Objective To investigate the effect of angiotensin receptor blocker(ARB)on the occurrence of acute kidney injury(AKI)after acute ischemic stroke.Methods From January 2022 to July 2023,patients with acute ischemic stroke hospitalized in the department of neurology of Nanjing First Hospital were enrolled.A 1∶1 propensity score matching method was adopted to evaluate the effect of ARB on the occurrence of AKI in patients with acute ischemic stroke.Results According to the inclusion and exclusion criteria,919 patients were enrolled,among whom 182developed AKI,with an incidence rate of 19.8％.Compared with patients without AKI,those with AKI were older and had a higher proportion of hypertension,diabetes,coronary heart disease,and heart failure.They were ad-mitted with lower Glasgow coma scale(GCS)score and higher National Institute of Health Stroke Scale(NIHSS)score.In terms of labo-ratory test data,patients with AKI had higher white blood cell counts,serum creatinine,and lower hemoglobin,albumin,low-density lipoprotein,and total cholesterol.Additionally,patients with AKI underwent a higher proportion of endovascular treatments,used diuret-ics,and received mannitol.After matching propensity score,patients using ARB had a lower incidence of AKI(17.1％vs 25.0％,P=0.044)and a lower mortality rate(1.2％vs 5.8％,P=0.014)than those without ARB.There were no significant differences between the two groups in terms of renal replacement therapy,intensive care unit,and the length of hospital stay.Conclusion ARB may have a potential protective effect on the occurrence of AKI after acute ischemic stroke.

Objective To develop and implement a drug treatment pathway for the initial treatment of diffuse large B-cell lymphoma(DLBCL)and to provide a foundation for refined medication use and cost control management under the Diagnosis Related Groups(DRG)payment system.Methods Clinical pharmacists collaborated to develop a drug treatment pathway for the initial treatment of DLBCL,utilizing evidence-based medicine and evidence-based pharmacy principles.The PDCA(Plan-Do-Check-Act)cycle method was employed for administrative intervention.The hematology department served as a pilot unit to assess the impact on economic indicators,including inpatient costs,drug expenses,and DRG payment balance,as well as treatment efficacy and the incidence of adverse reactions.Results Compared to the control group,the RG13 intervention group exhibited a significant reduction in average total hospitalization costs and drug expenses,along with a decreased DRG payment balance deficits.All differences were statistically significant(P＜0.05).Conclusion The development and implementation of a drug treatment pathway for the initial treatment of DLBCL can effectively reduce treatment costs,prevent DRG overspending,and alleviate the economic burden on patients,while ensuring the safety and effectiveness of the treatment.

Objective To develop and implement a drug treatment pathway for the initial treatment of diffuse large B-cell lymphoma(DLBCL)and to provide a foundation for refined medication use and cost control management under the Diagnosis Related Groups(DRG)payment system.Methods Clinical pharmacists collaborated to develop a drug treatment pathway for the initial treatment of DLBCL,utilizing evidence-based medicine and evidence-based pharmacy principles.The PDCA(Plan-Do-Check-Act)cycle method was employed for administrative intervention.The hematology department served as a pilot unit to assess the impact on economic indicators,including inpatient costs,drug expenses,and DRG payment balance,as well as treatment efficacy and the incidence of adverse reactions.Results Compared to the control group,the RG13 intervention group exhibited a significant reduction in average total hospitalization costs and drug expenses,along with a decreased DRG payment balance deficits.All differences were statistically significant(P＜0.05).Conclusion The development and implementation of a drug treatment pathway for the initial treatment of DLBCL can effectively reduce treatment costs,prevent DRG overspending,and alleviate the economic burden on patients,while ensuring the safety and effectiveness of the treatment.

Objective To investigate the effect of angiotensin receptor blocker(ARB)on the occurrence of acute kidney injury(AKI)after acute ischemic stroke.Methods From January 2022 to July 2023,patients with acute ischemic stroke hospitalized in the department of neurology of Nanjing First Hospital were enrolled.A 1∶1 propensity score matching method was adopted to evaluate the effect of ARB on the occurrence of AKI in patients with acute ischemic stroke.Results According to the inclusion and exclusion criteria,919 patients were enrolled,among whom 182developed AKI,with an incidence rate of 19.8％.Compared with patients without AKI,those with AKI were older and had a higher proportion of hypertension,diabetes,coronary heart disease,and heart failure.They were ad-mitted with lower Glasgow coma scale(GCS)score and higher National Institute of Health Stroke Scale(NIHSS)score.In terms of labo-ratory test data,patients with AKI had higher white blood cell counts,serum creatinine,and lower hemoglobin,albumin,low-density lipoprotein,and total cholesterol.Additionally,patients with AKI underwent a higher proportion of endovascular treatments,used diuret-ics,and received mannitol.After matching propensity score,patients using ARB had a lower incidence of AKI(17.1％vs 25.0％,P=0.044)and a lower mortality rate(1.2％vs 5.8％,P=0.014)than those without ARB.There were no significant differences between the two groups in terms of renal replacement therapy,intensive care unit,and the length of hospital stay.Conclusion ARB may have a potential protective effect on the occurrence of AKI after acute ischemic stroke.

