Effects of exercise on human energy metabolism in high temperature and high humidity environment / Efeitos do exercício sobre o metabolismo energético humano em ambientes de alta temperatura e umidade / Efectos del ejercicio sobre el metabolismo energético humano en ambientes de alta temperatura y humedad

ABSTRACT Introduction Many exercise enthusiasts have started participating in sports in the high-temperature environment in recent years due to the increasing popularity of these sports habits. However, their scientific studies still have a gap in their safety and effectiveness. Objective Measure the energy supply characteristics of fat and sugar oxidation during exercise in different high-temperature and humidity environments. Methods 20 healthy adult subjects were exposed to fixed-intensity exercise for 20 minutes at 30-33 oC, 20% relative humidity (RH), and 50% RH, respectively. Results Under the silent exposure condition, compared with RH 20% and RH 50% under high temperature, sugar oxidation was significantly increased (P<0.01), while fat oxidation was significantly reduced (P<0.01), and total energy consumption was significantly increased (P<0.01). Under the condition of 65% VO2 max exercise, compared with RH 20% and RH 50% at high temperatures, the amount of sugar oxidation was significantly reduced (P<0.05), and the total energy consumption was significantly reduced (P<0.05). Conclusion Under 65% exercise under VO2 max in the high temperature and humidity-controlled environment, the high temperature and medium humidity (RH 50%) environment consumes more energy, and there is a greater amount of sugar oxidation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução Muitos entusiastas do exercício físico começaram a participar de esportes no ambiente de altas temperaturas nos últimos anos devido a crescente popularidade desses hábitos esportivos, embora seus estudos científicos ainda apresentem uma lacuna sobre sua segurança e efetividade. Objetivo Comparar as características do fornecimento de energia de oxidação de gordura e açúcar durante o exercício em ambientes de alta temperatura e umidade diferentes. Métodos Um total de 20 sujeitos adultos saudáveis foram expostos a exercícios de intensidade fixa durante 20 minutos a 30-33 oC, 20% de umidade relativa (RH) e 50% de RH, respectivamente. Resultados Sob a condição de exposição silenciosa, comparado com RH 20% e RH 50% sob alta temperatura, a oxidação do açúcar foi significativamente aumentada (P<0,01), enquanto a oxidação da gordura foi significativamente reduzida (P<0,01), e o consumo total de energia foi significativamente incrementado (P<0,01). Sob a condição de 65% de exercício de VO2max, comparado com RH 20% e RH 50% a altas temperaturas, a quantidade de oxidação do açúcar foi significativamente reduzida (P<0,05), e o consumo total de energia foi significativamente reduzido (P<0,05). Conclusão Sob a condição de 65% de exercício sob VO2max, no ambiente de alta temperatura e umidade controlados, o ambiente de alta temperatura e umidade média (RH 50%) consome mais energia, havendo uma maior quantidade de oxidação de açúcar. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción En los últimos años, muchos aficionados al ejercicio han comenzado a practicar deportes en el entorno de altas temperaturas debido a la creciente popularidad de estos hábitos deportivos, aunque sus estudios científicos aún presentan lagunas sobre su seguridad y eficacia. Objetivo Comparar las características de suministro energético de la oxidación de grasas y azúcares durante el ejercicio en diferentes entornos de alta temperatura y humedad. Métodos Un total de 20 sujetos adultos sanos fueron expuestos a ejercicio de intensidad fija durante 20 minutos a 30-33 oC, 20% de humedad relativa (HR) y 50% de HR, respectivamente. Resultados Bajo la condición de exposición silenciosa, en comparación con RH 20% y RH 50% bajo alta temperatura, la oxidación de azúcar se incrementó significativamente (P<0.01), mientras que la oxidación de grasa se redujo significativamente (P<0.01), y el consumo total de energía se incrementó significativamente (P<0.01). Bajo la condición de ejercicio VO2max 65%, en comparación con RH 20% y RH 50% a alta temperatura, la cantidad de oxidación de azúcar se redujo significativamente (P<0,05), y el consumo total de energía se redujo significativamente (P<0,05). Conclusión Bajo la condición de 65% de ejercicio bajo VO2max en el ambiente controlado de alta temperatura y humedad, el ambiente de alta temperatura y humedad media (RH50%) consume más energía y hay una mayor cantidad de oxidación de azúcar. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Comparison of efficacy of pericapsular nerve group block combined with lateral femoral cutaneous nerve block versus fascia iliaca compartment block in elderly patients undergoing total hip arthroplasty under general anesthesia / 中华麻醉学杂志

