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1.
China Pharmacy ; (12): 2147-2151, 2022.
Article in Chinese | WPRIM | ID: wpr-941459

ABSTRACT

OBJECT IVE To evaluate the application effect of the whole cour se medication management mode led by pharmacists in rheumatic immune diseases. METHODS A total of 122 patients treated with tacrolimus or cyclosporine in the department of rheumatology and immunology of Wuhan No. 1 Hospital from 2018 to 2020 were selected as the study subjects. Among them ,44 cases in the control group were under the traditional supervision mode ;78 patients in the observation group adopted the whole course medication management mode led by pharmacists ,that was ,individual pharmacists and specialist clinical pharmacists cooperated and led ,and not only participated in the whole process of drug treatment but also involved in the whole process of therapeutic drug monitoring (TDM). On the basis of the control group ,the division of labor and cooperation among medical,pharmaceutical and nursing parties were strengthened ,and the homogeneous supervision was carried out for the outpatients and inpatients from admission to discharge . The daily dose of medication ,the rate of reaching the standard of blood drug concentration ,the incidence of problematic samples (the sample was calculated by the number of times ),the average hospitalization days ,the re-admission rate within 6 months after discharge ,the medication compliance score and the patient ’s satisfaction rate were compared between the two groups. RESULTS In the control group ,53 times of TDM were performed , including 18 times of tacrolimus monitoring and 35 times of cyclosporine monitoring ;in the observation group ,123 timesof TDM were performed ,including 55 times of tacrolimus monitoring and 68 times of cyclosporine monitoring. The daily dose of tacrolimus ,the daily dose of cyclosporine ,the rate of reaching the standard of cyclosporine blood drugconcentration,the inc idence of problematic samples ,the rate of re-admission within 6 months after discharge , the medication compliance score and the patient ’s satisfaction rate in the observation group were significantly better than those in the control group (P<0.05). CONCLUSIONS It can effectively improve the effect of the quality of pharmaceutical care to implement whole course and homogeneous medication management led by pharmacists and provide precise drug guidance for patients with rheumatic and immune diseases.

2.
Article in English | WPRIM | ID: wpr-919382

ABSTRACT

BACKGROUND@#Bone defect difficult to manage clinically and it is a big challenge to repair it. Secondary metabolites source from herb has shown potential for the treatment of bone defect. @*METHODS@#Mesenchymal stem cells (MSCs) were isolated from mice and incubated with urolithin A (UA) (10, 25, and 50 lg/mL). 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was performed to estimate apoptosis and mineralisation was evaluated by alkaline phosphatase assay and alizarin red S staining. A middle femoral defect was induced in mice and bone tissue was prepared for endochondral ossification by treating with UA. The effect of UA was estimated by determining markers of osteoblast proliferation in serum and micro-computed tomography to analyse bone defects. @*RESULTS@#UA enhanced mineralisation of MSCs and osteogenic gene markers in MSCs in vitro. Also, the bone defect score and bone mineral density were improved by UA. Moreover, UA ameliorated the altered Wnt3a protein and histopathological changes in bone defect mice. @*CONCLUSION@#Presented report conclude that UA enhances osteoblast proliferation in bone-defect mice by activating the Wnt pathway.

