Correlation between white blood cell count and intestinal resection in patients with acute mesenteric vein thrombosis.

OBJECTIVE: Acute mesenteric vein thrombosis (AMVT) is an acute abdominal disease with onset, rapid progression, and extensive intestinal necrosis that requires immediate surgical resection. The purpose of this study was to determine the risk factors for nosocomial intestinal resection in patients with AMVT. METHODS: We retrospectively analysed 64 patients with AMVT diagnosed by CTA at the Affiliated Hospital of Kunming University of Science and Technology from January 2013 to December 2021. We compared patients who underwent intestinal resection (42 patients) with those who did not undergo intestinal resection (22 patients). The area under the ROC curve was evaluated, and a forest map was drawn. RESULTS: Among the 64 patients, 6 (9.38%) had a fever, 60 (93.75%) had abdominal pain, 9 (14.06%) had a history of diabetes, 8 (12.5%) had a history of deep vein thrombosis (DVT), and 25 (39.06%) had ascites suggested by B ultrasound or CT after admission. The mean age of all patients was 49.86 ± 16.25 years. The mean age of the patients in the enterectomy group was 47.71 ± 16.20 years. The mean age of the patients in the conservative treatment group (without enterectomy) was 53.95 ± 15.90 years. In the univariate analysis, there were statistically significant differences in leukocyte count (P = 0.003), neutrophil count (P = 0.001), AST (P = 0.048), total bilirubin (P = 0.047), fibrinogen (P = 0.022) and DD2 (P = 0.024) between the two groups. The multivariate logistic regression analysis showed that admission white blood cell count (OR = 1.153, 95% CI: 1.039-1.280, P = 0.007) was an independent risk factor for intestinal resection in patients with AMVT. The ROC curve showed that the white blood cell count (AUC = 0.759 95% CI: 0.620-0.897; P = 0.001; optimal threshold: 7.815; sensitivity: 0.881; specificity: 0.636) had good predictive value for emergency enterectomy for AMVT. CONCLUSIONS: Among patients with AMVT, patients with a higher white blood cell count at admission were more likely to have intestinal necrosis and require emergency enterectomy. This study is helpful for clinicians to accurately determine whether emergency intestinal resection is needed in patients with AMVT after admission, prevent further intestinal necrosis, and improve the prognosis of patients.

[Key technologies in dosage form design of Chinese medicinal liquid preparations: application of component solubility and solubilization technology].

Modern liquid forms of Chinese medicine(CM), such as oral liquid, are similar to traditional decoction, but there are deficiencies in the selection and design of the dosage form, and the solubility of the pre-preparation material is critical. The property system for Chinese medicinal materials(CMMs) was established according to the previous research. The present study established the dosage form design strategy of oral liquid preparations of CM with the solubility as the core, and pointed out the relationship between the saturated volume of component(V_(i-n)) and daily dosage of preparation(V_d) was the key to the dosage form design. To be specific, the prescription can be designed into liquid preparation directly when V_(i-n)≤V_d, while V_(i-n)>V_d, the suitable solubilization technologies are needed. At present, the available solubilization technologies include the addition of excipients such as solubilizers/cosolvents, pH adjustment of the solution, and synergistic solubilization of intermediates and components for the preparation of pharmaceuticals. As reported, the polysaccharides of CM have shown great potential in the solubilization of insoluble components of CM, and they have certain prospects as a new solubilizing excipient.

[Study on anti-hygroscopic technology based on correlations between particle spatial properties and hygroscopicity of Chinese medicinal extracts].

This study was designed to investigate the correlations of the spatial structure properties of Chinese medicinal extracts with hygroscopicity and the anti-hygroscopic techniques. With Poria extract used as the model drug, pregelatinised starch and microcrystalline cellulose at different ratios were added into Poria fluid extract for preparing powder particles with diverse spatial structures using different drying processes. Then, their hygroscopic behaviours were characterized by equilibrium hygroscopicity(F~∞) and semi-hygroscopic time(t_(1/2)). The correlations of the hygroscopicity of each powder with the spatial structure properties such as particle size(D_(90)), porosity(ε), true density(ρ_t), and surface element distribution were analyzed using partial least-squares method. The F~∞ and t_(1/2) values of Poria extract prepared by three drying methods were sorted in a descending order as follows: F~∞(spray drying>drying at ordinary pressure>drying at reduced pressure); t_(1/2)(drying at reduced pressure>drying at ordinary pressure>spray drying). The powder obtained by spray drying showed a spherical structure with the smallest particle size and intra-particle ε but relatively stronger hygroscopicity. The large-scale surface element enrichment of the powders dried by reduced pressure effectively reduced their hygroscopicity. F~∞ and t_(1/2) were negatively correlated with ε but positively with D_(90), and the interactive influence of each spatial structural properties was not significant. There existed a correlation between the spatial structure of the powder particles of Chinese medicine extracts and their hygroscopicity, and the hygroscopicity could be improved by designing the spatial structure. This study has provided some practical basis for developing the moisture-proof technology of Chinese medicinal preparations.

