Analysis of DRG grouping effect and influential factors of hospitalization cost of diabetic patients / 中国药房

OBJECTIVE To explore the grouping efficacy of diagnosis related group （DRG） and the influential factors of hospitalization cost in diabetes cases， and to provide theoretical support for improving DRG payment system， reducing medical cost and enhancing the efficiency of medical insurance funds. METHODS The information of 4 368 diabetic patients who were hospitalized in a 3A hospital in Xi’an from January 1， 2021 to June 30， 2023 was retrospectively analyzed， and DRG grouping of them was summarized； the hospitalization costs of patients in different DRG groups were analyzed by using one way ANOVA and Bonferroni multiple comparison. Coefficient of variation （CV） was used for evaluation within the group， and the influential factors of hospitalization costs were analyzed by one-way linear regression analysis and multi-factor linear regression analysis. RESULTS & CONCLUSIONS The CV values of the four DRG groups were all lower than 0.8， indicating good grouping results and good consistency within the group； the difference of hospitalization cost among the four groups was statistically significant （P＜0.05）， and the hospitalization cost of China Healthcare Security-DRG version 1.1 FW11 group was significantly higher than those of other three groups （P＜0.05）. Length of stay， drug cost， the number of other diagnoses， test cost and payment method have significant positive effects on the hospitalization cost of diabetic patients. Whether there is pharmacist intervention has a significant negative influence on the hospitalization cost of patients. Under the DRG payment method， medical institutions can consider multidisciplinary linkage and incorporate a variety of management and service tools， including pharmacist’s intervention， to develop refined management measures， to reduce the economic burden of patients’ families and society.

Clinical phenotype and gene mutation analysis of neurodevelopmental disorders caused by CTNNB1 gene mutation / 中华神经科杂志

Objective:To investigate the clinical phenotype and gene mutation in a child with developmental disorders caused by CTNNB1 gene mutation. Methods:Clinical data of a child with CTNNB1 gene mutation who was admitted to Xiamen Hospital of Fudan University Affiliated Pediatric Hospital in May 2017 were collected, whole exome sequencing technology was applied to verify the family lineage of the child, and the pathogenicity of mutation site was analyzed. Results:The patient was a 6 years and 1 month old male, with a clinical phenotype including mental retardation, motor developmental disorders, speech disorders, visual disorders (internal strabismus), microcephaly, and behavioral problems (social withdrawal, overdependence, etc.), as well as panic syndrome (i.e., sudden shrieking in response to auditory and visual stimuli, extensional rigidity of the body, etc., followed by short periods of general extensional rigidity). The whole exome sequencing results showed the presence of a de novo mutation c.283(exon4)C>T in the CTNNB1 gene, and the c.283(exon4)C>T mutation was interpreted as pathogenic (PVS1+PS2+PS1+PM2+PM) according to the American College of Medical Genetics and Genomics variant classification criteria and guidelines. No relevant genetic variants were found in the parental family verification. Conclusion:CTNNB1 gene mutation c.283(exon4)C>T can cause neurodevelopmental disorders, including mental retardation, motor developmental disorders, speech disorders, visual disorders, microcephaly and behavioral abnormalities.

The relationship between insulin resistance and risk of long-term mortality in people without diabetes: a 30-year follow-up of the Daqing Diabetes Study / 中华内科杂志

Objective:To determine whether insulin resistance is associated with all-cause mortality in subjects without diabetes.Methods:A total of 505 participants without diabetes, 198 with normal glucose tolerance (NGT) and 307 with impaired glucose tolerance (IGT), were recruited from the Daqing Diabetes Study. The participants were followed up for 30 years. They were stratified into three groups (tertiles) according to baseline homeostasis model assessment of insulin resistance(HOMA-IR) levels, as the HOMA-IR 0, the HOMA-IR 1 and the HOMA-IR 2 groups, to assess the predictive effect of insulin resistance on risk of all-cause mortality.Results:During the 30-year follow-up, 52, 56 and 78 participants died across the three HOMA-IR groups, respectively. The corresponding mortality per 1 000 person-years (95 %CI) were 12.12 (9.56-15.01), 13.10 (10.46-16.03) and 19.91 (16.73-23.15), respectively. Participants in the HOMA-IR 2 group had a significantly higher risk of death than those in the HOMA-IR 0 group after adjustment of age, sex and smoking status ( HR=1.97,95 %CI 1.38-2.81, P<0.001). Cox analyses showed that a one standard deviation increase in HOMA-IR was associated with a 22% increase in the mortality after adjustment of potential confounders ( HR=1.22, 95 %CI 1.08-1.39, P=0.002). Conclusions:Insulin resistance is associated with increased risk of all-cause death in Chinese people without diabetes, suggesting that improving insulin resistance could be beneficial for people without diabetic in reducing risk of long-term all-cause mortality.

