OBJECTIVE To evaluate the safety of fondaparinux in pregnancy and provide reference for its rational clinical application. METHODS A search was conducted in databases including CNKI， Wanfang， PubMed， Embase， and Elsevier （the search time was from the construction of the database to December 17， 2024） to collect case report literature on fondaparinux use during pregnancy. Patient demographic information， fondaparinux use during pregnancy， concomitant medications， clinical manifestations， and treatment details were extracted for descriptive statistical analysis. RESULTS A total of 17 case reports regarding the use of fondaparinux during pregnancy were collected， involving 42 patients from 11 countries and 47 pregnancy records. Among these， 20 cases involved the use of fondaparinux for the prevention of pregnancy-related venous thromboembolism （VTE）， while 27 cases were fondaparinux treatment due to related conditions. A total of 29 occurrences of the patients were treated with fondaparinux due to a （family） history of VTE. Nine occurrences of complicated pregnancies were reported， and 35 patients had records of comorbidities or relevant medical histories. The adverse events that occurred during pregnancy with the use of fondaparinux include postpartum hemorrhage （7 cases） and excessive anticoagulation caused by inappropriate dosage （1 case）. Among the 7 cases of postpartum hemorrhage， 3 cases had a blood loss of no less than 1 000 mL （including 2 cases with uterine atony）， 3 cases had a drug discontinuation time of ≤12 h. CONCLUSIONS Based on the existing literature， the safety of fondaparinux during pregnancy is generally manageable， with the main adverse event being postpartum hemorrhage. The dosage， interval between discontinuation，comorbidities/medical history， and concomitant medications of fondaparinux may be the main causes of its adverse events.

On February 5,2024,the American Heart Association(AHA)released a scientific statement on the pharmacological management of cardiac arrhythmias in the fetal and neonatal periods.The statement discussed the mechanisms of arrhythmias,medication regimens,and fetal and neonatal aspects of pharmacokinetics.The statement proposed a consensus on drug treatment for arrhythmias in fetuses and newborns.This article interpreted the drug treatment part,and summarized the recommended medication and drug characteristics for fetal and neonatal arrhythmias to provide a reference for the drug treatment of fetal and neonatal arrhythmias in China.

In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.

Objective:To detect and analyze the contents of eight metal elements in water samples of plague foci in Yunnan Province.Methods:During the period from December 2015 to November 2016, the plague foci of Yulong, Jianchuan and Lianghe were selected as sampling sites, water samples were collected in areas with rodent activities in the 4 seasons of spring, summer, autumn and winter. The contents of eight metal elements calcium (Ca), iron (Fe), zinc (Zn), chromium (Cr), plumbum (Pb), manganese (Mn), cadmium (Cd) and cuprum (Cu) in water samples were measured by flame atomic absorption spectrometry (FAAS), and the data [median (interquartile distance)] were statistically analyzed.Results:Twenty-six, 58 and 54 water samples were collected from Yulong, Jianchuan and Lianghe plague foci, respectively. The contents of metal elements of Pb and Cd in water samples of the three plague foci [Yulong: 0.19 (0.78) and 0.08 (0.07) mg/L; Jianchuan: 0.23 (0.56) and 0.03 (0.06) mg/L; Lianghe: 0.13 (0.61) and 0.09 (0.08) mg/L] were higher than that of "Environmental Quality Standards for Surface Water" (Pb: 0.10 mg/L, Cd: 0.01 mg/L). There were significant differences in the contents of Ca and Cd elements among the three regions ( P < 0.05), but there was no significant difference in the contents of the other 6 metal elements among the three regions ( P > 0.05). The content of Ca element was the highest in Yulong plague foci, and the lowest in Lianghe plague foci ( P < 0.017). In the Yulong plague foci, there was no statistically significant difference in the content of Fe element in different seasons ( P > 0.05), and the differences in the contents of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Cr element in Jianchuan plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Ca element in Lianghe plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). Conclusion:The metal element contents of Pb and Cd are relatively abundant in water samples from 3 plague foci of Yunnan Province, and the seasonal variation trend of metal element content in water samples of Yulong and Jianchuan plague foci is similar.

