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This article reports a case of adrenal tumor in a reproductive-aged woman with hyperandrogenism misdiagnosed as polycystic ovary syndrome. The patient presented with menstrual disorder, elevated testosterone levels, and polycystic ovaries, initially diagnosed as polycystic ovary syndrome. Menstrual regularity was achieved after intermittent use of ethinylestradiol/cyproterone acetate and progesterone. Five years later, during a physical examination, a mass was discovered in the right adrenal gland, accompanied by elevated testosterone levels, polycystic ovaries, obesity, and insulin resistance. Laparoscopic resection of the right adrenal tumor was performed, and the pathological diagnosis was adrenal cortical oncocytoma. Postoperatively, menstrual regularity was restored, and testosterone levels normalized. This case highlights the importance of considering adrenal tumors secreting androgens in patients clinically diagnosed with polycystic ovary syndrome, and emphasizes the need for regular adrenal imaging follow-up.
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Bladder has many important functions as a urine storage and voiding organ. Bladder injury caused by various pathological factors may need bladder reconstruction. Currently the standard procedure for bladder reconstruction is gastrointestinal replacement. However, due to the significant difference in their structure and function, intestinal segment replacement may lead to complications such as hematuria, dysuria, calculi and tumor. With the recent advance in tissue engineering and regenerative medicine, new techniques have emerged for the repair of bladder defects. This paper reviews the recent progress in three aspects of urinary bladder tissue engineering, i.e., seeding cells, scaffolds and growth factors.
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Humans , Intercellular Signaling Peptides and Proteins , Regenerative Medicine , Tissue Engineering , Tissue Scaffolds , Urinary BladderABSTRACT
OBJECTIVE:To improve medication compliance of patients with nonvalvular atrial fibrillation (NVAF) to warfarin and its influential factors,and to provide reference for guaranteeing the safety and effectiveness of therapy.METHODS:A questionnaire survey was conducted among NVAF patients receiving warfarin anticoagulation in our hospital,MMAS-8 and WRKS were adopted to evaluate medication compliance of patients to warfarin and the understanding of patients to the knowledge of anticoagulation treatment.Related influential factors for medication compliance of patients to warfarin were investigated by x2 test,t test and Logistic multiple regression analysis.RESULTS:Totally 129 questionnaires were sent out,and 112 were effectively received with effective recovery of 86.82%.The mean score of MMAS was (6.54 ± 1.61),and 42.86% patients had good medication compliance.The mean score of WRKS was (7.95 ± 1.65);that of patients with good medication compliance was (9.31 ± 0.83),and that of patients with poor medication compliance was (6.92 ± 1.34).Single factor analysis showed that there was statistical significance in gender,age,occupation,educational level,the number of compliance,WRKS score between patients with good medication compliance and those with poor medication compliance (P<0.05).Multivariate Logistic regression analysis showed that WRKS score,gender,educational level and the number of compliance were significantly correlated with medication compliance (P<0.05).CONCLUSIONS:Poor medication compliance of NVAF patients to warfarin is related to multiple influential factors.The knowledge of warfarin anticoagulation is an important factor.
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OBJECTIVE:To improve medication compliance of patients with nonvalvular atrial fibrillation (NVAF) to warfarin and its influential factors,and to provide reference for guaranteeing the safety and effectiveness of therapy.METHODS:A questionnaire survey was conducted among NVAF patients receiving warfarin anticoagulation in our hospital,MMAS-8 and WRKS were adopted to evaluate medication compliance of patients to warfarin and the understanding of patients to the knowledge of anticoagulation treatment.Related influential factors for medication compliance of patients to warfarin were investigated by x2 test,t test and Logistic multiple regression analysis.RESULTS:Totally 129 questionnaires were sent out,and 112 were effectively received with effective recovery of 86.82%.The mean score of MMAS was (6.54 ± 1.61),and 42.86% patients had good medication compliance.The mean score of WRKS was (7.95 ± 1.65);that of patients with good medication compliance was (9.31 ± 0.83),and that of patients with poor medication compliance was (6.92 ± 1.34).Single factor analysis showed that there was statistical significance in gender,age,occupation,educational level,the number of compliance,WRKS score between patients with good medication compliance and those with poor medication compliance (P<0.05).Multivariate Logistic regression analysis showed that WRKS score,gender,educational level and the number of compliance were significantly correlated with medication compliance (P<0.05).CONCLUSIONS:Poor medication compliance of NVAF patients to warfarin is related to multiple influential factors.The knowledge of warfarin anticoagulation is an important factor.
