Advances in the Diagnosis and Treatment of Autism Spectrum Disorders in Children.

Objective: This study aims to review recent developments in the diagnosis and treatment of Autism Spectrum Disorder (ASD )and provide insights for its clinical management. Methods: The literatures were researched fro the pubmed, Wanfang and CNKI. We searched for research on the etiology, pathogenesis, diagnosis (screening and evaluation), and treatment of Autism spectrum disorder. When selecting papers to be included, priority should be given to randomized clinical trials, systematic evaluations, meta-analyses, clinical practice guidelines, and articles related to general medical readers. Results: ASD is a widely present neurodevelopmental disorder characterized by social and communication difficulties, narrow interests, and repetitive behavior, accompanied by symptoms such as irritability, self-harm, attention deficit hyperactivity disorder (ADHD), and sleep problems. Irritability, self-harm, ADHD, and sleep problems are common accompanying symptoms that contribute to the challenges faced by individuals with ASD. At present, there is no fully effective treatment method for ASD, and key factors affecting the prognosis of ASD include early diagnosis time, early language communication level, intelligence level, disease severity, comorbidities, family participation, appropriate intervention, and social support. Therefore, early individualized long-term comprehensive training and drug therapy, hyperbaric oxygen therapy, and combined family participation can improve the prognosis of pediatric patients. Before selecting treatment plans for children, collecting as much information as possible about various treatment methods and choosing personalized treatment plans based on the child's developmental assessment level is necessary. In addition, the treatment of ASD is also influenced by factors such as family economic status, parental mentality, and social environment. During the training process, it is important to be family-centered, tolerant, and understand children's behavior. Conclusion: It is significant to take effective treatment measures to improve the quality of life and prognosis of children with autism spectrum disorders.

Enhancing Prognosis, Quality of Life, and Psychological Well-being in Cerebral Stroke Patients through Meticulous Risk Management: A Comprehensive Study.

Background: Cerebral stroke (CS) remains a leading cause of mortality worldwide. In addition to effective treatment, nursing intervention plays a pivotal role in the rehabilitation of CS patients. Objective: This study aims to assess the impact of meticulous care integrated with risk management on rehabilitating cerebral stroke patients. The objective is to provide valuable clinical insights for the management of CS patients. Methods: A comparative observational study was conducted, including a total of 180 CS patients admitted between February 2020 and February 2022 were selected for this study. Among them, 98 patients received meticulous care combined with risk management (research group), while 82 patients underwent routine nursing intervention (control group). We analyzed the changes in the Fugl-Meyer Motor Assessment scale, National Institute of Health Stroke Scale, Activities of Daily Living scale, and Barthel Index before and after the care interventions. Additionally, we documented nursing risk events during treatment, assessed nursing quality scores, and conducted a quality-of-life survey after a one-year follow-up. Results: The research group exhibited significantly higher post-care scores in the Fugl-Meyer Motor Assessment, Activities of Daily Living, and Barthel Index, along with lower National Institute of Health Stroke Scale scores, compared to the control group (P < .05). Furthermore, the research group experienced a lower incidence of nursing risk events and demonstrated higher nursing quality (P < .05). During the prognostic follow-up, the research group displayed a superior quality of life compared to the control group (P < .05). Conclusions: Meticulous care integrated with risk management enhances the recovery of CS patients and is strongly recommended for clinical implementation.

Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study.

