bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of drug targets and potential molecular mechanisms for Wantong Jingu Tablet extract in treatment of rheumatoid arthritis: bioinformatics analysis of fibroblast-like synoviocytes
Authors: Li Zhaodong , Qi Fangyuan , Li Fan
Published: April 2020

Background: Rheumatoid arthritis- fibroblast-like synoviocytes (RA-FLSs) play important roles in pathogenesis of rheumatoid arthritis (RA). Wantong Jingu Tablet (WJT), a mixture of traditional Chinese medicine, is a potentially effective therapy for RA, but its underlying mechanism is unclear. In this study, we explore the effects of WJT on human RA-FLSs and the underlying molecular mechanism. Methods: The major components of WJT were determined using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS). Cell proliferative ability was evaluated by CCK-8, colony formation assay, and EdU incorporation assay. Cell apoptotic capacity was examined by caspase-3 and caspase-9 activity test. Protein levels of Bax and Bcl-2 were investigated by western blotting. High-throughput sequencing and bioinformatics analysis were conducted to screen and identify targeted genes, followed by identification by qRT-PCR and western blotting. Results: In this study, we have identified 346 compounds in WJT. Our results showed that WJT inhibited the RA-FLSs proliferation, and promoted apoptosis in a dose- and time-dependent manner. More importantly, 184 differentially expressed genes (DEGs) has been screened after WJT treatment based on DEGSeq2 and 278 DEGs was identified by DEGSeq2 combined with WGCNA. Then, 10 hub genes were identified based on two different analyses, while the expression levels of only SMC3 , THOC1 , BUB1 , and STAG2 were decreased after WJT treatment, which was identical to the sequencing profiles.Conclusions: WJT exerted its anti-proliferation and pro-apoptosis effects possibly through suppressing the expression of SMC3, THOC1, BUB1, and STAG2 in RA-FLSs. Thus, therapeutics targeting these genes may be a promising strategy for rescuing RA. Keywords: Rheumatoid arthritis; bioinformatics; fibroblast-like synoviocytes; Wantong Jingu Tablet
Associations of cognitive condition with nutritional status in an elderly population: an analysis based on a 7-year database in Chongqing, the Southwest of China
Authors: Yu Wuhan , Yu Weihua , Liu Xintong , Wan Tianchi , Chen Chenxi , Xiong Lei , Hu Cheng , Yu Xingyan , Yuan Shiyun , Zhang Wenbo , Zhong Fuxin , Qin Zhangjin , Yang Wenkai , Chen Daimin , Lü Yang
Published: April 2020

Background: Malnutrition is one of the health problems in the elderly population, which increases the risk of poor clinical outcomes. The purpose of this investigation was to evaluate the nutritional status and cognitive function of an elderly Chinese population, to explore the association between malnutrition and cognitive condition as well as the cognitive domain.Methods: A cross-sectional study was conducted in 2365 participants aged 60 years or above from January 2013 to September 2019. We used the Mini Nutritional Assessment Short Form (MNA-SF), and the Mini Mental State Examination (MMSE) to assess the impact of malnutrition on cognitive function. Nutrition-associated factors were analyzed.Results: 33.45% of the participants were identified as malnutrition risk and 5.54% were malnourished, while 36.74% had cognitive impairments. 48.63% had nutritional deficits and 53.65% had cognitive impairment in those over 80 years old. Malnutrition is associated with global cognition (ρ= 0.349, P < 0.0001) and the cognitive domain particularly in orientation (ρ= 0.343, P < 0.0001). The impact was extended to attention and calculation (ρ=0.310, P < 0.0001) as well as language (ρ= 0.302, P < 0.0001) of those over 80 years of age. Malnutrition is an independent risk factor for cognitive impairment after adjusting for other variables (OR=2.004, 95% CI: 1.621-2.479).Conclusion: The prevalence of malnutrition and cognitive impairment was relatively high and increased with age. Malnutrition leads to cognitive decline and disorientation, and also contributes to attention problems, calculation problem and language impairment in the oldest old. Thus, clinicians should assess the nutritional and cognitive status of the elderly regularly to the early dictation and timely intervention.
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
Authors: Han Xiudi , Liu Xuedong , Chen Liang , Wang Yimin , Li Hui , Zhou Fei , Xing Xiqian , Zhang Chunxiao , Suo Lijun , Wang Jinxiang , Yu Guohua , Wang Guangqiang , Yao Xuexin , Yu Hongxia , Wang Lei , Liu Meng , Xue Chunxue , Liu Bo , Zhu Xiaoli , Li Yanli , Xiao Ying , Li Lijuan , Cui Xiaojing , Cao Bin
Published: April 2020

Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO 2 /FiO 2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm 3 , pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration : A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb
Very High Baseline HIV viremia impairs efficacy of NNRTI-based ART: A long-term observation in treatment-naïve patients
Authors: Chen Shuai , Han Yang , Song Xiaojing , Li Yanling , Zhu Ting , Lu Hongzhou , Tang Xiaoping , Zhang Tong , Zhao Min , He Yun , He Shenghua , Wang Min , Li Yongzhen , Huang Shaobiao , Li Yong , Liu Jing , Cao Wei , Li Taisheng
Published: April 2020

