B0 Group Research Articles

Impact of exacerbation history on future risk and treatment outcomes in chronic obstructive pulmonary disease patients: A prospective cohort study based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) A and B classifications.

In this study, we aimed to explore the impact of exacerbation history on future exacerbation and mortality with different inhaled drugs in chronic obstructive pulmonary disease (COPD) patients based on a Global Initiative Chronic Obstructive Lung Disease (GOLD) A and B classifications. This observational study was based on the cohort study Real World Research of Diagnosis and Treatment of COPD (RealDTC). We collected data from COPD patients in China from 1 July 2017 to 31 December 2022. Patients were followed up until December 2023 or death. Further, we separated GOLD A and B patients into GOLD A0 and B0, who had no exacerbation during the previous year, and GOLD A1 and B1, who had only one exacerbation during the previous year. Study outcomes included moderate-to-severe exacerbation, hospitalisation, frequent exacerbation in the first year and all-cause mortality during total follow-up. Of the 8318 eligible patients, GOLD E group of patients suffered from a greater risk of exacerbation in the first year and death than patients in the GOLD A and B groups. GOLD A1 group had a higher risk of moderate-to-severe exacerbation (hazard ratio (HR) = 2.087; 95% confidence interval (CI) = 1.419-3.068), hospitalisation (HR = 1.704; 95% CI = 1.010-2.705) and frequent exacerbation (HR = 1.983; 95% CI = 1.046-3.709) compared to GOLD A0. GOLD B1 group had a risk of moderate-to-severe exacerbation (HR = 1.321; 95% CI = 1.105-1.679) and mortality (HR = 1.362; 95% CI = 1.026-1.963) that exceeded the risk in GOLD B0 group. The treatment outcome of different inhaled drugs had no statistical differences in GOLD A0 group. In GOLD A1 group, only inhaled corticosteroids (ICS), in addition to long-acting β-2 agonist (LABA) and long-acting muscarinic antagonist (LAMA), reduced the risk of moderate-to-severe exacerbation in the first year compared to only LAMA. As for the GOLD B0 group, LABA and LAMA decreased the odds of moderate-to-severe exacerbation, hospitalisation, frequent exacerbation and mortality compared to only LAMA. ICS, LABA, and LAMA in GOLD B0 also down-regulated the risk of frequent exacerbation, compared to only LAMA. In addition, GOLD B1 patients treated with LABA and LAMA or ICS, LABA, and LAMA had a lower risk of moderate-to-severe exacerbation and hospitalisation. Meanwhile, ICS, LABA, and LAMA also reduced the risk of frequent exacerbation and mortality, compared to only LAMA in the multivariate Cox analysis. Compared to the GOLD A or B group without exacerbation history, GOLD A patients with exacerbation history had a higher risk of future exacerbation, and GOLD B patients with exacerbation history had a higher risk of future exacerbation and mortality and benefited more from triple inhaler therapy.

Analysis of Antioxidant Capacity, Total Phenolic and Total Flavonoid Contents in Boric Acid applied Camellia sinensis L.

Consumption of Camellia sinensis L (tea), a popular beverage, is very common today. In addition to consuming tea as a beverage, it is suggested that it can also be added to other foods to increase their antioxidant activities. This study aimed to determine the antioxidant capacity, total phenolic, and total flavonoid contents of extracts prepared in different solvents of tea grown in soil treated with boric acid. The area in Rize/Turkey was divided into 4 groups. No application was made to the control group (B0 group). Boric acid prepared in sodium tetraborate buffer was applied to the other three areas as a single dose at concentrations of 100 (group B1), 300 (group B3), and 500 (group B5) mg/m2. The obtained tea leaves were ground and infused in water, 20% ethanol, and 50% ethanol by the classical infusion method. The extracts obtained after infusion were analyzed for total phenolic contents, flavonoid content, and antioxidant capacity. It was determined that 20% and 50% ethanol were a better solvent than water in terms of total phenolic content, flavonoid content, and antioxidant capacity. Although the total phenolic contents of tea leaves grown in soils treated with different doses of boric acid did not change, differences were observed in their flavonoid contents and antioxidant capacities. As a result, we can say that boric acid should be at a certain dose to improve the quality of the tea plant. In addition, different solvents can be used to reveal more of the tea content.

