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1.
China Pharmacy ; (12): 641-652, 2022.
Article in Chinese | WPRIM | ID: wpr-922997

ABSTRACT

In order to improve the management level of medicine list of medical institutions in China ,and help medical institutions build a medicine list of medical institutions with reasonable drug use structure ,standardized adjustment procedures , convenient operation and application and scientific evaluation methods ,so as to meet the needs of clinical rational drug use to the greatest extent ,with the support of the Pharmaceutical Care Professional Committee of the Chinese Pharmaceutical Association , China-Japan Friendship Hospital and the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital )jointly initiate and complete Guideline for the Evaluation of Medicine List in Chinese Medical Institutions jointly with a number of medical institutions. In strict accordance with the methodological requirements of World Health Organization standard guidelines ,based on the Delphi method ,the guideline formulation working group has constructed the quality evaluation index system and quantitative scoring table of medicine list management in medical institutions from the 5 dimensions of organization and management ,structure,adjustment,application and e valuation of the list. It is used to help medical institutions evaluate the quality of their medicine list management ,so asto play a positive role in the fine management of medicine list in medical institutions.

2.
Acta Pharmaceutica Sinica B ; (6): 2443-2461, 2022.
Article in English | WPRIM | ID: wpr-929402

ABSTRACT

Currently, there is still no effective curative treatment for the development of late-stage liver fibrosis. Here, we have illustrated that TB001, a dual glucagon-like peptide-1 receptor/glucagon receptor (GLP-1R/GCGR) agonist with higher affinity towards GCGR, could retard the progression of liver fibrosis in various rodent models, with remarkable potency, selectivity, extended half-life and low toxicity. Four types of liver fibrosis animal models which were induced by CCl4, α-naphthyl-isothiocyanate (ANIT), bile duct ligation (BDL) and Schistosoma japonicum were used in our study. We found that TB001 treatment dose-dependently significantly attenuated liver injury and collagen accumulation in these animal models. In addition to decreased levels of extracellular matrix (ECM) accumulation during hepatic injury, activation of hepatic stellate cells was also inhibited via suppression of TGF-β expression as well as downstream Smad signaling pathways particularly in CCl4-and S. japonicum-induced liver fibrosis. Moreover, TB001 attenuated liver fibrosis through blocking downstream activation of pro-inflammatory nuclear factor kappa B/NF-kappa-B inhibitor alpha (NFκB/IKBα) pathways as well as c-Jun N-terminal kinase (JNK)-dependent induction of hepatocyte apoptosis. Furthermore, GLP-1R and/or GCGR knock-down results represented GCGR played an important role in ameliorating CCl4-induced hepatic fibrosis. Therefore, TB001 can be used as a promising therapeutic candidate for the treatment of multiple causes of hepatic fibrosis demonstrated by our extensive pre-clinical evaluation of TB001.

3.
Acta Pharmaceutica Sinica B ; (6): 2315-2329, 2022.
Article in English | WPRIM | ID: wpr-929379

ABSTRACT

Pulmonary hypertension (PH) is a life-threatening disease characterized by pulmonary vascular remodeling, in which hyperproliferation of pulmonary artery smooth muscle cells (PASMCs) plays an important role. The cysteine 674 (C674) in the sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) is the critical redox regulatory cysteine to regulate SERCA2 activity. Heterozygous SERCA2 C674S knock-in mice (SKI), where one copy of C674 was substituted by serine to represent partial C674 oxidative inactivation, developed significant pulmonary vascular remodeling resembling human PH, and their right ventricular systolic pressure modestly increased with age. In PASMCs, substitution of C674 activated inositol requiring enzyme 1 alpha (IRE1α) and spliced X-box binding protein 1 (XBP1s) pathway, accelerated cell cycle and cell proliferation, which reversed by IRE1α/XBP1s pathway inhibitor 4μ8C. In addition, suppressing the IRE1α/XBP1s pathway prevented pulmonary vascular remodeling caused by substitution of C674. Similar to SERCA2a, SERCA2b is also important to restrict the proliferation of PASMCs. Our study articulates the causal effect of C674 oxidative inactivation on the development of pulmonary vascular remodeling and PH, emphasizing the importance of C674 in restricting PASMC proliferation to maintain pulmonary vascular homeostasis. Moreover, the IRE1α/XBP1s pathway and SERCA2 might be potential targets for PH therapy.

