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Objective The study was to investigate the activation of tumor necrosis factor α (TNF-α) mRNA transcription and protein expression in peripheral blood and activation of signal path PI3K/AKT in patients with chronic heart failure. Methods From February 2015 to April 2018, 244 patients with heart failure in the cardiovascular department of our hospital were selected as heart failure group, while 244 healthy cases were enrolled as the control group at the same time. The peripheral blood samples of two groups were collected. We detected the transcription and protein expression of TNF-α mRNA and the activation of PI3K, AKT in peripheral blood. The left ventricular ejection fraction (LVEF) were measured in two groups. The correlations between influencing factors and LVEF were analyzed. Results The levels of PI3K, AKT in the heart failure group were higher than those in the control group. The differences were statistically significant respectively (P < 0.05). The mRNA relative content and protein content of TNF-α in peripheral blood mononuclear cells of heart failure group were higher compared with those of control group (P < 0.05). The LVEF of heart failure group was significantly lower than that of the control group (34.50 ± 6.33) ％ versus (55.60 ± 2.49) ％, P < 0.001). Among 244 patients with heart failure, Spearman correlation analysis showed that there were significant positive correlations between TNF-a mRNA and protein expression levels and the levels of PI3K, AKT respectively (P < 0.05). Multiple factors unconditional Logistic regression analysis showed that the TNF-α mRNA, protein expression and PI3K, AKT levels in peripheral blood were independent risk factors for LVEF (P < 0.05). Conclusion The expression levels of PI3K, AKT and TNF-α are all significantly increased in chronic heart failure patients, which could participate in the occurrence and development of heart failure.
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Objective Clinical research is a critical procedure for the development of medicine.Reliability of the clinical research finding is determined by the quality of study design and analysis courses.It will also further impact the guideline development and clinical practice.This study was focus on the evaluation of clinical research quality during its whole process.Methods Subjects of this study were the clinical summary reports from a government funded project which were submitted in 2016.Standardized data collecting form had been used to capture the key features regarding to the quality of study design and data analysis.After the review of data accuracy,descriptive analysis had been carried to interpret the observed findings both for design and analysis aspects.Results There were 67 project summary reports included in our analysis.The top three investigated therapeutic areas were oncology,cardiovascular/cerebrovascular diseases and orthopedics (19.4 ％,11.9 ％ and 11.9 ％).Most of studies fulfilled the evaluation criteria according to their original plan.94 ％ studies were strictly compliance with the original protocol with no interim amendment.Meanwhile,the report on sample size determination and appropriate use of multi-variable analysis should be improved.Conclusions Usually,clinical research program can fulfill the evaluate goal according to funding requirements.But the methodology quality should be paid more attention.It is highly suggested to cooperate with the professional statistical team and do continuous improvement effort to enhance the validity of study findings.
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Objective To evaluate the surface anesthesia and antibacterial effect of compound lidocaine cream in indwelling urethral catheter in order to seek the optimal indwelling urethral catheter scheme in cardiac surgery.Methods A total of 198 patients undergoing elective cardiac surgery in this hospital from November 2016 to January 2017 were selected and divided into the two groups:the lidocaine cream group(L) and liquid paraffin control group(C).The visual analogue scale (VAS) and catheter-related bladder discomfort(CRBD) were used immediately after tracheal catheter extubation and at 2,4 h after extubation.The number of white blood cells and bacteria in urine were observed on postoperative 1,7 d.The urine culture results were observed on postoperative 7 d.Results The VAS and CRBD scores immediately after extubation in the group L was significantly lower than that in the group C(P＜0.05).The urine WBC count and bacterial count on postoperative 7 d in the group L were significantly lower than those in the group C(P＜0.05),the positive rate of urine culture on postoperative 7 d in the group L was significantly lower than that in the group C,the difference was statistically significant(5.05％ vs.13.13％,P＜0.05).Conclusion Compound lidocaine cream as lubrication indwelling urethral catheter can decrease the incidence rate of urinary tract infection on postoperative 7 d in the patients with cardiac operation,furthermore can prevent the wake agitation caused by indwelling urethral catheter.
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Objective To investigate the effects of dexmedetomidine on the activities of glycome-tabolism rate-limiting enzymes in erythrocytes and the plasma levels of glucose and malondialdehyde in pa-tients undergoing radical gastrectomy for cancer.Methods Sixty patients,38 males and 22 females,aged 60-80 years,scheduled for radical gastrectomy for cancer were randomly divided into dexmedetomidine group (group D)and control group (group C),30 cases in each group.The patients in group D were intra-venously infused 0.5 μg/kg dexmedetomidine 10 minutes before operation and perioperatively followed by an infusion at a rate of 0.3 μg·kg-1 ·h-1 until the abdomen were closed.Group C was infused the same a-mount of normal saline.Venous blood samples were collected for the measurement of phosphofructokinase (PFK),glucose-6-phasphate dehydrogenase (G-6PD)and aldose reductase (AR)activities in erythrocytes and the plasma levels of glucose and malondialdehyde (MDA)before induction (T0 ),60 min following the incision (T1 ),60 min (T2 ),day 1 (T3 )and day 2 (T4 )after operation.Results Compared with these at T0 ,the activity of PFK was decreased significantly and the activities of G-6PD and AR were increased markedly at T3 in both groups (P <0.05 or P <0.01),however the activity of the PFK was significantly higher,G-6PD and AR were significantly lower in group D than those in group C (P <0.05).The levels of plasma glucose elevated significantly at T1 (P <0.01),reached high peak values at T3 (P <0.01)and fell at T4 in both groups.The values of plasma glucose in group D were lower than those in group C at T1 ,T2 and T3 (P <0.01).The MDA concentration in both groups increased significantly at T3 (P <0.01),while that of group D was lower than group C (P < 0.05 ).Conclusion Dexmedetomidine could markedly decrease glucose level and alleviate oxidative stress and improve these erythrocyte glucose metabolism changes after radical gastrectomy for cancer in old patients.
