bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term trajectories of bmi predict carotid stiffness and plaque volume in type 2 diabetes older adults: a cohort study.
Authors: Moshe chen Botvin , Haratz Salo , Ravona-Springer Ramit , Heymann Anthony , Beeri Michal Schnaider , Tanne David
Published: May 2020

Background High body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study.Methods Carotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N = 471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n = 185, 44%), overweight trajectory (n = 188, 44.8%) and a trajectory of obesity (n = 47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories.Results Compared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β=-3.078, p = 0.037), cIMT (β = 0.095, p = 0.004), and carotid elastography (β = 0.181, p = 0.004) but not with plaque volume (β = 0.066, p = 0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR = 2.790, p = 0.033), impaired cIMT (OR = 5.277, p = 0.001) and large carotid plaque volume (OR = 8.456, p = 0.013) but not with carotid elastography (OR = 1.956, p = 0.140). Mean BMI was linearly associated with Distensibility (β=-0.275, p = 0.005) and cIMT (β = 0.005, p = 0.026).Conclusions Long-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.
Long-term outcomes after treatment of bare-metal stent restenosis with seal-wing or iopromide-coated paclitaxel-eluting balloon catheters.
Authors: Pleva Leos , Kukla Pavel , Zapletalova Jana , Hlinomaz Ota
Published: May 2020

Background: The efficacy of paclitaxel-eluting balloon catheters (PEB) is affected by the method of binding paclitaxel to the balloon catheter surface. The aim of this study was to compare the long-term efﬁcacy of seal-wing and iopromide-coated PEB for bare-metal stent restenosis (BMS-ISR) treatment. Methods:We analyzed 3-year clinical follow-up data of 132 patients with BMS-ISR. 64 of them were treated with seal-wing PEB, the control group comprised 68 patients from the iopromide-coated PEB arm of the previous TIS clinical study. Primary end-points included the occurrence of major adverse cardiac events (MACE; cardiovascular [CV] death, myocardial infarction [MI], or target vessel revascularization [TVR]) Results:At 3 year clinical follow-up, the incidence of MACE was significantly higher in the seal-wing PEB than in the iopromide-coated PEB group (40.6 % vs. 19.1%; p=0.008); the same can be said about TVR (26.9% vs. 8.8%; p=0.011). Similarly, the event-free survival was significantly longer in the iopromide-coated PEB than in the seal-wing PEB group (p=0.021). No significant differences were found between the groups where CV mortality (4.7% vs. 5.9%; p=1.000), MI (6.3% vs. 4.4%; p=0.712), definite stent thrombosis (0% vs. 2.9%; p=0.497) or the second MACE (4.7% vs. 1.5%; p=0.354) are concerned.Conclusions: Compared to iopromide-coated PEB, the use of seal-wing PEB for BMS-ISR treatment led to a significantly higher 3-year occurrence of MACE and TVR. Trial registartion: ClinicalTrials.gov; https://clinicaltrials.gov; NCT01735825 (Registered 7 Nov 2012).
Sofosbuvir/ledipasvir safety and efficacy for HCV patients with haemodialysis and compensated cirrhosis
Authors: Boushi Ebtisam , Cheha Khaled , Kakaje Ameer , Heydar Noha , Almokdad Rasha , Alassi Mohammed Waleed
Published: May 2020

Objectives: To evaluate the efficacy of Sofosbuvir/ledipasvir (SOF/LDV) combination for hepatitis C virus (HCV) in patients on haemodialysis and compensated liver cirrhosis as it was until recently approved by the FDA.Design: Retrospective study on patients who were on haemodialysis and used SOF/LDV for HCV.Setting: In one secondary health care facility (a hospital).Interventions: Treatment consisted of 90g of SOF/ 400g of LDV once daily. Patients were assessed for HCV at end treatment after 12 weeks and after 24 weeks for patients who had compensated cirrhosis with other follow-up for symptoms assessment.Results: The sample contained 16 males and 5 females with mean age of 40.9 years. Nineteen patients had no cirrhosis of the liver and the other two had clinical and radiological cirrhosis and had Child–Turcotte–Pugh (CTP) type B. Full follow-up was for only 20 patients and they all had HCV resolved as one patient passed away. Other factors were assessed such as HCV genotypes, but they had the same results with no difference in symptoms development (P>0.05).Conclusion: SOF/LDV combination is suggested to be effective when the patient is on haemodialysis and had compensated cirrhosis and CTP type B without the need of dose adjustment or increase duration with no major complications in patients with HCV 1a, 1b, 4, and 5.
Implementation and adherence to the Bedside Paediatric Early Warning System (BedsidePEWS) in a pediatric tertiary care hospital
Authors: Gawronski Orsola , Ferro Federico , Cecchetti Corrado , Atti Marta Luisa Ciofi Degli , Dall'oglio Immacolata , Tiozzo Emanuela , Raponi Massimiliano
Published: May 2020