Objective:To compare the efficacy of pericapsular nerve group (PENG) block combined with lateral femoral cutaneous nerve (LFCN) block versus fascia iliaca compartment block (FICB) in elderly patients undergoing total hip arthroplasty under general anesthesia.Methods:Fifty-eight patients of both sexes, aged 65-85 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective direct anterior approach to total hip arthroplasty, were divided into 2 groups ( n=29 each) using a random number table method: PENG block plus LFCN block group (PL group) and FICB group (F group). In group PL, the mixture (20 ml) of 0.375% ropivacaine hydrochloride and dexamethasone 3.3 mg was injected around the nerve innervating the hip joint capsule under ultrasound guidance.In group F, the mixture (30 ml) of 0.375% ropivacaine hydrochloride and dexamethasone 5 mg was injected around the nerve innervating the fascia iliaca compartment under ultrasound guidance.All the patients received patient-controlled intravenous analgesia with oxycodone after surgery.When visual analogue scale scores≥4 points, oxycodone 1 mg was intravenously injected as rescue analgesic.The intraoperative consumption of remifentanil was recorded.First time to ambulation, discharge destination, length of hospital stay, and effective pressing times of analgesic pump, requirement for rescue analgesia and the incidence of quadriceps weakness, nausea and vomiting and nerve block related complications within 48 h after surgery were recorded. Results:Compared with F group, intraoperative consumption of remifentanil was significantly decreased, effective pressing times of analgesic pump and incidence of quadriceps weakness were decreased, first time to ambulation and length of hospital stay were shortened, and first discharge destination was prolonged ( P<0.05), and no significant change was found in the requirement for rescue analgesia and the incidence of nausea ( P>0.05) in group PL. Conclusion:PENG block combined with LFCN block can reduce intraoperative consumption of opioids, be helpful for inhibiting postoperative pain sensitivity, and improve early recovery than FICB when used for total hip arthroplasty under general anesthesia.

Effectiveness evaluation of dietary intervention among migrant children in Hongshan District of Wuhan / 中国学校卫生

Objective@#To understand nutrient intake and dietary structure among migrant children in primary schools in Hongshan District of Wuhan, so as to carry out dietary nutrition intervention and evaluate the effectiveness of the intervention.@*Methods@#Stratified random sampling was used to select children in grade 3-6 who were randomly assigned to the intervention group (n=218) and the control group (n=222) from primary schools with a large number of migrant children in Hongshan District of Wuhan. After the baseline survey, the intervention group was given a two month diet intervention with "nutrition class" and knowledge lecture, and the caregivers of the intervention group were also given an intervention.@*Results@#At baseline, both groups had inadequate nutrient intake, with adequate intake rate of calcium, selenium, vitamin B 1 and vitamin B 2 less than 5%; children were lack of dietary diversity with adequate intake of vegitable, milk and milk product less than 5%. After intervention, the intake of energy, three main macronutrients, calcium, vitamin A, and vitamin C in the intervention group were higher than that of before intervention, as well as than the control group, differences were statistically significant (Z=2.22-8.65，2.62-8.46，P<0.05). In terms of dietary structure, adequate intake rate of cereals and miscellaneous beans increased from 55.5% to 68.8%, livestock and poultry meat increased from 45.9% to 56.4%, which were higher than that of the control group (56.3% and 44.6%) (χ 2=5.29-13.25，4.39-14.13，P<0.05).@*Conclusion@#Inadequate nutrient intake and unreasonable dietary structure of migrant children can be improved through short term dietary intervention including nutrition education to both parents and children.

Effect of BRCA1 on proliferation, migration and invasion of non-small cell lung cancer H1650 cells via Wnt/β-catenin pathway / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To investigate the effect of breast cancer susceptibility gene 1 (BRCA1) on the proliferation, migration and invasion of non-small cell lung cancer (NSCLC) H1650 cells through Wnt/β-catenin pathway. Methods: WB and qPCR were used to detect the mRNA and protein expressions of BRCA1 in NSCLC A549, H1299, H1650 cells and normal lung epithelial BEAS-2B cell. A stable BRCA1 over-expression cell line (LV-BRCA1) was constructed in H1650 cells, and blank control group (NC), negative control group (LV-BRCA1-NC), experimental group (LV-BRCA1) and inhibitor group (LV-BRCA1+XAV-939) were set up. The proliferative activity of cells in each group was detected by MTT assay, the migration ability of cells was detected by scratch test, the invasive ability of cells was detected by Transwell method, and the protein expression levels of BRCA1, cyclin D1, β-catenin, c-Myc and Cox2 were detected by WB. Results: The mRNA and protein expression levels of BRCA1 in NSCLC cells were significantly higher than those in BEAS-2B cells (all P<0.01). Up-regulation of BRCA1 expression in H1650 cells could significantly enhance cell proliferation, migration and invasion (P<0.05 or P<0.01), and increase the protein expressions of cyclin D1, β-catenin, c-Myc, Cox2 and c-Jun (P<0.05 or P<0.01). β-catenin inhibitor XAV-939 significantly down-regulated the proliferation, migration and invasion ability of H1650 cells over-expressing BRCA1, and decreased the protein expressions of cyclin D1, β-catenin, c-Myc, Cox2 and c-Jun (P<0.05 or P<0.01). Conclusion: BRCA1 can promote the proliferation, migration and invasion of NSCLC H1650 cells by activating Wnt/β-catenin pathway, and it is expected to be a potential diagnostic biomarker and treatment target for NSCLC.