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Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.
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Objective To build the suitable index system of the clinical research program acceptance evaluation.Methods The Delphi method and the weighted average method were adopted to determine the weight of each index.Results Followed by two rounds of Delphi method, twenty five evaluation indices were selected, including three first-class indices, seven second-class indices and fifteen third-class indices, and the weight of each index was calculated.Conclusions The index system,simple and reasonable, reflects the characteristics of clinical applied researches to a certain extent with a certain degree of operability, laid the foundation for the further supporting to carry out scientific research projects.
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<p><b>OBJECTIVE</b>To explore the safety and efficacy of lower dose of rituximab in the treatment of elderly autoimmune hemolytic anemia (AIHA).</p><p><b>METHODS</b>From May 2008 to February 2013, a total of 37 patients with newly diagnosed elderly AIHA patients were enrolled in the study, including 25 cases treated with prednisone 1 mg · kg⁻¹ · d⁻¹ for 4 weeks and 12 cases ineligible for glucocorticoid receiving rituximab (100 mg/week for 4 times).</p><p><b>RESULTS</b>Of the 25 patients with conventional glucocorticoid, 5 cases (20.0%) were complete remission (CR), 15 cases with partial remission (PR) and 5 cases without response. The overall response rate was 80.0%. Of the 12 cases with rituximab, 8 cases (66.7%) were CR, 3 cases with PR and 1 without response. The overall response rate was 91.7%. A significantly higher CR rate was seen in lower dose of rituximab, as compared to that in conventional glucocorticoid (P=0.038).</p><p><b>CONCLUSION</b>A lower dose of rituximab, with satisfactory safety and efficacy, was better than the conventional glucocorticoid in the treatment of elderly AIHA patients.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anemia, Hemolytic, Autoimmune , Drug Therapy , Antibodies, Monoclonal, Murine-Derived , Therapeutic Uses , Prednisone , Therapeutic Uses , Rituximab , Treatment OutcomeABSTRACT
The clinical features of 172 female and 1 067 male residents with gout in the coastal regions of Shandong province were analyzed.The results showed that as compared with male patients the onset of gout occurred at an older age in the female patients,and there were less obesity and tophi as well as less alcohol consumption and medication needed in the female patients.However,comorbidity with diabetes mellitus and coronary heart disease,as well as involvement of upper limb and other metatarsophalangeal joints were more prevalent in the female patients.
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<p><b>OBJECTIVE</b>To study the chemical constituents of bear bile.</p><p><b>METHOD</b>The compounds were isolated by repeated column HP20 macroporous adsorption resin, Sephadex LH-20, ODS and silica gel as packing materials. The structures were identified on the basis of extensive spectroscopic data analysis and by comparison of their spectral data reported.</p><p><b>RESULT</b>Nine compounds were identified as 4',7-dihydroxyisoflavone (1), 4',7-dihydroxy-6-methoxyisoflavone (2), 4',6,7-trihydroxyisoflavone (3), 4'-methoxy-7-hydroxyisoflavone (4), tauroursodeoxycholic acid (5), taurochenodeoxycholic acid (6), ursodeoxycholic acid (7), chenodeoxycholic acid (8), cholesterol (9).</p><p><b>CONCLUSION</b>Compounds 1-4 were separated from bear bile for the first time.</p>
Subject(s)
Animals , Bile , Chemistry , Gallbladder , Chemistry , Medicine, Chinese Traditional , Ursidae , MetabolismABSTRACT
Objective To investigate the effects of thoracic epidural anesthesia and analgesia on cellular immune function and erythrocytes glycometabolism in the patients undergoing thoracic surgery.Methods Forty esophageal carcinoma patients,classified as ASA Ⅰ or Ⅱ,scheduled for elective thoracic surgery were randomly divided into two groups with 20 cases each：group A underwent general anesthesia plus thoracic epidural anesthesia （TEA） during thoracic surgery and received patient-controlled epidural analgesia （PCEA） with fentanyl and ropivacaine postoperatively;group B received general anesthesia during thoracic surgery and patient-controlled intravenous analgesia （PCIA） postoperatively. Venous blood samples were collected for the measurement of Th1,Th2 and the activities of PFK,G-6PD and AR before the induction（T0）,2 h after the initiation of the incision（T1）,and 4 h（T2）,24 h（T3）and 48 h（T4）after surgery. Results The Th1/Th2 ratio in both groups were decreased significantly after completion of surgery compared with baseline levels （P0.05）. At T2,T3 and T4 the Th1/Th2 ratio in group A were higher than group B. Compared with these before operation,the activity of PFK was decreased significantly and the activities of G-6PD and AR in erythrocytes were increased markedly at T3 in group B（P0.05）.But erythrocytes PFK,G-6PD and AR activity slightly changed in group A.Conclusion These findings show that thoracic epidural anesthesia and PCEA may inhibit Th0 cells to differentiate into Th2 cells,protect cellular immune function and moderate erythrocyte glucose metabolism changes.