Identification of prognostic signatures in remnant gastric cancer through an interpretable risk model based on machine learning: a multicenter cohort study.

OBJECTIVE: The purpose of this study was to develop an individual survival prediction model based on multiple machine learning (ML) algorithms to predict survival probability for remnant gastric cancer (RGC). METHODS: Clinicopathologic data of 286 patients with RGC undergoing operation (radical resection and palliative resection) from a multi-institution database were enrolled and analyzed retrospectively. These individuals were split into training (80%) and test cohort (20%) by using random allocation. Nine commonly used ML methods were employed to construct survival prediction models. Algorithm performance was estimated by analyzing accuracy, precision, recall, F1-score, area under the receiver operating characteristic curve (AUC), confusion matrices, five-fold cross-validation, decision curve analysis (DCA), and calibration curve. The best model was selected through appropriate verification and validation and was suitably explained by the SHapley Additive exPlanations (SHAP) approach. RESULTS: Compared with the traditional methods, the RGC survival prediction models employing ML exhibited good performance. Except for the decision tree model, all other models performed well, with a mean ROC AUC above 0.7. The DCA findings suggest that the developed models have the potential to enhance clinical decision-making processes, thereby improving patient outcomes. The calibration curve reveals that all models except the decision tree model displayed commendable predictive performance. Through CatBoost-based modeling and SHAP analysis, the five-year survival probability is significantly influenced by several factors: the lymph node ratio (LNR), T stage, tumor size, resection margins, perineural invasion, and distant metastasis. CONCLUSIONS: This study established predictive models for survival probability at five years in RGC patients based on ML algorithms which showed high accuracy and applicative value.

Migration mechanisms of 90Sr and 137Cs on terraces.

In order to investigate the impact of environmental conditions on the distribution and migration of 90Sr in the Longji terrace environment, the activity concentrations of 90Sr and 137Cs were determined. The activity concentration ranges of 90Sr and 137Cs in surface soil were 0.15-1.04 Bq/kg and 2.16-6.94 Bq/kg, respectively. These results showed that there was a similar trend between the activity concentration of 90Sr and 137Cs in the surface soil along the runoff path and their activity concentration were influenced by the slope of the terraced terrain. On the other hand, the activity ranges of 90Sr and 137Cs in soil cores were 0.01-2.74 Bq/kg and 0.43-7.19 Bq/kg, respectively. These results indicate that the migration mechanism of 90Sr is different from that of 137Cs. As compared with 137Cs, 90Sr is significantly influenced by the moisture content. In addition, high span of 137Cs/90Sr activity ratios were found in this study, which were attributed to the characteristics of cultivated land and frequent artificial disturbances that intensified the migration of 90Sr.

Handelin alleviates cachexia- and aging-induced skeletal muscle atrophy by improving protein homeostasis and inhibiting inflammation.

