Integrating metabolomics and lipidomics revealed a decrease in plasma fatty acids but an increase in triglycerides in children with drug-refractory epilepsy.

OBJECTIVE: The drug-refractory epilepsy (DRE) in children is commonly observed but the underlying mechanisms remain elusive. We examined whether fatty acids (FAs) and lipids are potentially associated with the pharmacoresistance to valproic acid (VPA) therapy. METHODS: This single-center, retrospective cohort study was conducted using data from pediatric patients collected between May 2019 and December 2019 at the Children's Hospital of Nanjing Medical University. Ninety plasma samples from 53 responders with VPA monotherapy (RE group) and 37 non-responders with VPA polytherapy (NR group) were collected. Non-targeted metabolomics and lipidomics analysis for those plasma samples were performed to compare the potential differences of small metabolites and lipids between the two groups. Plasma metabolites and lipids passing the threshold of variable importance in projection value >1, fold change >1.2 or <0.8, and p-value <0.05 were regarded as statistically different substances. RESULTS: A total of 204 small metabolites and 433 lipids comprising 16 different lipid subclasses were identified. The well-established partial least squares-discriminant analysis (PLS-DA) revealed a good separation of the RE from the NR group. The FAs and glycerophospholipids status were significantly decreased in the NR group, but their triglycerides (TG) levels were significantly increased. The trend of TG levels in routine laboratory tests was in line with the lipidomics analysis. Meanwhile, cases from the NR group were characterized by a decreased level of citric acid and L-thyroxine, but with an increased level of glucose and 2-oxoglutarate. The top two enriched metabolic pathways involved in the DRE condition were biosynthesis of unsaturated FAs and linoleic acid metabolism. SIGNIFICANCE: The results of this study suggested an association between metabolism of FAs and the medically intractable epilepsy. Such novel findings might propose a potential mechanism linked to the energy metabolism. Ketogenic acid and FAs supplementation might therefore be high-priority strategies for DRE management.

[Mechanism of Taohong Siwu Decoction in treating soft tissue injury based on UPLC-Q-TOF-MS,network pharmacology and experimental verification].

To explore the action mechanism of Taohong Siwu Decoction(THSWD) in the treatment of soft tissue injury(STI) based on UPLC-Q-TOF-MS technique, network pharmacology and experimental verification method. UPLC-Q-TOF-MS technique was used to identify the chemical constituents of THSWD. The active ingredients and predicted target proteins of THSWD were screened out through TCMSP database. Cytoscape software was used to construct the active component-target-pathway network, and STRING database was used for protein interaction analysis. GeneCards and CTD databases were used to screen out relevant targets of STI. GO function and KEGG pathway enrichment analysis were performed through DAVID database. The rat model of STI was constructed, and Western blot was used to verify the effect of THSWD on key targets of relevant pathways. The results showed 40 active ingredients in THSWD, and 141 potential targets and 20 targets of STI. Target enrichment analysis of the active components produced 128 KEGG pathways, which were mainly concentrated in amino acid synthesis and metabolism, disease signaling pathways, apoptosis, inflammation and other relevant pathways. Western blot showed that THSWD intervention could significantly decrease PTGS2, CASP3, NFKB1, p-CASP3 and p-NFKB1, while enhancing the expression of TP53 protein in the STI samples of rats. According to the results of UPLC-Q-TOF-MS, network pharmacology and experimental verification, active ingredients in THSWD may play anti-inflammatory and antioxidant effects in NF-κB signaling pathway and apoptotic pathway, thus playing a role in the treatment of STI.

Acidogenic phosphorus recovery from the wastewater sludge of the membrane bioreactor systems with different iron-dosing modes.

A novel acidogenic phosphorus recovery (APR) process was developed in combination with Fe(III)-based chemical phosphorus removal and a membrane bioreactor (MBR) for enhanced wastewater treatment and effective P recovery. Two different system configurations were evaluated: Fe-dosing MBR (Fe-MBR), with the Fe-dosing into the MBR, and Fe-enhanced primary sedimentation followed by the MBR (FeP-MBR). The results show that both systems performed well for enhanced nutrient (N and P) removals and P recovery, with approximately 50% of the total P recovered from the municipal wastewater in the form of vivianite. Compared to the Fe-MBR system, FeP-MBR achieved more efficient P recovery under low food-waste loading conditions, maintained a higher ratio of biomass in activated sludge and experienced a slower rate of membrane fouling. Important functional bacteria were identified, including Prevotella and Selenomonas, which are active in hydrolysis and acidogenesis of sludge, and Aeromonas and Sulfurospirillum, which are involved in dissimilatory iron reduction.

[Characteristics of leaf carbon, nitrogen and phosphorus stoichiometry in relation to plant size of Machilus pauhoi].

To explore the effects of stand age on variation patterns of leaf C, N, P stoichiometric characteristics of Machilus pauhoi, two stands, i.e., 9 and 13 years old, were selected. The relationships between leaf nutrient contents (C, N and P) and diameters at breast height (DBH) of individual plants were analyzed. The data revealed that the individual variations of seedlings in M. pauhoi stands were strengthened with the stand development. The stand age had significant effects on leaf C, N, P contents and C:N ratio but not on C:P and N: P ratios. Specifically, the mean values of leaf C, N, P contents and N:P ratio in the 9-year-old stand were lower than those in the 13-year-old stand, whereas, inverse pattern of C:N and C:P ratios were found in the two stands. Furthermore, leaf N and P stoichiometry varied significantly within the stand. Specifically, leaf N and P contents, as well as their stoichiometric ratios, linearly correlated with DBH in the 9-year-old stand. On the contrary, leaf N and P stoichiometry showed quadratic correlation in 13-year-old stand (except leaf C:N which linearly correlated with DBH). Lastly, nutrient transfer rates of leaf N and P in the 9-year-old stand were higher than that in 13-year-old stand, and the discrepancies of leaf nutrient transfer strategy between growing and non-growing seasons were caused by the different growth phases and environmental conditions.

