Prognostic Nutritional Index as a Prognostic Factor for Very Early-Stage Hepatocellular Carcinoma.

INTRODUCTION: Field factors play more important roles in predicting the outcomes of patients compared with tumor factors in early-stage hepatocellular carcinoma (HCC). However, the prognostic ability of noninvasive serum marker scores for hepatic fibrosis and liver functional reserve on very early-stage HCC is still not yet determined. We aimed to investigate the performance of these serum marker scores in predicting the prognoses of patients with very early-stage HCC. METHODS: A total of 446 patients with very early-stage HCC from 2012 to 2022 were retrospectively enrolled. Serum biomarkers and prognostic scores determining overall survival (OS) were analyzed by Cox proportional hazards model. We compared the Akaike information criterion among the prognostic nutritional index (PNI), aspartate aminotransferase-to-platelet ratio index, albumin-bilirubin (ALBI) score, EZ (easy)-ALBI score, modified ALBI score, fibrosis-4 score, and lymphocyte-to-monocyte ratio to determine the predictability on the OS. RESULTS: After a median follow-up of 41.0 months (interquartile range 36.9-45.1 months), 81 patients died, with a 5-year OS rate of 71.0%. Among the noninvasive serum marker scores, PNI had the best performance in predicting the OS with the lowest Akaike information criterion (846.407) compared with other scores. Moreover, we stratified the patients into high-risk (PNI <45) and low-risk (PNI ≥45) groups. It showed that the 5-year OS rates were 83.4% and 60.8% in the low-risk and high-risk PNI groups, respectively ( P < 0.001). DISCUSSION: PNI had the best performance in predicting the OS for patients with very early-stage HCC.

Risk of placenta accreta spectrum following myomectomy: a nationwide cohort study.

BACKGROUND: Whether myomectomy increases the risk of placenta accreta spectrum in the following pregnancies remains controversial. OBJECTIVE: This study aimed to investigate the effect of myomectomy on the risk of placenta accreta spectrum in the following pregnancies. Moreover, different methods of myomectomy on the risk of placenta accreta spectrum were explored. STUDY DESIGN: A nationwide cohort study was conducted using data from the Taiwan National Health Insurance Research Database, including all pregnant patients in Taiwan who gave birth between January 2008 and December 2017. A 1:1 propensity score estimation matching was performed for the analysis of myomectomy on the risk of placenta accreta spectrum. Among pregnant patients who received myomectomy, different methods of myomectomy on the risk of placenta accreta spectrum were compared with the control group. RESULTS: Among the 1,371,458 pregnant patients in this study, 11,255 pregnant patients had a history of myomectomy. The risk of placenta accreta spectrum was higher in pregnant patients with a history of myomectomy than in pregnant patients without a history of myomectomy (incidence: 0.96% vs 0.20%; adjusted odds ratio, 2.28; 95% confidence interval, 1.85-2.81; P<.01). Among pregnant patients with a history of myomectomy, 5045 (46.87%) received laparotomic myomectomy, 3973 (36.93%) received laparoscopic myomectomy, and 1742 (16.20%) received hysteroscopic myomectomy. The incidence of placenta accreta spectrum was higher in the hysteroscopic group than in the laparotomic group or the laparoscopic group (1.89% [hysteroscopic group] vs 0.71% [laparotomic group] and 0.81% [laparoscopic group]; P<.05). Compared with patients without a history of myomectomy, the adjusted odds ratio for placenta accreta spectrum was 3.88 (95% confidence interval, 2.68-5.63; P<.05) in the hysteroscopic group. CONCLUSION: Myomectomy, especially hysteroscopic myomectomy, is associated with an increased risk of placenta accreta spectrum in the subsequent pregnancy.

Diallyl disulfide downregulating RhoGDI2 induces differentiation and inhibit invasion via the Rac1/Pak1/LIMK1 pathway in human leukemia HL-60 cells.

