Objective To investigate the clinical efficacy of sildenafil in treatment of pulmonary arterial hypertension (PH),in order to provide more theory basis for clinical treatment.Methods A total of 80 PH patients was enrolled in this study.All the 80 cases were divided into conventional treatment group and sildenafil treatment group with 40 cases each.The 6-min walk test distance,Brog dyspnea score,pulmonary artery systolic pressure(SPAP),heart rate,circulation systolic blood pressure (cSBP),circulation diastolic blood pressure (cDBP),alanine aminotransferase (ALT),aspartate aminotransferase (AST),blood urea nitrogen (BUN) and serum creatinine (SCr) were recorded before and after treatment.The clinical efficacy was compared between two groups.Results The 6-min walk test distance,Brog dyspnea score and SPAP before treatment in conventional treatment group and sildenafil treatment group were (258.62 ±58.34),(260.22 ± 54.33) m; (3.2 ± 1.1),(3.3 ± 1.2) scores; (70.66 ± 6.52),(71.09 ± 6.61) mm Hg (1 mm Hg =0.133 kPa),and there was no significant difference between two groups (P ＞ 0.05).The 6-min walk test distance was (332.67 ± 63.51),(411.47 ± 75.86) m after treatment in conventional treatment group and sildenalil treatment group,which was increased compared with that before treatment (P ＜ 0.05).Brog dyspnea score and SPAP were (2.6 ± 0.8),(2.0 ± 0.6) scores and (61.43 ± 5.27),(47.84 ± 5.15) mm Hg after treatment in conventional treatment group and sildenafil treatment group,which were decreased compared with those before treatment (P ＜ 0.05).The improvement of the 6-min walk test distance,Brog dyspnea score and SPAP in sildenafil treatment group were better than those in conventional treatment group (P ＜0.05).There was no significant difference in the heart rate,cSBP,cDBP,ALT,AST,BUN,SCr before and after treatment in two groups (P ＞ 0.05).The total effective rate in sildenafil treatment group was higher than that in conventional treatment group [77.5％ (31/40) vs.57.5％ (23/40)],and there was significant difference (P ＜ 0.05).The side effects were main headache,blushing,dyspepsia.Conclusion Sildenafil has more effective clinical efficacy in treating PH patients with accepted side-effect,which is worthy to be popularized in the clinical application.

Aim ToconstructHEK293cellsstablyex-pressing corticotropin releasing factor receptor 1 ( CRFR1 ) , and evaluate its function by the cAMP as-say.Methods CulturedHEK293cellsweretransfect-ed with CRFR1-expressing vector by Lipofectamine 2000 and were selected by using G418 . CRFR1 ex-pression was detected by Western blot, RT-PCR and immunofluorescence.Results Westernblot,RT-PCR and immunofluorescence data revealed that the HEK293 cells expressed CRFR1 protein stably. The dose-responsive relationship experiment revealed that CRF induced a CRFR1-mediated cAMP production in HEK293 cells with EC50 =(5. 64 ± 0. 05) × 10 -10 mol ·L-1.Conclusion HEK293celllinesstablyex-pressing CRFR1 were constructed successfully, which would provide a cellular model to facilitate the research on the biological function of CRFR1 and CRFR1-targe-ted drug screening.

