Purple Urine Bag Syndrome Amelioration without Antibiotic Therapy.

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An efficient and practical aerobic oxidation of benzylic methylenes by recyclable N-hydroxyimide.

An efficient and practical benzylic aerobic oxidation catalyzed by cheap and simple N-hydroxyimide organocatalyst has been achieved with high yields and broad substrate scope. The organocatalyst used can be recycled and reused by simple workup and only minute amount (1 mol% in most cases) of simple iron salt is used as promoter. Phenyl substrates with mild and strong electron-withdrawing group could also be oxygenated in high yields as well as other benzylic methylenes. Influence of substituents, gram-scale application, catalysts decay and general mechanism of this methodology has also been discussed.

L1CAM mutations in three fetuses diagnosed by medical exome sequencing.

OBJECTIVE: The L1 cell adhesion molecule (L1CAM) gene, encodes the L1 cell adhesion molecule, is involved in the central nervous system development. Its mutations result in L1 syndrome which is associated with brain malformation and nervous developmental delay. CASE REPORT: We presented three fetuses with hydrocephalus and agenesis of the corpus callosum detected by ultrasound, followed by medical exome sequencing (MES) test with L1CAM mutations: two known missense mutation c.551G > A (p. R184Q) and c.1354G > A (p. G452R), and a novel frameshift mutation c.1322delG which causes the early termination of translation (p. G441Afs∗72). By utilizing multiple computational analysis, all the variants were scored to be likely pathogenic. CONCLUSION: Combined use of ultrasound and MES to identify the molecular etiology of fetal anomalies may contribute to expanding our knowledge of the clinical phenotype of L1 syndrome observed in the south Chinese population.

Effect of Blood Pump Flow and Arteriovenous Fistula Blood Flow on the Blood Pressure and Cardiac Function in Patients Undergoing Maintenance Hemodialysis.

The effect of blood pump flow rate on the cardiac functions of hemodialysis patients with arteriovenous fistula (AVF) is largely unknown. This study aimed to investigate if blood pump flow rate (Qb) and AVF access flow rate (Qa) can affect the cardiac function of Chinese hemodialysis patients. A total of 72 patients undergoing AVF hemodialysis were included from March 2010 to June 2014 and dichotomized into the high- and low-flow groups using the medians of Qb (220 mL/min) and Qa (1000 mL/min) as the cutoffs. The cardiac function parameters were measured by ultrasound dilution technique within the first (t + 30) and the last (t - 30) 30 min of dialysis. At t + 30, Qb-high group had significantly higher systolic blood pressure (SBP) and mean arterial pressure (MAP) than Qb-low group. At t - 30, Qb-high group had higher SBP, diastolic blood pressure (DBP), and MAP than Qb-low group. Qa-high group had higher SBP, MAP, cardiac output (CO), cardiac index (CI), central blood volume (CBV), and lower peripheral resistance than Qa-low group. Multiple linear regression showed that at t - 30, Qb was positively correlated with SBP and MAP. Qa was positively correlated with CO, CI, CBV, and PR but negatively correlated with heart rate. Although Qb > 220 mL/min and Qa >1000 mL/min would elevate some parameters, the means of SBP, DBP, MAP remain within the normal range, indicating that appropriate increase in blood pump flow rate has little effect on the cardiac function of hemodialysis patients.

Short-term effect and adverse events of adalimumab versus placebo in inducing remission for moderate-to-severe ulcerative colitis: a meta-analysis.

BACKGROUND: Adalimumab is used in an attempt to maintain remission for Ulcerative colitis. This study was to evaluate the efficacy and adverse events of adalimumab compared with placebo in inducing remission of Ulcerative colitis. METHODS: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, OVID, BIOSIS, CNKI, and Google were searched. All randomized trials comparing adalimumab with placebo in inducing remission of moderate-to-severe ulcerative colitis were included. RESULTS: Two randomized controlled trials with a total of 754 participants met the inclusion criteria. The pooled risk ratio (RR) of clinical remission was 1.85 (95% confidence interval (CI) 1.26 to 2.72) following adalimumab treatment. RR of clinical response was 1.40 (95% CI 1.19 to 1.65) while that of mucosal healing was 1.23 (95% CI 1.03 to 1.47). RR of any adverse events was 1.00 (95% CI 0.93 to 1.09). CONCLUSION: Compared with placebo, administration of adalimumab may increase the proportion of patients with moderate-to-severe ulcerative colitis attaining clinical remission, clinical response and mucosal healing. Adalimumab is also tolerated well in these patients.

