The speed-limiting role in the onset of antidepres-sants:the re-establishment of the excitation/inhibi-tion(E/I)function balance in the mPFC of rats / 中国药理学与毒理学杂志

OBJECTIVE There are serious hazards in depression,and the precise mechanism underlying the delayed onset of clinical antidepressants remains unclear.The purpose of this study was to investigate the regular pattern of the speed-limiting role of excitation/inhibition(E/I)function balance in the mechanism of antidepressant action.METHODS Based on the previous study,we focused on glutamatergic pyramidal neurons in the medial prefrontal cortex(mPFC)here and used its excitability to represent the establishment of a new E/I functional balance.We studied the changes in the firing activity of glutamatergic pyramidal neuron in the mPFC at different administration times for five types of antidepressants that act on different pharmacological targets and different onset times,including fluoxetine(SSRI),duloxetine(SNRI),vilazodone[serotonin 1A receptor(5-HT1A)ago-nist and SSRI],ketamine[N-methyl-D-aspartate(NMDA)receptor antagonist],and hypidone hydrochloride(YL-0919,new antidepressant with sigma-1 receptor ago-nist and SSRI).We first examined the initial onset time of activation of pyramidal neurons using multichannel elec-trophysiological recordings and tested the antidepressant behavioral effects using the FST.We then selected three antidepressants(fluoxetine,ketamine,and vilazodone)to explore its effects on the BDNF-mTOR pathway by West-ern blotting.In addition,we disrupted the E/I function bal-ance using chemogenetics to investigate the antidepres-sant-like effects of YL-0919 and ketamine in the FST and TST.RESULTS We found that treatment with fluoxetine for 17 days significantly increased the firing activity of pyramidal neurons and decreased the immobility duration in the FST.Similarly,it took duloxetine for 10 d,vilazodone for 4 d,YL-0919 for 3 d and ketamine for 24 h,to exert such effects.Meanwhile,Western blotting results sug-gested that the expression of BDNF and phosphorylation of mTOR in the mPFC significantly increased.How-ever,haloperidol,a classic antipsychotic(without antide-pressant effects),exerted no such effects on the firing activities of pyramidal neurons.In addition,disrupting the E/I function balance(via activating the GABA neurons and inhibiting the glutamate neurons)blocks out the antidepressant-like effects of YL-0919 and ketamine in the FST and TST.CONCLUSION Taken together,our findings suggest that the commencement of antide-pressant effects may be accompanied by the increase in the firing activity of pyramidal neurons and the activation of the BDNF-mTOR pathway,which may be a necessary and rate-limiting process.The re-establishment of the E/I balance may be a landmark event for the onset of antide-pressant effects.

Analysis of Temporal parameters in the Speech of the Children with Hearing Loss

The surge of literature indicates that the to develop more effective speech training procedures for the subjects with hearingloss, it is necessary to study the deviation in their speech from that of the normal-hearing subjects and hence, the analysis ofspeech of the subjects with hearing loss becomes essential. The current investigation aimed at studying the temporalparameters of vowel and consonants in the speech in children with hearing loss. Sixteen bisyllabic words with stopconsonants and vowels, uttered by participants with severe sensorineural hearing loss and age and gender-matched normalhearing participants in the age range of eight to ten years were recorded and the temporal parameters namely vowel duration,closure duration, consonant duration, voice onset time, burst duration, and word duration were analysed acoustically. Resultsof statistical analyses revealed that there were significant differences in vowel duration, voice onset time, closure durationand consonant duration between the participants of two groups. No differences in burst duration were observed between theparticipants of both groups.

