Adolescent ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; blood ; drug therapy ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Infant ; Interleukin-23 ; blood ; Male

Objective To investigate the difference between the blood pressure readings between sitting and supine position,and to study the factors that associated with the sitting-supine blood pressure difference in patient with diabetes.Methods We measured the sitting blood pressure first then followed by the supine pressure in 356 diabetic patients,using a standard mercury sphygmomanometer.Patient's body weight,height and blood glucose levels were also measured.Results SBP and DBP were significantly higher in the supine position than in sitting position in diabetic patients(by 3.5?7.6/1.5?4.9 mm Hg,P

Objective To investigate whether the combination of maintenance hemodialysis (MHD) with hemoperfusion(HP) can improve the clearance rate of middle- and largemolecule uremic toxins so as to improve the quality of life and reduce the mortality in MHD patients. Methods A prospective, randomized and controlled clinical trial was carried out. One hundred MHD patients were selected and then randomly divided into two groups after four weeks of run-in period. HD+HP group received MHD alone 2 times a week and the combined treatment of HD with HP (HD+HP) once a week, whereas HD group received MHD alone 3 times a week. The follow up lasted for mean 2 years. The primary outcome was the death of patients. Secondary end points included clinical data, leptin, high sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6),β2 microglobulin (β2-MG), parathyroid hormone (PTH), tumor necrosis factor α (TNF-α) and the indexes of dimensions of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36Chinese Edition ). Results At the end of the two-year observation, the serum concentration of leptin, hsCRP, PTH, IL-6, β2-MG and TNF-α, systolic blood pressure (SBP), diastolic blood pressure(DBP), heart rate(HR), cardiothoracie ratio, left ventricular mass index (LVMI), EPO dose and the types of antihypertensive drugs used were lower in HD +HP group as compared to HD group (all P＜0.05). HD+HP group had higher hemoglobin (Hb), ejection fraction (EF) and body mass index (BMI) (all P＜0.05). No significant differences between two groups were found in terms of serum albumin (Alb), serum iron (SI), total iron binding capacity (TIBC), cardiac output (CO),Kt/V, early/atrial mitral inflow velocities (E/A) (all P＞0.05). Besides, the SF-36 indicated that the total score of overall dimensions in HD+HP group was higher (P＜0.05) and the quality of life of HD+HP group was evidently better as compared to HD group. The Kaplan-Meier survival curves for the 2-year observation period showed that patients in HD +HP group had obvious survival advantage, while Log-rank test results showed P＜0.05. No serious adverse incidents occurred during the HD+HP treatment. Conclusion HD+HP is superior to HD in eliminating regularly middleand large-molecules uremic toxins and has a potential role in improving the quality of life and survival rate of MHD patients.

Sulfur fumigation (SF) is a universal phenomenon in primary processing of Traditional Chinese Medicine (TCM) in modern times. In the process, fumigation, sulfur or both of them act on the TCMs. Some active components of TCMs change quantitatively or qualitatively during the processing. At the same time, the sulfur dioxide and heavy metal would remain and cause a serious influence on quality and future development of TCM. This article reviews the chemical compositions change after SF to study the change law and their influence on quality. This article provide references for SF in TCMs' processing for a better and safer quality.
Drug Contamination ; Fumigation ; methods ; Medicine, Chinese Traditional ; methods ; Quality Control ; Sulfur ; chemistry ; Technology, Pharmaceutical ; methods

Infestation, moldy and other phenomenon in the processing and storage of Chinese herbal medicines is a problem that faced in the production of Chinese traditional medicine. The low productivity of traditional processing methods can not guarantee the quality of Chinese herbal medicines. Sulfur fumigation is the first choice of grassroots to process the Chinese herbal medicine with its low cost and easy operation. Sulfur fumigation can solve some problems in the processing and storage of Chinese herbal medicines, but modern pharmacological studies show that long-term use of Chinese traditional medicine which is fumigated by sulfur can cause some serious harm to human liver, kidney and other organs. This paper conducts a review about the application history of sulfur fumigation, its influence to the quality of Chinese herbal medicines as well as domestic and foreign limits to sulfur quantity, and a brief introduction of the status of modern processing technologies in the processing of food and some Chinese herbal medicines, the problems ex- isting in the Chinese herbal medicines processing, which can provide a reference basis for the further research, development and application of investigating alternative technologies of sulfur fumigation.
Fumigation ; adverse effects ; methods ; Medicine, Chinese Traditional ; methods ; Quality Control ; Social Control, Formal ; Sulfur ; chemistry ; Technology, Pharmaceutical ; methods

