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1.
Chemistry ; 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32614093

RESUMO

Over the past decades, organometallic complexes with precious elements, such as ruthenium and iridium, were widely used as visible-light photoredox catalysts. Recently, more and more complexes based on earth-abundant and inexpensive elements have been used as sensitizers in photochemistry. Although the photoexcited state lifetimes of iron complexes are typically shorter than those of traditional photosensitizers, the utilization of iron catalysts in photochemistry has sprung up due to their abundance, low price, nontoxicity and novel properties, including exhibiting ligand to metal charge transfer states. This concept focuses on recent advance of light-driven iron-catalysis in organic transformations, including iron/photoredox dual catalysis, light-induced iron photoredox catalysis and light-induced generation of active iron catalysts. The prospect for future of this field is also discussed.

2.
Polymers (Basel) ; 12(7)2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32679867

RESUMO

With the raw materials of poly(vinylidene-co-hexafluoropropylene) (P(VDF-HFP)) and polyamide 6 (PA6, nylon 6), a sandwich-structured composite membrane, PA6/P(VDF-HFP)/PA6, is fabricated via sequential layer-by-layer electrospinning. The nylon-based composite exhibits high absorption to organic liquid electrolyte (270 wt%) owing to its high porosity (90.35%), good mechanical property (17.11 MPa), and outstanding shut-down behavior from approximately 145 to 230 °C. Moreover, the dimensional shrink of a wet PA6 porous membrane immersed into liquid electrolyte is cured due to the existence of the P(VDF-HFP) middle layer. After swelling by the LiPF6-based organic liquid electrolyte, the obtained PA6/P(VDF-HFP)/PA6-based gel polymer electrolytes (GPE) shows high ionic conductivity at room temperature (4.2 mS cm-1), a wide electrochemical stable window (4.8 V), and low activation energy for Li+ ion conduction (4.68 kJ mol-1). Benefiting from the precise porosity structure made of the interlaced electrospinning nanofibers and the superior physicochemical properties of the nylon-based composite GPE, the reversible Li+ ion dissolution/deposition behaviors between the GPE and Li anode are successfully realized with the Li/Li symmetrical cells (current density: 1.0 mA cm-2; areal capacity: 1.0 mAh cm-2) proceeding over 400 h at a polarization voltage of no more than 70 mV. Furthermore, the nylon-based composite GPE in assembled Li/LiFePO4 cells displays good electrochemical stability, high discharge capacity, good cycle durability, and high rate capability. This research provides a new strategy to fabricate gel polymer electrolytes via the electrospinning technique for rechargeable lithium batteries with good electrochemical performance, high security, and low cost.

4.
J Mol Neurosci ; 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32705526

RESUMO

Ketamine is a recreational drug that causes emotional and cognitive impairments, but its specific mechanisms of action are still unclear. Recent evidence suggests that Tau protein phosphorylation and targeted delivery to the postsynaptic area are closely related to its neurotoxicity, and our recent studies have shown that long-term ketamine administration causes excessive Tau protein phosphorylation. However, the regulatory mechanism of Tau protein phosphorylation induced by ketamine has not been clarified. In the present study, we administered a single ketamine injection and long-term (6 months) ketamine injections in C57BL/6 mice, to investigate the effects of different doses of ketamine on the expression levels of Tau protein and its phosphorylation, the expression levels and activities of the related protein phosphokinases GSK-3ß and CDK5, and the expression levels and activities of the related protein phosphatases PP2A and PP2B in the mouse hippocampus. Our results showed that both single-dose and long-term ketamine administration induced excessive phosphorylation of the Tau protein at ser202/thr205 and ser396. A single ketamine administration caused an increase in the activity of GSK-3ß (at high doses) and a decrease in the activity of PP2A. On the other hand, long-term ketamine administration resulted in an increase in the activities of GSK-3ß (at high doses) and CDK5, and a decrease in the activity of PP2A. Our results indicate that GSK-3ß, CDK5, and PP2A may be involved in ketamine-induced Tau protein phosphorylation.

