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1.
China Pharmacy ; (12): 611-616, 2022.
Article in Chinese | WPRIM | ID: wpr-920733

ABSTRACT

OBJECTIVE To evaluate the budget impact on medical insurance fund upon the treatment of pulmonary arterial hypertension(PAH)included in the outpatient special and chronic disease management policy (hereinafter refer to as the Policy ), so as to provide reference for medical insurance reimbursement decision-making. METHODS Based on the perspective of medical insurance payer ,a budget impact model with 10 million people was built to calculate the budget impact on the medical insurance fund in the next three years (2021-2023)after PAH treatment included in the Policy. The measured cost mainly included the cost of medicine,outpatient registration ,examinations,hospitalizations,and death events. RESULTS A total of 34-36 patients with PAH per year were expected to use targeted therapy during 2021-2023. For cities with outpatient costs not covered by the pooling fund of basic medical insurance ,upon the treatment of PAH included the Policy ,the annual expenditure of the medical insurance fund increased by about 40 000 yuan,i.e. an increase of about 1 000 yuan per patient. For cities with outpatient costs covered by the pooling fund ,the annual expenditure of the medical insurance fund increased by about 80 000 yuan,which was equal to 2 000 yuan increase per patient. The increment of above cost decreased year by year. CONCLUSIONS The incremental expenditure of the medical insurance fund is controllable after the treatment of PAH included the Policy ;with the implementation of the Policy ,the incremental expenditure of the medical insurance fund will be reduced year by year.

2.
China Pharmacy ; (12): 579-585, 2022.
Article in Chinese | WPRIM | ID: wpr-920728

ABSTRACT

OBJECTIVE To establish a comprehensive and rapid m ethod for the a nalysis of chemical constituents as phthalides and organic acids in Angelica sinensis ,and to provide scientific reference for the quality evaluation and pharmacodynamic substance research of A. sinensis . METHODS The 70% ethanol extract of A. sinensis was analyzed by ultra high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry (UPLC-Q-TOF/MS). The determination was performed on ACQUITY UPLC BEH-C 18 column with mobile phase consisted of 0.1% formic acid solution- acetonitrile(gradient elution )at the flow rate of 0.3 mL/min. The column temperature was set at 30 ℃,and sample size was 2 µL. The ion source was an electrospray ion source ,using positive ion scanning mode ,and the mass scanning range was m/z 50-1 000. Capillary voltage was 4 000 V; atomizer pressure was 35 psi;cracking voltage was 135 V and the taper hole voltage was 65 V;the temperature of dry gas was 320 ℃;the flow of dry gas was 10 L/min and the flow of sheath gas was 11 L/min;collision energy were 20 and 40 V. Qualitative Analysis 10.0 software was used to obtain the retention time of compounds ,the accurate mass number of excimer ion peaks and secondary fragments. The compounds were analyzed by comparing with the mass spectra of the reference substance ,combined with relevant literature ,mass spectrometry cleavage law and database such as Chemspider ,MassBank,PubChem. RESULTS A total of 72 compounds were identified or deduced from A. sinensis ,including 55 phthalides,13 organic acids and 4 other constituents. CONCLUSIONS The established method is rapid and accurate for the identification of chemical constituents from A. sinensis ,such as organic acids and phthalides ,which provides an efficient and rapid analytical method for the comprehensive characterization of its chemical constituents.

