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Tumor microenvironment (TME) is composed of abnormal tumor vasculature, extracellular matrix components, endothelial cells, pericytes, tumor associated fibroblasts, smooth muscle cells and immune cells, which is characterized by hypoxia, acidosis and high interstitial fluid pressure. Hypoxia and acidosis within the TME trigger an adjustment of the extracellular matrix (ECM), a response from neighbor stromal cells (e.g., fibroblasts) and immune cells (lymphocytes and macrophages), inducing tumor growth, angiogenesis, and ultimately, resulting in metastasis. What's more, the components of TME including abnormal tumor vasculature, rich composition of the ECM, and abundant stroma cells impair tumoral distribution and penetration of the drugs. At the same time, this stromal microenvironment plays a vital role in creating an immunosuppressive environment.Over the past years, more and more researches focus on targeting and remolding TME to improve therapeutic effects against tumors. Herein, we reviewed current strategies developed to target and remodel TME, including modulating tumor hypoxia, tumor vasculature, tumor associated fibroblasts, extracellular matrix components, tumor associated macrophage phenotypes and dendritic cells. Also, potential problems and future directions are pointed out in this review.
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Previous studies believe that patent paraumbilical vein in cirrhotic portal hypertension can reduce portal venous flow, portal venous pressure, and the development of esophageal varices and esophageal variceal bleeding, but there are still controversies over this issue in clinical practice. This article reviews the formation of portal systemic collateral circulation, the characteristics of the paraumbilical vein, the definition and diagnosis of patent paraumbilical vein, and the influence of patent paraumbilical vein on the development of esophageal varices and esophageal variceal bleeding, and it is believed that patent paraumbilical vein may not reduce the development of esophageal varices and esophageal variceal bleeding. Contrary to the previous points of view, patent paraumbilical vein should be regarded as a manifestation of the progression of cirrhotic portal hypertension, which can lead to the complications such as hepatic encephalopathy, and therefore, targeted prevention measures should be adopted in clinical practice.
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Objective:To evaluate the effect of different anesthesia methods on the immune function in the patients with oral squamous cell carcinoma.Methods:Forty patients of both sexes, aged 31-64 yr, with body mass index of 19-23 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective radical resection of oral squamous cell carcinoma and repair of the defect with free flap, were enrolled and randomized to receive either combined intravenous-inhalational anesthesia (VICA group, n=20) or total intravenous anesthesia (TIVA group, n=20) using a random number table method.In group VICA, anesthesia was induced with intravenous propofol 1.5-2.0 mg/kg, remifentanil 1-2 μg/kg, and cisatracurium 0.2 mg/kg, sevoflurane was continuously inhaled to maintain MAC at 1.3, sevoflurane inhalation was stopped at 1 h before the end of surgery, sevoflurane was replaced with propofol, propofol 4-6 mg·kg -1·h -1 was continuously infused until the end of operation, and dexmedetomidine 0.4 μg·kg -1·h -1, remifentanil 0.2-0.3 μg·kg -1·min -1 and cisatracurium 0.1 mg·kg -1·h -1 were intravenously infused at the same time to maintain anesthesia.In group TIVA, anesthesia induction was the same as those previously described in group VICA, and anesthesia was maintained with intravenous dexmedetomidine 0.4 μg·kg -1·h -1, propofol 4-6 mg·kg -1·h -1, remifentanil 0.2-0.3 μg·kg -1·min -1 and cisatracurium 0.1 mg·kg -1·h -1.Venous blood samples were taken at 30 min before anaesthesia induction (T 0), 3 h after anaesthesia (T 1), at the end of operation (T 2), and at 6, 24 and 48 h after operation (T 3-5) for determination of the serum concentrations of immunoglobulins (IgA, IgM, IgG), interleukins (IL-2, IL-6, IL-10, sIL-2Rα) and soluble interleukin-2 receptor alpha (sIL-2Rα) by enzyme-linked immunosorbent assay. Results:Compared with the baseline at T 0, the concentrations of serum sIL-2Rα at T 1-5, IL-2 at T 1-4 and IL-10 at T 1 were significantly decreased, the concentrations of serum IL-6 at T 1-5 and IL-10 at T 2-4 were increased, and the concentrations of serum IgA and IgM at T 1-5 were decreased in two groups, and the concentrations of serum IgG at T 1-5 in TIVA group and at T 1, 2 and T 4, 5 in VICA group were significantly decreased ( P<0.05).Compared with group TIVA, the concentrations of serum sIL-2Rα at T 2, 5, IL-6 at T 4, 5 and IL-10 at T 3, IgA at T 4 and IgG at T 3 were significantly increased, and the concentrations of serum IL-2 at T 1-5 and IgA at T 5 were decreased in group VICA ( P<0.05). Conclusions:Both general anesthesia methods have significant inhibitory effects on intraoperative and postoperative cellular immune function and humoral immune function in the patients with oral squamous cell carcinoma, and combined intravenous-inhalational anesthesia produces higher inhibitory effects on cellular immune function than total intravenous anesthesia.
