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Homology acting, molecular dynamics simulation and docking look at β-tubulin involving Schistosoma mansoni.
BACKGROUND This study aimed to assess the relationship between the use of dexmedetomidine and the incidence of acute kidney injury (AKI) in septic shock patients undergoing mechanical ventilation and reveal the potential mechanism. METHODS Septic shock patients undergoing mechanical ventilation were included. Patients were randomized into two groups including propofol group and dexmedetomidine group. Plasma samples were obtained from veins at 0, 12, 24, 72 and 120 h after receiving mechanical ventilation in ICU. RESULTS Cohorts with septic shock after mechanical ventilation in ICU had similar baseline and demographic characteristics. Serum creatinine (SCr) and blood urea nitrogen (BUN) was lower in dexmedetomidine group (P less then 0.05) and also lower renal injury markers were detected in the dexmedetomidine group, compared with propofol group (P less then 0.05). Dexmedetomidine infusion reduced the TNF-α, IL-1 level in blood samples and maintained the balance of proportion of CD4+ and CD8+ T-lymphocytes. Patients receiving dexmedetomidine were less likely to develop AKI. The median ICU stay was decreased in dexmedetomidine group (P less then 0.05). Moreover, the case and duration of CRRT was also decreased by using dexmedetomidine (P less then 0.05). There was no significant difference between the cohorts with respect to the duration of mechanical ventilation. CONCLUSIONS The use of dexmedetomidine infusion in ICU patients was associated with a decreased incidence of AKI and reduced ICU stay and CRRT performance. The mechanism may be related to antiinflammatory reaction and immunoregulation.BACKGROUND OP seriously affects the health status and quality of life of the elderly, even endangers life. This study aimed to investigate the prevalence and contributing factors of osteoporosis (OP) in the elderly over 70 years old of several Community Health Centers in Shanghai. METHODS A total of 565 elderly subjects were recruited and received questionnaire survey. The general characteristics, medical history and history of OP treatment were collected. Bone mineral density (BMD) was detected, and the awareness rate, prevalence and treatment rate were determined in all of the subjects. Moreover, activity of daily living and nutritional status were also evaluated. Logistic regression analysis was performed to calculate the OR and its 95% confidence interval. Bone turnover markers (BTMs) [procollagen type 1 N-peptide (P1NP), C-terminal cross-linked telopeptides of type 1 collagen (β-CTX), molecular fragment of N-terminal osteocalcin (N-MID), and 25 hydroxyvitamin D (25OHD)] were detected and their relationship with OP was further evaluated with Pearson correlation analysis. RESULTS (I) The awareness rate of OP was 89.7%, the prevalence was 39.5%, and the treatment rate was 59.5% in the elderly over 70 years old of 4 Community Health Center in Shanghai; (II) the male gender and good nutritional status were independent protective factors of OP, and aging and poor activity of daily living were independent risk factors of OP; (III) β-CTX was negatively related to BMD (r=-0.286, P=0.000), but P1NP, N-MID, and 25OHD were positively related to BMD (r=0.254, 0.349 and 0.357, P=0.000, 0.000 and 0.000). CONCLUSIONS Female gender, aging, malnutrition, and inability to take care of themselves are risk factors of OP in people over 70 years old of 4 Community Health Centers in Shanghai. Some BTMs are related to the BMD. BTMs together with BMD may be used to comprehensively evaluate the bone state, identify the old people with OP at early stage, and guide the clinical treatment and early monitoring of OP.Previous studies have demonstrated differences in the distribution of intracranial and/or extracranial atherosclerosis (I-ECAS) by region and race. Despite this, few studies have examined the distribution of arterial stenosis in ischemic stroke patients of the Zhuang population in Guangxi, China. We therefore aimed to investigate the distribution of cerebrovascular stenosis in ischemic stroke patients across different ethnicities in Guangxi province. Zoligratinib A total of 1,101 patients were divided into 2 groups according to their ethnicity the Zhuang group and Han group. All patients underwent 64-slice spiral computed tomographic angiography (CTA) scanning to document the presence of intracranial or extracranial stenosis. Results showed that (I) intracranial atherosclerosis (ICAS) a higher incidence of ECAS (51.1% vs. 48.9%); (II) I-ECAS was the most common lesion type, followed by ICAS; (III) Zhuang patients had a higher rate of ECAS ( 20.2% vs. 15.2%, P=0.047) and a lower rate of I-ECAS (35.8% vs. 42.3%, P=0.041) thbral atherosclerosis between ethnic groups.BACKGROUND To compare the effects of perioperative dexmedetomidine with placebo (or other sedation) on the rate of postoperative delirium in adult patients who underwent non-cardiac surgeries. METHODS A meta-analysis was performed on randomized, controlled trials. MEDLINE, the Cochrane Central Register of Controlled Trials, and Embase (to March 20, 2019) were searched for literature retrieval. The standardized primary outcome was postoperative delirium. We pooled risk ratios using a random-effects model. RESULTS From 10 trials with 2,286 total participants, we recorded 363 postoperative delirium events during the follow-up periods. Compared with the control group, patients in the dexmedetomidine group had a postoperative delirium relative risk of 0.53 [95% confidence interval (CI), 0.37-0.76]. When the dexmedetomidine infusion rate was higher than 0.2 μg/kg/h, the relative risk of postoperative delirium reduced significantly by 34%, compared with other sedation methods (relative risk =0.66; 95% CI, 0.47-0.94; P=0.02), with no heterogeneity (I²=31%, P=0.18). While it reduced by 62% when the dexmedetomidine infusion rate was lower than 0.2 μg/kg/h (relative risk =0.38; 95% CI, 0.27-0.54). CONCLUSIONS Compared to the placebo (or other sedation methods), perioperative dexmedetomidine sedation resulted in lower rates of postoperative delirium in adult patients who underwent non-cardiac surgery.BACKGROUND Many studies have demonstrated that vitamin D has clinical benefits when used to treat patients with chronic obstructive pulmonary disease (COPD). However, most of these studies have insufficient samples or inconsistent results. The aim of this meta-analysis was to evaluate the effects of vitamin D therapy in patients with COPD. METHODS We performed an electronic literature search of the databases PubMed, China National Knowledge Internet (CNKI), Embase, Web of Science and Wanfang Data. Meta-analysis was carried out by Review Manager Version 5.3 (Revman 5.3), and standardized mean difference (SMD) and mean difference (MD) were used to assess the efficacy of vitamin D therapy in patients with COPD. RESULTS A total of 25 articles involving 2,670 participants were included in this study. The overall results showed a statistical significance of vitamin D therapy in patients with COPD on forced expiratory volume in 1 second (FEV1) (SMD 1.21, 95% CI 0.76-1.66, P less then 0.01), FEV1/FVC (SMD 1.07, 95% CI 0.56-1.58, P less then 0.01), Exacerbations (SMD 0.39, 95% CI 0.23-0.64, P less then 0.01), Sputum volume (SMD -6.02, 95% CI -8.25 to 3.79, P less then 0.01), 6-minute walk distance (6MWD) (MD 8.82, 95% CI 1.67-15.98, P=0.02) and COPD assessment test (CAT) score (SMD -1.19, 95% CI -1.74 to 0.63, P less then 0.01). CONCLUSIONS Our analysis indicated that vitamin D used in patients with COPD could improve the lung function (FEV1, FEV1/FVC), 6MWD and reduce acute exacerbation, sputum volume and CAT score.Methadone has unique characteristics that make it an attractive agent for the treatment of chronic pain and opioid drug dependence. However, methadone prescription requires more clinical experience and close monitoring of patients to avoid its undesirable side effects. Recently, levorphanol has emerged as "a forgotten opioid" with a similar profile as methadone. Levorphanol has no impact on QTc prolongation and considerably less drug-drug interactions as compared to methadone. Lack of commercial availability, providers' unfamiliarity, and limited clinical data on its effectiveness remain practical issues. The objective of this article is to review and compare the safety considerations for methadone and levorphanol use.BACKGROUND To conduct an in vitro investigation into the effect of different concentrations of levocetirizine hydrochloride on the growth of human dermal papilla cells (hDPCs) the underlying mechanisms involved. METHODS hDPCs were cultured in Dulbecco's Modified Eagle Medium (DMEM) containing different concentrations of levocetirizine hydrochloride for 48 h. The growth of hDPCs was observed by immunofluorescence staining, and the cell proliferation was detected by MTT assay. After the hDPCs were cultured in DMEM containing 1, 10, 100, 1,000, and 10,000 ng/mL levocetirizine hydrochloride for 48 h, the mRNA expressions of cyclooxygenase 2 (COX-2), prostaglandin D2 synthase (PTGDS), prostaglandin E2 (PGE2), prostaglandin F2α (PGF2α), G protein-coupled receptor 44 (GPR44), protein kinase B (AKT), and glycogen synthase kinase 3β (GSK3β) were determined by real-time fluorescence-based quantitative polymerase chain reaction (PCR), and the protein expressions of PTGDS, phosphorylated protein kinase B (pAKT), and phosnd 0.35±0.042, respectively) (t=16.59, t=7.73, respectively; both P less then 0.05). CONCLUSIONS Levocetirizine hydrochloride may promote the growth and proliferation of hDPC in vitro by inhibiting the PGD2-GPR44 pathway and activating the AKT signaling pathway.BACKGROUND Unilateral contractions of the facial muscles characterize hemifacial spasm (HFS). Microvascular decompression (MVD) was widely accepted for the treatment of HFS. To investigate the operative effects and surgical complications in patients with HFS after MVD. METHODS A retrospective analysis of 540 patients with HFS after MVD was conducted from January 2017 to May 2018. All patients were followed up for 2 years on average. Surgical effects were evaluated on the patients' manifestations according to the Cohen score classification. RESULTS During the follow-up period, 455 patients (84.26%) were completely cured, 60 patients (11.11%) were partial relief, 25 patients (4.63%) were failed cure. The effective rate was 93.52% on the first day after MVD, and 95.37% on the follow-up period. Ten patients (1.85%) were facial paralysis (FP) on the 1st day of post-operation. Twenty-five patients (4.63%), FP; the patients with delayed facial palsy were all completely cured in 3 months. Fourteen patients (2.59%) were hearing deficit after MVD, in whom 8 patients (1.48%) had good improvement, and 6 patients (1.11%) had no changes. There was no recurrence case or death case recorded. CONCLUSIONS MVD is the best treatment choice that offers the prospect of a definitive cure for HFS. Skilled microsurgical techniques, as well as identifying and sufficiently decompressing offending vessels, are the key to ensuring a safe and successful MVD. Complications of this surgery are uncommon and transient.Fentanyl has been FDA approval as an analgesic since 1968 and multiple different fentanyl preparations have been developed over the years. Little was known about it is clinical utility defined by risks and benefits until recently. Present commercially available preparations are easily tampered and nonpharmacologic fentanyl has become the major cause of opioid deaths in the United States. This state-ofthe-art review will discuss fentanyl pharmacology, utility, safety and abuse.
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