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1.
China Pharmacy ; (12): 1260-1265, 2019.
Article in Chinese | WPRIM | ID: wpr-816975

ABSTRACT

OBJECTIVE: To establish antibiotics use rationality evaluation model in type Ⅰ incision surgery patients, and to provide reference for prescription review of clinical pharmacists. METHODS: Totally 432 inpatients underwent type Ⅰ surgical incision in a hospital from Jan. 1st- Dec. 31st, 2017 were selected as the research objects. The information of diagnosis and treatment including age, nosocomial infection, the number of kinds of antibiotics used were extracted. Based on the results of clinical pharmacists’ comments on the antibiotics use rationality in patients’ prevention and treatment, non-conditional Logistic regression and support vector machine (SVM) in machine learning method were used to convert clinical pharmacists’ comments into objective index that can be recognized by the machine learning model, using categories of antibiotics (preventive or therapeutic use) as dependent variables and the patient’s diagnosis and treatment information as independent variables. Classification and identification model was established for antibiotics use rationality in type Ⅰ incision surgery patients. Using sensitivity, specificity and Youden index as indexes, established mode was validated on the other 61 samples of type Ⅰ incision surgery patients. The rationality of antibiotics prescriptions in type Ⅰ incision surgery patients before (by manual review, Jan.-Dec. 2017) and after (Jan.-Oct. 2018) using the model were collected, and the effects of the model were evaluated. RESULTS: The sensitivity, specificity and Youden index of non-conditional Logistic regression model were 65.63%, 75.00% and 40.63%, respectively. Main parameters of the model established by SVM included gamma 0.01, cost 10, sensitivity 92.19%, specificity 87.50%, Youden index 79.69%. The model established by SVM was better than non-conditional Logistic regression. SVM was used to validate established mode, and sensitivity, specificity and Youden index were 100%, 88.57% and 88.57%, respectively. Compared with before using the model, the evaluation ratio increased from 69.44% to 100%, the rate of prophylactic use of antibiotics decreased from 23.84% to 16.43%, the rate of rational drug type selection increased from 37.86% to 54.39%, and treatment course shortened from 5.01 days to 3.26 days after using the model. CONCLUSIONS: Established antibiotics use rationality evaluation model in typeⅠincision surgery patients by SVM in machine learning method fully covers all the patients, promotes rational use of antibiotics in typeⅠincision surgery patients, and provides a new idea for pharmacist prescription comment.

