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1.
China Pharmacy ; (12): 209-216, 2022.
Article in Chinese | WPRIM | ID: wpr-913113

ABSTRACT

OBJECT IVE To evaluate the efficacy ,safety and cost-effectiveness of Qili qiangxin capsule in the treatment of chronic heart failure ,and provide reference for drug selection and evaluation in relevant institutions. METHODS Meta-analysis was performed to investigate clinical efficacy and safety of Qili qiangxin capsule combined with routine treatment (combined treatment group)versus routine treatment (routine treatment group )in the treatment of chronic heart failure. From the perspective of Chinese health care system ,a decision tree model was constructed. The time horizon of the model was 1 year. The effective rate obtained by meta-analysis was taken as the effect parameter ,and the total cost was calculated by drug cost and hospitalization cost ,to evaluate the cost-effectiveness of combined treatment versus routine treatment in the treatment of chronic heart failure. Subgroup analysis was carried out according to the course of treatment and literature quality ,and one-way sensitivity analysis and probability sensitivity analysis were adopted to check the robustness of basic analysis results. RESULTS Total of 72 literatures involving 9 575 patients were included in meta-analysis. Results of meta-analysis showed that effective rate ,left ventricular ejection fraction , N-terminal fragment of the prohomone brain-type natriuretic peptide and 6 minute walking distance in combined treatment group were all better than those of routine treatment group , while its safety was similar to routine therapy. The results of cost-effectiveness analysis showed that the cost of combined therapy was 1 867 yuan higher than that of routine therapy ,patients could get 0.016 QALYs more ,and the incremental cost-effectiveness ratio (ICER)was 117 861 yuan/QALY. If only high-quality literature were included for meta-analysis and the effectiveness parameters were obtained ,the ICERs of the combined therapy versus routine therapy were 102 162 yuan/QALY(based on all high-quality literature )and 72 354 yuan/QALY(based on high-quality literature with treatment course of 24 weeks). The results of the probability sensitivity analysis showed that taking twice China ’s per capita gross domestic product in 2020 as the willingness to pay threshold ,the probability of cost-effectiveness for Qili qiangxin capsule combined with routine therapy was 67.1% . CONCLUSIONS Compared with routine therapy ,Qili qiangxin capsule combined with routine therapy has better clinical efficacy ,equivalent safety and cost-effective.

2.
China Pharmacy ; (12): 133-138, 2021.
Article in Chinese | WPRIM | ID: wpr-862633

ABSTRACT

OBJECTIVE:To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS :The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ,some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS :Since 1994,the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ,the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act(BPCA)and Pediatric Research Equality Act (PREA). From 1998 to 2019,the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020,854 kinds of drugs had been modified in pediatric instructions ,792 of which had been carried out post marketing pediatric clinical research ,and the problem of incomplete pediatric instructions had also been greatly improved. At present ,China’s policies on pediatric drugs mainly included encouraging R&D innovation ,giving priority to review and approval ,and strengthening R&D technical guidance. Although certain achievements had been made ,there were still some problems ,such as imperfect policies and regulations ,and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ,pediatric research and the catalogue of pediatric drugs ,and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ,so as to improve the effectiveness ,safety and accessibilityof pediatric drugs.

3.
Article in Chinese | WPRIM | ID: wpr-912732

ABSTRACT

With the full implementation of the separation policy of medicine in China, the circulation of drugs in hospitals no longer produces direct economic value, but turns into the operating cost in the process of providing medical services. The research on the cost calculation of hospital pharmaceutical service can not only help the hospital to strengthen the internal cost management, but also provide the basis for the government policy compensation. This paper constructed a model of pharmaceutical service cost calculation based on job analysis, and produced basic pharmaceutical and advanced pharmaceutical service cost based on the data of a sample hospital.

4.
Article in Chinese | WPRIM | ID: wpr-872229

ABSTRACT

By comparing the proportion of hospital pharmaceutical functions and work contents of different levels of pharmaceutical professionals at home and abroad, the authors divided pharmaceutical care in medical institutions into basic pharmaceutical care based on drug management and advanced pharmaceutical care based on drug treatment. Different pharmaceutical service levels created different pharmaceutical service values. Pharmaceutical classification service can stimulate the work potential of pharmaceutical professionals at all levels, improve the service level of pharmacists, and provide basis for the better distribution of medical costs in China.

