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The adenosine 5'-triphosphate (ATP)-binding cassette (ABC) transporter, IrtAB, plays a vital role in the replication and viability of Mycobacterium tuberculosis (Mtb), where its function is to import iron-loaded siderophores. Unusually, it adopts the canonical type IV exporter fold. Herein, we report the structure of unliganded Mtb IrtAB and its structure in complex with ATP, ADP, or ATP analogue (AMP-PNP) at resolutions ranging from 2.8 to 3.5 Å. The structure of IrtAB bound ATP-Mg2+ shows a "head-to-tail" dimer of nucleotide-binding domains (NBDs), a closed amphipathic cavity within the transmembrane domains (TMDs), and a metal ion liganded to three histidine residues of IrtA in the cavity. Cryo-electron microscopy (Cryo-EM) structures and ATP hydrolysis assays show that the NBD of IrtA has a higher affinity for nucleotides and increased ATPase activity compared with IrtB. Moreover, the metal ion located in the TM region of IrtA is critical for the stabilization of the conformation of IrtAB during the transport cycle. This study provides a structural basis to explain the ATP-driven conformational changes that occur in IrtAB.
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Siderophores/metabolism , Iron/metabolism , Mycobacterium tuberculosis/metabolism , Cryoelectron Microscopy , Adenosine Triphosphate/metabolism , ATP-Binding Cassette TransportersABSTRACT
Starting from the inheritance and development of Chinese philosophy of life and Traditional Chinese Medicine (TCM) wisdom through the Chinese narrative medicine practice, this paper discussed the inheritance and correspondence relationship between the text reading ability in Chinese narrative medicine practice and the "four diagnostic" in TCM wisdom, narrative regulation and the "mind-body philosophy" in TCM, as well as the narrative wisdom and the "Tao produces one" in the Chinese philosophy of life. By analyzing the stories of contemporary doctors’ practice of narrative wisdom, this paper clarified that the Chinese narrative medicine system is a new model of medical education and clinical practice constructed by absorbing the essence elements of Chinese traditional life wisdom and TCM culture, and integrating the concept of western narrative medicine. It advocated for Chinese scholars to actively build the discipline of "narrative traditional Chinese medicine", constantly translate and introduce the achievements to foreign countries, and create a good narrative ecology of TCM.
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Objective:To evaluate the effect of dexamethasone combined with aminophylline on perioperative airway responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.Methods:Sixty-eight COVID-19 convalescent patients, aged 25-57 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing gynecological laparoscopic surgery, were divided into experimental group ( n=34) and control group ( n=34). In experimental group, dexamethasone 10 mg was intravenously injected at the beginning of anesthesia induction, and aminophylline 0.25 g (in 100 ml of normal saline) was intravenously infused for 10 min starting from 15 min before the end of surgery. In control group, the equal volume of normal saline was administrated instead at the same time point. Airway secretions, laryngospasm and bronchospasm were recorded from the time point before operation to 24 h after operation, and coughing was also recorded from emergence to 3 min after extubation. The blood eosinophils (EOS) count, percentage of EOS (EOS%), and neutrophil to lymphocyte ratio were determined, and plasma C reactive protein level was measured by enzyme-linked immunosorbent assay before operation and at 24 h after operation. The serum levels of interleukin-6, tumor necrosis factor-α and interferon-γ were measured before operation, at 5 and 10 min after extubation and at 24 h after operation. Results:Compared with control group, the incidence of coughing, severity of coughing, incidence of increased airway secretion, and grade of airway secretion were significantly decreased, the levels of EOS, EOS%, neutrophil to lymphocyte ratio and plasma C reactive protein in peripheral blood and serum levels of interferon-γ, interleukin-6 and tumor necrosis factor-α were significantly decreased after operation ( P<0.05), and no significant change was found in the incidence of bronchial spasm in experimental group ( P>0.05). No laryngeal spasm occurred in both groups. Conclusions:Dexamethasone combined with aminophylline can relieve the perioperative airway responses by inhibition of inflammatory responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.
