Humans ; Integrative Medicine ; standards ; Medicine, Chinese Traditional ; standards ; Practice Guidelines as Topic

Pathological cardiac hypertrophy is a maladaptive response in a variety of organic heart disease(OHD),which is characterized by mitochondrial dysfunction that results from disturbed energy metabolism. SIRT3, a mitochondria-localized sirtuin, regulates global mitochondrial lysine acetylation and preserves mitochondrial function. However, the mechanisms by which SIRT3 regulates cardiac hypertrophy remains to be further elucidated. In this study, we firstly demonstrated that expression of SIRT3 was decreased in AngiotensionⅡ(AngⅡ)-treated cardiomyocytes and in hearts of AngⅡ-induced cardiac hypertrophic mice. In addition, SIRT3 overexpression protected myocytes from hypertrophy, whereas SIRT3 silencing exacerbated Ang II-induced cardiomyocyte hypertrophy.In particular,SIRT3-KO mice exhibited significant cardiac hypertrophy. Mechanistically, we identified NMNAT3 (nicotinamide mononucleotide adenylyltransferase 3), the rate-limiting enzyme for mitochondrial NAD biosynthesis, as a new target and binding partner of SIRT3.Specifically,SIRT3 physically interacts with and deacety-lates NMNAT3,thereby enhancing the enzyme activity of NMNAT3 and contributing to SIRT3-mediated anti-hypertrophic effects.Moreover,NMNAT3 regulates the activity of SIRT3 via synthesis of mitochon-dria NAD.Taken together,these findings provide mechanistic insights into the negative regulatory role of SIRT3 in cardiac hypertrophy.Sirtuin 3(SIRT3),a mitochondrial deacetylase that may play an impor-tant role in regulating cardiac function and a potential target for CHF

In the first part of the paper, the main achievements and experience of disease control and prevention in China during last 50 years are described. Infectious diseases and parasitosis have been successfully controlled and prevented and people's health enhanced owing to the establishment of an effective system of public health, the launch of a campaign called "Patriotic Public Health", immunization planning, and the improvement of economic and environmental conditions. In the second part, the challenges to public health in China are presented. The threat from old and emerging infectious diseases, especially sexually transmitted diseases, a sustained increase in the prevalence of chronic non-infectious diseases (cardiovascular diseases tumors and diseases of the respiratory system), environmental problems and the health problems of aging are discussed. Finally, strategies for disease control and prevention in the new century is suggested.

OBJECTIVE: To establish an inductively coupled plasma mass spectrometry (ICP-MS) method for determination of Hg in biological samples. METHODS: The samples were digested with microwave digestion instrument. ICP-MS was applied to detect Hg in blood, urine and hair specimens by using 115In as an internal marker. The ability of gold to eliminate the memory effect of mercury was investigated with the gold amalgamate produced by gold and mercury. RESULTS: The limits of detection were in the 0.01 microg/L, and the accuracy of the method ranged from 97.0% to 107.1%. The concentration of gold was 10 microg/L and the memory effect of mercury was resolved. CONCLUSION The method is accurate, rapid, sensitive and suitable for the cases of mercury poisoning and the clinical diagnosis and monitoring for patients with mercury poisoning.
Forensic Toxicology ; Hair/chemistry* ; Humans ; Indicators and Reagents ; Mass Spectrometry/methods* ; Mercury/urine* ; Mercury Poisoning/diagnosis* ; Microwaves ; Reference Standards ; Reproducibility of Results ; Sensitivity and Specificity ; Specimen Handling/methods*

OBJECTIVETo evaluate the efficacy of iloprost in acute vasodilatation test during cardiac catheterization and to explore a useful hemodynamic indication regarding operability in the patients with severe pulmonary hypertension (PH) related to congenital heart disease (CHD).

