1.The theoretical research on Yi He rehabilitation in staging treatment of post-stroke hemiplegia
Tianzhu CHEN ; Tianyan CHEN ; Yong ZHANG ; Kang WU ; He JIN ; Yihuai ZOU
Journal of Beijing University of Traditional Chinese Medicine 2024;47(1):24-29
Yi He Rehabilitation,which is based on traditional Chinese rehabilitation treatments and rehabilitation principles from modern medicine,is effective in staging treatment of post-stroke hemiplegia.This paper systematically discusses the origin and annotation of Yi and He from the perspectives of traditional Chinese medicine and modern medicine.The medicinal connection between Yi and the body and its function is related to unobstructed attunement.Based on the connotation of Yi and He,we believe that the pathogenesis of post-stroke hemiplegia is the comprehensive result of abnormal effects of Yi on the organism at the microscopic level and abnormal effects of He on function at the macroscopic level,featured as tense muscle movement and a pathological process of abnormal motion,including the disturbance of yang qi with body dysfunction,the disorder of spirit with sinews and vessels with diversion,and the variation of brain collateral with physical and mental inconsistency.By inducing relaxation and calmness,Yi He rehabilitation takes effect in staging treatment of post-stroke hemiplegia with characteristic mechanisms.First,by calming ascending yang and relaxing the disordered body in periods of relaxation,it can achieve the maintenance function of the kinematic chain peripherally with passive rehabilitation.Second,by calming the disordered spirit and relaxing the inhibited meridian sinews in spasmodic periods,it can reconstruct the neural plasticity of motor function centrally with assistive rehabilitation.Third,by calming damaged brain collateral and relaxing the impassable zang organs in the recovery period,it can close the central-peripheral-central loop of rehabilitation with active rehabilitation.
2.Prognostic nutritional index application value for acute-on-chronic liver failure co-infection
Yamin WANG ; Yushan LIU ; Juan LI ; Qiao ZHANG ; Taotao YAN ; Danfeng REN ; Li ZHU ; Guoyu ZHANG ; Yuan YANG ; Jinfeng LIU ; Tianyan CHEN ; Yingren ZHAO ; Yingli HE
Chinese Journal of Hepatology 2024;32(3):235-241
Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated ( r ?=?-0.150, P ?0.05). Multivariate logistic analysis results showed that low PNI score ( OR=0.916, 95% CI: 0.865~0.970), ascites ( OR=4.243, 95% CI: 2.237~8.047), and hepatorenal syndrome ( OR=4.082, 95% CI : 1.106~15.067) were risk factors for ACLF co-infection ( P ?0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, P ?0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. Conclusion:Low PNI score and ACLF co-infection have a close correlation. Therefore, PNI has a certain appraisal value for ACLF co-infection.
3.A consensus on the management of allergy in kindergartens and primary schools
Chinese Journal of School Health 2023;44(2):167-172
Abstract
Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.
4. Interpretation of pharmacokinetic-based criteria for supporting alternative dosing regimens of programmed cell death receptor-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) blocking antibodies for treatment of patients with cancer guidance for industry
Wei LIU ; Ziyu WANG ; Junsheng XUE ; Rong CHEN ; Tianyan ZHOU ; Zhiheng YU
Chinese Journal of Clinical Pharmacology and Therapeutics 2022;27(1):86-94
In recent years, modeling and simulation technology based on pharmacometrics has received increasing attention in the development of innovation drugs. In August of 2021, FDA issued a guidance named Pharmacokinetic-Based Criteria for Supporting Alternative Dosing Regimens of Programmed Cell Death Receptor-1 (PD-1) or Programmed Cell Death-Ligand 1 (PD-L1) Blocking Antibodies for Treatment of Patients with Cancer Guidance for Industry, claiming the necessity of using population PK-based simulation method for the optimization of dosing regimens, and the corresponding implementation standards. This article first summarized the existing therapeutic regimens of PD-1/PD-L1 blocking antibodies in clinic as well as the main content of the guidance, and then cited some actual examples where population PK-based simulation method did contribute to the approval of the alternative dosing regimens. Besides, some critical considerations for the dosing regimen optimization of PD-1/PD-L1 blocking antibodies were also analyzed. In our view, this guidance would have positive impacts on the development of PD-1/PD-L1 blocking antibodies in the future. We hope that this article may provide some references for the colleagues in China.
