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Variability of Serum Concentration of Calcium, Phosphate and Parathyroid Hormone Depending on Time of Blood Draw for Patients on Nocturnal Home Hemodialysis

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Open Journal of Nephrology 2012年第4期2卷 65-71页

作者： Nasim Shahbazi Pierre A. Brown Ayub Akbari Deborah L. Zimmerman Department of Medicine Division of Nephrology Ottawa Hospital Ottawa Canada Department of Medicine Division of Nephrology Ottawa Hospital Ottawa Canada Kidney Research Centre of the ottawa hospital Research Institute Ottawa Canada Department of Medicine Division of Nephrology Thunder Bay Regional Health Sciences Centre Thunder Bay Canada

Background: Guidelines for patients treated with conventional hemodialysis patients have been written for target serum levels for calcium (Ca), phosphate (PO4) and intact parathyroid hormone (iPTH). No guidelines exist for nocturnal home hemodialysis (NHHD) patients for target values or timing of the blood sample draw. We undertook a prospective cohort study to examine the variability in pre, post and clinic (post-post) serum values for Ca, PO4, and iPTH in NHHD patients to determine if timing of blood draw could affect clinical decisions. Methods: Twenty prevalent NHHD patients collected blood pre and post their usual NHHD session with an additional blood sample drawn in clinic (post-post). Median and interquartile range of pre, post and clinic (post-post) values of iPTH, PO4 and Ca were calculated and compared with Freidman/Wilcoxon test. Serum concentrations were also categorized according to Canadian Society of Nephrology (CSN) guidelines target values for pre and clinic (post-post) samples. The proportion of patients that would be categorized differently by clinic (post-post) samples was determined. Results: There was a significant difference between pre-serum values compared to post and clinic (post-post) values. Overall, iPTH, PO4 and Ca values would be misclassified in 25%, 70% and 50% respectively if blood was drawn at the clinic visit (post-post) compared to pre-HD as per CSN guidelines. Conclusions: Although no specific guideline has been written for NHHD patients, to ensure consistency of management compared to in-centre HD patients, lab values should be drawn pre-HD until clinical evidence suggests that the recommendations should be different for NHHD.

关键词： Nocturnal Hemodialysis Calcium Phosphate Parathyroid Hormone

Benign penile skin anomalies in children:a primer for pediatricians

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World Journal of Pediatrics 2015年第4期11卷 316-323页

作者： Marco Castagnetti Mike Leonard Luis Guerra Ciro Esposito Marcello Cimador Section of Pediatric Urology Urology UnitUniversity Hospital of PadovaPaduaItaly Department of Surgery Division of Pediatric UrologyChildren's Hospital of Eastern OntarioUniversity of OttawaOttawaONCanada Department of Pediatrics Federico II University of NaplesItaly Section of Pediatric Urology and Pediatric Surgery Unit Department for Mother&Child Care and UrologyUniversity of PalermoPalermoItaly

Background:Abnormalities involving the skin coverage of the penis are diffi cult to defi ne,but they can significantly alter penile appearance,and be a cause of parental *** sources:The present review was based on a non-systematic search of the English language medical literature using a combination of key words including"penile skin anomalies"and the specific names of the different ***:Conditions were addressed in the following order,those mainly affecting the prepuce(phimosis,balanitis xerotica obliterans,balanitis,paraphimosis),those which alter penile configuration(inconspicuous penis and penile torsion),and lastly focal lesions(cysts,nevi and vascular lesions).Most of these anomalies are congenital,have no or minimal influence on urinary function,and can be detected on clinical *** improvement is *** the majority of cases undergoing surgery,the potential psychological implications of genital malformation on patient development are the main reason for treatment,and the age generally recommended for surgery is after 12 months of ***:This review provides the pediatrician with a handy tool to identify the most common penile skin anomalies,counsel parents adequately,make sensible and evidence based choices for management,and recognize complications or untoward outcomes in patients undergoing surgery.

关键词： balanitis xerotica obliterans foreskin penis phimosis

Establishing normal ranges for fetal and neonatal small and large intestinal lengths:results from a prospective postmortem study

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World Journal of Pediatric Surgery 2022年第3期5卷 139-146页

作者： Cameron Bardwell Dina El Demellawy Irina Oltean Michelle Murphy Amisha Agarwal Jemila S Hamid Deepti Reddy Nick Barrowman Joseph de Nanassy Ahmed Nasr Faculty of Medicine University of OttawaOttawaOntarioCanada Department of Pathology Children's Hospital of Eastern OntarioOttawaOntarioCanada Clinical Research Unit Children's Hospital of Eastern OntarioOttawaOntarioCanada Faculty of Science University of OttawaOttawaOntarioCanada Department of Mathematics and Statistics University of OttawaOttawaOntarioCanada Department of Surgery Children's Hospital of Eastern OntarioOttawaOntarioCanada

