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Objective: To explore the value of the assessment of plasma trimethylamine N-oxide (TMAO) combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the all-cause mortality, length of hospitalization, and hospital cost in ischemic heart failure (IHF) patients. Methods: This prospective cohort study included 189 patients (157 males, mean age (64.0±10.5) years) with a left ventricular ejection fraction<45% caused by coronary artery disease, who hospitalized in our department from March 2016 to December 2020. Baseline data, including demographics, comorbid conditions and laboratory examination, were analyzed. The cumulative rate of all-cause mortality was evaluated using the Kaplan-Meier method and compared between the groups according to the log-rank test. Relative risks were reported as hazard ratios (HR) and 95% confidence interval (95%CI) calculated using the Cox proportional-hazards analysis, with stepwise adjustment for covariables. Spearman correlation analysis was then performed to determine the relationship between TMAO combined with NT-proBNP and length of hospitalization and hospital cost. Results: There were 50 patients in the low TMAO+low NT-proBNP group, 89 patients in high TMAO or high NT-proBNP group, 50 patients in high TMAO+high NT-proBNP group. The mean follow-up period was 3.0 years. Death occurred in 70 patients (37.0%), 27 patients (54.0%) in high TMAO+high NT-proBNP group, 29 patients (32.6%) in high TMAO or high NT-proBNP group and 14 patients (28.0%) in low TMAO+low NT-proBNP group. TMAO, in combination with NT-proBNP, improved all-cause mortality prediction in IHF patients when stratified as none, one or both biomarker(s) elevation, with the highest risk of all-cause mortality in high TMAO+high NT-proBNP group (HR=3.62, 95%CI 1.89-6.96, P<0.001). ROC curve analysis further confirmed that TMAO combined with NT-proBNP strengthened the prediction performance on the risk of all-cause death (AUC=0.727(95%CI 0.640-0.813), sensitivity 55.0%, characteristic 83.1%). Spearman correlation analysis showed that IHF patients with high TMAO and high NT-proBNP were positively associated with longer duration of hospitalization (r=0.191,P=0.009), but not associated with higher hospital cost (r=0.030, P=0.686). Conclusions: TMAO combined with NT-proBNP are valuable prediction tool on risk stratification of patients with IHF, and those with two biomarkers elevation face the highest risk of mortality during follow-up period, and are associated with the longer hospital stay.
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Aged , Female , Humans , Male , Middle Aged , Biomarkers/blood , Heart Failure/diagnosis , Hospitalization , Methylamines/blood , Natriuretic Peptide, Brain/blood , Peptide Fragments , Prognosis , Prospective StudiesABSTRACT
BACKGROUND@#Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients.@*METHODS@#We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR).@*RESULTS@#Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS.@*CONCLUSION@#Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.
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OBJECTIVE： To explore current hot spots in drug research and application，and provide reference of the draft use standard for pharmacy journal editor. METHODS： Taking China Pharmacy （short for our magazine） as example，all literatures published by our magazine and included by CNKI were searched during inception （Jan. 1990） and Mar. 19th， 2019； top 150 literatures [top 100 non-review literatures （NRA） and top 50 review literatures （RA）] were collected according to comprehensive score of downloaded number and citied number as indicators， and then analyzed in respects of publication year，column of NRA，first author’s work unit， subject words； one literatures which the cited number was largest was analyzed separately. RESULTS： Totally 150 literatures were published between 1993 and 2016， while the literature amount reached the maximum value in 2010 （18 articles）. Among NRA， the most were in the columns of “pharmacy administration” （44 articles， 44.00％）， “TCM and ethnic medicine” （18 articles， 18.00％）， “pharmacists and pharmaceutical care” （14 articles， 14.00％）. Among 150 first authors，73 （48.67％） were from college， 62 （41.33％） were from hospital. Subject words of NRA were “status and development” （20 times）， “active ingredient” （14 times）， “international experience” （9 times）， while those of RA were “pharmacological action” （25 times）， “Chinese herbal medicine” （15 times）， “active ingredient” （12 times）. The Principles and Utilization of Sequential Analysis of DDD System of Drug in Hospitals was cited for 1 426 times， which was much higher than the second one （261 times）. CONCLUSIONS： This study can show the good literatures origin and study direction，provide reference to the hot spots for readers. At the same time， high-frequency cited literatures also suggests that researchers can conduct in-depth analysis of controversial and unclear contents in academic circles.
