Objective: To establish a bacterial endotoxin detection method for vidarabine monophosphate for injection and conduct methodological validation for harmanizing the quality control standard of this product.
Methods: According to the Chinese Pharmacopoeia 2020 volume Ⅳ general chapter 1143“Bacterial endotoxin test”, the limit of bacterial endotoxin was determined,interference test and endotoxin testing were performed.
Results: The bacterial endotoxin test were performed on 25 batches of test samples provided by 15 manufacturers according to the experienced experimented limitation which is the amount of endotoxin in 1 mg of adenosine monophosphate should be less than 0.06 EU. All results were found to be in compliance with the specified standards.
Conclusion: The established bacterial endotoxin method can be used for quality control of vidarabine monophosphate for injection.

Objective To study the Effect of Liuwei anxiao capsules combined with omeprazole for the gastric electrical parameters and gastrointestinal motility related indexes of patients with functional dyspepsia. Methods 86 patients with functional dyspepsia in our hospital from December 2014 to July 2016 were selected,and all the patients were randomly divided into control group and observation group,43 cases in each group,the control group were treated with omeprazole,the observation group were treated with Liuwei anxiao capsules on the basis of the control group,then the total effective rates of different symptoms,signs,gastric electrical parameters and gastrointestinal motility related indexes before and after the treatment of two groups were compared. Results The total effective rates of observation group with abdominal pain,abdominal distension,early satiety and belching were all higher than those of control group (P<0.05).3,7 and 14 days after treatment,compared with the pre-treatment, the difference of gastric electrical parameters between the two groups was statistically significant (P<0.05),the ratio of normal slow rhythm rhythm, main electrogastric power and electrogastric frequency in observation group were higher than those in control group (P<0.05),the percentage of bradycardia was lower than that in control group (P<0.05);there were significant differences in the indexes of gastrointestinal motility between the two groups before treatment (P<0.05),the level of MTL before and after meals was higher in the observation group than that in the control group (P<0.05), and the levels of SS before and after meals were lower than those in the control group (P<0.05). Conclusion Liuwei anxiao capsules combined with omeprazole in the treatment of functional dyspepsia in patients with significant effect,can significantly improve the patient's gastric electrical parameters and gastrointestinal motility related indicators,and improve the clinical symptoms.

Objective To observe the therapeutic effects of oral placement therapy (OPT) on managing sialorrhea after stroke.Methods A total of 37 stroke inpatients with sialorrhea were enrolled from January 2011 to September 2013 in the authors' department for the study and divided into 2 group on the basis of the time of enrollment.The control group (n =18) received 30min of routine treatment (including such neuromuscular facilitation techniques as Bobath and Rood techniques,motor relearning program,neuromuscular electrical stimulation and ice stimulation),twice daily,and the treatment group (n =19) received 15 min of routine treatment plus 15 min of OPT,twice daily.Frenchay Dysarthria Assessment was used to evaluate the sialorrhea severity and clinical efficacy before and 1,2 and 4 weeks after initiation of treatment.Results Sialorrhea symptom was significantly improved in treatment group after 1 week (P ＜ 0.05),while no significant improvement was observed in control group (P ＞ 0.05).After 2 and 4 weeks of treatments,significant improvements of sialorrhea were noted in both groups.After 1,2 and 4weeks of treatment,the total effective rate were 63.16％,94.74％ and 94.74％,respectively,in the treatment group,versus 5.88％,61.11％ and 61.11％,respectively,in the control group.The total effective rate of the treatment group were significantly higher in the above three time-points than the control group (P ＜ 0.05).Conclusions Oral placement therapy can improve sialorrhea symptom after stroke more effectively than routine treatment.