Auditory Cortical Temporal Processing and Hemispheric Asymmetry Revealed by N1 Dipole Source Activity in Adult Cochlear Implant Users / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cochlear implant (CI) changes the way that sound inputs are processed in the brain, possibly causing brain reorganization. Given that the pattern and degree of reorganization are known to be related to speech perception skill, information regarding hemispheric asymmetry can be used to predict behavioral performances in CI users. The current study investigated the hemispheric asymmetry of N1 dipole cortical activity in response to the temporally varied speech sounds and its relationship to speech perception abilities in adult CI users. SUBJECTS AND METHOD: The cortical activity was recorded from 64 scalp electrodes in 10 CI users and 11 normal-hearing controls. Speech stimuli were synthesized consonant-vowels, the /ba/-/pa/ continuum that ranged from 0 to 50 ms with a 6-step voice onset time (VOT). N1 dipole amplitudes, latencies, and locations were analyzed as a function of VOT and the direction of implantation. Also investigated was the relationship between N1 dipole lateralization and speech perception. RESULTS: For the N1 dipole location, significant location differences between CI and normal hearing groups were seen at 40 ms VOT in the anterior-posterior direction. For hemispheric asymmetry, the N1 dipole activity in good CI performers was higher in the auditory cortex contralateral to the stimulated ear, while poor CI performers showed greater ipsilateral activity. In addition, a lateralization index at 20 ms VOT showed significant correlation with the /ba/-/pa/ consonant perception scores in noise. CONCLUSION: The results suggest that the hemispheric asymmetry of N1 dipole activity in response to stimuli of temporally varied speech has a substantial clinical value, and that this can be used to estimate CI speech perception.

Evaluation Of Intubating Conditions With Rocuronium By Priming Technique. A Randomized Double Blind Study

BACKGROUND: a prospective, randomized, double-blind study was designed to evaluate the effects of priming technique with rocuronium bromide for intubation in adult patients undergoing surgical procedures.METHODS: sixty adult patients of 20-60 years of age with asa-1 physical status posted for surgical procedures were divided in to two groups. group c received normal saline (2ml) as priming dose and group p received 0.06mg/kg rocuronium (2 ml) as priming dose and after 3 minutes intubating dose group c received 6 mg /kg (5 ml) group p received the 5.4 mg /kg (5 ml) as intubating dose .muscle relaxation was assessed with nerve stimulator for every 10 seconds and assessed visually for loss of adduction of thumb and disappearance of t1 of train of four (TOF) stimuli. By this we can note the onset time of intubation (Ti) and intubating conditions were assessed buy cooper et al scoring system. Any adverse effects were also noted.RESULTS: The mean onset of intubation time (Ti) in the group P was 52.33±6.79 sec, in the group C was 95.67±11.04 sec ,P value is 0.00 it is highly significant. Minimum Ti is 80 sec. and maximum Ti is 120 sec. intubation scores as per “cooper et al scoring”were 8 or 9 in both the groups. There were no incidences of weakness, aspiration, bradycardia, ptosis, hypotension, in either of the groups during study observation.CONCLUSION: administration of Priming dose of rocuronium before the intubating dose causes the onset of neuromuscular block is rapid and onset time of intubation is became comparable to that of suxamethonium with excellent intubating conditions and without adverse effects.

Behavioral Perception and Neural Correlates of Categorical Perception in Cochlear Implant Users / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although many cochlear implant (CI) recipients receive significant benefits from using the implants, speech perception ability is still known to vary among CI users, and the variability is closely related to the ability of users to process temporal information. As one of the important temporal cues for speech perception in CI users, voice onset time (VOT) can be used to examine behavioral perception and neural correlates of temporal processing. In this study, we measured categorical perception and N1-P2 cortical auditory evoked potentials (CAEPs) using a /ba/-/pa/ VOT continuum in CI users as well as in normal-hearing (NH) listeners. SUBJECTS AND METHOD: Ten CI subjects and 11 NH controls participated in syllable identification tasks and in electroencephalography recording. CI subjects were divided into two groups, which were ‘good’ and ‘poor’ performers based on their speech perception scores. The stimuli used in both experiments were a synthetic /ba/-/pa/ VOT continuum. The identification boundary and N1-P2 peak-to-peak amplitude were measured for each subject group. RESULTS: Behavioral results revealed that poor CI performers had a delayed identification boundary compared to NH listeners and good CI performers. However, N1-P2 peak-to-peak amplitudes in both good and poor CI performers were significantly smaller than those in NH group. CONCLUSION: N1-P2 amplitudes reflected decreased auditory cortical activity of temporal cues in CI users. The categorical perception of good CI performers was similar to that of NH listeners, whereas their cortical responses were decreased to the level similar to that of poor CI performers. This finding indicates that CAEPs would be more sensitive to altered temporal processing of CI users than to behavioral measures.

