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1.
China Pharmacy ; (12): 542-547, 2022.
Article in Chinese | WPRIM | ID: wpr-920722

ABSTRACT

OBJECTIVE To explore the effects of acteoside on hypoxia/reoxygena tion(H/R)-induced cardiomyocyte damage by regulating Rho family GTPase 3(Rnd3)/nuclear factor κB(NF-κB)pathway. METHODS The H 9c2 cardiomyocyte were divided into control group (no administration ,no modeling ),H/R group (only modeling ),H/R+AS-L group ,H/R+AS-M group , H/R+AS-H group (10,30,90 μmol/L acteoside for above 3 groups firstly ,and then modeling ),H/R+pcDNA group [transfecting pcDNA (empty vector ) firstly,and then modeling] ,H/R + pcDNA-Rnd 3 group [overexpression of Rnd 3 by transfecting pcDNA-Rnd3(Rnd3 overexpression vector )firstly,and then modeling] ,H/R+AS-H+si-NC group [transfecting si-NC (negative control)firstly,and then giving 90 μmol/L acteoside and modeling],H/R+AS-H+si-Rnd3 group [inhibiting overexpression of Rnd 3 by transfecting si-Rnd 3 (Rnd3 small interfering RNA ) firstly,and then giving 90 μ mol/L acteoside and modeling]. After corresponding treatment ,the apoptotic rate ,release of lactate dehydrogenase (LDH),malondialdehyde(MDA)level,the activity of superoxide dismutase (SOD),the level of tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)and interleukin- 6(IL-6), mRNA and protein expression of Rnd 3 and NF-κB subunit p65(NF-κB p65),the expression of aspartate proteolytic enzyme 3 (Cleaved Caspase- 3)protein and Cleaved Caspase- 9 protein were detected. RESULTS Different concentrations of acteoside could reduce the apoptotic rate of H/R-induced H 9c2 cardiomyocyte,the protein expressions of Cleaved Caspase- 3 and Cleaved Caspase-9,mRNA and protein expressions of NF-κB p65,the levels of LDH release and MDA ,TNF-α,IL-1β and IL-6,while increase the activity of SOD and mRNA and protein expressions of Rnd 3(P<0.05),in a dose-dependent manner. Overexpression of Rnd 3 could decrease the apoptotic rate of H 9c2 cardiomyocyte,protein expressions of NF-κB p65,Cleaved Caspase- 3 and Cleaved Caspase- 9, the levels of LDH release , MDA, TNF-α,IL-1β and IL-6,while increase the protein expression of Rnd 3 and the activity of SOD (P<0.05). The inhibition overexpression of Rnd 3 could weaken the inhibitory effects of acteoside on H/R-induced apoptosis of H 9c2 cardiomyocyte, oxidative stress and inflammatory reaction (P<0.05). CONCLUSIONS Acteoside could regulate Rnd 3/NF-κ B pathway by promoting the expression of Rnd 3 and inhibiting the expression of NF-κB p65,inhibit cardiomyocyte apoptosis ,oxidative stress and inflammation reaction so as to relieve the H/R-induced cardiomyocyte damage.

2.
Chinese Journal of Geriatrics ; (12): 831-835, 2021.
Article in Chinese | WPRIM | ID: wpr-910924

ABSTRACT

Objective:To investigate the relationship between renal function and the total cerebral small vessel disease(CSVD)score in elderly patients with a mild stroke.Methods:Patients with a mild stroke(National Institutes of Health Stroke Scale score≤3)and aged 60 years and above hospitalized in our hospital from March to December 2019 were consecutively enrolled.Total CSVD scores were evaluated based on enlarged perivascular spaces, cerebral microbleeds, white matter hyperintensities of presumed vascular origin and lacunes of presumed vascular origin.The estimated glomerular filtration rate(eGFR)was derived by using the formula of chronic kidney disease epidemiology collaboration based on serum creatinine(CKD-EPI Scr). The relationship between eGFR and the total CSVD score was analyzed. Results:Of the 152 patients enrolled, 35, 38, 39, 28 and 12 had total CSVD scores of 0, 1, 2, 3 and 4, respectively.The age of patients increased and eGFR decreased with the increase of total CSVD scores(CSVD from 0 to 4, [(67.43±6.59), (68.42±6.83), (72.18±7.94), (76.46±7.75) vs.(79.92±6.17)years old, F=12.018, P<0.001]; [(92.94±12.45)ml·min -1·1.73m -2, (90.52±8.62)ml·min -1·1.73m -2, (89.45±8.48)ml·min -1·1.73m -2 and(83.90±7.19)ml·min -1·1.73m -2vs.(79.16±7.77)ml·min -1·1.73m -2, F=7.210, P<0.001]. Spearman correlation analysis showed that eGFR was negatively correlated with the total CSVD score( r=-0.399, P<0.001). After adjusting for risk factors including age, gender and hypertension, multivariate ordinary regression analysis showed that decreased eGFR was an independent risk factor for the total CSVD score( OR=0.957, 95% CI: 0.924-0.990, P=0.012). Conclusions:In elderly patients with a mild stroke, eGFR is an independent risk factor for the total CSVD score, which shows an increased burden as eGFR decreases.

