Lactate facilitated mitochondrial fission-derived ROS to promote pulmonary fibrosis via ERK/DRP-1 signaling.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung diseases, which mainly existed in middle-aged and elderly people. The accumulation of reactive oxygen species (ROS) is a common characteristic of IPF. Previous research also shown that lactate levels can be abnormally elevated in IPF patients. Emerging evidence suggested a relationship between lactate and ROS in IPF which needs further elucidation. In this article, we utilized a mouse model of BLM-induced pulmonary fibrosis to detect alterations in ROS levels and other indicators associated with fibrosis. Lactate could induce mitochondrial fragmentation by modulating expression and activity of DRP1 and ERK. Moreover, Increased ROS promoted P65 translocation into nucleus, leading to expression of lung fibrotic markers. Finally, Ulixertinib, Mdivi-1 and Mito-TEMPO, which were inhibitor activity of ERK, DRP1 and mtROS, respectively, could effectively prevented mitochondrial damage and production of ROS and eventually alleviate pulmonary fibrosis. Taken together, these findings suggested that lactate could promote lung fibrosis by increasing mitochondrial fission-derived ROS via ERK/DRP1 signaling, which may provide novel therapeutic solutions for IPF.

The Relationship between Socioeconomic Status and Academic Achievement is Mediated and Moderated by Executive Functions.

Executive function is an underlying mechanism linking family socioeconomic status (SES) and academic achievement. Previous studies mainly investigated either the mediating or moderating role of executive function within this relationship, which either overlook the individual differences that are independent of the environment or neglect the influence of the environment on shaping personal factors. To avoid a piecemeal approach to theory, the current study aimed to test the mediating and moderating roles of executive function in a single analytic model. Two hundred and thirty-six Chinese fifth graders (Mage = 10.70 years, SD = 0.49, range = 10.23-11.75 years, and 40.30% girls) were recruited. Their executive function performance was measured using eight different tasks, and their Chinese literacy skills and mathematics achievement were assessed by routine school evaluations. One year after the initial assessment, children's academic achievements were evaluated again. Results demonstrated that parental SES positively predicted children's academic achievement when controlling for prior academic achievement, and children's executive function mediated this relationship. Also, executive function moderated the association between SES and academic achievement in that, the negative predictive effect of low SES on academic achievement was only significant for children with lower levels of executive function, which is not shown in children with higher levels of executive function. By demonstrating the dual roles of executive function in the SES-achievement link, this work provides evidence for supporting the optimal development of children from diverse socioeconomic backgrounds and emphasizes the significance of developing individualized intervention strategies on executive function to mitigate the negative effect of low SES on children's academic achievement.

Choline metabolism in regulating inflammatory bowel disease-linked anxiety disorders: A multi-omics exploration of the gut-brain axis.

Anxiety and depression caused by inflammatory bowel disease (IBD) negatively affect the mental health of patients. Emerging studies have demonstrated that the gut-brain axis (GBA) mediates IBD-induced mood disorders, but the underlying mechanisms of these findings remain unknown. Therefore, it's vital to conduct comprehensive research on the GBA in IBD. Multi-omics studies can provide an understanding of the pathological mechanisms of the GBA in the development of IBD, helping to uncover the mechanisms underlying the onset and progression of the disease. Thus, we analyzed the prefrontal cortex (PFC) of Dextran Sulfate Sodium Salt (DSS)-induced IBD mice using transcriptomics and metabolomics. We observed increased mRNA related to acetylcholine synthesis and secretion, along with decreased phosphatidylcholine (PC) levels in the PFC of DSS group compared to the control group. Fecal metagenomics also revealed abnormalities in the microbiome and lipid metabolism in the DSS group. Since both acetylcholine and PC are choline metabolites, we posited that the DSS group may experience choline deficiency and choline metabolism disorders. Subsequently, when we supplemented CDP-choline, IBD mice exhibited improvements, including decreased anxiety-like behaviors, reduced PC degradation, and increased acetylcholine synthesis in the PFC. In addition, administration of CDP-choline can restore imbalances in the gut microbiome and disruptions in lipid metabolism caused by DSS treatment. This study provides compelling evidence to suggest that choline metabolism plays a crucial role in the development and treatment of mood disorders in IBD. Choline and its metabolites appear to have a significant role in maintaining the stability of the GBA.

