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OBJECTIVE To explore the hotspots of aging adaptation of drug package inserts, and to provide evidence for the development of aging adaptation of drug package inserts in China. METHODS The relevant English literature on drug package inserts for the elderly published from 2012 to 2022 was retrieved from Web of Science Core Collection; bibliometric analysis was performed by using VOSviewer and CiteSpace software, to explore research hotspots in this field, and summarize obstacles and solutions for the development of this field. RESULTS & CONCLUSIONS This study collected a total of 335 literature related to the aging adaption of drug package inserts, from 819 research institutions in 51 countries (regions), involving 2 174 authors. The research development of drug package insert adaptation for the elderly has slowed down in the past decade, and developed countries such as the United States and Japan dominate this field. Authors such as Wolf from Northwestern University in the United States, have the largest number of publications(12 literature). The research focuses in this field include the risk management of medication for the elderly, the updating of medication information for the elderly in drug package inserts, and the understanding and compliance of the elderly with drug package inserts and their influencing factors. The solutions to related obstacles in the development of aging adaption in drug package inserts include improving the visibility and readability of drug package inserts, filling in the information on elderly medication in drug package inserts, and so on. China can learn from the experiences and methods of other countries, conduct investigations into the influencing factors of elderly package inserts and pharmacokinetic studies based on the characteristics of the Chinese population, and improve the safety of medication for elderly patients in multiple dimensions.
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Objective:To investigate the clinical value of neuroendoscopic resection in recurrent or residual sellar and clivus tumors and the prevention and treatment of operative complications.Methods:A retrospective study was performed. Clinical data of 49 patients with residual or recurrent sellar and clivus tumors after neuroendoscopic resection in Department of Neurosurgery, First Affiliated Hospital of Sun Yat-sen University from November 2021 to October 2023 were collected; 45 patients were with pituitary adenoma, 3 were with craniopharyngioma, and 1 patient was with clivus chordoma; their surgical efficacy and complications were summarized and analyzed.Results:Total resection was achieved in 29 patients (59.2%), subtotal resection in 12 (24.5%), and partial resection in 8 (16.3%). Two patients (4.1%) had intraoperative internal carotid artery rupture and were given emergency laminar stenting, discharging with good recovery, but one of them left with unilateral motor nerve palsy. During 1-24 months of follow-up, 97.2% patients (35/36) had headache relief and visual acuity improvement, and no patient had permanent diabetes insipidus or cerebrospinal fluid rhinorrhea. Residual tumors increased in 3 patients (6.1%); no tumor recurrence after total resection was noted.Conclusion:Endoscopic resection of recurrent or residual sellar and clivus tumors is safe and effective; attention should be paid to the internal carotid artery during the operation.
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Objective: To analyze the clinical characteristics and imaging features of occupational pulmonary thesaurosis induced by dust of iron and its compounds (OPTIDIC). Methods: A total of 230 cases of occupational welder's pneumoconiosis (OWP) patients or observation subjects were selected as the research subjects using the retrospective analysis method. They were diagnosed in four occupational disease diagnosis institutions in Shandong Province from 2010 to 2017. The high kV X-ray chest radiography or chest digital radiograph (hereinafter referred to as X-ray) were re-read to screen OPTIDIC patients. The clinical data of OPTIDIC patients were collected and analyzed. Results: Among the 230 cases, 56 cases were diagnosed as OPTIDIC, accounting for 24.3%. The clinical symptoms of the 56 patients with OPTIDIC were cough, sputum, chest tightness, shortness of breath, and difficulty breathing, while their physical signs were low or coarse breath sounds in lungs and others. Most of the X-ray results showed p shadows or q shadows, accounted for 98.2%, of which p/p shadow and q/q shadow accounted for 62.5%. The result of chest computed tomography (CT) showed diffuse point/round shadow and diffuse glass shadow in OPTIDIC patients. The result of fibro-bronchoscopy showed that a large amount of iron lutein particles was accumulated in macrophages and biopsy of lung showed idiopathic pulmonary hemosiderosis in OPTIDIC patients. Conclusion: The clinical characteristics of OPTIDIC patients showed no different from OWP. However, the result of X-ray of OPTIDIC patients mainly showed small circular shadows, and their CT images mainly showed diffuse point/round shadows or grinding glass shadow, which could be used to the differential diagnosis of OPTIDIC and OWP.