Aliskiren attenuates cardiac dysfunction by modulation of the mTOR and apoptosis pathways

Aliskiren (ALS) is well known for its antihypertensive properties. However, the potential underlying the molecular mechanism and the anti-hypertrophic effect of ALS have not yet been fully elucidated. The aim of the present study was to investigate the role of ALS in mammalian target of rapamycin (mTOR) and apoptosis signaling using in vivo and in vitro models of cardiac hypertrophy. A rat model of cardiac hypertrophy was induced by isoproterenol treatment (5 mg·kg-1·day-1) for 4 weeks, with or without ALS treatment at 20 mg·kg-1·day-1. The expression of hypertrophic, fibrotic, and apoptotic markers was determined by RT-qPCR. The protein expression of apoptotic markers mTOR and p-mTOR was assessed by western blot analysis. The proliferation of H9C2 cells was monitored using the MTS assay. Cell apoptosis was analyzed using flow cytometry. In vivo, isoproterenol-treated rats exhibited worse cardiac function, whereas ALS treatment reversed these dysfunctions, which were associated with changes in p-mTOR, Bcl-2, Bax, and cleaved caspase-3 expression, as well as the number of apoptotic cells. In vitro, H9C2 cardiomyocyte viability was significantly inhibited and cardiac hypertrophy was induced by Ang II administration, but ALS reversed Ang II-induced H9C2 cardiomyocyte hypertrophy and death. Furthermore, Ang II triggered the activation of the mTOR and apoptosis pathways in hypertrophic cardiomyocytes that were inhibited by ALS treatment. These results indicated that ALS alleviated cardiac hypertrophy through inhibition of the mTOR and apoptosis pathways in cardiomyocytes.

Evaluation of ultrasound-guided continuous anterior quadratus lumborum block on postoperative analgesia in total hip arthroplasty / 中华麻醉学杂志

Objective To evaluate the effect of ultrasound-guided continuous anterior quadratus lumborum block (QLB) on postoperative analgesia in total hip arthroplasty.Methods Fifty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 65-80 yr,weighing 45-80 kg,scheduled for elective total hip arthroplasty under subarachnoid block,were divided into 2 groups (n =25 each) using a random number table method:ultrasound-guided continuous anterior quadratus lumborum block group (group Q) and routine analgesia group (group R).Anterior QLB was performed at the end of operation in group Q.Patient-controlled intravenous analgesia was performed with sufentanil after operation in two groups.Dezocine was given as rescue analgesic.Ramsay sedation score and the maximum angle for hip flexion and abduction of hip joint were recorded after operation,and the total consumption of sufentanil,requirement for dezocine and occurrence of adverse reactions were recorded within 72 h after operation.The occurrence of QLB-related complications was also recorded.Results Compared with group R,Ramsay sedation score was significantly decreased and the maximum angle for hip flexion and abduction of hip joint were increased at each time point after operation,and the total consumption of sufentanil,requirement for dezocine and incidence of nausea and vomiting were decreased in group Q (P ＜ 0.05).No QLB-related complications were found in group Q.Conclusion Ultrasound-guided continuous anterior QLB can produce better postoperative analgesia and reduce postoperative consumption of opioids with fewer adverse reactions in the patients undergoing total hip arthroplasty.

Propofol protects human cardiac AC16 cells from CoCl2-induced hypoxic injury / 中南大学学报(医学版)

To explore the effect of propofol on human cardiac AC16 cells under CoCl2-induced hypoxic injury and the possible mechanisms.
 Methods: Human AC16 cardiomyocytes were treated with cobalt chloride (CoCl2) to mimic hypoxic condition in cultured cardiomyocytes. The AC16 cells were divided into 3 groups: a control group, a CoCl2 hypoxia group (CoCl2 group), and a propofol+CoCl2 group (propofol+ CoCl2 group). The cell viability was assessed by cell counting kit-8 (CCK-8). Cell apoptosis ratio (AR) and the mitochondrial membrane potential (Δψm) were detected by flow cytometry. The reactive oxygen species (ROS) production in AC16 cells were determined with the ROS-sensitive fluorescent probe. Meanwhile, total intracellular levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in AC16 cells were detected with commercially available kits. Western blot was used to evaluate the activation of c-Jun N-terminal kinase (JNK) and p38 signaling pathways.
 Results: 1) Compared with the control group, AC16 cell viability was decreased significantly in the CoCl2 group following the treatment with 500 μmol/L CoCl2 (P<0.01); 2) Compared with the control group, AR value in AC16 cells was increased significantly in the CoCl2 group, while Δψm was decreased significantly (all P<0.01). Compared with the CoCl2 group, AR value in AC16 cells was decreased significantly in the propofol+CoCl2 group, while Δψm was increased significantly (both P<0.05); 3) Compared with the control group, the levels of ROS and MDA were increased significantly, and the level of SOD was significantly decreased in the CoCl2 group (all P<0.01). Compared with the CoCl2 group, the ROS and MDA levels in the propofol+CoCl2 group were increased significantly and the SOD levels were decreased significantly (all P<0.05); 4) Compared with the control group, the phosphorylation levels of JNK and p38 were increased significantly (both P<0.05) in the CoCl2 group. Compared with the CoCl2 group, the phosphorylation levels of JNK and p38 were decreased significantly in the propofol+CoCl2 group (both P<0.05).
 Conclusion: The pretreatment with propofol may protect human cardiac AC16 cells from the chemical hypoxia-induced injury through regulation of JNK and p38 signaling pathways.

