Study on population pharmacokinetics of dabigatran in elderly patients with non-valvular atrial fibrillation / 中国药房

OBJECTIVE To analyze influential factors for dabigatran exposure in elderly patients with non-valvular atrial fibrillation. METHODS The clinical information of 75 elderly patients diagnosed with non-valvular atrial fibrillation was collected from our hospital in Jan. 2019-Jun. 2020. One or two steady-state blood drug concentration samples were collected from each patient. NONMEM 7.2.0 software was used to establish a population pharmacokinetics model of dabigatran； the effects of different covariates on the apparent clearance of dabigatran were investigated， and the final model was verified by goodness of fit and Bootstrap method； NONMEM 7.2.0 software was used to analyze the drug exposure of ordinary elderly patients and elderly patients after taking dabigatran ester in different disease states. RESULTS Totally 122 blood concentration samples of dabigatran were collected. Advanced age， creatinine clearance and history of chronic heart failure were screened out as three significant covariates that influenced the clearance of dabigatran in elderly patients. The exposure of population with advanced age increased by about 50% compared with the general elderly， the exposure of population with history of chronic heart failure increased by nearly 30% compared with population without， and the exposure of population with moderate and severe renal injury increased by about 30% and 80% compared with mild. CONCLUSIONS Advanced age， renal injury and history of chronic heart failure are influential factors for elevated systemic exposure of dabigatran.

Construction andeffect evaluation of precise oral nutrition guidance program for postoperative patients with colorectal cancer undergoing accelerated rehabilitation / 中国实用护理杂志

Objective:To construct and evaluate the effect of precise oral nutrition guidance program for colorectal cancer patients with accelerated rehabilitation after operation.Methods:This study was a quasi experimental study. A total of 116 patients with colorectal cancer from department of Colorectal Surgery, Jiangsu Cancer Hospital from March to Deamber, 2021 were selected by convenience sampling method. They were divided into two groups according to their admission time, the experimental group (58 cases), was given precise oral nutrition guidance program after colorectal cancer surgery based. In the control group, 58 cases were treated with the conventional dietary guidance for rapid rehabilitation. The gastrointestinal tolerance rate, the compliance rate of oral nutritional supplements, the first defecation time after operation, albumin, total albumin, prealbumin and other nutritional indexes were compared between the two groups before and after intervention.Results:Finally, 111 cases were included, induding 56 in the experimental group and 55 in the control group. The compliance rate of oral nutritional supplements after intervention in the experimental group was 73.2% (41/56), higher than that in the control group 40.0%(22/55), and the difference between the two groups was statistically significant ( χ2 = 12.47, P<0.05). The first defecation time after operation in the experimental group was (29.51 ± 5.52) h, while in the control group was (61.48 ± 8.39) h, the difference between the two groups was significant ( t = -12.06, P<0.05). The postoperative enteral nutrition tolerance rate of the experimental group was 91.1% (51/56), which was higher than the 69.1%(38/55) in the control group, the difference between the two groups was statistically significant ( χ2 = 8.44, P<0.05). The serum total protein, albumin and prealbumin levels of the experimental group at discharge were (66.56 ± 5.15), (46.78 ± 7.62) g/L and (276.07 ± 53.57) mg/L, compared with the (60.27 ± 4.37), (39.12 ± 6.41) g/L and (230.14 ± 44.58) mg/L in the control group, the differences were statistically significant ( t = 6.66, 5.02, 4.91, all P<0.05). Conclusions:The implementation of precise oral nutrition guidance program is conducive to guiding the clinical practice of oral nutritional supplements in patients with colorectal cancer after surgery, improving patient compliance, reducing gastrointestinal intolerance, promoting intestinal function recovery, and improving nutritional status of patients.

