Polymorph control by designed ultrasound application strategy: The role of molecular self-assembly.

Molecular self-assembly plays a vital role in the nucleation process and sometimes determines the nucleation outcomes. In this study, ultrasound technology was applied to control polymorph nucleation. For the first time, different ultrasonic application methods based on the nucleation mechanisms have been proposed. For PZA-water and DHB-toluene systems that the molecular self-assembly in solution resembles the synthon in crystal structure, ultrasound pretreatment strategy was conducted to break the original molecular interactions to alter the nucleated form. When the solute molecular self-associates can't give sufficient information to predict the nucleated polymorph like INA-ethanol system, the method of introducing continuous ultrasonic irradiation in the nucleation stage was applied. The induction of ultrasound during nucleation process can break the original interactions firstly by shear forces and accelerate the occurrence of nucleation to avoid the reorientation and rearrangement of solute molecules. These strategies were proved to be effective in polymorph control and have a degree of applicability.

QX-OH/Levobupivacaine: A Structurally Novel, Potent Local Anesthetic Produces Fast-Onset and Long-Lasting Regional Anesthesia in Rats.

PURPOSE: Local anesthetics (LAs) are an important alternative for postoperative analgesia; however, the short duration of LAs limits their use. Thus, we previously developed LL-1, a mixture of QX-OH and levobupivacaine (LB) that produces regional anesthesia for more than 10 h in rats. The aim of this study is to investigate the long-acting mechanism of LL-1 in vivo and in vitro. METHODS: Regional anesthetic effects and local toxicity of the LL-1, QX-OH and LB treatment groups were investigated in a sciatic nerve block rat model. Whole-cell patch-clamping recordings were used to measure the inhibition Nav currents (INa ) in ND7/23 cells. RESULTS: The onset of LL-1 (35mM QX-OH+10mM LB) and 10 mM LB was 10 min, which was much faster than 35 mM QX-OH (27 [18, 60] min, t[12] = -4.535, p = 0.001). The duration of LL-1 (35mM QX-OH+10 mM LB) was significantly longer than 35 mM QX-OH or 10 mM LB alone (F[3, 35] = 191.336, p < 0.0001). No differences in local tissue toxicity were found between LL-1 and LB. In patch-clamping recordings, 5 mM QX-OH produced ~20% inhibition of I Na currents. LB at 40 µM inhibited I Na by 65.51%±3.63%, while QX-OH 2 mM+LB 40 µM inhibited I Na by 77.37%±3.36% (t[14] = 2.358, p = 0.025), and QX-OH 5 mM+LB 40 µM inhibited I Na by 83.88%±1.57% (t[13] = 4.191, p = 0.0003). Furthermore, I Na inhibition by QX-OH+LB was more persistent than that of LB alone during washout. CONCLUSION: LL-1 can produce an additive and stable inhibition of Nagv currents, which can contribute to the long-lasting regional anesthetic action.

Factors associated with seizure-related motor vehicle accidents among patients with epilepsy in West China.

PURPOSE: This study was conducted to investigate the relevant demographics and clinical factors contributing to seizure-related motor vehicle accidents in west China. METHODS: All driving patients who visited our epilepsy clinic in the West China Hospital, between October 2012 and October 2016, were invited to participate. Data on social demographics, clinical features, and motor vehicle accidents were collected during structured interviews. Binary logistic regression was used to identify factors associated with seizure-related motor vehicle accidents. RESULTS: In total, 519 patients reported driving after being diagnosed with epilepsy. Among them, thirty-nine (7.5%) patients experienced at least one seizure-related motor vehicle accidents. Patients who had seizure-free intervals ≥2 years had a 89% reduced chance of crashing compared to patients with shorter intervals. Logistic regression revealed that the interval of seizure freedom (B = -0.384, P = 0.007), number of antiepileptic drugs (AEDs) taken (B = 0.400, P = 0.041), and type of motor vehicle (B = 0.798, P = 0.021) were independently associated with seizure-related motor vehicle accidents. CONCLUSION: The interval of seizure freedom, number of AEDs taken, and type of motor vehicle should be considered when counseling patients with epilepsy on driving. A longer seizure-free interval suggested a compromised risk of seizure-related motor vehicle accidents.

Do Breast Implants Influence Breastfeeding? A Meta-Analysis of Comparative Studies.

BACKGROUND: Aesthetic breast implant augmentation surgery is the most popular plastic surgery worldwide. Many women choose to receive breast implants during their reproductive ages, although the long-term effects are still controversial. Research aim: We conducted a meta-analysis to assess the influence of aesthetic breast augmentation on breastfeeding. We also compared the exclusive breastfeeding rates of periareolar versus inframammary incision. METHODS: A systematic search for comparative studies about breast implants and breastfeeding was performed in PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science through May 2018. Meta-analysis was conducted with a random-effects model (or fixed effects, if heterogeneity was absent). RESULTS: Four cohorts and one cross-sectional study were included. There was a significant reduction in the exclusive breastfeeding rate for women with breast implants compared with women without implants, pooled relative risk = 0.63, 95% confidence interval [0.46, 0.86], as well as the breastfeeding rate, pooled relative risk = 0.88, 95% confidence interval [0.81, 0.95]. There was no evidence that periareolar incision was associated with a reduction in the exclusive breastfeeding rate, pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58]. CONCLUSION: Participants with breast implants are less likely to establish breastfeeding, especially exclusive breastfeeding. Periareolar incision does not appear to reduce the exclusive breastfeeding rate.

