Issue
Efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric diabetic ketoacidosis and its effect on serum inflammatory factors
Corresponding Author(s) : Wei Zhao
Cellular and Molecular Biology,
Vol. 66 No. 5: Issue 5
Abstract
Diabetic ketoacidosis (DKA) is a very serious disease that can occur in both types of diabetes (type 1 and 2). It is caused by a combination of high blood sugar and low insulin levels, which can cause the body to produce too much ketone. Ketones are toxic to human organs. This research aimed to investigate the clinical efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric DKA and its effect on serum inflammatory factors. For this purpose, a total of 122 children with DKA admitted to our hospital from April 2013 to May 2016 were selected as research objects. They were divided into group A with 60 cases and group B with 62 cases. Group B was treated with supplemental electrolytes, and group A was treated with low-dose insulin based on group B. The serum levels of TNF-α, IL-6, and IL-18 were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment, and the blood sugar, sodium, and potassium levels were measured by an automatic biochemical analyzer. The time when blood sugar reached the standard level when acidosis was corrected and hospitalization time was compared between the two groups. The total effective rate of group A was significantly higher than that of group B (p< 0.05). There was no significant difference in blood glucose, sodium, potassium, TNF-α, IL-6, and IL-18 levels between the two groups before treatment. (all p > 0.05). But the blood glucose, sodium and potassium levels in group A were significantly better than those in group B (all p< 0.001). The levels of serum TNF-α, IL-6, and IL-18 in group A were significantly lower than those in group B after treatment (all p< 0.001). After treatment, the time when blood sugar reached the standard level when acidosis was corrected and hospitalization time in group A were significantly shorter than those in group B (all p< 0.001). Low-dose insulin combined with electrolyte supplementation is effective in the treatment of DKA in children, which can effectively control blood sugar, sodium, potassium level, and inflammatory factor concentration.
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- Malik FS, Hall M, Mangione-Smith R, Keren R, Mahant S, Shah SS, Srivastava R, Wilson KM, Tieder JS. Patient characteristics associated with differences in admission frequency for diabetic ketoacidosis in United States children's hospitals. J Pediatr 2016; 171: 104-110.
- Aye T, Mazaika PK, Mauras N, Marzelli MJ, Shen H, Hershey T, Cato A, Weinzimer SA, White NH, Tsalikian E. Impact of Early Diabetic Ketoacidosis on the Developing Brain. Diabetes Care 2019; 42: 443-449.
- Bialo SR, Agrawal S, Boney CM, Quintos JB. Rare complications of pediatric diabetic ketoacidosis. World J Diabetes 2015; 6: 167.
- Cohen M, Leibovitz N, Shilo S, Zuckerman-Levin N, Shavit I, Shehadeh N. Subcutaneous regular insulin for the treatment of diabetic ketoacidosis in children. Pediatr Diabetes 2017; 18: 290-296.
- Jackman J, Chafe R, Albrechtsons D, Porter R, Nugent C, Waheed S, Newhook LA. Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada. BMC Res Notes 2015; 8: 1-5.
- Van Berkel M, Joseph J, Riha H. Successful implementation of a treatment protocol for diabetic ketoacidosis. Crit Care Med 2016; 44: 196.
- Inward CD, Chambers TL. Fluid management in diabetic ketoacidosis. Arch Dis Child 2002; 86: 443-444.
- Rameshkumar R, Satheesh P, Jain P. Standard dose (0.1 u/kg/hr) versus low dose (0.05 u/kg/hr) intravenous insulin infusion in the treatment of pediatric diabetic ketoacidosis randomized, double-blind controlled clinical trial. Pediatr Crit Care Med 2018; 19: 18.
- Orwoll BE. Challenging the One-Dose-Fits-All Model for Insulin in the Acute Treatment of Pediatric Diabetic Ketoacidosis. A Critical Appraisal of "Low-Dose Versus Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis: A Randomized Clinical Trial (JAMA Pediatrics 2014; 168: 999–1005.
