1.Efficacy of anrikefon versus tegileridine for analgesia in patients with moderate-to-severe pain after abdominal surgery with general anesthesia
Ziyuan LI ; Wenjie SU ; Meirong WANG ; Jun LI ; Daolin XIA ; Yuanliang CHEN ; Guiming HUANG ; Liang DONG ; Jia DENG ; Kaiming DUAN
Chinese Journal of Anesthesiology 2025;45(10):1291-1297
Objective:To compare the efficacy of anrikefon and tegileridine for analgesia in patients with moderate-to-severe pain after abdominal surgery with general anesthesia.Methods:In this multicenter, randomized, double-blind, active-controlled clinical trial, 101 patients with moderate to severe pain (numeric pain rating scale [NRS] score ≥4 within 4 h after operation) after abdominal surgery with general anesthesia between February 24 and April 1, 2025, aged 18-70 yr, with a body mass index of 18-40 kg/m 2, were assigned to anrikefon group ( n=50) and tegileridine group ( n=51) in a 1∶1 ratio using stratified blocked randomization. Double-dummy design was employed to maintain blinding. Each group received an initial intravenous injection of anrikefon 1 μg/kg or tegileridine 1 mg, followed by connection to a patient-controlled intravenous analgesia (PCIA) pump (the PCIA solution contained normal saline in anrikefon group; the PCIA solution contained tegileridine 5 mg in tegileridine pump) within 10 min. If the patient′s NRS score ≥4 at 8 and 16 h after the initial injection, anrikefon 1 μg/kg was intravenously injected in anrikefon group, and tegileridine group received the equal volume of normal saline. The primary efficacy endpoint was the sum of pain intensity difference (SPID) over the first 24 h after the initial dose (SPID 0-24h). The secondary efficacy endpoints included the incidence and severity of vomiting and nausea, incidence of postoperative nausea and vomiting(PONV), the proportion of patients who received antiemetic treatment, and total consumption of antiemetics within 0-24 h after the initial dose, NRS score at rest ≤ 1 at 24 h after the initial dose, and NRS score at rest ≤ 3 over the first 24 h after the initial dose. Safety indicators included adverse events, vital signs, physical examination findings, 12-lead ECG and laboratory test indicators, and adverse events of special interest. Results:Compared with tegileridine group, no significant change was found in the SPID 0-24h ( P>0.05), and the incidence of vomiting, PONV, proportion of patients requiring antiemetic medication, and total consumption of antiemetics were significantly decreased within the first 24 h after the initial dose in tegileridine group ( P<0.05). One treatment-emergent adverse event of Common Terminology Criteria for Adverse Events grade 3 or higher occurred in tegileridine group, while no treatment-emergent adverse events of Common Terminology Criteria for Adverse Events grade 3 or higher were found in anrikefon group. Among the adverse events of special interest, one case of respiratory depression and one case of cough occurred in tegileridine group, while one case of cough occurred in anrikefon group, with no respiratory depression. Conclusions:Anrikefon and tegileridine provide comparable analgesic efficacy for moderate-to-severe pain after abdominal surgery with general anesthesia. However, anrikefon exhibits an advantage in reducing the risk of PONV, with a superior safety profile.