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Objective:To evaluate the effects of different inhalation time on the minimum alveolar concentration (MAC) of sevoflurane in adult rats.Methods:Two hundred SPF healthy adult Sprague-Dawley rats (half male, half female), aged 8-10 weeks, weighing 200-260 g, were divided into 2 groups using a random number table method: inhalation of sevoflurane for 1 h group and inhalation of sevoflurane for 20 min group, with 100 rats in each group.Each group was subdivided into 10 subgroups with 10 rats in each subgroup, the initial concentration was preset at 1.50%, and the ratio between two successive concentrations r was 1.08.The tail clamping stimulus was applied to evaluate the efficacy of anesthesia in each subgroup, a positive response was defined as a body movement occurred within 1 min after tail clamping stimulus, and the response was defined as negative when no body movement occurred within 1 min after tail clamping.The Bliss method was used to calculate the MAC, EC 95 and 95% confidence interval (CI) of sevoflurane. Results:The MAC and EC 95 (95% CI) of sevoflurane were 2.09% (1.98%-2.20%) and 2.75% (2.56%-3.04%), respectively, in inhalation of sevoflurane for 1 h group, and 2.35% (2.22%-2.49%) and 3.10% (2.87%-3.45%), respectively, in inhalation of sevoflurane for 20 min group ( P<0.05). Conclusions:The MAC of sevoflurane in adult rats inhaled sevoflurane for 1 h is decreased than that inhaled for 20 min.
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Objective To evaluate clinical utility of the personalized drug delivery decision support system, Smart Dose, applied to the monitoring of therapeutic drugs in Chinese population. Methods Use Smart Dose system to predict the trough concentration of vancomycin in patients, analyze the difference between the predicted value and the measured value of the trough concentration, and to evaluate the prediction performance of the system for vancomycin blood concentration. Results Smart Dose adjusts the difference between the predicted value of concentration and the measured value, the average percentage error, and the average absolute percentage error is less than the difference between the predicted value of initial concentration and the measured value. The difference between the initial concentration prediction value and the measured value of the neurosurgery group was smaller than that of the non-neurosurgery group, and the prediction efficiency was better than that of the non-neurosurgery group. The predicted initial concentration of the high trough concentration group and the low-age group (<59 years old) are closer to the measured value. The predictive performance of different BMI for the initial concentration is similar. Conclusion Smart Dose system is more suitable for predicting the adjusted concentration of vancomycin; When used for initial concentration prediction, the prediction values of neurosurgery group, high trough concentration, and low age group are more accurate. Different BMI has similar performance in predicting initial concentration.
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This article introduces the development history of palliative medicine at home and abroad, investigates the existing problems of palliative medicine teaching in geriatrics, explores the improvement of geriatric palliative medicine education, and elaborates adopting theoretical teaching and clinical practice, including PBL teaching, case teaching and narrative medicine teaching, to carry out palliative medical education for geriatrics graduate students. The results showed that 67.9% of the students have increased the learning sense of palliative medicine, 92.5% of them think that palliative medicine is very important, and 75% of them think that they have enhanced their ability of language expression and communication with patients with advanced diseases, namely, the ability of end-of-life care.
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Objective@#To analyze the changes in coronary arterial microcirculation index and its possible influencing factors in elderly patients with hypertension.@*Methods@#In the retrospective case-control study, 36 elderly patients with hypertension in our hospital from May 2016 to April 2017 and meeting inclusion criteria were recruited as the hypertension group, and 36 matched non-hypertensive elderly patients during the same time were considered as the non-hypertensive group.Patients in the two groups underwent coronary angiography and percutaneous coronary function tests for the coronary heart disease symptoms such as chest pain and chest tightness.The changes of coronary microcirculation index were observed, and its possible influencing factors were analyzed in combination with other test results.@*Results@#The low-density lipoprotein level was lower, and plasma viscosity, erythrocyte sedimentation rate, serum high-sensitivity C-reactive protein and 24-h urinary protein were higher in the hypertension group than in the non-hypertensive group(P<0.05). The parameters were higher in the hypertension group versus in control group as follows: Left ventricular ejection fractions(LVEF), [(74.82±6.71 )% vs.(71.56±4.93 )%], Left ventricular mass[(189.72±33.40)g vs.(174.38±29.11)g], Left ventricular mass index[(101.70±16.25)g/cm2 vs.(89.68±10.46)g/cm2](t=2.077, 3.731 and 4.676, P<0.05 or P<0.01), and the proportion of patients with decreased LVEF(52.8%, 19 cases vs.27.8% 10 cases, χ2=4.676). Multivariate logistic regression analysis showed that low-density lipoprotein(OR=2.887, 95%CI: 1.754~8.193, P=0.035), plasma viscosity(OR=4.075, 95%CI: 1.629~7.386, P=0.001), erythrocyte sedimentation rate(OR=3.534, 95%CI: 1.293~6.730, P=0.001), serum high-sensitivity C-reactive protein(OR=2.821, 95%CI: 1.546~7.386, P=0.001), 24-h urinary protein(OR=3.712, 95%CI: 1.683~7.954, P=0.026), left ventricular mass index(OR=3.254, 95%CI: 1.286~6.735, P=0.004)and reduced left ventricular diastolic function(OR=5.069, 95%CI: 1.386~7.254, P=0.007)were the risk factors for abnormal changes in coronary microcirculation resistance index.@*Conclusions@#Elderly hypertensive patients have abnormal coronary microcirculation resistance index, and the intervention should be strengthened from the aspects of blood lipid, plasma viscosity, , inflammation, renal function and cardiac function, so as to improve coronary function and reduce adverse cardiovascular events.
