Oral iron is a commonly used preparation for the treatment of iron deficiency and iron-deficiency anemia in children, but its undesirable taste has become a major factor affecting clinical adherence to the medication. No studies have been conducted to evaluate the palatability of oral iron supplements. Thirteen representative oral iron supplements were selected to evaluate the palatability of oral iron supplements from different perspectives of in vivo and ex vivo by combining the electronic tongue (e-tongue) test, FaceReader facial expression analysis technology and taste interviews. E-tongue test results showed that iron dextran granlues were closest to odorless potassium chloride solution, basically free of bitterness and astringency, which was superior to the other products. FaceReader facial expression results showed that 58.7% of the subjects valued iron dextran granlues for their emotional efficacy higher than that of iron proteinsuccinylate oral solution. Among 43 participants aged ≥ 5 years, the taste preference for iron dextran granlues was 83.7%, and 83.7% of participants chose to take iron dextran granlues again. This study found that iron dextran granlues have a better taste and their flavor is more popular among children, which provides a reference for pediatric clinical use of oral iron supplementation preparations and a new idea for the evaluation of palatability of medications for children. This in vivo palatability evaluation is an investigational clinical trial that was approved by the Institutional Review Board of the Beijing Children's Hospital (No. 2021-149-Y).

Objective:To investigate the effects of early postoperative nutritional management under enhanced recovery after surgery (ERAS) guidelines on nutritional biochemical indicators and length of hospital stay in patients undergoing lumbar fusion surgery. Method:Ninety-four patients who underwent lumbar posterior internal fixation + intervertebral fusion surgery in Department of Orthopedics Ⅲ of Ningxia Medical University General Hospital from January 2020 to March 2021 were randomly divided into an intervention group (n=47) and a control group (n=47). The intervention group received nutritional intervention by a clinical nutritionist at 2 hours after anesthesia recovery, and the control group started to eat liquid diet at 6 hours after anesthesia recovery. The protein-calorie intake, blood glucose, total protein, albumin, hemoglobin, postoperative hospitalization time and total hospitalization time of the two groups were observed. Results:The protein-calorie intake of the intervention group was higher than that of the control group on the day of surgery and the first 3 days after surgery, with statistically significant differences (P<0.05). The blood glucose level of the intervention group was lower than that of the control group on the first day after surgery, with statistically significant differences (P<0.05). The total protein level of the intervention group was higher than that of the control group on the third day after surgery, with statistically significant differences (P<0.05). The albumin and hemoglobin levels of the intervention group were higher than those of the control group on the first and third days after surgery, with statistically significant differences (P<0.05). The incidence of abdominal distension and the length of hospital stay in the intervention group were lower than those in the control group, with statistically significant differences (P<0.05). Conclusion:Early postoperative nutritional management has a certain effect on improving nutritional and biochemical indicators and shortening the length of hospital stay in patients undergoing lumbar fusion surgery.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Benign prostatic hyperplasia(BPH) is a common disease in middle-aged and elderly men, with lower urinary tract symptoms as the main manifestation, severely affecting the quality of life of patients. The pathogenesis of BPH is not yet fully understood, and there are still some challenges and limitations in western medicine treatment for BPH. Therefore, finding new and more effective treatment strategies is urgent. In recent years, many basic and clinical studies have confirmed the important role of traditional Chinese medicine in the treatment of BPH. This article reviews the progress of basic and clinical research in the treatment of BPH with traditional Chinese medicine, and believes that basic research mainly focuses on the active ingredients of Chinese medicine [regulating pathways such as NF-E2-related factor 2(Nrf2)/antioxidant response element(ARE), nuclear factor κB(NF-κB), epidermal growth factor receptor(EGFR)/signal transducer and activator of transcription 3(STAT3), phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR), p38 mitogen-activated protein kinase(p38 MAPK)/forkhead box O subtype(FOXO3a), etc.], single Chinese herbs(regulating inflammatory factors, oxidative stress-related proteins, cell cycle-related proteins, and apoptotic factors, etc.), and Chinese herbal compounds and patent medicines [regulating extracellular signal-regulated kinase(ERK1/2), transforming growth factor-β(TGF-β)/Smad, mitogen-activated protein kinase(MAPK), PI3K/Akt, Nrf2, trefoil factor 2(TFF2)/Wnt, interleukin-6(IL-6)/Janus kinase 2(JAK2)/STAT3, hypoxia-inducible factor 1α(HIF-1α)/vascular endothelial growth factor receptor(VEGFR), etc.], and then play a therapeutic role by inhibiting BPH cell proliferation, oxidative stress, inflammatory response, promoting apoptosis, and inhibiting epithelial-mesenchymal transition. Clinical studies mainly focus on internal treatment, external treatment, combined internal and external treatment, and integrated Chinese and western medicine treatment as the main methods, aiming to improve traditional Chinese medicine syndrome scores, prostate symptom scores, residual urine volume, effective bladder volume, sexual quality of life, increase average urine flow rate, maximum urine flow rate, and promote balance of sex hormone secretion. Through this research, it is hoped to provide some reference ideas for clinical research and drug development for BPH.
Prostatic Hyperplasia/metabolism* ; Male ; Humans ; Drugs, Chinese Herbal/therapeutic use* ; Animals ; Signal Transduction/drug effects* ; Medicine, Chinese Traditional ; NF-E2-Related Factor 2/genetics*

