Enhancing regional control in p16-negative oropharyngeal cancer: A propensity score-matched analysis of upfront neck dissection and definitive chemoradiotherapy.

BACKGROUND: The presence of p16 and neck disease is important predictors of prognosis for oropharyngeal squamous cell carcinoma (OPSCC). Patients who are p16-negative and have clinically node-positive (cN+) disease generally have worse oncologic outcomes. This study aimed to investigate whether upfront neck dissection (UFND) could provide potential benefits for patients with cN+ p16-negative OPSCC. METHODS: Through this retrospective study, 76 patients with cN+ p16-negative OPSCC were analyzed, those who received either definite concurrent chemoradiotherapy (CCRT group) or UFND followed by chemoradiotherapy (UFND group). The primary endpoints were regional recurrence-free survival (RRFS), disease-specific survival (DSS), and overall survival (OS). Factors associated with survival were evaluated by univariate and multivariate analysis. Survival between the two groups was compared by propensity score-matched analysis. RESULTS: Matched 23 patients in each group through propensity analysis, the UFND group showed a significantly better 5-year RRFS (94.1% vs 61.0%, p = 0.011) compared to the CCRT group. Univariate analysis revealed that UFND was the sole factor associated with regional control (hazard ratio [HR] = 0.110; 95% CI, 0.014-0.879; p = 0.037). Furthermore, the study found that the CCRT group was associated with a higher dose of radiotherapy and exhibited a significantly higher risk of mortality due to pneumonia. CONCLUSION: The study indicated that UFND followed by CCRT may be a potential treatment option for patients with cN+ p16-negative OPSCC, as it can reduce the risk of regional recurrence. Additionally, the study highlights that definite CCRT is connected to a larger dose of radiotherapy and a higher risk of fatal pneumonia. These findings could be beneficial in informing clinical decision-making and improving treatment outcomes for patients with OPSCC.

Metabolically engineer Clostridium saccharoperbutylacetonicum for comprehensive conversion of acid whey into valuable biofuels and biochemicals.

As a byproduct of dairy production, the disposal of acid whey poses severe environmental challenges. Herein, an innovative solution involving metabolically engineering Clostridium saccharoperbutylacetonicum to convert all carbon sources in acid whey into sustainable biofuels and biochemicals was presented. By introducing several heterologous metabolic pathways relating to metabolisms of lactose, galactose, and lactate, the ultimately optimized strain, LM-09, exhibited exceptional performance by producing 15.1 g/L butanol with a yield of 0.33 g/g and a selectivity of 89.9%. Through further overexpression of alcohol acyl transferase, 2.7 g/L butyl acetate along with 6.4 g/L butanol was generated, resulting in a combined yield of 0.37 g/g. This study achieves the highest reported butanol titer and yield using acid whey as substrate in clostridia and marks pioneering production of esters using acid whey. The findings demonstrate an innovative bioprocess that enhances renewable feedstock biotransformation, thereby promoting economic viability and environmental sustainability of biomanufacturing.

Dilemmas and support strategies in dementia care: Experiences of case managers in Taiwan.

Objective: This study aimed to examine the dilemmas encountered and the countermeasures adopted by case managers, who care for individuals with dementia. The study also aimed to identify the types of support and assistance case managers require.Methods: In this qualitative study, the researchers conducted semi-structured interviews with 10 case managers, six from integrated dementia care centers and four from community-based dementia care centers in Taiwan.Results: The results are as follows: (1) Case managers providing services for individuals with dementia primarily encountered two major dilemmas, including cognitive differences (such as a lack of understanding of dementia, differences in ideas about dementia care, and distrust of the professionalism of case managers) with family members and their own insufficient professional capabilities, which made it difficult to reach a consensus on caregiving with family members and address the diverse conditions of individuals with dementia. (2) In response to these dilemmas, case managers adopted various approaches to enhance families' understanding of dementia and facilitate reaching a consensus on care. They also improved their professional capabilities through team discussions and resource networking. (3) The support and assistance required by case managers are continuous learning, the enhancement of their professional competencies, organizational support, and workload management.Conclusion: The findings of this study contribute to an understanding of the dilemmas faced by case managers in Taiwan's centers for integrated dementia care and community-based dementia care centers during policies implementation, as well as the strategies they adopted and the assistance they required. These results can also offer recommendations for policies, professional training, dementia services, and resources to reduce the disparity between policy and practice.