Objective To evaluate the therapeutic effect of thymosin alpha -1 with glucocorticoid in treat-ment of HBV -related hepatic failure.Methods 130 cases were randomly divided into two groups,they were all giv-en antiviral therapy,protect liver,anti -inflammatory,yellow suit the back support,etc.comprehensive treatment;and patients in treatment group were given thymosin alpha -1 with methyl -prednisone intravenously at the early stage of treating process,and then observed the clinic situation and cure rate of those sufferers,The biochemiccal indicator, PTA and blood serum HBV DNA capacity ending with the period of 4 weeks were tested.Results In both groups,the TBil,TC in serum had apparently improved compared with the baseline after the medication,the difference was signifi-cant (t =3.12,P <0.05 and t =3.05,P <0.05).The time of gastrointestinal symptoms improvement and bilirubin subsided time in treatment group were significantly shorter than those of the control group(t =3.34,P <0.01 and t =4.52,P <0.01 ).During the treatment,there was no significant adverse reaction,and there were no differences between two groups in Alt,PTA,HBV DNA,infection,gastrointestinal bleeding,hepatic encephalopathy and hepatore-nal syndrome.The effective rate of treatment group was 75.2%,which was higher than 50.3% of the control group (χ2 =11.02,P <0.01).Conclusion Patients with HBV -related hepatic failure of short -term application of thy-mosin alpha -1 with glucocorticoid treatment,can quickly improve symptoms,greatly improve the efficiency of survival rate,shortem hospitalization period,reduce side effects and enhance security.

Objective:To study the clinical effect of splenic arninopeptide combined with pulmicort on the bronchial asthma in children and its effect on the CD4+,CD8+ and serum IgE concentrations.Methods:88 cases of patients with acute exacerbation of bronchial asthma in our hospital from June 2015 to October 2016 were selected and randomly divided into the control group and the observation group,44 cases in each group.All the children were treated with cough and phlegm.In addition,the control group was given inhalation of Pulmicort suspension,the observation group of children was treated by spleen ammonia peptide oral freeze-dried powder on the basis of control group.The clinical efficacy,disappearance time of clinical symptoms,changes of lung function,hospitalization time and levels of CD4+,CD8+,CD4+/CD8+,Serum IgE concentration before and after treatment were compared between two groups.Results:The total effective rate of treatment group was significantly higher than that of the control group (P＜0.01).After treatment,the disappearance time of cough,chest wheezing,wheezing and hospitalization time of observation group were significantly shorter than those of the control group (P＜0.01),the FVC,FEV1 and FEV1/FVC,CD4+,CD4+/CD8+ levels after treatment were significantly higher than those in the control group (P＜0.01),and the serum IgE concentration was lower than that of the control group(P＜0.01).There was no significant difference in the incidence of adverse reactions and CD8+ between the two groups(P＞0.05).Conclusion:Splenic aminopeptide combined with Pulmicort could enhance the clinical efficacy of children with bronchial asthma,which could quickly improve the clinical symptoms and immune function with high safety.

A simple and sensitive liquid chromatographic method was developed for quantification of cefotetan disodium (CTT), a semi-synthetic cephamycin antibiotic, in human plasma. CTT and the internal standard chloramphenicol were extracted from plasma by a simple one-step protein precipitation with 35% (v/v) perchloric acid. Separation was carried out on a reverse-phase C18 column with a mobile phase of acetonitile-water containing 0.5% (v/v) phosphoric acids (20:80, v/v) at a flow rate of 1.0 mL/min. The column effluent was monitored by UV detection at 300 nm. The column temperature was maintained at 40°C. This method demonstrated good linearity in the range of 0.525-300.0 μg/mL, with correlation coefficients greater than 0.99. The limit of quantification (LOQ) was 0.525 μg/mL in human plasma. Intra- and inter-day precisions were less than 6.63% in terms of relative standard deviation (RSD). The accuracy, when expressed by the bias, ranged from 0.57% to 4.04%. The mean extraction recovery of CTT was higher than 40.94%. The method was found to be precise, accurate, and specific for CTT quantitative analysis, and was successfully applied for a pharmacokinetic study of CTT after a single intravenous dose of 1.0 g of CTT in healthy Chinese subjects.

