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Background: Emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) fixed-dose combination (FTC/TDF) is generally well-tolerated, although treatment-related adverse events have been reported. Methods: We report two cases of persons using FTC/TDF PrEP who had acute neuralgia in a Chinese PrEP demonstration trial. Results: Neurological symptoms subsided upon treatment discontinuation. Symptoms were reported as similar to one case's previous experiences with dolutegravir (DTG) + FTC + tenofovir alafenamide (TAF) (for PEP), leading to permanent discontinuation of PrEP. Conclusion: Acute facial neuralgia appears to be a rare idiosyncratic adverse event to FTC/TDF. HIV PrEP is widely recommended as a crucial measure for HIV prevention. In a demonstration trial in China, this article highlights two cases where facial neuralgia emerged as an unexpected side effect of PrEP medication, not previously mentioned in official prescribing information. These findings deepen our understanding of the potential side effects of emitricitabine/tenofovir disoproxil fumarate use and provide empirical evidence to enhance PrEP implementation further and address the challenges that may arise during its utilisation. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical effect of neoadjuvant chemotherapy in combination with laparoscopic surgery in treating progressive colorectal cancer. Methods: 90 patients with colorectal cancer admitted to Hebei Yanda Hospital, Hebei Langfang, China between December 2020 and December 2021 were enrolled. The patients were randomly grouped into control and study groups. Control group underwent laparoscopic surgery while the study group underwent neoadjuvant chemotherapy in addition to laparoscopic surgery. Gastrointestinal function recovery time, tumor control effect, tumor marker level, and adverse reactions were investigated and compared between the two groups. Results: Time to anal exhaust, time to first defecation, time to first solid food intake, and time to recover to normal bowel sounds were earlier in the study group compared to control group (p < 0.05). Study group exhibited a greater overall rate of tumor control response., while the rate of tumor lymphatic metastasis was also significant (p < 0.05). After treatment, the study group exhibited significantly lower levels of tumor markers compared to control group (p < 0.05). The occurrence of adverse reactions was not significant between the two groups (p > 0.05). Conclusion: Neoadjuvant chemotherapy in conjunction with laparoscopic surgery in the treatment of progressive rectal cancer improves patient outcomes and enhances prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Numerous studies have revealed severe damage to male fertility from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, raising concerns about the potential adverse impact on reproductive function of the coronavirus disease 2019 (COVID‐19) vaccine developed based on the virus. Interestingly, there are several researchers who have studied the impact of the COVID‐19 mRNA vaccine since then but have come up with conflicting results. As a near‐ideal candidate for mass immunization programs, inactivated SARS‐CoV‐2 vaccine has been widely used in many countries, particularly in less wealthy nations. However, little is known about its effect on male fertility. Here, we conducted a retrospective cohort study at a single large center for reproductive medicine in China between December 2021 and August 2022. Five hundred and nineteen fertile men with no history of laboratory‐confirmed COVID‐19 were included and categorized into four groups based on their vaccination status: unvaccinated group (n = 168), one‐dose vaccinated group (n = 8), fully vaccinated group (n = 183), and booster group (n = 160). All of them underwent a semen analysis and most had serum sex hormone levels tested. There were no significant differences in all semen parameters and sex hormone levels between the unvaccinated group and either vaccinated group. To account for possible vaccination‐to‐test interval‐specific changes, sub‐analyses were performed for two interval groups: ≤90 and >90 days. As expected, most of the semen parameters and sex hormone levels remained unchanged between the control and vaccinated groups. However, participants in vaccinated group (≤90 days) have decreased total sperm motility and increased follicle‐stimulating hormone level compared with the ones in unvaccinated group. Moreover, some trends similar to those found during COVID‐19 infection and recovery were observed in our study. Fortunately, all values are within the normal range. In addition, vaccinated participants reported few adverse reactions. No special medical intervention was required, and no serious adverse reactions happened. Our study suggests that inactivated SARS‐CoV‐2 vaccination does not impair male fertility, possibly due to the low frequency of adverse effects. This information reassures young male population who got this vaccine worldwide, and helps guide future vaccination efforts. [ABSTRACT FROM AUTHOR]

