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Health education is compulsory for patients with chronic and life-threatening disease, especially for those with diabetes mellitus (DM). This study aimed to examine the long-term effectiveness of the Diabetes Conversation Map Program (DCMP) among DM patients in Taiwan.A quasi-experimental research design using convenience sampling and nonrandom group assignment was applied to recruit 95 type 2 diabetic subjects from a hospital in Taiwan. In addition to routine care, the experiment group (n = 49) received 7 sessions of DCMP that delivered over 2 months, while the control group (n = 46) received only routine care during the same period. We conducted structured questionnaire survey and reviewed medical record at 3 time points (before DCMP, 3 days after DCMP, and 3 months after DCMP completion) to collect the effectiveness data. The effectiveness was determined using the generalized estimating equation model.We found that improvements in the body mass index, blood glucose, glycated hemoglobin, self-monitoring of blood glucose, and diabetic health literacy in the DCMP group compared with controls (all P values <.05), with no significant changes in depressive symptoms. The positive effects were further maintained for 3 months after DCMP.The findings may serve as a reference for helping healthcare professionals provide appropriate interventions to improve adaptation processes and clinical outcomes for DM patients.

Background: Listening to music can be a noninvasive method for reducing the anxiety level without any adverse effects. The aim of this study was to explore whether music can reduce anxiety and to compare two different styles of music, informal classical music and light music, to ascertain the more effective style of music in reducing anxiety in patients undergoing colonoscopy without sedation., Methods: This study enrolled 138 patients who underwent colonoscopy without sedation during a general health examination from February 2009 to January 2015. The patients were randomly assigned to a group that did not listen to music, a group that listened to music by David Tolley, or a group that listened to music by Kevin Kern. The State-Trait Anxiety Inventory was used to evaluate the status of anxiety., Results: A trend test for mild anxiety was performed on the patients in the three groups, and a significant trend was noted (p=0.017 for all patients; p=0.014 for analysis by sex). Multivariate analysis for mild anxiety on the patients in each group was also performed in this study, and music by Kevin Kern was found to have the lowest odds ratio (Odds ratio=0.34, p=0.045)., Conclusion: Listening to music, especially music by Kevin Kern, reduced the level of anxiety in patients undergoing colonoscopy examination without sedation., (Copyright © 2016. Published by Elsevier Taiwan LLC.)

Background: Critical value reporting has been widely adopted by hospitals throughout the world, but there were few reports about neonatal critical values. This study aimed to analyze characteristics of the neonatal critical values considered at our center and to provide information on improving neonatal intensive care., Methods: A retrospective study of critical values at a newborn tertiary center in China was conducted to assess neonatal critical values according to test, distribution, reporting time, patient outcome and the impact to the therapy., Results: In total, 926 critical values were recorded. Overall, 66.52% (616/926) of the items were reported within 24 hours of admission, 50.28% (465/926) during duty times and 54.75% (507/926) in the neonatal intensive care unit (NICU). The routine coagulation test was the most frequent source of critical values. Electrocardiography, blood gas analysis and therapeutic drug monitoring of drug levels were associated with the highest rates of treatment intervention (100%); routine coagulation tests were the lowest (23.14%). Sample quality was the main cause of false-positive critical values., Conclusions: The incidence of neonatal critical values peaked during the first 24 hours post-admission and during duty periods. Each newborn center needs to enact rapid treatment guidelines to address common critical values in order to facilitate clinical interventions. Periodically reviewing critical values could help to optimize clinical practices.

