ABSTRACT
OBJECTIVE： To analyze the occurrence of the adverse reactions （ADRs） caused by the compatibility of Ceftriaxone sodium for injection and dexamethasone in the same bottle， and to explore the regularity and characteristics of ADRs， so as to provide reference for clinical rational use of drugs. METHODS： The ADRs caused by the compatibility of ceftriaxone sodium and dexamethasone in the same bottle， reported to the National Adverse Drug Reaction Monitoring System from January 1， 2007 to December 31， 2016 were analyzed statistically， including the type of report， route of administration， type of reporting unit， gender and age of patients， occurrence time and month of occurrence of ADR， involved systems/organs and outcome， etc. the potential reasons were analyzed. RESULTS： A total of 2 111 cases were searched， and 1 289 cases （2 177 case times） were collected， of which 166 cases （12.88％） were severe ADR； route of administration was mainly intravenous drip （1 275 cases， 98.91％）； ADR reports mainly came from primary medical institutions （838 cases， 65.01％）； the male （679 cases， 52.68％） were slightly more than the female （610 cases， 47.32％）； the age of patients ranged 18 days-111 years old. The children under 4 years of age had more ADR （“number/age span” value was 141/5＝28.20 and higher than other age groups）； ADR occurred within 1 min to 14 d after medication， most of which occurred within 30 min （853 cases， 66.18％）； in summer （6-8 months）， ADR occurred more frequently （424 cases， 32.89％）； systems/organs involved in ADR were mainly skin and its appendants （1 059 case times， 48.64％ of total case times）， followed by gastrointestinal system （343 case times， 15.76％ of total case times）， systemic injury （291 case times， 13.37％ of total case times）. Among 1 289 ADR patients， 1 255 cases （97.36％） were cured or recovered， 28 cases （2.17％） were died， 4 cases （0.31％） did not improve， and 2 cases （0.16％） had sequelae. The compatibility of ceftriaxone sodium and dexamethasone in bottles had the risk of physical and chemical changes， which can reduce the efficacy and cause more ADR. Dexamethasone in the same bottle was not enough to completely prevent the allergic reaction of ceftriaxone sodium. CONCLUSIONS： In clinic， ceftriaxone sodium and dexamethasone should be avoided to be administered in the same bottle； clinical pharmacists and physicians can improve the ability of clinical pharmaceutical care in primary medical institutions， strengthen monitoring and publicity for patients， and prevent the occurrence of adverse drug reactions.
ABSTRACT
Objective To examine the prevalence of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS),and to evaluate the relationship of OSA with inflammatory biomarkers in ACS patients.Methods Patients with ACS treated at Beijing Anzhen Hopital from June 2015 to May 2017 were enrolled.Subjects were evaluated for OSA by sleep study,and were divided into a normal-mild OSA group (Apnea Hypopnea Index,AHI ＜ 15 times/h) and a moderate-severe OSA group (AHI ≥ 15 times/h).Laboratory examination and sleep study were monitored to analyze the effects of OSA on biomarkers by LSD-t test,Mann-whitney U test,or Chi-square test.Correlation analysis was performed to analyze the association of OSA with high sensitivity C-reactive protein (hs-CRP) by Spearman correlation anaylsis.Results A cohort of 836 patients with ACS were enrolled including 408 patients in the normal-mild OSA group and 428 patients in the moderate-severe OSA group.The levels of leukocyte(x 109L) [7.78 (6.33,9.86) vs 7.29 (6.01,9.16),P=0.006],neutrophils(× 109L) [5.05 (3.84,7.23)vs 4.80 (3.74,6.66),P=0.044],monocytes(x 109L) [0.42 (0.33,0.54) vs 0.39 (0.31,0.51),P=0.033],hsCRP(mg/L) [3.18 (1.10,11.52) vs 1.78 (0.65,6.46),P＜0.01],fibrinogen(g/L) [3.17 (2.87,3.74) vs 2.97 (2.59,3.50),P=0.002],and uric acid(μmol/L) [360 (302,422) vs 341(283,407),P=0.006] in the moderatesevere OSA group were significant higher than those in the normal-mild OSA group.AHI (correlation coefficient=0.171,R2=0.020,P＜0.01),ODI (correlation coefficient =0.201,R2=0.027,P＜0.01),and TSaO2 ＜ 90％ (correlation coefficient =0.105,R2=0.005,P＜0.01) were positively correlated with hs-CRP;minimal SaO2 (correlation coefficient=-0.100,R2=0.001,P=0.008) and mean SaO2 (correlation coefficient =-0.127,R2=0.006,P＜0.01) were negatively correlated with hs-CRP.Conclusions For patients with ACS,the level of inflammatory markers in the moderate-severe OSA group is significantly higher than that in the normal-mild OSA group.Hs-CRP is significantly associated with the severity of OSA.Diagnosis and monitoring of OSA should be considered in ACS management in the future.