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Objective@#To evaluate the effect of remifentanil on the minimum alveolar concentration of sevoflurane required to blunt the adrenergic response (MACBAR) in the patients with hepatic dysfunction undergoing laparoscopic surgery.@*Methods@#The patients, aged 18-64 yr, with body mass index < 30 kg/m2, undergoing elective laparoscopic hepatobiliary surgery, were selected.Patients with normal liver function were selected as control group (C group), and patients with liver dysfunction (Child-Pugh grade B) were selected as test group and divided into 3 subgroups by a random number table method: no remifentanil group (R0 group) and different target plasma concentrations of remifentanil groups (R1 group and R2 group). Anesthesia was induced by intravenously injecting propofol 2-3 mg/kg, remifentanil 2 μg/kg and cisatracurium 0.15 mg/kg.After endotracheal intubation, mechanical ventilation was performed.The end-tidal sevoflurane concentration was adjusted to the preset concentration in each group and maintained at the level for 20 min before the pneumoperitoneum was established.Anesthesia was maintained as follows: remifentanil was not used in C group and R0 group, and the target plasma concentration of remifentanil was 1 and 2 ng/ml in group R1 and group R2, respectively, and sevoflurane was inhaled.The MACBAR of sevoflurane was determined using the sequential method.The initial end-tidal sevoflurane concentrations were 5.0%, 4.6%, 2.6% and 2.4% in group C, group R0, group R1 and group R2, respectively.MAP and HR were recorded and blood samples were collected before and after pneumoperitoneum, and the plasma epinephrine and norepinephrine concentrations were measured by enzyme-linked immunosorbent assay, and the difference in MAP and HR before and after pneumoperitoneum was calculated.@*Results@#A total of 14 cases in group C, 19 cases in group R0, 19 cases in group R1 and 15 cases in group R2 completed the study.Compared with group C, the MACBAR of sevoflurane and plasma adrenergic concentration before and after pneumoperitoneum were significantly decreased (P<0.05), and no significant change was found the other parameters in group R0 (P>0.05). Compared with group R0, the MACBAR of sevoflurane was significantly decreased in group R1 and group R2, and HR before and after pneumoperitoneum and the difference were significantly decreased in group R2(P<0.05). The MACBAR of sevoflurane was significantly lower in group R2 than in group R1 (P<0.05).@*Conclusion@#Remifentanil can decrease the MACBAR of sevoflurane and enhance the efficacy in inhibiting the stress responses in the patients with hepatic dysfunction undergoing laparoscopic surgery.
