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1.
Acta Physiologica Sinica ; (6): 867-877, 2021.
Article in Chinese | WPRIM | ID: wpr-921290

ABSTRACT

The purpose of the present study was to investigate the effect of transient receptor potential vanilloid 4 (TRPV4) channel on the permeability of pulmonary microvascular endothelial cells (PMVECs) in rats with chronic hypoxia-induced pulmonary hypertension (CHPH), so as to clarify the mechanism of vascular endothelial dysfunction during the occurrence of pulmonary hypertension (PH). CHPH rat model was established by exposure to chronic hypoxia (CH) for 21 days. Primary PMVECs were cultured by adherent tissue blocks at the edge of the lung. The permeability coefficient of primary cultured PMVECs was detected by fluorescein isothiocyanate (FITC)-dextran. The structure of tight junction (TJ) was observed by transmission electron microscope. The expression of TRPV4 and TJ-related proteins, such as, Occludin, Claudin-5, ZO-1 were examined by real-time fluorescence quantitative PCR and Western blotting. The intracellular calcium concentration ([Ca


Subject(s)
Animals , Endothelial Cells , Hypertension, Pulmonary , Hypoxia/complications , Lung , Permeability , Rats , TRPV Cation Channels/genetics
2.
Chinese Journal of Urology ; (12): 740-746, 2021.
Article in Chinese | WPRIM | ID: wpr-911107

ABSTRACT

Objective:To explore the efficacy and safety of intravesical electrical stimulation (IVES) combined with a training for bladder motor and sensory dysfunction in the treatment of neurogenic underactive bladder(UAB).Methods:A prospective, single-blind, randomized controlled trial was used to study neurogenic UAB patients admitted to the China Rehabilitation Research Center from October 2019 to May 2021. Inclusive criteria included age≥18 years old, the patients who have been diagnosed as neurogenic UAB and the course of disease being more than 3 months; patients who have been undergone intermittent catheterization to empty the bladder or patients indicated for intermittent catheterization (post-void residual urine accounts for more than 40% of the functional bladder volume), voluntary signing of written informed consent, able to communicate well with researchers and comply with the requirements of the whole trial, and the patient not undergoing any treatment other than oral medication before IVES. Exclusion criteria included patients with low bladder compliance by urodynamic examination(<20 ml/cmH 2O), patients with mechanical outflow obstruction, patients with complete spinal cord injury, the patients with symptomatic urinary tract infection which was not cured, patients with hydronephrosis or bladder-ureteral reflux, patients with renal insufficiency(serum creatinine greater than 1.5 times of the upper limit of normality), patients with malignant tumors of the bladder or prostate, overactive bladder, Alzheimer's disease, brain atrophy, acute cerebrovascular disease, or cognitive impairment, patients who were pregnant or planning to be pregnant, bladder mucosa injury, patients with pacemakers or defibrillators, those who participated in other clinical trials 3 months before the study, and other circumstances that the researcher consider it is not suitable to be involved in this study. The patients were randomly divided into experimental group and control group according to the ratio of 1∶1. The experimental group used conventional transurethral insertion of bipolar catheter electrodes for IVES combined with bladder motor and sensory dysfunction training, and the control group underwent IVES with open circuit combined with bladder motor and sensory dysfunction training. The stimulation parameters of the two groups were two-way square wave, 1-30 mA intensity, 10-20 Hz frequency, 200 μs pulse width, once a day, lasting 30 minutes for each treatment, and for continuous 20 working days. The post-void residual urine, voiding efficiency, 24-hour intermittent catheterization times, first sensation of bladder filling volume and American Urological Association Symptom Index Quality of Life(AUA-SI-QOL) scores were recorded before and at the end of treatment. The adverse events during the treatment were recorded. Results:Fifty-two patients were selected and 50 patients completed the trial, including 26 patients in the experimental group and 24 patients in the control group. Before treatment, there were no significant differences in gender[16(male)/10(female)vs.13(male)/11(female), P=0.598], age [(40.7±13.5)years vs.(38.5±12.3)years, P=0.543], course of disease[0.71(0.42, 1.63)years vs.0.79(0.42, 1.50)years, P=0.695], post-void residual urine[300(193, 400)ml vs.325(178, 380)ml, P=0.724], voiding efficiency[17%(0, 47.8)% vs.21%(0, 38.0)%, P=0.960], 24-hour intermittent catheterization times[4(2, 4)vs.3(2, 4), P=0.692], first sensation volume during bladder filling[(325.8±74.3)ml vs.(307.5±75.0)ml, P=0.391] or AUA-SI-QOL scores[5(4, 5)vs.4(4, 5), P=0.313] between the experimental group and the control group. At the end of treatment, the post-void residual urine, first sensation volume during bladder filling and AUA-SI-QOL scores of the experimental group were significantly lower than those of the control group [250(40, 350)ml vs.300(200, 390)ml, P=0.034; (276.5±68.8)ml vs.(315.4±67.3)ml, P=0.049; 4(2, 4)vs.4(3, 5), P=0.024], and the voiding efficiency was significantly higher than that of the control group[33%(14.5, 84.5)% vs.18%(0, 35.8)%, P=0.041], but there was no significant difference in the number of 24-hour intermittent catheterization between the two groups [3(1, 4)vs.3(2, 4), P=0.174]. In the control group, there were no significant changes in post-void residual urine, voiding efficiency, 24-hour intermittent catheterization times, first sensation volume during bladder filling and AUA-SI-QOL scores before and after treatment [325(178, 380)ml vs.300(200, 390)ml, P=0.832; 21%(0, 38.0)% vs.18%(0, 35.8)%, P=0.943; 3(2, 4)vs.3(2, 4), P=0.239; (307.5±75.0)ml vs.(315.4±67.3)ml, P=0.257; 4(4, 5)vs.4(3, 5), P=0.157]. In the experimental group, there were significant improvements in post-void residual urine, voiding efficiency, 24-hour intermittent catheterization times, first sensation volume during bladder filling and AUA-SI-QOL scores before and after treatment [300(193, 400)ml vs.250(40, 350)ml, P<0.001; 17%(0, 47.8)% vs.33%(14.5, 84.5)%, P<0.001; 4(2, 4)vs.3(1, 4), P=0.011; (325.8±74.3)ml vs.(276.5±68.8)ml, P<0.001; 5(4, 5)vs.4(2, 4), P<0.001]. During the treatment period, 1 case of abdominal discomfort occurred in the experimental group and 1 case of urethral discomfort in the control group. After adjusting the stimulation intensity and catheter position, the discomfort disappeared without other serious adverse events. Conclusions:IVES combined with bladder motor sensory dysfunction training can not only effectively improve the bladder emptying efficiency and bladder sensation in patients with neurogenic UAB, but also be safe and easy to operate.

