Analysis of the incidence and related factors of hypothermia in patients with continuous renal replacement therapy / 中华危重病急救医学

OBJECTIVE@#To investigate the incidence and risk factors of hypothermia in patients with acute renal injury (AKI) receiving continuous renal replacement therapy (CRRT), and to compare the effects of different heating methods on the incidence of hypothermia in patients with CRRT.@*METHODS@#A prospective study was conducted. AKI patients with CRRT who were admitted to the department of critical care medicine of the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from January 2020 to December 2022 were enrolled as the study subjects. Patients were divided into dialysate heating group and reverse-piped heating group according to randomized numerical table method. Both groups were provided with reasonable treatment mode and parameter setting by the bedside physician according to the patient's specific condition. The dialysis heating group used the AsahiKASEI dialysis machine heating panel to heat the dialysis solution at 37 centigrade. The reverse-piped heating group used the Barkey blood heater from the Prismaflex CRRT system to heat the dialysis solution, and the heating line temperature was set at 41 centigrade. The patient's temperature was then continuously monitored. Hypothermia was defined as a temperature lower than 36 centigrade or a drop of more than 1 centigrade from the basal body temperature. The incidence and duration of hypothermia were compared between the two groups. Binary multivariate Logistic regression analysis was used to explore the influencing factors of hypothermia during CRRT in AKI patients.@*RESULTS@#A total of 73 patients with AKI treated with CRRT were eventually enrolled, including 37 in the dialysate heating group and 36 in the reverse-piped heating group. The incidence of hypothermia in the dialysis heating group was significantly lower than that in the reverse-piped heating group [40.5% (15/37) vs. 69.4% (25/36), P < 0.05], and the hypothermia occurred later than that in the reverse-piped heating group (hours: 5.40±0.92 vs. 3.35±0.92, P < 0.01). Patients were divided into hypothermic and non-hypothermic groups based on the presence or absence of hypothermia, and a univariate analysis of all indicators showed a significant decrease in mean arterial pressure (MAP) in hypothermic patients (n = 40) compared with the non-hypothermic patients [n = 33; mmHg (1 mmHg ≈ 0.133 kPa): 77.45±12.47 vs. 94.42±14.51, P < 0.01], shock, administration of medium and high doses of vasoactive drug (medium dose: 0.2-0.5 μg×kg-1×min-1, high dose: > 0.5 μg×kg-1×min-1) and CRRT treatment were significantly increased [shock: 45.0% (18/40) vs. 6.1% (2/33), administration of medium and high doses of vasoactive drugs: 82.5% (33/40) vs. 18.2% (6/33), administration of CRRT (mL×kg-1×h-1): 51.50±9.38 vs. 38.42±10.97, all P < 0.05], there were also significant differences in CRRT heating types between the two groups [in the hypothermia group, the main heating method was the infusion line heating, which was 62.5% (25/40), while in the non-hypothermia group, the main heating method was the dialysate heating, which was 66.7% (22/33), P < 0.05]. Including the above indicators in a binary multivariate Logistic regression analysis, it was found that shock [odds ratio (OR) = 17.633, 95% confidence interval (95%CI) was 1.487-209.064], mid-to-high-dose vasoactive drug (OR = 24.320, 95%CI was 3.076-192.294), CRRT heating type (reverse-piped heating; OR = 13.316, 95%CI was 1.485-119.377), and CRRT treatment dose (OR = 1.130, 95%CI was 1.020-1.251) were risk factors for hypothermia during CRRT in AKI patients (all P < 0.05), while MAP was protective factor (OR = 0.922, 95%CI was 0.861-0.987, P < 0.05).@*CONCLUSIONS@#AKI patients have a high incidence of hypothermia during CRRT treatment, and the incidence of hypothermia can be effectively reduced by heating CRRT treatment fluids. Shock, use of medium and high doses of vasoactive drug, CRRT heating type, and CRRT treatment dose are risk factors for hypothermia during CRRT in AKI patients, with MAP is a protective factor.

