Journal of Military Pharmaco-medicine

SAFETY OF THE HOAN LUC KHANG CAPSULE IN EXPERIMENTAL ANIMALS

Objectives: To assess the safety of the Hoan luc khang capsule in experimental animals. Methods: Acute toxicity was assessed in mice according to the Litchfield-Wilcoxon method and World Health Organization (WHO) guidelines. Subchronic toxicity was evaluated in rats using the Organization for Economic Co-operation and Development (OECD) and the Vietnam Ministry of Health guidelines. Results: At a maximal dose of 35 g/kg/day, which is 50 times more than the anticipated effective dose, no LD50 of Hoan luc khang capsules was detected in mice. Taking Hoan luc khang soft capsules at three dose levels of 390, 780, and 1560 mg/kg/day continuously for 42 days had no effect on the rat's weight, general health, histopathological images, or biochemical and hematological indicators. Conclusion: Hoan luc khang capsules are safe and do not produce any acute or subchronic toxicity in experimental animals.

Chemical composition and biological activity of Allium tuberosum leaf essential oil

Thai An Nguyen, Phan Lâm Vũ Lương, Linh Pham Thao, Tung Nguyen Thanh

Objective: To investigate the chemical composition and evaluate biological activity of Allium tuberosum leaf essential oil. Methods: The essential oil was hydrodistilled from materials using a Clevenger-type apparatus in accordance with the US Pharmacopoeia. The essential oil composition was analyzed using GC-MS. The antimicrobial activity of essential oil was evaluated by microdilution method while the cytotoxicity of the oil was evaluated by SRB test. Results: 23 components were identified in the essential oil through GC-MS analysis, accounting for 82.67% of the total oil. The identified components consisted of sulfide compounds. The antimicrobial activity evaluation results indicated that A. tuberosum essential oil exhibited potent antibacterial effects against Staphylococcus epidermidis, Enterococcus faecalis, and Salmonella enterica (MIC = 128 µg/ml). However, its antimicrobial effects on Escherichia coli and Candida albicans were found to be weaker (MIC = 256 µg/ml). The essential oil also exhibited cytotoxic effects on the cancer cell lines MCF-7 (Human breast cancer), SK-LU-1 (Human lung cancer), and HepG2 (Human liver cancer), with IC50 values ranging from 33.8 to 50.16 µg/mL. Conclusion: The study has clarified the chemical composition of A. tuberosum essential oil as well as shown the potential application of essential oils in treating infections as well as searching for compounds that can cause cancer cell toxicity.

RESEARCH ON PREPARATION OF ECHINACOSIDE-RICH LIQUID EXTRACT FROM CISTANCHE DESERTICOLA

Abstract Objectives: to prepare echinacoside-rich liquid extract from Cistanche deserticola. Methods: using echinacoside level and extraction efficiency to determine the methods as well as parameters for the liquid extraction process of echinacoside-rich Cistanche deserticola at a scale of 1 kg/batch. Results: the ultrasonic heating extraction method was selected, and the parameters were optimized, including the extraction solvent, which was ethanol (40%), the solvent/medicinal material ratio, which was 20/1, the extraction temperature, which was 60°C, and 2 extractions with an extraction time each time of 60 minutes. Conclusion: an extraction process of echinacoside-rich liquid extracted from Cistanche deserticola at 1 kg/batch scales was successfully established. Keyword: Cistanche, echinacoside, extraction

Evaluation of the toxicity and carcinogenicity of CAR-T cells in experimental animals

Cấn Văn Mão, Ngo Thu Hang

Mục tiêu nghiên cứu: Đánh giá khả năng gây độc và ung thư của khối tế bào CAR-T trên thực nghiệm để khẳng định chất lượng, đảm bảo độ an toàn của chế phẩm khối tế bào CAR-T. Đối tượng và phương pháp nghiên cứu: Thu thập khối tế bào CAR-T từ phòng nuôi cấy tế bào với nồng độ 5x107 tế bào/ml. 36 chuột nhắt trắng được chia thành 3 nhóm (12 chuột/nhóm), được chiếu xạ với liều 1.5Gy: Nhóm chứng được tiêm khối tế bào PBMC; Nhóm CAR thế hệ 2 (CAR2) tiêm khối khối tế bào CAR-T CD19RCD137/pMC; Nhóm CAR thế hệ 4 (CAR4) tiêm khối tế bào CAR-T CD19RCD137- iCasp9-IL15/pMC. Chuột được tiêm khối tế bào vào màng bụng sau đó được nuôi ở môi trường sạch và theo dõi các thông số. Kết quả: Ở thời điểm 1 tháng, 3 tháng và 6 tháng sau khi tiêm khối tế bào CAR-T không có chuột bị chết, không bị giảm cân và các chỉ số huyết học thay đổi không đáng kể (p>0,05). Màng bụng chuột trơn nhẵn, các cơ quan nội tạng mềm nhẵn, không thấy hình ảnh các khối bất thường hoặc các ổ viêm áp xe ở màng bụng, trong ổ bụng và ở các cơ quan nội tạng. Kết luận: Ở nồng độ nghiên cứu, tế bào CAR-T không gây ra độc tính, các thay đổi các chỉ số huyết học và ung thư trên động vật thưc nghiệm trong thời gian thử nghiệm.

