Fluorescence immunosensor based on a specific monoclonal antibody for highly sensitive and rapid detection of gizzerosine in feed.

Gizzerosine is a biogenic amine produced in fish meal drying process and posted higher mortality due to gizzard erosion in poultry than histamine. However, it is difficult to obtain gizzerosine and achieve sensitive practical detection due to its simple structure. Herein, a monoclonal antibody (mAb) specific to gizzerosine was generated based on the new structural design and a fluorescence immunosensor for sensitive and on-site detection of gizzerosine in feed was first established. Molecular modeling of the three-dimensional (3D) structure and surface electrostatic potential of gizzerosine indicated that the carbonyl group of gizzerosine hapten might affect the important sites of antigen-antibody interactions. The proposed structure was used to obtain the sensitive and specific mAb with IC50 of 3.88 ng/mL in indirect competitive ELISA which was approximately 100-fold lower than that of direct competitive ELISA. Considering the practical application scenarios, a fluorescence immunosensor based on microporous dry method integrated with independent quality control line was established to improve detection stability. Under the optimum conditions, the proposed immunosensor showed a good linear relationship from 1.10 to 19.78 ng/mL and provided a low detection limit of 50 ng/g which was approximately 80-fold lower than the maximum recommended amount (0.4 mg/kg) of gizzerosine in feed. The recoveries of 6 kinds of feed ranged from 83.1 % to 114.3 %, which was in good consistence with that of UHPLC-MS/MS. Overall, this work provides a fast, cost-effective and reliable on-site tool for rapid screening of gizzerosine residues in feed samples.

Magnolia biondii flower extract attenuates UVB-induced skin damage through high-mobility group box protein B1.

OBJECTIVE: Magnolia biondii, a plant containing many magnolian-like compounds in its flowers or buds, exhibits anti-inflammatory and antiallergic effects; however, no study has addressed its effect on alleviating ultraviolet light (UV)-induced skin damage. We thus aimed at studying the effects of M. biondii flower extract (MB) on UVB-induced skin damage and determine the relationship between cell damage and damage-associated molecular patterns (DAMPs). METHODS: Reconstructed epidermal models and foreskin samples were selected to detect cellular reactions after UVB irradiation and MB treatment. MTT, haematoxylin-eosin and immunofluorescence staining were used to examine total viability, sunburned cells and expression and migration of DAMPs at 16 or 48 h. Prostaglandin E2 (PGE-2) and interleukin 8 (IL-8) levels were measured using enzyme-linked immunosorbent assays. A clinical UVB-damaged test was carried out on human arms subjected to MB pre- or post-treatment. Human skin probes were used to measure erythema, melanin, ITA° and transepidermal water loss (TEWL), while skin photos were captured using the VISIA system. RESULTS: MB is rich in lignans such as magnolin, pinoresinol dimethyl ether and fargesin, and shows weak UV absorption at 280-320 nm. Coculturing with MB for 16 or 48 h after UVB irradiation improved the tissue viability and structure of Skinovo-Epi, and reduced the expression and migration of high mobility group box protein B1 (HMGB1) as well as the expression of IL-8 and PGE-2. In the excised foreskin treated with MB after UVB irradiation, the generation of 8-hidroxy-2-deoxyguanosine and nuclear transfer of HMGB1 were reduced. When pre-treated with MB for 3 days, UVB-induced skin erythema and ITA° were significantly decreased. When post-treated with MB for 5 days, a decrease in skin erythema, melanin and TEWL values and an increase in skin ITA° were observed. CONCLUSIONS: Treatment with MB attenuated UVB-induced skin damage, such as erythema, pigmentation and skin barrier function, by improving the tissue viability and structure and reducing sunburned cells and skin inflammation. This effect may be related to DNA damage, which causes the migration of HMGB1 from the nucleus to the outside of the cell to induce skin inflammation.

