Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis.

BACKGROUND: A meta-analysis has compared the pregnancy outcomes between women with and without RA, while the effect of disease severity on pregnancy outcomes within women with RA has not been explored. Therefore, we performed a systematic review and meta-analysis to assess the association between disease activity of RA and pregnancy outcomes. METHODS: Four English databases (Pubmed, Embase, Cochrane Library, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure [CNKI], VIP, and Wan Fang) was searched for eligible studies up to August 13, 2023. Cochran's Q test and the I2 statistic were used to assess the heterogeneity of the included studies. The odds ratio (OR) (for counting data) and weighted mean difference (WMD) (for measurement data) were calculated with 95% confidence intervals (95%CIs) using random-effect model (I2 ≥ 50%) or fixed-effect model (I2 < 50%). Subgroup analysis based on study design and regions was used to explore the sources of heterogeneity. Sensitivity analysis was performed for all outcomes and the publication bias was assessed using Begg's test. RESULTS: A total of 41 eligible articles were finally included. RA women had higher odds to suffer from preeclampsia, gestational diabetes, spontaneous abortion, and cesarean delivery (all P < 0.05). The infants born from RA mother showed the higher risk of stillbirth, SGA, LBW, congenital abnormalities, diabetes type 1, and asthma (all P < 0.05). The high disease activity of RA was significantly associated with the higher risk of cesarean delivery (OR: 2.29, 95%CI: 1.02-5.15) and premature delivery (OR: 5.61, 95%CI: 2.20-14.30). CONCLUSIONS: High disease activity of RA was associated with the high risk of adverse pregnancy outcomes, suggesting that it was important to control disease for RA women with high disease activity who prepared for pregnancy.

Total flavonoid extract from Dracocephalum moldavica L. improves pulmonary fibrosis by reducing inflammation and inhibiting the hedgehog signaling pathway.

Dracocephalum Moldavica L. is a traditional herb for improving pharynx and relieving cough. However, the effect on pulmonary fibrosis is not clear. In this study, we explored the impact and molecular mechanism of total flavonoid extract from Dracocephalum moldavica L. (TFDM) on bleomycin-induced pulmonary fibrosis mouse model. Lung function testing, lung inflammation and fibrosis, and the related factors were detected by the lung function analysis system, HE and Masson staining, ELISA, respectively. The expression of proteins was studied through Western Blot, immunohistochemistry, and immunofluorescence while the expression of genes was analyzed by RT-PCR. The results showed that TFDM significantly improved lung function in mice, reduced the content of inflammatory factors, thereby reducing the inflammation. It was found that expression of collagen type I, fibronectin, and α-smooth muscle actin was significantly decreased by TFDM. The results further showed that TFDM interferes with hedgehog signaling pathway by decreasing the expression of Shh, Ptch1, and SMO proteins and thereby inhibiting the generation of downstream target gene Gli1 and thus improving pulmonary fibrosis. Conclusively, these findings suggest that TFDM improve pulmonary fibrosis by reducing inflammation and inhibition of the hedgehog signaling pathway.

Determination of the Anti-Oxidative Stress Mechanism of Isodon suzhouensis Leaves by Employing Bioinformatic and Novel Research Technology.

Isodon suzhouensis from Suzhou, China, is a traditional Chinese herb with wide applications in medicine and food. The antioxidant activity against oxidative stress of the leaves of Isodon suzhouensis is a myth since long and is not explored earlier thoroughly. The present study is focused to explore the active components in Isodon suzhouensis leaf extracts responsible for antioxidant effects against oxidative stress and the potential mechanism of this activity. We obtained the chromatograms of Isodon suzhouensis leaf extracts by the high-performance liquid phase (HPLC) for possible detection of antioxidant constituents. Some compounds in Isodon suzhouensis leaf extracts were then further assessed through the luminol luminescence mechanism combined with HPLC analysis as well as with SwissTargetPrediction database that helped to screen out the other constituents. The targets for effects against oxidative stress were then further screened through the GeneCards database, and the PPI network was constructed. The targets were analyzed by GO and KEGG using the David database. The obtained results were then further studied by employing in vitro experimentation and protein expression analyses by Western blotting. It is found that Isodon suzhouensis leaf extracts contain rutin, isoquercetin, glaucocalyxin A, glaucocalyxin B, and other compounds with antioxidant activity. The activity map of the free radical scavenging signals from Isodon suzhouensis showed a strong ability to scavenge free radicals with the highest capacity of glaucocalyxin B followed by isoquercetin succeeding the glaucocalyxin A supervening the rutin. Further network pharmacological analyses and in vitro experimentation showed that Isodon suzhouensis leaf extracts interfere with TNF and the p38 MAPK signaling pathway for antioxidant effects against oxidative stress. Conclusively, it is found that Isodon suzhouensis leaf extracts possess strong antioxidant potential via targeting TNF and p38 MAPK signaling pathways against oxidative stress, providing scientific foundation for further studies on Isodon suzhouensis for the further therapeutic approach.

Knowledge and beliefs about autism spectrum disorders among physicians: a cross-sectional survey from China.

