A single-center, randomized, double-blind, dose-controlled trial of modified Sini Powder in treating mild to moderate generalized anxiety disorder(GAD) in the patients with syndrome of liver depression transforming into fire was conducted at Xiyuan Hospital, China Academy of Chinese Medical Sciences. A total of 80 patients with mild to moderate GAD and the syndrome of liver depression transforming into fire were included. Patients were assigned by the central randomization system at a ratio of 3∶1 into an observation group(n=60, receiving a conventional-dose of granules of modified Sini Powder) and a control group(n=20, receiving low-dose granules with the active ingredients being 50% of that in observation group). Assessments were conducted before treatment(baseline), after 2 weeks of introduction, after 2/4/8 weeks of treatment, and after 4 weeks of follow-up. The results were summarized as follows. In terms of primary outcome indicators, the observation group(62.2%) showed higher total response rate than the control group(26.6%)(P<0.05), and greater Hamilton anxiety scale(HAMA) score reduction after 8 weeks of treatment(P<0.05). In terms of secondary outcome indicators, the HAMA score(somatic anxiety score), traditional Chinese medicine(TCM) syndrome scores, Pittsburgh sleep quality index(PSQI) scale, and clinical global impression(CGI) scale score in the observation group showed a significant compared to the control group at each visit points(P<0.05). Adverse events occurred in 10 cases, including 9(16.9%) cases in the observation group and 1(6.6%) case in the control group. No adverse reaction was observed. In conclusion, conventional-dose modified Sini Powder demonstrated superior efficacy and favorable safety for mild and moderate GAD in the patients with the syndrome of liver depression transforming into fire over low-dose treatment.
Humans ; Male ; Female ; Adult ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/administration & dosage* ; Anxiety Disorders/drug therapy* ; Treatment Outcome ; Young Adult ; Powders ; Aged ; Liver/drug effects* ; Generalized Anxiety Disorder

Objective To establish the pharmacokinetic model of linezolid in neonates,and to optimize the administration regimen. Methods A prospective study was conducted among 64 neonates with sepsis who received linezolid as anti-infective therapy,and liquid chromatography-tandem mass spectrometry was used to measure the plasma concentration of the drug. Clinical data were collected,and nonlinear mixed effects modeling was used to establish a population pharmacokinetic (PPK) model. Monte Carlo simulation and evaluation was performed for the optimal administration regimen of children with different features. Results The pharmacokinetic properties of linezolid in neonates could be described by a single-compartment model with primary elimination,and the population typical values for apparent volume of distribution and clearance rate were 0.79 L and 0.34 L/h,respectively. The results of goodness of fit,visualization verification,and the Bootstrap method showed that the model was robust with reliable results of parameter estimation and prediction. Monte Carlo simulation results showed that the optimal administration regimen for linezolid in neonates was as follows:6 mg/kg,q8h,at 28 weeks of gestational age (GA);8 mg/kg,q8h,at 32 weeks of GA;9 mg/kg,q8h,at 34-37 weeks of GA;11 mg/kg,q8h,at 40 weeks of GA. Conclusions The PPK model established in this study can provide a reference for individual administration of linezolid in neonates. GA and body weight at the time of administration are significant influencing factors for the clearance rate of linezolid in neonates.

