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1.
Article in English | WPRIM | ID: wpr-927265

ABSTRACT

INTRODUCTION@#Percutaneous transluminal angioplasty (PTA) is commonly used to treat patients with chronic limb-threatening ischaemia (CLTI). This study aimed to examine the mortality and functional outcomes of patients with CLTI who predominantly had diabetes mellitus in a multi-ethnic Asian population in Singapore.@*METHODS@#Patients with CLTI who underwent PTA between January 2015 and March 2017 at the Vascular Unit at Singapore General Hospital, Singapore, were studied. Primary outcome measures were 30-day unplanned readmission, two-year major lower extremity amputation (LEA), mortality rates, and ambulation status at one, six and 12 months.@*RESULTS@#A total of 221 procedures were performed on 207 patients, of whom 184 (88.9%) were diabetics. The one-, six- and 12-month mortality rate was 7.7%, 16.4% and 21.7%, respectively. The two-year LEA rate was 30.0%. At six and 12 months, only 96 (46.4%) and 93 (44.9%) patients were ambulant, respectively. Multivariate analysis revealed that preoperative ambulatory status, haemoglobin, Wound Ischaemia and foot Infection (WIfI) score, and end-stage renal failure (ESRF) were independent predictors of one-year ambulatory status. Predictors of mortality at one, six and 12 months were ESRF, preoperative albumin level, impaired functional status and employment status.@*CONCLUSION@#PTA for CLTI was associated with low one-year mortality and two-year LEA rates but did not significantly improve ambulation status. ESRF and hypoalbuminaemia were independent predictors of mortality. ESRF/CKD and WIfI score were independent predictors of loss of ambulation at six months and one year. We need better risk stratification for patients with CLTI to decide between initial revascularisation and an immediate LEA policy.


Subject(s)
Amputation , Chronic Disease , Chronic Limb-Threatening Ischemia , Humans , Ischemia/surgery , Limb Salvage/methods , Lower Extremity/surgery , Peripheral Arterial Disease/surgery , Retrospective Studies , Risk Factors , Singapore , Treatment Outcome
2.
Article in Chinese | WPRIM | ID: wpr-906241

ABSTRACT

Objective:To evaluate the analgesic effects of Wenjing Zhitong prescription (WZP) and explore its possible analgesic mechanisms so as to provide experimental basis for research and development of new Chinese medicine. Method:Analgesic effects of WZP were evaluated by observing the writhing latency and number in the writhing models which were induced by oxytocin in rats as well as those induced by acetic acid and prostaglandin E<sub>1</sub> (PGE<sub>1</sub>), respectively in mice. Effect of WZP on uterine contraction frequency, amplitude and activity were evaluated by observing the oxytocin-induced contraction of uterine smooth muscle in rats and rabbits <italic>in vivo</italic>. In the oxytocin-induced rat writhing models, the content of prostaglandin F<sub>2</sub><italic><sub>α </sub></italic>(PGF<sub>2</sub><italic><sub>α</sub></italic>) and prostaglandin E<sub>2 </sub>(PGE<sub>2</sub>) in rat uterine tissues and the content of beta-endorphins (<italic>β</italic>-EP) in rat serum were detected by enzyme-linked immunosorbent assay (ELISA). Expression of estrogen receptor (ER) and oxytocin receptor (OTR) in rat uterine were tested by Real-time polymerase chain reaction(Real-time PCR) method to investigate the possible molecular mechanism of WZP for its analgesic effect. Result:Results of analgesic effect showed that in oxytocin-induced rat writhing experiment, the number of writhing responses in both the WZP (1.5,3.0 g·kg<sup>-1</sup>) group was lower than than in the model group (<italic>P</italic><0.05). In acetic acid-induced mice writhing experiment, the latency of writhing response in WZP (6.0 g·kg<sup>-1</sup>) group was significantly prolonged as compared with that in model group <italic>(P</italic><0.01), and the number of writhing response was significantly reduced (<italic>P</italic><0.05). In PGE<sub>1</sub>-induced mice writhing model, the writhing number in WZP (1.5,3.0,6.0 g·kg<sup>-1</sup>) groups was significantly lower than that in the model group (<italic>P</italic><0.05,<italic>P</italic><0.01). Results of effect on uterine smooth muscle demonstrated that WZP (0.38,0.75,1.50 g·kg<sup>-1</sup>) could significantly reduce the frequency of uterine smooth muscle contraction in rabbits (<italic>P</italic><0.05,<italic>P</italic><0.01), WZP (0.75,1.50,3.00 g·kg<sup>-1</sup>) could significantly reduce the contractile amplitude and activity of smooth muscle in the uterus of rats (<italic>P</italic><0.05). Results of molecular mechanisms of analgesic effects showed that the WZP (0.75,1.50,3.00 g·kg<sup>-1</sup>) significantly reduced the content of PGF<sub>2</sub><italic><sub>α</sub></italic> and the ratio of PGF<sub>2</sub><italic><sub>α</sub></italic> to PGE<sub>2</sub> in the uterine tissue of rats (<italic>P</italic><0.01). In the WZP (3.00 g·kg<sup>-1</sup>) group, the levels of <italic>β</italic>-EP in the serum of rats were significantly increased (<italic>P</italic><0.01), and the levels of OTR in uterus of rats in the WZP (1.50,3.00 g·kg<sup>-1</sup>) group were significantly decreased (<italic>P</italic><0.05). Conclusion:Pharmacological studies demonstrated potent analgesic effect of WZP, and such analgesic effect were mediated by significantly inhibiting contraction of uterine smooth muscle, decreasing the contents of PGF<sub>2</sub><italic><sub>α</sub> </italic>and ratio of PGF<sub>2</sub><italic><sub>α</sub></italic>/PGE<sub>2</sub>, reducing OTR expression in uterine as well as increasing the amount of <italic>β</italic>-EP in serum.

