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ABSTRACT: BACKGROUND: Loss of gut barrier function is crucial in mediating lung injury induced by hemorrhagic shock/resuscitation (HS). High-lipid enteral nutrition (HL) can preserve gut barrier function. We hypothesized that HL could also mitigate HS-induced lung injury. MATERIALS AND METHODS: Forty-eight adult male rats were randomly assigned to one of four experimental groups: HS; HS-HL; Sham; Sham-HL. HS was induced by blood drawing and mean blood pressure was maintained at 40-45 mmHg for 120 min followed by resuscitation with re-infusion of exsanguinated blood/saline mixtures. HL gavage was performed at 45 min before blood drawing and at the end of resuscitation. RESULTS: Intestinal permeability of the HS group was significantly higher than that of the Sham group (P < 0.001). Pulmonary concentrations of malondialdehyde (lipid peroxidation) and inflammatory molecules, including prostaglandin E2, tumor necrosis factor-α, interleukin-6, and macrophage inflammatory protein-2, of the HS group were significantly higher than those of the Sham group. Histologic analyses, including histopathology, wet/dry weight ratio, and neutrophil infiltration revealed moderate lung injury in the HS group. In contrast, intestinal permeability (P < 0.001) and pulmonary concentrations of tumor necrosis factor-α and macrophage inflammatory protein-2 (P = 0.021 and 0.01) of the HS-HL group were significantly lower than those of the HS group. However, pulmonary concentrations of malondialdehyde, prostaglandin E2, and interleukin-6 of the HS-HL and HS groups were comparable. Moreover, histologic analyses also revealed moderate lung injury in the HS-HL group. CONCLUSIONS: High-lipid enteral nutrition significantly mitigated gut barrier loss and partially mitigated lung inflammation but not oxidation and lung injury in hemorrhagic shock/resuscitation rats.
Journal of Surgical Research 04/2013; · 2.25 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of the study was to investigate the association between dialysis shift and subjective sleep quality in chronic haemodialyzed patients. DESIGN: A cross-sectional observational study. PARTICIPANTS AND METHODS: A total of 206 haemodialyzed patients aged from 22 to 71 participated in this study. Participants were grouped into the morning-shift and other-shifts groups. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). All participants also completed the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: Dialysis shift significantly predicted the PSQI score with patients receiving morning-shift haemodialysis having better sleep quality (β=0.15, p=0.01). Other independent predictors of the PSQI score included depression (β=0.42, p<0.001), anxiety (β=0.38, p<0.001), and tea drinking (β=0.20, p0.001). Together these factors explained 48.2% of the variance in the PSQI score. CONCLUSION: Morning dialysis shift was significantly associated with better subjective sleep quality in chronic haemodialyzed patients after adjusting for other confounders.
International journal of nursing studies 03/2013; · 1.91 Impact Factor
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ABSTRACT: We sought to elucidate the antiinflammation effect of human placental multipotent mesenchymal stromal cells (hPMSCs) and the possible molecular mechanisms.
Immortalized murine macrophages (RAW264.7 cells), with or without hPMSCs coincubation, were treated with endotoxin to induce expression of the relevant molecules.
The peak concentrations (means ± SD) of inflammatory molecules in endotoxin-activated macrophages with hPMSCs coincubation were significantly lower than those in endotoxin-activated macrophages without hPMSCs coincubation (tumor necrosis factor-α: 9.4±0.8 vs. 13.0±1.1 ng/ml; interleukin-6: 0.8±0.1 vs. 1.2±0.1 ng/ml; macrophage inflammatory protein-2: 345±30 vs. 666±51 ng/ml; intercellular adhesion molecule 1: 1.4±0.1 vs. 1.7±0.1 ng/ml; prostaglandin E2: 5.7±0.3 vs. 8.5±0.6 ng/ml; all P<0.008). Data of the activation of nuclear factor-κB and mitogen-activated protein kinases as well as the interaction between toll-like receptor 4 and myeloid differentiation primary response gene 88 paralleled those of the inflammatory molecules. In contrast, the endotoxin binding and toll-like receptor 4/myeloid differential-2 complex activation in endotoxin-activated macrophages with hPMSCs coincubation were comparable with those in endotoxin-activated macrophages without hPMSCs coincubation. As our data revealed that hPMSCs could induce low-grade prostaglandin E2 expression in macrophages, we also employed the selective cyclooxygenase-2 inhibitor NS-398 to further elucidate the possible role of prostaglandin E2. Our data revealed that the above-mentioned hPMSC-triggered inhibitory effects were significantly reversed by NS-398.
