Evaluation of the toxicological safety of erinacine A-enriched Hericium erinaceus in a 28-day oral feeding study in Sprague–Dawley rats

Natural products have attained great importance as they are believed to be the new alternative medicines for conventional therapy. As numerous studies have proved the tremendous medicinal values of Hericium erinaceus, it is necessary to take into account its safety as well as its risk for the recipient. However, mushroom mycelium has an identity distinct from mushrooms, as two specific classes of compounds, hericenones and erinacines, can only be extracted from both the fruit body and the cultured mycelium, respectively. Therefore, this is the first report on the evaluation of the toxicity of H. erinaceus mycelium, enriched with 5 mg/g erinacine A, by a 28-day repeated oral administration study in Sprague–Dawley rats. Three doses of 1 (Low), 2 (Mid) and 3 (High) g/kg body weight/day were selected for the study while distilled water served as control. All animals survived to the end of the study. No abnormal changes were observed in clinical signs. No adverse or test article-related differences were found in urinalysis, haematology and serum biochemistry parameters, between the treatment and control groups. No gross pathological findings and histopathological differences were seen. Therefore, the no-observed-adverse-effect level of erinacine A-enriched H. erinaceus is greater than 3 g/kg body weight/day.     

Epidemiology,pathophysiology, and treatment of traumatic cervical vascular injury

Operative techniques to treat traumatic cervical instability have evolved with the development of techniques such as occipital segmental plating, C1 lateral mass screws, a variety of C2 fixation techniques, and C1/C2 transarticular screw fixation, in addition to lateral mass and pedicle screws in the subaxial cervical spine. These advances have led to benefits, such as improved construct strength and enhanced biomechanical stability. In the current era, it is essential to have a good familiarity with the types of instrumentation available and a comprehensive understanding of the regional anatomy to avoid complications and optimize clinical outcomes.     

综合护理干预对老年股骨颈骨折患者术后首次排便的影响

目的探讨综合护理干预对老年股骨颈骨折患者术后首次排便的影响。方法便利抽样法选择2010年11月至2011年11月在镇江市第二人民医院住院治疗的84例老年股骨颈骨折需手术的患者为研究对象,按随机数字表法将其分为观察组和对照组,每组42例。观察组患者采用综合护理干预措施,对照组采用骨科常规护理措施,观察比较两组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间以及首次大便通畅度情况。结果观察组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间均早于对照组,且首次大便通畅度优于对照组,差异均有统计学意义(均P<0.01)。对照组有24例术后96h仍未排便,给予通便药物或灌肠干预,而观察组仅有1例患者需灌肠干预。结论综合干预措施能明显缩短老年股骨颈骨折患者术后肠功能恢复时间。     

婴幼儿接种乙肝疫苗预防乙型肝炎的临床观察

目的:观察婴幼儿接种乙肝疫苗的临床效果。方法:对近年来在我社区进行乙肝疫苗接种的婴幼儿进行临床追踪观察。结果:325例婴幼儿中抗-HBs阳性者320例,阳性率达98.5%;出现不良反应者10例,发生率3.1%,反应较轻,不需要特殊治疗,短时间内可消退。结论:婴幼儿接种乙肝疫苗可有效预防乙型肝炎,具有社会学意义和流行病学意义。     

Environmental and health impact of unrecovered API from pharmaceutical manufacturing wastes: A review of contemporary treatment,recycling and management strategies

Pharmaceutical industries are imminent for the survival of any contemporary society as their products are valuable for the populace's health and wellness. However, the wastes of these industries have become a nuisance with severe implications on human health and ecosystem, especially in many developing countries where they are discharged indiscriminately into the environment, either untreated or poorly treated. Pharmaceutical Manufacturing Waste (PMW) effluents have been reported to possess a high BOD and COD, as well as recoverable APIs of various classes of pharmaceuticals. Moreover, antibiotic residues in these effluents are implicated in the progression and spread of antibiotic resistance in the aquatic and agroecosystem. Globally, the diverse activities of various pharmaceutical industries, owing to their diverse products, have resulted in difficulty in developing universal management and treatment protocols. Consequently, regulatory bodies/institutions find it challenging to monitor waste disposal practices of these industries adequately, primarily owing to their non-disclosure policies of intellectual properties. Hence, to a large extent, the onus for a sustainable society regarding PMWs lies in the decision and policies of these industries. Therefore, this review aims to foster informed policy-making decisions regarding waste management practices of pharmaceutical industries.     