- Dong G, Liang L, Fu J, Zou C. Serum interleukin-18 levels are raised in diabetic ketoacidosis in Chinese children with type 1 diabetes mellitus. Indian Pediatr 2007; 44: 732-736.
- Chen X, Wu R. Diagnostic value of TNF-alpha and IL-10 for diabetic ketoacidosis with acute pancreatitis. Int J Clin Exp Med 2018; 11: 5860-5866.
- Kim JA, Kim DK, Jin Tae, Kang OH, Choi YA, Choi SC, Kim TH, Nah YH, Choi SJ, Kim YH. Acanthoic acid inhibits IL-8 production via MAPKs and NF-κB in a TNF-α-stimulated human intestinal epithelial cell line. Clin Chim Acta 2004; 342: 193-202.
- Dhatariya KK, Vellanki P. Treatment of diabetic ketoacidosis (DKA)/hyperglycemic hyperosmolar state (HHS): novel advances in the management of hyperglycemic crises (UK versus USA). Curr Diab Rep 2017;17: 33.
- Kanwal SK, Chhapola V, Kumar V. Predictors of altered sensorium at admission in children with diabetic ketoacidosis. Ind J Pediatr 2015; 82: 873-874.
- Fazeli Farsani S, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA. Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review. BMJ Open 2017; 7: e016587.
- Zubair M, Mohamed NG, Al Amri M. Clinical, demographic and biochemical profile of pediatric diabetic ketoacidosis patients in King Khalid Civilian Hospital, Tabuk. Med Sci 2018; 22: 70-77.
- Dhatariya KK, Nunney I, Higgins K, Sampson MJ, Iceton G. National survey of the management of diabetic ketoacidosis (DKA) in the UK in 2014. Diabet Med 2016; 33: 252-260.
- Ahmed F, Kazi SG, Khan W. Type 1 diabetes mellitus presenting with diabetic ketoacidosis (DKA) in a neonate. J Pak Med Assoc 2016; 66: 1026-1028.
- Miles JM, Gerich JE. 3Glucose and ketone body kinetics in diabetic ketoacidosis. Clin Endocrinol Metab 1983; 12: 303-319.
- Gupta D, Kirn M, Jamkhana ZA, Lee R, Albert SG, Rollins KM. A unified Hyperglycemia and Diabetic ketoacidosis (DKA) insulin infusion protocol based on an Excel algorithm and implemented via Electronic Medical Record (EMR) in Intensive Care Units. Diabetes Metab Syndr 2017; 11: 265-271.
- Karajgikar ND, Manroa P, Acharya R, Codario RA, Reider JA, Donihi AC, Salata RA, Korytkowski MT. Addressing pitfalls in management of diabetic ketoacidosis (DKA) with a standardized protocol 2019; 25: 407-412.
- Kapellen T, Vogel C, Telleis D, Siekmeyer M, Kiess W. Treatment of diabetic ketoacidosis (DKA) with 2 different regimens regarding fluid substitution and insulin dosage (0.025 vs. 0.1 units/kg/h).Exp Clin Endocrinol Diabetes 2012;120: 273-276.
- Cemeroglu AP, Thomas JP, Zande LT, Nguyen NT, Wood MA, Kleis L, Davis AT. Basal and bolus insulin requirements in children, adolescents, and young adults with type 1 diabetes mellitus on continuous subcutaneous insulin infusion (CSII): effects of age and puberty. Endocr Pract 2013;19: 805-811.
- Nallasamy K, Jayashree M, Singhi S, Bansal A. Low-Dose vs standard-dose insulin in pediatric diabetic ketoacidosis a randomized clinical trial. JAMA Pediatr 2014; 168: 999.
- Colino E, ílvarez Mí, Carcavilla A, Alonso M, Ros P, Barrio R . Insulin dose adjustment when changing from multiple daily injections to continuous subcutaneous insulin infusion in the pediatric age group. Acta Diabetol 2010; 47: 1-6.
