Publications by authors named "Chenxi Li"

273 Publications

Efficacy and safety of empagliflozin at different doses in patients with type 2 diabetes mellitus: A network meta-analysis based on randomized controlled trials.

J Clin Pharm Ther 2021 Sep 20. Epub 2021 Sep 20.

Department of Cardio-Thoracic Surgery, The second affiliated hospital of Nanchang University, Nanchang, China.

What Is Known And Objective: As an oral hypoglycaemic drug that significantly reduces cardiovascular risk, empagliflozin is often used in patients with type 2 diabetes mellitus (T2DM). However, the dosage and administration of empagliflozin are still controversial clinically. To determine the most appropriate dose, we performed this network meta-analysis.

Methods: We identified randomized controlled trials (RCTs) about empagliflozin from eight databases. We analysed the pharmacodynamics, adverse effects (AEs), and pharmacokinetics of empagliflozin at different doses.

Results: We identified 8264 articles, of which 23 RCTs with 10518 patients were included. Regarding haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), high-daily doses (10, 25, 50 mg) were significantly better than low doses (1, 2.5, 5 mg). For total AEs, there was a dose-response trend in which safety decreased with increasing doses. According to SUCRA sequencing, the order for lowering HbA1c was 25 > 50 > 10 > 5 > 1 mg, for lowering FPG was 50 > 25 > 10 > 5 > 2.5 > 1 mg and for safety was 1> 5 > 10 > 25> 2.5 > 50 mg. When considering HbA1c, FPG and total AEs, we performed a hierarchical cluster analysis and network meta-analysis to find that 25 mg performed best among different doses, which was more significant after long-term use (≥ 12 weeks). Pharmacokinetic parameters exhibited significant dose-response relationships.

What Is New And Conclusion: High-daily doses (10, 25, 50 mg) had better efficacy than low doses (1, 2.5, 5 mg). When considering HbA1c, FPG and total AEs, 25 mg performed best among the different doses in patients with T2DM.
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http://dx.doi.org/10.1111/jcpt.13521DOI Listing
September 2021

Early Microstructure Changes of White Matter Fiber Bundles in Patients with Amnestic Mild Cognitive Impairment Predicts Progression of Mild Cognitive Impairment to Alzheimer's Disease.

J Alzheimers Dis 2021 Sep 1. Epub 2021 Sep 1.

The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China.

Background: Amnestic mild cognitive impairment (aMCI) is the transitional stage between normal aging and Alzheimer's disease (AD). Some aMCI patients will progress into AD eventually, whereas others will not. If the trajectory of aMCI can be predicted, it would enable early diagnosis and early therapy of AD.

Objective: To explore the development trajectory of aMCI patients, we used diffusion tensor imaging to analyze the white matter microstructure changes of patients with different trajectories of aMCI.

Methods: We included three groups of subjects:1) aMCI patients who convert to AD (MCI-P); 2) aMCI patients who remain in MCI status (MCI-S); 3) normal controls (NC). We analyzed the fractional anisotropy and mean diffusion rate of brain regions, and we adopted logistic binomial regression model to predicate the development trajectory of aMCI.

Results: The fraction anisotropy value is significantly reduced, the mean diffusivity value is significantly increased in the two aMCI patient groups, and the MCI-P patients presented greater changes. Significant changes are mainly located in the cingulum, fornix, hippocampus, and uncinate fasciculus. These changed brain regions significantly correlated with the patient's Mini-Mental State Examination scores.

Conclusion: The study predicted the disease trajectory of different types of aMCI patients based on the characteristic values of the above-mentioned brain regions. The prediction accuracy rate can reach 90.2%, and the microstructure characteristics of the right cingulate band and the right hippocampus may have potential clinical application value to predict the disease trajectory.
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http://dx.doi.org/10.3233/JAD-210495DOI Listing
September 2021

Multiple genetic variants predict the progression-free survival of bevacizumab plus chemotherapy in advanced ovarian cancer: A retrospective study.

Medicine (Baltimore) 2021 Sep;100(35):e27130

Department of Oncology, First Affiliated Hospital of PLA General Hospital, China.

