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OBJECTIVE To evaluate the cost-effectiveness of ivabradine in the treatment of chronic heart failure （CHF） in the context of “Quadruple Therapy” from the perspective of the health system. METHODS Based on real-world cohort data， the Markov model was constructed according to the natural progression of CHF， with a cycle time of 3 months， a study timeframe of 20 years， and a discount rate of 5%. Using quality-adjusted life year （QALY） and incremental cost-effectiveness ratios （ICER） as the output indexes， the cost-utility analysis was used to evaluate the cost-effectiveness of ivabradine in combination with the “Quadruple Therapy” regimen， compared with the “Quadruple Therapy” regimen for the treatment of CHF， and the robustness of the results of the base analysis was verified by univariate sensitivity analysis and probabilistic sensitivity analysis. RESULTS The results of the base analysis showed that the ICER of ivabradine combined with the “Quadruple Therapy” regimen was 165 065.54 yuan/QALY， compared with the “Quadruple Therapy” regimen， which was lower than the willingness-to-pay （WTP） threshold （257 094 yuan/QALY） based on 3 times of China’s gross domestic product （GDP） per capita in 2022. The results of the univariate sensitivity analysis showed that the discount rate had the greatest impact on the robustness of the model. The probabilistic sensitivity analysis showed that the probability that the ivabradine combined with the “Quadruple Therapy” regimen was cost-effective under the WTP threshold in this study was 59.50%. CONCLUSIONS When using 3 times China’s 2022 GDP per capita （257 094 yuan/ QALY） as the WTP threshold， the combination of ivabradine and the “Quadruple Therapy” regimen for treating CHF is cost- effective.
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【Objective】 To study the genotypes of ABO ambiguous blood group samples(n=20) and identify their molecular biological characteristics. 【Methods】 The serological phenotype of the samples was analyzed by serological techniques. Seven exons of ABO gene were amplified by polymerase chain reaction (PCR) and the PCR products were directly sequenced; the genotypes and sequences of ABO subtypes were analyzed. 【Results】 The serological phenotypes of 20 samples presenting ABO ambiguous blood group were as follows: weak A antigen (n=5), weak A antigen combined with anti-A1 antibody (n=5), normal A antigen combined with anti-A1 antibody (n=2), weak B antigen (n=8). The genotypes of them were as follows: Ax02/O01 (n=3), Ael07/O01 (n=2), B313/O01 (n=2), A204/O02 (n=1), A220/O01 (n=1), Ael07/O02 (n=1), Ael02/O01 (n=1), Ael02/O02 (n=1), Ax03/O01 (n=1), Ax03/O02 (n=1), B313/O02 (n=1), B302/O01 (n=1), B302/O02 (n=1), Bw19/O02 (n=1), A102/B313 (n=1) and A101/Bw37 (n=1). 【Conclusion】 ABO genotyping technology can accurately identify the ambiguous blood group of samples, provide definite genetic information of blood group and ensure the safety of clinical transfusion.
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Objective:To summarize the clinical features, viral load changes, and outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant infection in mother-infant dyads during lactation period.Methods:A total of 24 pairs of lactating mothers and infants under one year old who were infected with SARS-CoV-2 and hospitalized in Lingang Branch of Shanghai Sixth People's Hospital from April 8 to May 30, 2022, were selected as the lactation group in this retrospective study. Another 24 non-lactating mothers, with children of one to three years old, who matched with those mothers in the lactation group in clinical classification and admission date were selected as the control group. Vaccination status, clinical symptoms, daily cycle threshold (Ct) of open reading frame 1ab ( ORF1ab) gene and nucleocapsid protein ( N) gene, and the duration of positive nucleic acid test were compared between the groups and were analyzed using two independent samples t test, one-way analysis of variance, LSD test, and Chi-square test. Results:Among the 24 infants in the lactation group with an age of (6.5±2.1) months, 23 cases were mild type, one was common, and none had been vaccinated against SARS-CoV-2. The maternal age of the lactation and the control group did not differ statistically [(28.7±6.4) vs (28.2±5.2) years, t=0.30, P=0.768]. Mothers with mild type accounted for 88% (21/24) and those with common for 12% (3/24) in both groups of mothers. Three mothers received one dose of vaccine and two received two in the lactation group, while three received one dose and three received two in the control group [21%(5/24) vs 25%(6/24), χ 2=0.12, P=0.731]. The most common symptoms of lactating infants were fever (100%, 24/24) , followed by diarrhea (58%, 14/24) , cough (50%, 12/24), and wheeze (29%, 7/24), those of the lactating mothers were fever (75%, 18/24) , cough (75%, 18/24) , and sore throat (63%, 15/24) , while those of non-lactating mothers were cough (88%, 21/24) , sore throat (71%, 17/24), and fever (58%, 14/24). The duration of positive nucleic acid test was the shortest in