BACKGROUND: Handelin is a bioactive compound from Chrysanthemum indicum L. that improves motor function and muscle integrity during aging in Caenorhabditis elegans. This study aimed to further evaluate the protective effects and molecular mechanisms of handelin in a mouse muscle atrophy model induced by cachexia and aging. METHODS: A tumour necrosis factor (TNF)-α-induced atrophy model was used to examine handelin activity in cultured C2C12 myotubes in vitro. Lipopolysaccharide (LPS)-treated 8-week-old model mice and 23-month-old (aged) mice were used to examine the therapeutic effects of handelin on cachexia- and aging-induced muscle atrophy, respectively, in vivo. Protein and mRNA expressions were analysed by Western blotting, ELISA and quantitative PCR, respectively. Skeletal muscle mass was measured by histological analysis. RESULTS: Handelin treatment resulted in an upregulation of protein levels of early (MyoD and myogenin) and late (myosin heavy chain, MyHC) differentiation markers in C2C12 myotubes (P < 0.05), and enhanced mitochondrial respiratory (P < 0.05). In TNF-α-induced myotube atrophy model, handelin maintained MyHC protein levels, increased insulin-like growth factor (Igf1) mRNA expression and phosphorylated protein kinase B protein levels (P < 0.05). Handelin also reduced atrogin-1 expression, inhibited nuclear factor-κB activation and reduced mRNA levels of interleukin (Il)6, Il1b and chemokine ligand 1 (Cxcl1) (P < 0.05). In LPS-treated mice, handelin increased body weight (P < 0.05), the weight (P < 0.01) and cross-sectional area (CSA) of the soleus muscle (P < 0.0001) and improved motor function (P < 0.05). In aged mice, handelin slightly increased the weight of the tibialis anterior muscle (P = 0.06) and CSA of the tibialis anterior and gastrocnemius muscles (P < 0.0001). In the tibialis anterior muscle of aged mice, handelin upregulated mRNA levels of Igf1 (P < 0.01), anti-inflammatory cytokine Il10 (P < 0.01), mitochondrial biogenesis genes (P < 0.05) and antioxidant-related enzymes (P < 0.05) and strengthened Sod and Cat enzyme activity (P < 0.05). Handelin also reduced lipid peroxidation and protein carbonylation, downregulated mRNA levels of Fbxo32, Mstn, Cxcl1, Il1b and Tnf (P < 0.05), and decreased IL-1ß levels in serum (P < 0.05). Knockdown of Hsp70 or using an Hsp70 inhibitor abolished the ameliorating effects of handelin on myotube atrophy. CONCLUSIONS: Handelin ameliorated cachexia- and aging-induced skeletal muscle atrophy in vitro and in vivo, by maintaining homeostasis of protein synthesis and degradation, possibly by inhibiting inflammation. Handelin is a potentially promising drug candidate for the treatment of muscle wasting.

Spatial distribution, source identification, and transportation paths of plutonium in the Beibu Gulf, South China Sea.

To investigate the spatial distribution and source of plutonium isotopes in the Beibu Gulf, surface sediments were collected and analyzed using sector field inductively coupled plasma mass spectrometry (SF-ICP-MS). The activities of 239+240Pu in surface sediments ranged from 0.012 to 0.451 mBq/g (mean: 0.171 ± 0.138 mBq/g, n = 36), indicating a decreasing trend in a counterclockwise direction from the southern bay mouth. The counterclockwise decreasing trend in the south of the bay mouth is similar to the current in the Beibu Gulf. The 240Pu/239Pu atom ratios in surface sediments ranged from 0.156 to 0.283 (mean: 0.236 ± 0.031, n = 36), slightly higher than that of the global fallout value of 0.18. This suggests that the Pu in the Beibu Gulf was a combination of global fallout and Pacific Proving Ground (PPG). The average contribution of the plutonium (Pu) derived from the PPG in the sediment was estimated to be 52 % ± 24 %.

Electroacupuncture attenuates inflammatory pain via peripheral cannabinoid receptor type 1 signaling pathway in mice.

Pain is strongly associated with neuro-immune activation. Thus, the emerging role of the endocannabinoid system in neuro-inflammation is important. Acupuncture has been used for over 2500 years and is widely accepted for the management of pain. Our study aimed to investigate the effects of electroacupuncture on the regulation of cannabinoid receptor type 1 within the peripheral nervous system. Inflammatory pain was induced by injecting Complete Freund's adjuvant to induce mechanical and thermal hyperalgesia. Electroacupuncture significantly attenuated the mechanical and thermal sensitivities, and AM251, a cannabinoid receptor type 1 antagonist, eliminated these effects. Dual immunofluorescence staining demonstrated that electroacupuncture elevated expression of cannabinoid receptor type 1, co-localized with Nav 1.8. Furthermore, electroacupuncture significantly reduced levels of Nav 1.8 and COX-2 by western blot analysis, but not vice versa as AM251 treatment. Our data indicate that electroacupuncture mediates antinociceptive effects through peripheral endocannabinoid system signaling pathway and provide evidence that electroacupuncture is beneficial for pain treatment.

Using the Caprini Risk Score to Increase Awareness of Venous Thrombus Embolism in the Community: Know Your Score II.