3.
China Pharmacy ; (12): 619-623, 2021.
Article in Chinese | WPRIM | ID: wpr-873679

ABSTRACT

OBJECTIVE:To investigate the effects of integrated su pervision mode by doctors ,pharmacists and nurses on the whole-process implementation of therapeutic drug monitoring (TDM). METHODS :The patients monitored with TDM in our hospital admitted from Jan. to Dec. 2018 were selected as control group ,treated with the traditional drug supervision mode (i.e. the work of doctors ,nurses and pharmacists was relatively independent ). Treatment group was composed of inpatients monitored with TDM from Jan. to Dec. 2019,treated with the integrated supervision mode of doctors ,nurses and pharmacists (i.e. doctors ,nurses and pharmacists cooperated with each other ,taking the patients and sample as the center ,pharmacists as the key link formulated the implementation standards of each link ,and clarified their respective responsibilities ). The concentration compliance rate ,the incidence of incorrect samples ,critical value notification rate ,clinical satisfaction ,drug recommendation feedback and adoption , compliance rates of 6 kinds of monitored drugs (sodium valproate ,digoxin,tacrolimus,cyclosporin,methotrexate,vancomycin) were compared between two groups. RESULTS :The overall compliance rate ,critical value notification rate and clinical satisfaction rate of the observation group were respectively 64.57%,99.39% and 97.22%,which were significantly higher than 57.86%, 96.80% and 92.22% of control group (P<0.05). The incidence of incorrect samples in observation group was 0.72%,which was significantly lower than 3.09% of control group (P<0.001). The feedback rate of individual pharmacists (89.19%),the feedback rate of doctors (80.50%)and the adoption rate of medication suggestions (69.98%)in the observation group were significantly higher than control group (50.34% ,71.46% and 55.36% ,P<0.001). The compliance rate of tacrolimus concentration in observation group was slightly lower than control group (73.40% vs 75.77%,P>0.05). The concentration compliance rate of other 5 varieties was higher than control group ,and the differences of valproate sodium ,digoxin and vancomycin concentrations between two groups were statistically significant (P<0.05). CONCLUSIONS :The implementation of integrated doctors ,nurses and pharmacists supervision mode in TDM can effectively improve the drug concentration compliance rate ,realize the . dynamic supervision and feedback of individualized drug use , which is conducive to ensure the safety of clinical medication.

4.
Article in Chinese | WPRIM | ID: wpr-871094

ABSTRACT

Objective:To study the clinical manifestations, diagnosis and treatment of primary hyperparathyroidism (PHPT) in pregnancy.Methods:This study involved six pregnant patients with PHPT who were admitted to Ruijin Hospital of Shanghai Jiao Tong University from August 2014 to November 2019. Their clinical manifestations, treatment strategies (multidisciplinary consultation with departments including Obstetrics, Endocrinology, Neonatology, General Surgery, Anesthesiology and Intensive Care Unit), maternal complications and maternal and infant outcomes were described and retrospectively analyzed.Results:(1) The median age of the six patients was 34(23-38) years old. PHPT was diagnosed in one case before pregnancy, four in the second or third trimester and one after delivery. The main clinical manifestations of four cases were nausea, vomiting, anorexia and other non-specific symptoms. Anemia was the most common maternal complication (five cases). Other complications included hypercalcemia crisis with renal failure (one case), multiple bone destruction and osteoporosis (one case). The median levels of serum calcium, parathyroid hormone and 25-hydroxyvitamin D were 3.08 (2.84-4.21) mmol/L, 216.7(93.1-2 603.6) ng/L and 29.66 (13.50-90.24) nmol/L, respectively. Results of parathyroid ultrasonography showed all patients had hypoechoic focus. Four cases underwent routine parathyroid radionuclide imaging showing abnormal radioactive concentration areas. (2) Obstetricians initiated the multidisciplinary team (MDT) for all patients to determine the treatment plans after communication with the patients and their families. One case received surgical treatment five months after delivery. Three cases received surgical treatment in the second trimester and among them, one terminated the pregnancy in the second trimester and the other two continued and achieved good pregnancy outcomes. Two cases underwent surgical treatment after giving up pregnancy and induced abortion. Postoperative pathology revealed that five cases were isolated parathyroid adenoma and one was parathyroid carcinoma. All of the patients were followed up and no abnormal serum calcium was reported. (3) One newborn had hypocalcemic convulsions one month after birth and was recovered by intravenous calcium supplementation. The newborn was followed up and the serum calcium level was normal so far. The other two neonates had normal serum calcium during follow-ups, but one of them was diagnosed with autism at the age of four and is now undergoing rehabilitation treatment.Conclusions:Pregnancy complicated by PHPT may lead to serious maternal and infant complications. MDT consultation ensures timely diagnosis, comprehensive treatment for the patients and better pregnancy outcomes.

