Effectiveness of integrated care for older adults-based interventions on depressive symptoms: A systematic review and meta-analysis.

AIM: To pool existing studies to assess the overall effectiveness of integrated care for older adults (ICOPE)-based interventions in improving depressive symptoms in older adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: Ten databases were systematically searched from inception to 15 July 2023 and the search was last updated on 2 September 2023. METHODS: Standardized mean difference (SMD) was calculated using random effects models. RoB 2 and GRADEpro GDT were used to assess the methodological quality and confidence in the cumulative evidence. Funnel plots, egger's test and begg's test were used to analyse publication bias. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity. RESULTS: The results of 18 studies showed ICOPE-based interventions had a significant effect on improving depressive symptoms (SMD = -.84; 95% CI, -1.20 to -.3647; p < .001; 18 RCTs, 5010 participants; very low-quality evidence). Subgroup analysis showed the intervention group was characterized by mean age (70-80 years old), intervention duration between 6 to 12 months, gender (female <50%), non-frail older adults, depressed older adults and mixed integration appeared to be more effective. Sensitivity analysis found the results to be robust. CONCLUSION: ICOPE-based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare professionals are expected to use ICOPE as one of the interventions for depressive symptoms in older adults, and this ICOPE could provide more comprehensive care services for older adults to reduce depressive symptoms. IMPACT: ICOPE-based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults. ICOPE-based interventions had a significant effect on reducing depressive symptoms in the older adults. The intervention group characterized by mean age of older adults, intervention duration, gender ratio, health condition and integration types may influence the effect size. REPORTING METHOD: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Long non-coding RNAs as epigenetic mediator and predictor of glioma progression, invasiveness, and prognosis.

Gliomas are aggressive brain tumors with high mortality rate. Over the past several years, non-coding RNAs, specifically the long non-coding RNAs (lncRNAs), have emerged as biomarkers of considerable interest. Emerging data reveals distinct patterns of expressions of several lncRNAs in the glioma tissues, relative to their expression in normal brains. This has led to the speculation for putative exploitation of lncRNAs as diagnostic biomarkers as well as biomarkers for targeted therapy. With a focus on lncRNAs that have shown promise as epigenetic biomarkers in the proliferation, migration, invasion, angiogenesis and metastasis in various glioma models, we discuss several such lncRNAs. The data from cell line / animal model-based studies as well as analysis from human patient samples is presented for the most up-to-date information on the topic. Overall, the information provided herein makes a compelling case for further evaluation of lncRNAs in clinical settings.

Social frailty as a predictor of adverse outcomes among older adults: a systematic review and meta-analysis.

BACKGROUND: With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function. AIMS: To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty. METHODS: Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale. RESULTS: A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)]. CONCLUSION: In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.

Comparative Analysis of Volatile Compounds from Four Radish Microgreen Cultivars Based on Ultrasonic Cell Disruption and HS-SPME/GC-MS.

The ultrasonic cell disruption method was used to efficiently extract isothiocyanates and other volatile compounds from radish microgreens. A total of 51 volatiles were identified and quantified by headspace solid-phase micro-extraction and gas chromatography-mass spectrometry (HS-SPME/GC-MS) in four radish microgreen cultivars, mainly including alcohols, aldehydes, isothiocyanates, sulfides, ketones, esters, terpenes, and hydrocarbons. The correlation between cultivars and volatile compounds was determined by chemometrics analysis, including principal component analysis (PCA) and hierarchical clustering heat maps. The aroma profiles were distinguished based on the odor activity value (OAV), odor contribution rate (OCR), and radar fingerprint chart (RFC) of volatile compounds. This study not only revealed the different flavor characteristics in four cultivars but also established a theoretical basis for the genetic improvement of radish microgreen flavors.

Lactate attenuates astrocytic inflammation by inhibiting ubiquitination and degradation of NDRG2 under oxygen-glucose deprivation conditions.