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Objective To analyze the changes in coronary arterial microcirculation index and its possible influencing factors in elderly patients with hypertension.Methods In the retrospective case-control study,36 elderly patients with hypertension in our hospital from May 2016 to April 2017 and meeting inclusion criteria were recruited as the hypertension group,and 36 matched nonhypertensive elderly patients during the same time were considered as the non-hypertensive group.Patients in the two groups underwent coronary angiography and percutaneous coronary function tests for the coronary heart disease symptoms such as chest pain and chest tightness.The changes of coronary microcirculation index were observed,and its possible influencing factors were analyzed in combination with other test results.Results The low-density lipoprotein level was lower,and plasma viscosity,erythrocyte sedimentation rate,serum high-sensitivity C-reactive protein and 24-h urinary protein were higher in the hypertension group than in the non-hypertensive group(P＜0.05).The parameters were higher in the hypertension group versus in control group as follows:Left ventricular ejection fractions (LVEF),[(74.82 ±-6.71) ％ vs.(71.56 ±-4.93) ％],Left ventricular mass[(189.72 ± 33.40) g vs.(174.38 ± 29.11) g],Left ventricular mass index [(101.70 ± 16.25)g/cm2 vs.(89.68 ± 10.46) g/cm2] (t =2.077,3.731 and 4.676,P ＜0.05 or P ＜0.01),and the proportion of patients with decreased LVEF (52.8％,19 cases vs.27.8％ 10 cases,x2 =4.676).Multivariate logistic regression analysis showed that low-density lipoprotein(OR =2.887,95 ％ CI:1.754～ 8.193,P =0.035),plasma viscosity(OR =4.075,95％ CI:1.629 ～ 7.386,P =0.001),erythrocyte sedimentation rate (OR =3.534,95％ CI:1.293 ～ 6.730,P =0.001),serum highsensitivity C-reactive protein (OR =2.821,95 ％ CI:1.546 ～ 7.386,P =0.001),24-h urinary protein (OR=3.712,95％CI:1.683～7.954,P =0.026),left ventricular mass index(OR =3.254,95％CI:1.286 ～ 6.735,P =0.004)and reduced left ventricular diastolic function(OR =5.069,95 ％ CI:1.386 ～7.254,P=0.007)were the risk factors for abnormal changes in coronary microcirculation resistance index.Conclusions Elderly hypertensive patients have abnormal coronary microcirculation resistance index,and the intervention should be strengthened from the aspects of blood lipid,plasma viscosity,,inflammation,renal function and cardiac function,so as to improve coronary function and reduce adverse cardiovascular events.
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Objective To evaluate the effect of remifentanil on the minimum alveolar concentration of sevoflurane required to blunt the adrenergic response(MACBAR)in the patients with hepatic dysfunction undergoing laparoscopic surgery.Methods The patients,aged 18-64 yr,with body mass index ＜ 30 kg/m2,undergoing elective laparoscopic hepatobiliary surgery,were selected.Patients with normal liver function were selected as control group(C group),and patients with liver dysfunction(Child-Pugh grade B)were selected as test group and divided into 3 subgroups by a random number table method: no remifen-tanil group(R0 group)and different target plasma concentrations of remifentanil groups(R1 group and R2 group).Anesthesia was induced by intravenously injecting propofol 2-3 mg/kg,remifentanil 2 μg/kg and cisatracurium 0.15 mg/kg.After endotracheal intubation,mechanical ventilation was performed.The end-tidal sevoflurane concentration was adjusted to the preset concentration in each group and maintained at the level for 20 min before the pneumoperitoneum was established.Anesthesia was maintained as follows:remifentanil was not used in C group and R0 group,and the target plasma concentration of remifentanil was 1 and 2 ng/ml in group R1 and group R2,respectively,and sevoflurane was inhaled.The MACBAR of sevoflurane was determined using the sequential method.The initial end-tidal sevoflurane concentrations were 5.0％,4.6％,2.6％and 2.4％in group C,group R0,group R1 and group R2,respectively.MAP and HR were recorded and blood samples were collected before and after pneumoperitoneum,and the plas-ma epinephrine and norepinephrine concentrations were measured by enzyme-linked immunosorbent assay,and the difference in MAP and HR before and after pneumoperitoneum was calculated.Results A total of 14 cases in group C,19 cases in group R0,19 cases in group R1 and 15 cases in group R2 completed the study.Compared with group C,the MACBAR of sevoflurane and plasma adrenergic concentration before and after pneumoperitoneum were significantly decreased(P＜0.05),and no significant change was found the other parameters in group R0(P>0.05).Compared with group R0,the MACBAR of sevoflurane was signifi-cantly decreased in group R1 and group R2,and HR before and after pneumoperitoneum and the difference were significantly decreased in group R2(P＜0.05).The MACBAR of sevoflurane was significantly lower in group R2 than in group R1(P＜0.05).Conclusion Remifentanil can decrease the MACBAR of sevoflurane and enhance the efficacy in inhibiting the stress responses in the patients with hepatic dysfunction undergo-ing laparoscopic surgery.