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Objective To explore the detailed underlying molecular and signaling mechanisms in the effects of icariin on bone formation by an in vitro cell model. Methods The proliferation of MC3T3-E1 osteoblast-like cells was evaluated by MTT, and gene expression of cell cycle related proteins in MC3T3-E1 cells after icariin treatment was detected by real-time PCR. The phosphorylation of MAPK signals, including ERK, P38, and JNK was determined by Western blot, and then the inhibitors of MAPK signals were used to treat cells with icariin alone or together to determine the role of MAPKs in the process of icariin treatment on MC3T3-E1 cell proliferation. Alkaline phosphatase and Alizarin red staining were used to detect the formation of mineralization nodules, and gene expressions of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in osteoblasts after being treated by icariin were evaluated by real-time PCR. ICI182780, and nilutamide was used to decide the participation of estrogen and androgen receptor signals in the process of icariin treatment on the differentiation and mineralization of MC3T3-E1 cells. Results Treatment with icariin promoted MC3T3-E1 cell growth in a time- and dose-dependent manner. This treatment also revealed that icariin increased the expression of mRNAs encoding both cyclin E and PCNA, positive regulators of cell growth, but decreased levels of mRNAs encoding Cdkn2b, a negative regulator of cell cycle progression. When MC3T3-E1 cells were cultured in a differentiated condition, icariin enhanced mineralized nodule formation and increased the expression of mRNAs encoding alkaline phosphatase, type Ⅰ collagen, and osteocalcin. Treatment with icariin significantly induced phosphorylation of both ERK and JNK and this phosphorylated effect occurred very rapidly within 5 minutes and reached peak at 15 minutes. Furthermore, the stimulated effects of icariin on proliferation and gene expression of cyclin E, PCNA, and Cdkn2b in MC3T3-E1 cells were dramatically attenuated by treatment with both U0126 and SP600125, inhibitors of MAPKs. Interestingly, such stimulating effects of icariin were at least partly reduced by treatment with ICI182780, an inhibitor of estrogen receptor. Icariin induced mineralized nodule formation and gene expression of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in MC3T3-E1 cells were also partly reduced when the cells were treated with ICI182780. Conclusions Our findings indicate that the anabolic effect of icariin on bone formation is, at least partly, mediated through the MAPK signaling pathway in order to modulate osteoblast proliferation and differentiation.
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Objective Recombinant human parathyroid hormone(1-34) [ rhPTH(1-34)] is the unique anabolic substance acting on the skeleton. The efficacy and safety of long-term administration of rhPTH(1-34) in Chinese postmenopausal women have not been evaluated. This study compared the clinical efficacy and safety of rhPTH(1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods A total of453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH(1-34) 20 μg(200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine ( L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover ( serum bone-specific alkaline phosphatase was measured by radioimmunoassay; C-telopeptide/ creatinine ( CTX/ Cr) measured by quantitative sandwich enzyme-linked immunosorbent assay) at 6, 12, and 18 months. Adverse events were recorded. Results rhPTH(1-34) increased lumbar BMD more significantly than that did by elcatonin at 6 months( M6), 12 months (M12), and 18 months(M18; 4. 3% vs 1. 94% , 6. 8% vs 2. 72% , 9. 51% vs 2. 86% , P<0. 01). There was only a small but significant increase of femoral neck BMD at M18(2. 64% , P<0. 01) in rhPTH(1-34) groups. There were greater increases in bone turnover markers in the rhPTH(1-34) group than in the elcatonin group at M6, M12, and M18[serum bone-specific alkaline phosphatase(BSAP) 93. 67% vs -3. 56% , 117. 78% vs -4. 12% , 49. 24% vs-5. 81% , P<0. 01; urinary CTX/ Cr 250% vs -29. 5% , 330% vs -41. 4% , 273 % vs -10. 6% , P<0. 01]. rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5. 36% (6 / 112) in elcatonin group and 3. 23% ( 11 / 341 ) in rhPTH ( 1-34 ) group ( P = 0. 303 ). Both treatments were well tolerated. Hypercaluria(9. 38% ) and hypercalcemia(7. 04% ) in rhPTH(1-34) group was transient and caused no clinical symptoms. Pruritus(8. 21% vs 2. 68, P=0. 044) and redness of injection site(4. 40% vs 0, P=0. 024) were more frequent in rhPTH(1-34). Nausea / vomiting(16. 07% vs 6. 16% , P = 0. 001) and hot flushes(7. 14% vs 0. 59% , P<0. 001) were more common in elcatonin group. Conclusion rhPTH(1-34) treatment was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months treatment. rhPTH(1-34) could ameliorate back pain effectively. The results of the present study indicate that rhPTH(1-34) is an effective, and safe agent in treating postmenopausal women with osteoporosis.
