Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis.

BACKGROUND: Current practice guidelines for optimal infusion rates during early intravenous hydration in patients with acute pancreatitis (AP) remain inconsistent. This systematic review and meta-analysis aimed to compare treatment outcomes between aggressive and non-aggressive intravenous hydration in severe and non-severe AP. METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase and Cochrane Library for randomized controlled trials (RCTs) on November 23, 2022, and hand-searched the reference lists of included RCTs, relevant review articles and clinical guidelines. We included RCTs that compared clinical outcomes from aggressive and non-aggressive intravenous hydration in AP. Meta-analysis was performed using a random-effects model for participants with severe AP and non-severe AP. Our primary outcome was all-cause mortality, and several secondary outcomes included fluid-related complications, clinical improvement and APACHE II scores within 48 h. RESULTS: We included a total of 9 RCTs with 953 participants. The meta-analysis indicated that, compared to non-aggressive intravenous hydration, aggressive intravenous hydration significantly increased mortality risk in severe AP (pooled RR: 2.45, 95% CI: 1.37, 4.40), while the result in non-severe AP was inconclusive (pooled RR: 2.26, 95% CI: 0.54, 9.44). However, aggressive intravenous hydration significantly increased fluid-related complication risk in both severe (pooled RR: 2.22, 95% CI 1.36, 3.63) and non-severe AP (pooled RR: 3.25, 95% CI: 1.53, 6.93). The meta-analysis indicated worse APACHE II scores (pooled mean difference: 3.31, 95% CI: 1.79, 4.84) in severe AP, and no increased likelihood of clinical improvement (pooled RR:1.20, 95% CI: 0.63, 2.29) in non-severe AP. Sensitivity analyses including only RCTs with goal-directed fluid therapy after initial fluid resuscitation therapy yielded consistent results. CONCLUSIONS: Aggressive intravenous hydration increased the mortality risk in severe AP, and fluid-related complication risk in both severe and non-severe AP. More conservative intravenous fluid resuscitation protocols for AP are suggested.

Neuroprotective Alkamides from the Aerial Parts of Achillea alpina L.

Three new alkamides, achilleamide B-D (1-3) along with five known alkamides (4-8) were isolated from the aerial parts of Achillea alpina L. Structures were elucidated by spectroscopic analysis. Modified Mosher's method and electronic circular dichroism (ECD) calculations were introduced for the absolute configuration of 3. The neuroprotective effects of all the compounds were evaluated by 6-hydroxydopamine (6-OHDA)-induced cell death in human neuroblastoma SH-SY5Y cells, with concentration for 50 % of maximal effect (EC50 ) values of 3.16-24.75 µM, and the structure-activity relationship was conducted.

Ilexsaponin A1 Ameliorates Diet-Induced Nonalcoholic Fatty Liver Disease by Regulating Bile Acid Metabolism in Mice.

Bile acid (BA) metabolism is an attractive therapeutic target in nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the effect of ilexsaponin A1 (IsA), a major bioactive ingredient of Ilex, on high-fat diet (HFD)-induced NAFLD in mice with a focus on BA homeostasis. Male C57BL/6J mice were fed an HFD to induce NAFLD and were treated with IsA (120 mg/kg) for 8 weeks. The results showed that administration of IsA significantly decreased serum total cholesterol (TC), attenuated liver steatosis, and decreased total hepatic BA levels in HFD-induced NAFLD mice. IsA-treated mice showed increased BA synthesis in the alternative pathway by upregulating the gene expression levels of sterol 27-hydroxylase (CYP27A1) and cholesterol 7b-hydroxylase (CYP7B1). IsA treatment accelerated efflux and decreased uptake of BA in liver by increasing hepatic farnesoid X receptor (FXR) and bile salt export pump (BSEP) expression, and reducing Na+-taurocholic acid cotransporting polypeptide (NTCP) expression. Alterations in the gut microbiota and increased bile salt hydrolase (BSH) activity might be related to enhanced fecal BA excretion in IsA-treated mice. This study demonstrates that consumption of IsA may prevent HFD-induced NAFLD and exert cholesterol-lowering effects, possibly by regulating the gut microbiota and BA metabolism.