OBJECTIF: Magnolia biondii, une plante dont les fleurs et les bourgeons contiennent de nombreux composés de type magnolien, possède des effets anti­inflammatoires et antiallergiques. Cependant, aucune étude n'a abordé son effet sur la réduction des lésions cutanées induites par la lumière ultraviolette (UV). Dès lors, nous avons cherché à étudier les effets de l'extrait de fleur de M. biondii sur les lésions cutanées induites par les UVB et à déterminer le lien entre les lésions cellulaires et les profils moléculaires associés aux lésions (PMAL). MÉTHODES: Des modèles épidermiques reconstruits et des échantillons de prépuce ont été sélectionnés pour détecter les réactions cellulaires après une irradiation aux UVB et un traitement par extrait de fleur de M. biondii. Le test MTT, l'hématoxyline­éosine (HE) et la coloration par immunofluorescence ont été utilisés pour examiner la viabilité totale, les cellules brûlées par le soleil, ainsi que l'expression et la migration des PMAL à 16 ou 48 h. Les taux de prostaglandine E2 (PGE­2) et d'interleukine 8 (IL­8) ont été mesurés par dosages immuno­enzymatiques (ELISA). Une analyse clinique des lésions dues aux UVB avant ou après traitement a été effectuée sur des bras humains traités par extrait de fleur de M. biondii. Des sondes cutanées humaines ont permis de mesurer l'érythème, le taux de mélanine, l'ITA° et la perte en eau transépidermique, tandis que la peau a été photographiée à l'aide du système VISIA. RÉSULTATS: L'extrait de fleur de M. biondii est riche en lignans, comme la magnoline, le pinorésinol diméthyléther et la fargésine, et montre une faible absorption des UV à une longueur d'onde de 280 à 320 nm. La mise en culture de l'extrait de fleur de M. biondii pendant 16 ou 48 h après irradiation aux UVB a amélioré la viabilité et la structure des tissus de Skinovo­Epi et réduit l'expression et la migration de la protéine B1 du groupe à haute mobilité (HMGB1), ainsi que l'expression de l'IL­8 et de la PGE­2. Dans le prépuce excisé traité par extrait de fleur de M. biondii après irradiation aux UVB, la génération de 8­hidroxy­2­désoxyguanosine et le transfert nucléaire de HMGB1 étaient réduits. Lors d'un prétraitement par extrait de fleur de M. biondii pendant 3 jours, l'érythème cutané induit par les UVB et l'ITA° avaient diminué significativement. Lors d'un post­traitement par extrait de fleur de M. biondii pendant 5 jours, une diminution des valeurs de l'érythème cutané, de la mélanine et de la perte en eau transépidermique et une augmentation de l'ITA° cutané ont été observées. CONCLUSIONS: Le traitement par extrait de fleur de M. biondii a atténué les lésions cutanées induites par les UVB, comme l'érythème, la pigmentation et la fonction de barrière cutanée, en améliorant la viabilité et la structure des tissus et en réduisant les cellules brûlées par le soleil et l'inflammation cutanée. Cet effet peut être lié à une altération de l'ADN, qui entraînent la migration du HMGB1 du noyau vers l'extérieur de la cellule, induisant ainsi une inflammation cutanée.

Correlation between the facial skin microbiome and sensitive skin using the 2bRAD-M technique.

OBJECTIVE: This study aimed to expound on the correlation between facial skin microbiome and sensitive skin (SS) using a novel sequencing technique. METHODS: We applied the 2bRAD sequencing for the microbiome, which enables accurate characterization of the low-biomass microbiome at species resolution to profile facial skin microbes in SS and non-SS groups. Further, the bacterial colonies were isolated and cultured from skin surfaces to study the pro-inflammatory effect on human keratinocytes by ELISA. RESULTS: We accordingly identified 1142 genera and 4436 strains. In the SS group, the proportions of Actinomyces and Microbotryomycetes were significantly increased, whereas that of Acidimicrobiia was decreased. Kruskal-Wallis analysis revealed significant differences in 11 genera and 35 species, among which the proportions of Dermabacter, Chryseobacterium, Rhodotorula and Peptoniphilus A were increased in the SS group. Analysis of the top 10 genera revealed increased proportions of Cutibacterium, Corynebacterium and Staphylococcus. Moreover, the proportion of Dermabacter hominis was significantly increased by 18.9-fold in the SS group, whereas those of many Streptococcus strains were significantly decreased. Focus on the isolated bacterial colonies from skin surfaces, more yellow colonies were found in SS group when cultured in Tryptic Soy Broth medium for 48 h, and more interleukin-8 was detected on keratinocytes after yellow colonies stimulation, such as S.capitis, M.luteus. CONCLUSIONS: This study suggests that more SS-associated microorganisms can be identified using the 2bRAD technique even with a small sample size. Dermabacter hominis and Chryseobacterium was firstly reported with a significantly increase in SS, and the S.capitis, as well as M.luteus, but not S.aureus, may be associated with skin inflammation.

