Effect of pharmacogenetic polymorphism on the antiplatelet aggregation effect of ticagrelor / 药学实践杂志

Objective To develop a pharmacogenomics study of ticagrelor in patients with acute coronary syndrome (ACS), identify the genetic factors that can predict individual differences in antiplatelet aggregation effects of ticagrelor, and provide a reference for the development of individualized regimens for ticagrelor. Methods 75 ACS patients of Chinese Han in a hospital in Fujian province in 2018 who met the entry criteria were recruited. The patient was given the tests for platelet function test, platelet aggregation rate and DNA detection. The whole exon sequencing method (WES) was used to detect the single nucleotide polymorphisms of SLO1B1, UGT2B7, P2Y12, PEAR1, ITGA2B and ITGB3. At the same time, the general clinical data of the patients were collected and recorded. The correlation between antiplatelet aggregation effects of ticagrelor and pharmacogenetic polymorphism was analyzed by one-way analysis of variance, multiple linear regression analysis and binary logistic regression analysis. Results One-way analysis of variance showed that SLCO1B1 rs2306283 mutant allele G could affect the antiplatelet aggregation effect of ticagrelor, the average platelet aggregation rate of patients carrying at least one allele G (AG+GG type) was significantly lower than that of wild homozygotes AA patients (8.07%±6.17% vs 13.88%±6.39%, P≤0.05). However, multivariate regression analysis after adjusting for confounding factors showed that SLCO1B1 rs2306283 mutant allele G was not an independent variable affecting the antiplatelet effects of ticagrelor (P>0.05). Conclusion Single nucleotide polymorphisms of genes related to ticagrelor transport receptors, targets, and platelet membrane receptors (including SLO1B1, UGT2B7, P2Y12, PEAR1, ITGA2B, ITGB3) in ACS patients of Han Chinese in Fujian province will not significantly affect the antiplatelet aggregation effect of ticagrelor, which provides a new treatment option for patients with genetic defects who are not suitable for clopidogrel.

The Therapeutic Effects of Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells on Scleroderma

BACKGROUND@#Scleroderma is a multisystem disease in which tissue fibrosis is caused by inflammation and vascular damage. The mortality of scleroderma has remained high due to a lack of effective treatments. However, exosomes derived from human umbilical cord mesenchymal stem cells (HUMSCs)-Ex have been regarded as potential treatments for various autoimmune diseases, and may also act as candidates for treating scleroderma. @*METHODS@#Mice with scleroderma received a single 50 lg HUMSCs-Ex. HUMSCs-Ex was characterized using transmission electron microscopy, nanoparticle tracking analysis and nanoflow cytometry. The therapeutic efficacy was assessed using histopathology, immunohistochemistry, immunofluorescence, quantitative real-time polymerase chain reaction, enzyme-linked immunosorbent assay and western blot. @*RESULTS@#HUMSCs-Ex ameliorated the deposition of extracellular matrix and suppressed the epithelial-mesenchymal transition process, and the effects lasted at least three weeks. In addition, HUMSCs-Ex promoted M1 macrophage polarization and inhibited M2 macrophage polarization, leading to the restoration of the balance of M1/M2 macrophages. @*CONCLUSION@#We investigated the potential antifibrotic and anti-inflammatory effects of HUMSCs-Ex in a bleomycininduced mouse model of scleroderma. So HUMSCs-Ex could be considered as a candidate therapy for scleroderma.

Possible Involvement of F1F0-ATP synthase and Intracellular ATP in Keratinocyte Differentiation in normal skin and skin lesions.

