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1.
China Pharmacy ; (12): 271-274, 2022.
Article in Chinese | WPRIM | ID: wpr-913082

ABSTRACT

OBJECTIVE To study the changes in medical-insuran ce payme nt limitations of anti tumor drugs in national medical- insurance negotiation (hereinafter referred to as “national negotiation ”)and recommendations of diagnosis and treatment guidelines corresponding to tumor issued by Chinese Society of Clinical Oncology (CSCO),so as to provide reference for the performance of national negotiation. METHODS The annual list of anti tumor drugs in national negotiation were summarized ;CSCO diagnosis and treatment guidelines were searched according to the tumor types restricted by the medical- insurance payment limitations of antitumor drugs in national negotiation ;the evidence evolution of the payment limitations of medical insurance for anti tumor drugs and CSCO diagnosis and treatment guidelines were analyzed quantitatively. RESULTS & CONCLUSIONS Finally,46 antitumor drugs in the agreement period were included ;seven of their payment limitations of medical insurance had changed ;and there were differences among the payment limitation of medical insurance ,drug labels and recommendations of CSCO diagnosis and treatment guidelines for 13 varieties;the recommendations ,strength of evidence ,recommendation level of CSCO diagnosis and treatment guidelines were changing for 28 varieties anti tumor drugs in different years ;the number of anti tumor drugs recommended by CSCO diagnosis and treatment guidelines differed significantly among different cancer varieties. The medical insurance payment limitations of anti tumor drugs in national negotiation have been gradually expanded ,and the corresponding recommendations ,strength of evidence, recommendation level in guidelines have been constantly improved. However , the payment limitation of B-19-H-20200622) medical insurance for most drugs are limited to the indicationsof drug labels and drugs for some cancers are scarce ,such as 85420393。E-mail:oushunlong@sohu.com esophageal cancer and nasopharyngeal carcinoma.

2.
Acta Pharmaceutica Sinica ; (12): 460-466, 2022.
Article in Chinese | WPRIM | ID: wpr-922922

ABSTRACT

Based on the similar structure of adrenaline shared by higenamine (HI), salsolinol (SA) and coryneine (CO), a photochemical colorimetric sensor based on the displacement reaction of o-diphenol hydroxyl group and alizarin red S-phenylboric acid system was constructed to quickly distinguish and identify the cardiac strength of Shengfupian. The results show that the optimal condition of the sensor is: the molar ratio of alizarin red S (ARS) to phenylboric acid (PA) is 1∶3, reaction temperature is 0 ℃; The preparation method of the sample solution is optimized as follows: 2.5 g of Shengfupian powder was taken, 10 times the amount of methanol was added, and 300 W, 40 kHz ultrasound was carried out for 15 min; methodological studies showed that the method had good precision, repeatability and stability. The |△G| value (G is green, |△G| = |G after - G before|) of each sample was obtained by response values determination of 14 batches of Shengfupian. LC-MS/MS was used to determine the contents of three cardiac components in Shengfupian. It was found that the order of the total contents of cardiotonic components was basically consistent with |△G|. Then the correlation was analyzed, and the correlation coefficient R2 was as high as 0.87, which proved the scientificity and accuracy of this method. This study fills the methodological gap of rapid evaluation of the quality of Shengfupian, and provides the key technical support for the high quality and good price of Shengfupian in the market circulation and clinical application.

3.
Organ Transplantation ; (6): 246-2022.
Article in Chinese | WPRIM | ID: wpr-920856

ABSTRACT

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.