Background: High baseline HIV-RNA level (≥100,000 copies/ml) has been proved to be related with weaker virological response to antiretroviral therapy (ART). However, it was not completely clear whether a very high pre-therapy viral load (≥500,000 copies/ml) can further impair the virological response, especially in the long run. Methods: A retrospective study based on data from multicenter cohorts in China was performed. We enlisted untreated HIV infected adults recruited between18 and 65 years old, who received China’s first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. All patients had baseline HIV-RNA levels over 500 copies/ml, showed good adherence, and were followed for at least 24 weeks. Virological suppression (VS) was defined as the first HIV-RNA <50 copies/ml which lasted for six months. Virological failure was defined as any of incomplete viral suppression (HIV-RNA ≥200 copies/mL with no recorded VS within 24 weeks of treatment) and viral rebound (confirmed HIV-RNA level ≥50 copies/mL after VS). Chi-square analysis was used to compare rates of VS between different HIV-RNA strata. Kaplan–Meier analysis and Cox regression model were used to compare time to virological suppression. Logistic regression was used to evaluate odds to virological failure. Results: 758 treatment-naïve HIV patients in China were enlisted. Median follow-up time (IQR) was 144 (108-276) weeks. Most patients (68.2%) were given tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV) regimen. By week 48, rates of VS in three groups (<100,000, 100,000-500,000 and ≥500,000 copies/ml) were 94.1%, 85.0%, and 63.8%, respectively ( p <0.001). Very high baseline HIV viremia over 500,000 copies/ml were found to be independently associated with delayed VS [≥500,000 vs. <100,000, adjusted relative hazard (95% CI), 0.455 (0.32-0.65); p <0.001] as well as incomplete viral suppression [≥500,000 vs. <100,000, adjusted odds ratio (aOR) (95% CI), 6.084 (2.761-13.407); p <0.001] and viral rebound [≥500,000 vs. <100,000, aOR (95% CI), 3.671 (1.009-13.355), p =0.048]. Conclusion: Very high levels of pre-treatment HIV-RNA were significantly related with delayed efficacy of NNRTI-based ART and increased risk of treatment failure. More potent initial regimens should be considered for those with very high baseline viremia.
Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection
Authors: Gu Lihu , Chen Bangsheng , Zheng Dingcheng , Mo Jiahang , Yuan Lingling , Mao Feiyan , Zhang Kang , Ng Derry Minyao , Chen Ping , Wang Dongjie
Published: April 2020

Background and objective: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.
Molecular typing, phenotypic and genotypic assessment of antibiotic resistance and virulence factors amongst the Staphylococcus aureus bacteria isolated from raw chicken meat
Authors: Fazel Nazanin , Karimi Sepideh , Momtaz Hassan
Published: April 2020

Background: Staphylococcus aureus is an important cause of foodborne diseases due to the consumption of contaminated raw chicken meat. The present research was performed to evaluate the phenotypic and genotypic properties of antibiotic resistance, virulence factor profiles and molecular typing of S. aureus strains isolated from chicken meat. A total of 36 S. aureus strains were isolated from raw chicken meat samples. Phenotypic pattern of antibiotic resistance was assessed by disk diffusion. Distribution of antibiotic resistance and virulence genes was evaluated by PCR. Molecular typing of isolates was perform ed by the ERIC-PCR. Results: Considering the over than 80% similarity, 36 S. aureus isolates were classified in 9 different profiles with 43 to 100% similarities. S. aureus strains showed the highest incidence of resistance against penicillin (100%), tetracycline (91.66%), cephalothin (77.77%), ciprofloxacin (75%), erythromycin (75%), mupirocin (63.88%), clindamycin (61.11%) and trimethoprim/sulfamethoxazole (61.11%). The most commonly detected antibiotic resistance genes amid the S. aureus isolates were mecA (100%), tetK (80.55%), tetM (66.66%), aacA-D (61.11%), msrA (55.55%) and ermA (55.55%). Total distribution of etB, etA, tsst-1, clfA and coa virulence factors amongst the S. aureus strains was 61.11%, 58.33%, 13.88%, 75% and 100%, respectively. Conclusions: Genetic cluster of bacteria affected the antibiotic resistance and virulence characters of S. aureus strains. S. aureus strains with the same ERIC-genetic cluster had similar antibiotic resistance and virulence characters which may show their similar origins. Presence of one or more virulence factors and antibiotic resistance genes amongst the resistant-S. aureus strains signifies an important public health threat rendering the consumption of raw or undercooked chicken meat.
Cytokine profile and nitric oxide levels in peritoneal macrophages of BALB/c mice exposed to Fucose-Mannose Ligand of Leishmania infantum combined with Glycyrrhizin
Authors: Hasan Namdar Ahmadabad , shafiei reza , Reza Hatam Gholam , Reza Zolfaghari Emameh , Ashok Aspatwar
Published: April 2020

