Inyección de composite fluido técnica analógica vs técnica digital en el tratamiento de desgaste dental: reporte de caso / Fluid composite injection analog vs digital technique in the treatment of dental wear: case report

El avance de la tecnología permite realizar cambios en la rehabilitación y estética, reduce los tiempos de trabajo y disminuye los riesgos que se presentan al momento de utilizar materiales convencionales para la toma de impresiones. Existen dos técnicas que se pueden emplear, la analógica y la digital; la primera presenta mayores riesgos que el operador no puede controlar, así como tiempos más prolongados. Este reporte describe la rehabilitación bucal en dos pacientes con desgaste dental, se optó por usar ambas técnicas, la analógica y la digital, como tratamiento; en la primera se empleó el encerado convencional y en la segunda el software Exocad para el encerado digital. Finalmente en ambos casos se aplicó (AU)

The advance of technology has allowed changes in rehabilitation and esthetics, providing shorter working times and reducing the risks that occur when using conventional materials for taking impressions. There are two techniques that can be used, analog and digital, the first one presents greater risks that the operator cannot control, as well as more time. This report describes the oral rehabilitation in patients with dental wear. The treatment was carried out using the analogical and digital techniques, the former using conventional waxing and the latter using Exocad software for the digital waxing; finally, in both cases the injection technique with high-load Flow resin was used (AU)

El reposicionamiento malar. Presentación de una técnica original: punto MM / Malar repositioning. Presentation of an original technique: point MM

El envejecimiento facial es una sinergia compleja de cambios texturales de la piel, hiper- o hipoactividad muscular, reabsorción del tejido graso y resorción ósea. El déficit de volumen resultante, la deflación y la posterior caída del tercio medio facial produce una cara menos atractiva y juvenil. Los procedimientos inyectables en región malar son cada vez más populares y solicitados por los pacientes. El conocimiento de la anatomía de la cara media es fundamental para el inyector. La comprensión de la irrigación facial puede ayudar a disminuir la exposición a la aparición de hematomas y complicaciones vasculares severas. Existen múltiples técnicas de inyección propuestas para el tercio medio, en este artículo presentamos una técnica original, simple, segura y eficaz con resultados satisfactorios y riesgo reducido

Facial aging is a complex synergy of textural skin changes, muscle hyperactivity, fat dysmorphism, bone resorption. The resulting volume deficit and deflation of the mid face produces a less attractive and youthful face. Injectable midface procedures are becoming increasingly popular and requested by patients. Knowledge of the anatomy of the midface is critical for the injector. Understanding the irrigation of the face can help decrease the risk of hematoma and severe vascular complications. There are multiple injection techniques proposed for the middle third, in this article we present a simple, safe and effective technique with satisfactory results and lower risk

Differences According to the Type of Exogenous Hyaluronic Acid and its Frequency of Infiltration in the Treatment of Temporomandibular Osteoarthritis / Diferencias Según el Tipo de Ácido Hiaurónico Exógeno y su Frecuencia de Infiltración en el Tratamiento de la Osteoartritis Temporomandibular

SUMMARY: One of the most important minimally invasive treatments today in temporomandibular joint osteoarthritis (TMJ- OA) is the intra-articular exogenous hyaluronic acid (HA) injection, which has yielded good results in pain relief and improves mandibular function with few side effects. However, the effectiveness of HA continues to be controversial, partly due to the heterogeneity in the injection protocols in their molecular weight, viscosity and frequency of infiltration, among other properties. The aim of this review is to identify the differences in the histological and clinical effects of the different types of HA and the frequency of infiltration on TMJ-OA treatment. Materials and methods: A bibliographic search was performed in the PubMed, Web of Science and Scopus databases. The search was limited up to September 2022. Search terms included "osteoarthritis", "hyaluronic acid, "molecular weight", "concentration", "viscosity", "dose" and "temporomandibular", using AND/OR as Boolean terms. Results: Exogenous HA in its different molecular weights offers an improvement in histological and clinical characteristics. Apparently, low and medium molecular weight HA presents better results. No clinical studies related to the degree of HA viscosity were found. Respect to the frequency of infiltration, single injection, weekly injections for 3 weeks, weekly injections for 5 weeks and other protocols are used. However, their comparison is complex. There seems to be differences in the effects of the different HA preparations for the treatment of TMJ-OA, mainly in their molecular weight. However, the evidence remains scant.