Objective To establish reference intervals(RIs)for fetal and neonatal small and large intestinal *** Linear measurements on small and large intestines were made upon postmortem examination of 131 preterm and term infants with gestational ages between 13 and 41 *** cases were referred from the Eastern Ontario and Western Québec regions to a tertiary care *** and sex partitions were considered and RI limits were *** Data consisted of 72 male(54.96%)and 59 female(45.04%)fetuses and neonates with mean gestational age of 25.6 *** showed that small and large intestinal lengths increased linearly with gestational *** for small intestinal length(cm)of fetuses and neonates aged 13-20 weeks were(21.1,122.4);of those aged 21-28 weeks were(57.7,203.8);of those aged 29-36 weeks were(83.6,337.1);and of those aged 37-41 weeks were(132.8,406.4).RIs for large intestinal length(cm)of fetuses and neonates from the same four age groups were(5.1,21.4),(12.7,39.7),(32.4,62.4),and(29.1,82.2).Conclusions Establishing accurate RIs for premature and term infants has clinical relevance for pathologists performing postmortem analysis and for surgeons planning postoperative management of *** results of this study reaffirm that fetal small and large intestinal lengths increase linearly with gestational age irrespective of *** studies should aim to further investigate the role of possible confounders on growth of fetal intestinal length,including maternal factors such as age and substance use during pregnancy.

关键词： fetal postmortem fetus

Is vitamin D receptor a druggable target for non-alcoholic steatohepatitis?

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World Journal of Gastroenterology 2020年第38期26卷 5812-5821页

作者： Ying Cao Xiang-Bing Shu Zemin Yao Guang Ji Li Zhang Institute of Digestive Diseases Longhua HospitalChina-Canada Center of Research for Digestive DiseasesShanghai University of Traditional Chinese MedicineShanghai 200032China Department of Geratology Baoshan Branch of Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai 201999China Department of Biochemistry Microbiology and ImmunologyUniversity of OttawaOttawa K1H8M5OntarioCanada

Nonalcoholic steatohepatitis(NASH)is a progressed stage of non-alcoholic fatty liver disease,and available therapeutic strategies for NASH are *** D receptor(VDR)is proposed as a druggable target for NASH due to the discovery of vitamin D deficiency in NASH *** date,vitamin D supplementation has not consistently conferred expected therapeutic benefits,raising the question of whether VDR can serve as a proper drug target for *** is known that VDR can interact with other ligands such as bile acids in addition to vitamin D,and its expression can be induced by fatty acids,and *** has also been shown that while activation of VDR in hepatic macrophages and hepatic stellate cells resulted in attenuation of hepatic inflammation and fibrosis,activation of VDR in hepatocytes could accelerate lipid ***,the multiplicity of VDR ligands,together with the cell type-specificity of VDR activation,must be taken into consideration in assessing the validity of VDR being a potential druggable target for NASH *** this end,we have evaluated the relationship between VDR activation and various contributing factors,such as gut microbiota,bile acid,fatty acids,and insulin,in addition to vitamin D,with an expectation that a potential drug might be identified that can elicit VDR activation in a tissue-and/or cell type-specific manner and therefore achieving therapeutic benefits in NASH.

关键词： Vitamin D receptor Non-alcoholic steatohepatitis Vitamin D Bile acids Inflammation Lipid metabolism

The Performance of Extracorporeal Membrane Oxygenation in Various Viral Pneumonia Pandemics: A Meta-Analysis and Systematic Review

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Journal of Clinical and Nursing Research 2024年第4期8卷 399-410页

作者： Yihui Li Yamin Yuan Jinquan Zhou Li Ma The Second hospital&Clinical Medical School Lanzhou UniversityDepartment of Critical Care MedicineLanzhou City 730030Gansu ProvinceChina

Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Methods: PubMed, the Cochrane Library, Embase, Web of Science, and other databases were searched to collect case-control or cohort studies on prognoses associated with ECMO treatment for viral pneumonia. Search terms included extracorporeal membrane oxygenation, ECMO, viral pneumonia, COVID-19, influenza, MERS, and others. According to the PICOS principle, two evaluators independently screened the literature, extracted the data, cross-checked the data, and extracted the data again. Two researchers evaluated the risk of bias in the included studies according to the Newcastle-ottawa Scale (NOS) and cross-checked the results. Meta-analysis was performed using RevMan 5.3 software. Results: Nine studies were included for analysis, encompassing a total of 4,330 patients, which were categorized into ECMO and CMV groups. There were no significant differences between the two groups in most baseline data;however, the ECMO group had a lower oxygenation index, and some studies reported higher SOFA scores in the ECMO group compared to the CMV group. There was no significant difference in in-hospital mortality between the two groups. The length of ICU stay, total hospital stay, and total mechanical ventilation time were longer in the ECMO group than in the CMV group. In terms of adverse events, there was no significant difference in the occurrence of kidney injury between the two groups. Bleeding events were reported in two studies, with more bleeding events occurring in the ECMO group. According to the subgroup analysis of different virus types, there were no statistical differences in the above aspects among patients with swine flu, novel coronavirus, and MERS. Conclusion: ECMO has a certain degree of positive significance in the treatment of severe viral pneumonia, but

