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Effect of Handing a Written Document to Share Concerns and Values with Physicians When Making Decisions about Starting Drug Treatment among Patients: A Pre-post Quasi-Experimental Study with Propensity Score Matching 在决定患者开始药物治疗时,提供书面文件与医生分享关注和价值观的影响:一项倾向评分匹配的前后准实验研究
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280086
S. Bito, Tomomi Iioka, Yasuhiro Yamada, E. Hiraoka, Taiju Miyagami
Background: There is lim ited evidence on the effectiveness of decision aids in promoting clinicians' understanding of patients' subjective perceptions. The aim of this study was to assess the impact of using a standard patient-completed template to express patients' views, preferences or concerns to their clinicians in a clinical decision-making setting on patients' perceived decisional conflict and post-decision regret. Methods: A pre-post quasi-experimental study with a six-month control period followed by a 12-month intervention period was conducted. Participants were recruited from six teaching hospitals and two clinics in Japan. The target population included 150 patients with diabetes mellitus, hypertension, and/or dyslipidaemia whose physicians had recently suggested drug treatment as a medical option. In the control period, a general informed consent booklet was distributed, and in the intervention period, a shared decision-making template was also provided. Patients were asked to complete the template, which was then attached to their electronic medical records. Results: Two months after enrolment, the decision conflict and regret scales were mailed to patients. Three months after enrolment, the decision status for starting drug treatment and the concordance between the patients' decision statuses and the initial medical recommendations were observed. Seventy-nine and seventy-one participants assigned to the control and intervention groups were enrolled. Fifty-five patient pairs generated by propensity score matching were analysed. No significant difference was observed between the two groups in the subscale scores of the decision conflict scale and the decision regret scale. The relative risk of patients with a decision status of ‘still considering’ starting drug treatment was 2.2 (95% CI, 1.02-4.9) in the intervention group. The concordance
背景:关于决策辅助在促进临床医生了解患者主观感受方面的有效性的证据有限。本研究的目的是评估在临床决策设置中使用标准的患者完成模板向临床医生表达患者的观点、偏好或关注点对患者感知的决策冲突和决策后后悔的影响。方法:采用前-后准实验研究,对照组为6个月,干预期为12个月。参与者是从日本的六家教学医院和两家诊所招募的。目标人群包括150名患有糖尿病、高血压和/或血脂异常的患者,他们的医生最近建议将药物治疗作为一种医疗选择。对照期发放一般知情同意书,干预期提供共享决策模板。患者被要求完成模板,然后将其附加到他们的电子医疗记录中。结果:入组2个月后,将决策冲突和后悔量表邮寄给患者。入组3个月后,观察患者开始药物治疗的决定状态,以及患者的决定状态与最初的医疗建议的一致性。分别有79名和71名参与者被分配到对照组和干预组。对倾向评分匹配产生的55对患者进行了分析。决策冲突量表和决策后悔量表的子量表得分在两组间无显著差异。干预组“仍考虑”开始药物治疗的患者的相对风险为2.2 (95% CI, 1.02-4.9)。的一致性
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引用次数: 0
Pleiotropic Effects of Statins-What is their Clinical Significance? 他汀类药物的多效作用——其临床意义?
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280074
Walter F. Riesen
Pleiotropic effects are effects not related to the primary effect of drugs. Statins, beside their primary effect, which is LDL-lowering, have several pleiotropic effects, such as anti-inflammation, anti-thrombotic effects, inhibition of smooth muscle cell proliferation and apoptosis, inhibition of migration and activation of macrophages. They increase blood glucose with the exception of pitavastatin. The clinical importance of these pleiotropic effects of statins however remains unclear. No matter of whether LDL-lowering was done by statins or by other means, the lowering of the cardiovascular risk is the same. The reduction in LDL-C per se is responsible for the beneficial effect. However, pleiotropic effects of statins might play a role with respect to micro vascular events. The difference in pleiotropic effects between the different statins might be a basis for a patient-oriented statin therapy.