Research on the elimination of low-concentration formaldehyde by Ag loaded onto Mn/CeO2 catalyst at room temperature.

Formaldehyde (HCHO) is one of the major air pollutants, and its effective removal at room temperature has proven to be a great challenge. In this study, an Ag/Mn/CeO2 catalyst for the catalytic oxidation of low-concentration HCHO at room temperature was prepared by a hydrothermal-calcination method. The removal performance of the Ag/Mn/CeO2 catalyst for HCHO was systematically studied, and its surface chemical properties and microstructure were analyzed. The incorporation of Ag did not change the mesoporous structure of the Mn/CeO2 catalyst but reduced the pore size and specific surface area. The Ag species included metallic Ag as the main component and part of Ag+. The well-dispersed Ag species on the catalyst provided sufficient active sites for the catalytic oxidation of HCHO. The more the Ag active sites, the more the lattice defects and oxygen vacancies generated from the interaction of Ag with Mn/CeO2. Precisely because of this, the Ag/Mn/CeO2 catalyst exhibited high catalytic activity for HCHO at room temperature with a removal efficiency of 96.76% within 22 h, which is 22.91% higher than that of the Mn/CeO2 catalyst. Moreover, the Ag/Mn/CeO2 catalyst showed good cycling stability and the removal efficiency reached 85.77% after five cycles. Therefore, the as-prepared catalyst is an effective and sustainable material that can be used to remove HCHO from actual indoor polluted air. This paper provides ideas for the research and development of efficient catalysts.

Computationally-driven epitope identification of PEDV N-protein and its application in development of immunoassay for PEDV detection.

The nucleocapsid (N) protein is a suitable candidate for early diagnosis of porcine epidemic diarrhea virus (PEDV). Here, we identified the linear B-cell epitopes of the PEDV N-protein by integrating a computational-experimental framework and constructed three-dimensional (3D) structure model of the N protein using the ColabFold program in Google Colaboratory. Furthermore, we prepared the monoclonal antibodies against the predicted epitopes and recombinant N protein, respectively, and selected pairing mAbs (named 9C4 and 3C5) to develop a double-antibody sandwich immunochromatographic test strip using CdSe/ZnS quantum dots (QDs)-labelled 9C4 and 3C5 as capture and detection antibodies, respectively. This strip can specifically detect PEDV within 10 min with a detection limit of less than 6.25 × 103 TCID50/mL. In comparison with RT-PCR for testing 90 clinical samples, the relative sensitivity and specificity of the strip were found to be 98.0% and 100%, respectively, with a concordance rate of 98.9% and a kappa value of 0.978, indicating that QDs-ICTS is a reliable method for the application of PEDV detection in clinical samples.

Plumbagin induces apoptosis, cell cycle arrest, and inhibits protein synthesis in LoVo colon cancer cells: A proteomic analysis.

Extracted from the roots of Plumbago zeylanica L., plumbagin is a natural naphthoquinone with potential as an anticancer compound. However, no studies have investigated its impact on LoVo (colon cancer) cells, and the specific mechanisms by which plumbagin exerts its anticancer effects remain to be established. The anticancer potential of plumbagin against LoVo cells was evaluated using a battery of assays, including MTT assay, clone formation assay, transwell chamber invasion assay, and wound-curing assay. Cell cycle analysis and cell apoptosis analysis were conducted to break down the anticancer impact of plumbagin on LoVo cells. A label-free proteomics technology was employed to investigate alterations in protein expression in LoVo cells treated with plumbagin. Our investigation indicated that plumbagin markedly inhibited the LoVo cells proliferation, and induced the apoptosis in LoVo cells, simultaneously induced G0/G1 phase cell cycle arrest. The LC-MS/MS proteomics assay revealed 78 proteins that were differentially expressed upon treatment with plumbagin. Bioinformatics and functional analyses indicated that these proteins were predominantly involved in protein synthesis and translation. Our findings revealed that multiple mechanisms are involved in the anticancer activity of plumbagin against LoVo cells, resulting in decreased cell viability. Proteomic analysis suggests that plumbagin may impede protein synthesis by reducing the expression of eukaryotic initiation factors. Our findings demonstrate that plumbagin exerts its anticancer activity against LoVo cells through multiple mechanisms, including inhibition of cell proliferation, induction of apoptosis, cell cycle arrest, and disruption of protein synthesis. These results provide new insights into the therapeutic potential of plumbagin for colon cancer treatment.