OBJECTIF: Cette étude visait à expliquer la corrélation entre le microbiome de la peau du visage et la peau sensible (PS) à l'aide d'une nouvelle technique de séquençage. MÉTHODES: Nous avons appliqué le séquençage 2bRAD pour le microbiome, ce qui nous a permis de caractériser précisément le microbiome à faible biomasse à la résolution des espèces pour profiler les microbes de la peau du visage dans les groupes PS et non­PS. En outre, les colonies bactériennes ont été isolées et cultivées à partir de surfaces cutanées pour étudier l'effet pro­inflammatoire sur les kératinocytes humains par ELISA. RÉSULTATS: Nous avons donc identifié 1 142 genres et 4 436 souches. Dans le groupe PS, on a pu constater des proportions d'Actinomyces et de microbotryomycètes significativement accrues, pour de moindres proportions d'Acidimicrobiia. L'analyse de Kruskal­Wallis a révélé des différences significatives dans 11 genres et 35 espèces, parmi lesquelles des proportions de Dermabacter, Chryseobacterium, Rhodotorula et Peptoniphilus A accrues dans le groupe PS. L'analyse des 10 principaux genres a montré une augmentation des proportions de Cutibacterium, Corynebacterium et Staphylococcus. En outre, la proportion de Dermabacter hominis a été multipliée par 18,9 dans le groupe PS, soit une augmentation significative, tandis que celle de nombreuses souches de Streptococcus s'est avérée significativement plus basse. En se concentrant sur les colonies bactériennes isolées des surfaces cutanées, plus de colonies jaunes ont été trouvées dans le groupe PS lorsqu'elles étaient cultivées dans du milieu de bouillon trypticase soja pendant 48 h, et davantage d'interleukine­8 a été détectée sur les kératinocytes après la stimulation des colonies jaunes comme S. capitis, M. luteus. CONCLUSIONS: Cette étude suggère que davantage de micro­organismes associés au PS peuvent être identifiés à l'aide de la technique 2bRAD, même avec un échantillon de petite taille. Dermabacter hominis et Chryseobacterium ont été rapportés avec une augmentation significative pour les PS, et S. capitis, ainsi que M. luteus, mais pas S. aureus, pouvant être associés à une inflammation cutanée.

A modified protocol for studying filaggrin degradation using a reconstructed human epidermis model under low and high humidity.

BACKGROUND: Filaggrin (FLG) is an essential protein that plays a vital role in maintaining skin barrier function and moisture levels, allowing the skin to adapt to dry environments. However, the precise temporal dynamics of FLG metabolism in the human epidermis remain poorly understood, and suitable tools to study these time-dependent effects are currently lacking. OBJECTIVE: To investigate the molecular mechanisms and time course of FLG metabolism and skin barrier function under high- and low-humidity conditions, utilizing a reconstructed epidermis model. METHODS: EpiSkin specimens cultured under humid or dry conditions for varying durations (2-48 h) were compared by assessing FLG degradation and skin barrier formation using immunofluorescence staining and western blotting. RESULTS: Under conditions of low humidity, the proteolysis of FLG in EpiSkin increased between 4 and 12 h and was accompanied by elevated levels of cysteine-aspartic protease (caspase)-14. The expression of peptidyl arginine deiminase 1 and calpain 1 also increased at 4 h. However, after 24 h, the expression of these three FLG-degrading proteins significantly decreased. Conversely, the levels of pyrrolidone-5-carboxylic acid and urocanic acid initially decreased at 2 h and then increased between 12 and 24 h. Additionally, the expression of skin barrier proteins, such as FLG, transglutaminase 5, loricrin and zonula occludens-1, decreased starting from 12 h. Notably, epidermal cell viability and activity were also inhibited. CONCLUSION: We propose a reliable and ethical model to study the temporal dynamics of FLG metabolism and its role in skin barrier function. Using a commercially reconstructed epidermis to mimic dry skin formation obviates the need for animal and human testing.