The antiinflammation effect of human placental multipotent mesenchymal stromal cells is mediated, at least in part, by prostaglandin E2 via a myeloid differentiation primary response gene 88-dependent pathway.
Anesthesiology 06/2012; 117(3):568-79. · 5.36 Impact Factor
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ABSTRACT: BACKGROUND: We sought to elucidate whether minocycline, a broad-spectrum tetracycline antibiotic with potent anti-inflammation capacity, could mitigate inflammatory response and organ dysfunction in the lungs and liver induced by hemorrhagic shock/resuscitation (HS) plus abdominal compartment syndrome (ACS). MATERIALS AND METHODS: Adult male rats were randomized to receive HS plus ACS or HS plus ACS plus minocycline (denoted as the HS/A and HS/A-M group, respectively; n = 12). Sham-instrumentation groups were employed to serve as the controls. Hemorrhagic shock/resuscitation was induced by blood drawing (mean arterial pressure: 40-45 mm Hg for 60 min) followed by shed blood/saline mixture reinfusion. Subsequently, intra-abdominal pressure (IAP) was increased to 25 mm Hg by injecting air into the preplaced intraperitoneal latex balloon to induce ACS. Minocycline (20 mg/kg) was intravenously administered immediately after resuscitation. IAP was maintained at 25 mm Hg for 6 h. Then, all rats were euthanized. RESULTS: The levels of polymorphonuclear leukocyte infiltration, the wet/dry weight ratio, and the concentrations of inflammatory molecules (e.g., chemokine, cytokine, and prostaglandin E(2)) in lung and liver tissues of the HS/A group were significantly higher than those of the HS/A-M groups (all P < 0.05). Moreover, the levels of lung dysfunction (assayed by arterial blood gas) and liver dysfunction (assayed by plasma concentrations of bilirubin, aspartate aminotransferase, and alaninine aminotransferase) of the HS/A group were significantly higher than those of the HS/A-M group (all P < 0.05). CONCLUSIONS: Minocycline ameliorates inflammatory response and organ dysfunction in the lungs and liver induced by hemorrhagic shock/resuscitation plus abdominal compartment syndrome.
Journal of Surgical Research 05/2012; · 2.25 Impact Factor
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ABSTRACT: BACKGROUND: Activation of sympathetic nervous system has a crucial role in mediating the pneumatic tourniquet inflation induced hyperdynamic response. Dexmedetomidine, a selective α(2)-adrenergic receptor agonist, has potent sympatholytic effects. We conducted this prospective, randomized, placebo-controlled, double-blinded study to elucidate the effects of dexmedetomidine on attenuating the tourniquet-induced hyperdynamic response during general anesthesia. MATERIALS AND METHODS: We included a total of 72 healthy adult patients undergoing elective lower limb surgery. Under general anesthesia, patients were randomized to the dexmedetomidine or the control group (n = 36 in each group). The dexmedetomidine group received a loading dose of dexmedetomidine (0.8 μg·kg(-1) over 10 min) followed by continuous infusion of dexmedetomidine (0.4 μg·kg(-1).h(-1)) until tourniquet deflation. The control group received normal saline instead. We compared tourniquet-induced changes in hemodynamic parameters between groups to elucidate the effects of dexmedetomidine. RESULTS: Tourniquet inflation induced significant increases in hemodynamic parameters, including heart rate, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, rate pressure product, cardiac output, and stroke volume in the control group. The effects of tourniquet inflation on increasing hemodynamic parameters were significantly attenuated by dexmedetomidine, heart rate (P < 0.001), systolic arterial pressure (P = 0.002), mean arterial pressure (P = 0.042), diastolic arterial pressure (P = 0.012), rate pressure product (P < 0.001), and cardiac output (P = 0.001) of the dexmedetomidine group were significantly lower than those of the control group. However, the stroke volume of these groups was comparable. CONCLUSIONS: Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in general anesthesia patients undergoing lower limb surgeries.
