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Objective To clarify the mechanisms that the response of fibroblast-like synovial (FLS) cellsto methotrexate (MTX) in rheumatoid arthritis (RA) and to provide theory basis for the drug treatment of RA.Methods Synovial fibroblasts were isolated from synovial tissue specimens obtained from patients with RA andexposed to MTX.Cell viability was measured using a MTT assay and cell apoptosis was valued by flow cytometry.Western blotting analysis of LC3 and immunocytochemistry were used to analyze the induction of autophagy in RA-FLS after treating with MTX.Transfection of siRNA was used to interfere the expression of Beclin1 to down-regulate the autophagy,cell apoptosis was valued by flow cytometry and western blot analysis was used to test the PARPp85 with or without the presence of MTX.Statistical product and service solutions (SPSS) 18.0 statistical software was used for statistical analysis of all experimental data.Independent sample t test was used according to data distribution status,homogeneity of variance,and normal distribution.GraphPad Prism 5.0 was used to draw statistical graphs.Results MTX induced apoptosis was increased in RA-FLS.MTX stimulated the autophagy response in RA-FLS by inducing autophagosome formation.In RA-FLS,transfection with Beclin1 siRNA inhibited autophagy and increased the susceptibility to MTX,which induced cell death.Conclusion Autophagy of RA-FLS contributes to the resistance to apoptosis induced by methotrexate.
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Objective@#To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population.@*Methods@#The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence.@*Results@#1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence.@*Conclusions@#The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.
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Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .
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Objective To derive a questionnaire to assess the risk of developing motor complications through a 3-year prospective investigation on 71 patients of Parkinson' s disease (PD) in the out clinic at our hospital.Methods Three years after the first assessment,71 PD out patients were reassessed using various scales,including Unified Parkinson Disease Rating Scale,Hoehn-Yahr grade,Mini Mental State Exam,Hamilton Depression Scale and Hamilton Anxiety Scale.Results The incidence of motor complications was 43.6％ (31/71).Logistic regression analysis showed that the prognostic factors for motor fluctuation were age of onset ≤ 54 (OR =6.4,95％ CI 1.7-24.5,P =0.006),the occurrence of swallowing difficulty (OR =3.8,95 ％ CI 1.0-14.1,P =0.04) and depression (OR =4.0,95 ％ CI 1.1-13.7,P =0.03),and the prognostic factors for dyskinesia were age of onset ≤54 (OR =48.5,95％ CI 1.9-121.0,P:0.02),the occurrence of falling (OR =64.1,95％ CI 2.9-142.2,P =0.008) and the daily levodopa dosage ＞ 600 mg(OR =17.5,95％ CI 1.1-276.2,P =0.04).Based on the regression model,the assessment questionnaire for motor complicationsincludes the followings:the questionnaire for motor fluctuations:the age of onset ≤54,2 points; the occurrence of swallowing difficulty,1 point; the occurrence of depression,1 point; the questionnaire for dyskinesia:the onset age ≤54,2 points; the occurrence of falling,3 points; daily levodopa dosage ＞ 600 mg,2 points.In all patients in this study,21.7％ (10/46) was asscssed to a total scorc of 0-1 which is associated with a low risk of motor fluctuation,8/16 had a score of 2 which is associated with intermediate risk and 8/9 got a score of 3-4 associated high risk; 10.2％ (5/49) had a score of 0-2,a low risk of dyskinesia,4/13 had a score of 3-4,a intermediate risk and 7/9 got a score of 5-7 which is associated with a high risk.Conclusions Age onset ≤54,the occurrence of swallowing difficulty,falling and depression,daily levodopa dosage ＞ 600 mg were considered to be the prognostic factors of motor complications in PD.The questionnaire may help to stratify PD patients into low-risk,medium-risk and high-risk groups for motor complications and the higher the score in the questionnaire is related to the higher risk of motor complications.
