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@#At present , methamphetamine has become a major hidden danger in global public health safety. In order to judge methamphetamine addicts and methamphetamine abstainers more scientifically and reliably, this study analyzed the endogenous metabolites in plasma, serum and urine of methamphetamine addicts, methamphetamine abstainers and healthy volunteers by highly sensitive high-throughput liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analytical instrument. The obtained metabolomic data were processed by univariate analysis (t-test) and multivariate analysis (PLS-DA and OPLS-DA) and eligible potential biomarkers were then screened.The identified biomarkers set enrichment analysis to find the connection between metabolites and metabolic pathways.Multivariate statistical results showed that methamphetamine acute group, recovery group and healthy group were clearly separated.3, 18 and 6 regulated metabolites were identified in serum, plasma and urine, respectively, suggesting that lipid metabolism was abnormal in methamphetamine acute group, and that fatty acid metabolism, sulfate/sulfite metabolism and sex hormone metabolism were abnormal in methamphetamine recovery group.The selected potential biomarkers in this study provide the possibility for scientific judgment of the clinical stage of methamphetamine detoxification.
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OBJECTIVE： To analyze the current status and trend of opioids consumption in China， and to provide reference for rational use of opioids. METHODS： Purchasing data on five opioids as fentanyl， morphine， pethidine， oxycodone and hydromorphone， were extracted from the database of the Medicine Economic Information Network from 2014 to 2016. Drug consumption was measured by the daily dose per million population （unit： S-DDD）， and the consumption amount of all opioids and different dosage forms （including oral dosage form， injection and other form） in China and different districts were analyzed and compared. RESULTS： The consumption amount of five opioids increased from 69.62 S-DDD in 2014 to 78.64 S-DDD in 2016. The consumption amount of hydromorphone and oxycodone showed an upward trend， while the consumption amount of morphine was basically unchanged， and the consumption amount of fentanyl and pethidine showed a downward trend. The consumption amount of oral dosage form increased from 39.77 S-DDD in 2014 to 45.61 S-DDD in 2016， the consumption amount of the injection increased from 20.74 S-DDD in 2014 to 24.23 S-DDD in 2016， and the consumption amount of other form decreased from 9.11 S-DDD in 2014 to 8.81 S-DDD in 2016. The consumption amount of oral dosage form was around twice that of injection， with the gap expanding yearly. Regionally， the consumption amount of five opioids in the eastern region was the highest， followed by the western region， and the lowest but the highest growth rate in the central region from 2014 to 2016 （in 2016， consumption amount of eastern， western and central regions were 94.04， 67.90， 63.78 S-DDD， with increase rate of 8.50％， 11.77％， 16.17％， compared with 2014）. Morphine was the most widely used drug in all regions， followed by fentanyl； in the eastern and central regions， the use of oral and injection dosage form increased year by year； in western region， the use of oral dosage forms increased while that of injection decreased year by year. CONCLUSIONS： The opioids consumption in China is increasing overall， with regional differences. Nonetheless， the overall consumption is still low. On the premise of strict supervision， it is necessary to take measures to promote the rational use of opioids in different areas.
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Objective To compare and explore the efficacy of regional citrate anticoagulation therapy and regional heparin anticoagulation therapy in continuous renal replacement therapy ( CRRT) of acute kidney injury ( AKI) patients with risk of bleeding by an retrospective study. Methods A total of 96 AKI patients with risk of bleeding were collected retrospectively and treated with CRRT. All the patients were divided into two groups:regional citrate group ( n=50) and regional heparin group ( n=46) . APTT, level of Ca2+, pH value, levels of HCO-3 and Na+, time of blood filter using and incidence of adverse events were compared between the two groups. Results Percentage of hypernatremia, metabolic alkalosis and elevation of transaminase in regional citrate group were 2.3%, 6.1%, 1.9%, respectively, those in the regional heparin group were 1.6%, 0.9%, 1.6%, respectively. The time of blood filter using in regional citrate group and regional heparin group were (70.0±5.3) h and (48.0±2.7) h, respectively (P<0.05). Incidence of bleeding event in regional citrate group and regional heparin group were 3.8% and 13.0%, respectively (P<0.05). Conclusion In patients with coagulation disorders or bleeding risk undergoing CRRT, regional citrate anticoagulation therapy is safer and more effective, and worthy of promotion.
