Objective:To explore the effectiveness of Acute Care of the Elderly(ACE)model and its existing problems in the clinical practice for older adults with acute clinical conditions.Methods:Using the random number table method, a random number sequence was generated, and the patients admitted to the Department of Geriatrics of Shenzhen Nanshan Hospital due to acute diseases From January 2019 to September 2021 were enrolled in the ACE model intervention group(160 cases)and the control group(77 cases)in a 2: 1 ratio.The inclusion criteria were based on disease severity, frailty assessment, and activity of daily living(ADL)assessment.The intervention time was 1-3 weeks.Outcomes of the patients include ADL, hospitalization days, hospitalization expenses, drug proportion, human resource investments, adverse events, 30-day readmission rate, and 1-year mortality.Results:There were no significant difference in baseline indicators such as frailty index and ADL score between the two groups at admission.The ADL score(Barthel index)of the ACE group was significantly improved compared with the control group at discharge(81.71±14.23 vs.70.9±23.89, P<0.001)and at 30 days after discharge(85.84±15.25 vs.68.29±30.91, P<0.001). The hospital cost[(12 735.81±6 541.41)￥ vs.(16 391.54±12 962.34)￥, P=0.002], drug proportion(21.34% vs.28.93 %, P=0.036)and 30-day readmission rate(13.1% vs.23.4%, P=0.037)of the ACE group were significantly lower compared to the control group.The human resource input(32.97±6.72 vs.25.03±5.31, P=0.008)and patient satisfaction(98.23% vs.90.66%, P=0.031)in the ACE group were significantly higher than those of the control group.(4)The incidence of adverse events during hospitalization was significantly lower in the ACE group than in the control group in terms of aspiration(0.63% vs.20.8%, P<0.001), falls(0 vs.10.4%, P<0.001), incontinence dermatitis(0 vs.3.9%, P=0.033), and 1-year mortality(6.3% vs.24.7%, P<0.001). There was no significant difference in the average length of stay(8.98±4.25 vs.10.03±5.32, P=0.101), pressure sores(13.01±4.77 vs.13.27±4.89, P=0.364), DVT risk score(8.53±2.79 vs.8.89±2.76, P=0.340)and medical staff satisfaction(73% vs.80%, P=0.240)between the two groups. Conclusions:The ACE model helps to reduce the disability rate of elderly patients with frailty, adverse events during hospitalization, save drug costs, and improve patient satisfaction.It is worth promoting in geriatric practice, but its localization management details and processes still face many challenges.

Objective To observe the clinic effects and safety of thoracic dorsal root ganglion(DRG) pulsed radiofrequency in treating post-thoracotomy pain syndrome(PTPS). Methods 47 PTPS patients were treated with thoracic DRG pulsed radiofrequency. VAS, Oxycodone dosage, medicine side effects before and after operation were recorded. Results The VAS before operation and 1 d, 15 d, 1 m, 3 m, 6 m, 12 m after operation were 6. 3 ±2. 4, 4. 1 ±1. 8, 3. 2 ±1. 3, 2. 5 ±1. 5, 2. 1 ±0. 9, 2. 0 ±0. 8 and 2. 2 ±1. 1 respectively. The oxycodone dosage were (28. 5 ±10. 2)mg, (12. 3 ±5. 7)mg, (8. 3 ±3. 8)mg, (7. 6 ± 3. 1) mg, (7. 0 ± 3. 4) mg, (6. 6 ± 2. 7) mg and (7. 2 ± 3. 2) mg respectively. The difference was significant compared with the preoperative (P＜0. 05). No serious complications occurred. Conclusion Thoracic DRG pulsed radiofrequency was a safe and effective method in treating PTPS.

