Analysis of chronic disease types and drug use of multiple chronic diseases based on regional pretrial center / 中国药房

OBJECTIVE To provide reference for chronic disease management in grass-root institution . METHODS System structure design and audit class setting of the regional pretrial center in Changning district of Shanghai were introduced. The number of prescriptions/medical orders from the start of application to February 28，2022 were counted. The prescriptions/medical orders intercepted by the system ，prescriptions/medical orders intervened by physicians ，chronic disease types and drug use of regional multiple chronic diseases were counted and analyzed. RESULTS Compared with the data when the center was on line in September 2021，total qualified rate of prescriptions/medical orders （97.67％ vs. 86.42％）significantly increased ，the number of prescriptions/ medical orders intercepted by the system and intervened by physicians decreased by 55.39％ and 72.67％ in February 2022， respectively. The top five diseases were hypertension （26.52％），coronary heart disease （20.53％），sleep disorders （16.71％），diabetes（15.24％）and bone diseases （14.09％）. Among them ， there were many problematic prescriptions involving coronary heart disease ，sleep disorder and bone disease. CONCLUSIONS The incidence of chronic diseases among community residents remains high. In addition to common chronic diseases such as coronary heart disease ，hypertension and diabetes ，the incidence of sleep disorders and bone diseases is also increasing. With the help of the regional pretrial center ，the focus of chronic disease management can be adjusted timely ，drug supervision can be carried out in real time so as to improve the level of rational drug use in grass-root institution.

Quantitative evaluation of the ciliary body parameters in eyes with acute primary angle-closure / 中华实验眼科杂志

Objective:To investigate the measurements of the ciliary body in patients with acute primary angle-closure (APAC).Methods:This was a case-control study.Subjects were admitted to Ningxia Eye Hospital from January to October 2016.Fifty-five consecutive patients diagnosed with APAC in one eye were presented as case groups, and their fellow eyes were presented as fellow groups.Fifty-five eyes from 55 age-matched normal controls were also recruited as control groups.A-scan ultrasonography and ultrasound biomicroscopy (UBM) were conducted to determine biometric measurements and ciliary body parameters.Biometric measurements included axial length (AL), lens thickness (LT), anterior chamber depth (ACD), pupil diameter (PD), anterior chamber width (ACW) and lens vault (LV). Ciliary body parameters included maximum ciliary body thickness (CBTmax), ciliary body thickness at the point of the scleral spur (CBT 0) and 1 000 μm from the scleral spur (CBT 1000), anterior placement of the ciliary body (APCB), and trabecular-ciliary process angle (TCA), respectively.Pearson correlation analysis was used to examine the correlation between the biometric measurements and the ciliary body parameters.Written informed consent was obtained from each subject before any medical examination.The study protocol was approved by the Ethics Committee of People's Hospital of Ningxia Hui Autonomous Region. Results:The ACD was smaller, while the PD and lens thickness were larger in eyes with APAC compared with their fellow eyes.The differences were statistically significant ( t=-6.805, 3.490, 2.624; all at P<0.05). Smaller AL and ACD measurements were found in the fellow eyes of APAC patients compared with normal eyes, and these differences were statistically significant ( t=-4.828, -6.947; both at P<0.001). For eyes with APAC, their fellow eyes and normal eyes, the average CBT max were (0.907±0.106), (0.960±0.098) and (1.020±0.108)mm; average TCA were (48.99±11.48)°, (51.32±10.87)° and (81.94±12.45)°, respectively.CBT max, CBT 0, CBT 1000, and TCA measukements were smaller, and APCB were larger in eyes with APAC compared with their fellow eyes, and these differences were statistically significant ( t=-5.354, -3.517, -3.407, -0.753; all at P<0.05). In addition, CBT max, CBT 0, CBT 1000, and TCA measurements were smaller, and APCB were larger in the fellow eyes compared with the normal eyes, these differences were also statistically significant ( t=-6.040, -3.132, -6.005, -13.509, 16.795; all at P<0.05). Positive correlations were found between AL and CBT 1000, and between AL and TCA ( r=0.335, P=0.012; r=0.380, P=0.004), while a negative correlation was found between intraocular pressure and CBTmax ( r=-0.289, P=0.032). Conclusions:In eyes with APAC, as well as their fellow eyes, ciliary bodies are thinner and anteriorly rotated, and this anatomical change is associated with shorter AL and high intraocular pressure.

