Children with Sickle Cell Disease in Northern Benin: Follow up of a Cohort at the Borgou/Alibori Branch of Integrated Medical Healthcare Center for Infants and Pregnant Women with Sickle Cell Disease from 2017 to 2022

Introduction: Sickle cell disease is a public health problem in sub-Saharan Africa. A national referral center for the management of infants and pregnant women with sickle cell disease (CPMI-NFED) was created three decades ago in Cotonou, in the south of Benin with two regional branches including that of Parakou in the North for better access of patients to specialized care. This work is a review of five years of activities in order to describe the epidemiological, clinical, hematological and evolutionary profiles of the children followed up in the said branch. Method: This was a descriptive and retrospective cross-sectional study on the medical records of children with sickle cell disease, followed up at the regional branch of CPMI-NFED in Borgou/Alibori from June 1, 2017 to May 31, 2022. The variables studied were epidemiological, clinical, biological and evolutionary. Results: A total of 101 children with sickle cell disease were included in the study, including 78 homozygous SS (77.2%) and 23 heterozygous SC (22.8%). Their mean age at inclusion was 51.2 ± 37.6 months [6 - 204]. The sex ratio was 1.4. Vaso-occlusive crises were the main diagnostic circumstances in 42.3% of homozygotes. More than half of the children (51.5%) had a regular follow-up. The average baseline level of hemoglobin (Hb) in homozygous children was 8.8 ± 1.4 g/dl [5.8 - 11.5];and the rate of Hb S varied between 61.9 and 94.7%. In heterozygous SC children, the mean baseline level of Hb was 10.7 ± 0.6 g/dl [9.7 - 11.5]. Acute complications observed during follow-up were dominated by pneumonia and vaso-occlusive crises in both phenotypes. The overall mortality was 3% and only affected homozygous patients. Conclusion: On average, three out of four children were homozygous in our cohort. The main acute complications were infectious and vaso-occlusive. The mortality only affected homozygous carriers. Specialized follow-up has contributed to improving the quality of life of children with sickle cell disease. This could be implemented on a large scale for better survival of children with sickle cell disease.

Diagnosis and treatment of biliary mucinous cystic neoplasms: A single-center experience

Background: Biliary mucinous cystic neoplasms(BMCNs) are rare hepatobiliary cystic tumors, which can be divided into noninvasive and invasive types. This study aimed to investigate the diagnosis, treatment, and prognosis of BMCNs in a large single center. Methods: We analyzed 49 patients with BMCNs confirmed by postoperative pathology at the First Afflliated Hospital, Zhejiang University School of Medicine between January 2007 and December 2021. Results: Among the 49 patients, 37 were female(75.5%), and the average age was 57.04 years. Common symptoms included abdominal discomfort, jaundice and fever, while 22 patients(44.9%) had no symptoms. Serum carbohydrate antigen(CA) 19-9 and CA125 concentrations were elevated in 34.8% and 19.6% of patients, respectively. Forty-eight patients had tumors in the intrahepatic bile ducts and only one had a tumor in the extrahepatic bile duct. Forty-eight patients with noninvasive intrahepatic BMCNs were further analyzed in terms of pathological features: 34(70.8%) had low-grade intraepithelial neoplasms(LGINs), and 14(29.2%) had high-grade intraepithelial neoplasms(HGINs). The potential immunohistochemical markers of BMCNs were cytokeratin(CK) 19, CK7, estrogen receptor and progesterone receptor. Follow-up data for 37 patients with intrahepatic BMCNs were obtained. The median overall survival(OS) of BMCNs was not reached. The longest survival time was 137 months.The 5-and 10-year OS rates were 100% and 85.4%, respectively. The 5-and 10-year recurrence-free survival(RFS) rates were 93.9% and 80.2%, respectively. Conclusions: BMCNs are rare cystic neoplasms that commonly occur in middle-aged females. BMCNs can only be diagnosed and classified by postoperative pathology, as there are no specific clinical presentations, serological indicators or imaging modalities for preoperative diagnosis. Complete surgical resection is necessary for BMCNs, and the postoperative prognosis is favorable.