2.
Article in Chinese | WPRIM | ID: wpr-774427

ABSTRACT

OBJECTIVE@#To explore the safety, feasibility and short-term efficacy of intracavitary uncut Roux-en-Y (URY) anastomosis in digestive tract reconstruction following laparoscopic total gastrectomy (LTG).@*METHODS@#From November 2015 to January 2018, 67 gastric cancer patients underwent intracavitary URY following LTG to reconstruct the digestive tract at Oncological Surgery Department of Fujian Provincial Hospital. There were 41 males and 26 females with age of 50 to 81 (61.9±7.4) years and body mass index (BMI) of (23.4±3.2) kg/m². Among 67 patients, 19 were gastric cardia carcinomas, 33 were gastric body carcinomas, and 15 were gastric fundus carcinomas; tumor size was (3.4±2.3) cm; 22 were Borrmann type I, 15 were type II, 21 were type III, and 19 were type IV; 29 were highly or moderately differentiated adenocarcinoma, 23 were lowly differentiated adenocarcinoma, and 15 were signet-ring cell carcinoma. After conventional laparoscopic D2 radical gastrectomy, the duodenum was closed and dissociated at 2 cm below the pyloric ring using the Echelon-flex endoscopic articulated linear Endo-GIA stapler, and the esophagus was dissociated above the esophagogastric junction (EGJ).URY and digestive tract reconstruction were performed under the direct vision of laparoscope: (1) Side-to-side esophagojejunostomy: An incision of 0.5 cm was made in the left lower edge of the esophageal closed end; jejunum about 25 cm distal away from the Treitz ligament was elevated to the lower end of esophagus; another incision of 0.5 cm was made in the contralateral of mesenteric side; both arms of the linear Endo-GIA stapler were inserted into the windows opened through esophagus and jejunum respectively to complete side-to-side anastomosis. The common opening of esophagus and jejunum was closed to complete esophagojejunostomy, forming the chyme outflow tract. (2) Side-to-side Braun jejunojejunostomy: Incisions of 0.5 cm were made in the proximal jejunum about 10 cm away from the esophagojejunal anastomosis and 35-40 cm away from the contralateral of mesenteric side of distal jejunum respectively for proximal-distal side-to-side jejunojejunostomy. The common opening was closed to form the biliopancreatic duodenal juice outflow tract. (3) Closure of the input loop jejunum in the esophagojejunal anastomosis: The input loop jejunum 2-3 cm away from the esophagojejunal anastomosis was closed using the non-blade linear stapler (ATS45NK), and the biliopancreatic duodenal juice reflux was blocked. Clinical data of these patients were collected for retrospective case series study. Surgical and digestive tract functional recovery, perioperative complications, as well as postoperative nutritional status were observed. Moreover, related indexes, such as anastomosis function and tumor recurrence were evaluated through endoscopic and imaging examinations during postoperative follows-up.@*RESULTS@#All the 67 patients completed the surgery successfully. The mean operative time was (259.4±38.5) minutes, digestive tract reconstruction time was (38.2±13.2) minutes, intraoperative blood loss was (73.4±38.4) ml, and number of harvested lymph node was 36.2±14.2. The mean distance from upper resection margin to upper tumor edge was (3.3±1.2) cm, distance from upper resection margin to dentate line was (1.2±0.7) cm, and 1 case had positive upper incisal margin, which became negative after the second resection. Moreover, the average length of the auxiliary incision was (3.2±0.4) cm. The mean postoperative intestinal exhaust time was (52.8±26.4) hours, time to liquid diet was (64.8±28.8) hours, and postoperative hospital stay was (8.4±2.5) days. The morbidity of postoperative complication was 10.4%(7/67). Among these 7 cases, 4 cases were grade IIIa of Clavien-Dindo classification, including 2 with esophagojejunal anastomosis leakage, 1 with duodenal stump leakage, and 1 with abdominal infection, and all these patients were recovered after conservative treatment. All the 67 patients were followed up. The mean nutrition index 12 months after surgery was 53.4±4.2, diameter of esophagojejunal anastomosis was (3.9±0.6) cm, the incidence of Roux-en-Y stasis syndrome was 3.0% (2/67), and the incidence of reflux esophagitis was 4.5% (3/67). No patient had recanalization of the closed input loop of esophagojejunal anastomosis, anastomotic stenosis, obstruction, or tumor recurrence at anastomosis.@*CONCLUSION@#Intracavitary URY anastomosis following LTG for digestive tract reconstruction is safe and feasible, leading to fast postoperative recovery of digestive tract function and favorable short-term efficacy.


Subject(s)
Anastomosis, Roux-en-Y , Methods , Anastomosis, Surgical , Female , Gastrectomy , Methods , Humans , Jejunum , Laparoscopy , Male , Retrospective Studies , Stomach Neoplasms , General Surgery
3.
Article in Chinese | WPRIM | ID: wpr-805684

ABSTRACT

Objective@#To understand the current situation of blood-borne occupational exposure among health care workers and evaluate the intervention effect of PDCA.@*Methods@#Retrospective survey was adopted to investigate and analyze the blood-borne occupational exposure incidents in a hospital from January 2015 to December 2018, and to compare the intervention effects after PDCA management.@*Results@#A total of 82 cases of occupational exposure occurred from 2015 to 2017, and only 9 cases happened after the implementation of PDCA intervention. The exposed population was mainly consisted of nurses (59 cases, 64.83%) , and mainly with low-working age (1-5 years) (56 cases, 61.54%) , and the main source of exposure was hepatitis B (34 cases, 37.36%) . In addition, after the implementation of PDCA, the vaccination rate of personnel was 77.78%, the standardized field treatment rate was 100%, the preventive drug use rate was 88.89%; The qualified rate of occupational protection assessment was higher than that before intervention, which all shows the difference was statistically significant (P<0.05) .@*Conclusion@#With the guide of PDCA management, Strengthen the training of new employees or ones with low working years as well as their awareness of protection, and standardize the relevant operational procedures, which can significantly improve the prevention of blood-borne occupational exposure and stress management of medical staff.