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Objective To study the antihypertensive efficacy and influence on the blood pressure parameters of nifedipine GITS therapy in patients with subacute cerebral infarction with essential hypertension by ambulatory blood pressure monitoring (ABPM).Methods Fifty-one cases of subacute cerebral infarction with essential hypertension were treated with nifedipine GITS for 14 days.ABPM were performed in all cases before and after treatment.The blood pressure parameters of blood pressure variability (BPV),morning blood pressure surge(MBPS),Trough/Peak(T/P),and smoothness index(SI) were analyzed.Results (1) After treatment with nifedipine GITS 30 mg/d for two weeks,the average 24-hour systolic blood pressure (SBP),day-time systolic blood pressure (dSBP),night-time systolic blood pressure (nSBP),24-hour diastolic blood pressure (DBP),day-time diastolic blood pressure (dDBP),night-time diastolic blood pressure (nDBP) significantly decreased((144.70 ± 14.89) mm Hg vs (163.10 ± 16.48) mm Hg,(145.67 ± 15.20) mm Hg vs (164.55 ±16.81) mm Hg,(140.85 ± 19.46) mm Hg vs (156.73 ±20.55) mm Hg,(81.24 ±8.88) mm Hg vs(89.49 ± 10.06) mm Hg,(81.25 ±9.40) mm Hg vs (90.18 ± 10.64) mm Hg,(81.34 ± 12.10) mm Hg vs (86.28 ±12.11) mmHg;t=11.01,11.53,5.29,8.71,7.53,2.31;P＜0.05)).(2) Defining the standard deviation(SD) of average blood pressure as the indexes of BPV,the blood pressure variability of systolic blood pressure(SBPV),day-time systolic blood pressure variability (dSBPV),night-time systolic blood pressure (nSBPV) decreased significantly ((16.52 ± 4.38) mm Hg vs (19.78 ± 6.72) mm Hg,(15.45 ± 4.71)mm Hg vs (17.88 ± 7.25)mm Hg,(14.94 ± 5.89) mm Hg vs (19.17 ± 8.27) mm Hg; t =3.38,2.19,2.99 ;P ＜0.05)) and the diastolic blood pressure didn't change.(3) There was negative correlation between smoothness index (SI) and BPV (r =-0.28 ; P ＜ 0.05).(4) The decreases of morning blood pressure surge (MBPS) of SBP was more significant after treatment ((22.65 ± 12.77) mm Hg) than that before treatment ((31.94 ±16.36) mm Hg).(5) The median of T/P ratio calculated by group methods was 0.721 for SBP and 0.676 for DBP,and it was 0.588 ± 0.360 for SBP and 0.628 ± 0.433 for DBP calculated by individual method.The medians of T/P ratio were above 0.5 by both methods.Conclusion It is of great significance to effectively control blood pressure and BPV in patients with stroke.Nifedipine GITS can constantly release medicine;it can lower the blood pressure,and significantly reduce BPV and MBPS.
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<p><b>OBJECTIVE</b>To study the protective effect and mechanism of salvianolic acid B on isolated heart ischemia/reperfusion injury in rats.</p><p><b>METHOD</b>Forty-eight SD rats were divided into 6 groups randomly(n = 8): the control group, the positive administration group (verapamil 150 microg x L(-1)), and high, middle and low-dose salvianolic acid B groups (10, 5, 2.5 mg x L(-1)). The myocardial ischemia/reperfusion injury model was established using the Langendorff method, re-perusing isolated working hearts for 30 min after ischemia for 25 min. A water-bag catheter was inserted in rat left atrium for recording the effect of salvianolic acid B on hemodynamics indexes-AST, LDH, SOD and MDA.</p><p><b>RESULT</b>Various group with different doses showed that salvianolic acid B decreased AST, release of LDH and formation of MDA and increased SOD activity.</p><p><b>CONCLUSION</b>Salvianolic acid B showed a protective effect on myocardial ischemia/reperfusion injury. Its mechanism may be related with improvement of cardiac contractility, cleaning of oxygen free radicals and reduction of lipid peroxidation.</p>
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Animals , Male , Rats , Benzofurans , Pharmacology , Drugs, Chinese Herbal , Pharmacology , Hemodynamics , In Vitro Techniques , L-Lactate Dehydrogenase , Metabolism , Malondialdehyde , Metabolism , Myocardial Reperfusion Injury , Metabolism , Rats, Sprague-Dawley , Superoxide Dismutase , Metabolism , Time FactorsABSTRACT