Inhibitory effect of targeting nanobubbles with cisplatin loading on small cell lung cancer proliferation / 中华超声影像学杂志

Objective:To prepare cisplatin-loaded anti-progastrin-releasing peptide (ProGRP) monoclonal antibody targeted nanobubbles, and to explore the proliferation inhibition effect and anti-cancer molecular mechanism of them on small cell lung cancer (SCLC).Methods:The cisplatin targeted nanobubbles were prepared by thin film hydrating method, and the physicochemical property were explored. The subcutaneous xenograft tumor models of SCLC in 10 nude mice were established, and the ultrasound molecular targeting development effect of cisplatin targeted nanobubbles was analyzed by using blank nanobubbles as control. Another 24 tumor-bearing nude mouse models were established and randomly divided into four groups: blank nanobubbles group, cisplatin group, cisplatin nanobubbles group, cisplatin targeted nanobubbles group. The tumor inhibition rate was calculated. The effect on SCLC proliferation was detected by CCK8 method. RT-PCR and Western blotting methods were used to detect SCLC proliferation related genes the P53, Rb, c-myc protein and mRNA expression level of change, the molecular regulatory mechanism was analyzed.Results:The cisplatin targeted nanobubbles were successfully prepared. The particle size was (467.3±42.3)nm, the structure was stable. The cisplatin targeted nanobubbles had a good effect of ultrasonic molecular development in SCLC xenograft.Compared with the control group, the proliferation of SCLC cells was significantly inhibited by cisplatin targeted nanobubbles. The RT-PCR and Western blotting analysis showed that compared with the control group, the mRNA and protein levels of the proliferation-related gene P53 and Rb in the cisplatin targeted nanovesicles group were significantly up-regulated, and the mRNA and protein levels of c-myc were significantly down-regulated (all P<0.05). Conclusions:The cisplatin targeted nanobubbles can inhibit the proliferation of SCLC, and may be used as a new potential targeted drug for the treatment of SCLC.

Combined application effect of X-ray scan and various ultrasound examination techniques in diagnosis and treatment of DDH / 中国辐射卫生

Objective The combined application of X-ray photography and various ultrasound examination techniques to evaluate the clinical outcome of developmental dysplasia of the hip (DDH) in early diagnosis and treatment. Methods A retrospective analysis of the data of 296 hips in 148 infants with DDH risk factors from September 2017 to September 2018 was classified by Graf method. Harcke method was applied to evaluate the stabilities of the hips. Ottobock harnesses was used for treatment depending on the classification. Human position spica cast would be given if no efficacy was seen and Novick method was applied to observe the location of femoral head and acetabulum. X-rays were given to the infants underwent treatments when they were above 1 year old and the developments of the hips were evaluated. Results There were 207 type Ⅰ hips, 76 type Ⅱ hips, 3 type D hips, 6 type Ⅲ hips and 4 type Ⅳ hips as Graf classification at first examination. 248 hips were stable, 27 hips were relaxed, 5 hips were dislocated when compressed, 13 hips were reducible and 3 hips were irreducible as Harcke classification. 81 hips were treated in all. All the hips turned to be in normal range at age of 1 year. Conclusion The combination of X-ray scan and three ultrasound tools are effective to comprehensively assess the hip joint and precisely diagnose DDH, which may benefit more infants.

