Exploring the mechanism of daphne-type diterpenes against gastric cancer cells.

Gastric cancer is one of the common malignant tumors. It is reported that daphne-type diterpenes have inhibitory effects on gastric cancer cells, but the mechanism is still unknown. To explore the detailed mechanism of the anticancer effect of daphne-type diterpenes, we carried out an integrated network pharmacology prediction study and selected an effective component (yuanhuacine, YHC) for the following validation in silico and in vitro. The result showed that daphne-type diterpenes exerted an anti-tumor effect by targeting proto-oncogene tyrosine-protein kinase SRC as well as regulating the Ras/MAPK signaling pathway, which caused the apoptosis and mitochondrial damage in gastric cancer cells.

Four Pairs of Neuroprotective Aryldihydronaphthalene-Type Lignanamide Enantiomers from the Herbs of Solanum lyratum.

Four pairs of aryldihydronaphthalene-type lignanamide enantiomers were isolated from Solanum lyratum (Solanaceae). The enantiomeric separation was accomplished by chiral-phase HPLC, and five undescribed compounds were elucidated. Analysis by various spectroscopy and ECD calculations, the structures of undescribed compounds were illuminated. The neuroprotective effects of all compounds were evaluated using H2 O2 -induced human neuroblastoma SH-SY5Y cells and AchE inhibition activity. Among them, compound 4 a exhibited remarkable neuroprotective effects at high concentrations of 25 and 50 µmol/L comparable to Trolox. Compound 1 a showed the highest AchE inhibition with the IC50 value of 3.06±2.40 µmol/L. Molecular docking of the three active compounds was performed and the linkage between the compounds and the active site of AchE was elucidated.

Synthesis and antidepressant activity of novel 1-(1-benzoylpiperidin-4-yl) methanamine derivatives selectively targeting SSRI/5-HT1A.

A series of novel 1-(1-benzoylpiperidin-4-yl) methanamine derivatives were synthesized and evaluated for the serotonin reuptake inhibitory abilities and binding affinities to the 5-HT1A receptor. The metabolic stabilities of these compounds were measured in vitro using human or mouse liver microsomes and the antidepressant activities were explored In vivo using the forced swimming test (FST) and tail suspension test (TST) in mice. The results indicated that the compound 12a exhibited strongest serotonin reuptake inhibition (IC50 = 8.2 nM) and marked 5-HT1A receptor affinity (Ki = 0.069 nM), which were significantly superior to lead compounds Ⅰ and Ⅱ. Meanwhile, compound 12a showed good metabolic stability in vitro and exhibited potential antidepressant-like effects in the FST and TST in mice.

Three cases of hepatic epithelioid hemangioendothelioma evaluated using conventional and contrast-enhanced ultrasound: Case reports.

Hepatic epithelioid hemangioendothelioma (HEHE) is a very rare vascular endothelial cell tumor, which lacks typical clinical manifestations and specificity of imaging features. Whether the background of fatty liver and the difference in Contrast enhanced ultrasound (CEUS) characteristics between large and small lesions has not been well defined. In this case reports, we described the ultrasound image features of three patients with HEHE. These three patients with HEHE have certain similar characteristics of conventional ultrasound and CEUS. CEUS imaging features include large nodules show earlier perfusion than liver parenchyma, with rim-enhancement, nonenhancing regions in the center, while small nodules show earlier perfusion than liver parenchyma, with hyperenhancement. All nodules show faster washout than hepatic parenchyma, showing heterogeneous hypoenhancement, and more washout lesions can be found in the PVP and LP. Conventional ultrasound and CEUS not only help to improve the diagnostic confidence of HEHE of rare liver tumors, but also can guide the biopsy area, making it easier to make accurate pathological diagnosis.

Long-term outcomes of osteotome sinus floor elevation with or without bone grafting: The 10-year results of a randomized controlled trial.