BACKGROUND: The incidence of autism spectrum disorders (ASDs) is increasing greatly, with high demands for earlier diagnosis and intervention. However, little is known about ASD knowledge and beliefs among physicians in China. METHODS: A questionnaire survey was used to assess the knowledge and beliefs about the diagnosis and management of ASD and 24 beliefs regarding the treatment and prognostic aspects of ASD among physicians of any medical specialty in China. RESULTS: A total of 1160 physicians were recruited and surveyed, with an average score of 8.48±2.66 (total of 18 points) for the questionnaire on the main symptoms of ASD and 14.35±3.69 (total of 24 points) for beliefs about ASD. Physicians' age, sex, specialty and practice years were related to their knowledge of identifying patients with ASD. Physicians specialising in paediatrics/psychology/psychiatry scored higher than those specialising in other specialties both in response to diagnostic questions (8.98±2.63 vs 8.30±2.65, p<0.001) and beliefs about ASD (15.57±3.44 vs 13.97±3.97, p<0.001). CONCLUSIONS: Knowledge and beliefs about ASD symptoms, diagnosis and treatment are insufficient among physicians in China. Education and training programmes on this topic should be enhanced in physicians of all specialties, especially for male physicians who have short years in practice.

The Inefficient and Unjust Global Distribution of COVID-19 Vaccines: From a Perspective of Critical Global Justice.

The coronavirus disease 2019 (COVID-19) pandemic has caused huge losses and massive damage to socio-economic development around the globe, which might even potentially evolve into a humanitarian crisis as it continues to spread. In response to the further resulting public threats, collaborative research, rapid production, and efficient and just distribution of vaccines have been given a top priority. However, there exists a serious inefficiency and injustice in the distribution of COVID-19 vaccines among different countries, regions, and social classes currently. Richer countries and regions have acquired far more vaccines than needed, further exacerbating the severity of the epidemic in underdeveloped and marginalized countries and regions. From a perspective of critical global justice, we explore the causes of the inefficient and unjust global distribution of vaccines and comprehensively examine the shortcomings of the current distribution frameworks, such as COVID-19 Vaccines Global Access Facility (COVAX). Then, under the framework of critical global justice, we propose a multi-phase fair priority model that improves the existing proportional distribution mechanism. This solution to the global injustice reoptimizes the cross-border and domestic vaccine distribution and aims to resolve the pandemic more efficiently. The proposed framework and methodology of vaccine distribution could be taken as an opportunity to consistently promote the development of the global socio-economic structure towards global justice more broadly and systematically.

The copper-catalyzed selective monoalkylation of active methylene compounds with alkylsilyl peroxides.

A novel method for a mild copper-catalyzed selective monoalkylation of active methylene compounds with various alkylsilyl peroxides has been developed. The reaction has a broad substrate scope and our mechanistic studies suggest the participation of radical species in this alkylation reaction.

Two novel reassortant H11N8 avian influenza viruses occur in wild birds found in East Dongting Lake, China.

During the surveillance of avian influenza viruses in East Dongting Lake, China (2014-2015), two H11N8 avian influenza viruses were detected in the bean goose (Anser fabalis) and the falcated teal (Anas falcata). Phylogenetic analysis showed that these two novel reassortant H11N8 avian influenza viruses contain genes from poultry and wild birds. This is the first report detecting the H11N8 subtype influenza virus from wild birds in Asia. These findings indicate a dissemination of avian influenza virus along the East Asian-Australian flyway. In addition, the interaction between poultry and wild birds was addressed suggesting the need for intensive surveillance of wild bird populations.

The genetic and phylogenetic analysis of a highly pathogenic influenza A H5N6 virus from a heron, southern China, 2013.

The H5N6 highly pathogenic avian influenza viruses (HPAIVs) have circulated within poultry in China since 2013. Infections of H5N6 in wild birds were reported since 2014. In order to investigate the infection history of H5N6 in wild birds, we conducted a retrospective analysis of H5 positive wild bird samples collected in 2013, the year H5N6 was discovered in poultry. We isolated a new HPAI H5N6 virus from a dead heron collected in 2013. The virus had high identity in all eight gene sequences to those collected from poultry in 2013 (for example, A/chicken/Shenzhen/1845/2013, 99.1%-99.7%). Our findings revealed that H5N6 HPAIVs infected wild birds in southern China since the emergence of H5N6 in poultry in 2013. The co-circulation of H5N6 between wild birds and poultry is very close, and should raise our attention more.

Identification of two novel avian influenza a (H5N6) viruses in wild birds, Shanghai, in 2016.

The H5N6 avian influenza virus (AIV) has been continuously reported in wild birds, which may contribute to further geographical spread during their long-distance migrations. Active AIV surveillance in wild birds was conducted during October and November 2016 in Shanghai, China. Two novel influenza A (H5N6) viruses were detected in samples from migratory waterfowl that are genetically similar to recent South Korea and Japan H5N6 viruses collected in 2016 and 2017, highlighting the role of migratory waterfowl in the dissemination of H5N6 viruses along migratory flyways.