Mechanism of " acupuncture for the opening of ATP sensitive potassium channel against cerebral ischemia reperfusion injury in rats / 中国针灸

OBJECTIVE@#To observe the mechanism of "" acupuncture for the opening of ATP sensitive potassium channel (K) against cerebral ischemia reperfusion injury in rats.@*METHODS@#Eighty-four rats were randomly divided into a sham-operation group, a model group, an electroacupuncture (EA) group, an EA+K blocker group, 21 rats in each group. 10 μL intracerebral injection with glipizide (1 μmol/5 μL) was used in the EA+K blocker group. The cerebral ischemia reperfusion model was established by Zea Longa's suture method in the model group, the EA group and the EA+K blocker group. Rats in the sham-operation group were received the same surgery but without nylon filament insertion. Acupuncture (20 min a time) was performed at "Neiguan" (PC 6), "Shuigou" (GV 26) and "Sanyinjiao" (SP 6) in the EA group and the EA+K blocker group at 10:00 and 16:00 for 3 days, firstly 90 min after model establishment. EA (2 Hz/15 Hz, 1 mA) was connected at the affected "Neiguan" (PC 6) and "Sanyinjiao" (SP 6). The same fixation was used in the sham-operation group and the model group, without EA. Neurological function was assessed by Zausinger's neurologic assessment scale. 2, 3, 5-triphenyltetrazolium chloride (TTC) staining was used to detect infarct volume. Neurocyte apoptosis in the hippocampus was detected by flow cytometry and the protein expressions of B lymphocytoma-2 gene (Bcl-2) and B cell lymphoma factor-associated X protein (Bax) were measured by Western-blot.@*RESULTS@#In comparison with the model group, the neurological score of the EA group increased (<0.01); the infarction volume and the hippocampal neuron's total apoptosis rate of the EA group decreased (both <0.05); the protein expression of Bcl-2 and Bcl-2/Bax of the EA group increased (<0.05, <0.01); and the protein expression of Bax of the EA group decreased (<0.01). Compared with the EA group, the neurological score of the EA+K blocker group decreased (<0.05); the total apoptosis rate of hippocampus neurons of the EA+K blocker group increased (<0.05); the expression of Bcl-2 protein of the EA+K blocker group reduced (<0.05); the expression of Bax protein of the EA+K blocker group increased (<0.05).@*CONCLUSION@#"" acupuncture has brain protective effect on rats with focal cerebral ischemia reperfusion injury. The mechanism may be related to regulating the opening of K channels and decreasing the apoptosis of neurons.

Recent clinical observation in treatment of chemotherapy-failed advanced lung adenocarcinoma cases with apatinib / 中国综合临床

Objective To analyze the treatment of chemotherapy?failed advanced lung adenocarcinoma cases and the adverse reactions with apatinib. Method Twenty?two patients received treatment of apatinib at a dose of 425 mg/day for two weeks,then at a dose of 675 mg/day for two weeks if could be tolerated. The efficacy was evaluated by the imaging,CEA and NSE. Results The clinical evaluation of patients were complete remis?sion( CR) 0 case,partial remission( PR) 5 cases,steady( SD) 13 cases,progress( PD) 3 cases,1 case termina?ted the treatment due to adverse reactions,and the objective response rate was 23. 8%(5/21),disease control rate was 85. 7%(18/21). After 4 weeks treatment,CEA and NSE were significantly reduced than the previous ((97. 45±79. 05) mg/L vs. (47. 05±31. 89) mg/L,(20. 27±6. 88) mg/L vs. (11. 09±8. 92) mg/L;t=2. 45, 3. 56;P0. 05) . The main side effects were hypertension and proteinuria( 72. 7%,59. 0%) . Conclusion The treatment of chemotherapy?failed advanced lung adenocarcinoma with apatinib has better exact effect,and toxicity could be controlled,so it was worthy of clinical treatment and evaluation of long?term efficacy.

