Changes in brain susceptibility in Wilson's disease patients: a quantitative susceptibility mapping study.

AIM: To assess changes in the susceptibility of the caudate nucleus (CN), putamen, and globus pallidus (GP) in patients with neurological and hepatic Wilson's disease (WD) by quantitative susceptibility mapping (QSM). MATERIAL AND METHODS: The brain MRI images of 33 patients diagnosed with WD and 20 age-matched controls were analysed retrospectively. All participants underwent brain T1-weighted, T2-weighted, and QSM imaging using a 1.5 T magnetic resonance imaging (MRI) machine. QSM maps were evaluated with the STISuite toolbox. The quantitative susceptibility levels of the CN, putamen, and GP were analysed using region of interest analysis on QSM maps. Differences among neurological WD patients, hepatic patients, and controls were determined. RESULTS: Susceptibility levels were significantly higher for all examined structures (CN, putamen and GP) in patients with neurological WD compared with controls (all p<0.05) and hepatic WD patients (all p<0.05). No statistically significant differences were found in susceptibility levels between patients with hepatic WD and controls (all p>0.05). CONCLUSION: The QSM technique is a valuable tool for detecting changes in brain susceptibility in WD patients, indicating abnormal metal deposition. Notably, the current findings suggest that neurological WD patients exhibit more severe susceptibility changes compared with hepatic WD patients. Therefore, QSM can be utilised as a complementary method to detect brain injury in WD patients.

Bibliometric analysis of intestinal microbiota in diabetic nephropathy.

OBJECTIVE: The purpose of this study is to use bibliometrics to explore the research overview and research hotspots. MATERIALS AND METHODS: The relevant literature on intestinal flora and diabetic nephropathy in the Web of Science Core Collection was sorted out, and VOSviewer, CiteSpace, Scimago Graphica and other software were used to conduct data visualization analysis on the number of publications, countries, institutions, journals, authors, keywords and citations. RESULTS: A total of 124 relevant literatures were included. From 2015 to 2022, the number of published papers increased every year. The countries, institutions and journals that published the most articles in this field are China, Isfahan University Medical Science and Frontiers in Pharmacology. Liu Bicheng and Mirlohi Maryam are the authors with the most published articles in this field. The main keywords of research in this field are obesity, inflammation, oxidative stress, indoxyl sulfate, short-chain fatty acids (SCFAs) and Chinese herbal medicine. CONCLUSIONS: This is the first bibliometric analysis of diabetic nephropathy and gut microbiota, reporting hot spots and emerging trends. Obesity, inflammation, oxidative stress, indoxyl sulfate, SCFAs and Chinese herbal medicine are the main keywords of current research, and SCFAs and Chinese herbal medicine may be the hotspots of future research.

[Chinese multidisciplinary expert consensus on the management of adverse drug reactions associated with savolitinib].

MET gene is a proto-oncogene, which encodes MET protein with tyrosine kinase activity. After binding to its ligand, hepatocyte growth factor, MET protein can induce MET dimerization and activate downstream signaling pathways, which plays a crucial role in tumor formation and metastasis. Savolitinib, as a specific tyrosine kinase inhibitor (TKI) targeting MET, selectively inhibits the phosphorylation of MET kinase with a significant inhibitory effect on tumors with MET abnormalities. Based on its significant efficacy shown in the registration studies, savolitinib was approved for marketing in China on June 22, 2021 for the treatment of advanced non-small cell lung cancer with MET 14 exon skipping mutations. In addition, many studies have shown that MET TKIs are equally effective in patients with advanced solid tumors with MET gene amplification or MET protein overexpression, and relevant registration clinical studies are ongoing. The most common adverse reactions during treatment with savolitinib include nausea, vomiting, peripheral edema, pyrexia, and hepatotoxicity. Based on two rounds of extensive nationwide investigations to guide clinicians, the consensus is compiled to use savolitinib rationally, prevent and treat various adverse reactions scientifically, and improve the clinical benefits and quality of life of patients. This consensus was prepared under the guidance of multidisciplinary experts, especially including the whole-process participation and valuable suggestions of experts in Traditional Chinese Medicine, thus reflecting the clinical treatment concept of integrated Chinese and western medicines.

