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1.
China Pharmacy ; (12): 1075-1081, 2022.
Article in Chinese | WPRIM | ID: wpr-923755

ABSTRACT

OBJECTIVE To prepare Gambogic acid (GA) nanocapsules (GA-LNCs) and Neogambogic acid (NGA) nanocapsules(NGA-LNCs),and to evaluate their antidiabetic activities. METHODS Using water as the aqueous phase ,medium- chain triglyceride as the oil phase and polyethylene glycol monostearate as the surfactant ,GA-LNCs and NGA-LNCs were prepared by phase inversion method. Using entrapment efficiency and drug-loading amount as index ,the formulation technologies of above 2 nanocapsules were optimized by simplex lattice design. Its physical and chemical properties were investigated. The diabetic mice model was established. GA-LNCs and NGA-LNCs (1.92 and 2.42 mg/kg respectively )were given intragastrically ,once a day ,for consecutive 6 weeks. The fasting blood glucose of mice ,the activities of superoxide dismutase (SOD)and glutathione peroxidase (GSH-Px),the contents of malondialdehyde (MDA),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol (LDL-C)were all detected. RESULTS The optimal formulation of 2 kinds of nanocapsules included 60% water,10% medium-chain triglyceride ,30% polyethylene glycol monostearate (total amount of the three was 2 g)and 35 mg GA or NGA . The encapsulation efficiencies of GA-LNCs and NGA-LNC obtained by the optimal formulation were (92.01±0.68)% and(93.12±2.11)%;the drug-loading amount were (0.99±0.21)% and(1.21±0.22)%, respectively. GA-LNCs and NGA-LNCs were yellow ,homogeneous and transparent liquid without precipitation. They were spherical in microscopic shape , and had obvious shell- Δ 基金项目:吉林省科技发展计划项目(No.20200404090YY);吉 membrane structure. The particle sizes were (28.11 ± 9.76) 林省教育厅科学技术研究项目(No.JJKH20210372KJ) *硕士研究生 。研究方向 :植物药 。E-mail:zhanhe0108@163. and(22.06±6.84)nm;Zeta potential were (-4.09±1.00) com and(-17.40±1.32)mV,and polydispersity were 0.93±0.06 # 通信作者:讲师,博士。研究方向:中药有效成分治疗疾病的作 and 0.74±0.12. The results of animal experiments showed that 用机制。E-mail:chenweijia_jlau@163.com both GA-LNCs and NGA-LNCs could sig nificantly increase 中国药房 2022年第33卷第9期 China Pharmacy 2022Vol. 33 No. 9 ·1075· the activities of SOD and GSH-Px and the seru m content of HDL-C (P<0.05 or P<0.01)in model mice ,and significantly decreased the fasting blood glucose and the serum contents of MDA , TC, TG and LDL-C (P<0.05 or P<0.01). CONCLUSIONS GA-LNCs,NGA-LNCs prepared in this study are good in physical and chemical properties and have good anti-diabetes activity.

2.
Article in Chinese | WPRIM | ID: wpr-923489

ABSTRACT

@#As a structural barrier between the brain and the systemic circulation, the blood-brain barrier prevents macromolecules and most small-molecule drugs from entering the brain, which make it difficuct to treat central diseases.Various solute carriers such as glucose transporters and amino acid transporters which can transport various nutrients into the brain, are highly expressed on the blood-brain barrier.The ligand corresponding to the transporter is modified on the nano-drug carrier, and the drug is carried across the blood-brain barrier through transporter-mediated transport, which can achieve high-efficiency delivery of drugs to the brain and improve the diagnostic sensitivity and therapeutic effect of central diseases.In this paper, we review different types of solute carriers to mediate nanoformulations such as liposomes, metal nanoparticles, polymer micelles and dendrimers across the blood-brain barrier for the treatment of brain diseases and discuss the opportunities and challenges of this strategy in future applications.