CONTEXTE: la filaggrine (FLG) est une protéine essentielle qui joue un rôle vital dans le maintien de la fonction de barrière cutanée et des taux d'humidité, permettant à la peau de s'adapter aux environnements secs. Cependant, la dynamique temporelle précise du métabolisme de la FLG dans l'épiderme humain reste mal comprise, et des outils appropriés pour étudier ces effets dépendant du temps font actuellement défaut. OBJECTIF: étudier les mécanismes moléculaires et l'évolution dans le temps du métabolisme de la FLG et de la fonction de barrière cutanée en milieux à humidité élevée et faible, en utilisant un modèle d'épiderme reconstruit. MÉTHODES: les échantillons EpiSkin cultivés en milieux humides ou secs pendant des durées variables (2 à 48 h) ont été comparés en évaluant la dégradation de la FLG et la formation d'une barrière cutanée à l'aide d'une coloration par immunofluorescence et d'un Western blot. RÉSULTATS: en milieux à faible humidité, la protéolyse de la FLG dans EpiSkin a augmenté entre 4 et 12 h et s'est accompagnée de taux élevés de cystéine­protéase aspartique (caspase)­14. L'expression du peptidyl arginine déiminase 1 et de la calpaïne 1 a également augmenté à 4 h. Cependant, après 24 h, l'expression de ces trois protéines de dégradation de la FLG a significativement diminué. Inversément, les taux d'acide pyrrolidone­5­carboxylique et d'acide urocanique ont initialement diminué au bout de 2 h, puis ont augmenté entre 12 et 24 h. En outre, l'expression des protéines de la barrière cutanée, telles que la FLG, la transglutaminase 5, la loricrine et le zonula occludens­1, a diminué à partir de 12 h. Notamment, la viabilité et l'activité des cellules épidermiques ont également été inhibées. CONCLUSION: nous proposons un modèle fiable et éthique pour étudier la dynamique temporelle du métabolisme de la FLG et son rôle dans la fonction de barrière cutanée. L'utilisation d'un épiderme reconstitué commercialement pour imiter la formation d'une peau sèche élimine la nécessité de réaliser des examens sur des animaux et des humains.

Dual-modular immunosensor for bongkrekic acid detection using specific monoclonal antibody.

Bongkrekic acid (BA) is a mitochondrial toxin that causes high mortality but is often mistakenly categorized as other food poisonings. The immunoassay of BA is still challenging since the specific antibody is unavailable. In this work, a monoclonal antibody specific to BA was first generated and a dual-modular immunosensor for on-site and laboratory detection was established. The antibody showed good affinity (Kd=0.33 µM) and sensitivity (IC50 =17.9 ng/mL in ELISA) with negligible cross-reactivity with common mycotoxins. In dual-modular conditions, fluorescence assay (FA) was conducted based on the inner filter effect of carbon dots (CDs) and oxidized 3,3',5,5'-tetramethylbenzidine (TMB), while the colorimetric assay (CA) was conducted using TMB2+-mediated rapid surface etching of gold nanostars (Au NSs). The proposed immunosensor showed good sensitivity and reproducibility to BA in food samples, with a limit of detection lower than 10 ng/mL and recovery ranging from 80.0% to 103.6%, which was in good consistence with that of standard LC-MS/MS. Overall, the proposed immunosensor is an ideal tool for screening BA contaminants in food with good sensitivity and high effectivity.

Inhibition of lipogenesis and sebum secretion for Lotus corniculatus seed extract in vitro and in vivo.