Defect-Engineered Charge Transfer in a PtCu/PrxCe1-xO2 Carbon-Free Catalyst for Promoting the Methanol Oxidation and Oxygen Reduction Reactions.

Platinum (Pt) and Pt-based alloys have been extensively studied as efficient catalysts for both the anode and cathode of direct methanol fuel cells (DMFC). Defect engineering has been revealed to be practicable in tuning the charge transfer between Pt and transition metals/supports, which leads to the charge density rearrangement and facilitates the electrocatalytic performance. Herein, Pr-doped CeO2 nanocubes were used as the noncarbon support of a PtCu catalyst. The concentration and structure of oxygen vacancy (Vo) defects were engineered by Pr doping. Besides the Vo monomer, the oxygen vacancy with a linear structure is also observed, leading to the one-dimensional PtCu. The Vo concentration shows the volcanic scenario as Pr increased. Accordingly, the activities of PtCu/PrxCe1-xO2 toward methanol oxidation and oxygen reduction reactions exhibit the volcanic scenario. PtCu/Pr0.15Ce0.85O2 exhibits the optimal catalytic performance with the specific activity 3.57 times higher than that of Pt/C toward MOR and 1.34 times higher toward ORR. The MOR and ORR mass activities of PtCu/Pr0.15Ce0.85O2 reached 1.05 and 0.12 A·mg-1, which are 3.09 and 0.92 times the values of Pt/C, respectively. The abundant Vo afforded surplus electrons, which tailored the electron transfer between PtCu and PrxCe1-xO2, leading to enhanced catalytic performance of PtCu/PrxCe1-xO2. DFT calculations on PtCu/Pr0.15Ce0.85O2 revealed that Pr doping reduced the band gap of CeO2 and lowered the overpotential.

Differences in patient-physician communication between the emergency department and other departments in a hospital setting in Taiwan.

BACKGROUND: Communication fosters trust and understanding between patients and physicians, and specific communication steps help to build relationships. Communication in the emergency department may be different from that in other departments due to differences in medical purposes and treatments. However, the characteristics of communication in the clinical settings of various departments have not been explored nor compared. OBJECTIVES: This study aimed to construct the steps in patient-physician communication based on the Roter Communication Model and compare communication performance between the emergency department and three other clinical settings-internal medicine, surgery, and family medicine departments. METHODS: Both qualitative and quantitative approaches were adopted. First, in-depth interviews were used to analyze clinical communication steps and meanings. Then, a quantitative questionnaire was designed based on the interview results to investigate differences in communication between the emergency department and the other three departments. Qualitative and quantitative data were analyzed from 20 interviews and 98 valid questionnaires. RESULTS: Patient-physician communication consists of four steps and ten factors. The four steps-greeting and data gathering, patient education and counseling, facilitation and patient activation, and building a relationship-had significant progressive effects. Patient education and counseling had an additional significant effect on building a relationship. The emergency department performed less well in the facilitation and patient activation, building a relationship step and the evaluation method, enhancement method, and attitude factors than the other departments. CONCLUSIONS: To improve the quality of patient-physician communication in the emergency department, physicians should strengthen the steps of facilitation and patient activation to encourage patients' active engagement in their health care.

Studying the non-thermal effects of microwave on amino acids in sterilized rainbow trout (Oncorhynchus mykiss) fillets using a double side approximating method.

The aim of this study was to investigate the impact of microwave non-thermal effects on thermal sensitive amino acids in rainbow trout (Oncorhynchus mykiss) fillets. To distinguish non-thermal effects from thermal effects occurring simultaneously, a Double Side Approximating Method (DSAM) derived from computational mathematics was developed. Two corresponding water bath treatments were designed for each microwave processing to approximate the time-temperature profiles at the hot and cold spots of the microwave processed samples while maintaining a comparable thermal intensity (F0). The microwave non-thermal effects on amino acids were determined by comparing the amount of each of 22 amino acids between the microwave processed and the two corresponding water bath treated rainbow trout fillets. The results indicated that the DSAM was successfully implemented, as the amino acid contents' order curve in the microwave processed samples was clearly exceeded the boundary formed by the two corresponding water bath treated samples. This finding confirmed the occurrence of microwave non-thermal effects on amino acids. The non-thermal effect resulted in a notable increase in the quantity of most amino acids, while it reduced the content of Lys and Hyp. Longer microwave processing times intensified these effects, while higher thermal processing intensities resulted in more damage to each amino acid.

