Qualitative study of body quality management experience in overweight or obese patients with breast cancer during chemotherapy / 中国实用护理杂志

Objective:To investigate the experience of body quality management in overweight or obese patients with breast cancer during chemotherapy, and to provide reference for formulating targeted nursing interventions.Methods:This study was a phenomenological study of qualitative research. Objective selected 10 obese patients with breast cancer from breast surgery of Provincial Hospital Affiliated to Shandong First Medical University and the First Affiliated Hospital of Shandong First Medical University to conduct semi-structured interviews during chemotherapy from March to May 2023. Colaizzi 7-step analysis method was used to sort out and analyze the data and extract the theme.Results:The average age of 10 overweight or obese breast cancer patients was 43.2 years. Three themes and eight subthemes were extracted, including insufficient motivation of body quality management (insufficient cognition, insufficient drive, insufficient motivation), disturbing experience of body quality management (uncertainty of disease, symptom distress during chemotherapy, inability to identify the correctness of information), regulation and support of body quality management (mastering correct methods of body quality regulation and support in all aspects).Conclusions:The motivation of body quality management in overweight or obese patients with breast cancer during chemotherapy is insufficient and there are many problems. Medical staff can take effective measures from clarifying the significance of body quality management, providing targeted information support, establishing a good social support system and providing effective body quality management guidance, so as to improve the effectiveness of body quality management in obese patients with breast cancer during chemotherapy.

Inclusion Bodies: Status Quo and Perspectives.

Multiple E. coli cultivations, producing recombinant proteins, lead to the formation of inclusion bodies (IBs). IBs historically were considered as nondesired by-products, due to their time- and cost-intensive purification. Nowadays, many obstacles in IB processing can be overcome. As a consequence, several industrial processes with E. coli favor IB formation over soluble production options due to the high space time yields obtained. Within this chapter, we discuss the state-of-the art biopharmaceutical IB process, review its challenges, highlight the recent developments and perspectives, and also propose alternative solutions, compared to the state-of-the art processing.

High Pressure Homogenization for Inclusion Body Isolation.

High pressure homogenization (HPH) is a commonly used method for cell lysis of Escherichia coli in order to release intracellularly produced recombinant proteins. For misfolded proteins in E. coli, focus is often put on the development of a suitable solubilization and refolding protocol. However, HPH can be a critical unit operation influencing inclusion body (IB) quality and, subsequently, refolding yields. Here, a protocol for homogenization and IB washing is presented in combination with analytical methods suitable to evaluate these unit operations. The protocol is based on a multivariate approach to identify suitable conditions during HPH. Furthermore, the described workflow is easily scalable and can, therefore, also be used if fixed homogenization conditions are already established.

Effects of standardized treatment combined with medical nutrition intervention on blood glucose level, body mass management and glucose metabolism at 3 months after delivery in patients with gestational diabetes mellitus / 中国基层医药

Objective:To investigate the effects of standardized treatment combined with medical nutrition intervention on blood glucose level, body mass management and glucose metabolism at 3 months postpartum in patients with gestational diabetes mellitus (GDM).Methods:A total of 114 patients with GDM who received treatment in Shunyi District Hospital of Beijing from June 2017 to October 2019 were included in this study. They were randomly divided into observation group ( n = 57) and control group ( n = 57). The control group was treated with standardized therapy, and the observation group was treated with standardized therapy combined with medical nutrition intervention. Blood glucose level, body mass management, glucose metabolism outcomes at 3 months postpartum, pregnancy outcome, and neonatal outcome were compared between the two groups. Results:After treatment, hemoglobin A1c (HbA1c), fasting blood glucose, 2-hour plasma glucose (2hPG) after breakfast, and 2hPG after dinner in the observation group were (5.20 ± 0.34)%, (4.69 ± 0.31) mmol/L, (7.32 ± 2.13) mmol/L, and (7.54 ± 2.36) mmol/L, respectively, which were significantly lower than those in the control group [(6.38 ± 0.42)%, (6.34 ± 0.45) mmol/L, (9.01 ± 2.27) mmol/L, (9.35 ± 2.47) mmol/L, t = 16.48, 22.79, 4.09, 4.00, all P < 0.001]. The increases in body mass and body mass index during pregnancy in the observation groups were (12.19 ± 2.35) kg and (4.52 ± 1.13) kg/m 2, respectively, which were significantly lower than those in the control group [(16.21 ± 2.64) kg, (6.11 ± 1.25) kg/m 2, t = 8.58, 7.12, both P < 0.001]. The abnormal rate of glucose metabolism at 3 months postpartum in the observation group was significantly lower than that in the control group [5.3% (3/57) vs. 8.8% (5/57), χ2 = 0.53, P = 0.462]. The incidences of premature rupture of membranes, polyhydramnios, and cesarean section in the observation group were 5.3% (3/57), 14.0% (8/57) and 15.8% (9/57), which were significantly lower than those in the control group [22.8% (13/57), 35.1% (20/57), 40.4% (23/57), χ2 = 7.27, 6.81, 8.51, all P < 0.05]. There were no significant differences in the incidences of pregnancy-induced hypertension and postpartum hemorrhage between the two groups (both P > 0.05). The incidences of premature births, macrosomia, respiratory distress, neonatal hypoglycemia and hyperbilirubinemia in the observation groups were 5.3% (3/57), 3.5% (2/57), 7.0% (4/57), 3.5% (2/57), 5.3% (3/57), respectively, which were significantly lower than those in the control group [22.8% (13/57), 17.5% (10/57), 21.1% (12/57), 15.8% (9/57), 19.3% (11/57), χ2 = 7.27, 5.96, 5.60, 4.93, 5.21, all P < 0.05). Conclusion:Standardized treatment combined with medical nutrition intervention can effectively reduce blood glucose level in patients with GMD, control body mass, and improve glucose metabolism at 3 months after delivery.