5.
Respir Res ; 21(1): 156, 2020 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-32571309

RESUMO

BACKGROUND: Clinical questionnaires are mainly applied as screening tools for identification of the Obstructive sleep apnea (OSA) patients. Little attention has been paid to assess the body functions and health status of the patients. International Classification of Functioning, Disability and Health (ICF) was designed for better understanding and describing functioning and disability of patients. This study adopted the Brief ICF-Sleep Disorders and Obesity Core Set to evaluate the impairment of functioning and health status of OSA patients. METHODS: Five hundred ninety-two participants were enrolled in this cross-sectional study. Data were collected using Brief ICF-Sleep Disorders and Obesity Core Set Polysomnography was performed and basic characteristics of the patients were recorded. RESULTS: The scores for the component Body Functions and Code b130, b134, b140, b440, b530, s330, d160, d240, d450 of the two core sets were significantly different among the patients divided by apnea-hypopnea index (AHI) or oxygen saturation (SaO2) nadir, but the frequency of code s330, d160, d240, d450 was low. The Body Functions component of the both sets were closely related to neck circumference (NC), body mass index (BMI), apnea-hypopnea index (AHI) of the OSA patients. Body Functions of the Brief ICF-Sleep Disorders performed better with a threshold of 4 with sensitivity, specificity and area under the receiver operating characteristic curve (AUC) as 0.62, 0.74, 0.68(AHI ≥ 5), 0.69, 0.63, 0.66 (AHI ≥ 15), 0.75, 0.56, 0.66 (AHI ≥ 30), 0.56, 0.70, 0.63 (SaO2 nadir≤90%), 0.67, 0.66, 0.66 (SaO2 nadir<85%), 0.71, 0.59, 0.65 (SaO2 nadir<80%), separately. CONCLUSION: The Body Functions component of both two sets could be an evaluation tool of impairment of body functions for OSA patients. The Brief ICF-Sleep Disorders Body Functions component performed better with a threshold of 4 and might provide a new insight for physicians to assess OSA patients.

6.
Int J Chron Obstruct Pulmon Dis ; 15: 1207-1216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32581527

RESUMO

Purpose: The co-existence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) has been described as the overlap syndrome. The objective of the study is to investigate the performance of Berlin Questionnaire (BQ), modified Berlin Questionnaire (MBQ), and STOP-Bang score in screening overlap syndrome from COPD subjects and investigate how pulmonary function interferes with questionnaire scoring. Subjects and Methods: Among 116 COPD subjects included in this study, 62 were overlap syndrome subjects and 54 were COPD subjects without OSA. Subjects included were asked to fill out the questionnaires to collect demographic characteristics of subjects and questionnaire scores of BQ, MBQ, and STOP-Bang; perform pulmonary function test to confirm their COPD diagnosis; and perform polysomnography. Results: AUC (area under the curve) of BQ, MBQ, and STOP-Bang score in screening OSA among patients with COPD was 0.71 (0.64-0.79), 0.75 (0.67-0.83), and 0.72 (0.64-0.80). In COPD subjects without OSA, FEV1%pred was statistically associated with the misdiagnosis of BQ (P= 0.0091), MBQ (P= 0.0143), and STOP-Bang (P= 0.0453). In patients with overlap syndrome, FVC%pred affected the risk of misdiagnosis of the three questionnaires (BQ: P= 0.0413; MBQ: P= 0.0150; STOP-Bang: P= 0.0241). BMI and neck circumferences (NC) were negatively correlated with FEV1%pred (BMI: P= 0.0454; NC: P= 0.0230) and FVC%pred (BMI: P= 0.0042; NC: P= 0.0367) in overlap subjects. In contrast, BMI was positively correlated with FEV1/FVC (P= 0.0141) and FEV1%pred (P= 0.0391) in COPD subjects without OSA. Conclusion: BQ, MBQ, and STOP-Bang score performed well in COPD subjects for screening OSA. The diagnosis of the three questionnaires was more accurate in subjects with lower FEV1%pred or FVC%pred value. Pulmonary function might exert influence on the diagnosis efficacy of the three questionnaires through BMI and neck circumference.

