Comparison of different interventions for the reduction of labor pain: A systematic review and network meta-analysis.

OBJECTIVE: This systematic review and network meta-analysis were performed to compare different interventions for the reduction of labor pain. METHODS: PubMed, Embase, Cochrane Library, Web of Science and ScienceDirect databases were searched for the randomized controlled trials (RCTs) meeting prespecified inclusion criteria up to January, 2023. Interventions including electrical acupoint stimulation (TEAS), epidural analgesia (EA) and control treatments. The primary outcomes included pain scores, failure rate of natural delivery, adverse events and Apgar scores. The methodological quality was assessed by the Cochrane risk of bias tool. Meta-analysis was performed by R software with gemtc package. Surfaces under the cumulative ranking curves (SUCRA) were used to rank the intervention. RESULTS: Twelve studies met the inclusion criteria and were included in the network meta-analysis. TEAS (WMD -3.1, 95% CrI -3.8, -2.5) and EA (WMD -2.1, 95% CrI -2.8, -1.3) was more effective than the control in decreasing VAS. TEAS ranked first (SUCRA, 90.9%), EA ranked second (SUCRA, 74.0%) and control ranked last (SUCRA, 35.0%) for reducing VAS. For patients with labor pain, with respect to the most effective treatment for reducing failure rate of natural delivery, TEAS ranked first (SUCRA, 96.6%), EA ranked second (SUCRA, 50.4%) and control ranked last (SUCRA, 3.0%). With regard to the Apgar scores, there was high probability that TEAS ranked first (SUCRA, 80.7%), compared to control (SUCRA, 41.4%) and EA (SUCRA 27.9%). With regard to the adverse events, there was high probability that TEAS ranked first (SUCRA, 99.9%), compared to control (SUCRA, 33.2%) and EA (SUCRA 17.6%). CONCLUSION: TEAS has the potential to serve as a viable alternative for women in labor, offering a simple, noninvasive, and non-pharmacological intervention that surpasses EA in terms of both analgesic effectiveness and safety for both mothers and neonates.

The effect of prophylactic antibiotics in acute upper gastrointestinal bleeding patients in the emergency department.

BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB); however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy. METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group (6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins (P=0.045) and endotracheal intubation (P=0.005) in the prophylactic antibiotic group, and endoscopic treatment (P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics. CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.

Oral delivery of a highly stable superoxide dismutase as a skin aging inhibitor.

As an effective antioxidant enzyme, superoxide dismutase (SOD) has been widely used as a food supplement, cosmetic additive, and therapeutic agent. However, oral delivery of SOD is challenging due to its relative instability, limited bioavailability, and low absorption efficiency in the gastrointestinal (GI) tract. We addressed these issues using a highly stable superoxide dismutase (hsSOD) generated from a hot spring microbial sample. This SOD exhibited a specific activity of 5000 IU/mg while retaining its enzymatic activity under low pH environments of an artificial GI system and in the presence of surfactants and various proteolytic enzymes. The inhibitory effects of hsSOD against skin-aging was evaluated under both in vitro and in vivo experiments using fibroblast cell and D-galactose induced aging-mouse models, respectively. Effective oral delivery of hsSOD promises wide applicability in pharmaceutical and food industries.

Short-term effects of wildfire on soil arthropods in a semi-arid grassland on the Loess Plateau.

Fires lead to dramatic shifts in ecosystems and have a large impact on the biota. Soil organisms, especially soil fauna, are often used as indicators of environmental change. At present, minimal attention has been paid to using soil fauna as an indicator of environmental change after a fire. Here, a field survey of burnt herbaceous vegetation in semi-arid areas was conducted to determine the response of soil arthropods to fire and their short-term recovery after fire. Overall, the abundance and biomass of soil arthropods was more sensitive to fire than the number of groups. The number of soil arthropod groups, especially the dominant groups (mites and springtails), was not significantly affected by wildfires. At the unburned site, soil arthropod abundance showed significant seasonal shifts that may be related to the vegetation properties, temperature, and precipitation caused by seasonal changes. In contrast, soil arthropods at the burnt sites showed a delayed recovery and had only reached 56%-82%, 17%-54%, and 91%-190% of the biomass in the unburnt forest at the 3, 6, and 9 months after the burning event. Our findings of soil arthropod abundance changes in the present study suggest that fire-induced changes in soil and vegetation properties (e.g., AN, LT, and VC) were crucial factors for the changes in soil arthropod abundance in this semi-arid grassland. We conclude that fire disturbance reduces the seasonal sensitivity of soil arthropods by altering their habitat. This study furthers our understanding of wildfire impact recovery by documenting the short-term temporal dynamics of soil arthropods.

