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ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MSE） technique， we identified qualitatively the metabolites of aristolochic acid（AAs） in rat in order to analyze the metabolic differences between water extract of Aristolochiae fructus（AFE） and Aristolochic acid Ⅰ（AAⅠ）. MethodSD rats were selected and administered AFE（110 g·kg-1·d-1） or AAⅠ（5 mg·kg-1·d-1） by oral for 5 days， respectively. Serum， urine and feces were collected after administration. Through sample pretreatment， ACQUITY UPLC BEH C18 column（2.1 mm×100 mm， 1.7 μm） was used with the mobile phase of 0.01% formic acid methanol（A）-0.01% formic acid water（B， containing 5 mmol·L-1 ammonium acetate） for gradient elution（0-1 min， 10%B； 1-7 min， 10%-75%B； 7-7.2 min， 75%-95%B； 7.2-10.2 min， 95%B； 10.2-10.3 min， 95%-10%B； 10.3-12 min， 10%B） at a flow rate of 0.3 mL·min-1. Positive ion mode of electrospray ionization（ESI+） was performed in the scanning range of m/z 100-1 200. In combination with UNIFI 1.9.4.053 system， the Pathway-MSE was used to qualitatively analyze and identify the AAs prototype and related metabolites in biological samples（serum， urine and feces）， and to compare the similarities and differences of metabolites in rats in the subacute toxicity test between AFE group and AAⅠ group. ResultCompared with AAⅠ group， 6， 10， 13 common metabolites and 14， 20， 30 unique metabolites were identified in biological samples（serum， urine and feces） of AFE group， respectively. Moreover， the main AAs components always followed the metabolic processes of demethylation， nitrate reduction and conjugation. Compared with common metabolites in AAⅠ group， prototype components of AAⅠ in serum and most metabolic derivatives of AAⅠ［AAⅠa， aristolochic lactam Ⅰ（ALⅠ）a， 7-OHALⅠ and its conjugated derivatives］ in biological samples were significantly increased in AFE group（P<0.05， P<0.01）， except that the metabolic amount of ALⅠ in feces of AFE group was remarkably lowed than that of AAⅠ group（P<0.01）. In addition， a variety of special ALⅠ efflux derivatives were also identified in the urine and feces of the AFE group. ConclusionAlthough major AAs components in AFE all show similar metabolic rules as AAⅠ components in vivo， the coexistence of multiple AAs components in Aristolochiae Fructus may affect the metabolism of AAⅠ， and achieve the attenuating effect by increasing the metabolic effection of AAⅠ and ALⅠ.
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Objective:To explore the effect of nurse-led management model in adherence of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who underwent non-invasive mechanical ventilation.Methods:92 patients with severe OSAHS diagnosed by polysomnography(PSG) and treated with non-invasive mechanical ventilation in Tianjin medical university general hospital from September 2019 to August 2020 were enrolled. The patients were divided into intervention group (45 cases) and control group (47 cases) by random number table. Then, basing on routine treatment and subsequent visit, the patients in intervention group received regular telephone follow-up interviews within one week of ventilator purchasing, and the interview was based on a standard telephone follow-up manuscript designed by Duffy and lasted for six months. The patients in control group received routine nursing treatment and regular subsequent visit, and were not followed up by telephone, but were encouraged to have telephone consultation. The Epworth sleepiness scale(ESS) scores of the two groups before and after the intervention and the compliance of non-invasive mechanical ventilation of the two groups after the intervention were compared.Results:After the intervention, the ESS scores of the two groups were lower than those before the intervention ( P<0.001), and the ESS scores of the intervention group were lower than those of the control group ( P<0.001). After the intervention, the compliance of noninvasive mechanical ventilation in the intervention group was better than that in the control group ( P<0.001). Conclusions:The nurse-led management model in combination with telephone follow-up can improve the sleepiness of patients and the adherence of using non-invasive mechanical.
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Objective To translate the Pulmonary Embolism Quality of Life (PEmb-QoL) Scale into Chinese and evaluate its reliability and validity. Methods The Chinese version of PEmb-QoL was translated from the original,back-translated and adjusted for cultural adaptation.The reliability and validity were tested in 212 patients with PE. Results The content validity index (CVI) of the PEmb-QoL Scale was 0.910, which indicated a desirable content validity. Factor analysis ex-tracted six common factors, which explained 82.177% of variance of the total scale, and each item had high factor loading quantity (>0.4).The test-retest reliability was 0.810, and Cronbach α was 0.894. Conclusions Chinese version of PEmb-QoL has been proved to be valid and reliable.It is a valuable tool for evaluating the quality of life among patients with pulmonary embolism disease.
