ABSTRACT
INTRODUCTION: Diabetes mellitus is an expanding global health problem. Currently, the home management of diabetes is mainly led by a multidisciplinary team based on telemedicine. However, the role nurses play in it remains inconclusive. This study aimed to investigate the effectiveness of nurse-led web-based intervention on glycated haemoglobin, blood pressure and lipid profile in patients with type 2 diabetes. METHODS: An exhaustive systematic literature search was undertaken using the following databases: PubMed, Web of Science, Embase, The Cochrane Central Register of Controlled Trials and CINAHL. Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias and using Modified Jadad Score system. We conducted a meta-analysis of randomized controlled trials that had been published from inception to July 2020, using Review Manager 5.3. RESULTS: Eleven randomized controlled trials were selected that included 2063 participants. Meta-analyses results indicated significant effects on not only glycated haemoglobin (pooled mean difference (MD) = -0.40, 95% confidence interval (CI): -0.5 to -0.26, p < 0.00001), but also on systolic blood pressure (pooled MD = -1.91, 95% CI: -3.73 to -0.09, p = 0.04) and low density lipoprotein (pooled standardized MD = -0.29, 95% CI: -0.44 to -0.15, p < 0.0001). There were no effects of nurse-led web-based intervention on fasting blood glucose, diastolic blood pressure, high density lipoprotein, body mass index and triglycerides. DISCUSSION: Nurse-led web-based intervention is a promising way to complement routine clinical care. However, the specific intervention content and intervention media still need to carry out large-scale well-designed randomized controlled trials. Systematic review registration: PROSPERO CRD 42020204565.
Subject(s)
Diabetes Mellitus, Type 2 , Internet-Based Intervention , Blood Pressure , Diabetes Mellitus, Type 2/therapy , Glycated Hemoglobin , Humans , Nurse's RoleABSTRACT
The chromatin modifier enhancer of zeste homolog 2 (EZH2) methylates lysine 27 of histone H3 (H3K27) and regulates T cell differentiation. However, the potential role of EZH2 in the pathogenesis of rheumatoid arthritis (RA) remains elusive. We analyzed EZH2 expression in PBMC, CD4+ T cells, CD19+ B cell, and CD14+ monocytes from active treatment-naïve RA patients and healthy controls (HC). We also suppressed EZH2 expression using EZH2 inhibitor GSK126 and measured CD4+ T cell differentiation, proliferation and apoptosis. We further examined TGFß-SMAD and RUNX1 signaling pathways in EZH2-suppressed CD4+ T cells. Finally, we explored the regulation mechanism of EZH2 by RA synovial fluid and fibroblast-like synoviocyte (FLS) by neutralizing key proinflammatory cytokines. EZH2 expression is lower in PBMC and CD4+ T cells from RA patients than those from HC. EZH2 inhibition suppressed regulatory T cells (Tregs) differentiation and FOXP3 transcription, and downregulated RUNX1 and upregulated SMAD7 expression in CD4+ T cells. RA synovial fluid and fibroblast-like synoviocytes suppressed EZH2 expression in CD4+ T cells, which was partially neutralized by anti-IL17 antibody. Taken together, EZH2 in CD4+ T cells from RA patients was attenuated, which suppressed FOXP3 transcription through downregulating RUNX1 and upregulating SMAD7 in CD4+ T cells, and ultimately suppressed Tregs differentiation. IL17 in RA synovial fluid might promote downregulation of EZH2 in CD4+ T cells. Defective EZH2 in CD4+ T cells might contribute to Treg deficiency in RA.
