Objective To investigate the clinical efficacy of atorvastatin in patients with lacunar infarctions (LI) and influence on cerebrovascular reactivity(CVR). Methods 60 patients with LI were randomly divided into observation group and control group. The patients of control group were given aspirin treatment, patients of observation group were given atorvastatin combination with aspirin therapy. The breath-holding index(BHI) before and after treatment was calculated. After continuous treatment for 3 months the clinical efficacy was evaluated. Results The total effective rate of the observation group was 90. 0% ,it was significantly higher than that of the control group(73.3% ),compared with the control group the difference was significant( x2 = 10. 428 ,P < 0. 05). The bilateral BHI of observation group significantly increased, compared with per-treatment and control group the difference was significant ( t =9. 455,6. 135 ,all P < 0. 05 ) ,but the bilateral BHI of control group had no significant difference compared with pertreatment ( P ＞ 0. 05 ). Conclusion Atorvastatin could effectively improve CVR in patients with LI. Therefore, atorvastatin had great significance for the prevention of stroke.

Objective:To analyze the intervention effect of a successfully created platform“intelligent interactive software for drug monitoring warning” on the decrease of medication errors and adverse drug events,and the increase of the drug treatment level. Meth-ods:The intensive care unit ( ICU) of our hospital was selected as the experiment group, and the ICU of the other two hospitals was used as the contrast group. During the first 18 months, both groups were without intervention. During the latter 18 months, the plat-form was used in the experiment group, and the clinical pharmacists employed alerts of the system in the practice of interaction with doctors to correct the medication errors. No intervention was performed in the contrast group. In addition, all adverse drug events in both groups were surveyed. Results:During the first period, 50 preventable adverse drug events were discovered with the incidence of 6. 8% in the experimental group. During the second period, the correct rate of the alerts was 97. 7%. Through the effective interven-tion,the alerts and their percentage in the prescriptions were from the maximum of 68 and 1. 1% to the minimum of 6 and 0. 1%. To-tally 17 preventable adverse drug events were found with the incidence of 2. 4% after the intervention. The decline was significant, 848 991 yuan of hospitalization expenses was saved, and 294 days of the length of stay were shortened. There was no change in the contrast group, and there was no change in unpreventable adverse drug events in the two groups before and after the intervention. Conclusion:The intelligent interactive software for drug monitoring warning can examine many sorts of medication errors,and decline the inci-dence rate of preventable adverse drug events in ICU. However, it needs to continuously improve the intelligence. Clinical pharmacists need to master the relevant conditions of patients to detect the irrational drug use based on the clinical practice for each patient.

Objective: To investigate the characteristics of breakthrough cases of varicella in Haishu District, Ningbo City, Zhejiang Province from 2017 to 2022, so as to provide the evidence for varicella prevention and control. Methods: Information on reported cases of varicella and vaccination in Haishu District from 2017 to 2022 were collected through the China Infectious Disease Reporting Management Information System and the Immunization Program Information Management System of Zhejiang Province. The breakthrough cases who had received 1 or 2 doses of varicella vaccine 42 days before the onset of disease were selected. The distribution of sex, age, region and the interval between onset and last immunization were descriptively analyzed. Results: A total of 1 563 varicella cases were reported from 2017 to 2022. There were 928 breakthrough cases (59.37%), of which 660 cases with 1-dose immunization history (42.23%) and 268 cases with 2-dose immunization history (17.15%). The proportion of 1-dose breakthrough cases in total annual cases showed a decreasing trend (P<0.05) from 2017 to 2022, while there was no significant tendency on the proportion of cases with 2-dose immunization history (P>0.05). There were 392 males (59.39%) and 268 females (40.61%) with 1-dose immunization history. There were 150 males (55.97%) and 118 females (44.03%) with 2-dose immunization history. Breakthrough cases with 1- and 2- dose immunization history had an median age of 13.00 (interquartile range, 4.00) and 9.00 (4.00) years, respectively, and the difference was statistically significant (P<0.05). The regional distribution of the breakthrough cases with 1- and 2- dose immunization history was mainly in the rural-urban fringe, with 319 cases (48.33%) and 137 cases (51.12%), respectively, and the difference was statistically significant (P<0.05). The median interval between onset and last immunization was 12.00 (interquartile range, 3.00) and 4.00 (3.00) years, respectively, and the difference was statistically significant (P<0.05). Conclusions The breakthrough cases of varicella in Haishu District from 2017 to 2022 were mainly cases with 1-dose immunization history, males, and residents in rural-urban fringe. The age was older and the interval between onset and the last immunization was longer in cases with 1-dose immunization history than in cases with 2-dose immunization history.