BACKGROUND: Immunotherapy with immune checkpoint inhibitors combined with an anti-angiogenic tyrosine-kinase inhibitor (TKI) has been shown to improve overall survival versus anti-angiogenic therapy alone in advanced solid tumours, but not in hepatocellular carcinoma. Therefore, a clinical study was conducted to compare the efficacy and safety of the anti-PD-1 antibody camrelizumab plus the VEGFR2-targeted TKI rivoceranib (also known as apatinib) versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma. METHODS: This randomised, open-label, international phase 3 trial (CARES-310) was done at 95 study sites across 13 countries and regions worldwide. Patients with unresectable or metastatic hepatocellular carcinoma who had not previously received any systemic treatment were randomly assigned (1:1) to receive either camrelizumab 200 mg intravenously every 2 weeks plus rivoceranib 250 mg orally once daily or sorafenib 400 mg orally twice daily. Randomisation was done via a centralised interactive response system. The primary endpoints were progression-free survival, as assessed by the blinded independent review committee per Response Evaluation Criteria in Solid Tumours version 1.1, and overall survival in the intention-to-treat population. Safety was assessed in all patients who received at least one dose of the study drugs. We report the findings from the prespecified primary analysis for progression-free survival and interim analysis for overall survival. This study is registered with ClinicalTrials.gov (NCT03764293). FINDINGS: Between June 28, 2019, and March 24, 2021, 543 patients were randomly assigned to the camrelizumab-rivoceranib (n=272) or sorafenib (n=271) group. At the primary analysis for progression-free survival (May 10, 2021), median follow-up was 7·8 months (IQR 4·1-10·6). Median progression-free survival was significantly improved with camrelizumab-rivoceranib versus sorafenib (5·6 months [95% CI 5·5-6·3] vs 3·7 months [2·8-3·7]; hazard ratio [HR] 0·52 [95% CI 0·41-0·65]; one-sided p<0·0001). At the interim analysis for overall survival (Feb 8, 2022), median follow-up was 14·5 months (IQR 9·1-18·7). Median overall survival was significantly extended with camrelizumab-rivoceranib versus sorafenib (22·1 months [95% CI 19·1-27·2] vs 15·2 months [13·0-18·5]; HR 0·62 [95% CI 0·49-0·80]; one-sided p<0·0001). The most common grade 3 or 4 treatment-related adverse events were hypertension (102 [38%] of 272 patients in the camrelizumab-rivoceranib group vs 40 [15%] of 269 patients in the sorafenib group), palmar-plantar erythrodysaesthesia syndrome (33 [12%] vs 41 [15%]), increased aspartate aminotransferase (45 [17%] vs 14 [5%]), and increased alanine aminotransferase (35 [13%] vs eight [3%]). Treatment-related serious adverse events were reported in 66 (24%) patients in the camrelizumab-rivoceranib group and 16 (6%) in the sorafenib group. Treatment-related death occurred in two patients: one patient in the camrelizumab-rivoceranib group (ie, multiple organ dysfunction syndrome) and one patient in the sorafenib group (ie, respiratory failure and circulatory collapse). INTERPRETATION: Camrelizumab plus rivoceranib showed a statistically significant and clinically meaningful benefit in progression-free survival and overall survival compared with sorafenib for patients with unresectable hepatocellular carcinoma, presenting as a new and effective first-line treatment option for this population. FUNDING: Jiangsu Hengrui Pharmaceuticals and Elevar Therapeutics.

Effects of Shenling Baizhu powder on pyrotinib-induced diarrhea: analysis of gut microbiota, metabonomics, and network pharmacology.

