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As-needed medication is commonly used for psychiatric inpatients' acute psychiatric and physical symptoms. Both patients and staff can initiate such medication. Earlier studies have focused on what and how as-needed medication has been used for psychiatric reasons. Little is known about how patients participate in planning, administration and evaluation of as-needed medication and its alternatives. Nursing documentation provides an insight into these practices.

Long-term inpatients have an active role in initiating as-needed medication. However, patients and staff may have divergent opinions on the need for medication. Alternatives to medication are mostly proposed by staff, and the feedback on as-needed medication events is usually provided from nurses' point of view.

Patients' views on decision-making and evaluation should be noticed and documented more. Patient participation can be promoted by planning as-needed medication and its alternatives beforehand.

INTRODUCTION Pro re nata (PRN) medication it participation needs to be recognized throughout the PRN process. Future research could continue to explore patient participation in planning and evaluating their PRN medication.

Patients participate in PRN by requesting medication. Their participation can be developed by supporting patients to communicate their choice of non-pharmacological methods, take the initiative for medication when needed and disclose their viewpoint on the effects of PRN.

Patients participate in PRN by requesting medication. Their participation can be developed by supporting patients to communicate their choice of non-pharmacological methods, take the initiative for medication when needed and disclose their viewpoint on the effects of PRN.

This study aimed to compare the estimated internal jugular vein (IJV) volume flow with Doppler ultrasound in patients with slow flow in the transverse sinuses and normal transverse sinuses on brain magnetic resonance imaging (MRI).

Eighty patients between the ages of 18 and 80 years who did not have any signs of sinus vein thrombosis on brain MRI were included. On MRI, cases with hyperintensity due to a signal void loss in the transverse sinuses in coronal fluid attenuation inversion recovery sequences were included in the slow-flow group. find more The presence of sinus thrombosis was excluded with other MRI pulse sequences and clinical findings. The participants were divided into 2 groups as having normal and slow flow according to MRI findings. Then bilateral IJV volume flow measurements were made by Doppler ultrasound. Bilateral volume flow was estimated by time-averaged blood flow velocities sampled in the center of the IJV, and IJV cross-sectional areas were measured. We defined the dominant IJV as the one having the higher estimated volume flow of the 2 sides.

Total estimated IJV blood flow was lower (P < .001) in patients with slow flow on MRI (546 mL/min) compared to those without (768 mL/min). A similar finding was seen for the nondominant IJV. In a receiver operating characteristic analysis, the cutoff value for the total estimated IJV volume flow was determined to be 590 mL/min, and the cutoff value for nondominant estimated IJV volume flow was determined to be 202 mL/min to distinguish between the groups.

Low estimated volume blood flow in the IJV is associated with MRI evidence of stasis in the ipsilateral transverse sinus.

Low estimated volume blood flow in the IJV is associated with MRI evidence of stasis in the ipsilateral transverse sinus.

Portal hypertension is a lethal complication of cirrhosis. Its mechanism and therapeutic targets remain largely unknown. Hepatic stellate cell (HSC) contraction increases intrahepatic vascular resistance contributing to portal hypertension. We investigated how HSC contraction was regulated by Wnt signaling and the therapeutic implication.

Liver tissues from cirrhotic patients were examined. Cirrhotic mice with genetic or pharmacological treatments were used for in vivo assessments and their primary cells were isolated. Cellular functions and signaling pathways were analyzed in human HSC-LX2 cells using real-time PCR, Western blotting, siRNA, luciferase reporter assay, chromatin immunoprecipitation, co-immunoprecipitation, and site-directed mutagenesis.

Wnt/β-catenin correlated with HSC contraction in human cirrhotic liver. Wnt3a stimulated Smo-independent Gli1 nuclear translocation followed by LARG-mediated RhoA activation leading to HSC contraction. Sufu negatively mediated Wnt3a-induced Gli1 nuclear tontraction via TCF4-dependent transrepression of Sufu. HSC-specific inhibition of β-catenin may have therapeutic benefits for cirrhotic portal hypertension.

The incidence of diabetes has been rising worldwide and is expected to increase to affect 591.9 million people by 2035 in China. Strict control of blood glucose can significantly reduce the risk of diabetic complications, but traditional interventions lack continuity, timeliness and teleonomy. The development of mobile health management has become a hot topic, as a very popular app in China, WeChat platform, has a large number of users every day. Many studies show the health management of patients with diabetes through WeChat can achieve the ideal effect. This study aims to evaluate the application of WeChat based on clinical research data, provide clinical evidence for medical staff and promote the self-management of patients with diabetes.

The PubMed, EMBASE, Cochrane Library, CNKI and Wanfang database were searched to identify related reports that were published up to 9 March 2020. The quality of included studies was assessed by Cochrane Collaboration risk assessment tool. Measures of interest were mea the lack of research in Western countries. Therefore, more high-quality studies with larger samples are needed in the future to verify our results.

Patients with severe long-chain fatty acid oxidation disorders (LC-FAODs) experience serious morbidity and mortality despite traditional dietary management including medium-chain triglyceride (MCT)-supplemented, low-fat diets. Triheptanoin is a triglyceride oil that is broken down to acetyl-coenzyme A (CoA) and propionyl-CoA, which replenishes deficient tricarboxylic acid cycle intermediates. We report the complex medical and nutrition management of triheptanoin therapy initiated emergently for 3 patients with LC-FAOD.

Triheptanoin (Ultragenyx Pharmaceutical, Inc, Novato, CA, USA) was administered to 3 patients with LC-FAOD on a compassionate-use basis. Triheptanoin was mixed with non-MCT-containing low-fat formula. Patients were closely followed with regular cardiac and laboratory monitoring.

Cardiac ejection fraction normalized after triheptanoin initiation. Patients experienced fewer hospitalizations related to metabolic crises while on triheptanoin. Patient 1 has tolerated oral administration without difficulty since birth.

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