Effect of different feeding methods on gastrointestinal function in critical patients (DFM-GFC): study protocol for a randomized controlled trial.

BACKGROUND: Enteral nutrition is a major pathway of nutrition for patients requiring critical care. However, it remains unclear whether intermittent or continuous feeding is the better approach, especially after nasogastric enteral nutrition via a gastric tube. Therefore, this randomized controlled clinical study was designed to observe the effects of different methods on critically ill patients. METHODS: Different Feeding Methods on Gastrointestinal Function of Critical patients (DFM-GFC) is a randomized clinical study that will be performed to assess the effects of three feeding methods on critically ill patients. A total of 90 critically ill patients will be equally randomized into three groups: continuous feeding, cyclic feeding, and intermittent feeding. The patients will be administered a gastrointestinal nutrition preparation over 24 h via a gastric tube or over 16 h via an intermittent pump. The primary outcome is the mean duration (days) to reach the caloric goal in each group. Secondary outcomes include the rate of onset of gastric residual, abdominal pressure, the rate of onset pneumonia, and the proportion of individuals achieving the caloric goal. Additionally, the length of intensive care unit (ICU) stay and mortality rate at 28 days post-enrolment will be evaluated. DISCUSSION: This study will observe the effects of different feeding methods on various parameters, such as the energy target and gastrointestinal motility, in critically ill patients to improve quality of life and reduce the case fatality rate. The purpose of this study is to explore whether there is a more effective, safer and cost-efficient feeding method for the clinical treatment of critically ill patients. TRIAL REGISTRATION: ID: NCT04224883, ClinicalTrials.gov , registered January 9, 2020.

LncRNA BANCR participates in polycystic ovary syndrome by promoting cell apoptosis.

The long non­coding RNA (lncRNA) BANCR is a well­studied lncRNA that serves pivotal roles in various malignancies; however, to the best of our knowledge, its involvement in polycystic ovary syndrome (PCOS) remains unknown. In the present study, the expression levels of lncRNA BANCR were detected in granulosa cells (GCs) from patients with PCOS and non­PCOS patients undergoing in vitro fertilization by reverse transcription­quantitative polymerase chain reaction. Subsequently, GCs and the KGN human granulosa­like tumor cell line were treated with insulin, and BANCR expression was detected. KGN cells were also transfected with a BANCR expression vector, after which, cell proliferation, apoptosis and the expression levels of pro­apoptotic B­cell lymphoma 2­associated X protein (Bax) and p53 were detected by Cell Counting kit­8 assay, MTT assay and western blotting, respectively. The results revealed that the expression levels of lncRNA BANCR in GCs were significantly higher in patients with PCOS compared with in non­PCOS patients. In addition, insulin treatment significantly upregulated the expression of BANCR in GCs and KGN cells. Transfection with the BANCR expression vector significantly inhibited proliferation and promoted apoptosis of KGN cells, and significantly promoted the expression levels of pro­apoptotic Bax and p53. Therefore, it may be concluded that lncRNA BANCR participates in PCOS by promoting cell apoptosis through the upregulation of Bax and p53.

Effects of Electro-Acupuncture at Zusanli, Guanyuan for Sepsis Patients and Its Mechanism through Immune Regulation.

OBJECTIVE: To evaluate the effect of electro-acupuncture on Zusanli (ST 36), Guanyuan (RN 4) in patients with sepsis, and explore its mechanism in term of immune regulation. METHODS: In this prospective randomized controlled trial, 60 patients with sepsis were randomly assigned to the control group and the intervention group equally by block randomization. Patients in the control group received routine treatment and those in the intervention group received electro-acupuncture at bilateral Zusanli and Guanyuan in addition to routine treatment, respectively. The mortality at 28 days, Acute Physiology and Chronic Health Evaluation (APACHE)-II score were compared to evaluate the effect, and the levels of T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and monocytes of human leukocyte antigen (HLA)-DR using flow cytometry were compared to explore the mechanism of this combined treatment. RESULTS: Fifty-eight patients completed the trial with 29 in each group. There was no significant difference of mortality in the 28th day between the two groups, with 5 death of 29 patients in the intervention group (17.2%) and 9 of 29 in the control group (31.0%). After treatment, APACHE-II score of both groups was significantly decreased, however, score of the intervention group was lower than the control group (13.28±7.07 vs. 17.10±5.83; P<0.01). The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ ratio of the intervention group improved after treatment and were higher than the control group (59.71%±11.94% vs. 52.54%±11.86%; 36.46%±7.60% vs. 31.58%±10.23%; 18.40%±8.82% vs. 23.07%±7.30%; 2.38±1.14 vs. 1.54±0.80, respectively; all P<0.05). The expression of HLA-DR significantly increased after treatment in the intervention group than that in the control group (7.28%±9.26% vs. 1.27%±7.00%; P<0.01). CONCLUSION: Electro-acupuncture at Zusanli and Guanyuan could improve clinical curative effect in patients with sepsis, which might be achieved by regulation of the immune system.

[Comparative study on abdominal acupuncture and western medicine for treatment of menopause depressive disorder].

OBJECTIVE: To observe the therapeutic effects between abdominal acupuncture and Deanxit for treatment of menopause depressive disorder, and to explore the efficacy and safety of abdominal acupuncture. METHODS: Sixty cases were randomly divided into an observation group and a control group, 30 cases in each. The observation group was treated with abdominal acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6) and Guanyuan (CV 4), etc. The control group was treated with oral administration of Deanxit. The patients in both groups were treated for 4 weeks and followed up for another 4 weeks, and they were evaluated by Hamilton Depression Scale (HAMD) every couple weeks. RESULTS: The total HAMD scores of 2 and 4 weeks treatments and 2 and 4 weeks follow-up were all reduced in both groups (all P < 0.01). The total scores of 2 and 4 weeks follow-up in observation group were lower than those in control group, with significant differences in statistical analysis (both P < 0.05). Compared with the clinical therapeutic effect of both groups after 4 weeks treatment, there was no significant difference (P > 0.05), however, after 4 weeks follow-up, the therapeutic effect in observation group was superior to that in control group, with significant difference in statistical analysis (P < 0.05). The safety indexes before and after treatment of both groups were normal, and the adverse reaction rate in observation group was much lower than that in control group (P < 0.05). CONCLUSION: Abdominal acupuncture is an effective and safe method for menopause depressive disorder, it improves the menopause depressive symptoms with persistent action, less symptoms relapse and adverse reactions.