To assess individual participants' baseline thrombosis risk calculated by Caprini Risk Score (CRS) before injury, illness, or hospitalization occur, to increase the awareness of venous thromboembolism (VTE) by viewing 2 short videos. A cross-sectional study was conducted online between August 2022 and January 2023 in the USA, UK, and India to assess the risk of thrombosis of individuals as a baseline. One nursing practitioner and 4 high school students were on the research team. Descriptive statistical methods were used in data analysis. A total of 928 usable completed questionnaires from 945 participants were analyzed. The mean CRS was 4.93 ± 3.175; 0 to 4 (N = 460, 49.6%), 5 to 8 (N = 394, 42.5%), and 9 (N = 74: 8.0%). History of blood clots (N = 247, 26.6%), <40 years old (N = 133, 52.6%); women on oral contraceptives (N = 324, 34.9%), history of smoking (30%), diabetes (26%), and inflammatory bowel disease (IBD; 17.3%). Top-level findings: High incidence of family history of thrombosis (26.6%), smoking, diabetes, contraceptives, and IBD. The average CRS (7.9) in patients over 75 years indicates that even a minor surgical procedure may be associated with significant VTE risk. We achieved an important goal by increasing awareness of VTE using this unique method involving high school students and a nurse working with friends and families to complete the CRS assessment. Encouraging the respondents to share information with their personal physicians prior to the event and keep these data in their medical file is a potential valuable source of saving time. This study emphasizes the importance of individuals collecting baseline information prior to illness or hospitalization.

Radioactivity research in mosses from typical Karst Regions in Leye Tiankeng, Southern China.

Radionuclides in environmental ecosystems have ecotoxicity and health impact on human and environment, so radioactive contamination has always been one of the global concerns. This study mainly focused on the radioactivity of mosses collected from the Leye Tiankeng Group in Guangxi. The activities of 239+240Pu measured by SF-ICP-MS and 137Cs measured by HPGe in moss and soil samples are as follows: 0-2.29 Bq/kg in mosses and 1.5-11.9 Bq/kg in soils for 137Cs, and 0.025-0.25Bq/kg in mosses and 0.07-0.51Bq/kg in soils for 239+240Pu. The range of 240Pu/239Pu atom ratios (0.201 in mosses and 0.184 in soils) and 239+240Pu/137Cs activity ratios (0.128 in mosses and 0.044 in soils) indicated that the 137Cs and 239+240Pu in study area were mainly contributed by global fallout. 137Cs and 239+240Pu showed similar distribution in soils. However, their behaviors in mosses were quite different due to the differences in the growth environment of mosses. The transfer factors of 137Cs and 239+240Pu from soil to moss varied in different growth stages and specific environments. A weak positive correlation among 137Cs, 239+240Pu in mosses and soil-derived radionuclides suggested that resettlement was predominant here. The negative correlation between 7Be, 210Pb and soil-derived radionuclides indicated that 7Be and 210Pb came from atmospheric components, while the weak correlation between them suggested that their specific sources were different. The Cu and Ni were moderately enriched in mosses here due to the use of agricultural fertilizers, At the same time, Zn was at a high level in the Lilang area, where transportation was more developed.

Diosgenin, a Natural Steroidal Sapogenin, Alleviates the Progression of Diabetic Retinopathy in Diabetic Mice.

BACKGROUND/AIM: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and a major cause of blindness in working-age adults. Diosgenin (DG), a natural steroidal sapogenin extracted from fenugreek seeds and wild yam roots, has hypolipidemic, hypoglycemic, anticancer, and anti-inflammatory properties. Given its pharmacological effects, we speculated that DG may be a promising treatment for DR. Therefore, this study was aimed at evaluating the effectiveness of DG in preventing or slowing DR progression in a mouse model (+Leprdb/+Leprdb strain) of type 2 diabetes (T2D). MATERIALS AND METHODS: DG (5.0 mg/kg body weight) or phosphate-buffered saline (PBS) was administered to 8-week-old T2D mice via oral gavage daily for 24 weeks. Paraffin-embedded eye tissues from the mice were collected and stained with hematoxylin and eosin to evaluate retinal histopathology. Apoptosis-related proteins BCL2-associated X (Bax), B-cell lymphoma 2 (Bcl-2), and cleaved caspase-3 were evaluated by western blotting of mouse retinas. RESULTS: Body weight was slightly reduced in the DG-treated group; however, glucose levels were not markedly different between the DG- and PBS-treated groups. Total retinal thickness, thickness of the photoreceptor and outer nuclear layers, and loss of ganglion cells significantly improved in the retina of the DG-treated T2D mice compared with those in the PBS-treated T2D mice. Cleaved caspase-3 level significantly decreased in the retina of the DG-treated T2D mice. Conclusion: DG alleviates DR pathology and exerts a protective effect on the T2D mouse retina. The inhibitory effects of DG on DR may involve mechanisms of the anti-apoptotic pathway.

