Adaptation strategies and functional transitions of microbial community in pyrene-contaminated soils promoted by lead with Pseudomonas veronii and its extracellular polymeric substances

Pyrene was designated as a remediation target in this study, and low contamination of lead (Pb) was set to induce heavy metal stress. Pseudomonas veronii and its extracellular polymeric substances (EPSs) were chosen for biofortification, with the aim of elucidating the structural, metabolic, and functional responses of soil microbial communities. Community analysis of soil microorganisms using high-throughput sequencing showed that the co-addition of P. veronii and EPSs resulted in an increase in relative abundance of phyla associated with pyrene degradation, and formed a symbiotic system dominated by Firmicutes and Proteobacteria, which involved in pyrene metabolism. Co-occurrence network analysis revealed that the module containing P. veronii was the only one exhibiting a positive correlation between bacterial abundance and pyrene removal, indicating the potential of bioaugmentation in enriching functional taxa. Biofortification also enhanced the abundance of functional gene linked to EPS production (biofilm formation-Pseudomonas aeruginosa) and pyrene degradation. Furthermore, 17 potential functional bacteria were screened out using random forest algorithm. Lead contamination further promoted the growth of Proteobacteria, intensified cooperative associations among bacteria, and increased the abundance of bacteria with positive correlation with pyrene degradation. The results offer novel perspectives on alterations in microbial communities resulting from the synergistic impact of heavy metal stress and biofortification.

Characteristics and associated factors of health information-seeking behaviour among patients with inflammatory bowel disease in the digital era: a scoping review

BACKGROUND

Health Information-Seeking Behaviour (HISB) is necessary for self-management and medical decision-making among patients with inflammatory bowel disease (IBD). With the advancement of information technology, health information needs and seeking are reshaped among patients with IBD. This scoping review aims to gain a comprehensive understanding of HISB of people with IBD in the digital age.

METHODS

This scoping review adhered to Arksey and O'Malley's framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews frameworks (PRISMA-ScR). A comprehensive literature search was conducted in PubMed, Embase, Web of Science, PsycINFO, CINAHL, and three Chinese databases from January 1, 2010 to April 10, 2023. Employing both deductive and inductive content analysis, we scrutinized studies using Wilson's model.

RESULTS

In total, 56 articles were selected. Within the information dimension of HISB among patients with IBD, treatment-related information, particularly medication-related information, was identified as the most critical information need. Other information requirements included basic IBD-related information, daily life and self-management, sexual and reproductive health, and other needs. In the sources dimension, of the eight common sources of information, the internet was the most frequently mentioned source of information, while face-to-face communication with healthcare professionals was the preferred source. Associated factors were categorized into six categories: demographic characteristics, psychological aspects, role-related or interpersonal traits, environmental aspects, source-related characteristics, and disease-related factors. Moreover, the results showed five types of HISB among people with IBD, including active searching, ongoing searching, passive attention, passive searching, and avoid seeking. Notably, active searching, especially social information seeking, appeared to be the predominant common type of HISB among people with IBD in the digital era.

CONCLUSION

Information needs and sources for patients with IBD exhibit variability, and their health information-seeking behaviour is influenced by a combination of diverse factors, including resource-related and individual factors. Future research should focus on the longitudinal changes in HISB among patients with IBD. Moreover, efforts should be made to develop information resources that are both convenient and provide credible information services, although the development of such resources requires further investigation and evaluation.

The impact of medication belief on adherence to infliximab in patients with Crohn's disease

Objective: Crohn's disease (CD) is an incurable chronic disease that requires long-term treatment. As an anti-tumor necrosis factor (TNF) agent, Infliximab (IFX) is widely used in the treatment of Crohn's disease, while the adherence is not high. The purpose of this study was to investigate the adherence to IFX among CD patients in China and evaluate the association between medication belief and IFX adherence. Methods: Demographic data, clinical information and patients' medication beliefs were collected using an online questionnaire and reviewing electronic medical records (EMRs). The Beliefs about Medicines Questionnaire (BMQ)-specific was used to assess medication beliefs which contains the BMQ-specific concern score and the BMQ-specific necessity score. An evaluation of adherence factors was conducted using univariate and multidimensional logistic regression analyses. Results: In all, 166 CD patients responded the online questionnaire among which 77 (46.39%) patients had high adherence. The BMQ-specific concern score in patients in low adherence was 30.00 and in high adherence patients was 27.50, and patients with lower BMQ-specific concern score had higher adherence (p = 0.013). The multiple regression analysis showed that the BMQ-specific concern score (OR = 0.940, 95% CI: 0.888-0.996) significantly affected the IFX adherence in CD patients. Otherwise, gender, marital status, time spent on the way (including the waiting time in infusion center) and accommodation to the center were also the influencing factors of adherence. Conclusion: The IFX adherence to CD in China was not high. Medicine concerns may be predictive factor of adherence. Education, the duration of IFX therapy and experience of adverse effects were not significantly associated with IFX adherence. By enhancing knowledge and relieving medicine concerns, we may increase patients' adherence to IFX.