[Content determination of eight phenols in Ilex hainanensis harvested at different time by HPLC-DAD].

This study intends to develop a high performance liquid chromatography-diode array detection(HPLC-DAD) method for simultaneous determination of chlorogenic acid, 2-hydroxymethyl-3-hydroxyl-1-butene-4-O-ß-D-(6″-O-caffeoyl)-glucopyranoside, pubescenoside B, huazhongilexone-7-O-ß-D-glucopyranoside, rutin, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C in Ilex hainanensis. The HPLC conditions are as follows: Waters XBridge C_(18 )column(4.6 mm×250 mm, 5 µm), mobile phase of 0.5% formic acid in water(A)-acetonitrile(B), gradient elution(0-8 min, 5%-12% B; 8-18 min, 12%-18% B; 18-30 min, 18%-25% B; 30-40 min, 25%-30% B; 40-42 min, 30%-80% B; 42-45 min, 80% B) at the flow rate of 0.8 mL·min~(-1), detection wavelengths of 282, 324, and 360 nm, column temperature of 25 ℃, and injection volume of 5 µL. The content of the 8 phenols in 8 samples was 0.30-6.29, 0.29-3.27, 0.15-10.4, 0.51-5.85, 0.49-9.02, 0.51-4.68, 1.93-13.4, and 0.87-5.95 mg·g~(-1), respectively. Moreover, the content of phenols in the samples collected in October was higher than that of samples harvested in other months. The established method is accurate and sensitive for the determination of phenols in I. hainanensis, which is useful for the quality improvement of this herbal medicine.

Synthesis of 2-amino-6-oxocyclohexenylsulfonamides and their activity against Botrytis cinerea.

BACKGROUND: With the objective of exploring the fungicidal activity of 2-oxocyclohexylsulfonamides (2), a series of novel 2-amino-6-oxocyclohexenylsulfonamides (6 to 23) were synthesised, and their fungicidal activities against Botrytis cinerea Pers. were evaluated in vitro and in vivo. RESULTS: The compounds were characterised by IR, 1H NMR and elemental analysis. Bioassay results of mycelial growth showed that compounds 6 to 23 had a moderate antifungal activity against B. cinerea. N-(2-methylphenyl)-2-(2-methylphenylamino)-4,4-dimethyl-6-oxocyclohexenylsulfonamide (13) and N-(2-chlorophenyl)-2-(2-chlorophenylamino)-6-oxocyclohexenylsulfonamide (21) showed best antifungal activities, with EC50 values of 8.05 and 10.56 µg mL(-1) respectively. Commercial fungicide procymidone provided an EC50 value of 0.63 µg mL(-1) . The conidial germination assay showed that most of compounds 6 to 23 possessed excellent inhibition of spore germination and germ-tube elongation of conidia of B. cinerea. For in vivo control of B. cinerea colonising cucumber leaves, the compound N-cyclohexyl-2-(cyclohexylamino)-4,4-dimethyl-6-oxocyclohexenylsulfonamide (19) showed a better control effect than the commercial fungicide procymidone. CONCLUSION: The present work demonstrated that 2-amino-6-oxocyclohexenylsulfonamides can be used as possible new lead compounds for further developing novel fungicides against B. cinerea.

[Study on the iodine nutrition and iodine deficiency disorders status in pasturing areas of Tibet-a non-epidemic area of iodine deficiency disorders in serious iodine deficiency district].

