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1.
China Pharmacy ; (12): 339-342, 2024.
Article in Chinese | WPRIM | ID: wpr-1006620

ABSTRACT

OBJECTIVE To explore and analyze the adverse drug event (ADE) signals of darolutamide and provide a reference for its clinical safe use. METHODS ADEs related to darotamide were collected based on the US FDA adverse event reporting system (FAERS) database from the third quarter of 2019 to the third quarter of 2022. Data mining and analysis were conducted by the report odds ratio (ROR) and proportional reporting ratio (PRR) methods. RESULTS A total of 565 ADE reports related to darolutamide were extracted, 356 ADE reports about darolutamide as the primary suspected drug were included, 38 ADE signals with darolutamide as the primary suspected drug were excavated, involving 15 system organ class (SOC), mainly concentrated in patients over 65 years old. The SOC of darotamide ADE signal mainly focused on various examinations, systemic diseases and various reactions at the administration site, benign/malignant tumors or those with unknown nature (including cystic and polypoid), kidney and urinary system diseases. A total of 13 ADE signals not mentioned in the instructions included increased prostate-specific antigen, dysphagia, cognitive impairment, erectile dysfunction, rhabdomyolysis, gynecomastia and decreased platelet count, etc. CONCLUSIONS When using darolutamide, in addition to ADE in the drug instruction, we should pay close attention to potential ADE, such as increased prostate-specific antigen, rhabdomyolysis, gynecomastia and decreased platelet count, so as to avoid drug withdrawal or organ damage caused by ADE.

2.
Chinese Journal of Biotechnology ; (12): 4085-4097, 2023.
Article in Chinese | WPRIM | ID: wpr-1008013

ABSTRACT

To prepare a lipid nanoparticle (LNP)-based subunit vaccine of Mycobacterium tuberculosis (Mtb) antigen EsxV and study its immunological characteristics, the LNP containing EsxV and c-di-AMP (EsxV: C: L) was prepared by thin film dispersion method, and its encapsulation rate, LNP morphology, particle size, surface charge and polyphase dispersion index were measured. BALB/c mice were immunized with EsxV: C: L by nasal drops. The levels of serum and mucosal antibodies, transcription and secretion of cytokines in lung and spleen, and the proportion of T cell subsets were detected after immunization. EsxV: C: L LNPs were obtained with uniform size and they were spherical and negatively charged. Compared with EsxV: C immunization, EsxV: C: L mucosal inoculation induced increased sIgA level in respiratory tract mucosa. Levels of IL-2 secreted from spleen and ratios of memory T cells and tissue-resident T cells in mice were also elevated. In conclusion, EsxV: C: L could induce stronger mucosal immunity and memory T cell immune responses, which may provide better protection against Mtb infection.


Subject(s)
Animals , Mice , Mycobacterium tuberculosis , Antigens, Bacterial , Immunization , Nanoparticles , Vaccines, Subunit , Mice, Inbred BALB C
3.
Psychiatry Investigation ; : 1-8, 2023.
Article in English | WPRIM | ID: wpr-968556

ABSTRACT

Objective@#Patients with schizophrenia are living at the border of society and their sexuality is often neglected. The aim of the study is to explore the association among The Brief Psychiatric Rating Scale (BPRS), quality of life (QoL), Taiwanese Depression Questionnaire, and Sexual Desire Inventory in people with schizophrenia (PwS). @*Methods@#This study used a cross-sectional design with 277 psychiatric inpatients. A descriptive analysis, difference analysis, and logistic regression model were presented to identify relevant variables that may affect the probability of good QoL. @*Results@#The study showed that male PwS had higher scores of standard deviation (SD) than females in PwS. The study also showed that smoking, early illness onset age, and shorter illness duration demonstrated a significantly higher SD. The logistic regression analysis showed that BPRS, depression, and SD significantly affected the probability of QoL. By structural equation model, SD would be positively correlated with mental status and SD would indirectly influence QoL. @*Conclusion@#Our results showed psychological and sociological factors interactions may contribute to the QoL and SD for PwS. This study also demonstrated a close relationship between SD, depression, and BPRS. These factors may predict the probability of good life quality for the PwS.

