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Li Zhang,1,* Mupeng Li,1,* Lianlian Fan,1 Fangfang Liu,1 Peiwen Zhang,1 Qian Huang,1 Gang Mai,1 Jianzhong Shentu1,2 1Phase 1 Clinical Trial Center, Deyang People′s Hospital, Deyang, Sichuan, People’s Republic of China; 2Research Center for Clinical Pharmacy, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianzhong Shentu, Email stjz@zju.edu.cn Gang Mai, Email stdygcp@163.comPurpose: Estradiol valerate (Progynova®) is used as hormone therapy to supplement estrogen deficiency. This study aimed to assess the bioequivalence of an estradiol valerate tablet and its generic form, under fasting and fed conditions.Methods: A randomized, open-label, single-dose, 2-period crossover study was conducted on healthy postmenopausal Chinese female volunteers under fasting and fed conditions. For each period, the subjects received either a 1 mg tablet of estradiol valerate or its generic. Blood samples were collected before dosing and up to 72 hours after administration. Plasma levels of total estrone, estradiol, and unconjugated estrone were quantified using a validated liquid chromatography-tandem mass spectrometry method.Results: A total of 54 volunteers were enrolled in this study. The primary pharmacokinetic parameters, including Cmax, AUC0-t, and AUC0-∞, were similar for the two drugs under both fasting and fed conditions, with 90% confidence intervals for the geometric mean ratios of these parameters, all meeting the bioequivalence criterion of 80– 125%. A total of 48 adverse events (AEs) were reported in the fed study compared with 24 AEs in the fasting study.Conclusion: Estradiol valerate and its generic form were bioequivalent and well tolerated under both fasting and fed conditions.Keywords: bioequivalence, estradiol valerate, postmenopausal, pharmacokinetics, safety

Background and Aim: Salinomycin sodium, a licensed coccidiostat in rabbits, is used for fattening at a dose of 20–25 mg/kg. Salinomycin toxicity may arise from many risk factors (e.g., overdosage or use in non-target animal species). Silymarin extracted from milk thistle has antioxidant, anti-inflammatory, and antiviral properties. This study aimed to investigate the adverse impacts of oral administration of salinomycin for 28 consecutive days and how to reduce its risks and side effects by administering silymarin. Materials and Methods: Eighty-four male New Zealand White bucks (1.750–2.000 kg) were randomly divided into seven groups (12 each). Group one was the control. Groups two and three were administered salinomycin orally (doses of 20 and 40 mg/kg ration). Group four was administered salinomycin (20 mg/kg ration) and silymarin (6.5 mg/kg body weight [BW]). Group five received salinomycin (40 mg/kg ration) and silymarin (13 mg/kg BW). Groups six and seven were administered silymarin at doses of 6.5 and 13 mg/kg BW. Rabbits were euthanized and slaughtered on day 29 using the Halal method. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, urea, total proteins, albumin, total cholesterol, and high- and low-density lipoprotein (HDL and LDL) were analyzed in serum. Glutathione (GSH), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) were estimated in the liver. A histopathological investigation was performed on the liver and kidney. Results: The MDA activity, AST, ALT, total protein, albumin, total cholesterol, triglyceride, LDL, urea, and creatinine values were significantly elevated in groups two and three. The GSH, catalase, SOD, and HDL were significantly lower in these groups than in the control group. There were moderate pathologic changes in the liver and kidney of the third group . However, the results of the fourth and fifth groups improved more than those of the second and third groups. The results of the sixth and seventh groups were nearly the same as those of the control group. Conclusion: Salinomycin toxicity was caused by oxidative damage because of reactive oxygen species formation. Silymarin (6.5 or 13 mg/kg BW) tends to prevent and treat accidental toxicity. However, the high dose of silymarin (13 mg/kg BW) had more renal and hepatoprotective capacities.

Acute gastroenteritis (AGE) induced by rotavirus has been a major disease burden in Egypt since 1981 when rotavirus was first reported in humans and calves. Genome segmentation facilitates the emergence of new virus serotypes, which allows reassortment during mixed infections, and is a characteristic feature of the family Reoviridae to which rotavirus belongs. The rotavirus genome involves 11 double-stranded RNA gene segments encoding 6 non-structural (NSP1–6) and 6 structural (VP1–4, VP6, VP7) proteins. Rotavirus A has a zoonotic potential associated with diarrhea. The primary strategy for prevention and control of bovine and human rotavirus infections is vaccination; however, routine rotavirus vaccination has not been implemented in the National Immunization Program. We evaluated studies published over the last 30 years that pertained to the epidemiology of circulating rotavirus genotypes among children, calves, and environmental samples in Egypt. The analysis revealed a rotavirus prevalence of 15%–100%, with diarrhea occurring throughout the year, but generally peaking during the cold months. G1 was the predominant genotype in children, followed by G2, G3, G4, G8, G9, and G12 throughout the study duration. Mixed infections were also detected. G6 was the predominant genotype in calves, followed by G10. There are still gaps in knowledge regarding molecular data of rotavirus infections in humans, animals, and environmental samples in Egypt, as well as the zoonotic potential of rotavirus disease. Therefore, it is critical to continue rotavirus surveillance in Egypt to further understand the epidemiology of rotavirus infections and the emerging new genotypes.

