Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

At present, the issues regarding multi-center clinical trials of new drugs of traditional Chinese medicine(TCM) remain: the lack of agreement on the content and scope of the ethical review among the ethics committee members of the center and the participating units results in repeated review, which leads to a time-consuming ethical review process. Moreover, the review capabilities of the ethics committees of various research centers are uneven, which is not necessarily beneficial to the protection of subjects' rights and safety. In view of the existing problems, to improve the efficiency of ethical review of multi-center clinical trials of new drugs of TCM and avoid repeated reviews, the TCM Clinical Evaluation Professional Committee of Chinese Pharmaceutical Association organized experts to formulate the "Consensus on collaborative ethical review of multi-center clinical trials of new drugs of TCM(version 1.0)"(hereinafter referred to as "Consensus"). The "Consensus" is formulated in accordance with the requirements of relevant documents such as but not limited to "the opinions on deepening the reform of the evaluation and approval system to encourage the innovation of pharmaceutical medical devices", "the regulations of ethical review of biomedical research involving human subjects". The "Consensus" covers the scope of application, formulation principles, conditions for the ethics committee of the center, sharing of ethical review resources, scope and procedure of collaborative review, rights and obligations, etc. The aims of the "Consensus" is to preliminarily explore and establish a scientific and operable ethical review procedure. Additionally, on the basis of fully protecting the rights and interests of the subjects, a collaborative ethical review agreement needs to be signed to clarify the ethical review responsibilities of all parties, to avoid repeated review, and to improve the efficiency and quality of ethical review in multi-center clinical trials of new drugs of TCM.
Biomedical Research ; Clinical Trials as Topic ; Consensus ; Drugs, Chinese Herbal ; Ethical Review ; Humans ; Medicine, Chinese Traditional ; Multicenter Studies as Topic ; Pharmaceutical Preparations

ObjectiveTo investigate the prevalence and epidemiological characteristics of norovirus in adult cases with infectious diarrhea in Putuo District of Shanghai， and provide scientific evidence for the prevention and control of infectious diarrhea caused by norovirus. MethodsFecal samples， clinical information and epidemiological data were collected from January 2013 through December 2019 in surveillance hospitals in Putuo District of Shanghai. Norovirus was examined by real-time fluorescent quantitative reverse transcription polymerase chain reaction （rRT-PCR）. ResultsIn 1 389 adult cases with infectious diarrhea， norovirus positive rate was 25.41%， which was significantly higher in male （27.16%） than female （23.89%）. Furthermore， in 353 cases positive for norovirus， GⅡ group was the most common （77.98%）.The positive rate was highest in the cases aged 30-44 years. Spring， autumn and winter were the seasons with higher incidence of norovirus （September to May）. The norovirus-infected cases had more nausea， vomiting， hyperactivity of bowel sounds， and watery stool， compared to the negative cases （P<0.05）. ConclusionThe detection rate of norovirus remains high in adult cases with infectious diarrhea in Putuo District of Shanghai， of which GII is predominant. Seasonality may be spring， autumn and winter. Therefore， it warrants the countermeasures， such as surveillance and health education， for prevention and control of norovirus in susceptible population during epidemic seasons.

Objective To construct the recombinant plasmids of knocking down Rho guanine dissociation inhibitor α (GDIα ) gene by using clustered regularly interspaced short palindromic repeats/associated protein 9 (CRISPR/Cas9) technique, and investigate the effect of Rho GDIα interference on the migration of Hepa 1-6 cells of mouse in order to provide the method of prevention and treatment of liver cancer. Methods To construct and identify the PX458-Rho GDIα-single guide (sg) RNAs by using CRISPR/Cas9 technique. And the Hepa 1-6 cells were transfected by liposomes with PX458-Rho GDIα-sgRNAs for 48 hours respectively, and cells treated with PX458 plasmids were used as control. The migration ability of Hepa 1-6 was checked by wound healing assay and Transwell assay, respectively. Results The expression of Rho GDIα was depressed in group of PX458-Rho GDIα-sgRNAl transfection which was detected by using RT-PCR. The migration distance of Hepa 1-6 in PX458-Rho GDIα-sgRNAl transfection group was significantly promoted comparing with the control group which was transfected with PX458 only, and the cell number of PX458-Rho GDIα-sgRNAl group was more than that in control group by using transwell assay, indicating concluded that knocking down of Rho GDIα promoted the migration ability of Hepal-6 cells. Conclusion The result is explicit that in vivo, Rho GDIα may inhibit the migration of Hepal-6 partially. Overexpression of Rho GDIα might be used as an important method to prevent the metastasize of carcinoma.