Objective To investigate the changes in endothelial progenitor cells (EPCs) number in peripheral blood of patients with acute cerebral infarction and after Naoxintong treatment.Methods Sixty patients were selected as subject and randomly divided into aspirin group and aspirin (30 patients) + Naoxintong group (30 patients).Meanwhile 30 patients without cerebral infarction were served as control group The number of peripheral blood EPCs were detected by flow cytometry at different time point.NIH-NINDS stroke score was used to elevate the neurological function.Results Compared with the control group,number of peripheral blood EPCs significantly decreased in the early stage of acute cerebral infarction (P ＜ 0.05),and then gradually increased until 7th day,which was back to the normal level.There was a positive correlation between improvement of NIHSS and number of peripheral blood EPCs in acute cerebral infarction.Compared with aspirin group,the number of peripheral blood EPCs in Naoxintong group increased sigrificanfly [41.40 ±0.18/million cells vs 41.40 ±0.18/million cells] at 14th day in patients treated with aspirin and Naoxintong.Conclusion The number of peripheral blood EPCs showed a U shape dynamic change in acute cerebral infarctior.Increase the number of peripheral blood EPCs might improve prognosis in patients with acute cerebral infarction.On the basis of routine treatment of aspirin,Naoxintong plus aspirin treatment might improve the number of peripheral blood EPCs in acute cerebral infarction.
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Objective To observe progression of motor symptoms and occurrence of motor complications in parkinsonian patients and investigate the rate of progression of motor symptoms and risk factors of motor complications.Methods One hundred and thirty patients diagnosed with PD in 2007 in Department of Neurology,Xinhua Hospital were followed up for 3 years.The Unified Parkinson' s Disease Rating Scale (UPDRS) and H-Y staging were used to assess and follow up motor symptoms and occurrence of motor complications,and analyze the rate of progression of motor symptoms and risk factors of motor complications with statistics.Results ( 1 ) Mean annual growth in H-Y staging was 2.5％,and UPDRS motor scores was 3.1％ ; the incidence of dysphagia at endpoint in patients was increased by 23.0％ compared with baseline; incidence of falls was increased by 16.7％;(2)Daily levodopa dose at endpoint ( OR =1.004,95％ CI 1.001—1.006,P =0.008 ) was independent risk factors with dyskinesia; While duration ( OR =1.637,95％ CI 1.083—2.473,P =0.019 ),levodopa treatment duration ( OR =0.698,95％ CI 0.494—0.987,P =0.042 ),daily levodopa dose at haseline ( OR =1.005,95％ CI 1.001—1.010,P =0.016) and at endpoint ( OR =1.014,95 ％ CI 1.001 —1.027,P =0.032 ) were risk factors with motor fluctuations.Conclusions As the disease progresses,motor function in parkinsonian patients gradually worsens,the incidence of swallowing difficulty and of falls is increased,and the incidence of motor complications is increased.The total exposure to levodopa in parkinsonian patients is predictor for motor complications.
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Objective To assess the development,progression and change of nonmotor symptoms in patients with Parkinson' s disease and its impact on patients' quality of life.Methods Eighty-seven consecutive patients with idiopathic Parkinson' s disease were studied.Parkinsonian status was assessed at baseline and 3 years follow-up using Unified Parkinson' s Disease Rating Scale (UPDRS) part Ⅲ & Ⅳ,Nonmotor Symptoms Questionnaire (NMSQuset),Parkinson-related quality of life (PDQ) scales.Paired ttest,Chi-square test,Spearman rank order correlation and hierarchical regression of the major statistical procedures were employed.Results At 3 years follow-up,compared to baseline,the UPDRS Ⅲ score (22.21 ±11.31 vs 30.49± 11.68),UPDRS Ⅳ score(1.00±1.54 vs 2.94±3.12),NMS score (7.98±3.96 vs 12.35 ± 5.12) and PDQ score (28.11 ± 22.88 vs 36.65 ± 26.95) were significantly higher ( t =- 5.54,- 5.75,- 6.46,- 5.29,all P =0.000,respectively).The aggravation of motor and nonmotor symptoms caused the decline of quality of life.The prevalence of constipation,problem of remembenng thing,nocturia ranked tops,and depression,and anxiety were still in the middle,compared with baseline.The prevalence of pains,sweating,dribbling,sense of incomplete emptying etc were significantly increased during the follow-up,△R2 were 21.6％ and 23.4％ respectively,resulting in the deterioration of quality of life.Conclusions PD nonmotor symptoms appear from the early stage.The motor and nonmotor symptoms aggravate over time.
