The role of hydrogen therapy in Alzheimer's disease management: Insights into mechanisms, administration routes, and future challenges

Alzheimer's disease (AD) is a progressive neurodegenerative disorder predominantly affecting the elderly. While conventional pharmacological therapies remain the primary treatment for AD, their efficacy is limited effectiveness and often associated with significant side effects. This underscores the urgent need to explore alternative, non-pharmacological interventions. Oxidative stress has been identified as a central player in AD pathology, influencing various aspects including amyloid-beta metabolism, tau phosphorylation, autophagy, neuroinflammation, mitochondrial dysfunction, and synaptic dysfunction. Among the emerging non-drug approaches, hydrogen therapy has garnered attention for its potential in mitigating these pathological conditions. This review provides a comprehensively overview of the therapeutic potential of hydrogen in AD. We delve into its mechanisms of action, administration routes, and discuss the current challenges and future prospects, with the aim of providing valuable insights to facilitate the clinical application of hydrogen-based therapies in AD management.

Hand Sanitizer Gels: Classification, Challenges, and the Future of Multipurpose Hand Hygiene Products

Hand hygiene is a crucial measure in the prevention and control of infections, and there is a growing awareness among individuals who are making a conscious effort to maintain hand cleanliness. With the advent of the SARS-CoV-2 outbreak, the demand for hand hygiene products has also gradually shifted towards those with antimicrobial properties. Among these products, hand sanitizer gels (HSGs) have gained considerable popularity as an efficient method of hand cleaning, due to their rapid drying and sustained antimicrobial efficacy. Concurrently, there has been a growing interest in novel HSGs that offer additional functions such as skin whitening, moisturizing, and anti-inflammatory effects. These novel HSGs effectively address concerns associated with the ingestion of antimicrobial ingredients and demonstrate reduced skin irritation, thereby alleviating hand dermatological issues. This review provides an extensive overview of the application scenarios, classification, and challenges associated with HSGs while emphasizing the emergence of novel components with biological functions, aiming to contribute to the advancement of hand hygiene practices and offer novel insights for the development of novel HSGs with outstanding antimicrobial properties with other multiple biological functions and desirable biosafety profiles.

Neurological complications of COVID-19

Corona Virus Disease 2019 (COVID-19) has caused several pandemic peaks worldwide due to its high variability and infectiousness, and COVID-19 has become a long-standing global public health problem. There is growing evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) frequently causes multi-organ injuries and more severe neurological manifestations. Therefore, increased awareness of possible neurological complications is beneficial in preventing and mitigating the impact of long-term sequelae and improving the prognostic outcome of critically ill patients with COVID-19. Here, we review the main pathways of SARS-CoV-2 neuroinvasion and the potential mechanisms causing neurological damage. We also discuss in detail neurological complications, aiming to provide cutting-edge basis for subsequent related basic research and clinical studies of diagnosis and treatment.

A deep learning based framework for the classification of multi- class capsule gastroscope image in gastroenterologic diagnosis

Purpose: The purpose of this paper is to develop a method to automatic classify capsule gastroscope image into three categories to prevent high-risk factors for carcinogenesis, such as atrophic gastritis (AG). The purpose of this research work is to develop a deep learning framework based on transfer learning to classify capsule gastroscope image into three categories: normal gastroscopic image, chronic erosive gastritis images, and ulcer gastric image. Method: In this research work, we proposed deep learning framework based on transfer learning to classify capsule gastroscope image into three categories: normal gastroscopic image, chronic erosive gastritis images, and ulcer gastric image. We used VGG- 16, ResNet-50, and Inception V3 pre-trained models, fine-tuned them and adjust hyperparameters according to our classification problem. Results: A dataset containing 380 images was collected for each capsule gastroscope image category, and divided into training set and test set in a ratio of 70%, and 30% respectively, and then based on the dataset, three methods, including as VGG- 16, ResNet-50, and Inception v3 are used. We achieved highest accuracy of 94.80% by using VGG- 16 to diagnose and classify capsule gastroscopic images into three categories: normal gastroscopic image, chronic erosive gastritis images, and ulcer gastric image. Our proposed approach classified capsule gastroscope image with respectable specificity and accuracy. Conclusion: The primary technique and industry standard for diagnosing and treating numerous stomach problems is gastroscopy. Capsule gastroscope is a new screening tool for gastric diseases. However, a number of elements, including image quality of capsule endoscopy, the doctors' experience and fatigue, limit its effectiveness. Early identification is necessary for high-risk factors for carcinogenesis, such as atrophic gastritis (AG). Our suggested framework will help prevent incorrect diagnoses brought on by low image quality, individual experience, and inadequate gastroscopy inspection coverage, among other factors. As a result, the suggested approach will raise the standard of gastroscopy. Deep learning has great potential in gastritis image classification for assisting with achieving accurate diagnoses after endoscopic procedures.

