Assessment for Nutritional Status Among Pre - School Children in South Delhi, India

Background: Weight is an important metric to measure protein energy status, and women from underdeveloped or developed nations who are heavier at pre - pregnancy deliver heavier babies. Methods: This study was conducted in JJ Colony, Madanpur Khadar Extension of South Delhi and included 50 children each in two groups (between 24 - 35 months and 36 - 47 months of age), with equal number of both genders. Anthropometric measurements of weight and height were measured. Results: Underweight in age 24 - 47 months: 51 (51%), 36 (36% ), 11 (11%) and 2 (2%) children were found to be in the ranges of normal weight, Grade - I, Grade - II, and severely underweight, respectively by Indian Academy of Paediatrics or IAP classification. By Gomez classification, the same were estimated to be 28 (28 %), 45 (45%), 25 (25%), and 2 (2%). Stunting and wasting in age 24 - 47 months: 52 (52%), 11 (11%), 16 (16%), and 21 (21%) children were found to be normal, in Grade - I, Grade - II and in Grade - III stunting respectively in height for age, while 82 (82%), 13 (13 %), 4 (4%), and 1 (1%) children were found to be normal, in Grade - I, Grade - II and Grade - III wasting in weight for height respectively; using the Waterlow classification. Conclusion: The most extensively used markers of nutritional quality in a population are anthropometric measures. In a total of 100 children, three types of assessments based on weight and height were done - weight for age to rule out underweight, height for age to rule out stunting and weight for height to rule out wasting.

Predictive Performance Of Different Diagnostic Criteria For Overweight And Obesity Between 2008-2015 In Adolescents

Background: The reference cut-offs for overweight and obesity have evolved from the use of International obesity task force (IOTF) to extended IOTF and revised Indian Academy of Pediatrics (IAP) growth charts. Methods: Secondary analysis of anthropometric data of school-going children from Delhi in the year 2008, 2013 and 2015 was performed. The proportions of children with overweight, obesity, and undernutrition were checked for agreement using different diagnostic cutoffs, and compared at three-time points. Results: Among 8417 adolescents, weighted Kappa statistics showed good agreement between extended IOTF and IAP cutoffs (k=0.933; 95% CI 0.93-0.94), between eIOTF and IOTF (k=0.624; 95% CI 0.619 - 0.629) and between IAP and IOTF (k=0.654; 95% CI 0.645-0.662). A higher proportion of adolescents were diagnosed with obesity with extended IOTF and IAP charts than IOTF charts (P<0.001 for both genders). The mean (SD) BMI showed a rising trend for adolescents overall from 19.61 (3.89) kg/m2 in 2008, 20.44 (4.37) kg/m2 in 2013 and 20.88 (4.60) kg/m2 in 2015 (P<0.001). 158 adolescent (97 girls) were undernourished using combined IAP and extended IOTF criteria. Conclusion: Both extended IOTF and IAP charts showed good agreement for diagnosing overweight and obesity in adolescents. A secular trend in malnutrition was observed in adolescent girls.

Apoptosis (programmed cell death) and its signals - A review / Apoptose, morte celular programada e seus sinais: uma revisão

Abstract Apoptosis is a sequential order of cell death occurring regularly to ensure a homeostatic balance between the rate of cell formation and cell death. However, a misplaced of this balancing function can contribute to an abnormal cell growth / proliferation or autoimmune disorders etc. Apoptosis is therefore said to be crucial from the point of development of an embryo throughout the growth of an organism contributing to the renewal of tissues and also the getting rid of inflammatory cells. This review seeks to elaborate on the recent overview of the mechanism involved in apoptosis, some element and signal contributing to its function and inhibition together with how their malfunction contribute to a number of cancer related cases.

Resumo A apoptose é uma ordem sequencial de morte celular que ocorre regularmente para garantir um equilíbrio homeostático entre a taxa de formação e a morte celular. No entanto, um desequilíbrio dessa função pode contribuir para um crescimento/proliferação celular anormal ou distúrbios autoimunes. A apoptose é, portanto, considerada crucial do ponto de desenvolvimento de um embrião ao longo do crescimento de um organismo que contribui para a renovação dos tecidos e também a eliminação de células inflamatórias. Esta revisão procura elaborar a recente visão geral do mecanismo envolvido na apoptose, alguns elementos e sinais que contribuem para sua função e inibição, além de como o mau funcionamento deles contribui para vários casos relacionados ao câncer.