AIMS: To assess the long-term clinical and radiographic results of implants placed using osteotome sinus floor elevation (OSFE) with or without bone grafting. MATERIALS AND METHODS: Forty-five patients were randomly assigned into two groups: Group 1 (OSFE with deproteinized bovine bone mineral) and Group 2 (OSFE without grafting). The patients were recalled at 1, 3, 5 and 10 years after surgery. The implant survival, endo-sinus bone gain (ESBG), marginal bone loss (MBL), peri-implant bone height (PBH, distance from the most coronal level to the most apical level of bone-to-implant contact), prosthesis survival and hardware complications, and peri-implant soft tissue conditions were assessed. RESULTS: Forty patients attended the 10-year examination. Mean residual bone height was 4.58 ± 1.28 mm. The 10-year cumulative survival rate was 90.7% for Group 1 and 95.0% for Group 2. The PBH was 5.89 ± 1.24 mm for Group 1 and 5.74 ± 1.43 mm for Group 2 at 10 years. The ESBG of both groups remained stable after 3 years. Two-thirds of the implants were free of hardware complications. No significant differences in MBL and peri-implant tissue parameters were found. CONCLUSION: OSFE with or without grafting both yielded predictable clinical outcomes with similar PBH (ClinicalTrials.gov. NCT01619956).

Evaluation of Volatile Compounds in Milks Fermented Using Traditional Starter Cultures and Probiotics Based on Odor Activity Value and Chemometric Techniques.

The volatile components of milks fermented using traditional starter cultures (Streptococcus thermophilus and Lactobacillus bulgaricus) and probiotics (Lactobacillus lactis, Lactobacillus bifidus, Lactobacillus casei, and Lactobacillus plantarum) were investigated by means of gas chromatography-mass spectrometry (GC-MS) combined with simultaneous distillation extraction (SDE). A total of 53 volatile compounds were detected, being 10 aldehydes, 11 ketones, 10 acids, 11 hydrocarbons, 7 benzene derivatives, and 4 other compounds. The starter culture was found to significantly affect the composition of volatile components in the fermented milks. Ketones and hydrocarbons were the dominant compounds in milk before fermentation, while acids were dominant compounds in the fermented samples. Compared with probiotics, there was greater abundance of volatile components in fermented milks with traditional strains. The importance of each volatile compound was assessed on the basis of odor, thresholds, and odor activity values (OAVs). Of the volatile compounds, 31 of them were found to be odor-active compounds (OAV > 1). The component with the highest OAVs in most samples was (E,E)-2,4-decadienal. Heatmap analysis and principal component analysis were employed to characterize the volatile profiles of milks fermented by different starter cultures. The results could help to better understand the influence of starter cultures on the odor quality of milks.

The effect of Yang Yan Qing E Wan on senescent phenotypes and the expression of ß-catenin and p16INK4a in human skin fibroblasts.

This aim of this study was to observe the effect of Yang Yan Qing E Wan (YYQEW) on senescent phenotypes and the expression of ß-catenin and p16INK4a in the hydrogen peroxide (H2O2)-induced premature senescence of normal human skin fibroblasts (NHSFs). Primary normal human skin fibroblasts were randomly divided into a normal group, a blank group, a model group, and a YYQEW group. The cells of the model group and the YYQEW group were exposed to 150 µmol/L H2O2 for 2 h. The morphological changes of the cells were analyzed by microscopy and by kits used to estimate the activities of the senescence-associated ß-galactosidase (SA-ß-gal), reactive oxygen species (ROS), and superoxide dismutase (SOD). The outcomes revealed that dyeing rate proportion of SA-ß-gal was 2.78% ± 0.22% in the normal group, 2.83% ± 0.29% in the blank group, 37.58% ± 2.56% in the model group, and 28.39% ± 0.93% in the YYQEW group. The number of SA-ß-gal positive cells was thus significantly higher in the model group than in the normal or blank group. There were also fewer SA-ß-gal positive cells in the YYQEW group compared with the model group. The expression of ROS and p16INK4a in the model group increased significantly compared with that in the normal or blank groups, while the expression of ROS and p16INK4a in the YYQEW group decreased significantly compared with that in the model group. The expression of SOD and ß-catenin in the model group decreased significantly compared with that in the normal or blank group, and the expression of SOD and ß-catenin in the YYQEW group increased significantly compared with that in the model group. Overall, it was found that YYQEW was able to delay the senescence of NHSFs induced by H2O2 treatment by alleviating oxidative stress and regulating a number of senescence-related molecules, such as ß-catenin and p16INK4a.

