Stress, anxiety and depression perceived by couples with recurrent miscarriage.

AIM: Recurrent miscarriage is considered a major life event. The main purposes of this study were to compare the differences in stress, anxiety, social support, sleep quality and depressive symptoms in couples experiencing recurrent miscarriage compared to peers who experience full-term normal childbirth in southern Taiwan. METHODS: Convenience sampling and snowball sampling were used respectively to recruit 78 couples with and 80 couples without recurrent miscarriage from October 2014 to July 2015. Five structured questionnaires including Perceived Stress Scale, State- Anxiety Inventory, Interpersonal Support Evaluation List, Pittsburgh Sleep Quality Index and Edinburgh Depression Scale were administered. RESULTS: Women who experienced recurrent miscarriage perceived significantly higher levels of stress, anxiety and depressive symptoms than their husbands. Women in the recurrent miscarriage group reported significantly greater depressive symptoms than women of the other group. A stepwise multiple regression analysis indicated key predictors of depressive symptoms among women of childbearing age, accounting for 62.9% of the variance, were anxiety, stress, social support and history of recurrent miscarriage. CONCLUSION: Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than their peers who experienced normal childbirth. Health professionals can use the knowledge gained from these findings to evaluate women with recurrent miscarriage for stress, anxiety and depressive symptoms and develop supportive interventions.

Antifungal susceptibilities of Candida glabrata species complex, Candida krusei, Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China: 3 year national surveillance.

OBJECTIVES: To define the antifungal susceptibility patterns of the most common non-albicans Candida spp. in China. METHODS: We evaluated the susceptibilities to nine antifungal drugs of Candida parapsilosis species complex, Candida tropicalis, Candida glabrata species complex and Candida krusei isolates from patients with invasive candidiasis at 11 hospitals over 3 years. Isolates were identified by MALDI-TOF MS supplemented by DNA sequencing. MICs were determined by Sensititre YeastOne(TM) using current clinical breakpoints/epidemiological cut-off values to assign susceptibility (or WT), and by CLSI M44-A2 disc diffusion for fluconazole and voriconazole. RESULTS: Of 1072 isolates, 392 (36.6%) were C. parapsilosis species complex. C. tropicalis, C. glabrata species complex and C. krusei comprised 35.4%, 24.3% and 3.7% of the isolates, respectively. Over 99.3% of the isolates were of WT phenotype to amphotericin B and 5-flucytosine. Susceptibility/WT rates to azoles among C. parapsilosis species complex were ≥97.5%. However, 11.6% and 9.5% of C. tropicalis isolates were non-susceptible to fluconazole and voriconazole, respectively (7.1% were resistant to both). Approximately 14.3% of C. glabrata sensu stricto isolates (n = 258) were fluconazole resistant, and 11.6% of C. glabrata sensu stricto isolates were cross-resistant to fluconazole and voriconazole. All C. krusei isolates were susceptible/WT to voriconazole, posaconazole and itraconazole. Overall, 97.7%-100% of isolates were susceptible to caspofungin, micafungin and anidulafungin, but 2.3% of C. glabrata were non-susceptible to anidulafungin. There was no azole/echinocandin co-resistance. Disc diffusion and Sensititre YeastOne(TM) methods showed >95% categorical agreement for fluconazole and voriconazole. CONCLUSIONS: In summary, reduced azole susceptibility was seen among C. tropicalis. Resistance to echinocandins was uncommon.

Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women.

BACKGROUND: Lavender inhalation aromatherapy is widely believed to impart a hypnotic effect, act as a mood stabilizer, and enhance the positive feelings of mothers toward their infants. However, research into these and other potential therapeutic effects of lavender tea has been limited. AIMS: This study was conducted in Taiwan to evaluate the effectiveness of lavender tea in relieving sleep quality, fatigue, and depression; and in improving maternal-infant attachment during the early postpartum period. METHODS: A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≥16) and with no history of allergy to herbal teas, foods, or medicines were assigned systematically to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink one cup of lavender tea after spending time to appreciate and smell the aroma each day for a period of 2 weeks, whereas their control group peers received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, Postpartum Fatigue Scale, and Postpartum Bonding Questionnaire were used to assess outcomes. RESULTS: ANCOVA analyses using education level and pretest scores as covariates showed that experimental group participants perceived less fatigue (F = 6.281, p = .014) and depression (F = 4.731, p = .033) and showed greater bonding with their infant (F = 4.022, p = .049) compared with the control group. However, the scores for all four instruments were similar for both groups at the 4-week posttest, suggesting that the positive effects of lavender tea were limited to the immediate term. LINKING EVIDENCE TO ACTION: Healthcare researchers assume accountability for integrating research results into clinical practice. The findings in this study can gain greater attention among healthcare practitioners and encourage the correct and positive use of herbal therapy in postpartum health care.