[Comparison of application effects of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population]

Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.

Effects of lncRNA ANRIL-knockdown on the proliferation, apoptosis and cell cycle of gastric cancer cells

Gastric cancer is one of the most common types of malignant tumor of the gastrointestinal tract worldwide. Cisplatin (DDP) is a commonly used chemotherapeutic drug in the clinic; however, the resistance of gastric cancer cells to DDP limits its efficacy. In the present study, drug-resistant gastric cancer cell lines were constructed using the stepwise continuous selection method, and the relative expression levels of long non-coding RNA (lncRNA) CDKN2B antisense RNA 1 (ANRIL) and microRNA (miR)-181a-5p were detected using reverse transcription-quantitative PCR. The knockdown of lncRNA ANRIL and miR-181a-5p expression was performed by transfection with shRNA-ANRIL and an miR-181a-5p inhibitor, respectively. Cellular proliferation and sensitivity to DDP were assessed using Cell Counting Kit-8 analysis. Cell apoptosis and cell cycle distribution were assessed using flow cytometry and western blotting. The binding relationships between ANRIL, miR-181a-5p and cyclin G1 (CCNG1) were verified using a dual luciferase reporter assay. The results revealed that the expression levels of miR-181a-5p were downregulated in all drug-resistant cell lines. ANRIL-knockdown inhibited cellular proliferation, and promoted apoptosis and cell cycle arrest; however, following the knockdown of miR-181a-5p, the inhibition of cell cycle arrest was alleviated. Notably, miR-181a-5p, ANRIL and CCNG1 were found to have targeting relationships. In conclusion, the findings of the present study suggested that knocking down the expression of ANRIL inhibited cellular proliferation, and promoted apoptosis and cell cycle arrest. Furthermore, its downstream target, miR-181a-5p, inhibited the proliferation of drug-resistant cells and enhanced their sensitivity to DDP.

Obstetricians' perspectives on trial of labor after cesarean (TOLAC) under the two-child policy in China: a cross-sectional study

Background

As the birth policy has been adjusted from one-child-one-couple to universal two-child-one-couple in China, there is an increasing number of women undergoing a second pregnancy after a previous cesarean section (CS). Undertaking an elective repeat CS (ERCS) has been taken for granted and has thus become a major contributor to the increasing CS rate in China. Promoting trial of labor after CS (TOLAC) can reduce the CS rate without compromising delivery outcomes. This study aimed to investigate Chinese obstetricians’ perspectives regarding TOLAC, and the factors associated with their decision-making regarding recommending TOLAC to pregnant women with a history of CS under the two-child policy.

Methods

A cross-sectional survey was carried out between May and July 2018. Binary logistic regression was used to determine the factors associated with the obstetricians’ intention to recommend TOLAC to pregnant women with a history of CS. The independent variables included sociodemographic factors and perceptions regarding TOLAC (selection criteria for TOLAC, basis underlying the selection criteria for TOLAC, and perceived challenges regarding promoting TOLAC).

Results

A total of 426 obstetricians were surveyed, with a response rate of ≥83%. The results showed that 31.0% of the obstetricians had no intention to recommend TOLAC to pregnant women with a history of CS. Their decisions were associated with the perceived lack of confidence regarding undergoing TOLAC among pregnant women with a history of CS and their families (odds ratio [OR] = 2.31; 95% CI: 1.38–1.38); obstetricians’ uncertainty about the safety of TOLAC for pregnant women with a history of CS (OR = 0.49; 95% CI: 0.27–0.96), and worries about medical lawsuits due to adverse delivery outcomes (OR = 0.14; 95% CI: 0.07–0.31). The main reported challenges regarding performing TOLAC were lack of clear guidelines for predicting or avoiding the risks associated with TOLAC (83.4%), obstetricians’ uncertainty about the safety of TOLAC for women with a history of CS (81.2%), pregnant women’s unwillingness to accept the risks associated with TOLAC (81.0%) or demand for ERCS (80.7%), and the perceived lack of confidence (77.5%) or understanding (69.7%) regarding undergoing TOLAC among pregnant women and their families.