3.
Article in Chinese | WPRIM | ID: wpr-924684

ABSTRACT

@#Objective     To evaluate the safety and efficacy of transcatheter aortic valve replacement (TAVR) using the SAPIEN 3 system. Methods    This was a prospective, multicenter, single arm study in 4 centers in China. The clinical data of 50 patients with high-risk symptomatic severe aortic stenosis who underwent TAVR using the SAPIEN 3 system from June 2017 to June 2019 were analyzed, including 27 males and 23 females aged 76.8±6.1 years. Results    The Society of Thoracic Surgeon score was 6.0%±2.8%. Totally, 20.0% of patients had severe bicuspid aortic stenosis. The operation time was 41.8±16.5 min and the hospital stay time was 8.5±5.0 d. At the postoperative 30-day follow-up, no all-cause mortality occurred and the device success rate was 89.5%. Major vascular complications occurred in one (2.0%) patient,  stroke in one (2.0%) patient, new pacemaker implantation in one (2.0%) patient, as well as coronary artery obstruction in one (2.0%) patient. There was no moderate or moderate/severe paravalvular leak. The aortic pressure gradient was decreased from 49.2±16.2 mm Hg before the operation to 12.4±4.6 mm Hg at the postoperative 30-day follow-up, and the valvular area was increased from 0.6±0.3 cm2 to 1.3±0.3 cm2 (P<0.01). Moreover, the New York Heart Association classification in 83.7% of the patients was improved during the follow-up. Conclusion    This pre-marketing multicenter study has demonstrated the safety and effectiveness of transfemoral TAVR with the SAPIEN 3 transcatheter valve system in Chinese aortic stenosis patients at high risk for surgery.

4.
Rev. bras. med. esporte ; 27(spe): 62-65, Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156126

ABSTRACT

ABSTRACT Community sports are a very important part of urban public service. It directly affects the quality of life of residents and plays an important role in improving the health level of the masses. However, there are still many problems in the current public sports service system, which hinders the provision of public health. In order to ensure the effectiveness of the indicators of community sports service guarantee system, this study uses the fuzzy analytic hierarchy process to construct the community public sports service guarantee system, and verifies the effectiveness of the system constructed by this method through an example application. The results show that the weight of each index from large to small is service effectiveness > residents' demand > service capacity > service content; the weight of service effectiveness is 48.46%, which is an important indicator of service guarantee system. In addition, the effectiveness of the community sports service system was verified, and the CR value of the evaluation index system was greater than 0.1, which showed that the consistency of the evaluation index system met the requirements. The public sports service guarantee system constructed by the research institute has good applicability and high practical value. I hope that the research results can provide some reference for the improvement of grass-roots sports service construction, and provide some theoretical support for the construction of grass-roots service evaluation system.


RESUMO O desporto comunitário é uma parte muito importante do serviço público urbano. Afeta diretamente a qualidade de vida da população e desempenha um papel importante na melhoria do nível de saúde das massas. No entanto, ainda há muitos problemas no atual sistema de serviço público de desporto comunitário, o que dificulta a prestação da saúde pública. A fim de garantir a eficácia dos indicadores do sistema de garantia do serviço desportivo, este estudo utiliza o processo hierárquico analítico difuso para construir o sistema de garantia do serviço desportivo público e verifica a eficácia do sistema construído por este método através de uma aplicação dada como exemplo. Os resultados mostram que o peso de cada índice, de alto para baixo, é a eficácia do serviço > demanda da população > capacidade de serviço > conteúdo de serviço; o peso da eficácia do serviço é 48.46%, que é um importante indicador do sistema de garantia do serviço. Além disso, a eficácia do sistema de serviços desportivos foi verificada, e o valor CR do índice de avaliação do sistema foi superior a 0.1, o que mostrou que a consistência do sistema de índice de avaliação satisfazia os requisitos. O sistema público de garantia do serviço desportivo construído pelo instituto de pesquisa tem boa aplicabilidade e elevado valor prático. Espero que os resultados da investigação possam servir de referência para a melhoria da construção de serviços desportivos de base e proporcionar algum apoio teórico à construção de um sistema de avaliação de serviços de base.


