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Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
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Female , Humans , Male , Chemotherapy, Adjuvant , Gastrectomy , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms/surgeryABSTRACT
Objective:To explore the long-term effect of Zhenzhu Tiaozhi capsule（FTZ） on hemoglobin A1c（HbA1c）in patients with type 2 diabetes mellitus （T2DM） based on real-world data. Method:T2DM patients who were provided with FTZ （FTZ group） and those receiving conventional hypoglycemic drugs （control group） were extracted from the hospital information system （HIS） of the First Affiliated Hospital of Guangdong Pharmaceutical University， followed by propensity score matching （PSM） for balancing the confounding factors between groups. With HbA1c as the efficacy evaluation index， the difference in efficacy between the two groups was compared using <italic>t</italic>-test and <italic>χ</italic><sup>2</sup> test. For repeated measurement data of the same patient， the difference in efficacy and the stability of FTZ against HbA1c were analyzed by generalized estimating equation （GEE）. The factors that might affect the efficacy of FTZ against HbA1c were subjected to multivariate linear regression analysis （MLRA）， and the subgroup analyses were then conducted after the stratification of relevant factors. Result:There were 46 patients included in the FTZ group and 1 208 patients in the control group. PSM yielded 42 pairs of samples with balanced covariates between groups. As revealed by one-year observation， ① HbA1c in the FTZ group after treatment was 6.51%±1.09%. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. At the same time， the HbA1c compliance rate in the FTZ group was 73.8% after treatment. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. ② The GEE results showed that the post-treatment HbA1c levels in the two groups were not significantly different from each other. Moreover， the HbA1c level remained stable over treatment time. ③ MLRA and subgroup analyses results demonstrated that FTZ was more effective in patients with high baseline HbA1c ［<italic>β</italic>=-0.530，95% confidence interval（CI） -0.850～-0.209，<italic>P</italic><0.01］ or those who were complicated with hypertension （<italic>β</italic>=-0.918，95%CI -1.614～-0.222，<italic>P</italic><0.05）. Conclusion:In the real world， FTZ is able to control the blood sugar， and its effect is similar to those of conventional hypoglycemic drugs. Besides， it is capable of stabilizing the blood sugar for a long time.
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Objective To evaluate the clinical value of 3D reconstruction in the single utility-port thoracoscopic segmentectomy of early stage NSCLC by propensity score matching (PSM). Methods We retrospectively analyzed clinical data of 150 early stage NSCLC patients undergoing single utility-port thoracoscopic segmentectomy. The patients were divided into reconstruction group (n=58) and non-reconstruction group (n=92) according to 3D reconstruction. PSM was performed on two groups to compare perioperative outcomes. Results Procedures were successfully completed on all patients, without perioperative death. In each group, 43 patients were successfully matched after PSM on the basis of 8 confounding factors, age, gender, smoking status, BMI, maximum tumor diameter on CT, tumor location, % FEV1 and type of planned segmentectomy. After PSM, in complex segmentectomy, the patients in the reconstruction group had shorter operation time (155.77±30.17 vs. 212.94±66.49min, P < 0.001) and less blood loss (46.00±25.94 vs. 88.79±68.36ml, P=0.002), compared with the non- reconstruction group. Conclusion Preoperative 3D reconstruction could help improve the efficiency of single utility-port thoracoscopic surgery for complex segmentectomy and reduce intraoperative bleeding.
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Objective : To explore the relationship between blood glucose and arteriosclerosis with cardio-ankle vascular index (CAVI) as the indicator of arteriosclerosis. Methods ¡¤ From 2016 to 2018, a total of 8 547 participants aged 18 years and above who completed physical examinations in the Physical Examination Center of the First Affiliated Hospital of Chongqing Medical University were selected to collect CAVI and other relevant biochemical indicators. Based on fast blood glucose (FBG) and history of diabetes, the subjects were divided into normal blood glucose group and hyperglycemia group. The 1:1 propensity score matching was used to match the gender, age, blood pressure, blood li-pids, and body mass index to balance the covariates between the groups. The matched data were analyzed by Logistic regression and restricted cubic spline (RCS) to explore the relationship and the dose-effect relationship between FBG and CAVI. Results ¡¤ A total of 1 463 pairs com-pleted propensity score matching, and the covariates between the two groups were balanced after matching. Logistic regression analysis showed that hyperglycemia was a risk factor of CAVI (OR=1.63, 95% CI 1.36-1.95). The RCS curve of FBG and CAVI abnormal risk showed an up-ward trend, i.e., as FBG increased, the risk of CAVI abnormalities increased. Conclusion ¡¤ As the fasting blood glucose increases, the risk of arteriosclerosis also increases.
