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With the rapid development of nanotechnology, the research and development of nanomedicine has become one of the current development directions of drug innovation. The pharmacokinetic characteristics of nanomedicine are significantly different from general drugs because of the scale effect based on nanostructures, and pharmacokinetics studies of nanomedicine may be different from the general drugs. This article focuses on the research strategies and considerations on non-clinical pharmacokinetics of nanomedicine, including test agents, in vivo/in vitro assays, biological sample analysis, data evaluation and analysis etc., providing references for developers.
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Objective To observe the influence of once pre-injection dexmedetomidine(DEX) on clinical effect in general anesthesia induction.Methods Sixty patients,ASA Ⅰ-Ⅲ,no sex limitation,undergoing elective laparoscopic cholecystectomy under general anesthesia were selected and divided into the 1ug/kg DEX group(D) and normal saline control group(C),30 cases in each group.The BIS values were recorded after medication infusion.Then the target controlled infusion(Marsh mode) of propofol was performed according to the plasma concentration.The plasma concentration was gradually increased until BIS value reaching 40.Then the effect-site concentration(Ce) of propofol was recorded at this time and sufentanil 0.5ug/kg was injected within 10 s.The bucking incidence rate within 1 min after injection of sufentanil was recorded and cisatracurium was injected again.The tracheal intubation was performed when the TOF value was 0.The time of train-of-four stimulation(TOF) to 0(effect onset time) and intubation time were recorded.The hemodynamic indexes were recorded at pre-administration(T0),post-administration(T1),after induction(T2),and after intubation(T3).The incidence rate of intraoperative awareness was recorded.Results The bucking incidence rate at 1 min after sufentanil injection in the group D was significantly lower than that in the group C(3.33％ vs.13.3％,P＜0.01).Ce of propofol in the group D was lower than that in the group C(P＜0.01).HR af T1 in the group D was decreased;HR and MAP at T2 in the group C were decreased,which at T3 were increased.No intraoperative awareness occurred in all cases.Conclusion Pre-injection of DEX 1ug/kg before induction can decrease the propofol dose and maintains hemodynamic stability.
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At present, the prevalence rate of diabetes presents a rising tendency. The cardiovascular disease is a major complication of diabetes mellitus and acute coronary syndrome (ACS) is a severe form of coronary heart disease. Compared with non-diabetic patients, the disease situation in diabetic ACS patients is more serious with more contradictory problems and difficulty in treatment. Although percutaneous coronary intervention (PCI) plays a certain role in re-canalization of coronary artery, after PCI the problems the patients with diabetic ACS will face are still serious. traditional Chinese medicine (TCM) recognizes that the etiology and pathogenesis of diabetic ACS are deficiency in Qi and Yin, and accumulation of blood stasis and toxin inside the body. Through clinical observation and retrospective analysis, it is found that using "supplementing Qi and nourishing Yin, activating blood circulation and detoxifying"can interfere with the patients' diabetic ACS and simplify the therapeutic regimen, which is an integrated regulatory treatment with multiple links, multiple pathways and multiple targets, and is a sufficient realization of unique superiority of traditional Chinese medicine by using holistic concept, syndrome differentiation and multiple-link interference for comprehensive prevention and treatment of diabetic ACS.
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At present, the prevalence rate of diabetes presents a rising tendency. The cardiovascular disease is a major complication of diabetes mellitus and acute coronary syndrome (ACS) is a severe form of coronary heart disease. Compared with non-diabetic patients, the disease situation in diabetic ACS patients is more serious with more contradictory problems and difficulty in treatment. Although percutaneous coronary intervention (PCI) plays a certain role in re-canalization of coronary artery, after PCI the problems the patients with diabetic ACS will face are still serious. traditional Chinese medicine (TCM) recognizes that the etiology and pathogenesis of diabetic ACS are deficiency in Qi and Yin, and accumulation of blood stasis and toxin inside the body. Through clinical observation and retrospective analysis, it is found that using "supplementing Qi and nourishing Yin, activating blood circulation and detoxifying"can interfere with the patients' diabetic ACS and simplify the therapeutic regimen, which is an integrated regulatory treatment with multiple links, multiple pathways and multiple targets, and is a sufficient realization of unique superiority of traditional Chinese medicine by using holistic concept, syndrome differentiation and multiple-link interference for comprehensive prevention and treatment of diabetic ACS.
