1.Short-term effects of intravitreal injection of anti-vascular endothelial growth factor drug on blood pressure and heart rate in patients aged over 80 years
Jing ZHAO ; Peng ZHANG ; Ling ZHANG ; Hong DAI
Chinese Journal of Geriatrics 2021;40(5):641-645
Objective:To investigate the changes of blood pressure and heart rate in patients aged over 80 years undergoing intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs under topical anesthesia without anesthetic monitoring in ophthalmology surgery, and to analyze the potential risk for surgery-induced acute cardiovascular and cerebrovascular events.Methods:This was a prospective observational cohort study.A total of 100 patients(aged 80 to 95 years, 47 males and 53 females)included 85 cases of wet age-related macular degeneration, 14 cases of retinal vein occlusion with macular edema, and 1 case of diabetic macular edema.These patients received anti-VEGF drugs injection, with accumulated injections of 1 to 36 times per patient.Blood pressure and heart rate were measured at visit to a medical clinic(as baseline), before operation, 0 min and 30 min after operation.The operation anxiety and pain scores were investigated by questionnaires.Comparison of systolic blood pressure, diastolic blood pressure and heart rate among four different time points was performed by Wilcoxon symbol rank test.Results:At four different time points i. e.at the baseline, before injection, 0 min and 30 min after injection, systolic blood pressure, diastolic blood pressure and heart rate showed an important regularity.The median systolic blood pressure at the four time points was 130(120-140)mmHg(1 mmHg=0.133 kPa), 142(129-149)mmHg, 153(139-164)mmHg and 143(130-151)mmHg, with ranges of 100-160 mmHg, 106-176 mmHg, 118-197 mmHg and 115-187 mmHg, respectively.The median diastolic blood pressure at the four time points was 70(65-75)mmHg, 76(69-83)mmHg, 81(73-87)mmHg and 75(69~81)mmHg, with ranges of 45-90 mmHg, 55-98 mmHg, 58-99 mmHg and 50-93 mmHg, respectively.The median heart rate at the four time-points was 70(65-80)beats/min, 72.5(65-81)beats/min, 73(66-80)beats/min and 70(65-76)times/min, with ranges of 50-95 beats/min, 48-101 beats/min, 51-93 beats/min and 50-87 beats/min, respectively.Systolic blood pressure and diastolic blood pressure were significantly increased from preoperative time to 0 min and 30 min after operation( P<0.01). Compared to the baseline, heart rate was increased before operation( P<0.01)and was decreased at 30 minutes after operation( P<0.01). Conclusions:Blood pressure fluctuation may exceed the safe range with an obvious increase of systolic blood pressure during the current intravitreal injection of anti-VEGF drugs in the patients aged over 80 years.Systolic blood pressure rises significantly before operation and falls back after operation, but it may last till 30 minutes after operation.The range of heart rate change is relatively small.Perioperative management and monitoring measures should be strengthened to reduce the risk of acute cardiovascular and cerebrovascular events.
2.Demands on the technology of prevention and treatment of hypertension and evaluation on training effect among doctors in county and countryside hospitals of Xinjiang
Yanying GUO ; Nanfang LI ; Jing HONG ; Ling ZHOU ; Yanrong HU
Chinese Journal of Primary Medicine and Pharmacy 2012;19(3):332-334
Objective To analyze the demands and to evaluate training effect on the knowledge and technology of prevention and treatment about hypertension among doctors in county and countryside hospitals of Xinjiang.Methods 336 doctors were trained about knowledge of prevention and treatment of hypertension and technology of useful therapeutic regimen,and were investigated for demands of the knowledge and technology and self-evaluation of training effect by questionnaire.Results The knowledge of prevention and treatment about hypertension and the technology of useful therapeutic regimen were needed urgently by 94.8% subjects.91.3% trained doctors thought that the technology suited practically in county and countryside hospitals,and 96.7% hospitals had condition of carrying out the technology.97.9% trained doctors expected this kind of technology on hypertension prevention and treatment to be trained again.74.1% trained doctors comprehended the technology,and the percent of doctor practically using the technology increased from pre-training 12.3% to post training 62.1%.Conclusion The knowledge of prevention and treatment about hypertension and technology of useful therapeutic regimen were needed urgently and were comprehended with training for the most doctors in county and countryside hospitals of Xinjiang.
