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@#Objective To provide clinical reference for the perioperative management of esophageal cancer patients with different stages of chronic obstructive pulmonary disease (COPD) through investigating the impact of COPD on postoperative complications and survival in esophageal cancer patients undergoing oesophagectomy. Methods The clinical data of 163 patients who underwent radical resection of esophageal cancer in our department from January 2015 to January 2018 were retrospectively analyzed, including 124 males and 39 females, with a median age of 64 years (IQR: 23.8 years). They were divided into a COPD group (n=87) and a non-COPD group (n=76) according to the presence of COPD before operation. The clinical data were collected and the postoperative complications and 2-year survival between the two groups were compared and analyzed. Results The incidence of major postoperative complications (pulmonary infection, respiratory failure, arrhythmia and anastomotic leakage) in the COPD group were higher than those in the non-COPD group (all P<0.05). Spearman correlation analysis showed that the severity of preoperative COPD was positively correlated with the incidence of postoperative complications in patients with esophageal cancer (r=0.437, P<0.001). The incidence of postoperative respiratory failure and mortality in patients with severe COPD were significantly higher than those in patients without COPD and those with mild or moderate COPD. The 2-year survival rate of patients with esophageal cancer in the COPD group was lower than that in the non-COPD group (56.1%vs. 78.5.%, P=0.001), and the severity of COPD was negatively correlated to the survival rate. Conclusion COPD significantly increases the incidence of postoperative complications in patients with esophageal cancer, which is not conducive to the prognosis of patients, and the severity of COPD is correlated with postoperative complications and 2-year survival rate.
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The distal femoral fracture, tibial plateau fracture and patellar fracture may all develop into traumatic knee arthritis, which is probably associated with knee dysfunction problems. Total knee arthroplasty (TKA) is an effective treatment for end-stage knee arthritis. The distal femoral valgus cut angle (VCA) is an important reference for distal femoral resection in TKA and significantly affects postoperative prosthesis position and lower extremity alignment after TKA. For VCA, the specific methods for definition, measurement methods, clinical application and influencing factors are currently controversial. Hence, the authors review the research progress in the role of VCA in TKA from the above-mentioned four aspects, hoping to provide a reference for accurate preoperative planning and intraoperative performance of TKA.
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Total knee arthroplasty (TKA) is an effective treatment for end-stage knee disease, with the postoperative alignment, component position, soft tissue balance, and prosthesis matching being key factors for the success of TKA. In order to achieve more accurate postoperative alignment and component position, better soft tissue balance and prosthesis matching for longer prosthesis longevity, better postoperative function and higher patient satisfaction, various intelligent accuracy technological aids such as computer assisted navigation (CAN), patient specific instrumentation (PSI), surgical robots, microsensors, customized implants (CI) and personalized 3D preoperative planning have emerged and are given high expectation. In this paper, the authors review the application and research progress of the above technological aids mainly from aspects of alignment, component position, clinical outcomes and cost analysis, so as to provide a reference for the application of related technological aids in TKA.
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Objective: To discuss the effect of herbal compatibility on the components of volatile oils in Menthae Haplocalycix Herba and Schizonepetae Herba,and the comparison of the anti-bacterial effects in vitro,in order to provide the experimental basis for investigating the effective material basis of their herb-pair. Method: Steam distillation was used to extract volatile oils of Menthae Haplocalycix Herba, Schizonepetae Herba,and their combination. GC-MS was employed to analyze their volatile oils,and the anti-bacterial effects in vitro were compared. Result: Totally 50 compounds were identified from the volatile oils of Menthae Haplocalycix Herba;41 compounds were identified from the volatile oils of Schizonepetae Herba;and 60 compounds were identified from the volatile oils of their herbal pairs. A total of 27 common compounds were found in the samples of three volatile oils. Totally 5 new compounds were detected in the volatile oils of their herbal pairs,and 9 compounds were not detected. In vitro,volatile oils of both their herbal pairs and individual herbs had bacteriostatic effects on dung Enterococcus (ATCC2922),Staphylococcus aureus (ATCC2923),Escherichia coli (ATCC35218),and E. coli (ATCC25922). Among them,volatile oils of their herbal pairs had stronger bacteriostatic effects on dung enterococcus (ATCC2922) and staphylococcus aureus (ATCC2923) than volatile oils of individual herbs. Moreover,the order of the inhibitory effects of volatile oils on E. coli (ATCC35218 and ATCC25922) were "herbal pairs=peppermint > herba schizonepetae". Conclusion: There were some changes between the volatile oils of individual herbs and the volatile oils of their herbal pairs. These phenomena may be caused by the occurrence of certain chemical reactions and physical changes in compatibility of decocting process. The antibacterial effects of volatile oils of their herbal pairs were better than those of individual herbs in vitro.