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Objective To investigate the risk factors and etiology of puerperal infection in pregnant women with scar uterus.Methods 276 cases of uterine scar pregnant women were prospectively collected in the hos-pital,according to the development of postpartum puerperal infection or not,all pregnant women were divided into an infection group(n=25)or a non infection group(control group)(n=251).The main clinical features between the two groups were compared and the risk factors of puerperal infection in pregnant women with u-terine scar were analyzed.Results Compared with the control group,the incidence of gestational <37 weeks, perilous placenta previa,postpartum hemorrhage,premature rupture of membranes,placental abruption,preg-nancy induced hypertension and the past history of vaginitis was significantly higher in the infection group,and the difference was statistically significant(P< 0.05).Multivariate logistics regression analysis showed that the risk factors of puerperal infection in pregnant women with scarred uterus included dangerous placenta pre-via,postpartum hemorrhage and placental abruption.Gram negative bacteria were more common,accounting for 72.00%,the most common gram negative bacteria were Escherichia coli(32.00%),the most common gram positive bacteria were Staphylococcus aureus(12.00%).Conclusion Dangerous placenta previa,post-partum hemorrhage and placental abruption are the risk factors of puerperal infection in pregnant women with uterine scar,and Gram negative bacteria are common pathogens.
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Objective To understand the measures and effects of schistosomiasis elimination in Wujin District,Changzhou City,so as to provide the reference for other similar areas. Methods The data of schistosomiasis prevention and control were collected and analyzed in Wujin District,Changzhou City from 1995 to 2015. Results From 1995 to 2015,the accumulated ar-ea for investigating Oncomelania hupensis snail habitats was 15934.01 hm2 in Wujin District,and the accumulated area with snail habitats was 34.61 hm2,but no schistosome-infected snails were found. The area of snail control by molluscicides was 234.59 hm2,and the area of snail control by environmental reform was 84.48 hm2 in 18 key points. There were 259.3 thousand person-times receiving the examinations for schistosomiasis,and there were 17314 head of livestock receiving the examinations for schistosomiasis,but no schistosome-infected cases were found. There were 2042 person-times receiving the extensive chemo-therapy. The popularizing rate of sanitary toilets was 99.25％in the whole district. The awareness rate of schistosomiasis control knowledge was 98.08％and the formation rate of proper behaviors was 97.82％in the population. Conclusions In Wujin Dis-trict,the aim of schistosomiasis elimination has been performed through the active control measures. However,there are still so-cial and natural risk factors of re-endemic of schistosomiasis,and therefore,the schistosomiasis monitoring work still should be strengthened.
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Objective To construct an evaluation index system for the core competence of tumor chemotherapy specialist nurses in China and to provide standards for training of tumor chemotherapy specialist nurses.Methods Through literature research and expert meeting,the first draft of index system was established,and consultation questionnaire was compiled.Two rounds of consultation were conducted with 23 experts in China using Delphi method.AHP method was used to determine the weights of indicators at all levels.Results The effective rates of 2 rounds of expert consultation were 100％ and 73.91％,respectively.In the 2 rounds of consultation,the expert authority coefficients were 0.855 and 0.867,respectively.The coordination coefficient of first and second level indexes and expert opinions were 0.693 and 0.371 (P＜0.001),respectively.The final evaluation index system for the core competence of tumor chemotherapy specialist nurses included 5 first-level indexes (positive professional attitude,sufficient clinical practice ability,strong educational counseling ability,basic clinical research and evidencebased practice ability,and basic management ability),16 second-level indexes,and 59 third-level indexes.Conclusion The evaluation index system for chemotherapy specialist nurses based on core competence determined by expert consultation is scientific and reasonable,and can provide a powerful basis for training qualified chemotherapy specialist nurses.