Abstract: Bevacizumab (BV) plus chemotherapy is broadly used in advanced ovarian cancer (OC). However, the efficacy of BV-based regimens for advanced OC patients is not satisfactory. Therefore, it is urgent to explore the predictive genetic biomarkers for BV.Tumor tissues from advanced OC patients receiving BV-based regimens were analyzed with a 150-gene targeted panel for next generation sequencing. The associations between gene alterations or clinicopathology features and progression-free survival (PFS) were analyzed by Kaplan-Meier curves or Cox regression. The association of the genetic alteration in potential predictive genes and expressions of 11 vascular endothelial growth factor-related genes were analyzed in The Cancer Genome Atlas cohort using 292 OC cases.Sixty two Chinese advanced OC patients treated with BV-based therapy were included. The median PFS of was 6.9 months, and objective response rate was 14.5%. In multivariate Cox regression analysis, the status of endothelial growth factor receptor (EGFR) (hazard ratio = 6.39, 95% confidence interval [CI] 2.25-18.13, P < .001) and human epidermal growth factor receptor 2 (HER2) (hazard ratio = 3.58, 95% CI 1.27-10.08, P = .016) were significantly correlated with PFS. MYC Proto-Oncogene amplification seemed to have a positive trend (hazard ratio = 0.21, 95% CI 0.05-1.02, P = .052). Moreover, EGFR and HER2 alterations were not prognostic factors of overall survival for OC in The Cancer Genome Atlas OC cohort. The vascular endothelial growth factor-related signature analysis indicated vascular endothelial factor A expression was upregulated with EGFR alterations (P = .034) which may be involved in BV resistance, and HER2 alterations were associated with hypoxia inducible factor 1 subunit alpha overexpression significantly (P = .029).EGFR or HER2 alterations are negative predictors of PFS for OC patient treated with BV plus chemotherapy. Therefore, the clinicians may consider to use alternative regimens such as anti-EGFR or anti-HER2 targeted therapy instead of BV-based regimens on these patients when standard care fail.
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http://dx.doi.org/10.1097/MD.0000000000027130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415939PMC
September 2021

Multi-marker genetic association and interaction tests with interval-censored survival outcomes.

Genet Epidemiol 2021 Sep 2. Epub 2021 Sep 2.

Department of Biostatistics, University of Florida, Gainesville, Florida, USA.

The development of set-based genetic-survival association tests has been focusing on right-censored survival outcomes. However, interval-censored failure time data arise widely from health science studies, especially those on the development of chronic diseases. In this paper, we proposed a suite of set-based genetic association and interaction tests for interval-censored survival outcomes under a unified weighted-V-statistic framework. Besides dealing with interval censoring, the new tests can account for genetic effect heterogeneity and accommodate left truncation of survival outcomes. Simulation studies showed that the new tests perform well in terms of size and power under various scenarios and that the new interaction test is more powerful than the standard likelihood ratio test for testing gene-gene/gene-environment interactions. The practical utility of the developed tests was illustrated by a genome-wide association study of age to early childhood caries.
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http://dx.doi.org/10.1002/gepi.22429DOI Listing
September 2021

Incidence, Predictors and Outcomes of Delirium in Complicated Type B Aortic Dissection Patients After Thoracic Endovascular Aortic Repair.

Clin Interv Aging 2021 26;16:1581-1589. Epub 2021 Aug 26.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.

Purpose: The present study aimed to investigate the incidence and predictors of post-operative delirium (POD) in patients with complicated type B aortic dissection (TBAD) undergoing TEVAR with/without concomitant procedures and to assess the association of POD with early and follow-up outcomes.

Methods: A retrospective single-center cross-sectional analysis was conducted using a prospectively maintained database from 2010 to 2017. Outcomes were postoperative clinical outcomes, early and follow-up survival.