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Depression is a kind of mental illness accompanied by complex etiology and pathogenesis in clinic. With the quickening pace of circadian rhythm and increase of life pressure in modern society, the incidence of depression is increasing year by year. Nowadays, some typical antidepressant Western medicines, such as selective serotonin re-uptake inhibitors (SSRI) and tricyclic antidepressants (TCA), have been used as the main therapeutic drugs in clinic. Unfortunately, administration of these drugs will result in severe adverse reactions, slow treatments, and low cure rates, thus obviously they can not be used for a long term. Sini San, which originated from written by Zhang zhongjing, is a prescription widely applied in clinic for curing mental illness and also a basic Chinese herbal formula for modern treatment of depression. This article would review the research progress on antidepressant effects of Sini San based on single herbs of Bupleuri Radix and Paeoniae Radix Alba, herb-pair of Bupleuri Radix-Paeoniae Radix Alba, and formula of Sini San, providing directions and ideas for future research on complicated Chinese herbal formulae.
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Humans , Antidepressive Agents , Pharmacology , Bupleurum , Chemistry , Depression , Drug Therapy , Drugs, Chinese Herbal , Pharmacology , Paeonia , ChemistryABSTRACT
Objective To develop an HPLC-MS/MS method for the simultaneous determination of 26 bile acids in Calculus Bovis Sativus (CBS) and Calculus Bovis (CB). Methods Chromatographic separation was performed on a Symmetry C18 column (150 mm × 2.1 mm, 3.5 μm) with linear gradient elution of water (0.1% formic acid + 10 mmol/L ammonium acetate) and methanol (0.1% formic acid + 10 mmol/L ammonium acetate) at a flow rate of 0.15 mL/min, and the injection volume was 10 μL. Switching electrospray ion source polarity in negative mode. The ion spray voltage was set at - 4 500 V, the turbo spray temperature was maintained at 350 ℃, and multiple-reaction monitoring (MRM) was employed. Results The 26 bile aicds showed good linearity within the linear ranges (r ≥ 0.991 4). The average recoveries of the bile acids ranged from 98.2% to 102.3%. The precisions (RSD) for the investigated components were less than 0.95%. There are some differences in variety and chemical components between CBS and CB. Conclusion The proposed method is reliable and has high sensitivity and good specificity, which allows the determination of various bile acids in CB.
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The metabolic profile of bile acids (MPBA) is an indicator that reflecting the varieties, contents and variations of biological bile acids (BAs). Many kinds of detection techniques can be used to detect different kinds of BAs in different tissues. By using various detection techniques, the MPBA has been applied in various diseases such as hepatobiliary diseases, gastrointestinal diseases, metabolic diseases and nervous system diseases and so on. In this paper, we reviewed the process of BAs synthesis and metabolism and analyzed the detection techniques of BAs in different tissues and the corresponding MPBA. At the same time, we summarized the application of BAs metabolism in related diseases. The MPBA provides a reference for the diagnosis and treatment of some diseases and it has certain advantages in disease diagnosis and curative effects evaluation, which worth further study.
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In order to realize the seamless connection between superior and inferior medical institutions and simplify the process of patient referral to superior medical hospitals from the community medical institutions,Zhenjiang First People's Hospital designs a two-way referral platform for direct registration to Zhenjiang First People’s Hospital from community medical institutions.The paper introduces the design process,features and realization steps of this platform.The platform can realize the sharing of patient information between the community medical institutions and the hospital,facilitate patients' seeing a doctor and improve medical service level.
