Differences in the perceptions of patients with primary biliary cholangitis and physicians from various hospital departments: An online survey.

OBJECTIVES: Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease that affects the quality of life (QoL) of patients. This study aimed to evaluate the differences in perceptions of PBC among physicians from different hospital departments and patients with PBC. METHODS: An online survey regarding the general knowledge, diagnosis, and management of PBC was completed by physicians and patients. RESULTS: A total of 239 patients with PBC and 239 physicians from eight hospital departments (gastroenterology, infectious diseases, rheumatology, hepatobiliary surgery, pathology, clinical laboratory, ultrasound, and radiology) completed the survey. The results showed that physicians from departments other than gastroenterologists and rheumatologists lacked knowledge of PBC, and that junior gastroenterologists were uncertain about the diagnostic and treatment pathways of PBC. Importantly, the lack of knowledge significantly impacted the QoL of patients, especially the emotional scores of PBC-40 (odds ratio -2.556, 95% confidence interval -3.852 to -1.260, P < 0.001). In addition, there was a perceived knowledge gap between patients and gastroenterologists. CONCLUSIONS: Physicians must improve their awareness of PBC. Patient education and patient-physician communication are important for improving the patient's QoL.

Comparison of Existing Clinical Scoring Systems in Predicting Severity and Prognoses of Hyperlipidemic Acute Pancreatitis in Chinese Patients: A Retrospective Study.

It is important to identify the severity of acute pancreatitis (AP) in the early course of the disease. Clinical scoring systems may be helpful to predict the prognosis of patients with early AP; however, few analysts have forecast the accuracy of scoring systems for the prognosis in hyperlipidemic acute pancreatitis (HLAP). The purpose of this study was to summarize the clinical characteristics of HLAP and compare the accuracy of conventional scoring systems in predicting the prognosis of HLAP. This study retrospectively analyzed all consecutively diagnosed AP patients between September 2008 and March 2014. We compared the clinical characteristics between HLAP and nonhyperlipidemic acute pancreatitis. The bedside index for severity of acute pancreatitis (BISAP), Ranson, computed tomography severity index (CTSI), and systemic inflammatory response syndrome (SIRS) scores were applied within 48 hours following admission. Of 909 AP patients, 129 (14.2%) had HLAP, 20 were classified as severe acute pancreatitis (SAP), 8 had pseudocysts, 9 had pancreatic necrosis, 30 had pleural effusions, 33 had SIRS, 14 had persistent organ failure, and there was 1 death. Among the HLAP patients, the area under curves for BISAP, Ranson, SIRS, and CTSI in predicting SAP were 0.905, 0.938, 0.812, and 0.834, 0.874, 0.726, 0.668, and 0.848 for local complications, and 0.904, 0.917, 0.758, and 0.849 for organ failure, respectively. HLAP patients were characterized by younger age at onset, higher recurrence rate, and being more prone to pancreatic necrosis, organ failure, and SAP. BISAP, Ranson, SIRS, and CTSI all have accuracy in predicting the prognosis of HLAP patients, but each has different strengths and weaknesses.

[Syntheses and spectral study of novel metal zinc organic phosphonate].

Two novel Zn2+ organic phosphonate Zn(4,4'-bipy)(HBCP) 1 and [Zn2 (phen)2 (BCP)(H2 BCP)].H2O2 were hydrothermally synthesized. The compound 1 is with two-dimensional layer framework whereas the compound 2 is zero-dimensional structure. The Zn2+ ion is four-coordinated in compound 1 while five or six-coordinated in compound 2. The relationship between their properties and structures was studied by using FTIR, two-dimensional (2D) correlation infrared spectroscopy under thermal perturbation, fluorescence and UV-Vis DRS spectrum etc. Upon light excitation at 350 nm, the compound 1 exhibits luminescence with a strong wide emission at 412 nm and a weak emission at 520 nm, while the compound 2 exhibits luminescence with a wide emission only at 398 nm under light excitation at 336 nm.