4.
Journal of Integrative Medicine ; (12): 237-243, 2022.
Article in English | WPRIM | ID: wpr-929224

ABSTRACT

OBJECTIVE@#To investigate the changes in the functional connectivity (FC) in the right insula between migraine without aura (MWoA) and healthy controls by using resting-state functional magnetic resonance imaging (rs-fMRI), and to observe the instant alteration of FC in MWoA during electroacupuncture (EA) stimulation at Shuaigu (GB8).@*METHODS@#A total of 30 patients with MWoA (PM group) and 30 healthy controls (HC group) underwent rs-fMRI scans. The PM group underwent a second rs-fMRI scan while receiving EA at GB8. The right insula subregions, including the ventral anterior insula (vAI), dorsal anterior insula (dAI) and posterior insula (PI), were selected as the seed points for FC analysis.@*RESULTS@#Aberrant FC, including dAI with right postcentral gyrus, PI with left precuneus, was found among PM before EA (PMa), PM during EA (PMb) and HC. Meanwhile, decreased FC between dAI and the right postcentral gyrus was found in the PMa compared to the HC and PMb. Increased FC between the PI and left precuneus was found in the PMa compared to the HC and PMb. Correlation analysis showed that the FC value of the right postcentral gyrus in PMa was negatively correlated with the scores of Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. The FC value of the left precuneus in PMa was positively correlated with the visual analogue scale score.@*CONCLUSION@#The alteration of FC between the right insula subregions and multiple brain regions may be an important index for MWoA. EA at GB8 was able to adjust the FC between the right insula subregions and parietal lobe, namely, the right dAI and right postcentral gyrus, and the right PI and left precuneus, thereby rendering an instant effect in the management of MWoA.


Subject(s)
Brain/diagnostic imaging , Electroacupuncture , Humans , Magnetic Resonance Imaging/methods , Migraine without Aura
5.
Journal of Integrative Medicine ; (12): 96-103, 2022.
Article in English | WPRIM | ID: wpr-929210

ABSTRACT

The term Jingluo, translated as meridian or channel, is a core component of traditional Chinese medicine (TCM) and has played a fundamental role in guiding the clinical practice of acupuncture for thousands of years. However, the essence of the meridian remains elusive and is a source of both confusion and debate for researchers. In this study, a "4D" systemic view on the essence of the meridian, namely substantial, functional, chronological, and cultural dimensions, was proposed based on a review of the ancient medical classics, recent research developments, and results from clinical practice. Previous studies have primarily focused on the substantial dimension of the meridian system, with scant interpretation about its functional domain. Neither systemic data nor evaluations have been adequately documented. Additionally, a limited but increasing number of studies have focused on the chronological and cultural dimensions. More investigations that embody the holistic concept of TCM and integrate the systemic modes and advanced techniques with dominant diseases of TCM need to be performed to obtain a more comprehensive understanding of the essence of meridians. The goal of this study is to yield useful information in understanding the essence of meridians and provide a reference and perspective for further research.


Subject(s)
Acupuncture , Acupuncture Points , Acupuncture Therapy , Medicine, Chinese Traditional , Meridians
6.
Article in English | WPRIM | ID: wpr-929027

ABSTRACT

OBJECTIVES@#Accurate breast lesion surface localization can guarantee accurate biopsy and local treatment. But there is no guideline to regular equipment and methods for the localization of breast lesions. The conventional non-invasive localization method is marker-based localization. The advantages of this method are simple and efficient. The disadvantages are that markers disappear easily under coupling agents; the positioning length of markers cannot last long on skin; and healthcare associated infection due to many patients using the same marker pen is potentially unavoidable. Breast lesion sticker (called sticker for short) is a new-type localization medical instrument in 2020. Our study aims to explore the clinical value of a new lesion stickers in breast lesion surface localization via comparison of the sticker and marker pen localization methods.@*METHODS@#This was a prospective cohort study. It was conducted in 67 patients who needed breast lesion surface localization before biopsy. The patients were randomly assigned into 2 groups. One group of patients used marker pen to mark breast lesion surface location by ultrasonography. The other group of patients used stickers. Patients labeled with markers on skin were swabbed agents before marking. Then the markers were checked by ultrasound scan. If the surface positions of breast lesion were not correct, the above procedure was repeated. In the sticker group, the stickers were released synchronously after the lesions were detected by ultrasound scan. Then locations were checked via scanning hole. If the surface positions of breast lesion were not correct, the above procedure was repeated. The accuracy of positioning, the length of positioning time and satisfaction of patients between the 2 groups were compared. The length of positioning time was calculated from the time when ultrasound detected the lesion to the time when the surface position of breast lesion was confirmed. The total score of patients' satisfaction was 5 points according to Service Quality Evaluation of SERVQUAL Scale, including sonographers' service attitude and their technical proficiency, other medical staffs' service attitude and their technical proficiency, hospital service procedures, positioning comfort, and positioning effects.@*RESULTS@#All 67 patients were females, aged 18-66 (39.73±13.10). There were 35 patients in the marker pen group and 32 patients in the sticker group. The time length of group used marker pen to localization was 22-88 (52.20±2.90) s, and the sticker group was 3-15 (9.22±0.58) s in length. The length of positioning time for the stickers was significantly shorter than that of the marker (P<0.01). Both methods were accurate in the surface localization of lesions before operation. The total scores of patients' satisfaction was 4-5 (4.92±0.02) in the stickers group, and 1-5 (3.35±0.10) in the marker pen group. The patients' satisfaction scores with the sticker were significantly higher than those with the marker pen (P<0.01). The length of positioning time and patients' satisfication scores for sonographer with 20 years' working experience were shorter and higher than those of sonographer with 10 years' working experience, respectively (both P<0.05).@*CONCLUSIONS@#The new breast lesion positioning stickers have more advantages than the marker pen in localization efficiency. It could reduce the workload of medical workers and increase patients' satisfaction to some extent. The stickers can be used not only in the breast lesions surface localization, but also in the skin location of pleural effusion and ascites, the skin location of surface masses, the skin location of thyroid nodule, and many other clinical marker areas, to further expand the scope of clinical application and value of the stickers.


