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1.
China Pharmacy ; (12): 358-365, 2022.
Article in Chinese | WPRIM | ID: wpr-913096

ABSTRACT

OBJECTIVE To systema tically evaluate the effectiveness and safety of gen eric and original drugs of atorvastatin , and to provide the latest evidence-based reference for drug selection in clinic. METHODS Retrieved from PubMed ,Cochrane Library,Embase,CNKI,VIP and Wanfang database ,intervention trials and observational studies about generic and original drugs of atorvastatin were collected during the inception to Apr. 2021. After data extraction of literatures met inclusion criteria ,the Cochrane risk bias evaluation tool 5.1.0 was used to evaluate the quality of intervention trials ;Newcastle-Ottawa Scale (NOS)was used to evaluate the quality of observational studies. RevMan 5.4 software was used to conduct meta-analysis ,and descrptive analysis was performed at the same time. RESULTS A total of 24 studies were included ,involving 21 randomized controlled trials (RCTs)and 3 retrospective cohort studies (RCSs),with 20 001 patients involved. Meta-analysis results of RCT showed there was no statistically significant difference between the two groups in reducing low-density lipoprotein cholesterol (LDL-C)levels [MD = - 0.05,95% CI(- 0.12,0.02),P=0.16] and increasing Δ 基金项目:国家重点研发计划项目(No.2017YFC0910004);山 东省重点研发计划项目(No.2020RKB14165) high-density lipoprotein cholesterol (HDL-C)levels [MD = *硕士研究生 。研究方向:临床药学。E-mail:1677032023@qq. - 0.00,95% CI(- 0.02,0.01),P=0.52];the degree of com reducing total cholesterol (TC)level [MD =-0.11,95%CI # 通信作者:主任药师,硕士生导师。研究方向:临床药学、药事 ( - 0.17,- 0.06),P<0.000 1] and triglyceride (TG) 管理。电话:0351-89268349。E-mail:13791120711@126.com level [MD =-0.05,95%CI(-0.09, -0.01),P=0.02] in ·358· China Pharmacy 2022Vol. 33 No. 3 中国药房 2022年第33卷第3期 generic drug group was lower than orig inal drug group ,with statistical significance difference. There was no statistical significance difference in total incidence of adverse drug reaction (ADR)[OR=1.08,95% CI(0.85,1.37),P=0.55] and the incidence of other ADR(P>0.05). The results of subgroup analysis showed that the reductions of TC and TG of generic drugs produced by Beijing Jialin Pharmaceutical Enterprise (hereinafter refer to Jialin generic drugs )were less than those of the original drug ,and the difference was statistically significant ;compared with original drugs ,there was no significant difference in other indexes or all indexes of the generic drugs from other manufacturers. Compared with original drugs ,the reductions of TC and TG in 20 mg/d group of Jialin generic drugs were less than original drug group ;the degree of TC reduction at 12 and 24 weeks of follow-up and TG reduction at 24 weeks of follow-up were less than those of the original drugs ,the difference was statistically significant ;there was no significant difference in other indexes. The qualitative description of RCS showed that for elderly patients with death/acute coronary syndrome ,there was no statistical difference between the two groups in terms of cardiovascular events or serious side effects. For the adult patients who switched from original drugs to generic drugs ,the effect of generic drugs instead of original drugs would not be reduced ,but the increase of HDL-C was less than that of original drug. CONCLUSIONS In terms of effectiveness,generic drugs of atorvastatin can replace original drugs and caution should be taken on the levels of HDL-C ,TC and TG for long time use ;in terms of safety ,generic drugs are similar to the original drugs.

2.
Article in Chinese | WPRIM | ID: wpr-908102

ABSTRACT

Objective:To develop and internally validate a fall related injury risk nomogram in of patients in Patients in hospital.Methods:Patients who fall during the hospital stay from a grade-three general hospital of Zhejiang province were recruited. Data were collected from January 2014 to December 2019. Data was collected after patients fall in hospital, including age, sex, and 18 other predictive factors. The LASSO regression model and multivariable logistic regression analysis were applied to build a predicting model. Discrimination and calibration of the predicting model were assessed using the C-index and calibration plot. Internal validation was assessed using the bootstrapping validation.Results:Of the 243 patients included in the study, 70 patients had fall related injury. The fall related injury probability was 28.81%. Predictors contained in the prediction nomogram included age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia. The model displayed good discrimination with a C-index of 0.823 (95% confidence interval 0.756-0.875) and good calibration. High C-index value of 0.803 could still be reached in the interval validation.Conclusion:This fall related injury risk nomogram in of patients in Patients in hospital incorporating the age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia could be conveniently used to predict fall related injury risk of patients in hospital.

