A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.

/pdf/physical-therapist-management-of-total-knee-arthroplasty-2w5bjf2jni.pdf

Physical Therapist Management of Total Knee Arthroplasty.

Nicotinamide (Nam, amide form of niacin acid or nicotinate), a precursor for nicotinamide adenine dinucleotide (NAD+), is important for normal physiological function of organisms. Nam also suppresses mobilization of Ca2+ from sarcoplasmic reticulum into cytoplasm through inhibiting ADP-ribose cyclase. Previously, we have demonstrated that a pharmacological dose of Nam normalizes maternal blood pressure in mouse models of preeclampsia, a pregnancy related hypertensive disorder. We hypothesized that Nam could decrease blood pressure in hypertensive conditions unrelated to pregnancy. Nam at a dose of 500 mg/kg/day was given to wild type (WT) mice treated with L-NAME, endothelial nitric oxide synthase (eNOS)-null and renin transgenic (Renin-Tg) mice via drinking water. Blood pressure was measured by tail-cuff at different stages of treatment. The function and structure of kidneys of WT mice with L-NAME were determined at the end of the study. The gene expression of markers of inflammation and fibrosis in the kidneys of WT mice with L-NAME was also measured. Nam effectively prevented increase in blood pressure in L-NAME treated mice and decreased elevated blood pressure in eNOS-null mice. However, it did not alter high blood pressure in Renin-Tg mice. Nam prevented increase in urinary albumin excretion and collagen deposit in kidneys of WT mice treated with L-NAME. In addition, Nam significantly decreased the mRNA levels of the markers of inflammation and fibrosis in the kidneys of WT mice treated with L-NAME. Nam may execute beneficial effects on hypertensive conditions associated with eNOS dysfunction via suppressing inflammation. Because Nam is generally regarded as safe in humans, it merits further evaluation for the tailored treatment for the subgroup of hypertensive cases associated with impaired eNOS system.

Beneficial effects of nicotinamide on hypertensive mice with impaired endothelial nitric oxide function.

This paper is a basic research project(NRF-2014R1A1A3052149) funded by the Government of Korea(Future Creation Science Department) with the support of the Korea Research Foundation.

/pdf/development-of-evidence-based-nursing-practice-guidelines-39mpide9qx.pdf

Development of Evidence-based Nursing Practice Guidelines for Cold Application in Adult Care

The severe acute respiratory coronavirus 2 (SARS-CoV-2) infection demonstrates a highly variable and unpredictable course. Several reports have claimed a smoker's paradox in coronavirus disease 2019 (COVID-19), in line with previous suggestions that smoking is associated with better survival after acute myocardial infarction and appears protective in preeclampsia. Several plausible physiological explanations exist accounting for the paradoxical observation of smoking engendering protection against SARS-CoV-2 infection. In this review, we delineate novel mechanisms whereby smoking habits and smokers' genetic polymorphism status affecting various nitric oxide (NO) pathways (endothelial NO synthase, cytochrome P450 (CYP450), erythropoietin receptor (EPOR); β-common receptor (βcR)), along with tobacco smoke modulation of microRNA-155 and aryl-hydrocarbon receptor (AHR) effects, may be important determinators of SARS-CoV-2 infection and COVID-19 course. While transient NO bioavailability increase and beneficial immunoregulatory modulations through the above-mentioned pathways using exogenous, endogenous, genetic and/or therapeutic modalities may have direct and specific, viricidal SARS-CoV-2 effects, employing tobacco smoke inhalation to achieve protection equals self-harm. Tobacco smoking remains the leading cause of death, illness, and impoverishment. 

https://link.springer.com/content/pdf/10.1007/s11010-023-04681-8.pdf

Live to die another day: novel insights may explain the pathophysiology behind smoker’s paradox in SARS-CoV-2 infection

Pharmacogenetics play an important role in determining the anti-hypertensive effects of blood pressure-lowering medications and have the potential to improve future patient care. Current literature on the topic, however, has a heavy focus on Caucasians and may not be generalisable to the Asian populations. Therefore, we have conducted this systematic review to summarise and evaluate the literature of the past decade. PubMed, Embase, and the Cochrane Register of Controlled Trials were searched for relevant studies from 1 January 2011 to 23 July 2021. The outcome of interest was the response to anti-hypertensive treatment in Asians according to each genetic polymorphism. A total of 26 studies with a total of 8837 patients were included in our review, covering five classes of anti-hypertensive agents-namely, angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta-blockers (BB), calcium channel blockers (CCB), and thiazide-like diuretics. Response to ACEI therapy was most susceptible to genotypic variations, while the efficacy of ARB and CCB were affected by pharmacogenetic differences to varying extent. For BB, only variations in the ADRB1 genotype significantly affects therapeutic response, while the therapeutic efficacy of thiazide-like diuretics was correlated with genotypic variations in the REN and ACE. This systematic review evaluated the impact of pharmacogenetic variations on the therapeutic efficacy of anti-hypertensive treatment in Asians and has described numerous drug-gene pairs that are potentially clinically important. Future prospective studies with larger sample sizes and longer follow-up periods are needed to better elucidate the impact of these drug-gene pairs. 

