PRMT5 Prevents Dilated Cardiomyopathy via Suppression of Protein O-GlcNAcylation.

[Figure: see text].

The Identification of Anthocyanins from Padus racemosa and Its Protective Effects on H2 O2 -Induced INS-1 Cells Damage and STZ-Induced Diabetes Mice.

Oxidative damage in cells induced by reactive oxygen species (ROS) is a main factor in diabetes mellitus diseases progression. The composition of anthocyanins from Padus racemosa (APR) and the protective effects of APR on H2 O2 -induced rat insulinoma (INS-1) cells damage and streptozocin (STZ)-induced diabetes mice were investigated in this study. The main components of APR were cyanidin-cyanidin glucosyl-rutinoside, cyanidin-cyanidin xylosyl-rutinoside, cyanidin-xylosyl-glucoside and cyanidin-rutinoside, which were determined by liquid chromatography-mass spectrometry (LC/MS). APR could scavenge the 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl radical and superoxide radical in vitro. ROS level was decreased and the cell viability was increased in INS-1 cells after treated with APR. Cell apoptosis induced by H2 O2 in INS-1 cells was decreased after incubation with APR. APR could decrease the phosphorylation of p38 and the nuclear translocation of p65, which indicated that APR could inhibit the activation of p38 Mitogen-activated protein kinase (MAPK) and Nuclear factor kappa B (NF-κB) cell signaling pathways. Meanwhile, APR could effectively reduce the blood glucose and blood lipid in STZ-induced diabetic mice. These results suggested that APR might be a potential agent for diabetes mellitus diseases treatment.

Assessing the early changes of cerebral glucose metabolism via dynamic (18)FDG-PET/CT during cardiac arrest.

To study the changes of cerebral glucose metabolism (CGM) during the phase of return of spontaneous circulation (ROSC) after cardiac arrest (CA), we used 18-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)FDG-PET/CT) to measure the CGM changes in six beagle canine models. After the baseline (18)FDG-PET/CT was recorded, ventricular fibrillation (VF) was induced for 6 min, followed by close-chest cardiopulmonary resuscitation (CPR) in conjunction with intravenous (IV) administration of epinephrine and external defibrillator shocks until ROSC was achieved, within 30 min. The (18)FDG was recorded prior to intravenous administration at 0 h (baseline), and at 4, 24, and 48 h after CA with ROSC. We evaluated the expression of two key control factors in canine CGM, hexokinase I (HXK I) and HXK II, by immunohistochemistry at the four above mentioned time points. Electrically induced VF of 6 min duration was successfully induced in the dogs. Resuscitation was then performed to maintain blood pressure stability. Serial (18)FDG-PET/CT scans found that the CGM decreased at 4 h after ROSC and remained lower than the baseline even at 48 h. The expression of HXK I and II levels were consistent with the changes in CGM. These data from our present work showed that (18)FDG-PET/CT imaging can be used to detect decreased CGM during CA and was consistent with the results of CMRgl. Furthermore, there were also concomitant changes in the expression of HXK I and HXK II. The decrease in CGM may be an early sign of hyperacute global cerebral ischemia.

Stimuli-responsive bacterial cellulose-g-poly(acrylic acid-co-acrylamide) hydrogels for oral controlled release drug delivery.

This study evaluated the potential of stimuli-responsive bacterial cellulose-g-poly(acrylic acid-co-acrylamide) hydrogels as oral controlled-release drug delivery carriers. Hydrogels were synthesized by graft copolymerization of the monomers onto bacterial cellulose (BC) fibers by using a microwave irradiation technique. The hydrogels were characterized by Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), thermogravimetric analysis (TGA) and scanning electron microscopy (SEM). FT-IR spectroscopy confirmed the grafting. XRD showed that the crystallinity of BC was reduced by grafting, whereas an increase in the thermal stability profile was observed in TGA. SEM showed that the hydrogels exhibited a highly porous morphology, which is suitable for drug loading. The hydrogels demonstrated a pH-responsive swelling behavior, with decreased swelling in acidic media, which increased with increase in pH of the media, reaching maximum swelling at pH 7. The release profile of the hydrogels was investigated in simulated gastric fluid (SGF) and simulated intestinal fluid (SIF). The hydrogels showed lesser release in SGF than in SIF, suggesting that hydrogels may be suitable drug carriers for oral controlled release of drug delivery in the lower gastrointestinal tract.

