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OBJECTIVE To systematically evaluate the difference of efficacy and safety of four kinds of commonly used haemocoagulases combined with proton pump inhibitor （PPI） for nonvariceal upper gastrointestinal bleeding （NVUGIB）， and to provide evidence-based basis for clinical decision-making. METHODS Retrieved from PubMed， Web of Science， Wanfang data， VIP and CNKI databases， randomized controlled trials （RCTs） or cohort studies about Hemocoagulase agkistrodon blomhoffii， Haemocoagulase agkistrodon， hemocoagulase and Hemocoagulase bothrops atrox combined with PPI were collected during the inception to Dec. 2021. Two researchers independently screened the literature， extracted data and evaluated the quality of included studies. ADDIS 1.16.8 software was used to conduct a Bayesian network meta-analysis. RESULTS A total of 33 studies were included， involving 3 602 patients. Results of network meta-analysis showed that： in terms of hemostatic efficacy， compared with PPI monotherapy， four kinds of haemocoagulases combined with PPI could significantly improve the hemostatic efficacy of patients （P＜0.05）； there was no statistical significance in the pairwise comparison of different hemocoagulases （P＞0.05）. The optimal probabilistic ranking of network meta-analysis was as follows： Hemocoagulase agkistrodon blomhoffii combined with PPI＞ Hemocoagulase bothrops atrox combined with PPI＞Haemocoagulase agkistrodon combined with PPI＞hemocoagulase combined with PPI＞PPI alone. In terms of the incidence of adverse drug reactions （ADR）， compared with PPI monotherapy， there was no statistical difference in the incidence of ADR among four kinds of haemocoagulases combined with PPI （P＞0.05）. There was no statistical significance in the pairwise 88325750。E-mail：fengyufei@126.com comparison of different hemocoagulases （P＞0.05）. The optimal probabilistic ranking of network meta-analysis was as follows： hemocoagulase combined with PPI＞Hemocoagulase bothrops atrox combined with PPI＞Hemocoagulase agkistrodon blomhoffii combined with PPI＞Haemocoagulase agkistrodon combined with PPI＞PPI alone. CONCLUSIONS Compared with PPI monotherapy， four different sources of hemocoagulases combined with PPI have better efficacy and similar safety in the treatment of NVUGIB. There is no significant difference in efficacy and safety among different hemocoagulases.
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OBJECTIVE To provide a reference for the standardized treatment of chronic obstructive pulmonary disease （COPD） and the adjustment of therapeutic drugs for COPD in the national essential medicine list. METHODS Relevant clinical experts， pharmaceutical experts and medical insurance experts were invited to sort out the COPD treatment drugs involved in the domestic and foreign COPD clinical guidelines， the national essential medicine list， the WHO standard list of essential medicine， the national medical insurance catalogue， and comparatively analyzed the COPD treatment drugs. RESULTS & CONCLUSIONS Compared with domestic clinical guidelines， foreign clinical guidelines included an additional COPD triple preparation， while involving fewer types of expectorants and antioxidants； there were only 12 kinds of COPD treatment drugs included in the WHO standard list of essential medicine， while there were 18 kinds in the national essential medicine list in China， and more theophylline drugs， expectorants and antioxidants were included. In addition， 15 kinds of COPD treatment drugs were found in both the national clinical guidelines and the national medical insurance catalogue， but not in the national essential medicine list， including terbutaline， levalbuterol hydrochloride， salmeterol， formoterol， indacaterol， beclometasone， mometasone furoate， salbutamol ipratropium， glycopyrronium formoterol， umeclidinium vilanterol， indacaterol glycopyrronium， beclometasone formoterol， budesonide/glycopyrrolate/formoterol fumarate， fluticasone furoate/vilanterol/umeclidinium， and fudosteine， which were mainly long-acting beta 2-agonists and COPD triple preparations. These drugs had certain evidence-based medicine evidence， their efficacy and economy had certain advantages， and their impact on the budget of the medical insurance fund was controllable. Therefore， it is suggested that the aforementioned drugs should be included in the essential medicines list in the subsequent update.