Sickness absence in relation to first childbirth in nulliparous women, employed in the education and care branches in the public or private sectors: A Swedish longitudinal cohort study.

BackgroundPregnancy and childbirth entail increased risks of sickness absence (SA). Many women work in education and care, two branches characterised by high SA levels; it is not known if the link between childbirth and SA in these branches differs between private and public sectors. We examined SA and disability pension (DP) in relation to childbirth among women working in the education and care branches, and if these patterns differed between public and private sectors.MethodsWe performed a Swedish register-based cohort study. Study participants were nulliparous women living in Sweden in December 2004 and employed in education or care (n = 120,013). We compared SA/DP in the three years before and after 2005 among women who had no childbirth during follow-up (B0), had one childbirth in 2005 and no more (B1), and had one childbirth in 2005 and at least one more during follow-up (B1+). Analyses were performed for all and by public or private sector.ResultsOf all studied women, 70% worked in the public sector. Women in B1 and B1+ had, except for the year before childbirth, comparable or lower mean combined SA/DP days than women in the B0 group; women in the B1+ group had, except for the year before childbirth, the lowest mean level of SA/DP. We observed no substantial differences in these patterns between public and private sectors.ConclusionsPatterns of SA/DP among nulliparous women who did or did not give birth did not differ substantially between public and private sectors among women in the educational and care branches.

Effect of intrathecal fentanyl on the incidence, severity, and duration of postdural puncture headache in parturients undergoing caesarean section: A randomised controlled trial.

Background and Aims:Postdural puncture headache (PDPH) is a side effect of spinal anaesthesia (SA). This study was conducted to investigate the effect of intrathecal fentanyl on the incidence, severity, and duration of PDPH.Methods:This was a prospective randomised controlled study including 220 parturients, who underwent Caesarean section (CS). They were divided into two groups for administration of SA with bupivacaine (bupivacaine group [B0], n = 111) or bupivacaine with fentanyl (bupivacaine fentanyl group [BF], n = 109). Haemodynamics, quality of anaesthesia, maternal side effects, and postoperative analgesia were noted. The neonatal Apgar score was recorded. The patients were followed up for 14 days after CS for the occurrence of PDPH, and its severity and duration. The collected data were statistically analysed, using the Statistical Package for the Social Sciences software version 25.Results:Regarding haemodynamics, heart rate increased at 5 min post-induction and blood pressure decreased at 2min post-induction in both groups. Excellent intraoperative anaesthesia was obtained in 91.7% and 79.3% of cases in groups BF and B0, respectively (P < 0.01). Longer duration of postoperative analgesia was present in the BF group as compared to the B0 group (P < 0.001). The incidence of PDPH decreased in the BF group in a non-significant manner, whereas its severity and duration increased significantly in the B0 group.Conclusion:Although the addition of intrathecal fentanyl to bupivacaine for SA in CS patients did not reduce the incidence of PDPH significantly, its severity and duration decreased significantly.

Dietary Bile Acids Enhance Growth, and Alleviate Hepatic Fibrosis Induced by a High Starch Diet via AKT/FOXO1 and cAMP/AMPK/SREBP1 Pathway in Micropterus salmoides.

A 10-week feeding trial was conducted to investigate the effects of dietary bile acids (BA) on growth, glucose and lipid metabolism, liver histopathology, and the underlying regulation mechanism on AKT/FOXO1 (forkhead box O1) and cAMP/AMPK/SREBP1 (sterol regulatory element-binding protein 1) pathway in largemouth bass (Micropterus salmoides) fed with a high starch diet. Six experimental diets were prepared with BA levels at 0 (B0), 80 (B80), 160 (B160), 240 (B240), 300 (B300), and 600 (B600) mg/kg in a basal diet with 18.7% starch. Each diet was fed to six replicates with 30 fish (6.17 ± 0.03 g) in each tank. The highest weight gain rate (WGR) was observed in B300 group and the optimal level of BA was estimated at 475 mg/kg by a monistic cubic equation regression analysis. Dietary BA inclusion decreased hepatosomatic index (HSI) and hepatic lipid content significantly. The fish in B300 group clearly showed alleviated hepatic fibrosis, but more steatohepatitis symptoms diagnosed with various histopathological and immunofluorescence analysis. 10 out of 12 samples were observed hepatic fibrosis in B0 group while only two fibrosis samples in B300 group. The promoted liver histopathology by dietary BA was related to improved glucose and lipid metabolism. Dietary BA inhibited the expression of G6Pase by activating AKT and reducing FOXO1 transcription, which improved the regulation ability of gluconeogenesis, activated cAMP/AMPK and repressed SREBP1 transcription to inhibit hepatic lipogenesis, which prevented hepatic lipid accumulation. In conclusion, dietary BA enhanced the growth and alleviated liver fibrosis induced by a high starch diet to steatohepatitis/recovery symptom via improving glucose and lipid metabolism, which regulated by AKT/FOXO1 and cAMP/AMPK/SREBP1 pathway in largemouth bass.