[Comparison of (18)F-FDG PET/CT and enhancement CT in diagnosing regional lymph node metastasis of colorectal cancer].

OBJECTIVE: The aim of this study was to compare the diagnostic value of (18)F-FDG PET/CT with contrast CT for regional lymph node metastasis of colorectal cancer. METHODS: Imaging results of 40 patients with colorectal cancer were retrospectively reviewed, and all the patients underwent both abdomen contrast CT and (18)F-FDG PET/CT imaging. Final diagnosis was made by histopathology. RESULTS: 20 colorectal cancer patients were verified with lymph node metastasis while the other 20 patients were absent. Finally, (18)F-FDG PET/CT produced 4 false-positive patients and 3 false-negative patients. (18)F-FDG PET/CT displayed sensitivity 85.0% (17/20), specificity 80.0% (16/20), positive predictive value 81.0% (17/21), negative predictive value 84.2% (16/19) and accuracy 82.5% (33/40) in the diagnosis of lymph node metastasis. Contrast CT produced 5 false-positive patients and 8 false-negative patients. Contrast CT had the sensitivity 60.0% (12/20), specificity 75.0% (15/20) , positive predictive value 70.6% (12/17), negative predictive value 65.2% (15/23) and accuracy 67.5% (27/40). Sensitivity and specificity of PET/CT was better than of contrast CT, but no statistically significant difference between PET/CT and contrast CT (P = 0.478, P = 0.893; P = 0.344. Fisher's exact test and McNemar test). CONCLUSION: Sensitivity and specificity of PET/CT was better than of contrast CT, but no statistically significant difference. Clinical works also need to select the appropriate inspection methods based on the patient's situation.

[Diagnostic value of (18)F-labeled NaF positron emission tomography-computed tomography imaging in the detection of bone metastases in patients with lung cancer before treatment].

OBJECTIVE: To evaluate the diagnostic values of (18)F-sodium fluoride ((18)F-NaF) positron emission tomography/computed tomography (PET/CT) imaging in the detection of bone metastases of lung cancer. METHODS: A total of 107 lung cancer patients were diagnosed by histopathology and undergone (18)F-NaF PET-CT imaging. RESULTS: Among them, the histopathologically diagnosed tumors included adenocarcinoma (n = 47), squamous cell carcinoma (n = 19), small cell lung cancer (n = 4) and other malignant types (n = 34). Bone metastases occurred in adenocarcinoma (n = 19) and squamous cell carcinoma (n = 4).(18)F-NaF PET/CT imaging had a high sensitivity of 100% in the diagnosis of bone metastases with malignant lung tumors. And its specificity was 98.7%, accuracy 99% and positive predictive value 97.0%. CONCLUSION: (18)F-NaF PET-CT imaging can detect the bone metastases of lung cancer preoperatively with a high level of sensitivity and accuracy.

Environmental innovation ambidexterity and customer relationship performance: evidence from the manufacturing industry in China.

Cleaner production and pollution prevention are not only essential for enterprises to improve resource utilization efficiency and competitiveness, but also realistic requirements for enterprises to comply with green manufacturing policies and regulations. Many previous studies have investigated the impacts of environmental innovation on products and environmental performance, but few of them have explored the impact of environmental innovation on customer relationships. The main purpose of this study is to investigate the basic strategies to enhance customer relationship in the context of green development. Building upon the resource-based view, the dynamic capability perspective, and the upper echelons theory, this study develops a conceptual model focusing on the effects of environmental innovation ambidexterity (EIA) on customer relationship performance (CRP), the mediating effects of green product innovation (GPI), and the moderating role of top management's environmental awareness. The results of a survey of 285 high-tech manufacturing enterprises in China show that EIA has a positive effect on CRP. The results of the study also indicate that GPI mediates the relationship between EIA and CRP, and top management's environmental awareness moderates the impact of EIA on CRP. The results offer novel insights for suppliers to improve CRP, and provide theoretical guidance for high-tech manufacturing enterprises to effectively implement pollution prevention and GPI.

