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Objective To evaluate the differences in efficacy,safety and economics of vancomycin hydrochloride for injection between two manufacturers based on real-world data.Methods A total of 6 757 cases of intravenous use of vancomycin hydrochloride for injection from different manufacturers between January 1,2013 and December 31,2019 in the Affiliated Drum Tower Hospital of Nanjing University Medical School were retrospectively analyzed,and 5308 cases were matched by 1∶1 propensity score method,including 2 654 cases in the group A(domestic drug group)and 2 654 cases in group B(the innovator drug group).The differences in efficacy and safety between the two groups were compared.Cost-effectiveness analysis was used to compare the drug economics of the two groups.Results There were no significant differences in clinical cure rate,bacterial clearance rate,and incidence of adverse events between the two groups(P>0.05).In terms of economics,the average cost of vancomycin per capita,average daily cost of vancomycin and average cost of antibiotics per capita were significantly different between the two groups(P<0.05),and the cost of group B was higher than that of group A.Conclusion The efficacy and safety of vancomycin hydrochloride for injection were consistent between the two manufacturers.
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Vitiligo, a skin pigmentation disorder caused by the loss of melanocytes in the basal layer of the skin, is manifested as creamy white or ivory white pigmented islands on the head, face, hair, areola, genitals, mucous membranes and traumatic areas with distinct borders, seriously affecting the patient’s social, physical, and mental health. The disease has attracted wide attention in the medical circle as a difficult aesthetic dermatosis with an increasing prevalence year by year. There are still blind spots in the hypotheses that autoimmunity, melanocyte autophagy, oxidative stress, autocytotoxicity, neurohumors, and genetic and environmental factors are associated with the pathogenesis of this disease. The commonly used Western medical therapies, including glucocorticoids, small-molecule antagonists, calcium-regulated neurophosphatase inhibitors, biologics, vitamin D derivatives, phototherapy, and surgery are flawed with side effects and prone to recurrence. Traditional Chinese Medicine (TCM) can treat vitiligo via a wide range of pathways and targets, with definite effects and low adverse reactions. Studies have demonstrated that TCM can promote autophagy of melanocytes and protect them from oxidative stress. However, there are few systematic summaries of the signaling pathways in the TCM treatment of vitiligo. Therefore, this paper introduces the main signaling pathways involved in the TCM treatment of vitiligo by reviewing the relevant articles published at home and abroad in recent years. Specifically, the signaling pathways include the molecular hydrogen-activated nuclear factor erythroid-related factor 2 (Nrf2), tyrosine kinase receptor (c-Kit), nuclear transcription factor-κB (NF-κB), Janus tyrosine protein kinase (JAK), mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), and adenosine monophosphate-activated protein kinase (AMPK) signaling pathways.
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Stent-assisted coil embolization is a common endovascular treatment for ruptured/unruptured intracranial aneurysms. Stent implantation process can damage vascular endothelium, activate platelet and coagulation cascade, and then increase the risk of thrombosis. In order to reduce the risk of postoperative embolism, antiplatelet therapy is required. Among them, aspirin combined with clopidogrel dual antiplatelet therapy is a commonly used strategy. For patients with low response to clopidogrel, tigrelol or cilostazol can be used as an alternative drug. Although the scheme has been considered to be effective and safe, it is still controversial.
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Objective@#To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting.@*Methods@#According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi′an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions.@*Results@#Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ2=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ2=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ2=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ2=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ2=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ2=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ2=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499).@*Conclusions@#The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.
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Endotoxemia is a pathophysiological manifestation caused by the release of large amounts of endotoxin from bacteria in the blood or in the lesion. It can cause multiple organ failure, irreversible shock, and even death. The mortality rate of endotoxemiaIt is high. Bacterial endotoxin is the main cause of endotoxemia. At present, there is no safe and effective drug to treat endotoxemia in clinic. Research shows that blood purification can effectively reduce endotoxin level in the blood, then achieve the goal of treatment of endotoxemia. In this paper, the pathogenesis of endotoxemia, the development of hemoperfusion therapy technology, the mechanism and research status of endotoxin adsorption by different hemoperfusion resin were discussed, and the performance and safety requirements of hemoperfusion adsorbent materials for endotoxemia treatment were studied, so as to provide theoretical support for the synthesis of new hemoperfusion adsorption materials for the treatment of endotoxemia.
