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.

     

Ahmed青光眼引流阀植入术治疗玻璃体切除术后难治性青光眼

目的：评价Ahmed 青光眼阀植入术治疗玻璃体手术后继发性青光眼的临床疗效。

方法：回顾分析在我院眼科应用Ahmed青光眼阀植入术治疗玻璃体手术后继发性青光眼患者23例23眼。

结果：患者术后平均随访29±3.7mo,术前平均眼压48.79±7.12mmHg,手术后24mo时平均眼压23.28±10.53mmHg,与术前眼压相比明显降低,具有显著性统计学差异(P<0.05); 术后1mo时,手术成功率82.6%,随访12、24mo时手术成功率分别为65.2%、52.2%。

结论：采用Ahmed青光眼阀植入术治疗玻璃体手术后的继发性青光眼是比较有效和相对安全的治疗方法。     

Ultrasensitive determination of ascorbic acid by using cobalt oxyhydroxide nanosheets to enhance the chemiluminescence of the luminol–H2O2 system

Ascorbic acid (AA) as an essential vitamin in the human body participates in various physiological reactions and plays a key role in many biochemical processes. Therefore, it is of vital importance to monitor and quantify AA in commercial tablets, beverages and food. In this work, a rapid and ultrasensitive chemiluminescence (CL) system for the detection of AA was developed, in which ultrathin cobalt oxyhydroxide (CoOOH) nanosheets were applied in the conventional luminol–H₂O₂ CL system. The results showed that ultrathin CoOOH nanosheets as a catalyzer remarkably improved the CL intensity of the CoOOH–luminol–H₂O₂ system, up to about 1400-fold. Under the optimized conditions, the CL inhibition efficiencies increase linearly with the concentrations of AA in the range of 1–500 pmol L⁻¹, and the limit of detection was 39 fmol L⁻¹. Moreover, the proposed CL system was successfully applied in the determination of AA in medicinal tablets with satisfactory results.

An ultrasensitive CL system for the determination of ascorbic acid in medicinal tablets was developed based on the enhancement effect of cobalt oxyhydroxide nanosheets on the luminol–H₂O₂ system.     

Extraction in cholinium-based magnetic ionic liquid aqueous two-phase system for the determination of berberine hydrochloride in Rhizoma coptidis

A magnetic ionic liquids (MILs)-based aqueous two-phase system (MIL-ATPs) obtained by mixing with a series of inorganic salts, which involves five cholinium MILs with the piperidinyloxy radical anion is reported for the first time. Phase diagrams for the new ATPs were experimentally determined at different temperatures (298.15–318.15 K) and the liquid–liquid equilibrium data for two-phase systems were correlated according to the empirical nonlinear expression. The effects of the types of MILs, temperature and inorganic salts on the binodal curve are discussed in detail. The MIL-ATPs coupled with HPLC-UV analysis was developed in the quantitation of berberine hydrochloride in Rhizoma coptidis. Under optimal conditions, the partition coefficient of berberine hydrochloride was 127.68 with the precision values (RSD%) of 1.40% and 2.83% for intra-day (n = 6) and inter-day (n = 3), respectively. The limit of detection (LOD) and limit of quantification (LOQ) for berberine hydrochloride were 0.023 mg L⁻¹ and 0.077 mg L⁻¹, respectively. The recoveries were obtained in the acceptable range of 97.4–101.2%. Moreover, the content of berberine hydrochloride in the raw material of Rhizoma coptidis was measured as 123.95 mg g⁻¹ with this method. Finally, 99.8% MIL was recovered for cycle application after the removal of berberine hydrochloride by using D101 resin. This study provides a meaningful reference for the application of MIL-ATPs with great prospects.

Five cholinium type organic magnetic ionic liquids have been applied in ionic liquid-based aqueous two-phase systems by mixing with a series of inorganic salts, which is reported to extract berberine in quantitative analysis for the first time.     