3.
Article in Chinese | WPRIM | ID: wpr-904764

ABSTRACT

Objective To analyze the current situation of off-label drug use for tic disorder in a tertiary maternity and child hospital, so as to promote clinical safe and rational drug use. Methods Through the hospital information system, the pediatric outpatient prescriptions diagnosed with tic disorder from July 2019 to August 2020 were selected, and the prescriptions of off-label use was evaluated according to the 2020 off-label drug management regulations. Results A total 1251 pediatric prescriptions diagnosed with tic disorder were collected. The incidence of off-label drug use was 29.58%. The main types of off-label were over-indications and over-age. The main varieties of off-label drug use were risperidone tablets (47.84%) and aripiprazole tablets (43.74%). Conclusion The off-label use of drug for tic disorder in pediatric outpatient department of our hospital is relatively common,and it is necessary to standardize the management of off-label drug use to ensure rational drug use.

4.
Organ Transplantation ; (6): 707-2021.
Article in Chinese | WPRIM | ID: wpr-904554

ABSTRACT

Objective To analyze the status of job satisfaction of human organ donation coordinators in Fujian province during the normalization period of novel coronavirus pneumonia (COVID-19) epidemic prevention and control and put forward corresponding suggestions. Methods The job satisfaction of human organ donation coordinators in Fujian province was investigated by online questionnaires. The correlation analysis of all dimensions of the overall job satisfaction of human organ donation coordinators was carried out, and the influencing factors of the overall job satisfaction were analyzed. Results The overall job satisfaction of human organ donation coordinators was (2.9±0.8), which was a relatively low score. The job promotion satisfaction was (4.7±1.3), (2.0±1.4) for the job pay and benefits satisfaction, and (2.0±1.3) for the job communication satisfaction. The job pay and benefits satisfaction was positively correlated with job communication satisfaction (r=0.653, P < 0.05). Multiple factors differed in job satisFfaction. The overall job satisfaction of human organ donation coordinators was associated with gender, nature of job, working years, average monthly income, age, educational background and nature of post. Conclusions The job satisfaction of human organ donation coordinators is relatively low in Fujian province during the normalization period of COVID-19 epidemic prevention and control. Flexible and diverse methods should be employed from the government and hospital levels to further improve security policies for human organ donation coordinators.

5.
Article in English | WPRIM | ID: wpr-881062

ABSTRACT

Triptolide (TP), an active component of Tripterygium wilfordiiHook. f. (TWHF), has been widely used for centuries as a traditional Chinese medicine. However, the clinical application of TP has been restricted due to multitarget toxicity, such as hepatotoxicity. In this study, 28 days of oral TP administration (100, 200, or 400 μg·kg

6.
Article in Chinese | WPRIM | ID: wpr-886884

ABSTRACT

Objective To provide reference for clinical pharmacists to participate in rational drug use through case study. Methods Clinical pharmacists participated in the optimization of treatment plan and performed pharmaceutical care for the patients according to their own characteristics, drug interactions, compatibility contraindications and adverse drug reactions. Results Clinical pharmacists provided pharmaceutical care for the patients with cerebrovascular diseases, Parkinson's disease, encephalitis and other diseases in the Department of Neurology by using pharmaceutical expertise, retrieved evidence-based support from literature and participating in the formulation of treatment plans. Those achieved individualized drug treatment, improve patient compliance, reduced the occurrence of unreasonable usage and dosage, inappropriate drug combination and improper drug selection, the treatment of adverse drug reactions, drug safety, and rational drug use. Conclusion Clinical pharmacists need to use their sound professional ability and good communication skills to help doctors make individualized drug delivery plans to ensure the safety, effectiveness and economy of drug treatment.

