Objective To explore the association between the genetic polymorphism of CYP3A4,CYP2D6 and response to methadone maintenance treatment(MMT)among heroin-dependent patients.Methods Patients undergoing MMT in 6 MMT clinics were randomly selected,information about general socia-demographic characteristics,drug abuse history,and MMT data of patients were collected,genotypes of peripheral blood CYP3A4 and CYP2D6 polymorphic loci were detected.Results A total of 820 patients were enrolled in the study,210 cases were with good response and 610 cases with poor response to MMT.Difference in age between different response groups was statistically significant(P<0.05).Distribution of genotype frequency and allele frequency of CYP3A4 rs2242480 and CYP2D6 rs16947 between good response and poor response groups was not significantly different(both P>0.05).Conclusion The association between CYP3A4 rs2242480,CYP2D6 rs16947 and response to MMT has not yet found in heroin-dependent patients.

Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.

AIM: To observe the change of TNF-? mRNA in hypertrophic cardiac myocytes induced by pressure overload in rats and the effect of captopril. METHODS: Serum and heart were collected 42 days after the cardiac hypertrophy model made by pressure overload by abdomen aorta-constriction (AC). Hypertrophic parameter and the concentration of TNF-? in serum and left ventricle were determined by ELISA. TNF-? mRNA in cardiac myocytes was determined by in situ hybridization and analyze by ELIA image analysis system. The orientation of (TNF-?) mRNA in cardiac myocytes was also observed. RESULTS: Left ventricle hypertrophy was observed 42 days after operation. TNF-? mRNA in AC group elevated 98% compared to sham-operated group and descended 64.14% by captopril ((P

Objective To investigate the correlation of interleukin-1β (IL-1β) ,homocysteine (HCY) ,cysta-tin (Cys-C) and glycosylated hemoglobin (HbA1c) levels and senile type 2 diabetic peripheral neuropathy. Methods 104 patients with type 2 diabetes mellitus received in the hospital from June 2014 to December 2016 were selected as study group ,52 patients with peripheral neuropathy were served as study group A (n=52) and 52 patients with type 2 diabetes were served as study group B (n=52) ,and 52 healthy persons who under-went health assessement were taken as the control group.The Cys-C level was measured by immunoturbidime-try ,the levels of HCY and IL-1β were measured by enzyme-linked immunosorbent assay.The HbA1c level was measured by high performance liquid chromatography ,the IL-1β ,HCY ,Cys-C and HbA1c levels were com-pared in the three groups ,and the relationship between IL-1β ,HCY ,Cys-C and HbA1c levels and senile type 2 diabetic peripheral neuropathy were analyzed.Results Single factor variance analysis showed that the levels of IL-1β ,HCY ,Cys-C and HbA1c in the three groups were statistically significant (P＜0.05) ;LSD-t test showed that the IL-1β ,HCY ,Cys-C and HbA1c levels in the study group B were higher than those in control group , and IL-1β ,HCY ,Cys-C and HbA1c levels in the study group A were higher than those in the study group B , and the difference was statistically significant (P＜ 0.05) ;logisticis regression analysis showed that IL-1β , HCY ,Cys-C ,HbA1c levels were associated with type 2 diabetic peripheral neuropathy (P＜0.05) ;Spearman test showed that IL-1β ,HCY ,Cys-C ,HbA1c levels were positively correlated with type 2 diabetic peripheral neuropathy (P＜0.05).Conclusion IL-1β ,HCY ,Cys-C and HbA1c levels are positively correlated with senile type 2 diabetic peripheral neuropathy in the elderly ,and the IL-1β ,HCY ,Cys-C and HbA1c levels can be used to determine type 2 diabetic peripheral neuropathy in clinical work.