Conclusion

A proportion of Chinese obstetricians did not intend to recommend TOLAC to pregnant women with a history of CS. This phenomenon was closely associated with obstetricians’ concerns about TOLAC safety and perceived attitudes of the pregnant women and their families regarding TOLAC. Effective measures are needed to help obstetricians predict and reduce the risks associated with TOLAC, clearly specify the indications for TOLAC, improve labor management, and popularize TOLAC in China. Additionally, public health education on TOLAC is necessary to improve the understanding of TOLAC among pregnant women with a history of CS and their families, and to improve their interactions with their obstetricians regarding shared decision making.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03559-1.

Effects of a Four-Day Mindfulness Intervention on Teachers' Stress and Affect: A Pilot Study in Eastern China

Stress is becoming increasingly prevalent among teacher groups, and this is problematic for education. Mindfulness training (MT) is a well-supported way to help various populations cope with and reduce stress. In this study, a 4-day intensive MT program that aimed to increase teachers' emotional health was developed and implemented into the existing post-service education for teachers in eastern China. A total of 161 teachers voluntarily enrolled in the course and were assigned to either the mindfulness group or the waitlist group. Participants completed measures of mindfulness, positive affect, negative affect, and perceived stress before and after the program. The results showed that MT had statistically significant positive effects on mindfulness, negative affect, and stress. The present findings indicate that a 4-day intensive MT program is a promising way to decrease teachers' stress and improve their emotional health. The practical meaning of the short-term intensive MT program for teachers is discussed. It is easier for teachers to enroll such a short-term training program, as it may have higher acceptance and feasibility than an 8-week training program in some areas. Clinical Trial Registration: www.ClinicalTrials.gov, identifier ChiCTR2000029653.

Mitigating distress and promoting positive aspects of caring in caregivers of children and adolescents with schizophrenia: Mediation effects of resilience, hope, and social support

Assistance for distressed caregivers can indirectly facilitate recovery of the people being cared for, yet how resilience, hope, and social support mediate between caregiving burden and adjustment outcomes is unclear. A structural equation model was constructed based on data from a cross-sectional survey of 324 caregivers of children and adolescents with schizophrenia using multidimensional caregiver burden inventory, Connor-Davidson resilience scale, Herth hope index, perceived social support scale, distress management screening measure, and positive aspects of caregiving instruments. On distress, caregiving burden had a relatively large direct effect, and an indirect effect, mainly mediated by resilience. Resilience had a greater effect than social support or hope on distress. On positive aspects of caregiving (PAC), caregiving burden had only an indirect effect, primarily via the processes from social support and resilience to hope. Hope had a significant direct effect, while resilience and support had moderate indirect effects on PAC via hope. Resilience is an important mediator between caregiving burden and distress, with a greatest effect. Resilience, hope, and social support all mediated between caregiving burden and PAC, with hope having a greatest effect. Reducing the care burden may greatly help to relieve caregiver distress. Providing needed social support, encouraging caregivers to proactively utilize the support, and enhancing resilient coping skills will be helpful in developing resilience and mitigating distress. Health professionals should assess and ameliorate burden, be particularly aware of caregiver hopes, provide formal support, and encourage informal support to promote PAC.

Risk factors associated with peripherally inserted central catheter-related venous thrombosis in hospitalized patients of advanced age

Objective

This study was performed to determine the risk factors associated with peripherally inserted central catheter (PICC)-related venous thrombosis in patients of advanced age (>65 years).

Methods

In total, 549 hospitalized patients aged 66 to 104 years who were undergoing PICC placement from January 2008 to December 2014 were enrolled. Symptomatic venous thrombosis was confirmed by B-mode or Doppler ultrasonography in the presence of clinical signs. Logistic regression analysis was performed on the variables of interest to identify the risk factors for thrombosis. Odds ratios (ORs) with the corresponding 95% confidence intervals were generated.

Results

Of the 549 patients with PICC placement, 106 (19.3%) developed PICC-associated venous thrombosis, 84 cases of which were symptomatic. The logistic regression results revealed that PICC-related venous thrombosis was associated with a history of venous thrombosis (OR, 6.745 [3.237–14.056]), number of lumens (OR, 1.934 [1.362–2.572] and OR, 3.762 [1.672–5.932] for dual and triple lumens, respectively), and PICC gauge (OR, 1.821 [1.256–2.537] and OR, 3.864 [1.367–8.251] for 5-Fr and 6-Fr, respectively).