4.
Journal of Clinical Hepatology ; (12): 570-574, 2021.
Article in Chinese | WPRIM | ID: wpr-873800

ABSTRACT

ObjectiveTo investigate the association of common clinical indices and noninvasive liver fibrosis scores with hepatic-type Wilson’s disease (WD) in Chinese patients and their ability to identify advanced liver fibrosis. MethodsA retrospective analysis was performed for the clinical data of 236 Chinese patients with WD who were diagnosed and treated in Beijing YouAn Hospital and China-Japan Friendship Hospital from May 1996 to April 2020. A total of 26 patients with hepatic-type WD who underwent liver pathological examination and had complete clinical data were enrolled; the METAVIR score was used to determine liver fibrosis stage, and the patients were divided into advanced liver fibrosis (F3 and F4 stages) group and non-advanced liver fibrosis (F0, F1, and F2 stages) groups. Three noninvasive liver fibrosis scores [Sheth index, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) index] were calculated for both groups, and the above indices and related clinical indices were compared between the two groups. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups. The Spearman rank correlation test was used for further analysis of indices with statistical significance, and the clinical indices and scoring criteria correlated with liver fibrosis degree were screened out; the receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. ResultsMost of the patients in this study developed the disease in childhood and adolescence, and among these patients, 10 (38.5%) had positive K-F ring and 17 (65%) were in the stage of advanced liver fibrosis. There were significant differences between the advanced liver fibrosis group and the non-advanced liver fibrosis group in white blood cell count (WBC) (Z=-2.102, P=0.036), hemoglobin (Hb) (t=-2.860, P=0009), platelet count (PLT) (t=-4.053, P<0.001), direct bilirubin (DBil) (Z=-2.130, P=0.033), albumin (Alb) (t=-2.875, P=0.008), and Sheth index (Z=-3.369, P=0.001). WBC, Hb, PLT, and Alb were negatively correlated with liver fibrosis degree in WD patients (r=-0.587, -0.610, -0.656, and -0.411, all P<0.05), and DBil and Sheth index were positively correlated with liver fibrosis degree (r=0.486 and 0.711, both P<0.05). The ROC curve analysis showed that WBC, DBil, Sheth index, Hb, PLT, and Alb had an AUC of >0.7, among which Sheth index had the largest AUC of 0.908, with a sensitivity of 70.6%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 64.3%. ConclusionSheth index has a better diagnostic efficiency than the other clinical indices alone and can well identify advanced liver fibrosis in Chinese patients with hepatic-type WD.

5.
Article in Chinese | WPRIM | ID: wpr-873752

ABSTRACT

The mixed teaching model combines the advantages of traditional teaching and network teaching in the “Internet +” era, which has become one of the important trends in the higher education teaching development. In order to follow this development trend, the human parasitology teaching team makes a reasonable use of modern information techniques, actively promotes the construction and application of online resources, and conducts mixed online and offline teaching based on MOOC resources and the experimental teaching digital platform. This mixed teaching model has shown a positive impact on both teaching and learning among teachers and students; however, students’ personalized independent and deep learning remains unsatisfactory. It is suggested that the online course resources construction, teaching design and digital literacy remain to be increased, so as to create a high-level, innovative and challenging online-offline mixed “golden course”

6.
Article in Chinese | WPRIM | ID: wpr-880152

ABSTRACT

OBJECTIVE@#To summarize and compare the clinical baseline characteristics of patients with monoclonal gammopathy of undetermined significance (MGUS), primary light chain amyloidosis (pAL), multiple myeloma (MM), or MM with concurrent amyloidosis, especially the differences in cytogenetic abnormalities.@*METHODS@#The clinical data of 15 cases of MGUS, 34 cases of pAL, 842 cases of MM and 23 cases of MM with concurrent amyloidosis were analyzed and compared retrospectively.@*RESULTS@#Cytogenetic statistics showed that the incidence of t (11; 14) in the four groups (MGUS vs pAL vs MM vs MM with concurrent amyloidosis) was 0%, 33.3%, 16.4%, and 15.8%, respectively (P=0.037); that of 13q deletion was 20.0%, 14.7%, 45.8% and 56.5%, respectively (P<0.001); gain of 1q21 was 50.0%, 12.5%, 47.4% and 40.9%, respectively (P=0.001). Proportion of pAL patients with 0, 1 and≥2 cytogenetic abnormalities (including 13q deletion, 17p deletion, 1q21 amplification and IgH translocation) accounted for 41.9%, 41.9% and 16.1%, respectively; while the proportion of the same category in MM was 17.6%, 27.3%, and 55.2% respectively; this ratio of MM with concurrent amyloidosis was more similar to MM. Subgroup analysis showed that genetic abnormalities (including 13q deletion, 17p deletion and 1q21 amplification) were comparable within t (11; 14) negative and positive groups. Compared with positive cases, t(11; 14) negative patients with MM or MGUS were more likely to have 13q deletions and multiple genetic abnormalities.@*CONCLUSION@#Clinical characteristics of pAL, especially cytogenetic abnormalities, are significantly different from MM with concurrent amyloidosis. It suggests that although the onset characteristics are similar, actually the two diseases belong to different disease subtypes which should be carefully predicted and identified.


