Systemic Hormonal Unloading (SHU) in secondary hypertension: Addressing the long-term adverse cardiovascular outcomes

@#Excess hormone production from adrenal tumors caused by primary hyperaldosteronism or pheochromocytoma are common etiologies for secondary hypertension. Studies have shown that sustained long-term circulating hormones in excess affect the blood vessels and cardiac structures. Inflammation of cardiomyocytes leads to fibrosis and eventual cardiomyopathy and is clinically presented as arrhythmia, nonfatal myocardial infarction, heart failure, or even death. The tissue changes and/or impaired cardiac function are reversible if early diagnosis and removal of the adrenal tumor by unilateral adrenalectomy is done. However, the condition becomes challenging if the adrenal lesions are bilateral. This article introduces the concept of systemic hormonal unloading and will discuss the philosophy of quality of life in managing bilateral adrenal disease.

Randomized Controlled Trial Design Based on Patient Cohorts： Methods and Applications of Trials Within Cohorts / 中国实验方剂学杂志

Trials within cohorts （TwiCs） are design methods derived from randomized controlled trials （RCTS）. They have been widely used in chronic disease areas such as tumors and cardiovascular diseases. The basis of the TwiCs design is a prospective cohort of specific diseases. When RCTS need to be implemented， some patients meeting the inclusion and exclusion criteria are randomly sampled from the cohort to receive "trial interventions"， while the remaining patients in the cohort who meet the inclusion and exclusion criteria continue to receive conventional treatment as control groups. By comparing the efficacy differences between the intervention measures of the trial group and the control group， the efficacy of intervention measures was evaluated. Within the cohort， the same process could be repeated to carry out multiple RCTS， so as to evaluate different intervention measures or compare the efficacy of different doses or timing of interventions. Compared with classical RCTS， TwiCs make it easier to recruit patients from the cohort and have higher external validity， providing a new research paradigm for improving the efficiency and applicability of RCTS in clinical practice. However， TwiCs may also face the challenge of poor compliance of patients in the cohort. Researchers need to take effective measures to control these patients in the design and operation of TwiCs. This article focused on the methodological key points during the implementation of TwiCs， including multi-stage informed consent （patients are informed of consent at three stages： entering the cohort， entering the trial group， and after the trial）， randomization procedures （only random sampling of patients from the cohort to receive "trial interventions"）， sample size calculation， and statistical analysis methods. The article also compared the differences between TwiCs and traditional RCTS and illustrated TwiCs research design and analysis with examples， so as to provide new research ideas and methods for clinical researchers.

An Effective Management for Thalassaemic Patients during Pregnancy

Background : Presence of thalassaemia is considered high risk in pregnancy. The present study find out the role of antenatal and intrapartum care to improve the outcome of pregnancy in thalassaemia. Materials and Method : The prospective longitudinal study was carried out on 25 patients. CBC, LFT, Ferritin, Hb electrophoresis, serial USG was done. Chorionic villous sampling was offered to thalassaemic women to decrease the number of babies born with Thalassaemia. Furthermore, management and treatment options provided to mother to overcome the incidence of maternal and neonatal complications during current pregnancy. Results : 44% of thalassaemic pregnant women had HbE ? thalassaemia, 8% ? thalassaemia major and others had thalassaemia carriers, while only 20% of their partners showed ? thalassaemia trait. All patients were anemic and during delivery mean Hb% were 8.42 g/dl, MCH 22.09 pg, MCV 73.56 fl, MCHC 29.86 g/dl and ferritin 241.51 ng/ ml. Third trimester USG exhibited 32% developed IUGR (Intrauterine growth restriction). 40% patients received blood transfusion after delivery. ? thalassaemia trait was identified in 20% babies at 6 month. Conclusion : Postpartum haemorrhage is a major complication of thalassaemia in pregnancy. After delivery a thorough neonatal check-up and haematological work-up is important for prevention of neonatal mortality and early detection of thalassaemia.

Laparoscopic evaluation of female genital tuberculosis in infertility: An observational study

Background & objectives: Female genital tuberculosis (FGTB) is an important variety of extrapulmonary TB causing significant morbidity, especially infertility, in developing countries like India. The aim of this study was to evaluate the laparoscopic findings of the FGTB. Methods: This was a cross-sectional study on 374 cases of diagnostic laparoscopy performed on FGTB cases with infertility. All patients underwent history taking and clinical examination and endometrial sampling/biopsy for acid-fast bacilli, microscopy, culture, PCR, GeneXpert (only last 167 cases) and histopathological evidence of epithelioid granuloma. Diagnostic laparoscopy was performed in all the cases to evaluate the findings of FGTB. Results: Mean age, parity, body mass index and duration of infertility were 27.5 yr, 0.29, 22.6 kg/m2 and 3.78 years, respectively. Primary infertility was found in 81 per cent and secondary infertility in 18.18 per cent of cases. Endometrial biopsy was positive for AFB microscopy in 4.8 per cent, culture in 6.4 per cent and epithelioid granuloma in 15.5 per cent. Positive peritoneal biopsy granuloma was seen in 5.88 per cent, PCR in 314 (83.95%) and GeneXpert in 31 (18.56%, out of last 167 cases) cases. Definite findings of FGTB were seen in 164 (43.86%) cases with beaded tubes (12.29%), tubercles (32.88%) and caseous nodules (14.96%). Probable findings of FGTB were seen in 210 (56.14%) cases with pelvic adhesions (23.52%), perihepatic adhesions (47.86%), shaggy areas (11.7%), pelvic adhesions (11.71%), encysted ascites (10.42%) and frozen pelvis in 3.7 per cent of cases. Interpretation & conclusions: The finding of this study suggests that laparoscopy is a useful modality to diagnose FGTB with a higher pickup rate of cases. Hence it should be included as a part of composite reference standard.