Uno de los tratamientos mínimamente invasivos más importantes en la actualidad en la artrosis de la articulación temporomandibular (OATM) es la inyección intraarticular de ácido hialurónico (AH) exógeno, que ha dado buenos resultados en el alivio del dolor y mejora la función mandibular con pocos efectos secundarios. Sin embargo, la efectividad del AH continúa siendo controversial, en parte debido a la heterogeneidad en los protocolos de inyección en cuanto a su peso molecular, viscosidad y frecuencia de infiltración, entre otras propiedades. El objetivo de esta revisión fue identificar las diferencias en los efectos histológicos y clínicos de los diferentes tipos de HA y la frecuencia de infiltración en el tratamiento de TMJ-OA. Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Web of Science y Scopus. La búsqueda se limitó hasta septiembre de 2022. Los términos de búsqueda incluyeron "osteoartritis", "ácido hialurónico", "peso molecular", "concentración", "viscosidad", "dosis" y "temporomandibular", utilizando AND/OR como términos booleanos. El HA exógeno en sus diferentes pesos moleculares ofrece una mejora en las características histológicas y clínicas. Aparentemente, el AH de bajo y medio peso molecular presenta mejores resultados. No se encontraron estudios clínicos relacionados con el grado de viscosidad del HA. Respecto a la frecuencia de infiltración, se utilizan inyecciones únicas, inyecciones semanales durante 3 semanas, inyecciones semanales durante 5 semanas y otros protocolos. Sin embargo, su comparación es compleja. Parece haber diferencias en los efectos de las diferentes preparaciones de HA para el tratamiento de la OA-TMJ, principalmente en su peso molecular. Sin embargo, la evidencia sigue siendo escasa.

Qualitative Histologic Assessment vs. Geomorphometric Analysis of Nerve Fiber Shape after the Intraneural Application of Liposomal Bupivacaine / Evaluación Histológica Cualitativa Versus Análisis Geomorfométrico de la Forma de la Fibra Nerviosa Después de la Aplicación Intraneural de Bupivacaína Liposomal

SUMMARY: The preserved form of all components of the nerve fiber is a prerequisite for the proper conduction of the nerve impulse. various factors can change the shape of nerve fibers. In everyday practice, qualitative histological analysis is the gold standard for detecting changes in shape. Geometric morphometry is an innovative method that objectively enables the assessment of changes in nerve fibers' shape after local anesthetics action. A total of sixty sciatic nerves were used as material, which was intraneural injected with saline solution in the control group (n=30), and a solution of 1.33 % liposomal bupivacaine (n=30) in the test group. After the animals were sacrificed, nerve samples were taken and histological preparations were made. The preparations were first described and examined using a qualitative histological method, after which digital images were made. The images were entered into the MorphoJ program and processed using the method of geometric morphometry. Qualitative histological examination revealed no differences in nerve fibers after intraneurally applied physiological solution and liposomal bupivacaine. Using the method of geometric morphometry, a statistically significant change in the shape of axons was found after intraneurally applied saline solution and liposomal bupivacaine (p=0.0059). No significant differences in histological changes were found after the qualitative histological analysis of nerve fiber cross-section preparations. A statistically significant change in the shape of nerve fiber axons was observed after geometric morphometric analysis of digital images after intraneural application of saline and liposomal bupivacaine.

La forma conservada de todos los componentes de la fibra nerviosa es un requisito previo para la conducción correcta del impulso nervioso. Varios factores pueden cambiar la forma de las fibras nerviosas. En la práctica diaria, el análisis histológico cualitativo es el estándar de oro para detectar cambios de forma. La morfometría geométrica es un método innovador que permite evaluar objetivamente los cambios en la forma de las fibras nerviosas después de la acción de los anestésicos locales. Se utilizó como material un total de sesenta nervios ciáticos, que se inyectaron intraneuralmente con solución salina en el grupo control (n=30), y una solución de bupivacaína liposomal al 1,33 % (n=30) en el grupo de prueba. Después de sacrificados los animales, se tomaron muestras de nervios y se realizaron preparaciones histológicas. Primero se describieron y examinaron las preparaciones utilizando un método histológico cualitativo, después de lo cual se tomaron imágenes digitales. Las imágenes fueron ingresadas al programa MorphoJ y procesadas mediante el método de morfometría geométrica. El examen histológico cualitativo no reveló diferencias en las fibras nerviosas después de la aplicación intraneural de solución fisiológica y bupivacaína liposomal. Usando el método de morfometría geométrica, se encontró un cambio estadísticamente significativo en la forma de los axones después de la aplicación intraneural de solución salina y bupivacaína liposomal (p = 0,0059). No se encontraron diferencias significativas en los cambios histológicos después del análisis histológico cualitativo de las preparaciones de secciones transversales de fibras nerviosas. Se observó un cambio estadísticamente significativo en la forma de los axones de las fibras nerviosas después del análisis de morfometría geométrica de imágenes digitales después de la aplicación intraneural de solución salina y bupivacaína liposomal.

