Predictors of a Favorable Response to Transforaminal Epidural Steroid Injections for Lumbar Radiculopathy in the Elderly.

BACKGROUND: The efficacy and its associated predictors of transforaminal epidural steroid injection (TFESI) in elderly patients with lumbar radiculopathy are unknown. OBJECTIVE: The purpose of this retrospective study was to identify the efficacy of TFESI in elderly patients with lumbar radiculopathy and its associated predictors of long-term outcomes. STUDY DESIGN: Retrospective study. SETTING: Interventional pain clinics in West China Hospital of Sichuan University. METHODS: In total, 294 elderly patients who were diagnosed with lumbar radiculopathy and underwent transforaminal epidural steroid injections from January 2019 through January 2022 were retrospectively analyzed. Demographic, clinical, magnetic resonance imaging, and TFESI-related information was collected to assess the predictive factors of long-term outcomes of the TFESI. Pain scores were assessed using the Numeric Rating Scale. Treatment success was defined as a >= 50% reduction in pain scores at 6 months. RESULTS: Multivariate logistic regression analysis revealed that the duration of symptoms, immediate postoperative response, and neutrophilic granulocyte percentage were independently associated with a favorable response to TFESI. In addition, the level of pain at the initial visit and the number of TFESI performed were also associated with a good response in the multivariate regression analysis, even though the association was not statistically significant. LIMITATIONS: Approximately 6% of the patients were lost to follow-up; therefore, selection bias may have slightly influenced our findings. In addition, our patients were not compared with a control population, and consequently, a placebo effect could not be assessed. CONCLUSION: This study revealed that a short duration of symptoms, good immediate postoperative response and high neutrophilic granulocyte percentage were long-term predictors of a good response to TFESI in elderly patients with lumbar radiculopathy.

Prevalence of Pain and Its Risk Factors Among ICU Personnel in Tertiary Hospital in China: A Cross-Sectional Study.

Background: Although pain is commonly observed among medical staff, studies on pain among intensive care unit personnel are uncommon, especially intensive care unit (ICU) doctors and workers. Moreover, few studies have focused on the prevalence of pain and the associated factors. Purpose: The aim of this study was to estimate the prevalence of pain among ICU personnel (including doctors, nurses and workers) and explore the risk factors for their pain. Methods: We conducted an online survey that included sociodemographic and work-related items and questions about pain, ergonomics, and psychological factors. We used the short version of the validated Depression-Anxiety-Stress Scale (DASS-21) to assess the relationship between pain and mental disorders. All ICU personnel at West China Hospital of Sichuan University participated in this study. Results: A total of 356 ICU personnel were included in the final analysis. The prevalence of pain was 72.2% among ICU nurses, 64.4% among ICU doctors and 52.9% among ICU workers. The most frequent location of pain was the lower back among nurses (65.9%) and workers (47.1%) and the neck among doctors (49.1%). The factors contributing to pain among ICU personnel were bending or twisting the neck, high levels of psychological fatigue, low self-perceived health status, female sex and high body mass index (BMI). Moreover, participants with pain indicated significantly higher depression (p ≤ 0.001), anxiety (p ≤ 0.001), and stress levels (p = 0.002) than those without pain. Conclusion: This study indicates that ICU personnel exhibit a high prevalence of pain. Many factors, especially psychosocial and ergonomic factors, contribute to pain levels among ICU personnel and the poorer mental health levels observed in those experiencing pain. Therefore, disease prevention and health promotion measures are needed to protect the health of ICU personnel.

An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis.

BACKGROUND: Fecal microbiota transplantation (FMT) as a promising therapy for ulcerative colitis (UC) remains controversial. We conducted a systematic review and meta-analysis to assess the efficiency and safety of FMT as a treatment for UC. METHODS: The target studies were identified by searching PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials and by manual supplementary retrieval. We conducted a general review and quantitative synthesis of included studies. We used the RevMan and Stata programs in the meta-analysis. The outcomes were total remission, clinical remission, steroid-free remission, and serious adverse events. We also performed subgroup analyses based on different populations. RESULTS: A total of 34 articles were included in the general review. Only 16 articles, including 4 randomized controlled trials, 2 controlled clinical trials, and 10 cohort studies, were selected for the meta-analysis. We found that donor FMT might be more effective than placebo for attaining total remission (risk ratio [RR]: 2.77, 95% confidence interval [CI]: 1.54-4.98; P = .0007), clinical remission (RR: 0.33, 95% CI: 0.24-0.41; P < .05), and steroid-free remission (RR: 3.63, 95% CI: 1.57-8.42; P = .003), but found no statistically significant difference in the incidence of serious adverse events (RR: 0.88, 95% CI: 0.34-2.31, P = .8). The subgroup analyses revealed significant differences between the pooled clinical remission rates for different regions, degrees of severity of the disease, and patients with steroid- or nonsteroid-dependent UC. CONCLUSIONS: FMT can achieve clinical remission and clinical response in patients with UC.

Protective Effect of Conditioned Media of Human Fetal Dermal Mesenchymal Stem Cells Can Inhibit Burn-induced Microvascular Hyperpermeability.