5.
Article in Chinese | WPRIM | ID: wpr-863810

ABSTRACT

Objective:To analyze the causes of SARS-CoV-2 nosocomial infection among healthcare workers (HCWs) and explore the effective precaution strategies in Emergency Center.Methods:The data of SARS-CoV-2 infected HCWs from January 5 to March 2, 2020 were retrospectively analyzed and compared under different conditions in Emergency Center of Zhongnan Hospital of Wuhan University.Results:Totally 13 SARS-CoV-2 infected HCWs (12 confirmed cases and 1 suspected case) were included in this study. The overall infection rate was 17.8% (13/73). The infection rates in outpatient/rescue room, isolation observation room and isolationin patient ward were 11.8% (4/34), 20.0% (3/15), 25% (6/24), respectively. The infection rate of physician was 13.0% (3/23), and the infection rate of nurse was 20.0% (10/50). All the infected HCWs had the definite exposure with confirmed or suspected COVID-19 patients. One asymptomatic cases were identified by laboratory findings of SARS-CoV-2 infection screening. There was no new confirmed SARS-CoV-2 infected HCWs after February 5, 2020. All the infected HCWs were cured.Conclusions:Under the epidemic of COVID-19, HCWs of Emergency Center have a high risk of occupational exposure and infection, especially for staffs working in COVID-19 isolation units. Scientific prevention and control management can effectively reduce the risk of SARS-CoV-2 infections and ensure the occupational safety for HCWs in Emergency Center.

6.
Article in Chinese | WPRIM | ID: wpr-828878

ABSTRACT

OBJECTIVE@#To prepare the recombinant peptide MVF-HER3 I composed of the 183-227aa peptide segment of human epidermal growth factor receptor 3 (HER3 I) and the measles virus protein 288-302 peptide segment (MVF), and prepare polyclonal antibodies (PcAb) against this recombinant peptide.@*METHODS@#The MVF-HER3 I gene was synthesized chemically and subcloned into pET21b or pET32a plasmid containing Thioredoxin (Trx) tag gene. The recombinant plasmids were identified by endonuclease digestion. MVF-HER3 I was expressed in BL21(DE3) cells under an optimal bacterial expression condition. The fusion protein Trx-MVF-HER3 I was purified using nickel ion affinity chromatography, and the purified protein was digested by enterokinase to remove Trx tag. The digested mixture underwent further nickel ion affinity chromatography to obtain purified MVF-HER3 I. The purified MVF-HER3 I was used to immunize SD rats subcutaneously for preparing anti-MVF-HER3 I PcAb. The titer of PcAb was determined using ELISA. The bindings of anti-MVF-HER3 I PcAb to MVF-HER3 I, native HER3 and MCF7 cells were analyzed using immunoblotting, immunoprecipitation and laser confocal microscopy. The growth inhibition effect of the antibodies on MCF7 cells cultured in the absence or presence of NRG was assessed using sulforhodamine B.@*RESULTS@#The recombinant peptide gene could not be expressed alone, but could be efficiently expressed after fusion with Trx gene under optimized conditions. The fusion peptide MVF-HER3 I was successfully prepared from Trx-MVF-HER3 I. The anti-MVF-HER3 I PcAb, with a titer reaching 1: 512 000, specifically bound to MVF-HER3 I, recognized native HER3 and bound to the membrane of MCF7 cells. The obtained PcAb could dose-dependently inhibit the growth of MCF7 cells irrespective of the presence or absence of NRG.@*CONCLUSIONS@#We successfully obtained the recombinant peptide MVF-HER3 I and prepared its PcAb, which can facilitate further functional analysis of HER3 signaling pathway.


