Improving Would Healing Ability by Training: Experiences of China

In China, chronic wounds are an important issue. However, wound care knowledge and the skill of health care professionals varies among hospitals and cities. A training program in wound care in China was completed in 2015 and achieved great success. To facilitate expertise in wound healing in China, a sequential training project supported by the Wound Healing Union and the Chinese Medical Doctor Association was initiated. The aim of the training program was mainly to improve experience and skills in wound healing. Until December 2016, a total of 301 medical staffs, including 134 physicians and 167 nurses, have been trained. Most of the doctors (92 of 134) and nurses (142 of 167) were from Grade IIIA/B hospitals, and there were no doctors and nurses from community hospitals. Most participants were satisfied about the training program, and more nurses were satisfied (79%) than doctors (60%). All trainees have completed 4½ months of training and passed a final examination.

Dislocation behaviors in nanotwinned diamond

Experimental results (Huang et al.) indicated that nanotwinned diamond (nt-diamond) has unprecedented hardness, whose physical mechanism has remained elusive. In this report, we categorize interaction modes between dislocations and twin planes in nt-diamond and calculate the associated reaction heat, activation energies, and barrier strength using molecular dynamics. On the basis of the Sachs model, twin thickness dependence of nt-diamond hardness is evaluated, which is in good agreement with the experimental data. We show that two factors contribute to the unusually high hardness of nt-diamond: high lattice frictional stress by the nature of carbon bonding in diamond and high athermal stress due to the Hall-Petch effect. Both factors stem from the low activation volumes and high activation energy for dislocation nucleation and propagation in diamond twin planes. This work provides new insights into hardening mechanisms in nt-diamond and will be helpful for developing new superhard materials in the future.

[Moxibustion combined with highly active antiretroviral therapy for CD4+ and γ chain cytokines of HIV infected patients]

OBJECTIVE

To compare the effects of moxibustion combined with highly active antiretroviral therapy (HAART) and simple HAART for human immunodeficiency virus (HIV) infected patients.

METHODS

A total of 100 patients with HIV receiving HAART were randomized into an observation group and a control group, 50 cases in each one. In the observation group, moxibustion was used at Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6), etc. combined with HAART of zidovudine, lamivudine, nevirapine and efavirenzone, etc. Simple HAART was used in the control group. The patients were observed for 18 months. The indexes were CD₄⁺, CD₄⁺/CD₈⁺, interleukin 2 (IL-2), interleukin 7 (IL-7), the incidence of side effects and the score of quality of life.

RESULTS

After treatment, CD₄⁺, CD₄⁺/CD₈⁺, serum IL-2 and the scores of quality of life (physiological, psychological, social relation fields and comprehensive score) increased and serum IL-7 decreased compared with those before treatment in the two groups (P<0.01, P<0.05), with better results except CD₄⁺ in the observation group (P<0.01, P<0.05). The incidences of gastrointestinal side effects and total side effects in the observation group were lower than those in the control group (14% (7/50) vs 32% (16/50), 58% (29/50) vs 80% (40/50), both P<0.05).

CONCLUSION

Moxibustion combined with HAART for HIV infected patients could reduce the incidence of side effects, improve medication compliance, CD₄⁺/CD₈⁺, IL-2, IL-7 and the quality of life.

Highly Selective and Sensitive Detection of Pb2+ in Aqueous Solution Using Tetra(4-pyridyl)porphyrin-Functionalized Thermosensitive Ionic Microgels

