Watching intense movies increase IOP of primary open angle glaucoma patients: A prospective study.

PURPOSE: To investigate intraocular pressure (IOP) changes while viewing smartphone movies under artificial intelligence (AI) monitoring. METHODS: In all, 48 subjects were recruited from the glaucoma clinic of Xianyou maternal and child health hospital from January 2018 to March 2020. The research consisted of three parts. In part 1, movies rated by the Motion Picture Association of America (MPAA) were viewed via smartphones of various screen sizes under AI supervision for 90minutes, at a distance of 40cm. IOP and biological parameters including anterior chamber angle, Schlemm's canal (SC) cross-sectional area, heart rate, systolic and diastolic blood pressures (SBP and DBP) were measured and analyzed. In part 2, blue-blocking glasses (BB glasses) were worn to repeat the above experiments. In part 3, the efficacy of AI in decreasing attention loss was analyzed. In addition, results were analyzed to determine whether interval breaks, prompted by AI, prevented IOP from rising. RESULTS: In part 1, the mean IOP of primary open angle glaucoma (POAG) subjects' right eyes significantly increased by 4.828 and 4.974mmHg after watching R and NC-17 movies, respectively. In their left eyes, it increased by 2.876 and 5.767 after watching R and NC-17 movies, respectively. The maximum IOP difference was also increased by 4.782 and 4.510 on right and left eyes, respectively, after viewing NC-17 movies on a 6.1-inch screen. Furthermore, the SC became narrower, whereas heart rate, DBP and SBP increased in the POAG group. In addition, maximum IOP difference was significantly correlated with SC cross-sectional area, DBP and SBP in the POAG group. In part 2, symptom scores were improved by BB glasses; however, IOP was not decreased. In part 3, attention loss was significantly decreased by AI monitoring. On the contrary, AI also prevented IOP from rising via promoting interval rest. CONCLUSION: Watching adult movies (NC-17) can significantly increase the IOP of POAG patients. AI can prevent IOP from rising by promoting interval rest when viewing NC-17 movies.

[A prospective cohort study on the clinical value of pelvic peritoneal reconstruction in laparoscopic anterior resection for middle and low rectal cancer].

Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.

[Epidemiological and pathogenic characteristics of mumps in Fujian province, 2005-2017].

Objective: To understand the epidemiological and etiological characteristics of mumps in Fujian province, 2005-2017. Methods: All the reported mumps cases were collected through the National Notifiable Disease Information Management System, 2005-2017. Active search and interviews were conducted to collect the information on vaccination of mumps. Throat swab specimens were collected for cells culture, genotyping and gene sequence analysis on mumps virus (MuV). Results: A total of 83 959 cases of mumps were reported in Fujian province from 2005 to 2017, with an average annual incidence of 17.6 per 100 000. Since 2007, the incidence appeared increasing but then decreasing, reaching the lowest level (7.5 per 100 000), after the setup of a monitoring program. Annually, the onset time of mumps showed an obvious two seasonal peaks, one from April to July, with a weakening trend, and the other from October to January with a rising trend. Most of the mumps cases occurred among students, kindergarten and scattered children (89.2%, 5 814/6 517), children aged 5-9 years (38.8%, 2 527/6 517), with cases reported from every region. Program from the pathogen surveillance showed that the transmission chain of G genotype mumps virus did exist in Fujian. Data from the sequence analysis revealed that mutations in the nucleotide of G genotype strain in 2015 had led to mutation of 6 amino acid sites in the SH gene coding region, resulting in the differences appearing in both nucleotide and amino acid homology with type A vaccine strain. Conclusions: The incidence of mumps decreased annually, in Fujian. Prevention programs should focus on primary and secondary school students. In Fujian province, we also noticed the transmission chain of mumps G genotype with some amino acid mutations in the SH gene coding region. Monitor programs on both epidemiologic and etiology, should be strengthened.

Rectal absorption of ozagrel from a suppository containing its commercial tablet in healthy human subjects.

A suppository containing an ozagrel tablet was prepared using Witepsol H-15 as a base, and its rectal absorption was studied in male human volunteers. In comparison, a commercially available ozagrel tablet was administered orally to all the individuals in a cross-over design. After rectal dosing, ozagrel was absorbed rapidly at a Tmax of 0.75 h, and its elimination half-life was longer than after oral dosing. The extent of absorption of ozagrel after both administration routes was similar. However, the bioavailability of the rectal suppository is 92 +/- 37% (mean +/- S.D.; n = 6) relative to the oral tablet. The tablet-containing suppository is easy to prepare, with its content being accurate and reproducible. Thus, the present study suggests that the rectal administration of an ozagrel suppository is a practical and promising alternative to oral administration, especially for patients who cannot take tablets orally. This study demonstrated for the first time the possibility of an ozagrel suppository in human subjects.

Pharmacokinetics of a Chinese traditional medicine, danshensu (3,4-dihydroxyphenyllactic acid), in rabbits using high-performance liquid chromatography.

An injectable solution of Danshen was prepared and its in vivo disposition was examined in rabbits. The presence of Danshensu, one of the active components of Danshen, in the obtained solution was confirmed by a simple high-performance liquid chromatographic (HPLC) method. The pharmacokinetics of Danshensu in rabbits was evaluated by the HPLC method for plasma Danshensu. The calibration curve for Danshensu was linear (r = 0.998) over the concentration range of 0.25-40.0 micrograms/ml. The intra-assay coefficients of variation (CVs) were 3.8, 3.1, and 3.1% at 1, 10, and 50 micrograms/ml, respectively, and the inter-assay CVs were 5.3, 5.3, and 2.9% at 1, 10, and 50 micrograms/ml, respectively. The analytical recovery of Danshensu in plasma averaged 95.2%. From the plasma concentration profile of Danshensu after its intravenous administration, the t1/2, mean residence time (MRT), Vdss, and Cltot were determined as 32 min, 48 min, 149 ml/kg, and 3.13 ml/min/kg, respectively.