Status quo and influencing factors of grief in maternal spouses after perinatal loss / 中国实用护理杂志

Objective:To investigate the status of grief among maternal spouse after perinatal loss, and analyze its influencing factors, so as to provide some reference for male grief supporting strategic.Methods:Using the convenient sampling method, 180 male spouses of hospitalized women in the Department of Obstetrics from Nanjing Maternity and Child Health Care Hospital from March to October 2022 were recruited. A cross-sectional survey was conducted by the general questionnaire, the Perinatal Grief Scale, the Family Adaptability and Cohesion Scale Ⅱ-Chinese Version, the Social Support Rating Scale, and the Simplified Coping Style Questionnaire.Results:The overall score of the Perinatal Grief Scale in male spouses of women who experienced a perinatal loss was (61.57 ± 14.14) points. The score of the Family Adaptability and Cohesion Scale Ⅱ-Chinese Version was (121 ± 14.42) points, the score of the Social Support Rating Scale was (34.23 ± 7.21) points, and the score of the Simplified Coping Style Questionnaire was (36.08 ± 7.64) points. Multiple linear regression analysis showed that participation in fetal interaction, loss of fetal age, social support and family adaptability were the main factors affecting male grief ( P<0.05). Conclusions:The grief among male spouses of women who experienced a perinatal loss is at a low level. The clinical medical staff can refer to the influencing factors and implement effective support, such as respecting the male's father status, coordinating social support resources, and improving the family's coping ability, in order to alleviate men's grief and help them return to normal life.

Development and Application of Medical Imaging Analysis Platform Based on Radiomics and Machine Learning Technologies / 中国医疗器械杂志

OBJECTIVE@#In order to solve the technical problems, clinical researchers face the process of medical imaging analysis such as data labeling, feature extraction and algorithm selection, a medical imaging oriented multi-disease research platform based on radiomics and machine learning technology was designed and constructed.@*METHODS@#Five aspects including data acquisition, data management, data analysis, modeling and data management were considered. This platform provides comprehensive functions such as data retrieve and data annotation, image feature extraction and dimension reduction, machine learning model running, results validation, visual analysis and automatic generation of analysis reports, thus an integrated solution for the whole process of radiomics analysis has been generated.@*RESULTS@#Clinical researchers can use this platform for the whole process of radiomics and machine learning analysis for medical images, and quickly produce research results.@*CONCLUSIONS@#This platform greatly shortens the time for medical image analysis research, decreasing the work difficulty of clinical researchers, as well as significantly promoting their working efficiency.

Immune-Related Pancreatitis Caused by Immune Checkpoint Inhibitor Nivolumab:Report of One Case / 中国医学科学院学报

In recent years,great progress has been achieved in the application of immune checkpoint inhibitors (ICI) in tumor immunotherapy.However,a variety of adverse reactions induced by ICI have been reported.Despite the high overall incidence of adverse reactions caused by ICI,some adverse reactions,such as immune-related pancreatitis,are rare in clinical practice.In this paper,a case of immune-related pancreatitis after treatment of advanced gastric cancer with nivolumab was identified.We analyzed the cause,treatment,incidence,and risk factors of the adverse reaction,aiming to improve the clinical diagnosis,treatment,and safe medication of rare adverse reactions associated with ICI.

Efficacy and safety of ceftazidime and avibactam sodium in the treatment of carbapenem-resistant organism infection / 中国药房

OBJECTIVE To observe the efficacy and safety of ceftazidime and avibactam sodium （CAZ/AVI） in the treatment of carbapenem-resistant organism （CRO） infection. METHODS The information of patients with CRO infection admitted to the Second Affiliated Hospital of Soochow University from September 2019 to March 2022 was collected， and the patients were retrospectively divided into observation group （48 cases） and control group （48 cases） according to the treatment plan. The control group was given Polycolistin B sulfate for injection intravenously at a dose of 500 000 U every 12 hours； no dose adjustment was performed in patients with renal insufficiency or receiving continuous renal replacement therapy （CRRT）. The observation group was given continuous micropump of CAZ/AVI for injection intravenously at a dose of 2.5 g every 8 hours for 2 continous hours； among them， the patients with renal insufficiency received an adjusted dose based on creatinine clearance， and no dose adjustment was performed in patients receiving CRRT. The clinical efficacy and microbiological efficacy as well as body temperature， white blood cell （WBC）， C-reactive protein （CRP） and procalcitonin （PCT） before and after treatment were compared between 2 groups. The prognosis and the occurrence of adverse drug reactions were recorded. The factors influencing the clinical efficacy were screened by Logistic regression analysis. RESULTS The effective rate and microbial clearance rate of the observation group were significantly higher than the control group （P＜0.05）. After treatment， body temperature， PCT and CRP of 2 groups were significantly lower than before treatment， and CRP of the observation group was significantly lower than the control （No.SDFEYJLC2105） group （P＜0.05）. There was no statistically significant differencebetween the two groups in terms of rehabilitation discharge rate， the proportion of patients transferred to general wards，the proportion of dead patients， and the total incidence ofadverse drug reactions （P＞0.05）. CAZ/AVI and prolonging therapy duration were more likely to achieve clinical benefits （odds ratios of 1.146， 7.707，P＜0.05）， while lung infection and CRRT may be independent risk factors for treatment failure （odds ratios of 0.182， 0.236， P＜0.05）. CONCLUSIONS CAZ/AVI has good efficacy and safety in the treatment of CRO infection， the appropriate extension of antibacterial treatment time can achieve a higher clinical response rate， while lung infection or CRRT may lead to treatment failure.

