Construction of 3D network aluminum sludge-based hydrogel beads: combination of macroization, amino functionalization, and resource utilization.

An aluminum sludge-based composite material was constructed against the problems of phosphorus pollution and the waste of aluminum sludge resources. Utilizing metal Ce doping and hydrogel microbeads with pore preparation, the adsorption performance of the original sludge was improved. Meanwhile, the macroscopic body was constructed, and on this basis, polyethyleneimine (PEI) was introduced to complete the amino functionalization further to enhance the adsorption of phosphorus by the adsorbent, and NH-CeAIS-10 microbeads were successfully prepared. In adsorption, microbeads with larger specific surface area and richer functional groups are better choice compared to original sludge. The results of SEM, BET, FT-IR, and XPS analyses indicate that the adsorption of phosphorus by the microbeads is mainly achieved through electrostatic interactions, ligand exchange, and the formation of inner-sphere complexes. According to the Langmuir model, the maximum phosphorus adsorption capacity of NH-CeAIS-10 was 29.56 mg g-1, which was four times higher compared to native aluminum sludge. This also confirms the significant enhancement of phosphorus adsorption through the modification of aluminum sludge. Besides, in dynamic adsorption column experiments, the material exhibited up to 99% removal in simulated wastewater for up to 30 days, demonstrating the great adsorption potential of NH-CeAIS-10 in engineering applications.

First Report of Powdery Mildew Caused by Golovinomyces circumfusus on Scutellaria baicalensis in China.

Scutellaria baicalensis Georgi is a member of the plant family Lamiaceae and is widely cultivated in China as a medicinal plant (Wang et al. 2021). In August 2022, an investigation of a 10-hectare field of S. baicalensis in Longxi county, Gansu province, China (35°18' N, 104°57' E) found that approximately 90% of the plants were infected with 70% leaves symptomatic. Initially, the thin, radial, irregular white colonies appeared on the adaxial surface of the plant leaves. Subsequently, the white colonies expanded and thickened to cover the entire adaxial surface of the leaves, and gradually spread to the stems and abaxial surface of the leaves. Finally, infected leaves dried out and defoliated prematurely. Tissue from infected plants was collected in order to identify the pathogen. Microscopic observations showed that hyphae were septate, branched, flexuous to straight, 3 to 9 µm wide. Appressoria were solitary and slightly to distinctly nipple-shaped. Conidiophores were erect, straight or somewhat flexuous, 105 to 145 × 8 to 13 µm in size (n=30). The conidia were ellipsoid to ovoid in shape, 25 to 39 × 12 to 21 µm (n=50), without obvious fibrosin bodies. Chasmothecia were globose or oblate, scattered to gregarious, dark brown, and 85 to 140 µm in diameter. Appendages were born equatorially on the ascomata, unbranched, 0.5 to 2.5 times as long as the chasmothecial diameter, interlaced with each other, and colorless. Asci were 5 to 12 per chasmothecium (n=30), obovate or suborbicular, 40 to 68 × 20 to 35 µm (n=30), mostly containing 2-3 ascospores. Ascospores were ellipsoid-ovoid, 14 to 24 × 10 to 15 µm (n=30). The fungus was identified as Golovinomyces circumfusus based on these morphological characteristics (Braun and Cook 2012). To validate the identity, the pathogen identification was confirmed through multi-locus phylogeny using internal transcribed spacer (ITS), 28S large ribosomal subunit, intergenic spacer (IGS) and beta-tubulin (TUB2) genes amplified. (Qiu et al. 2020). The resulting sequences were registered in GenBank (OR186707 for ITS, OQ861003 for 28S rDNA, OR193383 for IGS, OR205893 for TUB2). The phylogenetic tree was obtained using maximum parsimony (MP) in PAUP 4.0b. The phylogenetic analysis of the multi-locus sequences indicated that the strain HQ1 and G. circumfusus (type) clustered together on the same branch, confirming its identification. Pathogenicity tests were performed on potted 1-year-old plants of S. baicalensis according to Koch's postulates. Three plants were inoculated by gently pressing the naturally infected leaves onto 30 healthy leaves. Three non-inoculated healthy plants served as controls. Inoculated and control plants were placed in separate growth chamber (light/dark, 14 h/10 h; humidity, 70%; temperature, 25℃). After 12 days, the inoculated plants developed typical powdery mildew symptoms, but the control leaves remained without symptoms. The fungus on inoculated leaves was re-isolated, sequenced and confirmed as G. circumfusus based on morphological characteristics and molecular identification. Powdery mildew caused by G. circumfusus has been reported affecting Eupatorium cannabinum (Asteraceae) in Germany (Qiu et al. 2020), and Bidens pilosa var. radiata and Passiflora. edulis f. flavicarpa in Taiwan (Lin et al. 2020). There is no previous report about G. circumfusus causing powdery mildew on S. baicalensis. Moreover, although powdery mildew has been reported on S. baicalensis in China, the pathogen was not further identified (Zheng et al. 2010). To our knowledge, this is the first report of powdery mildew caused by G. circumfusus on S. baicalensis in China and worldwide.

