To observe normal bone marrow stromal function for supporting hematopoiesis and realize the correlation of bone marrow stromal function in patients with aplastic anemia (AA) and anisodamine therapy, normal human marrow CFU-GM was assayed on bone marrow stromal layer (SL) formed on week 3 culture, and the CFU-GM without SL as a control (100%). Results showed that the production of CFU-GM on the normal SL was significantly higher than that of the control. The production of CFU-GM on the SL of 4 AA patients, who responded to anisodamine, was < 80% of the control, and when 2 of them were reexamined for stromal function after treatment, the number of CFU-GM on SL rose up to 168.8% and 249.2% from 38.7% and 39.7% of the control respectively. While in the rest 6 patients, the number of CFU-GM was > 80% of the control, only one patient was improved by anisodamine therapy. So, normal bone marrow stromal layer can obviously support the growth of granulocyte/macrophage progenitor cells. Anisodamine therapy could be an effective agents for aplastic anemia with stromal dysfunction
Adolescent ; Adult ; Anemia, Aplastic ; drug therapy ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Bone Marrow Cells ; cytology ; Female ; Humans ; Male ; Middle Aged ; Solanaceous Alkaloids ; therapeutic use ; Statistics as Topic ; Stromal Cells ; physiology

Objectvi e To understand the correlation between the diabetes and the complications and the constitution of traditional Chinese medicine ( TCM ) in Baoshan District in Shanghai , and to provide scientific evidence for carrying out the targeted prevention and intervention measures.M ethods TCM body mass table was used to distinguish the TCM constitution of the diabetic patients and the control group .The relationship between TCM constitution and diabetes and its complications was analyzed by single factor and multiple factor logistic regression . Results There were less patients with yin-yang harmony constitution and yang deficiency constitution in the case group than in the control group , while more with qi deficiency constitution and phlegm-damp constitution than in the control group .Among a total of 879 cases of diabetic patients with1 235 physical elements , the top four biased constitution elements were identified including constitution of qi deficiency ( 15.22%), yin deficiency ( 8.42%), yang deficiency ( 8.42%) and phlegm-damp ( 8. 34%).The yin deficiency, qi deficiency and phlegm dampness constitution elements in the case group were significantly higher than in the control group .Among 875 cases in the control group with 1 129 physical elements , the top four biased constitution elements were yang deficiency (12.40 %), qi deficiency( 9.65%), yin deficiency (5.05%) and phlegm-damp (4.52%), which yin-yang harmony constitution and yang deficiency constitution elements were significantly higher than those of the case group .The incidence of complications of the diabetic patients with biased constitution was significantly higher than those with the yin-yang harmony constitution . Conclusion Phlegm dampness constitution , qi deficiency constitution and yin deficiency constitution are the main dangerous constitution of diabetes mellitus .The protective constitution of diabetes is yin-yang harmony constitution and yang deficiency constitution .The biased constitution elements are the risk factors of diabetes complications .

As a new strategy for the application of sacubitril/valsartan (LCZ696) in patients with CKD, much evidence showed that it improved the prognosis of patients with CKD. This review summarizes the efficacy and safety of sacubitril/valsartan in physiology, pathology, pharmacology and clinical application by searching Wanfang, CNKI, PubMed and other databases for related articles on the application of sacubitril/valsartan in CKD patients. Although LBQ657, the active product of sacubitril, has a high drug accumulation in patients with moderate, severe renal injury, and ESRD, it is not cleared in hemodialysis, and has very little eliminated in peritoneal dialysis, which does not affect its safety. Compared with angiotensin converting enzyme inhibitor and angiotensin receptor blocker drugs, LCZ696 could increase the blood pressure control rate, improve cardiac function, slow down the decline of glomerular filtration rate, and significantly improve cardiovascular outcomes without more adverse events. Sacubitril/valsartan can be used in all levels of CKD patients complicated with hypertension and/or heart failure, with reliable safety and tolerance.

OBJECTIVETo study the benefit of prophylactic antibiotics (PA) in totally percutaneous aortic endovascular repair (PEVAR) in the catheterization laboratory for reducing stent-graft infection and postimplantation syndrome (PIS).

METHODSThe clinical data were analyzed of patients undergoing thoracic endovascular aortic repairs. The patients were divided into non-PA group and PA group according to the use of prophylactic antibiotics before PEVAR. The diagnosis of infection was made by two senior physicians with reference to Hospital Acquired Infection Diagnostic Criteria Assessment released by the Ministry of Health of China.

RESULTSThe 95 enrolled patients included 35 with PA and 60 without PA group, who were comparable for baseline characteristics. Infection-related deaths occurred in 1 case in non-PA group and retrograde Stanford type A dissection and death occurred in 1 case in PA group (1.67% vs 2.85%, P=1.00). The PA and non-PA groups showed no significant difference in the incidence of postoperative infection (5% vs 2.86%, P=1.000), hospital stay (9.30±7.21 vs 10.06±5.69, P=0.094), infection-related mortality (1.67% vs 0%, P=1.00), or postoperative fever (70.90% vs 91.43%, P=0.20). The body temperature showed significant variations at different time points after procedure (F=19.831, P<0.001) irrelevant to the use of prophylactic antibiotics (F=0.978, P=0.326).

CONCLUSIONThe current data do not support the benefit of PA in reducing postoperative infection and PIS in patients undergoing PEVAR, but the patients without PA may have worse clinical outcomes in the event of postoperative infections.

Anti-Bacterial Agents ; administration & dosage ; Antibiotic Prophylaxis ; Aorta, Thoracic ; surgery ; China ; Endovascular Procedures ; Humans ; Length of Stay ; Postoperative Complications ; prevention & control ; Stents ; Vascular Surgical Procedures

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*