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In December 2021, in order to effectively solve the economic burden and payment difficulties of the elderly or disabled elderly and tumor patients in the promotion of " Internet plus nursing services", Ningbo included three home medical care services, namely, peripherally inserted central maintenance, urinary catheter care and nasogastric tube care with large patient needs and high frequency, into medical insurance, and could be paid at home(hereinafter referred to as: " medical insurance home payment" ). The author introduced the relevant concepts and service processes of " medical insurance home payment", and summarized the effects, problems and further improvement measures. After the implementation of the policy, the number of three nursing services included in " medical insurance home payment" reached 7 953 in 2022, with an increase of 105.29% over the same period in 2021, no adverse events occurred, and patient satisfaction was high. Ningbo " medical insurance home payment" could reduce the economic burden of patients and provide a reference for the medical insurance payment and service charges of " Internet plus nursing services" in China.
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Objective:To explore the effect of Xingnao Kaiqiao acupuncture treatment on brain network reorganization for the patients with stroke recovery, and therefore understand the neural mechanism underlying Xingnao Kaiqiao acupuncture treatment.Methods:Prospective case series study. Thirteen acute ischemia stroke patients were recruited from the Department of Neurology, Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine from Aug 2018 to Oct 2019. They were treated with Xingnao Kaiqiao acupuncture once a day for 10 consecutive days in addition to routine treatments, and received clinical assessments before treatment and 14 days after treatment onset. EEG signals were recorded during the first acupuncture treatment, from before inserting the needles (the baseline), during needle retention, to after removal of the needles. The brain network was constructed using phase locking index, and its clustering coefficient (CC), characteristic path length (PL) and small-worldness (S) were analyzed using one-way repeated ANOVA.Results:Compared with the baseline, the CC of delta-band network (sparsity=0.10: t=3.306, P=0.006; 0.12: t=2.909, P=0.013; 0.14: t=2.331, P=0.038) and the PL of delta-band (sparsity=0.12: t=3.236, P=0.007; 0.14: t=2.754, P=0.017, 0.18: t=2.878, P=0.014) and alpha-band (sparsity=0.10: t=2.432, P=0.032) networks were significantly decreased during the needle retention stage. Clinical assessments demonstrated a significant treatment efficacy of Xingnao Kaiqiao acupuncture, and its efficacy which was indicated by improved NIHSS score, was significantly correlated with the CC changes in the delta band network from baseline to needle retention. The correlation was strongest when the network sparsity was 0.12 ( r=0.78, P=0.002). Conclusion:Xingnao Kaiqiao acupuncture can regulate the brain network of stroke patients in real time, and this immediate regulation maybe associated with its treatment effect.
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Objective:To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia.Methods:Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared.Results:(1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m 2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m 2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion:Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m 2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.
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Objective:To develop an occupational stress management system for medical staff, in order to provide scientific reference for management actions.Methods:From January 2019 to July 2020, a stress management system initially took shape based on employee assistant program(EAP)and the assessment-prevention-control-evaluation organizational stress management model, pinpointing pediatrics featuring high occupational stress as the breakthrough point. Other means called into play include literature review and semi-structured interviews of pediatric managers and staff, for the purposes of learning the status of stress management. Delphi method was also used to learn by correspondence the occupational stress management system as seen by pediatric experts. The weight of items was determined by percentage method.Results:Eight managers and eight pediatric staff were interviewed, with four topics identified. Twenty experts participated in 2 rounds of Delphi inquiry by correspondence, and the recovery rates were 91% and 100% respectively. The authority coefficients were 0.78 and 0.80, and the Kendall coordination coefficients were 0.17 and 0.14(both P<0.01). The finalized occupational stress management system consists of 5 level-1 indicators, including organization system, stress assessment, stress prevention, stress control and effect evaluation, as well as 21 level-2 indicators and 71 level-3 indicators. Conclusions:The occupational stress management system of medical staff is scientific, reliable and comprehensive, serving as a useful reference for the hospital management in their occupational stress management work.