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Objective@#To translate the Pulmonary Embolism Quality of Life (PEmb-QoL) Scale into Chinese and evaluate its reliability and validity.@*Methods@#The Chinese version of PEmb-QoL was translated from the original, back-translated and adjusted for cultural adaptation.The reliability and validity were tested in 212 patients with PE.@*Results@#The content validity index (CVI) of the PEmb-QoL Scale was 0.910, which indicated a desirable content validity. Factor analysis ex-tracted six common factors, which explained 82.177% of variance of the total scale, and each item had high factor loading quantity (>0.4). The test-retest reliability was 0.810, and Cronbach α was 0.894.@*Conclusions@#Chinese version of PEmb-QoL has been proved to be valid and reliable. It is a valuable tool for evaluating the quality of life among patients with pulmonary embolism disease.
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Drug stability is closely related to drug safety and needs to be considered in the process of drug production, package and storage. To investigate the stability of epalrestat, a carboxylic acid derivative, a reversed-phase high-performance liquid chromatography (RP-HPLC) method was developed in this study and applied to analyzing the degradation kinetics of epalrestat in aqueous solutions in various conditions, such as dif-ferent pH, temperatures, ionic strengths, oxidation and irradiation. The calibration curve was A=1.6 × 105C–1.3 × 103 (r=0.999) with the liner range of 0.5–24 μg/mL, the intra-day and inter-day precision was less than 2.0%, as was the repeatibility. The average accuracy for different concentrations was more than 98.5%, indicating that perfect recoveries were achieved. Degradation kinetic parameters such as degradation rate constants (k), activation energy (Ea) and shelf life (t0.9) under different conditions were calculated and discussed. The results indicated that the degradation behavior of epalrestat was pH-dependent and the stability of epalrestat decreased with the rised irradiation and ionic strength;however, it was more stable in neutral and alkaline conditions as well as lower temperatures. The results showed that the degradation kinetics of epalrestat followed first-order reaction kinetics. Furthermore, the degradation products of epalrestat under stress conditions were identified by UHPLC-PDA-MS/MS, with seven degradation products being detected and four of them being tentatively identified.
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Objective: To investigate the effect and safety of interleukin-2 combined with cisplatin in the treatment of malignant pleural effusion.Methods: Totally 86 patients with malignant pleural effusion were randomly divided into the observation group (44 cases) and the control group (42 cases).The control group was treated with cisplatin, and the observation group was treated with interleukin-2 additionally.The treatment course was 3 weeks.The ascites relief, quality of life, survival status and tumor markers before and after the treatment, and the adverse drug reactions were compared between the groups.Results: The total ascites remission rate and the effective rate in the observation group were significantly higher than those in the control group (P0.05).Conclusion: Interleukin-2 combined with cisplatin can effectively relieve ascites and improve quality of life, which can also prolong the survival time of patients.
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Objective To investigate the effect of endoplasmic reticulum stress (ERS)-associated apoptosis on renal interstitial fibrosis induced by unilateral ureteral obstruction (UUO) in rats. Methods Eighteen healthy male Wistar rats undergoing UUO were sacrificed at 3,7,14 days after operation. Additional seven rats underwent sham operation. Histological changes were observed by HE and Masson staining. Immunohistochemistry was performed on renal tissue for α-smooth muscle actin (α-SMA). Chromatometry was used to detect the content of hydroxyproline. Apoptosis cells were determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and the electrophoresis analysis of genome DNA. The mRNA expression of glucose-regulated protein 78 (GRP78), which are important markers of ERS, were detected by RT-PCR. Western blotting was used to assess the protein level of GRP78 and cysteinyl aspartate specific proteinase-3 (caspase-3). Results Compared with sham operation group, the degree of renal interstitial and the level of hydroxyproline content of UUO group increased significantly (P<0.05). Immunohistochemistry staining indicated that a-SMA extensively expressed in renal tubular and interstitial cells. The apoptotic cells in the renal tubular and interstitium were continuously increased from day 3 to the end of experiment of UUO group. As early as 3 days after surgery, the mRNA level of GRP78 in UUO group increased compared with sham operation group (P<0.01), while the protein expression increased on day 7 after surgery (P<0.01). Prolonged ERS triggered apoptosis, the protein expression of caspase-3 increased significantly on day 3 after surgery (P< 0.05), and the expression sustained high level during the experiment afterwards. There was a positive correlation between GRP78 protein expression and hydroxyproline content (r =0.657, P< 0.01) as well as caspase-3 protein expression (r=0.714, P<0.01). Conclusions UUO induces a significant up-regulation in endoplasmic reticulum molecular chaperones at early stage, indicating that ERS response is activated in the rat kidney. Prolonged ERS can lead to renal tubular and interstitial cell apoptosis, and caspase-3-mediated ERS associated apoptosis may contribute to the fibrosis.
