Predictors and prognostic significance of the volume load trajectory: a longitudinal study in patients on peritoneal dialysis.

Volume overload in peritoneal dialysis patients is a common issue that can lead to poor prognosis. We employed a group trajectory model to categorize volume load trajectories and examined the factors associated with each trajectory class to explore the impact of different trajectory groups on clinical prognosis and residual renal function (RRF). This single-center prospective cohort study included 214 patients on maintenance peritoneal dialysis within a tertiary hospital. The ratio of extracellular water to total body water was measured using Bioimpedance analysis. The SAS 9.4 PROC Traj procedure was used to examine the group-based trajectory of the patients. A multivariate logistic regression model was used to calculate the adjusted odds ratios (aOR) of the associated factors to predict the trajectory class of participants. The average age of the included patients was 53.56 (SD: 11.77) years, with a male proportion of 46.7% and a median follow-up time of 6 months. The normal stable group accounted for 35.05% of the total population and maintained a normal and stable level, the moderate stable group accounted for 52.8% of the total population and showed a slightly higher and stable level, and the high fluctuation group accounted for 12.15% of the total population and showed a high and fluctuating level. A multivariate logistic regression analysis revealed that age, diabetes, and albumin levels are significant factors influencing the categorization of volume load trajectories. There were statistically significant differences in both the technical survival rate and the loss of residual renal function among the three trajectory groups.

Association Between the Blood Glucose Value at PACU Discharge and Postoperative Hypoglycemia in Nondiabetic Patients With Hyperglycemia After Hysteroscopic Surgery: A Retrospective Cohort Study.

PURPOSE: The target glycemic control for nondiabetic patients in the postanesthesia care unit (PACU) after hysteroscopic surgery remains unclear. Our goal is to determine the optimal level of glycemic control by finding the relationship between blood glucose level (BGL) leaving the PACU and postoperative hypoglycemia in nondiabetic patients. DESIGN: This retrospective cohort study was conducted at a comprehensive tertiary hospital in Chongqing, China between June 2018 and December 2020. METHODS: The target independent and dependent variables were BGL leaving the PACU and postoperative hypoglycemia, respectively. The primary outcome was the incidence of hypoglycemia. Logistic regression was used to explore the association between discharge BGL and hypoglycemia. The optimal glycemic control range was determined by using the receiver operating characteristic (ROC) curve. FINDINGS: Prior to insulin use, BGL in the insulin-using subgroup might be as high as 20 mmol/L. Hypoglycemia was related to the BGL while leaving the PACU (odds ratio (OR) 0.37 [95% confidence interval (CI) 0.22 to 0.65]). The best cut-off value (12.95 mmol/L) was determined by fitting the ROC curve. CONCLUSIONS: If severe hyperglycemia develops during hysteroscopic surgery in individuals with 5% glucose as the mediator of uterine distention, the recommendation is to maintain blood glucose above 12.95 mmol/L when treated with insulin.

Effect of renal function on high-density lipoprotein particles in patients with coronary heart disease.

BACKGROUND: Although renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease. METHODS: A total of 419 coronary heart disease patients and 105 non-coronary heart disease patients were included. HDL particle size, represented by HDL-C/apoA-I, was compared between groups stratified by estimated glomerular filtration rate (eGFR) and Gensini scores using standard Student's t test and one-way ANOVA. Pearson's correlation test was performed to analyze the association between eGFR and HDL-C/apoA-I in patients with coronary heart disease. The relationship between HDL particle size and the occurrence of coronary heart disease was explored using Univariate logistic regression analysis. RESULTS: In patients with coronary heart disease, between-group analysis revealed that HDL-C/apoA-I increased as eGFR declined, and significance appeared as eGFR declined to under 60 ml/min·1.73 m2 (P < 0.001), and Pearson's correlation test also confirmed an inverse correlation between eGFR and HDL-C/apoA-I levels in coronary heart disease patients. When stratified by Gensini scores, in coronary heart disease patients with eGFR ≥ 90 mL/(min·1.73 m2), those with higher Gensini scores had smaller HDL-C/apoA-I. However, with or without kidney insufficiency, smaller HDL-C/apoA-I was associated with a higher occurrence of coronary heart disease (P < 0.05). CONCLUSION: With the presence of renal insufficiency, HDL-C/apoA1 was higher in patients with coronary heart disease. Lower HDL-C/apoA1 was still associated with a higher occurrence of coronary heart disease, but the original association between lower HDL-C/apoA1 and more severe coronary artery stenosis was lost in patients with renal insufficiency.