Journal of Surgical Research 04/2012; · 2.25 Impact Factor
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ABSTRACT: Traumatic hemorrhagic shock and subsequent resuscitation may promote bacteria translocation and cause endotoxemia, a two-hit process that will induce severe lung injury. The pathogenesis involves oxidative stress, neutrophil infiltration, and inflammatory response. Platonin, a potent antioxidant, possesses potent anti-inflammation capacity. We sought to elucidate whether platonin could mitigate acute lung injury in a two-hit model of traumatic hemorrhage/resuscitation and subsequent endotoxemia.
Adult male rats were randomized to receive traumatic hemorrhage/resuscitation plus lipopolysaccharide (HS/L) alone or HS/L plus platonin (200 μg/kg; n = 12 in each group). Sham groups were used simultaneously. At 6 hours after resuscitation, rats were killed and the levels of lung injury were assayed.
Rats treated with HS/L alone had severe lung injury as evidenced by significant alterations in lung function (i.e., arterial blood gas and alveolar-arterial oxygen difference) and histology. Significant increases in polymorphonuclear leukocytes/alveoli ratio (neutrophil infiltration index) and significant increases in the concentrations of inflammatory molecules (including chemokine, cytokine, and prostaglandin E2) and malondialdehyde (lipid peroxidation index) revealed that HS/L caused significant oxidative stress, neutrophil infiltration, and inflammatory response in rat lungs. Moreover, our data revealed that the levels of functional and histologic alteration as well as polymorphonuclear leukocytes/alveoli ratio and the concentrations of inflammatory molecules and malondialdehyde in rats treated with HS/L plus platonin (200 μg/kg) were significantly lower than those treated with HR/L alone.
Platonin mitigates lung injury in a two-hit model of traumatic hemorrhage/resuscitation and endotoxemia in rats.
The journal of trauma and acute care surgery. 03/2012; 72(3):660-70.
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ABSTRACT: : Quality of life in patients with heart failure (HF) can be significantly impacted by poor sleep and its daytime consequences. As more attention is being paid to the sleep problems of HF patients, it is important to evaluate the degree of congruence between subjective and objective sleep measurements in this patient group.
: This study was developed to evaluate the congruence between sleep parameters as measured using a wrist-worn ActiGraph and a daily sleep log in patients with stable HF.
: Forty-three HF patients aged 40-92 years served as subjects. Sleep parameters were derived from actigraphy and a daily sleep log by averaging scores for 7 nights.
: There were significant differences in wake time after sleep onset (WASO) and total sleep time between the sleep log and the ActiGraph (both ps < .001). Neither WASO nor sleep onset latency, both derived from the sleep log, correlated significantly with actigraphy variables. The mean bias for WASO and total sleep time between methods was 54.1 min (SD = 47.5 min) and 109.3 min (SD = 91.68 min) as assessed using a Bland-Altman analysis. A majority (83.7%) of participants experienced sleep disturbances as assessed by actigraphy. However, fewer (53.5%) had sleep disturbances as assessed using the sleep log.
: A considerable degree of incongruence between actigraphy- and sleep log-derived measures of sleep exists in patients with stable HF.
The journal of nursing research: JNR 09/2011; 19(3):173-80. · 0.69 Impact Factor
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ABSTRACT: To examine the psychometric properties of the Chinese version of the Sleep-Associated Monitoring Index (SAMI) in Taiwanese haemodialysis patients.
An instrument translation and validation study.
A haemodialysis (HD) unit in a university-affiliated medical centre in northern Taiwan.