多效效应是指与药物原效无关的效应。他汀类药物除了具有降低ldl的主要作用外,还具有抗炎症、抗血栓形成、抑制平滑肌细胞增殖和凋亡、抑制巨噬细胞迁移和活化等多种作用。除了匹伐他汀,它们会增加血糖。然而,他汀类药物这些多效性的临床重要性尚不清楚。无论是通过他汀类药物还是其他方法降低ldl,降低心血管风险的效果都是一样的。LDL-C的降低本身就是有益效果的原因。然而,他汀类药物的多效性可能在微血管事件中起作用。不同他汀类药物的多效性差异可能是他汀类药物以患者为导向治疗的基础。
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引用次数: 0
Short-Chain Fructooligosaccharides Improve Gut Microbiota Composition in Patients with Type 2 Diabetes. A randomized, Open-Label, Controlled Pilot Clinical Trial 短链低聚果糖改善2型糖尿病患者肠道菌群组成一项随机、开放标签、对照的先导临床试验
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280087
G. García, D. Martínez, Josanne Soto, L. Rodríguez, M. Nuez
.
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引用次数: 1
Heideggerian Hermeneutic Phenomenological Study of Lived Experiences of Nursing Care during Childbirth 分娩期间护理生活经验的海德格尔解释学现象学研究
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280079
Nicholas Yakubu Danzima, Bismark Nantomah, Vivian Kapio Abem
Studies have confirmed that the nurse, during delivery, is the deciding factor whether the woman would have positive or negative birth experience. However, there is no literature on the lived experiences of nursing care rendered during childbirth in the context of Ghana. Hence this study was to discover women’s lived experiences of nursing care during childbirth. A Heideggerian phenomenological method was conducted on 10 women who had given birth. Data analysis was done using Diekermann, Allen and Tanner’s method. Analysis revealed three main themes: (1) Being-in-the-world of pregnant women in labor with emotional, physical, and informational support needs (2) Encounter with the health facility and practices and needing pampering and nice communication (3) Wishing for an environment of congenial and cordial relationship during childbirth. It is recommended that health professionals incorporate the themes emerged from this study into the plan of care for women during childbirth
研究已经证实,在分娩过程中,护士是决定女性是否会有积极或消极的分娩经历的因素。然而,在加纳的背景下,没有关于分娩期间护理护理的生活经验的文献。因此,本研究旨在探讨妇女在分娩期间的护理生活经验。用海德格尔现象学方法对10名生育过的妇女进行了研究。数据分析采用Diekermann, Allen和Tanner的方法。分析揭示了三个主要主题:(1)孕妇在分娩过程中需要情感、身体和信息支持;(2)遇到卫生设施和实践,需要呵护和良好的沟通;(3)希望在分娩过程中有一个融洽和亲切的环境。建议保健专业人员将这项研究得出的主题纳入妇女分娩护理计划
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引用次数: 0
Heterozygote Germline Mutations in Homologous Recombination Core Genes Can Predict for Pathologic Complete Response in Early Triple Negative Breast Cancer 同源重组核心基因杂合子种系突变可预测早期三阴性乳腺癌的病理完全缓解
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280110
C Fontaine, S De Brakeleer, E Teugels, V Renard, H Van den Bulck, P Vuylsteke, P. Glorieux, C Dopchie, S Joris, L Decoster, A Awada, K Punie, H Wildiers, J De Grève
Background: BSMO 2014-01 is a published prospective phase 2 study investigating neoadjuvant weekly paclitaxel and carboplatin, followed by epirubicin and cyclophosphamide in 63 patients with triple-negative breast cancer. Pathological complete response (pCR) was 54%. A secondary endpoint was to correlate pCR rate to the presence of germline pathogenic variants in DNA damage response (DDR) genes and in core genes involved in Homologous Recombination (HR).