Background: The Fucose-Mannose Ligand (FML) of Leishmania infantum is a complex glycoprotein which does not elicit adequate immunogenicity in human. In recent years, adjuvant compounds derived from plants have been used for improving the immunogenicity of the vaccines. Glycyrrhizin (GL) is a natural triterpenoid saponin that has known immunomodulatory activities. In the present study, we investigated the effects of a co-treatment with FML and GL on the production of cytokines and nitric oxide (NO) by macrophages, in vitro. Methods: Lipopolysaccharide (LPS) stimulated murine peritoneal macrophages were treated with FML (5 μg/ml) of Leishmania infantum and various concentrations of GL (1 μg/ml, or 10 μg/ml or 20 μg/ml). After 48h of treatment, cell culture supernatants were recovered and the levels of TNF-α, IL-10, IL-12p70, and IP-10 were measured by sandwich ELISA and NO concentration by Griess reaction. Results: Our results indicated that the treatment of activated macrophages with FML plus GL leads to enhanced production of NO, TNF-α, IL-12p70, and reduction of IL-10 levels in comparison with FML treatment alone. Conclusions: We, therefore, concluded that GL can improve the immunostimulatory effect of FML on macrophages and leads to polarization of them toward an M1-like phenotype.
Apolipoprotein A1 and lipoprotein(a) are protective factors for male papillary thyroid cancer patients. A cross-sectional study of single academic center in China.
Authors: Ma Maoguang , Wang Mingdian , Zhang Zhanqiang , Lin Bo , Sun Zicheng , Guan Haoyan , Lv Weiming , Li Jie
Published: April 2020

Background: Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC continued to increase over the past decades. Many studies showed that obesity is an independent risk factor for PTC and obese PTC patients tend to have a relative larger tumor size and higher grade of tumor stage. Obesity is closely related with lipid metabolism, while the correlation between serum lipid and PTC remains unclear. Therefore, this study aimed to investigate the association between serum lipid level and PTC. Methods: We retrospectively analyzed 1018 PTC patients diagnosed and treated in our hospital, all these cases were first diagnosed with PTC and had complete clinical information including ultrasound reports before surgery, serum lipid (CHOL, TG, HDL-c, LDL-c, Apo-A1, Apo-B, Apo-E, Lp (a)) results, surgical records and pathological reports. Results: All these serum lipid biomarkers did not associated with tumor size in the female group. In the male group, on crude analysis, Apo-A1 and Lp (a) showed a marginally significant association with tumor size OR and 95% CI 0.158 (0.021-1.777), p=0.072; 0.997 (0.993-1.000) p=0.082 respectively. After adjusting for age and multifocality, Apo-A1 and Lp (a) showed a significant association with tumor size OR and 95% CI 0.126 (0.016-0.974) p=0.047; 0.996 (0.992-1.000) p=0.046 respectively. This association become more apparent in a young male subgroup, OR and 95% CI 0.051 (0.005-0.497), p=0.009; 0.926 (0.978-1.012), p=0.037 respectively. CHOL, TG, HDL-c, LDL-c, Apo-B, Apo-E did not show significant association with tumor size. As for LNM, neither in the male group nor in the female group were found to be associated with any serum lipid biomarkers. Conclusion: As PTC incidences continues to increase, our study demonstrated that Apo-A1 and Lp (a) are two protective factors for male PTC patients and provided us new clues about PTC and lipid metabolism, which may contribute to further investigation concerning diagnosing and preventing this most common type of thyroid cancer.
World Delirium Awareness Day 2019, delirium and risk of falls in the hospital setting.
Authors: Shekhar Rozina , Chasle Briony , Stott Katrina , Vueti Vaulina , Deane Vicki , Edmonds Renee , Moseley Margaret , Shepherd Bernadette , Mayahi-Neysi Mandana , Wilson Carol , Sandhu Navjot , Smitha Juvilet , Phillips Jennifer , Marov Lynda , Perkins Margaret , Carr Sara , Richardson K'Sandra , McGuire Kathy , Gujraz Poumansing , Kumar Binita , Jankulovski Daniella , Dixon Kylie , Lata Yashwani , Zachariah Rinsy , Rolls Kaye , Warner Bradley , Chroinin Danielle Ni , Frost Steven Alfred
Published: April 2020

