Research on the establishment of standard limits for perfluorooctanoic acid and perfluorooctane sulfonate in the "Standards for Drinking Water Quality（GB5749-2022）"in China / 中华预防医学杂志

Perfluorinated compounds, especially Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are widely detected in water environments in China. Considering the potential health risks of drinking water exposure routes, PFOA and PFOS have been added to the water quality reference index of the newly issued "Standards for Drinking Water Quality (GB5749-2022)", with limit values of 40 and 80 ng/L, respectively. This study analyzed and discussed the relevant technical contents for determining the limits of the hygiene standard, including the environmental existence level and exposure status of PFOA and PFOS, health effects, derivation of safety reference values, and determination of hygiene standard limits. It also proposed prospects for the future direction of formulating drinking water standards.

Perfluorooctanoic acid-induced lipid metabolism disorder in SD rat liver and its effect on the expression of fatty acid metabolism-related proteins / 中南大学学报(医学版)

OBJECTIVES@#Perfluorooctanoic acid (PFOA) can cause lipid metabolism disorders in animal body and affect the lipolysis and synthesis of fatty acids. Peroxisome proliferators-activated receptor (PPAR) plays an extremely important role in this process. This study aims to explore the effects of PFOA on liver lipid metabolism disorders in Sprague Dewley (SD) rats and the expression of PPAR.@*METHODS@#A total of 40 male SD rats were randomly divided into 4 groups (n=10 in each group): a control group (ddH2O), a low-dose PFOA group [PFOA 1.25 mg/(kg·d)], a middle-dose PFOA group [PFOA 5.00 mg/(kg·d)], and a high-dose PFOA group [PFOA 20.00 mg/(kg·d)]. The rats were fed with normal diet, and PFOA exposure were performed by oral gavage for 14 days, and the rats were observed, weighted and recorded every day during the exposure. After the exposure, the blood was collected, and the livers were quickly stripped after the rats were killed. Part of the liver tissues were fixed in 4% paraformaldehyde for periodic acid-schiff (PAS) staining; the contents of HDLC, LDLC, TG, TC in serum and liver tissues, as well as the activities of their related enzymes were assayed; The expression levels of cyclic adenosine monophosphate-response element binding protein (Cbp), general control of amino acid synthesis 5-like 2 (Gcn5L2), peroxidation peroxisome proliferation factor activated receptor γ (PPAR), silent information regulator 1 (Sirt1) and human retinoid X receptor alpha 2 (Rxrα2) ) were detected by Western blotting.@*RESULTS@#After 14 days of PFOA exposure, the PAS staining positive particles in the cytoplasm and nucleus of SD rats in the medium and high dose groups were significantly reduced compared with the control group. The serum levels of LDLC and TC in the low-dose and middle-dose groups were significantly reduced compared with the control group (all P<0.05), while the high-dose group showed an increasing tendency, without siginificant difference (P>0.05), there was no significant difference in HDLC and TG (both P>0.05). The activities of alkaline phosphatase (AKP) and alanine aminotransferase (ALT) were increased significantly (both P<0.05) compared with control group; the ratio of ALT/aspartate aminotransferase (AST) in the high-dose group was increased significantly (P<0.05), there was no significant difference in LDH and TG (both P>0.05); the HDLC content in the liver tissues in the high-dose group was significantly reduced, compared with the control group (P<0.05); the TC contents in the liver tissues in the low, medium and high-dose groups were significantly increased (all P<0.05), there was no significant difference in LDLC and TG (both P>0.05); the AKP activity in the livers in the medium and high-dose groups was significantly increased (both P<0.05), there was no siginificant difference in LDH, ALT, and the ratio of ALT/AST (all P>0.05); the protein expression levels of Ppar γ, Cbp and Rxrα2 in the liver in the high dose groups were significantly down-regulated compared with the control group (all P<0.05), while the protein expression levels of Sirt1 were significantly up-regulated (all P<0.05).@*CONCLUSIONS@#PFOA exposure can cause lipid metabolism disorder and glycogen reduction in SD rat livers, which may be related to the activation of Sirt1 and inhibition of Ppar γ expression, leading to affecting the normal metabolism of fatty acids and promoting glycolysis.

Caprylic Acid Improves Lipid Metabolism, Suppresses the Inflammatory Response and Activates the ABCA1/p-JAK2/p-STAT3 Signaling Pathway in C57BL/6J Mice and RAW264.7 Cells / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to investigate the effects of caprylic acid (C8:0) on lipid metabolism and inflammation, and examine the mechanisms underlying these effects in mice and cells.@*METHODS@#Fifty-six 6-week-old male C57BL/6J mice were randomly allocated to four groups fed a high-fat diet (HFD) without or with 2% C8:0, palmitic acid (C16:0) or eicosapentaenoic acid (EPA). RAW246.7 cells were randomly divided into five groups: normal, lipopolysaccharide (LPS), LPS+C8:0, LPS+EPA and LPS+cAMP. The serum lipid profiles, inflammatory biomolecules, and ABCA1 and JAK2/STAT3 mRNA and protein expression were measured.@*RESULTS@#C8:0 decreased TC and LDL-C, and increased the HDL-C/LDL-C ratio after injection of LPS. Without LPS, it decreased TC in mice ( P < 0.05). Moreover, C8:0 decreased the inflammatory response after LPS treatment in both mice and cells ( P < 0.05). Mechanistic investigations in C57BL/6J mouse aortas after injection of LPS indicated that C8:0 resulted in higher ABCA1 and JAK2/STAT3 expression than that with HFD, C16:0 and EPA, and resulted in lower TNF-α, NF-κB mRNA expression than that with HFD ( P < 0.05). In RAW 264.7 cells, C8:0 resulted in lower expression of pNF-κBP65 than that in the LPS group, and higher protein expression of ABCA1, p-JAK2 and p-STAT3 than that in the LPS and LPS+cAMP groups ( P < 0.05).@*CONCLUSION@#Our studies demonstrated that C8:0 may play an important role in lipid metabolism and the inflammatory response, and the mechanism may be associated with ABCA1 and the p-JAK2/p-STAT3 signaling pathway.

