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1.
Chinese Medical Journal ; (24): 1967-1976, 2021.
Article in English | WPRIM | ID: wpr-887626

ABSTRACT

BACKGROUND@#Innovative coronavirus disease 2019 (COVID-19) vaccines, with elevated global manufacturing capacity, enhanced safety and efficacy, simplified dosing regimens, and distribution that is less cold chain-dependent, are still global imperatives for tackling the ongoing pandemic. A previous phase I trial indicated that the recombinant COVID-19 vaccine (V-01), which contains a fusion protein (IFN-PADRE-RBD-Fc dimer) as its antigen, is safe and well tolerated, capable of inducing rapid and robust immune responses, and warranted further testing in additional clinical trials. Herein, we aimed to assess the immunogenicity and safety of V-01, providing rationales of appropriate dose regimen for further efficacy study.@*METHODS@#A randomized, double-blind, placebo-controlled phase II clinical trial was initiated at the Gaozhou Municipal Centre for Disease Control and Prevention (Guangdong, China) in March 2021. Both younger (n = 440; 18-59 years of age) and older (n = 440; ≥60 years of age) adult participants in this trial were sequentially recruited into two distinct groups: two-dose regimen group in which participants were randomized either to follow a 10 or 25 μg of V-01 or placebo given intramuscularly 21 days apart (allocation ratio, 3:3:1, n = 120, 120, 40 for each regimen, respectively), or one-dose regimen groups in which participants were randomized either to receive a single injection of 50 μg of V-01 or placebo (allocation ratio, 3:1, n = 120, 40, respectively). The primary immunogenicity endpoints were the geometric mean titers of neutralizing antibodies against live severe acute respiratory syndrome coronavirus 2, and specific binding antibodies to the receptor binding domain (RBD). The primary safety endpoint evaluation was the frequencies and percentages of overall adverse events (AEs) within 30 days after full immunization.@*RESULTS@#V-01 provoked substantial immune responses in the two-dose group, achieving encouragingly high titers of neutralizing antibody and anti-RBD immunoglobulin, which peaked at day 35 (161.9 [95% confidence interval [CI]: 133.3-196.7] and 149.3 [95%CI: 123.9-179.9] in 10 and 25 μg V-01 group of younger adults, respectively; 111.6 [95%CI: 89.6-139.1] and 111.1 [95%CI: 89.2-138.4] in 10 and 25 μg V-01 group of older adults, respectively), and remained high at day 49 after a day-21 second dose; these levels significantly exceed those in convalescent serum from symptomatic COVID-19 patients (53.6, 95%CI: 31.3-91.7). Our preliminary data show that V-01 is safe and well tolerated, with reactogenicity predominantly being absent or mild in severity and only one vaccine-related grade 3 or worse AE being observed within 30 days. The older adult participants demonstrated a more favorable safety profile compared with those in the younger adult group: with AEs percentages of 19.2%, 25.8%, 17.5% in older adults vs. 34.2%, 23.3%, 26.7% in younger adults at the 10, 25 μg V-01 two-dose group, and 50 μg V-01 one-dose group, respectively.@*CONCLUSIONS@#The vaccine candidate V-01 appears to be safe and immunogenic. The preliminary findings support the advancement of the two-dose, 10 μg V-01 regimen to a phase III trial for a large-scale population-based evaluation of safety and efficacy.@*TRIAL REGISTRATION@#http://www.chictr.org.cn/index.aspx (No. ChiCTR2100045107, http://www.chictr.org.cn/showproj.aspx?proj=124702).


Subject(s)
Aged , Antibodies, Viral , COVID-19/therapy , COVID-19 Vaccines , Double-Blind Method , Humans , Immunization, Passive , Recombinant Fusion Proteins , SARS-CoV-2
2.
Article in Chinese | WPRIM | ID: wpr-912302

ABSTRACT

Acute aortic dissection is a critical and fetal cardiovascular disease with high morbidity and mortality. Acute lung injury is one of the common complications in the perioperative period of acute aortic dissection, which has serious effects on the prognosis of patients with acute aortic dissection and increase the mortality. Therefore, the prevention and treatment of acute lung injury complicated by acute aortic dissection is an urgent problem in clinic. This paper reviewed the risk factors, pathogenesis, methods for preservation and treatment for acute lung injury complicated by acute aortic dissection.

