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1.
Acta Pharmaceutica Sinica ; (12): 1-12, 2022.
Article in Chinese | WPRIM | ID: wpr-913160

ABSTRACT

Due to the complexity of tumor pathology, the demand for the combined use of multiple drugs in clinical treatment has become increasingly clear-cut. Multi-drug combination can act on multiple pathways and multiple targets simultaneously to exert synergistic effects. However, the current delivery strategy for multi-drug combination still needs to be optimized. Nano-drug delivery systems can carry drugs to overcome physiological and pathological barrier to target tumor tissues and cells, achieve the goal of continuous, controllable, and targeted delivery, and enhance the efficacy of anti-tumor synergism and detoxification. To meet the new requirements for smarter and more accurate antitumor multi-drug combinational therapy, the nano-drug delivery system has been well-designed to realize more functions. For instance, delivery of multiple drugs in accurate proportions and doses can make the multi-drug synergistic effect more precise; stimulus-responsive drug release can improve selectivity and reduce side effects; controlling the time-course relationship of multiple drugs can realize sequential drug combination effect. It has shown broad prospects in the field of tumor multidrug therapy and has become one of the new directions of research and development. This article reviews the recent developments in the application of tumor drug combination therapy strategies and their delivery systems, and analyzes the new requirements and challenges of multidrug combination for the development of nano-drug delivery systems.

2.
Article in English | WPRIM | ID: wpr-929248

ABSTRACT

Simiao Wan (SMW) is a traditional Chinese formula, including Atractylodis Rhizoma, Achyranthis Bidentatae Radix, Phellodendri Chinensis Cortex and Coicis Semen at the ratio of 1:1:2:2. It can be used to the treatment of diabetes. However, its bioactive compounds and underlying mechanism are unclear. This study aimed to screen the antilipolytic fraction from SMW and investigate its therapeutic mechanisms on hepatic insulin resistance. Different fractions of SMW were prepared by membrane separation combined with macroporous resin and their antilipolytic activities were screened in fasted mice. The effects of 60% ethanol elution (ESMW) on lipolysis were investigated in 3T3-L1 adipocytes stimulated by palmitic acid (PA) and high fat diet (HFD)-fed mice. In our study, ESMW is the bioactive fraction responsible for the antilipolytic activity of SMW and 13 compounds were characterized from ESMW by UHPLC-QTOF-MS/MS. ESMW suppressed protein kinase A (PKA)-hormone-sensitive lipase (HSL) related lipolysis and increased AMP-activated protein kinase (AMPK) phosphorylation in PA challenged 3T3-L1 adipocytes. AMPKα knockdown abolished the inhibitory effects of ESMW on IL-6 and HSL pSer-660, revealing that the antilipolytic and anti-inflammatory activities of ESMW are AMPK dependent. Furthermore, ESMW ameliorated insulin resistance and suppressed lipolysis in HFD-fed mice. It inhibited diacylglycerol accumulation in the liver and inhibited hepatic gluconeogenesis. Conditional medium collected from ESMW-treated 3T3-L1 cells ameliorated insulin action on hepatic gluconeogenesis in liver cells, demonstrating the antilipolytic activity contributed to ESMW beneficial effects on hepatic glucose production. In conclusion, ESMW, as the antilipolytic fraction of SMW, inhibited PKA-HSL related lipolysis by activating AMPK, thus inhibiting diacylglycerol (DAG) accumulation in the liver and thereby improving insulin resistance and hepatic gluconeogenesis.


Subject(s)
AMP-Activated Protein Kinases/metabolism , Animals , Insulin/metabolism , Lipolysis/physiology , Liver/metabolism , Mice , Tandem Mass Spectrometry
3.
Chinese Journal of Traumatology ; (6): 138-144, 2022.
Article in English | WPRIM | ID: wpr-928493

