Development, Reliability and Validity of the Medication Literacy Scale for Parents of Children with Epilepsy.

Purpose: This study aimed to develop a medication literacy scale for parents of children with epilepsy (MLSPCE) and to test the reliability and validity of the scale. Patients and Methods: The pilot scale was formulated based on the concept of medication literacy, the knowledge-attitude-practice model, and relevant literature reviews. It was formed through two rounds of expert consultations using the Delphi method. A survey of 657 parents of children with epilepsy, who were admitted to the neurology department or examined in the neuro-electrophysiological outpatient department of Guangzhou Women and Children Medical Center, using the pilot scale was conducted from October 2021 to January 2022 to test the reliability and validity of the scale questionnaire. The content validity of the scale questionnaire was assessed by consulting 20 neurology nursing, neurology clinician, and nursing education experts. Numbers, percentages, t-test, correlation analysis, Cronbach's alpha reliability coefficient and factor analysis were used for data analysis. Results: The MLSPCE included 34 items in four dimensions. Ten factors were drawn from the explorative factor analysis, with a cumulative variance contribution rate of 62.32%. The content validity index of each item on the 34-item scale was between 0.81 and 1.0, and the scale-content validity index/ average was 0.97. The correlation coefficient between each item and its dimension was between 0.399 and 0.760, the correlation coefficients between dimensions were between 0.150 and 0.382, and the correlation coefficients between each dimension and the total scale were between 0.390 and 0.845. Differences for all comparisons were statistically significant (P < 0.05). Cronbach's alpha coefficient for the total scale was 0.864, and the split-half reliability of the total scale was 0.923. Conclusion: All the statistical procedures performed in the validity and reliability stages of the study showed that MLSPCE is a valid and reliable tool for measuring medication literacy among Chinese parents of children with epilepsy.

Effects of Exercise Intervention Based on Self-efficacy Theory on Pregnant Women with Gestational Diabetes Mellitus.

BACKGROUND: During pregnancy, gestational diabetes mellitus (GDM)is a common complication. Although some exercise programs have been recommended clinically, many pregnant women have low exercise compliance, making it difficult to effectively control blood sugar. Therefore, this study constructed an exercise intervention plan based on self-efficacy theory and explored the effect of the program on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus. METHODS: A randomized controlled trial was conducted. A usual exercise program was implemented for the participants in the control group, and the participants in the intervention group received an exercise program on the basis of the control group and combined with the self-efficacy theory. Participants were assessed based on exercise self-efficacy, blood glucose, weight gain, exercise compliance, and pregnancy outcomes at week 4, week 8 and week 12. RESULTS: One hundred three gestational diabetes mellitus patients were recruited at baseline, 53 in the intervention group and 50 in the control group. After the intervention, the exercise self-efficacy score and exercise compliance of the intervention group were higher than those of the control group (P<0.05). Fasting blood glucose, 2-h post-prandial plasma glucose, weight gain during the intervention period, incidence of neonatal hypoglycemia, and incidence of gestational hypertension were lower than those in the control group (P<0.05). CONCLUSION: Implementing an exercise intervention based on self-efficacy theory for gestational diabetes mellitus patients can improve exercise self-efficacy and exercise compliance, effectively control blood glucose and weight gain, improve pregnancy outcomes, and promote maternal and infant safety.

Benefits of different combinations of aerobic and resistance exercise for improving plasma glucose and lipid metabolism and sleep quality among elderly patients with metabolic syndrome: a randomized controlled trial.

Exercise has beneficial effects on metabolic syndrome (MS). However, the exercise prescriptions that best support plasma glucose and lipid control remain unknown. We evaluated the effects of different combinations of aerobic and resistance training programs on plasma glucose and lipid metabolism and sleep quality in elderly MS patients. Eighty-five elderly MS patients were randomly assigned to five groups: aerobic training (AT), resistance training (RT), high aerobic with low resistance training (HALRT), high resistance with low aerobic training (HRLAT), or control. The exercise groups performed supervised moderate-intensity exercise during three 50-min sessions per week for 12 weeks. Body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), handgrip strength (HGS), fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels and sleep quality were evaluated at baseline and after 12 weeks. All intervention groups showed significant improvements in SBP, HGS, FPG, 2hPG, and Pittsburgh Sleep Quality Index (PSQI) scores compared to baseline (all p < 0.05), while DBP, TC, TG, and LDL-C levels were significantly improved only in the HRLAT and HALRT groups (p < 0.05). The HALRT group showed the largest improvements in WC, SBP, DBP, HGS, FPG, 2hPG, and PSQI score (p < 0.001). The largest improvements in BMI, TC, and LDL-C were observed in the HRLAT group (p < 0.001). The combined exercise prescriptions were more effective than aerobic or resistance training alone at improving plasma glucose and lipid metabolism and sleep quality in elderly MS patients.