[Successful treatment of very severe late-onset sinusoidal obstruction syndrome with recombinant human soluble thrombomodulin, steroids, and control of intra-abdominal pressure].

We report a case of a 16-year-old woman who achieved her third complete remission of acute lymphoblastic leukemia after undergoing allogeneic stem cell transplantation for the second time from an unrelated donor. On post-transplantation day 30, she showed weight gain, hepatomegaly, right hypochondriac pain, and ascites. On day 35, ultrasonography (US) revealed portal vein regurgitation. She was subsequently diagnosed with late-onset sinusoidal obstruction syndrome (SOS) and was transferred to the intensive care unit (ICU) on day 36 for multiple organ dysfunction syndrome (MODS) and disseminated intravascular coagulation, requiring mechanical ventilation. Her SOS was graded as very severe upon ICU admission. Recombinant human soluble thrombomodulin (380 U/kg/day) and methylprednisolone (2 mg/kg/day) therapies were initiated. Additionally, her intra-abdominal pressure had increased to 19 mmHg, which was thought to be the cause of MODS. Ascites drainage (1,000 ml/day), according to the treatment for abdominal compartment syndrome, improved her SOS and MODS. She was weaned from mechanical ventilation on the 10th day after ICU transfer, and US showed resolution of the portal vein regurgitation. She was transferred to the general ward on the 14th day. She had not experienced disease recurrence at her last visit (527 days after the second transplantation).

Association Between Body Weight Change Before and After Delivery and Development of Nonmetabolic Syndrome: A Prospective Study.

The aim of the work was to investigate the association between body weight change before and after delivery and development of nonmetabolic syndrome in Chinese females aged ≥40 years. We selected 789 participants without metabolic syndrome randomly from a baseline survey performed in Luzhou, China in 2011. We took the group with decreasing or no increasing body mass index difference during a pregnancy as "R-Body Mass Index 1" (n=286) and divided the group with increasing body mass index difference during a pregnancy into "R-Body Mass Index 2" (n=254) and "R-Body Mass Index 3" (n=249) based upon P50. All study participants were followed up every year, and a questionnaire, physical examination, and biochemical detection were administered after 3 years. Of 789 participants, 82 nonmetabolic syndrome women developed metabolic syndrome during 3-year follow-up. The morbidity of metabolic syndrome in the R-BMI1, R-BMI2, and R-BMI3 groups was 5.2%, 11.8%, and 14.9%, respectively. Compared to the R-BMI1 group, the relative risk for R-BMI2 was 1.92 (95% confidence interval: 1.03-3.58, p=0.040) and for R-BMI3 was 2.20 (95% confidence interval: 1.20-4.03, p=0.011). After adjusting for age, BMI, WHR, baseline blood glucose, HbA1c, TG, HDL-C, SBP, DBP, age of menarche and menopause, and delivery times, the relative risks were similar to the unadjusted relative risks. In conclusion, body weight change after delivery was associated with metabolic syndrome: the higher the weight gain, the higher the risk of metabolic syndrome.

Association between serum gamma-glutamyl transferase and serum uric acid levels in Chinese females: A cross-sectional study.