Long-term effects of metabolically healthy obesity on the risks of diabetes, cardiovascular disease events and its mortality over 23 years in the China Daqing diabetes prevention study / 中华内分泌代谢杂志

Objective:To investigate the long-term effects of metabolically healthy obesity on the risks of type 2 diabetes, cardiovascular disease events, and its mortality over a 23-year follow-up.Methods:Based on the results of an oral glucose tolerance test, there were 519 participants with normal glucose tolerance and 630 with newly diagnosed type 2 diabetes enrolled in 1986 and then given to assess the long-term clinical outcomes during the 23-year follow-up in Daqing. Metabolically healthy obesity was defined as the overweight and obese individuals with no metabolic abnormalities (diabetes, hypertension, hyperlipidemia). Finally, we identified 682 participants (350 with normal glucose tolerance and 332 with newly diagnosed diabetes). They were divided into five groups: 211 individuals with metabolically healthy normal weight (MHNW group), 58 with metabolically healthy overweight and obesity (MHO group), 81, 109, 223 were metabolically unhealthy overweight and obesity with hypertension (MUHO group), type 2 diabetes (MUDO group), hypertension and diabetes (MUHDO group). Incidences of type 2 diabetes, morbidity and mortality of cardiovascular disease were compared among these groups.Results:Over 23 years, instead of the morbidity and mortality of cardiovascular disease, the incidence of type 2 diabetes in MHO group was two times higher than in MHNW group ( 24.1%, 12.5/1 000 person years vs 10.9%, 5.2/1 000 person years, P=0.01), with an age, sex, and smoking history-adjusted hazard ratio ( HR) of 2.42 (95% CI 1.24-4.74, P=0.01). The morbidity and mortality of cardiovascular disease in the groups of overweight and obesity with metabolically unhealthy were higher than in MHNW group, and increased across the subjects with MUHO, MUDO, MUHDO ( P<0.05). Conclusion:Compared with metabolically healthy normal weight participants, the metabolically healthy obese group was at increased risk of type 2 diabetes but not cardiovascular disease events and its mortality. On the contrary, the overweight and obese groups with metabolic abnormalities had significant higher incidence of type 2 diabetes, morbidity and mortality of cardiovascular diseases.

Subjects with impaired glucose tolerance returned to normal glucose status for six years had lower long-term risk of diabetes: 20 years follow up of Daqing diabetes prevention study / 中华内科杂志

Objective To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years.Methods A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control,and diet,exercise and diet plus exercise groups in a six-year intervention trial in 1986.Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years.Results Among all the subjects,41.38％ of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years,and had a lower incidence of diabetes than subjects maintained IGT status (46.55％ vs.75.25％).Of note,in the intervention group,the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71％ vs.76.25％) after 20 years.There was high long-term risk for diabetes in the IGT subjects after the adjustment of age,sex and baseline glucose (HR=1.81,95％CI 1.27-2.58,P=0.001),whereas in the non-intervention group,no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43％ vs.65.22％) after adjusting of the same confounders (HR=1.03,95％CI 0.45-2.35,P=0.94).Conclusions IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT.However,this beneficial effect could only be viewed in the intervention group,but not in the non-intervention group.

The correlations between traditional Chinese medicine syndromes of chronic heart failure and its protopathy / 国际中医中药杂志

Objective To investigate the interaction between traditional Chinese medicine syndromes of patients with chronic heart failure (CHF) and the primary pathogenesis of CHF, so as to grasp the distribution regularity of TCM syndrome caused by different primary diseases and provide reference for better intervention of CHF. Methods A total of 580 patients with CHF were included in the clinical cross-sectional study. The baseline data of the patients, the primary disease and the four diagnosis information of TCM were collected. The syndromes of TCM were judged and the logistic regression method was used to analyze the correlation of CHF and the distribution of syndromes. Results Analysis of TCM Syndromes of CHF showed that the main syndromes were Qi deficiency syndrome, blood stasis syndrome, water retention syndrome, yin deficiency syndrome, phlegm syndrome, and yang deficiency syndrome. Further analysis showed that the above causes of CHF were related to the distribution of TCM syndromes. When coronary heart disease is the primary disease, blood stasis syndrome, yang deficiency syndrome, and yin deficiency syndrome are related to the occurrence of CHF (χ2 values are 0.480, 4.445, 0.192, P<0.05). When hypertension is the primary disease, blood stasis syndrome and phlegm syndrome are related to the occurrence of CHF (χ2 values are 12.344, 10.990, P<0.05); dilated cardiomyopathy is the primary disease, blood stasis syndrome and yang deficiency syndrome and chronic heart failure It is related (χ2=5.222, 3.456, P<0.05). Conclusions The distribution patterns of TCM Syndromes of CHF caused by different primary diseases were different, which was related to the pathogenesis of CHF. It is of great significance for better application of traditional Chinese medicine CHF syndrome differentiation during treatment, so as to form optimal treatment to reduce re-admitted into hospitalization rate and mortality in patients with CHF.