BACKGROUND: Brain lactate concentrations are enhanced in response to cerebral ischemia and promote the formation of reactive astrocytes, which are major components of the neuroinflammatory response and functional recovery, following cerebral ischemia. NDRG2 is upregulated during reactive astrocyte formation. However, its regulation and function are unclear. We studied the relationship between lactate and NDRG2 in astrocytes under conditions of ischemia or oxygen-glucose deprivation (OGD). METHODS: We examined astrocytic NDRG2 expression after middle cerebral artery occlusion (MCAO) using western blot and immunofluorescence staining. Under hypoxia conditions, we added exogenous L-lactate sodium (lactate) to cultured primary astrocytes to explore the effects of lactate on the ubiquitination modification of NDRG2. We profiled the transcriptomic features of NDRG2 silencing in astrocytes after 8 h of OGD conditions as well as exogenous lactate treatment by performing RNA-seq. Finally, we evaluated the molecular mechanisms of NDRG2 in regulating TNFα under OGD conditions using western blot and immunohistochemistry. RESULTS: Reactive astrocytes strongly expressed NDRG2 in a rat model of MCAO. We also showed that lactate stabilizes astrocytic NDRG2 by inhibiting its ubiquitination. NDRG2 inhibition in astrocytes increased inflammation and upregulated immune-associated genes and signaling pathways. NDRG2 knockdown induced TNFα expression and secretion via c-Jun phosphorylation. CONCLUSIONS: We revealed that under OGD conditions, lactate plays an important anti-inflammatory role and inhibits TNFα expression by stabilizing NDRG2, which is beneficial for neurological functional recovery. NDRG2 may be a new therapeutic target for cerebral ischemia.

Mitochondrial heat-shock cognate protein 70 contributes to auxin-mediated embryo development.

In Arabidopsis thaliana, mitochondrial-localized heat-shock cognate protein 70-1 (mtHSC70-1) plays an important role in vegetativegrowth. However, whether mtHSC70-1 affects reproductive growth remains unknown. Here, we found that the mtHSC70-1 gene was expressed in the provascular cells of the embryo proper from the early heart stage onward during embryogenesis. Phenotypic analyses of mthsc70-1 mutants revealed that mtHSC70 deficiency leads to defective embryo development and that this effect is mediated by auxin. In addition to a dwarf phenotype, the mthsc70-1 mutant displayed defects in flower morphology, anther development, and embryogenesis. At early developmental stages, the mthsc70-1 embryos exhibited abnormal cell divisions in both embryo proper and suspensor cells. From heart stage onward, they displayed an abnormal shape such as with no or very small cotyledon protrusions, had aberrant number of cotyledons, or were twisted. These embryo defects were associated with reduced or ectopic expression of auxin responsive reporter DR5rev:GFP. Consistently, the expression of auxin biosynthesis and polar auxin transport genes were markedly altered in mthsc70-1. On the other hand, mitochondrial retrograde regulation (MRR) was enhanced in mthsc70-1. Treatment of wild-type plants with an inhibitor that activates mitochondrial retrograde signaling reduced the expression level of auxin biosynthesis and polar auxin transport genes and induced phenotypes similar to those of mthsc70-1. Taken together, our data reveal that loss of function of mtHSC70-1 induces MRR, which inhibits auxin biosynthesis and polar auxin transport, leading to abnormal auxin gradients and defective embryo development.

