Moxibustion of Zusanli (ST36) and Shenshu (BL23) alleviates the inflammation of rheumatoid arthritis in rats through regulating macrophage migration inhibitory factor/glucocorticoids signaling

OBJECTIVE

To test the hypothesis that moxibustion may inhibit rheumatoid arthritis (RA) synovial inflammation by regulating the expression of macrophage migration inhibitory factor (MIF)/glucocorticoids (GCs).

METHODS

Fifty male Sprague-Dawley rats were randomly divided into five groups (n = 10 each): blank Control (CON) group, RA Model (RA) group, Moxibustion (MOX) group, MIF inhibitor (S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester (ISO-1) group, and Moxibustion + MIF inhibitor ISO-1 (MOX + ISO-1) group. Rats in the ISO-1 group and ISO-1 + MOX group were intraperitoneally injected with the inhibitor ISO-1. The rats in the RA group, ISO-1 group, MOX group, and ISO-1 + MOX group were injected with Freund's complete adjuvant (FCA) in the right hind footpad to establish an experimental RA rat model. In the MOX group and MOX + ISO-1 group, rats were treated with Moxa. The thickness of the footpads of the rats in each group was measured at three-time points before, after modeling and after moxibustion treatment. The contents of serum MIF, corticosterone (CORT), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected by enzyme-linked immunosorbent assay; and the contents of synovial MIF were detected by Western blot. Hematoxylin-eosin (HE) staining method was used to observe the pathological changes of synovial tissue under a section light microscope, and pathological scoring was performed according to the grading standard of the degree of synovial tissue disease.

RESULTS

Moxibustion was found to reduce the level of MIF and alleviate inflammation in RA rats in this study. In addition, after inhibiting the expression of MIF, the level of CORT increased, and the level of TNF-α decreased. Treating RA rats with inhibited MIF by moxibustion, the level of CORT was almost unchanged, but the level of TNF-α further decreased. The correlation analysis data suggested that MIF was positively related to the expression of TNF-α and negatively correlated with the expression of CORT.

CONCLUSION

Reducing MIF to increase CORT and decrease TNF-α by moxibustion treatment in RA. MIF may be a factor for moxibustion to regulate the expression of CORT, but the expression of TNF-α is due to the incomplete regulation of the MIF. This study added to the body of evidence pointing to moxibustion's anti-inflammatory mechanism in the treatment of RA.

Trends in Antimicrobial Prescription for Inpatients in Changsha, China, 2003 to 2014

BACKGROUND

China had implemented policies to limit antimicrobials prescription since 2004; we conducted this study to reflect the effect of these national policies by analyzing antimicrobial prescription trends of medical insurance in patients from 2003 to 2014 in Changsha city, China.

METHODS

The participants were inpatients of the medical insurance of urban workers (UEBMI). Data were extracted from medical insurance information system of Changsha Medical Insurance Institution, which directly connects with hospitals information systems.

RESULTS

Trend analysis showed great changes in antimicrobial prescription and inpatients' cost on antimicrobials over the study period. Antimicrobial prescription rates gradually declined over the study period from 79.0% in 2003 to 43.5% in 2014 (adjusted OR0.205; 95%CI 0.198 to 0.213). There was a quicker decline from 2011 to 2014 (with implementing national antimicrobial stewardship action plan) than the period from 2003 to 2010 (with implementing antimicrobials use education and self-management strategies). The proportion of inpatients used one antimicrobial increased significantly from 25.6% in 2003 to 46.7% in 2014, while the proportion of inpatients used three or more antimicrobials gradually decreased. Bacterial culture rate increased from 20.4% in 2003 to 36.6% in 2014 (adjusted OR 2.248; 95% CI 2.149 to 2.352). The average costs on antimicrobials decreased significantly, from 277.43 US Dollar in 2003 to 91.05 US Dollar in 2014.

CONCLUSION

National efforts to promote rational use of antimicrobials in clinical practice have had a positive effect over the past decade in China.