Estudios de corte transversal: un diseño de investigación a considerar en ciencias morfológicas / Cross section studies: a research design to consider in morphological sciences

Los estudios de corte transversal (ECT) inician en la década de los 40 en países Europeos. Los ECT corresponden a investigaciones de tipo observacional que permiten estudiar prevalencia de enfermedad, determinar asociación entre variables y el desarrollo de un efecto de interés, conocer propiedades de una prueba diagnóstica, y censar poblaciones; describiendo las características de una población en un momento y lugar determinado. Esto implica, que no se requieren periodos de seguimiento, que no son prospectivos ni retrospectivos; características que permiten que sean más baratos y fáciles de realizar en relación a los estudios longitudinales. Por otro lado, al ser de carácter descriptivo sirven como insumo y evidencia preliminar para estudios de mayor complejidad metodológica, como estudios de cohortes. Sin embargo, tienen limitantes y sesgos que deben ser considerados por los investigadores. El objetivo de este manuscrito fue generar un documento de estudio para revisar características esenciales, fortalezas y debilidades; discutir cuestiones metodológicas de los ECT en ciencias de la salud; y proporcionar algunos ejemplos obtenidos de la literatura, para mejor comprensión del diseño.

SUMMARY: Cross-sectional studies (CSS) began European countries in the 1940s in. The CSSs correspond to observational-type investigations that allow studying the prevalence of disease, determining the association between variables and the development of an effect of interest, discovering the properties of a diagnostic test, and censusing populations, describing the characteristics of a population at a given time and place. This implies that follow-up periods are not required, and that they are neither prospective nor retrospective. These characteristics allow them to be cheaper and easier to perform in relation to longitudinal studies. On the other hand, being descriptive in nature, they serve as input and preliminary evidence for studies of greater methodological complexity, such as cohort studies. However, they have limitations and biases that must be considered by researchers. The aim of this manuscript was to generate a study document to review essential characteristics, strengths and weaknesses; discuss methodological issues of ECT in health sciences; and provide some examples obtained from the literature, for a better understanding of the design.

Meta-análisis de la escala de capital intelectual: implicaciones para hacer frente a la pandemia del COVID-19

Introducción: la medición del capital intelectual como activo intangible se ha establecido a partir de una escala de seis dimensiones relacionada con formación, academia, laboral, profesional, sindical y organizativa. La pandemia ha generado estudios que muestran diferencias significativas entre estas dimensiones, abriendo la discusión sobre la validez metaanalítica. Objetivo: realizar una revisión documental, sistemática y metaanalítica, con una muestra de artículos publicados entre 2014 y 2021 en revistas indexadas en repositorios internacionales. Materiales y métodos: se realizó un estudio documental, sistemático y metaanalítico sobre una muestra de artículos publicados en repositorios internacionales en los últimos dos años. Se utilizó la Escala de Capital Intelectual, considerando sus dimensiones reportadas en la literatura. Resultados: se estableció la estructura y los umbrales de los efectos aleatorios, calculados mediante la ecuación para establecer el parámetro delta, considerando sus intervalos de confianza para la corrección de errores de muestreo y estimación, así como las diferencias entre grupos. Conclusión: se recomienda extender la revisión de la literatura hasta agosto de 2021, para poder contrastar ambas revisiones, y establecer así la validez metaanalítica de la escala, y discutir sus implicaciones en la era COVID-19.

Introduction: the measurement of intellectual capital as an intangible asset has been established from a scale of six dimensions related to training, academia; labor, professional, union, and organizational. The pandemic has generated studies that show significant differences between these dimensions, opening the discussion on meta-analytic validity. Objective: to carry out a documentary, systematic and meta-analytical review with a sample of articles published from 2014 to 2021 in journals indexed in international repositories. Materials and methods: a documentary, systematic and meta-analytical study was carried out on a sample of articles published in international repositories in the last two years. The Intellectual Capital Scale was used, considering its dimensions reported in the literature. Results: the structure and thresholds of the random effects were established, calculated by means of the equation to establish the delta parameter, considering their confidence intervals for correction of sampling and estimation errors, as well as differences between groups. Conclusion: it is recommended to extend the review of the literature until August 2021 in order to be able to contrast both reviews to establish the meta-analytic validity of the scale and discuss its implications in the COVID-19 era.