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Pulmonary arterial hypertension (PAH), also named as a cancer of cardiovascular disease, is a rare disease and has complicated pathogenesis. Recently, there are more understandings of PAH pathogeneses. According to the pathogenesis and active pathways, the clinically used drugs are classified into several groups incluidng prostacyclin analogues and prostacyclin receptor agonists, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase inhibitors, etc. To elevate the efficacy of the drugs, numerous drug delivery systems are developed. This review mainly summarized the pathological mechanism of PAH, drugs and drug delivery approaches in the treatment of PAH.
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Objective:To explore a medical big data algorithm to screen the core indicators in clinical database that can be used to evaluate the prognosis of elderly patients with pneumonia.Methods:Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis.Results:A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators ( n = 7), blood gas indicators ( n = 3), tumor markers indicators ( n = 3),coagulation related indicators ( n = 4), and nutrition and organ function indicators ( n = 6). ① The key indicators of blood gas in patients died of pneumonia: Cl - was 97-111 mmol/L in 51.6% (33 cases) of patients, lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H + was 0-46 mmol/L in 87.5% (56 cases) of patients. ② The key indicators of blood routine of patients died of pneumonia: hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×10 12/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×10 9/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. ③ The key indicators of tumor markers in patients died of pneumonia: 76.6% (49 cases) of patients had negative free prostate specific antigen/total prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 μg/L, and 75.0% (48 cases) had carbohydrate antigen 125 (CA125) between 0-104 kU/L.④ The key coagulation indexes of patients died of pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had adenosine diphosphate (ADP) inhibition rate of 0%-53%. ⑤ Nutrition and organ function key indicatorsin patients died of pneumonia: 92.2% (59 cases) of brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with uric acid (UA) for 21-41 μmol/L, 75.0% (48 cases) of the patients with albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had albumin/globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with lactate dehydrogenase (LDH) from 0-6.68 μmol/L·s -1·L -1. ⑥ Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with pneumonia. Conclusion:By using big data technology, 23 core indicators for evaluating the prognosis of elderly patients with pneumonia can be screened from the clinical database of emergency ward, which provides a new perspective and method for clinical evaluation of the prognosis of elderly patients with pneumonia.
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Objective:To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC).Methods:From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC).Results:There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group( F values were 56.832, 38.209, 23.415, respectively; χ 2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). Conclusion:Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis.
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Objective: To explore the effects and potential mechanism of Foshou Powder on Parkinson’s disease. Methods: Reserpine was injected in KM mice to establish Parkinson’s disease model, and hypothermia and akinesia were measured to evaluate the effects of volatile oil of Angelica sinensis, Ligusticum chuanxiong and combination. The human monoamine oxidase (hMAO) activity and inhibition mode were measured by fluorescence spectrophotometry in vitro with kynuramine as the common substrate of human monoamine oxidase A (hMAO-A) and human monoamine oxidase B (hMAO-B). On this basis, the 2 × 4 factorial design was applied to research the interaction between Angelica sinensis volatile oil and Ligusticum chuanxiong volatile oil. Results: The antagonistic experiments of reserpine showed that the application of Angelica sinensis volatile oil and Ligusticum chuanxiong volatile oil significantly improved hypothermia and akinesia. Enzyme activity test revealed that volatile oil of Angelica sinensis and Ligusticum chuanxiong had competitive inhibitory effects on hMAO-A and hMAO-B, and the combination of the two substances had significant synergistic effect on the activity of both hMAO. Conclusion: Angelica sinensis and Ligusticum chuanxiong in Foshou Powder have significant synergistic effects in the prevention and treatment of Parkinson’s disease, which may be related to the inhibition of MAO activity.