3.
Article in Chinese | WPRIM | ID: wpr-921660

ABSTRACT

Delayed-or non-healing wounds caused by trauma, surgical procedures, acute diseases, or chronic diseases, and proli-ferating scar have a serious impact on patients' quality of life and increase the economic and psychological burden on their families. Therefore, how to accelerate wound healing and obtain satisfactory aesthetic results is of great concern to researchers and is an urgent clinical problem to be solved. In recent years, the mechanisms of Chinese medicinal materials in accelerating wound healing and inhi-biting scar formation by regulating cytokines have been clarified, which provides a scientific basis for revealing the efficacy of Chinese medicinal materials against clinical trauma. This review focuses on the therapeutic effects of active ingredients, extracts, and topical preparations of Chinese medicinal materials through regulating cytokines in the inflammation, proliferation, and remodeling phases of wound healing. It is expected to provide evidence for the application of Chinese medicinal materials in wound therapy.


Subject(s)
China , Cytokines , Humans , Inflammation , Quality of Life , Wound Healing
4.
Chinese Medical Journal ; (24): 2865-2873, 2021.
Article in English | WPRIM | ID: wpr-921202

ABSTRACT

BACKGROUND@#Patients' recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients' recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.@*METHODS@#A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed.@*RESULTS@#A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P  0.050).@*CONCLUSIONS@#Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR-ONRC-14005096.


Subject(s)
Colorectal Neoplasms , Hand Strength , Humans , Length of Stay , Postoperative Complications , Preoperative Exercise , Quality of Life , Randomized Controlled Trials as Topic , Recovery of Function
5.
Chinese Journal of Trauma ; (12): 526-530, 2020.
Article in Chinese | WPRIM | ID: wpr-867742

ABSTRACT

Objective:To explore the effect of gradual dural decompression(GDD)in preventing intraoperative encephalocele in severe traumatic brain injury (TBI).Methods:A retrospective case-control study was conducted to analyze the clinical data of 78 patients with severe TBI admitted to Affiliated Hospital of North Sichuan Medical College from January 2015 to October 2018, including 55 males and 23 females, aged 15-68 years with an average age of 38.2 years. Thirty-eight patients were treated by GDD (GDD group). During the operation, the hematoma was cleared by opening a window in the area with more hematoma, then gradually cleared in the area without opening a window. Finally, the dural "junction" was cut and the skull was closed quickly after covering the dural patch. The other 40 patients were operated by fast open dural (FOD) operation (FOD group). The incidence of intraoperative encephalocele, intracranial pressure data at the time, 24 hours, 72 hours and 7 days after operation, incidence of delayed intracranial hematoma and glasgow outcome score (GOS) at 3 months after operation were compared between the two groups.Results:All patients (except for 26 deaths) were followed up for 3-14 months, with an average of 8 months. None had intraoperative encephalocele in GDD group, compared to 8 patients in FOD group ( P<0.05). Intracranial pressure in GDD group was respective (18.4±3.6)mmHg, (20.4±4.0)mmHg, (27.7±4.6)mmHg and (28.3±4.5)mmHg at the time, 24 hours, 72 hours and 7 days after operation, showing no significant differences compared to FOD group [(19.1±3.4)mmHg, (20.9±3.9)mmHg, (27.0±3.5)mmHg, (27.6±3.4)mmHg, respectively] ( P>0.05). There was no significant difference in the incidence of delayed intracranial hematoma between the two groups [16% (6/38) in GDD group and 16% (5/32) in FOD group (except 8 cases of intraoperative encephalocele)] ( P>0.05). Three months after operation, the good rate of GOS score of GDD group was 61% (23/28) higher than that of FOD group [28% (11/40)], and the mortality rate of GDD group was 21% (8/38) lower than that of FOD group [45% (18/40)] ( P<0.05). There was no significant difference between the two groups in medium severe disability and plant survival rate ( P>0.05). Conclusions:For patients with severe TBI, compared with FOD, GDD is more effective in reducing the incidence of intraoperative encephalocele, improving the prognosis and decreasing mortality.

