Evaluation of adalimumab biosimilar candidate (HS016) in Chinese patients with active ankylosing spondylitis based on a health survey: sub-analysis of a phase 3 study

Clinical Rheumatology - The equivalence of the biosimilar HS016 to adalimumab (Humira) for the treatment of active ankylosing spondylitis (AS) patients has been previously validated. The aim was to...     

Synthesis of High‐Molecular‐Weight Brush Polymers via RAFT Polymerization within the Micellar Nanoreactor of a PEG‐Based Macromonomer

The RAFT polymerization of an amphipathic PEG‐based macromonomer (mPEG‐g‐S) in water is performed. It is found that the polymerization proceeds via a micellar polymerization process. The polymerization kinetics, polymer chain extension, and polymer particle evolution of RAFT micellar polymerization are evaluated. It is demonstrated that the polymerization possesses a fast rate and high monomer conversion due to locally concentrating and orienting the hydrophobic polymerizing groups within the micellar nanoreactor. Moreover, the RAFT micellar polymerization is under good control since the polydispersity index (PDI) value of the synthesized brush copolymer is below 1.3 in most cases, even under polymerization conditions with the ratio of RAFT agent to macromonomer at 1:400. Polymerization leads to the formation of a completely grafted brush copolymer, and the as‐synthesized brush copolymer will self‐assemble into spherical particles during the polymerization process. This strategy is anticipated to be an efficient way for the controlled synthesis of completely grafted brush polymers with high molecular weights and their corresponding self‐assembled particles.

     

Erythromycin versus metoclopramide for post-pyloric spiral nasoenteric tube placement: a randomized non-inferiority trial

Purpose

To determine whether erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of self-propelled spiral nasoenteric tubes (NETs) in critically ill patients.

Methods

A prospective, multicenter, open-label, parallel, and non-inferiority randomized controlled trial was conducted comparing erythromycin with metoclopramide in facilitating post-pyloric placement of spiral NETs in critically ill patients admitted to intensive care units (ICUs) of eight tertiary hospitals in China. The primary outcome was procedure success defined as post-pyloric placement (spiral NETs reached the first portion of the duodenum or beyond confirmed by abdominal radiography 24 h after tube insertion).

Results

A total of 5688 patients were admitted to the ICUs. Of these, in 355 patients there was a plan to insert a nasoenteric feeding tube, of whom 332 were randomized, with 167 patients assigned to the erythromycin group and 165 patients assigned to the metoclopramide group. The success rate of post-pyloric placement was 57.5% (96/167) in the erythromycin group, as compared with 50.3% (83/165) in the metoclopramide group (a difference of 7.2%, 95% CI ??3.5% to 17.9%), in the intention-to-treat analysis, not including the prespecified margin of ??10% for non-inferiority. The success rates of post-D1 (reaching the second portion of the duodenum or beyond), post-D2 (reaching the third portion of the duodenum or beyond), post-D3 (reaching the fourth portion of the duodenum or beyond), and proximal jejunum placement and the incidence of any adverse events were not significantly different between the groups.

Conclusions

Erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of spiral NETs in critically ill patients. The success rates of post-D1, post-D2, post-D3, and proximal jejunum placement were not significantly different.

     

株洲市门诊儿童血铅水平及其影响因素的流行病学研究

目的了解株洲市门诊儿童血铅水平及其影响因素,为防治铅中毒提供针对性建议。方法对株洲地区儿科门诊的1 200例1月~14岁儿童进行问卷调查,并测定其静脉血铅水平和血清铁、钙、铜、镁、锌含量。结果 1)门诊儿童血铅水平平均为(96.1±64.4)μg/L,≥100.0μg/L者检出率达28.7%。2)逐步回归分析:血铅水平与全血铁、钙、铜含量呈负相关,而不认为血铅水平与全血镁、锌含量存在显著关系。3)Logistic回归分析:母亲年龄较大、常补充钙/铁/锌制剂、常食用乳类和乳制品、散居是儿童血铅含量≥100μg/L的保护因素。母亲文化程度低、父亲吸烟、男童、常在交通繁忙地带散步/玩耍、进食前几乎不洗手、常咬文具/玩具、常食爆米花、常吸吮手指/啃手指甲、常玩橡皮泥、常服中草药、经常饮用罐装饮料、住所距离主干道较近、居室有墙皮脱落、住所楼层较低、大年龄儿童是儿童血铅含量≥100μg/L的危险因素。结论株洲市门诊儿童血铅水平≥100.0μg/L检出率较高,当地政府和社会应以改善生态环境、加强营养干预、普及健康教育、落实行为指导为切入点,减轻儿童铅暴露及其危害。     

感染性腹泻患儿家长手卫生依从性调查

目的探讨感染性腹泻患儿家长手卫生依从性,并分析影响其依从性的原因,提出相应干预措施。方法采用隐蔽性现场观察与自制调查问卷相结合的方法,对92例患儿家长的手卫生依从性和影响其依从性的原因进行调查。结果患儿家长给患儿冲奶或喂奶、喂水前手卫生依从率为49.78%;给患儿擦净鼻涕、口水或更换尿布后手卫生依从率为73.12%。影响患儿家长手卫生依从性的原因排名居前2位的为患儿家长觉得没有必要(70.65%)、无频繁进行手卫生的习惯(57.61%)。结论医护人员应采取有效的干预措施,提高感染性腹泻患儿家长的手卫生依从性。     