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Endotoxemia is a pathophysiological manifestation caused by the release of large amounts of endotoxin from bacteria in the blood or in the lesion. It can cause multiple organ failure, irreversible shock, and even death. The mortality rate of endotoxemiaIt is high. Bacterial endotoxin is the main cause of endotoxemia. At present, there is no safe and effective drug to treat endotoxemia in clinic. Research shows that blood purification can effectively reduce endotoxin level in the blood, then achieve the goal of treatment of endotoxemia. In this paper, the pathogenesis of endotoxemia, the development of hemoperfusion therapy technology, the mechanism and research status of endotoxin adsorption by different hemoperfusion resin were discussed, and the performance and safety requirements of hemoperfusion adsorbent materials for endotoxemia treatment were studied, so as to provide theoretical support for the synthesis of new hemoperfusion adsorption materials for the treatment of endotoxemia.
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Objective To investigate the change in mortality of congenital malformation in children aged <5 years in Beijing from 2006 to 2015.Methods Using the death surveillance data in children aged <5 years in Beijing from 2006 to 2015,which was collected from the real-time surveillance network,we calculated the area and age distributions of the mortality of congenital malformation in children aged <5 years in Beijing.Meanwhile,the variations of age,time and space in the causes of deaths were discussed.Results The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015,the decrease rate was 63.17%.The decrease rate was highest in neonates (71.50%) (x2=57.993,P<0.01).Expect urban area (x2=3.384,P>0.05),the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area (x2=40.637 and 50.646,P<0.01).The proportion of the children died of congenital malformation decreased from 32.97% in 2006 to 23.24% in 2015,which mainly occurred in infancy and neonatal period (x2=9.395 and 4.354,P<0.05).The constituent ratios of the children died of neural tube defects,respiratory system abnormalities and other abnormalities decreased significantly (x2=13.478,7.358,7.912 and 10.074,P<0.01).The constituent ratios of children died of chromosomal abnormality,multiple malformations and digestive tract abnormality didn't decreased significantly (P>0.05).In the leading causes of deaths from congenital malformation,the mortality of congenital heart disease,neural tube defects and digestive tract atresia decreased obviously (x2=70.868,18.431 and 9.225,P<0.01),except biliary atresia (x2=1.407,P> 0.05).There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects,the mortality was higher in outer suburbs than in suburban and urban area (x2=45.783 and 6.649,P<0.05).Conclusion Although the mortality rate of children with congenital malformation in Beijing has declined year by year,it is still the main cause of deaths in children under 5 years old,and the prevention and control of related diseases should be strengthened.
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Objective To investigate the change in mortality of congenital malformation in children aged <5 years in Beijing from 2006 to 2015.Methods Using the death surveillance data in children aged <5 years in Beijing from 2006 to 2015,which was collected from the real-time surveillance network,we calculated the area and age distributions of the mortality of congenital malformation in children aged <5 years in Beijing.Meanwhile,the variations of age,time and space in the causes of deaths were discussed.Results The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015,the decrease rate was 63.17%.The decrease rate was highest in neonates (71.50%) (x2=57.993,P<0.01).Expect urban area (x2=3.384,P>0.05),the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area (x2=40.637 and 50.646,P<0.01).The proportion of the children died of congenital malformation decreased from 32.97% in 2006 to 23.24% in 2015,which mainly occurred in infancy and neonatal period (x2=9.395 and 4.354,P<0.05).The constituent ratios of the children died of neural tube defects,respiratory system abnormalities and other abnormalities decreased significantly (x2=13.478,7.358,7.912 and 10.074,P<0.01).The constituent ratios of children died of chromosomal abnormality,multiple malformations and digestive tract abnormality didn't decreased significantly (P>0.05).In the leading causes of deaths from congenital malformation,the mortality of congenital heart disease,neural tube defects and digestive tract atresia decreased obviously (x2=70.868,18.431 and 9.225,P<0.01),except biliary atresia (x2=1.407,P> 0.05).There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects,the mortality was higher in outer suburbs than in suburban and urban area (x2=45.783 and 6.649,P<0.05).Conclusion Although the mortality rate of children with congenital malformation in Beijing has declined year by year,it is still the main cause of deaths in children under 5 years old,and the prevention and control of related diseases should be strengthened.
