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1.
Chinese Journal of Hepatology ; (12): 415-421, 2023.
Article in Chinese | WPRIM | ID: wpr-986145

ABSTRACT

Objective: To evaluate the diagnostic value of serum human-βeta-defensin-1 level (HBD-1) for short-term (28-day) prognosis in patients with acute-on-chronic liver failure (ACLF). Methods: Fifty cases diagnosed with ACLF were selected. 20 cases with decompensated cirrhosis and 20 cases with compensated cirrhosis who were admitted at the same time were included. Age, gender, serum HBD-1 level, C-reactive protein (CRP), procalcitonin (PCT), neutrophil count/lymphocyte ratio (NLR), blood routine, coagulation function, liver function, kidney function, and other indicators from the three groups of patients were collected. Patients with ACLF were screened for indicators related to the short-term (28-day) prognosis. Patients were divided into an improvement group and a worsening group according to the 28-day disease outcome. The serum HBD-1 level and other above-mentioned indicators were compared between the two patient groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of serum HBD-1 levels for short-term prognosis in patients with ACLF. PCT, NLR, and prothrombin activity (PTA) application as a mono indicator and HBD-1 in combination with NLR, PCT, and PTA were compared to evaluate diagnostic efficacy for short-term prognosis in patients with ACLF. The intergroup mean of measurement data was determined using a t-test or analysis of variance. χ (2) test was used for comparison of count data. Spearman's rank correlation analysis was used for correlation analysis. Results: There was no statistically significant difference in age and gender among the three groups: ACLF, decompensated cirrhosis, and compensated cirrhosis (P > 0.05). The expression levels of serum HBD-1 in the ACLF group, decompensated cirrhosis group, and compensated cirrhosis group were (319.1 ± 44.4) ng/ml, (264.5 ± 46.5) ng/ml and (240.1 ± 35.4) ng/ml, respectively, while the ACLF group expression levels were significantly increased, with statistical significance (P < 0.01).The serum HBD-1 level was significantly higher in the ACLF worsening group (346.2 ± 43.6) ng/ml than that in the improvement group (308.5 ± 40.6) ng/ml, and the difference was statistically significant (P < 0.05). Correlation analysis showed that HBD-1, NLR, PCT, prothrombin time (PT), and international standardized ratio (INR) were negatively correlated with the 28-day disease outcome (improvement) of patients (P < 0.05). PTA was positively correlated with 28-day disease outcome (improvement) (P < 0.05). The area under the receiver operating characteristic curve (AUC) for evaluating HBD-1's diagnostic efficacy for short-term prognosis in patients with ACLF was 0.774, with a sensitivity of 0.750, a specificity of 0.786, and a cut-off point of 337.96 ng/ml. PCT, NLR, and PTA had greater diagnostic efficacy. HBD-1 combined with PTA had the highest diagnostic efficacy, with an AUC of 0.802, a sensitivity of 0.778, and a specificity of 0.786. The diagnostic efficacy of HBD-1+PCT, HBD-1+NLR and HBD-1, PCT, and NCR was superior to PTA mono. Conclusion: The serum HBD-1 level gradually increases with the aggravation of liver function injury and is negatively correlated with the short-term prognosis in patients with ACLF. Serum HBD-1 level has high sensitivity and specificity in predicting short-term prognosis in patients with ACLF, and its diagnostic efficacy is superior to that of PCT, NLR, and PTA. The combined application of HBD-1 and PTA has higher diagnostic efficacy; however, when the serum HBD-1 level is greater than 337.96ng/ml, it indicates poor prognosis in patients.


Subject(s)
Humans , Acute-On-Chronic Liver Failure/diagnosis , Prognosis , Liver Cirrhosis , C-Reactive Protein/analysis , ROC Curve , Defensins , Retrospective Studies
2.
Chinese Journal of Trauma ; (12): 97-106, 2023.
Article in Chinese | WPRIM | ID: wpr-992577

