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Objective To improve the quality of prescriptions and promote the rational drug application of Dingqing Tablets by investigating the outpatient prescriptions in a tertiary A hospital. Methods A total of 4 796 prescriptions of outpatient pharmacy patients from August 1, 2020 to August 1, 2021 were extracted from the hospital information system by the hospital information software, focusing on the analysis of indications, usage and dosage, drug interaction, etc. Results 10 departments including hematology department and geriatrics department were used Dingqing Tablets, and the irrationality was mainly manifested in the superposition of drug flavors and drug interactions. Conclusion Dingqing tablets were widely used in clinic and had remarkable curative effect. However, there are certain risks in the use of Dingqing tablets. It is necessary to add medication education and supervision to promote the safe and rational use of drugs in clinic.
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Objective:To explore the impact of completion rates of 3-hour and 6-hour sepsis bundle therapy on prognosis of patients with septic shock in Prefecture-level grade A hospitals, and analyze the risk factors for prognosis.Methods:A retrospective analysis was conducted to patients with septic shock in the intensive care unit (ICU) of Liaocheng People's Hospital, Shandong Province from January 1, 2020 to December 31, 2021. The data of gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), sites of infection, pathogenic microorganisms, completion rates of 3-hour and 6-hour sepsis bundle therapy, 28-day prognosis were collected. Logistic regression analysis was used to identify risk factors for patients' mortality at 28-day.Results:① Among 159 patients with septic shock, 93 survived and 66 died with 28-day. There were no significant differences in gender and age between the survival group and death group. Compared with the survival group, APACHE Ⅱ score and SOFA score were significantly higher in the death group [APACHE Ⅱ score: 26.85±5.04 vs. 20.67±4.29, SOFA score: 12.86±3.02 vs. 9.37±2.51, both P < 0.05]. ② Sites of infection in the 159 patients: 47 cases were abdominal infection (29.6%), 36 case were bloodstream infection (22.6%), 31 cases were pulmonary infection (19.5%), 16 cases were soft tissue infection (10.1%), 13 cases were urinary tract infection (8.2%), 12 cases were biliary tract infection (7.5%), and 4 cases were other sites infection (2.5%). Pathogens were found in 128 cases and the positive rate was 80.5%, including 90 cases of Gram-negative (G -) bacilli (56.6%), 27 cases of Gram-positive (G +) cocci (17.0%) and 11 cases of fungi (6.9%). The top three pathogenic bacteria were Escherichia coli (49 cases, 30.8%), Klebsiella pneumoniae (21 cases, 13.2%) and Staphylococcus aureus (15 cases, 9.4%). The differences were not statistically significant. ③ Among the 159 patients, 101 cases completed 3-hour sepsis bundle therapy (63.5%), including 67 cases (72.0%) in survival group and 34 cases (51.5%) in death group; 106 cases completed 6-hour sepsis bundle therapy (66.7%), including 70 cases (75.3%) in survival group and 36 cases (54.5%) in death group. The differences between the two groups were statistically significant (all P < 0.05). ④ The factors (APACHE Ⅱ score, SOFA score and completion rate of 3-hour and 6-hour sepsis bundle therapy) affecting the prognosis in the univariate analysis were included in the binary Logistic regression analysis, and the results showed that the APACHE Ⅱ score, SOFA score, completion rate of 3-hour sepsis bundle therapy were independent risk factors affecting mortality within 28-day [odds ratio ( OR) was 1.216, 1.303, 0.402, all P < 0.05]. Conclusions:The higher APACHE Ⅱ score and SOFA score in septic shock, the worse the prognosis. Improving the completion rates of 3-hour and 6-hour bundle therapy especially the completion rate of 3-hour bundle therapy can reduce the mortality of patients and improve the prognosis.
