Patient-reported Benefits and Limitations of Mobile Health Technologies for Diabetes in Pregnancy: A Scoping Review.

OBJECTIVES: For women with pre-existing and gestational diabetes, pregnancy involves specialized and intensive medical care to optimize maternal and infant outcomes. Medical management for patients with diabetes in pregnancy typically occurs via frequent face-to-face outpatient appointments. COVID-19-induced barriers to face-to-face care have identified the need for high-quality, patient-centred virtual health-care modalities, such as mobile health (mHealth) technologies. Our aim in this review was to identify the patient-reported benefits and limitations of mHealth technologies among women with diabetes in pregnancy. We also aimed to determine how the women's experiences aligned with the best practice standards for patient-centred communication. METHODS: The framework presented by Arksey and O'Malley for conducting scoping reviews, with refinements by Levac et al, was used to guide this review. Relevant studies were identified through comprehensive database searches of MEDLINE, Embase, Emcare and PsycINFO. Thomas and Harden's methods for the thematic synthesis of qualitative research in systematic reviews guided the synthesis of patient-reported benefits and limitations of mHealth technology. RESULTS: Overall, 19 studies describing the use of 16 unique mHealth technologies among 742 women were included in the final review. Patient-reported benefits of mHealth included convenience, support of psychosocial well-being and facilitation of diabetes self-management. Patient-reported limitations included lack of important technological features, perceived burdensome aspects of mHealth and lack of trust in virtual health care. CONCLUSIONS: Women with diabetes report some benefits from mHealth use during pregnancy. Codesigning future technologies with end users may help address the perceived limitations and effectiveness of mHealth technologies.

[Chinese medicinal formulae treat inflammatory bowel diseases through maintaining gut flora homeostasis].

Inflammatory bowel disease(IBD) is a chronic and recurrent inflammatory disorder of the gut, including Crohn's disease(CD) and ulcerative colitis(UC). The occurrence and development of IBD involves multiple pathogenic factors, and the dybiosis of gut flora is recognized as an important pathogenic mechanism of IBD. Therefore, restoring and maintaining the balance of gut flora including bacteria and fungi has become an effective option for IBD treatment. Based on the theoretical basis of the interaction between gut flora and IBD, this paper followed the principle of clinical syndrome differentiation for IBD therapy by traditional Chinese medicine(TCM), and summarized several Chinese medicinal formulae commonly used in IBD patients with large intestine damp-heat syndrome, intermingled heat and cold syndrome, spleen deficiency and dampness accumulation syndrome, spleen and kidney yang deficiency syndrome, liver stagnation and spleen deficiency syndrome, and severe heat poisoning syndrome. The therapeutic and regulatory effects of Shaoyao Decoction, Qingchang Suppository, Wumei Pills, Banxia Xiexin Decoction, Shenling Baizhu Powder, Lizhong Decoction, Sishen Pills, Tongxie Yaofang, Baitouweng Decoction, Gegen Qinlian Decoction, and Houttuyniae Herba prescriptions on gut flora of IBD patients were emphasized as well as the mechanisms. This study found that Chinese medicinal formulae increased the abundance of Bacteroidetes, Bifidobacteria, Lactobacillus, and other beneficial bacteria producing short-chain fatty acids, and reduced the abundance of Enterobacteriaceae and other harmful bacteria to restore the balance of gut flora, thus treating IBD. Confronting the recalcitrance and high recurrence of IBD, Chinese medicinal formulae provide new opportunities for IBD treatment through intervening dysbiosis of gut flora.

Patient-Reported Benefits and Limitations of Mobile Health Technologies for Diabetes in Pregnancy: Protocol for a Scoping Review.

