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Background: In Vietnam, there has been no survey conducted on the prescribing and monitoring practices of oral anticoagulants to ensure that patients with atrial fibrillation receive appropriate. Objective: Therefore, we conducted this research to clarify the aforementioned issue in our hospital. Methods: We carried out a cross-sectional study by reviewing outpatient electronic medical records at the University Medical Center in Ho Chi Minh City. Our study included 1087 patients aged 18 years or older diagnosed with non-valvular atrial fibrillation (NVAF), who visited the Cardiology clinic between January 1st, 2021, and June 30th, 2021. Results: Among the 1087 patients with non-valvular atrial fibrillation (NVAF), 1036 were eligible for anticoagulant therapy. However, only 847 (81.8%) received prescriptions for either Vitamin K antagonists (VKAs) (n=129, 15.2%) or Non-Vitamin K antagonist oral anticoagulants (NOACs) (n=718, 84.8%). NOAC prescriptions were more commonly found in patients aged 75 or older (adjusted odds ratio [OR]=2), those with health insurance coverage (adjusted OR=2.9), and in individuals with a history of hypertension (adjusted OR=2). On the contrary, patients with a farming occupation were less likely to be prescribed NOACs (adjusted OR=0.4). About 75% of patients adhered to the guidelines recommending close monitoring during anticoagulant treatment. Notably, inappropriate prescriptions were identified in 27.7% of cases, especially among those with no recorded body weight (which is necessary for precise dosing based on creatinine clearance), those without health insurance, those with undocumented CHA2DS2-VASc scores, or those who were concurrently using antiplatelet agents. Conclusion: A discrepancy persists between clinical guidelines and the actual practice in diagnosing and managing patients with non-valvular atrial fibrillation (NVAF). It is crucial to prioritize the regular reevaluation of thromboembolic risk scores at follow-up appointments, ensure strict adherence to clinical monitoring standards, and align anticoagulant medication prescriptions with established guidelines.
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Fibrilación Atrial , Accidente Cerebrovascular , Humanos , Anticoagulantes/uso terapéutico , Accidente Cerebrovascular/diagnóstico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Administración Oral , Estudios TransversalesRESUMEN
With the increasing demand to study the cause of complex diseases, mega cohort has gradually replaced the traditional small sample cohort and become the hotspot of epidemiological research. Follow-up is the essential step in a cohort study to obtain the information about the onset and death of diseases, migration or loss of follow-up of the cases. Its quality has a direct impact on the conclusions of cohort study. Therefore, it is necessary to develop a reasonable follow-up monitoring program for a mega cohort.In this paper, we summarized the contents and methods of the follow-up monitoring program in the mega cohorts at home and abroad, which aimed to provide suggestions for the new cohort and improve the follow-up program for the existing cohort.
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Humanos , Estudios de Cohortes , Estudios Epidemiológicos , Estudios de SeguimientoRESUMEN
PurposeThis study investigated the KAP towards COVID-19 and their influencing factors among primary and middle school students during the self-quarantine period in Beijing. MethodsThis was a cross-sectional study among students from 18 primary and middle schools in Beijing during March 2020. Stratified cluster sampling was conducted. Demographic and KAP-related COVID-19 information was collected through an online questionnaire. The influencing factors were analyzed by multivariable logistic regression. ResultsA total of 7,377 students were included. The overall correct rate for COVID-19 knowledge was 74.1%, while only 31.5% and 40.5% could identify the high-risk places of cross-infection and warning body temperature. Although 94.5% of respondents believed the epidemic could be controlled, over 50% expressed various concerns about the epidemic. The compliance rates for basic preventing behaviors were all over 80%, while those for "rational and effective ventilation" (39.2%) and "dinning separately" (38.6%) were low. The KAP levels were significantly differed according to various school categories of students. The COVID-19 knowledge (OR= 3.309, 95% CI: 2.921, 3.748) and attitude (OR=1.145, 95% CI: 1.003, 1.308) were associated with preventive practices. Besides, female, urban students, those with a healthy lifestyle, and those with the willingness to engage in healthcare tended to have better preventive practices. ConclusionMost students in Beijing hold a high level of knowledge, optimistic attitudes and have appropriate practices towards COVID-19. However, targeted interventions are still necessary, especially for students with high-risk characteristics. Implications and contributionsThe performance and the potential factors of COVID-19-related knowledge, attitudes and practices (KAP) among students in primary and middle schools is still unclear. This study investigates the characteristics and the level of KAP among students. The results of the study may contribute to the targeted education and interventions for students.