5.
Article in Chinese | WPRIM | ID: wpr-755698

ABSTRACT

Objective To study the effect of N-Methyl-D-asparticacid ( NMDA ) on the intracellular free calcium concentration ( [ Ca2+] i ) in primary cultured rat calvaria osteoblasts. Methods A calcium imaging technique was applied to observe [ Ca2+] i changes in primary cultured rat calvaria osteoblasts after stimulating by NMDA with various concentrations or pretreated with NMDA receptor noncompetitive antagonism MK801 ( Dizocilpin) . Results Different concentrations of NMDA caused [ Ca2+] i increases in varying degrees and by different ways. NMDA could evoke transient increase and secondary change in [ Ca2+] i including calcium oscillation or steady increase. MK801 inhibited NMDA-induced [ Ca2+] i increase in varying degrees. Conclusion These results indicated that there are abundant functional NMDA receptors expressed in primary cultured rat calvaria osteoblasts, showing different forms and varying degrees of [ Ca2+] i increases in response to different concentrations of NMDA. The characters of the blocking effect of MK801 to NMDA-induced [ Ca2+] i increasing, indicated that the NMDA receptors expressed in primary cultured rat calvaria osteoblasts differ in channel properties from those in central nervous system.

6.
Chinese Journal of Trauma ; (12): 677-681, 2019.
Article in Chinese | WPRIM | ID: wpr-754698

ABSTRACT

As China has not yet established a sound regional trauma treatment system and standardized trauma centers at all levels, the trauma treatment capability in China is poorer than that in the developed countries. At present, Shaanxi Province has not established a regional trauma treatment system and standardized trauma centers at all levels. Based on the analysis of the characteristics of geography, population and social environment in Shaanxi Province, the authors explore the concept of the trauma treatment system and the construction of trauma centers at all levels in Shaanxi Province on the platform of the trauma center of Shaanxi People's Hospital ( Grade I trauma center) . The authors clarify the respective hardware facilities, team structure, treatment process and quality control goals, training and management system of professional trauma teams in trauma centers at all levels, so as to provide reference for improving the overall level of trauma treatment in Shaanxi Province.

7.
Article in Chinese | WPRIM | ID: wpr-703007

ABSTRACT

Objective To investigate the construction and application in practice of information process management system in the treatment of acute ischemic stroke (AIS).Methods From August 2017 to November 2017,the clinical data of the 597 patients with suspected stroke received green channel treatment for stroke and incorporated into the information process management system at the Cerebrovascular Disease Center,Changhai Hospital,the Second Military Mcdical University were analyzed retrospectively.The operation status and operational efficiency of each link in the AIS treatment process were evaluated.The performance assessment indicators for stroke nurses and visiting doctors were developed.The accuracy and missed diagnosis of stroke determined by the stroke nurses were calculated.The operation ability of stroke nurses was evaluated by the doctor's arrival at triage desk to establishment of intravenous access time and signing of informed consent to rt-PA bolus time,with less than 10 min as the standard.The emergency response capability of consultation physicians was evaluated by calling consultation physician to arriving at the triage desk and establishing venous channel to transport to the CT room time,with less than 5 min as the standard.The standard-reaching rate was calculated.Results A total of 597 patients were prechecked as suspected stroke.Among them,549 patients with stroke were judged by doctors,430 established venous access,443 were transported to CT room,441 completed CT scan,and 52 were treated with venous thrombolysis.In the process,the median time of patients to hospital to doctor to triage desk,doctor to triage desk to establishment of venous channel,establishment of venous channel to transportion to CT room to completion of CT scan,completion of CT scan to rt-PA bolus,patients to hospital to completion of CT scan and patients to hospital to rt-PA bolus was 3 (1,5),8 (3,16),3 (2,5),3 (2,9),9 (3,22),20(10,30) and 27 (19,55) min,respectively.The stroke nurses determined the accuracy and misdiagnosis rate of stroke were 92.0% (549/597) and 8.4% (50/597) respectively.The standard-reaching rate of doctor to triage desk to establishment of venous channel,signing informed consent to rt-PA bolus time were 82.1% (353/430) and 80.8% (42/52) respectively.The standard-reaching rates of calling consultation doctor to doctor to triage desk,establishment of venous channel to transportion to CT room time were 94.5% (564/597) and 91.4% (405/443) respectively.Conclusion A process management system centered on "time management" may help analyze the efficiency of various links and personnel in the AIS treatment process,and optimize the process continuously.

