[Efficacy of bronchoalveolar lavage combined with prone positioning in children with Mycoplasma pneumoniae pneumonia and atelectasis: a prospective randomized controlled study]. / æ”¯æ°”ç®¡è‚ºæ³¡çŒæ´—è”åˆä¿¯å§ä½æ²»ç–—å„¿ç«¥è‚ºç‚Žæ”¯åŽŸä½“è‚ºç‚Žä¼´è‚ºä¸å¼ ç–—æ•ˆçš„å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To study the efficacy of bronchoalveolar lavage (BAL) combined with prone positioning in children with Mycoplasma pneumoniae pneumonia (MPP) and atelectasis and its effect on pulmonary function. METHODS: A prospective study was conducted on 94 children with MPP and atelectasis who were hospitalized in Ordos Central Hospital of Inner Mongolia from November 2020 to May 2023. The children were randomly divided into a treatment group and a control group, with 47 children in each group. The children in the treatment group were given conventional treatment, BAL, and prone positioning, and those in the control group were given conventional treatment and BAL. The two groups were compared in terms of fever, pulmonary signs, length of hospital stay, lung recruitment, and improvement in pulmonary function. RESULTS: Compared with the control group, the treatment group had significantly shorter time to improvement in pulmonary signs and length of hospital stay and a significantly higher rate of lung recruitment on day 7 of hospitalization, on the day of discharge, and at 1 week after discharge (P<0.05). Compared with the control group, the treatment group had significantly higher levels of forced vital capacity (FVC) as a percentage of the predicted value, forced expiratory volume (FEV) in 1 second as a percentage of the predicted value, ratio of FEV in 1 second to FVC, forced expiratory flow at 50% of FVC as a percentage of the predicted value, forced expiratory flow at 75% of FVC as a percentage of the predicted value, and maximal mid-expiratory flow as a percentage of the predicted value on the day of discharge and at 1 week after discharge (P<0.05). There was no significant difference in the time for body temperature to return to normal between the two groups (P>0.05). CONCLUSIONS: In the treatment of children with MPP and atelectasis, BAL combined with prone positioning can help to shorten the time to improvement in pulmonary signs and the length of hospital stay and promote lung recruitment and improvement in pulmonary function.

[Series of group standards of Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions].

Drug instructions,the statutory and technical documents recording effectiveness and safety information,are an important basis for guiding doctors,pharmacists,and patients to use drugs rationally,and their scientificity,standardization,and accuracy directly affect the medication safety of the public. The sections of adverse drug events,contraindications,precautions,warnings,and application for specific populations in drug instructions directly express safety information and measures for rational use of drugs. In the drug life cycle,marketing authorization holders( MAHs) need to update safety information in the instructions promptly to ensure the safety and effectiveness of clinical drug medication. At present,revising instructions is an important measure to control drug risks. In the drug life cycle,in order to standardize the revision of safety information in the instructions by MAHs and eliminate inexact terms such as " unclear",the Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions,a series of group standards,have been established under the guidance of Standardization Department,China Association of Chinese Medicine. Therefore,on the basis of the existing rules and regulations,the standardized technical procedures for revising instructions came into being to help clinical safe and rational medication of drugs,and implement the strategy of " Healthy China".

[Interpretation of Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions].

Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions,a series of group standards,were proposed by Professor ZHANG Bing from Research Center for Pharmacovigilance and Rational Use of Traditional Chinese Medicine,and underwent centralized management by Chinese Association of Chinese Medicine. They were officially released on July 23 and implemented on July 31,2021. The series of group standards consist of six sections,including general principles,adverse drug events,contraindications,precautions,application for special populations,and warnings. The section of general principles is comprised of holistic and programmatic expressions,which explain the general technical requirements for revising the marketed Chinese patent medicine instructions. The other five sections focus on information collection,screening,transformation,and illustration of specific items,forming a standardized revision technical process. This series of standards is the result of multiple rounds of research and the suggestions of more than 200 experts in different professional fields of " medicine-pharmacy-management-law-enterprise" have been gathered therein to reach a consensus. With the purposes of establishing standardized technical specifications for the revision of safety information in the marketed Chinese patent medicine instructions,guiding marketing authorization holders in revising the instructions,filling the gaps in the research of Chinese patent medicine instructions,promoting the deve-lopment of pharmaceutical care and academic research,and encouraging the rational and safe medication of Chinese patent medicine,the series of group standards is of great significance.

