[The application of rapid rehabilitation model of multidisciplinary cooperation in cesarean section and the evaluation of health economics].

Objective: To explore the application value of multiple disciplinary team Enhanced recovery after surgery (MDT-ERAS) in cesarean section and evaluate its health economic benefits. Methods: A total of 572 cases of pregnant women undergoing cesarean section in obstetrics department of Jiaxing Maternity and Child Health Care Hospital from March 2018 to March 2019 were selected and randomly divided into experimental group and control group, 286 cases in each group. The control group was treated with traditional rehabilitation mode, and the experimental group was treated with MDT-ERAS intervention to compare the difference of rehabilitation index and health economics index between the two groups, and to evaluate the application value and health economics benefit of MDT-ERAS. Results: The VAS scores of the two groups at 1 day after operation were higher than those at the time of returning to the ward after operation(1.81±0.40 VS. 1.58±0.39, 3.78±0.89 VS. 3.22±0.83, all P<0.05). The VAS scores at 2 days and 3 days after operation were lower than those at the time of returning to the ward(0.58±0.09 VS. 1.58±0.39, 1.02±0.15 VS. 1.58±0.39; 1.88±0.37 VS. 3.22±0.83, 2.67±0.44 VS. 3.22±0.83, all P<0.05). The VAS scores of the experimental group at each time point after operation were lower than those of the control group(1.58±0.39 VS. 3.22±0.83, 1.81±0.40 VS. 3.78±0.89, 1.02±0.15 VS. 2.67±0.44, 0.58±0.09 VS. 1.88±0.37), and these differences were statistically significant (P<0.05). The anal exhaust time, indwelling catheterization time, first time out of bed and first time eating time of the experimental group were lower than those of the control group, with statistical significance (P<0.05). Postpartum hemorrhage rate and neonatal milk addition rate in the experimental group were significantly lower than those in the control group (all P<0.05). The hospitalization time and hospitalization expenses of the experimental group were lower than those of the control group(all P<0.05), and the health economics benefit of the experimental group was significantly higher than that of the latter (P<0.05). Conclusion: MDT-ERAS can effectively improve the recovery rate of the parturient after cesarean section, ensure the analgesic effect and improve the maternal and infant outcomes, and has higher health and economic benefits, which is worthy of promotion.

[The analysis of clinical characteristics and disease activity in ankylosing spondylitis patients with hyperuircemia].

Objective: to investigate the clinical characteristics and disease activity in ankylosing spondylitis (AS) patients with hyperuricemia. Method: Laboratory tests, magnetic resonance imaging, disease activity and functional index of AS patients from Fudan University Zhongshan Hospital were collected. T test, square test were applied to investigate the difference between AS patients with hyperuricemia and AS patients with normal serum uric acid in clinical characteristics and disease activity in AS patients. Result: Among all the AS patients, 23.4% (22/94) patients accompanied with hyperuricemia. AS patients accompanied with hyperuricemia showed significant younger age (28.9±7.9 vs 35.8±11.1, P=0.002); higher serum alanine aminotransferase (33.6±23.6 vs 19.8±12.4, P=0.014), aspartate aminotransferase (23.8±8.7 vs 18.6±9.6, P=0.025) and creatinine (78.4±12.5 vs 69.8±13.3, P=0.009), lower Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (11.2±8.8 vs 17.9±12.0, P=0.027) and Bath Ankylosing Spondylitis Functional Index (BASFI) (0.7±0.9 vs 1.8±2.2, P=0.002) compared with AS patients whose serum uric acid level is normal. Conclusion: AS Patients with younger age, impaired hepatic and renal funtion and lower scores in BASDAI and BASFI tend to accompany with hyperuricemia.

[Effect of famine exposure on the risk of chronic disease in later life among population in Harbin].