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Resumo Este estudo verificou a influência da Estratégia Saúde da Família (ESF) no uso de serviços de saúde por crianças brasileiras menores de 5 anos de idade entrevistadas na Pesquisa Nacional de Saúde (PNS) 2013. Utilizou-se o método de Escore de Propensão (EP) para corrigir a falta de comparabilidade entre os grupos de crianças em estudo. O EP foi estimado por meio de regressão logística e reflete a probabilidade condicional de receber o cadastro na ESF dado um conjunto de covariáveis que retratam aspectos socioeconômicos, demográficos, sanitários e de saúde das crianças e das famílias que estes compõem. Foram estimadas as prevalências de consultas médicas e de internações hospitalares e incorporaram-se os efeitos da amostragem complexa da PNS em todas as fases da análise. Verificou-se que as crianças residentes de domicílios com cobertura da ESF têm piores condições socioeconômicas, sanitárias e de saúde, porém elas tiveram estimativas de consultas médicas e de internações hospitalares próximas a de crianças sem esse vínculo assistencial. Os dados sugerem que ESF pode corrigir desigualdades individuais e contextuais que impactam a saúde dos brasileiros ao favorecer o uso de serviços de saúde por crianças mesmo quando possuem piores condições de vida e saúde.
Abstract The scope of this study was to establish the influence of the Family Healthcare Strategy (FHS) in the use of health services for Brazilian children under 5 years of age interviewed in the 2013 National Health Survey (NHS). The Propensity Score Matching (PSM) method was used to correct the lack of comparability between the groups of children under scrutiny. The PSM was estimated by logistic regression and reflects the conditional probability of receiving registration in the FHS given a set of covariates that depict the socioeconomic, demographic, sanitary and health aspects of children and families who comprise same. The prevalence of medical visits and hospitalizations were estimated and incorporate the effects of the complex sample of NHS on all phases of analysis. It was found that children living in households with FHS coverage have worse socioeconomic, sanitary and health conditions, although they had options of medical appointments and hospitalizations close to the children without this healthcare link. The data suggest that the FHS can correct individual and contextual inequalities that impact the health of Brazilians by promoting the use of health services for children even when they have worse living and health conditions.
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Humans , Male , Female , Child, Preschool , Child Health Services/statistics & numerical data , Family Health , Delivery of Health Care/statistics & numerical data , National Health Programs/statistics & numerical data , Socioeconomic Factors , Brazil , Child Health Services/organization & administration , Cross-Sectional Studies , Health Surveys , Delivery of Health Care/organization & administration , Propensity Score , Hospitalization/statistics & numerical data , National Health Programs/organization & administrationABSTRACT
Objective: To evaluate and compare the clinical value of early enteral nutrition (EEN) and total parenteral nutrition (TPN) af-ter esophageal cancer surgery. Methods: We retrospectively analyzed 237 patients who underwent esophageal cancer surgery at Bei-jing Shijitan Hospital from March 2011 to March 2019. They were assigned into two groups based on the postoperative nutritional sup-port used: EEN (136 cases) and TPN (101 cases). Nutritional status, liver function, recovery of gastrointestinal function, days of hospital-ization, and postoperative complications were compared between the two groups after propensity score matching. Results: Using 1 :1 nearest neighbor matching, we successfully matched 91 pairs of patients. The prealbumin (PA) level was significantly higher in the EEN group than in the TPN group 7 days after surgery (P<0.05); however, there was no significant difference in albumin (ALB) level before surgery, 3 or 7 days after surgery. Additionally, the levels of ALT and AST in the EEN group were significantly lower than those in the TPN group 3 and 7 days after surgery (P<0.05). The incidence of acid reflux, vomiting, and diarrhea in the EEN group was higher than that in the TPN group, while the incidence of pulmonary edema and pulmonary infection was lower in the EEN group than in the TPN group (P<0.05). Conclusions: Compared with TPN, EEN is associated with a high incidence of acid reflux, vomiting, and diarrhea after esophageal cancer surgery, but it has a lower impact on liver function. EEN can promote the recovery of intestinal function, improve nutritional indicators, and shorten hospitalization time.