Leukemia is a type of disease in which hematopoietic stem cells proliferate clonally at the genetic level. We discovered previously by high-resolution mass spectrometry that diallyl disulfide (DADS), which is one of the effective ingredients of garlic, reduces the performance of RhoGDI2 from APL HL-60 cells. Although RhoGDI2 is oversubscribed in several cancer categories, the effect of RhoGDI2 in HL-60 cells has remained unexplained. We aimed to investigate the influence of RhoGDI2 on DADS-induced differentiation of HL-60 cells to elucidate the association among the effect of inhibition or over-expression of RhoGDI2 with HL-60 cell polarization, migration and invasion, which is important for establishing a novel generation of inducers to elicit leukemia cell polarization. Co-transfection with RhoGDI2-targeted miRNAs apparently decreases the malignant biological behavior of cells and upregulates cytopenias in DADS-treated HL-60 cell lines, which increases CD11b and decreases CD33 and mRNA levels of Rac1, PAK1 and LIMK1. Meanwhile, we generated HL-60 cell lines with high-expressing RhoGDI2. The proliferation, migration and invasion capacity of such cells were significantly increased by the treated with DADS, while the reduction capacity of the cells was decreased. There was a reduction in CD11b and an increase in CD33 production, as well as an increase in the mRNA levels of Rac1, PAK1 and LIMK1. It also confirmed that inhibition of RhoGDI2 attenuates the EMT cascade via the Rac1/Pak1/LIMK1 pathway, thereby inhibiting the malignant biological behavior of HL-60 cells. Thus, we considered that inhibition of RhoGDI2 expression might be a new therapeutic direction for the treatment of human promyelocytic leukemia. The anti-cancer property of DADS against HL-60 leukemia cells might be regulated by RhoGDI2 through the Rac1-Pak1-LIMK1 pathway, which provides new evidence for DADS as a clinical anti-cancer medicine.

Empagliflozin cardiovascular and renal effectiveness and safety compared to dipeptidyl peptidase-4 inhibitors across 11 countries in Europe and Asia: Results from the EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study.

BACKGROUND: Continued expansion of indications for sodium-glucose cotransporter-2 inhibitors increases importance of evaluating cardiovascular and kidney efficacy and safety of empagliflozin in patients with type 2 diabetes compared to similar therapies. METHODS: The EMPRISE Europe and Asia study is a non-interventional cohort study using data from 2014-2019 in seven European (Denmark, Finland, Germany, Norway, Spain, Sweden, United Kingdom) and four Asian (Israel, Japan, South Korea, Taiwan) countries. Patients with type 2 diabetes initiating empagliflozin were 1:1 propensity score matched to patients initiating dipeptidyl peptidase-4 inhibitors. Primary endpoints included hospitalization for heart failure, all-cause mortality, myocardial infarction and stroke. Other cardiovascular, renal, and safety outcomes were examined. FINDINGS: Among 83,946 matched patient pairs, (0·7 years overall mean follow-up time), initiation of empagliflozin was associated with lower risk of hospitalization for heart failure compared to dipeptidyl peptidase-4 inhibitors (Hazard Ratio 0·70; 95% CI 0.60 to 0.83). Risks of all-cause mortality (0·55; 0·48 to 0·63), stroke (0·82; 0·71 to 0·96), and end-stage renal disease (0·43; 0·30 to 0·63) were lower and risk for myocardial infarction, bone fracture, severe hypoglycemia, and lower-limb amputation were similar between initiators of empagliflozin and dipeptidyl peptidase-4 inhibitors. Initiation of empagliflozin was associated with higher risk for diabetic ketoacidosis (1·97; 1·28 to 3·03) compared to dipeptidyl peptidase-4 inhibitors. Results were consistent across continents and regions. INTERPRETATION: Results from this EMPRISE Europe and Asia study complements previous clinical trials and real-world studies by providing further evidence of the beneficial cardiorenal effects and overall safety of empagliflozin compared to dipeptidyl peptidase-4 inhibitors.

Sarcopenia-related gut microbial changes are associated with the risk of complications in people with cirrhosis.