Effectiveness of interventions in older adults with cognitive frailty: a systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: interventions targeting older adults with cognitive frailty have grown rapidly in recent years with inconsistent findings. However, there is no meta-analysis that has synthesised pooled estimates. OBJECTIVE: to synthesise the pooled effect of current targeted interventions in older people with cognitive frailty. METHODS: we conducted a systematic search in PubMed, Embase, Web of Science, the Cochrane Library, the JBI database and three Chinese databases (CNKI, Wan-Fang and VIP) for literature from the inception of the database until 8 March 2022. The mean difference or standardised mean difference with 95% CIs was calculated. The methodological quality was assessed by the Cochrane RoB 2.0. The certainty of evidence was assessed using the GRADE criteria. RESULTS: thirteen randomised controlled trials with a total of 1,089 participants were included. The results of the meta-analysis showed that older adults with cognitive frailty in the intervention groups had significant improvement in frailty score [MD = -1.67, 95% CI (-2.39, -0.95), P < 0.00001, I2 = 97%], global cognitive function [MD = 3.38, 95% CI (1.90, 4.85), P < 0.00001, I2 = 93%], mobility [MD = -0.96, 95% CI (-1.27, -1.66), P < 0.00001, I2 = 0%], muscle strength [SMD = 0.75, 95% CI (0.09, 1.41), P = 0.03, I2 = 85%] and nutritional status [MNA:MD = 5.64, 95% CI (3.99, 7.29), P < 0.00001, I2 = 89%; ALB: MD = 3.23, 95% CI (0.76, 5.71), P = 0.01, I2 = 93%; PALB: MD = 54.52, 95% CI (25.26, 83.77), P = 0.0003, I2 = 96%; TRF: MD = 0.64, 95% CI (0.22, 1.06), P = 0.003, I2 = 97%]. The overall certainty of the evidence ranged from low to moderate. CONCLUSIONS: interventions targeting older adults with cognitive frailty are effective in improving physical frailty, global cognitive function, physical function and nutritional status with low to moderate certainty. More research is still needed in the future to further enrich the evidence in these fields. PROSPERO NUMBER: CRD42022318758.

The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials.

BACKGROUND: The state of mild cognitive impairment (MCI) provides an optimal window for preventing progression to dementia. Combined cognitive intervention and physical exercise may yield additive and synergistic effects on cognition in older adults with MCI. OBJECTIVES: The purpose of this study was to assess the efficacy of a combined intervention to improve cognition in older adults with MCI by comparing a control group that underwent only cognitive intervention, a control group that underwent only physical exercise, and a control group that did not undergo cognitive intervention or physical exercise. DESIGN: Meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: The online databases of PubMed, Web of Science, Embase, the Cochrane Library, PsycINFO, and CINAHL were systematically searched. REVIEW METHODS: The outcomes were global cognition, memory, and executive function/attention. A sensitivity analysis was conducted when the I2 statistic was > 50%. RESULTS: A total of 16 studies were included. The results showed that the combined intervention had positive effects on global cognition compared to the effects of the other control group [SMD = 0.27, 95% CI (0.09, 0.44), p = 0.003]. Regarding memory, the combined intervention had positive effects compared to the effects observed in the single physical exercise group [SMD = 0.25, 95% CI (0.07, 0.44), p = 0.006] and the other control group [SMD = 0.29, 95% CI (0.12, 0.47), p = 0.001]. For executive function/attention, the combined intervention had also positive effects compared to the effects of the single cognitive intervention group [SMD = 0.28, 95% CI (0.09, 0.47), p = 0.004], the single physical exercise group [SMD = 0.32, 95% CI (0.16, 0.49), p = 0.0002], and the other control group [SMD = 0.23, 95% CI (0.05, 0.41), p = 0.01]. CONCLUSIONS: The combined intervention resulted in cognitive benefits in older adults with MCI and exhibited limited superiority over the single cognitive intervention and the single physical exercise on cognitive subdomains.

Clinical practice guidelines for the prevention and management of frailty: A systematic review.