7.
Chinese Journal of Neurology ; (12): 64-70, 2021.
Article in Chinese | WPRIM | ID: wpr-885392

ABSTRACT

With the aging of population, cerebral small vessel disease has attracted more and more attention. A growing body of literature has confirmed that retinal vascular changes can be used as a potential marker for the prediction of cerebral small vessel disease. The retina is recognized as a window into cerebrovascular and systemic vascular conditions. Combining traditional fundus photograph and fundus fluorescein angiography with optical coherence tomography angiography, the retinal vascular system of patients with cerebral small vessel disease can be comprehensively analyzed. This paper summarizes and analyzes the application of retinal angiography technology in different image types of cerebral small vessel disease and makes a review, in order to provide reference for the early diagnosis and prevention of cerebral small vessel disease.

8.
Article in Chinese | WPRIM | ID: wpr-862488

ABSTRACT

Objective To establish an assay method for monohydroxy carbamazepine, the active metabolite of oxcarbazepine, in human plasma. Methods Ornidazole was used as the internal standard. Plasma samples were processed with methanol and analyzed by HPLC. The column was ZORBAX Eclipse XDB-C18(150 mm×4.6 mm, 5 μm) with the mobile phase of water-acetonitrile (80∶20, V/V) at a flow rate of 1.0 ml/min. Dual wavelength detection is applied. The detection wavelength of monohydroxy carbamazepine was set at 192 nm and ornidazole at 318 nm. Results There was an excellent liner relationship for monohydroxy carbamazepine from 2 to 50 μg/ml(r= 0.998 6). The limit of quantification was 2 μg/ml with the range of accuracy between 95.57% and 100.59%. The RSD of intra-day and inter-day precisions were less than 15%. The average extraction recovery rate of MHC and internal standard were in the range of 89.62% to 98.76%. The RSD of stability was less than 6%. Conclusion This method is specific, sensitive, and easy to operate. It is suitable for the clinical assay of monohydroxy carbamazepine in human plasma.

9.
Article in Chinese | WPRIM | ID: wpr-877563

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).@*METHODS@#A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared.@*RESULTS@#Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (@*CONCLUSION@#Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.


Subject(s)
Acupuncture Therapy , Blood Glucose , Female , Glucose , Glucose Intolerance/therapy , Humans , Insulin , Insulin Resistance , Polycystic Ovary Syndrome/therapy
10.
Article in Chinese | WPRIM | ID: wpr-826644

ABSTRACT

OBJECTIVE@#To compare the curative effect between bloodletting at tip of ear with different amounts combined with western medication and western medication alone for early-stage stye.@*METHODS@#A total of 108 patients with early-stage stye were randomly divided into a 50 μL group (36 cases, 4 cases dropped off), a 100 μL group (36 cases, 2 cases dropped off) and a western medication group (36 cases, 5 cases dropped off). The patients in the western medication group were treated with levofloxacin eye drops and levofloxacin hydrochloride eye gel. Based on the treatment of the western medication group, the patients in the 50 μL group were treated with 50 μL bloodletting (about 3 drops) at tip of ear while the patients in the 100 μL group were treated with 100 μL bloodletting (about 6 drops) at tip of ear; the bloodletting was given once a day for 3 days. After treatment, the changes of visual analogue scale (VAS) and clinical effect were observed, and the patients were followed up by telephone on the 8th day.@*RESULTS@#After treatment, the VAS score in each group was reduced (0.05). One week after the onset of the disease, all the patients in the 50 μL group and 100 μL group were cured, and one patient in the western medication group was not cured, and treated with routine surgery.@*CONCLUSION@#Based on the conventional western medication treatment, bloodletting at tip of ear can significantly reduce the pain of stye, and the effect of 100 μL bleeding is better than 50 μL.