Burns often cause loss of skin barrier protection, fluid exudation, and local tissue edema, which hinder functional recovery. Effectively improving the quality of deep burn wound healing, shortening the wound healing time, and reducing tissue fluid leakage are urgent problems in the medical field. Human mesenchymal stem cells (MSCs) can effectively stabilize vascular endothelial injury. Fetal dermal MSCs (FDMSCs) are a newly discovered source of MSCs derived from the skin of accidentally aborted fetuses. However, the effect of FDMSCs on vascular permeability remains poorly understood. In this study, conditioned media from FDMSCs (F-CM) extracted from fetal skin tissue was prepared. The effect of F-CM on vascular permeability was evaluated using the internal circulation method FITC-dextran in vivo, and several in vitro assays, including cell viability assay, transwell permeability test, immunofluorescence, and western blotting. Altogether, our results demonstrate that F-CM could inhibit burn-induced microvascular hyperpermeability by increasing the protein expression levels of occludin and VE-cadherin, while restoring the expression of endothelial F-actin, and providing the foundation of a novel therapy for the treatment of burns with F-CM.

Comparisons of body-composition prediction accuracy: a study of 2 bioelectric impedance consumer devices in healthy Chinese persons using DXA and MRI as criteria methods.

We compared the accuracy of body-composition estimation for 2 commercial single-frequency bioelectric impedance analysis (BIA) devices in 200 healthy Chinese adults using magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) as criterion methods. We evaluated the fat mass percentage (%FM), skeletal muscle mass percentage (%SM), or total-body bone-free lean mass percentage (%TBBLM), and level of visceral fat mass (VF(level)) using the Omron HBF-359 (SF-BIA8) and Tanita BC-532 (SF-BIA4) BIA devices, MRI, and DXA. Both devices showed a similarly high correlation with DXA for %FM prediction (r=0.89 for SF-BIA8 and 0.90 for SF-BIA4) and with MRI and DXA for %SM and %TBBLM prediction (r=0.85 for SF-BIA8 and 0.89 for SF-BIA4). There were small but significant biases in all body-composition parameter evaluations except for %SM assessed by the SF-BIA8. Both the SF-BIA8 and SF-BIA4 provided small, insignificant mean biases but wide limits of agreement with MRI for VF(level) assessments. Both BIA devices can relatively accurately predict %FM and %SM in healthy Chinese adults. The SF-BIA8 is suitable for individual prediction of %SM, whereas the SF-BIA8 is required to eliminate systematic errors in this population by improving population-specific prediction equations from height, weight, and age to increase estimation accuracy.

Dynamic study into autophagy and apoptosis during orthodontic tooth movement.

Orthodontic tooth movement (OTM) has been widely observed worldwide. The OTM process is involved in several biological activities and can result in temporary hypoxia. The dynamic changes of autophagy and apoptosis during OTM have not, to the best of our knowledge, been previously reported. In the present study, an OTM animal model was established. Periodontal ligament cells (PDLCs) and osteoclasts were investigated using H&E and tartrate-resistant acid phosphatase staining. The changes in the expression levels of certain autophagy and apoptotic markers were investigated using immunohistochemical staining. A significant decrease in PDLC and an increase in osteoclast numbers were observed 1 day following OTM induction. The expression levels of Beclin-1 and LC3-II peaked at 1 h post-OTM, followed by a gradual decrease. The expression levels of P62 in each experimental group were significantly lower than those noted in the 0 h group. The expression levels of Bcl-2 were markedly increased 1 h following OTM and reached a maximum at 1 day post-OTM. The highest expression levels of Bax and caspase-3 were observed 7 days following OTM induction. The present study provided additional information regarding the involvement of autophagy and apoptotic markers in the OTM process and aided the understanding of the initiation and pathophysiological progression of this condition.

Coated, Stabilized Enhanced-Efficiency Nitrogen Fertilizers: Preparation and Effects on Maize Growth and Nitrogen Utilization.

Coated, slow/controlled release, or stabilized enhanced-efficiency nitrogen fertilizers (EENFs) are effective in improving nitrogen utilization efficiency (NUE) and crop yield. Better performance is expected from coated, stabilized EENFs where urease and nitrification inhibitors are treated in coated fertilizers. Firstly, five coated EENFs with different mass proportions of nature rubber (NR) in coating were prepared: CU0, CU1, CU2, CU3, CU4, and CU5 (0, 10, 20, 30, 40, and 50% of NR in coating). The controlled release performance of CU was tested by hydrostatic release test and the microstructure of controlled release urea, so as to screen the optimal addition ratio of NR (ER: NR = 7:3, CU3). Secondly, two coated, stabilized EENFs, CSU1 and CSU2, were prepared with natural rubber-modified epoxy resin (ER: NR = 7:3) as coating material. Seven treatments of different N fertilization were set up: CK (no N fertilization), urea, CU3, SU1, and SU2 (urease and nitrification inhibitors-treated urea fertilizers), CSU1 and CSU2 (urease and nitrification inhibitors-treated natural rubber-modified epoxy resin-coated urea fertilizers). Ammonia volatilization experiment and column leaching experiment showed that compared with conventional urea, NH3 volatilization loss was reduced by 20% and inorganic N leaching loss was reduced by 26% from CSU2, respectively. In the pot experiment, maize grain yield of 162.92 and 206.96 g/pot was achieved by CSU1 and CSU2, respectively, 41 and 79%, respectively, higher than that achieved by conventional urea. SUs treatments were more effective than conventional urea treatment in improving maize grain yield and NUE, but lower than in CSUs. The NUE, nitrogen fertilizer apparent utilization efficiency, partial factor productivity of applied N, and nitrogen utilization efficiency were 46, 30, 46, and 32%, respectively, higher in CSU1 and 58, 62, 58, and 29%, respectively, higher in CSU2 than in the conventional urea treatment. Compared with CSU1, CSU2 had better agronomic effectiveness with a higher NUE. It is recommended that urease and nitrification inhibitors be sandwiched between urea prill and the coating for preparation of novel, environmentally friendly coated, stabilized EENFs with high agronomic effectiveness, high NUE, and low N loss.