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Objective To assess the clinical therapeutic effects and safety of Jiangtang Shuxin decoction (JTSXD) on diabetic patients complicated with chronic heart failure (CHF),and to search for its possible function mechanisms.Methods A prospective randomized controlled study was conducted,80 diabetic patients complicated with CHF [New York Heart Association (NYHA) functional class Ⅱ-Ⅲ] admitted into the Department of Traditional Chinese Medicine (TCM) or of Cardiology in Affiliated Hospital of Guangxi Youjiang National Medical College from October 2015 to September 2016 were enrolled,they were assigned to an observation group and a control group by randomized method with a computer,and finally 77 patients (39 cases in observation group and 38 cases in control group) completed this trial.The patients in control group received standardized routine western medical treatment,while the observation group was additionally administered JTSXD (including ingredients:astragalus 15 g,ginseng 10 g,radix ophiopogonis 15 g,radix rehmanniae 15 g,comus 10 g,rhizome coptidis 8 g,peach kernel 10 g,salvia mitiorrhiza 10 g,magnoliaceae 10 g,yam 15 g) on the basis of conventional therapy.The therapeutic course for all the patients in both groups was 2 months.Before and after treatment,the 6-minute walking distance (6MWD) was assessed;the TCM syndrome accumulated scores of the two groups were calculated;the left ventricular end-diastolic volume (LVEDV),the left ventricle ejection fraction (LVEF),the stroke volume (SV),the cardiac output (CO),and the maximum blood flow velocity of early diastolic/atrium late diastolic (E/A) were detected by echocardiography.The serum levels of glycosylated hemoglobin (HbA1c),angiotensin Ⅱ (Ang Ⅱ) and plasma B type brain natriuretic peptide (BNP) were tested with enzyme linked immunosorbent assay (ELISA);the level changes of total cholesterol (TC),triglyeride (TG),high density lipoprotein cholesteral (HDL-C) and low density lipoprotein cholesteral (LDL-C) were observed.Results Compared with the control group,after treatment in the observed group,the TCM syndrome score of palpitation,fatigue and thetotal accumulated score were all obviously decreased (palpitation score:0.9 ± 0.4 vs.1.2 ± 0.8,fatigue score:1.1 ± 0.7 vs.1.7 ± 0.8,total accumulated score:4.8 ± 1.2 vs.8.1 ± 1.8,all P ＜ 0.05);the LVEDV,the serum levels of HbA1c,Ang Ⅱ and BNP were also obviously decreased in the observed group [LVEDV (mL):136.28 ± 17.52 vs.158.82 ± 19.03,HbA1c (％):6.11±0.36 vs.6.89 ±0.32,Ang Ⅱ (ng/L):66.48 ± 17.64 vs.84.55 ± 20.39,BNP (μg/L):138.45 ± 87.55 vs.219.14±88.83,all P ＜ 0.05];The 6MWD,LVEF,SV,CO and E/A were all increased plainly in the observed group [6MWD (m):470.47 ± 79.66 vs.428.46 ± 88.56,LVEF:0.51 ±0.05 vs.0.46 ± 0.04,SV (mL):55.36 ± 2.88 vs.50.32±2.76,CO (L/min):5.74±0.91 vs.4.92±0.74,E/A:1.18±0.27 vs.0.83±0.28,all P ＜ 0.05].The degrees of decreased levels in TC,TG,LDL-C and the degrees of increased levels of HDL-C in observed group were superior to those of the control group,but there were no statistical significant differences (all P ＞ 0.05).Conclusion JTSXD shows good therapeutic effect and safety for treatment of diabetic patients accompanied by CHF (NYHA functional class Ⅱ-Ⅲ),and its mechanisms may be related to its regulation of glucose (reduction of HbA1c level),correction of lipid metabolism disorders,improvement of myocardial energy supply,inhibition of the activation of renin-angiotensin-aldosterone system (RAAS) and the secretion of BNP.
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In order to build a good environment for the development of both staffs and hospital, our hospital carried out a strategy of Staffs Construct Hospital, Staffs Evolve Hospital, Staffs Make Hospital Powerful. This paper proposed a new idea of creating a new environ-ment for human development, that improved the soft power of personnel work with core values of the hospital, and advocated performance and compatibility.