AIMS: To systematically search for clinical practice guidelines focusing on the prevention and management of frailty, to evaluate their methodological quality and to synthesize the consensus recommendations. DESIGN: A systematic review. DATA SOURCES: Guideline websites, related professional association websites and electronic databases were systematically searched through 4 November 2020. REVIEW METHODS: We evaluated the methodological quality of the eligible guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II). Two reviewers synthesized the consensus recommendations proposed by at least two guidelines. RESULTS: Eight guidelines met the eligibility criteria and were included in the review. The mean scores of the six domains were as follows: the 'scope and purpose' domain scored 88.0%, the 'clarity of presentation' domain scored 81.9%, the 'stakeholder involvement' domain scored 63.4%, the 'editorial independence' domain scored 62.2%, the 'rigour of development' domain scored 61.1% and the 'applicability' domain scored 57.8%. In total, we synthesized 23 recommendations for the prevention and management of frailty that are consistent among the included guidelines. CONCLUSIONS: The number of clinical practice guidelines for the prevention and management of frailty is limited. The methodological quality of existing guidelines needs to be improved. Our synthesized findings provide an intuitive, convenient and summative reference resource for frailty prevention and management. It' is worth noting that recommendations described in the included guidelines require additional detail. IMPACT: Although the prevention and management of frailty is urgent, there is currently a lack of evidences guiding these processes, especially in the prevention. The methodological quality of existing guidelines is insufficient, and the recommendations described in the guidelines require additional detail. Therefore, users of these guidelines, especially nurses, should make a careful decision according to the specific situation when using. Nurses also have a key role in providing more clinical evidences for the improvement of the quality of the guidelines.

Development and Comprehensive SPE-UHPLC-MS/MS Analysis Optimization, Comparison, and Evaluation of 2,4-Epibrassinolide in Different Plant Tissues.

A determination method for trace 24-epibrassinolide (EBL) in plant tissues was developed using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The plant tissue samples were extracted using a methanol-formic acid solution, and the corresponding supernatant was purified with ODS C18 solid-phase extraction column. The extracts were separated using a Zorbax Eclipse Plus C18 (2.1 mm × 50 mm, 1.8 µm) column with methanol and 0.1% formic acid as the mobile phase. The ion source for the mass spectrometry was an electrospray ionization source with positive ion mode detection. The linear range of the target compound was 0.7~104 µg/kg, the limit of detection (LOD) was 0.11~0.37 µg/kg, the limit of quantification (LOQ) was 0.36~1.22 µg/kg, the recovery rate was 84.0~116.3%, and the relative standard deviation (RSD%) was 0.8~10.5. The samples of maize plumule, brassica rapeseed flower, and marigold leaf were detected using the external standard method. The optimization of the extraction method and detection method of EBL improved the detection sensitivity, laid a foundation for the artificial synthesis of EBL, improved the extraction rate of EBL, and provided a theoretical basis for the study of EBL in many plants.

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study.

BACKGROUND: Efficacy of pancreatic enzyme inhibitors in acute pancreatitis (AP) is unclear in China. AIMS: We aimed to present the current status of AP and evaluate the efficacy of pancreatic enzyme inhibitors in a larger population in China. METHOD: A retrospective, cross-sectional, real-world, multicenter analysis of a large dataset of patients presenting with AP from four hospitals of China over a two-year period was performed. Data were collected from the existing clinical records and the patients were grouped into medication group (somatostatin or octreotide or somatostatin and octreotide) and no medication group. Pair wise propensity score matching was performed for comparing somatostatin, octreotide and somatostatin/octreotide. The end points were incidence of disease complications, organ failure, hospitalization duration, and recovery time taken (hours) for serum amylase/serum lipase to normalcy. RESULTS: A total of 3900 patients were recruited and 2775 patients were included for analysis. A total of 1100, 661, 676 and 338 patients received either somatostatin or octreotide or somatostatin and octreotide or no medication, respectively. The incidence of complications (7.6% vs 13.6%), organ failure (4.5% vs 7.4%), and the instances of entering ICU (9.3% vs 13.3%) were higher in unmedicated group. Complications at discharge (2.91 times), organ failure (2.53 times), and hospitalization stay were higher in octreotide-treated patients compared with somatostatin-treated patients. In comparison to the octreotide group, the serum amylase/lipase recovery time was shorter in the somatostatin group. CONCLUSION: This real-world study suggested that the use of pancreatic enzyme inhibitors was positively associated with greater clinical efficacy in AP patients and somatostatin might be more effective than octreotide in real-world settings in China.

