The characteristics and influencing factors of medicine cost for orthopedic surgery patients in hospitals of Shanxi province / 中国药房

OBJECTIVE To analyze the characteristics and influencing factors of medicine cost for orthopedic surgery patients in Shanxi province， and to provide reference for the rational management of medicine cost in orthopedic surgery patients. METHODS A retrospective analysis was conducted on the case information of 584 204 orthopedic surgery patients in Shanxi province from 2016 to 2021. Medicine cost was analyzed by year， region， hospital level， type of surgery and type of surgical incision. Single factor analysis and generalized linear regression model were used to analyze the influencing factors of total medicine cost， and structural equation model was used for verification. RESULTS The research findings indicated that joint replacement surgery （42.61%） and post-fracture external fixation surgery （12.60%） were the most common types of procedures. There was statistical significance in medicine cost for different surgical types among different regions and hospital levels （P＜0.05）. In the Jinzhong region， the total medicine cost for post-fracture external fixation surgery was the highest （[ 11 719.97±4 374.73） yuan]， while in tertiary grade A hospitals， the total medicine cost for post-fracture external fixation surgery was also the highest （[ 13 584.71±4 531.82） yuan]. Among class Ⅰ incision surgeries， the cost of antibiotics for post-fracture external fixation surgery was the highest （[ 1 176.25±341.42） yuan]. Generalized linear regression model revealed that hospital location， hospital level， gender， payment method， length of hospital stays， and surgical type were the independent influencing factors for total medicine cost （P＜0.05）. Structural equation model further disclosed that hospital level， payment type， and surgical type had significant effects on total medicine cost （P＜0.05）. CONCLUSIONS Attention should be paid to the high cost of antibiotics for class Ⅰ incision surgery， and further research on their rational use should be conducted.

Electrophysiological characteristics of subacute combined degeneration of spinal cord in patients with nitrous oxide poisoning / 中国医师进修杂志

Objective:To analyze the electrophysiological characteristics of subacute combined degeneration of spinal cord in 10 patients with nitrous oxide poisoning.Methods:Ten patients with nitrous oxide poisoning (case group) and 20 controls (control group)treated in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from January 2016 to January 2020 were included in this study. MRI and electrophysiological examinations were performed on the head, cervical spine and thoracic spine, including distal motor latency (DML), motor nerve amplitude (CMAP), motor conduction velocity (MNCV), sensory conduction velocity (SNCV), sensory nerve amplitude (SNAP), N20 latency of upper limb cortical somatosensory evoked potential and P40 latency of lower limb cortical somatosensory evoked potential. The above indexes were compared between the two groups.Results:In the case group, DML of motor nerve was prolonged, MNCV was slowed down, CMAP was decreased, SNCV was slowed down and SNAP was decreased compared with the control group, the differences were statistically significant ( P<0.05). The incubation periods of N20 and P40 in the case group were longer than those in the control group: (32.70 ± 3.34) ms vs. (18.85 ± 1.37) ms, (57.00 ± 4.08) ms vs. (38.40 ± 1.54) ms, the differences were statistically significant ( t = 16.20, 18.20, P<0.01). The inverted "V" type T 2 long signal of cervical spinal cord and thoracic spinal cord could be seen on MRI of cervical or cervical and thoracic vertebrae in 5 patients. Conclusions:Nitrous oxide poisoning can cause obvious subacute combined degeneration of spinal cord, involving peripheral nerve and spinal cord damage. Peripheral nerve damage can involve motor fibers and sensory fibers, mainly axonal damage, accompanied by demyelination damage, especially in both lower limbs.

Potentiating CD8

Metabolic regulation has been proven to play a critical role in T cell antitumor immunity. However, cholesterol metabolism as a key component of this regulation remains largely unexplored. Herein, we found that the low-density lipoprotein receptor (LDLR), which has been previously identified as a transporter for cholesterol, plays a pivotal role in regulating CD8

Research progress of treatments on colorectal cancer in elderly patients / 中华老年医学杂志

The patients aged ≥ 60 years account for 70％ of Chinese population with colorectal cancer.However,with the increase of age,the treatment methods such as surgery,radiotherapy,chemotherapy become inappropriate and impeding factors for the self-care of the elderly.Several clinical trials show that only a part of the elderly,who are in good health condition,can get the clinical benefits from these therapies.Therefore,this review focused on the comprehensive treatments for elderly patients with colorectal cancer,then reached the best individualized treatment,so as to improve the survival and quality of life.

