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Safer drug use relies on the sustained vigilance and continual awareness of all individuals,and drug benefit-risk communication plays a pivotal role in facilitating this process.Foreign exploration on drug benefit-risk communication started relatively earlier.Upon scrutinizing the websites of drug regulatory authorities in the United States and Europe Union,it appears that these regions have established comprehensive communication regulation and practice systems,developed strategic plans and guidance,and communicated with healthcare professionals,patients and the public via various tools and channels,mainly including drug statutory information,new safety information,potential safety signals,etc.In China,drug benefit-risk communication is involved in the legislation,but the relevant guidelines and specific implementation rules are still lacking,and the evidence-based communication research and communication tools are relatively insufficient.We could learn from the experience of other countries,which involves enhancing regulatory implementation,establishing a communication framework,developing scientific evidence,assessing communication effectiveness,refining communication tools,and diminishing information barriers,in order to ultimately support patient and health care professionals to make informed decisions about medication.
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Objective:To construct and evaluate the effect of precise oral nutrition guidance program for colorectal cancer patients with accelerated rehabilitation after operation.Methods:This study was a quasi experimental study. A total of 116 patients with colorectal cancer from department of Colorectal Surgery, Jiangsu Cancer Hospital from March to Deamber, 2021 were selected by convenience sampling method. They were divided into two groups according to their admission time, the experimental group (58 cases), was given precise oral nutrition guidance program after colorectal cancer surgery based. In the control group, 58 cases were treated with the conventional dietary guidance for rapid rehabilitation. The gastrointestinal tolerance rate, the compliance rate of oral nutritional supplements, the first defecation time after operation, albumin, total albumin, prealbumin and other nutritional indexes were compared between the two groups before and after intervention.Results:Finally, 111 cases were included, induding 56 in the experimental group and 55 in the control group. The compliance rate of oral nutritional supplements after intervention in the experimental group was 73.2% (41/56), higher than that in the control group 40.0%(22/55), and the difference between the two groups was statistically significant ( χ2 = 12.47, P<0.05). The first defecation time after operation in the experimental group was (29.51 ± 5.52) h, while in the control group was (61.48 ± 8.39) h, the difference between the two groups was significant ( t = -12.06, P<0.05). The postoperative enteral nutrition tolerance rate of the experimental group was 91.1% (51/56), which was higher than the 69.1%(38/55) in the control group, the difference between the two groups was statistically significant ( χ2 = 8.44, P<0.05). The serum total protein, albumin and prealbumin levels of the experimental group at discharge were (66.56 ± 5.15), (46.78 ± 7.62) g/L and (276.07 ± 53.57) mg/L, compared with the (60.27 ± 4.37), (39.12 ± 6.41) g/L and (230.14 ± 44.58) mg/L in the control group, the differences were statistically significant ( t = 6.66, 5.02, 4.91, all P<0.05). Conclusions:The implementation of precise oral nutrition guidance program is conducive to guiding the clinical practice of oral nutritional supplements in patients with colorectal cancer after surgery, improving patient compliance, reducing gastrointestinal intolerance, promoting intestinal function recovery, and improving nutritional status of patients.