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OBJECTIVE：To i nvestigate the clini cal ch aracteristics of anaphylactic shock induced by piperacillin and its compound preparation ，and to provide reference for prevention and treatment of the severe ADR. METHODS ：A case of anaphylactic shock induced by piperacillin and sulbactam were analyzed in our hospital ，meanwhile ADR literatures about piperacillin alone and its compound preparation-induced anaphylactic shock were collected from Medline ，CNKI，Wanfang database and VIP during the inception to Jul. 2020. Gender and age of patients ，allergic history ，primary disease and treatment ，skin test ， administration route and dosage of piperacillin and its compound preparation ，occurrence time and main manifestations of anaphylactic shock ，treatment measure and prognosis were analyzed ，then prevention and treatment suggestions were put forward. RESULTS：The patient in this case was transferred to the ICU after partial hepatectomy. The use of piperacillin and sulbactam to prevent postoperative infection caused anaphylactic shock. A total of 28 literatures about anaphylactic shock induced by piperacillin and its compound preparations were collected from the database （involving 28 patients）. Among totally 29 patients，there were 12 male and 17 female；the majority of patients were 50-59 years old （6 cases，20.69％）. Three patients had allergic history （food， latex gloves ，etc.），and most of the primary diseases were infectious diseases or the drug used in perioperative period. Skin tests were carried out in 22 patients（75.86％）before medication and the results were negative. The possible allergenic drugs of 27 cases which were administered by intravenous route included piperacillin ，piperacillin sulbactam and piperacillin tazobactam. The dosage was different according to the primary disease and severity. 14 patients（55.56％）developed anaphylactic shock within 5 minutes after drug exposure. The main symptoms were systemic allergic reaction ，mainly involving the circulatory system. Except for two death cases ，the other patients ’symptoms were relieved after treatment. CONCLUSIONS ：Allergic history and skin test results may have limitation in predicting anaphylactic shock induced by piperacillin and its compound preparation. Close monitoring needs to be taken in patients during these medications. Rescue therapy should be prepared in advance and countermeasures need to be carried out promptly in case of anaphylactic shock.
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OBJECTIVE：To establish quantitative e valuation system of the prophylactic use of antibiotics in orthopedic type Ⅰ incision surgery ，and to provide reference for evaluating the rational prevention use of antibiotics in this type surgery scientifically. METHODS：Based on the Guidelines of Clinical Use of Antimicrobial Agents （2015 edition），drug instructions ，related guidelines and references ，experts from relevant departments jointly discussed and formulated the evaluation criteria for the rationality of the use of antibiotics in type Ⅰ incision in orthopedic surgery. AHP method was used to assign the weights for various indexes of evaluation criteria ；TOPSIS method was used to retrospectively analyze and evaluate the rationality of 120 cases of type Ⅰ incision surgery from 3 orthopedic departments in Peking University People ’s Hospital during Sept. 1st-30th，2019. RESULTS ：Established evaluation system included 4 primary indicators （medication indication ，usage and dosage ，medication timing ，other factors ）and 12 secondary indicators. Among the secondary indicators ，indications，drug selection and timing of preoperative administration were the most important （weights were 0.209，0.140，0.117）. Among 120 cases，30.83％ of drug use were reasonable ，47.50％ were basically reasonable and 21.67％ were unreasonable. Evaluation results obtained by AHP-TOPSIS were consistent with the actual situation. CONCLUSIONS ：The rationality evaluation method of prophylactic use of antibiotics in type Ⅰ incision surgery based on AHP-TOPSIS method can quantitatively evaluate the rationality of drug use by combining multiple indicators. The method is feasible ，operable，and the evaluation results can be quantified ，which has a wide range of application.