Genetic characterization of a densovirus isolated from great tit (Parus major) in China

During a study of ornithophilous viruses in China, a new densovirus (DNV) was isolated from the lung tissue of Parus major (PmDNV-JL). The complete genome of PmDNV-JL was cloned and sequenced. Five open reading frames (ORFs) were identified in the 5166 nt sequence, on the basis of deduced amino acids. It was further shown that this virus caused cytopathic effects (CPE) in Feline kidney cells. The NS1 gene sequence of PmDNV-JL shares 70–99% nucleotide sequence identity with isolates of the Blattella germanica densovirus (BgDNV) and BgDNV-like virus. Phylogenetic analysis indicated that the predicted amino acid sequences of capsid (VP) and non-structural domain (NS1) of PmDNV-JL clustered with the BgDNV and were similar to BgDNV-HB within the genus Densovirus.     

Factors affecting the survival following surgical treatment of chronic subdural haematoma: Single institutional experience

BackgroundChronic subdural haematoma (CSDH) is one of the most commonly treated condition in neurosurgery. It affects elderly populations who often have significant medical co-morbidities resulting in poor prognosis. The study aimed at identifying clinical factors influencing the survival following surgical management of CSDH.MethodsRetrospective study included 267 cases that underwent surgery for CSDH and followed over 5-year period (2010–2015); data retrieved with reference to operation details, radiology reports and discharge. Using logistic and Cox regression analysis, the patient survival data was analysed with respect to patient demographics, type of surgery, co-morbidities, anticoagulation treatment, and discharge destination.ResultsThe overall survival in the cohort was 37.0 months (IQR: 20.0–60.0). The median age of the patients was 76 years (IQR: 66–82) and the median length of hospital stay was 10 days (range 1–126 days; IQR: 6–17 days). The recurrence rate was 6.37% (n = 17). Fifty-three (19.85%) patients recorded deceased on the IPM database as of October 2016 and of those 11 died in hospital. Univariate Cox-regression analysis revealed increased age (HR: 1.80; 95%CI: 1.04–3.11), length of hospital stay (HR: 2.50; 95%CI: 1.41–4.41) and number of co-morbidities (HR: 2.19; 95%CI: 1.26–3.79) were associated with poor prognosis. Glasgow coma scale (GCS) at discharge was found to be significantly associated with survival whilst anticoagulation treatment did not. Multivariate analysis confirmed similar findings significant statistically.ConclusionAge at admission, median length of hospital stay, number of co-morbidities, GCS at discharge and discharge destination have been found to influence survival significant statistically.     

Long-term survival after chronic subdural haematoma

Outcome after chronic subdural haematoma (CSDH) is invariably assumed favourable: however, little data regarding long term survival (LTS) exists. One study reported excess mortality restricted to year 1, but with expected actuarial rates thereafter. We aimed to determine LTS after CSDH in a retrospective analysis relative to actuarial data from age-matched controls. Data was obtained in n = 155, (M:F 97:58, 69.3 ± 2.3 years). Follow-up maxima was 14.19 years (mean: 4.02 ± 3.07 years, median: 5.2 years). Mortality in-hospital, at 6 months, 1 year, 2 years and 5 years was n = 13 (8.39%), n = 22 (14.19%), n = 31 (20.35%), n = 42 (27.1%) and n = 54 (34.84%). LTS was significantly worse than controls (5.29 ± 0.59 years vs. 17.74 ± 1.8 years, hazard ratio [HR]: 3.52, P < 0.0001). Death most frequently related to pneumonia/sepsis and ischemic heart disease (IHD). Median modified Rankin score (mRS) in those discharged home (n = 94, 60.65%) was 2 [IQR: 1–3]. Discharge mRS in those who died at 6 months, 1 year, 2 years and 5 years was 5 [IQR: 3–6], 5 [IQR: 4–6], 3 [IQR: 1–3], 4 [IQR: 2–5]. Discharge mRS was significantly worse with year 1 mortality (P = 0.014). LTS related to discharge mRS (HR: 37.006, P < 0.001), post-operative motor-score (HR: 0.581, P = 0.0026), IHD (HR: 5.186, P = 0.005), warfarin-use (HR: 5.93, P = 0.036) and dementia (HR: 5.39, P = 0.031). No long term recurrences (LTR) were recorded. Although most were discharged home with mRS = 2, LTS was markedly less than previously reported: peers lived 12.4 years longer. Although greater in year 1, excess mortality was not restricted to year 1, but continued throughout prolonged follow-up. LTS related to discharge disability and dependence, and co-morbid risk factors for cerebral atrophy. No LTR suggests that, once ultimately closed, the ‘subdural space’ remains closed. CSDH patients represent a vulnerable group who require continued long-term medical surveillance.     

Succès du traitement par paclitaxel d’une rechute viscérale d’un sarcome de Kaposi après transplantation rénale

We report the observation of a patient who presented with post-transplant Kaposi's sarcoma after a delay of eight months with a dual cutaneous and palatal localisation. The reduction in immunosuppressive treatment and the introduction of Rapamune® allowed good clinical progress initially with regression of the skin lesions. He subsequently presented later a skin relapse with visceral localisation. Chemotherapy was conducted based on weekly paclitaxel infusions allowing partial remission and maintenance of renal graft function with good clinical tolerance.