ABSTRACT

PURPOSE@#The incidence of acute lung injury (ALI) in severe trauma patients is 48% and the mortality rate following acute respiratory distress syndrome evolved from ALI is up to 68.5%. Alveolar epithelial type 1 cells (AEC1s) and type 2 cells (AEC2s) are the key cells in the repair of injured lungs as well as fetal lung development. Therefore, the purification and culture of AEC1s and AEC2s play an important role in the research of repair and regeneration of lung tissue.@*METHODS@#Sprague-Dawley rats (3-4 weeks, 120-150 g) were purchased for experiment. Dispase and DNase I were jointly used to digest lung tissue to obtain a single-cell suspension of whole lung cells, and then magnetic bead cell sorting was performed to isolate T1α positive cells as AEC1s from the single-cell suspension by using polyclonal rabbit anti-T1a (a specific AEC1s membrane protein) antibodies combined with anti-rabbit IgG microbeads. Afterwards, alveolar epithelial cell membrane marker protein EpCAM was designed as a key label to sort AEC2s from the remaining T1α-neg cells by another positive immunomagnetic selection using monoclonal mouse anti-EpCAM antibodies and anti-mouse IgG microbeads. Cell purity was identified by immunofluorescence staining and flow cytometry.@*RESULTS@#The purity of AEC1s and AEC2s was 88.3% ± 3.8% and 92.6% ± 2.7%, respectively. The cell growth was observed as follows: AEC1s stretched within the 12-16 h, but the cells proliferated slowly; while AEC2s began to stretch after 24 h and proliferated rapidly from the 2nd day and began to differentiate after 3 days.@*CONCLUSION@#AEC1s and AEC2s sorted by this method have high purity and good viability. Therefore, our method provides a new approach for the isolation and culture of AEC1s and AEC2s as well as a new strategy for the research of lung repair and regeneration.


Subject(s)
Alveolar Epithelial Cells/cytology , Animals , Cell Culture Techniques , Cell Separation/methods , Immunoglobulin G/metabolism , Lung , Magnetic Phenomena , Rats , Rats, Sprague-Dawley
4.
Article in Chinese | WPRIM | ID: wpr-927854

ABSTRACT

BR55 is an ultrasound contrast agent targeting vascular endothelial growth factor receptor 2,which can be used to detect tumor neovascularization and improve the diagnostic accuracy.Overseas researchers have used BR55 for human ultrasound molecular imaging,which showed good safety and tolerance.We reviewed the research progress on BR55 applied in the evaluation of tumor neovascularization from the composition,characteristics,animal experiments,and clinical studies of BR55.


Subject(s)
Animals , Contrast Media , Humans , Microbubbles , Molecular Imaging/methods , Neovascularization, Pathologic/diagnostic imaging , Ultrasonography/methods , Vascular Endothelial Growth Factor Receptor-2/analysis
5.
Article in Chinese | WPRIM | ID: wpr-920796

ABSTRACT

Objective To screen for malignant tumors and high-risk factors in rural residents over 60 years old, so as to prevent and control the occurrence and development of tumors in the future. Methods The survey was conducted with reference to part of the questionnaire in the "Urban Cancer Early Diagnosis and Treatment Project and Evaluation of High-risk Populations". Clinical examinations included serum tumor marker detection, CT screening for lung cancer, occult blood (+) plus colonoscopy screening for colorectal cancer, and mammography screening. Individuals who were positive in the abovementioned clinical tests were defined as high-risk subjects. Results A total of 271 high-risk subjects (1.91%) were screened out of 14 161. Among the high-risk subjects, 71 cases of malignant tumors (26.19%) were found, with an incidence rate of 501.38 per 105. The top five tumors (63.38% of all diagnosed) were mainly concentrated in lung, upper digestive tract, blood system, urinary system, and rectum-colon. The proportion of malignant tumors detected by positive indicators was 61.54% of blood; 46.15% of carcinoembryonic antigen and carbohydrate antigen 125; 23.08% of alpha-fetoprotein; 16.66% of lung CT; and 3.09% of prostate PSA. The positive indicators in the high-risk subjects were mainly for the tumors in the prostate, lungs, liver, and CEA/CA125. The subjects with positive test indicators had lower average annual income in the last 5 years than the normal subject group (χ2=3.380, P=0.040). The subjects with positive test indicators had higher proportion in family history of tumors than the normal group (χ2=2.596, P=0.046). People in thehigh-risk group had a higher proportion than the normal group in suffering from hypertension, liver disease, gastrointestinal disease, respiratory system disease, and surgical treatment. Patients with high-risk tumors were found to have higher proportion than the normal group in showing pre-tumor clinical symptoms in the last 1 year. Study of the tumor-related risk factors found that the high-risk group had a higher proportion of high-fat/high-cholesterol diet, alcohol drinking, passive smoking, and personality depression. Conclusion High tumor risk factors have been identified in this population. It is necessary to strengthen the corresponding intervention and follow-up treatment of precancerous diseases in the future. We recommend the government to conduct tumor screening among high-risk groups to improve cost-effectiveness.

6.
Acta Pharmaceutica Sinica ; (12): 331-342, 2022.
Article in Chinese | WPRIM | ID: wpr-922912

ABSTRACT

Ionic liquids (ILs) are liquid mixtures formed by anions and cations in a certain stoichiometric ratio under certain conditions. They are widely used in various fields because of their simple preparation process, low volatility, high stability, high conductivity and non-flammability. Here, we firstly introduce their formation principles, classification, and physical and chemical properties in detail. Then, we summarize their functions in pharmaceutical preparations, such as improving the solubility of insoluble drugs, enhancing the stability of drugs, and promoting the permeability of drugs, as well as their role as active pharmaceutical ingredients (API) to fabricate new drug delivery systems of API-ILs. Finally, we reviewed the applications of ILs in different administration routes, including oral, transdermal, mucosal, and injection routes, and meanwhile offer perspectives for the further use of ILs.