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Objective:To summarize and analyze the current application status of oral mucosal graft (OMG) technique in the repair of ureteral strictures in China, and clarify the feasibility, safety and effectiveness of this technique.Methods:The 175 patients who underwent repair of ureteral stricture using oral mucosal patches from June 2015 to February 2022 were etrospectively analyzed in 14 medical centers in China, including 49 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 32 cases in Affiliated Seventh Medical Center of PLA General Hospital, 3 cases in The Second Hospital of Anhui Medical University, 6 cases in The First Affiliated Hospital of Zhengzhou University, 56 cases in Peking University First Hospital, 3 cases in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 cases in Shanghai Sixth People' s Hospital, 4 cases in General Hospital of Estern Theater Command, 4 cases in Lanzhou University Second Hospital, 2 cases in Guizhou Province People 's Hospital, 2 cases in Peking University People' s Hospital, 5 cases in Jinzhou First People's Hospital, 5 cases in The First Affiliated Hospital of Wannan Medical College, 1 case in Shandong Provincial Hospital. In this study, 127 patients (72.6%) used lingual mucosal patches, 32(18.3%) labial mucosa, and 16(9.1%) buccal mucosa. The surgical approach for OMG ureteral reconstruction was mainly minimally invasive, with robot-assisted laparoscopy in 84 patients (48.0%), traditional laparoscopic surgery in 87 patients (49.7%), and open surgery in only 4 patients (2.3%). There were 133 males and 42 females with an average age of (35.0±17.2) years. The mean body mass index (BMI) and stenosis length were (23.1±4.1) kg/m 2 and (4.7±1.8) cm, respectively. The stricture was located in the left ureter in 116 patients, right ureter in 58 case and bilateral ureter in 1 case. The most common causes of ureteral stricture were endoscopic surgery in 88(50.3%)patients, congenital stricture in 55(31.4%)patients, failed ureteroplasty in 29(16.6%)patients, history of extracorporeal shock wave lithotripsy in 13(7.4%)patients, radiotherapy history in 3(1.7%)patients and other causes in 6(3.4%)patients. Strictures were mainly located in the upper ureter, accounting for 61.7% (108/175 cases), followed by 36.0% (63/175) at the ureteropelvic junction and 2.3%(4/175)in the middle ureter. According to the surgical methods, the patients were divided into robot-assisted laparoscopic surgery group ( n=84), traditional laparoscopic surgery group ( n=87)and open surgery group ( n=4). Subgroup analysis of patients in robot-assisted laparoscopic and traditional laparoscopic surgery groups was performed. There were no significant difference in preoperative data between the two groups except for age (32.0±18.3) years vs.(37.0±15.9)years, P=0.040], BMI[(22.5±4.3)kg/m 2 vs. (23.7±3.6)kg/m 2, P=0.028], and etiology of stenosis [endoscopic injury, 34(40.5%) vs. 53(60.9%), P=0.012]. Preoperative hydronephrosis and stricture length were assessed by CTU and ureterography. Ureterography 7-9 weeks after surgery showed patency of the reconstructed segment, or no recurrence of hydronephrosis was judged as success. Evaluate the operation method, operation time, success rate, length of OMG in repairing ureteral stricture between laparoscopic and robot-assisted groups. Results:The overall success rate of oral mucosal graft repair surgery reached 97.7%(171/175). The success rate of ureteral reconstruction in the two groups were 96.4%(81/84)and 98.9%(86/87), respectively ( P=0.351), and the difference was not statistically significant. There was no significant difference for operation time, intraoperative blood loss, and mean oral mucosal length between the robotic and laparoscopic groups[(244.7±85.8) min and (222.7±83.5)min ( P=0.116), (58.9±38.6) ml and (68.4±45.5) ml ( P=0.217), (5.0±2.0) cm and (4.6±1.5) cm ( P=0.350)], respectively.Postoperative complications were reported in 23 (13.1%) patients, such as fever, urinary leakage, lymphatic leakage, infection, but only 2 (1.4%) cases patients had complications of Clavien-Dindo score ≥ Ⅲ. The two patients developed urinary stricture after surgery with failed conservative treatment, and no urinary stricture occurred following endoscopic treatment.The short-term (three months after surgery)incidence of complications in the site where the oral mucosa was taken, such as difficulty in opening mouth, pain, and swelling, was 12.0% (21/175), and there was no significant difference for oral complications between patients harvesting different length of mucosal graft. Conclusions:Ureteroplasty with oral mucosal graft is a safe, feasible and reliable technique for ureteral reconstruction. At present, minimally invasive technology is the main surgical approach for ureteroplasty, and there is no significant difference in operation time and success rate between robotic surgery and laparoscopic surgery.