Tetra(4-pyridyl)porphyrin (TPyP)-functionalized thermosensitive ionic microgels (TPyP5-MGs) were synthesized by a two-step quaternization method. The obtained TPyP5-MGs have a hydrodynamic radius of about 189 nm with uniform size distribution and exhibit thermosensitive character. The TPyP5-MG microgel suspensions can optically respond to trace Pb²⁺ ions in aqueous solution with high sensitivity and selectivity over the interference of other 19 species of metal ions (Yb³⁺, Gd³⁺, Ce³⁺, La³⁺, Bi³⁺, Ba²⁺, Zn²⁺, Ni²⁺, Co²⁺, Mn²⁺, Cr³⁺, K⁺, Na⁺, Li⁺, Al³⁺, Cu²⁺, Ag⁺, Cd²⁺, and Fe³⁺) by using UV-visible spectroscopy. The sensitivity of TPyP5-MGs toward Pb²⁺ can be further improved by increasing the solution temperature. The limit of detection for TPyP5-MG microgel suspensions in the detection of Pb²⁺ in aqueous solution at 50 °C is about 25.2 nM, which can be further improved to be 5.9 nM by using the method of higher order derivative spectrophotometry and is much lower than the U. S. EPA standard for the safety limit of Pb²⁺ ions in drinking water. It is further demonstrated that the TPyP5-MG microgel suspensions have a potential application in the detection of Pb²⁺ in real world samples, which give consistent results with those obtained by elemental analysis.

Feasibility and effectiveness of percutaneous balloon mitral valvuloplasty under echocardiographic guidance only

OBJECTIVE

Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice in patients with isolated mitral stenosis. This study aimed to assess the feasibility of PBMV under echocardiography guidance only of isolated mitral stenosis (MS).

METHODS

From October 2016 to Dec 2017, 20 consecutive patients with severe MS underwent PBMV with echocardiography as the only imaging modality at a single center. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography was conducted at 1, 3,6, and 12 months after the procedure.

RESULTS

All 20 patients successfully underwent PBMV under echocardiography guidance without radiation and contrast agent. Among them, 2 patients were pregnant, 5 had chronic renal failure, and 1 had history of allergy to contrast. Mitral transvalvular pressure gradient measured at catheterization dropped from 13.35 ± 2.85 mm Hg to 5.10 ± 1.17 mm Hg (P < .01). Mitral valve area increased from 0.82 ± 0.10 cm² pre-PBMV to 1.88 ± 0.24 cm² post-PBMV (P < .01). Mean balloon diameter was 26.63 ± 0.93 mm. Mild mitral regurgitation developed in 6 patients. Mean follow-up duration was 6.27 ± 3.12 months. At last follow-up, mitral valve area remained high (1.71 ± 0.14 cm² ) and mean transmitral pressure gradient low (6.07 ± 1.03 mm Hg). No pericardial effusion or peripheral vascular complications occurred.

CONCLUSION

In this small experience, PBMV could be successfully performed under only echocardiography guidance and appeared safe and effective while avoiding radiation and contrast agent use.

The use of fluorescent techniques in combination with flow cytometry for fast counting of Bifidobacterium longum ATCC BAA-2753 in BIFICO capsule

BIFICO is a main microecological drug that the main ingredient is Bifidobacterium longum ATCC BAA-2753. It's necessary to detect the number of Bifidobacterium longum ATCC BAA-2753 for quality control during the production of BIFICO. Plate count assay (PCA) is the most commonly used method for counting microbial cells. However, not all microorganisms can be counted by PCA. (e.g. uncultured microorganisms under specific growth conditions). In this study, a method of fluorescent techniques in combination with flow cytometry (FCM) was established for the counting of Bifidobacterium longum BAA-2753. Using SYTO9 and PI stain, flow cytometric analysis could easily differentiate live bacteria and dead bacteria. The number of live bacteria determined by FCM was about fourfold higher than that counted by PCA. Therefore, the FCM method could be a practical tool for the quality control of Bifidobacterium longum BAA-2753 in the industrial production of BIFICO.

Engineering Bulk, Layered, Multicomponent Nanostructures with High Energy Density

The precise control of individual components in multicomponent nanostructures is crucial to realizing their fascinating functionalities for applications in electronics, energy-conversion devices, and biotechnologies. However, this control remains particularly challenging for bulk, multicomponent nanomaterials because the desired structures of the constitute components often conflict. Herein, a strategy is reported for simultaneously controlling the structural properties of the constituent components in bulk multicomponent nanostructures through layered structural design. The power of this approach is illustrated by generating the desired structures of each constituent in a bulk multicomponent nanomaterial (SmCo + FeCo)/NdFeB, which cannot be attained with existing methods. The resulting nanostructure exhibits a record high energy density (31 MGOe) for this class of bulk nanocomposites composed of both hard and soft magnetic materials, with the soft magnetic fraction exceeding 20 wt%. It is anticipated that other properties beyond magnetism, such as the thermoelectric and mechanical properties, can also be tuned by engineering such layered architectures.