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Objective:To establish a liquid chromatography tandem mass spectrometry ( LC-MS/MS) method for the determination of 5-fluorouracil (5-Fu) in patient’s plasma and apply it in clinics patients validation. Methods:5-Fu was analyzed on an Agela Inno-val NH2 (2. 1 mm × 50 mm, 5 μm) column. Methanol:ultra pure water (2 ∶98) was used as the mobile phase with isocratic elution. The flow rate was 0. 3 ml ·min-1 and the column temperature was set at 40℃. The ion transitions with electrospray ionization negative model were m/z 128. 8→42. 1 and m/z 188. 6→42. 1 for 5-Fu and 5-bromouracil (the internal standard), respectively. The LC-MS/MS method was verified according to the guideline of quantitative analysis validation of biological samples ( Chinese Pharmacopoeia, 2015 edition, the fourth part) . Results:The calibration curve of 5-Fu was linear within the range of 10-1 000 ng · ml-1 . The lower limit of quantification was 10 ng · ml-1 . The precision, accuracy, matrix effect and stability within the linear range were all in line with the requirements of method validation. Conclusion:The LC-MS/MS method developed in the study for the determination of 5-Fu is simple, rapid, accurate and reproducible, which can be used for the plasma concentration detection of 5-Fu in patients.
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Objective:To summarize the drug interactions of haloperidol used in combination with the other drugs to provide refer-ence for safe, reasonable and effective use of haloperidol in clinics. Methods:By retrieving Micromedex? , Pubmed, CNKI and so on, the interactions between haloperidol and the other drugs were summarized and analyzed. Results:The effect of haloperidol was on do-pamine receptors, and haloperidol was mainly metabolized by hepatic cytochrome P450 ( CYP) enzymes. When haloperidol was com-bined with the other drugs, significant interactions of pharmacokinetics and pharmacodynamics were induced by affecting CYP enzymes or dopamine receptor. Conclusion:In clinical practice, the other drugs combined with haloperidol should be reasonable and careful to ensure safe, effective and rational drug use.
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Mobile medical service for patients is realized through Alipay hospital service window based on the new medical insurance mobile payment platform.The paper introduces overall business architecture of the platform and payment procedure realizing scheme,platform implementation and offline procedure to adapt to the platform,realizing real-time payment,optimizing the procedure of outpatient medical treatment,improving patients' experiences of being treated and enhancing their satisfaction.
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Objective:To investigate the effect of extract of mung bean seed coat ( MBSC) on the activity of CYP3A4 in vitro. Methods:Midazolam was used as the probe drug, and an HPLC method for determining the metabolite of midazolam ( l-hydroxyl mid-azolam) in rat liver microsome incubation system was established. Three important parameters including the incubation time, concen-tration of rat microsome and probe concentration were optimized for rat liver microsome incubation system, and then the optimal incuba-tion system was applied to study the effect of MBSC extract on CYP3A4 activity and the potential mechanism. Results: The results showed MBSC crude extract could inhibit CYP3A4 activity to 38. 14% as that in the control group(P<0. 05) with IC50 value of 489. 7μg·ml-1 . The mechanism might be related to competition-noncompetition inhibition. Conclusion: MBSC extract exhibits inhibitive potency to CYP3A4 in in-vitro model. Further studies should be conducted to check the influence of MBSC on CYP3A4 in vivo.
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Objective:To investigate the effect of extract of mung bean seed coat ( MBSC) on the activity of CYP3A4 in vitro. Methods:Midazolam was used as the probe drug, and an HPLC method for determining the metabolite of midazolam ( l-hydroxyl mid-azolam) in rat liver microsome incubation system was established. Three important parameters including the incubation time, concen-tration of rat microsome and probe concentration were optimized for rat liver microsome incubation system, and then the optimal incuba-tion system was applied to study the effect of MBSC extract on CYP3A4 activity and the potential mechanism. Results: The results showed MBSC crude extract could inhibit CYP3A4 activity to 38. 14% as that in the control group(P<0. 05) with IC50 value of 489. 7μg·ml-1 . The mechanism might be related to competition-noncompetition inhibition. Conclusion: MBSC extract exhibits inhibitive potency to CYP3A4 in in-vitro model. Further studies should be conducted to check the influence of MBSC on CYP3A4 in vivo.
