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Purpose@#Reports showed that some of intrahepatic cholangiocarcinoma (ICC) patients with lymph node metastasis (LNM) may also gain survival benefit undergone resection. However, the effect of the extent of LNM on prognosis and surgical indication is barely discussed. @*Methods@#From September 1994 to November 2018, primary ICC patients undergone initial curable surgery were enrolled. Based on the extent of LNM, we divided these patients into 4 groups, including patients with no LNM (group N0), LNM to hepatoduodenal ligament or common hepatic artery (region A, group A), LNM to gastrohepatic lymph nodes for left liver ICC and periduodenal and peripancreatic lymph node for right liver ICC (region B, group B), or LNM beyond these regions (region C, group C). Multivariable Cox regression analysis was performed to identify the prognostic factors for recurrencefree survival (RFS) and overall survival (OS) in all groups. @*Results@#A total of 133 patients were enrolled. There were 56, 21, 17, and 39 patients in groups N0, A, B, and C, respectively. There was significant difference between groups N0 and C in RFS (P < 0.001) and OS (P = 0.002). When we compared group N0 + A + B with group C, we also found that RFS (P < 0.001) and OS (P = 0.007) were significantly different. In multivariable analysis, the extent of LNM was an independent risk factor for RFS (P < 0.050). @*Conclusion@#ICC patients with the LNM to regions A and B could still achieve good prognosis with resection. Surgery should be carefully considered when LNM to region C.
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OBJECTIVE To evaluate the effectiveness， safety and economy of baloxavir marboxil in the treatment of influenza， and to provide evidence-based reference for the introduction of new drugs in hospitals and clinical medication decisions. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Epistemonikos， CBM， CNKI， VIP， Wanfang database， official websites and relevant databases of health technology assessment （HTA） institutions， the results of the included studies were descriptively analyzed after literature screening， data extraction and quality evaluation. RESULTS A total of 11 studies were included， involving 6 systematic reviews/meta-analyses and 5 pharmacoeconomic studies. Compared with placebo， baloxavir marboxil significantly shortened the time to alleviation of symptoms （TTAS） and time to resolution of fever （TTRF）， reduced the virus titer change from baseline at 24 h and 48 h after treatment and the incidence of bronchitis， with statistical significance （P＜ 0.05）. Compared with neuraminidase inhibitors （NAIs）， there were no significant differences in shortening TTRF and reducing the incidence of complications， pneumonia and bronchitis （P＞0.05）. The majority of studies suggested that there were no significant differences in shortening TTAS （P＞0.05）. Only very low-quality literature suggested that baloxavir marboxil could significantly reduce the virus titer change from baseline at 24 h and 48 h after treatment. In terms of safety， the incidences of adverse events （AEs） and drug-related adverse events （DRAEs） induced by baloxavir marboxil showed no significant differences， compared with peramivir and zanamivir （P＞0.05）. Some studies considered that the incidences of AEs and DRAEs with baloxavir marboxil were lower than placebo， oseltamivir and laninamivir. Compared with oseltamivir in China and laninamivir in Japan， baloxavir marboxil showed cost-effectiveness advantages. CONCLUSIONS Compared with placebo， baloxavir marboxil has good efficacy， safety and economy. Compared with NAIs （oseltamivir）， baloxavir marboxil has good economic advantages in China， but further high-quality studies are still needed regarding its safety and efficacy.
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Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
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Objective To explore the strategies of drug treatment and pharmaceutical care for children with bacterial meningitis. Methods The anti-infective therapy, therapeutic drug monitoring and dose adjustment of vancomycin in children with bacterial meningitis were analyzed and discussed according to relevant guidelines and literatures. Results Clinical pharmacists analyzed therapeutic regimen. According to the results of etiology and drug sensitivity, meropenem was discontinued and rifampicin was added. Based on drug monitoring of vancomycin, it is suggested to extend the infusion time of vancomycin to reach the target concentration. The child was discharged from hospital. Conclusion Recommendations of the relevant drug treatment guidelines and the latest medical research evidence should be provided by clinical pharmacists in order to promote reasonable and effective clinical uses of medicine.