Effect of social support on psychological-stress-induced anxiety and depressive symptoms in patients receiving peritoneal dialysis.

OBJECTIVE: The objective of this study was to assess the association of psychological stress and social support with anxiety and depressive symptoms in peritoneal dialysis (PD) patients with end-stage renal disease (ESRD). METHODS: Eighty-one patients receiving PD were recruited. Their demographic characteristics, psychological stress, and social support were determined with a structured questionnaire, and their anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale. RESULTS: Psychological stressors caused by ESRD and PD originated from five major sources, as determined by factor analysis. These included "Job and family crisis," "Worry about health and family being harmed," "Worry about daily life being restricted and physical appearance being altered," "Fear of decline in social ability," and "Fear of decline in physical function." Hierarchical linear regression analysis indicated that, after adjusting for gender, age, marital status, educational level, and duration of illness, solid social support can alleviate such symptoms.

Peroxisome proliferator-activated receptor-gamma is expressed by rat peritoneal mesothelial cells: its potential role in peritoneal cavity local defense.

BACKGROUND/AIMS: Peritoneal mesothelial cells (PMCs) play an important role in peritoneal inflammatory and immune response. It was reported that the peroxisomal proliferator-activated receptor-gamma (PPARgamma) ligand could effectively reduce inflammatory processes. However, the expression and function of PPARgamma in PMCs has not been reported. This study was to investigate the expression of PPARgamma in rat PMCs and the effect of PPARgamma activation on the production of CD40 and ICAM-1 induced by lipopolysaccharide (LPS). METHODS: Rat PMCs (RPMCs) were harvested from the peritoneal cavity of Sprague-Dawley rats and maintained under defined in vitro conditions. The cells were treated separately with LPS, 15d-PGJ(2), and ciglitazone at different time points. The mRNA and protein expression of PPARgamma, CD40 and ICAM-1 were detected by RT-PCR and Western blot, respectively. The intracellular distribution of PPARgamma was detected by immunocytochemistry. RESULTS: RPMCs expressed PPARgamma both at the mRNA and protein level. The specific signals for PPARgamma were mainly localized in the nucleus with weak staining in the cytoplasm. Stimulation of RPMCs with LPS resulted in a time-dependent increase in the expression of PPARgamma with the peak of mRNA at 3 h and protein at 12 h. Thereafter the expression of PPARgamma gradually attenuated. The mRNA expressions for CD40, ICAM-1 and protein expression of ICAM-1 were significantly upregulated following stimulation with LPS. Both 15d-PGJ(2) and ciglitazone decreased the expression of CD40 mRNA and ICAM-1 protein. However, ciglitazone was less effective than 15d-PGJ(2). CONCLUSIONS: There is constitutive expression of PPARgamma in cultured RPMCs and PPARgamma ligands which strongly inhibit LPS-induced CD40 and ICAM-1 production in RPMCs. It suggested that PPARgamma might play a part in the local defense of the peritoneal cavity by downregulating inflammatory mediators, which may play a potential role in preventing peritoneal fibrosis induced by peritonitis. Further in vivo study is needed to demonstrate the long-term effects.

[Medical devices' management and medical safety].

This article presents some suggestions about how to strengthen the management of medical devices so as to remove the hidden perils and risks of medical safety.

[Cardiopulmonary bypass of orthotopic heart transplantation].

OBJECTIVE: To summarize the extracorporeal circulation(ECC) management experiences on 4 cases of orthotopic heart transplantation. METHODS: All patients received moderate hypothermia and high flow rate perfusion. Many strategies were taken to maximize the protection of myocardium, lung, kidney and blood conservation. The donor hearts were arrested with aorto perfusion using modified St. Thomas solution at 4 degrees C. After being flushed with 5,000 mL cold saline, the donor hearts were perfused with 1,000 mL UW solution in 4 degrees C and preserved in ice saline. Ice mud was covered on the donor heart and cold saline was dripped into left atrium in the period of anastomosis. RESULTS: The ECC time was 133.3+/-13.1 min, and the warm and cold ischemia time was respectively 1-3 min and 142.0+/-28.2 min. All the cases recovered heart beats automatically. Left ventricular ejection fractions were 60%-65% a month postoperatively. One patient died of acute rejection 150 days postoperatively. 3 cases survived. CONCLUSION: Proper ECC management, importment organs and donor heart protection are the key to success in heart transplant operations.