bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Discrimination As A Barrier For The Treatment Of Chronic Diseases In Venezuelan Migrants Of Peru
Authors: Delgado-Flores Carolina , Cutrie Oscar Soto , Nieto Wendy
Published: May 2020

Objective: To determine the association between discrimination and treatment of chronic diseases in Venezuelan emigrants. Methodology: Cross-sectional study, secondary analysis of the database of the "Survey directed at the Venezuelan population residing in the country" (ENPOVE), carried out in Peru in 2018. To evaluate the main association, we used a regression model of poisson, by adjusting the effect of the multistage sample using the svy command, and obtaining prevalence ratios (RP) with their respective confidence intervals (95% CI).Results: A population of 865 Venezuelans (58.2% women, mean age: 36.6 ± 0.7 years) were evaluated, in which 54.8% reported having felt discriminated against for being Venezuelan and 89.2% reported not receiving treatment for their chronic disease. A statistically significant association was found between having been discriminated for being Venezuelan and having received treatment for chronic diseases, in the bivariate model (RPc: 0.38; 95% CI: 0.20–0.73) and the adjusted model (RPa: 0.49; 95% CI: 0.25–0.97).Conclusion: Our study found that having felt discriminated against decreases the prevalence of receiving treatment for chronic diseases by approximately 50% compared to those who did not report having been discriminated against. Future studies are necessary to evaluate the consistency of the results, with a larger population of Venezuelans residing in Peru.
Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19
Authors: Cai Yu-Qing , Zhang Xiao-Bin , Zeng Hui-Qing , Wei Xiao-Jie , Zhang Zhen-Yu , Chen Li-Da , Wang Ming-Hui , Yao Wen-Zhen , Huang Qiu-Fen , Ye Zhang-Qiang
Published: May 2020

Background: To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China.Methods: A total of 432 patients with laboratory confirmed COVID-19 were retrospectively enrolled and divided into non-severe and severe groups. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) on admission and the severity of COVID-19, respectively.Results: Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, the high level of NLR, LDH were independent predictor in the early classification of patients with COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Furthermore, combining NLR > 3.82 and LDH > 246U/L could increase the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001).Conclusions: The high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.Importance: COVID-19 has been a global pandemic. The mortality rate is range from 3.5-6.0%. In order to predict the risk factors of severity of COVID-19. we explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. We found that the high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.
Strategies to upgrade safety for at-home autologous stem cell transplantation in multiple myeloma patients.
Authors: Rodríguez-Lobato Luis Gerardo , Martínez-Roca Alexandra , Castaño-Díez Sandra , Palomino-Mosquera Alicia , Gutiérrez-García Gonzalo , Pedraza Alexandra , Suárez-Lledó María , Rovira Montserrat , Martínez Carmen , Larrea Carlos Fernández de , Cibeira María Teresa , Rosiñol Laura , Lozano Ester , Marín Pedro , Cid Joan , Lozano Miquel , Moreno-Castaño Ana Belén , Palomo Marta , Díaz-Ricart Maribel , Gallego Cristina , Hernando Adelina , Segura Susana , Carreras Enric , Urbano-Ispizua Álvaro , Bladé Joan , Fernández-Avilés Francesc
Published: May 2020

Background. Autologous stem cell transplantation (ASCT) remains the standard of care for young multiple myeloma (MM) patients; indeed, at-home ASCT has been positioned as an appropriate therapeutic strategy. However, despite the use of prophylactic antibiotics, neutropenic fever (NF) and hospital readmissions continue to pose as the most important limitations in the outpatient setting. It is possible that the febrile episodes may have a non-infectious etiology, and engraftment syndrome could play a more significant role. The aim of this study was to analyze the impact of both G-CSF withdrawal and the addition of primary prophylaxis with corticosteroids after ASCT.Methods. Between January 2002 and August 2018, 111 MM patients conditioned with melphalan were managed at-home beginning + 1 day after ASCT. Three groups were established: Group A (n = 33) received standard G-CSF post-ASCT; group B (n = 32) avoided G-CSF post-ASCT; group C (n = 46) avoided G-CSF yet added corticosteroid prophylaxis post-ASCT.Results. The incidence of NF among the groups was reduced (64%, 44%, and 24%; P < 0.001), with a non-significant decrease in hospital readmissions as well (12%, 6%, and 2%; P = 0.07). The most important variables identified for NF were: HCT-CI > 2 (OR 6.1; P = 0.002) and G-CSF avoidance plus corticosteroids (OR 0.1; P < 0.001); and for hospital readmission: age ≥ 60 years (OR 14.6; P = 0.04) and G-CSF avoidance plus corticosteroids (OR 0.07; P = 0.05).Conclusions. G-CSF avoidance and corticosteroid prophylaxis post ASCT minimize the incidence of NF in MM patients undergoing at-home ASCT.
Development and Assessment of the Quality of Life Instruments for Chronic Diseases-Gout(QLICD-GO) (V2.0)
Authors: Liu Qiongling , Wan Chonghua , Xie Xiaohua , Liu Xu , Zhang Xingshan , Rao Jiawei , Wang Xingjie , Pan Haiyan
Published: May 2020

