Research progress on the development of human neutrophil elastase inhibitors / 药学学报

Human neutrophil elastase (hNE) is a serine proteolytic enzyme mainly distributed in neutrophils. When the balance between anti-hNE protein and hNE is broken, excessive release of hNE can cause the occurrence of various diseases. Therefore, inhibition of hNE is a promising therapeutic strategy. In this paper, the structure, action mechanism, physiological function of hNE and the development of hNE inhibitors were briefly summarized, in order to provide information for the related research.

Impact of different types of heart failure on long-term renal prognosis in patients with renal insufficiency and heart failure / 中华肝脏病杂志

Objective: To investigate the effects of different types of heart failure on long-term renal prognosis in patients with renal insufficiency and heart failure. Methods: The patients with renal insufficiency [baseline estimated glomerular filtration rate < 60 ml·min-1·(1.73 m2)-1] and heart failure followed-up for more than 2 years and hospitalized in Beijing Anzhen Hospital, Capital Medical University from January 1, 2018 to June 30, 2019 were enrolled in this retrospective cohort study. The patients were divided into three groups based on the baseline left ventricular ejection fraction (LVEF): heart failure with reduced ejection fraction (HFrEF, LVEF < 40%) group, heart failure with mildly reduced ejection fraction (HFmrEF, 40% ≤ LVEF < 50%) group, and heart failure with preserved ejection fraction (HFpEF, LVEF ≥ 50%) group. Clinical data were collected and endpoint events (adverse renal outcome: the composite outcome of all-cause death or worsening renal function) were recorded through the electronic medical record system. Kaplan-Meier survival curve was used to analyze the incidence of endpoint events of different heart failure subgroups. Cox regression model was performed to analyze the risk factors of endpoint events. Results: A total of 228 patients with renal insufficiency complicated with heart failure were included, with age of (68.14±14.21) years old and 138 males (60.5%). There were 85 patients (37.3%) in the HFrEF group, 40 patients (17.5%) in the HFmrEF group, and 103 patients (45.2%) in the HFpEF group. There were statistically significant differences in age, proportion of age > 65 years old, sex distribution, systolic blood pressure, pulmonary artery pressure, serum sodium, serum calcium, hemoglobin, serum cholesterol, low-density lipoprotein cholesterol, serum uric acid, troponin I, hypersensitive C-reactive protein, LVEF, ventricular septal thickness, left ventricular end-diastolic diameter, B-type natriuretic peptide, estimated glomerular filtration rate, and proportions of using beta blockers, using spirolactone, myocardial infarction, hypertension, cardiomyopathy and atrial fibrillation (all P < 0.05). During the median follow-up of 36.0 (28.0, 46.0) months, 73 patients (32.0%) had adverse renal outcomes. The total incidences of adverse renal outcomes were 32.9% (28/85) in the HFrEF group, 35.0% (14/40) in the HFmrEF group, and 30.1% (31/103) in the HFpEF group. Kaplan-Meier survival curve showed that there was no significant difference in the incidence of endpoint events among the three groups (log-rank test χ2=0.17, P=0.680). Multivariate Cox regression analysis showed that HFpEF (HFrEF as reference, HR=2.430, 95% CI 1.055-5.596, P=0.037) was an independent influencing factor of endpoint events. Conclusions: The long-term renal prognosis of patients with renal insufficiency and heart failure is poor. Compared with HFrEF, HFpEF is an independent risk factor of poor long-term renal prognosis in renal insufficiency patients with heart failure.

Application and significance of mixed methods research in traditional Chinese medicine and narrative medicine / 中国中药杂志

Since narrative medicine was introduced in China, it has been widely used in medical education and clinical practice. The research on narrative medicine in China is especially characterized by its combination with traditional Chinese medicine(TCM). At present, the research on narrative medicine in China is still in the stage of small-scale practicing and theory advocating. Besides, there is also a lack of guidance on experimental design methodology for clinical application, which leads to few high-quality studies in this field. The present study reviewed the current high-quality research on narrative medicine to discuss the value and prospects of mixed methods research in narrative medicine. In addition, the common design, application procedures, and notes of mixed methods research were explained to provide references for the extensive applications of narrative medicine in the medical field, especially TCM clinical practice, education, and scientific research.