206 patients who were 18 or above, diagnosed with end-stage renal disease and under maintenance HD twice or thrice a week, 3 h or more per session for more than 3 months.
A principal component analysis was used to examine the construct validity of the SAMI. The participants were classified into poor (n=160) and good sleepers (n=46) using a cut-off value of 5 on the Pittsburgh Sleep Quality Index (PSQI). All participants filled out the Beck Depression Inventory (BDI) and Back Anxiety Inventory (BAI) along with the SAMI. Internal consistency was examined by the Cronbach's α. To assess test-retest reliability, the participants were asked to fill out the SAMI on a second occasion at a 2-week interval.
Eight subscales emerged from the principal component analysis. Individual with insomnia had significantly higher total SAMI scores (p<0.001). The SAMI total score significantly correlated to the PSQI, BDI, and BAI (r=0.65, 0.67, 0.67; all p<0.001). Cronbach's α was 0.95 for the entire scale. The intra-class correlation coefficient between the initial and retest SAMI total score was 0.72 (p<0.001). The SAMI-Chinese demonstrated an area under the receiver operation characteristic curve of 0.771 (SE=0.044; 95% CI: 0.685-0.857; p<0.001) in detecting individuals with poor sleep. A cut-off value of 51 indicated a sensitivity of 0.86 and a specificity of 0.63 in distinguishing between poor and good sleepers.
The SAMI-Chinese demonstrated excellent construct validity, contrast group validity, external validity, internal consistency, and satisfactory test-retest reliability. It also demonstrated satisfactory diagnostic ability for insomnia.
International journal of nursing studies 08/2011; 49(1):54-64. · 1.91 Impact Factor
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ABSTRACT: Pheochromocytoma is a catecholamine-producing tumor but rarely delayingly diagnosed until during pregnancy. We reported a pregnant woman who underwent emergent cesarean section because of intrauterine growth retardation, oligohydramnios, and hypertension. The existence of an undiagnosed pheochromocytoma was suspected by the unusual hemodynamic response to spinal anesthesia, abdominal compressions, and operative stimulus. Hypertensive crisis occurred during the operation and she was sent to the intensive care unit for postoperative care. In the intensive care unit, cardiovascular collapse occurred after nonselective β-adrenergic blockade. Unexpected hypertensive crisis during the perioperative period should alert clinicians to the possibility of a pheochromocytoma. For the treatment of choice, nonselective β-adrenergic blockade should not be used before the α-blockade.
Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists. 06/2011; 49(2):69-71.
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ABSTRACT: Oxidative stress and inflammatory response are crucial in mediating the development of acute lung injury induced by bilateral lower limb ischemia-reperfusion (I/R). Platonin, a potent antioxidant, possesses anti-inflammation capacity. We sought to elucidate whether platonin could mitigate acute lung injury induced by lower limb I/R.
Forty-eight adult male rats were allocated to receive I/R, I/R plus platonin (100 μg/kg intravenous injection immediately after reperfusion), sham instrumentation, or sham instrumentation plus platonin (denoted as the I/R, I/R-platonin, Sham, or Sham-platonin group, respectively; n = 12 in each group). Bilateral hind limb I/R was induced by applying rubber band tourniquets high around each thigh for 3 h followed by reperfusion for 3 h. After sacrifice, the degree of lung injury was determined.
Histologic findings revealed moderate inflammation in lung tissues of the I/R group and mild inflammation in those of the I/R-platonin group. Total cell number and protein concentration in bronchoalveolar lavage fluid as well as the leukocyte infiltration and myeloperoxidase activity in lung tissues of the I/R group were significantly higher than those of the I/R-platonin group. The pulmonary concentrations of macrophage inflammatory protein-2, interleukin-6, and prostaglandin E(2) of the I/R group were significantly higher than those of the I/R-platonin group. Moreover, the plasma nitric oxide concentration as well as the nitric oxide and malondialdehyde concentrations in lung tissues of the I/R group were significantly higher than those of the I/R-platonin group.
