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1.
Chinese Journal of School Health ; (12): 333-337, 2022.
Article in Chinese | WPRIM | ID: wpr-923099

ABSTRACT

Objective@#To explore relationship between screen time and myopia in children aged 11-14 years in China.@*Methods@#The data were extracted from "National Nutrition and Health Systematic Survey and Application for 0-18 Years Old Children". A total of 12 397 children aged 11-14 years old from 14 provinces and 28 districts/counties in seven regions of China were surveyed by using multi stage stratified random sampling method. Daily screen time and visual acuity information were collected through a questionnaire.@*Results@#The myopia rate of 11-14 years old children in China was 45.0%, among which the rate of girls was higher than that of boys, and the rate of urban was higher than that of rural, and it increased with age ( χ 2=178.82,79.25, 495.96 , P <0.01). The daily screen time median of 12 397 children was 40.0 minutes, with boys(40.0 min) longer than girls( 35.0 min ) and urban children(40 min) longer than rural children(33.0 min) ( χ 2=20.86,102.68, P <0.01). The myopia rate of boys ( 42.5 %) with daily screen time greater than or equal to 60 minutes was higher than that of boys (36.4%) with daily screen time less than 60 minutes, and the myopia rate of girls (55.6%) with daily screen time greater than or equal to 60 minutes was higher than that of girls (48.0%)( χ 2=23.62,34.15, P <0.01). After adjusting for age, gender, region, time of medium and high intensity physical activity, intake of sugary food and sugary beverages, daily sleep time, multivariable Logistic regression model showed that girls with daily screen time greater than or equal to 60 minutes ( OR=1.14, 95%CI =1.03-1.27) had a higher risk of myopia than those with less than 60 minutes. After adjusting for confounding factors, there was no correlation between daily screen time and the degree of myopia in boys or girls( P >0.05).@*Conclusion@#Daily screen time greater than or equal to 60 minutes may be a risk factor for myopia in girls aged 11 to 14 years old. Given the complexity of the factors that affect vision, researches are needed to examine the relationship between screen time and myopia.

2.
China Pharmacy ; (12): 745-757, 2022.
Article in Chinese | WPRIM | ID: wpr-923013

ABSTRACT

OBJECTIVE To sy stematically evaluate the relations hip between immune-related adverse events (irAEs) and efficacy of immune checkpoint inhibitors (ICIs) in the treatment of non-small cell lung cancer (NSCLC),and to provide evidence-based reference for clinical application of ICIs and safety evaluation. METHODS PubMed,Embase,Cochrane Library , Web of Science ,CNKI,Wanfang database ,VIP and CBM were searched to collect prospective or retrospective cohort studies on the correlation between irAEs and efficacy of ICIs in the treatment of NSCLC. The retrieval time was from the inception to June 30th,2021. After literature screening and data extraction ,Newcastle-Ottawa scale was used to evaluate the quality of included literatures. Meta-analysis and publication bias analysis were performed by using RevMan 5.3 software;Stata 15.0 software was used for sensitivity analysis. RESULTS A total of 7 957 patients were included in 31 studies. Meta-analysis showed that the objective response rate (ORR)[RR=2.34,95%CI(1.98,2.76),P<0.000 01],progression-free survival (PFS)[HR=0.49,95%CI (0.44,0.55),P<0.000 01] and overall survival (OS)[HR=0.45,95%CI(0.39,0.53),P<0.000 01] of irAEs group as well as ORR[RR=1.88,95%CI(1.57,2.25),P<0.000 01],PFS [HR =0.59,95%CI(0.50,0.69),P<0.000 01] and OS [HR =0.58,95%CI (0.48,0.70),P<0.000 01] of this group at 6th week were all significantly higher or longer than non irAEs group. According to organ specificity ,severity and quantity of irAEs,subgroup analysis showed that skin ,gastrointestinal and endocrine system ,mild irAEs(grade 1-2)and one or more than 2 kinds of irAEs were significantly correlated with the improvement of PFS and OS (P< 0.05),while liver and lung ,severe irAEs(≥ grade 3)were not significantly correlated with the improvement of PFS and com OS (P>0.05). Sensitivity analysis results showed that the results of the above-mentione d meta-analysis were relatively robust. The results of publication bias showed that there was may be some possibility of publication bias in this study. CONCLUSIONS For NSCLC patients treated with ICIS ,the occurrence of irAEs may be related to their good prognosis. The irAEs may be a predictor of the efficacy of ICIs.

3.
Article in Chinese | WPRIM | ID: wpr-911745

ABSTRACT

In order to provide efficient medical care to atrial fibrillation patients in the community, the Huamu Community Health Service Center in association with its medical consortium, Renji Hospital have developed a novel atrial fibrillation management system. With the collaboration of general practitioners and specialist team from the tertiary hospital, a special clinic for atrial fibrillation has been set up in the community health service center, which is based on the internet technology and the medical consortium platform. This article introduces the development of this novel system and the initial outcome of the measures, to provide a reference for the management of atrial fibrillation patients in the community.