OBJECTIVE: To investigate the association between serum gamma-glutamyl transferase (GGT) levels and serum uric acid levels in middle-aged and elderly Chinese females. METHODS: A cross-sectional population survey was performed in Luzhou, China (2014). Questionnaires, physical examinations and biochemical tests were conducted. Finally, we included 2486 females who were > 40 years old as participants. Multiple linear regression analysis was used to estimate the association of serum acid levels and other variables. Serum GGT levels were divided into four groups using the 25th, 50th and 75th percentiles as cut-off points. Finally, binary logistic regression analysis was used to investigate the association of different serum GGT quartiles with the risk of hyperuricemia. RESULTS: The prevalence of hyperuricemia was 25.1% in the studied population and gradually increased across the serum GGT quartiles (P < 0.05). Binary logistic regression analysis showed that compared with subjects in the lowest quartile of serum GGT levels, the adjusted odds ratio (ORs) for uric acid in the highest quartile was 2.34 (95% confidence interval (CI), 1.68-3.28, P < 0.001),after corrections for TG, TC, HDL-C, LDL-C, creatinine (CR), GGT, AST, ALT, fasting plasma glucose (FPG), postprandial 2-h plasma glucose, hemoglobin A1c(HbA1c), age, BMI, SBP, DBP, waist-to-hip ratio and neck circumference (NC). CONCLUSIONS: The serum GGT level is associated with hyperuricemia in middle-aged and elderly Chinese females.

Timing of antibiotic prophylaxis in term prelabor rupture of membranes: A retrospective cohort study using propensity-score matching.

OBJECTIVE: To assess whether earlier administration of antibiotic prophylaxis after prelabor rupture of membranes (PROM) at term would decrease the incidence of maternal and neonatal infections. METHODS: This is a retrospective cohort study comparing women with term PROM who were initiated antibiotic prophylaxis within or after 6 h, and within or after 12 h from PROM to delivery during January 2019 to December 2021. Women with term PROM receiving cephalosporin and without contraindications to vaginal delivery or confirmed or suspected infection were included in the study. The primary outcome was puerperal infection, which refers to the reproductive tract infection occurring within 42 days of delivery. The type of pharmacoeconomic evaluation was selected based on the results of compared effectiveness between the early group and the late group. Propensity-score matching (PSM) was used to adjust confounding. Subgroup and sensitivity analyses were used to verify the robustness of results. RESULTS: We enrolled 5353 women with term PROM, including 4331 initiated with antibiotic within 6 h, 1022 after 6 h, 5077 within 12 h, and 276 after 12 h. After PSM, no significant difference was observed in the baseline characteristics of the groups. There was no statistical difference between antibiotic use within 6 h and after 6 h, or within 12 h and after 12 h, in puerperal infection (4.6% vs. 4.3%, P = 0.826; 2.9% vs. 4.6%, P = 0.471, respectively), total maternal infection, neonatal sepsis, and total neonatal infection. Cost-minimization analysis showed there was no significant difference between antibiotic use within 6 h and after 6 h, or within 12 h and after 12 h, in direct medical costs. CONCLUSION: This study showed that there was no statistical difference in the efficacy and economy of antibiotic prophylaxis used within 6-12 h after rupture of membranes versus after 6-12 h in women with term PROM.

Characterization of a novel dipeptidyl peptidase 1 of Trichinella spiralis and its participation in larval invasion.

The research aimed to describe a new Trichinella spiralis dipeptidyl peptidase 1 (TsDPP1) and investigate its functions in the larval invasion of intestinal epithelial cells (IECs). The gene TsDPP1 was successfully replicated and produced in Escherichia coli BL21 (DE3), showing a strong immune response. TsDPP1 was detected in diverse stages of T. spiralis and showed significant expression in the intestine infective larvae (IIL) and adult worms at 6 days post infection, as confirmed by qPCR and Western blot analysis. The primary localization of TsDPP1 in this parasite was observed in cuticles, stichosomes, and embryos by using the indirect immunofluorescence assay (IIFA). rTsDPP1 exhibited the enzymatic function of natural dipeptidyl peptidase and showed specific binding to IECs, and the binding site was found to be localized on cell membrane. Following transfection with dsRNA-TsDPP1, the expression of TsDPP1 mRNA and protein in muscle larvae (ML) were decreased by approximately 63.52 % and 58.68 %, correspondingly. The activity of TsDPP1 in the ML and IIL treated with dsRNA-TsDPP1 was reduced by 42.98 % and 45.07 %, respectively. The acceleration of larval invasion of IECs was observed with rTsDPP1, while the invasion was suppressed by anti-rTsDPP1 serum. The ability of the larvae treated with dsRNA-TsDPP1 to invade IECs was hindered by 31.23 %. In mice infected with dsRNA-treated ML, the intestinal IIL, and adults experienced a significant decrease in worm burdens and a noticeable reduction in adult female length and fecundity compared to the PBS group. These findings indicated that TsDPP1 significantly impedes the invasion, growth, and reproductive capacity of T. spiralis in intestines, suggesting its potential as a target for anti-Trichinella vaccines.