7.
Biomater Sci ; 8(15): 4299-4307, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32597445

RESUMO

Temperature-sensitive liposomes (TSLs) have received constant attention due to the release of contents around the physiological temperature, which holds great potential in the treatment of tumors. However, the development of TSLs is limited by the long-term biotoxicity and low photothermal conversion efficiency of heat-generation materials. In this study, we develop a new D-A (donor-acceptor) structure NIR absorbing dye (C720) which exhibits a high photothermal conversion efficiency (62%), good photostability, and photothermal reproducibility. Then C720 is doped in the lipid bilayer and DOX (doxorubicin) is wrapped in the core of temperature sensitive liposomes to construct a C720 and DOX-loaded thermosensitive nanoplatform (CDTSL). The as-prepared CDTSL achieves NIR light controlled drug release and can be applied for photoacoustic imaging. In vitro and in vivo studies confirm that CDTSL exhibits high tumor suppressive efficiency by synergistic photothermal therapy and chemotherapy. Our research provides fundamental insights for the rational design and preparation of a promising nanoplatform for photoacoustic imaging and chemo-photothermal therapy.

8.
J Ethnopharmacol ; 260: 113045, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32504785

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Zishen Yutai Pills (ZYP), a famous traditional Chinese patent medicine, has been widely applied to avoid recurrent miscarriage and treat threatened abortion. Polysaccharides of ZYP (ZYPPs) play an essential role in the theraprutic effects of ZYP. However, the complex compositions of ZYP and the complicated structure of ZYPPs have posed great challenges and barriers to the quality evaluation of ZYP. AIM OF THE STUDY: To identify and characterize the ZYPPs for better quality control of ZYP, a reliable and valid quality control system was established in this study. MATERIALS AND METHODS: A multi-fingerprint profile strategy based on HPSEC-MALL-RID, FT-IR, and HPLC (complete acid digested fingerprint, partial acid digested fingerprint and enzymatically digested fingerprint) was established to identify and discriminate the chemical structure of ZYPPs. Besides, the purpose of revealing the relationships between structure and biological activity of ZYPPs, their chemical characteristics, in vitro antioxidant and anti-glycation activities were investigated and discussed. RESULTS: The similarity evaluation of ZYPPs indicated ZYPPs from different batches showed a high similarity based on the correlation coefficient values of multi-fingerprints. Furthermore, ZYPPs exhibited remarkable antioxidant and antiglycation properties, which might be attributed to their molecular weights and the content of uronic acids. CONCLUSIONS: These results indicated that the multiple fingerprint technique was reliable and effective for the improvement of quality control of ZYPPs, suggesting the multiple fingerprint technique could also be potentially applied as a valid and feasible strategy to control the quality of polysaccharide-enriched herbal medicines.