BackgroundClinical deterioration in children admitted to hospital wards often manifests through signs of increasing illness severity that may lead to unplanned Pediatric Intensive Care Unit admissions or cardiac arrest, if undetected. The Bedside Pediatric Early Warning System (BedsidePEWS) is a validated Canadian scoring system used at a large tertiary care children’ hospital to prevent critical illness and standardize the response to deteriorating children on the wards.MethodsA 6-month audit was performed to evaluate the use of the BedsidePEWS, escalation of patient observations, monitoring and medical reviews on the wards in 2018.Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student’s t test or Wilcoxon-Mann–Whitney test, as appropriate (P <0.05 considered as significant).ResultsA total of 522 Vital Signs (VS) and score calculations on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of VS and score documentation occurred <3 times per day in 33% of the observations. Adherence to the VS documentation frequency according to the hospital protocol was observed in 54% for all patients; for children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47%, P=0.006). The BedsidePEWS score was correctly calculated and documented in 84% of the observed VS documentation events. Systolic blood Pressure was recorded in 79% and Temperature in 91% of the VS recording events. Patients within a 0-2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50% of the patients in the 5-6 score range were reviewed within 4 hours and 42% of the patients with a score ≥7 within 2 hours. Transcutaneous Oxygen Saturation continuous monitoring was applied to 60% of the children at higher risk (BedsidePEWS ≥5).ConclusionsEscalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.
Altered expression of exosomal miRNAs from primary human trabecular meshwork cells induced by transforming growth factor-β2
Authors: Wang Yong , Zhang Jinling , Luo Jiawei , Guan Huaijin
Published: May 2020

Background

Primary open-angle glaucoma (POAG) is tightly related with extracellular matrix (ECM) remodeling of human trabecular meshwork cells (HTMCs). Transforming growth factor-β2 (TGF-β2) can induce ECM remodeling. MicroRNAs (miRNAs) serve as a potential therapeutic target in influencing the development of glaucoma by regulating TGF-β2. Recent studies also have found that exosomes may be involved in the regulation of intraocular pressure in patients of glaucoma. Therefore, the aim of the current study was to investigate the exosomal miRNAs expression changes derived from HTMCs treated with TGF-β2.
Methods

Exosomes were isolated from HTMCs supernatant cultured for 24 h with TGF-β2. The morphology of exosome pellets was examined by transmission electron microscopy. Nanoparticle tracking analysis used to demonstrate the particle size distribution. Total exosomal RNAs were extracted for subsequent miRNA gene chip analysis to investigate differentially expressed miRNAs between the control cells and treatment cells. Gene Ontology (GO) annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to predict potential target and validate possible functions of the exosomal miRNAs.
Results

There were 23 miRNAs up-regulated and 3 miRNAs down-regulated. Go annotation and KEGG pathway enrichment analysis revealed that 469,102 and 94 GO terms involved in biological processes, cellular components and molecular function for the possible functions of the 26 miRNAs.
Conclusions

These findings indicate that TGF-β2 may alter exosomal miRNAs expression to participate in the pathogenesis of POAG in which multiple molecular functions and pathways are involved. They may provide significant information for potential biomarkers for POAG diagnosis, clinical treatment and potential prognosis.
Clinical Significance of Hemodynamic Parameters Identified by Ultrasound in the Extracranial Internal Carotid Artery and Posterior Cerebral Artery of Patients with Moyamoya Disease
Authors: Zheng Shuai , Ge Peicong , Wang Jingzhe , Shi Zhiyong , Li Yi , Ning Bin , Zhang Jinghan , Cheng Linggang , Zhang Dong , He Wen
Published: May 2020

BackgroundDigital subtraction angiography (DSA), magnetic resonance angiography (MRA) and other imaging methods are limited in the long-term and dynamic examination of hemodynamic changes in moyamoya disease (MMD). The aim of this study was to investigate the hemodynamic changes using ultrasound according to DSA findings and explore the association between ultrasound parameters and clinical manifestations of MMD.MethodsHemodynamic parameters of the extracranial internal carotid artery (EICA) and posterior cerebral artery (PCA) identified by ultrasound were classified into 3 groups according to DSA findings, and differences in ultrasound parameters among DSA stages were compared. Then, according to clinical manifestations, 30 patients were divided into the stroke group and the transient ischemic attack (TIA) group. We compared the differences in the EICA and PCA ultrasound parameters between the two groups, and receiver operating characteristic (ROC) curves were used to evaluate the value of ultrasound parameters in diagnosing stroke and TIA in MMD patients.ResultsThe diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and flow volume (FV) of EICA decreased as the Suzuki stage advanced (D: p༜0 .001, PSV: p = 0.002, EDV: p = 0.001, FV: p༜0.001). The PSV and EDV of PCA increased as the scores of the leptomeningeal system from the PCA to the anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory advanced (PSV: p = 0.002, EDV: p༜0.001). Comparing the ultrasound parameters between the stroke group and the TIA group, the D and FV of EICA, the PSV and EDV of PCA were significantly different. ROC analysis showed that the area under the curve (AUC) based on the FV of EICA, the PSV of PCA and the combination of the two parameters were 0.676, 0.737 and 0.787, respectively, to diagnose stroke and TIA in MMD patients.ConclusionsOur results suggest that ultrasound parameters are related to DSA results, and that ultrasound is useful in predicting the clinical severity of MMD.Trial registration:Clinical Trial Registration-URL: http://www.chictr.org. Unique identifier: ChiCTR1900026075
Celastrol ameliorates experimental autoimmune neuritis by shifting the polarization of M1/M2 macrophages via the hypoxic response pathway
Authors: Qian Yun , Tang Bo , Jiang Minhai , Lu Shan , Huang Huan , Wei Wan
Published: May 2020

