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This paper summaries the Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E), a tool for evaluating risk of bias about non-randomized studies of exposures (NRSE), and introduces the application of ROBINS-E in a published NRSE. According to the characteristics of NRSE, evaluation fields and signaling questions were designed in ROBINS-E to provide essential information about risk of bias for NRSE included in systematic reviews and GRADE. ROBINS-E is the tool in assessment of risk of bias in observational studies and quasi-randomized studies. Although the tool has been used in practice to some extent, but it still needs further improvement. Attention should be paid to its update and progress.
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Humans , Bias , Environmental Exposure , Systematic Reviews as TopicABSTRACT
BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.
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Humans , COVID-19 , Medicine, Chinese Traditional , Network Meta-Analysis , Pandemics , SARS-CoV-2ABSTRACT
Objective@#To evaluate the effects of incretin-based therapies on body weight as the primary outcome, as well as on body mass index (BMI) and waist circumference (WC) as secondary outcomes.@*Methods@#Databases including Medline, Embase, the Cochrane Library, and clinicaltrials.gov (www.clinicaltrials.gov) were searched for randomized controlled trials (RCTs). Standard pairwise meta-analysis and network meta-analysis (NMA) were both carried out. The risk of bias (ROB) tool recommended by the Cochrane handbook was used to assess the quality of studies. Subgroup analysis, sensitivity analysis, meta-regression, and quality evaluation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were also performed.@*Results@#A total of 292 trials were included in this study. Compared with placebo, dipeptidyl-peptidase IV inhibitors (DPP-4Is) increased weight slightly by 0.31 kg [95% confidence interval ( ): 0.05, 0.58] and had negligible effects on BMI and WC. Compared with placebo, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lowered weight, BMI, and WC by -1.34 kg (95% : -1.60, -1.09), -1.10 kg/m (95% : -1.42, -0.78), and -1.28 cm (95% : -1.69, -0.86), respectively.@*Conclusion@#GLP-1 RAs were more effective than DPP-4Is in lowering the three indicators. Overall, the effects of GLP-1 RAs on weight, BMI, and WC were favorable.
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AlM:To investigate the expression transforming growth factor-β1 (TGF-β1) and heat shock protein 47 (HSP-47), in pterygium and normal conjunctiva tissues, in order to study the roles of these cytokines played in the pathogenesis in human pterygium. METHODS:The expression difference of TGF-β1, HSP-47 between human pterygium and normal conjunctive tissues were compared by immuno - histochemistry technique. RESULTS:The positive expression of TGF-β1, HSP-47 was stronger than in normal conjunctive tissues ( P CONCLUSlON:Over-expression of TGF-β1 and HSP-47 in pterygium compared to the normal conjunctiva tissues may play a critical role during the occurrence, development and invasion of the pterygium.
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<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis, and prognostic factors of testicular diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical and pathologic profiles of 58 cases of testicular DLBCL were investigated.Immunohistochemical stainings and EBER1/2 in situ hybridization were performed on formalin fixed tissues.</p><p><b>RESULTS</b>The average age of the patients was 62.1 years, and the median age was 65 years. The course of disease was short in most of the cases. Clinical stages at diagnosis were mainly stage I or II (87.9%, 51/58). Forty eight patients (82.8%) had unilateral testis involvement. Inguinal lymphadenopathy was observed in 12 (20.7%) patients and the other organs were seldom involved. Morphologically, centroblast-like neoplastic cells infiltrated interstitial tissue of testis diffusely and invaded into seminiferous tubules. Tunica albuginea and vessels were involved in 14 (24.1%) and 10 (17.2%) patients, respectively. Immunophenotype analysis showed predominant non-GCB type of DLBCL (48/58, 82.8%) by Hans classification. No EBV infection was detected. Follow-up data were available in 48 (82.8%) patients. Twenty eight patients (58.3%) died of the disease. One-year, 3-year, and 5-year overall survivals were 55.7%, 31.6% and 27.6%, respectively. Age (older than 60 years), B-symptoms, high serum level of LDH, advanced Ann Arbor stage as well as lack of combination of therapy were associated with a poor prognosis.</p><p><b>CONCLUSIONS</b>This large series of testicular DLBCL mainly present with local disease at diagnosis. Most cases show non-GCB immunophenotype. Despite early clinical stage at presentation, the prognosis is poor. Combined chemotherapy postoperation may prolong survival of the patients.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cyclophosphamide , Therapeutic Uses , Doxorubicin , Therapeutic Uses , Follow-Up Studies , Immunophenotyping , Interferon Regulatory Factors , Metabolism , Lactate Dehydrogenases , Metabolism , Lymphatic Metastasis , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Allergy and Immunology , Pathology , General Surgery , Neoplasm Staging , Neprilysin , Metabolism , Orchiectomy , Prednisone , Therapeutic Uses , Proto-Oncogene Proteins c-bcl-6 , Metabolism , Survival Rate , Testicular Neoplasms , Drug Therapy , Allergy and Immunology , Pathology , General Surgery , Vincristine , Therapeutic UsesABSTRACT
Objective: To construct a three-dimensional (3D) anatomic model of the lateral ventricles for teaching microneurosurgical anatomy and clinical surgery planning. Methods: The 3D model was constructed with a series of 176 MRIT2 head sections of a healthy male volunteer (36 years old) using software Matlab, Geomagic, Maya, etc. The 176 sections were subjected to management with software Matlab for image preprocessing and contour extracting; the acquired contours were subjected to software geomagic for 3D model constructing,3D-model and image connecting and other processings. Results: The 3D model of the lateral ventricles and related structures were successfully constructed using more than 240,000 remodeled polygons, and the contour of the model consisted well with the images. The model had a even better visual effect after combining the 3D-model and image. The model could be viewed from any angle and could be rotated by 360 degrees in any plane using any structure as the focal point of rotation. Moreover, the model could be reduced or enlarged using the zoom function. Conclusion: The constructed 3D model can be observed and studied repeatedly at any time, with no stress from surgery. The model may be used for interactive surgical exercises, paving a way for subsequent clinical practice.
