[Efficacy and safety of daptomycin in the treatment of gram-positive infective endocarditis: a meta-analysis]

Objective: To assess the efficacy and safety of daptomycin in the treatment of gram-positive infective endocarditis (IE) systematically. Methods: China Biology Medicine Database (CBM), China National Knowledge Internet (CNKI), Wanfang Data, VIP Database, PubMed, Embase, the Cochrane Library, and Web of Science were searched from the time of establishing databases to April 2022 to obtain relevant controlled and uncontrolled studies of daptomycin for gram-positive infective endocarditis, using key search terms ("daptomycin","gram-positive bacterial infections","endocarditis"). We performed literature screening according to inclusion/exclusion criteria, data extraction, and quality assessment, and performed random-effects meta-analyses for pooled results data using R software. Results: A total of 11 studies (including 13 articles) were included. The findings in the three controlled studies showed that in the treatment of staphylococcus aureus endocarditis, there was no statistically significant differences in in-hospital death risk (RR=0.66, 95%CI: 0.24-1.84, P=0.427) and 6-month death risk (RR=1.27, 95%CI: 0.75-2.14, P=0.374) for daptomycin versus anti-staphylococcal penicillin or vancomycin; in the treatment of enterococcal endocarditis, there was no statistically significant difference in death risk (both P>0.05) for daptomycin versus ampicillin combined with ceftriaxone (RR=0.39, 95%CI: 0.06-2.49) and ampicillin or vancomycin plus or minus gentamicin (RR=0.42, 95%CI: 0.05-3.36); and for daptomycin versus ampicillin or vancomycin combined with an aminoglycoside antibiotic, the differences in in-hospital death risk (RR=0.80, 95%CI: 0.11-5.83) and 6-month death risk (RR=0.47, 95%CI: 0.07-3.21) were not statistically significant(both P>0.05). In a cost-effectiveness study, daptomycin as first-line treatment could save the medical cost of 4 037 pounds per patient compared with vancomycin over a longer period of patient treatment. The results of the meta-analysis of uncontrolled studies showed that the mean clinical success rate of daptomycin for left-side endocarditis was 77% (95%CI: 70% to 83%; I²=28%), for MSSA-infective right-side endocarditis was 87% (95%CI: 73%-95%), and for MRSA-infective right-side endocarditis was 78% (95%CI: 38%-95%; I²=49%); while the mortality rate [mean mortality rate for left-side endocarditis was 13% (95%CI: 11%-17%; I²=0); the mortality rate for right-side endocarditis was reported in only 2 studies, 3% and 27%, respectively] or the rate of daptomycin-related adverse events (4%) was within the acceptable ranges for clinical practice. Conclusions: The death risk in the treatment of infective endocarditis with dattomycin is comparable to that of other antibiotics, and the clinical success rate is higher. Some efficacy may be achieved with daptomycin while other treatments are not effective in treating IE.

Structural origins of two-dimensional elastic bending in a nonaromatic organic molecular crystal

Mechanically flexible crystals are generally obtained based on weak interactions in the aromatic systems. Here, we reported the remarkable 2D elastic bending behaviors in a nonaromatic organic molecular crystal. The strong hydrogen bonding interactions are also verified to play a crucial role in the reversible bending.

MRI parameters for predicting the effect of ultrasound-guided high-intensity focused ultrasound in the ablation of uterine fibroids

AIM

To study the value of magnetic resonance imaging (MRI) parameters in predicting the efficacy of ultrasonic ablation of fibroids.

MATERIALS AND METHODS

A total of 91 patients were divided into groups based on non-perfused volume (NPV) ratio and blood supply type. The preoperative MRI parameters were measured and analysed. A correlation analysis between the MRI parameters and the NPV ratio was performed. Receiver operating characteristic (ROC) curves were used to analyse and determine the cut-off value of MRI parameters to predict the ablation rate of fibroids.

