Initial Stage Of Treatment Research Articles

ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ ДЕЛАМАНИД-СОДЕРЖАЩИХ РЕЖИМОВ У ПАЦИЕНТОВ С ЛЕКАРСТВЕННО УСТОЙЧИВЫМ ТУБЕРКУЛЕЗОМ И КОМОРБИДНОЙ СЕРДЕЧНО-СОСУДИСТОЙ ПАТОЛОГИЕЙ

Aim. To study the effectiveness of treatment with delamanid-containing regimens in patients with multidrug-resistant and extensively drug-resistant tuberculosis and comorbid cardiovascular diseases, to assess the frequency, structure, and severity of adverse events in the cardiovascular system in this group of patients. Materials and methods. The study included 125 adult patients with multidrug and extensive drug resistance who started treatment with delamanid-containing regimens from July 2016 to February 2018 at the Republican Research and Practical Center for Pulmonology and Tuberculosis and six regional anti-TB institutions. The main group included patients with multiple and extensive drug resistance and comorbid cardiovascular diseases (N = 46). The control group included patients with multiple and extensive drug resistance without comorbid cardiovascular diseases (N = 79). The formulation and coding of the diagnosis (the underlying disease and comorbid diseases (conditions)) corresponded to the International Classification of Diseases (ICD) of the 10th revision. Adverse events were classified according to the international dictionary MedDRA (Medical Dictionary for Regulatory Activities). The severity of adverse events classification complied with CTCAE (Common Terminology Criteria for Adverse Events). The severity of adverse events was determined in accordance with the definitions of ICH (The International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use), and the treatment outcomes were identified in accordance with clinical guidelines and WHO recommendations. The study materials were the data from the medical records of the patients in the E-Register "Tuberculosis". Sputum culture conversion was defined as two consecutive negative test results. Treatment outcomes were classified as successful and unsuccessful. For the analysis of adverse events, each event was considered as a unit of analysis both in the aggregate of all adverse events in the cardiovascular system and in groups of patients. Testing of statistical hypotheses was carried out at a critical level of significance p = 0.05, i.e. the difference was considered statistically significant if p < 0.05. Results. The effectiveness of treatment with delamanid-containing regimens in the group of patients with comorbid cardiovascular diseases was 88.0%, sputum conversion after 6 months of treatment (abacillation by culture) was observed in 93.0% of patients in this group, when compared no statistical difference was present in the effectiveness of treatment (p = 3.841) of the patients of the main group and those of the comparison group. In the analysis of long-term results, only one patient with cardiovascular comorbidity (3.0%) had a relapse of tuberculosis more than one year after successful treatment. 78.0% of patients of the main study group (with comorbid cardiovascular diseases) and 70.0% of the comparison group manifested cardiovascular adverse events during treatment. The most common adverse event in both groups was prolongation of the QTcF interval, which was recorded in 37.0% of patients with comorbid cardiovascular diseases and in 42.0% of patients without cardiovascular diseases (p = 0.597). Timely correction and careful monitoring of adverse events made it possible to avoid the development of life-threatening conditions in both groups of patients. In this regard, no withdrawal of anti-tuberculosis drugs was registered due to cardiovascular adverse events, including those due to the prolongation of the QTcF interval. The highest frequency of cardiovascular adverse events was detected during the first month of treatment of patients, then, in the course of treatment, it decreased, which may indirectly indicate the absence of a cumulative cardiotoxic effect of delamanid-containing treatment regimens. Conclusions. Treatment with delamanid-containing regimens in adult patients with multidrug-resistant tuberculosis and comorbid cardiovascular disease was effective and had an overall favorable cardiovascular safety profile comparable to the comparison group. Despite a large number of cardiovascular adverse events, they were manageable at the program level (prevailing at the initial stages of treatment, having light, mild or moderate severity, having been relieved), which made it possible to complete anti-tuberculosis treatment with delamanid-containing regimens.

Electroencephalographic Network Topologies Predict Antidepressant Responses in Patients With Major Depressive Disorder.