6.
Article in Chinese | WPRIM | ID: wpr-863267

ABSTRACT

Objective To compare the curative effect of three different surgical methods:peritoneal varicocele ligation,peritoneal single-port laparoscopy and microscopy on varicocele.Methods Retrospective analysis of the case data of 150 patients with varicocele treated in the Affiliated Hospital of Xuzhou Medical University from September 2016 to September 2018.The average age was 24.5 years,and the age range was 22-30 years.The patients were divided into three groups according to different surgical methods:open group,laparoscopy group and microscope group,with 50 cases in each group.Patients in the open group were treated with retroperitoneal spermatic cord ligation.Patients in the laparoscopic group were treated with single-hole laparoscopic laparoscopic surgery.Patients in the microscope group were treated with microscope surgery.Operation time,postoperative hospitalization time,hospitalization cost reserved arteries,surgical complications (such as testicular hydrocele,scrotal edema,epididymitis,testicular atrophy),recurrence,and semen quality improvement were compared between three groups.Measurement data were expressed as mean ± standard deviation(Mean ± SD),the two comparisons used the t test,the comparison between the three groups used the analysis of variance,and the comparison between the count data groups using the Chi-square test.Results The operation time of the patients in the microscope group [(52.52 ± 4.29) min] was longer than that of the open group [(36.60 ± 3.69) min] and the laparoscopic group [(39.54 ± 2.87) min].The difference between the two groups was statistically significant (P < 0.05);but the postoperative hospitalization time and hospitalization cost of patients in the microscope group [(2.16±0.95) d,(5251 ± 300) yuan] were higher than those in the open group [(3.80±0.78) d,(64 75 ±415) yuan)] and the laparoscopic group [(3.28 ± 1.01) d,(7 379 ± 273) yuan].The results of pairwise comparison showed that the difference between the microscope group,the open group and the laparoscopic group was statistically significant (P <0.05).Arterial preservation in the microscope group [47(94.0%)] were compared with the open group [35 (70.0%)],and laparoscopic group [30(60.0%)] had obvious advantages.Pairwise comparison results showed that the comparison between the microscope group and the open group and the laparoscopic group was statistically significant (P < 0.05).After follow-up for six months,2 cases were lost to follow-up in the microscope group,1 cases were lost to the open group,and 5 case was lost to the unilateral laparoscopic group.2(4.2%) patients had complications in the microscope group,and 14 (28.6%) patients had complications in the open group;9 (20.0%) patients had complications in the laparoscopic group,and the total incidence of complications showed a pairwise comparison,the difference between the microscope group,the open group and the laparoscopic group was significant (P < 0.05).The recurrence rate in the microscope group was 2.1% (1/48),the recurrence rate in the open group was 18.4% (9/49),and the recurrence rate in the laparoscopic group was 13.3% (6/45);the recurrence rate was compared in pairs,the difference between the microscope group,the open group and the laparoscopic group was significant (P < 0.05).The improvement rate of semen quality in the microscope group was 68.8% (33/48),the open group was 42.9% (21/49),the laparoscopic group was 55.6% (25/45),pairwise comparison results showed that the microscope group compared with the open group and laparoscopy group,the difference were statistically significant (P < 0.05).Conclusions Microscopic surgery has less trauma,faster postoperative recovery,shorter operation cost and hospitalization time.Postoperative complications and recurrence,and improved semen quality are all superior to open spermatic vein ligation and single-hole umbilical laparoscopic surgery,it is a safe and effective way to treat varicocele.

7.
Article in Chinese | WPRIM | ID: wpr-862676

ABSTRACT

Objective::Based on gene array technology, gene set enrichment analysis (GSEA) and immune infiltration analysis were performed on chip data of intracranial aneurysm (IA) mRNA expression profile, in order to provide theoretical basis for understanding the formation mechanism of IA. Method::The GSE75436 raw data were obtained from the gene expression omnibus (GEO). GSEA of biological process (BP) in gene ontology (GO) and Kyoto gene and genome encyclopedia (KEGG) signaling pathways were analyzed for gene expression profile by R software. The CIBERSORT deconvolution method was used to analyze the infiltration ratio of 22 types of immune cells in the expression profile. And COREMINE database was used to predict traditional Chinese medicines (TCMs), which were significant correlation with the enrichment result. Result::The GSEA results showed that the changes in gene expression of IA samples mainly involved in the regulation of cytokines, activation and differentiation of leukocyte, inflammatory immune response and other processes. The infiltration matrix analysis of immune cells showed that mast cells resting and neutrophils were significantly reduced in IA samples. The comparison of paired samples showed that mast cells and natural killer cells (NK cells) were significantly activated in the IA samples of the same individual, while neutrophils and T cells CD4 naive were significantly reduced. Through COREMINE prediction, it was found that Stephaniae Tetrandrae Radix was correlated with the activation of granulocytes, Sapindi Mukorossi Semen and Pistaciae Chinensis Cortex were correlated with the activation of neutrophils, Trichosanthis Semen, Paeoniae Radix Alba and Ligustri Lucidi Fructus were correlated with the cytotoxicity mediated by NK cells. Conclusion::Activation of mast cells and NK cells are closely associated with the occurrence and development of IA. The inflammatory immune processes and pathways such as nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) signaling pathway and cytotoxicity mediated by NK cells may be important factors in the pathogenesis of IA, and TCMs such as Stephaniae Tetrandrae Radix may be the potential molecular drug sources.