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This study aimed to obtain a recombinant human-source collagen for industrialization. First, based on the Gly-X-Y sequence of human type I collagen, we optimized the hydrophilic Gly-X-Y collagen peptide, designed the human collagen amino acid sequence and the corresponding nucleotide sequence. Next, the expression vector pPIC9K-COL was constructed via endonuclease digestion technology. We obtained an engineering strain of human-source collagen by electrotransforming Pichia pastoris, and then it was fermented, purified and identified. As a result, the expression level reached 4.5 g/L and the purity was over 95%. After amino acid N-terminal sequencing, molecular weight analysis, amino acid analysis and collagenase degradation test, we confirmed that the obtained collagen was consistent with designed primary structure of human-source collagen. After freeze-drying, we analyzed the collagen by scanning electron microscope and cell cytotoxicity, confirming that the collagen has porous fiber reticular structure and superior cytocompatibility. This indicates that human-source collagen has potential to be applied as biomedical material. In conclusion, we successfully obtained the expected human-source collagen and laid a foundation to its further application.
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Humans , Amino Acid Sequence , Biocompatible Materials , Collagen , Freeze Drying , Pichia , Recombinant ProteinsABSTRACT
Electrogenerated chemiluminescence (electrochemiluminescence, ECL) generates species at electrode surfaces, which undergoes electron-transfer reactions and forms excited states to emit light. It has be-come a very powerful analytical technique and has been widely used in such as clinical testing, bio-warfare agent detection, and pharmaceutical analysis. This review focuses on the current trends of molecular recognition-based biosensing methods for pharmaceutical analysis since 2010. It introduces a background of ECL and presents the recent ECL developments in ECL immunoassay (ECLIA), im-munosensors, enzyme-based biosensors, aptamer-based biosensors, and molecularly imprinted poly-mers (MIP)-based sensors. At last, the future perspective for these analytical methods is briefly discussed.
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Objective To compare the free hexafluoro-isopropanol (HFIP) concentrations in whole blood of patients inhaling different concentrations of sevoflurane and further evaluate the relationship with e-mergence agitation. Methods Forty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, scheduled for elective laparoscopic gastrointestinal surgery, were divided into 3 groups according to the inhaled conentration of sevoflurane using a random number table: 0. 86％group (group S1 , n= 13), 1. 71％ group (group S2 , n= 14) and 2. 57％ group (group S3 , n = 13). In S1 , S2 and S3 groups, the corresponding concentrations of sevoflurane were inhaled, remifentanil (target concentration 4-6 ng∕ml) was given by target-controlled infusion, and propofol (4-12 mg·kg-1 ·h-1 ) and cisatracurium 0. 1 mg·kg-1 ·h-1 were infused intravenously at the same time, and sevoflurane was in-haled for 3 h, and then inhalation was stopped. At 30 min and 1, 2 and 3 h of sevoflurane inhalation and 1, 3 and 5 h after stopping inhalation, central venous blood samples were collected for determination of free HFIP concentrations in whole blood by the method of two-stage headspace equilibration. The recovery time for spontaneous breathing, time for eye opening on verbal command, extubation time and development of agitation and moderate pain within 4 h after extubation were recorded. Results Free HFIP concentrations in whole blood peaked at 1 of inhalation, then gradually decreased, and the concentrations decreased con-tinuously after stopping inhalation in the three groups (P<0. 05). Compared with S1 group, free HFIP con-centrations in whole blood were significantly increased at each time point in S2 group, and free HFIP con-centrations in whole blood were decreased during inhalation and at 1 h after stopping inhalation in S3 group (P<0. 05). Compared with S2 group, free HFIP concentrations in whole blood were significantly decreased at each time point in S3 group (P<0. 05). The recovery time of spontaneous breathing, time for eye open-ing on verbal commands and extubation time were significantly longer in S3 group than in the other two groups (P<0. 05). There was no significant difference in the incidence of agitation or moderate pain among the three groups (P>0. 05). Conclusion Free HFIP concentrations in whole blood increase with the in-crease in inhaled sevoflurane concentrations, however, production of free HFIP is markedly inhibited when the inhaled concentration reaches 2. 57％, and free HFIP concentrations in whole blood decrease; free HFIP had nothing to do with the emergence agitation in patients.