3.Effect of pigment epithelium-derived factor on p38MAPK-CREB pathway and fibronectin in high glucose cultured human mesangial cells
Lan GAO ; Jing LI ; Ling GAO ; Hongmin CHEN ; Lian HONG
Chinese Journal of Nephrology 2012;28(3):212-216
Objective To investigate the effect of pigment epithelium- derived factor (PEDF) on p38MAPK-CREB pathway and the expression of fibronectin (FN) in human mesangial cells (HMCs) cultured with high glucose. Methods HMCs were treated with different concentrations of glucose and the osmotic control respectively in the presence or absence of PEDF for 24 h:normal glucose (5.6 mmol/L),24.4 mmol/L mannitol,high glucose (30 mmol/L),high glucose+PEDF(30 mmol/L glucose with 10 nmol/L PEDF,40 nmol/L PEDF or 100 nmol/L PEDF).After samples were collected,the expression of phospho-p38MAPK (p-p38) and p-CREB was assessed by Western blotting,while FN mRNA and protein expression was assessed with RT-PCR and ELISA respectively. Results In contrast to normal glucose and mannitol treatments,the expression of p-p38MAPK,p-CREB and FN increased significantly in high glucose group (all P< 0.01).However,PEDF abolished the up-regulation of p-p38MAPK,p-CREB and FN induced by high glucose (all P<0.05). Conclusion PEDF may inhibit fibrosis through P38MAPK-CREB pathway in diabetic nephropathy.
5.Application of PBL in theory teaching of pediatrics
Hong JING ; Qiwei CHEN ; Jia LUO ; Ling REN
Chinese Journal of Medical Education Research 2006;0(07):-
Objective To promote teaching qualities of pediatrics,problem-based learning (PBL)and lecture-based learnin(gLBL)were contrasted,and effects of the new teaching method were evaluated.Methods 58 medical students of English class Grade 2004 were chosen and divided into two groups,namely,PBL group,LBL group,each taught through the corresponding method in the chapter Rickets of Vitamin D Deficiency.At the end of the course,an objective exam was taken and the scores,checkout rate and excellent rate were used to assess the teaching quality.Results The scores and checkout rate of case analysis of the students in the PBL group are higher than that in the LBL group.Conclusion The approach of PBL can elevate the students'clinical thinking capability.
6.The anti-oxidative effect of deferiprone on ocular lens in diabetic rat
Hai-jing, WANG ; Hong-yan, GE ; Fei, LENG ; Ling-ling, DU ; Yi, ZHANG ; Ping, LIU
Chinese Journal of Experimental Ophthalmology 2011;29(12):1061-1064
Background Oxidative stress is thought to be responsible to diabetes-complicated cataract.Our previous study demonstrated that as an iron chelator,deferiprone can protect lens from oxidative damage.Objective This further study aimed to investigate the role of deferiprone on the formation of diabetic-complicated cataract.Methods Forty 6-week-old Wistar rats were included in the study and randomized into 4 groups.Eight of them were used as the normal control group.Diabetes mellitus animal models were established in 22 rats by the carbonhydratediet and fat diet and the intraperitoneal injection of 40 mg/kg streptozocin (STZ).The deferiprone of 50 mg and 100 mg were intragastrically given in 8 model rats respectively after 3 days once a day for 8 weeks.The opacification of lenses was examined under the slit lamp weekly after treatment.The animals were sacrificed and the lenses were obtained at the eighth week of deferiprone injection.The concentrations of water-soluble protein ( WSP),urine-soluble protein (USP) and alkali-soluble protein (ASP) in rat lens suspension were detected by Bradford method.The super oxide dimutese (SOD),malondialdehyde (MDA) and glutathione (GSH) were determined spectrometically using xanthine oxidase,thiobarbituric acid,dithio bis-nitrobenzoic acid.Results No evidently differences were found in the content of the WSP,USP and ASP among the these groups( F=1.73,0.18,0.09,P>0.05).The contents of MDA in 50 mg deferiprone group and 100 mg deferiprone group were ( 1.05 ± 0.10 ) mmol/g and ( 1.05 ± 0.22 ) mmol/g respectively,showing a significant decline in comparison with diabetic model group (P<0.05).The SOD and GSH contents in lens were (321.29±16.57) U/mg,(322.07±22.16) U/mg and (7.83±0.65 ) mg/g,(7.70±0.77 ) mg/g respectively in 50 mg deferiprone group and 100 mg deferiprone group and were considerably elevated in comparison with ( 298.70± 14.69 ) U/mg and ( 5.47 ± 1.01 ) mg/g of diabetic model groups ( P<0.05 ).No significant differences were found in the indexes mentioned above between 50 mg and 100 mg deferiprone groups(P>0.05).Conclusions Deferiprone can reduce oxidative stress and improve the energy metabolism of the lens in diabetic rats.