TESTICULAR HISTOPATHOLOGY CHARACTERTISTIC AND THE RESULT OF TESTICULAR SPERM EXTRACTION IN PATIENTS WITH NON-MOSAIC KLINEFELTER SYNDROME

Thế Sơn Trịnh, Thị Hằng Đoàn, Đức Minh Phạm, Văn Phi Trương, Hữu Việt Đinh

Objectives: Describe clinical and paraclinical characteristics of Klinefelter azoospermia patients, evaluate the ability to retrieve sperm using micro TESE in Klinefelter azoospermia patients. Subjects and methods: Descriptive, prospective study on 67 KS azoospermia patients (47, pure XXY) treated at three assisted reproductive facilities from 05/2023–05/2025. Clinical, endocrine, testicular volume, histopathological parameters and micro TESE results were collected and analyzed using descriptive statistics. Results: Mean age 34.1 ± 4.5 years; infertility duration 5.0 ± 4.4 years; BMI 23.1 ± 2.6 kg/m². Average FSH and LH were 37.2 ± 18.9 mIU/mL and 23.2 ± 8.2 mIU/mL, respectively; Testosterone 7.0 ± 5.1 ng/mL. Bilateral testicular volume was approximately 1.5 mL. Histopathology showed “only Sertoli cells” accounting for 46.3%, hyaline sclerosis 19.4%, spermatogenesis arrest 13.4% and spermatogenesis failure 20.9%. Micro TESE successfully collected sperm in 14/67 patients (20.9%). Conclusion: Azoospermic KS patients in Vietnam have the main histopathological feature of “only Sertoli cells” syndrome. The success rate of sperm retrieval by micro TESE is 21%, this technique provides the opportunity for biological fatherhood and should be indicated early also confirms the effectiveness of micro TESE in treating non-obstructive azoospermic patients with Klinefelter syndrome.

Distribution and Impact of CYP2C9, CYP2C19, and VKORC1 Genotypes on Acenocoumarol Dose Requirements in Elderly Patients

Objective: To investigate the distribution of CYP2C9, CYP2C19, and VKORC1 genotypes in elderly Vietnamese patients and to evaluate their associations with the maintenance dose of acenocoumarol required to achieve the target international normalized ratio (INR). Methods: A descriptive cross-sectional study was conducted at 30-4 Hospital, Ministry of Public Security, from January 2023 to January 2025. A total of 187 patients aged ≥60 years who were receiving stable acenocoumarol therapy were genotyped for CYP2C9 (*2, *3), CYP2C19 (*2, *3), and VKORC1 (-1639G>A). The mean weekly dose of acenocoumarol was compared across individual genotypes and combinations of two or three genes. Results: The distribution of genotypes was as follows: CYP2C9 *1/*1 (95%), VKORC1 AA (66%), and ≥1 reduced-function CYP2C19 allele (55%). Patients with CYP2C9 *1/*1 required a significantly higher dose than those with *2/*3 genotypes (10.63 ± 3.28 vs. 7.48 ± 3.17 mg/week; p = 0.011). VKORC1 AA carriers required significantly lower doses than GA or GG carriers (p < 0.001). No statistically significant difference was observed for CYP2C19 genotypes. The lowest dose among two-gene combinations was found in *2/*3 + VKORC1 AA, while the highest was in *1/*1 + VKORC1 GG. Among three-gene combinations, *2/*3 + AA + *1/*1 required the lowest dose and *1/*1 + GG + *2/*2 the highest. Conclusion: CYP2C9 and VKORC1 polymorphisms significantly influence acenocoumarol dose requirements in elderly patients. Pharmacogenetic testing of these variants may support personalized anticoagulation therapy in this population.

AGE- AND GENDER- RELATED VOLUMETRIC CHANGES OF THE VENTRAL THALAMIC NUCLEI IN A POPULATION OF NORMAL VIETNAMESE ADULTS

Thị Kim Phượng Nguyễn, Quốc Đông Tống, Thiện Huy Lý, Nguyễn Lê Chiến

Abstract Objective: This study aimed to determine the volumes and changes in the ventral thalamic nuclei with age-stage and sex in a population of healthy Vietnamese adults. Methods: Analysis of the volumes of the ventral thalamic nuclei was performed by using Freesurfer package (ver. 6.0) on structural brain magnetic resonance imaging (sMRI) data from 75 right-handed Vietnamese adults, including 38 males, aged 20-73; and 37 females, aged 18-87. Results: Thalamic volume and the volumes of the ventral thalamic nuclei showed no differences by gender. The ventral thalamic nuclei were shrunken in volume along with increasing age-stage, and this phenomenon occurred earlier in the ventral lateral nuclei, starting from the young-to-middle age period. Conclusion: This reduction in ventral thalamic nuclei volume may offer an explanation for the higher incidence and earlier onset of Parkinson's disease in males compared to those in females.

Expression of genes involved in JAK/STAT signaling pathway in lung cancer cells treated with measles virus vaccine and Cisplatin

Ngo Thu Hang, Đặng Thùy Linh, Nguyễn Mạnh Hà, Văn Mão Cấn

Mục tiêu: Đánh giá biểu hiện mRNA một số gene liên quan đến con đường JAK/STAT ở tế bào ung thư phổi được điều trị bằng virus vaccine sởi và Cisplatin. Phương pháp nghiên cứu: Sử dụng kỹ thuật flow cytometry để đánh giá tỷ lệ tế bào chết, tế bào apoptosis và tế bào hoạt tử và kỹ thuật real-time PCR để đánh giá biểu hiện mRNA của các gene STAT1, STAT3, JAK1, JAK2 và JAK3 ở tế bào ung thư phổi H460 sau khi được điều trị bằng virus vaccine sởi và Cisplatin. Kết quả: Mức độ biểu hiện các gene STAT3, JAK1, JAK2 và JAK3 giảm thấp ở các nhóm điều trị so với nhóm chứng (p < 0,05), trong khi mức độ biểu hiện STAT1 tăng hơn so với nhóm chứng (p < 0,05). Mức độ biểu hiện các gene STAT3, JAK1 có tương quan nghịch với tỷ lệ tế bào sống, tế bào apoptosis và tế bào hoại tử. Kết luận: Tế bào ung thư phổi H460 được điều trị bằng virus vaccine sởi phối hợp với Cisplatin có khả năng làm giảm biểu hiện các gene STAT3, JAK1, JAK2, JAK3 và tăng biểu hiện STAT1.