[Structural and spectral study of a novel rare-earth and 3-bi-pyridine acid polymer].

A novel zero-dimension coordination polymer Gd2 (In)6 (H2O)4 (1) (In = 3-bipyridine acid) was synthesized under hydrothermal condition. By the analysis of single-crystal X-ray diffraction, the structure of the compound is that two Gd atoms connect with zero-dimension bi- nucleus cluster by the bridged carboxylate of four Ins. Based on the determination of the structure, the 2D correlation FTIR spectra with the perturbations of magnetism and thermal was applied. Under the perturbations of temperature, the vibration of the carboxylate has the very strong response, which is related with the strong coordinating ability of the carboxylate. At the same time, due to the different coordinated mode of the carboxylate with Gd, the response of Gd--O bonds is different under the temperature perturbations. Under the perturbations of magnetism, the vibration of the carboxylate has also the very strong response, which may be related with one-negetive charge of the carboxylate. The 2D correlation ultraviolet spectral with the perturbation of magnetism were investigated. Compared with one-dimension ultraviolet spectral, the transition of the pi electrons in bi-pyridine ring and the charge transition from ligand to the metal have the very strong response. At the same time, the fluorescence spectral and TGA were studied.

[2D correlation spectral study of a coordination polymer [Eu(PCPOA)3 (H2O)]n].

A novel two dimensional coordination polymer [Eu(PCPOA)3 (H2O)], was synthesized under hydrothermal condition. Based on the determination of the structure, the 2D correlation FTIR spectra with the perturbation of magnetism and the 2D correlation fluorescence spectra with the perturbation of temperature were investigated. The energy bonds were calculated using CASTEP Program of Material studio. The Europium ions are nine-coordinated and the ligands adopted two different modes to connect the Eu3+ ions to 2D layer structure. The study of the 2D-FTIR reveals that the carboxylates coordinate with the center ions not only as monodentate, but also as bidentate chelate. The 2D fluorescence spectra indicates that the transition of (5)D0-->(7)F2 is influenced intensively by the perturbation of temperature.

Intradermal injection of capsaicin induces acute substance P release from rat spinal cord dorsal horn.

Increased release of substance P (SP) from the dorsal horn following noxious stimuli, such as spinal administration of capsaicin, has been demonstrated in previous studies. However, changes in the release of SP in response to intradermal injection of capsaicin still remain unknown. This study was designed to demonstrate in vivo spinal SP release following intradermal injection of capsaicin (3%, 50 microl), using polyimide tubing with a single hole introduced into the rat dorsal horn. The changes in the content of SP in the rat dorsal horn tissues before and after capsaicin (3%, 50 microl) injection were also investigated. The SP concentration in the samples was analyzed using an enzyme-linked immunosorbent assay (ELISA). We found that intradermal injection of capsaicin induced a quick SP release within the dorsal horn. The peak of the release appeared around 10 min after the injection. In contrast, intradermal injection of capsaicin had no significant effect on the SP content in the dorsal horn. This study has provided direct evidence of the effect of intradermal injection of capsaicin on SP release within the dorsal horn, with the major source being from the central terminals of primary afferents.

[Spectroscopic studies on the interactions of a hexadeca-carboxy zinc phthalocyanine and serum albumin and preparation of the bioconjugates].

The interactions of the new photosensitizer {2, 3, 9, 10, 16, 17, 23, 24-octakis[(3,5-dicarboxy)phenoxy]-phthalocyaninato}zinc(II) [ZnPc(COOH)16] and serum albumins (BSA and HSA) were investigated by absorption and fluorescence spectroscopy. The binding constants were found to be 2.25-2.94 x 10(6) L x mol(-1). The 1 : 1 ZnPc (COOH)16-BSA and ZnPc (COOH)16-BSA conjugates were also prepared by incubating a mixture of ZnPc(COOH)16 and the corresponding serum albumin in 2 : 1 mole ratio followed by separation by gel permeation chromatography. The Q band absorption and fluorescence emission of ZnPc(COOH)16 are slightly red-shifted in the conjugates, and the spectral features suggest that the phthalocyanine exists predominantly in monomeric form in the conjugates.