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@#Objective To compare the clinical efficacy and safety of da Vinci robot with totally no tube (TNT) versus subxiphoid video-assisted thymectomy surgery (SVATS) in the treatment of thymic tumors. Methods From 2019 to 2021, a retrospective analysis was conducted on patients with thymic tumor resection in the Department of Thoracic Surgery, General Hospital of Northern Theater Command. All patients underwent total thymectomy and mediastinal fat removal, and they were divided into a TNT group and a SVATS group according to the operation method. The intraoperative blood loss, conversion rate, postoperative visual analogue score (VAS), postoperative hospital stay time and postoperative complications were compared between the two groups. Results We finally included 435 patiets. There were 168 patients with 83 males and 85 females at an average age of 61.920±9.210 years in the TNT group and 267 patients with 147 males and 120 females at an average age of 61.460±8.119 years in the SVATS group. There was no death or postoperative myasthenic crisis in both groups. There was no statistical difference in postoperative hospital stay (1.540±0.500 d vs. 3.400±0.561 d, P=0.000), intraoperative blood loss (13.450±5.498 mL vs. 108.610±54.462 mL, P=0.000), postoperative 24 h VAS score (4.960±1.757 points vs. 3.600±1.708 points, P=0.000), or postoperative complication rate (3.0% vs. 11.6%, P=0.001). Conclusion TNT is a more efficient, safe, and effective surgical approach for treating thymic tumors, which can shorten hospital stay time and reduce postoperative complications. However, SVATS can minimize postoperative pain.
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Gypenosides, structurally analogous to ginsenosides and derived from a sustainable source, are recognized as the principal active compounds found in Gynostemma pentaphyllum, a Chinese medicinal plant used in the treatment of the metabolic syndrome. By bioactive tracking isolation of the plants collected from different regions across China, we obtained four new gypenosides (1-4), together with nine known gypenosides (5-13), from the methanol extract of the plant. The structures of new gypenosides were elucidated by one-dimensional (1D) and two-dimensional (2D) nuclear magnetic resonance (NMR) spectra, complemented by chemical degradation experiments. Through comprehensive evaluation involving COL1A1 promoter assays and PP2Cα activity assays, we established a definitive structure-activity relationship for these dammarane-type triterpenoids, affirming the indispensability of the C-3 saccharide chain and C-17 lactone ring in effectively impeding extracellular matrix (ECM) deposition within hepatic stellate cells. Further in vivo study on the CCl4-induced liver damage mouse model corroborated that compound 5 significantly ameliorated the process of hepatic fibrosis by oral administration. These results underscore the potential of dammarane-type triterpenoids as prospective anti-fibrotic leads and highlight their prevalence as key molecular frameworks in the therapeutic intervention of chronic hepatic disorders.
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Animals , Mice , Gynostemma , Liver Cirrhosis/drug therapy , Triterpenes/pharmacology , Ginsenosides , Extracellular Matrix , DammaranesРеферат
Aberrant activation of NLRP3 inflammasome in colonic macrophages strongly associates with the occurrence and progression of ulcerative colitis. Although targeting NLRP3 inflammasome has been considered to be a potential therapy, the underlying mechanism through which pathway the intestinal inflammation is modulated remains controversial. By focusing on the flavonoid lonicerin, one of the most abundant constituents existed in a long historical anti-inflammatory and anti-infectious herb