Study of the efficacy of combination therapy of SiRNAs in HepG2.2.15 cells.

BACKGROUND/AIMS: Hepatitis B virus (HBV) infection is a world-wide health problem. The major obstacles for current anti-HBV therapy are the low efficacy and the occurrence of drug resistant HBV mutations. Recent studies have demonstrated that combination therapy can enhance antiviral efficacy and overcome the shortcomings. Here, the inhibitory effect mediated by combination of small interfering RNAs (siRNAs) targeting different sites of HBV nuclear localization signal (NLS) was monitored in HepG2.2.15 cells. METHODOLOGY: Recombinant plasmid psil-HBV was constructed and transfected into HepG2.2.15 cells. At 48, 72 and 96h after transfection, culture media were collected and cells were harvested for HBV replication assay. HBsAg and HBeAg in the cell culture medium were detected by enzyme-linked immunoadsorbent assay. Intracellular viral DNA and covalently closed circular DNA (cccDNA) was quantified by real-time PCR. HBV viral mRNA was measured by reverse-transcript PCR. RESULTS: Our data demonstrated that the three used siRNAs showed marked anti-HBV effects. Combination of siRNAs, compared with individual use of each siRNA, exerted a stronger inhibition on antigen expression and viral replication, even though the final concentration of siRNA in the therapy was the same. More importantly, we showed that combination therapy significantly suppressed HBV cccDNA amplification. CONCLUSION: Our results revealed that combination of siRNAs mediated a stronger inhibition on viral replication and antigen expression in HepG2.2.15 cells, especially, the amplification of cccDNA.

Post-SARS knowledge sharing and professional commitment in the nursing profession.

AIM: The aim of the present study was to examine the 2003 severe acute respiratory syndrome (SARS) crisis in relation to the degree of knowledge sharing and professional commitment, as perceived by the current nursing staff in Taiwan. BACKGROUND: The mortality rate for medical personnel during the SARS outbreak in Taiwan, which began in April 2003, was the highest among Asian countries. The SARS crisis severely challenged not only the medical skills of nurses, but also their professional commitment. DESIGN: Survey. METHODS: This study was conducted between August-December 2005, in Taiwan. Data were collected by structured questionnaire. The questionnaire was distributed by post to 8056 nurses nationwide; 2833 nurses completed and returned the questionnaire for a valid response rate of 39%. RESULTS: The results showed that knowledge sharing correlated positively with professional commitment but negatively with the impact of SARS. Professional commitment negatively correlated with SARS impact (r = -0.074, p < 0.001); however, as knowledge sharing was a controlled variable, the partial correlation between SARS impact and professional commitment was -0.039 with a p-value of 0.045, indicating virtual insignificance. That is, knowledge sharing was an antecedent variable for both SARS impact and professional commitment. CONCLUSION: This cross-sectional study provides preliminary evidence that knowledge sharing is significantly correlated with impact of SARS and professional commitment of nursing personnel. RELEVANCE TO CLINICAL PRACTICE: Hospitals and healthcare services can enhance retention of medical personnel by encouraging knowledge sharing, which enhances professional commitment and alleviates the impact of newly introduced contagious diseases.

[Remediation Effects of Different Composite Materials on Cadmium-Contaminated Farmland Soil].

A pot experiment was conducted to study the application effects of three composite materials, namely SC (lime:organic compound fertilizer=2:3), LS (ferrous sulfate:lime=1:1) and LB (ferrous sulfate:biochar in combinations of 1:1, 1:2, 1:3, 1:4 and 1:5), on soil Cd bioavailability, Cd cumulative distribution in different wheat organs, and wheat yield. The results indicated that:① Addition of composite materials all significantly decreased the soil available Cd content by 50.2%-81.8% (SC), 29.4%-48.1% (LS), and 18.7%-42.2% (LB). Composite materials significantly increased soil pH by 1.37-2.28 (SC), 0.41-0.86 (LS), and 0.14-0.17 (LB) units. ② The Cd cumulative distribution in different wheat organs were in the order of root > leaf > stem > glume > grain. The translocation abilities of Cd in different organs were in the order of root > glume > stem and leaf. ③ Compared with the control, 0.67% SC addition and 0.67% LS addition significantly increased the wheat yields by 56.4% and 51.2%; LB addition significantly increased wheat yield by 39.6% to 51.2%. ④ The correlation analysis showed that soil pH was significantly negatively correlated with soil available Cd and Cd contents in different wheat organs. There were significant positive correlations between soil available Cd and Cd contents in different wheat organs, and the correlation coefficients were 0.711 (grain), 0.817 (glume), 0.593 (stem), 0.630 (leaf) and 0.622 (root). Meanwhile, there is also a significant positive correlation between Cd content in different wheat organs. ⑤ Comprehensively, the addition of 0.93% SC increased soil pH by a maximum of 2.28 units, and the soil available cadmium content was decreased by a maximum of 81.8%. Therefore, adding 0.93% SC was the most suitable treatment for repairing and controlling the Cd pollution in farmland soil.