[Synthesis and spectral study of three polyoxovanadium clusters].

Three polyoxovanadium clusters, [{Ni(phen)}2 V4O12] x H2O I, [N(CH2CH2)3NH]Na(H2O)6 {K4 (H2O)4 [V10 O28]} (H2O)4 II and [(CH3)4N]6 [V15 O36 Cl] III, have been synthesized under hydrothermal condition. The relationship between their properties and structures were studied by using FTIR, UV-Vis DRS and flurescence. The FTIR showed that the vibrational frequencies of the group are related to the structure of the materials. In UV-Vis DRS spectra of compound I, there are four characteristic wide peaks at 200, 230, 260 and 350 nm corresponding to O(t) --> V, O(mu) --> Ni, O(mu) --> V charge transfer and phen's pi-pi*, respectively. The fluorescence spectra of clusters have been studies. Finally, the quantum chemistry calculation was performed by Gaussian 98 program to explain the structure characteristic of compound I.

[Spectral study of two Bi (III) contained heteropolymate compounds].

Two Bi (III) contained heteropolymate compounds Cos [Bi2 Co2 W20 O70 (H2O)6] x 44H2O (I)and Na3 H2 [Ce3 (H2O)18 Bi2 W22 O76] x 23H2O (II) have been synthesized under hydrothermal condition. The relationship between their properties and structures was studied by using FTIR, NIR FT-Raman, and UV-Vis DRS etc. The characteristic vibrational frequencies nu(as) (M = O(d)) and nu(s) (M-O(b)-M) is related to the structure of the materials. Nu(as) (M-O(b)-M) is demonstrated to explain why the the oxidative ability becomes stronger when W atoms are substituted by Co atoms. In UV-Vis DRS spectra of compound I and II, there are two characteristic peaks at 254, 319 nm and 220, 310 nm coresponding O(d) --> W and to O(b), c --> W charge transfer, respectively. The wide and weak absorption band of compound I at 529 nm can be assigned as Co2+ d-d transfer. Finally, quantum chemistry calculation of compound I was performed to explain the structure characteristic.

[Spectral study of two compounds of molybdate salt with beta-[Mo8O26] anion].

Two compounds of organic molybdate-alkali salt: [H(4,4'-bipy)]2[K2Mo8O26](I) and H3 [Na Mo8 O26] (4,4'-bipy)5 (H2O)4 (II), with beta-[Mo8O26]4- anion, were synthesized. The relationship between their properties and structures was studied by using FTIR, Raman, NIR-Vis and fluorescence etc. They possess isolating beta-[Mo8O26]4- anion, whose terminal O atoms combine with alkali. The FTIR and Raman spectra showed that the vibrational frequencies of the group are related to the structure of the materials. In UV-Vis spectra of compound (I) and (II), there is a characteristic wide peak at 280-300 nm. The fluorescence spectra of compound (I) and (II) were studied, which showed that the wide emission peak is from 450 to 650 nm and excited by 350 nm for compound (I), and the emission peak is from 400 to 550 nm and excited by 325 nm for compound (II). For compound (I), the intensity of emission becomes stronger with decreasing of temperature, and so does the fluorescence lifetime.

Activation of protein kinase B/Akt signaling pathway contributes to mechanical hypersensitivity induced by capsaicin.

