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WHAT IS KNOWN AND OBJECTIVE: To investigate the general characteristics, economic burden, causative drugs and medical errors associated with litigation involving severe cutaneous adverse drug reactions (SCADRs) in China, with the aims of improving rational medication use and reducing the extent of damage from SCADRs. METHODS: This study analysed 150 lawsuit judgements involving SCADRs from 2005 to 2019, collected from China Judgments Online. RESULTS AND DISCUSSION: In total, 50% of lawsuits stemmed from SCADRs occurring in general hospitals. The average time elapsed from the date of occurrence of the SCADRs to the end of litigation procedures was 1055 days. Of the patients involved, 51% were female and more than two thirds (69%) were under 60 years old. The most common outcome of SCADRs was death (39%), followed by disabilities (30%). The average responsibility of the medical provider was 48 ± 29%. The average amount of compensation was $43 424. Of the cases studied, 51% of SCADRs were Stevens-Johnson syndrome or toxic epidermal necrolysis, which together accounted for 75% of cases with known clinical subtype. The overall average economic burden of SCADRs was $99 178, of which indirect costs made up the largest proportion (more than 60%). The most common causative drug groups were antimicrobial drugs (49%), Chinese patent medicine and Chinese herbal medicine (17%), and antipyretic analgesics (16%). Finally, 61% of medical errors were found to stem from violation of duty of care, 20% from violation of informed consent and 18% from violations related to the medical record writing and management system. WHAT IS NEW AND CONCLUSION: Severe cutaneous adverse drug reactions not only severely affect patient survival and quality of life, but also impose a heavy economic burden in terms of health care and societal costs. Medical providers should be better educated on strategies to reduce risk to patients and establish mechanisms of risk sharing and management.
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Efeitos Psicossociais da Doença , Toxidermias/epidemiologia , Legislação de Medicamentos/estatística & dados numéricos , Erros Médicos/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China , Toxidermias/economia , Feminino , Humanos , Jurisprudência , Masculino , Erros Médicos/economia , Erros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Síndrome de Stevens-Johnson/economia , Síndrome de Stevens-Johnson/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
OBJECTIVE: To evaluate the efficacy and safety of Ginkgolide Meglumine Injection (GMI) combined with Butylphthalide in the treatment of Acute Ischemic Stroke (AIS), and provide reference for rational clinical medication. METHODS: PubMed, Embase, Web of science, CNKI, Wanfang, VIP and other databases were searched for published studies on the treatment of AIS with GMI combined with Butylphthalide in both Chinese and English. The search period was from the establishment of the database to July 2023. The included studies that met the inclusion criteria were analyzed using RevMan 5.3 software for Meta-analysis. RESULTS: A total of 25 studies involving 2362 patients (experimental group = 1182, control group = 1180) were included. The results of meta-analysis showed that the overall effective rate of the experimental group was significantly higher than that of the control group [RR = 1.21, 95% CI (1.16, 1.26), P< 0.00001]. In addition, compared with the control group, the experimental group showed significant improvement in NIHSS score [SMD = -1.59, % CI (-2.00-1.18), P< 0.00001] and ADL score [SMD = 2.12, 95% CI (1.52, -2.72), P<0.00001], significant decrease in CRP [SMD = -2.24, 95% CI (-3.31, -1.18), P<0.0001] and TNF-α [SMD = -2.74, 95% CI (-4.45, -1.03), P< 0.005] levels, and improvement in plasma viscosity [SMD = -0.86, 95% CI (-1.07, -0.66), P< 0.00001]. However, the influence on homocysteine level remains inconclusive. Furthermore, there was no significant difference in the incidence of adverse reactions between the two groups [SMD = 0.95, 95% CI (0.71, 1.28), P> 0.05]. CONCLUSION: GMI combined with Butylphthalide shows good clinical application effects and good safety in the treatment of AIS. However, more large-sample, multicenter, randomized controlled are needed to confirm these findings.
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Benzofuranos , AVC Isquêmico , Humanos , Benzofuranos/efeitos adversos , Ginkgolídeos/efeitos adversos , Meglumina , Estudos Multicêntricos como AssuntoRESUMO
Mesenchymal stem cells (MSCs), distributed in many tissues in the human body, are multipotent cells capable of differentiating in specific directions. It is usually considered that the differentiation process of MSCs depends on specialized external stimulating factors, including cell signaling pathways, cytokines, and other physical stimuli. Recent findings have revealed other underrated roles in the differentiation process of MSCs, such as material morphology and exosomes. Although relevant achievements have substantially advanced the applicability of MSCs, some of these regulatory mechanisms still need to be better understood. Moreover, limitations such as long-term survival in vivo hinder the clinical application of MSCs therapy. This review article summarizes current knowledge regarding the differentiation patterns of MSCs under specific stimulating factors.