4.
China Journal of Chinese Materia Medica ; (24): 1352-1369, 2023.
Article in Chinese | WPRIM | ID: wpr-970606

ABSTRACT

Atherosclerosis(AS) is caused by impaired lipid metabolism, which deposits lipids in the intima, causes vascular fibrosis and calcification, and then leads to stiffening of the vascular wall. Hyperlipidemia(HLP) is one of the key risk factors for AS. Based on the theory of "nutrients return to the heart and fat accumulates in the channels", it is believed that the excess fat returning to the heart in the vessels is the key pathogenic factor of AS. The accumulation of fat in the vessels over time and the blood stasis are the pathological mechanisms leading to the development of HLP and AS, and "turbid phlegm and fat" and "blood stasis" are the pathological products of the progression of HLP into AS. Didang Decoction(DDD) is a potent prescription effective in activating blood circulation, removing blood stasis, resolving turbidity, lowering lipids, and dredging blood vessels, with the functions of dispelling stasis to promote regeneration, which has certain effects in the treatment of atherosclerotic diseases. This study employed high-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(HPLC-Q-TOF-MS/MS) to screen the main blood components of DDD, explored the targets and mechanisms of DDD against AS and HLP with network pharmacology, and verified the network pharmacological results by in vitro experiments. A total of 231 blood components of DDD were obtained, including 157 compounds with a composite score >60. There were 903 predicted targets obtained from SwissTargetPrediction and 279 disease targets from GeneCards, OMIM, and DisGeNET, and 79 potential target genes of DDD against AS and HLP were obtained by intersection. Gene Ontology(GO) analysis suggested that DDD presumably exerted regulation through biological processes such as cholesterol metabolism and inflammatory response, and Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis suggested that signaling pathways included lipid and atherosclerosis, insulin resistance, chemo-carcinogenesis-receptor activation, and AGE-RAGE signaling pathways in diabetic complications. In vitro experiments showed that DDD could reduce free fatty acid-induced lipid accumulation and cholesterol ester content in L02 cells and improve cellular activity, which might be related to the up-regulation of the expression of PPARα, LPL, PPARG, VEGFA, CETP, CYP1A1, and CYP3A4, and the down-regulation of the expression of TNF-α and IL-6. DDD may play a role in preventing and treating AS and HLP by improving lipid metabolism and inflammatory response, and inhibiting apoptosis with multi-component, multi-target, and multi-pathway characteristics.


Subject(s)
Humans , Hyperlipidemias/drug therapy , Tandem Mass Spectrometry , Chromatography, High Pressure Liquid , Network Pharmacology , Nutrients , Atherosclerosis/prevention & control , Lipids , Drugs, Chinese Herbal/pharmacology , Molecular Docking Simulation
5.
Organ Transplantation ; (6): 884-891, 2023.
Article in Chinese | WPRIM | ID: wpr-997823

ABSTRACT

Objective To explore the standardized management mode of the Ethics Committee for organ donation after citizen’s death in hospitals. Methods The situations of ethical review before and after the standardized adjustment of the Ethics Committee of human organ donation in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. Baseline data of donors before and after standardized adjustment of the Ethics Committee of human organ donation were compared. The influence of standardized adjustment of the Ethics Committee on the attendance rate of committee members and duration of ethical review were analyzed. Results No significant differences were observed in donors' ethical review data, such as gender, age and death determination, before and after standardized adjustment of Ethics Committee structure (all P>0.05). Significant difference was noted regarding the cause of death in ethical review (P<0.05). Univariate analysis showed that there were significant differences in the impact of Ethics Committee standardization adjustment and cause of death on the attendance rate of committee members (both P<0.05). Multivariate analysis revealed that gender, cause of death and standardized adjustment of the Ethics Committee were the influencing factors of the attendance rate of committee members, and the attendance rate of committee members after standardized adjustment was higher than that before adjustment (P<0.05). Univariate analysis showed that there were statistically significant differences in the effects of Ethics Committee standardized adjustment, attendance rate of committee members and cause of death on the duration of ethical review (all P<0.05). Multivariate analysis indicated that standardized adjustment of the ethics committee was the influencing factor of the duration of ethical review, and the duration of ethics review after standardized adjustment was shorter than that before adjustment (P<0.05). Conclusions Appropriate arrangement of the total number of ethics committee members and standardizing the review process may improve the efficiency of ethical review. Scientific evaluation mechanism for ethical committee members should be established by dynamically adjusting the ethical committee members, clarifying the responsibilities and tasks of members and secretaries, aiming to further improve standardized management level of ethical review for organ donation after citizen’s death.