3.
Acta Pharmaceutica Sinica ; (12): 492-499, 2022.
Article in Chinese | WPRIM | ID: wpr-922915

ABSTRACT

A novel sort of nano-component was extricated and isolated from Descurainiae Semen Carbonisatum (DSC), and its hemostatic component was considered through pharmacological experiments. A muffle furnace was used to prepare DSC at 250 ℃, 300 ℃ and 350 ℃, and the DSC dialysate at each temperature was obtained by the extraction and separation method. Low-resolution transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HR-TEM) were utilized to characterize the nano-components. Ultraviolet spectroscopy (UV-Vis), fluorescence spectroscopy (FL) and infrared spectroscopy (FTIR) were utilized to measure its optical characteristics and functional group information. The anti-hemorrhagic effects were evaluated by liver bleeding tests and the related hemostatic mechanisms of the obtained nano-components were further assessed by detecting blood coagulation and PLT quantity to discuss the hemostasis mechanism. The experiments complied with the Animal Ethics Committee of Beijing University of Chinese Medicine. TEM results showed that there was a novel type of nano-component in the DSC dialysate bag, which was named DSC nano-components (DSC-NCs). The experimental results of liver bleeding in mice showed that DSC-NCs prepared at 250 ℃, 300 ℃, and 350 ℃ could reduce the bleeding time of mice liver. Among them, DSC-NCs prepared at 350 °C had the best effect. In addition, DSC-NCs prepared at various temperatures can also reduce the prothrombin time (PT) value, increase the fibrinogen (FIB) value and the platelet (PLT) value to varying degrees. DSC-NCs have a certain hemostatic effect, which may be related to the activation of the exogenous coagulation system, the increase of FIB value and the increase of platelet content. This provides a new research direction for exploring the treatment of bleeding diseases, and provides a new perspective for the potential application of DSC-NCs in the medical field.

4.
Article in English | WPRIM | ID: wpr-928944

ABSTRACT

OBJECTIVE@#To explore if acupoint injection can improve analgesic effects or delivery outcomes in parturients who received combined spinal-epidural analgesia (CSEA) and patient-controlled epidural analgesia (PCEA) for labor analgesia.@*METHODS@#A total of 307 participants were prospectively collected from July 2017 to December 2019. The participants were randomized into the combined acupoint injection with CSEA plus PCEA group (AICP group, n=168) and CSEA plus PCEA group (CP group, n=139) for labor analgesia using a random number table. Both groups received CSEA plus PCEA at cervical dilation 3 cm during labor process, and parturients of the AICP group were implemented acupoint injection for which bilateral acupoint of Zusanli (ST 36) and Sanyinjiao (SP 6) were selected in addition. The primary outcome was Visual Analogue Scale (VAS) score, and the secondary outcomes were obstetric outcomes and requirement of anesthetics doses. Safety evaluations were performed after intervention.@*RESULTS@#The VAS scores were significantly lower in the AICP group than in the CP group at 10, 30, 60, and 120 min after labor analgesia (all P<0.05). The latent phase of the AICP group was shorter than that of the CP group (P<0.05). There were less additional anesthetics consumption, lower incidences of uterine atony, fever, pruritus and urinary retention in the AICP group than those in the CP group (all P<0.05).@*CONCLUSION@#Acupoint injection combined CSEA plus PCEA for labor analgesia can decrease the anesthetic consumption, improve analgesic quality, and reduce adverse reactions in the parturients. (Registration No. ChiMCTR-2000003120).


Subject(s)
Acupuncture Points , Analgesia, Obstetrical/adverse effects , Analgesia, Patient-Controlled/adverse effects , Anesthetics/pharmacology , Female , Humans , Labor, Obstetric , Pregnancy
5.
International Eye Science ; (12): 34-38, 2022.
Article in Chinese | WPRIM | ID: wpr-906725

ABSTRACT

@#AIM: To explore the changes and significance in JIA-U and to detect the levels of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup> regulatory B cells(Breg)in the peripheral blood of children with juvenile idiopathic arthritis-associated uveitis(JIA-U).<p>METHODS: From April 2018 to May 2020, 95 children with JIA-U were selected as JIA-U group; 70 children with juvenile idiopathic arthritis(JIA)were selected as JIA group, and all of them were diagnosed and treated in our hospital; another 75 healthy children in the same period were selected as the control group. The ratio of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg in peripheral blood was detected by flow cytometry; the level of IL-10 in peripheral blood was detected by ELISA; the correlation between CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg ratio and the expression of IL-10, the severity of JIA-U patients was analyzed by Pearson correlation coefficient method; the influencing factors of JIA-U were analyzed by Logistic regression. <p>RESULTS: Compared with the control group, the proportion of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg in peripheral blood of children in JIA group and JIA-U group was significantly lower(all <i>P</i><0.01), while the level of IL-10 was significantly higher(all <i>P</i><0.01); compared with JIA group, the proportion of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+Breg</sup> in JIA-U group was significantly lower(<i>P</i><0.01), while the level of IL-10 was significantly higher(<i>P</i><0.01); compared with the stationary phase, the ratio of CD1d<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg in the active phase of JIA and JIA-U patients was significantly reduced(all <i>P</i><0.01), and the IL-10 level was significantly increased(all <i>P</i><0.01); the ratio of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg was negatively correlated with the expression of IL-10 and the severity of JIA-U; multivariate analysis showed that low proportion of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg, less-joint JIA subtype, duration of arthritis < 4a, high levels of IL-10 were risk factors for JIA-U. <p>CONCLUSION: The proportion of CDld<sup>(hi)</sup>CD5<sup>+</sup>CD19<sup>+</sup>Breg in peripheral blood of children with JIA-U is significantly decreased, which may be involved in the occurrence and development of JIA-U, and has the potential to be used as an index to judge the severity of JIA-U.

