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In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery. .
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Humans , Lung Neoplasms/complications , COVID-19 , SARS-CoV-2 , Multiple Pulmonary Nodules , Pandemics/prevention & control , LungABSTRACT
BACKGROUND@#Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer.@*METHODS@#We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT.@*RESULTS@#DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05).@*CONCLUSIONS@#The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.
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Humans , Middle Aged , Aged , Lung Neoplasms/surgery , Incidence , Carcinoma, Non-Small-Cell Lung , Venous Thromboembolism , Venous Thrombosis/etiologyABSTRACT
OBJECTIVE:To interpret the new version of the Implementation Plan for Enrollment and Assessment of Clinical Pharmacist Teacher Training Project of Chinese Hospital Association (Trial)(hereinafter referred to as the “New Plan ”)officially announced by the Chinese Hospital Association in Sept. 2021,in order to provide guidance and reference for smoothly promoting the implementation of the New Plan and realizing the original intention of the reform. METHODS :The New Plan was interpreted from four aspects ,including the background of the formulation of the New Plan ,the main features presented ,the innovations and the issues that need to be paid attention to in the next implementation. RESULTS & CONCLUSIONS :The formulation and release of the New Plan marks the beginning of a new round of reform of the clinical pharmacist teacher training program of the Chinese Hospital Association. It is mainly based on the actual problems encountered in the operation of the current clinical pharmacist teacher training system ,the importance of clinical pharmacistteacher training itself ,and the opportunities and challenges that the development of the times has brought to our country ’s 163.com clinical pharmacy business. Research foundation , problem orientation and professional demonstration present important characteristics. Compared with the old plan ,the New Plan adds a substantive selection mechanism for majors ,which intends to achieve the necessary “strictness”in the enrollment process ;it reconstructs the overall training goal of the benchmarking project and the three-in-one assessment system ,which intends to achieve a reasonable “lax”of assessment link ;it removes restrictions on off-site training ,advocates wide-ranging professional docking,and improves the flexibility of the training system and process management. The implementation of the New Plan is a complex work involving multiple parties and is affected by many factors. It requires multiple teams to perform their duties and promote together. The teacher training base and expert team must understand the spirit of reform and achieve the stable implementation of the New Plan ;at the same time ,the communication between the project working group and the teaching base and experts should be strengthened ,and finally realize the original intention of the reform of cultivating more high-quality clinical pharmacy teachers.
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Epigenetic modification is closely related to the occurrence and development of tumors. It mainly regulates gene function and expression level through DNA methylation, histone modification, regulation of non-coding RNA and chromatin structure reconstruction. At present, epigenetic drugs have been gradually applied to the treatment of malignant tumors. Common drug types include: DNA methyltransferase inhibitors and histone deacetylase inhibitors. However, these drugs still have many shortcomings and a wide range of clinical applications need further research. Encouragingly, the epigenetic drugs in combination with various anti-tumor drugs have shown great application potential. In this paper, we summarized the development mechanism of epigenetics in malignant tumors and the progress of related drugs.
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BACKGROUND@#The incidence and mortality of lung cancer often rank first in all malignant tumors. DNA methylation, as one of epigenetics, often participates in the development and progression of tumors. CDO1 as a tumor suppressor gene always undergoes methylation changes early in tumor development. Therefore, this study aims to discuss the value of CDO1 methylation in the early diagnosis of lung cancer.@*METHODS@#Peripheral blood samples were collected from tumor patients and healthy people. Detection of the methylation level of CDO1 in plasma by sulfite modification and quantitative real-time PCR.@*RESULTS@#The level of gene methylation in peripheral blood of lung cancer patients was significantly higher than that of benign lung disease patients and healthy people. The methylation level of CDO1 was significantly different in the stratified comparison of gender, lymph node metastasis and tumor-node-metastasis (TNM) stage (P<0.05). The sensitivity and specificity of CDO1 were 52.2% and 78.6%, respectively. The overall accuracy of the diagnosis was significantly higher than that of the clinical tumor markers, and the sensitivity of CDO1 to stage I and II patients was the highest (40.8%, 47.1%). In addition, CDO1 could effectively increase the sensitivity of diagnosis in multiple joint examinations.@*CONCLUSIONS@#Detecting the methylation level of CDO1 has a potentially huge advantage for the early diagnosis of lung cancer.
