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Tic disorder (TD) is a neurodevelopmental disorder that starts in childhood with tics as its primary clinical manifestation.It is a group of movement disorders with unknown causes.At present, the main pathogenic genes of TD have not been identified.In this paper, TD neurotransmitter-associated susceptibility genes ( DRD2, DRD4, SLC6A4, HDC, ADRA2A), related susceptibility gene variations ( ASH1L, CELSR3, PNKD, NRXN1, CNTN6), and other susceptibility genes ( FLT3, SLITRK1) were reviewed to provide references for the precision treatment based on gene variations.
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Objective To analyze the influence of intraoperative blood glucose fluctuation and postoperative insulin resistance(IR)on postoperative cognitive dyfunction(POCD)in elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia.Methods A total of 352 elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia were collected and divided into the POCD group(n=84)and the non-POCD group(n=268).The covariates between the two groups were balanced by propensity score matching method(PSM).Eighty-four cases in each group were successfully matched.The data between the two groups before and after PSM were compared.After PSM,receiver operating characteristic(ROC)curve of blood glucose fluctuation amplitude for predicting POCD was drawn,and patients were divided into the low-level blood glucose fluctuation group(n=97)and the high-level blood glucose fluctuation group(n=71)according to the cut-off value.According to the existence of postoperative IR,patients were divided into the IR group(n=53)and the non-IR group(n=115).Then,incidences of POCD between groups were compared.Logistic regression was used to analyze the influencing factors of POCD.Results Before PSM,the POCD group had older age,higher blood glucose fluctuation amplitude,IR ratio,operation time,anesthesia time,propofol dosage,remifentanil dosage and sufentanil dosage in anesthesia maintenance period than those in the non-POCD group(P＜0.05).The POCD group had higher blood glucose fluctuation amplitude and IR ratio than those in the non-POCD group after PSM(P＜0.05).After PSM,the incidences of POCD in the high-level blood glucose fluctuation group and the IR group were higher than those in the low-level blood glucose fluctuation group and the non-IR group(P＜0.05).Logistic regression analysis showed that higher intraoperative blood glucose fluctuation(OR=9.140,95%CI:4.338-19.257)and postoperative IR(OR=4.034,95%CI:1.163-13.991)were risk factors of POCD.Conclusion The risk of POCD in elderly patients undergoing thoracoscopic radical lung cancer surgery under general anesthesia is increased in patients with higher intraoperative blood glucose fluctuation and postoperative IR.
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Objective:To investigate the association between regional white matter hyperintensity (WMH) volumes and cognitive impairment in Parkinson′s disease (PD) patients.Methods:The consecutive samples of PD cohort between October 2018 and August 2019 from the Department of Movement Disorders, Beijing Tiantan Hospital, Capital Medical University were retrospectively analyzed. Demographic and disease profiles, three-dimensional brain magnetic resonance imaging data were collected. Cognition was evaluated by Mini-Mental State Examination (MMSE), and mood was evaluated by Hamilton Anxiety Scale and Hamilton Depression Scale (HAMD). According to the MMSE score, patients were divided into PD with dementia group and PD without dementia group. WMH volume was automatically calculated using unidentified bright objects detector pipeline based on anatomical autonomic labeling atlas. Firstly, demographic and disease profiles, and WMH total volume were compared between groups with and without dementia. Then, partial correlation analysis [false discovery rate (FDR) corrected] and principal component (PC) regression analysis were used to assess the association between regional WMH volumes and the MMSE score.Results:Compared with PD without dementia group, PD with dementia group showed significantly higher WMH volume [5 125 (2 727, 13 718) mm 3vs 3 214 (1 959, 7 205) mm 3, Z=-2.256, P=0.024]. After adjusting for age, low density lipoprotein, cholesterol, and HAMD score, partial correlation analysis (FDR corrected) showed that WMH volumes in the right calcarine ( r=-0.204, PFDR-corrected=0.034), the right fusiform ( r=-0.180, PFDR-corrected=0.046), the right lingual ( r=-0.146, PFDR-corrected=0.047), the left middle temporal ( r=-0.168, PFDR-corrected=0.047), the left inferior parietal lobes ( r=-0.145, PFDR-corrected=0.047) and the right inferior parietal lobes ( r=-0.148, PFDR-corrected=0.047) were significantly associated with MMSE score. PC regression analysis demonstrated that MMSE score was significantly associated with PC2 ( B=-0.632, 95% CI -1.222--0.041, P=0.036), PC13 ( B=-1.384, 95% CI -2.155--0.613, P=0.001), and PC14 ( B=-0.913, 95% CI -1.599--0.227, P=0.009); PC2, PC13 and PC14 were mainly composed of temporo-parieto-occipital WMHs in the posterior brain, and the related WMH components accounted for 9.668% of WMH variance. Conclusions:The posterior WMH burden may be associated with cognitive impairment in PD patients. However, WMH burden may not be the main contributor to cognitive impairment in PD patients.