6.
Chinese Journal of Cardiology ; (12): 577-584, 2022.
Article in Chinese | WPRIM | ID: wpr-940891

ABSTRACT

Objective: To investigate the gene expression characteristics of peripheral blood mononuclear cells from patients with high altitude pulmonary hypertension (HAPH) in Naxi residents living in Lijiang, Yunnan, and to explore the underlying pathogenesis and value for potential drug selection. Methods: This is a case-control study. Six patients with HPAH (HPAH group) and 4 normal subjects (control group) were selected from the Naxi residents who originally lived in Lijiang, Yunnan Province. The general clinical data of the two groups were collected, and the related indexes of pulmonary artery pressure were collected. Peripheral blood mononuclear cells of the subjects were collected for RNA sequencing. The differences on gene expression, regulatory network of transcription factors and drug similarity between the two groups were compared. The results were compared with the public data of idiopathic pulmonary arterial hypertension (IPAH). Biological processes and signal pathways were analyzed and compared between HPAH and IPAH patients. Results: The age of 6 patients with HAPH was (68.1±8.3) years old, and there were 2 males (2/6). The age of 4 subjects in the control group was (62.3±10.9) years old, and there were 2 males (2/4). Tricuspid regurgitation velocity, tricuspid pressure gradient and pulmonary systolic pressure in HAPH group were significantly higher than those in control group (all P<0.05). The results of RNA sequencing showed that compared with the control group, 174 genes were significantly upregulated and 169 genes were downregulated in peripheral blood mononuclear cells of HAPH group. These differentially expressed genes were associated with 220 biological processes, 52 molecular functions and 23 cell components. A total of 21 biological processes and 2 signal pathways differed between HPAH and IPAH groups, most of which were related to inflammation and immune response. ZNF384, SP1 and STAT3 were selected as highly correlated transcription factors by transcription factor prediction analysis. Trichostatin A and vorinostat were screened out as potential drugs for the treatment of HAPH by drug similarity analysis. Conclusions: There are significant differences in gene expression in peripheral blood monocytes between HAPH patients and normal population, and inflammation and immune dysfunction are the main pathogenic factors. Trichostatin A and Vorinostat are potential drugs for the treatment of HAPH.


Subject(s)
Aged , Altitude , Altitude Sickness/genetics , Case-Control Studies , China , Familial Primary Pulmonary Hypertension/genetics , Humans , Hydroxamic Acids/therapeutic use , Hypertension, Pulmonary/genetics , Inflammation , Leukocytes, Mononuclear/pathology , Male , Middle Aged , Transcription Factors , Transcriptome/genetics , Vorinostat/therapeutic use
7.
Chinese Journal of Cardiology ; (12): 563-569, 2022.
Article in Chinese | WPRIM | ID: wpr-940889

ABSTRACT

Objective: To summarize the single center experience of transcatheter aortic valve replacement (TAVR) with a simplified operative protocol. Methods: Consecutive patients who underwent transfemoral TAVR (TF-TAVR) from July 2020 to December 2020 in Fuwai Hospital were retrospectively analyzed. We compared the baseline characteristic, procedure information, 30-day follow-up outcomes of the patients who underwent TF-TAVR without the simplified operative protocol (routine group) or with the simplified operative protocol (simplified protocol group). Results: 93 patients were collected, 42 patients belonging to routine group, 51 patients belonging to simplified protocol group. In simplified protocol group, there were 51 patients planned to use ultrasound-guided femoral access puncture, procedure was successful in all 51 patients (100%). There were 49 patients planned to use the radial artery as the secondary access, procedure was successful in 45 patients (92%). There were 48 patients planned to use the strategy of avoidance of urinary catheter, this strategy was achieved in 35 patients (73%). There were 12 patients planned to use the left ventricular guidewire to pace, procedure was successful in 11 patients (92%). There were no differences in baseline characteristics, major clinical endpoints and 30-day follow-up outcomes between the two groups. Meanwhile, the procedure time ((62.5±17.9)min vs. (78.3±16.7)min, P<0.001), operation room time ((133.7±25.1)min vs. (159.2±42.6)min, P<0.001), X-ray exposure time ((17.2±6.5)min vs. (20.2±7.7)min, P=0.027) were significantly shorten in simplified protocol group compared with the routine group. Conclusion: Our study results indicate that the simplified operative protocol of TF-TAVR is as effective and safe as the routine operative protocol, meanwhile using the simplified operative protocol can significantly increase the operative efficiency of TF-TAVR.