- Mudly S, Rambiritch V, Mayet L. An Identification of the Risk Factors Implicated in Diabetic Ketoacidosis (DKA). SAFP 2007; 49.
- Svart M, Rittig N, Mí¸ller N. Soluble CD 163 correlates with lipid metabolic adaptations in type 1 diabetes patients during ketoacidosis. J Diabetes Invest 2019; 10: 67-72.
- Nett ST, Noble JA, Levin DL, Cvijanovich NZ, Vavilala MS, Jarvis JD, Flori HR. Biomarkers and genetics of brain injury risk in diabetic ketoacidosis: A pilot study. J Pediatr Intensive Care 2014; 03: 059-066.
- O'Neill S, Drobatz K, Satyaraj E, Hess R. Evaluation of cytokines and hormones in dogs before and after treatment of diabetic ketoacidosis and in uncomplicated diabetes mellitus. Vet Immunol Immunopathol 2012; 148: 276-283.
- Karavanaki K, Karanika E, Georga S, Bartzeliotou A, Tsouvalas M, Konstantopoulos I, Fotinou A, Papassotiriou I, Karayianni C. Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM). Endocr J 2011; 58: 1045-1053.
- Popovic D, Lalic K, Jotic A, Milicic T, Bogdanovic J, ćorć‘evic M, Stankovic S, Jeremic V, Lalic NM. The inflammatory and hemostatic cardiovascular risk markers during acute hyperglycemic crisis in type 1 and type 2 diabetes. J Med Biochem 2019; 38: 126-133.
- Li W, Jia MX, Wang JH, Lu JL, Deng J, Tang JX, Liu, C. Association of MMP9-1562C/T and MMP13-77A/G Polymorphisms with Non-Small Cell Lung Cancer in Southern Chinese Population. Biomolecules 2019; 9(3): 107-119.
- Liang Y, Lin Q, Huang P, Wang Y, Li J, Zhang L, Cao J. Rice Bioactive Peptide Binding with TLR4 To Overcome H2O2-Induced Injury in Human Umbilical Vein Endothelial Cells through NF-kappa B Signaling. J Agri Food Chem 2018; 66(2): 440-448.
- Chen HX, Huang L, Yang L, Chen YT, Huang JM. Model-based method with nonlinear ultrasonic system identification for mechanical structural health assessment. Trans Emerge Telecommun Technol 2020; 1-15.
- Bordbar M, Darvishzadeh R, Pazhouhandeh M, Kahrizi D. An overview of genome editing methods based on endonucleases. Modern Genetics J 2020; 15(2): 75-92.
- Chen X, Xu Y, Meng L, Chen X, Yuan L, Cai Q, Shi W, Huang G. Non-parametric partial least squares-discriminant analysis model based on sum of ranking difference algorithm for tea grade identification using electronic tongue data. Sens Actuators B Chem 2020; 311:127924-127931.
- Guo T, Lin Q, Li X, Nie Y, Wang L, Shi L, Xu W, Hu T, Guo T, Luo F. Octacosanol Attenuates Inflammation in Both RAW264.7 Macrophages and a Mouse Model of Colitis. J Agri Food Chem 2017; 65(18): 3647-3658.
- Jiang X, Zhu B, Chevallier J, Xie R. Allocating provincial CO2 quotas for the Chinese national carbon program. Australian J Agri Res Econ 2018; 62(3): 457-479.
- Lou Y, Guo D, Zhang H, Song L. Effectiveness of mesenchymal stems cells cultured by hanging drop vs. conventional culturing on the repair of hypoxic-ischemic-damaged mouse brains, measured by stemness gene expression. Open Life Sci 2016; 11(1): 519-523.
- Lou Y, Shi J, Guo D, Qureshi AK, Song L. Function of PD-L1 in antitumor immunity of glioma cells. Saudi J Biol Sci 2017; 24(4): 803-807.
