General characteristics and reasons for the discontinuation of drug clinical trials in mainland China.

BACKGROUND: Although discontinuation is common in clinical trials, no study has been conducted to analyse the current situation and reasons for the suspension or discontinuation of drug clinical trials in China. This study aims to analyse the general characteristics and reasons for the discontinuation of registered clinical trials in mainland China and to identify the associated factors. METHODS: We conducted a cross-sectional observational study of discontinued trials registered in the Drug Trial Registration and Information Publication Platform before March 31, 2020. All trials with a status of terminated or stopped recorded in the platform were classified as discontinued trials and included in the analysis. The basic characteristics of the discontinued trials were recorded, reasons for trial discontinuation were recorded and divided into 4 categories as drug development strategy, trial planning, trial conduct and studied drug. Pearson's chi-square test and fisher's exact test were used to compare the differences in reasons for discontinuation between neoplasm trials and non-neoplasm trials, and to examine the associations of trial characteristics with different reasons related to trials discontinuation. RESULTS: Three hundred twelve discontinued trials were included in this study. The studied drugs were mainly chemical drugs [229 (73.4%)], and indications of the studied drugs were mainly neoplasms [77 (24.7%)]. Geographical location of the discontinued trials were mostly in northern [114 (36.5%)] and eastern [96 (30.8%)] China. Study type of the included trials was mainly bioequivalence studies [97 (31.1%)]. The most common reason for trial discontinuation was commercial or strategic decision [84 (26.9%)], followed by futility/lack of efficacy [70 (22.4%)]. The number of trial centers, sample size and whether participants had been enrolled were significantly associated with trial discontinuation (P <  0.05). Multiple center trials showed a higher rate of trial discontinuation due to trial conduct related reasons than single center trials (P <  0.05), trials with sample size > 500 showed a higher rate of trial discontinuation due to studied drug related reasons (P < 0.05), and trials enrolled participants showed a lower rate of trial discontinuation due to commercial or strategic decision and a higher rate of trial discontinuation due to studied drug related reasons than trials without enrolled participants (P < 0.05). Besides, neoplasm trials showed a higher rate of trial discontinuation due to poor recruitment and safety comparing with non-neoplasm trials (P < 0.05). CONCLUSIONS: Trial discontinuation in China mainly occurred because of commercial or strategic decision and futility/lack of efficacy of the studied drug. Clinical trials with multiple centers and a large sample size may more likely be discontinued due to trial conduct related reasons such as good clinical practice. Discontinuation due to drug safety and lack of efficacy in multiple center trials with a large sample size deserves more attention to avoid resources wastes. Full communication with regulatory authorities such as Center for Drug Evaluation and research institutes to develop a feasible protocol is important for sponsors to avoid trial discontinuation due to protocol issues.

Inpatient Care Expenditure of Terminally Ill Patients in the Geriatric Ward of Peking Union Medical College Hospital / 中国医学科学院学报

Objective To describe the inpatient care expenditure of the terminally ill patients in the geriatric ward of Peking Union Medical College Hospital and facilitate future research on the economic outcomes of hospice and palliative care.Methods The histories of patients admitted to the Department of Geriatrics of Peking Union Medical College Hospital during 2018 were reviewed by trained doctors.According to the diagnosis and overall health state,terminally ill patients were selected and enrolled in the study.Demographics,health and disease information,prescriptions,and expenditure details were retrieved from the HIS system.Results In 2018,35 patients were terminally ill and eligible for hospice care,including 20 males and 15 females,with the average age of(78±8)years(59-91 years),the average age-adjusted Charlson Comorbidity Index of 10±3,and the median Barthel index of 40(10,70).These patients had malignant tumor(23 cases),heart failure(4 cases),end-stage renal disease(1 case),end-stage liver disease(2 cases),dementia(4 cases)and other severe diseases(3 cases).The patients received standard care within the scope of internal medicine and geriatrics.Finally,8 patients died during hospitalization,and 27 were discharged alive.The 35 patients had the median length of stay of 15(12,23)days,the median inpatient expenditure of CNY 21 500(13 800,37 600),and the median daily expenditure of CNY 1425(970,2503).The percentage of expenditure was(28.5±12.3)% for medication,(33.2±18.0)% for tests and examinations,and 11.5%(6.4%,15.8%)for accommodation and medical services.The medications for symptom control costed CNY(77±58)per day on average,accounting for(5.2±3.5)% of the total expenditure.Conclusions The inpatient expenditure for terminally ill patients in the tertiary grade A hospital was higher than that reported in community hospitals providing hospice care.In terms of expenditure constitution,the money spent on medications and tests/examinations were similar,and the percentage of expenditure on medications for symptom control was low.There is a need for further research on the economic impact of hospice and palliative care among terminally ill patients in China.