Subject(s)
Breast/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Female , Humans , Male , Prospective Studies , Skin
7.
Article in English | WPRIM | ID: wpr-928971

ABSTRACT

OBJECTIVES@#Adolescents are at high risk of non-suicidal self-injury (NSSI). Currently, there is no clinical assessment tool for adolescent NSSI behaviors measurement with global consistency. The Ottawa Self-injury Inventory (OSI) is considered as a relatively comprehensive assessment tool for NSSI, but the questionnaire is discussed with excessive content and timecostly, which may affect the reliability of the measurement results for adolescent.Thus, this study, based on OSI, aims to revise the assessment tool for adolescent with NSSI that is suitable for both clinically and scientifically, referring to the diagnostic criteria for NSSI in the 5th Diagnostic and Statistical Manual of Mental Disorder (DSM-5).@*METHODS@#This study was led by the Second Xiangya Hospital of Central South University and collaborated with 6 mental health service institutions in China from August to December 2020. Adolescent aged from 12 to 24 years old who had self-injury behavior and met the DSM-5 diagnostic criteria for NSSI were continuously recruited in the psychiatric outpatient department or ward. After clinical diagnosis by an experienced attending psychiatrist or above, the general information and OSI were collected by questionnaires. SPSS 24.0 and AMOS structural equation model statistical softwares were used to conduct item analysis and exploratory factor analysis on the obtained data to complete the revision of the scale. Cronbach's alpha coefficient, split-half reliability, test-retest reliability, and content validity and structure validity were performed to analyze the reliability and validity and confirmatory factor analysis was carried out to test the structure validity for the revised scale.@*RESULTS@#A total of 234 adolescent with NSSI were enrolled, including 33 (14.1%) males and 201 (85.9%) females with the mean age of (16.2±2.6) years old. The most common clinical diagnoses were depression disorder (57.4%), bipolar disorder (20.9%), adolescent mood disorder (17.1%), etc. Nine items (item 2, 7, 11, 13, 23, 24, 10, 17, 18) in the functional scale of OSI were deleted according to extreme grouping method, correlation analysis, and principal component analysis in exploratory factor analysis. The revised functional scale for NSSI consisted of 15 items. The reliability analysis showed that the Cronbach's alpha coefficients of NSSI thought and behavior frequency, addiction characteristics, and function scales were 0.799, 0.798, and 0.835, respectively, and the split-half coefficients were 0.714, 0.727, and 0.852, respectively. The test-retest coefficients of the latter 2 scales were 0.466 and 0.560, respectively. The correlation coefficient between sub-items and total scores in each part of the scale showed good content validity. The exploratory factor analysis showed that a component was extracted from the frequency of thoughts and behaviors of NSSI, one component was extracted from the addictive characteristics, and three components were extracted from the functional part. The three functional subscales were social influence, external emotion regulation, and internal emotion regulation. The factor load of each item was >0.400.@*CONCLUSIONS@#The revised Chinese version OSI targeted the adolescent patients with mental disorders has relatively ideal reliability and validity. The scale shows high stability, dependability, and a reasonable degree of fit. It is a suitable assessment tool for clinical and scientific research on adolescent with NSSI.


Subject(s)
Adolescent , Adult , Child , Factor Analysis, Statistical , Female , Humans , Male , Mental Disorders/diagnosis , Psychometrics/methods , Reproducibility of Results , Self-Injurious Behavior/psychology , Surveys and Questionnaires , Young Adult
8.
Article in Chinese | WPRIM | ID: wpr-942361

ABSTRACT

Objective To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province. Methods A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients’ stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients. Results A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%). Conclusions The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.