6.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 230-238, 2023.
Article in Chinese | WPRIM | ID: wpr-988201

ABSTRACT

As one of the classic prescriptions of traditional Chinese medicine, Didangtang is an effective prescription for breaking and expelling blood stasis. It was considered that Didangtang damage the healthy qi and contained toxic Chinese medicinal materials such as leeches and gadflies, and thus it was rarely used. However, as the attention to classic prescriptions increases, Didangtang has been widely used in clinical practice and demonstrated definite efficacy in treating diabetes mellitus and its complications, malignant tumors, Alzheimer's disease, stroke, renal diseases, cardiovascular diseases, peripheral vascular diseases, gynecological disease, and male diseases according to the disease location, pathogenesis, symptoms, and pharmacological effects. Didangtang has the effects of mitigating insulin resistance, improving microvascular and peripheral vascular circulation, delaying diabetic macrovascular lesions, preventing vascular fibrosis, improving immunity, inhibiting tumor growth, protecting the brain tissue, nerve cells, vascular endothelial function, and kidney, reducing inflammation, and delaying aging. This paper summarizes the clinical application of Didangtang and initially explores the underlying mechanism.

7.
International Journal of Pediatrics ; (6): 524-528, 2022.
Article in Chinese | WPRIM | ID: wpr-954071

ABSTRACT

Bronchopulmonary dysplasia is one of the most common complications of preterm infants.The main pathological feature is dysplasia of the alveoli and pulmonary microvessels.Vitamin D is a steroid hormone.By binding to vitamin D receptors, it can protect the barrier function of alveolar epithelium, promote pulmonary vascularization, inhibit pulmonary fibrosis, regulate immune function, and repair damaged lung epithelial cells.It is beneficial to lung development and the improvement of lung function in preterm infants.Therefore, monitoring the level of vitamin D in the perinatal period and supplementing with appropriate doses is expected to be one of the ways to reduce the occurrence of moderate and severe bronchopulmonary dysplasia and improve the lung development of preterm infants.

8.
Chinese Pharmacological Bulletin ; (12): 119-125, 2022.
Article in Chinese | WPRIM | ID: wpr-1014182

ABSTRACT

Aim To explore the mechanism of cryptotanshinone (CTS) against non-small cell lung cancer (NSCLC) by using network pharmacology and bioinformatics methods. Methods Taking CTS as the research object, TCMSP database, SwissTargetPrediction and PharmMapper target prediction platform were used to collect CTS related targets; OMIM database, Gene-Cards data-base and TCGA database were employed to collect NSCLC related targets; String database and Cytoscape software were applied to construct PPI of intersection targets Network diagram, the hub targets were screened out, and AutoDock Vina was used for molecular docking verification; the R language clusterProfiler package was used to perform GO and KEGG enrichment analysis on the intersection targets; Cytoscape software was employed to construct the "CTS intersection targets-KEGG pathway" network. Results As a result, 75 intersecting targets were obtained, mainly involving various biological processes such as signal transduction, phosphorylation and dephosphorylation, apoptosis and vascular regulation, mainly through pancreatic cancer, colorectal cancer, cancer pathways and JAK-STAT signaling pathways. And cellular pathways such as apoptosis and natural killer cell-mediated cytotoxicity exerted their anti-NSCLC effects. Conclusions CTS exerts its anti-NSCLC effect through multiple targets and multiple pathways, which provides the theoretical support for further in-depth research.