5.Application and evaluation of matrix-assisted laser desorption ionization time-of-flight mass spectrometry in environmental pollution investigation of blood collection and supply institutions
Shunwei ZHANG ; Yan ZHOU ; Tianyan HU ; Yingjiao CHEN ; Jianhao YANG ; Jiaqi WU ; Yingjie QIU
Chinese Journal of Blood Transfusion 2022;35(2):209-212
【Objective】 To investigate the environmental pollution of blood collection and supply institutions by using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and evaluate its application value. 【Methods】 Colonies of air from blood donation sites, skin puncture sites of blood donors, platelet storage boxes, platelet collection equipment, object surfaces of related experimental consumables and cuff surfaces of staff after disinfection were collected, and typical colonies after cultivation were selected for microbial identification by microbial mass spectrometry and then compared with bacteria results detected in blood components from May 2017 to May 2021. 【Results】 Aseptic growth, the number of colonies ≤4.0 CFU/ dish, and the number of colonies > 4.0 CFU/dish accounted for 21.20%, 62.20% and 16.60%, respectively. The qualified rate from high to low was platelet storage box, bacteria settling in the air of blood donation room after disinfection, platelet collection equipment, skin puncture site of blood donors after disinfection, the surface of platelet consumables and the surface of medical staff's overalls. After disinfection, the blood donors' skin puncture sites were compared with other collection sites, and the t values were 2.0371, 1.508, 2.109, 1.961 and 1.778, respectively, with no significant difference (P>0.05). Thirty cases of bacterial contamination of blood components were detected from May 2017 to May 2021, among which the detection rate of apheresis platelets was the highest, and the t values were 1.731 and 2.272, relative to the contamination frequency of erythrocytes and plasma bacteria (P>0.05), while the t value was 2.875, relative to concentrated platelets, with significant difference (P<0.05). 【Conclusion】 Bacterial contamination of blood components mostly come from air bacteria settling, blood donors' arms and skin after disinfection, and surfaces of related equipment and materials. Therefore, it is of clinical significance to conduct strict disinfection of working sites, establish disinfection monitoring methods and formulate disinfection hygiene standards in blood stations.
6.Dynamic changes of lymphocytes and the disease progression in patients with coronavirus disease 2019 in Xi’an
Xi ZHANG ; Lei SHI ; Yonghao DU ; Feng YE ; Gang NIU ; Shumei LIN ; Yingren ZHAO ; Tianyan CHEN
Journal of Xi'an Jiaotong University(Medical Sciences) 2021;42(1):108-112
【Objective】 To analyze the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) in Xi’an so as to investigate the relationship between the dynamic changes of lymphocytes and the disease progression. 【Methods】 We retrospectively analyzed the clinical data of 15 patients with COVID-19 in The First Affiliated Hospital of Xi’an Jiaotong University from January 22 to February 16, 2020. 【Results】 Among the 15 patients with COVID-19, 8 were males and 7 were females, aged from 22 to 89 years. There were 12 ordinary cases (80%), 1 severe case (6.67%), and 2 critical cases(13.33%). There were 6 groups of family clusters.Most of the patients (14/15, 93.3%) had fever of different degrees. The average time from illness onset to admission was 2.80±1.66 days, and the average time from illness onset to diagnosis was 2.83±2.29 days. The main accompanying symptoms were dry cough (8/15, 53.33%) and shortness of breath (4/15, 26.67%). Nine patients (60%) who had low lymphocyte counts at admission, including of all of the critically ill patients (1 severe case and 2 critical cases) and 6 (6/12, 50%) ordinary patients. Lymphocyte counts in the ordinary cases increased gradually, but fluctuated in the severely ill patients. They were always at low level, or even decreased overall in critical cases. 【Conclusion】 In Xi’an City, COVID-19 mostly occurred in family clusters. Lymphocyte counts were reduced in most patients, especially in critically ill (severe and critical) ones. The lymphocyte count at admission and its kinetics during therapy may be an important predictor for the severity and prognosis of the disease.
7. Model informed precision dosing: China expert consensus report
Zheng JIAO ; Xingang LI ; Dewei SHANG ; Jing DONG ; Xiaocong ZUO ; Bing CHEN ; Jianmin LIU ; Yan PAN ; Tianyan ZHOU ; Jing ZHANG ; Dongyang LIU ; Lujin LI ; Yi FANG ; Guangli MA ; Junjie DING ; Wei ZHAO ; Rui CHEN ; Xiaoqiang XIANG ; Yuzhu WANG ; Jianjun GAO ; Haitang XIE ; Pei HU ; Qingshan ZHENG
Chinese Journal of Clinical Pharmacology and Therapeutics 2021;26(11):1215-1228
Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.