Patient subjective experience of treatment with long-acting injectable antipsychotics: a systematic review of qualitative studies / Experiência subjetiva do paciente no tratamento com antipsicóticos injetáveis de ação prolongada: uma revisão sistemática de estudos qualitativos

ABSTRACT Objective: To gain a better understanding of how long-acting injectable antipsychotic (LAI) therapy is perceived by patients. Methods: A search for qualitative studies has been carried out on PubMed, Google Scholar, PsycINFO and PsycArticles, yielding 11 studies suitable for a review of qualitative studies. The reporting approach chosen was meta-ethnography, following the ENTREQ statement recommendations. Key concepts common to the different studies were extrapolated and then analysed in a systematic and comparative way. Results: Some recurrent issues were associated with LAIs, such as fear of coercion, fear of needles and lack of knowledge about depot therapy. These topics are linked to each other and the patients most concerned about the disadvantages of LAIs are those who are less informed about them, or who have experienced coercion and trauma during hospitalisation. On the other hand, patients who had already received LAIs, and those who had a good therapeutic relationship with their healthcare providers expressed satisfaction with this form of treatment and its continuation. Conclusion: Long-acting injectable antipsychotics are a tool in the management of mental disorders, and a viable alternative to oral medication. Patients show curiosity towards this method of administration, but lack of knowledge is a common finding. Shared decision making about the use of LAIs antipsychotics requires that patients receive accurate information and support for their decision regarding medication.

RESUMO Objetivo: Compreender melhor de que forma a terapia com antipsicóticos injetáveis de ação prolongada (IAP) é percebida pelos pacientes. Métodos: Uma pesquisa por estudos qualitativos foi conduzida em PubMed, Google Scholar, PsycINFO e PsyArticles, resultando em 11 estudos adequados para desenvolver uma revisão de estudos qualitativos. A abordagem escolhida foi a metaetnografia, seguindo as recomendações da diretriz ENTREQ. Conceitos-chave comuns aos diferentes estudos foram extrapolados e analisados de forma sistemática e comparativa. Resultados: Alguns problemas recorrentes foram associados aos IAPs, como medo de coerção, medo de agulhas e falta de conhecimento sobre a terapia com medicação depot. Esses tópicos se conectam uns aos outros: os pacientes mais preocupados com as desvantagens dos IAPs são os menos informados a seu respeito ou aqueles que passaram por coação e traumas durante a hospitalização. Por outro lado, os pacientes que já receberam IAPs e aqueles que apresentam boa relação terapêutica com seus prestadores de assistência médica demonstraram satisfação com essa forma de tratamento e sua continuidade. Conclusão: Os antipsicóticos injetáveis de ação prolongada são um instrumento para a gestão de transtornos mentais e uma alternativa viável à medicação oral. Pacientes demonstram curiosidade em relação a esse método de administração, mas a falta de conhecimento é um fator comumente encontrado. A tomada de decisão compartilhada sobre o uso de antipsicóticos IAPs requer que os pacientes recebam informações precisas e apoio em suas decisões em relação à medicação.

Identification of potential genetic markers in prognosis of oral squamous cell carcinoma patients by bioinformatic analysis / 口腔疾病防治