Two Cases of Hypersensitivity Reactions Caused by Human Serum Albumin During Therapeutic Plasma Exchange

Iso-oncotic human serum albumin (HSA) is the primary replacement fluid of choice during therapeutic plasma exchange (TPE). Hypersensitivity reactions to HSA are rare, but require proper evaluation and management. In this article, we report two cases of hypersensitivity reactions to 5% HSA during TPE and discuss strategies to address this problem. The first case was a 60-year-old female patient, who was scheduled for TPE for treatment of recurrent focal segmental glomerulosclerosis after ABO-incompatible kidney transplantation. She developed a pruritic rash on her entire body during the first two sessions of TPE using 5% HSA. The third session was conducted using 500 mL normal saline, 1,000 mL 10% pentastarch, and 750 mL 5% HSA, where she eventually developed a pruritic rash when HSA was infused. There were no adverse events during the fourth and fifth session when fresh frozen plasma was used in place of HSA. The second case was a 50-year-old male patient diagnosed with optic neuritis, who was admitted for five sessions of TPE. The patient developed a pruritic rash on his entire body during the first session of TPE using 5% HSA. The patient experienced no adverse events during the following four sessions using fresh frozen plasma. Certain elements contained in HSA, such as albumin aggregates, prekallikrein activator, and caprylate-modified albumin, might be the reason for these hypersensitivity reactions. Careful selection of alternative replacement fluids is important to avoid premature termination of TPE procedures and secure optimal treatment options for patients.

Synthesis and anti-tumor activity of ginsenoside Rh_2 caprylic acid monoester / 中国中药杂志

Ginsenoside Rh_2,firstly isolated from red ginseng,is protopanaxadiol type of steroidal saponin. Rh_2 possessed variety of activities,but bioavailability of oral administration Rh_2 was extremely low due to poor absorption. Moreover,ginsenoside Rh_2 exhibited toxicity on human normal cells. Therefore,to improve stronger anti-tumor activity and attenuate toxicity,it was essential to design and optimize chemical structure of ginsenoside Rh_2. Through n-octanoylchloride modifications,a novel ester derivative of ginsenoside Rh_2 named caprylic acid monoester of Rh_2( C-Rh_2) was designed and synthesized. Structure of novel ginsenoside derivative was identified by1 D and 2 D NMR,as well as ESI-MS analyses. Anti-tumor effect of C-Rh_2 was tested on H22 tumor bearing mice. C-Rh_2 displayed certain anti-tumor activities and exhibited less toxicity than Rh_2. In the present study,C-Rh_2 as ester form of ginsenoside Rh_2 showed better anti-tumor activity and less toxicity,but the specific mechanism needs further investigation.

Application of positive airway pressure in restoring pulmonary function and thoracic mobility in the postoperative period of bariatric surgery: a randomized clinical trial / Aplicação de pressão positiva nas vias aéreas na restauração da função pulmonar e da mobilidade torácica no pós-operatório de cirurgia bariátrica: um ensaio clínico randomizado

Objective: To evaluate whether the application of bilevel positive airway pressure in the postoperative period of bariatric surgery might be more effective in restoring lung volume and capacity and thoracic mobility than the separate application of expiratory and inspiratory positive pressure. Method: Sixty morbidly obese adult subjects who were hospitalized for bariatric surgery and met the predefined inclusion criteria were evaluated. The pulmonary function and thoracic mobility were preoperatively assessed by spirometry and cirtometry and reevaluated on the 1st postoperative day. After preoperative evaluation, the subjects were randomized and allocated into groups: EPAP Group (n=20), IPPB Group (n=20) and BIPAP Group (n=20), then received the corresponding intervention: positive expiratory pressure (EPAP), inspiratory positive pressure breathing (IPPB) or bilevel inspiratory positive airway pressure (BIPAP), in 6 sets of 15 breaths or 30 minutes twice a day in the immediate postoperative period and on the 1st postoperative day, in addition to conventional physical therapy. Results: There was a significant postoperative reduction in spirometric variables (p<0.05), regardless of the technique used, with no significant difference among the techniques (p>0.05). Thoracic mobility was preserved only in group BIPAP (p>0.05), but no significant difference was found in the comparison among groups (p>0.05). Conclusion: The application of positive pressure does not seem to be effective in restoring lung function after bariatric surgery, but the use of bilevel positive pressure can preserve thoracic mobility, although this technique was not superior to the other techniques. .