Barriers and facilitators of adherence to awake prone positioning: a qualitative study using the COM-B model

BACKGROUND

Awake prone positioning (APP) is a recommended therapy for non-intubated ARDS patients, but adherence can be challenging. Understanding the barriers and facilitators of adherence to APP is essential to increase the adherence of therapy and improve patient outcomes. The objective of this study was to explore the barriers and facilitators of adherence to awake prone ventilation using a qualitative approach and the Capability, Opportunity, Motivation-Behavior (COM-B) model.

METHODS

Semi-structured, in-depth interviews were conducted with patients involved in awake prone ventilation. Data were analyzed using an adapted inductive thematical approach and mapped onto the COM-B model to identify barriers and facilitators to adherence of APP.

RESULTS

Nineteen patients were interviewed (aged 55-92 years). Fifteen themes were identified and mapped directly on to the six COM-B constructs, with "physical challenges" related to physical capability being the primary barrier. These COM-B sub-items reflected five other barriers, including low self-efficacy(M), treatment environment(O), availability of time(O), misconceptions about the treatment(C), and insufficient knowledge(C). Key facilitators in adhering to APP were ability to identify and overcome obstacles(C), availability and affordability of treatment(O), family influences(O), beliefs and trust in treatment(M), fear about the disease(M), and perceived benefits(M). In addition, three factors played the role of both facilitator and barrier, such as media influences(O), healthcare influences(O), and behavioral habits(M).

CONCLUSION

The COM-B model was proved to be a useful framework for identifying the barriers and facilitators of adherence to awake prone ventilation. The findings suggest that adherence behavior is a dynamic and balanced process and interventions aimed at improving adherence to APP should address the barriers related to capability, opportunity, and motivation. Healthcare providers should focus on providing proper guidance and training, creating a comfortable environment, and offering social support to improve patients' capability and opportunity. Additionally, promoting patients' positive beliefs and attitudes towards the treatment and addressing misconceptions and fears can further enhance patients' motivation to adhere to the treatment plan.

Environmental risks caused by livestock and poultry farms to the soils: Comparison of swine, chicken, and cattle farms

The lack of treatment systems for pollutants in family-livestock and poultry sites results in large amounts of untreated manure and urine being directly discharged to environment. The risks from veterinary antibiotic (VA) and heavy metal (HM) exposure in the rural environment require further research. In this investigation, 221 samples (feed, manure, surface soil, soil profiles, water, and plant) were collected from 41 livestock and poultry farms (swine, chichen, and cattle). Copper (Cu), zinc (Zn), oxytetracycline (OTC), and enrofloxacin (ENR) were frequently detected in the samples. Metals and VAs in sandy loam soils were more inclined to migrate to deep layers than those in loam soils. Copper and Zn in the polluted soils mainly existed in available forms, which facilitated their migration to deep soil layers. In this study, OTC was also observed to migrate more easily to deeper soil layers than ENR due to its relatively high pKa value. Eighteen antibiotic resistance genes (ARGs) and 5 metal resistance genes (MRGs) along with one mobile genetic element (MGE) occurred in the soils at 80 cm depth. Luteimonas, Clostridium_sensu_stricto_1, and Rhodanobacter were dominant genera detected in the soil samples from different sites, which might increase migration of ARGs or degradation of VAs. An ecological risk assessment suggested that VAs posed threats to the growth of Triticum aestivum L, Cucumis sativus L, and Brassiaca chinensis L. Remediation techniques including biochar/modified biochar, anaerobic digestion, and manure composting should be developed urgently for joint HM and VA pollution.