Distribution pattern of arthropods on the leaf surfaces of Acacia auriculiformis saplings / Padrão de distribuição de artrópodes nas superfícies foliares de plantas de Acacia auriculiformis

Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), a non-native pioneer species in Brazil with fast growth and rusticity, is used in restoration programs. Our goal was to assess during a 24-month survey the pattern of arthropods (phytophagous insects, bees, spiders, and predator insects) on the leaf surfaces of A. auriculiformis saplings. Fourteen species of phytophagous, two of bees and eleven of predators were most abundant on the adaxial surface. The values of the ecological indexes (abundance, diversity, and species richness) and the rarefaction, and k-dominance curves of phytophagous, bees and arthropod predators were highest on the adaxial leaf surface of A. auriculiformis. The k-dominance and abundance of Aleyrodidae (Hemiptera) (both leaf surfaces), the native stingless bee Tetragonisca angustula Latreille (Hymenoptera: Apidae) (both leaf surfaces) and the ant Brachymyrmex sp. (adaxial surface) and Pheidole sp. (Hymenoptera: Formicidae) (abaxial surface) were the highest between the taxonomic groups of phytophagous, bees, and predators, respectively on A. auriculiformis saplings. The ecological indexes and rarefaction, abundance, and k-dominance curves of phytophagous insects, bees, and predators were highest on the adaxial leaf surface. The preference of phytophagous insects for the adaxial leaf surface is probably due to the lower effort required to move on this surface. Understanding the arthropod preferences between leaf surfaces may help to develop sampling and pest management plans for the most abundant phytophagous insects on A. auriculiformis saplings. Also, knowledge on the preference pattern of bees and predators may be used to favour their conservation.

Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), espécie pioneira com rápido crescimento e rusticidade, é utilizada em programas de recuperação de áreas degradadas. O objetivo deste trabalho foi avaliar, durante 24 meses, o padrão de distribuição de artrópodes (insetos fitófagos, abelhas, aranhas e insetos predadores) nas superfícies foliares de A. auriculiformis. Quatorze espécies de fitófagos, duas de abelhas e onze de predadores foram mais abundantes na superfície adaxial. Índices ecológicos (abundância, diversidade e riqueza de espécies) e curvas de rarefação e dominância-k de fitófagos, abelhas e artrópodes predadores foram maiores na face adaxial de folhas de A. auriculiformis. A dominância-k e a abundância de Aleyrodidae (Hemiptera) (ambas as superfícies foliares), da abelha nativa sem ferrão Tetragonisca angustula Latreille (Hymenoptera: Apidae) (ambas as superfícies foliares) e das formigas Brachymyrmex sp. (superfície adaxial) e Pheidole sp. (Hymenoptera: Formicidae) (superfície abaxial) foram as maiores entre os grupos taxonômicos de fitófagos polinizadores e predadores, respectivamente, em plantas jovens de A. auriculiformis. A abundância, diversidade e riqueza e as curvas de rarefação e dominância-k de artrópodes fitófagos, abelhas e predadores foram maiores nas superfícies adaxiais das folhas dessa árvore. A preferência pela superfície adaxial da folha se deve, provavelmente, ao menor esforço para se movimentarem na mesma. Compreender as preferências dos artrópodes pelas superfícies foliares pode auxiliar no desenvolvimento de planos de amostragem e manejo de pragas em A. auriculiformis. Além disso, o conhecimento da distribuição de abelhas e predadores pode favorecer a conservação desses insetos.

Distribution pattern of arthropods on the leaf surfaces of Acacia auriculiformis saplings

Abstract Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), a non-native pioneer species in Brazil with fast growth and rusticity, is used in restoration programs. Our goal was to assess during a 24-month survey the pattern of arthropods (phytophagous insects, bees, spiders, and predator insects) on the leaf surfaces of A. auriculiformis saplings. Fourteen species of phytophagous, two of bees and eleven of predators were most abundant on the adaxial surface. The values of the ecological indexes (abundance, diversity, and species richness) and the rarefaction, and k-dominance curves of phytophagous, bees and arthropod predators were highest on the adaxial leaf surface of A. auriculiformis. The k-dominance and abundance of Aleyrodidae (Hemiptera) (both leaf surfaces), the native stingless bee Tetragonisca angustula Latreille (Hymenoptera: Apidae) (both leaf surfaces) and the ant Brachymyrmex sp. (adaxial surface) and Pheidole sp. (Hymenoptera: Formicidae) (abaxial surface) were the highest between the taxonomic groups of phytophagous, bees, and predators, respectively on A. auriculiformis saplings. The ecological indexes and rarefaction, abundance, and k-dominance curves of phytophagous insects, bees, and predators were highest on the adaxial leaf surface. The preference of phytophagous insects for the adaxial leaf surface is probably due to the lower effort required to move on this surface. Understanding the arthropod preferences between leaf surfaces may help to develop sampling and pest management plans for the most abundant phytophagous insects on A. auriculiformis saplings. Also, knowledge on the preference pattern of bees and predators may be used to favour their conservation.