Objective To determine the content of paeoniflorin in Fuzhengpingxiao capsule by HPLC method .Methods The content of paeoniflorin were determined by HPLC ,and the column was an Agilent Zorbax SB-C18 column (150 mm × 4 .6 mm ,5 μm);The mobile phase was acetonitrile and 5 mmol/L sodium dihydrogen phosphate (10:90) ,and the flow rate was set at 1 ml/min .Column temperature was 25°C ,detection wavelength was 230 nm ,injection volume was 10 μl ,and running time was 25 min .Results Paeoniflorin was linear (r=0 .9999) in the concentration of 25 .0-500 .0 μg/ml ,the linear equation was Y=12 .65 X +43 .54 ,and the average recovery was 92 .69％ with RSD value was 1 .77％ .Conclusion The method was easy to operate ,reliable and reproducible ,which could be used in the determination of paeoniflorin in FuzhengPingxiao capsule .

Objective To evaluate the effectiveness and safeness of X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen in the treatment of tdgeminal neuralgia.Methods Three hundred and sixty-eight patients with primary trigeminal neuralgia,admitted to our hospital from July 2011 to July 2014,were successfully treated with X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen.Three,30 and 90 d after treatment,the treatment effectiveness was evaluated.The recurrence rates were calculated one and two years after treatment or to the date of their relapses to hospital.Results All patients showed obvious pain relief,with visual analogue scale scores decreasing from 8.82±0.84 to 1.14±0.91,to 0.40±0.58,and then to 0.18±0.38 on 3rd,30th and 90th d.Their qualities of sleep were improved:quality of sleep scale scores dropped from 3.75± 0.73 to 2.18±0.66,to 1.37±0.48,and then to 1.02±0.15,respectively.Meanwhile,patient satisfaction was increased:as patient satisfaction scale scores reduced from 2.90±0.34 to 1.35±0.58,to 1.10±0.30,and then to 1.06±0.24,respectively.The main complications were masticatory muscle weakness in 67 patients (7.34％),and corneal hypesthesia in 20 patients (2.45％).Postoperative recurrence rate was 5.71％ in one year,and 21.20％ in two years.The mean time of effective therapeutic duration was 22.33± 12.70 months.Conclusions X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen is effective and safe for the treatment of primary trigeminal neuralgia,enjoying no severe complications and low recurrence rate.

Objective To study the irrational intravenous (IV) medication orders and promote rational medication applications.Methods A retrospective analysis was conducted to analyze the irrational prescriptions from January to December 2016.Results Among 39 948 IV medication orders reviewed, there were 134 irrational prescriptions of cytotoxic drugs (0.33％) and 222 irrational prescriptions of total parenteral nutrition(TPN)(0.56％).Within 356 irrational prescriptions, 19 had improper amount of diluent(5.34％), 95 inappropriate dosage(26.69％), 12 drug incompatibility(3.37％), 8 wrong diluent (2.24％) and 222 inappropriate TPN orders (62.36％).Conclusion The interventions of the clinical pharmacists are needed to reduce medication errors and improve the drug safety and effectiveness.

Objective To explore the roles of spinal microglial Src-family kinases (SFKs) in diabetic neuropathic pain. Methods Male Sprague-Dawley rats, weighing 200 ~ 220 g, were used in the experiments. The level of p-SFKs in spinal dorsal horn was detected by single immunofluorescence staining on day 7th , 14th and 28th after intraperitoneally injection of Streptozotocin (STZ) and its location was detected by double immunofluorescence staining. The changes of 50% paw-withdrawal thresholds of rat were detected by behavioral tests when PP2 , a specific inhibitor of SFKs , was intrathecally administered before intraperitoneally injection of STZ. Results Compared with vehicle group, the blood glucose level increased on day 1 (P < 0.001) and the hyperglycemia persisted at least for 28 days (P < 0.001) after intraperitoneally administered of STZ (50 mg/kg). Paw-withdrawal threshold (PWT) decreased gradually from day 1 (P < 0.05) and reached the minimum on day 28 (P < 0.001) after STZ administration. Meanwhile, the expression of p-SFKs in spinal dorsal horn markedly increased on day 7 (P < 0.01), day 14 (P < 0.01) and day 28 (P < 0.01). The p-SFKs was mainly co-localized only with microglia , but not with neurons or with astrocytes. Intrathecally administered of PP2 before STZ reversed STZ-induced mechanical hyperalgesia. Conclusion Microglial SFKs in spinal dorsal horn maybe play a pivotal role in diabetic neuropathic pain.