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BACKGROUND@#Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment. Our previous clinical trial demonstrated that berberine (BBR) hydrochloride might reduce the recurrence and canceration of colorectal adenoma (CRA). The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer (CRC).@*METHODS@#We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial, and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction. We further performed ApcMin/+ animal intervention tests, RNA sequencing, flow cytometry, immunohistochemistry, and enzyme-linked immunosorbent assays.@*RESULTS@#The abundance of fecal Veillonella parvula ( V . parvula ) decreased significantly after BBR administration ( P = 0.0016) and increased through the development from CRA to CRC. Patients with CRC with a higher V. parvula abundance had worse tumor staging and a higher lymph node metastasis rate. The intestinal immune pathway of Immunoglobulin A production was activated, and the expression of TNFSF13B (Tumor necrosis factor superfamily 13b, encoding B lymphocyte stimulator [BLyS]), the representative gene of this pathway, and the genes encoding its receptors (interleukin-10 and transforming growth factor beta) were significantly upregulated. Animal experiments revealed that V. parvula promoted colorectal carcinogenesis and increased BLyS levels, while BBR reversed this effect.@*CONCLUSION@#BBR might inhibit V. parvula and further weaken the immunomodulatory effect of B cells induced by V. parvula , thereby blocking the development of colorectal tumors.@*TRIAL REGISTRAION@#ClinicalTrials.gov, No. NCT02226185.
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Animales , Humanos , Berberina/uso terapéutico , Carcinogénesis , Veillonella , Neoplasias Colorrectales/genética , Microambiente TumoralRESUMEN
Tic disorders is a neurodevelopmental disorder that occurs in childhood. Its etiology and pathogenesis are not yet fully understood, and immune factors are currently a hot and difficult research topic. This article reviews the risk factors, neuroimmune factors, peripheral immune factors, and other related immune pathogenesis and new advances in immunotherapy for Tourette′s syndrome.
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Objective:To determine the regional boundary of para-aortic lymph node (PAN) metastasis in cervical cancer, and to explore the clinical target volume (CTV) margin.Methods:Eight-six patients with cervical cancer metastasis to PAN below and above left renal vein (LRV) were retrospectively included in this study. The anatomical relationship of the metastatic PANs and surrounding structures were analyzed according tocontrast-enhanced computed tomography (CT) and three dimensional reconstruction images.Results:Eight-six patients had metastatic PANs belowLRV: metastatic nodes were located onthe medial side of ovarian vessels and ureters, behind the renal veins, duodenum, mesenteric vessels, in front of the anterior border of lumbar vertebra and psoas. The inferior mesenteric vein was close to the left anterior side of PANs. Where the duodenum appeared, no node was presenton the anterolateral side of the inferior vena cava (IVC).Above the LRV, 27 patients had retrocrural node involvement along the azygos and hemiazgos vein, and 25/27 cases were located below the junction level of cardia and oesophagus, and 5/27 patients had metastatic lymph nodes between IVC and the right crura of diaphragm, all below the level of coeliac trunk artery.Conclusions:CTV margin delineation of PAN below and above LRV is recommended:superiorly, the junction level of cardia and oesophagus; laterally, crura and the medial side of ovarian vessels and ureters and inferior mesenteric vein; anteriorly, the posterior side of the coeliac trunk artery and renal veins and duodenum, mesenteric vessels; posteriorly, the anterior border of lumbar vertebra and psoas.