Sickness absence and disability pension before and after first childbirth and in nulliparous women: longitudinal analyses of three cohorts in Sweden

ObjectiveChildbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, detailed knowledge about SA/DP patterns around childbirth is lacking. We aimed to...

Dietary supplementation with Bacillus subtilis LT3‐1 enhance the growth, immunity and disease resistance against Streptococcus agalactiae infection in genetically improved farmed tilapia, Oreochromis niloticus

A feeding trial was conducted to investigate the effect of different levels of Bacillus subtilis LT3‐1 in diets on growth, immune parameters, intestinal morphology and disease resistance in genetically improved farmed tilapia, Oreochromis niloticus. Fish (46.91 ± 0.17 g) were fed with a basal diet supplemented with B. subtilis LT3‐1 at 0 (B0), 3.8 × 10¹⁰ (B1), 7.6 × 10¹⁰ (B2), 1.14 × 10¹¹ (B3) and 1.52 × 10¹¹ (B4) CFU kg⁻¹ for 6 weeks. The results showed that the weight gain of fish in B1 group was significantly enhanced compared to that in B0 group (p < 0.05). The addition of B. subtilis significantly affected serum biochemical indices (total protein, albumin, aspartate aminotransferase, alkaline phosphatase). Besides, the haematocrit, total counts of red and white blood cells, as well as the serum catalase and lysozyme activities, were increased, whereas the serum malondialdehyde, the serum immunoglobulin M and complement three contents were reduced. Parameters for intestinal morphology suggested a healthier intestine for the fish fed B. subtilis‐supplemented diets than fish fed the control diet. The survival rate after Streptococcus agalactiae challenge increased in tilapia fed with B. subtilis. The present study demonstrated B. subtilis can effectively improve growth, immunological status and resistance against S. agalactiae infection in tilapia farming.

Effect of intrathecal injection of bovineadrenalmedulla 8-22 on pain behavior in a mouse model of bone cancer pain

Objective To investigate the effect of intrathecal injection bovineadrenalmedulla 8-22 (BAM8-22) on pain behavior in a mouse model of bone cancer pain. Methods 50 male 8-10 week old C3H/HeJ mice weighing 18-22 g were divided randomly into 5 groups (n=8): sham group (S group), BCP group: artificial cerebrospinal fluid treat group(B0 group) and BAM8-22 treat groups (B1-B3 group). Group C and B were induced mouse models of bone cancer pain by intra-right-femur inoculations of osteolytic NCTC2472 cells while group S were injected only α-MEM. On the 14 d after inoculations, group S and BCP received intrathecal injection of artificial cerebrospinal fluid 5 μl, while group B1-B3 received intrathecal injection of BAM8-22 0.8, 2.4, 8.0 nmol, which dissolved in 5 μl artificial cerebrospinal fluid. They were intrathecally injected, respectively, once a day for 7 consecutive days starting from day 14 after inoculation. Mice received pain behavior tests including quantification of spontaneous flinches (NSF), paw withdrawal mechanical threshold (PWMT) 0.5 h before and at 2 h, after administration. Results Compared with S group [(1.80±0.20) times, (1.87±0.22) g], NSF [(14.67±2.65) times] was significantly increased (P=0.000) and MWT [(0.42±0.22) g] was significantly decreased (P=0.002) on 7-21 days after inoculation in BCP group. Compared with B0 group [(12.38±1.12) times, (0.48±0.22) g] and the basal level on 14th day before administration [(12.65±1.10) times, (0.46±0.19) g, P=0.012, 0.011, 0.001, 0.001], PWMT was significantly decreased, and NSF was increased at 2 h after administration in B2 group [(7.28±0.82) times, (1.01±0.13) g] and B3 groups [(4.18±1.02) times, (1.38±0.12) g, P=0.027, 0.025, 0.013, 0.009]. The analgesic effect of group B3 was more conspicuous compared with group B2 (P=0.007, 0.031). No obvious change of pain ethology indexes wag observed in group B1 [(12.03±1.22) times, (0.51±0.16) g] (P=0.096, 0.074, 0.527, 0.474). Conclusion Intrathecal BAM8-22 injection can effectively attenuated bone cancer pain with increased doses in the mouse model of bone cancer pain. Key words: Bone cancer pain; bovineadrenalmedulla 8-22; Behavior; Mouse