Subject(s)
Animals , Antibodies , Enzyme-Linked Immunosorbent Assay , Escherichia coli , Humans , Plasmids , Rats , Rats, Sprague-Dawley , Receptor, ErbB-3 , Allergy and Immunology , Recombinant Fusion Proteins
7.
China Pharmacy ; (12): 1239-1246, 2020.
Article in Chinese | WPRIM | ID: wpr-821614

ABSTRACT

OBJECTIVE:To provide reference for improving safe drug use in pregnant women. METHODS :Retrieved from as domestic and foreign literature retrieval platforms as CNKI and Web of Science ,the literatures about drug use in pregnancy period were collected and analyzed by using the literature analysis function provided by the retrieval platform and CiteSpace 5.5R2 software. The collected data of annual volume ,author,organization,keyword co-occurrence and literature co-citation analysis of domestic and foreign literatures are visualized ,and the research focus was analyzed. RESULTS :A total of 38 946 foreign literatures and 698 domestic literatures were included ,and domestic literatures were less than foreign literatures ;the literature volume on pregnancy drug use were increasing year by year at abroad,but the volume of domestic literatures fluctuates greatly and increased slowly. Foreign institutions and scholars worked closely together ,and built a close cooperation network ,especially in the United States. However ,the author team of domestic research was relatively scattered as a whole ,and the cooperation between researchers was less ,so a large cooperation team had not yet been formed. The most frequently cited literatures in the world were randomized controlled studies and large-scale cohort studies,the keyword “Risk”appears most frequently ,indicating that it focuses on the effects of pregnancy medication on pregnancy outcomes and offspring. The effects of antiepileptic drugs ,antidepressants and opioids used in pregnancy on pregnancy outcomes and child development were currently a research hotspot abroad. However ,there was a lack of large-scale sample and high-quality clinical research in China ,high-frequently keywords in domestic literatures indude “fetus”“hypertension in pregnancy ”etc.,which focused on the treatment of combined diseases in pregnancy and paid little attention to the long-term effects of medication in pregnancy. CONCLUSIONS:More and more attention had been paid to the study of drug use in pregnancy period. Domestic research needs to seize the international cooperation communication ,learns from the excellent experience of foreign research team ,and establishes domestic specific pregnancy medication research team. Relevant departments should introduce measures as soon as possible ,support medical institutions and drug production and developmententerprises to do a good job in the registration of pregnancy medication,establish the database of pregnancy medication inChina as soon as possible ,and improve the medication safety of pregnant patients.

8.
China Pharmacy ; (12): 989-996, 2020.
Article in Chinese | WPRIM | ID: wpr-820850

ABSTRACT

OBJECTIVE:To provide reference for the early diagnosis and selection of treatment regimens of pregnancy- associated breast cancer (PABC). METHODS :The disease characteristics ,treatment process and prognosis of 2 cases of PABC were analyzed in our hospital. The relevant literature published from Jan. 1986 to Apr. 2019 in PubMed database was retrieved. The case reports that the title ,keywords or abstracts involved “Breast cancer and pregnancy ”“Pregnancy-associated breast cancer ” “Breast cancer during pregnancy ”“Breast carcinoma during pregnancy ”“Case reports ”were included. Cases which didn ’t meet the definition of PABC were excluded. The general information ,tumor clinical characteristics ,drug treatment plan ,maternal/fetal prognosis and other information of patients were extracted for summary and descriptive statistical analysis. RESULTS & CONCLUSIONS:Two patients were both diagnosed during lactation. The prognosis was good after neoadjuvant chemotherapy and surgical resection. A total of 36 case reports were obtained through literature search and screening ,as well asclinical data of 45 patients(39 diagnosed during pregnancy and 6 diagnosed during lactation ).Neoadjuvant chemotherapy AC regimen (doxorubicin+ cyclophosphamide)was used in 35.0%(14/40)of cases after excluding the cases without relevant information ;elective caesarean section was performed in 59.5%(22/37)of cases ,37.8%(14/37)of cases were delivered ,and 1 case chose to terminate pregnancy;survival rate of patients was 80.8%(21/26),and the average weight of newborns was 2 407 g(1 015-3 830 g). Six patients each received taxanes during pregnancy and 9 patients during postpartum. The determination of chemotherapy for PABC should comprehensively consider a variety of factors. It is necessary to comprehensively weigh the benefit risks of the mother and child,try to avoid chemotherapy in early pregnancy ,and especially consider the impact of chemotherapy on the fetus. The chemotherapy regimen is still dominated by anthracyclines. Based on this ,an individualized regimen is formulated and close monitoring should be performed when using paclitaxel.