RESUMEN Los deportes comunitarios son una parte muy importante del servicio público urbano. Afecta directamente la calidad de vida de los residentes y juega un papel importante en la mejora del nivel de salud de las masas. Sin embargo, todavía existen muchos problemas en el actual sistema público de servicios deportivos, lo que dificulta la prestación de servicios de salud pública. Con el fin de asegurar la efectividad de los indicadores del sistema de garantía del servicio deportivo comunitario, este estudio utiliza el proceso de jerarquía analítica difusa para construir el sistema de garantía del servicio público deportivo comunitario, y verifica la efectividad del sistema construido por este método a través de una aplicación de ejemplo. Los resultados muestran que el peso de cada índice, de mayor a menor, es la eficacia del servicio> la demanda de los residentes> la capacidad del servicio> el contenido del servicio; el peso de la efectividad del servicio es del 48,46%, lo que es un indicador importante del sistema de garantía del servicio. Además, se verificó la efectividad del sistema de servicios deportivos comunitarios y el valor de RC del sistema de índice de evaluación fue mayor a 0.1, lo que mostró que la consistencia del sistema de índice de evaluación cumplió con los requisitos. El sistema de garantía del servicio público de deportes construido por el instituto de investigación tiene una buena aplicabilidad y un alto valor práctico. Espero que los resultados de la investigación puedan proporcionar alguna referencia para la mejora de la construcción de servicios deportivos de base y proporcionar algún apoyo teórico para la construcción de un sistema de evaluación de servicios de base.


Subject(s)
Humans , Sports , Public Sector , Community Health Planning , Healthy People Programs
5.
Article in Chinese | WPRIM | ID: wpr-873609

ABSTRACT

@#Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.

6.
Article in Chinese | WPRIM | ID: wpr-907892

ABSTRACT

Objective:To investigate the incidence and clinical characteristics of cranial imaging abnormalities in children with systemic lupus erythematosus (SLE) at the initial diagnosis.Methods:The clinical data of 74 children with SLE admitted to the Department of Rheumatology in Children′s Hospital Affiliated to Xi′an Jiaotong University for the initial diagnosis from January 2012 to May 2019 were subject to retrospective analysis.They were divided into the cranial imaging abnormality group and the cranial imaging non-abnormality group according to the imaging.A description and statistical analysis were carried out for both groups with respect to the course before initial diagnosis, gender, rash, arthralgia, hair loss, pulmonary lesions, white blood cells (WBC), hemoglobin (Hb), platelets (PLT), erythrocyte sedimentation rate (ESR), serum ferritin (FER), serum complement values (C 3 and C 4), anticardiolipin antibody (ACA), alanine aminotransferase (ALT), aspartate transaminase (AST), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC). Results:Seventy-four children with SLE underwent a cranial imaging exa-mination at the initial diagnosis, including 52 cases for magnetic resonance imaging (MRI) and 22 cases for CT.There were 36 abnormal cases (48.6%), including 27 cases (51.9%) in MRI and 9 cases (40.9%) in CT.Among 36 cases of abnormal cranial imaging in children with SLE, MRI abnormalities were mainly demyelinating lesions and sulcus widening (brain atrophy), while CT abnormalities were mainly sulcus widening (brain atrophy). There were 21 cases presenting with neurological symptoms, including 17 cases of headache, 11 cases of dizziness, 3 cases of convulsions, and 1 case of coma.There were no significant differences between both groups in the course before initial diagnosis, gender, rash, arthralgia and hair loss.Among the 36 cases of SLE with cranial imaging abnormalities, 20 cases presented with interstitial pulmonary lesions, of which 4 cases presented with pulmonary hemorrhage; Among 38 cases of SLE without cranial imaging abnormality, 8 cases presented with interstitial pulmonary lesions, which indicated that there were statistical differences between both groups; within terms of the laboratory test items, there were significant differences in PLT between both groups, and there was no significant difference in WBC, Hb, ESR, FER, C 3, C 4, ACA, ALT, AST, TG, HDL, LDL and TC. Conclusions:The cranial imaging abnormalities in children with SLE, especially the earlier occurrence in MRI, may occur before the manifestation of clinical symptoms of the nervous system.They were also associated with other important organ damages, such as abnormal blood system and lung lesions.Early detection may contribute to the short-term prognosis.

7.
Chinese Medical Journal ; (24): 2678-2684, 2021.
Article in English | WPRIM | ID: wpr-921230

ABSTRACT

BACKGROUND@#The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.@*METHODS@#CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.@*RESULTS@#The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).@*CONCLUSIONS@#TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.@*TRIAL REGISTRATION@#https://www.chictr.org.cn/ (No. ChiCTR2000038526).