- Lou Y, Yang J, Wang L, Chen X, Xin X, Liu Y. The clinical efficacy study of treatment to Chiari malformation type I with syringomyelia under the minimally invasive surgery of resection of Submeningeal cerebellar Tonsillar Herniation and reconstruction of Cisterna magna. Saudi J Biol Sci 2019; 26(8): 1927-1931.
- Zhang T, Wu X, Shaheen SM, Zhao Q, Liu X, Rinklebe J, Ren H. Ammonium nitrogen recovery from digestate by hydrothermal pretreatment followed by activated hydrochar sorption. Chem Eng J 2020; 379: 1-54.
- Zhu B, Pang R, Chevallier J, Wei YM, Vo DT. Including intangible costs into the cost-of-illness approach: a method refinement illustrated based on the PM2.5 economic burden in China. Europ J Health Econ 2019; 20(4): 501-511.
- Chen H, Chen Y, Yang L. Intelligent early structural health prognosis with nonlinear system identification for RFID signal analysis. Comput Commun 2020; 157: 150-161.
- Yang M, Abdalrahman H, Sonia U, Mohammed A, Vestine U, Wang M, Ebadi AG, Toughani M. The application of DNA molecular markers in the study of Codonopsis species genetic variation, a review. Cell Mol Biol 2020; 2: 23-30.
- He L, Fang H, Wang X, Wang Y, Ge H, Li C, Chen C, Wan Y, He H. The 100 most-cited articles in urological surgery: A bibliometric analysis. Int J Surg 2020; 75: 74-79.
- Nie Y, Luo F, Lin Q. Dietary nutrition and gut microflora: A promising target for treating diseases. Trends Food Sci Technol 2018; 75: 72-80.
- Nie Y, Luo F, Wang L, Yang T, Shi L, Li X, Shen J, Xu W, Guo T, Lin Q. Anti-hyperlipidemic effect of rice bran polysaccharide and its potential mechanism in high-fat diet mice. Food Func 2017; 8(11): 4028-4041.
- Ren Y, Jiao X, Zhang L. Expression level of fibroblast growth factor 5 (FGF5) in the peripheral blood of primary hypertension and its clinical significance. Saudi J Biol Sci 2018; 25(3): 469-473.
- Yaykasli KO, Yaykasli E, Ataoglu S, Ozsahin M, Memisogulları R, í‡elebi E, Uçgun T, Ozcan ME, Uslu M, Yuce H. The frequency of omentin Val109Asp polymorphism and the serum level of omentin in patients with Rheumatoid Arthritis. Acta Medica Mediterranea 2013; 29:521-526.
- Wang L, Lin Q, Yang T, Liang Y, Nie Y, Luo Y, Shen J, Fu X, Tang Y, Luo F. Oryzanol Modifies High Fat Diet-Induced Obesity, Liver Gene Expression Profile, and Inflammation Response in Mice. J Agri Food Chem 2017; 65(38): 8374-8385.
References
Malik FS, Hall M, Mangione-Smith R, Keren R, Mahant S, Shah SS, Srivastava R, Wilson KM, Tieder JS. Patient characteristics associated with differences in admission frequency for diabetic ketoacidosis in United States children's hospitals. J Pediatr 2016; 171: 104-110.
Aye T, Mazaika PK, Mauras N, Marzelli MJ, Shen H, Hershey T, Cato A, Weinzimer SA, White NH, Tsalikian E. Impact of Early Diabetic Ketoacidosis on the Developing Brain. Diabetes Care 2019; 42: 443-449.
Bialo SR, Agrawal S, Boney CM, Quintos JB. Rare complications of pediatric diabetic ketoacidosis. World J Diabetes 2015; 6: 167.
Cohen M, Leibovitz N, Shilo S, Zuckerman-Levin N, Shavit I, Shehadeh N. Subcutaneous regular insulin for the treatment of diabetic ketoacidosis in children. Pediatr Diabetes 2017; 18: 290-296.