Mannose facilitates Trichinella spiralis expulsion from the gut and alleviates inflammation of intestines and muscles in mice.

Trichinellosis is a major zoonotic parasitosis which is a vital risk to meat food safety. It is requisite to exploit new strategy to interdict food animal Trichinella infection and to obliterate Trichinella from food animals to ensure meat safety. Mannose is an oligosaccharide that specifically binds to the carbohydrate-recognition domain of C-type lectin; it has many physiological functions including reliving inflammation and regulating immune reaction. The purpose of this study was to investigate the suppressive role of mannose on T. spiralis larval invasion and infection, its effect on intestinal and muscle inflammation, and immune responses after challenge. The results showed that compared to the saline-treated infected mice, the mannose-treated infected mice had less intestinal adult and muscle worm burdens, mild inflammation of intestine and muscle of infected mice. The levels of specific anti-Trichinella IgG (IgG1/IgG2a), IgA and sIgA in mannose-treated infected mice were obviously inferior to saline-treated infected mice (P < 0.01). Furthermore, the levels of two cytokines (IFN-γ and IL-4) in mannose-treated infected mice were also significantly lower than the saline-treated infected mice (P < 0.01). The protective effect of the mannose against Trichinella infection might be not related to specific antibody and cellular immune responses. The above results demonstrated that mannose could be considered as a novel adjuvant therapeutic agent for anti-Trichinella drugs to block larval invasion at early stage of Trichinella infection.

Analysis of Pharmacological Activities and Mechanisms of Essential Oil in Leaves of C. grandis 'Tomentosa' by GC-MS/MS and Network Pharmacology.

BACKGROUND: Citrus grandis 'Tomentosa,' a fruit epicarp of C. grandis 'Tomentosa' or C. grandis (L.) Osbeck is widely used in health food and medicine. Based on our survey results, there are also rich essential oils with bioactivities in leaves, but the chemical compounds in this part and relevant pharmacological activities have never been studied systematically. Therefore, this study was to preliminarily decipher the pharmacological activities and mechanisms of the essential oil in leaves of C. grandis 'Tomentosa' by an integrated network pharmacology approach. METHODS: Essential oil compositions from leaves ofC. grandis 'Tomentosa' were identified using GC-MS/MS. And then, the targets of these oil compositions were predicted and screened from TCMSP, SwissTargetPrediction, STITCH and SEA databases. STRING database was used to construct the protein-protein interaction networks, and the eligible protein targets were input into WebGestalt 2019 to carry out GO enrichment and KEGG pathway enrichment analysis. Based on the potential targets, disease enrichment information was obtained by TTD databases. Cytoscape software was used to construct the component-target-disease network diagrams. RESULTS: Finally, 61 essential oil chemical components were identified by GC-MS/MS, which correspond to 679 potential targets. Biological function analysis showed 12, 19, and 12 GO entries related to biological processes, cell components and molecular functions, respectively. 43 KEGG pathways were identified, of which the most significant categories were terpenoid backbone biosynthesis, TNF signaling pathway and leishmaniasis. The component-target-disease network diagram revealed that the essential oil compositions in leaves of C. grandis 'Tomentosa' could treat tumors, immune diseases, neurodegenerative diseases and respiratory diseases, which were highly related to CHRM1, PTGS2, CASP3, MAP2K1 and CDC25B. CONCLUSION: This study may provide new insight into C. grandis 'Tomentosa' or C. grandis (L.) Osbeck and may provide useful information for future utilization and development.

Analysis of Noise Exposure Level and Influencing Factors of Small and Micro-Scale Enterprises in Beijing, China.