OBJECTIVE： To optimize the extraction technology of total vitamin E in Euryale ferox. METHODS： With the extraction amount of total vitamin E as reference index， using extraction time， extraction times， ultrasound power and comminution degree as reference factors， single fator test and Box-Behnken design-response surface methodology was used to optimize the extraction technology of total vitamin E from E. ferox. The validation tests were conducted for 3 times （the amounts of E. ferox were 2.0， 20.0， 40.0 g）. RESULTS： The optimal extraction technology of vitamin E included that extraction time of 80 min， extraction times of 3 times， ultrasound power of 240 W， comminution degree of 80 mesh. In validation test， extraction rates of total vitamin E were 2.063， 2.103， 2.085 mg/g （RSD＝2.6％， 1.5％， 1.3％， n＝3）， the relative errors of which to predicted value （2.092 mg/g） were 0.14％， 0.53％ and 0.33％， respectively. CONCLUSIONS： The optimal extraction technology is reasonable， stable and feasible， and can be used for the extraction of total vitamin E in E. ferox.

OBJECTIVE: To study the effect of traditional chinese medicine (TCM) compound on myeloid leukemia cells and to explore its anti-leukemic mechanism. METHODS: Myeloid leukemia cell lines were cultured in vitro and treated with TCM compound. The proliferation of the leukemia cells was measured by CCK8 method. The differentiation of the leukemia cells was evaluated by using Wright＇s staining method and by light microscopy, and the expression of differentiation-related surface antigens such as CD11B was measured and by flow cytometry, the apoptosis of the leukemia cells was detected by flow cytometry with using Annexin V staining. RESULTS: Compared with untreated 4 leukemia cell lines HL-60, MOLM-13, MV4-11, AML-M5, the proliferations of 4 leukemia cells treated with different concentrations of TCM compound decreased (P<0.05), and their proliferation inhibition were in a dose-dependent manner (r=0.9236; r=0.7488; r=0.8889; r=0.8119); compared with HL-60 and AML-M5 leukemia cells, the drug-treated 2 leukemia cells displayed obvious differentiated changes; compared with untreated HL-60 leukemia cell line, the expression of surface antigen CD11B increased by 85%±7.13% in HL-60 cells treated IC50 concentration of drug; compared with untreated AML-M5 leukemia cell line, the apoptotic rate of AML-M5 treated with 1.5 and 2 μl doses of TCM compound increased. (P<0.05). CONCLUSION The traditional chinese medicine compound may inhibit the proliferation of leukemia cell lines mainly by inducing leukemia cell differentiation and apoptosis.
Apoptosis ; Cell Differentiation ; Cell Proliferation ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute

Objective: To evaluate the patients′ survival and effectiveness of the live cancer screening for population at high risk for liver cancer in Qidong. Methods: According to the Expert Scheme proposed the Expert Committee of Early Detection and Early Treatment, China Cancer Foundation, diagnostical screening by using combined methods of alpha-fetoprotein and B ultrasound monitoring were carried out biannually in individuals with positive HBsAg who were screened from Qidong area. The evaluation indices of the effectiveness are task completion rate of screening, detection rate of liver cancer, early diagnosis rate, and treatment rate. The deadline of the follow-up for the surviving outcome was March 31, 2016. The life-table method was used to calculate the observed survival, and to make comparison and significant tests between survival rates in Group A (those found via repeated periodic screening) and Group B (those diagnosed without periodic screening). Results: Since 2007, 38 016 target population have been screened, and 3 703(9.74%) individuals with positive HBsAg were found. Except for 29 patients with liver cancer at the initial screening, 3 674 persons in the cohort were followed up; 268 patients with liver cancer were detected from the 33 199 person-times screening, with an annual detection rate of 1.61%. Of them, 186 patients were found in Group A(1.12%), in which 149 patients were the early cases, with an early detection rate of 80.11%; 167 out of 186(89.78%) patients received treatment after diagnosis. The incidence of liver cancer in this HBsAg (+ ) cohort of 25 452 person-years was 1 052.96 per 100 000 annually, 187 cases in males(1 488.45/100 000)and 81 cases in females(628.46/100 000). The 1-, 3-, 5-, and 8-year survival of all patients with liver cancer were 64.55%, 40.50%, 32.54%, and 19.65%, respectively. The 1-, 3-, 5-, and 8-year survival rates were 77.16%, 49.04%, 38.53%, and 24.25% in Group A, and were 36.25%, 21.21%, 21.21%, and 0% in Group B, respectively, with significant differences between two groups (P<0.05). Conclusion The findings show that screening of individuals at high-risk of development of liver cancer, with semiannual AFP and B ultrasound, according to the Expert Scheme, is effective not only in increasing detection rate but also in detecting liver cancer at early stage, and in improving patients′ survival as well.