The Physician-Patient Communication Behaviors Among Medical Specialists in a Hospital Setting.

Effective physician-patient communication builds robust physician-patient relationships and reduces medical disputes. However, much is unknown about the differences that exist in the communication behaviors of physicians in different departments. Using a mixed-methods research approach, the researchers used Roter Interaction Analysis System to uncover the communication behaviors of internists, surgeons, family physicians, and emergency physicians at a regional hospital in Taiwan. Semi-structured interviews were conducted to collect the communication experiences of 20 physicians from the internal medicine, surgery, family medicine, and emergency departments. The characteristics were presented through descriptive statistics, bar charts, and dendrograms. Physician-patient communications consisted of four dimensions, 10 factors, and 31 behaviors. The characteristics are as follows: (1) Internists need to improve their overall performance in terms of physician-patient communication behaviors; (2) Surgeons performed well in building relationships through non-verbal methods; (3) Family physicians excelled in facilitation and patient activation. (4) Emergency physicians performed well in patient education and counseling. The characteristics of the aforementioned communication behaviors among internists, surgeons, family physicians, and emergency physicians can be used to construct indicators of physician-patient communication in each department and to develop patient-centered healthcare services in the future.

Effects of acetic, malic, and citric acids on the large deformation behaviors of fish gelatin gels.

This research was aimed to quantify the effects of acetic acid, malic acid, and citric acid (0, 0.5, 1.0, and 2.0 g/100 g H2 O) on the stress-strain responses of fish gelatin (FG) gels (2, 4, and 6.67 g/100 g H2 O) under uniaxial compression up to 68% of deformation. The first-order Ogden model fitted quite well for the compression responses of FG gels (R2 = 0.9909-0.9997). Protons from the acids played a key role on weakening the FG gel structures (gel rigidity, µ, decreased 11%-27%), as the µ values and pH values of FG gels were linearly correlated (R2 = 0.8240-0.9748), regardless of the acid type. The addition of an acid also resulted in a significant increase (p < .002) in the strain hardening capacity (α) of gels with 2 g FG/100 g H2 O. Both µ and α values of FG gels with higher gelatin concentrations were less affected by an acid partly due to their stronger buffering effects. The µ and α values of FG gels as affected by acids could not be fully explained based upon the pH changes, implying that the effects of acetate, malate, and citrate ions on the gel structure could not be ignored.

Rapid and Sensitive Detection of Streptococcus iniae in Trachinotus ovatus Based on Multienzyme Isothermal Rapid Amplification.

Infectious diseases caused by Streptococcus iniae lead to massive death of fish, compose a serious threat to the global aquaculture industry, and constitute a risk to humans who deal with raw fish. In order to realize the early diagnosis of S. iniae, and control the outbreak and spread of disease, it is of great significance to establish fast, sensitive, and convenient detection methods for S. iniae. In the present study, two methods of real-time MIRA (multienzyme isothermal rapid amplification, MIRA) and MIRA-LFD (combining MIRA with lateral flow dipsticks (LFD)) for the simA gene of S. iniae were established, which could complete amplification at a constant temperature of 42 °C within 20 min. Real-time MIRA and MIRA-LFD assays showed high sensitivity (97 fg/µL or 7.6 × 102 CFU/mL), which were consistent with the sensitivity of real-time PCR and 10 times higher than that of PCR with strong specificity, repeatability simplicity, and rapidity for S. iniae originating from Trachinotus ovatus. In summary, real-time MIRA and MIRA-LFD provide effective ways for early diagnosis of S. iniae in aquaculture, especially for units in poor conditions.

Effects of Microwave Pasteurization on the Quality and Shelf-Life of Low-Sodium and Intermediate-Moisture Pacific Saury (Cololabis saira).