Medication therapy seems to be an effective treatment for major depressive disorder (MDD). However, although the efficacies of various medicines are equal or similar on average, they vary widely among individuals. Therefore, an understanding of methods for the timely evaluation of short-term therapeutic response and prediction of symptom improvement after a specific course of medication at the individual level at the initial stage of treatment is very important. In our present study, we sought to identify a neurobiological signature of the response to short-term antidepressant treatment. Related brain network analysis was applied in resting-state electroencephalogram (EEG) datasets from patients with MDD. The corresponding EEG networks were constructed accordingly and then quantitatively measured to predict the efficacy after eight weeks of medication, as well as to distinguish the therapeutic responders from non-responders. The results of our present study revealed that the corresponding resting-state EEG networks became significantly weaker after one week of treatment, and the eventual medication efficacy was reliably predicted using the changes in those network properties within the one-week medication regimen. Moreover, the corresponding resting-state networks at baseline were also proven to precisely distinguish those responders from other individuals with an accuracy of 96.67% when using the spatial network topologies as the discriminative features. These findings consistently provide a deeper neurobiological understanding of antidepressant treatment and a reliable and quantitative approach for personalized treatment of MDD.

Fracture Management by Traditional Bonesetters: A Tertiary Care Hospital Based Observational Study

Background: Fracture of bone is a persistent problem encountered in orthopaedic practice. The management of fracture of bone depends on reduction and immobility at the fracture site. The traditional bone setters formulate their own methods and practices for the management of fracture. This age-old art has not only survived since ages but also flourished with time and moreover to our surprise is challenging modern orthopaedic science in many ways. Aim of study: To find out various outcomes of fracture management by traditional bonesetters and the possible reason for their high patronage. Methods: Present study was conducted on patients with some kind of prior treatment received from TBS. The detailed history was collected about age, sex, socioeconomic condition, education, habit and habitats from each patient. Each case was subjected to detailed clinical and radiological examinations to evaluate the outcomes of the interventions of TBSs. Results: One hundred and fifty patients in the age group of (1–70) years were included in the study out of which 103 (69%) are male and 47 (31%) are females. 33% belong to age group of 30-45 years and 54% are of literate and fair socio-economic status. Malunion is the predominant form of presentation with 69 cases (46%) followed by non-union in 30 (20%) cases. 41 cases (28%) presented with impending ischemia at initial stages of treatment. Only 9 cases (6%) were presented with chronic osteomyelitis and infected non-union. Eventually 7 cases were ended with gangrene and amputation. Cost of surgery was the major cause (43%) followed by fear of surgery (23%) was observed for non-acceptance of modern orthopaedic system. Conclusion: The results in our study vindicate the fact that TBS play a major role in providing health care to the fracture patients. Lack of basic knowledge and aversion to referral system by TBS is responsible for complications. So, creating public awareness and integrating TBS in the healthcare system through proper training and due legislation seems to be the apt solution to combat this menace. Keywords: Traditional Bone Setters, chronic osteomylitis, Malunion and nonunion

Study of imaging changes following preoperative denosumab for giant cell tumor of bone

BackgroundThe changes in the characteristics of the tumor blood supply of giant cell tumor of bone over time after treatment with denosumab remain unclear. The purpose of this study was to evaluate the change in the blood supply imaging characteristics of giant cell tumor of bone after preoperative denosumab treatment and to provide evidence for evaluating the reasonable time for preoperative treatment. MethodsA total of 59 patients with giant cell tumor of bone who were treated in our hospital from 2014 to 2019 were enrolled in the study. All patients underwent enhanced CT examination of the tumor site before denosumab treatment and every month after treatment. The plain CT value and enhanced CT value of the tumor were measured, and the CT enhancement rate of the tumor was calculated. The change in the CT enhancement rate of the tumor over time after denosumab treatment was analyzed. ResultsThe average tumor enhancement rates were 2.14 (1.22–4.05), 1.60 (1.12–2.53), 1.38 (1.02–2.24), and 1.25 (1–2.11) before denosumab treatment and one month, three months, and six months after treatment, respectively. After denosumab treatment, the average monthly CT enhancement rate decreased as follows: 0.54 (25.2%) in the first month, 0.11 (5.15%) in the second to third months, and 0.04 (1.87%) in the fourth to sixth months. The tumor enhancement rate was no longer significantly reduced three months post-treatment. There was a significant correlation between the reduction in the CT enhancement rate and the initial CT enhancement rate (P = 0.000). ConclusionThe preoperative application of denosumab can reduce tumor blood supply. The decrease in the blood supply is the most significant in the initial stage of treatment. Following treatment, the decrease in the blood supply gradually reduces over time. Therefore, for the purpose of reducing intra-operative bleeding and facilitating surgery, application of denosumab treatment is not recommended more than three months before surgery.

