Objective To investigate the distribution of moderate to severe cancer pain and administrated dose of opioid drugs in order to provide the reference for the treatment of moderate and severe cancer pain.Methods Retrospective analyzed the clinical data of 146 patients with moderate to severe cancer pain.The information were recorded including opioid use dose,cancer pain incidence,age,gender,height,weight,body surface area and type of tumor.Results There were no significant difference among patients with opioids drug administration in terms of gender,average daily oral dose(x2 =0.473,Z =-0.185,P ＞ 0.05).Meanwhile cancer incidence rate was same in different age groups (x2 =2.280,P =0.684).The average daily opioid dose in patients with over 80 year old was the lowest among other age groups (Z =-2.745,-1.986,-2.141,-2.162;P ＜0.05).Cancer pain incidence in patients with hepatobiliary pancreatic tumors were 67.50％ (27/40),highest than other different types cancer including metastatic tumor(62.50％ (10/16)),urinary tumor (61.54％ (8/13)),lung cancer (52.63％ (50/95)),breast cancer and gynecological tumor (50.00％ (17/34)),gastrointestinal tumor(41.94％ (26/62)),other tumors 38.46％ (5/13) and head and neck tumor(25.00％ (3/12)),the difference was statistically significant (x2 =23.672,P ＜ 0.05).The average day oral morphine dose of different types tumor were listed as followed from high to low in the order:160 (80,200) mg of metastatic tumors,120 (60,160) mg of breast and gynecological tumor,100 (40,125) mg of lung cancer,90(45,115) mg of urinary tract tumors,80(60,160) mg of other tumors,70(50,90) mg of hepatobiliary pancreatic tumor,60 (40,80) mg of gastrointestinal tumor,55 (40,70) mg of head and neck tumor.There were significant differences in terms of among oral morphine dose per day of different type tumors (H=14.280,P ＜0.05).No correlation was found between pain patients with height,body mass,body surface area and average daily dose of morphine (r =-0.045,-0.042,-0.046 ; P ＜ 0.05).Conclusion No significant differences were found in terms of moderate to severe cancer pain among different type tumors at different and age groups.While there is significant difference in term of cancer pain incidence among different tumor types.The average daily amount of morphine in patients with cancer pain is not related to gender,height,body mass and body surface area.The average amount of morphine of patients with age over 80 years old is significantly lower than that of the other age groups,and the average amount of morphine t is related to cancer type.

Objective To elucidate the prevalence and risk factors of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD), and to investigate the associated problems in treatment. Methods A total of 254 PD patients in our division were enrolled in this study. CVD history, laboratory measurements, examinations of carotid atherosclerosis and left ventricular hypertrophy by ultrasonography were collected and associated factors were analyzed. The median follow-up time was 49 months. Results The overall prevalence of CVD was 37% (93/254). Diabetes, longer dialysis duration, hypertfiglyceridemia, hypoalbuminemia, hypoprealbuminemia were commonly found in the patients with new CVD event. The patients without pre-existing CVD had the higher Ccr, Kt/V, D/Pr, nPCR, serum albumin level. In those with pre-existing CVD, the hypertriglyceridemia and the duration of dialysis were independent predictors of progression of CVD. Differences of LAD, LVST, LVMI and IMT were significant between with and without pre-existing CVD groups. Kaplan-Meier curves showed that the presence of CVD was the independent risk factor of survival. Alb<330 g/L, LAD>39.6 mm and peritonitis were risk factors of CVD. Conclusion The prevalence of CVD in PD patients is quite high. CVD history should be realized, dialysis adequacy should be maintained, and peritonitis should be prevented.

Objective: To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture (OVCF) based on the theory of “dynamic-static integration”. Methods: Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A, B, and C for those undergoing surgery within 7, 7–21, and >21 days of fracture occurrence. The variations in the amount of bone cement injected, pre- and post-operative pain levels, functional activity, deformity correction of the injured vertebrae, bone cement leakage, and vertebral body height loss were compared among the three groups. Results: Regarding pain relief and functional activity, the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved. Furthermore, the deformities of the injured vertebrae in the three groups were significantly corrected, with Groups A and B exhibiting superior correction compared to Group C. Moreover, the bone cement leakage rates in groups A and C were higher than that in Group B. At the 3-month follow-up, the loss of vertebral height in Group C was significantly higher than those in groups A and B. Conclusion Kyphoplasty is effective for OVCF treatment. Early surgery can effectively restore the vertebral height of the injured vertebra, reduce kyphosis, and reduce height loss of the injured vertebra after surgery; nevertheless, treatment within 1–3 weeks of the fracture can reduce the occurrence of bone cement leakage, making the surgery safer. Therefore, surgical treatment within 1–3 weeks of fracture is safer and can achieve satisfactory therapeutic effects. From the perspective of traditional Chinese medicine, PKP surgery can transform the fracture end from a micromotion state to a fixed state, which fully embodies the theory of “dynamic-static integration”.