Subject(s)
Aortic Valve , Aortic Valve Stenosis/surgery , Femoral Artery/surgery , Humans , Retrospective Studies , Risk Factors , Time Factors , Transcatheter Aortic Valve Replacement/methods , Treatment Outcome
8.
Chinese Journal of School Health ; (12): 1224-1228, 2022.
Article in Chinese | WPRIM | ID: wpr-940260

ABSTRACT

Objective@#To explore the changes in liver function of Tibetan youth living in plateau with different body mass index (BMI) during the early stage of migration to the plain, and to provide scientific basis for high attitude de adaptation.@*Methods@#A total of 3 035 Tibetan youth who firstly migrated to the plain (Shaanxi) from the plateau (Tibet) were selected as the research subjects, and were screened for symptoms of plateau de adaptation. Participants were divided into four groups: underweight, normal weight, overweight and obese, and received liver function test on the 3rd, 6th, 9th dayafter migration, respectively. Chi square test was used to detect the abnormal rate of liver function indicators among each group, and binary Logistic regression analysis was used to explore the relationship between BMI and abnormal liver function indicators.@*Results@#The alanine aminotransferase(ALT), Aspartate aminotransferase(AST), γ glutamyl transpeptidase (GGT) of overweight Tibetan male and obese Tibetan male and female adolescents, the total bile acid (TBA) of overweight Tibetan male and obese Tibetan female were higher than those of the normal weight group at the early stage of de adaptation( P <0.05). With the de adaptation for 3, 6, 9 days, the indexes showed an overall upward trend, including: direct bilirubin (DBIL) in overweight male and female adolescents, total protein (TP) and globulose (GLOB) in obese female adolescents( P <0.05). The abnormal rate of overweight group (male ALT: 13.9%), obesity group (male and female ALT, GGT: 34.3%, 26.7%, 11.4%, 13.3%; female AST:10.0%) was significantly higher than that in underweight (2.8%, 3.5%, 0, 1.0%, 1.5%) and normal group(3.5%, 3.4%, 0.9%, 3.6%, 4.1%)( χ 2=48.07, 20.55, 20.55, 17.93, 10.23 , P <0.05). Binary Logistic regression analysis showed that after adjusting for age and gender, overweight was positively correlated with abnormal ALT( OR=2.10, 95%CI =1.20-3.62). Obesity was positively correlated with abnormal ALT( OR=5.50, 95%CI =4.23-7.40) and GGT( OR=4.10, 95%CI =2.03-6.74)( P <0.05).@*Conclusion@#During the early stage of migration to the plain among Tibetan youth living on the plateau, changes in liver function indicators are related to BMI. Overweight and obese Tibetans have a higher abnormal rate of liver damage indicators. It is suggested that individuals with high risk of obesity should undergo health examination and medical supervision when migrates from plateau to plain.