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Objective The aim of this study was to explore the effect of low density lipoprotein ( LDL) on the proliferation and differentiation of MC3T3-E1 osteoblasts, as well as the expression of low density lipoprotein receptor-related protein 5(LRP5) and dickkopf-1(DKK1) mRNA of MC3T3-E1 osteoblasts. The possible mechanisms of the treatment of atorvastatin on LDL expression in MC3T3-E1 osteoblasts were also investigated. Methods Proliferation, osteocalcin expression, LRP5, and expression of DKK1 mRNA of MC3T3-E1 with interaction of LDL at 0. 05, 0. 10, 0. 20 mg/ml levels after 24 h, 48 h, 72 h were detected by CCK8, ELISA, and fluorescence quantitative PCR. Furthermore, proliferation, osteocalcin expression, LRP5 and DKK1 mRNA of MC3T3-E1 after the treatment of atorvastatin of 10-6 mol/L and 10-5 mol/L were also be studied, respectively. Results The effect of LDL on proliferation, expression of osteocalcin and expression of LRP5 and DKK1 mRNA in MC3T3-E1 osteoblasts was the most obvious under LDL with 0. 20 mg/ml level. Under that level, atorvastatin (10-6 mol/L or 10-5 mol/L) was able to make the proliferation of MC3T3-E1 osteoblasts in 48 h and 72 h be decreased, while significantly caused upregulation of osteocalcin, LRP5 mRNA expression; and down regulated DKK1 mRNA expression ( all P<0. 05). Conclusions Atorvastatin can reduce the inhibitory effect of LDL on the proliferation and differentiation of osteoblasts. The mechanisms of atorvastatin on osteoblasts are possibly related to the osteoblast proliferation and expression of LRP5 mRNA and DKK1 mRNA of osteoblasts of wnt signal pathway.
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The pilot work urban workers medical network settlement of Anhui province has launched in full scale,effectively facilitating the population seeking medical service elsewhere.In this regard,the medical settlement of a pilot hospital is cited as an example to introduce the networked medical settlement in remote places,summarizing problems encountered,and coming up with proposals accordingly.
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Objective To observe the effect of icarrin on proliferation and differentiation of rat osteoblasts cultured in vitro as well as the expressions of bone morphogenetic protein-2 (BMP-2) and Osterix in rat osteoblast.Methods Calvarial osteoblasts were obtained from newborn (< 24 h) SD rats by trypsin-collagenase digestion.The culture medium with different icarrin concentrations and the second generation osteoblasts were mixed.The mRNA expressions of BMP-2,Osterix,ALP,and Col Ⅰ were detected by semiquantative RT-PCR.Then the second generation osteoblasts were cultured in the medium containing icariin (10 ng/ml) with or without BMP-2 antibody.After48 h,RT-PCR was used to estimate the mRNA expression of Osterix.Results In comparison with the control group,the mRNA expressions of BMP-2,Osterix,ALP,Col Ⅰ were increased in a dose-dependent manner (P<0.05) with a maximal effect at the concentration of 10 ng/ml.The mRNA expression of Osterix treated with the mixture of icarrin and BMP-2 antibody was significant decreased(P<0.05),and compared with the group of icarrin,however,the difference between the BMP-2 group and the mixture group was not statistically significant (P > 0.05).Conclusions Icarrin stimulates proliferation and differentiation of cultured osteoblast in vitro by increasing the mRNA expression of ALP and Col Ⅰ.Icarrin could stimulate Osterix gene expression by enchancing BMP-2 gene expression,finally,it could induce bone formation and prevent and/or treat osteoporosis.