the lactating infants [(9.2±2.1) d (5-14 d)], followed by mothers in the control group [(11.2±2.4) d (6-16 d)] and mothers in the lactation group [(14.0±4.2) d (8-26 d)] (LSD test, all P<0.05). Each day from day 2 to 9 after diagnosis, Ct values of nucleic acid of infants in the lactation group were all higher than those of mothers in both the lactation and control groups (LSD test, all P<0.05). On day 10, Ct value of nucleic acid infants was higher than that in mothers in the lactation group ( ORF1ab gene: 37.91±4.34 vs 32.79±5.47; N gene: 37.95±4.58 vs 32.66±5.77), which was lower than those in mothers in the control group ( ORF1ab gene: 32.79±5.47 vs 35.90±4.17; N gene: 32.66±5.77 vs 36.08±4.16) (LSD test, all P<0.05). On day 11, the nucleic acid Ct values of mothers in the lactation group were all lower than those in the control group ( ORF1ab gene: 35.03±3.74 vs 37.84±3.26, t=－2.78, P=0.008; N gene: 35.30±3.75 vs 38.11±2.90, t=－2.90, P=0.006). On day 12, Ct value of ORF1ab gene and N gene in mothers in the lactation group were similar to those in mothers in the control group (both P>0.05). Conclusions:The SARS-CoV-2 vaccination rate of mothers and infants were low during lactation. Lactating infants infected with SARS-CoV-2 Omicron variant have low virus load and may have a quick recovery, while for the lactating mothers, the virus load is high and the recovery is slow.
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Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.
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Objective:To explore the feasibility of using vascular graft interposition for lowering the complications of portal vein during pediatric liver transplantation.Methods:From June 1, 2013 to May 31, 2018, clinical data were collected for 297 children undergoing liver transplantation, including basic demographics, general preoperative status, preoperative tests, imaging findings, graft related profiles, surgical procedures and postoperative follow-ups, etc. Then the authors analyzed the effect of using interposition vessels upon lowering postoperative complications of portal vein reconstruction.Results:With a median age of 12 months, there were 153 boys (51.5%) and 144 girls (48.5%). The primary disease was mostly biliary atresia ( n=222, 74.7%). The median diameter of portal vein was 5 mm. There were 19 cases (6.4%) using vascular interposition. Among 20 cases of portal vein complications, there were portal vein stenosis ( n=17, 5.7%) and portal vein thrombosis ( n=3, 1.0%). After univariate analysis, binary Logistic regression analysis revealed that diameter of recipient's portal vein was an independent risk factor for the occurrence of portal vein complications after liver transplantation. Statistical analysis of children with portal vein diameter <4 mm ( n=90) was carried on and the results showed that there was no inter-group statistical difference ( χ2=3.061, P=0.080)on the occurrence of portal vein complications. Conclusions:Diameter of portal vein is an important factor affecting the strategic choice of portal vein reconstruction during pediatric liver transplantation and an independent risk factor for portal vein complications after liver transplantation. When the diameter of portal vein is ≤4 mm, using interposition vascular anastomosis shows no significant difference with other conventional modes.
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Objective:To analyze the epidemiological characteristics and trend of human brucellosis in Jinan City of Shandong Province from 2010 to 2019, so as to provide a scientific basis for improving prevention and control strategies and measures.Methods:The brucellosis surveillance data of Jinan City from 2010 to 2019 were obtained from the "Infectious Disease Surveillance System" in "China Information System of Disease Prevention and Control". Descriptive epidemiological methods were used to analyze the epidemiological situation and the three distributions (regional distribution, time distribution, population distribution) of cases.Results:A total of 1 882 cases of brucellosis were reported from 2010 to 2019, with an average incidence rate of 2.64/100 000. The incidence of brucellosis increased from 0.13/100 000 to 5.37/100 000, and reported incidence of brucellosis showed a increasing trend (χ 2trend=307.50, P<0.05). The epidemic areas were spread from 7 towns (streets) of 3 counties (districts) to 76 towns (streets) of 12 counties (districts). The cases were reported each month throughout the year with incidence peak period form April to July. The gender of the patients was mainly male, and the sex ratio of male to female was 2.66: 1.00 (1 368 ∶ 514). In terms of age distribution, 30-69 years old was peak age. Farmer was the predominant occupational group. Conclusions:In 2010 to 2019, the incidence of brucellosis in Jinan City has increased and the epidemic areas have expanded year by year. Corresponding measures for brucellosis prevention and control should be developed according to epidemiological characteristics in order to strengthen the capacity of epidemic prevention and control measures.