Hgs Deficiency Caused Restrictive Cardiomyopathy via Disrupting Proteostasis.

The molecular mechanisms underlying restrictive cardiomyopathy (RCM) are not fully understood. Hepatocyte growth factor-regulated tyrosine kinase substrate (HGS) is a vital element of Endosomal sorting required for transport (ESCRT), which mediates protein sorting for degradation and is crucial for protein homeostasis (proteostasis) maintenance. However, the physiological function and underlying mechanisms of HGS in RCM are unexplored. We hypothesized that HGS may play vital roles in cardiac homeostasis. Cardiomyocyte-specific Hgs gene knockout mice were generated and developed a phenotype similar to human RCM. Proteomic analysis revealed that Hgs deficiency impaired lysosomal homeostasis in cardiomyocytes. Loss of Hgs disrupted cholesterol transport and lysosomal integrity, resulting in lysosomal storage disorder (LSD) with aberrant autophagosome accumulation and protein aggregation. Suppression of protein aggregation by doxycycline treatment attenuated cardiac fibrosis, and diastolic dysfunction in Hgs-knockout mice. These findings uncovered a novel physiological role of HGS in regulating cardiac lysosomal homeostasis and proteostasis, suggesting that the deficient HGS contributes to LSD-associated RCM-like cardiomyopathy.

Medical Student Portfolios: A Systematic Scoping Review.

Phenomenon: Medical Student Portfolios (MSP)s allow medical students to reflect and better appreciate their clinical, research and academic experiences which promotes their individual personal and professional development. However, differences in adoption rate, content design and practice setting create significant variability in their employ. With MSPs increasingly used to evaluate professional competencies and the student's professional identity formation (PIF), this has become an area of concern. Approach: We adopt Krishna's Systematic Evidence-Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on MSPs. The structured search process of six databases, concurrent use of thematic and content analysis in the Split Approach and comparisons of the themes and categories with the tabulated summaries of included articles in the Jigsaw Perspective and Funnelling Process offers enhanced transparency and reproducibility to this review. Findings: The research team retrieved 14501 abstracts, reviewed 779 full-text articles and included 96 articles. Similarities between the themes, categories and tabulated summaries allowed the identification of the following funnelled domains: Purpose of MSPs, Content and structure of MSPs, Strengths and limitations of MSPs, Methods to improve MSPs, and Use of E-portfolios. Insights: Variability in the employ of MSPs arise as a result of a failure to recognise its different roles and uses. Here we propose additional roles of MSPs, in particular, building on a consistent set of content materials and assessments of milestones called micro-competencies. Whislt generalised micro-competencies assess achievement of general milestones expected of all medical students, personalised micro-competencies record attainment of particular skills, knowledge and attitudes balanced against the medical student's abilities, context and needs. This combination of micro-competencies in a consistent framework promises a holistic, authentic and longitudinal perspective of the medical student's development and maturing PIF.

Evaluation on curative effects of isokinetic muscle strength training for improving muscle function in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis.

BACKGROUND: Knee osteoarthritis (KOA) refers to a chronic deteriorating disease distinguished by degeneration of joint cartilage. Many clinical studies have demonstrated that isokinetic muscle strength training can improve muscle function in patients with KOA. However, although such studies deduce an excellent effect, the results remain controversial. Therefore, the present systematic review seeks to explore the curative effects of isokinetic muscle strength training to establish if it can improve muscle function in patients experiencing KOA. METHODS: This review will entail a systematic review and a comprehensive examination to establish all randomized controlled studies covering curative effects of isokinetic muscle strength training to improve muscle function in patients with KOA. We will obtain data from PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, and WanFang databases from inception to September 2021. In addition, the study will employ the criterion postulated by Cochrane to ascertain a quality evaluation and risk assessment of the studies included for analysis. Also, we will employ relative risk, mean differences, and standardized mean differences with 95% confidence intervals to estimate the effective measures. Also, we will employ Cochran Q test and I2 statics to assess heterogeneity among the 2 studies. RESULTS: Overall, this study anticipates providing accurate results and balanced inferences on curative effects of isokinetic muscle strength training for improving muscle function in patients with KOA. CONCLUSION: The study's inferences will offer evidence to decide whether isokinetic muscle strength training is an effective measure for improving muscle function in patients with KOA.