BACKGROUND: For women with pre-existing and gestational diabetes mellitus, pregnancy involves specialized and intensive medical care to improve maternal and infant outcomes. Medical management for patients with diabetes in pregnancy typically occurs via frequent face-to-face outpatient appointments. Barriers to face-to-face care during the COVID-19 pandemic have signaled the need for high-quality, patient-centered virtual health care modalities, such as mobile health (mHealth). OBJECTIVE: The objective of the proposed scoping review is to identify the patient-reported benefits and limitations of mHealth technology among women with diabetes in pregnancy. We also aim to determine how the women's experiences align with the best practice standards for patient-centered communication. METHODS: Arksey and O'Malley's framework for conducting scoping reviews with refinements by Levac et al will be used to guide the conduct of this scoping review. Relevant studies will be identified through comprehensive database searches of MEDLINE, Embase, Emcare, and PsycINFO. Following database searches, studies will be screened for eligibility at the title, abstract, and full-text level by two independent reviewers, with the inclusion of a third reviewer if required to reach consensus. Data charting of included studies will be conducted by one reviewer using a standardized data extraction form and verified independently by a second reviewer. Synthesis of results will be guided by Thomas and Harden's "Methods for the Thematic Synthesis of Qualitative Research in Systematic Reviews." RESULTS: As of August 2020, we have carried out the qualitative searches in the electronic databases MEDLINE, Embase, Emcare, and PsycINFO (Ovid interface) for a combined total of 8207 articles. Next, we plan to conduct the quantitative searches in the electronic databases MEDLINE, Embase, and Emcare (Ovid interface). We also plan to review the reference lists of relevant studies to identify additional eligible studies. CONCLUSIONS: With the results of this review, we hope to describe the patient-reported benefits and limitations of mHealth technology for women with diabetes in pregnancy. Furthermore, we aim to determine how women's experiences align with the best practice standards for patient-centered communication. Ultimately, our review can provide valuable information for guideline developers, policy makers, and clinicians related to mobile technologies to support virtual care delivery for women with diabetes in pregnancy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/29727.

Study on cell apoptosis based on bifurcation and sensitivity analysis.

Apoptosis plays critical roles in embryonic development and adult tissue homeostasis. It has been shown that several feedback loops regulate the intrinsic pathway of apoptosis. However, it remains elusive how they coordinately modulate apoptosis. For the three modules (initiator, amplifier, and executioner) of the intrinsic pathway, we mainly studied dynamics of the initiator and the executioner modules. In this paper, we aimed to identify important regulatory processes in apoptosis through bifurcation and single-parameter sensitivity analysis. We found that modules or feedback loops but not specific parameters determine the network functions. More exactly, the activity of BH3 plays a more important role in the initiator module and triggers the amplifier module. In addition, aC9 autocrine expression and C9/XIAP feedback loop are more sensitive in executioner module. We also found that three feedback loops respectively including BH3AC/BH3DR, MDM2/ARF/ASPP and p53helper/p53killer play more important roles in cell fate decisions after DNA damage. Our research provides a rational basis for the design of clinical trials of anticancer drugs.

The Relationship between Secondary Forest and Environmental Factors in the Southern Taihang Mountains.

It is important to understand the effects of environmental factors on secondary forest assembly for effective afforestation and vegetation restoration. We studied 24 20 m × 20 m quadrats of natural secondary forest in the southern Taihang Mountains. Canonical correspondence analysis (CCA) and two-way indicator hydrocarbon analysis were used to analyse the relationship between community vegetation and environmental factors. The CCA showed that 13 terrain and soil variables shared 68.17% of the total variance. The principal environmental variables, based on the most parsimonious CCA model, were (in order) elevation, soil total N, soil gravel content, slope, soil electrical conductivity, and pH. Samples were clustered into four forest types, with forest diversity affected by elevation, nutrients, and water gradients. Topographical variables affected forest assembly more than soil variables. Species diversity was evaluated using the Shannon-Wiener, Simpson's diversity, and Pielou's evenness indexes. The environmental factors that affected species distribution had different effects on species diversity. The vegetation-environment relationship in the southern region was different than the central region of the Taihang Mountains, and vegetation restoration was at an early stage. The terrain of the southern region, especially elevation and slope, should be considered for vegetation restoration and conservation.

[Effect of curcumin on radiosensitization of CNE-2 cells and its mechanism].