Background: Limited data support the notion that lipid ratios are risk factors for nonalcoholic fatty liver disease (NAFLD). We evaluated the association between lipid ratios and NAFLD., Methods: This was a large population, cross-sectional, retrospective study. Data on NAFLD severity, blood pressure, fasting glucose, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were obtained from 44,767 examinees at single health checkup center. The enrollees were stratified into four subgroups based on their TC/HDL-C and TG/HDL-C ratios. We used multivariate analyses to evaluate the odds between lipid ratios and NAFLD., Results: The prevalence rate of fatty liver in this study was 53.76%. In the baseline subgroup with the lowest TC/HDL-C and TG/HDL-C ratios, the prevalence of NAFLD, hypertension, and diabetes was lower than that of the other three subgroups. Patients with higher lipid ratios had a significantly greater risk for advanced NAFLD., Conclusions: Adults with high TC/HDL-C or TG/HDL-C ratios, or both, have a greater risk for NAFLD, especially advanced NAFLD., (Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.)

γ-Glutamyl transpeptidases (γ-GTs) are members of N-terminal nucleophile hydrolase superfamily. They are synthetized as single-chain precursors, which are then cleaved to form mature enzymes. Basic aspects of autocatalytic processing of these pro-enzymes are still unknown. Here we describe the X-ray structure of the precursor mimic of Bacillus licheniformis γ-GT (BlGT), obtained by mutating catalytically important threonine to alanine (T399A-BlGT), and report results of autoprocessing of mutants of His401, Thr415, Thr417, Glu419 and Arg571. Data suggest that Thr417 is in a competent position to activate the catalytic threonine (Thr399) for nucleophilic attack of the scissile peptide bond and that Thr415 plays a major role in assisting the process. On the basis of these new structural results, a possible mechanism of autoprocessing is proposed. This mechanism, which guesses the existence of a six-membered transition state involving one carbonyl and two hydroxyl groups, is in agreement with all the available experimental data collected on γ-GTs from different species and with our new Ala-scanning mutagenesis data., (Copyright © 2015 Elsevier B.V. All rights reserved.)

γ-Glutamyl transpeptidases (γ-GTs, EC 2.3.2.2) are a class of ubiquitous enzymes which initiate the cleavage of extracellular glutathione (γ-Glu-Cys-Gly, GSH) into its constituent glutamate, cysteine, and glycine and catalyze the transfer of its γ-glutamyl group to water (hydrolysis), amino acids or small peptides (transpeptidation). These proteins utilize a conserved Thr residue to process their chains into a large and a small subunit that then form the catalytically competent enzyme. Multiple sequence alignments have shown that some bacterial γ-GTs, including that from Bacillus licheniformis (BlGT), possess an extra sequence at the C-terminal tail of the large subunit, whose role is unknown. Here, autoprocessing, structure, catalytic activity and stability against both temperature and the chemical denaturant guanidinium hydrochloride of six BlGT extra-sequence deletion mutants have been characterized by SDS-PAGE, circular dichroism, intrinsic fluorescence and homology modeling. Data suggest that the extra sequence has a crucial role in enzyme activation and structural stability. Our results assist in the development of a structure-based interpretation of the autoprocessing reaction of γ-GTs and are helpful to unveil the molecular bases of their structural stability., (Copyright © 2014 Elsevier B.V. All rights reserved.)