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Objective:To provide the basis and direction for the establishment of the database of severe patients by analyizing of the disease composition and outcome of patients in the department of critical care medicine of the 3A hospital.Methods:The clinical data of 3 249 patients admitted to the department of critical care medicine of Liaocheng People's Hospital from January 1, 2019 to December 31, 2021 were retrospectively analyzed, including gender, age, admission time, admission route, diagnosis, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score 24 hours after admission, outcome and other information.Results:The mean age of 3 249 patients was (61.99±18.29) years old, and the proportion of young and old patients aged 60-74 years accounted the largest (34.01%). There were more males (1 800 cases) than females (1 449 cases). The most patients were admitted in January (119 cases) and the least in March (75 cases). The top eight diseases in the department of critical care medicine were respiratory system diseases (21.88%), multiple injuries (12.65%), cardiovascular system diseases (11.48%), gastrointestinal surgery diseases (9.42%), pathological obstetrics (7.76%), digestive system diseases (7.63%), urinary system diseases (5.69%) and nervous system diseases (5.23%). Among 3 249 critically ill patients, 54.36% (1 766 cases) were transferred to the general ward for treatment after improvement, with APACHE Ⅱ score was 17.99±5.51. 15.91% (517 cases) returned to local hospital for further treatment after improvement, APACHE Ⅱ score was 22.48±6.57. 1.51% (49 cases) were transferred to superior hospitals, APACHE Ⅱ score was 21.71±5.18. 24.22% (787 cases) were discharged automatically, APACHE Ⅱ score was 25.64±5.45. 4.00% (130 cases) died in intensive care unit (ICU), APACHE Ⅱ score was 29.08±8.10. The APACHE Ⅱ score of patients who died in ICU was higher than that of patients who were transferred to another department, another hospital or discharged automatically after their condition improved, and the differences were statistically significant (all P < 0.001). Among 3 249 patients, a total of 1 265 patients were admitted to ICU for sepsis caused by aggravated infection, and 44.43% (562 cases) of the 1 265 patients improved to the general ward after treatment, with APACHE Ⅱ score was 18.99±5.46. 19.21% (243 cases) returned to local hospital after treatment with APACHE Ⅱ score was 22.79±6.74. 1.50% (19 cases) were transferred to superior hospitals for further treatment with APACHE Ⅱ score was 21.21±4.81. 31.54% (399 cases) were discharged automatically with APACHE Ⅱ score was 25.55±4.84; 3.32% (42 cases) died in ICU with APACHE Ⅱ score was 27.69±7.92. The APACHE Ⅱ score of patients who died in ICU was higher than that of patients who were transferred to another department, another hospital or discharged automatically after their condition improved, and the difference was statistically significant (all P < 0.001). Conclusions:Among the patient admitted to ICU 2019-2021 in Liaocheng People's Hospital, respiratory system diseases accounted for the first, multiple injuries accounted for the second place, followed by cardiovascular system diseases, gastrointestinal surgery diseases, pathological obstetrics, etc. Males and elderly patients aged 60-74 years have a higher proportion of severe cases. APACHE Ⅱ scores were associated with patients' prognosis.
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Prokineticin 2 (PK2) is a newly discovered chemokine, which participates in various physiological functions of the body by binding to receptors PKR1 and PKR2. PK signaling pathway is a newly discovered important regulatory pathway for the occurrence and maintenance of pain after tissue injury and nerve injury in recent years. It plays a key role in regulating injury-related nociceptive events and is a potential therapeutic target for many diseases. The activation of PKRs can induce pain sensation and participate in the sensitivity of pain receptors to different stimuli. The PK system (PKs and PKRs) is an important link involved in inflammation and pain transmission in immune cells. PK2 is involved in the regulation of pain perception by activating PKR1 and PKR2 on primary sensory neurons. In rat primary sensory neurons, PK2 also enhances gated ion channel current through the PKC signaling pathway, inhibits GABA-activated currents, and sensitizes purine nucleotide P2 receptor (P2X). This paper reviews the research progress of PK2 in physical pain. We hope to find new drugs for the treatment of inflammatory pain that target the PKs signaling pathway in future studies.