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Objective To explore the clinical pharmacist participation in the treatment of pregnancy complicated with Clostridium difficile infection. Methods From the perspective of medications, clinical pharmacists followed evidence-based medical practice, combined pharmaceutical theory with clinical evidence and provided individualized pharmacy care in drug selection, dose adjustment, medication regime and liver protection treatment. Results Clinical pharmacists integrated into the treatment team to ensure the effectiveness and safety of medication in the patient with pregnancy. Conclusion The individualized pharmacy care improved the effectiveness of drug treatment.
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OBJECTIVE：To investigate the ro le of clinical pharmacists in the therapy of fetal tachycardia by oral administration of digoxin through mother. METHODS ：The clinical pharmacists participated in the whole process of drug therapy for a pregnant woman with fetal tachycardia. According to 31+6 weeks of gestation ，the fetal heart rate of 230 beats/min at admission，clinical pharmacists provided the suggestion for the doctor about the safety and blood concentration determination of digoxin in the treatment of fetal tachycardia by mother. The patient ’s blood potassium value was lower than the normal range ，and it was suggested that potassium should be supplemented before digoxin was used ，and the initial dose of digoxin was 0.5 mg per 12 h. On the 7th day in the hospital ，the dosage of digoxin should be adjusted to maintaining dose （0.25 mg per 12 h）；on the 11th day in the hospital ，the patient ’s blood sodium value was low ，and the clinical pharmacists gave diet guidance. At the same time ， the clinical pharmacists explained the adverse reactions of digoxin to the doctors ，nurses and patients ，and closely observed and educated the patients. RESULTS ：Doctors adopted the suggestions of the clinical pharmacists. The fetal heart rate decreased to 180 beats/min from hospital after 13 days of treatment. The maternal digoxin concentration remained stable. No adverse drug reactions occurred in the mother and infant. CONCLUSIONS ：Maternal and child safety should be taken into account in the medication of pregnant patients. The clinical pharmacists assisting doctors to formulate medication strategying ，and carrying out pharmaceutical care for patients ，can ensure the effectiveness and safety of medication for fetal tachycardia.
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Objective:To explore the imaging changes of lung lesions in patients with imported COVID-19 when reaching the discharge standard.Methods:The clinical and CT imaging data of 60 cured patients with imported COVID-19 and discharged from January to February 2020 in Anhui Province were retrospectively collected. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.Results:Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. In 5 mild patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. The first CT imaging features of 55 patients (53 common type and 2 severe type) were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common (55 cases). The features of chest CT in clinical outcomes were that the ground glass shadow in the lung gradually faded and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbed again followed by fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed. Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a large amount of fibrous foci remained after slow absorption.Conclusions:Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.
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2019-Novel coronavirus (2019-nCoV) caused an outbreak of corona virus disease 2019 (COVID-19) from December 2019 in China.2019-nCoV which was identified as a kind of beta coronavirus belongs to one of four coronavirus genera.Except 2019-nCoV, two other beta coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are also quite harmful to human beings.2019-nCoV uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV.And dipeptidyl peptidase 4 (DPP4) or CD26 is the cell receptor for MERS-CoV.The expression of ACE2 was found to have obvious positive expression in human corneal and conjunctival epithelium, and corneal endothelium.DPP4 activity was presented in normal animal conjunctival epithelium and fibroblasts of the subjacent connective tissue.It was also presented in the whole corneal epithelium and tear fluid of animal with severe injured corneas.The two receptors, ACE2 and DPP4, are involved in many cellular signaling pathways and pathophysiological processes.Their expression in the cells of ocular surface may be an access route of corona virus in eye, which provides clues to elucidating the pathogenesis of corona virus in the eyeballs.
