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.

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.

Objective: To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. Methods: Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. Results: A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046). Conclusion Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids.

Objective To construct a questionnaire for patients to participate in hand hygiene promotion in medical institutions,and provide a measuring tool for patients to participate in hand hygiene promotion.Methods A ques-tionnaire was constructed by methods of literature research,expert panel discussion,pre-investigation,and Delphi. Results This questionnaire was designed respectively for patients and health care workers,each contained 20 ques-tions,involving hand hygiene perception,willingness to participate in promoting hand hygiene,and participation method,et al.Conclusion A questionnaire for patients to participate hand hygiene promotion in medical institutions is preliminary constructed,which can be used for evaluating patients’and HCWs’willingness and relevant influen-cing factors of patients’participation in hand hygiene promotion in medical institutions.

OBJECTIVETo observe the protective effect of Injection of Panax quinquefolium diolsaponins (IPQDS) and its mechanism on acute myocardial infarction in rats.

METHODThe acute myocardial infarct model was prepared by left anterior descending coronary occulusion for 24 hours in open chest anesthetized rats. The myocardial infarct size (MIS) was calculated. The activities of serum creatine hosphokinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the contents of malondialdehyde (MDA) and nitric oxide (NO) were determined. Blood was collected to observe low shearing specific viscosity, middle shearing specific viscosity and high shearing specific viscosity of whole blood and plasma viscosity. At the same time, the platelet aggregation rate and platelet adherence rate were also determined.

RESULTIn rats treated by IPQDS (in a dosage of 12.5, 25 and 50 mg x kg(-1) d, i.p. 3d ), the MIS was significantly reduced. The activities of serum CK, LDH and AST, and the content of serum MDA were declined. The activities of SOD and GSH-Px, and the content of NO were increased markedly. In addition, low shearing specific viscosity, middle shearing specific viscosity and high shearing specific viscosity of whole blood and plasma viscosity as well as platelet aggregation rate were also declined significantly. But platelet adherence rate had no significant change.

CONCLUSIONIPQDS has a protective effect on acute myocardial ischemia, which may be related to increasing activity of antioxidase in body, scavenging the damage of peroxidation from oxygen free radicals, decreasing the viscosity of blood and plasma and preventting thrombosis etc.

Animals ; Aspartate Aminotransferases ; metabolism ; Creatine Kinase ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Myocardial Infarction ; drug therapy ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Wistar ; Saponins ; therapeutic use ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the effect of Acanthopanax senticosus saponins (ASS) on oxidative damage induced by hydrogen peroxide (H2O2 ) in cardiomyocytes.

METHODThe cardiomyocytes were induced to oxidative damaged by exposed to H2O2. We evaluated the level of oxidative injury through morphology change, the survival rate, the activity of lactate dehydrogenase (LDH) and the content of cellular malondialdehyde (MDA). The activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and the content of reductive glutathione (GSH) of cardiomyocytes were also determined.

RESULTWhen the cardiomyocytes were exposed to H2O, (50, 100, 200 micromol x L(-1)) for deigned time, the percentage of survival cells was down significantly (P < 0.01 or P < 0.001), and the activity of LDH and the content of MDA were increased markedly (P < 0.05, P < 0.01 or P < 0.001). These results show that the cells were subjected to oxidative damage. Treatment with ASS (600 mg x L(-1)) prior to H2O2 exposure could increase cell viability significantly, lessen cardiomyocyte morphological damaged change, and decrease LDH activity (1687.40 +/- 97.51) U x mL(-1) in media and cellular MDA content (16.50 +/- 2.66) nmol x mg(-1) markedly (P < 0.01 and P < 0.05). Furthermore, the activities of SOD (89.55 +/- 6.93) U x mg(-1), GSH-Px (845.87 +/- 63.76) mU x mg(-1), CAT (93.07 +/- 10.40) U x mg(-1) and the content of GSH (8.91 +/- 1.06) micromol x mg(-1) of cardiomyocytes were also raised by 600 mg x L(-1) l ASS (P < 0.05).

CONCLUSIONTaken together, the study implicate that ASS protects cardiomyocytes against oxidative-stress injury induced by H2O2 through reduction of lipid peroxidation and enhancement of the activity of antioxidant defense.

Animals ; Animals, Newborn ; Catalase ; metabolism ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Eleutherococcus ; chemistry ; Female ; Glutathione Peroxidase ; metabolism ; Hydrogen Peroxide ; pharmacology ; Male ; Myocytes, Cardiac ; drug effects ; enzymology ; metabolism ; Oxidative Stress ; drug effects ; Rats ; Rats, Wistar ; Saponins ; pharmacology ; Superoxide Dismutase ; metabolism

Objective To investigate the clinicopathologic features and imaging findings of several kinds of rare and uncommon brain embryonal tumours. Methods MRI or CT appearance and clinicopathologic features in 10 eases of histopathology confirmed brain embryonal tumours were retrospectively analyzed.Results Among 10 cases,there were supratentorial primitive neuroectodermal tumour(sPNET) in 6,ependymoblastoma in 2,medulloepithelioma and atypical teratoid/rhabdoid tumour (AT/RT)in 1 respectively.Patients in 4 cases were infancy and childhood.There was characteristic of the clinicopathologic features of tumors that were the evidence of accurate diagnosis. All lesions were located in the supratentorial region.The tumors were large,usually lobulated in shape irregularly and showed heterogeneous density or signal intensity with some cystic and necrotic areas.The tumors parenchyma appeared slightly high density on CT imaging,iso-or high signal on T2WI and slight low signal on T1WI with intense enhancement after contrast injection.Conclusion MRI or CT findings of rare and uncommon brain embryonal tumours were not characteristic,it Was very essential to know the tumors combined with the clinical and pathologic features.