Objective To determine the incidence and risk factors of acute kidney injury (AKI) in respiratory failure patients.Method Clinical data of 235 patients diagnosed as respiratory failure admitted in respiratory division and internal medicine intensive care unit in Renji Hospital from January 2006 to December 2008 were analyzed retrospectively.Patients'demographics,clinical data and laboratory examinations before and after respiratory failure were collected.The incidence,clinical risk factors and hospital mortality of AKI in the respiratory failure patients were analyzed.Multivariate Logistic regression analysis was used to investigate the independent risk factors of AKI in these patients.Results Of the total 235 patients,the average age was (70.05±12.85) years old,the ratio of male to female was 1.90:1.Seventy-seven patients developed AKI and the incidence was 32.8％.The incidence of AKI in those with hypertension (44.4％ vs 26.6％,P＜0.01) or chronic kidney disease(66.7％ vs 31.3％,P＜0.01) was significantly higher.The incidence of AKI in patients with mechanical ventilation was much higher than those without mechanical ventilation(44.8％ vs 13.3％,P＜0.01).The incidence of multi-organ system failure (33.8％ vs 5.7％,P＜0.01),the failure of weaning from mechanical ventilation(69.2％vs 32.5％,P＜0.01) and the mortality (51.9％ vs 13.3％,P＜0.01) in AK1 patients were higher than those without AKI.Multivariate Logistic regression analysis showed that age (OR=1.668),anemia (OR=0.980),baseline serum creatinine (OR=1.071) and mechanical ventilation (OR=3.222) were independent risk factors of AKI.Conclusions Incidence and mortality of AKI are quite high in respiratory failure patients.Age,baseline serum creatinine,anemia and mechanical ventilation are independent risk factors of AKI.

Objective To investigate the expression of metabotropic glutamate receptor (mGluR) in murine podocytes.Methods Conditional immortalized podocytes were used in the research.RT-PCR was used to estimate the mRNA expression.Western blotting,immunofluorescence staining and immunoelectron microscopy were employed to determine the protein production.EIA,EMSA and Western blotting were used to examine the cAMP generation and cAMP response element-binding protein (CREB) activation.Intracellular calcium was investigated using confocal microscopy.Results mGluR1 and 5 mRNA and protein were expressed in murine brain and podocytes.In glomeruli,most of mGluR1 expression located in podocytes and was expressed in the submembrane space of the podocytes.Podocytes treated with (S)-3,5-dihydroxyphenylglycine (DHPG,an agonist for mGluR1/5) rapidly generated cAMP and activated CREB.(RS)-1-Aminoindan-1,5-dicarboxylic acid (AIDA,a selective antagonist of mGluR1/5) and SQ22536 (an adenylate cyclase inhibitor),but not 2-aminoethoxydiphenyl borate (2-APB an antagonist of canonical transient receptor potential) blocked DHPG-induced cAMP generation and CREB activation.Following DHPG treatment,intracellular calcium level rose and was prevented by pre-treatment with AIDA and 2-APB.DHPG-induced calcium influx was also prevented by incubation with calcium-free medium.Conclusion Podocytes express functional mGluR1 and mGluR5.

ObjectiveTo observe the influence of different dietary protein intake (DPI) on nitrogen balance and nutritional indices in peritoneal dialysis (PD) patients, and explore the minimal DPI to maintain nitrogen balance.MethodsThirty-four PD patients were randomly divided into group A, B and C with DPI as 1.2, 0.9 and 0.6 g·kg-1·d-1 respectively. All the patients admitted into our hospital and completed a 10-day assessment for nitrogen balance, as well as nutritional status including serum albumin (Alb), pre-albumin at baseline, the 7th and 10th day. ResultsThe DPI of group A, B and C was (1.18±0.05), (0.87±0.02), (0.66±0.03) g·kg-1·d-1, whose differences were significant (P<0.01). The dietary energy intake (DEI) was 129.29 (117.57-133.89), 111.71 (100.42-133.47), 146.86 (128.03-163.18) kJ·kg-1·d-1 respectively. Nitrogen balance was positive in group A, B, C [2.99 (2.15-4.72) g, 1.20(0.59-1.89) g, 0.24 (-0.87-1.27) g]. The BUN decreased at the 7th and 10th day (P<0.01) in group C. The BUN and phosphorus in group A increased, but without significant difference as compared to baseline. No significant differences of nutritional status were found among three groups throughout the trial. ConclusionMinimal DPI 0.65 g·kg-1·d-1 plus the supplement of protein loss in dialysate can maintain the nitrogen balance in peritoneal dialysis patients.