Background Delirium is an acute change in cognition, common among older hospitalized patients, however, patients of all ages are at risk of delirium during a hospital stay. The International Federation of Delirium Societies promotes, each year, a World Delirium Awareness Day , to raise the awareness of, not just recognizing delirium in the hospital setting, but ensuring interventions are in place to prevent the development of delirium. Hospitalized patients with delirium have increased risk of adverse events such as falls, pressure injury, malnutrition, increased length of stay, increased health care costs, and mortality. This clinical audit aimed to estimate the risk of a subsequent fall, following an acute episode of in-hospital delirium, across a broad cross-sectional of clinical settings.Methods Seventeen adult acute inpatient wards across the South Western Sydney, Local Health District, undertook an audit of the number of admitted patients who had had at least one episode of delirium since being admitted to hospital. Using the hospital-based incident management reporting system, the rates of subsequent falls was compared between delirium and non-delirium patients.Results Fifty of the 473 patients (11.4%) were identified by the nursing staff to have had at least one episode of delirium since admission. The proportion of fallers among the delirium and non-delirium patients were 10% and 2%, respectively (p = 0.004). The rate of falls per 1000 patient days was 6.45 (95% confidence interval (CI) 2.1 to 15.1) among delirium patients, compared to 2.12 (95% CI 1.0 to 4.0) among patients without delirium. The risk of falling among delirium patients was 4.25 higher compared to non-delirium patients (adjusted hazard ratio (HR) = 4.25, 95% CI 1.26 to 14.39).Conclusion This clinical audit has been able to show that an acute episode of delirium increases the risk of an in-hospital fall fourfold. Importantly, these results have highlighted the need for a hospital wide approach, to not just in identifying delirium, but the need to have interventions in place to reduce the risk of delirium. In other words, delirium prevention should be ‘core business’ of all nursing care, across the acute hospital setting.
Preoperative Geriatric Nutritional Risk Index is an independent prognostic factor for postoperative survival after Gallbladder carcinoma radical surgery
Authors: Zhang Die , Xu Jing
Published: April 2020

Background

Surgical results of gallbladder cancer (CBG) are currently inadequate. The Geriatric Nutritional Risk Index (GNRI) can effectively assess nutritional status. The present study attempted to delve into investigating whether preoperative GNRI can act as a predicting factor for CBG.

Methods

202 consecutive GBC patients treated from 2010 to 2017 were taken retrospectively. By conducting univariate and multivariate Cox regression analyses on overall survival (OS) and recurrence-free survival (RFS), their preoperative GNRI was studied.

Results

Of the 202 patients, 103 (51.0%) had GNRI<100. The patients with low GNRI before surgery had the median OS of 26 months, less than that of patients having received high GNRI before surgery (39 months, P<0.001). GNRI displayed associations with less survival times in univariate (HR, 3.656; 95%CI, 2.308-5.790; P<0.001). As indicated from the results of multivariate analysis, patients exhibiting low GNRI showed a lower OS (HR, 2.386; 95%CI, 1.170-4.868; P=0.017) and RFS (HR, 7.610; 95%CI, 3.181-18.207; P<0.001) than those exhibiting high GNRI.

Conclusions

GNRI is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.
Ethnobotanical study on Sustainable use of Non-Timber Forest Products and their Source Plant Species contribute to balance Livelihood and Conservation: a case of Sera Forest, Amigna District, Southern Ethiopia
Authors: Kidane Leul , Balke Abu Balke
Published: April 2020

Background: Non-Timber Forest Products (NTFPs) do have significant role as local source for medicine, fiber, forage and sustenance and offer income opportunities for poverty mitigation mainly in rural families. Sustainable use of NTFPs is imperative so, this study was focused on the documentation of plant species used for NTFPs and their conservation status in Sera forest. Methods: The study applied a combination of plant ecological and ethnobotanical methods. Ethnobotanical data were gathered through semi-structured questionnaires and interviews which involved 230 (206 randomly sampled general and 24 purposively selected key informants); group discussion, guided field walk and market survey. Data were analyzed and presented using analytical methods of ethnobotany including descriptive statistics, informant consensus factor (ICF) and ranking. Results: A total of 137 plant species belonging to 49 families used as a source of NTFPs were documented from the study area. In addition, 11 major use categories of the NTFPs were identified. Out of these, medicine, fire wood and charcoal making and construction materials were the most dominant uses requiring large volume of NTFPs in the study area. The output of direct matrix ranking of plant species used for multipurpose revealed - Hagenia abyssinica ranked first followed by Olea europaea ssp cuspidata, Grewia mollis, Croton macrostachyus, Ximenia americana and Carissa spinarum. Hence, local communities of the study area possess rich potential indigenous knowledge that helped to use their natural resources for sustainable livelihood. Conclusions: Sera forest is rich in NTFPs bearing plants and associated indigenous conservation knowledge. However, nowadays illegal timber extractions, grazing, over harvesting NTFPs, farm expansion and fire hazards were found to be threatening of the plant resources in the study area. Therefore, awareness creation on complementary conservation (in-situ and ex-situ) and sustainable use of plant resources of the area for higher livelihood outcomes with lower environmental impacts is desirable.
Dexamethasone - loaded polymeric porous sponge as a hard tissue regeneration agent
Authors: Alagha Amjad
Published: April 2020