9.
China Pharmacy ; (12): 433-438, 2019.
Article in Chinese | WPRIM | ID: wpr-817082

ABSTRACT

OBJECTIVE: To investigate the research status,hotspots and frontiers of the artificial intelligence (AI) technology  applicated in pharmaceutical field, and to provide ideas for the development of related research in China. METHODS: Using bibliometric method, relevant journals and proceeding papers from 1998 to 2017 were searched from Web of Science database (“Article” and “Proceeding Paper” as retrieval words). Using analysis and retrieval results of ISI Web of Knowledge and its function of creating citation report, CiteSpace 5.2.R1 software was employed to draw knowledge map; quantitative statistics and qualitative analysis was conducted to summarized the research volume, co-citation, main research countries/areas, main research  institutions, main researchers, research hotspots and research frontiers in this field. RESULTS: A total of 3 674 related literatures were retrieved, and the number of global published literatures in this field increased rapidly from 1998 to 2017; the dominant nations included America, China, Britain and Germany because of their large number of publications,but China showd an obvious lack of international cooperation and excellent core teams. From the researcher’s point of view, the research in this field was in a state of “partially concentrated and overall dispersed” and lacked team cooperation. The research hotspots contained important core of AI technology (machine learning algorithms) and its application in pharmaceutical field (drug discovery and design), the classification of disease or adverse drug reaction, the establishment and optimization of pharmaceutical mode, drugs screening or pharmacodynamics prediction, the estbalishment of pharmaceutical database, etc. The recent research frontiers included “molecular docking” “machine learning” “Meta analysis” “precision medicine” “targeted therapy”, etc. CONCLUSIONS: AI applicated in pharmaceutical field is a hot research field with strong timeliness, and its application in the development of pharmaceutical industry is the general trend. However, there is still a gap between the current research level in this field in China and the international frontier research. In order to adapt to the international trend of the combination of AI technology and pharmacy, pharmacists in China should strengthen their cooperation with researchers in AI fields while doing well the basic work of experimental research and clinical trials,etc.

10.
China Pharmacy ; (12): 1158-1164, 2019.
Article in Chinese | WPRIM | ID: wpr-816956

ABSTRACT

OBJECTIVE: To provide reference for the revision of China National Formulary for Children and make a sample for Chinese medical institutions to formulate their own formulary. METHODS: The suggestions on formulary revision and the formulation of formulary in medical institutions were put forward through comparing the selection principle, catalogues, chapters, drug items, formulary quantity and coincident drugs of World Health Organization (WHO) Model Formulary for Children (2010 edition) (WMFc), British National Formulary (Children edition) (2016-2017 edition) (BNFc), Chinese National Formulary (Children edition) (2013 edition) (CNFc). RESULTS & CONCLUSIONS: The selection principle of WMFc was safe, effective and economical; that of BNFc was accurate and up-to-date, that of CNFc was safe, effective, economical and appropriate. The catalogues of three formularies included introduction, outline and separated section, but the contents or descriptions were different. For example, in separated section, WMFc was divided into 27 chapters, BNFc was divided into 16 chapters and CNFc was divided into 20 chapters. The chapters and catalogues of WMFc were classified according to ATC; those of BNFc were classified according to organ system and disease arrangement; those of CNFc were classified according to disease treatment system. 15 chapters of three formularies were the same, such as drug for nervous system diseases, drug for endocrine system and drug for respiratory system. The unique chapter of CNFc was “drugs for stomatological diseases”. The drug items of three formularies included drug name, indications, usage and dosage, contraindication, ADR, matters need attention, preparation and specifications, etc. Compared with CNFc, unique chapters of WMFc included ATC numbering, drug interaction, liver injury, etc.; those of BNFc included pharmacological action, interaction, allergy, etc. WMFc contained 271 drugs, CNFc 847 drugs and BNFc 955 drugs. Among them, there were 166 overlaps between WMFc and CNFc, 359 between BNFc and CNFc, 174 between WMFc and BNFc. There were 141 same drugs in the three formularies. When revising or formulating formulary, our country should not copy them mechanically, but should revise formulary according to our national conditions. It is necessary to refer to selection principles of WMFc and BNFc, update our children’s formulary in certain or real time, standardize drug access criteria of formulary, rationally increase the variety of drug and call on the relevant departments of the state to improve the standards for the formulation of drug instructions for children.