9.
Arch Toxicol ; 94(8): 2683-2690, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32524153

RESUMO

The dysregulation of Ras/Raf/MEK/ERK pathway governs occurrence and progression of cancers. In previous studies, genome-wide association studies (GWAS) have identified multiple gene loci related to gastric cancer. However, a great many genetic loci have been missed due to multiple statistical comparisons of GWAS. In this study, Multi-marker Analysis of GenoMic Annotation (MAGMA) was applied to analyze genes in Ras/Raf/MEK/ERK pathway and their single nucleotide polymorphisms (SNPs) based on Chinese GWAS including 1625 gastric cancer cases and 2100 controls. The SNP effects on gastric cancer susceptibility were calculated on the basis of a logistic regression model. Expression quantitative trait loci (eQTL) analysis was performed based on the genotype-tissue expression (GTEx) project. We identified that three SNPs in MAP2K1, rs4287513, rs76906202 and rs11631448 were markedly associated with gastric cancer risk (rs4287513: OR = 1.30, 95% CI = 1.10-1.54, P = 1.92 × 10-3; rs76906202: OR = 0.87, 95% CI = 0.79-0.96, P = 3.72 × 10-3; rs11631448: OR = 1.21, 95% CI = 1.05-1.39, P = 6.74 × 10-3). All the loci were eQTLs for MAP2K1 in normal gastric samples. Moreover, the low expression of MAP2K1 was significantly associated with poor survival in gastric cancer patients. Thus, MAP2K1 might represent a key gene related to gastric cancer in Ras/Raf/MEK/ERK pathway, whereas SNPs in MAP2K1 confer gastric cancer susceptibility by having biological effects on the MAP2K1 expression.

10.
Artigo em Inglês | MEDLINE | ID: mdl-32557175

RESUMO

Echinocandin B (ECB) is a key precursor of antifungal agent Anidulafungin, which has demonstrated clinical efficacy in patients with invasive candidiasis. In this study, the effects of microparticle-enhanced cultivation and methyl oleate on echinocandin B fermentation titer were investigated. The results showed that the titer was significantly influenced by the morphological type of mycelium, and mycelium pellet was beneficial to improve the titer of this secondary metabolism. First, different carbon sources were chosen for the fermentation, and methyl oleate achieved the highest echinocandin B titer of 2133 ± 50 mg/L, which was two times higher than that of the mannitol. The study further investigated the metabolic process of the fermentation, and the results showed that L-threonine concentration inside the cell could reach 275 mg/L at 168 h with methyl oleate, about 2.5 times higher than that of the mannitol. Therefore, L-threonine may be a key precursor of echinocandin B. In the end, a new method of adding microparticles for improving the mycelial morphology was used, and the addition of talcum powder (20 g/L, diameter of 45 µm) could make the maximum titer of echinocandin B reach 3148 ± 100 mg/L.

11.
Nature ; 583(7814): 154, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32555452

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

13.
Mediators Inflamm ; 2020: 8275026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32508527

RESUMO

Sepsis is a severe disease, which results from the excessive inflammatory response to the infection. Dysfunction of intestinal barrier is a crucial problem in various pathological conditions. Meanwhile, microRNAs exhibit significant roles in the modulation of many diseases, including sepsis. Multiple investigations indicate that miR-199a-5p participates in different human diseases. Nevertheless, little is known on the roles of miR-199a-5p in sepsis. Herein, we evaluated the mechanism of miR-199a-5p on the intestinal barrier dysfunction in sepsis. Intestinal mucosa permeability indicators including D-lactic acid, DAO, and FD-40 levels were determined, and they were greatly increased in sepsis. Then, we proved that miR-199a-5p was induced in sepsis mice tissues and isolated intestinal epithelial cells. Moreover, miR-199a-5p increased D-lactic acid, DAO, and FD-40 while inhibition of miR-199a-5p exhibited a reversed process. Additionally, we observed that miR-199a-5p affected the oxidative damage and inflammation in the intestine tissues from sepsis mice. The content of MDA was elevated whereas SOD was remarkably repressed in the miR-199a-5p mimic group. IL-6, IL-1ß, and TNF-α were induced by miR-199a-5p overexpression while IL-10 was reduced by miR-199a-5p. Subsequently, surfactant protein D (SP-D) was predicted as the target of miR-199a-5p. The activation of NF-κB has been identified in sepsis. Herein, we demonstrated that inhibitor of miR-199a-5p contributed to IEC injury via targeting SP-D and inactivating the NF-κB pathway. These revealed miR-199a-5p exacerbated the intestinal barrier dysfunction via inhibiting SP-D and activating the NF-κB pathway in sepsis.