Contamination of yellow-feathered broiler carcasses: Microbial diversity and succession during processing.

The processing environment of broiler processing plants is a potential major source of bacterial contamination of broiler carcasses. This study investigated the effect of processing water and processing time on the microbial diversity of yellow-feathered broiler carcasses at select stages of slaughter during one commercial processing day using a high-throughput sequencing technique targeting the V3V4 region of the 16S RNA gene. Our results demonstrated that Firmicutes and Proteobacteria were the dominant bacterial phyla of broiler carcasses and processing water in the chiller tank, whereas the processing water in the scalder tank contained a high abundance of Firmicutes and Deinococcus-Thermus. At the genus level, Escherichia-Shigella and Streptococcus were present on broiler carcasses with high abundances after defeathering, but their abundance decreased after washing and chilling. The bacterial community structure was revealed to become more complex at later stages of processing, as indicated by the consistent increase in microbial alpha diversity metrics (Chao 1, Shannoneven and Shannon) throughout the processing stages (p < 0.05). Significantly separate clustering of bacterial communities between scalder tank water and carcasses was revealed by PCoA analysis, indicating the limited effect of scalding water on the bacterial communities of broiler carcasses.

Characterization and Discrimination of Chinese Marinated Pork Hocks by Volatile Compound Profiling Using Solid Phase Microextraction Gas Chromatography-Mass Spectrometry/Olfactometry, Electronic Nose and Chemometrics.

The primary aim of this study was to investigate volatile constituents for the differentiation of Chinese marinated pork hocks from four local brands, Dahongmen (DHM), Daoxiangcun (DXC), Henghuitong (HHT) and Tianfuhao (TFH). To this end the volatile constituents were evaluated by gas chromatography-mass spectrometry/olfactometry (GC-MS/O), electronic nose (E-nose) and chemometrics. A total of 62 volatile compounds were identified and quantified in all pork hocks, and 24 of them were considered as odour-active compounds because their odour activity values (OAVs) were greater than 1. Hexanal (OAV at 3.6⁻20.3), octanal (OAV at 30.3⁻47.5), nonanal (OAV at 68.6⁻166.3), 1,8-cineole (OAV at 36.4⁻133.3), anethole (OAV at 5.9⁻28.3) and 2-pentylfuran (OAV at 3.5⁻29.7) were the key odour-active compounds contributing to the integral flavour of the marinated pork hocks. According to principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) of GC-MS/O and E-nose data, the results showed that the marinated pork hocks were clearly separated into three groups: DHM, HHT, and DXC-TFH. Nine odour-active compounds, heptanal, nonanal, 3-carene, d-limonene, ß-phellandrene, p-cymene, eugenol, 2-ethylfuran and 2-pentylfuran, were determined to represent potential flavour markers for the discrimination of marinated pork hocks. This study indicated the feasibility of using GC-MS/O coupled with the E-nose method for the differentiation of the volatile profile in different brands of marinated pork hocks.

Hepatic Expression of PEMT, but Not Dietary Choline Supplementation, Reverses the Protection against Atherosclerosis in Pemt-/-/Ldlr-/- Mice.

Background: Phosphatidylethanolamine N-methyltransferase (PEMT) converts phosphatidylethanolamine to phosphatidylcholine. Pemt-/-/low density lipoprotein receptor (Ldlr)-/- mice have significantly reduced plasma lipids and are protected against atherosclerosis. Recent studies have shown that choline can be metabolized by the gut flora into trimethylamine-N-oxide (TMAO), which is an emerging risk factor for atherosclerosis. Objective: The objective of this study was to determine whether ectopic hepatic PEMT expression or choline supplementation would promote atherosclerosis in Pemt-/-/Ldlr-/- mice. Methods: Male 8- to 10-wk-old Pemt+/+/Ldlr-/- (SKO) and Pemt-/-/Ldlr-/- (DKO) mice were injected with an adeno-associated virus (AAV) expressing green fluorescent protein (GFP) or human PEMT and fed a Western diet (40% of calories from fat, 0.5% cholesterol) for 8 wk. In a separate experiment, 8- to 10-wk-old SKO and half of the DKO male mice were fed a Western diet with normal (3 g/kg) choline for 12 wk. The remaining DKO mice [choline-supplemented (CS) DKO] were fed a CS Western diet (10 g choline/kg). Plasma lipid concentrations, choline metabolites, and aortic atherosclerosis were measured. Results: Plasma cholesterol, plasma TMAO, and aortic atherosclerosis were reduced by 60%, 40%, and 80%, respectively, in DKO mice compared with SKO mice. AAV-PEMT administration increased plasma cholesterol and TMAO by 30% and 40%, respectively, in DKO mice compared with AAV-GFP-treated DKO mice. Furthermore, AAV-PEMT-injected DKO mice developed atherosclerotic lesions similar to SKO mice. In the second study, there was no difference in atherosclerosis or plasma cholesterol between DKO and CS-DKO mice. However, plasma TMAO concentrations were increased 2.5-fold in CS-DKO mice compared with DKO mice. Conclusions: Reintroducing hepatic PEMT reversed the atheroprotective phenotype of DKO mice. Choline supplementation did not increase atherosclerosis or plasma cholesterol in DKO mice. Our data suggest that plasma TMAO does not induce atherosclerosis when plasma cholesterol is low. Furthermore, this is the first report to our knowledge that suggests that de novo choline synthesis alters TMAO status.

Endo-sinus bone formation after transalveolar sinus floor elevation without grafting with simultaneous implant placement: Histological and histomorphometric assessment in a dog model.

AIM: To evaluate endo-sinus new bone formation and implant osseointegration after transalveolar sinus floor elevation (TSFE) and simultaneous implant placement without any grafting materials and to investigate the influence of implant surface modification on bone healing process under this circumstance. MATERIALS AND METHODS: Transalveolar sinus floor elevation and simultaneous implant placement were conducted bilaterally on 12 Labrador dogs. No grafting materials were used during surgery. Implants with two different surfaces (SLA and SLActive) were placed in a split-mouth design. The animals were sacrificed 4, 8 and 24 weeks after surgery for histological and histomorphometric assessments. Bone-to-implant contact (BIC%), alveolar bone height (ABH) and the percentages of mineralized bone (MB%) in the area of interest were analysed. The probing depth (PD) and bleeding on probing (BOP) were also assessed to describe peri-implant health conditions. RESULTS: Sprouts of new bone in direct contact with implant surface were seen in the elevated area at every time point. Newly formed woven bone under sinus membrane was visible. SLActive implants exhibited favourable results compared with SLA implants regarding ABH at 4 weeks and BIC% at 4 and 8 weeks. Sites with BOP positive could be observed in both groups at any time point. No newly formed bone can be found on the implant apex with either SLA or SLActive surfaces at any time point. CONCLUSIONS: Spontaneous new bone formation from the parent bone walls could be observed after TFE without any grafting materials. No clear evidence of bone formation from the Schneiderian membrane could be found. Even though there were trends for quicker bone response of SLActive implants, this study failed to show the absolute advantage of SLActive in achieving endo-sinus bone formation.

Hyperentanglement purification using imperfect spatial entanglement.

As the interaction between the photons and the environment which will make the entangled photon pairs in less entangled states or even in mixed states, the security and the efficiency of quantum communication will decrease. We present an efficient hyperentanglement purification protocol that distills nonlocal high-fidelity hyper-entangled Bell states in both polarization and spatial-mode degrees of freedom from ensembles of two-photon system in mixed states using linear optics. Here, we consider the influence of the photon loss in the channel which generally is ignored in the conventional entanglement purification and hyperentanglement purification (HEP) schemes. Compared with previous HEP schemes, our HEP scheme decreases the requirement for nonlocal resources by employing high-dimensional mode-check measurement, and leads to a higher fidelity, especially in the range where the conventional HEP schemes become invalid but our scheme still can work.

Simultaneous determination of trimethylamine and trimethylamine N-oxide in mouse plasma samples by hydrophilic interaction liquid chromatography coupled to tandem mass spectrometry.

