RESUMEN
In recent years,the results of epidemiological research findings on chronic inflammatory demyelinating polyneuropathy(CIDP)in patients with diabetes mellitus(DM)are quite different,and its correlation is still controversial.Nevertheless,due to the high incidence and treatability of CIDP in DM patients,accurate diagnosis and differentiation of DM-CIDP are of great value for guiding clinical drug use.In terms of clinical manifestations,it can be distinguished by age of onset,disease duration,blood glucose control level and main symptom characteristics.Supplementary diagnostic methods frequently involve evaluating cerebrospinal fluid protein levels,demyelination patterns in electrophysiological tests and neuroimaging studies.Additionally,neuropathological examination and specific serum antibodies can provide more diagnostic support for distinguishing DM-CIDP.Furthermore,a positive response to immunomodulatory and/or immunosuppressive therapies supports the diagnosis of DM-CIDP.By comprehensively evaluating clinical manifestations,electrophysiological characteristics,laboratory tests,neuropathology,imaging,and treatment responses,the accuracy of the differential diagnosis for DM-CIDP can be improved.
RESUMEN
Objective@#To explore the association among clinical features, electromyography (EMG) and magnetic resonance neurography (MRN) in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). @*Methods@#A cross-sectional survey was conducted to enroll consecutively typical CIDP patients in Renmin Hospital of Wuhan University from May 2017 to May 2019. The Hughes Disability Scale (HDS) was used to evaluate the illness severity of the patients. The electrodiagnostic parameters including motor conduction velocity (MCV), compound muscle action potential (CMAP), F-wave latency, sensory nerve conduction velocity (SCV) and sensory nerve action potential (SNAP) of upper and lower limbs were analyzed. The patients whose response waveform can be elicited in all nerves were defined as group A, and those without response in one or more nerves as group B. MRN quantitative technique was used to calculate the cross-sectional area of nerves roots (nr-CSA) of brachial plexus and lumbosacral plexus. The linear regression method was used to analyze the correlation among clinical features, EMG and nr-CSA. @*Results@#A total of 32 patients with typical CIDP met the criteria, 75% (24/32) of whom were males. There were 16 patients in the mild group (group A) and 16 in the severe one (group B). The abnormal rate of F-wave latency was the highest. Cerebrospinal fluid (CSF) protein, HDS score were correlated significantly with the nr-CSA of brachial plexus and lumbosacral plexus in the two groups (group A: CSF protein and brachial plexus nr-CSA: r=0.498, P=0.004; CSF protein and lumbosacral plexus nr-CSA: r=0.479, P=0.007; HDS score and brachial plexus nr-CSA: r=0.650, P=0.000; HDS score and lumbosacral plexus nr-CSA: r=0.625, P=0.000. group B: CSF protein and brachial plexus nr-CSA: r=0.497, P=0.049; CSF protein and lumbosacral plexus nr-CSA: r=0.503, P=0.047; HDS score and brachial plexus nr-CSA: r=0.605, P=0.001; HDS score and lumbosacral plexus nr-CSA: r=0.648, P=0.000). MCV of median nerve and ulnar nerve was negatively correlated with nr-CSA of brachial plexus in the two groups (group A: MCV of median nerve and nr-CSA of brachial plexus: r=-0.309, P=0.019; MCV of ulnar nerve and nr-CSA of brachial plexus: r=-0.286, P=0.027. group B: MCV of median nerve and nr-CSA of brachial plexus: r=-0.660, P=0.000; MCV of ulnar nerve and nr-CSA of brachial plexus: r=-0.581, P=0.001). The F-wave latencies of median and ulnar nerves were positively correlated with nr-CSA of brachial plexus, and the CMAP amplitude of tibial nerve and SNAP amplitude of sural nerve were positively correlated with nr-CSA of lumbosacral plexus in group B. @*Conclusions@#Male patients with CIDP are predominant. The higher the nr-CSA in brachial plexus and lumbosacral plexus, the higher the CSF protein and disability score, and the larger the nr-CSA in brachial plexus, the slower the MCV in the median and ulnar nerve. For group B patients with more severe nerve injury, the larger nr-CSA of brachial plexus was, the longer F-wave latency of median and ulnar nerve was, and the larger nr-CSA of lumbosacral plexus was, the lower CMAP amplitude of tibial nerve and SNAP amplitude of sural nerve were. As a non-invasive test, MRN can be used to assist in the diagnosis of CIDP and to assess the severity of the disease.
