Clinical diagnostic significance of prealbumin, cholinesterase and retinol binding protein in liver cirrhosis combined with encephalopathy

OBJECTIVE

Hepatic encephalopathy is a common consequence of liver cirrhosis, but diagnosis can be difficult as it is based on clinical criteria alone. We hypothesised that serum prealbumin, cholinesterase and retinol binding protein (RBP) can help support the diagnosis of hepatic encephalopathy.

METHODS

We enrolled 306 cirrhotic patients (110 with encephalopathy), 100 chronic hepatitis B patients and 50 healthy controls, measuring routine liver function tests (ALT, AST, GGT, ALP, and bilirubin), albumin, prothrombin time, prealbumin, cholinesterase and RBP by routine methods. Logistic regression analysis and areas under the receiver operating characteristic curves (AUCs) were used to find predictive factors for hepatic encephalopathy.

RESULTS

There were differences in all laboratory indices between the three groups (all p < 0.001). In univariate analysis, albumin, prothrombin time, prealbumin, cholinesterase and RBP were significantly altered in those with encephalopathy (p < 0.01), but only prealbumin, cholinesterase and RBP levels were significant predictors in multivariate analysis, and each was linked to the severity of liver fibrosis defined by the Child-Pugh score (all p < 0.001). The AUCs (95% CI) of prealbumin, cholinesterase and RBP for diagnosing liver cirrhosis with hepatic encephalopathy were comparable at 0.85 (81-90), 0.81 (0.76-0.85) and 0.81 (0.76-0.86), respectively (all p < 0.01).

CONCLUSIONS

Serum prealbumin, cholinesterase and RBP levels are of potential clinical value in diagnosis of liver cirrhosis complicated by encephalopathy.

Mesenchymal stem cell therapy for heart failure: a meta-analysis

BACKGROUND

Mesenchymal stem cell (MSC) treatment has emerged as an important adjunct therapy for heart failure. However, the use of MSC to treat heart failure has not been well established. We conducted a systematic review and meta-analysis to evaluate the efficacy of MSC treatment for heart failure.

METHODS

PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of MSC treatment on cardiac function in heart failure were included in this analysis. Two investigators independently searched the articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using the fixed-effect model or random-effect model when appropriate.

RESULTS

Six RCTs involving 625 patients were included in the meta-analysis. Compared with control interventions in heart failure patients, MSC treatment had no significant influence on cardiovascular death (RR = 0.76; 95% CI = 0.38-1.52; p = 0.43); however, it was associated with significantly increased left ventricular ejection fraction (LVEF; mean = 9.64; 95% CI = 7.56-11.71; p < 0.00001) and reduced rehospitalization rate (RR = 0.41; 95% CI = 0.23-0.73; p = 0.003). In addition, no significant difference between the two groups was observed for the incidence of myocardial infarction (RR = 0.72; 95% CI = 0.10-5.02; p = 0.74), the recurrence of heart failure (RR = 0.88; 95% CI = 0.28-2.81; p = 0.83), and total death (RR = 0.68; 95% CI = 0.37-1.25; p = 0.21).

CONCLUSION

Although MSC treatment can significantly improve LVEF and reduce rehospitalization rates, it does not have a significant influence on cardiovascular death, myocardial infarction, heart failure, and total death.

[Mediating effect of work engagement between job stress and depressive symptoms in State Grid employees]

Objective: To explore the relationship between job stress, work engagement and depressive symptoms of State Grid workers, and to analyze the mediating effect of work engagement between job stress and depressive symptoms. Methods: A cross-sectional survey was conducted to investigate 845 employees from a State Grid company, using the brief job stress questionnaire, the Patient Health Questionnaire (PHQ-9) and 9-item Utrecht Work Engagement Scale (UWES-9) in March 2017. Results: The average score of work engagement was 4.49±1.42, the mean value of job stress was 1.15±0.33, the average score of depressive symptoms was 6.44±4.30, and the positive rate of depressive symptoms was 66.9%.There was a negative correlation between work engagement with both job stress and depressive symptoms (r=-0.193, -0.397, both P<0.01) , and job stress was positively correlated with depressive symptoms (r=0.260, P<0.01) . The relationship between job stress and depressive symptoms was partly mediated by work engagement, and the mediating effect accounted for 27.2% of the total effect. Conclusion: The work engagement of State Grid staff acts as the mediator between job stress and depressive symptoms, alleviating the depressive symptoms caused by job stress.