A method was developed that applies hydrophilic interaction liquid chromatography with tandem mass spectrometry in the multiple reaction monitoring mode to separate and accurately quantify trimethylamine and trimethylamine N-oxide in a single chromatographic run. This was achieved by converting trimethylamine to ethyl betaine, which is less volatile and hence results in greatly improved quantitation. Ethyl betaine also gives a similar response to trimethylamine N-oxide using positive-ion electrospray ionization mass spectrometry. It is readily separated from trimethylamine N-oxide by hydrophilic liquid chromatography in a 5 min run and with improved peak shape compared to underivatized trimethylamine. Validation of the method yielded a limit of detection (S/N ≥ 3) of 0.5 ng/mL for trimethylamine and 0.25 ng/mL for trimethylamine N-oxide. Method accuracies of 91.4-105.3% with precisions of 0.4-5.5% were obtained for standard mixtures over the range of 2.5-500 ng/mL. Recoveries measured for the extraction of trimethylamine and trimethylamine N-oxide spikes into mouse plasma were both >90%. The method, which simultaneously measures trimethylamine and trimethylamine N-oxide, was successfully applied to mouse plasma samples and could be adapted for use with other biological fluids.

Long-term outcomes of osteotome sinus floor elevation without bone grafts: a clinical retrospective study of 4-9 years.

OBJECTIVE: To evaluate the long-term clinical and radiographic outcomes of dental implant placed using osteotome sinus floor elevation (OSFE) without bone grafts, and to analyze the potential influence factors of implant survival and endo-sinus bone remodeling. MATERIAL AND METHODS: A retrospective study design was adopted. The clinical and radiographic data of 96 implants in 80 patients were collected after 4-9 (mean 5.40) years follow-up. Implant failures, peri-implant marginal bone loss (MBL), and endo-sinus bone remodeling on the radiographs were evaluated. A life-table analysis was used to assess the implant survival. Statistical models were established to investigate the potential influence factors of implant survival and endo-sinus bone gain (ESBG). RESULTS: In total, nine implants in seven patients failed, giving the 9-year cumulative survival rates of 90.6% and 91.3% for implant-based analysis and patient-based analysis, respectively. The mean MBL between implant installation and the 4- and 9-year follow-up visit was 0.46 ± 0.88 and 0.50 ± 1.69 mm, respectively. The average ESBG on radiographs was 2.95 ± 1.25 and 2.16 ± 1.13 mm at the 4- and 9-year follow-up. The final ESBG was found to be positively correlated to implant protrusion length after surgery without any other factors related. The implant survival rate was significantly lower in severe atrophic site (residual bone height <5 mm). CONCLUSION: Osteotome sinus floor elevation without bone grafts is a predictable treatment modality in the long run. But it should be used with caution when the initial bone height of the edentulous site is lower than 5 mm. The final endo-sinus bone height was found to be positively correlated to implant protrusion length measured on radiographs immediately after implant installation.

Periodontal and peri-implant microbiota in patients with healthy and inflamed periodontal and peri-implant tissues.

OBJECTIVE: To compare the prevalence and levels of six bacterial pathogens within the subgingival/submucosal microbiota at teeth versus implants with various clinical conditions. MATERIAL AND METHODS: Twenty-two Chinese were included. Four subgingival/submucosal sites were selected for microbiological sampling within each subject, that is, (1) healthy peri-implant tissues; (2) peri-implantitis [PPD ≥ 5 mm, presence of bleeding on probing (BOP) and confirmed radiographic bone loss]; (3) healthy gingiva; and (4) periodontitis (PPD ≥4 mm). Subgingival/submucosal plaque was sampled using paper points. Quantitative real-time polymerase chain reaction (q-PCR) was used to quantify six pathogens, including Porphyromonas gingivalis (P.g.), Treponema denticola (T.d.), Aggregatibacter actinomycetemcomitans (A.a.), Fusobacterium nucleatum (F.n.), Prevotella intermedia (P.i.), and Staphylococcus aureus (S.a.). Counts were log10-transformed. RESULTS: The most commonly detected species were S. a. and F. n., while A. a. and. P. i. had the lowest detection frequency. The detection frequencies of diseased tooth or implant sites for each of the six target species were either equal to or higher than the respective frequencies at the corresponding healthy sites. There were no statistically significant differences for any of the species or clinical sites (P > 0.05, Cochran's Q test). No statistically significant differences in the bacterial loads were found among the four clinical sites; with the exception of F. nucleatum. This was more abundant in periodontitis sites (P = 0.023, Friedman's 2-way anova). Both periodontal and peri-implant sites, irrespective of their health status, were revealed to harbor S. aureus cells. The log10-transformed loads of S. aureus were approximately 3.5 within each of the clinical sites (P = 0.232). This was the highest of the six species analyzed. CONCLUSIONS: Within the same subjects, putative periodontal pathogens were common to both periodontal and peri-implant sites irrespective of health status. The prevalence and levels of P. gingivalis and F. nucleatum were significantly associated with periodontitis, but not with peri-implantitis. A. actinomycetemcomitans was associated with both disease conditions, periodontitis and peri-implantitis, but not with either gingival or mucosal health.

