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Introduction: Kinesiophobia denotes an excessive and irrational apprehension towards physical activity or exercise among patients, stemming from a perception of susceptibility to painful injury or re-injury. Cardiac rehabilitation stands pivotal in the secondary prevention spectrum for individuals with cardiovascular ailments, with exercise constituting a cornerstone of this regimen. However, the emergence of kinesiophobia poses a formidable challenge, diminishing patient adherence to cardiac rehabilitation protocols, particularly among those grappling with chronic heart failure. To bolster exercise-based rehabilitation initiatives in this cohort, a thorough comprehension of the multifaceted factors precipitating kinesiophobia is imperative. This review endeavors to delineate prevailing evidence and prevalence concerning kinesiophobia triggers in chronic heart failure patients, while pinpointing research lacunae for future exploration. Methods: Employing a scoping review methodology, our investigation culled data from diverse scholarly databases, including Embase, PubMed, Scopus, CINAHL, Web of Science, Medline, Sinomed, CNKI, Wangfan, and VIP. Results: After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated. Discussion: Our findings underscore a notable prevalence of kinesiophobia in chronic heart failure patients, predominantly influenced by socio-demographic factors, psychological and cognitive factors, disease and treatment factors, as well as lifestyle and behavior. Armed with these insights, future interventions can be tailored to mitigate kinesiophobia levels, fostering enhanced engagement in exercise-centric cardiac rehabilitation endeavors among patients grappling with chronic heart failure.
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BACKGROUND: The conversion from a temporary to a permanent stoma (PS) following rectal cancer surgery significantly impacts the quality of life of patients. However, there is currently a lack of practical preoperative tools to predict PS formation. The purpose of this study is to establish a preoperative predictive model for PS using machine learning algorithms to guide clinical practice. METHODS: In this retrospective study, we analyzed clinical data from a total of 655 patients who underwent anterior resection for rectal cancer, with 552 patients from one medical center and 103 from another. Through machine learning algorithms, five predictive models were developed, and each was thoroughly evaluated for predictive performance. The model with superior predictive accuracy underwent additional validation using both an independent testing cohort and the external validation cohort. The Shapley Additive exPlanations (SHAP) approach was employed to elucidate the predictive factors influencing the model, providing an in-depth visual analysis of its decision-making process. RESULTS: Eight variables were selected for the construction of the model. The support vector machine (SVM) model exhibited superior predictive performance in the training set, evidenced by an AUC of 0.854 (95 % CI:0.803-0.904). This performance was corroborated in both the testing set and external validation set, where the model demonstrated an AUC of 0.851 (95%CI:0.748-0.954) and 0.815 (95%CI:0.710-0.919), respectively, indicating its efficacy in identifying the PS. CONCLUSIONS: The model(https://yangsu2023.shinyapps.io/psrisk/) indicated robust predictive performance in identifying PS after anterior resection for rectal cancer, potentially guiding surgeons in the preoperative stratification of patients, thus informing individualized treatment plans and improving patient outcomes.
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Aprendizado de Máquina , Neoplasias Retais , Estomas Cirúrgicos , Humanos , Neoplasias Retais/cirurgia , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Máquina de Vetores de Suporte , Qualidade de Vida , Protectomia/métodos , AlgoritmosRESUMO
The purpose of this study was to identify latent classes of chronic pain in older adults based on perceptual, cognitive, behavioral, emotional and social factors, and to explore the associations between each class of chronic pain and different cognitive domains. A total of 629 participants were included. Three classes of chronic pain were identified: "episodic recurrent mild pain with good psychosocial state" (class 1), "episodic recurrent moderate pain with general psychosocial state" (class 2) and "continuous multilocational severe pain with attacks accompanied by poor psychosocial state and avoidance of activity" (class 3). After adjusting for relevant confounders, chronic pain presenting as class 1 was associated with worse memory; class 2 was associated with worse global cognitive function, memory, information processing speed, and executive function; and class 3 was additionally associated with worse attention compared to class 2. The findings contribute to the development of targeted programs for treating pain and improving cognitive functioning.