[The works of Zhang Wenzhong as the Shang Yao Feng Yu in the early Tang Dynasty].

Zhang Wenzhong, a famous Chinese medical doctor in the early Tang Dynasty, was granted a particular position as Shang Yao Feng Yu, for the Empress Wu Ze Tian dealing with medication. He was good at dealing with stroke in particular. He also had unique viewpoints towards medical prescriptions and skills. He wrote medical books and developed his own medical theories. All these were recorded in both the Book of Tang and the New Book of Tang. However, most of his works had been lost due to time and the frequent wars in the middle and late Tang Dynasty. Six medical prescriptions signed by Zhang Wenzhong were discovered in documents unearthed from the Dun Huang Sutra Cave. They were believed to be important archives of Zhang Wenzhong's writing and medical thoughts. In addition, some pieces of work found in the documents unearthed from Tu Yu Gou were suspected of being written by Zhang Wenzhong. This can be compared with his works cited in the handed-down documents, such as The Collection of Secret Prescriptions (Wai Tai Mi Yao Fang). This paper takes a textual research approach to examine the medical works of Zhang Wenzhong, comparing the handed-down documents with the unearthed documents to examine his medical achievements.

The effect of metformin on vitamin B12 level in pediatric patients.

PURPOSE: Metformin is a common medication for patients with hyperglycemia. In adults, one well-documented side effect of metformin is vitamin B12 deficiency. However, this side effect has rarely been studied in pediatric patients. This study examined the changes of vitamin B12 level in pediatric patients being treated with metformin. METHODS: Data were collected from pediatric patients (n=151) with at least 3 months of consecutive metformin intake. The effects of dose of metformin on the mean vitamin B12 level were investigated at 6, 12, 24, and 36 months. The effect of compliance of metformin intake on vitamin B12 level also was studied. RESULTS: There was no significant decrease in mean vitamin B12 level at 6, 12, 24, or 36 months in patients treated with metformin. Mean vitamin B12 decrease was only noticeable (p<0.05) in patients taking a high dose of metformin with good compliance. Despite this change, the mean vitamin B12 remained well within the normal reference range. Furthermore, of the 151 patients studied, only 1 demonstrated vitamin B12 deficiency after 12 months of treatment. However, his B12 level was normal at 24 and 36 months without any vitamin B12 supplements. CONCLUSION: Our findings suggest that metformin treatment in children does not cause vitamin B12 deficiency; however, the effect of long-term consistent high-dose treatment on vitamin B12 level remains unknown.

[Efficacy of 1 384 cases of peritoneal carcinomatosis underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy].