RESUMEN
OBJECTIVE:To explore the management mode of key monitored drugs in hospital and to improve their rational use. METHODS:The pharmaceutical administration mode of key monitored drugs in our hospital was interpreted in respects of nontrol plan,control measures and control effect(using types and ranking of key monitored drugs among top 10 drugs in the list of consumption sum,ratio of consumption sum of key monitored drugs in total consumption sum,consumption sum per capita of key monitored drugs in the inpatients as indexes). RESULTS:Our hospital confirmed and implemented control plans as control target and control index by formulating key monitored drug list. Key monitored drug control was included in performance assessment management,procurement source management,supernormal early warning management,etc. The key monitored drug control was implemented from May 2016,up to May 2017,key monitored drugs ranked and decreased in number from the top 10 drugs in the list of consumption sum. The ratio of consumption sum of key monitored drugs in total consumption sum and consumption sum per capita of key monitored drugs in the inpatients decreased from 34.33% and 2 318.98 yuan before control(Jan. 2016-Apr. 2016)to 21.72% and 1 209.31 yuan in May 2017(decreasing by 36.73%,47.85%). CONCLUSIONS:Key monitored drug control obtains significant achievement in our hospital,can effectively promotes rational use of key monitored drug,saves medical insurance costs and reduces the economic burden of patients.
RESUMEN
Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.
RESUMEN
Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.
RESUMEN
Objective: To compare the application of Sofren injection in respiratory department before and after the intervention to provide reference for clinical application and pharmacy management.Methods: A retrospective study was conducted on the medical records of inpatients treated with Sofren injection, and then intervene the found problems.Comparative study of Sofren injection in respiratory department before and after the intervention was performed.Results: Among the 584 cases in the retrospective study, those with off-indications were 438 ones (75%), those with inappropriate solvents were 555 ones (95.03%), and those with improper course were 196 ones (33.56%).After the intervention in the clinical practice, the improvement rate of improper solvents was 98.70%, that of off-indications was 29.85%, and that of unsuitable course was 77.71%.Conclusion: Through comparative study on the main problems before the intervention and the effective performance of specific solutions, the application of Sofren injection in respiratory department is greatly improved, which provides reference for the special management of other drugs.
RESUMEN
OBJECTIVE:To provide reference for improving the teaching quality of the course of Drug Abuse and ADR Moni-toring in pharmacy master degree candidates. METHODS:In Pharmacy College of Jilin University,traditional teaching method was adopted among pharmacy master degree candidates of grade 2014(n=30,control group);case teaching method was adopted for the course of Drug Abuse and ADR Monitoring among those of grade 2015 (n=32,observation group). The teaching effects were evaluated by questionnaire and examination. RESULTS:Theoretical examination result and case analysis score as well as the rate of excellent case analysis score in observation group were all significantly higher than control group,with statistical signifi-cance (P<0.05). The satisfaction degree of observation group was significantly higher than that of control group in respects of teaching methods,arousing interest in classroom learning,establishing the awareness of safe and rational drug use,with statistical significance (P<0.05). CONCLUSIONS:For the course of Drug Abuse and ADR Monitoring in pharmacy master degree candi-dates,case teaching method improves students'exam results,stimulates students'interest and enthusiasm,promotes the establish-ment of students'safe and rational drug use consciousness and improves teaching quality.