OBJECTIVE: To explore the status of iodine nutrition and iodine deficiency disorders in the pasturing areas and agricultural regions in Tibet. METHODS: 30 families were selected respectively in pastoral Dangxiong county and agricultural Qushui county of Lasa. Drinking water and edible salt were collected for testing the iodine contents. In each type of the following populations including children aged 8 - 10, women of child-bearing age and male adults, 50 subjects were randomly sampled to examine their urinary iodine contents. Among them, 50 children and 50 women were randomly selected for goiter examination by palpation. RESULTS: Water iodine content was less than 2 µg/L, both in pasturing area and in agricultural areas. There was no iodized salt used in the families of pasturing areas, while 90% people consumed iodized salt in agricultural areas. The median of urinary iodine in pasturing area was 50.2 µg/L, significantly lower than that of agricultural area (193.2 µg/L). However, the goiter rate of children and women in pasturing area was significantly lower than that in agricultural area. CONCLUSION: Although iodine intake of populations in pasturing area of Tibet was severely deficient, there was no epidemic of Iodine Deficiency Disorders. This phenomenon noticed by the researchers deserved further investigation.

Synthesis, fungicidal activity, and structure-activity relationship of 2-oxo- and 2-hydroxycycloalkylsulfonamides.

To explore new potential fungicides, a series of novel compounds, including 11 2-oxocycloalkylsulfonamide (3) and 21 2-hydroxycycloalkylsulfonamide (4) derivatives, were synthesized and their structures were confirmed by (1)H nuclear magnetic resonance (NMR), infrared (IR), and elemental analysis. The results of the bioassay showed that the compounds 3 and 4 possessed excellent fungicidal activity against Botrytis cinerea Pers. both in vitro and in vivo. The fungicidal activity of the compounds with 7- or 8-membered rings is better than those with 5-, 6-, or 12-membered rings. According to the results of the mycelium growth rate test, the EC50 values of the compounds 3C, 4C, 3D, and 4D were 0.80, 0.85, 1.22, and 1.09 µg/mL, respectively, and similar to or better than commercial fungicide procymidone. The bioassay results of spore germination indicated that most of the compounds exhibited obvious inhibitory effects against B. cinerea and the inhibition rates of 2-oxocycloalkylsulfonamides were higher than 2-hydroxycycloalkylsulfonamides, among them. The EC50 values of compounds 3A, 3B17, 3E, and 4A were 4.21, 4.21 3.24, and 5.29 µg/mL, respectively. Those compounds containing 5- or 6-membered rings showed better activity than those containing 7-, 8-, or 12-membered rings. Furthermore, the results of the pot culture test showed that almost all of the compounds had effective control activity in vivo and 2-hydroxycycloalkylsulfonamides were obviously superior to 2-oxocycloalkylsulfonamides. The compounds 3E, 4C and 4D presented higher control efficacy than procymidone and pyrimethanil against gray mold disease on cucumber plants.

[Exploratory study on the association between high iodine intake and lipid].

OBJECTIVE: To explore the association between excessive iodine intake and lipid disorder in human bodies. METHODS: Based on the NTTST sample survey on water iodine in Suining of Jiangsu province, this study involved 81 residents whose drinking water containing excessive iodine and 101 residents who drank water with normal iodine content. Blood samples were tested and compared on lipids (TG, TC, HDL-C, LDL-C, apoA1, apoB) between the two groups, after adjusting the influences of age and gender. The study also compared the abnormal rate of each lipid indicator between the two groups. Corresponding RR values and 95% confidence interval were calculated. Correlation between iodine content in drinking water and blood lipid was also studied. RESULTS: apoA1 in the group with excessive iodine intake was significantly lower than that in the normal iodine group, while there were no significant differences between the two groups in other lipid indicators. The abnormal rate of HDL-C of excess iodine group (16.88%) was significantly higher than the rate of normal iodine group (7.22%) while there were no significant differences between the two groups in other lipid indicators. Both apoA1 and HDL-C in the excess iodine group had a negative correlation with water iodine, while the other indicators of two groups had no correlation with water iodine. CONCLUSION: Drinking water with excess iodine might increase the risk of lipid disorder.

[Effect of different plant growth regulators on transplanting survival ratio of Haloxylon ammodendron seedling and parasitic ratio of Cistanche deserticola].