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Objective To identify the chemical constituents of Xiakucao Xiaoliu mixture by high performance liquid chromatography-high resolution time-of-flight mass spectrometry (HPLC-TOF/MS). Methods The chromatographic separation ACE (3.0mm×150 mm) column was used. The mobile phase was methanol (A) and 0.1% formic acid (B). The gradient elution was: 0-5 min, 5% A; 5-10 min, 5%-15% A; 10-30 min, 15%-45%A; 30-40 min, 45%-70%B; 40-50 min, 70%-90%B. The injection volume was 2 μl. The flow rate was 0.4 ml/min. The column temperature was 25°C. The mass spectrometry was characterized by time-of-flight mass spectrometry, using ESI ion source. The common monitoring was in positive and negative ion mode. The reference ion was m/z 121.9856, 1033.9881. The scanning range was m/z 100-1200. Results A total of 37 chemical constituents were identified in the Xiakucao Xiaoliu mixture, 8 in the positive ion mode fragment voltage of 160 V, 28 in the negative ion mode fragment voltage of 160 V, and 19 in the fragment voltage of 260 V. Both positive and negative ions had 4 responses. The negative ion mode has 16 responses under both fragment voltages. And the ingredients were medicinal. Conclusion An effective method for the identification of the chemical constituents of Prunella vulgaris L. by HPLC-TOF/MS was established, which laid a foundation for its quality control and in-depth study in vivo.
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Objective To investigate the anti-inflammatory and analgesic effects of the active fractions of Tongfeng granules on rats with arthritis induced by complete Freund's adjuvant. Methods 56 SD rats were randomly divided into seven groups, blank group, model group, total flavonoids group, total organic acid group, total alkaloid group, Tongfeng granule group and positive control group. Except for the blank group, the remaining 6 groups established joints pathological model of inflammation. 15 days after the successful modeling, intragastric drug administration was continued for 30 days. The swelling of ankle joint, WBC, N%, IL-6, IL-10, TNF-α and the histopathology of joint were measured. Results Comparing with the model group, each effective fraction group of Tongfeng granules, Gout granules and positive control group decreased the ankle joint swelling rate significantly (P<0.01) and reduced fibrous tissue proliferation. There was no significant difference in WBC and N% of neutrophils. They significantly reduce the level of serum IL-6 and TNF-α, and increase the level of IL-10 (P<0.05, P<0.01). Conclusion This study clarifies the anti-inflammatory and analgesic effects of active fractions of Tongfeng granules and provides a basis for further clinical medication and preparation development.
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Objective:To investigate the clinical effect of "standardized 4 steps" in rheumatic mitral valve repair.Methods:We retrospectively analyze the clinical data of 136 rheumatic mitral valve disease patients undergoing mitral valve repair with "standardized 4 steps" from June 2016 to July 2019 and investigate its clinical outcome. The clinical outcome was compared with those of patients undergoing rheumatic mitral valve replacement.Results:The perioperative mortality was 2.94% in patients with mitral valve repair. Compared with preoperative period, left atrial diameter was significantly reduced and the early diastolic blood flow velocity across mitral valve(E peak) was significantly decreased at 1-week postoperative and follow-up period. The elimination rate of atrial fibrillation was 80.7% during follow-up period. The early clinical outcome and related complications had no difference between mitral repair group and mitral valve replacement group. The main echocardiographic indexes in two groups also had no statistical significance.Conclusion:The early clinical outcome of rheumatic mitral valve repair with "standardized 4 steps" is satisfactory. Rheumatic mitral valve repair with "standardized 4 steps" is feasible, safe and effective.