Клинический случай лечения венозной трофической язвы

Introduction. Varicose veins of the lower extremities with clinical form C2 and higher (if we take into account the modern international classification) is a slowly progressive disease. It needs therapy, besause if untreated, some complications can develop, such as: trophic disorders (lipodermatosclerosis, skin hyperpigmentation, trophic ulcers), bleeding from varicose veins with minimal trauma, thrombotic complications (varicothrombophlebitis, deep vein thrombosis, pulmonary embolism). Materials and methods. This article presents a description of a clinical case of an aged patient with a trophic ulcer of the lower third of the left leg against the background of varicose veins of the lower extremities in the saphenous vein system and the presence of concomitant moderate iron deficiency anemia, ischemic heart disease and hypertension. Considering these factors, endovenous radiofrequency ablation of the great saphenous vein and micro-foam echosclerotherapy of incompetent perforating veins of the leg were performed. Results and discussion. Our clinical observation of an aged patient with moderate iron deficiency anemia, ischemic heart disease and hypertension is an example of effective treatment of trophic ulcers against the background of varicose veins of the lower extremities in the saphenous vein system. Without waiting for the complete compensation of the anemia, the patient was operated on with a minimally invasive method, which contributed to the rapid healing of the trophic ulcer. As a result, after 2 weeks, the trophic ulcer decreased by 2 times, and 1 month after surgery and a 14-day course of infusion vascular therapy, the ulcer completely healed. Conclusion. Thus, in patients with an open trophic ulcer, the elimination of reflux (vertical and / or horizontal) at the initial stage of treatment creates ideal conditions for the fastest healing of the ulcer. The combination of minimally invasive methods of treatment (radiofrequency ablation and micro-foam sclerotherapy) and vascular therapy promotes rapid healing of trophic ulcers, shortens the recovery time of the body against the background of comorbid pathology, and provides a good cosmetic effect.

Correlation between CYP2C9 gene polymorphism and warfarin dose in Chinese Han population with coronary heart disease.

This study aimed to explore the correlation between CYP2C9 gene polymorphism and warfarin dose in Chinese Han patients with coronary heart disease. The selection was made to the analysis of blood coagulation test of Chinese Han ethnic group, 200 cases of coronary heart disease patients as target group, the patients were satisfied taking warfarin INR target (in the range of 2.0 ~ 3.0), the other to select 200 cases proved by physical examination health as health group. The warfarin dose and the clinical laboratory INR after warfarin administration were taken, and the DNA of the patients was extracted and tested. The CYP2C9 genotype and allele frequency of patients in the standard group were observed, and the basic information and gene test results of the healthy group and the standard group were compared. Patients in the standard group were grouped according to the CYP2C9 and VKORC1 genotype, and the warfarin dosage was compared respectively. The number of cases of anticoagulant overdose in patients with different genotypes in the target group at the initial stage of warfarin treatment was compared. Results showed that CYP2C9*1/*2, *2/*2, *2/*3, *3/*3 genotypes were not found by detecting CYP2C9 genotype and allele frequency in the standard group. There were no significant differences in genotype and allele frequency between the standard group and the healthy group (P BBB 0 0.05). The mean daily dose of the CYP2C9*1/*3 genotype was lower than the mean daily dose of warfarin required by the CYP2C9*1/*1 genotype, and the difference was statistically significant (P < 0.05). There were significant differences in the incidence of anticoagulation overdose at the initial stage of treatment among different CYP2C9 genotypes (P < 0.05), and the incidence of an anticoagulation overdose in group *1/*3 was significantly higher than that in group *1/*1. In general, There was a correlation between CYP2C9 gene polymorphism and warfarin dose in Chinese Han population with coronary heart disease. Compared with the wilD-type (*1/*1) enzyme, the metabolic ability of warfarin in mutant CYP2C9 enzyme (mainly *1/*3 in Chinese population) decreases, and the patients were sensitive to warfarin treatment, and the dose required decreases.