Newly developed gas-assisted sonodynamic therapy in cancer treatment

Sonodynamic therapy (SDT) is an emerging noninvasive treatment modality that utilizes low-frequency and low-intensity ultrasound (US) to trigger sensitizers to kill tumor cells with reactive oxygen species (ROS). Although SDT has attracted much attention for its properties including high tumor specificity and deep tissue penetration, its anticancer efficacy is still far from satisfactory. As a result, new strategies such as gas-assisted therapy have been proposed to further promote the effectiveness of SDT. In this review, the mechanisms of SDT and gas-assisted SDT are first summarized. Then, the applications of gas-assisted SDT for cancer therapy are introduced and categorized by gas types. Next, therapeutic systems for SDT that can realize real-time imaging are further presented. Finally, the challenges and perspectives of gas-assisted SDT for future clinical applications are discussed.

Investigation and analysis of the current situation of public elective courses for medical college students / 中华医学教育探索杂志

Objective:To investigate the importance, satisfaction and influencing factors of college students in a medical university, and to provide reference for the teaching reform of public elective courses.Methods:A questionnaire survey was conducted in this study among Batch 2018 students of Southern Medical University. A total of 691 questionnaires were distributed and 674 valid ones were recovered. The data were analyzed descriptively, and one-way ANOVA analysis and multiple linear regression analysis were carried out by using SPSS 20.0.Results:There were statistical differences between students' objective of elective course, evaluation of teachers, evaluation of courses and harvest of courses and students' satisfaction and attention to public elective courses ( P<0.05). Students who chose courses for improving their comprehensive quality paid more attention to public courses [(4.3±0.73) points] and had higher satisfaction [(4.34±0.69) points] than other options. Students with good evaluation on teachers' teaching paid more attention to public elective courses [(4.32±0.71) points] and their satisfaction [(4.45±0.62) points] was higher than other options. Students with good evaluation on the courses had the highest degree of attention [(4.35±0.71) points] and satisfaction [(4.47±0.63) points]. Students paid the highest attention [(4.75±0.53)points] to and had the highest satisfaction [(4.85±0.36) points] with the public elective courses with more course harvest. The multiple linear regression analysis found that the 5 variables, gender, teaching forms, teaching evaluation, course quality and course harvest had significant differences in the scores of public elective course satisfaction ( P<0.05). Conclusion:The male students, in inquiry teaching form, the higher evaluation on the teacher, the higher the course quality, and the more the course harvest, the higher the students' satisfaction with the public elective courses.

Tumor-targeted/reduction-triggered composite multifunctional nanoparticles for breast cancer chemo-photothermal combinational therapy

Breast cancer has become the most commonly diagnosed cancer type in the world. A combination of chemotherapy and photothermal therapy (PTT) has emerged as a promising strategy for breast cancer therapy. However, the intricacy of precise delivery and the ability to initiate drug release in specific tumor sites remains a challenging puzzle. Therefore, to ensure that the therapeutic agents are synchronously delivered to the tumor site for their synergistic effect, a multifunctional nanoparticle system (PCRHNs) is developed, which is grafted onto the prussian blue nanoparticles (PB NPs) by reduction-responsive camptothecin (CPT) prodrug copolymer, and then modified with tumor-targeting peptide cyclo(Asp-d-Phe-Lys-Arg-Gly) (cRGD) and hyaluronic acid (HA). PCRHNs exhibited nano-sized structure with good monodispersity, high load efficiency of CPT, triggered CPT release in response to reduction environment, and excellent photothermal conversion under laser irradiation. Furthermore, PCRHNs can act as a photoacoustic imaging contrast agent-guided PTT. In vivo studies indicate that PCRHNs exhibited excellent biocompatibility, prolonged blood circulation, enhanced tumor accumulation, allow tumor-specific chemo-photothermal therapy to achieve synergistic antitumor effects with reduced systemic toxicity. Moreover, hyperthermia-induced upregulation of heat shock protein 70 in the tumor cells could be inhibited by CPT. Collectively, PCRHNs may be a promising therapeutic way for breast cancer therapy.