Determination of acetone and butanone in urine of occupational populations by headspace-gas chromatography / 预防医学

Objective @#To establish a headspace-gas chromatography ( HS-GC ) method for the determination of acetone and butanone, the biomarkers of occupational exposure to isopropanol and butanone, in urine of occupational populations. @*Methods @#Urine samples at 5.0 mL were transferred to a headspace bottle, added with 2.0 g anhydrous sodium sulfate, sealed immediately, and placed in a headspace sampler-gas chromatograph-mass spectrometer. Following heating at 60 ℃ for 30 min, 0.5 mL urine samples were injected and separated with the DB-FFAP capillary chromatographic column, and determined with the flame ionization detector. In addition, the retention time and peak area were determined. @*Results @#The peak area appeared a linear relationship with mass concentrations of acetone at 0.16-80 mg/L and butanone at 0.03-16 mg/L (correlation coefficient, 0.999 9), with detection limits of 0.009 and 0.004 mg/L, quantitation limits of 0.03 and 0.02 mg/L, respectively. The mean recovery rates of spiked samples were 93.67%-99.37% and 91.18%-94.41% for low, medium and high concentrations of acetone and butanone, and the relative standard deviations of 1.53%-3.69% and 2.54%-6.58%, respectively. @*Conclusion @#A highly sensitive and repeatable HS-GC method is successfully established for simultaneous determination of acetone and butanone in urine samples by optimizing sample pretreatment and separation, which is feasible for qualitative and quantitative analyses of acetone and butanone in urine.

Current status and influencing factors of protracted postpartum urinary retention in women with labor analgesia / 中国实用护理杂志

Objective:To explore the current status and the influencing factors of protracted postpartum urinary retention(P-PUR) in women with labor analgesia, so as to provide evidences for early diagnosis and timely intervention for P-PUR.Methods:A total of 41 995 women who were given vaginal delivery under labor analgesia from January 2017 to October 2020 in Women′s Hospital of Nanjing Medical University were chosen as the research objects. A retrospective analysis was performed for the clinical data of 62 women with P-PUR, and a 1∶4 matching case control study was conducted. Logistic regression analysis was used to analyze the variables with statistical difference in univariate analysis, so as to explore the independent influencing factors of P-PUR in women with labor analgesia.Results:Among 41 995 women with labor analgesia, 62 women suffered from P-PUR, and the incidence was about 0.15% (62/41 995). The Logistic regression model showed that nulliparity ( OR=121.80, 95% CI 8.59-1 727.40, P<0.05), forceps delivery ( OR=13.41, 95% CI 2.21-81.58, P<0.05),Ⅱdegree porineal iaceration ( OR=0.04, 95% CI 0.01-0.11, P<0.05), episiotomy ( OR=0.13, 95% CI 0.04-0.47, P<0.05) and perineotomy with perineal laceration ( OR=0.20, 95% CI 0.06-0.63, P<0.05) were the independent risk factors. Conclusions:For primiparas with labor analgesia, interventions should be taken to reduce perineal injury, and indications of forceps delivery should be strictly controlled, so as to reduce P-PUR and adverse urinary tract complications.

Study on the influencing factors in pupils' disequilibrium refractive development / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.