Appropriate dose of Lactobacillus buchneri supplement improves intestinal microbiota and prevents diarrhoea in weaning Rex rabbits

This study examined the effects on intestinal microbiota and diarrhoea of Lactobacillus buchneri supplementation to the diet of weaning Rex rabbits. To this end, rabbits were treated with L. buchneri at two different doses (LC: 104 cfu/g diet and HC: 105 cfu/g diet) for 4 weeks. PCR-DGGE was used to determine the diversity of the intestinal microbiota, while real-time PCR permitted the detection of individual bacterial species. ELISA and real-time PCR allowed the identification of numerous cytokines in the intestinal tissues. Zonula occludens-1, polymeric immunoglobulin receptor and immunoglobulin A genes were examined to evaluate intestinal barriers. Results showed that the biodiversity of the intestinal microbiota of weaning Rex rabbits improved in the whole tract of the treated groups. The abundance of most detected bacterial species was highly increased in the duodenum, jejunum and ileum after L. buchneri administration. The species abundance in the HC group was more increased than in the LC group when compared to the control. Although the abundance of Enterobacteriaceae exhibited a different pattern, Escherichia coli was inhibited in all treatment groups. Toll-like receptor (TLR)2 and TLR4 genes were down-regulated in all intestinal tissues as the microbiota changed. In the LC group, the secretion of the inflammatory cytokine tumour necrosis factor-α was reduced, the gene expression of the anti-inflammatory cytokine interleukin (IL)-4 was up-regulated and the expression of intestinal-barrier-related genes was enhanced. Conversely, IL-4 expression was increased and the expression of other tested genes did not change in the HC group. The beneficial effects of LC were greater than those of HC or the control in terms of improving the daily weight gain and survival rate of weaning Rex rabbits and reducing their diarrhoea rate. Therefore, 104 cfu/g L. buchneri treatment improved the microbiota of weaning Rex rabbits and prevented diarrhoea in these animals.

Microbiome of Total Versus Live Bacteria in the Gut of Rex Rabbits

Gastrointestinal bacteria are essential for host health, and only viable microorganisms contribute to gastrointestinal functions. When evaluating the gut microbiota by next generation sequencing method, dead bacteria, which compose a proportion of gut bacteria, may distort analysis of the live gut microbiota. We collected stomach, jejunum, ileum, cecum, and colon contents from Rex rabbits. A modified propidium monoazide (PMA) treatment protocol was used to exclude DNA from dead bacteria. Analysis of untreated samples yielded total bacteria, and analysis of PMA-treated samples yielded live bacteria. Quantitative polymerase chain reaction and 16S rRNA gene sequencing were performed to evaluate the live-to-total bacteria ratio and compare the difference between live and total microbiota in the entire digestive tract. A low proportion of live bacteria in the foregut (stomach 1.12%, jejunum 1.2%, ileum 2.84%) and a high proportion of live bacteria in the hindgut (cecum 24.66%, colon 19.08%) were observed. A significant difference existed between total and live microbiota. Clostridiales, Ruminococcaceae, and S24-7 dominated the hindgut of both groups, while Acinetobacter and Cupriavidus dominated only in live foregut microbiota. Clostridiales and Ruminococcaceae abundance decreased, while S24-7 increased in live hindgut microbiota. The alpha- and beta-diversities differed significantly between groups. Analysis of networks showed the mutual relationship between live bacteria differed vastly when compared with total bacteria. Our study revealed a large number of dead bacteria existed in the digestive tract of Rex rabbits and distorted the community profile of the live microbiota. Total bacteria is an improper representation of the live gut microbiota, particularly in the foregut.

