OBJECTIVE:To observe the clinical efficacy and safety of triple therapy of aspirin,clopidogrel and urinary kallidi-nogenase in the treatment of recurrent transient ischemic attack. METHODS:180 patients with recurrent transient ischemic attack were randomly divided into control group and observation group. Control group was orally treated with Aspirin enteric-coated tab-lets 100 mg,once a day + Clopidogrel hydrogen sulfate tablets 75 mg,once a day. Based on the treatment of control group,obser-vation group was additionally treated with Urinary kallidinogenase for injection 0.15 PNA unit adding into Sodium chloride injec-tion 100 ml by intravenous injection,once a day. The treatment course for both groups was 2 weeks. The clinic data was observed, including clinical efficacy,and LDL,HDL TC and TG levels before and after treatment,recurrence rate of cerebral ischemia,inci-dence of cerebral infarction and adverse reactions after 6 months of follow-up. RESULTS:The total effective rate in observation group was significantly higher than control group,and the recurrence rate of cerebral ischemia and incidence of cerebral infarction were significantly lower than control group(P<0.05). After treatment,HDL level in 2 groups were significantly higher than be-fore,and observation group was higher than control group;levels of LDL,TC and TG were significantly lower than before,and observation group was lower than control group(P<0.05). There were no severe adverse reactions in groups during treatment. CON-CLUSIONS:Triple therapy of aspirin,clopidogrel and urinary kallidinogenase has significant efficacy in the treatment of transient ischemic attack,with good safety.

Objective To evaluate the efficacy and safety of sirolimus and tacrolimus after renal transplantation.Method PubMed,Web of knowledge,Medline and the Cochrane controlled trials register,Chinese Biomedicaldatabase,and Vip database were searched with the terms and Boolean operators as (kidney transplantation OR renal transplantation) AND (sirolimus OR rapamycin OR rapamune) AND (tacrolimus OR FK506 OR prograf).Results retrieved were updated on November,2015.Data were extracted for patient and graft mortality,acute rejection (AR),wound complications,infection,GFR,withdrawl.Professional meta analysis software RevMan 5.3 was employed.Result Altogether,1810 patients from 10 randomized controlled trials (RCTs) were included.Patients in the sirolimus group showed a decreased rate of graft mortality and infection (RR =0.63,95％ CI,0.45-0.89,P=0.009;RR=4.42,95％ CI,1.73-11.31,P=0.002).Patients in the sirolimus group showed an increased rate of AR,wound complications,GFR,withdrawl (SMD=-0.52,95％ CI,-0.73-0.31,P＜0.000 01;RR=0.54,95％ CI,0.40-0.73,P＜0.000 1;RR=0.17,95％ CI,0.11-0.25,P＜0.000 01;RR =0.44,95％ CI,0.37-0.51,P＜0.000 01).The patient mortality was insignificantly different between two groups.Conclusion This meta-analysis concluded that sirolimus showed advantage over tacrolimus about safety when used early after renal transplantation.The options of immunosuppressive regimens after kidney transplantation should be based on the specific condition.To obtain more reliable and accurate clinical data,the RCTs with more rational design,higher methodological quality,larger sample size,including domestic patients,longer follow-up are still needed.

Objeetive To analyze the clinical efficacy of liver transplantation (OLT) for patients with hepatopulmonary syndrome (HPS).Methods From 2008 to 2013,420 adult patients underwent liver transplantation in our hospital.There were 91 patients with,and 329 patients without,HPS.The 5-year survival and mortality rates after OLT for the two groups were retrospectively analyzed.Results There were no significant differences between patients without and with HPS in age,primary disease,Child-Pugh score,MELD score,cold ischemia time and warm ischemia time.However,the differences on serum albumin [(29.6 ± 1.2) g/L vs.(26.4 ± 1.6) g/L] and blood oxygen pressure [(61.0 ±9.0) mmHg (1 mmHg =0.133 kPa) vs.(87.0 ± 6.0) mmHg] were significantly different (P ＜ 0.05).The 1-year cure rate was 65.9％ (60/91) in 91 patients with HPS after liver transplantation.The 1,3,5-year cumulative survival rates for patients without HPS were 97.3％,90.9％ and 80.3％,respectively,and the main causes of death were primary graft dysfunction,recurrent cardiovascular events and primary disease recurrence or tumors.The 1,3,5-year cumulative survival rates for patients with HPS were 65.9％,59.3％ and 56.0％,and the main causes of death were multiple-organ failure,pulmonary infection and cerebrovascular events.Kaplan-Meier survival curve analysis showed that the survival of patients with HPS was significantly lower than that of patients without HPS (P ＜ 0.05).Conclusions Liver transplantation is the most effective treatment for patients with HPS,but the short-term mortality rate is relatively high.We still need to learn more about HPS to improve the survival rate of patients with HPS after liver transplantation.

OBJECTIVEThis study investigated the thrombolitic effect of Tianma Xinnao capsule and its preliminary mechanism, as well as the effect on coagulation system.

METHODCharlton's and Tomihisa's methods were modified to investigate the thrombolytic effect of Tianma Xinnao capsule. The activities of type 1 plasminogen activator inhibitor (PAI-1) and tissue-type plasminogen activator (tPA) in rabbit plasma were assayed by use of ELISA. The effects of Tianma Xinnao capsule were also evaluated on euglobulin lysis time (ELT), prothrombin time (PT), kaolin partial thromboplastin time (KPTT), thrombin time (TT), fibrinogen (Fib) and hemorheology.

