The effect of pharmacist-led medication therapy management in the multidisciplinary care of acute kidney injury survivors

The Acute Disease Quality Initiative advocates multidisciplinary care for the survivors of acute kidney injury (AKI). The bundled care strategy recognizes the role of pharmacists. However, their specific contributions in this context remain underexplored. Methods: This retrospective study examined the efficacy of pharmacist-led post-AKI pharmaceutical care in outpatient settings at a single center. Adults with recent AKI during hospitalization, maintaining an estimated glomerular filtration rate <45 mL/min/1.73 m2 postdischarge, were enrolled in a multidisciplinary team care program from March 2022 to January 2023, with a 6-month follow-up period. Pharmacist-delivered care adhered to international multidisciplinary consensus guidelines. Efficacy was evaluated by analyzing medication-related recommendations, medication adherence, nephrotoxic drug utilization, and renoprotective medication usage before and after the intervention. Results: A total of 40 patients were referred to the pharmacist-managed clinic. Of these, 33 patients (mean age, 63 ± 15 years; 60.6% male) attended the clinic. Nineteen patients completed follow-up visits. The pharmacist provided 14 medication-related recommendations to relevant physicians, with 10 of these recommendations (71.4%) being accepted. There was a significant decrease in the use of modifiable nephrotoxic drugs (p = 0.03). However, no significant improvements were noted in medication adherence or the utilization of renoprotective medications. Conclusion: Our study underscores the potential benefits of pharmacist-led post-AKI bundled care strategy in outpatient settings. We observed a significant reduction in the utilization of modifiable nephrotoxic drugs, indicating the effectiveness of pharmacist interventions in optimizing medication regimens to mitigate renal harm.

Comparison of the Effect of Endometrectomy and Hysterectomy of Patients with Refractory Menorrhagia / 中山大学学报(医学科学版)

[Objective] To researchthe influence of endometrectomy and hysterectomy on the physiology and mentality of patients with refractory menorrhagia.[Method] This research selected 110 patients with refractory menorrhagia that accepted in our hospital from January,2015 to January,2017 as the object of study.Under the consent of patients,they were randomly divided into the endometrectomy group and hysterectomy group.Then the rate of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS),the recovery condition of colporrhagia and improvement of anemia of both groups were compared.[Result] Before treatment,the compare between both group's rate of SAS and SDS are not statistically significant (P＞0.05),after treatment,the SAS and SDS rate of endometrectomy group are respectively (45.31±3.58) and (46.31±3.46),which are both significantly lower than the hysterectomy group (P＜0.05);the endometrectomy group has a good rate of 94.55％ on the recovery condition of colporrhagia,which is significantly higher than the hysterectomy group's 81.81％ (P＜0.05);before surgery,the compare of hemoglobin quantity between two group are not statistically significant (P＞0.05);within 1,3 and 6 months after surgery,the hemoglobin level of endometrectomy group are significantly higher than the hysterectomy group (P＜0.05).[Conclusion] Both endometrectomy and hysterectomy can effectively treat patients with refractory menorrhagia,but endometrectomy has less influence on patient's physiology and mentality,which can facilitate patient's recovery and could be widely applied on clinical treatment.

Functional slit lamp biomicroscopy detects hemodynamics parameters of conjunctival microvessel in normal adults and its clinical values / 眼科新进展

Objeetive To investigate the detection of hemodynamiCS parameters of conjunctival microvessels by functional slit lamp biomicroscopy (FSLB) in normal adult and its clinical application values.Methods Randomly selected 16 postgraduate students aged 21 to 25 years from the Nanchang University and Zhongshan Ophthalmic Center,including 8 males and 8 females.The density,length and diameter of conjunctival microvessel and the flow velocity of arteriolar and venular blood were measured by FSLB and software program (BenoitTM,TruSoft Inc,St.Petersburg,FL,USA),as well as the indicators' characteristics of the subjects' were analyzed.Results As for subjects' right eyes,the microvascular density,length,diameter,and the arteriolar and venular blood flow velocity were no significant difference between the upper,and lower sides,as well as between nasal and temporal sides (all P ＞ 0.05);meanwhile the microvascular density,length and diameter of the upper and lower sides were both lower than those of the nasal and temporal sides,and the differences were statistically significant (all P ＜ 0.05),while the arteriolar and venular blood flow velocity of the upper and lower sides were both significantly higher than those of the nasal and temporal sides,and the differences were statistically significant (all P ＜ 0.05).In addition,the changes in hemodynamics parameters of conjunctival microvessels of the left eyes and total eyes in subjects were consistent with the right eyes.Conclusion FSLB can clearly obtain hemodynamics parameters of conjunctival microvessels in healthy grown-ups,and has a promising clinical value.

