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【Objective:】 To preliminary construct a scientific, systematic and applicable evaluation index system of the interest conflict for medical institutions ethics committee. 【Methods:】 Literature retrieval, interpretation of laws and regulations, expert group discussion and Delphi expert letter inquiry were used to screen indicators and determine the evaluation index system of interest conflict and the weight of various indicators. 【Results:】 The response rates of the two rounds of correspondence questionnaire were both 100%, the authority coefficient Cr values of the two rounds were 0.855 and 0.865, and the coordination coefficient W values of the two rounds were 0.817 and 0.826, which were statistically significant (P<0.05). The final formed system included 3 first-level indicators, 10 second-level indicators and 25 third-level indicators. 【Conclusion:】 The evaluation index system of interest conflict for medical institution ethics committee is scientific and reliable.
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By analyzing the problems such as the non-standard phenomenon in the implementation and operation of the current chief review system, the unclear responsibility of the chief review committee, and the lack of sound safeguard measures in the implementation of the chief review system, this paper put forward some suggestions, such as establishing and perfecting the chief review system of the ethics committee, clearly specifying the responsibilities and rights of the chief review committee, comprehensively strengthening the safeguard work and other improvement measures for the implementation of the chief review system, so as to provide suggestions for the more standardized and efficient operation of the chief review system in ethics review in China.
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Through the definition of the concepts of disabled and demented elderly, caregivers, work ethic, and ethical principles of caring for elderly with disability and dementia, this paper analyzed the ethical risk factors from the work ethics level of caregivers, the overall service ability and management level of care industry, the caregivers’ occupational burnout, and the degree of social public support and recognition of caregivers’ profession. It is proposed that paying attention to the cultivation of the caregivers’ work ethic quality, establishing the work ethic supervision and evaluation system of caregivers of the elderly with disability and dementia, exploring the successful experience of integrating ethic norms into the care of the elderly with disability and dementia, and safeguarding the rights and interests of the caregivers of the elderly with disability and dementia, so as to gradually reduce the work ethic risk of caregivers of the elderly with disability and dementia, improve the work ethic quality of caregivers, and safeguard the rights and interests of the disabled and demented elderly to the greatest extent.
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Objective To study the intestinal absorption kinetics of Tripterygium wilfordii (TW) solid dispersions and the effects of different intestinal segments, drug concentrations, pH value, and P-glycoprotein (P-gp) on intestinal absorption. Methods The absorption behavior was investigated in situ with a single-pass intestinal perfusion (SPIP) model in rats. The content of each index component was determined by HPLC. The gravimetric method was used to correct the data and calculate the absorption rate constant (Ka) and apparent permeability coefficient (Papp) of each index component. Results The index components of TW were absorbed in the whole intestine, and the absorption rate constant (Ka) of all the index components of TW solid dispersion was significantly increased than that of extract (P < 0.05), and had some differences among different segments. With the increase of drug concentration, the absorption of each index component had saturation phenomenon, which indicated that it may be carrier-mediated transport mechanism. Acidic environment (pH 5.4) was beneficial to the absorption of various index components, especially the acidic content celastrol. After adding P-gp inhibitor, the Ka and Papp of celastrol were significantly different from those without P-gp inhibitor (P < 0.05), which suggested that it may be the P-gp substrate. Conclusion All the index components of TW solid dispersion are absorbed in the whole intestine and have saturation phenomenon, which suggested the absorption may be carrier-mediated transport mechanism. Acidic environment is beneficial to the absorption of all components. The absorption process of celastrol is affected by drug concentration and P-gp inhibitor, which indicated that it may be P-gp substrate. The preparation of solid dispersing can significantly enhance the absorption of various components of TW, suggesting that all the index components are BCS II drugs, and the bioavailability of the preparation may be improved.
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AIM To prepare silymarin solid dispersions and to evaluate the dissolution rates of five constituents.METHODS Taking F68 and PVPk30 as a combined carrier,the solid dispersions were prepared by solvent fusion method.Then the effects of combined carrier ratio and drug-carrier ratio on dissolution rates of silybin,isosilybin,silydianin,silycristin and taxifolin were investigated.RESULTS The optimal conditions were determined to be 1 ∶ 3 for combined carrier ratio,and 1 ∶ 5 for drug-carrier ratio.These five constituents displayed much higher dissolution rates in solid dispersions than those in raw medicine and physical mixture (silymarin-carrier).CONCLUSION Solid dispersions can significantly increase the dissolution rates of effective components in silymarin.
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Objective To investigate the therapeutic effect and safety of ESE (endoscopic submucosalexcavation) as the derivative technology of ESD (endoscopic submucosal dissection) for intestinal Neuroendocrinetumor. Methods A total of 23 lesions diagnosed as Neuroendocrine tumor were treated by ESE. Pathologicaldiagnosis was performed. Reverse events were recorded.Patients were followed up for recurrence andmetastasis. Results Lesions, 0.4 ~ 3.0 cm (medium size 1.0 cm) in diameter,were all resected at one ESE procedure.The operation time was 20 ~ 75 min (medium 30 min). Postoperative bleeding occurred in one case .Initiative fullthickness resection was made in one case due to the violation of muscularis propria layer. 23 cases were histologicallydiagnosed as neuroendocrine tumor, with 21 as G1 and 2 as G2, none as G3. Within 3 gastric neuroendocrine tumors,2 were type 1 and 1 was type 2. All resected samples were free of residual tumor cell in the lateral and basalmargins. Conclusion ESE is safe and efficacious for the treatment of intestinal neuroendocrine tumor.
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Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P＜0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P＜0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P＜ 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P＞ 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2％,93.0％,86.9％,and 97.5％ respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.
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Objective To investigate the expression changes of microRNAs and VEGF-NOTCH in renal ischemic injury in mice, and to explore the potential mechanism associated with renal angiogenesis.Method Male Balb/c mice were subjected to a standard renal ischemia to induce acute kidney injury (AKI) after 45 min of bilateral renal artery clamping. Following 4 h, 24 h of reperfusion or sham operation, kindey tissues were collected and subjected to detect the expression changes of microRNAs which relatived with angiogenesis and VEGF, Flk-1, Notch1 mRNA by Quantitative Real-time RT-PCR. Flk-1 protein was detected by Western blotting analysis at 24 h and 72 h following Ischemia/Reperfusion(I/R) injury. The expression of CD31 was examined in tissue sections by immunohistochemistry staining, and the microvessels in ischemic region of each group were counted. Results miRNA-210 and miRNA-92a expression increased significantly, with prominent changes at 4 h and 24 h after reperfusion( P ＜ 0.05 ). VEGF and Flk-1 mRNA expression and Flk-1 protein were increased in renal I/R compared with control group respectively (P＜0.05 ).Immunohistochemistry staining results of CD31 showed a significant increase of microvessels in renal ischemic region. Conclusion This study first reported the changes in miRNAs expression in response to kidney I/R in mouse. our results implied that miRNAs may be involved in targeting VEGF-Notch pathway signaling to regulate angiogenesis after renal I/R injury. It provided novel insights into the angiogenesis mechanism of renal ischemic injury.