BACKGROUND: Shenling Baizhu Powder (SBP) is a traditional Chinese medicine (TCM) prescription, which has the good efficacy on gastrointestinal toxicity. In this study, we used gut microbiota analysis, metabonomics and network pharmacology to investigate the therapeutic effect of SBP on pyrotinib-induced diarrhea. METHODS: 24 Rats were randomly divided into 4 groups: control group, SBP group (3.6 g/kg /bid SBP for 10 days), pyrotinib model group (80 mg/kg/qd pyrotinib) and pyrotinib + SBP treatment group. A 16S rRNA sequencing was used to detect the microbiome of rat fecal bowel. Metabolic profiles were collected by non-targeted metabolomics and key metabolic pathways were identified using MetaboAnalyst 5.0. The antitumor effect of SBP on cells treated with pyrotinib was measured using a CCK-8 assay. Network pharmacology was used to predict the target and action pathway of SBP in treating pyrotinib-related diarrhea. RESULTS: In vivo study indicated that SBP could significantly alleviate pyrotinib-induced diarrhea, reaching a therapeutic effect of 66.7%. SBP could regulate pyrotinib-induced microbiota disorder. LEfSe research revealed that the SBP could potentially decrease the relative abundance of Escherichia, Helicobacter and Enterobacteriaceae and increase the relative abundance of Lachnospiraceae, Bacilli, Lactobacillales etc. In addition, 25-Hydroxycholesterol, Guanidinosuccinic acid, 5-Hydroxyindolepyruvate and cAMP were selected as potential biomarkers of SBP for pyrotinib-induced diarrhea. Moreover, Spearman's analysis showed a correlation between gut microbiota and metabolite: the decreased 25-hydroxycholesterol in the pyrotinib + SBP treatment group was negatively correlated with Lachnospiraceae while positively correlated with Escherichia and Helicobacter. Meanwhile, SBP did not affect the inhibitory effect of pyrotinib on BT-474 cells and Calu-3 cells in vitro. Also, the network analysis further revealed that SBP treated pyrotinib-induced diarrhea through multiple pathways, including inflammatory bowel disease, IL-17 signaling pathway, pathogenic Escherichia coli infection and cAMP signaling pathway. CONCLUSIONS: SBP could effectively relieve pyrotinib-induced diarrhea, revealing that intestinal flora and its metabolites may be involved in this process.

Effects of Fatty Alcohols with Different Chain Lengths on the Performance of Low pH Biomass-Based Foams for Radioactive Decontamination.

Compared with polymers and nanoparticles, fatty alcohols can not only increase the stability of foam, but also maintain better foamability at pH < 2, which is beneficial to reduce waste liquid and increase decontamination efficiency for radioactive surface pollution. However, different fatty alcohols have different hydrophobic chain lengths. The effects of fatty alcohols with different chain lengths on the performance of decontamination foam were studied at pH < 2, to assist in the selection of suitable fatty alcohols as foam stabilizers. Combined with betaine surfactant and phytic acid, biomass-based foams were synthesized using fatty alcohols with different chain lengths. When the hydrophobic tail groups of the fatty alcohol and the surfactant were the same, the foam showed the best performance, including the lowest surface tension, the highest liquid film strength, the greatest sag-resistance and the best stability. However, when the hydrophobic tail groups were different, the space between adjacent surface active molecules was increased by thermal motion of the excess terminal tail segments (a tail-wagging effect), and the adsorption density reduced on the gas-liquid interface, leading to increased surface tension and decreased liquid film strength, sag-resistance and stability. The use of decontamination foam stabilized by fatty alcohols with the same hydrophobic group as the surfactant was found to increase the decontamination rate of radioactive uranium pollution from 64 to over 90% on a vertical surface.

Radioactive decontamination in low-temperature environments by using a novel high-strength strippable coating.

Accidents involving nuclear leakage and radioactive source diffusion will result in a substantial amount of radioactive pollution, posing a threat to the world's environment as well as human safety. To get rid of the pollution, this work describes a new type of strippable detergent coating designed to remove radioactive contamination, especially in low-temperature conditions. In situ polymerization was employed to make EC/PUA/PVAc detergent from degradable ethyl cellulose (EC), tea polyphenols (TP), and polyvinyl acetate (PVAc), and polytetramethylene ether glycol bis-para-aminobenzoate (P1000). The film-forming performance, decontamination efficiency, and mechanical properties of the decontamination coating formed by the detergent were studied. Designed to work in a low-temperature environment, the detergent can be sprayed and peeled to remove surface radioactive staining. A universal material testing machine was used to assess the low-temperature rheometry, SEM, EDX, FT-IR, and other variables and to characterize the decontamination coating and the decontamination mechanism of the detergent. At -10-10 °C, the EC/PUA/PVAc detergent has good fluidity and sprayability and forms a strippable coating. The tensile strength of the decontamination coating can be as high as 26.4 MPa, and its 180° peel strength on ceramic tile, glass, stainless steel, cement, marble are 0.49 ± 0.08 N/m, 1.82 ± 0.41 N/m, 3.03 ± 1.65 N/m, 35.60 ± 1.17 N/m, 44.43 ± 4.10 N/m, respectively. The decontamination factors ranged from 3.32 to 10.02, with a decontamination rate above 85%.

