bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous Production of Β-glucanase and Protease From Bacillus Velezensis Strain Identified in the Manure of Piglets.
Authors: Khalid Anam , Ye Miao , Wei Chunjie , Dai Binghong , Yang Ru , Wang Zaigui
Published: June 2020

Background: β-glucanase and protease, are the representative of most worldwide enzyme market. In this study, a strain producing β-glucanase and protease, identified as one type of Bacillus velezensis and named Y1, was isolated from the manure of piglet.Results:Its optimal β-glucanase-producing conditions were as: fermentation temperature of 37 °C, fermentation time of 60 h, initial pH of 6.0, outfit fluid amount of 50 mL/250 mL and carbon to nitrogen ratio was 1:1. The properties of the β-glucanasewere that the most suitable reaction temperature was 65°C, the optimum pH was pH 6.0. The optimal protease-producing conditions were fermentation temperature of 37 °C, fermentation time of 60 h, initial pH of 7.0, outfit fluid amount of 75/250 mL and carbon to nitrogen ratio of 2:3.The properties of the protease showed that the most suitable reaction temperature was 50°C, the optimum pH was 6.0. And the enzyme had the best stability at 45°Cand pH 7.0. The effects of each factor on producing β-glucanase and protease by B. velezensis Y1 were as follows: temperature > time > pH > loaded liquid volume. The amplified PCR fragments of β-glucanase and protease were 1434 bp containing an open reading frame of 1413 bp encoding a protein with 444 amino acids and 1752 bp containing an open reading frame of 1521 bp encoding a protein with 506 amino acids, respectively.Conclusion: This study identified the enzymes production, optimized the fermentation conditions of β-glucanase and protease by B. velezensis. As well as the enzyme properties were investigated and genes were cloned.
Breeding Practice and Correlation of Conformation Traits With Milk Offtake of Camel in Afar Region
Authors: Gebremariam Birhane Hailay , Hailemicheal Abrha , Gebru Muez , Girmay Shishay , Baragabr Fsahatsion Hailemariam , Tilahun Sisay
Published: June 2020

Background: Camel are able to survive and well adapted in harsh environment and reproduce in such environment due to their unique physiology and morphology. It is also serves as source of cash income, milk, meat etc. The study was conducted in four districts of Afar Regional State with the objective of determine the breeding practice and correlation of conformation traits with milk offtake of camel. Method: Purposive random sampling were employed to select districts and target farmers. Milk offtake, body and udder conformation traits were taken from 320 she-camels. All the collected data were analyzed using Statistical Package for Social Sciences version 20.0 (SPSS, 2017) and index was computed using weight average. Result: The breeding objective of the farmers in the study area were milk, meat, wealth and social statues. Primordial traits preference for selecting breeding she-camel was based on milk yield, body size and conformation, disease resistance, fast growth and adaptation with an index value of 0.119, 0.105, 0.10, 0.096 and 0.094, respectively. Feed and recurrent drought, disease incidence, poor veterinary service, lack of modern breeding program hinders the productive performance whereas, poor feed quality, long age at first service, calving interval, calve mortality and abortion were the major challenges for reproductive performance of she-camels. District had a significant variation on udder and body conformation traits. The mean value of naval height, naval length, body length, foreleg length, hind leg length, pelvic length, height girth and hump circumference were 2.04±0.06, 2.46±0.06, 145±1.39, 149.24±1.30, 163.78±1.19, 25.33±0.31, 236.05±1.47and 78.51±1.06cm, respectively. The average value of milk yield, distance between fore teat, distance between rear teat, fore teat circumference, fore teat height, udder size circumference, udder size height and udder size length were 837.46±7.66, 7.92±0.36, 7.06±0.06, 6.71±0.11, 5.09±0.08, 45.13±1.34, 6.80±0.27 and 14.30±0.33cm, respectively. The correlation coefficient between body conformation trait and milk offtake were significant positively correlated with height at girth and chest length. Highest correlation coefficient was obtained between milk offtake and hind teat circumference, udder size circumference and udder size length.Conclusion: It was concluded that camel had a conceivable for the multiuse role to produce income for pastoral and agro-pastoral livestock keepers.
Liver involvement by plasma cell myeloma mimicking clear cell carcinoma, a potential pitfall.
Authors: Vagena Fotini-Rosi , Sill Heinz , Beham-Schmid Christine
Published: June 2020

Background: Unusual morphological variants of plasma cell myeloma are a diagnostic challenge.Case presentation: A 60 year old woman with low-back pain was diagnosed with a plasma cell myeloma in the bone marrow. Concurrently a tumour was found in the liver. The histological specimen of the liver resembled a clear cell carcinoma, but the immunophenotype revealed plasma cell myeloma.Conclusion: In tumours with an extraordinary morphology and not conclusive immunohistochemical results the use of plasma cell antibodies may lead to the correct diagnosis.
Protective Effects of Ginsenoside Rc Against Acute Cold Exposure Induced Myocardial Injury in Rats
Authors: Xue Yan , Yu Xiao-Feng , Zhang Xiu-Hang , Yu Ping , Li Yuan-Geng , Fu Wen-Wen , Yu Jia-Ao , Sui Da-Yun
Published: June 2020

