Cigarette Smoke Mediates Nasal Epithelial Barrier Dysfunction via TNF-α.

BACKGROUND: Extensive data suggest that exposure to cigarette smoke can induce pulmonary epithelial barrier dysfunction. However, the effects of cigarette smoke on the nasal epithelial barrier are still unclear. Here, we investigated the consequence and mechanism of cigarette smoke on the nasal epithelial barrier. METHODS: Sprague Dawley rats were exposed to cigarette smoke for 3 or 6 months, and changes in inflammatory markers and nasal barrier function were evaluated. Moreover, underlying mechanisms were explored. Finally, normal human bronchial epithelial cells were cultured with or without tumor necrosis factor-alpha (TNF-α) in vitro, and the levels of continuity and tight junction-associated proteins were measured. RESULTS: In vivo experiments showed that the nasal mucosal barrier function of rats exposed to cigarette smoke was disturbed. Indeed, proteins associated with tight junctions were decreased, and the levels of inflammatory factors, such as IL-8, IL-6, and TNF-α, were dramatically increased in comparison to those of control animals. In vitro, TNF-α was shown to disrupt the continuity of proteins associated with tight junctions and to downregulate the expression of these proteins in bronchial epithelial cells. CONCLUSIONS: We found that cigarette smoke disrupted the nasal mucosal barrier, and the extent of the damage was correlated with the duration of cigarette smoke exposure. We showed that TNF-α can disrupt the continuity and attenuate the expression of tight junction proteins in human bronchial epithelial cells. Therefore, cigarette smoke may induce nasal epithelial barrier dysfunction through TNF-α.

Effectiveness of different antithrombotic agents in combination with tranexamic acid for venous thromboembolism prophylaxis and blood management after total knee replacement: a prospective randomized study.

BACKGROUND: Tranexamic acid (TXA) has been widely applied in total knee arthroplasty (TKA) to significantly reduce perioperative blood loss and improve knee function recovery in patients after surgery. The choice of antithrombotic agents for venous thromboembolism (VTE) prevention after TKA is controversial. Therefore, this study aimed to compare the effects of different antithrombotic agents on patients after primary unilateral TKA in the context of applied TXA. METHODS: A total of 180 patients undergoing primary unilateral TKA from October 2020 to December 2021 were included in this study. All patients were given an intraoperative drip of 60 mg/kg TXA. Thereafter, patients were divided into three groups (n = 60 each). Baseline data were comparable among the three groups. The average follow-up time was 3.02 ± 0.09 months. Group 1 enrolled patients receiving oral rivaroxaban (RA) at 10 mg, Group 2 included patients who received subcutaneous Dalteparin sodium at 2500 IU, while Group 3 included patients taking oral aspirin (ASA) at 100 mg. Patients in all the three groups received treatment once a day for 30 days at 12 h postoperatively. The primary outcomes in this study were post-treatment drainage volume and thrombotic complication rate. The secondary outcomes included hematologic parameters, transfusion rate, intraoperative blood loss, total blood loss (TBL), and bleeding complication rate. RESULTS: The average drainage volume after treatment was significantly lower in Group 3 than in Group 1 and Group 2 (205.2 ± 69.0 vs 243.4 ± 72.5 vs 295.4 ± 72.5 ml, P < 0.001), and there was a significant difference between Group 1 and Group 2 (243.4 ± 72.5 mL vs 295.4 ± 72.5 mL, P < 0.001). The blood transfusion rate of Group 2 dramatically increased compared with Group 1 and Group 3 (20.0% vs 6.7% vs 5.0%, P = 0.01). The bleeding complication rate in Group 1 apparently increased relative to Group 2 and Group 3 (26.7% vs 10.0% vs 8.3%, P = 0.008). Besides, there was no significant difference in the thrombotic complication rate among the three groups. CONCLUSION: Under the background of TXA application, ASA, RA, and Dalteparin sodium were all effective on preventing VTE after TKA. In addition, ASA effectively reduced post-treatment Hemoglobin (Hb) loss, drainage volume, TBL, transfusion rate, and bleeding complications compared with RA and Dalteparin sodium. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200060169). Date of Registration: 21/05/2022.

