The effect of perceived social support and health literacy on parental COVID-19 vaccine hesitation in preschool children: a cross-sectional study.

Children are generally susceptible to COVID-19, and infection with COVID-19 may cause serious harm to children. COVID-19 vaccination is an effective way to prevent infection at present, and many factors affect children's COVID-19 vaccination. This study aimed to explore the effects of perceived social support and health literacy on hesitancy towards first and second vaccine dose. This cross-sectional study was conducted in the Minhang District of Shanghai, China, in October 2022. A total of 1150 parents of preschool children from 10 kindergartens participated. The survey encompassed four sections, capturing data on sociodemographic attributes, health literacy, perceived social support, and parental COVID-19 vaccine hesitancy. Health literacy was measured using a self-designed questionnaire consisting of four dimensions. Perceived social support was assessed using the MSPSS questionnaire. Hierarchical multiple logistic regression was used to examine the relationship between the independent variables and parental hesitancy towards the first and second doses of COVID-19 vaccine. Parental hesitancy rate for the first dose of the COVID-19 vaccine was 69.6%, and for the second dose, it was 33.1%. The final integrated model showed that parental hesitancy towards the first and the second dose of COVID-19 vaccine was associated with parental educational level, allergy in children, information decision-making and information comprehension ability, perceived social support from family and friends. Health literacy and perceived social support are influence factors for parental hesitancy towards COVID-19 vaccine for preschool children. The findings will provide insights for future intervention studies on COVID-19 vaccine hesitancy and inform the development of vaccination policies.

Knockdown of PRMT1 suppresses the malignant biological behavior of osteosarcoma cells and increases cisplatin sensitivity via c-Myc-mediated BCAT1 downregulation.

Increasing evidence indicated that protein arginine methyltransferase-1 (PRMT1) is an oncogene in multiple malignant tumors, including osteosarcoma (OS). The aim of this study was to investigate the underlying mechanism of PRMT1 in OS. The effects of PRMT1 or BCAT1, branched-chain amino acid transaminase 1 (BCAT1) on OS cell proliferation, invasion, autophagy, and apoptosis in vitro were examined. Moreover, molecular control of PRMT1 on c-Myc or transactivation of BCAT1 on c-Myc was assessed by chromatin immunoprecipitation and quantitative reverse transcription PCR assays. The effects of PRMT1 in vivo were examined with a xenograft tumor model. The results showed that PRMT1 was potently upregulated in OS tissues and cells. Upregulation of PRMT1 markedly increased OS cell proliferation and invasion in vitro and reduced cell apoptosis, whereas PRMT1 silencing showed the opposite effects. Cisplatin, one of the most effective chemotherapeutic drugs, improved cell survival rate by inducing the expression of PRMT1 to downregulate the cisplatin sensitivity. Meanwhile, the cisplatin-induced upregulation of PRMT1 expression caused dramatically autophagy induction and autophagy-mediated apoptosis by inactivating the mTOR signaling pathway, which could be reversed by 3-methyladenine, an autophagy inhibitor, or PRMT1 silencing. PRMT1 could activate c-Myc transcription and increase c-Myc-mediated expression of BCAT1. Furthermore, BCAT1 overexpression counteracted the effects of PRMT1 knockdown on cell proliferation, invasion, and apoptosis. Of note, deficiency of PRMT1 suppressed tumor growth in vivo. PRMT1 facilitated the proliferation and invasion of OS cells, inhibited cell apoptosis, and decreased chemotherapy sensitivity through c-Myc/BCAT1 axis, which may become potential target in treating OS.

Parents' intention to vaccinate their preschool children against COVID-19: Combining the health belief model and the theory of planned behavior.

