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BACKGROUND: Immune checkpoint inhibitors (ICIs) combined with chemotherapy have become the first-line treatment of metastatic gastric and gastroesophageal adenocarcinomas (GEACs). This study aims to figure out the optimal combined positive score (CPS) cutoff value. METHODS: We searched for randomized phase III trials to investigate the efficacy of ICIs plus chemotherapy for metastatic GEACs compared with chemotherapy alone. Pooled analyses of hazard ratios (HRs) based on PD-L1 expression were performed. RESULTS: A total of six trials (KEYNOTE-062, KEYNOTE-590, KEYNOTE-859, ATTRACTION-04, CheckMate 649, and ORIENT-16) were included, comprising 5,242 patients. ICIs plus chemotherapy significantly improved OS (HR: 0.79, 95% CI 0.72-0.86 in global patients; HR: 0.75, 95% CI 0.57-0.98 in Asian patients) and PFS (HR: 0.74, 95% CI 0.68-0.82 in global patients; HR: 0.64, 95% CI 0.56-0.73 in Asian patients) compared with chemotherapy alone. The differences in OS (ratio of HR: 1.05, 95% CI 0.79-1.40; predictive value: - 5.1%) and PFS (ratio of HR: 1.16, 95% CI 0.98-1.36; predictive value: - 13.5%) were not statistically significant between the global and Asian patients. Subgroup analyses indicated that the optimal CPS threshold was at ≥ 5 for OS and ≥ 10 for PFS with the highest predictive values. CONCLUSIONS: The benefit derived from ICIs plus chemotherapy is similar between Asian and global GEAC patients. However, those with a PD-L1 CPS < 5 or CPS < 10 may not have significant benefits from ICIs therapy. Therefore, it is advisable to routinely assess PD-L1 expression in GEAC patients considered for ICIs treatment.
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Adenocarcinoma , Protocolos de Quimioterapia Combinada Antineoplásica , Antígeno B7-H1 , Inibidores de Checkpoint Imunológico , Receptor ErbB-2 , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/mortalidade , Antígeno B7-H1/metabolismo , Antígeno B7-H1/antagonistas & inibidores , Inibidores de Checkpoint Imunológico/uso terapêutico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/metabolismo , Adenocarcinoma/mortalidade , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Receptor ErbB-2/metabolismo , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Ensaios Clínicos Fase III como Assunto , Biomarcadores Tumorais/metabolismoRESUMO
Paralytic shellfish toxins (PSTs) produced by some marine dinoflagellates can cause severe human intoxication via vectors like bivalves. Toxic dinoflagellate Gymnodinium catenatum produce a novel group of hydroxybenzoate PSTs named GC toxins, but their biokinetics in bivalves haven't been well examined. In this experiment, we analyzed PSTs in bay scallops Argopecten irradians exposed to G. catenatum (strain MEL11) to determine their accumulation, elimination, anatomical distribution, and biotransformation. To our surprise, up to 30% of the PSTs were accumulated in the adductor muscle of scallops at the end of the experiment, and the toxicity of adductor muscle exceeded the regulatory limit of 800 µg STXeq/kg in only 6 days. High concentration of toxins in the adductor muscle are likely linked to the rapid transfer of GC toxins from viscera to other tissues. Moreover, most GC toxins in scallops were found rapidly transformed to decarbamoyl toxins through enzyme-mediated hydrolysis, which was further supported by the in vitro incubation experiments. Our study demonstrates that GC toxins actively participate in toxin distribution and transformation in scallops, which may increase the risks of food poisoning associated with the consumption of scallop adductor muscle. ENVIRONMENTAL IMPLICATION: The negative impacts of harmful algal blooms (HABs) have become a global environmental concern under the joint effects of cultural eutrophication and climate change. Our study, targeted on the biokinetics of paralytic shellfish toxins in scallops exposed to Gymnodinium catenatum producing unique GC toxins, aims to elucidate potential risks of seafood poisoning associated with GC toxins. The findings of this study will help us to understand the roles of GC toxins in seafood poisoning, and to develop effective management strategies against toxic algal blooms and phycotoxins.
