Regional anaesthesia education for consultants and specialists in the UK: a mixed-methods analysis.

BACKGROUND: Regional anaesthesia plays an important role in perioperative care, but gaps in proficiency persist among consultants and specialists. This study aimed to assess confidence levels in performing Plan A blocks among this cohort and to examine the barriers and facilitators influencing regional anaesthesia education. METHODS: Utilising a mixed-methods design, we performed a quantitative survey to gauge self-reported confidence in performing Plan A blocks, coupled with qualitative interviews to explore the complexities of educational barriers and facilitators. UK consultant and specialist anaesthetists were included in the study. RESULTS: A total of 369 survey responses were analysed. Only 22% of survey respondents expressed confidence in performing all Plan A blocks. Specialists (odds ratio [OR] 0.391, 95% confidence interval [CI] 0.179-0.855, P=0.016) and those in their roles for >10 yr (OR 0.551, 95% CI 0.327-0.927, P = 0.024) reported lower confidence levels. A purposive sample was selected for interviews, and data saturation was reached at 31 interviews. Peer-led learning emerged as the most effective learning modality for consultants and specialists. Barriers to regional anaesthesia education included apprehensions regarding complications, self-perceived incompetence, lack of continuing professional development time, insufficient support from the multidisciplinary team, and a lack of inclusivity within the regional anaesthesia community. Organisational culture had a substantial impact, with the presence of local regional anaesthesia champions emerging as a key facilitator. CONCLUSIONS: This study highlights persistent perceived deficiencies in regional anaesthesia skills among consultants and specialists. We identified multiple barriers and facilitators, providing insights for targeted interventions aimed at improving regional anaesthesia education in this group.

The long noncoding RNAs lnc10 and lnc11 regulating flavonoid biosynthesis in Ginkgo biloba.

Although long non-coding RNAs have been recognized to play important roles in plant, their possible functions and potential mechanism in Ginkgo biloba flavonoid biosynthesis are poorly understood. Flavonoids are important secondary metabolites and healthy components of Ginkgo biloba. They have been widely used in food, medicine, and natural health products. Most previous studies have focused on the molecular mechanisms of structural genes and transcription factors that regulate flavonoid biosynthesis. Few reports have examined the biological functions of flavonoid biosynthesis by long non-coding RNAs in G. biloba. Long noncoding RNAs associated with flavonoid biosynthesis in G. biloba have been identified through RNA sequencing, but the function of lncRNAs has not been reported. In this study, the expression levels of lnc10 and lnc11 were identified. Quantitative real-time polymerase chain reaction analysis revealed that lnc10 and lnc11 were expressed in all detected organs, and they showed significantly higher levels in immature and mature leaves than in other organs. In addition, to fully identify the function of lnc10 and lnc11 in flavonoid biosynthesis in G. biloba, lnc10 and lnc11 were cloned from G. biloba, and were transformed into Arabidopsis and overexpressed. Compared with the wild type, the flavonoid content was increased in transgenic plants. Moreover, the RNA-sequencing analysis of wild-type, lnc10-overexpression, and lnc11-overexpression plants screened out 2019 and 2552 differentially expressed genes, and the transcript levels of structural genes and transcription factors associated with flavonoid biosynthesis were higher in transgenic Arabidopsis than in the wild type, indicating that lnc10 and lnc11 activated flavonoid biosynthesis in the transgenic lines. Overall, these results suggest that lnc10 and lnc11 positively regulate flavonoid biosynthesis in G. biloba.

China's application of the One Health approach in addressing public health threats at the human-animal-environment interface: Advances and challenges.

Background: Due to emerging issues such as global climate change and zoonotic disease pandemics, the One Health approach has gained more attention since the turn of the 21st century. Although One Health thinking has deep roots and early applications in Chinese history, significant gaps exist in China's real-world implementation at the complex interface of the human-animal-environment. Methods: We abstracted the data from the global One Health index study and analysed China's performance in selected fields based on Structure-Process-Outcome model. By comparing China to the Belt & Road and G20 countries, the advances and gaps in China's One Health performance were determined and analysed. Findings: For the selected scientific fields, China generally performs better in ensuring food security and controlling antimicrobial resistance and worse in addressing climate change. Based on the SPO model, the "structure" indicators have the highest proportion (80.00%) of high ranking and the "outcome" indicators have the highest proportion (20.00%) of low ranking. When compared with Belt and Road countries, China scores above the median in almost all indicators (16 out of 18) under the selected scientific fields. When compared with G20 countries, China ranks highest in food security (scores 72.56 and ranks 6th), and lowest in climate change (48.74, 11th). Conclusion: Our results indicate that while China has made significant efforts to enhance the application of the One Health approach in national policies, it still faces challenges in translating policies into practical measures. It is recommended that a holistic One Health action framework be established for China in accordance with diverse social and cultural contexts, with a particular emphasis on overcoming data barriers and mobilizing stakeholders both domestically and globally. Implementation mechanisms, with clarified stakeholder responsibilities and incentives, should be improved along with top-level design.