Objective To develop and assess the Quality of Life Instruments for Chronic Diseases-Gout (QLICD-GO [V2.0]).Methods The instrument was developed using a programmatic decision-making method to combine the general module of the Quality of Life Instruments for Chronic Diseases and a new specific module. The instrument was assessed by measuring the quality of life of 116 patients with gout.Results The QLICD-GO(V2.0) included 28 items from the general module of chronic diseases and 12 items in three facets from the specific module. In addition to the field of physiological function, the internal consistency reliability of other fields and dimensions of the instrument was > 0.7 and the split-half reliability was > 0.5. Three common factors were extracted from the specific module, with a cumulative variance contribution rate of 57.54%. The standardized response means of the specific module and the whole instrument were 0.94 and 1.20, respectively.Conclusions The QLICD-GO(V2.0) has good reliability, validity, and responsiveness. The instrument comprehensively and objectively reflects the quality of life of patients with gout, and it can be used to assess treatment regimens developed by medical staff.
Applying a General Systems Theory framework in Mental Health Treatment Pathways: the case of the Hellenic Center of Mental Health and Research
Authors: Katrakazas Panagiotis , Grigoriadou Aliki , Koutrouris Dimitrios
Published: May 2020

Language, socio-emotional and cognitive development in children and adolescents with mental health issues is getting increased attention over the last years. Establishing communication patterns and addressing behavioural diversities among this population should be of priority, along with a better understanding in a large variety of patient characteristics within the operational framework of mental healthcare centers. As integrated systems’ approaches are still missing to correlate patients' characteristics and predict treatment services’ efficiency in a macroscopic scale, a General Systems Theory framework is hereby proposed. This framework is applied and tested against the operational framework of the Hellenic Center of Mental Health and Research, in order to identify the need of such an approach and the strong cooperation between medical and population interactions. Using such frameworks as a prerequisite to identify important factors can lead to evaluating their impact on the treatment outcome and depict the complexity of pathways potentially related to the children’s development.
Fungal endophytes of high altitude ethnomedicinal plants as a bioresource of industrially imperative enzymes
Authors: Kapoor Neha , Mushtaque Abu , Gambhir Lokesh
Published: May 2020

Endophytic fungi have been in the spotlight as a reservoir of novel agents with diverse bioactivities. Similarity in chemical diversity with the host plant makes them an amenable target for industrial interventions. A wide range of compounds as secondary metabolites and enzymes are manufactured inside the endophytic fungal factory. However, utilization of endophytic fungi as industrially imperative enzyme producers has been a scarce event. The present study was conducted to bio-prospect the fungal endophytes present in the high altitude medicinal plants of Uttarakhand, as industrially imperative enzyme producers. A total of 58 different endophytic isolates were obtained from Pinus sabiniana, Cinnamomum tamala, Cinnamomum verum, Ocimum tenuiflorum and Rhododendron arboreum. Endophytic fungal colonization was highest, 31%, in Pinus sabiniana. The pure isolates were further explored for the production of amylases, cellulases, proteases and L-asparaginase. Out of 58 isolates, 40 isolates exhibited potent enzyme productivity. #7PSSTB isolate was considered as superlative contender on account of its relatively higher production of all the three enzymes viz. amylases, cellulases, proteases. Partial purification of #7PSSTB extract showed compelling enzymatic activity corroborating the existence of exogenous enzyme in the extract. Interestingly, #9 RASTB, #11 RASTB and #17 RASTB exhibited the production of therapeutically imperative L-asparaginase enzyme. The present study puts the spotlight on endophytic diversity in the high altitude medicinal plants as a source of enzymes of industrial interest. Production of L-asparaginase paves the way of pharmaceutical intervention to explore anti-oncogenic effects in the endophytic fungal repository of high altitude regions.
Shared Content on Facebook Often Propagates Inaccurate or Misleading Information Regarding Covid-19
Authors: Tewfik George , Aziz Rania , Shulman Steven , Naftalovich Rotem , Gilels Sofia
Published: May 2020

With billions of monthly active users, Facebook has an unprecedented ability for the dissemination of information. In healthcare, attempts have been made to utilize this tool for goals such as predicting disease onset; however, shared articles that omit information or propagate incorrect statements may have a negative effect. The goal of this study was to assess the accuracy of information in the nascent months of the 2019-2020 Covid-19 outbreak.The fifty most popular articles on Facebook for the period between November 2019 and March 25, 2020 (as collated by Buzzsumo- a social media analyzing tool) were analyzed by independent researchers and sorted into classifications for accurate, inaccurate and misleading. Following evaluation, 32% of articles were deemed to be accurate, 18% inaccurate, and 50% misleading (as defined by containing both accurate and inaccurate information). To restate, 68% of the 50 most popular articles on Facebook were not accurate during the study period. Impressions, shares and comments on Facebook in a summation of inaccurate and misleading articles were also analyzed in separate fashion and found to be 71.44%, 74.97%, and 80.22% respectively. These numbers outpace the 68% of total articles for which these types of stories account.In addition, shares were individually assessed as they indicate a desire to propagate the information forward on the part of the user, and were found to have occurred 6.61 million times in the inaccurate and misleading group compared to 2.2 million for accurate articles, for a cumulative rate of 74.9% of shares, again outpacing the 68% expected.There is a high rate of both inaccurate and misleading information related to the Covid-19 outbreak on Facebook, as assessed by physician reviewers. This information is not only more prevalent than the accurate information, but also received more engagement via overall impressions, as well as shares and comments. Although there is no clear remedy for this phenomenon, its implications range from general distrust to non-adherence to precaution guidelines or required actions. There is also a question regarding Facebook’s policing of itself and the content on its site, as well as that content published to it from other websites.
Inflammatory Potential of Diet and Risk of Incident Knee Osteoarthritis: A Prospective Cohort Study
Authors: Liu Qiang , Hebert James R. , Shivappa Nitin , Guo Jianjun , Tao Ke , Zeng Chao , Lei Guanghua , Lin Jianhao , Zhang Yuqing
Published: May 2020