THE CHARACTERISTICS OF SPONTANEOUS PORTOSYSTEMIC SHUNTS ON 64-ROW DETECTOR COMPUTED TOMOGRAPHY IN PATIENTS WITH CIRRHOSIS

Phung Anh Tuan, Đường Quý Đỗ

Objectives: The aim of this study is to discriber the characteristics of spontaneous portosystemic shunts (SPSS) on 64-row detector CT. Subjects and methods: Study was performed on 90 patients that were treated at 103 Military Hospital from Apr. 2024 to Mar. 2025. Evaluate the characteristics of SPSS on CT: the extent and location of SPSS, numbers, diameter… Determine relationship between the presence of oesophageal varices with that of others. Results: SPSS were found on 73.3%. Most common was esophageal varices. There were good agreements between endoscopy and CT in diagnosing esophageal and gastric varices. The esophageal varices showed a significant relationship with paraesophageal, gastric and left gastric varices. Conclusion: The 64-row detector CT image is helpful for determine the characteristics of SPSS on patients with cirrhosis.

ROLE OF NON-CONTRAST MULTI-SEASON COMPUTED TOMOGRAPHY OF THE THROAT IN THE EVALUATION OF LUNG TUMOROUS LESIONS

Hoàng Văn Lương, Nguyễn Ngọc Trung

Objective: To describe the imaging characteristics of lung tumor lesions on non-contrast CT scans. And initially determine the value of non-contrast chest CT scans in the differential diagnosis of benign or malignant lung tumor lesions. Research method: Retrospective, cross-sectional study of 104 patients with lung tumor lesions diagnosed by CT-guided core biopsy at the National Lung Hospital from April 2024 to December 2024. Results: Mean age 58.3 ± 12.9 years. Male 58.6%, female 41.4%. Benign nodules 43.3%, malignant nodules 56.7%. Peripheral nodules 93.3%, central 6.9%. Average mean size (AMS) 15.2 ± 6.5mm. Lesions with AMS ≥ 10mm are 1.28 times more likely to be malignant than lesions with AMS < 10mm. The signs of spiny border, lobulation and lesion size ≥ 10mm are statistically significantly associated with lung cancer diagnosis when controlling for other factors (p < 0.05). Từ khóa: Nốt phổi đơn độc; Nốt phổi; Ung thư phổi CLVT had sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of 78.0%, 82.2%, 85.2%, 74.0% and 79.8%, respectively. Conclusion: Pulmonary nodules are mostly found in the periphery, with the right lung accounting for 2/3 of the lesions. The rate of malignant nodules is higher than that of benign nodules. Non-contrast CT has a relatively high value in distinguishing a benign or malignant lung lesion. Keywords: Solitary pulmonary Nodules; Lung nodules; Lung cancer

RESEARCH ON THE CHARACTERISTICS OF SEPT9 GEN METHYLATION IN SERUM BEFORE AND AFTER SURGERY IN STAGE III COLORECTAL CANCER

Thuỳ Linh Dương, Viết Hoành Hồ , Khánh Vân Nguyễn, Hữu Thọ Hồ, Văn Ba Nguyễn

Objective: To study the characteristics of SEPT9 gene methylation (mSEPT9) in peripheral blood before and after radical surgery in patients with stage III colorectal cancer (CRC). Methods: A cross-sectional descriptive study, with follow-up of 50 stage III CRC patients treated at Military Hospital 103 and K Hospital from January 2021 to December 2024. Results: The percentage of positive mSEPT9 in plasma after surgery was 34% (17/50), significantly reduced compared to 84% (42/50) before surgery. ROC curve analysis showed that the value of distinguishing the progression status when combining positive mSEPT9 before and after surgery was good (AUC=0,755, p<0,05). Patients with positive mSEPT9 after surgery higher risk of progression compared to those with negative mSEPT9 after surgery (OR=7, p<0,05). Multivariate analysis indicated that mSEPT9 after surgery (HR: 10,738, p<0,05) is an independent predictive factor for significantly shorter PFS in stage III CRC patients with positive mSEPT9 after surgery. Conclusion: mSEPT9 has prognostic value and is useful for monitoring progression after radical surgery in stage III CRC patients.

CLINICAL CHARACTERISTICS OF PATIENTS UNDERGOING LONG-TERM GLUCOCORTICOID THERAPY AT THE OUTPATIENT CLINIC OF NGUYỄN TRI PHƯƠNG HOSPITAL

Trúc Dung Nguyễn, Thành Tuấn Nguyễn, Quang Khanh Tran

Objectives: This study aims to characterize the clinical manifestations of patients undergoing long-term glucocorticoid therapy at the outpatient clinic of Nguyễn Tri Phương Hospital and to ascertain the prevalence of glucocorticoid-induced secondary adrenal insufficiency through the insulin tolerance test. Methods: A cross-sectional study was conducted on 96 patients undergoing long-term glucocorticoid therapy at the outpatient clinic of Nguyễn Tri Phương Hospital between May 2023 and February 2024. Results: Among 96 patients, the most commonly observed clinical manifestations included abdominal obesity (24%), thin and easily bruised skin (15,6%), fatigue (13,5%), exhaustion (11,5%), loss of appetite (11,5%), moon face (9,4%), cataracts (8,3%), dizziness (4,2%), abdominal or thigh striae (4,2%), nausea and vomiting (5,2%), buffalo hump (3,1%), and neuropsychiatric symptoms (3,1%). The prevalence of glucocorticoid-induced secondary adrenal insufficiency, as determined by the insulin tolerance test, was 58,3%. Conclusion: Patients receiving long-term glucocorticoid therapy exhibit a wide range of clinical symptoms. The insulin tolerance test confirmed a 58,3% prevalence of secondary adrenal insufficiency, underscoring the importance of early detection and appropriate management in this patient population. Keywords: Clinical characteristics, long-term glucocorticoid therapy, insulin tolerance test.