Objective: To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus, obesity, hypertension, coronary heart disease and stroke in the population of Harbin. Methods: Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin. Retrospective cohort study design was used. Related risks on chronic diseases including diabetes mellitus, obesity, hypertension, coronary heart disease and stroke, were compared among the famine exposed or non-exposed people, respectively by logistic analysis method. Results: After adjusted for factors as age, sex, physical activity, smoking, alcohol intake, diet, family history of diseases, it appeared that the factor 'famine exposure' had increased the risks of diseases as obesity (OR=1.204, 95%CI: 1.104-1.313, P<0.01), hypertension (OR=1.315, 95%CI: 1.210-1.429, P<0.01) and coronary heart disease (OR=1.495, 95%CI: 1.369-1.632, P<0.01). The lower the age of population being exposed to famine, the greater the risk of the development of all kinds of chronic diseases. Conclusions: Famine exposure appeared a risk factor for obesity, hypertension, and coronary heart disease. It is of great significance to ensure the life-long nutrition of the people, especially in the early and adolescent stages, to prevent obesity, hypertension, and coronary heart disease in their later lives.

Chemical characteristics for different parts of Panax notoginseng using pressurized liquid extraction and HPLC-ELSD.

The chemical characteristics for different parts of Panax notoginseng, including root, fibre root, rhizome, stem, leaf, flower and seed, were determined using high performance liquid chromatography-evaporative light scattering detection (HPLC-ELSD) and pressurized liquid extraction (PLE). Eight major saponins, namely notoginsenoside R1, ginsenosides Rg1, Re, Rb1, Rc, Rb2, Rb3 and Rd were also quantitatively compared among the different parts of P. notoginseng. The chromatograms showed that there was significant difference between underground (root, fibre root, rhizome) and aerial (leaf and flower) parts from P. notoginseng, though the similarities of entire chromatographic patterns among tested samples from underground (0.965+/-0.029, n=12) and aerial parts (0.987+/-0.014, n=5) were similar, respectively. Especially, no saponin was detected in the seed of P. notoginseng. Hierarchical clustering analysis based on eight investigated saponins or the ratios of contents for ginsenoside Rg1/Rb1 and ginsenoside Rb3/Rb1 showed that the samples from different parts of P. notoginseng were divided into three main clusters. One cluster was underground parts, which contained rich protopanaxatriol and protopanaxadiol types saponins. The leaf and flower were in the same cluster, which contained protopanaxadiol type saponins only. Especially, ginsenoside Rc, Rb2 and Rb3, rare in the underground parts, were rich in aerial parts of P. notoginseng. The stem of P. notoginseng was another cluster. Based on the cluster analysis, the chemical characteristics for different parts of P. notoginseng were revealed. They are composite cluster (underground parts), protopanaxadiol cluster (aerial parts) and interim (stem) cluster, which was the one between the two typical clusters, respectively. The result shows that chemical characteristics of underground parts and aerial parts from P. notoginseng are obviously different, which is helpful for pharmacological evaluation and quality control of P. notoginseng.

The TGF-beta type III receptor is localized to the medial edge epithelium during palatal fusion.

During palatal fusion, the medial edge epithelial cells (MEE) but not the oral/nasal palatal epithelium, selectively undergo epithelial-mesenchymal transformation. It is known that this process is regulated, at least in part, by endogenous TGF-beta3. One conceivable mechanism is that restricted expression of TGF-beta receptors (TbetaRs) in a subpopulation of cells may localize TGF-beta responsiveness (Brown et al., 1999). However, TGF-beta type II receptor (TbetaR-II) is expressed by all palatal epithelial cells during palatal fusion (Cui et al., 1998) and therefore cannot localize TGF-beta3 responsiveness. To investigate the role of TGF-beta type III receptor (TbetaR-III) in MEE transformation, we examined the expression pattern of TbetaR-III in the developing palate from E12 to E15 mice in vivo and in vitro by immunohistochemistry and compared the expression pattern to that of type I receptor (TbetaR-I). The expression of TbetaR-III was temporo-spatially restricted to the MEE during palatal fusion, while the expression of TbetaR-I was primarily localized in all palatal epithelia, consistent with the expression patterns of TbetaR-II and TGF-beta3 (Cui et al., 1998). These results support our hypothesis that TbetaR-III localizes and mediates the developmental role of TGF-beta3 on MEE transformation by specific expression in the MEE. TbetaR-III may modulate TGF-beta3 binding to TbetaR-II in the MEE cells to locally enhance TGF-beta3 autocrine signaling through the TbetaR-I/TbetaR-II receptor complex, which contributes to MEE selective epithelial-mesenchymal transformation.