Background : The aim of this study is to achieve the principles of tissue engineering using biopolymers to be applied in the field of vital endodontic treatment with the aim of stimulating stem cells and engineering and regeneration of dentin tissue. the blend was loaded with the steroidal anti-inflammatory drug, dexamethasone, and the porous drug-loaded bio-sponge was produced by lyophilization. Bio-sponge, as a direct pulp capping agent, was histologically studied compared to calcium hydroxide Ca(OH)2 in an animal experiment. Results: The results indicated the effectiveness of the bio-sponge as a direct pulp agent, where the dentin bridge was formed faster than Ca(OH)2 treated samples,. There was no inflammatory response in the pulp tissue throughout the follow-up period. Conclusions : The porous bio-sponge loaded with dexamethasone with a neutral pH resulted in enhancement the odontoblast differentiation from stem cells, resulted in the formation of a renewed dentin bridge without the slightest inflammatory response in the pulp.
Acellular dermal matrix treats lower extremity full-thickness skin defect on one-stage without skin graft or flaps
Authors: Li Gongchi , Zhou Pan , Liu Hanlin , Peng Han , Li Binghui , Chen Jianghai
Published: April 2020

Background Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers. Methods This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, was covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days. Results After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing. Conclusions These findings may mean acellular dermal matrix is a novel method oﬀering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.
The surgical outcomes and perioperative complications of bowel resection as part of debulking surgery of advanced ovarian cancer patients.
Authors: Ye Shuang , Wang Yiyong , Chen Lei , Wu Xiaohua , Yang Huijuan , Xiang Libing
Published: April 2020

Background: To review the utilization and perioperative outcomes of bowel resection during cytoreduction of ovarian cancer patients in our institution. Methods: All the patients who received bowel resection including anastomosis and ostomy formation between 2006/01 and 2018/12 were identified. Clinicopathological information was abstracted from the medical records. Postoperative morbidities were assessed according to Clavien-Dindo classification (CDC).Results: There were 182 patients in the anastomosis group and 100 patients in the ostomy group, leading to a total of 282 patients. The median age was 57 years and most patients had high-grade serous histology (88.7%). 49 (17.3%) patients received neoadjuvant chemotherapy. During operation, 78.7% patients had ascites and the median volume was 800 mL. Extensive bowel resection (at least two-segment) and upper abdominal operation was performed in 29 (10.2%) and 69 (24.4%) patients, respectively. Rectosigmoid colon was the most commonly resected (83.8%), followed by right hemicolectomy (5.9%) and small bowel resection (2.8%). No macroscopic residual disease was observed in 42.9% of the patients, while 87.9% of had residual disease ≤1 cm. For the entire cohort, 19.9% (56/282) experienced different complications, not including anastomotic leak (AL). Severe complications (CDC 3-5) accounted for 7.8%, mostly pleural effusion requiring drainage (3.5%), and followed by wound dehiscence requiring delayed repair in operation room (1.8%). Nine patients experienced AL: one in the ostomy group with extensive bowel resection and eight in the anastomosis group. The overall AL rate was 4.2% (9/212) per anastomosis. The AL rate per anastomosis was quite comparable in different populations: 4.4% (patients in the anastomosis group), 4.3% (patients with one-segment bowel resection and anastomosis), 4.0% (patients with extensive bowel resection and anastomosis) and 5.0% (patients with isolated rectosigmoid resection and anastomosis).Conclusions: Execution of bowel resection as part of debulking surgery of patients with newly diagnosed ovarian cancer resulted in an acceptable morbidity rate.
Impact of Prognostic Nutritional Index on Survival in Recurrent High-Grade Glial Tumors Treated with Systemic Treatment
Authors: Alan Ozkan , Telli Tugba Akin , Basoglu Tugba , Arikan Rukiye , Demircan Nazim Can , Ercelep Ozlem , Bozkurt Suheyla , Atasoy Beste Melek , Dane Faysal , Yumuk Perran Fulden
Published: April 2020

Background: Primary brain tumors are relatively rare malignancy, with high-grade gliomas (glioblastoma multiforme and anaplastic gliomas) are the most common types . We aimed to evaluate the prognostic value of Prognostic Nutritional Index (PNI), which is calculated by lymphocyte count and albumin, in recurrent high-grade glioma patients treated with systemic treatment.Methods: Data of 92 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012-2018 was retrospectively collected and analyzed. PNI was calculated as: [(10 × serum albumin (g/dL)) + (0.005 × total lymphocyte count)]. Patients were categorized according to the median PNI value. We investigated the prognostic role of PNI groups, and survival outcomes.Results: Median value of PNI was 46.02, and median follow-up duration was 9 months (1-68 months). Median overall survival (OS) was 8.1 months (95%CI: 6.04-10.3). Median OS was significantly longer in patients with PNI> 46.02 compared to patients with PNI ≤ 46.02 (13.9 months (95%CI: 9.8-18.1), and 6.07 months (95%CI: 4.3-7.7), p=0.01, respectively). In multivariate analysis, PNI was found to be an independent prognostic factor for OS [HR:0.54(95%CI:0.3-0.97), p=0.03)].Conclusion: In our study, the PNI was found to be an independent prognostic biomarker in patients with recurrent high-grade gliomas, but further prospective trials are necessary to validate its prognostic role.
Neural Adhesion Molecule Close Homolog of L1 Deficiency Exacerbates DSS-Induced Colitis in Mice
Authors: Han Ying , Zhu Ling-Ling , Wang Xiaomeng , Xiang Cheng , Zhao Ming , Zhao Tong , Guo Liang , Liu Dan , Wu Kuiwu , Fan Ming , Shi Ming
Published: April 2020

