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【Objective】 To investigate the correlation of serum exosomal microRNA-301a (miR-301a) with cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. 【Methods】 A total of 211 patients with diabetic nephropathy treated with peritoneal dialysis from June 2019 to June 2020 in the First Hospital Affiliated of Hebei North University were selected as study subjects. Serum exosomal miR-301a was detected by real-time fluorescence quantitative polymerase chain reaction. The patients were divided into high miR-301a group and low miR-301a group based on the median of miR-301a; the clinical data of the two groups were compared. The correlation of miR-301a with high-sensitivity C-reactive protein (hs-CRP) was analyzed by Spearman. Linear regression was applied to analyze the factors associated with the effect of miR-301a. The patients were followed up for two years. Kaplan-Meier and Log-Rank were conducted to compare the cumulative incidence of cardiovascular and cerebrovascular events between the two groups, and COX regression and restricted cubic spline were used to analyze the level-effect relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis. 【Results】 Thirty-seven cases (17.54%) of cardiovascular and cerebrovascular events occurred during follow-up. The hs-CRP level and dialysis duration were lower in low miR-301a group than in high miR-301a group (P<0.05). There was a positive correlation between miR-301a and hs-CRP (rs=0.237, P=0.001). Linear regression analysis showed that hs-CRP was independently associated with miR-301a (P<0.05). The cumulative cardiovascular and cerebrovascular event rate in low miR-301a group was 3.70% (4/108), which was lower than that in high miR-301a group [32.04% (33/103), P<0.001]. COX regression analysis showed that high serum albumin level was an independent protective factor for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy,while high hs-CRP level and miR-301a >1.46 were independent risk factors for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. Restricted cubic spline fitting COX regression analysis showed a non-linear relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy (P<0.05). 【Conclusion】 hs-CRP is independently associated with miR-301a in diabetic nephropathy peritoneal dialysis patients. High miR-301a level suggests a high risk of cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy.
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Objective To explore the physician-pharmacist joint outpatient service mode of chronic obstructive pulmonary disease ( COPD) and asthma. Methods Cases of COPD or asthma patients who visited the joint outpatient department from June 2021 to December 2021 were collected in our hospital, the inhaler usage score，compliance ( MMAS-8) score，clinical control efficacy，incidence of adverse reactions and patient satisfaction were evaluated before and after pharmaceutical care intervention and statistically analyzed．Results The inhaler usage score，MMAS-8 score，and the Asthma Control Test（ACT）/COPD Assessment Test（CAT） score had been changed significantly after the intervention (P<0.05). Patient satisfaction with pharmaceutical care was basically above 94.75%．Conclusion Pharmaceutical care provided by joint outpatient department in our hospital could help COPD and asthma patients to use inhaler device correctly，resulting in improving compliance of inhaler usage, better disease control，and reducing the occurrence of adverse drug reactions, which could be a positive attempt and exploration of standardized pharmaceutical care model for patients with COPD and asthma．
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Objective:To observe the changes of serum micro-inflammatory and nutritional status in elderly peritoneal dialysis patients after treatment with bifidobacterium triple viable bacteria, and the impact of Bifidobacterium triple viable bacteria treatment on the endpoint.Methods:Totally 180 elderly patients receiving peritoneal dialysis were divided into control group and observation group, with 90 cases in each.Both groups were treated on the basis of the routine treatment, the observation group was treated with oral Bifidobacterium triple viable bacteria for twelve months.Before treatment, 6 months and 12 months after treatment, fasting venous blood from the patients in the two groups were collected in the morning.The levels of serum micro-inflammatory indexes[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8), C-reactive protein(CRP)]were detected by ELISA.The nutritional status and dialysis adequacy