4.
Article in Chinese | WPRIM | ID: wpr-798152

ABSTRACT

Objective@#To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care.@*Methods@#The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′ general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses.@*Results@#The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency, the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P < 0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P < 0.01). The regression equation was: y=27.12+8.273.@*Conclusions@#Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.

5.
Article in Chinese | WPRIM | ID: wpr-743685

ABSTRACT

Objective To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care. Methods The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses. Results The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency﹐the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P<0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P<0.01). The regression equation was: y=27.12+8.273x. Conclusions Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.

6.
Article in Chinese | WPRIM | ID: wpr-706921

ABSTRACT

Conventional oxygen therapy (COT) is generally provided through a low flow rate device including a nasal cannula or facemask. Since the benefits of high-flow nasal cannula (HFNC) oxygen therapy in adults with acute respiratory failure (ARF) have firstly been demonstrated by Roca et al and because of its effectivity and comfort and good compliance, it has shown greater advantageous than COT and it has been increasingly used in adults with mild to moderate ARF and obtained very nice therapeutic effect. However, because of the specificity of emergency environment and the more complexity of HFNC system than COT, the use of HFNC in department of emergency is still controversial. Since HFNC system delivers oxygen by high-flow rate, the dilution of inspired oxygen concentration (FiO2) by room air can be maximally decreased, and the system can provide the highest flow rate up to 60 L/min, being greater than the patients' peak inspiration flow flow (PIF); the high flow rate can dilute the carbon dioxide (CO2) concentration in the anatomical dead space, and the above several factors can guarantee that HFNC may deliver 0.21-1.00 relatively constant FiO2. Therefore, HFNC as a new noninvasive supplemental oxygen therapy has been increasingly widely studied and used in the adult patients with ARF. In this article, we will review the HFNC physiological effects and its advances in application for adult patients in department of emergency.

7.
Article in Chinese | WPRIM | ID: wpr-610706

ABSTRACT

Objective To explore the in vitro spermostatic effects and the mechanisms of ceritinib,a novel candidate from the active compound pools previously screened for the regulation of sperm function.Methods The vigor sperm of human and mouse were incubated with ceritinib for 20seconds,and the sperm motility was evaluated by computer assistant sperm analysis (CASA).The integrity of the sperm plasma membrane and the survival ratio of sperm was assessed by hypo-osmotic swelling (HOS) assay and SYBR-14/PI staining.The damage of sperm plasma membrane was detected by electron microscope.The cytotoxicity of ceritinib to VK2/E6E7,End1/E6E7 and Ect1/E6E7 cells was measured by CCK-8 assay and fluorescent staining.Results The minimal effective concentration (MEC) of ceritinib to (5-10) × 106/mL human sperm within 20 seconds was (74.87 ± 31.46)μmol/L,which was significantly lower than the MEC of nonoxynol-9 (219.75 ± 20.89) μmol/L measured in the same condition.The time-dose related spermostatic effects of ceritinib were measured by CASA system.Ceritinib was able to damage sperm membrane and caused sperm death with HOS and SYBR-14/PI staining.With electron microscopy,the sperm membrane was observed to be ruptured,and the heads and tails of sperm were separated by ceritinib.Ceritinib was also able to damage the epithelial cells.Conclusions Ceritinib has acute spermostatic effects and potential contraceptive effects.

8.
Journal of Practical Radiology ; (12): 1209-1212, 2017.
Article in Chinese | WPRIM | ID: wpr-608947

ABSTRACT

Objective To evaluate the usefulness of diffusion-weighted imaging(DWI) in the diagnosis and differential diagnosis of gallbladder wall thickening diseases.Methods 42 patients with gallbladder wall thickening (16 patients with carcinoma and 26 patients with benign lesion) were included in this study.All patients performed conventional MRI and DWI.The diagnostic performances of three methods (conventional MRI,visual assessment of color fusion image from DWI and T2WI,and ADC measurement) were evaluated by two radiologists.Results The area under the receiver operating characteristic curve were 0.570,0.849,0.901 for conventional MRI,visual assessment and ADC measurement respectively.The accuracy,sensitivity and specificity were 59.5%,62.5%,57.7% for conventional MRI,85.7%,81.2%,88.5% for visual assessment of color fusion image,and 83.3%,80.0%,85.2% for ADC measurement,respectivily.The mean ADC value of gallbladder cacinoma[(1.15±0.35)×10-3mm2/s]was significantly less than that of gallbladder benign lesion [(1.99±0.61)×10-3mm2/s](P<0.01).Conclusion The DWI(visual assessment of color fusion image and ADC measurement)might be a useful tool for diagnosis and differential diagnosis of the gallbladder wall thickening diseases.

