Effectiveness and safety of digital rectal stimulation and abdominal massage for neurogenic bowel dysfunction in stroke patients: a randomized controlled trial protocol.

BACKGROUND: Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, duration of hospitalization, medical expenses, and even mortality. Although current guidelines suggest a conservative strategy for addressing bowel dysfunction, which includes techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of interventions remains limited in healthcare facilities. METHODS: This study follows a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be 6 weeks. The primary outcome measures will be the Wexner score. Furthermore, secondary outcomes measure will be assessed, including Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence Quality of Life (FI-QoL). DISCUSSION: This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD. The findings will provide information that can contribute to the formulation of bowel management strategies. TRIAL REGISTRATION: The study has been registered in the Chinese Clinical Registry under the number ChiCTR2300071709. This registration was completed on May 23, 2023. All items from the World Health Organization Trial Registration Data set are described in this manuscript.

Identification and validation of a novel prognostic circadian rhythm-related gene signature for stomach adenocarcinoma.

Circadian rhythm genes were reported to be strongly associated with the development and prognosis of circadian rhythm disorders related to stomach adenocarcinoma (STAD), which is one of the most prevalent cancers. This study aimed to identify a circadian rhythm-related gene signature that could help predict STAD outcome. Using bioinformatics analysis approaches, 105 genes were examined in 350 patients with STAD. Overall, six hub-type circadian rhythm-associated genes (GNA11, PER1, SOX14, EZH2, MAGED1, and NR1D1) were identified using univariate and multivariate Cox regression analyses. These genes were then used to build a genetic predictive model, which was further validated using a publicly available dataset (GSE26899). Overall, genes associated with the circadian rhythm were found to be substantially correlated with the characteristics of the STAD patients (grade, sex, and M stage). In addition, the circadian rhythm-related gene signature was significantly associated with the MAPK and Notch signaling pathways, which are known risk factors for poorer STAD outcome. Taken together, these findings suggest that the herein proposed prognostic model based on six circadian rhythm-associated genes may have predictive value and potential application for clinical decision-making and for personalized treatment of STAD.

Temporal metabolite responsiveness of microbiota in the tea plant phyllosphere promotes continuous suppression of fungal pathogens.

INTRODUCTION: A broad spectrum of rhizosphere bacteria and fungi were shown to play a central role for health, fitness and productivity of their host plants. However, implications of host metabolism on microbiota assembly in the phyllosphere and potential consequences for holobiont functioning were sparsely addressed. Previous observations indicated that tea plants might reduce disease occurrence in various forests located in their proximity; the underlying mechanisms and potential implications of the phyllosphere microbiota remained elusive. OBJECTIVES: This study aimed atdeciphering microbiome assembly in the tea plant phyllosphere throughout shoot development as well as elucidating potential implications of host metabolites in this process. The main focus was to explore hidden interconnections between the homeostasis of the phyllosphere microbiome and resistance to fungal pathogens. METHODS: Profiling of host metabolites and microbiome analyses based on high-throughput sequencing were integrated to identify drivers of microbiome assembly throughout shoot development in the phyllosphere of tea plants. This was complemented by tracking of beneficial microorganisms in all compartments of the plant. Synthetic assemblages (SynAss), bioassays and field surveys were implemented to verify functioning of the phyllosphere microbiota. RESULTS: Theophylline and epigallocatechin gallate, two prevalent metabolites at the early and late shoot development stage respectively, were identified as the main drivers of microbial community assembly. Flavobacterium and Myriangium were distinct microbial responders at the early stage, while Parabacteroides and Mortierella were more enriched at the late stage. Reconstructed, stage-specific SynAss suppressed various tree phytopathogens by 13.0%-69.3% in vitro and reduced disease incidence by 8.24%-41.3% in vivo. CONCLUSION: The findings indicate that a functional phyllosphere microbiota was assembled along with development-specific metabolites in tea plants, which continuously suppressed prevalent fungal pathogens. The insights gained into the temporally resolved metabolite response of the tea plant microbiota could provide novel solutions for disease management.

Mind-body therapies for older adults with dementia: a systematic review and meta-analysis.

PURPOSE: This systematic review of randomised controlled trials (RCTs) aimed to determine the effects of mind-body therapies (MBTs) among older adults with dementia. METHODS: We searched five electronic databases (PubMed, PsycINFO, Web of Science, EMBASE, and the Cochrane Library) for publications investigating the effect of MBTs until July 14th, 2020. We included published peer-reviewed RCTs among participants with a mean age of 60 and above and a diagnosis of any dementia. Eligible studies included measurements for all types of health outcomes, including cognitive function, neuropsychiatric inventory, depressive syndromes, agitation, psychosocial status, and other health outcomes. Two investigators extracted data, the risk of bias for each study was evaluated through Review Manager, and statistical meta-analysis was performed using Stata. RESULTS: A total of nine studies met the eligibility criteria, with full-text available for systematic review. Five of them, with 338 participants, were included in the meta-analysis. For most included RCTs of the review, the methodological quality was moderate. The meta-analysis showed that Tai Chi had a mild effect on global cognitive function (Mini-Mental State Examination, SMD = 0.40, 95% CI 0.10-0.70). Yoga and aromatherapy may also be beneficial for depression, and these three MBTs improved quality of life. CONCLUSION: The current review suggested that MBTs may act as potential non-pharmaceutical approaches to improve certain health outcomes among older populations with dementia. Systematic review and meta-analysis registration: PROSPERO CRD42021198514.

Kidney-targeted baicalin-lysozyme conjugate ameliorates renal fibrosis in rats with diabetic nephropathy induced by streptozotocin.

BACKGROUND: Diabetic nephropathy (DN) is one of the most common and serious complications of diabetes, and is the most important cause of death for diabetic patients. Baicalin (BAI) has anti-oxidative, anti-inflammatory and anti-apoptotic activities, which play a role in attenuating insulin resistance and protecting the kidney. Moreover, cell-specific targeting of renal tubular cells is an approach to enhance drug accumulation in the kidney. METHODS: Forty-five Sprague-Dawley rats were divided into four groups. A diabetes model was created using streptozotocin (STZ) intraperitoneally injection. The four groups included: Control group (n = 10), DN (n = 15), BAI treatment (BAI; n = 10) and BAI-LZM treatment (BAI-LZM; n = 10) groups. In the current study, the renoprotection and anti-fibrotic effects of BAI-lysozyme (LZM) conjugate were further investigated in rats with DN induced by STZ compared with BAI treatment alone. RESULTS: The results suggest that BAI-LZM better ameliorates renal impairment, metabolic disorder and renal fibrosis than BAI alone in rats with DN, and the potential regulatory mechanism likely involves inhibiting inflammation via the nuclear factor-κB signaling pathway, inhibiting extracellular matrix accumulation via the transforming growth factor-ß/Smad3 pathway and regulating cell proliferation via the insulin-like growth factor (IGF)-1/IGF-1 receptor/p38 Mitogen-activated protein kinase (MAPK) pathway. BAI and the kidney-targeted BAI-LZM can utilize the body's cytoprotective pathways to reactivate autophagy (as indicated by the autophagy markers mechanistic target of rapamycin and sirtuin 1 to ameliorate DN outcomes. CONCLUSIONS: Our data support the traditional use of S. baicalensis as an important anti-DN traditional chinese medicine (TCM), and BAI, above all BAI-LZM, is a promising source for the identification of molecules with anti-DN effects.

Double-layer substrate of shale ceramsite and active alumina tidal flow constructed wetland enhanced nitrogen removal from decentralized domestic sewage.

This study explored the application of shale ceramsite (SC) overlaid onto active alumina (AA) to function as a double-layer substrate in tidal flow constructed wetland (TFCW, SC-AA-TFCW) for decentralized domestic sewage treatment. This was compared to AA or SC substrate alone (AA-TFCW or SC-TFCW) for nitrogen removal, variation of dissolved oxygen and porosity in TFCWs, as well as structure of bacterial communities at varied hydraulic load (HL) of 0.204-2.448 m3/m2 d with time ratio of the wet and dry phase of 3:1. The results demonstrate that SC-AA-TFCW removed 86% NH4+-N and 79% total nitrogen at HL of 0.612 m3/m2 d, which was better than AA-TFCW(76%) or SC-TFCW(49%). The higher nitrogen removal performance in SC-AA-TFCW was mainly attributed to enhanced oxygen transportation due to non-uniform flow field and irregular gap distribution in layered structure, as well as less pore blockage during long-term operation. Denitrifying bacteria including Dechloromonas, Acidovorax, Chryseobacterium and Thermomonas species took up 32% of the microbiome in SC-AA-TFCW, which was higher than in AA-TFCW (17%) and SC-TFCW (7.7%). This study highlighted the importance of layered structures and determined an optimal HL of TFCW to achieve an efficient and stable nitrogen removal for domestic sewage treatment.

Enhanced simultaneous organics and nutrients removal in tidal flow constructed wetland using activated alumina as substrate treating domestic wastewater.

A tidal flow constructed wetland (TFCW), a commonly applied system to clean wastewater, contains a substrate to assist pollutants removal, while the choice of substrate affects the formation of bacterial biofilms. Herein, activated alumina-TFCW (A-TFCW) with hydraulic load of 1.35 m3/(m2·d) parallel with shale ceramisite (S-TFCW) was investigated for treating domestic wastewater, aiming to enhance simultaneous long-term removal of organics, nitrogen and phosphorus. A-TFCW achieved significantly higher COD, NH4+-N, TN and TP removal efficiency than S-TFCW, with the removal efficiency of 85.9% COD, 85.4% NH4+-N, 72.8% TN and 96.4% TP respectively. Denitrifying bacteria dominated in both formed biofilms, with higher relative abundance of nitrifying bacteria and denitrifying bacteria in A-TFCW. These results demonstrated that AA substrate was more suitable to be applied in enhancing the removal performance in TFCW for the treatment of domestic wastewater.

[Clinical research of vasospasm and vagus reflex during radial artery puncture treated with auricular point sticking].

OBJECTIVE: To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS). METHODS: A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan (AH6a), Shenmen (TF4), Pizhixia (AT4), Neifenmi (CO18), Xin (CO15), Shen (CO10), Shenshangxian (TG2p), 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections. RESULTS: The incidence of angiospasm was 4.9% (11/224) in the observation group, which was lower than 13.3% (34/256) in the control group (P<0.01). The incidence of vagal reflex of the observation group was 7.1% (16/224), which was lower than 19.5% (50/256) of the control group (P<0.01). The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6% (8/224), 7.1% (16/224), 6.3% (14/224) respectively in the observation group, which were lower than 14.8% (38/256), 15.6% (40/256), 15.2% (39/256) in the control group (all P<0.01). . CONCLUSION: Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.

[Microbial Population Dynamics During Sludge Granulation in a Simultaneous Nitrogen and Phosphorus Removal System].

In this study, domestic sewage was utilized to cultivate aerobic granular sludge (AGS) in a simultaneous nitrogen and phosphorus removal (SNPR) system. The bacterial population dynamics during the aerobic sludge granulation were investigated to reveal the granulation mechanisms using Illumina MiSeq PE300 high-throughput sequencing. Quantitative real time polymerase chain reactions (PCR) were used to investigate shifts in the abundance of ammonia-oxidizing bacteria (AOB), ammonia-oxidizing archaea (AOA), nitrite-oxidizing bacteria (NOB) and polyphosphate accumulating organisms (PAOs). After cultivation for 100 d, the AGS was compact and demonstrated good SNPR performance. During the AGS formation process, extracellular polysaccharides obviously increased, while extracellular proteins kept relatively stable. The abundance of AOA significantly decreased during the formation of AGS process, while the abundance of PAOs increased. The bacterial diversity increased at first and then decreased during the formation of AGS. The bacterial community changed dramatically during aerobic sludge granulation. Persistent operational taxonomic units (OTUs) accounted for 92.70% of the total sequences. Proteobacteria (31.07%-53.67%), Bacteroidetes (6.70%-16.50%) and Chloroflexi (7.84%-13.36%) were the dominant phyla. Candidatus competibacter was obviously enriched in the AGS formation process (increased from 0.11% in the seed sludge to 35.33% in the AGS) and may play an important role in the formation of AGS.

[Observation on clinical therapeutic effect of acupuncture on upper limb spasticity in the patient of poststroke].

OBJECTIVE: To observe therapeutic effect of acupuncture at acupoints selected according to rehabilitation medical theory on upper limb spasticity in the patient of poststroke. METHODS: Sixty cases were randomly divided into an acupuncture group and an electro-stimulation group, 30 cases in each group. The acupuncture group were treated by acupuncture at the contralateral scalp motor region of the affected limb, Jiquan (HT 1), Chize (LU 5), Daling (PC 7) on the flexor side and Jianyu (LI 15), Tianjing (TE 10), Yangchi (TE 4) on the extensor muscle side of the affected limb; the electro-stimulation group were treated by electric stimulation. The two groups also were treated with necessary medical treatment and anti-spasm rehabilitation motor training. The course was 3 weeks. Modified Ashworth Scale for muscle spasm (MAS), modified Fugl-Meyer Assessment (FMA) for upper limb motor function, and Modified Barthel Index (MBI) for ability of daily living were used for assessment of the therapeutic effect. RESULTS: After treatment, the spasm was significantly alleviated, the motor function of the upper limb and daily living ability were significantly increased (P<0.01) in the two groups; after treatment, BMI scores in the acupuncture group was very significantly superior to that in the electro-stimulation group. The total effective rate was 93.3% in the acupuncture group and 86.7% in the electro-stimulation group, with no significant difference between the two groups. CONCLUSION: Proper acupuncture is an effective method for upper limb spasm in the patient of poststroke, and the therapeutic effect is better for mild-moderate spasm of the upper limb.