Objetivo: Avaliar se a aplicação de dois níveis de pressão positiva nas vias aéreas no pós-operatório de cirurgia bariátrica pode ser mais efetiva do que quando aplicadas pressões positivas expiratória e inspiratória separadamente na restauração dos volumes e capacidades pulmonares e na mobilidade torácica. Método: Foram avaliadas 60 voluntárias adultas, obesas mórbidas, internadas para realização da cirurgia bariátrica. Afunção pulmonar e a mobilidade torácica foram avaliadas por meio da espirometria e da cirtometria no pré-operatório e reavaliadas no primeiro pós-operatório. Após a avaliação pré-operatória, as voluntárias foram randomizadas e alocadas nos grupos G EPAP (n=20), G RPPI (n=20) e G BIPAP (n=20) e então receberam a intervenção proposta, pressão positiva expiratória nas vias aéreas (EPAP), respiração por pressão positiva inspiratória (RPPI) ou pressão positiva binível nas vias aéreas (BIPAP), em sessões de seis séries de 15 respirações ou de 30 minutos, duas vezes ao dia no pós-operatório imediato e no primeiro pós-operatório, além do tratamento fisioterapêutico convencional. Resultados: Houve redução significativa das variáveis espirométricas no pós-operatório (p<0,05), independente do recurso utilizado, não havendo diferença significativa entre as técnicas (p>0,05), e preservação da mobilidade torácica somente nas voluntárias do grupo BIPAP (p>0,05), porém sem diferença nas comparações entre os grupos (p>0,05). Conclusão: A aplicação de pressão positiva parece não ser efetiva na restauração da função ...

Functional priorities reported by parents of children with cerebral palsy: contribution to the pediatric rehabilitation process / Prioridades funcionais identificadas por pais de crianças com paralisia cerebral:contribuições para o processo de reabilitação infantil

Background: Collaborative actions between family and therapist are essential to the rehabilitation process, and they can be a catalyst mechanism to the positive outcomes in children with cerebral palsy (CP). Objectives: To describe functional priorities established by caregivers of CP children by level of severity and age, and to assess changes on performance and satisfaction on functional priorities reported by caregivers, in 6-month interval. Method: 75 CP children, weekly assisted at Associação Mineira de Reabilitação, on physical and occupational therapy services. The following information was collected: gross motor function (Gross Motor Function Classification System-GMFCS) and functional priorities established by caregivers (Canadian Occupational Performance Measure-COPM). Data were collected in two moments, with a 6-month interval. Results: The main functional demands presented by caregivers were related to self-care activities (48.2%). Parents of children with severe motor impairment (GMFCS V) pointed higher number of demands related to play (p=0.0036), compared to the other severity levels. Parents of younger children reported higher number of demands in mobility (p=0.025) and play (p=0.007), compared to other age groups. After 6 months, there were significant increase on COPM performance (p=0.0001) and satisfaction scores (p=0.0001). Conclusions: Parents of CP children identified functional priorities in similar performance domains, by level of severity and age. Orienting the pediatric rehabilitation process to promote changes in functional priorities indentified by caregivers can contribute to the reinforcement of the parent-therapist collaboration. .

Contextualização: Ações colaborativas entre família e terapeuta são essenciais para o processo de reabilitação, podendo constituir mecanismo catalisador de desfechos funcionais positivos para crianças com paralisia cerebral (PC). Objetivos: Descrever prioridades funcionais identificadas por cuidadores de crianças com PC por nível de gravidade e idade e avaliar mudanças no desempenho e satisfação reportadas pelos cuidadores nas prioridades identificadas no intervalo de seis meses. Método: De 75 crianças com PC, atendidas semanalmente naAssociação Mineira de Reabilitação, nos serviços de fisioterapia e de terapia ocupacional, foram coletadas informações referentes à função motora grossa (Sistema de Classificação da Função Motora Grossa-GMFCS) e às prioridades funcionais estabelecidas pelos cuidadores (Medida Canadense de Desempenho Ocupacional-COPM). Os dados foram coletados em dois períodos, com intervalo de seis meses. Resultados: As principais demandas apontadas pelos cuidadores referiram-se às atividades de cuidados pessoais (48,2%). Pais de crianças com comprometimento motor grave (GMFCS V) apresentaram maior número de demandas relacionadas ao brincar (p=0,036), comparadas com outros níveis de comprometimento. Pais de crianças mais jovens reportaram maior número de demandas em mobilidade (p=0,025) e brincar (p=0,007) em relação aos outros grupos etários. Após seis meses, observou-se aumento significativo dos escores de desempenho (p=0,0001) e de satisfação (p=0,0001) da COPM. Conclusões: Pais de crianças com PC identificaram prioridades funcionais em áreas de desempenho semelhantes por nível de gravidade da função motora grossa e por grupo etário. Direcionar o processo ...

Breathing exercises: influence on breathing patterns and thoracoabdominal motion in healthy subjects / Exercícios respiratórios: influência sobre o padrão respiratório e o movimento toracoabdominal em indivíduos saudáveis

BACKGROUND: The mechanisms underlying breathing exercises have not been fully elucidated. OBJECTIVES: To evaluate the impact of four on breathing exercises (diaphragmatic breathing, inspiratory sighs, sustained maximal inspiration and intercostal exercise) the on breathing pattern and thoracoabdominal motion in healthy subjects. METHOD: Fifteen subjects of both sexes, aged 23±1.5 years old and with normal pulmonary function tests, participated in the study. The subjects were evaluated using the optoelectronic plethysmography system in a supine position with a trunk inclination of 45° during quiet breathing and the breathing exercises. The order of the breathing exercises was randomized. Statistical analysis was performed by the Friedman test and an ANOVA for repeated measures with one factor (breathing exercises), followed by preplanned contrasts and Bonferroni correction. A p<0.005 value was considered significant. RESULTS: All breathing exercises significantly increased the tidal volume of the chest wall (Vcw) and reduced the respiratory rate (RR) in comparison to quiet breathing. The diaphragmatic breathing exercise was responsible for the lowest Vcw, the lowest contribution of the rib cage, and the highest contribution of the abdomen. The sustained maximal inspiration exercise promoted greater reduction in RR compared to the diaphragmatic and intercostal exercises. Inspiratory sighs and intercostal exercises were responsible for the highest values of minute ventilation. Thoracoabdominal asynchrony variables increased significantly during diaphragmatic breathing. CONCLUSIONS: The results showed that the breathing exercises investigated in this study produced modifications in the breathing pattern (e.g., increase in tidal volume and decrease in RR) as well as in thoracoabdominal motion (e.g., increase in abdominal contribution during diaphragmatic breathing), among others. .