Subject(s)
Arthritis, Rheumatoid/etiology , Cell Differentiation/genetics , Cell Differentiation/immunology , Enhancer of Zeste Homolog 2 Protein/deficiency , T-Lymphocytes, Regulatory/immunology , T-Lymphocytes, Regulatory/metabolism , Arthritis, Rheumatoid/metabolism , Arthritis, Rheumatoid/pathology , B-Lymphocytes/immunology , B-Lymphocytes/metabolism , Biomarkers , Case-Control Studies , Cytokines/metabolism , Histones/metabolism , Humans , Inflammation Mediators/metabolism , Lymphocyte Activation/genetics , Lymphocyte Activation/immunology , Monocytes/immunology , Monocytes/metabolism , Synovial Fluid/immunology , Synovial Fluid/metabolism , T-Lymphocyte Subsets/immunology , T-Lymphocyte Subsets/metabolism , T-Lymphocytes, Regulatory/cytologyABSTRACT
Ca2+ is an important microbial growth factor that can affect the activity, flocculation, and sedimentation of activated sludge. In order to study the roles of Ca2+ in the activated sludge system, the activity changes of ammonium oxidizing bacteria (AOB) and nitrite oxidizing bacteria (NOB) were analyzed using the specific oxygen uptake rates (SOURAOB and SOURNOB). The changes in composition and structure of extracellular polymeric substances (EPS) were analyzed using Fourier transform infrared spectroscopy (FTIR) and three-dimensional excitation emission fluorescence spectroscopy (3D-EEM). The effects of Ca2+on the nitrification activity and microbial metabolites were investigated. The results showed that when the Ca2+concentration increased from 0.45 mmol·L-1 to 3 mmol·L-1, SOURAOB and SOURNOB increased from 6.3 mg·(g·h)-1 to 10.4 mg·(g·h)-1 and from 2.3 mg·(g·h)-1 to 3.7 mg·(g·h)-1, respectively. The EPS concentrations increased from 68 mg·g-1 to 93 mg·g-1, and the flocculation ability (FA) of the sludge was improved. When the Ca2+ concentration was higher than 3 mmol·L-1, SOURAOB and SOURNOBboth decreased. The FA was maintained at about 30%, and the particle size of the sludge continued to increase. Based on FTIR analysis, the main components of EPS were always amino, amide â , and carboxyl with an increase in Ca2+ concentration. Based on EEM analysis, the composition of loosely-bound (LB)-EPS did not change, and humic acid substances appeared in the tightly-bound (TB)-EPS at low nitrification rates. Low concentrations of Ca2+ promoted nitrification activity and flocculation of the sludge. However, high concentrations of Ca2+ led to a decline in the sludge nitrification activity.
ABSTRACT
In order to improve the biological removal efficiency of nitrogen and phosphorus and bioflocculation performance of salt-containing wastewater, the effect of NaCl salinity on the efficiency of denitrification and phosphorus removal in the anoxic zone of an A2/O process was investigated. Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) were used to analyze the composition and structure of extracellular polymeric substances (EPS) in activated sludge of the anoxic zone, to discern the effect of salinity on bioflocculation. Results showed that when NaCl salinity was 0-5 g·L-1, flocculation ability (FA) in A2/O anoxic zone was about 44% and the sludge particle size was 45.5 µm. EPS content increased from 52.3 mg·L-1 to 62 mg·L-1 and protein (PN)/polysaccharide (PS) remained at 2.1. When NaCl salinity increased from 10 g·L-1 to 40 g·L-1, bioflocculation of sludge significantly decreased. FA decreased from 40% to 22% and sludge particle size decreased from 43.7 µm to 32.1 µm. EPS content increased from 76.5 mg·L-1 to 101.0 mg·L-1 and PN/PS decreased from 1.5 to 1.3. Based on FTIR analysis, with increase in salinity, the main components of EPS were always amino, amideâ , and carboxyl. Based on XPS analysis, increasing salinity led to charge transfer of some groups (such as C, O, and N groups) during the interaction between EPS and Na+, but its form did not change.