Ganoderma lucidum (GL) is a well-known medicinal mushroom that has been extensively cultivated. Our previous study has shown that abundant Trichoderma colonies grow on the casing soil surface, posing cultivation obstacles for GL. However, an understanding of species-level characteristics of Trichoderma strains and their adverse effects on GL growth is limited. This study aimed to investigate the diversity and potential effects of Trichoderma from GL-cultivated soils. Over 700 Trichoderma isolates were collected from two trails in Longquan Country, southeast China. Eight Trichoderma species, including T. atrioviride, T. guizhouense, T. hamatum, T. harzianum, T. koningiopsis, T. pleuroticola, T. sp. irale, and T. virens, were identified based on the combination alignment of tef-1α and rpb2 sequences. The number of Trichoderma colonies increased dramatically during GL cultivation, with an increase of 9.2-fold in the Lanju trail. T. virens accounted for the most colonies (33.33 and 32.50% in Lanju and Chengbei, respectively) at the end of GL cultivation. The Trichoderma species growth varied but was satisfactory under different temperature or pH conditions. Moreover, Trichoderma species showed different adverse effects on GL growth. The non-volatile metabolites from T. virens and volatile metabolites from T. atroviride displayed the strongest antagonistic activity. Furthermore, the volatile 6-pentyl-2H-pyran-2-one (6- PP) showed a significant inhibitory effect on GL growth with an 8.79 μl mL−1 headspace of 50% effective concentration. The different Trichoderma spp. produced different amounts of 6-PP. The most efficient 6-PP producer was T. atroviride. To the best of our knowledge, this study is the first to demonstrate the abundance of competitive Trichoderma species associated with GL cultivation. Our results would contribute to. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Toripalimab (Tuoyi™) is a selective, recombinant, humanized monoclonal antibody against programmed death protein 1 (PD-1) developed by Shanghai Junshi Bioscience Co., Ltd. Toripalimab is able to bind to PD-1 and block the interaction with its ligands. The binding of toripalimab to PD-1 is mainly attributed to the heavy chain of the former and the FG loop of the latter. Toripalimab received a conditional approval in China for the treatment of melanoma (second-line) in December, 2018. It has also received approvals to treat nasopharyngeal carcinoma (first-line and third-line) and urothelial carcinoma (second-line) in 2021. Additionally, several orphan drug designations were granted to toripalimab by the US Food and Drug Administration. Toripalimab has exhibited primary anti-tumor effects in tumors such as melanoma, lung cancer, digestive tract tumors, hepatobiliary and pancreatic tumors, neuroendocrine neoplasms, nasopharyngeal carcinoma and urothelial carcinoma. It showed a satisfactory anti-tumor effect and long-term survival benefits in Chinese melanoma patients, while the combination of axitinib with toripalimab exhibited an impressive result in metastatic mucosal melanoma. As a checkpoint inhibitor, toripalimab was generally well-tolerated in the enrolled patients. Due to different study populations, comparisons could not be made directly between toripalimab and other drugs in most cases. Nevertheless, the introduction of toripalimab may offer a valuable choice for decision-making in the treatment of tumors in the future. [ABSTRACT FROM AUTHOR]

