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Objective:To investigate the prognosis and related factors of ischemic cardiomyopathy.Methods:Clinical data of 271 patients with acute decompensated chronic heart failure admitted to the Cardiac Intensive Care Unit of Tianjin Chest Hospital from December 2019 to June 2022 were enrolled, including 135 cases with ischemic cardiomyopathy (ICM group) and 136 cases with non-ischemic cardiomyopathy (NICM group). Patients were followed up for 48 weeks; and the primary endpoint was all-cause death and/or readmission due to heart failure, the secondary end point was cardiogenic death. Kaplan-Meier survival curve was used to compare the difference in prognosis between the two groups. Univariate and multivariate Cox regression models were used to evaluate the factors influencing the primary and secondary end points of ischemic cardiomyopathy.Results:Compared with the NICM group, ICM group had higher proportion of patients with older age, fast pulse rate, high body mass index, comorbidities of hypertension, diabetes, chronic kidney disease, stroke or peripheral vascular disease; and greater left ventricular end-diastolic diameter, right ventricular end-diastolic anteroposterial diameter, pulmonary artery systolic blood pressure, and left ventricular ejection fraction (all P<0.05). Kaplan-Meier survival analysis showed that survival without primary endpoint (Log-rank P=0.009) and survival without secondary endpoint (Log-rank P=0.037) were lower in the ICM group than in the NICM group. Multivariate Cox regression analysis showed that elevated triglyceride (TG)/high density lipoprotein-cholesterol (HDL-C) ratio and elevated neutrophil percentage were independent risk factors for primary and secondary endpoint events in patients with ischemic cardiomyopathy. Conclusions:Patients with ischemic cardiomyopathy have lower survival rates than those with non-ischemic cardiomyopathy. High levels of TG/HDL-C ratio and neutrophil percentage are independent risk factors for poor prognosis in ischemic cardiomyopathy.
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Objective:To deliver understanding of the latest research progress on clinical trials and approval of dermatological drugs in China in 2020.Methods:A registration and information disclosure platform for drug clinical studies and a query system for domestic and imported drugs in the National Medical Products Administration of China were searched for registered clinical trials and approved dermatological drugs, respectively. The number and stages of clinical trials, indications and classification of involved products, and listed dermatological drugs in 2020 were summarized and depicted.Results:There were 157 dermatological drug trials registered in China in 2020, accounting for 6.16% of all the 2 548 clinical drug trials, including 127 (80.9%) initiated by Chinese pharmaceutical enterprises and 25 (15.9%) international multicenter trials. Among the 127 drug trials initiated by Chinese pharmaceutical enterprises, bioequivalence trials were mostly common, accounting for 55.9% (71/127) . Compared with global pharmaceutical enterprises, domestic pharmaceutical companies initiated significantly decreased proportions of international multicenter trials (1.9% [3/157] vs. 14.0% [22/157], P < 0.001) , but significantly increased proportions of phaseⅠclinical trials and bioequivalence trials (24.4% [31/127] vs. 10.0% [3/30], 55.9% [71/127] vs. 0, respectively, both P < 0.001) . Totally, 90 kinds of dermatological drug were involved in all the trials, psoriasis, atopic dermatitis and melanoma were the most common indications, and innovative drugs accounted for 53.3% (48/90) ; the proportion of innovative drugs was significantly lower in domestic pharmaceutical companies than in global pharmaceutical companies (43.2% [32/74] vs. 16/16, P < 0.001) . In addition, 28 dermatological drugs developed by 22 pharmaceutical companies were approved in China in 2020, of which 21 drugs were developed by domestic pharmaceutical companies. Conclusion:Clinical drug trials carried out by domestic pharmaceutical companies mostly focus on generic drugs, and it is still necessary for domestic pharmaceutical companies to further improve the innovation ability.
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Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.