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Dor Crônica , Disfunção Cognitiva , Humanos , Idoso , Dor Crônica/psicologia , Estudos Transversais , Análise de Classes Latentes , Cognição , Função ExecutivaRESUMO
Leptospirosis is a zoonosis that is related to potential respiratory, renal, neurological, and cardiovascular failure. At present, antibiotics are the recommended treatment, but due to the underlying cause of the disease, they may induce the Jarisch-Herxheimer reaction (JHR) within 24 hours. At the same time, we speculate that JHR may aggravate the natural course of leptospirosis. Considering that there are few available reports on this event, we will share a case of pulmonary hemorrhagic leptospirosis, where antibiotic treatment is suspected to have triggered the JHR. This report is expected to improve clinical attention to the relationship between leptospirosis and JHR.
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BACKGROUND: Although recurrence rates after radiofrequency catheter ablation (RFCA) in patients with atrial fibrillation (AF) remain high, there are a limited number of novel, high-quality mathematical predictive models that can be used to assess early recurrence after RFCA in patients with AF. PURPOSE: To identify the preoperative serum biomarkers and clinical characteristics associated with post-RFCA early recurrence of AF and develop a novel risk model based on least absolute shrinkage and selection operator (LASSO) regression to select important variables for predicting the risk of early recurrence of AF after RFCA. METHODS: This study collected a dataset of 136 atrial fibrillation patients who underwent RFCA for the first time at Peking University Shenzhen Hospital from May 2016 to July 2022. The dataset included clinical characteristics, laboratory results, medication treatments, and other relevant parameters. LASSO regression was performed on 100 cycles of data. Variables present in at least one of the 100 cycles were selected to determine factors associated with the early recurrence of AF. Then, multivariable logistic regression analysis was applied to build a prediction model introducing the predictors selected from the LASSO regression analysis. A nomogram model for early post-RFCA recurrence in AF patients was developed based on visual analysis of the selected variables. Internal validation was conducted using the bootstrap method with 100 resamples. The model's discriminatory ability was determined by calculating the area under the curve (AUC), and calibration analysis and decision curve analysis (DCA) were performed on the model. RESULTS: In a 3-month follow-up of AF patients (n = 136) who underwent RFCA, there were 47 recurrences of and 89 non-recurrences of AF after RFCA. P, PLR, RDW, LDL, and CRI-II were associated with early recurrence of AF after RFCA in patients with AF (p < 0.05). We developed a predictive model using LASSO regression, incorporating four robust factors (PLR, RDW, LDL, CRI-II). The AUC of this prediction model was 0.7248 (95% CI 0.6342-0.8155), and the AUC of the internal validation using the bootstrap method was 0.8403 (95% CI 0.7684-0.9122). The model demonstrated a strong predictive capability, along with favorable calibration and clinical applicability. The Hosmer-Lemeshow test indicated that there was good consistency between the predicted and observed values. Additionally, DCA highlighted the model's advantages in terms of its clinical application. CONCLUSIONS: We have developed and validated a risk prediction model for the early recurrence of AF after RFCA, demonstrating strong clinical applicability and diagnostic performance. This model plays a crucial role in guiding physicians in preoperative assessment and clinical decision-making. This novel approach also provides physicians with personalized management recommendations.