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Ginger (Zingiber officinale Roscoe) is a high-value food and herb worldwide. The quality of ginger is often related to its production regions. In this study, stable isotopes, multiple elements, and metabolites were investigated together to realize ginger origin traceability. Chemometrics showed that ginger samples could be preliminarily separated, and 4 isotopes (δ13C, δ2H, δ18O, and δ34S), 12 mineral elements (Rb, Mn, V, Na, Sm, K, Ga, Cd, Al, Ti, Mg, and Li), 1 bioelement (%C), and 143 metabolites were the most important variables for discrimination. Furthermore, three algorithms were introduced, and the fused dataset based on VIP features led to the highest accuracies for origin classification, with predictive rates of 98% for K-nearest neighbor and 100% for support vector machine and random forest. The results demonstrated that isotopic, elemental, and metabolic fingerprints were useful indicators for the geographical origins of Chinese ginger.
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Zingiber officinale , Quimiometria , Isótopos , Minerais , MetabolômicaRESUMO
Food authenticity regarding different varieties and geographical origins is increasingly becoming a concern for consumers. In this study, headspace gas chromatography-mass spectrometry (HS-GC-MS) and fast gas chromatography electronic nose (fast GC e-nose) were used to successfully distinguish the varieties and geographical origins of dried gingers from seven major production areas in China. By chemometric analysis, a distinct separation between the two varieties of ginger was achieved based on HS-GC-MS. Furthermore, flavor information extracted by fast GC e-nose realized the discrimination of geographical origins, and some potential flavor components were selected as important factors for origin certification. Moreover, several pattern recognition algorithms were compared in varietal and regional identification, and random forest (RF) led to the highest accuracies for discrimination. Overall, a rapid and precise method combining multivariate chemometrics and algorithms was developed to determine varieties and geographical origins of ginger, and it could also be applied to other agricultural products.
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Compostos Orgânicos Voláteis , Zingiber officinale , Quimiometria , China , Nariz Eletrônico , Cromatografia Gasosa-Espectrometria de Massas/métodos , Zingiber officinale/química , Compostos Orgânicos Voláteis/análiseRESUMO
In mammalian ovaries, the avascular environment within follicular cavity is supposed to cause hypoxic status in granulosa cells (GCs), leading to apoptotic cell death accompanied by cumulative reactive oxygen species (ROS) production. Melatonin (N-acetyl-5-methoxytryptamine, MT), a broad-spectrum antioxidant that exists in porcine follicle fluid, was suggested to maintain GCs survival under stress conditions. In this study, using the established hypoxic model (1% O2) of cultured porcine GCs, we explored the effect of MT on GCs apoptosis. The results showed that MT restored cell viability and reduced the apoptosis of GCs during hypoxia exposure. In addition, GCs treated with MT exhibited decreased ROS levels and increased expression of antioxidant enzymes including heme oxygenase-1 (HO-1), glutathione S-transferase (GST), superoxide dismutase 1 (SOD1), and catalase (CAT) upon hypoxia incubation. Moreover, the hypoxia-induced expression of cleaved caspase 3, 8, and 9 was significantly inhibited after MT treatment. In contrast, blocking melatonin receptor 2 (MTNR1B) with a competitive antagonist 4-phenyl-2-propionamidotetralin (4P-PDOT) diminished the inhibitory effects of MT on caspase 3 activation. By detecting levels of protein kinase (PKA), a downstream kinase of MTNR1B, we further confirmed the involvement of MT-MTNR1B signaling in mediating GCs protection during hypoxia stress. Together, the present data provide mechanistic evidence suggesting the role of MT in defending GCs from hypoxia-induced apoptosis.
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A structurally stable stacked multilayer carbonitride is predicted with the aid of ab initio calculations. This carbonitride consists of C3N tetrahedra, and is similar to T-carbon and thus named T-C3N. Its 2-dimensional (2D) monolayer is also carefully investigated in this work. The studies on electronic properties reveal that bulk and 2D T-C3N are insulators with a 5.542 eV indirect band gap and a 5.741 eV direct band gap, respectively. However, the monolayer T-C3N exhibits an excellent uniform porosity. Its 5.50 Å pore size is perfect for water nanofiltration. The adsorption and permeation of water molecules on the monolayer T-C3N are investigated. Its promising potential application in highly efficient nanofiltration membranes for seawater desalination is discussed.
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Depression, a psychiatric and dysthymic disorder, severely affects the learning, work and life quality. The main pathogenesis of depression is associated with central nervous system (CNS) dysfunction. Taurine has been demonstrated to exert protective effects on the brain development and can improve learning ability and memory. Our study investigated the antidepressant-like effects of taurine pre-treatment by examining the changes in depression-like behavior, hormones, neurotransmitters, inflammatory factors and neurotrophic factors in the hippocampus of a chronic unpredictable mild stress (CUMS)-induced depressive rat model. Taurine was found to inhibit the decrease of sucrose consumption and prevent the deficiency of spatial memory and anxiety in rats exposed to CUMS, suggesting a preventive effect of taurine on depression-like behavior. Furthermore, the decreased levels of 5-hydroxytryptamine, dopamine, noradrenaline; the increased levels of glutamate, corticosterone; and the decreased expressions of fibroblast growth factor-2, vascular endothelial growth factor and brain derived neurotrophic factor in depressive rats were hindered by taurine pre-administration. However, tumor necrosis factor-α and interleukin-1ß levels were not significantly changed by taurine. The results demonstrated that the anti-depressive effect of taurine may be involved in the regulation of hypothalamic-pituitary-adrenal (HPA) axis and the promotion of neurogenesis, neuronal survival and growth in the hippocampus.
