Bioequivalence of metformin hydrochloride sustained-release tablets under fed condition in healthy subjects / 中国药科大学学报

@#To evaluate bioequivalence and safety of two kinds of metformin hydrochloride sustained-release tablets (test preparation vs reference preparation) under the condition of fed and single administration.A single center, randomized, open, single-dose, two-period, two-sequence, and double-crossover design was used.32 healthy subjects took 0.5 g of test preparation or reference preparation under fed and single-dose administration.4 mL of venous blood was collected from before administration (0 h) to 1, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12, 15, 24, 36 and 48 h after administration.The concentration of metformin in plasma samples was detected, and then the pharmacokinetic parameters were calculated by WinNonlin 7.0 software.When the 90% confidence intervals of cmax, AUC0-t and AUC0-∞ geometric mean ratio of test preparation and reference preparation were within 80.00%-125.00% equivalent intervals respectively, the bioequivalence of the two preparations was proved.One subject fell off due to adverse events.The main pharmacokinetic parameters of test preparation and reference preparation as follows: cmax were (0.68 ± 0.14) and (0.65 ± 0.11) mg/L, AUC0-t were (7.33 ± 1.65) and (7.00 ± 1.89) h·mg/L, AUC0-∞ were (7.39 ± 1.67) and (7.06 ± 1.91) h·mg/L, respectively.The 90% confidence intervals of the geometric mean ratio of the two main pharmacokinetic parameters were 101.45%-109.14%, 100.08%-112.32% and 100.24%-112.28%, respectively, which fell within the bioequivalence interval of 80.00%-125.00%.There were no serious adverse events and unexpected adverse events during the trial.The results show that test preparation and reference preparation are bioequivalent under fed and single-dose administration, safe and well tolerated in healthy subjects.

Time selection and course of treatment of cerebral resuscitation with hyperbaric oxygen / 中华危重病急救医学

Objective:To explore the effect of treatment opportunity and course of hyperbaric oxygen (HBO) on the curative effect of cerebral resuscitation patients after successful cardiopulmonary resuscitation (CPR).Methods:Eighty-nine patients who underwent cerebral resuscitation after CPR admitted to the second department of the First Hospital of Jilin University from June 2015 to June 2019 were enrolled. All patients underwent conventional drug therapy after admission, and HBO therapy was added on the basis of conventional drug therapy at different intervention times, and all patients received at least 3 courses of HBO treatment. Glasgow coma scale (GCS) score and amplitude-integrated electroencephalography (aEEG) score on different treatment opportunity (i.e. intervention of HBO within 12 hours, 12-72 hours, 4-7 days, 8-21 days after successful CPR) and different course of HBO (i.e. 1, 2 and 3 courses of treatment) were recorded. Repeated measurement analysis of variance was used to assess whether the treatment opportunity or course of treatment affects the GCS score and aEEG score. Then, paired sample t test was used to further analyze the results of repeated measurement analysis of variance and evaluate the specific effect of treatment course or intervention time on the efficacy. Results:A total of 89 patients were enrolled. 8, 20, 33 and 28 patients started HBO treatment at < 12 hours, 12-72 hours, 4-7 days and 8-21 days after successful CPR. ① GCS score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on GCS score was statistically significant ( F = 71.735, P = 0.000). The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant ( F = 0.455, P = 0.817). Paired sample t test showed that the means of GCS scores before HBO treatment and treatment 1, 2, 3 courses were 3.56, 4.80, 5.55 and 6.49 respectively, and the difference of pairwise pairing between different groups were statistically significant (all P < 0.01). ②aEEG score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on aEEG score was statistically significant ( F = 96.965, P = 0.000).The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant ( F = 1.735, P = 0.112). Paired sample t test showed that the means of aEEG scores before HBO treatment and treatment 1, 2, 3 courses were 1.71, 2.21, 2.52 and 3.03 respectively (all P < 0.01). Conclusions:The effect of HBO on cerebral resuscitation after CPR is obvious. The longer the course of HBO is, the more significant the effect of cerebral resuscitation is. Within 21 days after successful CPR, the treatment opportunity of HBO had no significant effect on the effect of cerebral resuscitation.