ABSTRACT

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

3.
Chinese journal of integrative medicine ; (12): 119-126, 2023.
Article in English | WPRIM | ID: wpr-971326

ABSTRACT

OBJECTIVE@#To study effects of Shenmai Injection on hypertensive heart failure and its mechanism for inhibiting myocardial fibrosis.@*METHODS@#Salt-sensitive (Dahl/SS) rats were fed with normal diet (0.3% NaCl) and the high-salt diet (8% NaCl) to observe the changes in blood pressure and heart function, as the control group and the model group. Salt-insensitive rats (SS-13BN) were fed with the high-salt diet (8% NaCl) as the negative control group. After modeling, the model rats were randomly divided into heart failure (HF) group, Shenmai Injection (SMI) group and pirfenidone (PFD) group by a random number table, with 6 rats in each group. They were given sterilized water, SMI and pirfenidone, respectively. Blood pressure, cardiac function, fibrosis and related molecular expression were detected by sphygmomanometer, echocardiogram, enzyme linked immunosorbent assay (ELISA), hematoxylin-eosin staining, Masson staining, immunofluorescence and qPCR analysis.@*RESULTS@#After high-salt feeding, compared with the control and negative control group, in the model group the blood pressure increased significantly, the left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly reduced, and the serum NT-proBNP concentration increased significantly (all P<0.05); furthermore, the arrangement of myocardial cells was disordered, the edema was severe, and the degree of myocardial fibrosis was also significantly increased (P<0.05); the protein and mRNA expressions of collagen type I (Col I) were up-regulated (P<0.05), and the mRNA expressions of transforming growth factor β 1 (TGF- β 1), Smad2 and Smad3 were significantly up-regulated (P<0.05). Compared with HF group, after intervention of Shenmai Injection, LVEF and LVFS increased, myocardial morphology was improved, collagen volume fraction decreased significantly (P<0.05), and the mRNA expressions of Col I, TGF- β 1, Smad2 and Smad3, as well as Col I protein expression, were all significantly down-regulated (all P<0.05).@*CONCLUSION@#Myocardial fibrosis is the main pathological manifestation of hypertensive heart failure, and Shenmai Injection could inhibit myocardial fibrosis and effectively improve heart failure by regulating TGF-β 1/Smad signaling pathway.


Subject(s)
Rats , Animals , Stroke Volume , Sodium Chloride , Rats, Inbred Dahl , Ventricular Function, Left , Heart Failure , Transforming Growth Factor beta1/metabolism , Hypertension , Fibrosis , RNA, Messenger
4.
Acta Pharmaceutica Sinica B ; (6): 2592-2608, 2022.
Article in English | WPRIM | ID: wpr-929393

ABSTRACT

Self-assembling carrier-free nanodrugs are attractive agents because they accumulate at tumor by an enhanced permeability and retention (EPR) effect without introduction of inactive substances, and some nanodrugs can alter the immune environment. We synthesized a peptidyl arginine deiminase 4 (PAD4) molecular inhibitor, ZD-E-1M. It could self-assembled into nanodrug ZD-E-1. Using confocal laser scanning microscopy, we observed its cellular colocalization, PAD4 activity and neutrophil extracellular traps (NETs) formation. The populations of immune cells and expression of immune-related proteins were determined by single-cell mass cytometry. ZD-E-1 formed nanoflowers in an acidic environment, whereas it formed nanospheres at pH 7.4. Accumulation of ZD-E-1 at tumor was pH-responsive because of its pH-dependent differences in the size and shape. It could enter the nucleus and bind to PAD4 to prolong the intracellular retention time. In mice, ZD-E-1 inhibited tumor growth and metastasis by inhibiting PAD4 activity and NETs formation. Besides, ZD-E-1 could regulate the ratio of immune cells in LLC tumor-bearing mice. Immunosuppressive proteins like LAG3 were suppressed, while IFN-γ and TNF-α as stimulators of tumor immune response were upregulated. Overall, ZD-E-1 is a self-assembling carrier-free nanodrug that responds to pH, inhibits PAD4 activity, blocks neutrophil extracellular traps formation, and improves the tumor immune microenvironment.

5.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 233-239, 2022.
Article in Chinese | WPRIM | ID: wpr-940714

ABSTRACT

Chronic heart failure is a serious heart disease with dyspnea and limited activity tolerance as the main clinical manifestations. Autophagy is a self-protection mechanism in eukaryotic cells and plays an important role in the development of heart failure. Appropriately increasing the level of autophagy during the compensated stage of heart failure and timely removal of necrotic myocardial organelles and other harmful garbage can inhibit myocardial hypertrophy to a certain extent,alleviate myocardial remodeling,and delay heart failure. The theory of healthy Qi and pathogenic Qi is an important basic theory for explaining the occurrence of diseases,and struggle between healthy Qi and pathogenic Qi exists in the entire onset of chronic heart failure,which may lead to pathogenic Qi invasion and healthy Qi deficiency. The regulatory effect of autophagy on cardiomyocytes is similar to the theory of healthy Qi and pathogenic Qi in traditional Chinese medicine (TCM). Autophagy is the body's self-regulatory mechanism for healthy Qi and pathogenic Qi in a dose-effect manner,Specifically,autophagy can only protect the body's cells to a certain extent,and healthy Qi can only take effect within a certain range and degree. To protect the body from external pathogenic factors,excessive or insufficient autophagy may destroy the stability of the body's environment. In this regard,we use the theory of healthy Qi and pathogenic Qi as a starting point to clarify the function of autophagy in the development of chronic heart failure from a macro and micro perspective,and propose adjusting the balance of healthy Qi and pathogenic Qi in the body to regulate the autophagy of cardiomyocytes. The principle of prevention and treatment is expected to lay the foundation for modern research on the function of autophagy in the development of chronic heart failure in TCM,find novel therapy for chronic heart failure at different stages,and provide new insights into the diagnosis and treatment of chronic heart failure.