Objective To discuss the value of detection of small liver tumor with Galactose-Bovine-serum-albumin containing superparamagetic(Gal-BSA-SPIO) in rabbits primarily.Methods Gal-BSA-SPIO was obtained by stabilizing small superparamagnetic iron with galactose-bovine-serum-albumin,and its size was measured.Models of liver tumor(diameter＜1.5 cm) in rabbits were founded.The animals were randomly divided into groups of SPIO (n=10) and group of Gal-BSA-SPIO (n=10).Each group was further subdivided as 5 μmol Fe/kg group (n=5) and 10 μmol Fe/kg group (n=5),respectively.All animals were performed magnetic resonance imaging before and after administration of agents according to groups.SE T2WI,FSE T2WI and GRE T2WI sequences were used.Then signal of noise(SNR) of liver and contrast-noise ratio(CNR) of tumor-liver were measured and compared statistically.The histopathology study was performed for liver and tumor specimens after MR imaging.Results The mean value for the volume size was 34.4 nm,and the core particle size was 14.8 nm.The differences of liver SNR between before and after enhancement for 5 μmol Fe/kg SPIO,5 μmol Fe/kg Gal-BSA-SPIO,10 μmol Fe/kg SPIO and 10 μmol Fe/kg Gal-BSA-SPIO group were (1.92±0.42),(3.75±0.51),(3.25±0.72) and (4.73±0.34) on SE sequence,respectively;(1.56±0.18),(3.56±0.64),(3.33±0.16) and (4.83±0.16) on FSE sequence,respectively;(5.55±0.91),(9.58±0.66),(9.20±0.29) and (10.63±0.32) on GRE sequence,respectively.There were significant differences between all groups for difierent doses and agents and within all different sequences (P＜0.01).The differences of tumor-liver CNR between before and after enhancement of these 4 groups were(2.22±0.68),(5.27±0.22),(4.25±0.51) and (6.97±0.63) on SE sequence,respectively;(1.73±0.41),(4.46±0.54),(3.73±0.49)and (5.39±0.39) on FSE sequence,respectively;(5.98±0.71),(11.79±0.57),(9.57±0.54)and(14.64±1.35)on GRE sequence,respectively.The differences between all groups of different doses and agents and within all sequences showed significant (P＜0.01). Histopathological study revealed that Gal-BSA-SPIO was mainly distributed in hepatocytes while SPIO mainly in Kupffer cells.Conclusion Gal-BSA-SPIO is a agent with good negative enhancement effect in liver.It may be helpful for detecting small tumor of liver.

Objective To explore the expression and significance of chemokine CXC reeeptor (CXCR)3 and CXCR4 and their ligands(CXCL)at the early pregnancy decidua and villi.Methods Decidual mononuclear cells were isolated from the normal decidua of 5-8 weeks pregnant women by lymphocyte separation medium in vitro.CD56+natural killer(NK)cells were purified by dynabeads cell sorter kiL Purity and phenotype of CD56+decidua NK cells were analyzed by fluorescence-activated eell sorter (FACS).Gene expression of CXCR3 and CXCR4 in decidua NK cells and CXCL9,CXCL10 and CXCL12 in early pregnancy decidua and villi was assessed bv RT.PCIZ Protein expression of CXCL9,CXCL10 in normal endometrium and early pregnancy decidua was characterized and quantified by streptavidin-biotin pemxidase chain reaction(SP)immunohistochemistry and computered image analysis system.Correlations between the gray degree of CXCL9 and CXCL10 and the number of CD56+NK cells in upper tissue were analyzed by Spearman's correlation ceefficient rank tesL Results The phenotype of 98.7%decidua NK cells was CD56bright.The genes of CXCR3 and CXCR4 were expressed in decidua NK cells and that of CXCL9 and CXCL1O were expressed in early pregnancy decidua and CXCLI2 in early pregnancy villi.CXCL9 and CXCL10 were expressed in the cytoplasm of surface epithelia,glandular epithelia and stromal cells of early pregnancy deeidua and were not expressed in villi by immunohistochemistry.The gray degree of CXCL9 and CXCL10 in the secretory phase endometrium(56±43,59±47)was stronger than that in the proliferative phase(16±18,8±14,P<0.05)and reached the highest(143±35,158±29,P<0.05)in the early pregnancy decidua.The number of cD+56 NK cell in the secretory phase endometrium(60±20)was more than that in the proliferative phase endometrium(23±4,P<0.05)and was the most in the early pregnancy decidua(114±15,P<0.05).The gray degree of CXCL9 in upper tissue had a positive correlation with the number of CD+56 cells(r=0.88,P<0.05)and that of CXCL10 had a similar pattern to CXCL9(r=0.86,P<0.05).Condusion The interactions between CXCL9,CXCL10 and CXCL12 expressed in decidua and villi and CXCR3,CXCR4 expressed in CD+56 decidua NK cells may influence the CD+56 NK cell recruitment at the maternal-fetal interface.

Objective To study the effect of Acanthopanax senticosus saponins (ASS) on organ blood flow and vascular resistance in anesthetized dogs.Methods The cerebral blood flow(CBF),cerebral vascular resistance(CVR),peripheral blood flow(PBF),peripheral vascular resistance(PVR),blood pressure(SDP and DBP) and heart rate(HR) were measured using the MF-27 electromagnetic flowmeter.Results ASS(15 and 30 mg?kg~(-1) iv perfusion for 60 min) augmented CBF and PBF,decreased CVR and PVR within 180 min and slowed down HR at 60-180 min.In addition,ASS(30 mg?kg~(-1) iv perfusion for 60 min) could obviously reduce SBP and DBP.Conclusion Protective effect of ASS on experimental cerebral ischemia may be related to improving cerebral circulation and increasing cerebral blood supplyment.