4.
Article in Chinese | WPRIM | ID: wpr-911239

ABSTRACT

Objective:To evaluate the efficacy of continuous infusion of lidocaine via urinary catheter for postoperative analgesia in patients undergoing urological surgery.Methods:Forty male American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective percutaneous nephrolithotomy, were divided into 2 groups ( n=20 each) using a random number table method: continuous infusion of lidocaine through urinary catheter group (group L) and patient controlled intravenous analgesia (PCIA) group (group PCIA). All the patients underwent total intravenous anesthesia, and a matched type of sterile urethral irrigation catheter was inserted after the operation.In group L, 0.5% lidocaine was continuously infused at a rate of 5 ml/h via the urinary catheter, while the equal volume of 0.9% normal saline was continuously infused via the urinary catheter, and PCIA was connected in group PCIA.PCIA solution contained sufentanil 125 μg (diluted to 250 ml in normal saline), and the PCA pump was set up with a 5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 5 ml/h.When visual analogue score was>4, sufentanil 0.05 μg/kg was injected intravenously as rescue analgesic.The development and severity of catheter-related bladder discomfort (CRBD) were recorded immediately at the end of the operation (T 1), and at 6 h (T 2), 24 h (T 3) and 48 h (T 4) after the operation, respectively.Riker sedation-agitation scale (SAS) score was recorded at T 1, 2, and QoR-9 scale was recorded at T 3, 4.The concentrations of serum cortisol (Cor), norepinephrine (NE), epinephrine (E) and blood glucose (Glu) were measured by enzyme linked immunosorbent assay.First off-bed time, exhaust time, length of hospital stay after surgery, and the requirement for rescue analgesia and adverse reactions (nausea and vomiting, respiratory depression, hypotension, skin itching) within 48 h after the operation were recorded. Results:Compared with group PCIA, the incidence of CRBD and the severity were significantly decreased at T 1-4, SAS score was decreased at T 1, 2, QoR-9 score was increased at T 3, 4, Cor, NE, E and Glu concentrations were decreased at T 1-4, the incidence of postoperative rescue analgesia was decreased, first off-bed time, exhaust time and length of hospital stay after surgery was shortened, and the incidence of postoperative nausea and vomiting, respiratory depression, hypotension, skin itching was decreased in group L ( P<0.05). Conclusion:Continuous infusion of lidocaine through the urinary catheter can provide good postoperative analgesia, reduce postoperative stress response and adverse reactions, and facilitate early postoperative recovery in patients undergoing urological surgery.

5.
Article in Chinese | WPRIM | ID: wpr-908660

ABSTRACT

Objective:To analyze the correlation between serum ferritin (SF), perilipin, leptin and the outcome of patients with gestational diabetes mellitus (GDM).Methods:From October 2017 to December 2019, 126 patients with GDM who underwent maternity checkups in Baoding Fourth Central Hospital and gave birth were selected as the GDM group, and 82 normal pregnant women during the same period were selected as the control group for retrospective analysis. The levels of serum SF, perilipin, and leptin in the GDM group and the control group were measured and compared, and the expressions of serum indexes of patients with different blood glucose control and different pregnancy outcomes in the GDM group were measured. Pearson correlation analysis was used to explore the correlation between the expression of serum indexes in GDM patients and fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), and insulin resistance index (HOMA-IR). Logistic regression was used to analyze the relationship between the expression of serum indicators and adverse pregnancy outcomes in GDM patients. The receiver operating characteristic (ROC) curve was used to observe the value of single serum indexes and to predict the pregnancy outcome of GDM patients.Results:The levels of SF, perilipin and leptin in GDM group were higher than those in control group: (152.48 ± 37.64) μg/L vs. (109.27 ± 32.16) μg/L, (857.06 ± 192.35) ng/L vs. (262.83 ± 104.7) ng/L, (23.54 ± 2.28) μg/L vs.(14.62 ± 1.83) μg/L, the differences were statistically significant ( P<0.05). The levels of SF, perilipin and leptin in patients with good blood glucose control in GDM group were lower than those in patients with poor blood glucose control: (132.10 ± 36.52) μg/L vs. (176.37 ± 40.06) μg/L, (176.37 ± 40.06) ng/L vs. (946.42 ± 205.37) ng/L, (21.49 ± 2.16) μg/L vs. (25.94 ± 2.40) μg/L, the differences were statistically significant ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients were positively correlated with FPG, 2 h PG and HOMA-IR levels ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients with adverse pregnancy outcomes were higher than those in patients without occurrence: (182.86 ± 42.29) μg/L vs. (138.86 ± 35.47) μg/L, (1 013.35 ± 216.07) ng/L vs. (787.00 ± 183.49) ng/L, (27.04 ± 2.5) μg/L vs. (21.97 ± 2.07) μg/L, the differences were statistically significant ( P<0.05). Logistic regression analysis showed that serum SF, perilipin and leptin were closely related to the adverse pregnancy outcomes in GDM patients ( P<0.05). ROC curve analysis showed that the sensitivity and the specificity of SF, perilipin, leptin combined detection to predict GDM patients with adverse pregnancy outcomes was 76.92% and 83.91%. Conclusions:The serum SF, perilipin and leptin are abnormally high expression in GDM patients, and it is positively correlated with blood glucose level and HOMA-IR. Joint detection can improve the predictive value of adverse pregnancy outcomes and provide a basis for early intervention.