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Patients with Ⅲa staging have a large proportion in non-small cell lung cancer(NSCLC). These patients often lost the opportunity to complete excision of the tumor because the tumor have invaded adja-cent vital organs when diagnosed. Besides,Ⅲa staging contains a lot of complicated clinical TNM stages,so, the opinions of experts at home and abroad are various about treatment of NSCLC with Ⅲa staging. Neoadjuvant therapy, surgery, radiation therapy and chemotherapy play important roles under different conditions. Especially surgery is occupying a pivotal position in comprehensive therapy of Ⅲa NSCLC.
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OBJECTIVE:To compare the efficacy and safety of dabigatran and warfarin respectively used in atrial fibrillation patients after radiofrequency ablation(RFCA). METHODS:Data of 141 nonvalvular atrial fibrillation patients,who scheduled for RFCA,were retrospectively analyzed and divided into warfarin group(71 cases)and dabigatran group(70 cases)by different med-ication. Patients in warfarin group should stop warfarin if they took before,then changed to Low molecular weight heparin calcium injection 100 U/kg,subcutaneous injection,taking RFCA when INR was lower than 1.5,stopping low molecular weight heparin 12 h before surgery;Low molecular weight heparin calcium injection 100 U/kg was intravenously injected when surgery;orally tak-ing Warfarin sodium tablet 4.5 mg after 4-6 h,once a day,meanwhile bridged overlapping treated at least 3-5 d with low molecu-lar weight heparin;monitoring once INR every 3 d after surgery,maintaining INR 2.0-3.0,taking warfalin at least 3 months. Pa-tients in dabigatran group stopped taking the anticoagulant drugs when admission,then changed to Dabigatran etexilate capsule 110 mg(age≥70 years old or body mass0.05). CONCLUSIONS:Dabigatran has similar anticoagulant efficacy and safety with warfarin in atrial fibrillation pa-tients after RFCA.
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Objective:To provide reference for the pharmaceutical care for aged acute cerebral infarction with various complica-tions. Methods:Clinical pharmacists participated in the treatment for an elder patient with acute cerebral infarction complicated with gastrointestinal bleeding, liver dysfunction and pulmonary infection through providing drug therapy information, analyzing the effect and safety of drug therapy and adjusting the pharmaceutical care plan according to the drug efficacy in time. Results:Taking use of phar-maceutical knowledge, clinical pharmacists provided whole-course pharmaceutical care for the treatment of the patient and coordinated with doctors to make the drug therapy, which guaranteed the effectiveness and safety of therapy. Conclusion:The old are with high in-cidence of cerebral infarction, and complications are common. Due to their physiological dysfunction and the other reasons, high safety risk exists in their drug therapy. Clinical pharmacists can use their professional knowledge to provide whole-course pharmaceutical care for the patients in order to improve the therapeutic effect and promote the rational drug use.
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Objective:To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in atrial fibrillation( AF) pa-tients after radiofrequency catheter ablation( RFCA) . Methods:A retrospective analysis was performed in the study. Totally 141 AF pa-tients with RFCA in our hospital were enrolled from January 2014 to October 2015. The patients were divided into rivaroxaban group(70 patients)and warfarin group (71 patients). In rivaroxaban group,rivaroxaban(10 mg, po,qd)was given for at least 3 months after RFCA. In warfarin group,low molecular heparin (100 IU·kg-1,ih) was given before RFCA, and standard dose of warfarin (3-5 mg,po,qd) was given for at least 3 months by adjusting the INR within the range of 2. 0-3. 0 after RFCA as bridging therapy. The death rate, throm-boem bolism events and bleeding events between the groups were evaluated and companed groups. Results: There were no significant differences in baseline characteristics between the groups except the diastolic pressure. There were no significant differences in the death and thromboembolism events(transient cerebral ischemia , ischemic encephalopathy, 2/70 vs 4/71,P>0. 05)between the groups. There were no TIMI major bleeding events in both groups. There were no significant differences in minor bleeding events between the groups (3/70 vs 4/71,P>0. 05). Conclusion: Compared with those of warfarin,the effectiveness and safety of rivaroxaban show the similar effect in AF patients after RFCA. Rivaroxaban can be safely and effectively used in AF patients with low or middle risk of thromboembo-lism after RFCA.