Mitochondrial genomes of Tapes dorsatus and Cardita variegata:insights into Heteroconchia phylogeny

Heteroconchia,a widespread and abundant aquatic invertebrate,is an important clade of bivalve mollusks.The relationship between the three branches of Heteroconchia,Palaeoheterodonta,Archiheterodonta,and Euheterodonta has become a main controversy in molecular studies of the relationships between bivalves.In the present study,we assembled the complete mitochondrial genomes of Tapes dorsatus(Veneridae)and Cardita variegata(Carditidae)using high-throughput sequencing.C.variegata is the first mitochondrial genome belonging to the family Carditidae to be reported.We used 12 protein coding genes(excluding atp8)from the complete mitochondrial genomes of 146 species to recover the internal relationships of Heteroconchia.Our results support the traditional view of early branching of Palaeoheterodonta and the recovery of the monophyly of Palaeoheterodonta,Anomalodesmata,Imparidentia.Rearrangement analysis show that gene arrangement within Venerida was highly variable.Time-calibrated phylogenetic studies based on a relaxed molecular clock model suggested that Veneridae originated approximately 337.62 million years ago(Ma)and split into two major clades,whereas Carditidae originated approximately 510.09 Ma.Our results provide evidence of the internal relationships of Heteroconchia.

Gene characterization and phylogenetic analysis of four mitochondrial genomes in Caenogastropoda

Caenogastropoda is a highly diverse group,containing~60%of all existing gastropods.Species in this subclass predominantly inhabit marine environments and have a high ecological and economic value.Owing to the increase in relevant phylogenetic studies,our understanding of between species relatedness in Caenogastropoda has improved.However,the biodiversity,taxonomic status,and phylogenetic relationships of this group remain unclear.In the present study,we performed next-generation sequencing of four complete mitochondrial genomes from three families(Buccinidae,Columbellidae,and Cypraeidae)and the four mitogenomes were classical circular structures,with a length of 16177 bp in Volutharpa ampullacea,16244 bp in Mitrella albuginosa,16926bp in Mauritia arabica asiatica and 15422 bp in Erronea errones.Base composition analysis indicated that whole sequences were biased toward A and T.Then compared them with 171 complete mitochondrial genomes of Caenogastropoda.The phylogenetic relationship of Caenogastropoda derived from Maximum Likelihood(ML)and Bayesian Inference(BI)trees constructed based on CDS sequences was consistent with the results of traditional morphological analysis,with all three families showing close relationships.This study supported Caenogastropoda at the molecular level as a separate clade of Mollusca.According to our divergence time estimations,Caenogastropoda was formed during the middle Triassic period(~247.2–237 Ma).Our novel mitochondrial genomes provide evidence for the speciation of Caenogastropoda in addition to elucidating the mitochondrial genomic evolution of this subclass.

The Effects of Accumulated Short Bouts of Mobile-Based Physical Activity Programs on Depression,Perceived Stress,and Negative Affectivity among College Students in South Korea:Quasi-Experimental Study

Regular physical activity(PA)is known to enhance multifaceted health benefits,including both physical and mental health.However,traditional in-person physical activity programs have drawbacks,including time constraints for busy people.Although evidence suggests positive impacts on mental health through mobile-based physical activity,effects of accumulated short bouts of physical activity using mobile devices are unexplored.Thus,this study aims to investigate these effects,focusing on depression,perceived stress,and negative affectivity among South Korean college students.Forty-six healthy college students were divided into the accumulated group(n=23,female=47.8%)and control group(n=23,female=47.6%).The accumulated group engaged in mobile-based physical activity,following guidelines to accumulate a minimum of two times per day and three times a week.Sessions were divided into short bouts,ensuing each bout lasted at least 10 min.The control group did not engage in any specific physical activity.The data analysis involved comparing the scores of the intervention and control groups using several statistical techniques,such as independent sample t-test,paired sample t-tests,and 2(time)×2(group)repeated measures analysis of variance.The demographic characteristics at the pre-test showed no statistically significant differences between the groups.The accumulated group had significant decreases in depression(t_(40)=2.59,p=0.013,Cohen’s D=0.84)and perceived stress(t_(40)=2.06,p=0.046,Cohen’s D=0.56)from the pre-to post-test.The control group exhibited no statistically significant differences in any variables.Furthermore,there were significant effects of time on depression scores(F1,36=4.77,p=0.036,η_(p)^(2)=0.12)while significant interaction effects were also observed for depression(F_(1,36)=6.59,p=0.015,η_(p)^(2)=0.16).This study offers informative insights into the potential advantages of mobile-based physical activity programs with accumulated periods for enhancing mental health,specifically in relation to depression.This study illuminates the current ongoing discussions on efficient approaches to encourage mobile-based physical activity and improve mental well-being,addressing various lifestyles and busy schedules.

