Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Mucoadhesive buccal films of tramadol for effective pain management / Filmes bucais mucoadesivos de tramadol para o controle eficaz da dor

Abstract Background and objectives: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. Methods: Buccal films of tramadol hydrochloride were prepared by solvent casting method. The prepared films were evaluated for the various evaluation parameters like thickness, surface pH, weight uniformity, content uniformity, folding endurance, swelling index, in vitro drug release study, in vitro test for mucoadhesion and in vivo studies (primary mucosal irritancy test and analgesic activity). Results: All the formulations exhibited good results for physicochemical characterizations. In in vitro drug release study the films exhibited controlled release more than 12 hours. The formulation BFT2 (containing chitosan and PVP K-90) showed no irritant effect on buccal mucosa and elicit the significant in vivo analgesic activity with 57.14% analgesia against that of standard (61.04%). It was concluded that the mucoadhesive films of tramadol hydrochloride can be effectively used to alleviate the severe pain of orthopedic injuries with prompt onset and prolonged action.

Resumo Justificativa e objetivos: O cloridrato de tramadol é um analgésico opioide de ação central que se liga a receptores opioides específicos. É usado no tratamento de dor crônica e recomendado como fármaco de primeira linha para o tratamento no pós-operatório ou em dor aguda induzida por lesão ortopédica. O presente estudo visa a preparar e avaliar o filme bucal mucoadesivo de cloridrato de tramadol como uma nova forma de analgesia prolongada para pacientes com lesões ortopédicas. Método: Filmes bucais de cloridrato de tramadol foram preparados pelo método de evaporação de solvente. Os filmes preparados foram avaliados para os vários parâmetros de avaliação, como espessura, pH da superfície, uniformidade do peso, uniformidade do conteúdo, resistência a dobras, índice de intumescimento, estudo de liberação da droga in vitro, teste in vitro para mucoadesão e estudos in vivo (teste de irritação da mucosa primária e atividade analgésica). Resultados: Todas as formulações apresentaram bons resultados para caracterizações físico-químicas. Em estudo de libertação de droga in vitro, os filmes exibiram liberação controlada por mais de 12 horas. A formulação de BFT2 (com quitosana e PVP K-90) não mostrou efeito irritante sobre a mucosa bucal e provocou uma atividade analgésica significativa in vivo com 57,14% de analgesia versus a do padrão (61,04%). Concluiu-se que os filmes mucoadesivos de cloridrato de tramadol podem ser usados eficazmente para aliviar a dor intensa de lesões ortopédicas com início rápido e ação prolongada.

Valsartan decreases platelet activity and arterial thrombotic events in elderly patients with hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiotensin type 1 receptor (AT 1 R) antagonists are extensively used for blood pressure control in elderly patients with hypertension. This study aimed to investigate the inhibitory effects of AT 1 R antagonist valsartan on platelet aggregation and the occurrence of cardio-cerebral thrombotic events in elderly patients with hypertension.</p><p><b>METHODS</b>Two-hundred and ten patients with hypertension and aged > 60 years were randomized to valsartan (n = 140) or amlodipine (n = 70) on admission. The primary endpoint was platelet aggregation rate (PAR) induced by arachidonic acid at discharge, and the secondary endpoint was the rate of thrombotic events including brain infarction and myocardial infarction during follow-up. Human aortic endothelial cells (HAECs) were stimulated by angiotensin II (Ang II, 100 nmol/L) with or without pretreatment of valsartan (100 nmol/L), and relative expression of cyclooxygenase-2 (COX-2) and thromboxane B 2 (TXB 2 ) and both p38 mitogen-activated protein kinase (p38MAPK) and nuclear factor-kB (NF-kB) activities were assessed. Statistical analyses were performed by GraphPad Prism 5.0 software (GraphPad Software, Inc., California, USA).</p><p><b>RESULTS</b>PAR was lower after treatment with valsartan (11.49 ± 0.69% vs. 18.71 ± 2.47%, P < 0.001), associated with more reduced plasma levels of COX-2 (76.94 ± 7.07 U/L vs. 116.4 ± 15.89 U/L, P < 0.001) and TXB 2 (1667 ± 56.50 pg/ml vs. 2207 ± 180.20 pg/ml) (all P < 0.001). Plasma COX-2 and TXB 2 levels correlated significantly with PAR in overall patients (r = 0.109, P < 0.001). During follow-up (median, 18 months), there was a significantly lower thrombotic event rate in patients treated with valsartan (14.3% vs. 32.8%, P = 0.002). Relative expression of COX-2 and secretion of TXB 2 with concordant phosphorylation of p38MAPK and NF-kB were increased in HAECs when stimulated by Ang II (100 nmol/L) but were significantly decreased by valsartan pretreatment (100 nmol/L).</p><p><b>CONCLUSIONS</b>AT 1 R antagonist valsartan decreases platelet activity by attenuating COX-2/TXA 2 expression through p38MAPK and NF-kB pathways and reduces the occurrence of cardio-cerebral thrombotic events in elderly patients with hypertension.</p>

TCM topical and enema in the treatment of 35 patients with recurrent endometrial shift disease / 中国基层医药