Correlation analysis between corneal biomechanical parameters and high-order aberrations in myopia children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the correlation between corneal biomechanical parameters measured by the corneal visualization Scheimpflug Technology(Corvis ST)and corneal high-order aberrations(HOAs)in children with mild to moderate myopia.METHODS:A cross-sectional study. A total of 255 pediatric patients with myopia enrolled from April to July 2021 in Tianjin Medical University Eye Hospital were continuously collected, and all the right eyes were taken for analysis. Corneal biomechanical parameters were obtained from Corvis ST. Pentacam three-dimensional anterior segment analyzer was used to measure total corneal higher-order aberrations(RMSh), third order aberrations(RMS3)and fourth order aberrations(RMS4).RESULTS:RMS3 was positively correlated with the second applanation time(A2T)(r=0.175, P=0.009)and negatively correlated with the axis length(AL)(r=-0.155, P=0.014). RMS4 was negatively correlated with the highest concavity radius(HCR)(r=-0.165, P=0.009). RMSh was negatively correlated with HCR and AL(r=-0.152, P=0.037; r=-0.175, P=0.005).CONCLUSION:There is a correlation between corneal biomechanical parameters and HOAs in children with myopia. Cornea with higher stiffness and stronger deformation resistance has smaller RMS3, RMS4 and RMSh.

Discovery and confirmation of protein action site AK1 of ginsenosides in brain based on DARTS technology / 中国中药杂志

This study aims to explore the targets of ginsenosides in brain based on drug affinity responsive target stability(DARTS) technology. Specifically, DARTS technology was combined with label-free liquid chromatography tandem mass spectrometry(LC-MS) to screen out the proteins in the brain that might interact with ginsenosides. Based on the screening results, adenylate kinase 1(AK1) was selected for further confirmation. First, the His-AK1 fusion protein was yielded successively through the construction of recombinant prokaryotic expression vector, expression of target protein, and purification of the fusion protein. Biolayer interferometry(BLI) was employed to detect the direct interaction of Rg_1, Re, Rb_1, Rd, Rh_2, F1, Rh_1, compound K(CK), 25-OH-PPD, protopanaxa-diol(PPD), and protopanaxatriol(PPT) with AK1, thereby screening the ginsenoside monomer or sapogenin that had strong direct interaction with the suspected target protein AK1. Then, the BLI was used to further determine the kinetic parameters for the binding of PPD(strongest interaction with AK1) to His-AK1 fusion protein. Finally, molecular docking technology was applied to analyze the binding properties between the two. With DARTS and LC-MS, multiple differential proteins were screened out, and AK1 was selected based on previous research for target verification. Fusion protein His-AK1 was obtained by prokaryotic expression, and the response(nm) of Re, Rg_1, Rd, Rb_1, Rh_1, Rh_2, F1, PPT, PPD, 25-OH-PPD, and CK with His-AK1 was respectively 0.003 1, 0.001 9, 0.042 8, 0.022 2, 0.013 4, 0.037 3, 0.013 9, 0.030 7, 0.140 2, 0.016 0, and 0.040 8. The K_(on), K_(off), and K_D values of PPD and His-AK1 were determined by the BLI as 1.22×10~2 mol~(-1)·L·s~(-1), 1.04×10~(-2) s~(-1), 8.52×10~(-5) mol·L~(-1). According to the molecular docking result, PPD bound to AK1 with the absolute value of the docking score of 3.438, and hydrogen bonds mainly formed between the two. Thus, AK1 is one of the protein action sites of ginsenosides in the brain. The direct interaction between ginsenoside metabolite PPD and AK1 is the strongest.

Comparison of sitagliptin and acarbose in patients with type 2 diabetes mellitus complicated with sarcopenia / 中国医师进修杂志