Effects of Palliative Care Consultation on Medicals in Peking Union Medical College Hospital / 中国医学科学院学报

Objective To explore the effects of palliative care consultation on medical professionals who have requested it in Peking Union Medical College Hospital. Methods Semi-structured interviews were conducted with 17 medical professionals who had requested palliative care consultation.Results Palliative care consultation had the following positive effects:building a bridge for doctor-patient communication,providing psychological support to reduce the sense of occupational exhaustion for medical professionals,providing technical support for medical professionals to help patients relieve symptoms,helping medical professionals in the multidisciplinary learning of palliative care,adding humanistic care and neglected ethical concerns.Conclusion Palliative care consultation improves the quality of care for dying patients,and the capacity of consultation needs to be enhanced urgently.

Relationship between Vowel Production and Speech Clarity in Post-stroke Dysarthria Patients / 中国康复理论与实践

Objective:To explore the characteristics of vowel production of dysarthria after stroke, and the relationship between vowel production and speech clarity. Methods:From October, 2019 to January, 2020, 19 patients with post-stroke dysarthria and 18 healthy controls were asked to read a short essay to extract vowels, and measured the jaw distance, tongue distance, F2i/F2u, vowel space area (VSA), vowel articulation index (VAI), F1 and F2 variability, and speech clarity. The correlation between vowel production and speech clarity were analyzed. Results:Tongue distance, F2i/F2u, VSA, VAI, and speech clarity were less in the patients than in the controls (|t| > 2.268, P < 0.05), while F2 variability was more (t = 2.375, P < 0.05). F2i/F2u (r = 0.465), VAI (r = 0.488) and F2 variability (r = -0.504) were correlated to speech clarity (P < 0.05). Conclusion:The vowel production impaired in patients with post-stroke dysarthria, featured as abnormal articulatory movements, concentration of vowels and poor stability of vowels, which impacts the speech clarity.

Transcutaneous partial pressure of carbon dioxide monitoring during EUS-guided drainage of peripancreatic fluid collections using carbon dioxide insufflation: A prospective study.

BACKGROUND: Carbon dioxide (CO2) insufflation has become more commonly used in EUS-guided interventions in recent years. However, there is a paucity of information regarding methods by which to monitor in vivo CO2 levels. This study aimed to assess the feasibility of a novel noninvasive method to monitor transcutaneous partial pressure of CO2 [INSIDE:1] levels during EUS-guided drainage of peripancreatic fluid collections (PFCs). The safety of CO2 insufflation in EUS-guided interventions was also investigated. PATIENTS AND METHODS: Patients who underwent EUS-guided PFC drainage between September 2015 and December 2016 at Shengjing Hospital of China Medical University were prospectively enrolled in this study. [INSIDE:2] was measured in all patients using a noninvasive sensor throughout the procedure. RESULTS: There were 25 patients eligible to be included in this study. The mean procedure time was 53.1 min. The mean [INSIDE:2] level was 40 ± 4 mmHg and 48 ± 5 mmHg before and after the procedure, respectively. The mean peak [INSIDE:2] during the procedure was significantly higher at 53 ± 6 mmHg (P < 0.0001). No complications associated with CO2 insufflation such as CO2 narcosis, gas embolism, or arrhythmias were encountered. CONCLUSIONS: [INSIDE:2] monitoring can accurately reflect the level of [INSIDE:3] continuously and noninvasively. CO2 insufflation is safe for patients undergoing relatively complicated EUS-guided drainage of PFCs.

