Objective To investigate the relationship between kinase insert domain receptor(KDR)rs2305948 polymorphism and clopidogrel resistance(CR)in patients with acute coronary syndrome after receiving percutaneous coronary intervention(PCI).Methods A total of 468 patients with acute coronary syndrome,who were admitted to the Zhangjiakou Municipal First Hospital of China from September 2022 to September 2023,were selected as the subjects of study.All patients received PCI treatment and took medication of clopidogrel after the treatment.The occurrence of CR was recorded.The factors influencing the occurrence of CR were analyzed.The clinical significance of KDR rs2305948 polymorphism in predicting CR in patients with acute coronary syndrome after receiving PCI was evaluated.Results Of 468 patients with acute coronary syndrome,116(24.79％)developed CR.Logistic multivariate regression analysis indicated that low-density lipoprotein cholesterol(LDL-C,95％CI=1.420-8.390,OR=3.452),type 2 vascular endothelial growth factor receptor(VEGFR-2,95％CI=1.374-8.118,OR=3.340),KDR rs2305948 T/T genotype(95％CI=1.677-9.905,OR=4.076),and T allele(95％CI=1.390-8.207,OR=3.377)were the independent factors influencing the occurrence of CR inpatients with acute coronary syndrome after receiving PCI(all P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity,specificity,and area under ROC curve(AUC)of the T/T genotype of KDR rs2305948 in predicting CR in patients with acute coronary syndrome after receiving PCI were 75.86％,70.45％,and 0.773(95％CI=0.666-0.880)respectively.Conclusion In patients with acute coronary syndrome after receiving PCI,the risk of developing CR is higher.The KDR rs2305948 polymorphism is correlated with CR in patients with acute coronary syndrome after receiving PCI,and it has a certain predictive value for CR.

Objective To explore the application effect of the multidisciplinary team collaboration model in vascular access management for patients with maintenance hemodialysis.Methods A total of 102 patients with maintenance hemodialysis in the hospital from October 2023 to October 2024 were selected as the research subjects,and they were randomly divided into observation group and control group by the random number table method,with 51 cases in each group.The observation group re-ceived routine nursing combined with the multidisciplinary team collaboration model,while the control group received routine nursing.The multidisciplinary team collaboration model involved professionals from multiple disciplines,including nephrologists,vascular surgeons,interventional radiologists,B-ultrasound doctors,clinical pharmacists,nutritionists,psychological counselors,the head nurse of the blood purification center,and blood purification specialist nurses.The intervention duration was 6 months.The related indicators of dialysis adequacy[urea reduction ratio(URR),equilibrium urea clearance rate(eKt/V)],psychological burden[the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS)],vascular access satisfaction degree[the Simple Version of Vascular Access Questionnaire(VAQ)],quality of life[the Kidney Disease-Targeted Areas Scale(KDTA)and the 36-item Short-form Health Survey(SF-36)],and complications were compared between the two groups before and after the intervention.Results After the intervention,the levels of URR and eKt/V and the score of each dimension of quality of life in the observation group were signifi-cantly higher than those in the control group,while the SAS and SDS scores were significantly lower than those in the control group(P＜0.05).After the intervention,the satisfaction rate of vascular access in the observation group was 96.08％(49/51),which was significantly higher than 80.39％(41/51)in the control group(x2=6.044,P=0.014).The total complication rate in the observa-tion group was 1.96％(1/51),which was significantly lower than 13.73％(7/51)in the control group(P＜0.05).Conclusion The adoption of the multidisciplinary team collaboration model for patients with maintenance hemodialysis is beneficial for improving the adequacy of hemodialysis,re-ducing psychological burden,enhancing vascular access satisfaction and quality of life,and preven-ting complications.

Objective To explore the clinical outcome of modified turtle shell moxibustion along the meridian for patients with primary dysmenorrhea caused by cold congelation and blood stasis.Methods Sixty patients with primary dysmenorrhea caused by cold congelation and blood stasis who were treated in Fuyang Women and Children's Hospital from August 2020 to August 2021 were included in this study.The patients were divided into test group and control group according to the random number table method,with 30 cases in each group.The control group was treated with ibuprofen granules,and the test group was treated with modified soft-shelled turtle moxibustion along the meridian pushing and ironing in addition to the treatment of the control group.Both groups were treated for 3 menstrual cycles.The Traditional Chinese Medical symptom scores,pain duration,visual analogue scale(VAS)score,clinical efficacy,serum prostaglandin E2(PGE2),prostaglandin F2a(PGF2a)and adverse reactions were compared between the two groups.Results The scores of cold pain in lower abdomen,chills in extremities,lumbosacral soreness,and dark menstrual blood with blood stasis,as well as the VAS score after treatment were significantly lower than those before treatment in both groups(P＜0.05),and these scores in the test group were significantly lower than those in the control group after treatment(P＜0.05).The duration of pain was significantly shortened after treatment in both groups,and the duration of pain in the test group was significantly shorter than that in the control group(P＜0.05).The total effective rate of the test group was significantly higher than that of the control group(P＜0.05).After treatment,serum PGE2 level was significantly increased and the PGE2a level was significantly decreased in both groups(P＜0.05),and the test group had higher level of PGE2 and lower level of PGF2a than the control group after treatment(P＜0.05).No gastrointestinal reactions or bleeding occurred.Conclusion The modified turtle shell moxibustion through meridian pushing and ironing is a safe and effective treatment for primary dysmenorrhea due to cold blood stasis syndrome.It can improve clinical symptoms and regulate the level of prostaglandins.