Comparative study on deep venous thrombosis onset in hospitalized patients with different underlying diseases / 中华内科杂志

Objective To improve the understanding of deep venous thrombosis (DVT),the present study was conducted to investigate the difference of DVT onset in hospitalized patients with different underlying diseases.Methods This is a single-center retrospective study from Beijing Shijitan Hospital.Clinical data from hospital onset DVT patients from 2007 to 2016 were collected.DVT was confirmed with compression ultrasonography (CUS),color Doppler flow imaging (CDFI),CT venography (CTV),magnetic resonance venography (MRV),lower extremities radionuclide venography(RDV) or conventional venography (CV).The risk factors of DVT in hospital were analyzed with a Chi-square analysis.Results A total of 5 063 patients (1.65％) with DVT involving 5 024 veins were identified from 305 922 inpatients admitted without DVT during ten years.Among DVT patients,2 752 were males (54.36％) and 2 311 were females (45.64％) with age of (74.1±15.9) years (range from 1 to 103 years).Patients with DVT were elder and longer inhospital than those without DVT (P＜ 0.001).Patients with respiratory diseases had higher incidence of DVT (6.83％,OR=5.498,95％CI 5.151-5.868) than those with other system diseases,in which patients with respiratory failure had the highest incidence of DVT (9.53％,95％CI 6.912-8.018) among all patients.The risks of having DVT were higher in patients with serious internal medicine diseases than those in patients with trauma,or cataclasis / operations,or invasive manipulations.Among all DVT patients,71.54％ of them were with inflammation diseases,55.56％ were with hypertension and 54.93％ were with structural heart disease.DVT often occurred in inferior extremities (83.78％,4 360/5 063) in patients irrespective of underlying diseases.Conclusions There is an association between underlying diseases of hospitalized patients and the development of DVT.Patients with internal medicine diseases had higher risk to develop DVT than those with trauma or cataclasis / operations or invasive manipulations.To prevent the development of DVT,its screening should be emphasized in patients with serious internal diseases.

Treatment experience of ataxia syndrome caused by excessive use of "White & Black Tablet" / 中国中西医结合急救杂志

White & Black Tablet is a kind of over-the-counter drugs commonly used in the treatment of common cold, excessive use may cause poisoning symptoms, the light symptom can be cleared without treatment, the serious manifestation is the appearance of central nervous system signs and symptoms, and even the most serious one may die of respiratory or/and circulatory failure. Our department recently admitted a patient with acute "White & Black Tablet" poisoning leading to ataxia syndrome, and the diagnosis and treatment experiences of this case were summarized in this report.

Clinical features of hospitalized patients with deep venous thrombosis / 中华内科杂志

Objective To increase the consciousness of incident deep venous thrombosis (DVT) in hospitalized patients. Methods This is a retrospective study of hospitalized patients with DVT in Beijing Shijitan Hospital from 2007 to 2016. Clinical features of DVT patients who were admitted with no DVT were summarized. The demographic and epidemiological characteristics, involved site of veins, department of patients and risk factors were discussed. Results A total of 5063 patients were complicated with DVT from 305922 inpatients who were without DVT at the admission during past 10 years. Among them, 54.36%(2752/ 5063) were men. The age of the patients was (74.1 ± 15.9) years old (range 1-103 years) with 37.78%of them in 80 to 89 age group. The incidence of DVT in the hospital was 1.65%. It increased yearly during the past decade (from 0.50% to 2.74%), and increased with age in patients from 1 to 99 years old (7.32% in 90-99 age group). Totally, 5204 veins were involved in the patients. Most thrombosis involved inferior vena cava system (96.54%,5024/5204), especially deep veins of lower extremity (83.78%,4360/5204), some involved portal veins (8.61%,448/5204) and a little was found in superior venae cava (3.46%, 180/5204). More DVT patients were in department of internal medicine than those in department of surgery (2.95%vs 0.97%,P<0.01). ICU had the highest rate of DVT among the hospital departments (9.75%). No DVT occurred in department of newborn. Risk factors of DVT were inflammatory diseases (71.54%), age over 75 years old (67.25%), and heart diseases (58.98%). Conclusion Sensitivity of detection on DVT should be emphasized in hospitalized patients with DVT risk, especially at the department with high incident of DVT.