CONTEXTUALIZAÇÃO: Os mecanismos envolvidos na execução dos exercícios respiratórios não foram completamente elucidados. OBJETIVOS: Avaliar o impacto de quatro exercícios respiratórios(diafragmático, suspiros inspiratórios, inspiração máxima sustentada e intercostal) sobre o padrão respiratório e o movimento toracoabdominal em indivíduos saudáveis. MÉTODO: Participaram do estudo15 indivíduos de ambos os sexos (23±1,5 anos com prova de função pulmonar normal). Os indivíduos foram avaliados por meio da pletismografia optoeletrônica na posição supina com inclinação de tronco de 45° durante a respiração tranquila e durante a realização dos exercícios respiratórios. A ordem dos exercícios foi randomizada. Os dados foram analisados pelo teste de Friedman e ANOVA para medidas repetidas com um fator (exercícios respiratórios) seguidos de contrastes pré-planejados e correção de Bonferroni, sendo p<0,005 considerado significativo. RESULTADOS: Todos os exercícios respiratórios promoveram aumento significativo do volume corrente da parede torácica (VCpt) e redução da frequência respiratória (f) quando comparados à respiração tranquila. O exercício diafragmático foi responsável pelo menor VCpt, menor contribuição da caixa torácica e maior contribuição do abdômen. A inspiração máxima sustentada promoveu redução significativamente maior da f comparada aos exercícios diafragmático e intercostal. Os exercícios suspiros inspiratórios e intercostal foram responsáveis pelos maiores valores de ventilação minuto. Os índices de assincronia toracoabdominal aumentaram significativamente ...

El cuidado enfermero como problema ético: concepto y principios prácticos aplicados al acto de cuidado / Nursing care as an ethical problem: concepts and principles applied to the act of caring / O cuidado de enfermagem como problema ético: conceitos e princípios aplicados ao ato de cuidar

En este trabajo los autores estudian la naturaleza del acto del cuidado, destacan la importancia de la ética en las profesiones vinculadas con la salud de las personas y desarrollan, a la luz de la tradición central de la filosofía moral occidental, un conjunto de principios que deben guiar la actividad de la enfermería.

In this paper the authors study the nature of the act of care, emphasize the importance of ethics in the professions related to the health of people and develop, in the light of the central tradition of Western moral philosophy, a set of principles that should guide nursing activity.

Neste trabalho, os autores refletem sobre a natureza do ato de cuidar, enfatizam a importância da ética nas profissões relacionadas com a saúde das pessoas e desenvolvem, à luz da tradição central da filosofia moral ocidental, um conjunto de princípios que deve orientar o trabalho de enfermagem.

Comunicação não verbal entre enfermeiros e idosos à luz da proxêmica / Nonverbal communication between nurses and the elderly based on the proxemics / Comunicación no verbal entre enfermeros y ancianos a la luz de la proxémica

Objetivou-se analisar a comunicação não verbal entre enfermeiros e idosos na consulta de enfermagem à luz do referencial teórico de Hall. Estudo exploratório descritivo com abordagem quantitativa, realizado por filmagens das consultas de enfermagem com idosos em Unidades Básicas de Saúde do município de João Pessoa-Paraíba, analisadas a cada um minuto, totalizando 1.575 interações não verbais. A análise mostra predomínio de enfermeiros (90,63%) e idosos (65,63%) do sexo feminino e classificação regular para a maioria dos fatores com prevalência da postura sentada (80,09%), cadeiras uma em frente a outra (64,46%), distância pessoal (91,40%), expressão facial tranquila (59,78%), uso do toque apenas ao realizar um procedimento técnico (53,33%), interação visual enquanto manipula objetos (57,69%) e volume de voz inalterado (48,79%). Esses resultados refletem a necessidade de os enfermeiros dominarem conscientemente suas manifestações corporais e faciais a fim de melhor interagirem com o idoso.

The aim is to analyze the nonverbal communication between nurses and the elderly in the nursing consultation based on the theory by Hall. The research concerns a descriptive exploratory study and it has a quantitative approach. It took place through filmings of the nursing consultations which happened in Health Basic Units in João Pessoa, Paraíba, Brazil, observed every minute, a total of 1.575 nonverbal interactions. The analysis has showed the predominance of the female nurses (90.63%) and the elderly (65.63) and a regular classification for most of the factors as a prevalence of a sitting set (80.09), opposite chairs (64.46%), personal distance (91.40%), calm facial expression (59.78%), touch was used for a technical procedure (53.33%), visual interaction for the manipulation of the objects (57.69) and no alteration in the voice volume (48.79%). These results reflect the necessity of the nurses to domain consciously their corporal and facial manifestations in order to improve the interaction with the elderly.