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Mountain-agarwood plays an important role in ethnic medicine in China for its pharmaceutical value. Modern pharmacological researches demonstrated that mountain-agarwood was effective for its anti-myocardial ischemia, antibacterial, anti-inflammatory, antitumor and analgesic effects. Mountain-agarwood derives from the peeled roots, stems or twigs of Syringa pinnatifolia which belongs to Syringa genus. It often depends on the purple substance and fragrance to estimate the formation of mountain-agarwood. However, the mechanism of mountain-agarwood formation has not been reported. To observe the microcosmic change in the process during the formation of mountain-agarwood, this study described the microscopic and histochemical characteristics of mountain-agarwood formation through histochemical staining. Our results showed that a significant difference of the distribution of tyloses existed during mountain-agarwood formation. It was observed that inchoate mountain-agarwood had more starch granules and viable cells than mountain-agarwood formed with high level or low level. The amount of polysaccharide and degree of lignification were increased during the mountain-agarwood formation. The results indicated that the mountain-agarwood, which meets the quality requirements for pharmaceutical use, contained the following characteristics: a large amount of purple tyloses in heartwood; yellow-brown tyloses distributing in heartwood and sapwood which were less in the latter; lignification with high level; a few viable cells; lots of polysaccharide and few starch granules in xylem rays cell. This study is aimed to reveal the change of histochemical characteristics during mountain-agarwood formation, and lay the foundation for exploring the mechanism of mountain-agarwood formation.
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Humans , China , Myocardial Ischemia , Syringa , ThymelaeaceaeABSTRACT
@#Congenital hypertrophy of the retinal pigment epithelium(CHRPE)is a rare fundus lesion. It usually does not cause serious clinical symptoms. However, incorrect diagnosis and treatment frequently occurred clinically because most ophthalmologists have little knowledge about it. Thus, we conducted the current study to investigate the clinical characteristics and prognosis of CHRPE, to provide evidence for differential diagnosis clinically and further guideline for treatment and follow-up.
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Objective :To explore correlation between severity of coronary artery lesion and risk factors of coronary heart disease (CHD) in CHD patients .Methods :The 452 patients ,who had clinical complete data and underwent coronary angiography in our hospital from Jan 2012 to Jan 2013 were retrospectively analyzed ,including 64 non‐CHD cases (non‐CHD group) and 388 CHD cases (CHD group).Correlation among number ,length ,size ,stenotic degree of diseased coronary artery vessels and CHD risk factors were explored .Results : (1) Compared with non‐CHD group ,there were significant rise in percentages of men ,hypertension (EH) and diabetes mellitus (DM) in CHD group , P＜0.05 or ＜0.01 ; (2) In CHD group ,compared with single vessel coronary disease group ,there were significant rise in age ,percentages of EH ,DM and patients with low HDL‐C in multi‐vessel coronary disease group , P＜0. 05 or ＜ 0. 01 ;compared with large vessel lesion patients ,there were significant rise in age and DM percentage ,and significant reduction in percentage of smokers in small vessel lesion patients , P＜ 0.01 all ;com‐pared with stenosis ＜90% group ,there was significant reduction in LVEF and significant rise in percentage of pa‐tients with elevated LDL‐C level in stenosis≥90% group , P＜0.05 or ＜0. 01 ;(3) Multivariate linear regression a‐nalysis and linear correlation analysis indicated that size of diseased coronary artery vessels was significant inversely correlated with age ( r＝ －0. 181 , P＝0.001) ;severity of coronary disease was significant inversely correlated with LVEF ( r＝ －0.213 , P＝0.001) ,and significant positively correlated with heart rate ( r＝0. 133 , P＝0.009) and LDL‐C level ( r＝0. 141 , P＝0.001).Conclusion :Risk factors for CHD , including aging , smoking , complicated DM , EH , hyperlipidemia , tachycardia and left ventricular systolic dysfunction etc ., will further aggravate coro‐ nary artery lesion .
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The present article summarized development history and domestic and foreign research condition of intelli‐gent diagnostic technique , focused on its development and application in ECG diagnosis , narrated methods and di‐agnostic process of ECG intelligent diagnosis , and made an investigation and prospect on development of ECG intel‐ligent diagnostic technique .