Background: As a novel irreversible pan-ErbB inhibitor recently approved in China, pyrotinib has exhibited promising anticancer efficacy and acceptable safety profile in HER2-positive metastatic breast cancer (mBC). The aim of this retrospective study was to estimate the efficacy and safety of pyrotinib treatment in Chinese mBC patients. Methods: We retrospectively reviewed the real-world clinicopathological and treatment data of HER2-positive mBC patients receiving pyrotinib-based treatment from August 2018 to July 2019 in Qilu Hospital of Shandong University and other medical centers of Shandong Province in China. Results: A total of 64 patients treated with pyrotinib were included for analysis, and the median follow-up duration was 260 days (interquartile range, 199.0 to 339.0 days). Fifty-nine (92.2%) patients had been previously treated with trastuzumab and/or T-DM1, while 11 (17.2%) patients had been exposed to lapatinib. The objective response rate (ORR) of all patients was 73.4%, and the disease control rate (DCR) was 98.4%, with a clinical benefit rate (CBR) of 87.5%. Patients with exposure to lapatinib responded well to pyrotinib-based treatment, although the ORR was significantly lower compared with that of patients without exposure to lapatinib (44.1% vs 77.5%, p=0.037). Previous lapatinib exposure was negatively associated with the objective response of pyrotinib treatment (odds ratio [OR]=0.248, 95% confidence interval [CI]  0.063– 0.970, p=0.045). The median progression-free survival (mPFS) for patients with previous lapatinib exposure and patients with visceral metastasis was 299 days (95% CI 240.1– 357.9 days) and 359 days (95% CI 258.3– 459.7 days), respectively. But the mPFS of the whole cohort has not been reached until the cut-off date. Cox multivariate analysis revealed that only visceral metastasis was an independent predictor of significantly shorter PFS (p=0.041) but not previous exposure to lapatinib (p=0.092). Diarrhea (28.1%), hand-foot syndrome (17.2%), and neutropenia (9.4%) were the most common grade 3 adverse events associated with pyrotinib treatment. Conclusion: Pyrotinib is highly beneficial to HER2-positive metastatic breast cancer patients, even in patients with previous lapatinib exposure. Pyrotinib is a feasible replacement of lapatinib in combination with chemotherapeutic drugs or as a monotherapy. Adverse effects are tolerable and easily manageable. [ABSTRACT FROM AUTHOR]

Summary: Background Esophageal cancer is a very common malignant tumor in China, especially esophageal squamous cell carcinoma (ESCC), but there is currently no effective treatment for patients after first-line chemotherapy failure. Apatinib has shown promising outcomes in treatment with various solid tumors. Objectives To evaluate the clinical efficacy and safety of apatinib combined with S-1 in the treatment of advanced ESCC patients after first-line chemotherapy failure. Methods In this prospective study, fifteen patients with advanced ESCC who failed first-line chemotherapy were enrolled from Nov 2016 to Apr 2019. Patients received the combination therapy with apatinib (250-500 mg, once daily) plus S-1 (40–60 mg based on body surface area, twice daily). Primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), disease control rate (DCR) and objective response rate (ORR). Adverse events (AEs) were recorded to evaluate the safety. Results A total of 12 patients were included in the efficacy analysis. The median PFS was 6.23 months, and the median OS was 8.83 months. Two (16.67%) patients achieved partial remission, 9 patients (75.00%) achieved stable disease and 1 (8.33%) patient achieved progressive disease. DCR and ORR was 91.67%and 16.67%, respectively. Most frequent AEs were hypertension, myelosuppression, weakness, hemorrhage, hand-foot syndrome, total bilirubin elevation, sick, proteinuria, oral ulcer, loss of appetite, and transaminase elevation. The most AEs were in grade I~II. Conclusion The combination therapy of apatinib plus S-1 was effective and well tolerated in the treatment of advanced ESCC patients after first-line chemotherapy failure. The combination therapy has the potential to be a potent therapeutic option for advanced ESCC patients after first-line chemotherapy failure. [ABSTRACT FROM AUTHOR]