3.
Chinese Journal of Urology ; (12): 449-454, 2021.
Article in Chinese | WPRIM | ID: wpr-911048

ABSTRACT

Objective:Evaluate the influence of different pressure transmission media of urodynamic water filled catheter(WFC) and air charged catheter(ACC) on the pressure measurement results to determine whether they can be used interchangeably.Methods:The results of 2 147 patients who underwent urodynamic examination in our hospital from January 2014 to December 2020 were retrospectively analyzed. A total of 2 538 times of bladder manometry data were obtained, including 1 299 times in WFC group, 856 times in male and 443 times in female, aged 37(24, 50)years, course of disease 1.2(0.4, 5.0) years, 1 130 times in neurogenic bladder(NB)and 169 times in non-neurogenic bladder(N-NB); In ACC group, there were 1 239 times, 773 times for male and 466 times for female, with age of 37(24, 55)years, course of disease of 1.5(0.5, 6.0)years, 1 040 times for Nb and 199 times for N-NB. There was no significant difference in baseline data of general clinical data between the two groups. The intravesical pressure(Pves), intra-abdominal pressure(Pabd)and detrusor pressure(Pdet) of WFC and ACC patients during filling and urination were analyzed. For traumatic spinal cord injury(SCI) and idiopathic patients, the two sets of pressure measurement data were analyzed separately. Nonparametric test and Chi-square test were used to compare the Pves, Pabd, and Pdet recorded by the two manometry catheters before, at the end and after urination, the maximum detrusor pressure at DO(Pdet.max-DO), and the maximum detrusor pressure during spontaneous urination (Pdet. max) and the detrusor pressure (Pdet.Qmax) corresponding to the maximum urine flow rate, the maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) during resting urethral pressure profile, and the initial cough Pdet signal pattern (typeⅠ, typeⅡand typeⅢ).Results:Regardless of the cause, the Pabd values measured by ACC were significantly higher than WFC before filling, end filling and after voiding[18(10, 26)cmH 2O vs.15(11, 21)cmH 2O; 23(16, 31)cmH 2O vs. 20(14, 26)cmH 2O; 23(15, 31)cmH 2O vs.18(12, 24)cmH 2O], and Pdet were significantly lower than WFC[0(0, 0) cmH 2O vs. 0(0, 1)cmH 2O; 5(1, 13)cmH 2O vs. 9(4, 17)cmH 2O; 6(1, 12)cmH 2O vs. 7(3, 14)cmH 2O]. In the initial cough state, Pves and Pabd increase value were also significantly lower than that of WFC [22(12, 36)cmH 2O vs. 23(14, 38)cmH 2O; 20(10, 33)cmH 2O vs. 21(12, 36)cmH 2O]. The Pves measured by ACC was also significantly higher than WFC before filling and after voiding[18(10, 27)cmH 2O vs. 16(11, 21)cmH 2O; 30(22, 39)cmH 2O vs. 26(20, 36)cmH 2O]. Maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) measured by ACC were significantly higher than WFC [91(69, 118)cmH 2O vs.81(64, 106)cmH 2O; 77(55, 103)cmH 2O vs. 68(48, 91)cmH 2O], and there were no significant differences in Pdet.max-DO、Pdet.max和Pdet.Qmax. For patients with traumatic SCI, the Pves measured by ACC was significantly higher than WFC before filling[15(10, 24)cmH 2O vs. 14(10, 20)cmH 2O], and only MUP was significantly higher than WFC in the measurement of urethral pressure[95(71, 119)cmH 2O vs. 85(65, 112)cmH 2O], and there were no significant differences in Pdet.max-DO, Pdet.max, Pdet.Qmax and MUCP. For idiopathic patients, Pves measured by ACC before filling and after urination were significantly higher than WFC[25(20, 29)cmH 2O vs. 18(11, 23)cmH 2O; 35(29, 44)cmH 2O vs. 28(20, 38)cmH 2O], while Pdet.max-DO, Pdet.max, Pdet.Q max, MUP and MUCP were not significantly different in different pressure measurement systems. For the comparison of the initial cough Pdet signal pattern, ACC is easier to detect type Ⅰ, and WFC is easier to detect type Ⅱ and type Ⅲ. Conclusions:Compared with WFC, ACC measured higher Pves and Pabd and lower Pdet in resting state, and lower Pves and Pabd in initial cough state. The pressure values and signal pattern measured by WFC and ACC are not completely consistent, so they cannot be used interchangeably.