Hodgkin lymphoma (HL) is a highly curable disease, and even in advanced-stage patients, more than 90% of them can achieve long-term survival. Due to its few adverse reactions and good curative effect, the ABVD regimen is currently used as the standard first-line chemotherapy for HL. In order to further improve the efficacy, the new first-line combination therapies and salvage therapeutic regimens for relapsed/refractory HL are continuously updated, such as anti-CD30 monoclonal antibody brentuximab vedotin combined with immune checkpoint inhibitors or chemotherapy, programmed death receptor 1 with chemotherapy or chimeric antigen receptor T-cells are gradually showing their advantages. This article summarizes the treatment progress of HL at the 61st American Society of Hematology Annual Meeting 2019.

Objective To elucidate the association of fibroblast growth factor 23 (FGF23)with coronary artery calcification in patients with moderate and advanced stage chronic kidney diseases (CKD). Methods Serum intact FGF23 levels in 150 patients with CKD stage 3 to 5 and 25 age- and sex-matched healthy controls were measured by ELISA.The association between FGF23 and coronary artery calcification was studied. Results Serum FGF23 levels in CKD patients were significantly higher than those in healthy controls [196.46 (83.09,355.02) ng/L vs 27.17 (21.63,51.20) ng/L,P＜0.01].The levels of FGF23 were significantly higher in dialyzed patients than those in non-dialyzed patients (P＜0.01),and hemodialysis patients had higher levels as compared to peritoneal dialysis ones [6048.29 (1129.08,34807.45) ng/L vs 1625.80 (602.83,7521.78) ng/L,P＜0.01].The incidence of coronary artery calcification was relatively high in patients with moderate and advanced stage CKD (74/130,56.9％ ).Serum FGF23 level was positively correlated with coronary artery calcification score (CaS) (r=0.177,P＜0.05).Logistic regression analysis showed that age (β=0.091,OR=1.095,P＜0.01),duration of dialysis (β=2.013,OR=7.483,P＜0.05) and FGF23 level (β=0.838,OR=2.311,P＜0.05) were independent risk factors for coronary artery calcification in patients with moderate and advanced stage CKD.ROC curve of coronary artery calcification revealed that area under curve (AUC) of FGF23 was 0.705 (P＜0.01).With the cut-off value of FGF23 as 786.73 ng/L,the diagnostic sensitivity and specificity in coronary artery calcification were 62.5％ and 75.9％.ROC curve of coronary artery calcification showed that AUC of alkaline phosphatase (AKP) was 0.626 (P=0.017).With the cutoff value of AKP as 79.75 U/L,the diagnostic sensitivity and specificity in coronary artery calcification were 84.5％ and 41.5％.There was no diagnostic value of serum phosphorus in coronary artery calcification. Conclusions Serum FGF23 level is correlated with coronary artery.calcification in patients with moderate and advanced stage CKD.The sensitivity of FGF23 is lower and the specificity is higher than those of AKP for the diagnosis of coronary artery calcification.

OBJECTIVETo establish the HPLC fingerprint of Angelica polymorpha.

METHODThe 10 batches of A. polymorpha were measured by HPLC with isoimperatorin as a reference substance and the chromatographic experients were performed on Kromasil 100A C18 column (4.6 mm x 250 mm, 5 microm), eluted with acetonitrile and water as mobile phase in gradient mode. The flow rate was 1.0 m x min(-1) and the detection wavelength was 254 nm.

RESULTThe common mode of the HPLC fingerprints were set up. There were 8 common peaks in the fingerprint of 10 samples, and the similarity of the 10 samples was more than 0.9.

CONCLUSIONThe method is simple, accurate and have a good reaptability. The quality of A. polymorpha can be controlled effectively by the HPLC fingerprint.

Angelica ; chemistry ; China ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Furocoumarins ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reference Standards ; Reproducibility of Results

Objective To establish the HPLC fingerprints of Tangbikang Granules; To scientifically evaluate and effectively control the quality of Tangbikang Granules; To ensure its production stability. Methods HPLC was performed on the column of Germany Merck RP-18 endcapped (250 mm × 4.6 mm, 5 μm) with mobile phase of acetonitrile-0.1% formic acid water; column temperature was 40 ℃; flow rate was 1.0 mL/min; detection wavelength was 240 nm; volume injection was 20 μL. Fingerprint Similarity Evaluation Software (edition 2004A) of Chinese Pharmacopoeia Commission was used to evaluate the similarity of the 10 batches of Tangbikang Granules, and to analyze the correlations of 9 ingredients in Tangbikang Granules. Results Wogonoside was used as the reference peak, and the common mode for the HPLC fingerprints was set up. The similarities of the 10 batches of Tangbikang Granules were above 0.930, and altogether 25 common peaks in the chromatograms were found, of which 18 peaks were assigned to Chinese materia medica in Tangbikang Granules. Conclusion The method has good separability and is accurate and simple, which can provide references for the quality control of Tangbikang Granules.