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ObjectiveTo observe the effect of Huangqi Baihe granules on the hypoxia-inducible factor 1α （HIF-1α）/nuclear factor-κB （NF-κB）/NOD-like receptor hot protein domain related protein 3 （NLRP3） signaling pathway in a rat model of high altitude hypoxia. MethodSixty male SPF SD rats were randomly divided into blank group， model group， dexamethasone group （5 mg·kg-1）， and high， middle， and low-dose groups of Huangqi Baihe granules （4.1， 2.05， 1.025 g·kg-1）. Among them， each Chinese medicine group was administrated orally for continuously 14 d， once a day， and the dexamethasone group was injected intraperitoneally for continuously 3 d as the positive control group. On the 15th d， the model group， dexamethasone group， and high， middle， and low dose groups of Huangqi Baihe granules were exposed to the simulated high altitude， low pressure， and low oxygen environment in the animal low-pressure simulation cabin， and the exposure lasted for 3 d. Blood was collected from the abdominal aorta and serum was separated， and the brain tissue was taken after being killed. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in brain tissue. Enzyme-linked immunosorbent assay （ELISA） was used to detect the content of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in rat serum. Western blot was used to detect HIF-1α， NLRP3， phosphorylated nuclear factor-κB （p-NF-κB）， NF-κB， desquamation D （GSDMD）， and cysteine aspartate-specitis protein-1（Caspase-1） in rats of each group. The mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 were detected by real-time quantitative polymerase chain reaction （Real-time PCR）. ResultThe results of HE staining showed that as compared with the normal group， the pathological sections of brain tissues in the model group showed that pyramidal cells were loosely arranged and distributed in disorder， with different sizes. Compared with the model group， the pathological changes in pyramidal cells in the dexamethasone group and high and middle-dose groups of Huangqi Baihe granules were reduced. The results of ELISA showed that as compared with the normal group， the content of TNF-α， IL-6， and IL-1β in the serum of rats in the model group was significantly higher （P<0.01）. Compared with the model group， the content of TNF-α， IL-6， and IL-1β in the serum of rats in the dexamethasone group and high and middle-dose groups of Huangqi Baihe granules decreased significantly （P<0.05， P<0.01）. The results of Western blot showed that as compared with the normal group， the relative protein expression levels of HIF-1α， NLRP3， p-NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of the model group were significantly higher （P<0.01）. As compared with the model group， the relative expressions of HIF-1α， NLRP3， p-NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the dexamethasone group and the high-dose group of Huangqi Baihe granules were significantly decreased （P<0.05， P<0.01）. The relative protein expression levels of HIF-1α， NLRP3， p-NF-κB p65， and Caspase-1 in the brain tissue of rats in the middle-dose group of Huangqi Baihe granules decreased significantly （P<0.01）， and the relative protein expression of HIF-1α in the brain tissue of rats in the low-dose group of Huangqi Baihe granules was reduced （P<0.05）. The Real-time PCR analysis showed that as compared with the normal group， the mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of the model group were significantly increased （P<0.01）. As compared with the model group， the mRNA expression levels of HIF-1α， NLRP3， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the dexamethasone group were significantly decreased （P<0.01）. The mRNA expression levels of HIF-1α， NF-κB p65， GSDMD， and Caspase-1 in the brain tissue of rats in the high-dose group of Huangqi Baihe granules decreased significantly （P<0.01）. The mRNA expression levels of HIF-1α， NLRP3， and Caspase-1in the brain tissue of rats in the middle-dose group of Huangqi granules decreased （P<0.05， P<0.01）. ConclusionThe protective effect of Huangqi Baihe granules on acute brain injury in low-pressure hypoxic rats may be related to the HIF-1α/NF-κB/NLRP3 signaling pathway.