Diabetic ulcer with cutaneous squamous cell carcinoma:A case report

BACKGROUND Chronic skin ulcers are a risk factor for the development of skin tumors.In patients with diabetes,chronic refractory ulcers may also contribute to higher susceptibility to skin tumors.Timely surgical removal of chronic and nonhealing diabetic foot ulcers can effectively prevent progression to squamous cell carcinoma.Such cases may be misdiagnosed owing to currently insufficient clinical evidence.However,in cases of chronic ulcer wounds,it is crucial to enhance clinical awareness regarding their potential progression into malignant lesions.CASE SUMMARY An 84-year-old male patient with diabetes presented with a significantly ulcerated area on his foot.The ulcer had been present to varying degrees since 1996.Between 2012 and July 2019,even after receiving treatments such as herbal medicines or heat clearance and detoxification complete healing of the wound was not achieved.In July 2020,histopathological analysis confirmed a well-differentiated cutaneous squamous cell carcinoma.After the treatments,the ulcer wound healed slowly and did not expand.CONCLUSION Potentially malignant lesions in chronic ulcer wounds should be identified and treated in a timely manner to prevent their progression.

Etiology of anterior choroidal artery infarction:a systematic review

Objective:To systematically review the etiology of anterior choroidal artery(AChA)infarction.Methods:A systematic literature search up to May 11,2024,for AChA infarction with its etiology.Epidemiologic and clinical data of patients,anatomic distribution of the lesions,and etiologic classification of AChA infarction were extracted.Results:A total of 1007 individual patient data was included(967 from retrospective clinical studies and 40 from case reports).Among the clinical research,patients’mean age was 64.7.There were 62.24%of male and 37.76%of female patients.Hypertension(66.04%)was the most common risk factor for patients with AChA infarction.Dyslipidemia(32.92%),diabetes mellitus(30.93%),and smoking(26.54%)were also common risk factors.Moreover,the posterior limb of the internal capsule was the most frequently affected structure.Undetermined etiology(n=173,38.02%),according to the trial of org 10172 in acute stroke treatment(TOAST)etiological classification,was the most common etiology,followed by small vessel disease(n=117,25.71%),large artery atherosclerosis(n=84,18.46%),and cardioembolism(n=63,13.85%).Furthermore,eighteen strokes were caused by other determined etiologies(3.96%).Conclusions:Undetermined etiology was the most common etiology of AChA infarction.Hypertension,dyslipidemia,diabetes mellitus,and smoking were common risk factors for patients with AChA infarction.It is necessary to prevent the risk factors.

Violence at work and its relationship with burnout, depression and anxiety in healthcare professionals of the emergency services

The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare professionals of the emergency services. Methods: 315 physicians, nurses, orderlies and ambulance drivers of Critical Care and Emergency Devices (CCED) in the Andalusian Public Health System, in the province of Granada (Spain) participated. They were interviewed about the exposure to violence at work and answered a battery of questions that measured burnout, depression and anxiety. Results: Physical aggression was significantly related to emotional exhaustion, personal accomplishment at work, depression and anxiety. Psychological aggression was associated with personal accomplishment. Logistic regression showed that the CCED professionals who have suffered physical aggression were 4.2 and 2.6 times more likely to have suffered anxiety and reduced personal accomplishment, respectively, than those who did not suffer physical aggression. On the other hand, feelings of anxiety and reduced personal accomplishment increase the professionals’ risk (3.4 and 2.1 times more likely, respectively) of suffering from physical aggression. Conclusion: The results suggest that exposure to violence is related to the other psychological problems tested: emotional exhaustion and personal accomplishment (two components of burnout), depression and anxiety. In addition, physical violence is a risk factor for anxiety and diminished personal accomplishment of the CCED professionals.