9.
Cancer Research and Clinic ; (6): 577-583, 2017.
Article in Chinese | WPRIM | ID: wpr-659016

ABSTRACT

Objective To investigate the mechanism of natural carboxyl-terminal truncated HBx(with 31 amino acids deleted at the C-terminal end) (HBxΔ31)-dependent down-regulation of Rho GDP dissociation inhibitor alpha (RhoGDIα) expression and its role in enhancing hepatocellular carcinoma (HCC) metastasis. Methods HepG2 cells with stable expression of wild type HBx and its deletion mutant HBxΔ31 protein were selected as the study subjects. The effects of HBx and HBxΔ31 on RhoGDIα expression in HepG2 cells was detected using real-time quantitative reverse transcription PCR(RT-qPCR)and Western blot analysis.A series of deleted and mutated variants of the RhoGDIα promoter were made and individually co-transfected with HBx-and HBxΔ31-expressing vectors or control empty vector into HepG2 cells. The luciferase reporter assay was used to identify the cis-regulatory elements of the RhoGDIα promoter in response to HBxΔ31 regulation.The interaction between Myc-associated zinc finger protein (MAZ) and HBxΔ31 was examined by co-immunoprecipitation experiment. Eelectrophoretic mobility shift assay (EMSA) was performed to determine interaction of MAZ with the RhoGDIα promoter in HBxΔ31-expressing HepG2 cells. The impact of reduced RhoGDIα expression by HBxΔ31 on cell-invasive activity was analyzed by the Matrigel cell invasion assay. In addition, the effects of silencing of shRNA-mediated RhoGDIα in HepG2 or introduction of RhoGDIα by transfection in HBxΔ31-expressing HepG2 cells on cell-invasion were investigated.Results HBxΔ31,but not HBx, suppressed RhoGDIα expression at transcriptional levels. Analysis of the deletion and mutation of RhoGDIα promoter showed that the HBxΔ31 repressive element localized between nt-460 and -242 bp of RhoGDIα promoter and that the transcription factor MAZ binding sites was required for RhoGDIα promoter inactivation regulated by HBxΔ31. In addition, HBxΔ31 represses RhoGDIα expression by enhancing MAZ binding to its promoter through directly associating with MAZ. The cell-migratory and cell-invasive activity were significantly increased in sh-RhoGDIα-expressing HepG2 cells, as compared to control cells (migrated cells number:58±5 vs.98±7,invaded cells number:55±6 vs.113±6,t=18.91 and t=20.12,both P<0.01). However, ectopic expression of RhoGDIα in HBxΔ31-expressing HepG2 cells significantly decreased cell migration and invasion(migrated cells number:40±4 vs.115±5,invaded cells number:42±4 vs.102±4, t=18.14 and t=16.31, both P<0.001). Conclusion Carboxyl-terminal truncated HBx deregulates RhoGDIα expression through MAZ,in turn which promotes the invasion and metastasis of HCC.

