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1.
Article in Chinese | WPRIM | ID: wpr-862540

ABSTRACT

With in-depth studies on the pathogenesis, pathophysiology, treatment, and prognosis of liver cirrhosis in recent years, there have been great changes in staging and treatment concepts among scholars in China and globally. Besides the traditional staging system of compensated and decompensated liver cirrhosis, liver cirrhosis can be divided into five stages based on ascites, variceal bleeding, and severe infection, which highlights the features of this disease in different disease stages and this provides potential targets and basis for treatment. At present, the comprehensive management of liver cirrhosis, including etiological treatment, treatment targeting key pathogenesis and major complications, nutritional support, exercise guidance, and lifestyle adjustment (smoking cessation, alcohol withdrawal, and improvement of oral hygiene), is the key to delaying disease progression and improving prognosis, and liver transplantation remains the most effective approach for end-stage liver cirrhosis.

2.
Acta Pharmaceutica Sinica ; (12): 734-742, 2021.
Article in Chinese | WPRIM | ID: wpr-876527

ABSTRACT

With a deepening understanding of cancer treatment, immune checkpoint inhibitors are recognized widely as a novel fundamental remedy for various malignancies with effectiveness and safety. With the development of pharmacometrics, model-informed drug development (MIDD) has emerged to accelerate the process of clinical research for new drugs and improve the accuracy of decision-making in new drug research, especially for immune checkpoint inhibitors. As a typical illustration, the research development of pembrolizumab is presented in this review to highlight the application of MIDD, which may provide a reference for the development of other new antitumor drugs.

3.
Acta Pharmaceutica Sinica ; (12): 831-834, 2021.
Article in Chinese | WPRIM | ID: wpr-876526

ABSTRACT

Five cadinane-type sesquiterpenoids were isolated from the n-hexane extract of Commiphora myrrha by using various chromatographic techniques, including silica gel, ODS and semi-preparative HPLC. Their structures were identified by physicochemical properties and spectroscopic data. These compounds were defined as (3S,4R)-3,9-dimethoxymyrrhone (1), 9-methoxymyrrhone (2), myrrhone (3), commiterpene B (4) and comosone Ⅱ (5). Compound 1 is a new compound, of which the absolute configuration was established by single crystal X-ray crystallographic analysis. Compound 5 is firstly isolated from the Commiphora genus.

4.
Article in Chinese | WPRIM | ID: wpr-875954

ABSTRACT

Objective To fully understand the actual situation and existing problems in vaccination outpatient services, which will provide information to support and improve the standardized construction of vaccination outpatient service and the whole-process vaccination management. Methods Cross-sectional study was conducted among all the vaccination outpatient services in Huangpu District of Shanghai.Data were collected by self-examination and health supervision.Analysis was focused on the conformance with the six aspects of management requirements, which included institution and personnel management, layout of facilities, vaccine and cold-chain management, vaccination management, disinfection and isolation management and medical waste management. Results Twenty-one vaccination clinics were included in the study.There were significant differences for conformance between self-examination and health supervision, public and private medical institutions (P < 0.05).There was no significant difference in the overall compliance rate among six aspects of management requirement (P > 0.05), indicating that they were relatively balanced.On analysis within the 6 aspects, there were significant differences in the indicator compliance rate for 4 aspects of management requirement, including institution and personnel management, layout of facilities, vaccine and cold-chain management, disinfection and isolation management (P < 0.05). Conclusion The standardized construction of vaccination outpatient service should be strengthened with the emphasis on the following: implementation and consolidation of management requirements, enhancement of responsibility consciousness in vaccination outpatient service, construction of special-need vaccination outpatient service in private medical institutions, and improvement of publicity and guidance education.