Background: Ginsenoside Rc is one of the cardinal bioactive components of Panax ginseng that has been studied for various biological activities. This study aimed to investigate the protective effects of ginsenoside Rc against acute cold exposure induced myocardial injury in rats.Methods: The rats were intragastrically administrated with ginsenoside Rc (10, 20 mg/kg) or vehicle daily for 7 days. One hour after the seventh-day administration, 3% pentobarbital sodium was used to anesthetize the rats. Rats of the control group were kept in room temperature (22 ± 1 ℃) and the other groups of rats were exposed to low ambient temperature (-15 ± 1 ℃) in a cold chamber for 6 h. Cardiac function was monitored and recorded as well. To evaluate the protective effects of ginsenoside Rc, we also measured myocardial specific enzymes (lactate dehydrogenase, aspartate aminotransferase and creatine kinase-MB) in plasma, whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR) and hematocrit (HCT). The pathological changes of myocardium were observed through histopathological examination. The mRNA expression levels of TNF-α, IL-1β and IL-6 were by real-time quantitative PCR analysis. And the expressions of silent information regulator1 (SIRT1), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax) and Procaspase-3 in heart tissues were measured by Western blot method.Results: Ginsenoside Rc alone had no effect on cardiac function, myocardial enzyme activities and hemorheology in normal rats. Compared with the model group, pretreatment with ginsenoside Rc significantly improved cardiac function, diminished myocardial specific enzymes release and decreased erythrocyte aggregation index. As a result, the pretreatment regulated abnormal hemorheology, attenuated myocardial histological changes and structural abnormalities, reduced the mRNA expression levels of cardiac inflammatory markers. Ginsenoside Rc also resulted in up-regulating SIRT1, Bcl-2 and Procaspase-3 expressions and down-regulating Bax expression.Conclusion: The current study suggests that ginsenoside Rc alleviates acute cold exposure induced myocardial injury in rats by inhibiting cardiomyocyte apoptosis via SIRT1 and reducing inflammatory response.
Establishment of a systemic inflammatory response syndrome model and evaluation of the efficacy of umbilical cord mesenchymal stem cell transplantation
Authors: Ruan Guangping , Yao Xiang , Liu-Gao Mi-yang , Wang Jin-xiang , Cai Xue-min , Li Zi-an , Pang Rong-qing , Pan Xing-hua
Published: June 2020

Based on the characteristics of modern weapon injury, a repetitive model of traumatic systemic inflammatory response syndrome (SIRS) and an evaluation system were established. The models were treated with GFP-labeled tree shrew umbilical cord mesenchymal stem cells (UCMSCs). Forty out of 50 tree shrews were used to make a unilateral femoral comminuted fracture. LPS was injected intravenously to create a traumatic SIRS model. The other 10 shrews were used as normal controls. After the model was established for 10 days, 20 tree shrews were injected in the veins with GFP-labeled UCMSCs, and 18 tree shrews were not injected as the model control group. The distribution of GFP-labeled cells in vivo was measured at 2 and 10 days after injection. Twenty days after treatment, the model group, the normal control group, and the treatment group were taken to observe the pathological changes in each tissue, and blood samples were taken for the changes in liver function, renal function and heart function. Distribution of GFP-positive cells was observed in all tissues at 2 and 10 days after injection. After treatment, the HE staining results of the treatment group were close to those of the normal group, and the model group had a certain degree of lesions. The results of liver function, renal function and heart function tests in the treatment group were returned to normal, and the results in the model group were abnormally increased. UCMSCs have a certain effect on the treatment of traumatic SIRS and provide a new technical solution for modern weapon trauma treatment.
Linkage between commuting time and sickness absence in the context of China: transmission channels and heterogeneous effects
Authors: wang zicheng , Liu Jiachun , Guo Murong
Published: June 2020

Background

Most of employees in urban China have experienced a heavy commuting burden,which has become an urgent issue that should be solved in the process of new urbanization strategy. However, not only has the exploration of relationship between the commuting and sickness absence been still scant in China, but also there is no discussion made to analyze the mechanism linking the commuting time and sickness absence. To address these gaps, this study firstly investigates the commuting-absence effect as well as the potential transmission channel between them.
Methods

Using a unique dataset of 2013 Matched Employer-Employee Survey (CMEES) in China, we apply the zero-inflated negative binomial model to explore the nexus between the commuting and sickness absence. To discuss the potential mechanism linking commuting and sickness absence in the context of China, the estimations of the commuting on health-related outcomes and work efforts are performed by the OLS and Logit regression to discuss the mechanism.
Results

The empirical results reveal that the commute has a positive effect on sickness absence, while it is still robust against several specifications. More importantly, the commuting-absence effect is mainly transmitted through health-related outcomes of employees, whereas we find no clear evidence supporting the shirking behaviors. Additionally, the heterogeneous effects of commuting-absence are differentiated across the Hukou status, gender, transportation modes, scale of cities and types of enterprises.
Conclusion

The longer commute induces to lower productivities through the sickness absence, that is, the longer journey from home to work is positively related with the increasing sickness absence, which keeps in consistency with previous studies. And the potential effect of commute-sickness absence is mainly transmitted through their health-related outcomes. Additionally, the impacts of commute time on sickness absence are differentiated across the Hukou status, gender, transportation modes, scale of cities and types of enterprise.
What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction.
Authors: Sansone Pasquale , Giaccari Luca Gregorio , Faenza Mario , Costanzo Pasquale Di , Izzo Sara , Aurilio Caterina , Coppolino Francesco , Passavanti Maria Beatrice , Pota Vincenzo , Pace Maria Caterina
Published: June 2020

