Objective:To retrieve, evaluate, and integrate the best evidence for the management of neurogenic bowel dysfunction (NBD) in spinal cord injury patients both domestically and internationally, providing a basis for relevant evidence-based practices.Methods:The guidelines, expert consensus, clinical decision-making, and systematic review of NBD management for spinal cord injury patients were electronically searched in various databases and professional association websites at home and abroad. The search period was from database establishment to March 31, 2023.Results:A total of 13 articles were included, including five guidelines, five evidence summaries, two expert consensus, and one clinical decision-making. A total of 33 recommendations for NBD management in spinal cord injury patients were summarized from five aspects of medical history assessment, medication management, physical therapy, diet and exercise, and health education.Conclusions:The best evidence for NBD management in spinal cord injury patients summarized is scientific and practical. Medical and nursing staff should selectively apply the best evidence based on clinical practice.

Objective:To systematically review and integrate the real feelings and needs of caregivers of children with liver transplantation.Methods:The computer search was conducted on China National Knowledge Infrastructure, China Biology Medicine disc, VIP, Wanfang Data, PubMed, Scopus, Web of Science, SDS, PsycINFO, CINAHL and Embase to collect qualitative studies on the real experiences of caregivers of children with liver transplantation. The search period was from establishment of the databases to July 31, 2023. The quality of the included literature was evaluated using the qualitative research appraisal tool of Australia Joanna Briggs Institute Evidence-based Health Care Center, and the results were analyzed using the Meta-integration method.Results:A total of eight articles were included, and 35 research results were extracted, which were summarized into 10 new categories and integrated into four results, namely, the dilemma of multiple challenges, complex emotional experience, multi-dimensional care needs and positive coping strategies.Conclusions:The caregivers of children with liver transplantation are faced with great pressure and difficulties in the process of care, and they are eager for multifaceted support. Medical staff should pay attention to the inner experience and needs of caregivers and construct supportive intervention programs to reduce their physical and mental burden and improve the quality of care for children with liver transplantation.

Objective To investigate the correlation between hepatic triglyceride content and glucose lipid metabolism,insulin resistance and β cell function.Methods A total of 32 type 2 diabetic patients with nonalcoholic fatty liver disease was recruited in this study.Hepatic triglyceride content was measured with liver proton magnetic resonance spectroscopy.Oral glucose tolerance test (OGTT) was carried out in all participants,with measurements of plasma glucose and insulin levels.The homeostasis model assessment insulin resistance index (HOMA-IR),hepatic insulin resistance (HIR),and Matsuda Index (MSI) were used to assess insulin resistance.The homeostasis model assessment beta cell function (HOMA-βF),early insulin secretion index (EISI) and late insulin secretion index (LISI) were used to assess β cell function.Results Hepatic triglyceride contents had positive correlations with body mass index (BMI),waist circumference,Body fat,aspartate transaminase (AST),alanine transaminase (ALT),triglycerides (TG),HOMA-IR,HIR,and negative correlations with MSI.Stepwise regression analysis showed that body fat and HOMA-IR were independently risk factors for hepatic triglyceride contents.Conclusions Hepatic triglyceride content is closely correlated with obesity,liver function,blood lipid,and insulin resistance;especially obesity and insulin resistance are the most important factors.

OBJECTIVETo study the influences of carbon disulfide (CS2) exposure on fatty acid metabolism in apolipoprotein E (ApoE) knockout mice and C57BL/6J mice.

METHODSTwenty-four male ApoE knockout mice were randomly and equally divided into four groups: a CS2-exposed normal diet group, a CS2-unexposed normal diet group, a CS2-exposed high-fat diet group, and a CS2-unexposed high-fat diet group. Twenty-four C57BL/6J male mice were divided into four groups in the same way. The CS2-exposed groups were exposed to CS2 (1 g/m(3)) by static inhalation for 5 hours a day, 5 days a week. After two weeks, the whole blood of mice was collected. Methyl ester derivatization of fatty acids was performed using an acid-catalyzed method. Fatty acid contents before and after exposure were compared by gas chromatography-mass spectroscopy.