Prognostic analysis of different comprehensive treatment models for locally advanced esophageal squamous cell carcinoma based on propensity score matching / 中华外科杂志

Objective: To compare the effects of preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the long-term survival of patients with radical resection for esophageal squamous cell carcinoma. Methods: Totally 1 082 patients with stage T3-4aN0-3M0 thoracic esophageal squamous cell carcinoma were recruited in this study who underwent radical resection at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University from January 2005 to January 2015. There were 798 males and 284 females, with a median age of 61 years (range: 37 to 86 years). There were 138 patients undergoing preoperative neoadjuvant chemotherapy, 392 patients postoperative adjuvant chemotherapy, and 552 patients surgery alone. The neoadjuvant chemotherapy group was used as the benchmark group to match the propensity score with the adjuvant chemotherapy group and the surgery-only group respectively at a ratio of 1∶3. A total of 7 covariates including tumor location, number of positive lymph nodes, tumor invasion depth, tumor differentiation degree, surgical procedure, vascular tumor thrombus and nerve invasion were included, and the caliper value was taken as 0.1. After matching, a total of 699 patients were included for the analysis, including 128 patients in the neoadjuvant chemotherapy group, 267 patients in the adjuvant chemotherapy group, and 304 patients in the surgery alone group. The Kaplan-Meier method was used to generate the survival curves which was tested by the Log-rank method for survival analysis. Results: After matching analysis, the 5-year overall survival rate was 41.5% in the neoadjuvant chemotherapy group with a median overall survival time of 43 months (95%CI: 27 to 59 months), 57.6% in the adjuvant chemotherapy group with a median overall survival time unreached, and 24.9% in the surgery alone group with a median overall survival time of 28 months (95%CI: 25 to 31 months) (χ²=60.475, P<0.01). For overall survival after matching, the adjuvant chemotherapy group was better than the neoadjuvant chemotherapy group (χ²=11.384, P=0.001), the neoadjuvant chemotherapy group was better than the surgery alone group (χ²=8.654, P=0.003), and the adjuvant chemotherapy group was better than surgery alone group (χ²=60.234, P<0.01). Conclusion: Both preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy can improve the long-term survival of patients with locally advanced esophageal squamous cell carcinoma undergoing radical resection, and the improvement effect of postoperative adjuvant chemotherapy is more obvious.

Prospective study on the effect of parecoxib sodium analgesia on pain and stress response after surgery in elderly patients with hip fracture / 中国骨伤

OBJECTIVE@#To investigate the effect of parecoxib sodium preemptive analgesia on pain and stress response after surgery in elderly hip fracture patients.@*METHODS@#The clinical data of 70 elderly patients with hip fracture treated in our hospital from October 2017 to October 2019 were prospectively analyzed. According to different analgesic patterns, 35 cases were randomly divided into experimental group, aged 65 to 86(78.5±9.1) years, 21 males and 14 females, including 18 femoral neck fractures and 17 femoral intertrochanteric fractures. There were 35 cases in control group, aged 66 to 88 (80.6±8.1) years, 18 males, and 17 females, including 20 cases of femoral neck fractures and 15 cases of intertrochantericfractures. The visual analogue scale (VAS) at 4 h, 12 h, 24 h, 48 h, and 72 h after surgery, the incidence of delirium and stress indicators of malondialdehyde (MDA), superoxide dismutase (SOD), cortisol (COR), and epinephrise (E) postoperatively in the two groups were observed.@*RESULTS@#At 4 h, 12 h, 24 h, 48 h after surgery, the VAS score of experimental group was lower than that of the control group, and the difference was statistically significant (@*CONCLUSION@#The advanced analgesic application of parecoxib sodium can significantly reduce the postoperative stress response of elderly hip fracture patients, enhance the postoperative analgesic effect, reduce the incidence of postoperative delirium, and improve the quality of rehabilitation of patients.