Subject(s)
Amyloidosis , Humans , In Situ Hybridization, Fluorescence , Monoclonal Gammopathy of Undetermined Significance/complications , Multiple Myeloma , Retrospective Studies
7.
Article in Chinese | WPRIM | ID: wpr-888103

ABSTRACT

Volatile oil is the main effective component and an important quality indicator of Artemisia argyi leaves. In this study, 100 germplasm resources of A. argyi were collected from all the related habitats in China. The total volatile oils in A. argyi leaves were extracted by steam distillation and the content was determined by GC-MS. The result demonstrated that the content of total volatile oils was in the range of 0.53%-2.55%, with the average of 1.43%. A total of 39 chemical constituents were identified from the volatile oils, including 13 shared by the 100 germplasm resources. Clustering analysis of the 39 constituents showed that the 100 A. argyi samples were categorized into groups Ⅰ(9), Ⅱ(2), Ⅲ(66) and Ⅳ(23), and group Ⅲ had the most volatile medicinal components, with the highest content. Five principal components(PCs) were extracted from 13 shared constituents, which explained 73.454% of the total variance. PC1, PC2, and PC3 mainly reflected the pharmacological activity of volatile oils and the rest two the aroma information. The volatile oils identified in this study lay a foundation for variety breeding of and rational utilization of volatile oils in A. argyi leaves.


Subject(s)
Artemisia , Distillation , Oils, Volatile , Plant Breeding , Plant Leaves
8.
Article in Chinese | WPRIM | ID: wpr-887993

ABSTRACT

The effect of Danhong Injection on the endogenous metabolites of rabbit platelets was analyzed by the liquid chromatography-mass spectrometry( LC-MS) based metabonomic approach. Anti-platelet aggregation was detected after Danhong Injection treatment and the changes of platelet metabolites were analyzed by metabonomics. Principal component analysis( PCA) and partial least squares discriminant analysis( PLS-DA) were performed to investigate the effect of Danhong Injection on endogenous metabolites of platelets,characterize the biomarkers,and explore the relevant pathways and the underlying mechanism. As demonstrated by the pharmacodynamic results,Danhong Injection of different doses and concentrations antagonized platelet aggregation in a dose-and concentration-dependent manner. In contrast to the control group,25 differential metabolites such as nicotinic acid,nicotinic acid riboside,and hypoxanthine were screened out after platelets were treated by Danhong Injection. These metabolites,serving as important biomarkers,were mainly enriched in the nicotinic acid-niacinamide metabolic pathway and purine metabolic pathway. This study explored the therapeutic mechanism of Danhong Injection from a microscopic perspective by metabonomics,which is expected to provide a new idea for the investigation of platelet-related mechanisms.


Subject(s)
Animals , Biomarkers , Blood Platelets , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/pharmacology , Metabolomics , Rabbits , Technology
9.
Article in Chinese | WPRIM | ID: wpr-887981