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Bivalves , Dinoflagellida , Pectinidae , Intoxicação por Frutos do Mar , Animais , Humanos , Toxinas Marinhas/toxicidade , Intoxicação por Frutos do Mar/etiologia , Pectinidae/metabolismo , Bivalves/metabolismo , Hidroxibenzoatos/metabolismo , Alimentos Marinhos , Frutos do MarRESUMO
Objectives: Cervical discomfort and other symptoms may be attributable to the middle cervical sympathetic ganglion. The aim of this study was to explore the sonographic features of this ganglion in anatomical specimens and cadavers and evaluate the feasibility of its visualization using high-resolution ultrasonography. Methods: We examined three cervical sympathetic-ganglion specimens and two fresh cadavers using high-resolution ultrasound to explore the sonographic features of this ganglion. Basic imaging characteristics examined included the shape, echo intensity, and location of the ganglion. Core-needle biopsy was performed to examine the suspected middle cervical sympathetic ganglion in the two fresh cadavers and verify the accuracy of the sonographic identification via pathological examination. Results: The middle cervical sympathetic ganglion appeared on high-resolution ultrasonography as an oval-shaped hypoechoic structure, with at least one continuous hypoechoic line connected to each ending in the anatomical specimens and fresh cadavers, and it was distinctly different from the adjacent lymph nodes. Discussion: Based on an adequate understanding of both its location and sonographic features, the direct visualization of the middle cervical sympathetic ganglion using high-resolution ultrasonography is feasible.
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OBJECTIVE: Abdominal aortic aneurysm (AAA) is an aneurysm-like dilated and highly fatal cardiovascular disease. CD8+ T cells have been shown to be critical for vascular pathological processes, but the contribution of these lymphocytes to vascular diseases remains elusive. METHODS AND RESULTS: Eight-week-old male wildtype (CD8+/+) and Cd8a knockout (CD8-/-) mice were used in a calcium chloride2 (CaCl2)-induced experimental AAA model. At 6âweeks after surgery, CD8+ T-cell deletion prevented the formation of AAA, accompanied by reductions of the levels of inflammatory (interferon-γ [IFN-γ], interleukin-1ß, monocyte chemoattractant protein-1, intracellular adhesion molecule-1, vascular cell adhesion molecule-1, NOD-like receptor protein 3, caspase-1), oxidative stress [NADPH oxidase and gp91phox], and proteolysis (cathepsin S, cathepsin K, matrix metalloproteinase-2 [MMP-2] and MMP-9) proteins and/or genes in plasma and/or AAA tissues. Immunoreactivities of MMP-2 and MMP-9 were observed in macrophages. An injection of IFN-γ and adoptive transfer of CD8+ T cells of IFN-γ+/+ mice diminished CD8-/--mediated vasculoprotective actions in the AAA mice. In vitro, IFN-γ enhanced MMP-2 and MMP-9 gelatinolytic activities in macrophage and/or vascular smooth muscle cells. CONCLUSION: The vasculoprotective effects of CD8+ T-cell deletion in a mouse CaCl2-induced AAA model were likely attributable to, at least in part, the attenuation of IFN-γ-dependent inflammation action, oxidative stress production, and proteolysis, suggesting a novel therapeutic target for AAA formation by regulating CD8+ T-cell-derived IFN-γ secretion.
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Patients with residual nasopharyngeal carcinoma after receiving definitive treatment have poor prognoses. Although immune checkpoint therapies have achieved breakthroughs for treating recurrent and metastatic nasopharyngeal carcinoma, none of these strategies have been assessed for treating residual nasopharyngeal carcinoma. In this single-arm, phase 2 trial, we aimed to evaluate the antitumor efficacy and safety of toripalimab (anti-PD1 antibody) plus capecitabine in patients with residual nasopharyngeal carcinoma after definitive treatment (ChiCTR1900023710). Primary endpoint of this trial was the objective response rate assessed according to RECIST (version 1.1). Secondary endpoints included complete response rate, disease control rate, duration of response, progression-free survival, safety profile, and treatment compliance. Between June 1, 2020, and May 31, 2021, 23 patients were recruited and received six cycles of toripalimab plus capecitabine every 3 weeks. In efficacy analyses, 13 patients (56.5%) had complete response, and 9 patients (39.1%) had partial response, with an objective response rate of 95.7% (95% CI 78.1-99.9). The trial met its prespecified primary endpoint. In safety analyses, 21 of (91.3%) 23 patients had treatment-related adverse events. The most frequently reported adverse event was hand-foot syndrome (11 patients [47.8%]). The most common grade 3 adverse event was hand-foot syndrome (two patients [8.7%]). No grades 4-5 treatment-related adverse events were recorded. This phase 2 trial shows that combining toripalimab with capecitabine has promising antitumour activity and a manageable safety profile for patients with residual nasopharyngeal carcinoma.