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Jaundice is a common clinical problem in neonatal period.Phototherapy is a common treatment for neonatal jaundice, but it also has side effects such as fever, diarrhea, rash and so on.In recent years, probiotics have been widely used in neonates with jaundice because they are beneficial to the health of the host, especially when they are treated with light and probiotics are added at the same time, which is more conducive to the elimination of jaundice.Studies have shown that abnormal bilirubin metabolism is closely related to microecology.This article reviews the mechanism and clinical application of probiotics in adjuvant treatment of neonatal jaundice.
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Objective@#To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard.@*Method@#The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.@*Results@#Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption.@*Conclusion@#Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.
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Novel coronavirus (2019-nCoV) caused an outbreak of corona virus disease 2019 (COVID-19) from December 2019 in China. 2019-nCoV which was identified is a kind of beta coronavirus belongs to one of four coronavirus genera. Except 2019-nCoV, two other beta coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are also quite harmful to human beings. 2019-nCoV uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV. And dipeptidyl peptidase 4 (DPP4) or CD26 is the cell receptor for MERS-CoV. The expression of ACE2 was found to have obvious positive expression in human corneal and conjunctival epithelium, and corneal endothelium. DPP4 activity was presented in normal animal conjunctival epithelium and fibroblasts of the subjacent connective tissue. It was also presented in the whole corneal epithelium and tear fluid of animal with severe injured corneas. The two receptors, ACE2 and DPP4, involve in many cellular signaling pathways and pathophysiological processes. Their expression in the cells of ocular surface may be an access route of corona virus in eye, which provides clues to elucidating the pathogenesis of corona virus in the eyeballs.
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Objective:To observe the efficacy and safety of intravitreal injection of conbercept in the treatment of proliferatived diabetic retinophathy (PDR) complicated with vitreous hemorrhage by minimally invasive vitreoretinal surgery.Methods:Prospective clinical study. A total of 50 patients with PDR complicated with vitreous hemorrhage clinically diagnosed in Tianjin Medical University Eye Hospital who needed vitrectomy were recruited in this study. According to the principle of informed consent, the patients were divided into two groups: postoperative injection group and the control group. Twenty-five eyes of 25 patients in each group were examined before operation. No significant proliferative changes in the posterior pole and traction retinal detachment were observed. There was significant difference of age between two groups ( t=-24.697, P=0.030), but no significant difference of sex ( χ2=0.330, P=0.564), duration of diabetes ( t=-1.144, P=0.258), logMAR BCVA ( t=-0.148, P=0.883), lens state ( χ2=0.397, P=0.529), panretinal laser photocoagulation ( χ2=1.333, P=0.248). The postoperative injection group was treated with intravitreous injection of 0.05 ml conbercept (10 mg/ml) immediately after 27G minimally invasive vitrectomy. The other treatment and follow-up were the same as those in the postoperative injection group except for conbercept injection. All patients underwent routine slit-lamp examination, indirect ophthalmoscope and B-ultrasound examination before operation. The main outcome measure included the time of operation, the incidence rate of iatrogenic retinal holes and silicone oil filling. The recurrence of vitreous hemorrhage, BCVA, intraocular pressure, central retinal thickness (CRT), postoperative complications and progression were recorded 1 week, 1 month, 3 months and 6 months after operation. Results:At 1 week and 1, 3, 6 months after operation, there was significant difference of logMAR BCVA between the two groups ( t=-4.980, -4.840, -4.892, -5.439; P<0.001). At 3 and 6 months after operation, the recurrence of vitreous hemorrhage in the postoperative injection group was lower than that in the control group, but there was no statistical difference between two groups ( χ2=3.030, 4.153; P=0.192, 0.103). At 1 week and 1, 3, 6 months after operation, the CRT in the postoperative injection group was lower than that in the control group, the difference was significant ( t=-2.622, -2.638, -3.613, -3.037; P=0.012, 0.010, 0.001, 0.004, 0.005). There was no complications such as choroid detachment, proliferative vitreoretinopathy, retinal detachment, iris redness and neovascular glaucoma in all the eyes after operation. Conclusions:Intravitreal injection of conbercept in the treatment of PDR after operation is safe and effective. It can reduce the recurrence of vitreous hemorrhage after vitrectomy, improve the BCVA.
