[Diagnosis and treatment of testicular and epididymal diseases in Tibetan area].

OBJECTIVE: To explore the clinical types, prevention and treatment of testicular and epididymal diseases in the Tibetan area. METHODS: We retrospectively analyzed the clinical data of 105 cases of testicular or epididymal diseases treated in our department from 2007 to 2009. All the patients were permanent inhabitants in Tibet. RESULTS: Among the 105 patients, the main types of testicular and epididymal diseases were tuberculosis (27 cases) and tumor (21 cases). And 99% of the patients were Tibetan farmers and herdsmen. CONCLUSION: Tibetan farmers and herdsmen have a poor knowledge about testicular and epididymal diseases and their prevention and treatment. Clinicians and related institutions need to strengthen health education on these diseases in Tibetan area to improve the early awareness, early diagnosis, early prevention and early treatment of testicular and epididymal diseases.

[Treatment of critically ill influenza A H1N1 patients in plateau region].

OBJECTIVE: To discuss the strategy of treatment of critically ill influenza A H1N1 patients in plateau region. METHODS: Four seriously ill and 4 critically ill patients suffering from influenza A H1N1 were admitted to the intensive care unit during October 10th through December 19th 2009. They were treated with antivirus drug, antibiotics, corticosteroid, measures to enhance immune function, fluid and electrolyte supplementation, symptomatic treatment, and mechanical ventilation. With their clinical data the distinguishing features in the treatment of these patients were analyzed. RESULTS: Oseltamivir as an antivirus drug, and moxifloxacin together with ceftriaxone or cefoperazone were given to all the patients. Fluid replacement was controlled to avoid over hydration. Corticosteroid was administered to 3 seriously ill patients and 3 critically ill patients. Methylprednisolone was given to 1 critically ill patient. gamma-globulin was given to 7 patients. Four patients underwent atraumatic mechanical ventilation with bi-level positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP) with good result. Owing to deterioration in respiratory function, traumatic mechanical ventilation was instituted in a critically ill patient, primarily with synchronized intermittent mandatory ventilation (SIMV)+pressure support ventilation (PSV)+high positive end expiratory pressure (PEEP). The condition of the patient was improved, and ventilation modality was changed to spontaneous respiration+PSV+low PEEP before weaning. Finally the patient was weaned from respirator successfully. All the 8 patients survived and discharged from the hospital. CONCLUSION: Short term, full dosage of corticosteroid should be given to seriously ill and critically ill influenza A H1N1 patients according to specification, and atraumatic mechanical ventilation should be installed early in the treatment.

Protective effect and mechanism of Qiwei Tiexie capsule on 3T3-L1 adipocytes cells and rats with nonalcoholic fatty liver disease by regulating LXRα, PPARγ, and NF-κB-iNOS-NO signaling pathways.

ETHNOPHARMACOLOGICAL RELEVANCE: Qiwei Tiexie capsule (QWTX) is a representative prescription of Tibetan medicine, which is widely used for long-term treatment of chronic liver disease and nonalcoholic fatty liver disease (NAFLD). AIM OF THE STUDY: This study explored the effects and mechanism of QWTX on 3T3-L1 adipocytes and NAFLD. MATERIALS AND METHODS: The 3T3-L1 preadipocytes and NAFLD rat model were used in the study. In 3T3-L1 cells, the cytotoxicity of QWTX was tested by CKK-8, and glucose uptake and fat acid oxidation were assessed by 2-deoxy-D-[3H] glucose and [1-14C] palmitic acid, respectively. The expression levels of carnitine palmitoyltransferase-1 (CPT-1), liver X receptor α (LXRα), peroxisome proliferator-activated receptor (PPAR) γ, inducible nitric oxide synthase (iNOS), ikappa B α (IκBα), and AKT were determined by PCR and western blot. NAFLD was established by the administration of fat emulsion and sucrose for 9 weeks. The effects of QWTX on lipid metabolism, liver function, and hepatic morphology were observed in NAFLD rats by HE and transmission electron microscope. Serum level of nitric oxide (NO) and fee fatty acid (FFA), superoxide dismutase (SOD) and malondialdehyde (MDA) contents in the liver, as well as the expression levels of Cytochrome P450 2E1 (CYP2E1), NF-κB, monocyte chemoattractant protein 1 (MCP-1), CPT-1, LXRα, PPARα, PPARß/δ, PPARγ, and iNOS were all detected. RESULTS: QWTX showed no cell cytotoxicity in 3T3-L1 preadipocyte cells, and increased the 14CO2 production rate to 4.15, which indicated the reducing the fatty accumulation. In NAFLD, QWTX attenuated liver steatosis, fat vacuoles and inflammation from the HE staining and electron micrograph tests. For the oxidative stress biomarkers, serum FFA level was reduced and serum NO level was enhanced after QWTX treatment. In liver tissue, SOD was decreased and MDA was significantly increased in NAFLD, and both of them were restored by QWTX. NF-κB and CYP2E1 were also upregulated in NAFLD, while downregulated by QWTX. Downregulation of LXRα, PPARγ and iNOS by QWTX were both observed in the 3T3-L1 adipocytes and NAFLD model. CONCLUSIONS: QWTX protected the liver injury in differentiated 3T3-L1 adipocytes and NAFLD by regulating the LXRα, PPARγ, and NF-κB-iNOS-NO signal pathways.