6.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 219-226, 2022.
Article in Chinese | WPRIM | ID: wpr-940503

ABSTRACT

Inflammation is the key pathogenic feature of heart failure (HF), and its overexpression can cause myocardial hypertrophy, apoptosis and fibrosis, aggravating the process of HF. Macrophages are important immune cells in human body with high heterogeneity, which involve in inflammation response and maintain heart homeostasis. Macrophage polarization is a dynamic process. Under the stimulation of different microenvironment, it can polarize two subsets, including classically activated M1 type and alternatively activated M2 type, which are antagonistic to each other. When macrophages polarize into the pro-inflammatory phenotype (M1), the inflammatory response is initiated, the anti-inflammatory phenotype (M2) plays a role in inhibiting inflammation and repairing tissue. At the same time, in different stages of development of HF, M1 and M2 macrophages can be transformed into each other, which is similar to the connotation of Yin-yang restriction, balance and transformation of traditional Chinese medicine (TCM) theory. Based on this, this paper intends to clarify the relationship between M1 and M2 macrophages by Yin-yang theory, proposing that the clinical prevention and treatment of HF should pay attention to regulating micro and macro inflammatory responses, regulating macrophage polarization, and achieving the balance between anti-inflammatory and pro-inflammation, which is consistent with the balance of Yin-yang in TCM theory. It can provide a new target and direction for TCM treatment of HF.

7.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 192-198, 2022.
Article in Chinese | WPRIM | ID: wpr-940469

ABSTRACT

Hyperthyroidism is a systemic disease characterized by clinical signs and symptoms of hypermetabolism and sympathetic nervous excitement. Based on the clinical diagnostic criteria of traditional Chinese and western medicine for hyperthyroidism,the present study summarized and evaluated animal models of hyperthyroidism. In model evaluation,the models with high coincidence degree in western medicine included the exogenous drug delivery model, the model immune to adenovirus expressing thyrotropin receptor (TSHR),the model immune to nucleic acid, and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. The models with high coincidence degrees in traditional Chinese medicine included the exogenous drug delivery model, the model immune to adenovirus expressing TSHR,and the model of liver-yang ascendant hyperactivity syndrome and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. In light of the coincidence degree, and advantages and disadvantages of traditional Chinese and western medicine,the ideal hyperthyroidism animal models are the exogenous drug delivery model, and the model immune to adenovirus expressing TSHR. In addition to the evaluation of the coincidence degree of animal models of hyperthyroidism in traditional Chinese and western medicine,this study also analyzed the advantages,disadvantages, and problems of the animal models of hyperthyroidism. Most of the animal models of hyperthyroidism were not consistent with the complexity of hyperthyroidism in clinical practice, and standardized and unified syndrome differentiation standards and four-examination information collection standards have not yet been formed. Besides, there have been few studies on the hyperthyroidism model in disease-syndrome combination in traditional Chinese medicine. To make the animal models of hyperthyroidism suitable for clinical practice,the present study proposed the improvement directions of animal models of hyperthyroidism and the necessity of promoting the evaluation system to provide a theoretical basis for the evaluation of the curative effect of Chinese medicine on hyperthyroidism, and exploration of its pharmacological action, as well as the follow-up research on the pathogenesis,prevention, and treatment of hyperthyroidism,which is expected to establish a perfect disease-syndrome model of hyperthyroidism in line with clinical characteristics of traditional Chinese and western medicine.