Functional slit lamp biomicroscopy detects hemodynamics parameters of conjunctival microvessel in normal adults and its clinical values / 眼科新进展

Objeetive To investigate the detection of hemodynamiCS parameters of conjunctival microvessels by functional slit lamp biomicroscopy (FSLB) in normal adult and its clinical application values.Methods Randomly selected 16 postgraduate students aged 21 to 25 years from the Nanchang University and Zhongshan Ophthalmic Center,including 8 males and 8 females.The density,length and diameter of conjunctival microvessel and the flow velocity of arteriolar and venular blood were measured by FSLB and software program (BenoitTM,TruSoft Inc,St.Petersburg,FL,USA),as well as the indicators' characteristics of the subjects' were analyzed.Results As for subjects' right eyes,the microvascular density,length,diameter,and the arteriolar and venular blood flow velocity were no significant difference between the upper,and lower sides,as well as between nasal and temporal sides (all P ＞ 0.05);meanwhile the microvascular density,length and diameter of the upper and lower sides were both lower than those of the nasal and temporal sides,and the differences were statistically significant (all P ＜ 0.05),while the arteriolar and venular blood flow velocity of the upper and lower sides were both significantly higher than those of the nasal and temporal sides,and the differences were statistically significant (all P ＜ 0.05).In addition,the changes in hemodynamics parameters of conjunctival microvessels of the left eyes and total eyes in subjects were consistent with the right eyes.Conclusion FSLB can clearly obtain hemodynamics parameters of conjunctival microvessels in healthy grown-ups,and has a promising clinical value.

Application of multiplex PCR combined with invasive reaction and chromogenic reaction catalyzed by gold nanoparticles in detection of encephalitis and meningitis virus / 中国人兽共患病学报

We developed a method for detecting encephalitis and meningitis virus by using multiplex PCR combined with invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles.Primers were designed based on the conservative regions of encephalitis and meningitis virus (Eastern equine encephalitis virus,EEEV;Western equine encephalomyelitis virus,WEEV;West Nile virus,WNV;Nipah virus,NiPA;Japanese encephalitis virus,JEV).Multiplex PCR system,invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles were established to detect different encephalitis and meningitis virus in one reaction.Tick-borne encephalitis virus (TBEV),St Louis encephalitis virus (StLEV),Chikungunya virus (CHIKV) and Dengue virus(DV) were used to test its specificity.Quantitative RNA transcribed in vitro and PCR fragments were used to assess its sensitivity.Clinical specimens collected from JEV patients were detected by this method.A method for detecting encephalitis and meningitis virus by using multiplex PCR,invasive reaction and a chromogenic reaction catalyzed by gold nanoparticles were successfully established.This method can detect targeted pathogens specifically,and it has no cross reaction with TBEV,StLEV,CHIKV and DV.The detecting limitation for different targets was 103 copies/μL.Clinical samples were positive for JEV nucleic acids for above assay.The method presented here has characteristic of high specificity,sensitivity and throughput.The results can be observed by visual inspection.This method has broad application prospects in pathogen detection.

Growth inhibitory effect of microRNA-519b-3p on larynx squamous Hep-2 cells / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of microRNA-519b-3p (miR-519b-3p) on laryngeal carcinoma Hep-2 cell growth, and to analyze the underlying molecular mechanisms.</p><p><b>METHODS</b>The effects of miR-519b-3p on the growth and cell cycle of Hep-2 cells transfected with miR-519b-3p mimic were tested by MTT assay and flow cytometry, respectively. The mRNA and protein expressions of the related genes were tested by reverse transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. The expressions of miR-519b-3p were tested by real-time RT-PCR in 48 pairs of laryngeal carcinoma and adjacent tissue samples.</p><p><b>RESULTS</b>The expression of miR-519b-3p in laryngeal carcinoma tissues was significant lower than that in adjacent non-cancerous tissues (S(ΔCt) = 2.989, t = 2.693, P < 0.01) . Increasing the level of miR-519b-3p inhibited significantly Hep-2 cell proliferation, arrested the cell cycle in the G2/M phase (10.29% ± 4.63%, t = 4.395, P < 0.05) , and decreased significantly the percentage of cells in the S phase (7.56% ± 2.05%, t = 3.555, P < 0.05) , with the increase in the expression of cyclin dependent kinase (CDK) 1 and the decrease in the expressions of CDK 2 and Cyclin A. RT-PCR and Western blot showed that miR-519b-3p down-regulated the protein but not mRNA expressions of HuR and cyclooxygenase-2(COX-2) genes.</p><p><b>CONCLUSIONS</b>The expression of MiR-519b-3p as carcinoma suppressor gene is low in laryngeal carcinoma. The cell cycle of Hep-2 cells was arrested in the G2/M phase by MiR-519b-3p.</p>

Epithelium constitution for esophageal tissue engineering using electrospinning technology / 生物工程学报

The basement membrane (BM) is crucial in regulating the physical and biological activities of esophageal epithelial cells which attach to the underlying BM. In order to simulate the natural construction of BM, we prepared the fibrous scaffolds using biodegradable polylactide (PLA) and silk fibroin (SF) as the materials via electrospinning technology. BM's proteins containing collagen (IV), laminin, entactin and proteoglycan were extracted from porcine esophagus and coated on the eletrospun fibers. Morphology, mechanical strength, biodegradability and cytocompatibility of the coated and uncoated scaffolds were tested and evaluated using scanning electron micrography, mechanical test system, immunofluorescence assay and western blotting with CK14 as the primary antibody. The fibrous scaffold PLA or PLA/SF, generated from the present protocol had good formation and mechanical and biodegradable properties. After coating with BM's proteins, the scaffold could enhance the growth and differentiation of esophageal epithelial cells, which would contribute to remodel and regenerate the tissue engineered epithelium and further contribute to engineer the whole esophagus in future.

