Practice of "ideological and political education" in online nursing teaching under the COVID-19 epidemic / 中华医学教育探索杂志

Jishou University School of Medicine has actively explored the application and effect of online teaching of "ideological and political education" in nursing courses under the COVID-19 epidemic. Taking 135 undergraduates majoring in nursing in batch 2017 as research objects, this study introduces the implementation scheme of online teaching of "ideological and political education". The results show that the online teaching of "ideological and political education" can help nursing undergraduates to establish the professional identity and cultivate medical ethics during the epidemic, to enhance the awareness of the prevention and control of the epidemic, to strengthen the understanding of relevant nursing professional knowledge, and improve students' learning attitude, worthy of reference and promotion.

Liraglutide prevents high glucose-induced adhesion of endothelial cells to monocyte by targeting IKK/NF-κB / 中国医师杂志

Objective To investigate the inhibition effect of liraglutide (lira) on high glucose-induced adhesion of endothelial cells to monocyte.Methods Human umbilical vascular endothelial cells (HUVECs) induced by high glucose (20 mmol/L) were incubated with different concentrations of liraglutide (0,0.3,3,30 nmol/L) for different time.THP-1 cells were pre-labeled with Calcein-AM and then incubated with HUVECs for 1 h,M199 medium were used for washing the nonadherent cells for 3 times,and the adhesion of HUVECs to THP-1 cells were measured by Fluorence microplate reader;real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) were employed to detect the mRNA and protein expression of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1),respectively.Western blot was used to measure the content of IκBα,p-IκBα and the distribution of p65 in plasma and nuclear.GST-IκBα was introduced as substrate to test the activity of IκB-kinase (IKK).Results The adhesion of HUVECs to THP-1 (P ＜ 0.01),the mRNA and protein expression of VCAM-1 and ICAM-1 (P ＜ 0.05,P ＜ 0.01),the phosphorylation of κBα (P ＜ 0.05,P ＜ 0.01),the translocation of p65 subunit from plasma to nuclear and the activity of IKK (P ＜ 0.01) in HUVECs were all elevated by stimulation with 20 mmol/L glucose,and the content of IκBα was decreased accordingly (P ＜0.01).Pre-incubation with lira could reverse the above effect of high concentration of glucose.Conclusions Lira could reduce VCAM-1 and ICAM-1 expression through IKK/NF-κB pathways in 20 mmol/L glucose-induced HUVECs,which finally suppress THP-1-HUVECs adhesion.

Changes in 25 hydroxyvitamin D level in school-aged children with orthostatic hypertension / 中华实用儿科临床杂志

Objective To explore the change in 25 hydroxyvitamin D[25 -(OH)D]level in school - aged children with orthostatic hypertension (OHT). Methods Nineteen cases of school - aged children with OHT confirmed diagnosis by head - up tilt table test at the Department of Pediatric Cardiovasology,Children′s Medical Center,the Second Xiangya Hospital,Central South University,from October 2014 to February 2017,were selected as OHT group, including 17 males and 2 females,and their ages were from 7 to 14(11. 21 ± 2. 70)years old. Nineteen healthy children including 17 males and 2 females and aged 8 to 14(11. 05 ± 2. 35)years old who had a healthy examination of child care at the hospital in the same period were selected as healthy control group. In two groups of children all possible basic diseases were eliminated,such as severe liver and kidney disease,abnormal thyroid function and metabolic bone disease and/ or the long - term use of 25 -(OH)D metabolism drugs,accepted the serum 25 -(OH)D detection. Results (1)There was no significant difference in age and gender between the OHT group and the healthy control group(t = 0. 559,P > 0. 05;χ2 = 0. 000,P > 0. 05). The 25 -(OH)D levels were significantly lower in the OHT group than those in the healthy control group [(39. 62 ± 10. 65)nmol/ L vs. (64. 83 ± 10. 28)nmol/ L,t = - 7. 422,P <0. 01]. (2)25 -(OH)D levels had no correlation with age,gender,height,body mass,systolic pressure,or diastolic blood pressure (r = 0. 254,0. 047,0. 195,0. 019,- 0. 191,- 0. 184,all P > 0. 05). Taking 25 -(OH)D level as dependent variable,age,gender,height,body mass,systolic pressure,diastolic blood pressure as independent variables, multiple stepwise regression equation to predict 25 -(OH)D level was not fit. Conclusion Lower level of 25 -(OH)D may be one of the mechanisms for the onset of the school - aged children with OHT.