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Anticorpos Monoclonais Humanizados , Síndrome Mão-Pé , Neoplasias Nasofaríngeas , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Capecitabina/uso terapêutico , Síndrome Mão-Pé/etiologia , Carcinoma Nasofaríngeo/tratamento farmacológico , Neoplasias Nasofaríngeas/tratamento farmacológico , Neoplasias Nasofaríngeas/patologiaRESUMO
A number of studies have suggested that coronavirus disease 2019 (COVID-19) can cause liver damage. However, clinical features and outcome of COVID-19 in patients with liver injury remain to be further investigated. In this study, the clinical data of 265 COVID-19 patients admitted to seven tertiary hospitals were collected. Based on a threshold for transaminase or total bilirubin levels at two times the normal upper limit, patients were divided into mild or moderate/severe liver injury groups. Among the 265 patients, 183 patients showed liver injury within 48âhours of admission. Aspartate aminotransferase levels were predominantly elevated in the liver injury group, but albumin levels were reduced. Moreover, fibrinogen and D-dimer were significantly increased. Furthermore, 68% of the patients with moderate/severe liver injury had one or more underlying diseases. Almost half of these patients developed acute respiratory distress syndrome (44%) and secondary infections (46%). These patients showed increased interleukin-6 and interleukin-10 levels and a decrease in PaO2 and the oxygenation index. In addition, levels of alanine aminotransferase, aspartate aminotransferase, and albumin were correlated with the oxygenation index, D-dimer and lymphocyte counts. Furthermore, a novel prognostic assessment model based on liver function was established, which accuracy reached 88% and was able to accurately assess the prognosis of COVID-19 patients.
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ABSTRACT Introduction Currently, the physical quality of college students has been declining, contrary to China's goal of building a strong and competitive country for sports. Therefore, developing certain plans to improve students' physical quality and coordination ability is necessary. Objective Study the reflection of muscle strength training in the abdominal core by aerobic gymnastics on students' physical coordination ability. Methods 36 volunteers were randomly divided into experimental and control groups. The explosive strength of the central regions and the body coordination and balance ability of the two groups of students were measured before and after the experiment, and the data were classified. Results In the experimental group, the value of supine, incline, right side, left side, jump 360 °, and single foot rotation 360 ° were improved. The evolution of the experimental group was much higher than the control group. Conclusion Muscular strength training in the abdominal core with aerobic gymnastics can effectively regulate students' physical quality and movement coordination, thus establishing a good physical basis for daily work, studies, and routine. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução Atualmente, a qualidade física dos estudantes universitários vem diminuindo, o que contraria o objetivo da China em construir um país forte e competitivo para o esporte. Portanto, é necessário apresentar certos planos para melhorar a qualidade física e a capacidade de coordenação dos estudantes. Objetivo Estudar o reflexo do treinamento da força muscular no centro abdominal por ginástica aeróbica na capacidade de coordenação física dos estudantes. Métodos 36 voluntários foram divididos aleatoriamente em grupo experimental e grupo de controle. A força explosiva das regiões centrais e a capacidade de coordenação e equilíbrio corporal dos dois grupos de estudantes foram medidas antes e depois do experimento, sendo os dados classificados. Resultados No grupo experimental, o valor de supino, inclinado, lado direito, lado esquerdo, salto 360° e rotação de um único pé 360° foram melhorados. A evolução do grupo experimental foi muito maior do que a do grupo de controle. Conclusão O treinamento de força muscular no centro abdominal com ginástica aeróbica pode efetivamente regular a qualidade física e a coordenação de movimentos dos alunos, estabelecendo assim uma boa base física para o trabalho diário, estudos e rotina. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción En la actualidad, la calidad física de los estudiantes universitarios ha ido disminuyendo, lo que va en contra del objetivo de China de construir un país fuerte y competitivo para el deporte. Por lo tanto, es necesario idear ciertos planes para mejorar la calidad física y la capacidad de coordinación de los alumnos. Objetivo Estudiar el reflejo del entrenamiento de la fuerza muscular en el núcleo abdominal mediante la gimnasia aeróbica en la capacidad de coordinación física de los alumnos. Métodos 36 voluntarios fueron divididos aleatoriamente en grupo experimental y grupo de control. Se midió la fuerza explosiva de las regiones centrales y la coordinación corporal y la capacidad de equilibrio de los dos grupos de estudiantes antes y después del experimento, y se clasificaron los datos. Resultados En el grupo experimental, se mejoró el valor de la posición supina, la inclinación, el lado derecho, el lado izquierdo, el salto de 360° y la rotación de un solo pie de 360°. La evolución del grupo experimental fue muy superior a la del grupo de control. Conclusión El entrenamiento de la fuerza muscular en el núcleo abdominal con gimnasia aeróbica puede regular eficazmente la calidad física y la coordinación de los movimientos de los alumnos, estableciendo así una buena base física para el trabajo diario, los estudios y la rutina. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Objective:To investigate the influencing factors of hyperuricemia(HUA) and explore early intervention of metabolic diseases.Methods:A total of 70 523 participants were selected from the database of check-ups in 2016. Univariate analysis and logistic regression analysis were used to identify related factors of HUA. Correspondence analysis was performed for the aggregation of different levels of uric acid(UA) and related factors. The mediating effect of mean blood pressure(MBP) between abnormal metabolic indicators and abnormal renal function was tested.Results:The age, sex, occupation, body mass index(BMI), systolic blood pressure, diastolic blood pressure, blood urea nitrogen(BUN), creatinine(Cr), estimated glomerular filtration rate(eGFR), fasting plasma glucose(FPG), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol, plasma viscosity were significantly related to HUA( P<0.001). Logistic regression analysis showed that youth, male, hypertension, TC, TG, and Cr were risk factors for HUA, while HDL-C was a protective factor for HUA( P<0.001). Correspondence analysis showed that during the gradual increase of UA, TC was the first to appear abnormal, followed by hypertension and TG, and the increase of Cr appeared last. Mediating effect showed that in changes of UA, the mediating effects of MBP on TC, TG, and HDL-C were 36.35%, 12.63%, and 9.41%, respectively. In changes of eGFR, the mediating effects of MBP on TC, TG and HDL-C were 30.20%, 27.70%, and 6.13%, respectively. Conclusions:UA is positively correlated with blood pressure, TC, and TG, and inversely with HDL-C. TC and TG have an impact on renal impairment, in which MBP plays a mediating role.
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From the perspective of data users, ensuring the relevance and reliability of big data in healthcare and medicine via assessments on data appropriateness is a prerequisite for generating high-quality real-world evidence, which could guarantee good representativeness and generalizability of real-world studies. This review summarized the quality dimensions, definitions, evaluation indexes and calculating methods of assessment on the appropriateness of real-world data (RWD) according to guidance from different countries and international organizations, as well as exploring the opportunities and challenges for better assessing RWD appropriateness.
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Humanos , Big Data , Atenção à Saúde , Reprodutibilidade dos TestesRESUMO
Protein-protein interactions (PPI) are involved in a variety of biological processes, including cell-to-cell interactions, metabolism and development control. The misregulation, post-translational modification and interference of PPI are related to a variety of human diseases, making the regulation of these interactions a very attractive field of drug discovery. In recent years, the interaction between MDM2 and p53 has become a research hotspot, which plays an important role in the treatment of tumors. But unfortunately there are no such inhibitors approved all over the world. In this view, recent advances of MDM2-p53 inhibitors were briefly described and its inhibitors with potential therapeutic activities in clinical studies were introduced.