11.
Article in Chinese | WPRIM | ID: wpr-862461

ABSTRACT

Objective To evaluate the effect of increasing sunshine time or 1, 25(OH)2D3 supplement on improving Vitamin D blood level and reduction of microalbuminuria in early stage diabetic nephropathy (DN) patients. Methods A total of 150 early stage type 2 DN patients with serum 25(OH)D3 lower than 15 mg/L were included.The patients were divided into sunshine group (n=50), 1, 25(OH)2D3 supplement group (n=50), and control group (n=50).After three-month treatment, serum 25(OH)D3 level and urinary albumin to creatinine ratio(ACR)were compared among these three groups. Results Before treatment, there were no differences in serum 25(OH)D3, ACR, HbA1c among the three groups.After three-month treatment, serum 25(OH)D3 level was significantly improved in sunshine group, and ACR was reduced significantly in both sunshine group and 1, 25(OH)2D3 group. Conclusion Increasing sunshine time can improve Vitamin D level and reduce microalbuminuria in early stage diabetic nephropathy patients.

12.
Chinese Acupuncture & Moxibustion ; (12): 1154-1158, 2020.
Article in Chinese | WPRIM | ID: wpr-877578

ABSTRACT

OBJECTIVE@#To compare the clinical effect of the combined treatment of acupuncture, moxibustion, Chinese herbal medicine and western medication and simple western medication on polycystic ovary syndrome (PCOS) of kidney deficiency and blood stagnation pattern and explore the effect on endometrial receptivity and the expression of serum homeobox gene A10 (HOXA10).@*METHODS@#A total of 60 patients with PCOS of kidney deficiency and blood stagnation pattern were randomized into a combined treatment group and a western medication group, 30 cases in each one. In the western medication group, on the fifth day of menstruation, clomiphene citrate tablets were taken orally, 50 mg each time, once daily, consecutively for 5 days. On the day when the follicle diameter was ≥ 18 mm, chorionic gonadotrophin for muscular injection, a dose of 10 000 U was given. Before sleep, the aspirin enteric-coated tablets were taken orally, 50 mg (except during menstruation). In the combined treatment group, on the base of the treatment as the western medication group, acupuncture and moxibustion were adopted and the Chinese herbal for tonifying the kidney and activating blood circulation was taken orally. The acupoints were Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Sanyinjiao (SP 6), Zigong (EX-CA 1), etc. Acupuncture was remained for 30 min each time, once every two days and discontinued during menstruation. Chinese herbal was given from the 3rd day of menstruation till the onset of the next menstruation, one dose each day. After consecutive treatment for 3 menstrual cycles in the two groups, the real-time polymerase chain reaction (RT-PCR) method was adopted to determine the expression of serum HOXA10 before and after treatment in the patients of the two groups. The endometrial thickness at ovulatory phase, uterine arterial flow 7 days after ovulation [including uterine arterial pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV)/end diastolic velocity (EDV), meaning S/D], pregnancy rate and the score of Chinese medicine symptoms before and after treatment were compared in the patients between the two groups.@*RESULTS@#① After treatment, the expression of serum HOXA10 was higher than that before treatment in the patients of the two groups (@*CONCLUSION@#The combined treatment with acupuncture, moxibustion and medication effectively improves endometrial receptivity and uterine arterial flow in the patients with PCOS of kidney deficiency and blood stagnation pattern and increases pregnancy rate. The therapeutic effect is better than the simple western medication and its mechanism is probably related to the regulation of serum HOXA10 expression.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Female , Genes, Homeobox , Homeobox A10 Proteins , Humans , Kidney , Moxibustion , Polycystic Ovary Syndrome/genetics , Pregnancy
13.
Chinese Acupuncture & Moxibustion ; (12): 1291-1294, 2020.
Article in Chinese | WPRIM | ID: wpr-877530