Objective To explore the clinical efficacy of nibble debridement combined with silver ions dressing in treatment of diabetic foot ulcer.Methods The data of 238 patients with diabetic foot ulcer in people's hospital of Meishan from January 2012 to December 2016 were retrospectively analyzed.Of which 125 patients were treated by nibble debridement combined with silver ions dressing(nibble debridement group),113 patients were treated with surgical debridement combined with silver ions dressing(surgical debridement group).The clinical efficacy,wound healing time and complication between two groups were compared.Results The wound healing time of nibble debridement group was (37.5 ± 10.8) days,which was shorter than (45.3 ± 11.7) days of surgical debridement group,the difference was significant (P ＜0.05).The total effective rate of nibble debridement group was 92.80％,which was higher than 73.45％ of surgical debridement group,the difference was significant(P ＜ 0.05).No complication occurred in two groups.Conclusion The method of nibble debridement combined with silver ions dressing treatment has a better satisfactory clinical result,shorter wound healing time and lower medical costs for patients with diabetic foot ulcer.

BACKGROUND:Along with the widespread application of biodegradable materials in the field of medicine and the in-depth research of biomechanics,the drawbacks of traditional medical metal materials are increasingly appearing.In recent years,researchers at home and abroad focus on biodegradable materials that are represented by high molecular polymer to seek new breakthroughs in the field of spinal instability.OBJECTIVE:To investigate biomechanical changes of polylactic acid-polyglycolic acid (PLGA) lumbar interbody fusion cage in the body and discusses its feasibility for treating segmental instability of the spine.METHODS:Forty-two healthy pigs (9 months old) were randomly divided into two groups (n=21),and L4/5 intervertebral disc nucleus pulposus was removed in all animals.In experimental group,PLGA lumbar interbody fusion cage filled with broken bone was implanted;and in control group,autologous bone was implanted.X-ray was performed to observe the fusion of operation segments at 4,12 and 72 weeks postoperatively.Feasibility of fibrous fusion was measured by biomechanical test.Histologically,bone graft fusion at the surgical site and material degradation were detected.RESULTS AND CONCLUSION:(1) Imaging examination:Bone graft fusion in two groups was not visible at 4 weeks after operation.Evidence of increasing fusion was found in the experimental group at 12 weeks after operation;a visible part of the bone bridge was found in the control group,in which there was one case of fusion.Degradation of the fusion cage with one case of fusion in experimental group was found after 72 weeks after operation,and two cases of fusion in the control group.(2) Biomechanical test:There was no difference in the spinal range of motion between the two groups in different states at 4 weeks after operation (P ＞ 0.05).The spinal range values of motion at most of the states at 72 weeks after operation were significantly lower than those at 4 weeks after operation.(3) Cell histology observation:With the passage of time,the materials in the experimental group degraded gradually;new bone grew slowly and then fast,with bone fusion step by step.Fusion results were similar in the two groups.Our experimental findings indicate that the PLGA lumbar fusion cage has good biocompatibility.In addition to the individual state (left flexion),the mechanical properties of the fusion cage are similar to that of autogenous bone,and the fusion cage enables the segmental reconstruction of the pig spine to the maximum extent.

Objective To systematically evaluate the psychological intervention effect of music therapy on the patients during the digestive endoscopic process.Methods The databases of EMbase,PubMed,Cochrane Library,CNKI,VIP,Wanfang and CSCD were retrieved by computer,the retrieval time was from their establishment to March 2016.The randomized controlled trials (RCTs) on the music therapy application in the digestive endoscopic process were included.The data were independently extracted by 2 researchers for conducting the literature quality assessment.After extracting and checking the data,the meta analysis was performed by using the RevMan 5.3 software.Results Twenty-six RCTs conforming to the standard were included,involving 4593 patients.The meta analysis results showed that the music therapy could alleviate the anxiety status(SMD=-0.82,95％ CI:-1.14--0.49,P＜0.01),relieve the pain perception(WMD=-1.27,95％CI:-1.87--0.66,P＜0.01),remit the vital signs fluctuations of blood pressure,heart rate and respiratory rate(P＜0.01),meanwhile shorten the duration of examination procedure (WMD=-4.64,95％CI:-6.75--2.52,P＜0.01).Conclusion The current evidences indicate that the music application during the digestive endoscopic process can obviously decrease the anxiety status and pain perception.