背景:BSMO 2014-01是一项已发表的前瞻性2期研究,研究了63例三阴性乳腺癌患者的每周新辅助紫杉醇和卡铂,随后是表柔比星和环磷酰胺。病理完全缓解(pCR)为54%。次要终点是将pCR率与DNA损伤反应(DDR)基因和参与同源重组(HR)的核心基因中种系致病变异的存在相关联。
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引用次数: 0
Outpatient Administration of Blinatumomab Infusion and Hematopoietic Stem Cell Transplantation as Treatment for Patients with Refractory Acute Lymphoblastic Leukemia in a Pediatric Oncologic Center in Mexico 在墨西哥儿科肿瘤中心,布利纳单抗输注和造血干细胞移植治疗难治性急性淋巴细胞白血病的门诊管理
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280106
Godoy-Fernández JF, Cubría-Juárez MP, Zapata-Tarrés M, Taveras-Rodríguez O, Briseño-Rebollar EV
Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer and the most common subtype of pediatric leukemia, the high toxicity of chemotherapy, the relapse and refractory disease of many patients require the development of novel therapeutic approaches such as targeted immunotherapy in combination with Hematopoietic Stem Cell Transplantation (HSCT). These new therapeutic approaches must be taken in count to revolutionize the management of numerous ALL subtypes, improve treatment outcomes and maintain low toxicity without losing the effectiveness of the treatment. Our retrospective, longitudinal, observational, descriptive study evaluated a novel therapeutic approach in a Pediatric Oncologic Center in Mexico, the outpatient administration of blinatumomab infusion in patients with relapsed/refractory acute lymphoblastic leukemia (R/R ALL). The study demonstrated that 100% of the patients went into remission after Blinatumomab infusion and there was no mortality associated.
急性淋巴细胞白血病(Acute Lymphoblastic Leukemia, ALL)是儿科最常见的癌症,也是儿科白血病最常见的亚型,化疗的高毒性、许多患者的复发和难治性疾病需要开发新的治疗方法,如靶向免疫治疗联合造血干细胞移植(Hematopoietic Stem Cell Transplantation, HSCT)。必须考虑到这些新的治疗方法,以彻底改变对众多ALL亚型的管理,改善治疗结果,并在不失去治疗有效性的情况下保持低毒性。我们的回顾性、纵向、观察性、描述性研究评估了墨西哥儿科肿瘤中心的一种新的治疗方法,即门诊输注blinatumomab治疗复发/难治性急性淋巴细胞白血病(R/R ALL)患者。该研究表明,100%的患者在输注Blinatumomab后进入缓解期,且无死亡率相关。
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引用次数: 0
A Cost-Benefit Analysis of Bivalent Covid-19 Vaccines 新型冠状病毒二价疫苗的成本效益分析
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280116
Dan-Yu Lin, Yangjianchen Xu, Donglin Zeng, Shadia Khan Sunny
The cost-benefit ratios of the bivalent vaccines were unknown. To address this issue, we considered surveillance data on the administration of the Moderna and Pfizer-BioNTech bivalent vaccines and clinical outcomes from September 1, 2022 to February 10, 2023 for North Carolina residents 12 years of age or older. We found that booster vaccination was much more beneficial for people 65 years of age or older than for people 12–64 years of age, mainly because the risks of hospitalization and death were much higher in the older age group.
二价疫苗的成本效益比尚不清楚。为了解决这一问题,我们考虑了2022年9月1日至2023年2月10日期间北卡罗来纳州12岁及以上居民使用Moderna和辉瑞- biontech二价疫苗的监测数据和临床结果。我们发现,与12-64岁的人群相比,65岁及以上的人群加强接种疫苗的益处要大得多,这主要是因为老年人住院和死亡的风险要高得多。
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引用次数: 0
The ERK Signaling Cascade Inhibits Gonadotropin-Stimulated Steroidogenesis. ERK信号级联抑制促性腺激素刺激的类固醇生成。
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280066
Rony Seger, Tamar Hanoch, Revital Rosenberg, Ada Dantes, Wolfgang E Merz, Jerome F Strauss, Abraham Amsterdam

The response of granulosa cells to Luteinizing Hormone (LH) and Follicle- Stimulating Hormone (FSH) is mediated mainly by cAMP/protein kinase A (PKA) signaling. Notably, the activity of the extracellular signal-regulated kinase (ERK) signaling cascade is elevated in response to these stimuli as well. We studied the involvement of the ERK cascade in LH- and FSH-induced steroidogenesis in two granulosa-derived cell lines, rLHR-4 and rFSHR-17, respectively. We found that stimulation of these cells with the appropriate gonadotropin induced ERK activation as well as progesterone production downstream of PKA. Inhibition of ERK activity enhanced gonadotropin-stimulated progesterone production, which was correlated with increased expression of the Steroidogenic Acute Regulatory Protein (StAR), a key regulator of progesterone synthesis. Therefore, it is likely that gonadotropin-stimulated progesterone formation is regulated by a pathway that includes PKA and StAR, and this process is down-regulated by ERK, due to attenuation of StAR expression. Our results suggest that activation of PKA signaling by gonadotropins not only induces steroidogenesis but also activates down-regulation machinery involving the ERK cascade. The activation of ERK by gonadotropins as well as by other agents may be a key mechanism for the modulation of gonadotropin-induced steroidogenesis.