Analysis of the effect of sequential high-flow nasal canula oxygen therapy in post-extubation mechanically ventilated patients in intensive care unit / 中华危重病急救医学

Objective:To observe the application effect of high-flow nasal canula oxygen therapy (HFNC) after extubation in patients with mechanical ventilation (MV) in the intensive care unit (ICU).Methods:A prospective study was conducted. From January 2018 to June 2020, 163 MV patients admitted to Yijishan Hospital of Wannan Medical College were enrolled, and they were divided into HFNC group (82 cases) and traditional oxygen therapy group (81 cases) according to the oxygen therapy model. The patients included in the study were given conventional treatment according to their condition. In the HFNC group, oxygen was inhaled by a nasal high-flow humidification therapy instrument. The gas flow was gradually increased from 35 L/min to 60 L/min according to the patient's tolerance, and the temperature was set at 34-37 ℃. The fraction of inspiration oxygen (FiO 2) was set according to the patient's pulse oxygen saturation (SpO 2) and SpO 2 was maintained at 0.95-0.98. A disposable oxygen mask or nasal cannula was used to inhale oxygen in the traditional oxygen therapy group, and the oxygen flow was 5-8 L/min, maintaining the patient's SpO 2 at 0.95-0.98. The differences in MV duration before extubation, total MV duration, intubation time, reintubation time, extubation failure rate, ICU mortality, ICU stay, and in-hospital stay were compared between the two groups, and weaning failure were analyzed. Results:There was no significant differences in MV duration before extubation (days: 4.33±3.83 vs. 4.15±3.03), tracheal intubation duration (days: 4.34±1.87 vs. 4.20±3.35), ICU mortality [4.9% (4/82) vs. 3.7% (3/81)] and in-hospital stay [days: 28.93 (15.00, 32.00) vs. 27.69 (15.00, 38.00)] between HFNC group and traditional oxygen therapy group (all P > 0.05). The total MV duration in the HFNC group (days: 4.48±2.43 vs. 5.67±3.84) and ICU stay [days: 6.57 (4.00, 7.00) vs. 7.74 (5.00, 9.00)] were significantly shorter than those in the traditional oxygen therapy group, the reintubation duration of the HFNC group was significantly longer than that of the traditional oxygen therapy group (hours: 35.75±10.15 vs. 19.92±13.12), and the weaning failure rate was significantly lower than that of the traditional oxygen therapy group [4.9% (4/82) vs. 16.0% (13/81), all P < 0.05]. Among the reasons for weaning failure traditional oxygen therapy group had lower ability of airway secretion clearance than that of the HFNC group [8.64% (7/81) vs. 0% (0/82), P < 0.05], there was no statistically differences in the morbidity of heart failure, respiratory muscle weakness, hypoxemia, and change of consciousness between the two groups. Conclusion:For MV patients in the ICU, the sequential application of HFNC after extubation can reduce the rate of weaning failure and the incidence of adverse events, shorten the length of ICU stay.

Visual analysis of hot spots in foreign pre-oxygenation research based on citespace / 中国实用护理杂志

Objective:To visually analyze the general situation and development of pre-oxygenation research abroad, and provide a reference for further development of pre-oxygenation in China.Methods:Using the WOS core data set as the data source, CiteSpace V software was used to visually analyze the literature published from January 1, 2000 to November 29, 2019.Results:The number of papers has shown a rapid upward trend since 2013, the US has the most papers. Research hotspots mainly focus on tracheal intubation, intensive care unit, apnea oxidation, non-invasive ventilation and complications.Conclusion:The United States is in the leading position in the study of pre-oxygenation, and China is still in the initial stage in the study of pre-oxygenation. We should strengthen cooperation and exchange with developed countries such as Europe and America. The application of pre-oxygenation outside the operating room and the selection of pre oxygenation tools are the direction of further research.