Desensitization therapy for iodinated contrast media (ICM) aims to induce drug tolerance in patients with a history of severe allergic reactions to ICM in a short time. Currently, there is no widely accepted consensus on inducing desensitization to avoid severe allergic responses to ICM. The clinically successful cases have shown that prophylactic use of antihistamines and glucocorticoids can increase the desensitization effect; repeatedly desensitizing and gradually increasing the dose can be conducive to establishing better tolerance to ICM. Most desensitization effects, including stress resistance, can endure 24-48 h. The mechanisms of desensitization therapy remain unclear, the initial dose, administration interval and dose gradient are largely based on clinical experiences and the reaction of patients. This article reviews the current research progress on ICM-related allergies, desensitization methods and related mechanisms, as well as the benefits and hazards of desensitization, to provide a reference for desensitization treatment of hypersensitivity to ICM .
Humans ; Contrast Media/adverse effects* ; Consensus ; Glucocorticoids ; Hypersensitivity

Cardiac disease is the general term of diseases, caused by damage to the structure or abnormal function of the heart. Its morbidity and mortality have remained high, seriously threatening the lives and health of people. The tyrosine kinase receptor ErbB2 (also known as EGFR2 or HER2) was originally discovered for its oncogenic activity, however, recent studies have found that ErbB2 have protective effects in various heart diseases. Therefore, this article reviews the role and underlying mechanism of ErbB2 in myocardial infarction, myocardial ischemia/reperfusion injury, cardiac hypertrophy, heart failure, doxorubicin-induced cardiotoxic injury and diabetic cardiomyopathy. Furthermore, this article also preliminarily discusses the application prospects, limitations and development directions of ErbB2 as a clinical diagnostic marker and therapeutic target for heart disease.

AIM: To analyze the effect of influential factors on the estimation of pharmacokinetic parameters of teicoplanin, this study was proposed to develop the population pharmacokinetic (PPK) model of teicoplanin in patients with renal insufficiency. METHODS: A total of 66 routine blood teicoplanin concentration monitoring data were collected from 46 cases with renal insufficiency, and a nonlinear mixed effect modeling program was used to establish one-compartment model with Monolix 2021R1 software. Furthermore, 20 routine blood teicoplanin concentration monitoring data were also collected from the other 20 cases with renal insufficiency, and the external validation of the model was performed by goodness-of-fit parameter method. RESULTS: The one compartment model was an appropriate model for simulating the pharmacokinetics of teicoplanin in patients with renal insufficiency. The typical values of apparent volume of distribution and clearance rate were 148.9 L and 0.13 L/h, respectively. Glomerular filtration rate and body weight, instead of other factors, were the primary variables that affected the elimination of teicoplanin in vivo. CONCLUSION: The population pharmacokinetic model of teicoplanin established in the present study was effective and stable, which could also predict the dynamic change of teicoplanin concentration. As a result, the population pharmacokinetic model could provide references for the rational use of teicoplanin in special populations.

To investigate the therapeutic effects of oral osthole on streptozotocin (STZ)-induced type 1 diabetes mellitus(T1DM) mice and explore its internal mechanism. METHODS: The diabetes model induced by STZ was established. Mice were randomly divided into control group, STZ model group, STZ+osthole group (20 mg/kg). Body weight, blood glucose, urine protein, blood urea nitrogen and creatinine were observed to detect renal function. The degree of renal tissue damage was detected by H&E staining and PAS staining, and the degree of renal fibrosis was detected by Sirius Red staining. CD68 and F4/80 immunofluorescence staining was used to observe the infiltration of macrophages in kidney tissue. The mRNA expressive levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) in renal tissue were detected by RT-qPCR. The protein expressive levels of phospho-NF-κB p65, NF-κB p65, IκBα, phospho-IκBα, phospho-p38 and p38 were detected by Western blot in renal tissue. RESULTS: Compared with the STZ model group, the levels of urinary protein, blood urea nitrogen, creatinine were significantly decreased after osthole treatment (P<0.05 or P<0.01). The renal structure disorder, mesangial matrix area, collagen fiber accumulation, and macrophage infiltration were significantly improved (P<0.05 or P<0.01). The expression of mRNA of pro-inflammatory cytokines TNF-α and IL-6 were significantly decreased (P<0.05 or P<0.001). The expression of phospho-NF-κB p65, phospho-IκBα and phospho-p38 were significantly down-regulated (P<0.05 or P<0.01), while the protein expression level of NF-κB p65, IκBα was up-regulated (P<0.05). CONCLUSION: Osthole has a protective effect on kidney injury caused by diabetes and inhibits NF-κB and p38/MAPK signaling pathway.