The vaccination rate of COVID-19 in preschool children is low, and parents' intention to vaccinate their children is also low due to multiple factors. This study aimed to establish an integrated model based on the Health Belief Model (HBM)and Theory of Planned Behavior (TPB), to explore the factors influencing parents' intention to vaccinate their preschool children with the first and second doses of COVID-19 vaccines. A total of 1264 parents of preschool children from 10 kindergartens participated in this study. Hierarchical multiple logistic regression was used to analyze the intention separately. For the integrated model with the first dose of vaccine of COVID-19, introducing the HBM variable in model 1 explained 33.98% of the variance (F = 398.71, p < .001), then upon adding the TPB variable in model 2, the explanation of variance increased to 41.93% (F = 491.94, p < .001) and parents' intention were associated with their perceived barriers, cues to action, and subjective norms. For the integrated model with the second dose of vaccine of COVID-19, introducing the HBM variable in Model 1 explained 23.76% of the variance (F = 68.82, p < .001), then upon adding the TPB variable in model 2, the explanation of variance increased to 26.67% (F = 77.24, p < .001), and parents' intention was associated with cues to action and subjective norms. The combination of the two theories improves the explanatory power of parents' intention to vaccinate their preschool children against COVID-19, and provides a basis for the development of effective interventions for vaccination of COVID-19 for preschool children.

Association of oral health knowledge, self-efficacy and behaviours with oral health-related quality of life in Chinese primary school children: a cross-sectional study.

OBJECTIVE: Achieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children. METHODS: In this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson's correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors. RESULTS: Four hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours. CONCLUSION: This study revealed a pathway of association between children's oral health knowledge and their OHRQOL, in which children's oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children's OHRQOL and helps to identify direct or indirect intervention targets.

Parents' intentions toward preschool children's myopia preventive behaviors: Combining the health belief model and the theory of planned behavior.

Objective: This study aimed to develop an integrated model based on the health belief model (HBM) and the theory of planned behavior (TPB) to explore the influencing factors of parents' intentions toward preschool children's myopia preventive behaviors. Methods: This cross-sectional study was conducted in Minhang District, Shanghai, China in January 2022. One thousand six hundred and twenty-eight parents of preschool children from seven preschools were recruited in the study. A four-part questionnaire was used to collect data on socio-demographic characteristics, HBM variables, TPB variables and parental intentions. This study used exploratory factor analysis to analyze HBM and TPB items. Hierarchical multiple regression analysis was performed to explore the relationship between independent variables and parents' intentions toward preschool children's myopia preventive behaviors. Results: The final integrative model showed that perceived severity, perceived barriers, attitudes, subjective norms, and perceived behavioral control were associated with parents' intentions toward preschool children's myopia preventive behaviors. In model 1, Child's age was entered as a control variable and explained 0.6% of the variance (F = 7.241, p = 0.007). When the HBM variables were entered in model 2, the proportion of variance increased to 25.4% (F = 73.290, P < 0.001). In model 3, TPB variables were entered and explained 63.2% of the variance (F = 246.076, p < 0.001). Conclusion: The integrated model of HBM and TPB constructed in this study significantly improved the degree of explanation of parents' intentions toward preschool children's myopia preventive behaviors. Parents' perceived severity, perceived barriers, attitudes, subjective norms, and perceived behavioral control can be prioritized intervention targets for myopia preventive practices in preschool children.

The association between comorbidities and stigma among breast cancer survivors.

This study aimed to explore the association between types and numbers of comorbidities and stigma among breast cancer survivors (BCSs). A cross-sectional study was conducted among 937 BCSs in Shanghai Cancer Rehabilitation Club. All participants were asked to fill in an online questionnaire including Stigma Scale for Chronic Illnesses 8-item version (SSCI-8) and questions on sociodemographic characteristics and health status. Multivariate linear regression was used to analyze the association between comorbidities and stigma, adjusting for confounding factors. Results showed that nearly 70% of the participants had one or more comorbidities. The participants with stroke, digestive diseases or musculoskeletal diseases had significantly higher stigma than those without the above comorbidities. In addition, stigma was higher among survivors in the group with a greater number of comorbidities. Thus, it is important to strengthen the management of stigma in BCSs, especially for those with comorbidities.

Circular RNA VMA21 ameliorates IL-1ß-engendered chondrocyte injury through the miR-495-3p/FBWX7 signaling axis.