Objective:To observe the changes of skeletal muscle indexes in elderly patients with type 2 diabetes complicated with sarcopenia treated with sitagliptin and acarbose.Methods:A total of 60 patients over 60 years old with type 2 diabetes complicated with sarcopenia in Dalian Municipal Central Hospital from January 2019 to January 2020 were selected and divided into two groups by random number table method.One group received sitagliptin and metformin,and the other group received acarbose and metformin. The changes of skeletal muscle indexes, glucagon-like peptides-1 (GLP-1), insulin resistance index (HOMA-IR) and inflammatory indexes were compared between the two groups at baseline and 36 weeks after treatment.Results:After treatment, the skeletal muscle index (SMI) of sitagliptin group was increased (5.94 ± 1.52 vs. 5.99 ± 1.52), and the difference was statistically significant ( P<0.05). Muscle strength and SMI decreased in acarbosse group (18.75 ± 4.64 vs. 17.72 ± 4.44, 6.09 ± 1.74 vs. 6.00 ± 1.71), with statistical significance ( P<0.05). GLP-1 increased in sitagliptin group, 0 min: (10.65 ± 1.68) pmol/L vs. (12.41 ± 1.88) pmol/L; 60 min: (22.79 ± 2.85) pmol/L vs. (25.51 ± 2.79) pmol/L; 120 min: (24.26 ± 2.94) pmol/L vs. (29.49 ± 2.91) pmol/L; 180 min: (11.68 ± 1.84) pmol/L vs. (12.88 ± 1.83) pmol/L. There were significant differences ( P<0.05). HOMA-IR and CRP decreased: 4.73 ± 3.04 vs. 3.16 ± 2.41, (2.39 ± 0.50) mg/L vs. (2.33 ± 0.43) mg/L, and the differences were statistically significant ( P<0.05). HOMA-IR in acarbose group decreased after treatment (5.80 ± 3.94 vs. 4.00 ± 1.63), and the difference was statistically significant ( P<0.05). Comparison between the two groups after treatment, the decreased value of muscle strength in sitagliptin group was less than that in acarbose group, and the difference was statistically significant ( P<0.05). GLP-1 and overall GLP-1 area under the curve in sitagliptin group were higher than those in acarbose group (67.64 ± 6.81 vs. 58.98 ± 6.72), with statistical significance ( P<0.05). HOMA-IR and CRP in sitagliptin group were lower than those in acarborose group: 3.16 ± 2.42 vs. 4.00 ± 1.63, (2.33 ± 0.43) mg/L vs. (2.41 ± 0.70) mg/L, with statistical significances ( P<0.05). Conclusions:Sitagliptin therapy improves muscle mass and protects muscle strength in elderly patients with type 2 diabetes mellitus and sarcopenia.

Immunotherapy and Pharmaceutical Care for Non-small-cell Lung Cancer Complicated with Hyperthyroidism:Report of One Case / 中国医学科学院学报

Based on our experience in treating one patients with non-small cell lung cancer complicated with hyperthyroidism,the following considerations in immunotherapy and pharmaceutical care are proposed:role of iodine contrast and contrast agent selection in patients with hyperthyroidism;selection of hemostatic agents and assessment of thrombosis risk in patients with hemoptysis caused by tumor invasion of bronchus;influence of glucocorticoid use on the treatment with programmed cell death-1(PD-1)inhibitor and the role of PD-1 inhibitors in patients with a history of hyperthyroidism;education methods for patients refuse to receive opioids.The participation of clinical pharmacists in the Multiple Disciplinary Team and the multi-dimensional pharmaceutical monitoring for patients can improve the safety and rationality of medications.

Associations of distribution of time spent in physical activity and sedentary behavior with obesity / 北京大学学报(医学版)

OBJECTIVE@#To explore associations of distribution of time spent in physical activity (PA) and sedentary behavior (SB) with obesity with taking account that time is finite during the day of adult residents in Wuhai City.@*METHODS@#A cross-sectional study was undertaken in Wuhai City, and we carried out a sampling of local residents aged 18-79 by using multiple stratified cluster sampling method. Data about social demographic characteristics, time spent in PA and SB, diet intake, controlling situation of chronic disease and other covariates were obtained by qualified investigators for face-to-face questionnaire survey. Data about height, weight, and waist circumstance, were obtained by doctors in a secondary hospital or above for body measurements. The statistical method used in our study was known as compositional data analysis, which had been used to process compositional data in many fields. Liner regression analysis with compositional data was used to synthetically analyze the associations of distribution of time spent in PA and SB with obesity,and to investigate the effect of re-allocating time from one behavior to another one whilst the remaining one was kept stable.@*RESULTS@#The investigation revealed the special advantage of compositional data analysis in processing time-use data. The result of liner regression analysis with the compositional data showed that after controlling the potential confounding factors, the associations of distribution of time spent in PA and SB was significantly associated with body mass index (BMI, P<0.001) and the negative natural logarithm of waist to height ratio (-lnWHtR, P<0.001). Among them, in professional population, the proportion of time spent in moderate-to-vigorous physical activity (MVPA) was negatively correlated with -lnWHtR (β=-0.008, P=0.022), while the proportion of time spent in SB was positively correlated with BMI and -lnWHtR (β=0.117, P=0.003; β=0.007, P=0.005). However, in nonprofessional population, the proportion of time spent in MVPA was only negatively correlated with BMI (β=-0.079, P=0.041). Nevertheless, the proportion of time spent in low-intensity physical activity (LIPA) was not significantly associated with BMI and -lnWHtR in both professional and nonprofessional population. In addition, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior were not symmetrical, and 10 minutes of MVPA replacing LIPA or SB had a greater influence on intervention and prevention of obesity than 10 minutes MVPA being replaced by LIPA or SB.@*CONCLUSION@#The research has resulted in a solution of the associations of the distribution of time spent in PA, SB with health risk. Our results suggest that public health messages should target the health effects of the distribution of time of PA and SB synergistically in developing PA guidelines and health management practice, rather than simply increasing or decreasing the absolute time of PA or SB, so that we can provide scientific suggestions to make people get a profounder healthy effect.