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Objective To investigate the biliary complications and recovery of liver function after liver transplantation from citizen's deceased donors (DCD) versus standard criteria donors (SCD).Method The clinical data of 269 patients who underwent orthotopic liver transplantation from January 2009 to December 2016 at the Fuzhou General Hospital were collected.197 livers were from SCD and 72 from DCD.Propensity score matching (PSM) was used to compare the biliary complications and recovery of liver function after liver transplantation in the two groups.Results PSM matched 61 pairs of patients.There were 10 (16.4％) and 8 (13.1％) biliary complications in the DCD and the SCD groups,respectively,with no significant difference between them (P ＞ 0.05).The recovery of liver function was significantly delayed in the DCD group when compared with the SCD group.The levels of ALT,AST,GGT and AKP in the DCD group were significant different on the postoperative first,third,fifth,seventh and fourteenth day (P ＜ 0.05).At 30 days after surgery,there was no significant difference in liver function between the two groups.Conclusions Liver grafts from DCD had a significant impact on the recovery of liver function.When compared with the SCD group,the DCD group recovered significantly slower in liver function.There was no significant increase in the incidence of biliary complications.
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At present, China's medical service costs keep rising, and residents' out-of-pocket medical expen-ses are also increasing heavily. The prepayment reform of medical insurance is considered as an important starting point to solve the problem. It is of great significance to evaluate the effect of prepaid medical insurance reform on con-trolling medical expenses and reducing economic burden when sick. In order to achieve the objective of this study, a use of CHARLS data 2011 &2015 and DIDPSM theory, and a combination of the Interaction Item Model and PSM model, and make use of a natural experiment developed from experimental reform stage for the comprehensive promo-tion stage of new rural cooperative medical system (NCMS) in 2012, were very crucial. This paper finds that:(1) Prepayment system can control the rise in outpatient and inpatient expenses. Compared with those who did not partici-pate in NCMS in the initial stage of reform, after the universal reform, outpatient and inpatient expenses dropped by 6. 3％ and 41％, the average decrease was 1041yuan and 2895yuan, respectively. (2) After the universal reform, the insured patients' medical burden of outpatient and inpatient reduced by 17％ and 33％. Prepayment system has, to some extent, resisted the rise in medical expense, and alleviated the burden of medical treatment. (3) On the basis of PSM, the estimated value and significance of coefficients have not changed, the effect of PPS reform is good. The poli-cy implication is that accelerating the prepayment system reform is the key way to control the growing medical expenses.
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Objective To investigate SCCmec types in clinical isolates of methicillin-resistant Staphylococcus epidermidis (MRSE) carrying psm-mec.Methods We collected 165 strains of Staphylococcus epidermidis identified by automated microbiological identification system and screened MRSE by PCR amplification of esp and mecA gene.Strains with psm-mec were identified by amplification of psm-mec,fudoh and p221 DNA fragment;mec,ccr and SCCmec typing was conducted by multiplex PCR assay.Results Among 138 strains of MRSE,29 strains were identified as MRSE with psm-mec,and the carrying rate was 17.58%.Results of mec and ccr typing by multiple PCR showed that MRSE with psm-mec carried Class A mec,but the ccr type had obvious diversity.Results of SCCmec typing showed that all strains with psm-mec belonged to type Ⅱ and/or Ⅲ SCCmec.Conclusion Clinical isolates of MRSE with psm-mec carry homologous type Ⅱ and/or Ⅲ SCCmec harboring Class A mec.
