Application of continuous renal replacement therapy in the treatment of neonates with inherited metabolic diseases / 中国当代儿科杂志

OBJECTIVE@#To study the efficacy and safety of continuous renal replacement therapy (CRRT) in the treatment of neonates with inherited metabolic diseases and hyperammonemia.@*METHODS@#A retrospective analysis was performed on the medical records of neonates with inherited metabolic diseases and hyperammonemia who were hospitalized and underwent CRRT in the Department of Neonatology, Hunan Children's Hospital, from September 2016 to March 2020, including general conditions, clinical indices, laboratory markers, and adverse reactions.@*RESULTS@#A total of 11 neonates were enrolled, with 7 boys (64%) and 4 girls (36%). The neonates had a mean gestational age of (38.9±0.8) weeks, a mean body weight of (3 091±266) g on admission, and an age of (5.7±2.0) days at the time of CRRT. The main clinical manifestations were vomiting (100%), convulsions (100%), and coma (55%), and the main primary disease was urea cycle disorder (55%). The mean duration of CRRT was (44±14) hours, the medium duration of coma before CRRT was 2 hours, and the total duration of coma was 10 hours. The patients had a mean hospital stay of (18±10) days and a survival rate of 73%, and 2 survivors had epilepsy. After treatment, all patients had significant reductions in blood ammonia, lactic acid, and K@*CONCLUSIONS@#CRRT is safe and effective in the treatment of neonates with inherited metabolic diseases and hyperammonemia.

A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Synthetic study of vonoprazan fumarate / 国际药学研究杂志

Objective To develop a practical synthetic process of vonoprazan fumarate with high-yield and lower impurities to meet the quality requirements. Methods By using 5-(2-fluorophenyl)pyrrole-3-carboxaldehyde as the starting material,the qualified vonoprazan fumarate was synthesized via the following steps:①N-sulfonylation and the chloride impurity was removed by recrystalli-zation from MeOH;②the aldehyde was converted to amine by reductive amination,followed by forming the vonoprazan chloride to re-move the dimethylamino impurity;③vonoprazan free base was obtained by neutralization and then converted to fumarate at room tem-perature and finally recrystallized from MeOH/H2O(1:1). Results An impurity controllable synthetic process was developed with a 4％total yield improving. The final product was confirmed by ESI-MS and 1H NMR. Conclusion The synthetic process with single im-purity less than 0.1％and purity above 99.5％was obtained and suitable for scale production of vonoprazan fumarate.

Effects of guipi pill on bone marrow cell cycle of mice exposed to benzene / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of Guipi Pill (GPP) on bone marrow cell cycle of mice exposed to benzene and to explore its possible mechanisms for regulating hematopoiesis.</p><p><b>METHODS</b>Seventy-two Kunming mice were randomly divided into 6 groups, i.e., the normal control group, the model group, the Western medicine treatment group, the large, middle, and small dose GPP groups, 12 in each group. The mice were exposed to manually simulated high concentrations of benzene fqr eight h every day, fourteen successive days, to replicate benzene intoxication model. Mice in the large, middle, and small dose GPP groups were administered with 8, 4, 2 mg/kg GPP per day respectively by gastrogavage. Mice in the Western medicine treatment group were administered with leucogen (at the daily dose of 1.5 mg/kg) and batyl alcohol (at the daily dose of 5 mg/kg) by gastrogavage. Mice in the model group and the normal control group were administered with normal saline by gastrogavage, once daily, for 3 successive weeks. The nucleated bone marrow cell count and the cell cycle of bone marrow cells were detected using flow cytometry.</p><p><b>RESULTS</b>Compared with the normal control group, the nucleated bone marrow cell count obviously decreased in the model group (P <0.05). Compared with the model group, the nucleated bone marrow cell count obviously increased in the large and small dose GPP groups, and the Western medicine treatment group (P <0.01). Compared with the normal control group, the S phase cell ratio and proliferation index (PI) increased, and the G0/G1 phase cell ratio decreased in the model group, showing statistical difference (P <0.05). The G0/G1 phase cell ratio decreased, while the G2/M phase cell ratio and PI increased in the large dose GPP group. The S phase cell ratio decreased in the middle dose GPP group, showing statistical difference when compared with the model group (P <0.01, P <0.05). Compared with the Western medicine treatment group, the G2/M phase cell ratio and PI increased, and the G0/G1 phase cell ratio decreased in the large dose GPP group, showing statistical difference (P <0.01).</p><p><b>CONCLUSION</b>GPP could promote the recovery of hematopoietic functions of benzene exposed mice by ending off G1 or G2-phase arrest, accelerating G0/G1-S phase and S-G2/M phase transition, promoting the proliferation of bone marrow hematopoietic cells, and improving the peripheral hemogram.</p>

Study on protective effect of acteoside on cellular model of Alzheimer's disease induced by okadaic acid / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of acteoside on SK-N-SH nerve cell injury induced by okadaic acid (OA).</p><p><b>METHOD</b>SK-N-SH nerve cells were processed with 20 nmol * L OA to establish the Alzheimer's disease (AD) cellular model, and 5, 10, 20 mg . L-1 acteoside was used to antagonize against its effect. Cell morphology was observed under inverted microscope. The cell survival rate was detected with MTT, and the LDH release rate was measured by enzyme label kit. Western blot was applied to determine the expression of phosphorylation tau proteins in nerve cells.</p><p><b>RESULT</b>The acteoside could significantly improve SK-N-SH cell morphology, enhance the cell survival rate, decrease the cell LDH release rate and the expression of phosphorylated tau proteins at p-Ser 199/202 and p-Ser 404 sites, up-regulated the expression of at non-phosphorylated tau proteins at Ser 202 site and Ser 404 sites.</p><p><b>CONCLUSION</b>Acteoside has significant protective effect on nerve cell injury induced by OA.</p>

Effect of acteoside on learning and memory impairment induced by scopolamine in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study on the effect of acteoside on learning and memory of dementia mice.</p><p><b>METHOD</b>Mice were orally administered with acteoside for 10 days. Scopolamine was used to establish the acquired learning disability in mice. Their learning and memory were detected with a behavioral experiment (step-down test). After the behavior test, corticocerebral and hippocampus tissues of mice were detected with biochemical indexes, including GSH-Px, T-SOD, MDA, TChE and contents of protein in brain tissues.</p><p><b>RESULT</b>Mice were administered with acteoside for 10 d in advance to alleviate the acquired learning disability induced by scopolamine. Compared with the model group, acteoside increased the latency period in the step-down test and reduced error times. Besides, acteoside increased the activity of GSH-Px, T-SOD, TChE and protein content in their brain tissues, but decreased MDA content.</p><p><b>CONCLUSION</b>Acteoside can significantly alleviate the acquired learning disability in mice induced by scopolamine. Its mechanism may be related with its effect of inhibiting the generation of free radicals in mice and improving the function of the central cholinergic system.</p>