Background & Aims: Sarcopenia and gut dysbiosis are common in individuals with cirrhosis. However, the association between sarcopenia and microbial alterations, and the subsequent impact on cirrhotic outcomes are poorly understood. This study aimed to identify muscle-dependent microbial changes and related risks of cirrhotic complications. Methods: From September 2018 to December 2020, 89 individuals with cirrhosis and 16 healthy volunteers were prospectively enrolled. Muscle and nutritional status, serum amino acids, and fecal microbiota were analyzed. The association between microbial signatures of sarcopenia and cirrhotic complications was investigated. Results: A decline in muscle mass and strength were associated with gut microbial alterations in individuals with cirrhosis. The greatest microbial dissimilarity was observed between those with sarcopenia (both decline in muscle mass and strength) and those with normal-muscle status (p = 0.035). Individuals with sarcopenia had lower serum levels of alanine, valine, leucine, isoleucine, proline, tryptophan and ornithine. Besides, gut microbial functions associated with amino acid biosynthesis were significantly reduced in individuals with sarcopenia and cirrhosis. Depletion of Dialister, Ruminococcus 2, and Anaerostipes were associated with cirrhotic sarcopenia, and significantly correlated with the serum levels of amino acids. Individuals with coexistent depletion of Ruminococcus 2 and Anaerostipes developed more infectious (44.4% vs. 3.0%) and non-infectious (74.1% vs. 3.0%) complications, and more hospitalizations (54 vs. 3) than those with cirrhosis with good microbial signatures (all p <0.001). In contrast, fecal enrichment of Ruminococcus 2 and Anaerostipes independently decreased the risk of 1-year complications. Conclusions: Sarcopenia-related fecal microbial alterations are associated with cirrhotic complications. These findings may facilitate measures to improve the outcomes of individuals with cirrhosis and sarcopenia by modifying gut microbiota. Impact and implications: The composition and biosynthetic functions of gut microbiota are significantly changed in individuals with sarcopenic cirrhosis. Those with a sarcopenia-related poor microbial signature, in which Ruminococcus 2 and Anaerostipes were both depleted, had significantly more infectious and non-infectious complications, as well as more hospitalizations. These findings highlight the therapeutic potential of modifying the gut microbiota of individuals with sarcopenic cirrhosis to improve their clinical outcomes.

Development of a self-assessment questionnaire of abnormal menstruation and evaluation of its reliability and validity / 上海预防医学

ObjectiveTo develop a self-assessment questionnaire for menstrual abnormalities and test its reliability and validity. To provide an assessment tool for self-identification of abnormal menstruation in young women and to investigate the health seeking situation of abnormal menstruation in the population. MethodsFifteen physicians with clinical experience were invited to participate in the Delphi expert consultations. Medical indications for menstrual abnormalities were constructed and questionnaires were formed based on domestic and international literature， expert meetings and 2 rounds of Delphi expert consultations. A whole-group sampling was used to select 923 female college students from a medical school in Shanghai for the survey， and 306 of them were retested. The internal consistency， retest correlation， researcher-investigator evaluation correlation， and structural and response validity of the questionnaire were examined. ResultsThe questionnaire formed 6 dimensions with 17 indications. The positive coefficients for the two rounds of consulting experts were >90%. The mean authority coefficient was 0.857. The Kendall W coordination coefficient was 0.465 and 0.455， respectively （P<0.001）. The questionnaire Cronbach's alpha coefficient was 0.622. The retest correlation coefficient was 0.459. The correlation coefficient between the researcher's score and the respondents' self-assessment was 0.562. The five common factors extracted by factor analysis were consistent with the structure of the questionnaire， and the cumulative contribution of variance was 54.4%. Total questionnaire scores were moderately to highly correlated with each dimension score （0.409 to 0.699）. There was low correlation between the dimensions （-0.002 to 0.203）. Girls who had sought medical care had higher scores on the total questionnaire， category A， category B， cycle dimension， menstrual dimension， and dysmenorrhea/PMS dimension than girls who had not sought medical care （P<0.01）， and the difference between the two groups in menstrual volume dimension scores was not statistically significant. ConclusionThe self-assessment questionnaire for menstrual abnormalities developed in this study has acceptable reliability， good structure validity and response validity. It can provide a self-examination tool and medical consultation guidance for young women with abnormal menstruation.