Longitudinal association between depressive symptoms and cognitive decline among middle-aged and elderly population.

BACKGROUND: Depression is considered a risk factor for cognitive decline. The long-term impact of depressive symptoms on cognitive performance has not been established thus far. OBJECTIVES: This study aimed to determine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly population. METHODS: We included 10,387 adults aged ≥45 years from the Health and Retirement Study (2004 to 2014) in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CESD) scale. Participant's cognitive function was assessed via the telephone interview for cognitive status (TICS); the total cognitive score ranged from 0 to 35. We classified the participants into four clusters according to the quartile of the total cognitive score (TCS). We examined the change of depressive symptoms and cognitive performance by using the unconditional latent growth curve modeling (LGCM) method, and a parallel LGCM method was used to examine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly adults in each cluster. RESULTS: Participants with lower levels of cognitive performance were associated with a greater risk of high depressive symptoms. Results from unconditional LGCM showed a sustained decline in cognitive performance and an increasing trend in depressive symptoms per 2 years for each cluster of participants. The parallel LGCM indicated that baseline levels of depression showed a significant negative correlation with the cognitive performance at baseline (ß [95% CI] of intercept(Dep) predicting intercept(TCS) were -0.33 [-0.41, -0.26], -0.03[-0.06, -0.00], -0.05 [-0.07, -0.02] and -0.64 [-0.70,-0.58], for clusters of Q1 to Q3 and the entire population, respectively). Further, a significant positive prospective association was observed between baseline levels of depression and changes in cognitive performance (intercept(Dep) predicting slope(TCS) were -0.05 [-0.08, -0.02], -0.09[-0.13, -0.05], -0.12 [-0.15, -0.08], -0.11 [-0.15, -0.06] and -0.04 [-0.06,-0.02] for clusters of Q1 to Q4 and the entire population, respectively). Moreover, for participants with the highest quartile of TCS, the rising trend of depressive symptoms accelerated the decline of cognitive performance during the follow-up period (Slope(Dep) predicting Slope(TCS): -0.44 [-0.86, -0.01]). CONCLUSION: Our results suggest that depressive symptoms were associated with lower cognitive performance and larger subsequent decline during follow-up period. Adults with depression may require more medical attention, and early intervention is required to delay the development of cognitive impairment and dementia.

Promoting enteral tube feeding safety and performance in preterm infants: A systematic review.

BACKGROUND: Enteral tube feeding is commonly used in preterm infants to provide enteral nutrition. Nurses play a crucial role in promoting feeding safety and performance. OBJECTIVES: The aims of this systematic review were to identify nursing practices regarding feeding safety and performance promotion in preterm infants with enteral tube feeding and summarize evidence on the effectiveness of these practices. METHODS: A comprehensive search was performed in six databases (MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane Library, and Scopus). Studies on nursing practices aimed at promoting feeding safety and performance in preterm infants with enteral tube feeding were included. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized controlled studies and the tool of risk-of-bias in non-randomized studies of interventions (ROBINS-I) for non-randomized studies of interventions. A narrative synthesis strategy was employed to gather evidence and analyze data. RESULTS: 61 studies (47 randomized controlled studies and 14 quasi-experimental studies) covering seven categories of practices were included. The identified nursing practices included controlling feeding interval, selecting feeding position, monitoring gastric residual, disposing of gastric residual, managing feeding temperature, feeding promotion stimulation, and supplementary methods during the transition from tube to oral feeding. Evidence supported the effectiveness of oro-motor stimulation and non-nutritive sucking as feeding performance promotion strategies in preterm infants. Other practices were suggested to be used cautiously or recommended to be further studied due to limited evidence. CONCLUSIONS: The review identified seven categories of nursing practices in promoting feeding safety and performance in preterm infants receiving enteral tube feeding. Oro-motor stimulation and non-nutritive sucking can be used in clinical settings to promote feeding performance in preterm infants with enteral tube feeding. Other practices will continue to be dictated by local preferences and cost factors until more robust evidence becomes available. REGISTRATION: PROSPERO database (CRD42020196256).