This study explored the function of circular RNA VMA21 (circVMA21) in osteoarthritis (OA). IL-1ß inducement reduced the expression of circVMA21 in C28/I2 cells and human primary chondrocytes. Forced expression of circVMA21 heightened cell viability and attenuated cell apoptosis, accompanied by upregulation of Bcl-2, and downregulation of Bax and C-caspase-3 in C28/I2 cells in response to IL-1ß exposure. CircVMA21 overexpression diminished the expression of MMP1 and MMP13, augmented the expression of COL2A1, and impeded the production of IL-6, TNF-α, prostaglandin E2 (PGE2) and NO. CircVMA21 served as a competitive endogenous RNA by sponging miR-495-3p. F-box and WD40 domain protein 7 (FBWX7) was identified as a target of miR-495-3p. The compensation experiments affirmed that circVMA21-mediated protective effects on IL-1ß-irritated chondrocytes through the miR-495-3p/FBWX7 axis. The role of circVMA21 was also confirmed in an OA rat model. Collectively, these findings revealed a protective effect of circVMA21in OA by intercepting the miR-495-3p/FBWX7 crosstalk.

Hypoxia inducible factor-3α promotes osteosarcoma progression by activating KDM3A-mediated demethylation of SOX9.

Hypoxia/oxygen-sensing signally is closely associated with many tumor progressions, including osteosarcoma (OS). Previous research principally focused on the function of hypoxia-inducible factor (HIF)-1α and HIF-2α as the major hypoxia-associated transcription factors in OS, however, the role of HIF-3α has not been investigated. Our study found that HIF-3α was upregulated in OS tissues and cell lines. HIF-3α overexpression facilitated cell proliferation and invasion, and inhibited apoptosis, whereas HIF-3α knockdown showed the opposite results. Chromatin immunoprecipitation analysis revealed that lysine demethylase 3A (KDM3A) expression was transcriptionally activated by HIF-3α under hypoxia, and KDM3A occupied the SRY-box transcription factor 9 (SOX9) gene promoter region through H3 lysine 9 dimethylation (H3K9me2). Additionally, rescue results revealed that KDM3A or SOX9 overexpression reversed the effects of HIF-3α silence on cell functions. The Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway inhibitor cucurbitacin I suppressed the promotive effects of HIF-3α overexpression on cell proliferation, invasion and TAK2/STAT3 pathway. Finally, OS cell line MG-63 transfected with HIF-3α short hairpin RNA (HIF-3α shRNA) were subcutaneously injected into nude mice, and the results found that HIF-3α knockdown significantly inhibited the xenograft tumor growth of OS in vivo. In conclusion, this study reveals that HIF-3α promotes OS progression in vitro and in vivo by activating KDM3A-mediated SOX9 promoter demethylation, which may provide a potential therapeutic mechanism for OS.

Promote the activation and ring opening of intermediates for stable photocatalytic toluene degradation over Zn-Ti-LDH.

Improving the selectivity of photocatalysis and reducing the generation of toxic by-products are the two key challenges for the development of highly efficient and stable photocatalysts. In this work, it was revealed that Zn-Ti-layered double hydroxide (ZT-LDH) photocatalyst, which generated less intermediates, showed better toluene degradation efficiency (removal ratio, 75.2%) and stability, compared with P25 (removal ratio, 10.9%). During the photocatalytic toluene degradation, benzaldehyde and benzoic acid were the main intermediates existed in the gas phase and on the surface of the catalyst, respectively. By combining experiments with theoretical calculation, it was found that the hydrogen atoms on the hydroxyl groups in the LDH would selectively attract the oxygen atoms in the carbon-oxygen double bond of the two major intermediates, facilitating their adsorption and activation on ZT-LDH. Besides, the surface electronic structure of ZT-LDH was demonstrated to facilitate the ring-opening reaction of the two major intermediates, eventually maintaining high activity and stability. This work could provide new molecular perspectives for understanding the photocatalytic reactions in VOCs degradation and developing efficient and stable photocatalysts.

Improving the Autogenous Self-Sealing of Mortar: Influence of Curing Condition.