Preventive Effect of ω-6 Soybean Oil Fatty Emulsion on Gastric Ulcer in Rats / 医药导报

Objective To study the preventive effect ofω-6 soybean oil fatty emulsion on gastric ulcer caused by acetic acid in rat model, and investigate its mechanisms. Methods Thirty healthy rats were randomly and equally assigned to the following 3 groups:sham operation,gastric ulcer,andω-6 Soybean oil fatty emulsion group.The model was induced by acetic acid. Five days after the model was established successfully,rats in ω-6 soybean oil group received the treatment by tail intravenous injection with the dose of 10 mL.kg-1 .d-1 ,the sham operation group and gastric ulcer group were given the same dose of 0.9%sodium chloride solution.The rats were sacrificed at 10th day after the treatment.The pathological changes of rat gastric ulcer tissue were observed by HE staining, and the concentration of gastric acid was detected by acid-base neutralization method,as well as the activity of pepsin was detected by colorimetry.Serum NO concentration was detected with nitrate reductive enzymatic method, and the expression of EGFR in gastric mucosal was detected with immunohistochemical method. Results Gastric ulcer area inω-6 soybean oil fatty emulsion group (5.67±2.32 mm2) was significantly lower than that in gastric ulcer group(8.68±1.98 mm2). The concentration of gastric acid (1.70±0.53 mmol.L-1), activity of pepsin(23.12±6.97 U) and NO level (64.62±13.86μmol.L-1 ) inω-6 soybean oil fatty emulsion group were much lower than those in the model control group.While the expression of EGFR in gastric ulcer tissue was increased after treatment withω-6 soybean oil fatty emulsion. Conclusion ω-6 soybean oil fatty emulsion exerts significant promotion effect on the healing of gastric ulcer,and its mechanism might be related to inhibiting the level of gastric acid, pepsin and NO, while improving the protective effect of EGFR on gastric mucosa.

Clinical Significance of Ezrin Associated Subcellular Localization of E-cadherin Expression in Lymph Nodes Positive Breast Cancer / 中国医科大学学报

Objective To investigate the relationship between Ezrin expression and subcellular localization of E?cadherin(E?cad),and explore the clinical significance of this relationship to pathological features such as lymph nodes metastasis in breast cancer. Methods Ninety four cases of breast cancer tissue samples with lymph node metastasis were collected. The expression of Ezrin and E?cad was detected by immunohistochemi?cal method. Results The positive rates of and E?cad and Ezrin were respectively 45.7%and 58.5%in 94 nodes positive breast cancer,containing membranal expression of E?cad(E?cadm)in 20 cases and cytoplasmic expression of E?cad(E?cadc)in 23 cases;the frequency of E?cadc positive staining was significantly higher in Ezrin(+)tissues than that in Ezrin(-)tissues(P=0.025);E?cad expression level was significantly lower in TNMⅡ?Ⅲstage cases(P=0.001),and Ezrin expression(P=0.036)and E?cadc(P=0.013)was significantly increased in bigger cases;com?pared with E?cad(+),Ezrin(-),E?cadm tissues,the number of lymph node metastasis in E?cad(-)(P=0.011),Ezrin(+)(P=0.002),E?cadc (P=0.020)tissues were increased significantly;in the order of E?cad(+)/Ezrin(-),E?cad(-)/Ezrin(-),E?cad(+)/Ezrin(+),and E?cad(-)/Ezrin(+),the number of lymph node metastasis was increased significantly(P<0.001);similarly,in the order of E?cadm/Ezrin(-),E?cadc/Ezrin(-),E?cadm/Ezrin(+),and E?cadc/Ezrin(+),the number of lymph node metastasis was increased significantly(P=0.007). Conclusion Ezrin may regulate the subcellular localization of E?cad in metastatic breast cancer ,which may affect the course of breast cancer and promote the metastasis of lymph nodes.

