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Aim To investigate the relationship between monocyte chemoattractant protein-1(MCP-1) and pulmonary artery hypertension after acute pulmonary thromboembolism(PTE), and to explore the effects and mechanisms of resveratrol with MCP-1 in the acute PTE as well.Methods The acute PTE model of Sprague-Dawley rats was replicated using self-thrombosis.The rats were randomly divided into five groups(Normal, Solvent, acute PTE, antibody Cl142, and resveratrol), and 1h, 4h, 8h and 3 points were observed in each group.A model of acute PTE was established by infusion of an autologous blood clot into the pulmonary artery through a polyethylene catheter.Resveratrol or Cl142, dissolved in 1％ dimethyl sulfoxide(DMSO), was administered to the animals through caudalvein 1 h prior to the beginning of acute PTE modeling.Rats in normal control group and solvent control group were injected with normal saline and 1％ DMSO respectively.The mean pulmonary artery pressure(MPAP) and the mRNA and protein expression of MCP-1 were measured at each time point.Results ① The acute PTE group MPAP, MCP-1 mRNA and protein expression were significantly higher than those of the control group(P<0.05) at the same time;② The resveratrol group′s MPAP and MCP-1 mRNA, protein expression were significantly lower than those of the acute PTE group(P<0.05) at the same time;③ The Cl142 group MPAP and MCP-1 mRNA, protein expression were markedly reduced in the acute PTE group(P<0.05) at the same time.Conclusions The large expression of MCP-1 after acute PTE is involved in the formation of pulmonary hypertension after acute PTE.Resveratrol can reduce the pressure of pulmonary artery after acute PTE by down-regulating the MCP-1 expression.
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The practice of catastrophic disease insurance in China is an important attempt to decentralize administration and build a service-oriented government.Under the developing model of governmental service purchase, an efficient supervision is the key part of ensuring and upgrading the effectiveness of catastrophic disease insurance system.Starting from theoretical analysis on the service outsourcing of the operating mechanism and its features, this paper discusses the legal attributes and supervision responsibilities of catastrophic disease insurance in China, and then explores the main problems of the current regulation system in view of regulatory responsibilities, supervisory subjects, as well as supervision contents, methods and means, etc.For these problems, it's urgent to re-draw a definite boundary of government responsibilities for the system, determine the supervisory subject as human resources and social security departments, and develop unified standards at provincial level for the bidding process.It's also necessary to establish a scientific performance evaluation system, promote multi-sector joint supervision among different government sectors involved, practice information sharing and means of digital regulation, in order to achieve efficient supervision of catastrophic disease insurance in China.
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@#To develop new synthetic process of ceftriaxone sodium, 7-amino-3-［(2, 5-dihydro-6-hydroxy-2-methyl-5-oxo-1, 2, 4-triazin-3-yl)thiomethyl］-3-cephem-4-carboxylic acid(7-ACT)was synthesized from 7-aminocephalosporanicacid(7-ACA)by reaction with 2, 5-dihydro-6-hydroxy-2-methyl-3-mercapto-5-oxo-1, 2, 4-triazine(TTZ)under the catalysis of BF3/C2H3N. Ceftriaxone was prepared from 7-ACT by condensation with 2-(2-amino-4-thiazolyl)-2-methoxyiminoacetic thiobenzothiazole ester(AE)using triethylamine as catalyst. After removing the by-product 2-mercaptobenzothiazole(M)through filtration, the filtrate was treated with sodium acetate to give ceftriaxone sodium. This improved process eliminates the working procedure for separating compound M from the mother liquor, and has the advantages of less solvent consumption and convenient operation, and has been successfully used in commercial production.