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OBJECTIVE:To establish a method for the concentration determination of voriconazole in human plasma.METHODS:Plasma samples were precipitated with acetonitrile.Using ketoconazole as internal standard,HPLC method was adopted.The determination was performed on Dionex U-3000 Dimonsil C18 column with mobile phase consisted of triethylamine-glacial acetic acid-water mixed solution (1 ∶ 1∶98,V/V/V,pH was about 4.0)-acetonitrile (40∶60,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 255 nm.The column temperature was 40 ℃,and sample size was 20 μL.RESULTS:The linear range of voriconazole was 0.2-20.0 μg/mL.The limits of quantification was 0.2 μg/mL,and the minimum detection limit was 0.03 μg/mL.RSDs of inter-day and intra-day were lower than 10％.The method recoveries were 92.06％-106.26％ (RSD＜5％,n=5),and extraction recoveries were 75.62 ％-90.59 ％ (RSD ＜ 5 ％,n=5).The plasma concentration of voriconazole in 10 children ranged 0.22-4.90 μg/mL (n =10).CONCLUSIONS:The method is simple,rapid,specific and can be used for drug monitoring of voriconazole.
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Objective To observe the effects of acupuncture therapy on triglyceride (TG) content of quadriceps femoris in the high fat diet feeding-induced insulin resistance rats; To discuss acupuncture mechanisms to improve the insulin sensitivity. Methods Thirty-two Wistar rats at the age of eight weeks were randomly divided into normal group, model group, electro-acupuncture group, and sham electro-acupuncture group. The normal group was given basic diet, and model group, electro-acupuncture group and sham electro-acupuncture group were given high fat diet for 8 weeks, after which, the model of insulin resistance was successfully obtained. Electro-acupuncture group was given acupuncture therapy with “Guanyuan (GV4)”, “Zhognwan (GV12)”, “Zusanli (ST36)”, and “Fenglong (ST40)” for 8 weeks. Sham electro-acupuncture group was given stimulation at non-acupuncture points which were not on the meridians and near the acupoints but not at the area of the acupoints. In addition, food intake and body weight of each group were recorded, blood glucose was tested, TG content of quadriceps femoris was measured by enzymatic method after the treatment. Results The weight of the rats and TG levels of quadriceps femoris in electro-acupuncture group and sham electro-acupuncture group were significantly lower than those in model group, with significant statistical difference (P<0.05), especially in electro-acupuncture group. Conclusion Acupuncture therapy could improve insulin sensitivity to prevent and its related diseases.
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Objective To investigate the effect of “Shuangguyitong acupuncture therapy on serum interleukin-6 of streptozotocin (STZ) induced diabetic rats. Methods Among seventy-three 180～220 g Wistar rats, thirteen were assigned as normal control group (group A) and sixty were induced diabetes by injecting STZ into celiac cavity. The diabetic rats were randomly divided into model group(group B), “Yitong” treatment group (group C), “Shuangguyitong” acupuncture group (group D) and common acupuncture group (group E). After two courses of treatment, serum IL-6 was tested by radioimmunoassay (RIA) . The blood glucose was measured by sugar equipment. Results The high blood glucose of the diabetic rats were lowered significantly in group D and E (P
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Objective To study the effect of Potentilla Discolour Bunge (PDB) on the NOS expression of the vascular endothelial cells (VEC) of DM rats. Methods The DM rat model was established by alloxan injected, and then the rats were treated with herb of PDB for 4 weeks continuously. The NOS expression of VEC were assayed by histochemistry method and image analysis system. Result NOS OD value of the PDB group was higher than that of model group and Glibenclamide group (P
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OBJECTIVE:To prepare Duzhong pingya dispersible tablets and establish their quality control.METHODS:The ratios of the excipients were optimized with disintegrating time,dispersible uniformity and compressibility as indexes.The Duzhong pingya dispersible tablets were prepared by trituration,and the content of chlorogenic acid was determined by HPLC.RESULTS:The optimized ratios of the excipients were as follows:manicol 60 g,microcry stalline cellulose 40 g,low-substituted hydroxypropyl cellulose 30 g,gum arabic 20 g,crospovidone 4 g,magnesium stearate 2 g,edulcorant 2 g,and plasdone vis quantum.The optimized Duzhong pingya dispersible tablets were brown in color and up to the standard in dispersible uniformity.The linear range of chlorogenic acid was 1.882～18.820 ?g(r=0.999 9)and its average recovery rate was 99.2%(RSD=1.63%,n=6).CONCLUSION:The ratios of the excipients were up to the standard required for the preparation technology,and the established quality standard is applicable for the quality control of Duzhong pingya dispersible tablets.
