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  • BMJ  (15)
  • 1
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    Vascular protection and regenerative effects of intranasal DL-3-N-butylphthalide treatment after ischaemic stroke in mice
    BMJ ; 2021
    In:  Stroke and Vascular Neurology Vol. 6, No. 1 ( 2021-03), p. 74-79
    Details
    In: Stroke and Vascular Neurology, BMJ, Vol. 6, No. 1 ( 2021-03), p. 74-79
    Abstract: To investigate the effects of DL-3-N-butylphthalide (NBP) via intranasal delivery after ischaemic stroke in mice. Methods C57BL/6 mice were divided into three groups: sham, stroke with vehicle and stroke with NBP treatment. Ischaemic stroke was induced by permanent ligation of right middle cerebral artery with 7 min common carotid artery occlusion. NBP (100 mg/kg) or vehicle was intranasally administered at 1 hour after stroke and repeated once a day until sacrifice. Bromodeoxyuridine (BrdU) (50 mg/kg/day) was given from the third day until sacrifice. Sensorimotor function was tested during 1–21 days after stroke. Local cerebral blood flow in the ischaemic and peri-infarct regions was measured using laser Doppler flowmetry before, during and 3 days after ischaemia. Expressions of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase as well as regenerative marker BrdU in the peri-infarct region were analysed by western blotting and immunohistochemical methods. Results Compared with the vehicle group, NBP treatment significantly increased the VEGF expression in the poststroke brain. Stroke mice that received NBP showed significantly less vascular damage after stroke and more new neurons and blood vessels in the peri-infarct region at 21 days after stroke. In the adhesive removal test, the sensorimotor function of stroke mice treated with NBP performed significantly better at 1, 3 and 7 days after stroke compared with vehicle controls. Conclusion Daily intranasal NBP treatment provides protective and neurogenic/angiogenic effects in the poststroke brain, accompanied with functional improvements after a focal ischaemic stroke in mice.
    Type of Medium: Online Resource
    ISSN: 2059-8688 , 2059-8696
    URL: Article
    DOI: 10.1136/svn-2020-000364
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2847692-X
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  • 2
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    Short-term and low-dose IL-2 therapy restores the Th17/Treg balance in the peripheral blood of patients with primary Sjögren’s syndrome
    BMJ ; 2018
    In:  Annals of the Rheumatic Diseases Vol. 77, No. 12 ( 2018-12), p. 1838-1840
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 77, No. 12 ( 2018-12), p. 1838-1840
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
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    DOI: 10.1136/annrheumdis-2018-213036
    DOI: 10.1136/annrheumdis-2018-213036.supp11
    DOI: 10.1136/annrheumdis-2018-213036.supp3
    DOI: 10.1136/annrheumdis-2018-213036.supp8
    DOI: 10.1136/annrheumdis-2018-213036.supp4
    DOI: 10.1136/annrheumdis-2018-213036.supp9
    DOI: 10.1136/annrheumdis-2018-213036.supp10
    DOI: 10.1136/annrheumdis-2018-213036.supp1
    DOI: 10.1136/annrheumdis-2018-213036.supp2
    DOI: 10.1136/annrheumdis-2018-213036.supp5
    DOI: 10.1136/annrheumdis-2018-213036.supp6
    DOI: 10.1136/annrheumdis-2018-213036.supp7
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 1481557-6
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  • 3
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    Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis (INSPIRES)
    BMJ ; 2023
    In:  Stroke and Vascular Neurology Vol. 8, No. 3 ( 2023-06), p. 249-258
    Details
    In: Stroke and Vascular Neurology, BMJ, Vol. 8, No. 3 ( 2023-06), p. 249-258
    Abstract: It remains unclear if intensive antiplatelet and statin treatments begun within 24–72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe. Methods The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial is a randomised, double-blind, placebo-controlled, multicentre and 2×2 factorial trial. 6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack (TIA) within the previous 72 hours that is attributed to ≥50% atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial. Eligible subjects will be randomised 1:1:1:1 to one of four groups: (1) intensive antiplatelet therapy (combined clopidogrel and aspirin for days 1–21, then aspirin placebo and clopidogrel for days 22–90) plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days, then 40 mg daily for days 22–90); (2) intensive antiplatelet therapy plus delayed intensive statin therapy (atorvastatin placebo for days 1–3, followed by 40 mg per day of atorvastatin for days 4–90); (3) standard antiplatelet therapy (combination of clopidogrel placebo with aspirin for 90 days) plus immediate intensive statin therapy and (4) standard antiplatelet therapy plus delayed intensive statin therapy. The primary efficacy endpoint is any new stroke (ischaemic or haemorrhagic) within 90 days after randomisation. The primary safety endpoint is moderate to severe bleeding at 90 days. Conclusion The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin. Trial registration number NCT03635749 .