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Objective:To analyze the cognitive dysfunction and its influencing factors in patients with multisystem atrophy(MSA).Methods:A total of 143 hospitalized patients with MSA in our hospital from January 2015 to January 2020 were selected as the research objects.The cognitive function was evaluated by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scales, meanwhile, the influencing factors of cognitive function were analyzed.Results:The average score of MMSE scale of 143 MSA patients ranged from 9 to 30 points, and the MMSE test identified 86 patients(60.1%)with cognitive impairment, including 58 cases(40.6%)with mild cognitive impairment, 27 cases(18.9%)with moderate cognitive impairment and 1 case(0.7%)with severe cognitive impairment.The average score of MoCA scale of 143 MSA patients ranged from 5 to 30 points, among which 111 cases(77.6%)had cognitive impairment, including 69 cases with mild cognitive impairment(48.3%), 35 cases with moderate cognitive impairment(24.5%)and 7 cases with severe cognitive impairment(4.9%). Both the total scores of MMSE and MoCA scores of MSA patients were not correlated with age of onset, old age, gender, disease duration, type of MSA(MSA-C), orthostatic hypotension(OH), urinary retention, positivity of anal sphincter electromyography(ASEMG), triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), fasting blood glucose and glycosylated hemoglobin, serum uric acid and residual urine volume(all P>0.05). Logistic regression analysis showed that fasting blood glucose was a risk factor for cognitive impairment identified by MMSE( OR=2.224, 95% CI: 1.108-4.462, P=0.024); MSA-C( OR=3.905, 95% CI: 1.302-11.713, P=0.015)and TG( OR=3.494, 95% CI: 1.061-11.501, P=0.040)were risk factors for cognitive impairment identified by MoCA.There were no significant differences in above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients identified by MMSE scale( P>0.05). Similarly, there were no significant differences in the above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients by MoCA scale( P>0.05). Logistic regression analysis showed that TG was a risk factor for moderate to severe cognitive impairment identified by MMSE( OR=17.624, 95% CI: 2.596-119.669, P=0.003), while TC was a protective factor( OR=0.006, 95% CI: 0.000-0.714, P=0.036). Logistic regression analysis did not find the influencing factors of moderate to severe cognitive impairment as suggested by MoCA score. Conclusions:There is a high incidence of cognitive impairment in MSA patients.The type of MSA(MSA-C), blood glucose and blood lipid may be influence factors of cognitive impairment in MSA patients.Age of onset, old age, gender, disease duration, autonomic dysfunction, and uric acid have no significant correlation with cognitive impairment of MSA.
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Objective@#To understand the vitamin D nutritional status and associated factors of children and adolescents aged 6-18 in Yinchuan, so as to provide theoretical basis for improving the vitamin D malnutrition status of children and adolescents.@*Methods@#Using stratified cluster sampling method, 1 615 children and adolescents from 36 classes in 2 primary schools, junior high schools and high schools were randomly selected from Yinchuan, Ningxia. Venous blood sampling,physical examinations and questionnaires were conducted.@*Results@#The vitamin D deficiency rate and appropriate rate for students were 66.9% and 33.1%, respectively. There was a statistically significant difference in vitamin D deficiency among different age groups(χ2=25.65, P<0.05). The 6-year-old group had the highest(79.2%), followed by the 13-year-old group (76.6%), and the 12-year-old group (75.3%). The results of binary Logistic regression showed that the factors influencing the vitamin D nutritional status of children and adolescents included age(OR=0.95), daily outdoor exercise time(OR=0.49), exclusive breastfeeding (OR=0.63) and mother’s education(OR=0.73, 0.43). The decision tree QUEST and Logistic regression combination model results show that the key factors affecting vitamin D nutrition status include daily outdoor exercise time, age, mother’s education, BMI, and interaction between outdoor exercise time and age, interaction between outdoor exercise time and mother’s education, interaction between age and mother’s education, interaction between exclusive breastfeeding and BMI.@*Conclusion@#The detection rate of vitamin D deficiency in children and adolescents aged 6-18 in Yinchuan is high, factors associated with vitamin D nutritional status includes daily outdoor exercise time, age, mother’s education, BMI, and interaction between outdoor exercise time and age, interaction between outdoor exercise time and mother’s education, interaction between age and mother’s education, interaction between exclusive breastfeeding and BMI.