Significance of emergency observation time of measurement with high-sensitive troponin T in patients with chest pain / 实用医学杂志

Objective To investigate the value of emergency observation time of chest pain patients for ruling-out myocardial infarction by using high-sensitive troponin T. Method Total 1 687 patients with chest pain from December 2015 to August 2016 visiting Sichuan University Huaxi Hospital emergency department were en-rolled.We included 1082 patients who diagnose with AMI finally.We define the time from the start of the chest pain to visiting the emergency as the onset time.We analyzed the level of high-sensitive troponin T of AMI patients at dif-ferent onset time and calculated the rate of patients with hs-cTnT level lower than the conventional hs-cTnT thresh-old of 14 ng/L. Result Among 1082 cases of AMI patients,32 patients with hs-cTnT level below threshold(14 ng/L).The for whose The onset time over 5h was observed in AMI patients with hs-cTnT level over 14 ng/L.Con-clusion AMI can not be excluded in chest pain patients whose hs-cTnT levels below the conventional threshold value of 14 ng/L,and these people should be dynamically monitored for 5h in emergency department.The patients can exclude AMI if the hs-cTnT levels are below 14 ng/L after 5 hours.

Effect of influence of different priming dose of cisatracurium on the onset time / 临床麻醉学杂志

Objective To investigate different priming dose of cisatracurium effect on the onset time.Methods In the First Affiliated Hospital of Nanjing Medical University from November 2014 to April 2015,eighty adult patients (male 41 cases,female 39 cases age from 18 to 60.) scheduled for selective surgery,were randomly divided into four groups,20 in each.Control group (group C) priming with 3 ml saline,group C1 priming with cisatracurium 15 μg/kg,group C2 priming with cisatra curium 30 μg/kg and group C3 priming with cisatracurium 50 μg/kg,1 minutes after the priming injection,each group respectively received the left over intubation dose of cisatracurium 0.15,0.135,0.12,0.10 mg/kg,followed by anesthesia induction of midazolam 0.05 mg/kg,fentanyl 5.0 μg/kg,etomidate 0.3 mg/kg.Neuromuscular block was monitored using train of four stimulation mode.The time when T4/T1=0 after the left over intubation dose of cisatracurium injection and adverse reaction were recorded.Results The onset time in group C3 (114.2±14.1) s was significantly less than that in group C2 (136.3±428.1) s,group C1 (164.6±26.9) s and group C (165.9±10.8) s (P＜0.01).No adverse reaction of dyspnea,urticaria,arrhythmia occurred after priming injection of cisatracurium in all the four groups.Conclusion Priming dose of 50 μg/mg cisatracurium can significantly shorten the onset time compared to the priming dose of 15 μg/mg and 30 μg/mg.

Analysis on risk factors and clinical significance in patients with pancreatic cancer / 重庆医学

Objective To investigate the risk factors and clinical significances in the patients with pancreatic cancer(PC). Methods The clinical data of 936 patients with PC in the Affiliated Hospital of Chongqing Medical University during the past 10 years were retrospectively analyzed,and contemporaneous 832 age and sex-matched cases of non-complicating tumor and disease of digestive system and metabolic abnormality were collected as the control group.The differences and correlation between the two groups were analyzed retrospectively,including the gender,age,incidence and course of diabetes mellitus(DM),category of hypogly-cemic drugs,body mass index(BMI),history of pancreatitis,family history of PC and family history of diabetes.Results (1)There were more males than females in PC group,moreover the male proportion was much higher than the female proportion with the age growing.In the PC group,251 cases(26.8%)were complicating DM,which was significantly higher than 13.0% of DM occurrence rate in the control group(P<0.01);in the PC group,new onset DM was up to 14.1%(132/936),which was obviously higher than 3.4% in the control group(P<0.01).The family history of PC,history of pancreatitis,family history of diabetes,overweight and obesity were the independent risk factors for PC.The risk of PC in new-onset DM patients was increased by 4.9 times.Metformin could decrease the risk of developing PC.The time from diagnosed DM to PC in the metformin group was longest[(18.86 ± 3.46) months],which in the non-medication group was shortest[(6.44 ± 1.07)months].Conclusion New-onset DM patients with fami-ly history of DM,family history of PC,history of pancreatitis,overweight and obese should be vigilant to develop PC.For the new-onset DM patients,anti-diabetic drugs influence the onset time of PC and metformin may have effect to delay the occurrence and de-velopment of PC.