Effects and mechanism of ginsenoside Rh2 on the proliferation and apoptosis of human glioma cells / 中国药房

ABSTRACT OBJECTIVE To investigate the effects and mechanism of ginsenoside Rh2 on the proliferation and apoptosis in human glioma U87 and U251 cells. METHODS Using human glioma U87 and U251 cells as subjects， the proliferation and apoptosis， as well as the expression of histone deacetylase 1（HDAC1） protein and apoptosis-related proteins [B cell lymphoma-2（Bcl-2）， Bcl-2-associated X protein （Bax） and cleaved caspase-3] were detected after being treated with different concentrations of ginsenoside Rh2. RESULTS The concentrations of 10，20，30，40，50，60，70，80 μmol/L ginsenoside Rh2 could generally significantly increase the proliferation inhibition rate of U87 and U251 cells （P＜0.05 or P＜0.01）， and the half inhibitory concentrations of this component after 48 hours of action were 51.34 and 55.84 μmol/L， respectively；30，50 μmol/L ginsenoside Rh2 could increase the total apoptotic rate of both types of cells， reduced the protein expressions of HDAC1 and Bcl-2， and increased the protein expressions of Bax and cleaved caspase-3 significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Ginsenoside Rh2 has a significant inhibitory effect on the proliferation of glioma cells and promotes the apoptosis of cells， which may be through reducing the expression of HDAC1 protein and activating the Bcl-2 family protein-mediated apoptosis pathway.

Food security and diet quality among urban poor adolescents in Kuala Lumpur, Malaysia

BACKGROUND/OBJECTIVES@#This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. @*SUBJECTS/METHODS@#A cross-sectional survey was conducted among 188 adolescents aged 13–18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. @*RESULTS@#The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = −0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. @*CONCLUSIONS@#Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

SmHPPR1 from Salvia miltiorrhiza regulated the biosynthesis of salvianolic acids / 药学学报

italic>Salvia miltiorrhiza Bunge is a traditional Chinese medicinal herb widely used to treat cardiovascular and cerebrovascular diseases at clinic. Its main water-soluble components are rosmarinic acid (RA) and salvianolic acid B (SAB), which are produced by phenylpropanoid pathway. 4-Hydroxyphenylpyruvate reductase (HPPR) is a key enzyme in phenylpropanoid metabolism pathway. SmHPPR1 was cloned from S. miltiorrhiza and was constructed into plant expression vector pJR-SmHPPR1. On this basis, SmHPPR1 transgenic Arabidopsis plants were induced and the content of 4-hydroxyphenyllactic acid (pHPL) was determined. SmHPPR1-overexpressing (SmHPPR1-OE) hairy roots of S. miltiorrhiza were obtained and the concentration of active components and transcriptome analysis were performed. The results showed that the concentration of pHPL in SmHPPR1 transgenic Arabidopsis T1 was 0.594 mg·g-1 dry weight. The concentration of RA, SAB and total salvianolic acid in SmHPPR1-OE-3 hairy roots were 1.09, 1.29, 1.15 times of that in control-3, respectively, and the content of Danshensu was 36.26% of that in control-3. Transcriptomic analysis revealed that overexpression of SmHPPR1 caused the upregulation of other phenylpropanoid pathway genes like SmTAT2. Protein-protein interaction indicated CYT (TR74706_c0_g1), NADP+ (TR26565_c0_g1) and NADP+ (TR68771_c0_g1) is the central node of the network and participated in metabolic process and cellular process. The tracking work in this study proved that SmHPPR1 could catalyze the reduction of 4-hydroxyphenylpyruvic acid to 4-hydroxyphenyllactic acid in SmHPPR1 transgenic Arabidopsis, and SmHPPR1-overexpressing in hairy roots of S. miltiorrhiza could increase the concentration of salvianolic acids through synergistically regulating other pathway genes.

Infection of primary nasal epithelial cells differentiates among lethal and seasonal human coronaviruses

The nasal epithelium is the initial entry portal and primary barrier to infection by all human coronaviruses (HCoVs). We utilize primary nasal epithelial cells grown at air-liquid interface, which recapitulate the heterogeneous cellular population as well as mucociliary clearance functions of the in vivo nasal epithelium, to compare lethal (SARS-CoV-2 and MERS-CoV) and seasonal (HCoV-NL63 and HCoV-229E) HCoVs. All four HCoVs replicate productively in nasal cultures but diverge significantly in terms of cytotoxicity induced following infection, as the seasonal HCoVs as well as SARS-CoV-2 cause cellular cytotoxicity as well as epithelial barrier disruption, while MERS-CoV does not. Treatment of nasal cultures with type 2 cytokine IL-13 to mimic asthmatic airways differentially impacts HCoV replication, enhancing MERS-CoV replication but reducing that of SARS-CoV-2 and HCoV-NL63. This study highlights diversity among HCoVs during infection of the nasal epithelium, which is likely to influence downstream infection outcomes such as disease severity and transmissibility.

