The effect of buzzy®, DistrACTION® cards on reducing pediatric pain and fear during blood collection in the rheumatology polyclinic: A randomized controlled trial.

PURPOSE: The aim of this study was to compare the effectiveness of Buzzy® and DistrACTION® Cards in reducing children's pain and fear while taking venous blood samples. METHODS: This research was designed as a randomized controlled experimental study. The study population consisted of children aged 6-12 years admitted to the Pediatric Rheumatology Diseases Polyclinic in a Faculty of Medicine in Germany. The sample of the study consisted of 96 children (Buzzy® = 32, DistrACTION® Cards = 32, control = 32) who met the patient selection criteria and agreed to participate in the study. The data were obtained using a Child and Family Information Form, the Children Fear Scale (CFS), and the Faces Pain Scale-Revised (FPS-R). The data were evaluated using the Pearson chi-square test, Kruskal-Wallis test, One-way ANOVA test with Bonferroni correction, and Fisher-Freeman-Halton. FINDINGS: In the study, the average age of the children was 9.21 ± 2.15 years. The Buzzy® group had the lowest pain and procedural fear scores (self-report = 0.88 ± 1.13, 0.31 ± 0.47; parent report = 0.75 ± 0.98, 0.34 ± 0.48, and researcher report = 0.81 ± 1.00, 0.31 ± 0.54, respectively) than the DC, and control groups. CONCLUSIONS: The Buzzy® method was effective in reducing venipuncture pain and fear in children. PRACTICE IMPLICATIONS: Nurses can use the Buzzy® methods to help reduce venipuncture pain and fear in children. The clinical trial registration number is NCT05560074. (https://clinicaltrials.gov/ct2/show/study/NCT05560074).

The diagnostic value of miR-21 combined with CT in patients with liver cancer

Purpose To explore the diagnostic value of miR-21 combined with computed tomography (CT) in patients with liver cancer. Methods A total of 112 patients in our hospital were confirmed liver cancer by examination, and were collected as cancer group. Another 100 patients with hepatic focal nodular hyperplasia in the same period were collected as control group. The diagnostic value of miR-21 and CT on liver cancer was observed. Results The level of miR-21 in cancer group was significantly higher than that in control group, the difference was statistically significant (p < 0.05). The alpha-fetoprotein (AFP) level was tested. It was found that the AFP level in cancer group was significantly higher than that in control group (p < 0.001). The correlation between AFP and miR-21 levels in liver cancer patients was detected. It turned out that AFP and miR-21 had correlation. According to receiver operating curve (ROC) calculation results, the best cut-off value for miR-21 diagnosis was 4.142. The sensitivity, specificity and accuracy of diagnosis of miR-21 alone were 64.29%, 87.00% and 75.00%, respectively. The sensitivity, specificity and accuracy of diagnosis of CT alone were 91.07%, 62.00% and 77.36%, respectively. There were 108 cases of true positive and 80 cases of true negative after combined diagnosis in the two groups. The sensitivity, specificity and accuracy of combined diagnosis were 96.43%, 80.00% and 88.68%, respectively. Comparing the value of single diagnosis and combined diagnosis, we found that the accuracy, sensitivity and specificity of combined diagnosis were significantly higher than that of single diagnosis (p < 0.05). Conclusion CT combined with miR-21 has great diagnostic value in liver cancer and may be a potential diagnostic indicator for liver cancer (AU)

The diagnostic value of miR-21 combined with CT in patients with liver cancer.

PURPOSE: To explore the diagnostic value of miR-21 combined with computed tomography (CT) in patients with liver cancer. METHODS: A total of 112 patients in our hospital were confirmed liver cancer by examination, and were collected as cancer group. Another 100 patients with hepatic focal nodular hyperplasia in the same period were collected as control group. The diagnostic value of miR-21 and CT on liver cancer was observed. RESULTS: The level of miR-21 in cancer group was significantly higher than that in control group, the difference was statistically significant (p < 0.05). The alpha-fetoprotein (AFP) level was tested. It was found that the AFP level in cancer group was significantly higher than that in control group (p < 0.001). The correlation between AFP and miR-21 levels in liver cancer patients was detected. It turned out that AFP and miR-21 had correlation. According to receiver operating curve (ROC) calculation results, the best cut-off value for miR-21 diagnosis was 4.142. The sensitivity, specificity and accuracy of diagnosis of miR-21 alone were 64.29%, 87.00% and 75.00%, respectively. The sensitivity, specificity and accuracy of diagnosis of CT alone were 91.07%, 62.00% and 77.36%, respectively. There were 108 cases of true positive and 80 cases of true negative after combined diagnosis in the two groups. The sensitivity, specificity and accuracy of combined diagnosis were 96.43%, 80.00% and 88.68%, respectively. Comparing the value of single diagnosis and combined diagnosis, we found that the accuracy, sensitivity and specificity of combined diagnosis were significantly higher than that of single diagnosis (p < 0.05). CONCLUSION: CT combined with miR-21 has great diagnostic value in liver cancer and may be a potential diagnostic indicator for liver cancer.