Influence of TiCN addition on the microstructures and mechanical properties of the AZ31 alloy.

The microstructure and mechanical properties of extruded AZ31 + xTiCN (x = 0, 0.4, 0.8, 1.2 wt%) were investigated, and the strengthening mechanism was discussed. X-ray diffraction and energy dispersive spectroscopy (EDS) confirmed that the Al4C3 and Al2MgC2 duplex phase particles were generated in situ by TiCN and Al particles, which act as the nucleation precursors of Mg grains during solidification. The grain size decreased and then increased with increasing TiCN addition. The yield strength (YS) and ultimate tensile strength (UTS) increased with increasing TiCN addition reaching a maximum (217.5 MPa) at 0.4 wt%, and in contrast, the elongation index (EI) continuously decreased with increasing TiCN addition.

Chondrosarcoma of the toe: A case report and literature review.

BACKGROUND: Chondrosarcoma of the foot is a rare malignant bone tumour, and it is even rarer when it originates in a toe bone. Surgical excision is the only effective treatment. The osteolytic destruction of the tumour severely affects limb function and carries the risk of distant metastasis. Most such tumours are removed surgically to minimize local recurrence and distant metastases, maximize limb function, and prolong the patient's tumour-free survival time. The main objective of this article is to present the case of a chondrosarcoma that invaded the first phalanx of the left foot and formed a large phalangeal mass with osteolytic destruction of the distal bone. CASE SUMMARY: A 74-year-old man suffered from swelling of his left toe for six months, with pain and swelling for two months. Computed tomography and magnetic resonance imaging showed that the tumour on the first phalanx of the left foot was approximately 54.9 mm × 44.6 mm, surrounded by a significant soft tissue signal mass, with osteolytic destruction of the distal phalanx and a speckled bone-like high-density shadow within it. CONCLUSION: Chondrosarcoma occurring in a toe bone is extremely rare. In this case, extensive surgical resection of the large low-grade chondrosarcoma, which showed osteolytic destruction and invaded the distal metatarsal bone, was safe and effective.

Meta-analysis and systematic review of the efficacy and resistance for human immunodeficiency virus type 1 integrase strand transfer inhibitors.

Integrase strand transfer inhibitors (INSTIs) are the most recent class of antiretroviral drugs with potent and durable antiviral activity used to treat human immunodeficiency virus type 1 (HIV-1) infection. However, development of drug resistance increases the risk of treatment failure, disease progression and mortality. A better understanding of drug efficacy and resistance against INSTIs is crucial for their efficient use and the development of new antiretrovirals. A meta-analysis of studies reporting efficacy and resistance data on INSTI use in HIV-infected patients was performed. Odds ratios (ORs) of efficacy outcome data favouring INSTI use in different clinical settings demonstrated that INSTIs have higher efficacy compared with drugs of other classes. For combination antiretroviral therapy-naïve patients and virologically-suppressed patients who switched to INSTI-based therapy, the OR was 1.484 (95% CI 1.229-1.790) and 1.341 (95% CI 0.913-1.971), respectively. ORs of resistance data indicated decreased treatment-emergent resistance development to dolutegravir (DTG) upon virological failure than to non-INSTIs (OR = 0.081, 95% CI 0.004-1.849), whereas the opposite was observed for raltegravir (RAL) (OR = 3.137, 95% CI 1.827-5.385) and elvitegravir (EVG) (OR = 1.886, 95% CI 0.569-6.252). Pooled analysis of resistance data indicated that development of resistance to DTG and bictegravir was rare, whereas EVG and RAL had low genetic barriers to resistance and the intensive cross-resistance between them limits INSTI efficiency. Efficient means of monitoring the emergence of resistance to INSTIs and the development of drugs with high genetic barriers are clear paths for future research.