We investigated the involvement of the protein kinase B/Akt (PKB/Akt) signaling pathway in the mechanical hypersensitivity induced in rats by capsaicin. Intradermal injection of capsaicin results in activation of PKB/Akt in the lumbar spinal cord, most prominently in the dorsal horn, starting by 5 min after capsaicin injection and lasting at least 1h. The activated PKB/Akt in the spinal cord is in neurons, since phospho-PKB/Akt (p-PKB/Akt) colocalizes with the neuronal marker, neuronal-specific nuclear protein (NeuN). The mechanical hypersensitivity is shown by the enhanced paw withdrawal frequency to applications of von Frey filaments with different bending forces (30, 100, 200 mN) on the rat paw. Pre-treatment with several different PKB/Akt inhibitors, including SH-6, Akt inhibitor IV, and Akt inhibitor V, blocked the mechanical hypersensitivity induced by intradermal injection of capsaicin, a measure of spinal cord central sensitization. Two structurally unrelated phosphoinositide 3-Kinase (PI3K, upstream of PKB/Akt) inhibitors, Wortmannin and LY294002, also prevented the mechanical hypersensitivity induced by intradermal injection of capsaicin. Furthermore, post-treatment with the PI3K inhibitor, Wortmannin, or PKB/Akt inhibitors, such as NL-71-101, SH-6, Akt inhibitor IV, and inhibitor V significantly reduced the established mechanical hypersensitivity induced by capsaicin. The PKB/Akt signaling pathway in the spinal cord is therefore involved in pain hypersensitivity.

[Spectral study of some polyoxovanadium borates].

Four novel polyoxovanadium borates with [(VO)12O6B18O42], namely (enH2)6 H3 [(VO)12O6B18O42].13H2O(1), [Ni (en)2]6 H3 [(VO)12 O6B18O42].8H2O(2), [Cu(en)2]5 H3 [(VO)12 O6B18 O42] [B(OH)3]2. 16H20(3) and(enH2)4 Na4H3 [(VO)12 O6B18O42].8H2O(4), were synthesized. The relationship between their properties and structures were studied by using FTIR, UV-Vis DRS and fluorescence etc. Among these compounds, compound (1) possesses isolated [(VO)12O6B18O42] cage, there is a ring of B18O42 sandwiched between two vanadium-oxygen clusters V6O18 by eighteen B--(micro3--O)--V bonds, while compound (2) is rather six [Ni(en)2], each connected with the B18O42 ring by two Ni--(micro3--O)--B. In compounds (3) and (4), the anion clusters [(VO)12 O6B18O42]13- are connected with [Cu(en)2]2+ and Na+ , respectively. Thus, the compounds (3) and (4) are extended to an infinite two-dimensional network structure, respectively. These characteristic vibrational frequencies of polyoxovanadium borates are related to the structures of these compounds. In UV/Vis DRS spectra, there are two characteristic peaks of polyoxometalates at 205 and 260 nm, respectively. The fluorescence spectra of these four compounds have been studied, and they have emission peaks at 415 nm excited by 310 nm which are caused by Omicro-->Mo. The fluorescence lifetimes of these compounds have been studied.

[Study on the modification of short chain phoshate ammonium salt of bentonites].

The Organobentonites were synthesized by means of the ionexchange reaction of Na+ between tetramethylammonium chloride and tetrabutylammonium chloride quaternary ammonium salts, and sodium base bentonites. The authors used FTIR, X-ray diffraction diagram and DSC thermograms to characterize the structure of the modified bentonites, and discussed the effect of different quaternary ammonium salt on the properties of organobentonites. The results showed that ions of the surfactants had entered into the chip layer of the bentonites, changed the hydrophilic environment of the chip layer into a hydrophobic environment, increased the distance among the chip layers, and improved the compatibility between montmorillonite andthe organic phases. All of these have laid a base for the preparation of nanometer composite material of high polymer/bentonite.

Calcitonin gene-related peptide receptor activation produces PKA- and PKC-dependent mechanical hyperalgesia and central sensitization.