METHODSThe clinical data of 46 patients [mean age (12 ± 9) years] with severe PH related to CHD from June 2006 to December 2008 was retrospectively analyzed. All patients underwent standard right and left cardiac catheterization and a trial of inhaled iloprost test during cardiac catheterization. The mean pulmonary arterial pressure was (80 ± 13) mm Hg (1 mm Hg = 0.133 kPa) and pulmonary vascular resistance index was (17 ± 10) wood.m². A positive response to inhaled iloprost was defined as a decrease of at least 20% in pulmonary vascular resistance index (PVRI) without changes on systemic artery pressure. Patients with positive response to iloprost underwent cardiac surgical repair. The pulmonary artery pressure and PVRI was monitored by Swan-Ganz catheter postoperatively.

RESULTSOf the 46 patients, 29 (63.1%) showed a positive response after iloprost inhalation, defined by a significant reduction in PVRI from (15 ± 6) wood.m(2) at baseline to (9 ± 4) wood.m² in response to iloprost inhalation therapy (P < 0.05). The ratio of pulmonary to systemic resistance (Rp/Rs) decreased from 0.7 ± 0.2 to 0.4 ± 0.2 (P < 0.05). Seventeen patients (36.9%) didn't respond to iloprost displayed only little changes in PVRI [from (21 ± 10) wood.m(2) to (19 ± 9) wood.m²] and Rp/Rs (from 1.0 ± 0.5 to 0.9 ± 0.5). Out of 29 positive patients, 21 (72%) underwent successful cardiac surgical repair with a reduction of mean pulmonary arterial pressure (mPAP) to an average of (27 ± 10) mm Hg after the operation. Only 2 patients out of the 17 patients from the negative group were referred to surgery. Their mPAP was greater than 45 mm Hg.

CONCLUSIONSA significant reduction in pulmonary artery pressure after cardiac surgery was observed in patients with positive response to inhaled iloprost. Inhaled iloprost may be a valuable tool in the preoperative evaluation of patients with severe PH related to CHD.

Administration, Inhalation ; Adolescent ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; physiopathology ; surgery ; Hemodynamics ; drug effects ; Humans ; Hypertension, Pulmonary ; physiopathology ; surgery ; Iloprost ; pharmacology ; Infant ; Lung ; blood supply ; Male ; Preoperative Care ; Retrospective Studies ; Vasodilator Agents ; pharmacology ; Young Adult

OBJECTIVETo study the relation between histopathologic grading and some of the cytogenetic and molecular biology characteristics of breast cancer.

METHODSOn the basis of estrogen receptor (ER) expression, DNA content, S-phase fraction (SPF), bcl-2 and mutant p53 protein (mtp53) expression were examined by FCM in 121 breast cancer patients. In 66 patients with invasive ductal breast cancer, histopathologic grading was also examined.

RESULTSThe aneuploidy rate and DNA index (DI) were significantly different in grade I, II and III breast cancer. SPF and mtp53 expression significantly increased with increase in histopathologic grading (P < 0.05), but bcl-2 did not show this trend. SPF and mtp53 expression were significantly more in breast cancer with negative ER than in those with positive ER (P < 0.05). Again, no such differences in bcl-2 regardless of ER expression. Correlations existed between DI vs SPF, DI vs mtp53, and SPF vs mtp53 expressions (P < 0.01) but bcl-2 did not correlate with any one of them.

CONCLUSIONCytogenetic and molecular biology studies on the basis of histopathologic grading may provide more information in prognostic prediction of breast cancer.

Adolescent ; Adult ; Aneuploidy ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; DNA, Neoplasm ; analysis ; Female ; Flow Cytometry ; Humans ; Middle Aged ; Mutation ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Receptors, Estrogen ; biosynthesis ; genetics ; S Phase ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics

OBJECTIVECytokines such as VEGF and IGF play an important role in maintaining the function of blood vascular endothelium. And Akt1 is an important molecule in the intra-cellular signaling transduction. This study aims to investigate the molecular mechanism of Shugan Yiyang (SGYY) capsule in the treatment of arteriogenic erectile dysfunction (AED) by detecting the expressions and phosphorylation of VEGF, IGF and Akt1 in AED rats.

