Pay attention to the whole process management of diabetic retinopathy / 中华眼底病杂志

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it is a key ocular fundus disease that needs to be paid attention to in the next five years according to the "14th Five-Year" Plan for Eye Health. Promoting the systematic management of DR and constructing the chronic disease management system are the key to the next step of national eye health work. It is necessary to further improve the management mode of the whole course of DR patients with chronic eye disease through the joint action of medical security system at all levels, including strengthening supporting policies of primary medical institutions, optimizing medical service mode and process, strengthening scientific education to improve patients' and doctors' disease cognition, and updating authoritative Chinese DR guidelines to standardize diagnosis and treatment. It is hoped that the low vision and blindness caused by DR in China can be greatly reduced after the implementation of the "14th Five-Year" Plan for Eye Health.

Comparison of two kinds of noninvasive ventilation mode in premature infants with respiratory failure / 中国小儿急救医学

Objective To investigate the difference of two models of respiratory failure in preterm infants with nasal continuous positive airway pressure(nCPAP)and nasal biphasic positive airway pressure (nBiPAP).Methods Comparative analysis of 81cases of premature infants with respiratory failure requi-ring respiratory support was needed.They were applied nCPAP and nBiPAP ventilation mode treatment.The use of breathing machine and total oxygen inhalation time,the number of treatment failures,the PEEP param-eters of the ventilator,the total number of recent complications and secondary infections were compared.Re-sults In the nBiPAP treatment group,the average time of noninvasive ventilation was(96.34±31.5)h,the total time of oxygen inhalation was(10.11 ±9.39)d,3cases of treatment failure,the incidence of severe complications was 5.56%(2/36),PEEP (4.08±0.73)cmH2O (1cmH2O =0.098kPa ).In the nCPAP group,the average time of noninvasive ventilation was(114.14±41.69)h,the total time of oxygen inhalation was(17.53±15.96)d,15cases were failed,the incidence of severe complications was 15.56%(7/45), PEEP(5.11±1.01)cmH2O.There were significant differences between the two groups(P﹤0.05).But there were no significant differences in infection control and patent ductus arteriosus (P ﹥0.05).Conclusion nBiPAP as one of the first choice treatment for premature infants with respiratory failure significantly better than nCPAP,as soon as the proper use can avoid invasive ventilation.

Cognition Investigation of Adverse Drug Reaction among Medical Staff with Different Occupations and Dif-ferent Professional Titles in Our Hospital / 中国药房

OBJECTIVE:To provide reference for improving the cognition of medical staff for adverse drug reactions(ADR). METHODS:A questionnaire survey was conducted on the spot among the physicians,nurses and pharmacists with different profes-sional titles in our hospital to investigate their cognition about ADR concept,their judgment for ADR and ADR reporting,and the results were analyzed by statistical methods. RESULTS:Totally 452 questionnaires were sent out,and 439 were effectively re-ceived,with effective rate of 97.12%. In terms of correct cognition rate about ADR basic concept and the main reasons,the sur-veyed pharmacists were higher than physicians and nurses,the senior professional titles of surveyed pharmacists were higher than the intermediate and junior,the pharmacists with senior professional titles were the highest and the junior were the lowest,the dif-ferences were statistically significant(P<0.05);in terms of the proportion of certain for ADR judgment,the surveyed nurses were lower than pharmacists and physicians,the surveyed physicians with senior and intermediate professional titles were higher the ju-nior,the surveyed nurses with intermediate titles were higher than the junior,the surveyed pharmacists with senior professional ti-tles were higher than the intermediate and the junior,the differences were statistically significant(P<0.05);in terms of cognition about ADR reporting,the surveyed pharmacists were the highest and the nurses were the lowest,the differences were statistically significant (P<0.05),while in terms of the proportion of knowing ADR reporting timing limit,reporting procedures and depart-ments,the surveyed pharmacists and physicians with junior professional titles were lower than the senior and intermediate,the dif-ferences were statistically significant(P<0.05);in terms of reasons for missed ADR reporting,the proportion of consideration of the risk of causing medical disputes for doctors of the surveyed physicians was higher than pharmacists and nurses,while the sur-veyed nurses showed higher proportion for doing not understand reporting procedures,doing not reporting,thinking ADR reporting was dispensable and uncertain for ADR identification,the differences were statistically significant (P<0.05). CONCLUSIONS:Medical staff with different professional titles and occupations have different cognition about ADR basic concept,judgment and re-porting,the pharmacist are relatively good,followed by the physician and nurse,especially the nurse,and the medical staff with junior professional titles are relatively poor. It is necessary to strengthen ADR education and training for them,play professional ad-vantages from the pharmacist and optimize ADR reporting procedures to improve the reporting rate and quality of ADR.