Goat's milk (GM), sheep's milk (SM), and its fermentation products are renowned for their nutritional and health advantages, yet they often face challenges in the market due to their distinctive flavor, which some consumers find unpleasant. The incorporation of fruit purees presents an appealing solution for enhancing taste, odor and masking the undesirable flavors in these dairy products. The current study aimed to investigate the effects of supplementing plain fermented GM or SM with date puree (DP) at concentrations of 1.5, 3, and 5% on physicochemical, antioxidant, rheological and sensory properties of the products. The pH-values, ash, fibers, antioxidants, and viscosity of both flavored goat drinkable yogurt (FGY) and flavored sheep-drinkable yogurt (FSY) were significantly higher (p≤0.05) compared to both plain drinkables. Drinkable yogurt fortified with 5% DP had a higher total solid content, while samples fortified with 1.5% and 3% DP had higher protein and fat contents than the control samples. The addition of DP improved significantly (p≤0.05) the sensory attributes of FGY and FSY, and the yogurt samples were more acceptable than controls. The cold storage (5◦C) for 10 days had significant effects (p≤0.05) on the properties of all yogurt samples. In conclusion, the addition of DP improved the physicochemical, rheological, and all sensory properties of goat and sheep yogurt. [ABSTRACT FROM AUTHOR]

Objectives The robotic retroauricular approach and transoral endoscopic thyroidectomy vestibular approach (TOETVA) have been employed to avoid anterior neck scarring in thyroidectomy with good success. However, outcomes have yet to be compared between techniques. We compare our initial clinical experience with these approaches for thyroid lobectomy at our institution. Methods A review of initial consecutive patients who underwent robotic facelift thyroidectomy (RFT) (August 2011–August 2016) at our institution was conducted. This was compared with the same number of initial consecutive patients who underwent TOETVA (September 2016–September 2017) at our institution. Demographics, operative time, pathology, complications, and learning curve were compared between cohorts. Learning curve was defined based on the slope of linear regression models of operative time versus case number. Results There were 20 patients in each cohort. There was no statistically significant difference in demographic data between cohorts. One hundred percent of RFT cases versus 95% TOETVA cases (P = .999) were completed without conversion to standard open technique with median operative times of 201 (124–293) minutes versus 188 (89–343) minutes with RFT and TOETVA, respectively (P = .36). There was no incidence of permanent recurrent laryngeal nerve injury in either cohort. The slopes of the regression models were 0.29 versus −8.32 (P = .005) for RFT and TOETVA, respectively. Conclusion RFT and TOETVA are safe and feasible options for patients motivated to avoid an anterior neck scar. However, the quicker learning curve without the need for a costly robotic system may make TOETVA the preferred technique for institutions wishing to perform anterior cervical incision‐sparing thyroidectomy. Level of Evidence 4

OBJECTIVE: To explore the feasibility of the Internet + nursing service mode in family rehabilitation of elderly patients with osteoarthritic diseases. PATIENTS AND METHODS: The control group (n=50) received routine rehabilitation treatment procedures and discharge guidance. For the observation group (n=50), extended nursing rehabilitation service was conducted through the Internet + nursing service platform based on the routine treatment in the control group. RESULTS: (1) The compliance with follow-up of the patients in the observation group was significantly higher than that in the control group; (2) The total satisfaction of patients in the observation group was significantly higher than that in the control group; (3) The VAS (1 month: 4.36±1.15 vs. 5.86±1.61, p<0.05; 3 months 4.36±1.15 vs. 5.86±1.61, p<0.05), SAS (1 month: 37.21±14.16 vs. 49.31±13.45, p<0.05; 3 months 26.73±8.25 vs. 40.33±9.50, p<0.05), SDS (1 month: 32.36±10.15 vs. 46.32±12.61, p<0.05; 3 months 27.11±8.08 vs. 40.62±11.40, p<0.05) and PSQI (1 month: 13.64 ± 1.13 vs. 16.31 ± 3.45, p<0.05; 3 months 11.54 ± 1.87 vs. 15.74 ± 1.36, p<0.05) scores in the observational group were significantly lower than that in control group at one month and three months after discharge. The ADL (1 month: 86.86 ± 4.13 vs. 74.33 ± 3.44, p<0.05; 3 months 90.34 ± 7.87 vs. 78.52 ± 6.36, p<0.05) scores in the observational group were significantly higher than that in control group at one month and three months after discharge. CONCLUSIONS: The extended rehabilitation nursing management for family rehabilitation of elderly patients with osteoarthritic diseases through the Internet + nursing service is a family rehabilitation model suitable for elderly patients with osteoarthritic diseases in China and has positive significance in developing a diversified medical nursing model. [ABSTRACT FROM AUTHOR]

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