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Capsule endoscopy is one of the main diagnostic methods of small bowel diseases. In small bowel capsule endoscopy, the main factors that influence the diagnostic rate of diseases include gastrointestinal examination completion rate and intestinal preparation, etc. The upper gastrointestinal transit time is one of the main influence factors of examination completion rate. This article reviewed risk factors and clinical management of prolonged upper gastrointestinal transit time in capsule endoscopy.
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Objective:To evaluate the lung protection of pressure-controlled ventilation volume guaranteed (PCV-VG) in elderly patients undergoing laparoscopic surgery in Trendelenburg position.Methods:Sixty patients of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, aged 65-80 yr, with body mass index of 19-27 kg/m 2, scheduled for elective laparoscopic radical prostatectomy or laparoscopic radical cystectomy, were allocated into 2 groups ( n=30 each) by a random number table method: VCV group (group V) and PCV-VG group (group P). Tracheal intubation was performed after induction of anesthesia.The anesthesia machine was connected to perform mechanical ventilation with tidal volume of 7 ml/kg (corrected body weight), positive end-expiratory pressure at 5 cmH 2O, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 50%, fresh gas flow at 2 L/min and respiratory rate 12-15 breaths/min in two groups.Recruitment maneuver was performed with a pressure of 30 cmH 2O, lasting for 30 s, starting from 5 min before the end of administration.The airway peak pressure (P peak), airway plateau pressure (P plat), driving pressure (DP), and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T 1), 5 min after changing position (T 2), 5, 30, 60, 90 and 120 min of pneumoperitoneum (T 3-7) and 5 min after restoring the supine position and after the end of pneumoperitoneum (T 8). Blood samples were collected from the radial artery for blood gas analysis at T 1, T 4 and T 6 and when modified Aldrete score reached 10 in postanesthesia care unit, and pH value, partial pressure of arterial oxygen (PaO 2), partial pressure of arterial carbon dioxide (PaCO 2), arterial oxygen saturation (SaO 2) and alveolar-arterial oxygen gradient (P A-aO 2) were recorded.Blood samples were collected from the radial artery before induction of anesthesia and at the end of surgery for determination of concentrations of Clara cell protein (CC-16), interleukin-6 (IL-6) and neutrophil elastase (NE) in serum by enzyme-linked immunosorbent assay.The development of pulmonary complications was recorded within 7 days after surgery. Results:Compared with group V, P peak was significantly decreased at T 1-8, P plat and DP were decreased at T 5-7, Cdyn was increased at T 2-7, P A-aO 2 was decreased at T 1, 4, 6, serum CC-16, IL-6 and NE concentrations were decreased at the end of surgery ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group P ( P>0.05). Conclusion:PCV-VG can produce lung protection to some extent in elderly patients undergoing laparoscopic surgery in Trendelenburg position.
