With the development of aging population,the rational drug use in old people was paid more attention nowadays. So far, a number of studies in Europe, Asia and North America showed that lots of prescriptions with potential irrational drug use could be found out using STOPP & START criteria. In China, there is no systematic tool for guiding the rational drug use in old people yet, therefore, we can learn the content of STOPP&START criteria and use them for reference to promote the rational drug use in Chinese old people and lay the foundation for establishing rational drug use judgment criteria suitable for Chinese old people.

ObjectiveTo evaluate the therapeutic effect of Salvia miltiorrhiza and ligustrazine as an adjuvant therapy in the patients with electric arcburns.MethodsFifty patients with electric arc burns were divided into 2 groups according to the random number table, with 25 in each group. The patients in the treatment group received intravenous infusion of 10 ml Salvia miltiorrhiza and ligustrazineinjection for 7 days in addition to the conventional therapies, and those in the control group only treated with conventional therapies.ResultsThe rates of wound healing in the treatment group were significantly improved at 7 days(25.7% ± 3.1%vs.21.3%± 3.0%;t=5.122,P=0.000) and 14 days(60.3% ± 8.6%vs.53.8% ± 10.8%;t=2.434,P=0.022) than the control group. While at 21 days, there was no significant difference between the two groups (99.4% ± 1.7%vs.98.7% ± 2.7%;t=1.163,P=0.265). The time to wound healing in the treatment group was significantly shorter than that in the control group (18.9 ± 2.5 dvs.20.3 ± 2.2 d;t=-1.216,P=0.020).ConclusionsSalvia miltiorrhiza and ligustrazine injections as an adjuvant therapy has a beneficial therapeuticeffect in patients with electric arc burns.

ObjectiveTo explore the association of smoking to the Aspirin and Clopidogrel antiplatelet in patients with stable angina after percutaneous coronary intervention (PCI). Methods241 smoking patients and 252 non-smoking patients underwent PCI for stable coronary artery disease, all patients had taken aspirin 100 mg/d for 7 d or more. The arachidonic acid (AA)- and adenosine diphosphate (ADP)-induced platelet aggregation were tested as they got in hospital. Then, they accepted Clopidogrel 300 mg as loading dose, continued with 75 mg/d for 3 d. The ADP-induced platelet aggregation were re-tested. ResultsThe incidence of aspirin resistance (AR) and aspirin semiresponder (ASR) was 19.1% in all the cases, and was 25.5% in smoking group, 14.3% in non-smoking group (P=0.027). Age (OR=3.79，95%CI: 1.77～8.12) and smoking (OR=1.98，95%CI: 1.18～4.43) were the independent risk factors of AR and ASR. The incidence of Clopidogrel resistance was 19.5% in all the cases, and was 13.2% in smoking group, 24.3% in non-smoking group (P=0.03). Smoking (OR=0.22，95%CI: 0.09～0.54) may reduce the risk of Clopidogrel resistance. ConclusionSmoking increased the risk of AR and ASR, but reduced the risk of Clopidogrel resistance.

Child ; Consensus ; Diarrhea ; diagnosis ; therapy ; Humans

Acute Kidney Injury ; blood ; physiopathology ; therapy ; Blood Pressure ; Critical Illness ; therapy ; Electrolytes ; blood ; Female ; Hemofiltration ; methods ; Humans ; Infant ; Male ; Prognosis

Objective To investigate the effect of salidroside on brain edema and neurological function in global cerebral ischemia-reperfusion injury in rats.Methods A total of 100 Sprague Dawley rats were randomly divided into sham operation,ischemia-reperfusion and salidroside 12,24 and 48 mg/kg groups (n =20 in each group),and than redivided into 6 h,24 h,72 h and 7 dsubgroups (n =5 in each subgroup).A rat model of global cerebral ischemia was established using the four-vessel occlusion method.Immediately after modeling,all groups were administered intragastrically for 7 days.The brain water content was quantitated by the wet-dry weight method.The neurological evaluation was performed using a neurological deficit score (NDS).Results After modeling both the ischemia-reperfusion group and all the salidroside groups had significant neurological deficit,and as time went by,it was improved gradually.Compared to the ischemia-reperfusion group at the corresponding time points,neurological deficit in all the salidroside groups was improved significantly (all P ＜ 0.05),and showing a dose-dependent trend.Compared to the salidroside 12 mg/kg and 24 mg/kg groups,neurological deficit in the salidroside 48 mg/kg group was improved significantly at 72 hours and 7 days (all P ＜ 0.05).The brain water contents began to increase at 6 hours after modeling in the the ischemia-reperfusion group and all the salidroside group.They reached the peak at 72 hours,and significantly higher than that in the sham operation group (all P ＜ 0.05).The brain water contents in all the salidroside group were significantly lower than those in the ischemiareperfusion group at 24 and 72 hours after modeling (all P ＜ 0.05) and showing a dosedependent trend.The brain water content in the salidroside 48 mg/kg group was close to that in the sham operation group at 7 days after modeling.Conclusions Salidroside may significantlydecrease brain edema and improve neurological function in global cerebral ischemia-reperfusion injury in rats,and it has a neuroprotective effect.