Understand the noise exposure level and influencing factors of small and micro-scale enterprises in Beijing, and support the formulation of noise prevention and control policies. Noise hazards in small- and micro-scale enterprises were monitored from May to December 2021 using a combination of questionnaire survey and on-site noise monitoring. The survey included questions on the basic characteristics of the enterprise, the situation of noise protection facilities, and protective equipment. We calculated the equivalent to the sound level of 8 h per day (LEX, 8h) or the equivalent of the sound level of 40 h per week (LEX,w) and the exceeding rate. Unconditional logistic regression was used to analyze the influencing factors. We recruited 194 enterprises in our study, including 145 small- and 49 micro-scale enterprises. Overall, 9.9% of the noise points exceeded the Chinese national standard, which was 85 dB(A). The detected noise of micro-enterprises significantly (P < .001) exceeded that of small enterprises. This is the first study to examine noise hazards of small and micro-scale enterprises in Beijing in recent years. Our results showed noise hazard prevention in Beijing is grim. It is suggested that the government should strengthen supervision, allocate responsibility to the employer, and guide them to establish and improve the management system for controlling noise hazards, to effectively reduce its impact on the health of workers.

Transcriptome-based analysis of early post-mortem formation of pale, soft, and exudative (PSE) pork.

Pale, soft, and exudative (PSE) meat can cause consumer dissatisfaction and economic losses. This study determined meat quality, glycolytic enzyme activity, and differential gene expression in the longissimus lumborum (LL) and semimembranosus (SM) of normal and PSE pork carcasses. The SM did not result in PSE meat. Hexokinase, lactate dehydrogenase, and pyruvate kinase activities were lower in the SM of PSE carcasses than in the normal carcasses. Functional enrichment analysis revealed that immune, inflammatory, and muscle fibre genes were significantly enriched in PSE pork. More specifically, PPP1R3G and MSS51 may be key genes regulating pork quality in the SM. Meanwhile, the differential expression of PLVAB, ADIPOQ, LEP, MYH4, MYH7, MYL3, MYL6B, FOS, ATF3, and HSPA6 may induce PSE formation in the LL. These results may provide insights into PSE pork formation mechanisms and reveal candidate genes for improving meat quality after validation.

Oral immunization with attenuated Salmonella encoding an elastase elicits protective immunity against Trichinella spiralis infection.

Elastase belongs to the serine protease family. Previous studies showed that Trichinella spiralis elastase (TsE) was highly expressed in intestinal infective larvae (IIL). Recombinant TsE (rTsE) promoted the larval intrusion of enteral epithelium cells (IECs), whereas anti-rTsE antibodies and siRNA impeded larval intrusion. Subcutaneous vaccination of mice with rTsE showed a partial protective immunity, suggesting that TsE might be a promising vaccine target against Trichinella infection. In this study, complete TsE cDNA sequence was cloned into pcDNA3.1, and the rTsE DNA was transformed into attenuated S. typhimurium strain ΔcyaSL1344. Oral vaccination of mice with TsE DNA elicited a systemic Th1/Th2/Treg mixed immune response and gut local mucosal sIgA response. Immunized mice exhibited a significant immune protection against T. spiralis larval challenge, as demonstrated by a 52.48% reduction of enteral adult worms and a 69.43% reduction of muscle larvae. The protection might be related to the TsE-induced production of intestinal mucus, specific anti-TsE sIgA and IgG, and secretion of IFN-γ, IL-2, IL-4 and IL-10, which protected gut mucosa from larval intrusion, suppressed worm development and impeded female reproduction. The results demonstrated that attenuated Salmonella-delivered TsE DNA vaccine provided a prospective strategy for the control of Trichinella infection in food animals.

Molecular characterization of a novel cathepsin L from Trichinella spiralis and its participation in invasion, development and reproduction.

Cathepsin L is one member of cysteine protease superfamily and widely distributed in parasitic organisms, it plays the important roles in worm invasion, migration, nutrient intake, molting and immune evasion. The objective of this study was to investigate the biological characteristics of a novel cathepsin L from Trichinella spiralis (TsCL) and its role in larval invasion, development and reproduction. TsCL has a functional domain of C1 peptidase, which belongs to cathepsin L family. The complete TsCL sequence was cloned and expressed in Escherichia coli BL21. The rTsCL has good immunogenicity. RT-PCR and Western blotting analysis showed that TsCL was transcribed and expressed at different T. spiralis phases (e.g., muscle larvae, intestinal infectious larvae, adult worms and newborn larvae). Immunofluorescence test revealed that TsCL was principally localized in the cuticle, stichosome, midgut and female intrauterine embryos of the nematode. rTsCL has the capacity to specially bind with intestinal epithelial cells (IECs) and the binding sites was located in the cytoplasm. rTsCL promoted larval penetration into IEC, while anti-rTsCL antibodies inhibited the invasion. The silencing of TsCL gene by specific dsRNA significantly reduced the TsCL expression and enzyme activity, and also reduced larval invasive ability, development and female reproduction. The results showed that TsCL is an obligatory protease in T. spiralis lifecycle. TsCL participates in worm invasion, development and reproduction, and may be regarded as a potential candidate vaccine/drug target against T. spiralis infection.