3.
Singapore medical journal ; : 582-587, 2021.
Article in English | WPRIM | ID: wpr-920931

ABSTRACT

INTRODUCTION@#This study aimed to assess understanding of the potential risks associated with medical imaging among caregivers and adolescent patients in a paediatric emergency department (PED) in Singapore.@*METHODS@#A prospective convenience sample survey was performed involving adolescents and caregivers presenting to our PED from December 2015 to May 2016. The questionnaire examined demographic data, knowledge of imaging procedures and radiation risks, and expectations regarding information provided about medical radiation.@*RESULTS@#A total of 349 questionnaires were returned (caregivers 82.5%, adolescents 17.5%). A mean of 6.2 ± 2.4 (out of 11) questions were correctly answered. Those who had tertiary education fared better than those who did not (36.4% vs. 17.2% scoring above the mean, p = 0.001). Age, gender, history of previous imaging and imaging performed during the visit did not affect the score. Two-thirds of the participants did not associate medical radiation with any negative lifetime risk of cancers or know that different scans entailed differing amounts of radiation. Most were unaware that the radiation dose in medical imaging is adjusted to a child's size. Among patients who underwent imaging, 90.1% received explanations on the need for scans, and 26.5% were informed of the risks involved. Almost all participants wished to be informed of imaging indications and risks. More preferred to learn this from physicians (75.6%) or technicians (51.6%) rather than through educational pamphlets (34.4%) or Internet resources (22.9%).@*CONCLUSION@#Awareness regarding medical radiation needs to be improved in our patient population. A mismatch exists between caregiver expectations and the actual procedure of disclosure of the risk associated with radiation.

4.
Article | IMSEAR | ID: sea-210706

ABSTRACT

The absence of dispensing separation between private doctor clinics and pharmacies is the main challenge of theMalaysian community pharmacists. Within this context, the utilization of non-prescription medicines for minorailments treatment is one of the major roles of the pharmacists. This study aimed to evaluate the minor ailmentsmanagement using non-prescription medicines among the Malaysian community pharmacists. This was a crosssectional descriptive study. The entire population of Malaysian community pharmacists (n = 2,730) were invitedfor participation. Data were collected across the first 10 requests for minor ailments management involved adultconsumers in a working day. A total of 173 pharmacists were participated (response rate 6.3%) and 1,704 consumerswith 2,149 minor ailments were encountered. The consumers mostly have one minor ailment (78.3%) and involvedacute conditions (92.3%). Productive cough (7.3%), fever (6.3%), and dermatitis (6.1%) were most commonlymanaged by the pharmacists. Cetirizine (5.9%), paracetamol (4.7%), and diclofenac (4.2%) were most frequentlydispensed and each consumer received an average (median) of two medications. The median duration of treatment was5 days [inter-quartile range (IQR): 3–7] and the cost of treatment involved only medicines cost (median: RM 13.40;IQR: 8.00–21.00) without any consultation fee. The majority of the consumers (75.5%) sought help from pharmacistsfirst without consulting the doctors. Only 16.4% of the consumers were followed-up by the pharmacists. In conclusion,the pharmacists actively managed the minor ailments with an affordable cost of treatment. Guidelines and an auditsystem should be established to enhance the minor ailments practices of the pharmacists.