Objective:To investigate the effects of bunched cognitive behavior intervention on disease fear and psychological security in patients with glioma.Methods:A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enrollment, all subjects were divided into research group( n=44)and control group( n=48). The patients in control group received routine medical and nursing intervention, and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention, including 4 intervention cycles.At enrollment, 2 weeks after intervention, and 4 weeks after intervention, all subjects were evaluated by the fear of progression questionnaire-short form (FoP-Q-SF), safety questionnaire (SQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF, SQ, SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups. Results:(1)The total FoP-Q-SF score, physiological health dimension scores, and social family dimension scores of the two groups showed significant interaction effects before and after intervention ( F=254.839, 52.738, 12.237, all P<0.05). Further simple effect analysis showed that after 2 and 4 weeks of intervention, the FoP-Q-SF scores of the research group (2 weeks after intervention: 33.80±4.94, 36.48±4.04; 4 weeks after intervention: 31.25±4.55, 35.94±4.47) and social family dimensions (2 weeks after intervention: 15.32±2.56 points, 17.06±2.14; 4 weeks after intervention: 14.05±2.59, 16.96±1.99) were lower than those of the control group (all P<0.05). The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention (4 weeks after intervention: 17.30±2.92, 19.06±2.38) ( P<0.05). After 4 weeks of intervention, the FoP-Q-SF score, physiological health dimension score, and social family dimension score of the research group were all lower than those at 2 weeks after intervention and before intervention (all P<0.05). (2)The total SQ score, interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention( F=193.129, 54.706, 44.015, all P<0.05). Further simple effect testing showed that after 2 and 4 weeks of intervention, the total SQ score and interpersonal security score of the research group were higher than those of the control group (all P<0.05). The determined control score of the research group was higher than that of the control group after 4 weeks of intervention ( P<0.05). After 2 and 4 weeks of intervention, the total SQ score, interpersonal security score, and determination control score of the research group were higher than before intervention (all P<0.05), and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention (both P<0.05). (3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention( F=237.867, 282.882, both P<0.05). Further simple effect analysis showed that after 2 and 4 weeks intervention, the SAS and SDS scores of the research group were lower than those of the control group (all P<0.05). The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention (all P<0.05). The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention (both P<0.05). Conclusion:Bundled cognitive behavioral intervention can improve disease fear and negative emotions in patients with glioma, and enhance psychological security.

Using China National Knowledge Infrastructure, Wanfang, and PubMed database, literature search was conducted with the keywords ^“pregnancy^” and ^“monkeypox^”, and 27 related research articles were selected for analysis. Through a comprehensive review of the related literature, we aim to improve our knowledge of this viral disease, better our prevention, treatment and responses to future monkeypox outbreaks in China, so as to better protect the safety of mothers and infants. Maternal monkeypox can be prevented and controlled, if active and effective measures are taken in time. Drawing on the experience and lessons from monkeypox outbreaks at home and abroad, it is suggested that hospitals and public health agencies at all levels should raise awareness, and establish an effective emergency preparedness system for the prevention and control of potential future outbreaks.

Objective:To investigate the clinical effect of minimally invasive catheterization based on computer 3D-Slicer software system in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods:Three hundred and fifty patients with HICH treated in People′s Hospital of Lanling County in Shandongfrom June 2019 to June 2020 were selected as the research object. According to the operation method, they were divided into 3D-Slicer group (175 cases) and CT group (175 cases). They were treated with 3D-Slicer software-assisted minimally invasive catheterization and minimally invasive soft-channel drainage under CT localization, respectively. The general conditions of the surgery, hematoma clearance rate and laboratory indexes, oxidative stress index and prognosis were compared between the two groups.Results:The intraoperative blood loss, the hospitalizationtimein the 3D-Slicer group were lower than those in the CT group: (81.42 ± 12.33) ml vs. (101.54 ± 11.71) ml, (15.67 ± 3.71) d vs. (17.22 ± 3.52) d; the success rate of one-time successful puncture to preset position in the 3D-Slicer group was higher than that in the CT group: 100.00%(175/175) vs. 81.14%(142/175), there were statistical differences ( χ 2 = 34.26, P<0.05). The hematoma clearance rate after the surgery for 1, 3 and 7d in the 3D-Slicer group were higher than those in the CT group:(87.93 ± 8.54)% vs. (66.43 ± 7.99)%, (92.48 ± 10.31)% vs. (89.52 ± 11.74)%, (96.37 ± 10.22)% vs. (94.30 ± 9.25)%, there were statistical differences( P<0.05). After the surgery for 7 d, the levels of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) in the 3D-Slicer group were higher than those in the CT group: (121.36 ± 10.59)U/L vs. (109.14 ± 9.05) U/L, (92.80 ± 8.63) μg/L vs. (81.45 ± 9.11) μg/L, (24.64 ± 5.43) U/L vs. (20.84 ± 3.47) U/L; while the level of malondialdehyde (MDA) was lower than that in the CT group: (4.42 ± 0.57)μmol/L vs. (5.19 ± 0.51) μmol/L, there were statistical differences ( P<0.05). After the surgery for 3 months, the rate of favorable prognosis in the 3D-Slicer group was higher than that in the CT group 73.71%(129/175) vs. 62.29%(199/175), there was statistical difference ( χ2 = 5.25, P<0.05). Conclusions:Minimally invasive catheterization based on 3D-Slicer software system in the treatment of HICH can not only improve the clinical efficacy, but also shorten the hospitalization time, reduce intraoperative blood loss, and improve the prognosis.