7.Effects of fluoride on the expression of vascular endothelial growth factor in fibroblast of mice
Ling, QI ; Chun-hong, CHEN ; hui, LIU ; Zhi-tao, ZHAO ; Ling, JING
Chinese Journal of Endemiology 2010;29(2):130-134
Objective To observe the expression of vascular endothelial growth factor(VEGF) mRNA and protein in fluoride(F~-) treated fibroblast(FB) of mice in planar(2D) and FBs populated collagen lattice(3D) culture systems and to further explore the effects of VEGF on the osteogenic action of FB. Methods FB were divided into 0 (control group), 0.0001,0.0010,0.1000,1.0000,10.0000 and 20.0000 mg/L groups(F~-). The levels of VEGF mRNA and protein at 48 h were measured by using RT-PCR, ELISA and immunohistochemistry (IHC) methods. Results The expression of VEGF mRNA increased obviously in group of 0.1000 mg/L(1.08 ± 0.09) in 3D FB compared with the control group(0.93 ± 0.02, all P < 0.05). Fluoride increased the content of VEGF protein obviously in groups of 0.1000,1.0000,10.0000 mg/L(0.19 ± 0.02, 0.26 ± 0.01 and 0.32 ± 0.01 ), higher than that in 2D FB culture supematant in the control group(0.14 ± 0.01, all P < 0.05) ; and in groups of 0.1000, 1.0000 rag/L(0.59 ± 0.06 and 0.52 ± 0.03) it was higher than that in 3D FB culture supematant in the control group(0.37 ± 0.05, all P< 0.01 ). The IHC results showed that the VEGF positive staining cells increased significantly in group of 0.001 mg/L (0.45 ± 0.05) in 2D FB when it was compared with control group(0.36 ± 0.03, P< 0.05); and in groups of 0.0010, 0.1000, 1.0000 rag/L(0.62 ± 0.04,0.70 ± 0.06 and 0.65 ± 0.07) are it was higher than that in 3D FB control group (0.44 ± 0.04, P < 0.05 or < 0.01 ). Conclusions The higher expression of VEGF mRNA and protein in 2D and 3D FB induced by fluoride may play an important role in stimulating the osteogenesis ability in FB.
8.Phylogenetic Analysis of Homologous Proteins Encoded by UL2 and UL23 genes of Herpesviridae
Long-ding, LIU ; Wen-juan, WU ; Min, HONG ; Hai-jing, SHI ; Shao-hui, MA ; Jing-jing, WANG ; Hong-ling, ZHAO ; Yun, LIAO ; Qi-han, LI
Virologica Sinica 2007;22(3):207-211
The proteins encoded by the Herpesviridae β-gene play a critical role in the replication stage of the virus. In this paper, phylogenetic analyses provided evidence that someβ-gene products, such as UL2 and UL23 from HSV1, have their homologous genes in its family, and also exist in prokaryotic organisms, indicating that these viruses appear to have been assembled over evolutionary time by numerous independent events of horizontal gene transfer.