ABSTRACT
Objective@#To investigate the impact of moderate/severe obstructive sleep apnea (OSA) on the prognosis of acute myocardial infarction.@*Methods@#We prospectively selected patients with acute myocardial infarction (AMI) who were hospitalized at the Emergency Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. Patients who met the inclusion criteria were examined with portable sleep respiration monitoring. Patients were divided into moderate/severe OSA group (apnea-hypopnea index (AHI)≥15 beats/hour) and no/mild OSA group (AHI<15 beats/hour) according to sleep AHI. The incidence of major adverse cerebrovascular events (MACCE) after discharge was compared between the two groups, and the independent risk factors of MACCE were analyzed.@*Results@#A total of 432 patients were enrolled in this study, including 211 moderate/severe OSA patients (48.8%). Compared with no/mild OSA group,patients with moderate/severe OSA had higher body mass index ((27.17±3.22) kg/m2 vs. (25.55±3.44) kg/m2, t=-5.033,P<0.001), higher proportion of history of percutaneous coronary intervention (PCI) (18.5%(39/211) vs. 8.6%(19/221), χ2=9.076,P=0.003), and higher proportion of 3-vessel disease (31.3%(66/211) vs. 24.9%(55/221), χ2=10.196,P=0.017). The median follow-up time was 1.0 (0.7, 1.7) years. The incidence of MACCE in the moderate/severe OSA and no/mild group was 19.9%(42/211) and 11.3%(25/221), respectively. Kaplan-Meier analysis showed a higher cumulative risk of MACCE in patients with moderate/severe OSA (log-rank test,χ2=5.467, P=0.019). Multivariate Cox regression analysis showed that moderate/severe OSA (HR=1.915, 95%CI 1.016-3.611, P=0.045) and diabetes mellitus (HR=1.819, 95%CI 1.022-3.238, P=0.042) were independent risk factors for MACCE at 1 year post discharge in patients with AMI.@*Conclusions@#Nearly half of AMI patients are complicated with moderate/severe OSA in this patient cohort. Coronary artery disease is more severe in AMI patients complicating with moderate/severe OSA. Moderate/severe OSA is an independent risk factor for MACCE at 1 year after discharge in patients with AMI. Whether the prognosis of AMI can be improved by intervention of OSA remains to be investigated.@*Trial Registration@#Clinical Trial.gov, NCT03362385.
ABSTRACT
Objective@#To explore the association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease (CHD).@*Methods@#A total of 784 patients with CHD were consecutively enrolled at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. According to thyroid function test results, patients were divided into hypothyroidism group (79 cases) and non-hypothyroidism group (705 cases). All patients had undergone sleep monitoring. The sleep apnea status was compared between the two groups. Multivariate logistic regression and linear regression models were used to analyze the association between hypothyroidism and sleep breathing disorders in patients with CHD.@*Results@#The proportion of females, mean body weight and body mass index in the hypothyroidism group were higher than those in the non-hypothyroidism group [26.6% vs.16.2%, (78.6±11.6) kg vs. (75.7±12.0) kg, (27.7±3.2) kg/m2 vs. (26.6±3.5) kg/m2, all P<0.05]. Patients in hypothyroidism group had a decreased average oxygen saturation (SaO2) compared with patients in non-hypothyroidism group [ (93.2±2.9) % vs. (93.9±2.0) %, P=0.030]. In addition, events of hypoventilation in hypothyroidism group were significantly higher than those in non-hypothyroidism group[92.5 (45.8, 758.3) times vs. 68.0 (33.0, 125.0) times, P=0.013]. There were no significant differences in apnea hypopnea index, diagnosis of obstructive sleep apnea and other sleep breathing parameters between the two groups (P>0.05). A multiple linear regression analysis found that in patients with CHD, the correlation between hypothyroidism and average sleep SaO2 was significant (β=-0.508, 95%CI -0.989--0.026, P=0.039).@*Conclusions@#CHD patients with hypothyroidism had a lower sleep average SaO2, and a higher sleep hypopnea events. There is a correlation between hypothyroidism and sleep hypoxia in patients with CHD.@*Clinical trial registration@#clinicalTrials.gov, NCT03362385.