Aerobic Exercise of Low to Moderate Intensity Corrects Unequal Changes in BKCa Subunit Expression in the Mesenteric Arteries of Spontaneously Hypertensive Rats

Accumulating evidence indicates that hypertension is associated with “ion channel remodeling” of vascular smooth muscle cells (VSMCs). The objective of this study was to determine the effects of exercise intensity/volume on hypertension-associated changes in large-conductance Ca2+-activated K+ (BKCa) channels in mesenteric arteries (MAs) from spontaneously hypertensive rats (SHR). Male SHRs were randomly assigned to three groups: a low-intensity aerobic exercise group (SHR-L: 14 m/min), a moderate-intensity aerobic exercise group (SHR-M: 20 m/min), and a sedentary group (SHR). Age-matched Wistar-Kyoto rats (WKYs) were used as normotensive controls. Exercise groups completed an 8-week exercise program. Elevation of the α and β1 proteins was unequal in MA myocytes from SHRs, with the β1 subunit increasing more than the α subunit. BKCa contribution to vascular tone regulation was higher in the myocytes and arteries of SHRs compared to WKYs. SHR BKCa channel subunit protein expression, β1/α ratio, whole cell current density and single-channel open probability was also increased compared with WKYs. Aerobic exercise lowered systemic blood pressure and normalized hypertension-associated BKCa alterations to normotensive control levels in the SHRs. These effects were more pronounced in the moderate-intensity group than in the low-intensity group. There is a dose-effect for aerobic exercise training in the range of low to moderate-intensity and accompanying volume for the correction of the pathological adaptation of BKCa channels in myocytes of MAs from SHR.

Examining the role of socioeconomic deprivation in ethnic differences in sexually transmitted infection diagnosis rates in England: evidence from surveillance data

Differences by ethnic group in STI diagnosis rates have long been recognized in England. We investigated whether these may be explained by ethnic disparities in socioeconomic deprivation (SED). Data on all diagnoses made in sexual health clinics in England in 2013 were obtained from the mandatory STI surveillance system. Poisson regression was used to calculate incidence rate ratios (IRRs) of STIs, by ethnicity, with and without adjustment for index of multiple deprivation (IMD) a measure of area-level deprivation. Unadjusted IRRs (95% confidence intervals) were highest for gonorrhoea [8·18 (7·77-8·61) and 5·76 (5·28-6·29)] and genital herpes [4·24 (3·99-4·51) and 3·58 (3·23-3·98)] for people of black Caribbean and non-Caribbean/non-African black ethnicity and IRRs were highest for syphilis [8·76 (7·97-9·63)] and genital warts [2·23 (2·17-2·29)] for people of non-British/non-Irish white ethnicity compared to white British ethnicity. After adjustment for IMD, IRRs for gonorrhoea [5·76 (5·47-6·07)] and genital herpes [3·73 (3·50-3·97)] declined but remained highest for black Caribbeans and IRRs for syphilis [7·35 (6·68-8·09)] and genital warts [2·10 (2·04-2·16)] declined but remained highest for non-British/non-Irish white compared to white British. In England, ethnic disparities in STI diagnosis rates are partially explained by SED, but behavioural and contextual factors likely contribute. Clinic and community-based interventions should involve social peer networks to ensure they are targeted and culturally sensitive.

Multistate outbreak of listeriosis caused by imported cheese and evidence of cross-contamination of other cheeses, USA, 2012

Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0-825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March-October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.

A trend towards increasing viral load in newly diagnosed HIV-infected inpatients in southeast China

Peripheral blood viral load is an important indicator of viral production and clearance. Previous studies have suggested that viral load might predict the rate of decrease in CD4+ cell count and progression to AIDS and death. Here, we conducted a retrospective analysis of the trends in HIV-1 viral load in southeast China. Among inpatients newly diagnosed with HIV infection, we found that viral load has increased over the past decade from 4·20 log10 copies/ml in 2002 to 6·61 log10 copies/ml in 2014, with a mean increase of 0·19 log10 copies/ml each year. However, the CD4+ cell count was stable and insensitive to changes in viral load. Thus, increasing viral load appears to be an emerging trend in newly diagnosed HIV-infected inpatients.