Objective@#To analyze the differentially expressed genes of patients with oral squamous cell carcinoma (OSCC) from paracarcinoma through biological information analysis to preliminarily identify OSCC-associated genes. @*Methods@#GSE23558, GSE37991 and GSE30784 were downloaded from the Gene Expression Omnibus (GEO), which is the mRNA expression profile dataset. The differentially expressed genes (DEGs) were identified based on the gene ontology and the Kyoto Encyclopedia of Genes and Genomes. Then, the protein-protein interaction (PPI) network was constructed using the STRING online tool, and Cytoscape was used to filter the critical genes. Furthermore, key genes involved in the survival of patients with OSCC were analyzed using Kaplan-Meier analysis. The expression of hub genes was validated based on GEPIA（http://gepia.cancer-pku.cn/）. @*Results @#A total of 212 DEGs were screened, and further analysis revealed 16 core genes, among which the core genes associated with prognosis included aurora kinase A (AURKA), aurora kinase B (AURKB), apoptosis inhibiting factor 5 (BIRC5), cell division cycle 6 (CDC6), E2F transcription factor 7 (E2F7), ubiquitin-like with PHD and ring finger domains 1 (UHRF1). These key genes were highly expressed in patients with oral squamous cell carcinoma, and the survival time of patients was short; the difference was statistically significant (P < 0.05).@*Conclusion @# AURKA, AURKB, BIRC5, CDC6, E2F7 and UHRF1 may be useful as potential biomarkers for OSCC prognosis prediction.

Prospective study of midline abdominal incisional hernia repair by component separation technique augmented with prosthetic mesh

Background: In our tertiary care hospital, we receive a large number of acute abdomen cases. Raised intra-abdominal pressure (IAP) makes laparostomy mandatory initially and abdominal wall approximation cannot be completed due to compromised state in most cases. Large incisional hernias were seen on complete healing and this study was done to see the feasibility of component separation technique (CST) with mesh augmentation.Methods: 30 patients were subjected to CST with mesh augmentation. Preoperative defect size mapping, Pre- and post-operative monitoring of IAP were done. Pain scoring by visual analogue scale (VAS), early and late complications was noted. Patients were followed up for 60 months.Results: CST with mesh augmentation was found to be feasible with 96.77% success rate as no recurrence was noted in follow up. Preoperative average Basal metabolic index was 26.09. Size of defect varied from 17-20×9-16 cm2 (length X width). Seroma seen in 50% of patients was managed without any intervention. Skin necrosis in 6.6% and wound dehiscence in 3.33%, managed with minimal debridement & local wound care respectively. Respiratory compromise and hematoma were not seen and no patient required any active ICU care. Average length of hospital stay was 5.22 days. Close monitoring of IAP in immediate post-operative period was found to be significant.Conclusion: Physical acceptance of stable abdominal wall gives a psychological boost to patients with early recovery in form of ambulation and early return to work.

Novel Biomarkers for Prediction of Response to Preoperative Systemic Therapies in Gastric Cancer

Preoperative chemo- and radiotherapeutic strategies followed by surgery are currently a standard approach for treating locally advanced gastric and esophagogastric junction cancer in Western countries. However, in a large number of cases, the tumor is extremely resistant to these treatments and the patients are exposed to unnecessary toxicity and delayed surgical therapy. The current clinical trials evaluating the combination of preoperative systemic therapies with modern targeted and immunotherapeutic agents represent a unique opportunity for identifying predictive biomarkers of response to select patients that would benefit the most from these treatments. However, it is of utmost importance that these potential biomarkers are corroborated by extensive preclinical and translational research. The aim of this review article is to present the most promising biomarkers of response to classic chemotherapeutic, anti-HER2, antiangiogenic, and immunotherapeutic agents that can be potentially useful for personalized preoperative systemic therapies in gastric cancer patients.

The study of the expressions of apoptosis and its related protein by knockdown of human immunodeficiency virus-1 vpr gene / 中华传染病杂志