The F1F0-ATP synthase, an enzyme complex, is mainly located on the mitochondrial inner membrane or sometimes cytomembrane to generate or hydrolyze ATP, play a role in cell proliferation. This study focused on the role of F1F0-ATP synthase in keratinocyte differentiation, and its relationship with intracellular and extracellular ATP (InATP and ExATP). The F1F0-ATP synthase ß subunit (ATP5B) expression in various skin tissues and confluence-dependent HaCaT differentiation models was detected. ATP5B expression increased with keratinocyte and HaCaT cell differentiation in normal skin, some epidermis hyper-proliferative diseases, squamous cell carcinoma, and the HaCaT cell differentiation model. The impact of InATP and ExATP content on HaCaT differentiation was reflected by the expression of the differentiation marker involucrin. Inhibition of F1F0-ATP synthase blocked HaCaT cell differentiation, which was associated with a decrease of InATP content, but not with changes of ExATP. Our results revealed that F1F0-ATP synthase expression is associated with the process of keratinocyte differentiation which may possibly be related to InATP synthesis.

The research and establishment of antibiotics differentiated indexes for clinical application in Department of Digestive System / 药学实践杂志

Objective To promote the rational antibacterial drug use for common digestive system (DS) diseases by reviewing the clinical application of antibacterial drugs for hospitalized patients, formulating the hospital clinical specification of antibacterial drugs for common DS diseases and establishing the clinical application of antibacterial drug differentiation index for DS department.Methods 300 cases were selected from 2 060 hospitalized DS patients in the year 2014 based on the given disease ratio.The usage rate and intensity of antibiotics were calculated with survey and medical statistical analysis.The differentiation index for the clinical application of antibacterial drugs were established.Results Theoretical values of usage rate and use intensity of antibiotics in DS department were 29.0%, 41.5 DDDs according to analysis.However, the practical values were 40.3%, 50.3 DDDs.Conclusion It is necessary to improve the level of clinical antibacterial drug use.One effective way to achieve such goal is to establish the differentiation index of antibacterial drug clinical application for the department.

Percutaneous puncturing drainage for the treatment of liver abscess: analysis of its curative effect and influence factors / 介入放射学杂志

Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,

Mortality trend of inpatients with connective tissue diseases: 2005-2014 / 中南大学学报(医学版)

Objective:To analyze the trend relevant factors leading to death and their patterns over a 10-year period in inpatients with connective tissue diseases (CTDs).Methods:All clinical data about death in inpatients with CTDs were retrospectively reviewed between 2005 and 2014 at the Department of Rheumatology and Immunology in Xiangya Hospital of Central South University.Results:In the 10-year time period,the overall hospital mortality was 15.689‰.The disease itself accounted for 44.71% of the total causes of death,infection accounted for 42.94%,and comorbidities accounted for 12.35%.The constituent ratio of deaths and the average hospital mortality caused by the disease itself declined gradually year by year,and the constituent ratio of deaths caused by infection and comorbidities increased gradually year by year (P<0.05).In 2013-2014,infection was the leading cause of death,which accounted for 51.06%.The survival time for CTDs inpatients with interstitial lung disease (ILD) was shorter than that of CTDs inpatients without ILD,and even the risk of death was 1.722 times of the latter.The proportion of deaths caused by the disease itself was the highest in systemic sclerosis and systemic lupus erythematosus,that by infection was the highest in idiopathic inflammatory myopathy (IIM),and that by comorbidities was the highest in rheumatoid arthritis.Conclusion:The proportion of deaths and the hospital mortality in CTDs inpatients caused by the disease itself show a declining trend,while the proportion of deaths caused by infection and comorbidities increase.CTDs patients with ILD have shorter survival time and an increase in risk of death.