Cannabinoid receptor agonist WIN55212-2 reduces unpredictable mild stress-induced depressive behavior of rats.

BACKGROUND: Depression is a neurological disorder characterized by persistent low mood. A number of studies have suggested that the use of type 1 cannabinoid receptor (CB1R) agonists can reduce depressive behavior, but its effect on the depressive behavior and nerve damage of rats exposed to chronic unpredictable mild stress (CUMS) has not been reported. METHODS: Rats were exposed to CUMS for 4 weeks to induce depressive behavior. Male Sprague-Dawley (SD) rats aged 6-8 weeks were randomly divided into six groups: control group (control), depression group (CUMS), depression + fluoxetine group (Flu), depression + WIN55212-2 group (WIN), depression + NF-κB inhibitor group (PDTC), and depression + WIN + PDTC group (WIN + PDTC). We performed four behavioral experiments test to evaluate the depressive behaviors of rats. Hematoxylin and eosin (HE) and Nissl staining were performed to observe the neuron structures of the hippocampus. Enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and cyclooxygenase-2 (COX-2). Biochemical experiments were performed to evaluate the concentrations of nitric oxide (NO), malondialdehyde (MDA), reactive oxygen species (ROS), and superoxide dismutase (SOD). Fluorescence quantitative PCR was used to detect the mRNA expression of brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), and inducible nitric oxide synthase (iNOS) in the hippocampus, and western blot was performed to detect protein expression levels related to the NF-κB signaling pathway in the hippocampus. RESULTS: Compared with the normal control group, CUMS significantly induced abnormal behaviors in stressed rats. The concentrations of pro-inflammatory factors and oxidative stress injury factors in the hippocampus of the CUMS group increased significantly. The interventions of Flu, WIN, and PDTC significantly reduced neuroinflammation and oxidative stress injury. Compared with the WIN group, the WIN + PDTC intervention group had better results. In addition, WIN could significantly inhibit the activation of the NF-κB signaling pathway. CONCLUSIONS: This study showed that cannabinoid receptor agonists can reduce the CUMS-induced depressive behaviors of rats by blocking the NF-κB signaling pathway to alleviate neuroinflammation and oxidative stress injury.

Corticostriatal Hypermetabolism in Moyamoya Disease-Induced Hemichorea: Two Case Reports and a Literature Review.

Moyamoya disease (MMD) is a rare cause of chorea, and its pathophysiological mechanism remains unclear. We explore the use of cerebral positron emission tomography (PET) to study brain functional connectivity in 2 patients with MMD-induced hemichorea. Abnormal metabolism of brain was analyzed by 18F-fluorodeoxyglucose (18F-FDG) PET images. Dopamine transporters (DAT) PET evaluated the integrity of the cerebral dopamine system. A comprehensive systemic literature search of the PubMed database was also conducted. The 18F-FDG imaging of our patients showed no responsible hypometabolism in affected brain areas, while hypermetabolism in the affected caudate nucleus, putamen and fronto-parietal areas could be seen. DAT PET imaging was normal in patient 1 (a 23-year-old woman), while remarkably reduced DAT binding was seen in the left striatum of patient 2 (a 48-year-old woman). The literature review of 9 publications revealed that 11 patients who underwent single photon emission computed tomography (SPECT) showed cerebral hypoperfusion in the cortex and subcortical area; 18F-FDG PET was performed in 3 cases, which revealed hypermetabolism in the affected striatum in 2 cases. These findings suggest that the striatal and cortical hypermetabolism in the first patient result from underactivity in indirect pathway from basal ganglia-thalamocortical circuits, causing increased activity of excitatory glutamatergic thalamostriatal and thalamocortical projection neurons. The collateral vessels in the basal ganglia might lead to disruption of normal basal ganglia signaling. A dominant left hemisphere with corpus callosal connections to the right basal ganglia resulting into left hemichorea is the most probable explanation for the second patient. We have identified abnormal functional connectivity in basal ganglia-thalamocortical circuits in patients with MMD-induced chorea highlighting the corticostriatal pathway plays an important role in the pathogenesis of MMD-induced chorea.