Component identification of modified sanmiao pills by UPLC-Xevo G2-XS QTOF and its anti-gouty arthritis mechanism based on network pharmacology and experimental verification.

ETHNOPHARMACOLOGICAL RELEVANCE: Modified sanmiao pills (MSMP), a traditional Chinese medicine (TCM) formula, is consisted of rhizome of Smilax glabra Roxb., Cortexes of Phellodendron chinensis Schneid., rhizome of Atractylodes chinensis (DC.) Koidz., and roots of Cyathula officinalis Kuan. in a ratio of 3:3:2:1. This formula has been broadly applied to treat gouty arthritis (GA) in China. AIMS OF THE STUDY: To elaborate the pharmacodynamic material basis and pharmacological mechanism of MSMP against GA. MATERIALS AND METHODS: UPLC-Xevo G2-XS QTOF combined with UNIFI platform was applied to qualitatively assess the chemical compounds of MSMP. Network pharmacology and molecular docking were used to identify the active compounds, core targets and key pathways of MSMP against GA. The GA mice model was established by MSU suspension injecting into ankle joint. The swelling index of ankle joint, expressions of inflammatory cytokines, and histopathological changes in mice ankle joints were determined to validate the therapeutic effect of MSMP against GA. The protein expressions of TLRs/MyD88/NF-κB signaling pathway and NLRP3 inflammasome in vivo was detected by Western blotting. RESULTS: In total, 34 chemical compounds and 302 potential targets of MSMP were ascertained, of which 28 were overlapping targets pertaining to GA. 143 KEGG enrichment pathway were obtained, of which the NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, and NF-κB signaling pathway were strongly associated with GA. In silico study indicated that the active compounds had excellent binding affinity to core targets. In vivo study confirmed that MSMP observably decreased swelling index and alleviated pathological damage to ankle joints in acute GA mice. Besides, MSMP significantly inhibited the secretion of inflammatory cytokines (IL-1ß, IL-6, and TNF-α) induced by MSU, as well as the expression levels of key proteins involved in TLRs/MyD88/NF-κB signaling pathway and NLRP3 inflammasome. CONCLUSION: MSMP possessed a pronounced therapeutic effect on acute GA. Results from network pharmacology and molecular docking showed that obaculactone, oxyberberine, and neoisoastilbin might treat gouty arthritis by down-regulating TLRs/MyD88/NF-κB signaling pathway and NLRP3 inflammasome.

Assessment of integrated patterns of human-animal-environment health: a holistic and stratified analysis.

BACKGROUND: Data-driven research is a very important component of One Health. As the core part of the global One Health index (GOHI), the global One Health Intrinsic Drivers index (IDI) is a framework for evaluating the baseline conditions of human-animal-environment health. This study aims to assess the global performance in terms of GOH-IDI, compare it across different World Bank regions, and analyze the relationships between GOH-IDI and national economic levels. METHODS: The raw data among 146 countries were collected from authoritative databases and official reports in November 2021. Descriptive statistical analysis, data visualization and manipulation, Shapiro normality test and ridge maps were used to evaluate and identify the spatial and classificatory distribution of GOH-IDI. This paper uses the World Bank regional classification and the World Bank income groups to analyse the relationship between GOH-IDI and regional economic levels, and completes the case studies of representative countries. RESULTS: The performance of One Health Intrinsic Driver in 146 countries was evaluated. The mean (standard deviation, SD) score of GOH-IDI is 54.05 (4.95). The values (mean SD) of different regions are North America (60.44, 2.36), Europe and Central Asia (57.73, 3.29), Middle East and North Africa (57.02, 2.56), East Asia and Pacific (53.87, 5.22), Latin America and the Caribbean (53.75, 2.20), South Asia (52.45, 2.61) and sub-Saharan Africa (48.27, 2.48). Gross national income per capita was moderately correlated with GOH-IDI (R2 = 0.651, Deviance explained = 66.6%, P < 0.005). Low income countries have the best performance in some secondary indicators, including Non-communicable Diseases and Mental Health and Health risks. Five indicators are not statistically different at each economic level, including Animal Epidemic Disease, Animal Biodiversity, Air Quality and Climate Change, Land Resources and Environmental Biodiversity. CONCLUSIONS: The GOH-IDI is a crucial tool to evaluate the situation of One Health. There are inter-regional differences in GOH-IDI significantly at the worldwide level. The best performing region for GOH-IDI was North America and the worst was sub-Saharan Africa. There is a positive correlation between the GOH-IDI and country economic status, with high-income countries performing well in most indicators. GOH-IDI facilitates researchers' understanding of the multidimensional situation in each country and invests more attention in scientific questions that need to be addressed urgently.