El objetivo es analizar la comunicación no verbal entre enfermeros y ancianos en la consulta de enfermería bajo la teoría de Hall. Estudio exploratório descriptivo con abordaje cuantitativa, realizada a través de filmaciones de consultas con ancioanos en Unidades Básicas de Saúde de João Pessoa - Paraíba, totalizando 1.1575 interacciones no verbales. El análisis muestra predomínio de enfermeros (60,63%) y ancianos (65,63%) de sexo femenino y classificación Regular para la mayoría de factores con predominio de postura sentada (80,09%), sillas una frente a otra (64,46%), distancia personal (91,40%), expresión facial tranquila (59,78%), uso de contacto sólo para realizar procedimientos técnicos (53,33%), interacción visual cuando manipula objetos (57,69%) y volumen de voz inalterado (48,79%). Estos resultados reflejan la necessidad de que los enfermeros dominen conscientemente manifestaciones corporales y faciales a fin de mejorar la interacción con el anciano.

Applying Nightingale charts to evaluate the heterogeneity of biomedical waste in a Hospital / Aplicação de gráficos nightingaleanos para avaliação da heterogeneidade de Resíduos de Serviço de Saúde de um hospital / Aplicación de gráficos Nightingale para la evaluación de la heterogeneidad de los residuos sanitarios en un Hospital

OBJECTIVES: to evaluate the heterogeneity of biomedical waste (BW) using Nightingale charts. METHOD: cross-sectional study consisting of data collection on wastes (direct observation of receptacles, physical characterisation, and gravimetric composition), development of a Management Information System, and creation of statistical charts. RESULTS: the wastes with the greatest degree of heterogeneity are, in order, recyclable, infectious, and organic wastes; chemical waste had the most efficient segregation; Nightingale charts are useful for quick visualisation and systematisation of information on heterogeneity. CONCLUSION: the development of a management information system and the use of Nightingale charts allows for the identification and correction of errors in waste segregation, which increase health risks and contamination by infectious and chemical wastes and reduce the sale and profit from recyclables. .

OBJETIVO: avaliar a heterogeneidade dos Resíduos de Serviço de Saúde por meio da aplicação de gráficos nightingaleanos. MÉTODO: estudo transversal, que consiste na coleta de dados sobre resíduos (observação direta dos locais de armazenamento, caracterização física e composição gravimétrica), desenvolvimento de um Sistema de Informação Gerencial e construção de gráficos estatísticos. RESULTADOS: os resíduos que apresentam maior grau de heterogeneidade são os recicláveis, infectantes e orgânicos, respectivamente; o resíduo químico atingiu maior eficiência na segregação; os gráficos nightingaleanos são úteis na visualização rápida e na sistematização das informações sobre a heterogeneidade. CONCLUSÃO: o desenvolvimento de um sistema de informação gerencial e a utilização dos gráficos nigthingaleanos permite identificar e corrigir erros na segregação dos resíduos que impactam tanto no aumento de riscos à saúde e de contaminação por resíduos infectantes e químicos como na redução da comercialização e receita com os recicláveis. .

OBJETIVO: evaluar la heterogeneidad de los residuos sanitarios (RS) usando gráficos Nightingale. MÉTODO: estudio transversal que consiste en la recopilación de datos sobre los residuos (observación directa de los recipientes, caracterización física y composición gravimétrica), desarrollo de un Sistema de Información para la Gestión y creación de gráficos estadísticos. RESULTADOS: los residuos con el mayor grado de heterogeneidad son los reciclables, infecciosos, y los residuos orgánicos, respectivamente; la segregación de los residuos químicos fue la más eficiente; los gráficos Nightingale son útiles para la visualización rápida y sistematización de la información sobre la heterogeneidad. CONCLUSIÓN: el desarrollo de un sistema de información para la gestión y el uso de gráficos Nightingale permiten la identificación y corrección de errores en la separación de los residuos; dichos errores aumentan los riesgos de salud y la contaminación por residuos infecciosos y químicos, y reducen la venta y beneficio obtenible de los materiales reciclables. .

The health-disease process and the family health strategy: the user's perspective / Processo saúde/doença e estratégia de saúde da família: o olhar do usuário / El proceso salud-enfermedad y la estrategia salud de la familia: la perspectiva del usuario

OBJECTIVE: to analyze the meanings Primary Health Care users attribute to their health-disease process and the services used. METHODS: this qualitative research uses the focus group technique to interview two groups of users the service monitors. The first is a group of elderly people and the second of pregnant women. To analyze the meanings, the discourse analysis technique and the reference framework of health promotion are used. RESULTS: the group of elderly, being mostly female arterial hypertension and diabetes mellitus patients, visualizes the health-disease process as the evolution of human existence controlled by divine power, signifying the health service as a blessing in the control of the disease. The Group of young pregnant women signified health as the ability for self-care and disease as the disability for that purposes, considering the Primary Health Care service as responsible for the recovery of individual and family health. FINAL CONSIDERATIONS: the users demonstrated dissatisfaction with bureaucratic and vertical relations present at the health services. In each group, it was observed that the meanings for health and disease and meanings of the health service the users elaborated can be related. .

OBJETIVO: analisar os significados atribuídos pelos usuários da Atenção Primária à Saúde ao seu processo de saúde/doença e aos serviços utilizados. MÉTODOS: pesquisa qualitativa utilizando a técnica do grupo focal para entrevista com dois grupos de usuários acompanhados pelo serviço, sendo o primeiro um grupo de idosos e o segundo, de mulheres gestantes. Para análise dos significados, usou-se a técnica de análise de discurso e referencial da promoção em saúde. RESULTADOS: grupo de idosos, maioria feminina, portadores de hipertensão arterial e diabetes mellitus, visualiza o processo de saúde/doença como evolução da existência humana controlada pelo poder divino, significando o serviço de saúde como uma bênção no controle da doença. O grupo de gestantes jovens significou saúde como capacidade para autocuidado e doença como incapacidade para tal, concebendo o serviço de Atenção Primária como responsável pela recuperação da saúde individual e familiar. CONSIDERAÇÕES FINAIS: os usuários demonstraram insatisfação com relações burocratizadas e verticalizadas presentes no serviço de saúde. Observou-se, em cada grupo, que significados para saúde e doença e significados do serviço de saúde elaborados pelos usuários podem estar relacionados. .