8.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 117-124, 2022.
Article in Chinese | WPRIM | ID: wpr-940360

ABSTRACT

ObjectiveTo study the pathological process and changes of metabolites in myocardial tissue of heart failure induced by transverse aortic constriction (TAC) in rats. MethodRats were treated with TAC operation and divided into TAC-30 d group and TAC-60 d group, and sham operation group at the same period was set up as control. Echocardiography and pathological staining of myocardial tissue were performed on rats in each group. Enzyme-linked immunosorbent assay was used to determine the expression of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and adenosine triphosphate (ATP) in serum. Liquid chromatography-mass spectrometry was used to observe the changes of metabolites and related pathways in myocardial tissue, the mobile phase consisted of 25 mmol·L-1 ammonium acetate and 25 mmol·L-1 ammonia hydroxide in water (A) and acetonitrile (B) for gradient elution (0-0.5 min, 95%B; 0.5-7 min, 95%-65%B; 7-8 min, 65%-40%B; 8-9 min, 40%B; 9-9.1 min, 40%-95%B; 9.1-12 min, 95%B), electrospray ionization was used under positive and negative ion detection modes, acquisition range was m/z 70-1 050. ResultCompared with the sham-30 d group, the left ventricular internal diameter at end-systole (LVIDs) in TAC-30 d group was significantly decreased (P<0.01), and left ventricular ejection fraction (LVEF), fraction shortening (FS), left ventricular end-diastolic posterior wall thickness (LVPWd), left vebtricular end-systolic posterior wall thickness (LVPWs) were significantly increased (P<0.01), there were cardiomyocyte arrangement disorder, edema, collagen fibre hyperplasia, the content of NT-probNP was significantly increased, while the content of ATP was significantly decreased (P<0.01), and 15 metabolites with abnormal expression were involved in pyrimidine metabolic pathway, pantothenic acid and coenzyme A biosynthesis pathway. Compared with the sham-60 d group, LVEF and FS in the TAC-60 d group were significantly decreased (P<0.01), and left ventricular internal diameter at end-diastole (LVIDd), LVIDs and LVPWd were increased (P<0.05, P<0.01), the edema of myocardial cells increased obviously, myocardium fibers degenerated, coagulation necrosis appeared, and a large amount of collagen fibers were deposited, the expression of NT-proBNP increased and the expression of ATP decreased (P<0.01), there were 21 metabolites with abnormal expression, involving pyrimidine metabolic pathway, and starch and sucrose metabolic pathway. ConclusionAt 30 d after TAC, there are myocardial hypertrophy, lipid metabolism disorder, pyrimidine metabolism disorder and energy imbalance. At 60 d after TAC, there are heart failure, aggravation of lipid metabolism disorder, excessive activation of glucose metabolism, and continuous disorder of pyrimidine metabolism.

9.
China Journal of Chinese Materia Medica ; (24): 6574-6578, 2021.
Article in Chinese | WPRIM | ID: wpr-921818

ABSTRACT

Hypertension, a cardiovascular disease with main clinical manifestations of dizziness and elevated blood pressure, especially elevated arterial pressure, features high prevalence rate and low control rate, which affects patients' quality of life. Therefore, establishing a good animal model of hypertension is of great significance for its diagnosis and clinical prevention and treatment. Based on the clinical characteristics of hypertension in traditional Chinese and western medicine, this study summarized the advantages and disadvantages of current hypertension animal models: gene-related model, surgery-caused model, drug-induced model, and environment-induced model, and investigated the similarity to the clinical symptoms in traditional Chinese medicine and Western medicine. Among them, spontaneously hypertensive rats, models established with the surgical two-kidney one-clip, one-kidney one-clip, two-kidney two-clip, and abdominal aorta constriction methods, models induced with the drug deoxycorticosterone acetate, and models induced with the high-fat high-purine diet showed symptoms highly similar to the clinical manifestations. Then, the corresponding evaluation and improvement methods of hypertension animal models were proposed. This study provides suggestions for the establishment of hypertension animal model so that the symptoms are more similar to the clinical characteristics of hypertension in traditional Chinese and Western medicine, which is important for the clinical diagnosis and treatment of hypertension.


Subject(s)
Animals , Humans , Rats , Blood Pressure , China , Disease Models, Animal , Hypertension/drug therapy , Medicine, Chinese Traditional , Quality of Life
10.
China Journal of Chinese Materia Medica ; (24): 5152-5158, 2021.
Article in Chinese | WPRIM | ID: wpr-921657

ABSTRACT

Rheumatoid arthritis(RA) is an autoimmune disease involving multiple joints bilaterally with symmetrical polyarthritis as the main symptom. The high disability rate of this disease seriously affects the quality of life of patients and even threatens their lives. The establishment of a good animal model is of great significance for the diagnosis and clinical prevention of RA. Based on the clinical characteristics of RA in traditional Chinese and Western medicine, the common animal models of RA were summarized, including drug-induced, gene-related, and syndrome and disease combined models. Joint swelling, pain, redness, nodules, and joint deformity are the main criteria for model evaluation, which have certain differences from the clinical diagnostic criteria of RA. From the perspective of syndrome differentiation, the animal model combining syndrome and disease only simulates the syndrome of traditional Chinese medicine and has no direct causal relationship with the formation of RA. In this paper, we analyzed the advantages and disadvantages of animal models of RA and the coincidence degree of the models with the clinical characteristics and then put forward the corresponding recommendations for the evaluation and improvement of these models, aiming to make the animal models of RA closer to the clinical symptoms and play an important role in the clinical diagnosis and treatment of RA.