Objective: Peritoneal carcinomatosis refers to a group of heterogeneous (primary or secondary) malignancies in the surface of the peritoneum. Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is a comprehensive treatment strategy aiming at peritoneal carcinomatosis. This study analyzed the efficacy and safety of CRS+HIPEC in patients with peritoneal carcinomatosis, and explored prognostic factors. Methods: In this descriptive case-series study, the clinicopathological data of 1384 consecutive patients with peritoneal carcinomatosis treated in Zhongnan Hospital of Wuhan University (330 patients) and Shijitan Hospital of Capital Medical University (1054 patients) from January 2004 to January 2020 were collected retrospectively. Treatment patterns of CRS+HIPEC characteristics (operative time, number of resected organs, number of stripped peritoneum, number of anastomosis, and HIPEC regimens), safety [blood loss volume, postoperative severe adverse event (SAE) and treatment outcome], survival time and prognostic factors influencing survival were analyzed. The SAE was defined as grade III-IV adverse event according to the Peritoneal Surface Oncology Group International Textbook. Perioperative period was defined from the day of CRS+HIPEC to postoperative 30th day. OS was calculated from the day of CRS+HIPEC to the date of death or the last follow-up. Kaplan-Meier method was used for survival analysis, and log-rank test was used for comparison between groups. Cox regression model was used to identify the prognostic factors. Results: Among 1384 peritoneal carcinomatosis patients, 529 (38.2%) were male; median age was 55 (10-87) years old; median body mass index (BMI) was 22.6 kg/m(2); peritoneal carcinomatosis of 164 (11.8%) patients were from gastric cancer, 287 (20.7%) from colorectal cancer, 356 (25.7%) from pseudomyxoma peritonei, 90 (6.5%) from malignant peritoneal mesothelioma, 300 (21.7%) from gynecological cancer or primary peritoneal carcinoma, and 187 (13.5%) from retroperitoneal sarcoma, lung cancer, breast cancer, and other rare tumors. The median duration of CRS+HIPEC was 595 (90-1170) minutes, median number of resected organs was 2 (0-10), median number of resected peritoneal area were 4 (0-9), median peritoneal cancer index (PCI) was 21(1-39). Completeness of cytoreduction (CC) score of 0-1 was observed in 857 cases (61.9%). Regarding HIPEC regimens, there were 917 cases (66.3%) with cisplatin plus docetaxel, 183 cases (13.2%) with cisplatin plus mitomycin, 43 cases (3.1%) with adriamycin plus ifosfamide, and the other 240 cases (17.3%) with modified regimens. Perioperative SAE developed in 331 peritoneal carcinomatosis patients (23.9%) with 500 cases, of whom 21 patients (1.5%) died during the perioperative period due to ineffective treatment, while the others recovered after active treatment. During median follow-up time of 8.6 (0.3-82.7) months, there were 414 deaths (29.9%). The median OS was 38.2 months (95% CI: 30.6-45.8), and the 1-, 3-, 5-year survival rate was 73.5%, 50.4% and 39.3%, respectively. The median OS of peritoneal carcinomatosis patients from gastric cancer, colorectal cancer, pseudomyxoma peritonei, malignant peritoneal mesothelioma and female genital cancer or primary peritoneal carcinomatosis was 11.3 months (95% CI: 8.9-13.8), 18.1 months (95% CI: 13.5-22.6), 59.7 months (95% CI: 48.0-71.4), 19.5 months (95% CI: 6.0-33.0) and 51.7 months (95% CI: 14.6-88.8), respectively, and the difference among groups was statistically significant (P<0.001). Univariate and multivariate analyses revealed that the primary gastric cancer (HR=4.639, 95% CI: 1.692-12.724), primary colorectal cancer (HR=4.292, 95% CI: 1.957-9.420), primary malignant peritoneal mesothelioma (HR=2.741, 95% CI: 1.162-6.466), Karnofsky performance status (KPS) score of 60 (HR=4.606, 95% CI: 2.144-9.895), KPS score of 70 (HR=3.434, 95% CI: 1.977-5.965), CC score of 1 (HR=2.683, 95% CI: 1.440~4.999), CC score of 2-3 (HR=3.661,95% CI: 1.956-6.852) and perioperative SAE (HR=2.588, 95% CI: 1.846-3.629) were independent prognostic factors influencing survival with statistically significant differences (all P<0.05). Conclusions: CRS+HIPEC is an effective integrated treatment strategy for patients with peritoneal carcinomatosis, which can prolong survival with acceptable safety. Preoperative evaluation of patients' general condition is necessary and CRS+HIPEC should be carefully considered to perform for patients with preoperative KPS score <80. During the operation, the optimal CRS should be achieved on condition that safety is granted. In addition, it is necessary to prevent perioperative SAE to reduce the risk of death in peritoneal carcinomatosis patients.