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Objective@#To analyze the epidemiological trend and characteristics of human brucellosis in Laiwu City of Shandong Province, and to provide a scientific basis for improving prevention and control strategies and measures.@*Methods@#The information on the outbreaks of brucellsis in Laiwu City from 2011 to 2017 collected from the "Infectious Disease Reporting Information Management System" in the "China Information System of Disease Prevention and Control", and a retrospective analysis method was used to descriptive statistical analysis of the three distributions (time distribution, regional distribution, population distribution) and transmission route of brucellosis cases.@*Results@#A total of 146 cases of brucellosis were reported from 2011 to 2017. The incidence of brucellosis increased from 0.23/100 000 in 2011 to 2.98/100 000 in 2017, showing an increasing trend year by year (χ2trend=55.56, P < 0.05); the scope of outbreak was expanding, and the epidemic area was spread from 2 towns (streets) in 2011 to 17 towns (streets) in 2017. There were cases of brucellosis in the whole year, the onset time was mainly concentrated in April and May; the gender of the patients was mainly male, and the male-female ratio was 2.84: 1.00 (108:38); the onset age was mainly concentrated in 30-70 years old; the occupational distribution was dominated by farmers. The transmission route was mainly direct contact infection of occupational population, accounting for 78.77% (115/146); followed by food-borne infection, accounting for 13.70% (20/146).@*Conclusions@#The outbreak of brucellosis in Laiwu City is on the rise and the scope of the epidemic area is expanding, occupation is dominated by farmers, the transmission route is mainly direct contact. The health education and awareness of self-protection for related occupational population should be strengthened.
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Objective To analyze the epidemiological trend and characteristics of human brucellosis in Laiwu City of Shandong Province, and to provide a scientific basis for improving prevention and control strategies and measures. Methods The information on the outbreaks of brucellsis in Laiwu City from 2011 to 2017 collected from the "Infectious Disease Reporting Information Management System" in the "China Information System of Disease Prevention and Control", and a retrospective analysis method was used to descriptive statistical analysis of the three distributions (time distribution, regional distribution, population distribution) and transmission route of brucellosis cases. Results A total of 146 cases of brucellosis were reported from 2011 to 2017. The incidence of brucellosis increased from 0.23/100000 in 2011 to 2.98/100000 in 2017, showing an increasing trend year by year (χ2trend = 55.56, P < 0.05); the scope of outbreak was expanding, and the epidemic area was spread from 2 towns (streets) in 2011 to 17 towns (streets) in 2017. There were cases of brucellosis in the whole year, the onset time was mainly concentrated in April and May; the gender of the patients was mainly male, and the male-female ratio was 2.84 : 1.00 (108 : 38); the onset age was mainly concentrated in 30 - 70 years old; the occupational distribution was dominated by farmers. The transmission route was mainly direct contact infection of occupational population, accounting for 78.77％ (115/146); followed by food-borne infection, accounting for 13.70％ (20/146). Conclusions The outbreak of brucellosis in Laiwu City is on the rise and the scope of the epidemic area is expanding, occupation is dominated by farmers, the transmission route is mainly direct contact. The health education and awareness of self -protection for related occupational population should be strengthened.
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Objective To investigate characteristics of Treponema pallidum (Tp)-induced macrophage-derived exosomes and its effect on the proliferation of human umbilical vein endothelial cells (HUVEC).Methods Tp strains were collected from the testis of male rabbit,which were infected with Tp (Nichols strain).The human mononuclear macrophages (THP-1) were induced into macrophages by incubation with propylene glycol methyl ether acetate (PMA),and then the macrophages were divided into 2 groups:experimental group incubated with Tp for 12 hours followed by 48-hour normal culture,and control group receiving normal culture.After the treatment,exosome suspensions were collected,and exosomes were extracted by differential centrifugation and exoEasy Maxi Kit.Transmission electron microscopy and Western blot analyses were performed to identify the exosomes,and nanoparticle tracking analysis (NTA) was conducted to measure the diameters and concentrations of exosomes.In vitro cultured HUVECs were divided into 3 groups,which were cultured with the 10 μl of suspensions containing exosomes derived from Tp-stimulated macrophages at a concentration of 4.5 × 108/ml (experimental group),10 μl of suspensions containing exosomes derived from untreated macrophages at a concentration of 4.5 × 108/ml (control group),and 10 μl of exosome eluents (exosome eluent group),respectively.After the treatment,confocal laser scanning microscopy was performed to observe the phagocytosis of exosomes of HUVECs,and cell counting