Effects of telmisartan on resistin expression in a rat model of nonalcoholic steatohepatitis and insulin resistance / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of telmisartan on expression of resistin in serum and liver under conditions of nonalcoholic steatohepatitis (NASH) and insulin resistance using a rat model system.</p><p><b>METHODS</b>Forty-five male Sprague-Dawley rats were randomly divided into a normal control group (NC, n=10), a model control group (MC, n=15), a polyene phosphatidylcholine prevention group (PP, n=10), and a telmisartan prevention group (TP, n=10). The NC group was given a standard diet and the other groups were given a high-fat diet for 16 weeks in order to induce NASH. At the end of week 12, 5 rats in the MC group were sacrificed for pathology confirmation of the NASH model. At the end of week 12, the TP group was given telmisartan (8.0 mg/kg/d) and the PP group was given polyene phosphatidylcholine (8.4 mg/kg/d) for an additional 4 weeks by intragastric administration. At the end of week 16, all rats were sacrificed and body weights recorded. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), resistin, insulin and fasting blood glucose were measured. The insulin resistance value, HOMA-IR, was assessed by homeostasis mode assessment. Liver expression of the resistin protein was detected by western blotting and of the resistin mRNA was detected by RT-PCR. The F test and LSD test were used for statistical analyses.</p><p><b>RESULTS</b>Compared to the NC group, the body weight and HOMA-IR of rats in the MC group were significantly increased (P<0.01). The levels of serum resistin, and of resistin protein and mRNA in liver, were significantly higher in the MC group than in the NC group of rats (all P less than 0.01). The body weight of rats in the TP group was significantly lower than those in the MC group (P<0.05). The levels of serrn resistin, resistin protein and mRNA in the liver, and insulin resistance were significantly lower in the TP group than in the MC group of rats (all P<0.01). The PP group did not show significant differences in any of these measures, except for loss of body weight (P<0.05).</p><p><b>CONCLUSION</b>Telmisartan elicits preventive and protective effects in a NASH rat model.Telmisartan may improve insulin resistance in NASH rats by decreasing the expression of serum resistin, and liver resistin protein and mRNA.</p>

A multicenter study of fracture in patients with rheumatoid arthritis in China / 中华风湿病学杂志

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

A multicenter study of costs of drugs in rheumatoid arthritis in China / 中华风湿病学杂志

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

The investigation and analysis of the adverse effects of methotrexate in the treatment of rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate and analyze the adverse effect(AE) of methotrexate(MTX)in rheumatoid arthritis(RA).MethodsThree hundred and twenty-five RA patients were investigated with a questionnaire in clinical service of department of Rheumatology and Immunology, Peking University People's Hospital. SPSS 11.5 software was used for statistical analysis. Results① The total prevalence of AE was 34.2％. Among these, gastrointestinal AE were the most common, others included elevated liver enzymes,leucocytopenia,alopecia and dental ulcer. The incidence of drug withdrawal of MTX was 13.2％, elevated liver enzymes was the most common reason of withdrawal, other reasons were gastrointestinal AE, leucocytopenia,dental ulcer and alopecia. The gastrointestinal AE and dental ulcer occurred within one week after initiating the medication in average, while elevated liver enzymes and leucocytopenia usually occurred at about 1～2 months after the medication. ②The incidence of AE increased with the dosage. ③ Folic acid could significantly decrease the total incidence of AE(P＜0.05). The incidence of gastrointestinal AE, elevated liver enzymes,leucocytopenia and dental ulcer couldbe reduced by folic acid supplementation(P＜0.05).Conclusion The AE of MTX in RA treatment are common, many of which are slight and could be improved by reducing the dosage or symptomatic treatment. The AEs of MTX can be improved by folic acid supplement treatment.

