The adverse reactions in combination of angiotensin-converting enzyme inhibitors (ACEIs) and Ang II receptor blockers (ARBs) were severer than that in monotherapy for patients with nephropathy. The effect of candesartan on pharmacokinetics of enalaprilat in nephrotic rats was investigated to make references for the clinical therapy in patients with nephropathy to avoid related adverse effects.Nephrotic rats were prepared by adriamycin injection. Control group and one nephrotic group received enalapril alone, another nephrotic group received enalapril and candesartan simultaneously. Blood samples were drawn at time points after a single oral administration. The concentration of enalaprilat was determined using LC-MS/MS.Compared with control group and nephrotic group received enalapril alone respectively, Tmax of enalaprilat in nephrotic group received both enalapril and candesartan cilexetil prolonged about 21.43% and 6.224%, respectively; AUC(0-t) increased by 185.3% and 60.63%, respectively; Cmax increased by 219.4% and 56.64%, respectively; t1/2 increased by 163.7% and 30.05%, respectively; CL/F reduced by 65.12% and 40.78%, respectively. There were no significant differences of the V1/F of enalaprilat between three groups. The CL/F and t1/2 of enalaprilat showed significant correlations with serum creatinine (Scr) respectively (r = -0.7502; r = 0.5626).The combination with candesartan in nephrotic rats significantly changed the pharmacokinetics of enalaprilat, showing increased accumulation and decreased elimination. In view of these findings, we should lower dosage and prolong dosing interval for nephrotic patients in the combination of enalapril and candesartan.
131 women received Dimelys IUD from April 1, 1985 to March 31, 1986 in Beijing Xuan Wu Hospital. 45 women had the IUD inserted immediately after abortion and the rest had the insertion after menstruation. Follow-up visits were conducted on 1, 3, 6, 12, 18, 24, 30 and 36 months after the insertions. The total time of observation was 4036.5 person months. Data analysis was conducted following Potter Life Table. In the group, 12 women discontinued the use for clinical reasons including 6 cases of pregnancy with IUD implanted and 3 cases of expulsion. 94 cases reported no obvious changes in menstrual bleeding volume or in the length of the menstrual cycle. 22 cases reported minor increase of bleeding volumes, and 10 cases reported spotting. Continuation at 12, 24 and 36 months was 93.11%, 91.56% and 90.78% respectively. compared with copper IUD carriers, the group had lower rate of discontinuation for heavy menstrual bleeding probably because of its fewer contact points with uterine wall and reduced local irritation. Compared with the Thiery's 1987 reports of 12, 24, and 365 months continuation rates of 85.1%, 72.8% and 64%; 2.5% expulsion in three years; 5.7% pregnancy with IUD implanted and 15.7% discontinuation for increased menstrual bleeding and pain based on three-year follow-up study of Dimelys IUD used by 348 women, the group have lower rates for all the above measures.