Bone turnover markers in gingival crevicular fluid and blood serum of patients with fixed orthodontic appliances.

Bone remodelling can be followed through the bone turnover markers (BTMs). Aim of the present study was to record the fluctuation of an osteoclastic and an osteoblastic BTM [C-terminal telopeptide of type I collagen (CTX) and N-terminal pro-peptide of type I pro-collagen (PINP), respectively] in both the gingival crevicular fluid (GCF) and the serum of orthodontic patients before and after the initial application of orthodontic forces. Twenty-one Caucasian patients were prospectively evaluated. GCF and blood samples were collected in order to measure the selected biomarkers by ELISA at three time-points: exactly before, 5 days, and 14 days after bonding of the appliances. Standardized sample handling and patient preparation procedures were adopted in order to reduce pre-analytical variability. GCF and serum CTX levels were found to be independent of age, although higher in the serum of female subjects. PINP levels were found higher in the serum of patients ≥25 years old, as well as in the GCF of males. A positive correlation between serum and GCF baseline PINP levels was observed. The effect of orthodontic treatment on bone remodelling might not be absolutely representative of the local bone microenvironment as the levels of the specific BTMs where measured within the GCF of the lower front teeth. This is the first time PINP and CTX have been evaluated in the GCF and serum of orthodontic patients with fixed appliances. No statistically significant alterations of CTX and PINP levels in the GCF and the serum of patients were recorded over time during the initial stages of orthodontic treatment.

Synergistic effects of Cd, Si and Cr additions on precipitation strengthening and thermal stability of dispersoids in AA3003 alloy

The thermally stable Mn-rich dispersoids in Al alloys were recently reported to have a significant dispersion strengthening effect. Further improvements in the dispersion strengthening and thermal stability of Mn-rich dispersoids are required to achieve satisfactory mechanical properties for elevated temperature applications. This study reports that, with minor additions of Cd, Cr and increased Si content, the yield strength of the modified AA3003 alloy is increased by 39% compared to the base alloy subjected to the same heat treatment. Moreover, the thermal stability of the modified alloy when exposed to a long-term thermal holding up to 1000 h at 400 °C is greatly improved. Microstructural characterizations reveal that the dispersoids in the modified alloy are greatly refined, and their distribution is more homogeneous compared to the base alloy. It is observed that the Cd-rich clusters/nanoparticles formed in the initial stage of heat treatment, can effectively “attract” dispersoid-forming atoms (e.g. Mn, Si and Cr) and subsequently lead to a heterogeneous nucleation of dispersoids on them, which is responsible for the enhanced dispersoid precipitation and dispersion strengthening in the modified alloy. The partitioning of the low-diffusivity peritectic element Cr into dispersoids can improve the thermal stability and increase the number density of dispersoids in the centre of dendrite arms, which also contributes to the promising mechanical properties of the modified alloy.

