Disposable disinfection cap for preventing catheter-related blood stream infections: a Meta-analysis / 中国实用护理杂志

Objective:To evaluate the efficacy of disposable disinfection cap in preventing catheter-related blood stream infections (CRBSIs).Methods:Literature on the prevention of CRBSIs by disposable disinfection caps were retrieved from CNKI, Wanfang Database, VIP database, Chinese Biomedical Literature Database, PubMed, Cochrane Library, Embase and Web of Science databases. The retrieval period was from the database construction to June 30, 2022. After literature screening, data extraction and quality evaluation were independently carried out by 2 researchers, RevMan5.4 software was used for analysis.Results:A total of 12 articles were included, including 9 832 patients. Meta-analysis results showed that compared with conventional manual disinfection, disposable disinfection cap could reduce the incidence of CRBSIs, and the difference was statistically significant ( RR = 0.58, 95% CI 0.43-0.79, P<0.01). Disposable disinfection cap could reduce the incidence of CRBSIs in adults, but there was no significant difference in the incidence of CRBSIs in children ( P>0.05). It could reduce the incidence of CRBSIs in patients with indwelling vascular catheters in ICU ( RR = 0.58, 95% CI 0.38-0.89, P<0.05), but there was no statistical difference in the incidence of CRBSIs in patients without indwelling vascular catheters in ICU ( P>0.05). In addition, the compliance of the use of disinfection caps by nursing staff was improved by 80% - 90% and the treatment cost was saved by about 282 - 464 dollars. Conclusions:Disposable disinfection caps can reduce the occurrence of CRBSIs, improve the disinfection compliance of nursing staff, and save the hospitalization cost of patients. It is suggested to be popularized in clinical practice.

Dépistage de la stéatose hépatique par le Fibroscan/CAP chez les sujets noirs africains porteurs d'une Hépatite Virale B chronique en Côte d'Ivoire / Fibroscan/CAP screening for hepatic steatosis in black African subjects with chronic Viral Hepatitis B in Ivory Coast

Context and objectives As the global epidemic of obesity and metabolic syndrome progresses, the coexistence of fatty liver disease in patients with chronic viral hepatitis B (VHB) becomes significant. The objective of this work was to determine the frequency of hepatic steatosis assessed by Fibroscan/CAP (Controlled Attenuation Parameter) in patients with chronic VHB in Côte d'Ivoire. Methods. The study included 83 patients with chronic VHB. These were black patients who had performed a Fibroscan/CAP during the recruitment period and were willing to participate in the study. Patients with significant alcohol consumption, a secondary cause of hepatic steatosis, another liver disease regardless of the etiology associated with VHB were not included. Results. The frequency of hepatic steatosis in chronic HBV carriers assessed by CAP in our study population was 48.19 %, including 24.10 % of severe steatosis. Obesity was statistically correlated with the presence of steatosis in our patients. Patients who had steatosis on ultrasound were 5 times more likely to have steatosis on CAP. Significant fibrosis was insignificantly associated with steatosis. Conclusion. The frequency of fatty liver disease detected by fibroscan/CAP is high in patients with chronic VHB.

Contexte et objectifs Avec la progression de l'épidémie mondiale d'obésité et du syndrome métabolique, la coexistence d'une stéatose hépatique chez les patients porteurs d'une hépatite virale B chronique devient non négligeable. L'objectif de ce travail était de déterminer la fréquence de la stéatose hépatique chez les patients porteurs d'une hépatite virale B (HVB) chronique. Méthodes. Il s'agissait d'une série des cas de HVB de race noire, ayant réalisé un Fibroscan/CAP pendant la période du recrutement et consentants à participer à l'étude. Les patients ayant une consommation d'alcool significative, une cause secondaire de stéatose hépatique, une autre hépatopathie quelle que soit l'étiologie associée à l'hépatite B n'ont pas été inclus. Résultats. Quatre-vingt-trois patients porteurs d'une HVB ont été inclus. La fréquence de la stéatose hépatique chez les porteurs du VHB chronique était de 48,19 % dont 24,10 % de stéatose sévère. L'obésité était statistiquement corrélée à la présence d'une stéatose chez nos patients. Les patients qui avaient une stéatose à l'échographie étaient 5 fois plus à risque d'avoir une stéatose au CAP. La fibrose significative était associée de façon non significative à la stéatose. Conclusion : Près de la moitié des patients porteurs d'une hépatite virale B chronique présente une stéatose hépatique.