[The research progress of keratin's roles in the pathology of middle ear cholesteatoma].

Keratin (K) is the main component of the epithelial cell mesenchymal cytoskeleton, which protects the integrity of epithelial cells and maintains the function of normal epithelial cells. The expression of keratin affects epidermal proliferation and differentiation, and so as to be used as a marker for proliferation, differentiation and migration of keratinocytes. Middle ear cholesteatoma is one of the common ear diseases. In the middle ear cholesteatoma, keratinocytes over-proliferate and keratin debris accumulates. In this paper, we reviewed the recent studies on middle ear cholesteatoma and explained the possible mechanisms of keratin in the pathogenesis of middle ear cholesteatoma from the aspects of "proliferation" and " bone resorption ". At the same time, the existing problems as well as the prospect of the future research were discussed.

[The efficacy of cognitive behavioral therapy in insomnic patients with or without comorbidities: a pilot study].

Objectives: To evaluate the effectiveness of cognitive behavior therapy for insomnia (CBT-i) in chronic insomnia patients in terms of the improvements of psychological and sleep diary parameters. Methods: Patients who met the diagnostic criteria of chronic insomnia, were divided into primary group or comorbid group. Both groups received standard CBT-i interventions. Psychological scales and sleep diaries were used to evaluate participants' severity of insomnia and psychological conditions related to insomnia at four time points: before intervention (baseline), immediate after intervention, 4 weeks and 16 weeks after intervention. Results: Both groups achieved significant improvements after intervention on psychological measurements and sleep diary parameters. Such improvements were maintained at 4-week and 16-week follow-ups. The sleep diary data indicated that by the end of the intervention, there were significant differences on sleep onset latency (51.72 min to 10.53 min in primary group, P<0.01; 59.26 min to 15.67min in comorbid group, P<0.01) and sleep efficiency (71% to 95% in primary group, P<0.01; 68% to 90% in comorbid group, P<0.01). There were differences on sleep onset latency (10.00 min vs. 13.93 min, P<0.05), total sleep time (355.71 min vs. 327.85 min, P<0.05) and sleep efficiency (95% vs. 91%, P<0.01) in primary group and comorbid group respectively. No differences were found on wake after sleep onset in the two groups. Conclusions: Chronic insomnia patients with or without comorbidities both have improvements after CBT-i. Sleep diary parameters rather than psychological measurements are different in two groups. Thus, CBT-i is an effective non-pharmaceutical therapy inpatients with chronic insomnia.

The overexpression of Fra1 disorders the inflammatory cytokine secretion by mTEC of myasthenia gravis thymus.

The thymus of a myasthenia gravis (MG) patient is often accompanied by and effected with follicular hyperplasia. Inflammatory cytokines in thymus induce the formation of germinal centres (GC). MG thymic inflammatory cytokines are predominantly secreted by stromal cells. Our previous studies revealed that the expression level of the Fra1 protein, which is a Fos member of the activator protein 1 transcription factors (AP-1), was higher in the MG thymus compared with that of the normal thymus. Based on that, we demonstrated that Fra1 was mainly expressed in medulla thymic epithelial cells (mTECs) and that the rate of Fra1 positive mTECs in the MG thymus was higher than normal. In vitro, we found that the expression of CCL-5, CCL-19 and CCL-21 could be regulated by Fra1 in mTEC and that IL-1ß, IL-6, IL-8 and ICAM1 were downregulated in the Fra1 overexpression group and upregulated in the Fra1 knock-down group. Meanwhile, we detected that the expression levels of suppressor of cytokine signalling 3 (SOCS3) were significantly upregulated along with the overexpression of Fra1. Hence, we considered that the overexpression of Fra1 disrupted inflammatory cytokine secretion by mTEC in the MG thymus and that STAT3 and SOCS3 were strongly involved in this process.

[Which route leads from chronic back pain to depression? A path analysis on direct and indirect effects using the cognitive mediators catastrophizing and helplessness/hopelessness in a general population sample]. / Welcher Weg führt von chronischen Rückenschmerzen zur Depressivität? Eine Pfadanalyse zu direkten und indirekten Effekten unter Berücksichtigung kognitiver Mediatoren des Katastrophisierens und der Hilf-/Hoffnungslosigkeit in einer Allgemeinbevölkerungsstichprobe.