[Impact of Biochar on Soil Bulk Density and Aggregates of Lou Soil].

The effect of biochar on the bulk density and aggregate stability of Lou soil was evaluated and compared after biochar was applied for 2 years and 5 years through a field-positioning experiment. Five biochar amounts were applied in this study, as follows:0 t·hm-2 (B0), 20 t·hm-2 (B20), 40 t·hm-2 (B40), 60 t·hm-2 (B60), and 80 t·hm-2 (B80). The biochar was produced by pyrolysis of stems and branches from fruit trees at the temperature of 450℃ with limited oxygen apply. At the beginning of the study, biochar was mixed thoroughly with the surface soil (0-20 cm). After 5 years, the soil bulk density and aggregate stability of 0-30 cm soil layers (0-10, 10-20, and 20-30 cm) were measured and compared with the results obtained after 2 years with the purpose of observing the long-term and persist effects of biochar application. The results showed that:① compared with the results after 2 years of application, the effect of biochar on the aggregates at depths of 0-10 cm and 10-20 cm after 5 years were less distinct, and the effect on soil aggregates at depths of 20-30 cm was significantly enhanced; ② compared with the 2 year application, the aggregate stability and the content of the>0.25 mm aggregate size fraction were significantly increased at 0-10 cm depths after 5 years of biochar application at a rate of 40 t·hm-2, while bulk density was significantly decreased; at 10-20 cm and 20-30 cm soil depths, the stability of aggregates and the content of the>0.25 mm aggregate size fraction was significantly increased, while the bulk density was significantly decreased after 5 years of biochar application at a rate of 60-80 t·hm-2;③ when the biochar application rate was 60 t·hm-2, the increase in soil organic carbon was the highest after 5 years. After biochar was applied for 5 years, its effect was more significant lower in the soil profile; the soil bulk density was significantly reduced, and aggregate stability and the content of>0.25 mm aggregates were significantly increased at depths of 20-30 cm. Based on a comprehensive evaluation of the improvement effects and economic benefits, the most suitable biochar application rate was found to be 40-60 t·hm-2. It was further concluded that the effect of biochar on soil aggregates was gradual and sustainable.

[Microbiology and management of gaseous gangrene:the Sichuan experience of 20 earthquake cases].

Wound secretion from 20 patients with gaseous gangrene was collected for Gram staining, bacterial culture and drug sensitivity tests. The results indicated that gaseous gangrene was caused by the co-infection of both aerobic and anaerobic bacteria. Gram-negative bacilli were slightly more common than other aerobic bacteria in gaseous gangrene wound, which was different from the findings of ordinary gaseous gangrene.

[Pollution Characteristics and Health Risk Assessment of VOCs Fugitively Emitted from Typical Brewers].

Food processing plants are an important industrial source of volatile organic compounds (VOCs). Research on the unorganized emissions of VOCs to the surrounding environment from food processing plants is still quite scarce. The purpose of this study was to investigate the concentration characteristics, odor pollution, and health risk of the VOCs fugitively emitted from the brewing industry. The concentration characteristics of VOCs fugitively emitted from a typical vinegar factory and a typical distillery were detected via portable gas chromatography-mass spectrometry. The thresholds of the diluted multiple and sensory methods were also used for analyzing the VOCs. In addition, the assessment of health risk was conducted according to the US EPA evaluation model. The results show that the concentrations of the total VOCs emitted from the vinegar factory and the distillery were 0.968 mg·m-3 and 0.293 mg·m-3, respectively. Ethyl acetate and acetic acid were the main VOCs in the atmosphere of the vinegar plant, accounting for 76.3% and 13.5% of the total VOCs, respectively. The VOCs of the distillery were mainly characterized by ethanol and ethyl acetate, which accounted for 56.3% and 30.4% of the total VOCs, respectively. Oxygen-containing VOCs were the most important component of the studied brewing industry source. The total odor indices of the VOCs emitted from the vinegar factory and the distillery were both higher than 1, which indicates that their unorganized emission of VOCs have odor pollution to the atmosphere. The odor concentrations of the vinegar factory and the distillery were also higher than the standard limit of malodorous pollutants. The results of the health risk assessment show that the carcinogenic risk indices of VOCs were 2.45×10-6 and 5.25×10-6, respectively, which exceeded the suggested risk value by the EPA but were lower than the OSHA and ICRP values.