Delayed Terminal Ileal Perforation in a Relapsed/Refractory B-Cell Lymphoma Patient with Rapid Remission Following Chimeric Antigen Receptor T-Cell Therapy / Journal of the Korean Cancer Association, 대한암학회지

Chimeric antigen receptor T-cell strategy targeting CD19 (CART19) has prominent anti-tumor effect for relapsed/refractory B-cell lymphomas. CART19-associated complications have been gradually recognized, however, late-onset complications have not been extensively studied. Herein, for the first time we report a diffuse large B-cell lymphoma patient with terminal ileum involvement obtained rapid remission and developed spontaneous terminal ileal perforation 38 days following CART19 infusion. The late-onset perforation reminds us that, for the safety of CART treatment, more cautions are warranted for the management of delayed GI complications.

Value of fecal tumor M2 pyruvate kinase in colorectal adenoma detection / 中国综合临床

Objective To estimate the value of fecal tumor M2-PK in the detection of colorectal adenoma and to evaluate its potential as a screening tool for colorectal adenoma.Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the fecal tumor M2-PK in stool samples of 65 patients with colorectal adenoma and 25 controls.At the same time,the peripheral blood tumor markers such as carcinoembryonic antigen (CEA),carbohydrate antigen (CA) 19-9,CA24-2 and fecal occult blood test (FOBT) were detected in the colorectal adenoma group.Results The detection value of fecal tumor M2-PK in the colorectal adenoma group showed a significant increase,compared with the control group((6.033±4.123) U/ml vs.(2.782±1.464) U/ml,t=-3.839,P=0.000).The highest detection value was found in the group where the diameter of adenoma was greater than or equal to 2 cm ((8.775±6.548) U/ml,t=9.635,P=0.034).The larger the diameter of adenoma,the higher the positive rate of fecal tumor M2-PK (85.7% vs.41.7% vs.29.6%,χ2=11.977,P=0.003).In the colorectal adenoma group,The positive detection rate of fecal tumor M2-PK was significantly higher than that of CEA,CA19-9,CA24-2 and FOBT (46.2% vs.6.2% vs.1.5% vs.1.5% vs.27.7%,?2=76.607,P=0.000).Conclusion Fecal tumor M2 pyruvate kinase has a good clinical value in the diagnosis of colorectal adenoma.

The extraction and acute toxicity testing of Moringa oleifera leaves and seeds / 药学实践杂志

Objective To test the acute toxicity and determine the safe dose range of Moringa oleifera leaves and seeds.Methods Acute toxicity tests were performed based on the documented experimental designs in Research Methods of Pharmacology of Chinese Traditional Medicine.Results The maximum tolerated dose of the superfine powder and alcoholic-aqueous extract of Moringa oleifera leaves were 0.4 g/20 g and 0.8 g/20 g for mice.The safe dose for human is under or equal to 10 g/50 kg and 20 g/50 kg.Conclusion Moringa oleifera leaves were safe for medical and food use.The further research and development is warranted for this plant.