Training the swallowing and respiration of preterm infants / 中华物理医学与康复杂志

Objective:To explore the effect of swallowing training combined with respiratory intervention on the swallowing function and early neurodevelopment of preterm infants.Methods:Sixty-two preterm infants in neonatal intensive care were randomly divided into a study group of 30 and a control group of 32. All received routine treatment and nursing care plus touching, but the study group was additionally provided with swallowing and respiratory training. The duration of gastric tube use was observed, and a 20-item neonatal behavioral neurological assessment (NBNA) was administered at 40 weeks of corrected gestational age.Results:The average period of gastric intubation in the study group [(56.27±22.26) days] was significantly shorter than the control group′s average [(68.97±23.96) days]. The study group′s average NBNA score was significantly higher. Moreover, the NBNA scores were significantly negatively correlated with the intubation times.Conclusions:Swallowing training combined with respiratory intervention can improve the swallowing function of preterm infants, shorten the time a gastric tube is needed, and improve their early neurodevelopment.

Progress in the pathogenesis of irritable bowel syndrome in children / 国际儿科学杂志

Irritable bowel syndrome(IBS)is a common functional gastrointestinal disorder disease in children, and it is also a common cause of chronic abdominal pain in children.It not only seriously affects the life quality of children and their families, but also places a great burden on the Health Care System.At present, the exact pathogenesis of IBS is not completely clear, and most of the studies on the pathophysiological mechanism of IBS are based on adults, which poses a certain challenge to the effective management of children with IBS.Recent research progress of the pathogenesis of IBS was reviewed briefly in this paper, so as to provide a better strategy for the treatment of children with IBS.

Clinical significance of serum gastrin, C-reactive protein and D-dimer in Henoch-Schönlein purpura children with abdominal symptoms / 中华实用儿科临床杂志

Objective@#To investigate the clinical significance of serum gastrin-17, C-reactive protein (CRP) and D-dimer (D-D) levels in early diagnosis and severity evaluation of Henoch-Schölein purpura (HSP) children with abdominal symptoms.@*Methods@#Retrospective analysis was performed in 120 children with initial HSP admitted to the Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University from December 2016 to December 2017, among them, there were 70 cases with abdominal symptoms, and 50 patients without abdominal symptoms.And 20 healthy children who underwent health consultation at the First Affiliated Hospital of Anhui Medical University were selected as a healthy control group.Serum gastrin-17, CRP and D-D levels in acute phase in the HSP children were detected, and the correlation between these parameters and purpura symptom scores was analyzed.Together with gastroscope, the severity of HSP with abdominal symptoms was evaluated.@*Results@#(1) Serum gastrin-17 level in HSP children with abdominal symptoms were obviously lower than that of the other of type HSP group and the healthy control group [(3.12±1.64) pmol/L vs.(6.85±1.28) pmol/L and (7.15±1.03) pmol/L], and the differences were statistically significant (all P<0.001); the levels were decreased most significantly in HSP children with early gastrointestinal symptoms [(1.77±0.50) pmol/L vs.(4.01±1.51) pmol/L], and the difference was statistically significant (P<0.001); the pathological changes under gastroscope were obvious in HSP children with early gastrointestinal symptoms (χ2=8.095 2, P<0.05). (2) Serum CRP and D-D levels in the HSP children with abdo-minal symptoms were striking higher than those in the healthy control group [(18.39±4.48) mg/L vs.(3.95±1.65) mg/L; (2.53±1.17) mg/L vs.(0.59±0.41) mg/L], and the differences were statistically significant (all P<0.001), which were both increased most significantly in the HSP children with early gastrointestinal symptoms [(19.98±5.45) mg/L vs.(17.33±3.37) mg/L; (3.48±0.96) mg/L vs.(1.89±0.80) mg/L], and the diffe-rences were statistically significant (all P<0.05). (3) Serum gastrin-17 level was negatively correlated with purpura symptom scores (r=-0.907, P<0.01); serum CRP and D-D levels were both positively correlated with purpura symptom scores (r=0.974, 0.928, all P<0.01).@*Conclusions@#Serum gastrin-17, CRP and D-D levels in acute phase can be used as serological markers for early diagnosis of HSP children with abdominal symptoms, especially in HSP children with early gastrointestinal symptoms.