Objective To observe the diagnostic value of four serum inflammatory biomarkers,including interleukin 6(IL-6),interleukin 12P70(IL-12P70),serum amyloid A(SAA),and procalcitonin(PCT),in rheumatoid arthritis(RA)and to analyze their relationship with the disease activity.Methods The study included 60 RA patients admitted to the Department of Rheumatology at Anhui Provincial Hospital of Traditional Chinese Medicine between December 2022 and December 2023.Thirty healthy individuals from the hospital's physical examination center served as the control group.Serum levels of IL-6 and IL-12P70 were detected using flow cytometry.SAA levels were determined by immunoturbidimetry,and PCT levels were assessed by chemiluminescence.Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),and anticyclic citrullinated peptide(ACCP)were detected using an automated biochemical analyzer.The 28-joint disease activity scores(DAS28-ESR)based on ESR were observed.Statistical analysis included t-tests,rank-sum tests,and Kruskal-Wallis H tests to compare the expression differences of the biomarkers among different groups.The diagnostic value of these biomarkers for RA was analyzed by ROC curve analysis.Spearman correlation analysis was performed to assess the relationships between the four inflammatory biomarkers and CRP,ESR,RF,ACCP,and DAS28-ESR.Results 1)The expression levels of SAA,IL-6,and IL-12P70 in the RA group were significantly higher than those in the control group(P＜0.01).2)ROC curve analysis showed that the area under the curve(AUC)for PCT was 0.611(95%confidence interval[CI]:0.488-0.735,P＞0.05),for SAA,it was 0.819(95%CI:0.733-0.906,P＜0.01),for IL-6,it was 0.875(95%CI:0.803-0.946,P＜0.01),and for IL-12P70,it was 0.832(95%CI:0.746-0.917,P＜0.01).The combined index of IL-6,IL-12P70,SAA,and PCT had an AUC of 0.973(95%CI:0.942-1.000,P＜0.01).This indicates that the four inflammatory biomarkers can assist in the diagnosis of rheumatoid arthritis.3)The expression levels of PCT and SAA varied significantly among the high,moderate,and low activity RA groups(P＜0.01).4)In RA patients,CRP was positively correlated with SAA(rs=0.75,P＜0.01),and IL-6(rs=0.52,P＜0.01).ESR was positively correlated with SAA(rs=0.36,P＜0.01).DAS28-ESR was positively correlated with PCT(rs=0.34,P=0.01),SAA(rs=0.51,P＜0.01)and IL-6(rs=0.33,P=0.01).Conclusion The four inflammatory biomarkers(PCT,SAA,IL-6,and IL-12P70)are closely related to rheumatoid arthritis disease activity and can serve as serum indicators to assist in the diagnosis and assessment of RA.

Objective:To investigate drug resistance gene in Mycoplasma pneumoniae(MP) and the distribution of 13 respiratory pathogens in bronchoalveolar lavage fluid(BALF) of children with Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 100 BALF of children with MPP in Peking University Third Hospital and Peking University First Hospital from January 2018 to January 2019 were collected.Fluorogenic quantitative PCR was used to detect nucleic acid and it′s drug resistance gene of MP and multiple PCR method was adopted to detect influenza A virus, influenza A virus-H 1N 1, influenza A virus-H 3N 2, influenza B, human parainfluenza virus, adenovirus, human bocavirus, human rhinovirus, Chlamydia pneumoniae, human metapneumovirus, MP, human coronavirus, and respi-ratory syncytial virus gene, and the results were compared by using Chi square test. Results:In 100 BALF samples, MP and drug resistance gene were detected by fluorogenic quantitative PCR.Totally, 83 cases (83.00%) were MP positive and 78 cases (93.98%) were drug resistant.All of them had the point mutations A2063G in V region of 23S rRNA domain.A total of 13 kinds of respiratory pathogens were detected by multiplex PCR method, and 89 cases (89.00%) were positive.Totally, 79 cases (79.00%) were MP positive, of which 74 cases (74.00%) detected only MP, and 5 cases (5.00%) detected MP combined with other pathogens.Other pathogens were detected in 10 cases (10.00%). The virus detection rate of 0-4 years old group was higher than that of >4-6 years old group ( P=0.042) and >6 years old group ( P=0.002), and the differences were statistically significant. Conclusions:MP can be detected in most BALF samples of MPP children, the drug resistance phenomenon is serious, and the main point mutation is A2063G.There were other respiratory pathogens and 2 or 3 pathogens were detected in a small number of BALF samples.