Subject(s)
Aged , Aged, 80 and over , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Humans , Male , Registries , Retrospective Studies , Risk Factors , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome
8.
Chinese Medical Journal ; (24): 2685-2691, 2021.
Article in English | WPRIM | ID: wpr-921223

ABSTRACT

BACKGROUND@#Nitinol-containing devices are widely used in clinical practice. However, there are concerns about nickel release after nitinol-containing device implantation. This study aimed to compare the efficacy and safety of a parylene-coated occluder vs. a traditional nitinol-containing device for atrial septal defect (ASD).@*METHODS@#One-hundred-and-eight patients with ASD were prospectively enrolled and randomly assigned to either the trial group to receive a parylene-coated occluder (n = 54) or the control group to receive a traditional occluder (n = 54). The plugging success rate at 6 months after device implantation and the pre- and post-implantation serum nickel levels were compared between the two groups. A non-inferiority design was used to prove that the therapeutic effect of the parylene-coated device was non-inferior to that of the traditional device. The Cochran-Mantel-Haenszel chi-squared test with adjustment for central effects was used for the comparison between groups.@*RESULTS@#At 6 months after implantation, successful ASD closure was achieved in 52 of 53 patients (98.11%) in both the trial and control groups (95% confidence interval (CI): [-4.90, 5.16]) based on per-protocol set analysis. The absolute value of the lower limit of the 95% CI was 4.90%, which was less than the specified non-inferiority margin of 8%. No deaths or severe complications occurred during 6 months of follow-up. The serum nickel levels were significantly increased at 2 weeks and reached the maximum value at 1 month after implantation in the control group (P  0.05).@*CONCLUSIONS@#The efficacy of a parylene-coated ASD occluder is non-inferior to that of a traditional uncoated ASD occluder. The parylene-coated occluder prevents nickel release after device implantation and may be an alternative for ASD, especially in patients with a nickel allergy.


Subject(s)
Cardiac Catheterization , Heart Septal Defects, Atrial/surgery , Humans , Polymers , Prospective Studies , Prosthesis Design , Septal Occluder Device/adverse effects , Treatment Outcome , Xylenes
9.
Chinese Journal of Rheumatology ; (12): 721-726,C11-1,C11-2, 2021.
Article in Chinese | WPRIM | ID: wpr-910217