With the construction of projects under severe environments, new and higher requirements are put forward for the properties of concrete, especially the autogenous self-sealing property, which is greatly affected by the curing environment and the state of the water. Herein, six types of curing conditions, including in air with a relative humidity of 30%, 60%, and 95%; flowing water; wet-dry cycles; and static water, are designed to investigate the autogenous self-sealing of mortar under different curing conditions. The results showed that the self-sealing ratios are higher than 60% and the cracks are closed for the mortar undergoing the wet-dry cycles and the static water. However, the self-sealing ratios of mortar are lower than 10% and the cracks are almost unchanged when the mortar is cured in the air with a relative humidity (RH) of 30% and 60%. The static liquid water is more conducive to the continued hydration of cement and the formation of CaCO3 than the flowing water. The research provides guidance for the design of concrete and the improvement of autogenous self-sealing when the concrete serves in different environments.

Bi8Se7: Delocalized Interlayer π-Bond Interactions Enhancing Carrier Mobility and Thermoelectric Performance near Room Temperature.

Environmental heat-to-electric energy conversion provides a promising solution to power sensors used for wearable and portable devices. Yet the near-room-temperature thermoelectric materials are extremely rare. The natural heterostructure [Bi2]m[Bi2Q3]n family provides an important platform to search and develop the cheaper and less toxic of such materials. However, the bottleneck problem in this family is how to enhance the interlayer electrical conductivity (σ). Herein, we uncover for the first time that the delocalized π-bond interaction between the stacking layers in the [Bi2]m[Bi2Se3]n family effectively increases the interlayer carrier mobility (µH) and σ. Moreover, we propose an empirical index, F = Dpx,py(Bi0)/Dpx,py(Bi3+) along the kz direction in the Brillouin zone to evaluate the strength of the interlayer delocalized π-bond. F is optimized at a value of 1, under which µH is maximized. Interestingly, Bi8Se7 possessing an optimal F = 1.06 is predicted to have the best µH in the [Bi2]m[Bi2Q3]n family. Our subsequent experiments confirm the as-synthesized Bi8Se7 exhibiting n-type behavior with a µH value (33.08 cm2/(V s) at 300 K) that is higher than that of BiSe (26.19 cm2/(V s) at 300 K) and an enhanced σ value. Furthermore, the Te/Sb codoping, via varying the top of the valence band, significantly increases the Seebeck coefficient and eventually enhances the ZT value to ∼0.7 in Bi5.6Sb2.4Se5Te2 at 425 K along the hot-pressing direction, which is comparable to the optimized value of BiSe. According to the single parabolic band model prediction, the ZT of Bi5.6Sb2.4Se5Te2 may reach ∼1.2 at 425 K, suggesting a novel and promising n-type thermoelectric material near room temperature.

Pathologic and hemodynamic changes of common carotid artery in obstructive sleep apnea hypopnea syndrome in a porcine model

Background/aim: To prepare a porcine model of obstructive sleep apnea-hypopnea syndrome (OSAHS) and observe the pathological and hemodynamic changes in the common carotid artery. Materials and methods: Twelve male miniature pigs were randomly divided into the model and control group (n = 6). Pigs in the model group were kept in an air-flow negative pressure chamber at 0.96 ± 0.01 kPa, and the air oxygen content, temperature, and humidity were kept at normal culture conditions in both groups. After pigs in the model group presented symptoms of OSAHS, changes in the hemodynamics and morphology of the carotid artery were analyzed using color Doppler, and light and electron microscopy. Results: An animal model of OSAHS was successfully created. The internal diameter of the carotid artery of pigs in the model group was decreased, while the intima thickness, peak-systolic mean velocity, and resistance index were increased when compared to the control group (P < 0.05). The results of the light and electron microscopy revealed an incomplete elastic plate, increased media thickness, irregular morphology of the smooth muscle cells, increased collagen fiber bundles, partially disordered elastic fibers, and smooth muscle layers. The quantitative analysis showed significantly increased elastic fibers in the media of the carotid artery in the model group (P < 0.01). Conclusion: Pathological changes in the tissue structure and hemodynamics in the negative pressure-induced pig OSAHS model were observed. We suggest that alterations in the upper airway pressure during OSAHS may lead to cardiovascular conditions through its pathological effects on the carotid artery.