Effect of repeated Shengmai-San administration on nifedipine pharmacokinetics and the risk/benefit under co-treatment.

Herbal interactions with nifedipine/felodipine through cytochrome P450 (CYP) 3A inhibition is significant in humans. Shengmai-San (SMS), a three-herbal formula of Chinese medicine, is commonly prescribed in Asia populations for cardiovascular disorders. This study aimed to elucidate the impact of SMS on nifedipine/felodipine treatment by the findings from rat pharmacokinetic study of nifedipine to the retrospective cohort study of patients with hypertension. The 3-week SMS treatment increased the systemic exposure to nifedipine by nearly two-fold and decreased nifedipine clearance by 39% in rats. Among the ingredients of SMS component herbs, schisandrin B, schisantherin A, and methylophiopogonanone A, inhibited the nifedipine oxidation (NFO) activities of rat hepatic and intestinal microsomes, as well as human CYP3A4. Methylophiopogonanone A was identified as a time-dependent inhibitor of CYP3A4. After 1:5 propensity score matching, 4,894 patients with nifedipine/felodipine use were analyzed. In patients receiving nifedipine/felodipine, the subgroup with concurrent SMS treatment had a higher incidence of headache (92.70 per 1,000 personyears) than the subgroup without SMS treatment (51.10 per 1,000 person-years). There was a positive association between headache incidence and cumulative doses of SMS (1-60 g SMS: hazard ratio (HR): 1.39; 95% confidence interval (CI): 1.11-1.74; >60 g SMS: HR: 1.97; 95% CI: 1.62-2.39; p < 0.0001). However, patients who had higher cumulative SMS doses had a lower risk of all-cause mortality (1-60 g SMS: HR: 0.67; 95% CI: 0.47-0.94; >60 g SMS: HR: 0.54; 95% CI: 0.37-0.79; p = 0.001). Results demonstrated increased rat plasma nifedipine levels after 3-week SMS treatment and increased headache incidence should be noted in nifedipine/felodipine-treated patients with prolonged SMS administration.

Empirical food webs of 12 tropical reservoirs in Singapore.

Background: Food webs summarise trophic interactions of the biotic components within an ecosystem, which can influence nutrient dynamics and energy flows, ultimately affecting ecosystem functions and services. Food webs represent the hypothesised trophic links between predators and prey and can be presented as empirical food webs, in which the relative strength/importance of the respective links are quantified. Some common methods used in food web research include gut content analysis (GCA) and stable isotope analysis (SIA). We combine both methods to construct empirical food web models as a basis for monitoring and studying ecosystem-level outcomes of natural (e.g. species turnover in fish assemblage) and intentional environmental change (e.g. biomanipulation). New information: We present 12 food webs from tropical reservoir communities in Singapore and summarise the topology of each with widely-used network indices (e.g. connectance, link density). Each reservoir was surveyed over 4-6 sampling occasions, during which, representative animal groups (i.e. fish species and taxonomic/functional groups of zooplankton and benthic macroinvertebrates) and all likely sources of primary production (i.e. macrophytes, periphyton, phytoplankton and riparian terrestrial plants) were collected. We analysed gut content in fishes and bulk isotope (d13C and d15N) profiles of all animals (i.e. fishes and invertebrates) and plants collected. Both sets of information were used to estimate the relative strength of trophic relationships using Bayesian mixing models. We document our protocol here, alongside a script in the R programming language for executing data management/analyses/visualisation procedures used in our study. These data can be used to glean insights into trends in inter- and intra-specific or guild interactions in analogous freshwater lake habitats.