14.
Mol Pharm ; 17(7): 2260-2274, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32433886

RESUMO

Reactive oxygen species (ROS) are chemically reactive species that are produced in cellular aerobic metabolism. They mainly include superoxide anion, hydrogen peroxide, hydroxyl radicals, singlet oxygen, ozone, and nitric oxide and are implicated in many physiological and pathological processes. Bilirubin, a cardinal pigment in the bile, has been increasingly investigated to treat cancer, diabetes, ischemia-reperfusion injury, asthma, and inflammatory bowel diseases (IBD). Indeed, bilirubin has been shown to eliminate ROS production, so it is now considered as a promising therapeutic agent for ROS-mediated diseases and can be used for the development of antioxidative nanomedicines. This review summarizes the current knowledge of the physiological mechanisms of ROS production and its role in pathological changes and focuses on discussing the antioxidative effects of bilirubin and its application in the experimental studies of nanomedicines. Previous studies have shown that bilirubin was mainly used as a responsive molecule in the microenvironment of ROS overproduction in neoplastic tissues for the development of anticancer nanodrugs; however, it could also exert powerful ROS scavenging activity in chronic inflammation and ischemia-reperfusion injury. Therefore, bilirubin, as an inartificial ROS scavenger, is expected to be used for the development of nanomedicines against more diseases due to the universality of ROS involvement in human pathological conditions.

15.
Pharmacol Res ; 158: 104937, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32464331

RESUMO

Ganoderma lucidum (Leyss. ex Fr.) Karst. is a valuable dietary supplement used worldwide for promoting health as well as a medicinal fungus for handling fatigue, immunological disorders, and cancer. Previous studies have revealed the immunoenhancing effect of G. lucidum and the polysaccharide extract, with potential involvement of gut microbiome. The oil of G. lucidum spores (GLSO)is one of the well-known G. lucidum-related products. However, there is little evidence supporting the immune promotion activity and the underlying mechanisms. The present study aims to investigate the immunoenhancing effect of GLSO in mice. GLSO enhanced macrophage phagocytosis and NK cell cytotoxicity of mice. Further microbiome and metabolomics studies showed that GLSO induced structural rearrangement of gut microbiota, mediating alterations in a wide range of metabolites. By clustering, multivariate and correlation analysis, the immunoenhancing effect of GLSO was found to be highly correlated with elevated abundance of several bacterial genera (Lactobacillus, Turicibacter and Romboutsia) and species (Lactobacillus_intestinalis and Lactobacillus_reuteri), and decreased level of Staphylococcus and Helicobacter, which resulted in the regulation of a range of key metabolites such as dopamine, prolyl-glutamine, pentahomomethionine, leucyl-glutamine, l-threonine, stearoylcarnitine, dolichyl ß-d-glucosyl phosphate, etc. These results provide new insights into the understanding of the modulatory effect of GLSO on immune system.

16.
Oxid Med Cell Longev ; 2020: 3050971, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32454936

RESUMO

Introduction: Alzheimer's disease (AD), the most common neurodegenerative disorder, is characterized by the accumulation of amyloid-ß (Aß) peptide and hyperphosphorylated tau protein. Accumulating evidence has revealed that the slow progressive deterioration of AD is associated with oxidative stress and chronic inflammation in the brain. Nuclear factor erythroid 2- (NF-E2-) related factor 2 (Nrf2), which acts through the Nrf2/ARE pathway, is a key regulator of the antioxidant and anti-inflammatory response. Although recent data show a link between Nrf2 and AD-related cognitive decline, the mechanism is still unknown. Thus, we explored how Nrf2 protects brain cells against the oxidative stress and inflammation of AD in a mouse model of AD (APP/PS1 transgenic (AT) mice) with genetic removal of Nrf2. Methods: The spatial learning and memory abilities of 12-month-old transgenic mice were evaluated using a Morris water maze test. Hippocampal levels of Nrf2, Aß, and p-tauS404 and of astrocytes and microglia were determined by immunostaining. Inflammatory cytokines were determined by ELISA and quantitative real-time polymerase chain reaction (qRT-PCR). Oxidative stress was measured by 8-hydroxydeoxyguanosine immunohistochemistry, and the antioxidant response was determined by qRT-PCR. Results: The spatial learning and memory abilities of AT mice were impaired after Nrf2 deletion. Aß and p-tauS404 accumulation was increased in the hippocampus of AT/Nrf2-KO mice. Astroglial and microglial activation was exacerbated, followed by upregulation of the proinflammatory cytokines IL-1ß, IL-6, and TNF-α. Conclusion: Our present results show that Nrf2 deficiency aggravates AD-like pathology in AT mice. This phenotype was associated with increased levels of oxidative and proinflammatory markers, which suggests that the Nrf2 pathway may be a promising therapeutic target for AD.

