AIMTo study the thermal stability, decomposition process and kinetics of such purine pharmaceuticals as aciclovir (Acv), penciclovir (Pcv), and their parent substance, guanine.

METHODSUsing infrared technique, accelerating test method and thermogravimetry to investigate the thermal decomposition processes and using Coast-Redfern method, MKN method and Ozawa method to deal with the data to get kinetic functions.

RESULTSThe decomposition process and the formed products were derived, the kinetic model function was suggested by comparison of the kinetic parameters.

CONCLUSIONPcv and Acv's degrading product for the first step is guanine. The sequences of their thermal stabilities is: Pcv > Acv. The two drugs' kinetic equation of thermal decomposition is expressed as: da/dt = Ae-Ea/RT2(1-alpha)3/2.

Acyclovir ; analogs & derivatives ; chemistry ; Drug Stability ; Guanine ; chemistry ; Hot Temperature ; Kinetics ; Thermodynamics ; Thermogravimetry

OBJECTIVEThis study aimed to explore the secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou.

METHODSThe data of physical examination was collected from the routine measurements carried out by the Health Care Facilities of Primary and Secondary schools between 2007 and 2011. Random stratified cluster sampling was conducted, all the students aged 5-18 years old form 19 primary and secondary schools from 4 districts (Tianhe district, Yuexiu district, Baiyun district and Haizhu district) were included in this survey, including 27 944 students in 2007 and 38 284 students in 2011. Body mass index reference norm established by Working Group on Obesity in China (WGOC) and the WHO cut-off criteria were employed for overweight and obesity screening, and the trend was analyzed.

RESULTSPrevalence of obesity in children and adolescents (7-18 years old) significantly increased from 5.96% (1 553/26 055) in 2007 to 6.56% (2 339/35 664) in 2011, and the difference showed statistical significance (χ(2) = 9.195, P < 0.05). Overweight and obesity was more common in boys (overweight: 13.25% (1 766/13 329) in 2007 and 13.87% (2 559/18 451) in 2011; obesity: 7.82% (1 042/13 329) in 2007 and 8.63% (1 592/18 451) in 2011) than in girls (overweight: 7.43% (946/12 726) in 2007 and 8.17% (1 406/17 213) in 2011; obesity: 4.11% (523/12 726) in 2007 and 4.48% (771/17 213) in 2011), and the difference showed statistical significance (overweight:χ(2) = 236.123 in 2007 and χ(2) = 292.892 in 2011; obesity:χ(2) = 158.533 in 2007 and χ(2) = 247.794 in 2011. All P values < 0.05). Further analysis found that significant increases occurred in boys aged 16 and 17 years old and in girls aged 12 years old (boy: 16 years old,χ(2) = 6.820, P < 0.05. 17 years old, χ(2) = 4.893, P < 0.05. girl: 12 years old,χ(2) = 5.921, P < 0.05).

RESULTSof Join-point regression showed that for boys less than 10 years old the prevalence increased with age increasing (in 2007, APC = 3.75; in 2011, APC = 1.76), while over 10 years old the prevalence decreased with age increasing (in 2007, 10-18 years old's APC = -18.58; in 2011, 10-18 years old's APC = -15.95). While for girls the prevalence of obesity increased with age increasing between 7-9 years old (APC = 12.16), decreased with age increasing through 9 to 18 years old (APC = -17.23) in 2007. The prevalence decreased with age increasing for girls in 2011 (APC = -4.66).

CONCLUSIONThe prevalence of obesity is high and still increasing in children and adolescents in Guangzhou, and it is higher in boys than in girls. It is more likely to become obesity at 10 years for boys, and for girls the prevalence decrease with age increasing.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence

OBJECTIVETo explore the development and prognosis of the acute flaccid paralysis (AFP) associated with enterovirus 71 (EV71) infection through clinical follow-up study for clinical and magnetic resonance imaging (MRI) features based on the research progress of virology and pathology.

METHODSixteen children with HFMD associated with AFP in hospital from May 1, 2011 to August 31, 2011 were investigated and the patients received intensive rehabilitation training. The 16 cases were divided into two groups (the recovery or the sequela) by if the muscle strength recovered to level 4 after intensive rehabilitation. The MRI findings of 15 children were analyzed and among them, 6 patients were reexamined after one month. The clinical markers were compared between groups including course of disease, WBC, WBC in cerebrospinal fluid (CSF), ventilator support, therapy, the worst muscle strength, the initial tendon reflex, the muscle atrophy, and multi-limb paralysis. The data were analyzed by t test and χ2 test with SPSS10.0.

RESULTAll the 16 children were infected with enterovirus 71 (EV71). The myodynamia of 7 children were level 0, 4 children had serious upper limbs paralysis. The neck muscle in 3 cases and the brain stem motor ruckus in 4 cases were involved. The ankle clonus of non-completely paralyzed limbs in 14 cases occurred during rehabilitation. Eight children had the better prognosis, the other 8 children had sequela. 0 level muscle strength (0 case vs. 7 cases, χ2=12.4), the initial tendon reflex (2 cases vs. 8 cases, χ2=9.6), obvious muscle atrophy (0 case vs. 8 cases, χ2=16), were significantly different in the children with the recovery when compared to the sequela (P<0.01). The severe upper limbs paralysis had the worse prognosis than the severe lower limbs paralysis. MR imaging showed signs of spinal nerve root inflammation and the bilateral hyperintense lesions, symmetrical in the posterior portions of the medulla, pons, and asymmetrical in the ventral horns of cervical spinal cord. Signal enhancement occurred only in the early MRI examination.