The prospects and pitfalls in the endovascular treatment of moyamoya disease-associated intracranial aneurysms.

Moyamoya disease (MMD) is characterized by progressive stenosis or occlusion of the distal internal carotid artery and simultaneous formation of collateral vasculature. The fragile alteration and increased hemodynamic stress in the intra- and extracranial vasculature would conjointly result in the formation of intracranial aneurysms in MMD patients. According to our classification, the MMD-associated aneurysms are divided into the major artery aneurysms (MAAs) and non-MAAs. The non-MAAs are further subdivided into the distal choroidal artery aneurysms, moyamoya vessel aneurysms, transdural collateral aneurysms, and anastomosis aneurysms. Currently, endovascular treatment (EVT) has become the main stream for the MMD-associated aneurysms. There is no difference to EVT for the MMD-associated MAAs of the non-stenosed major arteries with that in the non-MMD patients. While it is a big challenge to perform EVT for MMD-associated aneurysms in the stenosed arteries. Generally speaking, the parent arteries of the non-MAAs are slim, and super-selective catheterization is technically difficult. Most of the times, parent artery occlusion with liquid embolic agents or coils can only be performed. The vasculature in MMD patients is fragile; perioperative management and meticulous intraoperative manipulation are also very important to avoid complications during EVT. In spites of the complications, the EVT can bring good outcome in selected cases of MMD-associated aneurysms.

Graphene Assisted in the Analysis of Coumarins in Angelicae Pubescentis Radix by Dispersive Liquid-Liquid Microextraction Combined with 1H-qNMR.

The content of active components in traditional Chinese medicine is relatively small, and it is difficult to detect some trace components with modern analytical instruments, so good pretreatment and extraction are very important in the experiment. Graphene was introduced by a dispersive liquid-liquid microextraction method based on solidification of floating organic drop (DLLME-SFO) with graphene/1-dodecyl alcohol used as the extractant, and this method, combined with quantitative proton nuclear magnetic resonance spectroscopy (1H-qNMR), was used to simultaneously qualitative and quantitative osthole, columbianadin and isoimperatorin in Angelicae Pubescentis Radix. In this experiment, a magnetic stirrer was used for extraction, all NMR spectra were recorded on a Bruker Advance III 600 MHz spectrometer with dimethyl sulfoxide-d6 (DMSO-d6) as deuterated solvent and pyrazine as the internal standard. The influencing factors and NMR parameters in the extraction process were investigated and optimized. In addition, the methodology of the established method was also examined. The quantitative signals of osthole, columbianadin and isoimperatorin were at a chemical shift of δ6.25-δ6.26 ppm, δ6.83-δ6.85 ppm, and δ6.31-δ6.32 ppm. The linear ranges of osthole, columbianadin and isoimperatorin were all 0.0455-2.2727 mg/mL, and R2 were 0.9994, 0.9994 and 0.9995, respectively. The limits of detection of osthole, columbianadin and isoimperatorin were 0.0660, 0.0720, 0.0620 mg, and the limits of quantification of osthole, columbianadin and isoimperatorin were 0.2201, 0.2401, 0.2066 mg/mL. The solution had good stability and repeatability within 24 h. The recoveries of osthole, columbianadin and isoimperatorin were 102.26%, 99.89%, 103.28%, respectively. The established method is simple and easy to operate, which greatly reduces the cumbersome pretreatment of samples and has high extraction efficiency.

Extraction and Analysis of Six Effective Components in Glycyrrhiza uralensis Fisch by Deep Eutectic Solvents (DES) Combined with Quantitative Analysis of Multi-Components by Single Marker (QAMS) Method.