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Objective To summarize the clinical features in idiopathic hypotony maculopathy.Methods A retrospective case series study.Eighteen eyes of 18 patients who were diagnosed with idiopathic hypotony maculopathy were enrolled in the Second Affiliated Hospital of Wenzhou Medical University from August 2012 to December 2017.There were 8 males (8 eyes) and 10 females (10 eyes).All patients underwent examinations including BCVA,optometry,slit lamp microscope,fundus color photography,UBM,B-mode ultrasound,OCT,FFA and axial length (AL).BCVA was recorded with logMAR acuity.The results of affected eyes and contralateral healthy eyes were compared.Paired t test was performed to compare the intraocular pressure (IOP),diopter and AL of the affected eyes and contralateral healthy eyes.Results Among 18 eyes,there were 6 eyes with logMAR BCVA< 1.0,10 eyes with logMAR BCVA 1.0-2.0,2 eyes with light perception.The average diopter was +2.32± 1.78 D.The average IOP was 5.18± 1.38 mmHg (1 mmHg=0.133 kPa).The average AL was 20.92± 1.61 mm.The differences of IOP (t=21.6,P< 0.000),diopter (t=5.9,P=0.002) and AL (t=9.13,P<0.000) between the affected eyes and contralateral healthy eyes were significant.The inflammatory reaction in the anterior segment was observed in 13 eyes (72.22%).In the posterior segment,all the eyes were documented with chorioretinal folds,optic disc swelling and retinal phlebectasia were also demonstrated in 14 eyes,while with macular uplift in 7 eyes.In the UBM and gonioscope examination,the angle chamber was open in all patients with ciliary body cyst in 6 eyes,while no ciliary body detachment was detected.All eyes had been examined with B-scan ultrasound and found the increasing thickness of eye ball in all eyes,and nodular changes in the optic papilla in 5 eyes.The chorioretinal folds were further confirmed by OCT with the appearance of the gear shape,much more obviously in the chomid than that in retina.In the FFA,fluorescein leakage was found around the optic disc in 13 eyes at the late stage,while there was no obvious abnormal leakage in the macular or poster part of retina.Conclusions Idiopathic hypotony maculopathy could present with various clinical manifestations.The choroiretinal folds is typical clinical sign.
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Objective To explore the surface morphological and biomechanical properties differences of peripheral blood mononuclear cells (PBMCs) between groups of patients with mitochondrial diabetes caused by mt.3243A > G mutation and healthy controls.Methods 2 milliliters blood were obtained from each subject of the mitochondrial diabetes group (n =5) and the control group (n =5).The PBMCs were separated from the blood using the standard Ficoll-Hypaque density-gradient centrifugation method and detected by atomic force microscope (AFM).Results The morphological analysis revealed that compared with control group,the PBMCs of diabetic patients tended to have a lower cell height (0.73 ± 0.24μm vs 2.49 ± 1.17μm,P =0.011) and a much rougher cell membrane (Ra:161.8 ± 33.2nm vs 66.4 ± 16.3 nm,P =0.000;Rq:202.2 ± 40.9nm vs 85.4 ± 17.1 nm,P =0.000).The adhesion force distribution was nearly three times higher in PBMCs of diabetic patients than that of the control group (779.6 ± 190.0pN vs 161.1 ± 83.1 pN,P =0.000).The Young's modulus of PBMCs was significantly increased in diabetic patients (421.4 ± 140.0kPa vs 138.3 ± 77.2kPa,P < 0.01),indicating that diabetic PBMCs were stiffer than control cells.Conclusion Our study demonstrated the surface morphological and biomechanical properties changes in mitochondrial diabetes caused by mt.3243A > G mutation at PBMCs level,which was beneficial to the better understanding of the pathophysiological mechanisms of mitochondrial diabetes associated with mt.3243A > G mutation.
