The quality of life in Chinese population with chronic non-communicable diseases according to EQ-5D-3L: a systematic review

Purpose

Over the past decade, a changing spectrum of disease has turned chronic non-communicable diseases (CNCDs) into the leading cause of death worldwide. During the 2015 in China, there were more than 6.6 million deaths from NCDs, which was the highest rate around the world. In the present study, we performed a systematic review to analyze the health-related quality of life (HRQoL) according to EQ-5D-3L instrument in patients with different kinds of CNCDs in China.

Methods

We searched PubMed, Embase, Web of Science, Cochrane Library, VIP, WanFang Data, and CNKI databases up to April 12, 2018, to identify all relevant studies that reported on HRQoL assessed by EQ-5D-3L instrument in Chinese patients with CNCDs. Expert consultation and hand-searching of reference lists from retrieved studies were employed to identify additional references. The variation of mean utility values, EQ-VAS score ranges, and responses for each EQ-5D dimension described in relevant studies were extracted.

Results

A total of 5027 English-language articles and 618 Chinese-language articles were identified, among which 38 articles met full inclusion criteria. These 38 studies involved 18 kinds of CNCDs. In this review, the health utility for diabetes mellitus ranged from 0.79 to 0.94 (EQ-5D VAS scores from 61.5 to 78.6), hypertension from 0.78 to 0.93 (70.1–77.4), coronary heart disease from 0.75 to 0.90 (71.0–77.0), chronic obstructive pulmonary disease from 0.64 to 0.80 (55.0–67.0), epilepsy from 0.83 to 0.87 (78.3–79.6), cerebral infarction from 0.51 to 0.75 (49.7–79.0), while children cerebral palsy was 0.44 (27.3).

Conclusions

EQ-5D-3L is widely used in studies of HRQoL associated with CNCDs in China. Our results suggest that many factors may influence the measurement results of health utilities, including age, gender, sample source, comorbidities, rural/urban, and EQ-5D-3L value sets.

     

HIV-1 Glycoprotein 120 Enhancement of N-Methyl-D-Aspartate NMDA Receptor-Mediated Excitatory Postsynaptic Currents: Implications for HIV-1-Associated Neural Injury

It is widely accepted that human immunodeficiency virus type 1 (HIV-1) envelope glycoprotein 120 (gp120) plays an important role in HIV-1-induced neural injury and pathogenesis of HIV-1-associated dementia (HAND). Multiple pathways have been proposed for gp120-induced neurotoxicity, amongst is the activation of N-Methyl-D-Aspartate receptors (NMDARs). It has been shown that gp120 causes neuronal injury or death and gp120 transgenic mice exhibit neurological similarity to that of HAND, all of which can be blocked or attenuated by NMDAR antagonists. Several lines of evidence indicate the subtype and location of activated NMDARs are key determinants of the nature of NMDAR physiology. To examine the subtype and the location of NMDARs affected by gp120, we studied gp120 on subtype NMDAR-mediated EPSCs in the CA1 region of rat hippocampal slices through “blind” whole-cell patch recordings. Our results showed bath application of gp120 increased both NR2A- and NR2B-mediated EPSCs possibly via a presynaptic mechanism, with much stronger effect on NR2B-mediated EPSCs. In contrast, gp120 failed on enhancing AMPA receptor-mediated EPSCs. Ca²⁺ imaging studies revealed that gp120 potentiated glutamate-induced increase of intracellular Ca²⁺ concentration in rat hippocampal neuronal cultures which were blocked by a NMDAR antagonist, but not by an AMPA receptor antagonist, indicating gp120 induces Ca²⁺ influx through NMDARs. Further investigations demonstrated that gp120 increased the EPSCs mediated by extrasynaptic NR2BRs. Taken together, these results demonstrate that gp120 interacts with both NR2A and NR2B subtypes of NMDARs with a predominant action on the extrasynaptic NR2B, implicating a role NR2B may play in HIV-1-associated neuropathology.     