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Objective To investigate clinical effect of Danhong injection combined with edaravone in patients with idiopathic pulmonary fibrosis (IPF) and influence on TNF-αand TGF-β1 in serum.Methods 67 patients were randomly divided into Treatment Group (n=35) and Control Group (n=32) in Xuanwu hospital of Nanjing from March 2011 to December 2014.All the patients were treated by comprehensive conventional treatment, and then control group was treated by edaravone, treatment group were treated by Danhong injection on the basis of control group.The clinical efficiency, PaO2 , carbon monoxide diffusing capacity (Dlco) and the levels of inflammatory factors between two groups were compared.Results After treatment, the clinical total effective rate(97.14%) of treatment group was statistically higher than that of control group (75.00%, Z=-2.035,P=0.042).After treatment, partial pressure of oxygen(PaO2) and Dlco in treatment group were increased significantly(all P<0.05);and it was statistically higher then control group (all P<0.05).TNF-αand TGF-β1 in treatment group were decreased significantly (all P<0.05);and it was also statistically higher then control group (all P<0.05).Conclusion Danhong injection combined with edaravone is effective in treatment of IPF, which can significantly improve the pulmonary function and levels of inflammatory factors.
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Two systems which covered nearly 1. 1 billion people in China’s social health insurance, namely the New Rural Cooperative Medical Scheme ( NRCMS ) and the Urban Residents’ Health Insurance System ( URHIS ) , have been depended mainly on government support with high percentage of premium subsidies. This paper deals with the current situation and probes into the main subsidy policy problems by making an overall analysis on the policies of 31 cross-country provinces , and in result points out four problems including the long-term mechanism shortage, in-distinct responsibility between governments at different levels, the equity deficiency and the subsidies inefficiency. Finally, the paper concludes with enlightening some corresponding policies and suggestions.
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The rapid development of MOOC is both an opportunity and a challenge for the higher education in our country .The information literacy of college and university teachers plays an important role in the success implemen-tation of MOOC.The development and characteristics of MOOC were described, the problems existed in information literacy of college and university teachers under MOOC environment were analyzed with strategies put forward for improving the information literacy of college and university teachers from the aspects of ideological concept , training methods, assessment criteria, and information environment .
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The key policy for the Chinese governments to support the health insurance development has been to provide high percentage of premium subsidies in the 1 . 1 billion Yuan insured for the two of the basic medical insur-ance systems. According to the current policy, governments should share the responsibility of several hundreds of bil-lions Yuan of subsidies per year. However, because of the indistinct of the responsibility between governments at all levels and the shortage of systematic and long-term duty share mechanism, the current system has been directly affect-ing the fairer and more sustainable health insurance system development. Concerning these issues, this paper primari-ly thought about the contributory principle of subsides after analyzing the present situation and the main problems. Therefore, taking the three factors including disposable income per capita, consumption expenditure per capita and fi-nancial revenue per capita into account, it provides a“5 steps approach” about the contribution of the central govern-ment fiscal subsides using entropy evaluation method, and suggests a proposed program on the governments contribu-tion liability at the provincial or decentralized level based on the “fiscal subsides index”. Thoughts and conclusions drawn from this paper have a significant meaning into the establishment of a fairer and more sustainable financial sup-port mechanism for the basic medical insurance.
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Aim To study the role of TNF-α/NF-κB signaling in matrix metalloproteinase ( MMP)-9 expres-sion induced by lipopolysaccharide ( LPS ) in airway epithelial cells, and to investigate the effects of lenti-virus mediated RNAi targeting a disintegrin and metal-loproteinase 17 ( ADAM17 ) gene on MMP-9 expression induced by LPS. Methods The ADAM17 siRNA ex-pression vector was constructed, and packaged to re-combinant lentivirus in 293T cells. The HBE4-E6/E7 cells were pretreated for 30 min by NF-κB inhibitor ( PDTC) and a recombinant human TNFR p75-Fc fu-sion protein ( Etanercept) , or infected by the recombi-nant lentivirus for 72 h, and then stimulated for 24 h by LPS or TNF-α. The release of TNF-α was detected by ELISA. The mRNA and protein levels of MMP-9 were analyzed respectively by RT-PCR and Western blot. NF-κB activity was detected by electrophoretic mobility shift assay. Results LPS and TNF-α signifi-cantly increased MMP-9 mRNA and protein expressions and the activation of NF-κB in HBE4-E6/E7 cells ( P0. 05 ) . And PDTC significantly inhibited MMP-9 mRNA and protein expressions and the activation of NF-κB induced by TNF-α ( P <0. 05 ) . Conclusions TNF-α/NF-κB signaling partic-ipates in the regulation of MMP-9 expression induced by LPS in airway epithelial cells, and lentivirus-media-ted RNAi targeting ADAM17 plays an important role in that signaling pathway upstream by regulating TNF-αrelease.