Correlation of clinicopathologic features of Filipino primary breast cancer patients with HER2 Subgroups classified according to the ASCO/CAP 2018 breast cancer HER2 testing guidelines

Background@#Guidelines for testing human epidermal growth factor receptor 2 (HER2) in breast cancer using fluorescence in situ hybridization (FISH) were released in 2018. These guidelines were jointly developed by the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) to achieve a clearer designation of breast cancer HER2 status. Clinical correlation with other factors was also considered appropriate, especially for those cases classified under ISH groups 2, 3, and 4.@*Objective@#In this study, we examined clinicopathologic features among Filipino breast cancer patients whose HER2 status was reclassified based on the 2018 ASCO/CAP guidelines.@*Methodology@#One hundred and thirty-two (132) breast cancer cases with immunohistochemistry (IHC) equivocal results in the Medical City were enrolled from January 2017 up to December 2020. HER2 FISH results classified under groups 2, 3, and 4 were then re-evaluated for HER2-IHC status in accordance with the 2018 ASCO/CAP guidelines. The relationship between clinicopathologic features and HER2 status was analyzed using the Fisher exact test.@*Results@#Significant differences were found in histologic type, nuclear pleomorphism, mitotic rate, progesterone receptor (PR) status, and regional lymph node involvement among the reclassified ISH groups. In the conv+ group, the tumor cells did not involve the regional lymph nodes as compared to group 5, where the tumor cells were involved. The conv- group had a higher grade for nuclear pleomorphism, mitotic count, and overall Nottingham Histologic Grade than group 5. There was a significant association between progesterone receptors among the conv- group and group 1.@*Conclusion@#Filipino breast cancer cases whose HER2 status was reclassified to negative following the 2018 ASCO/CAP guidelines had statistically different clinicopathologic features from those classified as group 5.

Comparison between endoscopic full-thickness resection and cap-assisted endoscopic full-thickness resection in the treatment of elderly patients with small gastric stromal tumors / 中华消化内镜杂志

Objective:To compare the safety and effectiveness of endoscopic full-thickness resection (EFR) and cap-assisted endoscopic full-thickness resection (EFR-C) in the treatment of small gastric stromal tumors (≤1.5 cm) in the elderly (≥60 years old).Methods:Data of elderly patients with small gastric stromal tumors who received EFR (41 cases) or EFR-C (25 cases) at Nanjing Drum Tower Hospital from May 2012 to August 2020 were analyzed retrospectively. The clinicopathological characteristics, the procedures, intraoperative and postoperative complications, postoperative efficacy and economic benefits were compared between the two groups.Results:The R0 resection rates of the EFR group and the EFR-C group were 95.1% (39/41) and 100% (25/25), respectively. The operation time [45.0 (32.5, 66.5) min VS 30.0 (20.0, 42.5) min, U=259.500, P=0.001] and resection time [30.0 (20.0, 50.5) min VS 9.0 (6.5, 16.5) min, U=127.000, P<0.001] of the EFR group were significantly longer than those of the EFR-C group. The rate of hot clamp use in the EFR group was higher than that in the EFR-C group [75.6% (31/41) VS 12.0% (3/25), χ ２=25.159, P<0.001]. The postoperative white blood cell count [8.3 (6.6,10.4)×10 9/L VS 6.3 (5.0,7.7) ×10 9/L, U=271.000, P=0.001] and postoperative neutrophil percentage (77.6%±8.8% VS 73.0%±6.8%, t=2.256, P=0.027) in the EFR group were higher than those in the EFR-C group. The postoperative antibiotic day in the EFR group was longer than that in the EFR-C group (2.8±2.0 days VS 1.0±2.0 days, t=3.625, P=0.001). The hospitalization costs in the EFR group were significantly higher than those in the EFR-C group (20 595.0±3 653.3 yuan VS 13 209.0±4 458.9 yuan, t=7.323, P<0.001). There was no recurrence or metastasis during the follow-up period. Conclusion:EFR and EFR-C are safe and effective for the treatment of small gastric stromal tumors in the elderly. Compared with EFR, EFR-C needs shorter operation time and lower medical costs, yields less postoperative inflammation, and is more suitable for the treatment of small gastric stromal tumors in the elderly.