[Association between Long Working Hours and Job Stress and Depression among Employees from a State Grid Company]

Objective: This study was to understand the current situation of long working hours and identify the association of long working hours and job stress and depression among workers from one district company of state grid. Methods: The project was done with the cross-sectional survey. All questionnaires were completed by self-administered with informed consent. Employees' weekly working hours was reported by themselves; Using the PHQ-9 scale to assess depression, the JDC Model to evaluate job stress, and SPSS software to analyze data, the single factor chi-square test and multivariate Logistic analysis were performed to identify the association between long working hours and job stress, depression. Results: there were 35.3 percent employees with over 44 hours a week. The association between increasing weekly working hours and job stress and depression was statistically significant. Compared to the reference group (≤44 h) , for those who worked more than 44 hours per week, the odds ratio of job stress was 2.02 (95%CI=1.27-3.23) times increased, and the odds ratio of depression was 1.60 (95%CI=1.01-2.55) times increased, especially for those (≥60 h) , the odds ratio was 3.69 (95%CI=1.45-9.41) and 2.76 (95%CI=1.09-7.03) respectively. Conclusion: Long working hours can significantly increase the risk of job stress and depression among workers. When their weekly working hours exceeds 60, long working hours will be the independent risk factor for both job stress and depression.

[A retrospective comparative study of continuous pumping for home enteral nutrition after esophagectomy]

Objective: To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. Methods: The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (n=56) and traditional tube feeding group (n=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ(2) test, Fisher exact test and t test, respectively. Results: Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ(2)=2.393, P=0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (t=7.720, P=0.000); the general enteral complications were significantly lower (26/52 vs. 5/56, χ(2)=22.225, P=0.000), the nutritional support complete rate was significantly higher (23/52 vs. 55/56, χ(2)=39.167, P=0.000). Conclusions: Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.

[Analysis of 124 Suicide Cases in Wuhua District in Kunming]

OBJECTIVES

To analyze the relationship between the suicide method and the sex, age, education background and cause of suicide to provide reference for the forensic identification of suicide.

METHODS

After scene investigation, external body examination, autopsy and case investigation, 124 identified suicide cases which happened in recent three years in Wuhua district in Kunming were collected. Analytical methods as chi-square test and descriptive statistics were performed by SPSS 22.0.

RESULTS

In all the suicide cases, male to female ratio was 1.53∶1. The suicide methods were mainly fatal fall, hanging and drowning. The ratio of local to non-native residents was 1∶1. The suicide rate in the people with primary school or junior middle school education level was highest. The group of >10-50 years tended to choose fatal fall suicide and people over 60 years were more likely to choose hanging. People with different academic background tended to choose fatal fall suicide. The suicide methods as fatal fall and hanging were chosen because of mental and physical diseases and economic problems, while the suicides with emotional problems were more likely to choose fatal fall and poisoning.

CONCLUSIONS

Suicide belongs to a kind of complex cases. For the cases of suspected suicide, complete exploration and overall consideration should be done to determine the nature of cases based on comprehensive analysis of all the influence factors.

[Analysis of relationship between (18)F-FDG PET/CT SUVmax of esophageal squamous cell carcinoma before treatment and postoperative survival]