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Chronic obstructive pulmonary disease (COPD) has a high incidence, and leads to irreversible lung dysfunction. Preventing COPD acute exacerbation (AECOPD) and delaying the progression of the disease are the focus of treatment. However, there is still a lack of precise and effective preventive measures. A significant feature of AECOPD is the high incidence in winter. The traditional concept is that cold air in winter can be accompanied by increased virus replication, environmental pollution, and reduced air humidity. Various confounding factors intertwine to promote the occurrence of AECOPD, and the impact of low temperature itself has been neglected. In recent years, with the development of molecular biology, more and more studies have found that abnormal secretion of airway mucin can lead to obstruction of mucus clearance, increase the chance of infection, and participate in the development of COPD. Low temperature can affect mucin secretion through various mechanisms. This article summarizes the particularity of COPD airway temperature and the related ways of low temperature leading to mucin changes. It draws people's attention to low temperature in order to carry out basic research and provide new intervention methods for predicting and preventing the occurrence of AECOPD.
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Objective To investigate the therapeutic effect of Xiakucao Xiaoliu mixture on Lewis lung cancer mice. Methods 30 mice with C57BL/6 mouse Lewis lung cancer xenograft model were randomly divided into three groups: model control group, Xiakucao Xiaoliu mixture group (M group), cisplatin group (DDP group). M group and DDP group were administered continuously for 14 days. Through the general observation of Lewis lung cancer mice, tumor size was determined, HE staining method was used to determine the histopathological changes of tumors, and the expression of CyclinD1 and P16 in tumor tissues was determined by immunohistochemistry. Results The tumor weight of the model control group was the heaviest, and the difference was statistically significant compared with other groups. (P<0.05). Survival state and quality of life of mice had been improved to some extent in M group. The results of tumor growth curve and HE staining in each group of mice showed that the growth of tumor cells had been inhibited and normal cells had been protected. The positive expression of CyclinD1 was significantly decreased in M group and DDP group (P<0.01), but the effect of M group on the improvement of P16 positive expression was not significant. Conclusion Xiakucao Xiaoliu mixture had a good effect on inhibiting lung tumor growth.
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OBJECTIVE: To improve the quality and efficiency of medication consultation and to promote rational drug use in clinic. METHODS: Totally of 520 cases of medication consultation records from the Affiliated Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM during Oct. 2015-Oct. 2016 were selected according to random number table, and then summarized and analyzed statistically in respects of consultation content, age and type of consultants, department, consulted medicine types, the number of combination of TCM and Western medicine, satisfactory degree of consultants, etc. RESULTS: The main consultation contents included usage and dosage (41. 92％), combination of TCM and Western medicine (12. 88％), etc. Consultants mainly aged 50-70 years old (48. 27％), and were mainly the patients and their family members (95. 96％). Consultants were primarily diagnosed in cardiology department and endocrinology department. Top 3 consulted medicine types were cardiovascular system medicines, nervous system medicines, digestive system medicines, and types of Chinese patent medicines were mainly coordinating medicines and activating blood and removing stasis medicines. Types of TCM combined with Western medicine were less than or equal to 3 kinds in 420 cases (80. 77％). Most patients were very satisfied with outpatient medication consultation (93. 65％). CONCLUSIONS: Rational drug use consultation improves medication compliance of patients, meets the needs of patients on medication safety knowledge, and provides a strong guarantee for safe and rational drug use in clinic.