indexes[nutritional status: albumin(ALB), hemoglobin(Hb), transferrin(TRF), prealbumin(PA), calcium ion, phosphorus ion; indicators of dialysis adequacy: serum creatinine(Scr), blood uric acid(BUA), blood urea nitrogen(BUN), cystatin C(Cys-c)levels]were detected by automatic blood biochemical analyzer.After 24 months of follow-up, the occurrence of endpoint events(peritonitis, abdominal pain, malnutrition, abdominal infection, cardiovascular and cerebrovascular accidents)in the two groups was recorded.Results:After 24 months of treatment, the levels of TNF-α, IL-6, IL-8 and CRP in the two groups were lower than those before treatment, and the observation group was lower than control group[(25.7±4.0)μg/L vs.(33.6±6.0)μg/L, (2.9±0.7)ng/L vs.(4.9±1.2)ng/L, (17.0±7.2)ng/L vs.(22.8±7.9)ng/L, (4.6±0.7)mg/L vs.(6.9±1.2)mg/L]( t=10.272, 13.134, 5.040, 15.575, respectively, P<0.05 for all). After 24 months of treatment, the levels of ALB, Hb, TRF, PA and calcium ion of the two groups were higher than before treatment, and the levels of phosphorus ion were lower than before treatment, and the changes of the above indicators in observation group were more obvious than those in the control group[(45.7±5.2)g/L vs.(39.8±4.9)g/L, (72.7±8.0)g/L vs.(68.6±9.0)g/L, (4.3±1.0)g/L vs.(3.0±0.6)g/L, (321.5±29.0)mg/L vs.(297.6±25.1)mg/L, (4.9±1.3)mmol/L vs.(2.9±0.9)mmol/L, (1.3±0.9)/L vs.(1.8±0.3 mmol/L)]( t=7.737, 3.213, 9.880, 5.9 00, 11.937, 4.415, P<0.05 for all). There was no significant difference in intestinal flora between the two groups before treatment( P>0.05). After 24 months, an increase was observed in Lactobacilli and Bifidobacteria in both groups, while Enterobacteria and Enterococcus in both groups were decreased, and the changes of the above indicators in the observation group were also more obvious than those in the control group[(8.4±0.9)IgCFU/g ratio(6.4±0.9)IgCFU/g, (8.8±1.3)IgCFU/g ratio(7.9±1.3)IgCFU/g, (7.1±0.9)IgCFU/g ratio(8.0±1.1)IgCFU/g, (5.4±0.7)IgCFU/g ratio(6.9±0.9)IgCFU/g]( t=14.248, 4.339, 5.825, 12.753, P<0.05 for all). There was no significant difference in dialysis adequacy index between the two groups before treatment( P>0.05 for all). After 24 months of treatment, the levels of Scr, BUA, BUN and Cys-C in both groups decreased, and those of the observation group were lower than those of the control group[(471.5±50.5)μmol/L vs.(623.3±62.6)μmol/L, (17.5±0.5)mmol/L vs.(20.6±1.8)mmol/L, (16.4 ± 3.0)mmol/L vs.(22.5±2.0)mmol/L, (1.9±0.5)mg/L vs.(3.0±0.7)mg/L]( t=17.877, 14.976, 15.842, 11.749, P<0.05 for all). The incidence of endpoint events in the observation group was significantly lower than that in the control group(12.2% vs.2.2%, t=6.574, P<0.05 for all). Conclusions:After the treatment of Bifidobacterium triple viable bacteria in elderly peritoneal dialysis patients, the micro-inflammatory state of the patients was reduced, the nutritional status was improved, and the incidence of endpoint events was low, and has high clinical promotion and application value.
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Objective To explore the effect of setting up standardized treatment demonstration ward for cancer pain on the management of narcotic drugs. Methods The study group (from 2015 to 2016 to create the standardized treatment of cancer pain ward) and control group (from 2013 to 2014 to create a standardized pain treatment demonstration unit ) all kinds of narcotic drugs dosage and medication frequency (DDDs), a monthly 30 prescriptions from tumor anesthesia, analysis of prescription writing quality qualified the rate and the rate of unreasonable use. Results The study group of patients with cancer pain drug usage and DDDs, oxycodone dosage rises fast, DDDs way ahead, dosage of morphine increased gradually, morphine dosage gradually decreased, transdermal fentanyl DDDs decreased, pethidine dosage remains low. The research group for the passing rate of prescription writing quality 99.3％, the control group of prescription writing quality qualified rate is 81.1％, the research group of narcotic drug use rate was only 4％, reasonable utilization rate is as high as 96％ is not reasonable, unreasonable use of narcotic drugs control group was as high as 18.5％, reasonable utilization rate is only 81.5％ (P<0.05). Conclusion The creation of standardized pain treatment demonstration unit narcotic drugs more reasonable structure, can improve the quality of narcotic drugs prescription writing qualified rate, reduce the rate of unreasonable use, reasonable use of pain medicine has positive significance to ensure patient safety and efficacy of.
