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OBJECTIVE: To prepare aloe-emodin solid dispersion (AE-SD) and determine the metabolic process of AE and AE-SD in vivo. METHODS: AE-SD was prepared viasolvent evaporation or solvent melting using PEG-6000 and PVP-K30 as carriers. Thermogravimetric analysis, X-ray diffraction spectroscopy, differential scanning calorimetry, Fourier transform infrared spectroscopy and scanning electron microscopy were used to identify the physical state of AE-SD. Optimal prescriptions were screened viathe dissolution degree determination method. Using Phoenix software, AE suspension and AE-SD were subjected to a pharmacokinetic comparison study analyzing the alteration of behavior in vivo after AE was prepared as a solid dispersion. Acute toxicity was assessed in mice, and the physiological toxicity was used as the determination criterion for toxicity. RESULTS: AE-SD showed that AE existed in the carrier in an amorphous state. Compared with polyethylene glycol, polyvinylpyrrolidone (PVP) inhibited AE crystallization, causing the drug to transform from a dense crystalline state to an amorphous form and increasing the degree of drug dispersion. Therefore, it was more suitable as a carrier material for AE-SD. The addition of poloxamer (POL) was more beneficial to the stability of solid dispersions and could reduce the amount of PVP. The dissolution test confirmed that the optimal ratio of AE to the composite vector AE-PVP-POL was 1ï¼2ï¼2, and its dissolution effect was also optimal. Based on the pharmacokinetic comparison, the drug absorption was faster and quickly reached the peak of blood drug concentration in AE-SD compared to AE, the Cmax of AE-SD was greater than that of AE, and t1/2 and mean residence time of AE-SD were less than AE. The results showed that the drug metabolism in AE-SD was better, and the residence time was shorter. The toxicology study showed that both AE and AE-SD had no toxicity. CONCLUSION: This paper established that the solubility of the drug could be increased after preparing a solid dispersion, as demonstrated by in vitro dissolution experiments. In vivo pharmacokinetics studies confirmed that AE-SD could improve the bioavailability of AE in vivo, providing a new concept for the research and development of AE preparations.
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Aloe , Emodin , Mice , Animals , X-Ray Diffraction , Povidone/chemistry , Spectroscopy, Fourier Transform Infrared/methods , PoloxamerABSTRACT
Objective:To investigate the clinical safety and efficacy of robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty for ureteral stricture.Methods:The clinical data of 6 patients with ureteral stricture admitted to the Guizhou Provincial People's Hospital from December 2020 to August 2022 were retrospectively analyzed. There were 3 males and 3 females, with an average age of (40.2±11.5) years old. The status of ureteral stricture and hydronephrosis was measured by ultrasonography, CT urography and ureteral retrograde angiography. There were 2 cases of left ureteral stricture and 4 cases of right ureteral stricture, including 4 cases of upper segment stricture and 2 cases of middle segment stricture. The separation of the renal pelvis on the affected side was 3.2 (2.1, 4.2) cm. The length of ureteral stricture was 3.8 (2.5, 4.3) (1.0-5.0) cm, and the preoperative blood creatinine was 90(71, 97)μmol/L. Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty was performed in all cases under general anesthesia. The strictured ureter segment was separated and longitudinally cut during the operation. The lingual mucosal grafts 2.5-5.0 cm in length and 1.0-1.5 cm in width was cut according to the stricture. Then the lingual mucosal grafts were harvested and placed in the strictured ureter as a ventral onlay. One double J tube was placed in the affected side in all cases during operation. The perioperative outcomes and complications were analyzed. The blood creatinine and renal pelvis separation on the affected side after surgery were compared with the preoperation.Results:All the surgeries were successfully completed. The average operative time was (190.8 ± 59.0) min, median blood loss was 40 (20, 63) ml, postoperative indwelling time of the drainage tube was 6 (4, 6) days, gastrointestinal function recovery time was 3 (2, 3) days, postoperative hospital stay was 6 (6, 7) days. The patients had clear pronunciation and lingual incision recovered 1 week post-operatively. The urine tube was removed 2 weeks after surgery, and the double J tube was removed 8 (6, 10) weeks post-operatively. Radiological examination revealed significant difference in hydronephrosis on the affected side 3 months post-operatively compared with the preoperation, and the separation of the renal pelvis on the affected side was 1.2 (1.2, 1.4) cm after surgery. The blood creatinine was 79(71, 104)μmol/L at 3 month after surgery, which was also improved compared with preoperative.Conclusions:Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty is a feasible and safe option for the treatment of ureteral stricture with less trauma, rapid recovery, and less complications.