Self-Propelled Janus Nanocatalytic Robots Guided by Magnetic Resonance Imaging for Enhanced Tumor Penetration and Therapy.

Biomedical micro/nanorobots as active delivery systems with the features of self-propulsion and controllable navigation have made tremendous progress in disease therapy and diagnosis, detection, and biodetoxification. However, existing micro/nanorobots are still suffering from complex drug loading, physiological drug stability, and uncontrollable drug release. To solve these problems, micro/nanorobots and nanocatalytic medicine as two independent research fields were integrated in this study to achieve self-propulsion-induced deeper tumor penetration and catalytic reaction-initiated tumor therapy in vivo. We presented self-propelled Janus nanocatalytic robots (JNCRs) guided by magnetic resonance imaging (MRI) for in vivo enhanced tumor therapy. These JNCRs exhibited active movement in H2O2 solution, and their migration in the tumor tissue could be tracked by non-invasive MRI in real time. Both increased temperature and reactive oxygen species production were induced by near-infrared light irradiation and iron-mediated Fenton reaction, showing great potential for tumor photothermal and chemodynamic therapy. In comparison with passive nanoparticles, these self-propelled JNCRs enabled deeper tumor penetration and enhanced tumor therapy after intratumoral injection. Importantly, these robots with biocompatible components and byproducts exhibited biosecurity in the mouse model. It is expected that our work could promote the combination of micro/nanorobots and nanocatalytic medicine, resulting in improved tumor therapy and potential clinical transformations.

Gestational bisphenol A exposure advances puberty onset in female offspring: Critical time window identification.

Increasing evidence shows that the early onset of puberty in female offspring may be caused by maternal prenatal exposure to bisphenol A (BPA) during pregnancy; however, the critical time window of maternal prenatal BPA exposure remains unknown. Here, we identify the critical time window of gestational BPA exposure that induces early onset of puberty in female offspring. Pregnant CD-1 mice were gavaged with BPA (8 mg/kg) daily during the early gestational stage (GD1-GD6), middle gestational stage (GD7-GD12) or late gestational stage (GD13-GD18). We show that maternal BPA exposure during the early and middle gestational stages could advance the vaginal opening time and increase the serum levels of kisspeptin-10 and GnRH in the female offspring at PND 34. Mechanistically, maternal BPA exposure during early and middle gestation could significantly increase CpG island methylation in the Eed gene promoters but reduce the mRNA expression of Eed in the hypothalamus tissues of the female offspring. In conclusion, the critical period of maternal BPA exposure-induced early onset of puberty in female offspring is early and middle gestation; this BPA-induced early onset of puberty might be partly attributed to epigenetic programming of the Eed gene in the hypothalamus. This study provides important insights regarding the relationship and the mechanisms between BPA and offspring pubertal development.

Ethyl Acetate Extract from Artemisia argyi Prevents Liver Damage in ConA-Induced Immunological Liver Injury Mice via Bax/Bcl-2 and TLR4/MyD88/NF-κB Signaling Pathways.