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Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 (ALDH-1)in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma ( IMPC) of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified ( IDC-NOS) without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results ( 1 ) The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases (37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases)than in IDC-NOS group(21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases)(P<0.05).(2)Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC (P<0.05).(3)The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients(P=0.003).In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression (P<0.05).In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis ( P =0.005).Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance .
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Objective To investigate the expression and clinical significance of tumor-associated macrophages (TAMs) in invasive micropapillary carcinoma (IMPC) of breast.Methods Immunohistochemical streptavidin-biotin method(LSAB) method for CD68 and CD163 were performed on 68 cases of IMPC and 72 cases of invasive ductal carcinoma,not otherwise specified(IDC-NOS).Results CD68 and CD163 were mainly expressed in IMPC interstitial macrophages in the cytoplasm or on the membrane,and occasionally expressed in tumor nest.CD68 positive rate in tumor stroma in IMPC (47/68,69.1％) was higher than in IDC-NOS group (37/72,51.5％),and the difference between the two groups was statistically significant (P =0.022).CD163 positive rate in tumor stroma between the two groups was not statistically significant(P =0.682).CD68 + macrophages in IMPC stroma were positively correlated with pathological stage,histological grade,lymph node metastasis,vascular invasion,and Ki67 expression(P ＜ 0.05),and inversely correlated with the expression of ER(P =0.037).Univariate analysis showed that CD68 + macrophages in the stroma of IMPC were significantly associated with progression-free survival(P =0.027),Conclusion The expression of TAMs was different in different types of breast carcinoma and widely expressed in IMPC,which may play a significant role in high invasion and metastasis behavior of IMPC.
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AIM:To synthesize a safe , efficient and targeted nanoparticulate carrier for siRNA delivery to pan-creatic cancer cells .METHODS: Iron oxide nanocrystal with carboxylic acid group-polyethyleneimine ( IONP-PEI ) was synthesized and investigated as a nonviral carrier of siRNA to the pancreatic cells .The size, surface and charge using zeta potential were characterized .The perfect charge ratio between amino groups of IONP-PEI and phosphate groups of siRNA ( N/P) was determined by the transfection efficiency detection , gel retardation assay and MTS assay .An antibody-directed nonviral vector , scFvCD44v6-IONP-PEI nanoparticle attaching to the cancer-associated CD44v6 single-chain variable frag-ment, was constructed as a cancer-targeting nanocarrier for siRNA delivery .Prussian blue staining and immunofluorescent staining were performed to detect the distribution of scFv CD44v6-IONP-PEI/siRNA complexes in the cells .The transfection efficiency , fluorescence intensity and the expression of KRAS at mRNA and protein levels in the cells transfected by IONP -PEI/siRNA and scFv CD44v6-IONP-PEI/siRNA were detected by flow cytometry , fluorescence microscopy , real-time PCR and Western blotting, respectively.RESULTS:The mass ratio of IONP to PEI was 0.75.The suitable ratio of N/P was 20. The averaged size and surface zeta potential of IONP-PEI/siRNA in deionized water were (51.3 ±2.2)nm (diameter) and (21.73 ±8.07)mV, respectively.Red fluorescence was seen in both targeting and nontargeting groups , which clearly re-vealed the intracellular distribution of siRNA and delivery agents .Transfection efficiencies in targeting and nontargeting groups were (89.75 ±1.81)%and (59.87 ±4.52)%, respectively.Down-regulation of the KRAS mRNA in Panc-1 cells transfected with siKRAS by scFvCD44v6-IONP-PEI and IONP-PEI was up to (34.02 ±6.15)%and (51.09 ±6.70)%, re-spectively .The protein level of KRAS was lower in targeting group than that in nontargeting group .CONCLUSION:scFvCD44v6-IONP-PEI is a safe and efficient nanoparticulate carrier for gene delivery .It is more effective to transfer siRNA into the cells and mediate gene silencing effect in vitro than the nontargeting group .