Effect and mechanism of ultrasound-guided quadratus lumborum block on postoperative early cognitive function after colorectal surgery / 临床麻醉学杂志

Objective To investigate the effect of ultrasound-guided quadratus lumborum block on cognitive function after laparoscopic colorectal surgery.Methods Seventy-six patients, there is no restriction on gender, aged 50-75 years, falling into ASA physical statusⅡorⅢ, who provided informed consent for their participation in this study and underwent colorectal surgery under general anesthesia were divided into two groups (groups Q and C).Induction of anesthesia was induced by intravenous midazolam 0.03 mg/kg, sufentanil 0.5μg/kg, etomidate 0.3 mg/kg and rocuronium 1 mg/kg in the two groups.Remifentanil 0.2-0.3μg·kg-1·min-1 and propofol 0.10-0.15 mg·kg-1·min-1 were maintained intravenously during anesthesia.0.375％ropivacaine 20 ml was injected between the psoas quadratus muscle and psoas major muscle under ultrasound guidance before extubation in group Q, only equal volume saline was given in group C.Neuropsychological tests were performed preoperatively as well as postoperative day 7.The postoperative pain was evaluated by VAS after surgery.The postoperative sleep quality was measured using a BIS-vista monitor.The changes of serum IL-6, IL-1β, TNF-αand CGRP levels were detected by ELISA at immediately after operation (T0), 1 hour (T1), 2 days (T2), 4 days (T3) and 7 days (T4) after operation.Results Seventy-six patients finished cognitive function tests (38 cases in group Q and 38 cases in group C), 12 cases (31.6％) were diagnosed as POCD in group C, 4 cases (10.5％) in group Q.Compared with group C, the incidence of POCD, VAS scores at 24 and 48 hours after operation in group Q were significantly lower (P<0.05), the sleeping time at night was longer, the serum levels of IL-6, IL-1βand TNF-αwere significantly lower at T2 and T3, and the serum levels of CGRP were significantly higher at T2-T4 (P<0.05 or P<0.01).Conclusion QLB treatment repaired the surgery induced early cognitive dysfunction by inhibiting the postoperative pain, excessive inflammatory response and improving the quality of sleep.

Quality appraisal of evidence-based guidelines on prevention and repair of perineal injury at vaginal delivery / 中华护理杂志

Objective To review the methodological quality of evidence-based guidelines on prevention and repair of perineal injury at vaginal delivery,and analyze the characteristics of guidelines to provide references for evidence-based decision-making.Methods We systematically searched websites of professional organizations,websites of clinical practice guidelines and databases for guidelines on prevention and repair of perineal injury,and used AGREE Ⅱ to evaluate the chosen guidelines.Results We identified totally 7 relevant evidence-based guidelines in this field.The average standardized scores of guidelines in 6 domains of AGREE Ⅱ were 90.21％(scope and purpose),68.25％ (stakeholder involvement),69.94％ (rigor of development),89.41％ (clarity of presentations),70.63％ (applicability),and 68.25％(independence),respectively.The overall standardized score for 7 guidelines was 75.65％,and the total score was 5.67 (7 points).For overall quality,4 of them were grade A and 3 of them were grade B.Conclusion The overall quality of included guidelines were high,but stakeholder involvement,rigor of development and independence in some guidelines needs to be improved.There was no Chinese evidence-based gui-deline in this field,and high-quality foreign guidelines could be used as evidence in combination with local conditions.

Revisiting ovarian cancer microenvironment: a friend or a foe?

Development of ovarian cancer involves the co-evolution of neoplastic cells together with the adjacent microenvironment. Steps of malignant progression including primary tumor outgrowth, therapeutic resistance, and distant metastasis are not determined solely by genetic alterations in ovarian cancer cells, but considerably shaped by the fitness advantage conferred by benign components in the ovarian stroma. As the dynamic cancer topography varies drastically during disease progression, heterologous cell types within the tumor microenvironment (TME) can actively determine the pathological track of ovarian cancer. Resembling many other solid tumor types, ovarian malignancy is nurtured by a TME whose dark side may have been overlooked, rather than overestimated. Further, harnessing breakthrough and targeting cures in human ovarian cancer requires insightful understanding of the merits and drawbacks of current treatment modalities, which mainly target transformed cells. Thus, designing novel and precise strategies that both eliminate cancer cells and manipulate the TME is increasingly recognized as a rational avenue to improve therapeutic outcome and prevent disease deterioration of ovarian cancer patients.

Morphological characteristics of the cranial base of early Angle's class II division 1 malocclusion in permanent teeth / Características morfológicas de la base de cráneo en la maloclusión temprana clase II división 1 de Angle en dientes permanentes