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Objective To measure and compare sevoflurane minimum alveolar concentration (MAC)in newborn and adult rats.Methods The rats were divided into newborn rat (6-8 days) group (25 cases)and adult rat (8-10 weeks)group (25 cases).All rats were settled in the self-made device for anesthesia with inhaled sevoflurane,and the tails of rats were exposed out of the device. Sevoflurane was given via an anesthesia machine.Up-and-down method and clamping tail stimulus were applied to measure the MAC values of sevoflurane in the two groups.1.5% of sevoflurane was set as the initial concentration,and± 0.2% as adjustable gradient.A positive or negative response was judged by clamping tail stimulus in a 20 minutes interval.The mean MAC value of all rats in each group was defined as the MAC value.Results The MAC value of newborn rats was (2.58 ± 0.1 1)%,and the MAC value of adult rats was (2.32 ±0.13)%.A significant difference was found between the two groups (P <0.01).Conclusion The MAC value of newborn rats was much higher than that of adult rats.Newborn rats need a higher concentration of sevoflurane at the same depth of anesthesia when compared with adult rats.
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Objective To observe the neurotoxicity of epidural different dose of dexmedetomi-dine in combination with 0.75% bupivacaine.Methods Twenty-five rabbits weight 2-3 kg without gender tendency and equipped with an epidural lumbar catheter were allocated randomly to five groups with 5 cases each.The control group (group C)received injections of 1.5 ml normal saline,0.75%bupivacaine 1.5 ml plus normal saline 0.5 ml in group B,and the other treatment groups received in-jections of 0.75% bupivacaine 1 ml plus dexmedetomidine 0.1 μg/kg (group D1 ), 0.75%bupivacaine 1 ml plus dexmedetomidine 0.2 μg/kg (group D2 )or 0.75% bupivacaine 1 ml plus dexmedetomidine 0.4 μg/kg (group D3),in the same volume of 1.5 ml.After successive 3-day epi-dural administration of the drugs and a 3-day observation,the rabbits were killed and the spinal cord was examined under optical and electron microscope.Results Serious damages of neuron were found in 1 animal from group D2 and 2 from group D3 under optical microscope.There was unclear bounda-ries between gray and white matter.Some nerve cells appeared necrosis in the grey matter of spinal cord and the number of nerve cells was decreased.Some reversible changes were found in all groups under electron microscope.Conclusion Epidural administration of dexmedetomidine can induce spinal cord and spinal nerves injury dose-dependently,and the motor function can recuperated completely.
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Objective To explore the influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria.Methods 96 confirmed chronic urticaria patients were selected and divided into the control group and the observation group with 48 patients in each group according to random digit table.The control group was given with routine nursing mode.The observation group received combination of Chinese traditional and western medicine continuing nursing care.The treatment lasted for 12 months.Treatment effect and Dermatology Life Qudity Index (DLQI) evaluation were executed at the end of the 3rd,6th and 12th months.The relapse was inquired 2 months after the intervention by follow-up.Results The total effective rates in the control group and the observation group at the end of the 3rd,6th and 12th months were 75.6％ (34/45),80.0％ (36/45),82.2％ (37/45) and 87.0％ (40/46),91.3％ (42/46),93.5％ (43/46),the results showed significant difference,P ＜ 0.05.DLQI scores at the end of the 3rd,6th and 12th months in the control group and the observation group were (7.82±1.95),(7.04±1.58),(6.56±0.88) scores and (6.85±1.56),(5.71±1.03),(3.42±0.78) scores,the differences were significant,P＜0.05.The relapse interval time was (24.75±5.07) days and (38.20±7.22) days,the difference was statistically significant (P＜0.01).Conclusions Combination of Chinese traditional and western medicine continuing nursing care can significantly improve treatment outcome of chronic urticaria,reduce relapse rate,increase quality of life for patients with chronic urticaria,and it is better than routine nursing care and is worthy of being popularized.