ABSTRACT
Purpose To investigate the relationship between molecular phenotype of ductal carcinoma in situ ( DCIS) and that of inva-sive ductal carcinoma ( IDC) of the breast. Methods Immunohistochemical method was used to detect ER, PR, HER-2 and CK5 ex-pression in 165 cases of breast cancer, with DCIS and IDC existed in every one of the samples. Results In the 165 cases of breast cancer, the ER, PR, HER-2 and CK5 expression of IDC was positively correlated with that of DCIS, respectively. To evaluate IDC phenotype, the number of basal phenotype was 18 (10. 9%), HER-2-overexpression 20 (12. 1%), luminal A 102 (61. 8%), lumin-al B 20 (12. 1%), null phenotype 6 (3. 6%);to evaluate DCIS phenotype, the number of basal phenotype was 19 (11. 5%), HER-2-overexpression 20 (12. 1%), luminal A 104 (63%), luminal B 17 (10. 3%), null phenotype 5 (3%). 157 cases (95. 2%) of IDC had the same phenotype with DICS, but the rest 8 cases (4. 8%) not, three cases of luminal A DCIS transformed into one HER-2-overexpression and two null phenotype IDC, three of HER-2-overexpression DCIS transformed into luminal B IDC, one null pheno-type DCIS transformed into one luminal A IDC, and one basal phenotype DCIS transformed to HER-2-overexpression IDC. Conclusion Most of IDC have the same phenotype with DCIS, but there exist small part of DCIS which could transform into other phenotype IDC.
ABSTRACT
Objective To investigate the expressions and mutual relationship of Galectin-3 andβ-catenin in endome?triosis (EM). Methods Immunohistochemistry was used to detect expression levels of Galectin-3 andβ-catenin and their mutual relationship in expression was also examined. Samples were collected from ectopic endometrium of patients with en?dometriosis (ectopic endometrium group, n=34), eutopic endometrium of patients with endometriosis (eutopic endometrium group, n=34) and normal endometrium from people without endometriosis (control group, n=30). Results The expressions of Galectin-3 were seen in 88.2%, 85.3%, 50.0%of cases in ectopic endometrium group, eutopic endometrium group and control group respectively. On the other hand, the expression ofβ-catenin were seen in 55.9%, 52.9%, 26.7%of cases in ecto?pic endometrium group, eutopic endometrium group and control group respectively. In EMs patients, the expression of Galec?tin-3 andβ-catenin were significantly higher in ectopic endometrium and eutopic endometrium than those in normal endome?trium group(P<0.05). Expression of Galectin-3 was positive correlated with expression ofβ-catenin(rs=0.512, 0.428, P<0.01). Conclusion Galectin-3 andβ-catenin may play important roles synergistically in the pathogenesis of endometriosis.
ABSTRACT
@#To investigate the therapeutic effect and influence of quercetin and allopurinol on the function of liver and kidney in hyperuricemic rats, male SD rats were administered with the drugs by oral gavage once a day for seven consecutive days throughout the experiment. On the fifth day, the animal model of hyperuricemia was set up by hypoxanthine intraperitoneal injection. The serum was used for assaying the uric acid(UA), alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), direct bilirubin(DBIL), β2-microglobulin(β2-MG), serum cystatin C(Cys-C), urea nitrogen(Urea)and serum creatinine(Cr)with colorimetry, continuous monitoring, chemical oxidation and enzyme-linked immunosorbent assay. The results showed that quercetin had no effect on the uric acid levels of serum, and that allopurinol reduced uric acid levels in rats significantly(P< 0. 01). The serum levels of AST and ALT in rats substantially decreased compared with normal control group(P< 0. 01), while no significant differences were found in TBIL, and DBIL. Compared with normal control group, β2-MG and Cys-C levels were significantly increased in the other five groups(P< 0. 01), serum levels of Urea and Cr were significantly higher in the allopurinol group compared to the normal control group(P< 0. 01). Modeling and administration group showed mild histopathological changes in rat kidney. The results clearly demonstrated that quercetin had no effect on the uric acid levels of serum, and allopurinol lowered uric acid significantly. There was no significant effect on the function of liver by modeling and administration, however, there was potential impaiment of renal function after modeling. Quercetin did not exhibit a protective effect on renal injury and administration with allopurinol increased kidney damage.