Resumo Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), espécie pioneira com rápido crescimento e rusticidade, é utilizada em programas de recuperação de áreas degradadas. O objetivo deste trabalho foi avaliar, durante 24 meses, o padrão de distribuição de artrópodes (insetos fitófagos, abelhas, aranhas e insetos predadores) nas superfícies foliares de A. auriculiformis. Quatorze espécies de fitófagos, duas de abelhas e onze de predadores foram mais abundantes na superfície adaxial. Índices ecológicos (abundância, diversidade e riqueza de espécies) e curvas de rarefação e dominância-k de fitófagos, abelhas e artrópodes predadores foram maiores na face adaxial de folhas de A. auriculiformis. A dominância-k e a abundância de Aleyrodidae (Hemiptera) (ambas as superfícies foliares), da abelha nativa sem ferrão Tetragonisca angustula Latreille (Hymenoptera: Apidae) (ambas as superfícies foliares) e das formigas Brachymyrmex sp. (superfície adaxial) e Pheidole sp. (Hymenoptera: Formicidae) (superfície abaxial) foram as maiores entre os grupos taxonômicos de fitófagos polinizadores e predadores, respectivamente, em plantas jovens de A. auriculiformis. A abundância, diversidade e riqueza e as curvas de rarefação e dominância-k de artrópodes fitófagos, abelhas e predadores foram maiores nas superfícies adaxiais das folhas dessa árvore. A preferência pela superfície adaxial da folha se deve, provavelmente, ao menor esforço para se movimentarem na mesma. Compreender as preferências dos artrópodes pelas superfícies foliares pode auxiliar no desenvolvimento de planos de amostragem e manejo de pragas em A. auriculiformis. Além disso, o conhecimento da distribuição de abelhas e predadores pode favorecer a conservação desses insetos.

Distribution pattern of arthropods on the leaf surfaces of Acacia auriculiformis saplings / Padrão de distribuição de artrópodes nas superfícies foliares de plantas de Acacia auriculiformis

Abstract Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), a non-native pioneer species in Brazil with fast growth and rusticity, is used in restoration programs. Our goal was to assess during a 24-month survey the pattern of arthropods (phytophagous insects, bees, spiders, and predator insects) on the leaf surfaces of A. auriculiformis saplings. Fourteen species of phytophagous, two of bees and eleven of predators were most abundant on the adaxial surface. The values of the ecological indexes (abundance, diversity, and species richness) and the rarefaction, and k-dominance curves of phytophagous, bees and arthropod predators were highest on the adaxial leaf surface of A. auriculiformis. The k-dominance and abundance of Aleyrodidae (Hemiptera) (both leaf surfaces), the native stingless bee Tetragonisca angustula Latreille (Hymenoptera: Apidae) (both leaf surfaces) and the ant Brachymyrmex sp. (adaxial surface) and Pheidole sp. (Hymenoptera: Formicidae) (abaxial surface) were the highest between the taxonomic groups of phytophagous, bees, and predators, respectively on A. auriculiformis saplings. The ecological indexes and rarefaction, abundance, and k-dominance curves of phytophagous insects, bees, and predators were highest on the adaxial leaf surface. The preference of phytophagous insects for the adaxial leaf surface is probably due to the lower effort required to move on this surface. Understanding the arthropod preferences between leaf surfaces may help to develop sampling and pest management plans for the most abundant phytophagous insects on A. auriculiformis saplings. Also, knowledge on the preference pattern of bees and predators may be used to favour their conservation.

Resumo Acacia auriculiformis A. Cunn. Ex Benth. (Fabaceae), espécie pioneira com rápido crescimento e rusticidade, é utilizada em programas de recuperação de áreas degradadas. O objetivo deste trabalho foi avaliar, durante 24 meses, o padrão de distribuição de artrópodes (insetos fitófagos, abelhas, aranhas e insetos predadores) nas superfícies foliares de A. auriculiformis. Quatorze espécies de fitófagos, duas de abelhas e onze de predadores foram mais abundantes na superfície adaxial. Índices ecológicos (abundância, diversidade e riqueza de espécies) e curvas de rarefação e dominância-k de fitófagos, abelhas e artrópodes predadores foram maiores na face adaxial de folhas de A. auriculiformis. A dominância-k e a abundância de Aleyrodidae (Hemiptera) (ambas as superfícies foliares), da abelha nativa sem ferrão Tetragonisca angustula Latreille (Hymenoptera: Apidae) (ambas as superfícies foliares) e das formigas Brachymyrmex sp. (superfície adaxial) e Pheidole sp. (Hymenoptera: Formicidae) (superfície abaxial) foram as maiores entre os grupos taxonômicos de fitófagos polinizadores e predadores, respectivamente, em plantas jovens de A. auriculiformis. A abundância, diversidade e riqueza e as curvas de rarefação e dominância-k de artrópodes fitófagos, abelhas e predadores foram maiores nas superfícies adaxiais das folhas dessa árvore. A preferência pela superfície adaxial da folha se deve, provavelmente, ao menor esforço para se movimentarem na mesma. Compreender as preferências dos artrópodes pelas superfícies foliares pode auxiliar no desenvolvimento de planos de amostragem e manejo de pragas em A. auriculiformis. Além disso, o conhecimento da distribuição de abelhas e predadores pode favorecer a conservação desses insetos.

