Webbgrady1694

© 2020 Wiley Periodicals, Inc.BACKGROUND In metabolically stable horses, alpha-2-agonists suppress insulin secretion with transient hyperglycemia and rebound hyperinsulinemia. In horses with insulin dysregulation (ID), the effect of alpha-2-agonists has not been investigated; however, both the alpha-2-agonist-induced suppression of insulin secretion and rebound hyperinsulinemia could have clinical relevance. HYPOTHESIS/OBJECTIVES In horses with ID, alpha-2-agonists will alter insulin and glucose dynamics. ANIMALS Seven horses with ID and 7 control horses. METHODS In this randomized crossover study, xylazine hydrochloride (1.1 mg/kg) or detomidine hydrochloride (30 μg/kg) were administered IV, and blood was collected for glucose and insulin concentrations at 0, 15, 30, 45, 60, 90, 120, 150, 180, and 300 minutes after administration. Horses received each drug in a random order with a 24-hour washout period between drugs. Percent change in glucose and insulin concentrations was compared between groups, drugs, and over time with P  less then  .05 considered significant. RESULTS A significant time-dependent effect of both alpha-2-agonists on glucose and insulin concentrations in control and ID horses was identified (P = .01 for all comparisons). There was no significant effect of sedative selection and endocrine status on blood glucose concentration in either group; however, in ID horses, xylazine administration resulted in severe rebound hyperinsulinemia whereas detomidine administration did not (P = .02). selleck compound -2-agonists have a significant effect on glucose and insulin concentrations in horses. In ID horses, detomidine could minimize hyperinsulinemia when compared to xylazine. © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.Sperm quality is important for in vitro fertilisation and embryo transfer and intracytoplasmic sperm injection in the treatment of human infertility. The purpose of this study was to screen for biomarkers that could evaluate sperm quality. We analysed semen samples in 172 fertile males; multivariate logistic regression analysis showed that the levels of COX1 (17.5 ng/ml) in seminal plasma may represent a useful biomarker for sperm quality (area under the curve 0.745; sensitivity 0.808; specificity 0.722). Analysis indicated that the values of parameters related to sperm quality changed significantly (p  less then  .05) between COX1 level ≥ 17.5 ng/ml group and COX1 level  less then  17.5 ng/ml group. Further analysis of two consecutive semen samples (1-hr interval) from 48 subjects revealed that the first semen samples (COX1 levels ≥ 17.5 ng/ml) had a higher sperm concentration and a larger proportion of spermatozoa showing progressive motility, a lower rate of sperm DNA fragmentation and a lower proportion of spermatozoa undergoing the acrosome reaction spontaneously (p  less then  .05); identical results were observed for the second semen samples. These data indicated that COX1 could be used as an indicator for sperm status and may be helpful for identifying better quality spermatozoa for artificial insemination. © 2020 Blackwell Verlag GmbH.With the emergence of organ donation and donation technology, the previous indivisibility of the human body becomes divisible, and different human organs form a new life subject. With reference to specific case studies in China, a new life, consisting of donated organs from different bodies by donation, can be called "donated life." Donated life is a win-win action between altruism and egoism, that is, to save the lives of others and to regenerate the organs of donors or their relatives. Due to the emergence of this kind of life, traditional social ethics theories based on the marriage-related family find it difficult to difficult to explain the new realities. Thus, new thinking about social ethics is necessary. © 2020 John Wiley & Sons Ltd.This paper is an analysis of the limits of family authority to refuse life saving treatment for a family member (in the Chinese medical context). Family consent has long been praised and practiced in many non-Western cultural settings such as China and Japan. In contrast, the controversy of family refusal remains less examined despite its prevalence in low-income and middle-income countries. In this paper, we investigate family refusal in medical emergencies through a combination of legal, empirical and ethical approaches, which is highly relevant to the ongoing discussion about the place of informed consent in non-Western cultures. We first provide an overview of the Chinese legislation concerning informed consent to show the significance of family values in the context of medical decision-making and demonstrate the lack of legal support to override family refusal. Next, we present the findings of a vignette question that investigated how 11,771 medical professionals and 2,944 patients in China responded to the family refusal of emergency treatment for an unconscious patient. In our analysis of these results, we employ ethical reasoning to question the legitimacy of family refusal of life-sustaining emergency treatment for temporarily incompetent patients. Last, we examine some practical obstacles encountered by medical professionals wishing to override family refusal to give context to the discussion. © 2020 John Wiley & Sons Ltd.BACKGROUND Spontaneous bacterial peritonitis (SBP) is one of the most critical complications of decompensated liver cirrhosis. This study aimed to assess whether ascitic neutrophil gelatinase-associated lipocalin (NGAL), a reliable inflammation biomarker, can be used to detect SBP in decompensated cirrhosis patients and to predict mortality from decompensated cirrhosis-related SBP. METHODS This study included 204 hospitalized patients with ascites of decompensated liver cirrhosis and follow-up of 28 days. #link# We measured ascitic NGAL levels by the latex-enhanced immunoturbidimetric method. Simultaneously, we observed the patterns of ascitic NGAL levels in the SBP group after 7 days of anti-infection treatment with third-generation cephalosporins. RESULTS The ascitic NGAL levels significantly increased in the SBP group compared with that in the non-SBP group, 111(83.9, 178) ng/mL vs 48(35.4, 63) ng/mL, P  less then  .001. Likewise, the ascitic NGAL levels of SBP were higher than non-SBP with or without renal dysfunction.