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Objective To compare and explore the efficacy of regional citrate anticoagulation therapy and regional heparin anticoagulation therapy in continuous renal replacement therapy ( CRRT) of acute kidney injury ( AKI) patients with risk of bleeding by an retrospective study. Methods A total of 96 AKI patients with risk of bleeding were collected retrospectively and treated with CRRT. All the patients were divided into two groups:regional citrate group ( n=50) and regional heparin group ( n=46) . APTT, level of Ca2+, pH value, levels of HCO-3 and Na+, time of blood filter using and incidence of adverse events were compared between the two groups. Results Percentage of hypernatremia, metabolic alkalosis and elevation of transaminase in regional citrate group were 2.3%, 6.1%, 1.9%, respectively, those in the regional heparin group were 1.6%, 0.9%, 1.6%, respectively. The time of blood filter using in regional citrate group and regional heparin group were (70.0±5.3) h and (48.0±2.7) h, respectively (P<0.05). Incidence of bleeding event in regional citrate group and regional heparin group were 3.8% and 13.0%, respectively (P<0.05). Conclusion In patients with coagulation disorders or bleeding risk undergoing CRRT, regional citrate anticoagulation therapy is safer and more effective, and worthy of promotion.
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Objective To detect the changes in the immune function of opioid-dependent subjects during the withdrawal stage through the administration of Jitai tablet.Methods Subjects were treated as Jitai tablet alone,Jitai tablet plus buprenorphine and placebo,in a randomized,double-blind,placebo-controlled trial.Before and after the 14th day of withdrawal,levels of immunoglobulin (IgM,IgA,IgG),T cell subsets (CD3+,CD4+,CD8+,CD4+/CD8+) and cytokines (IL-2,IFN-γ,IL-4,IFN-γ/IL-4) were detected.Results Compared with healthy people,immunity function before withdrawal among the opioid abusers showed higher levels of IgM,IL-2,IFN-γ,IL-4 and lower level of CD3+ T,as (1.67 ± 0.87) g/L,(14.44 ± 13.50)％,(20.23 ± 15.10)％,(1.97 ± 1.59)％,(47.01 ± 13.62)％,respectively,with difference statistically significant (P＜0.05).There was no big difference of other immunity indicators between the two groups (P＞0.05).At the 14th day of withdrawal in placebo group,levels of IL-4 returned to normal while IFN-γ/IL-4 ratio increased by 3.43 times (P＜0.05).Levels of IgA,IgG,CD4+ and CD4+/CD8+ ratio fluctuated within normal range.There were no significant changes in other immunity indicators (P＞0.05).Compared with placebo group,fluctuation of IgG and IgM decreased in Jitai group during withdrawal period,together with a normal level of IgM at the 14th day.Level of IL-4 abnormally rose up by 0.54 times in Jitai tablet plus buprenorphine group,while IFN-γ/IL-4 ratio been switched back at the 14th day of withdrawal.Other immune indicators were not affected by medical interventions.Conclusion We noticed that certain impairment of the immune function might be restored by Jitai tablet during the withdrawal period.