Cohort Study of Therapeutic Drug Monitoring on Meropenem in Intensive Care Unit Patients / 医药导报

Objective To evaluate whether individualized dosage regimen based on therapeutic drug monitoring (TDM) is beneficial for improving the rate of pharmacokinetics/pharmacodynamics (PK/PD) reaching the standard and anti-infection efficacy. Methods Totally, 36 cases in the intensive care unit ( ICU ) of Nanjing Drum Tower Hospital using meropenem during January 2015 to December 2015 were collected, and divided into intervention group and control group. Results On the fourth day of administration, meropenem concentration in intervention group was significantly higher than that of the control group (22.5 μgmL-1 and 17.5 μgmL-1, respectively, P=0.007).With minimal inhibitory concentration (Cmin)>8 μgmL-1 serving as target, the rate of reaching the standard was both 22. 2% on day 2, 100. 0% and 72. 2% on day 4 in intervention group and control group, respectively (P=0.015). With minimal inhibitory concentration (Cmin) >32 μgmL-1 serving as target, the rate of reaching the standard was both 0 on day 2, 38. 9% and 5. 5% on day 4 in intervention group and control group, respectively (P=0.015). The clinical curative rate of the intervention group and control group was 83.3% and 72.2%, respectively (P=0.437), and the failure rate was 16.7% and 27.8%, respectively.Bacteria clearance rate was 88.9%and 55.5% in the intervention group and control group, respectively(P<0.05). Conclusion Individualized dosage regimen based on TDM in ICU patients is beneficial to improving the rate of PK/PD reaching the standard and anti-infection efficacy.

Cohort Study of Therapeutic Drug Monitoring on Meropenem in Intensive Care Unit Patients / 医药导报

Objective To evaluate whether individualized dosage regimen based on therapeutic drug monitoring (TDM) is beneficial for improving the rate of pharmacokinetics/pharmacodynamics (PK/PD) reaching the standard and anti-infection efficacy. Methods Totally, 36 cases in the intensive care unit ( ICU ) of Nanjing Drum Tower Hospital using meropenem during January 2015 to December 2015 were collected, and divided into intervention group and control group. Results On the fourth day of administration, meropenem concentration in intervention group was significantly higher than that of the control group (22.5 μgmL-1 and 17.5 μgmL-1, respectively, P=0.007).With minimal inhibitory concentration (Cmin)>8 μgmL-1 serving as target, the rate of reaching the standard was both 22. 2% on day 2, 100. 0% and 72. 2% on day 4 in intervention group and control group, respectively (P=0.015). With minimal inhibitory concentration (Cmin) >32 μgmL-1 serving as target, the rate of reaching the standard was both 0 on day 2, 38. 9% and 5. 5% on day 4 in intervention group and control group, respectively (P=0.015). The clinical curative rate of the intervention group and control group was 83.3% and 72.2%, respectively (P=0.437), and the failure rate was 16.7% and 27.8%, respectively.Bacteria clearance rate was 88.9%and 55.5% in the intervention group and control group, respectively(P<0.05). Conclusion Individualized dosage regimen based on TDM in ICU patients is beneficial to improving the rate of PK/PD reaching the standard and anti-infection efficacy.

Changes in P-wave, T-wave, and ST segment amplitude in 12 lead electrocardiogram in children with breath holding spell / 中南大学学报(医学版)

OBJECTIVE@#To explore the change of the amplitude of P wave, T wave and ST segment of 12 lead electrocardiogram (ECG) in children with breath holding spell.
@*METHODS@#A total of 29 children (24 males and 5 females) with breath holding spell in Second Xiangya Hospital, Central South University were enrolled for this study from October, 2009 to September, 2015. Their ages ranged from 3 months to 6 years, with an average of 1.82±1.27 years old. The control group consisted of 30 age-matched and gender-matched healthy children. All subjects were underwent electrocardiography by the SR-1000A comprehensive automatic electrocardiograph analyzer, and the changes of the ECG parameters were compared between the two groups.
@*RESULTS@#Compared with the control group, the amplitude of P-wave of V5 lead was decreased [(44.10±23.98) vs (58.30±21.19) μV, P<0.05], the amplitude of T-wave of V6 lead was increased [(423.80±122.6) vs (350.00±105.73) μV, P<0.05], the amplitude of ST segment of II lead was increased [(84.80±39.97) vs (57.30±38.77) μV, P<0.05], the amplitude of ST segment of aVR lead was increased [(-77.60±37.41) vs (-51.00±33.46) μV, P<0.05], the amplitude of ST segment of aVL lead was increased [(35.20±28.24) vs (17.70±33.90) μV, P<0.05], the amplitude of ST segment of V5 lead was increased [(111.00±59.36) vs (69.00±36.33) μV, P<0.05], the amplitude of ST segment of V6 lead was increased [(79.30±45.51) vs (51.30±33.19) μV, P<0.05]. 
@*CONCLUSION@#The children with breath holding spell have autonomic nerve dysfunction. The amplitude of ST segment changes is sensitive.

