Female ; Gastroscopy ; Humans ; Infant ; Intestinal Obstruction ; diagnosis ; therapy ; Treatment Outcome

OBJECTIVETo explore the role of group II metabotropic glutamate receptors in the modulation of basic respiratory rhythm.

METHODSNeonatal (0-3 days) SD rats of either sex were used. The medulla oblongata brain slice containing the medial region of the nucleus retrofacialis (mNRF) and the hypoglossal nerve rootlets was prepared, and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous carbogen (95% O2 and 5% CO2) within 3 min. The brain slices were quickly transferred to a recording chamber and continuously perfused with oxygen-saturated MKS at a rate of 4-6 ml/min at 27-29 degrees celsius. Eighteen medulla oblongata slices were divided into 3 groups and treated for 10 min with group II metabotropic glutamate receptor-specific agonist 2R,4R-4-aminopyrrolidine-2,4-dicarboxylate (APDC) (at concentrations of 10, 20, 50 micromol/L), group II metabotropic glutamate receptor antagonist (2S)-alpha-ethylglutamic acid (EGLU) (300 micromol/L), or APDC (50 micromol/L)+EGLU (300 micromol/L) after a 10 min APDC (50 micromol/L) application. Respiratory rhythmical discharge activity (RRDA) of the rootlets of the hypoglossal nerve was recorded by suction electrodes.

RESULTSAPDC produced a dose-dependent inhibitory effect on the RRDA, prolonging the respiratory cycle and expiratory time and decreasing the integral amplitude and inspiratory time. EGLU induced a significant decrease in the respiratory cycle and expiratory time. The effect of APDC on the respiratory rhythm was partially reversed by the application of APDC+EGLU.

CONCLUSIONGroup II metabotropic glutamate receptors are probably involved in the modulation of the RRDA in isolated neonatal rat brainstem slice.

Animals ; Animals, Newborn ; In Vitro Techniques ; Medulla Oblongata ; physiology ; Rats ; Rats, Sprague-Dawley ; Receptors, Metabotropic Glutamate ; physiology ; Respiratory Center ; physiology

The present study was to evaluate feasibility of a limited sampling strategy (LSS) in the prediction of inhibited hepatic CYP3A activity with systemic clearance of midazolam (MDZ), a hepatic CYP3A activity phenotyping probe. Rats were pretreated with a serial doses of ketoconazole, a selective inhibitor on CYP3A. Blood samples were collected and detected for MDZ at specified time points after intravenous injection of MDZ. Stepwise regression analysis and a Jack-knife validation procedures were performed in one group of rats as training set to establish the most informative LSS model for accurately estimating the clearance of MDZ. Another group of rats with same treatment was used as validation set to estimate the individual clearance based on predictive equations derived from the training set. Bland-Altman plots showed a good agreement between the systemic clearance calculated from DAS (CLobs) and corresponding parameter that was derived from three LSS models (CLest). LSS models derived from two or three sampling time points, including 60, 90 min, 30, 60, 90 min and 30, 60, 120 min, exhibited a good accuracy and acceptable error for estimating the CLobs of MDZ to evaluate hepatic CYP3A activity, especially the 60, 90 min LSS model is most accurate and convenient. The results supported that limited plasma sampling to predict the systemic clearance of MDZ is easier than the usual method for estimating CYP3A phenotyping when the hepatic activity of CYP3A is reduced in the rat. The present study provided theoretical basis and laboratory evidence for LSS to clinically evaluate metabolizing function of liver and
Animals ; Area Under Curve ; Aryl Hydrocarbon Hydroxylases ; antagonists & inhibitors ; genetics ; metabolism ; Cytochrome P-450 CYP3A ; genetics ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Dose-Response Relationship, Drug ; Enzyme Inhibitors ; pharmacology ; Injections, Intravenous ; Ketoconazole ; administration & dosage ; pharmacology ; Male ; Metabolic Clearance Rate ; Midazolam ; blood ; pharmacokinetics ; Phenotype ; Random Allocation ; Rats ; Rats, Wistar