ABSTRACT

OBJECTIVE@#To explore the effective therapy for treating chronic scapulohumeral periarthritis of cold-damp stagnation.@*METHODS@#A total of 90 cases of patients with chronic scapulohumeral periarthritis of cold-damp stagnation were randomly divided into an acupuncture and moxibustion group, a herbal cake separated moxibustion group and a routine rehabilitation group, 30 cases in each group. The routine rehabilitation group was treated with diclofenac sodium sustained-release tablets (0.1 g each time, taken after breakfast) and rehabilitation exercise, once a day. On the basis of the treatment in the routine rehabilitation group, the herbal cake separated moxibustion group was treated with herbal cake separated moxibustion at the affected side of Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9), once a day. On the basis of the treatment in the herbal cake separated moxibustion group, the acupuncture and moxibustion group was additionally given umbrella shaped acupuncture with round sharp needle at the affected side of Jianyu (LI 15), Jianliao (TE 14), Jianzhen (SI 9), Naohui (TE 13), Jianqian (Extra), Jugu (LI 16), etc. once every other day. Each group was treated for 10 d. Before and after treatment the pain visual analogue scale (VAS) score and activities of daily living (ADL) score, and degree of changes in shoulder joint activity were compared in each group, and the clinical effect was evaluated.@*RESULTS@#After treatment, the pain VAS scores of three groups were decreased (@*CONCLUSION@#On the basis of routine rehabilitation training, herbal cake separated moxibustion combined with umbrella shaped acupuncture with round sharp needle treating chronic scapulohumeral periarthritis of cold-damp stagnation can significantly reduce shoulder joint pain and improve shoulder joint function.


Subject(s)
Activities of Daily Living , Acupuncture Points , Acupuncture Therapy , Humans , Moxibustion , Periarthritis/therapy , Treatment Outcome
14.
Neurology Asia ; : 211-214, 2020.
Article in English | WPRIM | ID: wpr-877217

ABSTRACT

@#We presented four patients with sub-acute onset orthostatic headache in occipital and sub-occipital regions and neck pain. No loss of consciousness, neurologic deficit, trauma or cranial/spinal surgery history was noted. They had normal cerebrospinal fluid (CSF) opening pressure, normal laboratory studies, and diffuse pachymeningeal enhancement or sagging of brain on gadolinium-enhanced magnetic resonance imaging (MRI). Their symptoms resolved with intravenous large isotonic fluid or epidural blood patch. The diagnosis of spontaneous intracranial hypotension requires history of orthostatic headache, demonstration of lower CSF pressure, and abnormal findings on MRI. But these patients may have normal CSF opening pressure. CSF hypovolemia rather than CSF hypotension has been proposed as the underlying cause. Therefore, the CSF pressure may not be necessary for diagnosis in such patients with typical radiographic features. Thus, in the presence of convincing clinical symptoms and imaging abnormalities, a normal CSF pressure should not discourage the clinician from searching for a source of CSF leak.

15.
China Pharmacy ; (12): 1303-1308, 2020.
Article in Chinese | WPRIM | ID: wpr-821793

ABSTRACT

OBJECTIVE:To study the protective effects of Lespedeza cunea ta extract on glutamate-induced hippocampal cells HT22 injury of mice and its possible mechanism based on Nrf 2/HO-1 signaling pathway. METHODS :Using glutamate (5 mmol/L) to extablish the injury model of HT 22 cells. Using water soluble vitamin E as positive control (50 µmol/L),MTT assay was used to detect the effects of 0(blank control ),25,50,100 µg/mL petroleum ether extract ,dichloromethane extract ,ethyl acetate extract of L. cuneata on the proliferation of glutamate-induced injury cellsafter pretreated for 12 h. Using water soluble vitamin E as positive control (50 µmol/L),DCFH-DA assay was used to detect the effects of 0(blank control ),25,50,100 µg/mL L. cuneata dichloromethane extract on the level of active oxygen (ROS)in glutamate-induced injury cells after pretreated with 12 h. Using HO-1 agonist CoPP as positive control ,Western blotting method was used to detect the effects of 0(blank control ),25,50,100 µg/mL L. cuneata dichloromethane extract on the protein expression of HO- 1 after treated for 24 h. Western blotting method (treated for 0.5,1,1.5 h)and immunofluorescence staining (treated for 1 h)were used to detect the effects of 100 µg/mL L. cuneata dichloromethane extract on protein expression of Nrf 2 inside and outside the nucleus. After HO-1 gene was silenced by small interfering RNA (Si RNA )transfection technology ,the effects of 100 µg/mL L. cuneata dichloromethane extract on the survival rates of glutamate-induced injury cells and the level of ROS were detected. RESULTS :Compared with blank control ,50, 100 µg/mL L. cuneata dichloromethane extract could significantly improve the survival rate of glutamate-induced injury cells (P< 0.05),while reduced the level of ROS (P<0.05). 25,50, 100 µg/mL L. cuneata dichloromethane extract could increase the protein expression of HO- 1 in cells(P<0.05),while 100 com µg/mL L. cuneata dichloromethane extract could significantly decrease the protein le vel of Nrf 2 in cytoplasm and increasethat in nucleus (P<0.05). After HO-1 gene silencing ,the effects of L. cuneata dichloromethane extract on the proliferation promotion of glutamate-induced injury cells and the reduction of ROS level were reversed (P<0.05). CONCLUSIONS :L. cuneata dichloromethane extract can protect HT 22 cells against injury induced by glutamate through activating Nrf 2 pathway,inducing HO- 1 expression.