Background: Anti-tuberculosis therapy requires at least six-month treatment with continuous administration of combined antibiotics, including isoniazid, rifampicin, pyrazinamide, and ethambutol. The long-term exposure to antibiotics could cause consequent changes in gut microbiota, which may alter the gastrointestinal function and drug absorption in patients, thereby affect the outcome of treatment. The study aims to characterize the longitudinal changes of gut microbiota among tuberculosis (TB) patients under standardized first-line treatment and provide an understanding of the association between alterations in gut microbiota composition and unfavorable clinical outcomes.Methods: The study is a multicenter, observational prospective cohort study. Three study sites are purposively selected in the western (Sichuan Province) and eastern (Jiangsu Province and Shanghai) parts of China. Three-hundred patients with bacteriologically confirmed pulmonary TB are enrolled. All eligible patients should be investigated using structured questionnaires before treatment initiation; and be followed up during the treatment at Day-14, Month-2, Month-5, the end of treatment and the sixth month after ending therapy. Stool samples are to be collected at each visit, consisting of six stool samples from each patient. Additionally, 60 healthy volunteers from Sichuan province and Shanghai city will be recruited as healthy controls to form the baseline of patient gut microbiota in the Chinese population. The dynamic changes of gut microbiota in terms of alpha diversity, beta diversity, taxonomic composition are to be illustrated individually from the time at diagnosis until the sixth month after therapy is completed. Furthermore, the diversity and component of gut microbiota will be compared between the groups with and without unfavorable treatment outcome in terms of adverse effect and treatment failure.Discussion: Studies on the clinical manifestations, adverse reactions, and gut microbiota alterations will provide scientifically-sound evidence on the impact of gut microbiota alterations on TB treatment outcomes. The study is not only useful for guiding personalized TB treatment but also sheds light on the effects of continuous antibiotics administration on gut microbiota.Trial Registration: Chinese Clinical Trial Registry, trial ID: ChiCTR1900023369, May 24, 2019. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Deciphering the mobility and transfer of heavy metals in transition buffers is vital to understanding their behavior in mangrove forests. As one of the most redox-sensitive metals, the geochemical fractionation of sediment Chromium in mangrove forests and its health risks to the coastal fishermen folk is not clearly understood. This study investigated the current levels, enrichment, geochemical fractionation, and eco-toxicity on organisms of sediment Chromium from three mangrove forests in southeast China. A health risk assessment for different exposure pathways were also determined with Monte Carlo simulations technique. The results revealed that the concentration of sediment Chromium ranged from 30.75 mg kg−1 to 99.28 mg kg−1. The geochemical fractionations of sediment Chromium were mainly associated with amorphous Fe fraction, crystalline Fe fraction and residual fraction. Notably, 83.12% of samples analyzed in the residual phases of Chromium exceeded the background value of 40.7 mg kg−1. Adverse effect index revealed a considerably negative effect on benthos occurrence in the mangroves. Values of non-carcinogenic risks were below unity at all samples, whereas the cancer risks associated with Cr(VI) exposure via fish consumption at median were close to 1.73 × 10 − 5 . A sensitivity analysis indicated that sediment Cr(VI) concentration and exposure frequency were the most relevant variables in the risk model. As the first attempt to provide information on the human health risks of sediment Chromium in mangrove forests in China, findings from this study can help track potential adverse effects and avoid risks from sediment Chromium. • Chromium were mainly associated with residual phases. • Total carcinogenic risk of Cr(VI) followed the order of CR fish > CR oral > CR derm. • Cr(VI) concentration and exposure frequency were the most influential parameter in calculating CR fish. [ABSTRACT FROM AUTHOR]

Guangdong province is one of the provinces most frequently hit by tropical cyclones in China. Hand, foot and mouth disease (HFMD) continues to severely affect public health across the world. Our study aimed to evaluate the impacts of different grades of tropical cyclones and accompanying precipitation and wind velocity on HFMD among children younger than 6 years old in Guangdong province from 2009 to 2013. A time-stratified case-crossover design was used to examine the association between tropical cyclones and childhood HFMD. Principal component analysis (PCA) was first used to eliminate multicollinearity among meteorological variables. Conditional Poisson regression was then applied to calculate odds ratios (ORs) and the 95% confidence intervals (CIs). Tropical storms increased the risk of HFMD among children below 6 years of age on lag 4 days (OR = 1.55, 95%CI: 1.28–1.88). Tropical storms were also a risk factor for boys below 3 years of age, boys between 3 and 6 and girls below 3 years of age with the largest OR = 1.52 (95%CI:1.15–2.00), OR = 1.81 (95%CI = 1.21–2.71) and OR = 1.51 (95%CI = 1.04–2.19), respectively. Precipitation during tropical cyclones had an adverse effect on childhood HFMD when reaching 25–49.9 mm or above 100 mm with OR = 1.20 (95%CI = 1.00–1.43) on lag 0 day and OR = 1.25 (95%CI = 1.04–1.49) on lag 7 days, respectively. For extreme wind velocity during tropical cyclones, the impact on childhood HFMD was largest on the day tropical cyclones landed (OR = 1.25, 95%CI: 1.06–1.48) with winds up to 13.9–24.4 m/s. Tropical storms can increase the risk of HFMD among children younger than 3 years old, especially boys between 3 and 6 years old. Precipitation during tropical cyclones is a risk factor for childhood HFMD when it is between 25 and 49.9 mm or above 100 mm. As extreme wind velocity reaches 13.9–24.4 m/s, it has an adverse effect on children's health. Children below 3 years old and boys between 3 and 6 should be given more consideration during tropical storms. Image 1 • The study evaluated the impact of tropical cyclones on childhood HFMD. • Boys 0–6 and girls 0–3 were vulnerable to HFMD during tropical storms. • Precipitation between 25 and 49.9 mm or above 100 mm could increase the risk of HFMD. • Extreme wind velocity between 13.9 and 24.4 m/s was a risk factor of HFMD. [ABSTRACT FROM AUTHOR]