A simple and sensitive liquid chromatographic method was developed for quantification of cefotetan disodium (CTT), a semi-synthetic cephamycin antibiotic, in human plasma. CTT and the internal standard chloramphenicol were extracted from plasma by a simple one-step protein precipitation with 35% (v/v) perchloric acid. Separation was carried out on a reverse-phase C18 column with a mobile phase of acetonitile-water containing 0.5% (v/v) phosphoric acids (20:80, v/v) at a flow rate of 1.0 mL/min. The column effluent was monitored by UV detection at 300 nm. The column temperature was maintained at 40°C. This method demonstrated good linearity in the range of 0.525-300.0 μg/mL, with correlation coefficients greater than 0.99. The limit of quantification (LOQ) was 0.525 μg/mL in human plasma. Intra- and inter-day precisions were less than 6.63% in terms of relative standard deviation (RSD). The accuracy, when expressed by the bias, ranged from 0.57% to 4.04%. The mean extraction recovery of CTT was higher than 40.94%. The method was found to be precise, accurate, and specific for CTT quantitative analysis, and was successfully applied for a pharmacokinetic study of CTT after a single intravenous dose of 1.0 g of CTT in healthy Chinese subjects.
Cefotetan ; blood ; pharmacokinetics ; Chromatography, Liquid ; methods ; Humans

Objective:To identify the key convergence points in the medical-nursing combined care among literature, and establish a mechanism for medical-nursing combined care integration from the perspective of the synergy theory, for the purpose of promoting the integrated development of such care in China.Methods:Relevant literature on the medical-nursing combined care were retrieved from the CNKI database from September 2013 to September 2021. The search formula used was TI= "the medical-nursing care integration" AND SU=(convergence+ transformation+ coordination+ mechanism), while supplementary searches were made using " pkulaw.com database" and Baidu Scholar database. The method of literature content analysis was used to screen key points of the medical-nursing combined care, and the convergence mechanism was built based on the perspective of the synergy theory.Results:A total of 42 literatures were included in this study, 8 key convergence points of medica-nursing combined care integration were identified. Namely the 4 key horizontal convergence points of medical care, aging care, rehabilitation and nursing, the 3 key vertical convergence points of home care, institution care and community care, and the one key convergence point of institutional medical care. Based on the synergy theory and the 8 key convergence points, the " 431" convergence mechanism of medical-nursing combined care was constructed. This mechanism refered to the horizontal linkage of healthcare, nursing, rehabilitation and aging care, the vertical redirection among home care, institution care and community care modes, and the development mode focusing on institutional aging care.Conclusions:At present, the poor convergence between aging care and nursing care in China is a key roadblock hindering the integrated development of aging and nursing care. Medical-nursing combined care should be conducive to the " 431" convergence development, achieving horizontal linkage, vertical redirection, and resource sharing, for the purpose of high-quality development of China′s aging care system.

Objective: To evaluate the degree of psychological distress and analyze the influential factors of cancer patients receiving radiotherapy, aiming to provide theoretical basis for individualized psychological interventions. Methods: A cross-sectional survey of 157 cancer patients treated with radiotherapy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University in the previous year was conducted in terms of data collection and mean score of NCCN distress thermometer by using the convenience sampling method. Tumor types included nasopharyngeal cancer, breast cancer and cervical cancer, etc. The influential factors were analyzed by using logistic regression method. Results: The mean score of NCCN distress thermometer in 157 cancer patients was 4.07±0.19. Among them, 87 cases (55.41%) experienced significant psychological distress (NCCN distress thermometer score≥4). The main influential factors of psychological distress consisted of depression, loneliness, fear, appearance changes, urination changes, nausea, poor appetite, eating trouble, diarrhoea, constipation, pain and radiodermatitis. Logistic regression analysis demonstrated that nausea and urination changes were the independent influential factors of psychological distress. Conclusions Over half of cancer patients undergoing radiotherapy present with evident psychological distress. Somatic problems and emotional situations are the main factors of psychological pain. Consequently, it is highly necessary to emphasize the psychological health and actively resolve the somatic and emotional symptoms of cancer patients receiving radiotherapy.