Immunohistochemical localization of TGF-beta type II receptor and TGF-beta3 during palatogenesis in vivo and in vitro.

The disappearance of medial edge epithelium (MEE) is a critical event for palate fusion. TGF-beta3 is one factor participating in the regulation of this process. To investigate the nature of ligand-receptor interactions in vivo between TGF-beta3 and the type II TGF-beta receptor (TbetaR-II), we compared the expression pattern of the receptor with TGF-beta3. Immunohistochemical analysis of the mouse fetus from E12 to E15 showed that expression of TbetaR-II in the palate began at E13 when the palatal shelves were in a vertical orientation. TbetaR-II was localized in the epithelial cells. This epithelium-favored distribution remained during palatal shelf elevation, the medial edge epithelial adherence, and midline epithelial seam disruption. After palate fusion and mesenchyme confluence, weak expression of TbetaR-II was present in the mesenchyme. To verify the possibility that TGF-beta3 and TbetaR-II expression coincide, immunohistochemistry was used to localize them both in serial sections. The distribution pattern of TGF-beta3 was also epithelium-limited in the palate from E13 to E15, and the spatial localization was correlated with the expression of TbetaR-II. Immunohistochemical localization of TbetaR-II and TGF-beta3 in palatal shelves in organ culture had patterns that were consistent with the in vivo results. These results suggest that TGF-beta3 exerts its developmental role through TbetaR-II in an autocrine fashion. The expression of both TGF-beta3 and TbetaR-II was below the detectable level in the mesenchyme following MEE disruption, suggesting that the TGF-beta3 signal might not be required once the MEE has completed phenotypic transformation/migration.

Expression of transforming growth factor beta in radiation interstitial pneumonitis.

We investigated the changes in transforming growth factor beta 1 (TGF-beta 1) mRNA and TGF-beta 3 protein expression that occur in radiation interstitial pneumonitis. We used TGF-beta 1-cDNA probe in situ hybridization and TGF-beta 3 polyclonal antibody in immunohistochemical techniques. Our results showed that the distribution of TGF-beta 1 mRNA and TGF-beta 3 protein basically coincided in blood vessels, airways, lung parenchyma, and alveolar macrophages. However, bronchial epithelial cells expressed only TGF-beta 3 proteins and no TGF-beta 1 mRNA. We found an increased expression of TGF-beta 1 mRNA and TGF-beta 3 proteins in radiation interstitial pneumonitis.

Collagen gene expression in radiation interstitial pneumonitis.

By using type I and type III collagen cDNA probe and cDNA-mRNA in situ hybridization, we observed the changes of rat lung alpha 1(I) and alpha 1(III) collagen gene expression in radiation interstitial pneumonitis. The results showed that the expressed cell of type I and type III collagen were scattered within the fibroblasts in the thickened interalveolar walls. The type I and type III collagen mRNA content in irradiated animals were higher than those in the controls at 0.5, 1, 2, 3, 6, and 12 months.

Genetic distinction of radix adenophorae from its adulterants by the DNA sequence of 5S-rRNA spacer domains.