Factors Associated with Behaviors Toward End-of-life Care Among Chinese Oncology Nurses: A Cross-Sectional Study.

PURPOSE: The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses' behaviors toward EOL care. METHODS: A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses' Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. RESULTS: Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. CONCLUSIONS: The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.

A novel self-crosslinked gel microspheres of Premna microphylla turcz leaves for the absorption of uranium.

Premna microphylla turcz leaves (PMTL) is a resource-rich, biodegradable, renewable biomass. Here, a microsphere adsorbent was prepared from PMTL by a self-crosslinking method without any addition of chemical cross-linking agent, and characterized by SEM, FTIR, and XPS. The influence of preparation methods and conditions on the properties of the microspheres was studied and the self-crosslinking mechanism was analyzed. The effects of temperature, pH, contact time, uranium concentration, and adsorbent dosage on its adsorption performance toward to uranium were systematically explored. The results showed that PMTL endogenous pectin binding with endogenous Ca2+, Mg2+ and other metal ions to form an 'egg box' structure might be the mechanism of its self-crosslinking to form microspheres. The adsorption isotherms fitted well by the Freundlich model and the experimental maximum adsorption capacity of microspheres was 346.65 mg·g-1 at pH of 5, and kinetics data correlated well with the pseudo-second order model. The adsorption mechanism might be the coordination bonding between the uranium and oxygen-containing groups (hydroxyl and carboxyl groups), and the ion exchange between the uranium and metal ions (mainly Ca2+ and Mg2+). The PMTL microspheres are promising in treating uranium-containing wastewater in a more cost-effective and environmentally friendly manner.

Effects of a mind map-based life review programme on psychospiritual well-being in cancer patients undergoing chemotherapy: A randomised controlled trial.

OBJECTIVES: To evaluate the effects of a mind map-based life review programme (MBLRP) on psychological distress, hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy. METHODS: Eighty-four cancer patients undergoing chemotherapy from a university-affiliated hospital in Fujian, China. The participants were randomly allocated to a MBLRP group (n = 40) or usual care group (n = 44). Data were collected at baseline (T0), on the second day (T1) and four weeks after the programme (T2) using the Distress Thermometer, Meaning in Life Questionnaire, Herth Hope Scale and Self-transcendence Scale. RESULTS: No significant interaction effects for time and group membership were found for psychological distress either at T1 (t = -1.707, p = .090) or at T2 (t = -1.123, p = .263). The interaction effects for T1 and group membership were statistically significant for meaning in life (t = 3.487, p = .001) and hope (t = 5.313, p < .001), but not statistically significant for self-transcendence (t = 0.148, p = .882). The interaction effects for T2 and group membership were statistically significant for meaning in life (t = 2.592, p = .01), hope (t = 5.215, p < .001) and self-transcendence (t = 2.843, p = .005). CONCLUSIONS: The MBLRP could improve hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy.

Carboxymethyl konjac glucomannan mechanically reinforcing gellan gum microspheres for uranium removal.

Biosorbents have been a promising adsorbent to remove uranium while their poor mechanical properties prevent them from being widely used in practice. In this study, carboxymethyl konjac glucomannan (CMKGM) was incorporated to gellan gum to form a double-network gel micro spheres (CMKGM/GG-Al) for uranium removal with its mechanical strength fairly being reinforced. The compressive strength of the CMKGM/GG-Al microspheres was about 6 times than that of GG-Ca microspheres we prepared before while the adsorption capacity still be at a better value with the fitting maximum adsorption capacity being of 97.94 mg/g. Its uranium adsorption properties were investigated by considering the influence of pH, the adsorbent dosage, temperature, initial uranium concentration, time and coexisting ions. The adsorption mechanism was also investigated according to the SEM, EDX, FT-IR and XPS data analysis. The isotherm equilibrium data which were best fitted with Langmuir model and the kinetics data which were best fitted with pseudo-second-order model. It was inferred that the adsorption process was mainly the ion-exchange and the coordination with hydroxyl groups on the adsorbent surface and the adsorption process was endothermic and spontaneous. The CMKGM/GG-Al microspheres prepared in this study would be more conducive to practical application for uranium removal.