9.
Acta Pharmaceutica Sinica ; (12): 2857-2863, 2022.
Article in Chinese | WPRIM | ID: wpr-941501

ABSTRACT

In this study, a novel oral drug delivery system based on linolenic acid-modified chitosan (CS-LA) micelle was developed to improve the oral bioavailability of doxorubicin (DOX), which was proven by its in vivo intestinal absorption in rats. The DOX-loaded CS-LA micelles (CS-LA@DOX) were prepared by the dialysis method. The synthesized micelle material was identified by proton nuclear magnetic resonance spectroscopy (1H-NMR) and Fourier transform infrared spectroscopy (FT-IR). A series of the micelle properties, including particle size distribution, zeta potential, encapsulation efficiency (EE), drug loading (DL), micromorphology, polymorphy, and critical micelle concentration (CMC) were characterized or tested. The in vitro release of micelles was observed by the dialysis method, and the absorption-promoting effect of micelles was investigated by intestinal circulation experiments in rats. The animal welfare and experimental procedures were in accordance with the regulations of the Animal Ethics Committee of Guilin Medical University. The results of 1H-NMR and FT-IR showed that CS and LA were covalently bound via an amide linkage. The DOX encapsulated in the micelle core was in an amorphous state. The as-prepared micelles in the transmission electron microscope (TEM) image showed regular spherical shapes and uniform sizes with a series of excellent characteristics including (119.2 ± 2.1) nm of mean particle size [polymer dispersity index (PDI), 0.190 ± 0.08], +12.1 mV of zeta potential, (70.23 ± 0.74) % of EE, (8.77 ± 0.02) % of DL and 51.75 μg·mL-1 of CMC. Compared with the reference, DOX hydrochloride, the proposed micelle drug delivery system showed an obvious sustained-release effect in vitro release; and enhanced drug absorption in the small intestine of rats.

10.
Article in Chinese | WPRIM | ID: wpr-940498

ABSTRACT

ObjectiveTo investigate the potential mechanism of Xiao Chaihutang (XCHT) in the treatment of Alzheimer's disease (AD) based on network pharmacology and bioinformatics. MethodThe active components of XCHT and corresponding targets were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and the differentially expressed genes related to AD were searched from Gene Expression Omnibus (GEO). Thereby, the common targets of XCHT and AD were yielded, followed by Gene Ontology (GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the common targets. The component-target network and protein–protein interaction (PPI) network were constructed. Furthermore, amyloid β-protein (Aβ)1-40 was used to induce AD in PC12 cells and then the AD cells were intervened with XCHT. Afterward, cell viability was detected by Cell Counting Kit-8 (CCK-8) assay and cell morphology was observed based on 4',6-diamidino-2-phenylindole (DAPI) staining. Cell membrane potential was determined and apoptosis was detected by flow cytometry, and cellular immunofluorescence detects the expression of B-cell lymphoma-2 (Bcl-2)/Bcl-2-related X protein (Bax). Moreover, immunofluorescence assay was performed. ResultA total of 190 active components and 41 anti-AD targets of XCHT were screened out. The key components included mairin, quercetin, berberine, protoporphyrin, 24-ethylcholest-4-en-3-one, and β-D-ribofuranoside, and the core targets were sigma non-opioid intracellular receptor 1 (SIGMAR1), checkpoint kinase 1 (CHEK1), protein tyrosine phosphatase non-receptor type 6 (PTPN6), protein kinase C(PRKCH), inhibitor of nuclear factor kappa B kinase subunit beta (IKBKB), cathepsin D (CTSD), cysteine aspartate protease-3 (Caspase-3), Bax, and Bcl-2-like protein 1 (Bcl-2L1). The anti-AD targets of XCHT were involved in 302 GO terms (P < 0.05), particularly the regulation of neuronal cell apoptosis, and 73 KEGG pathways (P<0.05). The major pathways and biological processes included the apoptosis pathway, virus infection pathway, lipid and atherosclerosis pathway, and cancer-related pathways. In the in vitro experiment, the model group demonstrated the decrease in cell survival rate (P<0.05), increase in apoptosis rate (P<0.05), and down-regulation of mitochondrial membrane potential and Bcl-2/Bax ratio compared with the blank control. Compared with the model group, XCFT group showed the increase in cell survival rate (P<0.05), decrease in apoptosis rate (P<0.05), and up-regulation of mitochondrial membrane potential and Bcl-2/Bax ratio. ConclusionBased on network pharmacology, this study reveals the multi-component, multi-target, and multi-pathway characteristics of XCHT in the treatment of AD, laying a foundation for further research on the material basis and mechanism of this prescription.