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Objective To observe the effect of peripheral blood microRNA-182 (miR-182) combined with interleukin-17 (IL-17) in the early diagnosis of cerebral infarction (CI) in patients with eclampsia. Methods A prospective non-randomized controlled study was conducted. The patients with eclampsia admitted to intensive care unit (ICU) of Liaocheng People's Hospital from January 1st, 2013 to September 30th 2016 were enrolled. Cerebral imaging was conducted in 7 days after admission to make a definite diagnosis of the occurrence of CI, excluding patients with cerebral hemorrhage. Patients were divided into CI group and non-CI group. Twenty healthy women of childbearing age were selected as control group. Peripheral venous blood of all patients with eclampsia at 1 day after admission, the expression of miR-182 was detected by real-time fluorescence quantitative polymerase chain reaction (PCR), regulatory T cells (Treg) and T helper 17 cells (Th17) ratio was detected by flow cytometry, and the level of plasma IL-17 was detected by enzyme linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the indexes. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of each index for CI in patients with eclampsia. Results In the 30 patients with eclampsia, there were 13 cases of CI, including 10 case of cerebral venous thrombosis (CVT) and 3 cases of arterial thrombus; 17 cases of non-CI, including 15 cases of reversible posterior leukoencephalopathy syndrome (RPLS) and 2 cases without obvious abnormalities. Compared with control group, the levels of miR-182, Th17% and IL-17 in non-CI group and CI group were significantly higher, and the Treg% was significantly lower. The levels of parameters mentioned above were further increased in CI group than those in non-CI group [miR-182 (2-ΔΔCt): 2.35±0.79 vs. 1.75±0.56, Th17%: (5.16±1.89)% vs. (3.93±1.92)%, IL-17 (ng/L):37.45±6.20 vs. 26.65±5.13, all P < 0.05]. Pearson correlation analysis showed that miR-182 was positively correlated with Th17% and IL-17 (r1 = 0.761, r2 = 0.842, both P < 0.01). ROC curves showed that when the cut-off value of miR-182 was 2.88, the diagnosis sensitivity of preeclampsia CI was 84.6%, the specificity was 82.4%, and area under the ROC curve (AUC) was 0.816 [95%CI confidence interval (95%CI) = 0.641-0.992]; when cut-off value of IL-17 was 34.44 ng/L, diagnosis of preeclampsia CI the sensitivity was 71.5%, the specificity was 85.3%, and AUC was 0.773 (95%CI = 0.602-0.945); when miR-182 was combined with IL-17, the diagnosis sensitivity was 92.3%, specificity was 83.6%, and AUC was 0.896 (95%CI = 0.759-1.032). Conclusions To some extent the expression of miR-182 and IL-17 in peripheral blood can predict the occurrence of CI in early stage. When the two are used together, the predictive value is better.
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Objective To investigate the diagnostic values of procalcitonin (PCT),high sensitive C-reactive protein (hs-CRP),white blood cell (WBC)and percentage of neutrocyte (NEU％)in Gramnegative and Gram-positive bacterial blood stream infection in early stage of sepsis in order to investigate the correlation between PCT and APACHE lⅡ score as well as between PCT and SOFA score,and the prognostic value in assessment of Gram-negative and Gram-positive bacterial blood stream infection.Methods Clinical data of patients admitted to ICU from January 2012 through December 2014 were retrospectively analyzed.A total of 124 sepsis patients with blood stream infection were checked with PCT,hs-CRP,WBC and NEU％ tests,and APACHE Ⅱ score and SOFA score were calculated.The differences in APACHE Ⅱ score and SOFA score were compared between Gram-negative group (n =41) and Gram-positive group (n =83).The correlation between PCT and APACHE Ⅱ score as well as between PCT and SOFA score was analyzed.The differences in diagnostic values of PCT,hs-CRP,WBC and NEU％ between Gram-negative group and Grampositive group were analyzed by using receiver operating characteristic (ROC) curve and it was plotted to assess the prognostic values of PCT,hs-CRP,WBC and NEU％ for septic patients with blood stream infection.Results Compared with Gram-positive group,the levels of PCT [.55.32 (22.01,97.11) vs.2.13 (0.27,5.27)] (P ＜0.01),hs-CRP [105.09 (69.97,186.12) vs.70.54 (42.37,138.63)] (P=0.508),NEU％ [88.30 (75.79,93.52) vs.55.32 (22.01,97.11)] (P=0.302) were higher but WBC was lower [13.59 (10.74,17.58) vs.13.73 (11.32,20.90)] (P=0.058) in Gram-negative group.The ROC curve analysis of PCT showed the area under the curve (AUC) was 0.867 (95％ CI:0.789-0.946).When the optimal cutoff point of PCT was 17.48 ng/mL,the largest Youden's index was found to be 0.661 with 76.9％ sensitivity and 89.2％ specificity.Between two groups,there were significant differences in APACHE Ⅱ score and SOFA score (27.46 ± 9.60 vs.23.67 ± 7.74,P =0.020;8.05 ±3.38 vs.6.59-±3.45,P =0.028).There was significant difference in diagnostic value between PCT and SOFA (r =0.536,P =0.036) in Gram-negative group but no significant difference in Gram-positive group.Conclusions Higher PCT levels are found in Gram-negative group and it can play a role in differntiation between the Gram-negative group and Gram-positive group rather than hs-CRP,WBC and NEU％.PCT can be a better indicator for evaluation of severity of sepsis as well as for prognosis of sepsis patients with Gram-negative bacterium infection.