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Phosphorus (P) is abundant in soils in both inorganic and organic forms; nevertheless, it is unavailable to plants due to its fixation. Phosphate solubilising microorganisms including fungi play a pivotal role in making P available for plants by the process of solubilisation and mineralisation. Among the fungi that solubilize phosphate, the genera Aspergillus and Penicillium are the most representative although strains of Trichoderma and Rhizoctonia solani have also been reported as P solubilizers. Here, we report Neurospora discreta strain SR8 (NCCS Pune accession No. MCC1096 and NCBI accession No. KJ676544) as a P solubiliser as the first report. The strain was isolated from rhizospheric soil of Sorghum bicolor (L.) Moench. grown in semi-arid climate of a unique ecological zone of Kachchh, western India. The organism was identified on the basis of morphological characterization and by sequencing of ITS region. The strain SR8 survived the stressed environment in terms of high salinity and low precipitation rate in this area and could be a potent P solubiliser in stressed environments.
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<p><b>OBJECTIVE</b>To explore the correlation between propagated sensation along meridian (PSM) and TCM constitution at different age stages.</p><p><b>METHODS</b>According to age, 840 participants were divided into a youth group (326 cases), a middle aged group (243 cases) and an elderly group (271 cases). The TCM constitution of all the participants was evaluated, and the PSM test was performed. The distribution of TCM constitution, the occurring rate and transmission of PSM in each group were observed and compared; the correlation between PSM and the TCM constitution was preliminary investigated by Logistic regression analysis.</p><p><b>RESULTS</b>The distribution of nine types of TCM constitution in three groups:the proportion of normal constitution and partial constitution were significantly different (all<0.05); the occurring rate and transmission of PSM in three groups were not significantly different (all>0.05); the proportion of occurring rate for nine types of TCM constitutions in the whole population, from high to low, presented special intrinsic quality, neutral quality,-deficiency quality,-deficiency quality,-deficiency quality, damp-heat quality, phlegm-dampness quality,-stagnation quality and blood-stasis quality; besides, the proportion of occurring rate for different TCM constitutions in the youth group, middle aged group and elderly group was similar to that of whole population. The Logistic regression analysis results indicated the neutral quality (=0.025) and special intrinsic quality (=0.018) were positively while blood-stasis quality (=0.043) was negatively related with PSM in all subjects; the-deficiency quality (=0.025), phlegm-dampness quality (=0.019), blood-stasis quality (=0.012) and-stagnation quality (=0.035) were negatively related with PSM in youth group; the neutral quality (=0.001) was positively related with PSM inthe middle aged group; the neutral quality (=0.006) anddeficiency quality (=0.004) were positively related with PSM in the elderly group.</p><p><b>CONCLUSIONS</b>The occurrence of PSM in different age stages is related with TCM constitution, which could be increased in clinical treatment to improve acupuncture efficacy.</p>
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Objective To construct mutant strains of methicillin resistant Staphylococcus epidermi-dis (MRSE) with psm-mec gene deletion and to investigate the function of psm-mec gene.Methods The drug sensitivity test and DNA sequence analysis were performed to screen out the tetracycline and chloram -phenicol sensitive clinical strains of MRSE , whose upstream and downstream sequences of psm-mec gene were identical to those of the Staphylococcus epidermidis reference strain RP62A.The recombinant plasmid pBT2-Δpsm-mec was constructed by using the fusion PCR and a temperature sensitive shuttle plasmid .After being identified , the plasmid was transformed into the Staphylococcus aureus RN4220 strain by electropora-tion, and then transformed into the selected clinical isolates of MRSE .The mutant strains of MRSE with psm-mec deletion were screened out and identified after homologous recombination .The differences in biofilm formation between the mutant and wild-type strains were analyzed for further elucidation the relationships be-tween the psm-mec gene and biofilm formation in MRSE strains .Results Three clinical MRSE isolates for the construction of mutant strains with psm-mec gene deletion were screened out and identified by using drug sensitivity test and sequence alignment analysis .The mutants constructed via homogenous recombination were screened out and identified .Compared with the corresponding wild-type strains, the three mutants with psm-mec gene deletion showed significantly decreased ability of biofilm formation , demonstrating that the psm-mec genes strains induced the biofilm formation of MRSE .Conclusion The Δpsm-mec mutant strains were successfully constructed .The psm-mec gene played an important role in the biofilm formation of Staphy-lococcus epidermdis.