8.
Article in Chinese | WPRIM | ID: wpr-872326

ABSTRACT

Alongside the social and economic development in China, medical risks, economic risks, and legal risks rise as well in the management of public hospitals. However, the capabilities of these hospitals in prevention and control of medical risks and disposal of legal affairs fall far behind the increasingly complex legal affairs. In this consideration, the authors introduced their innovative practice in taking legal actions for prevention and control of medical risks in the hospital, analyzed the problems found in medical legal affairs, and put forward specific suggestions to promote the standardization and modernization of hospital legal affairs.

9.
Chinese Journal of Geriatrics ; (12): 249-254, 2020.
Article in Chinese | WPRIM | ID: wpr-869365

ABSTRACT

The novel coronavirus 2019(2019-nCoV)was first detected from patients with pneumonia of an unknown cause in Wuhan in December 2019.It has since been confirmed as the pathogen for the new coronavirus pneumonia, recently named coronavirus disease 2019(COVID-19) by the WHO.Although the general population is commonly susceptible to the disease, infected elderly people show fast progression and severe manifestations with a high proportion in serious or critical condition as a result of compromised immunity and underlying diseases.In order to improve the quality of nursing management, reduce complications and decrease mortality for critically ill elderly patients, we assembled a national expert group with expertise in critical care nursing to write this consensus, based on a literature review and a subsequent panel discussion.The consensus covers the assessment, clinical nursing management, nursing care following hospital discharge and other aspects of care for critically ill elderly patients with COVID-19, aiming to share insights and provide guidance for clinical practice.

10.
Article in Chinese | WPRIM | ID: wpr-837613

ABSTRACT

ObjectiveTo investigate the prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City. MethodsA cross-sectional questionnaire survey was conducted among AIDS patients in Nanchang City during the period between May and September, 2016. B. hominis infection was detected in patients’stool samples using a PCR assay, and the CD4+ T cell count was measured in subjects’blood samples. In addition, the risk factors of B. hominis infection in AIDS patients were identified using univariate and multivariate logistic regression analyses. Results A survey was conducted in Nanchang City from May to September 2016. A total of 505 AIDS patients were investigated, and the prevalence of B. hominis infection was 4.16%. Univariate analysis revealed that B. hominis infection correlated with the occupation (χ2 = 8.595, P = 0.049), education level (χ2 = 14.494, P = 0.001), type of daily drinking water (χ2 = 10.750, P = 0.020), root of HIV infections (χ2 = 8.755, P = 0.026) and receiving anti-HIV therapy (χ2 = 23.083, P = 0.001) among AIDS patients, and multivariate logistic regression analysis identified daily direct drinking of tap water as a risk factor of B. hominis infections [odds ratio (OR) = 7.988, 95% confidential interval (CI): (1.160, 55.004)] and anti-HIV therapy as a protective factor of B. hominis infection [OR = 0.183, 95% CI: (0.049, 0.685)]. Conclusions The prevalence of B. hominis is 4.16% among AIDS patients in Nanchang City. Daily direct drinking of tap water is a risk factor, and anti-HIV therapy is a protective factor of B. hominis infection among AIDS patients living in Nanchang City.

11.
Article in Chinese | WPRIM | ID: wpr-843175

ABSTRACT

Objective • To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods • The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients' BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results • The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion • Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.