Conclusions

A history of thrombosis, high number of lumens, and large-gauge catheters were strong risk factors for patients aged >65 years undergoing PICC placement.

Search for CP Violation in Neutrino and Antineutrino Oscillations by the T2K Experiment with 2.2×10^{21} Protons on Target

The T2K experiment measures muon neutrino disappearance and electron neutrino appearance in accelerator-produced neutrino and antineutrino beams. With an exposure of 14.7(7.6)×10^{20} protons on target in the neutrino (antineutrino) mode, 89 ν_{e} candidates and seven anti-ν_{e} candidates are observed, while 67.5 and 9.0 are expected for δ_{CP}=0 and normal mass ordering. The obtained 2σ confidence interval for the CP-violating phase, δ_{CP}, does not include the CP-conserving cases (δ_{CP}=0, π). The best-fit values of other parameters are sin^{2}θ_{23}=0.526_{-0.036}^{+0.032} and Δm_{32}^{2}=2.463_{-0.070}^{+0.071}×10^{-3}  eV^{2}/c^{4}.

Career intentions of PhD students in nursing: A cross-sectional survey

BACKGROUND

Despite the rapid growth of Chinese nursing PhD programs, little is known about the career intentions of students in this field.

OBJECTIVE

To investigate the career intentions of nursing PhD students.

DESIGN

Online cross-sectional survey.

PARTICIPANTS

Nursing PhD students at Chinese universities.

METHODS

An online questionnaire was designed and the data were analyzed using SPSS.

RESULTS

The mean age of the participants was 31.53 ± 4.92 years, and most were female (89.9%), married (74.2%), and had been employed previously (69.7%). Most intended to work in the city where their family lived (34.8%) or near their previous workplace (32.6%). Most (60.7%) desired to work in an educational institution (e.g., a university or college). The most common expected salary was 8000-11,999 RMB/month. The work benefits perceived as indispensable were "Five Insurances and One Fund" (77.5%), good educational resources for children (59.6%), financial allowances for PhD graduates (52.8%), staff dormitories/housing subsidies (50.6%), and tenure (50.6%). Nursing education (75.3%) and research (70.8%) were the most favored fields. The key job characteristics were the opportunity to put strengths to fullest use (79.8%), time to conduct research (60.7%), and work-life balance (51.7%). The key research conditions included a good research incentive mechanism (77.5%), a Basic Scientific Research Foundation (68.5%), opportunity to apply to conduct research projects (66.3%), and the nursing team's atmosphere regarding research (64.0%), and 91.0% were eager to study abroad (e.g., as part of an international exchange).

CONCLUSIONS

Nursing PhD students would like to work in their hometown or near their previous workplace. Most preferred working in an educational institution, and the most popular fields were nursing education and research (rather than clinical care), despite the high demand of hospital management for nursing PhD graduates. Flexible work, high-quality research conditions, a certain salary, work benefits, and training were key expectations.

[Multicenter investigation on cognition about preoperative nursing of emergency PCI]

OBJECTIVE

To know the mastery degree of percutaneous coronary intervention (PCI) preoperative nursing knowledge in nurses who are working in emergency department and cardiac ward.

METHODS

158 cases of nurses who came from three different class III grade hospitals with qualification for emergency PCI surgery of the Guizhou province were surveyed with self-made questionnaire. The survey was conducted in nurses who were working in different departments, and the educational background, age, title, category, the cognitive situation of the PCI preoperative nursing knowledge and necessity of preoperative preparations were investigated in nurses.

RESULTS

The whole pass rate was 48.10%; high qualification, high education, higher title of nurses for the nursing knowledge of the emergency PCI were better; the emergency PCI preoperative preparations for the necessity of cognitive about nurses were on the low side.

CONCLUSIONS

The cognition of the nursing knowledge and the necessity of emergency PCI in preoperative preparations as whole are on the low level, so specialized training should be strengthened to enhance the ability of specialized nursing.