Neoisoastilbin Ameliorates Acute Gouty Arthritis via Suppression of the NF-κB/NLRP3 Pathway.

Acute gouty arthritis (AGA) is an acute inflammatory disease, whose occurrence and development mechanism are associated with inflammatory reaction of joint tissue. This study investigated the role of neoisoastilbin (NIA) in the treatment of AGA and explored the underlying mechanisms. C57BL/6 mice underwent intraarticular injection of monosodium urate (MSU) to establish an AGA model in vivo. Enzyme-linked immunosorbent assay, histopathological hematoxylin-eosin staining, western blotting, and other methods were used to observe the therapeutic effects of NIA on AGA and investigate the role of the NF-κB/NLRP3 pathway in the treatment. We found that NIA effectively reduced MSU-induced joint swelling and inflammatory cell infiltration in a concentration-dependent manner. NIA also significantly reduced interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels as compared with the respective values in the model mice group. In addition, administration of NIA significantly mitigated the phosphorylation of NF-κB-related proteins (IKKα, NF-κB, and IκBα) and the expression of NLRP3-related proteins (NLRP3, caspase-1, and ASC) in MSU-induced joint tissues. In conclusion, our research indicated that NIA significantly improved AGA, and its underlying mechanism was achieved by simultaneously inhibiting the NF-κB/NLRP3 pathway and the expression of inflammatory factors. This research preliminarily suggested the potential role of NIA in the treatment of AGA.

Effects of 6-Hydroxykaempferol: A Potential Natural Product for Amelioration of Tendon Impairment.

Tendon impairment is a common injury associated with impairment of range of motion and pain. Currently, evidence has confirmed that natural herbs contribute to orthopedics and have shown excellent results in the clinical management of tendon impairment. Shujin Huoxue tablet (SHT) and its complex prescriptions are regularly used in tendon rupture therapy with positive results. This study aimed to discover the potential molecules that promote tendon healing. The Chinese traditional medicine system pharmacological database analysis platform (TCMSP) is the primary resource. The Traditional Chinese Medicine Integrated Database and Encyclopedia of Traditional Chinese Medicine database were used as secondary databases. The GeneCards database was used to search for reported tendinopathy-related genes by keywords. Functions of the targeted genes were analyzed using Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes. Protein-protein interaction information was extracted from the STRING database. Docking study, MTT assay, quantitative real-time PCR, and migration assays were performed to obtain a better understanding of the herbs according to cell function to test the basic pharmacological action in vitro. A total of 104 disease nodes, 496 target gene nodes, 35 ingredient nodes, and one drug node were extracted. According to the TCMSP database, 6-hydroxykaempferol, which reportedly promotes the proliferation of microvascular endothelial cells, is a molecule found in SHT. We found that it promoted the proliferation and migration of tendon fibroblasts and elevated tendon repair-related gene expression. Purified 6-hydroxykaempferol promoted the proliferation and migration of tendon fibroblasts and increased their mRNA expression in tendon proliferation.

Towards a global One Health index: a potential assessment tool for One Health performance.

BACKGROUND: A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed. METHODS: We describe five steps towards a global One Health index (GOHI), including (i) framework formulation; (ii) indicator selection; (iii) database building; (iv) weight determination; and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators. RESULTS: The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8-65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible. CONCLUSIONS: GOHI-subject to rigorous validation-would represent the world's first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.

Mixed methods evaluation of the impact of the COVID-19 ICU remote-learning rehabilitation course for frontline health professionals during the COVID-19 pandemic in the UK.

