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1.
China Pharmacy ; (12): 1165-1172, 2021.
Article in Chinese | WPRIM | ID: wpr-876882

ABSTRACT

OBJECTIVE:To provid e reference for promoting the application of real-world evidence in pediatric medical product R&D. METHODS :The progress of real-world evidence in pediatrics in the United States and Europe was introduced. The obstacles of real-world evidence in pediatric drug R&D were analyzed ,and a series of feasibility suggestions were put forward. RESULTS & CONCLUSIONS:Real world evidence had been widely used in pediatric medical product R&D ,including evaluation and validation of biomarkers and prognostic indicators ,clinical trial design and optimization ,support for extended indications , post-marketing safety monitoring/pharmacovigilance ,etc. There were still many obstacles ,such as data fragmentation and access restrictions,lack of standardized analysis methods for real-world evidence ,lack of key pediatric variables ,and difficulties in obtaining informed consent from pediatric patients. In order to promote the application of real-world evidence in pediatrics ,it is suggested to strengthen the construction of data infrastructure ,expand the application of general data model ,develop methods for collecting longitudinal data of pediatric patients ,and carry out reasonable research design.

2.
China Pharmacy ; (12): 904-910, 2021.
Article in Chinese | WPRIM | ID: wpr-876257

ABSTRACT

OBJECTIVE:To provide technical met hods for marketing authorization holder (MAH)to effectively use the data of adverse drug reaction (ADR),actively monitor and control the production quality risk ,and carry out drug production risk management. METHODS :Through establishing three-dimensional risk matrix and risk trend model ,the risk early warning system of MAH production line based on ADR report data is designed and developed ;the main functions of the system were applied and analyzed according to the actual ADR report data of a certain company. RESULTS :MAH production line risk warning system was established preliminarily. The main framework included data source and and processing module ,model construction module (three-dimensional matrix model included possibility index ,severity index and sensitivity index ,risk trend model was set according to the principle of product production batch number preparation ),and result output & analysis module. Five major functional modules included system configuratio ,production line signal detection ,visual statistical early warning ,ADR report management and standard data management. The application and analysis of ADR report data of a certain company showed that the system could realize detection and warning of the company ’s production line risk ,which intuitively reflected its high-risk production lines ,varieties and batch numbers. It was consistent wit h the actual safety sit uation of the company ’s varieties. CONCLUSIONS:The system can help MAH make use of ADR report data to actively monitor drug production quality risks in a timely manner ,investigate risk factors for high-risk production lines , high-risk varieties and high-risk batch numbers,and assist in decision-making on the direction of risk investigation.

3.
Article in Chinese | WPRIM | ID: wpr-887988

ABSTRACT

The chemical components of Lycii Fructus were analyzed by liquid chromatography( LC) and mass spectrometry( MS for the establishment of spectrum-activity relationship,on the basis of which its antioxidant active ingredients were determined. In this experiment,Lycii Fructus was extracted with different solvents and then separated into 80 samples by macroporous adsorption resin and reversed-phase chromatography,respectively. The antioxidant components were enriched into 11 samples and their scavenging abilities against DPPH free radical and ferric ion reducing antioxidant power( FRAP) were significantly stronger than those before the treatment( P<0. 05). The spectrum-activity relationship regarding the antioxidant activity in vitro of Lycii Fructus was established by Pearson correlation analysis,orthogonal partial least squares( OPLS) and elastic net regression. Six chromatographic peaks greatly contributing to the antioxidant activity in vitro of Lycii Fructus were identified as rutin( P6),quercetin( P35),scopoletin( P14),N-cis-feruloyl-4-O-β-D-glucopyranosyl-tyramine or N-( 4-O-β-D-glucopyranosyl-trans-feruloyl)-tyramine( P8), ferulic acid( P13) and1,3,5-dihydroxy-2-isoprenyl-3-xanthone( P23). The active components associated with free radical scavenging were rutin and quercetin both belonging to flavonoids. The reduction of Fe3+was based on phenylpropanoids such as ferulic acid,scopoletin,xanthone and phenolic amides. These results indicated that the antioxidant activity of Lycii Fructus was ascribed to the synergistic action of different products through different ways. Besides,the data analysis model should be chosen carefully for the establishment of spectrum-activity relationship,thus ensuring the reliability of results.