BACKGROUND: Immunological liver injury (ILI) is a common liver disease and lacks potent drugs for treatment. Artemisia argyi Lévl. et Vant. (A. argyi), a medicinal and edible homologous plant usually used in diet therapy to cure various liver diseases, provides a great option for the prevention of ILI. PURPOSE: To investigate the effect that ethyl acetate extract of A. argyi (AaEA) on Concanavalin A (ConA)-induced ILI and the mechanism of regulating Bax/Bcl-2 and TLR4/MyD88/NF-κB signaling pathways. METHODS: The chemical components of AaEA were studied by LC-MS. In animal experiments, the positive control group was administrated diammonium glycyrrhizinate (DIG, 100 mg/kg), while different doses of AaEA groups (AaEA-H, AaEA-M, AaEA-L) were pretreated with AaEA 2.00, 1.00, and 0.50 g/kg, respectively, by intragastric for seven days, once every day. Then, ConA (12.00 mg/kg) was used through tail intravenous injection to establish the ILI model. The blood samples and livers were collected to test the degree of liver dysfunction, inflammation, oxidative stress, histopathological changes, and cell apoptosis. Real-time PCR and Western blotting analysis were used to explain the mechanism of regulating Bax/Bcl-2 and TLR4/MyD88/NF-κB signaling pathways. RESULTS: The way in which AaEA prevents liver damage in immunological liver injury (ILI) mice caused by ConA was investigated for the first time. Pretreatment with AaEA reduced the expression of ALT, AST, and inflammatory factors (TNF-α and IFN-γ). Meanwhile, AaEA also reduced MDA levels but upregulated the contents of IL-4, SOD, and GSH-px, alleviating oxidative stress induced by ILI. Western blotting and real-time PCR analysis demonstrated that AaEA could regulate the expression level and relative mRNA expression of key proteins on Bax/Bcl-2 and TLR4/MyD88/NF-κB signaling pathways. Finally, 504 components from AaEA were identified by LC-MS analysis, mainly including flavones, phenolic acids, and terpenoids with anti-inflammatory and liver protective activities, which highlights the potential of AaEA for diet treatment of ILI. CONCLUSION: AaEA can work against ConA-induced ILI in mice by regulating Bax/Bcl-2 and TLR4/MyD88/NF-κB signaling pathways, which has the potential to be a great strategy for the prevention of ILI.

Identification of Molecular Targets and Underlying Mechanisms of Xiaoji Recipe against Pancreatic Cancer Based on Network Pharmacology.

Traditional Chinese medicine (TCM) is applied in the anticancer adjuvant therapy of various malignancies and pancreatic cancer included. Xiaoji recipe consists several TCM materials with anticancer activities. In our work, we intended to analyze the molecular targets as well as the underlying mechanisms of Xiaoji recipe against pancreatic cancer. A total of 32 active components and 522 potential targets of Xiaoji recipe were selected using the TCMSP and SwissTargetPrediction databases. The potential target gene prediction in pancreatic cancer was performed using OMIM, Disgenet, and Genecards databases, and totally, 998 target genes were obtained. The component-disease network was constructed using the Cytoscape software, and 116 shared targets of pancreatic cancer and Xiaoji recipe were screened out. As shown in the protein-protein interaction (PPI) network, the top 20 hub genes such as TP53, HRAS, AKT1, VEGFA, STAT3, EGFR, and SRC were further selected by degree. GO and KEGG functional enrichment analysis revealed that Xiaoji recipe may affect pancreatic cancer progression by targeting the PI3K/AKT and MAPK signaling pathways. Moreover, we performed in vitro assays to explore the effect of Xiaoji recipe on pancreatic cancer cells. The results revealed that Xiaoji recipe suppressed the viability and migration and promoted the apoptosis of pancreatic cancer cells via the inactivation of PI3K/AKT, MAPK, and STAT3 pathways. The findings of our study suggested the potential of Xiaoji recipe in the targeting therapy of pancreatic cancer.

Extraction and activity of chemical constituents from Houttuynia cordata Thunb by ultrasonic method.

Polyphenols and flavonoids are phytochemicals that have essential roles in human nutrition. In this regard, the contents of polyphenols and flavonoids in Houttuynia cordata Thunb and their antioxidant activities were evaluated in the current study. Two Houttuynia cordata materials with the same chromosome number and chemical type were used to comprehensively assess the contents of total phenols and flavonoids in different parts of H. cordata. These chemical components were extracted by the ultrasonic method. The results showed that the total phenols and antioxidant capacity of different parts of H. cordata were significantly different. The content of polyphenols in roots and stems was low, the antioxidant capacity was weak, the total phenols in flowers and leaves were high, and the antioxidant capacity was strong. Therefore, different parts of H. cordata had different pharmacological and food effects. The whole herb can be used as Chinese herbal medicine, and its young leaves and roots can be used as vegetables. Flavonoids are the main phenolic components, and total phenols are the main components of antioxidant activity. It can explain a very significant positive correlation between total phenols and flavonoids. Therefore, in the further breeding work of H. cordata, the procedure can be simplified by determining one of the above indexes to predict the varieties with high total phenolic and antioxidant activity.