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OBJECTIVE:To provide reference for strengthening the safety of the combination use of CYP3A4 inhibitors with statins in clinical treatment. METHODS:30 cases per month(totally 300 cases)(the hospitalization time was more than 10 days) discharged from the cardiology department of a third-level class A hospital during Jan. to Oct. 2013 were selected randomly,and statistical analysis was made into general information of patients,whether to use statins and CYP3A4 inhibitor,and whether to monitor safety indicators of liver and kidney function and creatine kinase. RESULTS:Totally 291 patients were treated with statins with a total use rate of 97%,including 265 cases of atorvastatin and 11 cases of simvastatin. The CYP3A4 inhibitors were com-bined with amlodipine,diltiazem,verapammy,amiodarone,Ginkgo biloba leaf,fenofibrate and clarithromycin,etc.,and 162 (59%) patients were given the combination use of simvastatin or atorvastatin with CYP3A4 inhibitors. But the liver and kidney function,creatine kinase and other safety indicators were not monitored by laboratory examination during medication. CONCLU-SIONS:Atorvastatin and simvastatin are used commonly in patients with cardiovascular disease,and the combination use rate with CYP3A4 inhibitor is relatively higher and needs long-term medication,drug dosage should be limited according to the direction of instructions and the adverse reactions induced by drug interactions should be noticed to strengthen medication monitor and education for patients.
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The talent researcher resource is a symbol of the integrated strength and thekey of competitive advantage for medical and health institutions.Scientific standards of selection criteria and equitable growing environment play an important role to attract and keep talents.Therefore,Department of science and education of the hospital established a talented management mechanism according to the development of disciplines and hospital,in order to use mechanism ofselect-cultivate-appointinstead of individual subjective.Methods rational systems of staff management and staff assessment were set up,so as to attract the talent and develop their talents,and to promote the development of disciplines and improve the satisfaction of hospital staffs.
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Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.
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Objective To compare the effect of bupivacaine and levobupivacaine for caudal anesthesia in infant and children.Methods Forty patients with age 3-6 years old in the state of ASA Ⅰ grade were randomly divided into bupivacaine group and levobupivacaine group,each 20 patients.Both groups received respectively bupivacaine or levobupivacine with the same concentration and volume.The blood pressure,heart rate and pulse oxygen saturation were monitored during the operation.The degree of pain and motor was assessed after the operation.Results Bupivacaine and levobupivacaine for caudal anesthesia in infant and children could provide good analgesic effects.The scores of pain was similar between the two groups and had no statistic significance (P ＞ 0.05).The scores of motor block in bupivacaine group was significantly higher than that in levobupivacaine group after anesthesia 60,90,120 min [(1.5 ±0.6) scores vs.(0.9 ±0.3) scores,(1.0 ±0.8) scores vs.(0.1 ±0.5) scores,(0.6 ±0.5) scores vs.(0.0 ±0.7)scores],there was significant difference (P ＜ 0.05).Conclusions Bupivacaine and levobupivacaine have the same analgesic potency.Levobupivacaine is better than bupivacaine in motor block.
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Objective To discuss the application of 18F-FDG PET/CT in epileptogenic zone localization.Methods Tirty-two patients with epilepsies were studied with interictal 18F-FDG PET/CT cerebral imaging,and all of them had scalp EEG,CT or MRI results for comparision.Results The sensitivity of 18F-FDG PET/CT was 90.6%,27 patients(84.5%) showed focal hypometabolism,2 patients(6.3%) showed focal hypermetabolism and rest 3 patients(9.4%) had negative result.The sensitivity of EEG was 65.6%(21/32),the sensitivity of CT and MRI was 31.0%(10/32).Conclusion 18F-FDG PET/CT was a sensitive and accurate image modality in the localization of epileptic foci.
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Objective To discuss the significance ofbispectral index (BIS) monitoring during the patients after general anesthesia while leaving the post-anesthetic intensive care unit (PAICU). Methods Seventy-five cases after general anesthesia were selected. When they were sent out of the PAICU, recorded their BIS. Results Twenty-one cases with BIS 90 - 100,48 cases with BIS 80 - 89 in slight calm and hypnosis,5 cases with BIS 70 - 79, and 1 case with BIS 50 - 60. Conclusions Without BIS monitoring,when sent out of the PAICU,most patients after general anesthesia are gently sedated and without too much risk. But still some patients are deeply sedated. BIS monitoring provides a nice reference for the patients while leaving the PAICU.