Scutellarin alleviates complete freund’s adjuvant-induced rheumatoid arthritis in mice by regulating the Keap1/Nrf2/HO-1 pathway

Scutellarin(SCU)is a herbal flavonoid glucuronide with multiple pharmacological activities,including antioxidant,anti-inflammation,vascular relaxation,anti-platelet,and myocardial protection.However,the effect of SCU on complete Freund’s adjuvant(CFA)-induced rheumatoid arthritis(RA)had not been studied.In this study,we investigated the beneficial effects of SCU in the CFA-induced RA mice model and the anti-arthritic activity was evaluated by paw edema.Enzyme-linked immunosorbent assay(ELISA)was carried out to evaluate the plasma levels of immunoglobulin(Ig)G,IgE,tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,receptor activator of nuclear factor-κB ligand(RANKL),and osteoprotegerin(OPG).Histological slides were prepared from the harvested paws of mice to determine the pathological changes in the joints.The proportions of T helper type 1(Th1)and T helper type 2(Th2)cells of CD4+T lymphocyte subsets were analyzed by flow cytometry.The expression of Kelch-like ECHassociated protein 1(Keap1),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)was analyzed using real-time quantitative PCR(RT-qPCR)and western blotting assays.The present study demonstrated that SCU prevented CFA-induced RA,and inhibited the expression of inflammation factors,IgG,IgE,TNF-α,IL-1β,and IL-6.While SCU also reduced the RANKL level,it increased OPG expression in RA mice.The Th1/Th2 ratio was significantly lower in mice treated with SCU.Additionally,HO-1 expression was reduced while the expression of Keap1 and Nrf2 was elevated following SCU treatment.Results provide preliminary evidence to employ SCU in arthritis treatment which might be related to the regulation of Th1/Th2 balance and the Keap1/Nrf2/HO-1 pathway.

Heterogeneity beyond tumor heterogeneity—SULF2 involvement in Wnt/β-catenin signaling activation in a heterogeneous side population of liver cancer cells

Introduction:Sulfatase 2(SULF2),an endogenous extracellular sulfatase,can remove 6-O-sulfate groups of glucosamine residues from heparan sulfate(HS)chains to modulate the Wnt/β-catenin signaling pathway,which plays an important role in both liver carcinogenesis and embryogenesis.Side population(SP)cells are widely identified as stem-like cancer cells and are closely related to carcinoma metastasis,recurrence,and poor patient prognosis.However,the roles of SULF2 in SP cells of hepatomas are unclear,and the underlying mechanism is undefined.Objectives:This study aimed to compare the heterogeneity between SP cells and non-side population(NSP)cells derived from three different liver cancer cell lines and to elucidate the involvement of the SULF2-Wnt/β-catenin axis in liver cancer stem cells(CSCs)and its impact on the processes of carcinogenesis and invasiveness.Methods:In this work,three different liver cancer SP cells(HepG2,Huh7,and PRC/PRL/5)were sorted by flow cytometry.We also examined the migration and invasion behaviors of SP and NSP cells.To determine if this high tumorigenic potential of SP cells is correlated to SULF2,qPCR,western blotting,and immunofluorescence analysis were conducted.We also performed nude mouse xenograft experiments for in vivo analysis.Results:The results from the in vitro colony formation assay showed that SP cells exhibited a 2-fold higher colony formation efficiency compared to their NSP counterparts.The SP cells exhibited significantly higher potentials in terms of their migratory capacity and invasive ability compared to NSP cells.We found that higher expression of SULF2 in SP cells was associated with greater capabilities for clonogenicity,migration,and invasion.It was also linked to higher activation of the Wnt/β-catenin signaling pathway via stimulation of key downstream factors,particularlyβ-catenin,c-Myc,and cyclin D1.Further,a positive correlation between the upregulated SULF2 expression and tumorigenesis in the in vivo nude mouse xenograft models was demonstrated,highlighting that the potential underlying mechanism was Wnt/β-catenin signaling pathway activation.Conclusion:Our findings show that variable SULF2 expression was associated with differential activation of the Wnt/β-catenin signaling pathway,which could lead to behavioral differences between SP and NSP cells and also among the SP cells of the three liver cancer cell lines assessed.It was reasonably concluded that the SULF2-Wnt/β-catenin axis could play an important role in the tumorigenicity of liver cancer stem cells.