Differences in chemical components in processing of dried ginger-steamed, sand-fried, and rice swill water-bleached Aconiti Lateralis Radix Praeparata pieces in "Jianchang" faction based on UPLC-MS/MS / 中国中药杂志

This study compared the changes in chemical components during the processing of different types of Aconiti Lateralis Radix Praeparata(ALRP) in "Jianchang" faction, i.e., dried ginger-steamed ALRP pieces(Yin-FP), sand-fried ALRP pieces(Yang-FP), and rice swill water-bleached ALRP pieces(DFP), and provided a scientific basis for the mechanism in toxicity reduction and efficacy enhancement from a compositional perspective. Samples were collected during the processing of the three types of ALRP pieces, yielding raw ALRP pieces, water-bleached Yin-FP, ginger juice-moistened Yin-FP, steamed Yin-FP, water-bleached Yang-FP, sand-fried Yang-FP, water-bleached DFP, rice swill water-bleached DFP, and roasted DFP. Aconitine, mesaconitine, hypaconitine, benzoylaconine, benzoylmesaconine, benzoylhypaconine, aconine, mesaconine, hypaconine, salsolinol, fuziline, and higenamine in the extracts were determined by UPLC-MS/MS, and then content analysis and cluster heatmap analysis were performed on 11 sets of samples. During the processing of the three types of ALRP pieces, bleaching significantly reduced the content of 12 alkaloids; steaming, stir-frying, and roasting significantly reduced the content of diester-type alkaloids(aconitine, mesaconitine, and hypaconitine) and significantly increased the content of monoester-type alkaloids(benzoylaconine, benzoylmesaconine, and benzoylhypaconine) and aminoalcohol-type alkaloids(aconine, mesaconine, and hypaconine). During the processing of Yin-FP, the diester-type alkaloids continuously decreased, while the monoester-type and aminoalcohol-type alkaloids showed an initial decrease followed by an increase. During the processing of Yin-FP, Yang-FP, and DFP, the diester-type alkaloids continuously decreased, while the monoester-type and aminoalcohol-type alkaloids showed an initial decrease followed by an increase. Steamed Yin-FP showed a higher increase in content than fried Yang-FP and roasted DFP. Comprehensive analysis of content differences in toxic and therapeutic components in three ALRP pieces suggests that the distinctive processing methods in "Jianchang" faction can indeed achieve detoxification and efficacy enhancement on ALRP. This study provides references for understanding the mechanisms of action of the three processing methods.

Estimation model for the exposure of mycophenolic acid in early renal transplant recipients / 中国药房

OBJECTIVE To establish the estimation model for the exposure of mycophenolic acid （MPA） in early renal transplant recipients [calculated by the area under the plasma concentration-time curve with 12 h （AUC0－12 h）]. METHODS Twenty kidney transplant recipients， who received triple immunosuppressive therapy of mycophenolate mofetil （MMF）+tacrolimus+ methylprednisolone， were selected and given MMF dispersible tablets （750 mg， q12 h） on the 15th day after the operation； the blood samples were collected from the patients before and 0.5， 1.0， 1.5， 2.0， 3.0， 4.0， 6.0， 8.0， 12.0 hours after the administration， respectively. The blood concentration of MPA was determined， and the pharmacokinetic parameters of MPA were calculated. The multivariate linear stepwise regression analysis method was used to fit an estimation formula for the finite sampling method suitable for MPA-AUC0－12 h of the recipients. Bland-Altman analysis was used to evaluate the agreement between the estimation formula and the classical pharmacokinetic method. RESULTS The main pharmacokinetic parameters of MPA in 20 renal transplant recipients： c0 was （1.53±0.84） μg/mL， cmax was （12.07±5.97） μg/mL， t1/2 was （5.41±3.67） h， tmax was （1.58±0.75） h， and the average AUC0－12 h calculated by the classical pharmacokinetic method was （33.95±13.40） μg·h/mL. MPA-AUC0－12 h was estimated with sampling points of “4.0， 8.0， 12.0 h”； the simplified calculation formula was AUC0－12 h＝12.058+2.819c4.0+7.045c8.0+ 3.879c12.0 （R 2＝0.934）. The predicted value had a good correlation and consistency with the measured value， and 95.0% of predicted values did not exceed the x±1.96SD （standard deviation） range. CONCLUSIONS The estimation model is established successfully for the exposure of MPA in early renal transplant recipients； the model has better prediction accuracy and fewer sampling points.