Epidemiological investigation of back pain and spondyloarthritis in Shougang resident communities / 中华内科杂志

Objective To investigate the epidemiological features of back pain, spondyloarthritis (SPA) and ankylosing spondylitis (AS) in Beijing Shougang district. Methods Set up Chinese version of questionnaire about incidence of spondyloarthro-pathy. Employees and retired ones were drawn out from subfactory units by non-randomized sampling. 15 357 subjects were investigated, of which 12 125 questionnaires were taken. Suspected cases were then screened with sacroiliac joint X ray and HLA-B27 testing. 2009 assessment in ankylosing spondylitis (ASAS) criteria were used for diagnosing SpA. Results Back pain is common with total incidence of 42.7%, and the most common pattern is mechanical pain. The incidence of SpA is 0.58% and that of AS is 0.36%, while only 28.9% AS patients had been diagnosed before and received treatment. Conclusion The AS incidence in Shougang district is similar with the epidemiological data got from other districts of China. And knowledge of SpA and AS is needed in China.

Risk Factors of Hospital Acquired Infection among Cirrhosis Patients / 中华医院感染学杂志

OBJECTIVE To investigate the incidence of hospital acquired infection among cirrhosis patients and analyze its correlated factors.METHODS The whole case history was analyzed retrospectively.RESULTS The incidence of hospital acquired infection was 21.33%,obviously higher than the average hospital infection rate(9.1%).It contained mainly respiratory tract infections and spontaneous bacterial peritonitis.It was positively correlated with patient's age,hospitalization time,liver function,hypoalbuminemia,leukocyte count,acute upper gastrointestinal bleeding and the invasive operations(P

THE MORPHOMETRY OF THE INTRAMEMBRANOUS PARTICLES OF THE DOG SINUS NODE CELLS——FREEZE REPLICA METHOD STUDY / 解剖学报

The morphometry of the intramembranous particles (IMP) of the dog sinus node cells was studied with freeze-cleaved specimens under H-500 electron microscope. The photographs of IMP of the P cells and transitional cells were analysed with imaging analytical system (IBAS Ⅰ+Ⅱ type). The results are as follows. The mean area of IMP: on PF and EF faces of P cells are 25.800nm~2 and 17.816nm~2. The mean values of IMP on PF and EF faces of the transitional cells are 46.041nm~2 and 88.633nm~2. The averages of the perimeter of IMP on the PF and EF faces of P cells are 20.735 nm and 18.078 nm, respectively. And those of the transitional cells are 28.780 nm and 43.901 nm. The diameters of circles of IMP of PF and EF faces of P cells are 5.220 nm and 4.402 nm. Those of PF and EF faces of the transitional cells are 7.010 nm and 10.476 nm. The mean values of form factor of IMP on PF and EF faces of P cells are 0.653 and 0.643, and those of transitional cells are 0.627 and 0.573. The mumbers of IMP are 1325/?m~2 and 345/?m~2 on PF and EF faces of P cells, and the mumbers of IMP of the transitional cells are 3225/?m~2 on PF face and 590/?m~2 on EF face.

THE ULTRASTRUCTURE OF THE B(?)OMEMBRANE OF THE DOG SINUS NODE CELL——BY FREEZE REPLICAS METHOD / 解剖学报

The fine structure of the biomembrane of the sinus node cells in the dog wasstudied with the replicas of freezecleaved specimens.The intramembranous particles.(IMP)in the PF and EF faces of the plasma mcmbrane of the sinus node cells,were present.The density of the IMP on the PF faces was more dense than those ofEF faces,In general,the shape of the IMP of the plasma membrane(PF and EFfaces)exhibited spherical or spheroidal.The IMP of PF faces may be divided into,three groups,i.e.the larger,medium and small size.Numerous endocytotic vesicles.found on the PF faces appeared as circular depressions and as small walled craterson EF faces.No regular array of the vesicles had been observed on both faces,TheIMP of the mitochondrial cristae were more dense than those of the depression.TheIMP of PF face of the nuclear membrane were observed.Their size and shapepresent a uniform appearance.There were many nuclear pores in the surface of thenuclear membrance.In the cytoplasm,longitudinal and transverse sections of the myofibrils werefound.On the transverse section,the myofilaments of A and I band werepresent.The intercalated disk was observed.The gap junctions present between thesinus node cells were proved by Masson-Pevet et al in the rabbits but were notfound in our specimens.