The effect of the quality improvement project of admission hypothermia on short-term outcomes of preterm infants less than 34 weeks gestational age / 中国小儿急救医学

Objective:To study the high risk factors of hypothermia in premature infants with gestational age ≤34 weeks, and to analyze the incidence of hypothermia before and after the implementation of the quality improvement program of hypothermia in hospital and its influence on various systemic complications, aiming to improve the early identification of hypothermia and to reveal the important clinical significance of temperature management in time.Methods:Clinical data of preterm infants born in Maternal and Child Health Hospital of Hubei Province from May 2017 to December 2018, with gestational age ≤34 weeks, and admitted within 1 hour after birth were collected.According to the admission temperature, the infants were divided into normal temperature group (36.5-37.5 ℃), mild hypothermia group (36.0-36.4 ℃), moderate hypothermia gsroup (32.0-35.9 ℃), and severe hypothermia group (<32.0 ℃). The high risk factors of hypothermia in premature infants were analyzed.The incidence and degree of hypothermia and the effects on the systemic complications before and after the implementation of the hypothermia quality improvement program were compared.Results:A total of 306 premature infants were enrolled in the study, including 63(20.6%)cases in the normal temperature group, 115(37.6%) cases in the mild hypothermia group, and 128(41.8%) cases in the moderate hypothermia group, without severe hypothermia.Infants with birth asphyxia were at higher risk for hypothermia( OR=0.195, 95% CI 0.046-0.833, P=0.027); the lower the Apgar score at 1 min( r=0.123, P=0.032)and 5 min after birth( r=0.136, P=0.017), the higher the risk of admission hypothermia.After the quality improvement project, the incidence of admission hypothermia decreased from 82.3% to 73.8%( χ2=32.67, P<0.001), and the use of pulmonary surfactant in infants with respiratory distress syndrome was significantly reduced(70.0% vs. 32.0%, χ2=40.11, P<0.001), and the incidence of hypotension within 72 hours after birth decreased(11.8% vs. 4.9%, χ2=3.87, P<0.049). Conclusion:Birth asphyxia is a risk factor for admission hypothermia in premature infants, and Apgar score is associated with admission hypothermia in premature infants.Temperature management of preterm infants can significantly reduce the incidence of hypothermia and hypotension, and reduce the use of pulmonary surfactant in respiratory distress syndrome infants.

Distribution and Drug Sensitivity Analysis of Pathogenic Bacteria Isolated from Patients in Hematology Department / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients in hematology department, in order to provide evidence for rational use of antibiotics in clinic.@*METHODS@#The distribution of pathogenic bacteria and drug sensitivity data of patients in the hematology department of The First Affiliated Hospital of Nanjing Medical University from 2015 to 2020 were retrospectively analyzed, and the pathogens isolated from different specimen types were compared.@*RESULTS@#A total of 2 029 strains of pathogenic bacteria were isolated from 1 501 patients in the hematology department from 2015 to 2020, and 62.2% of which were Gram-negative bacilli, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii. Gram-positive coccus accounted for 18.8%, mainly Coagulase-negative staphylococcus (CoNS) and Staphylococcus aureus. Fungi (17.4%) were mainly candida. The 2 029 strains were mainly isolated from respiratory tract (35.1%), blood (31.8%) and urine (19.2%) specimens. Gram-negative bacilli were the main pathogenic bacteria in different specimen types (>60%). K. pneumoniae, S. maltophilia and A. baumannii were the most common pathogens in respiratory specimens, E. coli, CoNS, K. pneumoniae and P. aeruginosa were common in blood samples, and E. coli and Enterococcus were most common in urine samples. Enterobacteriaceae had the highest susceptibility to amikacin and carbapenems (>90.0%), followed by piperacillin/tazobactam. P. aeruginosa strains had high sensitivity to antibiotics except aztreonam (<50.0%). The susceptibility of A. baumannii to multiple antibiotics was less than 70.0%. The antimicrobial resistance rates of E. coli and K. pneumoniae in respiratory tract specimens were higher than those in blood specimens and urine specimens.@*CONCLUSION@#Gram-negative bacilli are the main pathogenic bacteria isolated from patients in hematology department. The distribution of pathogens is different in different types of specimens, and the sensitivity of each strain to antibiotics is different. The rational use of antibiotics should be based on different parts of infection to prevent the occurrence of drug resistance.