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BackgroundEvidence regarding the effects of ambient air pollutants and meteorological factors on COVID-19 transmission is limited. ObjectivesTo explore the associations of air pollutants and meteorological factors with COVID-19 confirmed cases across 31 Chinese provinces during the outbreak period. MethodsThe number of COVID-19 confirmed cases, air pollutant concentrations and meteorological factors in 31 Chinese provinces from January 25 to February 29, 2020 were extracted from authoritative electronic databases. The associations were estimated for a single-day lag (lag0-lag6) as well as moving averages lag (lag01-lag05) using generalized additive mixed models (GAMMs), adjusted for time trends, day of the week, holidays and meteorological variables. Region-specific analyses and meta-analysis were conducted in five selected regions with diverse air pollution levels and weather conditions. Nonlinear exposure-response analyses were performed. ResultsWe examined 77,578 COVID-19 confirmed cases across 31 Chinese provinces during the study period. An increase of each interquartile range in PM2.5, PM10, SO2, NO2, O3 and CO at lag4 corresponded to 1.40 (1.37-1.43), 1.35 (1.32-1.37), 1.01 (1.00-1.02), 1.08 (1.07-1.10), 1.28 (1.27-1.29) and 1.26 (1.24-1.28) odds ratios (ORs) of daily COVID-19 confirmed new cases, respectively. For 1 {degrees}C, 1% and 1 m/s increase in temperature, relative humidity and wind velocity, the ORs were 0.97 (0.97-0.98), 0.96 (0.96-0.97), and 0.94 (0.92-0.95), respectively. The estimates of PM2.5, PM10, NO2 and all meteorological factors remained statistically significant after meta-analysis for the five selected regions. The exposure-response relationships showed that higher concentrations of air pollutants and lower meteorological factors were associated with daily COVID-19 confirmed new cases increasing. ConclusionsHigher air pollutant concentrations and lower temperature, relative humidity and wind velocity may favor COVID-19 transmission. As summer months are arriving in the Northern Hemisphere, the environmental factors and implementation of public health control measures may play an optimistic role in controlling COVID-19 epidemic.
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The consistency of drug quality is related to the clinical efficacy and safety,which is highly valued by the government and relevant industries. Compared with chemical medicine,traditional Chinese medicine originates from the nature,and is greatly influenced by natural factors,such as the place of origin,cultivation and processing technology,climate. The quality consistency of traditional Chinese medicine is poor. The quality consistency has become the pain point and difficulty of the development of the traditional Chinese medicine industry,which seriously affects the stability and controllability of clinical efficacy and the reproducibility or recognition of modern research results. It is also a bottleneck for Chinese patent medicine to enter the international market. Mixed batch blending technology is an effective method for the scientific guarantee of the quality consistency in other industries and disciplines,and widely applied in liquor making industry,tobacco industry and perfume industry. Overseas,mixed batch blending technology has been successfully applied in guaranteeing the quality consistency of Ginkgo biloba preparations Jinnado. It has been used in the production of Chinese formulations in Japan for more than 30 years. In recent years,mixed batch blending technology has been introduced into the pharmaceutical field to ensure the quality consistency of traditional Chinese medicine,and relevant research has gradually increased.This manuscript reviews the application of blending technology in other disciplines,summarizes the algorithm principles and software systems of mixed batch blending in traditional Chinese medicine or natural medicine,explains the specific implementation process of mixed batch blending technology,and looks forward to the application prospects of artificial intelligence and other new technologies,in the hope of providing new ideas and technologies for breaking through the problem of quality consistency,and boosting the high-quality and high-level development of Chinese medicine industry in the new era.