4.
Chinese Journal of Urology ; (12): 414-422, 2021.
Article in Chinese | WPRIM | ID: wpr-911043

ABSTRACT

Objective:To assess the efficacy and safety of 100 units of botulinum toxin A (BTX-A) intradetrusor injection in patients with overactive bladder.Methods:From April 2016 to December 2018, 17 tertiary hospitals were selected to participate in this prospective, multicenter, randomized, double-blind, placebo-controlled study. Two phases of study were conducted: the primary phase and the extended phase. This study enrolled patients aged 18 to 75 years who had been inadequately managed by anticholinergic therapy (insufficient efficacy or intolerable side effects) and had spontaneous voiding with overactive bladder. Exclusion criteria included patients with severe cardiac, renal and hepatic disorders, patients with previous botulinum toxin treatment for 6 months or allergic to BTX-A, patients with urinary tract infections, patients with urinary stones, urinary tract tumors, diabetes mellitus, and bleeding tendency. Eligible patients were randomly assigned to BTX-A group and placebo control group in a ratio of 2∶1. Two groups of patients received 20 intradetrusor injections of BTX-A 100U or placebo at the depth of the submucosal muscle layer respectively under cystoscope, including 5 injections at the base of the bladder, 3 injections to the bladder triangle, 5 injections each to the left and right walls and 2 injections to the top, sparing the bladder neck. As a placebo control group, patients received same volume of placebo containing no BTX-A and only adjuvant freeze-dried preparations for injection with the same method. A combination of gelatin, sucrose, and dextran served as adjuvants. Average micturition times per 24 hours, urinary incontinence (UI) episodes per day, average micturition volume per day, OAB symptom score(OABSS), and quality of life (QOL) score were recorded at baseline and the 2nd, 6th and 12th week after treatment. The primary efficacy endpoint was the change from baseline in the average micturition times per 24 hours at the 6th week after treatment. The secondary efficacy endpoints included the change from baseline in the average micturition times per 24 hours at 2nd and 12th week, as well as the change from baseline in the OABSS, QOL score, average frequency of urgency and UI episodes per day, urgency score, average micturition volume per day at 2nd, 6th and 12th week after treatment. Patients were followed for 12 weeks to assess adverse events (AEs). After assessed at week 12, if the micturition times has decreased less than 50% compared to baseline and the patient is willing to receive retreatment, then patients could enter the extended trial phase. In that phase, patients in both groups were injected with 100 units BTX-A from 12th week onwards and then followed up the same indicators for 12 weeks.Results:216 patients were enrolled in this trial (144 cases in the BTX-A group and 72 cases in the placebo control group). Baseline characteristics such as age (47.75±14.20 in the BTX-A group and 46.39±15.55 in the control group), sex (25 male/117 female in the BTX-A group and 10/61 in the control group), and disease duration (0.51 years in the BTX-A group and 0.60 years in the control group) were balanced between the two groups( P>0.05). A marked reduction from baseline in average micturition times per 24 hours was observed in all treatment groups at the 6th week and the reduction of the two groups was statistically different ( P<0.001 and P=0.008 respectively). Compared with the baseline, the average micturition times per 24 hours at the 6th week decreased from baseline by 2.40(0.70, 4.60)times for the BTX-A group and 0.70(-1.00, 3.30) times for the placebo control group respectively, and the difference between the two groups was considered to be statistically significant ( P=0.003). The change rates of average micturition times per 24 hours from baseline at the 6th week of the two groups were (16±22)% and (8±25)% respectively, and the difference between the two groups was statistically significant ( P=0.014). Compared with the baseline, the average micturition times per 24 hours at 2nd and 12th week decreased by 2.00(0.00, 4.00)and 3.30(0.60, 5.03)for the BTX-A group, 1.00(-1.00, 3.00)and 1.70(-1.45, 3.85)for the placebo control group respectively. The difference between two groups was considered to be statistically significant ( P=0.038 and P=0.012); the changes of average urgency times per day for the BTX-A group and the control group at the 2nd, 6th and 12th week were 2.00(0.00, 4.30)and 2.40(0.30, 5.00), 3.00(0.30, 5.70)and 0.70(-1.30, 2.70), 0.70(-1.30, 3.00) and 1.35(-1.15, 3.50), respectively. There were significant differences between two groups at the 2nd, 6th and 12th week, ( P=0.010, P=0.003 and P=0.025, respectively). The OABSS of the BTX-A group and the control group at the 6th week decreased by 1.00(0.00, 4.00)and 0.50(-1.00, 2.00) compared with the baseline, and the difference between the two groups was statistically significant ( P=0.003). 47 cases of BTX-A group and 34 cases of placebo control group entered the extended trial phase, and 40 and 28 cases completed the extended trial phase, respectively. The average micturition volume per 24 hours changed by -16.60(-41.60, -0.60)ml and -6.40(-22.40, 13.30)ml, (-35.67±54.41)ml and(-1.76±48.69)ml, (-36.14±41.51)ml and (-9.28±44.59)ml, (-35.85±43.35)ml and(-10.41±40.29)ml for two groups at the 12th, 14th, 18th and 24th week, and the difference between two groups was statistically significant at each follow-up time ( P=0.01, 0.006, 0.012 and 0.016, respectively). There was no significant difference in other parameters( P>0.05). However, adverse reactions after intradetrusor injection included increased residual urine volume (27 in the BTX-A group and 3 in the control group), dysuria (21 in the BTX-A group and 6 in the control group), urinary infection (19 in the BTX-A group and 6 in the control group), bladder neck obstruction (3 in the BTX-A group and 0 in the control group), hematuria (3 in the BTX-A group and 1 in the control group), elevated alanine aminotransferase (3 in the BTX-A group and 0 in the control group), etc. During the follow-up period, there was no significant difference in the other adverse events between two groups except the increase of residual urine volume( P<0.05). In the primary trial phase, among the 27 cases with increased residual urine volume in BTA group, only 1 case (3.70%) with PVR more than 300 ml; the PVR of 3 patients in the placebo group was less than 100 ml. The increase of residual urine volume caused by the injection could be improved or disappeared with the passage of time. Conclusions:Intradetrusor injection of Chinese BTX-A improved the average micturition times per 24 hours, the average daily urgent micturition times, OABSS, and average micturition volume per time, and reduced the adverse effects in patients with overactive bladder.Chinese BTX-A at dose of 100U demonstrated durable efficacy and safety in the management of overactive bladder.