9.
Chinese Journal of Preventive Medicine ; (12): 370-376, 2022.
Article in Chinese | WPRIM | ID: wpr-935295

ABSTRACT

To explore the protective immune effect induced by mucosal delivery heparin-binding hemagglutinin (HBHA)-a candidate vaccine antigen of Mycobacterium tuberculosis. Female C57BL/6 mice were between 6 and 8 weeks of age before experimental use. Thirty mice received different immunization strategies and were randomly divided into the control group, the early secreting antigen target-6 (ESAT-6) intranasal immunization group, the HBHA intranasal immunization group, the BCG priming PBS control group, or BCG priming HBHA boost group, 6 mice in each group. In order to analyzed the immune effect, the concentrations of plasma Interleukin-17A (IL-17A) and other cytokines were measured by ELISA. Quantitative real-time PCR analyses were performed to detect the relative quantity (RQ) mRNA of IL-17A in the lung. The lung tissue sections were stained to detect the formation of the tertiary lymphoid structures. The chemokines contributed to formation of the tertiary lymphoid structures were also measured. Flow cytometry was used to detect the frequency of Th1 and Th17 cells in the system. Sixty mice in the BCG priming PBS control group and the BCG priming HBHA boost group were sacrificed at different time points after infection to count the lung bacterial burden. The concentrations of plasma IL-17A and relative quantity of lung IL-17A mRNA were highest in the BCG priming HBHA boost group [(14.76±4.73) pg/mL,RQ (12.27±6.71)], which was significantly higher than the control group [(5.57±2.95) pg/mL,RQ (1.30±0.97)] (t=4.213, P<0.001; t=5.984, P<0.001), and also significantly higher than the BCG priming PBS control group [(6.81±2.18) pg/mL,RQ (1.44±1.16)] (t=3.646 P=0.001; t=6.185 P<0.001). Compared with the BCG priming PBS control group (0.38±0.38)% the frequency of spleen Th17 cells were also significantly increased (t=-0.280 , P=0.048) in the BCG-primary HBHA boost group (1.02±0.34)%. In addition, HBHA boosting could promote better formation of the tertiary lymphoid structures in the lung, and decrease the bacterial load on the early stage after BCG challenge. Collectively, mucosal delivery of HBHA can effectively enhance the protective effect after BCG vaccination, and it is a potential candidate vaccine component.


Subject(s)
Animals , Female , Humans , Mice , Antigens, Bacterial , Bacterial Proteins , Immunization, Secondary , Interleukin-17 , Lectins , Mice, Inbred C57BL , Mycobacterium tuberculosis , Tuberculosis/prevention & control , Tuberculosis Vaccines
10.
China Pharmacy ; (12): 1492-1499, 2022.
Article in Chinese | WPRIM | ID: wpr-927198