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Objective To study the infection status and the molecular characteristics of Vibrio parahaemolyticus isolated from diarrheal patients in Shenzhen, in 2007 to 2008 and to provide evidence for the prevention and control of diarrheal diseases caused by Vibrio parahaemolyticus. Methods More than 80 fecal specimens from four sentinel surveillance hospitals were collected and cultured each month. A total of 361 isolates of Vibrio parahaemolyticus were sero-typed and examined by real-time PCR for the presence of two major virulence genes, tdh and trh. Of 361 strains, 60 O3: K6 strains isolated from six suspected outbreaks in August, 2007 and in September, 2008 were typed by pulsed-field gel electrophoresis (PFGE). Results 4384 stool samples were detected in four sentinel surveillance hospitals and with 361 Vibrio parahaemolyticus strains isolated that belonged to 28 serotypes. Serotype O3:K6, O4:K8 and O1:KUT accounted for 67.90%, 7.50% and 6.10%, respectively. Of 361 strains, 337 strains belonged to tdh + trh- , 11 strains were tdh-trh- and 13 strains were tdh + trh +. The most prevalent serotype which caused diarrheal diseases was tdh + trh-in Shenzhen. The 60 isolates were discriminated into twenty different PFGE patterns, which belonged to three clones. Among the 60 isolates, most of the PFGE patterns of isolates from the suspected outbreak locations were identical and some strains isolated from different year were different. Conclusion Vibrio parahaemolyticus isolates in Shenzhen were dominated by O3:K6 strains. Most of these isolates carried tdh gene and few carried trh gene. Meanwhile, the identical patterns of isolates from 6 suspected outbreaks locations demonstrated that Vibrio parahaemolyticus outbreaks occurred in July 2007 and in September 2008 in Shenzhen. However, the dominated strains' PFGE patterns were different each year, indicating that the sources of Vibrio parahaemolyticus had a multiplex nature and the multiplex sources such as water, sea food and pickled products should be integrated monitored. Laboratory based surveillance of diarrheal diseases could contribute in establishing early warning system for the better prevention and control of diarrheal diseases.
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The phyA(m) gene encoding acid phytase and optimized neutral phytase phyCs gene were inserted into expression vector pPIC9K in correct orientation and transformed into Pichia pastoris in order to expand the pH profile of phytase and decrease the cost of production. The fusion phytase phyA(m)-phyCs gene was successfully overexpressed in P. pastoris as an active and extracellular phytase. The yield of total extracellular fusion phytase activity is (25.4+/-0.53) U/ml at the flask scale and (159.1+/-2.92) U/ml for high cell-density fermentation, respectively. Purified fusion phytase exhibits an optimal temperature at 55 degrees C and an optimal pH at 5.5~6.0 and its relative activity remains at a relatively high level of above 70% in the range of pH 2.0 to 7.0. About 51% to 63% of its original activity remains after incubation at 75 degrees C to 95 degrees C for 10 min. Due to heavy glycosylation, the expressed fusion phytase shows a broad and diffuse band in SDS-PAGE (sodium dodecyl sulfate-polyacrylamide gel electrophoresis). After deglycosylation by endoglycosidase H (EndoH(f)), the enzyme has an apparent molecular size of 95 kDa. The characterization of the fusion phytase was compared with those of phyCs and phyA(m).