Adenovirus-mediated siRNA targeting CXCR2 attenuates titanium particle-induced osteolysis by suppressing osteoclast formation.

BACKGROUND Wear particle-induced peri-implant loosening is the most common complication affecting long-term outcomes in patients who undergo total joint arthroplasty. Wear particles and by-products from joint replacements may cause chronic local inflammation and foreign body reactions, which can in turn lead to osteolysis. Thus, inhibiting the formation and activity of osteoclasts may improve the functionality and long-term success of total joint arthroplasty. The aim of this study was to interfere with CXC chemokine receptor type 2 (CXCR2) to explore its role in wear particle-induced osteolysis. MATERIAL AND METHODS Morphological and biochemical assays were used to assess osteoclastogenesis in vivo and in vitro. CXCR2 was upregulated in osteoclast formation. RESULTS Local injection with adenovirus-mediated siRNA targeting CXCR2 inhibited titanium-induced osteolysis in a mouse calvarial model in vivo. Furthermore, siCXCR2 suppressed osteoclast formation both directly by acting on osteoclasts themselves and indirectly by altering RANKL and OPG expression in osteoblasts in vitro. CONCLUSIONS CXCR2 plays a critical role in particle-induced osteolysis, and siCXCR2 may be a novel treatment for aseptic loosening.

Osteotome sinus floor elevation with and without grafting: an animal study in Labrador dogs.

AIM: To evaluate implant stability and histological outcomes after osteotome sinus floor elevation (OSFE) procedure, and to compare new bone formation and implant osseointegration with and without grafting. MATERIAL AND METHODS: OSFE with simultaneous implant placement was conducted bilaterally on 6 Labrador dogs. Twenty-four implants were placed. The right side sinus (Group 1) was grafted with biphasic calcium phosphate (BCP), whereas the left side (Group 2) was left without any grafting materials. The animals were euthanized 8 and 24 weeks after surgery for histological and histomorphometric assessment. Bone-to-implant contact (BIC%), alveolar bone height (ABH), bone density (BD) and grafting material density (GMD) were measured. The implant stability (ISQ) was assessed using resonance frequency analysis (RFA) at implant placement and 1, 2, 4, 8, 12, 24 weeks after surgery. RESULTS: Endo-sinus new bone with direct contact to implant surface were observed in two groups at both time points. ABH showed no difference between groups at both time points. BIC% and BD in Group 2 (40.05%, 35.90%) was higher than those in Group 1 (23.30%,25.59%) at 24 weeks. Significant shrinkage of grafting material was seen in Group 1. The GMD in Group 1 at 8 weeks was 24.35%, while it dropped to 19.90% at 24 weeks. The changing pattern of ISQ for both groups were similar. CONCLUSIONS: Spontaneous new bone formation and better bone-to-implant contact were found for OSFE without grafting. The grafting material application during OSFE procedure showed no advantages in histological results.

Effect of different thermal processing methods on sensory, nutritional, physicochemical and structural properties of Penaeus vannamei.