Effect of simplified feeding based only on wheat bran and brewer’s grain on rabbit performance and economic efficiency

&lt;p&gt;Simplified diets are based on maximum incorporation of fodder and/or by-products into animal feed, thus minimizing the formulation and the costs. This study aimed to evaluate the possibility of feeding fattening rabbits with a simplified diet composed of only two agro-industrial by-products inexpensive and locally available: brewer’s grain and wheat bran. At weaning (35 days), 68 rabbits were divided into two identical groups (mean weight = 833 g) and housed in individual cages until slaughter (77 days). Each of the two groups (B0 and SF) was fed &lt;em&gt;ad libitum&lt;/em&gt; either a commercial pelleted feed (control), or a simplified pelleted experimental diet "SF" containing 72% wheat bran and 27% brewer’s grain. The feed conversion was within the standards and similar in the two groups (3.55 on average). The growth rate and feed intake of B0 group were 12% higher (P &amp;lt;0.001) than that of the SF group (35.2g &lt;em&gt;vs&lt;/em&gt; 31.2 and 128.3 &lt;em&gt;vs &lt;/em&gt;113 g/d). The cold carcass yield and the carcass weight were respectively higher (P &amp;lt;0.001) by 4 units and by 9% in the control group. The carcass of SF group was less fatty (perirenal fat: -23%, inguinal fat: -41% and scapular fat:-14%). The economic efficiency was 40% better for SF diet with almost 50 Algerian Dinar more benefit (/kg of meat).&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Dietary butylated hydroxytoluene improves lipid metabolism, antioxidant and anti-apoptotic response of largemouth bass (Micropterus salmoides)

A 10-week growth trail was conducted to investigate the efficacy and tolerance of dietary butylated hydroxytoluene (BHT) by evaluating inflammation, apoptosis and hepatic disease related to oxidative stress in largemouth bass (Micropterus salmoides). Four experimental diets were prepared with BHT supplement levels of 0 (B0), 150 (B150), 300 (B300) and 1500 (B1500) mg/kg, in which B150 was at the maximum recommended level established by European Union Regulation, and the B300 and B1500 levels were 2 and 10-fold of B150, respectively. Each diet was fed to 6 replicates with 30 largemouth bass (initial body weight, IBW = 6.20 ± 0.01 g) in each tank. The BHT inclusion level did not affect the specific growth rate, but fish in the B150 group showed the lowest feed conversion rate (P < 0.05). BHT inclusion significantly decreased the levels of plasma TC, TG, LDL, ALT and AKP, and increased the (HDL-C)/TC ratio (P < 0.05). Plasma MDA was significantly decreased in the B150 group and GSH-Px was extremely enhanced in each BHT inclusion group (P < 0.05). Hepatic T-AOC was significantly enhanced and O2− was significantly decreased in each BHT inclusion group compared to the B0 group (P < 0.05), as well as hepatic MDA was significantly decreased in B1500 group (P < 0.05). Dietary BHT inclusion down-regulated the hepatic mRNA levels of inflammation, apoptosis and fibrosis related genes, including TNFα, TGF-β1, α-SMA, IL8, IL11β and caspase-9. Moreover, BHT could improve hepatic lipid metabolism via up-regulating the mRNA levels of APOA1, CYP7A1, CYP8B1, and down-regulating the mRNA levels of PPAR-γ and APOB. Histological examination of the liver morphology with H&E and Sirius Red staining showed that BHT inclusion decreased necrotic degenerative changes and collagen deposition in largemouth bass. An immunofluorescence examination revealed significantly decreased cleaved caspase-3 signals in the BHT groups. In conclusion, the results demonstrated that ROS induces hepatic cell apoptosis and fibrosis via the intrinsic pathway of apoptosis by activating caspase-9 in the mitochondria and then initiates apoptosis by activating caspase-3. Consuming 2.32–23.80 mg/kg·bw/d (150–1500 mg/kg in diet) of BHT effectively improved the plasma and hepatic lipid metabolism, antioxidant response as well as reduced ROS production, protecting hepatic cells from injury. It is implied that even a 10-fold increase of the maximum level of BHT (150 mg/kg) is safe for the largemouth bass.