Background : Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management . The aim of this study was t o establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery.Methods: Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for manag e ment of pain in adult after breast surgery . The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively.Results: Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting. After mastectomy, the use of locoregional anesthesia techniques seems to reduce pain, especially in the first hour after the end of the surgery. Other potentially beneficial effects of locoregional anesthesia emerged from our review include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay.Conclusion: T he results of this study support the technique of locoregional anesthesia for breast surgery.
Self-similar stochastic slip distributions on a non-planar fault for tsunami scenarios for megathrust earthquakes
Authors: Nakano Masaru , Murphy Shane , Agata Ryoichiro , Igarashi Yasuhiko , Okada Masato , Hori Takane
Published: June 2020

Megathrust earthquakes that occur repeatedly along the plate interface of subduction zones can cause severe damage due to strong ground motion and the destructive tsunamis they can generate. We developed a set of scenario earthquakes to evaluate tsunami hazards and tsunami early warning systems for such devastating earthquakes. Although it is known that the slip distribution on a fault strongly affects the tsunami height distribution in near-field coastal areas, the slip distribution of future earthquakes cannot be exactly predicted. One way to resolve this difficulty is to create a set of scenario earthquakes in which a set of heterogeneous slip distributions on the source fault is stochastically generated based on a given slip probability density function (SPDF). The slip distributions generated in this manner differ from event to event, but their average over a large ensemble of models converges to a predefined SPDF resembling the long-term average of ruptures on the target fault zone. We created a set of SPDF-based scenario earthquakes for an expected future Mw 8.2 Tonankai earthquake in the eastern half of the Nankai trough, off southwest Japan, and computed the ensuing tsunamis. We found that the estimated peak coastal amplitudes among the ensemble of tsunamis along the near-field coast differed by factors of 3 to 9 and the earliest and latest arrivals at each observation site differed by 400 to 700 s. The variations in both peak tsunami amplitude and arrival time at each site were well approximated by a Gaussian distribution. For cases in which the slip distribution is unknown, the average and standard deviation of these scenario datasets can provide first approximations of forecast tsunami height and arrival time and their uncertainties, respectively. At most coastal observation sites, tsunamis modelled similarly but using a uniform slip distribution underpredicted tsunami amplitudes but gave earlier arrival times than those modeled with a heterogeneous slip distribution. Use of these earlier arrival times may be useful for providing conservative early warnings of tsunami arrivals. Therefore, tsunami computations for both heterogeneous and uniform slip distributions are important for tsunami disaster mitigation.
Can corticosteroids improve the outcomes of patients with Covid-19? A retrospective cohort study of patients within and outside the epicentre
Authors: Yu He , Li Pei-Jun , Wang Ting , Yao Rong , Ni Zhong , Yang Huan , Liang Bin-Miao , Liu Dan , Luo Feng-Ming , Chen Hong , Liang Zongan
Published: June 2020

Background

The novel coronavirus disease 2019 (Covid-19) has been a worldwide pandemic with more than 300,000 deaths. Corticosteroids have been used in some patients with severe Covid-19 in order to control the systemic inflammation or cytokine storm, however, their effects and safety have not yet been elucidated.
Methods

Patients with confirmed Covid-19 were retrospectively included from both the epicentre and out of the epicentre. Patients were classified into two groups according to the use of systemic corticosteroids, and the mortality and the rate of virus clearance were compared between the two groups. In addition, independent factors associated with death after corticosteroids treatment were also identified.
Results

A total of 775 patients were included in our final analysis, of which 238 (30.7%) patients received systemic corticosteroids treatment. Compared with patients without corticosteroids treatment, patients with corticosteroids treatment had significantly higher mortality (19.3% vs. 3.7%, P < 0.001) and lower rate of virus clearance (43.2% vs. 66.7%, P < 0.001) although along with increase of SpO2/FiO2 and blood lymphocytes in patients with severe Covid-19. Corticosteroids treatment was associated with longer hospital length of stays and delayed virus clearance time. In patients with corticosteroids treatment, blood lymphocytes (odds ratio (OR) 0.792, 95% confidence interval (CI) 0.672–0.932, P = 0.005) and creatine kinase (CK) (OR 1.006, 95%CI 1.000-1.012, P = 0.038) were independent risk factors associated with death, with a sensitivity of 90.91% and 44.44% and a specificity of 70.75% and 94.05%, respectively.
Conclusions

In patients with Covid-19, corticosteroids treatment is associated with increased mortality and reduced rate of virus clearance.
Fermentation of Danggui Buxue Tang, an ancient Chinese herbal mixture, together with Lactobacillus plantarum enhances the anti-diabetic functions of herbal product
Authors: Guo Rui , Guo Shuchen , Gao Xiong , Wang Huaiyou , Hu Weihui , Duan Ran , Dong Tina T. X. , Tsim Karl W. K.
Published: June 2020