[Effects of acupuncture-drug compound anesthesia on perioperative inflammatory factors in patients undergoing cardiac surgery].

OBJECTIVE: To explore the effect of acupuncture-drug compound anesthesia on immune function in patients with extracorporeal circulation undergoing cardiac surgery. METHODS: Thirty cases undergoing cardiac surgery which included atrial septal defect neoplasty, ventricular septal defect neoplasty, mitral valve replacement and pulmonary valve coarctotomy were randomly divided into group A and group B, 15 cases in each group. Group A was given general anesthesia plus acupuncture at Neiguan (PC 6), Lieque (LU 7) and Yunmen (LU 2), and group B was given simple general anesthesia. Tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-10 (IL-10) levels before and after surgery were compared. RESULTS: The level of TNF-alpha was increased and the levels of IL-2 and IL-10 in the serum were decreased in both groups after extracorporeal circulation for 2 h and 24 h, and the ranges of all changes were more less in group A (all P < 0.05). CONCLUSION: Compared with simple general anesthesia, acupuncture-drug compound anesthesia can improve immune suppression partially in the perioperative periods under the same conditions of controlling anesthesia degree.

[Effects of electroacupuncture of unilateral and bilateral "zusanli" (ST 36) on serum TNF-alpha, IL-1 and IL-4 levels in rats with chronic inflammatory pain].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on serum tumor necrosis factor-alpha (TNF-alpha), IL-1 and IL-4 levels in rats with chronic inflammatory pain, so as to investigate its underlying mechanism in relieving pain. Methods Forty-eight SD rats were randomized into control, model, EA-unilateral ST 36, and EA-bilateral ST 36 groups, with 12 rats in each. Chronic inflammatory pain model was established by intradermal injection of Freund's complete adjuvant (0.1 mL) into the right paw. EA (2 Hz/100 Hz, 1-2-3 mA) was applied to the unilateral "Zusanli" (ST 36) and bilateral "Zusanli" (ST 36) for 30 min, once every 3 days and continuously for 4 weeks. Serum TNF-alpha, IL-1 and IL-4 contents were detected by enzyme linked immunosorbent assay. Results Compared with the control group, serum TNF-alpha, IL-1 and IL-4 contents of the model group increased significantly (P < 0.01), while in comparison with the model group, the levels of the 3 indexes were decreased considerably in both unilateral and bilateral ST 36 groups (P < 0.01). No significant differences were found between the unilateral ST 36 and bilateral ST 36 groups in serum TNF-alpha, IL-1 and IL-4 contents (P > 0.05). CONCLUSION: EA can effectively lower serum TNF-alpha, IL-1 and IL-4 levels in inflammatory pain rats, which may contribute to its effect in relieving inflammatory pain.

Intraoperative allogeneic red blood cell transfusion in ampullary cancer outcome after curative pancreatoduodenectomy: a clinical study and meta-analysis.

BACKGROUND: Allogeneic blood transfusion (ABT) containing packed red blood cells (RBCs) has a known immunosuppressive effect that may affect cancer metastases and recurrence. This study examined whether intraoperative allogeneic RBC transfusion is an independent risk factor of adverse outcome in patients with ampullary carcinoma after curative pancreatoduodenectomy. METHODS: The clinical data of 67 patients with carcinoma of the ampulla of Vatar underwent pancreatoduodenectomy between 1999 and 2004 were analyzed, and long-term follow-up visits were made for all patients. Kaplan-Meier statistics and Cox proportional hazard methodology were used to perform univariate and multivariate analysis to identify independent risk factors for survival. For the meta-analysis, all English-language studies regarding blood transfusion from carcinoma of the ampulla of Vatar or ampullary carcinoma and prognostic factors or factors for survival from 1995 to 2007 were reviewed, and contingency tables were constructed from which a summary relative risk was calculated. RESULTS: There were 43 patients (64.2%) who received an intraoperative ABT. The amount of intraoperative ABT ranged from 2 to 13 (mean, 4.25) units; there were 18 patients transfused at 2 units, and 25 patients transfused > or =3 units. The follow-up ranged from 2 to 90 (mean, 49) months. Forty-five patients (67.2%) died as a result of tumor progression. For patients transfused > or =3 units, median and cumulative 3-year and 5-year survivals were poorer significantly than that of patients transfused with 2 units and/or nontransfused patients (P < 0.05). After multivariate analysis, except for presence of lymph node metastasis (P = 0.023) and pancreatic invasion (P = 0.024), the intraoperative ABT > or =3 units was found to be an independent poor prognostic factor for those with ampullary cancer after curative pancreatoduodenectomy either (relative risk, 2.082; 95% confidence interval (CI), 1.048-4.135; P = 0.036). Meta-analysis of 346 patients showed the summary relative risk of an adverse outcome after intraoperative ABT in these studies was 2.55 (95% CI, 1.59-4.1). CONCLUSIONS: The amount of intraoperative ABT is one of the important factors that adversely influenced survival in patients with ampullary cancer after curative pancreatoduodenectomy. Healing anemia preoperatively and careful dissection to minimize intraoperative bleeding as much as possible are mandatory for reducing risk of the intraoperative ABT.