Subclavian Arterial Bleeding during Permanent Pacemaker Implantation: Clinical Case Report and Literature Review

Research objective: To study a clinical case that had a complication of subclavian artery bleeding during permanent pacemaker implantation process. Subject and Method: Clinical case report and literature review. Study of a patient had an indication for permanent pacemaker implantation who had complication of subclavian artery bleeding during the procedure. Result: An 84-year-old female patient was admitted to the hospital because of fainting spells with chest pain, on the background of dangerous complex arrhythmias and ischemic heart disease, and was prescribed a pacemaker for this patient. The patient had complication occurred during the procedure, which left subclavian artery bleeding was detected and treated promptly, a cardiac pacemaker was implanted on the right side of the chest, and the patient had a successful endovascular stent cover in the left subclavian artery. Conclude: Subclavian artery bleeding is a rare complication in the procedure of permanent pacemaker implantation, but it can still occur and requires quick detection and timely treatment, needs to be successful in cardiac pacemaker placement and subclavian artery drug-eluting stent cover placement intervention. Individualized patient risk assessment is needed;appropriate and standardized intervention techniques and experience can reduce the occurrence of this variable.

Acute idiopathic pancreatitis in pregnancy:A case study

Acute pancreatitis during pregnancy is a rare event,and can be associated with high maternal mortality and fetal loss.Gallstone disease is thought to be the most common causative factor of acute pancreatitis,but,in many cases,the cause remains unclear.We report a case of a 36-year-old woman at 35 wk of gestation,who presented with severe pain confined to the upper abdomen and radiating to the back.The patient was diagnosed with acute idiopathic pancreatitis,which was managed conservatively;she recovered within several days and then delivered a healthy baby.Therefore it is important to consider acute pancreatitis when a pregnant woman presents with upper abdominal pain,nausea and vomiting in order to improve fetal and maternal outcomes for patients with acute pancreatitis.

Homocysteine, hypertension, and risks of cardiovascular events and all-cause death in the Chinese elderly population: a prospective study

BACKGROUND Increased homocysteine levels are associated with the risk of cardiovascular disease(CVD)and death.However,their prevention has not been effective in decreasing CVD risk.This study investigated the individual and combined associations of hyperhomocysteinemia and hypertension with incident CVD events and all-cause death in the Chinese elderly population without a history of CVD.METHODS This prospective study was conducted among 1,257 elderly participants(mean age:69 years).A questionnaire survey,physical examinations,and laboratory tests were conducted to collect baseline data.Hyperhomocysteinemia was defined as homocysteine level≥15μmol/L.H-type hypertension was defined as concomitant hypertension and hyperhomocysteinemia.Multivariate Cox regression analysis was used to evaluate individual and combined associations of hyperhomocysteinemia and hypertension with the risks of incident CVD events and all-cause death.RESULTS Over a median of 4.84-year follow-up,hyperhomocysteinemia was independently associated with incident CVD events and all-cause death.The hazard ratios(HRs)were 1.45(95%CI:1.01−2.08)for incident CVD events and 1.55(95%CI:1.04−2.30)for all-cause death.After adjustment for confounding factors,H-type hypertension had the highest HRs for incident CVD events and all-cause death.The fully adjusted HRs were 2.44 for incident CVD events(95%CI:1.28−4.65),2.07 for stroke events(95%CI:1.01−4.29),8.33 for coronary events(95%CI:1.10−63.11),and 2.31 for all-cause death(95%CI:1.15−4.62).CONCLUSIONS Hyperhomocysteinemia was an independent risk factor,and when accompanied by hypertension,it contrib-uted to incident CVD events and all-cause death in the Chinese elderly population without a history of CVD.