Solid-phase microextraction of endogenous metabolites from intact tissue validated using a Biocrates standard reference method kit / 药物分析学报

Improved analytical methods for the metabolomic profiling of tissue samples are constantly needed.Currently,conventional sample preparation methods often involve tissue biopsy and/or homogenization,which disrupts the endogenous metabolome.In this study,solid-phase microextraction(SPME)fibers were used to monitor changes in endogenous compounds in homogenized and intact ovine lung tissue.Following SPME,a Biocrates AbsoluteIDQ assay was applied to make a downstream targeted metab-olomics analysis and confirm the advantages of in vivo SPME metabolomics.The AbsoluteIDQ kit enabled the targeted analysis of over 100 metabolites via solid-liquid extraction and SPME.Statistical analysis revealed significant differences between conventional liquid extractions from homogenized tissue and SPME results for both homogenized and intact tissue samples.In addition,principal component analysis revealed separated clustering among all the three sample groups,indicating changes in the metabolome due to tissue homogenization and the chosen sample preparation method.Furthermore,clear differences in free metabolites were observed when extractions were performed on the intact and homogenized tissue using identical SPME procedures.Specifically,a direct comparison showed that 47 statistically distinct metabolites were detected between the homogenized and intact lung tissue samples(P＜0.05)using mixed-mode SPME fibers.These changes were probably due to the disruptive homogenization of the tissue.This study's findings highlight both the importance of sample preparation in tissue-based metabolomics studies and SPME's unique ability to perform minimally invasive extractions without tissue biopsy or homogenization while providing broad metabolite coverage.

Application of the 3t sensorial saturation in femoral vein blood collection of premature infants / 中国实用护理杂志

Objective:To investigate the effect of the 3t sensorial saturation in the application of relieving pain and comfort due to femoral vein blood sampling in preterm infants, so as to provide the reference for the selection of clinical nursing plans.Methods:This was a quasi experimental study. A total of 110 preterm infants admitted to the neonatal unit of Shanxi Children′s Hospital from August 2021 to March 2022 were selected and divided into the control group and intervention group with 52 cases respectively by the random number table method. The control group implemented conventional care, and the intervention group implemented the 3t sensorial saturation method including taste, touch and talk on the basis of the control group. The pain and comfort of two groups were evaluated by the Premature Infant Pain Profile (PIPP) and COMFORTneo Scale at 3 min before, during, and 3 min after blood, and the heart rate and SpO 2 of the two groups were compared. Results:Finally, 52 premature infants were included in both groups. The PIPP score, the total score of the COMFORTneo Scale, the heart rate and SpO 2 were 2.00 (1.00, 3.00), 6.50 (6.00, 7.75), 4.00 (3.00, 5.00), 7.00 (6.00, 8.00), 17.00 (15.00, 19.00), 9.50 (9.00, 10.00) points, (137.29 ± 8.58), (148.31 ± 8.89), (143.06 ± 7.61) times/min, 0.980 (0.970, 0.990), 0.960 (0.950, 0.970), 0.980 (0.970, 0.990) in the intervention group, 2.00 (1.25, 3.00), 12.00 (11.00, 13.00), 7.00 (6.00, 8.00), 7.00 (6.00, 9.00), 25.00 (23.00, 27.00), 20.00 (19.00, 22.00) points, (141.54 ± 10.57), (179.71 ± 14.62), (162.00 ± 14.32) times/min, 0.980 (0.960, 0.990), 0.940 (0.920, 0.958), 0.960 (0.940, 0.978). The results of generalized estimating equation analysis showed that the PIPP score, total COMFORTneo Scale score and SpO 2 via different time points, subgroups, and subgroups with time points were statistically significant (Wald χ2 values were 16.72-2 489.71, all P<0.05). The results of two-factor repeated measures ANOVA showed that the interaction effects of heart rate via different time points, subgroups, and subgroups with time points were statistically significant ( F=253.08, 105.02, 77.17, all P<0.05). Conclusions:The 3t sensorial saturation method can effectively reduce pain during femoral vein blood sampling in preterm infants, can improve the comfort level of preterm infants, is conducive to the stabilization of vital signs in preterm infants, and is suitable for promotion and application in clinical care.

Research progress on detection methods for aromatic amine compounds in workplace air / 中国职业医学

Aromatic amine compounds are diverse, widely used, and highly toxic. They mainly exist in aerosol and vapor in workplace air. Occupational poisoning incidents caused by aromatic amine compounds occur from time to time. In China, occupational exposure limits have been established for only 11 aromatic amine compounds, with supporting detection methods developed only for four compounds： aniline, N-methylaniline, N,N-dimethylaniline, and p-nitroaniline. Most of the highly toxic and hazardous aromatic amine compounds do not have specific limit. Currently, regular sampling mediums for detecting aromatic amine compounds in the workplace air are absorbing solution, filter membrane, silica gel, and poly(styrene-divinylbenzene) resin. Regular detection methods are gas chromatography, liquid chromatography, fluorescence detection, and chromatography-mass spectrometry. However, these methods are mostly designed for detecting individual compounds or their specific forms, and there is a need to develop a detection method that can detect aromatic amine compounds existing in aerosol and vapor form simultaneously using a novel composite sampling tube.