Subject(s)
Animals , Humans , Arthritis, Rheumatoid/drug therapy , China , Disease Models, Animal , Medicine, Chinese Traditional , Quality of Life
11.
Korean Journal of Radiology ; : 1777-1785, 2021.
Article in English | WPRIM | ID: wpr-918203

ABSTRACT

Objective@#To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. @*Materials and Methods@#This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared.The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland–Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. @*Results@#No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0–232.28) and C (median, 60.25; IQR, 0–195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0–120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. @*Conclusion@#The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

12.
Chinese Journal of Medical Education Research ; (12): 691-693, 2021.
Article in Chinese | WPRIM | ID: wpr-908860

ABSTRACT

The diagnosis and treatment of traumatic brain injury (TBI) are basic skills that should be mastered by neurosurgery specialists during the standardized training. In view of the lack of TBI patients in our center, TBI training was entrusted to a joint base with more TBI patients. Based on clinical training and practice experience of the authors in recent years, including joint base introduction, basic requirement, theory and skill training, research training, humanity accomplishment improvement, inter-base communication and evaluation standard, we discuss the appropriate joint base training mode of TBI in standardized training of neurosurgery specialists, so as to provide reference for cultivating qualified and comprehensively developed neurosurgery specialists.

13.
Chinese Journal of School Health ; (12): 1899-1902, 2021.
Article in Chinese | WPRIM | ID: wpr-907088

ABSTRACT

Objective@#This study analyzes the development of school doctor personnel since the implementation of the national "School Health Work Regulations", from the salary of school doctors, followed by the management system of school doctors in primary and middle schools.@*Methods@#Representative provinces in the eastern, central and western regions of China were selected and surveyed through quantitative and qualitative method.@*Results@#The proportion of school doctors with medical background accounted for 33.64%, 31.6% school doctors had t o be established. A huge gap between income, bonus distribution and appraisal exsited between school doctors and school teachers. Wages of school doctors was much lower than that of education and social health sectors. The salary level showed regional imbalance, relatively higher in the eastern region and lower in the in the central and western regions with few exceptions. There were significant differences between medical background school doctors and non medical background school doctors in the highest educational background, income level, job nature, job placement, career development opportunity, income satisfaction, welfare and training satisfaction( χ 2=10.73,26.64,313.44,14.13,29.14,13.22,12.97,19.44, P < 0.05 ).@*Conclusion@#Government needs to pay attention to the school doctors in primary and secondary schools, integreate school health into public health management system. Relevant policies regarding school doctor management authority, school clinic and health center guideline, salary standards, as well as professional career development, are expected.

14.
Chinese Journal of Radiological Health ; (6): 417-422, 2021.
Article in Chinese | WPRIM | ID: wpr-974570

ABSTRACT

Objective Based on the anthropomorphic phantom experiment and Monte Carlo simulation, the patients’ skin dose, professionals’ dose, and spatial distribution of DSA (Digital Subtraction Angiography) radiation field in an intervention procedure, was performed, in order to provide the basis for the inference of patients’ skin injury and professionals’ radiation protection in intervention procedure. Methods In the simulation experiment, a PBU-60 anthropomorphic phantom was used as the patient and the skin dose of patient’s abdomen was measured by TLD (Thermoluminescence Dosimeters). X-ray and gamma radiation dosimeter (AT1121) was applied to measure the spatial distribution of DSA radiation field, which was verified using Monte Carlo software MCNP meanwhile. Furthermore, the radiation dosimetry of operative staffs at different stations and under different protection conditions was studied experimentally. Results The experimental measurements showed that the maximum skin dose of patients every 5-minute fluoroscopy was 18.62 mGy under the irradiation of PA in an abdominal interventional procedure. The results of Monte Carlo simulation and measurement experiments showed that the spatial distribution of DSA radiation fieldis similar to the butterfly distribution, which is related to distance and angle. The experimental results showed that the dose rate decreases exponentially with the increase of lead equivalent. Conclusion It is very significant to carry out skin dose measurementof patients during interventional surgery and follow-up patients with high dose after surgery. In interventional surgery, doctors should try to avoid the station of high dose rate. However, it is necessary to strengthen the radiation protection of the operator and the first assistant. Under the dual protections of bedside lead protective equipment and personal protective equipment, the exposure dose of intervention personnel can be significantly reduced.