Research Note: Effect of dietary cottonseed meal and soybean oil concentration on digesta passage time and amino acids digestibility in roosters.

Two experiments were conducted to study the effect of dietary cottonseed meal (CM) and soybean oil (SO) on passage time of digesta and standardized ileal digestibility (SID) of amino acids (AA). The experimental design was a 2 × 2 factorial arrangement evaluating the levels of CM (20 or 40 %) and SO (0 or 10 %). Experiment 1 estimated the effect of CM and SO on the passage time of digesta. Twenty-five Chinese yellow-feathered roosters (BW = 2.61 ± 0.08 kg; 26-wk-old) were individually weighed and allocated to 5 diets in 5 randomized complete blocks by initial BW. Experimental diet 1 contained 20% CM and 0 SO, diet 2 contained 20% CM and 10% SO, diet 3 contained 40% CM and 0% SO, diet 4 contained 40% CM and 10% SO, and a nitrogen-free diet was also fed. Passage time through the total digestive tract was determined by time-relative cumulation of dry excreta. Experiment 2 estimated the effect of CM and SO on SID of AA in CM. Thirty Chinese yellow-feathered roosters (BW = 2.91 ± 0.05 kg; 26-wk-old) were allocated to the 5 experimental diets in 6 randomized complete blocks by initial BW to determine the SID of AA. Increasing CM concentration significantly reduced the time for 50% relative cumulation of dry excreta (P < 0.05). Adding 10% SO tended to increase the time for 50% relative cumulation of dry excreta (0.05 < P < 0.10) relative to diets without SO. Dietary CM and SO did not affect the SID of indispensable AA or dispensable AA of CM significantly, but increasing dietary CM tended to reduce the SID of Lys (0.05 < P < 0.10). Increasing SO tended to reduce the SID of Met (0.05 < P < 0.10). There were no significant interactive effects of SO and CM (P > 0.10). These results suggest passage time is increased with dietary SO, and reduced with dietary CM, but digestibility of AA in CM was not significantly affected by dietary CM and SO.

Bioactive compounds from Artemisia dracunculus L. activate AMPK signaling in skeletal muscle.

An extract from Artemisia dracunculus L. (termed PMI-5011) improves glucose homeostasis by enhancing insulin action and reducing ectopic lipid accumulation, while increasing fat oxidation in skeletal muscle tissue in obese insulin resistant male mice. A chalcone, DMC-2, in PMI-5011 is the major bioactive that enhances insulin signaling and activation of AKT. However, the mechanism by which PMI-5011 improves lipid metabolism is unknown. AMPK is the cellular energy and metabolic sensor and a key regulator of lipid metabolism in muscle. This study examined PMI-5011 activation of AMPK signaling using murine C2C12 muscle cell culture and skeletal muscle tissue. Findings show that PMI-5011 increases Thr172-phosphorylation of AMPK in muscle cells and skeletal muscle tissue, while hepatic AMPK activation by PMI-5011 was not observed. Increased AMPK activity by PMI-5011 affects downstream signaling of AMPK, resulting in inhibition of ACC and increased SIRT1 protein levels. Selective deletion of DMC-2 from PMI-5011 demonstrates that compounds other than DMC-2 in a "DMC-2 knock out extract" (KOE) are responsible for AMPK activation and its downstream effects. Compared to 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) and metformin, the phytochemical mixture characterizing the KOE appears to more efficiently activate AMPK in muscle cells. KOE-mediated AMPK activation was LKB-1 independent, suggesting KOE does not activate AMPK via LKB-1 stimulation. Through AMPK activation, compounds in PMI-5011 may regulate lipid metabolism in skeletal muscle. Thus, the AMPK-activating potential of the KOE adds therapeutic value to PMI-5011 and its constituents in treating insulin resistance or type 2 diabetes.

Horizontal orientation of zygomorphic flowers: significance for rain protection and pollen transfer.