Background: Optimising outcomes for critically ill patients with COVID-19 patients requires early interdisciplinary rehabilitation. As admission numbers soared through the pandemic, the redeployed workforce needed rapid, effective training to deliver these rehabilitation interventions. Methods: The COVID-19 ICU Remote-Learning Rehab Course (CIRLC-rehab) is a one-day interdisciplinary course developed after the success of CIRLC-acute. The aim of CIRLC-rehab was to rapidly train healthcare professionals to deliver physical, nutritional and psychological rehabilitation strategies in the ICU/acute setting. The course used blended learning with interactive tutorials delivered by shielding critical care professionals. CIRLC-rehab was evaluated through a mixed-methods approach, including questionnaires, and follow-up semi-structured interviews to evaluate perceived impact on clinical practice. Quantitative data are reported as n (%) and means (SD). Inductive descriptive thematic analysis with methodological triangulation was used to analyse the qualitative data from the questionnaires and interviews. Results: 805 candidates completed CIRLC-rehab. 627 (78.8%) completed the post-course questionnaire. 95% (n = 596) found CIRLC-rehab extremely or very useful and 96.0% (n = 602) said they were very likely to recommend the course to colleagues. Overall confidence rose from 2.78/5 to 4.14/5. The course promoted holistic and humanised care, facilitated informal networks, promoted interdisciplinary working and equipped the candidates with practical rehabilitation strategies that they implemented into clinical practice. Conclusion: This pragmatic solution to educating redeployed staff during a pandemic increased candidates' confidence in the rehabilitation of critically ill patients. There was also evidence of modifications to clinical care utilising learning from the course that subjectively facilitated holistic and humanised rehabilitation, combined with the importance of recognising the humanity, of those working in ICU settings themselves. Whilst these data are self-reported, we believe that this work demonstrates the real-term benefits of remote, scalable and rapid educational delivery.

Different Scores Predict the Value of Hemorrhagic Transformation after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke.

OBJECTIVE: To evaluate the value of the Alberta stroke project early CT score (ASPECTS), DRAGON score, SEDAN score, and HAT score in predicting hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS). METHODS: The clinical data of 248 AIS patients treated with intravenous thrombolysis in our hospital from December 2017 to December 2019 were analyzed. According to the prognosis, all patients were divided into the non-HT group (n = 200) and the HT group (n = 48). Univariate analysis and multivariate logistic regression models were used to analyze clinical data to determine the influencing factors of HT after intravenous thrombolysis in AIS patients. The receiver operating characteristic curve was used to evaluate the ASPECTS, DRAGON, SEDAN, and HAT scores to the value of predicting HT after intravenous thrombolysis in AIS patients. RESULTS: The lower the ASPECTS score and the higher the DRAGON, SEDAN, and HAT scores, the higher the incidence of HT after intravenous thrombolysis in AIS patients (P < 0.05). The results of multivariate logistic regression analysis showed that the patient's age, atrial fibrillation, baseline NIHSS score, early signs of infarction on admission with head CT, time from onset to thrombolytic therapy, and thrombolytic drugs were all independent factors affecting intravenous thrombolysis in AIS patients (P < 0.05). The area under the curve (AUC) of the predictive value of ASPECTS for HT is 0.895 (95% CI 0.813-0.977). When the optimal cutoff value is 0.607, the sensitivity is 100% and the specificity is 60.7%. The AUC of the predictive value of DRAGON for HT is 0.877 (95% CI 0.790-0.964). When the optimal cutoff value is 0.665, the sensitivity is 84.4% and the specificity is 82.1%. The AUC of the predictive value of SEDAN for HT is 0.764 (95% CI 0.638-0.890). When the optimal cutoff value is 0.474, the sensitivity is 78.6% and the specificity is 68.8%. The AUC of the predictive value of HAT for HT is 0.777 (95% CI 0.651-0.903). When the optimal cutoff value is 0.509, the sensitivity is 68.8% and the specificity is 82.1%. CONCLUSION: The lower the ASPECTS score and the higher the DRAGON, SEDAN, and HAT scores, the higher the incidence of HT in AIS patients. The patient's age, atrial fibrillation, baseline NIHSS score, early signs of infarction on admission with head CT, time from onset to thrombolytic therapy, and thrombolytic drugs are all independent factors affecting HT in AIS patients. The scores of ASPECTS, DRAGON, SEDAN and HAT have certain value in predicting HT after intravenous thrombolysis in AIS patients, and the predicted value of ASPECTS score is the best.

Mixing of plant litters strengthens their remediation effects on crude oil-contaminated soil.