OBJECTIVE: To study the effect of different plant growth regulators on the transplanting survival ratio of Haloxylon ammodendron seedlings and parasitic ratio of Cistanche deserticola. METHODS: Different combinations of PDJ and rooting powder were used for rooting soaking with Haloxylon ammodendron seedlings, then the survival ratio of Haloxylon ammodendron and parasitic conditions of Cistanche deserticola were statistical analyzed by SAS software. RESULTS: PDJ had promotable effect on the inoculating survival ratio of Haloxylon ammodendron and the parasitic ratio, parasitic number and size of Cistanche deserticola, but had no significant effect on the transplanting survival ratio. High concentration of PDJ (1 x 10(-5) mol/L) and rooting powder treatment improved the inoculation survival ratio, and low concentration of PDJ (1 x 10(6) mol/L) treatment improved the parasitic ratio of Cistanche deserticola, but PDJ with rooting powder treatment had inhibitive effect on the parasitism of Cistanche deserticola. Principal component analysis showed that the transplanting survival ratio, inoculating survival ratio, parasitic ratio and the parasited number of Cistanche deserticola could be taken to evaluate the effect of different plant growth regulators, and the comprehensive effect was the best with PDJ treatment. CONCLUSION: Rooting soaking with PDJ can be used to improve the survival ratio of Haloxylon ammodendron seedling and parasitic ratio of Cistanche deserticola.

[Field study on the change of urinary iodine levels among family members with iodine content of 5 - 150 microg/L in drinking water before and after non-iodized salt intervention].

OBJECTIVE: To compare the changes of urinary iodine levels among the family members with iodine content of 5 - 150 microg/L in drinking water, before and after non-iodized salt intervention through a field trail study. METHODS: Family members who routinely drank water with iodine content 5 - 150 microg/L were chosen to substitute non-iodized salt for their current iodized salt for 2 months, and urine samples of the family members were collected for determination of iodine change before and after intervention was carried out. RESULTS: Median urinary iodine of school children, women with productive age and male adults exceeding 370 microg/L before intervention and the frequency distribution of urinary iodine were all above 70%. Our results revealed that iodine excess exited in three groups of family members. After intervention, all median urinary iodine level seemed to have decreased significantly, and groups with drinking water iodine 5.0 - 99.9 microg/L reduced to adequate or close to adequate while the group that drinking water iodine was 100 - 150 microg/L reached the cut-off point of excessive iodine level (300 microg/L). CONCLUSION: Results from your study posed the idea that the iodine adequate areas should be defined as the areas with iodine content of 5.0 - 100 microg/L in drinking water, and edible salt not be iodized in these areas. Areas with iodine content of 100 - 150 microg/L in drinking water should be classified as iodine excessive.

Piezo-assisted in vitro fertilization of mouse oocytes with spermatozoa retrieved from epididymides stored at 4 degree C.

This study was performed to investigate the effect of partial zona pellucida incision by piezo micromanipulation (ZIP) on the in vitro fertilizing ability of stored mouse spermatozoa. The storage conditions were optimized by storing the mouse epididymides at 4 C in mineral oil or in the mouse body for up to 4 days after death, and the retrieved spermatozoa were used to fertilize fresh oocytes. No significant difference was observed in fertilization rates between the treatments when epididymides were stored for up to 2 days, but the fertilization rates in mineral oil were higher (P<0.05) than those in the mouse body at 3 (41.4 vs. 16.2%) and 4 days (26.0 vs. 15.8%). Spermatozoa retrieved from epididymides stored in mineral oil were then used to fertilize fresh and vitrified oocytes with or without ZIP treatment. The fertilization rates of the ZIP fresh oocytes were higher than those of the zona-intact oocytes at each time point (1 to 4 days). After ZIP, the fertilization rates of spermatozoa stored for 1 and 2 days (91.2 and 86.6%, respectively) were similar (P>0.05) to that of fresh spermatozoa (91.9%). In regard to vitrified oocytes, the fertilization rates of zona-intact and ZIP oocytes using fresh spermatozoa were 46.7 and 84.7%, while the fertilization rates of vitrified ZIP oocytes using spermatozoa stored for 1 to 4 days ranged from 49.3 to 79.6%. When 2-cell embryos derived from ZIP fresh and vitrified oocytes inseminated with 2 day-stored spermatozoa were transferred into recipient females, 47.9 and 15.0% of the embryos developed to term, respectively. These results indicate that storing mouse epididymides at 4 C in mineral oil is more suitable than storage in the mouse body and that the ZIP technique improves the in vitro fertilizing ability of stored mouse spermatozoa in fresh oocytes and significantly increases the fertilization rate of vitrified oocytes with fresh spermatozoa.