3.
Article in Chinese | WPRIM | ID: wpr-904619

ABSTRACT

Objective To establish a deep learning-based visual model for intelligent recognition of Oncomelania hupensis, the intermediate host of Schistosoma japonicum, and evaluate the effects of different training strategies for O. hupensis image recognition. Methods A total of 2 614 datasets of O. hupensis snails and 4 similar snails were generated through field sampling and internet capture, and were divided into training sets and test sets. An intelligent recognition model was created based on deep learning, and was trained and tested. The precision, sensitivity, specificity, accuracy, F1 score and Youden index were calculated. In addition, the receiver operating characteristic (ROC) curve of the model for snail recognition was plotted to evaluate the effects of “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies on the accuracy of the model for snail recognition. Results Under the “transfer learning + data enhancement” strategy, the precision, sensitivity, specificity, accuracy, Youden index and F1 score of the model were 90.10%, 91.00%, 97.50%, 96.20%, 88.50% and 90.51% for snail recognition, which were all higher than those under both “new learning” and “transfer learning” strategies. There were significant differences in the sensitivity, specificity and accuracy of the model for snail recognition under “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies (all P values < 0.001). In addition, the area under the ROC curve of the model was highest (0.94) under the “transfer learning + dataenhancement” training strategy. Conclusions This is the first visual model for intelligent recognition of O. hupensis based on deep learning, which shows a high accuracy for snail image recognition. The “transfer learning + data enhancement” training strategy is helpful to improve the accuracy of the model for snail recognition.

4.
China Pharmacy ; (12): 2561-2566, 2021.
Article in Chinese | WPRIM | ID: wpr-904511

ABSTRACT

OBJECTIVE:To interpret the new version of the Implementation Plan for Enrollment and Assessment of Clinical Pharmacist Teacher Training Project of Chinese Hospital Association (Trial)(hereinafter referred to as the “New Plan ”)officially announced by the Chinese Hospital Association in Sept. 2021,in order to provide guidance and reference for smoothly promoting the implementation of the New Plan and realizing the original intention of the reform. METHODS :The New Plan was interpreted from four aspects ,including the background of the formulation of the New Plan ,the main features presented ,the innovations and the issues that need to be paid attention to in the next implementation. RESULTS & CONCLUSIONS :The formulation and release of the New Plan marks the beginning of a new round of reform of the clinical pharmacist teacher training program of the Chinese Hospital Association. It is mainly based on the actual problems encountered in the operation of the current clinical pharmacist teacher training system ,the importance of clinical pharmacistteacher training itself ,and the opportunities and challenges that the development of the times has brought to our country ’s 163.com clinical pharmacy business. Research foundation , problem orientation and professional demonstration present important characteristics. Compared with the old plan ,the New Plan adds a substantive selection mechanism for majors ,which intends to achieve the necessary “strictness”in the enrollment process ;it reconstructs the overall training goal of the benchmarking project and the three-in-one assessment system ,which intends to achieve a reasonable “lax”of assessment link ;it removes restrictions on off-site training ,advocates wide-ranging professional docking,and improves the flexibility of the training system and process management. The implementation of the New Plan is a complex work involving multiple parties and is affected by many factors. It requires multiple teams to perform their duties and promote together. The teacher training base and expert team must understand the spirit of reform and achieve the stable implementation of the New Plan ;at the same time ,the communication between the project working group and the teaching base and experts should be strengthened ,and finally realize the original intention of the reform of cultivating more high-quality clinical pharmacy teachers.

5.
Journal of Breast Cancer ; : 97-105, 2021.
Article in English | WPRIM | ID: wpr-898994

ABSTRACT

In the PALOMA-3 trial, the median progression-free survival (PFS) was longer among patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (ABC) treated with palbociclib plus fulvestrant than those treated with placebo plus fulvestrant. This subgroup analysis examined the efficacy and safety of palbociclib among Korean patients enrolled in PALOMA-3 (n = 43 [palbociclib group, n = 24; placebo group, n = 19]). In both groups, > 40% of patients were pre/perimenopausal at enrollment. The median PFS was significantly prolonged with palbociclib vs. placebo (12.3 [95% confidence interval (CI), 9.1–not estimable] vs. 5.4 months [95% CI, 1.9–9.2]; hazard ratio, 0.40 [95% CI, 0.19–0.83]; one-sided p = 0.005), and the confirmed objective response was 21.1% and 11.8%, respectively (odds ratio, 2.0 [95% CI, 0.24–24.8]). Neutropenia was the most common adverse event associated with palbociclib. Overall, palbociclib plus fulvestrant was effective and generally safe among Korean patients with HR+/HER2− ABC, regardless of menopausal status.