BackgroundGBS is an autoimmune disease characterized by inflammatory infiltration and demyelination of peripheral nerves. Macrophage polarization is involved in different stages of GBS. Altering the polarization of macrophages may be an effective therapeutic strategy for GBS. Celastrol was previously shown to contribute to anti-neuroinflammation. However, the mechanism underlying the effect of celastrol in GBS animal model experimental autoimmune neuritis (EAN) is unclear. We hypothesized that celastrol may shift the polarization of macrophages through the NRF /HIF-1αpathway.MethodsClinical scores, weight and histological changes were assessed to investigate the effects of celastrol on EAN. To detect the polarization state of macrophages, flow cytometry and immunofluorescence staining were applied. Inflammation cytokines were evaluated by ELISA. The expression of NRF2 and HIF-1α were detected by western-blot and immunofluorescence staining.ResultsCelastrol treatment significantly ameliorates the severity and neuroinflammation of EAN. The polarization state of macrophages from M1 to M2 was observed upon celastrol application. Consistently, pro-inflammatory cytokines were decreased, whereas anti-inflammatory cytokines were increased upon celastrol treatment. Furthermore, we found that celastrol treatment may increase expression of Nrf2 and decrease the expression of HIF-1α. ConclusionTaken together, these data demonstrate that celastrol may ameliorate the severity and neuroinflammation of EAN via promoting the polarization state of macrophages into M2, likely by modulating the hypoxic response. Celastrol may therefore serve as a novel therapeutic agent for GBS.
Intracytoplasmic expression of IL-6 and IL-17A in circulating CD4+ T cells are strongly associated with and predict disease activity in rheumatoid arthritis: A case-control study in Ghana
Authors: Sakyi Samuel Asamoah , Buckman Tonnies Abeku , Antwi-Berko Daniel , Yeboah-Mensah Kwame , Dey Dzifa , Owiredu Eddie-Williams , Amoani Benjamin , Mantey Richard
Published: May 2020

Background

T cell cytokines play important roles in the development and progression of rheumatoid arthritis (RA). Loss of Th1/Th2 and Th17/Treg balance has been reported in several inflammatory autoimmune diseases. However, their role in RA within the Ghanaian context has not been explored. Here, we evaluated the intracytoplasmic CD4 + T cell cytokine patterns in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity.
Methods

This case-control study included 48 newly-diagnosed RA patients and 30 healthy controls from two major hospitals in Ghana. Validated structured questionnaires were administered to obtain demographic data; blood samples were collected and processed for flow cytometric analysis.
Results

IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A, IL-6/IL-4 and IL-17/IL-10 expression were significantly higher in RA cases compared to the healthy controls. The expression of IL-6 (0.00 (0.00-0.98) vs 0.82 (0.34–1.10) vs 1.56 (1.39–1.68), p < 0.0001), IL-17A (0.00 (0.00-0.02) vs 0.19 (0.09–0.30) vs 0.99 (0.64–1.25), p < 0.0001) and IL-17A/IL-10 (0.00 (0.00-0.39) vs 0.15 (0.09–0.26) vs 0.88 (0.41–1.47), p < 0.0001) increased significantly from the healthy controls through RA patients with low DAS scores to RA patients with moderate DAS scores. IL-6 (β = 0.681, r2 = 0.527, p < 0.0001), IL-17A (β = 0.770, r2 = 0.593, p < 0.0001) and IL-17A/IL-10 (β = 0.677, r2 = 0.452, p < 0.0001) expression were significantly directly associated with DAS28 scores. IL-6 (Cutoff = 1.32, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) and IL-17A (Cutoff = 0.58, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) presented with the best discriminatory power in predicting moderate DAS scores from low DAS scores.
Conclusion

Th1 and Th17 related cytokines predominate in the pathophysiology of RA; with IL-6 and IL-17 being principally and differentially expressed based on the severity of the disease. IL-6 and IL-17A could serve as useful prognostic and disease-monitoring markers in RA in the African context.
Comparative study for Treatment of Domestic Wastewater Using Chlorella Vulgaris
Authors: Moondra Nandini , Jariwala Namrata , Christian Robin A
Published: May 2020

Tertiary treatment using chemicals frequently prompts secondary contamination of sludge, making other issues of safe disposal. Thus, vitality and cost required for tertiary treatment of wastewater stay an issue for industries and municipalities. In this study, different microalgal concentrations (20%, 25%, 30%, 35%, 40% and 45%) were studied to treat domestic wastewater at 11 hours HRT for both filtered and non- filtered effluent. During the study, removal was observed in Total Solids (TS), Total Dissolved Solids (TDS), Total Suspended Solids (TSS), Electrical Conductivity (EC), phosphate, ammonia and COD for all the microalgal concentrations mentioned. However, the maximum removal efficiency was observed at 30% microalgal concentration. Maximum removal efficiency found in ammonia, phosphate and COD for non-filtered effluent was 96.60%, 91.73% and 84.71% respectively, whereas, in the case of the filtered sample, removal efficiency reached up to 97.62%, 92.47% and 88.75% for ammonia, phosphate and COD respectively. In the case of solids (specifically TSS) and EC, removal efficiency reached up to 30.87% and 24.31% respectively for non-filtered effluent and was 48.00% and 25.88% in the filtered sample. The study showed that an algae-based system could accomplish more affordable and environment-friendly way to treat domestic wastewater without tertiary treatment to a desirable limit.
The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture
Authors: Zhang Dongzheng , Shen Yong
Published: May 2020