Combined Analysis of Neutrino and Antineutrino Oscillations at T2K

T2K reports its first results in the search for CP violation in neutrino oscillations using appearance and disappearance channels for neutrino- and antineutrino-mode beams. The data include all runs from January 2010 to May 2016 and comprise 7.482×10^{20} protons on target in neutrino mode, which yielded in the far detector 32 e-like and 135  μ-like events, and 7.471×10^{20} protons on target in antineutrino mode, which yielded 4 e-like and 66  μ-like events. Reactor measurements of sin^{2}2θ_{13} have been used as an additional constraint. The one-dimensional confidence interval at 90% for the phase δ_{CP} spans the range (-3.13, -0.39) for normal mass ordering. The CP conservation hypothesis (δ_{CP}=0, π) is excluded at 90% C.L.

[Survey of the third Zika virus disease case in the mainland of China]

OBJECTIVE

To evaluate the performance of Zika virus(ZIKV)disease prevention and control.

METHODS

Descriptive epidemiological analysis was conducted on the clinical manifestations, laboratory detection results and disease progression of the third imported ZIKV disease case in the mainland of China.

RESULTS

On 19 February 2016, a ZIKV disease case was confirmed in Yiwu, Zhejiang province, which was the third imported case of ZIKV disease confirmed by China CDC laboratory and expert consulting. The patient just had a travel to Fiji and Samoa and had mosquito bite history in Samoa. The patient was hospitalized on 16 February after the onset on 14 February and the eruption on 15 February. The body temperature of the patient became normal on 17 February, the rash disappeared on 19 February and the conjunctivitis resolved on 20 February. The positive detection of the viral nucleic acid in blood was only for 3 consecutive days, and the viral nucleic acid could be detected in urine even after negative detection in blood for 4 days.

CONCLUSION

The symptoms of the patient were typical. ZIKV can be detected by using blood sample in early phase, but after body temperature become normal, the virus can be detected in urine.

Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping

This work was aimed at studying the method of computer-aided diagnosis of early knee OA (OA: osteoarthritis). Based on the technique of MRI (MRI: Magnetic Resonance Imaging) T2 Mapping, through computer image processing, feature extraction, calculation and analysis via constructing a classifier, an effective computer-aided diagnosis method for knee OA was created to assist doctors in their accurate, timely and convenient detection of potential risk of OA. In order to evaluate this method, a total of 1380 data from the MRI images of 46 samples of knee joints were collected. These data were then modeled through linear regression on an offline general platform by the use of the ImageJ software, and a map of the physical parameter T2 was reconstructed. After the image processing, the T2 values of ten regions in the WORMS (WORMS: Whole-organ Magnetic Resonance Imaging Score) areas of the articular cartilage were extracted to be used as the eigenvalues in data mining. Then,a RBF (RBF: Radical Basis Function) network classifier was built to classify and identify the collected data. The classifier exhibited a final identification accuracy of 75%, indicating a good result of assisting diagnosis. Since the knee OA classifier constituted by a weights-directly-determined RBF neural network didn't require any iteration, our results demonstrated that the optimal weights, appropriate center and variance could be yielded through simple procedures. Furthermore, the accuracy for both the training samples and the testing samples from the normal group could reach 100%. Finally, the classifier was superior both in time efficiency and classification performance to the frequently used classifiers based on iterative learning. Thus it was suitable to be used as an aid to computer-aided diagnosis of early knee OA.

microRNA-183 down-regulates the expression of BKCaβ1 protein that is related to the severity of chronic obstructive pulmonary disease

OBJECTIVES

The aim of this study was to investigate the relationship between the expression of microRNA (miRNA)-183 and Ca(2+)-activated K(+) channels β1 subunit (BKCaβ1) in the lung tissues of patients with chronic obstructive pulmonary disease (COPD).

METHODS

Quantitative real-time polymerase chain reaction and Western blotting were used for detecting the expression of miRNA-183 and BKCaβ1 in the lung tissues from 45 COPD patients and 30 lung cancer patients without COPD. Possible miRNAs that target BKCaβ1 were forecasted by bioinformatics. The expression of these miRNAs in the peripheral blood of COPD patients was also examined. After transfecting vascular smooth muscle cells with pGCMV/EGFP/miR-183 plasmid, the expression of miRNA-183 and BKCaβ1 were detected by quantitative real-time polymerase chain reaction and Western blotting.

RESULTS

The expression of BKCaβ1 in the lung tissues of COPD patients was significantly lower than control. Western blotting data showed that the expression of BKCaβ1 protein in COPD group was significantly lower than control. After transfecting the vascular smooth muscle cells with pGCMV/EGFP/miR-183 plasmid, we found that the level of BKCaβ1 mRNA was not significantly reduced by the increase of miRNA-183 level, but the expression of BKCaβ1 protein was down-regulated.