Analysis on nanobubbles for enhanced ultrasound imaging of small-cell lung cancer in nude mice / 肿瘤研究与临床

Objective To prepare nanobubbles and analysis its application for enhanced ultrasound imaging of small-cell lung cancer (SCLC). Methods Nanobubbles were prepared using a thin-film hydration-sonication method. MTT assay was used to evaluate the cytotoxicity of the nanobubbles for SCLC H446 cell line. The contrast-enhanced ultrasound (CEUS) of xenografted SCLC tumors in 10 nude mice was performed using nanobubbles and micro-scale microbubbles, and compared with livers. The time-intensity curve (TIC) was obtained using the Gamma variate and the following parameters were calculated, including area under the curve, time to peak, arrival time, peak intensity, and half-peak time. Results Nanobubbles with spherical shape distributed homogeneously, without obvious aggregation, the mean diameters was (392.1 ±48.6) nm and average zeta potential was (-16.8 ±2.9) mV. The MTT results indicated that the nanobubbles had no obvious cytotoxicity toward H446 cell line within the concentrations used for in vivo ultrasound imaging with nanobubbles (5 μg/ml). CEUS with the nanobubbles showed significantly higher peak intensity, and half-peak time [(18.14 ±0.62) s, (141.55 ±8.21) s] in comparison with the micro-scale microbubbles [(14.82 ±0.51) s, (120.43 ±8.73) s] (P= 0.033, 0.040). There was no significant difference in time to arrival, area under the curve and time to peak (all P>0.05). Compared with livers, the nanobubbles in xenografted SCLC tumors showed significantly shorter time to peak, lower peak intensity and area under the curve, and higher half-peak time (all P 0.05). Conclusion Nanobubbles ultrasound enhanced contrast agent shows good stability and contrast-enhancement effect in vitro, and provides an experimental basis for targeting ultrasound imaging and therapeutics of SCLC.

Effect of Hydroxysafflor Yellow A on Pro/Anti-Inflammatory Cytokines in Peripheral Blood with Sepsis in Mice / 中山大学学报(医学科学版)

[Objective]To explore the effect of HSYA on pro/anti-inflammatory cytokine′s levels and mRNA expression in peripheral blood of mice.with sepsis.[Methods]Dividing NIH mice into four groups,as normal group,sham group,CLP group and HSYA group,24 mice in each group. The CLP sepsis mouse model was established. HSYA(120 mg/kg)were injected intravenously at 12 h before the operation ,and 0 h and 12 h following CLP ,and other groups were given normal saline. observed the animals behavior changes,measured the levels WBC,PLT,ALT,AST,BUN in serum,detected the levels and mRNA expression of IL-6, IL-10 ,TNF-α in peripheral blood. cultured of peripheral blood bacteria loads.[Results]24 h after surgery ,mice in CLP group appeared furring,feces residues on anus etc. compared to normal group,sham group and HSYA group,WBC,PLT,ALT,AST, BUN,levels and mRNA expression of IL-6,IL-10,TNF-αshowed significant increases,it was also found that bacterial load was significant increased in model group.[Conclusions]HSYA has a therapeutic effect in mice with sepsis ,can reduce bacteria into the blood,and inhibit inflammatory mediators which caused tissue damage.