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BACKGROUND: According to the thought "prevention of diseases", a conception of "strengthening the vital by acupuncture preconditioning (AP)" is suggested recently.OBJECTIVE: To investigate the effect of brain tissue extract after AP on cerebral ischemia-reperfusion injury.DESIGN: Random control experiment.SETTING: Institute of Acupuncture & Moxibustion and Massage, and Department of Anatomy and Embryology, Hubei College of Traditional Chinese Medicine.MATERIALS: Totally 102 adult Wistar rats were selected during the experiment, which was completed in the Institute of Acupuncture & Moxibustion and Massage of Hubei College of Traditional Chinese Medicine from September 2003 to July 2004. Among them, 20 rats were used to prepare cerebral tissue extract, and another 82 were used in the subsequent experiment.METHODS: The brain tissue extract was obtained from the rats which were given electroacupuncture at Shenshu (BL-23) and Baihui (DU-20).Totally 82 rats were randomly divided into 6 groups. Five rats in blank control group were taken as blank control, 15 in sham-operation control group were performed with sham operation, 16 in cerebral ischemia-reperfusion control group with cerebral ischemia-reperfusion, 16 in saline control group with the injection of saline intravenously firstly and then cerebral ischemia-reperfusion modeling, 15 in normal cerebral tissue extract control group with the injection of normal cerebral tissue extract intravenously firstly and then cerebral ischemia-reperfusion modeling, and 15 in AP cerebral tissue extract group with the injection of cerebral tissue extract intravenously firstly and then cerebral ischemia-reperfusion modeling.Intravenous injection was performed 2 hours and 1 hour before cerebral ischemic modeling, and each rat was injected twice with 1 mL/time. Brain tissue of the rats was taken ont 1, 3, 7 days after reperfusion respectively (or each group was divided into 3 subgroups with 5 rats in each) except those in blank control group. The blain tissue of rat in each group was selected at the relevant time points, and embedded with paraffin and cut into pieces. Cerebral histopathology was observed under the light scope (× 400)and the survival neurons were counted whose area was layer y of region Ⅰ in parietal cortex (inner cone).cortex.RESULTS: Two rats died during the experiment in cerebral ischemiareperfusion control group and saline control group respectively. Another Except blank control group and sham operation group, the brain sections of different time points in other groups showed scattering ischemic anoxic Count of survival neurons in layer Ⅴ of area I in parietal cortex: One day after reperfusion, survival nerve density of the brain ischemic reperfusion model group [(338.8±31.2)/mm2] was significantly lower than that of blank control group [(753.4±60.8)/mm2] (F=129.36, P ＜ 0.05); degeneration of the nerves became worse after reperfusion for 3 days and 7 days, but with no significant difference (F=1.76, P ＞ 0.05). There was no significant difference between the saline control group, normal brain tissue extract group and brain ischemic reperfusion model group at different time points (F=1.76, P ＞ 0.05). Survival neuron density in group of brain tissue extract after AP at the three time points was significantly higher than that in brain ischemic reperfusion model group [(438.1±41.0), (338.8±31.2)/mm2,(296.4±27.1), (124.8±13.4)/mm2; (269.5±30.4), (1.324±0.157)/mm2;F=129.36, P ＜ 0.05].CONCLUSION: Injection of the brain tissue extract after AP at Shenshu (BL-23) and Baihui (DU-20) into the celiac cavity of rats could obviously reduce the subsequent neuron loss induced by brain isehemia-reperfusion and protect brain from ischemia-reperfusion injury.
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Objective To study the function of ventrolateral medulla (VLM) in the treatment of rabbit myocardial ischemia by electroacupuncture at Neiguan point. Methods On the basis of the protection of rabbits against acute myocardial ischemia by electroacupuncture at Neiguan point,the action potential of rabbit's ischemic myocardial cell was observed after the VLM was blocked with Naloxone. Results Compared with the sham operation group, acute myocardial ischemia group and sham VLM block group,the ST segment potential remarkably increased and MAPA, MAPD_~50 ,MAPD_~90 significantly decreased in VLM block group. There were statistic significance(P