Objective: To evaluate the value of (18)F-FDG PET/CT in predicting long-term survival of esophageal squamous cell carcinoma(ESCC) before initial treatment. Methods: A total of 167 ESCC patients were retrospectively analyzed who underwent surgery between January 2010 and December 2014 in prospective database of Peking University Cancer Hospital Thoracic Surgery Department One, all cases were included according to inclusion and exclusion criteria.The relationship between SUVmax of the primary tumor and patients' age, gender, tumor location, tumor differentiation, tumor regression grade as well as long term survival were compared. Results: The median follow-up time of the 167 cases was 46.9 months(ranging from 30.5 to 86.2 months), with 1 year and 3 years postoperatively being 95.1% and 68.4%, respectively.The SUVmax of the tumor was positively correlated with cT(P<0.01), cN(P=0.033), cTNM(P=0.002) and pTNM(P=0.003)of the tumor.Patients with SUVmax ≤6 obtained a survival significantly better compared with patients with SUVmax>6, the 3 years OS were 83.4 % vs 65.6% (P=0.02) , and DFS were 82.4% vs 55.4%(P=0.006), respectively.The multivariate regression analysis demonstrated that the SUVmax>6 before treatment was the independent prognostic factor for OS (HR=3, 95%CI 1.050-8.568) and DFS (HR=3.971, 95% CI 1.408-11.200) of the ESCC patients. Conclusions: The higher the (18)F-FDG PET/CT SUVmax of the ESCC primary tumor, the poorer survival of the patients. Therefore, SUVmax could be used as an indicator to predict long term survival of the ESCC patients before treatment.

Design, synthesis, insecticidal activity and 3D-QSR study for novel trifluoromethyl pyridine derivatives containing an 1,3,4-oxadiazole moiety

A series of trifluoromethyl pyridine derivatives containing 1,3,4-oxadiazole moiety was designed, synthesized and bio-assayed for their insecticidal activity. The result of bio-assays indicated the synthesized compounds exhibited good insecticidal activity against Mythimna separata and Plutella xylostella, most of the title compounds show 100% insecticidal activity at 500 mg L⁻¹ and >80% activity at 250 mg L⁻¹ against the two pests. Compounds E18 and E27 showed LC₅₀ values of 38.5 and 30.8 mg L⁻¹ against Mythimna separata, respectively, which were close to that of avermectin (29.6 mg L⁻¹); compounds E5, E6, E9, E10, E15, E25, E26, and E27 showed 100% activity at 250 mg L⁻¹, which were better than chlorpyrifos (87%). CoMFA and CoMSIA models with good predictability were proposed, which revealed the electron-withdrawing groups with an appropriate bulk at 2- and 4-positions of benzene ring could enhance insecticidal activity.

Novel trifluoromethyl pyridine derivatives bearing 1,3,4-oxadiazole whereas synthesized, their which showed good insecticidal activity; a 3D-QSAR model with good predictability was is proposed.

PRAS40 promotes NF-κB transcriptional activity through association with p65

PRAS40 has been shown to have a crucial role in the repression of mammalian target of rapamycin (mTOR). Nonetheless, PRAS40 appears to have an oncogenic function in cancer cells. Whether PRAS40 mediates signaling independent of mTOR inhibition in cancer cells remains elusive. Here PRAS40 overexpression in lung adenocarcinoma and cutaneous melanoma was significantly correlated to worse prognosis. And we identified an unexpected role for PRAS40 in the regulation of nuclear factor (NF)-κB signaling. P65, a subunit of the NF-κB transcription factor complex, was confirmed to associate with PRAS40 by glutathione S-transferase co-precipitation. Importantly, we found that PRAS40 can enhance NF-κB transcriptional activity in a manner dependent upon PRAS40–P65 association. Furthermore, we found that a small p65-derived peptide can disrupt the PRAS40–P65 association and significantly decrease NF-κB transcriptional activity. These findings may help elucidate the pleiotropic functions of PRAS40 in cells and suggest a novel therapeutic strategy in cancer patients with high expression of PRAS40 and NF-κB.