Correlation and Clinical Significance of Ezrin and β-catenin Protein Expression in Sporadic Breast Cancer / 中国医科大学学报

Objective To explore the clinical significance of Ezrin and β?catenin in breast cancer. Methods Immunohistochemical staining method was adopted to detect Ezrin and β?catenin protein expression level in 145 cases of breast cancer tissues,and their correlation with clinical data and prognosis of breast cancer was analyzed. Results Ezrin was expressed in 70 cases(48.3%),β?catenin was expressed in 82 cases (56.6%),and there was significantly negative correlation(r=0.267,P=0.001). The higher histologic grade of breast cancer,the higher expres?sion level of Ezrin(P=0.007),and the lower expression level of β?catenin(P<0.001). Ezrin expression level was increased significantly(P=0.027),but β?catenin expression level was reduced significantly(P=0.011)in lymph node positive breast cancer tissue. Ezrin expression was sig?nificantly correlated with shorter overall survival(P=0.004)and disease free survival(P=0.017)of breast cancer patients,but β?catenin expres?sion was significantly correlated with longer overall survival(P<0.001)and disease free survival(P=0.001)of breast cancer patients. However , Ezrin and β?catenin were not the independent risk factors of breast cancer patients as determined by multivariate Cox regression. Conclusion Ez?rin was significantly negative correlated with β?catenin in breast cancer. They play a role in the progression and poor prognosis of breast cancer , which can be used as breast cancer treatment targets.

Protective Effect of ω-6 Soybean Oil Fat Emulsion on Folium Sennae-induced Diarrhea in Mice / 中国医科大学学报

Objective To investigate the protective effect of ω?6 soybean oil fat emulsion on folium sennae?induced diarrhea in mice. Methods Thirty?six Kunming mice were randomly divided into three groups,including control,diarrhea,ω?6 soybean oil fat emulsion group(12 mice in each group). Besides the mice in control group,other mice were administrated folium sennae by gavage for 15 days to establish the diarrhea model. Then mice in ω?6 soybean oil fat emulsion group received ω?6 soybean oil fat emulsion by intravenously administration at a dose of 15 mL/kg daily since 6th day after intragastric administration of folium sennae for 10 days. Animals in control group and diarrhea group were intravenously adminis?tered with same volume of saline. The body weight ,general state and diarrhea index of the mice in each group were dynamically assessed. Ten days after intravenous injection,mice in every group were sacrificed and tissues were collected. Morphology of intestine mucosa was observed after HE staining. Albumin(ALB)level in plasma was evaluated by biochemical method. Proliferating cell nuclear antigen(PCNA)expression in intestine mucosa were assessed by immunohistochemical method. Results Compared with that in the diarrhea group,the general status,body weight and diarrhea index of mice in ω?6 soybean oil fat emulsion group were improved significantly. Ten days after intravenously administration ,pathological change in intestine mucosa of mice in ω?6 soybean oil fat emulsion group was improved significantly ,ALB level in plasma and PCNA expression in intestine mucosa were significantly increased(P<0.05)compared with that in diarrhea group. Conclusion ω?6 soybean oil fat emulsion has a significant protective effect on the diarrhea of mice induced by folium sennae ,which may be related to the up?regulated expression of PCNA by ω?6 soybean oil fat emulsion.

Protective Effect of Omega-3 Fish Oil Fat Emulsion on Cyclophosphamide-induced Gastric Mucosal Injury in Mice / 中国医科大学学报

Objective to investigate the protective effect of omega-3 fish oil fat emulsion on cyclophosphamide-induced gastric mucosal injury in mice. Methods Forty-five kunming mice were randomly divided into three groups as control,model,and omega-3 fish oil fat emulsion group(with 15 mice in each group). Mice of the two experiment groups were administrated with cyclophosphamide i.p. for 2 days to establish the damage model. then mice in omega-3 fish oil fat emulsion group received omega-3 fish oil fat emulsion at a dose of 15 mL/kg daily for 14 days. Meanwhile,the ani-mals in control group and model group were intravenously administered with the same volume of saline. the weight and food intake of the mice in each group were assessed daily. Five mice in each group were respectively sacrificed at day 1,day 7,day 14 after intravenous injection. Morphology of gastric mucosa was observed by HE staining and the activities of SOD and MAO in gastric mucosa were measured respectively by xanthine oxida-tion and ultraviolet spectrophotometry methods. Results Compared with the model group,the general status,nutritional status and the injury in stomach mucosa in omega-3 fish oil fat emulsion group were significantly improved. After 14 day′s treatment,the activities of SOD and MAO in gas-tric mucosa of mice in omega-3 fish oil fat emulsion group were significantly increased(P < 0.05)compared with model group. Conclusion omega-3 fish oil fat emulsion has a significant protective effect on the cyclophosphamide induced injury in gastric mucosa of mice,which may be related to the upregulation of MAO and SOD.