Objective: To evaluate the clinical efficacy between the minimally-Invasive surgical (MIS)-transforaminal lumbar interbody fusion (TLIF) technique associated with percutaneous pedicle screws in micro endoscopy discectomyand MIS-TLIF technique associated with both sides of the lower lumbar spine Wiltse approach in Quadrant channel with treatment of single segment herniation associated with lumbar instability syndrome. Methods: From January 2012 to January 2015, 75 cases that meet the inclusion and exclusion criteria were treated by retrospective study method, which were divided into two groups in Department of Orthopedics, the Affiliated Hospital of Putian University.Experimental group(30 patients) were treated with MIS-TLIF technique associated with percutaneous pedicle screws in microendoscopy discectomy, control group were treated with MIS-TLIF technique associated with both sides of the lower lumbar spine Wiltse approach in Quadrant Chanel.Compare operation time, blood loss, postoperativehospital stay, clinical efficacy, nailing accuracy, fusion rate, postoperative pain scoring of two groups. Results: The blood loss[(102.1±5.5) min vs(103.7±7.7) min, t=-0.586, P>0.05], postoperative blood loss, hospital stay[(44.6±5.2) ml and(57.2±5.3) ml, (7.3±1.6) d and(9.3±1.9) d; t=-5.813, -2.774, P<0.05], JOA score before and after surgery in same group were statistically significant(P<0.05), respectively.Patients of two groups compared with operation time, clinical efficacy, nailing accuracy[group A: 97.5%, group B: 95.7%; χ(2)=3.00, P>0.05.Postoperative 3 month , group A: 96.7%(29/30), group B: 94.3%(33/35; χ(2)=0.79, P>0.05], fusion rate[group A: 96.7%(29/30), group B: 94.3%(33/35), χ(2)=0.79, P>0.05], preoperative JOA score[(20.4±2.4)score and(7.9±1.0), (19.1±2.7)score and(7.8±1.2)score], postoperative JOA score were no statistically significant respectively, P>0.05. JOA score of both groups were statistically significant respectively Before and after operate.Excellent rate: group A; 84.4%(25/30), group B: 80.0%(28/35), χ(2)=0.43, P>0.05. Conclusion: MIS-TLIF technique associated with percutaneous pedicle screws in micro endoscopy discectomy relative to conventional minimally invasive spine surgery had many advantages: minimal damage, operation conveniently, precisely clinical effect, that is a kind of feasible and reliable minimally invasive surgery which is worth promoting.目的：探讨显微内窥镜(MED)下经皮椎弓根螺钉微创经椎间孔入路椎间融合术(MIS-TLIF)治疗单节段腰椎间盘突出伴腰椎不稳症的临床疗效。 方法：将2012年1月至2015年1月莆田学院附属医院微创脊柱外科收治的经X线片、CT和MRI检查等明确诊断为单节段腰椎间盘突出伴腰椎不稳症，无严重器官功能障碍或系统性疾病的患者65例。30例患者纳入A组，采用MED下髓核摘除＋椎间植骨融合＋经皮椎弓根螺钉内固定治疗。35例患者纳入B组，采用Quadrant通道下腰椎双侧Wiltse入路MIS-TLIF术。比较两组患者手术时间、出血量、术后住院时间、置钉准确性、融合率、术前术后疼痛评分、临床疗效。 结果： A组和B组手术时间分别为(102.1±5.5) min和(103.7±7.7) min(t＝-0.586，P>0.05)；A组和B组术中出血量、术后住院时间分别为(44.6±5.2) ml和(57.2±5.3) ml，(7.3±1.6) d和(9.3±1.9) d(t分别为-5.813、-2.774，均P<0.05)。A组植入120颗椎弓根螺钉，B组植入140颗椎弓根螺钉，A组优良率为97.5%，B组优良率为95.7%(χ(2)＝3.00，P>0.05)。A组术后3个月融合率为96.7%(29/30)，B组术后3个月融合率为94.3%(33/35)(χ(2)＝0.79，P>0.05)。A组和B组术前、术后3个月日本骨科协会评估治疗评分(JOA)分别为(20.4±2.4)分和(7.9±1.0)、(19.1±2.7)分和(7.8±1.2)分；A组、B组术前JOA评分相比，术后JOA评分相比，差异无统计学意义(t分别为1.242、0.178，均P>0.05)；A组术前、术后JOA评分；B组术前、术后JOA评分差异有统计学意义(P<0.05)。两组患者术后临床疗效优良率A组为84.4%(25/30)，B组为80.0%(28/35)，差异无统计学意义(χ(2)＝0.43，P>0.05)。 结论： MED下经皮螺钉MISS-TLIF术为相对常规脊柱微创手术，创伤小，操作便捷，临床疗效确切，是一种可行、可靠的微创手术方式，值得推广。.
OBJECTIVE To study the estimate method of C. chinensis and C. australia. METHOD HPLC was used to determine the contents of four kinds of flavones of C. chinensis and C. australia growing on different hosts. RESULT C. chinensis and C. australia growing on different hosts both had hyperoside, quercetin, kaempferol and isorhamnetin. The content range of hyperoside was 2.790-6.502 mg/g and was higher than other flavones. The content ranges of quercetin, kaempferol and isorhamnetin were 0.025-0.176 mg/g, 0.001-0.213 mg/g and 0.001-0.077 mg/g, respectively. CONCLUSION The contents of hyperoside and quercetin are higher in C. chineasis than in C. australia. The contents of kaempferol and isorhamnetin are lower in C. chinensis than in C. australia. The hosts influence flavones content of C. chinensis and C. australia.