MỘT SỐ BẤT THƯỜNG CỦA THÔNG ĐỘNG - TĨNH MẠCH TỰ THÂN VÀ CÁC YẾU TỐ LIÊN QUAN Ở BỆNH NHÂN LỌC MÁU CHU KỲ TẠI BỆNH VIỆN TRUNG ƯƠNG THÁI NGUYÊN

tuan tu tran, Thoa Lý Thị, Phương Nguyễn Thị Ngọc

Objective: The study aims to identify common complications of arteriovenous fistula (AVF) and analyze related factors. Research Methods: A cross-sectional descriptive study was conducted on 244 hemodialysis patients using AVF from January to June 2024 at Thai Nguyen National Hospital. Data on patient characteristics, AVF morphology, and clinical factors were collected. Univariate and multivariate logistic regression models were used to find correlations. Results: Among the 244 patients, 58.6% were male and 41.4% were female, with an average age of 56.6±15.2 years. Approximately 18.5% had a BMI <18.5. The average duration of dialysis was 5.7±4.4 years. The average weight gain between sessions was 2.1 ± 0.8 kg. The average albumin concentration was 37.4±3.8 g/L. The fistula was primarily in the left arm (78.7%), with wrist and snuffbox positions accounting for 71.7%. The complication rate was 29.1%, with aneurysm at 53.5%, arterial stenosis at 18.3%, and infection at 2.8%. Patients with higher BMI had a reduced risk of complications (OR=0.58; p=0.014), while longer dialysis duration increased the risk (OR=1.12; p<0.001). Higher albumin levels reduced the risk of AVF complications (OR=0.89; p=0.016). Conclusion: The complication rate of AVF is relatively high. Dialysis duration, BMI, and albumin levels affect complications. Nutritional interventions and monitoring long-term patients may reduce complications. Cohort and multi-center studies are needed to confirm these factors.

ĐÁNH GIÁ TÌNH TRẠNG NHIỄM TRÙNG HUYẾT VÀ TÍNH KHÁNG KHÁNG SINH CỦA MỘT SỐ VI KHUẨN THƯỜNG GẶP Ở BỆNH NHÂN BẠCH CẦU CẤP ĐIỀU TRỊ HÓA CHẤT

Objectives: Evaluation of bloodstream infection and antibiotic resistance patterns of common bacteria in patients with acute leukemia undergoing chemotherapy at Department of Clinical Hematology, 108 Military Central Hospital. Subject and Method: This is a retrospective, case series study involving 44 admissions in patients with acute leukemia undergoing chemotherapy who had positive blood culture. The study was conducted at the Department of Clinical Hematology, 108 Military Central Hospital from January 2022 to February 2025. Results: The incidence of bloodstream infection among acute leukemia patients receiving chemotherapy was 9.3%. Gram-negative bacteria were the predominant pathogens, accounting for 86.4%, with K. pneumoniae (43.2%) and E. coli (34.1%) being the most common. The rate of multidrug-resistant (MDR) bacterial infections was 76.2%, all of which were caused by Gram-negative bacteria, primarily K. pneumoniae (53.1%) and E. coli (43.6%). Gram-positive bacteria accounted for 9.1%, mainly Staphylococcus aureus, which was sensitive to vancomycin and linezolid. Candida tropicalis was isolated in 4.5% of cases and was sensitive to caspofungin and micafungin. The bloodstream infcetion-related mortality rate was 20.5%. Conclusions: The incidence of bloodstream infection among acute leukemia patients receiving chemotherapy was 9.3%. Gram-negative bacteria were the most common causative agents (86.4%), with K. pneumoniae and E. coli being the predominant multidrug-resistant pathogens.

Efficacy of Pulsed Radiofrequency in Interventional Management of Chronic Spinal Pain

Minh Trung Phan, Ha Van Linh, Nghiêm Việt Dũng, Hà Văn Tuấn

This study aimed to evaluate the effectiveness of pulsed radiofrequency (PRF) in reducing pain in patients with chronic spinal pain conditions. A prospective, uncontrolled clinical intervention study was conducted on 90 patients with chronic cervical or lumbar spinal pain at the Department of Orthopedic Trauma Surgery – Thanh Nhan Hospital. Patients were treated using appropriate PRF techniques. Pain intensity was assessed using the Visual Analog Scale (VAS) at five time points: before intervention, 24 hours, 1 month, 3 months, and 6 months after intervention. The Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Patient Global Impression of Change (PGIC) were also used to evaluate treatment outcomes. The mean VAS score decreased from 5.7 ± 1.14 before treatment to 1.20 ± 1.39 at 6 months post-intervention (p<0.05). Both ODI and NDI scores showed statistically significant reductions. After 6 months, 82.2% of patients reported more than 50% pain relief. No serious complications were observed during or after the procedure. PRF is an effective and safe interventional method for managing chronic spinal pain, significantly improving patient’s quality of life. Key words: Pulsed radiofrequency (PRF); chronic spinal pain; interventional pain management; Visual Analog Scale (VAS); Oswestry Disability Index (ODI); Neck Disability Index (NDI); Patient Global Impression of Change (PGIC).

