Objective To evaluate the pharmacokinetic characteristics and safety of single and multiple oral azvudine tablets in healthy young and elderly Chinese subjects.Methods This was a open-label and parallel-group study.The trial consisted of two groups:healthy young subjects group and healthy elderly subjects group,with 12 subjects in each group.Enrolled subjects were first given a single dose,fasting oral azvudine tablet 5 mg,after a 3-day cleansing period entered the multiple dose phase,fasting oral azvudine tablet 5 mg·d-1 for 7 days.Results After a single dose of azvudine 5 mg,Cmax and AUC0-∞ were(4.76±2.12)ng·mL-1,(6.53±2.20)ng·mL-1·h,and Tmax,t1/2 were 0.75,1.87 h in young subjects;Cmax and AUC0-∞ were(6.40±3.25)ng·mL-1,(9.50±3.70)ng·mL-1·h,and Tmax,t1/2 were 0.63,2.66 h in elderly subjects.After a multiple dose of azvudine 5 mg·d-1 for 7 d,Cmax and AUC0-∞ were(3.26±1.61)ng·mL-1,(5.38±2.19)ng·mL-1·h,and Tmax,ss,t1/2,ss were 0.88,2.13 h in young subjects;Cmax,ss and AUC0-∞,ss were(3.97±2.09)ng·mL-1,(6.71±3.26)ng·mL-1·h,and Tmax,ss,t1/2,ss were 0.75,2.56 h in elderly subjects.Elderly/young geometric mean ratios and 90％CIs were 128.37％(88.23％-186.76％),139.93％(105.42％-185.72％),140.03％(106.33％-184.41％)for azvudine Cmax,AUC0-t,AUC0-∞ after a single dose,and were 118.66％(80.83％-174.20％),118.41％(83.60％-167.69％),118.95％(84.78％-166.89％)for azvudine Cmax,AUC0-t,AUC0_∞ after a multiple dose of azvudine 5 mg·d-1 for 7 d.Conclusion After single and multiple oral administration of azvudine tablets,systemic exposure to azvudine was higher in healthy elderly subjects compared with healthy young subjects.After taking azvudine tablets,the types,severity and incidence of adverse events and adverse drug reactions in healthy elderly people were not significantly different from those in healthy young subjects.Azvudine was found to be safe and well tolerated in healthy elderly subjects.

OBJECTIVE: To understand the true perception and attitude of the healthcare workers(HCWs) on the workplace violence(WPV) in a secondary Grade A hospital.METHODS: A total of 27 HCWs in a secondary Grade A hospital were selected as study subjects using a typical sampling method. Semi-structured interviews were conducted to collect the information of their perception and attitude on the types and effects of WPV, as well as on the coping measures and the work stress. The characteristics of WPV in the hospital were analyzed. RESULTS: The interviewees believed that verbal abuse was the most common type of WPV received by HCWs. Nurses and female workers were the main victims of WPV. Horizontal violence among colleagues and sexual harassment should not be ignored. Common causes of violent incidents for patients and their family members against HCWs included the fees for treatment, doctor-patient communication, patients alcohol abuse and treatment outcomes not meeting patients′ expectation. About half of the interviewees said that WPV had serious impact on their mental health. The follow-up coping measures to violent incidents were mostly to reassurance to patients with unconditional apology from the HCWs. More than half of the interviewees considered that they had acceptable workload, while some interviewees considered their work to be stressful. The interviewees suggested that improving doctor-patient communication, hospital systems, and the professional knowledge of HCWs were the recommended means to prevents and control the WPV. CONCLUSION: The perception and attitude of HCWs on WPV in this hospital are relatively scattered. Considering the complex causes, the serious consequences, and difficult coping measures, the hospitals, HCWs and all sectors of society need to take comprehensive measures to prevent WPV towards HCWs.

Objective To investigate the effects of fibroblast growth factor 2 (FGF-2) combined with tanshinoneⅡA on differentiation of rat bone marrow mesenchymal stem cells (BMSCs) into cardiomyocyte-like cells. Methods BMSCs were isolated and cultured. The cultured cells were identified by flow cytometry, BMSCs were divided into experimental control group, FGF-2 group, tanshinoneⅡA group and the combined induction group. The activity and value of BMSCs were detected by MTT. The Real-time PCR method was used to detect BMSCs. Expression of early myocardial transcription factors GATA-4 and Nkx2. 5; Immunocytochemical staining for detection of connexin43(Cx43)and cardiac troponin-Ⅰ(cTnI); Immunofluorescence staining for detection of desmin and Tm; The expression of desmin and tropomyosin(Tm)was detected by Western blotting. Results The cell activity and proliferation after induction were good. The expression of GATA-4 and Nkx2. 5 in the induction group were stronger than that in the experimental control group, and the difference was statistically significant (P<0. 05). The positive expression of Cx43 and cTnI in the induction group increased significantly. The markers of the combined group were the most obvious, and the difference was statistically significant (P<0. 05). The expression of Myo-specific protein desmin and Tm in the combined induction group increased significantly, and the difference was statistically significant (P<0. 05). Conclusion Both FGF-2 and tanshinoneⅡA can promote the proliferation of BMSCs and induce the differentiation of BMSCs into cardiomyocyte-like cells. The synergistic effect of the two is better than other groups.