Objective:To investigate the clinicopathologic characteristics of hepatic echinococcus granulosus (HEG).Methods:Thirteen cases of HEG were collected from Linzhi People′s Hospital between January 2017 to October 2020, and their clinicopathologic features, ultrasound classi?cation, immunophenotype and histochemical data were analyzed, retrospectively and the relevant literature was reviewed.Results:Thirteen patients (5 male patients, 8 female patients) were included in this cohort, and the mean age was 40 years. The most common clinical presentation was mild abdominal distention and pain (9/13). Based on WHO-IWGE ultrasound standardized classi?cation, these cases were classified into 5 types, including type CL (1 case), type CE1 (2 cases), type CE2 (4 cases), type CE3 (3 cases) and type CE4 (3 cases). Gross examination revealed a solitary cyst localized in the liver, varying from 2.7 to 13.5 cm in diameter, and most of them(10/13)were more than 10 cm. Histopathologically, these cysts possessed a thin inner germinal layer and outer adventitial layer, and a central cavity ?lled with a clear"hydatid"?uid. The germinal layer was continuous and generated brood capsules and protoscoleces. The laminated membranes were clearly demonstrated by elastic fiber and Gomori′s stains. Inside the"mother"cyst, there were a varying number of"daughter"vesicles of variable sizes. The inflammatory reaction around the cyst consisted of eosinophils, mononuclear cells immediately next to the cyst layer and sometimes formed granuloma and giant cells resembling the Langhan′s type giant cells. The lymphoid cells were positive for CD20 and CD3. The CD68 immunohistochemistry clearly demonstrated epithelioid cells of granuloma in two cases. Moreover, immunohistochemistry revealed plasma cells were locally positive for CD38, IgG and IgG4, but not meeting the criteria for IgG4 related lesion.Conclusions:Hepatic echinococcus granulosus is a zoonotic parasitic disease prevalent in pastoral areas such as Tibet. It is important to understand its clinical features, ultrasound characteristics and histological morphology.

Objective To explore application of our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture Methods A retrospective study was done of 5 patients with femoral neck fracture who had been treated from August 2016 to March 2017.They were 3 men and 2 women,aged from 33 to 60 years (average,46.5 years).Thin layer CT scanning was conducted on the patients' affected hip (at the left side in 2 cases and at the right side in 3).Based on their CT data,3D design software and 3D printing technique were used to manufacture the U-shaped transdermal surgical navigator and a real-sized model of the fracture.Operations were simulated using the U-shaped transdermal surgical navigator on the fracture model to determine the angle,depth and location of the screwing.Fixation of the fracture with cannulated screws was conducted after confirmation of satisfactory surgical parameters.The postoperative X-ray films of the patients were reviewed.Evaluations were conducted of the screw position,operating time,volume of operative bleeding,and number of intraoperative X-ray shots.Results The screw positions in the 5 patients were consistent with their preoperative design.Four patients had only one shot of fluoroscopy and one patient 3 shots.Their operating time ranged from 15 to 30 minutes,averaging 22.5 minutes;their bleeding ranged from 5 to 10 mL,averaging 7.5 mL.The 5 patients were followed up for an average of 4.5 months (from 3 to 6 months).By the Harris scoring at their final follow-ups,one was excellent,3 good and one fair.No complications like pain,functional impairment of the joint,or collapse or necrosis of the femoral head occurred during the follow-up.Conclusions Our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design can significandy improve the accuracy and safety of the cannulated screwing for femoral neck fractures.The operation is minimally invasive,reducing operating time and intraoperative blood loss.

To analyze naringin, naringenin and its metabolites in rat urine and feces after intragastric administration of alcohol extract of Exocarpium Citri Grandis, healthy SD rats were fed with alcohol extract of Exocarpium Citri Grandis for 3 days. On the last day, 0-24 h feces and 0-4 h, 4-8 h, 8-24 h urine were collected and analyzed by UPLC-Q-TOF/MS. The post-acquisition data were processed using Metabolynx The result is that naringin and its 6 metabolites, naringenin and its 4 metabolites were detected in the urine of rat. Meanwhile, naringin and its 3 metabolites, naringenin and its 2 metabolites were detected in the feces of rat.

OBJECTIVETo analyze naringin, naringenin and its metabolites in rat plasma after intragastric administration of exocarpium Citri grandis alcohol extract.

METHODRat blood samples were collected 1.0 hour after oral administration of 50 g x kg(-1) exocarpium Citri grandis alcohol extract and analyzed by UPLC-Q-TOF with MS(E) function. The post-acquisition data were processed using Metabolynx.

RESULTNaringin (M1), naringenin (M2), naringin-5-O-glucuronide (M3), naringin-4-O-glucuronide (M4), glucuronide conjugate of naringenin (M5), naringin-4-O-sulfate (M6), methylated conjugate of hydroxylated naringenin (M7), glucuronide and sulfate conjugate of naringenin (M8), glucuronide conjugate of hydroxylated naringenin (M9) in rat plasma were detected. M3, M4, M6 were first reported as the metabolites of naringin. M7, M9 were first reported as the metabolites of naringenin.

CONCLUSIONThe results indicated that naringin, naringenin can be metabolited as the forms of glucuronidation, sulfation and naringenin can also be metabolited as the forms of methylation with hydroxylation and glucuronidation with hydroxylation in vivo after administration.

Animals ; Chromatography, High Pressure Liquid ; Citrus ; chemistry ; Drug Administration Routes ; Flavanones ; blood ; metabolism ; Male ; Mass Spectrometry ; Plant Extracts ; administration & dosage ; blood ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley