Awareness and possible treatment options toward COVID-19 among selected healthcare professionals in National Capital Region

Background@#Since December 2019, SARS-CoV-2, otherwise known as coronavirus disease 2019 (COVID-19), has caused worldwide panic and is now a serious problem. As the situation worsens, the need for an official cure becomes more crucial and different methods are being considered for treating infected COVID-19 patients. @*Objectives@#This study aimed to emphasize and further elaborate on the existing and possible treatment methods against COVID-19 and assess the awareness of healthcare professionals (doctors, medical technologists, and nurses) on the treatments for COVID-19. @*Methodology@#The study utilized an exploratory sequential mixed methods design following the treatment and misinformation theories models. The respondents were selected based on inclusion and exclusion criteria and recruited through the snowball sampling technique. The study used an adapted survey questionnaire on the pathophysiology of COVID-19 and possible treatment options. Descriptive statistical analysis for quantitative data and open thematic coding is used in an online qualitative deductive data analysis. @*Results@#Based on the data, webinars, lectures, and discussions were the primary source of information among healthcare professionals. Most of the respondents showed proficiency with remdesivir among investigational selective medicines. Chloroquine was the top choice among selected repurposed drugs. They were aware of the convalescent plasma therapy that uses antibodies from the blood plasma of recovered COVID-19 patients. They were not aware of the different herbal treatments used to treat COVID-19. @*Conclusion@#Hence, chloroquine (repurposed drug), remdesivir (investigational drug), and convalescent plasma (adjunctive therapy) are the most well-known treatments for COVID-19. Most of the respondents were aware of the action and side effects of chloroquine, remdesevir, and convalescent plasma therapy.

Intravenous whole blood transfusion results in faster recovery of vascular integrity and increased survival in experimental cerebral malaria

BACKGROUND Cerebral malaria is a lethal complication of Plasmodium falciparum infections in need of better therapies. Previous work in murine experimental cerebral malaria (ECM) indicated that the combination of artemether plus intraperitoneal whole blood improved vascular integrity and increased survival compared to artemether alone. However, the effects of blood or plasma transfusion administered via the intravenous route have not previously been evaluated in ECM. OBJECTIVES To evaluate the effects of intravenous whole blood compared to intravenous plasma on hematological parameters, vascular integrity, and survival in artemether-treated ECM. METHODS Mice with late-stage ECM received artemether alone or in combination with whole blood or plasma administered via the jugular vein. The outcome measures were hematocrit and platelets; plasma angiopoietin 1, angiopoietin 2, and haptoglobin; blood-brain barrier permeability; and survival. FINDINGS Survival increased from 54% with artemether alone to 90% with the combination of artemether and intravenous whole blood. Intravenous plasma lowered survival to 18%. Intravenous transfusion provided fast and pronounced recoveries of hematocrit, platelets, angiopoietins levels and blood brain barrier integrity. MAIN CONCLUSIONS The outcome of artemether-treated ECM was improved by intravenous whole blood but worsened by intravenous plasma. Compared to prior studies of transfusion via the intraperitoneal route, intravenous administration was more efficacious.

Evaluation of adjunctive analgesia with intrathecal fentanyl along with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section

Background: Cesarean section (CS) is one of the most common surgical procedures in female patients. Authors aimed to evaluate the postoperative analgesic efficacy of adding intrathecal fentanyl to bupivacaine, and its effect on the onset and duration of spinal anesthesia along with its effect on mother and neonate.Methods: Study was performed on 60 cesarean section parturients divided into two groups. Group F received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml fentanyl (20 µg), and Group B received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml of normal saline. The parameters taken into consideration were pain scores, analgesic requirement, hemodynamic stability and side effects.Results: It was found that duration of sensory block was prolonged in fentanyl group (111 minutes vs 86 minutes, p<0.001). Duration of effective analgesia (174.36 minutes vs 127.81; p value <0.001) were also found to be prolonged in Group F with requirement of fewer postoperative analgesics (1.02 vs 2.76, p=0.03). There was not much difference in the occurrence of side effects in both the groups.Conclusions: Addition of fentanyl to intrathecal bupivacaine for cesarean section increases the duration of postoperative analgesia without increasing maternal or neonatal side effects.

Construction of the Evaluation System of the Research Quality of Medical Insurance Budget Impact Analysis / 中国药房

OBJECTIVE：To construc t the evaluation system of the research quality of medical insurance budget impact analysis （BIA），and to provide feasible evaluation tool for related departments as medical insurance department. METHODS ：Based on BIA guidance documents and relevant empirical literatures of ISPOR ，Canada，Poland，the United States and other countries ， combined with expert interview ，the relevant elements of medical insurance negotiation BIA material were confirmed （including key elements and adjuctive elements ）. The scale and system was established to calculate total score of BIA research quality evaluation. RESULTS ：Key elements included three data blocks as target population ，market situation and treatment cost ，involving 14 key elements such as total population ，new drug scenario market share ，treatment cost ，etc.. According to the degree of compliance，0-3 points were assigned and the lowest score after normalization was taken as the basic score of BIA research quality. The adjunctive elements included five data blocks as title & abstract ，research background ，analysis framework ，result presentation and other ，including 23 adjunctive elements such as title ，abstract，research angle ，research time limit ，etc.. According to whether there is quality grade difference ，the elements were divided into type A and type B ；the grade score （0-4 points）and 0/1 score（1 point for yes and 0 point for no ）were used respectively ，and the additional score of BIA research quality was obtained after calculation and addition. According to the addition of different weights （0.67 and 0.33）of basic score and additional score ，the total score system of BIA research quality evaluation could be calculated. CONCLUSIONS ：This study successfully constructed a new BIA quality evaluation system ，which can be used for the quality evaluation of BIA research submitted by medical insurance drug negotiation.

Adjunctive interventions to accelerate orthodontic tooth movement / 华西口腔医学杂志

Orthodontic treatment is a time-consuming process whose duration usually takes 2-3 years. In general, long-term treatment duration possesses higher risks of complications, which may have adverse impact on patients. Therefore, exploring safe and effective adjunctive interventions to accelerate orthodontic tooth movement and shortening the treatment duration are of profound clinical significance. Currently, numerous adjunctive interventions have been generated and developed to accelerate orthodontic tooth movement, which can be divided into two main categories: surgical and non-surgical. However, an intervention that is widely accepted as a routine practice in orthodontic clinic is lacking. This article aims to review com-mon adjunctive interventions used to accelerate orthodontic tooth movement. This review can be used as a basis to guide clinical practice, shorten treatment duration, and improve patients' prognosis.

Adjunctive Role of Bifrontal Transcranial Direct Current Stimulation in Distressed Patients with Severe Tinnitus

BACKGROUND: This study assessed the therapeutic effect of adjunctive bifrontal transcranial direct current stimulation (tDCS) in patients with tinnitus. METHODS: Forty-four patients who visited our university hospital with a complaint of non-pulsatile subjective tinnitus in January through December 2016 were enrolled. All patients received directive counseling and sound therapy, such as a sound generator or hearing aids, and/or oral clonazepam. Patients who agreed to undergo additional bifrontal tDCS were classified as the study group (n = 26). For tDCS, 1.5 mA of direct current was applied to the prefrontal cortex with a 10–20 EEG system for 20 minutes per session. RESULTS: The Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and Visual Analog Scale (VAS) scores decreased significantly after treatment (P 0.05). Logistic regression analysis revealed that the initial THI score was independently associated with improvement in the THI. However, tDCS was not a significant determinant of recovery. CONCLUSION: tDCS can be used as an adjunctive treatment in patients with severe tinnitus. Although tDCS did not decrease the loudness of tinnitus, it could alleviate the distress associated with the condition in some patients with a moderate or catastrophic handicap.