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Objective:To investigate the clinical efficacy of microsurgical resection in primary jugular foramen schwannomas (JFSs).Methods:A retrospective analysis was performed; the clinical data of 58 patients with JFSs treated by microsurgery in Department of Neurosurgery, First Affiliated Hospital of Sun Yat-sen University from May 2012 to June 2021 were collected. Seven patients accepted microsurgery via suboccipital retrosigmoid approach, and 51 patients accepted microsurgery via jugular foramen approach. Fifty-three patients were followed up for 4.5 years (ranged from 0.5-8.5 years); follow-ups included Karnofsky performance status (KPS) scores, postoperative complications, and imaging reexaminations. Results:Fifty patients (86.2%) achieved total tumor resection and 8 (13.8%) subtotal resection. The KPS scores at discharge were 68.6±14.9, which were significantly lower than the preoperative KPS scores (77.6±13.5, t=2.452, P=0.017). During the follow-up, 5 patients(9.4%) had tumor recurrence, and 39 patients (73.6%) had improved symptoms after surgery. One patient (1.9%, modified Samii D type) died of cerebellar hemorrhage and swelling after surgery. The main complications included new/aggravated hoarseness (11/53), cerebrospinal fluid leakage (7/53), new/aggravated dysphagia (5/53), and new facial paralysis (4/53). Conclusion:In microsurgical resection of JFSs, short-term symptoms of the lower cranial nerves may be exacerbated, but long-term results are good.
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Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.
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Dihydroorotate dehydrogenase is a flavin-dependent mitochondrial enzyme to catalyze the fourth step of the de novo synthesis of pyrimidine and to oxidize dihydroorotate to orotate. By selectively inhibiting dihydroorotate dehydrogenase, thereby inhibiting pyrimidine synthesis, the enzyme has been developed for the treatment of cancer, autoimmune diseases, bacterial or viral infections, parasitic diseases and so on. The development of inhibitory drugs requires a detailed understanding of the structural characteristics and catalytic cycle mechanism of dihydroorotate dehydrogenase. Therefore, this paper reviews these two aspects, and indicates perspectives of these inhibitors in clinical application.
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Catalyse , Mitochondries/métabolisme , Oxydoréduction , Oxidoreductases acting on CH-CH group donors/métabolismeRésumé
Objective:To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.Methods:From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University,clinical data of 41 patients with insular glioma,who underwent the surgery assisted with 3.0T iMRI and neuronavigation,were analyzed retrospectively,and the resection extent,complications and prognosis were evaluated.Results:Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning.After further resection,total tumor resection was achieved in 16 patients,subtotal resection in 18 and partial resection in 7.There was a statistical significant difference in tumor resection between pre-iMRI and post-iMRI according to the Fisher test (P<0.05).In the follow-up from 3 months to 3 years,the symptoms of the 41 patients had improved.Conclusion:iMRI corrected the shift of brain.Neuronavigation can accurately and timely assess the degree of resecting tumor.The combination of neuronavigation with surgery can maximally and safely resect insular glioma.
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Objective To evaluate the influence of Chinese patent medicine Banlangen Granules and Ganmao Qingre Granules on war‐farin anticogulation effect during the process for treating acute upper respiratory tract infection in the postoperative patients with mechanical valve replacement in order to provide the theoretical reference for clinical medication .Methods The patient receiving mitral valve replace‐ment ,aortic valve replacement or double‐valve replacement and long term postoperative oral warfarin anticoagulation treatment were select‐ed ,moreover the symptoms of complicating acute upper respiratory tract infection occurred .The patients were divided into 2 groups ,30 cases in each group .The group A adopted oral Banlangen Granules ,while the group B was treated by oral Ganmao Qingre Granules .The treat‐ment course was 3 d .The International Normalized Ratio (INR) in the two groups was monitored before medication ,at 72 h after medication and at 72 h after drug withdrawal .Complicating bleeding or embolism reaction was observed .The INR values at various time points were compared between the two groups and the INR values in each group were compared among 3 time points .Results The INR values in the Banlangen Granules group had statistical differences between 72 h and other two time points ,and the INR values at the same time point had statistical difference compared with the Ganmao Qingre Granules group (P0 .05) .Thirty cases had no complication occurrence .The Ganmao Qingre Granules group had no statistical difference among various time points (P>0 .05) ,thirty cases had no complication occur‐rence .Conclusion The warfarin combined with Banlangen Granules causes the INR value increase ,while warfarin combined with Ganmao Qingre Granules has no impact on the INR value ,therefore which suggests that the combination use of warfarin and Banlangen Granules should be cautious in clinic .