Study on the structure characterization and moisturizing effect of Tremella polysaccharide fermented from GCMCC5.39

The structure and moisture retention of Tremella polysaccharide fermented from GCMCC5.39(FTP)were evaluated.After UV,infrared spectrum analysis,HPAEC-PAD,HPSEC and 1 D NMR analysis,the composition of the purifi ed FTP was determined.Purifi ed components of fermented Tremella polysaccharide(FTPS)was made of galactose,mannose,glucose,galactosmine,glucosamine,and contain a large amount of hydroxyl,carbonyl and amino groups.FTPS wasα-neutral pyranose without uronic acid.FTPS-1 and FTPS-2 were obtained after purifi cation by DEAE-Sepharose Fast Flow Column.The molecular weights of FTPS-1 and FTPS-2 were 25722 and 177263 Da.FTPS-2 had a better ability to prevent moisture loss,and the optimal moisture retention period was 0–4 h.FTPS-2 could signifi cantly increase the moisture content of the skin epidermis and showed a dose-concentration relationship.The effect of FTPS-2 on the expression of different moisturizing genes was evaluated in a human skin keratinocyte model.The results showed that FTPS-2 has no cytotoxicity,and could signifi cantly promote AQP3,TGM1,CASP14,HYAL2,FLG gene expression level in HaCaT cells.It has the most signifi cant infl uence at HYAL2 protein expression on 50μg/mL.

Does antiviral therapy reduce complications of cirrhosis?

Chronic hepatitis B infection is associated with the development of cirrhosis, hepatocellular carcinoma, and finally liver-related mortality. Each year, approximately, 2%-5% of patients with hepatitis B virus (HBV)-related compensated cirrhosis develop decompensation, with additional clinical manifestations, such as ascites, jaundice, hepatic encephalopathy, and gastrointestinal bleeding. The outcome of decompensated HBV-related cirrhosis is poor, with a 5-year survival of 14%-35% compared to 84% in patients with compensated cirrhosis. Because the risk of disease progression is closely linked to a patient’s serum HBV DNA level, antiviral therapy may suppress viral replication, stabilize liver function and improve survival. This article briefly reviews the role that antiviral therapy plays in cirrhosis complications, particularly, in decompensation and acute-on-chronic liver failure.

Rabies Virus Neutralizing Activity,Safety,and Immunogenicity of Recombinant Human Rabies Antibody Compared with Human Rabies Immunoglobulin in Healthy Adults

Objective Preliminary assessment of rabies virus neutralizing activity,safety and immunogenicity of a recombinant human rabies antibody(NM57)compared with human rabies immunoglobulin(HRIG)in Chinese healthy adults.Methods Subjects were randomly(1:1:1)allocated to Groups A(20 IU/kg NM57),B(40 IU/kg NM57),or C(20 IU/kg HRIG).One injection was given on the day of enrollment.Blood samples were collected on days-7 to 0(pre-injection),3,7,14,28,and 42.Adverse events(AEs)and serious AEs(SAEs)were recorded over a period of 42 days after injection.Results All 60 subjects developed detectable rabies virus neutralizing antibodies(RVNAs)(>0.05 IU/mL)on days 3,7,14,28,and 42.The RVNA levels peaked on day 3 in all three groups,with a geometric mean concentration(GMC)of 0.2139 IU/mL in Group A,0.3660 IU/mL in Group B,and0.1994 IU/mL in Group C.At each follow-up point,the GMC in Group B was significantly higher than that in Groups A and C.The areas under the antibody concentration curve over 0-14 days and 0-42 days in Group B were significantly larger than those in Groups A and C.Fifteen AEs were reported.Except for one grade 2 myalgia in Group C,the other 14 were all grade 1.No SAEs were observed.Conclusion The rabies virus neutralizing activity of 40 IU/kg NM57 was superior to that of 20 IU/kg NM57 and 20 IU/kg HRIG,and the rabies virus neutralizing activity of 20 IU/kg NM57 and 20 IU/kg HRIG were similar.Safety was comparable between NM57 and HRIG.