Clinical significance of vascular endothelial growth factor levels in bronchoalveolar lavage fluid of patients with acute lung injury / 中华创伤杂志

Objective To test the levels of vascular endothelial growth factor (VEGF) in bronchoalveolar lavage fluid (BALF) during acute lung injury (ALI)/acute respiratory distress syndome (ARDS) after the interference with anticoagulation and fibrinolytic in an attempt to find a possible treatment plan for ALI/ARDS.Methods Oleic acid-induced ALI models were used in this study.A total of 96 rats were randomly assigned oleic acid group,salvianolate group,urokinase group,and saline group according to the random number table,with 24 animals per group.In oleic acid group,oleic acid (0.2 ml/kg,caudally) was administered alone.In addition to the oleic acid,the rats in salvianolate and urokinase groups received caudal injection with 10 ml/kg of 0.06％ salvianolate and 5,000 U/kg of urokinase respectively.In saline group,saline solution with an equal volume of oleic acid was caudally administered alone.Effect of the early use of salvianolate and urokinase on levels of VEGF in BALF was measured.Clinically,patients with ALI/ARDS composing survivor and death groups were enrolled and assessed by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and multiple organ dysfunction syndrome (MODS) score.Besides,healthy population was included as the controls to comparatively analyze the levels of VEGF in BALF in ALI/ARDS group.Results Of the rat models of ALI,early use of salvianolate or urokinase was associated with elevated level of VEGF in BALF (P ＜0.05),which subsequently attenuated the lung injury.In the clinical research,it was found that the level of VEGF in BALF in ALI/ARDS group was much lower than that in control group [(45.9 ± 5.7) pg/ml vs (60.6 ± 4.5) pg/ml] (P ＜ 0.01).The level of VEGF in BALF was negatively correlated with APACHE Ⅱor MODS scores (r =-0.542,-0.659,P ＜ 0.01).Moreover,patients in death group appeared lower VEGF level in BALF than those in survivor group(t =2.68,P ＜ 0.05).Conclusion VEGF level in BALF can be taken as an indicator of patient condition and outcome.Early use of anticoagulation or thrombolytic drugs may play a positive role on patients with ALI/ARDS.

Mice islet allograft tolerance induced by blockade of OX40/OX40L and CD40/CD154 costimulation pathway / 中华器官移植杂志

Objective To investigate the effects of blockade of OX40/OX40L costimulation pathway on mice islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice.Methods C57BL/6 mice were induced into diabetes mellitus as recipients,and were transplanted with DBA/2 mice islets.The recipients were divided into four groups,(1) treated with IgG as controls,(2) anti-OX40L mAb,(3) anti-CD154,(4) combined treatment of anti-OX40L mAb and anti CD154mAb.The mean survival time (MST) of islet allograft was observed.The expression of OX40 in activated T cells of CD154 deficient mice was detected.Effector T cells were obtained from the spleen of CD154 deficient mice cultured with or without anti-OX40L mAb for 3 days.The proliferation of T cells was assayed.Results The MST in the control group,anti-OX40L mAb group,anti-CD154 mAb group and anti OX40L mAb + anti-CD154 mAb group was 19,22,48,and ＞150 days respectively (P ＜0.05).The OX40 expression was readily induced in the 66％ activated T effector cells.CD154 deficient T effector cells proliferation was inhibited by the addition of anti-OX40L mAb in the culture in a dose-dependent fashion.Conclusion The blockade of OX40/OX40L costimulation pathway can promote islet allograft tolerance in CD40/CD154 costimulation pathway blockade mice by inhibiting the proliferation of T cells.

Study on the resonance frequency comparison between rat and rabbit bowels / 国际生物医学工程杂志