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Objective To explore the most accurate T staging and optimal surgical method of lung adenocarcinoma of trans-lobe type, and to provide supportive diagnosis as well as therapeutic evidences for this disease. Methods A total of 192 postoperative patients, hospitalized in Tianjin Medical University General Hospital from January 2008 to June 2013, who were diagnosed with lung adenocarcinoma were recruited. Patients were divided into three groups according to the 7th edition of TNM staging criteria issued by the IASLC in 2009. A total of 163 patients with T2 stage were selected as Group T2, and 12 patients with T3 stage were selected as Group T3, both of which were considered as control groups. Other 17 pa?tients who were diagnosed as trans-lobe type of lung adenocarcinoma, were Group trans-lobe. The clinical data and progno?sis were compared between three groups. The trans-lobe type of lung adenocarcinoma was diagnosed based on imaging and pathological examination. Subtypes of trans-lobe lung adenocarcinoma were identified by referring to 2011 international mul?tidisciplinary classification standard of lung adenocarcinoma. Kaplan-Meier method was used to analyze the prognosis of dif?ferent subtypes and surgical modus in patients with lung adenocarcinoma of trans-lobe type. Results By comparison, the postoperative survival rate was significantly lower in patients diagnosed with trans-lobe type of lung adenocarcinoma than that of Group T2 (P0.05). There were no significant differences in survival rates between different surgical modus (P<0.05). Seventeen patients with trans-lobe type of lung adenocarcinoma consisted of four subtypes, including 8 solid predominant, 5 acinar predominant, 3 papillary predomi?nant and 1 invasive mucinous adenocarcinoma. There were no statistical significances in postoperative survival time and sur?vival rates between four subtypes. Conclusion The clinical stage of trans-lobe type of lung adenocarcinoma should be clas?sified as stage T3. Both pulmonary bilobectomy and lobectomy combined with resection of proximal invaded lobe can be used as effective surgical therapies for trans-lobe type of lung adenocarcinoma.
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Objective:To evaluate the curative effect and safety of fasudil hydrochloride injection in the prevention and treatment of aneurysm postoperative cerebral vasospasm by meta-analysis. Methods: The randomized controlled trials were retrieved from PubMed, EMBASE, Cochrane Library, VIP, Wangfang, CNKI and so on. Meta-analysis was conducted using RevMan 5. 0 software. Results:Totally 418 reference studies were screened, from which 11 ones were chosen including 786 patients in all. In the treatment of cerebral vasospasm (CVS), there was no significant difference between the groups (OR=1. 56, 95%CI:0. 95-2. 58, P>0. 05). While in the prevention of CVS, the incidence rate of CVS in fasudil group was significantly lower than that in nimodipine group ( OR=0. 43, 95%CI:0. 23-0. 81, P=0. 008). However, the incidence rate of ADR in fasudile group was higher than that in nimodipine group (OR=0. 43, 95%CI:0. 25-0. 75,P=0. 003). Conclusion:In the prevention of CVS, fasudil may be better than nimodipine, while the incidence of ADR is higher.
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Objective To investigate fingerprint analysis and quantification of Rhizoma Drynaria. Methods HPLC fingerprints were carried out at 30℃on a Zirchrom C18 column (4.6 mm×200 mm, 5μm). The mobile phase was methanol (A) and phosphoric acid aqueous solution (pH3.6, B). Gradient programmer was performed in linear gradient. The chromatogram was monitored at a wavelength of 283 nm throughout the experiment and the chromatographic peaks were obtained, ranging from 200 nm to 400 nm. The injection volume was 10μl. Then quantitative analyses were carried out at 30℃on a Kromasil C18 column (250 mm×4.6 mm,5μm). Results In fingerprint analysis, plant materials from 16 regions were analyzed under the optimized HPLC conditions and 12 peaks were selected as characteristic peaks. Compared with the reference standards, 6 major chromatographic peaks were characterized and identified, with sum of peaks area over 70% according to area normalization method. Additionally, the similarity analysis and HCA analysis were performed and the results got mutual authentication. In quantitative analysis, the four compounds showed good regression(r>0.9995) within test ranges and the recovery of the method was in the range of 97.9%-103.7%. Conclusion The results revealed that the method of reference chromatographic fingerprints combined with multiple compounds determination could be used as an efficient strategy for systematic quality evaluation of Rhizoma Drynariae.