Clinical epidemiological characteristics and change trend of upper gastrointestinal bleeding over the past 15 years / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical epidemiology change trend of upper gastrointestinal bleeding (UGIB) over the past 15 years.</p><p><b>METHODS</b>Consecutive patients who was diagnosed as continuous UGIB in the endoscopy center of The First Affiliated Hospital of Sun-Yat University during the period from 1 January 1997 to 31 December 1998 and the period from 1 January 2012 to 31 December 2013 were enrolled in this study. Their gender, age, etiology, ulcer classification, endoscopic treatment and hospitalization mortality were compared between two periods.</p><p><b>RESULTS</b>In periods from 1997 to 1998 and 2012 to 2013, the detection rate of UGIB was 9.99%(928/9 287) and 4.49%(1 092/24 318)(χ=360.089, P=0.000); the percentage of male patients was 73.28%(680/928) and 72.44% (791/1 092) (χ=0.179, P=0.672), and the onset age was (47.3±16.4) years and (51.4±18.2) years (t=9.214, P=0.002) respectively. From 1997 to 1998, the first etiology of UGIB was peptic ulcer bleeding, accounting for 65.2%(605/928)[duodenal ulcer 47.8%(444/928), gastric ulcer 8.3%(77/928), stomal ulcer 2.3%(21/928), compound ulcer 6.8%(63/928)],the second was cancer bleeding(7.0%,65/928), and the third was esophageal and gastric varices bleeding (6.4%,59/928). From 2012 to 2013, peptic ulcer still was the first cause of UGIB, but the ratio obviously decreased to 52.7%(575/1092)(χ=32.467, P=0.000)[duodenal ulcer 31.9%(348/1092), gastric ulcer 9.4%(103/1092), stomal ulcer 2.8%(30/1092), compound ulcer 8.6%(94/1092)]. The decreased ratio of duodenal ulcer bleeding was the main reason (χ=53.724, P=0.000). Esophageal and gastric varices bleeding became the second cause (15.1%,165/1 092, χ=38.976, P=0.000), and cancer was the third cause (9.2%,101/1 092, χ=3.352, P=0.067). The largest increasing amplitude of the onset age was peptic ulcer bleeding [(46.2±16.7) years vs. (51.9±18.9) years, t=-5.548, P=0.000), and the greatest contribution to the amplitude was duodenal ulcer bleeding [(43.4±15.9) years vs. (48.4±19.4) years, t=-3.935, P=0.000], while the onset age of esophageal and gastric varices bleeding [(49.8±14.1) years vs. (48.8±13.9) years, t=0.458, P=0.648] and cancer [(58.4±13.4) years vs. (58.9±16.7) years, t=-0.196, P=0.845] did not change significantly. Compared with the period from 1997 to 1998, the detection rate of high risk peptic ulcer rebleeding (Forrest stage I(a, I(b, II(a and II(b) increased (χ=39.958, P=0.000) in the period from 2012 to 2013. From 1997 to 1998, 54 patients underwent endoscopic treatment, and the achievement ratio of hemostasis was 79.6% (43/54). From 2012 to 2013, 261 patients underwent endoscopic treatment and the achievement ratio of hemostasis was 96.9%(253/261), which was significantly higher (χ=23.287, P=0.000). Compared to the period from 1997 to 1998, more patients with variceal bleeding or non-variceal bleeding received endoscopic treatment in time (39.0% vs. 70.3%, χ=51.930, P=0.000; 3.6% vs. 15.6%, χ=62.292, P=0.000, respectively), and higher ratio of patients staging Forrest stage I(a to II(b also received endoscopic treatment in the period from 2012 to 2013 [27.4%(26/95) vs. 68.5%(111/162), χ=40.739, P=0.000]. More qualified endoscopic hemostatic techniques were used, containing thermocoagulation (0 vs. 15.2%, χ=79.518, P=0.000), hemostatic clip (0 vs. 55.9%, χ=20.879, P=0.000), hemostatic clip combined with thermocoagulation (4.3% vs. 16.4%, χ=5.154, P=0.023), while less single injection was used (87.1% vs. 6.2%, χ=10.420, P=0.001), and single spraying for hemostasis was completely abandoned in the period from 2012 to 2013. The ratio of inpatients undergoing reoperation decreased obviously in the period from 2012 to 2013 [9.3%(86/928) vs. 6.0%(65/1092), χ=7.970, P=0.005], while no significant difference was found in mortality during hospitalization between two periods.</p><p><b>CONCLUSION</b>Compared with the period from 1997 to1998, the mean onset age of UGIB increased, and the ratio of peptic ulcer bleeding decreased due to the reduction of duodenal ulcer bleeding, the detection rate of high risk peptic ulcer rebleeding increased, the cure rate of endoscopic treatment for UGIB increased, more reasonable and immediate hemostatic methods were used, but overall mortality did not change obviously in the period from 2012 to 2013.</p>

Comparison of Anesthetic Effect and Safety of Dexmedetomidine Hydrochloride and Propofol in Painless Colonoscopy / 中国药房