8.Terminal disinfection effect of hydrogen peroxide atomization sterilizer in blood centers
Shunwei ZHANG ; Jianhao YANG ; Yingjiao CHEN ; Yan ZHOU ; Tianyan HU ; Bei XU
Chinese Journal of Blood Transfusion 2021;34(5):532-535
【Objective】 To observe the effect of hydrogen peroxide atomization sterilizer using low concentration hydrogen peroxide disinfectant on the environment and object surface of physical examination area (hereinafter referred to as " physical examination area" ) in blood centers, so as to provide a simple method which is safe, efficient, easy to operate, harmless to human body and has no corrosive effect on equipment. 【Methods】 The physical examination area was disinfected with atomized hydrogen peroxide sterilizer, and the difference of colony number between air and surface before and after disinfection was compared to evaluate the disinfection effect. 【Results】 After disinfection, the hydrogen peroxide residue was detected for 25 times at 5 points, and the results were (0.7~1)ppm, with no statistical difference (P>0.05). 25 tests were carried out at 5 points, and the quartile of the test results was (0~2)CFU/ dish, and the qualified rate was 100%. The test results of bacteria before and after disinfection were statistically significant (P<0.05), which met the requirements of Class Ⅱ environment in Hygienic Standard for Hospital Disinfection(GB15982-2012). After disinfection, the quartile of surface colony detection results of workbench, blood donor seat, screen and door handle were (0~24.1)CFU/cm2, (1.6~55.4)CFU/cm2, (0~7.2)CFU/cm2 and (0~4.8)CFU/cm2, with the qualified rate at 80%, 48%, 100% and 100%, respectively, which were in accordance with the requirements of Class Ⅲenvironment in GB15982-2012. The number of colonies after disinfection at the above detection sites decreased significantly compared with that before disinfection (P<0.05). The surface contact plate pressing method and cotton swab smearing method were used to detect the number of colonies on the surface of sterilized work tables and blood donor seats, and the detection rate of the former was higher than that of the latter, with statistical significance (P<0.05). 【Conclusion】 After disinfection by hydrogen peroxide atomization sterilizer, the hydrogen peroxide residue met the requirements specified in the manual. The terminal disinfection effect of air in the physical examination area environment can meet the Class Ⅱ environmental requirements of GB15982-2012. However, the number of microorganisms on object surface after terminal disinfection was significantly lower than that before disinfection.
9.TCF-1 deficiency influences the composition of intestinal microbiota and enhances susceptibility to colonic inflammation.
Guotao YU ; Fang WANG ; Menghao YOU ; Tiansong XU ; Chunlei SHAO ; Yuning LIU ; Ruiqi LIU ; Min DENG ; Zhihong QI ; Zhao WANG ; Jingjing LIU ; Yingpeng YAO ; Jingjing CHEN ; Zhen SUN ; Shanshan HAO ; Wenhui GUO ; Tianyan ZHAO ; Zhengquan YU ; Qian ZHANG ; Yaofeng ZHAO ; Feng CHEN ; Shuyang YU
Protein & Cell 2020;11(5):380-386
10. General considerations of model-based meta-analysis
Lujin LI ; Junjie DING ; Dongyang LIU ; Xipei WANG ; Chenhui DENG ; Shangmin JI ; Wenjun CHEN ; Guangli MA ; Kun WANG ; Yucheng SHENG ; Ling XU ; Qi PEI ; Yuancheng CHEN ; Rui CHEN ; Jun SHI ; Gailing LI ; Yaning WANG ; Yuzhu WANG ; Haitang XIE ; Tianyan ZHOU ; Yi FANG ; Jing ZHANG ; Zheng JIAO ; Bei HU ; Qingshan ZHENG
Chinese Journal of Clinical Pharmacology and Therapeutics 2020;25(11):1250-1267
With the increasing cost of drug development and clinical trials, it is of great value to make full use of all kinds of data to improve the efficiency of drug development and to provide valid information for medication guidelines. Model-based meta-analysis (MBMA) combines mathematical models with meta-analysis to integrate information from multiple sources (preclinical and clinical data, etc.) and multiple dimensions (targets/mechanisms, pharmacokinetics/pharmacodynamics, diseases/indications, populations, regimens, biomarkers/efficacy/safety, etc.), which not only provides decision-making for all key points of drug development, but also provides effective information for rational drug use and cost-effectiveness analysis. The classical meta-analysis requires high homogeneity of the data, while MBMA can combine and analyze the heterogeneous data of different doses, different time courses, and different populations through modeling, so as to quantify the dose-effect relationship, time-effect relationship, and the relevant impact factors, and thus the efficacy or safety features at the level of dose, time and covariable that have not been involved in previous studies. Although the modeling and simulation methods of MBMA are similar to population pharmacokinetics/pharmacodynamics (Pop PK/PD), compared with Pop PK/PD, the advantage of MBMA is that it can make full use of literature data, which not only improves the strength of evidence, but also can answer the questions that have not been proved or can not be answered by a single study. At present, MBMA has become one of the important methods in the strategy of model-informed drug development (MIDD). This paper will focus on the application value, data analysis plan, data acquisition and processing, data analysis and reporting of MBMA, in order to provide reference for the application of MBMA in drug development and clinical practice.


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