5.
Article in Chinese | WPRIM | ID: wpr-910129

ABSTRACT

Objective:To evaluate the value of mitral annulus displacement(TMAD) measured by two-dimensional speckle tracking imaging in evaluating left ventricular(LV) systolic function before and after immunoglobulin(IVIG) treatment in children with Kawasaki disease(KD).Methods:Thirty-five hospitalized children with acute KD(KD group) and 40 healthy volunteers(control group)were enrolled from September 2020 to March 2021 in the Third Affiliated Hospital of Zhengzhou University. All participants underwent echocardiography.Left ventricular ejection fraction(LVEF) and left ventricular short axis shortening(LVFS) were calculated from M-mode echocardiography. All children had their apical four-chamber and two-chamber view recorded and stored in real time, and the images of the KD group were recorded in the acute, subacute and convalescent stages, respectively. The data was analyzed by QLab 13.0 offline quantitative analysis software. The TMAD parameters between the KD group and the control group were compared. And the TMAD parameters at different periods in the KD group were compared. Pearson correlation analysis was conducted to evaluate associations between TMAD parameters and LVEF and N-terminal B-type natriuretic peptide(NT-proBNP) in children with acute KD.Results:①The parameters of TMAD AP4 MV1, TMAD AP4 MV2, TMAD AP2 MV1, TMAD AP2 MV2, TMAD AP4 Midpt, TMAD AP4 Midpt%, TMAD AP2 Midpt and TMAD AP2 Midpt% were decreased in patients with KD at different periods than those of the control group(all P<0.05), while there was no significant difference in LVEF between the two groups( P>0.05). ②After IVIG treatment, the values of TMAD AP4 MV1, TMAD AP4 MV2, TMAD AP2 MV1, TMAD AP2 MV2, TMAD AP4 Midpt, TMAD AP4 Midpt%, TMAD AP2 Midpt and TMAD AP2 Midpt% in subacute stage of KD were higher than those in acute stage(all P<0.05), the values of TMAD AP4 Midpt% and TMAD AP2 Midpt% in the convalescent stage of KD were higher than those in the subacute stage(all P<0.05). ③The parameters of TMAD were positively correlated with LVEF( r=0.36, 0.40, 0.32, 0.28, 0.42, 0.46, 0.35, 0.37; all P<0.05) and negatively correlated with NT-proBNP( r=-0.61, -0.57, -0.40, -0.60, -0.63, -0.47, -0.61, -0.36; all P<0.05). Conclusions:TMAD measured by two-dimensional speckle tracking imaging can quickly and accurately evaluate left ventricular systolic function in children with KD before and after IVIG treatment, and TMAD combined with NT-proBNP can provide a new method for clinical management of KD.

6.
Chinese Medical Journal ; (24): 646-654, 2021.
Article in English | WPRIM | ID: wpr-878078

ABSTRACT

Cerebral amyloid angiopathy-related inflammation (CAA-RI) is a rare but increasingly recognized subtype of CAA. CAA-RI consists of two subtypes: inflammatory cerebral amyloid angiopathy and amyloid β (Aβ)-related angiitis. Acute or subacute onset of cognitive decline or behavioral changes is the most common symptom of CAA-RI. Rapid progressive dementia, headache, seizures, or focal neurological deficits, with patchy or confluent hyperintensity on T2 or fluid-attenuated inversion recovery sequences and evidence of strictly lobar microbleeds or cortical superficial siderosis on susceptibility-weighted imaging imply CAA-RI. The gold standard for diagnosis is autopsy or brain biopsy. However, biopsy is invasive; consequently, most clinically diagnosed cases have been based on clinical and radiological data. Other diagnostic indexes include the apolipoprotein E ε4 allele, Aβ and anti-Aβ antibodies in cerebral spinal fluid and amyloid positron emission tomography. Many diseases with similar clinical manifestations should be carefully ruled out. Immunosuppressive therapy is effective both during initial presentation and in relapses. The use of glucocorticoids and immunosuppressants improves prognosis. This article reviews the pathology and pathogenesis, clinical and imaging manifestations, diagnostic criteria, treatment, and prognosis of CAA-RI, and highlights unsolved problems in the existing research.


Subject(s)
Amyloid beta-Peptides , Cerebral Amyloid Angiopathy , Cerebral Hemorrhage , Humans , Inflammation , Magnetic Resonance Imaging , Vasculitis
7.
International Eye Science ; (12): 963-968, 2021.
Article in Chinese | WPRIM | ID: wpr-876736

ABSTRACT

@#AIM: To investigate the endoplasmic reticulum stress(ERS)induced by all-trans retinoic acid(ATRA)in ARPE-19 cells.<p>METHODS:Immunofluorescence, real-time quantitative polymerase chain reaction and Western blot were used to detect the protein and mRNA expression of related signal pathways during the process of endoplasmic reticulum stress response induced by ATRA in ARPE-19 cells.<p>RESULTS: With the accumulation of ATRA concentration, the protein and mRNA levels of endoplasmic reticulum stress response marker proteins chop and BiP were significantly increased(<i>P</i><0.001); in the downstream signaling pathways, perk, eIF2 α, ATF4, IRE1 α and XBP1 were up-regulated(<i>P</i><0.001), while the expression of ATF6 did not change(<i>P</i>>0.05).<p>CONCLUSION: Over accumulation of ATRA induces ERS in ARPE-19 cells and activates PERK-EIF2 α-ATF4 and IRE1 α-XBP1 signaling pathways

8.
Acta Pharmaceutica Sinica ; (12): 585-592, 2021.
Article in Chinese | WPRIM | ID: wpr-873768

ABSTRACT

Puerarin (PUE), as an isoflavone component, has a wide range of pharmacological activities, while its poorly aqueous solubility limits the development of solid oral dosage forms. In this study, PUE along with nicotinamide (NIC) were prepared into the coamorphous system by solvent-evaporation method and characterized by powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FT-IR). In addition, its dissolution behavior and solubilization mechanism were also investigated. PUE-NIC coamorphous was a single homogeneous binary system, with a single glass transition temperature at 35.1 ℃. In comparison to crystalline PUE, during the dissolution process, coamorphous PUE-NIC not only exhibited the "liquid-liquid phase separation" (LLPS) phenomenon, but the formation of Ap type complexation (1∶1 and 1∶2) between PUE and NIC molecules was also verified, which significantly improved the solubility of PUE and prolonged the supersaturation time, and would benefit its absorption.

9.
China Pharmacy ; (12): 2406-2410, 2021.
Article in Chinese | WPRIM | ID: wpr-886925

ABSTRACT

OBJECTIVE:To provide reference for the development and application of pharmacy popular-science video courseware. METHODS :Combined with the problems existing in the medication of patients with chronic diseases at the present stage and the key points of medication management ,the theme ,content and form of this popular-science were determined ;the video shooting and production were completed ,and publicity and promotion were carried out. Questionnaire survey was conducted , and the reception of pharmacy outpatient service in our hospital was counted ;the broadcasting effects of popular-science video were analyzed. RESULTS :The theme of popular-science video courseware was determined to be self-medication management of patients with chronic diseases at home assisted by pharmacists. Combined with the “five moments ”of medication safety proposed by WHO , the content included six units as knowing pharmacists ,understanding drugs ,taking drugs ,adding drugs ,checking drugs ,and discontinuing drugs. PPT video was used to explain the contents of each unit ,with an average duration of about 25 min. After the first unit was launched ,a total of 39 327 hits were received within two months. A total of 100 questionnaires were sent out ,97 questionnaires were collected (recovery rate of 97.0%). Among them ,80(82.5%)thought it helpful to watch the video. Within two months after the broadcast of unit 1 video,the reception volume of pharmacy outpatient department of our hospital (1 160 person times )increased by 104.2% compared with the two months in the same period last year (568 person times ),and increased by 18.7% compared with the two months before the broadcast (977 person times );99 patients came to the pharmacy outpatient department to consult because of watching the video ,and 55.6% of the registered patients consulted the demonstration of video courseware and repeatedly mentioned related problems. CONCLUSIONS :It is a beneficial exploration for pharmacists to develop popular-science video courseware with the theme of safe and rational drug use. It is the direction for future work to increase the scope of disease types ,target different groups of people or focus on different types of drugs and promot them in various forms.

10.
Article in Chinese | WPRIM | ID: wpr-882701

ABSTRACT

With the development of various laboratory testing techniques such as serum calcium and parathyroid hormone (PTH) , a large number of asymptomatic or normocalcemic primary hyperparathyroidism (PHPT) can be diagnosed early. PHPT has become the third most common endocrine disease affecting human health. Currently, most PHPT, especially normocalcemic primary hyperparathyroidism, are not primary diseases and may be related to vitamin D deficiency/insufficiency and/or insufficient calcium supplementation. That is, the relative hypocalcemia caused by long-term vitamin D deficiency/insufficiency and/or insufficient calcium supplementation leads to parathyroid hyperfunction, stimulates parathyroid hyperplasia, and secretes excessive parathyroid hormone to compensate for the regulation of calcium and phosphorus balance. When it is in the initial reversible stage, it can be cured by internal medicine; if it progresses freely, long-term hypocalcemia stimulation will lead to excessive parathyroid hyperplasia and even tumor occurrence with the formation of so-called PHPT and parathyroidectomy has to be performed. Therefore, routine screening of bone mineral density, calcium, magnesium, phosphours, 25-hydroxyvitamin D, parathyroid hormone and other bone metabolism indicators in the physical examination of general population is beneficial to the prevention and treatment of bone metabolism diseases, urinary stones and hyperparathyroidism. At the same time, attention should be paid to identifying the stage of prehyperparathyroidism in which vitamin D deficiency/insufficiency and insufficient calcium supplementation will stimulate parathyroid hyperfunction. Active intervention on prehyperparathyroidism is an effective way to avoid the development of primary hyperparathyroidism.