Computational Evaluation of Frictional Force Changes in Three-Point and Three-Bracket Bending Models

NiTi arch wires are commonly used at the initial stage of orthodontic treatment, due to their superelastic and biocompatibility properties. Numerous bending models have been considered to anticipate the mechanical responses of the superelastic NiTi wire in the oral environment. It is known that the magnitude of bending force exerted by the NiTi wire is relatively influenced by the magnitude of friction generated at the wire-support interfaces. These data on the variability of friction magnitude for various bending models, however, are very limited in the literature. This study investigated the magnitude of frictional force generated in different bending models through the numerical method. The frictional force in a three-point and a three-bracket model was quantified from the force difference, measured when the wire was deflected in friction and frictionless conditions. Overall, the frictional force magnitude gradually increased as the wire further pressing the support surface at higher deflection. The highest frictional force was recorded when the bracket support was considered, with values of 2.01 N during loading and 1.61 N during unloading. These loading and unloading frictional forces were significantly reduced to 0.25 N as soon as the point support was considered. The high frictional force generated in the bracket model transformed the constant force-deflection trend of superelastic NiTi wire into a gradient force.

The association between BDNF levels and risperidone-induced weight gain is dependent on the BDNF Val66Met polymorphism in antipsychotic-naive first episode schizophrenia patients: a 12-week prospective study

A growing number of studies have shown that brain-derived neurotrophic factor (BDNF) is associated with weight gain during antipsychotic treatment in schizophrenia patients. However, there is still a lack of research results in the initial stage of antipsychotic treatment. This study aimed to evaluate the relationship between weight gain caused by risperidone monotherapy for 12 weeks and BDNF level in antipsychotic-naive and first-episode (ANFE) patients with schizophrenia, and we hypothesize that this may depend on BDNF Val66Met gene polymorphism. In a 12-week longitudinal trial, 225 ANFE patients were enrolled and treated with risperidone. Body weight was measured at baseline and during the 12-week follow-up. After treatment, the average weight of ANFE patients increased by 2.6 kg. Furthermore, we found that in patients with Val/Val genotype, the increase in serum BDNF levels was negatively correlated with risperidone-induced weight gain (r = −0.44, p = 0.008). Regression analysis showed that the baseline BDNF level was a predictor of weight gain after treatment (β = −0.45, t = −3.0, p = 0.005). Our results suggest that the BDNF signaling may be involved in weight gain caused by risperidone treatment. Furthermore, the negative association between weight gain and increased BDNF levels during risperidone treatment in ANFE schizophrenia depends on the BDNF Val66Met polymorphism.

Analysis of Chlorhexidine Modified Cement in Orthodontic Patients: A Double-Blinded, Randomized, Controlled Trial.

Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design ( n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t -tests ( p < 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control ( p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control ( p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals ( p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 ( p = 0.022). The tooth enamel color ( p = 0.366) and ARI ( p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.

Plasma-Induced Catalyst Support Defects for the Photothermal Methanation of Carbon Dioxide.

The presence of defects in a catalyst support is known to benefit catalytic activity. In this work, a He-plasma treatment-based strategy for introducing and stabilising defects on a Ni/TiO2 catalyst for photothermal CO2 hydrogenation was established. The impact of pretreatment step sequence—which comprised He-plasma treatment and reduction/passivation—on defect generation and stabilisation within the support was evaluated. Characterisation of the Ni/TiO2 catalysts indicated that defects created in the TiO2 support during the initial plasma treatment stage were then stabilised by the reduction/passivation process, (P-R)Ni/TiO2. Conversely, performing reduction/passivation first, (R-P)Ni/TiO2, invoked a resistance to subsequent defect formation upon plasma treatment and consequently, poorer photothermal catalytic activity. The plasma treatment altered the metal-support interaction and ease of catalyst reduction. Under photothermal conditions, (P-R)Ni/TiO2 reached the highest methane production in 75 min, while (R-P)Ni/TiO2 required 165 min. Decoupling the impacts of light and heat indicated thermal dominance of the reaction with CO2 conversion observed from 200 °C onwards. Methane was the primary product with carbon monoxide detected at 350 °C (~2%) and 400 °C (~5%). Overall, the findings demonstrate the importance of pretreatment step sequence when utilising plasma treatment to generate active defect sites in a catalyst support.