12.
Article in Chinese | WPRIM | ID: wpr-799274

ABSTRACT

Objective@#To compare the curative effect of three different surgical methods: peritoneal varicocele ligation, peritoneal single-port laparoscopy and microscopy on varicocele.@*Methods@#Retrospective analysis of the case data of 150 patients with varicocele treated in the Affiliated Hospital of Xuzhou Medical University from September 2016 to September 2018. The average age was 24.5 years, and the age range was 22-30 years. The patients were divided into three groups according to different surgical methods: open group, laparoscopy group and microscope group, with 50 cases in each group. Patients in the open group were treated with retroperitoneal spermatic cord ligation. Patients in the laparoscopic group were treated with single-hole laparoscopic laparoscopic surgery. Patients in the microscope group were treated with microscope surgery. Operation time, postoperative hospitalization time, hospitalization cost reserved arteries, surgical complications (such as testicular hydrocele, scrotal edema, epididymitis, testicular atrophy), recurrence, and semen quality improvement were compared between three groups. Measurement data were expressed as mean ± standard deviation(Mean±SD), the two comparisons used the t test, the comparison between the three groups used the analysis of variance, and the comparison between the count data groups using the Chi-square test.@*Results@#The operation time of the patients in the microscope group [(52.52 ± 4.29) min] was longer than that of the open group [(36.60±3.69) min] and the laparoscopic group [(39.54±2.87) min]. The difference between the two groups was statistically significant (P<0.05); but the postoperative hospitalization time and hospitalization cost of patients in the microscope group [(2.16±0.95) d, (5 251 ± 300) yuan] were higher than those in the open group [(3.80±0.78) d, (64 75±415) yuan)]and the laparoscopic group [(3.28±1.01)d, (7 379±273) yuan] . The results of pairwise comparison showed that the difference between the microscope group, the open group and the laparoscopic group was statistically significant (P<0.05). Arterial preservation in the microscope group [47(94.0%)] were compared with the open group [35 (70.0%)], and laparoscopic group [30(60.0%)] had obvious advantages. Pairwise comparison results showed that the comparison between the microscope group and the open group and the laparoscopic group was statistically significant (P<0.05). After follow-up for six months, 2 cases were lost to follow-up in the microscope group, 1 cases were lost to the open group, and 5 case was lost to the unilateral laparoscopic group. 2(4.2%) patients had complications in the microscope group, and 14 (28.6%) patients had complications in the open group; 9 (20.0%) patients had complications in the laparoscopic group, and the total incidence of complications showed a pairwise comparison, the difference between the microscope group, the open group and the laparoscopic group was significant (P<0.05). The recurrence rate in the microscope group was 2.1% (1/48), the recurrence rate in the open group was 18.4% (9/49), and the recurrence rate in the laparoscopic group was 13.3% (6/45); the recurrence rate was compared in pairs, the difference between the microscope group, the open group and the laparoscopic group was significant (P<0.05) . The improvement rate of semen quality in the microscope group was 68.8% (33/48), the open group was 42.9%(21/49), the laparoscopic group was 55.6%(25/45), pairwise comparison results showed that the microscope group compared with the open group and laparoscopy group, the difference were statistically significant (P<0.05).@*Conclusions@#Microscopic surgery has less trauma, faster postoperative recovery, shorter operation cost and hospitalization time. Postoperative complications and recurrence, and improved semen quality are all superior to open spermatic vein ligation and single-hole umbilical laparoscopic surgery, it is a safe and effective way to treat varicocele.

13.
Journal of Medical Postgraduates ; (12): 988-993, 2019.
Article in Chinese | WPRIM | ID: wpr-818361

ABSTRACT

Airway allergic diseases are characterized by chronic inflammatory responses in airways. Leukotriene antagonists have been recently recommended as the first-line medication for respiratory allergic diseases, along with nasal glucocorticoids and antihistamines, due to their prominent efficacy and safety in allergic inflammation. This review summarized the clinical application of Montelukast, the representative drug of leukotriene antagonists, to treat allergic rhinitis, bronchial asthma, cough variant asthma, eosinophilia bronchitis and other diseases, in order to further explore the advantages and prospect of Montelukast in the application of airway allergic inflammation.