颗粒细胞对促黄体生成素(LH)和促卵泡激素(FSH)的反应主要由cAMP/蛋白激酶A (PKA)信号介导。值得注意的是,细胞外信号调节激酶(ERK)信号级联的活性在这些刺激下也会升高。我们研究了ERK级联在LH和fsh诱导的两种颗粒来源细胞系rLHR-4和rFSHR-17中的参与作用。我们发现用适当的促性腺激素刺激这些细胞可诱导ERK活化以及PKA下游的孕酮产生。抑制ERK活性可增强促性腺激素刺激的孕激素产生,这与类固醇急性调节蛋白(StAR)的表达增加有关,StAR是孕激素合成的关键调节因子。因此,促性腺激素刺激的孕酮形成很可能受到包括PKA和StAR在内的一条通路的调控,而由于StAR表达的衰减,这一过程被ERK下调。我们的研究结果表明,促性腺激素激活PKA信号不仅可以诱导类固醇生成,还可以激活涉及ERK级联的下调机制。促性腺激素以及其他药物对ERK的激活可能是调节促性腺激素诱导的类固醇生成的关键机制。
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引用次数: 27
Atopy and Food Allergies among Children Attending Outpatient Department of a Selected Tertiary Care Hospital in Dhaka City 达卡市某三级医院门诊儿童的特应性和食物过敏
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280088
Biplob Biswas, Wahida Khanam, D. Hossain, Mohammad Ahad Adnan, U. Datta, A. K. Naseruzzaman, Zamil Ahmed Manik, Tauhidul Islam, Kumar Datta, Ahmed Manik
Background: Atopic dermatitis (AD), also called atopic eczema, is a common chronic or recurrent inflammatory skin disease and affects 15-20% of children. Objective: The aim of the study was to determine the proportion of atopy and food allergies among children attending outpatient department of a selected tertiary care hospital in Dhaka city. Methodology: This was a cross-sectional study. It was carried out on 384 children from June 2022 to December 2022 at pediatric outpatient department in Institute of child and mother health (ICMH), Dhaka, Bangladesh. The statistical evaluation of the results by using a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). Result: Total 384 children were enrolled among them Mean age was (1.15±0.43) years, 52% were female and 92.18% had a family history of atopy. Regarding symptoms 4.3% had lip or tongue swelling, 8.5% had difficulty in swallowing, 39.30% had urticaria, 13.7% had dyspnea and 5.1% had anaphylaxis. 82.8% of the respondents had mild illness, 11.98% had moderate illness and 5.21% had severe illness. 48.6% had Cow's Milk allergy, 19.5% to beef, 3.3% to egg ,2.6%to hilsa fish and prawn respectively and 22.3% to others. Mean Eosinophil count was (11.62±2.14), IgE was (747.40±314.2) IU and the skin prick test was positive 90.0%. Conclusion : The predominant sign of food allergy in young children was atopic dermatitis. Allergic conjunctivitis, oral allergy syndrome and respiratory distress appeared later in the progression of symptoms. Additionally, anaphylaxis is usually used to affect older children.