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Objective:To explore the mediating effect of children's effortful control on the relationship between home environment and children's behavioral emotional problems in preschool children with malignant tumors and to provide evidences for family intervention on behavioral emotional problems in children.Methods:Totally 353 preschool children with malignant tumors were investigated with family adaptation and cohesion evaluation scales II (FACES II), child behavior questionnaire-very short form(CBQ-VSF) and strengths and difficulties questionnaire (SDQ), AMOS 22.0 software was used to construct a structural equation model in data analysis and the Bootstrap method was used to test the mediation effect.Results:The scores of family adaptation and cohesion, children's effortful control, difficulty questionnaire were(51.63±12.41), (55.43±10.16), (3.23±0.80) and (13.75±3.66). The scores of dimensions including emotion, conduct, hyperactivity, peer problems, prosocial of difficulty questionnaire were(2.83±0.90), (2.73±0.96), (2.67±0.93), (2.76±0.85), (2.67±0.85), respectively. Family adaptation and cohesion were positively correlated with children's effortful control ( r=0.244, 0.289, P<0.01). Children's effortful control was negatively correlated with children's behavioral emotional problems ( r=-0.365--0.302, all P<0.05). Family adaptation and cohesion were negatively correlated with children's behavioral/emotional problems ( r=-0.323--0.124, r=-0.342--0.181, all P<0.05). The direct effect value was -0.469, indirect effect value was -0.102, accounting for 17.86% of the total effect. Conclusion:Children's effortful control exert a significant mediating effect on the relationship between home environment and children's behavioral/emotional problems in preschool children with malignant tumors, suggesting that medical staff should pay attention to the level of effortful control of preschool children with malignant tumors in order to take effective actions to reduce children's behavioral/emotional problems and improve social applicability.
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Objective To study the safety and efficacy of colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection.Methods CNKI, Wanfang database , PubMed, Embase and Cochrane library were systematically searched.Randomized controlled trials about colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection were enrolled.The Cochrane Reviewers′Handbook 5.2 was employed to evaluate the quality of the enrolled studies. The primary outcome was all-cause mortality.The secondary outcomes included infection-related mortality, clinical response, bacterial clearance, nephrotoxicity and hepatotoxicity.Meta-analysis was conducted by RevMan 5.3 software.Results Seven articles containing 859 patients were finally included.There were no significantly statistical differences in all-cause mortality rate (relative risk [RR]=1.07, 95%CI:0.93-1.24, P>0.05), infection-related mortality rate (RR=1.35, 95%CI:0.98-1.87, P>0.05), bacterial clearance rate (RR=0.85, 95%CI:0.71-1.02, P=0.08), hepatotoxicity development rate (RR=0.68, 95%CI:0.41-1.13, P=0.14), and nephrotoxicity development rate (RR=1.01, 95%CI:0.85-1.22, P>0.05) between colistin monotherapy and combination therapy.The clinical response rate was higher in combination therapy than that in colistin monotherapy ( RR =0.81, 95%CI:0.66 -0.98, P =0.03).In the subgroup analysis, no statistical differences were found in all-cause mortality rate between colistin monotherapy and combination therapy for carbapenem-resistant Acinetobacter baumannii infection (RR=1.00, 95%CI:0.86-1.12, P>0.05). The dosage of colistin with or without loading dose was not associated with the treatment response .Conclusions Although colistin-based combination therapy has a better clinical response against carbapenem -resistant bacteria infection, especially for Acinetobacter baumannii infection, the mortality rate dose not decline compared to colistin monotherapy.Large-scale randomized controlled trials are needed to evaluate the effect in the future.
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Diffusion tensor imaging (DTI) is being used more and more widely in the diagnosis of central nervous system. Based on DTI, track density imaging (TDI) is an emerging technique applied to clinical use. This article introduced the principle and clinical application, analyzed pros and cons, and made conclusion and prospect of these two techniques.