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Objective To study the incidence of rapid eye movement sleep behavior disorder (RBD) and its impact on the clinical manifestations of patients with Parkinson' s disease (PD). Methods One hundred and twenty-four PD patients were included into this study and each of them was given the non motor symptoms questionnaire (NMSquest) to investigate the incidence of RBD. The PD patients were then divided into the RBD group and non RBD group, according to their answers to the NMSquest. Then the clinical differences were investigated between PD patients with and without RBD on the aspects of demographic characters, Hoehn-Yahr (H-Y) stage, the scores of Unified Parkinson Disease Rating Scale (UPDRS) sub-items, the incidence of non motor symptoms, and the dysfunctions of non motor systems (cognitive impairment, anxiety, depression and sleep disorders ). The evaluation tools of non motor functions include Mini Mental State Exam ( MMSE), Hamilton Depression Scale (HAMD), Parkins' s Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS). Results ( 1 ) 62.9% (78/124) of the PD patients have been experiencing RBD. (2) The course of the disease in RBD group ( 3.8 ± 2.8 ) was significantly shorter than non RBD group (5.0 ± 2.5, t = - 1. 972, P = 0. 048 ) while the sex, age, onset age and the mode of onset, Levodopa dose equivalents (LDE) and the kinds of medicines showed no difference between the two groups. (3) H-Y stage, the scores of UPDRS sub-items and the incidence of motor complications showed no difference between RBD and non RBD group. (4) Most of the non motor symptoms, including the gastrointestinal dysfunctions, autonomic dysfunctions, mood disorders and sleep disturbances, occurred much frequently in RBD group, however, the scores of MMSE, HAMD, HAMA,PDSS and ESS showed no difference between the RBD and non RBD group. Conclusion RBD commonly occurred in PD patients, and PD patients with RBD have a tendency to suffer from dysfunction of non motor systems.
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Objective To understand the operation room nurses' job stress and mental health status and discuss the countermeasures to ease pressure. Methods 82 patients were selected from five hospitals from April to August 2010. We used symptom checklist, self-rating anxiety scale, self-rating depression scale and nurse' job stress scale to carry out the questionnaire survey. Results The pressure of operation room nurses were related with their mental health status. Conclusions Some problems existed in mental health and work stress in operation room nurses, which should be highly valued by operation room nursing managers.
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OBJECTIVE:To analyze the problems of TCM injection included in Primary Medical Institutions Parts of National Essential Drugs List(2009 edition).METHODS:Danshen injection was taken as an example.The chemical composition of it (including water-soluble ingredients,fat-soluble components,other types of compounds,inorganic elements,proteins,tannins,polysaccharides,volatile oil),adverse reactions and quality standards were analyzed to investigate the problems of TCM injection included in Primary Medical Institutions Parts of National Essential Drugs List(2009 edition).RESULTS & CONCLUSION:Complex chemical composition of TCM injection and poor controlled quality standards require the further study.Because the safety of TCM injection is difficult to be guaranteed,it is necessary that reevaluation,research,consolidation of TCM injection.
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OBJECTIVE:To promote essential drug list into practice.METHODS:Relevant problems on the selection of National Essential Drug List were explored and analyzed.RESULTS & CONCLUSION:There are some problems on coordination of safety and effectiveness of drugs,price and the selection of traditional Chinese medicine.The advantage of first choice of essential drugs is not reflected completely.Large or small problems exist in selection process and individual drug verification.There was low credibility of drug evaluation.On the whole,the selection and formulation of essential drug list should be adjusted and improved continuously to guarantee the requirement of public medication.