14.
Chinese Medical Journal ; (24): 2812-2819, 2019.
Article in English | WPRIM | ID: wpr-781739

ABSTRACT

BACKGROUND@#Post-operative pain is unpleasant for patients and may worsen surgical recovery. Peri-operative multimodal analgesia has been used for many years; however, its efficacy still needs improvement. In the present study, a thorough peri-operative pain counseling and stratified management program based on risk assessment was implemented, with the goal of improving post-operative analgesia and patient satisfaction.@*METHODS@#This prospective, controlled, pilot study included 361 patients who underwent elective surgery. Of these 361 patients, 187 received peri-operative pain risk assessment and stratified analgesia and counseling (stratified analgesia group), while 174 received conventional multimodal analgesia (conventional group). The two groups were compared regarding the post-operative pain intensity, rescue analgesia administration, post-operative quality of recovery as assessed via the quality of recovery 40 questionnaire, total dosage of peri-operative opioids, analgesic satisfaction, and analgesic costs.@*RESULTS@#Compared with the conventional group, the stratified analgesia group reported decreased pain intensity during motion at 24 h post-operatively and required lower dosages of rescue analgesia (P = 0.03). The total quality of recovery 40 questionnaire score and the scores for physical wellbeing and pain were significantly better in the stratified analgesia group than the conventional group (P = 0.04); the stratified analgesia group also reported better scores for analgesic satisfaction (P = 0.03) and received lower dosages of opioids (P = 0.03). Analgesic costs were lower in the stratified analgesia group than the conventional group; the cost-effective ratio was 109 in the conventional group and 62 in the stratified analgesia group.@*CONCLUSIONS@#The analgesic efficacy was improved by the implementation of stratified analgesia based on surgical pain risk assessment and counseling. This stratified analgesia protocol increased the patients' analgesic satisfaction and improved the quality of recovery without increasing healthcare costs. The present findings may help improve the efficacy of peri-operative multimodal analgesia in clinical practice.@*CLINICAL TRIAL REGISTRY@#NCT02728973; https://clinicaltrials.gov/ct2/show/NCT02728973?term=NCT02728973&draw=2&rank=1.

15.
Article in Chinese | WPRIM | ID: wpr-756654

ABSTRACT

Objective To compare the differences found between the proportion of responsibility between in-house experts of the hospital and that of judicial appraisals for 52 cases of medical disputes of a hospital in recent years.Methods A total of 52 cases of disputes were selected, which were evaluated by the in-house experts screening meeting at a tertiary hospital in Beijing from 2015 to 2018.According to the causes of these disputes, these cases were divided into seven categories, calculating respectively the mean value of the proportion of judicial appraisal responsibility and that of in-house experts for all cases of the same category.The paired t test was used to compare the consistency of the above two methods.Results The overall level of judicial appraisal responsibility(35.00% ) was significantly higher than the in-house expert screening(20.96% ).Among them, the cases of improper selection of treatment plan, improper operation of surgery or insufficient evaluation of surgical difficulty risk, and medical disputes caused by complications, the degree of responsibility of the judicial appraisal institutions was quite different from that of in-house experts of the hospital.Conclusions Because the judicial appraisal agencies have certain difficulties in the identification of complex medical technology problems, it is recommended to establish a library of judicial appraisal experts as soon as possible to encourage the experts to participate in the trial of disputes.

16.
Article in Chinese | WPRIM | ID: wpr-772003

ABSTRACT

OBJECTIVE@#To establish a rapid and accurate "on/off" switch technique consisted of 3'-phosphorothioate-modified allele-specific primers and exo+ polymerase to screen the G719S and T790M mutations of epidermal growth factor receptor (EGFR) gene. The switch was used to identify cervical cancer patients who are sensitive to tyrosine kinase inhibitor (TKI).@*METHODS@#Allele-specific primers targeting recombinant wild-type and mutation-type templates were designed with 3' terminal phosphorothioate modification. Two-directional primer extension was carried out using Pfu polymerase. The G719S and T790M mutations were detected by the technique among cervical cancer tissues. The results were verified by Sanger sequencing.@*RESULTS@#No mutation was detected among the 80 cervical cancer cases, and the results were consistent with that of Sanger sequencing. No significant difference was found between the frequencies of the G719S and T790M mutations between the patient and the control groups (P> 0.05).@*CONCLUSION@#A sensitive "on/off" switch technique for detecting the two EGFR mutations was established. The G719S and T790M mutations are not associated with cervical cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Drug Resistance, Neoplasm , ErbB Receptors , Genetics , Female , Genes, erbB-1 , Humans , Lung Neoplasms , Mutation , Protein Kinase Inhibitors , Uterine Cervical Neoplasms , Genetics
17.
Article in Chinese | WPRIM | ID: wpr-774082