Objective To investigate the clinical effects of TCM herbs and enema in the treatment of recurrent uterine endometriosis and control of endometriosis recurrence.Methods The recurrent endometriosis patients were randomly divided into two groups,35 cases were treated with TCM herbs and Chinese medicine enema as the observation group,35 ninhydrin treatment of patients with pregnancy-ene as the control group,two groups of patients were treated for six months,the clinical efficacy and adverse reactions were observed.Results After treatment,VRS scores compared with the corresponding group before treatment was significantly lower.VRS scores in the observation group after treatment was significantly lower than the control group.The amenorrhea rate was significantly higher than control group,the complex tidal time at the end of treatment compared with the control group was significantly shorter,the observation group,no case of adverse reactions,the control group,patients experienced adverse events,observation group 4 cases(8.57％) recurrence,in the control group of 10 cases(28.57％) relapse,the difference between the two groups were statistically significant,The patients treatment of 30 cases of lesions decreased in size,the control group,had 28 cases of lesions smaller in size,there was no significant difference.Condtusion Chinese herbal enema and topical treatment of recurrent uterine endometriosis had significant efficacy,no adverse reactions,late recurrence is low.

Effects of slow release-fertilizers on yield, nutrient contents and quality of Coptis chinensis / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of four kind of slow-release fertilizers on yield and quality of Coptis chinensis.</p><p><b>METHOD</b>One to three years C. chinensis was fertilized with slow-release fertilizers twice in April and in September. The yield and nutrient content along with quality of C. chinensis were measured after two years growth.</p><p><b>RESULT AND CONCLUSION</b>All of the slow-release fertilizers increased the yield obviously, and the effect of SRF1 and SRF4 is the most significant. Comparing with control group, the N content in aerial part of 1-2 year-old C. chinensis treated with SRF1 and SRF4 was lower and P and K were higher than that of control group, and the N content in aerial part of 3 year-old C. chinensis treated with SRF1 and SRF4 was higher and P and K were higher than that of control group; The N content in the root of land 3 year-old C. chinensis treated with SRF1 and SRF4 showed no significant difference comparing with control group, and P and K were lower than that of control group, the N and P content in root of 2 year-old C. chinensis treated with SRF1 and SRF4 was higher and K were lower than that of control group. After two years growth berberine content of C. chinensis treated with SRF1, SRF2 and SRF3 were significantly increased, and total alkaloid content of C. chinensis treated with SRF1, SRF3 and SRF4 were significantly increased. We recommend that SRF4 is used as the special fertilizer for 1-year-old C. chinensis, and the SRF1 and SRF4 for 2-year-old C. chinensis, and the SRF1 for 3-year-old C. chinensis.</p>

Video-assisted thoracoscopic sympathectomy for the treatment of palmar hyperhidrosis in 588 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of video-assisted thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis and introduce the clinical experience in the prevention of complications.</p><p><b>METHODS</b>The clinic data of 588 cases of palmar hyperhidrosis who underwent bilateral sympathectomy from January 2003 and March 2007 was analyzed retrospectively. The curative results were compared between the T(2) levels denervation group (group A) and the T(2) levels remained denervation group (group B).</p><p><b>RESULTS</b>All operations were successfully performed under thoracoscope without severe morbidity and mortality. The curative rate of palmar hyperhidrosis was 99.8%. Accompanied axillary sweating and plantar sweating were improved in 84.0% and 71.0% patients respectively. All the patients were evaluated by a follow-up for 1 to 48 months with an average time of (20.3 +/- 2.3) months on the aspects of curative effect and occurrence of compensatory sweating. During one week after surgery, the transient postoperative hand sweating recurred in 10 cases and then disappeared within 1 to 3 days. Two cases experienced gustatory hyperhidrosis. One case experienced hand sweating at 8 th month postoperative. Side-effect of compensatory sweating were observed in 28.0 percent of group A and 13.4 percent of group B (P < 0.01).</p><p><b>CONCLUSIONS</b>Video-assisted thoracoscopic sympathectomy is an effective, safe and minimally invasive method for the treatment of hyperhidrosis. The method of T(2) levels remained denervation appears associated with less compensatory sweating.</p>

Epidemiological survey of primary palmar hyperhidrosis in adolescents / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Despite recent advances in recognition and treatment of primary palmar hyperhidrosis (PPH), the epidemiological survey has hardly been conducted. The aim of this study was to investigate the prevalence and epidemiological characteristics of primary PPH among adolescents in three cities of southeast China.</p><p><b>METHODS</b>Stratified-cluster sampling was carried out and cross-sectional epidemiological survey by questionnaire was applied among 33 000 college and high school students.</p><p><b>RESULTS</b>The prevalence rate of PPH was 4.36% affecting both sexes equally. Prevalence rate of severe PPH was 0.27%. The average age of onset was 12.27 +/- 2.12 years. The peak age of onset was 6 - 16 years, accounting for 97.2% of PPH population. Positive family history was found in 17.9% PPH cases. Besides palms, axillae and soles can be also affected.</p><p><b>CONCLUSIONS</b>PPH affects a larger group of individual than previously reported. More measures should be taken to enhance the recognition, diagnosis, and treatment of PPH.</p>