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Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids .Method DDDs ,DUI ,the distribution of cancer pain ,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medi-cal records from January in 2013 to December in 2014 .Results 292 medical records were selected and analyzed .Among them , 89 patients′pain score≥3 .The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives ,which is the main medication in treating the cancer pain patients .And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments .Conclusion Theutilization of opioids was basically rational ,but there still had some deficiencies . The intervention and management of narcotic drugs should be strengthened and deepened .
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Objective To observe the features of the changes in the whole blood N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in pregnant patients with complication of hypertensive disorders,its correlation to the severity of the illness,and to investigate the diagnostic value of point-of-care testing of NT-proBNP in patients with hypertensive disorders complicating pregnancy.Methods A prospective observation was conducted.Sixty-nine patients with hypertensive disorders complicating pregnancy admitted to Department of Critical Care Medicine of Liaocheng People's Hospital in Shandong Province from April 2013 to April 2015 were enrolled.All patients were divided into gestational hypertension group (n =16),preeclampsia group (n =30) and eclampsia group (n =23).At the same time,30 age-matched normal pregnant women were enrolled as the control group.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of all patients with hypertensive disorders complicating pregnancy were calculated within 24 hours after intensive care unit (ICU) admission.NT-proBNP in venous blood at 1,3,5 days after ICU admission was determined with point-of-care testing,in order to analyze the correlation of changes in NT-proBNP value in each group and the severity of the disorder.Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of NT-proBNP in the whole blood in hypertensive disorder complicating pregnancy.Results The APACHE Ⅱ score of the eclampsia group was significantly higher than that of the preeclampsia group,and it was higher than that of gestational hypertension group (15.91 ± 1.06,13.73 ± 1.09,10.31 ± 1.10,all P ＜ 0.01).The NT-proBNP in normal pregnancy group was lower than 125.00 ng/L,with a mean of 90.00 (79.75,100.00) ng/L.With the aggravation of the disease,NT-proBNP was gradually increased.On the first day in ICU,the NT-proBNP of the eclampsia gronp was significantly higher than that of the preeclampsia group,and it was higher in preeclampsia group than that of gestational hypertension group [ng/L:1960.00 (1 226.00,3 229.00),859.50 (626.75,2439.00),505.00 (171.25,604.05),P ＜ 0.05 or P ＜ 0.01].With the extension of duration of treatment,the levels of NT-proBNP (ng/L) in the eclampsia group,preeclampsia group,and gestational hypertension group was gradually decreased,and had a statistically significant difference on the fifth day as compared with that of the first day [310.00 (210.00,430.00) vs.1 960.00 (1 226.00,3 229.00) in eclampsia group,265.00 (229.50,333.25) vs.859.50 (626.75,2439.00) in preeclampsia group,and 203.00 (115.50,259.25) vs.505.00 (171.25,604.05) in gestational hypertension group,all P ＜ 0.01].APACHE Ⅱ score of the patient with hypertensive disorders complicating pregnancy was positively correlated with the level of NT-proBNP on the first day in ICU (r =0.795,P =0.000).It was shown by ROC curve analysis that the area under the ROC curve (AUC) of NT-proBNP in the whole blood for the diagnosis of the patient with hypertensive disorder complicating pregnancy was 0.986 [95％ confidence interval (95％C/) =0.753-0.924].When the cutoff value was 122.50 ng/L,the sensitivity was 97.1％,and the specificity was 100.0％.No patient died,all the 69 patients recovered and discharged.Conclusions The levels of NT-proBNP in the whole blood in the patients with hypertensive disorder complicating pregnancy,especially those with eclampsia,were significantly higher,and it was correlated with the severity of illness.After treatment,the levels were gradually lowered with the improvement of the disease.Therefore,it is concluded that the point-of-care testing of NT-proBNP in the whole blood has an excellent value for the diagnosis and evaluation of hypertensive disorder complication pregnancy.