ABSTRACT

Objective:To investigate the effect of iguratimod (IGU) on transforming growth factor-β 1 (TGF-β 1)-induced primary human lung fibroblasts (pHLFs) activation and collagen secretion. Methods:Mice pulmonary fibrosis (PF) models were established in vivo and were divided into three groups: the control group (CTR group), the Bleomycin (BLM) group and the BLM+IGU group, hematoxylin-eosin (HE) staining was used to observe lung morphology, and Masson staining was used to observe the degree of collagen accumulation in lung. Fibronectin and smooth muscle 22 (SM22) were detected by immunofluorescence, and the content of hydroxyproline in lung tissue was detected by chloramine-T method. In vitro, pHLFs were used to assess the effect of IGU on TGF-β 1 stimulation in four groups: CTR group, IGU group, TGF-β 1 group and TGF-β 1+IGU group, the apoptosis of cells was detected by flow cytometry, and the mRNA expression of collagen type Ⅰ (COL-Ⅰ) and collagen type Ⅲ (COL-Ⅲ) was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The protein levels of α-smooth muscle actin (α-SMA), fibronectin, p-Smad2, p-Smad3 and transcription coactivator p300 were detected by Western blot and immunofluorescence. One-way ANOVA was used for all data, and LSD- t test or Kruskal-Wallis test was used for pair comparison. Results:The content of hydroxyproline in CTR group, the BLM group and the BLM+IGU group was (0.552±0.075) μg/mg, (1.293±0.081) μg/mg and (0.833±0.053) μg/mg ( F=169.672, P<0.01) respectively. IGU reduced the content of hydroxyproline in the lung tissue of mice, reduced the accumulation of collagen in the lung, and thus reduced the degree of BLM-induced pulmonary fibrosis, and improved the pathological changes in the lung of mice. In cell experiments, IGU had no significant effect on apoptosis ( F=0.83, P=0.54). The relative expression levels of COL-Ⅰ mRNA in the CTR group, TGF-β 1 group and TGF-β 1+IGU group were (100.4±1.2), (299.0± 13.0) and (202.5±7.0) respectively ( F=468.7, P<0.01). The relative expression levels of COL-Ⅲ mRNA in the CTR group, TGF-β 1 group and TGF-β 1+IGU group were (99.8±1.9), (350.6±8.0) and (220.3±9.9) respectively ( F=468.7, P<0.01). The relative expression levels of α-SMA protein were (0.193±0.038) in CTR group, (0.530±0.061) in TGF-β 1 group, and (0.410±0.065) in TGF-β 1+IGU group ( F=35.620, P<0.01); The relative expression levels of fibronectin in CTR group, TGF-β 1 group, and TGF-β 1+IGU group were (0.200±0.020), (0.700±0.020) and (0.410±0.066) respectively ( F=123.326, P<0.01). The relative expression levels of p-Smad3 protein in CTR group, TGF-β 1 group, and TGF-β 1+IGU group were (0.120±0.020), (0.573±0.586) and (0.327±0.252) respectively( F=92.987, P<0.01); The relative expression levels of p300 in CTR group, TGF-β 1 group and TGF-β 1+IGU group were (0.180±0.055), (0.923±0.025) and (0.650±0.050) respectively ( F=207.676, P<0.01). IGU significantly decreased the mRNA expression levels of COL-Ⅰ and COL-Ⅲ induced by TGF-β 1, inhibited the protein expression levels of α-SMA, fibronectin, p300, and phosphorylation of Smad2/3. Conclusion:Our results revealed the beneficial effect of IGU on the inhibition of TGF-β 1-mediated pHLFs activation and collagen secretion via the Smad3/p300 pathway, thus suggest that it might act as an effective anti-fibrotic agent in preventing the progression of PF.

10.
Article in Chinese | WPRIM | ID: wpr-909025

ABSTRACT

Objective:To explore the effect of situational simulation training combined with Miller pyramid teaching on emergency response ability and nursing skills of specialized nurses in operating room.Methods:A total of 56 disaster nursing trainees who received specialized nurse training in the operating room of Mianyang Central Hospital from June 2019 to June 2020 were selected in the study, and they were divided into control group and research group in average according to the order of training time. The control group adopted clinical one-to-one teaching, while the research group adopted situational simulation training combined with Miller pyramid teaching. After the training, the teaching effect of specialized nurse training was evaluated by their professional theoretical knowledge and nursing skill operation results, and self-designed assessment scale was used to evaluate the emergency response ability and satisfaction with the training effect of the nurses. SPSS 22.0 was used for t test and chi-square test. Results:The results of theoretical knowledge and nursing skills operation of specialize nurses in operating room in the research group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.001). The scores of emergency capability assessment in the research group were significantly higher than those in the control group, with statistical significance ( P<0.001). The study group was better than the control group in 7 aspects of satisfaction, such as the improvement of the operation level of emergency ability, team cooperation ability, analysis and problem solving ability, clinical nursing decision-making ability, independent thinking ability and nurse-patient communication ability, with significant differences ( P<0.05). Conclusion:Situational simulation training combined with Miller pyramid teaching can significantly improve the emergency response ability, nursing skill operation and training satisfaction of operating room nurses, which is better than the traditional clinical teaching method, and is worthy of application and promotion in clinical nursing teaching.

11.
Chinese Journal of Neurology ; (12): 64-71, 2020.
Article in Chinese | WPRIM | ID: wpr-870766

ABSTRACT

Susceptibility-weighted imaging (SWI) is a tool that uses the intrinsic nature of local magnetic fields to enhance image contrast in order to improve the visibility of various susceptibility sources.SWI has blood oxygen levels dependent effect and is sensitive to the change of the cerebral oxygen saturation.This imaging method is applied to various diseases with abnormal deoxyhemoglobin concentration,such as ischemic stroke and cerebral arteriovenous malformation.Patients with acute ischemic stroke have elevated levels of deoxygenated hemoglobin in the affected area,so the ischemic area can show abnormal venous imaging on SWI images.SWI could recognize penumbra and guide the management of patients with acute stroke.Besides,SWI also could evaluate the severity of symptoms,predict prognosis and future surviving state.This paper reviews the research progress of the prominent hypointense vessels sign and its application in acute ischemic stroke.