RESUMEN
Objective:To investigate the rationality of off-label use of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient. Methods:Based on the related literatures, the application rationality of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient was analyzed. Results:The combination of tacrolimus and Wuzhi capsules against membranous nephropathy was an off -label drug use, however, it showed certain clinical rationality and economic efficiency. Conclusion:Off-label drug use commonly exists in clinics. Clinical pharmacists should provide evidence support for off-label drug use through searching and analyzing clinical evidences and closely monitoring therapeutic outcome.
RESUMEN
OBJECTIVE:To systematically review the efficacy of L-carnitine in the treatment of heart failure,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Medline,CJFD and Wanfang Database, randomized controlled trials(RCT)about the efficacy of L-carnitine in the treatment of heart failure were collected. Me-ta-analysis was performed by using Rev Man 5.1 software after data extraction and quality evaluation. RESULTS:Totally 42 RCTs were enrolled,involving 3 494 patients. Results of Meta-analysis showed,L-carnitine can significantly improve the effective rate [OR=4.07,95%CI(3.16,5.25),P<0.001],increase left ventricular ejection fraction(LVEF)[MD=4.49,95%CI(3.49,5.49),P<0.001],decrease brain natriuretic peptide(BNP)levels [MD=-130.17,95%CI(-193.81,-66.52),P<0.001] and improve walk-ing distance in 6 minutes [MD=46.12,95%CI(35.72,56.51),P<0.001],the differences were statistically significant. CONCLU-SIONS:L-carnitine has good efficacy in the treatment of heart failure,it can significantly improve LVEF,decrease BNP level and increase walking distance in 6 minutes.
RESUMEN
Objective To evaluate curative effect and safety of moxifloxacin in treatment of acute pelvic inflammatory with Meta analysis.Methods The database of Pubmed, MEDLINE, Cochrane, China Biology Medicine disc (DBMdisc), China National Knowledge Infrastructure (CNKI), Wanfang med online and VIP were retrieved, and randomized clinical trials of moxifloxacin in treatment of acute pelvic inflammatory which were open literatures published at home and abroad were collected from January 2000 to December 2014.The literatures which were accorded with the criterion were chosen and analyzed by Review Manager 5.1.7.Results The results showed that there were 14 literatures which were homogenous corresponded with the criterion, changeless benefit model statistics and analysis showed that the odds ratio (OR) was 3.76(95%CI 2.14-6.59, P<0.01).And there were 5 studies on bacterial removal showed that the OR was 2.34(95%CI 1.46-3.75, P<0.01).There were 12 studies on incidence of adverse reactions showed that the OR was 0.5(95%CI 0.30-0.86,P=0.01).Conclusion Meta analysis displayed that moxifloxacin is effective for acute pelvic inflammatory.But the high quality RCTs were too few in domestic studies in treatment of the acute pelvic inflammation with moxifloxacin and the overall level of studied quality needs improvement urgently.
RESUMEN
Objective To compare the clinical effect between laparoscopic oviduct-sparing operation and chemotherapy in treatment of tubal pregnancy.Methods A total of 103 patients with tubal pregnancy were divided into two group,group A(49 case)was treated with laparoscopic oviduct-sparing operation,group B(54 cage)was treated with chemotherapy.The clinical information was compared.Results Group A showed significant differences in shortening the time of hospitalization[(5.5±2.1)vs(18.3±5.4)d,P＜0.05],increasing the tubal patency rate (98.9%vs72.1%,P＜0.05),and increasing the chance of re-pregnancy(55.1%vs 44.2%,P＜0.05),when compared to group B.But had no significant effect on preventing the same side tubal pregnancy(24.4%vs27.9%,P＞0.05).Condusion Laparescopic oviduct-spring operation in treatment of tubal pregnancy has the advantages of rapid therapy,shorten treating time,and hisher re-pregnancy chance,it is worth of applying in practice.