Application of accelerated rehabilitation program for the treatment of intertrochanteric fracture of femur in the elderly / 中国骨伤

OBJECTIVE@#To evaluate the clinical value of accelerated rehabilitation in the treatment of intertrochanteric fracture of femur in the elderly.@*METHODS@#Eighty elderly patients with intertrochanteric fractures were selected from January 2016 to October 2018, and were divided into accelerated rehabilitation group and traditional rehabilitation group according to different treatment schemes, 40 cases in each group. There were 22 males and 18 females in accelerated rehabilitation group with an average age of (78.5±9.1) years old; 19 males and 21 females in traditional rehabilitation group with an average age of (80.6±8.1) years old. The perioperative blood loss, incidence of complications, hospitalization time, hospital stay, Harris hip score and improved BADL scale were compared between the two groups.@*RESULTS@#Eighty patients were followed up for more than 12 months, with an average follow-up time of (15.4±2.6) months. The total perioperative blood loss in the accelerated rehabilitation group was significantly lower than that in the traditional rehabilitation group(0.05). The time from admission to operation of the accelerated rehabilitation group(1.48±0.51) days was significantly shorter than that of the traditional rehabilitation group(4.35±1.55) days(0.05), and there was no significant difference in modified BADL score between the two groups(>0.05).@*CONCLUSIONS@#The application of accelerated rehabilitation program in elderly intertrochanteric fracture is safe and effective. It can reduce perioperative bleeding, shorten hospitalization time and accelerate the recovery of hip function.

The antitumor activity of STAT3 target inhibitor Bt354 andmolecular mechanism of anti-prostate cancer / 药学学报

Signal transducer and activator of transcription 3 (STAT3) was found in an abnormal constitutively active status in certain cancer tissues, and under these circumstances the interruption of STAT3 signaling pathway was proposed with the potential anti-cancer efficacy. In this study, our previous reported STAT3 inhibitor Bt354 can inhibit tumor growth in DU145 xenograft mice without affecting body weight. In groups treated with Bt354, the inhibition rate of tumor weight was 58.8%, 62.7% and 73.5% in 10, 20, 40 mg·kg-1 group, respectively. Particularly, the number of Ki 67 positive cells in the tumor sections was significantly decreased in Bt354 groups. Furthermore, Bt354 inhibited the nuclear translocation of STAT3 and consequently induced cell growth inhibition, apoptosis in DU145 cells. These findings suggest that Bt354 may be a potent anticancer agent for STAT3 activated prostate cancer cells. Procedures for animal study were performed with approval of the Animal Care and Use Committee of the Chinese Academy of Medical Sciences and Peking Union Medical College.