Trois nouveaux fragments de chaudrons des types de Cloonta et de Portglenone découverts dans le Nord-Ouest de la France : notes préliminaires sur la découverte du dépôt de la Chapelle des Roches (Le Châtellier, Orne), Bronze final atlantique 3

Un dépôt d’objets métalliques daté de l’âge du Bronze final, a été mis au jour en 2010 au lieu-dit la Chapelle des Roches, dans la commune du Châtellier (Orne). Ce dépôt, attribuable à l’étape de l’épée du type en langue de carpe contient les types d’objets classiques de l’horizon de Vénat (900-800 av. J.-C.). Cette étude préliminaire se propose de présenter les deux fragments de chaudrons qui y ont été découverts. Au vu du faible nombre d’exemplaires de ce type d’objet retrouvés sur le territoire français, la découverte de deux fragments bien conservés, déposés au sein d’un même dépôt, acquiert donc un caractère exceptionnel. Il s’agit dans les deux cas d’attaches d’anse. Cette trouvaille est également tout à fait originale pour la fin de l’âge du Bronze, dans le sens où c’est la première fois en Europe atlantique que deux attaches d’anse pouvant être connectées à deux groupes typologiques distincts sont associées au sein d’un même dépôt. Nous identifions donc le premier fragment du dépôt de la Chapelle des Roches comme étant une attache d’anse de chaudron du groupe B0 et du type de Cloonta, selon la classification renouvelée de S. Gerloff (Gerloff, 2010, p. 44). Le type de Cloonta n’était précisément connu et défini jusqu’alors que par deux exemplaires irlandais complets. Néanmoins, plusieurs fragments de chaudrons découverts en France et en péninsule Ibérique avaient déjà été hypothétiquement reliés au groupe B0 (Gerloff, 2010, p. 210, 228 et 342). En effet, ils présentaient de manière convaincante de nombreuses connections avec le type de Cloonta. Cependant, ces restes étaient beaucoup trop fragmentaires et trop peu spécifiques pour pouvoir bénéficier avec certitude d’une attribution typologique précise. De même, si la présence en France de chaudrons appartenant au groupe B avait déjà été proposée par le passé (Hawkes, 1952 ; Briard, 1966 ; Coffyn, 1985), l’observation récente de ces restes a par la suite invalidé ces attributions (Gerloff, 2010, p. 227). C’est ainsi la première fois que le type de Cloonta peut être attesté avec autant de certitude en France et qu’une attache d’anse de chaudron s’y référant est découverte hors d’Irlande. D’un point de vue interprétatif, cette découverte pourrait apparaître comme tout à fait marginale, si lors de cette étude, un autre fragment de chaudron du groupe B0 n’avait pas été reconnu au sein d’un autre dépôt du Nord-Ouest français. Cet article sera donc l’occasion de redécouvrir une pièce de l’important dépôt du Jardin des Plantes (Nantes, Loire-Atlantique). Cet objet, désigné depuis sa découverte comme étant un rebut de métal, peut aujourd’hui être clairement identifié et rattaché aux chaudrons du type de Cloonta. De même, la relecture récente du dépôt du Vern, découvert à Moëlan-sur-Mer (Finistère), nous permet d’enrichir le corpus des fragments de feuilles de bronze appartenant par hypothèse à des chaudrons du groupe B0. Les exemplaires complets du type de Cloonta ne bénéficiant pas de contextes chronologiques fiables, leur datation s’est donc basée sur l’appartenance potentielle au groupe B0 de plusieurs fragments de chaudrons découverts en France et en péninsule Ibérique. La contemporanéité certaine de ces restes avec la culture matérielle de l’horizon de l’épée du type en langue de carpe a donc favorisé la datation du type de Cloonta au Bronze final atlantique 3 (Gerloff, 2010, p. 342). Ainsi, la découverte du dépôt de la Chapelle des Roches, de même que la relecture du fragment de chaudron du dépôt du Jardin des Plantes nous donnent donc, pour la première fois, les moyens de pouvoir confirmer cette hypothèse. Le second fragment du dépôt de la Chapelle des Roches est une attache d’anse de chaudron appartenant au groupe A2 et au type de Portglenone. Cette découverte permet de compléter l’aire de distribution de ce type en France et de confirmer l’hypothèse de sa contemporanéité avec le type de Cloonta. En définitive, les habituelles interactions observées entre les cultures matérielles du Nord-Ouest français et celles des autres régions de la façade atlantique européenne ne trouvaient jusqu’alors que peu d’échos dans les cartes de répartition des chaudrons de la fin de l’âge du Bronze. Ainsi, cette étude permettra, sinon de reconsidérer ce constat, du moins d’étoffer une présence sur le territoire français encore discrète. De même, loin d’invalider les précédentes propositions de connections entre certains fragments de la péninsule Ibérique et les chaudrons irlandais du type de Cloonta, l’exemplaire de la Chapelle des Roches, permet de consolider ce lien, notamment grâce à certains détails morphologiques. Ainsi, cet article étaye un peu plus l’hypothèse que les exemplaires irlandais, très atypiques morphologiquement par rapport aux autres chaudrons des îles Britanniques, soient possiblement des importations ou des copies trahissant des influences venant du continent. Enfin, cette étude souligne, s’il en était encore besoin, les différences de modalités de constitution des dépôts et de traitements des objets, observables d’une région à une autre.