12.
Article in Chinese | WPRIM | ID: wpr-866679

ABSTRACT

Objective:To analyze the clinical characteristics and treatment of Stevens-Johnson syndrome.Methods:The clinical data of 30 children with Stevens-Johnson syndrome admitted to our hospital in recent 3 years(January 2016-June 2019) were retrospectively analyzed.Results:Among the 30 cases, 18 cases were male and 12 cases were female, the ratio of male to female was 3: 2.The average age of onset was (7.57±2.48)years, with the oldest age 13years and the youngest age was 2years.The 30 patients met the diagnostic criteria for Stevens-Johnson syndrome.Among the suspected allergen, there were 15 cases of antibiotics, accounting for 50%.There were 8 cases of antiepileptic drugs(4 cases of phenobarbital, 2 cases of carbamazepine and 2 cases of valproic acid), accounting for 26.7%.Five cases of NSAIDS (4 cases of ibuprofen and 2 cases of aspirin), accounted for 16.7%.Two cases had no specific sensitizing drugs, accounted for 6%.All 30 patients had oral mucosa and conjunctiva involvement, corneal ulcer complicated in 1 case.Vulva and genital were involved in 10 cases.All 30 cases received implosive therapy with methylprednisolone sodium succinate + intravenous gamma globulin, among which 3 cases were treated with plasma exchange due to obvious impairment of organ function.Four cases developed toxic epidermal necrolysis, three of which were treated with cyclosporine.One patient had neurological sequelae, manifested as consciousness disorder and limb movement disorder, and recovered after 2 months of rehabilitation treatment.Conclusion:For children with Stevens-Johnson syndrome, most of the children with abnormal liver function.The antiepileptic drugs and antibacterial drugs are the most susceptible drugs.After early identification, early use of high-dose glucocorticoid plus intravenous gamma globulin shock treatment, the prognosis of most patients is good.When the effect is not good, other immune inhibitors such as ciclosporin, biological agents and blood purification, etc.can also be used.

13.
Journal of Leukemia & Lymphoma ; (12): 374-377, 2020.
Article in Chinese | WPRIM | ID: wpr-862843

ABSTRACT

Haploidentical hematopoietic stem cell transplantation (HID-HSCT) is increasingly used worldwide as an important treatment for hematopoietic diseases. Thanks to the improvements in new treatment regimens and drugs, more patients with hematopoietic disorders can benefit from it. Selecting the appropriate donor is good to optimize clinical outcomes. Many factors need to be taken into consideration when choosing the optimum donor, such as donor-specific antibodies, donor age, genetic relationship, gender and ABO compatibility, human lymphocyte antigen (HLA) mismatch, natural killer cell alloreactivity, and serum status of donor cytomegalovirus. This article reviews the new progress of donor selection of HID-HSCT.

14.
Acta Pharmaceutica Sinica ; (12): 2883-2891, 2020.
Article in Chinese | WPRIM | ID: wpr-862292

ABSTRACT

The solubility/dissolution, hygroscopicity and mechanical properties of drug candidates have a profound effect on oral bioavailability, processability and stability. The physicochemical properties of crystalline drug are closely related to inner crystal structure. Crystal engineering technologies, as strategies of altering the crystal structure and tailoring physicochemical properties at molecular level, possess the potential of enhancing the pharmaceutical performance of product. The current article reviewed the modification of drug solubility/dissolution, hygroscopicity and mechanical properties by crystal engineering technologies through polymorphic selection, amorphization/co-amorphization, as well as co-crystallization, which provided a reference for the applications of pharmaceutical crystallography in improving physicochemical properties and druggability.

