Improve the clinical effective decision of the oral feeding readiness in preterm infants: Revise and validate the TC-POFRAS

BACKGROUND

Currently there is limited information to guide health professionals regarding the optimal time frame to initiate safe and effective oral feedings to preterm infants. The study aims to revise and validate a streamlined version of the Traditional Chinese-Preterm Oral Feeding Readiness Assessment Scale, the TC-POFRAS®, and evaluate its construct validity in the clinical decisions regarding feeding readiness of preterm infants.

METHODS

Eighty-one clinically stable preterm infants were assessed using the TC-POFRAS for oral feeding readiness. Item-total correlation analysis was used to check if any item was inconsistent with the averaged TC-POFRAS scores. Cronbach's α coefficient was used to evaluate the inter-item consistency. Exploratory factor analysis was used to determine the coherence of variables to reorganize assessment domains. The revised version of TC-POFRAS (TC-POFRAS®) was developed and a new cut-off score based on discriminant accuracy was established.

RESULTS

Based on the results from statistical analysis, five items ("lips posture," "tongue posture," "biting reflex," "gag reflex," and "tongue cupping") were deleted from the original TC-POFRAS to form the TC-POFRAS®. The TC-POFRAS®'s global accuracy was 92.1%. The cut-off value of 19 was the one that presented the most optimization of sensitivity based on specificity. The TC-POFRAS® was reconstructed into corrected gestational age and five behavioral domains.

CONCLUSIONS

The TC-POFRAS® is considered a valid, safe, and accurate objective instrument to assist health professionals to initiate oral feeding of preterm infants.

Dietary sodium and potassium and risk of diabetes: A prospective study using data from the China Health and Nutrition Survey

AIMS

Dietary sodium and potassium intakes are well-known risk factors for cardiovascular outcomes. However, the associations between dietary sodium and potassium and diabetes are still controversial. Our study aimed to examine whether dietary sodium, potassium and the sodium-potassium ratio are associated with the risk of diabetes, based on a large sample of Chinese adults.

METHODS

The study data were from the 2004-2009 China Health and Nutrition Survey (CHNS), and 5867 participants were eligible for analysis. Sodium and potassium intakes were estimated based on three consecutive 24-h recalls at an individual level combined with a food inventory at a household level performed over the same 3-day period. Diabetes was defined as fasting glucose ≥7.0mmol/L (≥126mg/dL), HbA_1c ≥6.5% or use of antidiabetic drugs.

RESULTS

Over a mean follow-up of 4.7 years, there were 611 (10.4%) incident cases of diabetes. Participants in the higher quartiles (Q3 and Q4) of sodium intake had significantly higher risks of diabetes than those with the lowest sodium intake [Q3, RR: 1.41, 95% CI: 1.06-1.86 and Q4, RR: 1.35, 95% CI: 1.02-1.80; P<0.001 for trend]. In addition, high sodium intakes were significantly associated with levels of fasting glucose and HbA_1c (P<0.05 for trend), with similar associations also found with sodium-potassium ratios (P<0.05 for trend), but not for potassium intakes.

CONCLUSION

This study found that higher sodium intakes and sodium-potassium ratios were significantly associated with a higher risk of diabetes. Further clinical research is now necessary to confirm these results.

Associations between muscle mass, physical activity and dietary behaviour in adolescents

BACKGROUND AND OBJECTIVES

Investigations in older individuals suggest that adequate nutrition and physical activity are particularly important to skeletal muscle health; however, data in adolescents are scant and equivocal. The objective was to determine the associations among diet, physical activity and skeletal muscle mass in adolescents.

METHODS

We assessed diet with four to seven 24-h recalls and physical activity by accelerometry in 640 adolescents. Using total body measures of fat-free soft tissue mass and fat mass assessed by dual-energy X-ray absorptiometry, the skeletal muscle mass index (SMMI) was derived by adjusting fat-free soft tissue mass for fat mass in addition to height.

RESULTS

Skeletal muscle mass index (SMMI) was negatively associated with consumption of sugar-sweetened beverages (standardized beta coefficient [β] = -0.10, P = 0.001) and saturated fats (β = -0.28, P < 0.001). SMMI was positively associated with physical activity (moderate + vigorous) (β = 0.20, P < 0.001). In further analysis, we observed a significant interaction between physical activity and sugar-sweetened beverage intake on SMMI (P = 0.002).