ABSTRACT

The basic features of glandular and non-glandular trichomes on leaves of Artemisia argyi( germplasms from Qichun,Ningbo,Tangyin,and Anguo,respectively) and related species A. stolonifera were observed by scanning electron microscopy( SEM)and compared. There were significant differences in trichome characteristics of leaves at all parts of A. argyi and A. stolonifera,which were closely related to the difference in chemical components. The length of non-glandular trichomes and size of glandular trichomes on middle leaves were the stablest. A. argyi and A. stolonifera can be distinguished by the density of glandular trichome. Additionally,the four germplasms of A. argyi can be discriminated via the density and curvature of non-glandular trichome. The density of non-glandular trichomes was the highest in A. stolonifera. For A. argyi,the germplasm from Qichun had the highest density of non-glandular trichomes on the abaxial surfaces of upper leaves and that from Ningbo had the largest non-glandular trichome curvature. With regard to the germplasm from Anguo,the T-shaped non-glandular trichomes of long stalks on the adaxial surfaces of the middle leaves were lodging-susceptible,and those with slender heads were wave-like. Statistics results of A. argyi and A. stolonifera are as follows: largest glandular trichomes on the adaxial and abaxial surfaces and highest glandular trichome density on the abaxial surfaces of the lower leaves in A. argyi germplasm from Ningbo,highest density of non-glandular trichomes on the abaxial surfaces of upper leaves in A. stolonifera,and highest density of glandular trichomes and non-glandular trichomes on the adaxial surfaces of the upper leaves in A. argyi germplasm from Qichun. According to the observation result under fluorescence microscope( FM),flavonoids were closely related to the size and density of non-glandular trichomes and size of glandular trichomes. The fluorescence intensity was the strongest and fluorescence area was the largest for flavonoids in A. argyi germplasms from Qichun and Tangyin,while the fluorescence for flavonoids was the weakest in A. stolonifera. It was the first time to observe and analyze the trichome ultrastructure of A. argyi leaves at different positions by SEM and FM. This study clarifies the differences between A. stolonifera and four famous A. argyi germplasms,which provides new evidence for the microscopic identification of A. argyi and its related species and serves as a reference for the study of the relationship of A. argyi structure with its components and functions.


Subject(s)
Artemisia , Flavonoids , Microscopy, Electron, Scanning , Plant Leaves , Trichomes
10.
Article in Chinese | WPRIM | ID: wpr-887979

ABSTRACT

During the high-temperature and rainy season from June to October in 2017-2019,serious southern blight broke out in the Cynanchum stauntonii planting area in Tuanfeng county,Hubei province,which had a great impact on the yield and quality of medicinal materials. In this study,the pathogen of C. stauntonii was isolated,purified,and identified,and the pathogenicity was tested according to Koch's postulates. Meanwhile,the biological characteristics of the pathogen were analyzed. On this basis,the effective fungicides were screened in laboratory. Finally,the pathogen( BQ-1) was identified as Athelia rolfsii( Deuteromycotina,Basidiomycota,anamorph: Sclerotium rolfsii). The optimum growth conditions for BQ-1 were 25-30 ℃,p H 5-8,and alternating light and dark.The effective chemical fungicides were lime-sulphur-synthelic-solution( LSSS) and flusilazole,and the effective botanical fungicide was osthole. BQ-1 was highly homologous to the pathogen HS-1 of peanut southern blight,with the similarity of 18 S r DNA and TEF sequences at 99. 09%. The southern blight in C. stauntonii might be resulted from that in peanut. In the production of C. stauntonii,the following measures should be taken: avoiding rotation or neighboring with peanut,draining water from June to October to reduce humidity,and reasonably applying fungicides.


Subject(s)
Basidiomycota , Cynanchum , Fungicides, Industrial/pharmacology , Humidity
11.
Article in Chinese | WPRIM | ID: wpr-887949

ABSTRACT

In this study, in order to evaluate the phenotypic diversity of Artemisia argyi germplasm resources and improve its efficiency of cultivation and breeding, 100 accessions of A. argyi germplasm resources from 58 regions in China were collected, 20 agronomic traits and leaf phenotypic traits were observed and described. The data were used for phenotypic diversity analysis, correlation analysis, principal component analysis and cluster analysis. The result showed that the genetic diversity index of 20 traits ranged from 0.82 to 4.37, among which the largest was the base depth and the smallest was the leaf width; the coefficient of variation of the 12 quantitative traits ranged from 10.55% to 41.47%. the highest coefficient of variation was the height of dead leaves, and the smallest was the content of chlorophyll, except for the angle of branches, all the quantitative characters tended to be normal distribution. The correlation analysis showed that 28 pairs of traits had significant correlation(P<0.01), and 13 pairs had significant correlation(P<0.05). According to principal component analysis, 20 traits were simplified into 9 principal components, and the cumulative contribution rate was 73.414%, nine traits including plant height, dead leaves heigh, stem diameter, symmetry of leave base, stipule, leaf tip shape, depth of the first pair of lobes, depth of the second pair of lobes and leaf yield were selected as key indexes for evaluating agronomic traits and leaf phenotypic traits of A.argyi germplasm resources. With cluster analysis, 100 accessions of A.argyi were classified into 3 groups, the groupⅠincluded the dwarf plants with thick stem and large leaf, the groupⅡincluded high plants with wide leaf and high yield, the group Ⅲ included dwarf plants with thin stem and flat bottom shape of leaf, which could provide the basis for cultivation identification and variety breeding of A.argyi germplasm resources.


