RESUMEN

Objective To investigate the incidence and causes of medication errors(MEs)related to aspirin in the eld-erly(≥60 years old)of China,to provide data for targeted precautions,and to promote medication safety in the elderly.Methods Reports about aspirin-related MEs in the elderly were extracted from the National Monitoring Network for Clinical Safe Drug Medication from September 22,2012 to September 22,2022.The severity of errors,content of errors,where errors were made,the personnel who made these errors,and causes of errors were analyzed retrospectively and statistically.Results A total of 386 MEs reports were extracted,235 males and 151 females,with a median age of 70(60-98)years old.Regarding the severity of MEs,errors of class B were dominating(314 cases,81.35%).As for the severe MEs(9 cases,2.33%),5 cases of ME were as-sociated with bleeding.There are four patients suffering from gastrointestinal bleeding:one patient took aspirin three times a day,one patient broke off enteric-coated tablets,one patient took aspirin as acarbose mistakenly,one patient took aspirin with Xuesai-tong for long time.One patient had urinary urgency,but did not seek medical attention in time,then developed into visible hema-turia.Two patients missed taking aspirin led to stent thrombosis.One patient suffered from diarrhea after overdosing on 29 pills of aspirin by mistake.One patient with hyperuricemia had gout after taking aspirin.Among these 386 MEs,224(58.03%)cases were triggered by physicians,the first three error factors were frequency(multiple times a day),dosage(the dosage of enteric-coated tablets is not the whole tablet),and variety.Most of these MEs were due to a lack of knowledge or training,and fatigue.Regarding the MEs caused by pharmacists(87 cases,22.54%).Pharmacists identified 274 cases(70.98%)of errors.Conclusion When it comes to aspirin-related MEs,it ought to be noticed that the drug usage and dosage,drug interaction,and selection of drug varieties when combining with other diseases(such as atrial fibrillation and hyperuricemia).It is recommended that information construction be fortified to decrease the ME of the prescription link,and the clinicians be better informed of rational drug use.At the same time,patient medication education should be improved.

RESUMEN

Rapid and living guidelines are those developed in response to public health emergencies in a short period of time using a scientific and standardized approach. Subsequently， they provide timely and credible recommendations for decision makers through regular and frequent updates of clinical evidence and recommendations. In this paper， we introduced the definition of rapid and living guideline as well as analyzed the basic characteristics of eight rapid and living guidelines in the field of traditional Chinese medicine （TCM） published till 2023 June， summarizing three core methodological issues in relation to how to rapidly develop guidelines， how to formulate recommendations when there is lack of evidence， and how to ensure the timeliness of guidelines. Based on the analysis of current rapid and living guidelines， it is implicated that there is necessity to carry out rapid and living guideline in the field of TCM， and the methodology of rapid integration of multivariate evidence in the field of TCM needs to be further explored； furthermore， it is necessary to further explore the obstacles of implementation of guidelines and promote timely updating， all of which provide certain theoretical references for relevant guideline developers and researchers.

RESUMEN

It is necessary to develop rapid and living guidelines in order to improve the evidence translation and guidance for clinical practice in emergency situations， and to enhance the participation of traditional Chinese medicine （TCM） in management of emergencies. This paper introduced the process of developing rapid and living guidelines of TCM and divided it into three stages， that is preparation， rapid development and dynamic updating， which highlights the features of rapid development， high quality， and dynamic updating and the integration with the predominance of TCM. By comparing with general guidelines on composition， personnel number， timing to formulate and communication patterns of the guideline working groups， as well as the content and number of clinical questions， this paper mainly gave suggestions on how to formulate a concise but authoritative team during the preparation stage， how to efficiently manage the guideline team and promote the development process from conflict of interest management， working and communication mode adjustment， and how to formulate and update the important and prioritized clinical questions， all of which may provide reference for the development of TCM rapid and living guidelines.