To investigate the effects of the mixing of litters on their remediation efficiency in petroleum-contaminated soil, litters from two common plants in the petroleum-contaminated region of Northern Shaanxi, China, Bothriochloa ischaemum (L.) Keng and Sophora davidii Kom. ex Pavol., and their mixture were mixed with 45 g/kg petroleum-contaminated soil. Based on these, a 150-day simulated remediation experiment was conducted at 25 °C and consistent moisture conditions. The effects on the degradation of petroleum components and the restoration of nutrient contents, pH, and enzymatic activity in the disturbed soil were detected. The effects of the litter treatments on the community structure and carbon source utilization characteristics of soil microorganisms were also studied. The results indicated that all litter treatments significantly accelerated the degradation of petroleum components, while the mixing of litter exhibited significant synergistic effects, leading to significantly higher degradation rates of saturated hydrocarbons, aromatic hydrocarbons, and nonhydrocarbon substances than the observed rates in the single-litter treatments and the predicted rates based on the single-litter treatments. Litter treatment significantly increased the N and P contents and enzymatic activity of contaminated soil. The effects of mixed litter on soil chemical and biological properties fell between the effects of the 2 types of single-litter treatments. However, the mixing of litters exhibited significant synergistic effects in supplementing available P and increasing sucrase, dehydrogenase, lignin peroxidase, and laccase activity, while it exhibited significant antagonistic effects in supplementing nitrate nitrogen and increasing urease, phosphatase, polyphenol oxidase, and manganese peroxidase activity. Litter treatment significantly altered the community structure of soil microorganisms. The relative abundances of some petroleum-degrading microbial phyla or genera in mixed litter-treated soil were significantly different from those in single litter-treated soils, which might contribute to the strengthened remediation effects of mixed litter treatment. The results might provide a theoretical basis for the more effect utilization of biomass resources in the remediation of petroleum-contaminated soil.

Dynamics of the remediating effects of plant litter on the biological and chemical properties of petroleum-contaminated soil.

To investigate the comprehensive remediating effects of plant residues on biological and chemical properties and the long-term dynamics of these effects, litter from Caragana korshinskii (caragana) or Ziziphus jujuba var. spinosa (jujube) was mixed with three types of soil that were contaminated with 12.49, 27.54, and 45.37 g kg-1 of petroleum. The mixtures were incubated at 20-25 °C with consistent soil moisture for 360 days. Subsequently, the litter impacts on the soil microbial population, the activities of 12 types of soil hydrolytic, and redox enzymes related to the cycling of C, N, and P, and the available N, P, and K contents were determined during the incubation. The results indicated that both types of litter significantly accelerated the reproduction of soil microbes and significantly increased the activities of most of the hydrolytic enzymes and the available nutrient contents after the short-term treatments, while the litters usually simultaneously depressed the activities of polyphenol oxidase and peroxidase in the slightly and moderately contaminated soils. However, the comprehensive remediating effects of the litters on the lightly contaminated soil significantly decreased over time while it recovered to some extent at the end of the experiment. The remediating effects on the seriously contaminated soil exhibited the opposite trend, and their remediating effects on the moderately contaminated soil exhibited continuous weakening. Generally, the remediating effects of the caragana litter were more noticeable than those of the jujube litter, except for the effect on the slightly contaminated soil after 180 days of treatment.

The flavonoid-rich fraction from rhizomes of Smilax glabra Roxb. ameliorates renal oxidative stress and inflammation in uric acid nephropathy rats through promoting uric acid excretion.

Uric acid metabolic disorder is considered to be the main pathogenesis of uric acid nephropathy (UN). Smilax glabra Roxb. is a traditional Chinese herb which has been used in the treatment of gout, but the mechanism was unclear. In this study, we investigated the protective effects of the flavonoid-rich fraction from rhizomes of Smilax glabra Roxb. (SGF) on uric acid nephropathy rats and its underlying mechanisms of promoting uric acid excretion. Sprague Dawley (SD) rats were induced by high purine diet (yeast pellets + adenine) for 5 weeks. Rats were orally treated with SGF or allopurinol daily. The biochemical parameters and enzymes in different treated rats were determined by commercial kits. Kidney pathology was visualized using optical microscopy and electron microscopy. Renal inflammatory factors were detected by ELISA. Renal fibrosis factors and uric acid transporters were analyzed by real time RT-PCR and western blot. The results showed that SGF significantly improved kidney function. Histopathologic examination revealed that urate-induced renal damage was markedly reversed by SGF. Meanwhile, SGF treatment was also found to significantly inhibit renal oxidative stress. SGF treatment obviously suppressed the inflammatory factors of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interleukin-1ß (IL-1ß), cyclooxygenase-2 (COX-2) and the profibrotic factors of basic fibroblast growth factor (bFGF), transforming growth factor-ß1 (TGF-ß1) expression in UN rats. Moreover, SGF either significantly inhibited uric acid production or promoted uric acid excretion in UN rats. The mechanism of SGF promoting uric acid excretion was related to its increase of ATP-binding cassette transporter G2 (ABCG2), organic anion transporter 1 (OAT1), organic anion transporters 2 (OCT2) and organic cation/carnitine transporters 2 (OCTN2) expression. In conclusion, SGF could ameliorate renal oxidative stress and inflammation in UN rats through promoting uric acid excretion.