Agentes de abultamiento en incontinencia de orina de esfuerzo femenina: una alternativa a las mallas suburetrales / Bulking agents in female stress urinary incontinence: an alternative to suburethral mesh

OBJETIVO: Presentar una serie de casos de agentes de abultamiento (AA) de nuestro centro. MATERIAL Y MÉTODOS: Estudio retrospectivo. Se evaluaron todos los casos operados con AA entre 2017 y 2022. La inyección de AA se realizó en quirófano, bajo sedación con anestesia local periuretral o raquídea. La inyección se realizó con uretroscopia, 0,5 cc en 4 puntos periuretrales (horas 2, 5, 7 y 10). Se analizaron datos demográficos, quirúrgicos y de seguimiento. RESULTADOS: 15 casos. 13/15 presentaron incontinencia urinaria mixta. Solo dos casos tenían incontinencia de orina de esfuerzo pura. El procedimiento fue ambulatorio. La mediana del tiempo operatorio fue 15 minutos (15-20). La mediana de seguimiento fue 5 meses (1-9). El índice de severidad preoperatorio promedio fue 10,6 y en el seguimiento fue 2,79. La Escala de Mejoría Global mostró mejoría en 12/15, y 12/15 estaban satisfechas con la cirugía con mejoría en la calidad de vida. CONCLUSIÓN: Los AA son una opción quirúrgica efectiva, con una tasa de éxito del 80% en otros reportes, siendo similar con nuestra casuística. Ofrecer esta opción es posible a la hora de hablar de terapias alternativas.

OBJECTIVE: To present a case series of bulking agents (BA) from our center. MATERIAL AND METHODS: Retrospective study. All cases operated with BA between 2017 and 2022 were evaluated. A BA injection was performed in the operating room, under periurethral local anesthesia sedation or spinal anesthesia. The injection was performed with urethroscopy, 0.5 cc in 4 periurethral points (hours 2, 5, 7 and 10). Demographic, surgical, and follow-up data were analyzed. RESULTS: 15 cases were reported. 13/15 patients presented with mixed urinary incontinence. Only 2 cases had pure stress urinary incontinence. The procedure was ambulatory. Median operative time was 15 minutes (15-20). Median follow-up was 5 months (1-9). The average preoperative Sandvik Severity Index was 10.6 and in follow-up was 2.79. The PGI showed improvement in 12/15, and 12/15 were satisfied with the surgery with quality-of-life improvement. CONCLUSION: BA are an effective surgical option, with a success rate of 80%, according to other reports, being similar with our casuistry. Offer this option is possible at the moment of discussing alternative therapies.

Overview of systematic reviews of Chinese herbal injections for sepsis / 中国中药杂志

In this study, an overview of systematic reviews/Meta-analysis(SR/MA) of Chinese herbal injections for sepsis was performed to provide references for clinical practice and promote the quality improvement of clinical evidence. Eight Chinese and English databases such as CNKI, Medline, and EMbase were electronically searched for SR/MA of Chinese herbal injections for sepsis from database inception to June 2022. AMSTAR 2, PRISMA 2020, and GRADE system, combined with Recommendations for Clinical Evidence Grading on Traditional Chinese Medicine Based on Evidence Body, were applied to evaluate the methodological quality, reporting quality, and evidence quality of the included articles. Twenty-seven articles of SR/MA were included, containing four Chinese herbal injections(Xuebijing Injection, Shenfu Injection, Shenmai Injection, and Shengmai Injection). AMSTAR 2 checklist showed that the methodological quality of the SR/MA ranged from moderate to very low. Item 2(prior study design) was the critical item with poor scores, and the non-critical items with poor scores were items 3(explain the selection of the study designs), items 10(report on the sources of funding), and items 16(conflicts of interest stated). In terms of PRISMA 2020, items in eight topics with complete reporting of missing>50%, including search strategy, certainty assessment, results of syntheses, certainty of evidence, registration and protocol, support, competing interests, availability of data, code and other materials. The included SR/MA involved 30 outcome indicators. Evidence quality of mortality, APACHE Ⅱ, and safety, the top three outcome indicators, was evaluated, and all of them were graded as the medium level. The lack of random allocation sequence, allocation concealment mechanism, blinding, and trial sample size was the main reason for the reduction of the evidence level. The available evidence shows that Chinese herbal injections can serve as an effective and safe adjunctive treatment for sepsis, which can reduce mortality, inhibit inflammation, improve coagulation function, and regulate immune function, tissue perfusion, and oxygenation in patients with sepsis. However, the quality of SR/MA was suboptimal, and more high-quality SR/MA is needed to provide evidence to support the efficacy and safety of Chinese herbal injections in the treatment of sepsis.