Research progress on application of multi-enzyme-catalyzed cascade reactions in enzymatic synthesis of natural products / 中国中药杂志

As a biocatalyst, enzyme has the advantages of high catalytic efficiency, strong reaction selectivity, specific target products, mild reaction conditions, and environmental friendliness, and serves as an important tool for the synthesis of complex organic molecules. With the continuous development of gene sequencing technology, molecular biology, genetic manipulation, and other technologies, the diversity of enzymes increases steadily and the reactions that can be catalyzed are also gradually diversified. In the process of enzyme-catalyzed synthesis, the majority of common enzymatic reactions can be achieved by single enzyme catalysis, while many complex reactions often require the participation of two or more enzymes. Therefore, the combination of multiple enzymes together to construct the multi-enzyme cascade reactions has become a research hotspot in the field of biochemistry. Nowadays, the biosynthetic pathways of more natural products with complex structures have been clarified, and secondary metabolic enzymes with novel catalytic activities have been identified, discovered, and combined in enzymatic synthesis of natural/unnatural molecules with diverse structures. This study summarized a series of examples of multi-enzyme-catalyzed cascades and highlighted the application of cascade catalysis methods in the synthesis of carbohydrates, nucleosides, flavonoids, terpenes, alkaloids, and chiral molecules. Furthermore, the existing problems and solutions of multi-enzyme-catalyzed cascade method were discussed, and the future development direction was prospected.

The mechanism research of Xiaoyan Lidan formula for the intervention of chronic intrahepatic cholestasis based on metabolomics combined with molecular docking analysis / 药学学报

In this study, the mechanism of Xiaoyan Lidan formula (XYLDF) against 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine (DDC)-induced chronic intrahepatic cholestasis (CIHC) in mice was investigated based on metabolomics, molecular docking and pharmacological methods. In the pharmacodynamics study, a dosage of 5 g·kg-1 (clinical equivalent) XYLDF was administered in DDC-induced mice, then the effect of XYLDF against CIHC was evaluated by measuring the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP) as well as total bilirubin (TBIL) in serum and observing liver histopathological changes. All experiments were approved by the Ethical Committee Experimental Animal Center of Guangzhou University of Chinese Medicine (ZYD-2021-001). The serum metabolites of mice in each group were detected and identified based on ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry, and the relevant biological pathways and molecular key targets were further enriched. Molecular docking technology was used to further evaluate the binding activity of the main active ingredients of XYLDF with potential targets. Subsequently, the in vitro experiment was conducted for the validation of the vital target. The results showed that compared with the model group, XYLDF significantly decreased the levels of ALT, AST, AKP and TBIL in the serum of CIHC mice, as well as alleviated inflammatory infiltration and hepatocyte necrosis in liver tissue. According to the metabonomic study, a total of 35 differential metabolites was identified as biomarkers associated with cholestasis, 12 of which were significantly recovered by XYLDF treatment. These biomarkers were involved in the pathways of primary bile acid biosynthesis and linoleic metabolism, which are closely related to the mechanism of XYLDF against CIHC. Protein-protein interaction network indicated that cytochrome P450 3A4 (CYP3A4) and cytochrome P450 1A1 (CYP1A1) are significant potential targets with good binding properties with six major active ingredients of XYLDF. Furthermore, it was found that 4-methoxy-5-hydroxycanthin-6-one, dehydroandrographolide and isodocarpin, three of the main active components in XYLDF, markedly induced the expression of CYP3A4 mRNA in vitro. This study revealed that XYLDF mainly mediates the biosynthesis of bile acids in CIHC mice to improve liver tissue lesions and bile efflux disorders, among which, CYP3A4 is the key target in the protection of XYLDF against CIHC. This research provides a reference for further elucidation of the pharmacological mechanism of XYLDF.

