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Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.
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Bariatric surgery is the most effective treatment for obesity with or without type 2 diabetes mellitus and its complications. With the growing incidence of type 2 diabetes mellitus, the number of hospitals performing bariatric surgery and surgical cases increase substantially. The problems in operation standardization, quality control of operation and postoperative management of the patients cause the failure in weight loss, hypoglycemia and severe complications, and revisional surgery is often required to correct the condition. We report a case of laparoscopic revisional surgery following nonstandard gastric bypass, and the reasons for failure of weight loss in first bariatric surgery, the current situation of bariatric surgery and revisional metabolic surgery were analyzed. This case demonstrates the clinical necessity of revisonal bariatric surgery and the importance of selection of the surgical approaches and indications.
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With the mutual communication and penetration of traditional Chinese medicine and modem medicine,the combination of traditional Chinese and western medicine is common in clinical practice.However,since western-style doctor is usually lack of traditional Chinese medicine theory knowledge,many problems exist in the combination of Chinese and western medicine.The problem that Chinese medicine containing ephedra alkaloids in combination with western medicine in pediatric medicine is especially serious.Because of the complexity of the children's drugs,improper use of the ephedra alkaloids is prone to adverse reactions.A comprehensive analysis of drugs containing ephedra alkaloids existing in the pediatric clinical application is performed,and in order to provide guidance for clinical rational drug use.
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Objective o evaluate the efficacy and safety of perampanel in the treatment of refractory partial-onset seizures.Methods The randomized controlled trials ofperampanel in treatment of refractory partial-onset seizures were searched from PubMed,EBSCO,EMbase,Cochrane Library,CBM,CNKI,VIP database,and Wanfang database by computer.Data were collected from establishment of the database to February 2017 and the each index was analyzed by meta-analysis with RevMan 5.0 software.Results Five RCT were included,including 1 500 patients with refractory partial-onset seizures.Meta-analysis results showed that there was a significant difference between perampanel and placebo in term of seizure-free rate [OR=3.75,95％CI(1.77,7.93),P =0.000 6] and percentage of patients achieving 50％ reduction in seizure frequency [OR=2.08,95％CI(1.69,2.56),P ＜ 0.001].Common adverse reactions of perampanel were dizziness,somnolence,headache,ataxia,nasopharyngifis,etc.The total rate of adverse reactions of the two Perampanel groups of 8 mg group and 12 mg group doses were higher than placebo group (P ＜ 0.05).Conclusion The clinical efficacy of perampanel in the treatment of refractory partial-onset seizures,and the adverse reactions is slight,patient is well tolerated.
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Objective o evaluate the efficacy and safety of perampanel in the treatment of refractory partial-onset seizures.Methods The randomized controlled trials ofperampanel in treatment of refractory partial-onset seizures were searched from PubMed,EBSCO,EMbase,Cochrane Library,CBM,CNKI,VIP database,and Wanfang database by computer.Data were collected from establishment of the database to February 2017 and the each index was analyzed by meta-analysis with RevMan 5.0 software.Results Five RCT were included,including 1 500 patients with refractory partial-onset seizures.Meta-analysis results showed that there was a significant difference between perampanel and placebo in term of seizure-free rate [OR=3.75,95％CI(1.77,7.93),P =0.000 6] and percentage of patients achieving 50％ reduction in seizure frequency [OR=2.08,95％CI(1.69,2.56),P ＜ 0.001].Common adverse reactions of perampanel were dizziness,somnolence,headache,ataxia,nasopharyngifis,etc.The total rate of adverse reactions of the two Perampanel groups of 8 mg group and 12 mg group doses were higher than placebo group (P ＜ 0.05).Conclusion The clinical efficacy of perampanel in the treatment of refractory partial-onset seizures,and the adverse reactions is slight,patient is well tolerated.
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Extraction is the critical link during pharmaceutical process of traditional Chinese medicine (TCM), which is directly related to the quality of drugs. So the key to technology upgrading of pharmaceutical equipment in Chinese materia medica enterprise is the development of new extraction techniques, which concerns the modernization of TCM. In this paper, fundamentals, traits, and development status of new extraction technologies were firstly introduced, including ultrasound extraction, microwave extraction, super fluid extraction, semi-bionic extraction method, enzymatic treatment extraction, continuous countercurrent extraction, vacuum extraction. Then information of projects supported by the National Natural Science Foundation of China was analyzed in order to recognize the assistance and research results of new extraction techniques. The patents authorized by the State Intellectual Property Office were also summarized for the purpose of understanding the achievement transformation. The information about extraction equipments was collected and screened to acquire the characteristics and market situation. The results showed that there are still problems about new extraction technologies, such as weak basic study, hard transformation of achievements, and the disconnection between research study and practical application. It is necessary to discuss the approaches and methods for accelerating the transformation of fundamental research, which will provide references for the long-term development of new extraction techniques of TCM.