    Type of Medium: Online Resource
    ISSN: 2059-8688 , 2059-8696
    URL: Article
    DOI: 10.1136/svn-2022-002084
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2847692-X
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  • 4
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    17 Neuromodification of refractory obsessive-compulsive disorder (OCD): evidence from cognitive, structural and functional remodelling of anterior capsulotomy
    BMJ ; 2022
    In:  Journal of Neurology, Neurosurgery & Psychiatry Vol. 93, No. 12 ( 2022-12), p. e3.9-
    Details
    In: Journal of Neurology, Neurosurgery & Psychiatry, BMJ, Vol. 93, No. 12 ( 2022-12), p. e3.9-
    Abstract: Converging evidence supports the effectiveness of anterior capsulotomy in the management of selected patients with refractory obsessive-compulsive disorder (OCD). Less is understood about the post-operative neural changes that contribute to clinical improvements or impairments that might occur which potentially could be avoided. The objective of this study is to identify the neuropsychological changes underlying the symptomatic relief in capsulotomy using an affective task-based fMRI study, and to discern potential post-operative cognitive changes associated with the surgery itself. Methods A task-based fMRI study using a modified aversive monetary incentive delay paradigm with negative imagery (separated into two phases: anticipation and feedback) and subsequent expectancy violation was applied to study emotional regulation, with specific focus on the functional changes along the fronto-striatal pathway. Selected tests from the Cambridge Neuropsychological Automated Test Battery (CANTAB) covering attention, memory and executive function known to be impaired in OCD were administered to assess the cognitive function in three groups of age, gender matched participants: OCD patients (OCD), OCD capsulotomy patients (at least six months after surgery, CAP), and healthy controls (HC). Voxel-based morphometry (VBM) was applied to detect whole-brain grey matter volume differences between HC, OCD and CAP, and its association with cognitive deficits. Results CAP showed lower OCD severity (Yale Brown Obsessive Compulsive Score), and better activities of daily living and quality of life scores compared to OCD controls with no differences in depression or anxiety scores. Task-based fMRI revealed decreased nucleus accumbens (NAc) activity during aversive anticipation in CAP, which correlated with the symptomatic ratings after surgery. Whole-brain analyses during the feedback phase found interaction effects in the left pregenual anterior cingulate cortex (pgACC) and the left inferior frontal cortex (IFG), where CAP showed lower activity towards the aversive outcome and towards the expected but missing aversive image during the expectancy violation phase, with both positively correlated with symptomatic ratings. Attenuated functional connectivity between seed NAc and pgACC was found in CAP as expected during aversive versus neutral anticipation (aversive 〉 neutral), suggesting a surgical impact of capsulotomy through downregulating the functional communication along the fronto-striatal pathway. Cognitive testing focusing on the differences between OCD and CAP or the potential effect of capsulotomy showed greater impairments in CAP in paired associative learning (PAL). All other cognitive measures were no different from OCD controls. CAP exhibited overall reduction of grey matter volume (GMV) in the ventral striatum, thalamus and left inferior frontal gyrus (IFG) relative to OCD controls. The total PAL error in CAP was associated with lower GMV in the left inferior frontal gyrus. Conclusions We show improvements in OCD severity, quality of life and disability post-capsulotomy. Potential impairments in cognitive status were limited to associative learning correlating with lower left inferior frontal cortex volumes which may reflect underlying severity or be related to capsulotomy effects. Our findings suggest targeting connectivity between NAc and pgACC, similar to the optimal target for deep brain stimulation in OCD, with post-operative effects modifying aversive processing. In contrast, potentially preserving tracts to the left inferior frontal cortex might be indicated. Our study contributes to the literature of anterior capsulotomy as an effective and well-tolerated treatment option for selected patients with refractory OCD and highlights overlaps between deep brain stimulation and capsulotomy in optimal targeting.