Analysis of Time-to-Onset and Onset-Pattern of Drug-Induced Blood Disorders with Monoclonal Antibody Agents / 医薬品情報学

Objectives: The aim of this study was to investigate both the time‐to‐onset and the onset‐pattern of drug‐induced blood disorders (DIBD) following the administration of monoclonal antibody agents through the use of the spontaneous adverse reaction reporting system of the Japanese Adverse Drug Event Report （JADER) database.Methods: Data in the JADER database from April 2004 to October 2017 were downloaded from the Pharmaceuticals and Medical Devices Agency website.　The DIBD dataset for monoclonal antibody agents was constructed based on the data for the drug information and adverse drug reactions.　The information for the adverse drug reactions was categorized in accordance with the preferred terms of the Medical Dictionary for Regulatory Activities and included thrombocytopenia, platelet count decreased, neutropenia, neutrophil count decreased, leukopenia, white blood cell count decreased, pancytopenia, anaemia, agranulocytosis, granulocyte count decreased, granulocytopenia, and bone marrow failure.　This dataset was then used to calculate the median onset times for the DIBD and the Weibull distribution parameters.Results: The median onset times of the DIBD for gemtuzumab ozogamicin, cetuximab, ramucirumab, trastuzumab, panitumumab, bevacizumab, infliximab, rituximab, trastuzumab, and ibritumomab tiuxetan (90Y) were 4, 10, 13, 14, 14, 14, 16, 16, 27, and 28 days, respectively.　The Weibull distributions for cetuximab, trastuzumab, bevacizumab, infliximab, and tocilizumab were estimated to fit the early failure type profile, while those for gemtuzumab ozogamicin, ramucirumab, rituximab, and ibritumomab tiuxetan (90Y) were estimated to fit the wear out failure type profile.　The Weibull distributions for panitumumab were estimated to fit the random failure type profile.Conclusions: The results of the present study clarified both the most likely time period and the onset‐pattern of DIBD that can occur in patients after the administration of monoclonal antibody agents.

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents / 대한마취과학회지

Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.

The Perceptual and Consonant Analysis for the Voice with Hypothyroidism

BACKGROUND AND OBJECTIVES: The main purpose of this study is to clarify perceptual and acoustic analysis for the patients with hypothyroidism after thyroidectomy especially focused on the characteristics of speech articulation with special reference to the consonant production. MATERIALS AND METHODS: The subjects of the research were 40 male and female adults (males : 5, females : 35). They were all received radioactive iodine treatment which after total thyroidectomy. Voice samples were collected during the three stages of after surgery, pre-radioisotope treatment (RIT), and post-RIT. The acoustic analysis was conducted by using Pratt (ver.5.2.21) after measuring voice onset time (VOT). The subjective evaluation of the voices used CAPE-V. RESULTS: A significant decrease in overall severity was displayed in the CAPE-V following RIT. It may be conjectured that this is connected to the change in voice following RIT. The loudness of the sound displayed a significant decrease in the CAPE-V following RIT. It is conjectured that this is connected to the decrease in vocal intensity following RIT. No statistically significant results were revealed for the comparative analysis on the voice onset time (VOT) in all plosives during the three periods. CONCLUSION: Perceptually, the overall severity of the voice with hypothyroidism was changed significantly before and after RIT. Eventhough VOT were not significantly changed, it tended to decrease VOT in patients with hypothyroidism.

Incidence and outcome of anti-tuberculosis drug-induced hepatotoxicity in tuberculosis inpatients / 中华流行病学杂志