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Humans , Diffusion Tensor Imaging , Nervous System , Diagnostic ImagingABSTRACT
Objective To investigate the effect of different concentration of uric acid on proliferation and phentyic change of HBZY-1 cells in vitro. Methods The morphological change of HBZY-1 cells exposed to uric acid was observed under the inverted microscope and transmission electronmicroscope. MTT bioassay was used to assess the effect of uric acid on the proliferation of HBZY-1 cell. ELISA method was used to assess the level of angiotensin Ⅱ in HBZY-1 cell incubated with different concentration of uric acid for different treatment duration.The protein and mRNA expression of α-smooth muscle actin (α-SMA) , transforming growth factor-β1 (TGF-β1) and fibronectin in HBZY-1 cells was measured by Western blot and RT-PCR assay, respectively. Results Uric acid (0.4 mmol/L, 24 h) could induce phentypic change of messangial cell from triangle to fibroblast-like morphology.Uric acid could significantly stimulate the proliferation of HBZY-1 cells for 24 h in a concentration-dependent manner (P < 0.05). Uric acid could stimulate the secration of angiotensin Ⅱ in a dose-and time-dependent manner.RT-PCR and Western blot results showed that the markers of myofibroblast transdifferentiation, including a-smooth muscle actin (α-SMA) , transforming growth factor-β1 (TGF-β1) and fibronectin, were significantly upregulated in HBZY-1 cell treated with over 0.1 mmol/L uric acid for 48 h compared with the control group (P < 0.05, respectively). Conclusion Uric acid can induce the proliferation and phentypic change of HBZY-1 in vitro.
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Disturbance of interhemispheric interactions after stroke has been widely reported. However, the dynamic change in the hyperacute stage of stroke remains to be elucidated. In this study, interhemispheric interactions and brain asymmetry in the early hours after infarction were investigated in animals from the aspect of nonlinear interdependences using bilateral EEG recordings. Both the right-to-left and the left-to-right hemispheric interdependences were impaired after unilateral stroke, with a significant decrease in the first two hours and a low level in the following twenty-two hours. The ipsilesional to contralesional interdependence was found more vulnerable to unilateral stroke, and the symmetry between the right-to-left and the left-to-right hemispheric interdependences was damaged. The brain symmetry index after four hours was significantly correlated with the infarct volume at twenty-four hours, suggesting its prognostic role as early as four hours post-stroke.
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Stroke , Animals , Brain , Brain Mapping , Functional Laterality , RatsABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of acupuncture on mRNA of the neurotransmitter serotonin transporter (5-HTT), 5-HTreceptor (5-HTR), norepinephrineα2 receptor (NEαR) in brain tissue in rats with post-stroke depression.</p><p><b>METHODS</b>Forty male SD rats were randomly divided into a normal group, a model group, a medication group and an acupuncture group, 10 rats in each one. The model of post-stroke depression was established by occlusion of middle cerebral artery and chronic unpredictable mild stress method. After model was successfully established, the rats in the normal group and model group received no treatment; the rats in medication group were treated with intragastric administration of fluoxetine (2 mg/kg); the rats in acupuncture group were treated with acupuncture at "Baihui" (GV 20), "Fengfu" (GV 16), "Shenmen" (HT 7) and "Taichong" (LR 3) for 20 min, during which manual stimulation was given once, once a day, 7 days as one course, and totally 3 courses were given with an interval of one day between courses. The changes of rat behavior and 5-HT, NE were observed after intervention; the RT-PCR method was applied to observe the mRNA of 5-HTT, 5-HTR, NEαR in hippocampus, raphe nucleus and locus coeruleus.</p><p><b>RESULTS</b>After treatment, compared with the normal group, the Zea Longa score in the model group was increased, while sugar water consumption, the number of horizontal and vertical movement of open-field test was reduced (all<0.01); compared with the model group, the Zea Longa score in the medication group and acupuncture group was reduced, while sugar water consumption, the number of horizontal and vertical movement of open-field test were increased (<0.01,<0.05); compared between the medication group and acupuncture group, the behavior changes were not significantly different (all>0.05). After treatment, compared with the normal group, the content of 5-HT and NE in brain tissue and mRNA expression of 5-HTT, 5-HTR in hippocampus, raphe nucleus and locus coeruleus in the model group were reduced (all<0.01), but the mRNA expression of NEαR was increased (<0.01);compared with the model group, the content of 5-HT and NE in brain tissue and mRNA expression of 5-HTT, 5-HTR in hippocampus, raphe nucleus and locus coeruleus in the medication group and acupuncture group were increased (<0.01,<0.05), while the mRNA expression of NEαR was reduced (all<0.01). The differences between medication group and acupuncture group were not significantly different (all>0.05).</p><p><b>CONCLUSIONS</b>Acupuncture could significantly improve behavioral change in rats with post-stroke depression, which may be related to the regulation of 5-HT, NE in cerebral cortex as well as mRNA expressions of 5-HTT, 5-HTR, NEαR in hippocampus, raphe nucleus and locus coeruleus.</p>