6.
Journal of Breast Cancer ; : 97-105, 2021.
Article in English | WPRIM | ID: wpr-891290

ABSTRACT

In the PALOMA-3 trial, the median progression-free survival (PFS) was longer among patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (ABC) treated with palbociclib plus fulvestrant than those treated with placebo plus fulvestrant. This subgroup analysis examined the efficacy and safety of palbociclib among Korean patients enrolled in PALOMA-3 (n = 43 [palbociclib group, n = 24; placebo group, n = 19]). In both groups, > 40% of patients were pre/perimenopausal at enrollment. The median PFS was significantly prolonged with palbociclib vs. placebo (12.3 [95% confidence interval (CI), 9.1–not estimable] vs. 5.4 months [95% CI, 1.9–9.2]; hazard ratio, 0.40 [95% CI, 0.19–0.83]; one-sided p = 0.005), and the confirmed objective response was 21.1% and 11.8%, respectively (odds ratio, 2.0 [95% CI, 0.24–24.8]). Neutropenia was the most common adverse event associated with palbociclib. Overall, palbociclib plus fulvestrant was effective and generally safe among Korean patients with HR+/HER2− ABC, regardless of menopausal status.

7.
Article in English | WPRIM | ID: wpr-922120

ABSTRACT

OBJECTIVE@#To evaluate the protective effects of Astragaloside IV (AST) in a rat model of myocardial injury induced by cecal ligation and puncture (CLP).@*METHODS@#The model of sepsis-induced cardiac dysfunction was induced by CLP. Using a random number table, 50 specific pathogen free grade of Sprague Dawley rats were randomized into 5 groups: the sham group (sham), the model group (CLP, 18 h/72 h) and AST group (18 h/72 h). Except the sham group, the rats in other groups received CLP surgery to induce sepsis. CLP groups received intragastric administration with normal saline after CLP. AST groups received intragastric administration with AST solution (40 mg/kg) once a day. The levels of inflammatory mediators and oxidative stress markers in the serum of the septic rats were determined via enzyme-linked immunosorbent assay (ELISA) at different time point, such as interleukin 6 (IL-6), IL-10, high mobility group box-1 protein B1 (HMGB-1), superoxide dismutase (SOD), and malondialdehyde (MDA). Cardiac function was determined by echocardiography. Moreover, changes in myocardial pathology were evaluated using hematoxylin and eosin staining. The levels of lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were analysed to determine the status of CLP-induced myocardium. In addition, the apotosis of myocardial cells was analysed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL). The protein levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), IκB kinase α (IKKα), nuclear factor kappa B p65 (NF-κB p65) were detected by Western blot analysis. Moreover, survival rate was investigated.@*RESULTS@#AST improved the survival rate of CLP-induced rats by up to 33.3% (P<0.05). The cardioprotective effect of AST was observed by increased ejection fraction, fractional shortening and left ventricular internal diameter in diastole respectively (P<0.01 or P<0.05). Subsequently, AST attenuated CLP-induced myocardial apoptosis and the ratio of Bcl-2/Bax in the myocardium, as well as the histological alterations of myocardium (P<0.01 or P<0.05); the generation of inflammatory cytokines (IL-6, IL-10, HMGB-1) and oxidative stress markers (SOD, MDA) in the serum was significantly alleviated (P<0.01 or P<0.05). On the other hand, AST markedly suppressed CLP-induced accumulation of IKK-α and NF-κB p65 subunit phosphorylation (P<0.01 or P<0.05).@*CONCLUSIONS@#AST plays a significant protective role in sepsis-induced cardiac dysfunction and survival outcome. The possible mechanism of cardioprotection is dependent on the activation of the IKK/NF-κB pathway in cardiomyocytes.


Subject(s)
Animals , Disease Models, Animal , Heart Diseases , NF-kappa B , Rats , Rats, Sprague-Dawley , Saponins , Sepsis/drug therapy , Triterpenes , Tumor Necrosis Factor-alpha
8.
Article in Chinese | WPRIM | ID: wpr-921715

