Efficacy of clonidine in the treatment of children with tic disorder co-morbid with attention deficit hyperactivity disorder.

OBJECTIVE: The current research was designed to assess the efficacy of clonidine in the treatment of children with tic disorder co-morbid with attention deficit hyperactivity disorder. PATIENTS AND METHODS: A total of 154 children with tic disorder co-morbid with attention deficit hyperactivity disorder admitted to our hospital from July 2019 to July 2022 were recruited and assigned to receive either methylphenidate hydrochloride plus haloperidol (observation group) or clonidine (experimental group), with 77 cases in each group. Outcome measures included clinical efficacy, Yale Global Tic Severity Scale (YGTSS) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and adverse events. RESULTS: Clonidine was associated with markedly higher clinical efficacy vs. methylphenidate hydrochloride plus haloperidol (p<0.05). Clonidine offered more significant mitigation of the tic disorder vs. methylphenidate hydrochloride plus haloperidol, as evinced by the lower kinetic tic scores, vocal tic scores, and total scores (p<0.05). Children exhibited markedly milder tic symptoms after clonidine monotherapy vs. those with dual therapy of methylphenidate hydrochloride and haloperidol, suggested by the lower scores of character problems, learning problems, psychosomatic disorders, hyperactivity/impulsivity, anxiety index, and hyperactivity index (p<0.05). Clonidine features a higher safety profile than methylphenidate hydrochloride plus haloperidol by reducing the incidence of adverse events (p<0.05). CONCLUSIONS: Clonidine effectively alleviates tic symptoms, reduces attention deficit and hyperactivity/impulsivity in children with tic disorder co-morbid attention deficit hyperactivity disorder, and features a high safety profile.

Analysis of factors leading to lid wiper epitheliopathy.

OBJECTIVE: Lid wiper epitheliopathy (LWE) has received more attention during the diagnosis and treatment of the dry eye. However, its causes and pathogenesis remain unclear. We aimed to explore the etiology of LWE by analyzing the association between the severity of LWE and different anatomical and tissue morphological examination characteristics using confocal microscopy on eyes with dry eye syndrome. PATIENTS AND METHODS: We recruited 350 patients with LWE and dry eye syndrome (350 eyes). We examined the eyes with lid-wiper staining, conjunctival staining, a comprehensive ocular surface exam using the OCULUS keratography 5M, conjunctival impression cytology, and confocal microscopy observations. We analyzed the associations between each indicator and the LWE staining score. RESULTS: According to the Spearman's analysis, the LWE staining score was weakly associated with thickness of the lipid layer (r=0.1737, p=0.0005) and severity of Meibomian gland dysfunction (r=0.2026, p<0.0001); and strongly associated with staging of conjunctival impression cytology (r= -0.7694, p<0.0001). Pearson's correlation analysis indicated that, LWE staining score was moderately associated with age (r=0.4165, p<0.0001), tear meniscus height (r=0 -0.4019, p<0.0001), and NIKBUT-first (noninvasive keratography tear film breakup time) (r= -0.5108, p<0.0001); and strongly associated with NIKBUT-average (r= -0.7820, p<0.0001) and ocular staining score (r=0.6113, p<0.00001). Some patients presented abnormal blinking. We observed deeper lesion depths and more holes and fissures in the lid wipers of patients with more severe LWE than in patients with milder LWE. CONCLUSIONS: Abnormal friction factors caused by insufficient lubrication between the lid wiper area and the ocular surface seem to influence the development and/or the severity of LWE. Aggravation of LWE further increases the frictional damage between the lid wiper and the ocular surface.

Pharmacokinetics of dexmedetomidine administered to patients with end-stage renal failure and secondary hyperparathyroidism undergoing general anaesthesia.