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Objective To investigate the effect of siRNA-mediated silencing of RNF2 on cell proliferation , migra-tion, cell cycle and apoptosis in human pancreatic cancer PANC-1 cells and its possible mechanism .Methods The siRNA interference was used to down-regulate RNF2 expression.Meanwhile, there were also empty transfection group whose cells were transfected with the control siRNA and mock group without any treatment .The result of transfection was evaluated by fluorescence microscope .The expression of RNF2 mRNA was detected by RT-qPCR. Western blot was applied to detect the expression of RNF 2 and p53.Cell proliferation and migration were analyzed by MTS assay and cell scratch assay , respectively .The transient transfection efficiency , apoptosis rate and cell cy-cle were measured by flow cytometry .Results Compared to the normalized human pancreatic duct epithelial cells , RNF2 expression in pancreatic cancer cells were higher ( P<0.05) .The expression of RNF2 mRNA and protein was decreased in PANC-1 cells by siRNA-RNF2 at 48 h post-transfection.Transfection with siRNA-RNF2 inhibited the proliferation and migration of PANC-1 cells (P<0.05), induced cell apoptosis (P<0.05), increased cell counts in phase G0/G1 and decreased in S and G2/M phase (P<0.05).What's more, after siRNA-RNF2 transfec-tion, the expression of p 53 protein was decreased .Conclusions siRNA-RNF2 can specifically knockdown the ex-pression of RNF2 gene and then inhibit the proliferation and migration of PANC-1 cells.These results indicate RNF2 may be a potential target of gene therapy for pancreatic cancer .
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Objective To evaluate the effects of acupuncture combined with lifestyle modification for essential hypertension by Meta-analysis. Methods Clinical randomized controlled trial literature about acupuncture combined with lifestyle modification for essential hypertension in CNKI, WanFang Data, CBM, VIP, PubMed, Embase, and Web of Science since establishment to February 20, 2017 were retrieved. Data extraction and quality assessment of studies were conducted by two researchers independently, and the Meta-analysis was performed by the software of RevMan5.3. Results 5 articles involving 467 patients were included. The results of Meta-analysis showed that acupuncture combined with lifestyle modification had more significant effect than lifestyle modification alone in lowing SBP [SMD=-1.52(-2.40,-0.64)], in lowing DBP [SMD=-1.02(-2.01,-0.03)], total effective rates [RR=1.27(1.13, 1.43)]. Conclusion Compared with lifestyle modification alone, acupuncture combined with lifestyle modification have significant effects for patients with essential hypertension, but because of the fewer studies included, bigger heterogeneity between studies and the lower quality of included studies still exist, the results should be further verified, and clinical applications should be treated with caution.
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Objective :To explore influence of oxidized low density lipoprotein (ox-LDL ) on migration function of THP-1 macrophages ,expression of microRNA 21 (miR-21) and mitogen-activated protein kinase (MAPK) path-way.Methods :Phorbol myristate acetate (PMA) of 160nmol/L was used to induce THP-1 cells to differentiate into macrophages.According to application of ox-LDL treatment and liposomes-mediated miR-21 inhibitor transfecting THP-1 macrophages (transfection for short) or not ,THP-1 macrophages were divided into blank control group (re-ceived neither ox-LDL treatment nor transfection ) ,ox-LDL group (received 50mg/L ox-LDL treatment without transfection) ,miR-21 inhibitor group (received 50mg/L ox-LDL treatment after transfection ) and miR-21 inhibitor negative-control group (received 50mg/L ox-LDL treatment after negative-control transfection ).THP-1 macro-phage migration number was measured by transwell method ,miR-21 expression was measured by real-time quantita-tive PCR ,and expression of dual specific phosphate 8 (DUSP-8) and phosphorylation level of MAPK pathway were measured by Western-blot method .Results :Compared with blank control group ,there were significant rise in mi-gration number of THP-1 macrophages [(74.10 ± 15.10) vs.(184.10 ± 26.28)] ,miR-21 expression [(1.00 ± 0.21) vs.(2.02 ± 0.27)] and phosphorylation levels of JNK and P38 protein ,and significant reduction in expression of DUSP-8 protein in ox-LDL group ,P＜0.01 all.Compared with ox-LDL group ,there were significant reductions in migration number of THP-1 macrophages [ (184.10 ± 26.28) vs.(58.50 ± 10.24)] ,miR-21 expression [ (2.02 ± 0.27) vs.(0.66 ± 0.16)] and phosphorylation levels of JNK and P38 protein ,and significant rise in expression of DUSP-8 protein in ox-LDL group , P＜0. 01 all .Conclusion : Ox-LDL enhances migration function of macrophages , which may be related to its effects of upregulating miR-21 expression ,enhancing phosphorylation of JNK and P38 protein of MAPK pathway and reducing DUSP-8 expression .