The effect of Ulinastatin on autophagy and apoptosis in the acute paraquat poisoning rats lung cellular / 中华急诊医学杂志

Objective To investigate the effects of ulinastatin on autophagy and apoptosis of lung cells in rats with acute paraquat poisoning.Methods A total of 150 Wistar rats were randomly (random number) divided into three groups.The rats in control group had stomach lavaged once with 1 mL of normal saline followed by intraperitoneal injection of 1 mL normal saline twice a day.PQ poisoning model was produced by stomach lavaged once with 1 mL of 40 mg/kg PQ solution followed by intraperitoneal injection of 1 mL normal saline once a day.In PQ + ulinastatin (PU) group,UTI in dose of 12 000 U/kg was intraperitoneally injected in rats twice a day.The lung tissue was obtained on the 7th day after modeling,and the histopathological changes were observed under microscope after hematoxylin and eosin (HE) staining.The positive expressions of autophagy-related LC3 protein LC3 and Bcl-2 pretein in lung tissue were observed after immunohistochemistry staining,and the levels of LC3、Bax 、Bcl-2 proteins were determined by Western blot.Results HE staining Results showed:it was observed from the PQ poisoning group that the abnormal cellular structure,enlargement in the pulmonary alveoli,leaking a lot of inflammatory cells,increased thickness of the alveoli wall and bleeding in the local area of lung tissue.Compared with the PQ poisoning group,the above changes in ulinastatin groups were relieved.Western blot Results showed:compared with the control group,the protein expressions of LC3-A/B were significantly increased in PQ poisoning group [LC3-A/B expression (A scale):0.22 ± 0.05 vs.0.14 ± 0.03,F =22.48,P ＜ 0.01].compared with PQ group,the expression of LC3 A/B obviously increased in the group of PU [LC3-A/B expression (A scale):0.36 ± 0.08 vs.0.22 ± 0.05,F =22.78,P ＜ 0.01].compared with Con group,the expression of Bcl-2/Bax obviously decreased in the group of PQ [Bcl-2/Bax expression (A scale),0.11 ±0.04 vs.0.83 ± 0.09,F =154.43,P ＜ 0.01].Compared with PQ poisoning group,the protein expressions of Bcl-2/Bax were obviously increased in PU groups [Bcl-2/Bax expression (A scale):(0.63 ± 018) vs.(0.11 ±0.04),F =154.43,P ＜0.01].Immunohistochemistry result:compared with Con group,the expression of LC3 and Bcl-2 obviously decreased in the group of PQ [LC3expression (A scale):(78.34±10.71) vs.(117.58±15.26),F=31.63,P＜0.01) (Bcl-2 expression (A scale):(62.54±9.74)vs.(130.52 ± 9.86,F =118.44,P ＜ 0.01).Compared with PQ poisoning group,the protein expressions of LC3 and Bcl-2 were obviously increased in PU groups [LC3expression (A scale):(162.58 ± 25.76) vs.(78.34 ± 10.71),F=31.63,P＜0.01]; [Bcl-2 expression (A scale):(145.56±10.26) vs.(62.54±9.74),F=118.44,P ＜ 0.01].Conclusions Theendoplasmic reticulum stress-autophagy is activated in the lung cells of rats with acute PQ poisoning.UTI can adjust endoplasmic reticul um stress,increased the expression of Bcl-2 and enhance the proportion of Bcl-2/Bax to protect the lungs of rats from acute PQ poisoning.