RESULTSThere were significant differences in fatty acid contents of mice between the four groups. For the C57BL/6J mice, the arachidic acid contents in the CS2-exposed high-fat diet group were significantly lower than those in the CS2-unexposed high-fat diet group (P = 0.045 0). For the ApoE knockout mice, the arachidonic acid contents in the CS2-exposed normal diet group were significantly lower than those in the CS2-unexposed control diet group (P = 0.045 2). For the ApoE knockout mice, the γ-linolenic acid contents in the CS2-exposed high-fat diet group were significantly higher than those in the unexposed high-fat diet group (P = 0.044 7).

CONCLUSIONExposure to CS2 can induce fatty acid metabolism disorder in mice, indicating that CS2 may increase the risk of atherosclerosis and other cardiovascular diseases.

Administration, Inhalation ; Animals ; Apolipoproteins E ; genetics ; Atherosclerosis ; Carbon Disulfide ; toxicity ; Diet, High-Fat ; Fatty Acids ; chemistry ; Lipid Metabolism ; drug effects ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout

OBJECTIVETo find out and analyze differentially expressed miRNAs in the plasma of benzene exposed workers, and explore the potential roles of plasma miRNAs in the development of hematologic toxicity induced by benzene exposure.

METHODSBy individual matching, low blood cell group, unstable blood cell group and normal group of 10 benzene exposed workers in each group were taken as subjects. Microarray was used to find out differentially expressed miRNAs among three groups. Three miRNAs validated by real-time quantitative PCR. Target genes of 9 miRNAs with the high abundance and significant difference were predicted using Target scan, Picture and miRanda softwares. David 6.7 online platform was used to perform GO term enrichment and KEGG pathway analysis of those targets.

RESULTSMicroarray screened out that 138 miRNAs were differentially expressed. Three significant classes of differentially expressed miRNAs were found with the cluster analysis. The detected expressions of miR-638, let-7f-5p and miR-223-3p by relative RT-qPCR was consistent with the microarray date. Pathway analysis showed that the most enriched pathway was focal adhesion, with 6 potential functional targets, including SOS₂, VCL, CCND2, COL4A6, IGF1 and MAPK1.

CONCLUSIONWe have identified the plasma miRNA profile in benzene exposed workers, and further analysis indicates that focal adhesion-associated miRNAs play a potential role in hematologic toxicity induced by benzene exposure.

Adult ; Benzene ; adverse effects ; Female ; Humans ; Male ; MicroRNAs ; genetics ; Middle Aged ; Occupational Exposure ; adverse effects ; Oligonucleotide Array Sequence Analysis ; Young Adult

OBJECTIVETo investigate atmospheric mercury concentration in the workplace and urinary mercury concentration in workers exposed to mercury in a thermometer factory, and to determine the levels and influencing factors of urinary Β₂-microglobulin (Β₂-MG) and retinol-binding protein (RBP) in these workers.

METHODSAn occupational health survey of the workplace was completed according to relevant national occupational health standards. Questionnaire survey and occupational health examination were conducted in 178 workers exposed to mercury in the factory. Statistical analysis was accomplished using SPSS 19.0.

RESULTSIn the workplace, atmospheric mercury concentration was out of limits at seven of eight detection points expressed by short-term exposure limit; it was out of limits at all the eight detection points shown by time-weighted average. Statistically significant difference in atmospheric mercury concentration was found among different detection points (F = 138.714, P < 0.001). The geometric mean of urinary mercury concentration measured in 154 workers was 171.607 µg/g. There were 127 workers with urinary mercury concentration exceeding the standard (82.5% over-standard rate). Significant difference in urinary mercury concentration was shown in the workers among different positions (χ² = 44.531, P < 0.01). Urinary mercury concentration was positively correlated with atmospheric mercury concentration (r = 0.624, P < 0.01). The mean urinary Β₂-MG level measured in 148 workers was 0.142 mg/L, and seven workers had urinary Β₂-MG levels greater than 0.3 mg/L (4.7% abnormal rate). The mean urinary RBP level measured in 153 workers was 0.485 mg/L, and 19 workers had urinary RBP levels greater than 0.7 mg/L (12.4% abnormal rate). Ordinal logistic regression showed that age >34 years (OR = 4.88, 95%CI: 2.24∼10.62) and length of service >15 years (OR = 2.50, 95%CI: 1.06-5.92) were risk factors for increased urinary Β₂-MG level. Age >45 years (OR = 7.52, 95%CI: 2.50∼22.65) was a risk factor for increased urinary RBP level.