Floral traits are recognized to have evolved under selection for abiotic and biotic factors. Complex zygomorphic flowers usually face horizontally. It has been proved that a horizontal orientation facilitates pollinator recognition and pollination efficiency, but its significance in adaptation to abiotic factors remains unknown. The floral orientation of Abelia × grandiflora naturally varies around horizontal (with an angle of -30 to +33° between the floral main axis and the horizontal). We examined whether three different floral orientations affected flower thermal conditions, response to rain and pollination. Results showed that floral orientation had no effect on diurnal variations in flower temperature. The anthers of all three flower orientations were wetted by rainfall, but the inclined upward-facing flowers contained significantly more rainwater. The horizontal flowers received significantly higher visitation by hawkmoths and had a higher stigmatic pollen load. In contrast, the upward flower orientation reduced pollination precision, while downward-facing flowers had decreased pollinator attraction. This study indicates that horizontal flowers may have evolved as a trade-off between rain protection and pollination. Zygomorphic flowers that deviate from a horizontal orientation may have lower fitness because of flower flooding by rainwater and decreased pollen transfer.

Neuroprotective effect of gastrodin in methamphetamine-induced apoptosis through regulating cAMP/PKA/CREB pathway in cortical neuron.

OBJECTIVE: Methamphetamine (MA) abuse induces neurotoxicity and causes neuronal cell apoptosis. Gastrodin is a traditional Chinese herbal medicine used for the treatment of nerve injuries, spinal cord injuries, and some central nervous system diseases as well. The present study investigated the neuroprotective effects of gastrodin against MA-induced neurotoxicity in neuronal cells and its potential protective mechanism. METHODS: The primary cortex neuronal culture was divided into four groups (control group, MA group, MA + gastrodin group, and MA + gastrodin + small interfering RNA group). The neurotoxicity of MA was assessed by detecting apoptotic cells by terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay and cell viability by cell counting kit 8 (CCK-8) method, the Tuj1-positive cells and the average axonal length were detected by immunofluorescence, and the expressions of cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), cAMP-response element-binding (CREB), and brain-derived neurotrophic factor (BDNF) proteins were detected by Western blot. RESULTS: The results of CCK-8 assay showed that 0.5 mM MA was an optimal concentration that induced neurotoxicity (p < 0.01). Pretreatment with 25 mg/L gastrodin exerted maximum protective effects on neuronal cells. The expression levels of cAMP, PKA, phosphorylated PKA, CREB, phosphorylated CREB, and BDNF proteins were decreased in the MA group, and pretreatment with gastrodin upregulated the expression levels of these proteins (p < 0.01). The expressions of PKA and CREB proteins showed no significant changes in the control group, MA group, and gastrodin group. Compared the MA + gastrodin + small interfering RNA group with MA + gastrodin group, the Tuj1-positive cells and the average axonal length were decreased significantly, while the number of apoptotic cells was increased (p < 0.05). CONCLUSION: Gastrodin has neuroprotective effects against MA-induced neurotoxicity, which exerts neuroprotective effects via regulation of cAMP/PKA/CREB signaling pathway and upregulates the expression of BDNF.

[Effect of intravenous granisetron combined and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chlorideon postoperative nausea and vomiting after gynecological laparoscopy].