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Objective To explore the effect of gum chewing combined with in-bed bicycle pedalling exercises on puerpera in first flatus and early ambulation after caesarean section so as to provide an effective approach to promoting maternal recovery after caesarean section.Methods A total of 80 puerpera from a general hospital in Guangzhou were selected as the study subjects by convenience sampling method.The puerpera who received caesarean section between October and December 2021were assigned to the control group(n=40)and the puerpera who received caesarean section between January to March 2022 were assigned to the observation group(n=40).Puerpera in the control group received routine nursing,while those in the intervention group were treated with a combination of gum chewing and in-bed bicycle pedalling exercises.The time of the first flatus and the time of ambulation 24 hours after intervention were observed and compared between the groups.Results All puerpera in the two groups completed the study.The time of the first flatus in the observation group was significantly earlier than that in the control group(25.63±11.39 hours vs.30.85±10.65 hours,P<0.05).The time for first ambulation in the observation group was shorter than that in the control group(34.89±4.83 h vs.39.0±4.15,P<0.05).Conclusions Gum chewing combined with bicycle-pedalling exercises can help an early flatus,help puerpera to achieve an earlier ambulation,and improve early rehabilitation after caesarean section.The method is simple,feasible,comfortable,safe and easy to be accepted.
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Objective:To explore the clinical characteristics of patients infected with 2019 novel coronavirus (2019-nCoV) Omicron variant in Zhuhai City.Methods:A retrospective study was conducted to compare the clinical characteristics of patients infected with 2019-nCoV Omicron variant (Omicron variant group, 39 cases) from January 13 to January 25, 2022, and those infected with 2019-nCoV non-Omicron variant (non-Omicron variant group, 98 cases) from January 17 to February 17, 2020, in the Fifth Affiliated Hospital of Sun Yat-sen University. Statistic methods were used by Mann-Whitney U test, chi-square test and Fisher exact probability test. Results:Among adults, the age of 21 patients in Omicron variant group was younger than that of 93 patients in non-Omicron variant group (34.0(26.0, 40.5) years vs 50.0(36.0, 62.0) years, Z=-3.81, P<0.001). Patients with underlying diseases in Omicron variant group were fewer than those in non-Omicron variant group (4.8%(1/21) vs 31.2%(29/93), χ2=6.17, P=0.013). The clinical classification of the Omicron variant group was mainly mild (71.4%(15/21)) or common type (28.6%(6/21)), while the non-Omicron variant group was dominated with common type (57.0%(53/93)) and severe type (23.7%(22/93)), and the clinical classification of the two groups had statistically difference ( χ2=31.79, P<0.001). The time of positive nucleic acid in Omicron variant group was longer than that in non-Omicron variant group (14.0(10.5, 16.5) d vs 8.5(4.0, 12.0) d, Z=-3.56, P<0.001). The proportion of pneumonia in Omicron variant group was less than that in non-Omicron variant group (28.6%(6/21) vs 86.0%(80/93), χ2=30.52, P<0.001). Differences were all statistically significant. There was no significant difference of the clinical characteristics in pediatric patients, but the proportion of children infected with 2019-nCoV Omicron variant was significantly higher than that infected with 2019-nCoV non-Omicron variant (46.2%(18/39) vs 5.1%(5/98), χ2=33.65, P<0.001). Conclusions:Adults infected with 2019-nCoV Omicron variant in Zhuhai City present with milder clinical symptoms, less proportion of pneumonia, but the time of positive nucleic acid is longer. The clinical characteristics of children infected with 2019-nCoV Omicron variant are not specific, while the proportion of children infected with 2019-nCoV Omicron variant is significantly higher.
