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Objective:To explore the changes of intracranial pressure in intensive care unit (ICU) patients during the occurrence and evolution of delirium by using bedside ultrasound to measure the optic nerve sheath diameter (ONSD) to evaluate intracranial pressure.Methods:A retrospective observational study was conducted. Adult patients who developed delirium during hospitalization in the general ICU of Beihai People's Hospital from October 2020 to November 2021 were enrolled, and patients who did not have ultrasonographic ONSD records within 24 hours after the diagnosis of delirium were excluded. The ONSD measured before delirium was recorded as ONSD 0, the ONSD measured within 24 hours of the onset of delirium recorded as ONSD 1, and the ONSD reexamined after ONSD 1 recorded as ONSD 2. Patients were divided into intracranial hypertension group (ONSD 1 > 5 mm) and normal intracranial pressure group (ONSD 1 ≤ 5 mm) according to the size of ONSD 1. According to the outcome of delirium, the patients were divided into cured, improved, and non-improved groups. The reduction ratio of ONSD 2 to ONSD 1 in the three groups were calculated and compared. Pearson correlation test was used to analyze the correlation between fluid balance and ONSD changes after delirium. Results:There were 43 patients, including 40 cases in the intracranial hypertension group (the incidence rate was 93.0%), 3 cases in the normal intracranial pressure group, 23 cases were cured, 13 cases were improved, and 7 cases were not improved. In the intracranial hypertension group, 11 cases had ONSD 0 and ONSD 1 records, and ONSD 1 was significantly higher than ONSD 0 [mm: 5.88±0.61 vs. 5.34±0.57, 95% confidence interval (95% CI) -0.85 to -0.23, P = 0.003]. The reduction ratio of ONSD 2 to ONSD 1 in the cured group was significantly higher than that in the improved group and the non-improved group [(12.04±6.20)% vs. (5.68±4.10)%, (0.17±3.96)%; 95% CI were 2.37 to 10.33, 6.41 to 17.31, P values were 0.003 and 0.000, respectively]. The correlation analysis showed that the reduction ratio of ONSD 2 to ONSD 1 was negatively correlated with fluid balance ( r = -0.42, 95% CI was -0.66 to -0.10, P = 0.012). Conclusions:The incidence of intracranial hypertension in ICU delirium patients is high. A more pronounced decrease in intracranial pressure predicts a better delirium outcome. Dynamic ONSD measurement can provide valuable information for the prevention and treatment of delirium.
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Molecular targeted therapy has become an emerging promising strategy in cancer treatment, and screening the agents targeting at cancer cell specific targets is very desirable for cancer treatment. Our previous study firstly found that a secretory peroxidase of class III derived from foxtail millet bran (FMBP) exhibited excellent targeting anti-colorectal cancer (CRC) activity in vivo and in vitro, whereas its underlying target remains unclear. The highlight of present study focuses on the finding that cell surface glucose-regulated protein 78 (csGRP78) abnormally located on CRC is positively correlated with the anti-CRC effects of FMBP, indicating it serves as a potential target of FMBP against CRC. Further, we demonstrated that the combination of FMBP with the nucleotide binding domain (NBD) of csGRP78 interfered with the downstream activation of signal transducer and activator of transcription 3 (STAT3) in CRC cells, thus promoting the intracellular accumulation of reactive oxygen species (ROS) and cell grown inhibition. These phenomena were further confirmed in nude mice tumor model. Collectively, our study highlights csGRP78 acts as an underlying target of FMBP against CRC, uncovering the clinical potential of FMBP as a targeted agent for CRC in the future.
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OBJECTIVE:To measure and analysis the related costs of drug-induced liver injury (D1LI) from different decision makers,and to provide reference for reducing related costs of DILI,improving medical insurance system and realizing effective health resource distribution.METHODS:In retrospective study,60 cured or recovered DILI inpatieuts were randomly selected as subjects from medical record management system of 4 hospitals in Henan province during Jun.2014-Jun.2015.Demographic character istic,clinical characteristic and related cost of DILI were analyzed retrospectively and the cost structure was also analyzed from different decison makers (patient,society,medical insurance payer).RESULTS:The total direct medical cost of 60 cases was 584 113.05 yuan,and total direct non-medical cost was 31 093.15 yuan and total indirect cost was 169 379.95 yuan.The total cost of DILI of fered by patients was 616 296.38 yuan;the total cost of DILI offered by society was 784 586.15 yuan;the total cost of DILI offered by medical insurance was 168 289.77 yuan.CONCLUSIONS:DILI results in serious economic damage for patients and society,deserving attracting extensive attention worldwide.The study provide reference for reducing patient's medical burden and improving medical insurance system,and contribute to optimize medical resource distribution.