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Algoritmos , Industria Farmacéutica , Medicamentos Herbarios Chinos , Medicina Tradicional China , Reproducibilidad de los Resultados , TecnologíaRESUMEN
Objective@#To investigate the genetic stability of virus seed H2M20K7 (K7) of live attenuated Hepatitis A virus H2 strain (HAV, H2 strain) for production of hepatitis A (Live) vaccine, lyophilized after continuous passages.@*Methods@#The virus seed K7 of H2 strain was proliferated and passaged in KMB17 cells in cell factories. Viruses of different passages were harvested after continuous passages. Virus RNA was extracted and the complete genomes of different virus passages (K7, K10, K11, K13, K15, K18) were sequenced by using next-generation deep sequencing. The mutation rates of different passages were compared. The infectivity titers of different virus passages of H2 strain were tested by ELISA.@*Results@#The mutation rates of complete genomes of different passages were low after continuous passages of master virus seed. The structure of gene was stable and non-synonymous mutation rate was lower than 0.57%. The mutation rate of 5 ’non-coding regions was lower than 0.1%. There was no significant mutation in VP1/2 A and 2C virulence site. The infectious titers of H2 strains of different passages were within 7.76-8.50 lgCCID50/ml. No statistically significant difference was found in this study.@*Conclusions@#The gene structure of the master virus seed, working seed and different passages of H2M20K7 after subculture was stable and the mutation rate was low. No significant mutation was found in 5’non-coding regions, and the critical virulence sites such as VP1/2 A, 2B and 2C showed attenuated characteristics with low mutation rate. Virulence of the virus did not changed. The H2 strain maintained stable viral infectivity and genetic stability and comply with the requirements as virus seed for vaccine manufacturing.
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Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100%,95% credibility interval from 86.87% to 97.30% and the BMDL higher than 85%;in PPS set he total data accuracy was 100%,95% credibility interval was from 92.89% to 100% and the BMDL was also higher than 85%.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.
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Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100%,95% credibility interval from 86.87% to 97.30% and the BMDL higher than 85%;in PPS set he total data accuracy was 100%,95% credibility interval was from 92.89% to 100% and the BMDL was also higher than 85%.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.
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To explore the impact of Salmonella on Enterococcusfaecalis isolate N41 under the coexisting,the growth traits and the transcription of 26 virulence genes of N41 at various growth phases were detected.Salmonella and/or N41 were inoculated and done plate counting,then growth curves were drawn and bacterial total RNA were extracted at given time points,quantitive realtime PCR was used to analyze the RNA transcription levels of 26 virulence genes of N41.The result showed that comparison with single incubation,the bacteria concentration of N41 dropped about 3.9 times,and Salmonella dropped about 110-times.Among 26 virulence genes of N41,the RNA transcription levels of 12 virulence genes such as ebpA,ebpC,rnjB,ace,ebpR,psr and so on were promoted at the four growth phases,but the RNA transcription levels of SlyA and sprE were dropped.Except that the RNA transcription levels of CylL-S,CylL-L,efaA and AS had no significant changes at the four growth phases,the mostly rest genes increased dramatically at post-log phase.This indicated that when incubated together,N41 inhibited the growth of Salmonella significantly,and Salmonella promoted the transcription levels of virulence genes of N41 as a whole.The results lay a foundation for further research on the interaction between bacteria species and the pathogenicity mechanism of Enterococci.
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BACKGROUND: Chilo suppressalis and Sesamia inferens are important lepidopteran rice pests that occur concurrently in rice-growing areas of China. The development of transgenic rice expressing Cry1A insecticidal proteins has provided a useful strategy for controlling these pests. RESULTS: This study evaluated the baseline susceptibilities of C. suppressalis and S. inferens to Cry1A, as well as their responses to selection with Cry1A. Wide geographic variation in susceptibility was observed across all field populations. Within a given population, the LC50 of both Cry1Ab and Cry1Ac against S. inferens was drastically higher than that of C. suppressalis. Large LC50 differences (74.6-fold) were detected between the two species for Cry1Ab in the Poyang population, while small differences (3.6-fold) were detected for Cry1Ac in the Changsha population. The Cry1Ac LC50 of C. suppressalis and S. inferens increased 8.4- and 4.4-fold after 21 and eight selection generations respectively. Additionally, the estimated realised heritabilities (h(2) ) of Cry1Ac tolerance were 0.11 in C. suppressalis and 0.292 in S. inferens. CONCLUSIONS: S. inferens exhibited a significantly lower susceptibility and more rapidly evolved resistance to Cry1A compared with C. suppressalis. Therefore, S. inferens is more likely to evolve increased resistance, which threatens the sustainability of rice expressing Cry1A protein.