Objective: To observe the effects of intravenous granisetron and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chloride on postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery. Methods: Qualified cases were collected according to prospective randomized controlled clinical trial design. 94 cases patients undergoing gynecological laparoscopic surgery without postoperative intravenous analgesia were selected from February 2017 to November 2018 in Beijing Aerospace General Hospital and The Affiliated Hangzhou Hospital of Nanjing Medical University. The patients were randomly divided into three groups: bilateral PC6 sham injection of 0.9% sodium chloride+ intravenous granisetron(group A, n=31); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous 0.9% sodium chloride(group B, n=33); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous granisetron(group C, n=30). The indexes including age, body mass index(BMI), type of surgery, surgery time, anesthesia time, liquid intake and output volume, the time from the completion of the operation to the removal of the tracheal catheter, the time from the completion to follow the instruction, respiratory depression, restlessness, arrhythmias and other adverse reactions during anesthesia recovery were recorded. Evaluated the nausea and vomiting according to the visual analogue scales (nausea visual analog scale, NVAS) 12 hours after the operation. Not only the dose and the related frequency of antiemetic drugs for rescue, but also the time of the first anal exsufflation and the pain 24 hours after the operation were recorded. Detected the concentration of motilin (MTL), when the operation started/awake after extubation/12 hours after the operation Results: The incidence of nausea and vomiting 12 hours after the operation in group A, B and C was 35.5%, 33.3%, 10.0%. The difference was statistically significant (χ(2)=0.654, P<0.05). The motilin after 12 hours of operation in group A, B and C was (564±76),(559±84),(472±69) ng/L. The difference was statistically significant (F=14.033, P<0.05). The incidence of nausea and vomiting and the motilin after 12 hours of operation in group C were lower than group A and B. The time for the first anal exsufflation in group A, B and C was (19±8),(19±7),(14±8)h.The difference was statistically significant (F=4.523, P<0.05). The time for the first anal exsufflation in group C was earlier than group A and B. Conclusion: Either intravenous granisetron or acupuncture point injection at PC6 of 0.9% sodium chloride can effectively reduce the incidence of postoperative nausea and vomiting after gynecological laparoscopic surgery. Intravenous granisetron combined with acupuncture point injection at PC6 of 0.9% sodium chloride has better effect and promotes the first anal exsufflation time, which is conducive to the rapid postoperative recovery of patients.

Synergistic antibacterial effects of Buddleja albiflora metabolites with antibiotics against Listeria monocytogenes.

Some plants of Buddleja genus possessed antimicrobial activity. In this study, the antibacterial activities of nine compounds from Buddleja albiflora were evaluated against Listeria monocytogenes, Staphyloccocus aureus, Escherichia coli and Pseudomonas aeruginosa, either alone or in combination with Erythromycin (Ery), Gentamicin (Gen) and Ampicillin (Amp). Checkerboard assay demonstrated that Kumatakenin elicited synergistic effects with all three antibiotics, and chrysin displayed synergistic effect with Ery against L. monocytogenes. Further experiments showed that the synergy effect was sufficient to eradicate biofilms formed by L. monocytogenes. Thus, our data highlighted that the combinations of secondary metabolites from B. albiflora and specific antibiotics were useful for the treatment of pathogens, which might help prevent the spread of antibiotic resistance through improving antibiotic effectiveness. SIGNIFICANCE AND IMPACT OF THE STUDY: This study measured the antibacterial activity of the metabolites from Buddleja albiflora and the synergistic interactions with antibiotics against Listeria monocytogenes on planktonic cells as well as on biofilms. The results of this study provide valuable evidence that Kumatakenin/antibiotic combination can be considered as a promising antimicrobial agent for the treatment of pathogens, which subsequently help prevent the spread of antibiotic resistance through improving antibiotic effectiveness.

[Current status of pesticides against ticks].

Ticks can spread a variety of diseases and cause serious damage to animal husbandry. However, the existing insecticide and vaccine control methods have some disadvantages. In this paper, we review the research status of tick pesticides, including the chemical pesticides and non-chemical pesticides (Chinese herbal medicine, nanometer material, virus, fungus and bacterium pesticides), and analyze the disadvantages of the existing researches on pesticides against ticks, in order to provide a theoretical reference for establishing high-efficient and safety tick control methods.

Discrete Superconducting Phases in FeSe-Derived Superconductors.