Association between intimate partner psychological violence and psychological distress among nurses: The role of personality traits and social support.

Aim: This study proposes investigating the risk and protective factors of intimate partner (IP) psychological violence and psychological distress to better promote psychological wellbeing for nurses and health outcomes for patients. Design: A cross-sectional study. Method: This cross-sectional study was carried out chiefly in Guangdong, Hunan, and Shaanxi provinces, in the east, central, and west of the Chinese economic areas, respectively. It was conducted in October 2021 using convenience sampling. A total of 843 nurses were eligible for the final analysis. Single-factor linear regression models were used to identify potential factors associated with IP psychological violence and psychological distress. In addition, the structural equation model was used to explore the role of personality traits and social support in the association between IP psychological violence and psychological distress. Results: The predictors for the score of IP psychological violence among nurses were participants' married status, contact frequency with a partner, perceived past-year psychological and physical violence experience, the alcohol consumption of partners, and personality traits and social support of partners. Moreover, the alcohol consumption of participants, the past-year experience of IP psychological violence, the score of psychological violence, personality traits, social support, and the personality traits of partners were associated factors affecting the psychological distress of nurses. In the structural model, the personality trait of partners had a direct pathway to psychological violence and social support. The results demonstrated that psychological violence significantly increased psychological distress. Conclusion: Personality traits and social support are essential factors influencing the relationship between IP psychological violence and psychological distress. Impact: The findings of this study emphasize the possibility and importance of identification and intervention for reducing IP psychological violence based on personality traits and social support.

Personality Profiles and Personal Factors Associated with Psychological Distress in Chinese Nurses.

BACKGROUND: A high prevalence of psychological distress is observed in nurses due to multiple occupational stressors. Personality traits and personal factors are important factors that lead to psychological distress. The personality profile reflects a combination of personality traits; however, the relationship between personality profiles and personal factors that affect psychological distress among nurses has not been defined. METHODS: This cross-sectional study was conducted in November 2020 in China. Convenience and snowball sampling were used to recruit participants. Latent profile analysis was used to identify personality profiles of nurses based on the big-five personality traits. Single-factor analysis and multivariate logistic regression were used to determine the factors affecting psychological distress. The structural equation model was used to verify the hypothetical model linking personality profiles, self-efficacy, psychological resilience, and coping style with psychological distress. RESULTS: A total of 953 Chinese nurses (934 female) with a mean (S.D.) age of 32.8 (8.6) years were recruited. Personality profiles identified were negative, normative, and positive. A personality profile may predict psychological distress directly and indirectly through self-efficacy, psychological resilience, and coping style. LIMITATIONS: No complex sampling limits the representativeness of Chinese nurses. External factors affecting psychological distress were not investigated. CONCLUSION: Nurses with anegative personality profile had a higher prevalence of psychological distress. This study establishes the importance of personality profile assessment to identify nurses at higher risk of psychological distress. It suggests that interventions should be based on self-efficacy, psychological resilience, and coping style as potential management strategies.

Psychological Distress and All-Cause, Cardiovascular Disease, Cancer Mortality Among Adults with and without Diabetes.

AIM: To examine the association of psychological distress with all-cause, cardiovascular disease (CVD) and cancer mortality in US adults, and verified whether the associations differed between participants with and without diabetes. METHODS: A total of 485,864 adults (446,288 without diabetes and 39,576 with diabetes) who participated in the National Health Interview Survey from 1997 to 2013 were linked to the National Death Index through December 31, 2015. Psychological distress was measured by the Kessler 6 distress scale (K6). Multivariable Cox proportional hazards regression models were performed to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between psychological distress and mortality. RESULTS: We ascertained 11,746 deaths (mean follow-up, 7. 7 years) among people with diabetes and 51,636 deaths (9.9 years) among those without diabetes. Psychological distress was associated with higher all-cause, CVD, and cancer mortality. Compared to non-diabetic adults without psychological distress, HRs (95% CI) were 1.07 (1.04 to 1.09) for mild, 1.26 (1.22 to 1.30) for moderate and 1.46 (1.38 to 1.55) for severe psychological distress. Compared to the same reference group, in diabetic participants the HRs were 1.39 (1.33 to 1.44) for no psychological distress, 1.59 (1.53 to 1.66) for mild, 1.90 (1.80 to 2.00) for moderate and 1.98 (1.82 to 2.17) for severe psychological distress. Similar associations were also observed for CVD and cancer mortality but with non-statistically significant interaction. CONCLUSION: Psychological distress was associated with higher mortality, particularly in participants with diabetes. Strategies to ameliorate psychological distress may be important to reduce mortality in this population.