Subject(s)
6-Phytase , Genetics , Metabolism , Amino Acid Sequence , Fermentation , Genetic Vectors , Molecular Sequence Data , Pichia , Genetics , Recombinant Fusion ProteinsABSTRACT
<p><b>OBJECTIVE</b>To investigate the genetic diversity of Ganoderma cultivars provided for the genuineness study, germ-plasm resource identification, genetic relationship study, breeding, introduction and cultivante of Ganoderma strains.</p><p><b>METHOD</b>With the software of NTSYSpc 2. 1, 24 materials, of G. lucidum and G. sinense, were studied using AFLP to construct the dendrogram.</p><p><b>RESULT</b>There were 177 polymorphic bands with 14 primer combinations. And all materials could be identified with AFLP.</p><p><b>CONCLUSION</b>There actually existed much genetic diversity at the molecular level among the germplasm resources of Ganoderma strains, and all the strains were clustered into G. lucidum group and G. sinense group at the similarity coefficient 0. 676.</p>
Subject(s)
Amplified Fragment Length Polymorphism Analysis , China , Cluster Analysis , DNA Primers , DNA, Fungal , Genetics , Ganoderma , Classification , Genetics , Genetic Variation , Phylogeny , Reishi , GeneticsABSTRACT
Objective: To evaluate hemostatic effects of a self-designed rapid-hemostatic-dressing (RHD) on bleeding of the partially ruptured superior sagittal sinus in dogs. Methods: Bleeding models of the partially ruptured superior sagittal sinus were established in 15 dogs by gunshot and surgery. The 15 model dogs were divided into 2 groups: RHD group (n=10) and control group (treated with surgicel, n=5). The survival time, blood loss, and other hematological parameters were measured over a 1-hour period. Results: The bleeding models of the partially ruptured superior sagittal sinus were successfully established in dogs. There were no significant differences in the baseline parameters of dogs compared with those 60 minutes after RHD treatment. The survival time in RHD group was significantly longer than that in control group and the blood loss was significantly lower than that of the control group (both P<0.05). Conclusion: RHD has satisfactory hemostatic effects on partially ruptured superior sagittal sinus in dogs, indicating it is an excellent hemostatic dressing.
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<p><b>OBJECTIVE</b>To investigate the metabolic regulation and apoptosis of Sailong bone extracts on rat osteoblast cells in vitro.</p><p><b>METHOD</b>Sailong bone fat-soluble extract, Sailong bone ethanol extract and Sailong bone aqueous extract were extracted with super critical fluid extraction (SCFE) , and Sailong bone boiling water component was extracted with distilled water directly. MTT assay was applied to determine the proliferation of the cell promoted by four Sailong bone extracts and PAS assay for the aqueous proportion of the cell at different doses.</p><p><b>RESULT</b>Sailong bone fat-soluble and aqueous extract (each 10 mg x mL (-1)) could significantly improve the proliferation of rat osteoblast cells ROS 17/2. 8 (P < 0. 01). Compared with the blank, the proportion of xub-G, of the different extracts from Sailong bone is reduce evidently. The result have shown the extracts from Sailong bone could reduce the rate of aqueous of cell and could suspend the aqueous.</p><p><b>CONCLUSION</b>Sailong bone can promoting the proliferation, degrading the rate of the apoptosis and delay the development of osteoblast to be the substitute of the bone of tiger as a Chinese materia medica.</p>
Subject(s)
Animals , Rats , Apoptosis , Bone and Bones , Chemistry , Cell Proliferation , Cells, Cultured , Dose-Response Relationship, Drug , Materia Medica , Pharmacology , Osteoblasts , Cell Biology , Rodentia , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To study the effect of Spatholobus suberectus on proliferation and the hematonic mechanism.</p><p><b>METHOD</b>The techniques of culture of hematopoietic cell and hematopoietic growth factor (HGF) assay were used.</p><p><b>RESULT</b>Spatholobus suberectus could obviously promote the proliferation of bone marrow cells in healthy and anaemic mice. The culture media of spleen cell, macrophage, lung and skeletal muscle treated with S. suberectus had much stronger stimulating effects on hematopoietic cells.</p><p><b>CONCLUSION</b>S. suberectus may enhance hematopoiesis by directly or indirectly stimulating stroma cell in hematopoietic inductive microenvironment and muscle tissue to secrete some HGF (Epo, GM-CSF, IL, and MK-CSF). This is one of the biological mechanisms for hematonic effect of S. suberectus.</p>
Subject(s)
Animals , Female , Male , Mice , Anemia , Pathology , Bone Marrow Cells , Cell Biology , Cell Proliferation , Colony-Stimulating Factors , Metabolism , Drugs, Chinese Herbal , Pharmacology , Fabaceae , Chemistry , Plant Stems , Chemistry , Plants, Medicinal , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To elucidate the molecular mechanism of Wendan Tang in prevention of lipid metabolism disorder in adult rats.</p><p><b>METHOD</b>On the basis of hyperlipidemia rat models, triglycerides (TG), total cholesterol (TC) in serum, activities of lipase (LA), lipoprotein lipase (LPL), hepatic lipase (HL) in liver, parts of hemogram and hepatic LDLR mRNA levels were investigated 21 days after the feeding of atherogenic diet.</p><p><b>RESULT</b>Wendan Tang significantly reduced the serum TG, TC and increased the activity of LPL and LA, but caused no chang in HL. The result of RT-PCR test showed that high fat and high cholesterol feeding could significantly induce the reduction of LDLR mRNA levels, while Wendan Tang could increase hepatic LDLR density.</p><p><b>CONCLUSION</b>Wendan Tang can prevent disorder of lipid metabolism by regulating TC, TG, LDL-c through upregaulation of LDLR transcription level and improving antioxidant ability.</p>