A general feature of unconventional superconductors is the existence of a superconducting dome in the phase diagram. Here we report a series of discrete superconducting phases in the simplest iron-based superconductor, FeSe thin flakes, by continuously tuning the carrier concentration through the intercalation of Li and Na ions with a solid ionic gating technique. Such discrete superconducting phases are robust against the substitution of 20% S for Se, but they are vulnerable to the substitution of 2% Cu for Fe, highlighting the importance of the iron site being intact. The superconducting phase diagram for FeSe derivatives is given, which is distinct from that of other unconventional superconductors.

[Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat peritoneal carcinomatosis from gastric cancer: a clinical study of 110 patients].

Objective: To evaluate the safety and efficacy of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+ HIPEC) in patients with peritoneal carcinomatosis from gastric cancer (GCPC). Methods: The clinical data and follow-up results of GCPC patients treated with CRS+ HIPEC were collected for a retrospective analysis. The primary endpoint was survival rate and the secondary endpoint was safety. Results: A total of 110 GCPC patients accepted CRS+ HIPEC, with a median overall survival (OS) of 13.1 months, and with 1-, 2-, 3-, and 5-year survival rates of 56.4%, 24.9%, 11.2%, and 7.8%, respectively. The perioperative mortality was 0.9%, and the morbidity of serious adverse events was 8.2%. Univariate analysis showed that gender, tumor marker before surgery, PC type, length of surgery, postoperative adjuvant chemotherapy, peritoneal cancer index (PCI), completeness of cytoreduction, HIPEC temperature, and ascites had a significant impact on OS. Multivariate Cox-analysis showed that completeness of cytoreduction, ascites, and postoperative adjuvant chemotherapy were independent factors of OS. Conclusion: CRS+ HIPEC improves survival for GCPC patients with normal preoperative tumor markers, low PCI, no ascites and synchronous PC. Stringent patient selection and complete CRS are two key factors for better survival.

[Textual research on Ð”Ñ .09319, a fragment of Dunhuang literature preserved in Russia].

Дх.09319, a fragment collected in the page 150 of Volume 14 of Dunhuang Literature Preserved in Russia, is damaged around the page, and only 6 lines of the text are remained. It is one of versions of San bu jiu hou lun (Treatise on Three Positions and Nine Indicators) in Su wen (Plain Questions), and different from another version of Dunhuang, Дх.00613+ P.3287. The two versions cannot be spliced together, but the former can supplement the texts of the latter. In addition, Дх.09319 is also significant to the collation of the missing popular version of San bu jiu hou lun of later generation.

Iron retention in iron-fortified rice and use of iron-fortified rice to treat women with iron deficiency: A pilot study.

OBJECTIVES: 1. Evaluate the effect of washing and cooking iron-fortified rice on iron retention and bioavailability. 2. Evaluate the effect of iron-fortified rice on women with iron deficiency anemia. METHODS: 1. Iron-fortified rice (18 mg/100 g as FeSO4) was cooked in Baton Rouge, Louisiana (C), rinsed and cooked (RC), fried and cooked (FC), cooked with extra water (CW), or soaked and cooked with extra water (SCW), and iron retention was determined. 2. Rice samples were cooked in Kampala, Uganda in a lab (C-Uganda) and households using traditional cooking method (TC-Uganda) and iron retention were determined. 3. Seventeen women with iron deficiency (low iron and/or low ferritin) anemia were randomized to 100 g/d of rice (two cooked 0.75 cup servings) for two weeks containing 18 mg/d iron (supplemented) or 0.5 mg/d iron (un-supplemented). Hemoglobin and hematocrit were evaluated at baseline and 2 weeks with other measures of iron metabolism. RESULTS: 1. Iron retention, from highest to lowest, was (C), (RC), (FC), (C-Uganda), (CW), (SCW) and (TC-Uganda). 2. Seventeen women were randomized and 15 completed the study (hemoglobin 10.6 ± 1.6 g, hematocrit 33.7 ± 4.1%), 9 in the iron-fortified rice group and 6 in the un-fortified rice group. The iron-fortified group had a greater increase in hemoglobin (0.82 g, p = 0.0035) and Hematocrit (1.83%, p = 0.0248) with directional differences in other measures of iron metabolism favoring the iron-fortified group. CONCLUSIONS: Iron-fortified rice increased hemoglobin and hematocrit in women with iron-deficient anemia. Iron deficiency and anemia are widespread in Southeast Asia and Africa and undermine development in these regions.