To summarize the clinical experience of Prof. Yan Jun-bai in treating rheumatic arthritis (RA) with suppurative moxibustion and aim to guide acupuncture treatment for RA. Prof. Yan believes that contributing factors of RA include external contraction of pathogenic factors, obstructed flow of qi and blood, internal phlegm-turbidity (due to deficiency of healthy qi or improper diet), and obstruction or malnourishment of meridians. As a result, the treatment strategies are to warm yang, remove pathogenic factors, and tonify the liver, spleen and kidney. Suppurative moxibustion is a reliable therapy for RA.

Objective To explore the protective effect of resveratrol (RSV) on intestine barrier injury induced by hemorrhagic shock and its mechanism in rats.Methods According to random number table method,sixty-four SPF grade male Sprague-Dawley (SD) rats were divided into four groups:Sham operation group (only the catheters were indwelled in arterial and venous passages after anesthesia),hemorrhagic shock model group (model group,the catheters were indwelled in arterial and venous passages after anesthesia,and 0.3 mL solvent was administrated after hemorrhagic shock),RSV group (the catheters were indwelled in arterial and venous passages after anesthesia,15 mg/kg RSV was administered after hemorrhagic shock),superoxide dismutase 2 (SOD2) specific inhibitor,2-Methoxyoestradiol (2-ME) group (on the basic treatment of RSV group,0.1 mmol/L 2-ME was administered).The hemorrhagic shock model was reproduced by femoral artery bleeding.After drug administration,all rats were divided into two parts.One part was used for observations on 24-hour survival rate and survival time,while in the other part,2 hours after the hemorrhagic shock,the blood was collected for determination of the content of serum D-lactic acid,and afterward the rats were executed to obtain small intestine tissues for the examination of histopathological changes and Chiu's score.Moreover,differences of expression levels of tight junction proteins (Occludin,Claudin,ZO-1) of small intestine tissue and the oxidative stress related indexes SOD2 activity and reduced glutathione (GSH),oxidized glutathione (GSSH),malonaldehyde (MDA) contents were compared among the groups.Results Compared with the sham group,the model group demonstrated decreased survival rate,SOD2 activity,GSH content,GSH/GSSH ratio,reduced survival time,significantly increased serum D-lactic acid activity,Chiu's score and MDA content,and decreased expressions of tight junction proteins in small intestine tissue.Compared with model group,the RSV group showed significant increased survival rate [75.0％ (6/8) vs.37.5％ (3/8)] and prolonged survival time (hours:21.0±4.3 vs.10.4±5.8,P ＜ 0.05),significantly decreased serum D-lactic acid (μg/L:380.18 ± 70.59 vs.500.88 ± 97.53) and Chiu's score (1.75 ± 0.71 vs.4.00± 0.53) in small intestine (both P ＜ 0.05),obviously increased expressions of tight junction proteins,SOD2 activity,GSH and GSH/GSSG [Occludin (gray value):0.89 ± 0.10 vs.0.43 ± 0.77,Claudin (gray value):0.78±0.06 vs.0.33 ± 0.05,ZO-1 (gray value):0.83 ± 0.06 vs.0.34 ± 0.07,all P ＜ 0.05],and the elevated SOD2 activity (kU/L:0.85 ± 0.12 vs.0.51 ± 0.11,P ＜ 0.05],as well as increased GSH content and GSH/GSSG ratio [GSH (μmol/L):7.25±1.01 vs.3.86±0.54,GSH/GSSG:6.39± 1.14 vs.1.56±0.25,both P ＜ 0.05] in the small intestine,and markedly reduced MDA content (ng/g:5.00± 1.31 vs.8.63±0.92,P ＜ 0.05).Compared with RSV group,the 2-ME group demonstrated significantly decreased survival rate [50.0％ (4/8) vs.75.0％ (6/8)] and further shorter survival time (hours:12.2 ± 5.7 vs.21.0±4.3),increased serum D-lactic acid (μg/L:463.88 ± 60.16 vs.380.18 ± 70.59),obviously elevated Chiu's score (3.13 ± 0.99 vs.1.75±0.71,P ＜ 0.05),decreased expressions of tight junction proteins [Occludin (gray value):0.55±0.04 vs.0.89±0.10,Claudin (gray value):0.38±0.05 vs.0.78±0.06,ZO-1 (gray value):0.41±0.04 vs.0.83±0.06,all P ＜ 0.05];moreover,the activity of SOD2,GSH content,GSH/GSSG ratio were greatly reduced [SOD2 activity (kU/L):0.58 ± 0.13 vs.0.85 ± 0.12,GSH (μmol/L):4.49 ± 0.52 vs.7.25 ± 1.01,GSH/GSSG:1.57 ± 0.39 vs.6.39 ± 1.14,all P ＜ 0.05],and increased MDA content (ng/g:6.25 ± 1.04 vs.5.00 ± 1.31,P ＜ 0.05).The small intestine tissue was basically normal in Sham group,and no significant pathological changes were seen;in the model group,the small intestine epithelial mierovilli were collapsed and the mucosal barrier was destroyed obviously;in the RSV group the damages of small intestine microvilli and barrier were markedly alleviated;in 2-ME group the pathological changes were more evident compared with those in the RSV group.Conclusion RSV can improve intestinal barrier injury following hemorrhagic shock in rats;its mechanism may be related to SOD2 activation.