Histological, Ultrastructural, and Physiological Evaluation of a Rat Model of Obstructive Sleep Apnea Syndrome.

BACKGROUND Patients with obstructive sleep apnea syndrome (OSAS) are at an increased risk of cardiovascular disease. The aims of this study were to develop a rat model of OSAS and to validate the use of the model by investigating respiratory and cardiovascular physiological parameters and morphological changes by light microscopy and electron microscopy. MATERIAL AND METHODS Sixty 3-month-old Sprague-Dawley rats were assigned to the model group (n=30) and the control group (n=30). The rats in the OSAS model group were injected with 0.1 ml sodium hyaluronate solution into the upper respiratory tract at the junction between the hard and soft palate. After one month, the model and normal rats were compared using tests of respiratory and cardiac function, and histology and electron microscopy of the lung and cardiac tissue. RESULTS In the rat model of OSAS, airway obstruction resulted in the collapse of the upper airway. Tests of respiratory function showed that the oxygen partial pressure, oxygen concentration, and oxygen saturation in the model group were significantly lower when compared with the control group. In the model group, histology of the heart showed cardiac myocyte disarray, and electron microscopy showed vacuolar degeneration and mitochondrial abnormalities. The rat model of upper airway occlusion showed pulmonary and cardiac changes that have been described in OSAS. CONCLUSIONS A rat model of upper airway occlusion resulted in physiological and morphological changes in the lung and heart due to hypoxia, and may be used for future studies on OSAS.

Vitamin K2 stimulates MC3T3­E1 osteoblast differentiation and mineralization through autophagy induction.

Vitamin K2 likely exerts its protective effects during osteoporosis by promoting osteoblast differentiation and mineralization. However, the precise mechanism remains to be fully elucidated. Autophagy maintains cell homeostasis by breaking down and eliminating damaged proteins and organelles. Increasing evidence in recent years has implicated autophagy in the development of osteoporosis. The aim of the present study was to verify whether vitamin K2 (VK2) can induce autophagy during the differentiation and mineralization of osteoblasts. In the present study, MC3T3­E1 osteoblasts were treated with various doses of VK2 (10­8­10­3 M) for 1­5 days. The results revealed no cytotoxicity at concentrations below 10­5 M, but cell viability was reduced in a dose­dependent manner at concentrations above 10­5 M. Furthermore, MC3T3­E1 osteoblasts were seeded in 6­well plates in complete medium supplemented with dexamethasone, ß­glycerophosphate and vitamin C (VC) for osteogenic differentiation. MC3T3­E1 osteoblasts treated with different concentrations (10­5, 10­6 and 10­7 M) of VK2 for 24 h on days 1, 3, 5 and 7 of the differentiation protocol. It was confirmed that VK2 promoted osteoblast differentiation and mineralization by using alkaline phosphatase (ALP) and alizarin red staining. Using western blotting, immunofluorescence, monodansylcadaverine staining and reverse transcription­quantitative polymerase chain reaction, it was observed that VK2 induced autophagy in osteoblasts. The results revealed that VK2 (1 µM) significantly increased ALP activity and the conversion of microtubule associated protein 1 light chain 3­α (LC3)II to LC3I in MC3T3­E1 osteoblasts (P<0.05) at every time point. The number of fluorescent bodies and the intensity increased with VK2, and decreased following treatment with 3­MA+VK2. There was an increase in the mRNA expression levels of ALP, osteocalcin (OCN) and Runt­related transcription factor 2 in VK2­treated cells (P<0.01). The present study further confirmed the association between autophagy and osteoblast differentiation and mineralization through treatment with an autophagy inhibitor [3­methyladenine (3­MA)]. Osteoblasts treated with 3­MA exhibited significant inhibition of ALP activity and osteogenic differentiation (both P<0.05). In addition, ALP activity and osteogenesis in the VK2+3­MA group was lower compared with VK2­treated cells (P<0.05 for both). The present study confirmed that VK2 stimulated autophagy in MC3T3 cells to promote differentiation and mineralization, which may be a potential therapeutic target for osteoporosis.

LPS promote Osteosarcoma invasion and migration through TLR4/HOTAIR.