5.
Journal of Clinical Hepatology ; (12): 817-822, 2021.
Article in Chinese | WPRIM | ID: wpr-875888

ABSTRACT

ObjectiveTo investigate the diagnostic efficiency of FibroTouch, FibroScan, and acoustic radiation force impulse (ARFI) for liver fibrosis in patients with primary biliary cholangitis (PBC). MethodsA retrospective analysis was performed for the patients who underwent liver biopsy and were then diagnosed with PBC in Beijing Friendship Hospital, Capital Medical University, from September 2014 to October 2018, and the METAVIR scoring system was used to evaluate the degree of liver fibrosis and inflammation. Within 1 week after liver biopsy, FibroTouch, FibroScan, and ARFI were used to measure liver stiffness (LS); with pathological results as the gold standard, the area under the ROC curve (AUC) was used to compare the value of FibroTouch, FibroScan, and ARFI in the diagnosis of liver fibrosis in PBC patients, and related influencing factors were analyzed; Youden index was used to calculate the cut-off values of LS for different degrees of liver fibrosis. The Kruskal-Wallis H test was used for comparison between multiple groups, and P value corrected by the Bonferroni method was used for further comparison between two groups. A Spearman correlation analysis was performed, and a multiple linear regression model was used for multivariate analysis. ResultsA total of 68 patients with PBC were enrolled in the study, among whom 13 had F0 liver fibrosis, 15 had F1 liver fibrosis, 18 had F2 liver fibrosis, 12 had F3 liver fibrosis, and 10 had F4 liver fibrosis. LS obtained by FibroTouch (FT-LS), LS obtained by FibroScan (FS-LS), and LS obtained by ARFI (ARFI-LS) were strongly positively correlated with the degree of liver fibrosis (r=0.798, 0.782, and 0.742, all P<0.001). FT-LS had AUCs of 0.922, 0.881, and 0.926, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 10.5 kPa, 15.8 kPa, and 17.5 kPa, respectively; FS-LS had AUCs of 0.918, 0.878, and 0.939, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 10.1 kPa, 12.9 kPa, and 18.2 kPa, respectively; ARFI-LS had AUCs of 0.904, 0.869, and 0.928, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 1.45 m/s, 1.83 m/s, and 2.08 m/s, respectively. There was no significant difference in diagnosing the same stage of liver fibrosis between FibroTouch, FibroScan, and ARFI (P>0.05). The multivariate analysis showed that degree of liver fibrosis (β=0.399, P<0.001), total bilirubin (β=0.466, P<0.001), and prothrombin time activity (β=-0.195, P=0.020) were influencing factors for FT-LS; degree of liver fibrosis (β=0370, P<0.001), aspartate aminotransferase (β=0.450, P<0.001), prothrombin time activity (β=-0.303, P=0.001), and alkaline phosphatase (β=-0.187, P=0.042) were influencing factors for FS-LS; degree of liver fibrosis (β=0.489, P<0.001), aspartate aminotransferase (β=0.467, P<0.001), and platelet count (β=-0.188, P=0.028) were influencing factors for ARFI-LS. ConclusionFibroTouch has similar efficiency to FibroScan and ARFI in the diagnosis of liver fibrosis in PBC patients, with relatively high diagnostic efficiency for significant liver fibrosis (F≥2) and liver cirrhosis (F=4), and therefore, it can be used as a reliable method for the diagnosis of liver fibrosis in PBC patients.

6.
Yonsei Medical Journal ; : 29-40, 2021.
Article in English | WPRIM | ID: wpr-875605

ABSTRACT

Purpose@#The aim of this study was to compare the efficacy of liver transplantation (LT) and liver resection (LR) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and to investigate risk factors affecting prognosis. @*Materials and Methods@#A total of 94 HCC patients with PVTT type I (segmental PVTT) and PVTT type II (lobar PVTT) were involved and divided into LR (n=47) and LT groups (n=47). Recurrence-free survival (RFS) and overall survival (OS) were compared before and after inverse probability of treatment weighting (IPTW). Prognostic factors for RFS and OS were explored. @*Results@#Two treatment groups were well-balanced using IPTW. In the entire cohort, LT provided a better prognosis than LR. Among patients with PVTT type I, RFS was better with LT (p=0.039); OS was not different significantly between LT and LR (p=0.093). In subgroup analysis of PVTT type I patients with α-fetoprotein (AFP) levels >200 ng/mL, LT elicited significantly longer median RFS (18.0 months vs. 2.1 months, p=0.022) and relatively longer median OS time (23.6 months vs. 9.8 months, p=0.065). Among patients with PVTT type II, no significant differences in RFS and OS were found between LT and LR (p=0.115 and 0.335, respectively). Multivariate analyses showed treatment allocation (LR), tumor size (>5 cm), AFP and aspartate aminotransferase (AST) levels to be risk factors of RFS and treatment allocation (LR), AFP and AST as risk factors for OS. @*Conclusion@#LT appeared to afford a better prognosis for HCC with PVTT type I than LR, especially in patients with AFP levels >200 ng/mL.