Subject(s)
Antioxidants , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Fruit , Phenols , Reproducibility of Results
4.
Article in Chinese | WPRIM | ID: wpr-883662

ABSTRACT

Objective:To investigate the effects of different doses of sodium arsenic (NaAsO 2) on mRNA transcription levels of nucleotide excision repair (NER) related genes in normal hepatocytes (L-02 cells) and the modification levels of histone H3 ninth lysine dimethylization (H3K9me2) in the promoter region. Methods:L-02 cells were treated with 0 (the control group) , 5, 10 and 20 μmol/L NaAsO 2 for 24 h ( n = 3). Single cell gel electrophoresis (SCGE) was used to detect DNA damage [Olive tail distance (OTM) and Tail DNA percentage (Tail DNA%)] in L-02 cells. The mRNA expression levels of Xeroderma pigmentosum (XP) gene A (XPA), XP gene D (XPD) and XP gene F (XPF) were detected by real-time fluorescence quantitative PCR. The modification levels of H3K9me2 in XPA, XPD and XPF gene promoter regions (CHIP1 and CHIP2) were detected by quantitative chromatin immunoprecipitation. Results:OTM and Tail DNA% were positively correlated with arsenic doses (in the control and 5, 10 and 20 μmol/L arsenic exposure groups, the values were 0.35 ± 0.09, 0.56 ± 0.18, 3.18 ± 0.31, 4.52 ± 0.55, 0.72 ± 0.05, 1.34 ± 0.26, 3.93 ± 0.43, 5.47 ± 0.65, respectively, r = 0.927, 0.948, P < 0.05). Compared with the control group, the mRNA expression levels of XPA, XPD and XPF in L-02 cells of 10 and 20 μmol/L arsenic exposure groups were significantly lower ( P < 0.05). Compared with the control group, the enrichment levels of H3K9me2 in XPA, XPD and XPF gene promoter regions (CHIP1 and CHIP2) in L-02 cells of 20 μmol/L arsenic exposure group were significantly higher ( P < 0.05). Conclusion:Arsenic may inhibit the transcription of NER related genes by increasing the enrichment level of H3K9me2 in the promoter regions (CHIP1 and CHIP2) of NER related genes, thereby reduce the DNA damage repair ability of L-02 cells, resulting in the aggravation of DNA damage.

5.
Article in Chinese | WPRIM | ID: wpr-882657

ABSTRACT

Objective:To analyze the clinical characteristics of acute drug poisoning, and provide better management for poisoned patients in Emergency Department.Methods:We retrospectively enrolled 197 patients diagnosed as acute drug poisoning in Emergency Department of Beijing Chaoyang Hospital from January 1, 2019 to December 31, 2019. Medical records included age, gender, baseline diseases, medication time, visit time, kinds of drugs, drug concentrations, accompanying symptom, hospitalization duration, treatment, fluid resuscitation and outcomes. The inclusion criteria were as follows: age≥ 14 years old, and met the criteria of acute poisoning. The exclusion criteria were as follows: age<14 years old; incomplete clinical data; pesticide poisoning; toxic gas poisoning; and other non-drug poisoning. All patients were divided into the survival group and death group according to their outcomes at the discharge. Clinical characteristics, laboratory parameters and treatments were compared using the Student’s t test, Mann-Whitney U test, as appropriate. Results:The mean age of all the patients was 38.9±20.4 years. The majority were young patients, accounting for 134 cases (68.0%). The accompanying symptoms included consciousness disturbance (106 cases), dizziness (56 cases), fatigue (38 cases), and nausea and/or vomiting (42 cases). The duration of medication-to-visit time was 0.5-96 h, with an average of 7.17±0.89 h. The types of drugs included 105 (53.2%) sedatives and hypnotics, 73 antipsychotics (37.1%), 17 antibiotics (8.6%), and 20 antipyretic analgesics (10.2%). The Glasgow comascale (GCS) score of patients in the survival group was higher than that of the death group (12.47±3.05 vs 7.60±4.43, P<0.01). In the death group, the alanine aminotransferase, urea nitrogen, creatinine, cardiac troponin I, prothrombin time, activated partial thromboplastin time, plasma fibrinogen and D-dimer were higher than those of the survival group (all P<0.05). One hundred and eighty-seven patients were cured, while 10 patients died. One hundred and fifty-nine patients were treated with gastric lavage, and 23 patients were treated with blood purification. The concentrations of toxic drugs before and after treatment in 134 poisoned patients were compared. The concentration of drugs after treatment was significantly lower than that before treatment. Conclusions:Acute non-pesticide poisoning in Emergency Department is mainly caused by sedatives, hypnotics, antipsychotics, and antipyretics and analgesics. It is important to conduct laboratory examinations for toxic medications to provide better management for poisoned patients. It is necessary to establish a standardized monitoring system and management path for acute drug poisoning.