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Objective To evaluate the clinical effect of CT-guided radiofrequency thermal coagulation in treating primary trigeminal neuralgia.Methods A total of 165 patients with primary trigeminal neuralgia were selected as research objects.The patients were randomly divided into radiofrequency thermal coagulation group (study group,n=83) and drug damage group (control group,n=82).For the treatment of trigeminal neuralgia,CT-guided radiofrequency thermal coagulation was carried out in the patients of the study group,and CT-guided percutaneous puncturing of oval foramen with epirubicin injection as chemical damage therapy was employed in the patients of the control group.Follow-up check-up was conducted at 3,6,12 and 36 months after the treatment.Visual analog score (VAS),total effective rate and incidence of complications were calculated and the results were compared between the two groups.Results The excellent therapeutic rate of the study group was significantly better than that of the control group,the difference between the two groups was statistically significant (P<0.05).The incidence of complications in the study group was remarkably lower than that in the control group,the difference between the two groups was statistically significant (P<0.05).The VAS pain score of the study group was much lower than that of the control group.The total therapeutic effect in the study group was more prominent.Conclusion In treating primary trigeminal neuralgia,CT-guided radiofrequency thermal coagulation has excellent clinical effect.Therefore,this technique is worthy of popularization and application in clinical practice.
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Objective To investigate the effects of different tidal volume mechanical ventilation on pulmonary function and inflammatory factors in gynecologic laparoscopic surgery.Methods 45 patients undergoing gynecological laparoscopic surgery without lung disease,ASA Ⅰ-Ⅱ,aged 20-45 years old,weight 45-65 kg,operation time 2-3 hours,were randomly divided into A,B,C three groups,15 cases in each group.Mechanical ventilation with different tidal volume of the three groups,A group,B group and C group were 8mL/kg,9mL/kg,10mL/kg.Blood gas analysis was performed before anesthesia (T0),30 minutes (T1),(T2),PA-aDO2 (60 minutes) (T3),and 120 min (T4),respectively,and the peak airway pressure and mean pressure were recorded.IL-6,TNF-α and IL-10 levels in plasma by radial artery blood sampling were simnultaneously determined.Results Comnpared with A group,the concentrations of Ppeak and Pmean were increased in B group at T1-T4 (t =5.13,4.78,6.54,5.32 and t =7.54,4.88,5.37,4.95;all P < 0.05),the concentration of Ppeak and Pmean in C group at T1-T4 increased (t =7.76,8.87,7.23,8.99 and t =6.42,7.38,7.62,9.86;all P < 0.05).Compared with B group,the concentrations of Ppeak and Pmean were increased in C group at T1-T4 (t =4.76,5.87,4.23,3.99 and t =4.76,3.99,6.06,4.52;all P < 0.05).Compared with A group,the A-aDO2 values of B group and C group were increased at T1,T2,T3 and T4 (t =5.32,5.48,4.88,5.69 and t =7.85,7.32,8.45,6.67;all P < 0.05).Compared with B group at the same time point,the A-aDO2 value of C group increased at four times of T1-T4 (t =5.62,4.38,6.94,4.22,P <0.05).Compared with group A,the concentration of A-aDO2 in C group was higher than that in B group at the same time point (t =4.45,4.87,5.32,4.79 and t =7.68,7.59,7.44,8.38;all P < 0.05).The levels of IL-6 and TNF-α in C group were significantly higher than those in the control group (t =4.78,5.56,7.62,8.03 and t =3.98,4.52,5.46,6.23;all P < 0.05).Compared with T0,IL-6 and TNF-α concentrations AT T2-T4 in A group had no statistically significant differences (all P > 0.05).Compared with B group,the levels of IL-6 and TNF-α in C group were significantly higher (t =4.58,4.99,6.53,4.77 and t =5.62,7.89,6.43,4.52;all P < 0.05).Compared with T0,IL-6 and TNF-α concentrations at T2-T4 in A group had no statistically significant differences (all P >0.05).There was no significant difference in IL-10 concentration among the thrce groups.Conclusion Laparoscopic surgery according to the end tidal carbon dioxide partial pressure (PetCO2) ventilation frequency,8 mL/kg tidal volume mechanical ventilation has no effect on the IL-6,TNF-alpha,IL-10 and other inflammatory factors,mechanical ventilation tidal volume is more appropriate.