15.
Cancer Research and Treatment ; : 406-418, 2020.
Article | WPRIM | ID: wpr-831057

ABSTRACT

Purpose@#This study aimed to investigate the potential systemic antitumor effects of stereotactic ablativeradiotherapy (SABR) and apatinib (a novel vascular endothelial growth factor receptor2 inhibitor) via reversing the immunosuppressive tumor microenvironment for lung carcinoma. @*Materials and Methods@#Lewis lung cancer cells were injected into C57BL/6 mice in the left hindlimb (primary tumor;irradiated) and in the right flank (secondary tumor; nonirradiated). When both tumors grewto the touchable size, mice were randomly divided into eight treatment groups. These groupsreceived normal saline or three distinct doses of apatinib (50 mg/kg, 150 mg/kg, and 200mg/kg) daily for 7 days, in combination with a single dose of 15 Gy radiotherapy or not tothe primary tumor. The further tumor growth/regression of mice were followed andobserved. @*Results@#For the single 15 Gy modality, tumor growth delay could only be observed at the primarytumor. When combining SABR and apatinib 200 mg/kg, significant retardation of both primaryand secondary tumor growth could be observed, indicated an abscopal effect wasinduced. Mechanism analysis suggested that programmed death-ligand 1 expressionincreased with SABR was counteract by additional apatinib therapy. Furthermore, whenapatinib was combined with SABR, the composition of immune cells could be changed.More importantly, this two-pronged approach evoked tumor antigen–specific immune responsesand the mice were resistant to another tumor rechallenge, finally, long-term survivalwas improved. @*Conclusion@#Our results suggested that the tumor microenvironment could be managed with apatinib,which was effective in eliciting an abscopal effect induced by SABR.

16.
Journal of Zhejiang University. Medical sciences ; (6): 253-259, 2020.
Article in Chinese | WPRIM | ID: wpr-828543

ABSTRACT

OBJECTIVE@#To establish a clinically applicable model of rapid identification of adverse drug reaction program (RiADP) for risk management and decision-making of clinical drug use.@*METHODS@#Based on the theory of disproportion analysis, frequency method and Bayes method, a clinically applicable RiADP model in R language background was established, and the parameters of the model were interpreted by MedDRA coding. Based on the actual monitoring data of FDA, the model was validated by the assessing hepatotoxicity of lopinavir/ritonavir (LPV/r).@*RESULTS@#The established RiADP model included four parameters: standard value of adverse drug reaction signal information, empirical Bayesian geometric mean value, ratio of reporting ratio and number of adverse drug reaction cases. Through the application of R language parameter package "phViD", the model parameters could be output quickly. After being encoded by MedDRA, it was converted into clinical terms to form a clinical interpretation report of adverse drug reactions. In addition, the evaluation results of LPV/r hepatotoxicity by the model were matched with the results reported in latest literature, which also proved the reliability of the model results.@*CONCLUSIONS@#In this study, a rapid identification method of adverse reactions based on post marketing drug monitoring data was established in R language environment, which is capable of sending rapid warning of adverse reactions of target drugs in public health emergencies, and providing intuitive evidence for risk management and decision-making of clinical drugs.


Subject(s)
Humans , Databases, Pharmaceutical , Decision Making, Computer-Assisted , Drug Monitoring , Drug-Related Side Effects and Adverse Reactions , HIV Protease Inhibitors , Pharmacology , Liver , Lopinavir , Toxicity , Models, Statistical , Reproducibility of Results , Software , Reference Standards
17.
Chinese Journal of Trauma ; (12): 455-462, 2020.
Article in Chinese | WPRIM | ID: wpr-867730

