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BACKGROUND: Nowadays, people have paid more and more attention to the quality of physical and mental health recovery after oral surgery anesthesia. As a remarkable feature of patient quality management, it can effectively reduce the risk of postoperative complications and pain in Post Anesthesia Care Unit (PACU). However, the patient management model in oral PACU remains unknown, especially in China. The purpose of this study is to explore the management elements of patient quality management in the oral PACU and to construct the management model. METHODS: Strauss and Corbin's grounded theory method was used to explore the experiences of three anesthesiologists, six anesthesia nurses and three administrators working in oral PACU. Twelve semi-structured interviews were conducted using face-to-face in a tertiary stomatological hospital from March to June, 2022. The interviews were transcribed and thematically analysed according to QSR NVivo 12.0 qualitative analysis tool. RESULTS: Three themes and ten subthemes were identified through an active analysis process, including three of the core team members: stomatological anesthesiologists, stomatological anesthesia nurses and administrators, three of the main functions: education and training, patient care and quality control and four of the team operation processes: analysis, plan, do, check. CONCLUSION: The patient quality management model of the oral PACU is helpful for the professional identity and career development of stomatological anesthesia staff in China, which can accelerate the professional development of oral anesthesia nursing quality. According to the model, the patient's pain and fear will decrease, meanwhile, safety and comfort will increase. It can make contributions to the theoretical research and clinical practice in the future.
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Anestesia , Anestesiologia , Humanos , Teoria Fundamentada , Dor , Complicações Pós-Operatórias , Melhoria de QualidadeRESUMO
OBJECTIVE: : To investigate the effect of Lycium barbarum polysaccharides (LBPs) on TLR/NF-κB independent pathway and serum tumor necrosis factor (TNF-α) level in diabetic MyD88-knockout mice. METHODS: : Diabetes was induced by feeding high-fat/high-sugar diet and injection of low-dose streptozotocin in MyD88-knockout mice. The diabetic mice were randomly divided into model group, positive control group and LBPs group. The expressions of TRAM, TRIF, TRAF6, RIP1 and TNF-α mRNA and proteins in mouse peritoneal macrophages were detected by real-time RT-PCR and Western blotting after LBPs treatment for 3 month. Serum TNF-α was determined with ELISA kit. RESULTS: : Real time RT-PCR showed that compared with model group, the relative expressions of Tram, Trif, Traf6 and Tnf-α mRNA in macrophages of LBPs group were significantly decreased and expression of Rip1 was significantly increased (all P<0.05). Expression of TRAM, TRIF, TRAF6, RIP1 and TNF-α proteins as well as serum TNF-α level had no significant difference between LBPs group and model group (all P>0.05). CONCLUSIONS: : LBPs may not inhibit serum TNF-α level through TLR/NF-κB independent pathway.
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Medicamentos de Ervas Chinesas , Fator 88 de Diferenciação Mieloide , NF-kappa B , Transdução de Sinais , Fator de Necrose Tumoral alfa , Animais , Diabetes Mellitus Experimental , Medicamentos de Ervas Chinesas/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Macrófagos Peritoneais/efeitos dos fármacos , Camundongos , Camundongos Knockout , Fator 88 de Diferenciação Mieloide/genética , NF-kappa B/genética , Distribuição Aleatória , Transdução de Sinais/efeitos dos fármacos , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Lycium barbarum L. polysaccharide (LBP) is prepared from Lycium barbarum L. (L. barbarum), which is a traditional Chinese medicine. LPB has been shown to have hypoglycemic effects. In order to gain some mechanistic insights on the hypoglycemic effects of LBP, we investigated the uptake of LBP and its effect on glucose absorption in the human intestinal epithelial cell line Caco2 cell. The uptake of LBP through Caco2 cell monolayer was time-dependent and was inhibited by phloridzin, a competitive inhibitor of SGLT-1. LPB decreased the absorption of glucose in Caco2 cell, and down-regulated the expression of SGLT-1. These results suggest that LBP might be transported across the human intestinal epithelium through SGLT-1 and it inhibits glucose uptake via down-regulating SGLT-1.