The circadian rhythm of neurally mediated syncope in children / 中华实用儿科临床杂志

Objective To explore the circadian rhythm of neurally mediated syncope (NMS)in children. Methods There were 21 6 children with NMS included in the study,including 91 male and 1 25 female,aged from 4 to 1 7 years old with a mean age of (1 1 .34 ±2.65)years,who came from the Specialist Syncope Outpatient Department or Inpatient Department of the Second Xiangya Hospital of Central South University from December 201 3 to October 201 5. The patients were divided into vasovagal syncope (VVS)group and postural tachycardia syndrome (POTS)group ac-cording to head -up tilt test (HUTT)results,including 1 78 VVS patients and 38 POTS patients.Ninety -four patients with NMS were in the 0.05).(2)The number of syncopal episodes in patients with VVS which occurred in the morning hours was strikingly higher than that of afternoon,evening or nighttime (P 0.05).Patients with VVS had a higher proportion of episodes in the morning but a lower proportion in the evening when compared with the POTS group (P <0.05).(3)The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients(χ2 =1 1 .001 ,P =0.01 2).(4)There seemed to be no difference in the frequency of syncopal episodes through the day between the <1 2 years old group and the ≥1 2 years old group(χ2 =1 .995,P =0.573).Conclusions The frequency of syncopal episodes in children with VVS displayed a clear circadian rhythm,with a peak in the morning,but the POTS patients did not show a circadian variation.The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients.

Changes in serum and urine electrolytes of children with neurally mediated syncope after oral rehydration salts [Ⅰ]treatment / 中华实用儿科临床杂志

Objective To explore the changes in serum and urine electrolytes of children with neurally media-ted syncope (NMS)after oral rehydration salts (ORS)[Ⅰ]treatment.Methods The study group included 135 patients [60 male and 75 female,aged 4 -16 years,average of (10.20 ±2.68)years old]with unexplained syncope and prodro-mal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head -up tilt test (HUTT),and completed serum electrolytes and 24 -hour urine electrolytes,and the serum electrolytes and 24 -hour u-rine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ],while negative HUTT patients were received health education.Then 21 -154(42.63 ±27.71) days later,the patients returned to hospital,for the inquiry of symptom improvement,and review of HUTT,24 -hour urine and serum electrolytes.Results (1)The total effective rate of ORS[Ⅰ]treatment was 62.96% (17 /27 cases),while negative conversion rate of HUTT was 48.15% (13 /27 cases).(2)There was no significant difference in serum electro-lytes,24 -hour urine electrolytes or 24 -hour urine volume between HUTT positive group and negative group during the first visit (all P >0.05).(3)In return visit,serum calcium [(2.30 ±0.10)mmol/L vs (2.20 ±0.09)mmol/L,t =2.72,P 0.05).(4)24 -hour urine sodium [(159.06 ±72.76)mmol/24 h vs (118.97 ±52.75)mmol/24 h,t =2.712,P 0.05).(5)There was no significant difference in serum elec-trolytes,24 -hour urine electrolytes or 24 -hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P >0.05).Conclusions ORS[Ⅰ]treatment can obviously increase the 24 -hour urine sodium,24 -hour urine chloride in children with NMS.ORS[Ⅰ]is an effective therapy for NMS.