[Technical specification for Instructions for Clinical Application of Chinese Patent Medicines in China Association of Chinese Medicine].

In order to solve the problems of confusion in clinical medication and imperfect instructions in Chinese patent medicines(CPMs), the Standardization Department of the China Association of Chinese Medicine and Center for Pharmacovigilance and Rational use of Chinese Medicine in Beijing University of Chinese Medicine jointly compiled the Instructions for Clinical Application of Chinese Patent Medicines(CPMs). As the interpretation and supplement of drug instruction information, it aims to guide clinical safety and rational use of CPMs. In addition, the technical specification for clinical application description of CPMs has been formulated, which covers the seven processes of "carding instructions, clinical investigation, data retrieval, data screening, evidence classification, path transformation and writing format". It will enable readers of Instructions for Clinical Application of Chinese Patent Medicines to understand the work behind the compilation.

The clinical benefits of Chinese patent medicines against COVID-19 based on current evidence.

The outbreak of emerging infectious pneumonia caused by 2019 Novel Coronavirus (2019-nCoV) has posed an enormous threat to public health, and traditional Chinese medicine (TCM) have made vast contribution to the prevention, treatment and rehabilitation of coronavirus disease 19 (COVID-19) among Chinese population. As an indispensable part of TCM, Chinese patent medicines (CPMs) are highly valued and critically acclaimed in their campaign to contain and tackle the epidemic, they can achieve considerable effects for both suspected cases under medical observation period, and confirmed individuals with serious underlying diseases or critical conditions. Given this, based on the Guideline on Diagnosis and Treatment of Coronavirus Disease 2019 in China, the present review summarized the basic information, clinical evidence and published literatures of recommended CPMs against COVID-19. The details were thoroughly introduced involving compositions, therapeutic effects, clinical indications, medication history of CPMs and the profiles of corresponding research. With regard to infected patients with different stages and syndrome, the preferable potentials and therapeutic mechanism of CPMs were addressed through the comprehensive collection of relevant literatures and on-going clinical trials. This study could provide an insight into clinical application and underlying mechanism of recommended CPMs against COVID-19, with the aim to share the Chinese experience in clinical practice and facilitate scientific development of TCM, especially CPMs in the fierce battle of COVID-19.

Relationship Between Aqueous Humor Levels of Cytokines and Axial Length in Patients With Diabetic Retinopathy.

PURPOSE: A negative relationship between intraocular vascular endothelial growth factor-A (VEGFA) and axial length was found, which may help explain why myopia with long axial length was a protective factor for development of diabetic retinopathy (DR). The aim of this study is to further assess the relationship between the aqueous humor levels of interlukin (IL)-8, IL-10, VEGFA, vascular adhesion molecule-1 (VCAM-1), basic fibroblast growth factor, VEGFB, and placental growth factor (PLGF) and axial length in eyes with DR. DESIGN: Retrospective, single-center, unmasked study. METHODS: Patients with age-related cataract and with/without DR who visited the Department of Ophthalmology at the Affiliated Hospital of Inner Mongolia Medical University were enrolled. The level of IL-8, IL-10, VEGFA, VCAM-1, and basic fibroblast growth factor were measured by cytometric bead array, and VEGFB and PLGF were measured by enzyme-linked immunosorbent assay. Axial length was measured by biometry. RESULTS: Totally 65 eyes of 65 patients were enrolled, including 14 patients with nonproliferative diabetic retinopathy, 16 patients with proliferative diabetic retinopathy (PDR), and 35 patients with age-related cataract as control. In the nonproliferative diabetic retinopathy group, the aqueous level of PLGF was negatively correlated with axial length (r = -0.576, P = 0.031), whereas the aqueous levels of IL-10 (r = 0.533, P = 0.049) and VCAM-1 (r = 0.566, P = 0.035) were positively correlated with axial length. In the proliferative diabetic retinopathy group, all cytokines did not significantly correlate with axial length. CONCLUSIONS: Among patients with diabetic retinopathy, we further found that aqueous levels of PLGF were negatively correlated with axial length, whereas VCAM-1 and IL-10 were positively correlated with axial length. These findings may suggest that these cytokines play a role in the development of DR, and further explain the relationship between the axial length and DR.