[Study on the amount of daily iodine intake of inhabitants living in drinking water with excessive iodine content areas after termination of iodized salt supply].

OBJECTIVE: To investigate the amount of daily iodine intake in the diet of the target population in drinking water with areas of excessive iodine after stopping supply of iodized salt, to provide evidence for developing strategies on control and prevention of excessive iodine. METHODS: 335 objectives were selected by a two-stage sampling method in 4 administrative villages with different iodine contents in drinking water. The amount of drinking water intake and dietary survey for 335 people were done by a door-to-door survey,while the iodine contents in the drinking water of each selected family, local staple food and vegetable were measured. RESULTS: The median level of iodine in drinking water was 431.5 microg/L while the daily amount of iodine intake among the three groups of waters with different iodine contents were all greater than RNI. The daily iodine intake of local people was all greater than UL in the areas where the water iodine contents were more than 300 microg/L. It was of statistical sense that the iodine mean intake per capita per day of the three groups differed at different water iodine levels (P < 0.01). The iodine mean intake per capita per day of the three groups of different water iodine levels increased along with water iodine and showed a uptrend (P < 0.01). 83.2%-98.7% of the daily iodine intake of the three groups was from drinking water and 1.3%-16.8% came from food. The iodine intake had high-positive correlation relation with the content of water iodine (P < 0.01). CONCLUSION: It was concluded that drinking water was the main source of iodine intake in areas with iodine excessive water by the percentage of over 80%. It was necessary to adopt measures to improve the quality of water to decrease the iodine content other than just stopping supplies of iodized salt in the areas where the water iodine contents were greater than 300 microg/L, in order to prevent and control excessive intake of iodine.

[Vitrification of mouse blastocyst by open pulled straw (OPS) method at different temperature].

To examine the efficiency of EDFS and EFS for blastocyst cryopreservation and to provide information for preparation of vitrification medium at different temperature, the present investigation was conducted to establish a model for vitrification of domestic animal's blastocyst and human blastocyst using mouse blastocyst as a model and OPS (open pulled straw) as the container. When ambient temperature was 25 degrees C and heating plate temperature was 37 degrees C, mouse blastocysts were vitrified using 1-step OPS method, after thawing, the expanded blastocyst (EB) rates of EDFS40 and EFS40 group (92.31%, 92.30%) were not different from that of the control (97.26%) (P > 0.05), however, the hatched blastocyst (HB) rate of EDFS40 group (59.62%) was significantly lower than that of the control (83.56%); When 2-step method was adopted at the same temperature, mouse blastocyst was successfully cryopreserved with EDFS30 and EFS40, the post-thawing EB rate (95.69%, 95.05%) and HB rate(80.48%, 78.95%) of both EDFS30 and EFS40 groups did not differ from those of the control (P > 0.05). When ambient temperature was 25 degrees C and heating plate was free, the EB rate (85.96%) and HB (75.44%) of embryos vitrified with EDFS40 using 1-step OPS method were not statistically different from those of the control (96.05% and 82.89%, respectively) (P > 0.05); the EB and HB rates (92.03%-95.31%, 67.19%-76.76%) of embryos vitrified with EDFS30, EDFS40 and EFS40 using 2-step OPS method were similar to those of the control (P > 0.05). According to in vitro development of vitrified embryos, the promising group was chosen for embryo transfer to examine in vivo development of vitrified embryos. When vitrified blastocysts were transferred into uterus of pseudopregnant mouse, the pregnancy rate of receipts (90.90%) and birth rate of foster mother (37.33%) were similar to those of fresh embryos (91.67% and 42.33%) (P > 0.05). All data demonstrated that mouse blastocyst was successfully cryopreserved with EDFS30, EDFS40 and EFS40 at different temperature and using different procedures.