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Objective To investigate the effect of bilevel positive airway pressure (BiPAP) ventilation on N terminal pro-brain natriuretic peptide (N proBNP) in patients with chronic pulmonary heart disease (CPHD) and hypercapnic respiratory failure.Methods Eighty patients with CPHD and hypercapnic respiratory failure were randomized into the conventional group (n=40) and BiPAP ventilation group (n=40).The COPD assessment test (CAT) score,APACHE Ⅱ score,arterial blood gas were measured and plasma level of N proBNP was detected by electrochemiluminescence immunoassay before and 120 h after treatment.The correlations of plasma N-proBNP levels with CAT scores,APACHE Ⅱ scores,levels of PaO2 and PaCO2 were analyzed.Results The plasma NT-proBNP level had positive correlations with PaCO2 level (r=0.539,P =0.003),CAT score (r＝0.506,P＝0.002,APACHEⅡ score (r=0.603,P=0.003),and had negative correlation with PaO2 level (r=-0.465,P=0.014) in the patients with CPHD and hypercapnic respiratory failure before treatment.Compared with pre-treatment,the scores of CAT and APACHE Ⅱ,the levels of PaO2 and PaCO2 were significantly improved 120 h after treatment.The improvements in APACHE Ⅱ,PaO2 and PaCO2 were more obviously significant in BiPAP ventilation group than in conventional group (t=5.55,5.92,4.12,respectively,P=0.002,0.001 and 0.000).The plasma levels of NT proBNP in both conventional and BiPAP ventilation groups were significantly descended 120 h after treatment than pre-treatment [(341.2±107.6) ng/L vs.(823.8±149.0) ng/L,(273.3±82.2) ng/L vs.(832.7± 163.0) ng/L,t=21.72,28.19,both P＜0.001],and the decrease of NT-proBNP level was more significantly in BiPAP ventilation group than in conventional group (t=4.17,P=0.002).Conclusions Plasma NT-proBNP level can reflect the severity of chronic pulmonary heart disease combined with hypercapnic respiratory failure.BiPAP ventilation can decrease the plasma level of NT proBNP in patients with CPHD and hypercapnic respiratory failure,which is an effective treatment for chronic pulmonary heart disease combined with hypercapnic respiratory failure.
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Objective To evaluate the value of magnetic resonance cholangiopancreatography(MRCP) in the diagnosis of biliary obstruction diseases by comparison with endoscopic retrograde cholangiopancreatography (ER-CP). Methods A total of 36 patients with biliary obstruction diseases underwent both MRCP and ERCP. To review the images obtained from ERCP and MRCP ,the diagnosis were compared according to pathology. MRCP and ERCP in the diagnosis and treatment of biliary obstruction disease were analysed. Results 36 patients including 16 biliary tumors, 15 cholelithiases,and five other diseases were analysed. The diagnosis accuracy of MRCP and ERCP for bil-iary obstruction diseases were 86.1% and 91.7 %, there was no significant difference( P > 0.05). Conclusion MR-CP can accurately define the obstructively sites, identify the obstructive causes and is a noninvasive and reliable exam-ination for biliary obstruction diseases.