Vasodilatory effect of midazolam on pre-contractions of in-vitro porcine coronary artery and its mechanisms / 中国药理学通报

Aim To investigate the effects of midazolam on porcine isolated coronary artery rings pre-contracted by potassium chloride(KCl)and the possible mechanism.Methods The vessel tension recorder system was used.Isotonic tension of porcine isolated coronary artery rings precontracted by KCl(30 mmol·L-1)was recorded.The vasorelaxing action of midazolam and effects of various drugs were observed in the rings.Results Midazolam(3×10-6～1×10-4 mol·L-1)respectively concentration-dependently reduced the contraction induced by KCl,and there was significant difference between the rings with intact and denude endothelium(P<0.05).On KCl-induced precontraction,midazolam′s relaxation was depressed by L-NAME and the blend of L-NAME and L-Arg(P<0.05),but was not affected by Indo,L-Arg and 1400W.The contraction was not prevented by pretreatment with the inhibitor of Na+/Ca2+ exchanger(KB-R7943).The inhibitor of KATP(Gli)restrained the diastolic function of midazolam(P<0.05),while the inhibitor of BKCa(TEA),Kir(BaCl2),KV(4-AP)had no obvious effect.Conclusions Midazolam produces remarkable vasodilatation on KCl pre-contracted porcine isolated coronary artery rings.Its relaxtion effect is via concentration-dependent and endothelium-dependent mechanisms and relevant to the production of NO.Na+/Ca2+ exchanger is not involved midazolam′s vasodilatation on KCl pre-contracted porcine coronary artery rings.The relaxant mechanism of midazolam may be concerned with KATP.The Kir,BKCa and KV may be not involved.

Research progress of treatments on colorectal cancer in elderly patients / 中华老年医学杂志

The patients aged ≥ 60 years account for 70％ of Chinese population with colorectal cancer.However,with the increase of age,the treatment methods such as surgery,radiotherapy,chemotherapy become inappropriate and impeding factors for the self-care of the elderly.Several clinical trials show that only a part of the elderly,who are in good health condition,can get the clinical benefits from these therapies.Therefore,this review focused on the comprehensive treatments for elderly patients with colorectal cancer,then reached the best individualized treatment,so as to improve the survival and quality of life.

Value of remote ECG consultation launched by cardiovascular disease specialized hospital / 心血管康复医学杂志

Objective:To explore the clinical value of remote ECG consultation for primary medical institutions. Methods:Remote ECG consultation data for medical institutions of different levels in Hubei Jianli county were sta-tistically analyzed.Results:In county hospitals of this area,there were 1334 cases of ECG consultation,the positive rate was 41.00% (547/1334),and the three abnormal ECG types with highest incidence rate were arrhythmia (27.29%),left ventricular hypertrophy (LVH,9.15%)and ST-T change (2.62%)in order;in rural health rooms of this area,there were 723 cases of ECG consultation,the positive rate was 55.19%(399/723),and the three ab-normal ECG types with highest incidence rate were arrhythmia (34.02%),ST-T change (11.07%)and LVH (5.39%)in order.Conclusion:The remote ECG consultation is easy to perform.It can rise the detection rate of transient abnormal ECG events in rural area,where is lack of ECG equipment and personnel,so it is worthy of ex-tending.