Mapping metabolite change in the mouse brain after esketamine injection by ambient mass spectrometry imaging and metabolomics.

Ketamine is a new, fast, and effective antidepression treatment method; however, the possible dissociation effects, sensory changes, abuse risk, and the inability to accurately identify whether patients have a significant response to ketamine limit its clinical use. Further exploration of the antidepressant mechanisms of ketamine will contribute to its safe and practical application. Metabolites, the products of upstream gene expression and protein regulatory networks, play an essential role in various physiological and pathophysiological processes. In traditional metabonomics it is difficult to achieve the spatial localization of metabolites, which limits the further analysis of brain metabonomics by researchers. Here, we used a metabolic network mapping method called ambient air flow-assisted desorption electrospray ionization (AFADESI)-mass spectrometry imaging (MSI). We found the main changes in glycerophospholipid metabolism around the brain and sphingolipid metabolism changed mainly in the globus pallidus, which showed the most significant metabolite change after esketamine injection. The spatial distribution of metabolic changes was evaluated in the whole brain, and the potential mechanism of esketamine's antidepressant effect was explored in this research.

(In)congruence in child-mother relationships and depressive symptoms in cross-boundary families.

A large number of school-aged children traveling between Mainland China and Hong Kong every day to attend school are known as cross-boundary students (). Daily cross-boundary schooling is likely to be a constant challenge for cross-boundary students and their families, putting them at great risk of mental health problems (e.g., depression). Nevertheless, intergenerational relationships may be positive contributors to their adaptation. Guided by the interdependence theory and the operations triad model, this study employed dyadic response surface analysis to take into account linear and curvilinear associations between child-mother relationships and their depressive symptoms. The cross-sectional results based on 187 child-mother dyads showed that when children and mothers reported relatively high levels of closeness and relatively low levels of conflict, they reported fewer depressive symptoms. The extreme closeness between children and their mothers posed particular risks to mothers, increasing maternal depressive symptoms. When children and mothers reported varying levels of closeness and conflict, they displayed greater depressive symptoms. One exception was that no significant association was observed between incongruence in closeness and children's depressive symptoms. Family-based interventions should be considered for promoting optimal child-mother combinations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of working memory updating and capacity in children's mathematical abilities: A developmental cascade model.

BACKGROUND: Previous studies indicated that working memory (WM) updating and WM capacity play essential roles in mathematical ability. However, it is unclear whether WM capacity mediates the effect of WM updating on mathematics, and whether the cascading effects vary with different mathematical domains. AIMS: The current study aims to explore the longitudinal mediating role of WM capacity between WM updating and mathematical performance, and how the relations change with the age and domains. SAMPLE: A total of 131 Chinese first-graders participated the study. METHODS: Participants were required to complete tasks on WM updating and WM capacity in Grade 1 and Grade 2, as well as paper-and-pencil tests on mathematics achievement in Grade 3. The role of WM updating and capacity in the development of pupil's mathematical achievement was examined. RESULTS: Results revealed that verbal WM updating in Grade 1 predicted basic arithmetic and logical-visuospatial ability in Grade 3 via its cascading effect on verbal WM capacity in Grade 2. Moreover, visuospatial WM updating in Grade 1 predicted visuospatial WM capacity in Grade 2. Visuospatial WM capacity in Grade 1 predicted logical-visuospatial ability in Grade 3 instead of basic arithmetic ability in Grade 3. CONCLUSIONS: The findings suggested that WM updating exerts effect on pupil's mathematical performance via WM capacity, meanwhile, this effect depends on children's mathematics domain.

Establishment of a modified Kyoto classification scoring model and its significance in the diagnosis of Helicobacter pylori current infection.