CONCLUSIONS

The present study indicated that miRNA-183 might play a role in the expression of BKCaβ1, and the expression of miRNA-183 and BKCaβ1 were possibly related with the pathogenetic pathways of COPD. Hippokratia 2014; 18 (4): 328-332.

The effect of tranexamic acid on artificial joint materials: a biomechanical study (the bioTRANX study)

Background

Tranexamic acid (TXA) has been successfully used to reduce bleeding in joint replacement. Recently local TXA has been advocated to reduce blood loss in total knee or hip replacement; however, this raised concerns about potential adverse effects of TXA upon the artificial joint replacement.

Materials and methods

In this biomechanical study we compared the effects of TXA and saline upon the following biomechanical properties of artificial joint materials—(1) tensile properties (ultimate strength, stiffness and Young’s modulus), (2) the wear rate using a multi-directional pin-on-plate machine, and (3) the surface topography of pins and plates before and after wear rate testing.

Results

There were no significant differences in tensile strength, wear rates or surface topography of either ultra-high-molecular-weight polyethylene pins or cobalt chromium molybdenum metal plates between specimens soaked in TXA and specimens soaked in saline.

Conclusion

Biomechanical testing shows that there are no biomechanical adverse affects on the properties of common artificial joint materials from using topical TXA.

Level of evidence

V

Comparison of prediction equations to estimate glomerular filtration rate in Chinese patients with chronic kidney disease

AIM

We sought to evaluate the applicability of formulae based on serum creatinine (SC) levels in Chinese patients with chronic kidney disease (CKD).

MATERIALS AND METHODS

Three hundred and twenty-seven patients with CKD who had undergone (99m) Tc-DTPA glomerular filtration rate (GFR) estimation were enrolled. The Cockcroft-Gault equation, SC-reciprocal equation, Gate equation, Hull equation, Jelliffe-1973 equation, Jelliffe-1971 equation, Mawer equation, Bjornsson equation, reexpressed 6-variable MDRD equation and reexpressed 4-variable MDRD equation were compared. Using the (99m) Tc-DTPA GFR as the standard GFR (sGFR), the accuracy of estimated GFR was compared with sGFR in various stages of CKD.

RESULTS

Median per cents of the absolute difference ranged from 28.16% to 39.39%, accuracy with a deviation less than 30% ranging from 39.4% to 53.5%, accuracy with a deviation less than 50% ranging from 63.0% to 80.7%. None of the equations had accuracy up to the 70% level with a deviation less than 30% from sGFR. Bland-Altman analysis demonstrated that mean difference ranged from -2.42 to 16.39 mL/min/1.73 m(2), whereas precision ranged from 82.66 to 106.15 mL/min/1.73 m(2). However, the agreement limits of all the equations exceeded the prior acceptable tolerances defined as 60 mL/min/1.73 m(2). Linear regression showed that the slopes of regression line ranged from 0.37 to 0.54 and intercepts ranged from -12.10 to 3.86. When the overall performance as well as bias and accuracy were compared in different stages of CKD, GFR estimated by Jelliffe-1973 equation, Cockcroft-Gault equation and Bjornsson equation showed promising results.

CONCLUSION

When SC was measured by the enzymatic method, GFR estimation equations showed great bias in Chinese CKD patients. At present, the Jelliffe-1973 equation and Cockcroft-Gault equation may be more accurate in the Chinese ethnic group.

Expression profile of circulating microRNAs in patients with irritable bowel syndrome

AIM: To investigate the differential expression of circulating microRNAs (miRNAs) between diarrhea-predominant irritable bowel syndrome (D-IBS)/constipation-predominant irritable bowel syndrome (C-IBS) and normal controls to profile abnormally expressed circulating miRNAs in IBS patients.

METHODS: Patients were diagnosed with D-IBS or C-IBS based on the Rome III criteria. MiRNA microarray was performed to detect mixed serum samples of either three patients with D-IBS, three patients with C-IBS, or three normal controls. After miRNA profiling, clustering analysis was conducted.

RESULTS: Compared to normal controls, there were two miRNAs down-regulated and two miRNAs up-regulated in the D-IBS group, and four miRNAs down-regulated and 59 miRNAs up-regulated in the C-IBS group. There was only one miRNA that was expressed differentially in D-IBS patients and 60 miRNAs in C-IBS patients. MiR-23b* was down-regulated and HCMV-miR-US5-2 and hsv2-miR-H11 up-regulated in both types of IBS. Compared to D-IBS patients, one miRNA was down-regulated and 26 miRNAs up-regulated in C-IBS patients.