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Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.
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Objective To investigate the clinical value of the peripheral blood monocyte human leukocyte antigen-DR (mHLA-DR) for assessment of degree of severity and the diagnosis of acute pancreatitis (AP). Methods A case-control study was conducted. Eighty-six AP patients admitted to Shandong Liaocheng People's Hospital from June 2014 to May 2015 were enrolled. Patients were classified into four groups [mild (n = 33), moderate (n = 25), severe (n = 16), critical (n = 12)] according to the disease classification. Eighty healthy persons subjected to physical examination center of our hospital at the same time were served as controls. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores in patients were estimated. Flow cytometry was used to measure the expression of the peripheral blood mHLA-DR, and the Pearson method was used to analyze the relationship between the level of mHLA-DR and the APACHE Ⅱ score. The receiver-operating characteristic curve (ROC) was plotted, and then the clinical value of the peripheral blood mHLA-DR was analyzed for the diagnostic value in AP patients. Results The expression of the mHLA-DR in patients with AP was significantly lower than that of healthy control group [(63.7±18.6)% vs. (86.4±8.3)%, t = 5.319, P < 0.001]. The expression levels of the mHLA-DR in mild group, moderate group, severe group, and critical group were (79.6±6.5)%, (66.4±9.4)%, (49.9±8.1)%, (32.5±12.0)%, respectively, and the APACHE Ⅱ score were 4.67±1.99, 5.88±2.05, 9.06±2.62, 12.33±3.96, respectively. Pair wise comparisons were statistically significant (all P < 0.05). The HLA-DR expression level in the peripheral blood of patients with AP was negatively correlated with the APACHE Ⅱ score (r = -0.695, P < 0.001). The area under the ROC curve (AUC) of mHLA-DR expression in peripheral blood for AP was 0.894 [95% confidence interval (95%CI) = 0.847-0.941, P < 0.001], and the cut-off point was 84.40%, with the sensitivity of 75.0%, the specificity of 90.7%, and the accuracy rate of 83.1%. The AUC of mHLA-DR expression for mild AP was 0.938 (95%CI = 0.889-0.987, P < 0.001), and the cut-off point was 72.70%, with the sensitivity of 87.9%, the specificity of 88.7%, and the accuracy rate of 88.4%. The AUC of mHLA-DR expression for severe and critical AP was 0.943 (95%CI = 0.881-1.005, P < 0.001), and the cut-off point was 57.85%, with the sensitivity of 84.0%, the specificity of 96.4%, and the accuracy rate of 90.6%. Conclusions The expression levels of the peripheral blood mHLA-DR in AP patients can reflect the degree of disease, and contribute to the diagnosis of AP. The value of mHLA-DR may be used as a new biological indicator in the diagnosis and assessment for the severity of AP.
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Objective To explore the key antecedent variables of team effectiveness and their correlation.Methods The stratified cluster random sampling was conducted to recruit 133 college students from a university in Fujian Province.Results (1) Communication and back up behaviors were positive predictors of team grade (β =0.645,0.315,P＜0.01)and satisfaction degree of team members (β=0.305,0.309,P＜0.01).Free riding had negative influence to the satisfaction of team members (β=-0.392,P＜0.01).(2)Accuracy of tusk cognition and tusk concern were positively related to team performance (β=0.513,0.470,P＜0.01),and accuracy of tusk cognition and team efficacy were predictors of satisfaction of team members (β=0.502,0.373,P＜0.01).(3)Team process variables mediated the relationship between team mentalmodel and tear effectiveness.Conclusion Antecedent variables include team process variables and team mental model.Between team mental model and team effectiveness,the team process variables play a mediating role.