11.
Chinese Journal of Hematology ; (12): 117-124, 2019.
Article in Chinese | WPRIM | ID: wpr-810464

ABSTRACT

Objective@#To compare the efficacy of induction chemotherapy with or without autologous hematopoietic stem cell transplantation (auto-HSCT) for newly diagnosed young diffuse large B cell lymphoma (DLBCL) patients.@*Methods@#The retrospective study was performed in 90 cases of young patients (≤60 years) with newly diagnosed DLBCL and an age-adjusted International Prognostic Index (aa-IPI) score of 2 or 3. All of them were treated with R-CHOP (32 cases, rituximab combined with CHOP), dose-intensive regimens (DA-EPOCH, Hyper CVAD/MA or ESHAP) combined with or without rituximab (25 cases), and consolidated with up-front auto-HSCT (33 cases), respectively. The efficacy and the potential predictors were evaluated.@*Results@#①The median age of 90 patients was 43 (18-60) years old. The median follow-up time was 42 (3-110) months. ②The 5-year progression-free survival (PFS) for R-CHOP group, dose-intensive chemotherapy group and auto-HSCT group were (33.5±10.7) %, (55.3±10.1) % and (65.8±13.6) % (P=0.012), the 5-year overall survival (OS) were (49.7±9.0) %, (61.6±10.2) % and (78.6±7.8) % (P=0.035), respectively. There was no significant difference in 5-years PFS and OS between the R-CHOP group and dose-intensive chemotherapy group (P=0.519, P=0.437) compared with that of the dose-intensive chemotherapy group, auto-HSCT group has higher 5-year PFS (P=0.042). ③ When stratified with IPI score, the high-risk group treated with auto-HSCT (26 cases) showed similar 5-years PFS and 5-years OS to those in the low-risk group with chemotherapy alone (12 cases were in R-CHOP group and 8 cases were in dose-intensive chemotherapy group) [5-years PFS were (62.3 ±14.3)%, (58.3 ±18.6)% and (51.4±18.7)%, respectively, P=0.686; 5-years OS were (69.2±13.9)%, (62.5±15.5)% and (58.3±18.6)%, respectively, P=0.592]. ④However, the high-risk group treated with auto-HSCT (26 cases) showed superior 5-years PFS (P=0.002) and 5-years OS (P=0.019) compared to the high-risk group with chemotherapy alone (20 cases were in R-CHOP group and 17 cases were in dose-intensive chemotherapy group) [5-years PFS were (62.3±14.3)%, (41.1±13.5)% and (21.9±11.6)%, respectively; 5-years OS were (69.2±13.9)%, (51.5%±14.0)% and (35.4±13.6)%, respectively]. ⑤In the univariate analysis, as a whole, patients diagnosed with GCB subtype had higher 3-years PFS (P=0.022) and 3-years OS (P=0.037) compared to non-GCB subtype patients; in subgroup analysis, patients diagnosed with GCB subtype had higher 3-years PFS and 3-years OS compared to non-GCB subtype both in R-CHOP group (P=0.030, P=0.041) and dose-intensive chemotherapy group (P=0.044, P=0.047), but not in auto-HSCT group (P=0.199, P=0.093). ⑥In the multivariate analysis, different molecular classification (GCB/non-GCB) was an independent predictor for PFS and OS both in R-CHOP group [HR=0.274 (95% CI 0.094-0.800), P=0.018; HR=0.408 (95% CI 0.164-1.015), P=0.045] and dose-intensive chemotherapy group [HR=0.423 (95% CI 0.043-1.152), P=0.048; HR=5.758 (95% CI 0.882-6.592), P=0.035]. However, there was no significant difference in PFS and OS for auto-HSCT group between GCB/non-GCB patients.@*Conclusion@#Induction chemotherapy followed by up-front auto-HSCT has significant effect on efficacy for young and untreated patients with high risk DLBCL. Combined with induction chemotherapy followed by up-front auto-HSCT could improve the prognosis of non-GCB patients.

12.
Article in Chinese | WPRIM | ID: wpr-791732

ABSTRACT

Craniopharyngioma is the most common benign intracranial tumor in children. The major post-operative complication is dysfunction of pituitary, which can result in many complicate clinical manifestations with hormonal deficiencies. Normochromic anemia has been reported as a common hematologic abnormality. However, pancytopenia is rarely reported so far. Here we describe a 21-year-old inpatient with the main complaint of nasal bleeding, who accepted craniopharyngioma surgery 9 years ago. Laboratory tests showed pancytopenia secondary to panhypopituitarism. This paper aims to increasing the awareness of this disease and accumulating clinical experiences for the clinicians.