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Medicamentos de Ervas Chinesas/farmacologia , Glucose/metabolismo , Hipoglicemiantes/farmacologia , Lycium/química , Células CACO-2 , Metabolismo dos Carboidratos , Regulação para Baixo , Transportador de Glucose Tipo 2/metabolismo , Humanos , Absorção Intestinal , RNA Mensageiro/genética , Transportador 1 de Glucose-Sódio/metabolismoRESUMO
Nifedipine is a potent antihypertensive medication classified as a dihydropyridine calcium channel blocker. The objective of this trial was to assess the bioequivalence of a 30-mg nifedipine controlled-release tablet and a reference drug in a cohort of healthy Chinese individuals. Two independent open-label, randomized, single-dose, crossover studies were conducted, 1 under fasting conditions (N = 44, with 1 participant dropping out midway) and the other under fed conditions (N = 44, with 4 participants dropping out midway). Plasma concentrations of nifedipine were determined using liquid chromatography-mass spectrometry, and pharmacokinetic (PK) parameters were calculated using noncompartmental analysis with Phoenix WinNonlin 8.0 software. In both fasting and fed studies, reasonable bioequivalence was observed for the PK parameters of both the test product and the reference drug. A good safety profile was demonstrated for both the test product and reference drug, with no serious adverse events reported, and both were similarly well tolerated. An important observation with food coadministration was that systemic exposure to nifedipine (based on area under the curve, AUC0-∞) was reduced by approximately 12%. The bioequivalence of the test product and reference drug under fasting/fed conditions in healthy subjects in China was demonstrated by the study results.
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Área Sob a Curva , Bloqueadores dos Canais de Cálcio , Estudos Cross-Over , Preparações de Ação Retardada , Jejum , Interações Alimento-Droga , Nifedipino , Comprimidos , Equivalência Terapêutica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Administração Oral , Povo Asiático , Bloqueadores dos Canais de Cálcio/farmacocinética , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/efeitos adversos , China , População do Leste Asiático , Voluntários Saudáveis , Nifedipino/farmacocinética , Nifedipino/administração & dosagem , Nifedipino/efeitos adversosRESUMO
Purpose: Nosocomial infection (NI) is associated with poor prognosis. The present study assessed the clinical and microbiological characteristics of NI patients in the intensive care unit (ICU) and investigated the clinical impact and risk factors for NI in ICU patients. Patients and Methods: An observational study was conducted in an adult general ICU. The electronic medical records of all patients admitted to the ICU for >2 days from 2018-2020 were analyzed retrospectively. Multivariate regression models were used to analyze the risk factors for NI in ICU patients. Propensity score-matching (PSM) was used to control the confounding factors between the case and control groups, thus analyzing the clinical impact of NIs. Results: The present study included 2425 patient admissions, of which 231 (9.53%) had NI. Acinetobacter baumannii (33.0%) was the most common bacteria. Long-term immunosuppressive therapy, disturbance of consciousness, blood transfusion, multiple organ dysfunction syndromes (MODS), treatment with three or more antibiotics, mechanical ventilation (MV), tracheotomy, the urinary catheter (UC), nasogastric catheter, and central venous catheter (CVC) were risk factors for NI in the ICU patients. After PSM, patients with NI had a prolonged length of stay (LOS) in the ICU and hospital, significant hospitalization expenses (all p<0.001), increased mortality (p=0.027), and predicted mortality (p=0.007). The differences in the ICU and hospital LOSs among three pathogens were statistically significant (p<0.001); the results of the Escherichia coli infection group were lower than the other two pathogenic groups. Conclusion: NI was associated with poor outcomes. The risk factors for NI identified in this study provided further insight into preventing NI.