OBJETIVO: analizar los significados atribuidos por los usuarios de la Atención Primaria de la Salud al proceso salud-enfermedad y a los servicios utilizados. MÉTODOS: investigación cualitativa que utiliza la técnica del grupo focal para entrevistar a dos grupos de usuarios acompañados por el servicio, el primer grupo de ancianos y el segundo de mujeres embarazadas. Para el análisis de los significados, fue usada la técnica de análisis de discurso y el referencial de la promoción de la salud. RESULTADOS: grupo de ancianos, mayoría femenina, con hipertensión arterial y diabetes mellitus, entiende el proceso salud-enfermedad como una evolución de la existencia humana controlada por el poder divino, significando al servicio de salud como una bendición para el control de la enfermedad. Para el Grupo de embarazadas jóvenes significó: la salud como una capacidad para el autocuidado y la enfermedad como la incapacidad para eso, concibiendo al servicio de Atención Primaria como responsable por la recuperación de la salud individual y familiar. CONSIDERACIONES FINALES: los usuarios demostraron insatisfacción con las relaciones burocratizadas y verticales, presentes en el servicio de salud. Se observó en cada grupo que los significados para salud y enfermedad y los significados del servicio de salud elaborados por los usuarios pueden estar relacionados. .

Componentes volátiles de Eriope crassipes, Hyptis conferta, H. dilatata, H. brachiata, H. suaveolens y H. mutabilis (Lamiaceae) / Volatile compounds of analysis of Eriope crassipes, Hyptis conferta, H. dilatata, H. brachiata, H. suaveolens y H. mutabilis (Lamiaceae)

This work presents the analysis by GC-MS of volatile metabolites of six Lamiaceae from Arauca (Colombia). In stems and leaves of Eriope crassipes were determined as the most abundants: citronellic acid (53,8 percent and 66,2 percent), and methyl citronellate (15,7 percent and 14,5 percent). In the inflorescences of Hyptis conferta were identified: t-cadinol (49,4 percent), and caryophyllene oxide (13,0 percent). From leaves and flowers of Hyptis dilatata were found: delta-3-carene (11,0 percent and 0,5 por ciento), camphor (43,8 percent and 12,2 percent), bornyl acetate (3,2 percent and 25,5 percent), E-caryophyllene (12,8 percent and 22,3 percent), and palustrol (6,0 percent and 10,3 percent). In the leaves of Hyptis brachiata were recognized: E-caryophyllene (8,3 percent), alpha-humulene (19,8 percent), and germacrene D (13,0 percent). The principal compounds in leaves and flowers of Hyptis suaveolens were: alpha-phellandrene (9,4 percent and 0,4 percent), limonene (10,5 percent and 2,5 percent), 1,8-cineole (1,3 percent and 15,2 por ciento), fenchone (10,8 por ciento and tr), E-caryophyllene (26,3 por ciento and 8,0 por ciento), and germacrene D (6,7 por ciento and 14,0 por ciento). In the leaves of Hyptis mutabilis were determined: sabinene (6,6 percent) beta-elemene (6,8 percent), germacrene D (14,9 percent), beta-selinene (8,8 percent), alpha-selinene (9,1 percent), and bicyclogermacrene (6,1 percent), as the most abundants.

Este trabajo presenta el análisis por GC-MS de los metabolitos volátiles de seis Lamiaceae recolectadas en Arauca (Colombia). En tallos y hojas de Eriope crassipes se determinaron como mayoritarios: ácido citronélico (53,8 por ciento y 66,2 por ciento), y citronelato de metilo (15,7 por ciento y 14,5 por ciento). En las inflorescencias de Hyptis conferta se identificaron: t-cadinol (49,4 por ciento), y óxido de cariofileno (13,0 por ciento). En hojas y flores de Hyptis dilatata se encontraron: delta-3-careno (11,0 por ciento y 0,5 por ciento), alcanfor (43,8 por ciento y 12,2 por ciento), acetato de bornilo (3,2 por ciento y 25,5 por ciento), E-cariofileno (12,8 por ciento y 22,3 por ciento), y palustrol (6,0 por ciento y 10,3 por ciento). En las hojas de Hyptis brachiata se reconocieron: E-cariofileno (8,3 por ciento), alfa-humuleno (19,8 por ciento), y germacreno D (13,0 por ciento). Los compuestos principales en hojas y flores de Hyptis suaveolens fueron: alfa-felandreno (9,4 por ciento y 0,4 por ciento), limoneno (10,5 por ciento y 2,5 por ciento), 1,8-cineol (1,3 por ciento y 15,2 por ciento), fenchona (10,8 por ciento y tr), E-cariofileno (26,3 por ciento y 8,0 por ciento), y germacreno D (6,7 por ciento y 14,0 por ciento). En las hojas de Hyptis mutabilis se determinaron: sabineno (6,6 por ciento), beta-elemeno (6,8 por ciento), germacreno D (14,9 por ciento), beta-selineno (8,8 por ciento), alfa-selineno (9,1 por ciento), y biciclogermacreno (6,1 por ciento), como los más abundantes.