6.
Article in Chinese | WPRIM | ID: wpr-907918

ABSTRACT

Objective:To summarize the causes of death and severe complication in the early diagnosis of children with neuroblastoma (NB), and to analyze the relative factors of early death of children with NB, so as to raise awareness and reduce early mortality by early detection and early intervention.Methods:Patients with newly diagnosed NB in the Hematology Oncology Center of Beijing Children′s Hospital from April 2007 to December 2017 were included consecutively, and those died within 1 month after diagnosis were retrospectively analyzed.The general data of patients, immediate causes of death, complications, time elapsed between death and diagnosis, whether to receive chemotherapy and other information were collected.Results:A total of 654 cases were included for diagnosis, treatment and follow-up, 31 cases of which died in early stage, accounting for 4.7% of the total.The major complication were pulmonary infection in 18 cases (58.1%) and bone marrow suppression after chemotherapy in 17 cases (54.8%), tumor rupture hemorrhage in 16 cases (51.6%), multiple organ failure in 8 cases (25.8%). Risk factor analysis of the 31 early death cases with NB was conducted.Single factor analysis: there were statistical differences between early death group and non-early death group in risk grouping ( P=0.006 6), bone marrow invasion ( P=0.020 7), site of primary tumor ( P=0.016 7), age ( P=0.003 3), lactate dehydrogenase (LDH) level ( P<0.000 1), neuron-specific enolase (NSE) level ( P<0.000 1), serum ferritin level ( P=0.016 0), D dimer level ( P<0.000 1), fibrinogen level ( P=0.002 7), diameter of tumor ( P<0.000 1), hemoglobin ( P<0.000 1), platelet level ( P<0.000 1), serum albumin level ( P<0.000 1). Multiple-factor analysis: age younger than 30 months, OR=2.824 (95% CI: 1.084-7.359), LDH level greater than 1 004 IU/L, OR=6.991 (95% CI: 2.135-22.887), albumin level less than 36 g/L, OR= 65.237 (95% CI: 2.024-13.545), hemoglobin level less than 92 g/L, OR=5.358 (95% CI: 2.024-13.545), platelet level less than 192×10 9/L, OR=3.554 (95% CI: 1.267-9.965). Conclusions:Strengthening vital signs detection after admission, identifying severe life-threatening complications such as rupture of tumors as early as possible, implementing symptomatic interventions such as appropriate sedation and active transfusion of blood products as early as possible after invasive operation, and transferring to intensive care unit for respiratory support when necessary are important means to avoid early death.

7.
Article in Chinese | WPRIM | ID: wpr-907611

ABSTRACT

Objective:To explore the effect of auricular point pressing pill combined with rhubarb acupoint application on intestinal preparation and prevention of adverse events in colonoscopy.Methods:A total of 220 patients who met the inclusion criteria from May 2019 to February 2020 were randomly divided into 4 groups, 55 in each group. The control group was only given compound polyethylene glycol electrolyte powder. The auricular plaster group was combined with auricular point pressing pill on the basis of the control group. The acupoint sticking group was combined with rhubarb acupoint application on the basis of the control group. The combination group was combined with auricular point pressing pill and rhubarb acupoint application on the basis of the control group. The quality of bowel preparation was evaluated by Boston Bowel Preparation Scale(BBPS), and the adverse events such as perianal discomfort, defecation discomfort, abdominal pain and abdominal distension were observed.Results:After treatment, there was significant difference in BBPS score among the four groups ( F=3.038, P=0.030). The BBPS score in the acupoint sticking group (7.45 ± 1.20 vs. 6.78 ± 1.32) and combination group (7.26 ± 1.11 vs. 6.78 ± 1.32) were significantly higher than those in the control group( P<0.05). After treatment, there were significant differences in abdominal pain and abdominal distension scores among the four groups ( F=2.947, 5.879, P=0.034, 0.001). The scores of perianal discomfort (0.07 ± 0.38 vs. 0.44 ± 1.07), defecation discomfort (0.40 ± 0.81 vs. 0.87 ± 1.32) and abdominal pain (0.93 ± 1.32 vs. 1.69 ± 1.61) in the combination group were significantly lower than those in the control group ( P<0.05), and the abdominal distension score (1.05 ± 1.00 vs. 1.64 ± 0.95) in the acupoint sticking was significantly lower than that of the control group ( P<0.05). Conclusion:Auricular combined with rhubarb powder acupoint application can improve the quality of bowel preparation and reduce intestinal adverse reactions. It can be used with polyethylene glycol electrolyte powder for the intestinal preparation process.

8.
Article in Chinese | WPRIM | ID: wpr-907242

ABSTRACT

Airway epithelial barrier dysfunction has been observed in allergic asthma patients.Inhaled allergens have shown a disruptive effect on the airway epithelial barrier.Airway barrier related genetic variation and epigenetics are also involved in the airway epithelial barrier dysfunction.A lot of studies believe that airway epithelial barrier dysfunction underlie the development of asthma.The study of the relationship between allergic asthma and airway epithelial barrier function will be helpful to understand the pathogenesis of allergic asthma and provide new ideas for the treatment of allergic asthma.