Clinical significance of serum gastrin,C _ reactive protein and D _ dimer in Henoch _ Sch?nlein purpura children with abdominal symptoms / 中华实用儿科临床杂志

Objective To investigate the clinical significance of serum gastrin _17,C _ reactive protein ( CRP)and D_dimer(D_D)levels in early diagnosis and severity evaluation of Henoch_Sch?lein purpura(HSP) children with abdominal symptoms. Methods Retrospective analysis was performed in 120 children with initial HSP admitted to the Department of Pediatrics,the First Affiliated Hospital of Anhui medical University from December 2016 to December 2017,among them,there were 70 cases with abdominal symptoms,and 50 patients without abdominal symptoms. And 20 healthy children who underwent health consultation at the First Affiliated Hospital of Anhui medical University were selected as a healthy control group. Serum gastrin_17,CRP and D_D levels in acute phase in the HSP children were detected,and the correlation between these parameters and purpura symptom scores was analyzed. Together with gastroscope,the severity of HSP with abdominal symptoms was evaluated. Results (1)Serum gastrin_17 level in HSP children with abdominal symptoms were obviously lower than that of the other of type HSP group and the healthy control group[(3. 12 ± 1. 64)pmol/L υs.(6. 85 ± 1. 28)pmol/L and(7. 15 ± 1. 03)pmol/L],and the differences were statistically significant(all P<0. 001);the levels were decreased most significantly in HSP children with early gastrointestinal symptoms[(1. 77 ± 0. 50)pmol/L υs.(4. 01 ± 1. 51)pmol/L],and the difference was sta_tistically significant(P<0. 001);the pathological changes under gastroscope were obvious in HSP children with early gastrointestinal symptoms(χ2 =8. 095 2,P<0. 05).(2)Serum CRP and D_D levels in the HSP children with abdo_minal symptoms were striking higher than those in the healthy control group[(18. 39 ± 4. 48)mg/L υs.(3. 95 ± 1. 65) mg/L;(2. 53 ± 1. 17)mg/L υs.(0. 59 ± 0. 41)mg/L],and the differences were statistically significant( all P <0. 001 ),which were both increased most significantly in the HSP children with early gastrointestinal symptoms [(19. 98 ± 5. 45)mg/L υs.(17. 33 ± 3. 37)mg/L;(3. 48 ± 0. 96)mg/L υs.(1. 89 ± 0. 80)mg/L],and the diffe_rences were statistically significant(all P<0. 05).(3)Serum gastrin_17 level was negatively correlated with purpura symptom scores(r= _0. 907,P<0. 01);serum CRP and D_D levels were both positively correlated with purpura symptom scores(r=0. 974,0. 928,all P<0. 01). Conclusions Serum gastrin_17,CRP and D_D levels in acute phase can be used as serological markers for early diagnosis of HSP children with abdominal symptoms,especially in HSP children with early gastrointestinal symptoms.

Effect of intestinal flora on expression of acid-sensitive ion channel 3 in rats and their regulation in intestinal motility in children with functional constipation / 中华实用儿科临床杂志

Objective@#To investigate the effect of intestinal flora in children with functional constipation (FC) on expression of acid-sensitive Ion channel 3(ASIC3) in rats and their regulation in intestinal motility.@*Methods@#Faeces of FC children identified according to RomeⅣ criteria and healthy children from the First Affiliated Hospital of Anhui Medical University from December 2017 to June 2018 were collected, and then made into fecal microbiota solution.A pseudo - sterile rat model was established, according to the random number table method, and the rats were randomly divided into the treatment group and the control group, with 12 rats in each group, then the treatment group was given fecal microbiota solution of the children with FC and the control group was given fecal microbiota solution of the healthy children.The visceral sensitivity and intestinal propulsion rate of rats were determined by means of abdominal withdrawal reflex (AWR), while the intestinal microorganism of rats and children with FC were determined by 16SrDNA high-throughput sequencing, and the expressions of ASIC3 of intestinal in mRNA and protein were determined by adopting fluorescence quantitative PCR and Western blot.@*Results@#The species and quantity of intestinal flora of the children with FC and rats implanted with FC faecal bacteria were reduced(all P<0.05), and firmicutes and bacteroidetes were the main bacteria; compared to the control group, the small intestine propulsion rate(52% vs.74%) and visceral sensitivity(78 mmHg vs.63 mmHg) of the treated group were significantly decreased compared with those in the control group (all P<0.05); the mRNA (0.003 1±0.000 8 vs.0.012 4±0.002 5) and protein levels of ASIC3 (0.013 2±0.001 9 vs.0.072 1±0.008 7) in the small intestine were down-regulated significantly(all P<0.05); and the mRNA (0.002 8±0.000 7 vs.0.009 4±0.001 1) and protein levels of ASIC3(0.038 2±0.004 5 vs.0.089 7±0.009 4) in the colon were down-regulated significantly(all P<0.05).@*Conclusions@#Children with FC have intestinal flora disorder, and intestinal flora of FC children may affect intestinal motility by down-regulating the expression of intestinal ASIC3 in rats.