Long-Term Effects of Botulinum Toxin Complex Type A Injection on Mechano- and Metabo-Sensitive Afferent Fibers Originating from Gastrocnemius Muscle.

The aim of the present study was to investigate long term effects of motor denervation by botulinum toxin complex type A (BoNT/A) from Clostridium Botulinum, on the afferent fibers originating from the gastrocnemius muscle of rats. Animals were divided in 2 experimental groups: 1) untreated animals acting as control and 2) treated animals in which the toxin was injected in the left muscle, the latter being itself divided into 3 subgroups according to their locomotor recovery with the help of a test based on footprint measurements of walking rats: i) no recovery (B0), ii) 50% recovery (B50) and iii) full recovery (B100). Then, muscle properties, metabosensitive afferent fiber responses to potassium chloride (KCl) and lactic acid injections and Electrically-Induced Fatigue (EIF), and mechanosensitive responses to tendon vibrations were measured. At the end of the experiment, rats were killed and the toxin injected muscles were weighted. After toxin injection, we observed a complete paralysis associated to a loss of force to muscle stimulation and a significant muscle atrophy, and a return to baseline when the animals recover. The response to fatigue was only decreased in the B0 group. The responses to KCl injections were only altered in the B100 groups while responses to lactic acid were altered in the 3 injected groups. Finally, our results indicated that neurotoxin altered the biphasic pattern of response of the mechanosensitive fiber to tendon vibrations in the B0 and B50 groups. These results indicated that neurotoxin injection induces muscle afferent activity alterations that persist and even worsen when the muscle has recovered his motor activity.