9.
Article in Chinese | WPRIM | ID: wpr-940202

ABSTRACT

ObjectiveTo investigate the protective effect of Zuoguiwan against 60Co-γ ray-induced premature aging of rats based on the phosphatidylinositol-3-kinases/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway. MethodSixty sexually mature female SD rats were irradiated with 60Co-γ rays (6.0 Gy, LD40) for 24 h at one time. Then they were randomized into model group, Bujiale group (0.18 g·kg-1·d-1), Bujiale (0.09 g·kg-1·d-1) + high-dose Zuoguiwan group (23.625 g·kg-1·d-1), high-dose Zuoguiwan group (23.625 g·kg-1·d-1), medium-dose Zuoguiwan group (9.45 g·kg-1·d-1), and low-dose Zuoguiwan group (4.725 g·kg-1·d-1). The administration (once a day) lasted 21 days. Serum indexes [follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)] of rats were detected by enzyme-linked immunosorbent assay (ELISA), and morphological changes of ovarian tissues were observed based on hematoxylin and eosin (HE) staining. The apoptosis rate of granulosa cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and the protein expression of phosphorylated (p)-PI3K, p-Akt, p-mTOR, B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) in ovarian tissues by Western blot. ResultCompared with normal group, model group demonstrated increase in serum FSH (P<0.01), decrease in E2 (P<0.05), and reduction of follicles and luteum in early ovary (P<0.01). Moreover, the elevation of apoptosis rate of granulosa cells (P<0.01), down-regulation of p-PI3K, p-Akt, p-mTOR, and Bcl-2 in ovarian tissue, and increase in expression of Bax were also observed in the model group as compared with the normal group (P<0.01). In comparison with the model group, the administration groups showed rise of the number of early ovarian follicles, decrease in the apoptosis rate of granulosa cells, increase in the expression of p-PI3K, p-Akt, p-mTOR, and Bcl-2, and down-regulation of Bax, particularly the Bujiale + high-dose Zuoguiwan group(P<0.05,P<0.01). ConclusionZuoguiwan protects radiation-damaged ovary by activating the expression of PI3K/Akt/mTOR protein in ovarian tissue, increasing Bcl-2, and inhibiting the expression of Bax.

10.
Article in Chinese | WPRIM | ID: wpr-940105

ABSTRACT

ObjectiveTo investigate the protective effect of Zuoguiwan against 60Co-γ ray-induced premature aging of rats based on the phosphatidylinositol-3-kinases/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway. MethodSixty sexually mature female SD rats were irradiated with 60Co-γ rays (6.0 Gy, LD40) for 24 h at one time. Then they were randomized into model group, Bujiale group (0.18 g·kg-1·d-1), Bujiale (0.09 g·kg-1·d-1) + high-dose Zuoguiwan group (23.625 g·kg-1·d-1), high-dose Zuoguiwan group (23.625 g·kg-1·d-1), medium-dose Zuoguiwan group (9.45 g·kg-1·d-1), and low-dose Zuoguiwan group (4.725 g·kg-1·d-1). The administration (once a day) lasted 21 days. Serum indexes [follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)] of rats were detected by enzyme-linked immunosorbent assay (ELISA), and morphological changes of ovarian tissues were observed based on hematoxylin and eosin (HE) staining. The apoptosis rate of granulosa cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and the protein expression of phosphorylated (p)-PI3K, p-Akt, p-mTOR, B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) in ovarian tissues by Western blot. ResultCompared with normal group, model group demonstrated increase in serum FSH (P<0.01), decrease in E2 (P<0.05), and reduction of follicles and luteum in early ovary (P<0.01). Moreover, the elevation of apoptosis rate of granulosa cells (P<0.01), down-regulation of p-PI3K, p-Akt, p-mTOR, and Bcl-2 in ovarian tissue, and increase in expression of Bax were also observed in the model group as compared with the normal group (P<0.01). In comparison with the model group, the administration groups showed rise of the number of early ovarian follicles, decrease in the apoptosis rate of granulosa cells, increase in the expression of p-PI3K, p-Akt, p-mTOR, and Bcl-2, and down-regulation of Bax, particularly the Bujiale + high-dose Zuoguiwan group(P<0.05,P<0.01). ConclusionZuoguiwan protects radiation-damaged ovary by activating the expression of PI3K/Akt/mTOR protein in ovarian tissue, increasing Bcl-2, and inhibiting the expression of Bax.

11.
Chinese Journal of Hepatology ; (12): 447-451, 2022.
Article in Chinese | WPRIM | ID: wpr-935965

ABSTRACT

Mitochondrial DNA is the mitochondria's own genetic material located within the mitochondrial matrix and is involved in cellular metabolism and energy supply. Mitochondrial DNA damage exacerbates oxidative stress by increasing the release of reactive oxygen species, while mitochondrial DNA release also triggers apoptosis and activates immune inflammatory responses through damage-related molecular patterns. Mitochondrial autophagy regulates mitochondrial DNA damage and release through a negative feedback mechanism to maintain intracellular homeostasis. Recent studies have shown that the occurrence and development of chronic liver disease are closely related to mitochondrial DNA-mediated immune inflammatory responses and oxidative stress.