Комбинированный подход к лечению хориоидальной неоваскуляризация у пациентов с хронической формой центральной серозной хориоретинопатии

Purpose. To evaluate the effectiveness of combined treatment of chronic central serous chorioretinopathy (CCSCRP) complicated by 1st type choroidal neovascularization (CNV), using subthreshold micropulse laser exposure (SMILV) on the retina and intravitreal administration of angiogenesis inhibitors (IAOAI). Material and methods. In the period from 2017 to 2019, 37 patients (20 men and 16 women) with monolateral chronic recurrent CCSCRP complicated with CNV 1st type, were observed at the Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution. The aged of patients were from 35 to 57 years. In the main group were included 22 patients (22 eyes). In the main group, the anti-VEGF drug was injected once at the initial stage of treatment. During the follow-up examination before the next injection, while the detachment of the neurosensory retina persisted, the patients were immediately transferred to the combination therapy (SMILV + IAOAI). 15 patients (15 eyes) were included in the control group, whose treatment was started with 5 loading doses of the anti-angiogenic drug with an interval of 4 weeks. Results. In the main group, the number of IAOAI varied from 5 to 8 (6.1 ± 0.8). After a single injection of an angiogenesis inhibitor, a positive result was achieved in 3 cases (14%). These patients were performed two additional IAOAI with an interval of 4 weeks, then the interval was increased to 8 weeks. 19 patients (86%) had the detachment of the neurosensory retina with a height of 135-252 µm (177±28.2 µm). SMILV followed by IAOAI was performed for these patients. During the year of observation, from 8 to 10 injections of the inhibitor (8.8 ± 0.77) were performed in the control group of the study. The positive effect after injections of the anti-VEGF drug for 5 months was achieved only in 6 cases (42%). Conclusion. The proposed combination of laser exposure followed by the administration of an angiogenesis inhibitor is effective and can be used as an alternative and safe treatment for 1st type choroidal neovascularization in patients with chronic cerebrovascular accident. Key words: choroidal neovascularization, chronic central serous chorioretinopathy, intravitreal administration of angiogenesis inhibitors, subthreshold micropulse laser exposure.

Synergism of rMV-Hu191 with cisplatin to treat gastric cancer by acid sphingomyelinase-mediated apoptosis requiring integrity of lipid raft microdomains

BackgroundDDP-based chemotherapy is one of the first-line treatment in GC. However, the therapeutic efficacy of DDP is limited due to side effects. Therefore, it is of great significance to develop novel adjuvants to synergize with DDP. We had demonstrated previously that rMV-Hu191 had antitumor activity in GC. Here we examined the synergism of rMV-Hu191 with DDP in vitro and in vivo.MethodsCellular proliferation, the synergistic effect and cell apoptosis were evaluated by CCK-8 assay, ZIP analysis and flow cytometry, respectively. The protein levels and location of ASMase were monitored by western blot and immunofluorescence assay. shRNA and imipramine were used to regulate the expression and activity of ASMase. MβCD was administrated to disrupt lipid rafts. Mice bearing GC xenografts were used to confirm the synergism in vivo.ResultsFrom our data, combinational therapy demonstrated synergistic cytotoxicity both in resistant GC cell lines from a Chinese patient and drug-nonresistant GC cell lines, and increased cell apoptosis, instead of viral replication. Integrity of lipid rafts and ASMase were required for rMV-Hu191- and combination-induced apoptosis. The ASMase was delivered to the lipid raft microdomains at the initial stage of rMV-Hu191 treatment. In vivo GC mice xenografts confirmed the synergism of combinational treatment, together with increased apoptosis and trivial side-effects.ConclusionsThis is the first study to demonstrate that rMV-Hu191 combined with DDP could be used as a potential therapeutic strategy in GC treatment and the ASMase and the integrity of lipid rafts are required for the synergistic effects.

Latamoxef for Neonates With Early-Onset Neonatal Sepsis: A Study Protocol for a Randomized Controlled Trial.