Results: A total of 517 complicated TBAD patients were enrolled. POD was observed in 13.3% (69/517) patients and was associated with increased hospital length of stay (LOS) and hospital costs (< 0.001 for both). Besides, POD was found to be an independent risk factor for prolonged ICU stay (odds ratio [OR] 4.39, 95% confidence interval [CI] 2.40-8.01, < 0.001) and early death (OR 4.42, 95% CI 1.26-15.54, = 0.020). Predictors of POD were hybrid procedure (OR 2.17, 95% CI 1.20-3.92, = 0.010), the use of benzodiazepine (OR 1.86, 95% CI 1.07-3.23, = 0.027) or quinolone (OR 2.35, 95% CI 1.26-4.38, = 0.007), creatinine >2 mg/dL (OR 3.25, 95% CI 1.57-6.72, = 0.001) and preoperative blood transfusion (OR 3.31, 95% CI 1.76-6.21, < 0.001). After a median follow-up of 73.6 months, POD remained as an independent indicator for follow-up mortality (hazard ratio [HR] 2.40, 95% CI 1.31-4.38, = 0.005) after adjusting potential confounders.

Conclusion: POD after TEVAR has an incidence of around 13% and could profoundly increase the in-hospital LOS, hospital costs, as well as the early and follow-up mortality. A series of risk factors, including hybrid procedure, the use of benzodiazepine or quinolone, creatinine >2 mg/dL and preoperative blood transfusion, were identified as independent risk factors for POD. Effective risk-stratification and patient-tailored management strategy should be developed to reduce the incidence of POD.
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http://dx.doi.org/10.2147/CIA.S328657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405167PMC
August 2021

Clostridium butyricum CB1 up-regulates FcRn expression via activation of TLR2/4-NF-κB signaling pathway in porcine small intestinal cells.

Vet Immunol Immunopathol 2021 Aug 25;240:110317. Epub 2021 Aug 25.

State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China; Key Laboratory of Preventive Veterinary Medicine in Hubei Province, The Cooperative Innovation Center for Sustainable Pig Production, Wuhan, China; Key Laboratory of Development of Veterinary Diagnostic Products, Ministry of Agriculture of the People's Republic of China, Wuhan, China. Electronic address:

The neonatal Fc receptor (FcRn) mediates the bidirectional transport of immunoglobulin G (IgG) across hyperpolarized epithelial cells. Overexpression of FcRn increases serum IgG and humoral immune response. Probiotics can improve the host's serum and intestinal mucosal IgG. However, whether probiotics regulate FcRn and its specific mechanism are still unclear. Our research showed that heat inactivated Clostridium butyricum CB1 (heat-inactivated CB1) up-regulated FcRn expression in porcine small intestinal epithelial (IPI-2I) cells. Furthermore, heat-inactivated CB1 stimulation activated the nuclear factor kappa B (NF-κB) signaling pathway. Moreover, FcRn expression decreased after blocking the NF-κB signaling pathway by NF-κB inhibitor BAY11-7028, suggesting that heat-inactivated CB1 induced FcRn expression via the NF-κB signaling pathway. Using small interfering RNAs (siRNAs), we found that knockdown of TLR2/4, MyD88 and TRIF reduced NF-κB activity induced by heat-inactivated CB1, as well as up-regulation of FcRn expression after heat-inactivated CB1 stimulation. Taken together, our data indicated that heat-inactivated CB1 up-regulated FcRn expression via TLR2/4-MyD88/TRIF-NF-κB signaling pathway. These results provided a new perspective for us to understand the enhancement of C. butyricum on intestinal mucosal immunity.
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http://dx.doi.org/10.1016/j.vetimm.2021.110317DOI Listing
August 2021

Glucose and pH Dual-Responsive Polymersomes with Multilevel Self-Regulation of Blood Glucose for Insulin Delivery.

Biomacromolecules 2021 09 23;22(9):3971-3979. Epub 2021 Aug 23.

College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China.

Smart insulin delivery systems now play essential roles in diabetes treatment, whereas most existing systems suffer from insufficient regulation against blood glucose. Here, a glucose and pH dual-responsive insulin delivery system with multilevel self-regulation of blood glucose was constructed. Photocross-linked dual-responsive polymersomes were prepared by the self-assembly of the diblock copolymer methoxyl poly(ethylene glycol)--poly[3-acrylamidophenylboronic acid--2-(diethylamino)ethyl methacrylate--2-hydroxy-4-(methacryloyloxy)benzophenone] (mPEG--P(AAPBA--DEAEMA--BMA)) synthesized by reversible addition-fragmentation chain transfer polymerization (RAFT), where insulin and glucose oxidase (GOx) were co-encapsulated inside. It is worth noting that the polymersomes with tunable membrane permeability are the first glucose-responsive platform consisting of both PBA and GOx. According to the pH change produced by gluconic acid, the pH-sensitive monomer DEAEMA endowed the polymersome membrane with multilevelly tunable and self-regulative permeability, further controlling the release behavior of insulin. This multilevel tunability was reflected directly in in vitro insulin release tests and was proven by the self-regulation of blood glucose in vivo. Promisingly, the polymersomes have great potential to be applied for the self-regulation of blood glucose in the treatment of diabetes.
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http://dx.doi.org/10.1021/acs.biomac.1c00772DOI Listing
September 2021