Marinobacter sp. Stable Hydrous Titanium Oxide-Functionalized Bovine Serum Albumin Nanospheres for Uranium Capture from Spiked Seawater.

A novel nanospherical hydrous titanium oxide adsorbent (hydrous titanium oxide-immobilized bovine serum albumin nanospheres, HTO-BSA-NSs) was prepared by immobilizing HTOs with a manipulated molecular mass and number of active sites for uranium on the surface of BSA-NSs. The adsorption performances of HTO-BSA-NSs were investigated in spiked natural seawater with extra 8 ppm uranium. The results demonstrated that HTO-BSA-NSs are capable of uranium capture from a complex aqueous matrix with a low uranium concentration. Meanwhile, the microbial stability of HTO-BSA-NSs in sterilized natural seawater with Marinobacter sp. was investigated and observed through an optical microscope and TEM, revealing that the wrapped HTOs could protect the BSA-NSs from the decomposition of microorganisms, and the structure and functional groups of HTO-BSA-NSs remain stable compared with the BSA-NSs. In addition, the uranium adsorption mechanism of HTO-BSA-NSs is mainly recognized as dehydrated complexation, which was concluded from characterization analysis, adsorption model fitting, and theoretical calculations based on density functional theory. The remarkable uranium adsorption performance and microbial stability of HTO-BSA-NSs indicated that they have the potential to be a low-cost and environmentally friendly adsorbent for uranium extraction from complex environments such as seawater or uranium-containing industrial wastewater.

Dose escalation of preoperative short-course radiotherapy followed by neoadjuvant chemotherapy in locally advanced rectal cancer: protocol for an open-label, single-centre, phase I clinical trial.

INTRODUCTION: Preoperative radiotherapy followed by total mesorectal excision with adjuvant chemotherapy has been recommended as the preferred treatment method for locally advanced rectal cancer (LARC). Similar rates of local control, survival and toxicity were observed in preoperative long-course chemoradiotherapy (LCRT) (45-50.4 Gy in 25-28 fractions) and in short-course radiotherapy (SCRT) with 25 Gy over five fractions. Both regimens lower the local recurrence rates compared with that of surgery followed by postoperative radiotherapy. With the simplicity and lower cost of SCRT, a growing number of patients have been receiving SCRT as preoperative radiotherapy. However, the currently established SCRT (25 Gy over five fractions) followed immediately by surgery resulted in poor downstaging and sphincter preservation rate. The pathological complete response (pCR) rate is also markedly lower with SCRT than with LCRT (0.7%vs16%). Several studies recommended SCRT with delayed surgery for more than 4 weeks with expectation of improved pathological outcomes and fewer postoperative complications. While a number of clinical trials demonstrated a persistently better overall local control with SCRT than with LCRT, overall survival advantage has not been observed. Since survival is mainly depended on distant metastases, efforts should be made towards more effective pathological response and systemic treatment. Given the apparent advantages of SCRT, we aimed to establish a dose escalation of SCRT and sequential modified FOLFOX6 (mFOLFOX6) as preoperative therapy for LARC with objectives of achieving an optimal balance of safety, cost effectiveness and clinical outcome, and to support further investigation of this regimen in a phase II/III setting. METHODS: In this phase I study, three dose levels (6Gy×5F, 7Gy×5F, 8Gy×5F to gross tumour volume, while keeping the rest of irradiated volume at 5Gy×5) of SCRT followed by four cycles of mFOLFOX6 chemotherapy as neoadjuvant therapy will be tested by using the traditional 3+3 design. The pCR rate, R0 resection rate, sphincter preservation rate and treatment related toxicity will be assessed. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of Fujian Medical University Union Hospital (No. 2017YF020-02) and all participants provided written informed consent. Results from our study will be disseminated in international peer-reviewed journals. All study procedures were developed in order to assure data protection and confidentiality. TRIAL REGISTRATION NUMBER: NCT03466424; Pre-results.