Research progress of gut microbiota in the antidepressant effect of traditional Chinese medicine / 药学学报

Depression is a common emotional mental disorder. Patients not only continuously showed depression, pessimism and apathy in mood, but also have gastrointestinal symptoms such as anorexia and constipation in body. Widely attention has been also received in the potential biological role of gut microbiota in the pathogenesis of depression. It plays an important role in the interaction between the intestine and the brain, not only affecting the intestinal barrier function, but also maintaining the homeostasis of host through the microbiota-gut-brain axis. In recent years, the traditional Chinese medicine (TCM) has the advantages of obvious therapeutic effects and few side effects when treating neuropsychiatric diseases, such as depression. The pharmacological mechanism of TCM exerting antidepressant effects by regulating the structure of gut microbiota, reducing displacement, and maintaining the normal function of gut microbiota has been also widely concerned. By investigating the relevant literature in recent years, this paper summarizes the antidepressant effect of TCM in different directions such as Chinese medicine monomer, single medicine and compound medicine. And this paper reviews the antidepressant effects and mechanisms of TCM at different levels, such as the correction of gut microbiota structure, the regulation of immunity, the transplantation of gut microbiota and the regulation of its metabolites. This paper will provide a basis for further explaining the mechanism of gut microbiota in depression and the mechanism of antidepressant effect of TCM.

Reeducation of medical research ethics based on medical staff's cognition and practice of medical research ethics / 中华医学科研管理杂志

Objective:To investigate and analyze the cognition of medical staff on medical research ethics in a grade A tertiary hospital, combined with the current situation of practice, to provide a basis and ideas for exploring new educational models of medical research ethics.Methods:Medical staff in a grade A tertiary hospital were investigated through an anonymous questionnaire to collect and analyze their cognition of medical research ethics and the current situation of practice.Results:There were statistically significant differences ( P<0.05) in the cognition of medical research ethics among different educational backgrounds, majors, and professional titles. The survey results showed that doctors, medical staff with graduate degrees or above, and senior title personnel had better cognition of medical research ethics than nurses, medical staff with bachelor degrees or below, and intermediate or junior title personnel. Conclusions:The medical staff's cognition and practice of medical research ethics are still insufficient. Hospitals should pay attention to the education of medical research ethics and enrich the content and form of training to improve the ethical literacy of medical personnel.

Dynamic two-dimensional characterization technique and influencing factors analysis of the hygroscopicity of Chinese medicine extracts / 药学学报

This study aims to construct a dynamic two-dimensional characterization technique for the hygroscopicity of traditional Chinese medicine extracts and investigate the effect of material properties of powders on hygroscopicity. The dynamic hygroscopicity-time curves of the powders were measured at 25 ℃ and 75% humidity, and the semi-equilibrium hygroscopicity time (t1/2) and equilibrium hygroscopicity (F∞) were derived as two-dimensional evaluation indicators. Finally, the correlation between the material properties and the hygroscopic behavior was analyzed by principal component analysis (PCA) and partial least squares analysis (PLS). The results showed that the dynamic two-dimensional characterization system of hygroscopicity constructed with 1/t1/2 = 0.1 h-1 and F∞ = 15% as the center can classify the hygroscopic behavior of traditional Chinese medicine extracts into four categories: fast hygroscopicity with strong hygroscopicity, slow hygroscopicity with strong hygroscopicity, fast hygroscopicity with weak hygroscopicity and slow hygroscopicity with weak hygroscopicity. The moisture absorption was negatively correlated with D50, D90, ρb and ρt; the moisture absorption rate was negatively correlated with D10, D50, D90, ρb, ρt, and positively correlated with moisture content. The hygroscopicity dynamic two-dimensional characterization indicators of Chinese medicine extracts (CMEs) constructed in this study matched with the physical properties. The method of dynamic multi-dimensional characterization technology is feasible and scientific, and the idea has strong promotional value.