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OBJECTIVE：To rapidly evaluate the effectiveness ，safety and economics of Ginkgo biloba extract（EGb）in the treatment of Alzheimer ’s disease （AD）patients，and to provide evidence-based reference for clinical drug selection and decision. METHODS：Retrieved from PubMed ，Embase，Cochrane Library ，Web of Science ，CNKI，CBM，Wanfang database ，health technology assessment （HTA）organization websites and database during the inception to Aug. 10，2020，HTA reports ，systematic reviews/Meta-analysis，and pharmacoeconomic studies of EGb versus placebo in the treatment of AD were collected. After literature screening and data extration ，HTA checklist ，AMSTAR-2 scale and CHEERS scale were used respectively to evaluate the literature quality of the included HTA report ，systematic review/Meta-analysis and pharmacoeconomics studies. The conclusion of the included studies were summarized by using qualitative description. RESULTS ：A total of 9 literatures were included ，involving 8 systematic reviews and 1 economic studies. In terms of effectiveness ，there was no statistical significance in MMSE score of EGb group，ADAS-Cog score of 120 mg EGb group ，compared with placebo group （P＞0.05）. Dementia Quality of Life （DQoL）score of EGb group was significantly higher than that of placebo group. The scores of short cognitive aptitude tests ，neuropsychiatric inventory（NPI），NPI caregiver version score ，ADAS-Cog score of 160 mg EGb group and 240 mg EGb group were significantly lower than those of control group （P＜0.05）. ADL scores of patients were inconsistent ；ADL scores of EGb group were significantly lower than those o f placebo group （P＜0.05），or there was no significant diff erence between 2 groups（P＞0.05）； . subgroup analysis by dose showed that there was no RDY2019-39） significant difference in ADL score between 120 mg EGb group and placebo group （P＞0.05）；ADL score of 240 mg E-mail：renxiaolei83@126.com EGb group were signicantly lower than that of placebo group （P＜0.05）. Subgroup analysis of clinical global impression 010-88325751。E-mail：lyi1267@126.com change （CGIC） score showed that there was no significant difference in CGIC score between EGb group and placebo group after receiving ＜200 mg EGb and 26 weeks of treatment （P＞ 0.05）；CGIC score of EGb group was significantly higher than that of placebo group after receiving ＞200 mg EGb and 24 weeks of treatment （P＜0.05）. In terms of safety ，there was no statistical significance in the incidence of ADR or the incidence of severe ADR between EGb group and placebo group （P＞0.05）. Subgroup analysis by dose showed that the incidence of ADR in 240 mg EGb group was significantly higher than placebo group （P＜0.05）. Economically ，EGb treatment for AD is cost-effective ，which could indirectly save the nursing costs of AD patients. CONCLUSIONS ：The efficacy of EGb in the treatment of AD is uncertain ， and the safety and economy are good.
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Objective:To comprehensively evaluate the utilization of some essential medicines among elderly people in clinic settings in China, in order to provide a reference for the selection of fully reimbursed medicines for the elderly.Methods:Expert consultations were conducted to evaluate the utilization of 58 essential medicines related to eight major therapeutic areas, including neurology, psychiatry, cardiovascular diseases, respiratory diseases, among elderly people.The evaluation indexes included safety, efficacy, compliance by medical staff, compliance by patients, clinical value, and pharmaceutical economics.Results:Except for psychiatry, authority coefficients for drugs related to the other therapeutic areas were greater than 0.7, indicating that experts were familiar with the indications of the medications.According to the comprehensive evaluation scores, 10 medicines, i.e., nitroglycerin, metoprolol tartrate, isosorbide dinitrate, omeprazole, metformin, amlodipine, aspirin, acarbose, valsartan, and clopidogrel, could be considered as the first choices for guaranteed essential drugs for the elderly.Meanwhile, another 10 medicines, including nifedipine, estazolam, tamsulosin, simvastatin, alfacalcidol, enalapril, bisoprolol, beclomethasone dipropionate, ipratropium, and salbutamol, could be considered as the second choices for guaranteed essential drugs for elderly people.Conclusions:The first choices recommended by experts as guaranteed essential drugs for the elderly are mainly cardiovascular, endocrine and respiratory medicines, in line with the disease spectrum of the elderly.The selection of essential medications with full cost reimbursement for elderly patients should be those frequently used and with a burden of high medicine costs.