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Objective To observe effects of intranasal sufentanil on analgesia.Methods Eighty-two patients,who scheduled for selective thyroidectomy were randomly divided into the observed group and the control group with 41 cases in each group.In the observed group,patients received intranasal sufentanil 20 μg before the incision about 10 minutes,then administered local infiltration with 0.5% lidocaine.In the control group,patients received water for injection which was placebo instead sufentanil.By double blind method observed verbal mting scale(VRS)score.The values of NBP,HR,SpO2 and respiration rate(RR)were recorded before intranasal drugs and 5,10,20,40,60 min after intranasal drugs.The amount of local anesthetic,the size of thyroid gland,the time of operation and the satisfaction were compared between the two groups.Nausea vomiting and pruritus were also observed in order to assess the safety of intranasal sufentanil.Results All patients completed the operation successfully.The RR in the observed group decreased to(13.1±0.5),(13.8±0.6),(13.8±0.8)times/min after intranasal sufentanil 10,20,40 min,and had significant difference with those before intranasal drugs(P＜0.05),anastated after 60 min.VRS score of the observed group was(2.0±0.4)scales,less than the control group,and had significant difference when the surgeon was dissecting thyroid gland(P＜0.05).The amount of local anesthetic in the observed group was(42.5±6.9)ml,less than the control group(63.7±4.3)ml(P＜0.05).The satisfaction had significant difference between the two groups(P＜0.05).Conclusion Intranasal sufentanil for analgesia is a safe and useful technology.
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Objective To observe the curative effect of adult ischemic necrosis of femoral head by intramedullary decompression and arterial pulse pressor infusion.Methods 82 patients with ischemic necrosis of femoral head were treated in the combined treatment of percutaneous intramedully decompression and pulse pressor five medicine combined infusion in target vessels using ZC-Ⅰ-discome.Results By follow-up for 12～48 months,the painful in hip joint was alleviated and joint movement was also improved.The regenerative vessels and bone in femoral head and neek were obvious.Conclusion This therapcutic methods is safe and superior to single interventional medicine treatment for ischemic necrosis of femoral head.
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AIM:To study the effects of inhalation of aerosolized low molecular weight heparin(LMWH)and standard heparin(SH) on the clotting time and bleeding time in guinea pigs and mice.METHODS:Guinea-pigs and mice inhaled aersolized LMWH and SH for 7 days,and the clotting time in guinea-pigs and tail bleeding time in mice were observed.RESULTS:Compared with vehicle,LMWH 800IU/L,400IU/L and SH 800IU/L,400IU/L had no significant effects on the clotting time in guinea-pigs and tail bleeding time in mice(P>0.05);There were no significant differences between LMWH 800IU/L,400IU/L and SH 800IU/L,400IU/L(P>0.05).CONCLUSION:Inhalation of aerosolized LMWH and SH had no significant effects on clotting time and bleeding time in animals.
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Objective To observe the curative effect of adult ischemic necrosis of femoral head by intramedullary decompression and arterial pulse pressor infusion.Methods 82 patients with ischemic necrosis of femoral head were treated in the combined treatment of percutaneous intramedully decompression and pulse pressor five medicine combined infusion in target vessels using ZC-Ⅰ-discome.Results By follow-up for 12～48 months,the painful in hip joint was alleviated and joint movement was also improved.The regenerative vessels and bone in femoral head and neek were obvious.Conclusion This therapcutic methods is safe and superior to single interventional medicine treatment for ischemic necrosis of femoral head.
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Inflammatory response clearly occured in pathologically vulnerable regions of the Alzheimers disease (AD) brain. Many proinflammatory mediators, such as IL-1, IL-6,TNF-? and TGF-?, were significantly up-regulated in the pathophysiological process of AD. In addition to their traditional actions as proinflammatory molecules, AD-specific interactions of the cytokines and amyloid ?(A?) may be pathophysiologically relevant, and there was a reciprocal relationship within the cytokines inducing and being induced by A?.