WHAT IS KNOWN AND OBJECTIVE: The primary objective of this study was to compare the pharmacokinetics of dexmedetomidine in patients with end-stage renal failure and secondary hyperparathyroidism with those in normal individuals. METHOD: Fifteen patients with end-stage renal failure and secondary hyperparathyroidism (Renal-failure Group) and 8 patients with normal renal and parathyroid gland function (Control Group) received intravenous 0.6 µg/kg dexmedetomidine for 10 minutes before anaesthesia induction. Arterial blood samples for plasma dexmedetomidine concentration analysis were drawn at regular intervals after the infusion was stopped. The pharmacokinetics were analysed using a nonlinear mixed-effect model with NONMEM software. The statistical significance of covariates was examined using the objective function (-2 log likelihood). In the forward inclusion and backward deletion, covariates (age, weight, sex, height, lean body mass [LBM], body surface area [BSA], body mass index [BMI], plasma albumin and grouping factor [renal failure or not]) were tested for significant effects on pharmacokinetic parameters. The validity of our population model was also evaluated using bootstrap simulations. RESULTS AND DISCUSSION: The dexmedetomidine concentration-time curves fitted best with the principles of a two-compartmental pharmacokinetic model. No covariate of systemic clearance further improved the model. The final pharmacokinetic parameter values were as follows: V1  = 60.6 L, V2  = 222 L, Cl1  = 0.825 L/min and Cl2  = 4.48 L/min. There was no influence of age, weight, sex, height, LBM, BSA, BMI, plasma albumin and grouping factor (renal failure or not) on pharmacokinetic parameters. Although the plasma albumin concentrations (35.46 ± 4.13 vs 44.10 ± 1.12 mmol/L, respectively, P < .05) and dosage of propofol were significantly lower in the Renal-failure Group than in the Control Group (81.68 ± 18.08 vs 63.07 ± 13.45 µg/kg/min, respectively, P < .05), there were no differences in the context-sensitive half-life and the revival time of anaesthesia between the 2 groups. WHAT IS NEW AND CONCLUSION: The pharmacokinetics of dexmedetomidine were best described by a two-compartment model in our study. The pharmacokinetic parameters of dexmedetomidine in patients with end-stage renal failure and hyperparathyroidism were similar to those in patients with normal renal function. Further studies of dexmedetomidine pharmacokinetics are recommended to optimize its clinical use.

Comparative pharmacokinetics of diaveridine in pigs and chickens following single intravenous and oral administration.

Comparative pharmacokinetic profiles of diaveridine following single intravenous and oral dose of 10 mg/kg body weight in healthy pigs and chickens were investigated, respectively. Concentrations of diaveridine in plasma samples were determined using a validated high-performance liquid chromatography-ultraviolet (HPLC-UV) method. The concentration-time data were subjected to noncompartmental kinetic analysis by WinNonlin program. The corresponding pharmacokinetic parameters in pigs or chickens after single intravenous administration were as follows, respectively: t1/2ß (elimination half-life) 0.74 ± 0.28 and 3.44 ± 1.07 h; Vd (apparent volume of distribution) 2.70 ± 0.99 and 3.86 ± 0.92 L/kg; ClB (body clearance) 2.59 ± 0.62 and 0.80 ± 0.14 L/h/kg; and AUC0-∞ (area under the blood concentration vs. time curve) 4.11 ± 1.13 and 12.87 ± 2.60 µg∙h/mL. The corresponding pharmacokinetic parameters in pigs or chickens after oral administration were as follows, respectively: t1/2ß 1.78 ± 0.41 and 2.91 ± 0.57 h; Cmax (maximum concentration) 0.43 ± 0.24 and 1.45 ± 0.57 µg/mL; Tmax (time to reach Cmax ) 1.04 ± 0.67 and 3.25 ± 0.71 h; and AUC0-∞ 1.33 ± 0.55 and 9.28 ± 2.69 µg∙h/mL. The oral bioavailability (F) of diaveridine in pigs or chickens was determined to be 34.6% and 72.2%, respectively. There were significant differences between the pharmacokinetics profiles in these two species.

Measurement of resilience in Chinese older people.

BACKGROUND: Resilience has been identified as a personal construct that may contribute to the process of healthy ageing in older people. To date, no measurement instrument has been tested to evaluate resilience in Chinese older people. AIM: To examine the psychometric testing and clinical application of the Chinese version of the Resilience Scale (RS) in Chinese older people. METHODS: A descriptive cross-sectional study design was used. Forward and backward translation procedures were used to obtain semantic equivalence of the original English version of the RS. Content validity was examined by identified experts, followed by exploratory factor analysis, item-to-total correlation, Cronbach's α coefficients and test-retest reliability. RESULTS: The 25-item Chinese version of Resilience Scale (RS-CN) was fully completed by 461 Chinese older people. Cronbach's α for the total Chinese version of the Revised Resilience Scale was 0.95, with a range of 0.85-0.89 for the sub-scales. Item-to-total correlation coefficients ranged from 0.51 to 0.75 and items were excluded with item-to-total correlations coefficients lower than 0.4. The test-retest reliability of the total scale was 0.80, sub-scale test-retest reliability ranged from 0.61 to 0.620. The exploratory principal component analysis with varimax rotation revealed RS-CN to have a four-factor structure. CONCLUSION: The RS-CN is a valid and reliable instrument for the measurement of the concept of resilience in Chinese older people. The results of this study provide cross-cultural evidence for the potential application of this scale in Chinese older people. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Greater insight into the psychological constructs of resilience in Chinese older people can lead to international comparisons and to the potential development of interventions for this population around the world.