Radix Adenophorae (Shashen), a traditional Chinese medicine commonly used as an antitussive and expectorant, is derived from roots of Adenophora stricta Miq. and Adenophora tetraphylla (Thunb.) Fisch. Twelve species and varieties of Adenophora and Glehnia, however, could act as substitutes or adulterants of Radix Adenophorae on the commercial markets in South East Asia, and roots of Adenophora hunanensis Nannf. and Glihnia littoralis F. Schmidt ex Miq. are the most common examples. The authentic identification of dried roots of A. stricta and A. tetraphylla, however, is difficult on the basis of appearance and morphology. A molecular genetic approach was developed here to identify the species of Radix Adenophorae. The 5S-rRNA spacer domains (approximately 250 bp) were amplified by the polymerase chain reaction (PCR) from genomic DNAs isolated from A. stricta, A. tetraphylla, A. hunanensis and G. littoralis, and subsequently, the nucleotide sequences were determined. Diversity in DNA sequence and restriction enzyme mapping among various species were found in their 5S-rRNA spacer domains, which could serve as markers for authentic identification of Radix Adenophorae.

[Extracorporeal shock wave lithotripsy in gallbladder stones: report of 200 cases].

The effect and experience in treating 200 patients having gallbladder stones with extracorporeal shock wave lithotripsy (ESWL) were reported. Traditional Chinese medicine was used in combination in these patients. The overall effective lithotriptic rate was 91%. In a follow-up study of 137 of the cases, the rate of complete disappearance of gallbladder stones was 16.8%, 25.5% and 39.4%, respectively 1, 3, and 6 months after lithotripsy. During treatment, the patients had no remarkable discomfort. The authors consider that the lithotriptic effect is related to the nature, size, morphology and structure of the stones and ESWL is promising non-operative treatment. However, improved instrumentation is necessary for better efficacy of lithotripsy.

[Studies on saponin accumulative in regularities Panax notoginseng (Burk) F. H. Chen].

OBJECTIVE: To determine the optimal harvest time for P. notoginseng through studying the changes of saponin contents with growth periods. METHODS: P. notoginseng samples were collected from the experimental plot regularly, and then the contents of total saponin and some main single saponins were analyzed by HPLC. RESULTS: Total saponin contents decreased from April through July, and increased from August through December. CONCLUSION: The optimal harvest time is determined as from October through December, which corresponds to the traditional harvest time.

[Studies on initial infection sources and channels of black spot on Panax notoginseng (Burk.) F.H. Chen].

OBJECTIVE: To probe into the occurring and developing regularities of black spot on Panax notoginseng for disease control. METHODS: After artificial inoculation, observation and analysis on the planting plots were conducted regularly. RESULTS: The main infection sources include diseased seeds, seedlings, plants and soils. On the plot of new cropping, the initial infection sources are diseased seeds and seedlings while diseased plants and soils with pathogens are the main sources onplot of old cropping. CONCLUSION: Wiping out the infection centre and sources are the major effective means for control of black spot on P. notoginseng.

A novel strategy with standardized reference extract qualification and single compound quantitative evaluation for quality control of Panax notoginseng used as a functional food.

Root of Panax notoginseng (Burk.) F.H. Chen (Sanqi in Chinese) is one of traditional Chinese medicines (TCMs) based functional food. Saponins are the major bioactive components. The shortage of reference compounds or chemical standards is one of the main bottlenecks for quality control of TCMs. A novel strategy, i.e. standardized reference extract based qualification and single calibrated components directly quantitative estimation of multiple analytes, was proposed to easily and effectively control the quality of natural functional foods such as Sanqi. The feasibility and credibility of this methodology were also assessed with a developed fast HPLC method. Five saponins, including ginsenoside Rg1, Re, Rb1, Rd and notoginsenoside R1 were rapidly separated using a conventional HPLC in 20 min. The quantification method was also compared with individual calibration curve method. The strategy is feasible and credible, which is easily and effectively adapted for improving the quality control of natural functional foods such as Sanqi.

A new bisabolane sesquiterpenoid from Euphorbia chrysocoma.

The new sesquiterpenoid (6R)-2-chloro-6-[(1S)-1,5-dimethylhex-4-en-1-yl]-3-methylcyclohex-2-en-1-one (1), together with ten known compounds, (6R)-6-[(1S)-1,5-dimethylhex-4-en-1-yl]-3-methylcyclohex-2-en-1-one (2), bauerenol acetate (3), lupenone (4), alpha-amyrenone (5), beta-sitosterol (6), stigmasterol (7), beta-amyrin (8), ursolic acid (9), betulinic acid (10), scopolin (11), have been isolated from the roots of Euphorbia chrysocoma Lévl. et Vant. Their structures have been elucidated by spectroscopic data.

