Andrographolide and its derivatives are effective compounds for gastrointestinal protection: a review.

OBJECTIVE: Andrographolide and its derivatives have many functions, such as anti-infection, anti-tumor, neuroprotection, and immune regulation. However, the gastrointestinal protective effects, especially gastrointestinal tumors, and inflammation-related diseases of andrographolide and its derivatives have not been well summarized and discussed. In this review, we aimed to summarize and discuss the pharmacological effects and underlying mechanisms of andrographolide and its derivatives in gastrointestinal protection, with a view to revealing more possibilities of andrographolide and its derivatives in gastrointestinal diseases prevention therapy. MATERIALS AND METHODS: The data in this review are searched and selected from PubMed with the keywords: Andrographolide and Andrographolide derivatives, and relevant data with gastrointestinal protection are extracted and discussed. RESULTS: Andrographolide and its derivatives have prophylactic and therapeutic effects in gastrointestinal disorders such as GU, gastric cancer, colorectal cancer, and inflammatory bowel disease. CONCLUSIONS: Andrographolide and its derivatives are effective compounds for gastrointestinal protection.

Efficacy of repetitive transcranial magnetic stimulation for post-stroke depression: a systematic review and meta-analysis of randomized clinical trials.

We aimed to conduct a meta-analysis to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with post-stroke depression (PSD). Six relevant electronic databases (PubMed, CENTRAL, Embase, Web of Science, CINAHL, and PsycINFO) were searched. Randomized controlled trials (RCTs) that compared rTMS with control condition for PSD were included. The mean change in depression symptom scores was defined as the primary efficacy outcome. Secondary outcomes included the remission rate of depression, stroke recovery, and cognitive function recovery. In total, 7 RCTs with 351 participants were included. At post-treatment, rTMS was significantly more effective than the control condition, with a standardized mean difference (SMD) of -1.15 (95%CI: -1.62 to -0.69; P<0.001, I2=71%) and remission with an odds ratio (OR) of 3.46 (95%CI: 1.68 to 7.12; P<0.001; I2=11%). As for stroke recovery, rTMS was also better than the control condition (SMD=-0.67, 95%CI: -1.02 to -0.32; P<0.001). However, no significant difference was found for cognitive function recovery between the two groups (SMD=4.07, 95%CI: -1.41 to 9.55; P=0.15). To explore the potential moderators for the primary outcome, a series of subgroup and sensitivity analyses were performed. The results implied that rTMS may be more effective in Asian samples than in North American samples (P=0.03). In conclusion, from the current evidence in this study, rTMS could be an effective treatment for patients with PSD. Further clinical studies with larger sample sizes and clearer subgroup definitions are needed to confirm these outcomes.

Efficacy of repetitive transcranial magnetic stimulation for post-stroke depression: a systematic review and meta-analysis of randomized clinical trials

We aimed to conduct a meta-analysis to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with post-stroke depression (PSD). Six relevant electronic databases (PubMed, CENTRAL, Embase, Web of Science, CINAHL, and PsycINFO) were searched. Randomized controlled trials (RCTs) that compared rTMS with control condition for PSD were included. The mean change in depression symptom scores was defined as the primary efficacy outcome. Secondary outcomes included the remission rate of depression, stroke recovery, and cognitive function recovery. In total, 7 RCTs with 351 participants were included. At post-treatment, rTMS was significantly more effective than the control condition, with a standardized mean difference (SMD) of -1.15 (95%CI: -1.62 to -0.69; P<0.001, I2=71%) and remission with an odds ratio (OR) of 3.46 (95%CI: 1.68 to 7.12; P<0.001; I2=11%). As for stroke recovery, rTMS was also better than the control condition (SMD=-0.67, 95%CI: -1.02 to -0.32; P<0.001). However, no significant difference was found for cognitive function recovery between the two groups (SMD=4.07, 95%CI: -1.41 to 9.55; P=0.15). To explore the potential moderators for the primary outcome, a series of subgroup and sensitivity analyses were performed. The results implied that rTMS may be more effective in Asian samples than in North American samples (P=0.03). In conclusion, from the current evidence in this study, rTMS could be an effective treatment for patients with PSD. Further clinical studies with larger sample sizes and clearer subgroup definitions are needed to confirm these outcomes.

Containing COVID-19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases.