ABSTRACT

OBJECTIVE To systema tically evaluate the efficacy and safety of blinatumomab for acute lymphoblastic leukemia (ALL)in order to provide evidence-based reference for clinical use. METHODS Retrieved from PubMed ,Embase,Web of Science,the Cochrane Library ,CNKI,Wanfang database and CBM during the inception to February 3,2022,randomized controlled trials (RCTs)and cohort studies of blinatumomab (experimental group ) versus conventional chemotherapy (control group )in the treatment of ALL were collected. After literature screening and data extraction ,the quality of RCTs was evaluated by the risk bias evaluation tool recommended by Cochrane handbook 5.1.0,and the quality of cohort studies was evaluated by the Newcastle-Ottawa scale (NOS). Meta-analysis was performed by RevMan 5.4 software. GRADE grading system was used to evaluate the evidence quality of outcomes. The publication bias was analyzed by inverted funnel plot. RESULTS A total of 8 studies were included ,involving 3 RCTs and 5 cohort studies ,with a total of 2 841 patients. Results of Meta-analysis showed that the overall survival rate more than one year [RR =1.30,95%CI(1.14,1.48),P<0.000 1],relapse-free survival rate [RR =1.78,95%CI(1.50,2.12),P<0.000 01],complete remission rate [RR =1.42,95%CI(1.11,1.82),P=0.006],the incidence of tremor [RR =16.98,95%CI(2.17,133.12),P=0.007],and the incidence of cytokine release syndrome [RR =14.11, 95%CI(3.43,58.01),P=0.000 2] in trial group were all significantly higher than control group ,but there was no statistical significance in the incidence of headache between two groups [RR =1.31,95%CI(0.66,2.59),P=0.44]. The incidence of adverse events with grade more than or equal to 3,infection,stomatitis,thrombocytopenia,febrile neutropenia ,anorexia, constipation,diarrhea,abdominal pain ,hypokalemia in trial group were significantly lower than control group (P<0.05). The incidence of cough ,rash and hypogamma globulinemia and fever in the trial group were significantly higher than control group (P<0.05). There was no statistical significance in the total incidence of adverse events ,sepsis,anemia,leucopenia,neutropenia, lymphopenia,nausea,vomiting,hyperglycemia,hypotension,hypertension,elevated transaminase or epistaxis between two groups(P>0.05). Results of subgroup analysis by study type showed that the overall survival rate ,relapse-free survival rate and complete response rate (except for cohort studies )of patients in trial group were significantly higher than control group in both RCTs and cohort studies (P<0.05). The results of GRADE evaluation showed that the overall quality of index evidence included in this study was low. There was little possibility of publication bias in this study based on the publication bias analysis. CONCLUSIONS Blinatumomab is effective in the treatment of ALL ,with low incidence of infection and adverse events of digestive system ,but high incidence of tremor ,cough,rash,fever,hypoproglobulinemia and cytokine release syndrome. The evidence quality of the indicators included in this study is generally low .

11.
Acta Pharmaceutica Sinica ; (12): 605-614, 2022.
Article in Chinese | WPRIM | ID: wpr-922903

ABSTRACT

Proteasome controls the degradation of proteins closely related to life activities and plays a key role in the maintenance of protein homeostasis. Proteasome activities decrease with aging, followed by the overwhelming production of damaged proteins which far exceed the protein consumption. Accumulation of these proteins leads to various diseases including neurodegenerative diseases. Therefore, inducing toxic protein degradation is considered as a promising solution for the treatment of these diseases, while increasing the activity of proteasome is considered as an important strategy. However, the research in this field is still in the preliminary stage, and this review will focus on the discussion of the research progress of various small molecule proteasome activators, including research methods, pharmacological effects, structure-activity relationships and the existing problems.

12.
International Journal of Biomedical Engineering ; (6): 532-536, 2022.
Article in Chinese | WPRIM | ID: wpr-989301

ABSTRACT

Objective:To evaluate the medium and long term clinical effect of three bone graft materials on periodontitis after periodontal regeneration.Methods:Initially, 16 patients with periodontitis after periodontal regeneration in Tianjin Stomatological Hospital from July 2017 to November 2018 were divided into three groups: Bio-Oss ( n=6), Bio-Gene ( n=5) and Bone 3(n=5) according to the differences in bone materials. Clinical and radiological results were evaluated at pre-surgery, post-6 months, and post-4 years. Results:The 6-month and 4-year clinical follow-up showed that, the depth of exploration (PD) and clinical attachment loss (CAL) of patients in the three groups were lower than those before operation (all P<0.05), and the changes of PD (ΔPD) and CAL (ΔCAL) were not statistically significant (all P>0.05). There was no statistically significant difference in gingival recession (GR) between the three groups (all P>0.05), and there was no statistically significant difference in the change of GR (ΔGR) between the groups (all P>0.05). From 6 months to 4 years after operation, there was no significant difference among ΔGR, ΔPD and ΔCAL groups (all P>0.05). At 6 months and 4 years after operation, the residual alveolar bone height (RBH%) of the three groups was significantly higher than that before operation (all P<0.05), and there was no significant difference between the two groups (all P>0.05); From 6 months to 4 years after operation, there was no significant difference in RBH% between the groups (all P>0.05). Conclusions:Three kinds of bone graft materials have significant clinical effects on periodontitis after periodontal regeneration, which can provide a reference for the selection of clinical regeneration materials.