Seed dormancy-life form profile for 358 species from the Xishuangbanna seasonal tropical rainforest, Yunnan Province, China compared to world database

Seed dormancy profiles are available for the major vegetation regions/types on earth. These were constructed using a composite of data from locations within each region. Furthermore, the proportion of species with nondormant (ND) seeds and the five classes of dormancy is available for each life form in each region. Using these data, we asked: will the results be the same if many species from a specific area as opposed to data compiled from many locationsare considered? Germination was tested for fresh seeds of 358 species in 95 families from the Xishuangbanna seasonal tropical rainforest (XSTRF): 177 trees, 66 shrubs, 57 vines and 58 herbs. Seeds of 12.3% of the species were ND, and 0.3, 14.8, 60.6, 12.0 and 0% of the species had morphological (MD), morphophysiological (MPD), physiological (PD), physical (PY), and combinational (PY + PD) dormancy, respectively. PD was more important than ND in all life forms, PY was highest in shrubs, MD was not important in any life form and MPD was most common for herb and vines. The seed dormancy profile for XSTRF differs considerably from the composite profile for this vegetation type worldwide, most obviously in ND being much lower and PD much higher in XSTRF.

Structural and dynamic properties of the C-terminal region of the Escherichia coli RNA chaperone Hfq: integrative experimental and computational studies

In Escherichia coli, hexameric Hfq is an important RNA chaperone that facilitates small RNA-mediated post-transcriptional regulation. The Hfq monomer consists of an evolutionarily conserved Sm domain (residues 1-65) and a flexible C-terminal region (residues 66-102). It has been recognized that the existence of the C-terminal region is important for the function of Hfq, but its detailed structural and dynamic properties remain elusive due to its disordered nature. In this work, using integrative experimental techniques, such as nuclear magnetic resonance spectroscopy and small-angle X-ray scattering, as well as multi-scale computational simulations, new insights into the structure and dynamics of the C-terminal region in the context of the Hfq hexamer are provided. Although the C-terminal region is intrinsically disordered, some residues (83-86) are motionally restricted. The hexameric core may affect the secondary structure propensity of the C-terminal region, due to transient interactions between them. The residues at the rim and the proximal side of the core have significantly more transient contacts with the C-terminal region than those residues at the distal side, which may facilitate the function of the C-terminal region in the release of double-stranded RNAs and the cycling of small non-coding RNAs. Structure ensembles constructed by fitting the experimental data also support that the C-terminal region prefers to locate at the proximal side. From multi-scale simulations, we propose that the C-terminal region may play a dual role of steric effect (especially at the proximal side) and recruitment (at the both sides) in the binding process of RNA substrates. Interestingly, we have found that these motionally restricted residues may serve as important binding sites for the incoming RNAs that is probably driven by favorable electrostatic interactions. These integrative studies may aid in our understanding of the functional role of the C-terminal region of Hfq.

Microplastics have a more profound impact than elevated temperatures on the predatory performance, digestion and energy metabolism of an Amazonian cichlid

Knowledge on the impacts of microplastics (MPs) pollution on freshwater environments and biota remains limited. Meanwhile, freshwater ecosystems have been threatened by elevated temperatures caused by climate change. To date, no information exists on how MPs-especially under elevated temperature conditions-affect predatory performance, digestive processes and metabolic pathways in freshwater organisms. Here, we examined MPs, elevated temperature and their combined effects on juveniles (0+ group) of an Amazonian cichlid, the discus fish (Symphysodon aequifasciatus). For 30 days, fish were exposed to ambient or elevated temperatures (i.e., 28 or 31 °C) in the absence or presence of MPs (i.e., 0 or 200 μg/L). The following metrics were quantified: MPs accumulation; predatory performance; and biomarkers involved in neurotransmission, digestion and energy production. The results showed that survival rate and body length were not affected by MPs, elevated temperatures or their combination. Elevated temperatures resulted in an increase in MP concentrations in fish bodies. Exposure to MPs decreased the post-exposure predatory performance (PEPP) at ambient temperatures but not at elevated temperatures. Elevated temperatures, however, had no effect on the PEPP but antagonistically interacted with MPs, leading to similar predatory performances under present and future conditions. Acetylcholinesterase (AChE) activity was only affected by MPs and decreased in the presence of MPs, indicating adverse effects in nervous and neuromuscular function and, thus, potentially in predatory performance. Trypsin activity was only influenced by MPs and decreased during exposure to MPs. Elevated temperatures or MPs alone increased the amylase activity but interacted antagonistically. Lipase activity was not influenced by either of the two stressors. In contrast, alkaline phosphatase (ALP) activity was affected by MPs or elevated temperatures alone and decreased with both stressors. Such results indicate deficits in the digestive capabilities of early-stage S. aequifasciatus under elevated temperature conditions and especially during exposure to MPs. Electron transport system (ETS) activity was not influenced by either of the two stressors. Both elevated temperatures and MPs alone increased LDH activity; however, the interaction between the two stressors cancelled activity but was still higher than activity in present conditions. Citrate synthase (CS) activity decreased with elevated temperature but increased during exposure to MPs. Cytochrome c oxidase (COX) activity was only influenced by MPs and increased in the presence of MPs. Thus, S. aequifasciatus juveniles exposed to elevated temperatures and MPs not only relied on anaerobic glycolysis for energy production but also depended on aerobic metabolism in the presence of MPs. Overall, these findings suggested that MPs showed a greater impact than elevated temperatures on the predatory performance, digestion and energy production of S. aequifasciatus. Nevertheless, juvenile survival and growth were minimally impacted, and thus, S. aequifasciatus could cope with near-future temperature increases and MP exposure.