Application of a population pharmacokinetic model for vancomycin in patients with severe neurosurgical disease / 中国感染与化疗杂志

Objective This study was designed to validate the utility of a population pharmacokinetic model established for vancomycin in patients with severe neurosurgical disease . Methods The clinical data including patient gender , age , body weight ,serum creatinine and albumin were collected retrospectively from patients in Nanjing Drum Tower Hospital to calculate the steady trough concentration of vancomycin using the previously established pharmacokinetic model .The predicted value was compared with the actual value .Results During the period from March 2013 to March 2014 ,53 blood samples with serum trough concentration of vancomycin were collected from 42 patients .The average trough concentration of vancomycin was 10 .9 mg/L (range from 1 .6 to 49 .1 mg/L) .The predicted trough level of vancomycin based on the population pharmacokinetic model was significantly correlated to the actual value(r=0 .857 ,P<0 .001) .The mean absolute percentage error was 0 .407 9 . The confidence interval was 9 .36‐14 .07 for the predicted values ,and 8 .92‐14 .32 for the actual values .Conclusions The pharmacokinetic model is valid and useful for planning intravenous dose of vancomycin in patients with severe neurosurgical disease .Large error (about 30% ) was observed in estimation of body weight due to coma .Reduced renal function following contrast agent and/or diuretic drug has an impact on the predicted results . The accuracy of prediction can be increased to nearly 70% after adjusting the covariates .

Relationship between vitamin D and cardiac autonomic dysfunction / 中华实用儿科临床杂志

The automatic nervous system(ANS) has 2 main branches:the sympathetic nervous system and the parasympathetic nervous system.The ANS controls mainly automatic bodily functions that are engaged in homeostasis.Autonomic dysfunction lead to many diseases,for example,orthostatic intolerance etc.The relationship between vitamin D and cardiovascular disease has becomes the focus of study gradually in recent years.1,25-dihydroxy vitamin D participates in the regulation of renin-angiotensin axis,vascular effects.Vitamin D deficiency triggers secondary hyperparathyroidism,promotes the development of hypertension,diabetes,dyslipidemia which can influence the incidence and prognosis of cardiovascular disease as well.The study confirmed that vitamin D deficiency is one of the risk factors of cardiac autonomic dysfunction diseases such as orthostatic intolerance.The mechanism is still not very clear.Supplement of vitamin D can offer an effective method to decrease cardiovascular disease risk in populations with low vitamin D status.

The blood concentration of hydroxychloroquine and its safety in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To study the blood concentration of hydroxychloroquine in patients with systemic lupus erythematosus (SLE) treated with different doses, and analyze the relationship between blood concentration of hydroxychloroquine and disease activity, and evaluate its safety.Methods Forty SLE patients were randomly divided into 2 groups, each group contained 20 cases.The patients in group A were treated with hydroxychloroquine (0.4 g, qd), while patients in group B were treated with hydroxychloroquine (0.2 g, qd).The treatment lasted more than six months in every patient.The blood concentrations of hydroxychloro-quine were detected by high performance liquid chromatography.The clinical and laboratory indices were collected.The systemic lupus erythematosus disease activity index (SLEDAI) score was recorded.The doses and varieties of combined hormone, immunosuppressant were recorded.The correlation of blood concentration of hydroxychloroquine and disease activity was analyzed.The significance was determined by Student's t test and Pearson correlation analysis.Results In SLE patients, the average blood concentration of hydro-xychloroquine was (402±190) ng/ml in group A and (150±60) ng/ml in group B (t=7.471, P＜0.01).The disease activities of patients in the two groups showed no significant difference (t=-0.172, P＞0.05).The platelet counts of patients in group A were significantly higher than those in group B[(188±88)×109/L vs (158 ±87) ×109/L] (t=4.375, P＜0.05).However, the other laboratory parameters showed no significant difference between the two groups (P＞0.05).Conclusion The results of this study indicate that the blood concentrations of hydroxy-chloroquine are significantly different in different dosages.The high dose of hydroxy-chloroquine is related to high platelet number in lupus patients.These findings suggest that hydroxychloroquine is safe and effective for SLE patients.

Observations on the Efficacy of Jin’s Three-needle Acupuncture plus Intelligence Training in Treating Mental Retardation in Children / 上海针灸杂志

Objective To investigate the clinical efficacy of Jin’s three-needle acupuncture plus intelligence training in treating mental retardation in children under 6 years old. Methods Three hundred mental retardation patients aged 0 to 6 were randomly allocated, according to their parents’ willingness, to treatment and control groups, 150 cases each. The treatment group received Jin’s three-needle acupuncture plus intelligence training and the control group, intelligence training alone. An assessment was made using Chinese revised version of the Gesell Developmental Schedules in both groups before and after treatment.Results The total efficacy rate was 84.7% in the treatment group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). The total efficacy rates in liver-kidney deficiency, heart-spleen deficiency, phlegm and blood stasis, and qi deficiency and blood stasis types were 86.8%, 86.8%, 76.5% and 75.0%, respectively, in the treatment group and 76.2%, 76.8%, 62.5% and 60.0%, respectively, in the control group. There were statistically significant differences in the total efficacy rates in different syndrome types between the two groups (P<0.05). The total efficacy rates in the patients with mild, moderate, severe and very severe diseases were 96.9%, 94.7%, 66.7% and 44.4%, respectively, in the treatment group and 90.0%, 82.5%, 47.8% and 35.3%, respectively, in the control group. There was a statistically significant difference in the total efficacy rate between the two groups of patients with moderate, severe or very severe disease (P<0.05).Conclusion Jin’s three-needle acupuncture plus intelligence training is an effective way to treat mental retardation in children.