Differences in the properties of extracellular polymeric substances responsible for PAH degradation isolated from Mycobacterium gilvum SN12 grown on pyrene and benzo[a]pyrene

This study aimed to evaluate the differences in the characteristics of extracellular polymeric substances (EPSs) secreted by Mycobacterium gilvum SN12 (M.g. SN12) cultured on pyrene (Pyr) and benzo[a]pyrene (BaP). A heating method was used to extract EPSs from M.g. SN12, and the composition, emulsifying activity, and morphology of EPS extracts were investigated. Results showed that EPS extracts varied significantly with Pyr or BaP addition to the bacterial cultures. The concentration of proteins and carbohydrates, the main components of the EPS extracts, first increased and then decreased, with an increase in the concentration of Pyr (0-120 mg L^-1) and BaP (0-120 mg L^-1). A similar trend was observed for the emulsifying activity of the EPS extracts. EPSs extracted from all cultures exhibited a compact structure with a smooth surface, except for EPSs extracted from BaP-grown M.g. SN12, which revealed a more fragile and softer surface. These findings suggest that Pyr and BaP had different influences on the properties of isolated EPSs, providing insights into the mechanism underlying polycyclic aromatic hydrocarbons (PAHs) biodegradation by some EPS-secreting bacteria. To the best of our knowledge, this is the first report on the texture profile of EPS samples extracted from M.g. SN12 grown on PAHs.

Development and validation of a competency evaluation model for hospital infection prevention and control practitioners in the post-pandemic era: a mixed methods study

Background

During the coronavirus disease 2019 pandemic, the management of nosocomial infections became even more crucial. There is an urgent need to develop a competency model for healthcare practitioners to combat public health emergencies.

Aim

To determine practitioners' competency in hospital infection prevention and control measures.

Methods

A theoretical framework was developed based on a literature review, key informant interviews, the Delphi method and a questionnaire survey. These items were evaluated based on response rate, maximum score, minimum score and mean score. Factor analyses, both exploratory and confirmatory, were used to determine the structure of the competency model.

Results

The effective response rate for the questionnaire was 88.29%, and Cronbach's α-coefficient was 0.964. Factor analysis revealed a Kaiser–Meyer–Olkin score of 0.945. Bartlett's test gave a χ²-value of 10523.439 (df=435; P<0.001). After exploratory factor analysis, the five-factor model was retained, four items were deleted and a five-dimensional, 26-item scale was obtained. The new structure's confirmatory factor analysis revealed high goodness of fit (comparative fit index=0.921; Tucker–Lewis index=0.911; standardized root mean square residual=0.053; root mean square error of approximation=0.044).

Conclusion

The proposed scale is a useful tool to assess the competency of hospital infection prevention and control practitioners, which can help hospitals to improve infection prevention and control.

Super-factors associated with transmission of occupational COVID-19 infection among healthcare staff in Wuhan, China

BACKGROUND

Globally, there have been many cases of coronavirus disease 2019 (COVID-19) among medical staff; however, the main factors associated with the infection are not well understood.

AIM

To identify the super-factors causing COVID-19 infection in medical staff in China.

METHODS

A cross-sectional study was conducted between January 1st and February 30th, 2020, in which front-line members of medical staff who took part in the care and treatment of patients with COVID-19 were enrolled. Epidemiological and demographic data between infected and uninfected groups were collected and compared. Social network analysis (SNA) was used to establish socio-metric social links between influencing factors.

FINDINGS

A total of 92 medical staff were enrolled. In all participant groups, the super-factor identified by the network was wearing a medical protective mask or surgical mask correctly (degree: 572; closeness: 25; betweenness centrality: 3.23). Touching the cheek, nose, and mouth while working was the super-factor in the infected group. This was the biggest node in the network and had the strongest influence (degree: 370; closeness: 29; betweenness centrality: 0.37). Self-protection score was the super-factor in the uninfected group but was the isolated factor in the infected group (degree: 201; closeness: 28; betweenness centrality: 5.64). For family members, the exposure history to Huanan Seafood Wholesale Market and the contact history to wild animals were two isolated nodes.

CONCLUSION

High self-protection score was the main factor that prevented medical staff from contracting COVID-19 infection. The main factor contributing to COVID-19 infections among medical staff was touching the cheek, nose, and mouth while working.

Monitoring of optical emissions in laser cladding of 316L stainless steel

Laser cladding is so complex that small disturbances may cause defects. Developing on-line monitoring technology for laser cladding is thus a priority task. Compared with expensive spectrometers and high-speed cameras, an economical optical sensing system based on two different photodiodes was established to optimize laser parameters and help monitor abnormal working conditions. In order to find optimal parameters, a series of experiments was carried out under different operating parameters such as laser power, scanning speed, and powder feeding rate. A practical rule is summarized to optimize process parameters by analyzing the time domain characteristics of the optical signal. Several experiments under different working conditions were performed to detect abnormal working conditions. Not only can an abnormal situation be recognized, but its type can also be distinguished by analyzing optical signals in the time and frequency domains. The optical sensing system provides a better understanding and accurate evaluation of laser cladding.