Omega-3 fatty acid supplementation as an adjunctive therapy in the treatment of chronic kidney disease: a meta-analysis

The aim of this study was to evaluate the benefits and risks of omega-3 fatty acid supplementation in patients with chronic kidney disease. A systematic search of articles in PubMed, Embase, the Cochrane Library, and reference lists was performed to find relevant literature. All eligible studies assessed proteinuria, the serum creatinine clearance rate, the estimated glomerular filtration rate, or the occurrence of end-stage renal disease. Standard mean differences with 95% confidence intervals for continuous data were used to estimate the effects of omega-3 fatty acid supplementation on renal function, as reflected by the serum creatinine clearance rate, proteinuria, the estimated glomerular filtration rate, and relative risk. Additionally, a random-effects model was used to estimate the effect of omega-3 fatty acid supplementation on the risk of end-stage renal disease. Nine randomized controlled trials evaluating 444 patients with chronic kidney disease were included in the study. The follow-up duration ranged from 2 to 76.8 months. Compared with no or low-dose omega-3 fatty acid supplementation, any or high-dose omega-3 fatty acid supplementation, respectively, was associated with a lower risk of proteinuria (SMD: -0.31; 95% CI: -0.53 to -0.10; p=0.004) but had little or no effect on the serum creatinine clearance rate (SMD: 0.22; 95% CI: -0.40 to 0.84; p=0.482) or the estimated glomerular filtration rate (SMD: 0.14; 95% CI: -0.13 to 0.42; p=0.296). However, this supplementation was associated with a reduced risk of end-stage renal disease (RR: 0.49; 95% CI: 0.24 to 0.99; p=0.047). In sum, omega-3 fatty acid supplementation is associated with a significantly reduced risk of end-stage renal disease and delays the progression of this disease.

Effects of Provincial Pharmaceutical Quality Control Center in Key Monitoring Drugs Supervision / 中国药房

OBJECTIVE:To promote effective supervision of key monitoring drugs by provincial pharmaceutical quality control center,and to improve rational drug use. METHODS:The effects of No.2 district of Sichuan province pharmaceutical quality con-trol center on 3 categories of key monitoring drugs guidance and supervision,through urging medical institution in the area to estab-lish key monitoring drugs supervision system,formulating prescription review guideline for 3 categories of key monitoring drugs [TCM injection,adjunctive drug,proton pump inhibitors (PPIs)],developing baseline data survey,inspecting the application of key monitoring drug in medical instaurations on the spot and other measures,were introduced. Through collecting the reports of re-gional quality control center to the provincial quality control center,supervision system of medical institutions were analyzed statisti-cally. Key monitoring drugs of medical institutions in the area were analyzed statistically in respects of rational utilization ratio,uti-lization quantity,utilization amount,etc.,so as to evaluate supervision effects. RESULTS:Up to Apr. 2016,92.26%medical insti-tutions had been aware of the relevant requirements of the documents;84.25% had established the hospital supervision system. 3 categories of key monitoring drugs prescription(orders)comment guideline had been developed in Mar. 2016. 18 third-grade class-A general medical institutions were randomly selected;among 3 categories,irrational utilization ratio of TCM injection decreased by 12.35%(35.41% vs. 47.76%);that of adjunctive drugs decreased by 9.64%(20.95% vs. 30.59%);that of PPIs decreased by 7.44%(40.49% vs. 47.93%) in May 2016,compare to Jan. 2016. Average consumption sum of them decreased by 12.07%, 13.30%,9.49%,respectively in Apr. 2016,compared to Jan. 2016. 55.02% medical institutions had started to collect the baseline data. CONCLUSIONS:The provincial pharmaceutical quality control center has played an important role on establishing a supervi-sion system,it can promote the effective supervision by guiding and supervising the medical institutions evaluating the supervision of medical institutions and pointing out the problems.