13.
Journal of Korean Neurosurgical Society ; : 534-542, 2021.
Article in English | WPRIM | ID: wpr-900104

ABSTRACT

Objective@#: While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA. @*Methods@#: This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation. @*Results@#: A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results. @*Conclusion@#: This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.

14.
Chinese Journal of Cardiology ; (12): 496-502, 2021.
Article in Chinese | WPRIM | ID: wpr-941307

ABSTRACT

Objective: To explore the relationship between daily tea intake and cardiovascular disease (CVD) mortality. Methods: PubMed, EMbase, The Cochrane, Chinese Biomedical Literature Database, CNKI, and Wanfang Database were searched to collect research on tea intake and CVD mortality. The search period was from the establishment of the database to June 2020. Two researchers independently screened and extracted literature. The risk of bias was evaluated in the included studies, a dose-response meta-analysis was conducted, sensitivity analysis and publication bias analysis of the research results, and quality evaluation of the included literature and GRADE classification of the evidence body were performed. Results: A total of 21 cohort or case-control studies were included, including 1 304 978 subjects. Among them, 38 222 deaths from CVD were reported. The quality scores of the included studies were all ≥ 6 points. The dose-response meta-analysis showed that for every additional cup of tea intake per day, the mortality rate of CVD decreased by about 3% (95%CI 0.95-0.98, P<0.05), and there was a non-linear dose-response relationship (P<0.05). Compared with people who do not drink tea, people who drink 1 to 8 cups of tea a day have 8% lower CVD mortality (RR=0.92, 95%CI 0.89-0.95), 13% (RR=0.87, 95 %CI 0.84-0.91), 15% (RR=0.85, 95%CI 0.82-0.89), 15% (RR=0.85, 95%CI 0.81-0.89), 16% (RR=0.84, 95%CI 0.80-0.89), 16% (RR=0.84, 95%CI 0.81-0.88), 16% (RR=0.84, 95%CI 0.81-0.87), 16% (RR=0.84, 95%CI 0.80-0.88), respectively. The results of traditional meta-analysis showed that compared with people who do not drink tea, people who drink more than 1 cup of tea a day are associated with 14% lower CVD mortality rate (RR=0.86, 95%CI 0.81-0.91, I2=73.2%, P<0.05). The results of subgroup analysis showed that compared with the corresponding people who did not drink tea, men who drank more than 1 cup of tea a day reduced the CVD mortality rate by 24%, women by 14%, European and American populations by 12%, and Asian populations by 15%. The population who consumed green tea decreased CVD mortality by 15%, and the population of non-smokers decreased CVD mortality by 20% (all P<0.05). The population who consumed black tea decreased CVD mortality by 8%, and the smoking population who consumed black tea decreased CVD mortality by 3%, and the difference was not statistically significant (all P>0.05). The results of the bias analysis showed that Begg=0.42 and Egger=0.62, indicating that the distribution on both sides of the funnel chart is symmetrical, suggesting that there is no publication bias. The results of sensitivity analysis showed that the effect size of the outcome index did not change significantly after excluding any article, indicating that the results are robust and credible. The GRADE evaluation showed that the evidence grades of the outcome indicators were all low grade. Conclusions: Daily tea consumption is related to reduced CVD mortality. It is therefore recommended to drink an appropriate amount of tea daily.


Subject(s)
Female , Humans , Male , Cardiovascular Diseases , Case-Control Studies , Cause of Death , Cohort Studies , Tea
15.
Asian Journal of Andrology ; (6): 472-478, 2021.
Article in English | WPRIM | ID: wpr-888455

ABSTRACT

Epigenetic changes are potentially important for the ontogeny and progression of tumors but are not usually studied because of the complexity of analyzing transcript regulation resulting from epigenetic alterations. Prostate cancer (PCa) is characterized by variable clinical manifestations and frequently unpredictable outcomes. We performed an expression quantitative trait loci (eQTL) analysis to identify the genomic regions that regulate gene expression in PCa and identified a relationship between DNA methylation and clinical information. Using multi-level information published in The Cancer Genome Atlas, we performed eQTL-based analyses on DNA methylation and gene expression. To better interpret these data, we correlated loci and clinical indexes to identify the important loci for both PCa development and progression. Our data demonstrated that although only a small proportion of genes are regulated via DNA methylation in PCa, these genes are enriched in important cancer-related groups. In addition, single nucleotide polymorphism analysis identified the locations of CpG sites and genes within at-risk loci, including the 19q13.2-q13.43 and 16q22.2-q23.1 loci. Further, an epigenetic association study of clinical indexes detected risk loci and pyrosequencing for site validation. Although DNA methylation-regulated genes across PCa samples are a small proportion, the associated genes play important roles in PCa carcinogenesis.