8.
Article in Chinese | WPRIM | ID: wpr-702981

ABSTRACT

Objective To investigate the influencing factor of the morphology of unruptured intracranial aneurysms for aneurysm wall enhancement under the high-resolution magnetic resonance imaging. Methods From January 2015 to December 2016,the clinical and imaging data of 68 consecutive patients with unruptured intracranial aneurysm (86 aneurysms) in Changhai Hospital,the Second Military Medical University were enrolled retrospectively. Vascular wall imaging technology was used to conduct aneurysm scan,and the aneurysm wall enhancement was identified by the imaging features before and after contrast enhancement. They were divided into either an enhancement group ( n=32,34 aneurysms) or a non-enhancement group (n=45,52 aneurysms) according to whether having the abnormal enhancement of aneurysm wall or not ( because some patients also have enhanced aneurysms and non-enhanced aneurysms, the number of cases of the enhanced or not was calculated seperately in both groups ) . Morphological parameters were calculated by 3D image data,including aneurysm size,ratio of height to width,volume ratio, dome-to-neck ratio, transverse length ratio, bottleneck factor, and inflow angle. Univariate and multivariate logistic analyses were used to determine the morphological influence factors of aneurysm wall enhancement. Results (1) A total of 34 (39. 5%) aneurysms had aneurysm wall enhancement and 52 (60. 5%) aneurysms did not have aneurysm wall enhancement. There were no significant differences in sex, age, hypertension,diabetes, smoking, family history of subarachnoid hemorrhage, and aneurysm site in both groups (all P>0. 05). (2) The aneurysm size,ratio of height to width,volume ratio,dome-to-neck ratio, and bottleneck factor in the enhancement group were larger than those of the non-enhancement group. There were significant differences between the 2 groups (9. 19 [6. 54,11. 04] mm vs. 5. 31 [4. 17,7. 37] mm, (1. 18 [1. 01,1. 69] vs. 0. 91 [0. 72,1. 25],(3. 62 [2. 30,4. 63] vs. 2. 18 [1. 37,2. 76],1. 52 [1. 25, 1. 99] vs. 1. 19 [1. 03,1. 51],and 1. 21 [1. 11,1. 69] vs. 1. 05 [0. 94,1. 31],all P<0. 01). The proportion of irregular morphologic aneurysms in the enhancement group was higher than that in the non-enhancement group. There was significant difference between the 2 groups (55. 9% [19/34] vs. 17. 3% [9/52],P<0. 01 ) . There were no significant differences in transverse length ratio and inflow angle between the 2 groups (all P>0. 05). (3) Because the ratio of height to width,volume ratio,dome-to-neck ratio,and bottleneck factor were related to the aneurysm size,the aneurysm size,inflow angle,and irregular shape were included in the multivariate logistic regression analysis. The results showed that aneurysm size ( OR,3. 727,95%CI 1. 933-6. 971,P<0. 01) and irregular shape (OR,3. 990,95%CI 1. 219-13. 065,P=0. 022) were the independent risk factors for aneurysm wall enhancement. Conclusions The size and irregular shape of unruptured intracranial aneurysms are the independent risk factors for aneurysm wall enhancement. High-resolution magnetic resonance wall imaging may become an effective and noninvasive imaging method for evaluating the ruptured risk of intracranial aneurysms.