Influence of repeated PICC catheterized on catheter tip location

Objective To explore the influence of repeatedly PICC catheterized on catheter tip position. Methods We analyzed the catheter tip position of patients who located PICC in one level three class-A hospital in Beijing from May to October in 2014. A total of 381 effective medical records were collected and divided into having the history of catheterization group and having no history of catheterization group depending on patients whether catheterized before. The patients having the history catheterization were divided into ipsilateral catheter group (B1 group) and no ipsilateral catheter group (B0 group), the catheter tip position was compared. Results The best catheter tip position for patients having the history of catheterization was 30.79%, which was lower than patients having no history group of 52.66% (χ2=17.565, P<0.01), and the patients of having catheterization history group had the incidence rate of shallow catheterization (47.74%) higher than 35.40% in the no catheterization history group (χ2=5.817, P<0.05). The patients of having catheterization history group happened the incidence of catheter tip position acquired dystopia of venae subclavia higher than patients having no catheterization history group (P<0.05). The best catheter tip position had lower rate in the B1 group comparing with B0 group, but the patients acquired dystopia of venae subclavia in the B1 group was lower than the patients in the B0 group (P<0.05). Conclusions Multiple PICC catheterization reduces the accuracy of catheter tip position, and impacts the safety and reservation of PICC. We should minimize the non-planned extubation incidences. If patients require re-catheterizaiton, we should select the opposite limbs to catheterize without catheterizaiton contraindication to ensure the safe of PICC catheterization. Key words: PICC; Catheter, catheterize; Complication

N-acethyl-cysteine reduces the occurrence of contrast-induced acute kidney injury in patients with renal dysfunction: a single-center randomized controlled trial

The occurrence of contrast-induced acute kidney injury (CIAKI) has paralleled the increased number of diagnostic interventions requiring radiographic contrast media (CM). Several strategies aimed at preventing renal injury following iodine have been carried out over the last several years. The aim of this study was to evaluate the impact of three different strategies aimed at preventing CIAKI in patients with renal dysfunction (serum creatinine >1.25 mg/dl or estimated creatinine clearance <45 ml/min) receiving low osmolar CM for diagnostic-therapeutic procedures. Candidates received 154 mmol NaHCO3 solution (B0) at a rate of 3 ml/kg/h from at least 2 h before the procedure and at 1 ml/kg/h during and for the next 6-12 h; the same schedule plus N-acethyl-cysteine (NAC) 600 mg twice daily the day before and the day of the procedure (BN) or NAC as above plus 154 mmol NaCl solution at a rate of 3 ml/kg/h from at least 2 h before the procedure and at 1 ml/kg/h during and for the next 6-12 h (SN). Serum creatinine (SCr) was measured at baseline and on days 2 or occasionally 3 after CM. The main outcome measure was the occurrence of CIAKI, defined as a ≥25% increase in SCr within 2-3 days of CM. The three groups were similar with regard to age, gender distribution, weight, baseline serum levels of creatinine, sodium, potassium, urate and estimated creatinine clearance. A larger proportion of individuals received ACEIs/ARAs in the BN group (p < 0.05), but in the SN group, more patients declared a past history of acute myocardial infarction or had high blood pressure, and few displayed mild-moderate left ventricular dysfunction (p < 0.05). CIAKI occurred in 24/123 (19.5%) assessable patients (15/42 in the B0 group, 3/43 in the BN group and 6/38 in the SN group; p < 0.01). Thus, 15/42 patients who did not receive NAC developed CIAKI in contrast to 9/81 who did (p < 0.01). Multivariate logistic regression models showed that the use of NAC was the unique factor associated with a statistically significant influence for the occurrence of CIAKI (OR: 0.18; 95% CI: 0.04-0.72; p = 0.016). The results from this study show that: (1) the occurrence of CIAKI after low-osmolar CM administration is similar to that reported worldwide. (2) NAC-based renoprotective measures are superior for the prevention of CIAKI in patients with previous renal dysfunction. (3) They also demonstrate that bicarbonate expansion alone has limited value in preventing CIAKI. For those individuals at risk, combination prophylaxis including volume expansion plus NAC should be recommended to reduce the chance of overt kidney injury following CM administration.