10.
Cancer Research and Clinic ; (6): 577-583, 2017.
Article in Chinese | WPRIM | ID: wpr-657196

ABSTRACT

Objective To investigate the mechanism of natural carboxyl-terminal truncated HBx(with 31 amino acids deleted at the C-terminal end) (HBxΔ31)-dependent down-regulation of Rho GDP dissociation inhibitor alpha (RhoGDIα) expression and its role in enhancing hepatocellular carcinoma (HCC) metastasis. Methods HepG2 cells with stable expression of wild type HBx and its deletion mutant HBxΔ31 protein were selected as the study subjects. The effects of HBx and HBxΔ31 on RhoGDIα expression in HepG2 cells was detected using real-time quantitative reverse transcription PCR(RT-qPCR)and Western blot analysis.A series of deleted and mutated variants of the RhoGDIα promoter were made and individually co-transfected with HBx-and HBxΔ31-expressing vectors or control empty vector into HepG2 cells. The luciferase reporter assay was used to identify the cis-regulatory elements of the RhoGDIα promoter in response to HBxΔ31 regulation.The interaction between Myc-associated zinc finger protein (MAZ) and HBxΔ31 was examined by co-immunoprecipitation experiment. Eelectrophoretic mobility shift assay (EMSA) was performed to determine interaction of MAZ with the RhoGDIα promoter in HBxΔ31-expressing HepG2 cells. The impact of reduced RhoGDIα expression by HBxΔ31 on cell-invasive activity was analyzed by the Matrigel cell invasion assay. In addition, the effects of silencing of shRNA-mediated RhoGDIα in HepG2 or introduction of RhoGDIα by transfection in HBxΔ31-expressing HepG2 cells on cell-invasion were investigated.Results HBxΔ31,but not HBx, suppressed RhoGDIα expression at transcriptional levels. Analysis of the deletion and mutation of RhoGDIα promoter showed that the HBxΔ31 repressive element localized between nt-460 and -242 bp of RhoGDIα promoter and that the transcription factor MAZ binding sites was required for RhoGDIα promoter inactivation regulated by HBxΔ31. In addition, HBxΔ31 represses RhoGDIα expression by enhancing MAZ binding to its promoter through directly associating with MAZ. The cell-migratory and cell-invasive activity were significantly increased in sh-RhoGDIα-expressing HepG2 cells, as compared to control cells (migrated cells number:58±5 vs.98±7,invaded cells number:55±6 vs.113±6,t=18.91 and t=20.12,both P<0.01). However, ectopic expression of RhoGDIα in HBxΔ31-expressing HepG2 cells significantly decreased cell migration and invasion(migrated cells number:40±4 vs.115±5,invaded cells number:42±4 vs.102±4, t=18.14 and t=16.31, both P<0.001). Conclusion Carboxyl-terminal truncated HBx deregulates RhoGDIα expression through MAZ,in turn which promotes the invasion and metastasis of HCC.

11.
Chongqing Medicine ; (36): 1012-1014, 2017.
Article in Chinese | WPRIM | ID: wpr-514967

ABSTRACT

Objective To study the expression of Toll-like receptor 4(TLR4) in peripheral blood mononuclear cell (PBMCs) and serum interleukin-6(IL-6) in wheezing children under 5 years of age.Methods A total of 224 wheezing children under 5 years of age were divided into API(asthma predictive index)-positive (n=116) and API-negative groups (n=108).Serum level of IL-6 and TLR4 expression on CD14+ monocytes were measured after wheezing was stable for one month.TLR4 expression on CD14+ monoeytes was quantified via flow-cytometry.Serum level of IL-6 was detected by ELISA.Results Serum level of IL-6 and TLR4 expression on CD14+ monocytes of API-positive group were higher than API-negative group [LR4(%):34.9±10.0 vs.30.2± 8.8;IL-6(ng/L):46.4±15.1 vs.40.5±13.6].There was a significant positive correlation between the expression of TLR4 and the content of serum IL-6 in two groups of wheezing children(P<0.05).Conclusion TLR4 may play a role in the pathogenesis of asthma through promoting the expression of IL-6.TLR4 may be a index to predicting asthma in wheezing children.

12.
Article in Chinese | WPRIM | ID: wpr-514850

ABSTRACT

BACKGROUND: The proliferation of peripheral blood stem cells among peripheral blood mononuclear cells (PBMCs) invitro remains unclear. There is no optimal marker for tracing PBMCs transplanted in vivo.OBJECTIVE: To observe the degree of PBMC proliferation in stem cell medium by EdU labeling and to explore thefeasibility of EdU-labeled peripheral blood stem cells.METHODS: New Zealand rabbit PBMCs were isolated and cultured for 1 to 5 days in stem cell medium supplementedwith EdU. The cells were observed and counted at 0, 1, 2, 3, 4 and 5 days in culture. The cells were harvested at eachtime point and stained with EdU fluorescent reagents. Then, confocal microscopy and flow cytometry were used to detectEdU-labeled cells.RESULTS AND CONCLUSION: (1) Freshly isolated rabbit PBMCs were rounded and showed clear outline. After 1 dayculture, most of the cells were suspended in the medium, spherical or round. There were also a few cell clusters andadherent cells scattered in a triangle or polygon shape; after 2 days culture, more cell debris were observed, and mostcells were round; when cultured for 3-5 days, increased cell debris, smaller cell mass and decreased cell densitysignificantly were observed. (2) With the prolongation of culture time, the cell count decreased gradually. (3) Whencultured for 1 day, EdU labeled cells in red were scattered. The number of cells marked with EdU red label increasedsignificantly at day 2 and remained unchanged after 3 days of culture. At 5 days of culture, the number of red cellsmarkedly decreased; the highest positive rate of EdU-labeled cells was (2.38±0.10)% at 2 days after culture. To conclude,these results showed that the proportion of proliferating cells in rabbit PBMCs was very low. EdU is capable of labelingproliferative cells among PBMCs.