A new indole-type alkaloid from the roots of Clematis florida var. plena.

One new indole-type alkaloid, α-L-rhamnopyranosyl-(1→6)-ß-D- glucopyranosyl 6-methoxy-3-indolecarbonate (1), together with three known alkaloids (2-4), one aromatic acid (5) and five known saponins (6-10), was isolated from the roots of Clematis florida var. plena. Their structures were established by NMR spectroscopic analysis and acid hydrolysis. In in vivo anti-inflammatory activity, n-butanol extract was found to be potent against ear edema in mice, with inhibition rate of 48.7% at a dose of 800 mg/kg. Furthermore, compounds 8 and 9 obtained from the n-butanol extract exhibited significant anti-inflammatory activities with inhibition rates of 50.9% and 54.7% at a dose of 200 mg/kg.

Accumulation and effects of uranium on aquatic macrophyte Nymphaea tetragona Georgi: Potential application to phytoremediation and environmental monitoring.

This study analyzed the ability of Nymphaea tetragona Georgi (N. tetragona) to accumulate water-borne uranium and any effects this could exert on this plant species. In accumulation experiments, N. tetragona was exposed (21 d) to different concentrations of uranium (0-55 mg L-1) and the content of uranium was determined in water and plant tissues (leaves, submerged position and plant) to determine the translocation factor (TF) and bioconcentration factor (BCF). The content of uranium in the plant and plant tissues showed concentration-dependent uptake, leaves were the predominant tissue for uranium accumulation, and TF and BCF values were both affected by the concentration of uranium in the water. In this research, the uranium content and BCF value in the leaves of N. tetragona were upto 3446 ±â€¯155 mg kg-1 and 73 ±â€¯3, respectively. In physiological experiments, uranium treatment boosted the activity of peroxidase (POD), superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) in the leaves, and increasing uranium concentrations aggravated damage to the cell membrane system. Uranium contamination significantly inhibited the content of soluble protein, as well as chlorophyll-a, chlorophyll-b and carotene in the leaves, indicating the structure and function of chloroplast were destroyed, reducing the photosynthetic performance of plants. These results indicate that the macrophyte N. tetragona can accumulate uranium while showing a stress response via metabolic mechanisms under uranium exposure, and it may be a suitable bioremediation candidate for aquatic marine contamination.

Preparation of tannin-immobilized gelatin/PVA nanofiber band for extraction of uranium (VI) from simulated seawater.

A novel gelatin/PVA composite nanofiber band loaded with bayberry tannin (GPNB-BT) was prepared by electrostatic spinning and crosslinking for extraction of uranium (VI) from simulated seawater. The influential factors of tannin loaded on the nanofiber band were investigated in detail. Surface morphology and fiber diameter of GPNB-BT were studied by Scanning Electron Microscopy (SEM). Functional groups of GPNB-BT were investigated by Fourier Transform Infrared Spectrometer (FTIR). The adsorption process and mechanism of uranium on GPNB-BT was characterized by Energy Dispersive X-ray (EDX) and X-ray Photoelectron Spectroscopy (XPS). The results revealed that the BT had been stably solidified on the GPNB. Compared with other tannin-immobilized membranes, the nano-network structure of GPNB-BT with 200-400 nm diameter of fibers can promote solidification of tannins and improve adsorption capacity of GPNB-BT for uranium. The maximum adsorption capacity of the GPNB-BT for uranium is 170 mg/g at the optimal pH of 5.5 in 80 mg/L of initial uranium concentration and 1.4 µg/g even at extremely low initial concentration of 3 µg/L in the simulated seawater for 24 h. The GPNB-BT with good hydraulic properties, floatability and adsorption capacity for uranium is expected to be widely used in separation and enrichment of uranium in seawater and radioactive waste water.

Retrospective study on efficacy of a paclitaxel combined with a leucovorin and fluorouracil regimen for advanced gastric cancer.