Objective Based on the medical records and follow-up records of hospitalized patients who received anti-tuberculosis therapy in the Third People' s Hospital of Zhenjiang in Jiangsu province from 2006 to 2012,we investigated the incidence and outcome of anti-tuberculosis drug induced hepatotoxicity (ATDH) and provided evidence for the prevention of ATDH.Methods According to tuberculosis patients' medical information and liver function test records,ATDH patients were diagnosed according to the criteria of International Consensus Meeting and American Thoracic Society respectively,then the related factors and outcomes were analyzed.Results A total of 1 967 hospitalized tuberculosis patients were reviewed retrospectively,in which 1 403 (71.3％) were men,1 790 (91.0％) were pulmonary tuberculosis patients,1 528 (77.8％) were patients receiving initiative treatment,979 (49.8％) were sputum smear-positive patients,and 1 297 (65.9％) had other complicated diseases.According to the criterion of International Consensus Meeting,the incidence of ATDH was 16.5％,the median time of onset was 25 days.According to the criterion of American Thoracic Society,the incidence of ATDH was 8.3％,the median time of onset was 23 days.The incidence of ATDH was significantly higher in males and HRZE therapy group (P＜0.05).Under the two liver criteria,69.5％ and 70.1％ of the patients changed primary therapy respectively after ATDH occurred.89.8％ and 88.4％ patients' liver function returned to normal range after changing or stopping therapy.Conclusion According to two liver injury criteria,the incidences of ATDH were 16.5％ and 8.3％ in hospitalized tuberculosis patients respectively,and ATDH mainly occurred in the furst month of anti-tuberculosis treatment.The monitoring of liver function should be strengthened in males and HRZE therapy group to reduce the incidence of ATDH.

Incidence and outcome of anti-tuberculosis drug-induced hepatotoxicity in tuberculosis inpatients / 中华流行病学杂志

Objective Based on the medical records and follow-up records of hospitalized patients who received anti-tuberculosis therapy in the Third People' s Hospital of Zhenjiang in Jiangsu province from 2006 to 2012,we investigated the incidence and outcome of anti-tuberculosis drug induced hepatotoxicity (ATDH) and provided evidence for the prevention of ATDH.Methods According to tuberculosis patients' medical information and liver function test records,ATDH patients were diagnosed according to the criteria of International Consensus Meeting and American Thoracic Society respectively,then the related factors and outcomes were analyzed.Results A total of 1 967 hospitalized tuberculosis patients were reviewed retrospectively,in which 1 403 (71.3％) were men,1 790 (91.0％) were pulmonary tuberculosis patients,1 528 (77.8％) were patients receiving initiative treatment,979 (49.8％) were sputum smear-positive patients,and 1 297 (65.9％) had other complicated diseases.According to the criterion of International Consensus Meeting,the incidence of ATDH was 16.5％,the median time of onset was 25 days.According to the criterion of American Thoracic Society,the incidence of ATDH was 8.3％,the median time of onset was 23 days.The incidence of ATDH was significantly higher in males and HRZE therapy group (P＜0.05).Under the two liver criteria,69.5％ and 70.1％ of the patients changed primary therapy respectively after ATDH occurred.89.8％ and 88.4％ patients' liver function returned to normal range after changing or stopping therapy.Conclusion According to two liver injury criteria,the incidences of ATDH were 16.5％ and 8.3％ in hospitalized tuberculosis patients respectively,and ATDH mainly occurred in the furst month of anti-tuberculosis treatment.The monitoring of liver function should be strengthened in males and HRZE therapy group to reduce the incidence of ATDH.

Seasonal Acclimatization in Summer versus Winter to Changes in the Sweating Response during Passive Heating in Korean Young Adult Men

We investigated the sweating response during passive heating (partial submersion up to the umbilical line in 42+/-0.5degrees C water, 30 min) after summer and winter seasonal acclimatization (SA). Testing was performed in July during the summer, 2011 [summer-SA; temp, 25.6+/-1.8degrees C; relative humidity (RH), 82.1+/-8.2%] and in January during the winter, 2012 (winter-SA; temp, -2.7+/-2.9degrees C; RH, 65.0+/-13.1%) in Cheonan (126degrees52'N, 33.38'E), Republic of Korea. All experiments were carried out in an automated climatic chamber (temp, 25.0+/-0.5degrees C: RH, 60.0+/-3.0%). Fifteen healthy men (age, 23.4+/-2.5 years; height, 175.0+/-5.9 cm; weight, 65.3+/-6.1 kg) participated in the study. Local sweat onset time was delayed during winter-SA compared to that after summer-SA (p< 0.001). Local sweat volume, whole body sweat volume, and evaporative loss volume decreased significantly after winter-SA compared to those after summer-SA (p<0.001). Changes in basal metabolic rate increased significantly after winter-SA (p< 0.001), and tympanic temperature and mean body temperature were significantly lower after summer-SA (p<0.05). In conclusion, central sudomotor acitivity becomes sensitive to summer-SA and blunt to winter-SA in Rebubic of Korea. These results suggest that the body adjusts its temperature by economically controlling the sweating rate but does not lower the thermal dissipation rate through a more effective evaporation scheme after summer-SA than that after winter-SA.