Objective:To verify the revised method of cerium sulfate catalytic spectrophotometry for iodide index of "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006).Methods:From July to September 2019, the Laboratory of Department for Endemic Disease Prevention and Control of Qinghai Institute for Disease Prevention and Control verified the revised method (determination of iodide in drinking water by cerium sulfate catalytic spectrophotometry) of cerium sulfate catalytic spectrophotometry (hereinafter referred to as original method) in "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006). The revised method was verified according to the requirements of "Standard Examination Methods for Drinking Water-Water Analysis Quality Control" (GB/T 5750.3-2006), including standard curve, detection limit, precision, accuracy and actual sample determination.Results:The linear range of the revised method was 0 - 20.0 μg/L, the correlation coefficient was - 0.999 4 - 0.999 8, and the detection limit was 0.231 μg/L. The relative standard deviation ( RSD) of low, medium and high iodine water samples of 6 times detection ranged from 1.4% to 9.6%, and the recoveries of low and medium water samples ranged from 89.0% to 108.0%. The detection results of national first-class reference materials for iodine composition analysis in water were within the range of standard value ± uncertainty. There was no significant difference in the test of results of 12 tap water samples between the revised method and the original standard method ( t = - 0.075, P > 0.05). Conclusion:The revised method has a good linear relationship of standard curve, high precision and accuracy, and good reproducibility, is simple and easy to operate, and is suitable for promotion and application.

Objective:To establish the hepatic organoid of hepatitis B virus (HBV) infection on the basis of induced pluripotent stem cells (iPSC) and an inverted colloidal crystal polyethylene glycol scaffold (ICC), and to evaluate the antiviral effect of nucleoside drugs.Methods:iPSC was differentiated into hepatocyte-like cells (HLC), and inoculated into ICC to construct a hepatic organoid. The relative mRNA expressions of Nanog homeobox (NANOG), sex determining region Y-box (SOX) 2, SOX17, forkhead box protein A2 (FOXA2), alpha fetoprotein (AFP) and albumin (ALB) were detected by real time quantitative polymerase chain reaction (RT-qPCR). Confocal laser microscopy was used to photograph the three-dimension (3D) structure of organs. The expression of sodium taurocholate cotransporting polypeptide (NTCP) in HLC was analyzed by Western blot and immunofluorescence. HepG2.2.15 cells were used to extract HBV virus particles to infect hepatic organoid. The relative expression of HBV pregenome RNA (pgRNA) in cells was detected by RT-qPCR. The expressions of hepatitis B core antigen (HBcAg) and hepatitis B surface antigen (HBsAg) in cytoplasm were observed under confocal laser microscopy. A total of 0.5 μmol/L entecavir and 0.5 μmol/L lamivudine were used to treat the infected cells respectively. The relative expression of HBV pgRNA in infected and uninfected cells was detected by RT-qPCR. Independent sample t test and one-way analysis of variance were used for statistical analysis. Results:Within 21 days of iPSC differentiation, the mRNA expressions of NANOG and SOX2 in stem cells markers decreased ( F=158.90 and 8.31, respectivley; P<0.001 and P=0.002, respectively), while the mRNA expressions of SOX17 and FOXA2 in the endoderm increased first and then decreased ( F=37.23 and 82.57, respectively, both P<0.001). In the later stage of differentiation, the mRNA expressions of AFP and ALB in liver cells increased ( F=4.65 and 34.64, respectively, P=0.012 and P<0.001, respectively), and all differences were statistically significant. NTCP was highly expressed in differentiated cells detected by Western blot and fluorescence microscopy, the protein expression level was 0.803±0.099. Confocal laser microscopy confirmed that the differentiated cells expressed ALB and presented spherical structure in ICC. The expression of HBV pgRNA and the immunostaining of HBsAg and HBcAg confirmed that HBV successfully infected hepatic organoid. Three days after the application of entecavir and lamivudine, the HBV pgRNA level decreased significantly both in entecavir group (0.665±0.220) and lamivudine group (0.503±0.117) compared to the uninfected cells (3.347±0.454), and the differences were both statistically significant ( t=10.53 and 12.72, respectively, both P<0.001). Conclusions:HLC display hepatic specific genes ALB and NTCP. Hepatic organoids constructed with iPSC and ICC have human liver function and can be infected by HBV. Entecavir and lamivudine could effectively inhibit the replication of HBV in hepatic organoids.