Clinical characteristics and analysis of familial oral lichen planus in eight Chinese families.

Oral lichen planus (OLP) is one of the most common oral mucosa diseases; however, familial OLP is uncommon. The present study reported and analyzed patients with familial OLP (n=18) in eight different Chinese families between January 1, 2012 and December 31, 2013. Parameters analyzed include gender, age at diagnosis, lesion distribution and lesion type. The follow-up period for each patient was a minimum of 1 year. In this survey, 18/88 individuals in the eight families were affected. Females were more frequently affected, and the female to male ratio for familial OLP (2.2:1) was higher compared with that previously reported for nonfamilial OLP (1.4:1). The age at diagnosis, lesion distribution and lesion type showed consistency with reports concerning nonfamilial OLP, with the exception of family VI, in which 4/5 children had OLP/LP lesions and were of an early age at diagnosis. There were two families in which three generations had been affected by OLP. In addition, it appeared that patients of the same generation in the same family were of a similar age at diagnosis. No malignant or premalignant lesion was identified in the 18 individuals diagnosed with OLP from the eight families. The present study supports the hypothesis that genetic predisposition may serve a role in the etiology of OLP.

[Study of effects of drugs on myocardial hypertrophy due to overload].

OBJECTIVE: To study the relation of expression change of tumor necrosis factor-alpha (TNF-alpha), angiotensin II (Ang II), and endothelin-1 (ET-1), and the effect of imidapril on myocardial hypertrophy due to overload. METHODS: Sixty-three rats were randomly divided into four groups: sham operation (n=15), overload group (n=16), imidapril group (n=16), and Caweidiluo group (n=16). Hypertrophic myocardium was reproduced in rats by constricting abdominal aorta. Blood samples and heart were harvested 12 weeks after aorta constriction, and myocardial hypertrophy index, the contents of Ang II, ET-1 in the myocardium and plasma were determined by radioimmunoassay and TNF-alpha in the myocardium and plasma were determined by enzyme linked immunoadsorbent assay. RESULTS: Left ventricle showed obvious hypertrophy 12 weeks after operation. The contents of TNF-alpha, Ang II and ET-1 in the myocardium, and the content of TNF-alpha in serum, Ang II and ET-1 in plasma were increased compared with those of controls (all P<0.01). The treatment of imidapril and Caweidiluo could restrain the development of left ventricle hypertrophy after operation, and imidapril decreased the contents of TNF-alpha, Ang II and ET-1 in myocardium compared with overload group (all P<0.01). Imidapril lowered the contents of TNF-alpha in serum, Ang II and ET-1 in plasma, compared with overload group (all P<0.01), but not ET-1. Caweidiluo lowered the contents of TNF-alpha, Ang II and ET-1 in myocardium, the contents of TNF-alpha in serum, Ang II and ET-1 in plasma (all P<0.01) compared with overload group (both P<0.01). CONCLUSION: The activation of rennin-angiotensin system (RAS) by over load results to an elevation of TNF-alpha contents in plasma and myocardium, and it is probably one of the major regulatory pathways of myocardial hypertrophy.

Sublethal vancomycin-induced ROS mediating antibiotic resistance in Staphylococcus aureus.

Staphylococcus aureus is the leading cause of many human infectious diseases. Besides infectious dangers, S. aureus is well-known for the quickly developed drug resistance. Although great efforts have been made, mechanisms underlying the antibiotic effects of S. aureus are still not well clarified. Recently, reports have shown that oxidative stress connects with bactericidal antibiotics [Dwyer et al. (2009) Curr. Opin. Microbiol. 12: , 482-489]. Based on this point, we demonstrate that reactive oxygen species (ROS) induced by sublethal vancomycin may be partly responsible for the antibiotic resistance in heterogeneous vancomycin resistant S. aureus (hVRSA). Sublethal vancomycin treatment may induce protective ROS productions in hVRSA, whereas reduction in ROS level in hVRSA strains may increase their vancomycin susceptibility. Moreover, low dose of ROS in VSSA (vancomycin susceptible S. aureus) strains may promote their survival under vancomycin conditions. Our findings reveal that modest ROS generation may be protective for vancomycin resistance in hVRSA. These results recover novel insights into the relationship between oxidative stress and bacterial resistance, which has important applications for further use of antibiotics and development of therapeutics strategies for hVRSA.