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Objective To investigate the bacterial resistance in nationwide and understand the distribution of bacterial and resistance trend.MethodsThe 6507 clinical isolates were collected from 19 hospitals in 17 cities.The susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The values of MIC50,MIC90 and MICrange were calculated by SPSS 17.0 and the susceptibilities of isolates to antimicrobial agents were determined by using CLSI (2010) guideline.Of all 6507 isolates,4691 strains were collected from target wards and 1816 were isolated from others wards.ResultsAmong 4691 strains,1156 were Gram-positive (24.6% ) and 3535 were Gram-negative (75.4%).Based on the minimum inhibitory concentration results,the prevalence of methicillin resistant Stapylococcus aureus and methicillin resistant Stapylococcus epidermidis are 51.6% ( 325/630 ) and 87.0% ( 228/262 ) respectively.Staphylococci showing intermediate or full resistance to vancomycin were not observed. Coagulase negative Staphylococci showed 2.5% (16/642)intermediate rate and 1.6% ( 10/642 ) full resistance rate to teicoplanin,and showed 0.5% ( 3/642 )resistance rate to linezolid.Antibiotic resistance rate of Enterococcus faecalis to ampicillin was 17.1%(19/111),while the resistance rate of Enterococcus faecium to ampicillin reached up to 85.0%(164/193).Three Enterococcus faecium were resistant to glycopeptides.The prevalence of penicillin resistance Streptococcus pneumoniae and penicillin intermediate Streptococcus pneumoniae were 41.2% ( 145/352) and 37.2% (131/352) respectively based on oral penicillin criterion,while the prevalence were 0.0% (0/352) and 6.0%(21/352) based on vein to non-meningitis criterion.A vast majority of Enterobacteriaceae maintained high susceptibility to carbapenems,with resistance rate less than 2.0%.In addition,tigecycline,moxalactam,fosfomycin and amikacin displayed desirable antibacterial activity against Enterbacteriaceae,and resistance rates to these drugs were all less than 10.0%.For non-fermenting Gramnegative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 23.1% ( 139/601 ) and 53.5% (419/784) respectively.Resistance rate of Acinetobacter baumannii was much higher than that during the period 2007 - 2008.Colistin,tigecycline,minocycline and fosfomycin demonstrated good antibacterial activity against Acinetobacter baumannii in vitro.Conclusions Compared with MOHNARIN 2007 -2008year surveillance results, significant increase in resistance rate of Acinetobacter baumannii was demonstrated.Resistant strains to linezolid and tigecycline were found.Bacterial resistance has been a widespread problem in our country,which requires much more attention.
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Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C < 7.0% at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21% ± 1.65% to 6.69%±0.83%,P<0.001),69.7% of the patients achieved HbA1C <7.0% at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P<0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2%,and the incidence of confirmed hypoglycemia was 3.8%.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.
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Objective To assess the coordinated regulation and the molecular mechanisms of 17β-estradiol and 1,25-dihydroxyvitamin D3 [ 1,25-( OH ) 2 D3 ] on the proliferation and differentiation of osteoblastic MC3T3-E1 cells.Methods MC3T3-E1 cells were cultured in phenol-red free α-MEM medium supplemented with 10% FBS,MTT assay was performed to determine the effects of 17β-estradiol and 1,25-( OH )2 D3 on MC3T3-E1 cells proliferation.After cells were treated with different agents,cell cycle related genes [ cyclin E,proliferation cell nuclear antigen ( PCNA ),and cyclin-dependent kinase inhibitor 2b ( Cdkn2b ) ] and markers of osteoblastic differentiation [ type Ⅰ collagen ( COL Ⅰ ),alkaline phosphatase ( ALP),osteopontin ( OPN ) ] were detected with SYBR green-based quantitative PCR.ALP activity was detected with BCIP/NBT method.Results 17β-estradiol could promote proliferation of MC3T3-E1 cells,which was accordant to its ability to increase cyclin E and PCNA and to inhibit Cdkn2b mRNA expression in MC3T3-E1 cells.However,1,25-( OH)2D3 had no effect on the proliferation of MC3T3-E1 cells and also did not enhance the proliferation of MC3T3-E1 cells stimulated by 17β-estradiol.On the other hand,17β-estradiol promoted the gene expression of differentiation markers Col Ⅰ,ALP,and OPN,and 1,25-(OH) 2 D3 synergistically increased the expression of these genes with 17 β-estradiol.Conclusion As two of the most important hormones which regulate bone metabolism,estrogen and vitamin D may coordinately promote osteoblast differentiation,but may not regulate osteoblasts proliferation synergistically.
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This paper was aimed to investigate the effects of icariin on the expression of p38 mitogen activated protein kinase(MAPK)protein in rat osteoblasts cultured in vitro, to elucidate the signal transduction of icariin in preventing and treating osteoporosis. The results showed that p38MAPK could be activated by icariin within 5min, and Cbfal could also be upregulated, and SB203580, an inhibitor of p38MAPK pathway, could partly inhibit Cbfal upregulation by icariin.