Evaluation of the effectiveness of specialized nursing team in the management of critical patients / 中国实用护理杂志

Objective@#To explore the application effect of a specialized team consisting of specialist nurses and some emergency care′s or intensive care′s head nurses of critically ill patients in the hospital.@*Methods@#From 2016 to 2018, the Critical Care Professional Group of implemented a provincial and above specialist nurses and the backbone of the specialist care departments of the acute and critical departments. A total of 23 members were composed of core members. A total of 56 liaison officers from each ward were selected to participate. The training and assessment activities presided over by the core staff of the professional group; at the same time, the professional group liaison officer is also the leader of the critical care quality control team in this ward, and implements the quality control of critical care patients; the core members are responsible for the guidance of the nursing care of critical patients in the hospital. The liaison staff carries out the training and assessment of the intensive care knowledge, skills and related nursing standards, norms, as well as the sharing of new technologies and new projects or research topics for acute and critical care, and the training of intensive care posts in the hospital. Before and after the operation of the specialized nursing team, the quality control scores of critically ill patients in 2015-2018, the satisfaction survey of nursing, the number of patents published by nurses in 2-25 years, the mortality rate of patients, and the results of unplanned extubation in 2016-2018 Compare.@*Results@#The quality control scores of critical care patients in 2015-2018 were 93.91±1.23, 94.07±1.38,94.33±1.24, 95.42±1.56. The difference was statistically significant (F=49.597, P < 0.01). Satisfaction survey scores were 94.92±2.28, 97.08±1.37, 97.82±1.52, 97.94±1.68, the difference was statistically significant (F=30.882, P < 0.01); work 2-20 years The number of nurses was 678, 809, 853, and 925 respectively. The number of patents published was 76, 119, 147, and 237, respectively. The difference was statistically significant (χ2=36.77, P < 0.01). 2016-2018 unplanned extubation rate was 4.98‰(127/25 517), 4.01‰(115/28 713), 3.25‰(112/34 493), the difference was statistically significant (χ2=10.958, P <0.01).@*Conclusions@#The professional nursing team operation mode can improve the core ability and comprehensive quality of nursing staff's intensive care, improve the quality of care management of critically ill patients, ensure patient safety, and achieve continuous improvement of nursing quality.

Surface electromyography-based biofeedback for treating dysphagia after radiation therapy / 中华物理医学与康复杂志

Objective To observe the effect of surface electromyographic biofeedback (sEMG BFB) combined with routine swallow training in treating dysphagia among those with nasopharyngeal carcinoma after radiation therapy.Methods Fifty dysphagic patients with nasopharyngeal carcinoma after radiation therapy were randomly divided into a biofeedback training group and a routine treatment group,each of 25.Both groups were given routine training including orofacial function training,sensory irritation,behavioral swallowing training,and electrical stimulation.The biofeedback group was additionally given behavioral swallowing training based on sEMG BFB.Before and 4 weeks after the treatment,a videofluoroscopic swallowing study was performed to observe the opening of the upper esophageal sphincter (UES).The penetration aspiration scale (PAS) and the functional oral intake scale (FOIS) were used to evaluate the subjects' swallowing function.Results Before the treatment there were no significant differences between the two groups in terms of UES opening,average PAS score or average FOIS score.Everyone improved significantly after the treatment,but compared with the routine treatment group,UES opening was significantly better after the treatment,the average PAS score was lower and the average FOIS score was higher in the biofeedback training group.Conclusion sEMG BFB combined with routine swallowing training can improve the UES opening and swallowing ability of dysphagic patients with nasopharyngeal carcinoma after radiation therapy.