2.Efficacy of anrikefon versus tegileridine for analgesia in patients with moderate-to-severe pain after abdominal surgery with general anesthesia
Ziyuan LI ; Wenjie SU ; Meirong WANG ; Jun LI ; Daolin XIA ; Yuanliang CHEN ; Guiming HUANG ; Liang DONG ; Jia DENG ; Kaiming DUAN
Chinese Journal of Anesthesiology 2025;45(10):1291-1297
Objective:To compare the efficacy of anrikefon and tegileridine for analgesia in patients with moderate-to-severe pain after abdominal surgery with general anesthesia.Methods:In this multicenter, randomized, double-blind, active-controlled clinical trial, 101 patients with moderate to severe pain (numeric pain rating scale [NRS] score ≥4 within 4 h after operation) after abdominal surgery with general anesthesia between February 24 and April 1, 2025, aged 18-70 yr, with a body mass index of 18-40 kg/m 2, were assigned to anrikefon group ( n=50) and tegileridine group ( n=51) in a 1∶1 ratio using stratified blocked randomization. Double-dummy design was employed to maintain blinding. Each group received an initial intravenous injection of anrikefon 1 μg/kg or tegileridine 1 mg, followed by connection to a patient-controlled intravenous analgesia (PCIA) pump (the PCIA solution contained normal saline in anrikefon group; the PCIA solution contained tegileridine 5 mg in tegileridine pump) within 10 min. If the patient′s NRS score ≥4 at 8 and 16 h after the initial injection, anrikefon 1 μg/kg was intravenously injected in anrikefon group, and tegileridine group received the equal volume of normal saline. The primary efficacy endpoint was the sum of pain intensity difference (SPID) over the first 24 h after the initial dose (SPID 0-24h). The secondary efficacy endpoints included the incidence and severity of vomiting and nausea, incidence of postoperative nausea and vomiting(PONV), the proportion of patients who received antiemetic treatment, and total consumption of antiemetics within 0-24 h after the initial dose, NRS score at rest ≤ 1 at 24 h after the initial dose, and NRS score at rest ≤ 3 over the first 24 h after the initial dose. Safety indicators included adverse events, vital signs, physical examination findings, 12-lead ECG and laboratory test indicators, and adverse events of special interest. Results:Compared with tegileridine group, no significant change was found in the SPID 0-24h ( P>0.05), and the incidence of vomiting, PONV, proportion of patients requiring antiemetic medication, and total consumption of antiemetics were significantly decreased within the first 24 h after the initial dose in tegileridine group ( P<0.05). One treatment-emergent adverse event of Common Terminology Criteria for Adverse Events grade 3 or higher occurred in tegileridine group, while no treatment-emergent adverse events of Common Terminology Criteria for Adverse Events grade 3 or higher were found in anrikefon group. Among the adverse events of special interest, one case of respiratory depression and one case of cough occurred in tegileridine group, while one case of cough occurred in anrikefon group, with no respiratory depression. Conclusions:Anrikefon and tegileridine provide comparable analgesic efficacy for moderate-to-severe pain after abdominal surgery with general anesthesia. However, anrikefon exhibits an advantage in reducing the risk of PONV, with a superior safety profile.
3.Bradyarrhythmia induced by misuse of excessive Cortex Periplocae
Xiaoyuan BIAN ; Chao CUI ; Wen HUANG ; Hui LI ; Guiming LIU
Adverse Drug Reactions Journal 2023;25(5):318-320
A 41-year-old female patient took decoction of Chinese medicine (containing 10 g of Fructus Lycii, 10 g of Radix Ginseng Rubra, and 15 g of Cortex Acanthopanax Radicis) by herself due to trigeminal neuralgia. After about 6 hours of medication, the patient developed palpitate suddenly, woke up in sleep, accompanied by dizziness. Her blood pressure was 95/63 mmHg. The electrocardiogram showed atrial fibrillation, and ventricular rate was 45 beats/min. Symptomatic treatments such as elevation of hypertension and improvement of myocardial metabolism were given, but the patient′s symptoms were not improved. After that, she developed nausea and vomiting, her heart rate decreased to 35 beats/min, and blood pressure decreased to 87/36 mmHg. Electrocardiogram showed junctional escape rhythm and T-wave change. Electrocardiogram monitoring and continuous oxygen inhalation, and symptomatic and supportive treatments such as continuous IV pumping of dopamine and dobutamine, and polarized solution were given. Eight days after treatment, the patient′s condition was improved. Electrocardiogram showed sinus rhythm. The patient sent the traditional Chinese medicine to a professional institution for identification, and found that it contained Cortex Periplocae, while the original prescription was Cortex Acanthopanax Radicis. Therefore, it is considered that the patient′s arrhythmia was caused by mistakenly use of excessive Cortex Periplocae.
