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Clozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.
A literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.
Thirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.
The prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.
Litostigma, a new Chinese genus of Gesneriaceae, is described and illustrated. It is characterised by its large flowers in comparison to its small leaves; slightly revolute leaf margins; 1-flowered cymes; crateriform or disciform stigma; and long ovoid capsule. Rather surprisingly, Litostigma falls among the basal didymocarpoid Gesneriaceae. Two new species, Litostigma coriaceifolium Y.G.Wei, F.Wen & M.Möller and Litostigma crystallinum Y.M.Shui & W.H.Chen, are described.
The strategies of repair of tetralogy of Fallot change with the age of patients. In children older than 4 years and adults, the optimal strategy may be to use different method of reconstruction of the right ventricular outflow tract from those followed in younger children, so as to avoid, or reduce, the pulmonary insufficiency that is increasingly known to compromise right ventricular function.
From April, 2001, through May, 2008, we undertook complete repair in 312 patients, 180 male and 132 female, with a mean age of 11.3 years ±0.4 years, and a range from 4 to 48 years, with typical clinical and morphological features of tetralogy of Fallot, including 42 patients with the ventriculo-arterial connection of double outlet right ventricle. The operation was performed under moderate hypothermia using blood cardioplegia. The ventricular septal defect was closed with a Dacron patch. When it was considered necessary to resect the musculature within the right ventricular outflow tract, or perform pulmonary valvotomy, we sought to preserve the function of the pulmonary valve by protecting as far as possible the native leaflets, or creating a folded monocusp of autologous pericardium.
The repair was achieved completely through right atrium in 192, through the right ventricular outflow tract in 83, and through the right atrium, the outflow tract, and the pulmonary trunk in 36 patients. A transjunctional patch was inserted in 169 patients, non-valved in all but 9. There were no differences regarding the periods of aortic cross-clamping or cardiopulmonary bypass. Of the patients, 5 died (1.6%), with no influence noted for the transjunctional patch. Of those having a non-valved patch inserted, three-tenths had pulmonary regurgitation of various degree, while those having a valved patch had minimal pulmonary insufficiency and good right ventricular function postoperatively, this being maintained after follow-up of 8 to 24-months.
Based on our experience, we suggest that the current strategy of repair of tetralogy of Fallot in older children and adults should be based on minimizing the insertion of transjunctional patches, this being indicated only in those with very small ventriculo-pulmonary junctions. If such a patch is necessary, then steps should be taken to preserve the function of the pulmonary valve.
To control the spread of bovine spongiform encephalopathy and scrapie, a method was developed for the simultaneous detection of bovine- and sheep-derived materials in feedstuffs. Chelex-100 was adopted for the fast extraction of animal genomic DNA. A pair of universal primers, designed on the basis of homology in sequences of bovine and sheep mtDNA, was used for PCR. This method is of great value to quarantine departments for its simplicity and rapid detection.
The magnetic properties and the domain structure of anisotropic melt-spun SmCo6.5Zr0.5 alloys with C addition was investigated by means of x-ray diffraction (XRD), magnetic measurement, and magnetic force microscopy. The XRD analyses showed that the addition of a few percent of C led to a significant increase in the coercivity and simultaneously affected the characterization of crystalline texture of the ribbons. The easy magnetization c axis changed from parallel to the ribbon plane for SmCo6.5Zr0.5 ribbons to normal to the ribbon plane for SmCo6.5Zr0.5C0.25−0.75 ribbons. An optimal coercivity of 0.92 T was obtained for the SmCo6.5Zr0.5C0.5 ribbon spun at 5 m/s. The corresponding remanence measured normal or parallel to the ribbon plane was 7.1 kGs or 3.1 kGs, respectively. The domain structure was studied by magnetic force microscopey. A strip-shaped domain was observed on the surface of the SmCo6.5Zr0.5 ribbons and the walls lay straight and parallel. For C-doped ribbons, the domain walls formed a maze domain pattern of grains with c axis normal to the ribbon plane. Scanning electron micrographs showed that a dendrite structure was present in the SmCoZr ribbon surface, and C addition caused the above-mentioned dendrite to diminish.
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