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Objective To explore the effects of losartan potassium and simvastatin combination therapy on oxidative stress indicators in diabetic patients on peritoneal dialysis through 12 weeks observation. Methods Diabetic patients with end-stage nephropathy (n=80) who were treated with continuous ambulatory peritoneal dialysis were randomly divided into two groups:control group who received routine treatment (n=40), treatment group who were given losartan potassium 50 mg, once per day and simvastatin 20 mg, once every night (n=40). HbA1C, Insulin dosage, Oxidative stress indicators(SOD, GSH-PX, MDA and Hcy)were compared between two groups before and after peritoneal dialysis. Results There was no significant difference of HbA1C between the 2 groups before and after treatment(P>0.05). The insulin doses increased be?fore dialysis in both groups after CAPD treatment. It is lower in the treatment group than that in the control group ( P<0.05). The expression levels of GSH-PX and SOD in treatment group were higher while the expressions of Hcy and MDA were lower after treatment. The expressions of GSH-PX and SOD were higher while the expressions of Hcy and MDA were lower in treat?ment group than those in control group when comparing the same time point(P<0.05). GSH-PX expression level was lower while the expressions of MDA and Hcy were higher after dialysis than those before dialysis in control group ( P<0.05). Con?clusion Losartan potassium combined with simvastatin treatment can improve curative effect and oxidative stress indicators in diabetic patients on peritoneal dialysis.
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AIM: To study the role of post-hemorrhagic shock mesenteric lymph (PHSML) drainage on the balance of angiotensin-converting enzyme ( ACE) and ACE2 in the kidney.METHODS:A hemorrhagic shock model was established and then fluid resuscitation was performed to the animals in shock and shock+drainage groups, and the PHMSL was drained in shock+drainage group after fluid resuscitation.After 6 h of resuscitation, the mRNA expression of ACE, ACE2, angiotensin II (Ang II) type 1 receptor (AT1R) and Mas-related G-protein-coupled receptor (MasR), and the levels of Ang II and Ang (1-7) in the renal tissues were observed.RESULTS:Hemorrhagic shock increased the levels of ACE mRNA, AT1R mRNA and Ang II, and decreased the levels of ACE2 mRNA, MasR mRNA and Ang(1-7) in the kid-ney.PHSML drainage abolished the effect of hemorrhagic shock on ACE2 and AT1R mRNA expression.Meanwhile, PHSML drainage reduced the hemorrhagic shock-induced increases in the ratios of ACE/ACE2, Ang II/Ang(1-7) and AT1R/MasR.CONCLUSION:The PHSML drainage restores the balance of ACE/ACE2, which is beneficial to alleviate acute kidney injury following hemorrhagic shock in the mice.
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AIM: To investigate the role of post-hemorrhagic shock mesenteric lymph (PHSML) in the enhancementof vascular permeability .METHODS: Eighteen Wistar rats were randomized into sham group , shock group,and shock plus mesenteric lymph drainage (shock +drainage) group.The rats in shock group and shock +drainagegroup were routinely subjected to hemorrhagic shock and hypotension [(40 ±2) mmHg] was maintained for 90 min, andthen the fluid resuscitation was performed.Mesenteric lymph was drained in the rats in shock +drainage group from resuscitationfinished to 6 h, for the observation of PHSML drainage on the vascular permeability in multiple tissues of hemorrhagicshock rats.Afterwards, human umbilical vein endothelial cells (HUVECs) were incubated with the PHSML in vitro to observethe effects of PHSML on the morphology and permeability of HUVECs .RESULTS: The degree of blue color and concentrationsof Evens blue in the lung, myocardium, kidney, liver, spleen and small intestine were significantly increased inthe shocked rats than that in sham group, while the ratios of the dry weight to the wet weight were decreased .The mesentericlymph drainage reversed these changes .Meanwhile, 4% and 10% of PHSML at 0 ~3 h and 3 ~6 h after resuscitation,and lipopolysaccharide (10 mg/L) all caused the damage of HUVECs, decreased the viability and trans-endothelial electricalresistance of HUVECs, and increased the permeability of HUVECs to fluorescein isothiocyanate -labeled albumin. CONCLUSION: PHSML is a vital factor in the enhancement of vascular permeability .