The objective of this study was to investigate the effects of microwave pasteurization on the quality and shelf-life of low-sodium and intermediate-moisture Pacific saury. Microwave pasteurization was used to process low-sodium (1.07% ± 0.06%) and intermediate-moisture saury (moisture content 30% ± 2%, water activity 0.810 ± 0.010) to produce high-quality ready-to-eat food stored at room temperature. Retort pasteurization with the same thermal processing level of F90 = 10 min was used for comparison. Results showed that microwave pasteurization had significantly (p < 0.001) shorter processing times (9.23 ± 0.19 min) compared with traditional retort pasteurization (17.43 ± 0.32 min). The cook value (C) and thiobarbituric acid (TBARS) content of microwave-pasteurized saury were significantly lower than that of retort-pasteurized saury (p < 0.05). With more microbial inactivation, microwave pasteurization brought better overall texture than retort processing. After 7 days of storage at 37 °C, the total plate count (TPC) and TBARS of microwave pasteurized saury still met the edible standard, while the TPC of retort pasteurized saury no longer did. These results showed that the combined processing of microwave pasteurization and mild drying (Aw < 0.85) could produce high-quality ready-to-eat saury products. These results indicate a new methodology for producing high-quality products stored at room temperature.

Protective effect of Anneslea fragrans ethanolic extract against CCl4-induced liver injury by inhibiting inflammatory response, oxidative stress and apoptosis.

Anneslea Fragrans Wall. (AF) is a medicinal and edible plant distributed in China. Its leaves and barks are generally used for the treatments of diarrhea, fever, and liver diseases. While its ethnopharmacological application against liver diseases has not been fully studied. This study was aimed to evaluate the hepatoprotective effect of ethanolic extract from A. fragrans (AFE) on CCl4 induced liver injury in mice. The results showed that AFE could effectively reduce plasma activities of ALT and AST, increase antioxidant enzymes activities (SOD and CAT) and GSH level, and decrease MDA content in CCl4 induced mice. AFE effectively decreased the expressions of inflammatory cytokines (IL-1ß, IL-6, TNF-α, COX-2 and iNOS), cell apoptosis-related proteins (Bax, caspase-3 and caspase-9) and increased Bcl-2 protein expression via inhibiting MAPK/ERK pathway. Additionally, TUNEL staining, Masson and Sirius red staining, immunohistochemical analyses revealed that AFE could inhibit the CCl4-induced hepatic fibrosis formation via reducing depositions of α-SMA, collagen I and collagen III proteins. Conclusively, the present study demonstrated that AFE had an hepatoprotective effect by suppressing MAPK/ERK pathway to inhibit oxidative stress, inflammatory response and apoptosis in CCl4-induced liver injury mice, suggesting that AFE might be served as a hepatoprotective ingredient in the prevention and treatment of liver injury.

Ultra-High Hydrostatic Pressure Pretreatment on White Que Zui Tea: Chemical Constituents, Antioxidant, Cytoprotective, and Anti-Inflammatory Activities.

Herbal tea has numerous biological activities and exhibits broad benefits for human health. In China, the flower buds of Lyonia ovalifolia are traditionally processed as herbal tea, namely White Que Zui tea (WQT). This study was aimed to evaluate the effect of ultra-high hydrostatic pressure (UHHP) pretreatment on the chemical constituents and biological activities of free, esterified, and insoluble-bound phenolic fractions from WQT. A total of 327 chemical constituents were identified by a quasi-targeted metabolomics analysis. UHHP pretreatment extremely inhibited reactive oxygen species (ROS) production and cell apoptosis in H2O2-induced HepG2 cells, and it increased the activities of intracellular antioxidant enzymes (SOD and CAT) and GSH content in different phenolic fractions from WQT. In addition, after UHHP pretreatment, the anti-inflammatory effects of different phenolic fractions from WQT were improved by inhibiting the production of nitric oxide (NO) and pro-inflammatory cytokines (TNF-α, IL-6, and IL-1ß) in LPS-induced RAW264.7 cells. Thus, the UHHP method might be a potential pretreatment strategy for improving the bioavailability of phytochemicals from natural plants.

Effects of high-temperature short-time processing on nutrition quality of Pacific saury (Cololabis saira) using extracted fatty acids as the indicator.