THIẾU VI CHẤT DINH DƯỠNG VÀ YẾU TỐ LIÊN QUAN Ở TRẺ ĐỘNG KINH KHỞI PHÁT TRƯỚC 6 THÁNG TUỔI TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Mục tiêu: Mô tả thiếu hụt vi chất dinh dưỡng (VCDD) và yếu tố liên quan ở trẻ mắc động kinh khởi phát sớm (ĐKKPS) trước 6 tháng tuổi. Phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 105 trẻ mắc bệnh ĐKKPS tại Bệnh viện Nhi Trung ương từ tháng 7/2023 - 6/2024. Thiếu hụt VCDD được đánh giá bằng lượng chất dinh dưỡng ăn vào so với nhu cầu khuyến nghị bằng phương pháp điều tra khẩu phần ăn 24 giờ và xét nghiệm huyết học - sinh hóa máu. Kết quả: Tỷ lệ trẻ không nhận đủ VCDD trong khẩu phần ăn với vitamin D là 89,5%, magie là 49,5%, sắt là 34,3%, kẽm là 31,4%, calci là 18,1%. Thiếu VCDD trên cận lâm sàng với thiếu máu (52,4%), calci (40%), kẽm (65,7%), vitamin D (30,5%), sắt (21,9%), magie (2,9%). Trẻ đáp ứng kém với điều trị có tỷ lệ thiếu sắt, vitamin B1 và vitamin B6 cao hơn rõ rệt (p < 0,05). Kết luận: Thiếu VCDD, đặc biệt vitamin D, sắt, calci, kẽm phổ biến ở trẻ mắc ĐKKPS, gợi ý cần sàng lọc và bổ sung sớm.

FACTORS RELATED TO THE SEVERITY OF ACUTE ASTHMA EXACERBATIONS IN PEDIATRIC ASTHMA PATIENTS AT CAN THO CHILDREN'S HOSPITAL (2024–2025)

Objective: To describe several clinical and paraclinical characteristics of children with acute asthma exacerbations; and to identify factors associated with exacerbations severity. Methods: A cross-sectional descriptive study was conducted on 112 children diagnosed with acute asthma exacerbations at the Respiratory Department of Can Tho Children's Hospital from June 2024 to December 2025. Results: The mean age was 6.33 ± 2.93 years. Tobacco smoke exposure was prevalent (50.9%). The most common clinical symptoms were cough (88.4%) and chest retractions (66.1%). Pulmonary co-infection was observed in 57.1% of cases. Moderate-to-severe exacerbations accounted for 73.2% of cases. In the multivariate logistic regression analysis, only chest retractions and pulmonary co-infection were identified as independent predictors of acute asthma exacerbation severity, with adjusted odds ratios (OR) of 428.09 (95% CI: 39.99–4582.39; p<0.001) and 17.41 (95% CI: 2.32–130.54; p=0.005), respectively. Conclusion: The study confirms that the severity of acute asthma exacerbations is significantly associated with chest retractions and pulmonary co-infection. Therefore, thorough clinical examination and effective infection control are critically required in children with asthma.

SỰ THAY ĐỔI NỒNG ĐỘ GLUCAGON LIKE PEPTIDE- 1 HUYẾT TƯƠNG Ở NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG MỚI KHỞI PHÁT SAU GHÉP THẬN

Thị Thùy Dung Nguyễn, Việt Thắng Lê, Minh Núi Nguyễn

Mục tiêu: Khảo sát sự thay đổi nồng độ glucagon-like peptide-1 (GLP-1) huyết tương ở người bệnh đái tháo đường (ĐTĐ) mới khởi phát sau ghép thận (new-onset diabetes after transplantation - NODAT). Phương pháp nghiên cứu: Nghiên cứu mô tả, cắt ngang, theo dõi dọc trên 81 bệnh nhân (BN) NODAT, 81 BN sau ghép thận không mắc ĐTĐ (không NODAT) và 53 người khỏe mạnh, tương đồng tuổi và giới tính tại Bệnh viện Quân y 103 từ tháng 10/2021 - 12/2023. Các BN NODAT được điều chỉnh chế độ ăn, thể dục, dùng thuốc kiểm soát glucose máu, cá thể hoá từng BN. Đánh giá kết quả kiểm soát glucose máu sau 3 tháng. Định lượng nồng độ GLP-1 huyết tương vào thời điểm khi phát hiện (T0) và sau 3 tháng kiểm soát glucose máu (T3). Kết quả: Nồng độ GLP-1 của nhóm BN NODAT là 7,65 (5,99 - 9,26) pmol/L, thấp hơn nhóm BN không NODAT là 8,82 (6,67 - 12,69) pmol/L và thấp hơn ở nhóm người khỏe là 10,7 (8,14 - 13,19) pmol/L, p < 0,001. Tỷ lệ giảm nồng độ GLP-1 ở nhóm NODAT là 22,2%, cao hơn nhóm chứng bệnh là 8,6%, với p < 0,05. Sau 3 tháng, nồng độ GLP-1 huyết tương là 10,61 (8,65 - 13,5) pmol/L, cao hơn so với trước điều trị, p < 0,001. Kết luận: Ở BN NODAT có giảm nồng độ GLP-1 huyết tương, sau 3 tháng điều trị nồng độ GLP-1 huyết tương có cải thiện ở nhóm BN này.