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Objective:To investigate the effects of iron deficiency in early life on neurobehavioral manifestations in CDH2 genetic mutation rats, in order to explore interaction between iron deficiency and CDH2 gene mutation in autism-like behavior.Methods:The 16 female SD rats with established CDH2 genetic mutations were randomly divided into 8 rats as iron deficiency group and 8 rats as normal diet control group.After mating, rats were fed low-iron diets during pregnancy and lactation or standard diets as control.The offsprings were randomly divided into 27 rats as iron deficiency group and 27 rats as control group.The voice communication ability of offspring was studied through ultrasonic vocalizations.The data and videos of open-field test, three-chamber social interaction test were recorded by animal behavioral video analysis system(Smart3.0). The characteristics of behavior changes were analyzed by statistical methods.Results:Total number of calls in rats aged 10 day in iron deficiency group[(755.67±161.86)times]were significantly lower than that in the control group[(1461.89±166.57)times]( P<0.05). Total calling duration[(41.77±16.17)s]were significantly lower than that in the control group[(86.22±10.07)s]( P<0.05). There is a certain synergistic effect of CDH2 genetic mutation and iron deficiency on the reduction of total calls in rats aged 6 and 8 day( P<0.05). The total distance, distance in zone-periphery, mean speed in zone-total and mean speed in zone-periphery of rats in iron deficiency group were all higher than that in the control group( P<0.05); the numbers of standing and rearing were reduced( P<0.05). In the second stage of the three-chamber test, the rats in the iron deficiency group had shorter communication time with the new stranger 2 and longer interaction time with the old stranger 1 compared with the control, showing a weakening trend of social ability, but the difference was not statistically significant( P>0.05). Conclusion:Autism-like behavioral changes occurred in rats with iron deficiency in early life and CDH2 genetic mutation, and there is a certain degree of synergy.Iron deficiency and CDH2 mutation may increase the risk of autism spectrum disorder.
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Objective:To analyze the mutation sites and characteristics of phospholipase CE1( PLCE1) gene in children with primary nephrotic syndrome(PNS) in Zhuang, Guangxi, China, so as to explore the expression status of PLCE1 protein in peripheral blood of PNS patients. Methods:(1)Blood samples of 154 Zhuang children with PNS and 98 healthy children of Zhuang nationality from July 2015 to September 2017 in Affiliated Hospital of Youjiang Medical College for Nationalities were collected to sequence PLCE1 gene with FastTarget target gene capture method in the combination with next generation sequencing.Based on the comparison between mutation results and information from the database, the pathogenicity, phenotype and distribution characteristics of these mutation sites were discovered and appraised.(2)The concentration of PLCE1 protein in serum samples were measured by enzyme-linked immuno sorbent assay, then the data of PNS group and healthy control group were compared and analyzed statistically with SPSS 25.0. Results:(1)A total of 18 low-frequency mutations of PLCE1 were observed, 5 of them(c.670C>T, c.578T>C, c.923G>T, c.4916C>T, and c. 5927_5929del) were found only in the PNS group, and 3 of them occurred in both PNS group and healthy control group: c.176C>T, c.389T>C, and c. 4304C>T.Five newly discovered mutations (c.923G>T, c.958T>A, c.1151C>T, c.2341A>G, and c. 3592G>C)were discovered and only c. 923 G>T is pathogenic mutation of PLCE1.(2)The concentration of PLCE1 protein in healthy control group was 414.65 (231.20, 729.81) ng/L and the level of PLCE1 in PNS group was 237.84 (116.14, 535.85) ng/L, ( Z=-3.212, P<0.001), and the value of PNS group was lower than that in the healthy control group. Conclusions:(1)As a new pathogenic mutation of PLCE1, c.923G>T was found.(2)The phenotype of PLCE1 gene mutation in Zhuang children with PNS was diverse, and they may differ by race and region.(3) PLCE1 protein of serum may act as a protective protein to guarantee various life activities of cells by participating in multiple signal transduction pathways.