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Objective:To evaluate the efficacy and safety of preoperative intravitreal conbercept (IVC) as an adjunct to pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR).Methods:A systematic search in EMbase, PubMed, Cochrane Library, Chinese periodical full text database (CNKI), Wanfang database and VIP database were conducted, studies about the effectiveness and safety of IVC combined with PPV in the management of PDR were collected.Two researchers independently screened the studies according to the inclusion criteria and exclusion criteria, and extracted the data.The quality of the randomized controlled trial (RCT) was evaluated by the modified Jadad scale, and the quality of the cohort study or case-control study was evaluated by the Newcastle Ottawa scale (NOS). Rev Man 5.3 was applied for data analysis.Results:A total of 11 RCTs, 2 cohort studies and 10 case-control studies involving 1 625 patients and 1 844 eyes were included.The final Jadad score for each RCT was more than 3, and the final NOS score for each cohort study and case-control study was more than 5.The results of Meta-analysis showed that the total effectiveness of treatment was significantly higher in the preoperative IVC group than that in the simple PPV group ( RR=1.31, 95% CI: 1.21-1.42, P<0.001). The average operation duration was significantly shorter in the preoperative IVC group compared with that in the simple PPV group (MD=-21.11, 95% CI: -26.39--15.83, P<0.001). The level of VEGF was significantly lower in the preoperative IVC group than that in the simple PPV group (MD=-15.33, 95% CI: -19.40--11.26, P<0.001). Preoperative IVC could reduce the incidences of intraoperative bleeding, iatrogenic retinal breaks, postoperative recurrent vitreous hemorrhage and temporary increase of intraocular pressure, with statistically significant differences between them (all at P<0.05). Conclusions:Preoperative intravitreal injection of conbercept shows better effect and safer than vitrectomy alone, and it has no serious side effect.
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Objective@#To understand the differences in physical indices, physical functions, and physical fitness among primary school students of De’ang and Han nationalities in the De’ang community, and to provide a reference for the healthy development of the physique of children and adolescents.@*Methods@#The cluster sampling method was used to select the test data of height, weight, vital capacity, 50 meter running, seated forward flexion, and 1 minute skipping rope of 2 493 De’ang and Han pupils in five complete primary schools in Mangshi, Dehong Prefecture. Differences in each indices were compared between groups.@*Results@#For physical indicators: height in boys in 8,9 and 11 year old group, girls in 7 and 8 year old group, were significantly higher in Han nationality,weight among Han boys of 9 years old was higher than Deang nationality; For physical function indicators: vital capacity of girls 11 years old group and 12 years old group, boys 9 years old group, 10 years old group, 12 years old group, children of Han nationality were higher than Deang peers. For physical fitness indicators: in 50 m running, Han boys of 8,9,10 and 12 year old,as well as Han girls of 8 year old were higher than age matched peers of De’ang nationality;For seated forward flexion, Han boys of 11 years old and girls of 9 years old, were lower than Deang; in 1 min skipping, Han boys of 9,10,11 and 12 year old,as well as Han girls of 9 and 10 year old, were lower than the De’ang nationality.@*Conclusion@#Unbalanced development of physical fitness is observed among primary school students of De’hong and Han nationality, with significant differences in physical, functional and fitness indices.
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Objective To systemically analyze the efficacy and safety of multi-oil fat emulsion injection (SMOF) in the premature infant parenteral nutrition support.Methods Databases including EMbase,PubMed,Cochrane Library,CNKI,VIP and Wanfang,were searched from libraries establishment to November 2017 for randomized controlled trials (RCTs) focusing on the efficacy and safety of SMOF in the premature infant parenteral nutrition support.All the literatures were retrieved and screened according to inclusion and exclusion criteria by two researchers.The software RevMan 5.3 was used for meta-analysis after the evaluation of methodology of quality.Results A total of 7 articles including 7 RCTs were enrolled.Meta-analysis showed that there were no significant differences in body length (OR=-0.25,95％ CI=-1.80-1.30,P=0.75),weight (OR=-0.12,95％ CI=-0.20-0.04,P=0.14),head circumference (OR=0.07,95％ CI=-0.83-0.96,P=0.88),lowdensity lipoprotein,high-density lipoprotein,direct bilirubin,serum creatinine (OR=-0.16,95％ CI=-0.59-0.26,P=0.45) between the infants receiving SMOF or Intralipid.But compared with the infants receiving Intralipid,hemoglobin (OR=-0.75,95％ CI=-1.49-0.00,P=0.05),red blood cells (OR=-0.23,95％ CI=-0.45-0.00,P=0.05) decreased in the infants receiving SMOF,and white blood cells (OR=1.91,95％ CI=0.46-3.37,P =0.01) increased.Conclusions SMOF can control the hemoglobin content in serum,reduce the risk and degree of jaundice in premature infant,with better safety.