Background: It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods: Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results: The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions: To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.
Increased percentage of Atrial Pace Ventricular Pace was associated with increased cardiovascular morality in patients with a DDD pacemaker
Authors: Lee Wen-Hsien , Lee Chee-Siong , Tsai Wei-Chung , Lin Feng-Hsien , Tsai Wan-Ling , Chen Ying-Chih , Chen Chang-Jen , Hsu Po-Chao , Chu Chun-Yuan , Lin Tsung-Hsien , Voon Wen-Chol , Su Ho-Ming
Published: May 2020

Background

Compared to single-chamber pacing system, dual chamber atrioventricular pacing system (DDD) was associated with reduced mortality and hospitalization for heart failure. High percentage of right ventricular pacing was reported to be associated with high cardiovascular events. However, another meta-analysis study showed ventricular pacing reduction modalities did not improve adverse clinical outcomes. Hence, the relationship between the pacing percentage and clinical outcomes is necessary to be further studied.
Methods

The present study was designed to evaluate the association of total and cardiovascular mortality with the percentages of atrial sense ventricular sense (ASVS), atrial sense ventricular pace (ASVP), atrial pace ventricular sense (APVS), and atrial pace ventricular pace (APVP) in patients with a DDD pacemaker. Study subjects were selected from patients arranged for permanent pacemaker follow-up at our special clinic. 177 patients with a DDD pacemaker were included. We collected their pacemaker follow-up data at their first visit for pacemaker follow-up after permanent pacemaker implantation.
Results

Among the 177 subjects, the mean follow-up to mortality was 2.44 ± 1.03 years. There were 22 and 10 patients documented as total and cardiovascular mortality. In the Cox proportional hazards regression analysis, old age (P = 0.030) and low hemoglobin (P = 0.007) were the predictors of increased total mortality and increased creatinine (P = 0.023) and high percentage of APVP (hazard ratio [HR], 1.030; 95% confidence interval [CI], 1.012–1.049; P = 0.001) were the predictors of increased cardiovascular mortality after multivariable analysis.
Conclusion

In patients with a DDD pacemaker, old age and low hemoglobin were associated with increased total mortality and high creatinene and high percentage of APVP were associated with increased cardiovascular mortality after multivariable analysis. Hence, reduction in unnecessary atrial and ventricular pacing in patients with a DDD pacemaker might be useful in improving cardiovascular prognosis.
Identification and validation of an immune-related prognostic signature for hepatocellular carcinoma
Authors: Xia Xinxin , Liu Hui , Li Yuejun
Published: May 2020

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality. The immune system plays vital roles in HCC initiation and progression. The present study aimed to construct an immune-gene related prognostic signature (IRPS) for predicting the prognosis of HCC patients. Methods: Gene expression data were retrieved from The Cancer Genome Atlas database. Univariate Cox regression analysis was carried out to identify differentially expressed genes that associated with overall survival. The IRPS was established via Lasso and multivariate Cox regression analysis. Both Cox regression analyses were conducted to determine the independent prognostic factors for HCC. Next, the association between the IRPS and clinical-related factors were evaluated. The prognostic values of the IRPS were further validated using the International Cancer Genome Consortium (ICGC) dataset. Gene set enrichment analyses (GSEA) were conducted to understand the biological mechanisms of the IRPS. Results: A total of 62 genes were identified to be candidate immune-related prognostic genes. Transcription factors-immunogenes network was generated to explore the interactions among these candidate genes. According to the results of Lasso and multivariate Cox regression analysis, we established an IRPS and confirmed its stability and reliability in ICGC dataset. The IRPS was significantly associated with advanced clinicopathological characteristics. Both Cox regression analyses revealed that the IRPS could be an independent risk factor influencing the prognosis of HCC patients. The relationships between the IRPS and infiltration immune cells demonstrated that the IRPS was associated with immune cell infiltration. GSEA identified significantly enriched pathways, which might assist in elucidating the biological mechanisms of the IRPS. Furthermore, a nomogram was constructed to estimate the survival probability of HCC patients.Conclusions: The IRPS was effective for predicting prognosis of HCC patients, which might serve as novel prognostic and therapeutic biomarkers for HCC.
Dynamic Monitoring of Cross-Bred Dogs for Translational Research in Ulcerative Colitis
Authors: Zhao Hairong , Wang Yujia , Liu Shengshuai , Yu Zhengyong , Xu Yusheng , Lu Qian , Liu Heng , Xu Zaiping , Zhang Chenggui , Zhao Yu
Published: May 2020