Effect of dietary intake before fasting on physiological distribution of 18F-FDG PET/CT imaging / 中华核医学与分子影像杂志

Objective:To explore the effect of dietary intake before fasting on the physiological distribution of 18F-FDG PET/CT, and to improve the 18F-FDG PET/CT image quality. Methods:From August 2019 to May 2020, questionnaire of dietary intake before fasting of 118 patients (73 males, 45 females; age (58.4±13.4) years) who performed PET/CT imaging in Zhongshan Hospital, Fudan University were retrospectively analyzed. The total dietary energy intake, the nutrient intake and energy supply ratio of the three energy source nutrients, the type of raw materials and the texture of diet were included. The SUV max and SUV mean of the liver, mediastinal blood pool and hip muscles were measured. Single-factor and multi-factors linear regression analyses were used to analyze data. Results:The fasting blood glucose of 118 subjects was (5.36±1.01) mmol/L. The texture of diet before fasting were general diet, semiliquid diet and liquid diet, which were 42 (35.59%), 72 (61.02%) and 4 (3.39%) subjects, respectively. The energy supply ratios of carbohydrate, protein and fat were (55.46±18.27)%, (16.70±7.38)% and (27.72±14.53)%, respectively. The results of multi-factors regression analysis indicted that protein energy ratio was an independent factor influencing SUV max ( β=0.005, P=0.031) and SUV mean ( β=0.003, P=0.042) of the hip muscles, and the texture of diet was an independent factor influencing SUV max ( β=0.126, P=0.030) and SUV mean ( β=0.197, P=0.002) of mediastinal blood pool. Conclusions:The dietary intake before fasting has significant effect on the imaging quality of 18F-FDG. The protein energy ratio is an independent factor influencing SUV max and SUV mean of the hip muscles. The texture of diet is an independent factor influencing SUV max and SUV mean of mediastinal blood pool.

Molecular Imaging of Abdominal Aortic Aneurysms with Positron Emission Tomography: A Systematic Review.

OBJECTIVE: Previous studies on the relationship between positron emission tomography (PET) images and abdominal aortic aneurysm (AAA) progression have shown contradictory results, and the objective of this study was to systematically review the role of PET in predicting AAA prognosis. DATA SOURCES: PubMed, Embase, and Web of Science were searched for studies evaluating the correlation between PET imaging results and AAA growth, repair, or rupture. REVIEW METHODS: Two authors independently performed the study search, data extraction, and quality assessment following a standard method. RESULTS: Of the 11 studies included in this review, nine used 18F-fluorodeoxyglucose (18F-FDG) PET and computed tomography (CT) imaging, whereas the remaining two used 18F-sodium fluoride (18F-NaF) PET/CT and 18F-FDG PET/magnetic resonance imaging (MRI). Findings from the 18F-FDG PET/CT studies were contradictory. Six studies found no significant association or correlation, and two studies found a significant negative correlation between 18F-FDG uptake and AAA expansion. Additionally, one study found that the 18F-FDG uptake was statistically positively related to the expansion rate in a specific AAA subgroup whose AAAs expanded significantly. Two studies suggested that increased 18F-FDG uptake was significantly associated with AAA repair, while the other studies either found no association between 18F-FDG uptake and AAA rupture or repair or failed to report the occurrence of clinical events. One PET/CT study that used 18F-NaF as a tracer showed that an increased tracer uptake was significantly associated with AAA growth and clinical events. Finally, the 18F-FDG PET/MRI study indicated that 18F-FDG uptake was not significantly correlated with AAA expansion. CONCLUSION: A definitive role for 18F-FDG PET imaging for AAA prognosis awaits further investigation, and new PET tracers such as 18F-NaF have the potential to be a promising method for predicting AAA clinical outcomes.

Molecular Disorder Induces an Unusual Phase Transition in a Potential 2D Chiral Ferroelectric Perovskite.

