To review the research progress of pure opioid receptor agonist oxycodone.The research progress of oxycodone in terms of pharmacokinetics,pharmacodynamics,adverse reactions,clinical application,combined medication and...To review the research progress of pure opioid receptor agonist oxycodone.The research progress of oxycodone in terms of pharmacokinetics,pharmacodynamics,adverse reactions,clinical application,combined medication and new progress in clinical application was summarized by referring to the literature.Oxycodone is a semi-synthetic thebaine derivative of opioid alkaloids,and is a pure opioidμandκreceptor agonist.The main action sites are the central nervous system and visceral smooth muscle.Due to its advantages of low adverse reactions,good analgesic effects,and a wide range of safe doses,the drug has been widely used in the control of acute and chronic postoperative pain,as well as malignant and non-malignant pain.Since the end of the 20^(th) century,researchers have begun to formulate antipyretic analgesics,opioid receptor agonists,opioid receptor antagonists,dopamine receptor antagonists and other drugs with oxycodone in different proportions to enhance the analgesic effect.At the same time,it can reduce the dosage of oxycodone and reduce its adverse reactions,so as to achieve the purpose of limiting opioid abuse.With the continuous research on the efficacy and safety of oxycodone in the perioperative period at home and abroad,oxycodone has become the only dual-opioid potent analgesic that can be used in clinical work.展开更多
Background The COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy(PWE),especially those with monthly household income<5000 RMB or with uncontrolled seizur...Background The COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy(PWE),especially those with monthly household income<5000 RMB or with uncontrolled seizures.Patients with Kessler scores>12 should consult a psychiatrist,especially during major disasters.This study was aimed to compare the frequency of psychological distress among Chinese PWE before and during the outbreak of the SARS-CoV-2 Omicron variant,and to identify risk factors for such distress.Methods In this prospective study,we collected sociodemographic data of PWE aged>14 years,who were treated at our center during December 1 to 15,2022.All participants completed the 6-item Kessler Psychological Distress Scale before the outbreak and again during the outbreak.Health visitors who were unrelated to those patients during the outbreak were included as a control.Multivariate logistic regression analysis was performed to identify risk factors of severe psychological distress and its exacerbation.Results Of the 223 PWE,127 were tested positive for SARS-CoV-2,while 174 of 218 controls were positive for SARS-CoV-2.The neurological symptoms were similar between PWE and controls with SARS-CoV-2.The average Kessler score of PWE was significantly higher during the outbreak than before it(9.93±3.98 vs.8.52±0.23,P<0.001).The average score of controls during the outbreak(5.146±0.35,P<0.001)was significantly lower than that of the PWE.We identified three independent predictors for severe psychological distress in PWE during the outbreak,i.e.,monthly household income<5000 RMB(OR=0.252,95%CI 0.064–0.998,P=0.048),severe psychological distress before the outbreak(OR=0.067,95%CI 0.026–0.174,P<0.001),and seizure onset within 30 days before the assessment during the outbreak(OR=0.356,95%CI 0.157–0.805,P=0.013).Of the three predictors,the last one was also an independent predictor for exacerbation of psychological distress during the outbreak(OR=0.302,95%CI 0.123–0.741,P=0.009).Conclusions Our analysis suggests that the COVID-19 pandemic has substantially increased psychological distress of individuals with epilepsy,regardless of the viral infection or not.Various neurological symptoms similar to those of“long COVID”appeared for the first time among these individuals during the Omicron outbreak,highlighting the need for clinicians to screen carefully for this condition.Management of epilepsy during the pandemic or a similar major disaster should focus on the control of seizures and maintenance of mental health,especially among those with monthly household incomes below 5000 RMB,suffering uncontrolled seizures and having a history of severe psychological distress.展开更多