Response of Leaf Traits of Eastern Qinghai-Tibetan Broad-Leaved Woody Plants to Climatic Factors.

Front Plant Sci 2021 30;12:679726. Epub 2021 Jul 30.

State Key Laboratory of Grassland Agro-ecosystems, School of Life Sciences, Lanzhou University, Lanzhou, China.

Plant ecologists have long been interested in quantifying how leaf traits vary with climate factors, but there is a paucity of knowledge on these relationships given a large number of the relevant leaf traits and climate factors to be considered. We examined the responses of 11 leaf traits (including leaf morphology, stomatal structure and chemical properties) to eight common climate factors for 340 eastern Qinghai-Tibetan woody species. We showed temperature as the strongest predictor of leaf size and shape, stomatal size and form, and leaf nitrogen and phosphorus concentrations, implying the important role of local heat quantity in determining the variation in the cell- or organ-level leaf morphology and leaf biochemical properties. The effects of moisture-related climate factors (including precipitation and humidity) on leaf growth were mainly through variability in leaf traits (e.g., specific leaf area and stomatal density) related to plant water-use physiological processes. In contrast, sunshine hours affected mainly cell- and organ-level leaf size and shape, with plants developing small/narrow leaves and stomata to decrease leaf damage and water loss under prolonged solar radiation. Moreover, two sets of significant leaf trait-climate relationships, i.e., the leaf/stomata size traits co-varying with temperature, and the water use-related leaf traits co-varying with precipitation, were obtained when analyzing multi-trait relationships, suggesting these traits as good indicators of climate gradients. Our findings contributed evidence to enhance understanding of the regional patterns in leaf trait variation and its environmental determinants.
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http://dx.doi.org/10.3389/fpls.2021.679726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363248PMC
July 2021

Age as a Risk Factor for Complications Following Anterior Cervical Discectomy and Fusion: Analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC).

Spine (Phila Pa 1976) 2021 Aug 13. Epub 2021 Aug 13.

Division of Neurosurgery, Ascension Providence Hospital, College of Human Medicine, Michigan State University, Southfield, MI Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI Division of Neurosurgery, Ascension Macomb-Oakland Hospital, Warren, MI Department of Neurosurgery, Henry Ford Hospital, Detroit, MI Department of Neurosurgery, University of Michigan, Ann Arbor, MI.

Study Design: Retrospective analysis of prospectively collected registry data using multivariable analyses of imputed data.

Objective: We sought to demonstrate that age would not be associated with complications in patients undergoing anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Elderly patients (≥70 yrs) undergoing ACDF are considered a higher risk for complications. However, conclusive evidence is lacking. The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a quality improvement collaborative with 30 hospitals across Michigan.

Methods: The study included all patients who had 1 to 4 level ACDF (September 2015-August 2019) for 90-day complications. Major and minor complications were defined using a validated classification. Multiple imputations were used to generate complete covariate datasets. Generalized estimating equation model was used to identify associations with complications using the whole cohort and elderly subgroup analyses. Bonferroni correction was used.

Results: Nine thousand one hundred thirty five patients (11.1% ≥ 70 yrs and 88.9% <70 yrs) with 2266 complications were analyzed. Comparing elderly versus non-elderly, the elderly had a significantly higher rate of any complications (31.5% vs. 24.0%, P < 0.001) and major complications (14.1% vs. 7.0%, P < 0.001). On multivariable analysis, age was not independently associated with any complication. POD#0 ambulation and preop independent ambulation were independently associated with significantly decreased odds of any complication. In the elderly, independent preoperative ambulation was protective for any complication (odds ratio [OR] 0.53, 0.39-0.73 95% confidence interval [CI]), especially major complications (OR 0.41, 0.27-0.61 95% CI).