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<p><b>OBJECTIVE</b>To compare the differences of clinical effects on primary hypertension between acupuncture combined with auricular point sticking and western medicine.</p><p><b>METHODS</b>Ninety patients with primary hypertension were randomly divided into a medication group and a combination group, 45 cases in each group. In the medication group, captopril tablets were treated with oral administration, 12.5 mg each time, twice a day; in the combination group, acupuncture and auricular point sticking were used, and acupuncture was applied at Renying (ST 9), Fengchi (GB 20) and Baihui (GV 20), while auricular point sticking was adopted at Shenmen (TF4), Xin (CO15), Jiangyagou and Jiaogan (AH6a), once a day for continuous 4 weeks. After treatment, the changes of 24 h ambulatory blood pressure, angiotensin II (Ang II) level, creatinine level and syndrome scores were observed and the clinical efficacy was assessed in the two groups.</p><p><b>RESULTS</b>After 4 weeks' treatment, the 24 h ambulatory blood pressure was both improved compared with that before treatment in the two groups (P<0.01, P<0.05). The reducing of 24 h ambulatory blood pressure in the combination group was superior to that in the medication group (P<0.05). There were reducing tendencies about coefficients of variation (CVs) of the two groups, and in the combination group, the CVs of 24 h ambulatory blood pressure and systolic pressure acquired more obvious reducing range compared with the medication group (both P<0.05). Serum Ang II level and plasma creatinine level of the patients in the two groups after treatment were both decreased (both P<0.05) and the reducing of Ang II level and creatinine level of the combination group was more obvious than that of the medication group (both P<0.05). The syndrome scores of the two groups after treatment were both remarkably decreased (both P<0.05), and the reducing of the syndrome scores of the combination group was more marked than that of the medication group (P<0.05). The total effective rate of the combination group was 95.6% (43/45), which was superior to 71.1% (32/45) of the medication group (P<0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with auricular point sticking for primary hypertension has reliable effect. It is better than captopril for the improvement of 24 h ambulatory blood pressure, AngII level and creatinine level, and can improve dizzy, palpitation and other clinical symptoms.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Acupuncture, Ear , Blood Pressure , Hypertension , Therapeutics , Treatment OutcomeABSTRACT
A sub-microsecond pulse generation applied for electroporation effects of tumor cell is presented in this paper. The principle of the generator is that the expected pulse waveform is intercepted from the RC discharge curve by controlling the on-off states of two IGBT modules with a synchronous controller. Experimental tests indicate that the generator can produce adjustable pulse waveform parameters with 0.5-3.5kV amplitude, 300-800 ns pulse duration, 1-400Hz repetition frequency rate, and it is suitable for the study of the electroporation effect experiments.
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Animals , Cell Line, Tumor , Cell Membrane , Electricity , Electroporation , Methods , Equipment Design , Microtechnology , NeoplasmsABSTRACT
Phenylketonuria (PKU) is a severe autosomal recessive disease which can cause irreversible damage to patients' neural system and results in severe mental retardation.Although the institution of a lowphenylalanine (Phe) diet has been a remarkable success in preventing the devastating damage associated with untreated PKU,there are always small but consistent gap in intelligence quotient (IQ) scores and executive functioning when compared to siblings or healthy age-related control groups.During the past few years,several types of new treatment strategies,such as genetic engineering,enzyme replacement,tetrahydrobiopterin (BH4),large neutral amino acids (LNAA),low-Phe diet and liver or liver cell transplantation therapies,have been studied and improved.This paper aims to introduce the research advances in pathogenesis of PKU,the treatment methods and the related molecular mechanism.
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Objective To determine the median effective dose (ED50 ) of ropivacaine for spinal anesthesia when combined with sufentanil in patients undergoing caesarean section. Methods Twenty-eight ASA Ⅰ or Ⅱ parturients, aged 18-40 yr, weighing 50-110 kg, undergoing cesarean section under combined spinal-epidural anesthesia, were enrolled in this study. Combined spinal-epidural anesthesia was performed at L2,3 interspace. The mixture of ropivacaine and 5 fig sufentanil was injected into the subarachnoid space over 30 s. The initial dose of ropivacaine was 11 mg. The dose was increased/decreased by 1 mg in the next patient. The ED50 and 95% confidence interval were calculated by up-and-down method. Results The ED50 of ropivacaine was 7.780 mg (95% confidence interval 6.850-8.836 mg). Conclusion When combined with sufentanil 5 μg, the ED50 of ropivacaine for spinal anesthesia is 7.780 mg in patients undergoing caesarean section.