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Objective To investigate the genetic location of SCCmec-associated psm-mec in Staphylococcus hominis isolated from blood culture,and to lay a foundation for further functional studies of psm-mec in Staphylococcus hominis.Methods 25 strains of Staphylococcus hominis isolated from positive blood culture were collected.mecA and psm-mec gene were amplified by PCR,and the SCCmec types were determined by the results of multiplex PCR assay.For analyzing the genetic location characteristic of psm-mec in SCCmec,three pair special PCR primers were used to measure mecR1/psm-mec,psm-mec/xylR and fudoh respectively.Results There were 21 strains of methicillin-resistant Staphylococcus hominis and 4 strains of methicillin-sensitive Staphylococcus hominis. The positive rate of psm-mec gene in methicillin-resistant Staphylococcus hominis was 47.6%,and no psm-mec gene was found in methicillin-sensitive Staphylococcus hominis.Among psm-mec positive strains,2 strains belonged to SCCmecⅢ,5 strains belonged to SCCmecⅢ-like,and 3 strains belonged to new SCCmec types.All of the 10 psm-mec positive strains were mecR1/psm-mec,psm-mec/xylR and fudoh gene positive.Conclusion SCCmec-associated psm-mec extensively exists in methicillin-resistant Staphylococ-cus hominis isolated from positive blood culture,which distributes mainly in typical SCCmecⅢ,SCCmecⅢ-like and new SCCmec types and locates between mecR1 and xylR gene.
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The purpose of this study was to suggest menu pricing strategy based on understanding about customer perceived value of products and services. The technique known as PSM (Price Sensitivity Measurement) was used for analysis of price sensitivity for 3 menu items of a family restaurant in Seoul. A questionnaire was developed through literature review and modified after pilot test. Questionnaires for the main survey were distributed to 250 customers on their visit to the restaurant, and a total of 138 questionnaires were used for analysis (55.2%). The statistical analysis of price sensitivity was conducted using PSM, and descriptive analyses were conducted using SPSS Win (12.0). The main results of this study were as follows: the price sensitivity of beef tenderloin steak was higher than two other menus and the stress range of teriyaki chicken was almost 0, that is, the price sensitivity of teriyaki chicken was very low. Present menu prices of 3 menu items were within the range of acceptable prices, but had some distances from the optimal pricing point. From the result of this study, it was concluded that price adjustment or price promotion strategy would be effective for increase in sales of beef tenderloin steak, and marketing strategies to enhance consumers' perceptions of value should be conducted for all menu items by situations. Overall, PSM technique could be a helpful tool for researchers and managers of foodservice organizations to understand how consumers' perceptions of value are affected by the interaction of price and quality.
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Humans , Chickens , Commerce , Marketing , Restaurants , SeoulABSTRACT
Laparoscopic cholecystectomy (LC) is considered as the gold standard operation for the removal of a nonmalignant, diseased gallbladder. With the increasing number of LCs, a number of gallbladder carcinomas have been unexpectedly found either during or following this procedure. The removal of unexpected gallbladder carcinomas by LC can cause also a new complication, port site metastasis (PSM), which is developed by the implantation of tumor cells into the abdominal wall at the port site. We report a rare case of PSM of gallbladder carcinoma which was unsuspected at the time of LC. A 65-year-old man underwent LC at another hospital for calculous cholecystitis. The histologic examination revealed an adenocarcinoma of the gallbladder infiltrating the muscle wall. Despite the surgeon's advice, the patient refused any additional treatment. Ten months after surgery, he visited our hospital because of a painful and palpable subcutaneous mass at the scar of the periumbilical trocar incision. The mass was biopsed and histological examination confirmed metastasis from the gallbladder carcinoma.