Change in renal function after sodium phosphate preparation for screening colonoscopy

AIM:To investigate the changes in renal function at 12-24 mo in patients following sodium phosphate(NaP) preparation for screening colonoscopy.METHODS:We carried out a retrospective study on the results from patients who received health check-up services as part of an employer-provided wellness program performed between August 2006 and May 2008 and who were followed up for 12-24 mo.Prior to screening colonoscopy,224 patients underwent bowel cleansing with NaP(NaP group) and 113 patients with polyethylene glycol(PEG group).The control group comprised 672 age-matched patients.We compared the changes in the creatinine levels and the glomerular filtration rates(GFRs) from baseline to 12-24 mo between the NaP,PEG,and control groups using two-way repeated measured analysis of variance.In addition,multivariate linear regression analysis was performed to assess the risk factors for a decreased GFR.RESULTS:The baseline mean serum creatinine level in the NaP,PEG,and control groups was 1.12 ± 0.15,1.12 ± 0.16,and 1.12 ± 0.15 mg/dL,which increased to 1.15 ± 0.15,1.15 ± 0.18,and 1.15 ± 0.15 mg/dL,respectively,after 12-24 mo.The baseline mean GFR in the NaP,PEG,and control groups was 69.0 ± 7.7,68.9 ± 8.0,and 69.6 ± 6.7 mL/min per 1.73 m2,which decreased to 66.5 ± 7.8,66.5 ± 8.3,and 67.4 ± 6.4 mL/min per 1.73 m2,respectively,after 12-24 mo.The changes in serum creatinine levels and GFRs were not significantly between the NaP,PEG,and control groups(P = 0.992 and P = 0.233,respectively).Using multivariate linear regression analysis,only the baseline GFR was associated with the change in GFR(P < 0.001).Indeed,the bowel preparations were not associated with the change in GFR(P = 0.297).CONCLUSION:NaP bowel preparation in subjects with normal renal function was not associated with renal injury,and NaP can thus be used safely for screening colonoscopy.

Association of serum pepsinogen with degree of gastric mucosal atrophy in an asymptomatic population

BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.

Effects of different acupuncture manipulations on protein expression in the parietal cortex of spontaneously hypertensive rats

Objective: To analyze the effects of twirling reinforcing and reducing manipulations on protein expression in parietal cortex of spontaneously hypertensive rats(SHRs), and elucidate the main mechanisms and differences between two manipulations in hypertension treatment.Methods: Rats were randomly divided into the control, model, twirling reinforcing manipulation(TRFM),and twirling reducing manipulation(TRDM) groups. The control and model groups received catch and fixation stimulations once a day for 14 days. The TRFM and TRDM groups were intervened once a day for 20 min for 14 days. On days 0, 2, 6, 10, and 14 after acupuncture, rat systolic blood pressures(SBPs) were measured. Differential protein(DP) expression in the rat parietal cortices was detected. Thereafter, GO functional significance and KEGG pathway enrichment analyses were performed.Results: Compared with the model group, SBP of rats in the TRDM and TRFM groups decreased on days 6 and 10 of acupuncture, respectively(P=.009;P <.001). Moreover, SBP of the TRDM group was significantly lower than that of the TRFM group on days 10 and 14 of acupuncture(P=.015;P=.013).Compared with control group, 601 and 1040 DPs were up-and downregulated, respectively, in the model group. Compared with model group, 44 and 28 up-and downregulated DPs were expressed, respectively,in the TRFM group. Compared with model group, expression of 616 and 427 up-and downregulated DPs,respectively, was found in the TRDM group. After combining the results of GO and KEGG enrichment analyses, five and one pathways were found to be related to the central antihypertensive mechanism of the parietal cortex during twirling reducing and reinforcing manipulations, respectively.Conclusion: TRDM showed a more effective antihypertensive effect on SHRs than TRFM;this antihypertensive effect was related to the regulation of different proteins and their biological functions.