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[Objective]This paper is to detail the system thinking of syndrome differentiation and treatment of eczema from the spleen and provide ideas for clinical diagnosis and treatment of eczema.[Methods]Combined with the understanding of eczema in Chinese and western medicine, detailing the ideas of syndrome differentiation and treatment of eczema from the spleen,which includes the etiology and pathogenesis, the basic rule and its application ideas, to reconcile the five internal organs, the syndrome differentiation of physique and caring spleen and stomach.[Results]The basic pathogenesis of eczema is the weak spleen loss the transport function.In clinical treatment,the main method to complement the spleen is preserving its transport function.On the basis of complementing the spleen,different times have different rules.It should clarify the rule of complementing the spleen to get rid of the wet evil.Types of hot evil or hot and wet evil,the rule is to get rid of the hot and wet evil.After symptom relief,herbs to complement the spleen should be added.Types of wet evil or blood deficiency resulting in wind evil,the rule is to complement the spleen to get rid of the wet evil.Attention to regulating the function of organs, not specifically treating the spleen,but make the spleen as the center to reconcile the five internal organs. The weak spleen is the physical tendencies of eczema patients. Individual differences have targeted treatment to correct the physique bias.Medication and daily life always pay attention to caring spleen and stomach.Diagnosis and treatment of eczema from the spleen can have guiding signficance. [Conclusion]The thinking of syndrome differentiation and treatment of eczema from the spleen has a guide to clinical significance,is worthy of further study and popularization.
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Objective To evaluate the effects of lentivirus-delivered short hairpin RNA (shRNA) targeting human papillomavirus 16 (HPV16) E7 gene on the expression of 4 kinds of DNA methyltransferases (DNMTs),including DNMT1,DNMT3A,DNMT3B and DNMT3L,in HPV16-positive cervical cancer cell line SiHa.Methods The recombinant plasmid containing HPV16 E7 gene-targeting shRNA was constructed firstly.Then,the BLOCK-iTTM lentiviral RNAi expression system kit was used to package the lentiviral vector,which was transfected into 293T cells.The lentivirus-containing supernatants were collected at 48 and 72 hours after transfection.The SiHa cells were divided into 3 groups to be cultured with lentiviral supernatant containing HPV16 E7 gene-targeting shRNA recombinant plasmids mixed with complete medium at a ratio of 1:1 (shRNA group),lentiviral supernatant containing empty plasmids mixed with complete medium at a ratio of 1:1 (negative control group),and complete medium alone (blank control group),respectively.Real-time fluorescence-based quantitative PCR (qRT-PCR) was performed to measure mRNA expression of HPV16 E7 and 4 kinds of DNMTs in the above 3 groups at 0,48,96 hours after infection,and Western blot analysis to determine protein expression of the 4 DNMTs at 48,96 hours after infection.Results There were no significant differences in the mRNA expression of HPV16 E7 and the 4 DNMTs among the shRNA group,negative control group and blank control group at 0 hour after infection (all P ＞ 0.05).At 48,96 hours after infection,the mRNA expression of HPV16 E7 and the 4 DNMTs decreased significantly in the shRNA group compared with the negative control group and blank control group (all P ＜ 0.05),but did not differ between the negative control group and blank control group (all P ＞ 0.05).Additionally,E7,DNMT1,DNMT3A,DNMT3B and DNMT3L gene-silencing efficiencies in the shRNA group were 71.13％,50.53％,13.72％,46.27％ and 17.92％ at 48 hours,and 83.50％,74.2％,47.8％,64.7％ and 48.9％ at 96 hours after infection,respectively.Western blot analysis showed that the protein expression of the 4 DNMTs significantly decreased in the shRNA group compared with the negative control group and blank control group at 48,96 hours after infection (all P ＜ 0.01).Moreover,the protein expression of DNMT1,DNMT3A,DNMT3B and DNMT3L in the shRNA group gradually decreased over time,and was inhibited by 84％,37.2％,59.8％ and 49.3％ at 48 hours respectively,and by 73.1％,68.7％,55.5％ and 65.5％ at 96 hours after infection respectively.Conclusion Targeted silencing of E7 gene in HPV16-positive SiHa cells can interfere with the mRNA and protein expression of DNMT1,DNMT3A,DNMT3B and DNMT3L.