15.
Chinese Journal of Neurology ; (12): 64-71, 2020.
Article in Chinese | WPRIM | ID: wpr-798981

ABSTRACT

Susceptibility-weighted imaging (SWI) is a tool that uses the intrinsic nature of local magnetic fields to enhance image contrast in order to improve the visibility of various susceptibility sources. SWI has blood oxygen levels dependent effect and is sensitive to the change of the cerebral oxygen saturation. This imaging method is applied to various diseases with abnormal deoxyhemoglobin concentration, such as ischemic stroke and cerebral arteriovenous malformation. Patients with acute ischemic stroke have elevated levels of deoxygenated hemoglobin in the affected area, so the ischemic area can show abnormal venous imaging on SWI images. SWI could recognize penumbra and guide the management of patients with acute stroke. Besides, SWI also could evaluate the severity of symptoms, predict prognosis and future surviving state. This paper reviews the research progress of the prominent hypointense vessels sign and its application in acute ischemic stroke.

16.
Article in Chinese | WPRIM | ID: wpr-781457

ABSTRACT

OBJECTIVE@#To investigate the preventive and therapeutic effects of endothelial progenitor cells on monocrotaline-induced hepatic vein occlusion disease in mice.@*METHODS@#C57BL/6 mice were randomly divided into 3 groups: saline group (n=15), monocrotaline group (n=15), and endothelial progenitor cell infusion group (n=15). Liver function (TBIL, ALT, AST), liver index, and serum levels of TNF-α and IL-6 were measured on the 8 day after intragastric administration. Hepatic sinusoidal endothelial cells, hepatic central venous endothelial cells and hepatocytes were observed by both HE and immunohistochemical staining. Hepatic fibrosis was observed by Masson's trichrome staining.@*RESULTS@#By the light microscopy, the liver of the monocrotaline group showed moderate to the severe injuries of hepatic sinusoidal and central venous endothelial cells, and hepatic venous congestion. Masson staining showed moderate to severe hepatic fibrosis of central vein and hepatic sinus. In the endothelial progenitor cell group, hepatic sinusoidal and central venous endothelial cell injuries, and the fibrosis of central hepatic vein and hepatic sinus were mild to moderate. Hepatic venous congestion was reduced in comparison with that in the mice of the monocrotaline group. Compared with the endothelial progenitor cell group, the liver index was higher, the liver function was more abnormal, and the serum expression levels of TNF-α and IL-6 were higher in the monocrotaline group.@*CONCLUSION@#The monocrotaline-induced damage of hepatic sinusoidal and central venous endothelial cells is an linitiating factor for hepatic vein occlusive disease. Infusion of endothelial progenitor cells can play a role in preventing and treating hepatic vein occlusion.

17.
Article in Chinese | WPRIM | ID: wpr-828641

ABSTRACT

OBJECTIVE@#To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China.@*METHODS@#According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017.@*RESULTS@#A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66).@*CONCLUSIONS@#Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.


Subject(s)
China , Female , Humans , Infant, Newborn , Meconium Aspiration Syndrome , Pregnancy , Respiratory Distress Syndrome, Newborn , Retrospective Studies
18.
Article in Chinese | WPRIM | ID: wpr-857508

ABSTRACT

OBJECTIVE: To investigate the effect of remifentanil postconditioning on myocardial hypoxia/reoxygenation (H/R) injury in adults, and to further explore the role of aquaporin-4 (AQP-4) in mediating this effect. METHODS: Trabecular muscles from the right atrial appendage of adults were treated with hypoxia for 90 min, followed by reoxygenation for 120 min. Then, remifentanil 0.01, 0.1 and 1.0 nmol·L-1was infused 10 min before the end of hypoxia until 10 min after the start of reoxygenation. The contractile tension of the trabecular muscles was monitored during the experiment. Western blotting was performed to evaluate AQP-4 expression at the end of the experiment. RESULTS: Compared with normal control group, muscle tension decreased significantly after 30 min of induction in H/R group (P<0.05), and it was reduced to the minimum at 90 min. The muscle tension at 150 min and 180 min in remifentanil 0.1 nmol·L-1group was higher than that in H/R group (P<0.05). The muscle tension in remifentanil 1.0 nmol·L-1group was higher than that in H/R group during reoxygenation (P<0.05). Compared with normal control group, the expression of AQP-4 protein in H/R group was significantly higher (P< 0.05), whereas the expression of AQP-4 in remifentanil 0.1 and 1.0 nmol·L-1groups was down-regulated compared with H/R group (P<0.05). CONCLUSION: Remifentanil can alleviate myocardial H/R injury in adults, and its effect may be related to the decreased expression of AQP-4.