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OBJECTIVE@#To estimate the prevalence rate of bone and joint injury in China and to describe the three-dimension distribution of the disease (area, time and people).@*METHODS@#Based on a cross-sectional design, a retrospective study was conducted by using Chinese basic medical insurance database from January 1, 2013 to December 31, 2017 to analyze the epidemiological characteristics of bone and joint injury. The prevalence rate of bone and joint injury in each city was calculated, and then using meta-analyses to estimate the pooled prevalence of each area and the whole country. The pooled prevalence rates were compared among the different groups of populations, in terms of geographical area, time and population characteristics (age and gender).@*RESULTS@#A total of 28 419 264 subjects were included in this study, including 705 793 patients with bone and joint injury. From 2013 to 2017, in Chinese basic medical insurance database, the overall prevalence rate of bone and joint injury was 141.5(95%CI: 90.4-203.7) per 10 000 population, and the prevalence rates of non-specific or polyarticular disease, knee disease, and shoulder disease were 101.6 (95%CI: 63.5-148.4)per 10 000 population, 22.5(95%CI:15.1-31.4)per 10 000 population and 10.9 (95%CI: 6.4-16.4)per 10 000 population. The prevalence rates varied across the areas, the highest rate was observed in North China, with the prevalence of 310.6 (95%CI: 12.6-989.7) per 10 000 population, and the lowest rate was observed in Southwest China, with the prevalence of 59.0 (95%CI: 37.5-85.2) per 10 000 population. The prevalence rate of bone and joint injury increased over the study period, from 111.1 (95%CI: 56.0-182.5)per 10 000 population in 2013 to 175.5 (95%CI: 116.8-245.5)per 10 000 population in 2017. The prevalence of bone and joint injury in the female population was 149.1 (95%CI: 94.2-215.9) per 10 000 population, which was higher than that of men [133.6(95%CI: 86.2-190.9) per 10 000 population]. The higher prevalence of knee disease, unspecified or polyarticular disease, and bone and joint injury were observed in people aged 60 years and older, while the prevalence of shoulder disease peaked in 40-59 years old people [20.6 (95%CI: 12.5-30.5) per 10 000 population].@*CONCLUSION@#This study reported a relative low prevalence of bone and joint injury in China from 2013 to 2017. The prevalence increased over the study period, and the highest prevalence rate was observed in North China. The prevalence rate showed differences among different groups of populations, and higher rates were observed in females and people aged 60 years and older.
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Bases de Dados Factuais , Seguro Saúde , Prevalência , Estudos Retrospectivos , População UrbanaRESUMO
Pharmacoepidemiology refers to the use of epidemiological research methods in studying the application and use of drugs in large populations to evaluate the safety and efficacy of medical products. Therefore, standardized pharmacoepidemiology research is the basis of the above work. Based on systematic reviews of national and international pharmacoepidemiological methodological standards and guidelines, and in combination with Chinese medical and health practice and experts’ opinions, the Professional Committee of Pharmacoepidemiology of Chinese Pharmaceutical Association developed the group standard, guide on methodological standards in pharmacoepidemiology (T/CPHARMA 002-2019), to better guide the work of pharmacoepidemiology. The guideline was designed to provide advice and reference for pharmacoepidemiology research by government, regulatory agencies, research institutions, and pharmaceutical manufacturers in China.
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Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82% in EDs,among the antibiotics prescribed,25.58% were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59%.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83%,21.68%,19.17% and 7.89% of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P<0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P<0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.
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Objective: To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China. Methods: Data from a national monitoring network for rational use of drugs was used. The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions, municipalities) of China. A total of 10 260 595 prescriptions from October 1, 2014 to December 31, 2016 were extracted. The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity. An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs. Results: The rate of antibiotic prescriptions was 27.82% in EDs, among the antibiotics prescribed, 25.58% were for the combination therapy with 2 or more antibiotic agents, and injectable antibiotic prescriptions accounted for 60.59%. Besides, the number of DDDs per 100 patient visits was 81.84. Broad-spectrum agents were the most commonly used antibiotics, among which the second and third generation cephalosporins, quinolones and macrolides accounted for 23.83%, 21.68%, 19.17% and 7.89% of all prescribed antibiotics, respectively. The use of antibiotics, including prescription frequency and use intensity, in EDs had a slight but significant increase tendency (P<0.05), and the seasonal variation of antibiotic use in EDs was obvious, characterized by the highest frequency and intensity of antibiotic use in winter, the differences were significant (P<0.05). Conclusion: The antibiotic prescription rate in EDs of classⅢ general hospitals in China was controlled at a low level, but the proportions of broad-spectrum antibiotics and injectable antibiotics were high, and a significant increase trend in antibiotic use in EDs was found.