Objective To observe the expression of apoptosis related protein c-inhibitor of apoptosis protein (IAP)2 by RNA interference of human immunodeficiency virus-1 (HIV-1)vpr gene and analyze the apoptosis of Jurkat cells.Methods Vector (NC),HIV-1vpr (vpr),vpr+ pRNAT-U6.1/Neo-vpr-56 (Si56) and vpr+ pRNAT-U6.1/Neo-vpr-160 (Si160) were transfected to Jurkat cells and cultured for 48 hours.The total RNA and protein were extracted.Expression of vpr gene was detected by reverse transcription (RT)-polymerase chain reaction (PCR) to confirm the success of transfection.Expression of c IAP2 was detected by RT-PCR and Western Blot.The apoptosis of Jurkat cells was observed by flow cytometry.Results Expression of vpr gene was detected in vpr,Si56 and Si160 groups.The mRNA expression levels in Si56 and Si160 groups were significantly lower than that in vpr group,which declined 87.2％ and 82.2％,respectively (P＜0.05).The levels of c IAP2 mRNA expression in vpr,Si56 and Si160 groups were increased by 3.75,2.49 and 2.65 folds,respectively,compared to that in NC group.However,the c-IAP2 mRNA expressions in Si56 and Si160 groups were lower than that in vpr group,which declined 33.7％ and 29.5％,respectively (P ＜ 0.05).The c-IAP2 protein expression was consistent with mRNA by immunoblotting,and those in Si56 and Si160 groups were declined 42.2％ and 46.8％,respectively,compared to that in vpr group (P＜0.05).The apoptosis of J urkat cells was detected in all groups.Compared to NC group,the apoptotic rate in vpr group was increased by 1.76 folds.However,the differences of apoptosis rate among NC,Si56 and Si160 groups were not statistically significant (all P＞0.05).Compared to vpr group,the apoptotic rates in Si56 and Si160 were significantly decreased by 19.26％ and 18.05％,respectively (P＜0.05).Conclusions The expression of c-IAP2 could be downregulated by knockdown of HIV-1 vpr gene in transcription and protein levels,and the apoptosis of Jurkat cells is inhibited.

New strategy for antagonizing drug resistance: targeting survivin / 中国药理学通报

Multidrug resistance ( MDR) often leads to failure of cancer chemotherapy. survivin, a member of the inhibitor of apoptosis proteins (IAP) family, is overexpressed in almost all kinds of tumor cells. Importantly, survivin has been identified as one of the most important molecules involved in the regulation of MDR. Therefore, inhibiting the activity of survivin or down-reg-ulating the expression of survivin might be an effective strategy to overcome tumor MDR. In this article, the roles of survivin in-volved in the development of drug resistance and the strategies to overcome drug resistance by targeting survivin are thus re-viewed.

The Effect of Pneumoperitoneum and Trendelenburg position on respiratory mechanics under general anesthesia during gynecological laparoscopic surgery / Монголын Анагаах Ухаан

Background@#Gynecological laparoscopic surgery requires pneumoperitoneum(PP) with CO₂ gas insufflation and Trendelenburg position. Pneumoperitoneum and Trendelenburg position may impact intraoperative respiratory mechanics in anesthetic management.The goal of this study was to evaluate the influence of Pneumoperitoneum and Trendelenburg position on respiratory mechanics and ventilation. @*Methods@#Twenty one patients scheduled for elective gynecological laparoscopy were evaluated. The patients had no preexisting lung and heart disease or pathologic lung function. Conventional general anesthesia with thiopental sodium, fentanyl, аtracrium and isoflurane was administered. The peak inspiratory pressure, plateau pressure, and end-tidal CO₂ were compared before after creation of pneumoperitoneum with an intraabdominal pressure of 15 mmH₂O, then after PP10, PP20, PP30 minutes in the 20° Trendelenburg position, and after deflation of pneumoperitoneum. The dynamic lung compliance was calculated.@*Results@#During of pneumoperitoneum, there were a significant increase in peak inspiratory pressure by 6 cmH₂O, plateau pressure by 5 cmH₂O, while dynamic lung compliance decreased by 11 ml/cmH₂O. General, the Trendelenburg position induced no significant hemodynamic and pulmonary changes.@*Conclusion@#The effects of pneumoperitoneum significantly reduced dynamic lung compliance and increased peak inspiratory and plateau pressures. The Tredelenburg position did not change these parameters. The end-tidal CO₂ significantly increased after pneumoperitoneum and CO₂ deflation.