Objective:To explore the relationships between medical coping modes of patients with COVID-19 and general information and social supports.Methods:From January 28 to February 20, 2020, a total of 128 patients in a designated hospital in Wuhan with novel coronavirus pneumonia were investigated using the General Information Questionnaire and the Chinese version of the Medical Coping Modes Questionnaire (MCMQ) by convenient sampling. Pearson univariate analysis and multiple linear regression were used to analyze the relationship between the basic situation of patients with novel coronavirus pneumonia and coping modes.Results:The scores of the face dimension and avoidance dimension of patients with COVID-19 were lower than the norm model, while the yield dimension was higher than the norm model, and the differences were statistically significant ( P<0.05) . Support utilization and complexity were influencing factors of the face dimension ( P<0.05) . Support utilization and age were influencing factors of the yielding dimension ( P<0.01) . Subjective support, the complexity dimension of disease uncertainty and the number of confirmed patients in the family were influencing factors of the avoidance dimension ( P<0.01) . Conclusions:Patients with COVID-19 have poor medical coping modes, and they are prone to face the disease with a negative attitude. Patients are unwilling to face the disease and the tendency to yield to the disease is greater. And the older the patients, the less likely they are to succumb to the disease. The more patients diagnosed in the family, the less likely they are to avoid the disease. Patients with higher social supports and utilization have a more reasonable medical coping mode. This reminds medical staff to pay more attention to the psychological problems of patients in coping with COVID-19 and improve their coping modes and methods.

Objective: To investigate the effect and safety of interleukin-2 combined with cisplatin in the treatment of malignant pleural effusion.Methods: Totally 86 patients with malignant pleural effusion were randomly divided into the observation group (44 cases) and the control group (42 cases).The control group was treated with cisplatin, and the observation group was treated with interleukin-2 additionally.The treatment course was 3 weeks.The ascites relief, quality of life, survival status and tumor markers before and after the treatment, and the adverse drug reactions were compared between the groups.Results: The total ascites remission rate and the effective rate in the observation group were significantly higher than those in the control group (P<0.05).Compared with those before the treatment, CEA, CA19-9 and CA450 decreased significantly after the treatment in both groups (P<0.05), those in the observation group were significantly lower than those in the control group (P<0.05).After the treatment, the physiological function, physiological occupation, emotional function, body pain and the other life quality scores in the observation group were significantly higher than those in the control group (P<0.05).The 24-month survival rate in the observation group was significantly higher than that in the control group (P<0.05).There were no significant differences in adverse drug reactions between the groups (P>0.05).Conclusion: Interleukin-2 combined with cisplatin can effectively relieve ascites and improve quality of life, which can also prolong the survival time of patients.

OBJECTIVE:To establish a method for the content determination of zolpidem tartrate in microsamples of rat plas-ma. METHODS:Rats were given zolpidem tartrate solution 3 mg/kg intragastrically,and 0.2 ml blood sample were collected and isolated. 50 μl plasma was precipitated by methanol,and the supernatant was determined by HPLC-fluorescence combined with ex-ternal method. Agilent HC-C18 column was used with mobile phase consisted of 0.03 mol/L KH2PO4 solution(containing 0.2% tri-ethylamine)-methanol (33∶67,V/V) at flow rate of 1.0 ml/min. The excitation and emission wavelengths were 254 nm and 390 nm,respectively. The sample size was 20 μl. RESULTS:The linear ranges of zolpidem tartrate in plasma was 2-200 μg/L(r=0.999 7),and the limit of quantification was 2 μg/L. The method recoveries of zolpidem were (96.96 ± 1.35)%-(105.0 ± 5.36)%(RSD=2.20%-4.88%,n=5),and extraction recoveries were (79.72 ± 0.01)%-(80.77 ± 0.02)%(RSD=1.34%-3.90%,n=5). The intra-day and inter-day RSDs were 1.40%-5.10% and 3.22%-9.25%(n=5),respectively. CONCLUSIONS:The method is simple,sensitive and suitable for the content determination of zolpidem tartrate in microsamples of plasma.