9.
Article in Chinese | WPRIM | ID: wpr-906473

ABSTRACT

Objective:To investigate the effect of Huayu Jiedu prescription (HYJDP) on gut microbiota and fecal metabolites in mice with endometriosis. Method:Normal female C57BL/6J mice were divided into normal control group (CO), endometriosis group (EM) and Chinese medicine Huayu Jiedu decocotion group (CM). CO and EM groups received normal saline and CM group received HYJDP by intragastric administration. Untargeted metabolomics method was used to detect metabolites in fecal supernatant of mice, and receiver operating characteristic (ROC) analysis was used to screen the differential metabolites, 16S rRNA high-throughput sequencing was used to detect the gut microbiota, and Spearman correlation coefficient was used to represent the degree of correlation between differential metabolites and intestinal flora. Lipopolysaccharides (LPSs) in intestinal wall tissue, serum and peritoneal lavage fluid were detected by enzyme-linked immunosorbent assay (ELISA). The expression of Vimentin and E-cadherin in ectopic lesions was detected by immunohistochemistry. Result:HYJDP alleviated the disorders of fecal metabolites and gut microbiota in EMS mice, especially with the recovered levels of homoveratric acid, melilotoside C and physapubescin in fecal supernatant. In the comparison of these three factors between EM group and CO group as well as between EM group and CM group, the variable important in projection (VIP) value was both above 2, and AUC in ROC analysis was both >0.9. As compared with EM group, HYJDP restored the abundance of species such as <italic>Lachnospiraceae_NK4A136_group</italic>, <italic>Lactobacillus</italic> and <italic>Blautia </italic>(<italic>P</italic><0.05). In addition, the level of LPS in peritoneal fluid supernatant of EM group was significantly higher than that of CO group (<italic>P</italic><0.05) and CM group (<italic>P</italic><0.05). The protein expression of vimentin and E-cadherin in endometriosis decreased significantly (<italic>P</italic><0.05). Conclusion:HYJDP which can improve the intestinal environment and reduce the level of LPS in mice with endometriosis, is an effective drug for the treatment of endometriosis.

10.
Chinese Journal of Digestion ; (12): 100-106, 2021.
Article in Chinese | WPRIM | ID: wpr-885736

ABSTRACT

Objective:To explore the expression of polypyrimidine tract-binding protein 1 (PTBP1) in gastric cancer (GC) tissues and GC cell lines, and the role of PTBP1 in the proliferation and metastasis of GC cells.Methods:From January to June in 2019 at The First Affiliated Hospital of Xi′an Jiaotong University, the cancer tissues and corresponding para-cancer tissues of GC patients underwent surgical resection were collected. The Kaplan-Meier Plotter database was used to analyze the survival of GC patients. The expression of PTBP1 was down-regulated by transfecting small interfering RNA (siRNA) in human GC cell lines SGC7901 and AGS with relatively high expression of PTBP1. The cells were divided into blank control group, negative control group, and PTBP1 knockdown group. The expression of PTBP1 at mRNA and protein level were detected by real-time fluorescence quantification polymerase chain reaction (RT-qPCR) and Western blotting. At 24, 48, 72 and 96-hour after transfection, the effect of PTBP1 on the proliferation of GC cells was observed by 3-(4, 5 dimethylthiazol)-2, 5 diphenyltetrazolium bromide (MTT) experiment. The changes of invasion and migration of GC cells after down-regulation of PTBP1 were detected by transwell assay. The expression changes of epithelial-mesenchymal transition (EMT) markers E-cadherin, N-cadherin and vimentin after down-regulation of PTBP1 in GC cells were determined by Western blotting. Indenpendent samples t test, analysis of variance and rank sum test were used for statistical analysis. Results:The Kaplan-Meier Plotter prognostic analysis showed that the overall survival of GC patients with high PTBP1 expression was shorter than that of GC patients with low PTBP1 expression (9.2 months, 6.2 months to 17.2 months vs. 19.0 months, 14.5 months to 28.4 months), and the difference was statistically significant ( Z=5.31, P<0.05). The results of RT-qPCR showed that in GC cell lines SGC7901 and AGS, the expression of PTBP1 at mRNA level of PTBP1 knockdown group was lower than that of blank control group and negative control group (SGC7901: 0.78±0.11 vs.3.10±0.19 and 2.99±0.23; AGS: 0.80±0.09 vs. 3.55±0.24 and 3.50±0.18), and the differences were statistically significant ( tSGC7901=10.57 and 8.08, tAGS=10.91 and 13.42; all P<0.01). The results of Western blotting indicated that in GC cell lines SGC7901 and AGS, the expression of PTBP1 at protein level of PTBP1 knockdown group was lower than those of blank control group and negative control group (SGC7901: 0.38±0.04 vs. 1.42±0.05 and 1.35±0.09; AGS: 0.17±0.02 vs. 1.52±0.08 and 1.38±0.45), and the differences were statistically significant ( tSGC7901=15.94 and 10.57, tAGS=16.60 and 20.80; all P<0.01). The results of MTT showed that at 48, 72 and 96-hour after transfection the absorbance values of PTBP1 knockdown group decreased by 0.25±0.01, 0.38±0.02, and 0.84±0.04 as compared with those of negative control group, and the decrease was the most significant at 96-hour after transfection, and the differences were statistically significant ( t=10.21、14.32, both P<0.01). The results of transwell experiment demonstrated that the number of invasion and migration cells of PTBP1 knockdown group were both less than that of the blank control group and the negative control group (SGC7901: 42.00±5.91 vs. 116.40±10.23 and 114.40±10.43; 39.60±6.77 vs. 125.80±11.51 and 122.40±5.90; AGS: 40.20±7.25 vs. 115.60±14.63 and 117.40±9.12; 36.00±5.20 vs. 122.40±12.10 and 125.40±12.74), and the differences were statistically significant ( tSGC7901=14.07, 13.50, 14.43 and 20.62; tAGS=10.27, 14.75, 14.68 and 16.76; all P<0.01). The results of Western blotting showed that the expression of E-cadherin of PTBP1 knockdown group was higher than that of the blank control group and the negative control group (SGC7901: 1.42±0.05 vs. 0.53±0.05 and 0.57±0.03; AGS: 1.34±0.04 vs. 0.54±0.03 and 0.61±0.01), however the expression levels of N-cadherin and vimentin were both lower than those of the blank control group and the negative control group (SGC7901: 0.50±0.03 vs. 1.64±0.05 and 1.46±0.07; 0.32±0.07 vs. 1.42±0.07 and 1.33±0.07; AGS: 0.37±0.06 vs. 1.47±0.04 and 1.36±0.04; 0.41±0.04 vs. 1.53±0.06 and 1.37±0.04), and the differences were statistically significant ( tSGC7901=11.63, 13.19, 18.83, 11.68, 11.43 and 10.43; tAGS= 15.02, 16.23, 14.67, 12.97, 14.45 and 17.18; all P<0.01). Conclusions:The expression levels of PTBP1 increase in GC tissues and cells, which may be involved in regulating the proliferation, metastasis and EMT of GC cells.

11.
Article in Chinese | WPRIM | ID: wpr-879817

ABSTRACT

OBJECTIVE@#To study the role of vascular endothelial growth factor-A (VEGF-A) in pulmonary vascular remodeling in neonatal rats with hypoxic pulmonary hypertension (HPH) by regulating survivin (SVV).@*METHODS@#A total of 96 neonatal rats were randomly divided into three groups: HPH+VEGF-A group, HPH group, and control group. Each group was further randomly divided into 3-, 7-, 10-, and 14-day subgroups (@*RESULTS@#The HPH group had a significantly higher mean RVSP than the control and HPH+VEGF-A groups at each time point (@*CONCLUSIONS@#Prophylactic intratracheal administration of exogenous VEGF-A in neonatal rats with HPH can inhibit pulmonary vascular remodeling and reduce pulmonary arterial pressure by upregulating the expression of SVV in the early stage of hypoxia. This provides a basis for the interventional treatment of pulmonary vascular remodeling in neonatal HPH.


Subject(s)
Animals , Animals, Newborn , Hypertension, Pulmonary/etiology , Hypoxia , Pulmonary Artery , Rats , Rats, Wistar , Vascular Endothelial Growth Factor A , Vascular Remodeling
12.
China Pharmacy ; (12): 1506-1514, 2021.
Article in Chinese | WPRIM | ID: wpr-881290

ABSTRACT

OBJECTIVE:To systematically evaluate the occurren ce of non-immune related adverse events (AEs)caused by immune checkpoint inhibitors (ICIs)alone or combined with routine chemotherapy in the treatment of non-small cell lung cancer (NSCLC),and to provide evidence-based reference for clinical medication. METHODS :Retrieved from PubMed ,Cochrane Library,Embase,CNKI,CBM,VIP and Wanfang database during the inception to Oct. 2020,randomized controlled trials (RCT) about ICIs alone or combined with routine chemotherapy (trial group )versus routine chemotherapy or placebo combined with routine chemotherapy (control group ) were collected. After literature screening and data extraction ,the quality of included literatures were evaluated with bias risk evaluation tool recommended by Cochrane systematic evaluator manual 5.1.0. Meta-analysis was performed by using Rev Man 5.3 software and Stata 15.0 software. Sensitivity analysis was conducted with Stata 15.0 software. Inverted funnel plot and Egger ’s test were used to analyze publication bias. RESULTS :A total of 20 RCTs were included , involving 12 283 patients. Results of Meta-analysis showed that the incidence of all grades and s evere AEs ,anemia,neutropenia, vomiting and alopecia as well as the incidence of thrombocytopenia,nausea and peripheral neuropathy in all grades of trial group were all significantly lower than control com group(P<0.05). There was no statistical significance in the incidence of termination of treatment , death, severe thrombocytopenia, severe nausea and severe peripheral neuropathy or all grades and severe diarrhea between 2 groups(P>0.05). Subgroup analysis showed that the incidence of all grade and total severe AEs ,the incidence of anemia ,neutropenia,thrombocytopenia,clinically relevant symptoms (except for severe diarrhea),termination of treatment and death of patients receiving ICIs alone in trial group were significantly lower than control group(P<0.05). The incidence of ermination of treatment and death ,the incidence of nausea ,vomiting,diarrhea and alopecia in all grade ,severe diarrhea of patients receiving ICIs and chemotherapy in trial group were all significantly higher than control group (P<0.05). Sensitivity analysis supported the above results. Analyze publication bias results showed that the possibility of publication bias in this study was small. CONCLUSIONS :For NSCLC patients ,the safety of ICIs is better than that of routine chemotherapy or placebo combined with routine chemotherapy in the treatment-related AEs ,hematologic toxicity and clinically relevant symptoms ;however,the risks of treatment discontinuation ,AEs-induced deaths ,and all-grade nausea ,vomiting, diarrhea,alopecia and severe diarrhea will be increased in the ICIs combined with routine chemotherapy.

13.
Acta Pharmaceutica Sinica B ; (6): 100-111, 2021.
Article in English | WPRIM | ID: wpr-881127

ABSTRACT

@#The antimicrobial peptide APKGVQGPNG (named YD), a natural peptide originating from Bacillus amyloliquefaciens CBSYD1, exhibited excellent antibacterial and antioxidant properties in vitro. These characteristics are closely related to inflammatory responses which is the central trigger for liver fibrosis. However, the therapeutic effects of YD against hepatic fibrosis and the underlying mechanisms are rarely studied. In this study, we show that YD improved liver function and inhibited the progression of liver fibrosis by measuring the serum transaminase activity and the expression of α-smooth muscle actin and collagen I in carbon tetrachloride-induced mice. Then we found that YD inhibited the level of miR-155, which plays an important role in inflammation and liver fibrosis. Bioinformatics analysis and luciferase reporter assay indicate that Casp12 is a new target of miR-155. We demonstrate that YD significantly decreases the contents of inflammatory cytokines and suppresses the NF-κB signaling pathway. Further studies show that transfection of the miR-155 mimic in RAW264.7 cells partially reversed the YD-mediated CASP12 upregulation, the downregulated levels of inflammatory cytokines, and the inactivation of the NF-κB pathways. Collectively, our study indicates that YD reduces inflammation through the miR-155–Casp12–NF-κB axis during liver fibrosis and provides a promising therapeutic candidate for hepatic fibrosis.

14.
Article in Chinese | WPRIM | ID: wpr-883547

ABSTRACT

Objective:To explore and evaluate the application of flipped classroom in the integrated curriculum of pathology and pathophysiology overview.Methods:This study included in 172 students from the 8-year program of clinical medicine of Batch 2016 (observation group), and 142 students of Batch 2014 (control group). The observation group adopted traditional classroom teaching combined with flipped classroom teaching, and the control group used only traditional classroom teaching. In the observation group, the teaching contents were redesigned in the form of flipped classroom. The relevant knowledge points were provided before class. Group discussions and in-class presentations were used in the teaching. And the cultivation of students' learning autonomy, interaction and innovation were emphasized. The teaching evaluation was obtained from the questionnaire survey and final exam performance of the two groups of students. SPSS 21.0 was used for t test. Results:Students in the observation group had high satisfaction with flipped classroom which was helpful to improve students' independent learning ability, oral expression ability and innovative thinking ability. However, there was no significant difference in the final exam scores between the two groups ( P=0.306). Conclusion:Flipped classroom teaching can improve students' interest in learning and stimulate their independent learning and innovation. However, the teaching effect evaluated only by the final performance can't reflect the superiority of flipped classroom, which should be assessed by more evaluation indexes.

15.
Article in Chinese | WPRIM | ID: wpr-883394

ABSTRACT

Objective:To analyze the influencing factors of short-term prognosis, and construct a 30-day mortality risk prediction model for patients with cardiogenic shock in Xinjiang region with nomogram.Methods:The clinical data of 295 patients with cardiogenic shock from 2013 to 2019 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. Univariate and multivariate Logistic regression were used to analyze the risk factors for 30-day death in patients with cardiogenic shock, the nomogram was used to construct a prediction model for the risk of death in patients with cardiogenic shock, and the consistency coefficient and receiver operating characteristic (ROC) curve were used to evaluate the model.Results:Among 295 patients, 182 died at 30 d (death group) and 113 survived (survival group). There were statistical differences in gender, age, ICU time, systolic blood pressure, white blood cell, neutrophil count, red blood cell distribution width (RDW), prothrombin time, potassium, blood glucose, serum creatinine, total bilirubin, bicarbonate, base excess, lactic acid, brain natriuretic peptide precursor (NT-proBNP), cardiac troponin I (cTnI) and the percentage of respiratory failure, liver disease, kidney disease between death group and survival group ( P<0.01 or<0.05). Multivariate Logistic regression analysis results showed that NT-proBNP, prothrombin time, cTnI, lactic acid and systolic blood pressure were independent risk factors of death in patients with cardiogenic shock ( OR = 1.00, 1.10, 1.30, 1.29 and 1.04; 95% CI 1.00 to 1.00, 1.01 to 1.18, 1.00 to 1.68, 1.01 to 1.65 and 1.02 to 1.07; P<0.01 or<0.05). The independent factors obtained from multivariate analysis were combined with clinical practice, Akaike information criterion (AIC) analysis was conducted to select modeling variables, and the variables included in the nomogram model were NT-proBNP, prothrombin time, cTnI and lactic acid. After 500 times of internal Bootstrap self-sampling verification of the nomogram model, the C index was 0.805, area under the curve was 0.846, and the optimum threshold value was 0.486, with a sensitivity of 78.6% and a specificity of 83.1%. Conclusions:NT-proBNP, prothrombin time, cTnI and lactic acid are the related influencing factors for the short-term prognosis of patients with cardiogenic shock, and the related nomogram prediction model is constructed, which has guiding significance for the early intervention of cardiogenic shock.