Application of automatic injection device based on automatic hemostasis in injection of radiopharmaceutical bolus injection / 生物医学工程学杂志

In clinical practice, radiopharmaceutical dynamic imaging technology requires the bolus injection method to complete injection. Due to the failure rate and radiation damage of manual injection, even experienced technicians still bear a lot of psychological burden. This study combined the advantages and disadvantages of various manual injection modes to develop the radiopharmaceutical bolus injector, and explored the application of automatic injection in the field of bolus injection from four aspects: radiation protection, occlusion response, sterility of injection process and effect of bolus injection. Compared with the current mainstream manual injection method, the bolus manufactured by the radiopharmaceutical bolus injector based on the automatic hemostasis method had a narrower full width at half maximum and better repeatability. At the same time, radiopharmaceutical bolus injector had reduced the radiation dose of the technician's palm by 98.8%, and ensured more efficient vein occlusion recognition performance and sterility of the entire injection process. The radiopharmaceutical bolus injector based on automatic hemostasis has application potential in improving the effect and repeatability of bolus injection.

Therapeutic Effects of Shenfu Injection in Shock / 中国结合医学杂志

Shock is the clinical manifestation of acute circulatory failure, which results in inadequate utilization of cellular oxygen. It is a common condition with high mortality rates in intensive care units. The intravenous administration of Shenfu Injection (SFI) may attenuate inflammation, regulate hemodynamics and oxygen metabolism; inhibit ischemia-reperfusion responses; and have adaptogenic and antiapoptotic effects. In this review, we have discussed the clinical applications and antishock pharmacological effects of SFI. Further in-depth and large-scale multicenter clinical studies are warranted to determine the therapeutic effects of SFI on shock.

Concerns of Technical Evaluation on Registration of Disposable Endoscopic Injection Needle / 中国医疗器械杂志

From the point of the technical evaluation of the registration of medical devices, the technical evaluation focus of the disposable endoscopic injection needle registration are briefly described in the chapters of the application overview documents, risk management data, product technical requirements, research data, toxic substance residues, biocompatibility evaluation, clinical evaluation data, et al. The common terms of technical requirements are specified, risk management and research materials list the project requirements for product characteristics. So as to accurately judge the product quality, improve the review efficiency, promote the development of the industry.

Covid-19: Vacina boa é a aplicada de forma adequada / Covid-19: Vacina boa é a aplicada de forma adequada

Na atualidade, fotografar ou gravar o instante da imunização contra a Covid-19 se tornou rotina compartilhada nas redes sociais. Essa exposição instigou a observação de uma questão relevante: a técnica de aplicação está correta? Com a veiculação de imagens, é possível visualizar as vacinas sendo administradas em diferentes áreas do músculo deltoide, o que pode acarretar efeitos adversos. A otimização da qualificação técnica e pedagógica dos profissionais que elaboram e ministram as capacitações, bem como o envolvimento efetivo dos vacinadores nos treinamentos para injeção intramuscular é uma necessidade constante para evitar mais danos à saúde da população

Currently, photographing or recording the instant of immunization against Covid-19 has become a shared routine on social networks. This exposition prompted the observation of a relevant question: is the application technique correct? With the transmission of images, it is possible to visualize the vaccines being administered in different areas of the deltoid muscle, which can cause adverse effects. The optimization of the technical and pedagogical qualification of the professionals who design and deliver the training, as well as the effective involvement of vaccinators in training for intramuscular injection, is a constant need to avoid further damage to the health of the population

Distribution of various volumes of methylene blue injection in suprainguinal fascia iliaca block under ultrasound guidance: a cadaveric study / Distribución de varios volúmenes de inyección de azul de metileno en el bloque suprainguinal de la fascia ilíaca bajo guía por ultrasonido: un estudio cadavérico