Microwave thermal processing is a promising technology to greatly improve product quality by achieving high-temperature short-time (HTST) processing for solid foods. And the non-thermal effect of microwave fields on nutritional quality is a major public concern. To distinguish the non-thermal effect of microwave fields, the thermal effect of HTST processing should be revealed first. The objective of this study was to investigate the effects of different HTST processing on quality of Pacific saury fillets using extracted fatty acids as the indicator. A self-developed thermal processing system was used to conduct the HTST processing with different heating rate (5.48-18.30°C/min), maximum heating temperature (123, 133 °C), and thermal processing level (F 0 = 3.0 min, 6.0 min). Results showed that the extraction coefficient of lipids and fatty acids decreased with increasing heating rates, which implied less thermal damage of fish tissue, while higher thermal processing level increased these extraction coefficients. However, higher maximum processing temperature caused serious thermal damage of fatty acids, especially for PUFAs. Furthermore, changing pattern of each fatty acid during different HTST processing was revealed, which provided fundamental data for designing microwave thermal processing and exploring microwave non-thermal effects.

High throughput-screening of native herbal compounds identifies taccaoside A as a cytotoxic compound that mediates RAS signaling in cancer stem cells.

BACKGROUND: Cancer stem cells (CSCs) are characterized by their ability to self-renew, to differentiate into multiple cell types and also drive tumor formation, altogether making them important cellular targets for therapeutic intervention. However, existing CSC-targeting drugs do not significantly improve clinical outcomes. More recently, preclinical studies of natural product-derived compounds have demonstrated their potential usefulness as a therapeutic cancer treatment through their cytotoxic actions on CSCs. PURPOSE: Here, we identify CSC-specific compounds derived from natural products and characterize their putative mechanisms of action in CSCs. METHODS: Glioblastoma stem cells (GSCs) were labeled with EGFP via homologous recombination and utilized for a high-throughput screen of 8,344 fractions from 386 herbal medicines. The fractions that extinguished EGFP fluorescence signal were then further characterized by LC-MS/MS. Next, several putative cytotoxic compounds were evaluated for their cytotoxic effects on GSCs, cancer cell lines and immortalized cells using a variety of methods to study cell proliferation (EdU incorporation assay), cell death (cleaved-Caspase-3 immunostaining), DNA damage (comet assay), mitochondrial membrane changes (JC-1 immunostaining), and tumor formation in vitro (soft agar colony forming assay). We also performed surface plasmon resonance analysis, western blotting, and immunohistochemistry to characterize the putative mechanisms underlying the cytotoxic effects of putative compounds on GSCs. Finally, we carried out xenograft tumor growth assays to study the cytotoxic potential of several candidates in vivo. RESULTS: Our high throughput screen led to the identification of the furostanol saponin taccaoside A and its two homologs from the rhizomatous geophyte Tacca. subflabellata that were cytotoxic to GSCs. Interestingly, the cytotoxic effect of taccaoside A on cell lines was significantly less compared to its homologs, owing to stereochemical differences of a carbon-carbon double bond between C-20 and C-22. Molecular studies revealed that taccaoside A binds to RAS to inhibit downstream effector signaling. Correspondingly, blockade of the interaction between taccaoside A and RAS abolished the inhibitory effect of this compound on CSCs. Furthermore, taccaoside A treatment was effective in limiting tumor cell growth in vivo. CONCLUSION: Our study yielded an effective approach to screen for CSC-specific agents. Through this approach, we identified taccaoside A from the rhizomatous geophyte Tacca. subflabellata are cytotoxic to CSCs through a molecular mechanism that involves RAS binding and suppression of its downstream signaling. Our findings indicate taccaoside A is a potential lead compound for anti-CSC drug discovery.

Polycationic Surfaces Promote Whole-Cell Immobilization and Induce Microgranulation of Clostridium saccharoperbutylacetonicum N1-4 for Enhanced Biobutanol Production.