Factors associated with physical activity in elderly nursing home residents: a path analysis.

BACKGROUND: Physical activity (PA) is low among elderly residents in nursing homes in China. We aimed to determine the factors that influence PA among elderly nursing home residents and their direct or indirect effects on PA levels. METHODS: The PA levels of the participants were measured using the International Physical Activity Questionnaire, and their health beliefs were assessed using a self-developed 18-item questionnaire titled the 'Health Beliefs of Nursing Home Residents Regarding Physical Activity' in accordance with Health Belief Model (HBM) constructs. The correlations between HBM constructs and PA levels were analyzed and a regression-based path analysis was conducted to examine the relationships between HBM constructs and PA levels. RESULTS: A total of 180 residents with a mean age of 82.5 years (standard deviation = 5.76) were recruited. Linear regression analysis revealed that self-efficacy (p < 0.001), perceived severity (p < 0.01), and cues to action (p < 0.01) were associated with the level of PA among nursing home residents. In the conceptual path model, self-efficacy, perceived severity, and cues to action had positive direct effects on the PA level, while perceived benefits and perceived barriers had indirect effects on the PA level. CONCLUSION: The residents' self-efficacy, perceived severity, and cues to action were found to be important factors that can affect the design and implementation of educational programs for PA. A better understanding of such associations may help healthcare providers design informed educational interventions to increase PA levels among nursing home residents.

Association between sleep duration and mortality risk among adults with type 2 diabetes: a prospective cohort study.

AIMS/HYPOTHESIS: This study aimed to investigate whether the effects of sleep duration interacted with the presence of diabetes. We specifically sought to examine the relationship between sleep duration and all-cause and cause-specific mortality in people with type 2 diabetes across sex, age at diagnosis, duration of diabetes and treatment type. METHODS: The sample consisted of 273,029 adults, including 248,817 without diabetes and 24,212 with type 2 diabetes, who participated in the National Health Interview Survey from 2004 to 2013 and whose data were linked to a mortality database up to 31 December 2015. Sleep duration was measured using self-report, whereby participants were asked 'on average how long do you sleep each day (≤5, 6, 7, 8, 9 or ≥10 h/day)?' The relationship between sleep duration and mortality risk was investigated using Cox proportional hazards regression model, with adjustments for demographics, BMI, lifestyle behaviours and clinical variables. RESULTS: Absolute mortality rate was higher in adults with diabetes and extremes of sleep duration (≤5 h/day, 215.0 per 10,000 person-years; ≥10 h/day, 363.5 per 10,000 person-years). There was a non-significant interaction between sleep duration and the presence of diabetes (p for interaction = 0.08). A J-shaped relationship existed between sleep duration and all-cause mortality risk in people with type 2 diabetes. Compared with the reference group (7 h/day), both shorter and longer sleep durations were associated with increased risk of all-cause mortality (≤5 h/day, HR 1.24 [95% CI 1.09, 1.40]; 6 h/day, HR 1.13 [1.01, 1.28]; 8 h/day, HR 1.17 [1.06, 1.30]; ≥10 h/day, HR 1.83 [1.61, 2.08]). Similar associations were also observed for mortality risk from CVD, cancer, kidney disease, Alzheimer's disease and chronic lower respiratory diseases. Longer sleep duration in those with a younger age at diabetes onset was associated with greater risks of all-cause and CVD mortality. Shorter sleep duration in individuals treated with both insulin and oral glucose-lowering medication was also associated with higher risks of all-cause and CVD mortality. CONCLUSIONS/INTERPRETATION: The associations between sleep duration and mortality risk may be different between diabetic and non-diabetic individuals. In people with type 2 diabetes, sleeping less or more than 7 h/day was associated with increased risk of all-cause and condition-specific mortality. The association was more prominent in those with a younger age at diabetes onset and receiving treatment with both oral glucose-lowering medication and insulin. This population may benefit from targeted sleep-related interventions to reduce the risks of adverse health outcomes. Graphical abstract.