Comparison of short-term and long-term outcomes between thoracoscopic pneumonectomy and open pneumonectomy for non-small cell lung cancer: a study based on propensity score matching / 中华外科杂志

Objective@#To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer.@*Methods@#The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using t test, χ2 test, Kaplan-Meier curve and Log-rank test, respectively.@*Results@#Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes vs. (171.3±43.5) minutes, t=2.50, P=0.02), more mediastinal lymph node dissection (M(QR): 17(9) vs. 11(10), W=388, P=0.02) and shorter postoperative hospital stay (7.0(3.5) vs. 9.0(3.0), W=285, P=0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% vs. 48.1%, P=0.10) and 3-year disease-free survival (67.4% vs. 47.2%, P=0.13) between the two groups.@*Conclusion@#Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.

Comparison of short-term and long-term outcomes between thoracoscopic pneumonectomy and open pneumonectomy for non-small cell lung cancer: a study based on propensity score matching / 中华外科杂志

Objective@#To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer.@*Methods@#The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using t test, χ2 test, Kaplan-Meier curve and Log-rank test, respectively.@*Results@#Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes vs. (171.3±43.5) minutes, t=2.50, P=0.02), more mediastinal lymph node dissection (M(QR): 17(9) vs. 11(10), W=388, P=0.02) and shorter postoperative hospital stay (7.0(3.5) vs. 9.0(3.0), W=285, P=0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% vs. 48.1%, P=0.10) and 3-year disease-free survival (67.4% vs. 47.2%, P=0.13) between the two groups.@*Conclusion@#Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.

Comparison of short-term and long-term outcomes between thoracoscopic pneumonectomy and open pneumonectomy for non-small cell lung cancer: a study based on propensity score matching / 中华外科杂志

To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using test, χ(2) test, Kaplan-Meier curve and Log-rank test, respectively. Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes . (171.3±43.5) minutes, 2.50, 0.02), more mediastinal lymph node dissection ((): 17(9) . 11(10), =388, 0.02) and shorter postoperative hospital stay (7.0(3.5) . 9.0(3.0), =285, 0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% . 48.1%, 0.10) and 3-year disease-free survival (67.4% . 47.2%, 0.13) between the two groups. Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.

Development of Diagnosis, Assessment and Rehabilitation Solution of Articulation Disorders for Children Using WHO Family International Classifications / 中国康复理论与实践

Results and Conclusion:Articulation disorder for children is classified to Developmental Speech Sound Disorder (6A01.0). It involves in the eye, ear and related structures (s2), structures involved in voice and speech (s3), especially structure of external ear (s240), structure of middle ear (s250) and structure of inner ear (s260); voice and speech functions (b3), especially articulation functions (b320); communication (d3), learning and applying knowledge (d1), interpersonal interactions and relationships (d7), and community, social and civic life (d9), especially speaking (d330), conversation (d350), using communication devices and techniques (d360) and acquiring language (d133). The assessment of articulation disorder should be covered articulation accuracy and motor function of articulation. A holistic rehabilitation solution for children with articulation disorder has been developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support. Objective:To explore the diagnosis of diseases and functioning of articulation function and conduct content analysis of assessment tools in Chinese, and to construct framework of rehabilitation solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (Children and Youth version) (ICF-CY) and International Classification of Health Interventions (ICHI). Methods:The diagnosis of disease and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic rehabilitation solution was constructed with ICF and ICHI.

Targeting LRH­1 in hepatoblastoma cell lines causes decreased proliferation.

Hepatoblastoma is the most common malignant liver tumor in children. Since it is often unresectable and exhibits drug resistance, the treatment of advanced hepatoblastoma is challenging. The orphan nuclear receptor liver receptor homolog­1 (LRH­1) serves prominent roles in malignancy; however, to the best of our knowledge, the role of LRH­1 in hepatoblastoma remains unknown. In the present study, human hepatoblastoma cell lines were analyzed; the mRNA and protein expression levels of LRH­1 were significantly higher in HepG2 and HuH6 cells compared with those in HepT1 cells and control THLE­2 cells. Knockdown of LRH­1 resulted in decreased HepG2 and HuH6 cell proliferation via downregulation of cyclin D1 (CCND1) and c­Myc. Furthermore, treatment with an LRH­1 antagonist (LRA) inhibited the proliferation and colony formation of cell lines in a dose­dependent manner, and induced cell cycle arrest at G1 phase through inhibition of CCND1 expression. Finally, LRA treatment enhanced the cytotoxic effects of doxorubicin on hepatoblastoma cells. Collectively, these findings suggested that LRH­1 may have an important role in the progression of hepatoblastoma and implicated LRA as a novel, potential therapeutic agent for the treatment of hepatoblastoma.