7.
Annals of Dermatology ; : 11-17, 2021.
Article in English | WPRIM | ID: wpr-874124

ABSTRACT

Background@#Epidermolysis bullosa (EB) is a rare genetic disease with widely different clinical manifestations, but the relationship between genotype and phenotype is not fully understood. In the present study, we recruited a Chinese family in which two members had been diagnosed with localized EB simplex (EBS), with clinical manifestation, including blisters and erosions on the soles of the feet since infancy. @*Objective@#To identify and confirm the genetic variation in a Chinese family diagnosed as localized EBS. @*Methods@#Our study included two patients, other healthy members of the family, and 100 normal controls. Genomic DNA samples were isolated from each participant, and then polymerase chain reaction (PCR) direct sequencing was performed. @*Results@#The results of PCR direct sequencing revealed a novel heterozygous missense mutation in codon 461 of exon 7 of KRT5 (c.1382T>C), which led to an amino acid change (p.L461P) in the patients with EBS but was absent in unaffected family members and 100 unrelated control samples. @*Conclusion@#The present study broadens the mutational spectrum of EBS, and this knowledge could be harnessed for prenatal screening, gene diagnosis, and gene therapy for lo-calized EBS.

8.
Journal of Clinical Hepatology ; (12): 654-659, 2021.
Article in Chinese | WPRIM | ID: wpr-873814

ABSTRACT

ObjectiveTo investigate the potential association between early-stage inflammatory response and late-stage infectious pancreatic necrosis (IPN) in patients with acute pancreatitis (AP). MethodsA retrospective analysis was performed for the clinical data of 219 patients with moderate-severe acute pancreatitis (MSAP) and 53 patients with severe acute pancreatitis (SAP) who were admitted to The Affiliated Hospital of Southwest Medical University from June 2019 to June 2020, and according to the presence or absence of systemic inflammatory response syndrome (SIRS) at the initial stage of the disease, they were divided into SIRS group with 160 patients and non-SRIS group with 112 patients. Baseline data, serological markers, complications, and mortality rate were included for analysis. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between multiple groups, and the Bonferroni method was used for further comparison between two groups. A logistic regression analysis was used to screen out valuable variables; the receiver operating characteristic (ROC) curve was used to compare the diagnostic value of variables, and the Z-test was used for pairwise comparison of area under the ROC curve (AUC). ResultsCompared with the non-SIRS group, the SIRS group had significantly higher white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (all P<0.05) and a significantly higher proportion of patients with acute peripancreatic necrosis (ANC), IPN, pancreatic necrosis (PN), organ dysfunction, multiple organ dysfunction syndrome (MODS), SAP, critically-ill acute pancreatitis (CAP), death, BISAP score >2, CTSI score >2,or RANSON score >2 (all P<0.05). The univariate analysis showed that SIRS duration, obesity, CRP, WBC, blood urea nitrogen, PN, ANC, SAP, MODS, RANSON score, BISAP score, and CTSI score were risk factors for IPN in patients with AP (all P<005), and the multivariate analysis showed that SIRS duration (odds ratio [OR]=1.307, 95% confidence interval [CI]: 1.081-1580, P=0006) and ANC (OR=42.247, 95% CI: 10.829-164.818, P<0.001) were risk factors for IPN; when ANC was excluded, SIRS duration (OR=1.430, 95% CI: 1.207-1.694, P<0.001) and PN (OR=5.296, 95% CI: 1.845-15.203, P=0.002) were risk factors for IPN. The ROC curve showed that SIRS duration (AUC=0.772, Youden index=0.521), RANSON score (AUC=0701, Youden index=0.319), BISAP score (AUC=0.741, Youden index=0.377), and CTSI score (AUC=0.765, Youden Index=0.414) had a certain value in predicting IPN, and there was no significant difference in AUC between any two indices. The long-duration SIRS group(>4 d) had a significantly higher proportion of patients with PN, ANC, IPN, SAP, or CAP than the non-SIRS group(0 d), the transient SIRS group(1~2 d), and the persistent SIRS group(3~4 d) (all P<0.05), and the persistent SIRS group had a significantly higher proportion of patients with SAP than the non-SIRS group (P<0.05). ConclusionAP patients with SIRS in the early stage are likely to develop organ failure and local complications, and there is a significant increase in the risk of IPN when SIRS duration is >4.5 days.