Background: Ulcerative colitis (UC)is a complex, chronic, immu ne-mediated inflammatory disease. The preclinical studies and assessment of UC drugs remain a major challenge. Dogs share similar environmental, genomic, anatomical, and intestinal physiologic features with humans. However, the model of UC in dogs is not understood and lacks systematic assessment. Methods: We developed a model for UC in the cross-bred dogs by different dose of acetic acid retention enema. Simultaneously, physiological pathologic indicators, including blood routine examination, inflammatory factor and colonoscopy, were monitored continuously for 14 days. Furthermore, olsalazine was used to treatment UC to evaluate the feasibility of the model. Results: The percentage of lymphocytes increases after induction UC by 10% acetic acid; C-reactive protein (CRP) and Cyclooxygenase-2(COX-2) are mainly inflammatory markers after induction UC by 10% or 7.5% acetic acid; acetic acid aggravates mucosal damage in a dose-dependent manner, and OLZ prevents 10% acetic acid-induced UC. The acetic acid concentration is controlled between 7.5 % and 10%, and the continuous damage of this model is 10 days.Conclusions: We suggest that cross-bred dogs represent a useful clinical model of UC, and it is suitable for translational research. Finally, we provide a model and dynamic endoscope atlas for UC in dogs.
The prognostic values of initial apoA-I and CRP kinetics in patients with advanced NSCLC: a retrospective study
Authors: Zhou Danli , Cheng Ting , Zhang Jinping , Ling Jingjing , Hong Yuan , Ping Fengfeng , Wang Yan
Published: May 2020

Background: To analyse the value of C-reactive protein (CRP) kinetics and initial apolipoproteinA1 (apoA-I) level as prognostic parameters in advanced non-small Cell Lung Cancer (NSCLC). Methods : Within a retrospective single-center study, serum CRP and apoA-I level were measured at baseline and at the start of each platinum-based chemotherapy cycle for 125 NSCLC patients. Survival analysis, calculated by the Kaplan–Meier method and log-rank test, was used to assess the prognostic significance of Serum CRP and apoA-I level and both levels. The non-parametric Spearman rank correlation coefficient (rs) was used to measure the correlation between apoA-I and CRP. Results: Lung cancer-specific survival were significantly different across three CRP kinetics groups ( P <0.001), such significant differences were also seen between different apoA-I groups. In multivariate analysis, both CRP kinetics and apoA-I were independent significant factors for overall survival. Patients in non-normalized CRP group with lower apoA-I had a poor prognosis. Spearman’s rank correlation analysis revealed that the apoA-I level presented a negative correlation with the CRP level during treatment (r= -2.793, P <0.05). Conclusions: CRP kinetics and apoA-I may be useful to predict the prognosis of NSCLC patients treated with first-line platinum-based chemotherapy and facilitate individualized treatment.
In-vitro activity of levofloxacin against bacterial pathogens collected in China：A ten-year（2009-2018） retrospective study
Authors: GAN LU , Li Yun , Lv Yuan , Zheng Bo
Published: May 2020

Background： This study was designed to evaluate the in-vitro activity of levofloxacin against bacterial pathogens collected from Chinese hospitalized patients between 2009 and 2018, and analysis the trends of levofloxacin resistance in China.Methods In this analysis, antimicrobial minimum inhibitory concentrations (MICs) experiments with levofloxacin and controls against a range of Gram-positive and Gram-negative bacteria collected from 2009 to 2018. MICs were determined using the agar dilution method according to the guidelines of Clinical and Laboratory Standards Institute (CLSI)，2019. Antimicrobial susceptibility was determined using CLSI breakpoints. Statistical tests were analysed by Statistical Package for the Social Sciences software (SPSS, Inc., Chicago, IL, USA), calculating the MIC90.Results In the past decade，the antibacterial activities of levofloxacin against Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, which were common gram-negative bacteria, were stable; the resistance rates of these bacteria had no significant changes or decreased slightly. The levofloxacin resistance rates of Staphylococcus aureus and Enterococcus faecalis, which were gram positive bacteria, decreased from 48.4% and 36.9% in 2009-2010 to 22.8% and 25.7% in 2017-2018, respectively, respectively. The levofloxacin resistance rate among Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pneumoniae, the common pathogens of community acquired pneumonia (CAP), were less than 3%. The levofloxacin resistance rates for Klebsiella pneumoniae and Acinetobacter baumannii increased. No difference in the levofloxacin resistance rates by age group (18-64, 65-74, ≥75 years old age groups) was observed. The resistance rate of strains isolated from ICU patients was usually 10-20% higher than that of non-ICU patients.Conclusion In recent ten years, levofloxacin has continued to be active in-vitro against the strains in its antibacterial spectrum. No significant change of resistance rates was observed and it still has a good antibacterial effect on the main pathogenic bacteria of community-acquired pneumonia, such as Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae and MSSA.
Hypertension, Diabetes and the Risk of Cardiac and Cerebrovascular Events: a prospective cohort study
Authors: Li Yao , Li Junjuan , Wang Jianli , Zhao Maoxiang , Wang Chi , Yao Siyu , Wang Miao , Wu Shouling , Xue Hao
Published: May 2020