ABSTRACT

OBJECTIVE@#To study the methylation level and dynamic change of 5-hydroxymethylcytosine (5hmC) in mitochondrial DNA (mtDNA) in the cerebral cortex of neonatal rats with hypoxic-ischemic brain damage.@*METHODS@#A total of 24 male Sprague-Dawley rats aged 7 days were randomly divided into control group, 24-hour model group and 48-hour model group (n=8 each). Common carotid artery ligation combined with hypoxic treatment was performed to establish an animal model of hypoxic-ischemic brain damage. The rats in the control group were not given ligation or hypoxic treatment. Oxidative bisulfite sequencing was used to measure the level of 5hmC in the cerebral cortex. Western blot was used to measure the expression of 5hmC-related enzymes TET1, TET2 and DNMT1.@*RESULTS@#The 24- and 48-hour model groups had a significantly higher level of 5hmC than the control group (P<0.05). Western blot showed a significant increase in the expression of DNMT1 in the 24- and 48-hour model groups (P<0.05). Compared with the control group, the 24- and 48-hour model groups had significant differences in the 5hmC level at multiple mitochondrial genetic loci (P<0.05).@*CONCLUSIONS@#The level of DNMT1, a key enzyme for 5hmC modification in mtDNA, in the cerebral cortex increases in neonatal rats with hypoxic-ischemic brain damage, suggesting that there is an abnormal methylation level of 5hmC after hypoxic-ischemic brain damage, which might be associated with the regulation of hypoxic-ischemic brain damage.


Subject(s)
Animals , Animals, Newborn , Cerebral Cortex , DNA, Mitochondrial , Hypoxia-Ischemia, Brain , Male , Rats , Rats, Sprague-Dawley
18.
Article in English | WPRIM | ID: wpr-772948

ABSTRACT

Proton pump inhibitors (PPIs) are commonly used to lessen symptoms in patients with gastroesophageal reflux disease (GERD). However, the effects of PPI therapy on the gastrointestinal microbiota in GERD patients remain unclear. We examined the association between the PPI usage and the microbiota present in gastric mucosal and fecal samples from GERD patients and healthy controls (HCs) using 16S rRNA gene sequencing. GERD patients taking PPIs were further divided into short-term and long-term PPI user groups. We showed that PPI administration lowered the relative bacterial diversity of the gastric microbiota in GERD patients. Compared to the non-PPI-user and HC groups, higher abundances of Planococcaceae, Oxalobacteraceae, and Sphingomonadaceae were found in the gastric microbiota from the PPI-user group. In addition, the Methylophilus genus was more highly abundant in the long-term PPI user group than in the short-term PPI-user group. Despite the absence of differences in alpha diversity, there were significant differences in the fecal bacterial composition of between GERD patients taking PPIs and those not taking PPIs. There was a higher abundance of Streptococcaceae, Veillonellaceae, Acidaminococcaceae, Micrococcaceae, and Flavobacteriaceae present in the fecal microbiota from the PPI-user group than those from the non-PPI-user and HC groups. Additionally, a significantly higher abundance of Ruminococcus was found in GERD patients on long-term PPI medication than that on short-term PPI medication. Our study indicates that PPI administration in patients with GERD has a significant effect on the abundance and structure of the gastric mucosal microbiota but only on the composition of the fecal microbiota.


Subject(s)
Adult , Aged , Bacteria , Genetics , Feces , Microbiology , Female , Gastric Mucosa , Microbiology , Gastroesophageal Reflux , Drug Therapy , Microbiology , Gastrointestinal Microbiome , Humans , Male , Microbiota , Middle Aged , Proton Pump Inhibitors , Therapeutic Uses , RNA, Ribosomal, 16S , Genetics
19.
Article in Chinese | WPRIM | ID: wpr-802321