[One case of pyoderma gangrenosum in the lower limbs in Tibetan Plateau treated with vacuum sealing drainage combined with irrigation of oxygen loaded fluid]

A 54 years old male patient with chronic leg ulcers was admitted in our hospital in November 2017. He was diagnosed as pyoderma gangrenosum by the pathological examination. Then the wound was treated with simple vacuum sealing drainage combined with irrigation of oxygen loaded fluid. This therapy overcame the shortage of hypoxia in the Tibetan Plateau on wound healing, resulting in a better wound healing. The patient was eventually cured and discharged from hospital.

Erythropoietin Ameliorates Lung Injury by Accelerating Pulmonary Endothelium Cell Proliferation via Janus Kinase-Signal Transducer and Activator of Transcription 3 Pathway After Kidney Ischemia and Reperfusion Injury

BACKGROUND/AIMS

Kidney ischemia and reperfusion injury could cause microvascular barrier dysfunction, lung inflammatory cascades activation, and programmed cell death of pulmonary endothelium, leading to acute lung injury. Our study aimed at determining whether erythropoietin (EPO) can ameliorate lung dysfunction following renal ischemia and reperfusion (IR) injury and explored the underlying mechanisms.

METHODS

In vivo, C57BL/6 mice received EPO (6000 U/kg) before right renal vascular pedicles clamping for 30 minutes, followed by 24 hours of reperfusion. The lung histopathologic changes and inflammatory cytokines expression were assessed. In vitro, cultured human umbilical vein endothelial cells were treated with EPO, and apoptosis rate, proliferation capacity, and phosphorylation status of the Janus kinase-signal transducer and activator of transcription 3 (Jak-STAT3) pathway were measured respectively in the presence or absence of lipopolysaccharide stimulation.

RESULTS

In vivo, EPO remarkably attenuated pulmonary interstitial and alveolar epithelial edema caused by renal IR injury. In vitro, the proliferation capacity of human umbilical vein endothelial cells was significantly increased under EPO stimulation, which correlated with changes in Jak-STAT3 signaling.

CONCLUSION

Our data indicated that EPO is able to ameliorate acute lung tissue damage induced by renal IR, and at least in part, via the Jak-STAT3 pathway.

A novel FGFR1-binding peptide attenuates the degeneration of articular cartilage in adult mice

OBJECTIVE

We previously reported that genetic ablation of (Fibroblast Growth Factors Receptors) FGFR1 in knee cartilage attenuates the degeneration of articular cartilage in adult mice, which suggests that FGFR1 is a potential targeting molecule for osteoarthritis (OA). Here, we identified R1-P1, an inhibitory peptide for FGFR1 and investigated its effect on the pathogenesis of OA in mice induced by destabilization of medial meniscus (DMM).

DESIGN

Binding ability between R1-P1 and FGFR1 protein was evaluated by enzyme-linked immuno sorbent assay (ELISA) and molecular docking. Alterations in cartilage were evaluated histologically. The expression levels of molecules associated with articular cartilage homeostasis and FGFR1 signaling were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting and immunohistochemistry (IHC). The chondrocyte apoptosis was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) assay.

RESULTS

R1-P1 had highly binding affinities to human FGFR1 protein, and efficiently inhibited extracellular signal-regulated kinase (ERK)1/2 pathway in mouse primary chondrocytes. In addition, R1-P1 attenuated the IL-1β induced significant loss of proteoglycan in full-thickness cartilage tissue from human femur head. Moreover, this peptide can significantly restore the IL-1β mediated loss of proteoglycan and type II collagen (Col II) and attenuate the expression of matrix metalloproteinase-13 (MMP13) in mouse primary chondrocytes. Finally, intra-articular injection of R1-P1 remarkably attenuated the loss of proteoglycan and the destruction of articular cartilage and decreased the expressions of extracellular matrix (ECM) degrading enzymes and apoptosis in articular chondrocytes of mice underwent DMM surgery.

CONCLUSIONS

R1-P1, a novel inhibitory peptide for FGFR1, attenuates the degeneration of articular cartilage in adult mice, which is a potential leading molecule for the treatment of OA.