Flavonoids in myocardial ischemia-reperfusion injury: Therapeutic effects and mechanisms / 中草药·英文版

Ischemic heart diseases are one of the major causes of death worldwide. Effective restoration of blood flow can significantly improve patients’ quality of life and reduce mortality. However, reperfusion injury cannot be ignored. Flavonoids possess well-established antioxidant properties; They also have other benefits that may be relevant for ameliorating myocardial ischemia-reperfusion injury (MIRI). In this review, we focus on flavonoids with cardiovascular-protection function and emphasize their pharmacological effects. The main mechanisms of flavonoid pharmacological activities against MIRI involve the following aspects: a) antioxidant, b) anti-inflammatory, c) anti-platelet aggregation, d) anti-apoptosis, and e) myocardial-function regulation activities. We also summarized the effectiveness of flavonoids for MIRI.

Hair Growth Promotion by δ-Opioid Receptor Activation

Literature has revealed that the delta opioid receptor (DOR) exhibited diverse pharmacological effects on neuron and skin. In the present study, we have investigated whether the activation of DOR has hair-growth promotion effects. Compared with other opioid receptor, DOR was highly expressed in epidermal component of hair follicle in human and rodents. The expression of DOR was high in the anagen phase, but it was low in the catagen and telogen phases during mouse hair cycle. Topical application of UFP-512, a specific DOR agonist, significantly accelerated the induction of the anagen in C 3H mice. Topical application of UFP-512 also increased the hair length in hair organ cultures and promoted the proliferation and the migration of outer root sheath (ORS) cells. Similarly, pharmacological inhibition of DOR by naltrindole significantly inhibited the anagen transition process and decreased hair length in hair organ cultures. Thus, we further examined whether Wnt/β-catenin pathway was related to the effects of DOR on hair growth. We found that Wnt/β-catenin pathway was activated by UFP-512 and siRNA for β-catenin attenuated the UFP-512 induced proliferation and migration of ORS cells. Collectively, result established that DOR was involved in hair cycle regulation, and that DOR agonists such as UFP-512 should be developed for novel hair-loss treatment.

Infection control status of novel coronavirus pneumonia and radiation safety at CT workplace / 中华放射医学与防护杂志

CT is an important imaging tool for the diagnosis of novel coronavirus pneumonia (COVID-19), therefore, it′s necessary to strictly control the disinfection of CT workplace and equipment and biosafety to avoid the place from becoming a potential infection source and to reduce the risk of infection of patients and radiological staff. It is also necessary to reduce the CT scan dose to minimize the radiation hazards on patients under the premise of ensuring the CT image quality and diagnostic efficiency. Based on the survey that novel coronavirus residues after disinfection at some CT workplace in domestic and overseas and the application of low-dose CT scan in diagnosis of COVID-19, as well as the current situation of radiological protection management in emergency hospital, this paper summarizes and proposes suggestions on infection control and radiological protection for CT workplace to strengthen the defense line of COVID-19 prevention and control.

Postoperative analgesic efficacy of nabuprofen combined with femoral nerve block in older adult patients subjected to knee arthroplasty / 中国基层医药