人感染H7N9禽流感26例临床特征与病毒基因分析研究

目的探讨人感染H7N9禽流感病毒患者的流行病学和临床特征,以及病毒分子生物学特征。方法收集湖南省2013、2014年确诊的26例人感染H7N9禽流感病毒患者的资料,对人和禽分离的H7N9病毒进行鉴定和测序分析。结果26例患者中,发热和咳嗽是最常见的起病症状,所有患者均存在肺炎;20例(76.92%)出现急性呼吸窘迫综合征(ARDS),25例(96.15%)初诊时白细胞下降或正常,发病至开始进行抗病毒治疗的平均时间为10 d。10例死亡,病死率达38.46%。患者分离的H7N9病毒株测序分析表明,发生了H7基因Gln226Leu和Gly186Val替换,PB2基因Asp701Asn突变。结论急性呼吸系统损害是人感染H7N9禽流感的主要临床表现,活禽暴露是人感染H7N9禽流感的重要危险因素,H7N9禽流感病毒基因发生了部分位点的适应性突变,更容易从禽类向人跨种传播引起人类严重疾病,需加强病原学监测。     

(B,N)-Doped 3D porous graphene–CNTs synthesized by chemical vapor deposition as a bi-functional catalyst for ORR and HER

Novel (B,N)-doped three-dimensional (3D) porous graphene–carbon nanotubes (CNTs) can be used as an excellent alkaline and acid tolerant electrocatalyst for both the oxygen reduction reaction (ORR) and the hydrogen evolution reaction (HER). Based on density functional theory, the H and O atoms’ pre-and post-adsorption energy can effectively reduce the reaction energy barrier.

A simple but very efficient two-step CVD method to prepare a (B,N)-doped 3D porous graphene–CNT hybrid material (B–N–G–CNT), and its catalytic performance for ORR and HER.     

44例注射用脂溶性维生素不良反应文献分析

目的探讨注射用脂溶性维生素所致不良反应的一般规律和特点,为临床合理用药提供参考。方法检索1994~2014年中国期刊全文数据库报道的注射用脂溶性维生素所致不良反应案例,并进行统计与分析。结果注射用脂溶性维生素所致不良反应多在用药过程中30 min内发生。不良反应累及机体多个系统,临床表现复杂多样,主要表现为过敏反应,严重者可出现呼吸困难或过敏性休克。结论临床医师和药师应重视注射用脂溶性维生素的不良反应,坚持合理用药。     

补血益母丸哺乳期暴露对大鼠亲代和子代发育毒性的研究

目的 观察补血益母丸对哺乳期的亲代母鼠及子代生长发育的影响,探讨其安全性。方法 妊娠大鼠100只,随机分为4组,即对照组（去离子水）和补血益母丸低、中、高剂量（3.8、11.4、34.2 g生药/kg）组,每组25只。F₀母鼠于哺乳期第0天开始ig给药,连续给药至哺乳期结束,每日l次。F₀母鼠观察一般状况、体质量、摄食量、分娩及哺乳情况;F1代大鼠观察仔鼠的外观、体质量、生理发育、神经反射、行为及生殖功能等。结果 未发现补血益母丸对F₀母鼠哺乳期以及胚胎和F1代大鼠生长发育有明显毒性和干扰作用。结论 补血益母丸对F₀代母鼠哺乳期及F1子代均无明显毒性,未见毒性反应的剂量（NOAEL）为34.2 g生药/kg,相当于临床人用剂量的53倍。     

Changes in sensorimotor regions of the cerebral cortex in congenital amusia:a case-control study

Perceiving pitch is a central function of the human auditory system;congenital amusia is a disorder of pitch perception.The underlying neural mechanisms of congenital amusia have been actively discussed.However,little attention has been paid to the changes in the motor rain within congenital amusia.In this case-control study,17 participants with congenital amusia and 14 healthy controls underwent functional magnetic resonance imaging while resting with their eyes closed.A voxel-based degree centrality method was used to identify abnormal functional network centrality by comparing degree centrality values between the congenital amusia group and the healthy control group.We found decreased degree centrality values in the right primary sensorimotor areas in participants with congenital amusia relative to controls,indicating potentially decreased centrality of the corresponding brain regions in the auditory-sensory motor feedback network.We found a significant positive correlation between the degree centrality values and the Montreal Battery of Evaluation of Amusia scores.In conclusion,our study identified novel,hitherto undiscussed candidate brain regions that may partly contribute to or be modulated by congenital amusia.Our evidence supports the view that sensorimotor coupling plays an important role in memory and musical discrimination.The study was approved by the Ethics Committee of the Second Xiangya Hospital,Central South University,China(No.WDX20180101GZ01) on February 9,2019.