Co-registration Analysis of Fluorodopa and Fluorodeoxyglucose Positron Emission Tomography for Differentiating Multiple System Atrophy Parkinsonism Type From Parkinson's Disease.

It is difficult to differentiate between Parkinson's disease and multiple system atrophy parkinsonian subtype (MSA-P) because of the overlap of their signs and symptoms. Enormous efforts have been made to develop positron emission tomography (PET) imaging to differentiate these diseases. This study aimed to investigate the co-registration analysis of 18F-fluorodopa and 18F-flurodeoxyglucose PET images to visualize the difference between Parkinson's disease and MSA-P. We enrolled 29 Parkinson's disease patients, 28 MSA-P patients, and 10 healthy controls, who underwent both 18F-fluorodopa and 18F-flurodeoxyglucose PET scans. Patients with Parkinson's disease and MSA-P exhibited reduced bilateral striatal 18F-fluorodopa uptake (p < 0.05, vs. healthy controls). Both regional specific uptake ratio analysis and statistical parametric mapping analysis of 18F-flurodeoxyglucose PET revealed hypometabolism in the bilateral putamen of MSA-P patients and hypermetabolism in the bilateral putamen of Parkinson's disease patients. There was a significant positive correlation between 18F-flurodeoxyglucose uptake and 18F-fluorodopa uptake in the contralateral posterior putamen of MSA-P patients (rs = 0.558, p = 0.002). Both 18F-flurodeoxyglucose and 18F-fluorodopa PET images showed that the striatum was rabbit-shaped in the healthy control group segmentation analysis. A defective rabbit-shaped striatum was observed in the 18F-fluorodopa PET image of patients with Parkinson's disease and MSA-P. In the segmentation analysis of 18F-flurodeoxyglucose PET image, an intact rabbit-shaped striatum was observed in Parkinson's disease patients, whereas a defective rabbit-shaped striatum was observed in MSA-P patients. These findings suggest that there were significant differences in the co-registration analysis of 18F-flurodeoxyglucose and 18F-fluorodopa PET images, which could be used in the individual analysis to differentiate Parkinson's disease from MSA-P.

Resuscitative Endovascular Balloon Occlusion of the Aorta for Blood Control in Lumbar Spine Tumor Resection Surgery: A Technical Note.

OBJECTIVES: To describe the technique of the aorta balloon occlusion, and evaluate the blood loss in lumbar spine tumor surgery assisted by aortic balloon occlusion, and to observe the balloon-related complications. METHODS: Six patients with lumbar spine tumor underwent resuscitative endovascular balloon occlusion of the aorta prior to tumor resections in our institution between May 2018 to January 2021. Medical records including demographic, diagnosis, tumor location, surgical approach, intraoperative blood loss, surgical duration, and perioperative balloon-related complication were evaluated retrospectively. RESULTS: This series included four males and two females, with a median age of 50 years (range 22 to 69). Of these, three primary tumors were plasmacytoma, giant cell tumor of bone, and osteosarcoma, while recurrence of undifferentiated pleomorphic sarcoma (UPS), recurrence of giant cell tumor of bone (GCT), and metastatic thyroid cancer were diagnosed in cases 1, 6, and 2, respectively. L2 was involved in cases 1 and 5. L3 was involved in case 6. L4 was involved in case 2, 3, and 6. L5 was involved in case 4. One-stage total en bloc resection surgery (TES) was accomplished in all patients; of this series, signal anterior approach was conducted in case 1, signal posterior approach was utilized in cases 2, 3, and 6, while combined anterior and posterior approach was performed in cases 4 and 5. The median intraoperative blood loss was 1683 mL and ranged from 400 to 3200 mL with a median surgical duration of 442 min and a range from 210 to 810 min. During the perioperative period, no serious balloon-related complications occurred. CONCLUSIONS: Endovascular balloon occlusion of the aorta successfully controls intraoperative exsanguination, contributing to a more radical tumor resection and a low rate of tumor cell contamination in lumbar tumor surgery.