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Objective To investigate the effect of depression-relieving and mind-tranquilizing acupuncture on behaviors and hippocampal neurotransmitters in rats with post-strike depression.Method Rats were randomized to normal, model, medication and acupuncture groups, 20 ratseach. A rat model of post-strike depression was made by middle cerebral artery occlusion and chronic unpredictable mild stress. The medication received an oral gavage of fluoxetine 2 mg/kg and the acupuncture group, acupuncture at points Baihui(GV20), Fengfu(GV6), Shenmen(HT7) and Taichong(LR3), 20 min retention of needles with one manipulation meanwhile, once daily, 7 days as one course of treatment, for a total of three courses with one day of rest between. Rat behaviors were observed and hippocampal neurotransmitters 5-hydroxytryptamine (5-HT), nonepinephrine (NE), acetylcholine (Ach),γ-aminobutyric acid (γ-GABA) and glutamic acid (Glu) were measured.Result The Zea Longa score was lower in the acupuncture group than in the model and medication groups at 15 and 22 days after intervention (P<0.01,P<0.05). Sugar water consumption increased in the acupuncture group compared with the model and medication groups at 7, 15 and 22 days after intervention (P<0.01). Sugar water consumption, open-box horizontal movement and vertical movement increasedin the medication and acupuncture groups at 7, 15 and 22 days after intervention compare with before intervention (P<0.01,P<0.05). Hippocampal 5-HT, NE, Ach,γ-GABA and Glu contents were significantly lower in the model group of rats than in the normal group (P<0.01) and were significantly higher in the acupuncture group of rats than in the model group (P<0.01,P<0.05).Conclusion Depression-relieving and mind-tranquilizing acupuncture can markedly improve behaviors in rats with post-strike depression. Its mechanism may be related to regulating rat neurotransmitters 5-HT, NE, Ach,γ-GABA and Glu expressions.
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To investigate the reorganization of functional brain network following amputation, twenty-two right-hand amputees and twenty-four age- and education-matched controls participated in a resting-state EEG study. EEG networks in alpha and beta bands were constructed using phase synchronization. Both global and local network parameters were compared between amputees and healthy controls. In the aspect of global connectivity, amputees showed increased clustering coefficient (C), decreased characteristic path length (L) and increased small worldness (S) in alpha band, and an increase of L in beta band. Meanwhile, in comparison with the controls, the right-hand amputees have lower nodal degree (k) in the sensorimotor cortex but higher k in the parietal area in the right hemisphere in alpha band. These alterations of network following amputation implied a decreased inhibition from the intact sensorimotor area and increased connections in the right parietal area, which supported the unmasking theory. Such connectivity changes might also relate to the phantom limb phenomenon.
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Amputees , Electroencephalography/methods , Hand , Sensorimotor Cortex/physiopathology , Adult , Amputation, Surgical , Case-Control Studies , Female , Humans , Male , Middle Aged , Phantom Limb/physiopathology , Signal Processing, Computer-AssistedABSTRACT
Objective To know the sleeping quality of clinical nurses in Urumqi, and analyze the influencing factors, put forward the corresponding countermeasures for different factors to improves the sleeping quality. Methods Randomly selected 407 nurses in clinical departments as the research objects in Urumqi top three hospitals, using the Pittsburgh sleep quality index scale (PSQI) and general situation questionnaire to investigate, and then analyzed the results of the survey. Results The incidence rate of sleeping disorders in emergency nurses was the highest (80.00%), followed by pediatric, intensive department, internal medicine, surgical department, operating room, outpatient and others was the lowest (39.02%). Gender (t=-2.015, P =0.045), age (F=8.509, P =0.000), establishment(F=3.609, P =0.013) were the influence factors of PSQI scores. Only the difference of the scores of hypnotic drugs between different ethnic groups was significant, P0.05. Conclusions Poor sleeping quality of nurses existed in every department, its sleeping quality status, department, gender, age and establishment have certain correlation, interventions should be strengthened, to improve the overall level of sleeping.