Diagnosis and treatment of pseudoaneurysm complicated with pancreatitis / 中华消化内镜杂志

Objective To analyze the diagnosis treatment and methods for pancreatic pseudoaneurysms complicated with pancreatitis. Methods The diagnostic methods,treatments and clinical effects of 11 patients with pancreatic pseudoaneurysms complicated with pancreatitis from January 2006 to December 2014 were retrospectively analyzed in Shengjing hospital. Results Two cases of pancreatic pseudoaneurysms were diagnosed by endoscopic ultrasonography(EUS). Eight cases were diagnosed with contrast-enhanced computed tomography. One case was diagnosed by angiography. Ten patients received endovascular embolization,and nine of them were successfully treated. Rebleeding occurred in one patient 28 days after embolization,and was successfully treated by repeated embolization. One patient was successfully treated by surgery. Conclusion Contrast-enhanced computed tomography and angiography are the current main methods to diagnose pancreatic pseudoaneurysms. With the wide use of EUS in the diagnosis of pancreatic disease,EUS becomes an option for diagnosis of pancreatic pseudoaneurysm. Traditionally, pancreatic pseudoaneurysm is treated by surgery. With the advancement of endovascular techniques, endovascular treatment has become the first-line treatment. Further studies with a large sample size are needed to establish the better diagnostic methods and treatments for pancreatic pseudoaneurysm.

Diagnosis and treatment of pseudoaneurysm complicated with pancreatitis / 中华消化内镜杂志

Objective@#To analyze the diagnosis treatment and methods for pancreatic pseudoaneurysms complicated with pancreatitis.@*Methods@#The diagnostic methods, treatments and clinical effects of 11 patients with pancreatic pseudoaneurysms complicated with pancreatitis from January 2006 to December 2014 were retrospectively analyzed in Shengjing hospital.@*Results@#Two cases of pancreatic pseudoaneurysms were diagnosed by endoscopic ultrasonography(EUS). Eight cases were diagnosed with contrast-enhanced computed tomography. One case was diagnosed by angiography. Ten patients received endovascular embolization, and nine of them were successfully treated. Rebleeding occurred in one patient 28 days after embolization, and was successfully treated by repeated embolization. One patient was successfully treated by surgery.@*Conclusion@#Contrast-enhanced computed tomography and angiography are the current main methods to diagnose pancreatic pseudoaneurysms. With the wide use of EUS in the diagnosis of pancreatic disease, EUS becomes an option for diagnosis of pancreatic pseudoaneurysm. Traditionally, pancreatic pseudoaneurysm is treated by surgery. With the advancement of endovascular techniques, endovascular treatment has become the first-line treatment. Further studies with a large sample size are needed to establish the better diagnostic methods and treatments for pancreatic pseudoaneurysm.

Needs of Continuing Education on Hospice and Palliative Care in China:A Questionnaire-based Survey / 中国医学科学院学报

Objective To analyzed the current situations and needs of the continuing education on hospice and palliative care (HPC) in China based on the response from trainees in the 2016 National Hospice and Palliative Medicine Training Program. Methods A questionnaire-based survey was performed among 141 trainees who attended the program held by Peking Union Medical College Hospital in 2016. The questionnaire items included the awareness and knowledge of HPC,learning Objective s,learning gains,and future plans. Results The trainees came from 19 provinces and municipalities. Their professions included doctors (66.0%),nurses (17.0%),physical therapists (1.4%),psychologists (5.0%),social workers (2.1%),volunteers (6.4%) and hospital managers (2.1%). Doctors'disciplines included geriatrics (56.0%),medical oncology (11.8%),and others (32.2%). Among these 141 participants,111 (78.7%) had not attended any HPC course before,134 (95.0%) were aware of HPC,and 131 (92.9%) needed help from others when providing care for terminally-ill patients. The median score for symptom control and communication skills among 141 trainees were 3.0(2.0,4.0) points and 1.0(0.0,2.0) points,respectively. The average score of the final examination involving case analysis and medical knowledge of symptom control was (59.1±18.0)scores (centesimal system). Finally,136 trainees (96.5%) were willing to receive further training on HPC. Conclusion It is important to do more HPC education and training among medical staff,so as to strengthen their knowledge and capability in symptom control,communication,and evaluation of death quality.