OBJECTIVE:To compare the anesthetic effect and safety of dexmedetomidine hydrochloride and propofol in pain-less colonoscopy. METHODS:80 patients who underwent painless colonoscopy was retrospectively analyzed and divided into group A and group B. Group A was given loading dose of 1 mg/kg propofol within 30 s and maintained with 6 mg/(kg·h);group B was given loading dose of 0.3 μg/kg Dexmedetomidine hydrochloride injection by micropump for slow pumping 5 min and maintained with 0.2-0.3 μg/(kg·h). Mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO2)and respiratory rate(RR)be-fore examination (T0),before microscopic examination (T1),1 min (T2) and 10 min(T3) after microscopic examination,1 min (T4)and 5 min(T5)after colonoscopy withdrawal,onset time of anesthesia,entry time,examination time and discharge time,pa-tients with adjunctive use of fentanyl and incidence of adverse reactions in 2 groups were observed. RESULTS:MAP in group A at T1 was significantly lower than T0,HR in 2 groups at T1-T3 was significantly lower than T0,the differences were statistically signifi-cant(P0.05). Onset time of an-esthesia,patients with adjunctive use of fentanyl and incidence of adverse reactions in group B were significantly lower than group B,the differences were statistically significant(P<0.05). CONCLUSIONS:Both dexmedetomidine hydrochloride and propofol has good anesthetic effect in painless colonoscopy,but dexmedetomidine has better safety.

Clinical observation and effect of stains collapse of traditional Chinese medicine in combination with tumor necrosis factor antagonist in treating ankylosing spondylitis / 中国实用护理杂志

Objective To study the clinical effect, safety of stains collapse of traditional Chinese medicine (TCM) combined with tumor necrosis factor-alpha (TNF-α) antagonist-a recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNF:Fc) and sulfasalazine (SSZ) in treatment of active ankylosing spondylitis (AS). Methods A total of 98 patients of AS of Gansu Provincial Hospital were divided into two groups in random, the western medicine group (rhTNF:Fc and SSZ, n=46) and the combining group (stains collapse of TCM, rhTNF:Fc and SSZ, n=52). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Patient Global Assessment (PGA), Visual Analogue Scale (VAS) of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground, thoracic activity, Schober test, and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), adverse reactions before and after treatment were observed and the clinical effect was evaluated in two groups. Results A total of 86 patients achieved the study finally, 45 patients in the combining group and 41 patients in the western medicine group. The effective rate of ASAS20 was better in the combining group than that in the western medicine group(χ2=4.814,P=0.028), the Bath ankylosing spondylitis disease activity index (BASDAI) 50 showed no significant difference between the two group (χ2=0.100,P=0.752). The total effective rate in the combining group than that in the western medicine group(χ2=3.873,P=0.049). In comparison with the same group before treatment, the above indicators were improved after treatment (P0.05). The adverse reactions showed no significant difference (P>0.05). Conclusions Stains collapse of TCM combined with rhTNF:Fc was more effective than single method in treatment of AS, it can alleviated the symptoms, body signs and body function, decrease indexes of inflammation, which has dramatic effect and good safety in clinic.

Effect of osthole on tricalcium phosphate particles-induced calvarial oste-olysis in a mouse model / 中国病理生理杂志

AIM: To observe the effect of osthole on tricalcium phosphate (TCP) particles-induced calvarial osteolysis in vivo.METHODS:Male ICR mice were randomly divided into sham group , TCP group and osthole group .A mouse calvarial model of osteolysis was established by TCP particles .On the second postoperative day , osthole (20 mg/kg) was locally injected into the calvarium under the periosteum 3 times a week.Two weeks after osthole treatment , blood and calvaria were collected to determine the level of bone turnover markers such as alkaline phosphatase ( ALP) , osteocalcin and tartrate-resistant acid phosphatase ( TRACP) .The periosteum was performed to examine the release of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and IL-1βby ELISA.The calvaria was obtained for histological and molecular analyses.RESULTS:Data from HE and TRACP staining revealed that osthole prevented TCP particles-induced obvious increase in osteoclastogenesis and resorption area in the metaphysis of mouse calvaria .Osthole treatment increased ALP ac-tivity and osteocalcin level , and dncreased the activity of TRACP in the mouse serum compared with TCP group .Further-more, TCP particles-induced the releases of TNF-α, IL-6 and IL-1βwere significantly suppressed by osthole treatment .In addition, Western blot demonstrated that endoplasmic reticulum ( ER) stress markers such as glucose-regulated protein 78 (GRP78) and CAAT/enhancer binding protein homologous protein (CHOP) were significantly up-regulated in TCP parti-cles-implanted calvarial mice , indicating that TCP particles triggered an ER stress response in the mouse calvarial osteolysis model , which obviously attenuated by osthole .CONCLUSION:Osthole inhibits TCP particles-induced calvarial osteolysis in mice, which is mediated by inhibition of ER stress signaling pathway .