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Objective@#To investigate the efficacy and safety of rapamycin in children with tuberous sclerosis complex (TSC) associated renal disease.@*Methods@#A prospective self-control study was conducted. The clinical data of 92 children diagnosed with tuberous sclerosis complex associated kidney disease at the People′s Liberation Army General Hospital from January 2011 to January 2019 were collected. The long-term rapamycin treatment for all patients initiated at 1 mg/(m2·d), which was gradually adjusted to reach a blood concentration of 5-10 μg/L. The changes of the maximum diameter of renal lesions in children after rapamycin treatment were observed and analyzed with Wilcoxon test.@*Results@#Ninety-two children, including 52 males and 40 females, who met the criteria were analyzed. Sixty patients had only renal angiomyolipoma(RAML), while 24 patients had only multiple renal cysts(MRC), and 8 patients had both lesions. The age of TSC diagnosis was 16.0 (7.0, 42.0) months, and the age of initial treatment with rapamycin was 63.5 (21.0, 103.0) months. The follow-up lasted for 12.0 (4.0, 23.0) months. Sequencing of TSC1 and TSC2 genes was performed in 54 children with TSC, including 3 patients (6%) with mutations in TSC1 gene and 51 patients (94%) with mutations in TSC2 gene. The maximum RAML diameter before treatment was 7.0 (4.0, 9.0) mm. The best effect reached at 3 months of treatment, with the diameter of 4.0 (0,7.0) mm. The maximum diameters at 6 months, 1 year and 1-2 years were 5.0 (0,9.8) mm, 5.0 (1.5, 8.5) mm, 5.5 (3.0, 9.0) mm, respectively, and were significantly different from the baseline (Z=-2.404,-2.350,-2.750,P=0.016,0.019,0.006, respectively). The maximum diameter after 2-3 years, and ≥3 years were 5.0 (3.9,7.0) mm and 6.0 (1.0, 11.0) mm, without significant difference from the baseline (Z=-0.856,-0.102,P=0.393,0.919, respectively).The maximum diameters of MRC after 3 months, 6 months, 1 year,1-2 years, 2-3 years, and ≥3 years were 11.0 (5.0, 14.0) mm,3.0 (0.0,11.0) mm,5.0 (0,21.0) mm,0 (0,14.0) mm,0 (0,10.0) mm, and 0 (0,18.3) mm, respectively, but were not significantly different rom the baseline (7.0 (5.0, 15.7) mm)(Z=-0.944,-1.214,-1.035,-1.896,-1.603,-1.214,P=0.345,0.225,0.301,0.058,0.109,0.225, respectively).Twenty-nine patients (32%) had oral ulcers during the entire treatment period, and no serious adverse reactions were observed.@*Conclusions@#Rapamycin could decrease the diameter of TSC-related RAML, but could not inhibit the growth of cysts. It is well tolerated in the treatment of renal diseases associated with tuberous sclerosis complex.
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Objective To evaluate the role of DNA methylation in sepsis-associated encephalopathy in mice.Methods A total of 144 clean-grade healthy male C57BL/6 mice,aged 6-8 weeks,weighing 20 -25 g,were divided into 4 groups (n=36 each) using a random number table method:sham operation group (group Sham),sepsis group (group Sepsis),sham operation plus S-adenosyl methionine (SAM) group (group Sham+SAM) and sepsis plus SAM group (group Sepsis+SAM).Sepsis was produced by cecum ligation and puncture (CLP).In Sham+SAM and Sepsis+SAM groups,DNA methylated methyl donor SAM 100 mg/kg was intraperitoneally injected at 1 h before operation and 12 h after operation,while the equal volume of normal saline was given instead in Sham and Sepsis groups.The cognitive function was assessed using Y-maze and contextual fear conditioning test at 1,3 and 7 days after CLP.Mice were sacrificed at 1,3 and 7 days after CLP,and the hippocampal tissues were taken for determination of genomewide DNA methylation (by colorimetric assay) and expression of DNA methyltransferase enzymes (DNMT1,DNMT3a,and DNMT3b),ten-eleven translocation (TET) enzymes (TET1,TET2 and TET3) and thymine-DNA glycosylase (TDG) mRNA (by fluorescent quantitative real-time).Results Compared with group Sham,the time of staying at the novel arm was significantly shortened,the percentage of time spent freezing and the total number of entries into each arm were reduced,genome-wide DNA methylation in hippocampal tissues was decreased at 1,3 and 7 days after CLP,the expression of DNMT1,DNMT3a,TET1,TET2,TET3 and TDG was up-regulated,and the expression of DNMT3b was down-regulated in group Sepsis (P＜0.05).Compared with group Sepsis,the time of staying at the novel arm was significantly prolonged,the percentage of time spent freezing and the total number of entries into each arm were increased,the expression of DNMT1,DNMT3a,TET1,TET2,TET3 and TDG mRNA was down-regulated,and the expression of DNMT3b was up-regulated in group Sepsis+SAM (P＜0.05).Conclusion DNA methylation is involved in the development of sepsis-associated encephalopathy in mice.