Subject(s)
Artemisia , China , Phenotype , Plant Breeding , Plant Leaves/genetics
12.
Article in Chinese | WPRIM | ID: wpr-912859

ABSTRACT

Objective: To observe the therapeutic efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate in treating chondromalacia patellae and its effect on inflammatory factors in knee joint fluid. Methods: Sixty-eight patients with chondromalacia patellae were randomized into a control group and an observation group, with 34 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate, while the observation group was given additional warm needling moxibustion treatment. Before and after treatment, the two groups were scored using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS), examined by magnetic resonance imaging (MRI) and determined for the levels of nuclear factor-κB (NF-κB), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in knee joint fluid. Clinical efficacy was estimated after treatment. Results: The effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the scores of pain, stiffness and daily activities, as well as the general score of WOMAC declined significantly in both groups (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the time cost for climbing up and down one staircase and VAS score decreased markedly in both groups (all P<0.05), and were shorter or lower in the observation group than in the control group (both P<0.05); the MRI grading showed no significant change in the control group after intervention (P>0.05), while the grading in the observation group showed notable improvement (P<0.05), and was better than that in the control group (P<0.05); the levels of NF-κB and IL-1β in knee joint fluid dropped significantly in the control group after treatment (both P<0.05), while the levels of NF-κB, TNF-α and IL-1β in knee joint fluid all decreased significantly in the observation group (all P<0.05) and were lower than those in the control group (all P<0.05). Conclusion: Warm needling moxibustion plus intra-articular injection of sodium hyaluronate can produce definite efficacy in treating chondromalacia patellae; it can mitigate the clinical symptoms, improve the lesion extent of chondromalacia and down-regulate the levels of NF-κB, TNF-α and IL-1β in knee joint fluid.

13.
Article in Chinese | WPRIM | ID: wpr-912079

ABSTRACT

From the first time that lymphokine active killer(LAK) cell , were induced in 1982, to the first chimeric antigen receptor T-cell (CAR-T) immunotherapy was used by Dr. Rosenberg in 2010 to successfully treat chronic lymphocytic leukemia (CLL), and Novartis′ CAR-T therapy Kymriah is approved by the FDA for B-lineage acute lymphoblastie leukemia (B-ALL) in 2017, CAR-T immunotherapy has entered a new era. The pipeline of CAR-T therapy is rapidly expanding, including the exploration of new targets. In addition to the research focus on CD19, CD20, CD22 and B cell maturation antigen(BCMA), new research directions such as dual targets, gene edited CAR-T are also constantly advancing. Compared with solid tumors that are limited by factors such as tumors microenvironment, CAR-T immunotherapy has more obvious effects in the field of hematological malignancies, such as the FDA approved CAR-T therapy Yescarta, Kymriah, Tecartus, Breyanzi and Abecma. This article will review the recent research progress of clinical treatment in hematological malignancies.