11.
Article in Chinese | WPRIM | ID: wpr-940462

ABSTRACT

ObjectiveTo explore the active ingredients, therapeutic targets, and relative signaling pathways of Tripterygium wilfordii in the treatment of triple negative breast cancer (TNBC) based on network pharmacology, and to verify the mechanism through in vitro cell model. MethodThe active ingredients of T. wilfordii were screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The targets of TNBC were obtained from DisGeNET and GeneCards. Venny was used to identify the potential therapeutic targets of T. wilfordii against TNBC. Protein-protein interaction (PPI) network was constructed with String database. Gene ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were carried out with DAVID to predict the mechanisms of potential targets. The molecular docking between triptolide and key targets were performed with AutoDock Vina. The effect of triptolide (0, 5, 10, 20, 30, 40, 50, 60, 80 nmol·L-1) on the proliferation of MDA-MB-231 cells was determined through methyl thiazolyl tetrazolium (MTT) assay. The effect of triptolide (0, 12.5, 25, 50 nmol·L-1) on the apoptosis of MDA-MB-231 cells was detected with Hoechst 33342 staining. Western blot was performed to detect the effect of triptolide (0, 25, 50 nmol·L-1) on the expression levels of key targets. ResultT. wilfordii had 23 active ingredients related to 55 potential targets of TNBC. GO and KEGG enrichment revealed that the potential targets were associated with 103 biological processes, 15 cellular components, and 35 molecular functions, and were involved in 140 signaling pathways including atherosclerosis and apoptosis. The results of molecular docking demonstrated that triptolide could bind with the targets including threonine kinase 1 (Akt1), vascular endothelial growth factor A (VEGFA), cellular tumor antigen p53 (p53), transcription factor AP-1 (JUN), signal transducer and activator of transcription 3 (STAT3), tumor necrosis factor (TNF), mitogen-activated protein kinase 8 (MAPK8), prostaglandin G/H synthase 2 (PTGS2), and Caspase-3. According to the results of MTT assay, triptolide (20, 30, 40, 50, 60, 80 nmol·L-1) inhibited the proliferation of MDA-MB-231 cells compared with blank control (P<0.05, P<0.01). Hoechst 33342 staining showed that triptolide (12, 25, 50 nmol·L-1) induced the apoptosis of MDA-MB-231 cells compared with black control (P<0.05, P<0.01). Western blot showcased that 50 nmol·L-1 triptolide down-regulated the relative expression levels of p-Akt, TNF-α, and VEGFA, while 25 and 50 nmol·L-1 triptolide up-regulated the relative expression level of p53 in a dose-dependent manner compared with the blank control (P<0.05, P<0.01). ConclusionT. wilfordii has multiple ingredients, targets, and pathways in the treatment of TNBC. It may regulate p53, VEGFA, TNF-α and other key targets to induce cell apoptosis and suppress angiogenesis and inflammatory response, which provides a scientific basis for the further investigation and clinical application of T. wilfordii.

12.
Article in Chinese | WPRIM | ID: wpr-940429

ABSTRACT

ObjectiveTo observe the clinical efficacy of Maxingshigantang enema in the treatment of infant viral pneumonia by comparing related indicators, and comprehensively evaluate the effect of traditional Chinese medicine (TCM) enema on the intestinal microenvironment. MethodSixty infants with viral pneumonia were selected and randomly divided into 3 groups. The dosage of enema drugs in high- (0.117 g·mL-1) and low-concentration (0.07 g·mL-1) TCM enema groups was same (3.5 g per time), and the control group received normal saline enema, once a day for 7 days. Finally, the curative effect, total symptom score, salivary secretory immunoglobulin A (sIgA), human beta defensin 2 (hBD2) and fecal calprotectin (CALP) of each group were statistically analyzed by SPSS 21.0, and the clinical efficacy of TCM enema in treating children with pneumonia and asthma was comprehensively evaluated. ResultThe curative effect of high-concentration TCM enema group (total effective rate 100%, χ2=7.059) was equivalent to that of low-concentration TCM enema group (total effective rate 95%, χ2=4.329), higher than that of control group (total effective rate 70%) (P<0.017). After treatment, compared with control group and low-concentration TCM enema group, high-concentration TCM enema group had higher total symptom score of children (P<0.05, P<0.01). The proportion of coccobacillus was reduced in three groups, with high- and low-concentration TCM enema groups lower than control group (P<0.05). The salivary sIgA concentration was increased in three groups (P<0.05), with high-concentration TCM enema group higher than the other groups (P<0.01). The hBD2 concentration was decreased in three groups, with high- and low-concentration TCM enema groups lower than control group (P<0.05). The three groups reduced the fecal CALP concentration, and high-concentration TCM enema group had the highest reduction, followed by low-concentration TCM enema group (P<0.01). ConclusionTCM enema outweighs western medicine in improving clinical symptoms, intestinal flora, and mucosal immune function, and reducing inflammation in children, and the high-concentration TCM enema group has better curative effect. Therefore, with easiness to operate, high compliance, and significant therapeutic effect, TCM enema is worthy of clinical promotion.

13.
Chinese Journal of Burns ; (6): 385-388, 2022.
Article in Chinese | WPRIM | ID: wpr-936023

ABSTRACT

The wound healing time, tension of wound edge, proliferation of fibroblast, and extracellular matrix deposition are the important factors of scar formation, and botulinum toxin type A can regulate the above. Prevention and treatment of scar with botulinum toxin type A is one of the hot topics of clinical research in recent years. This paper briefly reviews researches by scholars at home and abroad on the mechanism, clinical application, complications, and adverse effects of botulinum toxin type A in scar prevention and treatment.


Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cicatrix/prevention & control , Extracellular Matrix/pathology , Fibroblasts/drug effects , Humans , Wound Healing/drug effects
14.
Article in Chinese | WPRIM | ID: wpr-935832

ABSTRACT

Objective: To screen the physical, psychological and behavioral factors related to patients with temporomandibular disorders (TMD) by using Axis Ⅱ assessment instruments of diagnostic criteria for TMD(DC/TMD). And to provide a reference to establish personalized diagnosis and treatment plans for TMD patients so as to prevent TMD and reduce predisposing factors. Methods: A total of 141 TMD patients, who were admitted in the Department of Oral and Maxillofacial Surgery in School and Hospital of Stomatology, Wuhan University from October 2018 to February 2021 were selected. There were 121 females and 20 males, with an average age of 30 years. A total of 90 healthy people were included as controls. A full-time psychologist conducted relevant questionnaire surveys. The questionnaires include general clinical survey forms and TMD symptom questionnaire. In addition, Axis Ⅱ assessment instruments include graded chronic pain scale, jaw functional limitation scale, oral behaviors checklist, patient health questionnaire-9 (depression), generalized anxiety disorder scale, patient health questionnaire-15 (physical symptoms), etc. The main observational indicators include: pain level, pain impact rates, overall classification of chronic pain, limited chewing function score, limited motor function score, limited communication function score, total jaw function restricted score, depression score, anxiety score, somatic symptom score and oral behavior score.The survey data were imported into SPSS 22.0 software for statistical analysis. Results: In the TMD group 60.3% (85/141) patients had various degrees of pain, 24.1% (34/141) of those with pain effect grades from 1 to 3 and 61.0% (86/141) showed chronic pain overall grades from Ⅰ to Ⅳ. The chewing function restricted score was 2.67(1.17, 4.25), motor function restricted score was 4.25(1.75, 6.12), communication function restricted score was 1.13(1.00, 2.25) and total jaw function restricted score was 2.56(1.47, 4.15) respectively. Patients with mild depression or above accounted for 59.6%(84/141), patients with mild anxiety or above accounted for 56.7%(80/141), 46.1%(65/141) patients had somatization symptoms. Statistical differences (P<0.05) were determined between TMD group and control group in various scores of jaw function, oral behavior grading, depression, anxiety, and physical symptoms. Physical symptoms had significantly statistical difference between different diagnostic classification(P<0.05). Meanwhile, among the different chronic pain levels in the TMD group, there were statistical differences in the various scales of mandibular dysfunction, depression, anxiety, and somatization. In the TMD group, other significant differences were noticed between males and females in terms of the average score of mouth opening, verbal and facial communication, the total score of mandibular dysfunction as well as physical symptoms (P<0.05). Conclusions: Compared with the healthy people, patients with TMD had more abnormal oral behaviors, different restriction of the mandibular functional activities. At the same time, depression, anxiety, and somatization were more serious. Patients with osteoarthritis and subluxation of temporomandibular joint were more likely to suffer physical symptoms. TMD patients suffering from pain had more severe mandibular dysfunction and symptoms of depression, anxiety, and somatization.


Subject(s)
Adult , Depression/diagnosis , Facial Pain , Female , Humans , Male , Mandible , Somatoform Disorders , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Dysfunction Syndrome
15.
Chinese Journal of Pathology ; (12): 114-119, 2022.
Article in Chinese | WPRIM | ID: wpr-935486

ABSTRACT

Objective: To investigate the immunohistochemical expression of NKX3.1 and NKX2.2 in mesenchymal chondrosarcoma (MC), and to explore the differential diagnostic value of NKX3.1 and NKX2.2 in MC and other types of small round cell malignant tumors. Methods: A total of 12 cases of MC and 97 other small round cell malignant tumors diagnosed in Jinling Hospital, Nanjing University School of Medicine from 2001 to 2020 were collected for NKX3.1 and NKX2.2 immunohistochemical detection. Among them, two kinds of NKX3.1 antibodies [rabbit polyclonal antibody and rabbit monoclonal antibody (EP356)] were used for detection in 12 cases of MC, and one NKX3.1 antibody (rabbit polyclonal antibody) was detected in 97 cases of other small round cell malignant tumors, and the relevant literature was reviewed. Results: The 12 MC patients included 7 females and 5 males, with a mean age of 33 years (14-54 years). Nine cases were from bone and three from soft tissue. Among the 12 MC patients, 8 patients had postoperative recurrence or metastasis, and 3 of them died of tumor recurrence or metastasis. Histologically, 12 cases of MC showed typical bidirectional differentiation.The positive rate of both NKX3.1 antibodies in MC was 12/12, NKX3.1 was focal weakly positive in only one of 12 chondrosarcomas (grade 3), 5 alveolar rhabdomyosarcomas, 5 embryonal rhabdomyosarcomas, and 5 solitary fibrous tumors, respectively. The remaining 70 cases of other small round cell malignant tumors were negative. The positive rates of NKX2.2 in MC, Ewing sarcoma and olfactory neuroblastoma were 12/12, 15/15 and 4/5, respectively. In 12 cases of chondrosarcoma (grade 3), 5 cases of poorly differentiated synovial sarcoma, 5 cases of alveolar rhabdomyosarcoma, and 5 cases of solitary fibrous tumor, NKX2.2 was focally and weakly positive in only one case, respectively, and all the remaining 50 cases of other small round cell malignant tumors were negative. Conclusions: The expression of NKX3.1 and NKX2.2 proteins are significant indicators in the diagnosis of MC, and the combined detection of NKX3.1 and NKX2.2 can help distinguish MC from most other small round cell malignant tumors.