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Objective@#To evaluate the role of DNA methylation in sepsis-associated encephalopathy in mice.@*Methods@#A total of 144 clean-grade healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups (n=36 each) using a random number table method: sham operation group (group Sham), sepsis group (group Sepsis), sham operation plus S-adenosyl methionine (SAM) group (group Sham+ SAM) and sepsis plus SAM group (group Sepsis+ SAM). Sepsis was produced by cecum ligation and puncture (CLP). In Sham+ SAM and Sepsis+ SAM groups, DNA methylated methyl donor SAM 100 mg/kg was intraperitoneally injected at 1 h before operation and 12 h after operation, while the equal volume of normal saline was given instead in Sham and Sepsis groups.The cognitive function was assessed using Y-maze and contextual fear conditioning test at 1, 3 and 7 days after CLP.Mice were sacrificed at 1, 3 and 7 days after CLP, and the hippocampal tissues were taken for determination of genome-wide DNA methylation (by colorimetric assay) and expression of DNA methyltransferase enzymes (DNMT1, DNMT3a, and DNMT3b), ten-eleven translocation (TET) enzymes (TET1, TET2 and TET3) and thymine-DNA glycosylase (TDG) mRNA (by fluorescent quantitative real-time).@*Results@#Compared with group Sham, the time of staying at the novel arm was significantly shortened, the percentage of time spent freezing and the total number of entries into each arm were reduced, genome-wide DNA methylation in hippocampal tissues was decreased at 1, 3 and 7 days after CLP, the expression of DNMT1, DNMT3a, TET1, TET2, TET3 and TDG was up-regulated, and the expression of DNMT3b was down-regulated in group Sepsis (P<0.05). Compared with group Sepsis, the time of staying at the novel arm was significantly prolonged, the percentage of time spent freezing and the total number of entries into each arm were increased, the expression of DNMT1, DNMT3a, TET1, TET2, TET3 and TDG mRNA was down-regulated, and the expression of DNMT3b was up-regulated in group Sepsis+ SAM(P<0.05).@*Conclusion@#DNA methylation is involved in the development of sepsis-associated encephalopathy in mice.
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Objective To determine the median effective dose (EDs0) of etomidate inducing electroencephalogram (EEG) burst suppression (BS) in the patients with non-intracranial diseases.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index of 19-27 kg/m2,scheduled for elective non-intracranial surgery,were enrolled in this study.ED50 of etomidate was determined by Dixon's up-and-down sequential method.Etomidate was intravenously injected for 30 s at an initial dose of 0.30 mg/kg.The BS ratio was recorded within 6 min following the end of injection.Each time ED50 increased/decreased in the next patient depending on whether or not BS occurred.The difference between the two successive doses was 0.05 mg/kg.Successful induction of BS was defined as BS ratio＞ 10％,lasting more than 1 min.Probit analysis was used to calculate the ED50 and 95％ confidence interval of etomidate inducing EEG BS in the patients with non-intracranial diseases.Results The ED50 of etomidate inducing EEG BS was 0.70 mg/kg,and the 95％ confidence interval was 0.65-0.81 mg/kg in the patients with non-intracranial diseases.Conclusion The ED50 of etomidate inducing EEG BS is 0.70 mg/kg in the patients with non-intracranial diseases.