Jackman J, Chafe R, Albrechtsons D, Porter R, Nugent C, Waheed S, Newhook LA. Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada. BMC Res Notes 2015; 8: 1-5.
Van Berkel M, Joseph J, Riha H. Successful implementation of a treatment protocol for diabetic ketoacidosis. Crit Care Med 2016; 44: 196.
Inward CD, Chambers TL. Fluid management in diabetic ketoacidosis. Arch Dis Child 2002; 86: 443-444.
Rameshkumar R, Satheesh P, Jain P. Standard dose (0.1 u/kg/hr) versus low dose (0.05 u/kg/hr) intravenous insulin infusion in the treatment of pediatric diabetic ketoacidosis randomized, double-blind controlled clinical trial. Pediatr Crit Care Med 2018; 19: 18.
Orwoll BE. Challenging the One-Dose-Fits-All Model for Insulin in the Acute Treatment of Pediatric Diabetic Ketoacidosis. A Critical Appraisal of "Low-Dose Versus Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis: A Randomized Clinical Trial (JAMA Pediatrics 2014; 168: 999–1005.
Dong G, Liang L, Fu J, Zou C. Serum interleukin-18 levels are raised in diabetic ketoacidosis in Chinese children with type 1 diabetes mellitus. Indian Pediatr 2007; 44: 732-736.
Chen X, Wu R. Diagnostic value of TNF-alpha and IL-10 for diabetic ketoacidosis with acute pancreatitis. Int J Clin Exp Med 2018; 11: 5860-5866.
Kim JA, Kim DK, Jin Tae, Kang OH, Choi YA, Choi SC, Kim TH, Nah YH, Choi SJ, Kim YH. Acanthoic acid inhibits IL-8 production via MAPKs and NF-κB in a TNF-α-stimulated human intestinal epithelial cell line. Clin Chim Acta 2004; 342: 193-202.
Dhatariya KK, Vellanki P. Treatment of diabetic ketoacidosis (DKA)/hyperglycemic hyperosmolar state (HHS): novel advances in the management of hyperglycemic crises (UK versus USA). Curr Diab Rep 2017;17: 33.
Kanwal SK, Chhapola V, Kumar V. Predictors of altered sensorium at admission in children with diabetic ketoacidosis. Ind J Pediatr 2015; 82: 873-874.
Fazeli Farsani S, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA. Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review. BMJ Open 2017; 7: e016587.
Zubair M, Mohamed NG, Al Amri M. Clinical, demographic and biochemical profile of pediatric diabetic ketoacidosis patients in King Khalid Civilian Hospital, Tabuk. Med Sci 2018; 22: 70-77.
Dhatariya KK, Nunney I, Higgins K, Sampson MJ, Iceton G. National survey of the management of diabetic ketoacidosis (DKA) in the UK in 2014. Diabet Med 2016; 33: 252-260.
Ahmed F, Kazi SG, Khan W. Type 1 diabetes mellitus presenting with diabetic ketoacidosis (DKA) in a neonate. J Pak Med Assoc 2016; 66: 1026-1028.
Miles JM, Gerich JE. 3Glucose and ketone body kinetics in diabetic ketoacidosis. Clin Endocrinol Metab 1983; 12: 303-319.
Gupta D, Kirn M, Jamkhana ZA, Lee R, Albert SG, Rollins KM. A unified Hyperglycemia and Diabetic ketoacidosis (DKA) insulin infusion protocol based on an Excel algorithm and implemented via Electronic Medical Record (EMR) in Intensive Care Units. Diabetes Metab Syndr 2017; 11: 265-271.
Karajgikar ND, Manroa P, Acharya R, Codario RA, Reider JA, Donihi AC, Salata RA, Korytkowski MT. Addressing pitfalls in management of diabetic ketoacidosis (DKA) with a standardized protocol 2019; 25: 407-412.