CONCLUSION: Abnormal expression profile of circulating miRNAs in IBS patients may provide new biomarkers for diagnosis of this disease.

[Transformation of human bronchial epithelial cells BEP2D induced by ²³⁸Pu α-particles]

BACKGROUND

To establish a model for the study of transformation of human cell by radon and its progeny.

METHODS

BEP2D, a HPV18 immortalized human bronchial epithelial cell line, was irradiated with high-energy α-particles emitted by ²³⁸Pu.

RESULTS

A single 1. 5 Gy dose of α-particles induced transformation of the cells. A series of sequential steps arose among transformed cells, including altered growth kinetics, resistance to serum-induced terminal differentiation, and anchorage-independence growth.

CONCLUSIONS

This cell line may provide a model to study the cellular and molecular changes at various stages in radiation carcinogenesis.

Outcomes of maintenance therapy with tacrolimus versus azathioprine for active lupus nephritis: a multicenter randomized clinical trial

AIM

The optimal maintenance therapy for active diffuse lupus nephritis remains to be established. In this study, we explored the efficacy and safety of tacrolimus for maintaining remission of active lupus nephritis compared to that of azathioprine.

METHODS

Seventy patients with biopsy-proven lupus nephritis who achieved remission were enrolled in nine nephrology centers in China from 2006 to 2008. Patients were randomized either to tacrolimus plus prednisone (n = 34) or azathioprine plus prednisone (n = 36) for six months. Tacrolimus was titrated to achieve a trough blood concentration of 4-6 ng/mL, and the dosage of azathioprine was 2 mg/kg/d. Prednisone was administered at a dose of 10 mg/d to both groups. The primary outcome was incidence of relapse. Response, clinical parameters and adverse effects were secondary endpoints.

RESULTS

After six months of therapy, two of the azathioprine-treated patients developed renal relapse compared to none of the tacrolimus-treated patients (p = 0.49; odds ratio, 1.06; 95% CI (0.98, 1.15)). Leucopenia (defined as < 2000 cells per cubic millimeter) was significantly more frequent in the azathioprine group than the tacrolimus group (47% vs. 9%, p < .001).

CONCLUSION

In conjunction with prednisone, maintenance therapy with tacrolimus and azathioprine has a similar low rate of renal relapse, and the tacrolimus regimen has a more favorable safety profile, with less leucopenia. However, since our study lacked sufficient power, longer follow-up is needed to draw final conclusions.

[Differences of wound contraction and apoptosis in full-thickness burn wounds repaired with different artificial dermal stent in pigs]

OBJECTIVE

To investigate the roles and differences of angiogenesis of different dermal scaffolds on wound contraction and apoptosis during full-thickness burn wound repair.

METHODS

Wounds were observed at different time after the collagen-sulfonated carboxymethyl chitosan porous scaffold or collagen-chitosan porous scaffold or acellular dermal matrix were respectively transplanted on wounds of full thickness burn with debridement in Bama miniature pigs. At the same time, vessels and myo-fibroblasts expressing α-smooth muscle action(α-SMA) and apoptosis in wounds of different time were detected in situ by immunohistochemical staining, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling. The burn wounds without any scaffold transplantation were studied as the control.

RESULTS

Wounds with different scaffolds transplantation were different from granulation wounds. Vessels expressing α-SMA had been increasing continuously in the wounds from 1 to 3 weeks after different scaffolds transplantation and decreased in wounds after epidermis had been grafted for 2 weeks on surface of the scaffolds transplanted on wounds for 2 weeks. Vessels expressing α-SMA were the most in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the least in the control wounds without dermal scaffold at different time. Myo-fibroblasts expressing α-SMA was the least in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the peak of expressions was on the 2nd week, however, the peak in the wounds with the other two scaffolds transplantation and in the control wound without dermal scaffold was on the 3rd week. Myo-fibroblasts expressing α-SMA was the most in the control wounds. Apoptosis had been increasing continuously in the transplantation wounds from 2 to 4 weeks after different scaffolds transplantation, however, apoptosis had begun to increase continuously from 3 to 4 weeks in the control wounds. Apoptosis was the most in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the least in the control wounds without dermal scaffold from 3 to 4 weeks.