14.
Article in Chinese | WPRIM | ID: wpr-911990

ABSTRACT

Objective:To analyze the effects of different blood sampling methods on the incidence of iatrogenic blood loss, anemia, transfusion, and complications in very low birth weight infants (VLBWI) during hospitalization.Method:A retrospective analysis was performed on VLBWIs (birth weight <1 500 g) admitted to the neonatal intensive care unit of the Second Hospital of Yangtze University, Jingzhou Central Hospital, Hubei province, from January 2014 to December 2018. According to the first blood sampling method, these infants were subjected to the umbilical cord blood and peripheral blood groups. Blood sampling, transfusion, complications, and outcomes were compared between the two groups. Independent samples t-test, rank-sum test, and Chi-square (or Fisher's exact) test were used for statistical analysis. Results:(1) Totally 240 neonates enrolled, including 104 cases in the umbilical cord blood group and 136 in the peripheral blood group. There was no statistical significance in the general information and blood test results for the first time between the two groups. (2)The blood volume collected in the first week in the umbilical cord blood group was lower than that in the peripheral blood group [6.5 ml (1-23 ml) and 10 ml (1-30 ml), Z=-4.706, P<0.01]. Differences between the two groups in the blood volume at 2-9 weeks were insignificant (all P>0.05). The number of blood collection procedures in each of the first four weeks after birth in the umbilical cord blood group was less than that in the peripheral blood group ( Z value was-9.124,-2.272,-4.688, and-2.017, respectively, all P<0.05), but no statistical difference was found at the fifth week ( P>0.05). The time of the first red blood cell transfusion (RBCT) in the umbilical cord blood group was later than that in the peripheral blood group [4 weeks (1-7 weeks) vs 3 weeks (1-5 weeks), Z=-2.839, P<0.05]. The proportion of infants who have received RBCT twice or more times in the umbilical cord blood group was lower than that in the peripheral blood group [39.7% (25/63) vs 56.8% (50/88), χ2=4.312, P<0.05]. The rate of RBCT during the first three weeks in the umbilical cord blood group was lower than that in the peripheral blood group [34.9% (22/63) vs 59.1% (52/88), χ2=8.583, P<0.05]. There were no significant differences in the volume of RBCT per time, adverse reactions after transfusion, and the erythrocyte count, hemoglobin, and hematocrit before and after the first RBCT between the two groups. (3) The incidence of neonatal respiratory distress syndrome, neonatal necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage (grade Ⅲ-Ⅳ) and their outcomes were similar between the two groups (all P>0.05). Conclusion:Blood sampling methods show no significant effect on the total incidence of anemia and RBCT in VLBWIs during hospitalization. Umbilical cord blood sampling may delay the first RBCT time of VLBWIs and reduce the rate of RBCT in the first three weeks, but do not affect the incidence of complications.

15.
Article in Chinese | WPRIM | ID: wpr-911452

ABSTRACT

Objective:To evaluate the prognostic effects of two comprehensive geriatric assessment (CGA) methods in elderly patients with acute myeloid leukemia (AML).Methods:Ninety-seven patients with newly diagnosed AML at Beijing Hospital from August 2008 to December 2019 were included (≥60 years old). All patients were evaluated by two methods of CGA. One was IACA index proposed by Beijing Hospital, including instrumental activities of daily living (IADL), age, Charlson comorbidity index (CCI), albumin; the other was proposed by Italian FIL study group (FIL-CGA), including activities of daily living (ADL), IADL, age, and modified cumulative illness rating score for geriatrics (MCIRS-G).Results:Among 97 patients, 54 patients received standard chemotherapy, 16 with decitabine, 2 with targeted therapy and 25 with the best supportive therapy. The overall response rate (ORR) in 72 treated patients were 67.7%, 33.3% and 0 respectively in fit, unfit and frail groups according to IACA index ( P=0.001). Based on FIL-CGA, the ORRs of fit, unfit and frail groups were 52.5%, 41.7% and 35.0% respectively ( P=0.418). The 1-year OS rates of fit, unfit and frail groups regarding IACA method were 78.7%, 27.7% and 0 respectively ( P<0.01). The 1-year OS rates of fit, unfit and frail groups regarding FIL-CGA method were 67.8%, 28.2% and 13.9% respectively ( P<0.01), while no significant difference was seen between unfit group and frail group ( P=0.111). The early death rates of fit, unfit and frail groups by IACA were 0, 6.0% and 28.6% respectively ( P=0.006), while those by FIL-CGA were 2.3%, 5.9%, 13.9% respectively ( P=0.123). Conclusion:Compared with FIL-CGA method, IACA predicts more effectively the treatment response, survival and early mortality in elderly patients with AML.