SỐNG THÊM BỆNH KHÔNG TIẾN TRIỂN VÀ MỘT SỐ ĐẶC ĐIỂM LIÊN QUAN TRÊN BỆNH NHÂN CAO TUỔI UNG THƯ PHỔI KHÔNG TẾ BÀO NHỎ GIAI ĐOẠN IV ĐIỀU TRỊ DOCETAXEL

Thị Khánh Tâm Lê, Thị Hồng Ngọc Nguyễn

CHARACTERISTICS RELATED TO PROGRESSION FREE SURVIVAL IN IV STAGE NONSMALL CELL LUNG CANCER ELDERLY PATIENTS Abstract Objectives: Evaluating some factors related to progression-free survival in IV stage lung cancer elderly patients treated with Docetaxel. Methods: Retrospective, prospective, and longitudinal study Results: The median progression-free survival was 4.64 months. The progression-free survival correlated with high performance status, first-line response therapy, and number of metastatic organs. PFS did not correlate with age and concomitant chronic diseases. Conclusion: Docetaxel helps to improve progression-free survival in elderly IV stage lung cancer patients. Keywords: elderly patients, progression-free survival, non small cell lung cancer

Tiếng Việt

A cross-sectional descriptive study was conducted on 51 children aged 10 to 16 years with chronic kidney disease undergoing peritoneal dialysis at the National Children's Hospital between July 2024 April 2025. The study aimed to evaluate the nutritional status and the micronutrient content of their actual dietary intake. Among the 51 participants, the proportion of boys and girls were 49% and 51% respectively. The prevalence of severe and moderate stunting were 35.3% and 33.3% respectively. Severe and wasting were observed in 19.6% and 29.4% of the participants, respectively. Overweight based on BMI was found only in boys (8%). Analysis of the 24-hour dietary intake revealed that most minerals and vitamins – including sodium, potassium, phosphorus, magnesium, zinc, calcium, and vitamins B2, B3, B6, B9, B12, C, and A – did not meet the recommended intakes for Vietnamese children. Children with stunting consumed significantly lower amounts of potassium, zinc, vitamins B3, and C compared to those without malnutrition. These findings highlight the need for regular nutritional screening and targeted interventions in children with chronic kidney disease undergoing peritoneal dialysis to optimize growth and treatment outcomes.

EVALUATION OF SERUM ALBUMIN CHANGES AFTER PRIMARY HIP ARTHROPLASTY IN ELDERLY PATIENTS

Trần Cảnh Tùng Nguyễn, Duc Canh Nguyen, Nhat Dinh Vu, Hoang Anh Dang

Objectives: To evaluate changes in serum albumin after primary hip arthroplasty in elderly patients. Methods: A retrospective study was conducted on 142 patients aged ≥ 60 years, including 86 patients who underwent hemiarthroplasty and 57 patients who underwent total hip arthroplasty at Military Hospital 103 from April 2022 to December 2024. Serum albumin levels were measured preoperatively and 24 hours postoperatively. Results: The mean age was 74.27 ± 6.99 years. Patients undergoing hemiarthroplasty were older and showed a greater decrease in serum albumin. Serum albumin decreased significantly after surgery in both groups, with the magnitude of change positively correlated with age (r = 0.44; p < 0.0001) and female gender (p = 0.0037). No significant association was found between albumin changes and surgery duration. Conclusion: Hip arthroplasty surgery leads to a reduction in serum albumin in elderly patients. Pre- and postoperative nutritional assessment and supplementation play an important role in optimizing surgical outcomes.

EVALUATION OF RESULTS OF LABOR INDUCTION BY PROPESS IN PREGNANT WOMEN WITH PREMATURE RUPTURE OF MEMBRANES AT HA NOI OBSTETRIC AND GYNECOLOGY HOSPITAL IN 2024

Đinh Thị Thu Trang, Thu Hà Nguyễn, Lương Hoàng Thành, Văn Đạt Lê

Abstract Objectives: To evaluate the outcomes of labor induction using Propess in pregnant women with premature rupture of membranes (PROM). Methods: A retrospective, cross-sectional descriptive study was conducted on 56 pregnant women with PROM at Hanoi Obstetrics and Gynecology Hospital in 2024, eligible for vaginal delivery and underwent labor induction by Propess. Outcomes before and after labor induction were assessed through changes in the Bishop score, rates of vaginal delivery, cesarean delivery, and associated complications. Results:The Bishop score increased by an average of 4.09 points after Propess administration compared to baseline. The success rate of cervical ripening (defined as cervical dilation > 3cm) was 62.5%. Successful labor induction leading to vaginal delivery was achieved in 51.79% of the study population. Pregnant women who delivered vaginally within 12 hours of Propess insertion accounted for 68.96%. Among the 27/56 cesarean deliveries, the most common indication for surgery was failure of cervical progression, accounting for 66.67% of cases. Most pregnant women who underwent labor induction by Propess experienced no serious adverse events or complications. Conclusion:Propess is effective in cervical ripening and labor induction in cases of premature rupture of membranes. Due to the potential adverse effects, the use of Propess for labor induction must follow strict protocols and be closely monitored.

COMPARISON OF THE EFFECTS OF LIDOCAINE AND PROPOFOL ON HEMODYNAMIC RESPONSE AND AIRWAY REFLEX DURING THE TRACHEAL EXTUBATION PHASE FOLLOWING COSMETIC SURGERY

Văn Hiển Võ, Hải Trung Lê, Đăng Thứ Nguyễn

Abstract Objectives: To compare the effectiveness of lidocaine and propofol in controlling hemodynamic response and airway reflex during the tracheal extubation phase following cosmetic surgery. Methods: A prospective, clinical interventional, randomized grouping, comparative study was conducted on 60 patients undergoing cosmetic surgery with ASA I-II (according to American Society of Anesthesiologists). Patients were randomly divided into two groups: Group L (30 patients) received 1.5 mg/kg of intravenous lidocaine, and group P (30 patients) received 0.5 mg/kg of intravenous propofol when the patient began to breathe spontaneously, and extubation was performed after 5 minutes. The two groups were compared in terms of hemodynamic changes and airway reflex (cough, abnormal movements, and bronchospasm) before and after extubation. Results: Group P had more hemodynamic stability than group L, which was shown at the time immediately after extubation (T3): Heart rate and mean arterial pressure in group P were statistically significantly lower than in group L (p < 0.05). Group L showed superior suppression of coughing and airway reflex, with lower cough scores and incidence of laryngospasm (p < 0.001). Conclusion: Propofol is preferred for hemodynamic control, while lidocaine is more effective in airway reflex. Drug choice should be tailored to clinical goals and patient characteristics.