Treatment choice by patients with obstructive sleep apnea: data from two centers in China.

BACKGROUND: Standard management has been recommended for obstructive sleep apnea (OSA) by several guidelines, but patient choice in the practical setting is unclear. METHODS: A survey nested in two prospective cohort studies of OSA (enrollment: 2001-2010) in China. The last interview was conducted between July 2014 and May 2015, using a comprehensive 10-point questionnaire administered in a face-to-face or telephone interview, and assessed (I) whether the participant had received any OSA treatment; (II) why he or she had decided for or against treatment; (III) what treatment was received; (IV) whether the participant used continuous positive airway pressure (CPAP) or OA daily; and (V) the perceived efficacy of therapy. RESULTS: A total of 4,097 subjects with a mean age of 45 years [37-55] responded to this survey, with a response rate of 79.4% (4,097/5,160); 2,779 subjects (67.8%) did not receive any treatment: 1,485 (53.4%) believed that their condition was not serious, despite severe OSA in 53.7% of the patients. A multivariate regression showed that the decision to receive treatment was associated with: age between 45-59 years [odds ratio (OR) 0.805, 95% CI: 0.691-0.936; P<0.001], female gender (OR 0.492, 95% CI: 0.383-0.631; P<0.001), severe OSA (OR 1.92, 95% CI: 1.01-3.64; P<0.001), hypertension (OR 1.414, 95% CI: 1.209-1.654; P<0.001) and diabetes (OR 1.760, 95% CI: 1.043-2.972; P=0.034). In subjects receiving treatment (n=1,318), 50.9% reported negative perceptions about the treatments. CONCLUSIONS: Nearly two thirds of Chinese patients choose not to receive treatment after OSA diagnosis, and nearly half are negative about their treatments for OSA. This requires clinical attention, and warrants further study in different geographic settings.

Chinese herbal medicine for obesity: a randomized, double-blinded, multicenter, prospective trial.

Obesity is a serious medical problem worldwide. As a holistic therapy, traditional Chinese medicine (TCM) may have a potential in obesity management. In this controlled trial, we evaluated the safety and effectiveness of xin-ju-xiao-gao-fang (XJXGF), a TCM herbal formulation, in 140 obese subjects over a 24-week period. The XJXGF formula mainly consists of rhubarb, coptis, semen cassia, and citrus aurantium. Subjects with body mass index (BMI) 28-40 kg/m(2) were recruited at 5 centers in China. We assessed the changes in subjects' body weight, its related parameters, and the reduction of insulin resistance (IR) after administration of XJXGF formula or low-dose XJXGF (10% of the XJXGF formula, as control). After 24-week treatment, among participants in the XJXGF formula group and low-dose XJXGF group, the mean ± SE changes in the body weight were -3.58 ± 0.48 and -1.91 ± 0.38 kg, respectively (p < 0.01). The changes in the IR-index of two groups were -2.65 ± 1.04 and -1.58 ± 1.3, respectively (p < 0 .05). There were no serious adverse events reported during the 24-week trial. Participants reported 7 minor adverse events, 4 in the XJXGF formula group and 3 in the low-dose XJXGF group (p = 0.578). Future studies are needed to investigate the clinical utility of this TCM formulation in the treatment of obese subjects.

[Using multivariate multilevel model in studying the influential factors of violence among rural high school students in Changsha].