BACKGROUND AND AIMS: We aimed to establish a modified model of the Kyoto classification score and verify its accuracy for predicting Helicobacter pylori (HP) infection during endoscopy. METHODS: Patients who underwent gastroscopy from June 2020 to March 2021 were included in this study. Atrophy, intestinal metaplasia, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, spotty redness, xanthoma, map-like redness, fundic gland polyp, and regular arrangement of collecting venules (RAC) were recorded according to the Kyoto classification of gastritis. The HP infection status of participants was determined by a 13C breath test, anti-HP antibody, and histopathologic hematoxylin and eosin staining. The modified Kyoto classification scoring model was established based on univariate analysis and logistic regression analysis. The modified scoring model was used to judge the status of HP infection in patients undergoing gastroscopy from July to September 2021 and to evaluate the accuracy of the prediction. RESULTS: Of 667 participants in the derivation dataset, 326 cases had HP infection and 341 cases did not. Atrophy, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, and spotty redness were associated with HP current infection. Thus, a new scoring model, termed the modified Kyoto classification scoring model, was constructed that included atrophy, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, spotty redness, fundic gland polyp, and RAC as indicators. To test the model, 808 subjects, including 251 HP-positive patients, comprised the validation dataset. CONCLUSIONS: The modified Kyoto classification scoring model improved the accuracy of endoscopic determination of HP current infection and has clinical application potential in the Chinese population.

Bifico relieves irritable bowel syndrome by regulating gut microbiota dysbiosis and inflammatory cytokines.

PURPOSE: Gut microbiota dysbiosis, a core pathophysiology of irritable bowel syndrome (IBS), is closely related to immunological and metabolic functions. Gut microbiota-based therapeutics have been recently explored in several studies. Bifico is a probiotic cocktail widely used in gastrointestinal disorders which relate to the imbalance of gut microbiota. However, the efficacy and potential mechanisms of Bifico treatment in IBS remains incompletely understood. METHODS: Adopting a wrap restraint stress (WRS) -induced IBS mice model. Protective effect of Bifico in IBS mice was examined through abdominal withdrawal reflex (AWR) scores. 16S rDNA, 1H nuclear magnetic resonance (1H-NMR) and western blot assays were performed to analyze alterations of gut microbiota, microbiome metabolites and inflammatory cytokines, respectively. RESULTS: Bifico could decrease intestinal visceral hypersensitivity. Although gut microbiota diversity did not increase, composition of gut microbiota was changed after treatment of Bifico, which were characterized by an increase of Proteobacteria phylum and Actinobacteria phylum, Muribaculum genus, Bifidobacterium genus and a decrease of Parabacteroides genus, Sutterella genus and Lactobacillus genus. Moreover, Bifico elevated the concentration of short-chain fatty acids (SCFAs) and reduced protein levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). From further Spearman's correlation analysis, Bifidobacterium genus were positively correlated with SCFAs including propionate, butyrate, valerate and negatively correlated with IL-6 and TNF-α. CONCLUSION: Bifico could alleviate symptoms of IBS mice through regulation of the gut microbiota, elevating production of SCFAs and reducing the colonic inflammatory response.

Active and avoidant coping profiles in children and their relationship with anxiety and depression during the COVID-19 pandemic.

Active and avoidant coping styles are important dispositional factors in the development of anxiety and depression symptoms. Children use both active and avoidant coping strategies together in daily life. No studies have investigated the relationship between active-avoidant coping profiles and internalizing symptoms in children. The present study aimed to investigate children's active-avoidant coping profiles and assess the relationship that active-avoidant coping profiles have with anxiety and depression symptoms. A two-wave longitudinal study was conducted among 322 Chinese children in the People's Republic of China during the COVID-19 pandemic. Participants completed the Children's Coping Strategies Checklist-Revised 1 at Time 1 and the Revised Child Anxiety and Depression Scale at Time 1 and 6 months later (Time 2). Four active-avoidant coping profiles were revealed: low active copers, high active copers, balanced copers, and avoidant copers. Low and high active copers had lower levels of anxiety and depression symptoms than balanced copers and avoidant copers. Avoidant copers showed a larger decrease in depression symptoms than balanced copers and high active copers during the COVID-19 pandemic. It is important to improve children's active-avoidant coping profiles to relieve anxiety and depression symptoms.