BACKGROUND: Botanical ingredients are widely used in hair- and skin-care products. However, few studies have investigated the effectiveness of botanical products on counteracting sebum synthesis and secretion. OBJECTIVE: To investigate the composition of Lotus corniculatus seed extract (LC) and its potential inhibition of lipogenesis in SZ95 sebocytes and oily human skin. METHODS: The active components of LC solutions were identified by high-performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR). The in vitro effects of LC were evaluated using SZ95 cells treated with linoleic acid (LA) and dihydrotestosterone (DHT) and incubated with LCs for 24 h and 72 h. Lipogenesis was assessed by Oil Red O and Nile Red staining of the cells. In vivo effects were assessed on 30 subjects with oily skin who were enrolled in a randomized, blank-controlled trial and were treated with LC solution for 6 h and 4 weeks. The skin sebum contents and area on the forehead and cheeks were evaluated using a Sebumeter SM815 and Sebfix sebutape with Visioscan VC98. In addition, VISIA was used to collect half-face photos for analysis. RESULTS: A novel active molecule, 5'-o-rhamnosyl uridine, was identified in LC. LC exhibited a dose-dependent inhibitory effect on LA and DHT-induced lipid synthesis. When 5% LC was applied for 3 h, the skin sebum contents and area were significantly reduced compared with the vehicle control, with an obvious reduction after 6 h. Continued use of the serum containing 5% LC for 4 weeks resulted in a significant reduction in the skin sebum contents and area. No adverse reactions were reported during the study. CONCLUSIONS: Topical application of LC resulted in an immediate and long-lasting reduction of the sebum contents and area of oily human skin by reducing sebaceous lipogenesis through the LA and DHT pathways. This indicates the potential of LC as a new biological treatment for oily skin.

CONTEXTE: Les ingrédients végétaux sont largement utilisés dans les produits de soins des cheveux et de la peau. Cependant, peu d'études ont examiné l'efficacité des produits végétaux dans l'inhibition de la synthèse et de la sécrétion de sébum. OBJECTIF: Étudier les composants de l'extrait de graines de lotus (LC) et son effet inhibiteur potentiel sur la lipogenèse des cellules sébacées SZ95 et de la peau grasse. MÉTHODES: Les composants actifs de la solution LC ont été identifiés par chromatographie liquide à haute performance (HPLC) et par résonance magnétique nucléaire (NMR). Les effets de la LC in vitro ont été évalués à l'aide de cellules SZ95 traitées à l'acide linoléique (LA) et à la dihydrotestostérone (DHT) et incubées avec la LC pendant 24 et 72 heures. Les effets in vivo ont été évalués chez 30 sujets à peau grasse qui ont participé à un essai contrôlé randomisé à blanc et qui ont été traités avec une solution de LC pendant 6 heures et 4 semaines. Le sebumeter SM815 et le sebfix sebutape et le visioscan VC98 ont été utilisés pour évaluer la teneur en sébum et la surface de la peau sur le front et les joues. De plus, des photos de demi - visage ont été recueillies pour analyse à l'aide de VISIA. RÉSULTATS: Une nouvelle molécule active, 5'-o-rhamnosyluridine, a été identifiée dans la LC. La LC a un effet inhibiteur dose - dépendant sur la synthèse lipidique induite par LA et DHT. La teneur et la surface du sébum cutané ont été significativement diminuées par rapport à celles du support photographique après 3 heures d'application de 5% de LC, et significativement diminuées après 6 heures. L'utilization de sérum contenant 5% de LC pendant quatre semaines consécutives a entraîné une réduction significative de la teneur en sébum et de la surface de la peau. Aucun effet indésirable n'a été signalé au cours de l'étude. CONCLUSION: L'application topique de LC peut réduire la production de sébum par les voies LA et DHT, ce qui réduit immédiatement et durablement la teneur en sébum et la surface de la peau huileuse humaine. Cela démontre le potentiel de la LC en tant que nouveau traitement biologique de la peau huileuse.

Modulation of TRPV1 function by Citrus reticulata (tangerine) fruit extract for the treatment of sensitive skin.

