ABSTRACT
Direct oral anticoagulants,include direct thrombin inhibitor and direct factor Xa inhibitor.As the pharmacokinetics and pharmacodynamics of these drugs are known,their plasma concentration is not food-effective,and theoretically it is not necessary to monitor routinely.However, clinical practice in recent years has shown that anticoagulant effect of DOACs is required to evaluate in patients with thrombosis, major bleeding, emergency surgery, hepatic/renal dysfunction and other special situations.Recent studies have shown that routine coagulation assays such as activated partial thromboplastin time(APTT) and thrombin time(TT) can be used as laboratory screening tests for direct thrombin inhibitor dabigatran and prothrombin time(PT) can be used as laboratory screening test for direct factor Xa inhibitor rivaroxaban.DOAC′s quantitative measurements include dilute thrombin time(dTT),hemoclot thrombin inhibitor (HTI),ecarin clotting time (ECT) and ecarin chromogenic assay (ECA) for direct thrombin inhibitor and anti-FXa assay(rivaroxaban calibration) for rivaroxaban.Laboratories should establish their own monitoring range when performing these assays.
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Objective To investigate the effects of environmental enrichment (EE) on the neurological functions in patients with stroke. Methods From May, 2013 to November, 2015, 76 patients with stroke were selected and randomly divided into control group (n=39) and EE group (n=37). Both groups received routine therapy and the EE group received EE in addition. They were assessed with simplified Fugl-Meyer Assessment (FMA), Montreal Cognitive Assessment (MoCA) and modified Barthel Index (MBI) before and after treatment. Re-sults The scores of FMA, MoCA and MBI increased in both groups after treatment (t>2.339, P2.187, P<0.05). Conclusion EE could promote the recovery of cognitive function and activities of daily living in patients with stroke.
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Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.
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Objective There is a huge demand for rehabilitative services in Chongqing whereas detailed information regarding local clinical services and rehabilitative professionals are unknown. Therefore, a cross-sectional survey was conducted to generate a profile of current rehabilitative status in Chongqing for reference of relevant local parties and peers in other provinces of China to create a larger picture of rehabil-itation in China. Methods The survey began in early January of 2015 and ended on October 20th of 2015. With two categories of information, including background of rehabilitation professionals and rehabilitative clinical services, the self-made questionnaire was sent via email to rehabilitation therapists working in local clinical settings which fulfilled the inclusion criteria. The reminder was sent once a month to those who did not yet replied. The software SPSS 20.0 was used to analyze the data descriptively. Results 7 out of 13 in-volved clinical settings responded with an overall response rate of 53.8%. 98 out of 122 copies were adopted based on filling requirement. The result revealed 68.4%(n=67) of the participants were junior practitioners, 57.1%(n=56) of them had less than 5 years experience and 45.9%(n=45) were holding a diploma with little research experience. As for clinical services, assessment of ROM (94.9%, n=93) and manual muscle testing (94.9%, n=93) were mostly used. The physical therapy service was more prevalent than occupational therapy services. The clinical field mostly involved was adult rehabilitation (77.6%, n=76). Bedside training in the acute phase (81.6%, n=80) and one-to-one treatment (92.9%, n=91) was the most commonly seen mode of service in the departments. Conclusion The local rehabilitative professionals were featured by their young age with comparatively low educational level, qualification and weak research skills. The clinical services they provided were yet quite basic and simple. Thus, a set of policies regarding education and profession in rehabilitation therapy should be facilitated instantly and it also calls for the establishment of local academic society for rehabilitation therapists, thus promoting an all-round development of rehabilitative profession.
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Manual microscopic differential of white blood cell has been challenged by multiparameter flow cytometry,using monoclonal antibodies to define the different leukocyte types.Compared with manual differential,flow cytometry method is more sensitive,specific,objective and has good repeatability.Recent studies demonstrated flow cytometric differential correlates well with manual microscopic method and has good clinical performance for blast and immature granulocyte.Meanwhile more leukocyte populations can be identified with flow cytometric method,such as lymphocyte subset and CD 16 + monocyte,thus helping in monitoring blast in acute leukemia,B lymphocyte proliferative disorder differential diagnosis and minimal residual disease.With the development and improvement of flow cytometric differential,it might be a candidate reference method of leukocyte differential,gradually applied in the routine work.