Case-control Design and Real-world Database Studies / 薬剤疫学

A case-control design is one of common study designs in epidemiology. A case with an outcome event of interest is identified and a corresponding control without an outcome event is sampled from a study base, which give rise to the cases. Distribution of a past exposure to an agent of interest before the timing of sampling is compared between a case group and a control group, to yield an odds ratio of exposure as a risk index. A cohort design is usually costly because it requires a large sample size and a long-term follow-up period to power a study especially to detect rare outcome events. In contrast, a traditional case-control design brings efficiency in resource and time to study the association of an exposure and an outcome event by reducing a sample size to study an exposure and covariates after sampling compared with a traditional cohort design. This review article discusses whether a case-control sampling strategy in healthcare database studies, where all the data for the study variables necessary for analysis already exist and are readily available, remains advantageous over a cohort design from the viewpoints of study cost and utility.

Expert Consensus on Bilateral Inferior Petrosal Sinus Sampling in the Diagnosis of Cushing′s Syndrome (2023) / 罕见病研究

@#Cushing′s syndrome(CS)is a clinical syndrome caused by a variety of causes, with main manifestations exhibited by central obesity, purple skin striae, hypertension, and diabetes. In patients with adrenocorticotropic hormone(ACTH)-dependent CS, the result of bilateral inferior petrosal sinus sampling(BIPSS)is the gold standard for determining the source of ACTH in the absence of routine imaging findings.However, the indications, contraindications, operating procedures, precautions and outcome judgments of BIPSS differ from one medical center to another, and there are currently no international and domestic clinical guidelines and expert consensus on BIPSS. In order to further improve the operation specifications of BIPSS in the diagnosis process of difficult CS, the Hypothalamic and Pituitary Disease Group of the China Alliance for Rare Diseases and the Innovation Center of Pituitary Diseases of Peking Union Medical College Hospital organized experts in endocrinology, interventional radiology, neurosurgery and laboratory in China to formulate this consensus. This consensus aims to provide standardized methodological guidance for the use of BIPSS in the differential diagnostic process of CS in clinical practice.

Sampling data of fresh frozen plasma, cryoprecipitates and leukocyte-free platelet quality monitoring in Hebei Province from 2015 to 2021: a retrospective analysis / 中国输血杂志

【Objective】 To form the sampling data interval by retrospectively analyzing the sampling data of quality monitoring of fresh frozen plasma, cryoprecipitates and leukocyte-free platelets in all blood stations in Hebei Province during the past 7 years. 【Methods】 The data of blood component sampling from 12 blood station quality control laboratories in Hebei from 2015 to 2021 were collected. The FⅧ content and plasma protein content of fresh frozen plasma, the FⅧ content and fibrinogen content of cryoprecipitates, and the leukocyte residuals, red blood cell mixed and platelet content of leukocyte-free platelets were taken as the objects for discrete point and fitted curve analysis. 【Results】 The FⅧ level of fresh frozen plasma: (1.36±1.1) IU/mL, 5 blood stations showed a representative overall high or low or fluctuated characteristics; Fresh frozen plasm-plasma protein items: overall mean ±SD: (61.13±16.7) g/L, four blood stations showed scattered distribution or continuous high value scattered points; Cryoprecipitates FⅧ: the overall mean ±SD: (134.25±58.7) IU/mL, four blood stations showed the differentiation characteristics of continuous high, low or stable in the middle; Cryoprecipitates-fibrinogen items: the overall mean ±SD: (215.27±83.5) mg, five blood stations showed the overall high or low and fluctuated. Leukocyte-free apheresis platelet-to-leukocyte residual items: overall mean ±SD: 0.37±0.96 (×106/bag), two blood stations showed a relatively high representative overall characteristics, and the rest were concentrated between 0 and 1; The total mean ±SD of platelet-to-red blood cell mixture without leukocyte was 2.45±2.82 (×109/bag), with obvious segmented concentrated distribution, and scattered distribution in 3 blood centers. Platelet content: the overall mean ±SD was 3.14±1.55 (×1011/bag), many deviations were noticed in 3 blood stations, and 1 blood station showed representative overall high characteristics. 【Conclusion】 This analysis shows that the distribution status of each blood station in different items is similar. The distribution status of discrete point groups and the change trend of the concentrated part of the fitting curve show that there are some differences in the monitoring level between the quality control laboratories of each blood station, and the update of detection instruments and reagents and the selection of detection methods greatly affect the test results. The summary data presented the index interval framework formed in the past 7 years, which helped to understand the difference between the results of each laboratory, correct the accuracy of the test results, better play the guiding role of quality monitoring in the blood preparation process, and continue to enhance the standardization of the whole process of blood collection and supply in the province.