The pathogenic characteristics and ethnic differences of diabetic retinopathy / 解放军医学杂志

Diabetic retinopathy (DR) is one of the most common microangiopathies of diabetes mellitus (DM). It is due to abnormal blood glucose metabolism caused by insufficient insulin secretion or decreased activity. Its pathogenesis is complex, related to multi-gene inheritance and environmental factors. At present, the etiologic study of DR has been gradually deepened at home and abroad, but the epidemiological study of minority DR is lacking. This paper reviews DR's characteristics, ethnic differences and its characteristics in ethnic minority.

Long-term clinical outcomes of everolimus-eluting stent versus paclitaxel-eluting stent in patients undergoing percutaneous coronary interventions: a meta-analysis.

BACKGROUND: Everolimus -eluting stent (EES) is common used in patients undergoing percutaneous coronary interventions (PCI). Our purpose is to evaluate long-term clinical outcomes of everolimus -eluting stent (EES) versus paclitaxel-eluting stent (PES) in patients undergoing percutaneous coronaryinterventions (PCI) in randomized controlled trials (RCTs). METHODS: We searched Medline, EMBASE, Cochrane Library, CNKI, VIP and relevant websites ( https://scholar-google-com.ezproxy.lib.usf.edu/ ) for articles to compare outcomes between everolimus-eluting stent and paclitaxel-eluting stent without language or date restriction. RCTs that compared the use of everolimus -eluting stent and paclitaxel-eluting stent in PCI were included. Variables relating to patient, study characteristics, and clinical endpoints were extracted. Meta-analysis was performed using RevMan 5.2 software. RESULTS: We identified 6 published studies (from three randomized trials) more on everolimus-eluting stent (n = 3352) than paclitaxel-eluting (n = 1639), with follow-up duration ranging from 3, 4 and 5 years. Three-year outcomes of everolimus-eluting stent compared to paclitaxel-eluting were as following: the everolimus-eluting stent significantly reduced all-cause death (relative risk [RR]:0.63; 95% confidence interval [CI]: 0.46. to 0.82), MACE (RR: 0.56; 95% CI: 0.41 to 0.77), MI (RR: 0.64; 95% CI: 0.48 to 0.86), TLR (RR: 0.72; 95% CI: 0.59 to 0.88), ID-TLR (RR: 0.74; 95% CI: 0.59 to 0.92) and ST (RR: 0.54; 95% CI: 0.32 to 0.90). There was no difference in TVR between the everolimus-eluting and paclitaxel-eluting (RR: 0.76; 95% CI: 0.58 to 1.10); Four-year outcomes of everolimus-eluting compared to paclitaxel-eluting: the everolimus-eluting significantly reduced MACE (RR: 0.44; 95% CI: 0.18 to 0.98) and ID-TLR (RR: 0.47; 95 % CI: 0.23 to 0.97). There was no difference in MI (RR: 0.48; 95% CI: 0.16 to 1.46), TLR (RR: 0.46; 95% CI: 0.20 to 1.04) and ST ((RR: 0.34; 95% CI: 0.05 to 2.39). Five-year outcomes of everolimus-eluting stent compared to paclitaxel-eluting: There was no difference in ID-TLR (RR: 0.67; 95% CI: 0.45 to 1.02) and ST (RR: 0.71; 95% CI: 0.28 to 1.80). CONCLUSIONS: In the present meta-analysis, everolimus-eluting appeared to be safe and clinically effective in patients undergoing PCI in comparison to PES in 3-year clinical outcomes; there was similar no difference in reduction of ST between EES and PES in long-term(≥ 4 years) clinical follow-ups. Everolimus-eluting is more safety than paclitaxel-eluting in long-term clinical follow-ups, whether these effects can be applied to different patient subgroups warrants further investigation.