RESULTThe results showed that Tianma Xinnao capsule had a dose-dependent thrombolytic effect in rats. Tianma Xinnao capsule at 0.6 and 1.2 g x kg(-1) produced 40% and 50% of reperfusion rate, while obtained 50% and 40% of reocclusion rate; 0.3 g x kg(-1) of Tianma Xinnao capsule, however, had no effect on the reperfusion or reocclusion rate. Tianma Xinnao capsule significantly inhibited PAI-1 activity, while elevated tPA activity in rabbit plasma. Tianma Xinnao capsule markedly prolonged ELT, PT, and KPTT, and decreased Fib level. Tianma Xinnao capsule showed no significant influence on TT or high, medium, or low sheering viscosity.

CONCLUSIONIt is indicated that Tianma Xinnao capsule inhibited PAI-1 activity and increased tPA activity, and this property of Tianma Xinnao capsule is assigned to be responsible for the thrombolytic effect.

Animals ; Blood Coagulation ; drug effects ; Blood Viscosity ; drug effects ; Capsules ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Male ; Plasminogen Activator Inhibitor 1 ; metabolism ; Rabbits ; Rats ; Thrombosis ; blood ; drug therapy ; metabolism ; Tissue Plasminogen Activator ; metabolism

Objective: To study risk factors for non-alcoholic fatty liver disease (NAFLD) and vascular erectile dysfunction (ED) in patients with metabolic syndrome (MS). Methods: A total of 18 096 subjects were selected from people undergoing physical examination from 2008 to 2009 in northern cities of China by random cluster sampling method, and analyzed the risk factors for NAFLD and ED. Results: The 18 096 cases with age 18~76 (46.8±10.1) years old，containing 10 096 (55.79%) males and 8 000 (44.21%) females. Awareness rate of MS was 8.33% and prevalence rate of MS in healthy adults was 21.18%. Most common components of MS were hyperuricemia (27%, 4838/18096), obesity and overweight (21%), hypertension (20%,) and dyslipidemia (17%) in turn. Body mass index (BMI, kg/m2) and waist/hip ratio (WHR) of all MS subgroups from high to low were ED group [(28.9±1.1), (1.26±0.03)], overweight or obesity group [(27.5±2.3), (1.31±0.03)], prediabetes group [(26.8±2.6), (1.03±0.03)] and hypertension group [(26.1±1.3), (0.90±0.04)] in turn. A total of 3 721 MS patients （20.56%）complicated with NAFLD; By means of NAFLD complicated by MS as dependent variable, Logistic regression analysis indicated that increased ALT, waist circumference（WC）, age, DM family history, LDL-C and BMI (β=1.004~0.479, P=0.000~0.016 in turn) were risk factors for NAFLD, and physical exercise and occupational physical work were protective factors for NAFLD. There were 106 ED males and its prevalence rate was 1.04%; Logistic regression analysis indicated that age, WC, LDL-C, DM family history and BMI (β=0.681~0.238, P=0.000~0.018 in turn) were risk factors for ED, and educational degree, physical exercise and occupational physical work were protective factors for ED. Conclusion: Risk factors for NAFLD and ED in MS were closely correlated with MS. It’s a new path to prevent and treat NAFLD and ED through correcting risk factors of MS.

Objective To determine the effect of PGE1 on liver microcirculation disturbance following orthotopic liver transplantation in rats.Methods Forty male adult Wistar rats were divided randomly into 3 groups. Eight transplantations were established in both the experimental and control group, while in the sham group, the liver was dissected like in the experimental group, but no resection was performed. In the experimental group, PGE1 (0.5 μg/kg*min-1) was injected intravenously into the donor before the operation, and added (1 mg/L)to the flush and preservation fluid, while PGE1 was replaced by normal saline in the control group. Confocal laser scan microscopy, biochemical test, and optical and electronic microscopy were used.Results In the control group the reperfusion state was poor,leukocyte infiltration appeared in the center of lobule,and transaminase rose after transplantation. In the experimental group distinctive improvement was seen as compared with the control group (P<0.05). Histological findings showed progressive degeneration and necrosis following transplantation in the control group, while in the experimental group the histological changes were improved to some degree by the use of PGE1.Conclusions In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.

Objective:To explore the relationship between work stress, sense of coherence (SOC) and compassion fatigue (CF) among oncological nurses, and to study the mediating role of SOC between work stress and CF in oncological nurses.Methods:Totally 370 oncological nurses from 7 ClassⅢ Grade A hospitals in Anhui Province between November 2019 and January 2020 were conveniently selected and investigated with the Chinese Nurse Work Stressor Scale, Sense of Coherence Scale-13, Professional Quality of Life and the general information questionnaire. AMOS 21.0 and SPSS 23.0 were used for statistical analysis of the data. A total of 370 questionnaires were distributed and 345 valid questionnaires were returned.Results:The work stress of oncological nurses was negatively correlated with their SOC ( r=-0.547, P<0.01) , and positively correlated with job burnout and secondary trauma ( r=0.607, 0.418; P<0.01) ; SOC was negatively correlated with job burnout and secondary trauma ( r=-0.581, -0.405; P<0.01) . SOC played a mediating role between the work stress, job burnout and secondary trauma of oncological nurses, and the mediating effect accounted for 45.81% and 33.82% of the total effect, respectively. Conclusions:SOC is a mediating variable between the work stress and CF of oncological nurses. Actively assessing the level of nurses' SOC and providing interventions are helpful to reduce CF caused by work stress.

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