6.
Article in Chinese | WPRIM | ID: wpr-881488

ABSTRACT

Objective:To analyze the first suspected dengue fever case in Dapeng New District by characterizing the virus and exploring its origin. Methods:Dengue virus nucleic acid in blood sample was identified by real-time fluorescent RT-PCR. The E gene of dengue virus was amplified and sequenced. Homology and phylogenetic tree of this dengue virus were compared with the isolates from other regions. Results:Nucleic acid of dengue virus type 1 was detected in the serum sample from the suspected dengue fever patient. Phylogenetic tree showed that the homology based on nucleotide sequence of E gene of DP-DGR19001 was very similar with the isolates of MG894965/TW/CHN/2016 (99.87%), LC428079/VNM/2017(99.80%), MG894867/TW/CHN/2015 (99.60%) and MN512242/GX/CHN/2014 (99.46%). The deduced amino acid sequence of 5 isolates was 100% identical. The patient had traveled to high-incidence country Cambodia in 14 days before infection. Conclusions:The first suspected dengue fever case in Dapeng New District is caused by dengue virus type 1. The case is an imported dengue fever .

7.
Article in Chinese | WPRIM | ID: wpr-881385

ABSTRACT

@#Non-coding RNA (ncRNA) is a type of RNA that has no or limited protein-coding ability. It mainly includes microRNA (miRNA), long non-coding RNA (lncRNA), circular RNA (circRNA), transfer RNA (tRNA), PIWI-interacting RNA (piRNA), and small nucleolar RNA (snoRNA).At present, research has found that ncRNA plays a central role in regulating the function of pancreatic β cells, and that defects of insulin signaling is an important cause of diabetes.This article reviews the relationship between ncRNA and insulin signaling pathway in recent years, and discusses the possibility of ncRNA as a potential therapeutic target and clinical diagnostic marker for diabetes, hoping to provide some reference for the treatment and diagnosis of diabetes.