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Humanos , Antibacterianos/uso terapêutico , China , Prescrições de Medicamentos , Uso de Medicamentos , Serviço Hospitalar de Emergência , Hospitais , Hospitais GeraisRESUMO
Objective To evaluate the safety of Tanreqing injection among children in thereal world.Methods A multicenter,large sample,ambispective cohort study,with registration-type clinical safety monitoring.A total of 6 188 inpatients and patients from the emergency units,aged ≤14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China,were recruited between January,2014 and May,2015.The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection.Univariate analysis was used to explain the risk factors of ADR.Results The overall incidence of ADE was 4.20% (26 cases),including 4 serious ones.The incidence of ADR was 3.07% (19 cases),including 17 cases of general ADR and 2 cases of new ADR.All the ADR cases were mild or moderate,mostly showing damages in skin and appendages.The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured.Having histories of allergies to drugs or foods would increase the incidence of ADR.Conclusion Tanreqing injection caused low incidence of ADR in children.Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.
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Objective To evaluate the safety of Tanreqing injection among children in thereal world.Methods A multicenter,large sample,ambispective cohort study,with registration-type clinical safety monitoring.A total of 6 188 inpatients and patients from the emergency units,aged ≤14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China,were recruited between January,2014 and May,2015.The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection.Univariate analysis was used to explain the risk factors of ADR.Results The overall incidence of ADE was 4.20% (26 cases),including 4 serious ones.The incidence of ADR was 3.07% (19 cases),including 17 cases of general ADR and 2 cases of new ADR.All the ADR cases were mild or moderate,mostly showing damages in skin and appendages.The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured.Having histories of allergies to drugs or foods would increase the incidence of ADR.Conclusion Tanreqing injection caused low incidence of ADR in children.Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.
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Objective: To study the effect of titanium dioxide (TiO2) nanoparticles on intestinal glucose absorption in young rats and its size effect.Methods: In the study, 63 small intestine segments were isolated from 63 Sprague-Dawley rats (SD rats, 4-week-old) to prepare the everted gut sac model.In the first part of our work, the everted sacs were exposed to 0, 50 mg/L TiO2 nanoparticles (24 nm) for 2 h with the presence of a series of glucose concentrations (10, 25, 50, 100, 200, 400, and 800 mmol/L), and the glucose absorbing function of the everted sacs were assessed in the process.On the basis of the work, utilizing the same method, further study was carried out to compare the effects of TiO2 nanoparticles (24 nm) and fine-particles (120 nm) on intestinal glucose absorbing function with the presence of 400 mmol/L glucose and 0, 10, 50, 200 mg/L TiO2.3 intestine segments were used in each group.Results: The cumulative glucose absorption increased with time extension and increased glucose concentration.In the first part of our work, with the presence of 400 mmol/L glucose, the group treated with 50 mg/L TiO2 nanoparticles showed significantly lower cumulative glucose absorption and glucose absorbing rate than the control group at the exposure time of 30 min (tcumulative absorption=3.254, P<0.05;tglucose absorbing rate=3.958, P<0.05), 90 min (tcumulative absorption=3.323, P<0.05;tglucose absorbing rate=3.063, P<0.05) and 120 min (tcumulative absorption=2.834, P<0.05;tglucose absorbing rate=3.002, P<0.05).At other glucose concentrations, statistically significant differences in cumulative glucose absorption or glucose absorbing rates were not found between the TiO2 nanoparticle exposed group and the control group.In the second part of our work, when compared with the control group, no significant downregulations in cumulative glucose absorption or glucose absorbing rates were observed in both TiO2 nano-particle treated group and TiO2 fine particle treated group.Differences between the TiO2 nanoparticle treated group and the TiO2 fine particle treated group were not statistically significant.Conclusion: Short-term exposure to TiO2 nanoparticles may downregulate the intestinal glucose absorbing function in young rats, and the difference with TiO2 fine particlesis is not obvious.