ABSTRACT

Objective:To explore the molecular mechanism of Lycii Fructus and Salviae Miltiorrhizae Radix et Rhizoma (FLRSM) in the treatment of retinitis pigmentosa (RP) based on network pharmacology and bioinformatics. Method:Possible intake active components and targets of FLRSM were screened out and predicted by traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP). Gene targets related to RP were mined through disease gene databases. Protein-protein interaction (PPI) network of component-targets and disease-targets were mapped by functional protein association networks (STRING), and the intersection of the two networks was obtained. The gene ontology and kyoto encyclopedia of genes and genomes(KEGG) pathway of the intersection network were analyzed by the database for annotation, visualization and integrated discovery(DAVID). CytoHubba analysis was used to screen out the key targets. Result:A total of 390 active ingredients related to FLRSM were retrieved from TCMSP. According to pharmacokinetic parameters, 110 active ingredients were screened out, 19 active ingredients were further screened out, and 208 targets related to these constituents were retrieved. Totally 206 genes directly related to RP were obtained from the disease gene databases. And 79 genes were obtained from the intersection of PPI networks of component targets and disease targets. These genes mainly involved in biological processes, such as protein autophosphorylation, transcriptional regulation and cell proliferation, and the molecular functions mainly involved adenosine triphosphate binding, transcription factor activity, core promoter binding, and were enriched in nuclear, transcription factor complex, nucleus, cytoplasm and other regions. It was mainly related to neurotrophin signaling pathway, cell cycle related pathway and Wnt signaling pathway. And 8 key gene targets for FLRSM treatment of RP were identified by further screening. Conclusion:The material basis of pharmacodynamic action of FLRSM involves 19 active ingredients, such as porous sterol and tanshinone ⅡA. The key targets of FLRSM in the treatment of RP include 8 genes, such as E2F transcription factor 1(E2F1) and retinoblastoma gene1(RB1).The main mechanism is related to the regulation of neurotrophin signaling pathways, cell cycle related pathways and other signaling networks.

20.
International Journal of Surgery ; (12): 613-617, 2019.
Article in Chinese | WPRIM | ID: wpr-798220

ABSTRACT

Objective@#To observe the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in treating infertility caused by varicocele.@*Methods@#Retrospective analysis of 49 cases of infertility caused by varicocele admitted to the Affiliated Hospital Xuzhou Medical University from February 2015 to November 2016, average age was 27.5 years, aged 20-50 years; according to simple random method divided into experimental group (n=20) and control group (n=29). Patients in the experimental group were treated with laparoscopic high ligation of spermatic vein and compound xuanju capsule. Patients in the control group were treated with high ligation of spermatic vein. Semen quality (sperm concentration, forward motor sperm rate, sperm survival rate), peripheral blood sex hormone (follicle stimulating hormone, luteinizing hormone testosterone) were compared between the two groups before and 3 months after surgery. Pregnancy rate of the spouse 1 year after surgery were compared between the two groups. Measurement data were expressed as mean± standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test.@*Results@#Preoperative sperm concentration [(14.95±2.35) million/ml vs (15.69±3.35) million/ml, P=0.118], forward motor sperm rate [(24.35±3.72)% vs (25.10±3.89)%, P=0.221], sperm survival rate [(27.90±2.59)% vs (26.93±3.20)%, P=0.122]was not statistically significant between experimental group and control group. 3 months after operation, sperm concentration [(23.45±4.39) million/ml vs (20.07±2.91) million/ml, P=0.001], forward motor sperm rate [(34.80±3.56)% vs (31.62±3.75)%, P=0.001], sperm survival rate [(44.55±4.29)% vs (39.52±4.49)%, P=0.001] was statistically significant between experimental group and control group. Preoperative follicle stimulating hormone [(8.97±0.64) IU/L vs (9.17±0.96) IU/L, P=0.238] and luteinizing hormone [(6.75±0.49) IU/L vs (6.64±0.37) IU/L, P=0.744], testosterone [(10.87±1.66) nmol/L vs (9.98±1.17) nmol/L, P=0.064] was not statistical significance between experimental group and control group. 3 months after operation, Follicle stimulation. [(6.96±0.66) IU/L vs (7.34±0.77) IU/L, P=0.043], luteinizing hormone [(6.04±0.39) IU/L vs (6.15±0.38) IU/L, P=0.038], testosterone [(14.46±1.30) nmol/L vs (12.23±2.23) nmol/L, P=0.001] was statistically significant between experimental group and control group. Pregnancy rate of the spouse 1 year of the experimental group was higher than the control group [65.0% (13/20) vs 48.3% (14/29)], but it was not statistically significant between two groups (χ2=1.34, P=0.247).@*Conclusions@#Laparoscopic high ligation of spermatic vein combined with compound Xuanju capsule in the treatment of infertility caused by varicocele can significantly improve semen quality and sex hormone levels. From visual data, the natural pregnancy rate is also improved compared with the simple operation group. It is worthy of clinical recommendation.

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