OBJECTIVES: Osteosarcoma is one of common malignant tumors worldwide in the metaphysis of teenagers. The role of lncRNAs in Osteosarcoma has become an emerging area of research. MATERIALS AND METHODS: Cell migration and invasion were analyzed in Osteosarcoma cell following knockdown or overexpression by transfection with small interfering RNA (siRNA) or treated with LPS. Western blotting and Real-time RT-PCR methods were used to analyze the effects of LPS on EMT. RESULTS: We discovered that LPS could regulate cell migration and invasion and promote EMT. At the same time, LPS could regulate the expression of TLR4 and HOTAIR. In addition, knockdown of the expression of TLR4 partially reverses the promotion of cell invasion induced by LPS. CONCLUSIONS: Our results indicated that LPS coordinate the Osteosarcoma through TLR4/HOTAIR.

Autophagy protects bone marrow mesenchymal stem cells from palmitate­induced apoptosis through the ROS­JNK/p38 MAPK signaling pathways.

In recent years, the association between saturated fatty acids (FA) and bone cells has received a high level of attention. Previous studies have shown that palmitate (PA), a common saturated FA, can cause apoptosis in bone marrow mesenchymal stem cells (BMSCs). However, whether PA can induce autophagy, an important intracellular protection mechanism that is closely associated with apoptosis, in BMSCs is still unknown; the association between autophagy and apoptosis is also unclear. The aim of the present study was to determine whether PA can induce autophagy in BMSCs. When BMSCs were treated with PA for >18 h, p62 began to accumulate, indicating that autophagic flux was impaired by prolonged exposure to PA. In addition, the proportion of apoptotic cells was increased when autophagy was inhibited by the autophagy inhibitor 3­methyladenine. Furthermore, inducing autophagy by pretreating cells with rapamycin, a known inducer of autophagy, markedly reduced PA­induced apoptosis, suggesting that autophagy may serve a protective role in PA­induced apoptosis in BMSCs. PA also increased intracellular reactive oxygen species (ROS) production, which was decreased by the antioxidant N­Acetyl­cysteine, and promoted the activation of c­Jun N­terminal kinases (JNKs) and p38 mitogen­activated protein kinase (MAPK). The addition of JNK and p38 MAPK inhibitors substantially reduced autophagy. Therefore, the results indicated that PA can induce autophagy in BMSCs and protect cells from PA­induced apoptosis through the ROS­JNK/p38 MAPK signaling pathways. These results may improve the general understanding of the mechanisms through which BMSCs adapt to PA­induced apoptosis. The present study also provides a novel approach for the prevention and treatment of PA­induced lipotoxicity.

microRNA-544 promoted human osteosarcoma cell proliferation by downregulating AXIN2 expression.

microRNAs (miRNAs) perform various oncogenic or tumor suppressor functions in carcinogenesis. Currently, the underlying mechanisms of miRNAs in osteosarcoma (OS) are poorly understood. In the present study, it is demonstrated that expression of miR-544 was markedly upregulated in OS cells and clinical tissues. Furthermore, overexpression of miR-544 enhanced OS cell proliferation in vitro. Bioinformatics analysis indicated that miR-544 may target the 3'-untranslated region of axis formation inhibitor 2, which was validated using luciferase reporter gene assays. The present study demonstrated a vital role for miR-544 in promoting OS cell proliferation, indicating that it may represent a novel prognostic factor or therapeutic target for OS.

Low-dose dexamethasone affects osteoblast viability by inducing autophagy via intracellular ROS.