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Objective:To investigate the characteristics of Parkinson's disease (PD)combined with orthostatic hypotension (OH)and the impact of the condition on cognitive function.Methods:A total of 210 PD patients admitted to Beijing Tiantan Hospital were consecutively enrolled.Demographic data and clinical characteristics were recorded.Patients were divided into the PD with OH (PD-OH)group and the PD without OH (PD-NOH)group based on blood pressure values measured in both the supine and upright positions.Cognitive function of PD patients was evaluated using the Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment (MoCA)scales.Results:Of 210 PD patients, 68 (32.4%)had OH.Patients in the PD-OH group had a higher mean age (69.7±8.9 years vs.62.1±11.3 years), longer disease duration [5.0 (3.0-8.0)years vs.4.0 (2.0-6.0)years], a higher incidence of diabetes (30.9% vs.17.4%), higher levels of fasting blood glucose (5.3±1.1 mmol/L vs.5.0±1.0 mmol/L)and glycated hemoglobin A1c (6.1±0.9% vs.5.7±0.7%), and more advanced Hoehn-Yahr staging [stage 2.5 (2.0-3.0) vs.stage 2.0 (1.5-2.5)]than the PD-NOH group ( P<0.05). The total scores of the MMSE and MoCA scales were lower in the PD-OH group than in the PD-NOH group (25.1±4.9 scores vs.26.8±4.0 scores, 19.4±5.4 scores vs.21.4±5.3 scores, P<0.05). A comparison of each cognitive domain of the MMSE scale between the two groups revealed that the scores of attention and calculation (3.7±1.7 scores vs.4.2±1.3 scores), delayed recall (2.1±1.0 scores vs.2.5±0.8 scores)and visuospatial ability (0.6±0.5 scores vs.0.7±0.5 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). A comparison of each cognitive domain of the MoCA scale between the two groups displayed that the scores of visuospatial and executive function (2.4±1.6 scores vs.2.9±1.7 scores)and delayed recall (1.3±1.4 scores vs.2.3±1.6 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). Logistic regression analysis showed that age ( OR=1.061, 95% CI: 1.022-1.102, P=0.002)and score of delayed recall of the MoCA scale ( OR=0.690, 95% CI: 0.498-0.955, P=0.025)were independent related factors for PD-OH. Conclusions:Compared with patients without OH, PD-OH patients are older and have a longer duration, increased disease severity, and a higher incidence of and more serious diabetes mellitus.Age is an independent related factor for PD-OH.Cognitive function is significantly impaired in PD-OH patients, and delayed recall is an independent related factor for PD-OH.
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Objective@#To investigate the clinical characteristics of sleep disorders(SD)in patients with Alzheimer's disease(AD), and the relationship between SD and cognitive impairment.@*Methods@#According to the inclusion and exclusion criteria of AD, 89 consecutive AD patients admitted to Beijing Tiantan Hospital from January 2016 to January 2017 were included.The Pittsburgh sleep quality index(PSQI)scale was used to evaluate the overall sleep status.The patients were randomized into the AD with SD(AD-SD)group(PSQI>7)and the AD without SD(AD-NSD)group(PSQI<7). The cognitive function of AD patients was evaluated by the Montreal cognitive assessment(MoCA)scale, and the overall cognitive function and cognitive domains were compared between the AD-SD and AD-NSD groups.@*Results@#Of the 89 AD patients, 71 cases(79.78%)had SD.There was no significant difference in gender, age, age of onset, education level and disease duration between the AD-SD and AD-NSD groups(P>0.05). The factors in the PSQI scale had significant differences between AD-SD和AD-NSD groups, including sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, administration of sleeping medication and daytime dysfunction(P<0.05). Compared with the AD-NSD group, the AD-SD group showed that the total score of MoCA scale was significantly reduced(P<0.05), and the scores of delayed recall and language were significantly decreased(P<0.05). There was a negative correlation of the sleep time with the total score of MoCA scale and the score of delayed recall in the AD-SD group(r=-0.245 and -0.249, P=0.041 and 0.039). Night SD was negative correlated with the total score of MoCA scale and the score of delayed recall(r=-0.248 and -0.283, P=0.038 and 0.018).@*Conclusions@#The incidence of AD-SD is up to 79.78%.AD-SD patients have a worse subjective sleep quality, longer time to fall asleep, shorter sleep time, lower sleep efficiency, higher night SD, more use of sleep drugs and more daytime dysfunction.General cognitive dysfunction, delayed recall and language impairment are more obvious in AD-SD patients.In AD-SD group, longer time to fall asleep and night SD are related to the general cognitive function and delayed recall.