Recognizing and stabilizing miR-21 by chiral ruthenium(II) complexes.

MiR-21, a non-coding miRNA with 22 nucleotides, plays an important part in the proliferation, invasion, and metastasis of tumor cells. The present study demonstrates that isomers of chiral ruthenium(II) complexes with alkynes (Λ-1 and Δ-1) were synthesized by Songogashira coupling reaction by using microwave-assisted synthetic technology. The isomers can recognize and stabilize miR-21, with the Λ-isomer showing a stronger binding capacity than the Δ-isomer. Further studies showed that both isomers can be uptaken by MDA-MB-231 cells and enriched in the nucleus. Treatment with the Λ-/Δ-isomer downregulated the expression of miR-21. In a word, the development of chiral ruthenium(II) complexes act as potential inhibitors against tumor cells by recognizing, stabilizing, and regulating the expression of miR-21.

Methods of Gastric Tube Placement Verification in Neonates, Infants, and Children: A Systematic Review and Meta-Analysis.

INTRODUCTION: The objective was to evaluate diagnostic performance of multiple methods used to assess gastric tube placement verification in neonates, infants, and children. METHODS: A systematic review using the methods outlined in the Cochrane Handbook for Reviews of Diagnostic Test Accuracy was conducted. Eight databases were searched. Studies on neonates, infants, and children in which researchers compared different methods for gastric tube placement verification with x-ray reference standard were eligible in the review. RESULTS: Eight studies involving 911 participants that evaluated 9 index tests for gastric tube placement verification were included. Most studies were of moderate methodological quality, and most index tests were assessed in small individual studies. pH testing with cutoff values ≤ 6 for gastric tube position confirmation was the only index test subjected to meta-analysis, with the summary sensitivity and specificity being 0.77 (95% confidence interval [CI] 0.56-0.90) and 0.42 (95% CI 0.16-0.73). Other tests for gastric tube placement verification showed great variations in sensitivities and specificities. DISCUSSION: pH ≤ 6 is not sufficiently accurate to be recommended for gastric tube placement verification in neonates, infants, and children. Diagnostic performance of pH ≤ 4 or 5 and other methods cannot be determined because of the paucity of data and methodological variations in studies. Clinical practice related to the diagnostic tests used will continue to be dictated by local preferences and cost factors, until stronger evidence becomes available.

Different exercises for pregnant women with gestational diabetes: a meta-analysis of randomized controlled trials.

INTRODUCTION: There is evidence that maternal and child outcomes in patients with gestational diabetes mellitus (GDM) are associated with different exercise patterns. However, the evidence on which forms of exercise are beneficial for pregnant women with GDM is unclear. EVIDENCE ACQUISITION: PubMed, EMBASE, the Cochrane Library and the Web of Science were systematically searched for eligible studies until Feb.24, 2019. A randomized controlled trial (RCT) was used as the study method. The literature quality was evaluated and the data extracted by two researchers, and statistical analysis was carried out using Review Manage 5.2 software. EVIDENCE SYNTHESIS: A total of nine RCTs were included. The research results show that compared with the conventional treatment group, aerobic exercise reduced the fasting blood glucose (WMD=-0.35, 95% CI: -0.62 to -0.08, I2=87%), postprandial blood glucose (WMD=-0.62, 95% CI:-0.95 to -0.29, I2=84%) and glycosylated hemoglobin levels (WMD=-0.35, 95% CI:-0.49 to -0.20, I2=71%) in patients with GDM. Compared with the conventional treatment group, the dosage of insulin (WMD=0.97, 95% CI: 0.42-2.26, I2=0%) in patients with GDM in the resistance exercise group was reduced, and the effect of combined treatment was statistically significant. Compared with the conventional treatment group, the combination of aerobic exercise plus resistance exercise training reduced postprandial blood glucose in patients with GDM (WMD=-0.64, 95% CI:-0.94 to -0.34), and the combined treatment effect was statistically significant. CONCLUSIONS: Different types of exercise have different intervention effects on the outcome of patients with gestational diabetes. However, we do not have enough data to determine whether infants benefit from this exercise, and it is still necessary to conduct large-scale, high-quality and long-term intervention studies for verification.