Research and establishment of antibiotics differentiated indexes in clinical appli-cation of cardiothoracic surgery in our hospital / 药学实践杂志

Objective To formulate the clinical application specification of antibiotics ,make a deference index of antibac-terial drugs in chest department according to the investigation about the antibiotics′utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use .Methods The antibiotics′ap-plication information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection ,regarding with the relevant regulations and related clinical practice guidelines ,the clinical application specifica-tion of antibiotics was formulated and the analysis ,calculation ,statistics to the actual and theoretical value of the rate and inten-sity of antibiotics′application ,the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done .The differentiation index of them were establish .Results The rates of the actual antibiotics′appli-cation and the prophylactic antibiotics of type I incision respectively were 72 .7% and 92 .6% ,while the intensity of antibiotics′application was 61.2 DDDs/(100 persons · d ) . The deference indexes of them were developed 69 .3% , 63 .0% and 49.3 DDDs/(100 persons · d) .Conclusions There′re still much irrational places in the use of antibiotics in chest department of the hospital .It′s essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice .

Application of clinical nursing path in the respiratory function exercise of esophageal cancer patients / 现代临床护理

Objective To evaluate the effects of clinical nursing path on respiratory function exercise of patients with esophageal carcinoma.Methods A total of 60 postoperative patients with esophageal cancer were divided into the observation group and the control group according to the time period with 30 cases in each group.The observation group was given the clinical nursing pathway care in their respiratory exercise,and the control group routine nursing before and after the operation. The two groups were compared in terms of blood gas analysis implement on 5th day,pulmonary function on 10 th day and pulmonary complications after operation.Results PaO2,VC,MVV,FEV1 and FEV1/FVC in the observation group were much better than those of the control group.The incidence of complications was obviously lower than that of the control group(P<0.05). Conclusion Clinical nursing path used in respiratory function training of perioperative patients is effective for the improvement of pulmonary function and reduction of postoperative complications.

Expression of Vascular endothelial growth factor mRNA and protein in endothelial progenitor cells in patients during acute cerebral hemorrhage associated with hypertension / 中华神经科杂志

Objective To explore the expression of vascular endothelial growth factor (VEGF)mRNA and protein in endothelia progenitor cells (EPCs) and VEGF in the culture medium and serum of patients during acute period of cerebral hemorrhage associated with hypertension (APCHH). Methods Mononuclear cells from peripheral blood of patients with APCHH ( 16 patients) and hypertension ( 16 patients) were isolated and induced to EPCs. Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed to assay VEGF mRNA. VEGF protein was assessed by Western blotting. The VEGF protein level in patient's serum and culture medium ( at day 7 ) were assayed using VEGF ELISA Kit and compared between APCHH group and hypertension group. Results Compared with hypertension group, VEGF mRNA (0. 186 ±0. 035 versus 0.090 ±0.031, t =8.318, P ＜0.0l ) and protein (0. 223 ± 0. 028 versus 0.169 ± 0. 022, t = 3. 744, P ＜ 0. 01 ) expression of EPCs, the concentration of VEGF protein in the supernatant (414 ±37 versus 316 ±29, t =8. 270, P ＜0. 01 ) and in serum (408 ±49versus 222 ±34, t = 12.406, P ＜0. 01 ) were all significantly increased in APCHH group. Conclusion The VEGF protein levels in serum of patients and in the culture medium, VEGF mRNA and protein expression in EPCs were all significantly increased during acute periods of cerebral hemorrhage.

Effect of intermittent high glucose on proliferation and apoptosis of endothelial progenitor cells from human peripheral blood as well as the production of malondialdehyde and antioxidant / 中国组织工程研究