8.
Chinese Journal of Lung Cancer ; (12): 299-304, 2021.
Article in Chinese | WPRIM | ID: wpr-880271

ABSTRACT

BACKGROUND@#Bronchopleural fistula (BPF) is one of the most serious and rare postoperative complications, especially the bronchial stump fistula after lobectomy/pneumonectomy. Common treatment options include conservative medical treatment combined with surgery. However, due to the delayed healing of the fistula, the chest cavity continues to communicate with the outside world, and the patient is prone to complicated with severe thoracic infection and respiratory failure, so that the physical condition can hardly tolerate the second surgical procedure. Endoscopic treatment provides a new option for the treatment of this complication.@*METHODS@#A case of right pulmonary squamous cell carcinoma was admitted to the Department of Thoracic Surgery II, Peking University Cancer Hospital in June 2016. The diagnosis and treatment was retrospectively analyzed, and the literature was reviewed.@*RESULTS@#A 65 year old male patient was admitted to hospital because of "cough with blood in sputum for 3 months". Chest computed tomography (CT) showed soft tissue density mass shadow in the right lower lobe. A tumor could be seen in the opening of the right middle lobe and basal segment of lower lobe. Biopsy confirmed squamous cell carcinoma. Diagnosis consideration: squamous cell carcinoma of the middle and lower lobe of the right lung (cT2aN2, IIIa). Patients received gemcitabine plus cisplatin neoadjuvant chemotherapy for 2 cycles, and the effect of chemotherapy showed stable disease (SD). Four weeks after chemotherapy, the patient underwent video-assisted thoracic surgery (VATS) assisted right middle and lower lobectomy and mediastinal lymph node dissection. On the 5th day after operation, the patient developed acute respiratory distress syndrome (ARDS) and was transferred to intensive care unit (ICU) again after endotracheal intubation. On the 7th day after operation, the patient developed a right intermediate trunk bronchial stump fistula, but due to ARDS, the patient's physical condition could not tolerate the second operation. Under the support of extracorporeal membrane oxygenation (ECMO), a membrane covered, expandable, hinged stent was inserted into the intermediate trunk bronchial stump through rigid bronchoscope, and was successfully blocked. Due to no improvement in ARDS and irreversible pulmonary interstitial fibrosis, the patient received double lung transplantation successfully after systemic anti-infection treatment.@*CONCLUSIONS@#Endoscopic implantation of covered stent is a simple, safe and effective method for closure of bronchial stump fistula. When the patient's clinical situation is not suitable for immediate surgery, endoscopic stent implantation can be used as a preferred treatment method to create opportunities for follow-up treatment.

9.
Chinese Journal of Lung Cancer ; (12): 141-160, 2021.
Article in Chinese | WPRIM | ID: wpr-880252

ABSTRACT

BACKGROUND@#Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE).@*METHODS@#This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE.@*RESULTS@#This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively.@*CONCLUSIONS@#Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

10.
Article in Chinese | WPRIM | ID: wpr-880132

ABSTRACT

OBJECTIVE@#To analysis the relationship between different BMI (body mass index) and the clinical characteristics, laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia (AML), so as to investigate the effects of BMI to the efficacy of first induction chemotherapy.@*METHODS@#The clinical data of 145 newly diagnosed adult AML patients treated in the First Hospital of Lanzhou University from August 2015 to August 2019 were retrospective analyzed. According to the guidelines for prevention and control of overweight and obesity in Chinese adults, the BMI (kg/m@*RESULTS@#Among the 145 newly diagnosed adult AML patients, there were 71 males and 74 females. The median age was 50 years old(range 18 to 82 years old). There were 21 patients in underweight group (14.5%), 79 patients in normal weight group (54.5%), and 45 patients in overweight and obese group (31.0%). The patients with higher BMI level showed the older in age(P=0.018). There were significant differences in sex between the patients in each group(P=0.035). In overweight and obese patients, the number of male was significantly higher than female. There were no statistical differences in AML classification, comorbidities(Diabetes, hypertension, coronary heart disease), hospital days, whether secondary AML and FLT3 gene mutation among the patients in different BMI groups. There were significant differences in TG of the patients in the different groups, the overweight and obese patients were higher (P=0.007). There were no significant differences in WBC and Hb counts, ALB, TC, HDL, LDL, or LDH between the patients in each BMI group at newly diagnosed. The complete remission rate of the patients in the low body mass group or overweight and obese group were lower than that in the normal body weight group (P=0.035). The rate of documented infection during the first induction chemotherapy were significantly higher for the patients in low body mass group than those in normal weight group or overweight and obese group (P=0.038). There was no statistical difference in chemotherapy regimens, the number of chemotherapy until CR, febrile neutropenia, bleeding, and the time of neutropenia, liver and kidney toxicity among each BMI group. Multivariate analysis showed that overweight and obese (P=0.012) , FLT3 mutation (P=0.015) were the risk factors affecting the CR rate of the patients. And the patients with secondary AML, high-risk type, and newly diagnosed WBC ≥50×10@*CONCLUSION@#In newly diagnosed adult patients with AML, low body mass, overweight and obesity, and FLT3 mutations were the factors reducing the early efficacy of AML patients. There were more adverse reactions induced by chemotherapy in the low body mass group. Therefore, inappropriate BMI level can be a risk factor for assessing the prognosis of adults with newly diagnosed AML.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Cytarabine/therapeutic use , Female , Humans , Induction Chemotherapy , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Prognosis , Retrospective Studies , Young Adult
11.
Article in Chinese | WPRIM | ID: wpr-880099