RESULTS

The uterine fibroids group with an NPV ratio <80% and the group with an NPV ratio of ≥80% had significant differences in signal intensity (SI) at MRI T2-weighted imaging (WI), fibroid-to-rectus abdominis SI ratio (SIR) at T2WI, and blood supply type (p<0.05). There were no significant differences in fibroid volume, T2WI signal uniformity, and apparent diffusion coefficient (ADC) values. The ADC value and SI and SIR at MRI T2WI in the group with poor blood supply were lower than those in the group with a rich blood supply (p<0.05). SI at MRI T2WI correlated negatively with the NPV ratio. The cut-off values for SI and SIR at MRI T2WI of fibroids whose NPV ratio exceeds 80% were 220.58 and 1.315, respectively.

CONCLUSION

SI at MRI T2WI and blood supply type could be predictors of the efficacy of ablation. Ultrasonic ablation of fibroids with MRI T2WI hyperintensity and a rich blood supply had poor efficacy.

Predicting Progression from Normal to MCI and from MCI to AD Using Clinical Variables in the National Alzheimer's Coordinating Center Uniform Data Set Version 3: Application of Machine Learning Models and a Probability Calculator

Clinical trials are increasingly focused on pre-manifest and early Alzheimer's disease (AD). Accurately predicting clinical progressions from normal to MCI or from MCI to dementia/AD versus non-progression is challenging. Accurate identification of symptomatic progressors is important to avoid unnecessary treatment and improve trial efficiency. Due to large inter-individual variability, biomarker positivity and comorbidity information are often insufficient to identify those destined to have symptomatic progressions. Using only clinical variables, we aimed to predict clinical progressions, estimating probabilities of progressions with a small set of variables selected by machine learning approaches. This work updates our previous work that was applied to the National Alzheimer's Coordinating Center (NACC) Uniform Data Set Version 2 (V2), by using the most recent version (V3) with additional analyses. We generated a user-friendly conversion probability calculator which can be used for effectively pre-screening trial participants.

Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Older Adults with Sarcopenia: A Randomized, Double-Blind, Placebo-Controlled Study

OBJECTIVES

Sarcopenia is recognized as a major public health concern because of its association with several adverse health events. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation reportedly delays the loss of muscle mass and function; however, the effect of HMB on sarcopenia remains inconclusive. We aimed to evaluate the impact of HMB intervention on muscle strength, physical performance, body compositions, and inflammatory factors in older adults with sarcopenia.

DESIGN

Randomized, double-blind, placebo-controlled trial.

SETTING AND PARTICIPANTS

This study included subjects aged ≥60 years with sarcopenia which were assigned to the HMB group (HMBG, n=18) and the placebo group (PG, n=16).

INTERVENTION

The HMBG and PG were supplied with HMB and placebo products twice daily for 12 weeks, and both received resistance exercise training twice a week in 12 weeks.

MEASUREMENTS

Hand grip strength was selected as the primary outcome; gait speed, five-time chair stand test, body composition and inflammatory indicators were selected as the secondary outcomes. The differences in changes from baseline between the two groups were analyzed using the analysis of covariance(ANCOVA).

RESULTS

After the 12-week intervention, the HMBG demonstrated significantly greater improvements in handgrip strength (4.61(95%CI:2.93,6.28) kg, P<0.001), gait speed (0.11(95%CI:0.02,0.20)m/s, P=0.014), five-time chair stand test (-3.65 (95%CI:-5.72, -1.58)s, P=0.001), muscle quality (2.47(95%CI:1.15,3.80),kg.kg-1 P=0.001) and tumor necrosis factor-like weak inducer of apoptosis (-15.23(95%CI:-29.80,-0.66)pmol/mL, P=0.041) compared with the PG; no significant differences in skeletal muscle mass, skeletal muscle index, and other body composition parameters were found between the two groups.

CONCLUSION

In older adults with sarcopenia, HMB significantly enhance the effect of resistance exercise training on muscle strength, physical performance, muscle quality, and reduced inflammatory factors. Therefore, HMB supplementation could be an effective treatment for sarcorpenia. The trial protocol was registered at http://www.chictr.org.cn/showproj.aspx?proj=47571 as ChiCTR2000028778.

Famine Exposure during Early Life and Risk of Cancer in Adulthood: A Systematic Review and Meta-Analysis

OBJECTIVES

Emerging evidences have explored the association between famine exposure during early life and cancer risk in adulthood, but the results remain controversial and inconsistent. This study aimed to provide a comprehensive evidence on the relation of famine exposure to later cancer risk.