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Objective To evaluate the value of neutrophil gelatinase - associated lipocalin (NGAL) for diagnosis of acute kidney injury (AKI) after cardiopulmonary bypass established. Method 120 children undergoing cardiopulmonary bypass were enrolled in this prospectively study. Serial urine samples were analyzed by ELISA for NGAL expression. The primary outcome measure was AKI, which was defined as a 50% or greater increase in serum creatinine from baseline. Result 21 children ( 17.5% ) developed AKI. Urine concentrations of NGAL increased after cardiopulmonary bypass had been established for 2 hours. The concentration of NGAL in urine after cardiopulmonary bypass had been established for 2 hours was used to diagnose AKI. The area under the receiver-operating characteristic curve was 0. 96, the sensitivity was 92%, and the specificity was 91% for the cutoff value of 100ng/mg Cr. Conclusion Concentrations of NGAL in urine might be used as a sensitive and specific biomarker for early prediction of AKI after cardiopulmonary bypass had been established.
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Objective To explore the effects of fat emulsion made of fish oil for total parenteml nutrition on patients with systemic inflammatory response syndrome(SIRS).Methos Forty patients with SIRS in the intensive care unit(ICU),Liaocheng People's Hospital,from January to June 2007 were randomly divided into conventional total parenteral nutrition(TPN)group(group A,n=20)and fish oil emulsion+TIN group(group B,n=20).Patients of both groups received equal amount of nitrogen and calories.The energy give.Was 20 kcal/(kg·d),and nitrogen 0.2 g/(kg·d)for 7 days and the fish oil emulsion given was 1-2 ml/(kg·d)(Commoditieds:Omegaven,No.UK 1580,Wuxi,China SINO-SWEO Pharmaceutical CORP.Ltd.).The levels of serurn TNF-α,IL-1 and IL-6 were checked before TPN and 1 d,3 d and 7 d after TPN.The davs of ICU stay,the incidence of MODS and the mortality within 28 aays of two groups were also recorded.Data were analyzed wotj inde pent-saraples t test and paired-sarnples t test using the SPSS 10.34 software.Results There wsa no significant difference in APACHF-Ⅱ score between two groups of patients.Compared with group A,the levels of serum TNF-α,IL-1 and IL-6 in group B decreased markedly at different intervals(P<0.05,P<0.01).The duration of ICU slay shortened obviously in group B than that in group A[(11.5±2.4)days vs.(15.8±2.3)days,P<0.05].Conclusions The fat emulsion made of fish oil has protective effects on patients with SIRS by the mechanism of decrease in the levek of Serum TNF-α,IL-1 and IL-6,and thereby reduees the incidence of MODS,shortens the duration of ICU stay,increasing the survival rote of seriously ill patients.
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<p><b>OBJECTIVE</b>To investigate the relationship between blood nitrogen monoxide(NO) and PaO2 or PaCO2 levels in patients with severe and moderate acute carbon monoxide poisoning.</p><p><b>METHOD</b>The blood levels of NO in patients with severe and moderate acute carbon monoxide poisoning was assayed with nitrate reductase method, and its correlation with the blood levels of PaO2 and PaCO2 was analyzed.</p><p><b>RESULTS</b>The blood level of NO in patients with severe and moderate acute carbon monoxide poisoning were (36.6 +/- 9.9) and (35.7 +/- 10.7) mumol/L respectively, significantly lower than that of control group[(64.9 +/- 14.3) mumol/L, P < 0.01], but there was no significant difference between moderate and severe patients(P > 0.05). The analysis of linear correlation showed that there was significant positive correlation between NO and PaO2 but not PaCO2.</p><p><b>CONCLUSION</b>Anoxia of patients with acute carbon monoxide poisoning may be an important cause to reduce NO level in blood. This study provides the basis for low NO concentration inhalation in treatments of acute carbon monoxide poisoning.</p>