Background To examine the relation between inflammatory potential of diet and incident knee osteoarthritis (OA) and the role of BMI in the association of interest.Methods In the Osteoarthritis Initiative, the Dietary inflammatory index (DII®) was calculated based on the Block Brief 2000 Food Frequency Questionnaire and categorized into sex-specific quartiles. Outcomes were incident: (1) radiographic knee OA (ROA) (i.e., a KL grade ≥ 2), (2) symptomatic knee OA (SxOA) (i.e., a combination of a frequent knee pain and ROA). We fitted generalized estimating equation models to examine the association between DII® scores and incident knee OA. We performed mediation analyses to assess the mediation effect of BMI in the DII-OA relation.Results Over a 48-month follow-up period, 232 and 978 knees developed ROA and SxOA, respectively. Compared with the lowest (most anti-inflammatory) quartile of DII®, the odds ratio (OR) of incident ROA for the highest (most pro-inflammatory) quartile of DII® was 1.73 (95% confidence interval (CI): 1.15 to 2.62, P for trend = 0.007). The corresponding OR for SxOA was 1.43 (95% CI: 1.16 to 1.76, P for trend = 0.001). The DII®-OA association was significantly mediated via BMI with an indirect effect of 1.08 (95% CI: 1.04,1.13) for ROA and 1.13 (95% CI: 1.09, 1.16) for SxOA, accounting for 20.4% and 44.5% of total effect, respectively.Conclusions A higher inflammatory potential of diet increased the risk of knee OA. The association was significantly mediated via BMI. Targeting inflammatory potential of diet may be beneficial to reduce risk of knee OA.
The Influence of Low Birth Weight and Smoking on the Male Patients with Premature Coronary Heart Disease: a retrospective case-control study
Authors: Yu Guangwei , Hong Huashan , Wu Wenwei , Chen Lianglong , Lin Xiaohong
Published: May 2020

Background: Low birth weight (LBW) is one of the risk factors for coronary heart disease (CHD). The association of LBW and other risk factors with male patients with premature CHD has not been fully determined. This study aims to assess the association of LBW and other risk factors with the incidence of male patients with premature CHD.Methods We identified hospitalized male patients with premature CHD (CHD group) and healthy male subjects (control group) from January 2013 to December 2018. The differences of demographics, birth weight (BW) and other traditional risk factors were compared between the CHD group and the control group and logistic regression was used to estimate their effects on the risk of premature CHD.Results A total of 384 male subjects were enrolled in the study (183 in the CHD group vs 201 in the control group). There were significant differences in BW, smoking, diabetes and hyperlipidemia between the two groups (2.98±0.35 vs 3.37±0.39kg, P<0.001, 73.22% vs 27.36%, P<0.001, 8.74% vs 3.48%, P=0.033, 53.55% vs 37.31%, P=0.001) respectively. The risk of premature CHD increased significantly with the LBW (OR=4.530, 95% CI：1.331-15.412，P=0.016) and smoking (OR=6.748, 95% CI：4.258-10.693，P<0.001) respectively according to the multivariate logistic regression model. Conclusion LBW and smoking are independently and positively correlated with male patients with premature CHD. A history of LBW should be paid particularly attention in younger men for primordial prevention of premature CHD, especially away from tobacco.
Exosome-mediated miR-21 promotes angiogenesis within esophageal tumor microenvironment by activating PTEN/Akt signaling pathway in Vascular Endothelial Cells
Authors: Wang Tian , Liao Juan , Yang Zijie , Shen Weitao , Gao Zhi kui , Yin Jie chen , Yin Li hong , Liu Ran
Published: May 2020

Background

Angiogenesis, a pivotal component in the tumor microenvironment (TME), boosts tumor growth and metastasis. Cancer-derived exosomes, which have been widely reported to play a crucial role in the establishment of TME can be effective angiogenic modulators. We aim to investigate the contribution of microRNA-21 (miR-21) for angiogenesis which was packaged in cancer-derived exosomes in esophageal squamous cell carcinoma (ESCC).
Methods

The co-cultivation model was constructed to mimic the tumor microenvironment based at a physical level to explore the effects of cancer-derived exosomes on angiogenesis of human umbilical vein endothelial cells (HUVECs). EdU assay, transwell assay and tube formation assay formation experiments were conducted for the evaluation of HUVECs proliferation, migration, and angiogenesis, respectively. In addition, Dual-luciferase reporter (DLR) assay was performed to validate the relationship between miR-21 and its target gene PTEN. Similarly, miR-21 inhibitors and LY294002 was applied to evaluate the regulation of miR-21 via pro-angiogenesis in recipient HUVECs by PTEN/Akt signaling pathway.
Results