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This study was aimed to observe the influence ofQing-Chang Hua-Shi Recipe (QHR) on IL-6trans-signaling in experimental colitis mice, in order to initially explore the possible mechanisms of QHR for ulcerative colitis (UC). TNBS/ethanol was used in the establishment of colitis mice model. After intervention of medication, ELISA was used in the detection of soluble Interleukin-6 receptor (sIL-6R). Real-time PCR was used to detect the mRNA expression level of IL-6 and glycoprotein 130 (gp130). Western blot was used in the observation of protein expression of IL-6 and gp130 in the colonic mucosa. The results showed that the level of sIL-6R, the mRNA and protein expression of IL-6 and gp130 in the model group were significantly higher than that in the control group. QHR was able to reduce the sIL-6R level (P < 0.01), decreased the mRNA and protein expression of IL-6 and gp130 (P < 0.01) in the colon tissues among experimental colitis mice. It was concluded that QHR had good anti-inflammatory effects on experimental colitis mice. It might be associated with influencing IL-6trans-signaling.
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Objective:To explore the wound-healing effect and the anti-inflammatory activity of the aqueous extracts from the fresh roots and rhizomes of A. calamus. Methods: The image analysis techniques and the histological analysis were used to determine the wound-healing effect in the excised wound test, and the real-time RT-PCR techniques was used to evaluate the anti-inflammatory activi-ty in the lipopolysaccharide-induced RAW 264. 7 cells test. Results:The aqueous extracts were given 3 times a day since the model was established. The skin wound area was reduced significantly in the aqueous extracts group when compared with that in the control group since the 3rd day, the wound area in the aqueous extracts group was only 15% of that in the control group on the 13th day, and the wound-healing rate was enhanced significantly by the extracts. Moreover, the mRNA expressions of the inflammatory mediators such as TNF-α, IL-1β and IL-6 in the inflammatory RAW 264. 7 cells induced by lipopolysaccharide were inhibited effectively by the ex-tracts in a dose-dependant manner. Conclusion:The results indicate that the aqueous extracts from the fresh roots and rhizomes of A. calamus have significant wound-healing activity in animal excised wound model and anti-inflammatory activity in vitro.
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Objective To assess the effectiveness of western routine treatments combined with Tongxinluo capsule for angina pectoris .Methods The randomized controlled trials(RCTs ) of western routine treatments combined with tongxinluo capsule for angina pectoris were collected through searching on computer from the following databases ,CNKI (2000 -2011 ) ,WanFang Data (2000 -2011) ,WeiPu Data(2000-2011) ,PubMed(2000-2011) and manual search relevant journals ,conference papers .Results A total of 11 studies were included and improvement rate of abnormal ECG were estimated in 9 studies and improvement rate of symptoms of angina were estimated in 11 studies .ECG clinical evaluation of the treatment group relative to the control group ,relative risk (RR) value was 1 .40 (95% CI:1 .28‐1 .54) ,P<0 .01 ,symptoms of angina clinical evaluation ,treatment group relative to the control group RR value of 1.25 (95% CI:1 .18‐1 .32) ,P<0 .01 .Only slight gastrointestinal discomfort were found in treatment group .Conclusion Tongxinluo capsule in combination on the basis of conventional western treatment could effectively improve the clinical efficacy and drug safety .