13.
Article in Chinese | WPRIM | ID: wpr-821254

ABSTRACT

Objective@#To analyze the molecular epidemiological characteristics of Escherichia coli producing NDM-5 carbapenemase in the neonatal department of our hospital. @*Methods@#Three carbapenem-resistant Escherichia coli strains(E1, E2 and E3) isolated from neonatal ward of our hospital from August to September of 2017 were collected. Vitek 2 Compact system combined with K-B disk method was used for drug sensitivity test. The resistance genes were detected by PCR amplification. Plasmid replicon typing was detected by PCR. Plasmid conjugation tests were performed to explore the conjugating transfer of plasmids in the three strains. The homology of the three strains was analyzed by multiple locus sequence typing (MLST) and pulse field gel electrophoresis (PFGE). @*Results@#Drug susceptibility test showed that the three bacteria were resistant to most β-lactam antibiotics except Aztreonam, and resistant to quinolones and SMZ-TMP, but sensitive to aminoglycosides drugs. PCR and sequencing results indicated that the three strains carried bla SHV gene and extended-spectrum beta-lactamase gene (bla SHV , bla TEM and bla CTX-M ). The plasmid replicon type was IncX3. Transfer test of E1 strain was successful. MLST results indicated that all the three strains were ST1642 type. MLST and PFGE results indicated that the bands of the three bacteria were identical. @*Conclusion@#Both NDM-5 carbapenemase and extended-spectrum beta-lactamase were detectable in the three strains of carbapenem-resistant bacteria from neonatal department. MLST and PFGE results suggested that the three strains were from the same clonal source.

14.
Herald of Medicine ; (12): 44-47, 2018.
Article in Chinese | WPRIM | ID: wpr-665254

ABSTRACT

Objective To understand the current research of vancomycin against methicillin-resistant Staphylococcus aureus(MRSA) infection and to reflect major nations' scientific advances and influence in the field. Methods The literatures were searched from Web of Science citation database,using the term of"vancomycin"and"methicillin-resistant staphylococcus aureus"(1997—2016).The results were analyzed by bibliometric method concerning the numbers of literatures and citations. Results A total of 5 049 literatures were recorded in Web of Science.The total number of publications and citations was increased quickly from 1997 to 2016.The major type was journal article,about 84.492%.The most studies were on the aspects of microbiology and pharmacology.USA had the largest numbers of publications,accounting for 42.523% of all related publications. Most institutions were from USA,which had the highest number of publications with the highest quality.China ranked the seventh by the numbers of publications. Conclusion USA plays a leading role in this field and the research in China still lags behind its international peers.

15.
Article in Chinese | WPRIM | ID: wpr-701711

ABSTRACT

Objective To compare the effect of insulin or insulin secretagogues in the treatment of type 2 diabetes mellitus(T2DM) patients complicated with non -alcoholic fatty liver disease (NAFLD).Methods The study population consisted of 438 patients who were diagnosed T 2DM with B ultrasound checking screen fatty livers . According to different always used medications ,the patients were divided into insulin group and insulin secretagogous group.With the help of the B Doppler examination , the incidence rate of NAFLD was compared between the two groups .Further research chose respectively 113 patients from each group ,continued to use insulin for treatment ( group A);group B continued to use insulin secretagogous treatment (group B).After six months,when the patients visited to hospital again ,the impact of the two classes of drugs on the liver fat deposition was observed .Results There were 156 T2DM patients with NAFLD in group A(65.0%) and 131 T2DM patients with NAFLD in group B(66.2%).After six months of treatment ,TC,TG and LDL-C in group A and group B improved compared with before treatment [group A:TC decreased from (5.81 ±1.52)mmol/L to (4.14 ±1.82)mmol/L,t=3.575,P<0.05;TG decreased from (2.91 ±1.32) mmol/L to (2.14 ±1.40) mmol/L,t =0.770,P<0.05;LDL-C decreased from (3.67 ± 1.48)mmol/L to (3.11 ±1.21)mmol/L,t=2.120,P<0.05.Group B:TC decreased from (5.90 ±0.92)mmol/L to (4.37 ±1.22)mmol/L,t=4.016,P<0.05;TG decreased from (2.65 ±0.88)mmol/L to (2.21 ±1.02)mmol/L, t=0.554,P<0.05;LDL-C decreased from (3.91 ±1.38) mmol/L to (3.38 ±1.34) mmol/L,t=0.401,P<0.05].Changes of fatty liver with B ultrasound:the improvement rate was 10.7%in group A and 9.8%in group B, the difference between the two groups was not statistically significant (P>0.05).Conclusion In the T2DM popula-tion who used insulin or insulin secretagogues ,the prevalence of NAFLD is high .Exogenous insulin does not aggravate the liver lipid deposition .T2DM who used insulin or insulin secretagogues has different degrees of the improvement in blood sugar,lipid,Homa-IR and fatty liver.