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<p><b>OBJECTIVE</b>To analyze the clinical features and investigate the clinical diagnostic methods of hard metal lung disease (HMLD), then provide reference for the diagnostic criteria of occupational HMLD.</p><p><b>METHODS</b>Retrieved the open published case reports associated with HMLD from January, 2000 to June, 2014. Regarding the ages, sex, types and years of work, clinical features and laboratory results for analyzing.</p><p><b>RESULTS</b>Collected 21 clinical cases of HMLD belonged to 6 internal reports and 15 oversea reports. Among them 15 male and 6 female, ages were from 22 to 58, length of service between 1 year and 43 years. Clinical presentations included cough (20 cases), dyspnea on progressive (10 cases), and pulmonary function testing showed a restrictive abnormality. The imaging features presented as bilateral areas of ground-glass attenuation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The finding of giant cell interstitial pneumonia (GIP) was almost pathognomonic for hard metal pneumoconiosis. The main pathological findings contained a different levels of lymphocyte, acidophilic cell infiltration, hyperplasia of fibrous tissue and numerous large multinucleated histiocytes which ingested inflammatory cells were admixed with macrophages. 16 cases of the 21 reports showed GIP.</p><p><b>CONCLUSIONS</b>Clinical presentations include cough and dyspnea on progressive, and pulmonary function testing show a restrictive abnormality. The imaging features present as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The prime pathological findings contain interstitial pneumonia with intra-alveolar macrophages and a large amount of multinucleated histiocytes.</p>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Alliages , Cobalt , Poumon , Pneumopathies interstitielles , Anatomopathologie , Macrophages alvéolaires , Maladies professionnelles , Anatomopathologie , Pneumoconiose , Anatomopathologie , TungstèneRésumé
Objective We aimed to systematically review the effect of Comfeel transparent dressing for preventing PICC-associated phlebitis.Methods We electronically searched in China National Knowledge Infrastructure (CNKI),Chinese Science Technology Periodical Databases (VIP),Wanfang Database,China Biology Medicine Disc (CBM),PubMed and Embase for studies about effect of Comfeel transparent dressing for preventing PICC-associated phlebitis from inception to June 2014.Literature was screened and evaluated by inclusion and exclusion criterion.The RevMan 5.1 software was used for Meta-analysis.Results This study included 7 RCTs involving 524 patients.Meta analysis showed that compared with the 3M occlusive dressing,Comfeel transparent dressing could significantly decrease the incidence of PICC-associated phlebitis,OR=0.17,95%CI (0.08,0.34),Z=4.95,P<0.01.Conclusions Comfeel plus transparent dressing can prevent the incidence of PICC-associated phlebitis.
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<p><b>OBJECTIVE</b>To review the clinical features of acute toxicity of aromatic amino and nitro compounds.</p><p><b>METHODS</b>A total of 110 papers reporting 1240 cases of acute toxicity induced by aromatic amino and nitro compounds from 1979 to 2013 were collected from CNKI, VIP, and Wanfang database, and were analyzed in this study.</p><p><b>RESULTS</b>Of all included cases, 939 were caused by occupational exposure, and 301 were caused by exposure in daily life. A total of 1044 cases were male, and 196 were female. Age ranged from 9 days to 75 years. There were 13 cases of contact reaction. The numbers of mild, moderate, and severe toxicities were 358, 348, and 139, respectively, and the other 382 cases were not graded for severity. The average incubation period was 4.50±5.71 h (M = 3 h). The average incubation period of aniline toxicity was significantly shorter than that of nitrobenzene toxicity. Methemoglobinemia was found in 1146 cases, while cases of poisonings with 5-nitro-o-toluidine, 2-methyl-4-nitroaniline, and 3-chloro-2-methyl aniline were not found to have methemoglobinemia. The detection rates of MHb and HzB were 83.73% (674/805) and 40.19% (129/321), respectively. Sixty-two (19.31%) out of 321 cases were complicated by intravascular hemolysis, 270 (30.93%) out of 873 cases suffered hepatic impairment, 50 (12.25%) out of 408 cases were accompanied by renal damage. Consciousness disorders were found in 66 cases, and chemical cystitis was found in 36 cases. Oral poisoning could immediately induce severe symptoms including cyanosis, unconsciousness, and hemolysis. In prognosis analysis, it was found that the cure rate was 98.71% (1224/1240), and 14 cases of death were caused by multiple organ dysfunction syndrome, renal failure, uncontrolled hemorrhagic shock, myocardial infarction, and sudden death. Two cases were left with neurological sequelae.</p><p><b>CONCLUSION</b>The clinical manifestations of poisoning with aromatic amino and nitro compounds are methemoglobinemia, intravascular hemolysis, liver damage, and renal damage. Treatment with specific medicine methylene blue can produce ideal clinical prognosis, but severe poisoning may cause death from multiple organ failure.</p>
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Adolescent , Adulte , Sujet âgé , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Adulte d'âge moyen , Jeune adulte , Maladie aigüe , Dérivés du benzène , Intoxication , Composés nitrés , IntoxicationRésumé
In the experiment of atherosclerosis, the change of the cerebrovascular dynamic indexes (CVDI) was observed. In the atherosclerosis group, the values of carotid artery's mean flow (Qmcan), mean velocity (Vmcan), maximal velocity (Vmax), minimal velocity (Vmin) and cerebrovascular compliance for zero pressure (CO) were significantly decreased (P