Risk factors associated with nonalcoholic fatty liver disease evaluated by elastography in patients with type 2 diabetes

ABSTRACT Objective: There is controversy about the indication for nonalcoholic fatty liver disease (NAFLD) screening in patients with type 2 diabetes mellitus (T2D). The present study aims to contribute to NAFLD surveillance in patients with T2D, assessing the association of clinical and biological variables with hepatic stiffness and steatosis. Subjects and methods: A cross-sectional design was used, with data collection from electronic medical records, including adults with T2D who underwent transient elastography (TE) between June 2018 and December 2019. Liver stiffness and steatosis were evaluated using TE and controlled attenuation parameter (CAP), respectively, with cutoff points > 8 kpa for increased stiffness and > 275 dBm for steatosis. The relationship between clinical variables and elastography results were evaluated by bivariate correlation and multivariate analysis, using SPSS 27. Seventy-nine patients (n = 79) met the inclusion and exclusion criteria. Results: Advanced fibrosis and hepatic steatosis were detected in 17,7% and in 21,5% of the patients, respectively. There was a direct and significant correlation between CAP and BMI, waist circumference, HbA1c, triglycerides levels, and insulin doses and an inverse correlation with HDL. The waist circumference, low levels of HDL cholesterol and the insulin dose maintained a significant association with CAP values in multivariate analysis. Elastography values showed an inverse correlation with HDL and a direct correlation with BMI and insulin dose. The association was only maintained for the insulin dose in multivariate analysis. Conclusion: Our results suggest that clinical factors such as insulin dose, waist circumference, and HDL cholesterol levels could identify T2D patients more likely to present NAFLD.

Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

SUMMARY OBJECTIVE: Beta-lactams resistance is a major clinical problem in treating pneumonia. This study aimed to detect the extended-spectrum beta-lactamases (ESBL) genes in Klebsiella pneumoniae among patients with community-acquired pneumonia (CAP) in Al-Najaf City, Iraq. METHODS: A total of 511 sputum samples were obtained from all suspected patients with CAP in Al-Najaf City, Iraq, from March 2020 to September 2020. Sputum samples were subjected to microbiological tests. The disk diffusion method was used to test antibiotic sensitivity. Production of ESBLs was identified using phenotypic and genotypic methods. RESULTS: The total prevalence of K. pneumoniae was 31.9% (163/511). Using CHROM agar, 41 (25.2%) isolates were ESBL producers. The imipenem 0.0% (n=0/41) and norfloxacin 0.0% (n=0/41) were the most effective antibiotics. The multiplex polymerase chain reaction showed that 46.3% (n=19/41) of isolates harbored ESBL genes. Out of 19 ESBL producers, 47.4% and 15.8% harbored blaCTX-M and blaSHV, respectively. While blaCTX-M and blaSHV genes were detected in 7 (36.8%) isolates, simultaneously. CONCLUSIONS: The imipenem and norfloxacin can be used in empirical treatment of K. pneumoniae isolates in Iraq. The emergence of K. pneumoniae strains harboring ESBL resistance genes necessitates the development of a regular surveillance program to prevent the spreading of these isolates more in Iraqi health care systems.

Comparative study of CURB-65 and expanded CURB-65 score in community acquired pneumonia in a tertiary care hospital of Assam

Background:Community acquired pneumonia is one of the leading causesof morbidityand mortality in developing countries like India. The presentation of CAP may range from mild pneumonia characterized only by fever and productive cough to severe pneumonia leading to respiratory distress and sepsis syndrome requiring management in ICU. Any delay in ICU admission has been shown to be associated with increased mortality. This study was conducted to compare Expanded CURB-65 with CURB-65 scoring system in a tertiary care centre in Assam for early stratification of patients with CAP based of severity and expected prognosis.Methods: This hospital based prospective study was conducted between September 2020 to August 2021, and a total of 100 patients were taken and followed up form admission to up to30 days. CURB65 and expanded CURB 65 score was calculated for each patientand the accuracy of each score was statistically compared.Results:In our study out of 100 patients mean age of 60�.97 with Mortality rate of 16%. Total 29% patients were need ICU care. The Sensitivity, Specificity, PPV and NPV for predicting mortality and for ICU admission of Expanded CURB-65 score is found to be superior to CURB-65 Score. Conclusions:In comparison to the CURB-65 score system, the expanded CURB-65 score prioritises both clinical and laboratory criteria and is a more reliable marker for evaluating CAP severity and may improve the effectiveness of forecasting death in CAP patients.