Application of acupuncture in the emergency department for patients with ileus: A pilot prospective cohort clinical study.

Acupuncture can be conveniently used for pain control in patients with a variety of conditions, and it has obvious effects on various acute pains. In 2018, we implemented a program for emergency treatment with Chinese medicine to promote the integration of Chinese and Western medicine at the Emergency Department (ED). Ileus is a common cause of abdominal pain among patients in the ED, and it is an indication for emergency treatment with Chinese medicine. This study investigated the efficacy of acupuncture as a traditional Chinese medicine (TCM)-based treatment method for the treatment of patients with ileus in the ED. We analyzed data of patients with ileus, who visited ED between January and December 2019, and compared the length of ED stay between the Western medicine group and the Western medicine plus acupuncture group. Furthermore, pain intensity was measured by a visual analogue scale before and after acupuncture. We found that the length of ED stay was 10.8 hours lesser in the Western medicine plus acupuncture group than in the Western medicine group (P = .04), and the visual analogue scale score decreased by 2.0 on average from before to after acupuncture treatment (P = .02). Acupuncture treatment was effective and rapid in relieving the symptoms and discomfort in patients with ileus and in reducing their length of stay in the ED.

Naturally Occurring Bicoumarin Compound Daphnoretin Inhibits Growth and Induces Megakaryocytic Differentiation in Human Chronic Myeloid Leukemia Cells.

Daphnoretin extracted from the stem and roots of Wikstroemia indica (L.) C.A. Mey has been shown to possess antiviral and antitumor activities. Herein, we hypothesized that daphnoretin might induce megakaryocytic differentiation, thereby inhibiting the proliferation of cells and serving as a differentiation therapy agent for chronic myeloid leukemia (CML). Daphnoretin-treated K562 and HEL cells were examined for growth inhibition, cell morphology, and megakaryocyte-specific markers. Potential mechanisms of megakaryocytic differentiation of daphnoretin-treated K562 cells were evaluated. The results showed that daphnoretin inhibited the growth of K562 and HEL cells in a dose- and time-dependent manner. Flow cytometry analyses revealed that daphnoretin treatment slightly increased the proportion of sub-G1 and polyploid cells compared to that of dimethyl sulfoxide (DMSO)-treated control cells. Morphological examination showed that daphnoretin-treated K562 and HEL cells exhibited enlarged contours and multinucleation as megakaryocytic characteristics compared to DMSO-treated control cells. Daphnoretin treatment also dramatically enhanced the expression of megakaryocytic markers CD61 and CD41. Under optimal megakaryocytic differentiation conditions, daphnoretin increased the phosphorylation of STAT3 but not STAT5. In summary, daphnoretin inhibited cell growth and induced megakaryocytic differentiation in K562 and HEL cells. The efficacy of daphnoretin in vivo and in patients with CML may need further investigations for validation.

Characterization of the complete chloroplast genome sequence of Chinese endemic species of Nouelia insignis (Hyalideae, Asteraceae) and its phylogenetic implications.

This study was the first report complete chloroplast genome of Nouelia insignis (Asteraceae, Hyalideae), the large shrubs to small trees endemic to China. The circular whole cp genome of N. insignis was 151,524 bp in length, containing a large single-copy (LSC) region of 83,145 bp and a small single-copy (SSC) region of 18,261 bp. These two regions were separated by a pair of inverted repeat regions (IRa and IRb), each of them 25,060 bp in length. A total of 135 functional genes were encoded, consisting of 89 protein-coding genes, 38 tRNA genes, and eight rRNA genes. The overall GC content of the chloroplast genome sequence was 37.8%, and the GC contents of the LSC, SSC, and IR regions were 35.9, 31.5, and 43.2%, respectively. The phylogenetic analysis by the Bayesian analysis showed that the species of N. insignis was sister group with Gerbera jamesonii by strong support values, and thus was closely related to members of subfamilies of Cichorioideae and Pertyoideae. These results will be useful for the future studies of Asteraceae in the worldwide.