Background This study explored the adverse effect (AE) profile of phenobarbital (PB) among patients with active convulsive epilepsy (ACE) from resource-poor areas. Methods Patients with ACE were enrolled into an epilepsy management project in rural West China. Information was obtained from monthly follow-up questionnaires. The demographic and clinical features of the patients with AE were firstly described. After that, the occurrence rate was estimated for each subtype of AE at three different severity levels (mild, moderate, and serious). Survival analysis was used to determine the potential risk factors of AEs. Results A total of 7231 patients (3780 men) were included in the present cohort. During the follow-up time period (average 33.4 months), the most common AEs were drowsiness (moderate: 4.4%, serious: 0.68%), dizziness (moderate: 3.7%, serious: 0.5%), and headache (moderate: 2.9%, serious: 0.41%). In the confirmed AE groups (moderate and serious severity levels), the symptoms tended to be transient, with durations of less than 3 months. Polytherapy was an independent risk factor for AEs and had an increasing risk when the severity of the AE increased (Hazard Ratio 1.12, 1.55, and 2.52 for mild AE, moderate AE, and serious AE, respectively). Receiving a high dosage of PB (> 180 mg/day) indicated a slightly elevated risk (Hazard Ratio 1.22 and 1.27 for mild AE and moderate AE, respectively). Conclusion Phenobarbital demonstrates overall tolerability, and serious AEs were not common. Patients receiving a high dose of PB or polytherapy are at increased risk of developing AEs. [ABSTRACT FROM AUTHOR]

To evaluate the adverse reactions associated with the four types of monovalent antivenom currently used in China, we retrospectively analysed the data of all patients admitted for snakebites who received antivenom treatment at the main institution for the treatment of venomous snakebites in Guangzhou from January 2013 to December 2021. A total of 1658 patients were analysed in our study, and 60.7% (n = 1007) of the snakebite patients received antivenom treatment. The incidence rate of adverse reactions that occurred after the administration of all types of monovalent antivenom was 4.9% (n = 49), and the incidence rate of acute adverse reactions was 2.7% (n = 27). The number of adverse reactions that occurred was 38/744 (5.1%) in patients who received prophylactic application of glucocorticoids alone and 10/217 (4.6%) in those who received a combination of antihistamines and glucocorticoids (P = 0.83). The average doses of the antivenoms used in patients exhibiting acute adverse reactions and serum sickness were 3.31 ± 0.75 vials and 2.36 ± 0.26 vials, respectively (P = 0.28). The antivenom skin test showed high specificity (98.3%, 95% CI: 97.24%–99.01%) but low sensitivity (14.3%, 95% CI: 6.41%–27.86%). Our results showed that the four types of monovalent antivenom were safe. No significant difference was observed between the use of glucocorticoids alone and the use of antihistamines combined with glucocorticoids as premedication for the prevention of adverse reactions. Reducing the dose of antivenoms or reducing the combination of antivenoms did not help to reduce the occurrence of adverse reactions. Skin testing should not be recommended due to its low sensitivity. [Display omitted] • We analysed the adverse reactions associated with the four types of monovalent antivenom currently used in China. • The incidences of adverse reactions among the four types of monovalent antivenom showed no significant difference. • The incidence of adverse reactions to the four types of monovalent antivenom was found to be low (4.9%). [ABSTRACT FROM AUTHOR]