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Objective: To discuss the pharmaceutical care experience of clinical pharmacists in the antibacterial agents application in one patient with infection after coronary artery bypass graft ( CABG) . Methods:The clinical pharmacist participated in the treatment of the patient after CABG. According to the relevant laboratory indices and the extent of the infection combined with the vital signs of the patient, the pharmacist formulated and adjusted the anti-infection therapeutic regimen. The therapeutic effects and adverse reactions were observed as well. Results: Safte and high-quality individualized pharmaceutical service was provided to the patient by the pharmaceutical care of the clinical pharmacist in anti-infection treatment. Conclusion:Through the above practice, clinical pharmacists have played a positive role in reasonable using of anti-infective drugs in patients with cardiac surgery.
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Aim To investigate the proliferative effect and the apoptosis of human hepatoma SMMC-7721 cells induced by gallic acid ( GA ) , and its underlying mechanism. Methods SMMC-7721 cells were cul-tured in vitro. MTT assay was used to observe the pro-liferation of SMMC-7721 cells induced on GA 24 , 48 , 72 h. The morphological and ultra structural changes of the SMMC-7721 cells were observed by inverted micro-scope and transmission electron microscope respective-ly. Annexin V-FITC/PI staining was used to quantify the percentages of apoptosis in the total cell popula-tion. The expression of p53 mRNA was investigated by RT-PCR. Western blot was used to determine the pro-tein expression of p53. Results GA(6. 25~50 μmol ·L-1 ) markedly inhibited the activity of proliferation and induced apoptosis of SMMC-7721 cells after 48 h in a dose-dependent manner. GA significantly induced cell nuclear condensation and fragmentation. RT-PCR and Western blot results showed that GA could improve the expression of p53 mRNA and protein. Conclusion GA can inhibit the proliferation of human hepatoma SMMC-7721 cells and induce cells apoptosis. The mechanism may be associated with improving tumor suppressor gene p53 expression.
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<p><b>OBJECTIVE</b>To study the feasibility of digalactosyl diglyceride (DGDG) , which was used as a new type of emulsifier to prepare submicro-emulsion of bay oil.</p><p><b>METHOD</b>Bay oil was employed as the model drug, emulsifer in oil method was used to prepare foremilk. Through single factor investigation and central composite design-response surface methodology (CCD-RSM) , we optimized the preparation technology and formula respectively. The stability of sub-microemulsion was studied.</p><p><b>RESULT</b>The optima technology was following: emulsifer in oil method was used to prepare foremilk, temp was 60 degrees C, the micro emulsion was prepared by two-step high pressure homogen method with that the pressure was 80 Pa, 10 times, micropore film was used to sterilize, filling and sealing at the preservation of nitrogen. The best formula was following: soybean oil was 1.1%, DGDG was 1.6%, and sodium oleate was 0. 16%. The particle size of three batch submicro-emulsions were from 168.0 to 169.3 nm; Zeta potential were from-25.53 to 24.90 mV, pH value were from 8.48 to 8.52. The deviation between measured value and predictive value was 1.8%. It was stable in high temperature and illumination.</p><p><b>CONCLUSION</b>DGDG can be used as the emulsifier of bay oil sub-microemulsion.</p>
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Drug Stability , Emulsifying Agents , Chemistry , Emulsions , Chemistry , Galactolipids , Chemistry , Plant Oils , Chemistry , TemperatureABSTRACT
Objective To study the influences of dichloromethane extraction from crude and processed Cornus Officinalis on bone marrow cells of aging mice induced by D-galactose. Methods DNA damage of bone marrow cells of aging mice induced by D-galactose was detected by the comet assay, the expression of p53 mRNA was detected by RT-PCR. Results The tail formation rate of model group was significantly higher than the rate of control group (P
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OBJECTIVE:To establish a method and a technical process for the purification of total alkaloids from Gelsemium elegans Benth.with macroporous resin.METHODS:Different types of macroporous resin were used to separate and purify total alkaloids,the HPLC peak areas of the main ingredient of the alkaloids form Gelsemium elegans Benth.were compared and the optimum technological parameters were investigated.RESULTS:The HPD-500,HPD-600,HPD-800type macroporous resin showed better comprehensive absorption property,and HPD-800type macroporous resin were used to investigate parameter.CONCLUSIONS:The method of using HPD-800type and eluting with grade ethanol-water can be used to purify the total alkaloids from Gelsemium elegans Benth..