Immune thrombocytopenia purpura (ITP) is a disorder mediated by antiplatelet antibodies and characterized by accelerated destruction of platelets and impaired platelet production. The mainstay therapies for ITP have included corticosteroids, the immune globulin intravenous immunoglobulin and IV anti-D (monoclonal antibodies against the D antigen of the Rh system), vinblastine or a monoclonal anti-CD20 antibody that transiently depletes CD20(+) B cells, danazol, cyclophosphamide and even splenectomy to refractory one. Most of ITP patients responded to those treatment, while more than 30% of whom may relapse sooner or later. The recombinant forms of human TPO were discontinued from human use in clinic because recipients of these agents developed significant thrombocytopenia secondary to production of neutralizing antibodies that cross-reacted with endogenous TPO. All above mentioned treatments have side effects and severe infection may arise post splenectomy. The more powerful treatment with less side effects are needed. There are two TPO receptor agonist, AMG531 and Eltrompobag, have approved in Europe for the treatment of ITP. Both of them can improve the differentiation of megakaryocyte and platelets production. Combination treatment including pancytoprotector shows good effect in the treatment of refractory and relapsed ITP in China. Altogether, individual treatment of ITP is the contemporary trend in both clinical and preclinical practice. In this review the pathogenesis of ITP and its clinical therapies were reviewed, the individual regiments for treating ITP patients were discussed.
Humans ; Purpura, Thrombocytopenic, Idiopathic ; classification ; immunology ; therapy

Objective:To determine whether ox-LDL (oxdized low-density lipoprotein) is highly deposited on the uremic vessel wall and its influence on the vascular remodeling. Methods: Segments of radial arteries were obtained from 21 uremic subjects during the operation of A-V fistula prior to hemodialysis. Segments of internal thoracic arteries of similar diameter were obtained from patients with benign chest tumors as control.The vascular lesions and ox-LDL, CD68,MCP-1, eNOS,ET-1, PCNA,FN on the vessel wall were determined by means of H-E stain and immunohistochemistry. Results： With H-E stain,atherosclerotic plaques were found in the radial arteries of 4 uremic patients. The middle layer of the arteries in uremic patients were obviously thickened, and the T/D　(thickness of the wall/external diameter) ratio was significantly higher than those in control group(P<0.01). ox-LDL,CD68,MCP-1, ET-1, PCNA,FN on the vessel wall in uremic patients were much higher than those in control group (P<0.01). Moreover, ox-LDL on the vessel wall was positively related to the expression of other above mentioned substances on the vessel wall (P<0.01). Whereas the expression of eNOS on the vessel wall was lower than control group (P<0.01),and was negatively related to ox-LDL on the vessel wall(P<0.01). Conclusion: ox-LDL is an important factor contributing to uremic vascular remodeling by increasing the migration,adhesion and infiltration of monocyte,the proliferation of vascular smooth muscle cell and dysfunction of endothelia.

Objective:To determine whether ox-LDL (oxdized low-density lipoprotein) is highly deposited on the uremic vessel wall and its influence on the vascular remodeling. Methods: Segments of radial arteries were obtained from 21 uremic subjects during the operation of A-V fistula prior to hemodialysis. Segments of internal thoracic arteries of similar diameter were obtained from patients with benign chest tumors as control.The vascular lesions and ox-LDL, CD68,MCP-1, eNOS,ET-1, PCNA,FN on the vessel wall were determined by means of H-E stain and immunohistochemistry. Results： With H-E stain,atherosclerotic plaques were found in the radial arteries of 4 uremic patients. The middle layer of the arteries in uremic patients were obviously thickened, and the T/D　(thickness of the wall/external diameter) ratio was significantly higher than those in control group(P<0.01). ox-LDL,CD68,MCP-1, ET-1, PCNA,FN on the vessel wall in uremic patients were much higher than those in control group (P<0.01). Moreover, ox-LDL on the vessel wall was positively related to the expression of other above mentioned substances on the vessel wall (P<0.01). Whereas the expression of eNOS on the vessel wall was lower than control group (P<0.01),and was negatively related to ox-LDL on the vessel wall(P<0.01). Conclusion: ox-LDL is an important factor contributing to uremic vascular remodeling by increasing the migration,adhesion and infiltration of monocyte,the proliferation of vascular smooth muscle cell and dysfunction of endothelia.