19.
Article in Chinese | WPRIM | ID: wpr-847504

ABSTRACT

BACKGROUND: A great progress has been achieved in the allogeneic hematopoietic stem cell transplantation for aplastic anemia. However, graft-versus-host disease and graft failure after transplantation are still the main causes of non-relapse death, which seriously affect the survival of patients. OBJECTIVE: To summarize the current status and progress of allogeneic hematopoietic cell transplantation in the treatment of aplastic anemia. METHODS: The first author retrieved PubMed, CNKI, WanFang and VIP databases for the articles concerning allogeneic hematopoietic stem cell transplantation for aplastic anemia published from January 1990 to September 2019. The keywords were “aplastic anemia, matched sibling donor hematopoietic stem cell transplantation, unrelated donor hematopoietic stem cell transplantation, haploidentical hematopoietic stem cell transplantation, cord blood transplantation” in Chinese and English, respectively. Finally 55 eligible articles were included for result analysis. RESULTS AND CONCLUSION: HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation is the first choice. Unrelated donor hematopoietic stem cell transplantation may be an effective and feasible first-line therapy in pediatric severe aplastic anemia patients with no matched sibling donors. Haploidentical hematopoietic stem cell transplantation and cord blood transplantation can also be important transplantation methods for severe aplastic anemia when lack of HLA-matched donors.

20.
Journal of Medical Postgraduates ; (12): 741-747, 2020.
Article in Chinese | WPRIM | ID: wpr-822594

ABSTRACT

ObjectiveNeNewly onset atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI), which is considered to be related to cardiovascular adverse events. This paper aims to discuss the relationship between atrial fibrillation and long-term cardiovascular adverse events after acute myocardial infarction.MethodsA retrospective analysis of 483 STEMI patients with multivessel disease, who underwent emergency percutaneous coronary intervention (PCI) in Beijing Chaoyang Hospital from January 2014 to May 2017, was conducted. Patients were divided into two groups: AF group: n=52(10.8%) and non-AF group: n=431(89.2%) according to including criteria. The primary endpoint event was long-term major adverse cardiovascular events, including cardiovascular death, acute heart failure or ischemia stroke. The secondary endpoint event was defined as 30-day cardiovascular death. Multivariate logistic regression analysis and Cox proportional hazards mode were performed to analyze the relationship between newly onset atrial fibrillation and cardiovascular adverse events, such as cardiovascular death. ResultsCompared with non-AF group, AF group had older age, higher levels of C-reactive protein, erythrocyte sedimentation rate, creatinine, troponin, SYNTAX score and GRACE score and lower levels of total cholesterol, low density lipoproteins and ejection fraction (P<0.01). In the multivariate logistic regression analysis model, newly onset atrial fibrillation, age, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, admission creatinine level, fasting blood glucose, and coronary SYNTAX score were all independent risk factors associated with higher risks of 30-day cardiovascular death (OR=1.983, 95% CI=1.036-3.795, P=0.04). Using Cox proportional hazards mode, newly onset atrial fibrillation following primary PCI was associated with long-term clinical adverse cardiovascular event (HR=1.983, 95% CI=1.036-3.795, P=0.04) after adjusting all covariates. The area under the ROC curve for combined prediction mode with GRACE score and newly onset AF was comparable to the one for the model with GRACE score alone (0.788 vs 0.767,P=0.08).ConclusionNewly onset atrial fibrillation in STEMI patients with multivessel disease who underwent emergency PCI is associated with 30-day cardiovascular death and long-term clinical adverse cardiovascular events. However, newly onset atrial fibrillation does not increase the predictive value of GRACE score.

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