Ayurvedic Management of Hepatitis

Hepatitis is inflammation of liver parenchyma mostly caused by viruses and other factors. It’s a non-specific prodromal illness characterized by headache, myalgia, arthralgia, nausea, anorexia, dark urine, yellow discoloration of skin, mucosa, sclera and other tissues etc. Methodology: A diagnosed case of hepatitis, 37yrs old female patient, admitted in at Government Ayurvedic college & Hospital, Kadam Kaun, Patna, Having IPD No.1006, RN.7178. Based on symptoms, supported by blood investigation reports and Ayurvedic parameters, the condition diagnosed as Yakritsotha. Oral medicines given: Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathya ahara vihara were prescribed. Result: There was drastic decrease in all the symptoms. The effect of treatment was monitored during the follow up with routine blood examinations. The bilirubin level decreased from initial 6.2mg/dl to 1.0mg/dl. Discussion: This article is a discussion about a case of Hepatitis which was successfully treated by Ayurvedic line of treatment. The signs and symptoms, causes, pathos-physiology of Hepatitis, along with its co-relation in Ayurveda as Yakritsotha, its line of treatment and possible the mode of action of drugs were the main points of consideration. Conclusion: Use of medicines such as Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathy ahara vihara showed good result without any complication in the present study.

Clinical and endoscopic features and endoscopic treatment efficacy of cap polyposis / 中华消化内镜杂志

To investigate the clinical and endoscopic characteristics and endoscopic treatment efficacy of cap polyposis, data of 14 patients (56 polyps) who were histologically diagnosed as having cap polyposis after endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) in Beijing Friendship Hospital from June 2017 to February 2021 was retrospectively analyzed. Of the 14 patients, 8 were males and 6 were females. The age ranged from 14 to 74 years, including 7 cases of <60 years old and 7 cases of ≥60 years old. 7 patients (50.0%) had clinical manifestations. Four cases had multiple polyps and 10 cases (71.4%) had single polyps. There were 42 polyps (75.0%) located in the rectum, 13 (23.2%) in the sigmoid colon and 1 in the transverse colon. According to the classification of Yamada, 44 polyps (78.6%) were type Ⅰ, 3 polyps were type Ⅱ, 5 polyps were type Ⅲ and 4 polyps were type Ⅳ. Under endoscopy, there were 41 polyps (73.2%) with obvious white cap-like coverings on the surface and 23 polyps with obvious hyperemia and redness on the mucosa, 8 of which were both visible. Two cases were treated with ESD and 12 cases were treated with EMR, all of which were completely excised. No bleeding, perforation, infection or other complications occurred during and after operation. The clinical symptoms of 7 patients were relieved. During the follow-up period, 11 cases (78.6%) completed colonoscopy, and no polyp recurrence was found. In conclusion, there is no gender or age difference in patients of cap polyposis. It is usually single and located in the rectum and sigmoid colon with Yamada type Ⅰ. The surface of lesions is mostly covered with white cap. Patients may have no obvious clinical symptoms. Treatment of ESD and EMR is safe and effective for cap polyposis.

Conocimientos, actitudes y prácticas sobre salud ambiental en estudiantes universitarios / Knowledge, attitudes, and practices on environmental health in university students

La crisis ambiental es la primera crisis global generada por el desconocimiento, es por ello, que la educación respecto a la salud ambiental es el punto de partida para reemplatear la actitud de las relaciones del ser humano con su entorno. Por tal razón, esta investigación tuvo como objetivo determinar el nivel de conocimientos, actitudes y prácticas sobre salud ambiental en estudiantes ecuatorianos de la sede Huancayo de la Universidad Peruana Los Andes. La investigación fue descriptiva-transversal cuya muestra estuvo conformada por 147 estudiantes ecuatorianos matriculados en el segundo semestre 2021 de medicina y enfermería. Como instrumento se aplicó la encuesta CAP relacionadas con sostenibilidad de tres modulos y 18 ítems. Para el análisis de los datos, se calcularon proporciones y medidas de resumen, correlaciones de Spearman, prueba de Kolmogorov-Smirnov con corrección de Lilliefors. Como resultado se encontró que el nivel de conocimiento fue "Excelente" respecto conocimiento del significado de salud ambiental (x: 3,62), "Deficiente" en participación en acción de mejoramiento ambiental en la comunidad (x: 2,35) y "Malo" en participación de programas de educación ambiental (x: 1,27), así mismo, la clasificación porcentual y puntajes de las dimensiones pesquisadas fue "Deficiente" en el nivel de conocimiento (x: 52,01), "Deficiente" en actitudes (x: 53,23) y "Malo" en prácticas (x: 34,08). Es necesario implementar estrategias de abordaje integral en la formación de profesionales enfocados en el conocimiento de temas ambientales y el desarrollo de una conducta ambiental que repercutan en el mejoramiento de la salud publica(AU)