16.
Journal of Clinical Hepatology ; (12): 904-907, 2020.
Article in Chinese | WPRIM | ID: wpr-819195

ABSTRACT

Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive technique for the treatment of portal hypertension in liver cirrhosis. With the gradual maturity of TIPS technique and the continuous improvement of stent materials, the indications for TIPS are gradually expanded, the incidence rate of complications gradually decreases, and the treatment outcome is getting better and better. The impact of TIPS on the main organs of patients has attracted more and more attention in recent years, and this article reviews the effect of TIPS on the liver and the heart.

17.
Article in Chinese | WPRIM | ID: wpr-817811

ABSTRACT

Objective Based on the data of gemcitabine adverse reactions (ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided. Methods From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0. Results Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients (48.68% vs 36.77%) and the highest incidence in the age group of 50-69 years (44.14%). The patients with lower status (KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR (61.54%) and the highest incidence of ADR in thymic carcinoma (62.50%), followed by hematological and reproductive system tumors (58.62% and 57.14%, respectively); ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit. Conclusion Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs.

18.
Journal of Clinical Hepatology ; (12): 1970-1974, 2020.
Article in Chinese | WPRIM | ID: wpr-829159

ABSTRACT

ObjectiveTo investigate the effect of intraoperative Viatorr stent implantation for shunting of blood flow in the left or right branch of the portal vein on the clinical outcome of patients with cirrhotic portal hypertension undergoing transjugular intrahepatic portosystemic shunt (TIPS). MethodsA retrospective analysis was performed for the clinical data of 120 patients with cirrhotic portal hypertension who underwent TIPS in The General Hospital of Western Theater Command from March 2016 to December 2019, and according to the target position of portal vein puncture determined by intraoperative angiography, the patients were divided into left branch group and right branch group. The two groups were compared in terms of the incidence rates of postoperative recurrence and bleeding, stent dysfunction, and hepatic encephalopathy (HE) and survival. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier curve was used to calculate rebleeding rate, stent patency rate, incidence rate of HE, and survival rate. ResultsThe surgical success rate was 100% for all 120 patients, with a short-term hemostasis rate of 100%. Among the 120 patients, 52 underwent shunting of the left branch of the portal vein and 68 underwent shunting of the right branch. There was a significant reduction in portal venous pressure after surgery (9.98±2.84 mm Hg vs 24.72±5.11 mm Hg, t=37.76, P<0.01). The cumulative rebleeding rates at 12 and 24 months after surgery were 3.2% and 11.0%, respectively, and the cumulative incidence rates of HE at 3, 6, 12, and 24 months after surgery were 10.8%, 13.6%, 21.2%, and 24.5%, respectively. Among the 29 patients who experienced HE, 23 had grade Ⅰ-Ⅱ HE and 6 had grade Ⅲ HE. The cumulative incidence rates of stent dysfunction at 12 and 24 months after surgery were 7.1% and 21.4%, respectively. The cumulative survival rates at 12 and 24 months after surgery were 92.0% and 86.5%, respectively. As for comparison of the left branch group and the right branch group, there were no significant differences in postoperative stent patency rate, rebleeding rate, incidence rate of HE, and survival rate(all P<0.05). ConclusionTIPS is a safe and effective method for the treatment of cirrhotic portal hypertension, and intraoperative Viatorr stent implantation, no matter for establishing the shunt of the left or right branch of the portal vein, will not affect the clinical outcome of patients.