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Objective: The purpose of this study was to clarify the concept of transitional care in patients with heart failure. Background: Transitional care is increasingly being applied in patients with heart failure, but the concept of transitional care in heart failure patients is not uniform and confused with other definitions, which limits further research and practice on transitional care for these patients. Design: Rodgers' evolutionary concept analysis. Methods: A comprehensive literature search was conducted using the PUBMED, EMBASE, EBSCO, Chinese Biological Medicine (CBM), CNKI, and WANFANG databases (up to January 26, 2023). We used Rodgers' evolutionary concept analysis method to identify related concepts, attributes, antecedents, and consequences of transitional care in patients with heart failure. Results: A total of 33 articles were included. The following attributes belonging to transitional care in patients with heart failure were extracted from the literature: self-care, multidisciplinary collaboration, and information transmission. The antecedents were patients' health status, the health literacy of patients and caregivers, the role functions of the main implementer and social and medical resources. Consequences were separated into two categories: patient-centered health outcomes (all-cause mortality, health-related quality of life, discharge preparedness, self-care behaviors, satisfaction of patients) and healthcare utilization outcomes (hospital readmission, length of hospital stay, emergency department visits). Conclusion: This study found that transitional care in heart failure patients is a systemic care process during a vulnerable period that improves patient self-management and coordination between hospital resources and social support systems for continuous management to promote smooth patient transitions between different locations. This concept analysis will inform healthcare providers in designing evidence-based interventions and quality improvement strategies to ensure that transition processes lead to desired outcomes. In addition, this study will also be helpful for developing specific assessment tools to identify patients with HF who need transitional care.
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OBJECTIVE: To determine the relationship of napping with incident diabetes risk and glycaemic control in people with diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE (PubMed), EMBASE, Web of Science and the Cochrane Library were searched for studies published from database inception to 9 May 2023. ELIGIBILITY CRITERIA: Observational studies reporting the relationship of napping with diabetes or glycaemic control in patients with diabetes in adult populations were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened the literature, extracted data and assessed the quality of the included studies. The results were reported as ORs and 95% CIs, which were pooled by using fixed and random effects models, and subgroup analyses were performed. The Grading of Recommendations Assessment, Development and Evaluation method was used to assess the quality of the evidence. RESULTS: Forty studies were included in our review. Habitual napping was associated with an increased diabetes risk (OR 1.20, 95% CI 1.14 to 1.27) and poor glycaemic control in patients with diabetes (OR 2.05, 95% CI 1.55 to 2.73). Nap durations less than 30 min were unrelated to diabetes (OR 1.05, 95% CI 0.97 to 1.14). Nap durations of 30-60 min were associated with diabetes risk (OR 1.09, 95% CI 1.02 to 1.17), but there were differences in the subgroup analysis results. Nap durations of more than 60 min significantly increased the risk of diabetes (OR 1.31, 95% CI 1.20 to 1.44). CONCLUSIONS: Napping is associated with increased diabetes risk and poor glycaemic control, and future research will need to confirm whether there are sex and regional differences. Nap durations of more than 60 min significantly increases the risk of diabetes, and the relationship between nap duration and glycaemic control in patients with diabetes needs to be further explored in the future. PROSPERO REGISTRATION NUMBER: CRD42021292103.
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Diabetes Mellitus , Adulto , Humanos , Diabetes Mellitus/epidemiologia , Bases de Dados Factuais , Controle Glicêmico , MEDLINE , PubMedRESUMO
Purpose: We investigated the current state and trends in the area during the previous 10 years using bibliometric approaches to evaluate the global scientific output of research on electroactive materials and spinal cord injury. Methods: Studies on spinal cord injury in electroactive materials that were published between 2012 and 2022 were located using the Web of science (WOS) datebase. The software programs bibliometrix R-package and CiteSpace were used to do quantitative analyses of annual publications, nation, author, institution, journal source, co-cited references, and keywords. The studies were categorized by the research's main points using a qualitative analysis, and publications having more than 10 citations each year. Results: In the final analysis, 1,330 relevant papers or reviews were included. There is an increased tendency in both the average annual citation rate and the number of publications in the discipline. The United States and the University of Toronto are the countries and institutions that have contributed the most to this discipline, respectively. The majority of authors are from the China and United States. Zhang Y is the author with the most published articles and holds the top position in the cited author h-index species. The journal with the highest number of published articles is "Disability and rehabilitation"; the journal is divided into four main areas including physics, materials, chemistry, molecular, and biology. The keyword analysis revealed a shift in research hotspots from schwann cell, fracture, and urinary disorders to carbon-based materials, functional recovery, and surgery. Analysis of qualitative data revealed that the role and mechanism of injectable conductive hydrogels in spinal cord healing after damage is a hot topic of current study, with the mechanism primarily focusing on the inhibition of oxidative stress (Nrf2) and apoptosis (Casepase 3). Conclusion: Our bibliometric analysis indicates that research on electroactive materials for spinal cord injury remains an active field of study. Moreover, contemporary research is concentrated on carbon-based materials, functional rehabilitation, and surgery.