AIM:To investigate the tacrolimus dosage requirements and blood concentrations in adult-to-adult right lobe living donor liver transplantation (AALDLT) recipients with small-for-size (SFS) grafts.METHODS: During Janua...AIM:To investigate the tacrolimus dosage requirements and blood concentrations in adult-to-adult right lobe living donor liver transplantation (AALDLT) recipients with small-for-size (SFS) grafts.METHODS: During January 2007 and October 2008, a total of 54 cases of AALDLT with an observation period of 6 mo were enrolled in this study. The 54 patients were divided into two groups according to graft-recipient body weight ratio (GRBW): SFS grafts group (Group S, GRBW<0.8%, n=8) and non-SFS grafts group (Group N, GRBW ≥0.8%, n=46). Tacrolimus 12-hour blood levels and doses were recorded during weeks 1,2,3 and 4 and months 2,3,4,5 and 6 in group S and group N. Meanwhile, acute rejection rates, liver and renal function test results, and the number of potentially interacting medications were determined at each interval in the two groups. A comparison of tacrolimus dosage requirements and blood levels were made weekly in the first month post-surgery, and monthly from months 2 to 6.RESULTS: There were no differences in the demo-graphic characteristics, acute rejection rates, liver and renal function test results, or the number of potentially interacting medications administered between the two groups. The tacrolimus dosage requirements in group S were significantly lower than group N at 2 wk (2.8±0.4 mg/d vs 3.6±0.7 mg/d, P=0.006), 3 wk (2.9±0.7 mg/d vs 3.9±0.8 mg/d, P=0.008), 4 wk (2.9±0.8 mg/d vs 3.9±1.0 mg/d, P=0.023) and 2 mo (2.8±0.7 mg/d vs 3.8 ±1.1 mg/d, P=0.033). Tacrolimus 12-h trough concentrations were similar between the two groups at all times except for 2 wk post-transplantation, when the concentrations were signifi cantly greater in group S recipients than in group N recipients (11.3±4.8 ng/mL vs 7.0±3.8 ng/mL, P=0.026).CONCLUSION: SFS grafts recipients have signifi cantly decreased tacrolimus dosage requirements compared with non-SFS grafts recipients in AALDLT during the first 2 mo post-surgery.展开更多
基金Supported by The National Key Research and Development Program,No.2020YFC2005303.
文摘To review the research progress of pure opioid receptor agonist oxycodone.The research progress of oxycodone in terms of pharmacokinetics,pharmacodynamics,adverse reactions,clinical application,combined medication and new progress in clinical application was summarized by referring to the literature.Oxycodone is a semi-synthetic thebaine derivative of opioid alkaloids,and is a pure opioidμandκreceptor agonist.The main action sites are the central nervous system and visceral smooth muscle.Due to its advantages of low adverse reactions,good analgesic effects,and a wide range of safe doses,the drug has been widely used in the control of acute and chronic postoperative pain,as well as malignant and non-malignant pain.Since the end of the 20^(th) century,researchers have begun to formulate antipyretic analgesics,opioid receptor agonists,opioid receptor antagonists,dopamine receptor antagonists and other drugs with oxycodone in different proportions to enhance the analgesic effect.At the same time,it can reduce the dosage of oxycodone and reduce its adverse reactions,so as to achieve the purpose of limiting opioid abuse.With the continuous research on the efficacy and safety of oxycodone in the perioperative period at home and abroad,oxycodone has become the only dual-opioid potent analgesic that can be used in clinical work.
基金funded by the National Key R&D Program of China(2022YFC2503801)the Cadre Health Care Project of the Sichuan Provincial Department of Health(2023-110)the West China Nursing Discipline Development Special Fund Project,Sichuan University(HXHL21032).