A Network Pharmacology Approach to Investigate the Mechanism of Erjing Prescription in Type 2 Diabetes.

Erjing prescription (EJP) was an ancient formula that was recorded in the General Medical Collection of Royal Benevolence of the Song Dynasty. It has been frequently used to treat type 2 diabetes mellitus (T2DM) in the long history of China. The formula consists of Lycium barbarum L. and Polygonatum sibiricum F. Delaroche with a ratio of 1 : 1. This study aimed to identify the potential effects and mechanisms of EJP treatment T2DM. The target proteins and possible pathways of EJP in T2DM treatment were investigated by the approach of network pharmacology and real-time PCR (RT-PCR). 99 diabetes-related proteins were regulated by 56 bioactive constituents in EJP in 26 signal pathways by Cytoscape determination. According to GO analysis, 606 genes entries have been enriched. The PPI network suggested that AKT1, EGF, EGFR, MAPK1, and GSK3ß proteins were core genes. Among the 26 signal pathways, the PI3K-AKT signal pathway was tested by the RT-PCR. The expression level of PI3K p85, AKT1, GSK3ß, and Myc mRNA of this pathway was regulated by EJP. The study based on network pharmacology and RT-PCR analysis revealed that the blood sugar level was regulated by EJP via regulating the PI3K-AKT signal pathway. Plenty of new treatment methods for T2DM using EJP were provided by network pharmacology analysis.

Maternal vitamin D supplementation inhibits bisphenol A-induced proliferation of Th17 cells in adult offspring.

Bisphenol A (BPA) exposure can increase the risk of immune-related diseases in later life. Vitamin D3 (Vit D3) has been shown to have multiple immunomodulatory actions and has been used to treat immune diseases. However, the potential beneficial effects of Vit D3 on BPA-induced adverse effects in the immune system have not explored. We hypothesize that VitD3 may ameliorate BPA-induced side effects in the immune system, even in offspring of VitD3-supplemented mothers. Here, we established our experimental model by exposing pregnant dams with 1000 nM BPA with or without VitD3 (0.25 µg/kg, 1 µg/kg and 4 µg/kg) treatment. We show that mother's exposure to BPA increases proliferation of the spleen T helper 17 (Th17) cells and serum protein level of IL-17 in the offspring; however, VitD3 supplementation in mothers dose-dependently ameliorated these BPA-induced side effects on the immune system in the offspring as evidenced by attenuated upregulation of Th17 proliferation, and RORγt, IL-17, IL-6, and IL-23 expressions in the offspring. Our data provide the first evidence that maternal VitD3 supplementation offers benefits to the offspring by attenuating BPA-induced side effects on the immune system through vitamin D receptor (VDR)-dependent regulation of transcription factors and cytokines, suggesting its translational potential.

Structure of human GABAB receptor in an inactive state.

The human GABAB receptor-a member of the class C family of G-protein-coupled receptors (GPCRs)-mediates inhibitory neurotransmission and has been implicated in epilepsy, pain and addiction1. A unique GPCR that is known to require heterodimerization for function2-6, the GABAB receptor has two subunits, GABAB1 and GABAB2, that are structurally homologous but perform distinct and complementary functions. GABAB1 recognizes orthosteric ligands7,8, while GABAB2 couples with G proteins9-14. Each subunit is characterized by an extracellular Venus flytrap (VFT) module, a descending peptide linker, a seven-helix transmembrane domain and a cytoplasmic tail15. Although the VFT heterodimer structure has been resolved16, the structure of the full-length receptor and its transmembrane signalling mechanism remain unknown. Here we present a near full-length structure of the GABAB receptor, captured in an inactive state by cryo-electron microscopy. Our structure reveals several ligands that preassociate with the receptor, including two large endogenous phospholipids that are embedded within the transmembrane domains to maintain receptor integrity and modulate receptor function. We also identify a previously unknown heterodimer interface between transmembrane helices 3 and 5 of both subunits, which serves as a signature of the inactive conformation. A unique 'intersubunit latch' within this transmembrane interface maintains the inactive state, and its disruption leads to constitutive receptor activity.