Background
Danggui Buxue Tang (DBT), an ancient Chinese herbal decoction containing Astragali Radix and Angelicae Sinensis Radix at a ratio of 5: 1, is prescribed for menopausal women. Flavonoids and its flavonoid glycosides are considered as the major active ingredients within the herbal decoction; however, their amount is not controllable during the preparation. Besides, the aglycons within DBT are believed to have better gut absorption and pharmacological efficacy.
Methods
In order to enhance the therapeutic efficacy of DBT, the herbal extract was fermented together with Lactobacillus plantarum, a Gram-positive Lactobacillus commonly found in fermented food products.
Results
The fermentation of DBT with L. plantarum drove a completed conversion of calycosin-7-O-β-D-glucoside and ononin to calycosin and formononetin, respectively, as determined by UPLC-MS/MS analysis. The chemical transformation could be probably mediated by β-glycosidase within the fermented product. Several in vitro assays corresponding to anti-diabetic functions were compared between parental DBT against its fermented product, which included the activities against α-glucosidase, α-amylase and lipase, as well as anti-oxidation (e.g. DPPH radical-scavenging and total antioxidant capacities) and anti-glycation (e.g. BSA-methylglyoxal, BSA-fructose and arginine-methylglyoxal models). The fermented DBT showed increased activities in inhibiting α-glycosidase, suppressing DPPH radical-scavenging and anti-glycation, as compared to the original herbal product.
Conclusion
The results supported the possible application of L. plantarum or other Lactobacillus in fermenting herbal extract, as such to increase the yield and efficacy of the final products.
An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients
Authors: Saavedra Danay , Añé-Kourí Ana Laura , Sánchez Naivy , Filgueira Lázaro Manuel , Betancourt Julio , Herrera Carlos , Manso Leniel , Chavez Elibet , Caballero Armando , Hidalgo Carlos , Lorenzo Geydi , Cepeda Meylan , Valenzuela Carmen , Ramos Mayra , León Kalet , Mazorra Zaima , Crombet Tania
Published: June 2020

Background: Since the COVID-19 outbreak an unprecedented challenge for healthcare systems around the world has been placed. In Cuba, the first case of COVID-19 was reported on March 11. Elderly with multiple comorbidities have been the most risky population. Although most patients present a mild to moderate disease, some have developed severe symptoms. One of the possible mechanisms underlying rapid disease progression is a cytokine storm, in which interleukin (IL) -6 seems to be a major mediator. Itolizumabis a humanized recombinant anti-CD6 monoclonal antibody(MAb), with the ability of reducingserum interferon gamma(INF-γ), tumournecrosis factor alpha(TNFα) and IL-6. Based on these previous results in patients with psoriasis and rheumatoid arthritis, an expanded access clinical trial was approved by the Cuban regulatory agency for COVID-19 critically, severely and moderately ill patients. Results: We show here a short kinetic of IL-6 serum concentration in the first 24 COVID-19 patients treated with itolizumab. Most of patients were elderly with multiple comorbidities.We found that with one itolizumabdose, the circulating IL-6 decreased in critically and severely ill patients, whereas in moderately ill patients the values didn’trise as compared to theirlow baseline levels.Conclusion: These findings suggest that itolizumabcould be an attractive therapeutic option to decrease the negative outcome of the cytokine storm in COVID-19 patients.Trial registration: CECMED IIC RD-EC 179, RPCEC00000311. Registered 4May 2020 - Retrospectively registered, http://rpcec.sld.cu/ensayos/RPCEC00000311-Sp or http://rpcec.sld.cu/trials/RPCEC00000311-En
Numerical Investigations on the Influence of Innovative Hub Geometry Design for Augmented Performance in a Low Speed Centrifugal Fan
Authors: N Madhwesh , Karanth K Vasudeva , SHARMA N YAGNESH
Published: June 2020

Inlet region of a centrifugal fan is considered as one of the important flow domains which provides air into the impeller with adequate flow incidence. There is a dire need for flow guidance for incoming air in order to minimize induced swirl losses in the vicinity of eye of the impeller. An extrusion type of structure, commonly termed hub, is attached to the impeller of turbo machineswhich is used to reduce inlet turning losses and thereby enhancing the performance of the machine in terms of overall static pressure rise. It is seen from a careful literature survey that there has not been significant research on the effect of hub of various shapes and sizeson performance improvement. Analytical tool like computational fluid dynamics (CFD) capture the physics of flow losses encountered especially at the inlet region. This research work attempts to explore numerically the contributions of hub of hemi-spherical and ellipsoidal shapes and parametrically varied sizes on overall performance of the fan. The analysis shows that amongst hemi-spherical and ellipsoidal hub configurations considered in this work, an optimized ellipsoidal hub configuration is found to yield a significant contribution of about 8.4 % for head coefficient and 8.6 % in relative theoretical efficiency over the hub-less base configuration. Finally correlations are developed for the optimized hub shape configurations.
The universal sample holders of microanalytical instruments of FIB, TEM, NanoSIMS, and STXM-NEXAFS for the coordinated analysis of extraterrestrial materials
Authors: Ito Motoo , Tomioka Naotaka , Uesugi Kentaro , Uesugi Masayuki , Kodama Yu , Sakurai Ikuya , Okada Ikuo , Ohigashi Takuji , Yuzawa Hayato , Yamaguchi Akira , Imae Naoya , Karouji Yuzuru , Shirai Naoki , Yada Toru , Abe Masanao
Published: June 2020