9.
Article in Chinese | WPRIM | ID: wpr-911680

ABSTRACT

Objective:To explore the clinical efficacy of venovenous extracorporeal membrane oxygenation(V-V ECMO)in patients with severe acute respiratory distress syndrome(ARDS)caused by Pneumocystis pneumonitis(PJP)after kidney transplantation(KT).Methods:Cal data of 9 KT recipients on V-V ECMO were retrospectively analyzed. Timing of V-V ECMO support, complications during treatment and V-V ECMO performance were summarized.Results:All 9 patients with confirmed PJP adopted V-V ECMO with oxygenation index of 25~92 prior to V-V ECMO and average time from admission to initiating V-V ECMO was 5.56(1~17)days. Except for one death from hemorrhagic shock due to abdominal hemorrhage, the remainders were successfully weaned. Another recipient died from sepsis after weaning and there were 7 survivors. V-V ECMO support time was 215.5 h among 8 successfully weaned recipients. Among 7 survivors, 1 had premorbid deterioration of graft function and no fatal complications occurred.Conclusions:V-V ECMO is an effective treatment for severe ARDS caused by P. pneumoniae post-KT. And its early application is recommended for reducing complications and improving patient prognosis.

10.
Article in Chinese | WPRIM | ID: wpr-908799

ABSTRACT

Objective:To analyze the registration status of acute pancreatitis-related clinical studies registered on the Chinese Clinical Trial Registry (ChiCTR) and USA ClinicalTrials.gov database.Methods:The ChiCTR and ClinicalTrials.gov database were searched to collect, sort and analyze the clinical studies related to acute pancreatitis registered from the establishment of the database to December 31, 2020. The clinical trials were manually grouped, and the features of clinical researches were compared based on different registered data (2007-2014 vs 2015-2020) and different financial sources (self-support, enterprise support or public support). Results:A total of 157 registered clinical studies related to acute pancreatitis have been included (ChiCTR n=99; ClinicalTrial.gov n=58). The top three areas with the greatest number of registered clinical studies were Sichuan (28.0%), Shanghai (14.6%) and Jiangsu (12.1%), totally accounting for 54.7%. There were 91 interventional studies, 41 observational studies and 25 other type studies. Masking was performed in 34 studies (21.6%). Randomized parallel controlling was performed in 84 studies (53.5%). 30 trials (19.1%) were at Ⅳ phase, and 7 trials (4.4%) were at Ⅱ or Ⅲ phase. 2007-2014 group tended to use randomized parallel controlled design (68.3% vs 45.4%, P=0.005) and randomization grouping (76.7% vs 47.4%, P=0.001). 2015-2020 group tended to use relatively large sample (72.6% vs 47.4%, P=0.002)and data management committee (53.6% vs 25.0%, P=0.001). The differences between the two groups were statistically significant. Of 92 trials from ChiCTR database, 48 were self-supported, 5 was supported by enterprise, and 38 was supported by the public. The percentage of self-support and public support was 86.9%. Conclusions:The number of acute pancreatitis-related clinical studies registered on ChiCTR was generally on the increase. Most registered studies were funded by public finances or by the researchers' institutions self. There was a lack of phaseⅡ or phase Ⅲ.

11.
Article in Chinese | WPRIM | ID: wpr-906350

ABSTRACT

Infertility is commonly seen but difficult to treat in the department of obstetrics and gynecology. The incidence of infertility in women of childbearing age has reached as high as 25% in China, which seriously affects social harmony and people's happiness. As the lifestyle of modern women changes, thin endometrium has gradually become an important reason for infertility and embryo transfer failure. Such factors as repeated operations in uterine cavity and oral intake of hormones have resulted in destructed blood vessels and reduced blood flow in endometrium, impaired growth of glandular epithelial cells, insufficient local blood supply, retarded development of endometrium, reduced receptivity, and therefore poor acceptance of endometrium to the implanted gestational sac, which is not conducive to the implantation of fertilized eggs. As a result, the infertility will occur. Traditional Chinese medicine (TCM) has a long history of treating infertility. During the long-term clinical practice, physicians of ancient and modern times have gained rich experience in the diagnosis and treatment of infertility. The idea of "blood being the basis of women" sprouted in the Spring and Autumn and Warring States Periods and determined in the Song Dynasty as an important guiding principle that can be applied in various physiological periods of women. It emphasizes "blood regulation" for gynecological diseases to ensure sufficient blood in blood vessels and its normal circulation, thus allowing the thoroughfare and conception vessels and endometrium to be nourished and the pregnancy to be facilitated. With blood as the basis, the paper explored the physiopathological correlations of five zang organs and thoroughfare and conception vessels with blood, pointed out the preference for "blood harmonization" in ancient literature based on the differentiation of infertility into blood stasis, blood cold, blood heat, and blood deficiency syndromes, reviewed the key methods of modern physicians in assisting pregnancy including tonifying kidney and nourishing blood, tonifying kidney and activating blood, tonifying kidney and invigorating spleen, as well as invigorating kidney and soothing liver, and summarized the efficacy of integrated TCM and western medicine in promoting ovulation, regulating hormones, improving blood supply, and nourishing endometrium to assist pregnancy. All these would contribute to the clinical treatment and scientific research of thin endometrium in infertility from multiple angles.