To investigate the effects of morphological characteristics of cranial base on malocclusion by analyzing characteristics of sagittal and vertical facial types of Angle's class II division 1 malocclusion so as to provide theoretical references for clinical diagnosis and correction of early Angle's class II division 1 malocclusion in permanent teeth. We randomly selected lateral radiographs of the skull of 80 patients at the age of 12­14 years old from the Department of Orthodontics, Stomatological Hospital, Shanxi Medical University, China. There were 20 cases of Angle's class I malocclusion with average angle, 20 cases of Angle's class II division 1 malocclusion with average angle, 20 cases of Angle's class II division 1 malocclusion with low angle, and 20 cases of Angle's class II division 1 malocclusion with high angle. Winceph 8.0 software was used to measure 39 hard tissue markers and 13 indicators reflecting the characteristics of cranial base structure. One-way t-test was used in the average-angle class II division 1 group and average-angle class I group. Least significantdifference was utilized in patients with different vertical types of class II division 1 malocclusion.nterior (S-N) and posterior (S-Ba) cranial base lengths,and total cranial base length(Ba-N) were significantly longer in the class II division 1 patients compared with the class I patients. Significant differences in anterior cranial floor base angle (CF-PM), middle cranial floor base angle (Ba-SE-PM), and posterior cranial base inclination (SBa-FH) were determined between class II division 1 malocclusion and class I malocclusion patients. CF-PM angle and SBa-FH were smaller in class II division 1 subjects than in class I subjects. Ba-SE-PM angle and cranial floor base angle (Ba-SE-FMS) were larger in class II division 1 subjects than in class I subjects. No significant difference in cranial base angle (N-S-Ba) and anterior cranial base inclination (SN-FH) was detected between class II division 1 subjects and class I subjects. Morphology of cranial base and cranial floor base has a significant effect on sagittal and vertical facial types of Angle's class II division 1 malocclusion. The changes in the length of the posterior skull base and the inclination of the anterior skull base are mainly presented in the sagittal direction. Angle of cranial base and cranial floor base plays a certain role in vertical facial type of Angle's class II division 1 malocclusion.

El objetivo de este trabajo consistió en investigar los efectos de las características morfológicas de la base craneal sobre la maloclusión, a través del análisis de los siferentes tipos faciales de maloclusión Clase II de Angle (sagital y vertical), para proporcionar referencias teóricas para el diagnóstico clínico y la corrección temprana de la maloclusión de clase II división 1 de Angle en dientes permanentes. Se seleccionaron al azar radiografías laterales de cráneo de 80 pacientes, entre 12-14 años de edad, del Departamento de Ortodoncia, Hospital de Estomatología, Universidad Médica de Shanxi, China. Hubo 20 casos de maloclusión clase I de Angle con ángulo promedio, 20 casos de maloclusión clase II de Angle con ángulo promedio, 20 casos de maloclusión Clase II de Angle con ángulo bajo y 20 casos de maloclusión clase 1 de Angle con ángulo alto. Se utilizó el software Winceph 8.0 para medir 39 marcadores de tejido duro y 13 indicadores que reflejan las características de la estructura de la base de cráneo. Se usó la prueba t de una vía en el grupo clase II de división 1 con ángulo promedio y el grupo clase I con ángulo promedio. Se detectaron diferencias mínimas significativas en pacientes con diferentes tipos verticales de maloclusión clase II división 1. Las longitudes de la base de cráneo posterior (SN) y posterior (S-Ba), y la longitud total de la base craneal (Ba-N) fueron significativamente mayores en la clase II, en comparación con los pacientes de la clase I. Se determinaron diferencias significativas en el ángulo de la base del piso craneal anterior (CF-PM), el ángulo de la base del piso craneal medio (Ba-SE-PM) y la inclinación de la base craneana posterior (SBa-FH) entre la maloclusión clase II división 1 y los pacientes con maloclusión de clase I. Los ángulos de CF-PM y SBa-FH fueron más pequeños en la clase II división 1 que en la clase I. El ángulo de Ba-SE-PM y el ángulo de base del piso craneal (Ba-SE-FMS) fueron mayores en sujetos de clase II división 1 que en sujetos de clase I. No se detectaron diferencias significativas en el ángulo de la base craneana (N-S-Ba) y la inclinación de la base craneal anterior (SN-FH) entre los sujetos de la clase II división 1 y los de la clase I. La morfología de la base craneal y de la base del suelo craneal tiene un efecto significativo en los tipos faciales sagital y vertical de maloclusión Clase II división 1 de Angle. Los cambios en la longitud de la base posterior del cráneo y la inclinación de la base anterior del cráneo se presentaron principalmente en la dirección sagital. El ángulo de la base craneal y la base del suelo craneal tiene cierto rol en el tipo facial vertical de la clase II de Angle.

Implementation of the guideline based clinical practice program for identification and management of dys-phagia in stroke patients / 中华护理杂志

Objectives To implement the guideline-based clinical practice program for identification and manage-ment of dysphagia in stroke patients,and to create a good evidence-based practice culture,and to improve the quality of clinical care. Methods In this study,we use the Iowa model of evidence-based practice as a guide, reference guide issued by RNAO to implement the corresponding implementation strategy tool,and gradually apply the program to the pilot ward. Results The implementation of the program had a positive impact on the patient level (quality of life,satisfaction and hospitalization),the nurse level(satisfaction and knowledge),and the level of eachau-ditcriteria. Conclusion It is possible to improve the clinical nursing quality by adapting the high quality guide-lines for the identification and management of dysphagia in foreign countries and this study can provide reference for the research of future guideline implementation.