Objective:To investigate the postoperative analgesic efficacy of nabuprofen combined with femoral nerve block in older adult patients subjected to knee arthroplasty and its effects on cognitive function and serum S-100β protein level.Methods:Ninety-one older adult patients subjected to knee arthroplasty between March 2018 and March 2020 in Zhoushan Hospital of Traditional Chinese Medicine were included in this study. They were randomly divided into observation ( n = 45) and control ( n = 46) groups. Patients in both groups received femoral nerve block and catheterization. Naborphine and equal amount of 0.9% sodium chloride injection were intravenously administered in the observation and control groups, respectively for postoperative analgesia. Before and after surgery, Mini-Mental State Examination (MMSE) score, S-100β protein level and Visual Analogue Scale score, and adverse reactions were compared between the observation and control groups. Results:Before surgery, there was no significant difference in MMSE score between the two groups ( P > 0.05). At 3 days after surgery, MMSE score in each group was significantly decreased compared with before surgery (both P < 0.05). At 3 days after surgery, MMSE score in the observation group was significantly higher than that in the control group [(25.34 ± 1.31) points vs. (23.67 ± 1.53) points, t = 5.34, P < 0.05]. Before surgery, there was no significant difference in serum S-100β protein level between the two groups ( P > 0.05). At 1 and 3 days after surgery, serum S-100β protein level in each group was significantly increased compared with before surgery (both P < 0.05). At 7 days after surgery, serum S-100β protein level in each group recovered to pre-operative level. At 1 and 3 days after surgery, serum S-100β protein level in the observation group was significantly lower than that in the control group ( t = 10.20, 9.21, both P < 0.05). At 1, 3, 6, 12 and 24 hours after surgery, the Visual Analogue Scale score in the observation group was (1.14 ± 0.22) points, (1.43 ± 0.25) points, (1.87 ± 0.21) points, (3.56 ± 0.20) points, and (2.63 ± 0.23) points respectively, which was significantly lower than that in the control group [(2.53 ± 0.24) points, (2.53 ± 0.24) points, (3.56 ± 0.20) points, (3.98 ± 0.25) points, (4.23 ± 0.21) points, t = 5.10, 8.15, 9.41, 10.18, 11.42, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [13.33% (6/45) vs. 30.43% (14/46), χ2 = 3.88, P = 0.049]. Conclusion:Naborphine combined with femoral nerve block can effectively improve the postoperative cognitive function of older adult patients undergoing knee arthroplasty, provides good postoperative analgesia, and is highly safe.

Comparison of therapeutic effect for diabetic macular edema based on different optical coherence tomography patterns / 中华实验眼科杂志

Objective:To evaluate the efficacy of intravitreal ranibizumab (IVR) injection and/or laser photocoagulation on diabetic macular edema (DME) of different morphologic patterns based on optical coherence tomography (OCT).Methods:A non-randomized controlled clinical trial was conducted.A total of 79 diabetic patients (108 eyes) who were diagnosed as DME in Affiliated Hospital of Nanjing University of Chinese Medicine from March 2017 to February 2018 were enrolled.The subjects were divided into diffuse macular edema (DRT) group (41 eyes), cystoid macular edema (CME) group (37 eyes) and serous retinal detachment (SRD) group (30 eyes) according to the morphological characteristics of OCT, and received intravitreal injection of 0.05 ml (0.5 mg) ranibizumab and/or laser photocoagulation according to treatment guidelines.Best corrected visual acuity (BCVA), central macular thickness (CMT) of the subjects were recorded before treatment and 1 month, 3, 6 and 12 months after treatment.The morphologic changes of macular edema and complications were recorded.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Affiliated Hospital of Nanjing University of Chinese Medicine (No.2017NL-13-03). Written informed consent was obtained from each patient before any medical examination and treatment.Results:The 1-, 3-, 6- and 12-month post-treatment average BCVA (LogMAR) of the DRT, CME and SRD groups were improved in comparison with before treatment, and the average CMT of the three groups at various time points after treatment was reduced than that before treatment (all at P<0.05). For the 39 eyes who received IVR treatment, the 12-month post-treatment average BCVA (LogMAR) of the DRT group was 0.41±0.40, which was significantly better than 0.60±0.40 of the CME group ( P=0.039). The 12-month post-treatment CMT of the DRT group was (286.05±109.56) μm, which was significantly thinner than (338.30±101.87)μm of the SRD group ( P=0.045). For the 69 eyes who received IVR combined with laser photocoagulation treatment, the 6- and 12-month post-treatment average BCVA (LogMAR) of the DRT group were significantly better than those of the CME group ( P=0.048, 0.043), and the average CMT at 12 months after treatment in the DRT group was (304.59±106.66)μm, which was significantly smaller than (369.34±107.80)μm in the SRD group, showing a statistical significance ( P=0.041). During the follow-up, 5 eyes with SRD turned to DRT, and 3 SRD eyes turned to CME.No eye changing from DRT and CME to SRD was found. Conclusions:Intravitreal ranibizumab injection and/or laser photocoagulation can significantly improve BCVA and reduce CMT of DME patients, and the efficacy is better in eyes with DRT than eyes with SRD or CME.