Tissue-Specific Transcriptome Analysis Reveals Candidate Genes for Terpenoid and Phenylpropanoid Metabolism in the Medicinal Plant Ferula assafoetida.

Ferula assafoetida is a medicinal plant of the Apiaceae family that has traditionally been used for its therapeutic value. Particularly, terpenoid and phenylpropanoid metabolites, major components of the root-derived oleo-gum-resin, exhibit anti-inflammatory and cytotoxic activities, thus offering a resource for potential therapeutic lead compounds. However, genes and enzymes for terpenoid and coumarin-type phenylpropanoid metabolism have thus far remained uncharacterized in F. assafoetida Comparative de novo transcriptome analysis of roots, leaves, stems, and flowers was combined with computational annotation to identify candidate genes with probable roles in terpenoid and coumarin biosynthesis. Gene network analysis showed a high abundance of predicted terpenoid- and phenylpropanoid-metabolic pathway genes in flowers. These findings offer a deeper insight into natural product biosynthesis in F. assafoetida and provide genomic resources for exploiting the medicinal potential of this rare plant.

[Effect of Microbial Community Structure and Metabolites on Sludge Settling Ability Under Three Different Switching Condition Processes].

Using sodium acetate as the carbon source, sludge settling ability (settleability) was investigated under three processes:AAO nitrogen and phosphorus removal(process Ⅰ), AO nitrification-denitrification (process Ⅱ), and aerobic carbon removal (process Ⅲ). The succession of microbial community structures in sludge was traced, the content and composition of microbial metabolites were monitored, and the effects of operational mode on sludge settleability were analyzed. The results showed that the settleability of process Ⅰ was the best, followed by process Ⅲ and Ⅱ. Under the different operating conditions, the dominant bacteria and microbial community structure of the system changed significantly. The relative amount of Thiothrix was the dominant bacteria affecting the sludge settleability. The abundances of Thiothrix were only 0.08% and 1.51% with fresh sludge and in process Ⅰ; this abundance increased to 9.41% in process Ⅱ and decreased to 4.29% in process Ⅲ. The anaerobic zone of process I had an inhibitory effect on the growth of the bacterium, while the anoxic zone of process Ⅱ stimulated its dominant growth. At the same time, comparison showed that the microbial population diversity was highest in process Ⅰ. followed by processes Ⅱ and Ⅲ. The introduction of anoxic and anaerobic zones led to the increase of system function and environmental complexity, and increased microbial community diversity. Analyses of extracellular polymeric substances (EPS) and fluorescence characteristics showed that the changes in microbial community structure had a significant effect on the composition and content of EPS, which aggravated the process of improving or deteriorating settleability. The sludge settleability was found to be positively correlated with the ratio of protein and polysaccharide in loosely bound EPS.

A Finite Element Analysis of Stress Distribution and Disk Displacement in Response to Lumbar Rotation Manipulation in the Sitting and Side-Lying Positions.

OBJECTIVE: This study aimed to investigate stress distribution and disk displacement in healthy and degenerated intervertebral disks during simulated lumbar rotation manipulation (LRM) in the sitting and side-lying positions. METHODS: Three-dimensional (3D) finite element models of healthy, mildly degenerated and moderately degenerated L4/5 spinal units were reconstructed. Lumbar rotation manipulation in the sitting and side-lying positions were simulated, and alterations in stress distribution and disk displacement in the lumbar disks were observed. RESULTS: The application of LRM in the sitting or side-lying position resulted in a similar stress distribution in healthy, mildly degenerated, and moderately degenerated disks. Stress was concentrated at the anterior right side of the annulus. In all disks, intradiskal pressure (IDP) and maximum von Mises stress were higher during LRM in the sitting position than during LRM in the side-lying position. During these manipulations, Intradiskal pressure and stress in the annulus of moderately degenerated disks were higher than in mildly degenerated disks. Displacement was most obvious in healthy disks. CONCLUSIONS: Mildly and moderately degenerated lumbar disks were subject to higher stress during LRM in the sitting position than during LRM in the side-lying position. Intradiskal pressure and the maximum von Mises stress in the annulus of moderately degenerated disks increased, suggesting the need for caution when treating patients with moderately compromised disks. Although our results are in accordance with previously published data, they are simulated and preliminary and do not necessarily replicate the clinical condition.