4.Bradyarrhythmia induced by misuse of excessive Cortex Periplocae
Xiaoyuan BIAN ; Chao CUI ; Wen HUANG ; Hui LI ; Guiming LIU
Adverse Drug Reactions Journal 2023;25(5):318-320
A 41-year-old female patient took decoction of Chinese medicine (containing 10 g of Fructus Lycii, 10 g of Radix Ginseng Rubra, and 15 g of Cortex Acanthopanax Radicis) by herself due to trigeminal neuralgia. After about 6 hours of medication, the patient developed palpitate suddenly, woke up in sleep, accompanied by dizziness. Her blood pressure was 95/63 mmHg. The electrocardiogram showed atrial fibrillation, and ventricular rate was 45 beats/min. Symptomatic treatments such as elevation of hypertension and improvement of myocardial metabolism were given, but the patient′s symptoms were not improved. After that, she developed nausea and vomiting, her heart rate decreased to 35 beats/min, and blood pressure decreased to 87/36 mmHg. Electrocardiogram showed junctional escape rhythm and T-wave change. Electrocardiogram monitoring and continuous oxygen inhalation, and symptomatic and supportive treatments such as continuous IV pumping of dopamine and dobutamine, and polarized solution were given. Eight days after treatment, the patient′s condition was improved. Electrocardiogram showed sinus rhythm. The patient sent the traditional Chinese medicine to a professional institution for identification, and found that it contained Cortex Periplocae, while the original prescription was Cortex Acanthopanax Radicis. Therefore, it is considered that the patient′s arrhythmia was caused by mistakenly use of excessive Cortex Periplocae.
5.Study on the Rationality Evaluation Indicator System of Antibiotics with Delphi Method
Gefei HE ; Ji SUN ; Juanjuan HUANG ; Heng CHENG ; Liqiang HU ; Guiming DENG
China Pharmacy 2019;30(14):1881-1885
OBJECTIVE: To provide scientific evidence for establishing perfect rationality evaluation indicator system of antibiotics. METHODS: On the basis of literature research, Delphi method was used to conduct several rounds of consultations on 30 experts in related fields with E-mail and questionnaire field investigation. After several rounds of consultations, rationality evaluation index system for antibiotics was determined. The effective recovery rate of expert consultation questionnaire was used to express the positive coefficient of experts; the authoritative coefficient was used to express the authoritative degree of experts; the index importance assignment and the full score ratio were used to reflect the concentration degree of experts’ opinions; the coefficient of variation and the coefficient of coordination were used to express the coordination degree of experts’ opinions. RESULTS & CONCLUSIONS: After two rounds of consultations, response rates of the questionnaire in two rounds of surveys were 100% and 96.67%, indicating experts were highly motivated. The authoritative coefficients were 0.91 and 0.88, indicating experts had a high degree of authority. Finally, an evaluation index system for rationality of antibiotics was established, which included four first-level indicators (indications, drug selection, medication process, management indicators) and 35 second-level indicators. Among them, the mean value of importance scoring of first-level indicators ranged from 4.28 to 5.00, the full score ratio from 0.93 to 1.00, the coefficient of variation from 0.00 to 0.15 and the coefficient of coordination was 0.446 (P<0.001). While, the mean value of importance scoring of second-level indicators ranged from 3.83 to 4.79; the full score ratio from 0.67 to 1.00; variation coefficient from 0.10 to 0.26 and the coefficient of coordination was 0.115 (P<0.001), which indicating the system was reliable.