Background:The symptomatic bradyarrhythmia is Class Ⅰ indication for pacing therapy which is not a radical cure.The present study aimed to assess the feasibility and to present the initial results of the restricted ablation of the parasympathetic innervation surrounding sinus and atrioventricular (AV) nodes for treating patients with bradyarrhythmia.Methods:A total of 13 patients with cardiogenic syncope were included from May 2008 to June 2015.Under the guidance of fluoroscopy and/or three-dimensional geometry by 64-slice spiral computed tomography,atrial activation sequence in sinus rhythm was mapped.Chamber geometry was reconstructed manually or automatically using the Niobe Ⅱ magnetic navigation system integrated with the CARTO-remote magnetic technology (RMT) system.Cardioneuroablation was targeted at the high-amplitude fractionated electrograms surrounding the regions of His bundle and the site with the earliest activation in sinus rhythm.Areas surrounding the sinus node,AV node,and the phrenic nerve were avoided.Results:Thirteen patients completed the studies.Ablation was successfully performed in 12 patients and failed in one.The high-frequency potential was recorded in atrial electrograms surrounding the sinus or AV nodes in all the patients and disappeared in 15 s after radiofrequency applications.The vagal reaction was observed before the improvement of the sinus and AV node function.No complications occurred during the procedures.Patients were followed up for a mean of 13.0 ± 5.9 months.During the follow up ten patients remained free of symptoms,and two patients had a permanent cardiac pacemaker implanted due to spontaneous recurrence of syncope.The heart rate of post-ablation was higher than pre-ablation (69.0 ± 11.0 vs.49.0 ± 10.0 beats/min,t =4.56,P =0.008).The sinus node recovery time,Wenckebach block point,and atrium-His bundle interval were significantly shorter after ablation (1386.0±165.0 vs.921.0 ±64.0ms,t=7.45,P=0.002;590.0±96.0 vs.464.0± 39.0ms,t=2.38,P=0.023;106.0±5.0 vs.90.0 ± 12.0 ms,t =9.80,P =0.013 before and after ablation procedure,respectively).Conclusions:Ablation of sinoatrial and AV nodal peripheral fibrillar myocardium electrical activity might provide a new treatment to ameliorate paroxysmal sinus node dysfunction,high degree AV block,and vagal-mediated syncope.

Objective To understand of work status and professional ability of ICU specialist nurse,test their specialist ability level,improve and enhance the specialist nurse management to maximize their roles in promoting the development of clinical nursing.Methods 38 ICU nurse specialists who have got the nursing credentials more than one year were surveyed through self-questionnaire about working conditions,including general conditions,work status,income,self-assessment of specialist ability in future.Results 100％ ICU trained the younger nurses,and discuss the nursing management and problems.36.8％ nurses participated clinical nursing and night shift,5.3％ nurses have never joined ward inspection.Rates of reaching the standard were higher and above the 90％ in those three aspects: practice in clinical work,guided teaching and providing information for family member.Grasp of academic knowledge (86.8％),theory teaching (86.8％) and providing academic knowledge for nursing (86.8％) needed to be improved.Paper searching and reading (65.8％),paper writing (57.9％) and research design (47.4％) were relatively lower.Conclusions Culturing and using the specialist nurses in ICU lack the program and rationality; Specialist nurses have vague role; talent team was lacked; pay status needs increased; research ability needed enhanced; admittance,training and using criteria were lacked.