Physicians' Perception of Palliative Care Consultation Service in a Major General Hospital in China / 中国医学科学杂志(英文版)

Objective s The in-hosptial palliative care consultation (PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital. Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team, and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team. Physicians who applied for consultation in 2016 formally (requested from the department other than the Geriatrics) and informally (by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform. Results There were 103 physicians participated in the survey, including primary care physicians from the department of Internal Medicine (n=8), Gynaecology (n=16) and Surgery (n=13), rotating residents (n=30), visiting doctors (n=16) in Geriatric department, and PCC team members (n=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients' life; there were 91.6%, 95.2%, 90.4% physicians who felt it relieved the anxiety of patients, of family members and of care providers, respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence, and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree "PCC service helps the physicians better understand palliative care" than PCC members (97.6% vs. 80%, P0.05). Conclusion Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients, family members, and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.

Relationship between anxiety sensitivity and psychological health of soldiers: Mediating effect of resilience / 第二军医大学学报

Objective To investigate the relationship between anxiety sensitivity (AS), resilience and mental health of soldiers. Methods A total of 260 soldiers were selected from an army troop, and were surveyed by anxiety sensitivity index Ⅲ (ASI-3), Conner-Davidson resilience scale (CD-RISC) and self-reporting inventory (SCL-90). The relationships of these variables were analyzed by structure equation modeling analysis. Results Totally 240 (92.3%) valid questionnaires were collected. There were no significant differences in AS or mental health between soldiers with different demographic factors including service length, single-child or not, job division, educational level, or residence before entering army (P＞0.05). The total score of SCL-90 and each factor scores of soldiers with high-AS were significantly higher than those with low-AS (P＜0.01). The correlation analysis results showed that the total score of SCL-90 was positively correlated with the total score and each factor score of ASI-3 (rASI ＝0.487, rsomatic＝0.435, rsocial＝0.455, rcognitive＝0.445; P＜0.001), and was negatively correlated with each factor score of CD-RISC (rtenacity ＝0.315, rstrength ＝0.321, roptimism ＝0.227; P＜0.001). Structural equation modeling analysis and Sobel test showed that AS indirectly affected the mental health of soldiers through the mediating effect of resilience (χ2/df＝20.222/12＝1.685 2, P＝0.063, goodness of fit index [GFI]＝0.977, adjusted goodness of fit index [AGFI]＝0.946, normed fit index [NFI]＝0.977, relative fit index [RFI]＝0.960, incremental fit index [IFI]＝0.991, Tucker-Lewis index [TLI]＝0.983, comparative fit index [CFI]＝0.990, and root mean square error approximation [RMSEA]＝0.054). Conclusion RS has partial mediating effect on the relationship between AS and mental health of soldiers. More attention should be paid on the mental health of soldiers with high AS, so as to improve their RS and mental health.

A population pharmacokinetic model for individualised dosage regimens of vancomycin in Chinese neonates and young infants.

Population pharmacokinetic (PPK) modelling is an easy and impartment method for estimating drug concentration for use inindividualized therapy, especially for young patients and to help protect drug-induced diseases. The purpose of this study was to develop a PPK model for effective dosing of vancomycin in Chinese neonates and young infants. The PPK modelling tool Phoenix® NLME™ was use to assess demographic and routine clinical pharmacokinetic (PK) data retrospectively collected for patients admitted to Children's Hospital of Chongqing Medical University between 2011 and 2016. Data of patients admitted to the hospital between January and June of 2017 were used in validation study, and the final model was also preliminary validated in 2 cases in another hospital. A total of 421 serum samples from 316 patients were included in the initial PPK analysis. A two-compartment PPK model was developed, and exponential-error model was used to describe inter-individual variability of clearance. Residual variability was described by an additive model. The final PPK model was demonstrated as valid by internal and external model evaluation. Of note, the clearance and volume of vancomycin in Chinese neonates and young infants may be greater than in Caucasians. Herein, we describe the establishment of an accurate PPK model of vancomycin for Chinese neonates and young infants, which may be useful as a dosing algorithm for this particular paediatric population.

[Clinical features of acute poisoning in hospitalized children: an analysis of 586 cases].

