ABSTRACT
Autism Spectrum Disorder (ASD) is a series of complex neurodevelopmental disorders, which can affect children's social, behavioral and communication abilities. A member of the Sirtuins family of NAD + dependent deacetylases called SIRT2 could regulate the inflammation progress during stress, but the relevant mechanism has not been clearly defined. In the present study, the ASD model of wild type and SIRT2 knock out mice was established to evaluate the impact on the homeostasis of neurons in the hippocampus using western blotting, immunofluorescence and Nissl staining. The results showed that the amplification of neuronal richness was significantly decreased and neuroinflammation increased in the hippocampus following ASD due to autophagy, caused by enhancing the acetylation of FoxO1 using SIRT2 gene deletion and indicating this should be the target for ASD or other psychological stress treatment.
Subject(s)
Autism Spectrum Disorder , Autophagy , Forkhead Box Protein O1 , Hippocampus , Sirtuin 2 , Animals , Mice , Acetylation , Autism Spectrum Disorder/genetics , Hippocampus/metabolism , Mice, Knockout , Sirtuin 2/genetics , Sirtuin 2/metabolism , Forkhead Box Protein O1/metabolismABSTRACT
BACKGROUND: Peritoneal dialysis (PD) catheter migration impedes the efficacy of dialysis. Therefore, several techniques involving additional sutures or incisions have been proposed to maintain catheter position in the pelvis. AIM: To evaluate the efficacy of creating a short musculofascial tunnel beneath the anterior sheath of the rectus abdominis during PD catheter implantation. METHODS: Patients who underwent PD catheter implantation between 2015 and 2019 were included in this retrospective study. The patients were divided into two groups based on the procedure performed: Patients who underwent catheter implantation without a musculofascial tunnel before 2017 and those who underwent the procedure with a tunnel after 2017. We recorded patient characteristics and catheter complications over a two-year follow-up period. In addition, postoperative plain abdominal radiographs were reviewed to determine the catheter angle in the event of migration. RESULTS: The no-tunnel and tunnel groups included 115 and 107 patients, respectively. Compared to the no-tunnel group, the tunnel group showed lesser catheter angle deviation toward the pelvis (15.51 ± 11.30 vs 25.00 ± 23.08, P = 0.0002) immediately after the operation, and a smaller range of migration within 2 years postoperatively (13.48 ± 10.71 vs 44.34 ± 41.29, P < 0.0001). Four events of catheter dysfunction due to migration were observed in the no-tunnel group, and none occurred in the tunnel group. There was no difference in the two-year catheter function survival rate between the two groups (88.90% vs 84.79%, P = 0.3799). CONCLUSION: The musculofascial tunnel helps maintain catheter position in the pelvis and reduces migration, thus preventing catheter dysfunction.
ABSTRACT
Peritoneal dialysis (PD) education, which has been shown to impact life quality and survival rates, is thus crucial to patients with end-stage renal disease. As medical workers in the PD field, it is our hope and obligation to lead every patient to achieve their individual self-care goals. Although the International Society of Peritoneal Dialysis (ISPD) published guidelines for peritoneal dialysis training in 2006 to help build a comprehensive educational program for better outcomes, how to implement related education programs has not yet been taken seriously by clinical health workers. In Taiwan, no articles introducing these guidelines and no report on the clinical implementation of these guidelines have been published. Thus, this article was written to describe the ISPD guidelines on PD education, including education content, space requirements, soft / hard equipment needs, training hours, and mode. Medical workers may use evaluation and periodical retraining to continuously monitor the self-care ability of patients. Aided by timely home visitations, learning outcomes and patient adaption may be followed comprehensively. Furthermore, to help patients under PD strengthen their capabilities of self-management and self-care, practical training suggestions based on the practice experience of our PD center are also included in this article as references for all medical workers in the PD field.