Objective:To explore the willingness to use mobile healthcare in patients with gout and explore its influencing factors, and provide theoretical guidance for optimizing the gout mobile healthcare platform and improving patients' willingness to use it.Methods:This study was a cross-sectional study. Totally 234 patients with gout who attended the outpatient service in Shandong Provincial Gout Clinic Medical Center from November 2019 to January 2020 were selected by convenient sampling, and investigated with a self-designed general information questionnaire and questionnaire of gout patients' willingness to use mobile healthcare and its influencing factors. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of gout patients' willingness to use mobile healthcare.Results:A total of 53.85% (126/234) of patients with gout mainly used gout WeChat official account as a form of mobile healthcare, and the commonly used functions were diet guidance (64.96%, 152/234) , disease knowledge (60.26%, 141/234) , exercise guidance (54.27%, 127/234) ; 47.01% (110/234) of patients were not satisfied with mobile healthcare. The gout patients' willingness score to use mobile healthcare was (10.91±3.28) . Univariate analysis showed that there were statistically significant differences in the willingness scores of patients with different personal monthly income, education level, and whether have comorbid diseases ( F/t=12.511, 6.343, -2.229; P< 0.05) . Regression analysis showed that the influencing factors of gout patients' willingness to use mobile healthcare included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, information quality and system quality (adjust R2=0.446, P<0.01) . Conclusions:The willingness of gout patients to use mobile healthcare services is at a moderately high level, and there are differences between different individuals. The willingness to use mobile healthcare is affected by patients' health beliefs and the quality of mobile healthcare information systems.

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

Objective:Aphanamixis grandifolia，a perennial herb of genus Aphanamixis （Meliaceae），has effects in soothing activating collaterals，dredging paisy，expelling wind-evil and removing wetness. This paper aimed to investigate terpenoids from the stems and leaves of A. grandifolia and reveal the effective substances. Method:Totally 22 kg leaves and twigs of A. grandifolia were extracted with 90% EtOH for three times by heating reflux. These extracts were decompressed and concentrated，and then dissolved in water. The solvent was successively extracted with petroleum ether and ethyl acetate. The chemical constituents from petroleum ether and ethyl acetate fractions were isolated by macroporous，silica gel，Sephadex LH-20 and ODS columns，and their chemical structures were determined through MS，NMR analysis（¹H and ¹³C-NMR）and spectroscopic data from literatures，respectively. Result:Twelve compounds were obtained and identified as 16α-hydroxy-3-oxo-24-methyllanosta-7，9（11），24（31）-triene-21-oic acid （1），23（E）-cycloart-en-25-ethoxy-3-ol（2），23（Z）-9，19-cycloart-ene-3β，25-diol（3），23（E）-cycloart-en-3β，25-diol（4），labda-8，13-（E）-dien-15-ol（5），labda-7，13-（E）-dien-15-ol（6），vulgarol（7），（S，E）-6-[6-（5，5-dimethyl-4-oxo-4，5-dihydrofuran-3-yl]-2-methylhepta-1，6-dien-1-yl]-4-methyl-5，6-dihydro-2H-pyran-one（8），nemoralisin（9），nemoralisin C（10），1S，4R，5S，6R，7S，10S-1（5），6（7）-diepoxy-4-guaiol（11） and 1S，4S，5S，10R-4，10-guaianediol（12），respectively. Conclusion:The structures involves triterpenoids，diterpenoids and sesquiterpennoids，and eight of them （1-3，5-8 and 12） are obtained from A. grandifolia for the first time. Those compounds are also isolated from the geneus Aphanamixis for the first time.