Subject(s)
Extracellular Polymeric Substance Matrix/chemistry , Salinity , Sewage/chemistry , Waste Disposal, Fluid , Bioreactors , Flocculation , Nitrogen/isolation & purification , Phosphorus/isolation & purification , Sodium Chloride , WastewaterABSTRACT
OBJECTIVES: To explore the role of Vδ2 T cells in the pathogenesis of rheumatoid arthritis (RA). METHODS: Sixty-eight patients with RA, 21 patients with osteoarthritis and 21 healthy controls were enrolled in the study. All patients with RA fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA. Peripheral Vδ2T population, chemokine receptor expression and proinflammatory cytokine secretion were quantified by flow cytometry. The infiltration of Vδ2 T cells within the synovium was examined by immunohistochemistry and flow cytometry. The effect of tumour necrosis factor (TNF)-α and interleukin (IL)-6 on Vδ2 T migration was determined by flow cytometry and transwell migration assay. RESULTS: Peripheral Vδ2T cells, but not Vδ1 T cells, were significantly lower in patients with RA, which was negatively correlated with disease activity gauged by Disease Activity Score in 28 joints. Vδ2 T cells from RA accumulated in the synovium and produced high levels of proinflammatory cytokines including interferon-γ and IL-17. Phenotypically, Vδ2 T cells from RA showed elevated chemotaxis potential and expressed high levels of chemokine receptors CCR5 and CXCR3, which was driven by increased serum TNF-α through nuclear factor kappa B signalling. In vivo, TNF-α neutralising therapy dramatically downregulated CCR5 and CXCR3 on Vδ2 T cells and repopulated the peripheral Vδ2 T cells in patients with RA. CONCLUSIONS: High levels of TNF-α promoted CCR5 and CXCR3 expression in Vδ2 T cells from RA, which potentially infiltrated into the synovium and played crucial roles in the pathogenesis of RA. Targeting Vδ2 T cells might be a potential approach for RA.
Subject(s)
Arthritis, Rheumatoid/physiopathology , Chemotaxis , Receptors, Antigen, T-Cell, gamma-delta , Synovial Membrane/cytology , T-Lymphocytes/physiology , Arthritis, Rheumatoid/genetics , Case-Control Studies , Cell Movement/physiology , Flow Cytometry , Humans , Interleukin-6/metabolism , Osteoarthritis/genetics , Osteoarthritis/physiopathology , Receptors, CCR5/metabolism , Receptors, CXCR3/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
BACKGROUND: Many published data on the association between single nucleotide polymorphisms (SNPs) in the ESR1 gene and prostate cancer susceptibility are inconclusive. The aim of this Human Genome Epidemiology (HuGE) review and meta-analysis is to derive a more precise estimation of this relationship. METHODS: A literature search of PubMed, Embase, Web of Science and Chinese Biomedical (CBM) databases was conducted from their inception through July 1st, 2012. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of association. RESULTS: Twelve case-control studies were included with a total 2,165 prostate cancer cases and 3,361 healthy controls. When all the eligible studies were pooled into the meta-analysis, ESR1 PvuII (C>T) and XbaI (A>G) polymorphisms showed no association with the risk of prostate cancer. However, in the stratified analyses based on ethnicity and country, the results indicated that ESR1 PvuII (C>T) polymorphism was significantly associated with increased risk of prostate cancer among Asian populations, especially among Indian population; while ESR1 XbaI (A>G) polymorphism may significantly increase the risk of prostate cancer among American population. Furthermore, we also performed a pooled analysis for all eligible case-control studies to explore the role of codon 10 (T>C), codon 325 (C>G), codon 594 (G>A) and +261G>C polymorphisms in prostate cancer risk. Nevertheless, no significant associations between these polymorphisms and the risk of prostate cancer were observed. CONCLUSION: Results from the current meta-analysis indicate that ESR1 PvuII (C>T) polymorphism may be a risk factor for prostate cancer among Asian populations, especially among Indian population; while ESR1 XbaI (A>G) polymorphism may increase the risk of prostate cancer among American population.
Subject(s)
Estrogen Receptor alpha/genetics , Prostatic Neoplasms/pathology , Case-Control Studies , Databases, Factual , Genetic Predisposition to Disease , Humans , Male , Odds Ratio , Polymorphism, Single Nucleotide , Prostatic Neoplasms/genetics , Risk FactorsABSTRACT
A novel and simple rapid shaking-based method of ionic liquid dispersive liquid phase microextraction for the determination of six synthetic food colourants (Tartrazine, Amaranth, Sunset Yellow, Allura Red, Ponceau 4R, and Erythrosine) in soft drinks, sugar- and gelatin-based confectionery was established. High-performance liquid chromatography coupled with an ultraviolet detector was used for the determinations. The extraction procedure did not require a dispersive solvent, heat, ultrasonication, or additional chemical reagents. 1-Octyl-3-methylimidazolium tetrafluoroborate ([C8MIM][BF4]) was dispersed in an aqueous sample solution as fine droplets by manual shaking, enabling the easier migration of analytes into the ionic liquid phase. Factors such as the [C8MIM][BF4] volume, sample pH, extraction time, and centrifugation time were investigated. Under the optimum experimental conditions, the proposed method showed excellent detection sensitivity with limits of detection (signal-to-noise ratio=3) within 0.015-0.32 ng/mL. The method was also successfully used in analysing real food samples. Good spiked recoveries from 95.8%-104.5% were obtained.