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To investigate the effect of estrogen receptor (ER) agonist 17β-estradiol and G protein-coupled estrogen receptor 1 (GPER) agonist fulvestrant on masangial cell fibrogenesis under protein kinase C (PKC),we quantified type Ⅳ collagen (COL4A1),fibronectin (FN1),connective tissue growth factor (CTGF) and transforming growth factor-β1 (TGFβ1) gene transcription and semi-quantified phosphorylation of Akt signal upon Phorbol 12-myristate 13-acetate stimulation (which increased COL4A1,FN1,CTGF and TGFβ1 gene transcription to 2.5-0.5,1.4 ±0.2,26 ± 11 and 1.9 ±0.3 times compared with baseline,P <0.05) when incubated with the two drugs.It was found that 17β-estradiol and fulvestrant down-regulated COL4A1,FN1,CTGF and TGFβ1 genes transcription (P <0.05) and Akt signaling under PKC activation via ER and GPER.ER and GPER agonists are beneficial in protecting the mesangial cells from fibrogenic stimuli by inhibiting PKC signaling and excessive extracellular matrix production.
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Objective To investigate the efficacy of aripiprazole addition therapy on adiponectin and leptin in schizophrenia patients with olanzapine-induced weight gain. Methods Schizophrenia patients with clinically significant weight gain induced by olanzapine were randomly divided into two groups:treated with olanzapine+aripiprazole (5 mg/d, n=48) or olanzapine+placebo (n=46). The level of FBS, TG, TC, adiponectin, leptin, the body index (BMI) and the insu?lin resistance index (HOMA-IR) were measured before and 4, 8 and 12 weeks after treatment. Results Adiponectin in?creased and leptin as well as HOMA-IR decreased in olanzapine+aripiprazole group after 4, 8 and 12 weeks treatment (P<0.05). However, FBS, TG and TC decreased and BMI increased only after 8 and 12 weeks treatment(P<0.05). In olanzapine+placebo group, the dadiponectin decreased and leptin, HOMA-IR as well as BMI increased after 8 and 12 weeks treatment(P<0.05). In olanzapine + aripiprazole group the adiponectin, leptin and HOMA-IR of 4, 8 and 12 weeks and BMI of 8 and 12 weeks were different from olanzapine + placebo group(P<0.05). Conclusions In schizo?phrenia patients with olanzapine-induced weight gain, aripiprazole addition therapy can ameliorate the HOMA-IR and BMI probably through the regulation of adiponectin and leptin.
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Hemoperfusion is a kind of medical device which contacts directly with blood.In the application,fully considering the interaction between the blood and the sorbent material,so as to improve the blood compatibility is particularly important.With the development of medical science,chemistry and biomedical engineering,a variety of new materials of hemoperfusion have been studied and the blood compatibility of hemoperfusion sorbent has also been greatly improved,making the range of hemoperfusion clinical applications increasingly wide.This paper,combining related research results in recent years,reviews the research progress of the hemoperfusion adsorbent's blood compatibility in recent years.
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Objective To evaluate the impacts of the essential medicine system in Jiangsu Province on rational drug use in community health service centers.Methods 7667 outpatient prescriptions from 6 community health service centers in Nantong were selected by cluster sampling from January 2009 to December 2011,the part of SDUIs(Selected Drug Use Indicators)developed by WHO and the self-design indicators were employed to analyze rational use of drugs.Results After implementation of the essential medicine system,the average types of drugs per prescription decreased from 3.02 to 2.74,the rate of antibiotic drugs usage dropped from 61.43% to 51.2%,the rate of one antibiotic usage reduced from 33.94%to 28.58%,and two types from 20.43%to 15.8%,all with significant differences(P<0.001).The average expenses in single prescription arose from RMB 69.70 to 87.28,the rate of essential medicine usage increased from 81.22%to 85.60%,the injection utilization decreased from 31.14% to 14.13%,while TCM utilization ascended from 16.17%to 21.8%,all with significant differences(P<0.001).Condusion The essential medicine systems has positive impacts on rational drug use,but the expenses of per prescription are higher,and irrational antibiotic drugs are still a serious problem.