SUMMARY: The local anesthetic volume for a single-shot suprainguinal fascia iliaca block (SFIB) is a key factor of a block success because the courses of the three target nerves from the lumbar plexus (LP), the lateral femoral cutaneous nerve (LFCN), femoral nerve (FN), and obturator nerve (ON), at the inguinal area are isolated and within striking distance. Thus, this cadaveric study aims to demonstrate the distribution of dye staining on the LFCN, FN, ON, and LP following the ultrasound-guided SFIB using 15-50 ml of methylene blue. A total of 40 USG-SFIBs were performed on 20 fresh adult cadavers using 15, 20, 25, 30, 35, 40, 45, and 50 ml of methylene blue. After the injections, the pelvic and inguinal regions were dissected to directly visualize the dye stained on the LFCN, FN, ON, and LP. All FN and LFCN were stained heavily when the 15-50 ml of dye was injected. Higher volumes of dye (40-50 ml) spread more medially and stained on the ON and LP in 60 % of cases. To increase the possibility of dye spreading to all three target nerves and LP of the SFIB, a high volume (≥40 ml) of anesthetic is recommended. If only a blockade of the FN and LFCN is required, a low volume (15-25 ml) of anesthetic is sufficient.

RESUMEN: El volumen de anestésico local para un bloqueo de la fascia ilíaca suprainguinal (FISI) de una sola inyección es un factor clave para el éxito del bloqueo, debido a que los cursos de los tres nervios objetivo del plexo lumbar (PL), el nervio cutáneo femoral lateral (NCFL), femoral (NF) y el nervio obturador (NO), en el área inguinal están aislados y dentro de la distancia de abordaje. Por lo tanto, este estudio cadavérico tiene como objetivo demostrar la distribución de la tinción de tinte en NCFL, NF, NO y PL siguiendo el FISI guiado por ultrasonido usando 15-50 ml de azul de metileno. Se realizaron un total de 40 USG-FISI en 20 cadáveres adultos frescos utilizando 15, 20, 25, 30, 35, 40, 45 y 50 ml de azul de metileno. Después de las inyecciones, se disecaron las regiones pélvica e inguinal para visualizar directamente el tinte teñido en NCFL, NF, NO y PL. Todos los NF y NCFL se tiñeron intensamente cuando se inyectaron los 15- 50 ml de colorante. Volúmenes mayores de colorante (40-50 ml) se esparcen más medialmente y tiñen el NO y la PL en el 60 % de los casos. Para aumentar la posibilidad de que el colorante se propague a los tres nervios objetivo y al PL del FISI, se recomienda un volumen elevado (≥40 ml) de anestésico. Si solo se requiere un bloqueo de NF y NCFL, un volumen bajo (15-25 ml) de anestésico es suficiente.

Uso de vasopresina y suturas transfixivas para el tratamiento quirúrgico de la gestación ectópica intersticial / Use of vasopressin and transfixive sutures for the surgical treatment of interstitial ectopic gestation

Resumen La gestación cornual, también conocida como intersticial, es una gestación ectópica infrecuente que ocurre en 1/2500 a 1/5000 de los embarazos cuando el embrión implanta en el trayecto intramiometrial de la porción proximal de la trompa. Puede debutar como shock hipovolémico en un 25% de los casos, conllevando una mortalidad de hasta un 2,5%. Mediante ecografía se encuentra un saco gestacional excéntrico y rodeado por una fina capa de miometrio. El tratamiento, en la mayoría de los casos, es quirúrgico, y el control de la hemostasia supone todo un reto. Se presentan dos casos clínicos de mujeres con diagnóstico de gestación intersticial en quienes se realizó exéresis por laparoscopia tras inyección de vasopresina, permitiendo así controlar el sangrado. En una de las pacientes se practicaron también puntos transfixivos transitorios en la arteria uterina y el ligamento útero-ovárico.

Abstract Cornual gestation, also known as interstitial, is a rare ectopic gestation that occurs in 1/2500 to 1/5000 of pregnancies when the embryo implants in the intramyometrial tract of the proximal tube. It can debut as hypovolemic shock in 25% of cases, leading to a mortality rate of up to 2.5%. Using ultrasound, we will find an eccentric gestational sac surrounded by a thin layer of myometrium. Treatment, in most cases, is surgical and control of hemostasis is a challenge. Two clinical cases are presented of women with a diagnosis of interstitial pregnancy in whom transient transfixive sutures were performed at the level of the uterine artery and uterine-ovarian ligament and injection of vasopressin prior to laparoscopic exeresis, thus allowing the bleeding to be controlled.