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Objective To investigate the relationship of HSP27 expression with treatment response ,remission rate ,prognosis in multiple myeloma(MM) patients .Methods Eighty‐six patients with MM first diagnosis and 27 relapse cases were collected re‐spectively .Control was defined as non‐hematological malignance .The MM patients divided into first diagnosis ,relapse conventional chemotherapy group and bortezomib group .HSP27 expression and protein level were measured on pre‐and post 1 ,2 and 3 treatment circles .Results The tendency of HSP expression and protein level:relapse‐MM patients> first‐diagnosis MM patients> control . HSP27 expression and level in Ⅲ phase was higher than those in Ⅱ phase for first‐diagnosis MM patients .Bortizomib‐containing chemotherapy protocol showed more effectively decrease on HSP27 than chemotherapy treatment only .At post‐1 treatment circle , HSP271 and delayed the relapse time .Conclusion BMMNC‐HSP27 expression and protein level is associated with staging ,treatment response and prognosis in MM patients .
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Objective To evaluate the protection of combined clostridium butyricum and bifidobac-terium living powders for antibiotic-associated diarrhea ( AAD ) with all kinds of infections in hospitalized children,and to compare the therapeutic effect with saccharomyces boulardii. Methods This study was a prospective,randomized case-control clinical trial which collected the data of the hospitalized children with all kinds of infections in Pediactric Department of Shengjing Hospital of China Medical University between May 2011 to May 2012. A total of 552 cases were enrolled and 480 cases completed the study. A total of 240 chil-dren were in experimental group,80 cases received combined clostridium butyricum and bifidobacterium liv-ing powders 840 mg per time,twice a day and the other 160 cases received saccharomyces boulardii 250 mg per time,twice a day,for one week; the control group took none of probiltics. Two groups received routine antibiotic therapy. Everyday′s defecate frequency was recorded, the traits of excrement according to bristol stool assessment scale were evaluated,the incidence of diarrhea and drug related adverse reactions were coun-ted. Results During the studied 7 days,the AAD incidence was 4. 2%(10/240) in experimental group and 20. 4%(49/240) in control group,there was significant difference between two groups. The risk of AAD in experimental group decreased 58. 5%. Compared to saccharomyces boulardii,combined clostridium butyricum and bifidobacterium living powders decreased 38. 2% (RR=0. 728, 95%CI 0. 257~0. 784, P=0. 009). Compared to control group,the average defecate frequency decreased in experimental group,diarrhea duration contracted,there was statistic difference between two groups ( P<0. 01 ) . No drug related adverse reactions happened during the trial. Conclusion Both combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii could effectively reduce the risk of AAD in hospitalized children with bacterial infection,relieve diarrhea symptoms,short the duration of diarrhea,and did not find the adverse reac-tions. Combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii had the same protective effect for AAD of northern China children.