Nursing care on the sedation of patients with non-invasive ventilation / 中国实用护理杂志

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .

Significance of monitoring indexes of coagulation and fibrinolytic before and after delivery / 国际检验医学杂志

Objective To investigate the significance of detection of blood coagulation and fibrinolytic indexes before and after delivery.Methods 212 cases in the postpartum hemorrhage group(bleeding amount ≥500 mL)and 235 cases in the normal deliver-y group were retrospectively analyzed.The prothrombin time(PT),international normalized ratio(PT-INR),activated partial throm-boplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),blood platelets(PLT)and hemoglobin(HB)were de-tected before delivery and at 72 h after delivery.85 women with the physical examination were selected as the healthy group.Results Before delivery,PT/PT-INR,APTT,TT,PLT and HB in the normal delivery group were lower than those in the healthy group, while FIB and DD were higher than those in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB and PLT were lower than those in the normal delivery group. At 72 h after delivery,there was no statistically significant differences in PT/PT-INR,APTT,TT and DD between the normal de-livery group and the healthy group(P >0.05),but FIB was higher than that in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB,PLT and HB were lower than those in the normal delivery group.Conclusion Dynamically monitoring the change of the blood coagulation and fibrinolysis indexes before and after delivery has important significance in preventing postpartum hemorrhage and thrombosis.

Effect of TFB on TGF-β1 signaling pathway in HSC of liver fibrosis rats / 中国药理学通报

Aim To investigate the proliferation of HSCs stimulated by exogenous TGF-β1 (transforming growth factor betal),observe the effect of TFB(total flavonoids of Bidens Bipinnata L.)on smad2/7,typeⅠcollagen mRNA and protein expression of HSCs and study the protective effect and molecular mechanism of TFB on hepatic fibrosis.Methods HSCs were isolated with collagenase Ⅳ perfusion in situ and density gradient centrifugation. The effect of TFB on cell proliferation was observed by MTT colormetric assay. The auto-secretion of TGF-β1 and synthesis of type Ⅰ collagen were measured by enzyme-linked immuneadsordent assay (ELISA).Moreover,the expression of smad2/7, typeⅠcollagen mRNA and protein was measured by semi-quantitative RT-PCR and Western blot methods respectively.Results TFB could markedly inhibit the proliferation of HSCs of liver fibrosis rats stimulated by TGF-β1 and production of TGF-β1 and type Ⅰ collagen.In addition,TFB treatment could significantly down-regulate smad2 and type Ⅰ collagen mRNA expression and up-regulated smad7 mRNA expression of HSCs Smad2 protein expression of HSCs stimulated by TGF-β1 was also down-regulated by TFB.Conclusion TFB has the protective effect against hepatic fibrosis by inhibiting the activation of TGF-β1 signaling pathway and suppressing the HSC proliferation.

Aerosol Inhalation of Sodium Houttuyfonate Injection for Treatment of Pneumonia:A Systematic Review / 中国药房