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Through retrieval of all medical journals of CNKI and VIP from Jan. 1996 to Oct. 2012, ninety-nine articles were selected and analyzed. The result shows that reliable effect can be found in pain relieving, especially in pain of muscles and soft tissues. In mechanism research, action mechanism of Fu's subcutaneous needling (FSN) on pain relieving is expounded through theory of traditional medicine and modern medicine. Although the effect of FSN on pain relieving has been confirmed by numerous clinical trials, it is still lack of explanation on mechanism revealing. The further studies should focus on mechanism expounding, improving research methods and selecting more objective and reasonable evaluation system. Therefore, the effectiveness and scientificalness of FSN can be further enhanced.
Subject(s)
Humans , Acupuncture Analgesia , Methods , Acupuncture Therapy , Methods , Pain Management , Methods , Randomized Controlled Trials as TopicABSTRACT
<p><b>OBJECTIVE</b>To investigate the changes of auditory parameters during anesthesia and establish the assessment indicators for anesthesia monitoring in animal experiments.</p><p><b>METHODS</b>BALB/c mice of 4 to 6 weeks were given a single intraperitoneal dose of urethane, and the auditory evoked potential in the surgically exposed inferior colliculus in response to pure tone stimulation was recorded during urethane metabolism. The latency and amplitude data of the waves were extracted using Matlab software to analyze their variations during urethane metabolism.</p><p><b>RESULTS</b>The latency of the auditory evoked potential showed slight variation and was well correlated to time. The latency decreased progressively during urethane metabolism, fast in the initial 2 h and tending to stabilize afterwards.</p><p><b>CONCLUSION</b>The latency of the auditory evoked potential can be more suitable indicators than the amplitude for anesthetic effect monitoring.</p>
Subject(s)
Animals , Female , Male , Mice , Anesthetics, Intravenous , Drug Monitoring , Methods , Evoked Potentials, Auditory , Physiology , Inferior Colliculi , Physiology , Mice, Inbred BALB C , UrethaneABSTRACT
<p><b>OBJECTIVE</b>To investigate the mechanisms of different response patterns of the cochlear nucleus neurons based on a digital model.</p><p><b>METHODS</b>Based on the platform of Matlab7.0 and the integrate-and-fire model, we constructed the temporal coding model.</p><p><b>RESULTS</b>The model well simulated the response types of the primary-like, chopper, onset and buildup neurons by changing the settings of some parameters related to the properties of the neurons.</p><p><b>CONCLUSIONS</b>The properties of the neurons dictate the response patterns of the cochlear nucleus neurons. The simulation results are consistent with the literature. Understanding of the response properties of the cochlear nucleus neurons can provide assistance in the study of the auditory system.</p>
Subject(s)
Humans , Cochlear Nucleus , Physiology , Computer Simulation , Models, Neurological , Neurons , PhysiologyABSTRACT
Objective To explore a new method for in vitro culture and differentiation induction of rat adipose-derived stromal cells(ADSCs)into neural cells.Methods The retroperitoneal adipose tissue of adult SD rats was carefully dissected and digested using type Ⅰ collagenase.After centrifugation.the stromal cell pellet was resuspended in DMEM/F12 containing 10%fetal bovine serum (FBS).The ADSCs in passage 5 were harvested and cultured in serum-free Neurobasal (NB)medium supplemented with 20 ng/mL basic fibroblast growth factor(bFGF),20 ng/mL of epidermal growth factor (EGF)and N2(1:100)to induce neurosphere formation.The neurospheres in passage 2 were incubated in NB medium supplemented with 0.5 μmol/L all-trails-retinoic acid(RA),1%FBS,5%horse serum,and 50 ng/mL of brain-derived neurotrophic factor (BDNF)to induce the their differentiation into neuron-and glial-like cells.Immunofluorescent staining was performed to identify the differentiated cells. Results Early after inoculation,the spherical ADSCs were suspended in the medium and began to adhere to the wall of the culture flask 24 h after the inoculation.With the increase of the cell density in the cell culture,a fibroblast-like cell monolayer occurred.Neurosphere formation was observed 5-7 days after culturing the ADSCsin serum-free NB medium,and the neurospheres rapidly proliferated and reached a diameter of 100μm at 14 days of culture.The neurospheres further terminally differentiated into neuron-and glial-like cells with spherical morphology and clearly visible cell nuclei.The differentiated cells extended long and thin cell processes or reticular cell processes,and numerous cells established networks through the cell processes.Immunofluorescent staining showed that the neurospheres were positive for nestin (with a positivity rate of 75.62%±1.34%),and 57.62%±4.92%of the terminally differentiated cells expressed β-tubulin Ⅲ,a marker of immature neurons,and 11.25%±3.87%were positive for MAP2ab,a marker of mature neurons.Some of the differentiated cells were positive for glial fibrillary acidic protein (GFAP)expression(18.34%±3.87%)and galactoeerebroside(GalC)(14.35%±3.98%). Conclusions ADSCs from adult rat adipose tissue Can produce a large quantity of stable multipotent daughter cells.The two-step method for inducing the differentiation of ADSCs Can yield high rates of nestin-and β-tubulin Ⅲ-positive cells and some MAP2ab-positive cells.