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Objective To investigate the clinical characteristics of sleep disorders (SD)in patients with Alzheimer's disease(AD),and the relationship between SD and cognitive impairment.Methods According to the inclusion and exclusion criteria of AD,89 consecutive AD patients admitted to Beijing Tiantan Hospital from January 2016 to January 2017 were included.The Pittsburgh sleep quality index(PSQI)scale was used to evaluate the overall sleep status.The patients were randomized into the AD with SD(AD-SD) group (PSQI＞ 7) and the AD without SD (AD-NSD) group (PSQI ＜ 7).The cognitive function of AD patients was evaluated by the Montreal cognitive assessment (MoCA) scale,and the overall cognitive function and cognitive domains were compared between the AD-SD and AD-NSD groups.Results Of the 89 AD patients,71 cases (79.78％)had SD.There was no significant difference in gender,age,age of onset,education level and disease duration between the AD-SD and AD-NSD groups(P＞0.05).The factors in the PSQI scale had significant differences between AD-SD 和 AD-NSD groups,including sleep quality,sleep latency,sleep duration,sleep efficiency,sleep disturbance,administration of sleeping medication and daytime dysfunction(P＜0.05).Compared with the AD-NSD group,the AD-SD group showed that the total score of MoCA scale was significantly reduced(P＜0.05),and the scores of delayed recall and language were significantly decreased(P ＜ 0.05).There was a negative correlation of the sleep time with the total score of MoCA scale and the score of delayed recall in the AD-SD group(r =-0.245 and 0.249,P =0.041 and 0.039).Night SD was negative correlated with the total score of MoCA scale and the score of delayed recall(r=0.248 and-0.283,P =0.038 and 0.018).Conclusions The incidence of AD-SD is up to 79.78％.AD-SD patients have a worse subjective sleep quality,longer time to fall asleep,shorter sleep time,lower sleep efficiency,higher night SD,more use of sleep drugs and more daytime dysfunction.General cognitive dysfunction,delayed recall and language impairment are more obvious in AD-SD patients.In AD-SD group,longer time to fall asleep and night SD are related to the general cognitive function and delayed recall.
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Objective To investigate the expressions of Wnt-1 and FZD-1 in small cell lung cancer(SCLC) patients and their relations with chemotherapy resistance,clinical feature and prognosis.Methods Peripheral blood specimens were collected from 41 SCLC patients.The expression of Wnt-1 and FZD-1 in peripheral blood monouclear cells (PBMC) were detected.The relationship among the expression of Wnt-1 and FZD-1,clinicopathologic feature and prognosis was analyzed.Results The relative expression of Wnt-1 and FZD-1 in chemotherapy resistant group was significantly higher than that in chemotherapy sensitive group (all P ＜ 0.05).The expression of Wnt-1was positively correlated with that of FZD-1 (r =0.186,P ＜ 0.05).The FZD-1expression level was not correlated with patients' age,sex and smoking history (all P ＞ 0.05),but closely with clinic-staging (P =0.008).The Wnt-1 expression level was not correlated with patients' clinical features (all P ＞ 0.05).There was statistical difference in median survival time between Wnt-1 and FZD-1 high-expression group and low-expression group.Conclusions Wnt-1 and FZD-1relationships with chemotherapy resistance and prognosis.Wnt-1 and FZD-1 may act as an important role in chemotherapy resistance of SCLC and could be served as indicators for the chemotherapy resistance and outcome assessment of SCLC.
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OBJECTIVE:To explore the role of clinical pharmacists in the treatment of critical patients at perinatal stage. METHODS:During the treatment process of 4 critical patients at perinatal stage,according to the patients'special pathophysiolog-ic status (such as urea cycle disorder,dyslipidemia,severe infection,can not recover circulating blood volume rapidly,etc.), weighing the order of priority,based on relevant guidelines and literatures,clinical pharmacists provided individual medication ad-vices in respects of drug selection,medication timing,treatment course,drug combination and dosage adjustment,such as using cefuroxime,reduced glutathione,ursodesoxycholic acid,etc.,stopping drugs timely or adjusting antibiotics therapy plan. They al-so provided pharmaceutical care as lab index determination and ADR monitoring. RESULTS:Physicians adopted clinical pharma-cists'advices,and then 4 critical patients were all recovered. CONCLUSIONS:During the treatment course of critical patients at perinatal stage,clinical pharmacists should select safe and effective drugs as much as possible and adjust therapy plan in time ac-cording to clinical symptoms. When the security runs counter to effectiveness,clinical pharmacists should fully weigh the advantag-es and disadvantages and guarantee the maximum safety of pregnant or delivery women and fetuses.