ABSTRACT

Objective:To investigate the role of basic fibroblast growth factor (bFGF) in decreasing intracranial pressure in rats after intra-abdominal hypertension (IAH).Methods:A total of 60 healthy SD rats were selected for the experiment. Secondary IAH rat models were established by hemorrhagic shock/resuscitation, followed by injecting nitrogen into the peritoneal cavity of the rats to maintain an intra-abdominal pressure of 12mmHg and above. According to the random number table, the rats were divided into control group, IAH group, IAH+ bFGF group (bFGF group) and IAH+ bFGF+ PD173074 group (antagonist group), with 15 rats per group. Indicators were measured 4 hours after injury, including intracranial pressure, brain morphological observation, apparent diffusion coefficient (ADC) value, lactic acid content of brain MRI, brain water content and Evans blue exudation. Immunofluorescence staining, Western blotting and PCR were used to detect the expressions of phosphorylate-fibroblast growth factor receptor 1, 2 (p-FGFR1, 2), Zonula occludens-1 (ZO-1), β-catenin, matrix metalloproteinases 9 (MMP9), interleukin-1β (IL-1β) in brain microvascular endothelial cells (BMECs).Results:The intracranial pressure in IAH group [(5.52±0.45)mmHg] gradually increased 4 hours after injury compared control group [(3.36±0.30)mmHg]. Compared with IAH group, the intracranial pressurein bFGF group [(4.46±0.41)mmHg] was decreased ( P<0.05). Compared with bFGF group, the intracranial pressure in antagonist group [(5.36±0.44)mmHg] was enhanced ( P<0.05). Brain morphological observations in IAH group showed swelling and obvious cerebral edema, accompanied with a small amount of subarachnoid hemorrhage. Compared with IAH group, cerebral edema and brain swelling were relieved in bFGF group, while the antagonist group still showed cerebral edema and obvious brain swelling. At 4 hours after injury, MRI examination showed that the relative ADC value in IAH group (cortex: 0.82±0.11, corpus callosum: 1.26±0.17) was lower than that in control group (cortex: 1.00±0.13, corpus callosum: 1.43±0.15)( P<0.05). Compared with IAH group, the relative ADC value in bFGF group (cortex: 0.94±0.16, corpus callosum: 1.36±0.16) was increased ( P<0.05). Compared with bFGF group, the relative ADC value in antagonist group (cortex: 0.87±0.13, corpus callosum: 1.30±0.14) was decreased ( P<0.05). Relative lactic acid content in IAH group (cortex: 15.50±2.14, corpus callosum: 10.82±1.90)was higher than that in control group (cortex: 1.00±0.23, corpus callosum: 0.70±0.20)( P<0.05). Compared with IAH group, the relative lactic acid content in bFGF group (cortex: 10.85±1.42, corpus callosum: 6.96±1.30) was decreased ( P<0.05). Compared withbFGF group, the relative lactic acid content in antagonist group (cortex: 13.71±1.61, corpus callosum: 9.12±1.52) was increased ( P<0.05). The brain water content in IAH group [(87.9±0.8)%] was higher than that in control group [(76.3±0.9)%]. Compared with IAH group, the brain water content in bFGF group [(83.2±1.0)%] was decreased( P<0.05). Compared with bFGF group, the brain water content in antagonist group[(85.4±0.8)%] was increased ( P<0.05). Evans blue exudation in IAH group [(3.22±0.29)μg/ml] was greater than that in control group [(0.42±0.22)μg/ml]( P<0.05). Compared with IAH group, the Evans blue exudation in bFGF group [(2.04±0.25)μg/ml] was decreased ( P<0.05). Compared with bFGF group, the Evans blue exudation in antagonist group [(2.92±0.20)μg/ml] was increased ( P<0.05). Compared with control group, the expression of p-FGFR1 in BMECs in IAH group was weakened 4 hours after injury, but p-FGFR2 remained unchanged, the expressions of ZO-1, β-catenin protein and mRNA were weakened, and the expressions of MMP9, IL-1β protein and mRNA were enhanced ( P<0.05). Compared with IAH group, the expressions of p-FGFR1, ZO-1, β-catenin protein and mRNA were enhancedin bFGF group, and the expressions of MMP9, IL-1β protein and mRNA were weakened as well ( P<0.05). However, the expressions of p-FGFR1, ZO-1 and β-catenin protein and mRNA in antagonist group were weaker than those in bFGF group, and the expressions of MMP9 and IL-1β protein and mRNA were stronger than those in the bFGF group ( P<0.05). Conclusion:After IAH, the rat model presents damaged blood-brain barrier, increased cerebral edema, and increased intracranial pressure, and the use of bFGF can improve these symptoms. FGFR1 of BMECs is a key receptor for bFGF to play a protective role, and its receptor inhibitor PD173074 can attenuate the protective effect of bFGF.