To estimate the incidence rate and effects of risk factors on chronic kidney disease (CKD) in Chinese patients with diabetes, based on Electronic Health Records (EHRs) from the Chinese Electronic health Records Research in Yinzhou (CHERRY) Study.Using the CHERRY cohort study with the individual-level information on chronic disease management; and health administrative, clinical and laboratory databases, patients with diabetes without kidney disease at baseline were enrolled and followed up from January 2009 through December 2016. CKD was defined as the estimated glomerular filtration rate(eGFR) <60 mL/(min×1.73 m2) or urine albumin/creatinine ratio (ACR)≥3 mg/mmol. Standardized incidence rates of CKD in diabetic population were calculated according to the 2010 China census data. Cox proportional hazards models were used to explore the association of risk factors on CKD in patients with diabetes.Over a median 3.2 years of follow-up, 13 829 patients with diabetes were included in this analysis and 1 087 developed CKD. The crude and standardized incidence rate was 23.7(95%CI: 22.3-25.2) and 14.8(95%CI:12.1-17.6) per 1 000 person-years respectively. The incidence rate for developing CKD in patients with diabetes aged over 60 years was higher than those aged 60 and below (26.6 vs. 11.5 per 1 000 person-years, P<0.05). Cox proportional hazards models showed that age over 60 years(HR=1.88, 95%CI: 1.51-2.35), hypertension (HR=1.81, 95%CI: 1.56-2.10), total cholesterol (HR=1.07, 95%CI: 1.00-1.14) and duration of diabetes (HR per year increment=1.02, 95%CI: 1.00-1.03) and the level of high density lipoprotein cholesterol (HDLC, HR=0.49, 95%CI: 0.40-0.61) were significantly associated with CKD. No statistical significance was found for sex, smoking status, alcohol use and average level of fasting glucose (All P>0.05). Subgroup analysis indicated that even when the lipid levels were well-controlled, comorbidity of hypertension was still associated with CKD in the patients with diabetes.Incidence rate of chronic kidney disease in this Chinese population with diabetes was high. Age and comorbidity of hypertension were the most important risk factors for CKD, suggesting the priority for CKD screening in patients with diabetes in China. Control of blood pressure and lipid were especially crucial to prevent CKD in patients with diabetes.
To investigate the protective effect of Resveratrol (RES) on TNF-α-induced inhibition of osteogenic differentiation, thus alleviating the progression of osteoporosis (OP).OP model in rats was first conducted by performing ovariectomy (OVX). Rats were randomly divided into sham group, OVX group, and RES+OVX group. Body weight of each rat was regularly recorded every week. Bone mineral density (BMD) of rat femoral metaphysis was measured by micro-CT. Changes in radial degrees and loads of rat femora were examined through three-point bending experiments. Relative levels of OCN and Runx2 in each group were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Alkaline phosphatase (ALP) activity and calcification ability were assessed through ALP staining and alizarin red staining, respectively. Bone mesenchymal stem cells (BMSCs) were extracted from healthy rats and divided into control group, Tumor necrosis factor-α (TNF-α) group, RES group, and TNF-α+RES group based on different treatments. Relative levels of OCN and Runx2, ALP activity, and calcification ability in each group were detected in the same way. Finally, protein levels of NF-κB and β-catenin in BMSCs were determined.Rats in each group gained body weight during the experimental period, especially those in OVX group and RES+OVX group. No significant difference in the body weight was found between OVX group and RES+OVX group. BMD in rat femora of RES+OVX group was higher than in OVX group but lower than sham group. Elastic/max radial degree and elastic/max load of femora were markedly reduced in OVX group compared to RES+OVX group. Relative levels of OCN and Runx2, ALP activity and calcification ability decreased in OVX group relative to sham group, which were partially reversed by RES treatment. After osteogenic differentiation in BMSCs induced with TNF-α, viability and calcification ability were markedly reduced and were upregulated by RES treatment. Moreover, RES treatment enhanced the downregulated levels of OCN and Runx2 in BMSCs undergoing TNF-α induction. Upregulated protein levels of nuclear factor kappa-B (NF-κB) and β-catenin in TNF-α-induced BMSCs were downregulated by RES treatment.The inhibited osteogenic differentiation of BMSCs undergoing TNF-α induction is improved by resveratrol treatment, which contributes to alleviate the progression of osteoporosis.
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