Effects of dexmedetomidine on microcirculatory perfusion in rabbits with renal ischemia/reperfusion injury: quantitative evaluation with contrast-enhanced ultrasound / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of dexmedetomidine on renal microcirculatory perfusion in rabbits with renal ischemia/reperfusion (I/R) injury rabbit by quantitative analysis of contrast-enhanced ultrasound (CEUS).</p><p><b>METHODS</b>Twenty- four New Zealand rabbits were randomly divided into 3 groups (8 in each), including a control group, renal I/R injury group and dexmedetomidine group. In the latter two groups, the right kidney of the rabbits was resected and I/R injury was induced in the left kidney. In dexmedetomidine group, the rabbits received an intraperitoneal dose of 10 µg/kg dexmedetomidine 30 min before renal ischemia, and 24 h after reperfusion, the renal size and renal artery resistance (RI) were measured, and renal cortex perfusion was observed by CEUS. The time-to-peak intensity (TTP), peak signal intensity (PSI), gradient between start frame to peak frame (Grad) and area under the curve (AUC) were quantitatively analyzed using the time-intensity curves. Pathological changes of the kidney were also observed.</p><p><b>RESULTS</b>Compared with the control group, the rabbits in I/R and dexmedetomidine groups showed distinct changes of the renal size with obvious renal pathologies. RI, PPT and AUC all increased, and PSI and Grad decreased significantly in I/R and dexmedetomidine groups (P<0.05). Compared with I/R group, obvious improvement of the renal size and renal pathologies were observed in dexmedetomidine group, which showed significantly decreased RI, PPT and AUC and increased PSI and Grad (P<0.05).</p><p><b>CONCLUSION</b>CEUS combined with the time-intensity curve parameters allows quantitative and dynamic analysis of the protective effects of dexmedetomidine on microcirculatory perfusion in rabbits with renal I/R injury.</p>

Comparison between ultrasound-guided cervical transverse process block and interscalene brachial plexus block in patients undergoing proximal humeral surgeries / 临床麻醉学杂志

Objective To compare effectiveness,performance,onset time and complications between ultrasound-guided cervical transverse process block and interscalene brachial plexus block in patients undergoing proximal humeral surgeries.Methods Sixty patients,27 males and 33 females, aged 18-70 years,scheduled for proximal humeral surgeries were randomly divided into two groups. They were given either cervical transverse process block (group T,n =30)or ultrasound-guided in-terscalene brachial plexus block (group I,n =30).All patients received a total of 8 ml of 0.5% ropiv-acaine.The performance, anesthetic onset time, the side effects and block success rate were evaluated.Results Block procedure was quicker in group T than in group I [(8.73 ±3.1 7)min vs. (14.40±8.21)min,P <0.01].The severity of diaphragmatic paralysis in group T was significantly lower than in group I (P <0.01).The ultrasound-guided cervical transverse process block was more effective than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries (100% vs.80%,P <0.05).Conclusion The ultrasound-guided cervical transverse process block has a higher success rate and fewer incidence of diaphragmatic paralysis than the interscalene brachial plexus block in patients undergoing proximal humeral surgeries.

Effects of adiponectin on mitochondrial damage in septic rats with lung injury / 中华麻醉学杂志

Objective To evaluate the effects of adiponectin on the mitochondrial damage in septic rats with lung injury .Methods Sixty male Wistar rats ,aged 7-8 weeks ,weighing 180-220 g ,were randomly divided into 3 groups (n=20 each) using a random number table :sham operation group (S group) ,sepsis group (SEP group) and adiponectin group (APN group) .The animals were anesthetized with intraperitoneal 2% pentobarbital sodium 50 mg/kg .Sepsis was produced by cecum ligation and puncture (CLP) .In APN groups ,gene recombinant adiponectin 6 mg/kg was injected intraperitoneally at 12 h after CLP .At 24 h after the operation ,10 rats from each group were chosen and sacrificed ,and lungs were removed for detection of interleukin-6 (IL-6 ) and high-mobility group box-1 (HMGB1 ) contents . The mitochondria of lung samples were isolated for measurement of the malondialdehyde (MDA ) content and degree of mitochondrial swelling and mitochondrial activity . The survival rates within 7 days after operation were recorded in the left 10 rats in each group .Results Compared with S group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly increased ,the degree of mitochondrial swelling was increased , and the mitochondrial activity and survival rates within 7 days after operation were decreased in SEP group ( P<0.05 ) . Compared with SEP group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly decreased ,the degree of mitochondrial swelling was reduced ,and the mitochondrial activity and survival rates within 7 days after operation were increased in APN groups ( P< 0.05 ) .Conclusion Adiponectin can attenuate lung injury and raise the survival rates in septic rats ,and reduction of mitochondrial damage in lung tissues is involved in the mechanism .

Effect of dexmedetomidine on expression of OGG1 mRNA in rat hippocampal neurons subjected to oxygenglucose deprivation/reoxygenation and restoration / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on the expression of 8-Oxoguanine DNA glycosylase 1 (OGG1) mRNA in rat hippocampal neurons subjected to oxygen-glucose deprivation/reoxygenation and restoration (OGD/R).Methods Hippocampal neurons isolated from pathogen-free neonatal Sprague-Dawley rats born within 3 days,were cultured primarily and seeded in 96-well plates (100 μl/well) or 6-well plates (2 ml/well) at the density of 1 × 106 cells/ml.The cells were randomly divided into 5 groups (n=30 each):control group (group C),group OGD/R,and different concentrations of dexmedetomidine groups (DEX1-3 groups).The cells were cultured in normal culture medium in group C and the cells were subjected to OGD/R in the other groups.In DEX1-3 groups,dexmedetomidine with the final concentrations of 0.1,1.0 and 10.0μmol/L were added,respetively,at 2h before OGD.At 24h of restoration,hippocampal neurons were stained with haematoxylin and eosin (H.E) for examination of pathological changes,the cell survival rate was detected by MTT method,the activity of superoxide dismutase (SOD) and content of malondialdehyde (MDA) were detected by colorimetric method,and the expression of OGG1 mRNA was detected by RT-PCR.Results The pathological changes of neurons were obvious in group OGD/R,and the pathological changes of neurons were significantly mitigated in DEX1,DEX2 and DEX3 groups.Compared with group C,the cell survival rate and SOD activity were significantly decreased,MDA content was increased,and the expression of OGG1 mRNA was down-regulated in OGD/R,DEX1,DEX2 and DEX3 groups (P ＜ 0.05).Compared with group OGD/R,the cell survival rate and SOD activity were significantly increased,MDA content was decreased,and the expression of OGG1 mRNA was up-regulated in DEX1,DEX2 and DEX3 groups (P ＜ 0.05).There was no significant difference in the indices mentioned above between DEX1,DEX2 and DEX3 groups (P ＞ 0.05).Conclusion Dexmedetomidine may protect hippocampal neurons against oxidative stress injury by up-regulating the expression of OGG1 mRNA in rat hippocampal neurons subjected to OGD/R.

Role of heme oxygenase-1 in inflammatory responses in septic rats / 中华麻醉学杂志

Objective To evaluate the role of heme oxygenase-1 ( HO- 1 ) in inflanmatory responses in septic rats.Methods Seventy-two male Wistar rats,aged 10-14 weeks,weighing 250-300 g,were used in this study.The animals were anesthetized with intraperitoneal 2％ pentobarbital sodium 50 mg/kg.Sepsis was induced by cecal ligation and puncture (CLP).The animals were randomly divided into 4 groups ( n =18 each):control group (C group),CLP group,HO-1 inducer cobalt protoporphyrin Ⅸ (CoPPⅨ) group (Co group) and HO-1 inhibitor zinc protoporphyrin Ⅸ (ZnPPⅨ) group (Zn group).Six rats in each group were randomly chosen at 6,12 and 24 h after operation to collect blood samples,and then the animals were sacrificed to obtain lung tissues at 24 h after operation.The serum levels of TNF-α,IL-6 and high mobility group box 1 (HMGB1) were determined by ELISA.The expression of HMGB1 mRNA in lung tissues was detected by RT-PCR.Another 40 Wistar rats with the same conditions were grouped according to the method mentioned above and the survival curve was drawn.Results Compared with group C,the serum levels of TNF-α,IL-6 and HMGB1 were significantly increased,the expression of HMGB1 mRNA in lung tissues was up-regulated,and the survival rate was significantly decreased in CLP,Co and Zn groups ( P ＜0.05).Compared with group CLP,the serum levels of TNF-α,IL-6 and HMGB1 were significantly decreased,the expression of HMGB1 mRNA in lung tissues was down-regulated,and the survival rate was significantly increased in group Co ( P ＜ 0.05),while no significant change was found in the parameters mentioned above in group Zn ( P ＞ 0.05).Conclusion Inducing the expression of HO-1 is helpful in reducing inflammatory responses in septic rats.

Effects of dexmedetomidine pretreatment and postconditioning on renal ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To investigate the effects of dexmedctomidine pretreatment and postconditioning on renal ischemia-reperfusion (I/R) injury in rats.Methods Thirty-two male Wistar rats,aged 3-4 months,weighing 220-300 g,were randomly divided into 4 groups ( n =8 each):sham operation group ( group S),I/R group,dexmedetomidine pretreatment group (group Pre) and dexmedetomidine postconditioning group (group Post).The rats were anesthetized with phenobarbital sodium 65 mg/kg.Renal I/R was produced by occlusion of both renal pedicles for 60 min followed by 48 h reperfusion.Dexmedetomidine 50 μg/kg was given intraperitoneally at 30 min before ischemia and at the beginning of reperfusion in Pre and Post groups respectively.The concentrations of serum creatinine and blood urea were determined at 0,24 and 48 h of reperfusion (T1-3).The renal tissues were obtained at the end of reperfusion for microscopic examination and detection of apoptosis by TUNEL assay.Acute kidney tubular necrosis was scored and apoptosis index (AI) was calculated.Results Compared with group S,the concentration of serum creatinine and blood urea at T2.3,and acute kidney tubular necrosis score and AI were significantly increased in I/R,Pre and Post groups ( P ＜ 0.05).Compared with I/R group,the concentration of serum creatinine and blood urea at T2.3,acute kidney tubular necrosis score and AI were significantly decreased in Pre and Post groups ( P ＜ 0.05).Conclusion Both dexmedetomidine pretreatment and postconditioning can attenuate renal I/R injury through inhibition of cell apoptosis in rats.