CONCLUSIONIn the thermometer factory under study, atmospheric and urinary mercury concentrations both seriously exceeded the standards, which were harmful to the health of workers. High atmospheric mercury concentration, old age, and long length of service were risk factors for increased urinary Β₂-MG and RBP levels in workers exposed to mercury.

Adult ; Environmental Exposure ; Humans ; Kidney ; drug effects ; Kidney Diseases ; chemically induced ; Mercury ; analysis ; toxicity ; Occupational Exposure ; Risk Factors ; Threshold Limit Values ; Time Factors ; Workplace

OBJECTIVETo investigate the effects of carbon disulfide (CS(2)) inhalation on the lipid levels of ApoE knockout gene mice and C57BL/6J mice.

METHODSFifty-one male ApoE gene knockout mice were randomly divided into four groups: CS(2)-exposed normal diet group, CS(2)-unexposed normal diet group, CS(2)-exposed high-fat diet group, and CS(2)-unexposed high-fat diet group. Fifty male C57BL/6J mice were divided into four groups in the same way. The exposed groups received 1000 mg/m3 CS(2) by static inhalation (5h/d, 5d/w) for four weeks. The weight of each mouse was determined and recorded once a week. On the 14th day of exposure, six mice in each group were randomly selected to measure serum total cholesterol (TC) levels. On the 28th day of exposure, the serum levels of TC and low-density lipoprotein (LDL) in the remaining mice were measured.

RESULTSThe mean weight gain of exposed groups was less than that of the unexposed groups. On the 14th and 28th days of experiment, the TC levels of the CS2-exposed high-fat diet group were significantly higher than those of the CS(2)-unexposed high-fat diet group among ApoE knockout gene mice (P < 0.01 for both). On the 14th day of experiment, the TC levels of the CS(2)-unexposed high-fat diet group were significantly higher than those of the CS(2)-unexposed normal-diet group among C57BL/6J mice group (P < 0.05). On the 28th day of experiment, the LDL levels of the CS(2)-exposed high-fat diet group were significantly higher than those of the CS(2)-unexposed high-fat diet group among ApoE knockout gene mice (P = 0.003).

CONCLUSIONCS(2) exposure, high-fat diet, and ApoE gene knockout can elevate blood lipids in mice, thus increasing the risk of atherosclerosis.

Administration, Inhalation ; Animals ; Apolipoproteins E ; genetics ; Atherosclerosis ; Body Weight ; Carbon Disulfide ; toxicity ; Diet, High-Fat ; adverse effects ; Gene Knockout Techniques ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Lipoproteins, LDL ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout

ObjectiveTo investigate the postoperative 3D MRI appearances and their evolvement patterns of ACL grafts and bone tunnels at follow-up.Methods There were 26 double bundles ACL reconstructions and 16 single bundle ACL reconstructions,and a total of 56 follow-up 3D MR Imaging.MR images were reconstructed with MPR technique to evaluate grafts,bone tunnels,fixers and associated.complications.Proportions of grafts with hypointensity or hyperintensity and occurrence rates of marrow edema around bone tunnels were calculated respectively among groups of different periods after operation.ResultsThere were 24 grafts of hypointensity and 32 grafts of hyperintensity.Grafts of 2 cases were suspended with cross pins within femoral tunnels,graft of 1 case was suspended with an endobutton within the femoral tunnel,and grafts of other sites were fixed with interference screws.In the three periods as 3 months,6 to 9 months and over 12 months after cruciate ligament reconstruction,proportions of hypointensive grafts were 20/25,0/14 and 4/10 respectively,while proportions of hyperintensive grafts were 5/25,14/14 and 6/10 respectively,occurrence proportions of marrow edema around bone tunnels were 54/54,10/32 and 4/26 respectively.There was 1 tear graft,4 tibial tunnels placed anteriorly with ACL graft impingement on the intercondylar roof,3 femoral tunnels placed anteriorly,and 2 bone tunnels with mismatching interference screws.Conclusion3D MRI can accurately demonstrate the state of ACL grafts,bone tunnels,fixers and associated complications.Intensity of grafts presented a rise and reduce pattern after operation.