Exercise training prevents the attenuation of anesthetic pre-conditioning-mediated cardioprotection in diet-induced obese rats

BACKGROUND

Obesity abolishes anesthetic pre-conditioning-induced cardioprotection due to impaired reactive oxygen species (ROS)-mediated adenosine monophosphate-activated protein kinase (AMPK) pathway, a consequence of increased basal myocardial oxidative stress. Exercise training has been shown to attenuate obesity-related oxidative stress.

OBJECTIVE

This study tests whether exercise training could normalize ROS-mediated AMPK pathway and prevent the attenuation of anesthetic pre-conditioning-induced cardioprotection in obesity.

METHODS

Male Sprague-Dawley rats were divided into lean rats fed with control diet and obese rats fed with high-fat diet. After 4 weeks of feeding, lean and obese rats were assigned to sedentary conditions or treadmill exercise for 8 weeks.

RESULTS

There was no difference in infarct size between lean sedentary and obese sedentary rats after 25 min of myocardial ischemia followed by 120 min reperfusion. In lean rats, sevoflurane equally reduced infarct size in lean sedentary and lean exercise-trained rats. Molecular studies revealed that AMPK activity, endothelial nitric oxide synthase, and superoxide production measured at the end of ischemia in lean rats were increased in response to sevoflurane. In obese rats, sevoflurane increased the above molecular parameters and reduced infarct size in obese exercise-trained rats but not in obese sedentary rats. Additional study showed that obese exercise-trained rats had decreased basal oxidative stress than obese sedentary rats.

CONCLUSION

The results indicate that exercise training can prevent the attenuation of anesthetic cardioprotection in obesity. Preventing the attenuation of this strategy may be associated with reduced basal oxidative stress and normalized ROS-mediated AMPK pathway, but the causal relationship remains to be determined.

SPUTTERED TiO2 FILMS FOR PHOTOVOLTAIC CELL'S ANTIREFLECTION COATING

TiO2 films were prepared by the magnetron sputter system with various oxygen partial pressure ratios, for the application of photovoltaic (PV) cells, TiO2 single-layer and SiO2/TiO2 double-layer antireflection (AR) coatings were deposited on Si substrate. The experimental results indicate that TiO2 film deposited at oxygen partial pressure ratio of 15.4% exhibits smooth surface morphology, amorphous structure, and good optical transmittance, which is suitable for AR coating in the PV cell structure system. Furthermore, the weighted average reflectance in the range of 400–900 nm was about 10.3% and 3.7% for the TiO2 single-layer and SiO2/TiO2 double-layer AR coatings, respectively. With a double-layer AR coating, a 50.8% improvement in the efficiency of a Si PV cell was achieved.