ABSTRACT

This study adopted ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-QTOF-MS)-based untargeted metabolomic approaches for exploring the changes in endogenous metabolites of rat serum related to property differences between ginseng and American ginseng. Then the action mechanisms of them with warm and cool properties and the effects of processing on their property changes were investigated. Based on principal component analysis(PCA), the differences in metabolite profiles between ginseng, red ginseng, American ginseng, and red American ginseng were compared. After that, 16 potential differential endogenous biomarkers were identified by orthogonal partial least squares discriminant analysis(OPLS-DA) and online database searching. And the related metabolic pathways were systematically analyzed. By comparing content variations of these 16 potential differential endogenous biomarkers, we have found that 10 potential differential biomarkers were responsible for the warm property of ginseng and red ginseng, and 9 were related to the cool property of American ginseng and red American ginseng. As demonstrated by in-depth analysis of related metabolic pathways of differential biomarkers, ginseng and American ginseng mainly played a role in regulating the energy metabolism of amino acid, glycolysis, and fatty acids, during which they exhibited differences in property. The comparison of content variations of these differential endogenous between groups revealed that the energy metabolism of red ginseng group was stronger than that of ginseng group, consistent with the traditional processing theory that the warming and tonifying effects of ginseng could be enhanced after processing. The property of red American ginseng was similar to that of American ginseng, both cool in property, but American ginseng was cooler than red American ginseng. It can be seen that non-targeted metabolomic approaches can be utilized to study mechanisms underlying property differences of Chinese medicines and the effects of processing on their property changes.


Subject(s)
Animals , Biomarkers , Chromatography, High Pressure Liquid , Chromatography, Liquid , Mass Spectrometry , Metabolomics , Panax , Rats
9.
Article in Chinese | WPRIM | ID: wpr-911725

ABSTRACT

The general practice team of the Affiliated Hospital of Hangzhou Normal University and its medical consortium conducted health education for 73 diabetic patients from January to December 2019. The education was dealing with the knowledge and techniques of standardizing insulin administration, including the manipulations, rotation of injection sites and replacement of injection needles, etc. The questionnaire surveys on the knowledge of diabetic management and insulin administration were conducted before and after education. After education the number of patients who knew the injection site and skin disinfection increased from 68 and 69 to 73 and 73, respectively ( P>0.05); the number of patients who knew the injection depth and length of the needle used increased from 33 and 24 to 73 and 73, respectively ( P<0.05); the number of patients who knew pinching the skin, the angle of needle insertion increased from 30 and 44 to 73 and 73 ( P<0.05). After education the number of patients with pinch time>10 sec increased from 0 to 68 cases ( P<0.05); with needle stay>10 sec increased from 0 to 71 ( P<0.05); with rotation in the same area increased from 58 to 73 ( P<0.05); with repeated needle use decreased from 73 to 70 ( P>0.05). After education the blood glucose control of diabetic patients was improved: the glycosylated hemoglobin [(8.3±1.3)% vs. (6.8±0.5)%, t=9.00, P<0.05], fasting blood glucose [(7.7±0.8)mmol/L vs. (6.9±0.5)mmol/L, t=7.90, P<0.05] and 2-hour postprandial blood glucose[(11.4±2.1)mmol/L vs. (9.6±0.8)mmol/L, t=7.00, P<0.05] were significantly decreased. It is suggested that health education provided by the general practice team can standardize the insulin administration in diabetic patients and improve blood sugar control.

10.
Chinese Journal of Geriatrics ; (12): 1363-1367, 2021.
Article in Chinese | WPRIM | ID: wpr-911019

ABSTRACT

Objective:To observe the effects of abdominal obesity on cognitive status in patients with obstructive sleep apnea syndrome(OSAS).Methods:150 cases with moderate to severe OSAS patients were enrolled in this prospective case-control study in the Department of Neurology of Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to September 2020.According to whether abdominal obesity was complicated, the patients were divided into non-abdominal obesity group(n=31)and abdominal obesity group(n=119). The cognitive function of the patients was evaluated by Montreal Cognitive Assessment(Mo-CA)scale and Symbol Digit Modalities Test(SDMT)in the two groups, and the independent influencing factors of each cognitive function were determined by linear regression.Two factors Analysis of Variance(ANOVA)was used to analyze the main effects and interactions of Apnea Hypopnea Index(AHI)and abdominal obesity on various cognitive functions.Results:Compared with the non-abdominal obesity group, the body mass index, neck circumference, waist circumference, hip circumference, AHI, minimum oxygen saturation and oxygen de-saturation index(ODI)were significantly higher in the abdominal obesity group(all P<0.01). Before correction for any factors, the total score of Mo-CA, visual space and executive score and language score were lower in abdominal obesity group than in non-abdominal obesity group( P<0.01). After adjusting for gender, age, years of education, smoking history, drinking history, AHI and other factors, there were still significant differences in visual space, executive score and language score between the two groups( P<0.05), but there was no significant difference in the total score of Mo-Ca( P>0.05). The correct number of SDMT(40.4±14.5)was lower in non-abdominal obesity group than in abdominal obesity group(44.4±9.0), but the difference was not statistically significant( t=1.887, P>0.05). After adjusting for gender, age, years of education, smoking history, and drinking history, there was still no significant difference in AHI and other factors between the two groups( P>0.05). Regression analysis results showed that independent influencing factors of the total Mo-CA score were age, education, abdominal obesity, and AHI>30( β=-0.174, 0.213, 0.011, 0.158, respectively all P<0.05); the independent influencing factors of visual space and execution ability were the years of education and the abdominal obesity( β=0.182, -0.038, P<0.01); the independent influence factors of naming were gender( β=-0.176, P<0.01); independent influencing factors of attention were age( β=-0.159, P<0.01); independent influencing factors of language were abdominal obesity( β=-0.203, P<0.01); independent influences factors for abstract thinking ability were the length of education( β=0.204, P<0.01); independent influencing factors for delay recall were age, years of education and AHI>30(βvalues were -0.206, -0.125, and -0.174, respectively, all P<0.05, respectively); independent influencing factors for SDMT correct number were age, years of education(β values were -0.177, 0.153, respectively, all P<0.01, respectively). Interaction analysis results showed that there was an interaction between AHI and abdominal obesity in language score( P<0.05). Conclusions:Abdominal obesity can impair the visuospatial and executive abilities as well as language ability in moderate to severe obstructive sleep apnea patients.And there is an interaction between apnea-hypopnea index and MO-CA scores in language ability.