One case report of autoantibody-associated congenital heart block / 临床儿科杂志

ObjectiveTo explore the pathogenesis, clinical manifestations, diagnosis, and treatment of autoanti-body-associated congenital heart block.MethodsThe clinical data of one child with autoantibody-associated congenital heart block was retrospectively analyzed.ResultsIn 24 week gestation, fetal bradycardia had been found by routine fetal echocar-diography. After birth, the anti-SSA/Ro antibodies and anti-SSB/La antibodies were positive in both infant and her mother. The diagnosis of autoantibody-associated congenital heart block was conifrmed. Intravenous immunoglobulin at 1 g/kg was adminis-trated. At 6 months follow-up, the electrocardiogram suggested type I second degree atrioventricular block.ConclusionIn the fetus or neonates found to have bradycardia and excluded the cardiac structural abnormalities, the autoimmune antibody should been tested and early intervention should been promoted.

Inhibitory effect of a novel peptide GC31 on lipopolysaccharide-induced corneal inflammation / 中华实验眼科杂志

Background Most anti-inflammation eyedrops are limited in clinical application owing to multiple adverse effects.A novel peptide GC31 derived from human thrombomodulin has a natural anti-inflammatory activity.Compared with conventional anti-inflammatory eyedrops,GC31 possesses more advantages and potential clinical transforming value.However,relevant study is still lack.Objective The purpose of this study was to evaluate the anti-inflammatory effect of GC31 and the possible mechanisms.Methods Sixty SPF male Wistar rats aged 8-10 weeks were randomized into 6 groups using randomized number table.Non-specific keratitis models were established in 40 rats by intrastromal injection of 10 μl of lipopolysaccharide (LPS) dissolved in PBS.Different doses of GC31 (125 μg or 250 μg) or dexamethason soluble in PBS were sunconjunctically injected in the experimental eyes respectively in the low dose GC31 group,high dose of GC31 group and the dexamethason group,and 10 μl of PBS was used in the same way in the PBS control group.No drug was injected in the model group,and the normal rats were employed as the blank control group.The corneas were examined by slit lamp microscope and were scored based on the criteria of Anand 24 hours after injection.Then the corneas were collected for histopathological examination.Expression of nuclear factor-κB (NF-κB) p65 in the corneas was detected using immunochemistry.Expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) proteins were assayed using ELISA.Real-time PCR was used to detect the expressions of IL-6 mRNA and TNF-α mRNA.The use and care of the experimental animals followed Regulation for the Administration of Affair Concerning Experiment animals by State Science and Techonology Commission.Results A significant difference was seen in the ocular inflammatory scores among the six groups (F =301.238,P =0.000).The inflammatory scores were significantly lower in the high dose of GC31 group than those in the model group (1.85 ± 0.36 versus 2.90± 0.43) (t' =-5.144,P =0.000) ; and the scores in the dexamethason group was lower than those in the high dose of GC31 group(t' =-3.931,P=0.000).Infiltration of inflammatory cells in corneal tissue was milder in the high dose of GC31 and the dexamethason group compared with the model group.The positive response for NF-κB p65 was obviously weaker in the rat corneas in the low and high dose of GC31 groups and the dexamethason group in comparison with the model group.The contents of IL-6 and TNF-α proteins in the corneas were significantly reduced in the low and high dose of GC31 group and the dexamethason group compared with the model group (low dose group:t=-2.626,P=0.009;t'=-2.310,P=0.017.high dose group:t =-3.361,P=0.001 ;t'=-3.151,P=0.002),and the contents of IL-6 and TNF-α proteins in the dexamethason group were lower than those in the high dose of GC31 group (t=-3.361,P=0.001;t'=-3.360,P=0.000).In addition,the expression trend and compared results of IL-6 mRNA and TNF-α mRNA among the groups were similar to those of the IL-6 and TNF-α proteins (all at P＜0.01).Conclusions GC31 suppresses LPS-induced corneal inflammation response by downregulating the expression of inflammatory eytokines.The effect is more dominant in the doses of 250 μg than that in the doses of 125 μg.