Deep eutectic solvents (DESs) are green organic solvents that have broad prospects in the extraction of effective components of traditional Chinese medicine. This work employed the quantitative analysis of multi-components by a single marker (QAMS) method to quantitatively determine the six effective components of glycyrrhizic acid, liquiritin, isoliquiritin apioside, liquiritigenin, isoliquiritin, and glycyrrhetinic acid in Glycyrrhiza uralensis, which was used for comprehensive evaluation of the optimal extraction process by DESs. First, Choline Chloride: Lactic Acid (ChCl-LA, molar ratio 1:1) was selected as the most suitable DES by comparing the extraction yields of different DESs. Second, the extraction protocol was investigated by extraction time, extraction temperature, liquid-to-material ratio, molar ratio, and ultrasonic power. The Box-Behnken design (BBD) combined with response surface methodology (RSM) was used to investigate the optimal DES conditions. The result showed that the best DES system was 1.3-butanediol/choline chloride (ChCl) with the molar ratio of 4:1. The optimal extraction process of licorice was 20 mL/g, the water content was 30%, and the extraction time was 41 min. The comprehensive impact factor (z) was 0.92. At the same time, it was found that the microstructure of the residue extracted by the eutectic solvent was more severely damaged than the residue after the traditional solvent extraction through observation under an electron microscope. The DES has the characteristics of high efficiency and rapidity as an extraction solution.

Retraction Note: Bone mesenchymal stem cell-derivedexosomal microRNA-29b-3p preventshypoxic-ischemic injury in rat brain byactivating the PTEN-mediated Aktsignaling pathway.

An amendment to this paper has been published and can be accessed via the original article.

Correction to: Bone mesenchymal stem cell-derived exosomal microRNA-29b-3p prevents hypoxic-ischemic injury in rat brain by activating the PTEN-mediated Akt signaling pathway.

An amendment to this paper has been published and can be accessed via the original article.

Bone mesenchymal stem cell-derived exosomal microRNA-29b-3p prevents hypoxic-ischemic injury in rat brain by activating the PTEN-mediated Akt signaling pathway.

BACKGROUND: Mesenchymal stem cells (MSCs) are suspected to exert neuroprotective effects in brain injury, in part through the secretion of extracellular vesicles like exosomes containing bioactive compounds. We now investigate the mechanism by which bone marrow MSCs (BMSCs)-derived exosomes harboring the small non-coding RNA miR-29b-3p protect against hypoxic-ischemic brain injury in rats. METHODS: We established a rat model of middle cerebral artery occlusion (MCAO) and primary cortical neuron or brain microvascular endothelial cell (BMEC) models of oxygen and glucose deprivation (OGD). Exosomes were isolated from the culture medium of BMSCs. We treated the MCAO rats with BMSC-derived exosomes in vivo, and likewise the OGD-treated neurons and BMECs in vitro. We then measured apoptosis- and angiogenesis-related features using TUNEL and CD31 immunohistochemical staining and in vitro Matrigel angiogenesis assays. RESULTS: The dual luciferase reporter gene assay showed that miR-29b-3p targeted the protein phosphatase and tensin homolog (PTEN). miR-29b-3p was downregulated and PTEN was upregulated in the brain of MCAO rats and in OGD-treated cultured neurons. MCAO rats and OGD-treated neurons showed promoted apoptosis and decreased angiogenesis, but overexpression of miR-29b-3p or silencing of PTEN could reverse these alterations. Furthermore, miR-29b-3p could negatively regulate PTEN and activate the Akt signaling pathway. BMSCs-derived exosomes also exerted protective effects against apoptosis of OGD neurons and cell apoptosis in the brain samples from MCAO rats, where we also observed promotion of angiogenesis. CONCLUSION: BMSC-derived exosomal miR-29b-3p ameliorates ischemic brain injury by promoting angiogenesis and suppressing neuronal apoptosis, a finding which may be of great significance in the treatment of hypoxic-ischemic brain injury.

Efficacy of alginate-and chitosan-based scaffolds on the healing of diabetic skin wounds in animal experimental models and cell studies: A systematic review.