Objective:To investigate the expression of fibroblast growth factor 7 (FGF7) and related inflammatory factors in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:A case control study was conducted. The patients with AECOPD admitted to the First Affiliated Hospital of Xinjiang Medical University from November 2016 to January 2020 were enrolled. The patients were divided into mild group [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio (FEV1/FVC) < 0.70, FEV1 percentage in predicted value (FEV1%) ≥ 80%], moderate group (FEV1/FVC < 0.70, 50% ≤ FEV1% < 80%), and severe group (FEV1/FVC < 0.70, 30% ≤ FEV1% < 50%) based on their lung function test results, with 20 patients in each group, and 20 patients with normal pulmonary function who underwent elective non-thoracic surgery such as gastrointestinal surgery and orthopedics surgery in the same period were selected as controls. The demographic data, FEV1/FVC, FEV1%, FVC, maximum mid-expiratory flow percentage in predicted value (MMEF%), 6-minute walking test (6MWT), and St George Respiratory Questionnaire (SGRQ) score were recorded respectively. Serum levels of FGF7, interleukins (IL-6, IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Pearson correlation was used to analyze the correlation between TNF-α and lung function.Results:Compared with the normal pulmonary function group, the levels of FEV1/FVC, FEV1%, MMEF% and 6MWT in the mild, moderate and severe groups were significantly decreased, and the SGRQ scores were increased, the indicators continued to deteriorate with the aggravation of the disease, the statistical differences were found between severe group and normal pulmonary function group [FEV1/FVC: 0.39±0.09 vs. 0.81±0.04, FEV1%: (38.80±6.28)% vs. (109.58±13.80)%, MMEF%: (0.34±0.14)% vs. (2.69±0.99)%, 6MWT (m): 279.00±41.61 vs. 402.85±53.97, SGRQ scores: 34.95±6.71 vs. 2.60±2.06, all P < 0.05]. Compared with the normal pulmonary function group, the levels of FGF7 in the mild, moderate and severe groups were significantly lowered (ng/L: 6.31±2.65, 6.10±1.39, 6.64±1.77 vs. 8.29±3.51, all P < 0.05), but no significant difference was found among the mild, moderate and severe groups (all P > 0.05). Compared with the normal pulmonary function group, IL-6 and TNF-α levels were significantly increased in the mild, moderate and severe groups, and TNF-α increased with the aggravation of the disease, the statistical difference was found between severe group and normal pulmonary function group (ng/L: 7.42±2.28 vs. 3.83±0.92, P < 0.05). There was no significant difference in IL-1β level between the normal pulmonary function group and the mild, moderate, severe groups. Correlation analysis showed that TNF-α was negatively correlated with FEV1/FVC and FEV1% ( r values were -0.350 and -0.527, respectively, both P < 0.01). Conclusion:In AECOPD patients, serum FGF7 was decreased, while IL-6 and TNF-α were increased; however, with the aggravation of the disease, there was no significant change in the level of FGF7 in the peripheral blood, but the TNF-α level might be increased, accompanied by severe damage of small airway function.

OBJECTIVE: To evaluate the association between D2 dopamine receptor gene -141C Ins/Del polymorphism and heroin dependence in Chinese Han population. METHODS: Chinese and foreign databases were searched for relevant articles published from the establishment of database to March 2014. Case-control studies on D2 dopamine receptor gene -141C Ins/Del polymorphism with heroin dependence in Chinese Han population were gathered with Meta-analysis by Stata 12.0 software after data abstraction. RESULTS: Seven case-control studies on association between D2 dopamine receptor gene -141C Ins/ Del polymorphism and heroin dependence were included, which covered 3 211 heroin dependence patients and 1 979 controls. Meta-analysis results showed that the pooled odds ratio (OR), the 95% confidence interval (CI) and P value after combining genotypes were as follows: Ins/Ins vs Del/Del: OR=0.51, 95% CI: 0.27-0.96, P=0.017; Ins/Ins vs Ins/Del+Del/Del: OR=0.82, 95% CI: 0.72-0.94, P=0.448; Ins/Ins+ Ins/Del vs Del/Del: OR=0.53, 95% CI: 0.28-0.98, P=0.019; Ins/Del vs Del/Del: OR=0.59, 95% CI: 0.32-1.07, P=0.045; Ins vs Del: OR=0.79, 95% CI: 0.71-0.89, P=0.101). CONCLUSION D2 dopamine receptor gene -141C Ins/Del polymorphism is associated with heroin dependence in Chinese Han population, and Chinese Han population with Ins allele gene deletion are at lower risk of heroin dependence.
Alleles ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Genotype ; Heroin Dependence ; genetics ; Humans ; INDEL Mutation ; Polymorphism, Genetic ; Receptors, Dopamine D2 ; genetics