11.
Chinese Journal of Geriatrics ; (12): 991-995, 2021.
Article in Chinese | WPRIM | ID: wpr-910953

ABSTRACT

Objective:To quantitatively evaluate the left ventricular circumferential and longitudinal strain after percutaneous coronary intervention(PCI)in elderly patients with acute myocardial infarction(AMI)using speckle-tracking imaging(STI)on echocardiography.Methods:A prospective case-control study was conducted on 47 elderly patients diagnosed with ST-elevation AMI and undergoing percutaneous coronary interference(PCI)in our hospital from August 2017 to June 2020 as PCI-study group.The 35 normal subjects matched for age and sex were as a normal-control group.The longitudinal peak systolic strain(LPSS)and circumferential peak systolic strain(CPSS)were measured using STI at one week and three months after PCI in the two groups.Results:The values of LPSS and CPSS were apical segment > middle segment > basal segment, which was the similar between LPSS and CPSS.Compared with normal-control group, AMI-PCI group showed that CPSS and LPSS in each segment were significantly reduced at 1 week and 3 months after operation.Compared with the control group, all the CPSS and LPSS values were significantly decreased in AMI group at one week after PCI(-12.3±2.7)% vs.(-22.5±1.7)%( t=19.62, P<0.01); (-12.9±3.2)% vs.(-23.1±2.6)%( t=15.43, P<0.01). Both LPSS and CPSS values were improved at a certain extent at three months after PCI compared with AMI group at one week after PCI.The complete CPSS and LPSS values were significantly increased in AMI group at three months after PCI compared with one week after PCI(-16.8±2.6)% vs.(-12.3±2.7)%, ( t=8.23, P<0.01); (-17.0±3.3)% vs.(-12.9±3.2)%( t=6.11, P<0.01). But, there were still significant differences compared with the NC group(-16.8±2.6)% vs.(-22.5±1.7)%( t=11.29, P<0.01); (-17.0±3.3)% vs.(-23.1±2.6)%( t=9.04, P<0.01). Conclusions:The longitudinal and circumferential strain of left ventricle were severely damaged in elderly patients with AMI.The speckle-tracking imaging technique can be used to quantitatively evaluate the left ventricular strain and its improved situation after PCI in elderly AMI patients.