ObjectiveTo investigate the risk factors for portal vein thrombosis (PVT) in cirrhotic patients with esophageal varices, and to establish a nomogram for predicting the risk of PVT. MethodsA retrospective analysis was performed for the clinical data of 283 cirrhotic patients with esophageal varices who attended Shandong Provincial Hospital Affiliated to Shandong University from December 2013 to December 2018, and according to imaging findings, the patients were divided into PVT group with 119 patients and non-PVT group with 164 patients. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression analysis was used to screen out independent risk factors; a nomogram was established and validated based on the results of the multivariate logistic regression analysis, and C-index and calibration curve were used to evaluate its performance. ResultsThe univariate analysis showed that compared with the non-PVT group, the PVT group had significantly higher Child-Pugh class (χ2=9.388, P=0.009), proportion of patients with a history of splenectomy (χ2=26.805, P＜0.001), white blood cell count (Z=-2.248, P=0.025), platelet count (Z=-3.323, P=0.001), D-dimer(Z=-6.236, P＜0.001), and spleen thickness (Z=-2.432, P=0.015) and a significantly lower level of triglyceride (TG) (Z=-4.150, P＜0.001). The multivariate logistic regression analysis showed that a reduction in TG (odds ratio ［OR］=0.441, 95% confidence interval ［CI］: 0.190-0.889), an increase in D-dimer (OR=1.151, 95%CI: 1.041-1.272), prolonged prothrombin time (PT) (OR=1160, 95%CI: 1.025-1.313), and a history of splenectomy (OR=2.933, 95%CI: 1.164-7.389) were independent risk factors for PVT in cirrhotic patients with esophageal varices. In addition, a nomogram was established based on the results of the multivariate regression analysis, with a C-index of 0.745, and the calibration curve showed good consistency between the observed and predicted values for the development of PVT. ConclusionA reduction in TG, an increase in D-dimer, prolonged PT, and a history of splenectomy are independent risk factors for PVT in cirrhotic patients with esophageal varices, and the nomogram developed based on these results can provide a quantitative and intuitive tool for clinicians to assess the risk of PVT.

Objective:To study the influence of communication adequacy of critical patients on their willingness to participate in their own medical safety.Methods:From August 2019 to October 2019, a questionnaire survey was conducted on 209 critical patients.Results:The willingness to participate in the medical safety of critical patients was 3.92 ± 0.57, the willingness to participate was higher, the communication between doctors and patients was more sufficient, and the willingness to participate in the medical safety of patients was increased.Conclusions:Understanding the psychology of critical patients and paying attention to the sufficiency of communication between doctors and patients can increase the flexibility of patients' participation in medical safety and improve their willingness to participate in their own medical safety.

OBJECTIVETo study the role of Helicobacter pylori (H. pylori) infection in newly diagnosed childhood immune thrombocytopenia (ITP).

METHODSA total of 495 children with newly diagnosed ITP who were hospitalized for the first time between January 2011 and December 2013 were included as the case group. A total of 123 children with common respiratory tract infection (not ITP or other diseases of blood system) were randomly selected as the control group. All patients were divided into four groups by age: <1 year group, 1-3 years group, 3-7 years group, and 7-14 years group. The incidence of H. pylori infection in all age groups and the clinical outcomes of ITP children with or without H. pylori infection were retrospectively analyzed.

RESULTSThe incidence rate of H. pylori infection in the case group increased with increasing age. There was no significant difference in the incidence rate of H. pylori infection between the case and the control groups among subjects of the same age (P>0.05). All the ITP patients were not given anti-H. pylori treatment and only received the treatment (glucocorticoid and/or immunoglobulin) for ITP, and their remission rate declined with increasing age. There was no significant difference in the remission rate between the ITP children with H. pylori infection and those without H. pylori infection in the same age group (P>0.05).

CONCLUSIONSH. pylori infection may not be a major cause of ITP in children, and the clinical outcomes of children with acute ITP are not affected by receiving anti-H. pylori treatment or not.

Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Helicobacter Infections ; complications ; epidemiology ; Helicobacter pylori ; Humans ; Incidence ; Infant ; Male ; Purpura, Thrombocytopenic, Idiopathic ; etiology

With the development of genetics and advances in genetic testing technology,the demand for cancer genetic counseling has increased dramatically.Advanced practice nurses play a key role in personalized health care delivery.The oncology genetic nurse-led genetic counseling services in foreign countries are becoming more and more mature,but in China,the work of oncology genetic counseling started late,and the combination of genetics/genomics with nursing is still in its infancy.There is still a lack of relevant research on oncology genetic nurses.This article introduced the qualification certification,core competence and clinical practice content of foreign oncology genetic nurses,and summarized the clinical practice effect of oncology genetic nurses and the enlightenment to China's advanced nursing practice,which provided references for the construction of oncology genetic nurses training programs and clinical service models suitable for China's national conditions,so as to meet the needs of the development of advanced nursing practice and the growing demand for precision oncology and high-quality genetic medical care.

OBJECTIVESTo investigate total drinking water intake of adults in the four cities of China in summer.

METHODSA total of 1483 adults aged 18 - 60 yrs from Beijing, Shanghai, Chengdu and Guangzhou were selected using multiple-stage random sampling method. The information of amounts and types of daily drinking water was recorded by subjects for seven consecutive days using a quantitative measurement. The amounts and types of daily drinking water among different cities and between men and women or urban and rural was analyzed.