Clinical Observation of Zhenqi Fuzheng Granules in the Adjunctive Treatment of Cervical Cancer / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of Zhenqi fuzheng granules in the adjunctive treatment of cervical cancer. METHODS:86 patients with cervical cancer were randomly divided into control group(43 cases)and observation group (43 cases). Control group was given intravenous dripping of Diphenhydramine hydrochloride injection 20 mg,Granisetron hydrochloride and glucose injection 5 mg,Cimetidine injection 20 mg at 0.5 h before chemotherapy. After 0.5 h of intravenous drip-ping,the patients received chemotherapy:Docetaxel injection 40 mg/m2,d1,d8,intravenous dripping;Cisplatin for injection 25 mg/m2,d1-3,intravenous dripping;21 d as a cycle,a total of 4-6 cycles. On the basis of control group,observation group was addi-tionally given Zhenqi fuzheng granules 5 g,twice 2 day. Clinical efficacies of 2 groups were observed as well as T cell subsets in-dexes [CD3+,CD4+,CD8+,natural killer cell(NK)],KPS scores,termination,terminal time,the times of chemotherapy and the oc-currence of toxic reaction before and after treatment. RESULTS:The total remission rate of observation group was significantly higher than that of control group;the proportion of termination of chemotherapy in observation group was significantly lower than control group;terminal time of chemotherapy was significantly shorter than control group;the times of chemotherapy was signifi-cantly more than control group;the incidence of gastrointestinal reaction,anemia,thrombocytopenia and leukopenia were signifi-cantly lower than control group,with statistical significance(P0.05). Before treatment,there was no statistical significance in T cell subsets indexes and KPS scores between 2 groups(P>0.05). After treatment,CD3+,CD4+ and NK cells in observation group were significantly higher than before treatment and control group,while CD8+ was significantly lower than before treatment and control group;KPS scores of 2 groups were significantly higher than before,and the observation group was significantly higher than the control group,with statistical significance(P0.05). CONCLUSIONS:On the basis of routine treatment,Zhenqi fuzheng granules can improve therapeutic efficacy,immune function and the quality of life,moreover,reduce toxic reaction in patients with cervical can-cer.

Pharmaceutical Administration Practice of Adjunctive Drugs in Medical Institutions of Sichuan Province / 中国药房

OBJECTIVE:To explore effective pharmaceutical administration measures for the rational adjunctive drugs. METH-ODS:The effective pharmaceutical administration of adjunctive drugs in medical institutions of Sichuan province was introduced, including establishing key monitoring management system of adjunctive drugs (establishing and implementing prescription review system,rational drug use training,strict supervision and examination) and playing promotion effect of provincial pharmaceutical quality management control center on medical institutions,etc. The effects of pharmaceutical administration in 18 third-grade class-A medical institutions were evaluated through statistically analyzing rational utilization ratio,drug ratio,consumption sum of ad-junctive drugs. RESULTS:Up to May 2016,key monitoring management system of hospital adjunctive drugs had been established and improved in medical institutions over Sichuan province. The rational utilization ratio of adjunctive drugs in 18 medical institu-tions increased from 69.41% in Jan. 2016 to 79.05% in May 2016;drug ratio decreased from 29.22% to 27.93%. The monthly consumption sum of adjunctive drugs decreased from 22 970 000 yuan in Apr. 2015 to 17 380 000 yuan in Apr. 2016(decreasing by 20.49%). CONCLUSIONS:Medical institutions of Sichuan province conduct effective pharmaceutical administration of adjunc-tive drugs through establishing the key monitoring management system for medical institutions and playing the role of the provincial pharmaceutical quality management control center for the supervision.

New studies on adjunctive therapies for osteomyelitis / 中华创伤骨科杂志

Osteomyelitis,particularly chronic one,is still a huge challenge to orthopedic surgeons.The current treatment for osteomyelitis centers on sensitive antibiotic coverage and surgical debridement of nonviable tissue.However,treatment failure and recurrence are common.Recently,adjunctive therapies such as hyperbaric oxygenation have been widely applied in treatment of osteomyelitis to promote sanative effect on osteomyelitis.In this review,we will outline the rationales and current status of potential adjunctive therapies in osteomyelitis management.

Pentoxifylline as Adjunctive Therapy in Children with Acute Bacterial Meningitis

Introduction. Pentoxifylline, an inhibitor of tumor necrosis factor, has been shown in animal models of acute bacterial meningitis that reduce the host inflammatory response. Objective. To evaluate the effect of pentoxifylline administrated as adjunctive therapy in the treatment of acute bacterial meningitis in children. Material and methods. Prospective and open study that included children, between 3 months to 15 years old hospitalized in the Institute of Tropical Medicine, of Asunción, Paraguay, with the diagnosis of acute bacterial meningitis. Patients were randomly assigned, to receive in addition to antibiotic therapy (cefotaxime or ceftriaxone) pentoxifylline, dexamethasone, or neither. The presenting status was recorded and the course of disease monitored with preset criteria. The primary endpoints comprised death and severe neurological sequelae. Results. Eighty seven children received as adjunctive drug pentoxifylline (n=35), dexamethasone (n=30) and neither (n=22). At admission, the demographic, clinical and laboratory characteristics of the patients were comparable. There were no significant differences among the three groups regarding to the duration of fever and meningeal symptoms after admission. The mortality were comparable (11% in pentoxifylline, 13% in dexamethasone and 9% in control group) (p>0.6). Among the survivor patients, unfavorable outcome (severe sequelae) was observed in 13%, 20% and 15% for pentoxifylline-, dexamethasone- and control-group, respectively (p>0.5). Conclution. The data of the present study do not support the routine use of pentoxifylline as adjunctive therapy for bacterial meningitis in children.

