Patient-related factors related to prolonged preparation-to-colonoscopy interval and insufficient purgative intake before colonoscopy: A post-hoc observational study.

OBJECTIVES: Prolonged preparation-to-colonoscopy (PC) interval and insufficient purgative intake (PI) are two important indicators for quality of bowel preparation for colonoscopy. We aimed to investigate patient-related factors associated with increased PC interval or insufficient PI. METHODS: The post-hoc regression analyses were performed using the data from two prospective studies (NCT04434625 and NCT04101097). Patients receiving reinforced instructions for bowel preparation were recruited. The co-primary outcomes included prolonged PC interval or insufficient PI. RESULTS: Altogether 1806 patients from five endoscopic centers underwent bowel preparation from September 2019 to March 2021. The cut-off values were 6 h for PC interval and 80% for PI. In all, 116 (6.4%) and 73 (4.0%) presented an extended PC interval and insufficient PI, respectively. Multivariate logistic regression analysis showed that a low education level was significantly associated with PC interval ≥6 h. Female sex, body mass index (BMI), and coronary artery disease (CAD) were found to be significantly correlated with insufficient PI in univariate analysis, while multivariate analysis demonstrated BMI <20 kg/m2 (odds ratio [OR] 4.14, 95% confidence interval [CI] 1.92-8.94, P < 0.001) and 20-25 kg/m2 (OR 2.23, 95% CI 1.33-3.73, P = 0.002) and CAD (OR 3.23, 95% CI 1.22-8.53, P = 0.018) were identified as independent risk factors for PI <80%. CONCLUSIONS: In spite of reinforced education, a number of patients did not follow the instructions for bowel preparation. The factors for a prolonged PC interval did not overlap with those for insufficient PI. Individualized interference may be considered in different subpopulations.

[Study on the bending strength of cast porcelain material of different linker sizes].

PURPOSE: To investigate the relationship between size of different connectors and bending strength of cast porcelain materials. METHODS: The samples were divided into 5 groups according to the area of all-porcelain materials and simulated connector. In group A, simulated connector with cast porcelain material with a cross-section of 2 mm×3 mm was selected; In group B, simulated connector with cast porcelain material with a cross-section of 2 mm×4 mm was selected; In group C, simulated connector with cast porcelain material with a cross-section of 3 mm×3 mm was selected; In group D, simulated connector with cast porcelain material with a cross-section of 3 mm×4 mm was selected; In group E, simulated connector with zirconium oxide material with a cross-section of 2 mm×3 mm was selected. The fracture load was tested using classical three-point bending experiment, statistical analysis was performed using SPSS 18.0 software package. RESULTS: For lithium disilicate cast porcelain, the fracture load increased with increasing cross section area, but both below the shear zirconia fracture load with a cross section of 2 mm×3 mm(P＜0.05).The increase in width increased the fracture load of porcelain samples compared to the length. CONCLUSIONS: It is suitable to increase linker area when cast porcelain is applied to single-end bridge, which is especially achieved by increasing the width at the linker.

Neohesperidin enhances PGC-1α-mediated mitochondrial biogenesis and alleviates hepatic steatosis in high fat diet fed mice.

BACKGROUNDS: Mitochondria plays a critical role in the development and pathogenesis of nonalcoholic fatty liver disease (NAFLD). Neohesperidin (NHP) could lower blood glucose and prevent obesity in mice. However, the direct effect of NHP on hepatic steatosis has not been reported. METHODS: Mice were fed with either a chow diet or HFD with or without oral gavage of NHP for 12 weeks. A variety of biochemical and histological indicators were examined. In vitro cell culture model was utilized to demonstrate underlying molecular mechanism of the effect induced by NHP treatment. RESULTS: NHP increases mitochondrial biogenesis, improves hepatic steatosis and systematic insulin resistance in high fat diet (HFD) fed mice. NHP elevates hepatic mitochondrial biogenesis and fatty acid oxidation by increasing PGC-1α expression. Mechanistically, the activation of AMP-activated protein kinase (AMPK) is involved in NHP induced PGC-1α expression. CONCLUSIONS: PGC-1α-mediated mitochondrial biogenesis plays a vital role in the mitigation of hepatic steatosis treated by NHP. Our result suggests that NHP is a good candidate to be dietary supplement for the auxiliary treatment of NAFLD.

The flavonoid-rich Quzhou Fructus Aurantii extract modulates gut microbiota and prevents obesity in high-fat diet-fed mice.