Laryngotracheal reconstruction using autologous cartilage transplantation / 中国组织工程研究

BACKGROUND:Long-distance, large-range tracheal stenosis or defects are often seen in clinic, and laryngotracheal reconstruction is stil a difficult problem. OBJECTIVE:To investigate the effects of animal autologous cartilage transplantation in laryngotracheal reconstruction. METHODS:The cricoid cartilage and partial anterior tracheal wal from New Zealand rabbits were resected to prepare laryngotracheal defect models. Then, autologous costal perichondrium was taken for transplantation. After 8-24 weeks, surviving animals were sacrificed to observe the repair effects. RESULTS AND CONCLUSION:General observation showed that animals breathed and ate normaly, the implanted cartilage bonded tightly with the surrounding tissue, the wound healed wel without granulation tissue and scar formation, and there was a smooth inner surface covered by mucosa in the lumen. Under the light microscope, there was some mucosa generating at the wound site, and some fibroblasts and striated muscle cels existed in the outer layer, with a smal amount of new cartilage formation. There was also a linking between chondrocytes and muscle cels. These findings indicate that autologous cartilage transplantation can be applied for laryngotracheal reconstruction in animals, which has a good effect.

Effect of Danzhi Jiangtang Capsule Combined with Atorvastatin on Intima-media Thickness in Diabetes Patients without Hypertension / 世界科学技术-中医药现代化

This study was aimed to observe the curative effect and safety of Danzhi Jiangtang Capsule ( DJC ) combined with atorvastatin on carotid artery intima-media thickness (IMT) in diabetes patients without hyper-tension . A total of 196 diabetes patients without hypertension with incrassate carotid artery IMT were randomly divided into the control group ( 98 cases ) and the treatment group ( 98 cases ) . The conventional diabetes thera-py was given to both groups . The atorvastatin of 20 mg/night was given to the control group . And the atorvas-tatin 20 mg/night added with DJC 9 . 0 g/night were given to the treatment group . The treatment course was 12 months . Carotid artery IMT , carotid atherosclerotic plaque area , FPG , FIns , HOMA-IR , HbA1c , blood lipids , hepatorenal function and etc . were examined before and after the treatment respectively . The results showed that there was a significant positive correlation between carotid artery IMT and FIns , HOMA-IR , HbAlc , LDL-C . After 12-month treatment , the total effectiveness is 85 . 87% in the treatment group . And there was significant difference compared with the control group ( P < 0 . 05 ) . The levels of FPG , FIns , HOMA-IR , HbAlc of the treatment group had no difference compared with the control group . Compared with the control group, TC and LDL-C of the treatment group was obviously decreased (P < 0.05). And HDL-C was significantly increased ( P < 0 . 05 ) . The carotid artery IMT of the treatment group decreased from ( 0 . 11 ±0 . 01 ) cm to ( 0 . 08 ± 0 . 01 ) cm . And compared with the control group , there was statistical significance ( P <0 . 05 ) . The carotid atherosclerotic plaque area of 58 cases in the treatment group decreased from ( 0 . 37 ±0.56) cm2 to (0.21 ± 0.25) cm2. However, there was no statistical significance compared to the control group. There were 5 adverse events in the control group and 9 adverse events in the treatment group . And there was no difference between two groups. It was concluded that DJC combined with atorvastatin can regulate lipid metabolism and reduce carotid artery IMT .

Pre-hospital scoring system for evaluation of coal mine gas explosion injury / 中华创伤杂志

ObjectiveTo explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. MethodsAfter analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. ResultsOf 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. ConclusionRPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.