Platonin mitigates acute lung injury induced by bilateral lower limb I/R in rats.
Journal of Surgical Research 05/2011; 167(2):e255-62. · 2.25 Impact Factor
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ABSTRACT: We sought to elucidate the effects of naloxone on regulating the up-regulation of inflammatory molecules and activation of the transcription factor nuclear factor-kappaB (NF-κB) induced by endotoxin. Possible roles of the μ-opioid receptors and L-type calcium channels in mediating the effects of naloxone in this regard were also investigated.
RAW264.7 cells were treated with phosphate buffered saline, naloxone, lipopolysaccharide (LPS), LPS plus naloxone, LPS plus naloxone plus morphine (i.e., the nonselective opioid receptors agonist), LPS plus naloxone plus fentanyl (i.e., the μ-opioid receptors agonist), or LPS plus naloxone plus BAY-K8644 (i.e., the L-type calcium channel activator). After harvesting, production of inflammatory molecules and expression NF-κB were evaluated.
The effects of LPS on inducing the up-regulation of macrophage inflammatory protein-2, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, nitric oxide/inducible nitric oxide synthase, and prostaglandin E(2)/cyclooxygenase 2 were inhibited by naloxone. Naloxone also inhibited the effects of LPS on inducing NF-κB activation, including inhibitor-κB (I-κB) degradation, NF-κB nuclear translocation, and NF-κB-DNA binding. The effects of naloxone on inhibiting IL-1β up-regulation and NF-κB activation were enhanced by morphine. In contrast, the effects of naloxone on inhibiting IL-1β up-regulation and I-κB degradation were counteracted by fentanyl. Moreover, except for TNF-α, the effects of naloxone on inhibiting inflammatory molecules up-regulation and NF-κB activation were significantly counteracted by BAY-K8644.
Naloxone significantly inhibited endotoxin-induced up-regulation of inflammatory molecules and NF-κB activation. The mechanisms may involve antagonizing the L-type calcium channels and, to a lesser extent, the μ-opioid receptors.
Journal of Surgical Research 05/2011; 167(2):e263-72. · 2.25 Impact Factor
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ABSTRACT: Lower limb ischemia-reperfusion (I/R) imposes oxidative stress, elicits inflammatory response, and subsequently induces acute lung injury. Ischemic preconditioning (IP), a process of transient I/R, mitigates the acute lung injury induced by I/R. We sought to elucidate whether the protective effects of IP involve heme oxygenase-1 (HO-1).
Adult male rats were randomized to receive I/R, I/R plus IP, I/R plus IP plus the HO-1 inhibitor tin protoporphyrin (SnPP) (n = 12 in each group). Control groups were run simultaneously. I/R was induced by applying rubber band tourniquet high around each thigh for 3 h followed by reperfusion for 3 h. To achieve IP, three cycles of bilateral lower limb I/R (i.e., ischemia for 10 min followed by reperfusion for 10 min) were performed. IP was performed immediately before I/R. After sacrifice, degree of lung injury was determined.
Histologic findings, together with assays of leukocyte infiltration (polymorphonuclear leukocytes/alveoli ratio and myeloperoxidase activity) and lung water content (wet/dry weight ratio), confirmed that I/R induced acute lung injury. I/R also caused significant inflammatory response (increases in chemokine, cytokine, and prostaglandin E(2) concentrations), imposed significant oxidative stress (increases in nitric oxide and malondialdehyde concentrations), and up-regulated HO-1 expression in lung tissues. IP significantly enhanced HO-1 up-regulation and, in turn, mitigated oxidative stress, inflammatory response, and acute lung injury induced by I/R. In addition, the protective effects of IP were counteracted by SnPP.
The protective effects of IP on mitigating acute lung injury induced by lower limb I/R are mediated by HO-1.