γ-Glutamyltranspeptidases (γ-GTs) cleave the γ-glutamyl amide bond of glutathione and transfer the released γ-glutamyl group to water (hydrolysis) or acceptor amino acids (transpeptidation). These ubiquitous enzymes play a key role in the biosynthesis and degradation of glutathione, and in xenobiotic detoxification. Here we report the 3Å resolution crystal structure of Bacillus licheniformis γ-GT (BlGT) and that of its complex with l-Glu. X-ray structures confirm that BlGT belongs to the N-terminal nucleophilic hydrolase superfamily and reveal that the protein possesses an opened active site cleft similar to that reported for the homologous enzyme from Bacillus subtilis, but different from those observed for human γ-GT and for γ-GTs from other microorganisms. Data suggest that the binding of l-Glu induces a reordering of the C-terminal tail of BlGT large subunit and allow the identification of a cluster of acid residues that are potentially involved in the recognition of a metal ion. The role of these residues on the conformational stability of BlGT has been studied by characterizing the autoprocessing, enzymatic activity, chemical and thermal denaturation of four new Ala single mutants. The results show that replacement of Asp568 with an Ala affects both the autoprocessing and structural stability of the protein., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To observe the effect of Qingxuan Granule () on blood pressure variability of hypertensive patients with and without obstructive sleep apnea (OSA)., Methods: This study was a stratified, randomized, doubled-blind, placebo-controlled clinical trial. Ninety mild and moderate hypertensive patients with yin deficiency and yang hyperactivity syndrome were enrolled. Each patient received portable sleep monitoring for OSA diagnosis and 24-h ambulatory blood pressure monitoring (ABPM) for blood pressure diagnosis. According to the OSA diagnosis, the hypertensive patients were assigned to two subgroups, one with OSA (group A), the other without OSA (group B); and in each subgroup, the patients were randomly assigned to the treatment group (group A1 or group B1) and control group (group A2 or group B2). All of the patients were treated by Amlodpine Besylate, in addition, Qingxuan Granule was given to the treatment group (group A1 or group B1), and placebo was given to the control group (group A2 or group B2), respectively. After a 2-month treatment, each patient received portable sleep monitoring and 24-h ABPM again, the difference (D-value) of the blood pressure, and OSA index between pre-treatment and post-treatment were analyzed by covariance analysis in a generalized linear model. In this model, D-value was accepted as dependent variable Y, which was affected by treatment method (considered as factor a), the base level of all indices before treatment (considered as factor b), and OSA condition (considered as factor c)., Results: The following indices declined more in total treatment groups (groups A1+B1) than in total control groups (groups A2+B2, P a <0.05): 24-h systolic blood pressure (SBP) standard deviation (SD), daytime SBP SD, night time SBP SD, 24-h diastolic blood pressure (DBP) SD, 24-h DBP coefficient variation (CV), daytime DBP SD, night time DBP SD, and heart rate; the following indices declined less in the patients with OSA than those without OSA (P a <0.05): night time SBP, 24-h SBP SD, daytime SBP SD, night time SBP SD, 24-h DBP SD, 24-h DBP CV, daytime DBP SD, night time DBP SD, night time DBP CV, and heart rate; and the following indices increased less in the patients with OSA than those without OSA (P b <0.05): night time SBP fall rate, night time DBP fall rate. No significant difference was found in OSA' indices after taking Qingxuan Granule (P>0.05), with the exception that hypopnea index decreased and hypopnea improved (P<0.05)., Conclusions: For hypertensive patients, Qingxuan Granule could improve the blood pressure variability, and this effect could be weakened by OSA; also Qingxuan Granule could improve hypopnea in OSA patients.

Introduction: Abnormal ankle-brachial index (ABI) is associated with increased morbidity and mortality in hemodialysis patients. However, whether the decrease in ABI over time carries the prognostic value is unknown. The aim of this study was to assess whether the decrease in ABI over time was a good predictor of poor cardiovascular (CV) prognosis in hemodialysis patients., Methods: This study enrolled 234 routine hemodialysis patients and 173 patients completed the follow-up. The ABI was measured by an ABI-form device at baseline and at the first year follow-up. The ΔABI was defined as ABI measured at the first year follow-up minus ABI measured at baseline. Progressors of ABI were defined as patients with ΔABI < -0.3. CV events were defined as CV death, hospitalization for unstable angina, nonfatal myocardial infarction, hospitalization for arrhythmia, hospitalization for congestive heart failure and stroke., Results: The follow-up period was 37.8 ± 11.1 months. In the multivariate analysis, progressors of ABI (hazard ratio, 2.71; 95% confidence interval, 1.10-6.68, P = 0.03), decreased albumin and increased high-sensitivity C-reactive protein were associated with increased CV events., Conclusions: This longitudinal study showed ΔABI < -0.3 was independently associated with an increase in CV events. Hence, a great decrease in ABI over time might be a useful indicator of poor CV prognosis in hemodialysis patients.