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<p><b>BACKGROUND</b>Bilateral sudden sensorineural hearing loss (BSSHL) is rare and assumed to be a different clinical entity compared to unilateral SSHL (USSHL). This study examined the differences between the idiopathic BSSHL and USSHL.</p><p><b>METHODS</b>Forty-six sequential BSSHL patients (Se-BSSHL) and 68 simultaneous BSSHL (Si-BSSHL) were consecutively admitted between June 2008 and December 2015. Two sets of patients served as control groups: (1) USSHL patients with healthy contralateral ear and (2) USSHL patients with contralateral preexisting hearing loss (USSHLwCHL). We retrospectively analyzed differences among four cohorts using analysis of variance, Kruskal-Wallis test, Welch's t-test, and Chi-square test as appropriate before and after propensity score matching (PSM) based on age, gender, and body mass index (BMI).</p><p><b>RESULTS</b>The prevalence of idiopathic BSSHL was 8.6% (114/1329) among the total SSHL patients. In the total cohort, USSHL patients tended to be younger, female, and tended to have lower BMI, renal parameters, and total cholesterol in addition to higher high-density lipoprotein compared to the other three groups. Most routine blood indicators, some coagulation markers, and immunoglobulin M (H = 13.4, P = 0.004) were significantly different among the study groups. After PSM, the major significant differences were found in audiometric characteristics. Si-BSSHL and Se-BSSHL patients demonstrated similar hearing thresholds as USSHL but were significantly better than the USSHLwCHL patients across most frequencies before and after treatment (H = 30.0, P < 0.001 for initial hearing and H = 12.0, P = 0.007 for final hearing). Moreover, the BSSHL patients showed different hearing loss distribution patterns (more descending type, χ2 = 33.8, P = 0.001) with less hearing gain (H = 17.5, P < 0.001) compared to the USSHL patients.</p><p><b>CONCLUSIONS</b>Idiopathic BSSHL is a relatively rare subtype of SSHL with a higher rate of descending audiogram type and inferior hearing outcome rather than being classified as a completely different disease entity compared to USSHL.</p>
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Objective To evaluate the effect of fast track surgery nursing on percutaneous lumbar diskectomy. Methods A total of 126 patients were randomly divided into the control group and the experimental group,the control group received traditional nursing plan, the experimental group was given fast track surgery nursing plan. The nursing effect was observed. Results Postoperative anal exhaust time, feeding time, walking time, length of hospital stay ofthe experimental group were (1.61±0.71) days, (2.01±0.71) days, (4.70±2.12) days, (12.72±2.07) days, whichwere significantly shorter than those of the control group, which were (3.37±0.93) days, (2.27±0.63) days, (8.40±3.21) days, (15.81±2.14) days, the difference between two groups were statistically significant (t=4.012-6.068, P0.05). The Rdand Morris Questionnaire score of the experimental group was 21.67±3.48, which was higher than that of the control group(14.43 ± 2.01), the difference between two groups was statistically significant(χ2=6.077, P <0.05). Conclusion Fast track surgery nursing can promote the patient's postoperative rehabilitation ,reduce the postoperative complications, shorten the length of hospital stay and improve the quality of life.
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Oral film is a new type of oral preparation. Due to portability, simple preparation process and good clinical compliance, oral films have become the focus of novel drug delivery system in recent years. Meanwhile, oral films have been gradually used in the development of Chinese medicine preparations. According to the application and approval situation of different types of oral films both at home and abroad in recent years, their research and development status was analyzed, including the basic concept, formulation, manufacturing process and quality control, as well as related progress and development prospects of oral films applied in traditional Chinese medicine. Some suggestions on the technical evaluation of oral films were put forward by considering specific requirements from regulatory agencies. This paper could provide some references for the development and evaluation of oral films. Due to the complexity of the drug substances and the particularity of the drug product, the development and application of oral films in traditional Chinese medicine are still faced with opportunity and challenges.