HEPATIC PARENCHYMA LITHOTOMY OF HEPATOLITHIASIS: A CASE REPORT AT MILITARY HOSPITAL 175 Abstract

Văn Quỳnh Nguyễn, Lê Trung Hiếu

Hepatolithiasis is a common disease in the Asia-Pacific region in general and in Vietnam in particular, and management strategies are quite diverse with the aim of removing the stones completely. Our clinical case involves a 41-year-old female patient with no history of chronic illness who was admitted due to right upper quadrant pain accompanied by fever a few weeks prior. The patient was diagnosed with "Biliary tract infection due to right hepatolithiasis, stricture of the right hepatic duct, and common bile duct stones". The patient underwent open hepatic parenchyma lithotomy and common bile duct exploration to remove the stones, dilation of the right hepatic duct, and Kehr drainage. Postoperatively, the patient had a stable recovery and was discharged after 7 days of treatment. Through this case, we conclude that hepatic parenchyma lithotomy can be performed in selected cases, providing good stone clearance outcomes.

INITIAL ASSESSMENT OF LICHTENSTEIN INGUINAL HERNIA REPAIR USING SELF-ADHERING MESH AT MILITARY HOSPITAL 103

Võ Văn Triệu, Hồ Hữu An, Nguyễn Trọng Hòe, Trần Doanh Hiệu

Abstract Objectives: To evaluate the effectiveness of inguinal hernia repair using the Lichtenstein technique with self-gripping Progrip mesh compared to conventional Polypropylene mesh at Military Hospital 103. Methods: A retrospective, prospective, descriptive case series with a control group comparing two groups of patients who underwent inguinal hernia repair using the Lichtenstein technique at the Military Hospital 103 from January to June 2024. Group 1 included 27 patients (30 cases, with 3 patients having bilateral hernias) treated with self-gripping Progrip mesh. Group 2 included 40 patients (46 cases, with 6 patients having bilateral hernias) treated with conventional polypropylene mesh. The variables collected and compared between the two groups included epidemiological characteristics, surgical technique, and early and late postoperative outcomes. Results: The self-gripping mesh group had a statistically significant shorter mean mesh placement time and total operative time than the Polypropylene mesh group (p < 0.001). There were no statistically significant differences between the two groups in terms of postoperative pain, time to ambulation, length of hospital stay, early and late complications, or recurrence rates. Conclusion: Using self-gripping Progrip mesh in Lichtenstein inguinal hernia repair reduces operative and mesh placement time while achieving comparable early and late treatment outcomes to conventional Polypropylene mesh.

THE VALUE OF MOXAIC CLASSIFICATION IN THE PROGNOSIS OF TREATMENT OUTCOMES FOR MAJOR SOFT TISSUE INJURIES OF THE MAXILLOFACIAL REGION

Nguyen Trong Duc, Tạ Quang Hào

Objectives: To evaluate the value of the MOXAIC classification in predicting the treatment outcomes of major soft tissue injuries (MFTs) in the maxillofacial region. Methods: A retrospective, cross-sectional descriptive study was conducted on 177 patients with MFTs of the maxillofacial region treated at VietDuc University Hospital from January 2017 to December 2022. MFTs in the maxillofacial region were classified according to the MOXAIC system (O, X, A, I, C). Treatment outcomes were evaluated based on anatomical and aesthetic. Results: O, A, and C-shaped types have a high rate of good results, reaching over 78%, while types X-shaped and I-shaped have only less than 50% of good results; this difference is statistically significant (p < 0.001), showing that the MOXAIC classification has a good prognostic value for the treatment results of MFTs in the maxillofacial region. Conclusion: Wounds of the O, A, and C-shaped types, according to the MOXAIC classification, often have a better prognosis for treatment results.

EFFECTIVENESS OF ENDOSCOPIC TYMPANOSTOMY TUBE PLACEMENT IN THE TREATMENT OF OTITIS MEDIA WITH EFFUSION IN HEAD AND NECK CANCER PATIENTS

Abstract Objectives: To evaluate the effectiveness of endoscopic tympanostomy tube placement in treating otitis media with effusion in patients with head and neck cancer (HNC). Methods: A prospective, descriptive, interventional study was conducted on 30 HNC patients diagnosed with otitis media with effusion at Military Hospital 103 from March 2024 to March 2025. Results: Clinical symptoms, otoscopic findings, and hearing function significantly improved after endoscopic tympanostomy tube placement. The rates of symptoms and signs at preoperative, 1-month, and 3-month postoperative time points were as follows: Tinnitus (100%; 11.6%; 7.0%), hearing loss (67.4%; 9.3%; 7.0%), retracted tympanic membrane (62.8%; 9.3%; 2.3%), normal tympanic membrane shape (4.7%; 9.3%; 32.6%), thick yellowish tympanic membrane (51.2%; 18.6%; 2.3%), and normal tympanic membrane color (0%; 7.0%; 76.7%). Air hearing threshold improved from 50.2 ± 17.7dB to 30.4 ± 14.2dB and 20.5 ± 8.5dB. Bone hearing threshold improved from 30.7 ± 12.9dB to 23.4 ± 11.7dB and 19.0 ± 8.9dB. The overall outcome rate was 69.6% at 1 month and 79.1% at 3 months postoperatively. Conclusion: Endoscopic tympanostomy tube placement effectively treats otitis media with effusion in HNC patients in terms of signs relief, tympanic membrane morphology and color, and hearing improvement. Most symptoms improved significantly after 1 month and continued to improve up to 3 months postoperatively.