Meta-analysis and GRADE evaluation of Shuxuetong Injection in treatment of stroke in progressive / 中国中药杂志

This study aims to systematically evaluate the efficacy and safety of Shuxuetong Injection in the treatment of stroke in progressive. Randomized controlled trials of Shuxuetong Injection in the treatment of stroke in progressive were searched from CNKI, Wanfang, VIP, CMB, PubMed and EMbase. After strict literature screening, data extraction and quality evaluation, a total of 22 articles were included for analysis by RevMan 5.3. The Meta-analysis showed that Shuxuetong Injection combined with conventional treatment was superior to the conventional treatment alone in the major outcome indicators including effective rate(RR=1.27, 95%CI[1.20, 1.33], Z=9.18, P<0.000 01), deterioration rate(RR=0.38, 95%CI[0.22, 0.68], Z=3.31, P=0.000 9), NIHSS scores(MD=-3.89, 95%CI[-4.34,-3.43], Z=16.83, P<0.000 01), CSS scores(MD=-5.59, 95%CI[-6.42,-4.76], Z=13.20, P<0.000 01) and activity of daily living scores(MD=12.02, 95%CI[10.31, 13.72], Z=13.83, P<0.000 01), mortality during treatment was not increased(RR=0.40, 95%CI[0.13, 1.26], Z=1.56, P=0.12). Moreover, Shuxuetong Injection combined with conventional treatment further reduced the secondary outcome indicators including fibrinogen(MD=-0.35, 95%CI[-0.58,-0.13], Z=3.09, P=0.002), triglyceride(MD=-0.38, 95%CI[-0.67,-0.10], Z=2.65, P=0.008), low density lipoprotein cholesterol(MD=-0.72, 95%CI[-0.83,-0.61], Z=12.64, P<0.000 01), serum hypersensitive C-reactive protein(MD=-4.41, 95%CI[-6.96,-1.86], Z=3.38, P=0.000 7), and interleukin-6(MD=-5.43, 95%CI[-6.91,-3.96], Z=7.22, P<0.000 01). GRADE evaluation results showed that the major outcome indicators had low quality of evidence. Shuxuetong Injection in the treatment of stroke in progressive can improve the clinical effective rate, reduce the deterioration rate, improve the neurological function and activity of daily living, down-regulate the levels of fibrinogen, triglyceride, low density lipoprotein cholesterol and alleviate the inflammatory response. Although most studies have reported no adverse reactions, there are selective reports. The safety of Shuxuetong Injection needs to be further verified by more high-quality randomized controlled trial.

Exploration of nanofiltration conditions for separation of alcohol precipitation liquid during preparation of Reduning Injection by Box-Behnken design combined with flux attenuation / 中国中药杂志

This study employed Box-Behnken design combined with flux attenuation to explore the nanofiltration conditions for separation of alcohol precipitation liquid during the preparation of Reduning Injection and discussed the applicability of nanofiltration in the separation of the liquid with high-concentration ethanol. The effects of nanofiltration molecular weight cut-off(MWCO) and pH on the rejection of chlorogenic acid, 3,5-dicaffeoylquinic acid, and 4,5-dicaffeoylquinic acid were consistent with the principles of pore size sieving and charge effect, respectively. The rejection of the three phenolic acids was reduced by concentration polarization effect caused by trans-membrane pressure(TMP). The swelling of membrane surface decreased the pore size and membrane flux for effective separation. Chlorogenic acid and 4,5-dicaffeoylquinic acid were more sensitive to pH and ethanol concentration than 3,5-dicaffeoylquinic acid. A certain correlation existed between the compound structure and the separation factors of nanofiltration, and the separation rules were associated with the comprehensive effect of charge effect, pore size sieving, concentration polarization, steric hindrance and so on.

Design and Realization of Contrast Medium Biphasic Hyperbaric Injector / 中国医疗器械杂志

A biphasic hyperbaric injector based on BLDC is designed for alternate and mixed injection of contrast medium and normal saline in the process of contrast medium injection in hospital. The driver hardware and algorithm are optimized especially for high-pressure and high-speed injection requirements. The interface APP is designed with parameter-input and real-time pressure-plotting of injector's ports as two main functions. The whole device can realize the preset function and has high stability after testing.