Resumen Introducción. La pentoxifilina, un inhibidor del factor de necrosis tumoral, se ha demostrado en modelos animales de la meningitis bacteriana aguda que reducen la respuesta inflamatoria del huésped. Objetivo. Para evaluar el efecto de la pentoxifilina se administra como terapia auxiliar en el tratamiento de la meningitis bacteriana aguda en niños. Material y métodos. Estudio prospectivo y abierto que incluyó a los niños, entre 3 meses a 15 años de edad hospitalizado en el Instituto de Medicina Tropical, de Asunción, Paraguay, con el diagnóstico de la meningitis bacteriana aguda. Los pacientes fueron asignados al azar para recibir, además de la terapia con antibióticos (cefotaxima o ceftriaxona) pentoxifilina, dexametasona, o ninguno. El estado de presentación se registró y el curso de la enfermedad monitorizó con criterios preestablecidos. Los criterios de valoración primarios comprenden la muerte y secuelas neurológicas graves. Resultados: Ochenta y siete niños recibieron pentoxifilina drogas como adyuvante (n = 35), dexametasona (n = 30) y no (n = 22). Al ingreso, las características demográficas, clínicas y analíticas de los pacientes eran comparables. No hubo diferencias significativas entre los tres grupos en cuanto a la duración de la fiebre y los síntomas meníngeos después de la admisión. La mortalidad fue comparable (11% en pentoxifilina, 13% en dexametasona y 9% en el grupo control) (p > 0,6). Entre los pacientes sobrevivientes, se observó un resultado desfavorable (secuelas graves) en el 13%, 20% y 15% para pentoxifylline-, dexamethasone- y el control de grupos, respectivamente (p> 0,5). Conclución. Los datos del presente estudio no apoyan el uso rutinario de la pentoxifilina como tratamiento adyuvante para la meningitis bacteriana en niños.

Clinical Observation of Fuzheng Huaji Pills in the Adjunctive Treatment of Middle and Advanced Primary Liver Cancer / 中国药房

OBJECTIVE:To observe the clinical efficacy and ADR of Fuzheng huaji pills in the adjunctive treatment of mid-dle and advanced primary liver cancer. METHODS:122 patients with middle and advanced primary liver cancer who had lost the chance or were unwilling to accept surgery,radiotherapy or chemotherapy were randomly divided into control group (61 cases) and study group(61 cases). The control group received conservative treatment such as hepatoprotecives;the study group was treat-ed with Fuzheng huaji pills 1 pills per time,3 times a day,additionally for 30 days. The tumor volume changes,major clinical symptom scores,quality of life,hemorheology indexes and alpha-fetal protein(AFP),lab index and ADR were compared between 2 groups. RESULTS:After treatment,tumor stable rate of study group was 67.2%,the improvement rate of life quality 27.9%, and AFP(563.35±143.17)pg/L;the scores of liver pain,abdominal distension,loss of appetite and fatigue,and plasma viscosity, whole blood viscosity,erythrocyte sedimentation rate decreased greatly,there were significant differences,compared to control group (P<0.05). One patient in study group suffered from diarrhea,and the symptom was relieved after symptomatic treatment;no obvious ADR was found. CONCLUSIONS:Through stabling tumor, improving major clinical symptom, life quality and hemorheology indexes,Fuzheng huaji pills play a synergistic treatment effect on primary liver cancer.

Ozone (O3): an excellent adjunctive tool in medical and surgical management of patient.