关键词： Extracorporeal membrane oxygenation Viral pneumonia pandemic Meta-analysis

Making Sense of hospital Project MisPerformance: Over Budget, Late, Time and Time Again—Why? And What Can Be Done About It?

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Engineering 2022年第5期8卷 183-201页

作者： Peter E.D.Love Lavagnon A.Ika School of Civil and Mechanical Engineering Curtin UniversityPerthWA 6845Australia Telfer School of Management University of OttawaOttawaON KIN 6N5Canada

hospital projects worldwide often experience misperformance,showing a tendency to exceed their estimated cost,miss their deadline,suffer quality problems,and yield benefit *** this ubiquitous problem,this paper aims to make sense of this phenomenon by addressing the following research question:How can we make sense of hospital project misperformance,and what can be done to mitigate its occurrence?We use an illustrative case study approach and the analytical lens of sense-making to examine the misperformance of three mega-hospital *** research reveals issues such as scope changes,an inability to adapt and respond to risk and uncertainty,ineffectual project management and governance,and optimism bias,which combine to impact project performance *** suggest that the two prominent theoretical perspectives dominating the literature in this field fall short of adequately explaining hospital project *** provide suggestions for improving the procurement process of hospitals and submit there is a need to develop a robust and balanced theory of project misperformance.

关键词： Cost hospital Optimism bias Procurement Project management Performance Sense-making

IGFBP-3 Enhances IGF-II Cell SignaUng through Activation of Sphingosine Kinase and S1P Production in Human Extravillous Trophoblasts

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IGFBP-3 Enhances IGF-II Cell SignaUng through Activation of ...

“细胞活动生命活力”——中国细胞生物学学会全体会员代表大会暨第十二次学术大会

作者： Andree Gruslin Chronic Disease Program Ottawa Hospital Rcsearch InstituteOttawaONCanada Cellular and Molecular Medicine University of Ottawa Obstetrics and Gynecology The Ottawa HospitalOttawaONCanada

IGF system plays an essential role in placental development and fetal ***-3 forms a complex with IGF-Ⅱthus reducing its *** other cell types,however,IGFBP-3 has also been shown to positively regulate IGF cell signaling through up-regulating sphingosine kinase(Sphk).The objective of this study is to examine whether IGFBP-3 enhances IGF-Ⅱcell signaling in human extravillous trophoblasts(EVT) and exploring its underlying mechanism. By using Western blot,Western Ligand Blot analysis,our study shows that human EVT(HTR8/SVneo cells) secrete IGFBPs,including IGFBP-3,and IGF-Ⅱ.Pre-treatment of HTR8/SVneo cells with relatively low concentrations of IGFBP3(0.5 nM,1 h) enhances IGF-Ⅱ(1 nM,10 min)-induced cell signaling as indicated by increases in phosphorylation of AKT and ERK,as well as EVT *** contrast,when cells are treated with higher dosages of IGFBP-3(2 nM) and IGF-Ⅱ(1 nM,10 min),IGF-Ⅱcell signaling is inhibited. Co-treatment of IGFBP-3 and sphingosine induces ERK phosphorylation,an effect mediated by sphingosine phosphotate(S1P,the product of Sphk).This effect is attenuated by DMS(Sphk inhibitor). Furthermore,low dose IGFBP-3 treatment for 1 hour increases Sphk protein content and its phosphorylation in the membrane fraction of trophoblasts without affecting its total protein level,indicating IGFBP3 induces Sphk ***,we also observed that S1P itself enhances IGF-Ⅱ-mediated AKT and ERK phosphorylation as well as IGF-Ⅱ-induced IGF1R phosphorylation,providing evidence that S1P potentiates IGF-Ⅱcell signaling by activating IGF type 1 *** conclusion,at relatively low concentrations,IGFBP3 enhances IGF-Ⅱ-mediated signaling and cell migration by activating Sphk and S1P production in human EVT cell *** suggests a tight regulation of IGFBP-3 expression is important in the regulation of IGF-Ⅱ-related functions,including trophoblast migration.