PURPOSE: To investigate the efficacy of paclitaxel combined with a leucovorin and 5-fluorouracil regimen (PLF regimen; q2w) as neoadjuvant chemotherapy (NCT) for advanced gastric cancer. METHODS: A total of 183 patients with advanced gastric cancer who underwent 3 cycles of PLF regimen chemotherapy before surgery and received surgery 2 weeks after chemotherapy were enrolled as a treatment group. A total of 184 patients with advanced gastric cancer and no NCT during the same period were enrolled as the controls and treated with surgery. Both groups underwent a D2 radical gastrectomy and the standard postoperative adjuvant chemotherapy. RESULTS: In the NCT group, there were 19 cases of complete remission, 86 cases of partial remission, 72 cases of stable disease, and 6 cases of progressive disease, with an overall response rate of 57.4%. The R0 resection rate was higher than in the control group (85.2% vs 61.4%, p < .05). In the NCT group, 12 cases of esophagogastric cancer (20.7%) showed complete remission and 32 cases (55.2%) showed partial remission, while 7 cases of distal gastric cancer (5.6%) showed complete remission and 54 cases (43.2%) showed partial remission. Pathologic complete remission was higher for esophagogastric cancer than for distal gastric cancer (20.7% vs 3.2%, p < .05). Differences were found between the NCT and control groups in terms of 1-year, 3-year, and 5-year overall and disease-free survival. CONCLUSION: The PLF regimen showed good tolerability and a high response rate, especially for esophagogastric cancer. This regimen reduced the tumor size, lowered the tumor stage, and improved the R0 resection rate and survival rate.

Amelioration of hepatic steatosis is associated with modulation of gut microbiota and suppression of hepatic miR-34a in Gynostemma pentaphylla (Thunb.) Makino treated mice.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a chronic and progressive liver disease with an increased risk of morbidity and mortality. However, so far no specific pharmacotherapy has been approved. Gynostemma pentaphylla (Thunb.) Makino (GP) is a traditional Chinese medicine that is widely used against hyperlipemia as well as hyperglycemia. This study aims to evaluate the effect of GP on NAFLD and explore the possible mechanism. METHODS: High-fat-diet induced NAFLD mice model were orally administrated with GP at dose of 11.7 g/kg or equivalent volume of distilled water once a day for 16 weeks. Body weight, food intake and energy expenditure were assessed to evaluate the general condition of mice. The triglycerides, total cholesterol content in the liver and liver histopathology, serum lipid profile and serum insulin level, fecal microbiome, hepatic microRNAs and relative target genes were analyzed. RESULTS: Mice in GP treatment group displayed improved hepatic triglycerides content with lower lipid droplet in hepatocyte and NAFLD activity score. Besides, GP treatment altered the composition of gut microbiota and the relative abundance of some of the key components that are implicated in metabolic disorders, especially phylum Firmicutes (Eubacterium, Blautia, Clostridium and Lactobacillus). Several hepatic microRNAs were downregulated by GP treatment such as miR-130a, miR-34a, miR-29a, miR-199a, among which the expression miR-34a was altered by more than four-fold compared to that of HFD group (3:14). The correlation analysis showed that miR-34a was strongly related to the change of gut microbiota especially phylum Firmicutes (R = 0.796). Additionally, the target genes of miR-34a (HNF4α, PPARα and PPARα) were restored by GP both in mRNA and protein levels. CONCLUSION: Our results suggested that GP modulated the gut microbiota and suppressed hepatic miR-34a, which was associated with the amelioration of hepatic steatosis.

Adsorption of phosphorus from slaughterhouse wastewater by carboxymethyl konjac glucomannan loaded with lanthanum.