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<p><b>BACKGROUND</b>Pharmacological therapy for congestive heart failure (CHF) with ventricular arrhythmia is limited. In the study, our aim was to evaluate the effects of Chinese traditional medicine Shensong Yangxin capsules (SSYX) on heart rhythm and function in CHF patients with frequent ventricular premature complexes (VPCs).</p><p><b>METHODS</b>This double-blind, placebo-controlled, multicenter study randomized 465 CHF patients with frequent VPCs to the SSYX (n = 232) and placebo groups (n = 233) for 12 weeks of treatment. The primary endpoint was the VPCs monitored by a 24-h ambulatory electrocardiogram. The secondary endpoints included the left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, N-terminal pro-brain natriuretic peptide (NT-proBNP), New York Heart Association (NYHA) classification, 6-min walking distance (6MWD), Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, and composite cardiac events (CCEs).</p><p><b>RESULTS</b>The clinical characteristics were similar at baseline. SSYX caused a significantly greater decline in the total number of VPCs than the placebo did (-2145 ± 2848 vs. -841 ± 3411, P < 0.05). The secondary endpoints of the LVEF, NYHA classification, NT-proBNP, 6MWD, and MLHFQ scores showed a greater improvements in the SSYX group than in the placebo group (ΔLVEF at 12th week: 4.75 ± 7.13 vs. 3.30 ± 6.53; NYHA improvement rate at the 8th and 12th week: 32.6% vs. 21.8%, 40.5% vs. 25.7%; mean level of NT-proBNP in patients with NT-proBNP ≥125 pg/ml at 12th week: -122 [Q1, Q3: -524, 0] vs. -75 [Q1, Q3: -245, 0]; Δ6MWD at 12th week: 35.1 ± 38.6 vs. 17.2 ± 45.6; ΔMLHFQ at the 4th, 8th, and 12th week: -4.24 ± 6.15 vs. -2.31 ± 6.96, -8.19 ± 8.41 vs. -3.25 ± 9.40, -10.60 ± 9.41 vs. -4.83 ± 11.23, all P < 0.05). CCEs were not different between the groups during the study period.</p><p><b>CONCLUSIONS</b>In this 12-week pilot study, SSYX was demonstrated to have the benefits of VPCs suppression and cardiac function improvement with good compliance on a background of standard treatment for CHF.</p><p><b>TRIAL REGISTRATION</b>www.chictr.org.cn, ChiCTR-TRC-12002061 (http://www.chictr.org.cn/showproj.aspx?proj=7487) and Clinicaltrials.gov, NCT01612260 (https://clinicaltrials.gov/ct2/show/NCT01612260).</p>
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As a typical representative of Lepidopteran insects, the silkworm, Bombyx mori, has numerous advantages, such as simple husbandry, highly prolific nature, short generation time, easily handled to be operated with moderate body size, clear genetic background and abundant mutation resources. Silkworm has not only been studied by the geneticists, but also been used as a new laboratory animal model of human disease and drug screening. There is a plenty of genetic resources in silkworm, some of which could be used as models of human genetic diseases, such as Phenylketonuria, Parkinson 's disease, Hermansky-Pudlak syndrome and so on. Silkworm has also played a significant role in the study of pathogenesis of human pathogenic microorganisms. Moreover, silkworm could be used to evaluate the pharmacokinetic/pharmacodynamics properties and safety of a new drug comprehensively and systematically. At the same time, it can be used in the high throughput drug screening assays to shorten the period of the new drug research and development. This review summarizes that the silkworm is an excellent model in the drug screening assays, and has a potential in application to the large-scale drug screening.
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ObjectiveTo summarize the clinical manifestations and pathological features of congenital hepatic fibrosis (CHF), and to improve the experience in the diagnosis and treatment of this disease. MethodsA total of 13 patients with a confirmed diagnosis of CHF based on histopathological examinations who were hospitalized and treated in Xijing Hospital, Fourth Military Medical University, from January 2011 to June 2015 were analyzed retrospectively. The clinical data including age, clinical manifestations, laboratory markers, and imaging findings were summarized and analyzed. ResultsOf all the patients, there were 8 cases of portal hypertension type, 1 case of cholangitis type, 1 case of mixed type, and 1 case of latent type. The imaging findings suggested that 8 patients had liver and kidney cysts, and 4 patients had cavernous transformation of the portal vein. ConclusionCHF patients often have portal hypertension and normal liver function as prominent manifestations, with concurrent liver and kidney cysts and Caroli disease. Liver biopsy should be performed for unexplained liver cirrhosis, especially for patients with inconsistency between reduction in liver function and portal hypertension.