Efficient Microcystis removal and sulfonamide-resistance gene propagation mitigation by constructed wetlands and functional genes analysis.

Increasingly prevalent Microcystis blooms and the propagation of the associated resistance genes represent global environmental problems. Constructed wetlands (CWs) are a cost-effective technology used for wastewater treatment. In this study, the herb Alisma orientale and three industrial byproducts, namely, blast furnace slag, biochar, and sawdust, were selected to construct mini-CW units. Their potential to remediate toxic Microcystis and their influences on the behaviors of antibiotic-resistant genes (ARGs, sul1, sul2, and intl1) were analyzed. Approximately 98.46% of Microcystis cells were removed by the sawdust-based CW in just 2 d, wherein <0.37 µg/L residual microcystin (MC)-LR was detected, with a removal efficiency of >96.47%, which is potentially caused by the higher relative abundance of MC-degrading gene mlrA on the substrate. Lower target ARG accumulations in the sawdust-based CW may be attributed to the lower intl1 relative abundance and microbial function mobile element content, which could influence horizontal gene transfer. In three sequential batches for the treatment of eutrophic lake water, six sawdust-based CW units were assembled into CW microcosms. The efficiency of removal of Microcystis and MC-LR by planted CW microcosms ranged between 92.00% and 95.88% and between 86.48% and 94.82%, respectively; this was significantly (P < 0.05) higher than that by unplanted ones. Less accumulation of target ARGs was also observed in planted CWs. Planting considerably improved nitrogen removal, possibly owing to the enrichment of genes involved in the KEGG nitrogen metabolism pathway in the substrate through metagenomic analysis.

Case selection and implementation of tubeless percutaneous nephrolithotomy.

BACKGROUND: The tubeless percutaneous nephrolithotomy (PCNL) was proposed to eliminate the side effects of the nephrostomy tube in recent years, such as pain, channel infection, postoperative bleeding, and longer hospital stay. But there is neither clinical guidelines nor consensus about tubeless PCNL in clinical practice. The study is aimed to how to implement the tubeless PCNL step by step, including case selection preoperatively, improving the technique of the surgeon, making the correct decisions at the end of the procedure, which had not been previously examined. METHODS: From January 2017 to March 2018, 364 consecutive patients requiring PCNL were comprehensively analyzed preoperatively and patients were selected for scheduled tubeless PCNL based on four aspects. The selected patients were divided into two groups according to whether the nephrostomy tube was finally placed. The mean operative time, intraoperative blood loss, stone clearance rate, visual pain score, postoperative hospitalization days and perioperative complications were all evaluated. RESULTS: Based on the preoperative evaluation, 42 patients were selected for tubeless PCNL, among which there were finally 37 cases of completed tubeless PCNL. Compared with patients undergoing conventional PCNL, there were not statistical differences in the mean operative time (P=0.207) or intraoperative blood loss (P=0.450) in the tubeless group. Stone clearance rate was 100% in both groups. The visual pain scores in the tubeless PCNL group were lower on operation day (P=0.029), first postoperative day (P<0.001) and the day of discharge (P=0.025). The postoperative hospitalization for the tubeless PCNL group was shorter than that of the control group (P<0.001). No significant difference in grade 1 complications was seen (P=0.424), and no grade 2 or higher complications were observed in either group. CONCLUSIONS: Postoperative pain was significantly relieved and postoperative hospitalization was significantly shortened in the tubeless PCNL group. Tubeless PCNL is safe if patients are carefully selected using four criteria before operation, attention is paid to four key points and five confirmations are made during operation.

Plutonium isotopes and radionuclides in corals around Weizhou land in Beibu Gulf, China.