Pharmacokinetic-pharmacodynamic modelling of DP-1904, a novel thromboxane synthetase inhibitor in rabbits, based on an indirect response model.

A new imidazole derivative, DP-1904, produces a selective, potent and long-acting inhibition of thromboxane A2 (TXA2) syntheses and platelet aggregation. This study was designed to investigate the pharmacokinetics and pharmacodynamics (PK/PD) of DP-1904. DP-1904 disappeared from plasma with a half-life of 20 min after i.v. dosing, and the bioavailability after oral dosing was approximately 70%. The level of serum TXB2, which is a pharmacological marker for thromboxane synthetase inhibition, was measured to characterize the pharmacodynamics of DP-1904. A marked reduction of serum TXB2 was exhibited within 1 h after both i.v. and oral doses, reflecting the rapid onset of action of DP-1904. Serum TXB2 returned to the basal level much more slowly after oral dosing than after i.v. dosing, due to the longer half-life after oral dosing. An Emax model was employed to fit the pharmacological data after oral dosing, and IC50 and Emax values were estimated to be 5.0 ng/ml and 81%, respectively. In order to test its predictability, the PK/PD model was then used to predict a pharmacological profile after i.v. dosing; good agreement between the observed and predicted values was achieved. Thus, the present modelling procedure may be useful for optimizing the therapeutic regimens of DP-1904.

Pharmacokinetic and pharmacodynamic studies of a thromboxane synthetase inhibitor, ozagrel, in rabbits.

The pharmacokinetic and pharmacodynamic (PK/PD) characteristics of ozagrel, a new potent and selective thromboxane synthetase inhibitor, were investigated in rabbits after its intravenous, oral, and rectal administration. Serum level of TXB2 (the stable metabolite of TXA2), a direct pharmacological marker, was measured after each dosing. A marked reduction of serum TXB2 within 30 min was shown after the three routes of administration, reflecting rapid onset of action. Due to rapid and complete absorption (i.e., Tmax; 20 min, bioavailability; 100%) and longer duration of pharmacological action after rectal dosing, the rectum offers a practical delivery route for ozagrel. An Emax model was employed to fit the pharmacological data, and IC50 and Emax for thromboxane synthetase inhibition were estimated to be 56.0 ng/ml and 94%, respectively. These pharmacodynamic parameters were incorporated into an integrated mathematical model to simulate the PK/PD profiles of ozagrel after i.v., oral, and rectal administration at lower (50 mg) and higher (200 mg) doses, and good agreement between the experimental and calculated values was achieved. The present PK/PD model may be useful for optimizing the therapeutic regimens of ozagrel.

Rectal absorption of ozagrel from suppositories in rabbits.

Rectal absorption of ozagrel (a selective thromboxane synthetase inhibitor) from suppositories was studied in rabbits. Two kinds of suppositories were prepared, one was from ozagrel powder (OPS, ozagrel powder suppository), and the other from ozagrel tablet (OTS, ozagrel tablet suppository). Ozagrel from OPS was absorbed quickly with a Tmax value of 26.3 +/- 7.5 min, and the peak plasma level was significantly higher than that involving intravenous infusion or oral dose (50.3 +/- 6.7 vs. 32.8 +/- 5.4 or 9.9 +/- 1.2 micrograms/ml), indicating that OPS may be a useful dosage form rather than injection. OTS was absorbed less rapidly than OPS, but the AUCs of both suppositories were similar. Because OTS was prepared using an ozagrel tablet, it is fairly easy to get an equal content in each suppository. Therefore, OTS is not only an experimentally interesting dosage form, like OPS, but is also a practical preparation for clinical use.

Bioavailability of morphine in rabbits after rectal administration of suppository containing controlled release morphine tablet.

Two kinds of sustained release morphine suppositories have been prepared; one is an oleaginous base suppository (MSC) containing a controlled release morphine tablet (MST: MS Contin), and the other is a hollow-type suppository (MSCH) containing MST and morphine powder packed in its hollow space. In vitro release tests and in vivo rectal absorption experiments in rabbits were performed. The profiles of morphine release from MST and MSC in vitro were similar, and revealed that suppository bases had no effect on the release profile of morphine from the preparation. Morphine release from MSCH was rapid in the early phase, and then enclosed morphine was slowly and continuously released from MST. Phamacokinetics of morphine from the suppository were compared with the orally administered MST, and it was found that there was no difference in the maximum plasma concentration (Cmax) and the peak time (Tmax) between MSC and MST, but the mean residence time (MRT) of MSC was approximately three times longer than that of MST, and the extent of bioavailability (BA) of MSC was significantly larger than that of MST (71.6 +/- 14.2% and 11.9 +/- 4.0%, respectively). Cmax can be altered arbitrarily by changing the morphine content in the hollow space of MSCH. As in the case of MSC, the plasma concentration of morphine from MSCH was maintained. It is concluded from the above results that MSC is a satisfactory sustained release morphine suppository for the treatment of cancer pain, administering it twice a day, and that MSCH is effective due to its fast analgesic effect and sustained release nature not only for cancer pain but also for surgical operations.