Sex differences in the association between diabetes and risk of cardiovascular disease, cancer, and all-cause and cause-specific mortality: a systematic review and meta-analysis of 5,162,654 participants.

BACKGROUND: Studies have suggested sex differences in the mortality rate associated with diabetes. We conducted a meta-analysis to estimate the relative effect of diabetes on the risk of all-cause, cancer, cardiovascular disease (CVD), infectious disease, and respiratory disease mortality in women compared with men. METHODS: Studies published from their inception to April 1, 2018, identified through a systematic search of PubMed and EMBASE and review of references. We used the sex-specific RRs to derive the women-to-men ratio of RRs (RRR) and 95% CIs from each study. Subsequently, the RRR for each outcome was pooled with random-effects meta-analysis weighted by the inverse of the variances of the log RRRs. RESULTS: Forty-nine studies with 86 prospective cohorts met the inclusion criteria and were eligible for analysis. The pooled women-to-men RRR showed a 13% greater risk of all-cause mortality associated with diabetes in women than in men (RRR 1.13, 95% CI 1.07 to 1.19; P < 0.001). The pooled multiple-adjusted RRR indicated a 30% significantly greater excess risk of CVD mortality in women with diabetes compared with men (RRR 1.30, 95% CI 1.13 to 1.49; P < 0.001). Compared with men with diabetes, women with diabetes had a 58% greater risk of coronary heart disease (CHD) mortality, but only an 8% greater risk of stroke mortality (RRRCHD 1.58, 95% CI 1.32 to 1.90; P < 0.001; RRRstroke 1.08, 95% CI 1.01 to 1.15; P < 0.001). However, no sex differences were observed in pooled results of populations with or without diabetes for all-cancer (RRR 1.02, 95% CI 0.98 to 1.06; P = 0.21), infectious (RRR 1.13, 95% CI 0.90 to 1.38; P = 0.33), and respiratory mortality (RRR 1.08, 95% CI 0.95 to 1.23; P = 0.26). CONCLUSIONS: Compared with men with the same condition, women with diabetes have a 58% and 13% greater risk of CHD and all-cause mortality, respectively, although there was a significant heterogeneity between studies. This points to an urgent need to develop sex- and gender-specific risk assessment strategies and therapeutic interventions that target diabetes management in the context of CHD prevention.

Microwave-Assisted Synthesis of Imidazo[4,5-f][1,10]phenanthroline Derivatives as Apoptosis Inducers in Chemotherapy by Stabilizing Bcl-2 G-quadruplex DNA.

Herein, a series of imidazo[4,5-f][1,10] phenanthroline derivatives RPIP (PIP = imidazo [4,5-f][1,10] phenanthroline, R = NO2, 1; CF3, 2; Cl, 3; OH, 4) have been synthesized in yields of 82.3-94.7% at 100 °C under the irradiation of microwave. MTT assay has been utilized to evaluate the inhibitory activity (IC50) of these compounds against the growth of various tumor cells, and the results revealed that these compounds, especially 1, exhibited excellent inhibitory activity against the growth of A549 cells with IC50 of 15.03 µM. Moreover, it's also confirmed that 1 can penetrate into the membrane of tumor cells and distribute in mitochondria when observed under microscopy, resulting apoptosis of tumor cells. The further studies showed that 1 can bind to bcl-2 G-quadruplex DNA, which demonstrated by the increase of melting point of bcl-2 G4 DNA in the presence of 1, as well as electronic titration and emission spectra. In a word, this kind of compound may develop as a potential apoptosis inducer in cancer chemotherapy via binding and stabilizing to the bcl-2 G-quadruplex DNA.

Evaluation of Tanshinone IIA Developmental Toxicity in Zebrafish Embryos.