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Objective To study the changes of bone mineral density(BMD)and bone turnover in postmenopausal osteoporotic patients treated with salmon calcitonin nasal spray. Methods Sixty-seven postmenopausal osteoporotic patients were enrolled in our trial. All of them received calcium and vitamin D; 37patients were treated with salmon calcitonin nasal spray for 12 months and the other 30 patients received calcium and vitamin D only. Dual-energy X-ray absorptiometry(DEXA)and measurements of a series of bone turnover indices were performed before and after medication for 6 and 12 months. Results After treatment with salmon calcitonin nasal spray for6 months, BMD in lumbar spine 2-4 increased but no change occurred in femoral neck. However, after treatment for 12 months, BMD in both lumbar spine 2-4 and femoral neck increased. In the control group, BMD in lumbar spine 2-4 decreased after treatment for 6 and 12 months, but BMD in femoral neck decreased only after 12months. Comparing with the control group, after treatment with salmon calcitonin nasal spray, BMD in lumbar spine 2-4 and femoral neck were increased obviously. The level of TRACP-5b and NTX/Cr decreased after treatment with salmon calcitonin nasal spray for6 months and 12 months, while BALP increased only after treatment for 12 months. In the control group, BALP decreased after treatment for 12 months. The level of 25-(OH)vitamin D increased after treatment for 6 months and 12 months in both groups. Conclusions Long-term treatment with salmon calcitonin nasal spray prevents bone loss and may increase bone mass.
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Objective To compare the clinical efficacy and safety between recombinant human parathyroid hormone ( rhPTH) ( 1 -34) and elcatonin in the treatment of postmenopausal women with osteoporosis in China.Methods This 6 month, multicenter, randomized and controlled study enrolled 205 postmenopausal women with osteoporosis.They were randomized to receive either rhPTH (1 -34) 20 μg (200 U) daily or elcatonin 20 U weekly.Lumbar spine (L1-4 ) and femoral neck bone mineral density (BMD) and biochemical markers of bone turnover were measured. In the meantime adverse events were recorded. Results The results showed that both rhPTH ( 1 -34) and elcatonin increased L1-4 BMD significantly at the endpoint of the study, but femoral neck BMD did not change significantly.From baseline to endpoint, BMD of L1-4 and femoral neck in the rhPTH( 1-34) group increased by 5.51% (P <0.01) and 0.65% (P >0.05), but BMD of L1-4 and femoral neck in elcatonin group increased by 1.55% (P <0.05) and 0.11% (P>0.05).Moreover, the rhPTH(1-34) group had better improvement in L1-4 BMD than the elcatonin group at 3, 6 months, but there was no difference of BMD in these two groups with regard to femoral neck.There were greater mean increases of the bone markers in the rhPTH( 1-34) group than those in the elcatonin group at 3, 6 months [serum bone-specific alkaline phosphatase ( BSAP) 36.79% vs 0.31% ; 92.42% vs -0.17% ; the ratio of urine N-telopeptide of type I collagen and creatinine (NTX/Cr) 48.91% vs -5.32% ; 68.82% vs - 10.86%].Both kinds of treatment were well tolerated and there were no differences between the two groups in the rates of adverse events and serious adverse events.Conclusion It is concluded that rhPTH (1 -34) has more positive effects on bone formation than elcatonin as shown by the greater increments of L1-4 BMD and bone formation markers and the less occurrence of adverse events as well as no significant change in hepatic, renal or hemopoietic function.
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Objective To investigate the effects of icarrin on the activity and protein expression of core binding factor otl(Cbfa1) in rat osteoblasts cultured in vitro,and to explore whether mitogen-activated protein kinase (MAPK) pathway is involved in this process.Methods Calvarial osteoblasts were obtained from newborn (<24 h) SD rats by trypsin-coUagenase digestion method.The second generation osteoblasts were cultured in the medium containing icariin (10 ng/ml) or estradiol (10-8 mol/L) with or without extracellular-signal regulated kinase (ERK) inhibitor (UO126) or p38MAPK inhibitor (SB203580).Nuclear protein was extracted from osteoblasts.And then the activity of Cbfa1 was detected by ELISA.The amounts of Cbfa1 protein were detected by Western blot.Results Calvarial osteoblasts were obtained successfully and were used in this study after indentified by alkaline phosphatase and mineralized nodus staining.Cbfa1 expression and the activity in osteoblasts were up-regulated by both icariin and estradiol (P<0.05).The effects were partly inhibited by addition of U0126or SB203580 (P<0.05).Conclusions Either icarrin or estradiol can stimulate the proliferation and maturation of cultured osteoblasts in vitro via up-regulating the activity and expression of Cbfal.The MAPK signal pathway inhibitor seems to partly decrease Cbfa1 activity.It suggests that MAPK pathway may be involved in the transduction of icariin's impact on proliferation and mineralization of osteoblasts.