Berberine (BBR) is one of the main constituents in Rhizoma coptidis and it has widely been used for the treatment of diabetic nephropathy. The aims of the study were to investigate the effects and mechanism of action of berberine on renal damage in diabetic rats. Diabetes and hyperglycaemia were induced in rats by a high-fat diet and intraperitoneal injection of 40 mg/kg streptozotocin (STZ). Rats were randomly divided into 5 groups, such as i) control rats, ii) untreated diabetic rats iii) 250 mg/kg metformin-treated, iv and v) 100 and 200 mg/kg berberine-treated diabetic rats and treated separately for 8 weeks. The fasting blood glucose, insulin, total cholesterol, triglyceride, glycosylated hemoglobin were measured in rats. Kidneys were isolated at the end of the treatment for histology, Western blot analysis and estimation of malonaldehyde (MDA), superoxide dismutase (SOD) and renal advanced glycation endproducts (AGEs). The results revealed that berberine significantly decreased fasting blood glucose, insulin levels, total cholesterol, triglyceride levels, urinary protein excretion, serum creatinine (Scr) and blood urea nitrogen (BUN) in diabetic rats. The histological examinations revealed amelioration of diabetes-induced glomerular pathological changes following treatment with berberine. In addition, the protein expressions of nephrin and podocin were significantly increased. It seems likely that in rats berberine exerts an ameliorative effect on renal damage in diabetes induced by high-fat diet and streptozotocin. The possible mechanisms for the renoprotective effects of berberine may be related to inhibition of glycosylation and improvement of antioxidation that in turn upregulate the expressions of renal nephrin and podocin., (Copyright © 2012 Elsevier GmbH. All rights reserved.)

Background and Study Aims. To compare the effectiveness of two regimens, single-dose esomeprazole- and pantoprazole-based triple therapy, for Helicobacter pylori (H. pylori) eradication. Patients and Methods. A total of 453 patients were enrolled for H. pylori eradication. They were randomly assigned to either EAC group (Esomeprazole 40 mg once daily, Amoxicillin 1 g twice daily, Clarithromycin 500 mg twice daily for 7 days) or PAC group (Pantoprazole 40 mg twice daily, Amoxicillin 1 g twice daily, Clarithromycin 500 mg twice daily for 7 days). Follow-up endoscopy or urea breath test was scheduled 12-16 weeks after the eradication to evaluate the therapeutic response. Results. Higher eradication rate in EAC group than PAC group was shown by intention-to-treat analysis (EAC 72% versus PAC 55%, P < 0.05) and per-protocol analysis (EAC 91% versus PAC 72%, P < 0.05). The incidence of adverse effects (EAC 19% versus PAC 17%, P = 0.712) and the compliance (EAC 87% versus PAC 91%, P = 0.083) were comparable between these 2 groups. Conclusions. Single-dose esomeprazole-based triple therapy is effective for H. pylori eradication.

The transverse vibration of piezoceramic rectangular thin plates is investigated theoretically and experimentally using the Ritz's method incorporated with the defined equivalent constants. The equivalent constants are derived by comparing the characteristic equations of transverse resonant frequencies between isotropic and piezoceramic disks. By replacing the Poisson's ratio and flexural rigidity with the equivalent constants, the well-known Ritz's method can be used to investigate the transverse vibration of piezoceramic rectangular plates. Two different types of boundary conditions-clamped-free-free-free (CFFF) and clamped-free-clamped-free (CFCF)-are analyzed in this paper. For the experimental measurement, two optical techniques-amplitude-fluctuation electronic speckle pattern interferometry (AF-ESPI) and laser Doppler vibrometer (LDV)-are used to validate the analytical results. Both the transverse vibration modes and resonant frequencies of piezoceramic rectangular plates are obtained by the AF-ESPI method. Numerical calculations using the finite-element method (FEM) are performed, and the results are compared with the theoretical analysis and experimental measurements. Excellent agreements are obtained for results of both resonant frequencies and mode shapes. According to the theoretical calculations with different equivalent Poisson's ratios, resonant frequency variations versus aspect ratios ranging from 0.1 to 10 also are discussed for the first several modes in the work.