16.
Herald of Medicine ; (12): 206-211, 2018.
Article in Chinese | WPRIM | ID: wpr-700985

ABSTRACT

Aromatic antiepileptic drugs such as carbamazepine are the first-line treatment for epilepsy. The adverse reactions have greatly limited their clinical application. The occurrence rate of severe skin adverse reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is low,but they are often fatal.Human leukocyte antigen (HLA) gene polymorphisms are reported to be related with skin adverse reactions caused by aromatic antiepileptic drugs,but the exact mechanism is unclear.This article will perform a review about the correlation between skin adverse reactions caused by aromatic antiepileptic drugs and HLA gene polymorphisms published in recent years,in order to provide theoretical basis for further study of HLA susceptibility genes in Chinese Han population,and provide a reference for achieving individualized treatment of epilepsy.

17.
Article in Chinese | WPRIM | ID: wpr-807110

ABSTRACT

Objective@#To investigate the distribution of blaKPC gene in Lishui and to analyze the molecular epidemiological characteristics of Klebsiella pneumoniae (K.pneumoniae) blaKPC gene.@*Methods@#From 2010 to 2016, all of the non-repetitive K. pneumoniae carbapenemase (KPC)-producing isolates in Lishui Municipal Central Hospital were collected. They were identified with VITEK 2 Compact system and typed by multilocus sequence typing (MLST). Plasmids were classified based on the DNA sequences of replication initiators. Transposons were detected by PCR. Locations of blaKPC gene were verified through complete sequencing of the plasmids by next-generation sequencing (NGS).@*Results@#A total of 125 strains were collected. K. pneumoniae strains accounted for 88.8% (111) and among them, 103 were ST11 type. IncF plasmids were detected in 48.6% of K. pneumoniae strains and most of them carried mutant Tn1721/Tn4401 chimera (48/54 isolates). Untypable plasmids were discovered in 50.5% of isolated strains and most of them were positive for the wild-type chimera (54/56 isolates). IncF-positive strains isolated during the period of 2011 and 2013 accounted for 94.4%, followed by a dramatic decrease. However, 76.8% of the strains harboring untypable plasmids were isolated from 2014 to 2016 and the number increased year by year.@*Conclusion@#K. pneumoniae of ST11 type was the main cause of blaKPC gene dissemination in Lishui area. Strains carrying the IncF plasmids integrated with the mutant Tn1721/Tn4401 chimera and the untypable plasmids with the wild-type chimera were prevalent before and after 2014, respectively.

18.
Article in Chinese | WPRIM | ID: wpr-709942

ABSTRACT

Objective To explore the mechanism of bone marrow-derived endothelial progenitor cells (EPCs)in the treatment of peripheral neuropathy of diabetic rats. Methods Rats with diabetic peripheral neuropathy (DPN)were induced by streptozotocin(60 mg/kg). Male SD rats were divided into normal control group(NC group),DPN group, DPN+saline group(DPN+S group), and DPN+ EPCs group. Sciatic nerve motor nerve conduction velocity(MNCV)was measured. The expressions of NF-κB and myelin basic protein(MBP)in sciatic nerve were detected by immunohistochemistry. Results Compared with DPN group,the expression of NF-κB was reduced in the sciatic nerve of DPN+EPCs group,while the expression of NF-κB was increased in the sciatic nerve of DPN+ S group. There was no statistical difference in the expression of MBP between DPN and DPN+ EPCs groups. Compared with DPN+S group, the expression of MBP was higher in DPN+EPCs group. Conclusion Transplantation of EPCs inhibits the expression of NF-κB and increases the expression of MBP, which might be conducive to the repairs of nerve injury.