We developed universal sample holders (the Kochi grid, Kochi clamp, and Okazaki cell) and a transfer vessel (facility-to-facility transfer container (FFTC)) to analyze sensitive and fragile samples, such as extremely small extraterrestrial materials. The holders and container prevent degradation, contamination due to terrestrial atmosphere (water vapor and oxygen gas) and small particles, as well as mechanical sample damages. The FFTC can isolate the samples from the effects of the atmosphere for more than a week. The Kochi grid and clamp were made for a coordinate micro/nano-analysis that utilize a focused-ion beam apparatus, transmission electron microscope, and nanoscale secondary ion mass spectrometry. The Okazaki cell was made as an additional attachment for a scanning transmission X-ray microscope that uses near edge X-ray absorption fine structure. The coordinated analysis involving these holders was successfully carried out without any sample damage or loss, thereby enabling us to obtain sufficient quality of analytical datasets of textures, crystallography, elemental/isotopic abundances, and molecular functional groups for µm-sized minerals and organics in both an Antarctic micrometeorite and a carbonaceous chondrite. We will apply the coordinated analysis to acquire the complex characteristics in samples that obtain by the future spacecraft sample return mission.
Identification of LncRNA Prognostic Biomarkers Associated with Copy Number Variants in Gastric Cancer
Authors: Wang Anqiang , Chen Jiahui , Zhou Kai , He Qifei , Ji Ke , Ji Xin , Wu Xiaojiang , Zhang Ji , Bu Zhaode , Ji Jiafu
Published: June 2020

Backgrounds: Gastric cancer is one of the most common gastrointestinal carcinomas worldwide, with a poor prognosis. Prognosis prediction is very important in the treatment of gastric cancer .This study aimed to explore the prognostic value of lncRNA deregulated by copy number variants (CNVs) in gastric cancer. Methods: Multi-omics cluster analysis was performed to identify subtypes on the prognosis associated coding genes, CNVs and methylation sites. We conducted survival analyses on median expression level for all identified lncRNAs. Finally, we constructed and validated a prognostic model on lncRNAs with data of public and our center. Results: As a result, we identified six subtypes of gastric cancer with different prognosis (P=0.00446) and a total of 83 disease associated lncRNAs. We finally obtained five prognostic lncRNA biomarkers. Survival analyses showed that the high expression of all identified lncRNAs positive associated with worse prognosis. We also found that the prognostic model on five identified lncRNAs could predict survival with high 5-years AUC 0.69. And the differences of survival between high risk and low risk groups were significant in both of our and public database. In the multivariable analyses, we found that the prognostic model was an independent prognostic factor (p = 0.0104).Conclusions: We concluded that the prognostic model on five identified lncRNAs was closely related to the overall survival of gastric cancer and may serve as promising prognostic biomarkers of gastric cancer.
A Practical Framework for Conducting Video Telemedicine Visits with Trainees
Authors: Kwan Brian , Charat Stacy , Wooten Darcy , Hill Deanna , Restaino Nivedita , Friedman Lawrence
Published: June 2020

Background:Due to COVID-19, traditional clinical education for senior medical students has largely halted. In response to social distancing, many outpatient practices have transitioned to Telemedicine (TM). While TM has been integrated into undergraduate medical education curricula at many institutions, a published roadmap for incorporating learners into TM is not readily available.Aim:To describe one healthcare system’s transition to TM and propose a framework for including learners in video TM visitsSetting:Primary care clinics at an academic medical centerParticipants:Medical students, facultyProgram Description:Training protocols were distributed to providers and students. Multi-provider video visits were enabled for distance teaching. Students tested potential workflow models and provided feedback, facilitating creation of a 4-phase construct to guide inclusion of learners in video TM encounters.Program Evaluation:We employed a rapid feedback cycle to improve workflow process and to modify trainee and preceptor instructions. We analyzed student comments for narrative themes to plan for future evaluation of video TM encounters.Discussion:TM will be increasingly used in the provision of medical care. Clinician-educators will need to innovate in order to meet patient and learner expectations. TM will be an integral teaching tool and may enhance the educational experience.
Predictive Significance of Arachidonate 15-Lipoxygenase for Eosinophilic Chronic Rhinosinusitis with Nasal Polyps
Authors: Liang Zhuoping , Yan Bing , Liu Chang , Tan Ruyu , Wang Chengshuo , Zhang Luo
Published: June 2020