After 24 h co-cultivation with EC9706 cells, miR-21 levels in recipient HUVECs was raised. The results from EdU assay, transwell assay and blood vessel formation experiment showed that exosomes which were secreted from EC9706 cells (EC9706-Exo) delivered miR-21 stimulated proliferation, migration and tube formation of HUVECs. DLR assay indicated that miR-21 could directly bind to the 3'-untranslated region (UTR) of PTEN genes, real-time PCR and western blot analysis for PTEN showed it was inhibited by EC9706-Exo shuttled miR-21. Meanwhile, phospho-Akt (p-Akt) (Ser473), one of the downstream genes of PTEN, was significantly increased in recipient HUVECs compared to the control group, while inhibiting miR-21 and PI3K/Akt pathway respectively both led to a sharp decrease in p-Akt levels, suggesting that exosomal miR-21 promote angiogenesis via activating PTEN/Akt signaling pathway.
Conclusion

Exosomal miR-21 acts as a driver of pro-angiogenesis by activating PTEN/Akt signaling pathway, it might serve as a blood-based biomarker for ESCC metastasis. Suppressing the expression or blocking the transmission of these exosome-derived miR-21 might be a novel antiangiogenic therapeutic strategy for ESCC.
RBE-weighted dose conversions for patients with recurrent nasopharyngeal carcinoma receiving carbon-ion radiotherapy from the local effect model to the microdosimetric kinetic model
Authors: Zhang Liwen , Wang Weiwei , Hu Jiyi , Lu Jiade , Kong Lin
Published: May 2020

Background We sought to establish a conversion curve to convert the local effect model I (LEM) based RBE-weighted doses (LEM doses) in patients with locally recurrent nasopharyngeal carcinoma (rNPC) to the microdosimetric kinetic model (MKM) based RBE-weighted dose (MKM doses) model. We also converted the relevant organ at risk (OAR) constraints based on this curve. Methods Data from 13 patients with rNPC receiving carbon-ion radiotherapy (CIRT) in our hospital were collected. LEM in Raystation (V8A, Raystation, Sweden) was used to generate treatment plans. Clinical target volume CTV1(GTV+5mm)was given 63 Gy (RBE) in 21 fractions. Ninety-nine percent of target volumes should be covered by 95% of the prescriptions; the maximum doses of the brainstem and spinal cord were < 45 Gy (RBE) and < 30 Gy (RBE), respectively. The doses covering 20% volumes of optical nerves/chiasms D20 were < 30 Gy (RBE). Then physical doses of the LEM plans were recalculated by using MKM in Raystation to generate MKM plans. A series of the ratio of LEM dose to MKM dose was obtained as the conversion factor to obtain the conversion curve by using an isovolumetric dose method. Using prescriptions and OAR, constraints were converted to MKM doses with this curve. Results Conversion factors (LEM dose/MKM dose) from 1.37±0.02 to 3.09±0.09 corresponded to the LEM fractionated doses from 0.24 Gy (RBE) to 2.86 Gy (RBE), including the doses constraining upon OARs. LEM doses of 30 Gy (RBE) and 45 Gy (RBE) in 21 fractions were converted to MKM doses of 16.64 Gy (RBE) and 30.98 Gy (RBE) in 16 fractions. Conclusions This conversion curve could be used to convert LEM doses to MKM doses for patients with rNPC receiving CIRT, providing dose references for re-irradiation therapy.
Pyruvate dehydrogenase complex deficiency: updating the clinical, metabolic and mutational landscapes
Authors: Pavlu-Pereira Hana , Silva Maria João , Florindo Cristina , Sequeira Sílvia , Ferreira Ana Cristina , Duarte Sofia , Rodrigues Ana Luísa , Janeiro Patrícia , Oliveira Anabela , Gomes Daniel , Bandeira Anabela , Martins Esmeralda , Gomes Roseli , Soares Sérgia , de Almeida Isabel Tavares , Vicente João B , Rivera Isabel
Published: May 2020