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Objective To observe the effects of isoflurane (ISO) inhale anesthesia on the expression of brain-derived neurotrophic factor (BDNF) and Bcl-2 of hippocampal in rats.Methods A total of 54 SD rats were divided into 3 groups:control group (n=6),O2 group (n=24) and ISO group (n=24).All rats were given 1 week to adapt the environment.Then,rats in the control group were directly sacrificed to collect hippocampi specimens;rats in the O2 group inhaled mixed gas containing 40% O2 and air for 1 hour;rats in the ISO group anesthetized with 3 % ISO and maintained for 1 h with 1.8 % ISO after righting reflex disappeared,inhaling 40% O2 in the whole process of anesthesia.Respiratory rate and percutaneous oxygen saturation (SpO2) of the rats were observed before anesthesia,after induction,30 min after anesthesia,60 min after anesthesia and at the moment of analepsia,respectively.Rats in the O2 group and ISO group were sacrificed to extract hippocampi specimens at 6,12,24 and 72 h after treatment,respectively.The BDNF and Bcl-2 mRNA expression levels in hippocampus of rats were detected using the semi-quantitative reverse transcription PCR (RT-PCR).Results Compared to that before anesthesia,the respiratory rates after induction,30 min after anesthesia and 60 min after anesthesia were decreased (P<0.05),while no apparent changes was found in the SpO2 (P>0.05).Compared to the O2 group,the relative expressions of BDNF mRNA in hippocampi of rats in the ISO group were obviously decreased at 12 and 24 h after the treatment (P<0.05).After anesthesia,the relative expression of BDNF mRNA in rat hippocampus in the ISO group was decreased as time goes on,and the expression levels at 12 and 24 h after the treatment were lower than those in the control group (P<0.05).Compared to the O2 group and control group,the relative expression levels of Bcl-2 mRNA in hippocampi of the rats in the ISO group were lower at all time points for detection (P<0.05).Conclnsion ISO can generate transient inhibition effect on expressions of BDNF and Bcl-2 in hippocampus of rat.
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Objective:To study the anti-inflammatory effect of the ethanol extract of Coptis chinensis Franch.in vitro.Methods: An inflammatory cell model was established by stimulating the mouse peritoneal macrophages in vitro with lipopolysaccharide(LPS).LPS stimulated of RAW264.7 cells for a long time after administration of intervention.Effect of ethanol extract of Coptis chinensis Franch.on RAW264.7 cell growth activity was analyzed by MTT assay.The production of tumor necrosis factor-α(TNF-α),IL-1β,IL-6,NO,prostaglandin E2(PGE2) was determined by ELISA.The expression of mRNA of TNF-α,induced nitric oxide synthase(iNos) and HO-1 was detected by real-time fluorescent quantitative PCR(RT-PCR).Results: The ethanol extract of Coptis chinensis had no inhibition effect on the scope of RAW 264.7 cells the scope of 5-80 mg/L.Each treatment group concentration of interleukin-6 (IL-6),interleukin-1β (IL-1β),TNF-α,NO,prostaglandin E2 (PGE2) content of LPS stimulation model group were significantly (P<0.01),and content was not related to concentration.Real-time quantitative (RT-PCR) showed,the concentration of each treatment group were significantly lower iNos,HO-1 and TNF-α mRNA expression (P<0.05,P<0.05,P<0.01),and content was not related to concentration.Conclusion: Coptis chinensis Franch.ethanol extract has anti-inflammatory effects in vitro,the mechanism may be related to inhibition of TNF-α,NO and other inflammatory factors and the impact of the activation of arachidonic acid (AA) metabolism.
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Objective To observe the effects of isoflurane (ISO) inhale anesthesia on the expression of brain-derived neurotrophic factor (BDNF) and Bcl-2 of hippocampal in rats.Methods A total of 54 SD rats were divided into 3 groups:control group (n=6),O2 group (n=24) and ISO group (n=24).All rats were given 1 week to adapt the environment.Then,rats in the control group were directly sacrificed to collect hippocampi specimens;rats in the O2 group inhaled mixed gas containing 40% O2 and air for 1 hour;rats in the ISO group anesthetized with 3 % ISO and maintained for 1 h with 1.8 % ISO after righting reflex disappeared,inhaling 40% O2 in the whole process of anesthesia.Respiratory rate and percutaneous oxygen saturation (SpO2) of the rats were observed before anesthesia,after induction,30 min after anesthesia,60 min after anesthesia and at the moment of analepsia,respectively.Rats in the O2 group and ISO group were sacrificed to extract hippocampi specimens at 6,12,24 and 72 h after treatment,respectively.The BDNF and Bcl-2 mRNA expression levels in hippocampus of rats were detected using the semi-quantitative reverse transcription PCR (RT-PCR).Results Compared to that before anesthesia,the respiratory rates after induction,30 min after anesthesia and 60 min after anesthesia were decreased (P<0.05),while no apparent changes was found in the SpO2 (P>0.05).Compared to the O2 group,the relative expressions of BDNF mRNA in hippocampi of rats in the ISO group were obviously decreased at 12 and 24 h after the treatment (P<0.05).After anesthesia,the relative expression of BDNF mRNA in rat hippocampus in the ISO group was decreased as time goes on,and the expression levels at 12 and 24 h after the treatment were lower than those in the control group (P<0.05).Compared to the O2 group and control group,the relative expression levels of Bcl-2 mRNA in hippocampi of the rats in the ISO group were lower at all time points for detection (P<0.05).Conclnsion ISO can generate transient inhibition effect on expressions of BDNF and Bcl-2 in hippocampus of rat.