RESUMEN

The lack of direct evidence is an important problem faced in the formation of recommendations in rapid living guidelines of traditional Chinese medicine under public health emergencies， and the supplementation of indirect evidence can be a key method to solve this problem. For the collection of evidence， the type of evidence required， including direct and indirect evidence， should be clarified， and ‘direct first’ principle for selecting evidence can be set to standardize and accelerate the guideline development. When integrating evidence， recommendations can be formed directly if there is sufficient direct evidence， while regarding insufficient direct evidence， recommendations need to be supplemented and improved by integrating indirect evidence. In addition， when the body of evidence contains evidence from multiple sources， it is suggested to rate the evidence according to “higher rather than lower” principle. Finally， when forming recommendations， the level of evidence， safety and economic efficiency should be taken into consideration to determine the strength of the recommendation.

RESUMEN

In developing rapid and living guidelines of traditional Chinese medicine （TCM） in response to public health emergencies， it is important that evidence continue to be reviewed， and clinical questions and recommendations updated if necessary， due to the rapid changes in disease progression and the continuous generation of relevant research evidence. This paper proposed that the updating scope in dynamic mode should first be identified； then evidence monitoring should be carried out in four aspects， including clinical research， related guidelines or laws and regulations， disease progression， as well as clinical use of recommendations and clinical needs； finally， based on the results of the evidence monitoring， different options should be made， including revising the clinical questions， updating the evidence and recommendations， and withdrawing the guideline.

RESUMEN

Obesity initiates numerous diseases like cardiovascular, metabolic, and type 2 diabetes, and obesity is a vital cause of death worldwide. Plants are necessary to the source of life. Several drug compounds isolated from plants are called phytochemicals which are safe, effective drug moieties to treat several diseases. Berberine chloride is a dual topoisomerase I and II inhibitor, that exhibited potent antitumor activities against several malignancies. However, the effect of Berberine on mitochondria remains unknown. The focus of this study was to determine the role of Berberine on mitochondrial uncoupling protein (UCP1), ATP production, and cytotoxic effect of HEK293T cell at a time and dose-dependent manner analysis by CCK8 assay. The upregulation of mitochondrial UCP1 gene expression reduces adipocyte content by initiating thermogenesis. In this study, berberine chloride significantly up-regulates UCP1 gene expression in brown adipocytes. AT 10 µM concentration of Berberine 48 h treatment demonstrated significant cell death. The decreased level of ATP production leads to mitochondrial uncoupling. Initiate thermogenesis reducing fat droplets in adipocytes. The first time, we used molecular docking and dynamic of Berberine with UCP1 gene in this study and revealed therapeutic potential of Berberine via modulation of mitochondrial UCP1 gene. Further investigation will reveal new insight into mechanisms to treat metabolic-related diseases.Communicated by Ramaswamy H. Sarma.

Asunto(s)

RESUMEN

Objective:To analyze and compare the incidence of catheter related complications between midline catheter (MC) and peripherally inserted central catheter(PICC) within 30 days. Provide guidance and basis for medical staff to choose appropriate intravenous infusion tools to prevent catheter related complications.Methods:The randomized controlled trials, clinical controlled trials and cohort studies about MC and PICC related complications were searched in PubMed, Web of Science, Cochrane Library, Embase, EBSCO, Ovid, CNKI, VIP, Wanfang database and CBM, which were published at home and abroad up to December 31, 2021. After screening the literatures, extracting data and quality evaluation according to the inclusion and exclusion criteria, RevMan5.4 software was used for statistical analysis.Results:A total of ten articles were included in this study, including two randomized controlled trials, a clinical controlled trials, a prospective cohort study and six retrospective cohort studies, with 12 765 cases in MC group and 33 783 cases in PICC group. The results of Meta-analysis showed that the incidences of catheter-related bloodstream infection and catheter displacement in MC group were significantly lower than those in PICC group ( RR=0.37, 95% CI 0.18-0.76, P<0.05; RR=0.49, 95% CI 0.25-0.97, P<0.05). Conclusions:Compared with PICC in the early stage of intravenous infusion, MC is safer and more effective. When continuous infusion of isotonic or near-isotonic medications is required, and there is no need for continuous vesicant medications, MC can be preferred. However, more large-sample and high-quality studies are still needed to provide a basis for the popularization of MC in China.