12.
Article in Chinese | WPRIM | ID: wpr-906317

ABSTRACT

Perimenopausal anovulatory dysfunctional uterine bleeding (ADUB) is a severe acute disease that is difficult to be dealt with in gynecology, accounting for about 70% of abnormal uterine bleeding. The significant differences in bleeding patterns make it particularly challenging to treat. The main manifestations of perimenopausal ADUB are prolonged menstrual period, inexhaustible menstrual bleeding, or heavy inter-menstrual vaginal bleeding, which allow it to be classified into the category of metrorrhagia and metrostaxis in traditional Chinese medicine (TCM). After conducting in-depth research on this disease, physicians of the past dynasties have figured out its etiology and pathogenesis and accumulated rich experience in its differentiation and treatment, thus forming a relatively systematic theoretical system. The existing literature mainly focuses on four types of its pathogenesis, namely blood heat, blood stasis, spleen deficiency, and kidney deficiency, and there are few discussions on liver. However, patients with metrorrhagia and metrostaxis due to liver dysfunction are commonly seen in clinical practice. The theory of liver being innate basis of women explores the special physiological and pathological characteristics of women and emphasizes the important role of liver in the treatment of this disease based on its characteristic functions and meridian circulation. Considering the close relationship of liver Qi and blood with spleen, kidney, and thoroughfare and conception vessels, this paper discussed the TCM treatment of perimenopausal ADUB from the following four aspects: soothing liver Qi and nourishing liver blood, liver and kidney sharing the same source, simultaneous regulation of liver and spleen, and liver meridian circulation, so as to broaden the clinical treatment options. Perimenopause is a unique physiological period when women tend to suffer from Qi stagnation and blood deficiency. Liver, characterized by Yin in property and Yang in function, governs the free flow of Qi, induces ovulation, stores blood, and regulates blood volume. Therefore, the liver should be emphasized in the treatment of perimenopausal ADUB, which contributes to correcting the hormone disorder caused by abnormal ovulation, stopping bleeding, and alleviating perimenopausal symptoms. This paper has provided a new direction for the clinical treatment of perimenopausal ADUB .

13.
Article in Chinese | WPRIM | ID: wpr-883523

ABSTRACT

Objective:To explore the clinical features of acute pancreatitis in pregnancy (APIP) and the risk factors for fetal death.Methods:The clinical data of 90 patients with APIP in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed from January 2013 to June 2020. Based on the severity, the patients were classified into MAP groups ( n=41), MSAP groups ( n=33), SAP group ( n=16). According to the presence of fetal deaths, the patients were divided into fetal death group ( n=13) and fetal survival group ( n=77). The clinical characteristics and indicators of patients in each group were compared. Binary logistic regression analysis was performed on the variables with differences between groups to explore independent risk factors for fetal death. The receiver operating characteristic curves of laboratory indicators were drawn to evaluate their diagnostic efficacy. Results:Hyperlipidemia was the main cause in 90 APIP cases (42/90, 46.7%). The levels of LDH, CRP, blood glucose, D2 polymer, albumin and ApoA1, the 1-min and 5-min Apgar scores of neonates were statistically significant among MAP group, MSAP group and SAP group (all P<0.05). There were no maternal deaths in 90 cases and 13 fetal deaths (14.4%). Fetal mortality increased with the severity of APIP. APIP combined with hypertension ( OR=14.742, 95% CI 1.157-187.890, P=0.038), ketoacidosis ( OR=19.587, 95% CI 1.789-214.469, P=0.015) and CRP level ( OR=1.013, 95% CI 1.001-1.025, P=0.031) were risk factors for fetal death. ApoA1 level ( OR=0.118, 95% CI 0.021-0.664, P=0.015) was a protective factor for fetal death. The sensitivity and specificity of ApoA1 for predicting fetal death were 84.6% and 79.2%, the sensitivity and specificity of CRP for predicting fetal death were 76.9% and 84.4%, and the sensitivity and specificity of the combination of the two indicators for predicting fetal death were 100% and 67.5%. Conclusions:The severity of APIP was closely related to fetal death. Hypertension, ketoacidosis and blood level CRP were independent risk factors for fetal death, which should be paid special attention.