Objective To find out the accurate resonance frequencies and vibration characteristics of intestine,lung,kidney,stomach,heart and liver of rat and rabbit in low frequency and to provide basic data for the study of organs' resonance injury and reaction.Methods Eight rats and eight rabbits were anaesthetized with 1.5％ sodium pentobarbital and acceleration sensor was fixed to the surface of their bowels.The rats were fastened on their back on the veneer hung horizontally by rubber band.The veneer was hammered upward from the down side,and the biggest value of frequency spectrum was considered the resonance frequency.Rabbits were fastened on their back on vibration platform and 2 mm amplitude vibration was given with the sweeping-frequency from 2 Hz to 50 Hz.The bowels amplitudes on each frequency point were measured.The frequency corresponding to the biggest amplitude was considered the resonance frequency.Results The resonance frequencies of rat intestine,lung,kidney,stomach,heart and liver were respectively 3.8,3.2,6.6,7.0,4,6 and 3.0 Hz within frequency interval of 0 Hz to 20 Hz.The resonance frequencies of rabbit intestine,lung,kidney,stomach,heart and liver were respectively 6.0,5.0,7.0,8.0,6.0 and 7.0 Hz within frequency interval of 2 Hz to 50 Hz.The vibration amplitude of lung was the biggest at the resonance frequency.The resonance frequencies of both rat and rabbit bowels showed no statistical correlations to body weights,bowel mass and bowel volumes.Conclusion Bowel resonance frequencies of rat and that of rabbit are evidently statistical different except for that of kidney.The resonance frequency values of rabbit bowels are closer to that of dog and monkey than to that of rat.Thus the resonance injury characteristic of rabbit bowels can be the research basis for dog,monkey,and even human bowels resonance injury.

Characteristics of the sciatic nerve injuries inflicted by high-velocity triangle fragments in swine / 中华创伤杂志

Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.

Clinical analysis on hyponatremia in acute craniocerebral injury / 中华创伤杂志

Objecfive To explore pathological mechanism and treatment of central hyponatrem-ia. Methods Synchronous assay was made to detect changes of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),endogenous digitalis-like substance(EDLS),antideuretic hormone (ADH),Na+ concentrations in blood and urine as well as osmotic pressure of plasma and urine in 68 pa-tients with traumatic brain injury(TBI). Results Of all,there were 27 patients with hyponatremia,mostly in patients with severe or critical TBI.There found syndrome of inappropriate secretion of antidi-uretic hormone(SIADH)in 7 patients and cerebral salt wasting syndrome(CSWS)in 20. Conclu-sions The central hyponatremia in patients with TBI may be related to the increased secretion of EDLS and ADH.The decrease of ANP and BNP in blood has no direct effect on Na+ concentration in blood.In-travenous injection of extrinsic thyrotropin releasing hormone(TRH)may inhibit dilutional hyponatremia resulted from increased secretion of ADH in TBI patients.

Effect of astragaloside Ⅳ on contraction and relaxation in isolated rat aortic rings / 中国药理学通报

Aim To study the effect and investigate the underlying mechanism of astragaloside Ⅳ on contraction and relaxation in isolated rat aortic rings.Methods The relaxation effect of astragaloside Ⅳ(1～100 mg?L~(-1))on phenylephrine-preconstricted aorta ring was recorded.The effect of astragaloside Ⅳ on the contraction induced by cumulative phenylephrine,KCl or CaCl_2,was recorded respectively.Results Astragaloside Ⅳ dilated aortic vessels in a dose-dependent manner,which was partly inhibited by preincubation with non-selective nitric oxide synthase inhibitor,guanylyl cyclase inhibitor and cyclooxygenases inhibitor indomethacin.Astragaloside IV could also antagonize phenylephrine-,KCl-and CaCl_2-induced vessel contraction.Conclusion Astragaloside IV dilated aortic vessels partially though endothelium-dependent NO pathway and inhibited vessel contraction via interfering Ca~(2+) influx.

Quantitative parameters on nuclear DNA of ovarian mucinous cystadenomatous in differential diagnosis / 中国癌症杂志

Purpose:To study the value of nuclear DNA morphological parameters in differential diagnosis. Methods:Using the cellular image analysis instrument to quantitate nuclear DNA morphological parameters (including area, perimeter, major diameter, equivalent circle diameter and nuclear shape factor) in 38 cases of ovarian mucinous cystadenomatous and 5 normal ovarian epithelial tissue, and to analyze the relationship between histodifferentiation and nuclear morphological. Results:Statistical analysis showed that there were significant differences between the groups ( P 0.05). Conclusions:Nuclear DNA morphological parameters of ovarian mucinous cystadenomatous are useful markers, and may have some significance in pathological diagnosis.