OBJECTIVE: To investigate the effect of curcumin (Cur) on radiosensitivity of nasopharyngeal carcinoma cell CNE-2 and its mechanism. METHOD: The effect of curcumin on radiosensitivity was determined by the clone formation assay. The cell survival curve was fitted by Graph prism 6. 0. The changes in cell cycle were analyzed by flow cytometry (FCM). The differential expression of long non-coding RNA was detected by gene chip technology. Part of differentially expressed genes was verified by Real-time PCR. RESULT: After 10 micro mol L-1 Cur had worked for 24 h, its sensitization enhancement ratio was 1. 03, indicating that low concentration of curcumin could increase the radiosensitivity of nasopharyngeal carcinoma cells; FCM displayed a significant increase of G2 phase cells and significant decrease of S phase cells in the Cur combined radiation group. In the Cur group, the GUCY2GP, H2BFXP, LINC00623 IncRNA were significantly up-regulated and ZRANB2-AS2 LOC100506835, FLJ36000 IncRNA were significantly down-regulated. CONCLUSION: Cur has radiosensitizing effect on human nasopharyngeal carcinoma CNE-2 cells. Its mechanism may be related to the changes in the cell cycle distribution and the expression of long non-coding IncRNA.

Functional polymorphism in the 5'-UTR of CR2 is associated with susceptibility to nasopharyngeal carcinoma.

Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC) is a squamous cell cancer endemic in Southern China and Southeast Asia. It has been shown that inflammatory and immune responses during EBV infection contribute to the development of NPC. The complement receptor 2 (CR2) gene plays central roles during inflammatory and immune responses and, therefore, is a good candidate susceptibility gene for NPC. We performed PCR-based sequencing to identify multiple single-nucleotide polymorphisms (SNPs) within the exon regions of the CR2 gene in a Cantonese population. Two SNPs were screened in 528 NPC patients and 408 normal individuals to perform a case-control study matched according to age, gender and residence. Furthermore, we cloned the entire 5'-UTR and entire CR2 promoter into a luciferase report system and compared the luciferase activities between the different allelic constructs. A SNP in the 5'-UTR of CR2 (24 T/C, rs3813946) showed a significant association (P<0.01) with NPC in the Cantonese population studied. The subjects were categorized into 2 age groups: group 1, age ≤45 years and group 2, age >45 years. In group 1, the allelic frequencies of 24 T/C in the patients were significantly different from those of the controls (P=0.0034). The odds ratio (OR=1.81) also indicated a higher risk of NPC in individuals who carried the minor allele C. All constructs exerted allelic differences on luciferase activities, but only the susceptible allele +24C construct showed increased activity. Our findings implicate CR2 as a susceptibility gene for NPC and suggest that enhanced CR2 expression may be involved in the oncogenesis and development of NPC.

[Preliminary screening of activity fraction of Alchornea trewioides suppresses expression of subgenomic hepatitis C virus RNA in vitro].

OBJECTIVE: To screen activity fraction of Alchornea trewioides which suppresses expression of subgenomic Hepatitis C Virus (HCV) RNA in vitro. METHODS: Anti-HCV effects in vitro were examined in an HCV subgenomic replicon cell culture system--CBRH7919 (Jneo3-5B). The cells were exposed to different concentrations of A. trewioides initial ethanol extracts, portions of petroleum ether,ethyl acetate and n-butanol extracts with interferon a combined with ribavirin as positive control. The content of HCV RNA was examined by Quantitative PCR. The expression levels of functional proteins NS3 were examined in all groups by Western blot. Cell proliferation test with CCK-8 assay was used to evaluate the cytotoxicity of drugs. RESULTS: The study showed that exposure of CBRH7919 (Jneo3-5B) cells to ethyl acetate extract of A. trewioides resulted in a concentration-dependent inhibition of subgenomic HCV RNA replication and NS3 protein expression ability among the four extracts (P < 0.05). The activity of ethyl acetate extract was increased by 5.71 times than that of the initial ethanol extract. IC50 to subgenomic HCV RNA was 14.60 mg/L, CC50 to CBRH7919 (Jneo3-5B) cells was 40.30 mg/L and the treatment index (TI) was 2. 76. CONCLUSION: The ethyl acetate extract of A. trewioides is the activity fraction which can significantly interfere with subgenomic HCV RNA replication and expression of NS3 protein in vitro. These data suggest that ethyl acetate extract isolated from A. trewioides may have potential use as an anti-HCV compound.

[Effect of dachengqi decoction on expressions of TLR4 and TNF-alpha in the lung and the large intestine of mice with endotoxemia].