Expression and clinical significance of rhubarb on serum amylase and TNF-alpha of rat model of acute pancreatitis.

The aim of this study was to evaluate the therapeutic effect of rhubarb extract on acute pancreatitis. Ninety-six healthy Sprague Dawley rats, weighing 301±5.12 g were randomly divided into 4 groups: sham surgery (group A), acute pancreatitis model (group B), acute pancreatitis with normal saline (group C), and acute pancreatitis model with rhubarb (group D). The levels of serum amylase (AMY) and TNF-α were measured at 1st, 6th, 12th and 24th hour after modeling, and the pancreatic tissue were used to observe the pathologic changes. Compared to the sham group, the serum AMY and serum tumor necrosis factor (TNF-α) levels were significantly increased in the other groups (p <0.05). Compared to the model group and the saline group, the serum AMY, serum TNF-α level and pathological changes of rats in the rhubarb group were significantly lower (p <0.05). The serum AMY and TNF-α levels increased in acute pancreatitis. The rhubarb reduced the serum AMY and TNF-α level in rats with acute pancreatitis and reduced the pathological changes of pancreas and other tissues.

High-dose dexamethasone or all-trans-retinoic acid restores the balance of macrophages towards M2 in immune thrombocytopenia.

Essentials M1/M2 imbalance is involved in many autoimmune diseases, and could be restored. The expressions and functions of M1 and M2 were investigated in an in vitro culture system. A preferred M1 polarization is involved in the pathogenesis of immune thrombocytopenia (ITP). High-dose dexamethasone or all-trans-retinoic acid restores M1/M2 balance in ITP patients. SUMMARY: Background Immune thrombocytopenia (ITP) is an autoimmune disorder. Deficiency of immune tolerance in antigen-presenting cells and cross-communication between antigen-presenting cells and T cells are involved in the pathogenesis of ITP. Macrophages can polarize into proinflammatory M1 or anti-inflammatory M2 phenotypes in response to different environmental stimuli, and have diverse immunologic functions. Objectives To investigate the M1/M2 imbalance in ITP and whether high-dose dexamethasone (HD-DXM) or all-trans-retinoic acid (ATRA) could restore this imbalance. Methods The numbers of M1 and M2 macrophages in the spleens of ITP patients and patients with traumatic spleen rupture were analyzed by immunofluorescence. Monocyte-derived macrophages were cultured and induced with cytokines and drugs. The expression of M1 and M2 markers and functions of M1 and M2 macrophages before and after modulation by HD-DXM or ATRA were evaluated with flow cytometry and ELISA. Results There was preferred M1 polarization in ITP spleens as compared with healthy controls. Monocyte-derived macrophages from ITP patients had increased expression of M1 markers and impaired immunosuppressive functions. Either HD-DXM or ATRA corrected this imbalance by decreasing the expression of M1 markers and increasing the expression of M2 markers. Moreover, HD-DXM-modulated or ATRA-modulated macrophages suppressed both CD4+ and CD8+ T-cell proliferation and expanded CD4+ CD49+ LAG3+ type 1 T-regulatory cells. HD-DXM or ATRA modulated macrophages to shift the T-cell cytokine profile towards Th2. Treating patients with HD-DXM or ATRA revealed that macrophages induced from responders showed a predominant M2-like phenotype and immunosuppressive function. Conclusions Aberrant macrophage polarization is involved in the pathogenesis of ITP. Either HD-DXM or ATRA is able to correct this imbalance.