Background : Pyruvate dehydrogenase complex (PDC) catalyzes the irreversible decarboxylation of pyruvate into acetyl-CoA which ultimately generates ATP. PDC deficiency can be caused by alterations in any of the genes encoding its several subunits, and the resulting phenotype, though very heterogeneous, mainly affects the neuro-encephalic system. The aim of this study is to describe and discuss the clinic, metabolic and genotypic profiles of thirteen PDC deficient patients, thus seeking to establish possible genotype-phenotype correlations. Results : The mutational spectrum revealed that seven patients (54 %) carry mutations in the PDHA1 gene , encoding the E1α subunit, five patients (38 %) carry mutations in the PDHX gene, encoding the E3 binding protein, and the remaining patient (8 %) harbors mutations in the DLD gene, encoding the E3 subunit. These data corroborate PDHA1 mutations as the predominant cause of PDC deficiency, though revealing a notable prevalence of PDHX mutations among Portuguese patients, most of them carrying a seemingly private mutation (p.R284X). The biochemical analyses revealed high lactate and pyruvate plasma levels whereas de ratio L/P was under 16; enzymatic activities, when compared to control values, revealed to be independent from the genotype and ranged from 8.5% to 30% which may be considered a cut-off value for primary PDC deficiency. Concerning the clinical features, all patients displayed developmental delay/psychomotor retardation, the severity of which seems to correlate with the type and localization of the mutation carried by the patient. The therapeutic options essentially go through the administration of a ketogenic diet and supplementation with thiamine, although arginine aspartate intake revealed to be beneficial in some patients. Moreover, the in silico analysis of the missense mutations present in this PDC deficient population allowed to understand the molecular mechanism underlying these pathogenic variants. Conclusion : The identification of the disease-causing mutations, together with the functional and structural characterization of the mutant protein variants, allows to get insight on the severity of the clinical phenotype and the selection of the most appropriate therapy.
Metabolomics Study of Dried Ginger Extract on Serum and Urine in Blood Stasis Rats Based on UPLC-Q-TOF/MS
Authors: Su Min , Cao Gang , Wang Xiaoli , Daniel Raftery , Hong Yan , Han yanquan
Published: May 2020

Backgroud: According to the theory of traditional Chinese medicine (TCM), blood stasis syndrome (BSS) is the basis for many cardiovascular diseases. Ginger is often used as Chinese medicine (herb medicine) in China and Southeast Asia for the treatment of cardiovascular, respiratory, and digestive diseases. but the specific mechanism is unclear.Methods: After establishing an acute rat model of blood stasis syndrome, blood and urine of 5 groups of rats were collected for analysis of efficacy indicators. Aortic vessels are used for pathological testing. Serum and urine were used for metabolomics, multivariate statistical analysis was used to explore metabolites and metabolic pathways, and the correlation between metabolites and pharmacodynamic indicators was further explored.Results: In this experiment, the model of blood stasis syndrome was successfully established based on changes in vascular disease and the efficacy index. The experimental results show that the efficacy indicators of dried ginger (DG) extracts of different doses have different degrees of changes than model group (MG), and the high dose of dried ginger group (GJH) changes are the most significant (p < 0.05 or p < 0.01). And 22 metabolites (10 in serum and 12 in urine) were identified and contributed to the blood stasis progress. These metabolites mainly involve seven metabolism pathways in different impact-value. Dried ginger has therapeutic effects on BSS rats by regulating multiple metabolic pathways.Conclusion: This study provides an effective method for understanding the metabolic mechanism of dried ginger extracts on BSS.
Luteal Phase Progesterone Support Does Not Improve Ongoing Pregnancies in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers
Authors: Waldman Ian , Racowsky Catherine , Disler Emily , Thomas Ann , Andrea Lanes , Hornstein Mark
Published: May 2020

Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of progesterone luteal phase supplementation for cryopreserved/warmed blastocyst transfers in natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of progesterone supplementation beginning in the luteal phase and continued until 10 weeks gestational age in patients undergoing true natural cycle cryopreserved blastocyst transfer. Our outcome measures were ongoing pregnancy rate, positive serum beta human chorionic gonadotropin (HCG) level, implantation rate, clinical pregnancy rate, miscarriage/abortion rate, ectopic pregnancy rate, and multifetal gestation rate. Categorical data were analyzed utilizing Fisher’s exact test and non-parametric data were analyzed using the Wilcoxon rank sum test. We a priori adjusted for age.Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of progesterone luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve cycle outcomes. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.
Low serum level of apolipoprotein A1 is an indicator of severity in patients with coronavirus disease 2019
Authors: Yang Yayun , Zhu Zhe , Fan Lingyan , Ye Shuyuan , Lou Kehong , Hua Xin , Huang Zuoan , Shi Qiaoyun , Gao Guosheng
Published: May 2020

Background: Recently, dyslipidemia was observed in the patients of coronavirus disease 2019 (COVID-19), especially in the severe cases. This study aimed to explore the predictive value of blood lipid for the severity of COVID-19.Methods: All patients with COVID-19 who admitted to HwaMei Hospital, University of Chinese Academy of Sciences from January 23 to April 20, 2020 were included in this retrospective study. General clinical characteristics and laboratory data (including blood lipid parameters) were obtained, and their predictive values for the severity were analyzed.Results: 142 consecutive patients with COVID-19 were included. There were 125 cases in the non-severe group and 17 cases in the severe group. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1) at baseline were significantly lower in the severe group. ApoA1 and interleukin-6 (IL-6) were recognized as independent risk factors for the severity of COVID-19. ApoA1 had the highest area under the receiver operator characteristic curve (AUROC) among all the single markers (AUROC: 0.896, 95% CI: 0.834-0.941). Moreover, the risk model established upon ApoA1 and IL-6 enhanced the predictability (AUROC: 0.977, 95% CI: 0.932-0.995). On the other hand, ApoA1 in the severe group elevated during the treatment, there was no significant difference between the severe and non-severe groups in the recovery stage of disease.Conclusion: The profile of blood lipid in the severe patients with COVID-19 is quite different from that in the non-severe cases. Serum ApoA1 could severe as a good marker to reflect the severity of COVID-19.
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Breast Cancer: A Preliminary Report on 4 Cases
Authors: Yu Jun-Hui , Feng Yu , Li Xin-Bao , Zhang Cheng-Yan , Shi Feng , An Song-Lin , Liu Gang , Zhang Yan-Bin , Zhang Kai , Ji Zhong-He , Li Bing , Yan Guo-Jun , Li Yan-Ping , Li Yan
Published: May 2020