RESUMEN

Objective:This study aims to explore the feasibility of ethical review and mutual recognition, focusing on the operational efficiency and review processes of the Ethics Committees in Tianjin′s third-level hospitals.Methods:A thorough online survey was conducted across tertiary hospitals in Tianjin, utilizing a detailed questionnaire. The survey primarily examined the operations and reviews of Ethics Committees from 2019 to 2022, evaluating the efficiency of ethical reviews, the effectiveness of clinical research administration, and the hospitals′ perspectives on mutual recognition of ethical reviews. From 29 collected responses, 28 were deemed suitable for in-depth statistical analysis.Results:In Tianjin′s 28 surveyed tertiary hospitals, 16 routinely hold ethics review meetings monthly. Nine hospitals have established pre-ethics review processes, and three have achieved mutual recognition of their ethical review outcomes. Additionally, five hospitals have integrated electronic information systems. From 2019 to 2021, there has been an increase in clinical trials and Investigator-Initiated Trials (IITs) under initial review, with a significant presence of multi-center clinical trials (90%) and multi-center IIT studies (75%). The timeframe for clinical research review opinions ranged from 18.84 to 20.69 days between 2019 and September 2022, while the duration for clinical research review approvals varied from 22.03 to 23.68 days. During the same period, clinical trial management efficiency spanned from 48.42 to 62.65 days, and IIT study management efficiency was between 25.54 to 28.17 days. Participants identified the main factors influencing management efficiency as stemming from research institutions and sponsors.The majority of hospitals expressed support for the advancement of mutual recognition of ethical reviews and the implementation of a unified submission checklist and template.Conclusions:The Ethics Committees in Tianjin′s third-level hospitals have progressively evolved towards standardization. There is a marked improvement in the efficiency of ethical reviews and overall management of clinical research, indicating a positive development towards more streamlined and effective ethical governance in clinical studies.

RESUMEN

There are specific ethical requirements and review principles for submitting papers or reports in medical academic journals. Researchers often consult the ethics committee on the rationality of the ethical requirements of journals at the (to be) submission stage, or ask for assistance in solving the ethical review requirements of journals: applying for ethical review for the clinical research to which submitted papers or research reports. Based on the perspective of hospital ethics committee, this paper discussed the ethical review requirements of academic journals for clinical research papers or reports. Combined with the practice of handling clinical research authors’ demands, the current situation of applying for ethical review, common problems and cases, this paper put forward three suggestions: academic journals should concretize the ethical review requirements of submitted papers or reports; researchers should internalize "ethics first" in their hearts, and conduct research according to laws and regulations; ethics committee should give full play to positive guidance and services, and cooperate with clinical research management departments to strengthen and complete the supervision of clinical research. So as to provide ideas for further standardizing the publication of clinical research papers and reports.

RESUMEN

INTRODUCTION: Fatal familial insomnia (FFI) is a rare clinical case. The study was mainly to report the clinical symptoms and imaging and genetic characteristics of a FFI case with depression, with relevant literature summarized. PATIENT CONCERNS: A male, aged 57 years old, with mental disorders and progressive memory decline one year before admission. DIAGNOSIS: Clinical manifestations: he had obvious abnormal mental behavior, rapidly progressing dementia symptoms, stubborn insomnia, abnormal movements and laryngeal stridor after falling asleep at night. Imaging and genetic test results: the cranial magnetic resonance imaging showed frontal temporal lobe atrophy; the polysomnography results showed no effective sleep; the 14-3-3 test result of cerebrospinal fluid was negative; the prion protein (PRNP) test showed that the D178N gene locus had mutations. And the patient was finally diagnosed as FFI. INTERVENTIONS: There were no obvious effects in the treatment using medicines such as Risperidone, Olanzapine, Alprazolam, Clonazepam, and Deanxit. OUTCOMES: Mobility dysfunction of the patient was further aggravated. He was no longer able to move around on his own, and there were serious mental disorders. CONCLUSION: PRNP examination is of guiding significance for the diagnosis of the FFI of depression. Hence, it is very necessary to perform PRNP examination in clinical diagnosis of FFI of depression.