The application of UPLC-MS/MS to detect precursors of perfluorooctanoic acid and perfluoroalkyl carboxylatesin serum / 中华预防医学杂志

<p><b>OBJECTIVE</b>We established a method of UPLC-MS/MS that was to detect fifteen precursors of perfluoroalkyl sulfonates (PFSA) and perfluoroalkyl carboxylates (PFCA) in serum.</p><p><b>METHODS</b>Briefly, TBAS solution was added to sera, then the mixed solution was extracted with aliquots of MTBE. The MTBE aliquots were combined, evaporated to dryness under nitrogen, and reconsituted in 0.25 ml of methanol and water (1:1). Then the reconstituted solution through 0.2 µm nylon syringe filter was collected. Chromatographic separation was performed using a Waters ACQUITY (TM) BEH ¹⁸C column (50 mm × 2.1 mm × 1.7 mm). Analyte quantitation was performed in the negative electrospray ionization mode and multiple reaction monitoring (MRM).</p><p><b>RESULTS</b>Three target substances, 6: 6PFPi, 6: 8PFPi, 8: 8PFPi, were externally confirmed by standard addition. Rates of recovery for these three chemicals were from 41.01% to 112.13% in two standard levels. And the relative standard deviations (RSD) were lower than 11.63% and higher than 1.80%. The other twelve substances were quantified with internal standard. Moreover in two standard levels, rate of recovery for these chemicals ranged from 70.25% to 127.51%. And RSD were more than 1.23% and less than 15.45%. And the corresponding limit of detection (LOD) and limit of quantitation (LOQ) for all target substances were 0.1-5.0 pg/ml and 0.2-10.0 pg/ml. Then we detected these target substances in ten different human serum samples. The levels of few substances were higher than LOD. And the ranges of FOSA-M, N-EtFOSA-M, N-MeFOSAA, N-EtFOSAA were respectively < LOD-0.94 pg/ml, < LOD-10.08 pg/ml, < LOD-6.74 pg/ml, < LOD-1.04 pg/ml.</p><p><b>CONCLUSION</b>The method, with high sensitivity and accuracy, could meet the actual testing requirements.</p>

Validation of Octanoate Breath Test for Measuring Gastric Emptying in Rats

BACKGROUND/AIMS: Lack of simple and repeatable tests hampers gastric emptying studies in rats. The aim of this study was to adapt the 14C-octanoate solid gastric emptying breath test for application in rats, and to validate it against radioscintigraphic method. METHODS: After ingestion of a meal containing 3 mCi 99mTc and 2 microCi 14C-octanoate, 23 male Wistar rats were placed on a gamma camera in a airflow container. Scintigraphic images were taken at regular intervals. The amount of 14CO2 in a regularly replaced hyamine hydroxide solution, capturing CO2 in the outflow air, was counted using liquid scintillation spectrometry. 99mTc gastric retention curves and 14CO2-excretion curves were fitted to their respective data. Three rats underwent the same procedures after administration of atropine. RESULTS: Overall Tr10% (time at which 10% of the original amount of 99mTc remained in the stomach) was 355 +/- 64 minutes; Te90% (time at which 90% of total amount of 14CO2 was excreted) was 325 +/- 106 minutes. Their correlation coefficient was 0.71, R-square 0.50 and P < 0.005. Tr1/2 (50% of original amount of 99mTc remained) was 124 +/- 28 minutes; Te1/2 (50% of total amount of 14CO2 excreted) 114 +/- 32 minutes. Their correlation coefficient was 0.83 with R-square of 0.69 and P < 0.00005. In 12 immobilized animals correlation was even better: correlation coefficient 0.84; R-square 0.71 and P < 0.001 (Tr10% was 388 +/- 117 minutes; Te90% 532 +/- 219 minutes; Tr1/2 of 165 +/- 54 minutes; Te1/2 of 175 +/- 67 minutes). Atropine significantly lengthened all emptying times: 904 +/- 307 and 1461 +/- 684 minutes for Tr10% and Te90%, respectively; and 432 +/- 117 minutes for Tr1/2 and 473 +/- 190 minutes for Te1/2. CONCLUSIONS: We adapted and validated the 14C-octanoate gastric emptying breath test for application in rats.

Mechanisms of hydroxypropyl methylcellulose for the precipitation inhibitor of supersaturatable self-emulsifying drug delivery systems / 药学学报

Hydroxypropyl methylcellulose (HPMC) propels self-emulsifying drug delivery systems (SEDDS) to achieve the supersaturated state in gastrointestinal tract, which possesses important significance to enhance oral absorption for poorly water-soluble drugs. This study investigated capacities and mechanisms of HPMC with different viscosities (K4M, K15M and K100M) to inhibit drug precipitation of SEDDS in the simulated gastrointestinal tract environment in vitro. The results showed that HPMC inhibited drug precipitation during the dispersion of SEDDS under gastric conditions by inhibiting the formation of crystal nucleus and the growth of crystals. HPMC had evident effects on the rate of SEDDS lipolysis and benefited the distribution of drug molecules across into the aqueous phase and the decrease of drug sediment. The mechanisms were related to the formed network of HPMC and its viscosities and molecular weight. These results offered a reference for selecting appropriate type of HPMC as the precipitation inhibitor of supersaturatable SEDDS.