The environmental crisis is the first global crisis generated by ignorance, which is why education regarding environmental health is the starting point to replace the attitude of human relations with their environment. For this reason, this research aimed to determine the level of knowledge, attitudes, and practices on environmental health in Ecuadorian students from the Huancayo campus of the Universidad Peruana Los Andes. The research was descriptive-cross-sectional, whose sample consisted of 147 Ecuadorian students enrolled in the second semester of 2021 in medicine and nursing. As an instrument, the CAP survey related to sustainability of three modules and 18 items was applied. For data analysis, proportions and summary measures, Spearman correlations, Kolmogorov-Smirnov test with Lilliefors correction were calculated. As a result, it was found that the level of knowledge was "Excellent" regarding knowledge of the meaning of environmental health (x: 3.62), "Poor" in participation in environmental improvement action in the community (x: 2.35) and " Bad" in participation in environmental education programs (x: 1.27), likewise, the percentage classification and scores of the dimensions investigated was "Poor" in the level of knowledge (x: 52.01), "Poor" in attitudes (x: 53.23) and "Bad" in practices (x: 34.08). It is necessary to implement comprehensive approach strategies in the training of professionals focused on the knowledge of environmental issues and the development of an environmental behavior that has repercussions on the improvement of public health(AU)

Fibrofast and fibrosis-4 versus fibroscan as indicators of hepatic fibrosis in non-alcoholic fatty liver disease patients: A cross sectional Study

Aims: Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that includes simple steatosis, which can proceed to non-alcoholic steatohepatitis, cirrhosis, and, finally, hepatocellular carcinoma. Owing to the invasive nature of liver biopsy, the need for non-invasive tools were required for diagnosis. Objective: To compare the performance of simple biochemical scores (fibroblast) FIB-5 and (fibrosis-4) FIB-4 with fibroscan to differentiate mild to moderate fibrosis (MF; F0 to F2) from advanced fibrosis (AF; F3 to F4) in patients with NAFLD. Patients and methods: This cross-sectional study was done on 116 NAFLD patients. All patients were scanned with the FibroScan examination. FIB-5 and FIB-4 were calculated for all patients. Results: The mean kPa score (liver stiffness measurement score) of the patients belonging to advanced fibrosis [9.53 ± 1.05]. The FIB-4 score was significantly higher in patients with advanced fibrosis (1.54 ± 0.38) compared with patients with mild to moderate fibrosis (1.18 ± 0.44), p-value = 0.001, whereas the FIB-5 score was insignificant between patients. Conclusion: FIB-4 is superior to FIB-5 as a non-invasive simple marker in diagnosing advanced fibrosis in NAFLD patients.

Cap-assisted endoscopic sclerotherapy and procedure for prolapse and hemorrhoids for internal hemorrhoids: a randomized controlled study / 中华消化内镜杂志