A study on the protective effects of taxifolin on human umbilical vein endothelial cells and THP-1 cells damaged by hexavalent chromium: a probable mechanism for preventing cardiovascular disease induced by heavy metals.

Hexavalent chromium [Cr(vi)] which is a kind of heavy metal with strong oxidizing ability can induce cardiovascular disease (CVD), while taxifolin can protect cells and organisms against suffering from oxidative stress. In this study, the inhibitory effects of taxifolin against Cr(vi)-induced cell damage in human umbilical vein endothelial cells (HUVECs) and THP-1 cells were investigated. Cr(vi) could increase the phosphorylation of p38 and JNK, regulate the expression of Bax and Bcl-2 in both cell lines. Meanwhile, the Cr(vi) stimulation led to an increase of the expression of ICAM-1 and VCAM-1, and upregulated the adhesion of THP-1 cells to HUVECs. Furthermore, Cr(vi) could induce the activation of the nuclear factor kappa B (NF-κB) signaling pathway, the accumulation of p65 in the nucleus, and the increase in the phosphorylation of IκB and the expression of cleaved caspase-1 and IL-1ß in THP-1 cells. However, taxifolin could reverse the effects by inhibiting the activation of mitogen-activated protein kinases (MAPKs) and NF-κB signaling pathways, regulating the expression of apoptosis-related proteins, and alleviating the adhesion of THP-1 cells to HUVECs. Our findings demonstrated that taxifolin was a potential agent to prevent endothelial dysfunction, monocyte inflammation and cell adhesion induced by Cr(vi).

Cerebral Reorganization in Subacute Stroke Survivors after Virtual Reality-Based Training: A Preliminary Study.

BACKGROUND: Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. METHODS: Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also measured before and after intervention. RESULTS: Increased activation in the primary sensorimotor cortex of the lesioned hemisphere and supplementary motor areas of both sides for the paretic foot (p < 0.01) was observed postintervention. Statistically significant improvements were observed in gait velocity (p < 0.05). The change in voxel counts in the primary sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET (r = -0.719). CONCLUSIONS: We observed improved walking and increased activation in cortical regions of stroke survivors after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064.

Atypical antipsychotics: A review on the prevalence, monitoring, and management of their metabolic and cardiovascular side effects.

INTRODUCTION: Excessive weight gain, glucose intolerance, and dyslipidemia are well-known physical side effects of the metabolic syndrome commonly associated with atypical antipsychotic (AAP) treatment. We review these side effects of AAPs and their monitoring and management strategies. METHODS: A literature search was conducted to identify articles published on the prevalence, monitoring, and management of cardiometabolic side effects of AAPs. RESULTS: Comparative risk of AAPs on weight gain, hyperlipidemia, glucose intolerance, and QT interval corrected for heart rate prolongation varies across the AAPs currently available. Likewise, pharmacologic and nonpharmacologic options investigated for management of these side effects, and monitoring those at appropriate intervals, differ based on the clinical condition and risk factors identified. DISCUSSION: Atypical antipsychotics in general have little difference among them in short-term efficacy; however, the prevalence of their physical side effects substantially distinguishes them. It is of importance that clinicians carefully select AAPs bearing in mind the presence of risk factors, initiating patients directly on AAPs with a low risk of cardiometabolic side effects, and monitoring and managing those side effects at appropriate intervals.

Drug-related problems in patients with benign prostatic hyperplasia: a cross sectional retrospective study.