RESULTS OF HEPATECTOMY FOR THE TREATMENT OF HEPATOCELLULAR CARCINOMA AT THONG NHAT HOSPITAL

Objectives: To evaluate the early results of anatomical hepatectomy in treating hepatocellular carcinoma. Methods: A retrospective, descriptive study was conducted on 73 cases who underwent anatomical hepatectomy to treat hepatocellular carcinoma at Thong Nhat Hospital from August 2022 to August 2024. Result: The average age was 63.1 ± 17.5 years old, 72.6% were males. The incidence of viral hepatitis (B or C) was 65.8%. Increased AFP concentration accounted for 63.0%. The average number of tumors was 1.3 ± 0.3. The average tumor size was 4.3 ± 1.4cm. 87.7% of patients had two or more liver segments removed. The mean operation time was 253.2 ± 58.3 minutes; the mean blood loss was 215.6 ± 72.3mL. The average length of postoperative hospital stay was 12.2 ± 5.6 days. Postoperative complications (23.3%) included liver failure (1.4%), bleeding (2.7%), bile leak (2.7%), surgical wound infection (6.8%), pneumonia (1.4%), and pleural effusion (9.5%). Conclusion: Anatomical hepatectomy for the treatment of hepatocellular carcinoma is safe and feasible. It is necessary to monitor and evaluate the long-term outcomes of patients.

RESULTS OF CARE AND TREATMENT OF PATIENTS WITH IMMEDIATE IMPLANT AT 108 MILITARY CENTRAL HOSPITAL

Thị Hồng Vân An, Tuấn Anh Phạm, Hà Thanh Lưu, Duy Chiến Nguyễn, Văn An Nguyễn

Abstract Objectives: To analyze the results of care and treatment for patients with implant surgery. Methods: A cross-sectional descriptive study was conducted on 49 patients who received implants at the Department of Odontology, 108 Central Military Hospital. Results: Aged > 50 accounted for 67.35%; males accounted for 63.27%. The cause of implant surgery was mostly due to pathological tooth loss, accounting for 95.92%. 100% of patients were monitored for symptoms; there were no symptoms of pain, bleeding, or swelling from the 5th day after implant surgery. The care activity "Asking about health, promptly explaining questions" had the lowest rate (71.43%); the consultation activity "Guiding on oral hygiene" accounted for a low rate (77.5%); the remaining care activities had a high rate (> 90%). Patient satisfaction regarding "Waiting time for examination" had the lowest rate (87.76%). Early classification of treatment and care results showed that 10.2% of patients had complications, mainly mucosal inflammation (10.2%) and swelling (10.2%); only 6.12% had bleeding, and 2.02% had receding gums. Conclusion: The Department of Odontology should change the medical examination and treatment process to reduce waiting times for medical examinations and enhance patient satisfaction.

THE RELATIONSHIP BETWEEN BLOOD LACTATE LEVEL AT ADMISSION AND OUTCOMES IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

Trung Kiên Nguyễn, Văn Hải Trần

Abstract Objectives: To investigate the relationship between blood lactate at admission with the treatment outcome of patients with severe traumatic brain injury (TBI). Methods: A prospective, cohort study was conducted on 68 patients with severe TBI who were treated at the Intensive Care Unit (ICU), Military Hospital 105. Data were entered into the research medical records and processed according to statistical algorithms. Results: The average age of patients with severe TBI was 44.71 ± 19.93, the GCS score at admission was 6.59 ± 1.67, and the average lactate concentration at admission was 3.92 ± 1.76 mmol/L. Blood lactate at admission in the death group was higher than that of the survival group; the difference was statistically significant (p < 0.05). Blood lactate concentration had a moderate positive correlation with the length of hospital stay (r = 0.431) and the length of ICU stay (r = 0.458), with p < 0.05. The area under the curve (AUC) for predicting mortality based on blood lactate concentration at admission was 0.814. Conclusion: Blood lactate at admission is an important biomarker with prognostic significance for mortality in patients with severe traumatic brain injury.

COMMON HEPATIC ARTERY ARISING FROM THE SUPERIOR MESENTERIC ARTERY: A RARE CASE AT MILITARY HOSPITAL 175

Văn Mạnh Nguyễn, Nguyễn Văn Quỳnh, Thanh Huy Đoàn, Lê Trung Hiếu

The hepatic artery is the most variable hepatic pedicle anatomical structure, with the common hepatic artery anatomy occurring in approximately 80% of cases and the remaining 20% being variants. Understanding and recognizing the hepatic artery anatomy is very important in the practice of hepatobiliary and pancreatic surgery. In this report, we present a rare variant of the hepatic artery in which the common hepatic artery originates from the superior mesenteric artery (Michels type IX) discovered during the diagnosis and treatment of a 67-year-old female patient with a Klatskin tumor type IIIa. This vascular variant was identified preoperatively by multislice computed tomography and 3DVT. The patient underwent right hepatectomy, extrahepatic cholangiectomy, portal vein reconstruction, lymphadenectomy, and cholecystoenterostomy safely and recovered well postoperatively.