The aim of this study was to investigate the effect of different thermal processing methods on the nutritional and physicochemical qualities of Penaeus vannamei. Three different thermal processing methods, namely, drying (DS, 120 °C/40 min), steaming (SS, 100 °C/2 min), and microwaving (MS, 600 W/2 min) were used to treat the shrimps. Low-field nuclear magnetic resonance data indicated that fixed water was the main component of Penaeus vannamei. The ratio of fatty acids in MS and DS samples was more in line with the FAO/WHO recommended health requirements; The myofibrillar protein carbonyl group increased, whereas sulfhydryl content decreased after thermal processing, indicating that the proteins were oxidized by thermal processing. The magnitude of oxidation is: MS > SS > DS. Different thermal processing methods can exert great influence on color texture and nutrition to Penaeus vannamei, which can provide a theoretical knowledge for consumers to choose the appropriate processing method.

Identification of vancomycin-resistant enterococci clones and inter-hospital spread during an outbreak in Taiwan.

BACKGROUND: In 2003, nosocomial infections caused by vancomycin-resistant enterococci (VRE) occurred rarely in Taiwan. Between 2003 and 2010, however, the average prevalence of vancomycin resistance among enterococci spp. increased from 2% to 16% in community hospitals and from 3% to 21% in medical centers of Taiwan. We used molecular methods to investigate the epidemiology of VRE in a tertiary teaching hospital in Taiwan. METHODS: Between February 2009 and February 2011, rectal samples and infection site specimens were collected from all inpatients in the nephrology ward after patient consent was obtained. VRE strain types were determined by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). RESULTS: A total of 59 vanA gene-containing VRE isolates (1 per patient) were obtained; 24 originated from rectal sample surveillance of patients who exhibited no symptoms (22 Enterococcus faecium and 2 Enterococcus faecalis), and 35 had developed infections over 3 days after admission (32 E. faecium, 2 E. faecalis, and 1 Enterococcus durans). The 59 VRE isolates demonstrated vancomycin minimum inhibitory concentrations (MICs) of ≥256 µg/m. The MIC range for linezolid, tigecycline, and daptomycin was 0.25-1.5 µg/mL, 0.032-0.25 and 1-4 µg/mL, respectively. For 56 isolates, the MIC for teicoplanin was >8 µg/mL. The predominant types in the nephrology ward were MLST types 414, 78, and18 as well as PFGE types A, C, and D. CONCLUSION: VREs are endemic in nephrology wards. MLST 414 is the most predominant strain. The increase VRE prevalence is due to cross-transmission of VRE clones ST 414,78,18 by undetected VRE carriers. Because similar VRE STs had been reported in a different hospital of Taiwan, this finding may indicate inter-hospital VRE spread in Taiwan. Active surveillance and effective infection control policies are important controlling the spread of VRE in high risk hospital zones. All endemic VRE strains are resistant to teicoplanin but are sensitive to daptomycin, linezolid, and tigecycline.

Osteotome sinus floor elevation with or without grafting: a 3-year randomized controlled clinical trial.

AIMS: To evaluate the clinical and radiographic results of dental implant placed using osteotome sinus floor elevation (OSFE) with and without simultaneous grafting. MATERIALS & METHODS: Forty-five patients were randomly assigned into two groups: Group1: OSFE with deproteinized bovine bone mineral (DBBM) mixed with autogenous bone chips, and Group2: OSFE without grafting. The endo-sinus bone gain (ESBG) was assessed on radiographs at 6, 12, 24, 36 months following surgery as primary outcome measurement. Implant survivals and marginal bone loss (MBL) were assessed as secondary outcome measurements. RESULTS: Twenty-one implants in Group1 and 20 implants in Group2 were analysed. The residual bone height (RBH) was 4.63 ± 1.31 mm in average (4.67 ± 1.18 mm for Group1 and 4.58 ± 1.47 mm for Group2). The 3-year cumulative survival rates of implants were 95.2% for Group1 and 95.0% for Group2. The ESBG in Group1 reduced from 5.66 ± 0.99 mm at 6 months to 3.17 ± 1.95 mm at 36 months, whereas the ESBG in Group2 increased from 2.06 ± 1.01 mm at 6 months to 3.07 ± 1.68 mm at 36 months. The MBL after 3 years was 1.33 ± 0.46 mm in Group1 and 1.38 ± 0.23 mm in Group2. CONCLUSIONS: OSFE and simultaneous implant installation with and without grafting both resulted in predictable results. The application of grafting materials has no significant advantage in terms of clinical success.