9.
Article in Chinese | WPRIM | ID: wpr-734678

ABSTRACT

The prevalence of diabetes is increasing rapidly which becomes a serious economic burden to society. The effects of vitamin D beyond bone are increasingly recognized. Circulating level of vitamin D is associated with the development of obesity and type 2 diabetes in cross-sectional human studies. However, as to the therapeutic efficacy of vitamin D supplementation on the prevention of diabetes, the results derived from randomized controlled clinical trials were disappointing, probably due to variations in the vitamin D receptor genotypes, the dosages and courses of vitamin D treatments. However, two recent basic studies found that central administration of active vitamin D can improve glucose metabolism in diet induced obesity rats; and the combining use of active vitamin D analogue and BRD9 inhibitor rendered the chromatin of vitamin D response elements more accessible, thus more efficiently exerted its anti-inflammatory efficacy and protected islet β cell function in obese and diabetic mice models. Thus it is paramount important to explore some new approaches to prevent and treat diabetes with vitamin D and its active analogues.

10.
Article in Chinese | WPRIM | ID: wpr-806779

ABSTRACT

In the past decade, mounting evidence points to the possibility of targeting bone for treating, preventing, and predicting type 2 diabetes mellitus. Osteoblast-derived osteocalcin (OCN) can stimulate insulin secretion, enhance insulin sensitivity, and favor glucose and fatty acid uptake and utilization. Lipocalin 2 is another osteokine secreted by osteoblasts and acts in appetite suppression. Neuropeptide Y may function in browning of white adipose tissue and energy expenditure. Osteocytes are proposed to have impact on the browning of white adipose tissue and energy expenditure through the secretion of bone morphogenetic protein 7 and sclerostin. Active bone resorption is also implicated in glucose homeostasis. In addition, there is evidence indicating the involvement of bone-derived receptor activator of nuclear factor κ-B ligand in the regulation of energy metabolism. We collect and summarize recent advances and the rationales for treating, preventing, and predicting diabetes by targeting skeleton. (Chin J Endocrinol Metab, 2018, 34: 543-548)

11.
Article in English | WPRIM | ID: wpr-27512

ABSTRACT

OBJECTIVE: The Tubridge flow diverter (FD) is a novel device aimed at reconstructing the parent artery and occluding complex aneurysms. Retreatment of recurrent aneurysms using the FD is challenging. We report our initial experience in the repair of aneurysm recurrence with the FD. MATERIALS AND METHODS: A database was reviewed prospectively, and 8 patients with 8 recurrent aneurysms (mean size, 16.7 mm) were identified. Four aneurysms had previously ruptured. The previous aneurysm treatment consisted of coiling in 1 aneurysm and single-stent-assisted coiling in 7 aneurysms. The procedural complications and clinical and angiographic outcomes were analyzed. RESULTS: Six aneurysms were treated by using a single Tubridge FD alone, while the remaining 2 were treated with FD + coiling. The immediate results of the 8 aneurysms were that they all showed incomplete occlusion. Neither major ischemic nor hemorrhagic complications occurred; however, 1 patient experienced a vasospasm. Follow-up angiographies were available for 7 aneurysms; the mean follow-up was 16.9 months (7–36 months). Five aneurysms were completely occluded, whereas 2 had a residual neck. Severe asymptomatic stenosis of 1 parent artery of a vertebral artery dissecting aneurysm was found. All visible branches covered by the FD were patent. All patients were clinically assessed as having attained a favorable outcome (modified Rankin Scale score ≤ 2) at discharge and follow-up. CONCLUSION: In selected patients, the Tubridge FD can provide a safe and efficient option for the retreatment of recurrent aneurysms. Nevertheless, attention should be paid to several technical points.