ABSTRACT

OBJECTIVE@#To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma.@*METHODS@#36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis.@*RESULTS@#The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis.@*CONCLUSION@#The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , B-Lymphocytes , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, Non-Hodgkin/therapy , Retrospective Studies , Transplantation Conditioning , Transplantation, Autologous , Treatment Outcome
12.
Asian Journal of Andrology ; (6): 300-305, 2021.
Article in English | WPRIM | ID: wpr-879751

ABSTRACT

We performed this study to investigate the diagnostic performance of prostate-specific antigen density (PSAD) in a multicenter cohort of the Chinese Prostate Cancer Consortium. Outpatients with prostate-specific antigen (PSA) levels ≥4.0 ng ml

13.
Article in Chinese | WPRIM | ID: wpr-878726

ABSTRACT

Objective To explore the effect of dexmedetomidine(Dex)on sevoflurane-induced cognitive impairment in neonatal rats through Wnt signaling pathway. Methods Sixty 7-day-old SD rats were assigned into five groups:control group(without any intervention),Dex group(intraperitoneal injection of 25 μg/kg Dex),sevoflurane group(3% sevoflurane treatment for 4 hours),sevoflurane+Dex group(inhalation of 3% sevoflurane after injection of 25 μg/kg Dex for 4 hours),and sevoflurane+Dex+Wnt inhibitor group(Wnt inhibitor XAV393 and 25 μg/kg Dex were injected and 3% sevoflurane was inhaled for 4 hours).Three weeks later,Morris water maze was used to detect the cognitive function;TdT-mediated dUTP nick end labeling(TUNEL)staining was performed to detect the apoptosis of hippocampal neurons;neuronal nuclei (NeuN) staining was conducted to detect the survival of hippocampal neurons;Western blot was carried out to detect the expression of apoptosis-related proteins.The expression of the factors involved in Wnt/GSK-3β/β-catenin signaling pathway was detected by fluorescence quantitative polymerase chain reaction,and Western blot. Results Compared with the control group,there was no significant difference in the escape latency of Dex group(t=0.304,P=0.768);the escape latency in sevoflurane group(t=5.823,P=0.002),sevoflurane+Dex group(t=3.188,P=0.010),and sevoflurane+Dex+Wnt inhibitor group(t=5.784,P=0.002)was significantly prolonged.Compared with that in the sevoflurane group,the escape latency in sevoflurane+Dex group(t=3.646,P=0.005)was significantly shortened.Compared with that in sevoflurane+Dex group,the escape latency in sevoflurane+Dex+Wnt inhibitor group(t=3.296,P=0.008)was prolonged.Compared with that in the control group,the times of crossing platform in sevoflurane group(t=5.179, P=0.004),sevoflurane+Dex group(t=2.309,P=0.043),and sevoflurane+Dex+Wnt inhibitor group(t=3.871, P=0.003)decreased.Compared with that in sevoflurane group,the times of crossing platform in sevoflurane+Dex group(t=3.296,P=0.008)significantly increased.Compared with that in sevoflurane+Dex group,the times of crossing platform in sevoflurane+Dex+Wnt inhibitor group(t=2.361, P=0.041)reduced.Compared with the control group,there was no significant difference in the number of apoptotic cells in Dex group(t=1.920,P=0.127),and the number of apoptotic cells in sevoflurane group,sevoflurane+Dex group,and sevoflurane+Dex+Wnt inhibitor group increased by 16%(t=13.436,P=0.002),5%(t=7.752, P=0.001),and 11.5%(t=12.612,P=0.002),respectively.Compared with that in the sevoflurane group,the number of apoptotic cells in sevoflurane+Dex group and sevoflurane+Dex+Wnt inhibitor group decreased by 11%(t=8.521,P=0.002)and 5.5%(t=3.123,P=0.036),respectively.Compared with that in the sevoflurane+Dex group,the number of apoptotic cells in sevoflurane+Dex+Wnt inhibitor group increased by 6.5%(t=6.250,P=0.003).Compared with that in the control group,the number of positive cells in 0.15 mm