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AIM To investigate the neuroprotective effects and possible mechanisms of saponins from Anemarrhena asphodeloides Bge. (SAaB) on neuronal damage induced by amyloid β-protein fragments 25-35 (Aβ25-35). METHODS Cultured mouse peritoneal macrophages were stimulated with Aβ25-35 (20 μmol·L-1) for 0.5, 1, 2 and 6 h or preincubated with SAaB (10, 30 and 100 μmol·L-1)for 10 min or mitogen-activated protein kinase (MAPK) specific inhibitors (p38 MAPK inhibitor SB 203580 and MEK specific inhibitor PD98059) for 30 min prior to the addition of Aβ25-35(20 μmol·L-1). After stimulation with Aβ25-35 for the indicated times, total cellular extracts were prepared for Western blotting of extracellular signal-regulated kinase (ERK) and p38 MAPK. After stimulation with Aβ25-35 for 48 h, the supernatants of cultured macrophages were collected for quantification of tumor necrosis factor-α (TNF-α) and nitric oxide (NO) and protein expression of inducible nitric oxide synthase (iNOS) in macrophages was determined by immunocytochemical staining. To determine whether SAaB has protective effect against neuronal apoptosis mediated by Aβ25-35-induced macrophages activation, macrophages were stimulated with Aβ25-35 in the presence or absence of SAaB (10, 30 and 100 μmol·L-1) for 48 h and then the cell-free supernatant of Aβ25-35-stimulated macrophages was transferred to the culture of cerebellar granule neurons for 72 h. Neuronal apoptosis was quantitated by scoring the percentage of cells with apoptotic nuclear morphology after Hoechst 33258 staining. RESULTS Aβ25-35(20 μmol·L-1) significantly induced increase in phospho-ERK1/2 and phospho-p38 MAPK protein expression without affecting total protein levels and in the production of TNF-α and NO in cultured macrophages. Aβ25-35-induced increase of TNF-α production in macrophages involved activation of ERK1/2 signal pathway. Importantly, TNF-α and NO generated by cultured macrophages after Aβ25-35 stimulation may be responsible for the majority of the neuronal apoptosis. SAaB (30 and 100 μmol·L-1) significantly suppressed Aβ25-35-induced increase in phospho-ERK1/2 and phospho-p38 MAPK protein. In addition, SAaB (10, 30 and 100 μmol·L-1) also decreased the level of TNF-α and NO in supernatants of cultured macrophage and inhibited Aβ25-35-induced increase in iNOS protein expression of macrophages. Neuronal apoptosis mediated by Aβ25-35-induced macrophage activation was also significantly attenuated by treatment with SAaB (10, 30 and 100 μmol·L-1). CONCLUSION SAaB protects neurons against the neuronal cell death induced by Aβ25-35. The beneficial effects of SAaB may be related to the reduction of TNF-α and NO from activated macrophage induced by Aβ25-35.
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OBJECTIVE:To facilitate Chinese pharmaceutical industry's understanding and application of the new "Patent Law".METHODS:The amendment of the "Patent Law" related to 3 aspects of medicine,i.e.specifying regulations on the information disclosure in the utilization of genetic resources,adding the clause of forced permission for the patent drugs for the purpose of public health,and introducing the Bolar exception clause was analyzed using law hermeneutic.RESULTS & CONCLUSIONS:The medicine-related amendment of the new "Patent Law" generally reflects an international tendency of restricting pharmaceutical patents so as to maintain public interests,which is in line with the status quo of low technological level of pharmaceutical industry in China.
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Objective To investigate the distribution of Malassezia species in lesional and non-lesion-al sites of patients with pityriasis versicolor(PV),species-variation in different anatomic sites and in lesions with different pigmentation,and the relationship between various Malassezia species and severity and age of PV patients.Methods A total of629skin specimens taken by sterile adhesive tape from the lesions and non-lesional skin were inoculated on media containing rapeseed oil in113patients with PV.Isolated colonies were identified to species based on physiological and morphological characteristics.Results The isolation rates of Malassezia spp.were not significantly different from both lesions and corresponding non-lesional skin.Among non-lesional sites,the isolation rate was significantly higher in forehead and trunk than that in upper and lower extremities.Five species were identified out of565strains obtained from the patients,including M.sympodialis(44.78%),M.furfur(32.94%),M.globosa(11.68%),M.obtusa(5.84%)and M.restricta(4.76%).Two dif-ferent species were isolated simultaneously from27sites.There was no obvious difference in species distribu-tion patterns between lesions and non-lesional sites.M.restricta was isolated from forehead exclusively.Species-variation was closely linked to lesions with different pigmentation and the age of patients,not to the severity of disease.Conclusion There is neither statistical difference of Malassezia isolation rate and species distribution between lesions and non-lesional skin,nor correlation between disease severity and species-varia-tion.The anatomic sites,the diversity of pigmentation pattern and the age of patients seem to be associated with different Malassezia species.