Background Hypertension and diabetes are both risk factors of cardiac and cerebrovascular events (CCVEs), but the combination of those two factors had not been certified the relationships relevant to CCVEs. The objective of this study is to determine the relationships of hypertension, diabetes and CCVEs.Methods 78380 participants from Kailuan cohort had been analyzed. Baseline information was collected in the health exam and all the participants were regularly followed-up for every two years during 8.96 ± 0.75 years. Participants were divided into six groups according to their hypertension and diabetes status (normal, baseline or follow-up). The incidence of new-onset cerebral ischemic stroke (CI), stroke and CCVEs were respectively calculated. Multiple Cox Regression and Cum Hazard were performed to analyze the hazard ratio for risk of new-onset CI, stroke and CCVEs in each group adjusting for traditional cardiovascular risk markers.Results In total, 78380 participants (including 61950 men) with a mean age of 56.74 at baseline were enrolled in this study. During about 9 years of follow-up, 3734 CCVEs, 2972 stroke and 2340 CI occurred among all the patients, with the incidence density (Per 1,000 years) of 5.29, 4.07 and 3.32. In patients with baseline hypertension and diabetes, hazard ratios (HRs) and 95% confidence intervals (95%CIs) of new-onset CI (HR = 2.45, 95%CI: 1.93, 3.11), stroke (HR = 2.39, 95%CI: 1.92, 2.98) and CCVEs (HR = 2.08, 95% CI: 1.72, 2.52)were higher than the other groups (P < 0.001). Patients with baseline hypertension or diabetes and follow-up diabetes or hypertension had higher risk of CI, stroke and CCVEs than those who with baseline disease only.Conclusion Hypertension and diabetes alone, especially the combination of these two diseases at baseline and during follow up, contributed significantly to increased risk of new-onset CI, stroke and CCVEs during the 9 years follow up in this cohort.
Do we really have a lack of ventilators?
Authors: Nosáľ Vladimír
Published: May 2020

The pandemia of COVID-19 is considered as „ventilator dependent“ disease. In a short study there are presented data from Switzerland showing that there was only short period of time when the most of ventilators were needed, and moreover, their lack is highly probably not associated with increased frequency of deaths. COVID-19 showed us, that others parameters such as number of hospitalizations, patients on ICUs and ventilated patients may be important epidemiological markers.
Treatment with Doxycycline is Associated with Reduced Spleen Size in Hyper-Reactive Malarial Splenomegaly: A Cohort Study
Authors: Davies Peter John Barnard , Eyre Simon
Published: May 2020

Background:Hyper-reactive malarial splenomegaly (HMS)is a poorly understood sequela of chronic parasitaemia, caused by an aberrant immune response, and confers a high associated mortality. There arefew historical data on effective treatments, which are either unavailable or unaffordable in endemic areas. In Kagando, Western Uganda patients were treated with Doxycycline and followed up to measure the effect.Methods:Patients were identified by medical officers from March 2018 at Kagando Hospital who met Fakunle’s criteria for HMS; children under 12 years and pregnant women were excluded. The baseline full blood count and splenic size from the costal margin was measured and manually recorded. Patients were discharged with a 6-monthcourse of Doxycycline and asked to attend on completion for follow-up assessment. Spleenmeasurements and compliance wererecorded by medical officers, before being tabulated and analysed electronically. Results:In total 27 patients were treated for HMS over a two year period with 7 patients returning for a follow up between 6-15 months. The median age was 36 years with a near equal male to female ratio. Prior to treatment patients displayed a variable degree of pancytopenia with a median haemoglobin of 10.1, leucocytes 4.5 and platelets 82, and the median spleen size was 16cm from the costal margin. The Wilcoxon signed-rank test was used for statistical analysis. There was a significant reduction in spleen size p<0.05, with 4/7 showing complete resolution. There was a numericalimprovement in platelet count (median82 vs 125) p=0.16.Conclusions:Regular doxycycline use as malaria prophylaxis in a holoendemic area of Uganda was associated with a significant reduction in spleen size and a numerical improvement in platelet count. A larger cohort study and an improved follow-up regime is required to further characterise this effect. However, doxycyclineprovidesa practical and affordable treatment modality in a rural Ugandan population, with no current national or international guidelines. In some patients the benefit is seen up to a year from treatment completion.
Association between the Distal Gut Microbiome and Anxiety in Highly Active Individuals
Authors: Marroquin Elisa Morales , Fletcher Emma , Hwang Paul , Kim Caelin S. , Padgett Noah , Smeding Sonja , Scullin Michael K. , Gordon Paul M. , Greathouse K. Leigh
Published: May 2020

