Overview of Contraindicated Chinese Medicines for Pregnancy

Chinese medicines should be classified into drugs, which have both beneficial and harmful effects. For centuries, Chinese medicines have been widely used to relieve many symptoms and to treat complications during pregnancy. It is not clear how safe the Chinese medicines are being used during pregnancy and if there is any adverse effects to embryo-fetal development and prenatal and postnatal growth. Some Chinese medicines are indicated that they cannot be used in pregnancy. In this chapter, we will conduct a systematic review to summarize and characterize in details the Chinese medicines classified as contraindicated, not recommended and cautiously used for pregnancy in most updated version of Pharmacopeia of the People’s Republic of China. Clinical reports including clinical trials, case reports, case series and animal studies including short-term and long-term toxicity, specific organ toxicity and different species of the Chinese medicines will be studied. Unlike those pharmaceutical drugs not recommend for use during pregnancy because of known or suspected adverse or teratogenic effects evident by animal studies and/or clinical trials, most of the Chinese medicines were utilized for long history in culture which, however, has very limited scientific data regarding the adverse pregnant outcomes

Chinese Herbal Medicine and Its Application for Female Cancer

Chinese herbal medicines (CHMs) have been widely used to promote health and treat illnesses in daily medical care throughout Asia while mostly accepted as an alternative medical method in many nations of the western world. CHM has a unique therapeutic effect to reduce adverse effects on cancer patients caused by chemotherapy and surgery; however, we did not find any high-quality review for the claimed effects. In this review, we will summarize the history, basic theories and principles, and clinical applications of CHM for disorders, especially female cancers. Meta-analyses to evaluate the efficacy and safety of CHM in the treatment of ovarian cancer and breast cancer have been conducted. The results showed that combined CHMs and western medicines treatment (CHM-WM) had significantly relieved the symptoms and reduced the side effects after surgery and chemotherapy on both ovarian cancer and breast cancer. However, more high-quality and large-scale RCTs are necessary to confirm the efficacy and safety of CHM-WM intervention

Duration of untreated bipolar disorder: A multicenter study

Little is known about the demographic and clinical differences between short and long duration of untreated bipolar disorder (DUB) in Chinese patients. This study examined the demographic and clinical features of short (≤2 years) and long DUB (\u3e2 years) in China. A consecutively recruited sample of 555 patients with bipolar disorder (BD) was examined in 7 psychiatric hospitals and general hospital psychiatric units across China. Patients’ demographic and clinical characteristics were collected using a standardized protocol and data collection procedure. The mean DUB was 3.2 ± 6.0 years; long DUB accounted for 31.0% of the sample. Multivariate analyses revealed that longer duration of illness, diagnosis of BD type II, and earlier misdiagnosis of BD for major depressive disorder or schizophrenia were independently associated with long DUB. The mean DUB in Chinese BD patients was shorter than the reported figures from Western countries. The long-term impact of DUB on the outcome of BD is warranted

DEVELOPMENT AND VALIDATION OF THE TAIWAN CHILDREN’S ENVIRONMENTAL ACTION INDEX

In this study, we use Smith-Sebasto & Fortner’s (1994) Environmental Action Internal Control Index (EAICI) as a framework to develop, and validate a useful instrument for assessing environmental attitudes and behavior among elementary and middle school children within the Taiwanese context. We dub the new instrument the Taiwan Children’s Environmental Action Index (TCEAI). Our findings suggest that the TCEAI displays substantial internal consistency (Cronbach's alpha=.92), moderately positive correlations with self-report measures of environmentally responsible behavior (R = .35 to .46, p < .01), and few threats to validity by age or gender. The results suggest that the TCEAI may be used to elicit important dimensions of environmental attitudes and to predict environmentally responsible behavior for elementary and middle school children in Taiwan. Practical implications are discussed

Evaluation of Ertapenem use with Impact Assessment on Extended-Spectrum Beta-Lactamases (ESBL) Production and Gram-Negative resistance in Singapore General Hospital (SGH)