In the condition like increasing susceptibility to allergic reaction & weaken response to antibiotics, along with constantly growing prices for medical treatment, new non-medicinal methods are to be appreciated. The history of medical ozone starts in the XX century. The pioneers to apply ozone in clinical practice were E. Payer, A. Fish and H. Wolf. Ozone as an antiseptic means had been known and used from the beginning of the XX century, however, extensive and systemic research in the field of ozone therapy started in Germany in mid 70s, when ozone-resistant polymer materials and convenient ozone generating equipment came into every day clinical practice. Ozone (O3) therapy due to its disinfection effect & its capacity to transport & release oxygen into tissues is gaining a justified recognizing in many countries of the world. O3 therapy can produce its immune modulators, anti-inflammatory, bactericidal, virucidal, fungicidal, analgesics & other effects. Considering this the purpose of this literature is to highlight the significance of Ozone as an excellent adjunctive tool in the management of various medical and surgical conditions.

Meta-analysis on the efficacy and tolerability of the augmentation of antidepressants with atypical antipsychotics in patients with major depressive disorder

We assessed the efficacy and tolerability of the augmentation of antidepressants (ATDs) with atypical antipsychotics (AAPs) to treat patients with major depressive disorder. A retrograde study to identify relevant patient data included databases of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Database of Abstracts of Reviews of Effects. Data from 17 trials, involving 3807 participants, were identified. The remission rate (RR) and overall response rate (ORR) of adjunctive treatment with AAPs were significantly higher than placebo treatment: RR=1.90 (95%CI=1.61-2.23, z=7.74, P<0.00001) and ORR=1.68 (95%CI=1.45-1.94, z=7.07, P<0.00001). We found that the short-term (4 weeks) treatment [ORR=1.70 (95%CI=0.98-2.95, Z=1.89, P=0.06)] was significantly different from the long-term (6-12 weeks) treatment [ORR=1.68 (95%CI=1.45-1.94, z=7.07, P<0.00001)]. No significant difference in ORR was observed between groups with or without sedative drugs. The discontinuation rate due to adverse effects was higher for adjunctive treatment with AAPs: ORR=3.32 (95%CI=2.35-4.70, z=6.78, P<0.00001). These results demonstrate that the augmentation of ATDs with AAPs (olanzapine, quetiapine, aripiprazole, and risperidone) was more effective than a placebo in improving response and remission rates, although associated with a higher discontinuation rate due to adverse effects.

Curative Effect Observation of Transfer Factor Oral Solutions as Adjunctive Therapy in Elderly Patients with Recurrent Respiratory Tract Infection (RRTI) / 中国药师

Objective:To observe the curative effect of transfer factor oral solutions as the adjunctive therapy in ederly patients with recurrent respiratory tract infection ( RRTI) . Methods:Totally 74 ederly patients with RRTI were selected and divided into the observation group and the control group randomly. The patients in the two groups were given anti-infection and symptomatic treatment during the acute stage of attack. The patients in the observation group were additionally given transfer factor oral solutions 10ml, po, tid for 3 months. The changes in serum immunoglobulin IgG, IgA and IgM levels in the two groups before and after the medical treat-ment were compared, and the clinical curative effect and adverse drug reactions ( ADR) were observed as well. Results: After the medical treatment, the serum IgG, IgA and IgM levels in the observation group were obviously increased than before (P0. 05). The total clinical efficiency in the observation group was much higher than that in the control group (P0. 05). Conclusion:Transfer factor oral solutions as the adjunctive therapy in ederly patients with RRTI has the favorable clinical curative effect and safety, and the underlying mechanisms may be concerned with the effect of enhancing serum immunoglobulin IgG, IgA and IgM levels, as well as humoral immune function.

Modulation of cerebral malaria by curcumin as an adjunctive therapy

Cerebral malaria is the most severe and rapidly fatal neurological complication of Plasmodium falciparum infection and responsible for more than two million deaths annually. The current therapy is inadequate in terms of reducing mortality or post-treatment symptoms such as neurological and cognitive deficits. The pathophysiology of cerebral malaria is quite complex and offers a variety of targets which remain to be exploited for better therapeutic outcome. The present review discusses on the pathophysiology of cerebral malaria with particular emphasis on scope and promises of curcumin as an adjunctive therapy to improve survival and overcome neurological deficits.