CONCLUSION

Our study in adolescence suggests that physical activity and consumption of both sugar-sweetened beverages and saturated fats are associated with skeletal muscle mass. More importantly, our findings suggest that sugar-sweetened beverage intake may attenuate the beneficial effects of physical activity on skeletal muscle mass.

Transverse cardiac slicing and optical imaging for analysis of transmural gradients in membrane potential and Ca2+ transients in murine heart

Key points

A robust cardiac slicing approach was developed for optical mapping of transmural gradients in transmembrane potential (V_m) and intracellular Ca²⁺ transient (CaT) of murine heart.

Significant transmural gradients in V_m and CaT were observed in the left ventricle.

Frequency‐dependent action potentials and CaT alternans were observed in all ventricular regions with rapid pacing, with significantly greater incidence in the endocardium than epicardium.

The observations demonstrate the feasibility of our new approach to cardiac slicing for systematic analysis of intrinsic transmural and regional gradients in V_m and CaT.

Abstract

Transmural and regional gradients in membrane potential and Ca²⁺ transient in the murine heart are largely unexplored. Here, we developed and validated a robust approach which combines transverse ultra‐thin cardiac slices and high resolution optical mapping to enable systematic analysis of transmural and regional gradients in transmembrane potential (V_m) and intracellular Ca²⁺ transient (CaT) across the entire murine ventricles. The voltage dye RH237 or Ca²⁺ dye Rhod‐2 AM were loaded through the coronary circulation using a Langendorff perfusion system. Short‐axis slices (300 μm thick) were prepared from the entire ventricles (from the apex to the base) by using a high‐precision vibratome. Action potentials (APs) and CaTs were recorded with optical mapping during steady‐state baseline and rapid pacing. Significant transmural gradients in V_m and CaT were observed in the left ventricle, with longer AP duration (APD₅₀ and APD₇₅) and CaT duration (CaTD₅₀ and CaTD₇₅) in the endocardium compared with that in the epicardium. No significant regional gradients were observed along the apico‐basal axis of the left ventricle. Interventricular gradients were detected with significantly shorter APD₅₀, APD₇₅ and CaTD₅₀ in the right ventricle compared with left ventricle and ventricular septum. During rapid pacing, AP and CaT alternans were observed in most ventricular regions, with significantly greater incidence in the endocardium in comparison with epicardium. In conclusion, these observations demonstrate the feasibility of our new approach to cardiac slicing for systematic analysis of intrinsic transmural and regional gradients in V_m and CaT in murine ventricular tissue.

A robust cardiac slicing approach was developed for optical mapping of transmural gradients in transmembrane potential (V_m) and intracellular Ca²⁺ transient (CaT) of murine heart.

Significant transmural gradients in V_m and CaT were observed in the left ventricle.

Frequency‐dependent action potentials and CaT alternans were observed in all ventricular regions with rapid pacing, with significantly greater incidence in the endocardium than epicardium.

The observations demonstrate the feasibility of our new approach to cardiac slicing for systematic analysis of intrinsic transmural and regional gradients in V_m and CaT.

Vasculogenic mimicry in hepatocellular carcinoma contributes to portal vein invasion

Portal vein invasion (PVI) is common in hepatocellular carcinoma (HCC) and largely contributes to tumor recurrence after radical tumor resection or liver transplantation. Vasculogenic mimicry (VM) was an independent vascular system lined with tumor cells and associated with poor prognosis of HCC. The present study was conducted to evaluate the relationship between VM and portal vein invasion. A total of 44 HCC cases receiving anatomic liver resection were included in the study and were divided into groups with and without PVI. The prevalence of VM in each group was examined by CD34-PAS dual staining. The regulatory molecules of VM formation such as Notch1, Vimentin and matrix metalloproteinases (MMPs) were investigated by immunohistochemical staining. Analysis was performed to explore the association of PVI, VM and the VM regulatory molecules. PVI was found in 40.91% (18/44) cases and VM was found in 38.64% (17/44) cases in total samples. The incidence of VM was 72.22% (13/18) in PVI group while it was 15.38% (4/26) in non-PVI group (P<0.001), VM formation was positively correlated with PVI (r=0.574, P<0.001). The VM forming regulatory molecules such as Notch1, Vimentin, MMP-2 and MMP-9 were found to be correlated with PVI in HCC patients. Taken together, our results suggested that VM formation, alone with its regulatory molecules, is the promoting factor of PVI in hepatocellular carcinoma.