Objective:To compare the efficacy and safety of cap-assisted endoscopic sclerotherapy (CAES) and procedure for prolapse and hemorrhoids (PPH) for internal hemorrhoids.Methods:This study was a prospective double-blind controlled clinical one. A total of 80 patients with internal hemorrhoids who visited Baoding No.1 Central Hospital from March 2018 to March 2020 and met the inclusion and did not meet exclusion criteria, were randomly divided into CAES group ( n=40) and PPH group ( n=40) by random number table method, and received corresponding treatment respectively. The perioperative indices of the two groups were compared, including intraoperative blood loss, operation time, visual analogue scale (VAS) score at 24 and 48 hours after operation, length of hospital stay, treatment costs, time to return to normal life, and curative rates. The complications within 3 months after operation and the 1-year recurrence after operation were also compared between the two groups. Results:The operation was successfully completed in all patients. The intraoperative blood loss (0.54±0.15 mL VS 7.32±2.17 mL) and treatment cost (6 249.53±435.67 yuan VS 7 832.96±526.74 yuan) in CAES group were significantly lower than those in PPH group ( t=19.714, P<0.05; t=14.650, P<0.05). The length of hospital stay (3.53±0.94 d VS 5.18±1.36 d) and time to return to normal life (5.26±1.28 d VS 7.17±2.09 d) in CAES group were significantly lower than those in PPH group ( t=6.312, P<0.05; t=4.929, P<0.05). There was no significant difference in operation time between the two groups ( t=0.977, P>0.05). The VAS scores at 24 h (2.64±0.70 points VS 3.59±0.93 points) and 48 h (1.28±0.31 points VS 2.16±0.57 points) after operation in CAES group were significantly lower than those in PPH group ( t=5.162, P<0.05; t=8.578, P<0.05). There was no significant difference in the curative rate [90.0% (36/40) VS 97.5% (39/40)] between CAES group and PPH group ( χ2=0.853, P=0.356). During the follow-up period within 3 months after the operation, the incidence of urinary retention [0.0% (0/40) VS 15.0% (6/40)] and pain [2.5% (1/40) VS 22.5% (9/40)] in CAES group was significantly lower than those in PPH group ( χ2=4.504, P<0.05; χ2=7.314, P<0.05). No other complications occurred in the 80 patients. After 1 year of follow-up, the recurrence rate of CAES group was 7.5% (3/40), which was not statistically different from that in PPH group [5.0% (2/40), χ2=0.180, P>0.05]. Conclusion:As a new minimally invasive technique for the treatment of internal hemorrhoids, CAES has similar curative rate and 1-year recurrence rate to PPH. Compared with PPH, CAES shows the advantages of less trauma, less pain, faster recovery and lower cost.

Isolation, identification and characterization of a chloramphenicol-degrading bacterium / 生物工程学报

Microorganisms are the dominant players driving the degradation and transformation of chloramphenicol (CAP) in the environment. However, little bacterial strains are able to efficiently degrade and mineralize CAP, and the CAP degrading pathways mediated by oxidative reactions remain unclear. In this study, a highly efficient CAP-degrading microbial consortium, which mainly consists of Rhodococcus (relative abundance >70%), was obtained through an enrichment process using CAP-contaminated activated sludge as the inoculum. A bacterial strain CAP-2 capable of efficiently degrading CAP was isolated from the consortium and identified as Rhodococcus sp. by 16S rRNA gene analysis. Strain CAP-2 can efficiently degrade CAP under different nutrient conditions. Based on the biotransformation characteristics of the detected metabolite p-nitrobenzoic acid and the reported metabolites p-nitrobenzaldehyde and protocatechuate by strain CAP-2, a new oxidative pathway for the degradation of CAP was proposed. The side chain of CAP was oxidized and broken to generate p-nitrobenzaldehyde, which was further oxidized to p-nitrobenzoic acid. Strain CAP-2 can be used to further study the molecular mechanism of CAP catabolism, and has the potential to be used in in situ bioremediation of CAP-contaminated environment.

Current Status and Prospects of Non-Invasive Central Arterial Pressure Measurement / 医用生物力学

Cardiovascular disease is one of the important factors that threaten the health of residents, ranking the first among various causes of death, so the monitoring and diagnosis of human cardiovascular health is particularly important. Compared with traditional brachial artery pressure, central arterial pressure (CAP) has a higher correlation with the occurrence of many cardiovascular events. The measurement of CAP can more accurately reflect the real situation of human blood pressure, and provide an important basis for diagnosis and disease prevention. Therefore, the realization of high-precision, high-generalization ability and low-cost non-invasive measurement of CAP has always been the research focus in this field. This article combines the relevant literature in China and abroad to summarize the current status of CPA measurement, introduces related research progress from two aspects, namely parameter measurement and waveform measurement, and discusses the characteristics of the existing methods and the future development.