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Objective@#To analyze the bone mineral density and serum osteocalcin levels in postmenopausal women with idiopathic benign paroxysmal positional vertigo.@*Methods@#A total of 64 postmenopausal women with idiopathic BPPV were selected as the study group, and 98 postmenopausal healthy women were selected as the control group. Bone mineral density and serum osteocalcin levels were analyzed and compared between the groups.χ2 test was used for numeration data and t test was used for measurement data.@*Results@#The prevalence of osteoporosis or osteopenia in BPPV group 67.2% (43/64) was significantly higher than that in the control group 51.0% (50/98) (χ2=4.139, P=0.042). Among BPPV subjects, there was a negative correlation between osteocalcin and bone density T (r=-0.469, P<0.001). Osteocalcin was found in normal bone mass subgroup (13.61±4.32)μg/L, decreased bone mass subgroup (17.49±7.61)μg/L, and osteoporosis subgroup (20.83±6.72)μg/L, respectively, and the difference was statistically significant (F=5.39, P=0.007).@*Conclusions@#Bone mineral density in BPPV group is lower than that in control group. The lower the bone mineral density of the patients, the higher the osteocalcin in BPPV group.
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Objective To investigate the effects of low GI cereals on metabolomics and pregnancy outcomes in women with gestational diabetes mellitus (GDM),in order to explore the preventive and therapeutic mechanisms and provide the basis for nutritional interventions.Metbods Pregnant women with gestational diabetes were assigned to the treatment group (n=31),using low GI grains 12 weeks for nutrition intervention and the control group (n =31) according to the random digital table method;30 healthy pregnant women were enrolled as normal control group.At 36th gestational week serum was analyzed by 1H-NMR metabolomics approach.Pregnancy outcomes were gathered for statistics after delivery.Comparison among groups and related influencing factors analysis were conducted.Results After nutritional intervention for 12 weeks,there were statistically significant differences in 15 potential biomarkers associated with gestational diabetes between the treatment group and the control group (P＜0.05),and no statistically significant difference between the treatment group and the normal control group (P＞0.05),that was the pregnant women in the treatment group were close to normal pregnant women.Cesarean rate,gestational weight gain,glycosylated hemoglobin during delivery,fasting insulin and newborn birth weight were significantly lower in the treatment group than in the control group.Multiple linear regression analysis showed that the GI of diet,fasting insulin and blood glucose were influencing factors for metabolomics in women with GDM.Conclusions Using low GI cereals intervention treatments,the pregnancy outcomes of GDM are improved distinctly with the possible mechanisms as adjusting the related biomarkers.Our study provides evidences for further exploring etiology and the therapeutic mechanisms of GDM,and individualized medical nutrition treatment strategy.
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Objective@#Currently, parathyroid hormone (PTH) is mainly measured by the second generation intact PTH (iPTH) assay which detects both full-length (1-84)PTH and (7-84)PTH fragments. The third generation whole PTH (wPTH) assay however has turned out to be specific for (1-84) PTH. The aim of this study is to investigate the features of plasma iPTH, (1-84)PTH, (7-84)PTH levels in patients with stage 5 chronic kidney disease (CKD), and evaluate the effects of parathyroidectomy (PTX) on above markers in severe secondary hyperparathyroidism (SHPT) patients.@*Methods@#A cross-sectional study including 90 controls and 233 stage 5 CKD patients, and a prospective follow-up study in 31 severe SHPT patients were conducted. Plasma iPTH and (1-84)PTH levels were measured by the second and third generation assay, respectively. Circulating (7-84)PTH level was calculated by subtracting the (1-84)PTH value from the iPTH value.@*Results@#Plasma levels of iPTH, (1-84)PTH, (7-84)PTH were higher (P<0.01), and (1-84)PTH/iPTH was lower (P<0.01) in stage 5 CKD patients than in controls. For severe SHPT patients with PTX (n=74), plasma iPTH, (1-84)PTH and (7-84)PTH concentrations were significantly increased compared to non-PTX group (n=159) (P<0.01), and the increase of (7-84)PTH level was more striking than (1-84)PTH. Meanwhile, the value of (1-84)PTH/iPTH was decreased (P<0.01). Plasma iPTH level was strongly correlated with (1-84)PTH level (r=0.980, P<0.01) in stage 5 CKD patients. Also, both iPTH and (1-84)PTH levels were positively correlated with serum alkaline phosphatase, dialysis vintage and serum phosphorus (P<0.01). After PTX (median interval of follow-up: 7.1 months), plasma iPTH, (1-84)PTH, (7-84)PTH concentrations were decreased (by 92.9%, 89.7%, 95.8%, P<0.01, respectively) greatly and (1-84)PTH/iPTH was increased (P<0.01).@*Conclusions@#In stage 5 CKD patients, plasma iPTH, (1-84)PTH, (7-84)PTH levels are greatly increased while (1-84)PTH/iPTH is decreased, and PTX can significantly improve abnormality of above markers in severe SHPT patients. The second generation PTH assay overestimates the severity of SHPT, and the accurate measurement of (1-84)PTH by the third assays is more conducive to diagnosis and treatment of CKD and SHPT patients.
