Dynamic changes and clinical value of serum angiopoietin-2 and surfactant protein D in pediatric acute respiratory distress syndrome / 中国小儿急救医学

Objective:To study the relationship between the dynamic changes of angiopoietin-2 (Ang-2) and surfactant protein D (SP-D) in pediatric acute respiratory distress syndrome (pARDS) and the severity and prognosis of the disease.Methods:Using nested case-control study method, 80 children with pneumonia complicated with pARDS admitted to PICU at Fujian Maternal and Child Health Hospital from June 2018 to May 2021 were selected as pARDS group, and 19 healthy children with corresponding age were selected as control group.According to the oxygenation, the children in pARDS group were divided into three subgroups: mild group (23 cases), moderate group (32 cases) and severe group (25 cases). According to the prognosis at discharge, the children in pARDS group were divided into survival group (67 cases) and death group (13 cases). Ang-2 and SP-D were detected by enzyme-linked immunosorbent assay.The levels of Ang-2 and SP-D in children with pARDS of different severity on the first day were compared; The changes of Ang-2 and SP-D levels on the 1st, 3rd and 8th day of children in survival group and death group were compared, and the receiver operating characteristic (ROC) curve was plotted to compare the predictive value of Ang-2 and SP-D for pARDS prognosis.Results:(1) The levels of Ang-2 and SP-D on the first day in pARDS group were significantly higher than those in control group( P<0.001). (2) The levels of Ang-2 and SP-D on the first day in children with pARDS of different severity levels were significantly different ( P<0.001), and the levels of Ang-2 and SP-D increased gradually with the increase of disease severity.(3) The levels of Ang-2 and SP-D in death group were significantly higher than those in survival group on the 1st, 3rd and 8th day ( P<0.05). (4) Prognostic efficacy of Ang-2 and SP-D levels in pARDS group at different time points: when the areas under the ROC curve predicted by Ang-2 on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.808, 0.981 and 0.989, respectively; the optimal cut-off values were 6 000 pg/mL, 6 971 pg/mL and 4 171 pg/mL, respectively; the sensitivity was 84.6%, 92.3% and 92.3%, respectively; and the specificity was 76.1%, 97.0% and 98.5%, respectively.The areas under the ROC curve predicted by SP-D on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.689, 0.993 and 0.983, respectively; the optimal cut-off values were 13544 pg/mL, 16003 pg/mL and 12294 pg/mL, respectively; the sensitivity was 84.6%, 100.0% and 100.0%, respectively; and the specificity was 46.3%, 98.5% and 97.0%, respectively. Conclusion:Serum Ang-2 and SP-D levels in children with pARDS increase with the aggravation of the disease.The dynamic changes of Ang-2 and SP-D in children with pARDS with different prognosis are different during the course of disease, and monitoring serum Ang-2 and SP-D during the course of disease has a certain predictive value for clinical outcome.

Study on the medication rules of the Clinical Guidelines for Medical Records in the treatment of damp resistance spleen and stomach diseases / 国际中医中药杂志

Objective:To explore the thoughts and rules of Ye Tianshi’s medication in the treatment of damp-resistance spleen and stomach disease in the Clinical Guideline Medical Records. Methods:In the spleen and stomach-related diseases and dampness chapters of Clinical Guideline Medical Records, the medical cases selected in the spleen and stomach, disease syndrome ondampness were selected and entered into the Traditional Chinese Medicine Inheritance Assistance Platform System (V 2.5). The software was used to analyze the frequency, tastes, meridian, and for the association rules analysis and complex system entropy cluster analysis of medication. Results:A total of 162 prescriptions were included, involving 155 traditional Chinese medicines. The Poria, Magnoliae Officinalis Cortex, Citri Reticulatae Pericarpium, Atractylodis Macrocephalae Rhizoma, Alismatis Rhizoma, were used frequently. The Qi of medicationwere mainly warm, cold and flat, and the five tastes were mainly bitter, sweet and pungent, mainly belonging to the spleen, stomach and lung meridian. The core drugs in the associated network were Atractylodis Macrocephalae Rhizoma, Alismatis Rhizoma, Polyporus, Poria, Magnoliae Officinalis Cortex, Citri Reticulatae Pericarpium, Ginseng Radix et Rhizoma, Scutellariae Radix and Coptidis Rhizoma. In the analysis of the correlation between drugs, there are 106 combinations of 2 drugs, 19 combinations of 3 drugs, 1 combination of 4 drugs, and 15 drug pairs with a correlation coefficient greater than 0.03, such as " Cimicifugae Rhizoma- Puerariae Lobatae Radix" and " Atractylodis MacrocephalaeRhizoma- Cinnamomi Ramulus" , " Armeniacae Semen Amarum- Gardeniae Fructus" . Based on complex entropy clustering analysis, 5 pairs of core combinations were extracted, such as " Paeoniae Radix Alba- Coptidis Rhizoma- Nelumbinis Semen" and " Scutellariae Radix- Coptidis Rhizoma-Poria" , and 5 new prescription combinations were obtained, which had the effects of clearing heat and drying dampness, promoting Yang and surpassing dampness, regulating qi and removing dampness, warming yang and removing dampness, clearing heat and dampness. Conclusions:In Clinical Guideline Medical Records, Ye Tianshi stressed regulating Qi machine, eliminating and removing discharge in the treatment of spleen and stomach diseases with dampness resistance. He often used the treatment methods of dispersing lung and removing dampness, ascending Yang and surpassing dampness, conducting Qi and guiding dampness, aromatizing dampness, warming yang and removing dampness, relieving dampness with bitterness, reducing dampness, clearing heat and removing dampness.

Review of Experimental Studies on Sodium Ferulate preventing ischemical reperfusion injury of tissues / 国际中医中药杂志

Sodium Ferulate(SF)is sodium salt of ferulic acid.Experimental studies showed that SF can reduce ischemical reperfusion injury of brain,heart,and liver.Clinically,SF was widely used in cardio-cerebrovascular diseases and immune system disorder.In the article,the experimental studies on SF preventing ischemical reperfusion injury of tissues were reviewed.

Research on the Feasibility of Bacterial Endotoxin Test for Compound Jiagaimei Solution / 中国药房

OBJECTIVE: To establish bacterial endotoxin test for cardioplegic solution (compound jiagaimei solution).METHODS: Semi-quantitative analysis stated in volume Ⅱ of Chinese Pharmacopoiea (2005 edition) was used to detect 3 batches of compound jiagaimei solution with tachypleus amebocyte lysate (TAL).RESULTS: The interference factors of bacterial endotoxin test could be overcome through 6-fold dilution of cardioplegic solution.The content of bacterial endotoxin in 3 batches of samples were 0.36,0.36 and 0.255 EU?mL-1,respectively.They were all lower than the limitation of bacteria endotoxin of 1.5 EU?mL-1.CONCLUSION: It is feasible to detect bacterial endotoxin of compound jiagaimei solution using semi-quantitative analysis.