14.
Acta Pharmaceutica Sinica ; (12): 1544-1550, 2021.
Article in Chinese | WPRIM | ID: wpr-881551

ABSTRACT

Idiosyncratic drug-induced liver injury (IDILI) is an unpredictable serious adverse drug reaction, which only occurs in a minority of special susceptible individuals. Although the mechanism of IDILI has not been fully understood, several hypotheses have been proposed to explain the action mode and specific mechanism of IDILI. Of these hypotheses, inflammatory stress hypothesis is one of the most important theories. Under the condition of inflammatory stress, drugs interact with inflammation and mediate the occurrence of IDILI through a variety of mechanisms, which can induce the production of inflammatory cytokines, activate coagulation system, affect the activity of metabolites, induce cholestasis, affect mitochondrial damage, and others. This review will summarize the main mechanisms and influencing factors of IDILI mediated by inflammatory stress, in order to provide a reference for preclinical drug development and basic research on drug-induced liver injury.

15.
Article in Chinese | WPRIM | ID: wpr-921534

ABSTRACT

Objective To observe the role of ultrasound biomicroscopy(UBM)in two-year post-operative follow-up for primary open-angle glaucoma patients with modified CO


Subject(s)
Carbon Dioxide , Follow-Up Studies , Glaucoma, Open-Angle/surgery , Humans , Microscopy, Acoustic , Sclera/diagnostic imaging , Treatment Outcome
16.
China Occupational Medicine ; (6): 552-556, 2021.
Article in Chinese | WPRIM | ID: wpr-923087

ABSTRACT

Acute 1,2-dichloroethane poisoning causes serious illness, deaths and is a social event of great influence. The compilation of Technical Plan for Emergency Treatment of Acute 1,2-Dichloroethane Poisoning provides scientific guidance for effective treatment of 1,2-dichloroethane poisoning events. The plan describes in detail the specific practice and technical requirements of six links in the process of handling emergency of acute 1,2-dichloroethane poisoning, including accident investigation and treatment, risk assessment, collection and testing of samples, medical treatment, health monitoring and emergency response, et al. The key contents of individual protection requirements, investigation content, etiology determination, medical assistance and health education in the disposal of poisoning incidents were clarified, and the procedures and requirements of health education were added. The technical scheme is scientific, objective and operable, which can provide scientific guidance for the effective treatment of 1,2-dichloroethane poisoning accidents.

17.
Journal of Clinical Hepatology ; (12): 142-146, 2021.
Article in Chinese | WPRIM | ID: wpr-862559

ABSTRACT

ObjectiveTo investigate the clinical features of elderly patients with acute pancreatitis (AP) aged ≥80 years. MethodsA retrospective analysis was performed for 3642 patients with pancreatitis who were admitted to Department of Gastroenterology in The Affiliated Hospital of Southwest Medical University from January 2013 to December 2019, and according to age, they were divided into young group (aged <65 years) with 2955 patients, middle-aged group (aged 65-79 years) with 558 patients, and elderly group (aged ≥80 years) with 129 patients. Related clinical data were collected and analyzed, including sex, age, etiology, predisposing factors, past medical history, disease severity, complication, and clinical outcome. The independent samples one-way ANOVA-test was used for comparison of normally distributed continuous data between groups and the least significant difference t-test was used for comparison within each group; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups; the Kruskal-Wallis H test was used for comparison of ordinal categorical variables. ResultsIn the young group, there were 1721 male patients and 1234 female patients; in the middle-aged group, there were 214 male patients and 334 female patients; in the elderly group, there were 48 male patients and 81 female patients; the middle-aged group and the elderly group had a significantly higher proportion of female patients than the young group (62.8% vs 61.6% vs 41.8%, P<0.05). High-fat diet was the main predisposing factor for all three groups, and compared with the young group, the elderly group had a significantly lower proportion of patients with AP induced by alcohol or high-fat diet+alcohol (P<0.05). The elderly group had a significantly higher proportion of patients with the etiology of biliary diseases than the middle-aged group and the young group (798% vs 69.2% vs 41.4%, χ2=204.127, P<0.05), as well as a significantly lower proportion of patients with the etiology of hyperlipidemia, alcohol, or biliary diseases+hyperlipidemia (all P<0.05). Among the 129 patients in the elderly group, 83 (64.3%) had mild AP, 23 (17.8%) had moderate-severe AP, and 23 (17.8%) had severe AP; there was a significant difference in the constituent ratio of disease severity between the elderly group and the middle-aged/young groups (H=1972.5, P<005). The elderly group and the middle-aged group had a significantly lower proportion of patients with recurrence than the young group (both P<0.05). There were no significant differences in local complications between the three groups (all P>0.05), and as for systemic complications, compared with the young group, the elderly group had a significantly higher proportion of patients with pneumonia (3.9% vs 2.2%, P<0.05), acute kidney injury (AKI) (6.2% vs 2.5%, P<0.05), or multiple organ dysfunction syndrome (MODS) (7.8% vs 4.0%, P<0.05). Compared with the middle-aged group and the young group, the elderly group had a significantly lower proportion of cured patients (67.4% vs 76.3% vs 820%, P<0.05) and a significantly higher proportion of patients with improvement (23.3% vs 147%/12.7%, P<0.05). The elderly group and the middle-aged group had a significantly higher proportion of patients withdrawn from treatment than the young group (8.5%/5.9% vs 3.4%, P<0.05). There was 1 death in the elderly group (0.8%), 9 deaths in the middle-aged group (1.6%), and 16 deaths in the young group (0.5%), and there was no significant difference between the three groups (P>0.05). There were no significant differences in length of hospital stay and hospital costs between the three groups (P>0.05). ConclusionAP patients aged ≥80 years are mainly female and are often caused by biliary factors, and they are likely to develop the complications such as pneumonia, AKI, and MODS.