文摘Background The COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy(PWE),especially those with monthly household income<5000 RMB or with uncontrolled seizures.Patients with Kessler scores>12 should consult a psychiatrist,especially during major disasters.This study was aimed to compare the frequency of psychological distress among Chinese PWE before and during the outbreak of the SARS-CoV-2 Omicron variant,and to identify risk factors for such distress.Methods In this prospective study,we collected sociodemographic data of PWE aged>14 years,who were treated at our center during December 1 to 15,2022.All participants completed the 6-item Kessler Psychological Distress Scale before the outbreak and again during the outbreak.Health visitors who were unrelated to those patients during the outbreak were included as a control.Multivariate logistic regression analysis was performed to identify risk factors of severe psychological distress and its exacerbation.Results Of the 223 PWE,127 were tested positive for SARS-CoV-2,while 174 of 218 controls were positive for SARS-CoV-2.The neurological symptoms were similar between PWE and controls with SARS-CoV-2.The average Kessler score of PWE was significantly higher during the outbreak than before it(9.93±3.98 vs.8.52±0.23,P<0.001).The average score of controls during the outbreak(5.146±0.35,P<0.001)was significantly lower than that of the PWE.We identified three independent predictors for severe psychological distress in PWE during the outbreak,i.e.,monthly household income<5000 RMB(OR=0.252,95%CI 0.064–0.998,P=0.048),severe psychological distress before the outbreak(OR=0.067,95%CI 0.026–0.174,P<0.001),and seizure onset within 30 days before the assessment during the outbreak(OR=0.356,95%CI 0.157–0.805,P=0.013).Of the three predictors,the last one was also an independent predictor for exacerbation of psychological distress during the outbreak(OR=0.302,95%CI 0.123–0.741,P=0.009).Conclusions Our analysis suggests that the COVID-19 pandemic has substantially increased psychological distress of individuals with epilepsy,regardless of the viral infection or not.Various neurological symptoms similar to those of“long COVID”appeared for the first time among these individuals during the Omicron outbreak,highlighting the need for clinicians to screen carefully for this condition.Management of epilepsy during the pandemic or a similar major disaster should focus on the control of seizures and maintenance of mental health,especially among those with monthly household incomes below 5000 RMB,suffering uncontrolled seizures and having a history of severe psychological distress.
文摘AIM:To investigate the tacrolimus dosage requirements and blood concentrations in adult-to-adult right lobe living donor liver transplantation (AALDLT) recipients with small-for-size (SFS) grafts.METHODS: During January 2007 and October 2008, a total of 54 cases of AALDLT with an observation period of 6 mo were enrolled in this study. The 54 patients were divided into two groups according to graft-recipient body weight ratio (GRBW): SFS grafts group (Group S, GRBW<0.8%, n=8) and non-SFS grafts group (Group N, GRBW ≥0.8%, n=46). Tacrolimus 12-hour blood levels and doses were recorded during weeks 1,2,3 and 4 and months 2,3,4,5 and 6 in group S and group N. Meanwhile, acute rejection rates, liver and renal function test results, and the number of potentially interacting medications were determined at each interval in the two groups. A comparison of tacrolimus dosage requirements and blood levels were made weekly in the first month post-surgery, and monthly from months 2 to 6.RESULTS: There were no differences in the demo-graphic characteristics, acute rejection rates, liver and renal function test results, or the number of potentially interacting medications administered between the two groups. The tacrolimus dosage requirements in group S were significantly lower than group N at 2 wk (2.8±0.4 mg/d vs 3.6±0.7 mg/d, P=0.006), 3 wk (2.9±0.7 mg/d vs 3.9±0.8 mg/d, P=0.008), 4 wk (2.9±0.8 mg/d vs 3.9±1.0 mg/d, P=0.023) and 2 mo (2.8±0.7 mg/d vs 3.8 ±1.1 mg/d, P=0.033). Tacrolimus 12-h trough concentrations were similar between the two groups at all times except for 2 wk post-transplantation, when the concentrations were signifi cantly greater in group S recipients than in group N recipients (11.3±4.8 ng/mL vs 7.0±3.8 ng/mL, P=0.026).CONCLUSION: SFS grafts recipients have signifi cantly decreased tacrolimus dosage requirements compared with non-SFS grafts recipients in AALDLT during the first 2 mo post-surgery.