Hyperlipidemia compromises homing efficiency of systemically transplanted BMSCs and inhibits bone regeneration.

PURPOSE: Mesenchymal stem cells (MSCs) can selectively home to bone defects and play an essential role in promoting bone regeneration. As an adverse effect factor for bone metabolism, hyperlipidemia significantly impairs bone regeneration. In this study, bone marrow stromal cells (BMSCs) were systemically transplanted into a hyperlipidemic mouse model to explore the effect of hyperlipidemia on stem cell recruitment and bone regeneration. METHODS: Hyperlipidemia was established in ApoE-/- mice (on C57BL/6J background) fed with a high fat diet (HFD) for five weeks. C57BL/6 mice fed with the same diet served as controls. BMSCs labeled with the green fluorescent protein (GFP) were then injected via the tail vein and bone defects were created in the mandibles. The animals were sacrificed at weeks 1, 2 and 4 after surgery, and the fate of the transplanted BMSCs was monitored with a fluorescence microscope and immunohistochemical analysis. After hematoxylin and eosin (HE) staining and Masson's Trichrome (MT) staining, histomorphometric analysis was performed to evaluate bone regeneration. RESULTS: In both groups transplanted with BMSCs, the number of GFP-positive BMSCs detected in the bone defects reached its peak at 1 week after surgery and was decreased thereafter. However, at all time points, less GFP+ cells were detected in the ApoE-/- mice than in the corresponding control mice. BMSCs transplantation significantly enhanced new bone formation, but to a lesser degree in the ApoE-/- mice when compared with the control mice. CONCLUSIONS: Hyperlipidemia compromises homing efficiency of systemically transplanted BMSCs and inhibits bone regeneration.

[Clinical survey of a combined in-office cold light bleaching and nightguard vital bleaching system for tetracycline stained teeth].

OBJECTIVE: To evaluate the clinical efficacy of a combined in-office cold light bleaching and night-guard vital bleaching (NGVB) system for treating tetracycline stained teeth (TST). METHODS: 90 patients with light, medium and heavy TST were randomly and evenly divided into 3 groups. 30 patients with 472 TST from the treatment group were treated with in-office cold light bleaching and NGVB, 30 patients with 466 TST from the control group 1 were treated with in-office cold light bleaching and 30 patients with 469 TST from control group 2 were treated with NGVB. At the time of treatment completion, after half a year and after one year, Vitalescence esthetic restorative masters shade guide was used to record the change of color. Bleaching efficacy and course of treatment were calculated, and lightening stability were evaluated. RESULTS: 1) Three groups had satisfied lightening efficacy for light TST with 100% bleaching efficacy. The overall efficacy of treatment group and control group 2 were superior to the in-office cold light bleaching system (P < 0.05). Though there was no significant lightening efficacy difference between the treatment group and control group 2 (P > 0.05), the periods of treatment of the treatment group for light, medium and heavy TST were shortened by 43%, 46% and 49%, respectively, compared to the control group 2. 2) All three groups' treatment efficacy for light, medium and heavy TST became weaker progressively (P < 0.05). 3) For the treatment efficacy between the time of treatment completion and after half a year and one year, there was significant statistical difference (P < 0.01) for the control group 1, while there was no significant difference for both the treatment group and the control group 2 (P > 0.05). Both treatment group and control group 2 had better performance in treatment stability than control group 1. CONCLUSION: In treating the light and medium tetracycline stained teeth, the combined in-office cold light bleaching and NGVB system can achieve a more satisfied whitening result in much shorter period, and significantly enhance the long term whitening stability.

[Clinical evaluation and laboratory study of ultrasonic irrigation of the root canal].

OBJECTIVE: To assess the efficacy of ultrasonic irrigation of the root canal in vivo and in vitro. METHODS: Sixty anterior teeth or premolars with the diagnosis of periapical periodontitis were divided into two groups (syringe irrigation group, group S and ultrasonic irrigation group, group U) and were evaluated clinically. Sixty extracted teeth with single straight canals were selected. Forty of them were divided into two groups and were evaluated histologically. Another twenty teeth were divided into two groups and were evaluated by SEM. RESULTS: Clinically, the number of lateral canals obturated in group U was more than that in group S (P < 0.01). The incidence of pain during irrigation were 13.3% in group S, and 3.3% in group U (P > 0.05). Histologically, the amount of organic debris of the root canals in group U were significantly less than that in group S (P < 0.01). By SEM study, the number of visible open dentinal tubules in group U were significantly greater than that in group S (P < 0.05). CONCLUSION: Ultrasonic irrigation of the root canal will be a useful technique in root canal therapy.