Influence of blood pressure level on carotid intima-media thickness and plaque in elderly patients with coronary heart disease / 重庆医学

Objective To investigate the influence of blood pressure level on carotid intima‐media thickness (CIM T ) and plaque in elderly patients with coronary heart disease(CHD) .Methods 100 elderly CHD patients with hypertension admitted in our hospital from Jan .to Dec .2012 was collected .an epidemiological investigation was applied ,and blood pressure was measured .carotid CIMT and plaque were determined by colored Doppler ultrasound .multivariate linear regression model or Logistic regression model was used to analyze the effect of blood pressure on CIMT and plaque .Results A total of 100 subjects were enrolled .CIMT and plaque prevalence were (0 .7 ± 0 .1)mm ,45 .8% in 48 males and (0 .7 ± 0 .1)mm ,34 .6% in 52 females .the difference was statisti‐cally significant(χ2 =5 .609 ,P=0 .018) .multiple regression models showed that ,after adjusting relevant factors ,CIMT increased 0 .001 14 mm with SBP 1 mm Hg increase and CIMT increased 0 .001 18 mm with pulse pressure 1 mm Hg increase in males .Lo‐gistic regression model showed that the risk of plaque number >1 was higher in grade Ⅲhypertension compared to grade 1 hyper‐tension(OR= 2 .115 ,95% CI= 1 .128~ 3 .966 ,P= 0 .020) .Conclusion Elderly CHD patients with hypertension ,especially in males ,carotid CIMT increase while systolic BP and high pulse are high ,which cause the high risk of carotid artery plaque;hyperten‐sion is a independent risk factor for atherosclerosis in elderly CHD patients .

Pulmonary arterial hypertension after operation for congenital heart disease: analysis of baseline clinical characteristics of 122 Chinese patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the baseline clinical characteristics of patients with pulmonary arterial hypertension after operation for congenital heart disease (AO-CHD-PAH) in China.</p><p><b>METHODS</b>A total of 122 consecutive patients diagnosed as AO-CHD-PAH in Shanghai Pulmonary Hospital from September 1, 2006 to August 31, 2011 were retrospective analyzed.</p><p><b>RESULTS</b>Sixty-seven percent patients were female. The median age at procedure and diagnosis were 14.8 and 24.8 years old, respectively. The median duration from procedure of CHD to diagnosis of PAH was 7.3 years. The most frequent initial symptom (109/122, 89.3%) attributed to PAH was dyspnea on exertion. The frequent sign was accentuation of second heart sound on pulmonary valve area (113/122, 92.6%).Incidence of WHO functional PAH classes I/II was 53.3% (65/122) and mean 6 minutes walk distance was limited to (408.4 ± 103.3) m. Borg dyspnea score was 2.0 (1.0, 3.0).Right heart catheterization demonstrated severe elevated mean pulmonary arterial pressure [(71.6 ± 24.2) mmHg, 1 mmHg = 0.133 kPa] and pulmonary vascular resistance index [(29.1 ± 16.0) Wood U·m(2)] in this patient cohort. Cardiac index was (2.7 ± 0.9) L·min(-1)·m(-2), 90.2% (110/122) patients received PAH-specific therapy. The majority of PAH-specific therapy was phosphodiesterase type 5 inhibitor, which is somehow different from PAH-specific therapy regimen of American-European developed countries.</p><p><b>CONCLUSIONS</b>PAH-specific therapy rate is satisfactory for pulmonary arterial hypertension after operation for congenital heart disease in China and phosphodiesterase type 5 inhibitors are predominant PAH-specific medication in China.</p>

Comparison of clinical characteristics and survival on patients with idiopathic pulmonary arterial hypertension and familial pulmonary arterial hypertension during conventional therapy era and targeted therapy era / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension (IPAH) and familiar pulmonary arterial hypertension (FPAH) during conventional therapy era and targeted therapy era.</p><p><b>METHODS</b>IPAH and FPAH patients who were referred between Jan 1999 and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group (before 2005 no PAH-specific drug was available in China). All patients in this group were followed up till Jun 2005. IPAH and FPAH patients who were referred between Sep 2006 and Aug 2011 were defined as targeted therapy era group (new PAH-specific drugs were available in China since 2006) were analyzed. All patients in this group were followed up till Dec 2013. The primary endpoints were death and therapy medicine.</p><p><b>RESULTS</b>Seventy-two patients were enrolled in conventional therapy era group, 375 were enrolled in targeted therapy era group. The mean age was (35.9 ± 12.2) years and (34.5 ± 17.4) years respectively (P = 0.67), and women was predominant in both groups. There was no difference in WHO functional class and hemodynamic data between the two groups. About 90.3% patients were treated by calcium-channel blockers (CCB) in conventional therapy era group. In targeted therapy era group, almost all patients were treated by at least one PAH-specific drug, only 3.2% patients who had a positive response to acute pulmonary vasodilator testing were treated by CCB. The median survival time was 30.4 months in conventional therapy era group and 66.2 months in targeted therapy era group. The 1-, 2-, 3- and 5- year survival rates of IPAH and FPAH patients were 68.0%, 56.9%, 38.9% and 20.8% in conventional therapy era group, and 89.3%, 78.1%, 68.2% and 53.7% in targeted therapy era group respectively (P < 0.000 1).</p><p><b>CONCLUSION</b>Compared with conventional therapy era, the survival rate of Chinese IPAH and FPAH patients is significantly improved in targeted therapy era.</p>