Analytical indicators to characterize Particulate Organic Matter (POM) and its evolution in French Vertical Flow Constructed Wetlands (VFCWs)

The design of French VFCWs leads to the formation of a sludge layer at the surface of the first filters due to the retention of suspended solids from the percolation of unsettled wastewater. This layer plays a major role in the system but still little is known on its characteristics and evolutions. In this study, suspended solids and sludge deposits sampled from two French VFCW plants were analyzed by different methods in the objective to assess the evolution of particulate organic matter (POM) along the treatment chain and within the sludge layer, and identify relevant analytical indicators of these phenomena. The treatment chain included an aerobic trickling filter followed by FeCl₃ injection and two successive stages of filters. Thermal analyses showed that OM contents of suspended solids decreased along the treatment chain. POM in inflow suspended solids was predominantly composed of reactive, biodegradable compounds which were partly hydrolyzed and mineralized notably at the trickling filter stage. 3D fluorescence spectra collected from aqueous POM extracts confirmed the evolution of organic matter from low-molecular reactive compounds to more complex and stable structures such as humic-like substances. FTIR confirmed the mineralization of POM's reactive constituents along the treatment chain by the decrease in the intensities of the characteristics bands of aliphatic compounds or proteins, and its humification in the sludge deposits through the relative increase of the bands at 1634cm^-1 (v_C=O) and 1238cm^-1 (δ_C=O and/or δ_OH). Isotopic ratios δ²H/¹H and δ¹⁵N/¹⁴N were found to be good indicators of POM evolutions. The higher values of δ²H/¹H and δ¹⁵N/¹⁴N ratios measured in sludge deposits as compared to inflow suspended solids were related to POM humification and to microbial processes of POM hydrolysis and mineralization, respectively.

Meta-analysis of hypertension and osteoporotic fracture risk in women and men

The present meta-analysis synthesized evidence from 10 articles encompassing 28 independent studies to verify the association between hypertension and osteoporotic fracture risk in women and men. Our results indicate that the risk of osteoporotic fracture among individuals with hypertension was higher than that among individuals without hypertension.

INTRODUCTION

Epidemiological studies have suggested that hypertension is related to osteoporotic fracture. However, discrepancies exist in the reported findings. In this study, a systematic review of relevant published articles was conducted to verify the association between hypertension and osteoporotic fracture risk in women and men.

METHODS

PubMed (1953_October 5th, 2016) and Embase (1974_October 5th, 2016) were systematically searched for relevant articles. Odds ratios (ORs) and confidence intervals (CIs) were derived using random effect models. Categorical, subgroup, heterogeneity, publication bias, and meta-regression analyses were conducted.

RESULTS

We analyzed 10 articles encompassing 28 independent studies, 1,430,431 participants, and 148,048 osteoporotic fracture cases. The risk of osteoporotic fracture among individuals with hypertension was higher (pooled OR = 1.33, 95% CI 1.25-1.40; I ² = 72.3%, P < 0.001) than that among individuals without hypertension. The association between hypertension and fracture risk was slightly stronger in women (pooled OR = 1.52, 95% CI 1.30-1.79) than in men (pooled OR = 1.35, 95% CI 1.26-1.44). Studies conducted in Asia revealed results that were consistent with those of studies performed in Europe.

CONCLUSIONS

Hypertension is associated with osteoporotic fracture risk. However, the biological mechanisms underlying the effect of hypertension on osteoporotic fracture remain to be elucidated.

Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta-analysis

OBJECTIVES

The objective of this study was to perform a systematic review of the orthodontic literature with regard to efficiency, effectiveness and stability of treatment outcome with clear aligners compared with treatment with conventional brackets.

METHODS

An electronic search without time or language restrictions was undertaken in October 2014 in the following electronic databases: Google Scholar, the Cochrane Oral Health Group's Trials Register, Scopus, CENTRAL, MEDLINE via OVID, EMBASE via OVID and Web of Science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two authors were responsible for study selection, validity assessment and data extraction.

RESULTS

Four controlled clinical trials including a total of 252 participants satisfied the inclusion criteria. We grouped the trials into four main comparisons. One randomized controlled trial was classified as level 1B evidence, and three cohort studies were classified as level 2B evidence. Clear aligners appear to have a significant advantage with regard to chair time and treatment duration in mild-to-moderate cases based on several cross-sectional studies. No other differences in stability and occlusal characteristics after treatment were found between the two systems.

CONCLUSIONS

Despite claims about the effectiveness of clear aligners, evidence is generally lacking. Shortened treatment duration and chair time in mild-to-moderate cases appear to be the only significant effectiveness of clear aligners over conventional systems that are supported by the current evidence.

Novel stent in the palliation of malignant esophageal strictures: a retrospective study

The placement of metal stents is often used as a palliative treatment for malignant esophageal stenosis. We designed a novel stent that has been used clinically since 2011, and we therefore performed a retrospective study to compare the therapeutic effects of this novel metal stent to a conventional partially covered metal stent in patients with malignant esophageal strictures. The records of 201 consecutive patients who underwent placement of either the conventional partially covered metal stents (Group A, n = 92) or the new metal stents (Group B, n = 109) in the Endoscopy Center of General Hospital of Chengdu Military Command from October 2008 to March 2013 were reviewed. The median dysphagia score significantly improved in both groups 1 week following stent placement (P < 0.001). No significant differences were observed in success rate (P = 0.910) or the complication rate (P = 0.426) between groups. Six months after stent placement, recurrent dysphagia due to stent migration, tissue ingrowth or overgrowth or food obstruction occurred in 45% and 29% of patients in the conventional stent and new stent groups, respectively. The results of this retrospective study indicate that the new modified self-expandable metal stents (SEMS) is at least as safe and effective as the conventional partially covered SEMS in treatment of malignant esophageal strictures.