Highlights: [•] Heavy metals might pose transcriptional effects on stress responsive genes. [•] Heavy metals in fishes might pose risk of adverse health effects to human. [•] Heavy metals in sediments of the Yangtze River posed significant ecological risk. [ABSTRACT FROM AUTHOR]

Objective: An increased risk of serious adverse effects related to bevacizumab has been observed in many Western studies for metastatic colorectal cancer. To evaluate the safety of bevacizumab in Chinese patients, a safety study was conducted in Taiwan. Methods: Bevacizumab was provided by the Expanded Access Program in combination with first-line chemotherapy per investigator's choice. The primary objective is the safety profile, particularly the targeted adverse events such as proteinuria, bowel perforation, hypertension, wound healing complication, thromboembolism and bleeding. The second objectives include time to disease progression and overall survival time. Patients with major surgical procedure performed within the 28 days of bevacizumab were excluded from this study. Results: Forty patients were eligible for intent-to-treat analysis. The overall rate of objective response and disease control was 55.2 and 81.6%. The median time to disease progression and overall survival were 11.9 and 22.9 months. The actuarial 2-year survival was 46.6%. Regarding toxicity, 7 subjects (17.5%) had serious adverse effects related to study treatment. None of the patients in this cohort had arterial thrombotic events and bowel perforation. Conclusions: Bevacizumab demonstrates a similar activity and safety profile in Chinese patients. Life-threatening bowel complications were avoided in this study by excluding patients with major surgery within the first 28 days. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Along with the rapid growth of the global aging society, the mobile and health digital market has expanded greatly. Countless mobile medical apps (mmApps) have sprung up in the internet market, aiming to help patients with chronic diseases achieve medication safety., Objective: Based on the medication safety action plans proposed by the World Health Organization, we aimed to explore the effectiveness of mmApps in ensuring the medication safety of patients with chronic diseases, including whether mmApps can improve the willingness to report adverse drug events (ADEs), improve patients' medication adherence, and reduce medication errors. We hoped to verify our hypothesis through a systematic review and meta-analysis., Methods: The meta-analysis was performed in strict accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included literature searched from 7 databases-PubMed, Web Of Science, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, and SinoMed. The publication time was limited to the time of database establishment to April 30, 2022. Studies were screened based on inclusion and exclusion criteria. The data extracted included authors, years of publication, countries or regions, participants' characteristics, intervention groups, and control groups, among others. Our quality assessment followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions, Version 6.3. RevMan 5.2 software (Cochrane Collaboration) was used to analyze the statistical data, and a sensitivity analysis was performed to assess data stability. The degree of stability was calculated by using a different statistical method and excluding large-sample studies from the analysis., Results: We included 8 studies from 5 countries (China, the United States, France, Canada, and Spain) that were published from January 1, 2014, to December 31, 2021. The total number of participants was 1355, and we analyzed the characteristics of included studies, each app's features, the risk of bias, and quality. The results showed that mmApps could increase ADE reporting willingness (relative risk [RR] 2.59, 95% CI 1.26-5.30; P=.009) and significantly improve medication adherence (RR 1.17, 95% CI 1.04-1.31; P=.007), but they had little effect on reducing medication errors (RR 1.54, 95% CI 0.33-7.29; P=.58)., Conclusions: We analyzed the following three merits of mmApps, with regard to facilitating the willingness to report ADEs: mmApps facilitate more communication between patients and physicians, patients attach more importance to ADE reporting, and the processing of results is transparent. The use of mmApps improved medication adherence among patients with chronic diseases by conveying medical solutions, providing educational support, tracking medications, and allowing for remote consultations. Finally, we found 3 potential reasons for why our medication error results differed from those of other studies., Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42022322072; https://www.crd.york.ac.uk/prospero/display&#95;record.php?RecordID=322072., (©Ting ting Zhou, Rui Wang, Si jia Gu, Li ling Xie, Qing hua Zhao, Ming zhao Xiao, Yu lu Chen. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 22.11.2022.)