DESIGN

Systematic review and meta-analysis.

METHODS

Relevant reports published up to March, 2022 were identified by searching PubMed, Embase, Web of sciences and Medline databases. Pooled relative ratios (RRs) with 95% confidence intervals (CIs) were used to evaluate the effect famine exposure on cancer risk.

RESULTS

Totally, 18 published articles with 6,061,147 subjects were included in this study. Compared with unexposed group, early life famine exposure dramatically increased the risk of cancer in adulthood (RR=1.13, 95% CI: 1.04-1.22). The pooled RRs were different in terms of sex, exposure severity, exposure period, famine type, study design type and cancer location. A remarkably elevated risk for cancer was discerned in women exposed to famine (RR=1.09, 95% CI: 1.00-1.18), severe exposure (RR=1.12, 95% CI: 1.02-1.22) and adolescence exposure (RR=1.76, 95% CI: 1.02-2.50), Chinese famine exposure (RR=1.55, 95% CI: 1.29-1.82) and cohort studies (RR=1.28, 95% CI: 1.13-1.42). Moreover, a significant association of early-life famine exposure with increased risk of breast (RR=1.16, 95% CI: 1.05-1.27) and stomach cancers (RR=1.89, 95% CI: 1.24-2.54) was observed.

CONCLUSION

This meta-analysis suggests that exposure to famine during early life may increase the risk of cancer in adulthood. The above-mentioned association is pronounced in women exposed to famine, severe exposure, adolescence exposure, Chinese famine, cohort studies, breast and stomach cancers. It is essential for decision-makers to take targeted measures for improving population awareness regarding the long-term effect of early life nutritional status.

Associations of Pain and Sarcopenia with Successful Aging among Older People in China: Evidence from CHARLS

OBJECTIVES

Sarcopenia and chronic pain are geriatric syndromes that negatively impact the lives of older people. The aim of this study was to explore the relationship among sarcopenia, pain, and successful aging among older persons participating in the China Health and Retirement Longitudinal Study (CHARLS).

DESIGN

Cohort study with a 2-year follow-up.

SETTING AND PARTICIPANTS

Data were derived from 2 waves of the CHARLS, and 4280 community-dwelling participants aged ≥ 60 years were included in the study.

METHODS

Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Successful aging was defined following Rowe and Kahn's multidimensional model. Pain was assessed by a self-reported questionnaire. A generalized estimating equation (GEE) was used to examine the associations.

RESULTS

Longitudinal results demonstrated that compared with no sarcopenia, possible sarcopenia [OR (95%CI): 0.600 (0.304~1.188)] was not significantly associated with successful aging. Pain only was strongly associated with successful aging [0.388 (0.251~0.600)], whereas the association between sarcopenia only and successful aging was weaker [0.509 (0.287~0.905)]. The likelihood of being successful aging was substantially lower in the presence of coexisting sarcopenia and pain [0.268 (0.108~0.759)].

CONCLUSIONS

Both pain and sarcopenia are significant predictors for achieving successful aging among community-dwelling older adults. Early identification of sarcopenia and pain permits the implementation of treatment strategies and presents an opportunity to mitigate the risk of being unsuccessful aging.

Author Correction: Experimental study on thioredoxin redox inhibitor 1-methylpropyl 2-imidazolyl disulfide promoting apoptosis of multiple myeloma cells in vitro and in vivo

Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (4): 1283-1292. DOI: 10.26355/eurrev_202202_28121-PMID: 35253185-published online on December 15, 2022. After publication, the authors corrected the order of the author's affiliations as follows: Q.-D. Lin1,2,3,4, L.-N. Liu1,2,3,4, X.-Y. Liu1,2, Y. Yan1,2, B.-J. Fang1,2,3,4, Y.-L. Zhang1,2,3,4, J. Zhou1,2,3,4, Y.-F. Li1,2,3,4, W.-L. Zuo1,2,3,4, Y.-P. Song1,2,3,4 1Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou City, Henan Province, China 2Henan Cancer Hospital, Zhengzhou City, Henan Province, China 3Henan Key Lab of Experimental Hematology, Zhengzhou City, Henan Province, China 4Henan Institute of Hematology, Zhengzhou City, Henan Province, China There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/28121.