13.
China Pharmacist ; (12): 1679-1681,1682, 2016.
Article in Chinese | WPRIM | ID: wpr-605707

ABSTRACT

Objective:To prepare mesalazine hydroxypropyl-β-cyclodextrin ( MSZ-HP-β-CD) inclusion complexes and observe the properties. Methods:The inclusion complexes were prepared by a stirring method and the content of MSZ was determined by HPLC. The preparation technology was optimized by orthogonal test with the inclusion rate and the yield of inclusion complexes as the indices. The inclusion complexes were identified respectively by ultraviolet ( UV) spectrometry, X-ray diffraction ( XRD) and solubility. The dissolution rate was investigated. Results: Using the stirring method, the optimum preparation process was as follows: the inclusion temperature was 35 ℃, the ratio of MSZ to HP-β-CD was 1∶ 4 ( mg/g) , and the inclusion time was 3 h. The average inclusion rate of the complexes was 96. 28%, and the yield was 97. 87%. The identification results showed that the freeze-dried powder was inclusion complexes. Compared with that of MSZ, the dissolution of MSZ- HP-β-CD inclusion complexes was notably enhanced. Conclusion:The prepared MSZ-HP-β-CD with optimized technology has good reproducibility and stable technology, which can obviously improve the dissolution of MSZ.

14.
China Pharmacist ; (12): 639-641,642, 2016.
Article in Chinese | WPRIM | ID: wpr-603823

ABSTRACT

Objective:To prepare thermosensitive liquid suppositories of mesalazine( MSZ) HP-β-CD complex and study the in vitro properties. Methods:Poloxamer 407 (P407) and poloxamer 188 (P188) were used as the thermosensitive polymers to load MSZ HP-β-CD complex to prepare the thermosensitive liquid suppositories. The viscosity, gel strength, bioadhesion,in vitro gel erosion and drug release of MSZ HP-β-CD complex were compared with those of MSZ liquid suppositories. Results: Compared with that of MSZ liquid suppositories, the gel temperature of MSZ HP-β-CD complex liquid suppositories was stable, while the viscosity, gel strength and bioadhesion of MSZ HP-β-CD complex liquid suppositories were increased significantly. The in vitro gel erosion was not affected by MSZ HP-β-CD complex, while the drug release was notably enhanced. The drug release and gel erosion showed a good linear relation-ship. Conclusion:MSZ HP-β-CD complex liquid suppositories show good gel temperature, viscosity, gel erosion and bioadhesion, and the in vitro release rate is faster than that of MSZ liquid suppositories.