Asunto(s)

RESUMEN

Since December 2019,severe acute respiratory syndrome coronavirus 2 has been found to be the culprit in the coronavirus disease 2019 (COVID-19),causing a global pandemic.Despite the existence of many vaccine programs,the number of confirmed cases and fatalities due to COVID-19 is still increasing.Furthermore,a number of variants have been reported.Because of the absence of approved anti-coronavirus drugs,the treatment and management of COVID-19 has become a global challenge.Under these circumstances,drug repurposing is an effective method to identify candidate drugs with a shorter cycle of clinical trials.Here,we summarize the current status of the application of drug repurposing in COVID-19,including drug repurposing based on virtual computer screening,network pharmacology,and bioactivity,which may be a beneficial COVID-19 treatment.

RESUMEN

ObjectiveTo discuss the family environment characteristics of senior high school students with psychological problems， and to provide references for realizing management of senior high school students' mental health. MethodsA total of 1 917 senior high school students in Foshan No. 2 Middle School were enrolled， and assessed using Middle School Student Mental Health Scale （MSSMHS-60） and a self-compiled family environment questionnaire. Then the family environment characteristics of senior high school students with psychological problems were analyzed. ResultsThe total score of MSSMHS-60 was （1.83±0.49） in 1 917 senior high school students， and was （2.40±0.36） in 602 （31.40%） students with psychological problems. The detection rate of psychological problems demonstrated significant difference among senior high school students with different status of companionship， household finance， parental rearing style and kinship （χ2=16.951， 38.142， 90.545， 59.448， P<0.05 or 0.01）. Binary Logistic regression analysis showed that the presence of frequent parental quarrels was a risk factor for senior high school students' mental health （OR=3.120， P<0.01）. ConclusionThe detection rate of psychological problems is high among senior high school students in Foshan City， and family disputes is a risk factor for psychological problems.

RESUMEN

AIM: To provide reference for the clinical application of tigecycline and subsequent population pharmacokinetic-pharmacodynamics study in the future. METHODS: The Chinese and English keywords of "Tigecycline", "population pharmacokinetics", "population pharmacokinetic model", "pharmacodynamics" or "Tigecycline" pharmacokinetics "were used to search the relevant references published from the time of self-establishment to June 1, 2021 in PubMed, China Knowledge Infrastructure, Wanfang and other databases. The research progress of population pharmacokinetics and pharmacodynamics of tigecycline was reviewed. RESULTS & CONCLUSION: A total of 73 relevant references were retrieved, including 8 tigecycline PPK studies and 7 tigecycline PK/PD studies. At present, tigecycline PPK models had been established in patients with complex intra-abdominal infections, skin and skin and soft tissue infections, community-acquired pneumonia, nosocomial pneumonia, septic shock and other severe infections, including 8 two-compartment models. The main covariates affecting tigecycline plasma clearance were weight-related, liver function and renal function-related parameters. Body weight was also an important factor influencing the apparent volume of distribution. The effect of different disease types on the pharmacokinetics of tigecycline was different, and it needed to be considered and selected in combination with the specific circumstances of patients when formulating clinical dosing regimens. Pharmacodynamics studies should consider not only the type of disease, pathogens and patient factors themselves, but also the characteristics of atypical nonlinear plasma protein binding of tigecycline. In order to accurately understand the efficacy of different dose regimens, it was necessary to monitor the therapeutic drugs of tigecycline.

RESUMEN

Objective:To establish and evaluate the effect of graded training mode of clinical nutrition nursing in general hospital.Methods:A clinical nutrition nursing group was established, including core management group, quality control group, education and training group and liaison nurse group. Hierarchical training and practice of clinical nutrition nursing was conducted throughout the hospital, and effect of training was evaluated.Results:The nurses' nutrition knowledge increased from (66.60±9.72) to (85.06±7.85) points, nutrition attitude increased from (72.38±5.55) to (92.50±5.10) points, nutrition behavior increased from (66.87 ± 6.83) to (88.76 ± 7.60) points, and the differences were statistically significant ( t values were -15.520, -11.128, -12.238, P<0.01). The nutritional risk screening rate and nutritional intervention rate of patients were improved to 100%, and the academic level of nurses in nutritional nursing was further improved. Conclusion:The application of graded training mode of clinical nutrition nursing can improve nurses' nutritional knowledge and skills, improve nurses' professional and academic level, and improve patient clinical outcomes.