18.
Article in Chinese | WPRIM | ID: wpr-872222

ABSTRACT

Objective:To explore the influencing factors of 31-day unplanned readmission in obstetrics.Methods:The medical records and relevant clinical data of 29 public hospitals in a province in 2017 were collected to construct a two-level logistic regression model on the influencing factors of 31-day unplanned readmission.Results:In 2017, there were 71 330 obstetric patients discharged from 29 public hospitals, 690 of whom were unplanned readmitted in 31 days, accounting for 0.97%. The type of medical insurance payment, number of previous hospitalization, condition of previous hospitalization, age, history of cesarean section, pregnancy complications and complications during delivery were all the factors influencing the 31-day unplanned readmission of obstetrics.Conclusions:The condition of 31-day unplanned readmission could be influenced by the factors of sociology, previous visit and clinical. These factors should be considered reasonably in the evaluation and management of obstetric quality.

19.
Chinese Journal of Digestion ; (12): 546-554, 2020.
Article in Chinese | WPRIM | ID: wpr-871486

ABSTRACT

Objective:To investigate the effect and mechanism of Acyl-CoA: lysocardiolipin acyltransferase 1 (ALCAT1) on hepatocyte steatosis and oxidative stress in fatty liver cell model.Methods:A fatty liver cell model was established and induced by free fatty acids (FFA). The expression of ALCAT1 in fatty liver cell model was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. The empty siRNA plasmid and ALCAT1 siRNA plasmid were constructed. For the fatty liver cell model group, human normal hepatocytes (L-02 cells) were transfected with empty siRNA plasmid for 24 hours, and then cultured with FFA for 24 hours. For the ALCAT1 interfering group, L-02 cells were transfected with ALCAT1 siRNA plasmid for 24 hours, and then cultured with FFA for 24 hours. And L-02 cells cultured in common medium were used as as blank control group. Lipid droplet deposition and mitochondrial morphology were observed under transmission electron microscopy. The expression levels of autophagy-associated proteins (microtubule-associated protein 1 light chain 3 (LC3)-Ⅱ and Beclin1) and key proteins of autophagy signal pathway (mammalian target of rapamycin (mTOR) and serine/threonine kinase (AKT)) were measured by Western blotting. The expression levels of oxidative stress products (malondialdehyde, 4-hydroxynonenal (4-HNE) and reactive oxygen species (ROS)) and inflammatory factors (interleukin-6(IL-6) and tumor necrosis factor (TNF)-α) were detected by enzyme-linked immunosorbent assay (ELISA) kits. Independent sample t test was used for statistical analysis. Results:The mRNA and protein expression levels of ALCAT1 of the fatty liver cell model group were both higher than that of negative control group (9.26±0.83 vs. 1.02±0.12, 0.35±0.02 vs. 0.17±0.01), and the differences were statistically significant ( t=9.82 and 6.83, both P<0.05). The results of electron microscopy indicated that the deposition of lipid droplets of the fatty liver cell model group and ALCAT1 interfering group were both higher than that of blank control group (17.67±3.52 and 7.67±0.33 vs. 4.33±0.33), the quantity of lipid droplets deposition of ALCAT1 interfering group was lower than that of fatty liver cell model group (7.67±0.33 vs. 17.67±3.52), and the differences were statistically significant ( t=3.76, 7.07 and 2.82, all P<0.05). The degree of mitochondria swelling of fatty liver cell model group was higher than that of blank control group and the degree of mitochondria swelling of ALCAT1 interfering group was lower than that of fatty liver cell model group. The results of Western blotting showed that the expression level of LC3-Ⅱof the fatty liver cell model group was higher than that of the blank control group (0.43±0.01 vs. 0.28±0.02), and the difference was statistically significant ( t=7.32, P<0.05). However there was no significant