Medical teachers' affective domain teaching dilemma and path exploration: a cross-sectional study

BACKGROUND

In the student-centered modern teaching environment of higher education, the affective domain was of great value to the overall development of medical students and the sustainable development of medical education. However, in the teaching practice of the medical specialty in Our country, there are still a lot of phenomena that pay attention to knowledge teaching but neglect affective education. Compared with affective domain, teachers tended to focus on the learning of specialized knowledge and skills. This paper investigated the attitudes and evaluations of teachers and students of medical school on affective education, analyzed the current situation and problems of teaching in the affective educauion of medical professions, and explored the path of combining the affective field and medical profession from the perspective of medical teachers.

METHODS

A questionnaire survey was conducted among medical teachers and students across the country. Using the self-appointed teacher scale and the student scale to obtain their ratings of all dimensions of teaching in the affective field through a free online tool called "WenJuanXing". Descriptive statistics and multiple regression analysis methods were used to analyze the data to explore the obstacles in affective education and the factors affecting the outcome of affective education.

RESULTS

A total of 523 medical teachers and 3268 medical students were surveyed, according to the results of questionnaire data analysis, there are differences in the needs of senior and lower grade students in various dimensions of affective education, and the current Chinese medical teachers carrying out affective education are facing unclear positioning and interpretation of affective education goals, lack of affective experience in teaching methods, lack of affective education evaluation norms, lack of continuity and progressivity of affective cultivation, and school organizational mechanisms need to be improved.

CONCLUSIONS

This paper had some suggestions aimed at the above problem. Firstly, It is necessary to strengthen the construction of the organizational mechanism of medical universities, provide them with guarantees and training according to the characteristics of teachers of different teaching ages, and comprehensively improve teachers' affective literacy from the inside out. Secondly, teachers should design clear progressive goals and content systems of affective education, constructing an evaluation system of affective education in the experiential teaching method.

C-H Diselenation and Monoselenation of Electron-Deficient Alkenes via Radical Coupling at Room Temperature

A new, simple, and metal-free route for the diselenation of maleimides has been first developed employing (bis(trifluoroacetoxy)iodo)benzene (PIFA) at room temperature. The present method is compatible with different functional groups, and various diselenyl maleimides were obtained in moderate to excellent yields. Moreover, this protocol further highlights the unique practical application for the functionalization of biologically relevant molecules and amino acid derivatives. Preliminary mechanism studies suggest that radicals may be involved in this novel transformation. Additionally, this protocol is also applicable for the monoselenation of maleimides by switching the reaction conditions and selenation of other electron-deficient alkenes.

[Potential application of improved hard tissue section technique in the clinical pathological diagnosis of bone and bone marrow]

Objective: To discuss the application value of hard tissue section in the clinicopathology diagnosis. Methods: From March 2021 to December 2021, bone slices of 19 patients (1 patient with osteochondroma, 2 patients with chondrosarcoma, 4 patients with osteosarcoma, 2 patients with fibrous dysplasia, 2 patients with bone metastasis from thyroid papillary carcinoma, 2 patients with osteomyelitis, 4 patients with giant cell tumor of bone, 2 patients with Ewing sarcoma) and 16 hemopathy patients were collected from the Department of Pathology, Shanghai Sixth People's Hospital. Of the osteopathy patients, there were 14 male and 5 female with a median age of 31 (10-66) years. Meanwhile, there were 7 male and 9 female with a median age of 28 (16-65) years among these hemopathy patients. Thirty-five cases were treated with modified hard tissue slicing technique and paraffin embedding technique, respectively. The advantages and disadvantages of the two methods for clinical diagnosis of bone disease were compared by Hematoxylin-Eosin staining (H&E staining), immunohistochemical staining (IHC), fluorescence in situ hybridization (FISH) and Sanger sequencing. Results: The improved resin-embedded method showed better histological morphology and cell structure. Besides, the expression of Ki67, SATB2, CD34, SMA, CD68,MPO,CD4 and CD33 in immunohistochemical staining in bone tissues which were embedded in resin were more clear in the accurate positive localization than those using paraffin-embedded. MDM2 of FISH exhibited a higher fluorescence intensity and more accurate location. Meanwhile, both methods treated with Sanger sequencing met the requirements of DNA purity and mutation detection. Conclusion: The improved hard tissue section method is simple and short time-consuming, which is suitable for optimizing the clinical bone and bone marrow pathological diagnosis process.