Background: Breast cancer (BC) has been ranked as the first malignancy most common and the fifth in mortality rate among women in China [1]. Peritoneal metastases from BC is a rare disease and no guideline or international consensus for it. Objective: To summarize our experiences in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat breast cancer peritoneal carcinomatosis (BC PC). Methods: This is a retrospective study on the 4 BC PC patients underwent CRS+HIPEC at our center. The clinicopathological features and treatment details on the BC PC patients were analyzed. Result: The average age at CRS+HIPEC was 59.8 years. The average duration of CRS+HIPEC was 8.8 h. The median number of resected organ areas was 7. Overall survival from CRS+HIPEC were 31, 28, 16 and 52 months. There were no serious adverse events (SAEs) during perioperative period. Conclusions: The 4 cases provided evidence that integrated therapy with CRS+HIPEC may be a promising strategy to improve outcome for BC PC patients.
Remarkable metabolic reorganization and altered metabolic requirements in frog metamorphic climax
Authors: Zhu Wei , Chang Liming , Zhao Tian , Wang Bin , Jiang Jianping
Published: May 2020

BackgroundMetamorphic climax is the crucial stage of amphibian metamorphosis responsible for the morphological and functional changes for landing. This developmental period is most sensitive to environmental changes and pollution. Understanding its metabolic basis and requirements has great significance to ecological and toxicological researches. Rana omeimontis tadpoles are unique model for investigating this issue, as their liver has the dual role of metabolic regulation and fat storage.ResultsUsing a combined approach of transcriptomics and metabolomics, we revealed the metabolic reorganization during natural and T3-driven metamorphic climax by reconstructing the metabolic networks in the liver and tail of Rana omeimontis tadpoles. In metamorphic tadpoles, the metabolic flux from the apoptotic tail replaced hepatic fat storage as metabolic fuel, resulting in increased hepatic amino acid and fat level. In the liver, amino acid catabolism (transamination and urea cycle) was upregulated along with energy metabolism (TCA cycle and oxidative phosphorylation), while the carbohydrate and lipid catabolism (glycolysis, pentose phosphate pathway/PPP and β-oxidation) were decreased. Meanwhile, the hepatic glycogen phosphorylation and gluconeogenesis were upregulated, and the carbohydrate flux likely flowed into the synthesis of glycan units (e.g., UDP-glucuronate). In the tail, glycolysis, β-oxidation, and transamination were all downregulated, accompanied by synchronous downregulation of energy production and consumption. The glycogenolysis was maintained in the tail, and the carbohydrate flux likely flowed into both PPP and the synthesis of glycan units (e.g., UDP-glucuronate and UDP-glucosamine). Interestingly, the fatty acid elongation and desaturation, as well as the synthesis of bioactive lipid (e.g., prostaglandins) were encouraged in the tail during metamorphic climax. Protein synthesis was downregulated in both the liver and tail. The significance of these metabolic adjustments and their potential regulation mechanism were discussed.ConclusionThe energic strategy and anabolic requirements during metamorphic climax were revealed at molecular level. Amino acid has increased contribution to energy metabolism during metamorphic climax. Carbohydrate anabolism is more intensively required than protein synthesis for the body construction of the froglet. The tail plays a critical role in anabolism and even metabolic regulation. These findings would deepen our understanding on the requirement and proceeding of amphibian metamorphosis.
Aberrant White Matter Microstructure as a Potential Diagnostic Marker in Alzheimer’s Disease by Automated Fiber Quantification
Authors: Chen Haifeng , Qin Ruomeng , Luo Caimei , Li Mengchun , Liu Renyuan , Zhang Bing , Xu Yun , Zhao Hui , Bai Feng
Published: May 2020

Background: Alzheimer’s disease (AD) has been primarily considered a progressive neurodegenerative disorder of gray matter. Neuroimaging evidence has suggested white matter microstructure are also heavily affected in AD. However, whether white matter dysfunction are localized at the specific regions of fiber tracts and whether they would be a potential biomarker for AD remain unclear.Methods：By automated fiber quantification (AFQ), we applied diffusion tensor images from 25 healthy controls (HC), 24 amnestic mild cognitive impairment (aMCI) patients and 18 AD patients to create tract profiles along 16 major white matter fibers. We compared diffusion metrics [Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (DA) and radial diffusivity (DR)] at the global and local level of fiber tracts between groups. Partial correlation analyses were used to explore the associations between white matter changes and cognitive performance. To assess the diagnostic value, we enrolled the significantly altered diffusion metrics into a random forest (RF) classifier, a type of machine learning method.Results: In the global tract level, we found that aMCI and AD patients showed higher MD, DA and DR values in some fiber tracts mostly in the left hemisphere compared to HC. In the point-wise level, widespread disruption were distributed on specific locations of different tracts. The point-wise MD measurements presented the best classification performance with respect to differentiating AD from HC. The two most important variables were localized in the prefrontal potion of left uncinate fasciculus and anterior thalamic radiation. In addition, the point-wise DA in the posterior component of the left cingulum cingulate displayed the most robust discriminative ability to identify AD from aMCI. Conclusion：Our findings provide evidence that the left-sided microstructural integrity was vulnerable in white matter fiber tracts in AD. Furthermore, the frontal lobe portion of left uncinate fasciculus and anterior thalamic radiation and the posterior component of the left cingulum cingulate played the important role in the diagnosis and surveillance of AD. These results demonstrated the potential of white matter abnormalities as a diagnostic biomarker in AD.
ceRNA Network Development and Tumour-infiltrating Immune Cell Analysis in Metastatic Breast Cancer of Bone
Authors: Liu Shuzhong , Song An , Zhou Xi , Huo Zhen , Yao Siyuan , Liu Yong , Wang Yipeng
Published: May 2020

