ObjectiveTo evaluate the usage status of drugs in the treatment of senile cerebral infarction in Xuanwu Hospital of Capital Medical University in 2011, and to provide references for rational usage of drugs for inpatients with senile cerebral infarction. MethodsMedical records of the elderly (≥60 years old) inpatients with cerebral infarction in Xuanwu Hospital in 2011 were collected. ATC codes were used to standardize names of drug and classifications. Patients' general information, number of patients' used drugs, Defined Daily Doses (DDDs), and Drug Utilization Index (DUI) were calculated by using Microsoft Excel 2007 to evaluate the rationality of drugs usage. ResultsA total of 430 patients were included. The average age was 70.61±7.29 years old. The average types of diseases were 5.39. The major combined disease was circulatory system disease, accounting for 42.45%. A total of 15 656 medication records were included, involving 243 kinds of drugs (including different administration routes). The average number of used drugs for each patient during the admission was 17.11. The top 5 drugs based on percentage of patients with drug use were Ginkgo Biloba Preparation (injection), clopidogrel (oral), prostaglandin E1 (injection), atorvastatin (oral) and cinepazide (injection). The top 5 drugs of DDDs were Ginkgo Biloba Preparation (injection), ipratropium bromide (inhalation), prostaglandin E1 (injection), folic acid (orla), and clopidogrel (oral). The top 5 drugs of DUI were vitamin B12 (injection), multi-vitamin (oral), nikethamide (injection), methylprednisolone (injection), and vitamin C (oral). ConclusionFor therapeutic drugs used among the elderly patients with cerebral infarction in Xuanwu Hospital of Capital Medical University, the choice, dosage and administration route of medication are rational. However, the drugs with higher DUI are not related with major diseases, which indicates that we should pay attention to the irrational drug use of clinical application, so as to ensure safety, effectiveness and economy of drug application.
ObjectiveTo explore effect and mechanism of the carcinoma associated fibroblasts (CAFs) of breast cancer on growth and metastasis of breast cancer induced in nude mice by inoculation of CAFs and breast cancer cells. MethodsBreast cancer cell line of MDA-MB-231 (abbreviated as MDA), CAFs, and normal breast tissue fibroblasts (NFs) of the same breast cancer patient were collected, and mixed with normal saline (NS) or SDF-1 ligand blockers of four nitrogen heterocyclic fourteen alka (AMD3100, abbreviated as AMD) for inoculation of nude mice in vivo. According to the different combination, 36 nude mice were randomly divided into 6 groups:MDA+NS group, NFs+NS group, MDA+NFs+NS group, MDA+NFs+AMD group, MDA+CAFs+AMD group, and MDA+CAFs+NS group. Forty six days after the inoculation and feeding, volume of tumor, metastasis of lymph node, lung or liver were observed. In addition, level of plasma SDF-1 was tested by using ELISA method, and expressions of SDF-1 mRNA and protein in tumor specimens were detected by using real-time PCR and Western blot method respectively. ResultsExcept for NFs+ NS group, implanted tumor could be seen in nude mice of other 5 groups. In MDA+CAFs+NS group, the volume of tumor[(9.092±2.662) cm3], level of plasma SDF-1[(75.25±16.23) ng/L], and expression levels of SDF-1 mRNA (the median level was 14.714) and protein (the median level was 0.673). of tumor tissue were significantly greater or higher than those of the other 5 groups (P < 0.050). In addition, lymph node metastasis were found in 4 mice in MDA+CAFs+NS group, and 2 in MDA+NS group. The tumor metastasis of lung and liver was not found in all nude mice. ConclusionsCAFs can promote growth and lymph node metastasis of breast cancer, whose mechanism is related with SDF-1 secreted by CAFs and SDF-1/CXC chemokine receptor 4 (CXCR4), signal pathway.
ObjectiveTo investigate the effectiveness of one-stage repair and reconstruction of multiple ligament injuries of the knee under arthroscopy. MethodsBetween March 2007 and March 2009,25 patients (25 knees) with multiple ligament injuries of the knee underwent one-stage repair and reconstruction under arthroscopy.Of 25 cases,16 were male and 9 were female with an average age of 29.6 years (range,18-43 years).The causes of injury were traffic accident injury in 20 cases,falling injury from height in 3 cases,and sport injury in 2 cases.The time between injury and surgery was 8-14 days (mean,10.5 days).The preoperative Lysholm score was 37.92±3.57.The X-ray film and MRI examinations showed that 17 patients had tears of anterior cruciate ligament (ACL),posterior cruciate ligament (PCL),and medial collateral ligament,and 8 patients had tears of ACL,PCL,and posterolateral corner (PLC);5 cases had medial meniscus injury and 7 cases had lateral meniscus injury.The ACL,PCL,and PLC were reconstructed under arthroscopy with autologous tendon or allogeneic tendon,and the MCL was repaired.Early active and passive functional exercises were done postoperatively. ResultsAll the incisions healed by first intention,and there was no complications of infection and deep venous thrombosis.Twenty-five patients were followed up 24-78 months (mean,50.9 months).Six patients had knee stiff postoperatively;after manipulation under anesthsia,5 patients lost less than 15° of flexion and only 1 patient lost 26° of flexion.At last follow-up,the stability of the knee joint was significantly improved.There were significant differences in the anterior drawer test,posterior drawer test,Lachman test,and varus stress and valgus stress testing at 30° between at last follow-up and at preoperation (P<0.05).The postoperative Lysholm score was 87.84±4.85,which was significantly better than the preoperative score (t=52.053,P=0.000).The International Knee Documentation Committee (IKDC) rating was nearly normal in 16 cases (64%),abnormal in 8 cases (32%),and obviously abnormal in 1 case (4%). ConclusionOne-stage repair and reconstruction of multiple ligament injuries of the knee under arthroscopy can effectively restore the function of the knee joint,and the effectiveness is reliable.