Phylogenetic and genomic characterization of a novel atypical porcine pestivirus in China

Atypical porcine pestivirus (APPV) has been considered a novel pestivirus and causative agent of congenital tremor type A-II. An APPV CH-GX2016 strain was characterized from newly born piglets with clinical symptoms of congenital tremor in Guangxi, China. The genome of APPV CH-GX 2016 strain was 11,475 bp in length and encoded a polyprotein composed of the 3,635 amino acids. This genome sequence exhibited 88.0% to 90.8% nucleotide sequence homology with other APPV reference sequences in GenBank. Phylogenetic analysis further showed that APPV CH-GX is a novel pestivirus compared with previously described classical pestivirus strains. Therefore, APPV is present in pigs in China.

Aliskiren vs. angiotensin receptor blockers in hypertension: meta-analysis of randomized controlled trials

BACKGROUND

Aliskiren, a newly discovered renin inhibitor, blocks the renin-angiotensin system (RAS) from the top of the enzyme cascade and therefore, might provide comparable or even superior clinical efficacy of blood pressure (BP) control than angiotensin receptor blockers (ARBs). With this meta-analysis, we aimed to compare the efficacy and tolerability of aliskiren and ARBs in the treatment of hypertension in the short-term treatment period.

METHODS

Reports of randomized controlled trials (RCTs) comparing aliskiren and ARBs in patients with hypertension were selected by a search of the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. The main outcome measures were reduction in diastolic BP (DBP) and systolic BP (SBP) and rates of therapeutic response and BP control. We also compared the tolerability of aliskiren and ARBs. Revman v5.0 was used to obtain the pooled estimates.

RESULTS

We analyzed data from 10 reports of trials involving 3,732 participants. DBP and SBP reduction did not differ between aliskiren and ARBs (weighted mean difference (WMD), -0.18; 95% confidence interval (CI), -1.07 to 0.71, and WMD, 0.15; 95% CI, -1.38 to 1.69, respectively). Aliskiren and ARB treatment did not differ in rates of BP control or therapeutic response. Moreover, aliskiren and ARB treatment led to a similar number of adverse events, severe adverse events, and withdrawal due to adverse events.

CONCLUSION

Aliskiren is as effective as ARBs (losartan, valsartan, and irbesartan) in controlling BP and does not differ from ARBs in risk of adverse events.

Multimodality imaging of hypoxia in preclinical settings

Hypoxia has long been recognized to influence solid tumor response to therapy. Increasingly, hypoxia has also been implicated in tumor aggressiveness, including growth, development and metastatic potential. Thus, there is a fundamental, as well as a clinical interest, in assessing in situ tumor hypoxia. This review will examine diverse approaches focusing on the preclinical setting, particularly, in rodents. The strategies are inevitably a compromise in terms of sensitivity, precision, temporal and spatial resolution, as well as cost, feasibility, ease and robustness of implementation. We will review capabilities of multiple modalities and examine what makes them particularly suitable for investigating specific aspects of tumor pathophysiology. Current approaches range from nuclear imaging to magnetic resonance and optical, with varying degrees of invasiveness and ability to examine spatial heterogeneity, as well as dynamic response to interventions. Ideally, measurements would be non-invasive, exploiting endogenous reporters to reveal quantitatively local oxygen tension dynamics. A primary focus of this review is magnetic resonance imaging (MRI) based techniques, such as ¹⁹F MRI oximetry, which reveals not only hypoxia in vivo, but more significantly, spatial distribution of pO₂ quantitatively, with a precision relevant to radiobiology. It should be noted that preclinical methods may have very different criteria for acceptance, as compared with potential investigations for prognostic radiology or predictive biomarkers suitable for use in patients.