Custom made inclusion bodies: impact of classical process parameters and physiological parameters on inclusion body quality attributes.

BACKGROUND: The bacterium E. coli is a major host for recombinant protein production of non-glycosylated products. Depending on the expression strategy, the recombinant protein can be located intracellularly. In many cases the formation of inclusion bodies (IBs), protein aggregates inside of the cytoplasm of the cell, is favored in order to achieve high productivities and to cope with toxic products. However, subsequent downstream processing, including homogenization of the cells, centrifugation or solubilization of the IBs, is prone to variable process performance or can be characterized by low extraction yields as published elsewhere. It is hypothesized that variations in IB quality attributes (QA) are responsible for those effects and that such attributes can be controlled by upstream process conditions. This contribution is aimed at analyzing how standard process parameters, such as pH and temperature (T) as well as different controlled levels of physiological parameters, such as specific substrate uptake rates, can vary IB quality attributes. RESULTS: Classical process parameters like pH and T influence the expression of analyzed IB. The effect on the three QAs titer, size and purity could be successfully revealed. The developed data driven model showed that low temperatures and low pH are favorable for the expression of the two tested industrially relevant proteins. Based on this knowledge, physiological control using specific substrate feeding rate (of glucose) qs,Glu is altered and the impact is tested for one protein. CONCLUSIONS: Time dependent monitoring of IB QA-titer, purity, IB bead size-showed a dependence on classical process parameters pH and temperature. These findings are confirmed using a second industrially relevant strain. Optimized process conditions for pH and temperature were used to determine dependence on the physiological parameters, the specific substrate uptake rate (qs,Glu). Higher qs,Glu were shown to have a strong influence on the analyzed IB QAs and drastically increase the titer and purity in early time stages. We therefore present a novel approach to modulate-time dependently-quality attributes in upstream processing to enable robust downstream processing.

Analysis of Perinatal Outcomes and Pregnancy Complications at the Third Trimester in Excessive Fast Weight Gain Pregnant Women Who Had Normal 75g OGTT at the Second Trimester / 实用妇产科杂志

Objective:To analysis perinatal outcome and pregnancy complications in the third trimester in excessive fast weight gain pregnant women who had normal 75 g oral glucose tolerance test(OGTT) at the second trimester.Methods:422 pregnant women who examined and delivered in Department of Obstetrics,the Second Hospital of Tianjin Medical University from October 2015 to September 2016 were selected randomly for this study.All of them had normal pre-pregnancy body mass index (BMI) and 75 g OGTT test at 24-27 +6 gestational weeks.Mass growth more than 4000 g from 28-36 gestational weeks (average mass growth rate ≥500 g/w) were enrolled in study group(n =103),while others were included in control group(n =319).Statistical analysis was performed by t test and x 2 test.Results.The incidence rate of Gestational diabetes mellitus(GDM) (7.8％),gestational hypertensive (6.8％),mild preeclampsia (4.9％),premature rupture of membranes (PROM)(12.6％) and polyhydramnios(4.9％) in study group was significant higher than those in control group (2.8％,2.5％,1.9％,7.2％,1.3％).The rate of cesarean section (39.8％),macrosomia (10.7％),and neonatal hypoglycemia(4.9％)in study group was significant higher than those in control group (34.2％,6.0％,2.5％).The average birth weight in the study group was significant higher than that in the control group(3677-±351 g vs 3328 -±367g,P＜O.01).There was no significant difference in Apgar score between two groups(P ＞0.05).Conclusions:In the second trimester 75 g OGTT test normal pregnant women,poor diet and exercise management and excessive fast weight gain may increase the incidence of pregnancy complications and poorer perinatal outcomes.