5.
Article in English | WPRIM | ID: wpr-880737

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which first affected humans in China on December 31, 2019 (Shi et al., 2020). Coronaviruses generally cause mild, self-limiting upper respiratory tract infections in humans, such as the common cold, pneumonia, and gastroenteritis (To et al., 2013; Berry et al., 2015; Chan et al., 2015). According to the Report of the World Health Organization (WHO)-China Joint Mission on COVID-19 (WHO, 2020), the case fatality rate of COVID-19 increases with age, while the rate among males is higher than that among females (4.7% and 2.8%, respectively). Since an effective vaccine and specific anti-viral drugs are still under development, passive immunization using the convalescent plasma (CP) of recovered COVID-19 donors may offer a suitable therapeutic strategy for severely ill patients in the meantime. So far, several studies have shown therapeutic efficacy of CP transfusion in treating COVID-19 cases. A pilot study first reported that transfusion of CP with neutralizing antibody titers above 1:640 was well tolerated and could potentially improve clinical outcomes through neutralizing viremia in severe COVID-19 cases (Chen et al., 2020). Immunoglobulin G (IgG) and IgM are the most abundant and important antibodies in protecting the human body from viral attack (Arabi et al., 2015; Marano et al., 2016). Our study aimed to understand the aspects of plasma antibody titer levels in convalescent patients, as well as assessing the clinical characteristics of normal, severely ill, and critically ill patients, and thus provide a basis for guiding CP therapy. We also hoped to find indicators which could serve as a reference in predicting the progression of the disease.


Subject(s)
Adult , Aged , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/therapy , China , Female , Humans , Immunization, Passive , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged
6.
Chinese Acupuncture & Moxibustion ; (12): 1187-1190, 2020.
Article in Chinese | WPRIM | ID: wpr-877584

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect of acupuncture combined with cranial electrotherapy stimulation (CES) on generalized anxiety disorder (GAD).@*METHODS@#A total of 200 patients with GAD were randomized into an acupuncture+CES group, an acupuncture group, a CES group and a medication group, 50 cases in each one. In the medication group, patients were treated with tandospirone citrate tablet orally, 10 mg after breakfast, lunch and dinner respectively. In the CES group, CES was adopted by SCS brain electromedical instrument, 60 min each time, once a day. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Yintang (GV 29), Shenting (GV 24), etc., 30 min each time, once a day. In the acupuncture+CES group, CES was adopted before acupuncture. Treatment of sixty days was required in the 4 groups. Before and after treatment, the scores of Hamilton anxiety scale (HAMA), World Health Organization's quality of life questionnaire-brief version (WHOQOL-BREF) and treatment emergent symptom scale (TESS) were observed, the clinical effect was evaluated, and the relapse of anxiety during follow-up of 1 year after treatment was recorded in the 4 groups.@*RESULTS@#Compared before treatment, the scores of HAMA after treatment were decreased (@*CONCLUSION@#Acupuncture combined with CES can effectively relieve the symptoms in patients with GAD, improve the quality of life, reduce the occurrence of adverse reactions and the relapse rate, and its clinical effect is obviously superior to the western medication, the simple application of acupuncture or CES.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Anxiety Disorders/therapy , Electric Stimulation Therapy , Humans , Quality of Life , Treatment Outcome
7.
Article in Chinese | WPRIM | ID: wpr-873046