Calcitonin gene-related peptide (CGRP), acting through CGRP receptors, produces behavioral signs of mechanical hyperalgesia in rats and sensitization of wide dynamic range (WDR) neurons in the spinal cord dorsal horn. Although involvement of CGRP receptors in central sensitization has been confirmed, the second-messenger systems activated by CGRP receptor stimulation and involved in pain transmission are not clear. This study tested whether the hyperalgesia and sensitizing effects of CGRP receptor activation on WDR neurons are mediated by protein kinase A or C (PKA or PKC) signaling. Intrathecal injection of CGRP in rats produced mechanical hyperalgesia, as shown by paw withdrawal threshold tests. CGRP-induced hyperalgesia was attenuated significantly by the CGRP1 receptor antagonist, CGRP8-37. The effect was also attenuated significantly by a PKA inhibitor (H89) or a PKC inhibitor (chelerythrine chloride). Electrophysiological experiments demonstrated that superfusion of the spinal cord with CGRP-induced sensitization of spinal dorsal horn neurons. The CGRP effect could be blocked by CGRP8-37. Either a PKA or PKC inhibitor (H89 or chelerythrine) also attenuated this effect of CGRP. These results are consistent with the hypothesis that CGRP produces hyperalgesia by a direct action on CGRP1 receptors in the spinal cord dorsal horn and suggest that the effects of CGRP are mediated by both PKA and PKC second-messenger pathways.

Role of calcitonin gene-related peptide in the sensitization of dorsal horn neurons to mechanical stimulation after intradermal injection of capsaicin.

This study was designed to assess the role of calcitonin gene-related peptide (CGRP) and its receptor in the sensitization of dorsal horn neurons induced by intradermal injection of capsaicin in rats. Extracellular recordings were made from wide dynamic range (WDR) dorsal horn neurons with receptive fields on the hindpaw in the lumbar enlargement of anesthetized rats. The background activity and responses to brushing, pressing, and pinching the skin were assessed. A postsuperfusion or a presuperfusion of CGRP(8-37) paradigm was followed. When tested 30 min after capsaicin injection, there was an increase in background activity and responses to brush, press, and pinch applied to the receptive field. Superfusion of CGRP(8-37) into the spinal cord at 45 min after capsaicin injection significantly reversed the increased background activity and responses to brush, press, and pinch applied to the receptive field. On the other hand, spinal superfusion of CGRP(8-37) prior to capsaicin injection prevented the increased background activity and responses to brush, press, and pinch of WDR neurons that occurred following capsaicin injection in control experiments. A sensitization of spinal dorsal horn neurons could also be induced by superfusion of the spinal cord with CGRP. The effect could be blocked by CGRP(8-37) dose-dependently. Collectively, these results suggest that CGRP and its receptors are involved in the spinal cord central sensitization induced by intradermal injection of capsaicin.

Effects of intrathecal injections of melatonin analogs on capsaicin-induced secondary mechanical allodynia and hyperalgesia in rats.

Melatonin, its agonists/antagonists were administered intrathecally (i.t.) before/after intradermal injection of capsaicin. Capsaicin produced an increase in the paw withdrawal frequency (PWF) in the presumed area of secondary mechanical allodynia and hyperalgesia. Melatonin agonists in the absence of a capsaicin injection decreased the PWF significantly, whereas melatonin antagonists given intrathecally alone were ineffective in the absence of a capsaicin injection. Pre-treatment with a melatonin agonist i.t. caused a reduction in the PWF after capsaicin. In contrast, the PWF increased after capsaicin with pre-administration of a melatonin antagonist i.t. Combined pre-treatment with melatonin and a melatonin antagonist i.t. prevented the change in PWF induced by melatonin alone after capsaicin. Intrathecal post-treatment with a melatonin agonist reduced the enhanced PWF that followed an injection of capsaicin, but treatment with a combination of a melatonin agonist and its antagonist did not alter the responses. The PWF was unaffected when melatonin analogs were applied i.t. at the T6 level or were injected intramuscularly adjacent to the L4 vertebra. In spinal rats, the data showed comparable effects of melatonin analogs on capsaicin-induced secondary mechanical hyperalgesia. Animal motor function tested by 'activity box' showed that motion activity was not affected by i.t. melatonin or its antagonist. These results suggest that activation of the endogenous melatonin system in the spinal cord can reduce the generation, development and maintenance of central sensitization, with a resultant inhibition of capsaicin-induced secondary mechanical allodynia and hyperalgesia.