16.
Journal of Korean Neurosurgical Society ; : 534-542, 2021.
Article in English | WPRIM | ID: wpr-892400

ABSTRACT

Objective@#: While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA. @*Methods@#: This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation. @*Results@#: A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results. @*Conclusion@#: This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.

17.
Journal of Chinese Physician ; (12): 1007-1011, 2021.
Article in Chinese | WPRIM | ID: wpr-909657

ABSTRACT

Objective:We aimed to estimate the incidence of anxiety or depression in asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients and explore its related factors.Methods:Stable patients who were treated or followed up in the outpatient department of respiratory medicine in the First Hospital of China Medical University from March 2018 to March 2019 were enrolled, including 53 ACO patients, 74 asthma patients, and 138 patients with COPD. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluating the anxiety and depression status of the three groups of patients, and the risk factors of anxiety and/or depression in ACO patients were analyzed.Results:There were 33 cases (62.3%), 35 cases (47.3%) and 69 cases (50.0%) combined with anxiety in ACO, asthma and COPD group; there were 29 cases (54.7%), 25 cases (33.8%) and 58 cases (42.0%) combined with depression in ACO, asthma and COPD group, respectively. The patients with depression in ACO were significantly higher than those in asthma group ( P<0.05). There were 28 patients (52.8%), 24 patients (32.4%) and 52 patients (37.7%) combined with anxiety and depression in ACO, asthma and COPD group, respectively, with significant difference in ACO group and asthma group ( P<0.05). Multivariate logistic regression analysis showed that chronic obstructive pulmonary disease assessment test (CAT) score≥10 was associated with anxiety ( OR=15.00, P<0.01) or depression ( OR=8.667, P<0.01) in patients with ACO. Conclusions:Anxiety/depression is common in chronic airway disease. Compared with asthma, anxiety and/or depression is more frequent in the patients with ACO. ACO patients with high CAT scores should pay attention to screening for anxiety/depression.

18.
Chinese Critical Care Medicine ; (12): 927-932, 2021.
Article in Chinese | WPRIM | ID: wpr-909429

ABSTRACT

Objective:To summarize the best evidence for extubation management of adult patients with mechanical ventilation in the intensive care unit (ICU), which will provide practical guidelines for medical staffs.Methods:BMJ best clinical practice, UpToDate clinical consultants, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Medlive guide, Cochrane Library, JBI evidence-based Health Care Center Database, Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ebsco, SinoMed, CNKI, Wanfang Database, etc., were systematically searched. Clinical guidelines, systematic reviews, expert consensus, and randomized controlled trial (RCT) studies were searched from the above database unit August 31st, 2020. Literature quality was evaluated using Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREEⅡ), JBI quality evaluation tools, and Cochrane risk bias assessment. Two researchers evaluated the quality of the included literature respectively, and then the best evidence of endotracheal intubation and extubation management in ICU adult patients with mechanical ventilation was extracted and summarized.Results:A total of 12 articles were collected, including 2 guidelines, 5 systematic reviews, 2 expert consensus, and 3 RCTs. This paper summarizes 17 best evidences on extubation management of adult patients with mechanical ventilation in ICU, including accurate pre-extubation assessment, personnel and equipment, medication, posture, oxygen therapy, airway management, and post-extubation monitoring.Conclusion:Medical staff should choose the best evidence that meets the requirements of the clinical settings and standardize the management of patients after extubation to reduce the incidence of complications and re-intubation rate to ensure the safety of patients, which will be very important for the management of ICU adult patients with mechanical ventilation after extubation.