Shenqi Fuzheng Injection () Combined with Chemotherapy for Acute Leukemia: A Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To evaluate to the efficacy and safety of Shenqi Fuzheng Injection (, SFI) combined with chemotherapy in the treatment of acute leukemia (AL) by meta-analysis.@*METHODS@#PubMed, Cochrane library, Embase, SinoMed, China National Knowledge Infrastructure (CNKI), VIP Journal Integration Platform, Wanfang Database were searched from establishment to November 1, 2018. The randomized controlled trials (RCTs) of SFI combined with chemotherapy in the treatment of AL were included. The Cochrane risk assessment form (RevMan 5.1) was used to evaluate the quality of included studies.@*RESULTS@#A total of 14 RCTs and 1,088 patients was included. The quality evaluation were mostly low risk or unclear. Meta-analysis showed that compared with chemotherapy alone, SFI combined with chemotherapy can improve the total clinical effective rate in patients with AL (RR=1.15, 95% CI: 1.056-1.177; P=0.0001), and relieve adverse reactions caused by chemotherapy drugs, including infection (RR=0.561, 95% CI: 0.397-0.792; P=0.001), nausea and vomiting (RR=0.662, 95% CI: 0.524-0.835; P=0.001), bleeding (RR=0.548, 95% CI: 0.39-0.768; P=0.0001), cardiotoxicity (RR=0.230, 95% CI: 0.080-0.660; P=0.006) and hyperhidrosis (RR=0.348, 95% CI: 0.208-0.581; P=0.0001). The incidence rates of adverse reactions in SFI combined with chemotherapy group were significantly lower than that of the chemotherapy alone group (P<0.01).@*CONCLUSIONS@#Shenqi Fuzheng Injection combined with chemotherapy has good efficacy and safety for AL, and it can alleviate the adverse reactions caused by chemotherapy. However, subject to the limitations of the methodological quality of the literature, the conclusions of this study need to be further verified by large-scale and multi-center RCTs.

Which Is Safer, Chinese Medicine or Western Medicine? Comparative Analysis Based on Chinese Spontaneous Reporting Database / 中国结合医学杂志

OBJECTIVE@#To compare the safety differences between Chinese medicine (CM) and Western medicine (WM) based on Chinese Spontaneous Reporting Database (CSRD).@*METHODS@#Reports of adverse events (AEs) caused by CM and WM in the CSRD between 2010 and 2011 were selected. The following assessment indicators were constructed: the proportion of serious AEs (PSE), the average number of AEs (ANA), and the coverage rate of AEs (CRA). Further comparisons were also conducted, including the drugs with the most reported serious AEs, the AEs with the biggest report number, and the 5 serious AEs of interest (including death, anaphylactic shock, coma, dyspnea and abnormal liver function).@*RESULTS@#The PSE, ANA and CRA of WM were 1.09, 8.23 and 2.35 times higher than those of CM, respectively. The top 10 drugs with the most serious AEs were mainly injections for CM and antibiotics for WM. The AEs with the most reports were rash, pruritus, nausea, dizziness and vomiting for both CM and WM. The proportions of CM and WM in anaphylactic shock and coma were similar. For abnormal liver function and death, the proportions of WM were 5.47 and 3.00 times higher than those of CM, respectively.@*CONCLUSION@#Based on CSRD, CM was safer than WM at the average level from the perspective of adverse drug reactions.

Stability indicating Rp-UPLC method development and validation for the simultaneous estimation of fosnetupitant and palonosetron in bulk and injection dosage form

Abstract A stability indicating UPLC method has been developed and validated for the simultaneous determination of fosnetupitant and palonosetron in bulk and in injection dosage form. This combination is used for the prevention of acute and delayed nausea and vomiting associated with initial and repeated courses of highly emetogenic chemotherapy for cancer. The chromatographic analysis was performed on an HSS, RP C18 column (2.1 x 100 mm, 1.8 µm) with an isocratic mobile phase composed of 0.25 M potassium dihydrogen orthophosphate buffer (pH 6.5), pH adjusted with dilute sodium hydroxide:acetonitrile (55:45 v/v), at a flow rate of 0.5 mL/min, and the eluents were monitored at an isosbestic point of 286 nm. The developed method was validated according to the ICH guidelines pertaining to specificity, precision, accuracy, linearity and robustness, and the stability indicating nature of the method was established by forced degradation studies. The retention times of fosnetupitant and palonosetron were observed at 1.390 and 2.404 min, respectively. The developed method proved to be accurate and precise. Linearity was established between 4.70 and 14.10 µg/mL for fosnetupitant and between 0.05 and 0.15 µg/mL for palonosetron. The LOD and LOQ were 0.115 and 0.385 µg/mL, respectively, for fosnetupitant, and 0.005 and 0.016 µg/mL, respectively, for palonosetron. Therefore, the proposed UPLC method was reliable, reproducible, precise and sensitive for the quantification of fosnetupitant and palonosetron.