Journal of Surgical Research 05/2011; 167(2):e245-53. · 2.25 Impact Factor
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ABSTRACT: Magnesium sulfate (MgSO4) possesses potent anti-inflammation capacity. We sought to elucidate the effects of MgSO4 on mitigating acute lung injury induced by endotoxemia. MgSO4 is an antagonist of the L-type calcium channels and the N-methyl-D-aspartate (NMDA) receptor. The roles of the L-type calcium channels and NMDA receptor in this regard were also elucidated.
Ninety-six adult male rats were randomized to receive normal saline, MgSO4 (100 mg/kg), lipopolysaccharide (LPS), LPS plus MgSO4 (10, 50, or 100 mg/kg), LPS plus MgSO4 (100 mg/kg) plus the L-type calcium channel activator BAY-K8644, or LPS plus MgSO4 (100 mg/kg) plus exogenous NMDA (n=12 in each group). Between-group differences in lung injury were evaluated.
Histologic findings, in concert with assays of leukocyte infiltration (polymorphonuclear leukocytes/alveoli ratio and myeloperoxidase activity) and lung water content (wet/dry weight ratio), confirmed that LPS induced acute lung injury. LPS also caused significant inflammatory response (increases in chemokine, cytokine, and prostaglandin E2 concentrations) and imposed significant oxidative stress (increases in nitric oxide and malondialdehyde concentrations) in rat lungs. MgSO4 at the dosages of 50 mg/kg and 100 mg/kg, but not at 10 mg/kg, significantly mitigated the acute lung injury, lung inflammatory response, and oxidative stress caused by endotoxemia. Moreover, the protective effects of MgSO4 were counteracted by BAY-K8644 and exogenous NMDA.
MgSO4 mitigates lung inflammatory response, oxidative stress, and acute lung injury in endotoxemia rats in a dose-dependent manner. The mechanisms may involve antagonizing the L-type calcium channels and the NMDA receptor.
The Journal of trauma 05/2011; 70(5):1177-85; discussion 1185. · 2.48 Impact Factor
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ABSTRACT: Lower limb ischemia-reperfusion (I/R) elicits oxidative stress and causes inflammation in lung tissues that may lead to lung injury. Magnesium sulfate (MgSO(4)) possesses potent anti-oxidation and anti-inflammation capacity. We sought to elucidate whether MgSO(4) could mitigate I/R-induced lung injury. As MgSO(4) is an L-type calcium channel inhibitor, the role of the L-type calcium channels was elucidated.
Adult male rats were allocated to receive I/R, I/R plus MgSO(4) (10, 50, or 100 mg/kg), or I/R plus MgSO(4) (100 mg/kg) plus the L-type calcium channels activator BAY-K8644 (20 μg/kg) (n = 12 in each group). Control groups were run simultaneously. I/R was induced by applying rubber band tourniquets high around each thigh for 3 h followed by reperfusion for 3 h. After euthanization, degrees of lung injury, oxidative stress, and inflammation were determined.
Arterial blood gas and histologic assays, including histopathology, leukocyte infiltration (polymorphonuclear leukocytes/alveoli ratio and myeloperoxidase activity), and lung water content, confirmed that I/R caused significant lung injury. Significant increases in inflammatory molecules (chemokine, cytokine, and prostaglandin E(2) concentrations) and lipid peroxidation (malondialdehyde concentration) confirmed that I/R caused significant inflammation and oxidative stress in rat lungs. MgSO(4), at the dosages of 50 and 100 mg/kg but not 10 mg/kg, attenuated the oxidative stress, inflammation, and lung injury induced by I/R. Moreover, BAY-K8644 reversed the protective effects of MgSO(4).
MgSO(4) mitigates lung injury induced by bilateral lower limb I/R in rats. The mechanisms may involve inhibiting the L-type calcium channels.
Journal of Surgical Research 04/2011; 171(1):e97-106. · 2.25 Impact Factor
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ABSTRACT: Common pain assessment tools might not be the suitable tools to measure ventilated, critically ill patients' pain. The Behavioral Pain Scale measures observable behavior indicative of pain experienced by mechanically ventilated patients.
This study was conducted to generate a Chinese-language version of the Behavioral Pain Scale and to test its psychometric properties.