ABSTRACT
Purpose To investigate the expression and significance of androgen receptor (AR) in breast carcinoma with different ER and PR status.Methods Immunohistochemical method was used to detect AR, ER and PR expression in 173 cases of breast carcinoma, and all the cases were grouped according to: (1) AR status: AR~- positive subgroup and AR~- negative subgroup, (2) ER status: En subgroup (negative for both ER and PR), Ep subgroup (positive for ER and/or PR), (3)AR, ER and PR status: En-AR~+ subgroup (AR~- positive cases of En subgroup), En-AR~- subgroup (AR~-negative cases of En subgroup), Ep-AR~+ subgroup (AR~- positive cases of Ep subgroup), and Ep-AR~- subgroup (AR~-negative cases of Ep subgroup).En-AR~- subgroup also was called negativE-for-all subgroup, and the rest three subgroups were called partly-or-completely positive subgroup (positive for at least one of the three markers), and then, the groups were compared with clinicopathological features.Results The positive rate of AR was 62.8% (54/86) in Ep subgroup and 37.9%(33/87) in En subgroup, and there was significant difference between them (P=0.001).Compared to AR~-negative subgroup, AR~-positive subgroup had smaller tumor size, less mitosis count and lower grade(P<0.05).Compared to the other three subgroups, En-AR~- subgroup had more mitosis count and higher grade (P<0.01).In En subgroup,AR~- positive cases had less mitosis count and lower grade (P<0.05), and in Ep subgroup,AR~- positive cases had higher stage(P=0.000), but no significant difference were found among partly or completely positive subgroups.Conclusions The expression of AR may play a different role in breast carcinoma with different ER and PR status, because it indicates good prognosis in negative for both ER and PR subgroup, but bad in ER and/or PR positive subgroup. When choosing a personalized therapy, all the combinations of hormone receptor status should be considered for the patients.
ABSTRACT
OBJECTIVE: To analyze the uncertainty of determination of western medicine composition illegally added into Chinese patent drug and find out the effect factors of uncertainty in order to provide scientific basis for evaluating test report. METHODS: Antler tablets were tool as example. Qualitative analysis of additive composition was carried out using HPLC-MS method and the content of sildenafil citrate in each tablet was determined. Uncertainty of test was evaluated according to the regulation specified in Evaluation and Expression of Measurement of Uncertainty (JJF1059-1999). RESULTS: The uncertainty of the test is 0.10 mg in each tablet. CONCLUSION: The uncertainty of the experiment is mainly caused by non homogeneity of sample.
ABSTRACT
To observe the anti-fibrosis activity of recombinant human augmenter of liver regeneration (hALR). METHODS: Albumin induced rat model of liver fibrosis was established and hALR was given peritoneally after the model production. Serum concentration of alanine aminotransferase(ALT), aspartic aminotransferase(AST), lactate dehydrogenase(LDH), hepatic collagen contents and pathological examination were selected as observing parameter. RESULTS: Recombinant human augmenter of liver regeneration (hALR) could decrease ALT, AST, LDH concentration of fibrotic rats. The measurements of hepatic collagen contents showed that hepatic collagen contents in hALR treatment group was much lower than those of model group and negative control group. Pathological examination also indicated that the degree of liver fibrosis in hALR treatment group was attenuated in comparison with those of model group and negative control group. CONCLUSION: Recombinant human augmenter of liver regeneration (hALR) had reversal effects on immunocomplex induced rat liver fibrosis.
ABSTRACT
Histopathological and ultrastructural changes of the lungs were observed in various intervals after high-velocity bullet wounds of the two thighs of dogs. It was found that histologically there were microvascular dilatation, congestion, capillary rupture, interstitial and alveolar bleeding, focal atelecta-sis and pulmonary emphysema in the first half hour and the 6th hour after injury. In addition, microvascular embolism and hyaline membrane formation were seen in the 24th and 72nd hour after injury. Under electron microscopy, there were swelling of capillary endothelium, swelling, degeneration and necrosis of type I pneumocytes, shortening and decreasing of the microvilli of type II pneu-mocytes, significant vacuolation of the lamonar bodies, accumulation of leucocytes and platelets in the capillary lumen,and obvious decrease of the granules in the leucocytes. The mechanism of the pulmonary injury accompanying bullet wound of the thighs was discussed.