ABSTRACT

Objective:Potential targets and pathways of Qingfei Paidu decoction(QFPD)for treating coronavirus disease-2019(COVID-19) were analyzed based on the integrative pharmacology,the efficacy and material basis was predicted.This study provide a reference for the development and clinical application of QFPD. Method:Based on the integrative pharmacology of traditional Chinese medicine(TCMIP V2.0),the key targets and pathways of the intervention of QFPD on COVID-19 were enriched,the interaction network of "formula-herb-disease-targets-pathways" was constructed to explored the molecular mechanism of QFPD for the treatment of COVID-19. Result:The research results show that key-targets such as cell tumor antigen p53(tp53),protein kinase B1(Akt1),Nuclear factor nuclear transcription factor-κB(NF-κB)p105 subunit(NFKB1),nuclear factor p65 subunit(RELA),human NF-κB inhibited protein α(NFKBIA),ect.Closely associated with lung damage.The pathways such as interleukin signaling,adrenoceptors,7 members of the family of c-type lectin domains A(CLEC7A)/inflammasome pathway,phosphoinositide-3-kinase(PI3K)/protein kinase B(Akt)inflammatory signaling pathway,tp53 regulates transcription of DNA repair ect. may be the key pathways related with QFPD's effect on the treatment of COVID-19 accompany with lung injury, fever, cough and other symptoms.The results show that QFPD has many clinical effects, such as anti-inflammatory, anti-virus, strengthening immunity, inhibit the development of pulmonary fibrosis, protecting heart and lungs, treating asthma, regulating gastrointestinal tract, etc.In addition, there is a good synergism between the original prescription and the combined prescription, and each original prescription has its own emphasiscan prevention and treatment of COVID-19. Conclusion:QFPD plays a role in balancing immunity and eliminating inflammation,and it can treat COVID-19 by multi-pathway,multi-channel,multi-target and multi-link.This study also provides a new idea for the research of prevention and treatment of modern infectious diseases by use the traditional Chinese medicine.

8.
China Medical Equipment ; (12): 18-20, 2019.
Article in Chinese | WPRIM | ID: wpr-744947

ABSTRACT

Objective:To design an alarm system for patients'tumble based on a six-axes attitude sensor so as to monitor patients'tumble during they lied in bed of hospital or they acted in ward of hospital.Methods:The internet of things (IOT) platform with six-axes attitude sensor and Zigbee module which adopted the functions of measurement and calculation based on six-axes attitude sensor were used to compose automatic alarm system for patients'tumble in ward of hospital.Arduino was adopted as the development platform of hardware to obtain the sensors data that were worn on patients through the I2C trunk method.And through implemented preprocess and numerical value filtering for data to perform posture calculation.Results:This design has realized the recognition for patient's current position and the alarm in time for sudden event of tumble.It could assist clinical workers to achieve better care for patients.Conclusion:This design basically realizes the function of monitoring and alarm for the situation of patient's tumble, but there are some problems includes sporadic misjudgment and oversize wearing hardware.It is planned to improve the practicability of the system by improving the algorithm and hardware platform.

9.
Article in Chinese | WPRIM | ID: wpr-745089

ABSTRACT

Objective To determine the optimal pathway for S1 sacroiliac screwing based on the largest safe zone in Chinese population using 3D imaging models and observe its clinical application in patients with sacroiliac joint fracture or dislocation.Methods Pelvic CT scans of 54 Chinese adults were obtained to create reconstruction 3D models of the right hemi-pelvis.After the models were transparentized and rotated to the axial view of the S1 pedicle,the angle was slightly adjusted to maximize the translucent safe zone.Next,simulative insertion into the center of this zone was conducted with one virtual screw,as large as possible and tangent to the boundary.Measured were the diameter and length of the screw,the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine,and from the exit point to the S1 superior endplate and to the anterior cortex.The differences between males and females were analyzed.The above parameters of the optimal pathway for S1 sacroiliac screwing were used in insertion of 16 screws in the 12 patients with sacroiliac joint fracture or dislocation from January 2014 to January 2016 at Department of Orthopaedics and Traumatology,Nanfang Hospital.They were 8 males and 4 females,from 16 to 47 years of age (average,34 years).According to the Tile classification,6 cases belonged to Type Ⅱ and 6 ones to Type Ⅲ.The efficacy of S1 sacroiliac screwing was observed.Results In all the pelvic 3D imaging models,an oval translucent area for safe screw insertion could be easily identified from the S1 pedicle axial view.The maximum diameter and length of the optimal intraosseous pathway were 13.66 ±2.04 mm and 77.66 ±4.25 rmm;the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine were 32.77 ± 4.55 mm and 49.57 ± 5.24 mm;the vertical distances from the exit point to the S1 superior endplate and to the anterior cortex were 9.30 ± 1.54 mm and 15.85 ± 2.12 mm.The differences were of statistical significance between males and females regarding the maximum diameter,the distance from the entry point to the vertical axis,and the distance from the exit point to the anterior cortex (P < 0.05).All the 16 screws were safely implanted in the 12 patients.Conclusion The optimal screw pathway can be easily identified and its parameters can be measured in pelvic 3D imagingmodels using computer virtual technology.The clinical application has proved that the parameters can serve as a theoretical basis for safe placement of S1 sacroiliac screws.