As a new carrier of intercellular information, the exosomes is widely regarded as a natural drug carrier for its extensive distribution, non-immunity and targeting in human body. Chinese herbal drugs act at multiple targets and through different pathways in the prevention and treatment of diseases, but the preparation is relatively simple, there is a low solubility in the effective ingredients and low bioavailability, which limit the efficacy of the medicine. Using the new drug delivery approach of the exosomes, it is better to deliver the effective components to target cells. In this review, we reviewed the biological characteristics of exosomes and its application as a carrier of Chinese herbal drugs.

Cell Line, Tumor ; Enzyme Inhibitors ; pharmacology ; Heterocyclic Compounds, 1-Ring ; pharmacology ; Humans ; Proteasome Endopeptidase Complex ; drug effects

OBJECTIVETo investigate the indications, safety and efficacy of catheter directed thrombolysis for early left lower extremity deep venous thrombosis (DVT) without vena cava filters protection.

METHODSClinical data of 54 cases of early left lower extremity DVT received catheter directed thrombolysis without vena cava filters from July 2008 to June 2010 were retrospectively analyzed. The thrombosis was entire without free floating clots and no thrombosis in vena cava detected with ultrasound scan. Twenty-five patients were male and 29 were female with the average age of 52.8 years. Fifty-one of which were iliofemoral and popliteal, the other 3 were iliofemoral. The course were ≤ 7 d in 45 cases and these were 8 to 30 d in 9 cases. Urokinase of 300 000 U was infused through catheters per 2 h twice a day. Meanwhile 4000 U of low weight heparin was administered subcutaneously per 12 h, or heparin infusion at dosage of 18 U×kg(-1)×h(-1).

RESULTSThe procedure technically succeeded in all patients. In total cases venous score decreased to 4.6 ± 2.1 post 6 to 10 d of thrombolysis from 10.8 ± 1.0 with thrombolysis rate of 58% ± 18% which was not significantly different between groups of ≤ 7 d and 8 to 30 d (t = 1.02, P = 0.34). On 14(th) day, 11 patients (20.4%) completely recovered, 35 cases (64.8%) experienced large improvement, 8 patients (14.8%) had mild improvement and nobody was failed, resulting in total efficacy of 100%. No patient developed clinical symptomatic pulmonary embolism. SpO2 did not alter markedly post thrombolysis [(91.0 ± 2.6)% vs. (90.8 ± 2.4)%, t = 2.03, P = 0.05]. No patients suffered from cerebral hemorrhage and haemoturia, and catheter induced inflammation occurred in 4 cases (7.41%). There was mild bleeding in puncture sites in 11 patients (20.4%) during the course. There were 36 patients (66.7%) had been followed up with the time of 6 to 21 months. In which 31 cases had no lower extremity edema or had mild edema after activities. Two patients developed serious edema after activities for deep venous insufficiency. Three cases combined with malignant tumor or renal failure recurred.

CONCLUSIONSFor early left extremity DVT which is entire without free floating clots and no thrombosis in vena cava, catheter directed thrombolysis without filter protection maybe administered with safety, efficiency and lower expense.

Catheterization, Peripheral ; Female ; Fibrinolytic Agents ; administration & dosage ; therapeutic use ; Follow-Up Studies ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Pulmonary Embolism ; prevention & control ; Retrospective Studies ; Thrombolytic Therapy ; methods ; Urokinase-Type Plasminogen Activator ; administration & dosage ; therapeutic use ; Vena Cava Filters ; Venous Thrombosis ; complications ; therapy

BACKGROUNDAppropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.

METHODSA total of 22 029 and 8046 patients, who received medical care from a physician at an Olympic or Paralympic medical station, were included. The patient proportion among different personnel, various disease proportions at different kinds of venues, and the disease spectrum at specified venues at the Olympics and Paralympics were analyzed.