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<p><b>OBJECTIVE</b>To study the association between depression during pregnancy and low birth weight in neonates, and to provide a scientific basis for the prevention of low birth weight.</p><p><b>METHODS</b>Cohort studies on the association between depression during pregnancy and low birth weight were collected and a Meta analysis was performed. Data were extracted independently by two investigators, and quality assessment was performed according to Newcastle-Ottawa Scale. The Egger's test was used to evaluate publication bias.</p><p><b>RESULTS</b>A total of 12 cohort studies with 37 192 samples were included. The results of the Meta analysis showed that depression during pregnancy was associated with low birth weight (Z=2.08, P=0.038), and the neonates whose mothers had depression during pregnancy tended to have a high risk of low birth weight (RR=1.303, 95%CI: 1.015-1.672). The sensitivity analysis showed that the results of this Meta analysis were stable and reliable, and the Egger's test showed no publication bias.</p><p><b>CONCLUSIONS</b>Depression during pregnancy may be a risk factor for low birth weight in neonates.</p>
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Feminino , Humanos , Recém-Nascido , Gravidez , Estudos de Coortes , Depressão , Recém-Nascido de Baixo Peso , Complicações na GravidezRESUMO
Objective To compare the differences in the long-term survival rate and the tumor shrinkage rate of inoperable hepatocellular carcinoma (HCC) between transcatheter arterial chemoembolization (TACE) combined with percutaneous ablation therapy and simple TACE therapy in order to provide the basis for the clinical treatment of HCC.Methods Randomized controlled trials (RCT) for comparing the difference in survival rates between TACE plus PA and simple TACE for inoperable HCC were searched from medical literature database,from which the relevant data were extracted.According to Cochrane manual standard,the quality of inclusion literature was evaluated.Results A total of 15 RCT papers were included in this study,including 859 HCC patients.The results of meta-analysis showed that all the 1-year,2-year and 3-year survival rates in TACE plus PA group were better than those in simple TACE group (RR=1.454,95%CI=1.333and 1.586,Z=8.56,P<0.001;RR=1.781,95%CI=1.511 and 2.099,Z=6.88,P<0.001;RR=2.351,95%CI=1.808 and 3.059,Z=6.37,P<0.001,respectively).The tumor shrinkage rate in TACE plus PA group was also better than that in simple TACE group (RR=1.314,95%CI=1.190 and 1.452,Z=5.38,P<0.001).The sensitivity analysis indicated that the results of the differences in survival rate and tumor shrinkage rate between the two groups were reliable.Conclusion The 1-year,2-year and 3-year survival rates as well as the tumor shrinkage rate of TACE plus PA group are higher than those of simple TACE group.
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Objective:To understand the cognition and behavior of drug safety in Beijing middle school students and provide advice for relevant education.Methods:A cross-sectional survey using paper questionnaires was carried out on the student body of nine Beijing middle schools.Multi-stage proportionate stratified cluster sampling was adopted to enroll participants.In addition to demographic questions,the questionnaire included 17 questions assessing the cognition and behavior of safe drug use,prioritizing questions that aligned with the health education guideline for primary and secondary school students from Chinese Ministry of Education.Descriptive statistical methods were applied using the SAS 9.2 software.Results:Of the 4 220 students investigated,2 097(49.7%) were males and 2 123(50.3%) were females.The average age was (14.3 ± 1.7) years.2 030(48.1%) students were from downtown areas,1 511(35.8%) were from urban-rural linking areas and 679(16.1%) were from rural areas.Half (51.5%) of the respondents were junior high school students,and the others were from senior high schools (34.2%) and vocational high schools (14.3%).Most of the students (89.6%) lived off campus.The awareness rate of drug safety knowledge was 74.4%,the median score of drug safety behavior was 4 points (full score was 5 points) and there was a statistically positive correlation between the two (Spearman's correlation coefficient was 0.156,P <0.001).Both the awareness rates and the drug safety behavior scores were statistically different among the students in different regions,different school types and different residence types (P < 0.001).Multiple factors analysis demonstrated the correlation between the cognition degrees of both drug safety knowledge,behavior and the above factors.Of all the students,80.4% agreed that any drug could have adverse drug reactions;40.5% were aware that antibiotics couldn't kill viruses;as many as 49.6% mistook aspirin as antibiotic;97.4% would read drug instructions before taking them;Only 42.4% put expired drugs into special recycling bins;49.8% would deviate from the suggested dosage and frequency of their medication when they were sick with common diseases.Conclusion:Overall,the cognition of drug safety in Beijing middle school students is good,but problems still exist in medication adherence,the management of expired drugs and the antibiotics cognition,which need to be fixed through specific,pointed way of education.And more efforts should be made to improve the cognition in rural regions,vocational high schools and on campus students.