Vaccination of mice with recombinant novel aminopeptidase P and cathepsin X alone or in combination induces protective immunity against Trichinella spiralis infection.

Trichinella spiralis is a major foodborne zoonotic parasitic nematode which has a serious threat to meat food safety. Development of anti-Trichinella vaccine is requisite for control and elimination of Trichinella infection in food animals to ensure meat safety. Aminopeptidase P (TsAPP) and cathepsin X (TsCX) are two novel proteins identified in T. spiralis intestinal infectious L1 larvae (IIL1). The objective of this study was to investigate the protective immunity elicited by immunization with TsAPP and TsCX alone and TsAPP-TsCX in combination in a mouse model. The results demonstrate that subcutaneous vaccination of mice with rTsAPP, rTsCX or rTsAPP + rTsCX elicited a systemic humoral response (high levels of serum IgG, IgG1/IgG2a and IgA) and significant local gut mucosal sIgA responses. The vaccination with rTsAPP, rTsCX or rTsAPP + rTsCX also induced a systemic and local mixed Th1/Th2 response, as demonstrated by clear elevation levels of IFN-γ and IL-4 in vaccinated mice. Vaccination of mice with rTsAPP+rTsCX exhibited a 63.99 % reduction of intestinal adult worms and 68.50% reduction of muscle larva burdens, alleviated inflammation of intestinal mucosal and muscle tissues, and provided a higher immune protection than that of vaccination with rTsAPP or rTsCX alone. The results demonstrated that TsAPP and TsCX might be considered novel candidate target molecules for anti-Trichinella vaccines.

Proteomic analysis of hydrolytic proteases in excretory/secretory proteins from Trichinella spiralis intestinal infective larvae using zymography combined with shotgun LC-MS/MS approach.

The critical step of Trichinella spiralis infection is that the muscle larvae (ML) are activated to intestinal infective larvae (IIL) which invade the intestinal columnar epithelium to further develop. The IIL excretory/secretory (ES) proteins play an important role in host-parasite interaction. Proteolytic enzymes are able to mediate the tissue invasion, thereby increasing the susceptibility of parasites to their hosts. The aim of the current study was to screen and identify the natural active proteases in T. spiralis IIL ES proteins using Western blot and gel zymography combined with liquid chromatography tandem mass spectrometry (LC-MS/MS). The T. spiralis ML and IIL ES proteins were collected from the in vitro cultures and their enzymatic acitvities were examined by gelatin zymography and azocasein degradation. The protease activities were partially inhibited by PMSF, E-64 and EDTA. Three protein bands (45, 118 and 165 kDa) of T. spiralis IIL ES proteins were identified by shotgun LC-MS/MS because they have hydrolytic activity to gelatin compared to the ML ES proteins. Total of 30 T. spiralis proteins were identified and they are mainly serine proteinases (19), but also metalloproteinases (7) and cysteine proteinases (3). The qPCR results indicated that transcription levels of four T. spiralis protease genes (two serine proteases, a cathepsin B-like cysteine proteinase and a zinc metalloproteinase) at IIL stage were obviously higher than at the ML stage. These proteolytic enzymes are directly exposed to the host intestinal milieu and they may mediate the worm invasion of enteral epithelium and escaping from the host's immune responses. The results provide the new insights into understanding of the interaction of T. spiralis with host and the invasion mechanism.

Fibroblast response to interstitial flow: A state-of-the-art review.