Subject(s)
Animals , Animals, Newborn , Cognitive Dysfunction/chemically induced , Dexmedetomidine/pharmacology , Glycogen Synthase Kinase 3 beta , Rats , Rats, Sprague-Dawley , Sevoflurane/toxicity , Wnt Signaling Pathway , beta Catenin/metabolism
14.
Acta Physiologica Sinica ; (6): 286-294, 2021.
Article in Chinese | WPRIM | ID: wpr-878257

ABSTRACT

Many studies have shown that high-altitude exposure could significantly influence human cognition, and the approaches which could enhance the human cognition in high-altitude hypoxia environment attract great attention. In the present study, we recruited a total of 60 subjects who had been migrated to Tibet University as adults for more than one year. These participants were randomly divided into the experimental group and the control group. The participants in the experimental group were instructed to complete a hyperbaric oxygen treatment, and those in the control group just completed a wait condition. By using the attention network test (ANT), the changes of the attention function before and after a single session of hyperbaric oxygen treatment were explored. The results showed that single hyperbaric oxygen treatment significantly improved the orienting function of attention, with an obvious post-intervention effect, but not the alerting and conflict function of attention. We also found a strong association between alerting function and conflict function after the end of intervention, suggesting the change of the overall performance of attention function. The present findings might suggest that the improvement of attention function by a single session of hyperbaric oxygen intervention is derived from the increase of general cognitive resources, rather than the transfer of cognitive resources within the attention system.


Subject(s)
Adult , Humans , Hyperbaric Oxygenation , Orientation , Oxygen , Reaction Time , Tibet , Transients and Migrants
15.
Chinese Journal of Geriatrics ; (12): 842-846, 2021.
Article in Chinese | WPRIM | ID: wpr-910926

ABSTRACT

Objective:To investigate whether peritoneal dialysis can replace hemodialysis as an option for urgent-start dialysis for elderly patients with end-stage renal disease who need emergency initial dialysis.Methods:This was a retrospective cohort study, with enrolment of patients ≥65 years with end-stage renal disease who started hemodialysis or peritoneal dialysis for the first time at the nephrology department of our hospital between January 1, 2013 and June 1, 2019 and were followed up regularly.All patients started dialysis within 5 days of catheterization.According to different dialysis methods, patients were divided into the urgent-start hemodialysis(USHD)group and the urgent-start peritoneal dialysis(USPD)group, and were followed up until December 31, 2019.Short-term(30 days after the procedure)dialysis-related complications and survival were compared between the two groups.Results:A total of 89 elderly patients with end-stage renal disease receiving urgent-start dialysis were included, with 40 cases in the USPD group and 49 cases in the USHD group.There was no significant difference in the incidences of infection-related complications(0.0% vs.2.5%), non-infection-related complications(2.0% vs.2.5%), re-catheterization(0 vs.0)and bacteremia(0 vs.0)between the two groups( P> 0.05). The Kaplan-Meier survival curve showed that the median survival times of patients with USHD and with USPD were 63.0 months and 38.0 months, respectively, with no statistical significance(Log Rank, χ2=0.025, P=0.88). The Charlson comorbidity index( HR: 1.205, 95% CI: 1.026-1.415, P=0.023)and albumin level( HR: 0.949, 95% CI: 0.903-0.997, P=0.037)were independent risk factors for the survival and prognosis of elderly patients with urgent-start dialysis.Furthermore, we stratified and made an interactive analysis of the albumin level and the comorbidity index of elderly patients with urgent-start dialysis and found that there was no significant difference between the two modes of dialysis in the survival rate of elderly patients with end-stage renal disease( P>0.05). Conclusions:It is safe and effective to start dialysis within 5 days after peritoneal dialysis catheterization.For elderly patients with end-stage renal disease, peritoneal dialysis can replace hemodialysis as an option for urgent-start dialysis.