Subject(s)
Aneurysm , Aneurysm, Dissecting , Angiography , Arteries , Constriction, Pathologic , Follow-Up Studies , Humans , Intracranial Aneurysm , Neck , Parents , Prospective Studies , Recurrence , Retreatment , Vertebral Artery
12.
Article in Chinese | WPRIM | ID: wpr-613965

ABSTRACT

Objective To investigate the safety and effectiveness of using low-profile visualized intraluminal support (LVIS) stents for the treatment of aneurysms in the small intracranial vessels (diameter <2.5 mm).Methods Between October 2014 and April 2016,the clinical data of all 30 patients with intracranial saccular aneurysm treated with LVIS stents with the small parent arteries <2.5 mm in diameter in Changhai Hospital,the Second Military Medical University were analyzed retrospectively,including 7 ruptured aneurysms and 23 unruptured aneurysms.The anterior circulation aneurysm accounted for 93.3% (n=28),and the diameters of the parent arteries were 1.6-2.4 mm.The complications associated with surgery,angiography,clinical outcomes,and mid-term follow-up data were analyzed.Results The success rate of stent implantation was 100%.Immediate embolization results:Raymond grade Ⅰ in 12 cases (40.0%),Raymond grade Ⅱ in 11 cases (36.7%),and Raymond grade Ⅲ in 7 cases (23.3%).Complications occurred in 2 cases,including one perforating artery occlusion and one intraoperative rupture.Twenty-five patients accepted the angiographic follow-up (Raymond grade Ⅰ in 21 cases,grade Ⅱ in 3 cases,and grade Ⅲ in 1 case).The follow-up time ranged from 4 to 14 months,with an average of 8.1± 2.6 months.One patient had asymptomatic intracranial artery stenosis in the distal end of the stent.No new neurological dysfunction or death occurred.Conclusion The deployment of LVIS stents in small vessels is safe and feasible,the effect of mid-term follow-up is better.However,a larger sample study and long-term follow-up results are needed.

13.
Article in Chinese | WPRIM | ID: wpr-510773

ABSTRACT

Objective To preliminarily discuss the efficacy and safety of balloon protection technique in venous sinus in the embolization of lateral sinus dural arteriovenous fistula.Methods FromDecember 2012 to August 2016,7 consecutive patients with lateral sinus dural arteriovenous fistula embolized with Onyx under the protection of venous sinus balloon were enrolled retrospectively. Their clinical data,imaging data,and follow-up results were analyzed.Results In 7 patients,the fistulas of 3 cases were located in the sigmoid sinus and the fistulas of 4 cases were located in the transverse sinus. Immediately after operation, 5 patients were embolized completely and 2 were embolized mostly. All balloon protected venous sinuses maintained patency. Seven patients were followed up clinically and the follow-up time was 6-43 months. No new neurological deficits were observed. All 7 patients received whole DSA reexamination and the follow-up time was 6-11 months. It is suggested that 5 patients were completely cured,among them,the venous sinuses were patent in 4 cases,the venous sinus was occluded in 1 case;the fistula was stable and venous sinus patency in 1 case;and 1 had newly complicated venous sinus occlusion.Conclusion At the same time of embolization of the fistulas,the dural arteriovenous fistulas were embolized under the protection of venous sinus balloon. It could maintain long-term patency of venous sinus and be conductive to maintaining the stability of the embolization effect.