Background: The cell adhesion molecule CHL1, which belongs to the immunoglobulin superfamily, functions in a variety of physiological and pathological processes including neural development, tissue injury and repair. Recently, we found CHL1 was co-localized with GFAP positive cells in mouse colon tissue. Methods: Here, Colon tissues were collected from CHL1+/+ , CHL1+/- and CHL1-/- mice after dextran sodium sulfate (DSS) induced to investigate the effects of CHL1 on the development of DSS-induced colitis. Results: The data showed that CHL1 expression was increased in distal colon in a time-dependent manner after DSS-treatment. CHL1 deficiency induced more pronounced colitis features, an exacerbation of inflammation and damage to colonic tissues in DSS-induced mouse than that of wild type mouse. Moreover, CHL1-/- mice showed a remarkable increase of neutrophil and macrophage infiltration into colonic tissues, and then result in more severe damage to the intestinal epithelial cells and FITC leakage in CHL1 deficiency mice than that in WT mouse. Conclusions: Our results revealed a distinct colonic role for CHL1 in regulating DSS-induced colitis, CHL1 deficiency exacerbates DSS-induced colitis in mice, indicating that CHL1 may be an attractive therapeutic target for IBD.
Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: a cross-sectional study
Authors: Chen Miaomiao , Liu Xiyao , Zhang Jun , Sun Guoqiang , Gao Ying , Shi Yuan , Baker Philip N. , Zeng Jing , Zheng Yangxi , Luo Xin , Qi Hongbo
Published: April 2020

Background

During the Coronavirus Disease 2019 (COVID-19) outbreak, emergency traffic bans limited accessibility of some medical resource for pregnant women. Fear of viral transmission also prevented pregnant women from seeking routine antenatal care (ANC). This study described the needs of pregnant women and the contents of online obstetric consultation in representative areas with various severity of the epidemic in China.

Methods

From February 10 th to 23 rd , we collected data on online obstetric consultations and women’s satisfaction in mild, moderate and severe epidemic areas through an e-health provider’s platform. Information on women’s needs, contents of the consultation and satisfaction were collected and compared by epidemic areas.

Results

A total of 2599 pregnant women participated in this study, of whom 448, 1322 and 819 women were from the mild, moderate and severe epidemic areas, respectively. The distributions of the amount of online consultation were significantly different not only in different areas, but also in different trimesters. The more severe the epidemic was and the more advanced the pregnancy was, the higher the amount of second category (changed their schedules of ANC and/or delivery as well as method of delivery) was. 957 participants completed a satisfaction survey. For most of the participants, it’s their first time to use the e-health, and nearly 90% participants were completely or mostly satisfied with the online consultation.

Conclusions

Our study found that during the outbreak, many pregnant women had changed their scheduled ANC visits without authorization, and the more serious the epidemic was, the more common it occurred. The needs for online consultation was substantial. In order to prevent irreversible obstetric adverse events, an appropriate ANC contingency plan with e-health services is highly recommended during the Public Health Emergency of International Concern (PHEIC).
Evaluation for hypocenter estimation error in the southwestern Kuril trench using Japan and Russia joint seismic data
Authors: Ichiyanagi Masayoshi , Valentin Mikhaylov , Kostylev Dmitry , Levin Yuri , Takahashi Hiroaki
Published: April 2020

The southwestern Kuril trench is seismically active due to the subduction of the Pacific plate. Great earthquakes in this zone have frequently induced fatal disasters. Seismic monitoring and hypocenter catalogues provide fundamental information on earthquake occurrence and disaster mitigation. Real-time hypocenter and magnitude estimates are extremely crucial data for tsunami warning systems. However, this region is located in the international border zone between Japan and Russia. The Japan Meteorological Agency and Russian Academy of Sciences have routinely determined hypocenters and issued earthquake information independently. Waveform data have not yet been exchanged internationally in real time. Here, we evaluated how a hypothetical Japan-Russia joint seismic network could potentially improve the hypocenter estimation accuracy. Experiments using numerical and observed data indicated that the joint network extended the distance over which hypocenters can be accurately determined over 100 km eastward compared to the Japan network only. This fact suggests that joint seismic data have the potential to improve the hypocenter accuracy in this region, which would provide improved performance in gathering disaster information at the moment of a tsunami warning.
Candida tropicalis distribution and drug resistance correlated to ERG11 and UPC2 expression
Authors: Wang Dan , An Na , Yang Yuwei , Yang Xianggui , Fan Yingzi , Feng Jiafu
Published: April 2020