Abscess ; pathology ; Breast ; pathology ; Esophagus ; pathology ; surgery ; Foreign Bodies ; surgery ; Humans ; Neck ; pathology ; Otorhinolaryngologic Surgical Procedures ; Recurrence

AIM:To investigate the effects of P2X4 receptor on peri-sciatic administration of recombinant rat TNF-α(rrTNF)-induced mechanical allodynia.METHODS:Male Sprague-Dawley rats (180~200 g) were used in the experiments.The levels of P2X4 receptor on day 3, day 7 and day 14 after peri-sciatic administration of rrTNF were exam-ined by Western blot, and the location of P2X4 receptor in the spinal dorsal horn was observed by double immunofluores-cence staining.The changes of 50%paw-withdrawal thresholds of the rat were detected by behavioral test, and the level of TNF-αin the spinal dorsal horn was also examined by Western blot when TNP-ATP was intrathecally injected before the ad-ministration of rrTNF.RESULTS:Compared with control group, the expression of P2X4 receptor in the spinal dorsal horn on the ipsilateral side significantly increased on day 3, day 7 and day 14 (P<0.01) after rrTNF (100 ng/L) administra-tion.P2X4 receptor was co-localized only with microglia, but not with neurons or astrocytes.Intrathecal injection of TNP-ATP before rrTNF administration prevented mechanical allodynia induced by rrTNF and inhibited the upregulation of TNF-αin the spinal dorsal horn.CONCLUSION:P2X4 receptors in microglia may be involved in rrTNF-induced mechanical allodynia by the upregulation of TNF-αin the spinal dorsal horn.

OBJECTIVE: Dihydroartemisinin is a traditional anti-malarial drug, a derivative of the artemisinin, it has anti-tumor activity of a variety of tumor cells. This study investigated the effect of growth inhibition of nasopharyngeal carcinoma cells line CNE-2 induced by dihydroartemisinin and its possible mechanism. METHOD: The effect of DHA on the cell proliferation of CNE-2 was detected by CCK-8 assay with different concentrations and time. The effects of DHA on the cell apoptosis of CNE-2 were detected by Annexin V-FITC assay through flow cytometry and caspase-3 activity assay. RESULT: CCK-8 experimental results show that CNE-2 cell proliferation was suppressed with DHA treatment, as compared with the control group. DHA could induce marked apoptosis in CNE-2 by apoptosis assay, as compared with the control group, The percentages of apoptotic cells increased along with the increase of DHA concentrations in CNE-2; The activity of caspase-3 was increased following DHA treatment in a dose-dependent manner. CONCLUSION DHA could effectively inhibit proliferation and induce apoptosis of human nasopharyngeal carcinoma cells line CNE-2, the possible mechanism DHA induce apoptosis of CNE-2 cells by upregulating the expression of caspase-3.
Apoptosis ; drug effects ; Artemisinins ; pharmacology ; Carcinoma ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology

AIM: To investigate the effects of Src family kinases (SFKs) on adenosine 5'-triphosphate (ATP)-induced long-term potentiation (LTP) in the spinal dorsal horn. METHODS: Male Sprague-Dawley rats (250-280 g) were used in the experiments. Western blotting, electrophysiological recording in spinal dorsal horn in vivo and immunohistochemistry were used in the study. The C-fiber-evoked field potentials were recorded at the superficial layers of spinal dorsal horn at the lumbar enlargement and the phosphorylation level and location of SFKs in spinal dorsal horn were examined by Western blotting and immunohistochemistry. RESULTS: Thirty min and 60 min after ATP application, the levels of phosphorylated SFKs (p-SFKs) were significantly increased.The p-SFKs were expressed in microglia, but not in astrocytes or neurons. Spinal application of SFK inhibitors prevented ATP-induced LTP. CONCLUSION: Microglial SFKs may play an important role in ATP-induced LTP of C-fiber evoked field potentials in the spinal dorsal horn.