Morphine at “sub-analgesic” background infusion rate plus low-dose PCA bolus control pain better and is as safe as twice a bolus-only PCA regimen: A randomized, double blind study

Morphine for postoperative pain control is commonly titrated via intravenous patient-controlled analgesia (IV-PCA). An IV morphine background infusion is rarely used. We investigated whether analgesia is effectively attained and morphine consumption is reduced if PCA titration is coadjuvated by a continuous infusion protocol. Following colorectal cancer surgery, consenting patients were randomized to receive a minimal (“sub-analgesic”) dose of morphine 0.01mg/kg/h background infusion plus a 0.01mg/kg bolus (BI), or a 1.5mg bolus-only morphine (B0) (bolus ratio ∼1:2). Bolus lockout time was 7min in either case. All patients received 0.1mg/kg morphine before protocol initiation, and diclofenac 75mg intramuscularly b.i.d. during the study period, lasting 48h. Eighty-six patients (51 males, age 26–95 years) participated in the study. The total mean morphine consumption during the 48h was 25% lower in the BI than in the B0 group (P<0.05). Although the former applied the PCA device for boluses 19% less than the latter (P<0.05), their pain score was lower (P<0.05) most of the time, and they reported greater satisfaction (P<0.05) on a 10-scale numerical rating score. Pre- and postoperative vital signs were similar for both groups. No patient depicted hypoxemia or lapsed into deep sedation. Four BI and three B0 patients required treatment for postoperative nausea and vomiting. One BI patient had transient pruritus and one B0 69-year individual became disoriented 24h into treatment; either event subsided soon after stopping their respective regimen without the need for treatment. The main conclusions of the results are that very-low-dose background morphine infusion combined with small-dose PCA boluses may provide better pain relief, lower morphine consumption, and minimal complication rate as a 1.5mg PCA bolus-only protocol.

The exploratory about time-share and ranking for right to know the fact and selection of schizophrenic

Objective The best juncturest is exploratory that is to enjoyment right to know the fact and selection for schizophrenic. The best extentest is exploratory that is to enjoyment right to know the fact and selection with different time for schizophrenic. Methods The time was divided for on admission,hospitalization one week,hospitalization tow weeks, hospitalization three weeks and hospitalization four weeks five piece time section (time-share)about enjoymenting right to know the fact and selection of schizophrenic;and to enjoymenting right to know the fact and selection of schizophrenic extent was divided for not to know the fact, mere-know the fact and know the fact (ranking).The pathogenetic condition of schizophrenic were evaluated letting enjoyment identical extent right to know the fact and selection at different time and enjoyment identical time right to know the fact and selection at different extent for PANSS,SI and MAOS. Results The rate of schizophrenic cooperation was that A0 group was 63.64%,B0 group was 45.45%,C0 group was 32.73%,the difference had significance(χ2=21.30,P 0.05). Conclusion The schizophrenic are divided time-share and ranking enjoyment right to know the fact and selection according to patient's condition and the guardian to be stipulated by laws. The schizophrenic time-share and ranking for right to know the fact and selection method procedure simple and agility. The method suit our country. The methods have practical and theory value for actuality clinical work. Key words: Schizophrenic; Right to know the fact; Right to know the selection; Time-share; Ranking

The interference effects of non-rotated versus counter-rotated trials in visuomotor adaptation

An isometric torque-production task was used to investigate interference and retention in adaptation to multiple visuomotor environments. Subjects produced isometric flexion-extension and pronation-supination elbow torques to move a cursor to acquire targets as quickly as possible. Adaptation to a 30 degrees counter-clockwise (CCW) rotation (task A), was followed by a period of rest (control), trials with no rotation (task B0), or trials with a 60 degrees clockwise (CW) rotation (task B60). For all groups, retention of task A was assessed 5 h later. With initial training, all groups reduced the angular deviation of cursor paths early in the movements, indicating feedforward adaptation. For the control group, performance at commencement of the retest was significantly better than that at the beginning of the initial learning. For the B0 group, performance in the retest of task A was not dissimilar to that at the start of the initial learning, while for the B60 group retest performance in task A was markedly worse than initially observed. Our results indicate that close juxtaposition of two visuomotor environments precludes improved retest performance in the initial environment. Data for the B60 group, specifically larger angular errors upon retest compared with initial exposures, are consistent with the presence of anterograde interference. Furthermore, full interference occurred even when the visuomotor environment encountered in the second task was not rotated (B0). This latter novel result differs from those obtained for force field learning, where interference does not occur when task B does not impose perturbing forces, i.e., when B consists of a null field (Brashers-Krug et al., Nature 382:252-255, 1996). The results are consistent with recent proposals suggesting different interference mechanisms for visuomotor (kinematic) compared to force field (dynamic) adaptations, and have implications for the use of washout trials when studying interference between multiple visuomotor environments.