Early-onset neonatal sepsis (EONS), a bacterial infection that occurs within 72 h after birth, is associated with high likelihood of neonatal mortality. Latamoxef, a semi-synthetic oxacephem antibiotic developed in 1980s, has been brought back into empirical EONS treatment in recent years. In the preliminary work, we established a population pharmacokinetics (PPK) model for latamoxef in Chinese neonates. Moreover, in order to better guide clinical treatment, we conducted dose simulation and found that ascending administration frequency could improve the target rate of 70% of patients having a free antimicrobial drug concentration exceeding the MIC during 70% of the dosing interval (70% fT > MIC). Accordingly, this study is aimed to compare the 70% fT > MIC, efficacy and safety between conventional regimen and PPK model regimen for rational use of latamoxef in EONS treatment. A single-blind, multicenter randomized controlled trial (RCT) for latamoxef will be conducted in Chinese EONS patients. Neonates (≤3 days of age, expected number = 114) admitted to the hospital with the diagnosis of EONS and fulfilling inclusion and exclusion criteria will be randomized (ratio of 1:1) to either a conventional regimen (30 mg/kg q12h) or model regimen (20 mg/kg q8h) latamoxef treatment group for at least 3 days. Primary outcome measure will be 70% fT > MIC and secondary outcome indicators will be the latamoxef treatment failure, duration of antibiotic therapy, changes of white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT), blood culture results during administration and incidence of adverse event (AE)s. Assessments will be made at baseline, initial stage of latamoxef treatment (18–72 h) and before the end of latamoxef treatment. Ethical approval of our clinical trial has been granted by the ethics committee of the Beijing Children’s Hospital (ID: 2020-13-1). Written informed consent will be obtained from the parents of the participants. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR 2000040064).It is hoped that our study will provide a clinical basis for the rational clinical use of latamoxef in EONS treatment.

Screening and identification of genes affecting grain quality and spikelet fertility during high-temperature treatment in grain filling stage of rice

BackgroundRecent temperature increases due to rapid climate change have negatively affected rice yield and grain quality. Particularly, high temperatures during right after the flowering stage reduce spikelet fertility, while interfering with sugar energy transport, and cause severe damage to grain quality by forming chalkiness grains. The effect of high-temperature on spikelet fertility and grain quality during grain filling stage was evaluated using a double haploid line derived from another culture of F1 by crossing Cheongcheong and Nagdong cultivars. Quantitative trait locus (QTL) mapping identifies candidate genes significantly associated with spikelet fertility and grain quality at high temperatures.ResultsOur analysis screened OsSFq3 that contributes to spikelet fertility and grain quality at high-temperature. OsSFq3 was fine-mapped in the region RM15749-RM15689 on chromosome 3, wherein four candidate genes related to the synthesis and decomposition of amylose, a starch component, were predicted. Four major candidate genes, including OsSFq3, and 10 different genes involved in the synthesis and decomposition of amylose and amylopectin, which are starch constituents, together with relative expression levels were analyzed. OsSFq3 was highly expressed during the initial stage of high-temperature treatment. It exhibited high homology with FLOURY ENDOSPERM 6 in Gramineae plants and is therefore expected to function similarly.ConclusionThe QTL, major candidate genes, and OsSFq3 identified herein could be effectively used in breeding rice varieties to improve grain quality, while tolerating high temperatures, to cope with climate changes. Furthermore, linked markers can aid in marker-assisted selection of high-quality and -yield rice varieties tolerant to high temperatures.

Сравнительный анализ эффективности раннего и отложенного начала комбинированной медикаментозной терапии ДГПЖ