Background: Traditional thinking is that physical activity benefits mental and physical health, however, excessive physical activity can increase anxiety, depression, and affect the gut microbiome. Considering the strong connection between the gut and the brain, the purpose of the present study was to evaluate the association between gut microbiota composition and anxiety as well as depression in highly active individuals. Methods: Participants included 55 young adults (ages 18-25, 51% males). All participants were highly physically active, as determined by 7 days of SenseWear monitoring. Anxiety and depression were measured with the Beck Anxiety and Depression Inventories. Alpha diversity, beta diversity, and microbial composition were evaluated via 16S rRNA gene sequencing using distal gut samples. Results: Greater anxiety was associated with both lower distal gut alpha diversity ( P < 0.05) and higher beta diversity (PERMANOVA test; R-squared: 0.17562, P = 0.027), which appeared stronger in males. Genus level taxonomic abundance analysis showed Prevotella relative abundance as higher in males with higher anxiety ( P = 0.03, q=0.06). However, adjusted linear regression analysis, controlling for fiber intake and sex nullified the association between Prevotella and anxiety. Additional analysis demonstrated a strong association between lower dietary fiber intake and higher anxiety scores (Est.= -0.48, SE= 0.20 , P = 0.021). Conclusion: In highly active individuals, specifically males, there is a strong relationship between the gut microbiome, fiber intake, and anxiety. These data suggest highly active males with anxiety may benefit from increased dietary fiber intake.
Overexpression of HNF4α enhances umbilical cord mesenchymal stem cell function to treat acute liver failure in mice through macrophage polarization
Authors: Yu Yeping , Zhang Qiqi , Wu Ning , Xia Lei , Cao Jie , Xia Qiang , Zhao Jie , Zhang Jianjun , Hang Hualian
Published: May 2020

Background: Advances in research on stem cell therapy provide new feasible solutions for acute liver failure (ALF) treatment. Recent studies have demonstrated that the expression of hepatocyte nuclear factor 4α (HNF4α) reset within the damaged hepatocytes can restore normal physiological function. This study aimed to determine the role of human umbilical cord mesenchymal stem cells (HuMSCs) overexpressing HNF4α in ALF treatment.Method: We isolated and cultured HuMSCs in vitro, reversed it by lent virus expression HNF4α (hereinafter referred to as HuMSC-HNF4α). HuMSC-HNF4α was intraperitoneally administrated into the mice immediately after exposed to D-galactosamine / lipopolysaccharide (D-galn / LPS). To investigate their effects in ALF, we performed liver histological and serumbiochemical analysis. Macrophages differentiation and cytokines secreted by HuMSCs were evaluated to elucidate its mechanisms.Results: We found HuMSC-HNF4α has more obvious therapeutic effects on ALF than the negative control virus transfected the HuMSCs (HuMSC-CON). In vitro, HuMSC-HNF4α promotes the polarization of liver macrophages (Kupffer cells) to M2 phenotype, inhibits the inflammatory response of macrophages and reduces the levels of inflammatory factors such as TNF-α, IL-1β to reduce liver damage.Conclusion: Our research confirmed that the therapeutic effect of HuMSC-HNF4α on ALF is not the same as the previous passive support but an active intervention on excessive inflammation in the body. This provides new ideas for research and clinical practice in the future.
Prevalence and Risk factors of Infertility in a Mongolian Population
Authors: Negdel Tuvshinbayar , Ulziisaikhan Khishigjargal , Sengebaljir Davaakhuu , Enkhbat Arigbukh , Munkhbayar Badrakh , Bilegsuren Khantushig , Ganbold Ariunaa , Nanjid Khuderchuluun , Readhead Carol W. , Erkhembaatar Lkhagva-Ochir , Tuduvdorj Ekhembaatar , Malchinkhuu Munkhzol , Enkhtaivan Odkhuu
Published: May 2020

Background: Worldwide, the median prevalence of infertility is 9%, but rates in different countries vary from 3.5% to 16.7%. Infertility, which is defined by the World Health Organization (WHO) as the failure to conceive after 12 months of unprotected regular sexual intercourse, is not considered a medical condition but carries a social stigma and can greatly impact a couple’s self-esteem and wellbeing. There are a number of risk factors associated with infertility such as: genetic background, age, socio-economic factors, and health care including treatment of sexually transmitted diseases. We have achieved the first population-based study on the prevalence of infertility in reproductive aged women in Mongolia, and the factors that influence it.Method: We conducted a population-based, cross sectional study in 4 regions of Mongolia and the capital city, Ulaanbaatar: East, West, Central Khangai, Central, and Ulaanbaatar. Our questionnaire consisted of categories that influenced infertility such as: socio-economic status, lifestyle factors, health, reproductive history, present status and sexual function. Trained staff conducted face-to-face interviews with the participants.Results: A total of 1,920 couples residing in 4 regions of Mongolia and the capital city, Ulaanbaatar were studied. The median prevalence rate was 7.2%, which is similar to the worldwide infertility rate of 9%. Primary and secondary infertility was 2.5% and 5% respectively. Sexual transmitted diseases (STIs) contributed to secondary infertility. Our study showed that the most important risk factors for infertility were rural living and low levels of education. Only 14.8% of infertile patients received hormone therapy, and even fewer infertile patients (0.8%) received in vitro fertilization (IVF) treatment.Conclusions: Our study shows that two most significant risk factors for infertility were: reliving in rural communities and having a low level of education. Occupational conditions, and monthly household income were not significant risk factors for infertility. Since this is the first population-based study in Mongolia we were not able to measure trends in infertility prevalence but intend to do so in the future.
Evaluation of acute central serous chorioretinopathy using enhanced depth imaging OCT and multifocal electroretinography
Authors: Hong In Hwan , Chang In Boem , Han Jae Ryong
Published: May 2020