OBJECTIVE: To investigate the effect of Dachengqi Decoction (DCQD) on the key signaling molecules in lung and large intestine of mice with endotoxemia for exploring the exterior-interior relation between Fei and Dachang. METHODS: A total of 32 BALB/c mice were randomly and equally allocated into four groups: mice in Group C and D were made into endotoxemia model by intraperitoneal injection of 10 mg/kg lipopolysaccharide (LPS); while those in Group A and B were not modeled but given intraperitoneal injection of saline instead. Thirty min after then, saline to Group A and C, and DCQD to Group B and D were given by gastric infusion, and mice were sacrificed 6 h later. Their tissues of lung and large intestine were taken for observing pathological changes by inverted microscopy with HE staining; detecting expressions of tumor necrosis factor-alpha (TNF-alpha) by LiquiChip system; determining gene transcription and protein expression of toll-like receptor 4 (TLR4) using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, and the correlation of TNF-alpha and TLR4 levels in the lung and the large intestine tissue was analyzed. RESULTED: Compared with Group C, hemorrhage, pathologic toxemic features, including pulmonary edema and inflammatory cell infiltration as well as intestinal wall congestion and neutrophil infiltration, were significantly alleviated in Group D. Levels of TNF-alpha expression, TLR4 protein expression and gene transcription raised significantly in the modeled mice (P < 0.01), but comparison between the two modeled groups showed that the three parameters were lower in Group D than in Group C (P < 0. 01 or P < 0.05) respectively. Correlation analysis showed that the levels of TNF-alpha expression, TLR4 protein expression and gene transcription in pulmonary tissues were positively correlated with those in large intestinal tissues respectively (r = 0.973, P < 0.01, r = 0.906, P < 0.01, and r = 0.880, P < 0.01). CONCLUSIONS: The effects of DCQD in alleviating pulmonary and large intestinal inflammation induced by endotoxemia might be correlated to its reduction on levels of TNF-alpha expression, TLR4 protein expression and gene transcription. Levels of the three parameters in the lung are correlated with the corresponding levels in the large intestine, which suggested the existence of exterior-interior relation between Fei and Dachang.

Apigenin suppresses the growth of colorectal cancer xenografts via phosphorylation and up-regulated FADD expression.

Apigenin is a flavonoid belonging to the flavone structural class. It has been implicated as a chemopreventive agent against prostate and breast cancers. However, to the best of our knowledge, no published data are available regarding apigenin in colorectal cancer (CRC). The effects and mechanisms of apigenin on CRC may vary significantly. This study aimed to analyze the effects of apigenin on the growth of CRC xenografts in nude mice derived from SW480, as well as to investigate the underlying mechanisms. Whole-body fluorescence imaging is an inexpensive optical system used to visualize gene expression in small mammals using reporter genes, such as eGFP as a reporter. In our study, the expression of eGFP may reflect the size of the tumor. A terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) assay showed that apigenin promoted the apoptosis of CRC cells. Furthermore, the expression of five genes related to the proliferation and apoptosis of CRC, i.e., cyclin D1, BAG-1, Bcl-2, yrdC and Fas-associated protein with death domain (FADD), was detected by real-time quantitative RT-PCR. Among these genes, the up-regulated expression of FADD was noted in CRC xenograft tumors treated with apigenin. Immunohistochemistry and Western blotting confirmed the results at the protein level. Furthermore, Western blot analysis showed that apigenin induced the phosphorylation of FADD. Our findings suggest that apigenin enhances the expression of FADD and induces its phosphorylation, which may cause apoptosis of CRC cells and inhibition of tumor growth.

Proteomic analysis of chronic restraint stress-induced Gan (肝)-stagnancy syndrome in rats.

OBJECTIVE: To analyze the proteomic characteristics of Gan (肝)-stagnancy syndrome (GSS) by seeking the differential protein in blood and tissues of GSS model rats. METHODS: GSS model rats were established by chronic restraint stress, keeping rats in restrain chamber for 6 h every day for 21 successive days. Their blood and liver samples were collected at the end of experiment for differential protein detection with methods of isoelectrofocusing and polyacrylamide SDS-PAGE, silver staining, and scanning. The gel images were analyzed with Imagemaster 2D Elite software, and the excavated differential protein spots were identified with matrix assistant laser resolving TOF mass spectrometry, Western blot, ELISA, and RT-PCR, respectively. RESULTS: A method for isolating the protein in blood serum and tissues by two-dimensional gel electrophoresis was established and optimized. Six serum proteins and three liver proteins that differentially expressed were identified. The down-regulated differential proteins in serum of GSS model rats were serum albumin precursor, beta 1 globin, antibody against muscle acetylcholine receptor, Ig lambda-2 C region, and transthyretin (TTR), and those in liver tissue were aryl sulfotransferase, enoyl-CoA hydratase, and TTR. TTR down-regulation was found in both serum and liver. Preliminary biological information analysis showed that these differential proteins involved in immune, neuroendocrine, nutrition, and substance metabolism. CONCLUSION: Proteomic analysis of differential proteins showed that TTR, aryl sulfotransferase, and enoyl-CoA hydratase expressions are downregulated in the GSS model rats, suggesting that the susceptibility of cancer could be enhanced by chronic stress.