Curcumin Alleviates DSS-Induced Anxiety-Like Behaviors via the Microbial-Brain-Gut Axis.

The anxiety and depression caused by inflammatory bowel diseases (IBD) are known to greatly affect the mental health of patients. The mechanism of psychiatric disorders caused by IBD is not fully understood. Previous research has suggested that the gut microbiome plays a key role in IBD. Curcumin is a yellow polyphenol extracted from the rhizome of the ginger plant, which has been shown to have effects against both depression and anxiety. Research has indicated that curcumin affects the gut microbiome and exerts antianxiety and neuroprotective effects through the microbiota-gut-brain axis (MGB). However, whether curcumin can alleviate the psychiatric disorders caused by IBD and how curcumin affects the MGB axis through the gut microbiota have not been fully understood. Therefore, this study was aimed at determining the metabolic parameters and microbiological environment in the peripheral and central nervous system to determine the effects of curcumin against anxiety induced by dextran sulfate sodium salt (DSS) in mice. To elaborate on the link between the gut microbiota and how curcumin alleviates anxiety-like behaviors, we performed a fecal microbiota transplantation (FMT) experiment. The results suggested that curcumin can effectively relieve anxiety-like behaviors caused by DSS in mice. Further, curcumin treatment can alleviate disturbances in the gut microbiota and systemic disorders of lipid metabolism caused by DSS. Finally, through FMT, we verified that curcumin increased phosphatidylcholine in the prefrontal cortex of the mice and alleviated DSS-induced anxiety-like behaviors by modulating specific gut microbiota. We also revealed that Muribaculaceae may be a key part of the gut microbiota for curcumin to alleviate DSS-induced anxiety-like behaviors through the MGB axis.

Whether verbal and visuospatial working memory play different roles in pupil's mathematical abilities.

BACKGROUND: Previous research showed a significant association between mathematics and working memory (WM). However, evidence regarding the different effects of verbal and visuospatial WM on mathematical abilities was very limited. AIMS: The current research aims to explore the relationship between verbal and visuospatial WM with mathematical abilities, and how this relationship is moderated by age and math domains. We also wonder whether the results would change when we use several tests for each component and use a latent variable approach for more reliable measurement. SAMPLE: 131 first graders and 144 fifth graders from a primary school in Hangzhou, Zhejiang province, China, participated our research. METHODS: All participants completed three verbal and three visuospatial WM tasks, mathematics tests, and fluid intelligence test. Hierarchical multiple regression analysis was used to examine the pattern of relations among these constructs. RESULTS: The results of hierarchical multiple regression analysis showed that verbal WM significantly predicted mathematics achievement for fifth graders, while failed for first graders. However, visuospatial WM played a substantive role in both graders' mathematical performance. The different role of the two WM components also depend on various fields of mathematics. CONCLUSION: Our results indicated the distinct influence of verbal and visuospatial WM on primary school students' mathematical abilities and highlighted the developmental and domain-specific effects of WM on mathematics.

Stressful life events and children's socioemotional difficulties: Conditional indirect effects of resilience and executive function.

Although the association between life stress and children's socioemotional difficulties has been widely documented, few studies have adopted a cognitive-based resilience framework studying preadolescent psychosocial adjustment. This study examined whether the stress-difficulties associations are mediated by resilience and moderated by executive function (EF). A sample of 144 typically developing Chinese children (aged 10-12 years) completed measures assessing stressful life events, socioemotional difficulties, resilience, and computer-based EF (including working memory [WM] capacity and WM updating, inhibitory control, and cognitive flexibility). The results showed that stressful life events were positively associated with socioemotional difficulties through the mediating effect of diminished resilience. The direct and indirect effects of stressful life events on socioemotional difficulties varied across individual differences in EF. Specifically, compared with low to medium levels, high-level WM capacity and WM updating moderated the association between stressful life events and socioemotional difficulties. Cognitive flexibility moderated both direct and indirect effects, showing that for children with low to medium levels of cognitive flexibility, life stress was positively associated with socioemotional difficulties via the role of lower resilience; however, for those with high levels of cognitive flexibility, the direct and indirect effects were not significant. Inhibitory control showed significant direct associations with resilience and socioemotional difficulties but failed to be a moderator. The characteristics of the low-stress sample might limit the generalizability of this study. Nevertheless, our findings provide a rationale for integrating a cognitive-based resilience process and the multifaceted structure of EF to understand and promote preadolescents' positive adaptation.