BACKGROUND: Flavonoids are reported to modulate the composition of gut microbiota, which play an important role in preventing obesity and associated metabolic diseases. In this study, we investigated the effect of Total Flavonoids of Quzhou Fructus Aurantii Extract (TFQ) on gut microbial community in mice fed with a high-fat diet (HFD). METHODS: C57BL/6J mice were fed with either a chow diet or HFD with or without oral gavage of TFQ (300 mg/kg/day) for 12 weeks. RESULTS: Our data indicate TFQ significantly reduced obesity, inflammatio,n and liver steatosis. TFQ elevates the expression of tight junction proteins and reduces metabolic endotoxemia. In addition, TFQ treatment reverses HFD-induced gut dysbiosis, as indicated by the reduction of Firmicutes to Bacteroidetes ratio, the increase of genera Akkermansia and Alistipes, and the decrease of genera Dubosiella, Faecalibaculum, and Lactobacillus. CONCLUSION: These findings support a prebiotic role of TFQ as a dietary supplement for the intervention of gut dysbiosis and obesity-related metabolic disorders.

Astilbin ameliorates cisplatin-induced nephrotoxicity through reducing oxidative stress and inflammation.

Oxidative stress and inflammation are considered to be the main pathogenesis of cisplatin nephrotoxicity. Astilbin, a flavonoid with anti-oxidation and anti-inflammation function, has been used to treat heavy metal induced kidney injury. In this study, we investigated the protective effects of astilbin on cisplatin-induced nephrotoxicity and its underlying mechanisms. Our results showed that astilbin markedly inhibited cisplatin-induced cell apoptosis and recovered cell growth. Astilbin significantly decreased reactive oxygen species (ROS) accumulation and alleviated ROS-induced activation of p53, MAPKs and AKT signaling cascades, which in turn attenuated cisplatin-induced HEK-293 cell apoptosis. Astilbin effectively enhanced NRF2 activation and transcription of its targeting antioxidant genes to reduce ROS accumulation in cisplatin-induced HEK-293 cells. Furthermore, we found that astilbin obviously suppressed tumor necrosis factor alpha (TNF-α) expression and NF-κB activation, and also inhibited the expression of induced nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Finally, we confirmed that the effect of astilbin to improve renal oxidative stress and inflammation in cisplatin induced acute nephrotoxic mice. In conclusion, our study suggests that astilbin could ameliorate the cisplatin-induced nephrotoxicity by reducing oxidative stress and inflammation.

The effect of intravenous immunoglobulin passive immunotherapy on unexplained recurrent spontaneous abortion: a meta-analysis.

The aim of this study was to investigate the effect of passive immunotherapy using intravenous immunoglobulin (IVIG) on unexplained recurrent spontaneous abortion (RSA). Live birth rates were analysed and binary data were calculated using risk ratio and 95% confidence interval. Meta-analysis of 11 studies showed that the difference in the live birth rate between the IVIG treatment and placebo groups was on the margin of significance (RR = 1.25, 95% CI 1.00 to 1.56, P = 0.05). Both cumulative and trial sequential meta-analyses indicated potential beneficial effect of IVIG but the evidence was inconclusive. Subgroup analysis showed that the live birth rate in primary (RR = 0.88, 95% CI 0.71 to 1.07) and secondary (RR = 1.26, 95% CI 0.99 to 1.61) RSA patients was not significantly different between the IVIG and placebo groups. Live birth rate was significantly different when IVIG was administered before conception (RR = 1.67, 95% CI 1.30 to 2.14, P < 0.0001) but not after implantation (RR = 1.10, 95% CI 0.93 to 1.29). Evidence is insufficient to support the beneficial effects of IVIG on an unexplained RSA. Further high quality studies are needed to elucidate the effectiveness of IVIG.

[A study on correlation between sperm DNA fragmentation index and age of male, various parameters of sperm and in vitro fertilization outcome].

OBJECTIVE: To study the correlation between sperm DNA fragmentation index (DFI), age of male, various parameters of sperm, rates of fertilization, high quality embryo and pregnancy and implantation rates. METHODS: One hundred and eleven infertile couples were selected randomly, and DFI was tested by flow cytometry for the sperm used for IVF. The patients were divided into different groups according to the DFI scores. The results of each group were analyzed. RESULTS: The IVF normal fertilization was significantly lower in couples with sperm DFI over 10% (60.5%) than that in couples with DFI below 10% (70.1%) (P<0.05). Significantly positive correlation was found between DFI and the age of male (r=0.624, P<0.05). DFI was also significantly negatively correlated with the percentage of linearly progressive sperm (r=-0.360, P<0.05). There was no significant correlation between the rates of high quality cleaved embryos, pregnancy and implantation rate and sperm DFI. CONCLUSION: DFI scores are increased with male's age, and it can influence the sperm motility. DFI=10% can be considered as a critical point which can be used to estimate the clinical fertility rate of IVF. But it could not provide relative information about the rates of high quality embryos and pregnancy for infertile couples undergoing IVF procedure.