[Effects of sophoridine on the growth and expressions of p53 and vascular endothelial growth factor of transplanted solid tumor SW480 in nude mice].

OBJECTIVE: To study the effects of sophoridine on the transplanted solid tumor SW480 and the expression of p53 and vascular endothelial growth factor (VEGF) in the tumor in nude mice. METHODS: The nude mouse model bearing transplanted solid tumor SW480 was established, and the changes in the volume and weight of the tumor were determined after treatment of the mice with sophoridine. Western blotting and immunohistochemistry were employed to examine the expressions of p53 and VEGF proteins, respectively, and fluorescence quantitative PCR used to detect their mRNA expressions in the tumor tissue. RESULTS: The volume and weight of the tumor xenograft in sophoridine group decreased in comparison with those in the control group. Sophoridine treatment resulted in lowered expressions of p53 and VEGF at both the protein and mRNA levels in the tumor explants as compared with the control group, with a tumor inhibition rate of 34.07% in nude mice. CONCLUSION: Sophoridine can inhibit the growth of transplanted solid tumor of human SW480 cell line, the mechanism of which involves the inhibition of p53 and VEGF expression.

Nitrogen removal performance of anaerobic ammonia oxidation co-culture immobilized in different gel carriers.

Four materials were prepared as carriers for immobilizing anaerobic ammonium-oxidizing sludge. Nitrogen removal performance by these immobilized gel bead groups was evaluated. The removal ratios of ammonium and nitrite by CMC anammox-immobilized beads were 100% and 95.3% in 48 hours, respectively. The removal efficiencies of ammonium and nitrite by SA, PVA-SA and PVA anammox-immobilized beads were lower than the CMC beads. Subsequently, the physical properties of the beads were studied. PVA-SA was found to be the best support material among the four by comparing the case of the immobilization procedure, nitrogen removal efficiencies, and the costs of materials. PVA-SA gel entrapment was optimized by an orthogonal experiment. The SEM micrographs displayed that the surface structure of PVA-SA immobilized beads is loose and finely porous, which facilitates diffusion of the nitrogen. The SEM micrographs also clearly showed that anammox bacteria existed in the gel beads. All results clearly demonstrate that immobilizing anammox sludge in gel carriers is feasible and exhibit good performance. This research provided a new route to maintain sufficient amount of anammox sludge in a practical anammox reactor.

Expression, refolding, purification, and bioactivity of recombinant bifunctional protein, hIL-2/GM-CSF.

Interleukin-2 (IL-2) can stimulate T cell proliferation and differentiation when binding to its receptor on T cells. It produces a marked effect by enhancing the cytotoxicity of CD8+ T cells and natural killer cells. Granulocyte-macrophage colony stimulating factor (GM-CSF) is associated with many cells proliferation, such as dendritic cells, macrophages. Here, we report the construction, expression and purification of a bifunctional protein, hIL-2/GM-CSF, which may facilitate interaction between T cells and the antigen presentation cells and improve the efficiency of antigen presentation. We found that the use of chemicals and temperature shift is a peculiar system for induction of the Escherichia coli transformed with an IPTG-regulated hIL-2/GM-CSF expression vector in this research. After renaturation, anion exchange chromatography, metal affinity chromatography, and strict endotoxin-free cation exchange chromatography, the fusion protein devoid of endotoxin showed high purity. Cell proliferation experiments proved that this bifunctional protein retains both hIL-2 and GM-CSF biological activities. These results will facilitate the numerous subsequent studies on this bifunctional molecule.