11.
Article in Chinese | WPRIM | ID: wpr-908548

ABSTRACT

Objective:To investigate all-trans retinoic acid(ATRA)-induced apoptosis signaling pathway in ARPE-19 cells in vitro. Methods:The APRE-19 cell was treated with different concentrations of ATRA for 24 hours and 48 hours.Cell counting kit-8 (CCK-8) was used to detect the cell viability in order to determine the experimental concentration range.Flow cytometry and Western blot method were performed to evaluate the apoptosis and caspase related protein levels in ARPE-19 cells treated with 0, 2.5, 5, 10, 15 and 20 μmol/L of ATRA for 24 hours.Flow cytometry was used to detect the reactive oxygen species (ROS) and multicaspase levels and quantitative real-time PCR was carried out to determine the mRNA relative expression levels of caspase related proteins in ARPE-19 cells treated with 0, 2.5, 5, 10 and 20 μmol/L of ATRA, and 0 μmol/L ATRA group was used as the blank control group.Results:CCK-8 test showed that the half maximal inhibitory concentration of ARPE-19 cells treated with different concentrations of ATRA for 24 hours and 48 hours were 13.88 μmol/L and 11.99 μmol/L, respectively.The cell survival rates of ARPE-19 cells treated with different concentrations of ATRA for 24 hours and 48 hours were significantly different ( F=176.60, 350.30; both at P<0.01). When cultured for 24 hours, the cell survival rates of ARPE-19 cells in the 2 μmol/L and 6 μmol/L of ATRA groups were higher than that of the blank control group (both at P<0.05), and the cell survival rates of ARPE-19 cells in the 12, 14, 16, 18 and 20 μmol/L of ATRA groups were lower than that of the blank control group (all at P<0.05). Flow cytometry showed that there were significant differences in the apoptosis, ROS and multicaspase level among ARPE-19 cell groups treated with different concentrations of ATRA ( F=86.39, 116.84, 101.40; all at P<0.01). The apoptosis rates of APRE-19 cells in the 2.5 μmol/L and 5 μmol/L of ATRA groups were significantly decreased than that of the blank control group, and the apoptosis rate of APRE-19 cells in the 10, 15 and 20 μmol/L of ATRA groups were significantly increaseded than that of the blank control group (all at P<0.01). The relative expression levels of multicaspase and ROS were significantly higher in the 2.5, 5, 10 and 20 μmol/L of ATRA groups than that of the blank control group (all at P<0.01). Western blot assay showed that the relative expression level of caspase 9 was increased in the 2.5, 5, 10, 15 and 20 μmol/L of ATRA groups than that of the blank control group (all at P<0.05). Compared with the blank control group, the relative expression levels of caspase 12 were increased in the 2.5 μmol/L of ATRA group and reduced gradually in the 5, 10, 15 and 20 μmol/L of ATRA groups, among which there were significant differences between the blank control group and 2.5, 15, and 20 μmol/L of ATRA groups (all at P<0.05). The relative expression level of caspase 3 was significantly increased in the 5, 10 and 20 μmol/L of ATRA groups than that of the blank control group (all at P<0.05). The relative expression level of cleaved caspase 3 was significantly increased in the 2.5, 5, 10, 15 and 20 μmol/L of ATRA groups than that of the blank control group (all at P<0.01). Quantitative real-time PCR assay showed that the relative expression levels of caspase 9 and caspase 12 mRNA were significantly higher in the 2.5, 5, 10 and 20 μmol/L of ATRA groups than that of the blank control group (all at P<0.01). The relative expression levels of caspase 3 mRNA were significantly higher in the 5 μmol/L and 10 μmol/L of ATRA groups than that of the blank control group (both at P<0.01). When the concentration of ATRA was lower than 10 μmol/L, the relative expression levels of caspase 9 and caspase 12 mRNA were elevated in a concentration-dependent manner.When the concentration of ATRA reached 20 μmol/L, the relative expression levels of caspase 9 and caspase 12 mRNA were markedly decreased, but it was still higher than that of the blank control group. Conclusions:ATRA induces apoptosis in ARPE-19 cells in vitro through activating the reactive oxygen species and endogenous caspase-dependent apoptotic pathway.

12.
Article in Chinese | WPRIM | ID: wpr-907824

ABSTRACT

Vitamin D deficiency can be a trigger factor for recurrent oral ulcers. This article combining two cases of recurrent oral ulcers in patients with vitamin D deficiency who were cured by active vitamin D supplementation emphasizes that 25-hydroxyvitamin D and other indicators should be screened in patients with recurrent oral ulcers, so as to improve the understanding of the disease and the ability of clinical diagnosis and treatment for it.

13.
Article in Chinese | WPRIM | ID: wpr-907802

ABSTRACT

Hyperparathyroidism is a common endocrine disease that seriously affects human health, depending on its etiology, which can be divided into three types: primary, secondary and tertiary. In clinical practice, we found that some primary hyperparathyroidism may be secondary or tertiary hyperparathyroidism caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, and become a common type of hyperparathyroidism. The daily calcium intake of Chinese people is generally insufficient. Vitamin D can promote the absorption of calcium, but vitamin D deficiency/insufficiency is also a worldwide public health problem. Long-term hypocalcemia will stimulate parathyroid hyperplasia and secrete excessive parathyroid hormone, resulting in parathyroid hyperfunction (pre-hyperparathyroidism) and then secondary hyperparathyroidism, both of which may damage bone and release calcium into blood, leading to diseases of multiple organs and tissues. The detection of bone metabolism indexes such as calcium, magnesium, phosphorus, parathyroid hormone and vitamin D may be helpful for the early diagnosis of pre-hyperparathyroidism and hyperparathyroidism. Supplementation of calcium and vitamin D in early stage can control the development of the disease and change "unpreventable and uncontrollable" into "preventable and controllable" . The health screening of bone metabolism indexes and parathyroid ultrasonography should be advocated, and the prevention and treatment of calcium and/or vitamin D insufficiency associated parathyroid hyperfunction and hyperparathyroidism should be strengthened, so as to greatly improve the bone health, urinary calculus, metastatic vascular calcification and systemic abnormal calcium migration and precipitation in the population.

14.
Article in Chinese | WPRIM | ID: wpr-907756

ABSTRACT

Objective:To analyze the early volume characteristics of patients with severe cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the relationship between their early volume and the prognosis.Methods:This study reviewed patients of Emergency Medical University , treated with VA-ECMO and screened the patients with severe cardiogenic shock and VA-ECMO running more than 72 h for further study. The basic condition of the patients was recorded, and the fluid balance in the first 72 h was analyzed. The patients were grouped according to their fluid balance in the first 72 h. The gender, age, survival rate, continuous renal replacement therapy (CRRT) rate, intra-aortic balloon pump (IABP) rate, and invasive mechanical ventilation rate were compared between the two groups, and the relative risk to the prognosis was calculated. The prognosis was compared between the two groups. Results:Totally 77 patients with severe cardiogenic shock were enrolled. Forty-one cases survived, with an overall survival rate of 53.2%. The volume balance at 48-72 h and the total volume balance at the first 72 h were different between the survival and dead groups. Compared with the positive balance group, patients in the negative balance group were less likely to receive CRRT or invasive mechanical ventilation during the first 72 h. Patients in the negative balance group during the first 72 h had a better survival rate, and their relative risk of survival was 1.81 (95% confidence interval: 1.101, 2.985). However, there was no significant difference in survival rate according to every 24 h fluid balance.Conclusions:Patients with severe cardiogenic shock treated with VA-ECMO who had negative total volume balance during the first 72 h are more likely to survive and less likely to require CRRT or invasive mechanical ventilation.