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Objective To construct clinical nursing pathway for patients with laparoscopic cholecystectomy surgery in acute cholecystitis stage, and to provide standardized nursing service. Methods With case record and literature review as theoretical basis, Omaha System as frame, clinical nursing pathway with patient centered was developed through analysis of main nursing problem and intervention. Results Omaha System oriented clinical nursing pathway was constructed in different stages of Laparoscopic cholecystectomy surgery with acute calculous cholecystitis. Conclusions Combined standardized nursing language and nursing process, clinical nursing pathway based on Omaha system provide practicability nursing plan in different stage regarding time as the coordinate axle. It contains assessment, problem, intervention and outcome evaluation indexed, which is beneficial to improve nursing quality.
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OBJECTIVE:To investigate the effects of Butylphthalide and sodium chloride injection on neurological function and prognosis of elderly patients with hypertensive intracerebral hemorrhage(HICH)after trepanation and drainage surgery. METH-ODS:During Jan. 2015 to Jun. 2016,80 elderly HICH patients were selected from our hospital and then divided into control group and observation group according to random number table,with 40 cases in each group. Both group received trepanation and drain-age surgery. Control group was given routine treatment. Observation group was given Butylphthalide and sodium chloride injection 100 mL,ivgtt,bid,on the fifth day after surgery,on the basis of control group. Both groups received treatment for 14 d. Clinical efficacies of 2 groups were observed. CSS scores were compared between 2 groups before surgery and 28 d after operation;volume of encephaledema,serum levels of homocysteine(HCY)and substance P(SP)were compared between 2 groups before surgery and 14 d after operation. RESULTS:The total response rate of observation group was 87.5％,which was significantly higher than 67.5％ of control group, with statistical significance (P0.05). CSS scores 28 d after operation, SP levels 14 d after operation were significanthy increased,volume of encephaledema and serum levels of HCY in 2 groups were significantly decreased,and the observation group was significantly better than the control group,with statistical significance(P<0.05). CONCLUSIONS:Butylphthalide and sodium chloride injection can significantly improve clinical efficacy and hepatic func-tion damage,relieve postoperative encephaledema,reduce serum levels of HCY and increase SP levels in elderly HICH patients af-ter trepanation and drainage surgery.
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Objective To establish the normal reference range for serum folate of healthy children in Guangzhou region.Methods Levels of serum folate of 1 860 healthy children (1 061 males and 799 females) and 129 adults (52 males and 77 females) living in Guangzhou region were examined by LK3000V Vitamin Analyzer.Then the data were analyzed with statistical methods.Results ①There was no statistical difference between boys and girls for levels of serum folate in every group defined by age (P＞0.05).②The levels of serum folate [median(P2.5,P97.5)] defined by age were as follows:9.39 (6.12,14.85) nmol/L for 0～1 year-old group,10.65 (6.05,16.52) nmol/L for 1.01～17 year-old group and 11.12 (6.3,17.51) nmol/L for the adult group.Statistical difference was found between any two groups of the three (P＜0.05).③No statistical correlation was found between age and the level of serum folate (r=0.039,P=0.09).Conclusion Reference range for serum folate for healthy children in Guangzhou region include two parts:6.12～ 14.85 nmol/L for 0～ 1 year-old group and 6.05～～16.52 nmol/L for 1.01～17 year-old group.