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Effective influence management during advice-giving requires individuals to express confidence in the advice properly and switch timely between the 'competitive' strategy and the 'defensive' strategy. However, how advisers switch between these two strategies, and whether and why there exist individual differences during this process remain elusive. We used an advice-giving game that manipulated incentive contexts (Incentivized/Non-Incentivized) to induce the adviser's confidence expression strategy switching and measured the brain activities of adviser and advisee concurrently using functional near-infrared spectroscopy (fNIRS). Behaviorally, we observed individual differences in strategy switching. Some advisers applied the 'defensive' strategy when incentivized and the 'competitive' strategy when not incentivized, while others applied the 'competitive' strategy when incentivized and the 'defensive' strategy when not incentivized. This effect was mediated by the adviser's perceived stress in each condition and was reflected by the frequencies of advice-taking in the advisees. Neurally, brain activation in the dorsolateral prefrontal cortex (DLPFC) supported strategy switching, as well as interpersonal neural synchronization (INS) in the temporoparietal junction (TPJ) that supported influence management. This two-in-one process, i.e., confidence expression strategy switching and the corresponding influence management, was linked and modulated by the strength of DLPFC-TPJ functional connectivity in the adviser. We further developed a descriptive model that contributed to understanding the adviser's strategy switching during influence management.
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Encéfalo , Motivação , Humanos , Processos Mentais , Mapeamento Encefálico/métodos , Córtex Pré-Frontal/fisiologiaRESUMO
BACKGROUND: Dementia is an urgent public health problem worldwide, and the determination of the contribution of pain to cognitive decline or dementia is significant for the prevention of dementia. OBJECTIVE: To comprehensively explore the contribution of pain to subsequent cognitive decline or dementia and analyze possible influencing factors. DESIGN: Systematic review and meta-analysis of cohort studies. METHODS: We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, China National Knowledge Internet, WANFANG DATA and VIP for cohort studies from database inception to January 21, 2022. Random-effects meta-analysis was used to pool odds ratios (ORs) and 95% confidence intervals (CIs) of incident cognitive decline or dementia among patients with pain. Subgroup analyses and meta-regression were used to explore the sources of heterogeneity. RESULTS: A total of 35 cohort studies containing 1,122,503 participants were included. As a whole, pain (ORâ¯=â¯1.24; 95% CIâ¯=â¯1.17-1.31) was a risk factor for subsequent cognitive decline or dementia; headache, migraine, tension-type headache, widespread pain, and irritable bowel syndrome, but not burning mouth syndrome, were also risk factors. Pain increased the risk of all-cause dementia (ORâ¯=â¯1.26; 95% CIâ¯=â¯1.18-1.35), Alzheimer's disease (ORâ¯=â¯1.28; 95% CIâ¯=â¯1.12-1.47), and vascular dementia (ORâ¯=â¯1.31; 95% CIâ¯=â¯1.06-1.62). Pain interference (ORâ¯=â¯1.42; 95% CIâ¯=â¯1.16-1.74) was associated with an increased risk of cognitive decline or dementia, while pain intensity was not. Pooled results from studies with sample sizes less than 2000 or with relatively low quality showed that pain did not increase the risk of cognitive decline or dementia. There was no statistically significant increase in the risk of cognitive decline or dementia in people with pain aged ≥75â¯years. CONCLUSIONS: Our results demonstrated that pain increased the risk of subsequent cognitive decline or dementia. Sample size, study methodological quality, types of pain, pain severity (pain interference), and age composition of the study population may affect the relationship between pain and cognitive decline or dementia. REGISTRATION: PROSPERO (CRD42022316406).