Mechanism study of CeRNA regulatory network mediating malignant tumor phenotype / 国际肿瘤学杂志

Competing endogenous RNAs (CeRNAs) are crisscrossing regulatory networks. CeRNAs networks can mediate malignant tumor cell phenotypes, including proliferation and inhibition, autophagy, infinite growth, induction of angiogenesis and angiogenic mimicosis, immune escape, etc.. It is expected to provide new diagnostic markers and therapeutic targets for malignant tumors to master the regulation and function of CeRNAs mediated phenotype in malignant tumors.

Determination of digoxin in human plasma by LC-MS/MS and its application in pediatric patients / 中国药科大学学报

@#The aim of the study was to develop a simple, rapid and accurate LC-MS/MS method for the determination of digoxin.Digoxin-d3 was taken as the internal standard (IS), and sample preparation was achieved by liquid-liquid extraction.Chromatographic separation was performed on a Kinetex C18 column (2.1 mm × 50 mm, 2.6 μm; Phenomenex) using an isocratic elution with merely 2 min for each sample.The mobile phase consisted of water and acetonitrile solutions, both containing 1 mmol/L ammonium acetate and 1 mmol/L formic acid (55∶45).The detection was conducted on a TripleQuadTM 4500MD mass spectrometer coupled with electrospray ionization interface under positive-ion multiple reaction monitoring mode.The transitions were m/z 798.5 → 651.3 and m/z 801.6 → 654.4 for digoxin and digoxin-d3, respectively.Results showed that the method was linear over the range of 0.100-20.0 ng/mL.The selectivity, accuracy and precision, recovery and stability of the method were all within the acceptable limits with no matrix effect.This method was successfully applied to a girl treated with digoxin with substantial improvement of therapeutic effect and elimination of toxic reaction, so it can provide valuable fuidance and reference for individualized medication in clinical practice.

Analysis of related risk factors for the refracture of adjacent vertebral body after percutaneous kyphoplasty / 中国骨伤

OBJECTIVE@#To investigate the risk factors of vertebral refracture after percutaneous kyphoplasty (PKP) for osteoprotic vertebral compression fractures (OVCFs), and to provide reference for clinical prevention.@*METHODS@#A retrospective analysis of 228 OVCFs patients who met the inclusion criteria admitted from November 6, 2013 to December 14, 2018. There were 35 males and 193 females, with a male-to-female ratio of 3∶20, and aged 58 to 91 years with an average of (69.70±7.03) years. All patients were treated with PKP and had complete clinical data. According to whether refracture occurred after operation, they were divided into refracture group (24 cases) and non refracture group (204 cases). Factors that may be related to refracture (including gender, age, surgical segment, number of vertebral bodies in the surgical segment, whether combined with degenerative scoliosis, whether anti-osteoporosis treatment) were included in the univariate analyses, and the single factor analysis of statistically significant risk factors was carried out with multiple Logistic regression analysis to further clarify the independent risk factors for vertebral body refracture after PKP. Survival analysis was performed using the time of vertebral refracture after PKP as the end time of follow up, the occurrence of refracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor.@*RESULTS@#All 228 patients were followed up for 1.8 to 63.6 months with an average of (28.8±15.6) months, and the refracture rate was 10.5%(24/228). There were statistically significant differences between two groups in age, number of operative vertebral bodies, whether combinedwith degenerative scoliosis and whether anti osteoporosis treatment (@*CONCLUSION@#Combined scoliosis is an independent risk factor for refracture after OVCFs vertebroplasty, and it is also a possible high-risk factor for refracture after surgery.