12.
Chinese Journal of Orthopaedics ; (12): 1116-1124, 2021.
Article in Chinese | WPRIM | ID: wpr-910698

ABSTRACT

Objective:To analyze the surgical techniques, surgical indications and early clinical effects of 3D printed hemipelvic prostheses in the reconstruction of pelvic malignant tumors resected by the sacroiliac joint.Methods:From January 2016 to March 2020, a retrospective analysis of 9 patients with malignant tumors involving pelvis I+II or I+II+III region were treated with sacroiliac joint osteotomy and 3D printed pelvic prosthesis reconstruction. There were 7 males and 2 females; their age was 51.1±10.5 years (range 27-66 years). Among them, 5 cases were chondrosarcoma, 1 case was pleomorphic undifferentiated sarcoma, 2 cases were metastatic renal cell carcinoma, and 1 case was metastatic primitive neuroectodermal tumor. Resection of pelvic area I+II or I+II+III were according to the extent of tumor involvement. During the resection of pelvic I region, osteotomy was done through sacroiliac joint surface, and 3D printed hemipelvic prosthesis that fits the sacral auricular surface was used for reconstruction. Postoperative imaging examination was used to evaluate the acetabular rotation center deviation of the pelvic prosthesis; the International Bone Tumor Society (Musculoskeletal Tumor Society, MSTS) function score was used for functional evaluation; the patient's oncology outcome and postoperative complications were evaluated.Results:All 9 patients successfully completed the operation. The operation time was 3.5-6 hours, with an average of 4.5 hours. The intraoperative blood loss was 800-3 000 ml, with an average of 1 400 ml. 3 patients underwent resection and reconstruction of pelvis I+II area, 4 patients underwent pelvic resection and reconstruction of I+II+III area, 2 patients underwent pelvic I+II+III area combined with proximal femur resection and reconstruction; all patients were followed up. The follow-up time was 6-50 months, with an average of 16 months. At the last follow-up of 9 patients, the MSTS score was 12-26, with an average of 20.2; the postoperative rotation center horizontal displacement distance was 10.67±7.12 mm, and the vertical displacement was 8.56±4.22 mm. One case of metastatic cancer was found to have multiple metastases throughout the body during chemotherapy 3 months after surgery, and died in 7 months after surgery; 1 case of pelvic metastatic renal cell carcinoma developed multiple metastases within one and a half years after surgery, controlled by targeted drugs, and survived with the tumor; the rest seven cases had no recurrence at the surgical site and no distant metastasis was found.Conclusion:The semipelvic prosthesis with 3D printed auricular surface has potential advantages in reconstructing the bone defect of the pelvis I+II or I+II+III area after the sacroiliac joint osteotomy. The short-term efficacy is relatively satisfactory, and the long-term efficacy remains to be further observed.

13.
Chinese Journal of Orthopaedics ; (12): 1081-1089, 2021.
Article in Chinese | WPRIM | ID: wpr-910694

ABSTRACT

Objective:To investigate the alteration of immune microenvironment in giant cell tumor of bone (GCTB) after denosumab treatment from the aspect of immune cellsat single-cell level.Methods:During Nov 2018 and May 2020, fresh tumor excision tissues from GCTB cases were collected and received CyTOF analyses. CyTOF datasets were analyzed and visualized by t-distributed stochastic neighbor embedding (TSNE) method of reduction dimension. The compositions of immune cells in GCTB with or without denosumab treatment were compared. The supernatant of culture medium of ex vivo inoculated primary tumor tissues was harvested to clarify if the culturing supernatant could affect cell growth.Results:A total of 15 primary GCTB cases and three denosumab-treated samples were included in this study and were sent for CyTOF and multicolor FACS assay. GCTB was featured of T-cell and macrophage-like myeloid cell-dominant immune microenvironment. After denosumab treatment, the percentage of T-cells was significantly elevated, while the number of macrophage-like myeloid cells were reduced. Furthermore, the ratio of macrophage-like myeloid cells in total live cells was associated with the treatment period of denosumab. The multinuclear osteoclast like giant cells were characterized by the expression of γδTCR, while most of the intratumoral CD8+ T-cells were activated PD-1+CD69+T-cells. The culturing supernatant of denosumab treatment-free GCTB tissues reinforced cell proliferation in vitro, while this phenomenon was not seen when using denosumab treated tissues.Conclusion:Illustrated the immune cell atlas of GCTB, and preliminarily investigated the potential effects of immune cells on tumor progression in GCTB, providing some theoretical clues for prolonged use of denosumab in unresectable GCTB cases.

14.
Article in Chinese | WPRIM | ID: wpr-887871

ABSTRACT

Objective To evaluate the application value of abbreviated comprehensive geriatric assessment(aCGA)in elderly female breast cancer patients. Methods Eight aspects of the traditional CGA were simplified to form the aCGA assessment table,based on which the patients were classified into three grades of A,B and C according to the total scores.This study enrolled the elderly female patients with breast cancer aged 70 years and above who were treated in PUMC Hospital from June 2018 to January 2020.Eastern Cooperative Oncology Group(ECOG)scoring and aCGA grading were performed respectively,and the results of the two methods were compared. Results Of the 162 patients,111(68.5%)were classified by the aGGA method as grade A,43(26.5%)as grade B,and 8(5.0%)as grade C;131(80.9%)cases have concurrent diseases,and the most common complications were hypertension(


Subject(s)
Aged , Breast Neoplasms , Female , Geriatric Assessment , Humans
15.
Article in Chinese | WPRIM | ID: wpr-885839