18.
Chinese Pharmaceutical Journal ; (24): 685-691, 2020.
Article in Chinese | WPRIM | ID: wpr-857713

ABSTRACT

OBJECTIVE: To analyze and evaluate the safety signals of chloroquine in the patients, and to provide a valuable reference for rational use in clinic. METHODS: Both the reporting odds ratio (ROR) method and Bayesian confidence propagation neural network (BCPNN) were applied to analyze safety signals of chloroquine based upon the adverse drug events (ADEs) data ranging from 2004 to 2020 as reported in the Adverse Event Reporting System (FAERS) database of the Food and Drug Administration (FDA), and to systematically assesse the safety signals of chloroquine phosphate on various organs systems. RESULTS: Among the 2 063 reports of ADEs studied, 557 reports were considered to be mainly caused by chloroquine. The results demonstrated that the high-risk ADEs signals of chloroquine involved various systems, such as atrioventricular block complete (ROR=2.90, IC-2SD=1.64), ventricular fibrillation (ROR=3.40, IC-2SD=1.27), blindness (ROR=27.51, IC-2SD=0.55), cardiogenic shock (ROR=6.86, IC-2SD=0.54), vomiting (ROR=1.70, IC-2SD=1.83). Moreover, some rare ADEs with high-risk signals showed a correlation with chloroquine, including hypokalaemia (ROR=4.18,IC-2SD=1.51), renal failure acute (ROR=3.08, IC-2SD=0.30), methaemoglobinaemia (ROR=4.37, IC-2SD=0.03), and pyrexia (ROR=1.80, IC-2SD=1.84), which were consistent with literature reports. However, these ADEs were not listed in instruction and worth much attention in clinic. Moreover, basic diseases of patients and drug incompatibility need much attention to prevent the occurrence and exacerbation of chloroquine-related adverse reactions. CONCLUSION: A comprehensive analysis of the ADEs signals of chloroquine could shed some light on understanding of its safety characteristics and would provide valuable information for rational use of chloroquine in clinic, especially in treatment of COVID-19.

19.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 154-160, 2019.
Article in Chinese | WPRIM | ID: wpr-802214

ABSTRACT

Objective:To analyze and identify the non-medicinal parts in Zanthoxylum nitidum husk by HPLC-LTQ/Orbitrap-MS, and study the antioxidant activity, in order to provide the scientific basis for further research and development of Z. nitidum. Method:Data is collected by HPLC-LTQ/Orbitrap-MS,and high-resolution MS and MS2 spectra of mass spectrogram of chromatographic peaks were analyzed and compared with the literature database. The structure of each chromatographic peak was calculated and confirmed. The anti-oxidative activity of the Z. nitidum husk was studied by DPPH scavenging free radical ability and ABTS free radical scavenging ability. Result:Twenty-five alkaloids were identified from Z. nitidum husk. The main constituents were isoquinoline alkaloids (nitidine,liriodenine,magnocurarine),pyrrolidine alkaloid (allocryptopine,oxymatrine,oxysophocarpine),quinoline alkaloid (magnoflorine,nitidine chloride),and organic amine alkaloids (γ-sanshool). Antioxygenic activity was studied by DPPH scavenging free radical ability and ABTS free radical scavenging ability. The results showed that they were within the measured concentration range, the antioxidant activity increased with the rise of the sample concentration, a good dose dependence was presented. Conclusion:In this paper,the chemical constituents and the activity Z. nitidum husk were studied. Studies have shown a variety of alkaloids, with a good antioxidant activity. This study provides a reference for further research and development of Z. nitidum.

20.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 65-70, 2019.
Article in Chinese | WPRIM | ID: wpr-801932

ABSTRACT

Objective: To observe the effect of an active fraction of Polyrhachis vicina (AFPV) on systemic lupus erythematosus (SLE) and its possible mechanism based on animal and cell models. Method: Totally 60 SD rats were randomly divided into normal control group, model group, prednisone acetate group (5 mg·kg-1), and high, medium and low-dose AFPV groups (400, 200, 100 mg·kg-1). SLE model was replicated with bovine serum albumin-Freund's complete (incomplete) adjuvant. Arthus reaction was observed to study the effect of AFPV on the diameter of back skin redness in rats with SLE. The expressions of anti-double-stranded DNA (dsDNA) antibody, complements 3 (C3), complement 4 (C4), immunoglobulin M (IgM), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-31 (IL-31) and interleukin-33 (IL-33) in serum were detected by enzyme-linked immunosorbent assay. CD4+T cells were isolated from the spleens of MRL/lpr and C57BL/6J mice at the age of 16 to 18 weeks by immunomagnetic beads method. The expressions of miR-200a and miR-155 and the levels of zinc-finger-enhancer binding protein 1(ZEB1) and suppressor of cytokine signaling1(SOCS1) in CD4+T cells were observed to explore the effect of AFPV on SLE and its possible mechanism. Result: Compared with the normal group, the diameter of back skin swelling in the model group was significantly increased (PPPPPPP+T cells of MRL/lpr lupus mice. Compared with the model group, the expression of microRNA-200a increased significantly, the expression of microRNA-155 decreased significantly (PPConclusion: AFPV has therapeutic effect on rats with SLE, its mechanism may be related to the regulation of miR-200a/ZEB1 and miR-155/SOCS1.

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