Plutonium isotopes in the coral were determined with chemical separation method using AG 1-X8 and AG-MP-1M anion exchange resins and sector field inductively coupled plasma mass spectrometry (SF-ICP-MS) in order to elucidate the activity concentration and source of Pu around Weizhou land in Beibu Gulf, China. Furthermore, the activity concentrations of other radionuclides (238U, 226Ra, 232Th, 137Cs, 40K and 210Pb) were measured by a HPGe spectrometer. The activity concentration of 240+239Pu in the coral is determined to be in the range of 8.95-27.84 mBq/kg. The 240Pu/239Pu atom ratios in the samples range from 0.173 to 0.225, indicating that the main source of plutonium in this area is global fallout while the contribution of PPG is about 30%. Further, the activity concentrations of 238U, 232Th, 40K and 226Ra are determined to be in the range of 18.72-64.63, 1.37-20.8, 29.78-72.52 and 3.48-61.97 Bq/kg, respectively.

Effect of urea feeding on transforming and migrating soil fluorine in a tea garden of hilly region.

The hilly region of western Sichuan is famous for producing Mengding-mountain tea in China. However, it is very easy to enrich fluorine (F) in tea, which recently raised people's concern on fluorosis. In this study, we simulated the local special climate conditions, especially the natural precipitation through column leaching experiment to investigate the effect of fertilization on F desorption from soil. The results suggested different fertilizers could greatly affect desorption of F from soil, but only urea (CO(NH2)2) could significantly and continuously promote the dissolution of F from soil. Furthermore, to reveal the effect of CO(NH2)2 on migration of F from soil to tea, field plots experiment in a tea garden was carried out. The results showed that CO(NH2)2 promoted soil acidification continuously, resulting in the increase of dissolved F and Al content in soil, which were migrated to tea in the form of F-Al complex. Therefore, the key to reducing the F content in tea is to alleviate soil acidification and reduce F-Al complex content in soil. Most importantly, with CO(NH2)2 addition, the contents of F in tea increased significantly from first bud to fifth bud in comparison with those of without CO(NH2)2, especially in 2016, indicating the accelerating and prolonging enrichment of F in tea by adding CO(NH2)2. This study would have important guidance for controlling F mitigation from soil to tea by managing fertilizers application and anthropogenic activities.

Vertical distribution of Pu in forest soil in Qinghai-Tibet Plateau.

The 239+240Pu and 137Cs activities and 240Pu/239Pu atom ratios in surface soil and soil core collected from Qinghai-Tibet Plateau were investigated. The maximum of 239+240Pu and 137Cs activity concentrations in five soil cores were found in upper layers and have a same trend: the maximum followed by exponential decline. The 240Pu/239Pu atom ratio ranged from 0.160 ± 0.009 to 0.212 ± 0.012, clarified that the plutonium mainly came from the global fallout and the contribution of Lop Nor test sites was negligible. In addition, the vertical profiles of radionuclides (210Pb, 238U, 232Th, 226Ra, 40K) have been studied and a high correlation has been found between them. The correlations of Pu between organic matter (OM) and heavy metals were also studied. Person Correlation Coefficients revealed Pu had significant positive correlations with organic matter and Cd, Cu, Co, Zn, but negative correlation with Tl. The results have important implication for further understanding of the sources, records and environmental impacts of global and regional nuclear activities, which expanded the database of Pu activity level and atom ratio in Chinese soil and established a foundation for future environmental risk assessment.

Relevance of Physical Fitness and Cardiovascular Disease Risk.

BACKGROUND: This study explored the relationship between fitness performance, in terms of muscular endurance and cardiorespiratory fitness (CRF), and cardiovascular disease (CVD) risk.Methods and Results:The study was performed on 51,500 eligible participants from the Republic of China Armed Forces. Participants were divided into 4 groups (obese or non-obese males and females). Correlations between the Framingham risk score of coronary artery disease (FRS-CAD) and physical fitness (evaluated using 2-min push-ups, 2-min sit-ups, and 3,000-m non-weight-bearing running tests) were calculated using univariate and multivariate linear regression, as well as an extended model that adjusted for covariates. In males, regardless of obesity status, there were significant negative correlations between quartiles of fitness performance and the FRS-CAD (P<0.001) in the unadjusted and adjusted models, except for the sit-up test in the model adjusted for age, serum uric acid, hemoglobin, creatinine, current drinking, betel nut chewing, and running test speed. FRS-CAD was lower for higher quartiles of physical fitness (P for trend <0.001) in male participants. However, no significant relationship between fitness performance and FRS-CAD was observed in females, regardless of obesity status. CONCLUSIONS: The findings highlighted a substantial association between fitness performance and FRS-CAD, especially in adult males. Muscular endurance and CRF may be a convenient risk evaluation tool for future CVD risk in the general, healthy, young to middle-aged male population in Taiwan.