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Disfunção Cognitiva/complicações , Estudos de Coortes , Fatores de Risco , Dor/complicaçõesRESUMO
Behavioral decision theory argues that humans can adjust their third-party responses (e.g., punishment and compensation) to injustice by integrating unfair experiences. Typically, the mood plays an important role in such a decision-making process. However, the underlying neurocognitive bases remain largely unclear. We first employ a modified third-party justice game in which an allocator split an amount of money between oneself and a receiver. The participants can reapportion the money as observers by choosing from the following three costly options: compensate the receiver, accept the current allocation, or punish the allocator. Then, a second-party pseudo interaction is conducted where participants receive more (i.e., advantageous unfair experience) or less (i.e., disadvantageous unfair experience) than others. Finally, participants perform the third-party justice game again after unfair experiences. Here, we use functional near-infrared spectroscopy (fNIRS) to measure participants' brain activities during third-party responses to injustice. We find participants compensate more to the receiver after advantageous unfair experience, which involved enhanced positive emotion, weakened sense of unfairness, and is linked with increased activity in the right dorsolateral prefrontal cortex (rDLPFC). In contrast, participants punish more on the allocator after disadvantageous unfair experience, which might primarily stem from their negative emotional responses, strong sense of unfairness, and is associated with significantly decreased activity in the rDLPFC. Our results suggest that third-party compensation and punishment involved differential psychological and neural bases. Our findings highlight the crucial roles of second-party unfair experiences and the corresponding mood responses in third-party responses to unfairness, and unravel the intermediate neural architecture.
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Tomada de Decisões , Punição , Afeto , Tomada de Decisões/fisiologia , Emoções , Humanos , Punição/psicologia , Justiça Social/psicologiaRESUMO
Sleep duration, sleep quality and circadian rhythm disruption indicated by sleep chronotype are associated with type 2 diabetes. Sleep involves multiple dimensions that are closely interrelated. However, the sleep patterns of the population, and whether these sleep patterns are significantly associated with type 2 diabetes, are unknown when considering more sleep dimensions. Our objective was to explore the latent classes of sleep patterns in the population and identify sleep patterns associated with type 2 diabetes. Latent class analysis was used to explore the best latent classes of sleep patterns based on eleven sleep dimensions of the study population. Logistic regression was used to identify sleep patterns associated with type 2 diabetes. A total of 1200 participants were included in the study. There were three classes of sleep patterns in the study population: "circadian disruption with daytime dysfunction" (class 1), "poor sleep status with daytime sleepiness" (class 2), and "favorable sleep status" (class 3). After controlling for all confounding factors, people in class 2 have significantly higher prevalence of type 2 diabetes than those in class 3 (OR: 2.24, 95% CI 1.26-4.00). Sleep problems have aggregated characteristics. People with sleep patterns involving more or worse sleep problems have higher significantly prevalence of T2DM.
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Diabetes Mellitus Tipo 2 , Transtornos do Sono-Vigília , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Análise de Classes Latentes , Sono , Ritmo Circadiano , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/complicaçõesRESUMO
Air discharge showed significant inhibition on mycelial growth and spore germination of Fusarium oxysporum, one of the main spoilage fungi in post-harvest lotus roots which is an important economic aquatic vegetable in China. However, the antimicrobial mechanism of air discharge is not clear yet. In the present study, the effects of air discharge on F. oxysporum separated from post-harvest rotten lotus roots were characterized by analyzing surface charges, cell wall permeability, and changes in chitin and chitosan including surface morphology, functional groups, degree of deacetylation, crystallinity, and C/N ratio. After air discharge treatments, alkaline phosphatase leak assay revealed that cell wall permeability of F. oxysporum was magnified. What's more, zeta potentials of F. oxysporum increased and negative charges on cell surfaces decreased. The ordered and compact molecular arrangements of chitin and chitosan in cell walls of F. oxysporum were reduced. The deacetylation degree of chitin and chitosan increased, and the C/N ratios of chitin and chitosan decreased. It was concluded from these results that air discharge caused the transformation in structures of chitin and chitosan, resulting in the exposure of positively charged amino groups and decrease of negative charges on cell surfaces which brought damage to the structure and function of F. oxysporum's cell walls.