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<p><b>OBJECTIVE</b>To identify the cause of an outbreak of foot pain syndrome among students from a senior high school in Foshan.</p><p><b>METHODS</b>We defined a suspect case as onset of foot pain/numbness with unknown reason among students and teachers in a school of Foshan city, from February 10 to March 16, 2014. A suspect case was noticed as having both food pain and numbness. All the cases were searched through reviewing medical records in the nearby hospitals and school's clinic, also the records of absenteeism in school. Clinical information was collected from all the students, using a standardized questionnaire. Daily temperature was collected from all the students, between January 1 and March 31, 2014. A 1 : 2 individual matched case-control study was conducted to identify related risk factors on this epidemic. We interviewed all the cases and controls on their diet, physical activities and measures used for warming.</p><p><b>RESULTS</b>A total of 407 case-students were identified, with an attack rate (AR) as 26.5%. The AR was 37.3% in girls, compared to 12.9% in boys. The difference was statistically significant (χ² = 115.1, P < 0.01). Boarding students had a higher AR (31.8%) than the commuting students (16.2%). The difference was statistically significant (χ² = 43.2, P < 0.01). In girls, boarding students had higher AR (46.1%) than those commuting students (18.5%). The difference was statistically significant (χ² = 61.4, P < 0.01). No statistically significant difference was found between boarding or commuting students in boys. Outdoor temperature was coming down from 23 °C on February 6 to 6 °C on February 13, but gradually rose to 23 °C on February 28. There was a positive relationship (r = 0.65, P = 0.002) noticed between daily maximum temperature and the number of cases during February 13-28. Results from this case-control study showed that factors as lacking physical activities (OR = 2.8, 95% CI: 1.5-5.6), feeling cold in bed (OR = 3.0, 95% CI: 1.3-7.0) and having experienced similar symptoms (OR = 3.4, 95% CI: 1.1-11.0) could increase the risk of this disease.</p><p><b>CONCLUSION</b>This outbreak was possibly caused by the abrupt fluctuation of temperature within a short period.</p>
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Female , Humans , Male , Case-Control Studies , China , Epidemiology , Disease Outbreaks , Foot Diseases , Epidemiology , Pain , Epidemiology , Residence Characteristics , Risk Factors , Schools , Students , Surveys and Questionnaires , Syndrome , Temperature , Time Factors , TransportationABSTRACT
Objective To investigate the protective effect of bicyclol tablets on drug-induced hepatic injury in patients with severe psoriasis.Methods One hundred and six patients with severe psoriasis and drug-induced hepatic injury were enrolled in this study,and randomly divided into 2 groups:bicyclol group (53 cases) treated with oral bicyclol tablets (25 mg thrice a day) for 8 weeks,diammonium glycyrrhizinate group (53 cases) treated with diammonium glycyrrhizinate capsules (150 mg thrice a day) for 8 weeks.Serum biochemical indices of hepatic function were measured before and after treatment,therapeutic efficacy was evaluated,and adverse reactions were observed and recorded after treatment.Intergroup and intragroup differences in these parameters were assessed.Results During the treatment,3 patients were lost to follow up.After treatment,serum biochemical indices of hepatic function markedly improved in both the bicyclol group (52 cases) and diammonium glycyrrhizinate group (51 cases) (both P ＜ 0.01),and the bicyclol group showed a better treatment response than the diammonium glycyrrhizinate group (P ＜ 0.01).The marked response rate was 71.15％ and 47.06％ (P ＜ 0.05),and the response rate was 84.62％ and 66.67％ (P ＜ 0.05),respectively,in the bicyclol group and diammonium glycyrrhizinate group.No adverse reactions related to tested drugs were observed in either of the two groups.Conclusion Bicyclol can attenuate antipsoriatic drug-induced hepatic injury with good safety.