ABSTRACT

Combined with leukemia is a risk factor for aggravating diabetic retinopathy. A combination of diabetic retinopathy and leukemia can be expected to have a rapid progression and patients often visit the department of ophthalmology first. In addition to the typical manifestations of diabetic retinopathy such as retinal venous tortuous dilation, microaneurysm, retinal hemorrhage and exudation, patients may also be associated with leukemic retinopathy. Areas of extensive capillary non-perfusion and neovascularization may appear in the early stage of mild microangiopathy. Moreover, severe complications such as vitreous hemorrhage, neovascular membranes and traction retinal detachment appear earlier, which may be a prognostic indicator for poor vision. The causes of leukemia aggravating diabetic retinopathy include retinal ischemia due to hyperviscosity, anemia and thrombocytopenia, direct infiltration of tumor cells, chemotherapy and radiotherapy, high level of vascular endothelial growth factor. In clinic, rapidly progressing diabetic retinopathy should alert the ophthalmologist to the underlying hematological disorder. Patients with both diabetes and leukemia need to be screened much earlier and followed up at shorter intervals. Early detection and aggressive management may help preserve visual acuity in such cases.

16.
Article in Chinese | WPRIM | ID: wpr-885832

ABSTRACT

Objective:To observe and analyze the clinical features and prognosis of proliferative diabetic retinopathy (PDR) with chronic myeloid leukemia.Methods:A retrospective case series study. From May 2011 to December 2020, 5 patients (10 eyes) were included in this study in Eye-ENT Hospital of Fudan University. Basic information about the patient's age, gender, diabetes history and CML history were collected. The endocrine and hematological indexes of all patients were evaluated. All the patients were undertaken visual acuity, intraocular pressure, slit lamp and fundus examination and other examinations to observe the eye conditions. Ophthalmic treatments included panretinal laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, vitrectomy. During the follow up period from 5 months to 6 years, prognosis was observed at each office visit. During the follow up period, patients' vision, intraocular pressure, anterior segment and retinal status were observed.Results:There were 4 males and a female in 5 patients. The ages were from 27 to 49 years, with the mean age of 39 years. All patients were bilateral. All patients suffered type 2 diabetes for 3 months to 13 years. Four of them were diagnosed as chronic myeloid leukemia before visiting to ophthalmologists, while the other visited to ophthalmology first due to poor vision. The initial visual acuity ranged from light perception to 0.4 and 6 eyes were less than 0.1. In addition to the typical manifestations of diabetic retinopathy, such as venous tortuous dilation, exudation, microaneurysm and neovascularization, patients also presented with Roth spot as leukemic fundus manifestations. All eyes developed to PDR stage. Abnormal thickening of the neovascular membranes may occur in the lower part of the retina, with secondary traction retinal detachment. All the eyes were treated with pan retinal photocoagulation and 9 eyes underwent pars plana vitrectomy. After treatment, retina of 8 eyes kept flat. The best corrected visual acuity ranged from no light perception to 1.0, and only 4 eyes reached more than 0.2. Unfortunately, one eye lost vision because of secondary neovascular glaucoma.Conclusions:PDR patients with CMLof fundus not only have venous tortuous dilation, exudation, microaneurysm and neovascularization, also present with Roth spot as leukemic fundus manifestations. Diabetic retinopathy combined with CML could progress rapidly, and its aggravating complications such as hyperplastic membrane, vitreous hemorrhage and traction retinal detachment may result in poor visual prognosis. Early screening and treatment can help improve the prognosis of patients.

17.
Chinese Journal of Orthopaedics ; (12): 427-435, 2021.
Article in Chinese | WPRIM | ID: wpr-884730

ABSTRACT

Objective:To explore the curative effect of the "domino" sequential method with prosthesis preservation in the treatment of infection around the prosthesis after limb salvage surgery for bone tumors.Methods:A retrospective analysis of 11 patients with peripheral prosthetic infections after limb salvage surgery with prosthesis preserving "domino" from January 2016 to January 2020 was retrospectively analyzed, including 8 males and 3 females; age 21-74 years old, with an average of 51.8 years old. There were 6 cases of knee prosthesis for distal femoral tumor, 2 cases of proximal tibia knee prosthesis, 2 cases of pelvic prosthesis infection, and 1 case of middle femoral prosthesis. Before the operation, 8 cases had fever, and 2 cases had sinus. Sequential treatment failure is defined as: recurrence of infection. The treatment method is the debridement and lavage of the prosthesis and the systemic combined local application of drug-sensitive antibiotics to evaluate the patient's blood routine, C-reflective protein, erythrocyte sedimentation rate and other indicators, X-ray and CT of the surgical site, and the Musculoskeletal Tumor Society (MSTS) score.Results:The positive rate of microorganism culture was 72.7% (8/11), including 2 cases of Staphylococcus aureus, 1 case of Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus aureus, abalone There were 2 cases of Acinetobacter mannifolia and 1 case of Streptococcus degalactiae. The MSTS score before treatment and at the last follow-up after treatment increased from 10.91±2.31 points to 20.73±3.52 points, the difference was statistically significant ( t=7.162, P<0.05). A total of 3 cases of sequential treatment failed to control infection, and the operation success rate was 72.7% (8/11). One case was amputation, one case was long-term replacement of wound dressing, and one case was switched to antibiotic bone cement combined with intramedullary nail reverse double insertion technique to control infection. Conclusion:For bone tumors with clinical infection symptoms less than one month after limb salvage surgery, the use of prosthesis-preserving "domino" sequential method for treatment of prosthetic infections is desirable for early and mid-term clinical efficacy.