BACKGROUND: Sensitive skin (SS) is a clinical syndrome defined by the occurrence of unpleasant sensations (such as stinging, burning, pain, pruritus, and tingling) in response to stimuli that normally should not provoke them. According to growing evidence, transient receptor potential vanilloid subtype 1 (TRPV1) has elevated expression in individuals with SS and is linked with the severity of SS symptoms. However, its pathogenesis is still unknown. OBJECTIVE: Herein, Citrus reticulata (Tangerine) fruit extract (CR) was obtained and examined for its effect on SS with a focus on TRPV1 stimulation and expression. METHODS: A recombinant hTRPV1 over-expression cell line (HaCaT-TRPV1-OE cell) was constructed to screen substances and extracts from several plants. Intracellular calcium mobilization was monitored by Flexstation 3 and a fluorescence microscope using Fluo 8 AM fluorophore. Next, immunofluorescence was used to detect the TRPV1 expression under different stimulants treated for 24 h. To investigate the relief and increased tolerance of CR to lactic acid-induced skin discomfort, clinical tests were carried out on the nasolabial folds or cheek areas. RESULTS: According to the obtained results, compared to HaCaT cells, HaCaT-TRPV1-OE cells showed a higher expression of TRPV1. Neuronal hyperresponsiveness in SS triggered by capsaicin (CAP), lactic acid, phenoxyethanol or nicotinamide may be through activation of TRPV1 and increased TRPV1 expression. CAP activates TRPV1 in HaCaT-TRPV1-OE cells, and more than 100 plants or chemicals were tested for their inhibitory effects before being screened for CR. CR (1%-4%) inhibited TRPV1 activation induced by CAP or phenoxyethanol or nicotinamide. Meanwhile, CR (0.25%) suppressed TRPV1 protein expression induced by phenoxyethanol or lactic acid. In vivo results showed that CR not only instantly relieved lactic acid-induced skin discomfort under 5 min but also enhanced skin tolerance to lactic acid after 7 days of continuous use. CONCLUSIONS: Topical application of CR showed an instant and long-lasting improvement in SS by modulating the activation and expression of TRPV1. Moreover, it has been suggested that CR might act as a TRPV1 inhibitor to reduce skin irritation or sensitivity.

The moisturizing effect of Capparis spinosa fruit extract targeting filaggrin synthesis and degradation.

BACKGROUND: Small molecular natural products, such as betaine, have unique moisturizing advantages. Capparis spinosa L. fruit is rich in quaternary ammonium alkaloids such as betaine and stachydrine. However, few studies investigated its efficacy and mechanism on human skin. OBJECTIVE: Polysaccharides-free C. spinosa fruit extract (CS) was obtained to study its moisturizing effect and mechanisms focusing on filaggrin (FLG) synthesis and degradation. METHODS: The clinical moisturizing test was carried out on human arms, calves, and faces after CS treatment for 0.5-6 h. The change in the level of FLG, caspase 14, loricrin, and transglutaminase 5 (TGM 5) was measured by immunofluorescence after CS treatment for 4 and 24 h in a reconstructed epidermis model. Also, the content of pyrrolidone carboxylic acid (PCA) in the stratum corneum was tested by high-performance liquid chromatography (HPLC) both in the epidermis model and human calves. RESULTS: Compared with glycerin (positive control), 5% CS showed a strong skin hydration effect on arms and calves when applied for 0.5-6 h. Also, the face hydration increased at 0.5 and 4 h. In addition, 3% CS applied to the recombinant epidermis model under low humidity promoted the immunodetected levels of caspase 14 and PCA content but reduced the levels of FLG at 4 h, however, the levels of FLG, loricrin, and TGM 5 were promoted at 24 h. Meanwhile, CS treatment for 4 h in human calves increased the PCA content in the stratum corneum by 29.9%. CONCLUSIONS: Topical application of CS on human skin showed an instant and long-lasting increase in skin hydration by regulating the FLG network. It promoted FLG degradation to form PCA at 4 h both in vivo and in vitro, increasing FLG synthesis after 24 h, potentially reforming the FLG monomer reservoir to alleviate the skin's dry condition.

Demographic profile and ocular characteristics of stage 5 retinopathy of prematurity at a referral center in Northwest China: implications for implementation.