Two-dimensional hybrid halide perovskites with single chiral and ferroelectricity together with various structural phase transitions provide the possibility for more diverse functional properties. Here, we present a 2D chiral hybrid halide perovskite ferroelectric, [C6 H5 (CH2 )4 NH3 ]2 CdCl4 (4PBA-CdCl4 , 4PBA=4-phenylbutylamine) that experiences two continuous phase transitions from centrosymmetric triclinic P 1 ‾ to polar chiral monoclinic P2 and then to another centrosymmetric tetragonal P4/mmm with increasing temperature, accompanied by symmetry breaking, due to the prominent octahedral distortion and disorder transformation of organic 4PBA cations. In the polar chiral phase, 4PBA-CdCl4 gives a significant CD signal and has a moderate ferroelectric polarization of 0.35 µC/cm2 . In addition, 4PBA-CdCl4 occupies a wide band gap of 4.376 eV that is chiefly contributed by the inorganic CdCl6 octahedron. This finding offers an alternative pathway for designing new phase transitions and related physical properties in hybrid halide perovskites and other hybrid crystals.

Effects of Shengmai San on key enzymes involved in hepatic and intestinal drug metabolism in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Shengmai San (SMS) has been commonly used as a traditional Chinese medicine for the treatment of cardiovascular disorders, of which drug interactions need to be assessed for the safety concern. There is little evidence for the alterations of hepatic and intestinal drug-metabolizing enzymes after repeated SMS treatments to assess drug interactions. AIM OF THE STUDY: The studies aim to illustrate the effects of repeated treatments with SMS on cytochrome P450s (CYPs), reduced nicotinamide adenine dinucleotide (phosphate)-quinone oxidoreductase (NQO), uridine diphosphate-glucuronosyltransferase (UGT), and glutathione S-transferase (GST) using in vivo rat model. MATERIALS AND METHODS: The SMS was prepared using Schisandrae Fructus, Ginseng Radix, and Ophiopogonis Radix (OR) (1:2:2). Chromatographic analyses of decoctions were performed using ultra-performance liquid chromatography (UPLC) and LC-mass spectrometry. Sprague-Dawley rats were orally treated with the SMS and its component herbal decoctions for 2 or 3 weeks. Hepatic and intestinal enzyme activities were determined. CYP3A expression and the kinetics of intestinal nifedipine oxidation (NFO, a CYP3A marker reaction) were determined. RESULTS: Schisandrol A, schisandrin B, ginsenoside Rb1 and ophiopogonin D were identified in SMS. SMS selectively suppressed intestinal, but not hepatic, NFO activity in a dose- and time-dependent manner. Hepatic and intestinal UGT, NQO and GST activities were not affected. A 3-week SMS treatment decreased the maximal velocity of intestinal NFO by 50%, while the CYP3A protein level remained unchanged. Among SMS component herbs, the decoction of OR decreased intestinal NFO activity. CONCLUSIONS: These findings demonstrate that 3-week treatment with SMS and OR suppress intestinal, but not hepatic CYP3A function. It suggested that the potential interactions of SMS with CYP 3A drug substrates should be noticed, especially the drugs whose bioavailability depends heavily on intestinal CYP3A.

Matrix metalloproteinases activation in Toxocara canis induced pulmonary pathogenesis.

BACKGROUND: Toxocara canis, a source of visceral larva migrans, causes toxocariasis and induces respiratory symptoms. The reasons by which the pulmonary pathological alteration in the lungs infected with T. canis remain unclear. METHODS: The involvement of the pulmonary pathological alteration by histology, enzyme activity, and Western blot analysis in the lungs of BALB/c mice after the infection of 2000 embryonated eggs. RESULTS: The pathological effects gradually increased after the infection culminated in severe leukocyte infiltration and hemorrhage from days 4-14 post-inoculation. Gelatin zymography using substrate showed that the relative activity of matrix metalloproteinase (MMP) -9 and MMP-2 significantly increased in T. canis-infected mice. Western blot analysis indicated that the MMPs protein level of fibronectin monomer significantly increased in T. canis-infected mice compared with that in uninfected control. T. canis larvae mainly initiated leukocyte infiltration and hemorrhage in the lungs. CONCLUSION: These phenomena subsequently induced the activities of MMPs in parallel with the pathological changes in early stage pulmonary inflammation. In conclusion, T. canis larval migration activated the MMPs and caused pulmonary pathogenesis.