Tanshinone IIA (Tan-IIA) is derived from the dried roots of Salvia miltiorrhiza Bunge, a traditional Chinese medicine. Although Salvia miltiorrhiza has been applied for many years, the toxicity of the mono-constituent of Salvia miltiorrhiza, tanshinone IIA, is still understudied. This study evaluated the cardiotoxicity and developmental malformations of Tan-IIA by using zebrafish normal embryos and dechorionated embryos. After treatment with Tan-IIA in different concentrations for four-day periods, obvious pericardial edema, spinal curvature, and even missing tails were observed in zebrafish embryos. The LC50 values in the dechorionated embryo group at 72 h post-fertilization (hpf) and 96 hpf were 18.5 µM and 12.8 µM, respectively, and the teratogenicity was manifested at a concentration of about 1 µM. The main endpoints of teratogenicity were scoliosis, malformation of tail, and pericardium edema. Our findings displayed the potential cardiotoxicity and severe impact on the abnormal development of Tan-IIA in zebrafish embryo at high concentrations, which may help avoid the risk of its clinical application.

Diagnostic accuracy of ultrasonography for detecting nasogastric tube (NGT) placement in adults: A systematic review and meta analysis.

OBJECTIVE: To review the evidence on diagnostic accuracy of ultrasonography for detecting correct nasogastric tube (NGT) placement in adults compared to X-ray as the reference standard. METHODS: This is a systematic review and meta-analysis of observational studies, searched in the literature between 1961 and 2015. We included studies which compared the diagnostic accuracy of ultrasonography detection for NGT placement with X-ray in adult patients who were undergoing NGT placement for any reason in any care setting. We searched published studies in the following electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Web of Science, WanFang Data, China Journal Net, and the Chinese Biomedical Literature Database. Both English and non-English-language articles were retrieved. Risk of bias was assessed using a standard procedure according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. RESULTS: We included five studies involving a total of 420 adult patients undergoing nasogastric tube placement: three trials were undertaken in mechanically ventilated patients in prehospital settings and two involved participants with comma or severe trauma in emergency room or intensive care unit (ICU). Pooled results showed that ultrasonography had a sensitivity of 0.93 (95% CI 0.87 to 0.97), and specificity of 0.97 (95% CI 0. 23 to 1.00), suggesting that diagnostic performance of ultrasound is useful to confirm correct NGT placement, but not optimal to detect incorrect NGT position. This was confirmed through a summary receiver operator characteristics (SROC) curve that showed the area under the curve was 0.96 (95% CI 0.94 to 0.98). DISCUSSION: The main limitation of the review is the relatively moderate level of heterogeneity of included studies which may partially undermine the reliability and reproducibility of results. The insufficient studies included did not allow identification of possible sources of heterogeneity and exploration of reporting bias. Due to heterogeneity of studies, the diagnostic performance of ultrasonography could only be drawn cautiously. Physicians and nurses should perform routine X-ray if visualization of NGT is not possible. More well designed studies exploring ultrasound as a diagnostic tool for accuracy of NGT placement are needed to strengthen the current evidence.

Microwave-Assisted Synthesis of Arene Ru(II) Complexes Induce Tumor Cell Apoptosis Through Selectively Binding and Stabilizing bcl-2 G-Quadruplex DNA.

A series of arene Ru(II) complexes coordinated with phenanthroimidazole derivatives, [(η6-C6H6)Ru(l)Cl]Cl(1b L = p-ClPIP = 2-(4-Chlorophenyl)imidazole[4,5f] 1,10-phenanthroline; 2b L = m-ClPIP = 2-(3-Chlorophenyl)imidazole[4,5f] 1,10-phenanthroline; 3b L = p-NPIP = 2-(4-Nitrophenyl)imidazole[4,5f] 1,10-phenanthroline; 4b L = m-NPIP = 2-(3-Nitrophenyl) imidazole [4,5f] 1,10-phenanthroline) were synthesized in yields of 89.9%-92.7% under conditions of microwave irradiation heating for 30 min to liberate four arene Ru(II) complexes (1b, 2b, 3b, 4b). The anti-tumor activity of 1b against various tumor cells was evaluated by MTT assay. The results indicated that this complex blocked the growth of human lung adenocarcinoma A549 cells with an IC50 of 16.59 µM. Flow cytometric analysis showed that apoptosis of A549 cells was observed following treatment with 1b. Furthermore, the in vitro DNA-binding behaviors that were confirmed by spectroscopy indicated that 1b could selectively bind and stabilize bcl-2 G-quadruplex DNA to induce apoptosis of A549 cells. Therefore, the synthesized 1b has impressive bcl-2 G-quadruplex DNA-binding and stabilizing activities with potential applications in cancer chemotherapy.