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This article analyzed the characteristics of data of acupuncture and moxibustion in ancient books, and put forward to a mode of diagnosis and treatments according to acupuncture and moxibustion. A variety of data mining techniques were used to extract, integrate and display the theory, methods, meridians, acupoints and techniques in ancient books to establish a database platform of ancient books based on B/S architecture, which can be used by users. Also, this article described the framework, the function of the module, and the method of realizing each function of the experience platform of acupuncture ancient books, and demonstrated an interface of the results searched by key wordsstroke, and summarized the experience of building this platform and the advantages of the platform in the research and development of data of acupuncture ancient books.
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Objective To investigate the clinical features of Parkinson disease (PD)with constipation.Methods From October 2013 to August 2015,a total of 204 PD patients were consecutively recruited from the Departments of Geriatrics and Neurology,Beijing Tiantan Hospital,Capital Medical University,and were evaluated by Rome Ⅲ diagnostic criteria for functional constipation and other related scales of motor symptoms(MS)and non-motor symptoms(NMS),the activity of daily living(ADL)and quality of life.Results Overall,131 of 204(64.2％)PD patients with constipation were assigned to the PD-C group and 73 of 204 (35.8％)PD patients without constipation were assigned to the PD-NC group.In the PD-C group,38 of 131(29％)PD patients had constipation before motor symptoms occurred.The mean age and age of onset in the PD-C group were significantly older than those in the PD-NC group (64.13 ± 9.67 vs.58.35 ± 11.37;60.07 ± 10.46 vs.55.10±12.97;F=2.287,4.948;t=3.827,-2.788;P＜0.01 for both).Meanwhile,compared with the PD-NC group,the PD-C group was associated with dramatically longer disease duration (2.25,range:1.00-5.00 vs.2.00,range:1.00-3.13;Z =-2.254;P ＜ 0.05),increased scores of the Unified Parkinson Disease Rating Scale (UPDRS) Ⅲ (26.00 scores,range:18.00 37.50 vs.19.00,range:12.50-31.00;Z =-2.349,P ＜ 0.05),more advanced stages on the Hoehn-Yahr (H-Y) scale (2.00 stage,range:1.50-2.50 vs.1.50,range:1.00-2.50;Z=-2.334,P＜0.05),higher total numbers of NMS(11.00,range:6.00-15.00 vs.6.00,range:3.00-11.00;Z=-3.715,P＜0.05),and higher numbers of NMS occurring before and after MS(before,2.00,range:0.00-4.00 vs.1.00,range:0.00-2.00;after,8.00,range:3.00-14.00 vs.5.00,range:2.00-9.50;Z =-2.612,-2.630,respectively;P＜0.05 for both).Additionally,there were significant differences between the groups in the scores of the Hamilton depression scale (HAMD),the Hamilton anxiety scale (HAMA),the Pittsburgh sleep quality index (PSQI),the scales for outcomes in Parkinson disease-autonomic (SCOPA-AUT),the Fatigue severity scale (FSS),the Apathy scale,the Montreal Cognitive Assessment(MoCA)scale,the UPDRS Ⅱ and ADL Scale,and the PDQL-39 (all P＜0.05).Binary Logistic regression analysis showed that age,SCOPA-AUT,HAMA and HAMD were risk factors for PD-C(OR=1.091,1.107,1.10 and 1.080;P＜0.05 for all).Conclusions PD patients have a high incidence of constipation,and more than a quarter of patients have constipation before MS occurs.Meanwhile,PD patients with constipation are usually associated with old age and late age of onset,long disease duration,severe MS,frequent and severe NMS,bad cognition,emotional state and sleep,severe fatigue,and apathy.Moreover,advanced age,autonomic dysfunction,anxiety and depression increase the risk of PD with constipation.Constipation has a serious negative impact on the activity of daily living and quality of life in PD patients.