Study of nutritional assessment of children between 6 months to 5 years

Background: Nearly half of all deaths in children under 5 are attributable to under nutrition. Under nutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and contributes to delayed recovery. The WHO recommends the use of Z scores or standard deviation score (SDS) for evaluating anthropometry, so as to accurately classify individuals with indices below the extreme percentile. In India most paediatricians use IAP classification to classify malnutrition. The aim of the study is to assess the nutritional status of children between 6 months to 5 years of age attending tertiary rural hospital according to WHO criteria and to compare the result of this study with IAP classification for grading malnutrition. The objectives of the study is to assess the knowledge of mothers regarding feeding practices among these children particularly below 2 years of age and to observe associated clinical problems and state of other nutrient deficiencies. Materials and methods: A cross sectional and observational study of 200 children admitted in pediatric ward and NRC (nutritional rehabilitation centre) of Dhiraj Hospital were taken for the study, Piparia, Waghodia, Vadodara. Study was carried for a period of 18 months from April 2015 to September 2016 to assess the nutritional status of children according to WHO criteria and to compare it with IAP classification. Assessment of the nutritional status was done by clinical examination and anthropometry. Interrogation was done with children’s mothers in the language they understood regarding young children feeding practices and accordingly their knowledge was assessed. Data was compiled, categorized and analyzed by appropriate statistical method in consultation with a statistician. Pathak S, Yadav T, Joshi C, Sharma N, Gulabani S, Gandhi D. Study of nutritional assessment of children between 6 months to 5 years. IAIM, 2017; 4(2): 42-52. Page 43 Results: Total 200 patients were taken in the study. Result shows that out of 200 patients 108(54%) were males and 92(46%) were females. The distribution of patients was more in age group between 13 and 36 months with 86(43%), of which distribution of males more than females were. Distribution of patients according to SAM and MAM (WHO classification) shows 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM. Distribution of patients according to SAM and MAM (WHO classification) was studied. Result shows that out of 200 children taken in the study 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM according to WHO classification. Distribution of children according to IAP classification in the present study interprets that 103 (51.5%) of the total children came under grade II of IAP classification. WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. Comparison of MUAC (WHO) with WHO (SAM and MAM) of children taken in the present study interprets that 67 (33.5%) had SAM and 95 (47.5%) had MAM according to MUAC criteria, remaining 19% did not fall under SAM and MAM. Comparison of MUAC (SAM) with WHO (SAM) of children in present study interprets that only 67 (52.75%) children came under SAM according to MUAC criteria out of the 127 children of SAM according to WHO classification. Comparison of MUAC (WHO) and IAP classification of children in the present shows that 67 children had MUAC <11.5 cm, out of 67 children (with SAM according to MUAC criteria) 28 (41.79%) came under grade II and 21 (31.3 %) came under grade III of IAP classification. Out of 95 children (MUAC between 11.5 cm and 12.5 cm) 18 (18.94%) came under grade I and 58 (61.05%) came under grade II of IAP classification. Associated co morbidities among children in the present study shows that among 200 patient 152 (76%) had anaemia, 44 (22%) had diarrhoea, 14 (7%) had pedal oedema, 12 (6%) had vitamin A deficiency, 44 (22%) had URTI and 24 (12%) had LRTI. Knowledge Aptitude and Practice study was done among 50 mothers and the result shows that mothers had less knowledge regarding what to be given in complementary feed, importance of immunization, birth spacing interval, and danger signs indicating illness. Conclusion: The present study shows that WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. There was also disparity among results of WHO criteria IAP classification and MUAC classification. Single criteria can’t be justified in assessing malnutrition. KAP study reveals that mother’s knowledge is important in combating malnutrition

Clinical Observation of Changwei Shu Combined with Conventional Western Medicine Therapy in Treating Sepsis Patients with Gastrointestinal Dysfunction / 广州中医药大学学报