[Study on the dynamic variations of Z-ligustilide and n-butylidenephthalide content in essential oil of radix angelicae sinensis from different growth period].

OBJECTIVE: To study the variation of the biomass of the root and active components of Angelica sinensis during different growth periods. METHODS: 27 batches of Angelica sinensis were harvested from different growth periods, and the biomass of underground parts were determined; The Gas Chromatography-Mass Spectrometry (GC-MS) was used for determining the contents of Z-ligustilide and n-Butylidenephthalide in essential oil of Radix Angelicae Sinensis. RESULTS: The average contents of n-Butylidenephthalide and Z-ligustilide were more than 1% and 40% in the total essential oil of Radix Angelicae sinensis respectively. Their contents showed larger difference during different growth period. CONCLUSION: The contents of Z-ligustilide and n-Butylidenephthalide of Radix Angelicae Sinensis is closely related to their growth period.

[Relationship between ultrastructural features with the expression of connexin 43 in the uterine junction zone and pathogenesis of adenomyosis].

OBJECTIVE: to investigate the relationship between the ultrastructural features combined with the expression of connexin (Cx43) protein in uterine junction zone and pathogenesis of adenomyosis. METHODS: from Nov. 2008 to Nov. 2009, 30 patients with adenomyosis (including 14 cases with proliferative endometrium and 16 cases with secretory endometrium) as study group matched with 30 women with cervical intraepithelial neoplasia (CIN) III treated by hysterectomy as control group were enrolled in this study in Affiliated Hospital to Inner Mongolia Medical College. The expression of Cx43 in uterine junction zone of patients with adenomyosis was detected by immunohistochemisty staining. The ultrastucture of eutopic endometrium, uterine junction zone and outer 1/3 myometrium in both groups without history of dilatation and curettage, C-section and uterine surgery were observed by using transmission electron microscopy. RESULTS: (1) the expression of Cx43 in proliferative and secretroy uterine junction zone were 0.133 ± 0.018 and 0.137 ± 0.021 in study group and 0.154 ± 0.016 and 0.141 ± 0.018 in control group, which reached statistical difference (P < 0.05). However, it didn't show significant expression of Cx43 between proliferative and secretory uterine junction zone in study or control group (P > 0.05). The expression of Cx43 in proliferative and secretory of eutopic endometrium of 0.067 ± 0.017 and 0.062 ± 0142 in study group were significantly lower than 0.094 ± 0.005 and 0.080 ± 0.005 in control group. It didn't show statistical difference of Cx43 expression between proliferative and secretroy eutopic endometrium in both group. The expression Cx43 in outer myometrium of proliferative phase were 0.184 ± 0.022 in study group and 0.188 ± 0.028 in control group, which did not show significant difference (P > 0.05). It also did not exhibit statistical difference of Cx43 expression in outer myometrium of secretory phase (0.178 ± 0.022, 0.191 ± 0.025, P > 0.05). (2) Morphological changes: the area of uterine smooth muscle cells of the uterine junction zone of (24.3 ± 1.6) microm(2) in study group were significantly increased than (21.8 ± 2.0) microm(2) in control group (P < 0.01). The length of the cell membrane dense plaques of (1.07 ± 0.17) microm in study group was significantly increased than (0.71 ± 0.07) microm in control group (P < 0.01). The myocytes exhibited cellular hypertrophy and disordered arrangement and fewer caveolae. There was cylindrical and dentate, chromatin margination, more heterochromatin in which muscle cells of nuclear surface of the uterine junction zone. Less cytoplasmic myofilaments and more intermediate filaments. Mitochondria were increased, the volume increased significantly vacuolization. The rough endoplasmic reticulum and Golgi apparatus were more prominent. Otherewise, mast cells and fibroblasts were close and glandular epithelial cells showed desmosome connection which villus thickening and dense. All features were more prominent at the junctional zone. CONCLUSIONS: the down-regulation of Cx43 expression and ultrastructure changes in the junction zone might play an important role in pathogenesis of adenomyosis.