Subject(s)
Apoptosis , Autophagy , DNA, Mitochondrial/metabolism , Humans , Liver Diseases , Mitochondria , Oxidative Stress , Reactive Oxygen Species/metabolism
12.
Chinese Journal of Hepatology ; (12): 347-351, 2022.
Article in Chinese | WPRIM | ID: wpr-935952

ABSTRACT

Liver involvement is often observed in hematological disorders, resulting in liver abnormality, including unconjugated hyperbilirubinemia, monoclonal hyperglobulinemia, portal vein, or hepatic vein thrombosis or portal hypertension, hepatosplenomegaly, or iron accumulation in the liver. Here we summarize the major hematological diseases that often affect the liver: hemolytic anemia, defect in coagulation or anti-coagulation factors, myeloproliferative neoplasm, hemophagocytic lymphohistiocytosis, multiple myeloma, leukemia, and lymphoma. We hope this review will help clinicians diagnose and manage the patients with liver involvement by hematological disorders.


Subject(s)
Hematologic Diseases , Humans , Hypertension, Portal , Myeloproliferative Disorders/diagnosis , Portal Vein/pathology
13.
Chinese Journal of Pediatrics ; (12): 203-208, 2022.
Article in Chinese | WPRIM | ID: wpr-935671

ABSTRACT

Objective: To analyze the eligibility of empirical antibiotic therapy in culture positive sepsis in the pediatric intensive care unit (PICU), and to explore the application of antibiotic de-escalation (ADE) in children with sepsis and its impact on prognosis. Methods: A total of 123 children with sepsis-associated organ dysfunction or septic shock admitted to the PICU of Shengjing Hospital of China Medical University from January 2018 to December 2020 were retrospectively analyzed. The general information, laboratory tests, the use of empirical anti-bacterial drugs and the application of ADE were collected. According to the adjustment of anti-bacterial drugs, these children were divided into ADE group and non-ADE group. Comparisons between groups were performed with unpaired Student t test, or Mann-Whitney U test, or chi-square test or Fisher exact test. Results: In these 123 children, 70 were males and 53 were females, the age was 11.4 (2.8, 56.5) months. Body fluid culture was detected positive in 41 children including 3 children (7.3%) who received inadequate empirical antibiotic therapy and 38 children (92.7%) who received adequate empirical antibiotic therapy. Excluding 10 children who received appropriate therapy, 28 received unnecessary broad-spectrum antibiotics. There were no significant differences regarding the PICU all-cause mortality rates, length of PICU stay, hospitalization cost, duration of mechanical ventilation, as well as incidences of re-infection between the ADE group (n=46) and non-ADE group (n=77) (all P>0.05). However, among the 101 children who have used antibiotics against multidrug-resistant organism, the duration of such antibiotics use in ADE group (n=43) was shorter than that in non-ADE group (n=58) (5.0 (4.0, 12.0) vs. 9.5 (7.0, 13.0) d, Z=-3.14, P=0.002). Conclusions: Overuse of unnecessary broad-spectrum empirical antibiotics is very common, but the application of ADE is rather disappointing. ADE can reduce the use of anti-bacterial drugs against multi-drug resistant bacteria without significant adverse effects on prognosis in children with sepsis.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Child , Female , Humans , Infant , Male , Prognosis , Retrospective Studies , Sepsis/drug therapy , Shock, Septic
14.
Article in Chinese | WPRIM | ID: wpr-935320

ABSTRACT

Calcium plays an important role in various physiological activities of the human body, and long-term insufficient or excessive intake of calcium will have a negative impact on the body's health. Existing data show that insufficient dietary calcium intake is closely related to bone health, but the non-bone effects are not clear. Increasing dietary calcium and supplementing calcium (with or without vitamin D) have a certain beneficial effect on the bone mineral density and its peak of adolescents and can delay the bone loss of the elderly, but it can't improve the height and bone mineral density of adults and fracture in the elderly. This article introduces the physiological functions of calcium, dietary sources, human intake, and methods for formulating recommended amounts, and summarizes the relationship between calcium and health effects. It also recommends that when formulating the reference intake of dietary calcium for Chinese residents, more consideration should be given to the data and information of the Chinese population, combined with the characteristics of Chinese residents' genetics, absorption and metabolism.