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Objective To detect the changes in the immune function of opioid-dependent subjects during the withdrawal stage through the administration of Jitai tablet.Methods Subjects were treated as Jitai tablet alone,Jitai tablet plus buprenorphine and placebo,in a randomized,double-blind,placebo-controlled trial.Before and after the 14th day of withdrawal,levels of immunoglobulin (IgM,IgA,IgG),T cell subsets (CD3+,CD4+,CD8+,CD4+/CD8+) and cytokines (IL-2,IFN-γ,IL-4,IFN-γ/IL-4) were detected.Results Compared with healthy people,immunity function before withdrawal among the opioid abusers showed higher levels of IgM,IL-2,IFN-γ,IL-4 and lower level of CD3+ T,as (1.67 ± 0.87) g/L,(14.44 ± 13.50)％,(20.23 ± 15.10)％,(1.97 ± 1.59)％,(47.01 ± 13.62)％,respectively,with difference statistically significant (P＜0.05).There was no big difference of other immunity indicators between the two groups (P＞0.05).At the 14th day of withdrawal in placebo group,levels of IL-4 returned to normal while IFN-γ/IL-4 ratio increased by 3.43 times (P＜0.05).Levels of IgA,IgG,CD4+ and CD4+/CD8+ ratio fluctuated within normal range.There were no significant changes in other immunity indicators (P＞0.05).Compared with placebo group,fluctuation of IgG and IgM decreased in Jitai group during withdrawal period,together with a normal level of IgM at the 14th day.Level of IL-4 abnormally rose up by 0.54 times in Jitai tablet plus buprenorphine group,while IFN-γ/IL-4 ratio been switched back at the 14th day of withdrawal.Other immune indicators were not affected by medical interventions.Conclusion We noticed that certain impairment of the immune function might be restored by Jitai tablet during the withdrawal period.
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Objective To discuss the influence of psychological education on the resourcefulness of perioperative breast cancer patients. Methods Two hundred breast cancer patients from a first-class hospital in Fujian province were randomly assigned to the control group, in which routine care was done, and an intervention group, in which psychological education curriculum was employed at three stages on the basis of routine care. The resourcefulness scale was used in both two groups before and after the intervention to evaluate the score of individual and social resourcefulness and the total score of resourcefulness in these two groups. Results As to the control group, the score on individual resourcefulness and the total score on resourcefulness before and after the intervention had no significant differences (P>0.05), but the difference in the social resourcefulness scores before and after the intervention was statistically significant (P<0.05). The differences in the scores on the individual resourcefulness, social resourcefulness and the total score on resourcefulness in the intervention group before and after the intervention were all statistically different (P<0.001). What′s more, the scores of individual resourcefulness, social resourcefulness and the total score of resourcefulness between these two groups after the intervention were statistically different (P<0.001) as well. The scores of the intervention group were significantly higher than those of the control one. Conclusion The psychological education can significantly improve the resourcefulness level of perioperative breast cancer patients, which can help individuals to manage stress effectively.
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Aim: To establish a linear additive model for the predication of in vitro sinomenine hydrochloride release from the combination of immediate release, enteric-coated and sustained-release pellets based on the release profiles of each pellet type. Methods: Immediate release pellets were manufactured by extrusion/spher-onization technology. The operation of bottom-spraying in the fluid-bed equipment was conducted to enteric-coating using Eudragit~(R) L-30D-55 and sustained-release coating using Surelease~(R) . In vitro sinomenine hydrochloride release profiles of both uncoated and coated pellets were fitted to the chosen mathematical equations offered by the curve fitting toolbox of Matlab~(R) before a linear additive model was created based upon the best-to-fitting equations. The proportion of each pellet type in the combined format to generate the desired 24 h sinomenine hydrochloride release profile was solved by Matlab~(R). The predicted and assayed sinomenine hydrochloride release from the polled pellets was compared. Results: It was shown that the actual sinomenine hydrochloride release profiles of each pellet type were approximate to those of predicted ones. A linear additive model of the appropriate mathematical equations of each pellet was proven to be capable of controlling in vitro release of sinomenine hydrochloride multiple-unit pellets. Conclusion: A multiple-unit combined system of the selected pellets, as a novel sustained-release system, was successfully prepared. In vitro release performance of the calculated combination of each pellet type could be guaranteed by this approach in designing sustained-release drug delivery system.
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Many moral choices occur in the contemporary biomedicine. With the development of science and technology along the moral choices encountered by biomedicine have been becoming more and more frequent and complicated with the emergence of unmerous new phenomena,In this paper, the historical background, the foundational features and the key principles of moral choices in the contemporary biomedicine are primarily discussed.