BACKGROUND: Severe retinopathy of prematurity (ROP) with extremely unfavorable prognosis among infants can do great damage to individuals and bring tremendous social-economic burden. The purpose of this study is to describe the demographic and ocular characteristics of infants who presented with stage 5 ROP in order to identify reasons why they have become blind, and to identify contributing factors in order to focus great attention on the current ROP program and to inspire more effort in ROP screening in middle income countries. METHODS: A retrospective review of consecutive infants with stage 5 ROP from December 2010 to December 2016 in Department of Ophthalmology, Xijing Hospital. Various parameters retrieved included birthweight, gestational age, age at initial examination, postmenstrual age, screening details, check-up details and reasons for consultation. Ocular findings were recorded and also detected by ultrasonography. RESULTS: A retrospective review of 20 consecutive infants with stage 5 ROP are included. Mean birthweight was1712.3 ± 512.97 g and mean gestational age at birth was 32.1 ± 2.21 weeks. Median age at first consultancy was 9.7 month. Median postmenstrual age first consultancy was 52 weeks. All infants were never screened for ROP before they came to the referral center. Of twenty stage 5 ROP infants, 13 cases presented with bilateral stage 5 features. Of the 40 eyes of 20 infants, 33 eyes were diagnosed as stage 5. Leukocoric pupil, closed funnel configuration of retinal detachment (RD), posterior synechia, extraretinal fibrovascular proliferation and retinal folds were the most significant indicators of bad prognosis. Ten eyes appeared no fixation to light, while 30 eyes exhibited following to light or following to toys. CONCLUSIONS: Our study shows that in relatively less-developed regions of China, more needs to be done to spread awareness about the disease among pediatricians, neonatologists and ophthalmologists as well as parents of premature infants. Thus, a comprehensive control system which is a whole network of propaganda, screening, treatment and follow-up are encouraged especially in less developed areas in China as well as worldwide.

Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication.

Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns. We show that the implementation of some increasingly popular operational changes in the ways clinicians deliver care-including the use of teams or "pods," better information technology and sharing of data, and the use of nonphysicians-have the potential to offset completely the increase in demand for physician services while improving access to care, thereby averting a primary care physician shortage.

Burn disaster response planning in New York City: updated recommendations for best practices.

Since its inception in 2006, the New York City (NYC) Task Force for Patients with Burns has continued to develop a city-wide and regional response plan that addressed the triage, treatment, transportation of 50/million (400) adult and pediatric victims for 3 to 5 days after a large-scale burn disaster within NYC until such time that a burn center bed and transportation could be secured. The following presents updated recommendations on these planning efforts. Previously published literature, project deliverables, and meeting documents for the period of 2009-2010 were reviewed. A numerical simulation was designed to evaluate the triage algorithm developed for this plan. A new, secondary triage scoring algorithm, based on co-morbidities and predicted outcomes, was created to prioritize multiple patients within a given acuity and predicted survivability cohort. Recommendations for a centralized patient and resource tracking database, plan operations, activation thresholds, mass triage, communications, data flow, staffing, resource utilization, provider indemnification, and stakeholder roles and responsibilities were specified. Educational modules for prehospital providers and nonburn center nurses and physicians who would provide interim care to burn injured disaster victims were created and pilot tested. These updated best practice recommendations provide a strong foundation for further planning efforts, and as of February 2011, serve as the frame work for the NYC Burn Surge Response Plan that has been incorporated into the New York State Burn Plan.

Berberine inhibits hepatic stellate cell proliferation and prevents experimental liver fibrosis.

Proliferation of hepatic stellate cells (HSCs) is central for the development of fibrosis during liver injury. Our aim in this study was to determine whether berberine could inhibit HSC proliferation in vitro and prevent experimental liver fibrosis in vivo. Activated rat hepatic stellate cells (CFSCs) were incubated with various concentrations (0-20 microg/ml) of berberine. After 48 h incubation, berberine significantly inhibited CFSC proliferation and induced cell cycle arrest in G1 phase. Real-time and Western blotting revealed that both p21 and p27 expression was markedly reduced by berberine. Berberine also decreased Akt phosphorylation and FoxO1 phosphorylation, which led to FoxO1 nuclear translocation. Berberine effectively prevented CCl(4)-induced liver fibrosis in mice, which was accompanied by a decrease in the number of activated HSCs. Thus, berberine was able to prevent liver fibrosis by inhibition of hepatic stellate cell proliferation.