7.
Article in Chinese | WPRIM | ID: wpr-879446

ABSTRACT

OBJECTIVE@#To investigate expression of Semaphorin 3A in rats after spinal cord injury and explore possible mechanism of inhibiting of axonal regeneration after SCI.@*METHODS@#Forty healthy female SD rats, 8 weeks old, weighing (210.00±9.88) g, were randomly divided into control group(20 rats in group A) and model group(20 rats in group B). In control group, removal of T@*RESULTS@#After a simple spinal cord transection injury, hemorrhagic necrosis, localized edema, neurodegeneration, necrosis, and cyst formation occurred in the injured area, and glial scar formation occurred in glial cells. Semaphorin 3A expression levels in control group was low in the gray matter area. There was no expression of Semaphorin 3A in the injured area of spinal cord injury in model group 3 days after operation. On the 14th day, the expression of Semaphorin 3A in the injured area of spinal cord injury increased significantly and was at a high level. On the 28th day, the expression of Semaphorin 3A was moderate. On the 42th day, the positive expression of Semaphorin 3A returned to normal level.@*CONCLUSION@#The increased expression of Semaphorin 3A after spinal cord injury may be one of the mechanisms that inhibit axonal regeneration.


Subject(s)
Animals , Female , Rats , Rats, Sprague-Dawley , Semaphorin-3A/genetics , Spinal Cord , Spinal Cord Injuries/genetics
8.
Journal of Clinical Hepatology ; (12): 632-635, 2021.
Article in Chinese | WPRIM | ID: wpr-873810

ABSTRACT

ObjectiveTo investigate the clinical features of patients with different types of acute drug-induced liver injury (DILI) through a retrospective analysis. MethodsClinical data were collected from 790 patients who were diagnosed with acute DILI in Beijing YouAn Hospital and Beijing Tongren Hospital affiliated to Capital Medical University from December 2010 to March 2019, and according to the type of damaged target cell, the patients were divided into hepatocellular injury type group with 554 patients, cholestasis type group with 99 patients, and mixed type group with 137 patients. The patients were evaluated based on severity grade and score, clinical outcome, and Hy′s rule. An analysis of variance was used for comparison of normally distributed continuous data between three groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups. The chi-square test was used for comparison of categorical data between three groups. The Kruskal-Wallis H test was used for comparison of ranked data between three groups, and the Mann-Whitney U test was used for comparison between two groups. ResultsMost of the patients were female in all three groups, and the hepatocellular injury type group had a significantly higher proportion of female patients than the cholestasis type group (70.8% vs 54.5%, P<0.05), and the Cholestasis type group had a significantly lower proportion of female patients than the mixed type group(54.5% vs 54.7%, P<0.05). There were 244 patients with grade 3 hepatocellular injury type DILI (244/554, 44.4%), 56 patients with grade 3 cholestasis type DILI (56/99, 56.6%), and 46 patients with grade 3 mixed type DILI (46/137, 33.6%), and there was a significant difference between the three groups (χ2=36.589, P<0.05). Drugs inducing liver injury included traditional Chinese medicine, Western medicine, combination of traditional Chinese medicine and Western medicine, and other drugs, among which traditional Chinese medicine was the most common cause of liver injury. There was a significant difference in the outcome at discharge between the patients with different types (H=14.390, P=0.001). Compared with the cholestasis type group, the hepatocellular injury type group had a significantly higher cure rate and significantly lower uncured rate and mortality rate (all P<0.05). Among the 554 patients with hepatocellular injury type DILI, 388 (70.0%) met Hy′s rule and 166 (300%) did not meet Hy′s rule, and there was a significant difference in clinical outcome between these two groups (U=38 372.0, P=0.033). ConclusionDILI is more common in women, and most patients have hepatocellular injury type DILI. Traditional Chinese medicine is the main cause of liver injury. There is a high proportion of patients with severe DILI among the patients with hepatocellular injury type or cholestasis type. DILI often has good prognosis with a relatively low mortality rate. Hy′s rule cannot predict the death of patients with acute DILI.