Glucocorticoids (GCs) are closely associated with the progression of GC­induced osteoporosis (GIOP) by inhibiting osteoblast viability. However, endogenous GCs are important for bone development. In addition, previous studies have demonstrated that GCs could induce autophagy, a cytoprotective process that is protective against various stressors. In the present study, the aim is to explore whether osteoblasts exhibited dose­dependent viability in the presence of GCs due to autophagy. hFOB 1.19 osteoblasts were treated with various doses of dexamethasone (DEX; 10­8­10­4 M) for 0, 24, 48 and 72 h. The results revealed a biphasic effect of DEX on the viability of hFOB 1.19 cells; a high dose of DEX (≥10­6 M) accelerated cell apoptosis, while a low dose of DEX (10­8 M) increased cell viability. Furthermore, significantly increased autophagy was observed in the low dose DEX treatment group, as indicated by the expression of the autophagy­associated proteins beclin 1 and microtubule­associated protein light chain 3, and the detection of autophagosomes. Another finding was that DEX upregulated intracellular reactive oxygen species (ROS), which was decreased by the autophagy agonist rapamycin. The increase in autophagy and cell viability associated with low­dose DEX (10­8 M) was suppressed by the ROS scavenger catalase and the autophagy inhibitor 3­methyladenine. In conclusion, the results revealed that GCs affected osteoblast viability in a dose­dependent manner. A low dose of GCs increased osteoblast viability by inducing autophagy via intracellular ROS. The results indicate that autophagy may be a novel mechanism by which osteoblasts survive GC exposure and provide a potential therapeutic target for treating GIOP.

The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy.

Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e.g., volume controlled (VCV) versus pressure controlled (PCV)]; (III) use of therapeutic hypercapnia; (IV) use of alveolar recruitment (open-lung) strategy; (V) pre-and post-operative application of positive end expiratory pressure (PEEP); (VI) Inspired Oxygen concentration; (VII) Non-intubated thoracoscopic lobectomy; and (VIII) adjuvant pharmacologic options. The recommendations of class II are non-intubated thoracoscopic lobectomy may be an alternative to conventional one-lung ventilation in selected patients. The recommendations of class IIa are: (I) Therapeutic hypercapnia to maintain a partial pressure of carbon dioxide at 50-70 mmHg is reasonable for patients undergoing pulmonary lobectomy with one-lung ventilation; (II) PV with a tidal volume of 6 mL/kg and PEEP of 5 cmH2O are reasonable methods, based on current evidence; (III) alveolar recruitment [open lung ventilation (OLV)] may be beneficial in patients undergoing lobectomy with one-lung ventilation; (IV) PCV is recommended over VCV for patients undergoing lung resection; (V) pre- and post-operative CPAP can improve short-term oxygenation in patients undergoing lobectomy with one-lung ventilation; (VI) controlled mechanical ventilation with I:E ratio of 1:1 is reasonable in patients undergoing one-lung ventilation; (VII) use of lowest inspired oxygen concentration to maintain satisfactory arterial oxygen saturation is reasonable based on physiologic principles; (VIII) Adjuvant drugs such as nebulized budesonide, intravenous sivelestat and ulinastatin are reasonable and can be used to attenuate inflammatory response.

The Society for Translational Medicine: clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy.

The Society for Translational Medicine and The Chinese Society for Thoracic and Cardiovascular Surgery conducted a systematic review of the literature in an attempt to improve our understanding in the postoperative management of chest tubes of patients undergoing pulmonary lobectomy. Recommendations were produced and classified based on an internationally accepted GRADE system. The following recommendations were extracted in the present review: (I) chest tubes can be removed safely with daily pleural fluid of up to 450 mL (non-chylous and non-sanguinous), which may reduce chest tube duration and hospital length of stay (2B); (II) in rare instances, e.g., persistent abundant fluid production, the use of PrRP/B <0.5 when evaluating fluid output to determine chest tube removal might be beneficial (2B); (III) it is recommended that one chest tube is adequate following pulmonary lobectomy, except for hemorrhage and space problems (2A); (IV) chest tube clearance by milking and stripping is not recommended after lung resection (2B); (V) chest tube suction is not necessary for patients undergoing lobectomy after first postoperative day (2A); (VI) regulated chest tube suction [-11 (-1.08 kPa) to -20 (1.96 kPa) cmH2O depending upon the type of lobectomy] is not superior to regulated seal [-2 (0.196 kPa) cmH2O] when electronic drainage systems are used after lobectomy by thoracotomy (2B); (VII) chest tube removal recommended at the end of expiration and may be slightly superior to removal at the end of inspiration (2A); (VIII) electronic drainage systems are recommended in the management of chest tube in patients undergoing lobectomy (2B).