This systematic literature review was aimed to investigate the use of cell culture and animal models to evaluate the efficacy of alginate-and chitosan-based scaffolds on diabetic wound healing. We electronically searched the articles published until July 2019. The databases included five English databases such as PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, and three Chinese databases like CNKI, WanFang Data, and VIP. The related articles were manually searched to identify studies that were not searched by electronic database searches. Twenty-nine studies met the inclusion criteria. We divided the results into three groups: chitosan, alginate, and a combination of chitosan and alginate. Chitosan-, alginate-, and a combination of chitosan and alginate-based scaffolds showed good intervention effects on wound healing. Chitosan-based scaffolds were effective in diabetic skin wound healing. The effects of alginate and the combination of chitosan-and alginate-based scaffolds on diabetic skin wounds still need more research. However, due to the heterogeneity of animal and cell preclinical trials and the validity of the statistical analysis used in these studies, it is necessary to conduct a thorough study using well-designed experiments to confirm these results. In addition, properly designed chitosan-and/or alginate-based scaffolds with thorough preclinical evaluations are required prior to clinical applications.

Angiographic study of the transdural collaterals at the anterior cranial fossa in patients with Moyamoya disease.

Unlike its parietal, temporal, and occipital counterparts, the frontal lobe has a broad basal surface directly facing the anterior cranial fossa dura mater which could permit establishment of transdural collaterals (TDCs) with the frontal lobe. Studies on the TDCs from the anterior cranial fossa in moyamoya disease (MMD) are scarce and inadequately investigated. A retrospective study of 100 hemispheres in 50 patients who were diagnosed with MMD by catheter angiography between January 2015 and June 2019 was performed in our institution. TDCs through the anterior ethmoid artery (AEA) or posterior ethmoid artery (PEA) were divided into 3 types respectively based on their respective angioarchitecture. Furthermore, we also studied TDCs to the temporal, parietal, and occipital lobes and collaterals from the posterior circulation to the territory of the anterior cerebral artery. TDCs through the AEA and PEA were identified in 89 (89/100, 89%) and 73 (73/100, 73%) of the hemispheres. The vascularization state of the frontal lobe was good in 89 (89/100, 89%) hemispheres. Rete mirabile and TDCs through the PEA were statistically different among patients with different Suzuki stages. No statistical difference was noted in TDCs through the AEA, frontal TDCs from other sources, and the vascularization state of the frontal lobe with regard to different Suzuki stages. TDCs through the AEA and PEA at the anterior cranial fossa play a very important role in compensating the ischemic frontal lobe. The frontal lobe could be well compensated in most of the patients with TDCs at the anterior cranial fossa.

Endovascular treatment of the cavernous sinus dural arteriovenous fistula: current status and considerations.

A cavernous sinus dural arteriovenous fistula (CS-DAVF) is an abnormal arteriovenous communication involving the dura mater within or near the CS wall. The dural arteries from the internal carotid artery and external carotid artery supply the CS-DAVF, and the superior ophthalmic vein (SOV) and inferior petrous sinus (IPS) are frequent venous drainers. In CS-DAVF cases, high-risk lesions require treatment. Endovascular treatment (EVT) has been the first-line option for CS-DAVFs. To our knowledge, a review of the EVT of CS-DAVFs is lacking. Therefore, in this paper, we review the available literature on this issue. In addition, some illustrative cases are also provided to more concisely expound the EVT of CS-DAVFs. According to the recent literature, transvenous embolization via the IPS is considered the most effective method for EVT of CS-DAVFs. In addition, the transorbital approach is another reasonable choice. Other venous approaches can also be tried. Because of the low cure rate, transarterial embolization for CS-DAVFs is limited to only highly selected patients. In the EVT of CS-DAVFs, various agents have been used, including coil, Onyx, and n-butyl cyanoacrylate, with coil being the preferred one. In addition, when EVT cannot obliterate the CS-DAVF, stereotactic radiotherapy may be considered. In general, despite various complications, EVT is a feasible and effective method to manage CS-DAVFs by way of various access routes and can yield a good prognosis.