Application of the computer-assisted virtual reduction combined with 3D printing technique in acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the computer-assisted virtual reduction combined with 3D printing technique as preoperative planning and assess their therapeutic effects.</p><p><b>METHODS</b>Thirty-five cases of acetabular fracture treated by internal fixation from March 2011 and March 2014 were retrospectively analyzed. All patients underwent operations with internal fixations implanted. The patients were divided into 2 groups according whether they used the computer-assisted virtual reduction combined with 3D printing technology. Fifteen patients in the digital group included 9 males and 6 females with a mean age of (39.4±8.8) years old ranging from 22 to 58 years old;time from injury to the operation was (8.8±2.0) days;for Letournel-Judet classification, 4 cases were both column fracture, 5 cases were posterior wall fracture, 4 cases were T-fracture, 2 cases were posterior wall with transverse fracture. Twenty cases in the control group included 12 males and 8 females with a mean age of (38.7±13.1) years old ranging from 19 to 59 years old;time from injury to the operation was(8.2±2.3) days;for Letournel-Judet classification, 6 cases were both column fracture, 8 cases were posterior wall fracture, 3 cases were T-fracture, 3 cases were posterior wall with transverse fracture. The volume of intraoperative blood loss and blood transfusion, operative time, satisfaction rate of fracture reduction and excellent and good rate of d`Aubigne Postal function evaluation were compared between the two groups and statistical analysis was conducted.</p><p><b>RESULTS</b>All the incisions healed without infection occurred. All the fractures healed without breakage or loosening of plates and screws. There was 1 case of postoperative nerve stimulation symptoms in each group. One patient in the digital group was found necrosis of the femoral head at 6 months after operation. One patient in the control group was found heterotopic ossification at 8 months after operation. All patients were follow-up for 13 to 28 months with an average of 17.6 months. The volume of intraoperative blood loss and blood transfusion in the digital group were significantly less than those in the control group(<0.05). The operation time in the digital group was shorter than that in the control group(<0.05). The excellent and good rates of fracture reduction were 92.9%(14/15) and 85%(17/20) in the digital group and the control group respectively, and there was no statistical significance (>0.05). The excellent and good rates of Aubigne Postal function evaluation were 86.7%(13/15) and 80%(16/20) respectively, and there was no significant difference(>0.05).</p><p><b>CONCLUSIONS</b>The computer-assisted virtual reduction combined with 3D printing technique can reduce the operative time, volume of intraoperative blood loss and blood transfusion in acetabular surgeries for patients with acetabular fractures. The technique is an effective method for preoperative planning, which worth promoting.</p>

Application of chitosan-based hydrogels carrying antimicrobial agents in wound healing / 中国组织工程研究

BACKGROUND: With the development of chemical synthesis technology, the application of chitosan-based hydrogels as wound dressing has become a hotspot in current research. OBJECTIVE: To generally introduce the chitosan-based hydrogels and to review and summarize the application of chitosan-based hydrogels carrying antimicrobial agents in wound healing.METHODS: A computer retrieval of PubMed, Web of Science, Springerlink and Medline databases was performed with "chitosan hydrogel, wound healing, dressing, antimicrobial agents" as key words for relevant articles published from 2007 to 2016. Initially, 168 articles were retrieved, and finally 76 articles were included in result analysis. RESULTS AND CONCLUSION: Because of their inherent anti-inflammatory and antibacterial properties, chitosan-based hydrogels possess the ability of absorbing exudates and forming thin film between the wound and the external environment, to exert their advantages for chronic, non-healing wounds caused by infection. Furthermore, chitosan-based hydrogels carrying antibacterial agents can inhibit the growth of microorganisms in the wound, accelerating the progress of wound healing. Moreover, the antimicrobial agents, including organic antibacterial agents and inorganic antibacterial agents (especially nano-silver), show unique advantages in wound healing and microbial resistance in combination with chitosan-based hydrogels.

Application of chitosan-based hydrogels carrying antimicrobial agents in wound healing / 中国组织工程研究

BACKGROUND: With the development of chemical synthesis technology, the application of chitosan-based hydrogels as wound dressing has become a hotspot in current research. OBJECTIVE: To generally introduce the chitosan-based hydrogels and to review and summarize the application of chitosan-based hydrogels carrying antimicrobial agents in wound healing.METHODS: A computer retrieval of PubMed, Web of Science, Springerlink and Medline databases was performed with "chitosan hydrogel, wound healing, dressing, antimicrobial agents" as key words for relevant articles published from 2007 to 2016. Initially, 168 articles were retrieved, and finally 76 articles were included in result analysis. RESULTS AND CONCLUSION: Because of their inherent anti-inflammatory and antibacterial properties, chitosan-based hydrogels possess the ability of absorbing exudates and forming thin film between the wound and the external environment, to exert their advantages for chronic, non-healing wounds caused by infection. Furthermore, chitosan-based hydrogels carrying antibacterial agents can inhibit the growth of microorganisms in the wound, accelerating the progress of wound healing. Moreover, the antimicrobial agents, including organic antibacterial agents and inorganic antibacterial agents (especially nano-silver), show unique advantages in wound healing and microbial resistance in combination with chitosan-based hydrogels.