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Objective:To analyze the clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2 in Zhuhai city.Methods:A retrospective study was conducted to compare clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2, who were admitted in the Fifth Affiliated Hospital of Sun Yat-sen University during January 13 to March 8 2022. The Mann-Whitney U-test or Kruskal-Wallis H test was used for quantitative data, and the χ2 test or Fisher’s exact test was used for qualitative data. Results:Among 122 patients infected with the Omicron variant, there was 79 adults (BA.1 23 cases, BA.2 56 cases) and 43 children (BA.1 19 cases, BA.2 24 cases). In adults, patients infected with BA.2 sub-variant had a higher baseline viral loads at admission than BA.1 infected patients [7.64(6.92, 8.55) lg copies/mL vs. 6.64(6.04, 7.34) lg copies/mL; Z=-3.022, P=0.003]; compared to BA.1 patients, BA.2 patients had a higher proportion of mild and asymptomatic cases and a lower proportion of common infection cases ( χ2=8.052, P=0.012); the proportion of patients with pneumonia imaging changes in BA.1 patients was higher than that in BA.2 infected patients [(6/23, 26.1%) vs. (2/56, 3.6%); χ2=6.776, P=0.009). In children, the rate of fever in BA.2 group was higher than that in BA.1 group [(16/24, 66.7%) vs. ( 5/19, 26.3%); χ2=6.910, P=0.009); the proportion of patients with reduced lymphocyte counts in BA.2 group was higher than that in BA.1 group [(17/24, 70.8%) vs.(1/19, 5.3%); χ2=18.734, P<0.001). Compared with adult cases, children with BA.2 sub-variant infection had higher fever rate [(16/24, 66.7%) vs. (19/56, 33.9%); χ2=7.317, P=0.007). The viral loads of daily nasal swabs in BA.2 infected patients increased first and then decreased in both adults and children, with a greater decrease than BA.1 during the first two weeks. Conclusions:Compare with 2019-nCoV Omicron variant BA.1, BA.2 has a higher baseline viral loads in adults, which means much more contagious in the early stages. But the viral load drops faster in BA.2 infected patients. In children, BA.2 patients are more likely to have fever and reduced lymphocyte counts, which indicates that the prevention and control of 2019-nCoV Omicron sub-variant BA.2 is more difficult.
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Objective To evaluate the effects of oral undenatured collagen type Ⅱ on rehabilitation of knee osteoarthritis. Methods Sixteen patients with levelⅠand Ⅱ knee osteoarthritis (KOA) were recruited in this study. The WOMAC questionnaire was used to measure the symptoms of knee joint in patients. The KneeKG 3D evaluation system was used to measure the kinematics characteristics of the knee joints. The pair t-test was applied to analyze the differences in knee kinematics after taking undenatured collagen type Ⅱ for 3 months. Results After taking undenatured collagen type Ⅱ, the patient’s feeling of knee joint pain, stiffness, and the difficulty of daily life was reduced. In addition, the knee flexion angle increased from 51.8°±15.2° to 58.4°±10.7° (P<0.05), and the knee varus angle decreased to 2.1°±4.8°. The improvement rate of knee varus was 82%. Conclusions Taking undenatured collagen type Ⅱ for 3 months could play a role in rehabilitation for patients with early KOA. The knee range of motion was close to the level of healthy elderly people, thus improving the symptoms of knee varus.
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Objective To investigate the effect of oxytocin combined with misoprostol in the prevention of postpartum hemorrhage of uterine contraction,and to provide reference for clinical treatment.Methods 150 women who underwent cesarean section were randomly divided into observation group and control group,75 cases in each group.The two groups were all in the expulsion of the fetus after injection of oxytocin in the uterine wall.The control group after delivery of the placenta received oxytocin intravenous infusion in the prevention and treatment of postpar-tum hemorrhage,the observation group used misoprostol under the tongue to prevent postpartum hemorrhage.The inci-dence of bleeding and postpartum hemorrhage was compared between the two groups.The effective rate and incidence rate of adverse reactions of the two groups were compared.Results The bleeding volume of the observation group was (348.06 ±218.36) mL,and the incidence rate of postpartum hemorrhage was 2.67%,which were significantly lower than the control group (t=5.25,χ2 =12.37,all P<0.05).The effective rate of the observation group was 64%,the total effective rate was 93.33%,the total effective rate was significantly higher than that in the control group (χ2 =10.671,9.22,all P<0.05).1 case of nausea and vomiting occurred in the control group,2 cases had fever,the incidence rate of adverse reactions was 4.00%.5 cases in the observation group had nausea and vomiting,3 cases had fever,the incidence rate of adverse reactions was 10.67%.The incidence of adverse reactions had no significant difference between the two groups.Conclusion Oxytocin combined with misoprostol can significantly reduce the amount of postpartum hemorrhage,reduce the incidence of postpartum hemorrhage,and less adverse reactions,it is the effective treatment for prevention and treatment of uterine contraction fatigue postpartum hemorrhage.