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Ânions/farmacologia , Parede Celular/efeitos dos fármacos , Quitosana/metabolismo , Fusarium/citologia , Fusarium/efeitos dos fármacos , Lotus/microbiologia , Ozônio/farmacologia , Desinfecção/métodos , Microbiologia de Alimentos , Conservação de Alimentos/métodos , Permeabilidade/efeitos dos fármacosRESUMO
Oxygen vacancy engineering has emerged as an effective approach to improve the performance of catalysts for peroxymonosulfate (PMS) activation. Herein, we report a facile precipitation method followed by calcination to synthesize cost-effective and environmentally friendly magnesium-doped hematite (Mg/Fe2O3) composites. Multiple characterization results reveal that the incorporation of Mg can significantly increase the oxygen vacancies and specific surface area of 5%Mg/Fe2O3, leading to a significantly enhanced performance in degrading Rhodamine B (RhB) through PMS activation. In a typical reaction, almost complete RhB (10 mg/L) removal can be achieved by the activation of PMS (0.2 g/L) using 5%Mg/Fe2O3 (0.5 g/L). Moreover, the as-synthesized catalyst exhibits a broad pH working range (3.96-10.69), high stability, and recyclability. The effects of several parameters (e.g., catalyst amount, PMS dosage, solution pH and temperature, and coexisting inorganic anions) on the removal of RhB in the 5%Mg/Fe2O3/PMS system are investigated. A plausible PMS activation mechanism is proposed, and 1O2 and O2- are identified as the predominant reactive species in RhB degradation instead of SO4- and OH. This study provides new insights into the development of highly efficient iron-based catalysts and highlights their potential applications in environmental purification.
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Poluentes Ambientais , Oxigênio , Oxirredução , PeróxidosRESUMO
Aging is a complex phenomenon. Endothelial cell senescence is regarded as a vital characteristic of cardiovascular diseases. This study aims to identify differentially expressed genes in vascular endothelial cells (ECs) of different age groups by RNA sequencing (RNA-Seq) technique, and to explore which molecular pathways differentially expressed genes (DEGs) may enrich in. In this study, we used RNA-Seq to analyze DEGs in primary endothelial cells of young and old mice, and further analyzed them by gene ontology (GO) enrichment and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Our results showed that in total identified 229 of the DEGs, 104 were upregulated and 125 were downregulated in endothelial cells of aged mice compared with young mice. Gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the involvement of these DEGs in the regulation of morphogenesis of a branching structure, angiogenesis, upregulation of cell proliferation, and extracellular matrix (ECM)-receptor interaction. These results provided a novel insight to understand the molecular mechanisms underlying aortic endothelial cell senescence, and some of the novel candidate genes identified in this study may be valuable in elucidating the molecular mechanisms underlying endothelial cell senescence.
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Aging is tightly associated with various diseases, such as cardiovascular diseases; however, there is no effective biomarker to detect and evaluate the aging process in vivo. Therefore, it is critical to identify new aging biomarkers for earlier diagnose of aging-related diseases. This study investigated the profile of cytokines in serum samples of young and aged mice with the purpose of exploring new biomarkers that have remarkable alterations in aging. A solid-phase antibody array was used to screen 200 proteins in the mouse serum, among which 32 cytokines differentially expressed between young and aged mice were screened. The major proteins were secreted frizzled-related protein 3 (sFRP3), Fractalkine, IGFBP-5, IGFBP-6, etc. We select secreted frizzled-related protein 3 (sFRP3) in follow-up study. Then, enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of sFRP3. Our results revealed that the expression levels of sFRP3 in serum samples from aged mice were significantly higher than those in samples from young mice. ELISA data were identical to those obtained by the antibody array. Our findings indicated that sFRP3 has remarkable significance in senescence. Furthermore, we detected sFRP3 level in culture supernatants of primary endothelial cells, and the variation trend of sFRP3 levels in culture supernatant was consistent with serum data. We also detected serum sFRP3 amounts in healthy young and elderly individuals. Interestingly, serum sFRP3 amounts in the elderly were significantly increased compared with those of young individuals.