    Type of Medium: Online Resource
    ISSN: 0022-3050 , 1468-330X
    URL: Article
    DOI: 10.1136/jnnp-2022-BNPA.17
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1480429-3
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  • 5
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    Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study
    BMJ ; 2017
    In:  BMJ Open Vol. 7, No. 9 ( 2017-09), p. e016062-
    Details
    In: BMJ Open, BMJ, Vol. 7, No. 9 ( 2017-09), p. e016062-
    Abstract: Our study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS). Design Prospective cohort study. Setting Shenyang, China. Participants A total of 379 residents aged between 40 and 65 were enrolled. 253 of them were free of MetS and had been followed up for 4.5 years. Methods At baseline, all the participants underwent a thorough medical examination. A variety of anthropometric parameters were measured and calculated, including waist circumference (WC), body mass index (BMI), a body shape index (ABSI), abdominal volume index (AVI), body adiposity index, body roundness index, conicity index, waist-to-hip ratio and visceral adiposity index (VAI). After 4.5 year follow-up, we re-examined whether participants were suffering from MetS. A receiver operating characteristic (ROC) curve was applied to examine the potential of the above indices to identify the status and risk of MetS. Outcomes Occurrence of MetS. Results At baseline, 33.2% participants suffered from MetS. All of the anthropometric indices showed clinical significance, and VAI was superior to the other indices as it was found to have the largest area under the ROC curve. After a 4.5 year follow-up, 37.8% of men and 23.9% of women developed MetS. ROC curve analysis suggested that baseline BMI was the strongest predictor of MetS for men (0.77 (0.68–0.85)), and AVI was the strongest for women (0.72 (0.64–0.79)). However, no significant difference was observed between WC and both indices. In contrast, the baseline ABSI did not predict MetS in both genders. Conclusions The present study indicated that these different indices derived from anthropometric parameters have different discriminatory abilities for MetS. Although WC did not have the largest area under the ROC curve for diagnosing and predicting MetS, it may remain a better index of MetS status and risk because of its simplicity and wide use.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2017-016062
    DOI: 10.1136/bmjopen-2017-016062.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2017
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis
    BMJ ; 2017
    In:  BMJ Open Vol. 7, No. 10 ( 2017-10), p. e016053-
    Details
    In: BMJ Open, BMJ, Vol. 7, No. 10 ( 2017-10), p. e016053-
    Abstract: Subclinical hypothyroidism (SCH) has been associated with increased carotid intima-media thickness (C-IMT) in recent studies, but the effects of levothyroxine (L-T4) therapy on C-IMT in SCH patients are still controversial. Aim To evaluate the effect of L-T4 therapy on endothelial function as determined by C-IMT in patients with SCH. Methods BeforeJuly 2016, we searched the PubMed, Embase, Cochrane Library and Google Scholar databases, selecting published randomised controlled trials (RCTs) and self-controlled trials for the meta-analysis. Results Three RCTs with 117 patients were considered appropriate for the meta-analysis. The results of the meta-analysis indicated that L-T4 significantly decreased the development of C-IMT (weighted mean difference (WMD) −0.05 mm, 95% CI −0.08 to –0.01 mm; p=0.025). We also analysed nine studies (self-controlled trials) with 247 patients and extracted the IMT of SCH patients before and after L-T4 treatment. After L-T4 therapy, the pooled estimate of the WMD of decreased C-IMT was −0.04 mm (95% CI −0.07 to –0.02 mm; p=0.05). Subgroup analysis showed that L-T4 therapy was associated with a decrease in C-IMT among patients of mixed genders (WMD −0.03 mm, 95% CI −0.06 to –0.01 mm; p=0.145). L-T4 therapy was associated with a decrease in C-IMT among female patients (WMD −0.07 mm, 95% CI −0.14 to –0.01; p=0.186). Longer treatment ( 〉 6 months) also resulted in a significant decrease in C-IMT (WMD −0.05 mm, 95% CI −0.08 to –0.02; p=0.335). Conclusion This meta-analysis indicates that L-T4 treatment of SCH patients can reduce C-IMT, possibly as a result of the reduction of total cholesterol, triglyceride, low density lipoprotein, systolic blood pressure, diastolic blood pressure, lipoprotein(a), and flow-mediated dilatation. Decreased C-IMT was observed in SCH patients after long-term ( 〉 6 months) L-T4 treatment. RCTs with larger samples are needed to verify these observations.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
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    DOI: 10.1136/bmjopen-2017-016053
    DOI: 10.1136/bmjopen-2017-016053.supp1