[Effect of connective tissues underlying precancerous lesions combined with epithelia separated from normal mucosa].

The connective tissues underlying the precancerous changes of the epithelia were separated and combined with the epithelia which were separated from the normal mucosa. The combinations were transplanted in nude mice. Specimens were taken at 6 and 10 weeks after transplantation and routinely processed for microscopic examination. The results show that the connective tissue underlying epithelial dysplasia may induce the normal epithelium undergoing epithelial dysplasia changes. The experiment demonstrates the etiological importance of the connective tissue in the development of cancer, and may be applied clinically in the treatment of precancerous lesions.

Transforming growth factor-beta3 regulates transdifferentiation of medial edge epithelium during palatal fusion and associated degradation of the basement membrane.

Studies on transforming growth factor beta3 (TGF-beta3) deficient mice have shown that TGF-beta3 plays a critical role in palatogenesis. These null mutant mice have clefting of the secondary palate, caused by a defect in the process of fusion of the palatal shelves. A critical step in mammalian palatal fusion is removal of the medial edge epithelial cells from the midline seam and formation of continuous mesenchyme. To determine in more detail the role of TGF-beta3 in palatogenesis, we cultured TGF-beta3 null mutant and wild-type control palatal shelves in an organ culture system. The fate of the medial edge epithelial cells was studied in vitro using vital cell labeling and immunohistochemical techniques. Despite clear adherence, the null mutant palatal shelves did not fuse in vitro, but instead the medial edge epithelial cells survived at the midline position, and the basement membrane was resistant towards degradation. Supplementation of the culture medium with the mature form of TGF-beta3 was able to fully correct the defective fusion in the null mutant specimens. Our results demonstrate that the reason for the defective palatal fusion in TGF-beta3 (-/-) samples is not impaired adhesion. Our data define a specific role for TGF-beta3 in the events that control transdifferentiation of the medial edge epithelial cells including degradation of the underlying basement membrane.

Authentication of Panax notoginseng by 5S-rRNA spacer domain and random amplified polymorphic DNA (RAPD) analysis.

The great majority of Panax species are well-known herbal medicines in the Orient, and many of them share a close resemblance in appearance and chemical composition. Among these Panax species, the root of P. notoginseng (Sanqi) is a unique herb that has distinct clinical usage. Here, the 5S-rRNA spacer domains were isolated from P. notoginseng, P. japonicus var. major, P. stipuleanatus, P. quinquefolius, P. ginseng, P. zingiberensis, and P. wangianus, and four common adulterants of P. notoginseng including Curcuma wenyujin, Curcuma longa, Bletilla striata and Gynura segetum. The spacer domains were sequenced and compared, which showed over 75 % DNA identity among all Panax species, but not for the adulterants. In addition, random amplification of polymorphic DNA (RAPD) analysis was used to distinguish different members of Panax genus as well as the morphological variants of P. notoginseng. These molecular methods could be used in the authentic identification of P. notoginseng from other Panax species.

Ultraviolet-initiated reactions of H(2) with germanosilicate fibers and H(2) concentration dependence of the Bragg wavelength of a fiber grating.

We present a model with which to calculate the index increase induced in standard single-mode fiber by hydrogen loading. Also, we propose that the dominant products of reaction in UV-written hydrogenated standard communication fibers are GeE? and Si-OH. Based on the above models, we calculate the Bragg wavelength shifts that are due to hydrogen diffusion out of the fiber gratings. The relative effective index change that is due to hydrogen dissolved in fiber can be as much as 6 x 10(-4) if standard telecom fiber is hydrogen loaded with a concentration of ~1.44 mol.%. Theoretical results agree with experimental results.