Comparison of endoscopic mucosal resection with a cap and endoscopic submucosal dissection in the treatment of smaller gastric neuroendocrine neoplasms / 中华消化内镜杂志

Data of 55 cases of gastric neuroendocrine neoplasms (G-NENS) with diameter ≤12 mm in the First Affiliated Hospital of Zhengzhou University from August 2014 to August 2019 were retrospectively analyzed. According to the methods of endoscopic resection, the patients were divided into two groups: the endoscopic mucosal resection with a cap (EMR-C) group (35 cases) and the endoscopic submucosal dissection (ESD) group (20 cases). The results showed that the success rates of operation, the whole resection rates and the complete resection rates were all 100.0% in the two groups. Compared with the ESD group, the EMR-C group had a shorter median operation time (12.00 min VS 28.35 min, P<0.001), less mean hospitalization costs (21 165.19 yuan VS 28 400.35 yuan, P=0.004), and a similar overall incidence of complications [2.86% (1/35) VS 0, P=1.000]. By March 2020, the recurrence rate of EMR-C group and ESD group were 28.6% (10/35) and 15.0% (3/20), respectively, without significant difference ( P=0.418). It is suggested that for G-NENS with diameter ≤12 mm, without muscular invasion, lymph node metastasis or distant metastasis, EMR-C and ESD are both safe and effective, but EMR-C has more advantages in terms of operation time and hospitalization costs.

Pharmaceutical amorphous solid dispersion: A review of manufacturing strategies

Amorphous solid dispersions (ASDs) are popular for enhancing the solubility and bioavailability of poorly water-soluble drugs. Various approaches have been employed to produce ASDs and novel techniques are emerging. This review provides an updated overview of manufacturing techniques for preparing ASDs. As physical stability is a critical quality attribute for ASD, the impact of formulation, equipment, and process variables, together with the downstream processing on physical stability of ASDs have been discussed. Selection strategies are proposed to identify suitable manufacturing methods, which may aid in the development of ASDs with satisfactory physical stability.

Celastrol targets adenylyl cyclase-associated protein 1 to reduce macrophages-mediated inflammation and ameliorates high fat diet-induced metabolic syndrome in mice

Metabolic syndrome is a clustering of metabolic disorder with unclear molecular mechanism. Increasing studies have found that the pathogenesis and progression of metabolic syndrome are closely related to inflammation. Here, we report celastrol, a traditional Chinese medicine, can improve high fat diet-induced metabolic syndrome through suppressing resistin-induced inflammation. Mechanistically, celastrol binds to adenylyl cyclase associated protein 1 (CAP1) and inhibits the interaction between CAP1 and resistin, which restrains the cyclic adenylate monophosphate (cAMP)-protein kinase A (PKA)-nuclear factor kappa-B (NF-

Demethylzeylasteral (T-96) initiates extrinsic apoptosis against prostate cancer cells by inducing ROS-mediated ER stress and suppressing autophagic flux

BACKGROUND: Demethylzeylasteral (T-96) is a pharmacologically active triterpenoid monomer extracted from Tripterygium wilfordii Hook F (TWHF) that has been reported to exhibit anti-neoplastic effects against several types of cancer cells. However, the potential anti-tumour effects of T-96 against human Prostate cancer (CaP) cells and the possible underlying mechanisms have not been well studied. RESULTS: In the current study, T-96 exerted significant cytotoxicity to CaP cells in vitro and induced cell cycle arrest at S-phase in a dose-dependent manner. Mechanistically, T-96 promoted the initiation of autophagy but inhibited autophagic flux by inducing ROS-mediated endoplasmic reticulum (ER) stress which subsequently activated the extrinsic apoptosis pathway in CaP cells. These findings implied that T-96-induced ER stress activated the caspase-dependent apoptosis pathway to inhibit proliferation of CaP cells. Moreover, we observed that T-96 enhances the sensitivity of CaP cells to the chemotherapeutic drug, cisplatin. CONCLUSIONS: Taken together, our data demonstrated that T-96 is a novel modulator of ER stress and autophagy, and has potential therapeutic applications against CaP in the clinic.

The comparative agendas project in Latin America: data and coding / Comparative Agendas Project en América Latina: datos y codificación / O Comparative Agendas Project na América Latina: dados e codificação

Abstract This paper introduces the Comparative Agendas Project system of coding as well as a wealth of gathered and in process data from Latin America using this established and reliable system for capturing policy attention comparatively and over time. While this is not the first introduction of the coding system, it is the first introduction aimed at Latin America and a new type of political system beyond North American and European democracies. First, we present an overview of the Comparative Agendas Project (CAP) and the Master Codebook used to create comparative policy attention data across countries, over time, and between agendas. These details of CAP are discussed for Latin America in general and for Brazil, Colombia and Ecuador, countries that recently started to gather data using these coding.