Seed germination response to high temperature and water stress in three invasive Asteraceae weeds from Xishuangbanna, SW China

Crassocephalum crepidioides, Conyza canadensis, and Ageratum conyzoides are alien annuals naturalized in China, which produce a large number of viable seeds every year. They widely grow in Xishuangbanna, becoming troublesome weeds that compete with crops for water and nutrients. As seed germination is among the most important life-stages which contribute to plant distribution and invasiveness, its adaptation to temperature and water stress were investigated in these three species. Results showed that: (1) These three species have wide temperature ranges to allow seed germination, i.e., high germination and seedling percentages were achieved between 15°C and 30°C, but germination was seriously inhibited at 35°C; only A. conyzoides demonstrated relative preference for warmer temperatures with approximately 25% germination and seedling percentage at 35°C; (2) light was a vital germination prerequisite for C. crepidioides and A. conyzoides, whereas most C. canadensis seeds germinated in full darkness; (3) Although all three species have good adaptation to bare ground habitat characterized by high temperatures and water stress, including their tolerance to soil surface temperatures of 70°C in air-dried seeds, A. conyzoides seeds exhibited higher tolerance to both continuous and daily periodic high-temperature treatment at 40°C, and to water restriction (e.g., ca. 65% seeds germinated to -0.8 MPa created by NaCl), which is consistent with their field behavior in Xishuangbanna. This study suggests that seed high-temperature tolerance contributes to the weed attributes of these three species, and that adaptation to local micro-habitats is a critical determinant for invasiveness of an alien plant.

[Effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients]

Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy. After the treatment for 1 to 2 weeks, tissue flaps repair operations were performed. Four patients were repaired with inferior gluteal artery perforator flaps combined with long head of biceps femoris muscle flaps. Three patients were repaired with inferior gluteal artery perforator flaps combined with semimembranous muscle flaps. One patient was repaired with inferior gluteal artery perforator flap combined with gracilis muscle flap. One patient was repaired with femoral profound artery perforator flap combined with gluteus maximus muscle flap, and the distal area of femoral profound artery perforator flap of the patient which showed intraoperative cyanosis of 6 cm×4 cm was thinned to medium thickness skin to cover the muscle flap. The other eight patients showed no abnormality during operation. Size of perforator flaps ranged from 7 cm×5 cm to 14 cm×12 cm, and size of muscle flaps ranged from 11 cm×4 cm to 24 cm×6 cm. The donor sites of flaps were all sutured directly. Results: The tissue flaps and skin graft of all patients survived well after operation. During follow-up of 8 to 35 weeks, operative area of all patients showed good shape and texture, with no local diabrosis or recurrence of pressure ulcers. Conclusions: The combination of perforator flaps and muscle flaps is effective in repairing and reducing recurrence of grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients.