Application of Kolcaba's Comfort Theory in healthcare promoting adults' comfort: a scoping review.

BACKGROUND: Comfort is a primary goal of healthcare. Theory-informed interventions and measurement are essential for comfort enhancement. OBJECTIVES: To categorise and synthesise the international literature on the application of Kolcaba's Comfort Theory in research and practice aiming to promote adults' comfort. ELIGIBILITY CRITERIA: Papers reporting the application of Kolcaba's Comfort Theory on adult participants published in English and Chinese. SOURCES OF EVIDENCE: MEDLINE, CINAHL, APA PsycInfo, Embase, AMED, Web of Science, Scopus, The Cochrane Library, JBI EBP Database, CNKI, Wan Fang; grey literature of Google Scholar, Baidu Scholar and The Comfort Line were searched from January 1991 to January 2024. CHART METHODS: Following the Joanna Briggs Institute guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, two reviewers selected papers and extracted data independently using a standardised chart embedded in NVivo software. A thematic synthesis and a descriptive analysis were provided. RESULTS: The review included 359 papers. Approximately two-thirds (n=216, 60.2%) had been published since 2017. The majority of papers (n=316, 88.0%) originated from China, the USA, Turkey, Brazil and Portugal. The use of Kolcaba's Comfort Theory was dominated in a range of hospital settings (n=263) and with participants suffering neoplasms (n=55). Seven categories of theory application were identified: (I) interventions underpinned by Comfort Theory as the theoretical framework, (II) interventions evaluated by instruments derived from Comfort Theory, (III) descriptive or observational studies of services or practices underpinned by Comfort Theory, (IV) surveys using questionnaires derived from Comfort Theory, (V) questionnaires development or adaption based on Comfort Theory, (VI) qualitative studies interpreted by Comfort Theory and (VII) literature reviews and discussion about Comfort Theory use. The most commonly evaluated interventions included music therapy (n=31), position intervention (n=20) and massage (n=19), and the most commonly used questionnaire was General Comfort Questionnaire (n=109). CONCLUSIONS: Kolcaba's Comfort Theory has been largely used in interventions and assessments across a wide range of contexts, providing a set of options for practitioners. However, quantifying evidence is needed through further systematic reviews, and continuous development of Comfort Theory is warranted based on the categorisation by this review.

Tailings particle size effects on pollution and ecological remediation: A case study of an iron tailings reservoir.

The particle size distribution in tailings notably influences their physical properties and behavior. Despite this, our understanding of how the distribution of tailings particle sizes impacts in situ pollution and ecological remediation in in-situ environment remains limited. In this study, an iron tailings reservoir was sampled along a particle flow path to compare the pollution characteristic and microbial communities across regions with different particle sizes. The results revealed a gradual reduction in tailings particle size along the flow direction. The predominant mineral composition shifts from minerals such as albite and quartz to layered minerals. Total nitrogen, total organic carbon, and total metal concentrations increased, whereas the acid-generating potential decreased. The region with the finest tailings particle size exhibited the highest microbial diversity, featuring metal-resistant microorganisms such as KD4-96, Micrococcaceae, and Acidimicrobiia. Significant discrepancies were observed in tailings pollution and ecological risks across different particle sizes. Consequently, it is necessary to assess tailings reservoirs pollution in the early stages of remediation before determining appropriate remediation methods. These findings underscore that tailings particle distribution is a critical factor in shaping geochemical characteristics. The responsive nature of the microbial community further validated these outcomes and offered novel insights into the ecological remediation of tailings.

The effectiveness of continuity of care in patients with inflammatory bowel disease: a systematic review.

AIM: To investigate the effectiveness of continuity of care in patients with inflammatory bowel disease. BACKGROUND: The prevalence of inflammatory bowel disease(IBD) is increasing by years, especially in China. Moreover, IBD is prolonged and difficult to heal, which seriously impairs the quality of life of patients. Some studies have identified that continuity of care could contribute to the improvement of the quality of life, but the results remains inconclusive in patients with IBD. METHODS: PRISMA guidelines was the outline of this study. Review Manager Software (version 5.3) was used to carry out the data analysis. Outcome assessments included quality of life (QoL), remission rates, number of outpatient clinic visits, and medication adherence. RESULTS: Ultimately, 12 studies involving 2415 patients were brought into this meta-analysis. The results indicated there was no significant difference for continuity of care to improve the QoL in intervention group (SMD = 0.02, 95% CI: -0.08, 0.12). Besides, the remission rates of disease had no difference with those patients in the two groups (OR = 1.07, 95% CI: 0.72, 1.60). However, continued care could contribute to the number of outpatient clinic visits (MD = -0.84, 95% CI: -1.19, -0.49) and patients' adherence to medication significantly (OR = 2.40, 95% CI: 1.16, 4.95). CONCLUSIONS: IBD patients could benefited from continuity of care with reducing their number of clinic visits and improving medication adherence. Nonetheless, there was no evidence of continuity of care contribute to QoL and remission of disease for these patients.

Norad Competently Binds with Pum2 to Regulate Neuronal Apoptosis and Play a Neuroprotective Role After SAH in Mice.

Subarachnoid Hemorrhage (SAH) is a cerebrovascular disorder that has been found to have severe consequences, including a high mortality and disability rate. Research has indicated that neuronal death, particularly apoptosis, plays a major role in the neurological impairment that follows SAH. RNA-binding protein Pum2 can interfere with translation or other biological functions by connecting to the UGUAHAUA sequence on RNA. Noncoding RNA activated by DNA damage (Norad) contains some Pum2 recognition sequences, which may bind to Pum2 protein and affect its capacity to attach to target mRNA. The time course expression of Norad and Pum2 after SAH is analyzed by establishing a mouse SAH model. Subsequently, the purpose of this study is to investigate the potential role and mechanism of the Norad-Pum2 axis after SAH using lentivirus overexpression of Pum2 and knockdown of Norad. Analysis of Pum2 and Norad levels reveal that the former is significantly reduce and the latter is significantly increased in the SAH group compared to the sham group. Subsequent overexpression of Pum2 and Norad knockdown is found to reduce SAH-induced oxidative stress, neuronal apoptosis, and ultimately improve behavioral and cognitive changes in SAH mice. Our study indicates that Norad-Pum2 acts as a neuromodulator in SAH, and that by increasing Pum2 and decreasing Norad levels, SAH-induced neuronal apoptosis can be reduced and neurological deficits alleviated. Consequently, Norad-Pum2 may be a promising therapeutic target for SAH.

End-to-End Multimodal Sensor Dataset Collection Framework for Autonomous Vehicles.

Autonomous driving vehicles rely on sensors for the robust perception of their surroundings. Such vehicles are equipped with multiple perceptive sensors with a high level of redundancy to ensure safety and reliability in any driving condition. However, multi-sensor, such as camera, LiDAR, and radar systems raise requirements related to sensor calibration and synchronization, which are the fundamental blocks of any autonomous system. On the other hand, sensor fusion and integration have become important aspects of autonomous driving research and directly determine the efficiency and accuracy of advanced functions such as object detection and path planning. Classical model-based estimation and data-driven models are two mainstream approaches to achieving such integration. Most recent research is shifting to the latter, showing high robustness in real-world applications but requiring large quantities of data to be collected, synchronized, and properly categorized. However, there are two major research gaps in existing works: (i) they lack fusion (and synchronization) of multi-sensors, camera, LiDAR and radar; and (ii) generic scalable, and user-friendly end-to-end implementation. To generalize the implementation of the multi-sensor perceptive system, we introduce an end-to-end generic sensor dataset collection framework that includes both hardware deploying solutions and sensor fusion algorithms. The framework prototype integrates a diverse set of sensors, such as camera, LiDAR, and radar. Furthermore, we present a universal toolbox to calibrate and synchronize three types of sensors based on their characteristics. The framework also includes the fusion algorithms, which utilize the merits of three sensors, namely, camera, LiDAR, and radar, and fuse their sensory information in a manner that is helpful for object detection and tracking research. The generality of this framework makes it applicable in any robotic or autonomous applications and suitable for quick and large-scale practical deployment.

Effects of self-care programs on the incidence of diabetes among adults with prediabetes: A systematic review and meta-analysis of randomised controlled trials.

OBJECTIVES: To verify the effects of self-care programs among adults with prediabetes, to identify the preferable structure components and to summarise the core content components of self-care programs. DESIGN: A systematic review and meta-analysis of randomised controlled trials. METHODS: PubMed, Embase, Cochrane, CINAHL, PsycINFO, Wanfang, CNKI, Chinese Biomedical Database and Open Grey were searched for studies published from January 2002 to December, 2021. Meta-analysis was conducted to verify the effects of self-care programs on diabetes incidence. Subgroup analyses based on structure components were performed to contrast the effects. We made a critical analysis to generalise the core elements of content components. The study was reported according to PRISMA statement. RESULTS: Totally, 15 studies were included in systematic review, of which 14 studies were eligible for meta-analysis. The results of meta-analysis showed the incidence of diabetes for prediabetic adults receiving self-care programs was significantly lower than those who received usual care (OR 0.58; 95% CI 0.46 to 0.73). The results of subgroup analyses based on delivery mode, intervention implementer, health education brochures provided, and follow-up duration showed statistically significant reduction in incidence compared with control group (p < .05). However, the differences of these pair-wise comparisons (face-to-face or remote, individual or interdisciplinary team, with or without brochures provided, ≤1 year or >1 year) were not statistically significant (p > .05). Three core content elements were generalised: cognitive education, behaviour guidance and psychological support. CONCLUSIONS: Self-care programs can effectively delay the progression of prediabetes to diabetes. Regardless of the diversified structure components, self-care programs can achieve better effects on the diabetes incidence than usual care, while the optimal structure components still remain unknown. Cognitive education, behaviour guidance and psychological support are core elements for these programs. RELEVANCE TO CLINICAL PRACTICE: More clinical trials with rigorous study design are needed to provide further evidence.

Clinical Value Study on Contrast-Enhanced Ultrasound Combined with Enhanced CT in Early Diagnosis of Primary Hepatic Carcinoma.

Objective: To explore the clinical value of contrast-enhanced ultrasound combined with enhanced CT in the early diagnosis of primary hepatic carcinoma (PHC). Methods: 84 patients with suspected PHC in the early stage treated in our hospital from January 2020 to January 2022 were selected as the study subjects. All patients underwent contrast-enhanced ultrasound and enhanced CT examinations, and the surgery was performed for resection of lesions within 1 month. According to the results of postoperative pathology diagnosis, the benign group and the malignant group were included. The case data were viewed for the retrospective study to analyze the clinical application value by evaluating the diagnostic efficiency of contrast-enhanced ultrasound, enhanced CT, and their combination for PHC. Results: Among 84 suspected patients, 70 patients had PHC (malignant group) and 14 patients had other hepatic lesions (benign group) after postoperative histopathological examination. There was no significant difference in age, gender, clinical symptoms, and educational level between the two groups (P > 0.05), with obvious differences in the history of chronic hepatic disease, smoking, drinking, and infection of hepatitis B virus (HBV) between the two groups (P < 0.05). The enhancement time and regression time of the two groups were significantly different (P < 0.05), with no statistical difference in the enhancement pattern of photography (P > 0.05). For patients with PHC, the imaging features of the two inspection methods at arterial phase and lag phase were statistically different (P < 0.05). Taking pathologic findings as the gold standard, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of joint diagnosis were significantly higher than those of contrast-enhanced ultrasound and enhanced CT (P < 0.05), and the area under the curve of joint diagnosis was obviously larger than that of contrast-enhanced ultrasound and enhanced CT by placing the ROC curve for examination (P < 0.05). Conclusion: The combination of contrast-enhanced ultrasound and enhanced CT has a higher accuracy in the early diagnosis of PHC, and the diagnostic efficiency of contrast-enhanced ultrasound is higher than that of enhanced CT. In clinical practice, the physical condition and state of illness in patients should be fully considered, and the most suitable examination method should be selected to reduce their medical burden by taking into account their economic situation.

Icariin Inhibits Intestinal Inflammation of DSS-Induced Colitis Mice Through Modulating Intestinal Flora Abundance and Modulating p-p65/p65 Molecule.

BACKGROUND: Ulcerative colitis, as a kind of inflammatory bowel disease (IBD) is characterized by abdominal pain. This study aimed to investigate the effect of icariin (ICA) on the intestinal microflora of colitis mice. METHODS: Fifteen female C57BL/6 mice were randomly divided into the Control group, dextran sodium sulfate (DSS)-induced colitis (DSS) group, and ICA treatment (DSS+ICA) group. The severity of inflammation in DSS-induced colitis mice was evaluated using disease activity scoring (considering weight-loss percentage, stool-shape change, and stool-bleeding scoring). Pathological changes of mice intestinal tract were evaluated using hematoxylin-eosin (HE) staining. Serum levels of TNF-α and IL-6 were detected with enzyme-linked immunosorbent assay. Expressions of p65 and p-p65 (p-p65/p65 ratio) were analyzed using Western blot assay. 16S rDNA sequencing was used to analyze the abundance and composition of intestinal microflora. RESULTS: Compared with DSS group, ICA significantly improved disease activity (P < .05) and reduced inflammatory damage of colon tissues (P < .05) in DSS-induced colitis mice. Compared with the DSS group, mice in the ICA group demonstrated significant weight and colon length (P < .05). ICA significantly inhibited expressions of IL-6 and TNF-α compared to the DSS group (P < .05). p-p65/ p65 ratio in the DSS + ICA group was remarkably enhanced compared to the DSS group (P < .05). ICA significantly reduced the proportion and activity of Bacteroides, Helicobacteraceae, Turicibacter, and significantly increased that of beneficial microflora (Lactobacillus, Lachnospiraceae, Akkermansia), so as improved damages of colon tissues. CONCLUSION: ICA can improve intestinal flora abundance and composition of DSS-induced colitis mice, and inhibit tissue damage and inflammatory response through modulating the p-p65/p65 expression.

The role of multimodal ultrasonic flow imaging in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules.

BACKGROUND: Color Doppler imaging (CDFI), contrast-enhanced ultrasound (CEUS), and superb micro-vascular imaging (SMI) are used to observe blood flow characteristics in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules. The ability of these techniques to distinguish benign from malignant nodules was investigated. METHODS: A total of 75 TI-RADS 4 nodules were examined using CDFI, SMI, and CEUS. The blood flow characteristics shown by the three methods were added to the current TI-RADS classification to establish a new TI-RADS classification. The value of the three methods and the diagnostic accuracy of the new and old TI-RADS classification were compared. RESULTS: SMI better captured type II flow in benign nodules and type III flow in malignant nodules relative to CDFI. Malignant nodules detected with CEUS manifested mainly with hypo-enhancement, whereas benign nodules showed iso- and hyper-enhancement. The areas under the receiver operating characteristic (ROC) curves (AUC) obtained through the aforementioned flow distribution models were 0.690 (CDFI), 0.840 (SMI), 0.910 (CEUS), and 0.903 (CEUS and SMI combined mode), respectively. The diagnostic value of CEUS was the highest. Joint inspection using SMI with CEUS showed certain advantages in sensitivity, although the overall accuracy was equal to that of CEUS alone. Except for CDFI, the AUC of the new TI-RADS classification was significantly higher than that of the old one. Perforating vessels and low enhancement were independent predictors of thyroid carcinoma. CONCLUSIONS: Both SMI and CEUS visualized lower-velocity blood flow within TI-RADS 4 nodules. The new TI-RADS classification described here could improve diagnostic accuracy.

Trapidil determines the fate of RHF rats through inhibition of ER stress.

Pulmonary arterial hypertension is a fatal disease, especially when it causes right heart failure (RHF). However, it is difficult to treat. It has been reported that trapidil (Tra) can improve the redox balance and cardiac conditions. In this study, we investigated the effect of Tra on RHF induced by monocrotaline (MCT) in rats. Male Wistar rats were treated with MCT or Tra. Treatment lasted 28 days, then rats were euthanized after echocardiography and catheterization. Subsequently, lungs and right ventricular myocardia were evaluated by hematoxylin and eosin, Masson, and TUNEL staining. Protein expression was detected by western blotting. We found remarkably expanded right ventricle end-diastolic volume, decreased partial pressure of oxygen (PaO2), increased partial pressure of carbon dioxide (PaCO2), right ventricular systolic pressure, mean pulmonary arterial pressure, lung/body weight, and liver/body weight in the RHF rat group, as well as increases in the apoptosis rate and the expression of endoplasmic reticulum stress (ERS)-related proteins. However, these changes were significantly inhibited by Tra. Our data suggested that inhibition of ERS is essential for improving RHF, and that therapeutic intervention of Tra in RHF rats works by reducing ERS.

Astragalus Root dry extract restores connexin43 expression by targeting miR-1 in viral myocarditis.

BACKGROUND: Viral myocarditis is defined as viral infection of myocardial tissue leading to impaired heart function and heart failure. Accumulating evidences have shown that arrhythmia is one of important complicating diseases of viral myocarditis causing increased mortality and morbidity. There are no effective treatment for the viral infection and complicating arrhythmia. PURPOSE: This study investigated the effect and mechanism of Astragalus Root dry extract (ARDE) on arrhythmia induced by CVB3 in mice. METHODS: The mice and HL-1 cells were treated with CVB3 and ARDE. Reciprocal regulation of Cx43 and miR-1 were observed in the CVB3 infected mouse myocardium and culture HL-1 cells. RESULTS: CVB3 IP injection increased immune cell infiltration in mouse left ventricle and caused irregular arrhythmia. ARDE treatment prevented the increase of immune cell infiltration and arrhythmia. Overexpression of miR-1 significantly inhibited both endogenous Cx43 expression and Cx43 3'UTR luciferase activity in HL-1 cells. Mutation of census binding site of +1586-1593 bp not +465-472 bp in Cx43 3'UTR luciferase resulted in abolishment of miR-1 inhibitory effects in HL-1 cells. Loss-of- function of miR-1 restored CVB3-induced Cx43 expression reduction in cultured HL-1 cells. The presence of ARDE attenuated the augmented miR-1 induced by CVB3 infection in vivo and in vitro. CONCLUSION: This study identified that CVB3 infection reduced Cx43 expression by elevating miR-1 level in mouse viral myocarditis. For the first time, ARDE was shown to prevent arrhythmia, and rescue CVB3-induced endogenous Cx43 expression by regulating miR-1 level.

Association between QTc interval prolongation and outcomes of diabetic foot ulcers: Data from a 4-year follow-up study in China.

OBJECTIVES: To examine whether QTc interval prolongation is an independent risk factor of outcomes in patients with diabetic foot ulcers (DFU). RESEARCH DESIGN AND METHODS: 331 patients with type 2 diabetes and DFU hospitalized in a Chinese tertiary hospital were recruited. ECG was done at baseline and QTc interval was calculated through Bazett's formula. Participants were classified into 2 groups according to the QTc interval as prolonged (≥440 ms) or not (<440 ms). These patients were followed-up for an average of 48 months to observe the outcomes, including ulcer healing, ulcer recurrence, nonfatal cerebral or cardiovascular events (NCCVE), cerebral cardiovascular death, cardiac death and all-cause death. The associations between the risk of outcomes and QTc interval prolongation, as well as per 1-SD increase in QTc interval were analyzed by Cox proportional-hazards models. RESULTS: In terms of the univariate Cox proportional hazard models, patients with QTc interval prolongation had a higher all-cause mortality (HR = 1.621, 95%CI: 1.040-2.526, P = .013), higher cardiac mortality (HR = 2.011 95%CI: 1.106-3.657, P = .019), higher cerebral cardiovascular mortality (HR = 1.525, 95%CI: 0.8151-2.852, P = .045). The multivariate analysis showed that QTc prolongation was an independent risk factor for cardiac death (HR = 5.465, 95%CI: 2.818-8.112, P = .039). Similar results were obtained when QTc interval was used as a continue variable, a 1-SD increase in QTc interval was associated with an 5.883 times risk for cardiac mortality (HR = 6.883, 95%CI: 4.153-9.613, P = .012). The association between QTc interval prolongation with ulcer healing, recurrence and NCCVE were not observed either in univariate or multivariate analysis (P > .05). CONCLUSION: QTc interval prolongation was a plausible predictor for cardiac death in DFU patients, but it cannot accurately predict ulcer healing or recurrence.

Study of correlation between wall shear stress and elasticity in atherosclerotic carotid arteries.

OBJECTIVE: This paper presents the use of the texture matching method to measure the rabbit carotid artery elasticity value of the experimental group and control group respectively. It compares the experimental rabbits, when they are prompted by pathological histology to be at the period of carotid atherosclerosis fatty streaks and fiber plaques, with the control group. METHODS: We have used ultrasound linear array probe for scanning the rabbit carotid arteries. This allows us to obtain the wall shear stress (WSS) and the elasticity values in the atherosclerotic arteries. Using statistical analysis, we are able to clarify whether the texture matching method can diagnose atherosclerosis at the early stage. We also analyze the rabbit carotid artery elasticity and WSS values to make sure whether there is a correlation between both. Combining the texture matching method with the WSS quantitative analysis in the future can enable better prediction of the occurrence and development of atherosclerosis by using noninvasive medical imaging techniques. RESULTS: This study has confirmed that from the 2nd to the 10th week, with the development of atherosclerosis, the arterial WSS reduction has a negative correlation with the increasing of artery wall elasticity, which means that as the arterial WSS decreases the arterial wall becomes less elastic. Correlating shear stress with atherosclerosis can clarify that WSS can be used as one of the effective parameters of early diagnosis of atherosclerosis. CONCLUSION: In summary, we have found that the elasticity value can reflect the degree of atherosclerosis more objectively. Therefore, by using noninvasive imaging, the quantitative analysis of shear stress and combined with texture matching method can assist in the early diagnosis of atherosclerosis.

MiR-378 modulates energy imbalance and apoptosis of mitochondria induced by doxorubicin.

Doxorubicin (DOX) is an effective anticancer drug, however its clinical application is limited due to its cardiotoxicity. Therefore, understanding the mechanisms of cardiotoxicity induced by DOX is essential. We found that the level of miR-378 was decreased in the hearts of DOX-treated rats. Increasing the expression of miR-378 resulted in a decrease of lactate dehydrogenase (LDH) upon DOX treatment in vitro by targeting lactate dehydrogenase A (LDHA). Furthermore, bioinformatics analysis indicated that cyclophilin A (PPIA), a regulator of apoptosis, is also a direct target gene of miR-378. We confirmed this by Western blot. Our results also showed that the overexpression of miR-378 inhibited the hyperactivation of ER stress signaling induced by DOX. In addition, MiR-378 overexpression was found to protect cardiomyocytes from DOX-induced energy imbalance and apoptosis of mitochondria. These results may allow for a therapeutic approach that overcomes the cardiotoxicity of DOX-based treatments for cancer.

Calumenin DNA methylation and gene expression in viral myocarditis.

The main death reason is inflammatory response of myocardial tissue caused a sharp decline in myocardial contractility and heart failure. At present, viral myocarditis with heart failure is lack of effective and specific treatment. Basic and clinical studies have shown that intervention apoptosis is an effective way to prevent and cure heart failure. The mechanism of apoptosis is complex, endoplasmic reticulum (ER) stress is a new apoptotic signal transduction pathway was been found. In this study, the apoptosis could be increased in mice with CVB3 treatment. The ER stress related proteins GRP78, ATF4, CHOP were up-regulated in VMC. The mechanism of VMC regulated ERS induced apoptosis was identified. Calumenin protein could relieve ERS induced apoptosis in viral myocarditis in vivo. The DNA methylation of calumenin was analyzed in CON and VMC, however, we found VMC down-regulate the expression of calumenin unrelated with DNA methylation of calumenin.

Correlation between quantitative analysis of wall shear stress and intima-media thickness in atherosclerosis development in carotid arteries.

BACKGROUND: This paper presents quantitative analysis of blood flow shear stress by measuring the carotid arterial wall shear stress (WSS) and the intima-media thickness (IMT) of experimental rabbits fed with high-fat feedstuff on a weekly basis in order to cause atherosclerosis. METHODS: This study is based on establishing an atherosclerosis model of high-fat rabbits, and measuring the rabbits' common carotid arterial WSS of the experimental group and control group on a weekly basis. Detailed analysis was performed by using WSS quantification. RESULTS: We have demonstrated small significant difference of rabbit carotid artery WSS between the experimental group and the control group (P<0.01) from the 1st week onwards, while the IMT of experimental group had larger differences from 5th week compared with the control group (P<0.05). Next, we have shown that with increasing blood lipids, the rabbit carotid artery shear stress decreases and the rabbit carotid artery IMT goes up. The decrease of shear stress appears before the start of IMT growth. Furthermore, our receiver operator characteristic (ROC) curve analysis showed that when the mean value of shear stress is 1.198 dyne/cm2, the rabbit common carotid atherosclerosis fatty streaks sensitivity is 89.8%, and the specificity is 81.3%. The area under the ROC curve is 0.9283. CONCLUSIONS: All these data goes to show that WSS decreasing to 1.198 dyne/cm2 can be used as an indicator that rabbit common carotid artery comes into the period of fibrous plaques. In conclusion, our study is able to find and confirm that the decrease of the arterial WSS can predict the occurrence of atherosclerosis earlier, and offer help for positive clinical intervention.

Melatonin inhibits proliferation and invasion via repression of miRNA-155 in glioma cells.

Melatonin, an indolamine mostly synthesized in the pineal gland, exerts the anti-cancer effect by various mechanisms in glioma cells. Our previous study showed that miR-155 promoted glioma cell proliferation and invasion. However, the question of whether melatonin may inhibit glioma by regulating miRNAs has not yet been addressed. In this study, we found that melatonin (100µM, 1µM and 1nM) significantly inhibited the expression of miR-155 in human glioma cell lines U87, U373 and U251. Especially, the lowest expression of miR-155 was detected in 1µM melatonin-treated glioma cells. Melatonin (1µM) inhibits cell proliferation of U87 by promoting cell apoptosis. Nevertheless, melatonin had no effect on cell cycle distribution of U87 cells. Moreover, U87 cells treated with 1µM melatonin presented significantly lower migration and invasion ability when compared with control cells. Importantly, melatonin inhibited c-MYB expression, and c-MYB knockdown reduced miR-155 expression and migration and invasion in U87 cells. Taken together, for the first time, our findings show that melatonin inhibits miR-155 expression and thereby represses glioma cell proliferation, migration and invasion, and suggest that melatonin may downregulate the expression of miR-155 via repression of c-MYB. This will provide a theoretical basis for revealing the anti-glioma mechanisms of melatonin.

Association between estimated glomerular filtration rate and outcomes in patients with diabetic foot ulcers: a 3-year follow-up study.

OBJECTIVE: End-stage renal disease and dialysis have been proven to be associated with poor prognoses in diabetic foot ulcers (DFUs). However, it has rarely been reported whether and to what extent milder renal insufficiency affects the prognosis. The purpose of this study was to investigate the categorized impact of estimated glomerular filtration (eGFR) on the outcomes of patients with DFU. DESIGN AND METHODS: Three hundred and sixty-six DFU patients hospitalized in a Chinese tertiary hospital were recruited and classified into 4 groups according to the eGFRs as follows: normal (≥90), mildly reduced (60-89), moderately reduced (30-59), and severely reduced (<30). These patients were followed-up for an average of 37 months to observe the outcomes, including ulcer healing, amputation, ulcer recurrence, cardiac or cerebrovascular events and death. The associations between eGFR and the outcomes were analysed by Cox proportional-hazards models. RESULTS: Compared to patients with normal eGFR, patients with moderately reduced eGFR had higher risk of healing failure (hazard ratio (HR) = 2.08, 95% confidence interval (CI): 1.13-3.82), cardiac events (HR = 5.25, 95% CI: 2.17-12.89) and death (HR = 3.54, 95% CI: 1.36-9.20). Severely reduced eGFR was associated with higher incidence of healing failure (HR = 2.84, 95% CI: 1.25-6.49) and death (HR = 4.45, 95% CI: 1.23-16.07). The impact of eGFR on ulcer recurrence and cerebrovascular events was not observed in all groups. CONCLUSIONS: Moderately and severely reduced eGFR in patients with DFU were independent predictors for poor prognoses of both the limbs and the patients.

Time-dependent flow velocity measurement using two-dimensional color Doppler flow imaging and evaluation by Hagen-Poiseuille equation.

This paper aims to develop a technique to assess velocity flow profile and wall shear stress (WSS) spatial distribution across a vessel phantom representing an artery. Upon confirming the reliability of the technique, it was then used on a set of carotid arteries from a cohort of human subjects. We implemented color Doppler flow imaging (CDFI) for measurement of velocity profile in the artery cross section. Two dimensional instantaneous and time-dependent flow velocity and WSS vector fields were measured and their waveforms of peak velocities based on the technique were compared with WSS values generated by Hagen-Poiseuille equation. Seventy-five patients with intima-media thickening were prospectively enrolled and were divided into an IMT group. At the same time, another 75 healthy volunteers were enrolled as the control group. All the subjects were scanned and the DICOM files were imported into our in-house program. Next, we determine the velocity profile of carotid arteries in a set of 150 human subjects and compared them again. The peak velocities by the CDFI and Hagen-Poiseuille equation techniques were compared and statistically evaluated. The amounts of deviation for the two measured WSS profiles were performed and we demonstrated that they are not significantly different. At two different flow settings with peak flow velocity of 0.1, 0.5 (×10(-11)) m/s, the obtained WSS were 0.021 ± 0.04, 0.038 ± 0.05 m/s, respectively. For the patient population study, the mean WSS value calculated by Hagen-Poiseuille equation was 2.98 ± 0.15 dyne/cm(2), while it was 2.31 ± 0.14 dyne/cm(2) by our CDFI analysis program. The difference was not statistically significant (t = -1.057, P = 0.259). Similar to the Hagen-Poiseuille equation, a negative linear correlation was also found between the calculated WSS and intima-media thickness (P = 0.000). Using CDFI analysis, we found that the WSS distribution at the middle of the proximal plaque shoulder was larger than the top of the shoulder. CDFI can assess the velocity and WSS profile accurately and efficiently and may be used for clinical diagnosis of cardiovascular conditions.

Effect of CXCR4 pretreated with ultrasound-exposed microbubbles on accelerating homing of bone marrow mesenchymal stem cells to ischemic myocardium in AMI rats.

OBJECTIVE: To investigate the role and potential mechanism of CXCR4 in promoting targeted homing of bone marrow mesenchymal stem cells (BMSCs) with ultrasound-exposed microbubbles (UM) pretreatment. METHODS: Third generation BMSCs were divided into four groups control group, ultrasound (US) group, UM group and ultrasound-exposed microbubbles plus catalase group. RT-PCR and western blot were performed to determine the levels of CXCR4 mRNA transcription and protein expression, respectively. Third generation BMSCs were labeled with Fluo-α/AM and divided into three groups: control group, US group and UM group, and fluorescence intensities in the cells were observed immediately, 5 min and 15 min after intervention under fluorescence microscope. The calcium iron levels in the cells were analyzed. BMSCs were divided into five group: group A without calcium in the medium, group B, group C, group D and group E containing calcium chloride with concentration of l mol, 2 mol, 4 mol, anti-calcium-sensing receptor antibody, respectively. RT-PCR and western blot were performed to determine the levels of CXCR4 mRNA transcription and proteins expression of the third generation BMSCs of each group, respectively. RESULTS: The levels of CXCR4 mRNA transcription and protein expression between US group and control group had no statistically significant difference (P > 0.05) shown by RT-PCR and western blot; the transcription level in the UM group was significantly higher than that in US group and control group (P < 0.05); and in the ultrasound-exposed microbubbles plus catalase group, the transcription level was much lower than that in UM group. Fluorescence intensify in the cells of US group had no significant difference compared with that in the cells of the control group (P > 0.05), which in the cells of UM group was significantly higher than that in the cells of both US group and control group (P < 0.05). Compared to group A, expressions of CXCR4 of group B to D were significantly increased in concentration-dependent manner showed by RT-PCR and western blot (P < 0.05). Compared to group C, expressions of CXCR4 of group E were significantly decreased (P < 0.05). CONCLUSIONS: UM can promote the influx of calcium in BMSCs and increase mRNA transcription and protein expression of CXCR4. The latter may partly be caused by influx of calcium.