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Objective To explore in vitro cytotoxic activities of DCIKs against hepatocarcinoma cells by co-culturing cytokine-induced killer cells (CIKs) with dendritic cells (DCs) derived from peripheral blood of patients with hepatocellular carcinoma (HCC).Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 23 patients with HCC and cultured with cytokines to induce DCs and CIKs.DCIKs were induced by co-culturing CIKs with DCs.After 14 days of co-culture,the phenotypes of DCIKs and CIKs were analyzed by flow cytometry,and their in vitro cytotoxic activities against SMCC-7721 and HepG2 hepatocarcinoma cells were measured by MTT assay.Levels of IL-12,IL-4 and IFN-γ in the supernatants of cell culture were detected by enzyme-linked immunosorbent assay (ELISA).Results High expressions of CD3+CD8+ and CD3+CD56+ were observed on DCIKs.The percentages of effector cells,cytotoxic activity and cytokine secretion were all significantly increased with DCIKs as compared with those CIKs without DC co-culture (P＜0.05).Conclusion Co-culture of CIKs with DCs can enhance the differentiation of effector cells and the cytolytic activities of CIKs against hepatocarcinoma cells in vitro.Immunotherapy with DCIKs may be a promising strategy for the treatment of patients with HCC.
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To propose an equipment and technology package for oxygen preparation and supply under hypoxia conditions in order to meet the requirements of populations on the plateau .Different populations were analyzed in terms of their oxygen supply requirements, and the modes, schemes and equipment for oxygen supply were explored accordingly and then applied.Efforts in the past 20 years have resulted in the advances in the equipment for centralized, mobile and portable oxygen preparation and supply, though the equipment for individual use hads to be improved and the diffused oxygen supply scheme also needs to be further evaluated .
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Objective To observe the efficacy for the eradication of Helicobacter pylori (Hp) by using the 10-day sequential therapy consisting of omeprazle,amoxicillin,clarithromycin,and furazolidone,and to compare with the traditional triple-drug therapy.Methods 155 adult patients,who were Hp positive with peptic ulcer,chronic gastritis with mucosal atrophy or erosion,were selected and randomly divided into two groups.The patients in 10-day sequential therapy group received omeprazole and amoxicillin in the first 5 days followed by another 5 days of ome-prazole,clarithromycin and furazolidone.The patients in traditional triple-drug therapy group recieved omeprazole,amoxicillin,and clarithromycin for 7 days.Results The HP eradication rate of the 10-day sequential therapy group was 92.31% ,while the traditional triple-drug group was 72.73%.The difference between the two groups was statistically significant (P<0.01).Conclusion The 10-day sequential therapy consisting of omeprazole,amoxicillin,clarithromycin and furazolidone achieved higher eradication rate,and it was safe,and good compliance.
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Obiective To study controUing method for curing time of the materials based on isocyanate, and perfect making means and operating rules of transmitting apparatus for the wounded, Methods According to the controlling principles of the rate of chemical reaction, the influencing factors' were studied such as catalyzer, ambient temperature, mixture level of materials and materials volume by experiment. Results By the results of experiments, ambient temperature hasn't an effector impact on eufing time of isocyanate, catalyzer and mixture level of materials only have a little effect or impact on initial reaction time, but materials volume is an important factor of all. Conclusion By the means of experiments, the curing time of isocyanate is only influenced by the volume of materials, and the character is very useful to transmitting apparatus for the wounded in field battle or on-site emergency rescue.
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Cardiopulmonary resuscitation board (CPR Board) is an essential tool in emergency care, which can keep the patient's airway open and support the patient in the administration of CPR. This paper introduces the structure, performances and clinical trials of a CPR board.
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Objective Study and determine the suitable negative pressure condition for a negative pressure isolator. Method The filter efficiency, pressure, capabilities of inner environment and physiological parameters of the user were tested in different negative pressure conditions. Results The different negative pressure conditions influence above mentioned capabilities of the isolator considerably except for the filter efficiency Conclusion Under the conditions of -30Pa～-50Pa,those are optimized the capabilities of inner environment and physiological parameters of the user.