右美托咪定对先天性心脏病患儿围手术期心肌及脑损伤的影响

目的：探讨右美托咪定对先天性心脏病患儿围手术期血流动力学、心肌及脑功能指标的影响。方法：选取海南省人民医院及四川大学华西第二医院2017年8月至2018年8月收治的房间隔缺损或室间隔缺损需行修补术患儿98例,随机分为观察组（49例）和对照组（49例）。对照组进行基础常规麻醉、气管插管和机械通气,观察组在对照组基础上静脉注射右美托咪定,剂量为0.5 μg/(kg·d),直到手术完成。检测两组患儿体外循环（CPB）开始前（T1）、CPB结束10 min（T2）、术后6 h（T3）和术后12 h（T4）4个时间点血流动力学指标（心率、收缩压、舒张压）,在这4个时间点分别采集血液,采用ELISA试剂盒检测S-100β和神经元特异性烯醇化酶（NSE）水平以及缺血修饰白蛋白（IMA）、心肌肌钙蛋白I（cTnI）水平。结果：与对照组比较,观察组T2、T3时间点心率降低（P<0.05）,收缩压、舒张压升高（P<0.01）;观察组T2、T3、T4时间点IMA、cTnI、S-100β、NSE水平均降低（P<0.01）。与T1时间点比较,观察组T2和T3时间点心率均升高（P<0.05）;收缩压和舒张压各时间点比较差异无统计学意义（P>0.05）;T2、T3、T4时间点IMA、cTnI、S-100β、NSE水平显著升高（P<0.05）。结论：右美托咪定可维持先天性心脏病患儿动脉血压的稳定、降低心率、改善心肌损伤,降低NES和S-100β蛋白的水平。     

Cefoperazone-sulbactam and risk of coagulation disorders or bleeding: a retrospective cohort study

ABSTRACT

Objectives: Limited evidence has suggested that cefoperazone-sulbactam causes coagulation disorders and bleeding.

Methods: The authors conducted a retrospective study to compare patients receiving cefoperazone-sulbactam versus those treated with cefoperazone-tazobactam or ceftazidime. Propensity-score matching was used to explore whether treatment with cefoperazone-sulbactam increased the risk of prothrombin time (PT) prolongation, coagulation disorders, and bleeding, or decreased platelets (PLT).

Results: The cohort included 23,242 patients. Among patients receiving cefoperazone-sulbactam, the risk of PT prolongation, coagulation disorders, decreased PLT, and bleeding was 5.3%, 9.2%, 15.7%, and 4.2%, respectively. Propensity-score matching analyses suggested that cefoperazone-sulbactam increased the risk of PT prolongation (aOR 2.26, 95% CI 1.61–3.18), coagulation disorders (aOR 1.81, 95% CI 1.43–2.30), and decreased PLT (aOR 1.46, 95% CI 1.25–1.72), but not increase bleeding (aOR 1.05, 95% CI 0.79–1.40) compared with ceftazidime. Patients receiving cefoperazone-sulbactam had higher risk of PT prolongation (aOR 1.53, 95% CI 1.11–2.10), coagulation disorders (aOR 1.53, 95% CI 1.21–1.95), but not decreased PLT (aOR 0.93, 95% CI 0.81–1.07) or bleeding (aOR 1.11, 95% CI 0.87–1.42), compared with those receiving cefoperazone-tazobactam.

Conclusion: Cefoperazone-sulbactam may be associated with a higher risk of PT prolongation and coagulation disorders compared with cefoperazone-tazobactam and ceftazidime.     

Th17细胞在类风湿关节炎发病机制中的作用研究进展

类风湿关节炎(rheumatoid arthritis,RA)是临床常见炎症性自身免疫疾病,以早期进行性关节滑膜炎症为主要临床特征,晚期则多以关节软骨破坏及骨侵蚀为主要病理特征。RA病因复杂,病理机制至今未明,发病率高,5年期致残率高。Th17细胞作为CD4+T细胞的亚群之一,其分泌的IL-17、IL-21等促炎性细胞因子,在RA关节滑膜炎症和关节软骨破坏及骨侵蚀等多个病理环节均发挥重要作用。基于此,本文对近年来Th17细胞参与RA关节滑膜炎症和关节软骨破坏及骨侵蚀病程的相关研究文献进行综述和讨论,以期为RA发病机制研究提供新思路,为以Th17细胞为作用靶点的创新药物开发提供参考。     