Anti-aging effects of fetal dermal mesenchymal stem cells in a D-galactose-induced aging model of adult dermal fibroblasts.

The main characteristic of skin aging is the change in the composition of the dermis, mainly resulting from fibroblast senescence. Mesenchymal stem cells derived from fetal dermis are defined as fetal dermal mesenchymal stem cells; they reportedly exert wound healing effects on the skin and regulate keloid fibroblast proliferation. D-Galactose is widely used in animal aging models. In this study, we confirmed that D-galactose inhibits adult dermal fibroblast proliferation, and the inhibitory effect gradually increased with increasing concentration. Finally, we chose a concentration of 40 g/L D-galactose to induce adult dermal fibroblast senescence. D-Galactose increased the intensity of senescence-associated ß-galactosidase staining and the levels of reactive oxygen species in adult dermal fibroblasts. Furthermore, D-galactose increased the mRNA expression of p16, p21, and p53. The fetal dermal mesenchymal stem cell-conditioned medium improved the above-mentioned effects. Overall, fetal dermal mesenchymal stem cells exerted anti-aging effects against adult dermal fibroblasts induced by D-galactose via paracrine functions.

Fetal Dermal Mesenchymal Stem Cell-Derived Exosomes Accelerate Cutaneous Wound Healing by Activating Notch Signaling.

Fetal dermal mesenchymal stem cells (FDMSCs), isolated from fetal skin, are serving as a novel MSC candidate with great potential in regenerative medicine. More recently, the paracrine actions, especially MSC-derived exosomes, are being focused on the vital role in MSC-based cellular therapy. This study was to evaluate the therapeutic potential of exosomes secreted by FDMSCs in normal wound healing. First, the in vivo study indicated that FDMSC exosomes could accelerate wound closure in a mouse full-thickness skin wound model. Then, we investigated the role of FDMSC-derived exosomes on adult dermal fibroblast (ADFs). The results demonstrated that FDMSC exosomes could induce the proliferation, migration, and secretion of ADFs. We discovered that after treatment of exosomes, the Notch signaling pathway was activated. Then, we found that in FDMSC exosomes, the ligands of the Notch pathway were undetectable expect for Jagged 1, and the results of Jagged 1 mimic by peptide and knockdown by siRNA suggested that Jagged 1 may lead the activation of the Notch signal in ADFs. Collectively, our findings indicated that the FDMSC exosomes may promote wound healing by activating the ADF cell motility and secretion ability via the Notch signaling pathway, providing new aspects for the therapeutic strategy of FDMSC-derived exosomes for the treatment of skin wounds.

Identification of aaNAT5b as a spermine N-acetyltransferase in the mosquito, Aedes aegypti.

Mosquitoes transmit a number of diseases in animals and humans, including Dengue, Chikungunya and Zika viruses that affect millions of people each year. Controlling the disease-transmitting mosquitoes has proven to be a successful strategy to reduce the viruses transmission. Polyamines are required for the life cycle of the RNA viruses, Chikungunya virus and Zika virus, and a depletion of spermidine and spermine in the host via induction of spermine N-acetyltransferase restricts their replication. Spermine N-acetyltransferase is a key catabolic enzyme in the polyamine pathway, however there is no information of the enzyme identification in any insects. Aliphatic polyamines play a fundamental role in tissue growth and development in organisms. They are acetylated by spermidine/spermine N1-acetyltransferase (SAT). In this study we provided a molecular and biochemical identification of SAT from Aedes aegypti mosquitoes. Screening of purified recombinant proteins against polyamines established that aaNAT5b, named previously based on sequence similarity with identified aaNAT1 in insects, is active to spermine and spermidine. A crystal structure was determined and used in molecular docking in this study. Key residues were identified to be involved in spermine binding using molecular docking and simulation. In addition, SAT transcript was down regulated by blood feeding using a real time PCR test. Based on its substrate profile and transcriptional levels after blood feeding, together with previous reports for polyamines required in arboviruses replication, SAT might be potentially used as a target to control arboviruses with human interference.