Background Eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) exhibits a poorer outcome compared with non-eosinophilic chronic rhinosinusitis with nasal polyps (nonECRSwNP), so it is significant to identify effective markers to differentiate ECRSwNP in guiding the treatment strategies of these patients. Although arachidonate 15-lipoxygenase (ALOX15) is positioned as a marker of eosinophilic inflammation, its study in differentiating ECRSwNP has not been reported. The aim of this study is to assess the potential of ALOX15 in distinguishing and predicting ECRSwNP. Methods Forty-eight patients with chronic rhinosinusitis with nasal polyps (CRSwNP), including 30 ECRSwNP and 18 nonECRSwNP patients, were enrolled. ALOX15 mRNA level was determined in polyps by real-time polymerase chain reaction (RT-PCR). The patients’ baseline characteristics were evaluated and analyzed for correlations with ALOX15. Receiver operating characteristic (ROC) curve was used to assess the predictive significance of the potential predictors for ECRSwNP. Results ALOX15 mRNA level was significantly higher in ECRSwNP patients than in nonECRSwNP patients ( P < 0.001). ALOX15 mRNA was significantly correlated with tissue and blood eosinophil percentages ( r = 0.565, P < 0.001 and r = 0.395, P = 0.006), olfaction scores ( r = 0.400, P = 0.005), total visual analogue scale (VAS) symptom scores ( r = 0.383, P = 0.007), ethmoid/maxillary sinus (E/M) ratio ( r = 0.463, P = 0.001), and endoscopy scores ( r = 0.409, P = 0.004). Logistic regression analysis showed ALOX15 mRNA level and percentage of blood eosinophils to be predictive factors for ECRSwNP ( P = 0.004 and P = 0.036, respectively). ROC curve indicated ALOX15 to have high predictive accuracy for ECRSwNP (area under the curve (AUC) = 0.909), which was further improved by combination of ALOX15 with percentage of blood eosinophils (AUC = 0.933). Conclusions The relative ALOX15 mRNA level alone or in combination with blood eosinophils might be a reliable biomarker for predicting a diagnosis of ECRSwNP.
Severe Fatigue Due to Valproate-induced Hypothyroidism in a Case of Bipolar Disorder
Authors: Kanamori Tadashi , Suzuki Masahiro , Kaneko Yoshiyuki , Yamada Kouju , Kubo Hideyuki , Uchiyama Makoto
Published: June 2020

Background: Valproate-induced hypothyroidism is a rare conditionand has been considered asymptomatic. Here, we report a case of bipolar I disorder who developed symptomatic valproate-induced hypothyroidism.Case presentation: A 44-year-old woman with bipolar I disorder complained of severe fatigue after starting valproate. She showed a hormonal pattern of central hypothyroidism. Thyroid autoantibodies were negative, and no pituitary abnormality was seen on magnetic resonance imaging. After stopping valproate, her severe fatigue rapidly improved with normalizing thyroid function.Conclusions:Our case suggests that valproate-induced hypothyroidism should be considered when patients complain of excessive fatigue under treatment with valproate.
Thevebioside, the Active Ingredient of Traditional Chinese Medicine, Inhibits SRC3 Mediated Signaling by Ubiquitination to Induce NSCLC Cells Apoptosis
Authors: Yao Chao , Su Lin , Zhang Fei , Zhu Xiaowen , Zhu Yangzhuangzhuang , Wei Luyao , Jiao Xiaoning , Hou Yifei , Chen Xiao , Wang Wantao , Wang Jie , Zhu Xiandan , Zou Chunpu , Zhu Shiguo , Xu Zihang
Published: June 2020

Background:The high incidence and mortality of lung cancer has been a widespread concern in the world, among which non-small cell lung cancer (NSCLC)accounts for more than 85% of lung cancer, and its 5-year prognosis is pretty poor. Accumulating studies have shown that traditional Chinese medicine (TCM) and its active ingredients have shown good anti-tumor activity. Based on the results of our previous high-throughput screening, it was the first time to find that Thevebioside (THB, an active ingredient from TCM) is sensitive to NSCLC cells, and then we will still the first to reveal the underling mechanism of its tumor suppressive activity.Methods: In this study, MTT and colony formation assay were used to detect cell growth. Annexin V/ propidium iodide, Hoechst 33342 were applied to test the process of cellular apoptosis or cell cycle arrest which determined by flow cytometry in NSCLC (A549 and H460) cells. qRT-PCR and Western blot was utilized to value the level of expression of SRC&(SRC1-3) and apoptosis related proteins. The ubiquitination degradation of SRC3 was through proteasome dependent pathway were examined by the usage of CHX and MG132 and the co-immunoprecipitation assay. The anticancer activity of THB, Neritaloside，Odoroside H and digoxin in vivo were monitored in nude mice by subcutaneous inoculation or intrapulmonary injection of A549 cells and then administrated these agents (2 mg/ kg or 4mg/kg) by intraperitoneal injection three times a week for 30 days. Tumor growth was monitored by a luciferase living imaging system. Body weight of mice and tumor volume were measured weekly. The survival carve was recorded. Pathological histology of liver, kidney and heart were detected by H&E staining, and its functions were tested by ELISA. Results：THB effectively inhibits the outgrowth of NSCLC cells (A549 and H460) by inducing cellular apoptosis. SRC-3 was significantly down-regulated after THB treatment dependent on ubiquitin-proteasome-mediated degradation, which subsequently inhibited the AKT signaling pathway to promte apoptosis. Animal study supported in vitro results, showing THB had a good suppressive effect on tumor growth. Besides, it also indicated that THB without overt cytotoxic effect on liver, kidney and heart.Conclusion：THB , as an active extract from TCM，exerted inhibitory effect on tumor growth of NSCLC by down-regulating the expression of SCR-3 rely on the ubiquitin-proteasome degradation pathway, thereby inhibiting the AKT signaling to induce cellular apoptosis , with minimal toxicity.
Case Report: Diagnosis and Treatment of a Giant Retroperitoneal Liposarcoma Presenting as an Irreducible Inguinal Hernia
Authors: Yuan Zhiqing , Li Qiwei , Sun Jianhua , Zhou Wei , Chen Tao
Published: June 2020