Subject(s)
Biomarkers, Tumor , Chondrosarcoma, Mesenchymal/diagnosis , Diagnosis, Differential , Female , Homeodomain Proteins , Humans , Immunohistochemistry , Male , Nuclear Proteins
16.
Article in Chinese | WPRIM | ID: wpr-935311

ABSTRACT

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.


Subject(s)
COVID-19 , Cohort Studies , Contact Tracing , Humans , Incidence , Prospective Studies
17.
Article in Chinese | WPRIM | ID: wpr-933500

ABSTRACT

Objective:To investigate the efficacy of tumescent anesthesia combined with skin and soft tissue expansion for the repair of congenital giant melanocytic nevi.Methods:From July 2015 to December 2019, 41 patients with congenital giant melanocytic nevi, including 24 males and 17 females aged 7 - 45 years, were collected from the Department of Dermatology, Xijing Hospital, the Fourth Military Medical University. Skin lesions ranged from 5 cm × 12 cm to 12 cm × 18 cm in size, and were located on the scalp in 13 cases, on the face in 18 cases, as well as on the trunk in 10 cases. Before surgery, the composition of tumescent solution was adjusted according to the body weight, operation duration, skin lesion area, etc., and the total dose and peak plasma concentration of lidocaine should be below 35 mg/kg and 4 mg/L respectively. All the patients received tissue expander placement and second-stage flap transfer under tumescent anesthesia.Results:During surgery, satisfactory effect of tumescent anesthesia was achieved in all the 41 patients, the pain score assessed by a numerical rating scale was 1.82 ± 0.54. In addition, the surgical field and dissection levels were clear with little bleeding and no related complications. Follow-up of 3 - 36 months showed that the skin flaps matched the surrounding skin tissues well, with relatively concealed incision lines and soft flat scars.Conclusion:For the treatment of congenital giant melanocytic nevi, tumescent anesthesia is effective and safe, which combined with skin and soft tissue expansion can effectively reduce the incidence of postoperative complications, and this strategy is worthy of clinical promotion.

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Article in Chinese | WPRIM | ID: wpr-933436

ABSTRACT

Objective:To evaluate the effects of neuromuscular blocking agents (NMBA) on oxygenation and respiratory conditions in patients with acute respiratory distress syndrome(ARDS).Methods:English databases such as MEDLINE, Embase and Web of Science were searched online, as well as Chinese databases such as China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database and Wanfang Database. Randomized controlled trials (RCTs) of NMBA therapy for ARDS with publication date up to May 2020 were retrieved. Literature was screened according to inclusion and exclusion criteria, and the main analysis indicators were oxygenation index.Results:A total of 5 RCTs were included, and 1 462 ARDS patients were enrolled. Compared with the control group, the ratio of partial arterial oxygen pressure to fraction of inspired (PaO 2)/(FiO 2) significantly improved in the intervention group after 72 hours MD=14.39, (95 %CI 6.40-22.38, P=0.000 4) and 96 hours of NMBA, but there was no difference between PaO 2/FiO 2 at 24 and 48 hours ( P>0.05).Positive end expiratory pressure (PEEP) significantly decreased at 72 hours ( MD=-0.45, 95 %CI -0.87--0.03, P=0.04) and 96 hours ( MD=-0.82, 95 %CI -1.39--0.26, P=0.004) treatment with NMBA, while there was no significant difference in PEEP between 24 and 48 hours after treatment ( P>0.05). At 96 h, plateau pressure (Pplat) in the intervention group was significantly lower ( MD=-1.69, 95 %CI -2.64--0.75, P=0.000 4), and there was no significant difference in Pplat between 24, 48 and 72 h after treatment ( P>0.05). Conclusion:The early use of NMBA within 48 hours has a delayed improvement effect on oxygenation and ventilator conditions in ARDS patients.