difference in the expression level of Beclin1 between fatty live cell model group and blank control group (0.93±0.05 vs. 0.98±0.05, P>0.05). The expression levels of LC3-Ⅱ and Beclin1 of the ALCAT1 interfering group were both higher than those of the fatty liver cell model group and blank control group (0.95±0.04 vs. 0.42±0.01 and 0.28±0.02, 2.07±0.06 vs. 0.93±0.05 and 0.98±0.05), and the differences were statistically significant ( t=13.30, 15.63, 14.05 and 13.02, all P<0.05). The expression levels of mTOR of the fatty liver cell model group and ALCAT1 interfering group were both lower than that of the blank control group (1.44±0.02 and 0.74±0.01 vs. 1.93±0.10), the expression level of mTOR of the ALCAT1 interfering group was lower than that of the fatty liver cell model group (0.74±0.01 vs. 1.44±0.02), and the differences were statistically significant ( t=4.83, 12.04 and 32.14, all P<0.05). The expression levels of phosphorylated AKT of the fatty liver cell model group and ALCAT1 interfering group were both lower than that of the blank control group (0.14±0.01 and 0.07±0.01 vs. 0.28±0.01), while the expression level of phosphorylated AKT of the ALCAT1 interfering group was lower than that of the fatty liver cell model group (0.07±0.01 vs. 0.14±0.01), and the differences were statistically significant ( t=8.59, 14.10 and 5.96, all P<0.05). The results of ELISA indicated that the expression levels of ROS, malondialdehyde, 4-HNE, IL-6 and TNF-α of the fatty liver cell model group and the ALCAT1 interfering group were all higher than those of the blank control group ((11.44±0.30) and (5.84±0.36) g/L vs. (1.72±0.38) g/L; (19.94±2.47) and (11.95±1.55) μmol/L vs. (1.47±0.18) μmol/L; (5.00±0.43) and (2.99±0.37) ng/L vs. (1.46±0.23) ng/L; (203.40±5.16) and (92.07±11.98) ng/L vs. (23.32±3.33) ng/L; (123.70±8.38) and (67.42±4.88) ng/L vs. (47.18±4.57) ng/L), and the differences were all statistically significant ( t=19.86, 7.86, 7.45, 6.74, 7.22, 3.49, 29.34, 5.53, 8.02 and 3.03, all P<0.05). While the expression levels of ROS, 4-HNE, IL-6 and TNF-α of the ALCAT1 interfering group were all lower than those of the fatty liver cell model group ((5.84±0.36) g/L vs. (11.44±0.30) g/L, (2.99±0.37) ng/L vs. (5.00±0.43) ng/L, (92.07±11.98) ng/L vs. (203.40±5.16) ng/L and (67.42±4.88) ng/L vs. (123.70±8.38) ng/L), and all the differences were statistically significant ( t=11.99, 3.51, 8.54 and 5.81, all P<0.05). There was no statistically significant difference in the expression of malondialdehyde between ALCAT1 interfering group and fatty liver cell model group ((11.95±1.55) μmol/L vs. (19.94±2.47) μmol/L, P>0.05). Conclusions:The expression of ALCAT1 is up-regulated in fatty liver cell model. Knockdown of ALCAT1 can inhibit the expression of mTOR pathway proteins, activate autophagy, alleviate hepatocyte steatosis, oxidative stress and inflammatory response.

20.
Article in Chinese | WPRIM | ID: wpr-793024

ABSTRACT

Malignant pleural effusion (MPE) is one of the common complications of tumor. Acupuncture-moxibustion therapy has several advantages for treatment of MPE. Acupuncture is regarded as a complex individualized intervention, and its characteristics of TCM is difficult to be reflected by strict randomized controlled trials. The registry study provides more possibilities for the data collection of individualized diagnosis and treatment under the guidance of the overall concept and syndrome differentiation, and is more suitable for data management and collection of large samples and multi-center trials in the real-world study. It has become an opportunity to carry out real-world study of acupuncture for MPE. There are many challenges in the registry study of acupuncture for MPE. However, it is of great significance to collect real-world data of acupuncture for MPE to improve the clinical effect of MPE and provide a new clinical research method for acupuncture in tumors and related complications.

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