BACKGROUND: Ertapenem (preferred choice for ESBL-producing organisms) use exhibited an increasing trend from 2006 to 2008. As extensive use of ertapenem might induce the mutation of resistant bacteria strains to ertapenem, we aimed to assess the appropriateness and impact of ertapenem-use, on ESBL production, the trends of gram-negative bacterial resistance and on the utilization of other antibiotics in our institution. METHODS: Inpatients who received a dose of ertapenem during 1 January 2006 to 31 December 2008, were reviewed. Pertinent patient clinical data was extracted from the pharmacy databases and assessed for appropriateness based on dose and indication. Relevant data from Network for Antimicrobial Resistance Surveillance (Singapore) (NARSS) was extracted, to cross-correlate with ertapenem via time series to assess its impact on hospital epidemiology, trends of gram-negative resistance and consumption of other antibiotics from 2006 to mid-2010. RESULTS: 906 cases were reviewed. Ertapenem therapy was appropriate in 72.4% (93.7% success rate). CNS adverse events were noted in 3.2%. Readmission rate (30-day) due to re-infection (same pathogen) was 5.5%. Fifty cases had cultures growing Pseudomonas aeruginosa within 30 days of ertapenem initiation, with 25 cases growing carbapenem-resistant Pseudomonas aeruginosa. Ertapenem use increased from 0.45 DDD/100 patient days in 2006 to 1.2 DDD/100 patient days in mid-2010. Overall, the increasing trend of ertapenem consumption correlated with 1) increasing incidence-densities of ciprofloxacin-resistant/cephalosporin-resistant E. coli at zero time lag; 2) increasing incidence-densities of ertapenem-resistant Escherichia. coli and Klebsiella spp. at zero time lag; 3) increasing incidence-density of carbapenem-resistant Pseudomonas aeruginosa, at zero time lag. Increasing ertapenem consumption was significantly correlated with decreasing consumption of cefepime (R(2) = 0.37344) 3 months later. It was significantly correlated with a decrease in imipenem consumption (R(2) = 0.31081), with no time lag but was correlated with subsequent increasing consumption of meropenem (R(2) = 0.4092) 6 months later. CONCLUSION: Ertapenem use was appropriate. Increasing Ertapenem consumption did not result in a decreasing trend of ESBL producing enterobacteriaceae and could result in the selection for multi-drug resistant bacteria

Persistence of Japanese Encephalitis Virus Is Associated with Abnormal Expression of the Nonstructural Protein NS1 in Host Cells

AbstractPersistent infection with Japanese encephalitis virus (JEV) was established in murine neuroblastoma N18 cells, and the persistency has been maintained in cell culture for over 6 months. From the persistently infected cells, a clone named C2-2 was selected and expanded to form a stable cell line. The vast majority of C2-2 cells showed viral protein staining by immunofluorescence and continuously produced low levels of virus (103to 104PFU/ml) without marked cytopathic effects or cyclic variations. In addition to the wild-type viral proteins, truncated forms of the viral nonstructural protein 1 (NS1) as well as its derivative NS1′ were produced in C2-2 cells. Both truncated NS1 and NS1′ contain deletions at their N-termini; however, the analyses by RT–PCR and direct sequencing of the viral RNA failed to detect any truncations or mutations within the NS1 region, suggesting that NS1 truncation was a result of a unique posttranslational proteolytic cleavage of NS1 in the persistently infected cells. Similar but not identical truncation of NS1 was also observed in two other persistently infected cell lines established in Vero and DBT (murine astrocytoma) cells. However, viruses released from C2-2 cells did not produce truncated NS1 upon infection of N18 cells, suggesting that NS1 truncations were the result of virus–cell interaction in persistently infected cells. These data indicate a strong association between abnormal NS1 expression and JEV persistency. A probable involvement of dysfunctional NS1 in the establishment and/or maintenance of JEV persistency in tissue culture is discussed