19.
Chinese Journal of Trauma ; (12): 436-443, 2022.
Article in Chinese | WPRIM | ID: wpr-932263

ABSTRACT

Objective:To investigate the risk factors for preoperative hypoxemia in geriatric patients with hip fracture.Methods:A case-control study was used to analyze the clinical data of 99 geriatric patients with hip fracture admitted to Zhongda Hospital affiliated to Southeast University between November 2020 and August 2021. There were 29 males and 70 females, aged 67-96 years [(82.6±6.2)years]. The patients were divided into hypoxemia group ( n=51) and non-hypoxemia group ( n=48) using partial arterial partial pressure of oxygen (PaO 2)<80 mmHg while breathing room air at emergency as the reference standard. The two groups were compared in terms of sex, age, fracture types, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, pulmonary diseases diagnosed by preoperative chest CT [atelectasis, pleural effusion, chronic obstructive pulmonary disease (COPD)], time from injury to visit, New York Heart Association (NYHA) classification, Barthel index, KATZ index, modified Medicine Research Council (mMRC) dyspnea scale, numeric rating scale (NRS), smoking, drinking, comorbidities (hypertension, diabetes mellitus, Parkinson′s disease, Alzheimer′s disease, cerebral infarction, coronary atherosclerotic heart disease), body temperature, blood routine test at first examination (erythrocyte count, leukocyte count, C-reactive protein, hemoglobin), biochemistry (serum albumin, blood glucose, blood creatinine, blood urea nitrogen), electrolyte (serum potassium, serum sodium), and other related examinations [D-dimer, brain natriuretic peptide (BNP), lactic acid]. Univariate analysis was performed to the correlation of those indicators with preoperative hypoxemia. Multivariate Logistic regression analysis was used to identify the independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture. Results:Differences in sex, age, fracture types, BMI, pulmonary diseases diagnosed by preoperative chest CT, time from injury to visit, Barthel index, KATZ index, NRS, smoking, drinking, comorbidities, body temperature, first laboratory results of erythrocyte count, biochemistry, electrolyte and other related examinations were not statistically significant between the two groups (all P>0.05). The two groups showed statistical differences in ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination, C-reaction protein and hemoglobin (all P<0.05). Univariate analysis indicated that ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination and C-reaction protein were correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture (all P<0.05). Multivariate Logistic regressions analysis indicated that higher mMRC dyspnea scale ( OR=2.30, 95% CI 1.10-4.81, P<0.05), higher leukocyte count at first examination ( OR=1.24, 95% CI 1.05-1.45, P<0.05), higher level of C-reaction protein ( OR=1.02, 95% CI 1.01-1.03, P<0.05) and higher level of hemoglobin ( OR=1.04, 95% CI 1.01-1.07, P<0.05) were significantly correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture. Conclusion:Higher mMRC dyspnea scale, higher leukocyte count, higher level of C-reaction protein and higher level of hemoglobin are independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture.

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Article in Chinese | WPRIM | ID: wpr-931094

ABSTRACT

Objective:To compare the one-year postoperative visual quality after trifocal intraocular lens (IOL) implantation and monofocal IOL implantation.Methods:A cohort study was conducted.Forty-one eyes from 41 age-related cataract patients who underwent phacoemulsification extraction combined with IOL implantation in Nanjing Drum Tower Hospital from May 2017 to June 2018 were enrolled.The patients were divided into trifocal IOL group (20 eyes) receiving ZEISS AT LISA tri 839MP trifocal IOL implantation and monofocal IOL group (21 eyes) receiving ZEISS 603P monofocal IOL implantation according to their willingness.One year after surgery, uncorrected distant visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity (BCDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were detected in both groups.The patient point spread function (PSF), modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), OQAS Ⅱ values at 100%, 20%, and 9% contrast (OV 100%, OV 20%, OV 9%) and objective scattering index (OSI) were measured by OQAS Ⅱ.Wavefront aberrations including total aberration (TA), total high order aberrations (tHOAs), spherical aberration, coma, trefoil aberration, total low order aberrations (tLOAs), defocus, and astigmatism were evaluated with the iTrace visual function analyzer.All aberrations were represented by root mean square.The visual acuity of operative eyes was measured with a phoropter, and defocus curves were drawn with visual acuity better than 0.5 LogMAR.The incidence of posterior capsular opacification (PCO) in the IOL region was quantitatively analyzed by Sellman method.Visual function was scored by visual function index (VF-14). This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (No.2018-219-01). Written informed consent was obtained from each subject prior to any medical examination.Results:One year after the operation, UCIVA, UCNVA, DCIVA, and DCNVA of trifocal IOL group were significantly better than those of monofocal IOL group, and the differences were statistically significant (all at P<0.001). OQAS Ⅱ visual quality indicators showed that the MTF cutoff frequency, SR, OV 100%, and OSI values of trifocal IOL group were significantly higher than those of monofocal IOL group, showing statistically significant differences (all at P<0.001). No significant difference in wavefront aberrations was found between the two groups (all at P>0.05). Defocus curve showed that the LogMAR visual acuity of patients at -1.0 D, -1.5 D, -2.0 D, -2.5 D, -3.0 D, and -3.5 D (namely, 1 m, 66 cm, 50 cm, 40 cm, 33 cm, and 29 cm) in monofocal IOL group were significantly better than those in trifocal IOL group (all at P<0.05). There was a higher incidence of PCO in trifocal IOL group than monofocal IOL group, with a statistically significant difference ( χ 2=41.0, P<0.001). The VF-14 score of trifocal IOL group was 87.99±1.09, which was significantly higher than 81.49±1.67 of monofocal IOL group ( t=10.301, P<0.001). Conclusions:One year after trifocal IOL implantation, the full range of vision, subjective and objective visual quality of eyes are better than eyes implanted with monofocal IOL.

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