9.
Acta Pharmaceutica Sinica ; (12): 130-137, 2021.
Article in Chinese | WPRIM | ID: wpr-872610

ABSTRACT

With the implementation of the two-child policy and the growing demand for child health, pediatric medication has been arousing widespread social concern. To develop the drugs suitable for children, including new compounds, new specifications and new dosage forms, is urgently required for pharmaceutical researchers. In this review, several technical bottlenecks for pediatric oral liquid preparations, as well as the novel strategies involved in drug nanocrystals, self-microemulsion, ion exchange resin and Pickering emulsion were discussed, which may be benefit to play a theoretical guiding role in the research and development of children's oral liquid formulation.

10.
Article in Chinese | WPRIM | ID: wpr-885967

ABSTRACT

Objective:To provide references for encouraging translation of medical and pharmaceutical research outcomes from a policy perspective.Methods:In view of characteristics of such translation and using policy tools, the authors introduced the innovation value chain and innovation entity chain to create a three-dimensional analysis framework. The three dimensions refer to policy tools(supply side, environment side and demand side), innovation value chain(research and development, clinical research and pilot application, and commercial industrialization), and innovation entity chain(colleges, medial institutions, enterprises, government, and third parties). A three-dimensional framework was introduced for textual quantitative analysis, centering on 70 policy documents on such translation released from 2015 to 2019.Results:Excessiveness was found in the environment side and supply side policy tools usage, while the demand side was deficient relatively; clinical research and pilot applications constitute the policy support weakness in innovation value chain; policy frequency on medical institutions and third parties was weak in the innovation entity chain dimension.Conclusions:Based on the three-dimensional framework analysis results and sector specifics, the paper proposed such policy recommendations as highlighting features of medical and pharmaceutical sector, activating incentives of hospitals and colleges, and expanding resources for clinical research.

11.
Article in Chinese | WPRIM | ID: wpr-885934

ABSTRACT

Objective:Based on the high-throughput detection technique of multiplex PCR combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, constructing the characteristic SNP profiles of different strains, and establishing a rapid, accurate and highly sensitive method for the diagnosis of bloodstream infection pathogens.Methods:Seven kinds of pathogens such as common Escherichia coli were selected as target. The multiple PCR reaction conditions was optimized, and the characteristic peaks of each target bacteria were detected by MALDI-TOF MS to establish the joint detect system. Common primer pairs and central homo-sequence primer pairs were designed to analyse the formation of primer dimer. Using simulated bacterial infection blood samples with detection system to determine specificity and sensitivity. One hundred and fifty blood samples from suspected bacteremia patients were collected from June to September 2020 in a hospital in Beijing, and the identification results were compared to traditional identification method of clinical application that are using χ 2 test. Results:The cycle threshold (Ct) value of the central homo-sequence primers that were designed were more than 38, with a delay of 6-10 cycles. The joint mass spectrometry detection system could detect seven kinds of bacteria divided into two groups at the same time. The target bacteria can be detected specific product of the peak, and the clinical strains other than the target strains only had primer peaks. All maps had non-specific miscellaneous peaks. The sensitivity of Escherichia coli could reach 50 CFU/ml, and the detection limit of other bacteria was 100 CFU/ml. The detection results of 150 patients showed that 46 cases were positive by traditional method. The positive rate was 30.67% (46/150), including two cases of mixed infection. Forty-eight cases were positive by mass spectrometry, and the positive rate was 32.0% (48/150), including three cases of mixed infections. The negative coincidence rate was 100% (101/101). The comparison of the two methods showed that the P=0.625>0.01, the Kappa=0.938, the sensitivity and specificity was 97.82%(45/46) and 97.11%(101/104), respectively. There was no significant difference between the two methods, and the results of nucleic acid mass spectrometry could also be used in clinic. Conclusions:The established detection system can not only quickly and accurately detect seven common pathogens causing bloodstream infection, and effectively shorten the time needed for traditional culture and identification, but also can detect multiple bacterial mixed infections at the same time to make up for the possibility of missed detection. Besides, the method can also be used to identify other bacteria.