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Objective:To analyze the participation of clinical pharmacist in the process of diagnose and treatment of typical critical patients and summarize the clinical and pharmaceutical thoughts of clinical pharmacist in pharmaceutical care in order to provide better service for clinics .Methods:Through the participation of clinical pharmacist in the process of diagnose and treatment of one patient with hypernatronemia complicated with demyelination after liver abscess drainage , and combined with the results of laboratory tests and imaging examination and drug treatment regimen , clinical pharmacists analyzed the radical causes of apostasies and feasible therapeutic measures, and then provided the reasonable suggestions for the medication .Results: Clinical pharmacist paid close attention to the medication history and disease evolution of the patient , assessed the therapeutic efficacy timely , communicated and discussed with clin-ical doctors actively , and then made out individualized treatment schedule for the patient , which obtained promising effects .Conclu-sion:Clinical pharmacist should grasp the principal contradictions and pay attention to details , which can play an important role in the treatment course of severe patients .
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OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for sever acute pancreatitis induced by hy-perlipidemia(HL-SAP)patient. METHODS:Clinical pharmacists participated in the therapy for a pregnant patient with HL-SAP af-ter cesarean section,assisted physicians to optimize therapy plan through analyzing the disease condition according clinical guide and relevant literatures. Clinical pharmacists suggested to decrease atorvastatin 20 mg,qd to 10 mg,qd in order to avoid the risk of rhabdomyolysis and liver injury. When patient’s hemogram kept stable and infection had been controlled,clinical pharmacists suggested antibiotics de-escalation treatment:Levofloxacin injection 0.5 g,ivgtt,qd+Metronidazole injection 0.5 g,ivgtt,q12 h in-stead of meropenem. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient was recovered and transfer to gastroenterology department 15 d later. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care for HL-SAP patient after cesarean section,and assist physicians to formulate therapy plan so as to reduce the incidence of ADR effectively and guaran-tee the safe and effective use of drugs.
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PURPOSE: The -1237T/C polymorphism of the Toll-like receptor 9 (TLR9) gene has been implicated in the susceptibility of inflammatory bowel diseases (IBDs), but the results remain conflicting. We further investigated this association via meta-analysis. MATERIALS AND METHODS: Multiple electronic databases were extensively searched until February, 2015. The strength of association was evaluated by calculating the pooled odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 2987 cases and 2388 controls from eight studies were analyzed. Overall, association was found between TLR9 -1237T/C polymorphism and the risk of IBDs when all the studies were pooled (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.13, 95% CI: 1.00-1.27, p=0.05). Stratification by ethnicity indicated an association between TLR9 -1237T/C polymorphism and IBDs risk in Caucasians (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.12, 95% CI: 1.00-1.27, p=0.05). When stratified by disease type, significant correlation were only found in the Crohn's disease subgroup (recessive model, OR: 1.69, 95% CI: 1.05-2.73, p=0.03; homozygote model, OR: 1.74, 95% CI: 1.07-2.82, p=0.02; allele model, OR: 1.15, 95% CI: 1.01-1.32, p=0.04). CONCLUSION: The present study suggested that the TLR9 -1237T/C polymorphism might act as a risk factor in the development of IBDs, particularly in Caucasians.
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Humans , Alleles , White People/genetics , Genetic Predisposition to Disease/genetics , Homozygote , Inflammatory Bowel Diseases/ethnology , Odds Ratio , Polymorphism, Genetic/genetics , Risk Factors , Toll-Like Receptor 9/geneticsABSTRACT
Objective:To evaluate the anti-infective therapy in a patient with multi-site infections after brain surgery and explore the role of clinical pharmacist in the treatment. Methods:With the applications of PK/PD characteristics of drugs and the coping strategies of resistant , vancomycin combined with fosfomycin were used to treat the intracranial infection caused by methicillin-resistant Staphylococcus epidermidis with vancomycin MIC of 2 mg·L-1 , and the dynamic adjustment of antibiotics was applied to treat the pulmonary infection caused by two kinds of pathogens including MDR bacteria. Results:The intracranial infection was successfully controlled, the pulmonary infection was also under control, and the overall condition of the patient was significantly improved. Conclusion: In the medical team, clinical pharmacists should make full use of their advantages in drug characteristics to carry out clinical pharmaceutical care.