15.
Article in Chinese | WPRIM | ID: wpr-733319

ABSTRACT

Objective To investigate the clinical characteristics and treatment of negative pressure pulmonary edema (NPPE) with acute laryngitis in children,and to monitor the change of inflammatory factors.Methods The data of 9 cases with NPPE and acute laryngitis in Pediatric Intensive Care Unit of Xuzhou Children's Hospital from August 2010 to March 2015 were analyzed.Ten children of acute laryngitis without NPPE in our hospital were selected as the control group.The changes of the TNF-α and IL-6 between the 2 groups were compared before and after treatment.Results (1) All the 9 children in NPPE group were associated with third degree laryngeal obstruction.The onset of NPPE in 8 cases varied from 8 minutes to half an hour following relief of obstruction,and 1 child with NPPE occurred 2hours after relief of obstruction.Four of the 9 children had pink frothy pulmonary secretions but the other 5 children did not.NPPE chest radiograph showed diffuse interstitial and alveolar infiltrates.All these patients received these therapeutic measures including mechanical ventilation,retaining high positive end expiratory pressure (PEEP) (5-8 cmH2O,1 cmH2O =0.098 kPa),glucocorticoids,limiting the fluid input volume to 60-80 mL/(kg · d).Three of the 9 cases were treated with diuretics.The disappearance of rales on chest auscultation varied from 6 hours to 30 hours.Duration of mechanical ventilation was less than 48 hours,and all the children were cured.(2) The levels of TNF-α and IL-6 in NPPE group were significantly higher than those in the control group before treatment [(369.16 ± 48.19) ng/L vs(281.77 ± 45.59) ng/L,(30.39 ± 9.60) ng/L vs (20.43 ± 4.80) ng/L,P < 0.05].After 48-hour treatment,the levels of TNF-α and IL-6 in both groups significantly decreased compared with before treatment (all P < 0.01);and the levels of TNF-α and IL-6 in NPPE group were (281.10 ±47.45) ng/L and (20.04 ±5.87) ng/L,respectively,which were also significantly higher than those in the control group(P < 0.05).Conclusions NPPE is manifested by rapid onset of respiratory distress rapidly after relief of the airway obstruction.Imaging suggested edema change.The prognosis will be good if early support of breath and limiting the fluid input volume are applied properly.The inflammatory response is one of the possible mechanisms of NPPE.

16.
Article in Chinese | WPRIM | ID: wpr-269752

ABSTRACT

<p><b>OBJECTIVE</b>To compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints.</p><p><b>METHODS</b>Sixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups.</p><p><b>RESULTS</b>The excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>Mild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.</p>


Subject(s)
Acupuncture Points , Adolescent , Adult , Collateral Ligaments , Wounds and Injuries , Electromagnetic Radiation , Female , Humans , Joint Diseases , Therapeutics , Magnetic Field Therapy , Male , Moxibustion , Pain Measurement , Young Adult
17.
Article in Chinese | WPRIM | ID: wpr-498787

ABSTRACT

Objective To investigate the effect of acupuncture plus Chinese herbal medication on plasma endothelin (ET-1) and calcitonin gene-related peptide (CGRP) in child patients with mesenteric lymphadenitis.Methods One hundred and eighty child patients with mesenteric lymphadenitis were randomly allocated to groups A, B and C, 60 cases each. Group A received acupuncture at Zusanli and pricking Sifeng points plus oral administration of Wudang Babao Zijinding; group B, oral administration of amoxicillin and clavulanate potassium granules; group C, oral administration of Wudang Babao Zijinding alone. ET-1 and CGRP contents were measured in the three groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in ET-1 and CGRP contents in group A (P<0.01). There were statistically significant post-treatment differences in ET-1 and CGRP contents between group A and group B or C (P<0.01).Conclusions Acupuncture plus Chinese herbal medication is an effective way to treat mesenteric lymphadenitis in children. It can regulate ET-1 and CGRP in the patients.

18.
Article in Chinese | WPRIM | ID: wpr-477187

ABSTRACT

Objective To investigate the correlation between plasma soluble CD14 (sCD14)level and disease progression in patients with acute phase of acquired immunodeficiency syndrome (AIDS). Methods Forty-one human immunodeficiency virus (HIV)-infected patients were followed up from June 2007 to June 2010 in Beijing You′an Hospital,including 20 patients with CD4 + T lymphocyte counts more than 350/μL,and 21 less than 350/μL after 3 years of HIV infection.Twenty healthy blood donors were recruited as controls.Enzyme-linked immunosorbent assay (ELISA)was employed to test the plasma sCD14 level of healthy controls and patients infected with HIV at 1 -30 d,31 -90 d,91 - 180 d and 181 -360 d.Student t test was used to compare the means between two groups.ANOVA analysis was used to compare the means among more than two groups.Results The mean plasma sCD14 level in control group was (1 654±904)μg/L.Three years after HIV infection,the sCD14 level of patients with CD4 + T lymphocyte counts less than 350/μL group was (4 214±2 635)μg/L,which was higher than that of patients with CD4 + T lymphocyte counts more than 350/μL ([2 275 ±1 457 ]μg/L).The difference was statistically significant(t=-5 .41 ,P <0.01).The plasma sCD14 level in patients infected with HIV 181 -360 d was significantly higher than that in patients infected with HIV 1 - 30 days ([4 485 ± 2 779]μg/L vs [2 577 ±1 635 ]μg/L;t = -3.39,P <0.05 ).The plasma sCD14 level was positively correlated with HIV viral load (r =0.35,P =0.000 1 ),and negatively correlated with CD4 + T lymphocyte counts (r=-0.28,P =0.001 ).Conclusions The plasma sCD14 level in patients with acute phase of HIV infection is higher than that of healthy people,which increases with prolonged HIV infection.Plasma sCD14 level in of HIV infection acute phase may be closely related to HIV/AIDS progression.