https://www.nature.com/articles/s41371-022-00765-y.pdf

The clinical impact of anti-hypertensive treatment drug-gene pairs in the asian population: a systematic review of publications in the past decade

INTRODUCTION Genetic factors and lifestyle exposures, as well as their combinations, play important roles in the development of hypertension. We examined whether cigarette smoking, alcohol drinking and the Glu298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene generate combined effects on blood pressure (BP) in hypertensive subjects. METHODS A total of 342 essential hypertensive subjects were recruited from Susong community in Anhui province, China, from July 2017 to January 2018, and the plasma biochemical parameters and the genotype on Glu298Asp polymorphism were determined. RESULTS There were no gender differences in the distributions of alleles and genotypes in hypertensive subjects. The proportions of cigarette smoking and alcohol drinking in male hypertensive subjects were remarkably higher than those in the females (p<0.001). The systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels of mutant genotypes (Glu/Asp and Asp/Asp) were significantly higher than those of wild genotype (Glu/Glu) (p=0.013 and 0.026, respectively) in male hypertensive subjects. Moreover, the SBP and DBP levels of the mutant genotype were remarkably higher than those of wild genotype in both cigarette smoking and alcohol drinking male hypertensive subjects (p=0.034 and 0.043, respectively). CONCLUSIONS Cigarette smoking, alcohol drinking and the Glu298Asp polymorphism of the eNOS gene generate combined effects that increase the susceptibility of the mutant genotype to BP in Chinese male hypertensive subjects.

http://www.tobaccoinduceddiseases.org/pdf-110678-41594?filename=Combined effects of.pdf

Combined effects of cigarette smoking, alcohol drinking and eNOS Glu298Asp polymorphism on blood pressure in Chinese male hypertensive subjects.

The invention discloses a special feeding bottle for medicine feeding of an infant. The feeding bottle comprises a feeding bottle body, a medicine tube, a baffle, a limiting sleeve, a piston, a push rod, a feeding bottle cap, a nipple, a first leaking hole, a medicine feeding hose, a connector, elastic shielding cloth, a hanging ring, a grasping ring and a hook rod. The special feeding bottle for medicine feeding of the infant is ingenious in structure and strong in function. Firstly, the feeding bottle can reduce resistance of the infant by cooperating with milk, and medicine feeding of medical staff is facilitated; secondly, by means of a shielding protection structure, the situation that the infant sees the medicine tube can be avoided, vigilance of the infant is reduced, the milk can be kept warm and liquid medicine can be shaded; finally, great convenience is brought to medical staff for medicine feeding of the infant, and the feeding bottle can be conveniently applied and popularized in clinic.

Special feeding bottle for medicine feeding of infant

Background: It is generally believed that essential hypertension is influenced by both genetic and environmental factors, as well as their interactions. Tissue kallikrein encoded by the tissue kallikrein gene (KLK1) is a key serine proteinase of kallikrein–kinin system, which is capable of generating potent vasactive peptides, kinins, by selective cleavage of the kininogen substrate. It was reported that the A2233 → C polymorphism in KLK1 gene is associated with essential hypertension. The aim of this study was to examine whether the molecular variations of KLK1 play role in determining the therapeutic response to benazepril, an ACE inhibitor. Methods: A total of 331 hypertensive individuals were recruited and treated with benazepril for 15 days. A variant impact of KLK1 A2233C was revealed. Chi-square analysis showed that the hypertensive subjects with the mutation genotype (AC + CC) had a higher proportion in systolic blood pressure (SBP, 88.1% vs. 79.0%, χ2 = 4.141, p = 0.042) and diastolic blo...

A positive association between the human tissue kallikerin gene A2233C polymorphism and blood pressure response to benazepril.

The utility model discloses a pressurization cold compress area, including the bandage, first air cushion, first ice bag, the second air cushion, the second ice bag, first intake pipe, the gasbag, an unidirectional valve, the manometer, the second intake pipe, the outlet duct, insulated bag, this pressurization cold compress area, and the device is also advantaged by ingenious structure, functions are powerful, the operation is thus simple, through using the device, the area of contact of ice bag with patient's treatment position has been increased, and simultaneously, the device fixes phenomenons such as the slippage simply can not appear, and the treatment is chronic, need not frequent change, the efficiency of patient's therapeutical progress and medical personnel's work is improved.

Pressurization cold compress area

The utility model discloses a finger function training ware, in using, at first point the length difference according to the patient, the patient holds first locating pin earlier, and rotatory first locating pin, through first locating pin and the driven effect of connecting plate screw thread, the messenger win that the locating pin promotes or the pulling slide and do along the orientation of guide way around the round trip movement, through above regulation, make the finger -stall adjust to being fit for the position that the patient pointed the exercise, the patient puts into the finger -stall with the finger of oneself again, the patient can fold the finger this moment, through the mode of foling, it drives finger -stall linkage elasticity rope and stay cord and along patient's centre of the palm removal to make the patient point, the in -process that is removing, stay cord pulling pressure gauge, through the numerical value that the pressure gauge showed, the patient can be clear the pulling force value of knowing oneself finger what are, this finger function training ware, through using the device, the patient can carry out appropriate increase to the degree of oneself taking exercise, very big improvement the recovered progress of patient.

Finger function training ware

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