Suppression of neuropathic pain by peripheral electrical stimulation in rats: mu-opioid receptor and NMDA receptor implicated.

Peripheral electrical stimulation (PES) has been utilized to manage chronic pain associated with nerve injury. However, the data on clinical effectiveness are conflicting and the neurophysiological mechanism is not well known. This study was designed to assess whether PES relieved neuropathic pain and its possible mechanisms. The neuropathic pain model was made with lumbar 5th (L5) and 6th (L6) spinal nerve ligations in rats. Nociceptive responses of the rats were assessed by the cold plate test (the number and duration of paw lifts that occurred in 5 min on a 5 +/- 1 degrees C cold plate). PES with a frequency of 2 Hz and at increasing strengths was given for 30 min via stainless-steel needles inserted into standard acupoints on the leg and back, respectively. Immunochemistry was used to examine the immunoreactivity of the NMDA receptor 1 (NR1) subunit in the spinal cord dorsal horn. The results are as follows: (1) PES relieved neuropathic pain and the effect was blocked by 1.0 mg/kg naloxone. (2) The effect of one session of PES lasted up to 12 h. (3) Repetitive PES showed a cumulative effect and no tolerance was observed. (4) There was a significant increase of NR1 immunoreactivity in the superficial laminae of the spinal cord of neuropathic pain rats as compared with naive rats. This increase could be reversed by repetitive 2 Hz PES. These results suggest that PES can relieve neuropathic pain, and that mu-opioid receptors and NMDA receptors are involved in the effect of PES.

[Structural characterization of rare-earth stearate and its thermal stability mechanism for PVC].

Structural characterization of rare-earth stearate was conducted by FTIR and XRD. The results show that the bonds between the stearate and rare-earth metal ions in rare-earth stearate are main ionic character and have the stratified crystalline structure with the crystal layer formed from a plane layer of rare-earth ions combined with two layers of fully extended zigzag chains of stearic acid radicals arranged parallell to each other on its both sides, and the rare-earth ions axes are inclined to the crystal layer planes in it. Congo red test showed that the stabilizing time increased when the stabilizers' concentration increased. The order of stability of this four rare-earth stearates is Last>Ndst>Yst>Dyst. Furthermore, the thermal stability mechanism of rare earth stearate for PVC has been presumed by FTIR. The results indicate that Last and Ndst can bate the chain reaction and exchange the labile functional groups in the backbone chains for other more stable substituents derived from the stabilizer and change the framework, while Yst and Dyst's effect is not clear.

[Hydrothermal synthesis and spectra properties of compound Mn5(PO3(OH))2(PO4)2(H2O)4].

The title compound Mn5(PO3(OH))2(PO4)2(H2O)4 was synthesized under hydrothermal condition. Its crystal structure was determined by single-crystal X-ray diffraction. DRS, IR, fluorescence and TGA spectra were used to characterize the title compound. As a result, the compound is formed by linking with PO4 and MnO6, and the oxygen in it can be divided to three categories, so in IR spectra the characteristic peaks of Mn-O and P-O are separated in to three, respectively. In DRS there aretwo peaks at 210 and 250 nm coresponding Od-->Mn and Ob,c-->Mn. In fluorescence spectra the emission peaks are located at 354 and 413 nm when excited at 218 and 310 nm. Besides, thermal behavior of the compound is discussed by TGA diagrams. Finally, quantum chemistry calculation is performed to explain the structure characteristic. HF = -4558.6595551 a.u., HOMO(Alpha) = - 0.280 80a. u, LOMO(Alpha) = 0.01527 a.u., deltaE(Alpha) = 0.29607 a.u.; HOMO(Beta) = -0.25919 a.u., LOMO(Beta) = 0.00108 a.u., deltaE(Beta) = 0.260 72 a.u. and Dipole = 4.2082 Debye.