Acyl-CoA Z9- and Z10-desaturase genes from a New Zealand leafroller moth species, Planotortrix octo

Two cDNAs encoding acyl-CoA Z9-desaturase from the fat body and Z10-desaturase from the pheromone gland of the greenhead leafroller moth, Planotortrix octo, were obtained by RACE PCR. The Z9-desaturase (Pocto-Z9) cDNA spans 2291 nt with an ORF encoding a 352 amino-acid protein, which has 65% identity to Trichoplusia ni Delta 9 desaturase (Tni-Z9). The Z10-desaturase (Pocto-Z10) cDNA spans 2777 nt with an ORF encoding a protein with 356 amino acids. Pocto-Z10 shows lower identity to Pocto-Z9 and Tni-Z9 (48 and 46%, respectively) and relatively higher identity to the Delta 11 desaturases of T. ni and Helicoverpa zea (57 and 56%, respectively). The ORFs of these two P. octo cDNAs were constructed into an expression vector, YEpOLEX, that complemented the unsaturated fatty acid (UFA) auxotrophy of a desaturase-deficient ole1 strain of Saccharomyces cerevisiae. Expression of Pocto-Z9 produced a 5:2 ratio of Z9-16 and Z9-18 acids, with minor amounts (<4%) of Z9-14, Z9-15, and Z9-17 acids. Pocto-Z10 was successfully expressed in the YEpOLEX system when complemented with Z11-18:Me, and the major desaturase product proved to be Z10-16:Acid. The results confirm the regio- and stereo-selectivity of this unusual Delta 10 desaturase.

A 4-year follow-up study of women with Norplant-2 contraceptive implants

One-hundred-thirty of 178 women who received Norplant-2 implants were followed prospectively for 4 years. Menstrual disorders were the most common reason for discontinuation. Only one patient conceived, for a failure rate of 0.6%.

S-nitrosylation is emerging as a specific and fundamental posttranslational protein modification: head-to-head comparison with O-phosphorylation

Nitric oxide (NO) is a free-radical product of mammalian cell metabolism that plays diverse and important roles in the regulation of cell function. Biological actions of NO arise as a direct consequence of chemical reactions between NO or NO-derived species and protein targets. Reactions of NO with transition metals in target proteins have garnered the most attention to date as the principal mechanism of NO signaling; nonetheless, S-nitrosylation of protein Cys residues is rapidly moving to center stage in importance. In general, however, there has been a delay in adequate appreciation of the role of S-nitrosylation in biological signaling by NO. This lag is attributed to a poor understanding of the basis for selective targeting of NO to particular thiols, and methodological limitations in accurately quantifying this modification--recent breakthroughs in concepts and methods diminish these barriers. Here, we consider the wheres and whys of protein S-nitrosylation and its basis for specificity. Protein S-nitrosylation potentially represents a ubiquitous and fundamental mechanism for posttranslational control of protein activity on a par with that of O-phosphorylation.

N-linked oligosaccharides of vomeromodulin, a putative pheromone transporter in rat

Vomeromodulin, a putative pheromone transporter of the rat vomeronasal organ, was isolated by lectin chromatography, purified, and subjected to a mass spectrometric (MS) system of glycan structural determination. Through a combination of exoglycosidase treatments and measurements by matrix-assisted laser desorption/ionization MS, the N-glycans of vomeromodulin were identified as mainly sialylated and fucosylated biantennary structures. The microheterogeneity of N-glycan structures was also due to the presence of galactose residues with different types of linkages.

Dynamic study of nitric oxide and endothelin-1 during endotoxin shock and effects of their antagonists on hemodynamics

OBJECTIVE

To examine the relationship between the profound hypotension in endotoxic shock and the dynamic changes of nitric oxide (NO) and endothelin-1 (ET-1), so as to figure out which of the NO or ET-1 was more involved in the pathogenesis of endotoxic shock. And to investigate whether an offset of their opposite vasoactive effects would occur during endotoxic shock.

METHODS

24 rabbits were anesthetized and instrumented for recording hemodynamics. Endotoxin (E. coli 026: B6, 600 micrograms/kg) was bolus injected intravenously and the animals were randomly divided into four groups. Group I was control without any more intervention, and Group II, III, IV received bolus injections of L-NMA (10 mg/kg), phosphoramidon (2 mg/kg) or dexamethasone (2 mg/kg) respectively at 30 min post-endotoxin. Plasma NO3-, ET-1 and hemodynamics were measured at regular intervals. Their relationships were compared and analysed.