Low molecular weight heparin and aspirin for prevention of deep vein thrombosisafter orthopaedic surgery: a systematic review and meta-analysis

Journal of Thrombosis and Thrombolysis - To comprehensively evaluate the clinical effects of low molecular weight heparin (LMWH) and aspirin for deep vein thrombosis (DVT) patients after...     

2009—2020年合肥市肺结核空间特征分析

目的: 分析2009—2020年合肥市肺结核疫情特征及空间聚集性。方法: 通过收集“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中合肥市2009—2020年肺结核数据,筛选出肺结核患者42681例,利用GeoDa和Arcgis 10.8空间分析软件进行分析,在街道/乡镇水平上绘制空间分布地图,探索空间分布规律及肺结核发病冷热点地区。结果: 2009—2020年合肥市肺结核共报告42681例,报告发病率从2009年57.96/10万(4195/7237966)下降到2020年31.04/10万(2908/9369881),整体呈现波动下降趋势($\chi _{趋势}^{2}$=12.531,P<0.001);全局空间自相关结果显示2009—2014年合肥市肺结核发病呈现空间自相关性(Moran’s I值均>0,P值均<0.05);2015—2020年空间分布偏向随机性。局部自相关分析显示高-高聚集发病街道/乡镇主要集中在长丰县、肥东县;低-低聚集区主要集中在老城区(庐阳区、包河区)。冷热点分析发现,热点区域有2个,分布在长丰县义井乡和肥西县严店乡。结论: 合肥市肺结核疫情存在一定的聚集性,后续应针对不同的县(区)街道/乡镇特点采取不同的防控措施,加大高-高聚集区的街道和热点区域的防控力度。     

我院感染实时监控系统的应用与体会

目的 总结分析医院感染实时监控系统用于预防与控制医院感染的应用与体会.方法 回顾性分析2011年10月-2013年9月应用医院感染实时监测系统对医院感染预防与控制的效果.结果 医院感染预防控制工作成效显著,医院感染率、漏报率明显下降,病原学送检率总体呈上升趋势,抗菌药物使用率符合国家标准.结论 通过医院感染实时监控系统的应用提高了医院感染监测效率.     

Overexpression of the transgene for manganese superoxide dismutase (MnSOD) in 32D cl 3 cells prevents apoptosis induction by TNF-alpha,IL-3 withdrawal,and ionizing radiation

OBJECTIVE: Stabilization of the mitochondria in IL-3-dependent hematopoietic progenitor cell line 32D cl 3 by overexpression of the transgene for manganese superoxide dismutase (MnSOD) prior to ionizing radiation prevents apoptosis. We now demonstrate that overexpression of the MnSOD transgene also protects 32D cl 3 cells from apoptosis caused by exposure to tumor necrosis factor-alpha (TNF-alpha) or withdrawal of interleukin (IL)-3. MATERIALS AND METHODS: The hematopoietic progenitor cell line, 32D cl 3, and subclones overexpressing the human MnSOD transgene, 1F2 or 2C6, were radiated to 1000 cGy or were exposed to TNF-alpha (0 to 100 etag/mL) or were subjected to IL-3 withdrawal. The cells were then examined at several time points for DNA strand breaks using a comet assay, depolarization of the mitochondrial membrane, activation of caspase-3, PARP cleavage, and apoptosis, and also for changes in cell cycle distribution. RESULTS: Overexpression of the transgene for MnSOD resulted in increased survival following exposure to radiation, exposure to TNF-alpha, or IL-3 withdrawal. The cell lines overexpressing MnSOD (1F2 or 2C6) displayed decreased radiation-induced, TNF-alpha-induced, or IL-3 withdrawal-induced mitochondrial membrane permeability, caspase-3 and PARP activation, and apoptosis. CONCLUSIONS: Overexpression of the human MnSOD transgene in 32D cl 3 cells results in stabilization of the mitochondria and reduction in radiation-, TNF-alpha-, or IL-3 withdrawal-induced damage. Thus, MnSOD stabilization of the mitochondrial membrane is relevant to reduction of apoptosis by several classes of oxidative stress inducers.     

Experimental study of bioartificial liver with cultured human liver cells

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