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Innate lymphoid cells (ILCs) are associated with innate immunity and tissue remodeling. However, the changes in ILCs and their role in acute cerebral infarction (ACI) remain unexplored. This study aimed to examine the expression of ILCs in patients with ACI and explore the mechanism underlying changes in ILCs induced by the atherosclerotic factor oxidized low-density lipoprotein (ox-LDL). The levels of ILC1, ILC2, and ILC3 in the blood of patients with ACI and controls were examined at the time of admission. The correlation of serum levels of ox-LDL and inflammatory biomarkers with the level of ILCs and the effects of ox-LDL on ILCs in vitro were analyzed. Our results showed that the levels of ILC1 increased while the levels of ILC2 decreased in patients with ACI compared with controls. Serum levels of ox-LDL, LDL-C, and biochemical biomarkers correlated positively with the levels of ILC1 and ILC1/ILC2 ratio but negatively with the levels of ILC2. The in vitro incubation of peripheral blood mononuclear cells (PBMC) with ox-LDL resulted in an elevation of the levels of ILC1s and a marked reduction in the levels of ILC2s in a dose-dependent manner. ILC1s and ILC2s were more susceptible to ox-LDL-mediated alterations in patients with ACI than in controls. Furthermore, the expression of Interleukin 18 (IL-18), IL-33 and IL-23 in PBMCs was detected by real-time PCR, which showed the change trends of related key cytokines were highly consistent with the variation of ILC subsets. These results suggested that the levels of ILC1s and ILC2s appeared to be a novel, sensitive indicator for diagnosing ACI. Ox-LDL directly affected ILC1s and ILC2s, thus contributing to the alternations of ILC1 and ILC2 and occurrence of ACI.
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T-helper 17 (Th17) cells produce Interleukin-17 (IL-17) that plays an important role in host-defense. However, little is known whether aging affects the functions of human Th17 cells. In this study, we examine age-associated alteration in Th17-cell response; correlation between Th17-cells and endothelial cell senescence; and the occurrence of acute cerebral infarction (ACI). First, we examined Th17-frequency, phenotyping, key transcription factors, and relevant cytokines in healthy elderly, middle-aged and young-people along with elderly-patients with ACI. We detected levels of endothelial cell senescence markers in mRNA and inflammatory biomarker in serum among the groups. Correlations of Th17 frequency to levels of cytokines and endothelial cell senescence biomarkers have been analyzed. Finally, effects of IL-17 on endothelial cell senescence were explored in vitro. Our study demonstrated that healthy elderly-people have an increased Th17 frequency, RORγt expression and Th17 related cytokines (IL-17, IL-6) levels in peripheral blood compared to healthy middle-aged and young-people. Furthermore, elderly-ACI patients also have an increased Th17 expression as compared to healthy elderly-people. There was no significant difference in levels of memory Th17 frequency among the 4 groups, indicating that IL-17 is mainly produced by memory CD4+ T cells. There were no significant correlations between Th17 frequencies, levels of cytokines, inflammatory biomarkers in serum and endothelial cell senescence biomarkers in mRNA. Cell experiments about human umbilical vein endothelial cells (HUVECs) co-culture with IL-17 demonstrated that IL-17 promotes endothelial cell senescence which is closely related to ACI occurrence. Our results suggested that aging and ACI occurrence strengthen Th17-cell response. Th17/IL-17 may promote endothelial cell senescence, subsequently contributing to ACI occurrence in humans.