kit-8 to evaluate the proliferative activity of HUVECs.Results The exosomes were saucer-like microvesicles with diameters of 30-100 nm under the transmission electron microscope.Western blot analyses showed that membrane proteins CD63,CD9 and CD81 were abundantly expressed by exosomes.Under the same conditions,NTA revealed that there were no significant differences in the particle diameter (u =1.90,P ＞ 0.05) and concentration of exosomes (Z =-1.604,P =0.109) between the experimental group and the control group.After co-culture with HUVECs for 5 hours,confocal laser scanning microscopy showed scatteredly distributed exosomes with green fluorescence in the HUVECs in the experimental group and control group.After 12-hour co-culture with the exosome suspensions,the proliferative activity of HUVECs was significantly higher in the experimental group and the control group than in the exosome eluent group (both P ＜ 0.05).After 24-and 48-hour treatment with exosome suspensions,the proliferative activity of HUVECs in the control group was still significantly increased compared with that in the exosome eluent group,and peaked at 48 hours (all P ＜ 0.05).Moreover,there were no significant differences in the proliferative activity of HUVECs between the experimental group and exosome eluent group at 24 and 48 hours (both P ＞ 0.05).At 72 hours,no significant differences in the proliferative activity of HUVECs were observed among the experimental group,the control group and the exosome eluent group (all P ＞ 0.05).Conclusions The exosomes secreted by THP-1 cells-derived macrophages evidently increased the proliferative activity of HUVECs within 48 hours,which peaked at 48 hours.After the stimulation with Tp,the exosomes secreted by THP-1 cells-derived macrophages were similar to those without Tp stimulation in morphology,size and concentration,and only increased the proliferative activity of HUVECs within 12 hours.
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To introduce a trend chart electronic nursing record sheet which takes the real-time data acquisition and monitoring module as the core technology, and observes its characteristics and advantages in clinical application. At the same time, it makes a prospect for the information construction of the critical care record. The module can acquire and upload monitoring data of monitor and ventilator in real time, automatically and completely. The data can be extracted according to the setting frequency and uploaded to the hospital information system (HIS). In the corresponding position of the intensive care record Generate dynamic change trends and save the monitoring data in the database, and the data can be stored for a long time. The application of real-time data acquisition module can save indirect nursing time and improve the nursing efficiency, meanwhile, the whole monitoring data is of great significance to the research and medical records analysis.
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Objective To investigate how the clinical pharmacists participate in the regime design and adjustment in the treatment of infectious disease and to show how clinical pharmacists to team with physicians for patient′s infection control by contributing their special knowledge .Method From August 2012 to April 2014 ,141 patients were consulted by the clinical pharmacists for the infectious diseases .The patient′s basic information ,ward distribution ,consultation purpose ,etiology of infections and adoption of the suggestions were analyzed .Results Among 141 consulted cases ,most patients belonged to the urology ,hepatobiliary surgery and neurosurgery department (accounted for 26 .95% ,21 .99% and 17 .73% respectively) .The top three consultation subjects are the use of ‘special use class’ antimicrobials ,regime adjustment and medication choice (ac-counted for 85 .82% ,74 .62% and 59 .57% ) .133 suggestions from clinical pharmacists were accepted ,1 was partially adopted and 7 were rejected (accounted for 94 .33% ,0 .71% and 4 .96% ) .Conclusion The clinical pharmacists play important roles in the treatment of infectious disease by providing the consultations to clinicians .With their special knowledge ,clinical pharma-cists can make a good contribution to ensure the safe and effective drug therapies .
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Objective To investigate the inhibitory effect of rhIFN-γ on human chronic myeloid leukemia cell line K562,and the impaction on the expression of CD123.Methods MTT method was used to test cell relative viability with rhIFN-γ at different concentrations.The expression of CD123 on K562 ceils was detected by flow cytometry.Results The relative inhibition of K562 cells proliferation was hampered when the cells were treated with rhIFN-γ for 72 h at the concentration of 5 x 10P ～ 108 U/L,respectively.However,rhIFN-γ at 2 x 105 U/L was benefit to K562 cells proliferation.After treatment with rhIFN-γ at 0,2 x 105 U/L and 107 U/L,the percentages of CD123 expression on K562 cells were (4.10 ± 1.46) ％,(7.2 ± 2.50) ％ as well as (21.6 ± 1.17) ％,respectively.Compared with the control group,107 U/L rhIFN-γ significantly increased the expression of CD123 on K562 cells (P＜0.05).Conclusion The effect of rhIFN-γ on the growth of K562 cells has two aspects (inhibition or proliferation),and it can increase the expression of CD 123.