Integrating Patient Concerns into Parkinson’s Disease Management

Parkinson’s disease (PD) is a complex motor and non-motor disorder and management is often challenging. In this review, we explore emerging approaches to improve the care of patients, drawing from the literature regarding patient-centred care, patient and caregiver perspectives and priorities, gaps in knowledge among patients and caregivers and the need for accurate information, individual variability in disease manifestations, prognostication of disease course, new developments in health technologies and personalized medicine, specialty care, pharmacological and non-pharmacological management, financial burden, lifestyle and work-related issues, support groups and palliative care.     

右冠状动脉介入治疗的临床疗效及安全性观察

目的　观察右冠状动脉 (冠脉 )介入治疗 (PCI)的临床疗效及安全性。方法　回顾性分析 1995— 2 0 0 2年间进行的 188例 2 0 2处右冠脉靶血管介入治疗的特点。结果　 188例右冠脉病变共 2 0 2处右冠脉靶血管 ,靶血管介入成功率为 91 1%,其中 15 0例植入支架 174枚 ;PCI失败 18例 ,均发生在右冠脉近中段 ;室颤 2例 ,PCI后无复流现象 6例 ,早期急性冠脉闭塞 1例 ,冠脉破裂 3例 ,死亡 3例。随访 1～ 96月 ,绝大多数临床症状改善。结论　右冠脉病变的PCI是一项成功率高、并发症少、近远期临床疗效俱佳的治疗手段。     

Dried Ginger Extract Restores the T Helper Type 1/T Helper Type 2 Balance and Antibody Production in Cyclophosphamide-Induced Immunocompromised Mice after Flu Vaccination

Dried ginger (Zingiberis Processum Rhizoma (ZR)) is frequently used to prevent or treat common cold and flu. This study aimed to investigate the influence of ZR extracts on influenza-specific antibody production in cyclophosphamide (Cy)-induced immunocompromised mice. Female BALB/c mice were injected three times with saline or Cy. To investigate the effect of ZR, either distilled water or ZR was administered orally to mice daily for 10 days after Cy injection. After ZR administration, the mice were immunized with the 2017/2018 influenza vaccine. Pretreatment with ZR extracts enhanced influenza-specific antibody production in Cy-induced immunocompromised mice after flu vaccination and restored the influenza antigen-specific T helper (Th) type 1/Th2 balance to the normal state. Further, ZR suppressed the eosinophil enrichment caused by Cy injection in the spleen. We demonstrated that ZR can be used to increase antibody production in immunocompromised individuals before vaccination.     

冠心病患者白细胞表面粘附蛋白的表达研究

目的　观察冠心病患者三种白细胞表面粘附相关蛋白的表达及其与冠心病严重性和冠状动脉狭窄程度的关系。方法　采用流式细胞仪免疫荧光法测定中性粒细胞、单核细胞和淋巴细胞表面粘附相关蛋白 CD1 1 a和CD1 1 b含量。结果　冠心病组淋巴细胞及中性粒细胞表面粘附蛋白 CD1 1 b的表达明显高于正常人 ,尤以不稳定型组增高显著 (P<0 .0 1～ 0 .0 5 )。尽管在冠脉病变狭窄 >80 %组 ,其三种白细胞的 CD1 1 b水平高于狭窄程度轻的组 ,但尚未见统计学差异。结论　冠心病存在炎症反应 ,外周血中性粒细胞、淋巴细胞 CD1 1 b表达增高 ,是冠心病疾病加重的反映     

医院中药现代物流管理的应用探讨

本文从分析我国发展医院中药物流管理的必要性入手,研究现代物流管理理念在医院中药流通过程中的应用,探讨医院中药物流管理的具体内容,提出我国医院中药物流管理发展的对策和建议,以期达到降低医院经营成本,保障中药质量,提升医院整体竞争力的目的。     

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study

Background  Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.

Methods  Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm³ for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.

Results  Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas—acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.

Conclusions  In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.

     

Continued Postoperative Use of Tumor Necrosis Factor-α Inhibitors for the Prevention of Crohn’s Disease Recurrence

Background/AimsMany patients with Crohn’s disease (CD) undergo intestinal resection during the disease course. Despite surgery, postoperative recurrence (POR) commonly occurs. Although postoperative use of tumor necrosis factor α (TNF-α) inhibitors is known to be effective in preventing POR, few studies have evaluated the effectiveness of continuing the same TNF-α inhibitors postoperatively in patients who received TNF-ɑ inhibitors before surgery.MethodsThis retrospective observational study was performed in a single tertiary medical center. We retrospectively reviewed patients who had undergone the first intestinal resection due to CD and divided them into two groups TNF-α inhibitor users in both the preoperative and postoperative periods, and TNF-α inhibitor users in only the preoperative period. We compared the clinical outcomes between these two groups.ResultsIn total, 45 patients who used TNF-α inhibitors preoperatively were recruited. Among them, TNF-α inhibitors were used postoperatively in 20 patients (44.4%). The baseline characteristics except age at diagnosis were similar in both groups. The rates of surgical and endoscopic recurrence were not different between the two groups, but the cumulative clinical recurrence rate was significantly lower in the postoperative TNF-α inhibitors group (log-rank p=0.003). In multivariate Cox regression analysis, postoperative TNF-α inhibitors use was significantly associated with a decreased risk of clinical recurrence (adjusted hazard ratio, 0.204; 95% confidence interval, 0.060 to 0.691; p=0.011).ConclusionsContinuing TNF-α inhibitors postoperatively in patients who were receiving TNF-α inhibitors before surgery significantly reduced the rate of clinical recurrence. For patients with CD who received TNF-α inhibitors preoperatively, continuing their use after surgery could be recommended.     

Safety,tolerability, and pharmacokinetics of single and multiple topical ophthalmic administration of imatinib mesylate in healthy subjects

For the long‐term efficacy of dry eye disease treatment, relieving underlying inflammation is necessary. Imatinib mesylate is a novel ophthalmic formulation of imatinib mesylate, which is expected to alleviate inflammation by inhibiting the discoidin domain receptor 1 activity. This study aims to evaluate the safety and pharmacokinetics of imatinib mesylate in healthy subjects. A randomized, double‐blind, placebo‐controlled study was conducted. In a single ascending dose, 16 subjects received a single eye drop of imatinib mesylate 0.1%, 0.3%, or matching placebo. In the multiple ascending dose (MAD), subjects received multiple eye drops of imatinib mesylate 0.1%, 0.3%, or matching placebo once daily for 7 days. Safety and tolerability were assessed by ophthalmic examination, including the visual analog scale (VAS) to monitor the burning sensation in the eyes. A total of four treatment‐emergent adverse events (TEAEs) occurred during the study. All TEAEs were mildly severe with no serious cases. VAS results in the 0.1% MAD group exhibited highest score of two points, whereas it was less than one point in others. Insignificant difference between the imatinib mesylate and placebo groups in the VAS results was seen. After a single dose administration of imatinib mesylate 0.1%, all plasma concentrations were below the lower limit of quantification. The peak plasma concentrations of imatinib were less than 0.54 µg/L in all groups. In conclusion, a single and multiple topical ophthalmic administration of imatinib mesylate was well‐tolerated in healthy subjects. Because there was minimal systemic exposure to imatinib, the adverse effect in the body seems to be insignificant.