The overview of the property system and characterization techniques of Chinese medicine materials before the pharmaceutical / 药学学报

At present, the modernization of Chinese medicine preparations (CMPs) is still a challenging task. The 3 typical Chinese medicine materials (CMMs) used for preparing CMPs are the powders, extracts, and components of Chinese medicine and their properties of CMMs are important for designing CMPs. Basing on our long term research, we have established a property system for CMMs according to the state of CMMs under an exactly condition and according to the interaction characteristics between substances. The property system could be divided into 5 categories: material composition, spatial structure, body property, surface property, physicochemical properties, and they could also be divided into 18 subcategories. Furthermore, we also established the corresponding index and characterization system, where the 61 indexes and characterization techniques were systematically summarized. At last, we hope that the article will promote the modernization of CMPs.

Analgesic effects of naborphine versus dezocine after surgery for supracondylar fracture of humerus in children / 中国基层医药

Objective:To compare the analgesic effects of naborphine and desorine after surgery for supracondylar fracture of humerus in children.Methods:Eighty-seven children with supracondylar fracture of humerus who received surgical treatment in Zhoushan Hospital of Traditional Chinese Medicine between January 2019 and January 2020 were included in this study. They were randomly assigned to receive postoperative analgesia either with dezocine (control group, n = 44) or naborphine (observation group, n = 43). The postoperative agitation score, postanesthetic recovery score, postoperative visual analogue scale score, and adverse reactions were determined between the two groups. Results:The heart rate and mean arterial pressure at the time of extubation were (102 ± 7) beats/min and (83 ± 6) mmHg respectively in the observation group, which were significantly lower than those in the control group [(115 ± 8) beats/min, (92 ± 7) mmHg, t = 6.214, 8.283, P < 0.05]. In the observation group, the postoperative agitation score was (4.45 ± 0.34) points, (5.02 ± 0.38) points, and (3.65 ± 0.39) points, at the time of spontaneous eye opening, at the time of extubation and at 30 minutes after extubation respectively, which were significantly lower than those in the control group [(5.31 ± 0.48) points, (5.75 ± 0.35) points, (4.12 ± 0.37) points, t = 6.392, 7.194, 7.382, all P < 0.05]. At 30 min, 3 h and 6 h after surgery, the visual analogue scale scores in the observation group were significantly lower than those in the control group ( t = 5.345, 6.124, 7.553, P < 0.05). The time to return to spontaneous breathing, the time to spontaneous eye opening and the time to extubation in the observation group were (7.32 ± 4.17) min, (11.65 ± 3.32) min, (12.13 ± 2.41) min, respectively, which were significantly shorter than those in the control group [(10.34 ± 4.15) min, (14.43 ± 3.18) min, (15.16 ± 2.23) min, t = 7.216, 5.382, 7.319, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [6.97% (3/43) vs. 27.27% (12/44), χ2 = 6.280, P < 0.05]. Conclusion:Naborphine for analgesia after surgery for supracondylar fracture of humerus in children can effectively reduce the incidence of agitation during the recovery period, enhance postoperative analgesic effect, and lower the incidence of reverse reactions.

Safety of intravitreal injection of recombinant human endostatin in rabbits / 中华实验眼科杂志