12.
Article in Chinese | WPRIM | ID: wpr-885165

ABSTRACT

Objective:Donor cytomegalovirus (CMV) serological negative status may have an adverse effect on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT), while there is inadequate data for Chinese people. This study is to explore the impact of donor CMV serological status on the outcome of CMV seropositive patients receiving allo-HSCT.Methods:Our study retrospectively analyzed 16 CMV seropositive patients with hematological malignancies receiving allogeneic grafts from CMV seronegative donors (antibody IgG negative) at Peking University People′s Hospital from March 2013 to March 2020, which was defined as D -/R + group. The other 64 CMV seropositive patients receiving grafts from CMV seropositive donors at the same period of time were selected as matched controls through a propensity score with 1∶4 depending on age, disease state and donor-recipient relationship (D +/R + group). Results:Patients in D -/R + group developed CMV DNAemia later than patients in the D +/R + group (+37 days vs. +31 days after allo-HSCT, P=0.011), but the duration of CMV DNAemia in D -/R + group was longer than that of D +/R + group (99 days vs. 34 days, P=0.012). The rate of CMV reactivation 4 times or more in D -/R + group was 4/16, significantly higher than that of D +/R + group (4.7%, 3/64, P=0.01). The incidences of refractory CMV DNAemia (14/16 vs. 56.3%, P=0.021) and CMV disease (4/16 vs. 4.7%, P=0.01) in D -/R + group were both higher than those in D +/R + group. In addition, the application of CMV-CTL as the second-line antiviral treatment in D -/R + group was more than that in D +/R + group. Univariate analysis and multivariate analysis suggested that CMV serological negativity is an independent risk factor for refractory CMV DNAemia and the duration of CMV infection. The cumulative incidence of aGVHDⅡ-Ⅳ, cGVHD, 3-year probability of NRM, overall survival, and the cumulative incidence of relapse were all comparable in two groups. Conclusions:Although there is no significant effect on OS and NRM, the incidence of refractory CMV DNAemia, the frequency of virus reactivation, and the development of CMV disease in D -/R + group are higher than those in controls. Therefore, CMV seropositive donors are preferred for CMV seropositive patients.

13.
Article in Chinese | WPRIM | ID: wpr-884610

ABSTRACT

Objective:To study the efficacy of direct intrahepatic portosystemic shunt (DIPS) in treatment of Budd-Chiari syndrome (BCS).Methods:From January 1, 2015 to June 31, 2017, consecutive patients with BCS who were treated with DIPS at the Department of Interventional Therapy of Beijing Shijitan Hospital, the Liver Disease Research Center of Beijing Friendship Hospital and the General Surgery Department of Beijing Ditan Hospital were retrospectively analyzed. The symptoms, physical signs (including abdominal distension, ascites, pleural effusion, splenomegaly, hepatic encephalopathy) and perioperative laboratory results of these patients were collected and analyzed. Biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and portal pressure gradient were compared before and 2 weeks after treatment. The patients were followed up for at least 3 years to assess their clinical symptoms, patency of shunt, oncological status and survival.Results:Of 67 patients with BCS who were included in the study, there were 45 males and 22 females, aged (38.12±23.22) years. The BCS classification of these patients were hepatic vein type ( n=65), including 62 patients with complete hepatic vein obstruction, 3 patients with hepatic vein occlusion due to thrombosis, and 2 patients with mixed hepatic vein and inferior vena cava occlusion. All 67 patients underwent DIPS with 93 stents being implanted. In addition, 43 patients underwent gastric coronary vein embolization, and 2 patients with mixed type of BCS underwent inferior vena cava stenting. The portal pressure gradient decreased from (22.17±9.16) mmHg (1 mmHg=0.133 kPa) to (9.87±4.75) mmHg, the difference was statistically significant ( P<0.05). Abdominal distension was relieved, at one month and ascites completely subsided in 3 months after operation. The liver congestion and swelling were obviously relieved. Comparison of patients 2 weeks after operation and before operation, ALT decreased from (65.28±27.75) U/L to (28.43±13.46)U/L, AST from (68.75±29.23) U/L to (26.92±13.33)U/L, TBil from (175.31±80.48)μmol/L to (45.08±26.54)μmol/L, DBil from (127.55±44.65)μmol/L to (35.12±10.77)μmol/L, and albumin increased from (31.56±7.22) g/L to (44.18±11.36)g/L, the difference was statistically significant (all P<0.05). All patients were followed up for at least 3 years. Shunt stenosis was detected in 5 patients (7.46%) with shunt expansion being performed, variceal bleeding in 2 patients (2.99%), ascites recurrence in 4 patients (5.97%) and hepatic encephalopathy in 2 patients (2.99%). No patients were diagnosed with hepatic cancer, and no patients died. Conclusion:DIPS was efficacious, safe and reliable to that BCS patients. It rapidly reduced portal venous pressure, relieved liver congestion, and restored liver morphology and liver function in these patients.