18.
Article in Chinese | WPRIM | ID: wpr-884257

ABSTRACT

Objective:To use an isokinetic test to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.Methods:A retrospective study was conducted of the 23 patients who had been treated at Department of Orthopedics, The Forth Medical Center, General Hospital of Chinese PLA by a tunnel beneath paratenon for acute Achilles tendon rupture from January 2017 to January 2018. They were 22 males and one female, aged from 26 to 60 years (average, 35.7 years), with 11 right and 12 left sides involved. Surgery was performed 0.5 to 7.0 days (average, 2.7 days) after injury. Length of incision, skin necrosis, infection, re-rupture, ankle-hindfoot score of American Orthopedic Foot & Ankle Society (AOFAS) and Achilles tendon total rupture scores (ATRS) were followed up for 18 months. Surgical outcomes were objectively evaluated by an isokinetic test to compare the recovery of muscle strength and endurance between the affected and normal sides.Results:Skin necrosis, infection or re-rupture occurred in none of the patients. Incision length averaged 1.4 cm (from 1 to 2 cm), AOFAS 99.1 (from 93 to 100, giving an excellent and good rate of 100%), and ATRS 97.0 (from 88 to 100). Isokinetic evaluation showed that the peak torques of ankle plantar flexion and dorsal extension at 5 test speeds (30°/s, 60°/s, 90°/s, 120°/s and 240°/s) were not significantly different between the affected and normal sides ( P>0.05). In the endurance test, the total work of ankle plantar flexion was (691.2±258.8) J on the normal side and (670.6±304.2) J on the affected side, showing no significant difference between the 2 sides ( P>0.05); the total work of ankle dorsal extension at the normal side was (407.3±119.2) J, significantly larger than that at the affected side [(362.2±117.5) J] ( P=0.001). Conclusion:An isokinetic test can be used to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.

19.
Article in English | WPRIM | ID: wpr-881062

ABSTRACT

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

20.
Article in English | WPRIM | ID: wpr-880493

ABSTRACT

OBJECTIVE@#To investigate the effect of Chinese compound Shensong Yangxin Capsule ( , SSYX) on myocardial microcirculation in myocardial-infarcted rabbits.@*METHODS@#Myocardial infarction (MI) was established in rabbits by ligation of the left circumflex coronary. Thirty rabbits were randomly divided into the control group, the MI group (model), and the MI treated with SSYX group (MI+SSYX) by a random number table method. After 4 weeks of administration, low-energy real-time myocardial contrast echocardiography (RT-MCE) was conducted to assess the microcirculatory perfusion. Immunofluorescence double staining was used to detect the capillary density. The endothelial ultrastructure was observed with a transmission electron microscope. The mRNA expression levels of vascular endothelial growth factor (VEGF), endothelin 1 (ET-1), prostaglandin I2 (PGI2) and endothelial nitric oxide synthase (eNOS) were measured by real-time quantitative polymerase chain reaction (Real-time PCR). The plasmic levels of ET-1, thromboxane A2 (TXA2), nitric oxide (NO) and von willebrand factor (vWF) were examined with enzyme-linked immunosorbent assays (ELISA).@*RESULTS@#SSYX significantly improved the myocardial blood volume, myocardial micro bubble velocity, and myocardial inflow according to the examination of RT-MCE, and it visibly ameliorated the capillary endothelial structure. Furthermore, compared with the MI group, the plasma levels of TXA2, ET-1 and vWF contents significantly decreased in the MI+SSYX group, and the ET-1 mRNA expression levels of myocardium in the border zone significantly decreased, and the VEGF, PGI2 and eNOS mRNA expression levels significantly increased (all P<0.05).@*CONCLUSIONS@#SSYX has favorable advantages in ameliorating the impaired myocardial microcirculation following MI. The mechanisms of the effect are related to the ability of SSYX in balancing the endothelial-derived vasodilators and vasoconstrictors, and up-regulating the expression of VEGF and eNOS.

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