Professor Meng Moody and His Dedication to the Four Chinese Pharmacopeias before and after the Founding of P.R. China / 中国药学杂志

Prof. Meng Moody and his professional career, especially his experience in Peking Union Medical College Hospital over 1925 to 1931 was briefly reviewed. He took the Interim Director of the Pharmacy Department in 1926 and 1930, respectively, while John Cameron left for vacation. Regarding to his dedications to Chinese Pharmacopeia in 1930's and after the founding of P. R. China, respectively, he played major role there.

Effects of Acorus tatarinowii Schott and its active component -5- hydroxymethylfurfural on ERK/CREB signal in hippocampus of exercise-induced fatigue rats / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of Acorus tatarinowii Schott and its active component 5- hydroxymethyl furfural (HMF) on learning and memory and ERK/CREB signal in hippocampus of rats with exercise-induced fatigue.@*METHODS@#SD rats were randomly divided into normal group (A), exercise group (B), exercise + HMF low, middle and high dose treatment group (C, D, E), exercise + acorus tatarinowii Schott low, middle and high dose treatment group (F, G, H), with ten rats in each group. The rats in group C, D and E were treated with HMF at the doses of 0.10, 1.00 and 3.00 mg. kg by ig. The rats in group F, G and H were treated with the extracts of Acorus tatarinowii Schott at the doses of 0.12, 1.20 and 4.80 g. kg by ig. Learning and memory of rats were tested by the method of water maze experiment, and the expression levels of p-ERK1/2 and p-CREB protein in hippocampus of rats were tested by the method of Western blot in the end of the experiment.@*RESULTS@#The escape latencies of E and H groups were lower than those of groups B, C, D, F and G; and the numbers of plateau crossing were more than those of groups B, C, D, F and G and the expression levels of p-ERK1/2, p-CREB protein were higher than those of groups B, C, D, F and G , respectively(P ＜ 0.01). There was no significant difference in the above indexes among groups A, E and H(P＞0.05) except that the expression levels of p-ERK2 protein in group E were lower than those in group A and H (P＜0.05).@*CONCLUSION@#Acorus tatarinowii and its active component- HMF can improve the learning and memory of rats with exercise-induced fatigue, and the mechanism is related to the up-regulation of ERK / CREB signal in hippocampus of rats with exercise-induced fatigue.

Protective effects of spirulina on hippocampal injury in exercise-fatigue mice and its mechanism / 中国应用生理学杂志