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Objective To investigate the effect of preoperative and postoperative inspiratory muscle training(IMT) on cardiopulmonary function and quality of life for patients undergoing esophagectomy.Methods Sixty patients who had received esophagectomy for esophageal cancer were randomly divided into an observation group (n =30) and a control group (n =30).All of the subjects were given conventional treatment (including preoperative health education,abdominal respiration training,pursed lip respiration training and expectoration training).On this basis,the patients in the treatment group were advised to do deep respiratory training using a breathing training device,four times a day,lasting 20 minutes each time,for 10 days (including five days before and five days after the operation).Respiratory muscle strength,blood gases,six minute walk test (6MWT) distances and Borg dyspnea scores were measured on admission,on the day prior to the operation and on the 1st,3rd and 5th day after the operation.And also on admission and on the 5th day after the operation their pulmonary function was tested,and their psychological status and quality of life were evaluated using the hospital anxiety and depression scale (HADS) and the Nottingham health profile (NHP) respectively.Results There was no significant difference in any index between the two groups on admission(P ＞ 0.05).Everyone's respiratory function and exercise capacity were sharply decreased,and Borg dyspnea score increased on the first postoperative day,and then gradually and significantly improved in both groups compared to that on admission(P ＜ 0.05).On the fifth postoperative day,the maximal inspiratory pressure of 67.41 ± 14.53 mmH2O,maximal ventilatory volume of 79.83 ± 5.37 L,6MWT of 427.19 ± 46.52 m,Borg score of 1.45 ± 0.48 points,postoperative anxiety score of 8.14 ±2.80 points,NHP total (128.91 ± 25.12 points),NHP pain score (24.66 ± 10.12 points),NHP sleeping score (25.18 ± 9.75 points),and NHP physical activity scores (22.81 ± 10.72 points) were significantly more improved in the observation group than those in the control group(P ＜ 0.05).Conclusion Preoperative and postoperative inspiratory muscle training can significantly reduce postoperative anxiety symptoms,improve postoperative cardiopulmonary function and the quality of life during perioperative period.Such therapy deserves further clinical research.
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Objective To assess the value of nuchal translu-cency in combination with non-invasive prenatal DNA test in fetal with chromosomal disease. Methods A total of 713 cases with single pregnancies, with 11 ~ 14 gestational weeks, were enrolled in this study. We measured the thickness of nuchal translu-cency, If the thickness was abnomal, the pregnant women would receive the non-invasive prenatal DNA test on voluntary basis and were followed up. Results There were 27 cases with abnormal NT among 713 cases. Twenty-one cases received non-invasive prenatal DNA test , the test results showed that 3 cases were trisomy 21 , 1 cases was trisomy 18. Among the 17 cases with normal chromosome karyotype, 6 cases were found abnomal during the follw-up. Two cases were found abnomal among the 6 cases undergo the non-invasive prenatal DNA test.The thickness of NT, ranging from 3.7 mm to 4.4 mm, was trisomy 21, with the average of 4.0 mm, and the thickness of NT was 5.0mm and was trisomy 18. Conclusions The application of nuchal translu-cency in combination with non-invasive prenatal DNA test could improve the ability to find fetal chromosomal disease and to decrease the birth defect.