[A field trial study on the influence of different salt iodine concentration on urinary iodine excrition among the target population].

OBJECTIVE: To evaluate the influence of different salt iodine concentration on urinary iodine excrition among the target population and to determine the appropriate level of salt iodization to the local people. METHODS: In the 31-day random control trial, 1099 subjects from 399 families were randomly distributed into four groups and were supplied with iodized-salt with different iodine concentration of (6 +/- 2)mg/kg, (15 +/- 2)mg/kg, (24 +/- 2)mg/kg and (34 +/- 2)mg/kg, respectively. The original family salt was retrieved, whose iodine content was determined in those subjects' families with single-blind method. Baseline survey was conducted including salt and urinary iodine of the subjects. From the 27th day after the intervention, the urinary samples of the subjects were continuously collected for 5 days and urinary iodine was tesed respectively. Meanwhile, daily meal investigation was conducted to evaluate the influences originated from food. RESULTS: The median of local water iodine content was 3.05 microg/L and the average salt iodine concentration was (36.4 +/- 5.4)mg/kg while 98.8% of the household consumed sufficient iodized-salt. The medians of baseline urinary iodine of the subjects were 293.6 microg/L in city, and 508.8 microg/L in the countryside. The urinary iodine medians of four groups in the day of 28th after intervention were 97.2 microg/L, 198.6 microg/L, 249.4 microg/L, and 330.7 microg/L respectively in the city group, while they were 100.5 microg/L, 193.0 microg/L, 246.3 microg/L and 308.3 microg/L seperately in the countryside group. There was no statistically significant differences among the medians of urine iodine in the 27th, 28th, 29th, 30th and 31st day after intervention (P > 0.05). CONCLUSIONS: The target areas were with iodine deficiency which possessed high coverage of qualified iodized-salt at household level. The average urinary iodine level of the subjects was slightly higher than the standard level, according to the baseline survey. The intervetion trail showed that the salt iodine concentration of 15-24 mg/kg was sufficient to the local people.

[Effect of universal salt iodization on the dosage of antithyroid drug].

OBJECTIVE: To investigate the effect of universal salt iodization (USI) on antithyroid drug. METHODS: One hundred and one patients with untreated hyperthyroidism were randomly divided into two sex and age-matched groups: group A (n = 45, consuming pure salt without iodine) and group B (n = 56, consuming iodated salt). The same dosage of 300 mg propylthiouracil (PTU) was given to both groups at beginning, the serum TT4. TT3, FT4, FT3, and TSH were measured before and 1, 2, 3, 6 months after PTU treatment, when the serum TT4, TT3, FT4. FT3, and TSH were back to the normal ranges, the dosage of PTU was decreased to maintain the normal levels of serum thyroid hormones. RESULTS: The urine iodine and serum thyroid hormone levels were not significantly different between group A and group B before the treatment (P > 0.05). The urine iodine of group A was significant lower 2 - 3 months after the treatment (148.4 micro g/L) than before the treatment (213.4 micro g/L, P < 0.01). There were not significant differences in serum TT4, TT3, FT4, and FT3 between group A and B before the treatment (all P > 0.05). One month after the treatment the serum TT4 and TT3 in group A were (153 +/- 50) nmol/L and (3.6 +/- 1.2) nmol/L respectively, both significantly lower than those of the group B [(177 +/- 64) nmol/L and (2.7 +/- 1.5) nmol/L respectively, P = 0.041 and 0.033], however, there was no significant difference in other serum thyroid hormones between the group A and group B. The dosage of PTU was not significantly different between group A and B 1 month after the treatment, but became significantly higher in group B than in group A 2, 3, and 6 months after the treatment (214,189, and 178 mg/d respectively vs. 190, 147, and 116 mg/d respectively, and 24, 42, and 62 mg/day more respectively, all P < 0.05). CONCLUSION: Hyperthyroidism can be effectively controlled by PTU while the patients consume iodated salt, but the dosage of PUT needed should be higher than while the patients consume pure salt.