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Ulcerative colitis is a chronic, nonspecific and complex intestinal disease. The current clinical treatment guideline of this disease recommends a variety of options with oral western medicines, such as aminosalicylic acids, glucocorticosteroids, and immunosuppressors. However, due to their unstable therapeutic effects, high toxicities, and strong drug dependence, they are not suitable for long-term administration. Baizhu Shaoyao powder, a traditional Chinese medicinal prescription, is clinically and commonly used for tonifying spleen and softening liver as well as eliminating dampness and relieving diarrhea. Recent researches suggest that Baizhu Shaoyao powder has significant effect in the treatment of ulcerative colitis. This article reviewed the research progress on the curative effect and action mechanism of Baizhu Shaoyao powder in treating ulcerative colitis, and provided the ideas and directions for its further research in future.
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As the smallest unit of traditional Chinese medicinal formula compatibility, herb-pair has the basic characteristic of traditional Chinese medicinal formula compatibility. In recent years, herb-pair investigation has attracted much attention, which is an indispensable part of modernization of traditional Chinese medicine. With the decrease of the efficiency in the discovery of new drug, how to discover new drugs from traditional Chinese medicinal herb-pair has also been a bottleneck for the research and development of drug. The authors reviewed the domestic and foreign literatures in the latest years and summarized the current situations and the existing problems of herb-pair study. Based on these investigations, the authors innovatively proposed a novel concept of "precision herb-pair". Difference from traditional Chinese medicinal herb-pair or formulae with extensive roles and unclear efficacies, "precision herb-pair" belongs to a developed new mini herb-pair formula with an exact treatment and a relatively clear composition based on a certain specific disease. In addition, the authors also proposed a new strategy of "herb-pair - screen of multiple constituents based on column separation and in vitro cell viability - fuzzy target recognition pharmacology - re-evaluation of precision herb-pair", and successfully applied it to the development of a precision herb-pair from Astragali Radix-Corni Fructus in treatment of diabetic nephropathy. This proposed new strategy is simple, easy to carry out, and has a wide application, and can offer references and thoughts for the modern investigation of herb-pair and the research and development of new drug.
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OBJECTIVE:To establish a method for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film. METHODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of methanol-20 mmol/L phosphate buffer(pH was adjusted to 7.40 with glacial acetic acid)(55∶45,V/V)at a flow rate of 1.0 ml/min, column temperature was 30 ℃,detection wavelength was 242 nm and volume injection was 10 μl. RESULTS:The linear range were 1-100μg/ml for both ornidazole(r=0.999 7)and dexamethasone sodium phosphate(r=0.999 9);RSDs of precision,stabili-ty and reproducibility tests were lower than 2.0%;recoveries were 96.50%-99.80%(RSD=1.02%,n=9) and 96.50%-99.60%(RSD=0.99%,n=9). CONCLUSIONS:The method is specific with good precision and stability and high accuracy,and can be used for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film.
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OBJECTIVE: To investigate the compatibility of dexamethasone sodium phosphate injection and ondansetron hydrochloride injection. METHODS: The dexamethasone sodium phosphate injection and ondansetron hydrochloride injection were dissolved with 5% glucose injection and 0.9% sodium chloride injection respectively at commonly used concentrations in clinic. The contents of dexamethasone sodium phosphate and ondansetron hydrochloride were determined by HPLC at 0, 3, 6, and 24 h after the preparation of solution. Meanwhile, the pH and number of indiscerptible particles in these solutions were also determined. RESULTS :The mixtures of the two drugs were highly stable within 24 h, without obvious change in pH and color. The numbers of insoluble particles greater than 10 and 25 μm were acceptable. CONCLUSION: Dexamethasone sodium phosphate injection is compatible with ondansetron hydrochloride injection.