19.
Article in Chinese | WPRIM | ID: wpr-709052

ABSTRACT

Objective To analyze the drug resistance phenotype and genetic background of New Delhi metallo-β-lactamase (NDM)-producing bacterial strains in Lishui area of Zhejiang province.Methods The imipenem-resistant Enterobacteriaceae strains were isolated from January 2012 to December 2016 in Lishui Municipal Central Hospital of Zhejiang Province.Mrieux Vitek 2 Compact system was used to identified strains and PCR was used to screen for blaNDMgene.Susceptibility was detected by K-B method and MICs were obtained by Vitek 2 with GN13 cards.Plasmids typing was carried out by DNA sequencing of the replication initiator with the transconjugates as templates.The blaNDMgenetic contexts were detected by PCR and complete genome sequencing.Results A total of 102 strains of carbapenem-resistant enterobacteria (CRE), mainly Escherichia coli and Enterobacter cloacae, were isolated, of which 15 were positive for blaNDMwith a positive detection rate of 14.7%.The resistance rate to β-lactam antibiotics was 100%, and the resistance rates to aztreonam, compound sulfamethoxazole , tobramycin and gentamicin were all >80%;and the resistance rate to quinolones was >50%.Among the 15 NDM-producing strains , 12 strains were positive for Hodge test, and 2 strains of Enterobacter cloacae and 1 strain of Escherichia coli were negative. There were 11 strains of blaNDM-1and 4 strains of blaNDM-1.A variety of plasmid types such as IncX 3, IncFIIγ and IncA/C were detected, and 4 blaNDM-5genes were located in the IncX3 plasmid.Four blaNDMsurrounding gene structures were found, of which 8 blaNDM-1genes were located in ISAb125-hyp-blaNDM-1-bleMBL-TrpF-DsbC-IS26, while blaNDM-5was located in IS3000-IS5-blaNDM-5-bleMBL-TrpF-DsbC-IS26 structure, and the former was reported for the first time in China.Conclusion NDM-producing bacterial strains in Lishui area are prevalent at a low level and have high sensitivity to fosfomycin and polymyxin .The blaNDMgene may have multiple sources, but IncX3 plasmid is still the main source for gene transfer.Some new types of blaNDM-1 gene structure have been also found in this study.

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Article in Chinese | WPRIM | ID: wpr-706848

ABSTRACT

Objective: To compare the efficacy between chemotherapy plus granulocyte colony-stimulating factor (G-CSF) and chemotherapy plus G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood stem cells (PBSC) and hematopoietic recovery after transplantation in patients with multiple myeloma (MM). Methods: A retrospective study of autologous PBSC (APBSC) mobilization data of 56 MM patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to July 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. The mobilization efficacy and hematopoietic recovery were analyzed. Results: In the univariate analysis, the successful collection rate of a single harvest in women and in patients with ISS stage Ⅲ and R-ISS stage Ⅱ/Ⅲ and treated with chemotherapy plus G-CSF was lower (P<0.05). However, age (≤60 years vs.>60 years), subtype, D-S staging (Ⅰ+Ⅱvs.Ⅲ), number of cycles of chemotherapy before mobilization (≤6 cycles vs.>6 cycles), disease phase before mobilization (PR vs. CR), and interval between diagnosis and mobilization (≤18 months vs.>18 months) were not correlated with CD34+ cell collection and successful mobilization rates (P>0.05). In the multivariate model, the successful mobilization rate in patients who received the chemotherapy plus G-CSF and GM-CSF mobilization regimen was higher (OR=12.009, 95% CI=1.961-73.537). The effect of mobilization regimens remained significant (P=0.007). Hematopoietic recovery without transplantation-related mortality occurred successfully in all patients. Conclusions: Chemotherapy plus G-CSF and GM-CSF mobilization regimens can significantly increase the effect of APBSC mobilization and ensure the recovery of hematopoietic function after transplantation. Chemotherapy plus G-CSF and GM-CSF mobilization regimens are safe and effective for mobilizing APBSCs.

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