背景:特应性皮炎(AD),又称特应性湿疹,是一种常见的慢性或复发性炎症性皮肤病,影响15-20%的儿童。目的:本研究的目的是确定在达卡市某三级医院门诊就诊的儿童中特应性和食物过敏的比例。方法:这是一项横断面研究。该研究于2022年6月至2022年12月在孟加拉国达卡妇幼保健研究所儿科门诊部对384名儿童进行了检查。使用基于窗口的计算机软件程序设计的社会科学统计软件包(SPSS-24)对结果进行统计评估。结果:共纳入384例患儿,平均年龄(1.15±0.43)岁,女性占52%,有特应性家族史的占92.18%。在症状方面,4.3%有唇或舌肿,8.5%有吞咽困难,39.30%有荨麻疹,13.7%有呼吸困难,5.1%有过敏反应。82.8%为轻病,11.98%为中病,5.21%为重病。对牛奶过敏的占48.6%,对牛肉过敏的占19.5%,对鸡蛋过敏的占3.3%,对鱼和对虾过敏的占2.6%,对其他过敏的占22.3%。平均嗜酸性粒细胞计数为(11.62±2.14),IgE为(747.40±314.2)IU,皮肤点刺试验阳性率为90.0%。结论:幼儿食物过敏主要表现为特应性皮炎。变应性结膜炎、口腔过敏综合征和呼吸窘迫出现在症状进展的后期。此外,过敏反应通常用于年龄较大的儿童。
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引用次数: 0
Selection of an Attenuated Rifampicin Resistant Mutant of Streptococcus Iniae and Evaluation of its Immunoprotective Effect as Naturally Delivered Vaccines 牛链球菌抗利福平减毒突变株的筛选及其作为自然递送疫苗的免疫保护作用评价
Pub Date : 2023-01-01 DOI: 10.26502/jbb.2642-91280068
Guodong Luo, AnyuanZhang, L. Chen, Hui Wang, Lan Yu
Streptococcus iniae is a Gram-positive bacterium and a significant pathogen to a wide range of farmed fish. In the present study, we obtained a SF1 derivative, SF1M1, by selecting rifampicin resistance mutants. Compared to the wild type, SF1M1 (i) was slow in growth, (ii) showed less extracellular protease activity and produced a much lower amount of siderophores, and (iii) had a median lethal dose that is more than 100 times higher. In vitro and in vivo studies showed that the attenuated virulence of SF1M1 was stably maintained in the absence of selective pressure. To examine the potential of SF1M1 as a naturally delivered vaccine, Japanese flounder ( Paralichthys olivaceus ) were vaccinated with SF1M1 via bath immersion and oral feeding. At one and two months post-vaccination, the fish were challenged with SF1 or a heterogeneous strain S. iniae 29177, which is of serotype II. The results showed that fish vaccinated with SF1M1 exhibited relative percent survival rates of 54%-70% and produced specific serum antibodies that enhanced complement-mediated bactericidal activity against both SF1 and S. iniae 29177. Taken together, these results indicate that SF1M1 is an effective oral and immersion vaccine that induces protective immunity against serotype I and serotype II S. iniae .
牛链球菌是一种革兰氏阳性细菌,是多种养殖鱼类的重要病原体。在本研究中,我们通过选择利福平耐药突变体获得了SF1衍生物SF1M1。与野生型相比,SF1M1 (i)生长缓慢,(ii)细胞外蛋白酶活性较低,产生的铁载体数量少得多,(iii)中位致死剂量高出100倍以上。体外和体内研究表明,在没有选择压力的情况下,SF1M1的减毒力稳定维持。为了研究SF1M1作为一种自然递送疫苗的潜力,我们通过浴液浸泡和口服喂养的方式接种了日本比目鱼(parichthys olivaceus)。在接种疫苗后1个月和2个月,用SF1或血清II型的异种猪链球菌29177攻毒鱼。结果表明,接种SF1M1的鱼的相对存活率为54%-70%,并产生特异性血清抗体,增强了补体介导的对SF1和S. iniae 29177的杀菌活性。综上所述,这些结果表明SF1M1是一种有效的口服和浸渍疫苗,可诱导对血清I型和血清II型猪链球菌的保护性免疫。
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引用次数: 0
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Journal of Biotechnology and Biomedicine
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