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<p><b>OBJECTIVE</b>To evaluate the effect of thermal cycling on surface microstructure of different light-curing composite resins.</p><p><b>METHODS</b>A nanofilled composite (Z350) and 4 microhybrid composites (P60, Z250, Spectrum, and AP-X) were fabricated from lateral to center to form cubic specimens. The lateral surfaces were abrased and polished before water storage and 40 000 thermal cycles (5/55 degrees celsius;). The mean surface roughness (Ra) were measured and compared before and after thermal cycling, and the changes of microstructure were observed under scanning electron microscope (SEM).</p><p><b>RESULTS</b>Significant decreases of Ra were observed in the composites, especially in Spectrum (from 0.164±0.024 µm to 0.140±0.017 µm, P<0.001) and Z250 (from 0.169±0.035 µm to 0.144±0.033 µm, P<0.001), whose Ra approximated that of P60 (0.121±0.028 µm) with smoothly polished surface. SEM revealed scratches and shallower pits on the surface of all the 5 resins, and fissures occurred on Z350 following the thermal cycling.</p><p><b>CONCLUSION</b>Water storage and thermal cycling may produce polishing effect on composite resins and cause fissures on nanofilled composite resins.</p>
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Composite Resins , Dental Polishing , Light-Curing of Dental Adhesives , Materials Testing , Surface Properties , TemperatureABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of synthesized advanced glycation end products (AGE) on apoptosis of human gingival fibroblasts (HGF) and the possible role of caspase-dependent pathway in the process of AGE-induced apoptosis.</p><p><b>METHODS</b>HGF were incubated with AGE-human serum albumin (AGE-HSA). The activity of caspase-8, caspase-9 and caspase-3 were detected by microplate reader after 12 and 24 hours. HGF were incubated with caspase inhibitors for 1 hour, and then incubated with AGE-HSA for 24 hours, HGF was first stained by Hoechst33258 and observed under inverted microscope, and then double stained by annexin V and propidine iodide (PI) and observed by flow cytometry (FCM). The activity of caspase-3 was determined by caspase-3 assay kit and observed by microplate reader.</p><p><b>RESULTS</b>Caspases activity of caspase-8, -9, -3 was 0.1097 ± 0.0051, 0.0965 ± 0.0051 and 0.1280 ± 0.0103 after 12 h of incubation with AGE-HSA and HGF, respectively, and 0.1558 ± 0.0053, 0.1308 ± 0.0035 and 0.1954 ± 0.0051 after 24 h of incubation with AGE-HSA and HGF, respectively (P < 0.05). Positive cells number was 247.7 ± 32.4, 200.1 ± 14.6, 154.1 ± 14.4 and 131.3 ± 14.6 in caspase inhibitor groups by Hoechst33258 staining, respectively. Apoptotic rate was (25.57 ± 2.20)%, (38.87 ± 3.31)%, (17.17 ± 2.24)% and (14.73 ± 2.48)% in caspase inhibitor groups by annexin V-PI staining, respectively. The difference between different groups was significant (P < 0.05). Caspase-3 activity was reduced to 0.1274 ± 0.0076, 0.1465 ± 0.0062, 0.1044 ± 0.0051 in caspase inhibitor groups, respectively. The difference between different groups was significant (P < 0.05).</p><p><b>CONCLUSIONS</b>Apoptosis of HGF induced by AGE-HSA may be mainly through activation of caspase-dependant pathway in which cytoplasmic pathway may play a predominant role.</p>
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Adolescent , Adult , Child , Humans , Young Adult , Apoptosis , Caspase 3 , Metabolism , Caspase 8 , Metabolism , Caspase 9 , Metabolism , Caspase Inhibitors , Pharmacology , Caspases , Metabolism , Cells, Cultured , Fibroblasts , Cell Biology , Metabolism , Gingiva , Cell Biology , Glycation End Products, Advanced , Pharmacology , Oligopeptides , Pharmacology , Serum Albumin , Pharmacology , Serum Albumin, Human , Signal TransductionABSTRACT
<p><b>OBJECTIVE</b>To study the clinical results of surgery for rotationally and vertically unstable pelvis fracture.</p><p><b>METHODS</b>Thirty-four patients with rotationally and vertically unstable pelvis fractures were treated. There were 23 male and 11 female,with the average age of 36 years ranging from 13 to 56 years. There were 9 cases of type APC III, 14 cases of type LC III, and 11 cases of type VS according to Young-Burgess Classifiction. All patients' pelvis were treated with temporary external fixation after hospitalization, and were treated with open reduction and internal fixation through anterior approach after stabilization of body condition.</p><p><b>RESULTS</b>All patients were followed up for 12 to 48 months (average 21 months). All the incisions healed well, and the fractures got union for 3 to 6 months. According to the Majeed evaluation, the results were excellent in 21 cases, good in 10, fair in 3. All patients were not remained deformity of rotation and dislocation. But 3 patients remained lameness, 4 remained low back pain, 3 remained both leg and feet numbness.</p><p><b>CONCLUSION</b>In the management of the rotationally and vertically unstable pelvis fractures, a stable pelvis can be reconstructed by effective open reduction and internal fixation through the anterior approaches, so that further sequelae can be reduced.</p>