Netrins and Frazzled/DCC promote the migration and mesenchymal to epithelial transition of Drosophila midgut cells.

Mesenchymal-epithelial transitions (METs) are important in both development and the growth of secondary tumours. Although the molecular basis for epithelial polarity is well studied, less is known about the cues that induce MET. Here we show that Netrins, well known as chemotropic guidance factors, provide a basal polarising cue during the Drosophila midgut MET. Both netrinA and netrinB are expressed in the visceral mesoderm, the substrate upon which midgut cells migrate, while their receptor frazzled (fra) is expressed in midgut cells. Netrins are required to polarise Fra to the basal surface, and Netrins and Fra undergo mutually-dependent endocytosis, with Fra subsequently trafficking to late endosomes. Mutations to fra and netrins affect both migration and MET but to different degrees. Loss of fra strongly delays migration, midgut cells fail to extend protrusions, and apico-basal polarisation of proteins and epithelium formation is inhibited. In netrin mutants, the migration phenotype is weaker and cells still extend protrusions. However, apico-basal polarisation of proteins, including Fra, and FActin is greatly disrupted and a monolayer fails to form. Delocalised accumulations of FActin are prevalent in netrin mutants but not fra mutants suggesting delocalised Fra may disrupt the MET. ßPS localisation is also affected in netrin mutants in that a basal gradient is reduced while localisation to the midgut/VM interface is increased. Since a similar effect is seen when endocytosis is inhibited, Netrin and Fra may regulate Integrin turnover. The results suggest Netrin-dependent basal polarisation of Fra is critical for the formation of an epithelium.

The Chriz-Z4 complex recruits JIL-1 to polytene chromosomes, a requirement for interband-specific phosphorylation of H3S10.

The conserved band-interband pattern is thought to reflect the looped-domain organization of insect polytene chromosomes. Previously, we have shown that the chromodomain protein Chriz and the zinc-finger protein Z4 are essentially required for the maintenance of polytene chromosome structure. Here we show that both proteins form a complex that recruits the JIL-1 kinase to polytene chromosomes, enabling local H3S10 phosphorylation of interband nucleosomal histones. Interband targeting domains were identified at the N-terminal regions of Chriz and Z4, and our data suggest partial cooperation of the complex with the BEAF boundary element protein in polytene and diploid cells. Reducing the core component Chriz by RNAi results in destabilization of the complex and a strong reduction of interband-specific histone H3S10 phosphorylation.

Mammalian apoptosis-inducing protein, HAP, induces bacterial cell death.

In attempting to produce the HAP, endoplasmic reticulum (ER) targeted apoptosis-inducing protein, as a GST-fusion protein we found that the expression of HAP, but not GST alone, induced bacterial cell death. The HAP protein inhibited the bacterial growth within 30 min after inducting HAP expression. The transmission electron microscopic examination revealed that the morphology of the bacterial cells expressing hap was changed dramatically: unusually elongated phenotype compared with those of controls and finally leading to cell death. The lethality of HAP was relieved by the addition of vitamin E as a reducing agent and under anaerobic growth conditions. These results suggest that a trace amount of HAP induces bacterial cell death and the death is related with reactive oxygen species (ROS).

Dimerization of two novel apoptosisinducing proteins and its function in regulating cell apoptosis.

Asy (apoptosis/saibousi Yutsudo) is a novel apoptosis-inducing gene found in 1999 by Yutsudo group in Japan. In 2000, Qi Bing et al. cloned another novel gene, named hap (homologue of ASY protein), which encoded the ASY interacting protein, from human lung cell line (WI-38) cDNA library by using yeast two-hybrid system. It has been proved that ASY formed homodimer in yeast and human cell line, ASY and HAP formed heterodimer in yeast cells, and both induced cell apoptosis in human tumor cell lines Sao2 and CGL4. This paper showed that HAP could form homodimer in yeast cells by yeast two-hybrid system; HAP and ASY could produce heterodimer in human cell line by cross-immunoprecipitation test; by using apoptosis-testing technologies such as AnnexinV, TUNEL, DNA ladder and Flow Cytometry, the cell apoptosis in human normal or tumor cell lines transfected with hap or asy individually or cotransfected by the both was qualified or quantified. It was firstly demonstrated that ASY or HAP induced cell apoptosis not only in human tumor cell lines, but also in human normal cell lines. Moreover, we proved that the heterodimer between ASY and HAP decreased apoptosis-inducing activity from the homodimer of ASY or HAP. It revealed that by choosing to form heterodimer or homodimer between ASY and / or HAP is an important mechanism of regulating apoptosis in human cell lines.