OBJECTIVES: Patients with COVID-19 may present with respiratory syndromes indistinguishable from common viruses. This poses a challenge for early detection during triage in the emergency department (ED). Over a 3-month period, our ED aimed to minimize nosocomial transmission by using broader suspect case criteria for better detection and using appropriate personal protective equipment (PPE) for health care workers (HCWs). METHODS: All ED admissions with respiratory syndromes over a 3-month period were tested for COVID-19. The sensitivity and specificity of screening criteria in detecting COVID-19 were assessed. A risk-stratified approach was adopted for PPE usage in the ED, based on high-risk "fever areas" and lower-risk zones. When a case of COVID-19 was confirmed, surveillance was conducted for potentially exposed patients and HCWs. RESULTS: A total of 1,841 cases presenting with respiratory syndromes required admission over the study period. Among these, 70 cases of COVID-19 were subsequently confirmed. The majority (84.2%, 59/70) were detected at ED triage because they fulfilled suspect case criteria. Of these, 34 met the official screening criteria; an additional 25 were detected by the broader internal screening criteria. Over the 12-week period, the cumulative sensitivity of internal screening criteria was 84.3% (95% confidence interval [CI] = 73.6% to 91.9%), whereas the sensitivity of the official screening criteria was 48.6% (95% CI = 36.4% to 60.8%). Given the broadened internal criteria, the preexisting ED "fever area" was insufficient and had to be expanded. However, there were no cases of nosocomial transmission from intra-ED exposure, despite extensive surveillance. CONCLUSION: Frontline physicians need to be given leeway to decide on the disposition of cases based on clinical suspicion during an ongoing outbreak of COVID-19. If a broader criterion is used at ED triage, ED facilities and isolation facilities need to be readied to accommodate a surge of suspect cases. Usage of appropriate PPE is essential in minimizing nosocomial transmission.

Observation of dark-bright vector solitons in fiber lasers.

We report the experimental observation of coherently coupled dark-bright vector solitons in single mode fiber lasers with either normal or anomalous cavity dispersion. The properties of these vector solitons were found to agree well with theoretical predictions based on the coherently coupled nonlinear Schrödinger equations. The experimental results clearly confirmed the existence of a fundamentally new form of optical solitons in coupled nonlinear systems.

[Gynecological acute abdomen in patients age under 18: an analysis of 237 cases].

Objective: To investigate the constituent ratio, clinical manifestation, diagnosis and treatment of gynecologic acute abdomen in patients age under 18. Methods: A retrospective study was conducted on 237 patients under 18 years old who had been admitted in Rizhao People's Hospital from June 2013 to November 2016. The patients were divided into two groups: groupⅠ (under ten years old, 49 cases) and group Ⅱ (ten to eighteen years old, 188 cases) . The first visit departments, constituent ratio, clinical manifestations and treatment methods of the two groups were summarized and analyzed. Results: The proportion of first visit department was gynecology department in the group Ⅰwas lower than that in group Ⅱ [18.4% (9/49) versus 69.1% (130/188) , P<0.01]. The proportion of diseases in the two groups was different; the proportion of ovarian tumors (59.2%, 29/49) , genital malformations (10.2%, 5/49) and ovarian torsions (10.2%, 5/49) in group Ⅰ were significantly higher than those in group Ⅱ, while the pregnancy related diseases in group Ⅱ (37.2%, 70/188) was significantly higher than that in group Ⅰ (P<0.01) . Conclusions: Clinicians should pay enough attention to the acute abdomen caused by gynecological factors in childhood and adolescence. The differential diagnosis of acute abdomen should pay attention to. In the choice of treatment methods, we should give full consideration to the special age, and try to maintain their normal growth and physiological function.

Ex vivo expansion of antigen-specific CD4+CD25+ regulatory T cells from autologous naïve CD4+ T cells of multiple sclerosis patients as a potential therapeutic approach.

OBJECTIVE: CD4+CD25+ regulatory T cells (Tregs) have been found to have a decreased effector function in patients with multiple sclerosis (MS). In this study, we co-cultured naïve CD4+ T cells of MS patients with myelin basic protein (MBP)85-99 peptide as specific antigen and allogenic B cells as antigen-presenting cells, in an attempt to generate adequate antigen-specific CD4+CD25+ Tregs with normal or improved immune function. PATIENTS AND METHODS: Naïve CD4+ T cells were isolated from peripheral blood mononuclear cells (PBMCs) from patients with MS (n=5) and healthy controls (HC, n=5). Furthermore, these purified naive CD4+ T cells were co-cultured with the CD40-activated B cells and MBP85-99 peptide to induce MBP-reactive CD4+CD25highCD127low Tregs. After harvesting these Tregs via a flow sorter, real-time PCR and mixed lymphocyte reaction (MLR) assay were performed to characterize cellular immune function. Supernatant interleukin (IL)-10 and transforming growth factor (TGF)-ß1 protein levels were detected by an enzyme-linked immunosorbent assay (ELISA). RESULTS: With this method, the frequency of CD4+CD25highCD127low Tregs in CD4+ T cells was 3.5%-6%. In both MS and HC groups, there were relatively lower proliferation indices (PI) of MLR assay but higher supernatant IL-10 and TGF-ß1 levels in the presence of MBP than those in the presence of other control antigens, where no significant differences were found. CONCLUSIONS: Via the ex vivo culture, adequate MBP-reactive CD4+CD25+ Tregsderived from autologous naïve CD4+ T cells of MS patients, were obtained and returned to normal without immune defects, and even upregulated their immunosuppressive function mostly through the elevated release of IL-10 and TGF-ß1.