Mitochondrial dysfunction induced by excessive ROS/RNS-metabolic cardiovascular disease and traditional Chinese medicines intervention / 中国中药杂志

Metabolic cardiovascular disease is a type of disease which almost caused by body carbohydrate and lipid metabolism dysfunction. Type 2 diabetes mellitus is a typical metabolic disease. It not only lead to the insulin resistance but also related to atherosclerosis. Oxidative stress is produced by the reactive oxygen/nitrogen species (ROS/RNS). Oxidative stress and its consequence events play important roles in atherosclerosis (AS). Mitochondria are both sources and targets of reactive oxygen and/or nitrogen species (ROS/RNS), and there is growing evidence that mitochondrial dysfunction may be relevant intermediate mechanism by which cardiovascular risk factors lead to the formation of vascular lesions. Several cardiovascular risk factors are demonstrated causes of mitochondrial damage. This review starts with excessive ROS/RNS-induced mitochondrial dysfunction. The authors emphasize the relationship among axis of excessive ROS/RNS-mitochondrial dysfunction-apoptosis-atherosclerosis. They also introduce several traditional Chinese medicines such as Ophiopogon japonicus, butin, Panax ginseng, Pueraria lobata, Solanum lyratum and so on in the treatment of relevant diseases through anti-ROS/RNS mechanism. Moreover, the TCMs also can anti-cancer and anti-fatigue,which show the speciality of TCMs different from the single effect of classical western medicines.

Apoptotic regulation and tRNA

Apoptotic regulation is critical to organismal homeostasis and protection against many human disease processes such as cancer. Significant research efforts over the past several decades have illuminated many signaling molecules and effecter proteins responsible for this form of programmed cell death. Recent evidence suggests that transfer RNA (tRNA) regulates apoptotic sensitivity at the level of cytochrome c-mediated apoptosome formation. This finding unexpectedly places tRNA at the nexus of cellular biosynthesis and survival. Here we review the current understanding of both the apoptotic machinery and tRNA biology. We describe the evidence linking tRNA and cytochrome c in depth, and speculate on the implications of this link in cell biology.

Study on effect of total saponins from Semen Nigellae on inflammatory mediators and ERK/MAPK pathway in stimulated macrophage / 中国中药杂志

<p><b>OBJECTIVE</b>To study the anti-inflammatory mechanism of total saponins from Semen Nigellae (TSSN).</p><p><b>METHOD</b>IFN-gamma plus LPS stimulated RAW 264. 7 macrophage has been used as inflammatory experimental model. Griess reaction for nitric oxide production, FRAP assay for total antioxidant capacity, RT-PCR for mRNA expression and Western blot for protein expression examination were performed.</p><p><b>RESULT</b>TSSN inhibited NO production in a dose-dependent manner. The gene and protein expression of iNOS were also suppressed by the herb extract. TSSN treatment significantly attenuated mRNA of inflammatory mediators such as COX-2, IL-1beta, IL-6 while increased PPAR-gamma gene and protein expression. Furthermore, phosphorylation of ERK (p-ERK) was markedly inhibited by TSSN.</p><p><b>CONCLUSION</b>TSSN suppressed pro-inflammatory mediators such as COX-2, IL-1beta, IL-6 and increased anti-inflammatory mediator PPAR-gamma expression. Meanwhile, TSSN inhibited over production of NO and iNOS expression through ERK/MAPK pathway.</p>