Subject(s)
Adolescent , Adult , Aged , Bone Density , Calcium , Calcium, Dietary/analysis , China/epidemiology , Humans , Vitamin D
15.
Chinese Journal of Cardiology ; (12): 450-457, 2022.
Article in Chinese | WPRIM | ID: wpr-935169

ABSTRACT

Objective: To explore and compare the effect of standard or prolonged dual antiplatelet therapy (DAPT) on the long-term prognosis of elderly patients with coronary heart disease complicated with diabetes mellitus after drug-eluting stent (DES) implantation. Methods: Consecutive patients with diabetes mellitus, ≥65 years old, underwent DES implantation, and had no adverse events within 1 year after operation underwent percutaneous coronary intervention (PCI) from January to December 2013 in Fuwai Hospital were enrolled in this prospective cohort study. These patients were divided into three groups according to DAPT duration: standard DAPT duration group (11 ≤ DAPT duration≤ 13 months) and prolonged DAPT duration group (13<DAPT duration≤ 24 months; DAPT duration>24 months). All the patients were followed up at 1, 6 months, 1, 2 and 5 years in order to collect the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), and type 2 to 5 bleeding events defined by the Federation of Bleeding Academic Research (BARC). MACCE were consisted of all cause death, myocardial infarction, target vessel revascularization or stroke. The incidence of clinical adverse events were compared among 3 different DAPT duration groups, and Cox regression model were used to analyze the effect of different DAPT duration on 5-year long-term prognosis. Results: A total of 1 562 patients were enrolled, aged (70.8±4.5) years, with 398 female (25.5%). There were 467 cases in standard DAPT duration group, 684 cases in 13<DAPT duration≤ 24 months group and 411 cases in DAPT duration>24 months group. The patients in standard DAPT duration group and the prolonged DAPT duration groups accounted for 29.9% (467/1 562) and 70.1% (1 095/1 562), respectively. The 5-year follow-up results showed that the incidence of all-cause death in 13<DAPT duration≤ 24 months group (4.8%(33/684) vs. 8.6%(40/467),P=0.011) and DAPT duration>24 month group(4.1%(17/411) vs. 8.6%(40/467),P=0.008) were significantly lower than in standard DAPT group. The incidence of myocardial infarction in 13<DAPT duration≤ 24 months group was lower than in standard DAPT duration group (1.9%(13/684) vs. 5.1%(24/467),P=0.002). The incidence of MACCE in 13<DAPT duration≤ 24 months group was the lowest (standard DAPT duration group, 13<DAPT duration≤ 24 months group and DAPT duration>24 month group were 19.3% (90/467), 12.3% (84/684), 20.2% (83/411), respectively, P<0.001). There was no significant difference in the incidence of stroke and bleeding events among the three groups (all P>0.05). Multivariate Cox analysis showed that compared with the standard DAPT group, prolonged DAPT to 13-24 months was negatively correlated with MACCE (HR=0.601, 95%CI 0.446-0.811, P=0.001), all-cause death (HR=0.568, 95%CI 0.357-0.903, P=0.017) and myocardial infarction (HR=0.353, 95%CI 0.179-0.695, P=0.003). DAPT>24 months was negatively correlated with all-cause death (HR=0.687, 95%CI 0.516-0.913, P=0.010) and positively correlated with revascularization (HR=1.404, 95%CI 1.116-1.765, P=0.004). There was no correlation between prolonged DAPT and bleeding events. Conclusions: For elderly patients with coronary heart disease complicated with diabetes mellitus underwent DES implantation, and had no MACCE and bleeding events within 1 year after operation, appropriately prolonging of the DAPT duration is related to the reduction of the risk of cardiovascular adverse events. Patients may benefit the most from the DAPT between 13 to 24 months. In addition, prolonging DAPT duration does not increase the incidence of bleeding events in this patient cohort.


Subject(s)
Aged , Coronary Artery Disease/surgery , Diabetes Mellitus , Drug Therapy, Combination , Drug-Eluting Stents/adverse effects , Female , Hemorrhage , Humans , Male , Myocardial Infarction/epidemiology , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors/therapeutic use , Prognosis , Prospective Studies , Stroke , Treatment Outcome
16.
Chinese Journal of Cardiology ; (12): 270-276, 2022.
Article in Chinese | WPRIM | ID: wpr-935139

ABSTRACT

Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.