Immobilization is a common strategy used to protect microbial cells to improve the performance of bioprocesses. However, the interaction mechanism between the cells and the immobilization material is generally poorly understood. In this study, we employed natural polysaccharide-based materials as immobilization carriers for clostridial fermentation in an attempt to enhance the production of butanol (a valuable biofuel/biochemical but highly toxic to the host cells) and meanwhile elucidate the interaction mechanisms related to immobilization. The utilization of chitosan powder as the immobilization carrier enhanced butanol productivity by 97% in the fermentation with Clostridium saccharoperbutylacetonicum N1-4 and improved butanol titer by 21% in the fermentation with Clostridium beijerinckii NCIMB 8052. Additionally, analogue derivatives using microcrystalline cellulose (MCC) and cotton cationized on the surface with 3-chloro-2-hydroxypropyltrymethylammonium (CHPTA) and 2-chloro-N,N-diethylaminoethyl chloride (DEAEC) were prepared and used as immobilization carriers for similar fermentation conditions. The CHPTA derivatives showed slightly increased production of butanol and total solvent with C. saccharoperbutylacetonicum. Overall, our results indicated that the interaction between the cell and the carrier material occurs through a double mechanism involving adsorption immobilization and induced aggregation. This work provides insights concerning the effects of the chemical properties of the carrier material (such as the cation density and surface area) on fermentation performance, enabling a better understanding of the interaction between bacterial cells and the cationic materials. The derivatization strategies employed in this study can be applied to most cellulosic materials to modulate the properties and enhance the interaction between the cell and the carrier material for immobilization, thus improving the bioprocess performance.

E Se tea alleviates acetaminophen-induced liver injury by activating the Nrf2 signaling pathway.

E Se tea is a traditional herbal tea used in the prevention of liver diseases. However, the hepatoprotective effect of E Se tea has not been investigated. This study aimed to determine the protective effect of E Se tea on acetaminophen (APAP)-induced acute liver injury and its potential mechanism. Hot water extracts and aqueous-ethanol extracts of E Se tea were obtained, which were analyzed to determine the chemical constituents of the tea. Phlorizin and phloretin were found to be the dominant chemical compounds. Histopathological analysis showed that E Se tea extract inhibited APAP-induced inflammatory infiltration, necrosis, and cellular vacuolization of hepatocytes in the liver tissue. The E Se tea extract could significantly ameliorate liver injury, inhibit an inflammatory response, and reduce oxidative stress. Western blot analysis revealed that E Se tea extract upregulated the expressions of nuclear Nrf2, HO-1 and NQO1 proteins and downregulated the expressions of cytoplasmic Nrf2 and Keap1 proteins in the hepatocyte. qPCR results showed that E Se tea extract also increased the expression of antioxidant genes (SOD2, Gpx1, GCLC and GCLM). These findings exhibited that E Se tea, enriched in dihydrochalcones, can be used to effectively prevent and manage liver dysfunction.

MiR-146a-5p, targeting ErbB4, promotes 3T3-L1 preadipocyte differentiation through the ERK1/2/PPAR-γ signaling pathway.

BACKGROUND: MicroRNAs (MiRNAs) are known to participate in preadipocyte differentiation, but the manner in which miR-146a-5p participates in this process remains unclear. This study was performed to examine the participation of miR-146a-5p in 3T3-L1 cell differentiation. MATERIAL AND METHODS: miR-146a-5p expression was upregulated and down-regulated to examine effects on 3T3-L1 cell differentiation. Bioinformatics analysis was performed to predict its target genes, and the signaling pathway it regulates was identified by qRT-PCR and Western blotting. The expression of miR-146a-5p in epididymal adipose tissue from obese mice and in an obese mouse adipose cell model was examined by qRT-PCR. RESULTS: 3T3-L1 cells differentiated into mature adipocytes successfully, as verified by increased areas of intracellular lipid droplets and elevated expression of mature adipocyte markers, and these cells had elevated miR-146a-5p expression. The intracellular lipid droplet and triglyceride contents and the expression of mature adipocyte markers were significantly increased in miR-146a-5p-overexpressing 3T3-L1 cells and markedly decreased in miR-146a-5p-inhibited 3T3-L1 cells. ErbB4 was a predicted target gene of miR-146a-5p. In miR-146a-5p-overexpressing 3T3-L1 cells, ErbB4 expression and ERK1/2 phosphorylation were decreased and the expression of PPAR-γ was increased; the opposite was observed in miR-146a-5p-inhibited 3T3-L1 cells. In addition, miR-146a-5p expression was significantly increased in the mouse epididymal adipose tissue and adipose cell model. CONCLUSIONS: Upregulated miR-146a-5p expression was related to 3T3-L1 cell differentiation. MiR-146a-5p promoted 3T3-L1 cell differentiation by targeting ErbB4 and via the ERK1/2/PPAR-γ signaling pathway.