BACKGROUND: Studies have demonstrated that intermittent high glucose can have a more severe impact on vascular endothelial function in comparison with persistent hyperglycemia.OBJECTIVE: To investigate the effect of intermittent high glucose on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from human peripheral blood in vitro as well as the production of malondialdehyde (MDA) and antioxidant. METHODS: Total mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation and then the cells were placed on fibronectin-coated culture dishes. After 7 days of culture, the adherent cells were identified as EPCs by laser scanning confocal microscope. The cells were synchronized and then stimulated with glucose 5.5 mmol/L (normal control group), 20 mmol/L (constant high glucose group), and 5.5/20 mmol/L (intermittent high glucose group, 5.5 and 20 mmol/L glucose culture solution was changed every 8 hours) for 72 hours. EPCs proliferation and apoptosis was measured by MTT assay and flow cytometry, respectively. The content of MDA and the activity of superoxide dismutase (SOD) in culture solution were detected with colorimetry.RESULTS AND CONCLUSION: After EPCs were exposed to constant high glucose (20 mmol/L) and intermittent high glucose (5.5/20 mmol/L) for 72 hours, proliferated cells were significantly reduced and the apoptosis rate was significantly increased compared with those exposed to normal glucose (P < 0.01). Furthermore, there was a significant increase in MDA contents as well as a significant reduce in SOD activities in the constant high glucose and intermittent high glucose group (P < 0.01), especially in the latter group. These findings indicated that both intermittent high glucose and constant glucose could inhibit the proliferation and promote the apoptosis of EPCs; however, intermittent high glucose appears to worsen the effects on EPCs. This is maybe due to the increased oxidative stress.

Research in curriculum construction of simulation and comprehensive experiment for clinical nursing / 中国实用护理杂志

Objective To investigate the curriculum construction and evaluation of teaching effectiveness of simulation and comprehensive experiment for clinical nursing. Methods Based on the investigation of hospital, taking working progress and working task of nurses as orientation, we constructed the curriculum of simulation and comprehensive experiment for clinical nursing, and unfold in junior class (before clinical practice) for student nurses. The teaching effect was evaluated. Results Unfolding simulation and comprehensive experiment could effectively enhance the nursing students' ability to transform theoretical knowledge into clinical nursing practice, and was favorable to change the role of nurses and improve the satisfaction degree of clinical practice.Conclusions Unfolding simulation and comprehensive experiment for clinical nursing for student nurses before clinical practice is practicable and essential.

Effect of glucagon like peptide-1 on proliferation and differentiation of endothelial progenitor cells and its mechanism / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect and mechanism of glucagon like peptide 1(GLP-1)on the proliferation and differentiation of endothelial progenitor cells(EPCs)derived from the peripheral blood.@*METHODS@#Mononuclear cells were isolated from human peripheral blood by density gradient centrifugation. After 7 days of culture,attached cells were stimulated with different cultures of 0.2% BSA,and GLP-1(1,10,and 20 nmol/L). Laser scanning confocal microscope was used to determine the EPCs from human peripheral blood.The activity of EPCs was observed under reverse microscope. MTT was used to determine the proliferation of EPCs. The expression of KDR,Flt-1,VE-cadherin,and eNOS mRNA was detected by RT-PCR.The concentration of serum VEGF was detected by ELISA. The expression of VEGF protein was detected by immunohistochemical SP method. The EPCs cultured in GLP-1 were intervened by VEGFmAb.@*RESULTS@#EPCs was proliferated more in the GLP-1 group(1,10,and 20 nmol/L) than in the control group (P<0.05 or P<0.01). The expression of KDR,FLT-1,VE-cadherin,eNOS mRNA and VEGF protein was higher than that in the control group(P<0.05 or P<0.01). VEGFmAb(100 ng/mL)down-regulated the expression of KDR,Flt-1,VE-cadherin,and eNOS mRNA.@*CONCLUSION@#GLP-1 can promote the proliferation and differentiation of EPCs derived from the peripheral blood by up-regulating VEGF autocrine.

