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Objective:To study the changes of patient-related costs and the use of stents and other consumables before and after the centralized procurement of coronary stents.Methods:The inpatient medical insurance settlement case data of 1,973 patients with coronary stent implantation admitted to Daping Hospital of Army Medical University from December 2019 to October 2021 were selected.Among them,the data of 1,317 cases of percutaneous cardiovascular surgery and coronary stent implantation with serious or complications and accompanying disease group were slected according to disease diagnosis related groups(DRG),which were divided into the pre-centralized procurement group(667 cases)and the post-centralized procurement group(650 cases)according to the centralized procurement of coronary stents before and after.The costs of patients'medical consumables with the consumption of patients'medical consumables and the impact of the use of consumables such as coronary stents on the costs of medical consumables were compared.Results:There was no significant statistical difference in the hospitalization days and the average number of stents used in patients undergoing percutaneous cardiovascular procedures and coronary stent implantation with centralized procurement of coronary stents.There was a statistically significant difference in the total diagnosis and treatment cost,medical consumables cost,medicines and consumables cost and medicines cost between the pre-centralized procurement group and the post-centralized procurement group(Z=-22.316,-23.546,-22.917,-5.724,P<0.05).The cost of stents[16 260(13 300,32 272)yuan],the number of catheter guidewire balloon sheaths consumables[5(4,8)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[8 719(5 805,15 372)yuan]in the pre-collection group were collected.There were statistically significant differences in the stent cost[1 059(590,1 770)yuan],the number of catheter guidewire balloon sheaths consumables[8(7,12)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[5 708(3 392,12 871)yuan]between the two groups(Z=-30.452,16.582,-7.670,P<0.05).There was a statistical correlation between the cost of coronary stents and the cost of catheter guidewire balloon sheaths before and after centralized volume procurement on the cost of medical consumables for patients(r=0.903,0.473,0.785,0.953,P<0.05).The correlation coefficient between the cost of coronary stents and the cost of medical consumables for patients in the post-centralized procurement group decreased compared to the pre-centralized procurement group,the correlation coefficient between the cost of catheter guidewire balloon sheath and the cost of medical consumables for patients increased.Conclusion:The centralized procurement of coronary stents has a significant cost control effect on patients in the disease groups,and affects the cost structure of medical consumables.Combined with DRG reform,it can continuously improve the standardization and scientificity of clinical use of medical consumables.
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Liver fibrosis is a compensatory response in the process of tissue repair after chronic liver injury, and it is also a necessary pathological process in the progression of a variety of chronic liver diseases. In the pathological state, the imbalance between hepatic oxidative system and antioxidant system can lead to the excessive production or insufficient clearance of reactive oxygen species (ROS)/reactive nitrogen species (RNS), which may induce the injury of hepatocytes, expand inflammatory response, and promote the development and progression of liver fibrosis. As a master regulator of oxidative stress and inflammatory response, NF-κB plays a key role in the process of liver fibrosis. Therefore, the cascade interaction between ROS/RNS and the NF-κB signaling pathway plays a guiding role in further clarifying the pathogenesis of liver fibrosis and exploring effective prevention and treatment strategies. This article reviews and discusses the interaction between ROS/RNS and the NF-κB signaling pathway and its important role in the progression of liver fibrosis, so as to provide strategies and references for targeted therapy for liver fibrosis.
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Primary hepatic carcinoma, hepatic carcinoma for short, is a common gastrointestinal tumor with an insidious onset and rapid progression, and its incidence rate is increasing year by year, seriously threatening the life and health of our people. At present, there is still a lack of specific markers for early diagnosis and treatment of hepatic carcinoma, so the research on its biological characteristics and pathogenesis has become very urgent. Metabolic reprogramming is one of the main characteristics of tumor cells, and lipid metabolic reprogramming is involved in the occurrence and development of hepatic carcinoma. Therefore, the key metabolic enzymes and regulatory molecules in the process of lipid metabolism are considered as important targets for the diagnosis and treatment of hepatic carcinoma. This paper mainly focuses on the signaling pathways and regulatory molecules related to hepatocellular carcinoma lipid metabolism, as well as the related anti-hepatoma drugs, so as to provide new ideas for the prevention and treatment of hepatic carcinoma.