Effects of APRV-BIPAP ventilation On lung recruitment/open maneuvers in piglets with acute lung injury / 中华急诊医学杂志

Objective To study the effects of APBV (airway pressure release ventilation) / BIPAP(bipha-sic positive airway pressure) on lung recmitment/open maneuvers in piglets with acute lung injury. Method The model of acute lung injury (ALI) was induced by E. coll. intraperitoneal injection in piglets. Based APRV/BI-PAP model, the different pressure combinations (Phigh/Plow) of RMs increased gradually, such as RMI(30/15),RM2(35/20), RM3(40/25), RM4(45/30),RM5(50/35), RM6(55/40), RM7(60/45) cmH2O. The effects of stepwise RMs were studied by computed tomography (CT) at iaspiratory phase. Meantime the oxygen index (PaO2/FiO2), hemodynamic parameter and mean pressure of airway (Pmean) were continuously observed. The piglets were killed when RiMs finished and pulmonary pathological examination were done routinely by optical microscope. Data was analyzed by self-contrast method, using SPSS 11.5 software package. Results were expressed as mean ± standard deviation (x±s). Multiple comparisons were made with One-way ANOVA. Pearson correlative analysis was used to describe the relativity of PaO2/FiO2 and the collapsed alveolar area. Changes were considered as statistically significant if P value was less than 0.05. Results Eight piglets with ALl model were successfully made and all of them showed different degree of alveolar collapse under chest CT scan. During RMs their PaO2/FiO2 increased obviously (P<0.05) were decreased obviously (P<0.05) too, specially after RM2 finished (P<0. 05). But the alveolar over-inflatian could be found in some non-diseased area. The heart rate (HR) increased and mean artery blood pressure (MAP) decreased significantly while the pressure combinations (Phigh/Plow) of RMs were added gradual]y ( P<0.05). Meantime the Pmean and Ppeak inspiratory pressure (PIP) of airway and central venous pressure (CVP) were increased significantly ( P<0.05). But when RMs were finished,all of these indexes were hack to the levels of pre-RMs. Even there were no barowaumas happened, such as pneumothorax and pneumomedistinum, the alveolar overdistention and interruption of the alveolar separation still could be seen by pathologic examination. Conclusions RMs could be done well by APRV/BIPAP. Phigh/Plow (35/20cmH2O) would be the best pressure combination with more efficacy of RMs and less influence on hemodynamics,airway pressure indexes and others. When the effect of RMs was satisfied enough, setting Phigh/Plow to 30/15cmH2O for 20 mitt may maintain the good efficacy of RMs.

Logistic Analysis of the Infectious ODDS Risks of Anticancer Drugs in GI Cancer Patients with Chemotherapy Regiments / 药物流行病学杂志

Objective:To analyze the infectious ODDS risks of anticancer plant alkaloids and other anticancer drugs in GI cancer patients with chemotherapy regiments.Method:2384 profiles of cancer patients agreeable with studying condition were collected.All the profiles were evaluated with different variants,and then these variants were analyzed with the logistic liner.Result:The line values of ages,days in hospital,insurances,alkylating agents,platinum antitumor com- pounds and other antitumor drugs were 0.010,0.147,-0.361,-0.930,-0.390,and-1.306.Conclusion:The infection OR of the ages and days in hospital increased OR factors and the medical insurances decreased OR factors.Antitumor antibiot- ics,antimetabolites,plant alkaloids had their higher infectious risks than platinum antiturnor compounds,alkylating agents and other antitumor drugs did in GI cancer patients with chemotherapy regiments.