This study was a prospective psychometric study. SETTINGS/PARTICIPANTS: : Seventy patients were recruited from two intensive care units in a medical center.
After instrument translation, psychometric testing which included inter-rater reliability, test-retest reliability, and construct validity was conducted. The construct validity was tested using criterion and discriminant validation strategies. A receiver-operating characteristic curve analysis was conducted to evaluate the ability of the translated tool to correctly detect pain. Measurement of body temperature and endotracheal suctioning were, respectively, selected as the non-painful and painful procedures. Two research nurses observed patients' pain-related behaviors when they were at rest and before/during the non-painful/painful procedures.
The Chinese translation captured the content of the original tool with appropriate adaptation to the cultural context. The inter-rater and test-retest reliabilities were confirmed by good Pearson correlations (r=.50-1.00, p<.001) and high agreement percentages (72.9-100.0%). The criterion validity was confirmed by (a) the score during the painful procedure for patients who considered it to be painful being higher than the score for patients who considered it not to be painful (t=2.28, p=.03), and (b) an increase in the score occurred for two (2.9%) patients during the non-painful procedure and for 68 (97.1%) patients during the painful procedure. The discriminant validity was confirmed by post hoc comparisons in a one-way ANOVA: the scores during the painful procedure were higher than the scores on other occasions (F=377.7, p<.001). The receiver-operating characteristic curve analysis showed that the translated tool had moderate accuracy.
The Chinese-language version of the Behavior Pain Scale was shown to be reliable and valid for adult patients on mechanical ventilation in medical intensive care units when exposed to rest, a non-painful procedure, and a painful procedure. An assessment tool including pain-related observable indicators can be used as one source to assess a patient's pain, especially with ventilated or non-communicative patients.
International journal of nursing studies 04/2011; 48(4):438-48. · 1.91 Impact Factor
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ABSTRACT: The present study examines the prevalence and characteristics of vegetarians in the Taiwanese elderly. We analysed data from the Elderly Nutrition and Health Survey in Taiwan (1999-2000), which used a multi-staged, stratified, clustered probability sampling design. Community-dwelling elderly (n 1071), aged 65 years and older, were included. Sociodemographic, anthropometric, lifestyle and metabolic variables, and eating habits were obtained through household interviews and health examinations. Nutrient intake was assessed using a 24 h dietary recall. Multivariable logistic regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the OR of the hypertension and the metabolic syndrome (MS) for vegetarians compared with omnivores. About 25 % of the Taiwanese elderly persons were vegetarians. Systolic pressure (OR 1·01, 95 % CI 1, 1·02, P = 0·038), female sex (OR 5·02, 95 % CI 3·11, 8·1, P < 0·001), smoking status (P = 0·034; current smoker (OR 0·45, 95 % CI 0·24, 0·85, P = 0·014)) and regular exercise (OR 1·87, 95 % CI 1·37, 2·56, P < 0·001) were independently associated with vegetarian status among Taiwanese elderly persons. Vegetarians consumed significantly lower daily total energy (P < 0·001), lower cholesterol (P = 0·002), a higher percentage of fat as PUFA (P = 0·022), higher Ca (P < 0·001) and higher crude fibres (P = 0·041) compared with omnivores. Between the two vegetarian diets, ovo- or lacto-vegetarian diets contained more beneficial micronutrients, such as K, Ca and Mg, and higher crude fibres than vegan diets (all P < 0·05). The likelihood of having hypertension and the MS was not significantly different between vegetarians and omnivores as examined by sex- or multivariate-adjusted logistic regression.
The British journal of nutrition 03/2011; 106(3):451-60. · 3.45 Impact Factor
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ABSTRACT: Haemorrhagic shock and subsequent resuscitation induce acute lung injury. We elucidated whether bilateral lower limb ischemic pre-conditioning (IP) could mitigate lung injury in haemorrhagic shock/resuscitation rats. The role of heme oxygenase-1 (HO-1) was also elucidated.