Is electroacupuncture safe and effective for treatment of stress urinary incontinence in women? A systematic review and meta-analysis.

OBJECTIVE: Stress urinary incontinence (SUI) is prevalent worldwide, particularly among elderly women. Although electroacupuncture (EA) has been accepted by many patients and physicians in Asia, its efficacy for SUI has not been evaluated scientifically and systematically. We aimed to conduct a systematic evaluation of the efficacy and safety of EA treatment for women with SUI. METHODS: We retrieved publications up to February 2019 from seven databases. Randomized controlled trials for women with SUI treated by EA were included. Therapeutic effect, 1-hour urine leakage and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) scores were the primary outcomes. The Cochrane Collection's RevMan 5.3 software was used to pool data. RESULTS: The 15 included articles demonstrated that EA for SUI was effective (odds ratio [OR], confidence interval [CI] = 5.64, 4.19-7.59; Ι2 = 22%). ICIQ-SF scores increased (standard mean difference, CI = -0.48, -0.62 to -0.33; Ι2 = 32%) and 1-hour urine leakage decreased (OR, CI = -4.14, -4.96 to -3.33; Ι2 = 78%) in patients undergoing EA compared with those receiving sham EA, physical exercise or medication. CONCLUSION: EA for women with SUI exhibited significant efficacy and safety for key outcomes.

Mitochondrial Dysfunction as a Novel Target for Neuroprotective Nutraceuticals in Ocular Diseases.

The eyes require a rich oxygen and nutrient supply; hence, the high-energy demand of the visual system makes it sensitive to oxidative stress. Excessive free radicals result in mitochondrial dysfunction and lead to retinal neurodegeneration, as an early stage of retinal metabolic disorders. Retinal cells are vulnerable because of their coordinated interaction and intricate neural networks. Nutraceuticals are believed to target multiple pathways and have shown neuroprotective benefits by scavenging free radicals and promoting mitochondrial gene expression. Furthermore, encouraging results demonstrate that nutraceuticals improve the organization of retinal cells and visual functions. This review discusses the mitochondrial impairments of retinal cells and the mechanisms underlying the neuroprotective effects of nutraceuticals. However, some unsolved problems still exist between laboratory study and clinical therapy. Poor bioavailability and bioaccessibility strongly limit their development. A new delivery system and improved formulation may offer promise for health care applications.

Electroacupuncture attenuates chronic fibromyalgia pain through the phosphorylated phosphoinositide 3-kinase signaling pathway in the mouse brain.

OBJECTIVES: Fibromyalgia (FM) is a central nervous system disorder characterized by widespread mechanical hyperalgesia due to unknown mechanisms. Several inflammatory mediators, such as interleukin-1 (IL-1), IL-6, IL-8, and tumor necrosis factor, are increased in the serum of FM patients. Although medications including pregabalin, duloxetine, and milnacipran are used to treat FM, the results are unsatisfying. In the present study we assessed whether electroacupuncture (EA) can reduce chronic FM pain and then proposed an underlying mechanism for this effect. MATERIALS AND METHODS: Chronic FM pain was induced in mice by dual acid saline injection lasting up to 4 weeks. RESULTS: Chronic FM pain was treated by EA manipulation, but not in the sham operated group. Phosphorylated phosphatidylinositol 3-kinase (pPI3K), protein kinase B, mechanistic target of rapamycin, and nuclear factor kappa-light-chain-enhancer of activated B cells were unaltered in the mouse dorsal root ganglion (DRG) and spinal cord (SC) after inducing FM and administering EA treatment. The pPI3K-associated nociceptive signaling pathway was increased in the thalamus of FM mice, but reversed by EA. Similar results were observed in the mouse somatosensory cortex. CONCLUSION: These data suggest that EA has a significant effect on a signaling pathway in brain areas of FM mice. These findings suggest the value of EA for clinical practice.