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To study the effects of tumor necrosis factor (TNF)-alpha on matrix metalloproteinase (MMP)-9 expression and activity in alveolar macrophages (AM) and to investigate the role of NF-kappaB in the induction, AM were collected from bronchoalveolar lavage fluid (BALF) of healthy subjects and patients with chronic obstructive pulmonary disease (COPD). MMP-9 expression and activity were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR), Western blotting and zymography. NF-kappaB activity was detected by electrophoretic mobility shift assay (EMSA). MMP-9 expression and activity induced by TNF-alpha in AM from healthy subjects or patients with COPD were significantly increased in a dose-dependent manner (P<0.05). NF-kappaB activity induced by TNF-alpha was significantly increased in AM from patients with COPD, and pyrrolidine dithiocarbamate (PDTC) and N-acetyl-L-cysteine (NAC) significantly inhibited the activation of NF-kappaB induced by TNF-alpha (P<0.05). The presents study suggested that the expression and activity of MMP-9 from AM can be induced by TNF-alpha, and TNF-alpha/NF-kappaB signal pathway may play an important role in the induction.
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To study the effects of tumor necrosis factor (TNF)-α on matrix metalloproteinase (MMP)-9 expression and activity in alveolar macrophages (AM) and to investigate the role of NF-κB in the induction, AM were collected from bronchoalveolar lavage fluid (BALF) of healthy subjects and patients with chronic obstructive pulmonary disease (COPD). MMP-9 expression and activity were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR), Western blotting and zymography. NF-κB activity was detected by electrophoretic mobility shift assay (EMSA). MMP-9 expression and activity induced by TNF-α in AM from healthy subjects or patients with COPD were significantly increased in a dose-dependent manner (P＜0.05). NF-κB activity induced by TNF-α was significantly increased in AM from patients with COPD, and pyrrolidine dithiocarbamate (PDTC) and N-acetyl-L-cysteine (NAC) significantly inhibited the activation of NF-κB induced by TNF-α (P＜0.05). The presents study suggested that the expression and activity of MMP-9 from AM can be induced by TNF-α, and TNF-α/NF-κB signal pathway may play an important role in the induction.
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To investigate the relationship between intracellular free Ca2+ concentration ([Ca2+]i)and calcium-activated chloride (Clca) channels of pulmonary artery smooth muscle cells (PASMCs) in rats under acute and chronic hypoxic conditions, acute hypoxia-induced contraction was observed in rat pulmonary artery by using routine blood vascular perfusion in vitro. The fluorescence Ca2+indicator Fura-2/AM was used to observe [Ca2+]i of rat PASMCs under normal and chronic hypoxic condition. The effect of Clca channels on PASMCs proliferation was assessed by MTT assay.The Clca channel blockersniflumic acid (NFA) and indaryloxyacetic acid (IAA-94) exerted inhibitory effects on acute hypoxia-evoked contractions in the pulmonary artery. Under chronic hypoxic condition, [Ca2+ ]i was increased. Under normoxic condition, [Ca2+]i was (123.63±18.98) nmol/L, and in hypoxic condition, [Ca2+]i was (281. 75±16.48) nmol/L (P＜0.01). Under normoxic condition, [Ca2+]i showed no significant change and no effect on Clca channels was observed (P＞0. 05). Chronic hypoxia increased [Ca2+]i which opened Clca channels. The NFA and IAA-94blocked the channels and decreased [Ca2+]i from (281. 75±16.48) nmol/L to (117.66±15.36)nmol/L (P＜0.01). MTT assay showed that under chronic hypoxic condition NFA and IAA-94 decreased the value of absorbency (A value) from 0. 459±0. 058 to 0. 224±0. 025 (P＜0.01).Hypoxia increased [Ca2+]i which opened Clca channels and had a positive-feedback in [Ca2+]i. Thismay play an important role in hypoxic pulmonary hypertension. Under chronic hypoxic condition,Clca channel may play a part in the regulation of proliferation of PASMCs.