Objective: To study the effect of Gardenia-Aweto compound (GAC) and two component on preventing acute respiratory distress syndrome (ARDS) by the rabbit model of ARDS induced by intravenous injection of oleic acid. To detect the efficiency component of GAC in preventing ARDS., Method: GAC was divided into two compounts, ethanol-soluble components (ESC) and ethanol-deposition components (EDC), based on polarity. Forty-three new zealand rabbits were randomly divided into five groups, the blank control group, the model group, the GAC groups, the ESC group, and the EDC group. The ARDS model was induced by intravenous injection of oleic acid. Dynamic changes of arterial blood gas, lung index, albumin in bronchoalveolar lavage fluid (BALF) in different groups and lung histological changes were observed and compared., Result: As compared with the blank group, in the model group, GAC group, ESC group, EDC group the arterial PO2 and oxygen saturation deprived continuously. While SO2 in GAC group at time points 30, 60, 90, 120 min (P < 0.05 or 0.01) and SO2 in ESC group at time points 30, 60, 90 min were higher than those in ARDS group. PO2 in ESC group at time points 30, 60 min (P < 0.05) were higher than those in ARDS group. The value of LI and W/D were higher in ARDS group than in sham group (P < 0.01), they were much lower in HD group than in ARDS group (P < 0.01). Concentration of BALF-albumin increased markedly in ARDS group and pre-treatment groups compared with sham group, but it was much lower in GAC group and ESC group, there was a significant difference between GAC group (P < 0.01), ESC group (P < 0.05) and ARDS group. The lung histological changes had been improved in GAC group and ESC group. But no significantly difference between above-mentioned parameters was found in comparison in the model group and in the EDC group., Conclusion: Preventive administration of GAC or ESC an protect the damaged lung function in ARDS rabbits induced by oleic acid. The efficiency component of GAC in preventing ARDS is ESC. GAC antagonizing ARDS may relate to its anti-inflammatory, immuno-modulatory, anti-oxidant and antithrombotic effects.

The mitochondrial DNA cytochrome b gene was sequenced from 27 catfish species representing 11 families and 24 genera catfishes in China. Aligning with cytochrome b sequences of eight catfish species from North America and Africa retrieved from GenBank, and selecting Astyanax mexicanu, Cyprinus carpio, and Sardinops melanostictus as outgroups, we constructed a matrix of 38 DNA sequences. The phylogenetic trees were constructed by using Bayesian method and Maximum Parsimony (MP) method. The results showed that (1) there are three base pair deletions of mitochondrial cytochrome b gene compared with Characiformes, Cypriniformes, and Clupeiformes; (2) the representatives of Chinese catfish species form a monophyletic group; and (3) the molecular phylogenetic trees constructed with both methods suggest that the families Sisoridae, Akysidae and Amblycipitidae form a monophyletic group, and the families Clariidae, Schilbidae, Ariidae, Ictaluridae, Cranoglanididae, Pangasiidae, Siluridae, Claroteidae, and Bagridae also form a monophyletic group. The families Cranoglanididae from China and Ictaluridae from North America form a sister-group relationship, and the families Clariidae, Ictaluridae, Siluridae, and Sisoridae are obviously monophyletic groups. But the position of the family Plotosidae was not resolved by Bayesian analysis and maximum parsimony inference.

Objective: To investigate the contents of paeoniflorin in different combination Jingzhixuefuzhuyu., Method: Using RP-HPLC to determine the contents of paeoniflorin in different combination Jingzhixuefuzhuyu extracts, an ODS column was used with a mobile phase of MeOH-H2O-HAC(25:75:0.15) and DAD detector at the wavelength of 230 nm., Result and Conclusion: Different combinations of Jingzhixuefu zhuyu had great influence to the contents of paeoniflorin.