天麻内生真菌提取物抗氧化活性及天麻素的测定（英文）

天麻是一种治疗头痛眩晕的传统中药材。然而,由于过度挖掘,其野生资源紧缺。本研究从荥经天麻中分离到14株内生真菌,对其中10株进行了鉴定,分别属于新丛赤壳属、子囊菌属、镰刀菌、树粉孢属、聚生小穴壳菌。以总抗氧化能力、DPPH自由基清除能力为指标,研究了10株内生真菌菌丝体醇提物抗氧化活性,并测定其总多酚和总黄酮含量。结果表明, GER6 (树粉孢属)和GER2 (子囊菌属)显示出良好的体外抗氧化活性,这可能与其酚类含量较高相关。但是在10株天麻内生真菌中仅GER6 (树粉孢属)中含有天麻素,其含量为39.2μg/g。综上可知,天麻内生真菌GER6 (树粉孢属)有望开发成为一种天然抗氧化剂,并有可能成为天麻替代品种。     

Interaction of deoxyschizandrin and schizandrin B with liver uptake transporters OATP1B1 and OATP1B3

1. Deoxyschizandrin and schizandrin B have diverse pharmacological effects, including hepatoprotective activity. We aim to study their hepatic uptake and their effects on the hepatic uptake of other clinical drugs mediated by OATP1B1 and OATP1B3.

2. Deoxyschizandrin exhibited a high affinity for OATP1B1 with K_m of 17.61?±?0.43?μM but a low affinity for OATP1B3. Similarly, schizandrin B also showed a strong affinity for OATP1B1 with K_m of 18.45?±?1.23?μM but a weak affinity for OATP1B3.

3. Atorvastatin and rifampicin could inhibit the uptake of deoxyschizandrin and schizandrin B mediated by OATP1B1.

4. Intriguingly, both deoxyschizandrin and schizandrin B significantly promoted the uptake of atorvastatin (with EC₅₀ of 50.58?±?8.08 and 24.70?±?5.82 µM, respectively) and rosuvastatin (with EC₅₀ of 13.46?±?2.70 and 8.99?±?4.73 µM, respectively) mediated by OATP1B1. Deoxyschizandrin could markedly promote the uptake of fluvastatin but inhibit the uptake of sodium taurocholate (TCNa) mediated by OATP1B1.

5. The promotion on hepatic uptake of statins mediated by OATP1B1 might lead to enhanced efficacy of cholesterol lowering and reduced risk of myopathy for hyperlipidemia patients when given statins together with deoxyschizandrin or schizandrin B.     

古尼拟青霉对小鼠缺血性脑损伤保护作用研究

探讨古尼拟青霉对小鼠急性脑损伤的保护作用。发现古尼拟青霉能显著延长小鼠断头后张口呼吸持续的时间,使小鼠双侧颈总动脉（含迷走神经）不完全结扎后的存活时间明显延长,提示该药可能对缺血性脑损伤有一定的保护作用。     

ClinicalControlled Study of Shenmai Injection(参麦注射液)and Aminophylline on DiaphragmFatigue

Objective: To compare the therapeutic effect of Shenmai injection (SM) and aminophylline (AP) on diaphragm fatigue in chronic obstructive pulmonary disease ( COPD ).Methods: Sixty-four COPD patients with respiratory failure and diaphragm fatigue were randomly divided into 2 groups. The SM group (n=33) was treated with oxygen inhalation, anti-infection agents, and SM injection (SM 40ml + 10% glucose 100ml). The AP group (n=31) was treated by the same comprehensive treatment but with AP 0. 25g instead of SM. The initial time of diaphragm fatigue disappearance, 24 hrs maintaining effect and the arterial blood gas analysis were observed.Results: The effect in 30 min and maintaining effect in 24 hrs in SM group were better than those in AP group. In both groups, PaO₂ increased and PaCO₂ decreased.Conclusion: The therapeutic effect of SM on COPD patients with respiratory failure and diaphragm fatigue was better than those of AP.