Background: Advanced breast cancer commonly metastasises to the bone and the molecular mechanism explaining the bone affinity of breast cancer cells is unclear. Thus, we developed nomograms based on a competing endogenous RNA (ceRNA) network and analysed tumour-infiltrating immunecells to elucidate the molecular pathways that may predict the prognosis of breast cancer patients.Methods: We obtained the RNA expression profile of 1091 primary breast cancer samples from The Cancer Genome Atlas database, 58 of which had bone metastasis. We analysed differential RNA expression patterns between breast cancer with and without bone metastasis and developed a ceRNA network. Cibersort was employed to differentiate between immune cell types based on tumour transcripts. Nomograms were then established using the ceRNA network and immune cell analysis. The value of prognostic factors was evaluated by Kaplan-Meier survival analysis and Cox proportional risk model.Results: There were significant differences in lncRNAs, 18 miRNAs, and 20mRNAs between breast cancer with and without bone metastasis, which were used to construct a ceRNA network. We found that the protein-coding genes gjb3, cammv, ptprz1,and fbn3 were significant in our Kaplan-Meier analysis. We also observed significant differences in plasma cell and follicular helper T cell populations between the two groups. In addition, the proportions of mast cells, gamma delta T cells, and plasma cells differed depending on disease location and stage. Our analysis revealed that a high proportion of follicular helper T cells and a low proportion of eosinophils promoted survival and that dlx6-as1, wnt6,and gabbr2expression may be related to bone metastasis of breast cancer.Conclusions: We provided a bioinformatic basis for exploring the molecular mechanism of bone metastasis in breast cancer patients and identified factors that may predict this.
Dynamic variability of Chinese medicine diseases and constitutions and syndromes on peritoneal cancer patients before and after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy
Authors: Zhang Liangdeng , Jiang Ming , Pan Guofeng , Yin Xianghua
Published: May 2020

Background: Peritoneal cancer is advanced stage of abdominal cancer. Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) that is the main surgical regimen for peritoneal cancer patients to delay the illness. However, postoperative recovery is a long process due to extensive removal of abdominal and pelvic organs by CRS. Meanwhile, integrated Chinese and western medicine could improve life quality of cancers. Methods: Investigating on change of disease symptoms indicators and constitution and syndrome types of peritoneal cancer patients through cross-sectional study that included three stage, before CRS plus HIPEC, within 1 week and within 3 months after CRS plus HIPEC. Results: Total 100 patients through CRS plus HIPEC included analysis. Within 1 week after CRS plus HIPEC, both blood albumin (ALB) and haemoglobin (HGB) decreased apparently comparing to before; within 3 months after CRS plus HIPEC, ALB and HGB elevated apparently comparing to within 1 week; all the differences were statistically significant (P<0.01). The differences of blood carbohydrate antigen (CA) 125, carcinoembryonic antigen (CEA), D-dimer (D-D), troponin I (TnI) , n-terminal precursor of brain natriuretic peptide (BNP), were statistically significant (P<0.01) between before and within 1 week and 3 months after CRS plus HIPEC. The differences of both constitution and syndrome types were statistically significant (P<0.01) between before and within 1 week and 3 months after CRS plus HIPEC. Conclusions: Peritoneal cancer patients’ diseases and symptoms changed apparently between before and after CRS plus HIPEC. Although, the symptomatic treatment methods by western medicine could apparently improve ALB, HGB, CA125, CEA, D-D, TnI, BNP, as well as cardiorespiratory function in a short term. Constitution groups and syndrome types of peritoneal cancer patients occurred dynamic variability between before and after CRS plus HIPEC. Generally, the primary tendency was healthy energy deficiency gradually, while pathogen excess through CRS plus HIPEC treatment. Constitutions and syndromes were mixed and complicated. Thus, to improve life quality and survival status of peritoneal cancer patients after CRS plus HIPEC, suggesting treatment integrating with Chinese medicine through the whole stage that considers diseases, symptoms, constitutions, syndromes, and the whole person.
Study on the mechanism of Indigo naturalis and its two main compounds (indigo and indirubin) in the treatment of ulcerative colitis based on TLR4/MyD88/NF-κB pathway and intestinal microorganisms
Authors: Yang Qi-yue , He Ya-nan , Ma Le-le , Xu Run-chun , Li Nan , Han Li , Yang Xiang-bo , Wang Fang , Zhang Dingkun
Published: May 2020