A Comparative Study on Mechanical and Biochemical Properties of Bovine Pericardium After Single or Double Crosslinking Treatment

BACKGROUND AND OBJECTIVES: Glutaraldehyde (GA) has been used as a representative method of tissue preservation in cardiovascular surgery. However, GA has showed limited durability including calcification, mechanical failure and toxicity. To overcome those unsolved problems, we analyzed the crosslinking differences of primary amines, GA and genipin in their mechanical and biochemical properties with a single or double crosslinking agent for clinical application. MATERIALS AND METHODS: Samples were divided into 3 groups; control, single crosslinking fixation and double crosslinking fixation after decellurarization using bovine pericardium. For analysis of the biochemical and mechanical properties of each crosslinking method, tensile strength, percentage strain, thermal stability, resistance to pronase, nynhydrin and cytotoxicity test were studied. RESULTS: Combined hexamethylene diamine and suberic acid in the carbodiimide hydrochloride/N-hydroxysucinimide solution (EDC/NHS) after decellurarization, tensile strength and strain percentage were not statistically significant compared to the single crosslinking treated groups (p>0.05). Tissue crosslinking stability was weak in single treatment of diphenylphosphoryl azide, suberic acid, low concentration of EDC, hexamethylene diamine and procyanidin groups, but thermal stability and resistance to the pronase and ninhydrin were markedly increased in concentrated EDC/NHS or after combined double treatment with low concentration of GA or genipin (p<0.001). CONCLUSION: Single or double crosslinking with low concentration of carbodiimide, diphenylphosphonyl azide, procyanidin, suberic acid and hexane diamine were not as effective in mechanical, biochemical, cytotoxic and crosslinking properties compared to GA or genipin fixation, but their mechanical and chemical properties were much improved when combined with low concentrations of GA or genipin in the double crosslinking process.

Switch of substrate specificity of hyperthermophilic acylaminoacyl peptidase by combination of protein and solvent engineering

The inherent evolvability of promiscuous enzymes endows them with great potential to be artificially evolved for novel functions. Previously, we succeeded in transforming a promiscuous acylaminoacyl peptidase (apAAP) from the hyperthermophilic archaeon Aeropyrum pernix K1 into a specific carboxylesterase by making a single mutation. In order to fulfill the urgent requirement of thermostable lipolytic enzymes, in this paper we describe how the substrate preference of apAAP can be further changed from p-nitrophenyl caprylate (pNP-C8) to p-nitrophenyl laurate (pNP-C12) by protein and solvent engineering. After one round of directed evolution and subsequent saturation mutagenesis at selected residues in the active site, three variants with enhanced activity towards pNP-C12 were identified. Additionally, a combined mutant W474V/F488G/R526V/T560W was generated, which had the highest catalytic efficiency (k (cat)/K (m)) for pNP-C12, about 71-fold higher than the wild type. Its activity was further increased by solvent engineering, resulting in an activity enhancement of 280-fold compared with the wild type in the presence of 30% DMSO. The structural basis for the improved activity was studied by substrate docking and molecular dynamics simulation. It was revealed that W474V and F488G mutations caused a significant change in the geometry of the active center, which may facilitate binding and subsequent hydrolysis of bulky substrates. In conclusion, the combination of protein and solvent engineering may be an effective approach to improve the activities of promiscuous enzymes and could be used to create naturally rare hyperthermophilic enzymes.

Early Satiety Is the Only Patient-Reported Symptom Associated With Delayed Gastric Emptying, as Assessed by Breath-Test

BACKGROUND/AIMS: To evaluate associations between delayed gastric emptying (GE) assessed by the octanoic acid breath test and upper gastrointestinal (GI) symptoms. METHODS: A historical, prospective study included 111 consecutive symptomatic adults referred for a GE breath test because of upper abdominal symptoms suggestive of delayed GE. Exclusion criteria included underlying organic disease associated with delayed GE. Patients completed a symptom questionnaire and underwent a GE octanoic breath test. Patients with delayed GE were compared with those with normal results, for upper GI symptoms. RESULTS: Early satiety was the only symptom significantly associated with delayed GE. It was observed in 52% of subjects with delayed GE compared to 33% patients with no evidence of delayed GE (P = 0.005). This association was seen for all degrees of severity of delayed GE. Patients with early satiety had a t1/2 of 153.9 +/- 84.6 minutes compared to 110.9 +/- 47.6 minutes in subjects without it (P = 0.002). In a logistic regression model, early satiety was significantly associated with delayed GE (OR, 2.29; 95% CI, 1.01-5.18; P = 0.048). CONCLUSIONS: Early satiety is the only patient-reported GI symptom associated with delayed GE. The utility of GE tests as a clinical diagnostic tool in the work-up of dyspeptic symptoms may be overrated.

Establishment and evaluation of a dynamic in vitro intestinal absorption model of lipid formulations / 药学学报

A new dynamic in vitro intestinal absorption model for screening and evaluating lipid formulations was established by means of the characteristics of the intestinal digestion and absorption of the lipid formulations. This model was composed of two systems, including intestinal digestion and the intestinal tissue culture, which drew the evaluation method of intestinal absorption into the in vitro lipolysis model. The influence of several important model parameters such as Ca2+, D-glucose, K+ on the two systems of this model has been investigated. The results showed that increasing of Ca2+ concentration could be significantly conductive to intestinal digestion. The increasing of D-glucose concentration could stepped significantly down the decay of the intestinal activity. K+ was able to maintain intestinal activity, but the influence of different concentration levels on the decay of the intestinal activity was of no significant difference. Thus the model parameters were set up as follows: Ca2+ for 10 mmol x L(-1), D-glucose for 15 mmol x L(-1) and K+ for 5.5 mmol x L(-1). Type I lipid formulation was evaluated with this model, and there was a significant correlation between the absorption curve in vitro and absorption curve in vivo of rats (r = 0.995 6, P < 0.01). These results demonstrated that this model can be an attractive and great potential method for the screening, evaluating and predicting of the lipid formulations.