Objective:To investigate and evaluate the safety of intravitreal injection of recombinant human endostatin (rh-endostatin) with different concentrations in rabbit eyes.Methods:Thirty healthy adult New Zealand white rabbits were enrolled with the right eyes selected as experimental eyes, and were randomly divided into five groups by random distribution of computer numbers, with 6 eyes in each group.The rabbits in the normal control group were given no treatment, and the rabbits in the normal saline group, 0.125 mg rh-endostatin group, 0.250 mg rh-endostatin group and 0.500 mg rh-endostatin group were treated with 100 μl of normal saline, 0.125 mg/100 μl, 0.250 mg/100 μl and 0.500 mg/100 μl rh-endostatin according to grouping, respectively.The anterior segment and fundus of the experimental eyes were examined using slit lamp biomicroscope and indirect ophthalmoscope, and the intraocular pressure (IOP) of the experimental eyes were measured with iCARE handheld tonometer before injection and 1 day, 3, 7, 14, 30 and 60 days after injection.Optical coherence tomography (OCT) examination was performed before the intravitreal injection and 7, 30, and 60 days after injection, respectively.Flash electroretinogram was performed before intravitreal injection and 14 days and 60 days after injection.The rabbits were sacrificed by euthanasia at 60th day after injection.Three experimental eyes of each group were dissected and made into paraffin section, and histopathological staining was used to detect the retinal structural changes.The retinal tissue was separated from the other three study eyes in each group, and the transmission electron microscope was employed to observe the ultrastructural changes of the retina.All animal experiments were performed in adherence to the Regulations of the State and the Animal Center of Yangzhou University Medical College for the Use of Animals in Research.Results:After intravitreal injection, no obvious anterior or posterior chamber change was observed by slit lamp microscopy in all groups at any time point.Flocculent seepage was observed in one eye of the 0.125 mg and 0.500 mg rh-endostatin group, respectively, which was then absorbed completely on the 7th and 14th day.OCT examination showed no abnormal light reflection or morphological changes in fundus of day after injection in all the groups.There was no significant difference in IOP, a-wave and b-wave amplitude among all the groups at different time points ( Fgroup=0.134, 0.101, 0.476; Ftime=1.709, 2.479, 1.706; all at P>0.05). Neither light nor electron microscopy showed any retinal damage in any group. Conclusions:Intravitreal injection of rh-endostatin is safe at the dosage of 0.125-0.500 mg in rabbits.

Therapeutic drug monitoring for monoclonal antibody：progress in the application of LC-MS/MS technique / 中国药科大学学报

@#With the rapid development of biopharmaceuticals, therapeutic monoclonal antibodies (mAbs) are widely accepted due to their low side-effects and high therapeutic efficacy. Individual differences in the response to mAb drugs put forward new requirements for therapeutic drug monitoring of antibody drugs.Therefore, the need for accurate and robust bioanalytical methods is increasing.Recently, LC-MS/MS has been gaining increasing interest in the field of large molecules.In this article, the recent advances in this emerging field are reviewed, along with common issues and analytical approaches.Thus, this review article is helpful for better understanding the advance of LC-MS/MS technique in the field of therapeutic drug monitoring for mAbs.

Study on anti-hygroscopic technology based on correlations between particle spatial properties and hygroscopicity of Chinese medicinal extracts / 中国中药杂志

This study was designed to investigate the correlations of the spatial structure properties of Chinese medicinal extracts with hygroscopicity and the anti-hygroscopic techniques. With Poria extract used as the model drug, pregelatinised starch and microcrystalline cellulose at different ratios were added into Poria fluid extract for preparing powder particles with diverse spatial structures using different drying processes. Then, their hygroscopic behaviours were characterized by equilibrium hygroscopicity(F~∞) and semi-hygroscopic time(t_(1/2)). The correlations of the hygroscopicity of each powder with the spatial structure properties such as particle size(D_(90)), porosity(ε), true density(ρ_t), and surface element distribution were analyzed using partial least-squares method. The F~∞ and t_(1/2) values of Poria extract prepared by three drying methods were sorted in a descending order as follows: F~∞(spray drying>drying at ordinary pressure>drying at reduced pressure); t_(1/2)(drying at reduced pressure>drying at ordinary pressure>spray drying). The powder obtained by spray drying showed a spherical structure with the smallest particle size and intra-particle ε but relatively stronger hygroscopicity. The large-scale surface element enrichment of the powders dried by reduced pressure effectively reduced their hygroscopicity. F~∞ and t_(1/2) were negatively correlated with ε but positively with D_(90), and the interactive influence of each spatial structural properties was not significant. There existed a correlation between the spatial structure of the powder particles of Chinese medicine extracts and their hygroscopicity, and the hygroscopicity could be improved by designing the spatial structure. This study has provided some practical basis for developing the moisture-proof technology of Chinese medicinal preparations.