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Objective The aim of this article was to deeply study the effects of different molecular weight of proteins and different structures of chemical substances on the adsorption specificity of HB-H-6 resin.Methods HB-H-6 resin was adopted to adsorb 5 different molecular weight proteins and different structural chemical substances including proteins,saccharides,human serum albumin (HAS),dextran and lipid,and then underwent static adsorption experiments in vitro.The adsorption rates of different structural chemical substances were analyzed from two experiments and the results were compared.Results The experiment results of HB-H-6 resin adsorption showed that the average adsorption rates of 5 different molecular weight proteins,myoglobin (Myo,16 700),ovalbumin (OVA,44 000),HAS (66 200),β-gal (130 000) and IgG (150 000),were significantly different:(0.00±0.33)%,(8.02± 1.23)%,(43.19±2.31)%,(34.25±1.07)% and (0.00±0.69)%.In the studies on adsorption of different structural chemical substances,the average adsorption rates of different structural chemical substances proteins,saccharides,lipid were significantly different:the absorption rates of plasma total protein,albumin,globulin,glucose,triglyceride and cholesterol groups were:(11.18±0.72)%,(10.74±0.66)%,(11.74± 1.22)%,(7.17±0.12)%,(1.06± 1.04)%,(3.05± 0.65)%.The absorption rates of HAS and dextran groups were:(43.19±2.31)% and (5.44±1.46)%.Conclusion In conclusion,the proteins' molecular weight of best adsorption condition is from 66 Ku to 130 Ku.The average adsorption rates of different structural chemical substances proteins,saccharides,lipid are significantly different.The average adsorption rates of proteins are higher than that of saccharides and lipid.It shows that HB-H-6 resin has adsorption specificity on different molecular weight proteins and different structural chemical substances.
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ObjectiveCurrently,adsorption materials applied to remove low density lipoprotein (LDL) still remain defects.HB-H-8 resin has not been put in use in removing LDL.This study focused on primary evaluation of adsorption capability of HB-H-8 resin.MethodsHB-H-8 resin was used in the adsorption of LDL of patient that was higher than the normal range of blood sample in dynamic test and static test in vitro.ResultsThe time of adsorption saturation was two hours,and the optimum temperature was 37℃.The results of adsorption in vitro showed that the average adsorption rates of LDL and high density lipoprotein (HDL) were 63.2% and 1.9%,respectively.ConclusionHB-H-8 resin has LDL higher adsorption capability,thus made it to be a potential blood purification material for the removal of LDL.
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Objective To describe CT and MRI findings of the global choroidal hemangioma, and to investigate their value in the diagnosis and differentiation. Methods Nine choroidal hemangioma patients proven by surgical pathology( n =3)or clinic information ( n =6) were analyzed. CT scan was performed in 6 cases and MRI in 4 cases. All cases were examined by ultrasound and 3 with fundus fluorescein angiography (FFA). Results Two cases showed slight or crescent like thickening and iso density with respect to the global wall on CT scan. 5 cases on enhanced CT showed a flat or shuttle shaped homogeneous mass with marked enhancement. MRI ( n =3) revealed high signal intensity on T 1WI and low signal intensity on T 2WI with respect to the vitreous. 1 small tumor was found clearly by postcontrast fat suppressed T 1WI. Ultrasound showed homogeneous mass ( n =1) and inhomogeneous mass ( n =8), with retinal detachment in all cases. Conclusion CT + MRI + ultrasound can get most of the diagnostic imaging data for choroidal hemangioma. MRI was superior to CT and ultrasound in the diagnosis of choroidal hemangioma and differential diagnosis from other malignant tumors.