Objective To study the distributions of three single nucleotide polymorphisms (SNPs) in β-arrestin2 (ARRB2) which including rs3786047,rs1045280 and rs2036657 and to elucidate the relationship between these SNPs and response to methadone maintenance treatment (MMT) among heroin-dependent patients of Han ethnicity population in Hunan.Methods Han MMT patients were recruited in four random-chosen MMT clinics from Hunan province.Demographics,history of drug-use and MMT were recorded.ARRB2 SNPs were genotyped to determine the association between SNPs and response to MMT.Results Distributions of the three SNPs were in Hardy-Weinberg equilibrium in both groups (responders vs.non-responders).There was no statistical significance in the distribution frequency of genotype on rs3786047 (x2=0.486 2,P=0.784),rs1045280 (x2=1.591 9,P=0.451) and rs2036657 (x2=1.061 5,P=0.588) in ARRB2 among the responders or the non-responders.Conclusion Associations between the ARRB2 genotypes,rs3786047,rs1045280 and rs2036657,and MMT response in Han MMT patients in Hunan province did not appear.

Objective To optimize the treatment process of patients in Ophthalmology Outpatient, so as to enhance patient′s satisfaction and quality of care service. Methods The nurse manager of Department of Ophthalmology experienced treatment process in other hospital with team and summarized the feeling of other hospital′s treatment process, and improve the treatment process according to the existed problems including reconstruction of Outpatient work process, the implementation of registration system in Outpatient, building up Office of Returning Visit, doing extended nursing, developing “I am patient” activity, training communication ability and skills for constructing doctor-patient relationship, strengthening health education and other nursing services. Results 2014 and 2015 in Ophthalmology Outpatient of our hospital, the patients′ waiting time for treatment became short after carrying out the experience of nurses′transposition experience ( P<0.05) , and the patients′satisfaction were significantly improved after exchanging ( P<0. 05 ) , as well as the reduction of effective complaint rate (P<0.05).Conclusions To optimize the treatment process of patients in Department of Ophthalmology can shorten the time of treatment waiting time, improve the satisfaction of outpatients, so as to improve the quality of nursing service.

Objective:To explore the pros and cons of sequential high-flow nasal cannula (HFNC) and non-invasive positive pressure ventilation (NIPPV) immediately following early extubated patients with severe respiratory failure (SRF) due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD), so as to provide evidence for clinical selection of optimal scheme.Methods:Consecutive AECOPD patients admitted to the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to September 2020 were screened for enrollment. Patients were between 40 years old and 85 years old with acute exacerbation of bronchial-pulmonary infection, who received endotracheal intubation mechanical ventilation (ETI-MV) as the initial respiratory support method. The pattern of synchronous intermittent mandatory ventilation (SIMV) was used in the study. The parameters were set as follows: tidal volume (VT) 8 mL/kg, support pressure 10-15 cmH 2O (1 cmH 2O = 0.098 kPa), positive end-expiratory pressure (PEEP) 4-6 cmH 2O and the ratio of inspiratory to expiratory time 1.5-2.5∶1. Under these conditions, the plateau pressure (Pplat) was maintained less than 30 cmH 2O. The minimum fraction of inspired oxygen was adjusted to keep the pulse oxygen saturation no less than 0.92. When the pulmonary infection control window (PIC window) occurred, the subjects were extubated immediately and randomly divided into two groups, with one group receiving HFNC (called HFNC group), the other group receiving NIPPV (called NIPPV group). Patients with failed sequential HFNC or NIPPV underwent tracheal re-intubation. The rate of tracheal re-intubation within 7 days of extubation, complications (such as nose and face crush injury and gastric distension), in-hospital mortality, duration of ETI before PIC window, length of RICU stay and length of hospital stay were compared, respectively. Results:Forty-four patients were enrolled in the study, 20 in the HFNC group and 24 in the NIPPV group. There was no significant difference in the duration of ETI before PIC window between HFNC and NIPPV groups (hours: 95.9±13.1 vs. 91.8±20.4, P > 0.05). The rate of tracheal re-intubation within 7 days in the HFNC group was significantly higher than that in the NIPPV group [35.0% (7/20) vs. 4.2 % (1/24), P < 0.05]. However, the incidence of complication in the HFNC group was significantly lower than that in the NIPPV group [0% (0/20) vs. 25.0% (6/24), P < 0.05]. Compared with the NIPPV group, the in-hospital mortality in the HFNC group was slightly higher [5.0% (1/20) vs. 4.2% (1/24)], the length of RICU stay (days: 19.5±10.8 vs. 15.5±7.2) and the length of hospital stay (days: 27.4±12.2 vs. 23.3±10.9) were slightly longer, without statistical differences (all P > 0.05). Conclusion:For early extubated patients with SRF due to AECOPD, the compliance of sequential HFNC increased and the complications decreased significantly, but the final effect may be worse than sequential NIPPV.