Objective To observe the clinical curative effects of Changwei Shu combined with conventional western medicine therapy in treating the sepsis patients with gastrointestinal dysfunction.Methods A total of 120 cases of sepsis patients with gastrointestinal dysfunction were randomly divided into treatment group and control group,60 patients in each group.The control group was given conventional western medicine therapy,and the treatment group was given Changwei Shu combined with conventional western medicine therapy.After treatment for 7 days,the clinical efficacy and safety were evaluated by observing the changes in white blood cell (WBC) count,procalcitonin (PCT) level,intra-abdominal pressure (IAP),gastrointestinal dysfunction scores,and scores of acute physiology and chronic health evaluation (APACHE Ⅱ).Results (1) For one case dropped out and one was excluded from the treatment group,and 4 cases dropped out and 2 were excluded from the control group,a total of 58 cases in the treatment group and 54 in the control group were included into the study at the end of the trial.(2) The total effective rate of the treatment group was 91.38％ and that of the control group was 88.89％,the difference being significant (P ＜ 0.05).(3) After treatment,WBC count,PCT level and IAP of the two groups were improved (P ＜ 0.01 compared with those before treatment),and the improvement of the treatment group was superior to that of the control group (P ＜ 0.01).(4) After treatment,gastrointestinal dysfunction scores and APACHE Ⅱ scores of the two groups were decreased(P ＜ 0.01 compared with those before treatment),and the decrease of the treatment group was superior to that of the control group (P ＜ 0.01).(5) During the treatment,4 cases from the treatment group had nausea,and 5 cases from the control group had nausea and abdominal distention,and the symptoms disappeared spontaneously one week later.No obvious changes were found in the hepatic and renal function of the two groups.Conclusion Changwei Shu exerts an effect on reducing the inflammation,improving the gastrointestinal function,and relieving the illness severity of sepsis patients with gastrointestinal dysfunction.

Apoptosis (programmed cell death) and its signals - A review

Abstract Apoptosis is a sequential order of cell death occurring regularly to ensure a homeostatic balance between the rate of cell formation and cell death. However, a misplaced of this balancing function can contribute to an abnormal cell growth / proliferation or autoimmune disorders etc. Apoptosis is therefore said to be crucial from the point of development of an embryo throughout the growth of an organism contributing to the renewal of tissues and also the getting rid of inflammatory cells. This review seeks to elaborate on the recent overview of the mechanism involved in apoptosis, some element and signal contributing to its function and inhibition together with how their malfunction contribute to a number of cancer related cases.

Resumo A apoptose é uma ordem sequencial de morte celular que ocorre regularmente para garantir um equilíbrio homeostático entre a taxa de formação e a morte celular. No entanto, um desequilíbrio dessa função pode contribuir para um crescimento/proliferação celular anormal ou distúrbios autoimunes. A apoptose é, portanto, considerada crucial do ponto de desenvolvimento de um embrião ao longo do crescimento de um organismo que contribui para a renovação dos tecidos e também a eliminação de células inflamatórias. Esta revisão procura elaborar a recente visão geral do mecanismo envolvido na apoptose, alguns elementos e sinais que contribuem para sua função e inibição, além de como o mau funcionamento deles contribui para vários casos relacionados ao câncer.

Abdomen y corazón ¿El primer paso del síndrome cardiorrenal? / Abdomen and heart The first step of the cardiorenal syndrome?

A pesar de los grandes avances en la cardiología en el siglo XX y XXI, la insuficiencia cardiaca sigue suponiendo la principal causa de hospitalización en las personas ancianas y presentando un pronóstico ominoso. Además, a pesar de los múltiples estudios sobre nuevas dianas farmacológicas, apenas hemos avanzado en el campo del tratamiento, tal vez porque aún existen lagunas en su fisiopatología. No debemos olvidar que la insuficiencia cardiaca es un compendio de signos y síntomas que engloban múltiples órganos y sistemas. Mucho se está investigando sobre la relación entre riñón y corazón en forma de síndrome cardiorrenal. Algo cada vez más en boga es el papel del abdomen en la disfunción orgánica de la insuficiencia cardiaca. En ese sentido, el sistema venoso contiene el 70 por ciento del volumen sanguíneo, siendo almacenado en su mayor parte dentro de las vísceras abdominales. Un aumento del tono simpático supone aumento intenso del retorno venoso tan importante como para aumentar las presiones de llenado y justificar una descompensación cardíaca. La congestión sistémica determina un aumento en la presión intraabdominal que está correlacionada con la disfunción renal en la insuficiencia cardíaca avanzada. La hipoperfusión tisular intestinal supone microtraslocación bacteriana promoviendo el status proinflamatorio típico de este síndrome. La visión holística e integrada de la insuficiencia cardiaca puede suponer un avance tanto en la estratificación del riesgo como en las estrategias terapéuticas. Grandes pasos se están dando en este sentido con estudios sobre la ultrafiltración, paracentesis, diálisis peritoneal, suero hipertónico o fármacos adsorbentes del sodio.(AU)