RESULTSThe median of daily total drinking water of subjects was 1488 ml, with significant difference among the four cities (1579, 1793, 1150, 1467 ml in Beijing, Shanghai, Chengdu and Guangzhou city, respectively, χ(2) = 154.31, P = 0.000). The median of daily drinking water was significantly higher in men (1679 ml) than women (1370 ml) (Z = 8.34, P = 0.000), but no significant difference was found between urban (1514 ml) and rural (1466 ml) daily drinking water median (Z = -0.81, P = 0.420). The median of daily consumption of plain water, tea and beverages were 786, 109, 186 ml, respectively. Among four cities, the highest consumption of plain water was in subjects of Guangzhou (917 ml), while the highest tea consumption in Shanghai (257 ml) and the highest beverages consumption in Shanghai (323 ml) and Beijing (264 ml). Consumption of tea in men (229 ml) was significantly higher than that in women (57 ml) (Z = 7.52, P = 0.000). Subjects in urban (693 ml) had lower consumption of plain water than those in rural (914 ml). The proportion was 32.4% (480/1483) for subjects with water drinking less than 1200 ml per day.

CONCLUSIONThe daily consumption of total drinking water, including plain water, tea and beverages is different in adults among different cities and is different in gender and regions. It is nearly 1/3 of subjects with daily total drinking water less than current Chinese recommended water intake (1200 ml).

Adolescent ; Adult ; Beverages ; China ; Drinking ; physiology ; Drinking Water ; Female ; Humans ; Male ; Middle Aged ; Seasons ; Urban Population ; Young Adult

BACKGROUNDAngiotensin type 1 receptor (AT 1 R) antagonists are extensively used for blood pressure control in elderly patients with hypertension. This study aimed to investigate the inhibitory effects of AT 1 R antagonist valsartan on platelet aggregation and the occurrence of cardio-cerebral thrombotic events in elderly patients with hypertension.

METHODSTwo-hundred and ten patients with hypertension and aged > 60 years were randomized to valsartan (n = 140) or amlodipine (n = 70) on admission. The primary endpoint was platelet aggregation rate (PAR) induced by arachidonic acid at discharge, and the secondary endpoint was the rate of thrombotic events including brain infarction and myocardial infarction during follow-up. Human aortic endothelial cells (HAECs) were stimulated by angiotensin II (Ang II, 100 nmol/L) with or without pretreatment of valsartan (100 nmol/L), and relative expression of cyclooxygenase-2 (COX-2) and thromboxane B 2 (TXB 2 ) and both p38 mitogen-activated protein kinase (p38MAPK) and nuclear factor-kB (NF-kB) activities were assessed. Statistical analyses were performed by GraphPad Prism 5.0 software (GraphPad Software, Inc., California, USA).

RESULTSPAR was lower after treatment with valsartan (11.49 ± 0.69% vs. 18.71 ± 2.47%, P < 0.001), associated with more reduced plasma levels of COX-2 (76.94 ± 7.07 U/L vs. 116.4 ± 15.89 U/L, P < 0.001) and TXB 2 (1667 ± 56.50 pg/ml vs. 2207 ± 180.20 pg/ml) (all P < 0.001). Plasma COX-2 and TXB 2 levels correlated significantly with PAR in overall patients (r = 0.109, P < 0.001). During follow-up (median, 18 months), there was a significantly lower thrombotic event rate in patients treated with valsartan (14.3% vs. 32.8%, P = 0.002). Relative expression of COX-2 and secretion of TXB 2 with concordant phosphorylation of p38MAPK and NF-kB were increased in HAECs when stimulated by Ang II (100 nmol/L) but were significantly decreased by valsartan pretreatment (100 nmol/L).

CONCLUSIONSAT 1 R antagonist valsartan decreases platelet activity by attenuating COX-2/TXA 2 expression through p38MAPK and NF-kB pathways and reduces the occurrence of cardio-cerebral thrombotic events in elderly patients with hypertension.

Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists ; therapeutic use ; Blood Platelets ; drug effects ; Blotting, Western ; Cell Line ; Cyclooxygenase 2 ; blood ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Platelet Aggregation ; drug effects ; Real-Time Polymerase Chain Reaction ; Tetrazoles ; therapeutic use ; Thrombosis ; blood ; drug therapy ; Thromboxane B2 ; blood ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

Objective To establish a height prediction model of Chinese Han male based on the reported 547 height-associated single nucleotide polymorphisms (SNPs) loci in Europeans, and assess its accuracy for height estimation. Methods The DNA typing was analyzed in 59 Han male samples of Shandong province by Affymetrix SNP Array 6.0 chip and HiSeq 4000 sequencing platform. Prediction model was established using 547 height-associated SNPs loci as predictors and weight allele sums (WAS) as com-puting method. The accuracy of height prediction model was analysed using receiver operating characteris-tic (ROC) curve and area under curve (AUC). Results There was no height-associated SNPs locus was found by genome-wide association studies. In present study, height prediction model was established by WAS and obtained an AUC of 0.67 (95％CI:0.53-0.90). Conclusion It has reference value for predicting the height of Han male in Shandong province by WAS model based on 547 SNPs loci, while it is still necessary to further promote the accuracy of the prediction model by screening more height-associated SNPs loci with population heterogeneity.