17.
Mediators Inflamm ; 2020: 8232734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32410866

RESUMO

Sepsis and intestinal injury triggered by sepsis are common in intensive care units, which can contribute to a high mortality. lncRNAs can modulate gene expression, and they are closely involved in multiple diseases, including sepsis. In our present study, we investigated the biological function of MEG3 in sepsis, especially during the intestinal injury. Currently, we observed that in LPS-induced sepsis mouse models, the intestinal injury was triggered. Meanwhile, we reported that MEG3 was greatly decreased in vivo, with an increase of miR-129-5p and inhibition of SP-D. Then, MEG3 was overexpressed, and we found that its overexpression repressed the intestinal injury via downregulating miR-129-5p in sepsis mice. Moreover, TNF-α and IL-6 expression was elevated in intestinal tissues compared to the control groups. MEG3 restrained the activation of TNF-α and IL-6, in sepsis models. Subsequently, to induce the inflammatory injury of sepsis, human colorectal Caco2 cells were treated with 10 ng/ml LPS. 10 ng/ml LPS significantly inhibited Caco2 cell proliferation and increased the apoptosis. Additionally, MEG3 was decreased whereas miR-129-5p was obviously increased in Caco2 cells incubated with LPS. Interestingly, we showed that MEG3 repressed cell apoptosis partly and enhanced Caco2 cell proliferation. miR-129-5p overexpression could reverse the effect of MEG3 in vitro. Previously, we proved SP-D was reduced in sepsis and it depressed the intestinal injury in vivo. Finally, the correlation among MEG3, miR-129-5p, and SP-D was predicted and confirmed in our investigation. These findings indicated that MEG3 might be a potential target for intestinal damage caused by sepsis via regulating miR-129-5p and SP-D.

18.
J Toxicol Sci ; 45(5): 271-280, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32404559

RESUMO

Environmental neurotoxins such as paraquat (PQ), manganese, and 1-1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) are associated with a higher risk of Parkinson's disease (PD). These parkinsonian toxins exert certain common toxicological effects on astroglia; however, their role in the regulatory functions of astroglial secretory proteins remains unclear. In a previous study, we observed that secretogranin II (SCG2) and secretogranin III (SCG3), which are important components of the regulated secretory pathway, were elevated in PQ-activated U118 astroglia. In the current study, we used the parkinsonian toxins dopamine (DA), active metabolite of MPTP (MPP+), MnCl2, and lipopolysaccharide (LPS) as inducers, and studied the potential regulation of SCG2 and SCG3. Our results showed that all the parkinsonian toxins except LPS affected astroglial viability but did not cause apoptosis. Exposure to DA, MPP+, and MnCl2 upregulated glial fibrillary acidic protein (GFAP), a marker for astrocyte activation, and stimulated the levels of several astrocytic-derived factors. Further, DA, MPP+, and MnCl2 exposure impeded astroglial cell cycle progression. Moreover, the expression of SCG3 was elevated, while its exosecretion was inhibited in astroglia activated by parkinsonian toxins. The level of SCG2 remained unchanged. In combination with our previous findings, the results of this study indicate that SCG3 may act as a cofactor in astrocyte activation stimulated by various toxins, and the regulation of SCG3 could be involved in the toxicological mechanism by which parkinsonian toxins affect astroglia.