10.
Article in Chinese | WPRIM | ID: wpr-802223

ABSTRACT

Diarrhea-predominant irritable bowel syndrome (IBS-D) is not only a biological mental disorder, but also a kind of chronic functional bowel disease induced by many factors. The pathogenesis of IBS-D is related to visceral sensory abnormalities, intestinal dynamics abnormalities, intestinal mucosal micro-inflammatory reactions, heredity, dietary intolerance and other factors. The visceral hypersensitivity is one of the main pathophysiology, and refers to an unknown cause of intestinal hypersensitivity to cold, bad mood and other stimuli. However, its mechanism remains unclear. The pathogenesis of IBS-D is closely related to the disturbance of brain and intestinal interaction. IBS-D patients often suffer from anxiety, depression and other psychiatric symptoms due to repeated illness, but long-term chronic mental stress can induce and aggravate IBS-D visceral hypersensitivity. Brain-derived neurotrophic factor (BDNF) and its high-affinity receptor tyrosine kinase B (TrkB) are hotspots in studies about brain-gut axis. BDNF is a highly expressed cytokine in the central nervous system and gastrointestinal tract, and can promote the development of the nervous system, maintain the normal function of mature nerve cells and regulate the gastrointestinal motility and visceral sensitivity. Intestinal microbiota is the key link of brain-gut interaction. Mental disorders are closely related to intestinal symptoms caused by changes in intestinal microbial environment. Repeated mental stimulation can lead to changes in intestinal flora; on the other hand, changes in intestinal flora structure are closely related to the development of the nervous system and the function of the brain. With intestinal microbiota as the study object, this article mainly discusses the effect of intestinal microbiota in regulating visceral hypersensitivity of IBS-D based on brain-gut axis (BDNF/TrkB signaling pathway).

11.
Article in Chinese | WPRIM | ID: wpr-777509

ABSTRACT

Hepatic fibrosis is a liver damage healing response affected by a variety of factors; its formation is associated with multiple cytokines and a variety of signaling pathways. Transforming growth factor beta1( TGF-β1) is one of the strongest fibrosis cytokines known,and involves almost all the key links in hepatic fibrosis. TGF-β1/Smads signal pathway is the most classical pathway for TGF-β1 to play its role in promoting fibrosis as well as one of the most important signaling pathways of hepatic fibrosis formation. Studies for the signal pathway have made a series of scientific research achievements in recently years. Traditional Chinese medicine has the advantages of " multiple ingredients,multiple targets and less side effects",and is widely used in the clinical treatment of hepatic fibrosis.Effective components of traditional Chinese medicine are monomer compounds,which are extracted and purified from traditional Chinese medicine. Nowadays,the molecular biology studies of effective traditional Chinese medicine have become a hotspot. Modern advanced technology and methods can be used to directly clarify the targets and the signaling pathways,reveal the mechanism of traditional Chinese medicine in treating diseases,and promote the modernization and international development of traditional Chinese medicine industry. This review summarized the structure,function and application of TGF-β1/Smads signaling pathway in the progress of anti-hepatic fibrosis,and analyzed the action mode and possible mechanism of various effective components of traditional Chinese medicine in regulating TGF-β1/Smads signaling pathway and intervening the treatment of hepatic fibrosis in the past five years,so as to put forward new ideas for innovating new targeted traditional Chinese medicine for hepatic fibrosis.


Subject(s)
Animals , Drugs, Chinese Herbal , Liver Cirrhosis , Medicine, Chinese Traditional , Signal Transduction , Smad Proteins , Transforming Growth Factor beta1
12.
Article in Chinese | WPRIM | ID: wpr-776545