Subject(s)
Adolescent , Adult , Extracorporeal Membrane Oxygenation/methods , Female , Hospital Mortality , Humans , Middle Aged , Myocarditis/therapy , Retrospective Studies , Treatment Outcome , Young Adult
17.
Chinese Journal of Cardiology ; (12): 142-149, 2022.
Article in Chinese | WPRIM | ID: wpr-935118

ABSTRACT

Objective: To investigate the efficacy and safety of left bundle branch pacing(LBBP) in patients after transcatheter aortic valve implantation (TAVI). Methods: This is a retrospective study. A total of 35 patients underwent TAVI and received pacemaker implantation from January 2018 to December 2020 in Beijing Fuwai Hospital were enrolled. Patients were divided into LBBP group (n=12) and right ventricular apex pacing (RVAP) group (n=23) according to the pacing position. The success rate of operation in LBBP group was calculated, and the occurrence of complications were observed, and the parameters of pacemaker were measured on the 3rd day and 1, 3 and 6 months after operation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and ECG indexes were compared between the two groups on the 3rd day and 1, 3, and 6 months after pacemaker implantation. Result: A total of 35 patients were included, The age was (76.4±7.7) years, including 19 males (54.3%). The procedure time ((86.58±17.10)min vs. (68.74±9.18)min, P<0.001) and fluoroscopy duration ((20.08±4.44)min vs. (17.00±2.26)min, P<0.001) were significantly longer in LBBP group compared with RVAP group. The operation success rate of LBBP group was 11/12. There was no serious operation related complications such as pneumothorax, hemothorax, electrode dislocation, infection, and lower limb bleeding. The patients were followed up for 7.43 (5.21, 9.84) months. The programmed parameters of pacemaker were in the ideal range and stable during follow-up. At 3 and 6 months after operation, the left ventricular ejection fraction in LBBP group was higher than that in RVAP Group (at 3 months: (60.75±2.89)% vs. (57.35±3.33)%, P=0.004; at 6 months: (63.17±3.33)% vs. (56.17±3.97)%, P<0.001), NT-proBNP values was lower in LBBP group than that in RVAP Group (at 3 months: 822 (607, 1 150)ng/L vs. 1 052 (902, 1 536)ng/L, P=0.006; at 6 months: 440 (330,679)ng/L vs. 783 (588, 1 023)ng/L, P=0.001). At 1, 3 and 6 months after operation, the QRS duration was shorter in LBBP group than that in RVAP group (1 month: 99 (97, 107)ms vs. 126(124, 130)ms, P<0.001; 3 months: 98(96, 105)ms vs. 129(128, 133)ms, P<0.001; 6 months: 96(94, 104)ms vs. 130(128, 132)ms, P<0.001). Conclusions: For patients with permanent pacemaker indications after TAVI, LBBP is feasible, safe and reliable. It could improve the cardiac function in the short term, the long-term effect of LBBP needs to be further observed.


Subject(s)
Aged , Aged, 80 and over , Bundle of His , Cardiac Pacing, Artificial/methods , Electrocardiography/methods , Fluoroscopy , Humans , Male , Retrospective Studies , Stroke Volume , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Ventricular Function, Left
18.
Article in Chinese | WPRIM | ID: wpr-933464

ABSTRACT

Relapsing polychondritis is an immune mediated systemic inflammatory disease, involving the cartilaginous and proteoglycan rich structures. The characteristic manifestations were inflammation and deformity of ear and nasal cartilage. Here, Chinese Rheumatology Association summarized manifestations, diagnosis and disease activity index evaluation of relapsing polychondritis, standardized treatment regimens, to improve disease prognosis.

19.
Article in Chinese | WPRIM | ID: wpr-933463

ABSTRACT

Takayasu′s arteritis (TAK) mainly involves the aorta and its major branches, which is characterized as a chronic, progressive and inflammatory disease. China belongs to one of the regions with a high prevalence of TAK referring to its global distribution. However, it is insufficient for the spread and update of standardized diagnosis and treatment of TAK. Based on the evidence and guidelines from China and other countries, Chinese Rheumatology Association developed the standardized diagnosis and treatment of TAK in China. The purpose is to standardize the methods for diagnosis of TAK, assessment of disease activity and disease severity, strategies of internal treatment and timing of surgical intervention, and further leading to protect the function of important organs and improve the disease prognosis.

20.
Article in Chinese | WPRIM | ID: wpr-933456

ABSTRACT

Adult-onset Still′s disease (AOSD) is a rare systemic autoinflammatory disorder. In China, standardized diagnosis and treatment for AOSD is insufficient. Based on the evidence from China and other countries, Chinese Rheumatology Association developed standardization of diagnosis and treatment of AOSD in China. The purpose is to standardize the methods for diagnosis of AOSD, treatment strategies, and reduce misdiagnosis, missed diagnosis and irreversible damage.

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