Objective:To investigate the influencing factors of endotracheal intubation and mechanical ventilation (ETI-MV) in patients with acute respiratory distress syndrome (ARDS) caused by viral pneumonia, and to provide evidence for individualized use of ETI-MV.Methods:Patients with ARDS due to viral pneumonia admitted to the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed from November 2017 to March 2022. The gender, age, concomitant diseases, clinical symptoms and signs, complications, lab results, ARDS severity, infectious virus type, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), respiratory support methods and prognosis-related variables were collected. Univariate analysis was performed on each factor, and the variables with statistical significance in the univariate analysis were subjected multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of each index for the implementation of ETI-MV.Results:A total of 117 patients were enrolled in the study, including 61 patients in the ETI-MV group, and 3 patients (4.9%), 39 patients (63.9%) and 19 patients (31.1%) with mild, moderate and severe ARDS, respectively. There were 56 patients in non-ETI-MV group, and the mild, moderate and severe ARDS cases were 16 cases (28.6%), 38 cases (67.8%) and 2 cases (3.6%), respectively. There was significant difference between the two groups ( P < 0.05). Univariate analysis showed that during 24 hours admitted to RICU, the levels of interleukin-6 [IL-6 (ng/L): 104.0±90.0 vs. 62.4±76.0], oxygenation index [PaO 2/FiO 2 (mmHg, 1 mmHg≈0.133 kPa): 123.9±30.9 vs. 173.6±28.5], the proportion of cases with pulmonary infiltrating opacity distribution range ≥ 3/4 lung fields [85.3% (52/61) vs. 21.5% (12/56)], APACHE Ⅱ score ≥ 16.5 [67.2% (41/61) vs. 42.9% (24/56)], the rate of nosocomial invasive aspergillus infection [14.8% (9/61) vs. 3.6% (2/56)], the percentage of nosocomial bacterial infection [16.4% (10/61) vs. 3.6% (2/56)], and the lowest CD4 + T lymphocyte count in the course of the disease [cells/mm 3: 192.2±35.8 vs. 215.0±58.3] had significant differences between ETI-MV and non-ETI-MV group (all P < 0.05). Multivariate Logistic regression analysis showed that during 24 hours admitted to RICU the distribution range of pulmonary infiltrating opacity ≥ 3/4 the lung fields [odds ratio ( OR) = 12.527, 95% confidence interval (95% CI) = 3.279-47.859, P < 0.001], APACHE Ⅱ score ≥ 16.5 ( OR = 30.604, 95% CI = 4.318-216.932, P = 0.001), PaO 2/FiO 2 ( OR = 0.948, 95% CI = 0.925-0.972, P < 0.001), CD4 + T lymphocytes cell count ( OR = 0.975, 95% CI = 0.955-0.995, P = 0.015), and nosocomial bacterial infection ( OR = 38.338, 95% CI = 1.638-897.158, P = 0.023) were independent risk factors for ETI-MV. The area under the ROC curve (AUC) of ROC showed that PaO 2/FiO 2 had the greatest predictive value for ETI-MV, with AUC of 0.903, sensitivity of 91.1% and specificity of 95.1% in case of cutoff value of 151 mmHg. The AUC of pulmonary infiltrating opacity distribution range was 0.809, the sensitivity of 85.2%, specificity of 78.6% when the cutoff value was ≥ 3/4 lung field. APACHE Ⅱ scores had the lowest predictive value for selecting ETI-MV, with AUC of 0.704, sensitivity of 83.6% and specificity of 57.1% under the cutoff value was 16.5. Conclusions:For patients with ARDS caused by viral pneumonia, PaO 2/FiO 2 is still the classic reference for selecting ETI-MV, however, the distribution range of pulmonary infiltrating opacity and the systemic severity of the disease during 24 hours admitted to the RICU may provide supplemental helpful information to determine whether the patients choose ETI-MV, especially for moderate ARDS.