RNAi of Grp78 may disturb the fusion of ICR mouse palate cultured in vitro

RNA interference (RNAi) is a powerful tool to silence or minimize gene expression, and palate culture in vitro is an important technique for study of the palate development. Our previous study demonstrated that the gene expression of glucose-regulated protein-78 (Grp78) was downregulation in the all-trans retinoic acid-induced mouse models of cleft palate (CP) during embryogenesis. To find the role of Grp78, the small interfering RNA (siRNA) of this gene carried by fluorescent vector was injected with a microinjector, through which about 30 pmol siRNA was injected into the Institute of Cancer Research (ICR) mouse palate explants. After 6, 12, 24, 48, and 72 h, these palate explants were removed from culture to observe their fluorescent and Alcian blue-staining phenotypes, and the expression of the unfolded protein response (UPR) key members (Grp78, Inositol-responsive enzyme 1, protein kinase RNA-like endoplasmic reticulum kinase, activating transcription factor-6 and X-box binding protein-1) was measured. After cultured for 72 h, the partially or completely fused bilateral palates were observed in the control siRNA group, while CPs were found in the Grp78 siRNA group. In the Grp78 siRNA group, the relatively mRNA abundance of the key genes belonged to UPR at each time point was lower than that of the control siRNA group, and their protein expression also displayed the same change. By the system of RNAi strategies with mouse palate culture, we found the siRNA of Grp78 disturbed the fusion of mouse palate cultured in vitro.

[Workplace social capital and intention to stay among Chinese nurses: a structural equation model]

Objective: To explore a model that workplace social capital is associated with intention to stay (ITS) in the nursing profession and that this association is partially mediated by organizational commitment, job satisfaction, and job stress among Chinese nurses. Methods: A cross-sectional, observationalstudy was conducted in Shanghai, China between September and December 2014. Two thousandforty-two nurses from 23 healthcare organizations were recruited for the current study using a two-stage sampling process.Intention to stay, workplace social capital, job satisfaction, organizational commitment, and job stress was measured by validated scale. Measured variable path analysis (MVPA) was used to test their hypothesized relationships. Results: There were significant positive direct effects from workplace social capital (β=0.11, P<0.01) , organizational commitment (β=0.81, P<0.01) and job satisfaction (β=0.03, P<0.01) to ITS, and a negative direct effects from job strain to ITS (β=-0.03, P<0.01) . The model explained 84% of the variability in ITS. Additionally, workplace social capital had significant positive direct effects on organizational commitment (β=0.65, P<0.01) , job satisfaction (β=0.44, P<0.01) and negative direct effects on job strain (β=-0.35, P<0.01) . The indirect effect of social capital to ITS was 0.55. Job satisfaction was positively associated with organizational commitment (r=0.47, P<0.01) , and negtively associated with job stress (r=-0.12, P<0.01) . Job stress was negtively associated with organizational commitment (r=-0.20, P<0.01) . Conclusion: This study suggests that greater workplace social capital may lead to higher ITS in nursing primarily by increasing commitment to the nursing occupation and their job satisfaction and by reducing their sense of job stress.

Two new molybdates based on ∞[MonO3n+1]2− units (n = 11, 4) with proton conduction under ionothermal

Two new members of the _∞[Mo_nO_3n+1]²⁻ family with high proton conduction synthesized under ionothermal condition.

A prospective one-year natural history study of mucopolysaccharidosis types IIIA and IIIB: Implications for clinical trial design

Mucopolysaccharidosis type III is a group of four autosomal recessive enzyme deficiencies leading to tissue accumulation of heparan sulfate. Central nervous system disease is prominent, with initial normal development followed by neurocognitive decline leading to death. In order to define outcome measures suitable for gene transfer trials, we prospectively assessed disease progression in MPS IIIA and IIIB subjects >2years old at three time points over one year (baseline, 6 and 12months). Fifteen IIIA (9 male, 6 female; age 5.0±1.9years) and ten IIIB subjects (8 male, 2 female; age 8.6±3years) were enrolled, and twenty subjects completed assessments at all time points. Cognitive function as assessed by Mullen Scales maximized at the 2.5 to 3year old developmental level, and showed a significant age-related decline over a 6month interval in three of five subdomains. Leiter nonverbal IQ (NVIQ) standard scores declined toward the test floor in the cohort by 6 to 8years of age, but showed significant mean declines over a 6month interval in those <7years old (p=0.0029) and in those with NVIQ score≥45 (p=0.0313). Parental report of adaptive behavior as assessed by the Vineland-II composite score inversely correlated with age and showed a significant mean decline over 6month intervals (p=0.0004). Abdominal MRI demonstrated increased volumes in liver (mean 2.2 times normal) and spleen (mean 1.9 times normal) without significant change over one year; brain MRI showed ventriculomegaly and loss of cortical volume in all subjects. Biochemical measures included urine glycosaminoglycan (GAG) levels, which although elevated showed a decline correlating with age (p<0.0001) and approached normal values in older subjects. CSF protein levels were elevated in 32% at enrollment, and elevations of AST and ALT were frequent. CSF enzyme activity levels for either SGSH (in MPS IIIA subjects) or NAGLU (in MPS IIIB) significantly differed from normal controls. Several other behavioral or functional measures were found to be uninformative in this population, including timed functional motor tests. Our results suggest that cognitive development as assessed by the Mullen and Leiter-R and adaptive behavior assessment by the Vineland parent interview are suitable functional outcomes for interventional trials in MPS IIIA or IIIB, and that CSF enzyme assay may be a useful biomarker to assess central nervous system transgene expression in gene transfer trials.