RESULTSAt both games, the patient proportion varied by accreditation status. The staff accounted for the largest number of visits at the Olympics (44.83%) and Paralympics (36.95%), with respiratory diseases the most common. Various disease spectrums were discovered at the different kinds of venues. Surgical diseases were the most frequently listed reason for visits, both at competition and non-competition venues, especially during the Paralympics. The sport-related injuries accounted for a majority of the surgical cases during both games. At training venues, ear nose and throat diseases accounted for the greatest number of visits during both games.

CONCLUSIONSDuring both games, people contracted different diseases at different venues. Adequate surgeons should be designated to offer assistance mostly in trauma situations. Appropriate numbers of physicians in respiratory diseases and otorhinolaryngology is of great importance.

Anniversaries and Special Events ; China ; Emergency Medical Services ; utilization ; Humans ; Population Surveillance ; Public Health ; statistics & numerical data ; Sports

OBJECTIVETo observe the expression pattern of bone morphogenetic protein receptor IA (BMPR IA) in rats after contusive spinal cord injury.

METHODSThe expressions of BMPR IA, IB, and II were detected by immunochemistry in the spinal cord of normal adult rats, and the expression of BMPR IA was detected in the infinite horizons impactor model at 1, 3, 7, 14, 30, and 60 days after spinal cord injury.

RESULTSIn the spinal cord of normal adult rats, BMPR IA and II were expressed predominantly in the oligodentrocytes and neurons in the grey matter, and also in some astrocytes and numerous microglia cells. Only a low level of BMPR IB expression was detected in the neurons of the grey matter. After spinal cord injury, the expression of BMP IA markedly increased with sustained strong expression in the astrocytes till one month after the injury; its expression was also increased obviously in the microglia cells activated by the injury.

CONCLUSIONThe expression of BMPR IA increases significantly in the astrocytes and activated microglia cells in rats after contusive spinal cord injury, suggesting the involvement of BMP signaling pathway in the physiological and pathological role of glia cells.

Animals ; Astrocytes ; metabolism ; Bone Morphogenetic Protein Receptors, Type I ; metabolism ; Female ; Microglia ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism

Objective To monitor the exercise load in daily life activities, a reliable method to estimate the real-time plantar pressure based only on a few sensors was presented. Methods Pedar-X pressure insoles were applied to collect plantar pressures from 10 healthy young adults performing 5 typical motions (vertical jump-landing, level walking, level running, stair ascending and stair descending). Stepwise linear regression was performed to reconstruct a mathematic model of calculating the foot force for each style of the motion based on 99 individual pressure data. Then these models were validated by comparing the plantar pressures measured by Pedar-X system and the estimated values by these models when other 4 subjects conducted the same 5 motions and the continuous motion composed of the 5 motions. Results Regardless of the single motion or continuous motion, the foot force calculated by each model for each motion, as well as that calculated by level walking model for each motion were almost the same as the data measured by Pedar-X system. In addition, there was no significant difference between the estimated values by each motion model and level walking model. Conclusions The foot force in daily life activities can be monitored effectively by level walking model with only 5 pressure sensors placed under T1, M2, M3, HM and HL region of the foot.

OBJECTIVE: To explore the relationship between best corrected visual acuity (BCVA) and refraction parameters in myopia. METHODS: Two thousand two hundred and seventy-four patients (4245 eyes) with different degrees of myopia were collected. Their BCVA, diopter of spherical (DS), diopter of cylinder (DC), astigmatism axis, axial length (AL) and corneal thickness were detected. The influence of those parameters on BCVA was studied and the mathematical model of the relationship between BCVA and other parameters including the age and gender of patients was established. RESULTS: The logistic regression analysis showed that there were correlations between the BCVA (y) and DS (x1), DC (x2), gender (x3), AL (x4), corneal thickness (x5), astigmatism axis (x6) and age (x7) (P<0.05): y=0.580 6-0.034 0 x1-0.046 8 x2+0.056 5 x3+0.016 5 x4+ 0.0007 x5+0.000 2 x6-0.005 8 x7. CONCLUSION For people with myopia, age, gender and corneal thickness have small effect on BCVA, while the DS, DC, AL and astigmatism axis have significant effect on BCVA. The BCVA would decline following the extension of DS, DC and AL. It is helpful to assess the vision of myopia by analyzing the refraction parameters comprehensively.
Adolescent ; Adult ; Child ; Cornea/pathology* ; Female ; Forensic Medicine/methods* ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Myopia/physiopathology* ; Refraction, Ocular/physiology* ; Refractometry ; Visual Acuity ; Visual Fields/physiology* ; Young Adult