Objective To prospectively evaluate the value of diffusion-weighted imaging with background signal suppression (DWIBS) in the detection and diagnoses of metastatic cervical lymph nodes. Methods Twenty patients with head and neck squamous cell carcinomas underwent conventional MRI and DWIBS. The ADC values were measured and compared between metastatic and benign lymph nodes. The abilities of DWIBS and conventional MRI in the evaluation of metastatic cervical lymph nodes were compared. Results Conventional MRI demonstrated 101 lymph nodes, in which 58 were diagnosed as metastatic nodes. When MRI criteria were used for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity, accuracy, positive and negative predictive value were 78% (47/60), 81%(44/54), 80% (91/114), 82% (47/57) and 77% (44/57), respectively. The mean ADC values of metastatic nodes (n =60) and benign nodes (n =54) were (0.945 ±0.122) × 10-3 mm2/s and (1. 210 ±0. 151 ) × 10-3 mm2/s ( t = - 10. 354 ,P ＜0. 01 ). When an ADC value of 1. 090 × 10 -3 mm2/s was used as the threshold for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity,accuracy, positive and negative predictive value were 88% (53/60), 80% (43/54), 84% (96/114), 83%(53/64) and 86% (43/50), respectively. Conclusion DWIBS is helpful in diagnosing metastatic cervical lymph nodes of head and neck squamous cell carcinoma, and is superior to conventional MRI in their detection.

Objective To analysis the effect of axial loading to ADC value, FA of lumbar intervetebral discs. Methods Forty five patients with low back pain (age range, 25 to 54 years) were evaluated with MR T2WI, MR T1WI and diffusion tensor imaging (DTI) of the lumbar spine. Following axial loading with 40% to 50% body weight for 10 minutes, a repeat DTI was performed. DTI were obtained by using an echo-planar imaging ( EPI ) sequence, TE 89 ms, TR 2500 ms, b value of 400 s/mm2,6 noncollinear diffusion directions. Scan time was approximately 4 min 10 s. An isotropic ADC map, FA map and bo map were calculated from DTI sequence. The mean ADC value, FA prior to and following axialloading were analyzed with t test and Rank Sum test. Results Forty five patients with 225 discs were evaluated and 223 discs were included in the study except for 2 calcified discs. The Pfirrmann grading results were as following: 100 Grade Ⅱ , 48 Grade Ⅲ, 59 Grade Ⅳ, and 16 Grade Ⅴ. No significant difference existed in the mean ADC value before [ ( 1666 ± 252 ) × 10-3 mm2/s ] and after [ ( 1662 ± 253 ) ×10 -3 mm2/s ] axial loading ( Z = - 1.363, P ＞ 0.05 ), but the mean FA [ ( 301 ± 104 ) × 10 -3, ( 316 ±112) × 10-3 ] value increased ( Z = - 2.794, P ＜ 0.05 ). The paired-samples t test show that the mean ADC value [ ( 1685 ± 190) × 10-3 mm2/s, ( 1624 ± 180) × 10-3mm2/s] of Grade Ⅲ discs decreased after axial loading, t=3.513, P＜0. 05, Grade Ⅲ, Ⅳdiscs mean FA value [(300±87) ×10-3, (326±87) ×10-3 for Grade Ⅲ and (348 ±67) × 10-3, (351 ± 71 ) × 10-3 for Grade Ⅳ ] increased, t = - 2. 210,- 2.006, P ＜ 0.05. No significant difference existed in Grade Ⅱ , Ⅳ and Ⅴ discs ADC value, all the P ＞0.05. No significant difference existed in Grade Ⅱ and Ⅴ discs FA value, both the P ＞ 0.05. Conclusions Short time axial loading mainly affect the mildly degenerated discs, the ADC value decreases and the disc diffusion ability decreases. No obvious change in ADC value or disc diffusion ability existed in the normal and severely degenerated discs.