Interstitial flow (IF) modulates both the biochemical and biophysical cues surrounding cells. It represents a very important regulating mechanism for cell/tissue function and has been commonly utilized in tissue engineering (TE). This article discusses the possible regulating mechanisms of IF on fibroblasts, the various fibroblast responses to IF, the current challenges in understanding the IF-fibroblast relationship and the application of IF for fibroblast involved TE. In particular, IF can affect fibroblast growth at both intracellular (e.g., calcium signaling, protein/proteinase secretion) and cellular (e.g., autocrine/paracrine signaling, proliferation, differentiation, alignment, adhesion, migration) levels. One major challenge for understanding IF-fibroblast interaction has been the determination of the flow and cell growth condition at microlevel especially in a three-dimensional environment. To utilize IF and optimize the fluidic environment for TE, several influencing factors in the system including perfusate composition, flow profile, nutrient supply, signaling molecule effect, scaffold property, and fibroblast type should be considered.

Binding of elastase-1 and enterocytes facilitates Trichinella spiralis larval intrusion of the host's intestinal epithelium.

Elastase-1 is one member of serine protease family, distributes in organisms widely and plays a crucial role in the invasion and development of Trichinella spiralis. In order to identify the binding of T. spiralis elastase-1 (TsEla) with host's intestinal epithelial cells (IECs) and its role in Trichinella larval intrusion, TsEla gene was cloned and expressed in our previous study. The recombinant TsEla (rTsEla) has the enzymatic activity to degrade specific peptide substrate. A specific binding between rTsEla and IECs was detected by Far Western blot and ELISA. In an in vitro invasion assay, rTsEla promoted the larval intrusion, whereas anti-rTsEla serum inhibited the larval penetration. The larval intrusion was also suppressed after the silencing of TsEla by siRNA. Silencing of TsEla gene by siRNA-291 meditated RNA interference suppressed TsEla protein expression, reduced the worm infectivity, development and reproductive capacity. These results indicated that TsEla plays an important role in the T. spiralis intrusion of host's intestinal epithelia, and it could be a prospective vaccine molecular target against T. spiralis infection.

An instrument for evaluating the clinical applicability of guidelines.

OBJECTIVE: To establish an instrument for evaluating the clinical applicability of guidelines from the guideline-users' perspective. METHODS: We established this instrument through forming a working group, forming an initial list of items based on a qualitative systematic review, establishing initial instrument via two rounds of modified Delphi surveys, and external review the initial instrument. RESULTS: The results of modified Delphi surveys establishing appraisal aspects, appraisal items, general information of the evaluator met the preset requirements. The instrument includes three parts: general information of the evaluator (12 items), evaluation of clinical applicability (12 items, including items on the availability, readability, acceptability, feasibility, and overall applicability of guideline), and scoring scheme. CONCLUSIONS: The instrument for evaluating the clinical applicability of guidelines from the guideline-users' perspective provides criteria and methods for improving the clinical applicability of guidelines during development and updating.

Differential proteomic analysis of nasal polyps, chronic sinusitis, and normal nasal mucosa tissues.

OBJECTIVE: To compare protein expression in nasal polyps, chronic sinusitis, and normal nasal mucosa tissues using proteomic technology. DESIGN: Cross-sectional survey. SUBJECTS AND METHODS: Proteins extracted from the three kinds of tissues (seven samples per group) were separated by immobilized pH4-7 gradient two-dimensional gel electrophoresis (2-DE). PDQuest software was used to analyze 2-DE images, and the differentially expressed protein spots were identified with the use of both MALDI-TOF-MS and ESI-Q-TOF-MS. Of the differentially expressed proteins, Cu/ZnSOD and PLUNC were validated with the use of immunohistochemical tests. RESULTS: High-resolution, reproducible 2-DE patterns were obtained, and 30 differentially expressed protein spots were found. The intensity of Cu/ZnSOD and PLUNC differed significantly on immunohistochemical validation. CONCLUSION: These differentially expressed proteins are involved in airway inflammatory reaction, immune response, oxidative stress, and metabolic reaction after exposure to irritants. In the future, several of these proteins may prove useful for exploring the pathogenesis of nasal polyps and chronic sinusitis or as objective biomarkers for quantitatively monitoring disease progression or response to therapy.