16.
Article in Chinese | WPRIM | ID: wpr-906392

ABSTRACT

Objective:To explore the effect of Gandou Fumu decoction (GDFMD) on the oxidative damage of HepG2 cells induced by CuCl<sub>2 </sub>based on the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway. Method:CuCl<sub>2</sub> (200 μmol·L<sup>-1</sup>) was used to induce a copper-loaded HepG2 cell model. HepG2 cells were divided into a blank group (HepG2 cells + blank rat serum), a model group (HepG2 cells + CuCl<sub>2</sub> + normal rat serum), a GDFMD group (HepG2 cells + CuCl<sub>2</sub> + GDFMD-medicated rat serum), an inhibitor group (HepG2 cells + NVP-BEZ235 + normal rat serum), and a GDFMD + NVP-BEZ235 group (HepG2 cells + NVP-BEZ235 + GDFMD-medicated rat serum). ELISA method was used to determine superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, and malondialdehyde (MDA) content. The expression of microtubule-associated protein 1 light chain 3 (LC3) was detected by immunofluorescence. Phospho-PI3K/PI3K (p-PI3K/PI3K), p-Akt/Akt, p-mTOR/mTOR, Beclin-1, LC3Ⅱ/LC3Ⅰ, and p62/Actin were determined by Western blot. PI3K, Akt, mTOR, Beclin-1, LC3Ⅰ, LC3Ⅱ, p62 mRNA expression was measured by real-time polymerase chain reaction (PCR). Result:Compared with the blank group, the model group displayed decreased activities of SOD and GSH-Px and increased content of MDA (<italic>P</italic><0.01). Compared with the model group, the GDFMD group showed elevated activities of SOD and GSH-Px and reduced content of MDA (<italic>P</italic><0.05, <italic>P</italic><0.01), while the inhibitor group exhibited weakened GSH-Px activity and up-regulated content of MDA (<italic>P</italic><0.05). Compared with the blank group, the model group showed diminished expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, and p62, and increased expression of Beclin-1 and LC3Ⅱ/LC3Ⅰ (<italic>P</italic><0.01). The expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, and p62 was elevated, and the expression of Beclin-1 and LC3Ⅱ/LC3Ⅰ declined in the GDFMD group (<italic>P</italic><0.05,<italic> P<</italic>0.01), while the p-PI3K/PI3K and p-mTOR/mTOR expression was down-regulated and the Beclin-1 and LC3Ⅱ/LC3 I expression was increased in the inhibitor group (<italic>P</italic><0.05, <italic>P<</italic>0.01) as compared with those in the model group. Compared with the GDFMD group, the GDFMD + NVP-BEZ235 group showed down-regulated expression of p-Akt/Akt and p-mTOR/mTOR and up-regulated expression of Beclin-1 and LC3Ⅱ/LC3Ⅰ(<italic>P</italic><0.05, <italic>P</italic><0.01). The expression of LC3Ⅱ protein in the model group was increased (<italic>P</italic><0.01) as compared with that in the blank group. The expression of LC3Ⅱ protein was lower in the GDFMD group than in the model group, and higher in the GDFMD + NVP-BEZ235 group than in the GDFMD group. No significant difference in the expression of PI3K, Akt, and mTOR mRNA was observed among the groups. Compared with the blank group, the model group displayed lowered expression of p62 mRNA, and elevated expression of Beclin-1, LC3Ⅰ, and LC3Ⅱ mRNA (<italic>P</italic><0.01). Compared with the model group, the GDFMD group exhibited increased expression of p62 mRNA, and declining expression of Beclin-1, LC3Ⅰ, and LC3Ⅱ mRNA (<italic>P</italic><0.01), while the inhibitor group showed increased expression of Beclin-1 mRNA (<italic>P</italic><0.05). The expression of Beclin-1 and LC3Ⅱ mRNA in the GDFMD + NVP-BEZ235 group was elevated (<italic>P</italic><0.01) as compared with that in the GDFMD group. Conclusion:GDFMD may inhibit the excessive autophagy and alleviate the oxidative damage of HepG2 cells induced by CuCl<sub>2</sub>, with the underlying mechanism related to the activation of PI3K/Akt/mTOR signalling pathway.