ABSTRACT

OBJECTIVE@#To investigate the therapeutic effects of the black buckwheat leaf (BBL) in type 2 diabetes mellitus mice and its effects on pancreas and spleen.@*METHODS@#Forty male C57 / B16 mice (SPF) were randomly divided into normal control (NC) group (n=10) and the experimental group (n=30), the experimental group were fed with high sugar and high fat, combined with intraperitoneal injection of streptozotocin in small dose to establish the model of type 2 diabetes mellitus (T2DM). Those thirty model mice were randomly divided into 3 groups (n=10), diabetes mellitus group (DM), low dose of BBL (DM+L) treated group, high dose of BBL (DM+H) treated group. The mice in the NC group and the DM group were given normal saline per day, and the DM+L group and DM+H group were treated with black tartary buckwheat at the doses of 0.21g/kg·d and 0.42g/kg·d respectively. After 14 days. All mice were executed by cervical dislocation, then blood samples were collected, pancreas and spleen were removed for subsequent experiments. The serum levels of fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TCH) and insulin were detected. TNF-α protein in spleen tissue was detected by ELISA kit. The morphology of pancreas tissue was observed by HE staining, and the spleen coefficient was calculated. The expression levels of insulin receptor substrate-1(IRS-1) mRNA and IRS-1 protein in pancreatic tissue were detected.@*RESULTS@#Compared with the control group, the serum levels of FBG, TC and TCH in the model group were increased significantly, while the serum level of insulin was decreased significantly (P<0.05), the expression of TNF-α protein in spleen tissues was obviously raised, the expressions of IRS-1 mRNA and IRS-1 protein in pancreatic tissue in model group were decreased significantly (P<0.05). Compared with the model group, the serum levels of FBG, TC and TCH were decreased significantly in the BBL treated groups. The serum insulin level, spleen coefficient, TNF-α protein expression level in spleen tissue, IRS-1 mRNA expression and IRS-1 protein expression levels in pancreatic tissue in BBL treated group were increased significantly (P< 0.05). High-dose black tartary buckwheat leaves (0.42g/kg·d) exerted a more significant effect.@*CONCLUSION@#Stem and leaf of black bitter buckwheat has significant therapeutic effects on reducing blood sugar and blood fat in type 2 diabetic mice, and has certain protective effects on pancreas and spleen of diabetic mice.


Subject(s)
Animals , Diabetes Mellitus, Experimental , Drug Therapy , Diabetes Mellitus, Type 2 , Drug Therapy , Fagopyrum , Chemistry , Male , Mice , Mice, Inbred C57BL , Pancreas , Plant Leaves , Chemistry , Plant Stems , Chemistry , Random Allocation , Spleen , Streptozocin
13.
Article in Chinese | WPRIM | ID: wpr-712922

ABSTRACT

[Objective]To evaluate the effects of dexmedetomidine intratracheal instillation on quality of emergence from general anesthesia in patients undergoing gynecologic laparoscopic operation. [Methods]Ninety patients of ASA I orⅡ,aged 18~64 years old,weighed 40~80 kg,scheduled for elective gynecological 1aparoscopic surgery under general anes-thesia,expected surgery time 1-2 h,requiring endotracheal extubation after surgery,were randomly divided into 3 group (n=30 each):control group(group C),exmedetomidine administered intratracheally group(group D1)and dexmedetomi-dine administered intravenously group(group D2).At the beginning of operation,2 μg/kg of dexmedetomidine were infused intratracheal through the drug injection hole of disposable enhanced Ⅲendotracheal tube in group D1 and 0.5 μg/kg of dex-medetomidine were intravenous pumped in 10 minutes in group D2,while saline was used in group C.The patients were sent to postanesthesia care unit after extubaion. MAP and HR were recorded at the time of dexmedetomidine or saline infused (T0),and 5,10,15,30 min(T2-T4)after dexmedetomidine or saline infused,immediately after extubation(T5),and 5,10,15,30 min(T6-T9)after extubation.The time of the patients to recover spontaneous breath,eye opening,extubation and direc-tional power were recorded.The cough reflex scores and sedation-agitation scale during extubation,the visual analogue scale and Ramsay sedation scale at 30 minutes after extubation were also recorded.[Results]①Compared with T0,MAP and HR increased statistically at T5~T7in group C,MAP increased statistically at T5~T6and HR increased statistically at T5~T7in group D1 and D2(P<0.05).Compared with group C,MAP and HR at T5~T7decreased statistically in group D1 and D2(P<0.05).②The scores of cough reflex,sedation-agitation scale and visual analogue scale were significantly lower in group Dl and D2 than in group C(P<0.5).③The incidence of agitation,high blood pressure and tachycardia were significantly lower in group D1 and D2 than in group C(P<0.05).[Conclusions]Either intravenous pumping or intratracheal instillation of dex-medetomidine for patients undergoing gynecological laparoscopic surgery can effectively keep stable perioperative hemody-namics,relieve cough reflex,agitation incidence and enhance the quality of emergence from general anesthesia recovery.