The study on estimation of the onset time by fluid-attenuated inversion recovery in acute ischemic stroke / 中国神经精神疾病杂志

Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke (ALS) based on the analysis of signal strength through the fluid-attenuated inversion-recov?ery (FLAIR)and volume of interest (ROI) in ALS patients with known time of onset. Method Forty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups:0~180 min, 180~360 min and 360~720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsi?lateral and contralateral sides were measured. Result There was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0~180 min and 180~360 min groups than in 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0~180 min, 180~360 min and 360~729 min groups, respectively. Conclusion FLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR posi?tive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.

Effects of ephedrine pretreatment and cisatracurium priming on the cisatracurium-induced neuromuscular blockade and hemodynamics in elderly patients / 中国综合临床

Objective To compare the effects of Ephedrine and combined with small dose cisatracurium treatments on the onset time of cisatracurium and hemodynamics in elderly patients.Methods Sixty cases of elderly patients undergoing elective surgery under general anesthesia were randomly divided into 4 groups:E group (ephedrine pretreatment),P group (cisatracurium primin),PE group (cisatracurium priming and ephedrine pretreatment) and C group(control),and each group of 15 cases.Cisatracurium 0.15 mg/kg were given in P group and PE group,and then ephedrine 70 μg/kg were given in PE group and E group.Anesthesia was induced with target controlled infusion of propofol (target plasma concentration 3-5 pg/ml),fentanyl 3-4 pg/kg.Cisatracurium 0.015 mg/kg were given in E group and C group,and P group and PE group dose intravenous cannula remaining.Tracheal intubation was performed when the twitch height depressed to 0.Results The Onset time of PE,C,E and P group were (164±28) s,(306±61) s,(187±31) s and (193±40) s and there were significant differences(F=33.990,P＜0.01).The onset time of PE group was shorter than that in C,E,P group,and the difference was significant (P＜0.05).Systolic pressure (SBP) and mean arterial pressure (MAP) levels in four groups after induction were lower than those before induction (F =35.783,30.015,P =0.000).SBP,diastolic blood pressure (DBP),MAP in PE group and E group were significant higher than those in C group(P＜0.05).After inductions,heart rate(HR) in PE group was significant different form that in C group(P ＜0.05),and HR of C group was significantly decrease than before inductions(P＜0.05).After inductions,the cases with DBP were 11 patients(73.3％) in C group,10 patients(66.7％) in P group:,5 patients(33.3％) in E group,and 4 patients (26.7％) in PE group,the different were significant (x2 =9.867,P ＜ 0.05).After intubation,cases with increase blood press were 3 patients (20.0％) in C group,5 patients(33.3％) in E group,and 4 patients(26.7％) in E group and PE group(P＞0.05).Conclusion Ephedrine of 70 μg/kg can relief the circulatory depression and accelerate the onset time of cisatracurium in the elderly patients.Combined with cisatracurium priming can further shorten the onset time and be for elders.

Children with Functional Abdominal Pain Treated with Shaoyao Gancao Decoction / 浙江中医药大学学报

Objective] To observe the clinical effect of Shaoyao Gancao Decoction on treating children functional abdominal pain to offer reference for further observation. [Method] Choose 200 children patients in pediatric outpatient department of Changxing County TCM Hospital, randomly divide them into treatment and control groups in order, n=100. The treatment one was administered revised Shaoyao Gancao Decoction, the control one orally took Medilac-Vita; both for 4 courses, then observe the cure effects. [Result] In treatment group, total effective rate 94.00%; for control one, it was 86.00%. The comparison of both had difference of statistical meaning( P<0.05). On comparing their abdominal pain relieve, in treatment group, there's more in first 2w and showed marked summit value in the first week; while in control one, there's no marked summit value; so the treatment group was more obvious than other one on relieving pain in the first 2w(P<0.05). The side effect occurrence rate of treatment group was less than other one, the difference between them had statistical meaning(P<0.05). [Conclusion] The revised Saoyao Gancao Decoction has marked cure effect on children functional abdominal pain, worth clinical promotion.