19.
Chinese Journal of Geriatrics ; (12): 249-252, 2015.
Article in Chinese | WPRIM | ID: wpr-469829

ABSTRACT

Objective To investigate the association between serum level of secretory type Ⅱ phospholipase A2 (sPLA2 Ⅱ a) and carotid intima-media thickness (CIMT) in elderly patients with metabolic syndrome (MS).Methods A total of 124 consecutive MS patients aged over 65 years were enrolled and another 90 elderly non-MS subjects were served as controls.The serum concentration of sPLA2 Ⅱ a was measured by enzyme-linked immunosorbent assay.Blood pressure,blood lipids and blood glucose levels etc.were also measured.The carotid intima-media thickness was examined by color Doppler ultrasonography.Results Serum level of sPLA2 Ⅱ a was significantly higher in elderly MS patients than in control group [(4.41±1.55)μg/L vs.(2.39±0.97)μg/L,P< 0.05].Compared with the control group,elderly MS patients showed CIMT was significantly increased [(1.17±0.24) mm vs.(0.89±0.24)mm,P<0.05].Serum level of sPLA2 Ⅱ a were higher in elderly obesity patients than in normal BMI subjects [(4.76±0.99)μg/L vs.(2.84±0.54)μg/L,P<0.05].Multiple regression analysis indicated that sPLA2 Ⅱ a level was an independent risk factor for CIMT in elderly MS patients after adjusting for the effects of BMI,IL-6 and high sensitive C-reactive protein (hs CRP) on CIMT(r=0.38,P<0.01).Conclusions Serum level of sPLA2 Ⅱ a is increased in elderly MS patients and is independently correlated with CIMT,which has a predictive value for atherosclerosis,sPLA2 Ⅱ a may be involved in the process of vascular endothelial injury.

20.
Article in Chinese | WPRIM | ID: wpr-466770

ABSTRACT

Obgective To observe the effect of Milrinone combined with Esmolol in the treatment of severe hand-foot-and-mouth disease (HFMD) so as to improve the prognosis.Methods Eighty-two cases of children with critically severe HFMD,who were hospitalized in the Intensive Care Unit of Xuzhou Children's Hospital,were enrolled in the study from may of 2013 to June of 2014,and were randomly divided into a control group and an observation group.The control group was given intravenous Milrinone,and the observation group was given Milrinone combined with Esmolol.The heart rate (HR),systolic blood pressure (SBP),cardiac output (CO),left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP),norepinephrine (NE) were detected on admission and checked again 1 hour and 48 hours again after treatment.The changes in the above indicators were compared before and after therapy to evaluate the clinical curative effect.Results (1) There was no significant difference in the HR,SBP,CO,LVEF,BNP and NE between the 2 groups before treatment(all P > 0.05).(2) The HR,SBP,CO and LVEF of 2 groups were significantly improved after 1 hour treatment compared with those before treatment (all P < 0.05),and the BNP and NE of the control group were not obviously improved compared with those before therapy (all P > 0.05),but the significant changes were seen in the observation group (all P < 0.05).Forty-eight hours after the treatment,all the observed indicators in 2 groups were significantly improved compared with those before treatment(all P < 0.01).(3)Compared with control group,the HR,SBP,CO,LVEF and BNP of the observation group were significantly improved after 1 hour treatment (t =2.08,2.12,-2.11,-2.37,2.07,all P < 0.05),but the NE of the observation group had no obvious improvement (t =0.83,P > 0.05).All the observed indicators of the observation group were significantly improved compared with the control group after 48 hours treatment(t =3.76,2.48,-2.70,-2.27,5.37,2.74,all P < 0.05).Conclusions Milrinone combined with Esmolol can significantly improve the cardiac function and the vital signs of the children with critically severe HFMD,which can be recommended clinically.

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