OBJECTIVE To provide a reference for the safe use of abatacept in clinic. METHODS Based on the United States FDA Adverse Event Reporting System （FAERS） database， the generic name of the drug “abatacept” and the trade name “Orencia” were used as the search keywords to retrieve drug adverse event （ADE） signal of abatacept as primary suspected drug. The reported odds ratio method and proportional reporting ratio method in the proportional imbalance method and Excel 2020 software were used to mine and analyze the signals. RESULTS A total of 93 189 abatacept-induced ADE reports were retrieved， mainly female cases （75.98%）， and the age was mainly concentrated in 18-64 years old （35.17%）； main countries reporting data were the United States （47.41%） and Canada （30.59%）， and the number of reports was generally increasing year by year. A total of 3 092 ADE signals were screened， of which the signals associated with the primary disease were similar to those described in the drug instruction of abatacept， such as rheumatoid arthritis， arthralgia， joint swelling， etc.； followed by ADE signals related to infusion reactions， including pain， fatigue， rash， etc. All selected ADE signals involved 27 system organ classes， mainly involved systemic diseases and drug site conditions， musculoskeletal and connective tissue diseases， injury， poisoning and surgical complications， infections and invasive diseases， gastrointestinal diseases， neurological diseases， respiratory， thoracic and mediastinal diseases， heart diseases， benign， malignant and unspecified tumors and reproductive system and breast diseases， etc. A total of 22 ADE signals were not included in the drug instructions of abatacept among the top 50 ADE signals in the number list of reported cases， including fatigue， drug intolerance， abdominal discomfort， swelling， lupus erythematosus， peripheral swelling， cell sores， diarrhea， elevated liver enzymes and lower respiratory tract infection， etc. CONCLUSIONS In the process of clinical use of abatacept， special attention should be paid to infection and its carcinogenicity， while assessing the risk of respiratory and cardiovascular system diseases in patients； when patients suffer from these two underlying diseases， the pros and cons should be weighed carefully before selecting drug； in addition， the drug-induced ADE in the neurological， gastrointestinal and reproductive system cannot be ignored.

Objective To observe the clinical efficacy of levofloxacin combined with levofloxacin scheme in the treatment of pulmonary tuberculosis patients with positive hepatitis B surface antigen(HBsAg)and its impact on drug-induced liver injury.Methods Pulmonary tuberculosis patients with positive HBsAg were divided into treatment group and control group according to the anti-tuberculosis treatment plan.The treatment group received 2HLZE/4HLE anti-tuberculosis regimen(levofloxacin 0.6 g,twice a week+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5 g,tid)for 6 months,and the control group received 2HRZE/4HRE anti-tuberculosis regimen(levofloxacin 0.6 g,qd+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5 g,tid)for 6 months.The sputum smear conversion rate,liver function indicators[glutamate pyruvate transaminase(GPT),glutamate oxaloacetate transaminase(GOT),serum total bilirubin(TBIL)],clinical efficacy,drug-induced liver injury,as well as the incidence of adverse drug reactions were compared between the two groups.Results A total of 41 patients were enrolled in the treatment group and 39 patients in the control group.After treatment,the clinical total effective rates in the treatment and control groups were 97.56％and 79.49％,which showed statistically significant difference(P＜0.05).After 4 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 90.24％and 71.79％,respectively;after 6 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 95.12％and 79.49％,respectively,both showing statistically significant differences(all P＜0.05).After 6 months of treatment,the GPT levels in the treatment group and the control group were(87.39±17.26)and(101.49±23.48)U·L-1,the GOT levels were(97.54±19.25)and(119.63±21.57)U·L-1,and the TBIL levels were(31.53±9.35)and(38.27±9.64)μmol·L-1,respectively,all showing statistically significant differences(all P＜0.05).The incidence of drug-induced liver injury in the treatment group and the control group was 19.51％and 41.03％respectively,and the time of liver injury occurrence was(12.98±2.26)and(10.23±1.95)days,both showing statistically significant differences(all P＜0.05).The total incidences of adverse reactions in the treatment group and the control group was 29.27％and 64.10％respectively,with statistically significant differences(P＜0.05).Conclusion Compared with the levofloxacin scheme,the levofloxacin combined with levofloxacin scheme can reduce the incidence and severity of drug-induced liver injury and improve the clinical treatment efficacy in pulmonary tuberculosis patients with positive HBsAg.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