OBJECTIVE@#To investigate the roles of BDNF/TrkB neurotrophic signaling in hippocampal injury for fatigue rats induced by incremental load exercise and the protective effects and mechanism of spirulina supplement.@*METHODS@#Sixty SD rats were randomly divided into normal control group (NC), normal plus spirulina group(NS), exercise model group (EM), exercise plus spirulina group (ES), and positive control group (PC), 12 rats in each group.Group EM, Group ES and Group PC were applied by treadmill running with high-intensity increasing for three weeks, and Group NC had not any intervention measures.Group ES and Group NS were treated with spirulina at a dose of 300 mg/kg.bw.by intragastric administration.Group PC was gavaged at the same volume of ginseng extract of 1.92 g/kg for three weeks.The expressions of brain-derived neurotrophic factor (BDNF), tyrosine kinase recptor (TrkB), phospho-tyrosine kinase recptor (p-TrkB) were tested by Western blot and immunohistochemical method, and micromorphology changes of hippocampal CA1 were observed by light microscope at the end of the experiment.The general situations of rats such as body weights were recorded during the experiment.@*RESULTS@#Compared with Group NC, Group EM showed significantly decrease in body weight and hippocampal CA1 neurons of the group loosely arrayed and disarrayed and some neurons were shrinked, and even some neurons disappeared.The expressions of BDNF, TrkB and p-TrkB in group EM were increased significantly(<0.01).Compared with Group EM, body weight of Group ES was increased significantly, and the above mentioned injuries of neurons were improved significantly:the number of neurons and nissl bodies were significantly increased and the neurons arrayed regularly and its morphology was more complete.The expressions of BDNF, TrkB and p-TrkB in the group were increased significantly(<0.05 or <0.01).And there was no difference between Group ES and Group PC.@*CONCLUSIONS@#BDNF/TrkB neurotrophic signal pathway could be involved in the repair process of hippocampal nervous damage caused by incremental load exercise for fatigue rats.Spirulina supplement had a protective effect on the damaged nervous through increasing the expressions of BDNF, TrkB and p-TrkB.

Analysis of existing problems of patients' physical restraint in intensive care unit and nursing strategies / 中国中西医结合急救杂志

The patients in the intensive care unit (ICU) often suffer from complicated and serious diseases, they are frequently necessary to have multiple tubes indwelling into the body and many practical measures or surgical operations performed by doctors or nurses, and generally they have no family members accompanying them in the unit. In order to avoid various accidents and ensure reaching the aim of treatment, according to the patient's individual situation, physical restraint straps are regularly applied. But the straps used for ICU patients may cause many problems in the course of restraint. In this paper, the existing problems are analyzed to reduce the adverse effects of this protective restraint on the physical and mental health of the patients.

Analysis on English Literature of Prescription Refills for Chronic Diseases / 中国药师

Objective:To search the English literatures on prescription refills for chronic diseases for a systemic analysis and to explore the mode and the management measures in order to develop the prescription refill and medication therapy management service for patients with chronic diseases in China .Methods:In the pubmed database , the literatures related to prescription refills published before April 2016 was retrieved.The literatures were analyzed by classification of country or region , the types of drugs and the other in-formation.Results:It was found that the United States , Britain and Sweden were the countries with the most prescription refills .The medications for hypertention , diabetes , hyperlipidemia and other chronic diseases respectively were the most types of medications men -tioned.Age, educational level, race, language, type of medication, and so on.were the factors that affected patient compliance . Pharmacists played a role in auditing , intervention and follow-up in prescription refills programs .Conclusion: The programs of pre-scription refills is well developed in America and Europe , which may be a good way to solve the demand in long-term caremedication therapy for those patients in China .

Study on related factors of repeated attack of child otitis media with effusion / 重庆医学

Objective To investigate the risk factors of repeated episodes of child otitis media with effusion(OME).Methods One hundred and twenty-one children cases of repeated OME within 1 year in the Affiliated Children's Hospital of Nanjing Medical University from February 2013 to August 2015 were selected as the repeated group and contemporaneous 125 cases of non-repeated OME were selected as the control group.The repeated OME related factors were performed the univariate and multivariate analysis.Furthermore the occurrence rates of main risk factors and annual onset frequency of nasal disease were compared among different age groups.Results The Logistic multivariate regression analysis results indicated that younger age,allergic rhinitis,recurrent upper respiratory tract infections,tonsil hypertrophy Ⅳ°,adenoid hypertrophy Ⅲ °and Ⅳ ° and poor mastoid gasification were major risk factors for recurrence of OME.The incidence rate of repeated upper respiratory tract infections in the 3-＜7 years old group and ＜3 years old group was obviously higher than that in the7-14 years old group(P＜0.05),adenoid hypertrophy in the ＜3 years old group and 7-14 years old group was lower than that in the 3-＜7 years old group(P＜0.05).The annual onset frequency of nasal disease in the repeated group was significantly higher than that in the control group(P=0.000).Conclusion Child OME is the results of multivariate factors combined action.The smaller the age,the more the annual onset frequency and the higher the possibility of OME repeated onset.