Application andevaluation of random quality control sampling in donor blood detetion by ELISA / 中国输血杂志

【Objective】 To evaluate the effectiveness of random quality control sampling in blood sample detetion by ELISA. 【Methods】 Blood samples of 5 mL specification of blood donors from our blood station from May to July 2022 were selected for routine operation on a fully automated sampler. J standard substances(3 mL specification) as daily samples were added to A1 well, H12 well and random wells of HBsAg, anti-HCV, anti-HIV, and -TP, and then placed in a fully automated enzyme immunoassay analyzer for testing. With random well quality control as the internal quality control judgment standard, 20 consecutive tests were conducted and were divided into A1 (well) group, H12 (well) group and random (well) group according to different well positions. Quality control maps were drawn using Levey-Jennings quality control chart with random group as the framework, and were compared with the quality control map of A1 well and H12 well results in the same day. 【Results】 The mean quality control levels of infectious indicators of blood transfusion in blood donors by ELISA were: HBsAg 3.87±0.28, anti-HCV 3.79±0.38, anti-HIV 3.64±0.30 and anti-TP 4.53±0.51. 【Comparison】 of HBsAg, anti-HCV, anti-HIV and anti-TP, between random group, A1 group and H12 group were HBsAg 3.87± 0.28 vs 4.09±0.30 vs 3.64±0.26, anti-HCV 3.78±0.37 vs 3.96±0.38 vs 3.63±0.38, anti-HIV 3.63±0.31 vs 3.82±0.32 vs 3.48±0.28 and anti-TP 4.51±0.51 vs 4.71±0.52 vs 4.36±0.51, The S/CO value of each indicator were H12 group<random group<Al group (P<0.05), and the mean quality control levels of random group were similar to each detection indicator (P>0.05) . Using random group as the quality control framework standard, 5 points in group A1 fell outside of +2s, and 1 point in group H12 fell outside of -2s, resulting in a total of 6 alarms. With the quality control substance placed in A1 well of the ELISA plate, the judgment of detection results of the entire ELISA plate could be inevitably affected, especially the last row of low concentration virus marker samples on the ELISA plate. 【Conclusion】 The application of random quality control sampling method in donor blood by ELISA is scientific and reasonable, which can reduce the systematic error caused by artificial setting of ELISA plate fixed well positions and can also discover edge effects that affect the detection results.

External quality assessment of laboratories in blood stations of Hebei Province in 2022: a retrospective analysis of HeBEQA project / 中国输血杂志

【Objective】 To conduct the laboratory quality assessment between 12 blood stations in Hebei province, analyze the results and explore the accuracy and comparability of testing, so as to improve the level of testing ability and quality management. 【Methods】 With reference to the external quality assessment rules of National Center for Clinical Laboratories and combined with the instructions of quality assessment samples, daily testing process of the laboratories were assessed. The quality indicators include blood cell count (WBC, RBC, Hb, HCT, MCV, MCH, MCHC and PLT), biochemical items (TP) and coagulation parameters (FIB and FⅧ). 【Results】 There are still problems in laboratories in terms of personnel operation, instrument maintenance and the impact of different reagent batches, especially in biochemical items and coagulation parameters. The pass rate of biochemical items was the lowest, only 72.75%, and that of blood cell count was the highest, reaching 98.75%. 【Conclusion】 With the progress of the project, the quality monitoring level of daily blood sampling tests in the quality control laboratory of each blood station has been improved. However, it is still necessary for each laboratory to improve the testing ability and quality management to a higher level in Hebei.

Investigation on quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai， 2022 / 上海预防医学

ObjectiveTo investigate the quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai. MethodsSwab samples of medical staff’ hands and environments of different SARS-CoV-2 nucleic acid sampling sites were collected from July to September 2022， with the total number of bacterial colonies cultured and counted. ResultsA total of 728 swab samples were collected from 69 sampling sites. The median total number of bacterial colonies on hand surface， object surface and air samples were 0 CFU·cm-2， 0 CFU·cm-2， and1 CFU·（petri dish∙5 min）-1， respectively， and P95 was 13 CFU·cm-2， 5.3 CFU·cm-2， and 17.8 CFU·（culture vessel∙5 min）-1， respectively. According to the GB 15982‒2012 Hygienic Standard for Disinfection in Hospitals class Ⅳ environment， 680 samples met the standard （93.4%）. Furthermore， 96.9%， 92.0%， and 92.2% of the samples in the sampling sites of tertiary/secondary hospitals， community health centers， and community convenience sampling sites met the standard， respectively. Quality of disinfection did not differ significantly across these sampling sites. ConclusionThe quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai is generally good. Additionally， hand hygiene of medical staff and disinfection on object surface in some sampling sites need to be strengthened.