[Paeoniflorin ameliorates liver injury of MRL/lpr mice through inhibition of NF-κB pathway].

Objective To investigate the effects of paeoniflorin (PF) on liver injury of MRL/lpr mice and its underlying mechanisms. Methods The research included 10 normal control C57BL/6 mice and 40 MRL/lpr mice. MRL/lpr mice were randomly assigned equally to a blank control group, a dexamethasone (1.5 mg/kg) group, and two PF (20, 40 mg/kg) groups. The serum levels of alanine transaminase (ALT) and aspartate transaminase (AST) were tested with microplate assay. Inflammatory cytokines in the serum and liver were also detected using ELISA. Liver pathological changes were observed using HE staining. The protein levels of receptor interacting protein140 (RIP140), Toll-like receptor 4 (TLR4), p-NF-κBp65, NF-κBp65, p-IκBα and IκBα in the liver were detected by Western blot analysis. Results PF significantly decreased the serum levels of AST and ALT, obviously decreased the expressions of the inflammatory cytokines IL-1ß, IL-6 and TNF-α in the serum and liver, alleviated liver pathological changes and inhibited the expressions of RIP140, TLR4, p-NF-κBp65, p-IκBα proteins in the MRL/lpr mice. Conclusion PF has protective effects against liver injury in MRL/lpr mice by inhibiting NF-κB pathway.

Complementary and alternative medicine use amongst patients with cardiovascular disease in Singapore.

BACKGROUND: Data on complementary and alternative medicine (CAM) use in patients with cardiovascular disease (CVD) are lacking. We aim to investigate the prevalence of CAM use among patients with CVD attending a tertiary centre for cardiovascular care, their attitudes and beliefs towards CAM, and factors associated with CAM usage. METHODS: A cross-sectional, self-administered written survey was conducted on consecutive patients attending outpatient cardiovascular clinics at our tertiary institution over 2 months from June to July 2014. Information gathered included demographic data and various aspects of CAM use. RESULTS: A total of 768 responses (562 males, mean age 57 ± 13 years, 74 % Chinese, 6 % Malay, 14 % Indian) were included. The prevalence of CAM use in the cohort was 43.4 % (333/768). Biologically-based systems (29.4 %) was the most common type of CAM used. Some patients (19.0 %) used multiple types of CAM simultaneously. External influences (78.1 %) were cited more than internal influences (47.8 %) to affect CAM use. Malay ethnicity (compared to Chinese) was the only significant negative multivariate predictor of CAM use (OR = 0.531 (95 % CI 0.147 to 0.838), p = 0.018). A significantly higher proportion of CAM users compared to non-CAM users were non-compliant to medications (35.6 %, n = 114 vs. 20.5 %, n = 84, p < 0.001) and consults (41.4 %, n = 130 vs. 28.1 %, n = 112, p < 0.001) respectively. CONCLUSION: The usage of CAM is prevalent amongst our patients with CVD. CAM use was associated with poorer reported compliance to medications and consults. Understanding the factors influencing CAM use amongst CVD patients provides medical professionals with an opportunity to better discuss CAM use and potentially enhance the patient-physician interaction.

Miniscalpel-Needle Treatment Is Effective for Work-Related Neck and Shoulder Musculoskeletal Disorders.