Objectives: To study the association between neonatal discharge preparedness and adverse health events., Methods: The neonates who were born in hospitals from different regions of Gansu Province in China and their parents were enrolled as subjects, and an investigation was performed for the discharge preparedness. According to the level of discharge preparedness, the subjects were divided into low-, middle-, and high-level groups. The neonates were followed up to observe the incidence rate of adverse health events within one month after discharge. The association between neonatal discharge preparedness and adverse health events was analyzed., Results: The neonates with adverse health events had a significantly lower level of discharge preparedness than those without adverse events ( P <0.05). The multivariate logistic regression analysis showed that the incidence rate of adverse health events was reduced by 34.8% in the middle-level group and 78.7% in the high-level group compared with the low-level group ( P <0.05). The readmission rate of neonates was 8.1% (35/430), and the neonates readmitted had a significantly lower level of discharge preparedness than those not readmitted ( P <0.05). The multivariate logistic regression analysis showed that the readmission rate of neonates was reduced by 67.4% in the middle-level group and 84.2% in the high-level group compared with the low-level group ( P <0.05)., Conclusions: Discharge preparedness may affect the incidence of adverse health events and the rate of readmission within one month after discharge. Medical staff should adopt effective intervention measures to improve discharge preparedness, so as to reduce the incidence of adverse health events and the rate of readmission.

Abstract: Objective: Antiepileptic drugs (AEDs) have been widely used in patients with epilepsy but the adverse effects in adult Chinese patients have not been investigated. This study evaluated the adverse effects of four commonly prescribed AED monotherapies with carbamazepine (CBZ), phenytoin (PHT), valproate (VPA), and lamotrigine (LTG) in adult Chinese patients with epilepsy. Methods: The prospective open-label clinical trial was conducted at the Chongqing Epilepsy Center. The study enrolled 505 adults with newly diagnosed epilepsy, including generalized tonic–clonic (n =110), partial and partial secondarily generalized (n =395) seizures. Patients were evaluated by two clinicians at the Center and were prescribed one type of AED monotherapy with CBZ, PHT, VPA or LTG for a 24-month period. An adverse effect profile, as well as efficacy of monotherapy, was obtained through a face-to-face interview with the patient at each visit. A physical examination and routine laboratory tests were performed during a clinical screening. Results: A total of 62.6% (316/505) patients successfully completed the AED monotherapy study: 64.3% of those receiving CBZ, 55.9%—PHT, 61.5%—VPA, and 66.2%—LTG. However, 34.7% of the patients discontinued the AED monotherapy because of unsatisfactory seizure control. Overall, 18% of patients experienced adverse effects: for CBZ (25/168; 14.9%), PHT (18/59; 30.5%), VPA (32/192; 16.7%) and LTG (16/86; 18.6%). The most common drug-related adverse events included gastrointestinal disturbances, loss of appetite and nausea, weight gain and fatigue/tiredness. Tremor and nystagmus occurred in some patients receiving PHT and VPA. Two CBZ, one PHT and four LTG patients (n =7) discontinued the study due to rash. Conclusion: Adult Chinese patients with epilepsy accepted and tolerated monotherapy with CBZ, PHT, VPA, and LTG. No fatal adverse events occurred. Unsatisfactory seizure control was a primary reason for withdrawal from the AED monotherapy study. [Copyright &y& Elsevier]

Objectives: The β-blocker propranolol was discovered to be highly effective for the treatment of infantile hemangiomas (IHs), since 2008. Although some side effects have been reported earlier, no serious side effects of its use have been reported so far in Asia, especially in China. To determine the safety of this therapy, the side effects were analyzed in 97 infants who used propranolol (2 mg kg−1·d−1) against hemangioma from 2010 to 2011. Materials and methods: Routine blood and urine tests, hepatic and renal function tests, myocardial enzyme, electrolytes and blood sugar levels at baseline were performed. Electrocardiogram monitoring was performed 48 h after administration of the first dose (2 mg kg−1·d−1). Every patient ( n = 97) was required to report to the hospital once a month. Results: The following adverse effects were observed: bronchial hyperactivity ( n = 5), cyanosis and cold extremities ( n = 1), agranulocytosis ( n = 1), and low body temperature ( n = 1). These side effects were reported for the first time in Asia. Conclusions: Although propranolol is effective against IHs, its potential side effects should be considered and appropriate monitoring performed. Further studies need to be conducted to determine the optimal dose and duration of propranolol treatment for large and complex hemangiomas. [ABSTRACT FROM AUTHOR]

