Objective To study the pharmacokinetic characteristics of the test formulation of compound lidocaine cream and reference formulation of lidocaine and prilocaine cream in Chinese healthy subjects and to evaluate whether there is bioequivalence between the two formulations.Methods A single-center,single-dose,randomized,open-label,two-period,two-sequence,crossover design was used.This study included 40 healthy subjects,and in each period,test formulation or reference formulation 60 g was applied to the skin in front of both thighs(200 cm2 each side,a total of 400 cm2)under fasting conditions,and the drug was left on for at least 5 h after application.The concentrations of lidocaine and prilocaine in plasma were determined using liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.Pharmacokinetic parameters were calculated using WinNonlin 8.0 software to evaluate the bioequivalence of the two formulations.Results After the application of the test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream on both thighs of the subjects,the pharmacokinetic parameters of lidocaine in plasma were as follows:Cmax were(167.27±91.33)and(156.13±66.86)ng·mL-1,AUC0-t were(1 651.78±685.09)and(1 636.69±617.23)ng·mL-1·h,AUC0-∞ were(1 669.85±684.65)and(1 654.37±618.30)ng·mL-1·h,the adjusted geometric mean ratios were 104.49％,101.88％and 101.89％,respectively,with 90％confidence intervals of 98.18％-111.20％,97.80％-106.13％and 97.87％-106.07％,all within the range of 80.00％-125.00％.The pharmacokinetic parameters of prilocaine in plasma were as follows:Cmax were(95.66±48.84)and(87.52±39.16)ng·mL-1,AUC0-t were(790.86±263.99)and(774.14±256.42)ng·mL-1·h,AUC0_m were(807.27±264.67)and(792.84±254.06)ng·mL-1 h,the adjusted geometric mean ratios were 107.34％,103.55％and 102.98％,respectively with 90％confidence intervals of 101.69％-113.31％,99.94％-107.30％and 99.65％-106.43％,all within the range of 80.00％-125.00％.Conclusion The test formulation compound lidocaine cream and the reference formulation lidocaine and prilocaine cream are bioequivalent.

The purpose of this study was to enrich the genomic information and provide a basis for further development and utilization of Polygonatum kingianum. The fresh rhizome of P. kingianum was used as the experimental material, and the full-length transcriptome was sequenced by PacBio Sequel platform. The final measured polymerase reads were 1 120 485, with a total of 77.73 GB of data. In NR database, 41 864 homologous sequence alignments were aligned to 5 species; 40 506 were annotated in the KOG database and classified into 26 categories based on their functionality; 69 060 GO annotated 32 functional groups divided into 3 categories: cellular components, molecular functions, and biological processes; 45 779 annotations were added to 145 metabolic pathways in the KEGG database. Among them, there are 127 identified transcripts related to polysaccharide synthesis in the glycolysis/gluconeogenesis metabolic pathway, 144 in the starch and sucrose metabolic pathway, 85 in the amino acid sugar and nucleotide sugar metabolic pathway, and 69 in the fructose and mannose metabolic pathway. In addition, 1 781 transcription factors were detected, distributed in 37 transcription factor families; 180 293 SSR loci were detected, among which single base repeats accounted for the most, accounting for 30.48% of all base repeats, and at least five base repeats, accounting for only 0.14% of single base repeats. The results of this study provide important data supporting for enriching the genomic information of P. kingianum and exploring its effective biosynthetic pathway.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

AIM To study the neoflavonoids from Dalbergia cochinchinensis Pierre ex Laness and their anti-hypoxia/reoxygenation injury activities on H9c2 myocardial cells.METHODS The 70%ethanol extract from D.cochinchinensis was isolated and purified by silica gel,Sephadex LH-20 and reverse-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The CCK-8 method was used to detect their activities on H9c2 cells and protective effects on hypoxia-reoxygenation injury of H9c2 cells,and their structure-activity relationship was analyzed.RESULTS Twelve compounds were isolated and identified as latifolin(1),5-O-methyllatifolin(2),mimosifoliol(3),5-O-methydalbergiphenol(4),dalbergiphenol(5),cearoin(6),2,4-dihydroxy-5-methoxy-benzophenone(7),2-hydroxy-4,5-dimethoxybenzophenone(8),melannoin(9),2,2′,5-trihydroxy-4-methoxybenzophenone(10),dalbergin(11),4-methoxydalbergione(12).The dalbergiphenols and dalbergins had little toxicity to H9c2 cells,and dalbergiphenols had strong activity against hypoxia-reoxygenation injury of H9c2 cells.CONCLUSION Compound 8 is a new natural product.Compounds 4,9 are isolated from this plant for the first time.Dalbergiphenols may be the main neoflavonoids against hypoxia-reoxygenation injury of H9c2 cells.

Objective:To evaluate the repair protocols for intraoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal clival malignancy resection (EECR) and to analyze the risk factors of surgical complication.Methods:The clinical data of patients who underwent EECR and had intraoperative CSF leaks in XuanWu Hospital, Capital Medical University between January 2012 and January 2024 were reviewed. The pathological results, imaging data, location of the dural defect, degree of intraoperative CSF leaks, repair materials, complications such as postoperative central nervous system (CNS) infections, types of antibiotics used, bacterial culture and drug sensitivity results, secondary repair, and follow-up results were collected. IBM SPSS 26 software was used to evaluate the effectiveness of the repair. Additionally, statistical analysis was conducted on perioperative complications such as CNS infections.Results:Twenty-eight patients underwent 31 EECR and 36 skull base reconstructions. There were 14 females and 14 males, aged from 4 to 70 years old, with a median of 53 years. For the repair, autologous materials such as free turbinate flap, free nasoseptal flap, pedicled nasoseptal flap, and fascia lata combined with mashed muscle were used. Initial reconstruction was successful in 26 cases, while 5 patients required a second repair, which was also successful. Postoperatively CNS infections occurred in 4 patients, and all of whom were cured. Follow-up ranged from 3 to 146 months, with no delayed CSF leak reported. The infection rate was significantly higher in patients whose first repair failed compared to those whose repair was successful (Fisher exact test, P<0.001). Conclusions:The use of different autologous materials based on the patient′s condition can effectively repair CSF leakage that occurs during EECR. Howerver, the success rate of initial repair requires improvement, as the risk of CNS infection significantly increases after a failed repair..

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14, 2022, to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases and percentages (%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’ s choice (55 cases 44.72%) .Conclusions:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors from plastic surgery department of public hospitals or medical beauty institutions and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14 to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases(%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’s choice (55 cases, 44.72%).Conclusion:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14, 2022, to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases and percentages (%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’ s choice (55 cases 44.72%) .Conclusions:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors from plastic surgery department of public hospitals or medical beauty institutions and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14 to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases(%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’s choice (55 cases, 44.72%).Conclusion:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.