BACKGROUND: Chronic pain and depression are highly comorbid; however, the longitudinal link is only partially understood. This study examined direct and indirect effects of chronic back pain on depression using path analysis in a general population sample, focussing on cognitive mediator variables. METHODS: Analyses are based on 413 participants (aged 18-75 years) in a population-based postal survey on back pain who reported chronic back pain at baseline. Follow-up data were collected after 1 year. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Fear-avoidance-beliefs (FABQ), catastrophizing and helplessness/hopelessness (KRSS) were considered as cognitive mediators. Data were analyzed using path analysis. RESULTS: Chronic back pain had no direct effect on depression at follow-up when controlling for cognitive mediators. A mediating effect emerged for helplessness/hopelessness but not for catastrophizing or fear-avoidance beliefs. CONCLUSIONS: These results support the cognitive mediation hypothesis which assumes that psychological variables mediate the association between pain and depression. The importance of helplessness/hopelessness is of relevance for the treatment of patients with chronic back pain.

Methods for increasing nitrile biotransformation into amides using Mesorhizobium sp.

Nitriles are potential soil pollutants from industrial wastewater. There has been increased demand for efficient process for nitrile degradation process. Nitrile hydratase (NHase) has been extensively used in the production of acrylamide and treatment of organocyanide contaminated industrial effluents. The NHase of Mesorhizobium sp., isolated from polyacrylonitrile activated sludge from fiber manufacturing wastewater treatment systems was studied in the whole bacterial cells. Different chemicals were added to observe the variation in the percentage of acrylonitrile converted into acrylamide. The result indicated that cobalt ions were the NHase cofactor and could increase the NHase activity. The addition of propionaldehyde, or butyraldehyde could enhance the acrylonitrile conversion rate. Therefore, acrylamide could be accumulated effectively and the percentage of acrylonitrile converted into acrylamide increased. Propionaldehyde was the most effective NHase activator. The percentage of acrylonitrile converted into acrylamide was nearly 100% at 3.8 h when propionaldehyde was added at about 207.4 mg/l. The addition of benzaldehyde was unable to increase the percentage of acrylonitrile converted into acrylamide. EDTA and acrylamide showed no effect on NHase activity. However, 0.1 mg/l of Ag2SO4 would slightly inhibit NHase activity, producing an acrylonitrile conversion rate of 492.9 mg/l with 54.9% converted at 29.1 h. The ability of the acrylonitrile biotransformation was completely inhibited if the Ag2SO4 concentration was above 0.5 mg/l.

Comparison of blood counts in splenic, renal and mesenteric arterial and venous blood in post-pubertal rabbits.

OBJECTIVES: To compare blood counts between arterial and venous blood to and from visceral organs and indirectly look into the function of the organs. METHODS: Splenic, renal and superior mesenteric arterial and venous blood samples were obtained from the arteries and veins in 38 post-pubertal rabbits and blood profile, including complete and differential blood counts, haemoglobin concentration and haematocrit, were measured with an automatic haematology analyser. RESULTS AND CONCLUSIONS: The rabbit spleen released a large amount of leucocytes (both lymphocytes and granulocytes) into the splenic venous blood (a venous increase of 33% in total leucocyte count), and also received more leucocytes (36-58% more in terms of concentration) from the artery than the kidney or intestine. Significantly fewer red blood cells were present in the renal venous blood than in the arterial blood (a venous reduction of 5% in erythrocyte count), but it remains to be clarified why and how the reduction was induced. More than 3-4% of water might be taken into the mesenteric venous blood during microcirculation (a venous reduction of 3-4% in erythrocyte-related parameters) and a significant number of leucocytes (mainly large leucocytes) in the mesenteric blood capillaries might migrate into the surrounding intestinal tissue (a venous reduction of 13% in leucocyte count).

Titanium(IV) chloride and quaternary ammonium salt promoted Baylis-Hillman reaction.

The Baylis-Hillman reaction of aldehydes with alpha,beta-unsaturated ketones can be drastically affected by the reaction temperature and Lewis bases. When the reaction was carried out at -78 degrees C using catalytic amounts of quaternary ammonium salts (R4N+X-, X = Cl, Br, I) as Lewis bases, in the presence of titanium(IV) chloride, the chlorinated aldol adduct 1 was obtained as the major product. Quaternary ammonium bromides and iodides (R4N+X-, X = Br, I) have higher catalytic activity than corresponding chlorides (R4N+Cl-). Quaternary ammonium fluorides (R4N+F-) do not have activity at all. The amounts of Lewis acid and quaternary ammonium salts used affect the reaction rate and product. A plausible reaction mechanism is proposed. If the reaction was carried out at room temperature (about 20 degrees C) in the presence of titanium(IV) chloride and quaternary ammonium salts (R4N+X-, X = Cl, Br, I), the elimination product 3, derived from 1, was formed as the major product.

[Electrophoretic migration behavior of deoxyribonucleic acid fragments in three polymer solution concentration regions].