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Objective To explore the effect of different doses remifentanil on hyperalgesia and the analgesic effect of gynecological laparoscopic operation.Methods Ninety gynecologic laparoscopic operation patients were divided into A group,B group and C group by random digits table method with 30 cases each.The anesthesia induction in A group and B group was intravenous injection remifentanil 1.5 μ g/kg,propofol 2 mg/kg,cisatracurium 0.2 mg/kg,and in C group was intravenous injection fentanyl 3 μ g/kg,propofol 2 mg/kg,cisatracurium 0.2 mg/kg.The maintenance of anesthesia in A group was infusion of remifentanil 0.3 μ g/ (kg· min),in B group was infusion of remifentanil 0.2 μ g/ (kg· min),and in C group was infusion of fentanyl 2 μ g/kg.The operation time,anesthesia time,time to extubation,intraoperative doses of propofol and remifentanil (A group and B group) were recorded.The visual analogue score (VAS) before operation and 15,30,60,120,240 min after extubation were recorded.The analgesia time,number of analgesia and adverse reaction after extubation were observed.Results There were no statistical differences in operation time and anesthesia time among 3 groups (P ＞ 0.05).The extubation time in A group and B group was significantly shorter than that in C group:(5.9 ± 2.7) and (6.1 ± 2.3) min vs.(9.6 ± 3.3) min,the dose of propofol in A group was significantly lower than that in B group and C group:(461.3 ± 69.7) mg vs.(543.4 ± 101.9) and (552.5 ± 93.8) ng,the dose of remifentanil in A group was significantly higher than that in B group:(1.12 ± 0.33) mg vs.(0.71 ± 0.1 l) mg,there were statistical differences (P＜ 0.05).The VAS 15,30,60,120,240 min after extubation in 3 groups were significantly higher than those before operation,A group:(7.3 ± 1.2),(7.4 ± 1.3),(6.5 ± 0.8),(4.5 ± 0.6),(4.1 ± 0.3) scores vs.(1.2 ± 0.3) scores,B group:(6.4 ± 1.5),(6.6 ± 1.1),(5.3 ± 0.4),(4.6 ± 0.3),(4.0 ± 0.4) scores vs.(1.5 ± 0.4) scores,C group:(3.4 ± 0.5),(4.2 ± 0.8),(4.1 ± 0.6),(3.8 ± 0.7),(3.8 ± 0.6) scores vs.(1.4 ± 0.2) scores,there were statistical differences (P ＜ 0.05).The VAS 15,30,60 min after extubation in A group were significantly higher than those in B group,and the VAS 15,30,60,120 min after extubation in A group and B group were significantly higher than those in C group,there were statistical differences (P ＜ 0.05).There was no statistical difference in VAS 240 min after extubation among 3 groups (P ＞ 0.05).The number of analgesia in A group,B group and C group were 28,29 and 3 cases,and the analgesia time were (16.1 ± 4.6),(17.9 ± 5.8) and (68.5 ± 10.l) min,there were statistical differences (P＜ 0.05),there were no statistical differences between A group and B group (P＞ 0.05),and there were statistical difference between A group,B group and C group (P ＜ 0.05).There was no statistical difference in adverse reaction among 3 groups (P ＞ 0.05),and there was no respiratory depression in 3 groups.Conclusion The degree of hyperalgesia is related to the dose of remifentanil during gynecologic laparoscopic operation.
ABSTRACT
Clinical pharmaceutical care for patients with postoperative infection had been carrying out by clinical pharmacy group and a suit of normalized pharmacy consultation on postoperative infection was summarized by using standardized consultation process and consultation method in our hospital for eight years .Postoperative infection , especially the serious infection , only through the normalized pharmacy consultation procedure , including standardized management or standardized service processes , the main con-tradiction and formulate feasible countermeasure could be quickly grasped , infection could be controlled in time , medication errors could be reduced even be eliminated .
ABSTRACT
To compare two commonly used statistical approaches:the multilevel model and the latent growth curve model in analyzing longitudinal data. A longitudinal data set,obtained from the quality of life in patients with colorectal cancer after operation,was used to illustrate the similarities and differences between the two methods. Results from the study indicated that the latent growth curve modeling was equivalent to multilevel modeling with regards to longitudinal data which could yield identical results for the estimates of parameters. Multilevel model approach seemed easier for model specification. However,latent growth curve model had the advantage of providing model evaluation and was more flexible in statistical modeling by allowing the incorporation of latent variables. Both multilevel and latent growth curve models were suitable for analyzing longitudinal data with advantages on their own,they conld be chosen by researchers under different situation to be chosen accordingly by researchers under different situation.
ABSTRACT
To compare two commonly used statistical approaches:the multilevel model and the latent growth curve model in analyzing longitudinal data. A longitudinal data set,obtained from the quality of life in patients with colorectal cancer after operation,was used to illustrate the similarities and differences between the two methods. Results from the study indicated that the latent growth curve modeling was equivalent to multilevel modeling with regards to longitudinal data which could yield identical results for the estimates of parameters. Multilevel model approach seemed easier for model specification. However,latent growth curve model had the advantage of providing model evaluation and was more flexible in statistical modeling by allowing the incorporation of latent variables. Both multilevel and latent growth curve models were suitable for analyzing longitudinal data with advantages on their own,they conld be chosen by researchers under different situation to be chosen accordingly by researchers under different situation.