ABSTRACT
Objective To explore the influencing factors of readmission in coronary heart disease patients with heart failure by constructing a multilevel Cox regression model. Methods A total of 1 433 coronary heart disease patients with heart failure were consecutively enrolled, from two hospitals in Shanxi Province from January, 2014 to December, 2017. Patients’ medical records (including baseline data, examination and treatment) were recorded and patients were followed up. The median follow-up period was 23 months. Univariate Cox regression analysis and mutivariate Cox regression analysis were used to screen the independent variables. Two-level Cox regression model was used to analyze the influencing factors. Results Rehospitalization occurred in 436(30.4%) cases. Two-level Cox regression model showed that advanced age(HR=1.010, 95% CI:1.001-1.019, P=0.032), male(HR=1.234, 95% CI: 1.009-1.509, P=0.040), physical labor(HR=1.458, 95% CI: 1.036-2.050, P=0.030),urban medical insurance (HR=1.513, 95% CI: 1.120-2.043, P=0.007), and prolonged QRS interval (HR=1.004, 95% CI:1.001-1.008, P=0.018) were independent risk factors for readmission coronary heart disease patients with heart failure. High urine specific gravity(HR=0.000, 95% CI:0.000-0.059, P=0.021) was a protective factor. Conclusions The age, gender, occupation, urban medical insurance, QRS intervall, and urine specific gravity are influencing factors of readmission in coronary heart disease patients with heart failure. Strengthening clinical nursing and monitoring and perfecting social security system can reduce the occurrence of patients’ rehospitalization.
ABSTRACT
The objective of this paper was to establish a level A in vitro-in vivo correlation (IVIVC) for goserelin acetate extended release microspheres for injection. Three kinds of goserelin acetate microspheres with different release rates were prepared and the critical physicochemical properties, such as drug loading, particle size, glass transition temperature and morphology were characterized. In vitro dissolution test of the prepared goserelin acetate microspheres was performed using sample-and-separate method at 45 ℃ in 5% (v/v) methanol. The morphology of the microspheres and the molecular weight of poly (lactic-co-glycolic acid) (PLGA) of the prepared goserelin acetate microspheres were investigated to research the release mechanism of microspheres. The plasma concentration of goserelin was detected after intramuscular injection of goserelin acetate microspheres to SD rats, and correlated with the in vitro release profiles after processing by percent AUC method. The pharmacokinetic experimental protocol of goserelin acetate microspheres for injection in SD rats was approved by the Animal Ethics Committee of Shandong Luye Pharmaceutical Co., Ltd. The results indicated that the developed sample and separate method was able to detect differences in the release characteristics of the prepared goserelin acetate microspheres, and the in vitro-in vivo correlation of goserelin acetate microspheres was excellent (r > 0.98) and had good predictive ability in SD rats.
ABSTRACT
To systematically review the clinical efficacy and safety of Yinzhihuang oral liquid in the treatment of intrahepatic cholestasis of pregnancy(ICP). Literatures published by June 2016 were searched in databases, such as Medline, Pubmed, Cochrane Library, China National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Full-text Database(VIP), Chinese biomedical literature database(CBM), and Wanfang Database. Randomized controlled trials(RCT) of Yinzhihuang oral liquid were collected according to the inclusion criteria, and the methodological quality of selected literatures was evaluated. The Meta-analysis was conducted by using RevMan 5.3 software. A total of 7 RCTs involving 711 patients were included. The results of Meta-analysis showed that, compared with control group, Yinzhihuang oral liquid significantly alleviated pruritus symptoms[MD=－0.68, 95%CI(－0.95,－041), P<0.000 01], reduced blood biochemical indexes including TBA[MD=－7.23, 95%CI (－10.88,－3.58), P=0.000 1], TB[MD=－1.90, 95%CI(－3.09,－0.70), P=0.002], ALT[MD=－39.08, 95%CI (－56.46,－21.70), P<0.000 1], and CG [MD=－0.71, 95%CI(－0.89,－0.52), P<0.000 01]. In the respect of pregnancy outcome, Yinzhihuang oral liquid can distinctly improve birth weight [MD=430.03, 95%CI (219.28, 640.78), P<0.000 1]. However, there was no significant difference in cesarean section rate [OR=0.93, 95%CI (0.36, 2.36), P=0.87], preterm birth rates [OR=0.63, 95%CI (0.28, 1.42), P=0.26], and neonatal asphyxia rate [OR=0.50, 95%CI (0.18, 1.43), P=0.20]. Yinzhihuang oral liquid showed better efficiency and slighter adverse reaction. However, more rigorously designed, double-blind, randomized controlled trials with large sample size and high quality are required to provide further evidences.
ABSTRACT
Objective: To investigate the inhibition of tetrahydropalmatine (THP) enantiomers on main cytochrome P450 (CYP450) in human liver microsomes and the mechanism. Methods: The effects of (-)-THP and (+)-THP on the activies of main phase I metabolic enzymes in human liver microsomes, CYP1A2, CYP2C9, CYP2C19, CYP3A1, CYP2E1, and CYP2D6 were investigated using Cocktail probe drugs method; The effect of preincubation with (-)-THP on the CYP2D6 substrate dextromethorphan demethylation activity in human liver microsomes were investigated using a two-step incubation scheme and study its inhibitory mechanism was studied; The enzyme inhibitory kinetic parameters of CYP2D6 by (-)-THP were investigated using time-dependent incubation with human liver microsomes. Results: The inhibitory effect of (+)-THP on CYP450 subtype was not significant, while.CYP2D6 activity was significantly inhibited by (-)-THP (IC50 = 0.46 μmol/L). The value of IC50 preincubation with or without NADPH were 2.40 and 0.46 μmol/L, respectively, IC50 (-) NADPH/IC50 (+) NADPH = 5.22. And the enzyme inhibitory kinetic parameters of Ki and Kinact were 0.690 μmol/L and 0.0846 min-1, respectively. Conclusion: (-)-THP has a strong inhibition on CYP2D6, and the type of inhibition is mechanism-based inhibiton (MBI), which should indicate a potential metabolic drug-drug interaction mediated by (-)-THP in clinical application.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the value of multi-slice spiral CT (MSCT) and impedance audiometry in preoperative evaluation of eustachian tube function in patients with otitis media.</p><p><b>METHODS</b>MSCT and impedance audiometry were performed in 61 patients with otitis media (63 ears), and the results were graded to analyze the correlation between the two examinations. The pathological changes at the tympanic orifice were recorded during surgical exploration of the eustachian tube, and the results were compared with those by MSCT and impedance audiometry.</p><p><b>RESULTS</b>MSCT revealed normal findings in 8 ears, mild pathological changes in 19 ears, and severe changes in 36 ears. Soft tissue shadows at the tympanic orifice was found in 16 ears, and 47 ears were free of the shadows. Impedance audiometry showed normal findings in 20 ears, mild pathological changes in 15 ears, and severe changes in 28 ears. In surgical exploration, tympanic orifice lesions were detected in 22 ears, and were not detected in 41 ears. The rank correlation coefficient between MSCT and impedance audiometry was 0.706, suggesting a correlation between the two examinations. Goodness-of-fit test showed good match of the results of MSCT and surgical exploration (P=0.000, kappa=0.627).</p><p><b>CONCLUSION</b>MSCT combined with impedance audiometry provides a means for comprehensive evaluation of eustachian tube function and lesions, which greatly facilitates surgical planning and treatment of the lesions.</p>