Background: Retroperitoneal liposarcoma protrude to the inguinoscrotal area presenting as an irreducible inguinal hernia is extremely rare. For the rare cases and little experience of diagnosis and treatment of this disorder, the clinical guidelines are vacant. We report a successful example for the management of a giant retroperitoneal liposarcoma extending to the inguinoscrotal area. Case presentation: A 55-year-old male patient was admitted to our hospital in August 2018 with a large left inguinal mass without abdominal pain or digestive symptoms. Preoperative contrast-enhanced computed tomography revealed an abdominopelvic huge mass, and ultrasound guided biopsies showed liposarcoma. The patient also suffered from dilated cardiomyopathy and the left ventricular ejection fraction is only 39%. The left renal pedicle was squeezed by the mass and the left glomerular filtration rate is as low as 29.25ml/min. Intraoperatively, the mass was incarcerated in the inguinal canal and involved the left testis. We performed a radical tumor resection with two incisions, including resection of the retroperitoneal tumor, resection of the scrotal tumor and a tension-free repair of left inguinal hernia. The resected specimen for the retroperitoneal part measured 50*28*9 cm, weighed 13.5 kilograms and the scrotal part measured 16.5*7*4.5 cm, weighed 6.2 kilograms. Pathologically, the tumor was diagnosed as a well-differentiated liposarcoma, and originated from perirenal fat. The patient did not undergo adjuvant therapy post-operation and is completely clinical remission fifteen months after the operation. Conclusions: Careful distinction for inguinoscrotal mass is essential to minimize complications and improve patient prognosis. The prime principle to treat well differential retroperitoneal liposarcomas is radical resection with protection of vital organs and vessels.
Impact of Neutrophil-Lymphocyte Ratio on Long-term Outcomes of Patients with Coronary Chronic Total Occlusion After Percutaneous Coronary Intervention
Authors: Gao Ke , Li Bo-Lin , Yang Lei , Xue Yan-Bo , Yang Wan-Ying , Wu Yue , Zheng Xiao-pu
Published: June 2020

Background: The impact of preprocedural neutrophil-lymphocyte ratio (NLR) level on subsequent adverse cardiovascular events and health status in coronary chronic total occlusion (CTO) patients after stent implantation is unclear. The present study aims to evaluate the impact of NLR level on long-term clinical outcomes and health status of CTO patients after percutaneous coronary intervention (PCI) in the drug eluting stent era.Methods: A total of 311 CTO patients who underwent successful PCI with new-generation drug-eluting stent and with follow-up were enrolled. Patients were classified into 3 groups according to the tertiles of NLR level at baseline. The primary endpoint (major adverse cardiac events, MACE) was a composite of cardiac death, target-vessel myocardial infarction (MI), and ischemia-driven target-vessel revascularization (TVR) on follow-up. Multivariable COX regression analysis was performed to estimate the relationships between the parameters and MACE.Results: Compared with the low and intermediate tertile groups, preprocedural platelet-lymphocyte ratio (PLR) level and age were significantly higher in the high NLR tertile group. After a median follow-up of 32 (interquartile range: 20 to 44) months, MACE was observed in 10 patients (9.7%) in the low tertile, in 21 (20.2%) in the intermediate tertile, and in 31 (29.8%) in the high tertile group (P = 0.001). Kaplan-Meier analysis demonstrated a significantly higher incidence of MACE, mainly driven by TVR, in patients with high tertile than the low and intermediate tertile groups. Multivariable COX regression analysis showed NLR and occluded length as independent predictors of MACE. No statistically differences were observed regarding the five domains of Seattle Angina Questionnaire (SAQ) scores among the 3 groups (all P > 0.05).Conclusions: In conclusion, in patients who underwent PCI for CTO lesions, elevated NLR level was independently associated with MACE (driven by TVR) on follow-up.
Tobacco rattle virus -induced gene silencing in Hevea brasiliensis
Authors: Li Hui-Liang , Guo Dong , Wang Ying , Zhu Jia-Hong , Qu Long , Peng Shi-Qing
Published: June 2020

BackgroundSince it is very difficult to obtain gene knockouts in rubber tree (Hevea Brasiliensis) due to low genetic transformation efficiency. Virus-induced gene silencing (VIGS) is a powerful gene silencing tool that has been intensively applied in plant. Up to now, the application of VIGS in rubber tree has not yet been reported.ResultsHevea brasiliensis phytoene desaturase (HbPDS) was identified in H. brasiliensis genome. The prediction of small interfering RNAs (siRNAs) from HbPDS and the silencing gene fragment (SGF) were predicted and a length of 409 bp SGF was chosen to be tested. We show that the tobacco rattle virus (TRV) -VIGS is able to induce effective HbPDS silencing in rubber tree. The TRV-VIGS system has the potential for functional gene studies in rubber tree.ConclusionsThis is the first time to report VIGS in rubber tree. The present TRV-VIGS method could be further applied to produce gene silenced rubber tree plants, to advance functional gene of rubber tree. The applied TRV-VIGS method will achieve deeper underground into the natural rubber biosynthesis and regulation in this important rubber-producing plant.
A Real-World Study for Polymyxin B in the Treatment of Carbapenems Resistant Gram-Negative Bacilli
Authors: Zhang Xiaojuan , Qi Shaoyan , Duan Xiaoguang , Han Bing , Zhang Shuguang , Liu Shaohua , Wang Haixu , Zhang Haibo , Sun Tongwen
Published: June 2020