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Objective: To investigate the shortage of emergency medicines in emergency department of 76 medical institutions in China, and find out the reasons and the measurements. Methods: The shortage of emergency medicines in 76 class-Ⅰ, class-Ⅱ and class-Ⅲmedical institutions from 22 provinces, autonomous regions and municipalities across the country was investigated by question-naires, and the data obtained from the survey were collected and analyzed by Excel 2007. Results: Totally 76 questionnaires were sent out, and all of them were recycled with the effective recovery of 100% . Pralidoxime chloride injection ranked the first in 59 investiga-ted medicines with the shortage rate of 63. 16% , which was at the top spot in the list of the different medical institutions as well. The main reasons of drug shortage were as follows: less clinical requirements, lost-bid in centralized bidding and price inversion. Conclu-sion: It is suggested that the relevant management departments should establish a reasonable pricing mechanism and carry out policy guarantee for the urgent need of emergency medicines with low dosage and low price.
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Objective To understand the patterns of outpatient prescription medications in the hospital's elderly patients.Methods Data for all outpatient prescriptions at our hospital written for seniors (≥60 years old) between 2013 and 2014 were collected and medications were ranked based on the price.The top 100 medications were chosen for analysis.Results The most expensive and most frequently prescribed three therapeutic groups were drugs for cardiovascular,endocrine & metabolic,and bone & joint disorders.Medication numbers and prices varied among different age groups,with the 60-64 and 75-79 groups representing the highest numbers and prices.The average price (460.3 yuan) per prescription for male patients was higher than that (399.3 yuan) for female patients.Conclusions The cost of prescription drugs in elderly patients is higher than in middle-aged patients,with drugs for non communicable chronic diseases accounting for most of the expenses.Polypharmacy is also a prominent issue.Prescriptions for chronic illnesses in the elderly should follow well established guidelines and appropriately managed.
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Objective To investigate the current status and features of the use of medical resources for emergency patients with medical insurance in China clarified by analysis of large numbers of data.Methods Using the database from China Medical Insurance Research Association's research group,the total amount and the average cost of emergency medicines for patients with medical insurance,as well as the proportion of emergency medicines in total medical resources used in the emergency department were statistically analyzed.Additional analyses were made based on cities and medical institutions of different levels.Results The data were collected from more than 63 million pieces of medication information,from which 260 thousand pieces of information involved in emergency medicine used within 100 sorts of emergency medicines.The use of emergency medicines for emergency cases accounted for a low proportion of over all medicine used in emergency department in our country,and the specifications of emergency medicine were limited in a few kinds of medicine such as tetanus antitoxin injectio (1500 U),50％ glucose solution in 20 ml water,and 50 g mannitol in 250 ml water frequently used as the leading essential agents.The sum of consumption of emergency medicines in tertiary hospitals was the highest among all levels of medical institutions,and the proportion of which in all medicine used in the emergency department also in the first place of the list.In the third-tier cities,although the sum of consumption of emergency medicines accounted for a small proportion of the whole country,the proportion of which in all kinds of medicine used in the emergency department was highest,while the situation of first-tier cities was just on the contrary.Except for only a few medicines,the ranking of the use of any emergency medicine else varied little in different cities and in various medical institutions.Conclusions On one hand,the current status and characteristics of the use of emergency medicines for emergency patients with medical insurance in China may be related to the characteristics of emergency departments and emergency cases,and on the other hand,they could also be influenced by medicines in clinical needs,clinical compliance,and shortages.This study showed the clinical application of emergency medicines in China in the past three years,which can provide some clinical data for the revision of emergency drug list in the future.