    DOI: 10.1136/bmjopen-2017-016053.supp2
    DOI: 10.1136/bmjopen-2017-016053.supp3
    DOI: 10.1136/bmjopen-2017-016053.supp4
    DOI: 10.1136/bmjopen-2017-016053.supp5
    DOI: 10.1136/bmjopen-2017-016053.supp6
    Language: English
    Publisher: BMJ
    Publication Date: 2017
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  • 7
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    Predicting the local COVID-19 outbreak around the world with meteorological conditions: a model-based qualitative study
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 11 ( 2020-11), p. e041397-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 11 ( 2020-11), p. e041397-
    Abstract: This study aims to investigate the relationship between daily weather and transmission rate of SARS-CoV-2, and to develop a generalised model for future prediction of the COVID-19 spreading rate for a certain area with meteorological factors. Design A retrospective, qualitative study. Methods and analysis We collected 382 596 records of weather data with four meteorological factors, namely, average temperature, relative humidity, wind speed, and air visibility, and 15 192 records of epidemic data with daily new confirmed case counts (1 587 209 confirmed cases in total) in nearly 500 areas worldwide from 20 January 2020 to 9 April 2020. Epidemic data were modelled against weather data to find a model that could best predict the future outbreak. Results Significant correlation of the daily new confirmed case count with the weather 3 to 7 days ago were found. SARS-CoV-2 is easy to spread under weather conditions of average temperature at 5 to 15°C, relative humidity at 70% to 80%, wind speed at 1.5 to 4.5 m/s and air visibility less than 10 statute miles. A short-term model with these four meteorological variables was derived to predict the daily increase in COVID-19 cases; and a long-term model using temperature to predict the pandemic in the next week to month was derived. Taken China as a discovery dataset, it was well validated with worldwide data. According to this model, there are five viral transmission patterns, ‘restricted’, ‘controlled’, ‘natural’, ‘tropical’ and ‘southern’. This model’s prediction performance correlates with actual observations best (over 0.9 correlation coefficient) under natural spread mode of SARS-CoV-2 when there is not much human interference such as epidemic control. Conclusions This model can be used for prediction of the future outbreak, and illustrating the effect of epidemic control for a certain area.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-041397
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 8
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    Clinical features of NOTCH2NLC -related neuronal intranuclear inclusion disease
    BMJ ; 2022
    In:  Journal of Neurology, Neurosurgery & Psychiatry Vol. 93, No. 12 ( 2022-12), p. 1289-1298
    Details
    In: Journal of Neurology, Neurosurgery & Psychiatry, BMJ, Vol. 93, No. 12 ( 2022-12), p. 1289-1298
    Abstract: Abnormal expanded GGC repeats within the NOTCH2HLC gene has been confirmed as the genetic mechanism for most Asian patients with neuronal intranuclear inclusion disease (NIID). This cross-sectional observational study aimed to characterise the clinical features of NOTCH2NLC -related NIID in China. Methods Patients with NOTCH2NLC -related NIID underwent an evaluation of clinical symptoms, a neuropsychological assessment, electrophysiological examination, MRI and skin biopsy. Results In the 247 patients with NOTCH2NLC -related NIID, 149 cases were sporadic, while 98 had a positive family history. The most common manifestations were paroxysmal symptoms (66.8%), autonomic dysfunction (64.0%), movement disorders (50.2%), cognitive impairment (49.4%) and muscle weakness (30.8%). Based on the initial presentation and main symptomology, NIID was divided into four subgroups: dementia dominant (n=94), movement disorder dominant (n=63), paroxysmal symptom dominant (n=61) and muscle weakness dominant (n=29). Clinical (42.7%) and subclinical (49.1%) peripheral neuropathies were common in all types. Typical diffusion-weighted imaging subcortical lace signs were more frequent in patients with dementia (93.9%) and paroxysmal symptoms types (94.9%) than in those with muscle weakness (50.0%) and movement disorders types (86.4%). GGC repeat sizes were negatively correlated with age of onset (r=−0.196, p 〈 0.05), and in the muscle weakness-dominant type (median 155.00), the number of repeats was much higher than in the other three groups (p 〈 0.05). In NIID pedigrees, significant genetic anticipation was observed (p 〈 0.05) without repeat instability (p=0.454) during transmission. Conclusions NIID is not rare; however, it is usually misdiagnosed as other diseases. Our results help to extend the known clinical spectrum of NOTCH2NLC -related NIID.