19.
Article in Chinese | WPRIM | ID: wpr-752260

ABSTRACT

Objective To explore the clinical features of hemophagocytic syndrome in children and the signifi﹣cance of gene detection. Methods TWenty-tWo pediatric patients diagnosed as hemophagocytic syndrome since 2004 clinical and laboratory criteria Were enrolled in Children's Hospital Affiliated to Zhengzhou University from January 2014 to January 2016. The clinical data of patients Were analyzed,and the genes associated With hemophagocytic syn﹣drome Were detected. The clinical biochemical indicators Were compared betWeen mutation group and non -mutation group. Results TWenty-tWo cases of patients(3 months to 12 years)Were enrolled,including 10 males and 12 fe﹣males,and the proportion of children over 5 years old accounted for the highest proportion,accounting for 50%,and all of them had fever,liver,spleen and lymph node enlargement. The main test results Were as folloWs:peripheral blood cells decreased in 6 cases( 27. 27%),hemophagocytic phenomena presented in bone marroW smears in 12 cases (54. 55%),abnormal liver function in 18 cases(81. 82%),and loW serum albumin in 22 cases(100. 00%). High serum ferritin levels Were detected in 20 cases(90. 91%);the detection of natural killer(NK)cell activity shoWed nor﹣mal activity( active > 15%) in 7 cases( 31. 82%),and decreased activity( activity ≤ 15%) in 15 cases (68. 18%). The genes associated With hemophagocytic syndrome Were detected in 22 cases of patients,and 12 of them Were associated With mutations related to hemophagocytic syndrome,accounting for 54. 55%. LYST,ITK and UNC13D gene Were common. There Was no statistical difference in Which ages of onset,symptoms of the nervous system,and labo﹣ratory data of leukocyte count,red blood cell count,hemoglobin,platelet count,NK cell activities,prognosis,hemophago﹣cytic phenomena shoWed in bone marroW smears,alanine aminotransferase,albumin,triglyceride,ferritin and fibrinogen betWeen mutation group and non-mutation group(all P>0. 05). Conclusions Pediatric hemophagocytic syndrome is mostly accompanied by fever,liver,spleen and lymph node enlargement,and most of them are accompanied by gene mu﹣tations. LYST,ITK and UNC13D gene are commonly seen. But there is no significant correlation betWeen gene mutation and general condition,biochemical index and severity of the disease.

20.
Article in Chinese | WPRIM | ID: wpr-752212

ABSTRACT

Objective To rkskarch,dkvklop and vkrife of a simplk scrkkning path for 4-6 ekar old childrkn's sknsore intkgration. Methods Nink hundrkd and thirte-six childrkn agkd 4-6 ekars wkrk invkstigatkd be stratifikd clustkr random sampling from Octobkr to Novkmbkr of 2017,of whom 476 wkrk boes and 460 wkrk girls. L sknsore intk-gration rating scalk(Childrkn's Edition)was uskd to asskss thk sknsore intkgration abilite,and thk main kntre construc-tion profilk scrkkning scalk was kxtractkd according to thk factor analesis,and thk critical valuk was dktkrminkd in com-bination with thk arka undkr thk subjkct opkrating charactkristic curvk( AOC),thk rkliabilite,validite,sknsitivite and spkcificite wkrk kvaluatkd. ResuIts Thk sknsore intkgration disordkr ratk of 4-6 ekar old childrkn was 47. 76﹪,and thk 14 main factors wkrk kxtractkd be factor analesis,and thk cumulativk contribution ratk was 75. 052﹪. Lftkr thk max-imal orthogonal rotation of varianck,thk itkms with factor load matrix cokfficiknt ≥0. 75 wkrk sklkctkd to construct thk simplk sknsore intkgration scrkkning scalk,which wkrk simplifikd to 2 classification options from 13 itkms in thk original tablk. Thk sknsitivite of thk simplk scrkkning scalk was 82. 77﹪,and thk spkcificite was 80. 16﹪,and thk arka undkr thk AOC curvk was 0. 815. Thk corrklation cokfficiknts of vkstibular balanck,propriockption,tactilk sknsation,visual smoothnkss and auditore rkcognition with thk summare tablk wkrk 0. 793,0. 372,0. 699,0. 604,0. 482,rkspkctivkle( all P﹦0. 000). Thk Kappa of thk summare tablks and gknkrad tablk was 0. 628(P﹦0. 000). Thk Cronbach's Llpha of thk summare tablk was 0. 767. ConcIusions Thk simplk scrkkning scalk simplifiks thk sknsore intkgration rating scalk into skvkral main itkms,which is simplk to opkratk and can bk uskd as a primare scrkkning mkthod for sknsore intkgration disordkr.

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