CONCLUSIONIn the evolution of AFP due to EV71 infection, the upper motor neuron damage is common, the prognosis is related with the severity of early paralysis and neuron damage. MR imaging is helpful to understand the pathological mechanism of AFP.

Child, Preschool ; Enterovirus A, Human ; pathogenicity ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; diagnosis ; pathology ; virology ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Paralysis ; diagnosis ; pathology ; virology ; Prognosis

OBJECTIVETo evaluate the feasibility and effectiveness of needle and syringe exchange program among a community of injecting drug users (IDUs) on AIDS prevention.

METHODSA quasi-experiment design was used in a controlled community intervention study. Needle and syringe exchange program was implemented for 10 months in IDUs of an intervention community, including peer education and health education, provision of free needles and syringes, and collecting back of used needles and syringes by trained peer educators and local health workers, whereas no intervention measure in a control community was instituted. Interviews with IDUs were conducted before and after intervention with a snowballing strategy to evaluate its effectiveness.

RESULTSA total of 428 and 429 IDUs were interviewed with structured questionnaire before and after intervention in intervention and control communities, respectively. Results revealed that awareness of HIV-related knowledge increased from 29.4% to 58.7% in the intervention community. Multivariate logistic regression analysis showed that awareness of HIV-related knowledge was higher in those who had read health education materials (OR = 2.93, 95% CI 2.12 - 4.04). As compared with the baseline data, frequency of sharing needles and syringes in past 30 days in the intervention community decreased from 48.9% to 20.4% in before intervention community (chi(2) = 41.02, P = 0.001), whereas there was no significant change in the control community. The causes of sharing needles and syringes in the intervention community included 'disable to get needle and syringe during the night', 'lack of needle and syringe when injecting at friend's home', 'not daring to buy needle and syringe for fear of being arrested' and 'no money to buy needle and syringe', declined markedly.

CONCLUSIONSNeedle and syringe exchange program was feasible and effective in reducing their risky drug injecting behavior among IDUs in communities. Such strategy should be adopted in the country to reduce rapid spread of HIV.

Adult ; China ; epidemiology ; Female ; HIV Infections ; prevention & control ; transmission ; Health Education ; Humans ; Male ; Needle Sharing ; adverse effects ; statistics & numerical data ; Needle-Exchange Programs ; economics ; organization & administration ; Pilot Projects ; Program Evaluation ; Substance Abuse, Intravenous ; complications ; epidemiology

Objective: To investigate the clinical characteristics, treatment experiences and prognostic factors for descending necrotizing mediastinitis (DNM). Methods: A retrospective analysis was performed on the data of 22 patients with DNM diagnosed and treated in Henan Provincial People's Hospital from January 2016 to August 2022, including 16 males and 6 females, aged 29-79 years. After admission, all patients underwent CT scanning of the maxillofacial, cervical, and thoracic regions to confirm their diagnoses. Emergency incision and drainage were performed. The neck incision was treated with continuous vacuum sealing drainage. According to the prognoses, the patients were divided into cure group and death group, and the prognostic factors were analyzed. SPSS 25.0 software was used to analyze the clinical data. Rusults: The main complaints were dysphagia (45.5%, 10/22) and dyspnea (50.0%, 11/22). Odontogenic infection accounted for 45.5% (10/22) and oropharyngeal infection accounted for 54.5% (12/22). There were 16 cases in the cured group and 6 cases in the death group, with a total mortality rate of 27.3%. The mortality rates of DNM typeⅠand typeⅡwere respectively 16.7% and 40%. Compared with the cured group, the death group had higher incidences for diabetes, coronary heart disease and septic shock (all P<0.05). There were statistically significant differences between the cure group and the death group in procalcitonin level (50.43 (137.64) ng/ml vs 2.92 (6.33) ng/ml, M(IQR), Z=3.023, P<0.05) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score (16.10±2.40 vs 6.75±3.19, t=6.524, P<0.05). Conclution: DNM is rare, with high mortality, high incidence of septic shock, and the increased procalcitonin level and APACHE Ⅱ score combined diabetes and coronary heart disease are the poor prognostic factors for DNM. Early incision and drainage combined with continuous vacuum sealing drainage technique is a better way to treat DNM.
Male ; Female ; Humans ; Mediastinitis/diagnosis* ; Shock, Septic/complications* ; Retrospective Studies ; Procalcitonin ; Prognosis ; Drainage/adverse effects* ; Necrosis/therapy*

OBJECTIVE: To develop a few-shot learning (FSL) approach for classifying optical coherence tomography (OCT) images in patients with inherited retinal disorders (IRDs). METHODS: In this study, an FSL model based on a student-teacher learning framework was designed to classify images. 2,317 images from 189 participants were included. Of these, 1,126 images revealed IRDs, 533 were normal samples, and 658 were control samples. RESULTS: The FSL model achieved a total accuracy of 0.974-0.983, total sensitivity of 0.934-0.957, total specificity of 0.984-0.990, and total F1 score of 0.935-0.957, which were superior to the total accuracy of the baseline model of 0.943-0.954, total sensitivity of 0.866-0.886, total specificity of 0.962-0.971, and total F1 score of 0.859-0.885. The performance of most subclassifications also exhibited advantages. Moreover, the FSL model had a higher area under curves (AUC) of the receiver operating characteristic (ROC) curves in most subclassifications. CONCLUSION This study demonstrates the effective use of the FSL model for the classification of OCT images from patients with IRDs, normal, and control participants with a smaller volume of data. The general principle and similar network architectures can also be applied to other retinal diseases with a low prevalence.
Humans ; Tomography, Optical Coherence ; Deep Learning ; Retinal Diseases/diagnostic imaging* ; Retina/diagnostic imaging* ; ROC Curve