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<p><b>OBJECTIVE</b>To evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation.</p><p><b>METHODS</b>A total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment.</p><p><b>RESULTS</b>The results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all>0.05), indicating the comparability among groups. After treatment, FMA and BI scores were all increased apparently in the three groups as compared with those before treatment (all<0.05). MAS grade was reduced remarkably as compared with that before treatment (all<0.05). After treatment, FMA and BI scores in the alliance therapy group were higher than those in the combination group and the rehabilitation group (all<0.05). FMA and BI scores in the combination group were higher than those in the rehabilitation group (both<0.05). MAS grade in the alliance therapy group was lower than those in the combination group and the rehabilitation group (both<0.05). MAS grade in the combination group was lower than that in the rehabilitation group (<0.05).</p><p><b>CONCLUSION</b>The alliance therapy with scalp acupuncture, music therapy and rehabilitation achieve the remarkable clinical therapeutic effects on post-stroke spasmodic hemiplegia as compared with the routine rehabilitation and the combination of music therapy and rehabilitation.</p>
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The present paper aims to investigate the relation between characteristic parameters of transesophageal photoelectric pulse wave in descending aorta and ambulatory artery blood pressure. The chests of ten adult experimental dogs were performed to take the photoelectric pulse wave of descending aorta transesophageally. The concurrent femoral artery invasive blood pressure was recorded simultaneously. Stepwise regression analysis method was used to study the correlation efficient between characteristic parameters of descending aorta pulse wave (H, h, h/H, g/H, At, s, H(1 + ts/td), k)and invasive artery blood pressure. The characteristic parameters, k and h/H (ratio: 90% and 80%) was proved that they had good correlation with systolic pressure; and k, H and s (ratio: 90%, 80% and 70%), had good correlation with diastolic pressure; while k and H (ratio: 90% for both) had good correlation with mean pressure. The mean values of multiple correlation coefficients of the selected characteristic parameters of descending aorta pulse wave with systolic pressure, diastolic pressure and mean pressure of femoral artery were 0.871, 0.900 and 0.856, respectively. The characteristic parameters of descending aorta pulse wave had specific correlation with systolic pressure, diastolic pressure and mean pressure.
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Animals , Dogs , Female , Male , Aorta, Thoracic , Physiology , Blood Pressure , Physiology , Blood Pressure Monitoring, Ambulatory , Methods , Electrophysiologic Techniques, Cardiac , Methods , Femoral Artery , Physiology , Pulse Wave Analysis , Methods , Regression AnalysisРеферат
Anterior cruciate ligament (ACL) has two important functional roles, including biomechanics and proprioceptive sense. A groat propr!oceptive sense is a basis to exactly obtain highly functional exercise. ACL injury may block perception and conduction information and seriously influence motion and daily activities. A complete rehabilitation of ACL function depends on rehabilitation of both mechanical structure and proprioceptive sense. Therefore, reconstruction of joint function following ACL injury is focus on reconstruction of both joint biomechanical stability and proprioceptive sense. This study was designed by distribution and function of proprioceptive sense to analyze the altemation of propdoceptive sense following ACE injury, and to investigate the related factors and ways for rehabilitation of propriocaptive sense following ACL reconstruction.