16.
Article in Chinese | WPRIM | ID: wpr-911261

ABSTRACT

Objective:To evaluate the mechanism of dexmedetomidine alleviating sevoflurane-induced neurotoxicity and the relationship with neuroglobin (Ngb) in neonatal rats.Methods:Eighty-four healthy male Sprague-Dawley rats, aged 7 days, weighing 12-16 g, were divided into 4 groups ( n=21 each) using a random number table method: control group (group C), sevoflurane group (group S), sevoflurane plus dexmedetomidine group (group SD), and sevoflurane plus dexmedetomidine and yohimbine group (group SDY). Sevoflurane anesthesia method: anesthesia was induced by inhaling 8% sevoflurane and then maintained by inhaling 3% sevoflurane for 4 h. At the end of anesthesia, dexmedetomidine 50 μg/kg was intraperitoneally injected in group SD, and 0.5 mg/kg yohimbine (α 2 adrenergic receptor antagonist) was intraperitoneally injected immediately after the end of intraperitoneal injection of dexmedetomidine 50 μg/kg in group SDY.Six rats were randomly selected from each group and sacrificed at 24 h after the end of anesthesia.The brain tissues were removed for determination of histopathologic changes in hippocampal CA1 region (using HE staining), the expression of Ngb in the area of the hippocampus (by immunofluorescence staining) and the expression of cytochrome C (Cyt c) and caspase-3 (by Western blot). The other rats were fed until 28 days old, and Morris water maze test was performed. Results:Compared with group C, the expression of Ngb, Cyt c and caspase-3 was significantly up-regulated ( P<0.05), histopathologic changes in hippocampal CA1 region were accentuated, and Ngb fluorescence intensity was increased in group S. Compared with group S, the expression of Ngb was significantly up-regulated, expression of Cyt c and caspase-3 was down-regulated, the escape latency was shortened ( P<0.05), histopathologic changes in hippocampal CA1 region were reduced, and Ngb fluorescence intensity was increased in group SD.Compared with group SD, the expression of Ngb was significantly down-regulated, expression of Cyt c and caspase-3 was up-regulated, the escape latency was prolonged ( P<0.05), histopathologic changes in hippocampal CA1 region were accentuated, and Ngb fluorescence intensity was decreased in group SDY. Conclusion:The mechanism by which dexmedetomidine reduces sevoflurane-induced neurotoxicity may be related to activating α 2 adrenergic receptors and up-regulating the expression of Ngb in neonatal rats.

17.
Article in Chinese | WPRIM | ID: wpr-910852

ABSTRACT

Objective:To explore the effect of the application of hierarchical and special quality control in the quality control management of an ultrasound department.Methods:The hierarchical and special quality control method was used to control ultrasonic reports that were related to four quality control areas: basic quality control, deep quality control, obstetrical quality control, and critical value quality control. Changes in the qualified reporting and comprehensive clinical satisfaction rates before and after the implementation of hierarchical and special quality control were examined.Results:After the implementation of hierarchical and special quality control, the qualified rates of basic quality control, deep quality control, obstetrical quality control, and critical value quality control increased significantly. The comprehensive clinical satisfaction score was (90.58±1.79) points, which was higher than before the model was applied [(80.37±2.72) points], and the difference was statistically significant ( P<0.01). Conclusion:The implementation of hierarchical and special quality control measure can effectively improve the quality of ultrasonic diagnoses and comprehensive clinical satisfaction.

18.
Article in Chinese | WPRIM | ID: wpr-910353

ABSTRACT

Objective:To discuss the problems existing in the implementation of the Chinese health industry standard WS 523-2019 by testing SPECT device.Methods:Under the WS 523-2019 standards, a total of 10 SPECT devices were tested with regard to their SPECT reconstructed spatial resolution (SRSR), system planar sensitivity (SPS), system spatial resolution (SSR), whole body system spatial resolution (WSSR), intrinsic uniformity (IU), intrinsic count rate performance (ICR), intrinsic spatial resolution (ISR) and intrinsic spatial linearity(ISL).Result:Under the requirements of WS 523-2019 standards for qualified limits, there are 3 devices with ISL unqualified and the rest of the performances qualified. The new standards basically can meet the clinical requirements and reflected the overall performance of SPECT.Conclusions:The distance between the radiation source and the surface of the detector has great influence on the spatial resolution.In the measurement of ISL, there must be a lead grid separately in the x and y directions. The lead grids with the parallel slits shall be positioned on the detector with the center slit centered on the detector. It is suggested to add rotation center in the new standards.