Clinical observation of Xuebijing Injection on adjunctive therapy for stroke-associated pneumonia / 中草药

Objective: To observe the clinical therapeutic effect of Xuebijing Injection on stroke-associated pneumonia (SAP). Methods: A total of 42 patients with SAP were randomly divided into two groups. The patients in the two groups were all given regular treatment. Besides the regular treatment, the patients in the Xuebijing group received iv drip of 50 mL Xuebijing Injection twice a day. The course of the treatment was 7 d. Results: The total effective rate in Xuebijing group (90.5%) was significantly higher than that in the control group (66.7%) (P < 0.05). Compared with the control group, the body temperature, respiration, heart rate, white blood cell count, and C-reactive protein of Xuebijing group were obviously improved (P < 0.05). Compared with the control group,the time of defervescence and cough relief in Xuebijing group reduced obviously (P < 0.05). There were no obvious adverse reactions in all patients. Conclusion: Xuebijing Injection has the anti-inflammatory effect and it is a positive adjunctive therapy for the treatment of SAP without obvious adverse reactions.

The Effects of Adjuvant Therapy of Atypical Antipsychotics on the Change of Clinical Symptoms in Patients with Major Depressive Disorder in a University Hospital: 1 Year Follow-Up Study / 신경정신의학

OBJECTIVES: This study is to assess the effects of adjuvant therapy of atypical antipsychotics on the change clinical symptoms in patients with major depressive disorder. METHODS: We conducted a chart review of patients, who visited a university hospital. Ninety seven patients were divided into two groups : patients with adjuvant use of antipsychotics with antidepressants (AD+AAP ; n=32) and patients with only antidepressants (AD ; n=65). We compared and analyzed three clinical domains including depressive symptoms, anxiety symptoms and sleep qualities between two groups. Depressive symptoms, Anxiety symptoms, and sleep pattern were evaluated by Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) at baseline (first day of admission) and 1 year later. RESULTS: During 1 year, the BDI scores of AD+AAP group has been greatly decreased, compared to AD group (F=5.87, p=0.02). In the comparison of patients with severe symptoms of major depressive disorder (BDI score >21), there was significant difference in the change of BDI score between AD+AAP and AD (F=4.14, p=0.04). After 1 year, there were no significant differences in BAI score change (F=0.51, p=0.47), PSQI score change (F=0.89, p=0.35) between two group. However, the duration of adjunctive therapy and the type of atypical antipsychotics would not impact the results. CONCLUSION: Current study suggested that adjuvant therapy of atypical antipsychotics would be effective on depressive symptoms in patients with severe major depressive disorder, compared to the treatment with antidepressants alone.

Reattachment of Partially Amputated Ear Based On 7 mm-wide Small Skin Pedicle without Vascular Anastomosis

PURPOSE: It has been reported that the ear perfusion can maintain by a very small pedicle because the ear has good vascularized system. Replantation of an amputated ear with vascular anastmosis, has been reported before and offers the succeessful reconstructive results. But, in this paper we report a case of complete nonmicrosurgical salvage of a nearly amputated ear based on 7 mm-wide small skin pedicle with adjunctive therapies. METHODS: A 49-year-old man was referred with a nearly complete detachment of left ear. The blood supply to the ear was maintained exclusively on 7 mm-wide small skin pedicle in the lobule. After we identified the fresh bleeding at the distal margin of the detached ear, we performed the primary repair. At the end of the procedure, the areas of the concha bowl and helical root appeared to be congested. So the immediate postoperative treatment for improving the tissue survival was done with Lipo-Prostaglandin E1 (Eglandin(R)) injection, leech apply and antibiotics medications. RESULTS: Assessment of the replanted ear on postoperative day 14 revealed a nearly viable auricle including the helical root. The ear appeared to be entirely healed, with excellent projection and fully restored normal elasticity. CONCLUSION: We found the complete salvage of a nearly amputated ear based on 7 mm-wide small skin pedicle with adjunctive therapies including Lipo-Prostaglandin E1 (Eglandin(R)) injection, leech apply and antibiotics without microsurgery.