An epidemiologyical study on Miao drum and hypertension in Miao women / 重庆医学

Objective To study the relationship between Miao drum and hypertension in the Miao women of the countryside . Methods A survey of blood pressure measurement and questionnaire investigation were conducted among 1 069 Miao females ,by using cluster multistage sampling in countryside of Hunan ,Hubei ,Chongqing ,and Guizhou .A case-control analysis for 226 cases with new diagnosed hypertension and 226 controls with normal blood pressure .Results Among 1 069 sample ,the standardized prevalence rate of hypertemion was 24 .5% .There were significant differences in the prevalence rates of hypertension between the different age groups(χ2 =174 .46 ,P<0 .01) .The single factor logistic regression analysis(OR=0 .383 ,95% CI:0 .262-0 .558)and multi-conditional logistic regression analysis(OR=0 .379 ,95% CI:0 .255-0 .565)showed that Miao drum was probably protective factor for hypertension in the Miao women of the countryside .Conclusion Miao drum was probably protective factor for hyperten-sion in the Miao women of the countryside in Hunan ,Hubei ,Chongqing ,and Guizhou .Long-term adherence to participate in miao drum exercise may prevent high blood pressure .

LC-MS/MS assay of methylphenidate: stability and pharmacokinetics in human / 药学学报

The study aims to solve the instability problem of methylphenidate (MPH) in plasma, and establish a LC-MS/MS method for simultaneous determining of MPH in human plasma. The stabilities of MPH in different media were studied, and the degradation characteristics of MPH in these media were also investigated by HPLC and LC-MS/MS. To a 200 microL aliquot of freshly collected plasma sample, 10 microL 2% formic acid was added immediately to prevent the hydrolysis of MPH in human plasma samples. Chromatographic separation was performed on a Sapphire C18 column using the mobile phase of methanol - 5 mmol.L-1 ammonium acetate buffer solution containing 0.1% formic acid (46 : 54). MPH was quantified by tandem mass spectrometry operating in positive electrospray ionization mode with multiple reaction monitoring. The detection used the transitions of protonated molecules at m/z 234.2-->84.1 for MPH and m/z 260.3-->183.1 for propranolol (IS), separately. The intra- and inter-assay precisions were all below 5.0%. The accuracies were all in standard ranges. The linear calibration curve was obtained in the concentration range of 0.035-40 ng.mL-1. The methods fulfilled the demand. The method was used to determine the concentration of MPH in human plasma after a single dose of 36 mg MPH tablet to 6 healthy Chinese volunteers. The method is suitable for the precisely determination of MPH and for pharmacokinetic study of MPH in human plasma.

Study on the correlation between HLA-DRB1 genes and unexplained recurrent spontaneous abortions in Xiangxi Tujia and Han population / 中国综合临床

Objective To analyze the HLA - DRB1 gene polymorphism and the hereditary association with unexplained recurrent spontaneous abortions(URSA)in a population of Tujia and Han nationality from west part of Hunan province in China. Methods The alleles at the HLA-DRB1 typing were analyzed by polymerase chain reac-tion-sequence specific primers (PCR-SSP) in 76 URSA Tujia population and 68 URSA Han population and 82 healthy Tujia population and 75 healthy Han population. Results ①DRB1*04 frequency of URSA in Tujia and Han population was strikingly higher than that of the healthy Tujia and Han population(RR>1,Pc <0.01),but the DRB1*12 frequency was strikingly lower than that of the healthy Tujia and Han population respectively(RR<1,Pc <0.01). ②DRB1*07 frequency of URSA in Tujia population was strikingly higher than that of the URSA in Han population (18.08% : 5.28%, Pc<0.01). Conclusion HLA-DRB1*04 maybe predisposing genes of URSA in Tujia and Han population,and HLA-DRB1*12 maybe associated with an antagonist effect in the pathogenesis of UR-SA in this population.