19.
Chinese Journal of Radiology ; (12): 1287-1293, 2021.
Article in Chinese | WPRIM | ID: wpr-910294

ABSTRACT

Objective:To explore the lesion characteristics and predictors of invasive coronary angiography (ICA)-verified obstructive lesions with fractional flow reserve (FFR)>0.80, that is, anatomy-function mismatch.Methods:A total of 515 obstructive vessels in 419 coronary disease patients from 11 Chinese medical centers undergoing coronary CT angiography and ICA and FFR were retrospectively analyzed. All vessels had one target lesion with diameter stenosis ≥50 % by ICA. There were 229 vessels in the match group (FFR≤0.80) and 286 vessels in the mismatch group (FFR>0.80). The lesion characteristics including lesion territory, the distance of the coronary artery ostium to the proximal end of the lesion, minimum lumen area, reference lumen area, plaque length and burden, plaque volume and component volume, remodeling index and plaque morphological complexity were measured and compared between the two groups. Optimal thresholds of quantitative plaque characteristics were defined by Yoden index. Logistic regression analysis was used to analyze the predictors of anatomy-function mismatch. Area under receiver operating characteristic curve (AUC) was used to analyze the ability of different lesion features to predict mismatched lesions.Results:The coronary stenosis, plaque burden and length, plaque volume (including each component volume) in the mismatch group were smaller than those in the match group, and FFR, minimum lumen area were larger (all P<0.05). Left anterior descending artery (LAD) lesion and severe complex plaque were more common in the match group than the mismatch group with a statistically significant difference. Univariate logistic regression analysis showed that LAD lesion, minimum lumen area>4 mm 2, plaque burden and length, plaque calcification volume<27 mm 3, plaque lipid volume<30 mm 3, plaque fiber volume<150 mm 3 and plaque morphological complexity were predictiors of anatomic function mismatched lesions; Multivariate logistic regression showed that the minimum lumen area>4 mm 2 (OR=3.371, 95%CI 1.903-5.973, P<0.001), plaque lipid volume<30 mm 3 (OR=3.014, 95%CI 1.691-5.373, P<0.001), plaque morphological complexity (mild OR=17.772, 95%CI 8.072-39.128, P<0.001, moderate OR=6.383, 95%CI 3.739-10.896, P<0.001) were independent predictors of mismatched lesions. The AUC of the model based on the minimum lumen area, plaque lipid volume and morphological complexity was 0.824, which was superior to either of the plaque feature alone ( P<0.001). Conclusions:The minimum lumen area, lipid volume and plaque morphological complexity are independent predictors of the anatomical-functional mismatch lesions, and the combination can significantly improve the prediction value.

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Article in Chinese | WPRIM | ID: wpr-909487

ABSTRACT

Presenilin (PS) is the main pathogenic gene of familial Alzheimer's disease(AD). Mutations of PS gene can promote the processing of amyloid precursor protein (APP) into a toxic form of amyloid beta protein (Aβ), which plays an important role in the pathogenesis of AD.However, the current targeted therapy for Aβ has not yet produced a good effect on AD, suggesting the existence of additional pathogenic mechanisms.In recent years, the abnormal calcium homeostasis and its pathological role in AD have attracted people's attention.The calcium signaling pathway is regulated by presenilin.And the calcium regulation of PS gene mutant neurons is impaired, resulting in reduced ability to deal with oxidative stress, which leads to cell death and promotes the occurrence of AD.In addition, damage to neuronal autophagy induced by PS gene mutations also depends on the ability to partially deplete endoplasmic reticulum calcium content.Recent studies have shown that abnormal Ca 2+ homeostasis caused by PS gene mutations can lead to impaired mitochondrial metabolism and defects in brain network activity.This review will focus on the calcium signaling pathway, and explore the pathogenesis of presenilin in AD through the regulation of calcium signals from the perspectives of impaired autophagy, endoplasmic reticulum stress, mitochondrial dysfunction, apoptosis and defects in brain network activity, so as to provide ideas for the etiology of AD and the discovery of drug targets.

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