Expression and meaning of pro-angiogenic factors in retinopathy of diabetic rats / 中南大学学报(医学版)

Objective To detect the expression of vascular endotheilal growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), and its receptor CXCR-4 in the retinopathy of diabetic rats, and to explore the relationship between those factors and diabetic-retinopathy(DR). Methods Diabetes was induced in 40 rats with a single intraperitional injection of streptozotocin(STZ). Experimental rats were randomly divided into M1 (diabetic for 1 month), M3 (diabetic for 3 months), and M5 (diabetic for 5 months) groups, and another 10 rats served as a normal control group (NC). Retinal vascular status was observed by transmission electron microscope. After retinal stretched preparation, VEGF, SDF-1α and CXCR-4 immunohistochemistry were done. Retinal VEGF, SDF-1α, and CXCR-4 mRNA were detected by semi-quantitative RT-PCR. Protein expression was measured by Western blot. Results Under transmission electron microscope, change in vascular status was found in M1 to M5 groups, but not in the NC group. The changes became increasingly serious with the prolongation of the disease. By immunohistochemistry, we found the expression of VEGF, SDF-1α, and CXCR-4 on the retina increased gradually. It increased after injecting STZ for 1 month and increased significantly after 5 months.VEGF, SDF-1α, and CXCR-4 mRNA expression increased obviously after injecting STZ for 1 month and increased significantly after 5 months. Western blot showed that protein of VEGF, SDF-1α, and CXCR-4 had no change after injecting STZ for 1 month. It began to increase in the M3 group and increased most in the M5 group. Conclusion The expression of VEGF, SDF-1α, and CXCR-4 on the retina in retinopathy of diabetic rats increases gradually with the prolongation of the disease. It is an important factor for diabetic retinopathy.

Correlated study on preoperative health status and perioperative complication incidence of aged patients / 中国医师进修杂志

Objective To explore the relativity of preoperative health status and perioperative com-plication incidence of aged patients. Methods The chnical data of 3108 old aged people (60 and above 60 years old)who were operated from January 2006 to November 2007 was retrospectively analysed. General e-valuated preoperative health status, and summarized perioperative complication incidence. Results Before operation, 68.7% patients had one or more coexist disease, 41.1% patients had two or more coexist dis-eases, 38.7% had three coexist diseases in the meantime. After operation,one or more complications oc-curred in 21.4% (666/3108)patients, 2.8% (88/3108) patients died because of heart,brain,lung, kidney function failure. Conclusions Aged patients have more coexist diseases, the complications and death rates are higher than those in younger patients. The complications are correlated with preoperative health status and coexist diseases. Some factors could influence the patients rehabilitation,such as heart,brain,lung, kidney function, water-electrolyte balance and blood glucose change.

Analysis of 1359 ADR Cases in Our Hospital / 中国药房

OBJECTIVE:To promote hospital rational drug use. METHODS:A total of 1 359 ADR cases submitted to State ADR Center by our hospital from 2005 to 2007 vial network system were analyzed statistically in respect of patients' age and sex,the drugs involved,routes of administration,ADR-involved organs or systems,and turnover etc. RESULTS:Of the total 1 359 cases,25.75% were induced by antimicrobial drugs and 55.33% were induced by intravenous route. The lesions of skin and its accessories were the predominant presentation of ADR,and the majority ADR cases had a good turnover. CONCLUSION:The incidence of ADR can be reduced by strengthening the education on and monitoring of ADR as well as the sense of responsibility of medical staff.

Adverse Drug Reactions:Analysis of 618 Cases in Our Hospital / 中国药房

OBJECTIVE:To discuss the characteristics and regularities of adverse drug reactions (ADR) in our hospital. METHODS:ADR reports of 618 cases collected via ADR network system and submitted to state ADR database from 2005 to 2006 were analyzed statistically in respect of patients' age and sex,rating of correlated factors and outcome,clinical manifestations,routes of administration,and the involved drugs etc. RESULTS:Anti-infective drugs dominated the first place on the list of ADR incidence rate,followed by antineoplastic agent and Chinese patent medicines. The main symptoms of ADR were drug eruption,allergic,athma,followed by gastrointestinal reaction. There were fewer incidences of serious ADR such as bone marrow depression,hypoleukemia and shock. CONCLUSION:The ADR monitoring in Fuzhou General Hospital is lack and should be strengthened,and knowledge of ADR must be publicized for guiding the rational,safe and effective drug use in clinic.