OBJECTIVE: To provide evidence for setting up violence intervention programs in rural middle schools, through studying the influential factors. METHODS: Taking variables including emotional, physical and sexual violence in the past year as the multi-dependent variables before multivariate multilevel model logistic regression model was adopted to analyze the correlations among the three kinds of violence and the influential factors. RESULTS: Among 3620 respondents, the incidence rates of emotional, physical and sexual violence weres 21.5%, 24.3% and 2.0% respectively. The correlation coefficients between emotional violence vs. physical violence, emotional violence vs. sexual violence, physical violence vs. sexual violence were 0.337, 0.133, 0.131 respectively when the random effect of class difference was separated by multivariate multilevel model. There was an internal aggregation of the incidence rate on physical violence in different grades (chi2=4.286, P = 0.038) and an internal relevant between emotional violence vs. sexual violence (chi2 = 4.239, P = 0.039), physical violence vs. sexual violence (chi2 = 4.482, P = 0.034). The influential factors on the incidence rates of violence would include: sex, smoking status, family without harmony, tendency of bullying others and the level on self-esteem etc. CONCLUSION: When the random effect of class difference was separated by multivariate multilevel model, the estimated results would be more precise. Other than paying more attention to both individual and family influential factors when taking measures to reduce the incidence rate of violence in high school students, the effect of environment in the class should not be ignored.

[The application of support vector machine for prediction of posttraumatic stress disorder on adults in flood district].

INTRODUCTION: To predict the occurrence of posttraumatic stress disorder (PTSD), using a Support Vector Machine (SVM) on adults in flood district. Diagnostic and Statistical Manuals on Mental Disorders (IV Edition) were used to examine and diagnose the victims in flood districts. Based on the forecasting model of SVM with PTSD as dependent variables and 23 influence factors of PTSD as independent variables, prediction of PTSD was conducted among the victims. After considering 23 influence factors into the prediction model, the agreement rate of prediction of the model was 88.05 percent, with sensitivity as 75.0 percent, and specificity as 89.4 percent. CONCLUSION: The prediction model based on SVM with 23 influence factors had good effect on predicting the occurrence of PTSD.

[Risk prediction model of perinatal congenital heart disease].

Through analyzing the influencing factors of congenital heart disease (CHD), it is aimed to establish CHD risk prediction model in fetus, and simultaneously provide theoretical foundation for CHD prevention. One-factor logistic regression method was used to screen the significant factors regarding CHD, and to separately adopt multiple-factor non-conditional logistic regression method and decision tree to set up model prediction fetus CHD risk and to analyze the advantages and shortcomings. Correct classification rates turned to be 80.93% and 82.79% respectively among 215 'training samples' by the two methods and the rates were 85.45% and 89.09% respectively among 55 'testing samples'. The alliance of logistic regression and decision tree can overcome influence by co-linearity to guarantee the accuracy and perfection, as well as promoting the predictive accuracy.

Steroidal saponins from the roots of Asparagus filicinus.

Two new steroidal saponins with a new aglycone moiety, aspafiliosides E (1) and F (2), were isolated from the roots of Asparagus filicinus Buch.-Ham. Their structures were fully elucidated on the basis of detailed spectroscopic study and chemical analysis.

Filiasparosides A-D, cytotoxic steroidal saponins from the roots of Asparagus filicinus.

Four new steroidal saponins, filiasparosides A-D (1-4), together with known aspafiliosides A (5) and B (6) were isolated from the roots of Asparagus filicinus. The structures of these new compounds were elucidated by detailed spectroscopic study and chemical analysis. Compounds 1-6 were cytotoxic against human lung carcinoma (A549) and breast adenocarcinoma (MCF-7) tumor cell lines with EC(50) values of 2.3-16.8 microg/mL. Compound 3 showed the most potent cytotoxicity, with EC(50) values of 2.3 and 3.0 microg/mL toward A549 and MCF-7 cell lines, respectively.

[Identification of volatile components in rat urine after oral administration of "wu-hu-tang"].

OBJECTIVE: To identify the volatile components in rat urine after oral administration of "Wu-Hu-Tang" (WHT). METHOD: GC-MS technique was applied to analyzing urine samples. RESULT: Eighteen components were detected in the WHT-treated rat urine other than the corresponding control. Among them, 14 components were identified, and 7 were also found in the extract of WHT. CONCLUSION: The above detected components might be derived from WHT, and some of them are effective components of WHT.