[Current situation and development of Chinese trauma care system]

Trauma has always been a global public health issue and urgently needed to be solved. It has great practical significance for the research of trauma care system. There are two mainstream models of trauma care system in the world. One is the prehospital care represented by the United States and the United Kingdom, which emphasizes rapid transport, and the other is the prehospital care represented by France and Germany, which emphasizes on-site care. The trauma care system was deficient in most developing countries. During the past ten years, rapid progresses have been achieved in trauma care system construction in China which refers to "Chinese regional trauma care system(CRTCS)". CRTCS is established in one administrative region, with one large tertiary hospital as trauma center and five to six secondary hospitals as trauma care sites to form the closed-cycle regional trauma triage and transportation protocols. After several years of construction and implementation, CRTCS is considered to be a feasible new trauma care system in line with the characteristics of China's national conditions, which can significantly shorten the time of trauma treatment and reduce the mortality of trauma. It is worthy of reference for developing countries.

MicroRNA-137 inhibits pituitary prolactinoma proliferation by targeting AKT2

PURPOSE

Prolactinoma is the most common type of pituitary adenoma. Most prolactinoma need medical treatment, but some of them are aggressive and require surgery. In previous decades, some miRNAs have been manifested as oncogenes or tumor suppressors. Consequently, miRNAs' abnormal expression involves tumorigenesis, invasion, and metastasis of different types of tumors, including pituitary tumors. The current study aim to explore the aggressiveness-associated miRNAs in prolactinoma and underlying molecular mechanisms based on the bioinformatic analysis and fundamental experiment studies.

METHODS

GSE46294 miRNA expression profile from the Gene Expression Omnibus (GEO) database was downloaded. Differentially expressed miRNAs (DEMs) were filtered from this data. Subsequently, the target genes of downregulated miRNAs were analyzed by Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. RT-qPCR, western blot, and CCK-8 assays were used to validate the effect of miR-137 on the proliferation of MMQ cells through AKT2. Finally, the binding site of rat miR-137 to AKT2 were predicted by Targetscan and Bibiserv database, and verified by double luciferase reporter assay.

RESULTS

Twenty-four changed DEMs (fourteen upregulated and ten downregulated) were identified. Target genes of downregulated DEMs were classified into three groups by GO terms. KEGG pathway enrichment analysis revealed these target genes enriched in the PI3K-Akt pathway. We also confirmed that miR-137 can target AKT2 and inhibit the proliferation of MMQ cells induced by AKT2.

CONCLUSION

MiR-137 suppressed prolactinomas' aggressive behavior by targeting AKT2.

An Imbalanced Fault Diagnosis Method Based on TFFO and CNN for Rotating Machinery

Deep learning-based fault diagnosis usually requires a rich supply of data, but fault samples are scarce in practice, posing a considerable challenge for existing diagnosis approaches to achieve highly accurate fault detection in real applications. This paper proposes an imbalanced fault diagnosis of rotatory machinery that combines time-frequency feature oversampling (TFFO) with a convolutional neural network (CNN). First, the sliding segmentation sampling method is employed to primarily increase the number of fault samples in the form of one-dimensional signals. Immediately after, the signals are converted into two-dimensional time-frequency feature maps by continuous wavelet transform (CWT). Subsequently, the minority samples are expanded again using the synthetic minority oversampling technique (SMOTE) to realize TFFO. After such two-fold data expansion, a balanced data set is obtained and imported to an improved 2dCNN based on the LeNet-5 to implement fault diagnosis. In order to verify the proposed method, two experiments involving single and compound faults are conducted on locomotive wheel-set bearings and a gearbox, resulting in several datasets with different imbalanced degrees and various signal-to-noise ratios. The results demonstrate the advantages of the proposed method in terms of classification accuracy and stability as well as noise robustness in imbalanced fault diagnosis, and the fault classification accuracy is over 97%.