14.
Article in Chinese | WPRIM | ID: wpr-884285

ABSTRACT

Objective:To analyze the ultrasonographic images and clinical characteristics of congenital mesoblastic nephroma (CMN), and to investigate the differential performances with Wilm′s tumor (WT).Methods:Twenty-one cases of CMN patients confirmed by pathology from December 2008 to December 2019 in Beijing Children′s Hospital, Capital Medical University were collected as the CMN group, and in the same criterion, 51 cases of WT patients were taken as WT group. Ultrasonographic images and clinical characteristics were collected retrospectively, and then the tumor size, site, echo and age were compared and analyzed between the two groups. ROC curve was used to evaluate the differential performance.Results:The difference analysis showed that except for echo ( P=0.694), there were statistically significant differences in tumor size, site and age between the two groups (all P<0.05). In prenatal, the incidence of CMN was significantly higher than WT (61.9% vs 3.9%, P<0.001), and the specificity was 96.1%. The median age (interquartile range) of CMN after birth was significantly earlier than WT( Z=-4.044, P<0.001). The area under the ROC was 0.949, the best cutoff was 112.5 days, with a sensitivity of 87.5% and a specificity of 93.9%. Conclusions:It is difficult to distinguish CMN and WT by echo, but the diagnosis performance can be improved through combining tumor size with site, especially age.

15.
Chinese Critical Care Medicine ; (12): 252-256, 2021.
Article in Chinese | WPRIM | ID: wpr-883869

ABSTRACT

With the continuous improvement of treatment ability in intensive care unit (ICU), many critically ill and complex patients have survived due to the development of technology. However, most of them suffer from the psychological and physiological problems of post-intensive care syndrome (PICS). Therefore, the early identification and prevention of PICS is particularly critical. We should understand the pathophysiological mechanism of PICS, strictly implement ABCDEFG bundle management measures [including airway management (A), breath (B), reasonable analgesia and sedation treatment (C), prevention of delirium (D), early rehabilitation (E), family engagement (F), good communication (G)] during ICU hospitalization, and pay attention to reasonable nutritional support, optimizing blood glucose management, providing positive psychological intervention and support to patients through family members' encouragement and accompanying, ICU diary and other forms, following up the health status of patients transferred out/discharged from ICU, providing multi-disciplinary and professional continuing medical services, finding the entry point and timing of traditional Chinese medicine intervention, and giving full play to the advantages of integrated traditional Chinese and Western medicine treatment, which can improve the quality of life of patients. This article reviews the pathophysiological mechanism, risk factors, prevention and management measures, traditional Chinese medicine syndrome differentiation and treatment of PICS, in order to improve the early identification, diagnosis and treatment of critical patients with PICS, and improve the prognosis of patients.