[Direct anterior approach versus posterolateral approach for total hip arthroplasty in the lateral decubitus position]

Objective: To compare the clinical efficacy of the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in the lateral decubitus position. Methods: From July to December, 2014, 104 patients randomly divided into two equal groups of the DAA group and the PLA group underwent unilateral primary THA procedures.All procedures were performed by the same surgeon in the Department of Orthopaedics, the Affiliated Anhui Provincial Hospital of Anhui Medical University.General data, perioperative index, postoperative function and radiological evaluation were recorded and statistically analyzed. Results: The patients had an average follow-up of 14 (range, 10-16) months.No significant differences were detected with respect to the operation time, incision length, preoperative Hb concentration and transfusion rate between two groups (P> 0.05 for all comparisons). However, there were significant differences associated with the intraoperative bleeding, postoperative drainage and postoperative Hb concentration in the two groups(P<0.05 for all comparisons). The DAA group showed significant superior outcomes compared with the PLA group in the Harris hip scores [(83.6±7.1) vs (79.8±6.6), P<0.05], WOMAC[ (28.9±6.1) vs (36.1±6.9), P<0.001], and VAS pain scores[ (2.2±0.9) vs (2.9±1.1), P<0.05]at 1 month after surgery. No differences were seen between the study groups in the evaluation of radiography and the incidence of adverse event (P> 0.05 for all comparisons). Conclusions: Compared with the posterolateral approach, the present study shows the exciting results in patients underwent the DAA THA in the lateral decubitus position at early follow-up.The advantages of THA using the DAA include less operative trauma, alleviation of postoperative pain, and faster postoperative rehabilitation. It is a safe, reliable and effective surgery approach.

Upregulated microRNA-301a in osteosarcoma promotes tumor progression by targeting CDC14A

MicroRNAs (miRs) are associated with tumor progression in various cancers, such as gastric and hepatic carcinomas, and lung cancer. miR-301a is overexpressed and displays oncogenic activity in cancers. We investigated the biological involvement of miR-301a in osteosarcoma (OS). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to analyze expression levels of miR-301a in 24 OS and matched adjacent non-tumor tissues. A miR-301a mimic was transferred into OS cell lines U-2 OS and MG-63 to upregulate miR-301a. The effects of miR-301a were investigated by examining cell proliferation, migration, and the cell cycle. The miR-301 target was predicted by TargetScan and confirmed by western blotting and qRT-PCR. The expression of miR-301a was significantly higher in OS tissues compared with the matched adjacent non-tumor tissues (0.959 ± 0.39 vs 3.9516 ± 1.18). Upregulated miR-301a significantly increased proliferation at 48 and 72 h compared to the negative control (U-2 OS: 2.11 ± 0.21 vs 2.88 ± 0.24; 2.70 ± 0.26 vs 3.71 ± 0.24; MG-63: 2.19 ± 0.20 vs 3.19 ± 0.22; 3.1 ± 0.25 vs 4.01 ± 0.27) and migration capability (U-2 OS: 100 ± 20.19 vs 150.68 ± 32.83; MG-63: 100 ± 17.20 vs 133.35 ± 26.26), and decreased apoptosis in both U-2 OS (10.87 ± 2.53 vs 4.01 ± 2.23) and MG-63 (15.26 ± 2.15 vs 8.25 ± 3.07). The cell cycle studies revealed that miR-301a caused an increase of the G2 population in U-2 OS (38.6 ± 6.58 vs 47.2 ± 7.27) and MG-63 (44.01 ± 5.28 vs 57.9 ± 4.25). Additional experiments indicated that CDC14A was upregulated by miR-301a (0.63 ± 0.06 vs 0.98 ± 0.06; 1.49 ± 0.25 vs 2.99 ± 0.14). Overexpressed miR-301a may increase CDC14A expression and promote cell proliferation and migration in OS cells. Therefore, miR- 301a may be useful for osteosarcoma diagnosis and therapy.