Value of neutrophils/lymphocytes ratio on predicting the prognosis of patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention:a meta-analysis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the value of neutrophils/lymphocytes ratio (NLR) on predicting the cardiovascular events at hospital discharge and ≥ 12 months follow-up for patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) by meta-analysis.</p><p><b>METHODS</b>Both English and Chinese databases, including PubMed, EMBASE, Wanfang database from their reception to June 2014 were searched to identify randomized controlled studies or non-randomized controlled studies that reported relationship between NLR and the prognosis of patients with STEMI undergoing PCI.The Newcastle-OttawaScale (NOS) system was employed to assess the quality of literatures enrolled in this study. Two reviewers assessed the quality of each trial and extracted data independently. A standardized form and RevMan 5.2 software were used to extract information, and perform quantitative analysis, respectively.</p><p><b>RESULTS</b>A total of 1 953 patients from 6 clinical trials were included in this meta-analysis. The risks of all-cause mortality (RR:0.29, 95% CI: 0.19-0.46, P<0.001), major adverse cardiac events (RR: 0.38, 95% CI: 0.31-0.46, P<0.001), nonfatal myocardial infarction (RR: 0.43, 95% CI: 0.28-0.67, P<0.001), stent thrombosis (RR: 0.32, 95% CI: 0.19-0.53, P<0.001), and TIMI flow after PCI procedure < 3 grade (RR: 0.34, 95% CI: 0.14-0.86, P = 0.020) were significantly lower in patients with NLR ≤ 3.30 compared patients with NLR > 3.30 at hospital discharge. During ≥ 12 months follow-up, the risks of death (RR: 0.33, 95% CI: 0.23-0.45, P<0.001), major adverse cardiac events (RR: 0.27, 95% CI: 0.20-0.35, P < 0.001) were significantly lower. Whereas nonfatal myocardial infarction was not significantly different (RR: 0.42, 95% CI: 0.05-3.45, P = 0.420) in patients with NLR ≤ 3.30 compared patients with NLR > 3.30.</p><p><b>CONCLUSIONS</b>Results from this meta-analysis show that the NLR could predict short- and long-term prognosis in patients with STEMI undergoing PCI. This finding needs to be validated by large-scale clinical trials in the future.</p>

Effect and mechanisms of Shenmai injection on contractions of porcine coronary artery / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the vasodilative action and the possible mechanisms of Shenmai injection on porcine coronary artery.</p><p><b>METHOD</b>Isometric tensions of the porcine coronary artery ring precontracted with potassium chloride (KCl) were recorded in vitro when the doses of 0.1, 0.5, 1, 5, 10, 50 mL x L(-1) of Shenmai injective were cumulatively added into the organ bath of porcine coronary artery ring.</p><p><b>RESULT</b>Shenmai injection caused same vasorelaxation of porcine coronary artery rings with endothelium intact and denuded precontracted with KCl in a concentration-dependent manner. Pretreatment with TEA and 4-AP prohibited the vasorelaxation by Shenmai injection, but pretreatment with KB-R7943, BaCl2, Gli did not affect the vascular effect of Shenmai injection.</p><p><b>CONCLUSION</b>Shenmai injection could produce vasodilatation on KCl pre-contracted porcine coronary artery rings. It seems that K(Ca) and K(V) channel play an important role in the relaxation of the porcine coronary artery rings pre-contracted with KCl.</p>

Effects of electrophysiological examination on assessment of compression of nerve in patients with thoracic outlet syndrome / 中国组织工程研究

BACKGROUND: Thoracic outlet syndrome can be divided into nervous system type and vascular type according to different compressed structure. Nervous system type has typical clinic manifestations,physical signs,radiological evidence and electromyogram variation. So,there is wide prospect for clinic application about evaluation of compression of nerve in patients with thoracic outlet syndrome by electrophysiological examination.OBJECTIVE: To study diagnostic significance of electrophysiological examination to thoracic outlet syndrome.DESIGN: A completed and randomized research based on patients.SETTING: An electrophysiological department in a municipal hospital.PARTICIPANTS: Twenty patients diagnosed as thoracic outlet syndrome were collected in Neurology and Neurosurgery Department,Hand Surgery Department and Clinic of Dalian Central Hospital from April 1998 to July2002,in which there were 5 males and 15 females,aged 31 -67,average46.0 years,with course of 2 - 7 years,average 4.5 years.METHODS: Nerve conduction velocity,wave amplitude and corresponding muscular needle electrode electromyogram(EMG) of median nerve,ulnar nerve,interior and exterior cutaneous nerve in forearm,suprascapular nerve,axillary nerve,musculocutaneous nerve,radial nerve were tested by keypoint myoelectricity evoked potential equipment made in Denmark.MAIN OUTCOME MEASURES: The results of nerve electrophysiological examination.RESULTS: The type of compression of nerve trunk manifested as slower sensory and motor conduction velocity of nerve dominated by corresponding trunk across axillary section,lower wave amplitude and loss of nerve of corresponding muscle.CONCLUSION: Nerve electrophysiological examination is of important significance to diagnose thoracic outlet syndrome.