14.
Intestinal Research ; : 571-578, 2018.
Article in English | WPRIM | ID: wpr-717947

ABSTRACT

BACKGROUND/AIMS: Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term consequences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily functional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence. METHODS: Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability: < 3.5) and Beliefs about Medicines Questionnaire (high necessity/concerns: ≥16). The primary outcome was the association between medication non-adherence and disability. Secondary outcomes were the predictors of these outcomes. RESULTS: A total of 173 subjects on IBD maintenance medications were recruited (98 Crohn’s disease, 75 ulcerative colitis: median IBD-DI, –5.0; interquartile range [IQR], –14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P < 0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (–16.0 vs. –2.0, P < 0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P < 0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50–9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14–6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11–5.92; P=0.028). CONCLUSIONS: Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability.


Subject(s)
Colitis, Ulcerative , Compliance , Crohn Disease , Female , Hemorrhage , Hospitalization , Humans , Inflammatory Bowel Diseases , Mars , Medication Adherence , Recurrence , Referral and Consultation
15.
Article in Chinese | WPRIM | ID: wpr-699488

ABSTRACT

Objective To investigate the expression of interleukin-17 (IL-17) in peripheral blood mononuclear cells (PBMC) of patients with multiple myeloma and analyse it's clinical significance.Methods Thirty patients with multiple myeloma in the Department of Hematopathy,the Third Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2017 were selected as observation group;and thirty healthy donors whose gender and age machted with patients in the observation group were selected as control group.Peripheral blood mononuclear cells were obtained from subjects in observation group and control group by using the method of density gradient centrifugation.The content of IL-17 in supernatant of PBMC culture solution of subjects in the two groups was detected by enzyme linked immunosorbent assay and the expression of IL-17 mRNA in PBMC was detected by quantitative real-time polymerase chain reaction;the cellular morphology of PBMC of subjects in control group was observed by scanning electron microscope after co-culturing with the serum of patients in observation group.Results The content of IL-17 in supernatant of PBMC culture solution of subjects in the observation group and control group was (30.79 ± 4.96),(10.10 ± 4.15) ng · L-1 respectively;the content of IL-17 in supernatant of PBMC culture solution of subjects in the observation group was significantly higher than that in the control group (t =3.412,P < 0.05).The expression of IL-17 mRNA in PBMC in the observation group and control group was 4.28 ± 1.34 and 2.45 ±0.95 respectively;the expression of IL-17 mRNA in PBMC in the observation was significantly higher than that in the control group (t =2.796,P <0.05).After co-culturing of PBMC of subjects in the control group with the serum of patients in the observation group,the morphology of PBMC changed obviously,and membrane desquamate,membrane disintegration,even membranolysis were observed in some cells with the prolongation of co-culture time.Conclusion The over-expression of IL-17 in PBMC of patients with multiple myeloma may play a certain role in the occurrence and development of this disease.

16.
Chinese Medical Journal ; (24): 1450-1456, 2018.
Article in English | WPRIM | ID: wpr-688098

ABSTRACT

<p><b>Background</b>Cardiotoxicity is one of the most serious chronic complications of anthracyclines therapy. Assessment of the left ventricular ejection fraction (LVEF) fails to detect subtle cardiac dysfunction of left ventricular (LV). This study aimed to detect and evaluate new parameters of subclinical anthracyclines' cardiotoxicity in children with solid tumor.</p><p><b>Methods</b>A detailed echocardiographic examination was performed in 36 children with hepatoblastoma or rhabdomyosarcoma after receiving anthracyclines' chemotherapy and 36 healthy controls from January 2015 to December 2016. The LVEF, ratio of early diastolic peak velocity of transmitral flow (E) and septal diastolic e' mitral annular peak velocity (e'), tricuspid annular plane systolic excursion (TAPSE), and LV global longitudinal strain (GLS) were evaluated using M-mode, tissue Doppler imaging (TDI), and two-dimensional speckle tracking echocardiography (2D-STE), respectively. Echocardiographic parameters were compared between patient group and healthy controls. All patients were divided into two subgroups based on their anthracyclines' cumulative dosage (<300 mg/m subgroup and ≥300 mg/m subgroup).</p><p><b>Results</b>All patients had no presentation of heart failure and LVEF within normal range (65.7 ± 5.1%). Compared with healthy controls, the mean E/e' increased significantly (7.9 ± 0.7 vs. 10.2 ± 3.5, t = 3.72, P < 0.01), mean TAPSE decreased significantly (17.2 ± 1.3 mm vs. 14.2 ± 3.0 mm, t = -4.03, P < 0.01), and mean LV GLS decreased significantly (-22.2% ± 1.9% vs. -17.9% ± 2.9%, t = -5.58, P < 0.01) in patient group. Compared with subgroup with anthracyclines' cumulative dosage < 300 mg/m, mean LV GLS decreased significantly (-18.7 ± 2.7% vs. -16.5 ± 2.1%, t = 2.15, P = 0.04), the mean E/e' increased significantly (9.1 ± 1.5 vs. 11.5 ± 4.9, t = -2.17, P = 0.04), and mean TAPSE decreased significantly (14.2 ± 2.1 mm vs. 12.5 ± 2.2 mm, t = -2.82, P = 0.02) in subgroup with anthracyclines' cumulative dosage ≥300 mg/m.</p><p><b>Conclusions</b>LV GLS is helpful in the early detection of subclinical LV dysfunction using 2D-STE. E/e' and TAPSE are other sensitive parameters in detecting subclinical cardiac dysfunction of both ventricles by TDI. These parameters show significant change with different anthracyclines' cumulative dosage, so cumulative dosage should be controlled in clinical treatment.</p>