6.Analysis of diagnosis and treatment of 23 infants with atrial tachycardia
Guiming YANG ; Rong JIANG ; Sheng ZHAO ; Liyun ZHENG ; Dahai ZHANG ; Yungong WANG ; Xiaobi HUANG ; Jun GUO
Chinese Journal of Postgraduates of Medicine 2019;42(3):204-207
Objective To study the clinical characteristics, respond of treatment and prognosis in infants with atrial tachycardia (AT). Methods The clinical data of 23 infants with AT from August 2014 to November 2016 were retrospectively analyzed. The respond of treatment and prognosis were observed. Results Of all the 23 infants with AT, incessant AT was in 5 cases, and paroxysmal AT was in 18 cases. There were 13 infants diagnosed with AT combined with cardiac insufficiency, and among them, 5 cases were combined with tachycardia induced cardiomyopathy (TIC). Echocardiography showed that atrial septal defect in 3 cases, patent foramen oval in 6 cases, ventricular septal defect in 1 case, ventricular septal defect combined with patent foramen oval in 2 cases, ventricular septal defect combined with atrial septal defect in 1 case, and ventricular septal defect combined with coarctation of the aorta in 1 case. The curative effect was excellent in 11 cases, effective in 8 cases, and ineffective in 4 cases at discharge. There was no statistical difference in curative effect between patients with normal cardiac function and cardiac insufficiency at discharge (P>0.05). The infants were followed up for 12 months, AT disappeared in 19 cases, 1 case progressed to sick sinus syndrome, and 3 cases were lost in follow-up. Conclusions AT can be insidious in infants, but with a favorable prognosis if treated with cardiotonic drugs and antiarrhythmic drugs during the short and mid-term follow-up. Long-term follow-up should be taken to learn more about the prognosis.
7.The expression and significance of CD276 and CD133 in colorectal cancer and precancerous lesions
Gaofeng LU ; Lina HUANG ; Jingli REN ; Guiming HU ; Ziheng ZHENG ; Jiaxun WU ; Yipeng ZHU ; Fuai TANG
Chinese Journal of Internal Medicine 2018;57(6):450-453
In order to study the significance of CD276 and CD133 in the development and progression of colorectal cancer (CRC),the expression of CD276 and CD133 was detected by immunohistochemistry in CRC and precancerous lesions.The results showed that the intensity of CD276 and CD133 in CRC samples was higher than that in adenoma group and non-adenoma group.CD276 and CD133 single and double positive expression were significantly correlated with CRC lymph node metastasis,distant metastasis and survival.CD276 and CD133 are significantly correlated to the development and progression of CRC and associated with poor prognosis.
8.Expression and its clinical significance of gastric and intestinal phenotypic markers in 47 Siewert type Ⅱ and type Ⅲ early gastroesophageal junctional cancers
Yuhan JIANG ; Zhiguo ZHAO ; Zhibo CAO ; Yingfa ZHOU ; Chao LIU ; Jingli REN ; Guiming HU ; Yanling HUANG ; Yanan WANG
Chinese Journal of Digestion 2017;37(3):183-189
Objective To investigate the expression of gastric and intestinal phenotypic markers in Siewert typeⅡand Ⅲ early gastroesophageal junction(GEJ) cancer, and to explore its correlation with clinic-pathological features.Methods From April 2010 to July 2015, 53 cases diagnosed as early GEJ cancer were enrolled.The gastric and intestinal phenotypic markers such as mucin5AC(MUC5AC),mucin6(MUC6),mucin2(MUC2),caudal related homeodomain transcription 2(CDX2) and cluster of differentiation 10(CD10) were detected, and then the patients were divided into gastric type, gastrointestinal type, intestinal type and non-classified type according to the results of immunohistochemical staining.Combined with Siewert classification the clinicopathological features were analyzed.Chi square test or Fisher′s exact test was performed for statistical analysis.Results In the cancer tissues of 47 patients with Siewert type Ⅱand Ⅲ early GEJ cancer, the case numbers of positive expression of MUC5AC,MUC6,MUC2, CDX2 and CD10 were 21(44.7%),19(40.4%),31(66.0%),27(57.4%) and 17(36.2%),respectively;the case numbers of gastric type, gastrointestinal type, intestinal type