17.
Article in Chinese | WPRIM | ID: wpr-906132

ABSTRACT

With the development of urbanization and the change of lifestyle, people have gradually developed unhealthy living habits, such as high-fat diet and reduced physical activity, which promotes the increasing number of diabetes patients and becomes an escalating public health problem worldwide. Therefore, it is urgent to explore effective measures to prevent and treat diabetes. Recent studies have shown that intestinal flora is closely related to the occurrence and development of diabetes, making it a potential target for the treatment of diabetes. A healthy intestinal environment is an important internal environment for physiological and metabolic activities of the human body. Intestinal flora homeostasis is accompanied by physiological metabolic disorders of the body, such as induced metabolic endotoxemia, bile acid metabolism disorders and reduced production of short chain fatty acid (SCFA), which leads to low-grade chronic inflammation and insulin resistance in the body that are important pathological processes of diabetes. Traditional Chinese medicine (TCM) has been used in the treatment of diabetes, with a remarkable curative effect. At present, there are extensive studies on the active ingredients of TCM and the compound of TCM for regulating structure of intestinal flora and improving symptoms of diabetes. A large number of studies have shown a dynamic two-way relationship between TCM and intestinal flora. Specifically, intestinal flora can transform TCM into polyphenols, alkaloids, saponins and other active substances with a pharmacological effect, in turn, these active ingredients can reverse the imbalance of intestinal microecology, and the recovery of intestinal flora imbalance can improve the symptoms of diabetes. It can be seen that intestinal flora is a bridge for TCM treatment of diabetes, which may be one of the mechanisms of TCM treatment of diabetes. This paper reviews the active ingredients of TCM and the compound of TCM in the treatment of diabetes, in order to provide reference for the exploration of prevention and treatment of diabetes.

18.
Journal of Clinical Hepatology ; (12): 2429-2434, 2021.
Article in Chinese | WPRIM | ID: wpr-904964

ABSTRACT

Liver fibrosis is the initial stage of the development of various chronic liver diseases into liver cirrhosis and is a reversible process. As a subset of extracellular vesicles that can carry active substances such as proteins, lipids, and RNA, exosomes are involved in intercellular signal communication and have attracted more and more attention in recent years. Studies have shown that non-coding RNAs in exosomes play an important role in the development and progression of liver fibrosis. This article discusses the mechanism of action of exosome long non- coding RNAs (including MALAT1, H19, GAS5, MEG3, PVT1, and P21), exosome short non-coding RNAs (including micro-RNA, small nucleolus RNA, PIWI-interacting RNA, and small interference RNA), and exosome circular RNA in the development and progression of liver fibrosis, and it is concluded that exosomes from different sources (such as hepatocytes and cholangiocytes) carrying non-coding RNAs mainly affect the activation, proliferation, migration, and transformation of hepatic stellate cells. In-depth studies of exosome non-coding RNAs in the future are expected to find potential new targets for the treatment of liver fibrosis.

19.
Journal of Clinical Hepatology ; (12): 2429-2434, 2021.
Article in Chinese | WPRIM | ID: wpr-904914

ABSTRACT

Liver fibrosis is the initial stage of the development of various chronic liver diseases into liver cirrhosis and is a reversible process. As a subset of extracellular vesicles that can carry active substances such as proteins, lipids, and RNA, exosomes are involved in intercellular signal communication and have attracted more and more attention in recent years. Studies have shown that non-coding RNAs in exosomes play an important role in the development and progression of liver fibrosis. This article discusses the mechanism of action of exosome long non- coding RNAs (including MALAT1, H19, GAS5, MEG3, PVT1, and P21), exosome short non-coding RNAs (including micro-RNA, small nucleolus RNA, PIWI-interacting RNA, and small interference RNA), and exosome circular RNA in the development and progression of liver fibrosis, and it is concluded that exosomes from different sources (such as hepatocytes and cholangiocytes) carrying non-coding RNAs mainly affect the activation, proliferation, migration, and transformation of hepatic stellate cells. In-depth studies of exosome non-coding RNAs in the future are expected to find potential new targets for the treatment of liver fibrosis.

20.
Asian Journal of Andrology ; (6): 415-420, 2021.
Article in English | WPRIM | ID: wpr-888428

ABSTRACT

To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0-10.0 ng ml

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