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To investigate the relationship between intracellular free Ca2+ concentration ([Ca2+]i) and calcium-activated chloride (Clca) channels of pulmonary artery smooth muscle cells (PASMCs) in rats under acute and chronic hypoxic conditions, acute hypoxia-induced contraction was observed in rat pulmonary artery by using routine blood vascular perfusion in vitro. The fluorescence Ca2+ indicator Fura-2/AM was used to observe [Ca2+]i of rat PASMCs under normal and chronic hypoxic condition. The effect of Clca channels on PASMCs proliferation was assessed by MTT assay. The Clca channel blockers niflumic acid (NFA) and indaryloxyacetic acid (IAA-94) exerted inhibitory effects on acute hypoxia-evoked contractions in the pulmonary artery. Under chronic hypoxic condition, [Ca2+]i was increased. Under normoxic condition, [Ca2+]i was (123.63 +/- 18.98) nmol/L, and in hypoxic condition, [Ca2+]i was (281.75 +/- 16.48) nmol/L (P 0.05). Chronic hypoxia increased [Ca2+]i which opened Clca channels. The NFA and IAA-94 blocked the channels and decreased [Ca2+]i from (281.75 +/- 16.48) nmol/L to (117.66 +/- 15.36) nmol/L (P<0.01). MTT assay showed that under chronic hypoxic condition NFA and IAA-94 decreased the value of absorbency (A value) from 0.459 +/- 0.058 to 0.224 +/- 0.025 (P<0.01). Hypoxia increased [Ca2+]i which opened Clca channels and had a positive-feedback in [Ca2+]i. This may play an important role in hypoxic pulmonary hypertension. Under chronic hypoxic condition, Clca channel may play a part in the regulation of proliferation of PASMCs.
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Objective To explore the effects of Sodium Nitroprusside(SNP) on apoptosis of airway smooth muscle cells(ASMCs) of asthmatic rats in vitro.Methods Ten Wister rats were selected to make the models of asthma.The effect of SNP on the survival rate of asthmatic rat airway smooth muscle cells was detected by MTT method.The apoptosis of cells was detected by TUNEL method and flow cytometry.Results Comparing with asthma group,the survival rate of ASMCs was decreased significantly in SNP plus asthma group by MTT method(P
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Objective To explore the features of the airway inflammation in a rat model of chronic bronchitis and study the role of IL-8 in the pathogenesis of chronic bronchitis. Methods The rat model of chronic bronchitis was set up by injecting LPS into trachea. Cell count and cytological classification in BALF were performed in experimental group and control group. The level of IL-8 in both serum and lung tissues of the two groups rats was measured by ELISA. Results The levels of IL-8 in both serum and lung tissues in the rats with chronic bronchitis were significantly higher than those in healthy control rats.The number of neutrophil in BALF of the rats with chronic bronchitis was significantly more than that in healthy control rats. Conclusion Both IL-8 and neutrophil were involved in airway inflammation of chronic bronchitis, and might play an important role in the pathogenesis of chronic bronchitis.
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AIM: To investigate the role of intracellular free Ca2+ concentration ([Ca2+]i) in the regulation of calcium-activated chloride (ClCa) channels in pulmonary artery smooth muscle cells (PASMCs) of rats under normoxic, acute and chronic hypoxic conditions. METHODS: Acute hypoxia-induced contraction was observed in rat pulmonary artery by using routine blood vascular perfusion in vitro. The fluorescence Ca2+ indicator Fura-2/AM was used to observe [Ca2+]i of rat PASMCs in normal and chronic hypoxic condition. The influences of ClCa channels on PASMCs proliferation were assessed by MTT assay. RESULTS: (1) The ClCa channel blockers niflumic acid (NFA) and indaryloxyacetic acid (IAA-94) produced inhibitory effects on acute hypoxia-evoked contractions in pulmonary artery. (2) Under chronic hypoxic condition, [Ca2+]i was increased. In normoxic condition, [Ca2+]i was (123.63?18.98) nmol/L, and in hypoxic condition, [Ca2+]i was (281.75?16.48)nmol/L (P0.05). (4) Chronic hypoxic increased [Ca2+]i which opened ClCa channels. The NFA and IAA-94 blocked them and decreased [Ca2+]i from (281.75?16.48)nmol/L to (117.66?15.36)nmol/L (P