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Proteínas Bacterianas/toxicidad , Endotoxinas/toxicidad , Proteínas Hemolisinas/toxicidad , Insecticidas/toxicidad , Mariposas Nocturnas/efectos de los fármacos , Animales , Toxinas de Bacillus thuringiensis , Resistencia a los Insecticidas , Mariposas Nocturnas/fisiologíaRESUMEN
Objective This study aimed to explore clinical characteristics of four types of obesity based on metabolic classification. Methods Forty-eight obese patients were divided according to their clinical characteristics into 4 groups including metabolic healthy obesity (MHO), hypometabolic obesity (LMO), hypermetabolic obesity (HMO), and metabolic obesity with inflammation (IMO). 20 normal weight individuals were also recruited as a control group. Body fat, body weight, visceral index, and basal metabolism were measured by Omron body fat meter. Fat content and its distribution were measured by dual energy X-ray absorptiometry. All participating patients underwent various tests for 75 g oral glucose tolerance, blood glucose, insulin, C peptide. Lipid profile, thyroid function and sex hormones levels, and inflammation factors were also measured. Results (1)Patients in MHO group had higher body fat content, but had no metabolic disorder and inflammation. Their hormones levels were normal. (2) Lower metabolic rate and lower hormones levels were found in the patients in LMO group with increasing visceral fat. Trunk/subcutaneous fat mass was significantly higher than that in MHO group(1. 19 ± 0. 25 vs 0. 97 ± 0. 32, P<0. 05). There were abnormal lipid and glucose metabolism in LMO group. The insulin action index was significantly lower than that in MHO group(0. 006 6 ± 0. 002 7 vs 0. 012 1 ± 0. 009 5, P<0. 05). The area under the curve of glucoseconcentrationwassignificantlyhigherinLMOgroupthanthatinMHOgroup[(18.71±8.68vs12.70±4.63) mmol/L, P<0. 05]. (3)Heart rate and blood pressure were higher in HMO group. The heart rate was significantly increased compared with that in MHO group [(90. 50 ± 8. 24 vs 73. 20 ± 14. 11) beat/min, P<0. 05]. The waist circumference was significantly larger than that in MHO group [(111. 88 ± 10. 54 vs 98. 05 ± 15. 56) cm, P<0. 05]. (4) In IMO group, insulin action index was significantly lower than MHO group (0. 007 0 ± 0. 003 3 vs 0.0121±0.0095,P<0.05). ThetrunkfatmassanduricacidlevelsweresignificantlyhigherthanMHOgroup [(17236.38±4610.60vs15816.10±5453.42)gand(468.28±121.32vs376.84±97.14) μmol/L,bothP<0. 05]. Patients in IMO group had acanthosis nigricans, but their glucose level was relatively normal. Conclusion The metabolic-based obese diagnosis is essential for understanding the obesity etiology and providing individualized treatment.
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In this paper, microcrystalline cellulose WJ101 was used as a model material to investigate the effect of various process parameters on granule yield and friability after dry granulation with a single factor and the effect of comprehensive inspection process parameters on the effect of granule yield and friability, then the correlation between process parameters and granule quality was established. The regress equation was established between process parameters and granule yield and friability by multiple regression analysis, the affecting the order of the size of the order of the process parameters on granule yield and friability was: rollers speed > rollers pressure > speed of horizontal feed. Granule yield was positively correlated with pressure and speed of horizontal feed and negatively correlated rollers speed, while friability was on the contrary. By comparison, fitted value and real value, fitted and real value are basically the same of no significant differences (P > 0.05) and with high precision and reliability.