16.
Article in Chinese | WPRIM | ID: wpr-883771

ABSTRACT

Objective:To investigate the protective effect of dagglitazine on cardiovascular and renal function in patients with type 2 diabetes mellitus.Methods:A total of 200 patients with type 2 diabetes patients with poor blood glucose control who received treatment in Huxi Hospital Affiliated to Jining Medical University (Shanxian Central Hospital) from January to December 2019 were included in this study. They were randomly assigned to receive treatment with either metformin ( n = 100, control group) or dagglitazine ( n = 100, observation group) based on diet control and exercise therapy for 12 weeks. Before and after treatment, blood glucose, blood lipid, blood pressure, body mass index, cardiac function and renal function were compared between the control and observation groups. Adverse reactions were also monitored in each group. Results:After treatment, blood glucose, blood lipid, body mass index, cardiac function and renal function in each group were improved compared with before treatment (all P < 0.05). Fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, body mass index, left ventricular end diastolic diameter, serum creatinine, uric acid and cystatin C in the observation group were (6.48 ± 0.72) mmol/L, (8.03 ± 0.77) mmol/L, (6.16 ± 0.63)%, (126.03 ± 3.86) mmHg, (75.62 ± 2.87) mmHg, (3.83 ± 0.17) mmol/L, (2.21 ± 0.36) mmol/L, (2.34 ± 0.15) mmol/L, (23.03 ± 0.55) kg/m 2, (52.10 ± 2.13) mm, (39.97 ± 1.62) μmol/L, (237.17 ± 20.34) μmol/L, (0.64 ± 0.06) mg/L, respectively, which were significantly lower than (8.01 ± 0.84) mmol/L, (10.03 ± 0.90) mmol/L, (7.30 ± 0.72)%, (130.06 ± 4.79) mmHg, (79.60 ± 3.19) mmHg, (4.67 ± 0.37) mmol/L, (2.51 ± 0.57) mmol/L, (2.74 ± 0.19) mmol/L, (24.03 ± 0.60) kg/m 2, (57.22 ± 1.74) mm, (80.00 ± 6.88) μmol/L, (281.62 ± 40.52) μmol/L, (0.76 ± 0.09) mg/L, t = 13.850, 16.866, 11.933, 6.549, 9.263, 20.879, 4.469, 16.982, 12.410, 18.634, 10.626, 9.804, 18.876, all P < 0.001). After treatment, high density lipoprotein cholesterol, left ventricular ejection fraction, and the average distance walked by patients during the 6-min walk test in the observation group were (2.47 ± 0.15) mmol/L, (39.97 ± 1.62)%, (366.50 ± 17.74) m, which were significantly superior to those in the control group [(1.70 ± 0.20) mmol/L, (36.77 ± 1.21)%, (323.70 ± 12.48) m, t = 30.255, 16.435, 19.733, all P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dagglitazine protects cardiovascular and renal function by reducing blood glucose, blood pressure, blood lipid, serum creatinine, serum uric acid levels and decreasing body mass index in patients with type 2 diabetes mellitus.

17.
Article in Chinese | WPRIM | ID: wpr-883178

ABSTRACT

Objective:To evaluate the relationship of vitamin D deficiency(VDD) between sepsis and septic shock among critical ill children, and investigate the influence of VDD on etiology and prognosis of sepsis.Methods:The observational cohort studies, involving vitamin D and critically ill children, were searched in Medline, Web of Science, EBSCO host and China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform.The quality assessment was conducted on the basis of the Newcastle-Ottawa Quality Assessment Scale.Consistent definitions of sepsis and septic shock were applied and standardized data were obtained following the study design.We retrieved the clinical outcomes related to septic shock and serum 25-hydroxyvitamin D 3concentrations and made a meta-analysis for the relation between VDD and clinical outcomes at two cut-offs. Results:In the analysis of collected data including severe VDD as a risk factor for incidence of sepsis and septic shock, the pooled RRwas 1.71(95% CI1.11 to 2.63, P=0.01) and 2.05(95% CI1.35 to 3.10, P<0.001) respectively, which were all higher compared with VDD.And severe VDD was also associated with cv-SOFA score( RR0.68, 95% CI0.45 to 0.91, P<0.001). However, no significant differences in mortality or the duration of vasopressor was found at severe VDD or VDD cut-off levels among septic shock patients. Conclusion:Among pediatric critical illness, severe VDD is more likely related to the incidence for sepsis and septic shock compared with VDD.And comorbidity with severe VDD could increase the cv-SOFA score of septic children.