Background: Indigo naturalis is a natural dye extracted from plants and has a good anti-inflammatory effect. Clinical studies have shown that it can improve ulcerative colitis (UC), but the active constituents and the mechanism are unclear. Methods: The anti-UC activity of Indigo naturalis and its two main compounds (indigo and indirubin) were investigated in dextran sulfate sodium (DSS)-induced UC mice. Indigo naturalis, indigo and indirubin were administrated to DSS-induced UC rats by oral gavage for 1 weeks. The anti-UC effect was evaluated by pathological section, inflammatory cytokine production, western blotting, and gut microbiota analysis via 16S rRNA sequencing. Results: Indigo naturalis, indigo and indirubin can improve the UC induced by DSS. Their effect intensity is Indigo naturalis > indirubin > indigo based on disease activity index, body weight, colon length and pathological section. Indigo naturalis, indigo and indirubin also decrease the expression of NF-κB，TLR4 and MYD88 proteins, thus reducing the level of related inflammation cytokines (IL-1β, IL-6 and TNF-α) both in serum and tissue. In addition, Indigo naturalis and indigo improved symptoms of gut microbial disturbance, and decreased Firmicutes/Bacteroidetes ratio and the significantly increased probiotics such as Lactobacillus. Indirubin has little effect on the regulation of gut microbial. Conclusions: Indigo naturalis could attenuate the DSS-induced UC in mice, by means of ameliorating intestinal inflammation, improving intestinal mucosa, and regulating the disturbed gut microbiota. Indigo and indirubin could also attenuate the DSS-induced UC in mice, but their comprehensive effect is not as good as Indigo naturalis.
Development of the child’s ego strength scale: An observation-based assessment of the board game behaviors in play therapy in Korea
Authors: Lee Ji Yoen , Lee Young-ae , Yoo Mee Sook
Published: May 2020

BackgroundThe purpose of this study was to develop a scale for assessing children’s ego strength through the observation of children playing board games in a therapeutic setting. To assess the ego strength of children in this developmental stage, it is necessary to observe their attitudes during game play therapy, which is the most comfortable psychotherapy technique for children at this developmental stageMethodData were collected from 127 play therapists and play therapist-supervisors, who observed 55 children aged 7–9 who received play therapy in Korea. The scale was created through factor analysis and verification of criterion-related validity.ResultsWe generated a Child’s Ego Strength Scale (CESS) consisting of five sub-factors (Coping Strategy, Cognitive Strategy, Ego Restriction, Interpersonal Functioning, Frustration Tolerance) through exploratory factor analysis. The scale met the goodness of fit criteria in a confirmatory factor analysis. The analysis of therapy sessions of children with strong and weak ego strength, as identified by play therapists, showed a significant difference between the two groups in all five sub-variables. There was a significant correlation between the CESS scores and scores of ego strength-related variables of the Rorschach scale, indicating good criterion-related validity.ConclusionThe CESS appears to be a practical method for the assessment of ego strength in the field of child counseling.
Clinical Characteristics and Surgical Treatment of Esophageal Spinal Metastasis - A Single Center 10-year Retrospective Study
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Yao Siyuan , Wang Yipeng , Liu Yong
Published: May 2020

Objective:Our research aims to discuss the clinical characteristics, treatment methods, and prognostic characteristics of patients with esophageal cancer spinal metastasis. It is one of the largest clinical studies on the disease to date. The purpose is to improve clinicians’ understanding of the clinical features and prognosis of esophageal spine metastases and share our experience in dealing with this entity.Methods: Six patients with spinal metastasis due to esophageal cancer who had received surgical treatment at the bone tumor center of Peking Union Medical College Hospital from January 2010 to January 2020 were selected. The clinical data, surgical records, imaging examinations, pathological reports, and immunohistochemical results of all patients were reviewed by the team. In the study, we applied two surgical treatments, namely open surgery and percutaneous vertebroplasty. Radiotherapy, chemotherapy, and targeted therapy were used as adjuvant treatments. Retrospective analysis of the patient’s basic clinical data was done.Results:All six patients with metastatic spinal esophageal cancer (MSEC) were male with an average age of 58.0 ± 5.3 years. The average duration between the esophageal cancer resection and diagnosis of spinal metastases was 24.8 (2-72) months. Of the six patients, four had spinal metastases located in the thoracic spine and two had metastases located in the lumbar spine. We referred to the revised Tokuhashi score and Tomita score to recommend individualized surgical treatment plans for patients, and fully respected the patients’ wishes. All six patients underwent surgical treatment, a total of six operations, including four percutaneous vertebroplasty and two open surgery. After the operations, the symptoms of the patients improved significantly. During the follow-up, all six patients died of the disease with the average time from spinal surgery to death being 8.8 ± 3.7 months.Conclusions: In general, patients with esophageal cancer spine metastases have a poor prognosis, and the average survival time of these patients often does not exceed 12 months. The combination of surgical treatment and postoperative adjuvant therapy can control symptoms effectively and improve the patient’s quality of life.