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OBJECTIVE:To provide reference for standardized management of skin test of cephalosporin injection in our hos-pital. METHODS:In retrospective analysis,skin test of 8 kinds of cephalosporin [cefotaxime(1.0 g),cefotaxime(0.5 g),cefoti-am (1.0 g),cefotiam (0.5 g),ceftazidime (0.5 g),cefminox (0.5 g),cefminox (1.0 g),ceftriaxone (1.0 g)] and the cost of skin test, related cost of allergic reaction induced by cephalosporin injection were analyzed statistically during Sept. 1st, 2015-Aug. 31th,2016. The cost of skin test of cephalosporin injection was compared with allergic reaction cost reduced by skin test. RESULTS:The positive rate of 100330 patients who used above 8 kinds of cephalosporin injections was 6.27%;the rate of skin test was 82.49%;the direct cost of skin test was 3434411.72 yuan;the indirect cost was 141985.12 yuan;the cost of pa-tient was 3162901.44 yuan;the cost of medical insurance was 259096.28 yuan;the cost of the whole society was 3576396.84 yuan. From the perspective of the whole society,the cost of skin test of cephalosporin injections was(447049.61±247395.07)yuan, and allergic reaction cost reduced by skin test was (316075.48 ± 260600.49)yuan. The cost of skin test was significantly higher than allergic reaction cost reduced by skin test,with statistical significance(P<0.05). CONCLUSIONS:Skin test of cephalosporin injection is low in positive rate,has high expense. The government standardizes the management of skin test of cephalosporin injec-tion and reduces the economic burden of patients under the premise of ensuring the safety of drug use.
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Objective To establish a method for the determination of hesPeridin and cinnamaldehyde in siweiqing buccal tablets. Methods A high Performance liquid chromatograPhy ( HPLC) method was established. The chromatograPhic conditions were as follows: the chromatograPhic column Inertsil ODS_SP ( 4. 6 mmí150 mm, 5 μm ) with the mixture of acetonitrile and water as mobile Phase in gradient mode,the detection waVelength of 290 nm,the flow rate of 1. 0 mL·min-1 ,the column temPerature of 30℃,the theoretical Plate number no less than 3 000. Results The linear relationshiP between content and Peak area was obtained in the range of 0. 025-0. 500 μg for cinnamaldehyde and 0. 10-2. 00 μg for hesPeridin. RSD of the Peak area of cinnamaldehyde and hesPeridin for the Precision test,the stability test and the rePeatability test were 1. 16%and 1. 03%,1. 27%and 1. 08%,1. 23%and 1. 28%,resPectiVely. The aVerage recoVery of cinnamaldehyde was 99. 24%with RSD of 1. 65%(n=9). The aVerage recoVery of hesPeridin was 99. 39%with RSD of 1. 85%(n=9). Conclusion The method can be aPPlied to quantitatiVe assay of cinnamaldehyde and hesPeridin in siweiqing buccal tablets with good reProducibility and sPecificity. The recoVery result met the accePtance criteria. The method can effectiVely control the quality of siweiqing buccal tablets with good sPecificity,reProducibility and stability,and can be aPPlied to the quality control of siweiqing buccal tablets.
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Cancer-related fatigue(CRF) is one of the important symptoms for cancer patients,especially for the long-term survival patients after treatment.Its complexity and interdependency with other symptoms make it difficult to identify the clear underlying mechanisms. No single etiologic model provides a satisfactory explanation of cancer-related fatigue.For mild fatigue,non-pharmacological therapy is recommended.Non-pharmacological therapy combined with pharmacological therapies is recommended for patients with moderate and severe fatigue.
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The relationship between carotid artery stenosis and cognitive function are receiving increasing attention.Most studies have shown that carotid artery stenosis has a direct impact on cognitive impairment.Carotid endarterectomy or stenting can improve the cognitive function to varying degrees in patients with carotid artery stenosis.The mechanism of cognitive impairment in patients with carotid artery disease may be associated with hypoperfusion,white matter lesions,multiple lacunar infarction and spontaneous emboli.
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It is an important measure in improving the practical teaching quality at Chinese westem medical colleges to strengthen the training practice of part-time assistant teachers in clinical teaching bases. To establish a good training model,we should take into consideration its operability and practicability, as well as the positivity of the teachers.The key to making the training succeful is to ascertain the direction and contents, to set up an instructors' team, and to make a specific training plan.
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Objective To define the correlation between the proliferating cell nuclear antigen (PCNA) and metastasis-related gene nm-23-H 1, and to correlate their espressions with clinical features,radiosensitivity and prognostic variables in exophageal squamous cell carcinoma (ESCC), to establish some biological parameters obtained prior to therapy though which we can predict radiosensitivity and outcome.Methods PCNA and nm-23-H 1 expression protein were determined by immunohistochemical technique with formalin-fixed paraffin-embedded specimens from 59 patients with ESCC who had received definitive radical radiation and had been followed up for more than 3 years. The values were assessed by distributions of patients , disease factors, including age,sex,lesion site,legth ,histological grade and prognosis.Results The findings showed that the mean labelling indices of PCNA and nm-23-H 1 were significantly higher in ESCC than in the normal esophageal tissue (P0.05).Conclusions PCNA and nm-23-H 1 indices can be taken as biological endpoints to predicting therapeutic response, local and systemic control of disease.