METHODSWe established AED models in 60 three-month-old adult male SD rats by bilateral ligation of the internal iliac artery, and assigned them to a sham operation group, a model control group, a sildenafil group, a low-dose SGYY group (0.5 g/[kg x d]) and a high-dose SGYY group (1 g/[kg x d]). After 30 days of gavage, we assayed the plasma concentrations of VEGF and IGF in the carotid artery of the rats by ELISA, detected the expressions of VEGF and IGF mRNA by real-time PCR and determined the expression and phosphorylation of Aktl protein in the corpus cavernosum penis by Western blot.

RESULTSIn the model control group, the expressions of VEGF and IGF mRNA were 0.41 +/- 0.06 and 0.42 +/- 0.06, the plasma concentrations of VEGF and IGF were (28.59 +/- 24.97) pg/ml and (15.82 +/- 4.37) ng/ml, and the expression of p-Aktl/Akt1 was 0.93 +/- 0.14. While in the high-dose SGYY group, the expressions of VEGF and IGF mRNA were 0.77 +/- 0.04 and 0.78 +/- 0.05, the plasma concentrations of VEGF and IGF were (95.83 +/- 37.34) pg/ml and (20.45 +/- 3.83) ng/ml, and the expression of p-Aktl/Aktl was 1.43 +/- 0.50. All the parameters above were significantly higher in the high-dose SGYY than in the model control group (P < 0.05), and so were they in the low-dose SGYY group except the plasma concentration of IGF (P < 0.05).

CONCLUSIONSGYY can significantly upregulate the expressions of VEGF, IGF and Akt1 in the corpus cavernosum penis of AED rats, and improve the function of blood vascular endothelium, which is probably an important mechanism of SGYY capsule acting on AED.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Erectile Dysfunction ; drug therapy ; etiology ; metabolism ; Insulin-Like Growth Factor I ; metabolism ; Male ; Phytotherapy ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Rats, Sprague-Dawley ; Somatomedins ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

AIMTo identify the factors influencing diagnosis and treatment of chronic prostatitis (CP) among Chinese urologists.

METHODSA sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP.

RESULTSA total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP (odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650-3.923; P < 0.001) was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital (OR, 2.799; 95% CI, 1.719-4.559; P < 0.001) and the routine use of the 4- or the 2-glass test (OR, 3.194; 95% CI, 2.069-4.931; P < 0.001) were determined to be significant factors influencing the use of the National Institutes of Health (NIH) new classification system. According to the same model, belief of bacterial infection in the etiology of CP (OR, 3.415; 95% CI, 2.024-5.762; P < 0.001) and the routine use of bacterial culture test (OR, 2.261; 95% CI, 1.364-3.749; P < 0.01) were important factors influencing the routine prescription of antibiotics.

CONCLUSIONOur findings suggest that attitudes towards CP, and the characteristics of individual urologists' practices may influence the diagnosis and treatment of CP among Chinese urologists.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; China ; Chronic Disease ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Practice Patterns, Physicians' ; Prostatitis ; diagnosis ; drug therapy ; microbiology ; Surveys and Questionnaires

OBJECTIVETo discuss the diagnosis and treatment of the crush syndrome in the earthquake.

METHODSThirty-five patients with crush syndrome caused by earthquake were involved the retrospective study. The role of nutritional support, active wound treatment and hemodialysis on the patients' recovery was observed.

RESULTSThe function of the heart and kidneys were gradually improved by the planned removal of the necrotic tissue, which laid a foundation for the further repair of the wound.

CONCLUSIONThe removal of necrotic tissue, which can decrease the toxic absorption, will improve the success rate for treatment of the crush syndrome patients when being assisted with the hemodialysis.

Adolescent ; Adult ; Aged ; China ; Crush Syndrome ; complications ; physiopathology ; surgery ; therapy ; Disasters ; statistics & numerical data ; Earthquakes ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis ; Retrospective Studies