Subject(s)
Anthracyclines , Therapeutic Uses , Cardiotoxicity , Diagnosis , Child, Preschool , Echocardiography , Female , Heart Failure , Drug Therapy , Pathology , Humans , Infant , Male , Ventricular Function, Left
18.
Article in Chinese | WPRIM | ID: wpr-333453

ABSTRACT

The clinical value of transvaginal ultrasound in clinical surgical treatment of cesarean scar pregnancy (CSP) was evaluated.The clinical data of 104 patients with CSP admitted at Tongji Hospital from 2013 to 2016 were collected and analyzed retrospectively,including the patients' age,gestational age,the size of gestational sac or uneven mass,the uterine scar thickness,β human chorionic gonadotropin (hCG) levels and so on.Of these 104 cases,30 cases were subjected to laparotomy,29 cases to laparoscopy,27 cases to hysteroscopy,16 cases to ultrasound-guided uterine curettage,and 2 cases to conservative treatment.The transvaginal ultrasound showed that uterine scar thickness and gestational sac or uneven mass size had significant difference (P<0.05) among different surgical methods by comparatively analyzing the patients' data.It was suggested that transvaginal ultrasound may provide the valuable reference for choosing clinical surgical procedures for CSP.

19.
Article in Chinese | WPRIM | ID: wpr-712415

ABSTRACT

After a description of the concept of research frontier, advantages and disadvantages of qualitative and quantitative research frontier analysis methods, application of qualitative and quantitative research frontier analysis methods and existed problems, it was pointed out that the automatic detection method of heterogeneous data source text mining was a trend for the research frontier identification methods.

20.
Article in Chinese | WPRIM | ID: wpr-311592

ABSTRACT

<p><b>OBJECTIVE</b>To detect the expression of microRNA-210(miR-210) in childhood acute lymphoblastic leukemia(ALL), and to evaluate the role of the joint detection of miR-210 and MRD in the prognosis and clinical treatment of pediatric ALL.</p><p><b>METHODS</b>Eighty-eight children diagnosed with ALL were included in the study. miR-210 was quantitatively detected by real-time quantitative polymerase chain reaction(RQ-PCR) in 88 ALL patients. The average Ct value of samples obtained from 5 pediatric ALL patients with long-term complete continuous remission (CCR>5 years) was used as a calibrator. The expression levels of miR-210 in newly diagnosed patients was calculated by the 2method and presented as multiple changes compared with that of the 5 CCR patients.</p><p><b>RESULTS</b>The expression of miR-210 in the favorable prognosis group was significantly higher than that in the unfavorable prognosis group (10.64±1.5 vs 3.27±0.68)(P<0.05). Compared with the miR-210 high-expression group, poorer relapse-free survival(RFS), event-free survival(EFS) and overall survival(OS) (P all <0.001) were found in the low-expression group. Based on the expression of miR-210 and MRD, the 88 cases were divided into 3 groups. The relapse rate of miR-210-MRD high-risk group (70%) was significantly higher than that of the miR-210-MRD middle-risk group(6.25%) and miR-210-MRD low-risk group (2.1%). Kaplan-Meier survival analysis demonstrated that the miR-210-MRD high-risk group had poorer RFS, EFS and OS than those in other 2 groups (P all <0.01).</p><p><b>CONCLUSION</b>The expression level of miR-210 is an independent prognostic factor for pediatric ALL, and the miR-210 is a good useful indicator for predicting the relapse and induction failure of childhood ALL. Joint detection of miR-210 and MRD can help predict outcomes more precisely, thus may be used as an effective mean of determining prognosis, monitoring recurrence, and guiding treatment.</p>

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