Ethanolic Extract from Pteris wallichiana Alleviates DSS-Induced Intestinal Inflammation and Intestinal Barrier Dysfunction by Inhibiting the TLR4/NF-κB Pathway and Regulating Tight Junction Proteins.

The aim of the research was to determine the protective effect and mechanism of Pteris wallichiana J. Agardh extract (PWE) on DSS-induced ulcerative colitis (UC) in mice. In this research, PWE is rich in flavonoids and diterpenoids by UPLC-MS/MS analysis. In LPS-induced RAW264.7 cells, PWE reduced the productions of inflammatory factors (i.e., NO, TNF-α, IL-6, and IL-1ß). In DSS-induced UC in mice, PWE improved disease activity index (DAI) score, attenuated oxidative stress by decreasing MPO and MDA activities and activating GSH and SOD levels, and inhibited TNF-α, IL-6, and IL-1ß expressions in the colonic tissues. PWE also improved the intestinal barrier by upregulating the expressions of tight junction proteins, including occludin and ZO-1. Moreover, PWE extract alleviated intestinal inflammation by suppressing the TLR4/MyD88/NF-κB signaling pathway. Conclusion: PWE can alleviate DSS-induced UC in mice by increasing the expressions of intestinal tight junction proteins and inhibiting the TLR4/NF-κB inflammatory pathway.

6'-O-Caffeoylarbutin from Que Zui tea ameliorates acetaminophen-induced liver injury via enhancing antioxidant ability and regulating the PI3K signaling pathway.

Que Zui tea (QT), a traditional herbal tea in China, has a significant hepatoprotective effect. 6'-O-Caffeoylarbutin (CA) is the most abundant chemical compound in the QT. However, the hepatoprotective effect of CA has not been investigated. This study is aimed to evaluate the protective effect of CA on acetaminophen (APAP) induced hepatotoxicity in vivo and in vitro and its possible underlying mechanism. In APAP-induced HepG-2 cells, CA inhibited intracellular ROS accumulation and cell apoptosis, and improved the expression of antioxidants including SOD, CAT and GSH. In APAP-administrated mice, CA pretreatment remarkably ameliorated the histopathological damage and inflammatory response, and antioxidant enzyme activity in the serum and liver tissues. Moreover, the immunohistochemistry and immunofluorescence assay results revealed that the CA markedly reduced ROS production and apoptosis, and activated antioxidant transcription factor Nrf2 in the liver. Meanwhile, molecular docking results showed that the strong binding force of CA and PI3K was due to the higher number of hydrogen- and π-bonds with active site residues. Notably, CA pretreatment significantly regulated the expression of PI3K, Akt, Nrf2, NQO1, HO-1, Bcl-2, Bax, caspase-3, and caspase-9 proteins in APAP-treated liver tissues. These data demonstrated that CA had a protective effect against APAP-induced hepatotoxicity via regulating the PI3K/Akt and Nrf2 signaling pathway.

Patient-physician communication in the emergency department in Taiwan: physicians' perspectives.

BACKGROUND: Effective patient-physician communication promotes trust and understanding between physicians and patients and reduces medical disputes. In this study, the Roter Interaction Analysis System was used to explore physician-patient communication behaviors in the emergency departments of Taiwanese hospitals. METHOD: Data was collected from the dialogues between 8 emergency physicians and 54 patients through nonparticipant observation, and 675 pieces of data were quantitatively and qualitatively analyzed. RESULTS: The results showed that: 1. Emergency physicians' communication behaviors are task-focused. They usually ask closed-ended questions to collect data to identify the symptoms quickly and provide medical treatment. 2. Socioemotion-oriented physician-patient communication behaviors are less common in the emergency department and only serve as an aid for health education and follow-up. Due to time constraints, it is difficult to establish relationships with patients and evoke their positivity. CONCLUSIONS: It is suggested that future education programs on physician-patient communication in the emergency department should focus on strengthening physicians' ability to communicate with patients in a more open way. They should adopt socioemotional-oriented communication skills, expressing respect and kindness, and allowing patients to briefly describe their symptoms and participate in the treatment process to achieve physician-patient consensus.