To study the efficacy and safety of intravenous thrombolysis for the older acute ischemic stroke patients, clinical data were prospectively analyzed from 168 patients with acute ischemic stroke including 42 older adult patients (ET group), 66 younger patients (NET group) treated with rt-PA, and 60 older adult patients treated without rt-PA (ENT group). Stroke severity was assessed with an NIHSS score at baseline, 1-day and 14-day after treatment. Functional outcomes were evaluated by the modified Rankin scale and a Barthel index. Adverse effects were observed during the treatment. The rate of "good" prognosis was higher in the ET group than that in the ENT group at 90 days post-stroke. In older patients with stroke, thrombolytic therapy was found to be of greater benefit to patients with lower NIHSS scores at baseline, or patients classified as posterior circulation infarction, than for patients with higher NIHSS scores or infarctions located in other brain regions. Thrombolytic therapy may exhibit long-term efficacy by improving the future quality of life for older stroke patients with fewer bleeding risk factors and lower baseline NIHSS scores., Competing Interests: None

Objective: We aimed to examine the feasibility and toxicity of EC-T dose-dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early-stage breast cancer population with high recurrence risk. Methods: 370 patients with early-stage breast cancer at high risk of recurrence were treated with EC-T dose-dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G-CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed. Results: 370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9% experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk ( OR =1.268, P =0.046; OR =1.244, P =0.036). With G-CSF support, the probability of grade 3-4 dose limiting toxicity, i. e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased( P >0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay ( P =0.814) or dose reduction ( P =0.282). Conclusions: EC-T dose-dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen. With G-CSF support, epirubicin 85-90 mg/m(2) is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.

Aim: Major depressive disorder (MDD) is a common psychiatric disorder with a complicated pathogenesis and genetic predisposition. The objective of this article is to explore the relationship between the four SNPs of circadian locomotor output cycles kaput (CLOCK) gene (rs11932595, rs12504300, rs3805148, rs534654) and the efficacy of antidepressants. Materials & methods: This study enrolled a total of 600 patients, who met the DSM-V diagnostic criteria for MDD. All subjects were treated with single selective serotonin reuptake inhibitors. The HAMD 17  and adverse reaction scale (TESS/UKU) were used to assess the efficacy of antidepressants and adverse effects. The PCR and DNA sequencing analysis were used to genotype loci of CLOCK gene., Results: The antidepressants efficacy of subjects with rs11932595 AA genotype was significantly higher than those with GG+GA genotypes (p = 0.035). But this p-value was not significant after false discovery rate (FDR) adjustment., Conclusion: The variant of CLOCK gene may be associated with the efficacy of selective serotonin reuptake inhibitors in Chinese Han MDD patients.

Background: Chinese herbal medicine is an alternative therapy for menopausal problems and is widely practiced in China and many other Asian countries. However, efficacies and side-effects are rarely assessed according to the standards of evidence-based medicine., Patients and Methods: This is a prospective observatory study following efficacy and side-effects of a semi-individualized Chinese herbal mixture "Tiáo Gēng Tāng (TGT)" in 30 patients for 3 months. Another group of 30 patients receiving hormone therapy with tibolone was included as a positive comparison. Common questionnaire-based measuring instruments were: modified Kupperman index, menopause rating scale, life quality and Chinese medical symptom scale (CMSS). Follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were determined before and three months after the treatments., Results: Significant improvement was seen in overall scores of all the four measurements in both groups. For some symptoms, including dry mouth, tinnitus, poor appetite and constipation, TGT was more effective than tibolone. For psychosocial and sexual sub-scales of life quality, tibolone has a slightly higher remedy rate than TGT. TGT lowered FSH and LH significantly, as tibolone did, but elevated E2 significantly less than tibolone. Various adverse events, including body weight increase, abdomen discomfort, nausea/vomiting, emotional instability, pressure in breasts and dizziness, were reported by patients treated with tibolone, whereas only diarrhea was observed in two patients treated with TGT., Conclusion: TGT alleviates menopausal symptoms with similar efficacy as tibolone but has fewer side effects., (Copyright © 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)