Elevated plasma levels and monocyte-associated expression of CD137 ligand in patients with acute atherothrombotic stroke.

BACKGROUND: CD137 ligand (CD137L) is expressed by various immune cells and exists in membrane-bound and soluble forms. Recently, CD137L was found to be localized to macrophages in human atherosclerotic lesions and CD137L levels were much higher in atherosclerotic lesions than in normal arteries. However, the role of CD137L with different forms in atherothrombotic stroke remains unclear. PATIENTS AND METHODS: The soluble CD137L (sCD137L) protein and CD137L expression on monocytes were analyzed by an enzyme-linked immunosorbent assay and flow cytometry in peripheral blood of patients with acute ischemic atherosclerotic stroke, atherosclerosis controls and normal controls. RESULTS: During the initial 24h after onset, the stroke patients had elevated plasma sCD137L levels (133.2 pg/ml) and CD137L expression on monocytes [7.9 ± 4.1%, 7.0 ± 4.0 mean fluorescence intensity (MFI)] as compared with normal controls (75 pg/ml, p < 0.05; 4.6 ± 2.4%, 4.1 ± 2.7 MFI, p < 0.05). CONCLUSIONS: The dysregulation of CD137L expression may reflect a persistent chronic inflammatory response that may have been induced during early stages of the disease. Our results strongly suggest that the abnormal expression of CD137L on monocytes may lead to dyregulated CD137L/CD137 signaling and consequently form part of a positive-feedback, inflammation-promoting circuit in stroke, while the elevated sCD137L protein levels may function as a self-regulatory mechanism of CD137/CD137L interaction and costimulation.

One-year follow-up study of post-traumatic stress disorder among adolescents following the Wen-Chuan earthquake in China.

Post-traumatic stress disorder (PTSD) is the most common psychological disorder among victims of natural disasters. PTSD prevalence and risk factors among adolescents remain unidentified among victims of the Wen-Chuan earthquake. This study screened survivors to determine the prevalence of PTSD and examined risk factors for PTSD among adolescents at three Wen-Chuan secondary schools. PTSD screening was done using the PTSD Checklist-Civilian version (PCL-C). A generalized estimating equation approach was used to control for repeated measurements in the same individuals and to predict risk factors for PTSD. The study included 1,474 students in grades 7, 8, 10 and 11 from three Wen-Chuan secondary schools at 4, 6, 9, and 12 months after the earthquake. The average age of students was 15.0 (13.0, 16.0) both at the first and the second time point, and 16.0 (14.0, 17.0) at the third and the fourth time point. The screened prevalence of PTSD was 11.2%, 8.8%, 6.8% and 5.7% at 4, 6, 9, and 12 months after the earthquake, respectively. Risk factors for PTSD were: time duration, school location (the proximity of epicenter), grade, nationality, parent injury, and severe property damage. In conclusion, PTSD risk factors are in accordance with previous studies; however, the role of nationality and time duration in post-traumatic stress disorder merits further research.

Periodic ZnO nanorod arrays defined by polystyrene microsphere self-assembled monolayers.

We demonstrate a low-cost and effective method to fabricate hexagonally patterned, vertically aligned ZnO nanorod arrays. Selective wet-etching is used to develop the catalyzing gold particle hexagonal pattern with the aid of a polystyrene microsphere self-assembled monolayer. The gold particles have tunable sizes independent of the polystyrene microsphere's diameter and are inherently round in shape. Each ZnO rod is grown individually from a catalyzing site via catalyst-initiated epitaxy, and the original hexagonal periodicity is well-preserved. The rods have flat ends, and the diameters of the rods can be controlled well by the amount of source materials. This method provides a promising way to create ZnO one-dimensional nanostructures for applications as two-dimensional photonic crystal, sensor arrays, nanolaser arrays, and optoelectronic devices.