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Objective:To investigate the efficacy of Qingruxiao granules combined with tamoxifen in the treatment of breast hyperplasia and its effect on serum hypoxia-inducible factor-alpha (HIF-α), angiopoietin-2 (Ang-2) and prolactin (PRL) levels. Methods:Ninety-eight patients with breast hyperplasia admitted to Xi'an No.3 Hospital from June 2020 to January 2022 were retrospectively included in this study. They were divided into control and observation groups ( n = 49/group) according to different treatments. The control group was treated with tamoxifen alone. The observation group was treated with Qingruxiao granules combined with tamoxifen. Clinical efficacy, symptom score, ultrasound parameters (glandular layer thickness, longest diameter of mass, maximum diameter of hypoechoic area, inner diameter of lactating tube), endocrine hormone levels (estradiol, progesterone, and prolactin), HIF-α, and Ang-2 pre- and post-treatment, as well as the incidence of adverse reactions were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [93.88% (4/49) vs. 77.55%, χ2 = 5.33, P < 0.05). After treatment, breast mass score, breast pain, systemic accompanying symptom, and nipple discharge in the observation group were (1.34 ± 0.29) points, (1.02 ± 0.36) points, (0.68 ± 0.17) points, (0.97 ± 0.15) points, respectively, which were significantly lower than (1.57 ± 0.23) points, (1.45 ± 0.41) points, (0.95 ± 0.26) points, and (1.28 ± 0.26) points, respectively, in the control group ( t = 4.35, 5.52, 6.08, 7.23, all P < 0.001). The glandular layer thickness, the longest diameter of mass, the maximum diameter of hypoechoic area, and the inner diameter of lactating duct in the observation group were (9.45 ± 1.67) mm, (11.46 ± 3.68) mm, (14.37 ± 4.22) mm, and (1.23 ± 0.39) mm, respectively, which were significantly lower than (11.26 ± 2.51) mm, (16.33 ± 4.01) mm, (19.87 ± 5.01) mm, (1.54 ± 0.48) mm in the control group ( t = 4.20, 2.26, 5.88, 3.51, all P < 0.001). Serum estradiol and prolactin levels in the observation group were (122.35 ± 29.76) ng/L and (205.64 ± 36.42) IU/L, respectively, which were significantly lower than (139.76 ± 30.48) ng/L and (251.49 ± 41.87) IU/L in the control group ( t = 2.86, 5.78, both P < 0.05). Serum progesterone level in the observation group was (9.22 ± 1.57) μg/L, which was significantly higher than (7.18 ± 1.21) μg/L in the control group ( t = -7.20, P < 0.05). Serum HIF-α and Ang-2 levels in the observation group were (0.15 ± 0.05) ng/L and (0.98 ± 0.11) ng/L, respectively, which were significantly lower than (0.24 ± 0.07) ng/L and (1.49 ± 0.22) ng/L in the control group ( t = 7.32, 14.51, both P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Qingruxiao granules combined with tamoxifen can effectively improve clinical symptoms, reduce tumor size, regulate endocrine hormone levels, decrease the expression of angiogenic factors in patients with breast hyperplasia, and is highly safe.
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Liver fibrosis, a common pathological process of most types of chronic liver diseases, is caused by the excessive deposition of extracellular matrix proteins after chronic liver injury. An increasing number of evidence has shown that oxidative stress is closely associated with the development and progression of liver fibrosis and is involved in the pathological process of liver fibrosis caused by various factors. With natural constituents and a clear structure, Chinese herbal monomers herbs have achieved a marked clinical effect in the treatment of liver fibrosis. This article reviews the research advances in monomers of Chinese herbs in the treatment of liver fibrosis by regulating oxidative stress-related signaling pathways.
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OBJECTIVE：To study the improve ment effect of salvianolate on renal interstitial fibrosis （RIF）model rats and its possible mechanism. METHODS ：Totally 50 male SD rats were randomly divided into normal group ，model group ，losartan group （positive control group ，9 mg/kg）and salvianolate low-dose and high-dose groups （18，36 mg/kg）according to body weight ，with 10 rats in each group. Except for normal group ，other groups were given adenine 250 mg/kg intragastrically to establish RIF model. After modeling ，administration groups were given relevant medicine intragastrically ，and normal group and model group were given constant volume of normal saline intragastrically ，the volume was 10 mL/kg，once a day ，for consecutive 30 days. After last medication，the serum levels of creatinine （Scr），urea nitrogen （BUN）and 24 h proteinuria （24 h UPro ）were detected by ELISA. HE staining and Masson staining were used to observe the histopathological characteristics and fibrosis of the kidney. The degree of renal tubular injury and glomerulosclerosis were scored ，and the percentage of positive staining area of renal tissue was calculated ； immunohistochemistry and Western blot assay were used to determine the protein expression of Wnt 5a，Wnt5b，and β-catenin. RESULTS：Compared with normal group ，Scr，BUN and 24 h UPro levels ，renal tubular injury score ， glomerulosclerosis score ， the percentage of positive staining area in renal tissue ，the protein expression of Wnt 5a and β-catenin were increased significantly in model group （P＜0.05），while the expression of Wnt 5b protein was decreased significantly （P＜0.05）. Pathological changes such as mesangial hyperplasia ，fibrous tissue increase and inflammatory cell infiltration were observed under microscope. Compared with model group ，above indexes of rats were improved significantly in losartan group ，salvianolate low-dose and high-dose groups （P＜ 0.05），and the effect of salvianolate had dose-dependent trend. CONCLUSIONS ：Salvianolate has the improvement effect on RIF model rats induced by adenine ，and its mechanism may be related to inhibition of Wnt/ β-catenin signal pathway.