Kapellen T, Vogel C, Telleis D, Siekmeyer M, Kiess W. Treatment of diabetic ketoacidosis (DKA) with 2 different regimens regarding fluid substitution and insulin dosage (0.025 vs. 0.1 units/kg/h).Exp Clin Endocrinol Diabetes 2012;120: 273-276.
Cemeroglu AP, Thomas JP, Zande LT, Nguyen NT, Wood MA, Kleis L, Davis AT. Basal and bolus insulin requirements in children, adolescents, and young adults with type 1 diabetes mellitus on continuous subcutaneous insulin infusion (CSII): effects of age and puberty. Endocr Pract 2013;19: 805-811.
Nallasamy K, Jayashree M, Singhi S, Bansal A. Low-Dose vs standard-dose insulin in pediatric diabetic ketoacidosis a randomized clinical trial. JAMA Pediatr 2014; 168: 999.
Colino E, ílvarez Mí, Carcavilla A, Alonso M, Ros P, Barrio R . Insulin dose adjustment when changing from multiple daily injections to continuous subcutaneous insulin infusion in the pediatric age group. Acta Diabetol 2010; 47: 1-6.
Mudly S, Rambiritch V, Mayet L. An Identification of the Risk Factors Implicated in Diabetic Ketoacidosis (DKA). SAFP 2007; 49.
Svart M, Rittig N, Mí¸ller N. Soluble CD 163 correlates with lipid metabolic adaptations in type 1 diabetes patients during ketoacidosis. J Diabetes Invest 2019; 10: 67-72.
Nett ST, Noble JA, Levin DL, Cvijanovich NZ, Vavilala MS, Jarvis JD, Flori HR. Biomarkers and genetics of brain injury risk in diabetic ketoacidosis: A pilot study. J Pediatr Intensive Care 2014; 03: 059-066.
O'Neill S, Drobatz K, Satyaraj E, Hess R. Evaluation of cytokines and hormones in dogs before and after treatment of diabetic ketoacidosis and in uncomplicated diabetes mellitus. Vet Immunol Immunopathol 2012; 148: 276-283.
Karavanaki K, Karanika E, Georga S, Bartzeliotou A, Tsouvalas M, Konstantopoulos I, Fotinou A, Papassotiriou I, Karayianni C. Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM). Endocr J 2011; 58: 1045-1053.
Popovic D, Lalic K, Jotic A, Milicic T, Bogdanovic J, ćorć‘evic M, Stankovic S, Jeremic V, Lalic NM. The inflammatory and hemostatic cardiovascular risk markers during acute hyperglycemic crisis in type 1 and type 2 diabetes. J Med Biochem 2019; 38: 126-133.
Li W, Jia MX, Wang JH, Lu JL, Deng J, Tang JX, Liu, C. Association of MMP9-1562C/T and MMP13-77A/G Polymorphisms with Non-Small Cell Lung Cancer in Southern Chinese Population. Biomolecules 2019; 9(3): 107-119.
Liang Y, Lin Q, Huang P, Wang Y, Li J, Zhang L, Cao J. Rice Bioactive Peptide Binding with TLR4 To Overcome H2O2-Induced Injury in Human Umbilical Vein Endothelial Cells through NF-kappa B Signaling. J Agri Food Chem 2018; 66(2): 440-448.
Chen HX, Huang L, Yang L, Chen YT, Huang JM. Model-based method with nonlinear ultrasonic system identification for mechanical structural health assessment. Trans Emerge Telecommun Technol 2020; 1-15.
Bordbar M, Darvishzadeh R, Pazhouhandeh M, Kahrizi D. An overview of genome editing methods based on endonucleases. Modern Genetics J 2020; 15(2): 75-92.
Chen X, Xu Y, Meng L, Chen X, Yuan L, Cai Q, Shi W, Huang G. Non-parametric partial least squares-discriminant analysis model based on sum of ranking difference algorithm for tea grade identification using electronic tongue data. Sens Actuators B Chem 2020; 311:127924-127931.