RESULTS

Plasma ET-1 achieved its peak level at 60 min post-endotoxin, and then waned. Plasma NO3- started rising at 120 min post-endotoxin, then progressive increase continued till the last measurement at 180 min post-endotoxin. The decrease of blood pressure was significant at about 120 min post-endotoxin and further went down until death. The changes of hemodynamics and NO showed a quite close temporal correspondence between the increase of NO and the decrease of blood pressure. L-NMA and phosphoramidon obviously reduced the plasma levels of NO and ET-1 to below their respective baseline levels, and showed transient effect of increase on blood pressure. Soon afterwards, however, the status of hemodynamics was aggravated. Dexamethasone just inhibited the excessive increase of NO and ET-1 during endotoxic shock without interfering their baseline levels and showed most beneficial effects on hemodynamics.

CONCLUSIONS

Both NO and ET-1 increase during endotoxic shock, but only the increase of NO has a close temporal correspondence with the decrease of blood pressure. It suggests a more important role of NO in pathogenesis of endotoxic shock. The increase of NO and ET-1 is different in time-process, which indicates that an offset of their opposite vasoactive effects would not occur. Intreference against the increase of NO and ET-1 during endotoxic shock is most beneficial when their baseline levels are maintained.

Syndet is a novel SNAP-25 related protein expressed in many tissues

SNAP-25 is a synaptosomal associated protein localized at the plasma membrane of nerve terminals. SNAP-25 associates with syntaxin 1 and vesicle-associated membrane protein-2 (VAMP-2) and is thought to form a complex essential for neurotransmitter release. We have identified syndet, a novel protein related to the family of SNAP-25 isoforms. Like SNAP-25, syndet has regions with high probability of forming coiled coils, a cysteine rich-domain, and lacks a signal sequence or transmembrane domains. Syndet is tightly bound to membranes, possibly by acylation within the cysteine-rich domain. Syndet is expressed in non-neuronal tissues. In adipocytes, syndet is found at the plasma membrane and in an intracellular compartment. The identification of syndet supports the hypothesis that multiple SNAP-25 related proteins ensure specificity of vesicle fusion at the cell surface.

[Repair of skin defects on the anterior portion of the foot with reversed dorsalis pedis flap]

Based on anatomical observations of the course of skin arteries and venous drainage of the reversed dorsalis pedis flap in 30 adult cadaversmretrograde dorsalis pedis flaps have been performed on six patients to repair their skin defects on the anterior portion of the foot. All the flaps survived without severe swelling or any necrosis. Clinical applications indicated that the blood supply and venous drainage of the flap were satisfactory. The advantages and key points of the operation were discussed in this paper.

[Experimental studies of protective effects of ischemic myocardium preconditioning and its mechanism]

Recent research has shown that repeated brief myocardial ischemia (RBMI) can increase the tolerance of myocardium to a subsequent sustained ischemia and have protective effects on myocardial cells. With the isolated rat heart Langendorff model, we investigated the effects of RBMI on myocardial morphology, systolic function, coronary flow rates (CFR), myocardial membrane phospholipid (PL) content and its marker enzyme's activity (5'-AMPase). The results showed: After ischemia-reflow, the HR, LVP and CFR in control and experimental groups had no significant difference (P > 0.05). But the PL content and specific activity of 5'-AMPase were significantly higher in the experimental group than that in control group (P < 0.01, P < 0.05). And the observations of ultrastructure suggested that the myocardium of the experimental group was preserved better than that in control group. It was also shown that RBMI had protective effects on myocardial membrane structure, and however effective had no relation to CFR.

A study of the effect of magnetized water on enzyme activities by potentiometric enzyme electrode method

A very promising glutamate decarboxylase electrode, which has linear response range of 5.6 x 10(-5)-1.2 x 10(-2) mol/L. Nernstian slope of 50 mV/decade, detection limit of 3.2 x 10(-5) mol/L and response time less than 3 min, has been designed to observe and evaluate quantitatively the effect of magnetized water on enzyme activities by potentiometric enzyme electrode method. It was found that the activity of glutamate decarboxylase can increase by 30% in magnetized water. The mechanism of increased enzyme activity was discussed in the present paper. Such a new finding will probably lead to some new explanations for the physiological and biological mechanism of the effect of magnetized water on living organisms, thus providing a new approach to the study of the effect of magnetized water.