The Yin and Yang of regulatory T cell and therapy progress in autoimmune disease.

Autoimmune diseases (ADs) are primarily mediated by the failure of immunological self-tolerance. Regulatory T cells (Tregs) play a critical role in the maintenance of induced tolerance to peripheral self-antigens, suppressing immoderate immune responses deleterious to the host and preventing the AD development. Tregs and suppressive cytokines are homeostatic with effective cells plus pro-inflammatory cytokines in healthy hosts which is defined as "Yang", and ADs are usually induced in case of disturbed homeostasis, which is defined as "Yin". Indeed, the Yin-Yang balance could explain the pathogenic mechanism of ADs. Tregs not only suppress CD4+ and CD8+ T cells but also can suppress other immune cells such as B cell, natural killer cell, DC and other antigen-presenting cell through cell-cell contact or secreting suppressive cytokines. In Tregs, Foxp3 as an intracellular protein displays a more specific marker than currently used other cell-surface markers (such as CD25, CD40L, CTLA-4, ICOS and GITR) in defining the naturally occurring CD4+ Tregs. Though the precise mechanism for the opposite effects of Tregs has not been fully elucidated, the importance of Tregs in ADs has been proved to be associated with kinds of immunocytes. At present, the surface marker, frequency and function of Tregs existed conflicts and hence the Tregs therapy in ADs faces challenges. Though some success has been achieved with Tregs therapy in few ADs both in murine models and humans, more effort should paid to meet the future challenges. This review summarizes the progress and discusses the phenotypic, numeric and functional abnormalities of Tregs and is the first time to systematically review the progress of Tregs therapy in kinds of ADs.

Characteristic patterns of normal meridian acupoint temperature.

BACKGROUND: Body temperature is an important indicator of health and illness. However, a single temperature measurement is not always reliable. Such measurements can be made using meridians, which are energy channels with acupoints being the nodes. To date, there is no published reference of meridian acupoint temperatures applicable to human health, and there is no clear digitalized indicator that could be utilized to evaluate human health by way of meridian acupoints up to now. METHODS: Our study recruited 100 healthy medical college students for the measurement of acupoint temperature. The temperatures of 135 acupoints of 14 main meridians were measured using infrared thermometers in order to provide a comprehensive body temperature reading of each study participant. RESULTS: The degree of the acupoint temperature consistently ranged from 34.88°C to 36.14°C. The gross thermograph was concentric, with high degree readings around the heart and low degree readings originating from the feet. The left and right body sides had significant correlation between the degrees of bilateral same name acupoint temperatures of 12 regular meridians (correlation coefficient, 0.367-0.985; p < 0.0001). There was also a significant correlation between the acupoint temperature for the governor vessel and the conception vessel (correlation coefficient, 0.083; p = 0.006). CONCLUSION: These findings indicate that meridian acupoint temperature is characterized by a consistently narrow range, as well as concentricity and symmetry in body temperature degree readings in college students. Meridian acupoint temperature may be a sensitive and valuable indicator to assist in the accurate evaluation of meridian and general human health, and the significance and changes of acupoint temperature in clinical conditions warrants future exploration.

Morning breathing exercises prolong lifespan by improving hyperventilation in people living with respiratory cancer.

Disturbance of oxygen-carbon dioxide homeostasis has an impact on cancer. Little is known about the effect of breath training on cancer patients. Here we report our 10-year experience with morning breathing exercises (MBE) in peer-support programs for cancer survivors.We performed a cohort study to investigate long-term surviving patients with lung cancer (LC) and nasopharyngeal cancer (NPC) who practiced MBE on a daily basis. End-tidal breath holding time (ETBHT) after MBE was measured to reflect improvement in alveolar O2 pressure and alveolar CO2 pressure capacity.Patients (female, 57) with a diagnosis of LC (90 patients) and NPC (32 patients) were included. Seventy-six of them were MBE trainees. Average survival years were higher in MBE trainees (9.8 ±â€Š9.5) than nontrainees (3.3 ±â€Š2.8). The 5-year survival rate was 56.6% for MBE trainees and 19.6% for nontrainees (RR = 5.371, 95% CI = 2.271-12.636, P < 0.001). Survival probability of the trainees further increased 17.9-fold for the 10-year survival rate. Compared with the nontrainees, the MBE trainees shows no significant differences in ETBHT (baseline, P = 0.795; 1-2 years, P = 0.301; 3-4 years, P = 0.059) at baseline and within the first 4 years. From the 5th year onwards, significant improvements were observed in ETBHT, aCO2%, PaCO2, and PaO2 (P = 0.028). In total, 18 trainees (40.9%) and 20 nontrainees (74.1%) developed new metastasis (RR = 0.315, 95% CI = 0.108-0.919, P = 0.031).MBE might benefit for the long-term survival in patients with LC and NPC due to improvement in hyperventilation.

Impacts of soil petroleum contamination on nutrient release during litter decomposition of Hippophae rhamnoides.

Petroleum exploitation causes contamination of shrub lands close to oil wells. Soil petroleum contamination affects nutrient release during the litter decomposition of shrubs, which influences nutrient recycling and the maintenance of soil fertility. Hence, this contamination may reduce the long-term growth and stability of shrub communities and consequently, the effects of phytoremediation. Fresh foliar litter of Hippophae rhamnoides, a potential phytoremediating species, was collected for this study. The litter was placed in litterbags and then buried in different petroleum-polluted soil media (the petroleum concentrations were 15, 30, and 45 g kg(-1) dry soil, which were considered as slightly, moderately and seriously polluted soil, respectively) for a decomposition test. The impacts of petroleum contamination on the release of nutrients (including N, P, K, Cu, Zn, Fe, Mn, Ca and Mg) were assessed. The results showed that (1) after one year of decomposition, the release of all nutrients was accelerated in the slightly polluted soil. In the moderately polluted soil, P release was accelerated, while Cu, Zn and Mn release was inhibited. In the seriously polluted soil, Cu and Zn release was accelerated, while the release of the other nutrients was inhibited. (2) The effect of petroleum on nutrient release from litter differed in different periods during decomposition; this was mainly due to changes in soil microorganisms and enzymes under the stress of petroleum contamination. (3) To maintain the nutrient cycling and the soil fertility of shrub lands, H. rhamnoides is only suitable for phytoremediation of soils containing less than 30 g kg(-1) of petroleum.

Effect of petroleum on decomposition of shrub-grass litters in soil in Northern Shaanxi of China.

The impacts of petroleum contamination on the litter decomposition of shrub-grass land would directly influence nutrient cycling, and the stability and function of ecosystem. Ten common shrub and grass species from Yujiaping oil deposits were studied. Litters from these species were placed into litterbags and buried in petroleum-contaminated soil with 3 levels of contamination (slight, moderate and serious pollution with petroleum concentrations of 15, 30 and 45 g/kg, respectively). A decomposition experiment was then conducted in the lab to investigate the impacts of petroleum contamination on litter decomposition rates. Slight pollution did not inhibit the decomposition of any litters and significantly promoted the litter decomposition of Hippophae rhamnoides, Caragana korshinskii, Amorpha fruticosa, Ziziphus jujuba var. spinosa, Periploca sepium, Medicago sativa and Bothriochloa ischaemum. Moderate pollution significantly inhibited litter decomposition of M. sativa, Coronilla varia, Artemisia vestita and Trrifolium repens and significantly promoted the litter decomposition of C. korshinskii, Z. jujuba var. spinosa and P. sepium. Serious pollution significantly inhibited the litter decomposition of H. rhamnoides, A. fruticosa, B. ischaemum and A. vestita and significantly promoted the litter decomposition of Z. jujuba var. spinosa, P. sepium and M. sativa. In addition, the impacts of petroleum contamination did not exhibit a uniform increase or decrease as petroleum concentration increased. Inhibitory effects of petroleum on litter decomposition may hinder the substance cycling and result in the degradation of plant communities in contaminated areas.

Dynamics of the biological properties of soil and the nutrient release of Amorpha fruticosa L. litter in soil polluted by crude oil.

Litter from Amorpha fruticosa, a potential phytoremediating plant, was collected and used in a decomposition experiment that involved the litterbag in soil polluted by crude oil. The dynamics of the biological properties of soil and the nutrient release of the litter were detected. The results indicated that (1) in lightly polluted soil (LP, petroleum concentration was 15 g kg(-1)), the bacteria (including actinomycetes), and fungi populations were significant higher than those in unpolluted soil (CK) at the 1st month after pollution, and the bacteria (including actinomycetes) populations were higher than those in the CK at the 6th and 12th months. In moderately polluted soil (MP, 30 g kg(-1)), the bacteria (including actinomycetes) populations were higher than those in the CK at the 1st and 6th months, whereas only the actinomycetes population was greater than that in the CK at the 12th month. In seriously polluted soil (SP, 45 g kg(-1)), only the fungi population was higher than that in the CK at the 6th month. (2) The activities of soil protease, carboxymethyl cellulase, and sucrase were generally inhibited in polluted soil. Peroxidase activity was generally inhibited in the LP and MP soil, and polyphenol oxidase activity was inhibited in the SP soil at 6-12 months. (3) At the end of litter decomposition, the LP soil significantly increased the release rate of all nutrients, except for K. The MP soil reduced the release rate of Fe and Mn, whereas it increased that of C and Cu. The SP soil decreased the release rate of all nutrients except for Cu and Zn. In conclusion, SP by crude oil would lead to limitations in the release of nutrients from the litter and to decreases in the community stability of a phytoremediating plant. A. fruticosa could only be used in phytoremediation of polluted soil at concentrations below 45 g kg(-1) (crude).

Efficacy of the wen dan decoction, a Chinese herbal formula, for metabolic syndrome.

CONTEXT: Metabolic syndrome (MS) refers to the clustering of metabolic derangements that include hyperglycemia, dyslipidemia, hypertension, and chronic kidney impairment. Those conditions are well known as being synergistically responsible for morbidity from cardiovascular disease as well as for driving the global epidemic of type 2 diabetes. It is still unknown whether an exact unifying pathogenesis of MS exists. OBJECTIVE: The meta-analysis intended to analyze the use of Chinese medicine (CM) as a therapeutic tool to explore indirectly the unifying pathogenesis of MS. METHODS: PubMed, the Chinese National Knowledge Infrastructure (CNKI), and the Wanfang databases were systematically searched from inception to November 2013 for randomized, controlled trials (RCTs) that compared treatment efficacy for MS patients using the Wen Dan decoction (WDD), a CM formula, versus Western conventional therapeutics. OUTCOME MEASURES: Measurements included tests of the overall therapeutic efficacy of WDD for hyperglycemia, hypertension, dyslipidemia, and renal functions, and the study also analyzed adverse events. Data were expressed as weighted mean differences (WMDs), with 95% confidence intervals (95% CIs) and the odds ratio (OR). RESULTS: A total of 31 RCTs were included for meta-analysis, involving 2512 patients and including 1282 participants in the intervention groups. The pooled data favored WDD over the control treatments as follows: (1) hyperglycemia, with a WMD of -0.95 mmol/L (95% CI: -1.19 to -0.71); (2) hypertension, with a WMD of -7.40 mm Hg (95% CI: -9.86 to -4.93); (3) dyslipidemia: (a) total cholesterol (TC), with a WMD of -0.62 mmol/L (95% CI: -0.90 to -0.33); (b) triglycerides (TGs), with a WMD of -0.32 mmol/L (95% CI: -0.52 to -0.13); (c) low-density lipoproteins (LDPs), with a WMD of -0.22 mmol/L (95% CI: -0.41 to -0.02); and (d) high-density lipoproteins (HDPs), with a WMD of 0.10 mmol/L (95% CI: 0.03 to 0.17); and (4) of renal functions: (a) urea, with a WMD of -3.41 mmol/L (95% CI: -5.50 to -1.32) and (b) creatinine, with a WMD of -68.81 µmol/L (95% CI: -132.63 to -4.98). No statistical significance was documented in creatinine clearance between the 2 treatments with a WMD of 15.47 mL/min (95% CI: -7.71 to 38.64). The overall efficacy rate was 91.4% for WDD and 66.9% for the control treatments (OR: 5.33; 95% CI: 4.06 to 6.99). Adverse events were rare and minor. CONCLUSIONS: The consistent improvements found in metabolic profiles by use of the single herbal formula may indirectly imply a common pathogenesis in MS.