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Objective To evaluate the safety and efficacy of a domestic recombinant human tumor necrosis factor receptor type Ⅱ- IgG Fc fusion protein (rhTNFR-Fc)for the treatment of moderate to severe psoriasis vulgaris. Methods A multicenter, randomized, double blind, parallel-group, positive drug-controlled clinical trial was conducted. According to random numbers generated by a hierarchical segmentation method using the SAS 9.2 software, patients with moderate to severe psoriasis vulgaris were randomly divided into two groups to be injected with two kinds of domestic rhTNFR-Fc under the trade names of Anbainuo(test group)and Yisaipu(control group)respectively at a dose of 25 mg twice a week for 12 consecutive weeks. The primary endpoint was the proportion of patients achieving a 50%, 75% and 90% reduction in psoriasis area and severity index(PASI50, PASI75 and PASI90)at week 2, 6 and 12 after initiation of the treatment. Adverse reactions were also recorded. Statistical analysis was carried out by using the chi-square test, Fisher′s exact test, two-sample t-test, and noninferiority trials with the software SAS 9.2. Results A total of 180 patients were enrolled in this study from 5 centers, and 174 completed this trial, of whom, 88 were assigned to the test group and 86 to the control group. Analysis of the full analysis set (FAS)revealed no significant differences in PASI50(75.6%(68/90)vs. 82.2%(74/90), P > 0.05)or PASI75(51.1%(46/90)vs. 50.0%(45/90), P > 0.05) between the test group and control group, but a significant increase in PASI90 in the test group compared with the control group (30.0% (27/90)vs.16.7% (15/90), χ2 = 4.472, P 0.05), most of which were mild, and subsided spontaneously or after appropriate treatment. Conclusion The domestic rhTNFR-Fc (trade name:Anbainuo)25 mg twice a week for 12 weeks is effective and safe for the treatment of moderate to severe psoriasis——————————vulgaris.
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Objective To measure the mRNA expression of interleukin receptors (IL-2R?IL-4R and IL-10R) in peripheral blood mononuclear cells (PBMCs) from patients with chronic idiopathic urticaria (CIU). Methods Thirty CIU patients and 30 controls were enrolled in this study. PBMCs were separated from the peripheral blood specimens. Reverse transcription-polymerase chain reaction (RT-PCR) technique was applied to semi-quantitatively analyze the mRNA expression. Results The expression level of IL-10R mRNA was significantly increased in patients with CIU than that in the healthy controls, while that of IL-2R and IL-4R mRNA in PBMCs showed no significant difference. Conclusion Our results suggest that IL-10R might be involved in the pathogenesis of CIU.
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Objective To observe the clinical efficacy and safety of 0.1% mometasone furoate cream in the topical treatment of eczematous dermatoses including neurodermatitis and eczema. Methods A randomized double-blind parallel controlled clinical trial was conducted. The home made mometasone furoate cream or imported Eloson cream was topically used in patients with such dermatoses once daily for 4 weeks, respectively. Symptom/sign scores were evaluated at the beginning of the treatment and at the 1st, 2nd, 3rd, 4th week after the initiation of the treatment. Results Two hundred and eighty-four patients were enrolled in the trial, including 143 patients with eczema and 141 patients with neurodermatitis. There are 142 patients each in test group and control group separately. All symptom/sign scores and total scores were significantly decreased 1, 2, 3, and 4 week after the treatment. No statistically significant difference was observed between the two groups. The cure rate and improvement rate in eczema patients were 78.87% and 97.18% in the test group; 84.51% and 92.96% in the control group; respectively. While the cure rate and improvement rate in neurodermatitis patients were 75.71% and 100% in the test group; 80.28% and 94.37% in the control group; respectively. The cure rate and improvement rate of total patients were 77.30% and 98.58% in the test group; 82.39% and 93.64% in the control group; respectively. No statistically significant difference in efficacy was observed between the two groups. There was no severe side effect in the two groups. One patient had mild contact dermatitis in the test group. Conclusions These results suggest that 0.1% mometasone furoate cream is an effective and safe drug in the treatment of neurodermatitis and eczema.
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Objective To determine the serum soluble CD226/PTA1(sCD226/PTA1)level in pa-tients with psoriasis vulgaris.Methods Serum sCD226/PTA1level was measured by sandwich ELISA in30patients with psoriasis vulgaris before treatment(17patients in active stage and13in inactive stage),10patients after treatment,and15healthy individuals as a control.Results Serum sCD226/PTA1level was significantly increased in patients with psoriasis compared with that in healthy controls(P