Objective: This study is to analyze the distribution characteristics and drug resistance of Candida tropicalis, and the relationship between ERG11 and UPC2 expression and the resistance to azole.Methods: The Candida tropicalis were cultured and identified by the Sabouraud Agar Medium, CHROM Agar Candida and France Bio-Mérieux ATB test. The total RNA of the collected strains was extracted, and the ERG11 and UPC2 mRNA expression levels were analyzed by the quantitative real-time PCR. Results: Totally 2872 clinical isolates of Candida, including 319 strains of Candida tropicalis were analyzed herein, which were mainly distributed in the Departments of Respiratory Medicine and ICU. The specimen type was mainly based on the airway secretion, and the detection trend in four years was mainly related to the type of the departments and specimens. The resistance rates of Candida tropicalis to fluconazole, itraconazole and voriconazole have been increasing year by year. The mRNA expression levels of ERG11 and UPC2 in the fluconazole resistant group were significantly higher than the sensitive group. In addition, there was a significant linear positive correlation between these two genes in the fluconazole resistant group.Conclusions: Over-expression of ERG11 and UPC2 genes in Candida tropicalis could increase the resistance to antifungal drugs. The routine detection of ERG11 and UPC2 for high-risk patients in the key departments would provide theoretical basis for the rational application of antifungal drugs.
The Association Between Chiropractic Conservatism and the Ability to make Appropriate Clinical decisions: A Survey on Chiropractic Students in Denmark
Authors: Nim Casper Glissmann , O'Neill Søren , Lauridsen Henrik Hein , Goncalves Guillaume , Jensen Rikke Krüger , Leboeuf-Yde Charlotte
Published: April 2020

Background We investigated whether a university-based educational system would overrule the strong link (odds ratios >20) between chiropractic conservatism and the inability to recognize non-indications to chiropractic treatment that had been shown to exist in a previous study of a private chiropractic college. We i) sought to define the clinical decision profile of the students in a university-based course embedded in a medical school, and ii) investigated whether students’ clinical judgment was affected by their conservatism score determined from a ten item questionnaire and collapsed into four categories.Methods In a cross-sectional survey, 3 rd to 5 th year chiropractic students, attending the University of Southern Denmark and recently graduated interns were categorized into four levels of conservatism, which were cross-tabulated with the ability to answer appropriately on 9 cases concerning i) contra-indications, ii) non-indications and iii) indications to chiropractic treatment. Data were analyzed using logistic regression.Results In all, 146 participants (76%) completed the survey, of which 70% belonged in the two lowest conservatism groups with three outliers (group 4). Their ability to answer correctly to the clinical cases was generally acceptable. The level of conservatism (categories 1-3) was moderately (but not statistically significantly) associated with an inability to recognize non -indications to treatment (odds ratios ~3.5). Three outliers (category 4), however, answered inappropriately on the majority of the 9 clinical cases.Conclusions The Danish students’ clinical acumen in correctly judging the appropriateness of spinal manipulation in the clinical cases was fairly similar to that shown in the previous survey on chiropractic students attending a private college. Contrary to the findings at the private college, the level of conservatism did not have a strong association with the inability to recognize non-indications. Although a university-based education does not immunize its students against chiropractic conservatism, it does appear to attenuate its consequences on their clinical judgment.
Risk perception and behavioral response to COVID-19 in Iraqi Kurdistan Region
Authors: Shabu Sherzad , Amen Karwan M , Mahmood Kazhan I. , Shabila Nazar P.
Published: April 2020

Background Understanding how people perceive the risk of the coronavirus disease (COVID-19) outbreak and its impact on undertaking protective behavior can guide the public health policymakers in taking the required measures to limit the magnitude of this outbreak. This study aimed to understand the risk perception and the behavioral response of the university academics and students towards the COVID-19. Methods A self-administered online survey was conducted among the academic staff and university students in Iraqi Kurdistan Region. The survey questionnaire included eight main questions about the main aspects of personal risk perception and behavioral response to COVID-19 based on a five or nine-point ordinal scale. The eight questions included the number of contacts, the perceived threat level of COVID-19, personal risk perception, ability to avoid infection, frequency of undertaking the protective measures, adherence to the curfew, the negative impact of COVID-19 on life, and sources of obtaining information. Results A total of 976 individuals participated in the study with a mean age ± SD of 25.8±9.7 years. The respondents had the highest perceived threat level towards COVID-19 (mean score = 2.79) in comparison to other medical threats. Around 62% of respondents had no contacts outside their homes. A high percentage of the respondents perceived their risk of getting infection, serious illness, and death as highly unlikely (26.9%, 29.7%, and 41.7%, respectively). The percentage of the respondents who applied these measures frequently or always was high for most of the behaviors, except for wearing masks, wearing gloves, and avoiding touching face. There was a significant ( P <0.001) weak positive correlation between risk perception with protective behaviors; overall risk (beta = 0.080, r=0.189), risk of getting infection (beta=0.066, r=0.179), risk of getting serious illness (beta=0.070, r=0.176) and risk of death (beta=0.058, r=0.154). Conclusion The perceived risk of getting infection with COVID-19 is relatively low. The respondents follow protective behavior measures reasonably. However, the frequency of undertaking some important protective behaviors is relatively low. The risk perception of COVID-19 has a weakly positive impact on following protective behavior. Changing behavior remains a challenge even for the well educated and well aware people.
Development and Validation of a Diagnostic Nomogram to Predict COVID-19 Pneumonia
Authors: Wang Zhiyi , Weng Jie , Li Zhongwang , Hou Ruonan , Zhou Lebin , Ye Hua , Chen Ying , Yang Ting , Chen Daqing , Wang Liang , Liu Xiaodong , Shen Xian , Jin Shengwei
Published: April 2020