OBJECTIVES: To study the association between paroxysmal nocturnal hemoglobinuria (PNH) clone and immunosuppressive therapy (IST) in children with severe aplastic anemia (SAA). METHODS: A retrospective analysis was performed on the medical data of 151 children with SAA who were admitted and received IST from January 2012 to May 2020. According to the status of PNH clone, these children were divided into a negative PNH clone group (n=135) and a positive PNH clone group (n=16). Propensity score matching was used to balance the confounding factors, and the impact of PNH clone on the therapeutic effect of IST was analyzed. RESULTS: The children with positive PNH clone accounted for 10.6% (16/151), and the median granulocyte clone size was 1.8%. The children with positive PNH clone had an older age and a higher reticulocyte count at diagnosis (P<0.05). After propensity score matching, there were no significant differences in baseline features between the negative PNH clone and positive PNH clone groups (P>0.05). The positive PNH clone group had a significantly lower overall response rate than the negative PNH clone group at 6, 12, and 24 months after IST (P<0.05). The evolution of PNH clone was heterogeneous after IST, and the children with PNH clone showed an increase in the 3-year cumulative incidence rate of aplastic anemia-PNH syndrome (P<0.05). CONCLUSIONS SAA children with positive PNH clone at diagnosis tend to have poor response to IST and are more likely to develop aplastic anemia-PNH syndrome.
Anemia, Aplastic/drug therapy* ; Child ; Clone Cells ; Hemoglobinuria, Paroxysmal/etiology* ; Humans ; Immunosuppression Therapy ; Retrospective Studies

Objective:To explore the current situation of rumination and hope level in stroke patients and to analyze the effect of rumination on their hope level, so as to provide a basis for clinical intervention.Methods:Using the convenient sampling method, stroke patients admitted to Lanling County People's Hospital from March to June 2021 were selected as the research objects. General data questionnaire, Chinese Version of Event Related Rumination Inventory (C-ERRI) and Herth Hope Scale were used to investigate the patients. Multiple linear regression analysis was used to analyze the influencing factors. A total of 100 questionnaires were distributed in this study, and 92 valid questionnaires were recovered, with an effective recovery rate of 92.0%.Results:The total score of C-ERRI in 92 stroke patients was (29.40±7.89) and the total score of Herth Hope Scale was (32.97±6.52) . Pearson correlation analysis showed that purposeful rumination in stroke patients was positively correlated with the total score and each dimension scores of Herth Hope Scale ( P<0.05) . The results of multiple linear regression analysis showed that gender, education level, economic income level, Barthel index and purposeful rumination were influencing factors of the hope level of stroke patients ( P<0.05) . Conclusions:The hope level of stroke patients is not high, and more attention should be paid to stroke patients who are female, have a lower education level, a lower level of economic income and have poor activities of daily living. And certain measures should be taken to improve the level of purposeful rumination of patients, thereby raising its hope level.