<b>3. Evaluation of Drug Induced Severe Eruption Cases in the Japanese Adverse Drug Event Report Database and Commonality of the Reported Drugs</b> / 薬剤疫学

From April 2012, Japanese Adverse Drug Event Report database (JADER) has become downloadable for utilization in the public, under the specified acceptable use policy. Given the situation, we focused on the severe eruptions which cases are increased in the public Relief System for Sufferers from Adverse Drug Reactions, for the purpose to analyze the characteristics of typical severe eruptions and a trend or a commonality in the corresponding reported drugs, by utilizing JADER. Disproportionate reporting obtained with ROR (Reporting Odds Ratio) and distribution parameter estimations obtained with Weibull distribution fit for the onset time of drug adverse reactions, were applied for the analysis in addition to the summary of frequency. We obtained 10,171 cases of severe eruptions from JADER, after exclusion of duplicated reports. In the Drug Induced Hypersensitivity Syndrome (DIHS), which has characteristics in clinical time course and causal drugs, we confirmed that typical causal drugs such as anti-epilepsy are frequently reported in JADER. On the other hand, drugs other than typical causal drugs also showed high ROR signal values. In the estimation of Weibull distribution shape parameter fit for drug adverse reaction onset time, DIHS gave estimation apparently different from other severe eruptions. Coincide with the estimation, histogram of onset time for DIHS showed the peak at around 20 days after drug administration, which is later than other severe eruptions. We conclude that analytical approach to obtaining information from multiple aspects of JADER data should be a useful effort for the persons who are engaged in preventive action for drug adverse reactions.

<b>2. Comparison of the Onset Time Profile among the Interferon Formulations in Adverse Drug Reaction of Suicide- or Diabetes-Related</b> / 薬剤疫学

Japanese Adverse Drug Event Report database (Abbreviation; JADER) was disclosed April 2012 and will be expected to have a major role in the establishment of the adequate information for the proper usage of drugs. In this paper, we were compared using the shape parameters that were estimated by fitting the Weibull distribution, whether the adverse drug reaction of suicide- or diabetes-related onset time profiles vary depending on the type of interferon formulations. The data were used JADER of August 2013. The combined number of adverse drug reaction and drug that duplicates removed was 702,925. In diabetes-related side effects, the distribution of adverse drug reaction time was different among formulations. The shape parameters of the Weibull distribution are 1.49 (1.09-1.94), 0.84 (0.66-1.05) and 1.07 (0.92-1.23)(point estimates and two-sided 95% confidence interval) in interferon-α,-β and peginterferon, respectively. Interferon-α is categorized as the wear-out failure type adverse drug reaction onset time profile from which its 95% confidence interval exceeds 1. Peginterferon is classified as the random failures type from which its point estimates is almost 1. Since the upper 95% confidence interval is near 1, the time profile of interferon-β is close to the early failures type. We conclude that the combination of the shape parameter of the Weibull distribution and the visual inspection, like histogram and box plot, is useful in the monitoring of adverse drug reaction onset time profile.

Uso do Voice Onset Time associado à diadococinesia oral e laríngea na avaliação da disartria na Esclerose lateral amiotrófica / Using Voice Onset Time (VOT) in association with oral and laryngeal diadochokinesia in evaluation of the dysarthria in Amyotrophic lateral sclerosis / El uso del Voice Onset Time asociado con diadochokinesia oral y laringeal en la evaluación de la disartria en esclerosis lateral amiotrófica