Resumen: Este artículo presenta el sistema de codificación del Comparative Agendas Project, que es capaz de capturar la atención política de manera comparada y a lo largo del tiempo. Presenta también una amplia gama de datos recogidos y procesados en América Latina, sobre la base de este consolidado y fiable sistema de codificación. Aunque no sea un sistema inédito, esta es la primera vez que se introduce en América Latina y en un tipo de sistema político diferente del que se observa en las democracias de América do Norte y Europa. Para ello, ofrecemos una descripción del Comparative Agendas Project y de su libro de códigos (Master Codebook), usado para obtener datos de atención política de forma comparada entre países y distintos tipos de agendas a lo largo del tiempo. Esos detalles se discuten en relación con América Latina en general y con el contexto nacional de Brasil, Colombia y Ecuador, países de la región que cuentan con el primer conjunto de datos recogidos con ese sistema de codificación.

Resumo Esse artigo apresenta o sistema de codificação do Comparative Agendas Project, que é capaz de capturar a atenção política de maneira comparada e ao longo do tempo. Apresenta também uma ampla gama de dados coletados e em processamento na América Latina, já usando esse consolidado e confiável sistema de codificação. Embora não seja um sistema inédito, essa é a primeira vez que está sendo introduzido na América Latina e em um tipo de sistema político diferente do que se observa nas democracias da América do Norte e da Europa. Para isso, oferecemos um panorama do Comparative Agendas Project e de seu livro de códigos (Master Codebook), usado para obter dados de atenção política de forma comparada entre os países e suas agendas, ao longo do tempo. Esses detalhes são discutidos em relação a América Latina em geral e ao contexto nacional do Brasil, Colômbia e Equador, países da região que contam com a primeira leva de dados processados com esse sistema de codificação.

A Predictive Model of Hearing Outcome for Cochlear Implantation in Children below 5 Years of Age

Background: Cochlear Implantation (CI) has become an important modality of treatment for children with severe to profoundpre-lingual sensorineural hearing loss who do not benefit from hearing aids (HAs). The final outcome is not totally predictable,as there are a large number of factors which either alone or in combination will play their roles in the final outcome of CI.Aim of the Study: This study aims to evaluate prospectively the relative impact of multiple pre-, peri-, and post-operative factorson the final outcome of the CI in pre-lingual hearing impaired children aged 5 years under “Sruthitharangam” free cochlearimplant program of Government of Kerala.Materials and Methods: This study was conducted at Government Medical College, Kozhikode (GMC-KKD), Kerala, fromJanuary 2014 to January 2015. The study group consisted of 60 patients screened from the patients who have attendedAuditory verbal habilitation (AVH) categories of Auditory Performance (CAP) test, Meaningful auditory integration scale (MAIS)and Speech intelligibility rating test (SIR) at GMC-KKD, Kerala. Counseling of parents was done regarding regular follow-upsand therapy/support to the child at home.Observations and Results: Pearson correlation test and Spearman correlation test were done to check the correlation betweenage at which HA was first fitted and MAIS scores. Correlation between the age at which HA first fitted and MAIS was negative.As the age at which HAs were fitted increases, the MAIS score decreases. This indicates the significance of using the residualhearing and stimulation of auditory nerve as early as possible. Pearson correlation and Spearman correlation tests were appliedto check the correlation between age of surgery and MAIS score and found that there was negative correlation existing betweenage of surgery and MAIS scores. This meant, as the age at which surgery was done increases, the MAIS score decreases.Pearson correlation test and Spearman correlation tests were applied to check the MAIS scores and duration of AVH with HAs.Conclusions: A Cochlear implant was not a passive sensory aid or sensory substitution device that simply replaces a damaged ordefective cochlea to restore normal hearing but requires prolonged period of aural rehabilitation that involves perceptual learning,adaptation, and readjustment of their attention. The various risk factors that affect the auditory gain and speech perception eitheracting singly or in combination and the statistical analysis of the present study showed are the age at implantation, duration ofauditory deprivation, and the residual hearing which have a direct impact on the outcome over a period of 1 year.