[Characterization analysis technique of Panax notoginseng saponin subcomponents for prevention and treatment of myocardial ischemia based on their structure and effect differences].

According to the structure and effect differences of Panax notoginseng saponin components(PNSC), subcomponent division and network pharmacological characterization were conducted to provide a research basis for the medicinal properties of P.notoginseng saponin subcomponents and the technical design of unit preparations. PNSC were screened by the TCMSP database and subcomponents were classified according to systematic clustering. Then the subcomponents obtained were subjected to target prediction and attribution analysis by PharmMapper server, GeneCards, DisGeNET and HOME-NCBI-GENE database. A subcomponent target interaction network was constructed by using the STRING database. KEGG and GO enrichment analysis were performed on each subcomponent target using the DAVID database. The subcomponents-targets-pathways visualization network was constructed by Cytoscape. The subcomponent targets and pathways involved were compared to analyze the differences in anti-myocardial ischemic drug mechanisms and the rationality of subcomponent division. Eighteen compounds of PNSC were screened out, and classified into three subcomponents A, B, and C according to their properties, involving 67 targets and 17 common anti-myocardial ischemic pathways directly or indirectly related to myocardial ischemia. Subcomponent A had the highest number of targets and the target interaction was dense, possibly indicating its key role in the mechanism of pharmacodynamics. Subcomponents A, B, and C had similar basic structures, and KEGG and GO analysis showed that they all can enhance the heart function and protection of cardiomyocytes by inhibiting apoptosis, promoting angiogenesis and regulating inflammatory response to play the effect on myocardial ischemia. This study fully reflected the differences in the efficacy of various subcomponents in preventing and treating myocardial ischemia due to the different physical properties of P. notoginseng saponin subcomponents. To some extent, the differences in the efficacy of each subcomponent in the prevention and treatment of myocardial ischemia could verify the rationality of the division of P. notoginseng saponin subcomponents according to the structural properties, realizing the characterization of P. notoginseng saponin subcomponents based on structure and effect differences.

[Current status of human Schistosoma japonicum infection and reinfection in marshland and lake regions of Xinjian County, Jiangxi Province, China].

OBJECTIVE: To understand the dynamics of human infection and reinfection of Schistosoma japonicum after chemotherapy in marshland and lake endemic regions so as to provide the evidence for developing a cost-effective control strategy. METHODS: From 2007 to 2011, the schistosome infection, intensities and reinfection of population were investigated and the results were analyzed dynamically in Caohui Village, a national schistosomiasis surveillance site in Changyi Township, Xinjian County, Jiangxi Province, China. RESULTS: The schistosome infection rate was 3.55% and the mean intensity was 1.56 in 2007, and the schistosome infection rate was 1.52% and the mean intensity was 1.60 in 2011. The reinfection rates were 2.70%, 9.09% and 2.47% in 2009, 2010, and 2011, respectively. CONCLUSION: The schistosomiasis endemic situation shows a downtrend in the village. However, the reinfection is still serious; therefore, we should strengthen the research of risk factors of reinfection and control them.

[Effect of niclosamide spreading oil on killing schistosome cercariae].

Dechlorinated water (100 ml, 30 degrees C) was put into a plate (diameter 15 cm), and 1% niclosamide spreading oil 5 microl was added, then a ring of Schistosoma japonicum cercariae were picked up to the plate. The time of killing all the cercariae was observed at three time points (immediately, 24, 48 h), and the dechlorinated water was used as control. The results showed that schistosome cercariae were all killed in three minutes by 1% niclosamide spreading oil at the three time points. The cercaria-killing effects of each time point were not significantly different (F = 0.062, P > 0.05). The cercariae were alive in the control in 48 h.