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Aged , Humans , Abdominal Wall , Adenocarcinoma , Cholecystectomy, Laparoscopic , Cholecystitis , Cicatrix , Gallbladder , Neoplasm Metastasis , Surgical InstrumentsABSTRACT
Human skin sections of the Goukoku (LI·4)-corresponding area and its surroudings were collected and they were stained with H. E. dyes. Abundant nerve fibers and blood vessels were observed in the Goukoku (LI·4)-corresponding area, while their numbers were slightly decreased in the non-acupoint area on the meridian. Their numbers in the extra-meridian non-acupoint area were the lowest.<br>Substance P-containing nerve fibers were examined by histochemistry in the same areas, and many of them were observed in the Goukoku (LI·4)-corresponding area. And further more, they were closely associated with lymphatic vessels. These findings suggest the mechanism that Substance-P secreted by the stimulation of acupoint, is transported to the lymph node via lymphatic vessels, thus leading the stimulation of the lymphatic system.<br>Lymphatic vessels with abundant smooth muscles were predominantly noted in the Goukoku (LI·4)-corresponding area and scarcely in the non-acupoint area by fluorescent stain. This finding suggests that hypersensitive one may feel the contraction of lymphatic smooth muscle induced by the Substance-P as a phenomenon of propagated sensations along the meridians (PSM).
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Objective To determine the relative molecular weight(M_r) of polysaccharide-2b of moutan(PSM_(2b)) to establish the standard of reference substance.Methods PSM_(2b) was separated by a Sepharose 4B column and then PSM_(2b-A) and PSM_(2b-B) were obtained after cryodesiccation.Then HPLC was used to determine their M_r.Ultrapure water was used as mobile phase to compare with 0.7% Na_2SO_4 solution.Results PSM_(2b-A) was pure.The M_r and polydispersity(D) of PSM_(2b-A) obtained by use of dextran as standard were 3.596 2?10~(5) and 4.15 in 0.7% Na_2SO_4 solution phase,respectively,and in ultrapure water phase the M_r and D were 4.758 5?10~(5) and 1.03,respectively.Conclusion Different results are detected by different mobile phases in determination of M_r and D of PSM_(2b-A) by HPLC.And the ultrapure water as mobile phase is more suitable than 0.7% Na_2SO_4 solution.
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Various acupuncture stimulations were given to a 60 year-old housewife with a distinct meridian phenomenon to observe subsequent PSM. Clear PSM was induced either by finger pressure, press needle or low frequency press needle stimulation of Guanchong (terminal point). Scarless moxibustion applied to a source point induced clearer PSM than that to a terminal point. Comparing the propagating speeds of the PSM induced by press needle stimulations of the terminal points of the twelve meridians, those of liver, kidney and spleeen were the fastest (about 70cm/sec) and those of heart and large intestine were the slowest (1cm/sec). The propagation of PSM was blocked by 50-60mmHg of manchette pressure or by about 400g/cm local pressure using a pressure meter.
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The direction of echo sensation of each acupoint was examined on the patients who showed obvious meridian phenomenon.<br>The heart meridian and large intestine meridian were chosen. Echo sensation propagating both directions, i. e. afferently and efferently, was seen most often, then afferently only and efferent only followed.<br>The direction of echo sensation did not neccesarilycoincide with that of meridian stream.
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AIM To study the effect of polysaccharides 2b from Mudan cortex (PSM 2b) on type 2 diabetes mellitus (T2DM) rats and explore its mechanism. METHODS T2DM rat model was established by low dosage streptozotocin and high sucrose fat diet. The drugs were administrated by ig for 5 weeks. The serum glucose was assayed with GOD POD method. Insulin was determined by radioimmunoassay. Insulin receptors of the plasma membrane from rat liver were determined with radioligand binding assay of receptors (RBAR). RESULTS PSM 2b could significantly lower fasting blood glucose (FBG), improve impaired glucose telarance (IGT) and dyslipidemia. It could also remarkably raise receptor total (RT2) of the low affinity insulin receptor (InsR) and insulin sensitivity index (ISI) in T2DM rats. CONCLUSION PSM 2b has an obvious therapeatic effect on T2DM in rats. Its mechamsm is relatively improve insulin resistance (IR) in T2DM rats by raising the number of InsR.