Background To evaluate the functional and structural abnormalities in patients with acute central serous chorioretinopathy (CSC) by multifocal electroretinography (mfERG) and enhanced depth imaging optical coherence tomography (EDI-OCT) Methods This prospective observational study included 57 patients with unilateral CSC. Both eyes underwent mfERG and EDI-OCT. Peak amplitudes and implicit times of the ﬁrst kernel responses were analyzed and compared with those in 25 age-matched normal controls. Correlational analyses were performed between the mfERG results and EDI-OCT parameters. The thicknesses of the central retina, subretinal fluid, and choroid was measured at baseline and 3 months later. Results Compared with the normal controls, the amplitude and implicit time on mfERG were significantly impaired in the area with serous retinal detachment (SRD). The P1 amplitude and implicit time of the areas beyond the SRD were also found to be significantly impaired in the affected eyes. Eyes with a greater reduction in SRD had a less impaired mfERG response in fellow eyes than those whose retinal detachments were not spontaneously decreased by more than 90% after 3 months. Correlational analysis did not reveal any significant correlations between mfERG values and OCT parameters except for central choroidal thickness. The subfoveal choroidal thickness was negatively correlated with the mfERG parameters. Conclusion The findings of this study indicate diffuse functional impairment in acute CSC which involves both eyes and areas beyond the SRD. The retinal response of the unaffected eye was associated with regression of SRD and functional retinal abnormality is correlated with pathological changes in the choroid.
Clinico-microbiological Profile of Burkholderia cepacia Keratitis: a Case Series
Authors: Ho Ming-Chih , Kang Eugene Yu-Chuan , Yeh Lung-Kun , Ma David HK , Lin Hsin-Chiung , Tan Hsin-Yuan , Chen Hung-Chi , Hsiao Ching-Hsi
Published: May 2020

Background
Burkholderia cepacia, a pathogen, has rarely been documented as a cause of corneal infection. The clinical and microbiological profiles of B. cepacia keratitis are reported herein.
Methods
We retrospectively reviewed the medical record of 17 patients with culture-proven B. cepacia keratitis, treated between 2000 and 2019 at Chang Gung Memorial Hospital, Taiwan. Our data included predisposing factors, clinical presentations, treatments, and visual outcomes of B. cepacia keratitis as well as the drug susceptibility of the causative agent.
Results
The most common predisposing factor for B. cepacia keratitis was preexisting ocular disease (7, 41.2%), particularly herpetic keratitis (5). Polymicrobial infection was detected in 7 (41.2%) eyes. All B. cepacia isolates were susceptible to ceftazidime. Main medical treatments included levofloxacin or ceftazidime. Surgical treatment was required in 5 (29.4%) patients. Only 4 (23.5%) patients exhibited final visual acuity better than 20/200.
Conclusions
B. cepacia keratitis primarily affects patients with preexisting ocular disease, particularly herpetic keratitis, and responds well to ceftazidime or fluoroquinolones. However, the visual outcomes are generally poor.
Proteomic analysis of banana xylem sap provides insight into resistant mechanisms to Fusarium oxysporum f. sp. cubense Tropical Race 4
Authors: Zhang Lei , Liu Lina , Li Shu , Bai Tingting , Xu Shengtao , Fan Huacai , Yin Kesuo , He Ping , Wang Yunyue , Tang Weihua , Zheng Sijun
Published: May 2020

Background: Fusarium wilt is a destructive soilborne disease of banana caused by Fusarium oxysporum f. sp. cubense (Foc), especially Tropical Race 4 (TR4), which is a xylem-invading fungus. It was evident that xylem sap contained macromolecules, such as proteins, involved in disease-resistance processes. However, there is no research to analyze changes in banana xylem sap proteins response to TR4 to date. Methods: To gain an integrated understanding of differential protein expression in banana xylem sap during TR4 infection, we performed a comparative proteomic analysis of xylem sap in resistant ‘Pahang’ and susceptible ‘Brazilian’ bananas inoculated with TR4.Results: A total of 1036 proteins were detected in xylem sap of both bananas, among which some proteins are involved in ‘signal transduction’, ‘environmental adaptation’, ‘biosynthesis of secondary metabolites’ and ‘lipid metabolism’, indicating that xylem sap contained defense-related proteins. A number of 129 differential expression proteins (DEPs) were identified in 4 possible pairs between resistant and susceptible tested combinations. Of these DEPs, hypersensitive-induced response protein 1 (HIR1), E3 ubiquitin ligase (E3) might play negative roles in ‘Pahang’ response to TR4 attack, whereas chalcone isomerase (CHI), glycine-rich RNA-binding protein (GRP), carboxylesterase (CXE) and GDSL lipase (GLIP) might play positive roles in ‘Pahang’ defense against TR4 infection. Conclusions: Banana xylem sap contained defense-related proteins, among which HIRP1, E3, CHI, GRP, CXE and GLIP involved in banana defense against TR4. To our knowledge, this is first report to analyze changes in banana xylem sap proteins response to TR4, which help us to explore molecular mechanisms of banana resistant to Fusarium wilt.