19.
China Pharmacy ; (12): 484-489, 2020.
Article in Chinese | WPRIM | ID: wpr-817297

ABSTRACT

OBJECTIVE:To systematically evaluat e the efficacy and safety of intranasal administration of dexmedetomidine versus oral administration of chloral hydrate for programmed sedation in children. METHODS :Retrieved from Cochrane Library ,PubMed, Embase,CBM,CNKI and Wanfang database ,randomized controlled trials (RCTs)about intranasal administration of dexmedetomidine (trial group )versus oral administration of chloral hydrate (control group )for programmed sedation in children were collected. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of the included literatures after literature screening and data extraction,and Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS :A total of 8 RCTs were included , with a total of 1 413 children. Meta-analysis showed that the sedation success rate [RR =1.13,95%CI(1.02,1.25),P=0.02],sedation onset time [MD =-1.07,95%CI(-1.82,-0.31),P=0.006],sedation duration [MD =-8.25,95%CI(-14.02,-2.47),P= 0.005],wake-up time [MD =-9.63,95%CI(-15.40,-3.86),P=0.001],the incidence of nausea and vomiting [RR =0.05,95%CI (0.02,0.14),P<0.000 01] in the trial group were significantly better than those in control group. There was no statistical significance in the incidence of SpO 2<95% [RR=0.60,95%CI(0.24,1.54),P=0.29],incidence of hypotension [RR =1.18,95%CI(0.51, 2.74),P=0.71],incidence of bradycardia [RR =1.33,95%CI(0.18,9.88),P=0.78] between 2 groups. CONCLUSIONS :Intranasal administration of dexmedetomidine has better efficacy than oral administration of chloral hydrate for programmed sedation in children with good safety.

20.
Chinese Critical Care Medicine ; (12): 1178-1182, 2020.
Article in Chinese | WPRIM | ID: wpr-866985

ABSTRACT

Objective:To explore the pathological characteristics and outcomes of elderly patients with community acquired pneumonia (CAP) accompanied by coronavirus disease 2019 (COVID-19).Methods:The diagnosis and treatment process of one elderly patient with CAP accompanied by COVID-19 who was admitted to COVID-19 Treatment Center of Liaoning Province on February 7, 2020 were reviewed. The experience of treatment by analyzing the characteristics of such type of patients during diagnosis and treatment were summarized.Results:A female patient, aged 79 years ald, was admitted to the Center with following features: fever, dry cough, fatigue with dyspnea, scattered moist rales in both lungs, oxygenation index (PaCO 2/FiO 2) of 95 mmHg (1 mmHg = 0.133 kPa), and diffuse interstitial pneumonia in both lungs indicated by chest CT, of which the majority were ground glass-like and fibrous lesions. It was confirmed to be consistent with the feature of severe COVID-19 cases. The patient was successfully cured one month later following anti-inflammatory, anti-viral and high-flow oxygen therapies, homeostasis maintenance of the body, psychological counseling, etc. Accordingly, the treatment experience in CAP combined with COVID-19 in the elderly patients was summarized as follows. In respiratory system, the timing of high-flow oxygen therapy and mechanical ventilation should be seized. As for anti-inflammatory and antiviral therapy, attention should be paid to the treatment of CAP as well as antiviral therapy and symptomatic and supportive therapy. With the progression of the disease, the production of drug-resistant bacteria and the possibility of fungal infection should be paid attention to. For the circulatory system, we should pay attention to the stability of fluid volume and internal environment, and strengthen hemodynamic monitoring and bedside ultrasound to evaluate the cardiovascular capacity-load. In the aspect of the immune system, the selection of the application time of immune-enhancers and glucocorticoids should be paid attention to. In terms of enteral nutrition, early low-fat and high-protein diet is conducive to the recovery of intestinal function and the prevention of bacterial translocation. In addition to the protection of the function of important organs, therapies such as reasonable sedation and psychological intervention should also be used. Conclusions:Elderly patients with CAP accompanied by COVID-19 have complicated conditions and high degree of difficulty in treatment. Comprehensive evaluation of the disease as well as synthetic and effective intervention are the key factors of successful treatment of such patients.

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