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Objective:To explore the change of serum 25-hydroxyvitamin D [25(OH)D] and prediction for outcome of acute ischemic stroke in emergency. Methods:From October, 2017 to September, 2019, 224 patients with acute ischemic stroke in emergency and 240 healthy controls were detected serum 25(OH)D within 24 hours after enrollment. The patients were assessed with National Institute of Health Stroke Scale (NIHSS) and Nutritional Risk Screening 2002 (NRS2002), and measured biochemics within 24 hours after admission. They were assessed with modified Rankin Scale (mRS) 180 days after stroke, and divided into favourable group (mRS ≤ 2, n = 106) and unfavourable group (mRS > 2, n = 118). The factors related with the outcome were analyzed with Logistic regression, and the prediction of 25(OH)D for the outcome were analyzed with receiver operator characteristic (ROC) curve. Results:Serum 25(OH)D was less in the patients than in the controls (Z = 4.296, P < 0.001), and less in the unfavourable group than in the favourable group (Z = 5.876, P < 0.001). Serum 25(OH)D (OR = 0.925, P < 0.05) was related with the outcome even controlling the impacts of age, sex, nutritional risk, infarct volume, scores of NIHSS, etc. The area under curve for serum 25(OH)D predicting outcome was 0.795 (P < 0.001). The cut-off point of prediction was 13.17 ng/ml, with the Yoden index of 0.548, which yielded a sensitivity of 0.746 and a specificity of 0.802. Conclusion:Serum 25-hydroxyvitamin D may predict the outcome 180 days after acute ischemic stroke, which may help for risk stratification in emergency.
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Objective: To prepare magnolol solid dispersions (Mag-SD), magnolol phospholipids complex (Mag-PC) and magnolol solid lipid nanoparticles (Mag-SLN), and compare their effects on the pharmacokinetics in vivo. Methods: Solvent evaporation method was used to prepare Mag-SD and Mag-PC. Their existential state of Mag in Mag-SD and Mag-PC were analyzed by X-ray power diffraction (XRPD). High pressure homogenization method was employed to prepare Mag-SLN, its particle size and Zeta potential were also studied. The dissolution in vitro of Mag-SD, Mag-PC and Mag-SLN were also studied compared to magnolol suspension. SD rats in each group were administered intragastrically with magnolol, Mag-SD, Mag-PC and Mag-SLN, respectively. The concentration of magnolol in blood was analyzed by HPLC, and the main pharmacokinetic parameters were obtained. The pharmacokinetic behavior and bioavailability of magnolol, Mag-SD, Mag-PC and Mag-SLN were also compared. Results: The results of XRPD indicated that magnolol showed an amorphous state in Mag-SD and Mag-PC. The average particle size and Zeta potential of Mag-SLN was (161.37 ± 3.77) nm and (-29.16 ± 1.83) mV, respectively. The results of dissolution in vitro indicated that the cumulative dissolution of magnolol was 30.6% within 12 h. Mag-SD, Mag-PC and Mag-SLN enhanced its cumulative dissolution to 96.3%, 76.4% and 45.9%, respectively. The results of pharmacokinetics in vivo showed that Cmax, AUC0-t and AUC0-∞ of Mag-SD, Mag-PC and Mag-SLN were enhanced greatly compared to magnolol suspension. Mag-PC, Mag-SD and Mag-SLN increased its Cmax from (429.67 ± 53.12) ng/mL to (533.62 ± 59.01), (721.73 ± 103.44) and (1 063.21 ± 108.22) ng/mL, respectively. The bioavailability of Mag-SD, Mag-PC and Mag-SLN were enhanced to 1.38, 2.12 and 3.45 times, respectively. Conclusion: Mag-SD, Mag-PC and Mag-SLN could promote the absorption of magnolol in SD rats notably. In addition, Mag-SLN could give a better effect on the bioavailability.
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Objective:To explore the characteristics of nosocomial infection in patients with spinal cord injury, and analyze the risk factors. Methods:From January, 2015 to June, 2017, 526 patients with spinal cord injury in our hospital were reviewed. The distribution of pathogens and the characteristics of drug resistance of strains were summarized, and the risk factors of nosocomial infection were analyzed. Results:There were 159 person-times with nosocomial infection, and most of the infections were found in urinary tract (60.4%) and lower in respiratory tract (28.9%). The main pathogenic germs were Escherichia coli (39.0%), Pseudomonas aeruginosa (15.7%), Klebsiella pneumoniae (11.3%) and Proteus mirabilis (9.4%). The main pathogens were resistant to second or third generation of cephalosporins and quinolones moderately or severely, but sensitive to compound preparations containing beta-lactamase inhibitors, carbapenems and aminoglycosides. The risk factors for the nosocomial infections in the spinal cord injury patients included the hospitalization time, severity of spinal cord injury, invasive operation history, nutritional risk and use of antibiotics (P < 0.05). Conclusion:Most of the nosocomial infections in patients with spinal cord injury are in urinary tract and respiratory tract. Gram-negative bacilli are the main pathogenic bacteria, which often show multiple drug resistance. It is necessary to take targeted interventions according to the risk factors of nosocomial infections in order to improve the quality of life of patients.
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Sulfur fumigation, which is traditional method for preservation, pest control, insecticide and sterilization, has long been widely used in processing and storage and played a positive role of traditional Chinese medicine (TCM). As some businesses sided pursuit of profit, abused and repeated use of sulfur fumigation, have resulted in a large number of harmful residues, such as sulf dioxide (SO2) and harmful heavy metals, which brings a significant impact and danger on human health. This article summarizes the sulfur species and the sulfur fumigation methods and analyzes the harmful substances in TCM after sulfur fumigation, to provide a reference of the choice of species for the sulfur, the optimization of sulfur fumigation process and the standardized processing of TCM after sulfur fumigation.