9.Investigation and analysis of expenses of outpatients at counties and townships medical institutions in Xinjiang Uygur Autonomous Region
Sufang ZHAO ; Nanfang LI ; Yanying GUO ; Ling ZHOU ; Jing HONG ; Zhitao YAN ; Hongmei WANG ; Xiaoguang YAO
Chinese Journal of Primary Medicine and Pharmacy 2011;18(24):3320-3322
ObjectiveTo understand condition about cost and economic burden of outpatients in countries and townships medical institutions in Xinjiang.MethodsThirty-one medical institution were selected and the cost and income of one-day outpatients were investigated,then the cost of different diseases,age groups and payment methods and the later disease cost burden were analyzed.ResultsOut-patient expenses of top ten common diseases was pneumonia100.12 yuan,injury 85.18 yuan,hypertension and coronary heart disease(CHD) 69.13 yuan,examination and diseases related to pregnancy 49.60 yuan,disease of the genitourinary system 41.71 yuan,enterogastrtis 34.80 yuan,bronchitis 30.72yuan,osteoarthrosis 24.60 yuan,upper respiratory infection ( URI ) 23.63 yuan,scytitis 21.14yuan;The outpatient expenses of those taking part in Neotype Countryside Cooperative Medical Care Insurance,whose family-month-income was less than 250 yuan,was 18.07 yuan,which disease cost burden was 25.56%.ConclusionThe expenses of infectious diseases in country and township hospitals was in the top ten.The cost of chronic non-communicable diseases was rising significantly;For those participating Neotype Countryside Cooperative Medical Care Insurance,the outpatient expenses was low and the disease economic burden was higher.
10.Data analysis of investigation results on iodine deficiency disorders in Gansu Province in 2011
Yan-ling, WANG ; Xiao-nian, ZHU ; Wei, SUN ; Jing, ZHENG ; Hong-bo, LI
Chinese Journal of Endemiology 2013;(3):288-292
Objective To master the condition of iodine deficiency disorders (IDD),residents iodine nutritional status and implementation of prevention measures in Gansu Province and to provide a basis for developing control strategies.Methods Thirty primary schools were selected in Gansu Province utilizing cluster sampling methodology in 2011,In each selected school,40 children aged 8-10 were randomly selected for thyroid examination and urine samples were collected from 12 children,at the same time measuring the average daily salt intake of domestic residents by 3 days weighing method.On the spot random urine samples and salt samples were collected from a subset of children included in the study.Three towns near the selected school were selected randomly and random urine samples were collected from 5 pregnant and 5 lactating women in each selected town.One drinking water sample was collected for analysis from different sources in five directions(east,south,west,north and central)in each administrative village with the sampled schools.In areas with centralized water supply,two tap water samples were collected for analysis.Results The water iodine median of 83 water samples was 2.02 μg/L,the range was 0.20-36.92 μg/L,and iodine median of 1199 salt samples was 27.4 mg/kg,iodine level in 89.2% (74/83) of the water samples was lower than 10 μg/L.The iodized salt coverage rate was 98.0% (1175/1199),the qualified rate of iodized salt was 90.3% (1061/1175) and the consumption rate of qualified iodized salt was 88.5% (1061/1199).Total of 360 salt samples intake of households were collected,per capita daily salt was 8.5 g,and the range was 2.5-17.8 g.Total of 1200 children thyroid were checked,the thyroid goiter rate(TGR)of children was 2.8%(34/1200) by B-ultrasound and 3.5% (42/1200) by palpation.Total of 359,450 and 450 urine samples of childen aged 8-10,pregnant and lactating women,the urinary iodine median were 216.0,168.6,161.9 μg/L,respectively.Conclusions Great progress has been made in the prevention and control of IDD in Gansu Province.IDD has been controlled effectively and the urinary iodine medians are at optimal levels.