RESUMEN

Objective:To investigate the effects of methyltransferase-like protein 14 (METTL14)-mediated long-chain non-coding RNA EIF3J antisense RNA1 (Inc EIF3J-AS1) on the migration and invasion of cholangiocarcinoma cells and its mechanism.Methods:From September 2017 to December 2018, 10 pairs of cholangiocarcinoma and adjacent normal tissues were collected from the First Affiliated Hospital of Naval Medical University, which were surgically resected and pathologically confirmed. The expression of METTL14 mRNA and Inc EIF3J-AS1 in cholangiocarcinoma tissues was detected by fluorescence quantitative PCR, and the protein expression of METTL14 was detected by Western blotting. Cholangiocarcinoma cell lines HUCCTI and RBE were divided into control group and METTL14 or Inc EIF3J-AS1 knockdown group. The corresponding normal lentivirus was transfected in the control group, and METTL14 or Inc EIF3J-AS1 knockdown group was transfected with lentivirus that interfered with the expression of METTL14 or Inc EIF3J-AS1, respectively. Transwell assay was used to detect the ability of cell migration and invasion, and Western blotting was used to detect the expression of epidermal growth factor receptor (EGFR) and AKT protein.Results:The expressions of METTL14 mRNA and lnc EIF3J-AS1 in cholangiocarcinoma tissues were significantly higher than those in adjacent normal tissues (0.075±0.012 vs 0.031±0.006, 0.140±0.032 vs 0.064±0.012), and there was a positive correlation between expression of METTL4 mRNA and expression of lnc EIF3J-AS1 ( r=0.883, P=0.0007). The expression of METTL14 protein in cholangiocarcinoma tissues was higher than that in adjacent normal tissues (0.354±0.131 vs 0.187±0.183). Compared with the control group, the expression of lnc EIF3J-AS1 was significantly lower in METTL14 or Inc EIF3J-AS1 knockdown group (0.217±0.020 vs 1.000±0.052, 0.149±0.066 vs 1.000±0.045). The migration and invasion ability of cell lines HUCCTI and RBE decreased significantly in lnc EIF3J-AS1 knockout group (5.00±0.58 vs 23.33±0.33, 20.33±0.67 vs 70.67±0.33; 12.00±0.58 vs 25.00±2.52, 22.33±0.89 vs 43.67±0.33). The expression of EGFR and p-AKT/AKT protein were also significantly decreased (0.109±0.015 vs 1.000±0.018, 0.226±0.036 vs 1.000±0.051; 0.118±0.052 vs 1.000±0.069, 0.132±0.098 vs 1.000±0.023). The above differences were statistically significant (all P<0.05). Conclusions:Abnormal expression of lnc EIF3J-AS1 in cholangiocarcinoma mediated by METTL14 can promote tumor cell migration and invasion.

RESUMEN

OBJECTIVE@#To explore the genetic basis for a Chinese pedigree affected with genetic epilepsy with febrile seizures plus (GEFS+).@*METHODS@#Clinical data of the proband and his family members were collected. Following extraction of genomic DNA, the proband was subjected to high-throughput sequencing. Candidate variant was verified by Sanger sequencing of the proband and other family members.@*RESULTS@#The pedigree, including 6 patients with febrile seizures from 3 generations, was diagnosed with typical GEFS+. Among them, 2 had febrile seizures (FS), 1 had febrile seizures plus (FS+), and 3 had febrile seizures with focal seizures. High-throughput sequencing revealed that the proband has carried a heterozygous missense variant of c.4522T>A (p.Tyr1508Asn) of the SCN1A gene. Sanger sequencing confirmed that other five patients and one normal member from the pedigree have also carried the same variant, which yielded a penetrance of 85.7%.@*CONCLUSION@#The c.4522T>A (p.Tyr1508Asn) of the SCN1A gene probably underlay the disease in this pedigree. The pattern of inheritance was consistent with autosomal dominant inheritance with incomplete penetrance. Above finding has enriched the variant spectrum of the SCN1A gene.