Objective To investigate the risk of postpartum haemorrhage in HBV-infected pregnant women. Methods Cohort or case-control studies that discussed the relationship between hepatitis b virus infection and pregnancy outcome were searched in PubMed , EMBASE , Wiley Online Library , Cochrane Library , Google Scholar, CBM, WanFang database and CNKI etc. (till August 2015). The quality of included Cohort or case-control studies was evaluated , and Meta-analysis was performed with Rev Man5.2 software. Results Four observational case-control studies and 17 cohort studies , involving 19 549 women in observation , were identifled. Meta-Analysis results displayed that the incidence of postpartum haemorrhage in HBV-infected women was 9.3%, while 2.8% in women without HBV [RR = 2.97, 95% CI (2.25 ~ 3.92),P < 0.01]. Compared with normal-risk women , the incidence of postpartum haemorrhage of HBV-infected women with normal hepatic function was also higher [RR = 2.56, 95% CI (2.01 ~ 3.25),P < 0.01]. HBV-infected women with hepatic dysfunction had higher incidence of postpartum haemorrhage than those with normal hepatic function [RR = 2.67, 95% CI (2.17~ 3.28),P < 0.01]. Conclusions HBV-infected women are at higher risk of postpartum haemorrhage than normal pregnancy women and further hepatic dysfunction would lead to a continuing increase of the risk.

Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for hepatitis E virus(HEV)antibodies.Although acute hepatitis E is often self-limited and has a favorable prognosis,some populations experience severe manifestations,which may progress to liver failure.Moreover,some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis.Proactive screening,reducing misdiagnosis,improving patient management,timely anti-viral therapy for severe and chronic cases,and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E.This review focused on the clinical presentation,management,and prevention of hepatitis E.

Objective: To explore the relationship between plasma amyloid-β (Aβ) and cognitive decline during 2 year follow-up in a population-based cohort in Xi′an rural areas. Methods: The study was conducted in Qubao village in Xi′an suburbs cognitively normal residents over 40 years old were recruited from October 2014 to March 2015 and given a face-to-face standardized interview. Mini-mental state examination (MMSE) was employed to evaluate the global cognitive function, and quantification of plasma Aβ was measured by sandwich enzyme-linked immunosorbent assay (ELISA) at baseline. Two years later, MMSE was tested at the end of study. Then logistic regression was performed to analyze the relationship between baseline Aβ and cognitive change during 2 year follow-up. Results: A total of 1 020 participants completed the study, among whom 223 subjects (21.9%) presented MMSE scores decline (defined as MMSE scores decreased ≥2 points). Compared with those without decline, participants in the MMSE decline group were older (P<0.001) and had lower education level (P<0.001), while gender, hypertension, hyperlipemia, diabetes mellitus and APOE genotype were not significantly different between two groups. One-way analysis of variance (ANOVA) showed that the MMSE score decline was slighter in the lower tertile of baseline Aβ₁-40 compared with middle tertile (P=0.012), while MMSE decline were similar between different Aβ₁-42 level groups and Aβ_1-42/Aβ_1-40 ratio groups (P=0.758, P=0.671, respectively). Multivariable logistic regression analysis showed that MMSE scores in the lower baseline plasma Aβ_1-40 level declined more slowly (OR=0.565, 95%CI 0.379-0.845, P=0.005). However, the MMSE decline were also similar among different baseline plasma Aβ_1-42 levels groups and Aβ_1-42/Aβ_1-40 ratio groups. Conclusion Population with lower level of baseline plasma Aβ_1-40 manifests lower cognitive decline during 2 years, however further investigation on dynamics of plasma Aβ and long term follow up are needed.