Endothelial dysfunction in patients with primary aldosteronism: a biomarker of target organ damage.

Primary aldosteronism (PA) has been associated with increased target organ damage (TOD), most likely through mineralocorticoid receptor-dependent endothelial dysfunction, in comparison with essential hypertension (EH). The aim of this study was to evaluate the level of biomarkers of endothelial dysfunction in PA and the relationship with left ventricular hypertrophy (LVH) and microalbuminuria (MAU). A total of 50 PA patients and 51 patients with EH individually matched for age, sex, blood pressure and duration of hypertension participated in this study. Biomarkers of endothelial dysfunction, including von Willebrand factor (vWF), intercellular adhesion molecule 1 (ICAM-1) and oxidized low-density lipoprotein (ox-LDL), were measured. Plasma aldosterone concentration (PAC), MAU and echocardiography were also evaluated. In PA patients, vWF, ICAM-1, ox-LDL, LVH and MAU were all significantly higher than in EH patients (all P<0.05). Furthermore, LVH was positively correlated with PAC (P=0.002), vWF (P=0.013) and ox-LDL (P=0.020). MAU was positively correlated with PAC (P<0.001), vWF (P=0.013) and ICAM-1 (P=0.001). Multiple regression analysis indicated that vWF, ICAM-1 and PAC independently predicted MAU (all P<0.05). Likewise, PAC, vWF and ox-LDL were significant predictors of LVH (all P<0.05). Taken together, our results suggest that endothelial dysfunction may contribute to TOD in PA patients.

Initial Growth of Single-Crystalline Nanowires: From 3D Nucleation to 2D Growth.

The initial growth stage of the single-crystalline Sb and Co nanowires with preferential orientation was studied, which were synthesized in porous anodic alumina membranes by the pulsed electrodeposition technique. It was revealed that the initial growth of the nanowires is a three-dimensional nucleation process, and then gradually transforms to two-dimensional growth via progressive nucleation mechanism, which resulting in a structure transition from polycrystalline to single crystalline. The competition among the nuclei inside the nanoscaled-confined channel and the growth kinetics is responsible for the structure transition of the initial grown nanowires.

Thermal Contraction of Electrodeposited Bi/BiSb Superlattice Nanowires.

The lattice parameter of Bi/BiSb superlattice nanowire (SLNW) has been measured using in situ high-temperature X-ray diffraction method. The single crystalline Bi/BiSb SLNW arrays with different bilayer thicknesses have been fabricated within the porous anodic alumina membranes (AAMs) by a charge-controlled pulse electrodeposition. Different temperature dependences of the lattice parameter and thermal expansion coefficient were found for the SLNWs. It was found that the thermal expansion coefficient of the SLNWs with a large bilayer thickness has weak temperature dependence, and the interface stress and defect are the main factors responsible for the thermal contraction of the SLNWs.

Impact of obstructive sleep apnoea on clinical characteristics and outcomes in patients with acute coronary syndrome following percutaneous coronary intervention.

This study tested whether obstructive sleep apnoea syndrome (OSAS) influenced clinical characteristics and outcomes after successful percutaneous coronary intervention (PCI) in 123 consecutive patients with acute coronary syndrome (ACS). Patients with an apnoea-hypopnea index (AHI) >or= 5 were considered as having OSAS. Carotid ultrasonography and echocardiography were performed, and C-reactive protein (CRP) and fibrinogen were measured. Co-existence of ACS and OSAS occurred in 76 patients (61.8%) and patients with OSAS had a greater interventricular septum thickness (IVST) and higher levels of CRP than non-OSAS patients. In an elderly subpopulation (>or= 75 years of age), two-vessel disease was significantly more common and fibrinogen levels were significantly higher in OSAS than non-OSAS patients. Carotid intima-media thickness (IMT) correlated with the AHI in ACS patients. In elderly ACS patients, IMT, Gensini score and fibrinogen correlated with AHI. Patients were followed up for 1 year for major adverse cardiac events (MACEs) and no significant difference in major MACEs was found after this period between OASAS and non-OSAS patients. This study indicates that OSAS is associated with inflammation and increased IVST in ACS patients after successful PCI and, in elderly ACS patients, also with CAD severity and enhanced blood coagulability.