and non-classified type were 11(23.4%),14(29.8%),21(44.7%) and one(2.1%), respectively.The positive expression rates of MUC5AC and MUC6 in Siewert typeⅡwere 55.9%(19/34) and 50.0%(17/34),which were higher than those of Siewert typeⅢ(2/13), and the positive expression rate of MUC2 was 55.9%(19/34), which was lower than that of Siewert typeⅢ(12/13), and the differences were statistically significant (x2=6.240,4.679 and 4.053;all P<0.05).In Siewert typeⅡ, the proportion of intestinal type was 32.4%(11/34), which was lower than that of Siewert typeⅢ(10/13), and the differences were statistically significant (x2=7.142,P=0.010).In patients with Siewert typeⅡand Ⅲ early cancer, males predominated in intestinal type which were mostly well differentiated type with less submucosal carcinoma.The maximum diameter of tumor was less than those of gastric type and gastrointestinal type.In paracancerous mucosal tissues, the incidences of intestinal metaplasia in gastrointestinal type and intestinal type were 11/14 and 81.0%(17/21), which were higher than that of gastric type (3/11);the incidences of atrophy in gastrointestinal type and intestinal type were 12/14 and 85.7%(18/21),which were higher than that of gastric type (4/11),and the differences were statistically significant (Fisher′s exact test,all P<0.05).Conclusions Siewert typeⅡand Ⅲ early GEJ cancer can directly originated not only from gastric mucosa, but also from gastrointestinal and intestinal mucosa.Atrophy and intestinal metaplasia could exist before cancer genesis.
9.Effects of Different Methods of Preparation on the Contents of Chemical Components in Ligustri Lucidi Fructus
Wei XIAO ; Jan HUANG ; Zhifeng CHEN ; Guiming GUO
Chinese Journal of Information on Traditional Chinese Medicine 2015;(7):82-85
Objective To investigate the effects of different methods of preparation on the contents of nuzhenide and oleanolic acid in Ligustri Lucidi Fructus. Methods The same batch of Ligustri Lucidi Fructus was under preparation and process. RP-HPLC was used to determine the contents of nuzhenide and oleanolic acid in crude samples, wine-prepared samples, vinegar-prepared samples, and salt-prepared samples. Results The contents of nuzhenide were in the order as follow:salt-prepared samples (1.997 5%)>crude samples (1.600 7%)>wine-prepared samples (1.144 6%)>vinegar-prepared samples (0.894 6%). The contents of oleanolic acid were in the order as follow:wine-prepared samples (1.120 2%)>salt-prepared samples (0.924 6%)>vinegar-prepared samples (0.913 2%)>crude samples (0.899 8%). Conclusion Different methods of preparation have certain effects on the contents of nuzhenide and oleanolic acid in Ligustri Lucidi Fructus.
10.Prediction of new long non-coding RNA of laryngeal carcinoma by high-throughput RNA-Seq data
Yang ZHANG ; Guiming LIU ; Guoliang WANG ; Qi ZHONG ; Xiaohong CHEN ; Jugao FANG ; Zhigang HUANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(8):637-642
Objective To screen and identify the new long non-coding RNAs from transcriptome of laryngeal squamous cell cancer using strand-specific RNA-Seq technology and bioinformatics tools,and to analyze the difference expression of these LncRNAs.Methods RNA was extracted from laryngeal squamous cell cancer tissues of 10 patients and the strand-specific libraries were constructed for high-throughput sequencing.The low-quality data were filtered and the high quality sequencing reads were mapped to the reference genome and assembled.The obtained transcripts were classified and annotated,the optimized LncRNA identification pipeline was used to discover novel LncRNA in these transcriptome,and the characteristics of LncRNA were analyzed.Results A more optimized pipeline were established and 134 new LncRNA transcripts were found,which was not included in the public database.The new LncRNA transcripts had some characteristics in length distribution,ORF length,and expression.Conclusion Some new LncRNA from the transcriptome of laryngeal carcinoma were identified,with different expression,and they may play an important role in laryngeal squamous cell cancer.

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