    Type of Medium: Online Resource
    ISSN: 0022-3050 , 1468-330X
    URL: Article
    DOI: 10.1136/jnnp-2022-329772
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1480429-3
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  • 9
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    Common susceptibility variants of KDR and IGF-1R are associated with poststroke depression in the Chinese population
    BMJ ; 2023
    In:  General Psychiatry Vol. 36, No. 1 ( 2023-01), p. e100928-
    Details
    In: General Psychiatry, BMJ, Vol. 36, No. 1 ( 2023-01), p. e100928-
    Abstract: Depression, one of the most frequent complications after stroke, increases the disease’s burden and physical disability. Poststroke depression (PSD) is a multifactorial disease with genetic, environmental and biological factors involved in its occurrence. Genetic studies on PSD to date have mainly focused on the monoamine system and brain-derived neurotrophic factors. However, understanding is still limited about the influence of the single nucleotide polymorphism (SNP) of other neurotrophic factors on PSD. Aims The present study aimed to investigate the relationship between seven vascular endothelial growth factor (VEGF) family gene variants that occur with PSD. Methods A multicentre candidate gene study from five hospitals in Jiangsu Province from June 2013 to December 2014 involved 121 patients with PSD and 131 patients with non-PSD. Demographic characteristics and neuropsychological assessments were collected. The χ 2 test was used to evaluate categorical variables, while the independent t-test was applied to continuous variables. SNPs in seven genes ( VEGFA , VEGFB , KDR , FLT-1 , IGF-1 , IGF-1R and PlGF ) were genotyped. Single-marker association for PSD was analysed by χ 2 tests and logistic regression using SPSS and PLINK software. Results Patients with PSD included more women and those with lower education levels, lower body mass indexes, lower Mini-Mental State Examination scores, and higher scores on the 17-item Hamilton Depression Rating Scale than non-PSD patients. Ninety-two SNPs with seven genes were genotyped and passed quality control. The rs7692791 CC genotypes, the C allele of KDR and the rs9282715 T allele of IGF-1R increased the risk for PSD (χ 2 =7.881, p=0.019; χ 2 =4.259, p=0.039; χ 2 =4.222, p=0.040, respectively). In addition, the SNP rs7692791 of KDR was significantly associated with PSD by the logistic regression of an additive model (p=0.015, OR=9.584, 95% CI: 1.549 to 59.31). Conclusions Patients with rs7692791 C allele carriers or the CC genotype of KDR and the rs9282715 T allele of IGF-1R may have PSD susceptibility. Findings such as these may help clinicians to identify the high-risk population for PSD earlier and, thus, enable them to provide more timely interventions. Trial registration number ChiCTR-OCH-13003133.
    Type of Medium: Online Resource
    ISSN: 2517-729X
    URL: Article
    URL: Article
    DOI: 10.1136/gpsych-2022-100928
    DOI: 10.1136/gpsych-2022-100928.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2941976-1
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    Comparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial
    BMJ ; 2023
    In:  Regional Anesthesia & Pain Medicine Vol. 48, No. 2 ( 2023-02), p. 61-66
    Details
    In: Regional Anesthesia & Pain Medicine, BMJ, Vol. 48, No. 2 ( 2023-02), p. 61-66
    Abstract: We compared analgesic outcomes between single-orifice and multiorifice wire-reinforced catheters under 480 mL/hour delivery rate with programmed intermittent epidural bolus administration. Methods Between August and November 2021, 182 nulliparous and healthy women with singleton pregnancy, 2–5 cm cervical dilation, and requesting neuraxial analgesia were randomized to receive either single-orifice or multiorifice catheters. Epidural analgesia was initiated and maintained with 0.1% ropivacaine and 0.3 µg/mL sufentanil. Programmed intermittent epidural bolus volume of 10 mL was administered every 45 min at 480 mL/hour beginning immediately after the test dose. Primary outcome was the percentage of parturients in the two groups with adequate analgesia 20 min after the initial bolus. Results Compared with multiorifice catheters, single-orifice catheters were associated with a higher proportion of parturients with adequate analgesia (71.8% vs 56.0%, respectively; 95% CI 1.3% to 29%, p=0.03) and more frequent S 2 sensory blockade (37.6% vs 22.6%, respectively; 95% CI −30% to 1%, p=0.03) 20 min after block initiation. Median time (IQR) to adequate analgesia was 12 (8–30) min and 20 (10–47) min with single-orifice and multiorifice catheters, respectively (95% CI 0.1 to 0.7 min, p 〈 0.01). The median (IQR) ropivacaine consumption per hour was higher in parturients receiving multiorifice catheters than those with single-orifice catheters (15.3 (13.3–17.0) mg/hour vs 13.3 (13.3–15.4) mg/hour, respectively; 95% CI 0.2 to 0.8 mg/hour, p 〈 0.001). Conclusion Single-orifice catheters used for programmed intermittent epidural bolus at 480 mL/hour for epidural labor analgesia had improved analgesic efficacy than multiorifice catheters. Trial registration number ChiCTR2100049872.
    Type of Medium: Online Resource
    ISSN: 1098-7339 , 1532-8651
    URL: Article
    URL: Article
    DOI: 10.1136/rapm-2022-103723
    DOI: 10.1136/rapm-2022-103723.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2028901-7
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