Chronic hepatitis virus infection in patients with multiple myeloma: clinical characteristics and outcomes

OBJECTIVES: Cytotoxic agents and steroids are used to treat lymphoid malignancies, but these compounds may exacerbate chronic viral hepatitis. For patients with multiple myeloma, the impact of preexisting hepatitis virus infection is unclear. The aim of this study is to explore the characteristics and outcomes of myeloma patients with chronic hepatitis virus infection. METHODS: From 2003 to 2008, 155 myeloma patients were examined to determine their chronic hepatitis virus infection statuses using serologic tests for the hepatitis B (HBV) and C viruses (HCV). Clinical parameters and outcome variables were retrieved via a medical chart review. RESULTS: The estimated prevalences of chronic HBV and HCV infections were 11.0 percent (n = 17) and 9.0 percent (n = 14), respectively. The characteristics of patients who were hepatitis virus carriers and those who were not were similar. However, carrier patients had a higher prevalence of conventional cytogenetic abnormalities (64.3 percent vs. 25.0 percent). The cumulative incidences of grade 3-4 elevation of the level of alanine transaminase, 30.0 percent vs. 12.0 percent, and hyperbilirubinemia, 20.0 percent vs. 1.6 percent, were higher in carriers as well. In a Kaplan-Meier analysis, carrier patients had worse overall survival (median: 16.0 vs. 42.4 months). The prognostic value of carrier status was not statistically significant in the multivariate analysis, but an age of more than 65 years old, the presence of cytogenetic abnormalities, a beta-2-microglobulin level of more than 3.5 mg/L, and a serum creatinine level of more than 2 mg/ dL were independent factors associated with poor prognosis. CONCLUSION: Myeloma patients with chronic hepatitis virus infections might be a distinct subgroup, and close monitoring of hepatic adverse events should be mandatory.

Determination of the concentration of very long chain fatty acids in serum by liquid chromatography-tandem mass spectrometry / 中华检验医学杂志

Objective To establish a method for very long chain fatty acids( VLCFA )with liquid chromatography-tandem mass spectrometry( LC-MS/MS ). Methods One hundred and one healthy cases and 35 suspected ALD patients collected from April to June in 2009 were enrolled into this study. Quantitative analyzed the concentrations of VLCFA in serum was performed using liquid chromatography-tandem mass spectrometry. The precision, accuracy and recovery were analyzed, and the stability of VLCFA concentration of sample under room temperature and repeated freeze-thawing were also investigated. Serum levels of VLCFA in 101 normal cases were determined and analyzed statistically. The results for the 35 randomly chosen serum samples were compared with those from MDI in Germany. Results Serum VLCFA were separated well under these gradient condition with small interference. The linear range of C22:0 was from 2 mg/L to 64 mg/L, the recovery was 99. 92% -102. 05%, and the relative standard deviation ( RSD ) of intra-day and inter-day was less than 6% and 9% respectively. For C24:0 they were 2-64 mg/L. 95. 12%-100. 44%. ≤6%, ≤7%,respectively. For C26:0, they were 0-8 mg/L, 92.21%-103.71%, ≤7%, ≤8%, respectively. The accuracy of C22: 0,C24:0 and C26:0 were among 85% to 115%. The samples could be stable within 12 h at room temperature and repeated 10 times freeze-thawing. The values of VLCFA in 101 normal cases followed a normal distribution and the measured values were C22:0 =( 19. 43 ±4.43 ) mg/L,C24:0 =( 19. 10 ±4. 58 )mg/L, C26:0 = ( 0. 21 ± 0. 11 ) mg/L, the ratio of C24: 0/C22:0 and C26:0/C22: 0 were ( 0. 99 ± 0. 13 )and ( 0. 01 ±0. 01 ) respectively. The statistical analysis showed the concentration of C26:0 in adults ( 0. 18±0. 10 ) mg/L and children ( 0. 21 ± 0. 08 ) mg/L, C24: 0/C22:0 in adults ( 1.01 ± 0. 10 ) and children ( 0. 99 ±0. 14 ) has no significant( t values were 1. 439,0. 806, respectively, all P ＞ 0. 05 ); the ratio of C24:0/C22:0 in male (1.05 ± 0. 10 ) and female (0.97 ± 0. 10 ) has significant difference ( t =3. 394,P =0. 001 ). Compared the values determined by MDI laboratory, the results of C22: 0( 16. 93 ±4. 30 ) mg/L,C24: 0( 19. 57 ± 6. 40 ) mg/L by this method and C22:0 ( 13.85 ± 3. 17 ) mg/L, C24:0( 16. 10 ±5.84 ) mg/L by MDI have significant differences( t = 8. 401 ,P =0. 000;t =9. 914,P =0. 000 ),but C26:0( 0.68 ±0.48 ) mg/L, C24:0/C22:0( 1.20 ±0.40 ), C26: 0/C22:0 ( 0.04 ±0.04 )by this method and C26: 0( 0. 65 ± 0. 67 ) mg/L, C24:0/C22: 0( 1.19 ± 0. 43 ), C26:0/C22: 0 ( 0. 05 ± 0. 05 )by MDI have no differences( t values were 0. 372,0. 317,0. 945 ,respectively ,all P ＞0. 05 ). Conclusions The quantitative analysis method for serum very long chain fatty acid using LC-MS/MS is accurate, sensitive,specific and stable. It could provide important biochemistry information for diagnosis in clinic.