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Celulosa , Química , Composición de Medicamentos , Métodos , Dureza , Modelos Químicos , Tamaño de la Partícula , Análisis de Regresión , Tecnología Farmacéutica , MétodosRESUMEN
Objective: To study the effect of microcrystalline cellulose (MCC) on compressibility and moldability of Galla chinensis extract (GCE). Methods: Four types of MCC were chosen and mixed with GCE respectively in different proportions. The powder was tabletted by Korsch XP-1 Intelligent Induction Tablet Machine, and the compressibility and moldability were evaluated using plasticity constant, elastic recovery, compression ratio, yield pressure, tensile strength, and their change rules as indexes. Results: The compressibility and moldability of GCE were poor. CeolusKG802 was the best at improving elastic recovery and compression ratio among the four kinds of MCC. AvicelDG improved the plasticity constant and tensile strength most when the adding amount was low, and CeolusKG802 improved them most when the adding amount was high. To yield pressure, CeolusKG802 exhibited greater reduction than the other MCC when added in a low amount. As for a high amount, the result was opposite. Conclusion: MCC has good compressibility and moldability in the compression process; Different types of MCC have different advantages. The change law of compression parameters is obtained by investigating the compression of mixed powders of MCC with different proportions on GCE.
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Objective To investigate the effect of X-ray irradiation on the expression of free ubiquitin in the serum, small intestine, and heart tissues of C57 BL/6N mice. Methods The amount of free ubiquitin protein in the serum and tissue homogenates was analyzed quantitatively with ELISA and Western Blotting assay. The mRNA expressions of free ubiquitin in the tissues were detected by RT-PCR. Results At 24 or 48 h after radiation, the free ubiquitin level in the serum and small intestine tissue increased asymptotically with increasing of radiation dose (F=183?1, 435?3, P 0?05). Conclusions Because of the high expressions of free ubiquitin protein in the radiosensitive mice tissues, X-ray radiation could increase the concentration of free ubiquitin in serum. The changes of free ubiquitin may be related to cellular radiosensitivity and tissue injury.
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<p><b>OBJECTIVE</b>To study the effect of aluminume adjuvant and immunization schedule on immunogenicity of Sabin inactivated poliovirus vaccine.</p><p><b>METHODS</b>Four batches of Sabin IPV were produced by different concentrations of type 1, 2, and 3 poliovirus and administrated on three-dose schedule at 0, 1, 2 months and 0, 2, 4 months on rats. Serum samples were collected one month after each dose and neutralizing antibody titers against three types poliovirus were determined by micro-neutralization assay.</p><p><b>RESULTS</b>The GMTs of neutralizing antibodies against three types poliovirus increased significantly and the seropositivity rates were 100% in all groups after 3 doses. There was no significant difference between two immunization schedules, and the 0, 2, 4 month schedule could induce higher level neutralizing antibody compared to the 0, 1, 2 month schedule. The groups with aluminum adjuvant could induce higher level neutralizing antibody compared to the groups without adjuvant.</p><p><b>CONCLUSION</b>Aluminum djuvant and immunization schedule could improve the immunogenicity of Sabin IPV.</p>
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Animales , Femenino , Masculino , Ratas , Adyuvantes Inmunológicos , Farmacología , Hidróxido de Aluminio , Farmacología , Anticuerpos Antivirales , Sangre , Esquemas de Inmunización , Vacuna Antipolio Oral , Alergia e Inmunología , Ratas WistarRESUMEN
Chronic kidney disease (CKD) is a major public health problem that affects about 10% of the general population. Current approaches to characterize the category and progression of CKD are normally based on renal histopathological results and clinical parameters. However, this information is not sufficient to predict CKD progression risk reliably or to guide preventive interventions. Nowadays, the appearance of systems biology has brought forward the concepts of "-omics" technologies, including genomics, transcriptomics, proteomics, and metabolomics. Systems biology, together with molecular analysis approaches such as microarray analysis, genome-wide association studies (GWAS), and serial analysis of gene expression (SAGE), has provided the framework for a comprehensive analysis of renal disease and serves as a starting point for generating novel molecular diagnostic tools for use in nephrology. In particular, analysis of urinary mRNA and protein levels is rapidly evolving as a non-invasive approach for CKD monitoring. All these systems biological molecular approaches are required for application of the concept of "personalized medicine" to progressive CKD, which will result in tailoring therapy for each patient, in contrast to the "one-size-fits-all" therapies currently in use.