关键词： Trophoblast Invasion IGFBP-3 IGF-Ⅱ Sphingosine Kinase

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Science China(Life Sciences) 2021年第1期64卷 96-106页

作者： Zhijun Zhang Hongxing Zhang Chun-Ming Xie Meng Zhang Yachen Shi Ruize Song Xiang Lu Haisan Zhang Kun Li Bi Wang Yongfeng Yang Xianrui Li Jianli Zhu Yang Zhao Ti-Fei Yuan Georg Northoff Department of Neurology of Affiliated Zhongda hospital Institute of Neuropsychiatry and Medical School of Southeast UniversityNanjing210009China Department of Psychology of Xinxiang Medical University Xinxiang453003China Second Affiliated hospital of Xinxiang Medical University Xinxiang453002China Deaprtment of Biostatistics School of Public HealthNanjing Medical UniversityNanjing211166China Shanghai Mental Health Center Shanghai Jiaotong University School of MedicineShanghai200030China Mental Health Center and 7th hospital Zhejiang University School of MedicineHangzhou310013China Royal ottawa Mental Health Centre University of Ottawa Institute of Mental Health ResearchOttawaONK1Z 7K4Canada

To determine whether repetitive transcranial magnetic stimulation(rTMS)of the visual cortex(VC)provides effective and welltolerated treatment and whether magnetic resonance imaging(MRI)measures functional change of the VC as a biomarker of therapeutic effect in major depressive disorder(MDD),we performed a sham-controlled,double-blind,randomized,three-arm VC rTMS treatment study in 74 MDD *** rTMS(10 Hz,90%of resting motor threshold,1,600 pulses over20 min twice per day)was performed over the VC for five *** outcome was measured by Hamilton Depression Rating Scale(HAMD-24)at days 0,1,3,5 and after terminating rTMS,with follow-up at four *** was measured at days 0 *** individualized group exhibited the greatest change in HAMD-24 scores after VC rTMS for 5 days(F=5.53,P=0.005),which were maintained during follow-up period(F=4.22,P=0.016).All patients reported good *** in VC taskrelated functional MRI correlated with symptomatic reduction in the individualized *** reduced the initially abnormal increase in resting state functional connectivity from the VC to the pre/subgenual anterior cingulate cortex at day 5,especially in the individualized *** demonstrated therapeutic potential and good tolerance of VC rTMS in MDD patients,indicated by biomarkers of f MRI measurement.

关键词： major depressive disorder visual cortex functional magnetic resonance imaging repetitive transcranial magnetic stimulation neuronavigated individualized treatment

Integrated miRNA and mRNA Analysis Identified Potential Mechanisms and Targets of Qianggan Extracts in Preventing Nonalcoholic Steatohepatitis

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World Journal of Traditional Chinese Medicine 2022年第1期8卷 77-86页

作者： Jie Huang Meng Li Wen-Jun Zhou Ze-Min Yao Guang Ji Li Zhang Ming-Zhe Zhu China-Canada Center of Research for Digestive Diseases Institute of Digestive DiseasesLonghua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina Department of Biochemistry Microbiology and ImmunologyOttawa Institute of Systems BiologyUniversity of OttawaOttawaCanada School of Public Health Shanghai University of Traditional Chinese MedicineShanghaiChina

Objective: Qianggan(QG) extract is a patented traditional Chinese medicine that has been widely used for the clinical treatment of nonalcoholic steatohepatitis(NASH). However, its mechanism remains unclear. Methods: The efficacy of QG was evaluated in mice with methionine-and-choline-deficient diet-induced NASH by measuring serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels and by H and E staining of liver sections. Microarray and bioinformatics analyses were performed to obtain hepatic micro RNA(mi RNA) and m RNA expression profiles and to mine potential mechanisms and therapeutic targets. Furthermore, representative mi RNA and m RNA expression levels were validated by quantitative real-time polymerase chain reaction(q RT-PCR). Results: QG extract significantly improved NASH. Twelve differentially expressed mi RNAs and 1124 differentially changed m RNAs were identified as potential targets of QG extract. Integrated analysis detected 976 mi RNA–m RNA regulatory pairs, and networks including 11 mi RNAs and 427 m RNAs were constructed by Cytoscape. Hub nodes including mi R-7050-5p, mi R-212-3p, Bcl2l11, and Kras were filtered out. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses revealed that 427 m RNAs were enriched in pathways including apoptotic process, immune response, Fox O signaling pathway, and natural killer cell-mediated cytotoxicity. We also constructed a protein–protein interaction network with 254 nodes, and identified hub genes including Kras, Fasl, and Ncam1. Finally, the results of q RT-PCR were in good accordance with microarray data. Conclusion: This study identified important hub mi RNAs and m RNAs involved in the mechanism of QG extract and which might provide potential therapeutic targets for patients with NASH.

关键词： Fatty liver gene regulatory networks microarray analysis Qianggan extract Traditional Chinese Medicine