19.
Biosci Rep ; 40(5)2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32368783

RESUMO

Neuromuscular electrical stimulation (NMES) has been shown to produce benefits in the muscle function of chronic obstructive pulmonary disease (COPD) patients. The definite effectiveness of NMES, applied in isolation or concurrently with conventional pulmonary rehabilitation (PR) or exercise training, remains unclear. This review was to determine the effects of NMES on exercise capacity, functional performance, symptoms, and health-related quality of life (HRQoL) in COPD patients. Electronic databases (PubMed, Embase, Web of Science, the Cochrane Library) were searched for relevant randomized controlled trials (RCTs). Two investigators independently screened the eligible studies up to February 2020 that used NMES as the intervention group. The outcome measures were 6-min walking distance (6MWD), peak rate of oxygen uptake (VO2 peak), St George's Respiratory Questionnaire (SGRQ), and symptoms of dyspnoea and fatigue. Data were extracted using a predefined table and papers were appraised using Downs and Black tool. We analyzed 13 RCTs with 447 COPD patients. In the analysis of 6MWD, pooled estimates showed a significant increase in the NMES group, compared with the control group (mean difference (MD) = 27.05, 95% confidence interval (CI): 8.46-45.63, P<0.001). There were also improvements in symptoms of dyspnea or leg fatigue, and reduction in London Chest Activity of Daily Living (LCADL) scores. No statistically significant difference was observed in VO2 peak, peak power, and SGRQ. NMES could improve exercise capacity and reduce perceived sensation of dyspnea during exercise in patients with COPD, but not to be recommended as an effective alternative training modality in the rehabilitation of stable COPD patients.

20.
Curr Med Sci ; 40(2): 348-353, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32337696

RESUMO

China's universal two-child policy was released in October of 2015. How would this new policy influence the rate of overall cesarean delivery (CD) in China? The objective of this paper is to investigate the trend of overall CD rate with the increase of number of multiparous women based on a big childbirth center of China (a tertiary hospital) in 2016. In this study, 22 530 cases from the medical record department of a big childbirth center of China from January 1 to December 31 in 2016 were enrolled as research objects. Electronic health records of these selected objects were retrieved. According to the history of childbirth, the selected cases were divided into primiparous group containing 16 340 cases and multiparous group containing 6190 cases. Chi-square test was carried out to compare the rate of CD, neuraxial labor analgesia, maternity insurance between the two groups; t-test was performed to compare the in-hospital days and gestational age at birth between the two groups. Pearson correlation coefficient was used to evaluate the relationship among observed monthly rate of multiparas, overall CD rate, and Elective Repeat Cesarean Delivery (ERCD) rate. The results showed that the CD rate in multiparous group was 55.46%, which was higher than that in primiparous group (34.66%, P<0.05). The rate of neuraxial labor analgesia in multiparas group was 9.29%, which was lower than that in primiparas group (35.94%, P<0.05). However, the rate of maternity insurance was higher in multiparas group (57.00%) than that in primiparas group (41.08%, P<0.05). The hospital cost and in-hospital days in multiparas group were higher, and the gestational age at birth in multiparas group was lower than in primiparas group (P<0.05). The overall CD rate slightly dropped in the first 4 months of the year (P<0.05), then increased from 36.27% (April) to 43.21% (December) (P<0.05). The rate of multiparas women and ERCD had the same trend (P<0.05). There were linear correlations among the rate of overall CD, the rate of multiparas women and the rate of ERCD rate (P<0.05). With the opening of China's two-child policy, the increasing rate of overall CD is directly related with the high rate of ERCD. Trials of Labor After Cesarean Section (TOLAC) in safe mode to reduce overall CD rate are warranted in the future.

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