Background and aim:Few studies have reported hepatitis B surface antigen(HBsAg)kinetics after nucleos(t)ide analog(NA)discontinuation in patients with noncirrhotic chronic hepatitis B(CHB).The study specifically investigated long-term HBsAg kinetics after NA discontinuation. Methods:Between January 2014 to January 2024,this study prospectively enrolled 106 outpatients with noncirrhotic CHB who met the discontinuation criteria after NA consolidation treatment.Demographic,clinical,and laboratory data were collected and analyzed after NA discontinuation. Results:Ninety-six patients who finished 5 years of follow-up were included.HBsAg remained unde-tectable in 29 patients with end of treatment(EOT)HBsAg negativity.Among 67 patients with EOT HBsAg positivity,HBsAg seroclearance occurred in 12(17.9％)patients with an estimated annual inci-dence of HBsAg seroclearance of 3.6％.Patients with EOT HBsAg levels of ≤1000 IU/mL had a higher HBsAg seroclearance rate than those with EOT HBsAg levels of＞1000 IU/mL(33.3％vs.5.4％).The pro-portion of patients with HBsAg ≤1000 IU/mL increased during follow-up.Logistic regression analysis indicated that the EOT HBsAg level was an independent factor for HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL.The optimal EOT HBsAg cutoff for both HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL was 359 IU/mL. Conclusions:Patients with EOT HBsAg negativity experienced no relapse and maintained HBsAg sero-clearance during 5 years of follow-up after NA discontinuation.A higher HBsAg seroclearance rate can be obtained in patients with EOT HBsAg levels of ≤1000 IU/mL during 5 years of follow-up after NA discontinuation.Close monitoring and proper NA retreatment are recommended to guarantee the safety of NA discontinuation.

To explore the relationship between plasma amyloid?β (Aβ) and cognitive decline during 2 year follow?up in a population?based cohort in Xi′an rural areas. Methods The study was conducted in Qubao village in Xi′an suburbs cognitively normal residents over 40 years old were recruited from October 2014 to March 2015 and given a face?to?face standardized interview. Mini?mental state examination (MMSE) was employed to evaluate the global cognitive function, and quantification of plasma Aβ was measured by sandwich enzyme?linked immunosorbent assay (ELISA) at baseline. Two years later, MMSE was tested at the end of study. Then logistic regression was performed to analyze the relationship between baseline Aβ and cognitive change during 2 year follow?up. Results A total of 1 020 participants completed the study, among whom 223 subjects (21.9%) presented MMSE scores decline (defined as MMSE scores decreased≥2 points). Compared with those without decline, participants in the MMSE decline group were older (P<0.001) and had lower education level (P<0.001), while gender, hypertension, hyperlipemia, diabetes mellitus and APOE genotype were not significantly different between two groups. One?way analysis of variance (ANOVA) showed that the MMSE score decline was slighter in the lower tertile of baseline Aβ1?40 compared with middle tertile (P=0.012), while MMSE decline were similar between different A β 1?42 level groups and A β 1?42/A β 1?40 ratio groups (P=0.758, P=0.671, respectively). Multivariable logistic regression analysis showed that MMSE scores in the lower baseline plasma A β 1?40 level declined more slowly (OR=0.565, 95%CI 0.379-0.845, P=0.005). However, the MMSE decline were also similar among different baseline plasma Aβ1?42 levels groups and Aβ1?42/Aβ1?40 ratio groups. Conclusion Population with lower level of baseline plasma Aβ1?40 manifests lower cognitive decline during 2 years, however further investigation on dynamics of plasma Aβ and long term follow up are needed.

OBJECTIVETo provide further pathogenic evidence of Granulocytic ehrlichia infection in China.

METHODSSpecific primers derived from 444-Epank gene were used to amplify Granulocytic ehrlichia DNA from specimens of ticks, animals and human blood. PCR products of ticks were cloned and sequenced.

RESULTS444 bp specific DNA fragments were amplified from 2 of 62 pools of Ixodes persulcatus collected from Heilongjiang province and 1 of 129 blood specimens from forest workers in Inner Mongolia. Eight animal specimens were negative. PCR products from ticks were then cloned and sequenced. It differed at 23 positions in comparison to American strain (AF047897) with 94.9% homology. The homology of deduced ammonia was 88.44%.

CONCLUSIONOur findings further confirmed that Granulocytic ehrlichia infection did exist in China.

DNA, Bacterial ; analysis ; Ehrlichia ; classification ; genetics ; isolation & purification ; Ehrlichiosis ; microbiology ; Genes, Bacterial ; Humans ; Phylogeny ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Background: and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. Methods: This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). Results: Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. Conclusions In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.