Inflammatory dentigerous cyst of mandibular first premolar associated with endodontically treated primary first molar: a rare case report

AIM

Inflammatory dentigerous cysts usually occur in the mixed dentition. It has been reported that inflammatory lesions from the root area of a deciduous tooth bring about the development of dentigerous cysts around the unerupted permanent tooth bud. Endodontic treatment is a common and successful procedure for periapical inflammation in children. An inflammatory dentigerous cyst can occur in conjunction with endodontically treated primary tooth.

CASE REPORT

This article reports a case of 6 years and 6 months old boy, with a single, well-defined, unilocular, radiolucent area enclosing the first right unerupted mandibular premolar, accidentally discovered on the panoramic radiograph. The first right primary molar had received a root canal treatment 18 months prior. Clinical findings combined with radiographic and microscopic examinations confirmed the diagnosis of inflammatory dentigerous cyst. As treatment, enucleation of the cyst with removal of the involved permanent tooth was chosen and a removable partial denture was supplied to the patient after surgery. The 5-year follow-up revealed good healing of the bony lesion and displaced teeth.

CONCLUSION

This case presented a severe and rare complication of endodontically treated primary tooth, and the recommendation includes: (1) early diagnosis of dentigerous cysts, which is essential to prevent extensive treatment; (2) more information on the adverse side effects of an endodontic treatment should be given to patients and parents; (3) patients should be informed about the importance of follow-ups and radiographic follow-up should be routinised.

The novel BH-3 mimetic apogossypolone induces Beclin-1- and ROS-mediated autophagy in human hepatocellular carcinoma [corrected] cells

Apogossypolone (ApoG2), a novel derivative of gossypol, exhibits superior antitumor activity in Bcl-2 transgenic mice, and induces autophagy in several cancer cells. However, the detailed mechanisms are not well known. In the present study, we showed that ApoG2 induced autophagy through Beclin-1- and reactive oxygen species (ROS)-dependent manners in human hepatocellular carcinoma (HCC) cells. Incubating the HCC cell with ApoG2 abrogated the interaction of Beclin-1 and Bcl-2/xL, stimulated ROS generation, increased phosphorylation of ERK and JNK, and HMGB1 translocation from the nucleus to cytoplasm while suppressing mTOR. Moreover, inhibition of the ROS-mediated autophagy by antioxidant N-acetyl-cysteine (NAC) potentiates ApoG2-induced apoptosis and cell killing. Our results show that ApoG2 induced protective autophagy in HCC cells, partly due to ROS generation, suggesting that antioxidant may serve as a potential chemosensitizer to enhance cancer cell death through blocking ApoG2-stimulated autophagy. Our novel insights may facilitate the rational design of clinical trials for Bcl-2-targeted cancer therapy.

Surgical vs general practitioner assessment: diagnostic accuracy in 2-week-wait colorectal cancer referrals

AIM

It has been recommended that patients with suspected colorectal cancer should proceed straight to an endoscopic test to increase speed of diagnosis, using only the information in the general practitioner's referral letter. This study aims to establish whether the diagnostic accuracy of the first surgical outpatient assessment is significantly greater than the general practitioner's assessment and if so by what means.

METHOD

Demographic variables, symptoms and signs were collected from the first surgical outpatient assessment letters and the general practitioners' referral letters in 2-week-wait colorectal cancer referrals made between 2002 and 2005. Multiple logistic regression models derived from both the surgeons' and the general practitioners' letters were compared with receiver operator characteristic curves.

RESULTS

Variables were collected from 978 2-week-wait colorectal cancer referrals. The median age was 69 years (range 19-98) and the male to female ratio was 1:2. Seventy-eight referrals were diagnosed with colorectal cancer. Surgeons' models demonstrated significantly greater diagnostic accuracy than general practitioners' models (area under the curve, 0.84 vs 0.73; P < 0.003). General practitioners' letters contained significantly less information than surgeons' letters (P < 0.001), but correcting for this did not account for the difference in diagnostic accuracy. The single variable that accounted for the difference in diagnostic accuracy was examination of the rectum by rigid sigmoidoscopy.

CONCLUSION

Rigid sigmoidoscopy significantly improves the diagnostic accuracy of clinical assessment in patients with suspected colorectal cancer. If rigid sigmoidoscopy were omitted in a straight-to-test pathway, some patients would be denied the opportunity for immediate diagnosis.