18.
Article in Chinese | WPRIM | ID: wpr-883095

ABSTRACT

Objective:To explore risk factors of skin pruritus in peritoneal dialysis patients and the effect of individualized care intervention, to provide guidance for clinical practice.Methods:The total of 87 patients with peritoneal dialysis who were followed-up with pruritus in the Beijing Anzhen Hospital from January 2017 to June 2020 were selected. The Visual Analogue Scale (VAS) was used to evaluate the degree of pruritus, and the patients were divided into two groups: mild-to-moderate skin pruritus group (VAS≤6 points) and severe skin pruritus group (VAS>6 points). The risk factors of severe skin pruritus were analyzed by single factor and multivariate Logistic regression. The improvement of skin pruritus after 3 months of individualized nursing intervention was observed.Results:Among the 87 patients, the mild-to-moderate skin pruritus group and the severe skin pruritus group accounted for 64.4%(56/87) and 35.6%(31/87), respectively. Single factor analysis showed that the age, prevalence of diabetes, serum albumin, serum phosphorus, intact parathyroid hormone and C-reactive protein levels were (61.8 ± 11.5) years old, 33.3%(19/56), (36.3 ± 5.3) g/L, (1.6 ± 0.5) mmol/L, 328.4(144.9, 494.5) ng/L, 2.8(0.6, 8.3) ng/L in the mild-to-moderate skin pruritus group, and (67.0 ± 9.2) years old, 61.1%(19/31), (33.9 ± 4.8) g/L, (1.9 ± 0.3) mmol/L, 397.0(300.0,758.6) ng/L, 7.2(2.6, 17.2) mg/L in the severe skin pruritus group, the differences were significant between the two groups ( t values were -2.17, 2.14, -2.32, Z values were -2.28, -2.90, χ 2 value was 6.07, P<0.05). Logistic multivariate regression analysis showed that low albumin, high blood phosphorus and high C-reactive protein were independent risk factors for severe skin pruritus in peritoneal dialysis patients ( P<0.05). After 3 months of individualized care,18.4% (16/87) patients had complete remission,19.5% (17/87) patients significantly relieved, 55.2% (48/87) relieved, 6.9% (6/87) were ineffective, and the total response rate was 93.1%(81/87). Conclusions:More than one-third of peritoneal dialysis patients with pruritus are severe. Lower serum albumin, higher serum phosphorus and higher C-reactive protein are independent risk factors for severe pruritus in peritoneal dialysis patients. Individualized care can effectively improve pruritus in peritoneal dialysis patients.

19.
Article in Chinese | WPRIM | ID: wpr-883038

ABSTRACT

Objective:To evaluate the reliability of several formulae for estimating the quantity of glucose absorption of peritoneal dialysate (GA).Methods:Forty-four patients receiving continuous ambulatory peritoneal dialysis (CAPD) were enrolled in this study. The quantities of GA obtained from actual measurement and estimation were compared to judge whether there was statistical difference between them.Results:The GA quantities estimated by Grodstein formula, Bodnar formula, K/DOQI formula, empirical method A (based on 60% absorption rate) and empirical method B (based on 50% absorption rate in daytime and 80% absorption rate in night) were as follows: 81.3 (64.2, 118.0) g, (97.8±19.7) g, (94.1±25.8) g, 87.1 (76.2, 109.0) g and (89.5±16.0) g, respectively; the actually measured GA quantity was [94.2 (77.5, 111.6)] g. Wilcoxon signed rank test of paired samples showed that only the results of Bodnar formula and K/DOQI formula did not present statistical differences from actually measured result.Conclusion:It can be considered to use Bodnar formula and K/DOQI formula to roughly estimate the GA quantity of CAPD patients, but to accurately understand the individual GA value, actual measurement is still required.

20.
International Journal of Surgery ; (12): 145-148,F3, 2021.
Article in Chinese | WPRIM | ID: wpr-882457

ABSTRACT

Breast-contour preservation(BCP)encompasses all strategies to preserve the contour of the breast following breast-conserving surgery (BCS) and immediate postmastectomy breast reconstruction (IBR). With the continuous advancement of breast surgery, postoperative outcomes and quality of life of breast cancer patients have been significantly improved. Previous studies reported on BCP as a new comprehensive parameter for evaluating outcomes of breast cancer treatment. Based on preoperative comprehensive evaluation of patients′ general condition, characteristic of breast tumor, and breast morphology, individualized surgical strategy is formulated to improve BCP for early-stage breast cancer and improve postoperative outcomes of patients. Combined with the morphological characteristics of Chinese women′s breasts, breast contour can be preserved not only by BCS and IBR, but also by nipple-areola complex-sparing mastectomy in some breast cancer patients, thereby reducing psychosomatic impact as a result of losing breast mound.

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