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<p><b>OBJECTIVE</b>To investigate the influence of intrauterine infection caused by lipopolysaccharide on Toll-like receptor 4 (TLR4) signaling pathway in fetal and neonatal rat lungs in order to explore immunomodulating activity of innate immunity responding to intrauterine infection and its effect on lung development.</p><p><b>METHODS</b>On day 17 of pregnancy, 30 pregnant Sprague-Dawley (SD) rats were randomly divided into two groups: LPS group and saline group. For LPS group, LPS (10 microl, 40 microg/ml) was intrauterine injected between every two embryonic sacs of the pregnant rats, while the rats in the control group were injected with the same volume of pyrogen-free saline. Lung tissues of fetal rats and corresponding placental tissues were collected on the embryonic day 18 (E18), E20, and E22. Neonatal lung tissues were also harvested on postnatal day 1 (P1), P3, and P7. Lung sections and placental tissues were stained with hematoxylin and eosin for histological examination. Reverse transcription quantitative polymerase chain reaction (RT-PCR) analysis was performed to test mRNA expression for TLR4, myeloid differentiation 88 (MyD88) and IL-1beta, while immunohistochemistry was used to evaluate TLR4 and MyD88 expression in lung tissues. All data were analyzed with one-way analysis of variance (ANOVA) and q test.</p><p><b>RESULTS</b>(1) Placental hematoxylin-eosin staining showed a great number of neutrophils infiltration, obvious interstitial hyperplasia and narrow capillaries in placental tissues in the LPS group which indicated that intrauterine infection occurred. However, there were no obvious inflammatory cells in the control group. (2) On E18, E20 and E22, the lung of LPS group showed no obvious pathological changes, and there were no apparent neutrophils infiltrated in alveoli, then some structural changes appeared. On P7, we found that the number of alveoli decreased, space of alveoli was larger than ever, septa thickened, but without significant constructive disorder. (3) In the LPS group, the TLR4, MyD88 and IL-1beta mRNA levels increased compared with control group, higher than control group at E20 and E22 (P < 0.05), and peaked at E22. Then the expression levels of these substances decreased slowly. (4) The result of immunohistochemistry showed that in lung tissues of the two groups at E18, there was no remarkable positive staining of TLR4 and MyD88, which mainly expressed in cytoplasm of bronchiole and alveolar epithelial cells, then positive cells increased slowly.</p><p><b>CONCLUSION</b>(1) For perinatal rat lungs, intrauterine LPS infusion can induce an increased expression levels of TLR4 and MyD88 to a certain extent, which then returned to normal level gradually. At the same time, lung tissues showed a mild pathological change and inflammatory reaction. We propose that innate immune system of fetal lungs controls the magnitude of the LPS-induced cytokine response during the perinatal period. (2) The findings confirmed that LPS-activated signaling transduction pathway was the MyD88-dependent pathway.</p>
Subject(s)
Animals , Female , Pregnancy , Rats , Animals, Newborn , Infections , Metabolism , Interleukin-1beta , Metabolism , Lipopolysaccharides , Pharmacology , Lung , Metabolism , Myeloid Differentiation Factor 88 , Metabolism , Pregnancy Complications, Infectious , Metabolism , Prenatal Exposure Delayed Effects , Rats, Sprague-Dawley , Signal Transduction , Toll-Like Receptor 4 , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of bicuculline on the first spike latency of the neurons in the inferior colliculus of mice and investigate the role of GABA inhibition in sound signal processing of the neurons.</p><p><b>METHODS</b>In vivo extracellular recording was performed on the inferior colliculus of 13 BALB/c mice (4 to 5 weeks old) to record the neuronal response to pure tones. Bicuculline, a GABA-A receptor antagonist, was applied to the neurons iontophoretically through one channel in the three-barrel glass-pipettes. The first spike latency and other response properties of the characteristic frequency were recorded for analysis.