Benign Prostatic Hyperplasia (BPH) patients are at risk of acquiring drug-related problems (DRPs), as it is present in the majority of aging men. To date, DRPs among BPH patients have not been well studied. We conducted this retrospective study in a tertiary hospital in Malaysia from January 2009 to June 2012 with the aim of identifying the factors associated with DRPs among BPH patients. The Pharmaceutical Care Network Europe Classification Version (PCNE) 5.01 was used as a tool to classify DRPs. We enrolled 203 patients from 259 hospital admissions. A total of 390 DRPs were found and there was an average of 1.5±1.3 problems per hospitalization. 76.1% of hospital admissions included at least one DRP. The most common DRP categories encountered were drug choice problems (45.9%), drug interactions (24.9%), and dosing problems (13.3%). Factors such as advanced age (p = 0.005), a hospital stay of more than 6 days (p = 0.001), polydrug treatments (p<0.001), multiple comorbidities (p<0.001), and comorbid cardiovascular disease (p = 0.011), diabetes mellitus(p = 0.001), hypertension (p<0.001) and renal impairment (p = 0.011) were significantly associated with the occurrence of DRPs. These data indicated that the prevalence of DRPs is high among BPH patients. The identification of different subtypes of DRPs and the factors associated with DRPs may facilitate risk reduction for BPH patients.

Effects of general anesthesia combined with epidural block or transverse abdominis plane block on intraoperative anesthetic dosages, stress response and inflammatory response in patients undergoing radical resection of colorectal cancer / 医学研究生学报

Objective The choice of perioperative analgesia regimens for radical resection of colorectal cancer is still controversial. The purpose of this study was to compare the effects of general anesthesia combined with epidural block or transverse abdominis plane block on surgical recovery of patients, and provide a basis for the choice of analgesic methods for radical resection of colorectal cancer. Methods The clinical data of 118 patients who underwent laparoscopic radical resection of colorectal cancer under general anesthesia in Affiliated Hospital of Nantong University between February 2016 and May 2018 were retrospectively analyzed, and the patients were divided into group A (epidural block, n=61) and group B (transverse abdominis plane block, n=57) according to anesthesia regimens. The two groups were given the same general anesthesia induction and maintenance medication. The dosages of general anesthetics in two groups were recorded, and the postoperative recovery situations (including first anal exhaust time, eating time, ambulation time, hospital stay and visual analogue scale score) were compared, and the stress indexes of heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), cortisol (Cor) and norepinephrine (NE)], immune indexes of CD4+, CD8+, CD4+/CD8+, total T lymphocyte count and natural killer cell (NK) count and inflammation indicators of human chemokine CXC ligand 8 (CXCL8), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were detected in two groups at different time points. Results The dosage of sufentanil in group A was lower than that in group B [(25.36±4.74) μg vs (28.43±3.69) μg] (P<0.001). The first anal exhaust time, eating time and first ambulation time in group A were shorter than those in group B (P<0.05). The VAS scores in group A were lower than those in group B at different time points (P<0.001). The levels of HR, MAP, Cor and NE in group A were lower than those in group B at T2~T3, and the SpO2 at T2 was lower than that in group B [(5.11±0.31)% vs (5.96±0.34)%] (P<0.05). At 24h after operation, the CD8+ and total T cell in group A were lower than those in group B [(20.79±13.02)% vs (26.91±10.22)%, (60.23±8.97)% vs (64.33±12.76)%] while the CD4+/CD8+ and NK cell count were higher than those in group B [(1.66±0.63) vs (1.25±0.95), (27.71±10.98)% vs (20.02±1.74) %] (P<0.05). The levels of CXCL8, IL-6 and TNF-α were lower than those in group B (P<0.05). There was no significant difference in the incidence rate of adverse reactions between group A and group B (3.28% vs 5.26%) (P>0.05). Conclusion General anesthesia combined with epidural block can reduce the dosages of anesthetic drugs in radical resection of colorectal cancer, reduce the body stress response and inflammatory response, and weaken the early immunosuppressive effects, and its overall analgesic effects are better than those of combined transverse abdominis plane block.