14.
Article in Chinese | WPRIM | ID: wpr-509938

ABSTRACT

Objective To evaluate the risk factors for interventional treatment of neurological complications in elderly patients with rupture intracranial aneurysms.Methods Form December 2004 to December 2014,520 consecutive old patients (≥ 60 years) with ruptured intracranial aneurysm treated at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.The imaging and clinical follow-up results at day 30 after procedure were documented.According to whether the occurrence of interventional therapy-related neurological complications (including intraoperative aneurysm rupture,interventional therapy-related thromboembolic events,early postoperative aneurysm rebleeding,new postoperative subdural hemorrhage or intraparenchymal hemorrhage),they were divided into a complication group (n =68) and a non-complication group (n =452).Univariate statistical analysis and multivariate Logistic regression analysis were used to screen the independent risk factors for the occurrence of neurologic complications after interventional therapy.Results The incidence of neurological complications in 520 patients with aneurysm was 13.1% (n =68).Multivariate Logistic regression analysis showed that the history of hypertension (OR,2.207,95 % CI 1.149-4.240,P < 0.05),Hunt-Hess grade Ⅳ-Ⅴ (OR,4.287,95% CI 2.048-8.971,P < 0.01),Fisher grade Ⅲ-Ⅳ (OR,2.686,95% CI 1.483-4.865,P < 0.01),wide-neeked aneurysm (OR,2.884,95 % CI 1.511-5.505,P < 0.01),aneurysm bleb (OR,4.560,95 % CI 2.500-8.321,P < 0.01),and aneurysm < 3 mm (OR,5.748,95 % CI 2.122-15.570,P < 0.01) were the independent risk factors for treatment-related neurological complications in the interventional treatment of intracranial ruptured aneurysms in the elderly.Conclusion The history of hypertension,high Hunt-Hess grade,high Fisher grade,wide-neck aneurysm,aneurysm bleb,and micro-aneurysm are the independent risk factors for treatment-related neurological complications in interventional treatment of intracranial ruptured aneurysms in the elderly.

15.
Article in Chinese | WPRIM | ID: wpr-509608

ABSTRACT

microRNAs is a class of non-coding RNA, which is the transcriptional regulator of gene expression at the post transcriptional level.These endogenous non-coding RNA are expressed abnormally in tumor cells, in the tumor cell growth, reproduction, apoptosis and metastasis and other processes play an important regulatory role.Recently, microRNAs was widely regarded as biological diagnostic and prognostic markers of tumor in clinic, has been widely viewed.This article will introduce the important role of miRNA in tumor gene expression, as well as the use of miRNA as a tumor targeted therapy clinical application before the need to solve the problem .

16.
Article in Chinese | WPRIM | ID: wpr-507020

ABSTRACT

[Summary] Extracellular calcium is essential for the regulation of a variety of biological processes. Calcium-sensing receptor (CaSR) plays a central role in maintaining Ca2+ homeostasis, while G-protein α-11 (Gα11 ) subunit and adaptor-related protein complex 2 sigma (AP2σ) are also involved in CaSR signaling transduction. Loss- or gain-of-function mutations of these encoding genes cause different types of familial hypocalciuric hypercalcaemia (FHH) and autosomal dominant hypocalcaemia (ADH). Calcimimetic and calcilytic drugs are useful in treating these FHH and ADH disorders. The current paper is a Chinese translation of a review entitled as “Disorder of the calcium-sensing receptor and partner proteins: insights into the molecular basis of calcium homeostasis” published in 《 Journal of Molecular Endocrinology》(2016,57:R127-R142) with the permission from the author and the journal.

17.
Herald of Medicine ; (12): 109-113, 2017.
Article in Chinese | WPRIM | ID: wpr-506689

ABSTRACT

Objective To develop transparency measurement scale on medicine use information in primary health care facilities. Methods The dimensions and items of scale were determined through literature review and expert consultation. The scale was used to investigate 100 primary health care facilities in eastern, central and western regions. Correlation coefficient analysis, Cronbach's coefficient, and exploratory factor analysis were used to select items. Five dimensions and 20 items were selected for the final scale. Cronbach's coefficient was used to evaluate the reliability of the formal scale. Factor analysis was used for construct validity evaluation. Results Dimensions were measured, including service processes, organization and regulation for pharmacy administration, patients informing and education, medicine catalogue, and the economic burden of patients. The scale had good reliability since overall Cronbach coefficient was 0. 844. Factor analysis extracted five common factors, total explaining 89. 69% of the cumulative variance, and the item distribution in five common factors was completely consistent with formal scale, indicating good construct validity. Conclusion This scale had good reliability and validity as a measurement tool to evaluate the transparency level of primary health care facilities in China.