SEGMENTATION OF BREAST THERMOGRAM: IMPROVED BOUNDARY DETECTION WITH MODIFIED SNAKE ALGORITHM

Background: Breast cancer is a common and dreadful disease in women. One in five cancers in Singaporean women is due to breast cancer. Breast health is every woman's right and responsibility. In average, every $100 spent on breast mammogram screening, an additional $33 was spent on evaluating possible false-positive results. Thermography, with its non-radiation, non-contact and low-cost basis has been demonstrated to be a valuable and safe early risk marker of breast pathology, and an excellent case management tool available today in the ongoing monitoring and treatment of breast disease. The surface temperature and the vascularization pattern of the breast could indicate breast diseases and early detection saves lives. To establish the surface isotherm pattern of the breast and the normal range of cyclic variations of temperature distribution can assist in identifying the abnormal infrared images of diseased breasts. Before these thermograms can be analyzed objectively via computer algorithm, they must be digitized and segmented. The authors present a method to segment thermograms and extract useful region from the background. Thermography could detect the presence of tumors much earlier and of much smaller size than mammography. This paper thus aims to develop an intelligent diagnostic system based on thermography for the detection of tumors in breast. Methods: We have examined about 50 normal, healthy female volunteers in Nanyang Technological University and 130 patients in Singapore General Hospital. We did the examinations for some of them continuously for two months. From these examinations, we obtained about 1000 thermograms for contact and 800 thermograms for non-contact approaches. Standard ambient conditions were observed for all examinations. The thermograms obtained were analyzed. The first step in processing these thermograms is image segmentation. Its aim is to discern the useful region from the background. In general, autonomous segmentation is one of the most difficult tasks in image processing. This step in the process determines the eventual success or failure of the analysis. In this work, two different techniques have been presented to extract the objects from the background. Results: After analyzing these thermograms and with reference to some relevant well-documented papers, we were able to classify the thermograms. The step is very useful in identifying the normal or suspected (abnormal) thermograms. A series of thermograms was studied with the help of the in-house developed computer software. On the basis of the anatomic and vascular symmetry, the surface temperature distributions of both left and right breasts were compared. The surface isotherm pattern of breasts can indicate the local metabolism and vascularity of the underlying tissues, and the change in local blood or glandular activities can be reflected in the surface temperature of breast. We evaluated the temperature distribution pattern and the menstrual cyclic variation of temperature with time. All these results can be used to detect breast cancer. Conclusion: Automatic identification of object and surface boundary of breast thermal images is a difficult and challenging task. Both the traditional snake and gradient vector flow snake failed to detect the boundary of these images successfully. In this work, a new method is proposed in conjunction with image pre-processing, image transition, image derivative, filtering and gradient vector flow snake. This novel method can easily detect the boundary of the breast thermal image with good agreement.

Predictable prolonged suppression of gastric acidity with a novel proton pump inhibitor, AGN 201904-Z

BACKGROUND

AGN 201904-Z is a new, slowly absorbed, acid-stable pro-proton pump inhibitor (pro-PPI) rapidly converted to omeprazole in the systemic circulation giving a prolonged residence time.

AIM

To investigate pharmacodynamics and pharmacokinetics of AGN 201904-Z compared to esomeprazole.

METHODS

A randomized, open-label, parallel group, investigator-blinded intragastric pH study was conducted in 24 healthy Helicobacter pylori negative male volunteers. AGN 201904-Z enteric-coated capsules (600 mg/day) or esomeprazole delayed-release tablets (40 mg/day) were administered for 5 days. Twenty-four-hour intragastric pH recordings were acquired at baseline, days 1, 3 and 5 with blood levels of omeprazole, AGN 201904-Z and gastrin.

RESULTS

On day 1, median nocturnal pH and proportion of nocturnal time with pH >or=4 and 24-h and nocturnal time pH >or=5 were significantly higher with AGN 201904-Z than esomeprazole. At day 5, 24-h and median nocturnal pH were significantly higher for AGN 201904-Z than esomeprazole (P < 0.0001). There was also a marked reduction in periods of nocturnal pH <4.0. Area under curve of the AGN 201904-Z active metabolite (omeprazole) in the blood was twice that of esomeprazole at day 5.

CONCLUSIONS

AGN 201904-Z produced a significantly greater and more prolonged acid suppression than esomeprazole, and nocturnal acid suppression was more prolonged over all 5 days. AGN 201904-Z should provide true once-a-day treatment and better clinical efficacy than current PPIs.

Apocaligonellidus nom. nov. for Echinopsis Fan &amp; Chen, 1996, preoccupied (Acari: Prostigmata: Raphignathoidea: Xenocaligonellididae)

In 1996 we proposed the name Echinopsis for a monotypic new genus in the mite family Xenocaligonellididae (= Xenocaligonellidae) (Fan and Chen, 1996), without noticing that the same name had already been used for an echinodermatan genus (Agassiz 1840; Mortensen 1951). So a new name is required for that genus. Apocaligonellidus nom. nov. is hereby proposed as a replacement.