Despite the great progress in Cardiology during the last century, heart failure keeps being the main cause of hospitalization among elderly, with an awful prognosis. In spite of multiple studies about drug targets, we have hardly made progress regarding the treatment, maybe because there are gaps concerning physiopathology. Heart failure is a set of signs and symptoms encompassing multiple organs and systems. Lots of studies about cardiorenal syndrome are being published. In this sense, abdominal contribution to organic dysfunction in heart failure is becoming a rising topic. Therefore, venous system contains 70 percent of the total blood volume, mostly in splanchnic capacitance veins. Sympathetic stimulation suppose an important shift of blood from splanchnic veins to effective circulatory volume, rising increasing filling pressures and justifying acute decompensated heart failure. Systemic congestion may lead to a state of increased intra-abdominal pressure which is correlated with renal dysfunction in advanced heart failure. Tisular hypoperfusion leads to bacterial translocation triggering systemic inflammation typical of heart failure. This holyistic vision may suppose an important progress on risk stratification and treatment strategies. Among those under investigation are ultrafiltration, paracentesis peritoneal dialyisis, hypertonic saline or oral sodium binders.(AU)

The impact of relevant factors in mechanical ventilation on intra-abdominal pressure in patients with ALI/ARDS / 中华急诊医学杂志

Objective To investigate the impact of relevant factors in mechanical ventilation on intraabdominal pressure in patients with ALI/ARDS by continuous monitoring of intra-abdominal pressure.Methods A total of 116 ALI/ARDS patients treated with mechanical ventilation in ICU were enrolled in this study.Intra-abdominal pressure (IAP) was recorded continuously.Meanwhile ventilator parameters, arterial blood gas analysis, hemodynamic variables, and as well as the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid (BALF) were determined and recorded.The detection of risk factors for intra-abdomen hypertension (IAH) were carried out using multivariate stepwise logistic regression.ROC curve analysis used to estimate the diagnostic performance of these parameters for IAH.Results The oxygenation index (PaO2/FiO2) in patients with IAH after 2 hours' mechanical ventilation was significantly lower than that in patients with normal intra-abdomen pressure (IAP) (P ＜ 0.01);PEEP and RR in mechanical ventilation were higher in IAH group (P ＜ 0.01 or P =0.001);Mean artery pressure (MAP), ejection time percent (ET), stroke volume (SV), cardiac index (CI) were lower in IAH group than those in normal IAP group (P ＜ 0.01);the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid were higher in IAH group than those in normal IAP group (P ＜ 0.01);IAH patients have a higher mortality on 28 d (Log rank test, P =0.023).Poor oxygenation index (PaO2/ FiO2) after 2 hours' ventilation, high PEEP setting, low MAP, ET, SV, CI and elevated IL-4 in the BALF were resulted in increasing risk of IAH for ARDS patients under mechanical ventilation support.Conclusions The monitoring of intra-abdominal pressure should be emphasized for ALI/ARDS patients when mechanical ventilation was employed.PaO2/FiO2, SV and IL-4 in BALF might be the independent risk factors of IAH.

Comparison of 2006 WHO and Indian Academy of Pediatrics Recommended Growth Charts of Under Five Indian Children.

This cross-sectional study was undertaken to compare WHO and Indian Academy of Pediatrics (IAP) recommended growth charts compiled by Agarwal. 2105 children aged less than 5 years, attending 132 Anganwadi centres in Mysore city, were included by simple random sampling method. Weight and height of all children were recorded and plotted on both WHO and IAP charts. WHO charts detected more boys as underweight compared to IAP charts (P<0.0001). When weight charts of girls were compared there was no difference between the two charts. WHO charts detected more children with stunting than IAP charts, which was true for both boys and girls (P=0.001).

Molecular analysis of the iap gene of Listeria monocytogenes isolated from cheeses in Rio Grande do Sul, Brazil

The polymorphic region sequences in the iap gene were analyzed in 25 strains of Listeria monocytogenes isolated from cheeses in the state of Rio Grande do Sul, and compared with reference strains. This investigation distinguished two clusters of L. monocytogenes: I (20 strains) and II (5 strains).