Phosphorus removal was an important measure in the control of eutrophication of water environment. In this study, a novel phosphorus removal adsorbent of lanthanum-loaded carboxymethyl konjac glucomannan microspheres (CMKGM-La) was successfully prepared by the method of electrostatic spraying and sol-gel, and was characterized by SEM, XPS and EDX. Batch experiments were performed to evaluate the adsorption capacity at different conditions: pH, temperature, initial concentration, adsorbent dosage and contact time. The results showed that the adsorption kinetics data correlated well with the pseudo-second-order kinetic model and the adsorption isotherm was well described by the Langmuir isotherm model with the maximum capacity of 16.06 mg·g-1 for CMKGM-La microspheres at pH of 4 and 318.15 K. The adsorption of phosphorus was a spontaneous, entropy-increasing and endothermic process. The possible adsorption mechanism of phosphorus on the CMKGM-La microspheres consisted of the coordination reaction of La (III) with phosphorus and electrostatic attraction between protonated hydroxyl and phosphorus. The presence of co-existing ions (such as NH4+, Cl-, SO42-, SiO32- and CO32-) had no significant effect on phosphorus removal. These results suggested that the adsorbent of CMKGM-La microspheres was a promising adsorbent for the removal of phosphorus from slaughterhouse wastewater.

Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint: a randomized controlled trial.

BACKGROUND: Allergic rhinitis is a common respiratory disease. Acupuncture is used to treat it in traditional Chinese medicine, and generally, the L120, ST2 and ST36 acupoints are selected in clinical practice. We report a new method of acupuncture at the sphenopalatine acupoint (SPA) for treatment of persistent allergic rhinitis (PAR). The effect of this treatment was investigated using two different needling depths. The efficacy of this treatment was associated with accurate stimulation of the sphenopalatine ganglion (SPG). METHODS/DESIGN: A total of 61 patients diagnosed with PAR were randomly allocated to either the acupuncture or the sham acupuncture group. The difference between the groups was the needle depth when acupuncture was administered, which was 50 mm and 20 mm. Alteration in total nasal symptom score (TNSS) was the primary outcome. Quality of life, medication dosages and adverse events were secondary outcomes, measured using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Confidence assessment was performed to evaluate data from the treatment and follow-up periods. RESULTS: Results were: (1) average TNSS in the treatment group was significantly lower than in the control group at week 4 (median and 25th and 75th percentiles were 5.00 (4.00, 7.00) and 8.00 (7.00, 10.00), respectively (P < 0.001)). However, scores in the two groups were not significantly different at week 12; (2) quality of life (RQLQ) was significantly improved at week 2 in the treatment group compared to the control group (scores of 35.47 ± 8.20 and 45.48 ± 8.84; P < 0.001); (3) during the follow-up period, the medication dosage in the treatment group was much lower than in the control group (3.64 ± 1.45 and 6.14 ± 2.34; P < 0.05); and (4) no adverse events were observed in either group during treatment. CONCLUSIONS: This pilot study revealed a profound effect of acupuncture at the SPA on prevention of PAR development. The TNSS in the treatment group (needle depth 50 mm), was significantly lower than in the control group (needle depth of only 20 mm). Our result demonstrates that performing acupuncture directly at the SPA to stimulate the SPG is an effective method to treat PAR. TRIAL REGISTRATION: Acupuncture Clinical Trial Registry, AMCTR-OOR-16000014 and Chinese Clinical Trial Register, ChiCTR-IOR-16009211 . Registered on 1 September 1 2016.

Adsorption behavior of 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin on pristine and doped black phosphorene: A DFT study.

Polychlorinated dibenzo-p-dioxins (PCDDs) are highly toxic to humans. The search for novel and effective methods and materials for detecting or removing these gas pollutants is becoming more important and urgent. With its high specific surface area, abundance, and variety of potential applications, phosphorene has attracted much research interest. In this study, density functional theory was used to study the interactions between a doped phosphorene sheet and a tetrachlorodibenzo-p-dioxin (TCDD) molecule. The initial configurations of the TCDD and metallic (Ca or Ti) or nonmetallic (S and Se) dopants were investigated during the TCDD-phosphorene interaction study. Adsorption energy, isosurface of electron density difference, and density of states analysis were utilized to explore the interactions between TCDD and phosphorene. The results indicated that Ca dopant effectively improved the interaction between TCDD and phosphorene. Se dopant reduced the interaction between TCDD and phosphorene. Combining interactions between TCDD and the pristine, Ca-doped, and Se-doped phosphorenes, phosphorene could be a promising candidate for TCDD sensing and removal.