Background: High morbidity and mortality due to carbapenem-resistant Gram-negative bacilli (CRGNB) was a challenge for clinicians has led to the resurgence of polymyxin B (PMB) use in the last decade. The goal of our multicenter, real-world study was to evaluate the efficacy and safety of PMB in the treatment of CRGNB.Methods: The real-world study included the patients with intravenous PMB at least 7 days during the period of October 2018 to June 2019. Data was collected from electronic patients register and follow-up. The primary outcome was 28-day mortality, the secondary outcomes included hospital mortality, occurrence of adverse events during PMB therapy. Associations between these variables and 28-day mortality or all-cause hospital mortality were explored through univariate analyses and multivariable logistic regression. At the same time, therapeutic effects were observed. Results: The study included 100 patients. There were 39% presence of septic shock, 49% need mechanical ventilation at the beginning of therapy. The infection and condition improved after 7 days of PMB treatment. The major adverse reactions occurred in 16 cases (16%). The overall 28-day mortality was 40%. In terms of clinical characteristics, mean Sequential Organ Failure Assessment (6.77 versus 9.25，P = 0.004)，mean Acute Physiology and Chronic Health Evaluation II (APACHEII) scores (16.17 versus 19.78, P = 0.016) and the number of patient with mechanical ventilation (21 versus 30, P = 0.000) or septic shock (17 versus 32, P = 0.000) were lower in survivors group than nonsurvivors group. The mortality of 85 patients with identify pathogens was 38.82%, while the mortality of patients with negative pathogen culture results was 46.67% (P = 0.580). Multivariate analysis showed that mechanical ventilation (P = 0.023, OR = 3.5; CI: 1.194–10.739), septic shock (P = 0.002, OR = 5.960; CI: 1.923–18.473) were associated with 28-day mortality.Conclusion: Our research found that PMB may be as effective and safe as standard antibiotics for the treatment of CRGNB. Timely and appropriate use of PMB will have a positive impact on the clinical outcomes of patients with sepsis in CRGNB.
Risk of Anterior Cruciate Ligament Injury in Obese Population: A Retrospective Study in a Single Center in Saudi Arabia
Authors: Alsayed Hasan , Alkhateeb Mohammed , Aldossary Asma Abdulaziz , Houbani Khalid , AlJamaan Yousef , Aldakheel Dakheel , Alrashidi Yousef
Published: June 2020

Background: The Anterior cruciate ligament (ACL) injury is among the most common orthopedic injuries(1). The Elevated Body Mass Index (BMI), can contribute to non-contact ACL injury(5). This study aims to assess the risk of (ACL) injury in obese people (BMI) more than 30 Kg\m2).Methodology: This is a retrospective cohort series was done in a tertiary care center in Kingdom of Saudi Arabia . A total of 302 patients, who had ACL reconstruction surgery in a period between (January 2008 to December 2018) were included. (BMI) was classified based on WHO classification, baseline characteristics data include: Age, gender, nationality, type of injury, classification of injury, mechanism of injury, and mode of injury. Binary regression analysis was done to predict the effect of obesity on a selected baseline characteristic of patients (type of sport, Isolated\ combined, type of injury, reinjury rate).Result:Our study showed that sport related injury is significantly higher among overweight and obese group (P: 0,007). Moreover, the combined ACL tear was higher among overweight and obese group (P: 0,001). In binary regression analysis for the selected baseline characteristics we found that obese people have chance to develop combined (ACL) injury 2 times higher when compared to those with isolated ACL injury with a p value of (0,003). However, the other selected variables like mode of injury, type of sport, mechanism of injury and type of graft were not significance. Conclusion: Elevated BMI was associated with higher risk of developing ACL tear.
Postoperative incidence of seizure and ischemic events in patients with epileptic type moyamoya disease: a meta-analysis of single rate
Authors: LIU JINGJING , Xu Qinlan , Niu Hongchuan , Wang Rong , Ye Xun , Liu Xianzeng
Published: June 2020

BackgroundSurgery is a conventional mature treatment for moyamoya disease (MMD). However, whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and ischemic events in patients with epileptic type moyamoya disease.MethodThe study was a systematic review and critical appraisal with a meta-analysis of cohort studies, both prospective and retrospective. Studies were identified by a computerized search of Pubmed, EMBASE, Web of Science, Wanfang, and CNKI databases. In a literature search, a total of 8 cohort studies were identified. The I2statistic was used to quantify heterogeneity. A fixed-effect model was used to synthesize the results. The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.ResultsThe pooled estimated postoperative incidence of seizure in patients with epileptic type moyamoya disease was 21.52%. The pooled estimated postoperative incidence of ischemic events in patients with epileptic type moyamoya disease was7.42%. Low substantial heterogeneity and potential publication bias were present.ConclusionEvidence from this study suggests that the postoperative incidence of seizure and ischemic events is relatively low. Surgery is an effective and secure therapy for patients with epileptic type moyamoya disease.