A seqüência da região polimórfica do gene iap foi analisada em 25 cepas de Listeria monocytogenes isoladas de queijo no Estado do Rio Grande do Sul e comparadas com cepas referências. Esta investigação distinguiu L. monocytogenes em dois grupos: I (20 cepas) e II (5 cepas).

The Function of SeMNPV IAP3 in Mammalian Cells / 中国病毒学·英文版

The baculoviral inhibitors of apoptosis play a significant role in infectivity and viral host-range, which make them potential candidates for the engineering and improvement of baculovirus insecticidal. The iap3 gene of Spodoptera exigua nucleopolyhedrovirus (SeMNPV), amplified by PCR, was 939 bp encoding IAP3. The PCR product was cloned into EcoR I/Bam H I of the plasmid pEGFP-C1. GFP was fused to the N-terminaus of IAP3 to study distribution in HEK293. It was observed that the plasmid expressing IAP3 significantly inhibited apoptosis induced by cisplatin in HEK293 cells. We conclude that the IAP3 of SeMNPV is functional in mammalian cells.

Survivin, Possible Marker and Prognostic Factor in Oral Squamous Cell Carcinomas

Survivin is a member of the inhibitors of apoptosis (IAP) family that have been known to inhibit activated caspases in apoptosis. In contrast to most IAP family members, survivin mRNA is expressed during fetal development, is not found in normal adult tissues and is overexpressed again in the cancer. Though survivin expression has been documented in most human cancers, little is known about its expression in OSCC and its potential value as a predictor of cancer survival. The purpose of this study was to investigate survivin expression in OSCC and to evaluate its value as a prognostic marker. We evaluated survivin expressions in cancer lines and OSCC samples and investigated the relationships between survivin expressions and clinico-pathological parameters including stage, differentiation, proliferation, lymph node metastasis, blood vessel density, and gelatinolytic activity. With immunohistochemistry, we analyzed survivin expression in 38 OSCCs. Patients' clinico-pathological parameters and their survival rate were analyzed to reveal their correlations with Survivin expressions. We cultured oral cancer cell lines and evaluated the correlation between gelatinolytic activities and survivin expressions of them. Survivin protein was observed both in nuclei and cytoplasm of tumor specimens while little or not observed in normal gingival mucosal tissues. Additionally, survivin expressions were correlated with lymph node metastasis, tumor proliferation and survival rate. Survivin expression was observed in 100% of 38 samples of OSCC and its expression levels are statistically associated with the proliferative activity of the tumors, lymph node metastasis and the survival of the patients. Based on these results, survivin is commonly expressed in OSCC and may thus provide valuable prognostic information related with lymph node metastasis, proliferation and survival rate as well as a potential therapeutic target in OSCC.

Homocysteine-induced apoptosis of endothelial cells and roles of caspase3 / 上海第二医科大学学报

Objective To investigate whether homocysteine(Hcy) induces apoptosis of endothelial cells via a pathway involving caspases3 and whether simvastatin antagonizes the proapoptotic effects of Hcy by regulating c-IAP. Methods Human umbilical vein endothelial cells(HUVEC) were treated with Hcy,with or without simvastatin,for 24 h.Cell apoptosis was evaluated by Annexin V staining and flow cytometery,as well as TUNEL.The mRNA and protein levels of caspase3,c-IAP-1 and c-IAP-2 were analyzed by RT-PCR and Western blot,respectively. Results Treatment with both low(0.5 mmol/L) and high(3.0 mmol/L) concentrations of Hcy-induced HUVEC apoptosis was accompanied by an increased level of caspase3 expression and activation,together with decreased c-IAP-1 and c-IAP-2 level.Simvastatin upregulated c-IAP-1 and c-IAP-2 expression while attenuated Hcy-induced apoptosis and caspase3 activation. Conclusion Hcy may induce HUVEC apoptosis via a pathway involving caspase3,which can be partially antagonized by simvastatin,possibly through upregulated c-IAP-1 and c-IAP-2 expression.