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OBJECTIVE To investigate the variation of in vitro activity,the ?-lactamases,type diversity and the homology of multiple resistances in Acinetobacter isolated.METHODS The multiple resistant Acinetobacter were selected to detect susceptibility test by K-B antimicrobial agents.The resistant rates were analyzed by WHONET 5.4,the isolates ?-lactamases phenotype was detected by three-dimensional test,genomic types were measured by PFGE.The ?-lactamases genotype was determined by PCR assay with specific-primer,and DNA sequencing was also used to analyze resistance-related gene.RESULTS Twenty-eight of 45 strains were OXA producing strains(68.3%),10 strains were IMP producing strains(24.4%),13 strains were TEM producing strains(31.7%),18 strains were CTX-M producing strains(43.9%),6 strains were PER producing strains(14.6%),and 7 strains were AmpC producing strains(17.1%).None produced SHV ?-lactamases.Twenty-four strains were produced 2 or more than 2 kinds of ?-lactamases.CONCLUSIONS The multiple resistance of Acinetobacter can produce kinds of ?-lactamases,but producing ?-lactamases are not the only one mechanism.
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The diagnosis and treatment of invasive fungal infections has been attracting more and more attention along with the increase incidence in the current clinical practice.We hereby work out this paper to elaborate some key issues,coveting the history and methodology of anti-fungal susceptibility testing, the MIC recognition of yeast fungus and mycelial fungus,breakpoint interpretation,and finally the guidance for clinical practice.To better undemtand susceptibility test results and improve the guality of susceptibility tests in this review,we chosed several most-often used anti-fungal drugs and explained their effect activity.
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Objective To investigate the effect of total flavonoids of Herba Epimedii (HEF) on the apoptosis of osteoblasts in the ovariectomized (OVX) rats. Methods Fifty-four female rats were allocated into 6 groups (9 rats in each group) ; OVX group, sham-operated group, 3 groups with OVX followed by three different dosages of HEF(40,80 and 160 mg· kg-1·d-1) and another group by nilestriol (0.1 mg· kg-1·d-1) for 12 weeks respectively. Bone mineral density (BMD) of whole body of rats was determined by DEXA. The serum level of estradiol was measured by radioimmunologic assay. Apoptotic ceils were examined using terminal dexynudeotidyl transferase-mediated dUTP nick end labeling (TUNEL) and observed by electron microscope. The protein expressions of transforming growth factor (TGF)-β1 ,fibroblast growth factor (FGF)-2 and Fas were tested withimmunohistochemical methods. Results Compared with the OVX group,BMD in the HEF treated (80 and 160 mg ·kg-1·d-1) groups were increased (P < 0.01), but the serum level of estradiol was not increased (P >0.05). Positive expression rate of apoptotie osteoblasts and osteocytes in the OVX group was significantly higher than that in sham-operated group after 12 weeks (P < 0. 01), and were decreased after HEF treatment (P < 0.01).Compared with the OVX group, Fas expression in the HEF treated groups was significantly decreased (P < 0.01), and expressions of TGF-β1 and FGF-2 were significantly increased, especially in 80 and 160 mg·kg-1·d-1 HEF groups (P < 0.01). Conclusion HEF has antiosteoporotic effect in ovariectomized rats. HEF can inhibit apoptosis of osteoblasts and osteocytes, which may thus contribute to its antiosteoporotic effect.
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OBJECTIVE To investigate the occupational hazard situation among medical staff and conduct effective measure and enhance the medical care.METHODS A questionnaire survey on occupational hazard had been completed among the hospitals in Fengtai District in Beijing in three years.RESULTS The rate of sharp damage of medical staff was 72.13%,from them the nurses were with highest rate(81.49%).The higher rate of sharp damage was in the operating theater(88.32%)and the surgical department(82.49%).CONCLUSIONS To assure the medical safety,we should pay more attention to the occupational hazard management.