[Study on an intervention model of "schools without infected students with schistosoma japonica" in heavy endemic areas].

OBJECTIVE: To study an intervention model of "schools without infected students with schistosoma japonica", to control and prevent students from schistosoma infection. METHODS: Twelve primary schools of four heavy endemic counties (districts) with schistosomiasis in the Poyang Lake areas were selected as the study fields, of which, ten schools were the experimental groups, and the other two schools were the control groups by cluster random sampling. All enrolment students were the target population. The baseline survey was carried out in 2005, and an intervention model, "information dissemination + behavior participation + behavior encouragement", was applied in the experiment groups in 2006 - 2008, then the effect of intervention was assessed. RESULTS: Before intervention (2005), the anti-schistosomiasis knowledge awareness rate of experimental and control groups were 14.75% (324/2196) and 16.58% (91/549), and the different was not significant (χ(2) = 1.14, P > 0.05); the rate of accurate attitude of anti-schistosomiasis were 14.71% (323/2196) and 11.84% (65/549) in experimental and control groups, and the difference was not significant (χ(2) = 2.98, P > 0.05); the rate of contacting infected water were 15.44% (18 988/122 976) and 15.03% (4622/30 744) in experimental and control group and the difference was not significant (χ(2) = 3.13, P > 0.05); and the infection rate of schistosomiasis of experiment control groups were 9.65% (212/2196) and 10.56% (58/549), the difference was not significant (χ(2) = 0.41, P > 0.05). After one year intervention (2006), the anti-schistosomiasis knowledge awareness rate of experimental and control groups were 97.79% (2032/2078) and 18.11% (98/541), and the different was significant (χ(2) = 1794.31, P < 0.01); the rate of accurate attitude of anti-schistosomiasis were 99.09% (2059/2078) and 13.49% (73/541) in experimental and control group, and the difference was significant (χ(2) = 2077.45, P < 0.01). After 1 - 3 years intervention (2006 - 2008), there were no any contactors with infected water and infectors with schistosome in students of the experiment group in successive 3 years. While in the control group of the same period, the rate contacting infected water were 16.12% (4884/30 296), 11.11% (3079/27 720) and 12.25% (3451/28 168); the infection rate of schistosomiasis were 8.87% (48/541), 7.47% (37/495) and 7.95% (40/503), respectively. CONCLUSION: The intervention model of health promotion, "information dissemination + behavior participation + behavior encouragement", can effectively control and prevent students from infecting schistosoma japonica in heavy endemic areas with schistosomiasis.

[Establishment and application of school-based health promotion and intervention model of schistosomiasis in lake-type endemic area].

OBJECTIVE: To establish an intervention model of school health promotion, and apply it in developing "schistosomiasis-free schools". METHODS: At the pilot stage, all students of Henghu primary school and Banshan primary school in Xinjian County of Jiangxi Province were selected as experiment group and control group, respectively. A baseline survey covered knowledge and attitude on schistosomiasis control, water contact behaviors and Schistosoma japonicum infection rate. Two health promotion intervention models, i.e. "information communication + training of protection skill + reward & punishment" (model A, 1993-1999) and "information communication + behavior participation + encouragement" (model B, 2000-2007), were implemented in Henghu school. The effect of two models was compared by infection rate. At the application stage, all students of 8 schools in Xinjian County, Nanchang County, and Jinxian County were chosen for evaluation of the effectiveness of Model B with same methods and index. RESULTS: Before intervention there was no significant statistical difference on the passed rate of anti-schistosomiasis knowledge, correct rate of anti-schistosomiasis attitude, frequency of infested water exposure and the infection rate between Henghu and Banshan schools (P > 0.05). In Henghu school, the intervention showed significant effect on the scores of knowledge and attitude after one year (P < 0.01), raised from 9.0% and 55.1% before intervention to 94.4% and 98.9% after intervention, respectively. The frequency of infested water exposure and the infection rate significantly decreased from 14.6% and 13.5% before intervention to 1.9% and 2.3%, respectively (P < 0.01). In 2-7 years after intervention, there were only one or two schistosomiasis cases each year. At the application stage, no schistosomiasis cases were found among Model B target population in two successive years after intervention. CONCLUSION: The practice of Model B can be extended to other schools in endemic area to develop "schistosomiasis-free schools".