Strategy for linker selection to enhance refolding and bioactivity of VAS-TRAIL fusion protein based on inclusion body conformation and activity.

A bifunctional fusion protein, VAS-TRAIL, was designed for superior therapeutic efficacy by combining anti-angiogenesis activity with tumor-selective apoptosis activity. The protein was expressed as inclusion body (IB) in Escherichia coli. To enhance refolding yield and bioactivity, four fusions were constructed with different linkers (no linker, flexible linker, rigid linker, and helix-forming linker). A novel linker selection strategy based on IB conformational quality and activity was applied to predict the suitable linker. The conformational quality and activity of VAS-TRAIL IBs were analyzed by ATR-FTIR and cytotoxicity assay, respectively. Results demonstrated that aggregated VRT (fusion with rigid linker) contained the highest native-like ß structure content and retained part of the expected activity, namely, cytotoxicity activity on tumor cells. This finding suggested that the rigid linker was the most suitable candidate. Further results of in vitro refolding and subsequent circular dichroism and activity assay of four refolded fusions were significantly correlated with the predictions. Refolding of VRT yielded more soluble proteins containing the expected secondary structure and the highest bioactivity compared with that of other fusions. Our research may offer an efficient method for the high-throughput design of aggregated-prone therapeutic fusion protein.

The relationship between the hemodynamic changes in head-up tilt test and the height, body quality and body mass index in children / 中国小儿急救医学

Objective To explore the relationship between the hemodynamic changes in head-up tilt test(HUTT) and the height,body quality and body mass index in children.Methods We choosed 1906 cases of unexplained syncope,headache,dizziness in children who came from Children Syncope Outpatient in the Second Xiangya Hospital of Central South University from Jan.2000 to Aug.2012,Male 964 cases and female 942 cases.Their ages were 2 to 17.92 years old.The average age was 10.84 ± 2.97 years old.The height and body mass in children was measured,BMI was calculated.After obtain written informed consent subjects or guardian,the HUTT was carried.According to the result of HUTT and reaction type,the children were divided into HUTT negative group,orthostatic tachycardia syndrome(POTS) group,vasovagal syncope (VVS) vascular inhibitory type group,VVS heart inhibited type group,the VVS mixed group.Results Compared to the HUTT negative group,the age increased in POTS group and VVS vascular inhibitory group and VVS mixed group(P ＜ 0.05),height and body quality and body surface area increased in POTS group and VVS vascular inhibitory group and VVS mixed group(P ＜ 0.01).Compared to POTS group,body quality and body surface area reduced in VVS vascular inhibitory group and VVS mixed group(P ＜ 0.05).VVS heart inhibitory group was no statistically significant difference compared with the other groups (P ＞ 0.05).Conclusion There is a certain relationship between the hemodynamic changes in HUTT and the height,body quality and BMI in children.

Effect of cytomegalovirus infection on infant weight growth and correlation between the weight growth and copies number of the virus / 中国综合临床

Objective To investigate the effect of cytomegalovirus(HCMV) infection on infant bodyquality growth,and analysis of the correlation between children of all ages body-quality growth rate and copy number of the virus.Methods One hundred and sixty-eight children with HCMV infection were enrolled in the current study who were hospitalized from Oct.2012 to Oct 2013 in the Affiliated Hospital of Xuzhou Medical College.Children's urine HCMV-DNA copy number was measured by TaqMan probe fluorescence quantitative PCR.The retrospective study was conducted to compare the HCMV infection in children with weight-for-age and normal children.The correlation between children with body-quality growth rate and copy number of the virus was analyzed.Results All 168 urine specimens were positive regarding HCMV-DNA.The age of all distribution was from 1 month to 3 years.There was a negative correlation between the increase body weigh and the copies of virus of children with 3-6 months (r =-0.774,P ＜ 0.01).Conclusion The growth and development of children with HCMV at age before 6 months were slower than Children with the same age.The growth of cytomegalovirus infection increase gradually speeding when they were over 6 months and it was approaching to that same age when they are 2 years old.The growth rate is lower than that of normal children when HCMV children were before 1 years old.The correlation of body-quality growth rate and the number of copies of the virus was negative,especially from 3 months to 6 months.