Objective:To investigate the correlation between hyperreflective dots (HRD) and lipid levels and systemic inflammatory factors in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).Methods:A cross-sectional clinical study. From December 2016 to June 2020, 118 eyes of 118 patients with retinal vein occlusion diagnosed in the Department of Ophthalmology, Central Theater Command Hospital of People's Liberation Army were included in the study. Among them, 67 cases of BRVO and 51 cases of CRVO were divided into CRVO group and BRVO group accordingly. Peripheral venous blood was drawn from the patients within 3 days after the eye examination to detect the percentage of neutrophils, monocytes, hypersensitive C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a). The ratio of monocytes to high-density lipoprotein (MHR) was also calculated. The 3D OCT-2000 instrument from Topcon (Japan) was used to measure the central retinal thickness (CRT) and the numbers of HRD. According to the different distribution position, HRD is divided into inner retina HRD, outer retina HRD, and total retina HRD.The independent sample t test was used to compare the continuous variables of the two groups, and the χ2 test was used to compare the rates. The correlation between HRD counts and blood lipid levels and peripheral blood inflammation indicators in patients with different types of RVO was analyzed by Spearman correlation analysis. Results:The average age of patients in the BRVO group and CRVO group were 60.1±9.5 and 53.6±15.7 years, respectively; the prevalence of hypertension was 53.7% (36/67) and 24.5% (12/51), respectively. Comparison of age ( t=2.634) and prevalence of hypertension ( χ2=11.298) between the two groups showed statistically significant differences ( P<0.05). Gender ( χ2=2.000), course of disease ( t=-1.101), prevalence of diabetes ( χ2=1.315), eye category ( χ2=1.742), baseline visual acuity ( t=1.792), intraocular pressure ( t=0.708), CRT ( t=1.318), and peripheral blood include the percentage of neutrophils, the absolute number of monocytes, CRP, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein(a), MHR ( t=-0.559, 1.126, 0.579, 1.299, -0.134, 0.556, 1.230, -0.267, 0.483), the difference was not statistically significant. Correlation analysis showed that the HRD counts in the outer retina of BRVO patients were positively correlated with total cholesterol ( r=0.289, P=0.036); the HRD in the inner retina and total HRD counts of CRVO patients were positively correlated with CRP ( r=0.406, 0.343; P=0.004, 0.014). There was no correlation between HRD counts and percentage of neutrophils, absolute number of monocytes, triglycerides, high-density lipoprotein, low-density lipoprotein, lipoprotein(a), and MHR ( P>0.05). Conclusion:The number of HRD is related to the blood lipid level in BRVO patients and CRP (an inflammatory index) in CRVO patients.

Objective To assess the clinical safety and effectiveness of Boomerang closure device (Boomerang Percutaneous Femoral Access Management System) applied to patients undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI).Methods206 patients undergoing CAG and/or PCI were randomly divided into the heparin group and low molecular heparin (LWMH) group. The hemostasia success rate, hemostasia time, manual pressure time, device dwell time, complication rate and time to ambulation with each other of two groups were compared.ResultsThe heparin group and LWMH group both had high hemostasia success rate (98.06% and 99.03%), there wasn't significant difference between two groups. There was one patient with hematoma formation in the heparin group and LWMH group respectively. There was no significant difference between two groups in hemostasia time, manual pressure time, the device dwell time and time to ambulation.ConclusionAfter CAG and/or PCI, administered heparin and low molecular heparin is no effect on Boomerang closure device, and Boomerang closure device has a high hemostasia success rate.

Objective To report our experience in versatile use of double fascial flaps in reconstruction of facial skin defects.Methods A total of 10 patients were enrolled in this study (6 males and 4 females,aged 14-46 years).Based on the location,size and shape of the facial skin defects after tumor resection,paralleled double fascial flaps,vertical double fasical flaps and special angle double fascial flaps were designed respectively.Results All the patients were followed up for 6-12 months after operation.Operative incision split combined with infection was observed in one case.Mild pigmentation around the incision was observed in two cases.The cosmetic results were quite satisfactory to all patients.Conclusions As far as the advantages,minimal donor site morbidity,versatile designation as concerned,the double fascial flaps are good choices in the repair of facial skin defects.

Objective To explore the characteristics of ischemia-reperfusion induced infant lung damage and the potential mechanisms of the injuried.Methods Both infant (15-21 days old) and adult (5-6 months old) rabbits were subjected to either ischemia-reperfusion or sham operation.Ischemia-reperfusion was induced by clamping the right pulmonary hilum for 1 hour and then removal of the clamp for 4 hours under anesthesia.The lung tissue were sampled for histological examination by light and electron microcopies and for biological evaluation of mitochondrial alterations.Production and expression of free radical species-hydroxyl radical (ROS-HR),malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-PX),myeloid differentiation factor-88 (MyD-88),and nuclear factor-κB (NF-κB) in the lung tissue were also examined.In addition,circulating levels of interleukin-β and tumor necrosis factor-α were measured during the ischemia-reperfusion process.Results In comparison to adult lungs,the infant lungs had more increased neutrophil infiltration,edema,swelled alveolar epithelial and endothelial cells,and severer mitochondrial impairment reflected by damage of the inner membrane as well as decrease in the membrane potential after ischemia-reperfusion.The lungs in infant animals subjected to sham operation displayed higher levels of ROS-HR and MDA and lower levels of SOD and GSH-PX than those in adult controls.The lungs in infants with ischemia-reperfusion were found to further produce more ROS-HR,and MDA,and less SOD and GSH-PX than the ischemia-reperfused adult lungs.Moreover,the circulating levels of interleukin-1β and tumor necrosis factor-α were elevated during the period of ischemia-reperfusion,particularly in the infant animals,which appeared to be associated with the expression of MyD-88 and NF-κB in the lungs.Conclusion Lung ischemia-reperfusion causes more severe lung damage in infants than in adults,probably due to combination of low antioxidant capacity and overproduction of ROS in infants.