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Objective To investigate the current status and characteristics of the use of essential medicines in Chinese Medicare patients aged 65 and over.Methods Using the database from China Medical Insurance Research Association's research group to statistically analyze the total amount and the average cost of chemical and biological essential medicines for outpatients and emergency cases according to age groups in 2013 2015,and ranking and analysis were focused on the expenditure and the number of prescriptions of essential medicines for patients aged 65 and over.Additional analyses were made based on four regions (Eastern,Central,West and Northeast) and medical institutions of different levels.Results The data included nearly 20 million items of medications (4.43 million for patients ≥65 years,) and 307 essential medicines.In Western China,the portion of consumption of national essential medicines by patients aged 65 and over was 46.68％,which was higher than in any other regions.The portion of consumption by tertiary hospitals was the highest among all levels of medical institutions (＞ 40.00％).In all regions and medical institutions,cardiovascular drugs,hormones and endocrine drugs,and antimicrobials were the top categories for patients aged above 65,in terms of both expenditure and prescription numbers.There were some differences in the rankings of prescription numbers for essential medicines between patients aged 65 and over and those aged below 65.The numbers of prescriptions of the top 20 drugs varied little in different regions and medical institutions,and only a few drugs' rankings were different.Conclusions There are some differences in categories and rankings of commonly used essential medicines between younger and elder patients with medical insurance,and cardiovascular drugs are the most commonly used in patients aged 60 and over.These are in line with the spectrum and pathophysiological characteristics of diseases in the elderly.The types of basic drugs most commonly used by outpatients aged 65 and over have stayed stable across regions,and can provide clinical data for the selection of essential medicines with full cost reimbursement for elderly patients.
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AIM To investigate the tissue distribution of brucine-loaded solid lipid nanoparticles in mice in vivo.METHODS Mice were intravenously injected with suspension of prepared brucine-loaded solid lipid nanoparticles and marked by fluorescein isothiocyanate (FITC).The in vivo tissue distribution of nanoparticles was analyzed by having the brucine contents in various tissues (heart,liver,spleen,lung,kidney and bone) determined by HPLC,after which fluorescence confocal laser endomicroscopy was used for further detection.RESULTS Brucine had its the highest (1.64) relative intake efficiency (Re) in mice liver,and the nanoparticles shared all over one value of targeting efficiencies (Te) in various tissues,manifesting a much stronger selectivity to liver than that of brucine solution.With the extension of time,the FITC-narked nanoparticles displayed a rich extracellular to intracellular distribution indicating a positive correlation.CONCLUSION Brucine's increased distribution in the liver tissue of mice due to its solid lipid nanoparticle form shows obvious for liver targeting.
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Objective Using zebrafish to analyze the effect of water temperature on the recovery of spinal cord in-jury. To detect the cell proliferation and changes of gene expression at the injury site during the process of recovery. Meth-ods Surgical operation was performed to induce spinal cord injury ( SCI) on adult fish. Water at a series of temperature was applied to culture the fish. Swimming ability was adopted to observe the recovery of spinal cord injury following surger?y. Vibration sections and immunohistochemistry were performed to observe the cell number post SCI at different stages. The changes of gdnf and nos gene expression were determined by real?time PCR. Results The water temperature changes from 28℃ to 32℃ did not affect the swimming ability of non?injured and sham?injured fish ( P>0. 05 ) . The swimming ability recovered mostly in 8 weeks post spinal cord injury. At 32℃, the swimming ability recovered faster than at 28℃ or at 30℃(P<0. 05). The cell proliferation increased obviously following spinal cord injury (P<0. 05). The proliferation of cells surrounding the spinal cord in jury was more extensive in SCI fishes incubated in 32℃ water than in 28℃ or 30℃ water ( P<0. 05). Real?time PCR assay showed that gdnf was up?regulated in all groups post SCI at 24 h, and 7 and 14 days (P<0. 05). The nos expression was up?regulated in all groups following SCI in 24 h (P<0. 05) and 7 days. There was no sig?nificant difference between the SCI group and sham?injury group (P<0. 05), while after 14 days, the expression of nos was reduced in the SCI group compared with the sham?injury group (P<0. 05). Conclusions A slight increase of incu?bating water temperature can accelerate the recovery of spinal cord injury in zebrafish.