Epilepsy-related concerns among patients with epilepsy in West China.

PURPOSE: In the present study, we aimed to investigate patient-derived epilepsy-related concerns among Chinese individuals with epilepsy and the impact of seizure control on patient concerns. METHODS: All adult patients with epilepsy who had visited the outpatient clinic at West China Hospital between July 2014 and June 2016 were invited to participate in the study. All patients were given a blank sheet of paper and asked to list any concerns they had regarding their disease in order of importance. Demographic and clinical characteristics were also evaluated while regression models were used to examine the impact of seizure control on patient concerns. RESULTS: A total of 1040 patients reported 2202 concerns across 25 distinct categories. The most frequently listed concerns were worries about seizures (55.4%), maintaining a job (17.4%), and the heritability of epilepsy (16.0%). The legal right to drive was listed by only 3.5% of patients who took the survey while seizure recurrence was described by participants as the most important concern (379, 36.4%). Compared with the group with uncontrolled seizures, the group with controlled seizures reported less frequently about "holding down a job" (odds ratio (OR): 0.333 (0.187-0.591)), "fear of being injured during a seizure" (OR: 0.353 (0.183-0.682)), and "leading a normal life" (OR: 0.452 (0.234-0.871)), but they reported more frequently about "having another seizure" (OR: 2.447 (1.614-3.710)), "problems with medication side effects" (OR: 1.733 (1.148-2.616)), and their "legal right or ability to drive" (OR: 2.360 (1.094-5.092)). CONCLUSION: Our findings indicated that Chinese adults with epilepsy had various concerns, some of which differed from those observed in Western populations. Concerns about heritability of seizures, marriage, and pregnancy were of greater concern to Chinese patients compared with Western patients while the legal right to drive appeared to be less of a concern to Chinese patients. Patients with controlled seizures may still have many concerns. Chinese physicians should monitor patient concerns even among those whose seizures remain controlled to meet their needs. More time and attention should be given to address these issues in clinical practice in the context of Chinese culture.

Re-usable electrochemical glucose sensors integrated into a smartphone platform.

This article demonstrates a new smartphone-based reusable glucose meter. The glucose meter includes a custom-built smartphone case that houses a permanent bare sensor strip, a stylus that is loaded with enzyme-carbon composite pellets, and sensor instrumentation circuits. A custom-designed Android-based software application was developed to enable easy and clear display of measured glucose concentration. A typical test involves the user loading the software, using the stylus to dispense an enzymatic pellet on top of the bare sensor strip affixed to the case, and then introducing the sample. The electronic module then acquires and wirelessly transmits the data to the application software to be displayed on the screen. The deployed pellet is then discarded to regain the fresh bare sensor surface. Such a unique working principle allows the system to overcome challenges faced by previously reported reusable sensors, such as enzyme degradation, leaching, and hysteresis effects. Studies reveal that the enzyme loaded in the pellets are stable for up to 8 months at ambient conditions, and generate reproducible sensor signals. The work illustrates the significance of the pellet-based sensing system towards realizing a reusable, point-of-care sensor that snugly fits around a smartphone and which does not face issues usually common to reusable sensors. The versatility of this system allows it to be easily modified to detect other analytes for application in a wide range of healthcare, environmental and defense domains.

Social support for people with epilepsy in China.

The aim of this study was to better understand social support in adult people with epilepsy (PWE) in China and to explore the factors related to weaker or stronger social support in PWE when compared with a group of matching healthy controls. Consecutively, we recruited PWE from the epilepsy outpatient clinic of the West China Hospital and healthy controls from nearby urban and rural areas. People with epilepsy and healthy controls were gender- and age-matched. Each participant was interviewed and completed the following instruments: the Social Support Rating Scale (SSRS) and the Hospital Anxiety and Depression Scale (HADS). In addition, we measured quality of life (QoL) in PWE using the Quality of Life in Epilepsy Inventory (QOLIE-31). We compared the SSRS scores between PWE and healthy controls and searched for relevant factors using correlation and regression analyses. The results showed that PWE scored lower on the SSRS than healthy controls. For PWE, early onset and depression were related to weaker social support. In healthy controls, being married and being psychiatrically healthy (i.e., scored lower on the HADS) were related to stronger support. Family members, especially parents and spouses, were the most powerful supporters for PWE and healthy people, but PWE relied on their families to a greater extent. Early intervention and psychiatric treatment are important to address and improve social support for PWE.