Sexual function and sexual activity in young total hip arthroplasty Chinese patients: A retrospective cohort study.

Introduction: As an essential component of quality of life, there is limited evidence of sexual function (SF), especially for young patients, before and after total hip arthroplasty (THA). This study aims to enhance the understanding of SF status and assess patient perspectives before and after THA. Methods: A total of 109 patients who received THA were enrolled into our retrospective cohort study. To assess the SF status before and after THA, patients were required to fill out a standardized SF questionnaire [female sexual function index (FSFI) or brief sexual function inventory (BSFI) for males] and a specifically designated questionnaire regarding perspectives toward sexual activity and attitudes to sexual-related information. Results: Total average scores of both FSFI and BSFI were higher post-THA. For female patients, the FSFI scores were significantly higher in the domain of desire, orgasm, and satisfaction (p < 0.05). For male patients, the BSFI scores were also improved in the sex drive and satisfaction domain post-operation (p < 0.05). A large proportion of the patients (64.22%) reported difficulty in sexual activity preoperatively, primarily due to restricted motion (82.86%) and hip pain (74.29%). After a successful procedure, there was a reduction in difficulty in patients' sexual activity post-THA (39.45%), mainly attributed to less pain (72.09%) and greater mobility (79.07%). In addition, subgroup analysis results indicated that gender and severity of hip stiffness and pain were crucial factors that could affect the patient's SF status. Furthermore, the majority of patients reported that they desired information concerning sexual activity, but only 12.84% of patients were informed well. Patients' preferred channels to acquire sexual-related information was a booklet (65.59%, n = 61), followed by informing a surgeon and a nurse. The most concerning questions regarding the sexual activity of patients were the time to recovery (90.32%) and safe postures (76.34%). Conclusion: The majority of men and women who underwent THA reported their SF status return to baseline or have improved, mainly attributable to less pain and greater mobility. Age and severity of hip pain/stiffness were the factors that could affect patients' SF status. Sexual education for young THA patients is needed due to the lack of related information during hospitalization.

Impact of Helicobacter pylori eradication on the gastric microbiome.

BACKGROUND: Helicobacter pylori (Hp) eradication has been used for many years. Yet, the impact of this eradication on the normal gastric microflora is not well understood. In this study, we explored the effect of eradication on the stomach microbial community and its recovery after successful Hp eradication. METHODS: Among the 89 included patients, 23, 17, 40, and 9 were included in the Hp-negative, Hp-positive, successful eradication, and failed eradication groups, respectively. Four subgroups were further determined according to disease status (Hp-negative chronic gastritis [N-CG], Hp-negative atrophic gastritis [N-AG], successful-eradication chronic gastritis [SE-CG], and atrophic gastritis with successful eradication [SE-AG]). During the endoscopic examination, one piece of gastric mucosa tissue was obtained from the lesser curvature side of the gastric antrum and gastric corpus, respectively. In addition, 16S rDNA gene sequencing was used to analyze the gastric mucosal microbiome. RESULTS: In the Hp-negative group, the gastric microbiota was dominated by five phyla: Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Fusobacteria. After successfully eradicating Hp, the bacterial flora in the stomach recovered to a considerable extent. In the failed eradication group, the flora was similar to the flora in Hp-positive subjects based on the alpha and beta diversities. Among the groups, Curvibacter and Acinetobacter were enriched in the presence of Hp (i.e., failed eradication and Hp-positive groups), suggesting that these two genera could be used as biomarkers in the symbiotic flora in the presence of Hp. SE-CG was characterized by an increase in Firmicutes taxa and a decrease in Proteobacteria taxa compared with N-CG. SE-AG was characterized by a decrease in Firmicutes relative to N-AG. Finally, no differences were found in the pairwise comparisons of nitrate and nitrite reductase functions of the microflora among the four subgroups. CONCLUSIONS: After Hp infection, the diversity and relative abundance of gastric microflora were significantly decreased. Yet, gastric microbiota could be partially restored to the Hp-negative status after eradication. Still, this effect was incomplete and might contribute to the long-term risks.

Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study.

BACKGROUND: Dyspepsia is one of the commonest clinical disorder. However, controversy remains over the role of endoscopy in patients with dyspepsia. No studies have evaluated the diagnostic value of endoscopy in patients with no warning symptoms according to the Rome IV criteria. AIM: To study the diagnostic value of endoscopy in dyspeptic patients with no warning symptoms. METHODS: This cross-sectional study included dyspeptic patients with no warning symptoms who met the inclusion and exclusion criteria at The First Affiliated Hospital, Zhejiang Chinese Medical University from April 2018 to February 2019. The clinical data were collected using questionnaires, including dyspeptic information, warning symptoms, other diseases, family history and basic demographic data. Based on dyspeptic symptoms, patients can be divided into epigastric pain syndrome, postprandial distress syndrome or overlapping subtypes. RESULTS: A total of 1016 cases were enrolled, 304 (29.9%) had clinically significant findings that were detectable by endoscopy. The endoscopy findings included esophageal lesions in 180 (17.7%) cases, peptic ulcers in 115 (11.3%) cases and malignancy in 9 (0.89%) patients. Multivariate logistic regression analysis showed that males [odds ratio (OR) = 1.758, P < 0.001], body mass index > 25 (OR = 1.660; P = 0.005), epigastric pain (OR = 1.423; P = 0.019) and Helicobacter pylori infection (OR = 1.949; P < 0.001) were independently associated with risk factors for the presence of clinically significant findings on endoscopy. CONCLUSION: Chinese patients with dyspepsia with no warning symptoms should undergo endoscopy, particularly males, patients with body mass index > 25, epigastric pain or Helicobacter pylori infection.

Efficacy of short-term moderate or high-dose statin therapy for the prevention of contrast-induced nephropathy in high-risk patients with chronic kidney disease: systematic review and meta-analysis.

Although previous studies have indicated that statin therapy can effectively prevent the development of CIN, this observation remains controversial, especially in high-risk patients. A meta-analysis was performed to evaluate the efficacy of statin pretreatment for preventing the development of CIN in patients with chronic kidney disease (CKD) and to determine its effectiveness in various subgroups. We searched the online databases PubMed, EMBASE, and the Cochrane Library. RCTs that involved the comparison of the short-term moderate or high-dose statin pretreatment with placebo for CIN prevention in CKD patients undergoing angiography were included. The primary outcome was CIN prevalence. Seven RCTs comprising 4256 participants were investigated in this analysis. The risk of developing CIN in patients pretreated with statins was significantly lower than that in patients pretreated with placebo (RR=0.57, 95%CI=0.43-0.76, p=0.000). The SCr values of the statin group, when analyzed 48h after angiography were lower than those of the placebo group ((SMD=-0.15, 95% CI=-0.27 to -0.04, p=0.011). In the subgroup analysis, statin pretreatment could decrease the risk of CIN in CKD patients with DM (RR=0.54, 95% CI=0.39-0.76, p=0.000), but not in CKD patients without DM (RR=0.84, 95% CI=0.44-1.60, p=0.606). The efficacy of atorvastatin for preventing CIN was consistent with that observed with the use of rosuvastatin. The risk ratios (RR) were 0.51 (95% CI=0.32-0.81, p=0.004) and 0.60 (95% CI=0.41-0.88, p=0.009), respectively. Our study demonstrated that statin pretreatment could prevent the development of CIN in CKD patients. However, subgroup analysis demonstrated that statin pretreatment, despite being effective in preventing CIN in patients with CKD and DM, was not helpful for CKD patients without DM. Rosuvastatin and atorvastatin exhibited similar preventive effects with respect to CIN.