Adult male rats were randomized to receive haemorrhagic shock/resuscitation (HS), HS plus IP, or HS plus IP plus the HO-1 inhibitor tin protoporphyrin (SnPP) (n = 12 in each group). Sham groups were employed simultaneously. For pre-conditioning, 3 cycles of limb IP (10 min ischemia followed by 10 min reperfusion) were performed immediately before haemorrhagic shock. Haemorrhagic shock (mean arterial pressure: 40-45 mmHg) was induced by blood drawing and maintained for 120 min. SnPP was injected 5 min before resuscitation. Shed blood/saline mixtures were re-infused to achieve resuscitation. After monitoring for another 8h, rats were sacrificed. Arterial blood gas and alveolar-arterial oxygen difference (lung function index), histology, polymorphonuclear leukocytes/alveoli ratio (leukocyte infiltration index), wet/dry weight ratio (water content index), inflammatory molecules (e.g., chemokine, cytokine, prostaglandin E(2)), and malondialdehyde (lipid peroxidation index) assays were preformed.
Haemorrhagic shock/resuscitation induced significant lung function alterations and significant increases in leukocyte infiltration, water content, inflammation, and lipid peroxidation in lungs. Histological analysis confirmed that haemorrhagic shock/resuscitation caused marked lung injury. Limb IP significantly mitigated the adverse effects of haemorrhagic shock/resuscitation. Moreover, the protective effects of limb IP were reversed by SnPP.
Limb IP mitigates lung injury in haemorrhagic shock/resuscitation rats. The mechanisms may involve HO-1.
Resuscitation 03/2011; 82(6):760-6. · 3.60 Impact Factor
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ABSTRACT: The purpose of this study was to examine the reliability, validity, sensitivity, and specificity of the Chinese Version of the Mood Disorder Questionnaire (MDQ-C). A total of 170 patients were administered the Mini International Neuropsychological Interview and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision as criterion standard by on-site psychiatrists. The Cronbach's alpha, test-retest reliability, and the content validity index of the MDQ-C were .83, .76, and .80, respectively. Factor analysis revealed that two factors, elevated mood overactivity and irritable behavior, explained 40.89% of the variance. On the basis of the sensitivity and specificity results, the optimal cutoff point was 6. The MDQ-C is an effective short and comprehensive tool with robust psychometric properties for diagnosis of bipolar disorders, specifically for patients with bipolar I.
Archives of psychiatric nursing 02/2011; 25(1):53-62. · 0.90 Impact Factor
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ABSTRACT: Numerous studies have revealed that kiwifruit contains many medicinally useful compounds, among which antioxidants and serotonin may be beneficial in the treatment of the sleep disorders. The aim of this study was to evaluate the effects of kiwifruit on sleep patterns, including sleep onset, duration, and quality. In this study, we applied a free-living, self-controlled diet design. Twenty-four subjects (2 males, 22 females) 20 to 55 years of age consumed 2 kiwifruits 1 hour before bedtime nightly for 4 weeks. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), a 3-day sleep diary, and the Actigraph sleep/activity logger watch were used to assess the subjective and objective parameters of sleep quality, including time to bed, time of sleep onset, waking time after sleep onset, time of getting up, total sleep time, and self-reported sleep quality and sleep onset latency, waking time after sleep onset, total sleep time, and sleep efficiency before and after the intervention. After 4 weeks of kiwifruit consumption, the subjective CPSQI score, waking time after sleep onset, and sleep onset latency were significantly decreased (42.4%, 28.9%, and 35.4%, respectively). Total sleep time and sleep efficiency were significantly increased (13.4% and 5.41%, respectively). Kiwifruit consumption may improve sleep onset, duration, and efficiency in adults with self-reported sleep disturbances. Further investigation of the sleep-promoting properties of kiwifruit may be warranted.
Asia Pacific Journal of Clinical Nutrition 01/2011; 20(2):169-74. · 1.13 Impact Factor
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Journal of Surgical Research - J SURG RES. 01/2011; 167(2).