16.
Article in Chinese | WPRIM | ID: wpr-846520

ABSTRACT

Objective: To study the chemical constituents of the sterns and leaves parts of Abies chensiensis. Methods: The isolation and purification were carried out by HP-20 macroporous resin, Sephadex LH-20, silica gel column chromatography, semi-preparative HPLC. Their structures were elucidated on the basis of physicochemical properties and spectroscopic data. Results: Twenty-four compounds were isolated and elucidated from the sterns and leaves parts of A. chensiensis, their structures were identified as 7,14,24-mariesatrien-26,23-olide-3α,23-diol (1), (23R)-3α-hydroxy-9,19-cyclo-9β-lanost-24-en-26,23-olide (2), 7-oxocallitrisic acid (3), 23-hydroxy-3-oxomariesia-8 (9),14,24-trien-26,23-olide (4), neoabiestrine E (5), 3-oxo-9β-lanosta-7,24-dien-26,23R-olide (6), 7,14,22Z,24-mariesatetraen-26,23-olide-3-one (7), (+)-rel-3α-hydroxy-23-oxocycloart-25 (27)-en-26-oic acid (8), cycloart-25-en- 3β,24-diol (9), neoabiestrine H (10), 3-oxo-24,25,26,27-tetranolanost-8-en-23-oic acid (11), abiesadine C (12), 13β-epidioxy-8 (14)-abieten-18-oic acid (13), dehydroabietic acid (14), 15-hydroxydehydroabietic acid (15), methyl 18-methoxydehydroabietate (16), 7β-hydroxy dehydroabietic acid (17), dehydroabietan-18-ol (18), centdaroic acid (19), abietic acid (20), 6,8,11,13-abi-etatrien-18-oic acid (21), abiesadine B (22), abiesadine N (23), 12β-hydroxyabietic acid (24). Conclusion: All compounds are isolated from the plants of A. chensiensis for the first time, and compound 11 is isolated from the Abies genus for the first time.

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Article in Chinese | WPRIM | ID: wpr-855898

ABSTRACT

AIM: Recent studies have shown that the cannabinoid receptor 1 (CNR1) gene played an important role in diabetes and its complications development. And liraglutide was of positive therapeutic significance in patients with type 2 diabetes mellitus. This study was to investigate the influence of CNR1 genetic variation on the clinical outcomes of early stage type 2 diabetes mellitus treated with liraglutide. METHODS: From March 2016 to December 2018, a total of 230 patients with early stage type 2 diabetes mellitus were included as the research object in this study. The patients were treated with liraglutide, and the clinical outcomes were evaluated 16 weeks later. Additionally, peripheral blood and part of the patients with fresh peripheral blood specimens of the patients were collected for the genotyping of the genetic variation and CNR1 gene mRNA expression, respectively. The correlation between genetic polymorphism and other baseline characteristics was analyzed by chi square test and non-parametric test. The mRNA expression of CNR1 in different genotypes was analyzed by non-parametric test. RESULTS:All of the 230 diabetes mellitus patients were of available for efficacy evaluation. BMI, FPG, 2H PG and HbA1c of all patients decreased significantly after 16 weeks of treatment, and the difference was statistically significant compared with that before treatment (P<0.05). In terms of the CNR1 gene polymorphism analysis, only rs1049353 was found to be of clinical significance. The prevalence of rs1049353 among the 230 patients were as follows: GG genotype 188 cases (81.74%), GA genotype 39 cases (16.96%), AA genotype 3 cases (1.30%), the minor allele frequency is 0.10, The distribution of three genotypes were in accordance with Hardy-Weinberg Equilibrium (P=0.551). GA genotype and AA genotype patients were merged in the following analysis. The clinical outcomes analysis indicated that BMI index of GA/AA genotype patients decreased (3.4±0.9) kg/m2 on average, FPG index decreased (5.1±0.9) mmol/l on average, HbA1c decreased (2.7±0.5)%. And the BMI index of GG genotype patients decreased (3.0±1.5) kg/m2 on average, FPG index decreased (4.7±1.3) mmol/l on average, HbA1c decreased (2.6±0.5)%, respectively. There were statistically significant differences between the two genotypes. Additionally, of the 125 available specimens for CNR1 gene mRNA analysis, the results showed that the mRNA expression of CNR1 in the patients with GG genotypes were significantly higher than those of the GA/AA genotype patients[(4.2±1.3) vs. (2.8±1.2), P<0.001)]. In terms of adverse reactions, the incidence of adverse reactions during treatment was relatively low, and gradually disappeared after drug withdrawal, and there was no significant correlation with CNR1 gene rs1049353 polymorphism. CONCLUSION:It is safe and effective in early stage type 2 diabetes patients received liraglutide treatment. And the clinical outcomes of the patients received liraglutide treatment may be influenced by CNR1 rs1049353 through mediating the mRNA expression of CNR1.