Guo T, Lin Q, Li X, Nie Y, Wang L, Shi L, Xu W, Hu T, Guo T, Luo F. Octacosanol Attenuates Inflammation in Both RAW264.7 Macrophages and a Mouse Model of Colitis. J Agri Food Chem 2017; 65(18): 3647-3658.
Jiang X, Zhu B, Chevallier J, Xie R. Allocating provincial CO2 quotas for the Chinese national carbon program. Australian J Agri Res Econ 2018; 62(3): 457-479.
Lou Y, Guo D, Zhang H, Song L. Effectiveness of mesenchymal stems cells cultured by hanging drop vs. conventional culturing on the repair of hypoxic-ischemic-damaged mouse brains, measured by stemness gene expression. Open Life Sci 2016; 11(1): 519-523.
Lou Y, Shi J, Guo D, Qureshi AK, Song L. Function of PD-L1 in antitumor immunity of glioma cells. Saudi J Biol Sci 2017; 24(4): 803-807.
Lou Y, Yang J, Wang L, Chen X, Xin X, Liu Y. The clinical efficacy study of treatment to Chiari malformation type I with syringomyelia under the minimally invasive surgery of resection of Submeningeal cerebellar Tonsillar Herniation and reconstruction of Cisterna magna. Saudi J Biol Sci 2019; 26(8): 1927-1931.
Zhang T, Wu X, Shaheen SM, Zhao Q, Liu X, Rinklebe J, Ren H. Ammonium nitrogen recovery from digestate by hydrothermal pretreatment followed by activated hydrochar sorption. Chem Eng J 2020; 379: 1-54.
Zhu B, Pang R, Chevallier J, Wei YM, Vo DT. Including intangible costs into the cost-of-illness approach: a method refinement illustrated based on the PM2.5 economic burden in China. Europ J Health Econ 2019; 20(4): 501-511.
Chen H, Chen Y, Yang L. Intelligent early structural health prognosis with nonlinear system identification for RFID signal analysis. Comput Commun 2020; 157: 150-161.
Yang M, Abdalrahman H, Sonia U, Mohammed A, Vestine U, Wang M, Ebadi AG, Toughani M. The application of DNA molecular markers in the study of Codonopsis species genetic variation, a review. Cell Mol Biol 2020; 2: 23-30.
He L, Fang H, Wang X, Wang Y, Ge H, Li C, Chen C, Wan Y, He H. The 100 most-cited articles in urological surgery: A bibliometric analysis. Int J Surg 2020; 75: 74-79.
Nie Y, Luo F, Lin Q. Dietary nutrition and gut microflora: A promising target for treating diseases. Trends Food Sci Technol 2018; 75: 72-80.
Nie Y, Luo F, Wang L, Yang T, Shi L, Li X, Shen J, Xu W, Guo T, Lin Q. Anti-hyperlipidemic effect of rice bran polysaccharide and its potential mechanism in high-fat diet mice. Food Func 2017; 8(11): 4028-4041.
Ren Y, Jiao X, Zhang L. Expression level of fibroblast growth factor 5 (FGF5) in the peripheral blood of primary hypertension and its clinical significance. Saudi J Biol Sci 2018; 25(3): 469-473.
Yaykasli KO, Yaykasli E, Ataoglu S, Ozsahin M, Memisogulları R, í‡elebi E, Uçgun T, Ozcan ME, Uslu M, Yuce H. The frequency of omentin Val109Asp polymorphism and the serum level of omentin in patients with Rheumatoid Arthritis. Acta Medica Mediterranea 2013; 29:521-526.
Wang L, Lin Q, Yang T, Liang Y, Nie Y, Luo Y, Shen J, Fu X, Tang Y, Luo F. Oryzanol Modifies High Fat Diet-Induced Obesity, Liver Gene Expression Profile, and Inflammation Response in Mice. J Agri Food Chem 2017; 65(38): 8374-8385.