Introduction Currently, -blockers (-AB) and 5-alpha-reductase inhibitors (I-5-AR) are recommended as the drugs of choice for the treatment of patients with benign prostatic hyperplasia (BPH). However, despite the clear advantages of combination therapy, at the initial stages of treatment, I-5-AR is either not prescribed at all, or added to therapy after a few months. The aim of our study is to study the effectiveness of early and various options for delayed combined drug therapy of patients with BPH using -AB and I-5-AR. Materials and methods The study included 90 patients with BPH, who were divided into three groups of 30 people. In group 1, monotherapy with drugs from the -AB group was performed for 6 months, after which they were transferred to treatment with a combined drug. In group 2, monotherapy was performed for three months, after which they were also transferred to treatment with a combined drug. And in group 3, patients were prescribed combination therapy from day 1. Results Early combination therapy with dutasteride was more effective than delayed Therapy for 6 months. There were no significant differences in the main parameters studied between patients who simultaneously started combination therapy and switched to it after 3 months, by the end of the 12th month of treatment. However, early therapy is a combined drug made it possible to achieve a more rapid effect in relation to LUTS. Conclusion Thus, the data obtained confirm the clinical recommendations regarding the expediency of early initiation of combined therapy with an -adrenoblocker and a 5-reductase inhibitor in patients with moderate and severe LUTS caused by BPH and the risk of disease progression. Postponing the transition to combination therapy for 6 months or more may lead to a decrease in the effectiveness of treatment of patients in this category.

Morphological evolution of TiC particles with different stoichiometries by hydrofluoric acid etching treatment

AbstractThe effects of hydrofluoric acid (HF) etching time on the morphology of the titanium carbide (TiC) particles with different stoichiometries were investigated. TiC particles with two C/Ti molar ratios of 0.5 and 1.0 were prepared by mechanical alloying. Then, the powders were immersed in the HF solution for different times of 48, 96, and 142 h. Results showed that the morphology of TiC particles greatly changed after HF etching. In general, a roughing phenomenon was observed as a function of the immersion time in the HF solution. The irregular shape of the TiC particles changed to the spherical shapes by increasing the HF etching time. However, the changing tendency of TiC particles with different stoichiometries was different. The shape of prepared powders with a C/Ti molar ratio of 1.0 was polyhedron at the initial stages of HF treatment, while the shape of prepared powders with a C/Ti molar ratio of 0.5 was near‐spherical. However, with increasing the immersion time, the shape of both samples changed to a spherical one. The degree of roughing phenomenon of the prepared powders with a C/Ti molar ratio of 0.5 was lower than that of the prepared powders with a C/Ti molar ratio of 1.0.

Analysis of a glide path creation necessity at the initial stages of endodontic treatment

Aim. Article is to detail the positive and negative aspects associated with the creation of a glide path with various types of endodontic instruments.Materials and methods. During a systematic review of the literature, Russian – and English-language publications were studied in the electronic databases PubMed, Google Scholar. Articles, the content of which concerns the methods of creating a glide path, as well as possible complications were included in analysis.Results. 60 articles were reviewed during the review. After analyzing the literature according to the inclusion and exclusion criteria, the total number of publications has become 32.Conclusions. According to the studied literature, it can be said that the glide path provides a predictable behavior of rotary tools and it is a recommended condition for achieving the success of endodontic treatment at the stage of canal mechanical treatment and preventing iatrogenic complications.

A comparison of group art therapy in decreasing the depression level of leukemia pediatric patients

IntroductionCancer and its treatment often impose physical and psychological consequences. Children with cancer are not only at a risk of adverse events resulting from medical procedures but also severe effects on their social and mental health as a result of its treatment. Depression being one of the most common psychiatric disorders associated with cancer in children and adolescents. The current study aims to provide evidence of an easy and inexpensive intervention that can be used in oncology patients in a low resource setting to help maintain mental health stability in pedriatric patients..ObjectivesTo examine the effectiveness of therapeutic group art therapy, in reducing depression scores in children with cancer.MethodsThe study is quasi experimental, through convinient sampling data of fifteen children in initial stage of thier treatment were selected. They were divided into two groups experimental and controlled through random allocation. Three sessions of forty minutes of group art therapy was given in experimental group, in control normal treatment was provided excluding group art therapy. Childhood Depression Scale (CDI) was used in both group as pre and post test to determine the depression level.ResultsThe results shows a positive change in the level of depression in experimental group as compared to controlled group.ConclusionsGroup art therapy is an effective and inexpensive way of reducing depression level of paediatric leukemia patients that can be used by oncology healthcare centres worldwide with trained mental healthcare professionals in order to maintain positive treatment results of cancer.