The effect of selective phosphatase inhibitors Salubrinal on autophagy and apoptosis in the lung tissue of rats with acute paraquat poisoning / 中华危重病急救医学

Objective To investigate the effect of selective phosphatase inhibitors Salubrinal on autophagy and apoptosis in the lung tissue of rats with acute paraquat (PQ) poisoning,and to explore its mechanism.Methods 200 Wistar rats were randomly divided into four groups by randomized arrangement table formed by computer,with 50 rats in each group.PQ poisoning model was reproduced by one time gastric lavage with 1 mL of 40 mg/kg PQ solution followed by intraperitoneal injection of 1 mL normal saline (NS) once a day.The rats in control group were lavaged once with 1 mL of NS followed by intraperitoneal injection of 1 mL NS twice a day.The rats in Sal 0.5 and Sal 1.0 groups were intraperitoneal injected with 1 mL Salubrinal 0.5 mg/kg or 1.0 mg/kg on the 1st,3rd,and 5th day after PQ poisoning once a day.The lung tissue was harvested on the 7th day after poisoning,and the changes in histomorphology were observed using hematoxylin and eosin (HE) staining.The positive expression of autophagy-related protein LC3-Ⅱ in lung tissue was observed after immunohistochemistry staining,and LC3-Ⅱ and caspase-3 protein expressions were determined by Western Blot.Results HE staining results showed partial abnormal pulmonary structure in the PQ poisoning group:collapse of pulmonary alveoli,enlargement of the cavity,local infiltration of inflammatory cells,increasing thickness in the alveoli wall and obvious bleeding in the local lung tissue.Compared with the PQ poisoning group,the above changes in Sal 0.5 and Sal 1.0 groups were obviously relieved.It was shown by immunohistochemistry staining that compared with control group,the positive expression of LC3-Ⅱ was obviously decreased in the PQ poisoning group,Sal 0.5,and Sal 1.0 groups (A value:78.34 ± 10.71,76.52 ± 8.21,77.48 ± 9.11 vs.117.58 ± 15.26,all P＜0.05).There was no significant difference in positive expression of LC3-Ⅱ between each of the later three groups (all P＞0.05).Western Blot results showed:compared with the control group,the protein expressions of LC3-Ⅱ and caspase-3 were significantly increased in PQ poisoning group [LC3-Ⅱ (A value):0.22 ±0.05 vs.0.14 ±0.03,caspase-3 (A value):0.115 ± 0.013 vs.0.023 ± 0.006,both P＜0.05].Compared with PQ poisoning group,the protein expressions of LC3-Ⅱ and caspase-3 were obviously decreased in the Sal 0.5 and Sal 1.0 groups [LC3-Ⅱ (A value):0.19 ±0.05,0.18 ±0.04 vs.0.22 ±0.05; caspase-3 (A value):0.078 ±0.012,0.076 ±0.010 vs.0.115 ±0.013,all P＜0.05].Conclusions The endoplasmic reticulum stress-autophagy is activated in the pulmonary cell of acute PQ poisoning rats.Salubrinal can decrease the autophagy and apoptosis in the lung of rats with acute PQ poisoning,which play a role in the treatment.

Intra- and interobserver reproducibility in the assessment of coronary artery disease: evaluation with invasive coronary angiography and CT coronary angiography / 中华放射学杂志

Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.