OBJECTIVE:To evaluate the effectiveness and safety of an aerosol inhalation of Sodium Houttuyfonate injection in accessory treatment of pneumonia.METHODS:Biomedical databases,including Medline,EMbase,The Cochrane Central Register of Controlled Trials,CBM-disk and CNKI were searched.Randomized controlled trials(RCTs) and quasi-RCTs that compare aerosol inhalation of Sodium Houttuyfonate injection with placebo or other aerosol inhalation regimens were collected.A critical quality assessment and Meta-analysis were performed for included studies.RESULTS:Six RCTs were included and all of them were carried out in China.None of the trials described the method of randomization,allocation concealment,blind,and follow-up.With Junci scales,6 trials scored C degree.Compared with the control group,aerosol inhalation of Sodium Houttuyfonate injection showed significantly higher total improvement rate.We didn't find any RCTs describing the safety of Sodium Houttuyfonate injection aerosol inhalation.CONCLUSION:Because of the low quality of RCTs on Sodium Houttuyfonate injection aerosol inhalation for pneumonia and the lack of RCTs describing the safety of Sodium Houttuyfonate injection aerosol inhalation,no reliable conclusion can be drawn from our Meta-analysis about its efficacy and safety.Well-designed RCTs are urgently needed to evaluate the value and safety of aerosol inhalation of Sodium Houttuyfonate injection in treating pneumonia.

Clinical analysis of 45 patients with severe acute respiratory syndrome / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the clinical and radiological features of severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Analysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5 - 20, 2003. Also included is a summation of the clinical features of SARS.</p><p><b>RESULTS</b>(1) SARS appears to have high infectivity; (2) the most common symptom is fever; (3) the count of leukocyte is normal or decreased; (4) most patients (35/45, 77.8%) had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1% (32/45) of the patients and, (5) the percentage of patients who developed severe pneumonia (24.4%) is higher than those who developed typical pneumonia.</p><p><b>CONCLUSION</b>SARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combat this infection.</p>

Therapeutic effects of total flavones of Bidens bipinnata L(TFB) on liver fibrosis in rats and its mechanisms / 中国药理学通报

Aim To explore the therapeutic effect of total flavones of Bidens Bipinnata L (TFB) on liver fibrosis in rats and its mechanism. Methods The model of rat liver fibrosis was adopted which was induced by CCl4 injection. The effects of TFB were observed on the levels of serum HA,PCⅢ,CIV and Hyp in rats liver fibrosis,and on liver histopathological changes as well as collagen hyperplasia formation in liver tissue. The apoptosis of HSC were detected by double-staining of ?-smooth muscle actin (?-SMA) and TUNEL. The study in vitro was carried out on the culture of isolated hepatic stellate cells. Cell proliferation was detected with MTT assay. Cell apoptosis was detected by electron microscopy and flow cytometry. Results TFB can significantly reduce serum HA,PCⅢ,CⅣ and Hyp contents in liver fibrosis of rats,improve the liver pathologic injury,reduce collagen hyperplasia in liver of liver fibrosis rats,inhibit the activation and proliferation of HSC,and promote the apoptosis of HSC. In addition TFB could significantly inhibit the proliferation and increased the apoptosis of isolated and cultured HSC compared with the control group. Conclusions TFB has a significant therapeutic effect on the liver fibrosis rats,probably its inhibition of proliferation and stimulation of activated HSC apoptosis may be an important mechanism of its therapeutical effect against liver fibrosis.

Total flavones of Bidens pilosa L′s effect on cytokines in liver fibrosis rats / 中国药理学通报

Objectives To study the effect of total flavones of Bidens pilosa L (TFB) on cytokines production in liver fibrosis rats. Methods Rat liver fibrosis was induced by CCl450%, 0.1 ml?(100 g)-1 body weight twice a week for 18 weeks. TFB (160,80,40 mg?kg-1) was used daily via gastrogavage at 9 week. Levels of TNF-? and IL-1? in serum were determinate by radioimmunoassay. Liver samples were collected after experiments and stained by immuninochemistry of TGF-?1 and NF-?B. Moreover TGF-?1 mRNA expression in liver tissue was detected by RT-PCR technology. Results TFB (160, 80 mg?kg-1) could significantly reduce serum TNF-? and IL-1? contents; TFB(160, 80, 40 mg?kg-1) could effectively prevent the expression of NF-?B,as was TGF-?1 of TFB(160, 80 mg?kg-1). Moreover TFB (160, 80 mg?kg-1) could significantly reduce TGF-?1 mRNA in liver fibrosis rats. Conclusion TFB had protective effect on liver fibrosis by its inhibition of cytokine production.