Asunto(s)

RESUMEN

OBJECTIVE：To predict the potenti al target and mechanism of Astragali Radix in the treatment of ulcerative colitis （UC），and to provide reference for the clinical application of Astragali Radix in the treatment of UC. METHODS ：The active components and their corresponding target genes of Astragali Radix were retrieved by TCMSP and UniProt KB database.related target genes of UC were searched by Gene Cards GZK-2018-5） database. The intersection target genes of Astragali Radix and were obtained by Venny 2.1.0 online mapping tool ，and interaction network of “drug-compound-intersection target ” was constructed by using Cytoscape 3.7.0 software. PPI network of intersecting targets was obtained by using STRING 结合动物模型。E-mail：172924249@qq.com database， and the visualization analysis and topological analysis w ere carried out by using Cytoscape 3.7.0 software to obtain the core target genes. By using DAVID database ，the gene ontology （GO） function annotation and KEGG pathway enrichment of intersecting target genes were carried out ，and the “target-pathway”enrichment network was constructed by using Cytoscape 3.7.0 software. Through Auto Dock vina 1.1.2 software， the top five active components in the list of degree value were linked with the protein encoded by the core target genes ；Discovery Studio 3.5 software was applied to draw out binding pattern map. RESULTS ：There were 143 compounds in Astragali Radix ，20 active components were screened out ，and 189 corresponding target genes were selected ；there were 4 356 UC disease related target genes. There were 126 intersection target genes of Astragali Radix （involving 14 active components ）and UC. The core target genes in PPI network were AKT1，MAPK1，RB1，JUN，etc. A total of 2 294 GO items （q value＜0.05）were obtained from GO functional annotation ，including 2 093 biological process items （e.g. response to lipopolysaccharide ，response to molecule of bacterial origin ），49 cell composition items （e.g. membrane raft ，membrane microdomain ），and 152 molecular function items （e.g. nuclear receptor activity ，ligand-activated transcription factor activity ）. KEGG pathway enrichment analysis yielded 160 items（q value＜0.05），such as fluid shear stress and atherosclerosis signaling pathway ，phosphatidylinositol 3 kinase/protein kinase B （PI3K/Akt） signaling pathway ，interleukin-17 （IL-17） signaling pathway. Molecular docking results showed that top 5 active ingredients （quercetin，kaempferol，formenonetin，isorhamnetin，7-O-methylisomucronulatol） in the list of degree value had binding energies ＜5.0 kcal/mol with the protein encoded core targets. CONCLUSIONS ：Quercetin，kaempferol，formononetin and other active components in Astragali Radix may play a role in the treatment of UC through the action of MAPK14，JUN，AKT1 and other target genes ，and then on the signal pathways such as PI 3K/Akt and IL- 17.

RESUMEN

Objective:To identify a novel desmoplakin(DSP)gene variants which associated with the risk of prostate cancer in Northern Chinese.Methods:Analyzing RNA-Seq data of tumor-normal pairs from 10 Northern Chinese cases with prostate cancer, 26 candidate single-nucleotide variants(SNVs)in tumor mRNA with potential biological significance were screened.The genotyping and association analysis of these variants were performed in the peripheral blood genomic DNA from 245 Northern Chinese individuals with prostate cancer and 100 matched controls by using Sequenom MassArray System.Results:We identified that two previously unrecognized SNVs CHST12 rs12536223 C>T( P=0.033, OR=2.730, 95% CI: 1.046-7.097)and DSP rs28763961 A>T( P=0.030, OR=0.55, 95% CI: 0.315-0.948)were associated with prostate cancer.Carriers of rs28763961T allele versus carriers of rs28763961A allele showed a higher DSP expression in tumor tissue( P=0.036)and lower total prostate-specific antigen(PSA)level( P=0.007)in peripheral blood. Conclusions:rs12536223 and rs28763961 are associated with prostate cancer in Northern Chinese.The carrier status of rs28763961T allele decreases the risk of prostate cancer.

RESUMEN

The authors have withdrawn their manuscript whilst they perform additional experiments to test some of their conclusions further. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.

RESUMEN

Bronchopulmonary Dysplasia (BPD) is one of the most common chronic lung diseases of premature infants.Due to the immature development of autoimmune system and the influence of their own diseases,the risk of vaccine-preventable diseases of children with BPD is significantly increasing.Timely and effective vaccination for children with BPD is the key to prevent further lung injury and to improve the survival rate.This article reviews the current situation and progress of vaccination for children with BPD or premature infants in recent years,in order to provide reference for the vaccination of children with BPD.