</p><p><b>RESULTS</b>A total of 30 well-isolated single neurons were recorded. Increased spike counts characterized 96% of the neurons, with either increased (40%) or decreased (60%) latency of neuronal responses. Characteristic frequency alterations occurred in 50% of the neurons with increased spike latency, and the minimum threshold showed linear changes.</p><p><b>CONCLUSION</b>GABAergic inhibition may participate in the latency formation and increased frequency selectivity of mouse inferior colliculus neurons by lateral inhibition. The changes in the first spike latency can be indicative of the information integration in GABAergic neurons at the synaptic level.</p>
Subject(s)
Animals , Female , Male , Mice , Acoustic Stimulation , Psychology , Action Potentials , Bicuculline , Pharmacology , GABA Antagonists , Pharmacology , Inferior Colliculi , Physiology , Mice, Inbred BALB C , Neurons , Physiology , gamma-Aminobutyric Acid , PhysiologyABSTRACT
<p><b>AIM</b>To prepare cisplatin multivesicular liposomes with high encapsulation efficiency and sustained-release character, and compare the release characteristics with conventional liposomes prepared by reverse-phase evaporation method.</p><p><b>METHODS</b>Cisplatin multivesicular liposomes were prepared using multiple emulsion method. The concentrations of cisplatin and lipids in the liposomes were measured by flameless atomic absorbance spectroscopy (FAAS) and phosphalipid enzyme reagent method, respectively. The encapsulation efficiency, size and release of the cisplatin from the liposomes were studied in vitro.</p><p><b>RESULTS</b>The mean diameter of cisplatin multivesicular liposomes was (16.6 +/- 1.0) micron. The encapsulation efficiency of cisplatin was more than 80%. The release profile in vitro fitted with a first-order equation. The releasing t1/2 of cisplatin multivesicular liposomes is 37.7 h, which is 8.4 that of conventional liposomes. Co-membrane stabilizer has remarkable stabilizing effect on the multivesicular liposomal membrane confirmed by differential scattering calorimetry (DSC).</p><p><b>CONCLUSION</b>The cisplatin multivesicular liposomes showed high encapsulation efficiency and sustained-release character.</p>
Subject(s)
Antineoplastic Agents , Cisplatin , Delayed-Action Preparations , Drug Carriers , Drug Delivery Systems , Liposomes , Particle Size , Technology, Pharmaceutical , MethodsABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of medium and long-chain triglyceride on the immune function of burn patients during early postburn stage and its possible mechanism.</p><p><b>METHODS</b>Thirty burn patients with TBSA exceeding 30% were enrolled in this study and were randomly divided into two groups (n = 15 in each group). The patients in F group were supplemented orally with enteral nutrient Fresubin 750MCT containing medium (MCT) and long-chain triglyceride (LCT), and those in N group with Nutrition containing only LCT. All the patients were treated with nutritional support beginning from 24 PBH, continued for 10 days. The changes in plasma levels of IL-2, IL-4, PGE(2) and T lymphocyte transformation rate (LTR) in peripheral blood of patients in the two groups were determined on 1, 4, 7 and 10 postburn days (PBDs).</p><p><b>RESULTS</b>The plasma IL-2 level in all time points exhibited no difference in all patients (P > 0.05). The plasma level of PGE(2) on PBD 4 in F group was obviously lower than that in N group (P < 0.01). The plasma level of IL-4 on PBDs 4, 7 and 10 in F group were evidently higher than that in N group (P < 0.01). The T LTR in peripheral blood on PBDs 4 and 7 in F group was much higher than that in N group (P < 0.05 - 0.01).</p><p><b>CONCLUSION</b>Enteral nutrient containing MCT/LCT seemed to be superior to that containing only LCT in the improvement of postburn immune function in burn patients.</p>