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OBJECTIVE: To provide reference for the selection of inhaled corticosteroids (ICS) in clinic. METHODS: A questionnaire survey was conducted among pediatricians from medical institutions of 11 provinces (districts, cities) to analyze the drug selection and reasons, dosage form selection [by comprehensive score (CS)] of 3 kinds of ICS as budesonide (BUD), beclomethasone (BDP) and fluticasone (FP), medication compliance and influential factors (by CS). RESULTS: A total of 200 questionnaires were sent out, and 196 valid questionnaires were collected with effective rate of 98.00%. Pediatric clinicians preferred BUD as a control drug for asthma in children (158 cases, 80.61%), followed by FP (22 cases, 11.22%) and BDP (2 cases, 1.02%) and the rest had no tendency (14 cases, 7.14%). Clinicians who chose BUD mainly believed that the drug had better clinical efficacy, and was more recommended by guidelines and experts, more recognized by patients and so on. In addition, of all inhalation equipment for children asthma, pediatric clinicians believed that parents or children were more easier to master atomizer (CS: 4.04), followed by pressurized metered dose inhalers (pMDI) (with spacer) (CS: 2.75), pMDI (without spacer) (CS: 1.71), dry powder inhalers (DPI) (turbuhaler) (CS: 1.46) and DPI (accuhaler) (CS: 1.08). For the evaluation of patients’ medication compliance, 48 (24.49%), 88 (44.90%), 58 (29.59%) pediatricians thought that the actual administration accounted for <50%, 50%-74%, 75%-99% of the medical order dosages, respectively. Only 2 (1.02%) subjects thought that the patients would fully obey. The main factors affecting children’s medication compliance were worrying about side effects of long-term medication (CS: 9.19), drug withdrawal after improvement (CS: 8.16), and children’s treatment incompatibility (CS: 7.82). CONCLUSIONS: Pediatricians tend to choose BUD as drug for asthma control, and atomizer is treated as the easiest inhalation equipment for children. At the same time, pediatricians have low evaluation on the medication compliance of parents and children.
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Due to the weak foundation of clinical trials,the pre-market data of pediatric medicine is insufficient. Therefore,a comprehensive evaluation system of pediatric clinical medicine is urgently needed to safeguard the children′s medication safety. This article provides the method and builds path to establish the comprehensive evaluation system from the aspects of biulding organization?al structure,operational process and evaluation methodology,respectively. Further,based on the concept ofEvidence-based or other?wise evidence-created,and following the example of“Mini-Sentinel”of the United States,the big data in medicine can be used to overcome the“Evidence-created”difficulty in the evaluation of pediatric medication. Thus more extensive comprehensive evaluation can be made through collecting the clinical data generated from the real world for the pediatric medication. In the future ,the compre?hensive evaluation system of pediatric clinical medicine established on the basis of big data can be linked to thePrecision MedicineProject in our country,the evaluation bases can be the Mini-Sentinel to collect big medical data and biological samples,thus to bring a steady flow of power for promoting the pediatric medicine active surveillance and pediatric precision medicine ,and finally to safeguard the children′s health in our country.
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To compare two enrichment and preservation methods of urinary proteins, stored in polyvinylidene difluoride (PVDF) membrane (Urimem) or direct freezing, we examined the differences between the two methods in time, space, costs of supplies and electricity, degree of protein degradation and convenience of the sample handling. The urimem method is superior in the storage space, the cost of electricity and the clinical convenience compared to the direct freezing method. However, the direct freezing method is superior in the time and the cost of supplies to the urimem method. The enrichment and preservation of urinary proteins using urimem have more cost-effective benefits compared to those of the direct freezing method.
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Humanos , Análisis Costo-Beneficio , Congelación , Polivinilos , Preservación Biológica , Métodos , Proteínas , Química , Orina , QuímicaRESUMEN
Nitrocellulose membrane based urinary protein preservation method is simple, fast and economic, but its advantage over the traditionally used acetone precipitation method is still unclear. In this work, we prepared urinary proteins by the two methods by LC-MS/MS. Then we used protein spectra counts to assess the reproducibility of the two methods. Proteins identified by the two methods were almost the same in number, spectral count distribution and distribution of coefficients of variation value. In conclusion, nitrocellulose membrane method is generally the same as acetone precipitation method. It can be used for large scale preservation of clinical urine samples.