A review of the clinical approach to persistent pain following total hip replacement

Total hip arthroplasty is effective in reducing pain and improving functional outcome for a variety of hip pathologies. Approximately 27% patients, however, complain of pain at 6 months' follow-up following surgery. The pain may worsen over time and can become severe and chronic in around 4% of patients who ultimately require revision surgery. Therefore, it is important for clinicians to comprehensively assess patients undergoing total hip arthroplasty in order to identify the underlying pathology of a painful hip and then offer prompt treatment. Causes of hip pain after total hip arthroplasty are analysed in this article, as well as the systematic approach to evaluation and appropriate diagnostic investigations.

[Association between sense of coherence and occupational stress of workers in modern service industry in Shanghai, China]

Objective: To investigate understand the current status of the sense of coherence and occupational stress in modern service workers, and to analyze the association between occupational stress and the sense of coherence. Methods: From March to April, 2016, 834 modern service workers from 3 companies in Shanghai, China (in air transportation industry, marketing industry, and travel industry) were surveyed by non-ran-dom sampling. The self-completion questionnaires were filled out anonymously given the informed consent of the workers. The occupational stress questionnaire was used to evaluate occupational stress, and the Chinese version of the Sense of Coherence Scale (SOC-13) was used to assess the mental health. Results: The mean score for the sense of coherence of the respondents was 61.54±10.46, and 50.1% of them were self-rated as having occupational stress. There were significant differences in SOC score between groups with different ages, marital status, positions, lengths of service, family per capita monthly income, and weekly work hours (P<0.05). The occupational stress score differed significantly across groups with different marital status, lengths of service, and weekly work hours (P<0.05). The scores for working autonomy, social support, and occupational stress differed significantly between groups with different SOC levels (P<0.05). There were significant differences in SOC score and the distribution of low-SOC respondents between groups with different levels of working autonomy, social support, and occupational stress. High SOC is a protective factor for occupational stress (OR=0.39, 95%CI 0.26~ 0.59). Conclusion: Modern service workers in Shanghai have high SOC and moderate occupational stress. Therefore, improving SOC may reduce occupational stress.

Molecular cloning and expression analysis of Fem1b from oriental river prawn Macrobrachium nipponense

Feminization-1 homolog b (Fem1b) is one of the genes essential for male development and play central roles in sex determination of Caenorhabditis elegans. In this study, we cloned and characterized the full-length Fem1b cDNA from the freshwater prawn Macrobrachium nipponense (MnFem1b) in different tissues and at different developmental stages. Real-time quantitative reverse polymerase chain reaction (RT-qPCR) showed that the MnFem1b gene was expressed in all investigated tissues, with the highest expression level found in the testes. The results revealed that the MnFem1b gene might play roles in aspects of development of the male prawn phenotype. The RT-qPCR also revealed that MnFem1b mRNA expression was significantly increased at 10 days after metamorphosis. The expression levels in all investigated tissues showed a certain degree of sexually dimorphism, the expression levels in males were significantly higher than those in females (P < 0.05). Notably, the highest expression of MnFem1b was found in the testes. The expression of MnFem1b in different tissues indicates that it plays multiple biological functions in M. nipponense.