15.
Article in Chinese | WPRIM | ID: wpr-907755

ABSTRACT

Objective:To study the application of blood products in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and evaluate its effect on the prognosis.Methods:A total of 83 adult patients treated with VA-ECMO in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to January 2020 were grouped by survival to explore the risk factors of 28-day mortality using binary logistic regression, and the threshold was calculated by ROC curve.Results:Platelet transfusion ( OR=2.506, 95% CI: 1.142-5.499) and non-myocarditis disease ( OR=6.881, 95% CI: 1.615-29.316) were the risk factors of 28-day mortality in adult VA-ECMO patients. The threshold of platelet transfusion was 0.427 mL/(kg·d) (sensitivity 78.4%, specificity 69.6% , AUC 0.735). Conclusions:The increased platelet transfusion is related to the poor prognosis of adult patients with VA-ECMO. Refractory myocarditis patients are better treated with VA-ECMO.

16.
Article in Chinese | WPRIM | ID: wpr-907748

ABSTRACT

Objective:To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) support in acute myocardial infarction (AMI) complicated by cardiogenic shock.Methods:Thirty-seven AMI patients received ECMO from March 2016 to October 2020 in Emergency Department of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Gensini score was used to evaluate the coronary lesion severity, vasoactive-inotropic score (VIS) was used to assess the usage of vasoactive-inotropic drugs, and cumulative fluid balance (CFB) was used to calculate the fluid balance status, respectively. According to the infarct-related artery, positive/negative fluid balance, and survival/death outcome, the patients were divided into the negative and positive fluid balance groups, and the survival and death groups, respectively. The relationship between Gensini score, 24-hVIS, CFB and patient outcome was analyzed.Results:Thirty AMI-ECMO patients were enrolled, 12 patients survived and 18 died with a mortality rate of 60.0%, and 80.0% of the infarct-related artery were left main and proximal left anterior descending artery. The Gensini score was 77 (52, 120), 24-h VIS 50.0 (31.1, 80.4), daily fluid volume 28.7 (26.6, 34.4) mL/(kg·d), and CBF -1.8 (-9.7, 8.0) mL/kg. The mortality and 24-h VIS of the negative fluid balance group were significantly lower than those of the positive fluid balance group, and the Gensini score, 24-h VIS and CBF of the survival group were significantly lower than those of the death group.Conclusions:LM and pLAD are the most common infarct-related arteries in AMI-ECMO patients, the Gensini score and 24-h VIS have a certain prognostic value, and early negative fluid balance may improve the survival rate.

17.
Article in Chinese | WPRIM | ID: wpr-906420

ABSTRACT

Objective:To explore the effects and mechanism of Chinese classical prescription Dahuang Zhechongwan on silicosis in mice. Method:Thirty-six male Kunming mice of SPF grade were randomized into the normal control group, model control group, tetrandrine (Tet, 0.039 mg·kg<sup>-1</sup>) group, as well as high- (1.560 g·kg<sup>-1</sup>), medium- (0.780 g·kg<sup>-1</sup>), and low-dose (0.390 g·kg<sup>-1</sup>) Dahuang Zhechongwan groups, with six mice in each group. Mice in all groups except for the normal control group underwent static inhalation of silica (SiO<sub>2</sub>) dust for 40 consecutive days to induce fibrosis. After 28 days of intervention with corresponding drugs, the mice were sacrificed to collect the serum and lung tissues, with the former used for detecting tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-1<italic>β </italic>(IL-1<italic>β</italic>), IL-6, and hydroxyproline (HYP) levels by enzyme-linked immunosorbent assay (ELISA) and the latter for observing the pathological changes. Meanwhile, the protein and mRNA expression levels of p38 mitogen-activated protein kinase (p38 MAPK), nuclear transcription factor-<italic>κ</italic>B (NF-<italic>κ</italic>B), transforming growth factor-<italic>β</italic><sub>1</sub> (TGF-<italic>β</italic><sub>1</sub>), <italic>α</italic>-smooth muscle actin (<italic>α</italic>-SMA), Smad2, Smad3, and Smad7 in the lung tissues were determined by Western blot and real-time polymerase chain reaction (Real-time PCR). Result:Compared with the normal group, the contents of TNF-<italic>α</italic>, IL-1<italic>β</italic>, IL-6 and HYP in the model group were significantly increased, the difference was statistically significant(<italic>P</italic><0.05,<italic>P</italic><0.01); compared with the model group, the high-dose group of Dahuang Zhechongwan could significantly reduce the contents of TNF-<italic>α</italic>, IL-6 and HYP in the serum of mice(<italic>P</italic><0.05, <italic>P</italic><0.01), indicating that Dahuang Zhechongwan could reduce the lung inflammation of silicosis mice. At the same time, compared with the normal group, the protein and mRNA expression levels of p38 MAPK, NF-<italic>κ</italic>B p65, TGF-<italic>β</italic><sub>1</sub>, <italic>α</italic>-SMA, Smad2 and Smad3 in the model group were significantly increased(<italic>P</italic><0.05,<italic>P</italic><0.01), while the protein and mRNA expression levels of Smad7 were significantly decreased(<italic>P</italic><0.01); compared with the model group, the protein and mRNA expression levels of p38 MAPK, NF-<italic>κ</italic>B p65, TGF-<italic>β</italic><sub>1</sub>, <italic>α</italic>-SMA, Smad2 and Smad3 in the high-dose Dahuang Zhechongwan group were significantly increased the protein and mRNA expression levels were significantly decreased(<italic>P</italic><0.05,<italic>P</italic><0.01), while Smad7 protein and mRNA expression levels were significantly increased(<italic>P</italic><0.05,<italic>P</italic><0.01). Conclusion:Dahuang Zhechongwan ameliorates the alveolar inflammation, extracellular matrix (ECM) deposition, and fibrosis in mice with silicosis possibly by regulating the p38 MAPK/NF-<italic>κ</italic>B/TGF-<italic>β</italic><sub>1</sub> pathway.