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Objective To evaluate the application value of MSCT in the diagnosis of carotid cavernous fistula(CCF).Methods The data of 10 patients who had been confirmed with CCF by DSA were retrospectively analyzed to compare the imaging features of MSCT plain scan,CTA,post reconstruction imaging and other examination ways.Results 10 patients with CCF which were manifested by superior ophthalmic vein enlargement in CT plain scan,early appearance of superior ophthalmic vein and cavernous sinus enlargement in CTA were studied.The orificium fistulae can be displayed through the multi planar reconstruction (MPR)and the curved planar reconstruction (CPR).The focal region can be well displayed through the volume rendering (VR)and the maximum intensity projection (MIP). CT,MRI,DSA and color doppler ultrasonography have both advantages and limitations in the diagnosis of CCF.Conclusion MSCT can achieve characteristic imaging findings through scan,CTA technology and various post reconstruction methods,it has significant value in the early diagnosis and treatment of CCF.
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BACKGROUND:Previous studies have shown that kainic acid injected into hippocampus can significantly upregulate the expression of excitatory KA1 subunit of the kainate receptor in the hippocampus, and endoplasmic reticulum stress markers, phosphorylation of the alpha subunit of eukaryotic initiation factor 2, accompanied by celldeath. OBJECTIVE:To explore the mechanism of endoplasmic reticulum stress after kainic acid is injected into the hippocampus.METHODS:0.15 nmol kainic acid was injected into the hippocampal CA1 region of 32 adult male Kunming mice, the injection time was 60 seconds. At different time points (1, 2, 3, 4, 5, 6, 8 and 12 hours) after kainic acid was injected, the Bederson score analysis was performed, and then the brain was harvested after cerebral perfusion. FJB staining of brain sections and immunofluorescence double labeled observation were also performed. RESULTS AND CONCLUSION:(1) At 3, 4, 5, 6, 8 hours after kainic acid injection, Bederson score showed severe injury of central nervous system function, and FJB staining showed the increased of celldeath in the hippocampus (P0.05). (2) According to the results of FJB staining, the brain sections were selected at 3, 8 hours for immunohistochemistry. The expressionlevels of KA1 receptors and endoplasmic reticulum stress marker P-eIF2αwere up-regulated at the same time after kainic acid was injected into hippocampus. Two single-staining KA1 and P-eIF2αimmunofluorescence images were synthesized into one over-lapped double-stained image, and two images overlapped, indicating that the up-regulated expression of KA1 and endoplasmic reticulum stress occurred in the same nerve cells. Kainic acid first up-regulated the excitatory receptor KA1 expression, which may cause cellendoplasmic reticulum dysfunction and result in the endoplasmic reticulum stress response, further promoting neuronal celldeath.
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In this research, X-ray photograph and kinescope were applied to observe the whole process of barium swallowing statically and dynamically before and after acupuncture treatment by the radiography of the upper alimentary tract (RART). The observation was made on the objective changes about the functional renovation of contractor muscle of pharynx and epiglottis muscle. Among 36 cases, function of speaking basically recovered in 3 cases, function of swallowing 16 cases,function of expectorating sputum 15 c ases, and for function of water drinking 13 cases. The total effective rate: 75.0% for function of speaking, 97.2% for function of swallowing, 75.0% for function of expectorating sputum, 97.2% for function of water drinking.
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13.1mmol/L were treated by 2 weeks short-term intensive insulin treatment. FBS, Fasting blood insulin(FINS), glycosylated hemoglobin A1c (HbA1c), 2 hours postprandial blood sugar(PBS 2), Homa ? and Homa IR were measured and compared between pre-treatment and post-treatment. Results After 2 weeks short-term intensive insulin treatment, the excellent control of FBS, PBS 2 in 23 out of 27 patients were achieved respectively in (5.6?2.3)days and (8.5?3.5)days. Homa ? significantly increased, and HbA1c and Homa IR decreased comared with pre-treatment. Conclusions The excellent glycemia control and improvement of ?-cell function can be induced by short-term intensive insulin treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.
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AIM It is difficult to identify the Chinese crude drug snake gallbladder accurately by morphological and microscopical characteristics or chemical components only. In order to solve the problem, the technique based on DNA molecular marker was introduced into the authentication of snake gallbladder. METHODS DNA templates were extracted from the membrane or the bile of snake gallbladder, and also from the muscle of the original animal Elaphe schrenckii. About 400 bp DNA fragments of 12S rRNA gene were amplified from the templates and sequenced subsequently. RESULTS Enough amounts of DNA templates could be extracted from a bit of membrane or bile of snake gallbladder. The sequence of amplicons from the membrane, bile and muscle of the same individual were identical completely. CONCLUSION The technique of DNA molecular marker could be used for the authentication of snake gallbladder and bile. The results indicate that the technique could be used for the identification of crude drugs from other animal secretion. DNA sequence analysis also demonstrated that the origins of commercial snake gallbladder were complicated and more efficient quality control was necessary for supervising the crude drug in the market.
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Objective To investigate the relationship between thyroid hormones and Lp(a) the pituitary-thyroid axis in elder patients with congestive heart failure(CHF). Methods 50 normal controls and 158 elder patients with CHF who had not thyroid gland illness were involved in this study. Levels of FT 3, FT 4, TSH and Lp(a) in serum were measured. Patients were divided into two groups according to the course of chronic heart failure: patients with the course of CHF