Objective To investigate the predictive value of quantitative flow ratio(QFR)on the occurrence of major adverse cardiovascular events(MACE)3 years after percutaneous coronary intervention(PCI)in patients with non-acute myocardial infarction.Methods This study included 139 patients with non-acute myocardial infarction who underwent PCI from January 2020 to June 2020 in the cardiac catheterization room of our hospital,all of them underwent post-PCI target vessel QFR measurements,and the incidence of MACE was followed up 3 years after PCI.The cut-off value of QFR was calculated by receiver operating characteristic(ROC)curve,according to which patients were divided into QFR＞0.95 group and QFR≤0.95 group,and patients were divided into MACE group and non-MACE group depending on whether MACE occurs.The independent influencing factors of post-PCI QFR in patients with non-acute myocardial infarction were investigated by univariate and multifactorial linear regression analysis.Univariate and multivariate Cox regression analysis was used to investigate the predictive value of post-PCI QFR in the occurrence of MACE 3 years after PCI in patients with non-acute myocardial infarction.The long-term prognosis of patients with QFR＞0.95 and those with QFR≤0.95 was compared by drawing the survival curve of no-MACE event.Results ROC curve analysis showed that post-PCI QFR predicted the occurrence of MACE 3 years after surgery in non-acute myocardial infarction patients with statistical significance(AUC 0.666,95％CI 0.556-0.777,P=0.003),and the cut-off value of MACE was 0.95.The sensitivity and specificity were 75.00％and 51.30％for the diagnosis of MACE with QFR≤0.95.Patients were divided into QFR≤0.95 group(n=74)and QFR＞0.95 group(n=65)according to the cut-off value.Multivariate linear regression analysis showed that the maximum area stenosis rate after PCI was an independent factor for post-PCI QFR(P＜0.001).Multivariate Cox regression analysis showed that body mass index(BMI),post-PCI QFR,three-vessel lesions and post-PCI QFR groups were independent influencing factors of no-MACE lifetime.The no-MACE survival curve showed that the long-term prognosis of patients in the QFR＞0.95 group was significantly better than that in the QFR≤0.95 group(x2=5.272,P=0.022).Conclusions The optimal cut-off value of post-PCI QFR for predicting the occurrence of MACE 3 years after PCI in non-acute myocardial infarction patients was 0.95,and patients with QFR≤0.95 had worse long-term prognosis,and BMI,three-vessel lesions,and post-PCI QFR≤0.95 were independent risk factors for the occurrence of MACE 3 years in non-acute myocardial infarction patients after PCI.

A flavoring agent and a suspension agent were prepared for extemporaneous compounding. The stability of the two agents before and after drug loading was investigated, and the taste of the suspension after extemporaneous compounding was evaluated by electronic tongue technology. The two agents remained stable under the conditions of influence factor test, accelerated test and long-term test. The appearance properties of the two agents did not change. The relative density of the flavoring agent was maintained at 1.053-1.075, and the pH was stable at 4.2-4.5. The relative density of the suspension agent was maintained at 0.999-1.022, and the pH was stable at 4.0-4.5. Seven kinds of drugs, including warfarin sodium tablets and spironolactone tablets, were mixed with these two oral solvents, and the content uniformity and stability were detected respectively. The results showed that the preparations could be evenly dispersed and the physical and chemical properties were stable. The results of taste evaluation showed that in captopril group and chloral hydrate group, the flavoring agent had the best effect on taste correction. In warfarin sodium group, rifampicin group, spironolactone group, vitamin B1 group and vitamin B2 group, the blending agents had the best effect on taste correction.

The whole herb of Solanum nigrum L. can be used as the herbal drug. In this study, UHPLC-Q Exactive high resolution mass combined with GNPS molecular network was used for the rapid characterization of the components in the leaves of S. nigrum L. A total of 157 compounds were identified, including 30 steroid alkaloids, 61 steroid saponins, 35 flavonoids, and 31 other compounds (amino acids and organic acids), by comparison with the data reported in the literature, and mass fragmentation characteristics analysis, as well as the correlation of known and unknown nodes in the GNPS molecular network. Compared with the fruits and stems, the leaves of S. nigrum L was rich in a variety of steroidal saponins, steroidal alkaloids, and flavonoids, and the results lay the foundation for the precise resources utilization of S. nigrum L.

OBJECTIVE: This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline (BR) and the conventional treatment regimen (CR, not containing Bedaquiline) for the treatment of adults with multidrug-resistant tuberculosis (MDR-TB) in China. METHODS: A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years. The model parameter data were synthesized from the literature, the national TB surveillance information system, and consultation with experts. The incremental cost-effectiveness ratio (ICER) of BR vs. CR was determined. RESULTS: BR ( vs. CR) had a higher sputum culture conversion rate and cure rate and prevented many premature deaths (decreased by 12.8%), thereby obtaining more quality-adjusted life years (QALYs) (increased by 2.31 years). The per capita cost in BR was as high as 138,000 yuan, roughly double that of CR. The ICER for BR was 33,700 yuan/QALY, which was lower than China's 1× per capita Gross Domestic Product (GDP) in 2020 (72,400 yuan). CONCLUSION BR is shown to be cost effective. When the unit price of Bedaquiline reaches or falls below 57.21 yuan per unit, BR is expected to be the dominant strategy in China over CR.
Adult ; Humans ; Antitubercular Agents/therapeutic use* ; Cost-Effectiveness Analysis ; Cost-Benefit Analysis ; Tuberculosis, Multidrug-Resistant/drug therapy* ; China/epidemiology*