Relationship between levels of secreted phospholipase A₂ groups IIA and X in the airways and asthma severity

Background Secreted phospholipase A(2) (sPLA(2) ) may be important mediators of asthma, but the specific sPLA(2) s involved in asthma are not known. Objective To evaluate sPLA(2) group IIA, V, and X proteins (sPLA(2) -IIA, sPLA(2) -V, and sPLA(2) -X) in bronchoalveolar lavage (BAL) fluid, BAL cells, and airway epithelial cells of subjects with and without asthma, and examine the relationship between the levels of specific sPLA(2) enzymes and airway inflammation, asthma severity, and lung function. Methods The expression of sPLA(2) -IIA, sPLA(2) -V, and sPLA(2) -X in BAL cells and epithelial brushings was assessed by qPCR. The levels of these sPLA(2) proteins and sPLA(2) activity with and without group II and group X-specific inhibitors were measured in BAL fluid from 18 controls and 39 asthmatics. Results The airway epithelium expressed sPLA(2) -X at higher levels than either sPLA(2) -IIA or sPLA(2) -V, whereas BAL cells expressed sPLA(2) -IIA and sPLA(2) -X at similar levels. The majority of sPLA(2) activity in BAL fluid was attributed to either sPLA(2) -IIA or sPLA(2) -X. After 10-fold concentration of BAL fluid, the levels of sPLA(2) -X normalized to total protein were increased in asthma and were associated with lung function, the concentration of induced sputum neutrophils, and prostaglandin E(2) . The levels of sPLA(2) -IIA were elevated in asthma when normalized to total protein, but were not related to lung function, markers of airway inflammation or eicosanoid formation. Conclusions and Clinical Relevance These data indicate that sPLA(2) -IIA and sPLA(2) -X are the major sPLA(2) s in human airways, and suggest a link between the levels of sPLA(2) -X in the airways and several features of asthma.

Strong impact of acute kidney injury on survival after liver transplantation

Acute kidney injury (AKI) is a major complication in orthotopic liver transplantation (OLT). In an evaluation of Acute Kidney Injury Network (AKIN) criteria in liver transplanted patients, we retrospectively analyzed the usefulness of these criteria to predict survival of 193 consecutive patients at a single center who underwent primary OLT for clinical parameters and peak AKI. Postoperative AKI according to AKIN occurred in 60.1% of the patients, namely, stages 1, 2, and 3 in 30%, 13% and 17.1% respectively. Using multivariate logistic regression, AKIN stage 1 and 2 AKI were independently associated with the pre-OLT Model for End-Stage Liver Disease (MELD) score and age, while stage 3 AKI was independently associated with MELD and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. The 28-day and 1-year mortality post-OLT of AKI patients were 15.5% and 25.9% respectively compared with 0% and 3.9% among non-AKI patients (P < .05 for both). The survival rates of non-AKI and stages 1, 2, and 3 AKI subjects were 96%, 85.5%, 84%, and 45.3%, respectively. Cox regression analysis showed independent risk factors for mortality during the first year after transplantation to include post-OLT AKI (12.1; P < .05), post-OLT infection (HR 4.7; P < .01), pre-OLT hypertension (HR 4.4; P < .01) hazard ratio [HR] and post-OLT APACHE II ≥10 (HR 3.6; P < .05). We concluded that AKI as defined by the AKIN criteria is a major complication of OLT linked to a poor outcomes. It remains to be evaluated whether aggressive perioperative therapy to prevent AKI can improve survival among OLT patients.

Impaired interhemispheric inhibition in writer's cramp

OBJECTIVES

Reduced cortical inhibition is a feature of focal hand dystonia and this likely contributes to excessive muscle contractions. Inhibition from the opposite hemisphere, known as interhemispheric inhibition (IHI), was studied bidirectionally in 7 right-handed patients with writer's cramp (WC) and age-matched healthy controls in a cross-sectional physiologic study.

METHODS

IHI was measured with paired transcranial magnetic stimulation with the conditioning stimulus applied to the motor cortex and the test stimulus applied to the contralateral motor cortex. Surface EMG was measured in right and left first dorsal interosseous muscles during rest, and while holding a pen between the thumb and index finger at 20% maximum voluntary contraction with the right dystonia-affected hand. The time course and magnitude of IHI was studied at interstimulus intervals of 6, 8, 10, 12, 30, 40, and 50 msec between the conditioning stimulus and test stimulus.

RESULTS

In WC at rest, IHI was significantly reduced in the dystonia-affected right hand (IHI from right to left motor cortex) at both short (SIHI, 10-12 msec) and long (LIHI, 30-40 msec) intervals compared to the unaffected hand. Compared to controls, SIHI and LIHI were reduced in the dystonia-affected hand only. There was no difference in IHI between controls and WC during the task of holding a pen.

CONCLUSIONS

In WC, both SIHI and LIHI are reduced in the dystonia-affected hand compared to the unaffected hand and to healthy controls. Impaired IHI may contribute to excessive muscle contraction in WC.