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Objective To investigate the effects of Kruppel-like factor 6 (KLF6) on the apoptotic and migration ability of HepG2 cell, and the developmental role of KLF6 on zebrafish liver.Methods Constructed plasmid with shRNA-KLF6 was transfected in HepG2 and L-02.The impacts of loss of KLF6 on HepG2 was investigated by Western bolt, apoptosis analyses, cell cycle detection and scratch experiment;KLF6 morpholino oligonucleotides was microinjected into the Tg(lfabp:eGFP) transgenic zebrafish embryos.The morphant phenotype of the liver was imaged and the protein expression of KLF6 after knockdown of KLF6 was analyzed by Immunofluorescence staining.Results The expression of KLF6 in L-02 was significantly higher than in HepG2.After knockout of KLF6, KLF6 protein expression and apoptosis were significantly reduced.In addition, the cell cycle mainly stated in S phase and the migration ability of HepG2 was enhanced.After klf6 knockdown in transgenic zebrafish larvae, the development of zebrafish liver was delayed and KLF6 expression was obviously decreased in the liver.Conclusions The reduction of KLF6 expression increased the proliferation and migration ability, and reduced the apoptosis of HepG2.Loss of KLF6 affects the development of zebrafish liver, which may open a possibility to use zebrafish as a liver cancer model and for anti-liver cancer drug screening.
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ObjectiveTo investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy.MethodSixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi (GB20), Yifeng (TE17), Dicang (ST4)-to-Jiache (ST6) and Lianquan (CV23) acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota’s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups.ResultThe therapeutic effects evaluated using the Kubota’s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group (P<0.05). The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group (P<0.01).ConclusionCrossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.
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Objective To explore the clinical effect of excision of peripheral sympathetic nerve network in common carotid artery on children with cerebral palsy (CP)and the effect on their cognitive function. Methods A ret-rospective study method was admitted to preschool children with CP in 69 cases in Center of Brain Disease,the Third Hospital Affiliated to Xinxiang Medical University from July 2008 to August 2014, the common carotid artery sympathetic with the surrounding network stripping off resection treatment of 43 cases ( surgery group) ,without the use of surgery in the treatment of children with 26 cases ( no operation group) . The muscle tension improved, movement to improve the ability of 2 groups before and after treatment 6 months were detected and compared. Developmental quotient ( DQ) ,intelligence quotient ( IQ) ,bilateral middle cerebral artery ( MCA) hemodynamic index difference were deter-mined between 2 groups before and after treatment 6 months. Results After treatment 6 months,the muscle tension score and walking ability score of the surgery group were significantly better than those of no operation group [(2. 2± 1. 1) scores vs (4. 5±0. 6)scores,(3. 5±0. 7) scores vs (2. 7±0. 8) scores,all P<0. 05],and significantly improved compared with before treatment[(4. 8±0. 6)scores,(2. 2±0. 9)scores,all P<0. 05]. After treatment 6 months,the IQ score,fine motor, social adaptation, personal social, language score and MCA mean velocity ( MV ) , peak velocity ( PV) ,resistance index ( RI) ,pulsatility index ( PI) determination value of the surgery group were significantly higher than those of no operation group and before treatment (all P<0. 05). Conclusions Excision of peripheral sympathetic nerve network on common carotid artery has a good clinical effect in the treatment of CP , and can significantly improve the cognitive function of children with CP .
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Pharmacology, pharmacokinetics, clinical study and safety of dapagliflozin in the treatment of type 2 diabetes mellitus were reviewed in the paper. As a sodium-glucose cotransporter 2 (SGLT2) inhibitor, dapagliflozin can reduce HbA1c, FPG and body weight of patients with type 2 diabetes mellitus. The main adverse reaction is genital infection. The antihypertensive effect of dapagliflo-zin is still under study at present.
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Objective:To study the characteristics,related factors and precautionary measures of ceftriaxone-induced anaphylactic shock,and provide reference for clinical safe medication.Method:The literature between January, 1994 and December,2007 was collected from Chinese Journal Full-text Database,Chinese Science and Technology Journal Full-text Database,and Wanfang Medicine Data China info,70 cases with ceftriaxone-induced anaphylactic shock were reviewed and analyzed.Result:Of the 70 cases,43(61.4%) were male,and 27(38.6%) were female.64(91.4%) received intravenous fusion or intravenous injection and 6(8.6%),intramuscular or prostate capsule injection.Most of the anaphylactic shock cases occurred within 20 minutes(71.2%) after administration.61 cases recovered(87.1%) and 8 cases died(11.4%) and 1 cases became vegetable(1.5%) after treatment.Conclusion:The ceftriaxone-induced anaphylactic shock is rapid so as to be timely rescued.Patients should be asked about their case history and medication history in detail before treatment in order to reduce occurrences of shock.