18.
Article in Chinese | WPRIM | ID: wpr-673045

ABSTRACT

Objective To evaluate the safety and effectiveness of Pipeline embolization device (PED) for the treatment of large and giant intracranial aneurysms.Methods Frorn November 2014 to May 2016,the clinical and radiological data of 33 patients with intracranial aneurysm confirmed by DSA or head CT angiography (CTA) or head magnetic resonance angiography (MRA) at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.Its safety and effectiveness were evaluated.Results The Pipelines were successfully released in 33 patients with 35 aneurysms,10 aneurysms were implanted by using PED alone,25 were implanted by using PED combined with coil embolization (including 2 were implanted by using Pipeline bridging technology).During the perioperative period,1 thrombotic event(one aneurysm) occurred and had hemorrhagic transformation.One(one aneurysm) died of fatal aneurysm delayed bleeding.Thirty-one patients (33 aneurysms) were followed up clinically,the follow-up time was 4-18 months,no bleeding or thrombosis events occurred.Eighteen aneurysms received a short-term postoperative imaging follow-up (3-5 months,enhanced MRA or DSA),of which 10 had neck residue or aneurysm development,and 8 aneurysms did not have development at all,and 19 achieved postoperative mid-term imaging follow-up (6-16 months,enhanced MRA or DSA).Two of them had neck residue and 17 did not develop at all.Conclusion Pipeline for the treatment of intracranial large and giant aneurysms may be safe and effective.However,the complications of intracranial hemorrhage cannot be ignored after implantation of embolization device.Its related mechanism needs to be further studied.

19.
Article in Chinese | WPRIM | ID: wpr-664334

ABSTRACT

Objective To investigate the safety and efficacy of endovascular treatment of distal middle cerebral artery aneurysms. Methods From January 2009 to December 2016,the medical records of 13 consecutive patients with distal middle cerebral artery aneurysm (a total of 14 aneurysms)were reviewed and enrolled. Endovascular treatment included coils,coils with liquid embolic materials,or using liquid embolic material alone for embolization of aneurysms or occlusion of parent arteries. The immediate outcome of aneurysm treatment was evaluated by Raymond classification,and the clinical prognosis was evaluated by the modified Rankin scale (mRS). DSA was use to conduct imaging follow-up study and was compared with the immediate treatment outcome in order to determine whether the aneurysms recurred or not. Results Of the 13 patients,8 were males,with an average age of 40 ±14 years. The maximum diameter of aneurysm was 1. 0 -12. 0 mm,the median size was 4. 5 mm. Fourteen aneurysms were successfully treated by endovascular treatment,4 of them were embolized,and the parent aneurysms were retained;10 aneurysms and parent arteries were occluded. Twelve aneurysms did not develop immediately after operation,and 2 of them had residual aneurysms. No new nerve dysfunction and related complications were found after endovascular treatment. The clinical follow-up period was 9 -96 months,and the median time was 30. 9 months. Twelve aneurysms were followed up for 6 -24 months with a median time of 15. 2 months. No recurrence of aneurysms were observed. Conclusions Using endovascular treatment technology for the treatment of distal middle cerebral artery aneurysms is safe and effective. It can be considered in the development of treatment programs.

20.
Article in Chinese | WPRIM | ID: wpr-663848

ABSTRACT

Primary hyperparathyroidism (PHPT) with negative or inconsistent imaging is a significant clinical problem. Surgery is the best chance in curing PHPT. Preoperative imaging is performed for lesion localization to help selecting the proper operative approaches. However,negative or inconsistent imaging could not exclude the diagnosis of PHPT and should not be ruled out the decision of operation. Therefore, for PHPT patients who had indication for surgery but with negative or inconsistent imaging result(s), it is better to transfer the patient to experienced center and surgeons for a proper surgical treatment.

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