CT-guided thoracic biopsy: evaluating diagnostic yield and complications

<p><b>INTRODUCTION</b>This study retrospectively evaluated CT-guided thoracic biopsies for diagnostic yield, accuracy and complications.</p><p><b>MATERIALS AND METHODS</b>A retrospective analysis of 384 patients (mean age 62.7 years; male/female = 251/133) who underwent 399 CT-guided thoracic biopsies were performed for evaluating diagnostic yield, accuracy and complications. Correlations between patients age, procedure factors (biopsy-needle size, number of passes, lesion-size, lesion-depth and traversed lung-length) and complications such as pneumothorax, haemothorax and haemoptysis were evaluated. A comparison between fine needle aspiration (FNA) group and core ± FNA group for diagnostic yield and complications was also performed.</p><p><b>RESULTS</b>FNA was performed in 349 patients and core ± FNA in 50 patients. The biopsy samples were adequate in 91.9% and the diagnostic accuracy for malignant lesions was 96.8% with 95.7% sensitivity and 100% specificity. Pneumothorax (detected on CT) occurred in 139 cases (34.8%) and only 12 (3.0%) required insertion of an intercostals drain. Mild haemoptysis occurred in 13 patients (3.2%) and small haemothoraces in 2 patients. Pneumothorax occurrence was significantly associated with the traversed lung-length (>3mm), lesion-size (≤33 mm) and lesion-depth (≥60mm) (P <0.05). Haemoptysis occurrence was also significantly associated with traversed lunglength (>3mm) and lesion-size (≤33 mm) (P <0.05). There was no significant difference between diagnostic yield and complication rate between FNA and core ± FNA groups.</p><p><b>CONCLUSION</b>CT-guided thoracic biopsy is a safe procedure with high diagnostic yield and low risk of significant complications. Traversed lung-length and smaller lesion size are associated with occurrence of pneumothorax and haemoptysis.</p>

Compatibility of polyurethane membranes after surface modification with human hypopharyngeal fibroblasts / 中国组织工程研究

BACKGROUND:Polyurethane has good mechanical and physical characteristics and is extensively used in clinical and experimental studies, but its hydrophobicity and histocompatibility are not ideal, which limits its use in tissue engineering as a biomaterial scaffold to some extents. OBJECTIVE:To observe the hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin and its compatibility with human hypopharyngeal cel s. METHODS:The changes in hydrophilicity of polyurethane membrane grafted with silk fibroin and glutin were detected by contact angle measurements. Human hypopharyngeal fibroblasts were cultured in vitro on polyurethane membrane, silk fibroin-polyurethane membrane, glutin-polyurethane membrane and tissue culture plate. Cel compatibility was compared using cytometry and cel morphology obsevation. RESULTS AND CONCLUSION:Hydrophilicity of silk fibroin-or glutin-polyurethane membranes significantly increased (Pglutin-polyurethane membrane (Pthan that on the polyurethane membrane, especial y on the silk fibroin-polyurethane membrane. These suggested that hydrophilicity and cel compatibility of silk fibroin-or glutin-polyurethane membrane were elevated.

Neuroapplication of amplatzer vascular plug for therapeutic sacrifice of major craniocerebral arteries: an initial clinical experience

<p><b>INTRODUCTION</b>Clinical use of the Amplatzer vascular plug in the cardiopulmonary and peripheral vasculatures has been described extensively in the literature. We present our initial experience in adapting this device for therapeutic sacrifice of major craniocerebral arteries.</p><p><b>MATERIALS AND METHODS</b>Between July 2007 and November 2008, 8 patients (mean age 59.1 years; range 18 to 82 years) underwent therapeutic occlusion of major craniocerebral arteries using the device, for direct caroticocavernous fistula (1 patient), symptomatic unruptured giant cavernous internal carotid aneurysms (2 patients), and preoperative embolisation before surgical resections of skull base tumours that had encroached upon the internal carotid or vertebral artery (5 patients). The plugs were used alone or in conjunction with detachable platinum coils. The applications of the device, as well as the angiographic and clinical results of the procedures were evaluated.</p><p><b>RESULTS</b>Applications of the plugs were straightforward and successful in all cases, with hermetic occlusions of all target arteries. When used without additional coils, several plugs were deployed in tandem to achieve complete occlusion of the artery. No migration of the device was seen. No patient developed untoward neurological deficits following the procedures, and the 3- and/or 6-month follow-up showed stable results.</p><p><b>CONCLUSION</b>The Amplatzer vascular plug could be a valuable addition to the neurointerventional armamentarium, particularly in therapeutic occlusion of major craniocerebral arteries. Rigidity of the delivery system limits its current use to vessels below the skull base. The potential risk of distal thromboembolism also requires further evaluation.</p>