The theory of polymer coils shrinking in semi-dilute solution has recently been developed on polymer solution. The polymer solution from coils shrinking concentration Cs to uniform entangled concentt concentration C+ has been defined as semi-dilute solution. We experimentally investigated the electrophoretic migration behavior of 100 bp deoxyribonucleic acid (DNA) Ladder in hydroxypropyl methyl cellulose (HPMC) concentration ranging from 1.25 g/L to 16.06 g/L. The friction force mobility mu f is used to express the friction force that DNA will encounter in capillary electrophoresis. Our results indicate the division of polymer solution into three regions depending on the relationship of mu f and HPMC concentration and Ferguson plot. Resolutions of 200 bp/300 bp and 700 bp/800 bp show semi-dilute polymer solution suits large fragments and small fragments DNA separation respectively. the results confirm that the current polymer theory is valid under actual CE condition.

Myoglobin clearance during continuous veno-venous hemofiltration with or without dialysis.

The management of acute myoglobinuric renal failure, the major complication of rhabdomyolysis, continues to be a treatment dilemma for the clinician as limited therapeutic options are available. Previously, we have demonstrated that continuous arteriovenous hemofiltration (CAVH) is an effective technique for removing myoglobin in an animal model. In the present study, swine were administered four grams of equine myoglobin intravenously and underwent the continuous veno-venous hemofiltration (CVVH) procedure for six hours each. Animals were studied in each of the following groups: CVVH at a pump rate 100 ml/minute, CVVH at a pump rate 200 ml/minute and CVVH at a pump rate 100 ml/minute plus dialysis at a dialysate flow rate of one Liter/h. Once the filtering process was initiated there was a rapid and sustained production of ultrafiltrate in all groups. The amount of myoglobin excreted in the ultrafiltrate over the six-hour filtering period was 688, 948 and 570 mg which corresponded to 17, 24 and 14 percent of the administered dose, respectively, for the three treatments. In comparison to previous CAVH experiments, CVVH removed more circulating myoglobin and the addition of the dialysis component did not appear to improve removal. Based on these findings, it appears that the CVVH hemofiltration system is a viable option for the removal of systemic myoglobin.

[Evaluation of rapid colon preparation by oral intake of dulcolax for colorectal surgery].

The optimal result of colorectal surgery is best achieved by adequate preoperative colon preparation, which should be simple, safe, rapid, and thoroughly clean with little or no discomfort at all for patients. Conventional mechanical preparation, though effective, is time-consuming and unpleasant for patients, therefore new methods have been frequently presented in recent literature to meet the above ideal. A prospective and randomized study was conducted to evaluate preoperative colon preparation in elective, nonobstructive colorectal surgery. Group I included 32 patients who received three-day diet control and enema, while group II included 42 patients who received one-day diet control and oral dulcolax. Both groups were given systemic antibiotics. The result favored group II because of its significantly less abdominal fullness, but the electrolyte change and bacteriologic study revealed no significant difference between two groups. Neither did they exhibit variance in the adequacy of bowel cleansing (81.3% in group I vs 81% in group II). It is therefore suggested that, without enema and with less abdominal fullness, oral dulcolax should be encouraged for colon preparation in colorectal surgery.

[Report on a fungus parasitizing Entamoeba histolytica].

Infection of Entamoeba histolytica with chytridiaceous fungus Sphaerita was observed in some specimens obtained from a farmer and stained with iron-haematoxylin. The fungi were found in 78% of the cysts, mostly immature ones. Within the amoebae this parasite occurred singly, in groups, or in the form of a sporangium. It was located in the cytoplasm, the glycogen mass or the chromatoidal bars. In the same specimen, the parasitic fungus was also found in 18% of E. coli cysts; in 11% of E. nana cysts; while only one of 16 E. hartmanni cysts was parasitized. It is an interesting case of superimposed parasitism so far reported in China as well as a rare case of several species of amoebae being heavily involved with the same in the scientific literature.

One-stage operation for obstructing carcinomas of the left colon and rectum.

A consecutive series of 28 patients with acutely obstructing carcinomas of the left colon and rectum were encountered during the last three years. Two patients treated by loop colostomy only were excluded from the study. Fifteen patients received a one-stage operation of immediate resection and primary anastomosis without proximal colostomy. The remaining 11 patients were treated by a conventional staged operation. The operative mortality and complications were similar in both groups. The duration of hospital stay in the former was half of that in the latter. Of nine patients treated by subtotal or total colectomy with primary anastomosis, the average number of bowel movements three months after surgery was 1.8 per day. Intraoperative colonic irrigation was performed in five patients of the one-stage group and permitted a safe primary anastomosis. The immediate results of the one-stage operation were surprisingly good. The authors propose it as the treatment of choice for the majority of patients with obstructing carcinomas of the left colon and rectum.