A Esclerose Lateral Amiotrófica (ELA) é uma doença progressiva que envolve a degeneração do sistema motor, afetando neurônios motores superiores e inferiores. Os sinais clínicos da ELA variam de acordo com a região afetada. As funções fonoarticulatórias, deglutitórias e respiratórias são muitas vezes afetadas e em relação à avaliação e monitoramento das alterações encontradas na fonoarticulação, a diadococinesia (DDK) é amplamente utilizada. A análise do Voice Onset Time (VOT) associada à DDK pode contribuir para avaliação acurada da disartria na ELA. Participaram do estudo 10 sujeitos com ELA (GE) e 13 sujeitos que formaram o grupo controle (GC). O número de sujeitos com ELA representa uma amostra considerável visto que a doença tem rápido curso e os sujeitos se encontravam em um estágio avançado da doença. Foi realizada análise da DDK e do VOT e aplicado teste estatístico para verificar possíveis diferenças na DDK entre o GC e o GE. Os parâmetros da DDK, Média do período da DDK (AVP) e Média da taxa da DDK (AVR), mostraram diferenças em todas as tarefas. Desvio-padrão do período (SDP) e Coeficiente de Perturbação do período (JITT) apresentaram diferença para duas tarefas (/ta/ e /ka/). A análise do VOT dos sujeitos permitiu caracterizar qualitativamente a produção das tarefas da DDK e mostrou que os sujeitos, principalmente com comprometimento bulbar, não chegam a produzir o som esperado pelo teste, tornando insuficiente a utilização apenas da DDK nesses casos. A associação do VOT à DDK possibilita avaliação mais completa e qualitativa da disartria em doenças como a ELA com sintomas bulbares...

Amyotrophic lateral sclerosis is a progressive degenerative disease that involves the motor neurons (upper and lower motor neurons). The presenting clinical symptoms are associated with involved areas and include speech disorders, swallowing disorders and respiratory problems. The diadochokinesia (DDK) is used to evaluate speech disorders presenting on ALS. The Voice Onset Time (VOT) analysis in association with diadochokinesia may contribute to improve analysis of speech in subjects with ALS. 10 subjects with ALS were studied (GE) and 13 subjects without neurological problems were the control group (GC). The number of ALS´ subjects in this study represents a considerable corpus as the ALS disease has a fast progression and the subjects were in an advanced state of the disease. The DDK and VOT were measured. The statistical analysis of DDK data showed differences between groups to Average Diadochokinesia Period (AVP), Average Diadochokinesia Rate (AVR), Standard Deviation of Period (SDP) and Perturbation of Diadochokinesia Period (JITT) parameters. AVP and AVR showed differences in all tasks. JITT and SDP indicated differences to /ta/ and /ka/ tasks. The VOT analysis allows a qualitative characterization of the subjects´ speech production in DDK and showed that the subjects (with bulbar symptoms) did not produce the sound production expected what turns the singular use of DDK analyzes insufficient in this cases. Associate VOT and DDK guarantees complete and qualitative analyses of speech production in ALS disease, which can present immobility of facial movements...

Esclerosis Lateral Amiotrófica (ELA) es una enfermedad progresiva que implica en la degeneración del sistema motor, afectando las neuronas motoras superiores e inferiores. Los signos clínicos de ELA difieren de acuerdo a la región afectada. Las funciones de habla, deglutición y respiración son a menudo afectadas y en relación a la evaluación y seguimiento de los cambios encontrados en la articulación del habla, la diadochokinesia (DDK) es ampliamente utilizada. El análisis del Voice Onset Time (VOT) asociado con la DDK puede contribuir para una evaluación mas exacta de la disartria en ELA. Participaron del estudio 10 sujetos con ELA (GE) y 13 sujetos que formaron el grupo control (GC). Elnúmero de sujetos con ELA representa una poblacion considerable ya que la enfermedad tiene un curso rápido y los sujetos se encontraban en una fase avanzada de la enfermedad. Se realizó el análisis de DDK y VOT y se aplicó prueba estadística para comprobar las diferencias posibles en la DDK entre GC y GE. Los parámetros de la DDK, el pormedio del período de la DDK (AVP) y el pormedio de la tasa de la DDK (AVR), mostraron diferencias en todas las tareas. La Desviación Estándar del Período (SDP) y el Coeficiente de Perturbación del período (JITT) presentan diferencia para dos tareas (/ta/ y /ka/). El análisis del VOT de los sujetos permitió caracterizar cualitativamente la producción de las tareas de DDK y mostró que los sujetos, principalmente con comprometimiento bulbar, no llegan a producir el sonido esperado en la prueba, hasiendo insuficiente el uso apenas de la DDK en estos casos. La asociación de la VOT a la DDK posibilita una evaluación más completa y cualitativa de la disartria en enfermedades como ELA con síntomas bulbares...