Added value of three-phase bone scintigraphy combined with SPECT/CT for differential diagnosis of periprosthetic infection and prosthesis loosening / 中华核医学与分子影像杂志

Objective:To explore the advantage of three-phase bone scintigraphy combined with SPECT/CT over three-phase bone scintigraphy in the differential diagnosis of periprosthetic infection from prosthesis loosening in patients after prosthesis replacement.Methods:Seventy patients (27 males, 43 females, age (69.5±10.5) years) who were suspected with prosthesis loosening or periprosthetic infection underwent 99Tc m-methylene diphosphonate (MDP) three-phase bone scintigraphy and SPECT/CT from October 2008 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively reviewed. All patients had pathological diagnoses based on surgical resection or lesion biopsy. The diagnostic efficiency of three-phase bone scintigraphy images and three-phase bone scintigraphy combined with SPECT/CT were evaluated. χ2 test was used for data analysis. Results:Among 70 patients, 34(48.6%, 34/70) were diagnosed as periprosthetic infection and 36(51.4%, 36/70) were diagnosed as prosthesis loosening. Using three-phase bone scintigraphy for the differential diagnosis of bone lesions, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 94.1%(32/34), 77.8%(28/36), 85.7%(60/70), 80.0%(32/40) and 93.3%(28/30), when combined with SPECT/CT, the corresponding results were 94.1%(32/34), 94.4%(34/36), 94.3%(66/70), 94.1%(32/34), 94.4%(34/36), respectively. The specificity and accuracy were increased ( χ2 values: 4.167, 4.167, both P=0.031). Conclusion:Combination of three-phase bone scintigraphy with SPECT/CT can provide added value over three-phase bone scintigraphy for differential diagnosis in patients with periprosthetic loosening or periprosthetic infection.

Development and psychometric test of discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome patients / 中国实用护理杂志

Objective:To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS) patients and test the reliability and validity of the questionnaire.Methods:Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool. The questionnaire was developed though 2 rounds Delphi consultation and a pilot test. A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire, item analysis was used to screen items. SPSS 22.0 software was used for reliability test and exploratory factor analysis, the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results:The questionnaire consisted 2 dimensions(external discrimination and internal discrimination) and 10 items. Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients, and the cumulative variance contribution rates were 48.367% and 55.403%, respectively. The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio ( χ2/ df) was 2.831, P<0.05, root mean square of approximation error (RMSEA) was 0.093, goodness of fit index (GFI) was 0.928, comparative fit index (CFI) was 0.925, incremental fit index (IFI) was 0.926; the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed that χ2/ df was 1.740, P<0.05; RMSEA was 0.076, GFI was 0.925, CFI was 0.936, IFI was 0.938. The content validity of the questionnaire was 0.9. The Cronbach α coefficientof questionnaire was 0.811, and the test-retest coefficient was 0.862 ( P<0.01). Conclusions:The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity, and it can be used to measure the discrimination for HIV/AIDS patients.

Analysis of epidemic characteristics of COVID-19 clusters in Chenzhou， Hunan Province / 上海预防医学

Objective:To analyze the epidemiological characteristics of 8 clusters of coronavirus disease 2019 （COVID-19） in Chenzhou City， and provide scientific basis for epidemic prevention and control. Methods:Descriptive epidemiological analysis was conducted for 8 COVID-19 clusters， comparing and analyzing the differences of infection rates among close contacts within and outside the family， and emphatically describing two typical cases. Results:8 COVID-19 clusters were reported in Chenzhou with a total of 31 cases from January to February， 2020. The main source of infection of the family index cases was Hubei Province. Cough symptoms were observed in 67.74% of the cases， followed by fever （54.84%）. The infection rate of close contacts within the family （55.00%） was higher than that outside the family （2.56%）， and the difference was statistically significant （χ2=28.177， P<0.001）. The infection rate of spouse of the family index cases was 85.71%， higher than that of parents （77.78%）， other family members （44.44%） and children （40.00%）， and the difference was not statistically significant （χ2=6.004， P=0.120）. Two typical cases suggested that both COVID-19 pre-symptomatic and asymptomatic patients have the potential to excrete the virus from the body and become sources of infection. Conclusion:Effective family prevention and control measures and early sampling and screening of people in key epidemic areas are conducive to early detection， early isolation and early treatment of infected people， so as to avoid the occurrence and spread of family clusters.