Background The COVID-19 virus is an emerging virus associated with severe respiratory illness first detected in December, 2019, and rapidly spread worldwide. The aim of this study was to establish an effective diagnostic nomogram for suspected COVID-19 pneumonia patients. Methods We used the LASSO aggression and multivariable logistic regression methods to explore the predictive factors associated with COVID-19 pneumonia, and established the diagnostic nomogram for COVID-19 pneumonia using multivariable regression. This diagnostic nomogram was assessed by the internal and external validation data set. Further, we plotted decision curves and clinical impact curve to evaluate the clinical usefulness of this diagnostic nomogram. Results The predictive factors including the epidemiological history, wedge-shaped or fan-shaped lesion parallel to or near the pleura, bilateral lower lobes, ground glass opacities, crazy paving pattern and white blood cell (WBC) count were contained in the nomogram. In the primary cohort, the C-statistic for predicting the probability of the COVID-19 pneumonia was 0.967, even higher than the C-statistic (0.961) in initial viral nucleic acid nomogram which was established using the univariable regression. The C-statistic was 0.848 in external validation cohort. Good calibration curves were observed for the prediction probability in the internal validation and external validation cohort. The nomogram both performed well in terms of discrimination and calibration. Moreover, decision curve and clinical impact curve were also beneficial for COVID-19 pneumonia patients. Conclusion Our nomogram can be used to predict COVID-19 pneumonia accurately and favourably.
Effects of oral administration of ticagrelor on the plasma level of adrenaline, histamine, serotonin, and acetylcholine in rat
Authors: Yang Xiuling , Guo Xue , Yanan Li , Jiaxi Li , Yue Liu
Published: April 2020

Background: Ticagrelor as a reversible P2Y12 receptor antagonist which plays an important role in the treatment of acute coronary syndrome (ACS). Dyspnea is one of the main adverse reactions of ticagrelor, however the mechanism is not clearly now. The aim of this study was to assess the possible relationship between ticagrelor-related dyspnea and some neurotransmitter in plasma which can contract the bronchial smooth muscle.Methods: The effects of ticagrelor on the plasma level of adrenaline, histamine, serotonin, and acetylcholine was studied in rats. Ticagrelor was administered at a loading dose of 24 mg/kg for the first time, and then maintenance dose 12 mg/kg, twice a day for 6 days. The plasma level of adrenaline, histamine, serotonin, and acetylcholine was determined by LC-MS/MS.Results: The plasma level of serotonin increased after ticagrelor administrating, especially at 1.5h ( p <0.05) reach the level of statistical significance. The level of serotonin in plasma was consistent with ticagrelor blood concentration. Meanwhile, ticagrelor can cause a decrease in the plasma concentration of histamine, and the change was statistically significant at time points of 1.5h, 3.5h and 10.5h respectively. The concentration of the adrenaline and acetylcholine had no change.Conclusions: The results of this study reveal that ticagrelor can increases blood serotonin levels and this may be a cause of dyspnea ticagrelor-related.
Serum NGAL is elevated in patients with asthma and persistent airflow obstruction
Authors: Kono Yuta , Kawagoe Junichiro , Togashi Yuki , Toriyama Kazutoshi , Yajima Chika , Tsuji Takao , Nakayama Hideaki , Kasagi Satoshi , Abe Shinji , Setoguchi Yasuhiro , Ishiwari Mayuko
Published: April 2020

Background: Neutrophilic airway inflammation is one of the features of severe asthma. Neutrophil gelatinase-associated lipocalin (NGAL), or lipocalin-2, is a glycoprotein associated with neutrophilic inflammation and can be detected in blood. Recently, blood NGAL levels have been reported to be elevated in chronic obstructive pulmonary disease. However, the clinical significance of serum NGAL levels in patients with asthma has not been elucidated. The aim of this study was to explore the association between serum NGAL level and clinical parameters in patients with asthma.Methods: Sixty-one non-smoking people with stable asthma were enrolled in this study. All patients underwent blood collection and pulmonary function tests. The associations between serum NGAL levels and clinical parameters were analyzed retrospectively. Results: Serum NGAL levels in patients with asthma and obstructive ventilatory disorder were higher than those in patients with asthma without obstructive ventilatory disorder (76.4 ± 51.4 ng/mL vs 39.3 ± 27.4 ng/mL, p=0.0019). Serum NGAL levels were correlated with forced expired flow at 50% of vital capacity %predicted and forced expired flow at 25% of vital capacity %predicted (r=-0.3373, p=0.0089 and r=-0.2900, p=0.0234, respectively). Results of a multiple regression analysis demonstrated that serum NGAL level was independently associated with obstructive ventilatory disorder.Conclusion: Serum NGAL levels were elevated in patients with asthma and obstructive ventilatory disorder. NGAL may be involved in airway remodeling possibly mediated by neutrophilic inflammation in asthma.