Subject(s)
Candy/analysis , Carbonated Beverages/analysis , Chromatography, High Pressure Liquid/methods , Food Coloring Agents/analysis , Food Coloring Agents/isolation & purification , Liquid Phase Microextraction/methods , Carbohydrates/analysis , Food Coloring Agents/chemical synthesis , Gelatin/analysis , Ionic Liquids/chemistry , Liquid Phase Microextraction/instrumentationABSTRACT
In this paper, bioaugmentation was applied to upgrade a full-scale activated sludge system (S2) into a contact oxidation system (S1). Results showed that when chemical oxygen demand (COD) and ammonia nitrogen (NH(4)(+)-N) concentration of the petrochemical wastewater were 320-530 mg/L and 8-25mg/L, respectively, the bioaugmented process (S1) took only 20 days when they were below 80 mg/L and 10mg/L, respectively. However, the unbioaugmented conventional activated sludge process (S2) spent 30 days to reach the similar effluent quality. As the organic loading rate (OLR) increased from 0.6 to 0.9 and finally up to 1.10 kg COD/m(3)d, S1 showed strong resistance to shock loadings and restored after three days compared to the seven days required by S2. Based on the results of this paper, it shows that bioaugementation application is feasible and efficient for the process upgrade due to the availability of the bioaugmented specialized consortia.
Subject(s)
Bioreactors/microbiology , Industrial Waste/prevention & control , Petroleum/microbiology , Sewage/microbiology , Water Pollutants, Chemical/metabolism , Water Purification/methods , Oxidation-ReductionABSTRACT
One strain, named as Bacillus sp. F2, of which flocculent ability can reach 84%, was separated. Flocculent genomic library was constructed. The total genomic DNA of F2 was extracted. It was partly digested by restriction enzyme Sau3AI and then was connected with carrier PUC19DNA which was totally digested by restriction enzyme BamHI and further was converted to competent cells JM109. These cells were smeared on the ampicillin substrate. After one night culture, we selected them by white-blue spot screening and constructed the flocculent genomic library. The library included 3.5 x 10(4) recons and the titre was 3.5 x 10(5) dpfu/mL. strain of Escherichia coli. positive clone FC2, which could express flocculent activity, was acquired after selection. Flocculent tests showed that the flocculent efficiency of FC2 was 90%, which was slightly higher than the original flocculent bacterium F2 and greatly higher than the competent cell JM109 (6.9%). It demonstrated that FC2's flocculent characteristic inherited from the original flocculent bacterium F2. By adopting the tapping mode AFM and Zeta-potential test, the flocculent microtopography of FC2, F2 and pure kaolin suspending solution was identified. The AFM study revealed that, compared to the kaolin suspending solution with and without F2's fermented liquid, the kaolin suspending solution which has cloning bacterium FC2's fermented liquid had larger flocculent gel and more compact spherical structure, and the surface was rough with high degree concave and convex, and had large specific surface area and strong adsorption ability to the suspending particles in the solution. After adding the fermented solution of cloning bacterium FC2 into kaolin suspending solution, the amorphous and incompact flocculent particles transformed into spherical structure which was compact and had even horizontal dimension, which indicated that the agglutinin in FC2's fermented liquid could easily take kaolin suspending particles as its adsorption core and adsorbed on its surface and the flocculent efficiency was about 90%, which gave further confirmation to the great pollution removal capability of FC2's fermented liquid. The results of Zeta-potential test illustrated that the intensity of electrovalent bond was different, resulting in various flocculent morphology, which provided significant evidences for studying flocculent mechanisms of biofloculant.