Protective effect of Ulinastatin on lung pathological changes in paraquat intoxication rats / 中华急诊医学杂志

Objective To evaluate the protective effect of Ulinastatin on pathological changes of lung induced by paraquat (PQ) intoxication in rats. Method Sixty female SD rats were randomly and equally divided into three groups ( n = 20 in each group). On the experimental day, the rats of group A (control group) received 1 mL of saline intragastrically; the rats of group B (PQ, group) received 1 mL of PQ intragastrically (40 mg/kg diluted in saline) and then treated with saline injected intraperitoneally once a day, and the rats of group Group C (Ulinastatin treatment group) received 1 mL of PQ intragastrically (40 mg/kg,diluted in saline) and then treated with 1 mL of Ulinastatin ( 120 000 IU/kg) intraperitoneally twice a day. The rats ( n = 5 in each subgroup) were sacrificed on the 7th, 14th, 21st, and 28th day for observing the histopathological changes of the lung stained with hematoxylin-eosin stain (HE) and Masson's trichrome stain. Data were semi-quantitatively analyzed by SPSS10.0 software. Hierarchical data were analyzed by rank and inspection. The data that have significance analyzed by comparison test (Bonferroni methods). Results Paraquat intoxication resulted in significant alveolitis and lung fibrosis. Ulinastatin treatment alleviated lung edema, hemorrhage, inflammatory cell infiltration, and fiber aggregation. Conclusions These data demonstrated the Ulinastatin exerted protective effects against PQ-induced lung injury. Ulinastatin could to be used in clinical management for PQ intoxication.

The diagnostic value of neutrophilic alkaline phosphatase activity detection in systemic lupus erythematosus / 中国基层医药

Objective To explore the diagnostic value of NAP activity detection in SLE.Methods Technique of AS-BI was used to NAP staining of peripheral blood smear in patients with newly-diagnosed SLE(30 cases)and normal healthy women(30 cases),to observe positive rate and positive score of NAP.Results The positive rate was(22.1±8.8)% in group SLE,(56.8±9.4)% in group normal;The positive score was(22.2±8.9)in group SLE,(58.2±9.8)in group normal.The positive rate and positive score were much lower in patients with SLE comparing with those in group normal.Differences were statistically significant(P＜0.01).Conclusions The detection of NAP is useful in the patients with newly-diagnosed SLE,but we must go on researching the pathogenesis of NAP activity decreased in SLE.

Effects of valsartan on left cardiac function and vasoactive substance after acute myocardial infarction in rats / 吉林大学学报(医学版)

Objective To investigate the effects of valsartan on experimental left cardiac function and the vasoactive substance in rats with acute myocardial infarction (AMI).Methods Seventy Wistar rats were randomly divided into 6 group:①Sham groups: including Sham 1(n=5) and Sham 4(n=5).The pericardium of rats in Sham groups were cut open and sutured immediately.The rats were routinely breeded for 1 week and 4 weeks,1.5 mL saline was poured into stomach once a day.②Control groups: AMI 1 (n=10) and AMI 4 (n=10).Anterior descending branches of coronary artery of Wistar rats were ligated to establish models of AMI.The rats with AMI were poured into stomach with 1.5 mL saline once a day after AMI for 1 week and 4 weeks.③Valsartan groups: VAS 1 (n=10) and VAS 4 (n=10).The rats with AMI were poured into stomach with valsartan 10 mg?kg-1 and 1.5 mL saline for 1 week and 4 weeks(once a day).Cardiac function was assayed by arterial cannulatio.Angiotensin Ⅱ(Ang Ⅱ),aldosterone (ALD),endothelin (ET),thromboxane A2(TXA2) and prostacyclin I2 (PGI2) in serum were measured by radioimmunoassay.Results ① Valsartan could evidently improve cardiac function on the 1st and 4th week after experimental AMI.+dp/dtmax and-dp/dtmax were both increased on the 1st and 4th week and more evidently on the 4 week.②Compared with control groups,valsartan decreased the levels of ALD,ET and TXA2 in plasma and increased the levels of AngⅡ and PGI2 in plasma.Conclusion Valsartan could improve left cardiac function on late stage of infarction,the effect improve not only systolic function,but also diastolic function.