18.
Article in Chinese | WPRIM | ID: wpr-906166

ABSTRACT

Dahuang Zhechongwan (DHZCW) is a classic prescription from the Jingui Yaolue(《金匮要略》) by ZHANG Zhong-jing,with the effects of tonifying deficiency, relaxing the middle, promoting regeneration, and resolving stasis. It has been widely used in the clinical treatment of various diseases with definite efficacy achieved. The research on multiple organ fibrosis has shown that DHZCW can slow down the development of organ fibrosis in the heart, liver, kidney, lung, etc., and good results in both clinical practice and experimental research have been obtained. The present study reviewed the previous investigations on the experimental mechanism of DHZCW in the treatment of multiple organ fibrosis and revealed that the pathogenesis was closely related despite different disease sites. From the perspective of traditional Chinese medicine (TCM),these diseases shared a common pathogenesis,which was manifested by deficiency. Long-term diseases led to the formation of "dried blood". From the perspective of modern medicine, the diseases all showed pathological changes in the deposition of extracellular matrix (ECM), and their occurrence and development were all based on certain effector cells [such as hepatic stellate cell (HSC) and pancreatic stellate cell (PSC)], with same cytokines [such as tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),IL-1β,and α-smooth muscle actin (α-SMA)] and some key pathways [transforming growth factor-β1 (TGF-β1)/Smad, phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt), and lipopolysaccharide (LPS) paracrine and autocrine mechanisms] involved. As a classic prescription for "deficiency-induced dry blood", DHZCW was effective in treating fibrosis, which was presumedly related to the inhibition of ECM deposition by intervening in the above-mentioned mechanisms, thereby delaying the disease progression. This study is expected to provide literature support to clarify the scientific connotation of DHZCW in the treatment of multiple organ fibrosis and lay a foundation for further experimental and clinical research.

19.
Article in Chinese | WPRIM | ID: wpr-905870

ABSTRACT

Objective:To evaluate the clinical efficacy and safety of Longmu Zhuanggu granule for the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency. Method:This multicenter stratified, block-randomized, double-blind, double-dummy, positive drug (pidotimod granule) parallel controlled, and non-inferiority trail intended to included 240 children patients and divided them into the experimental group (<italic>n</italic>=120) and the control group (<italic>n</italic>=120) at the ratio of 1∶1. Patients in both groups were treated for eight successive weeks and followed up for 12 months. The cure rates, numbers of respiratory infections, average courses of disease, curative effects of traditional Chinese medicine (TCM) syndrome, curative effects of individual symptoms, curative effects of immune indexes, and safety indexes between the two groups were observed and compared. Result:A total of 237 subjects were collected from 10 research centers, including 119 cases in the control group and 118 in the experimental group. There were 236 cases enrolled into the full analysis set (FAS), 210 into the per-protocol set (PPS), and 236 into the safety set (SS). The baseline data of the two groups were not significantly different from each other, indicating that they were comparable. The cure rates of the experimental group and control group were 75.21% (88/117) and 73.95%(88/119), respectively, with the 95% confidence interval (CI) of difference between the two groups being 1.26% (-9.85%,12.37%) for FAS and 3.81% (-6.28%,13.90%) for PPS. The 95% CI fell within the 10% non-inferiority margin, implying that non-infertility test of the cure rate in the treatment of endpoint disease was valid, and the conclusions of FAS and PPS analysis were consistent. There was no significant difference in the number or course of upper respiratory infection, bronchitis, and pneumonia. The difference in curative effects of TCM syndrome between the two groups after four weeks of treatment was not remarkable. After eight weeks of treatment, the total effective rate of the experimental group was 84.62%(99/117), statistically higher than 78.15%(93/119) of the control group(<italic>χ</italic><sup>2</sup>=-3.26,<italic>P</italic><0.05). There were no significant differences in the disappearance rates of individual symptoms between the two groups after four weeks of treatment. After eight weeks of treatment, the experimental group and control group exhibited the disappearance rates of 67.50%(54/80) and 47.37%(36/76) for shortness of breath and laziness to speak, 75.00%(54/72) and 53.33%(40/75) for poor appetite, 54.55%(60/110) and 37.84%(42/111) for hyperhidrosis, respectively, with obviously better outcomes observed in the experimental group (<italic>P</italic><0.05,<italic>P</italic><0.01). The inter-group comparison revealed significant differences in immune indexes after eight weeks of treatment. As demonstrated by comparison with the situations before treatment, IgA, IgG, IgM, and CD4 did not change significantly after treatment. Except for CD8 in the experimental group (<italic>P</italic><0.05), there was no significant difference in other immune indexes before and after treatment There was no significant difference in the incidence of adverse reactions. Conclusion:Longmu Zhuanggu granule is not inferior to pidomod granule in the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency, and it exhibits good safety, implying its promising clinical application value.

20.
Article in Chinese | WPRIM | ID: wpr-905197

ABSTRACT

Objective:To explore the clinical characteristics of urination disorders in multiple system atrophy (MSA). Methods:The clinical data and imaging urodynamic examination of twelve MSA patients with severe urination disorders from June, 2013 to March, 2021 were retrospectively analyzed. Results:Among twelve cases, there were eight cases with acontractile detrusor, one case with detrusor overactivity, one case with detrusor-sphincter dyssynergia, one case with filling detrusor hyperactivity and voiding-phase dyssynergia (DO+DSD), and one case with normal urodynamics. Conclusion:The clinical symptoms of MSA are complex, and the early diagnosis is difficult. Electrophysiological and MRI examinations can be helpful for diagnosis.

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