CONCLUSION

Sulfonated carboxymethyl chitosan can promote migration of reparative cells and angiogenesis, and it can repair full-thickness burn wound fast and well.

Mesangial medium with IgA1 from IgA nephropathy inhibits nephrin expression in mouse podocytes

BACKGROUND

IgA nephropathy (IgAN) is characterized by mesangial deposition of polymeric IgA1, and podocyte injury plays an important role in glomerulosclerosis of the disease. Our previous study indicated that medium of mesangial cells co-incubated with aggregated IgA1 (aIgA1), isolated from IgAN patients, down-regulated nephrin expression. Yet the mechanism remains unclear.

MATERIALS AND METHODS

Podocytes were incubated with a medium of mesangial cells co-incubated with aIgA1, which was isolated from IgAN patients, and enalaprilat (10(-5) M), valsartan (10(-5) M) and anti-mouse tumour necrosis factor-alpha antibody (50 ng mL(-1)) separately. Nephrin expression in podocytes was measured by real-time polymerase chain reaction and Western blot analysis.

RESULTS

The level of angiotensinogen and angiotensin-converting enzyme mRNAs in podocytes, as well as angiotensin, was also increased by a medium of mesangial cells co-incubated with aIgA1 from IgAN patients (P<0.05). Enalaprilat or valsartan partly improved nephrin expression when compared with that by podocytes exposed to the mesangial medium (P<0.05), while the nephrin expression of podocytes with enalaprilat or valsartan was lower than that of podocytes exposed to medium of mesangial cells stimulated by aIgA1 from healthy control (P<0.05). However, anti-mouse tumour necrosis factor-alpha antibody did not show any improvement in nephrin expression.

CONCLUSION

Our findings implicate that local renin angiotensin system activation in podocytes is partly involved in down-regulation of nephrin by mesangial medium in IgA nephropathy.

Molecular characterization of toxigenic and atoxigenic Aspergillus flavus isolates, collected from peanut fields in China

AIMS

The objectives of this study were to assess the genetic relationships between toxigenic and atoxigenic isolates of Aspergillus flavus collected from peanut fields in China, and to analyse deletions within the aflatoxin biosynthetic gene cluster for the atoxigenic isolates.

METHODS AND RESULTS

Analysis of random-amplified polymorphic DNA and microsatellite-primed PCR data showed that the toxigenic and atoxigenic isolates of A. flavus were not clustered based on their regions and their ability of aflatoxin and sclerotial production. These results were further supported by DNA sequence of ITS, pksA and omtA genes. PCR assays showed that 24 of 35 isolates containing no detectable aflatoxins had the entire aflatoxin gene cluster. Eleven atoxigenic isolates had five different deletion patterns in the cluster.

CONCLUSIONS

Toxigenic and atoxigenic isolates of A. flavus are genetically similar, but some atoxigenic isolates having deletions within the aflatoxin gene cluster can be identified readily by PCR assays.

SIGNIFICANCE AND IMPACT OF THE STUDY

Because the extensive deletions within the aflatoxin gene cluster are not rare in the atoxigenic isolates, analysis of deletion within the cluster would be an effective method for the rapid screening of atoxigenic isolates for developing biocontrol agents.

[Experiment study of guiding bone tissue regeneration by frozen homologous periosteum]

OBJECTIVE

Explores the feasibility of guiding bone tissue regeneration by frozen homologous periosteum.

METHODS

Rabbit's cranial periosteum was taken and refrigerated. In thirty-one white Japanese big ear rabbits, defects of the mandible were created. Defect at one side was covered with the membrane, another side not. The rabbits were sacrificed on four, eight, twelve, sixteen weeks. Specimens were examined by naked eye, X-ray, and histology.

RESULTS

The frozen homologous periosteummet the requirement of guiding bone tissue regeneration There was no rejection, and could be kept 8 for 12 weeks in the body. It had the favorable efficacy of obstructing the fiber tissue from filling into bone defects and had an efficacy of guiding bone tissue regeneration.

CONCLUSIONS

Frozen homologous periosteum is a perfect guiding bone tissue regeneration membrane.

Simultaneous imaging of proton and fluorine at moderate field

Simultaneous imaging of proton and fluorine nuclei distributed in a unique sample has been performed by multiplexing the receiver coil's frequency for nmr signal acquisition. Implementation of the technique and modifications of a conventional spectrometer are described for operating at 0.13 T.