OBJECTIVE: To investigate the clinical features of acute poisoning in hospitalized children. METHODS: A retrospective analysis was performed on the clinical data of 586 hospitalized children who were diagnosed with poisoning and discharged from the Children's Hospital of Chongqing Medical University between January 2006 and December 2015. RESULTS: The patients included 354 males and 232 females (age: 24 days to 15.8 years). Of the 586 cases, 450 (76.8%) were infants and preschool children; 463 (79.0%) came from rural areas; 551 (94.0%) were hospitalized because of unintentional poisoning. The drug poisoning, pesticide poisoning, and rodenticide poisoning accounted for 221 cases (37.7%), 167 cases (28.5%), and 175 cases (29.9%) respectively. There was a significant difference in the distribution of the poisoning toxins between urban and rural children (P<0.01), and drugs and pesticides were the most common toxins for urban and rural children respectively. There were significant differences in main clinical manifestations between the children with drug poisoning, pesticide poisoning, and rodenticide poisoning (P<0.01), who presented with main clinical symptoms of the nervous system, digestive system, and circulatory system respectively. There was no significant difference in overall response rate between the children poisoned by different toxins. CONCLUSIONS: Acute poisoning is most common in infants and preschool children. The majority of the patients are from rural areas. The majority of acute poisoning is unintentional. Poisoning by drugs is the main type of acute poisoning. There is no significant difference in overall response rate between the children poisoned by different toxins, but their clinical manifestations are different.

Clinical features of acute poisoning in hospitalized children: an analysis of 586 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of acute poisoning in hospitalized children.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 586 hospitalized children who were diagnosed with poisoning and discharged from the Children's Hospital of Chongqing Medical University between January 2006 and December 2015.</p><p><b>RESULTS</b>The patients included 354 males and 232 females (age: 24 days to 15.8 years). Of the 586 cases, 450 (76.8%) were infants and preschool children; 463 (79.0%) came from rural areas; 551 (94.0%) were hospitalized because of unintentional poisoning. The drug poisoning, pesticide poisoning, and rodenticide poisoning accounted for 221 cases (37.7%), 167 cases (28.5%), and 175 cases (29.9%) respectively. There was a significant difference in the distribution of the poisoning toxins between urban and rural children (P<0.01), and drugs and pesticides were the most common toxins for urban and rural children respectively. There were significant differences in main clinical manifestations between the children with drug poisoning, pesticide poisoning, and rodenticide poisoning (P<0.01), who presented with main clinical symptoms of the nervous system, digestive system, and circulatory system respectively. There was no significant difference in overall response rate between the children poisoned by different toxins.</p><p><b>CONCLUSIONS</b>Acute poisoning is most common in infants and preschool children. The majority of the patients are from rural areas. The majority of acute poisoning is unintentional. Poisoning by drugs is the main type of acute poisoning. There is no significant difference in overall response rate between the children poisoned by different toxins, but their clinical manifestations are different.</p>

Direct Evidence for Daily Plasticity of Electrical Coupling between Rod Photoreceptors in the Mammalian Retina.

Rod photoreceptors are electrically coupled through gap junctions. Coupling is a key determinant of their light response properties, but whether rod electrical coupling is dynamically regulated remains elusive and controversial. Here, we have obtained direct measurements of the conductance between adjacent rods in mouse retina and present evidence that rod electrical coupling strength is dependent on the time of day, the lighting conditions, and the mouse strain. Specifically, we show in CBA/Ca mice that under circadian conditions, the rod junctional conductance has a median value of 98 pS during the subjective day and of 493 pS during the subjective night. In C57BL/6 mice, the median junctional conductance between dark-adapted rods is ∼140 pS, regardless of the time in the circadian cycle. Adaptation to bright light decreases the rod junctional conductance to ∼0 pS, regardless of the time of day or the mouse strain. Together, these results establish the high degree of plasticity of rod electrical coupling over the course of the day. Estimates of the rod coupling strength will provide a foundation for further investigations of rod interactions and the role of rod coupling in the ability of the visual system to anticipate, assimilate, and respond to the daily changes in ambient light intensity. SIGNIFICANCE STATEMENT: Many cells in the CNS communicate via gap junctions, or electrical synapses, the regulation of which remains largely unknown. Here, we show that the strength of electrical coupling between rod photoreceptors of the retina is regulated by the time of day and the lighting conditions. This mechanism may help us understand some key aspects of day and night vision as well as some visual malfunctions.