Economic impact of gastrointestinal nematodes in Morada Nova sheep in Brazil / Impacto econômico de nematódeos gastrintestinais em ovinos Morada Nova no Brasil

Abstract This study evaluated the economic impact of gastrointestinal nematode (GIN) infection in Morada Nova lambs under different parasite chemical control conditions. For this, 246 lambs, in the rainy and dry season, were randomized into groups according to their anthelmintic treatment with levamisole: control (CT: no treatment); routine treatment (RT: treated every 42 days); and targeted selective treatment (TST: treated according to the average daily weight gain, DWG). From 63 days of age (D63) to D210, the lambs were weighed and monitored for GIN infection parameters. Spending on anthelmintics in the production system was 1.3% of the total economic result. The economic result per animal (R$ 5.00 = US$ 1.00) was higher in the RT group, amounting to US$ 6.60 in the rainy and US$ 5.69 in the dry season, due to higher DWG. Thus, RT presented economic results 14.4% and 10.9% higher than CT, and 7.2% and 1.9% higher than TST, in the rainy and dry season, respectively. However, fast development of resistance made RT unfeasible. Here, the economic impact of GIN infection on a national scale is discussed, demonstrating its importance and the impossibility of profitable and sustainable sheep production without adequate control.

Resumo Este estudo avaliou o impacto econômico da infecção por nematoides gastrintestinais (NGI), em cordeiros Morada Nova, sob diferentes condições de controle químico dos parasitas. Para isso, 246 cordeiros, na estação chuvosa e seca, foram randomizados em grupos de acordo com o tratamento com levamisol: controle (TC: sem tratamento); tratamento rotineiro (TR: tratado a cada 42 dias); e tratamento seletivo direcionado (TST: tratado de acordo com o ganho de peso médio diário, GMD). Dos 63 dias de idade (D63) ao D210, os cordeiros foram pesados ​​e monitorados quanto aos parâmetros de infecção por NGI. O gasto com anti-helmínticos no sistema produtivo foi de 1,3% do resultado econômico total. O resultado econômico por animal (R$ 5,00 = US$ 1,00) foi maior no grupo RT, totalizando US$ 6,60 na estação chuvosa e US$ 5,69 na seca, devido ao maior GMD. Assim, o RT apresentou resultados econômicos 14,4% e 10,9% superiores ao TC, e 7,2% e 1,9% superiores ao TST, no período chuvoso e seco, respectivamente. Entretanto o rápido desenvolvimento de resistência inviabiliza o TR. O impacto econômico da infecção por NGI em escala nacional são aqui discutidos, demonstrando sua importância e a impossibilidade de uma ovinocultura lucrativa e sustentável sem o controle adequado.

Protective effects of Baicalin injection on severe acute pancreatitis through regulating follistatin-like-1 signaling pathway by down-regulating miR-429 expression in mice

Abstract In China, Scutellaria is used for treating inflammatory-related diseases. Baicalin is the main active component of Scutellaria and has protective effects on acute pancreatitis. However, the mechanism of Baicalin is still unclear. In this study, the protective effects of baicalin on acute pancreatitis induced by taurocholate and its mechanism are investigated. In this study, mice were randomly divided into three groups: sham operation, model, and treatment groups. Acute pancreatitis in mice was induced by intraperitoneal injection of taurocholate (35 mg/kg). The treatment group was given baicalin (100 mg/kg) 2 h before acute pancreatitis induction. The mRNA expression levels of miR-429, nuclear factor kappa B65(NF-kB65), toll-like receptor 4(TLR4), TNF receptor associated factor6 (TRAF6), NF-kappa-B inhibitor(IkB), Follistatin-like 1 (FSTL1), and interleukin-1 receptor-associated kinase (IRAK) in the liver tissues 24 h after intraperitoneal injection were detected by RT-PCR. Then, the expression levels of NF-kB65, p-NF-κB65, TLR4, TRAF6, IkB, FSTL1, IRAK, p- IRAK, and p- IkB-а proteins were detected by Western blot. IL-6, TNF-α and IL-1 ß in plasma were measured by ELISA, and histopathological changes in the pancreases of the mice were observed. The results showed that after baicalin treatment, miR-429 expression in the pancreatic tissues and the expression levels of NF-kB65, TLR4, TRAF6, p-IkB-а, FSTL1, and p-IRAK decreased. Similarly, pancreatic myeloperoxidase (MPO) activity and the plasma levels of IL-6, TNF-а, IL-12, IL-1ß1, endotoxin, serum amylase, and lipase were reduced. Thus, the pancreatic injury induced by taurocholate was alleviated. The present study indicates that pretreatment with Baicalin can alleviate acute pancreatic injury induced by taurocholate in mice. The mechanism may be associated with the decreased miR-429 expression, reduced FSTL1 signaling pathway activity, TLR4 and TLR4/MyD88 signaling pathway inhibition, and reduced pancreatic inflammation. FSTL1 is the regulatory target for miR-429