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Objective To explore the effect of continued nursing intervention on quality of life of patients with chronic obstructive pulmonary disease. Methods The study took use of randomized controltest. All the 130 patients who were on admission because of acute exacerbation of chronic obstructive pulmonary disease were randomly divided into the intervention group (62 cases) and the control group (68 cases). The intervention group received telephone and home follow-up for one year, and the control group was provided conventional care. Lung function, SGRQ and dyspnea degree were collected on one-month,three-month, six-month, twelve-month after intervention. Results Lung function and activity scores of SGRQ, dyspnea degree and six minutes walk test between two groups had statistical significance after intervention. Conclusions Continued nursing intervention can postpone the rate of FEV1% declining, reduce dysnea degree, decrease the frequency of acute exacerbation, increase the quality of life of COPD patients.
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ObjectiveTo investigate the therapeutic value of noninvasive mechanical ventilation in patients with conscious disturbance due to severe chronic obstructive pulmonary disease (COPD) with respiratory failure. MethodsForty-two patients with conscious disturbance due to COPD complicated with respiratory failure were selected in the study. GALILEO or PAPHAEL large EMT ventilator produced by Switzerland Hamilton Company was used for noninvasive mechanical ventilation with P-SIMV+PSV+PEEP mode. Meanwhile, the change of vital signs, consciousness, the degree of inspiratory muscle fatigue and blood gas indexes were observed before and after treatment. Glasgow coma scale (GCS) was applied to evaluate the consciousness, and scale for accessory muscle use was adopted to measure the degree of inspiratory muscle fatigue. ResultsAll the patients were treated successfully. Compared with admission, the pH value, the pressure of arterial carbon dioxide (PaCO2) and the arterial oxygen pressure/inhaled oxygen concentration (PaO2/FiO2)were significantly improved 2 hours, 4 hours and 24 hours after treatment. The respiration rate and heart rate were markedly decreased 24 hours after treatment, which indicated that the condition of the patients tended to be stable and the patients could endure the therapy. The average GCS was increased from 5.69-1-0.93 to 10.45±1.23 (t= 31.68, P<0.001), and the state of consciousness was improved significantly. The scale for accessory muscle use was decreased from 3.70±0. 45 to 2. 06±0. 52 (t = 31.21, P < 0. 001), and the respiratory muscle fatigue was relieved. ConclusionsNoninvasive mechanical ventilation has obvious clinical curative effect on severe infection and conscious disturbance due to severe COPD complicated with respiratory failure.
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OBJECTIVE To assess the superiority of new type bi-level positive airway pressure(Bi-PAP) in treating overlap syndrome. METHODS Sixteen cases diagnosed overlap syndrome were quickly given Bi-PAP treatment simultaneously,where their therapeutic efficacy of antibiotic,relieving spasm,diuresis and respiratory stimulant in advance was not fine.All patients were divided into new type Bi-PAP and old Bi-PAP groups based on the type of machines used. RESULTS Seven of 16 patients receiving new type Bi-PAP got remission through non-invasive mechanical ventilation.Among the other 9 patients receiving old type Bi-PAP,6 got remission through non-invasive mechanical ventilation,3 received invasive mechanical ventilation because of poor response to non-invasive mechanical ventilation. CONCLUSIONS More acute overlap syndrome patients can get remission through new type Bi-PAP without invasive mechanical ventilation and have decreased possibility of getting hospital-acquired pneumonia.
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Objective To investigate the effects of oxidative stress on the expressions of transforming growth factor-?1(TGF-?1) and transforming growth factor-? receptor Ⅰ(TGF-?RⅠ) in rat unilateral ureteral obstruction(UUO) models.Methods Thirfty Wistar rats were randomly assigned into three groups:SOR group(sham-operated group,n=7);UUO group(operation group,n=11);US group(spironolactone 50 mg?kg-1?d-1 by daily gastric gavage after UUO,n=12).All the rats were killed 14 d after surgery.Renal fibrosis was assessed by the determination of tissue hydroxyproline(HYP) content.Malondialdehyde(MDA),superoxide dismutase(SOD) as well as aldosterone(ALD) content were measured.Histological changes were observed by HE and Masson staining.Immunohistochemistry was performed to detect the expressions of TGF-?1 and TGF-?RⅠ.Western blotting was used the determine the expression of TGF?RⅠ protein.Results Compared with sham group,the ALD contents in plasma and kidney tissues in UUO group significantly increased(P