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Antidepressivos/administração & dosagem , Depressão/tratamento farmacológico , Estresse Psicológico/tratamento farmacológico , Taurina/administração & dosagem , Animais , Antidepressivos/farmacologia , Depressão/metabolismo , Depressão/psicologia , Modelos Animais de Doenças , Dopamina/metabolismo , Fator 2 de Crescimento de Fibroblastos/metabolismo , Norepinefrina/metabolismo , Ratos , Serotonina/metabolismo , Memória Espacial/efeitos dos fármacos , Estresse Psicológico/metabolismo , Taurina/farmacologiaRESUMO
OBJECTIVE: To compare accuracy of the Pentacam with A-ultrasonoscope in the measurement of central corneal thickness. METHODS: According to the degree of myopia, 107 myopic patients (211 eyes) were divided into four groups. The central corneal thickness was measured with the Pentacam system and A-ultrasonoscope. The results were compared statistically and the differences between these two methods were analyzed. RESULTS: Mean values of central corneal thickness measured by the Pentacam system and A-ultrasonoscope was (535.58 +/- 36.34) microm and (536.73 +/- 37.18) microm, respectively. There was no difference in the results obtained by these two methods in each myopia group (P > 0.05). The 95% limits of agreement were (-1.88, -0.42). CONCLUSIONS: The data shows that the results obtained by Pentacam system do not have significant difference as compared with that from the A-ultrasonoscope. The Pentacam system can provide precise results and has the advantage of simplicity and non-contact. Therefore, it would be a promising instrument for the evaluation of central corneal thickness before the cornea refractive surgery.
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Córnea/anatomia & histologia , Imageamento Tridimensional/métodos , Adolescente , Adulto , Câmara Anterior/diagnóstico por imagem , Córnea/diagnóstico por imagem , Técnicas de Diagnóstico Oftalmológico/instrumentação , Feminino , Humanos , Masculino , Miopia/patologia , UltrassonografiaRESUMO
BACKGROUND: This study investigated the association of the 27 SNPs located in RASGRF1. GJD2, and ACTC1 genes with pathological myopia in a Chinese Han population. METHODS: Myopia patients were stratified according to whether they did (n = 274) or did not (n = 131) have myopic macular degeneration (MMD). The SNPbrowser software was used to identify specific SNPs for analysis and minimal allele frequency of >20%, and a pairwise r(2) < 0.85 were genotyped using MALDI-TOF mass spectrometry. RESULTS: Before controlling for false discovery rate, the frequency of the rs1867315 C/C genotype compared with healthy controls was lower in the myopia group (p = 0.006) and in myopia patients without macular degeneration (p = 0.019). The frequency of the rs670957A/A genotype was also lower in patients without MMD compared with controls (p = 0.045). For rs2070664, the frequency of the A allele was higher in the patients with MMD compared to those without MMD (p = 0.032). After controlling for a false discovery rate of 5%, there was no significant difference in genotype and allele frequencies between these groups. CONCLUSION: In this study, there was no association of the analyzed SNPs located in RASGRF1. GJD2, and ACTC1 with pathological myopia, suggesting that SNPs included in our study have no or a limited role in causing pathologic myopia in this Chinese Han population.
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Actinas/genética , Povo Asiático/genética , Cromossomos Humanos Par 15/genética , Conexinas/genética , Miopia Degenerativa/genética , Polimorfismo de Nucleotídeo Único , ras-GRF1/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Feminino , Frequência do Gene , Genótipo , Técnicas de Genotipagem , Humanos , Masculino , Pessoa de Meia-Idade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Adulto Jovem , Proteína delta-2 de Junções ComunicantesRESUMO
Flexible and low-loss hollow waveguide has many advantages as an absorption cell for spectroscopic gas sensing. The characteristics of the sensing system are dependent on the parameters of the hollow waveguide cell. In this paper, a mathematical model was proposed to analyze the waveguide cell by considering waveguide loss, effective optical path length, and signal-to-noise ratio of the system. Simulation results show that the gas absorption intensity and system sensitivity are dependent not only on the waveguide length but also on the bore-diameter, signal-to-noise ratio, and the concentration of the target gases. The results provide optimizing methods for the sensing system and algorithms for error compensation. Preliminary experiments on concentration detection of methane gas were carried out and measured data showed good agreements with the simulation results.