Background. Work-related musculoskeletal disorders (MSDs) are a group of painful disorders of muscles, tendons, and nerves, such as neck and shoulder MSD. This study was designed to use miniscalpel-needle (MSN) technique as an intervention for work-related MSDs. Methods. Thirty-one patients with work-related MSDs and 28 healthy subjects were enrolled as controls in this study. The MSD symptoms of each patient were assessed by visual analog scale (VAS) and neck disability index (NDI). Blood samples were collected from control subjects and MSD patients before and after treatment. Serum levels of C-reactive protein (CRP) and tumor necrosis factor (TNF) were measured using ELISA. Results. Prior to MSN treatment, serum levels of CRP and TNF were significantly higher in the MSD patients than the healthy controls. Serum CRP levels correlated with VAS and NDI scores, and serum TNF levels correlated with NDI scores. Compared to pretreatment, VAS and NDI scores were significantly lower in MSD patients after MSN treatment, while serum CRP and TNF levels were significantly lower compared with the healthy control levels. Conclusions. Our results indicate that MSN may be an effective intervention for work-related MSDs and be associated with lower serum levels of inflammatory biomarkers.

Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up.

OBJECTIVE: Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN) release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain. METHODS: We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI), numerical pain rating scale (NPRS), and active cervical range of motion (CROM). The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine) until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3-5 times without rotation. RESULTS: A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain) were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment) was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53), a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4-11). At 12 months after the treatment, both NPRS and NDI were significantly lower [3 (0, 9) vs. 7 (5, 10) at the baseline for NPRS; [7 (0, 21) vs. 17 (9, 36) for NDI; p<0.001 for both]. All 6 measures of CROM were significantly higher at 12 months vs. the baseline. No severe complications (such as nerve damage and hematoma) were noted. DISCUSSION: MSN release is effective, even 12 months after the treatment, in patients with chronic neck pain. Caution must be exercised in data interpretation due to the respective nature of the study and lack of a comparator group.

Miniscalpel-Needle versus Steroid Injection for Plantar Fasciitis: A Randomized Controlled Trial with a 12-Month Follow-Up.

Plantar fasciitis is the most common cause of heel pain in adults. A novel alternative medical instrument, the miniscalpel-needle (MSN), which is based on an acupuncture needle, has been recently developed in China. The objective of this study was to evaluate the effectiveness of the MSN release treatment versus that of traditional steroid injection for plantar fasciitis. Patients with plantar fasciitis were randomly assigned to 2 groups and followed up for 12 months, with 29 receiving MSN treatment and 25 receiving steroid injection treatment. The results showed that visual analog scale scores for morning pain, active pain, and overall heel pain all were decreased significantly in the MSN group from 1 to 12 months after treatment. In contrast, treatment with steroid injection showed a significant effect only at the 1-month follow-up but not at 6 or 12 months after treatment. Moreover, the MSN group achieved more rapid and sustained improvements than the steroid group throughout the duration of this study. No severe side effects were observed with MSN treatment. Our data suggest that the MSN release treatment is safe and has a significant benefit for plantar fasciitis compared to steroid injection.

Choice of primary health care source in an urbanized low-income community in Singapore: a mixed-methods study.

INTRODUCTION: Cost and misperceptions may discourage lower income Singaporeans from utilizing primary care. We investigated sources of primary care in a low-income Singaporean community in a mixed-methods study. METHODS: Residents of a low-income public rental flat neighbourhood were asked for sociodemographic details and preferred source of primary care relative to their higher income neighbours. In the qualitative component, interviewers elicited, from patients and health care providers, barriers/enablers to seeking care from Western-trained doctors. Interviewees were selected via purposive sampling. Transcripts were analyzed thematically, and iterative analysis was carried out using established qualitative method. RESULTS: Participation was 89.8% (359/400). Only 11.1% (40/359) preferred to approach Western-trained doctors, 29.5% (106/359) preferred alternative medicine, 6.7% (24/359) approached family/friends and 52.6% (189/359) preferred self-reliance. Comparing against higher income neighbours, rental flat residents were more likely to turn to alternative medicine and family members but less likely to turn to Western-trained doctors (P < 0.001). For the qualitative component, a total of 20 patients and 9 providers were interviewed before data saturation was reached. Patient and provider comments fell into the following content areas: primary care characteristics, knowledge, costs, priorities, attitudes and information sources. Self-reliance was perceived as acceptable for 'small' illnesses but not for 'big' ones, communal spirit was cited as a reason for consulting family/friends and social distance from primary care practitioners was highlighted as a reason for not consulting Western-trained doctors. CONCLUSION: Western-trained physicians are not the first choice of lower income Singaporeans for seeking primary care. Knowledge, primary care characteristics and costs were identified as potential barriers/enablers.