This study was directed at estimating the value of platelet count in the course of in-vitro hemolytic tests by roller pump. Five paired in-vitro tests were conducted using the POLYSTAN pump(group A) and COBE pump(group B). The pumps ran 16 hours. The samples for platelet count and plasma-free hemoglobin were taken before pumping, and every 2 hours after 4 hours of pumping. The 2 groups' platelet count and plasma-free hemoglobin levels were found to be linearly increasing with the hours of pumping and linear regression analysis showed the platelet count and plasma-free hemoglobin were positively correlated. These data suggested that platelet count could be used as an index in evaluating the in-vitro hemolytic properties of blood pumps.
Assisted Circulation ; Hemoglobins ; analysis ; Hemolysis ; Humans ; Linear Models ; Platelet Count

To observe the erythrocyte fragility and morphological changes of erythrocytes caused by roller pump. Ten tests were divided into two groups, Polystan pediatric pump group A (n = 5) and COBE pump group B (n = 5). Ten whole blood samples (each 400 ml) were circulated in the roller pump for 16 h. Erythrocyte fragility and free hemoglobin were measured before pumping and at every 2 hours during pumping. The possible morphological changes of erythrocytes caused by roller pump were observed by scanning electron microscope. The electron microscopic observation was made before pumping and at every 4 hours throughout pumping. Results showed that the erythrocyte fragility of two groups was not increased during a long period of pumping. The number of acanthocytes of two groups was 1.77/1.81% in the samples before pumping and 6.12/7.13, 9.18/8.73, 13.21/12.89, 16.53/17.21% at 4 h, 8 h, 12 h, and 16 h respectively. The free hemoglobin level of two groups was increased linearly during a long duration of pumping and the index of hemolysis of two groups was 0.296 mg/L/h and 0.3993 mg/L/h respectively. The result shows: 1. the erythrocyte fragility was not increased during a long period of pumping; 2. the erythrocyte membrane was injured or broken by roller pump directly; 3. the morphological changes of erythrocytes would be the basis of post operative hemolysis.
Erythrocyte Deformability ; Heart-Lung Machine ; adverse effects ; Hemoglobins ; analysis ; Hemolysis ; Humans ; In Vitro Techniques ; Osmotic Fragility ; Time Factors

In order to assess the transvalvular gradient of a Chinese-made Jiuling solid pyrolytic carbon bileaflet heart valve prosthesis, we determined its hydrodynamics in the laboratory and then measured the hemodynamic performance in the animals and patiens. The Jiuling prosthesis was tested in a pulsatile flow simulator in the aortic position. Six sheep subjected to mitral replacement with 21 mm Jiuling prosthesis were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress were performed in two sheep 60 months after implantation. Clinically, 14 cases of aortic valve and 10 cases of mitral valve in the patients who underwent valve replacement with Jiuling heart valve prosthesis were measured by open cardiac catheterization and Doppler echocardiopgraphy. The results showed that Juiling heart valve prosthesis had lower mean transvalvular gradient (below 10 mmHg) at any given tissue annulus diameter. In animal experiments, the transvalvular gradients of 6 sheep were 5.2 +/- 1.7 mmHg intraoperatively, and of 2 sheep 60 months after implantation were 6.1 +/- 0.3 mmHg by catheterization. In patients, the mean transvalvular gradients in the aortic position measured by means of catheterization and echocardiography were 6.26-4.10 mmHg and 9.42-7.48 mmHg; the gradients in the mitral position were 2.10-1.9 mmHg and 5.281-4.10 mmHg respectively. The above results demonstrate that Jiuling valve prosthesis has excellent hemodynamic performance.
Adult ; Animals ; Aortic Valve ; surgery ; Biocompatible Materials ; Carbon ; chemistry ; Echocardiography ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Hemodynamics ; physiology ; Humans ; Male ; Mitral Valve ; surgery ; Prosthesis Design ; Sheep ; Ventricular Function, Left

Primary female urethral adenocarcinoma is rare. This paper reports a case of primary urethral mucinous adenocarcinoma complicated with signet ring cell carcinoma. The patient underwent urethral tumor resection in another hospital. Postoperative examination indicated that the tumor remained, and the tumor was completely removed after urethral tumor resection. After 11 months of follow-up, there was no tumor residue or recurrence.