18.
Clinical Medicine of China ; (12): 228-232, 2020.
Article in Chinese | WPRIM | ID: wpr-867525

ABSTRACT

Objective:To investigate the relationship between angiopoietin-like protein 4(ANGPTL4) and vascular endothelial growth factor(VEGF) in serum and lower limb arterial lesions in Type 2 diabetes mellitus.Methods:Using the method of retrospective cohort study, 164 inpatients with type 2 diabetes admitted to the Department of Endocrinology, Dahua hospital, Xuhui District, Shanghai from October 2017 to December 2018 were selected as the type 2 diabetes group, and 69 healthy people in the same period were collected as the normal control group.According to the ankle brachial index<0.9, diabetic patients were divided into two groups: the group without lower extremity artery disease and the group with lower extremity artery disease.The levels of ANGPTL4 and VEGF in serum were measured by enzyme-linked immunosorbent assay.Results:(1)Compared with the normal control group: the concentration of ANGPTL4 in serum of lower extremity arterial disease group and no lower extremity arterial disease group((44.78±15.15), (47.46±10.43) μg/L) were lower than that of normal control group((52.87±12.74) μg/L), the difference was statistically significant (all P<0.05). The serum VEGF concentration in lower extremity arterial disease group and no lower extremity arterial disease group((340.98±76.18), (314.83±75.30) ng/L) were higher than that in normal control group((282.58±81.4) ng/L), the difference was statistically significant(all P<0.05). (2)Compared with no lower extremity arterial disease group: the concentration of ANGPTL4 in serum of lower extremity arterial disease group was lower than that of no lower extremity arterial disease group, but the difference was not statistically significant( P>0.05). The serum VEGF concentration in lower extremity arterial disease group was higher than that in no lower extremity arterial disease group, the difference was statistically significant( P<0.05). (3)Correlation analysis: Diabetes mellitus and diabetic course>10 years( OR 4.594, 95% CI2.540-8.311, P<0.001), fasting blood glucose>8 mmol/L( OR 2.353, 95% CI1.023-5.416, P=0.044), glycosylated hemoglobin>8%( OR 6.442, 95% CI 2.874-14.441, P<0.001) and the increase of VEGF( OR 3.745, 95% CI1.566-8.953, P=0.003) are risk factors for lower limb arterial disease in type 2 diabetes, while the increase of ANGPTL( OR 0.154, 95% CI0.064-0.372, P<0.001) can reduce the occurrence of lower limb arterial disease in type 2 diabetes. Conclusion:ANGPTL4 is a protective factor and VEGF is a risk factor of type 2 diabetes mellitus.Both of them influence each other and participate in its occurrence and development.

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Article in Chinese | WPRIM | ID: wpr-865997

ABSTRACT

Objective:To explore the effect of the situational doctor-patient communication skills training course based on chest pain center.Methods:The "5+3" integrated students of clinical medicine were selected to take the doctor-patient communication skills training course. The typical cases of chest pain center were written as module units, and were divided into 3 modules according to the disease types and the training contents of doctor-patient communication. The effect evaluation was performed before the course and after each module course, including the Liverpool doctor communication skills assessment scale, the college student empathy ability scale and emotional intelligence evaluation scale.Results:The students' communication ability, empathy ability, and emotional intelligence were significantly improved by three modules of practical training courses (all P<0.05). Among them, the communication ability of medical students was improved after each lecture in module 1, module 2 and module 3 (all P<0.05), which was 84% higher than that before the course [(28.2±2.7) vs. (15.3±3.9)]. After each lecture in module 1 and module 2, the empathy ability of medical students was improved (both P<0.05), which was 34% higher than that before teaching [(132.7±12.5) vs. (99.0±17.4)]. After each lecture in module 2 and module 3, the emotional intelligence of medical students was improved by 34% [(138.5±13.0) vs. (103.0±16.6)] (both P<0.05). Conclusion:The situational doctor-patient communication skills training course based on chest pain center, as a practical course of doctor-patient communication for medical students at the undergraduate stage, can effectively improve students' doctor-patient communication ability, empathy ability and emotional intelligence.

20.
Article in Chinese | WPRIM | ID: wpr-864801

ABSTRACT

Objective:To explore the application effect of traditional Chinese medicine comprehensive nursing on elderly patients with coronary heart disease(qi stagnation and blood stasis type) constipation.Methods:A total of 126 elderly patients with coronary heart disease (qi stagnation and blood stasis type) constipation were divided into the control group and the experimental group by random digits table method, 63 cases each; the control group received routine nursing, and the experimental group was given traditional Chinese medicine comprehensive nursing; comparing the two groups of patients defecation, mental state, recurrence rate, and nursing satisfaction.Results:There was no significant difference in defecation frequency, each defecation time, defecation smoothness score, fecal trait score, fall inflated score, and self-Rating Anxiety Scale (SAS) score( P >0.05). After one month of nursing, defecation frequency, each defecation time, defecation smoothness score, fecal trait score, fall inflated score, and SAS score were (4.09±0.86) times/week, (5.12±1.24) min/time, (2.57±0.39) points, (1.53±0.31) points, (0.97±0.21) points, (49.27±4.15)points in the experimental group, (3.12±0.61) times/week, (6.87±1.52) min/time, (2.59±0.36) points, (2.02±0.44) points, (1.29±0.27) points, (54.42±6.01) points in the control group, the differences were significant ( t values were -6.638-7.081, all P<0.05). Within 1 month after nursing, the recurrence rate of constipation in the experimental group (14.3%, 9/63) was lower than that in the control group (74.6%, 47/63) , and the satisfaction rate of the experimental group (98.4%, 62/63) was higher than that in the control group (69.8%, 44/63) , the differences were significant(× 2 values were 46.414, 19.257, P<0.05). Conclusions:Traditional Chinese medicine comprehensive care for elderly patients with coronary heart disease (qi stagnation and blood stasis type) constipation can significantly improve their defecation and psychological state, and can reduce the recurrence rate and improve the patient's satisfaction with nursing, which deserves further clinical application and research.

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