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Y-chromosome short tandem repeat (Y-STR) and Y-chromosome single nucleotide polymorphism (Y-SNP) are genetic markers on the male Y chromosome for individual identification, forensic applications, and paternal genetic history analysis. In this study we successfully genotyped 38 Y-STR loci and 24 Y-SNP loci of Pudong Han (n = 689) and Chongming Han (n = 530) in Shanghai. The haplotype diversity of the Y filer platinum genotyping system was the highest in the Han population in the Pudong area of Shanghai (0.99996) and Chongming Island (0.99997). The proportion of unique haplotypes was 97.10% (Pudong) and 98.49% (Chongming), respectively. The multidimensional scaling analysis and phylogenetic analysis were performed according to the genetic distance Rst, which was calculated based on the Y-STR gene frequency data. Moreover, we made a comparison on the frequency distribution analysis and principal component analysis of haplogroups in both populations. As a result, Shanghai Pudong Han, Chongming Island Han, and Jiangsu Han were determined to have a strong genetic affinity. The haplogroup distribution characteristics of the Pudong Han and Chongming Han populations were similar to those of the southern Han population. The results of haplotype network analysis showed that Jiangsu Wujiang Han and Jiangsu Changshu Han had more paternal genetic contributions to the formation of Shanghai Pudong Han and Chongming Island Han. Through the joint analysis of SNPs and STRs, this study deeply analyzed the paternal genetic structure of the Pudong Han and Chongming Han populations. The addition of Y-SNP haplogroups to forensic applications can provide information for pedigree investigation.
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Cromossomos Humanos Y , Polimorfismo de Nucleotídeo Único , China , Cromossomos Humanos Y/genética , Etnicidade/genética , Genética Populacional , Humanos , Masculino , Repetições de Microssatélites , Filogenia , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
INTRODUCTION: This study aimed to examine the medication prescriptions for hypertension in a class 1 and grade A hospital in Shanxi province to provide references for clinical rational drug use. METHODS: An inpatient medical record inquiry system was used to evaluate the use of antihypertensives in a hypertensive population (age ≥ 18 years old) who received a prescription for one or more antihypertensives between January 2017 and December 2019. The hypertensive population was categorized into grades (1, 2, and 3), age groups, and different comorbidities to analyze the medication prescriptions. Drug analysis included angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor antagonist (ARB), calcium channel blocker (CCB), diuretics, and beta-receptor blockers (B-RB). SPSS16.0 was used for statistical analysis, including one-way analysis of variance (ANOVA,) chi-squared test, and multifactor logistic regression analysis. RESULTS: The overall control rate of blood pressure was 60.79%. The control rates of single, double, triple, and quadruple antihypertensives were 70.08%, 59.97%, 56.27%, and 45.23%, respectively. There were more cases of grade 3 than grades 1 and 2. The 18-65 years group was larger than the 66-79 years and ≥ 80 years groups. With the increase in grade, the prescription rate of the single drug decreased and the prescription rate of the combination drug increased, but this phenomenon was not obvious in different age groups. The most common drug prescribed for monotherapy was CCB; CCB combined with B-RB had the highest drug use in the double group by age or grade. Statistically significant differences were detected in the type of comorbidities between different age groups (P < 0.001), while only some differences were observed between different grades. Also, statistically significant differences were observed in the drugs prescribed for patients with hypertension with different comorbidities (P < 0.001). Factors influencing the efficiency of antihypertensives included sex, age, diabetes, heart failure, and usage of CCB and B-RB. The prescription rate of ARB combined with B-RB was relatively higher in grade 2 cases. B-RB was the primary drug for patients with diabetes, significantly increasing the blood glucose level. CONCLUSIONS: The medication prescription of this hospital was in line with the requirements of China's hypertension prevention and treatment guidelines. The pathophysiology of patients with hypertension in different age groups, increased use of combination drugs, and rational drug requirement should be considered when prescribing drugs.