Conclusion: Age was not an independent risk factor for complications in patients that underwent ACDF. In the elderly, independent preoperative ambulation was especially protective for major complications.Level of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000004200DOI Listing
August 2021

Repeated anodal high-definition transcranial direct current stimulation over the left dorsolateral prefrontal cortex in mild cognitive impairment patients increased regional homogeneity in multiple brain regions.

PLoS One 2021 13;16(8):e0256100. Epub 2021 Aug 13.

The Key Laboratory of Biomedical Information Engineering of Ministry of Education, The Key Laboratory of Neuro-informatics and Rehabilitation Engineering of Ministry of Civil Affairs, and Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China.

Transcranial direct current stimulation (tDCS) can improve cognitive function. However, it is not clear how high-definition tDCS (HD-tDCS) regulates the cognitive function and its neural mechanism, especially in individuals with mild cognitive impairment (MCI). This study aimed to examine whether HD-tDCS can modulate cognitive function in individuals with MCI and to determine whether the potential variety is related to spontaneous brain activity changes recorded by resting-state functional magnetic resonance imaging (rs-fMRI). Forty-three individuals with MCI were randomly assigned to receive either 10 HD-tDCS sessions or 10 sham sessions to the left dorsolateral prefrontal cortex (L-DLPFC). The fractional amplitude of low-frequency fluctuation (fALFF) and the regional homogeneity (ReHo) was computed using rs-fMRI data from all participants. The results showed that the fALFF and ReHo values changed in multiple areas following HD-tDCS. Brain regions with significant decreases in fALFF values include the Insula R, Precuneus R, Thalamus L, and Parietal Sup R, while the Temporal Inf R, Fusiform L, Occipital Sup L, Calcarine R, and Angular R showed significantly increased in their fALFF values. The brain regions with significant increases in ReHo values include the Temporal Inf R, Putamen L, Frontal Mid L, Precentral R, Frontal Sup Medial L, Frontal Sup R, and Precentral L. We found that HD-tDCS can alter the intensity and synchrony of brain activity, and our results indicate that fALFF and ReHo analysis are sensitive indicators for the detection of HD-tDCS during spontaneous brain activity. Interestingly, HD-tDCS increases the ReHo values of multiple brain regions, which may be related to the underlying mechanism of its clinical effects, these may also be related to a potential compensation mechanism involving the mobilization of more regions to complete a function following a functional decline.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256100PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363005PMC
August 2021

Olfaction and Physical Functioning in Older Adults: A Longitudinal Study.

J Gerontol A Biol Sci Med Sci 2021 Aug 11. Epub 2021 Aug 11.

Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States.

Background: Poor olfaction is associated with worse functional performance in older adults, but longitudinal evidence is lacking. We investigated poor olfaction in relation to longitudinal changes in physical functioning among community-dwelling older adults.

Methods: The analysis included 2,319 participants from the Health, Aging and Body Composition Study (aged 71-82 years, 47·9% men, and 37·3% blacks) who completed the Brief Smell Identification Test in 1999-2000. Olfaction was defined as good (test score 11-12), moderate (9-10), or poor (0-8). Physical functioning was assessed up to four times over 8 years, using the Short Physical Performance Battery (SPPB) and the Health ABC Physical Performance Battery (HABCPPB). We conducted joint model analyses and reported the differences in annual declines across olfaction groups.

Results: During the follow-up, compared to those with good olfaction, older adults with poor olfaction had greater annual declines in both the SPPB score (-0.137, 95%CI: -0.186, -0.088) and all its subscales: standing balance (-0.068, 95%CI:-0.091, -0.044), chair stand (-0.046, 95%CI: -0.070, -0.022), and gait speed (-0.022, 95%CI: -0.042, -0.001). A similar observation was made for the HABCPPB score (difference in annual decline: -0.032, 95%CI:-0.042, -0.021). These findings are robust and cannot be explained by measured confounding from demographics, lifestyle factors, chronic diseases, nor by potential biases due to death and loss of follow-up. Similar associations were observed across subgroups of sex, race, and self-reported general health status.

Conclusion: This study provides the first epidemiological evidence that poor olfaction predicts a faster decline in physical functioning. Future studies should investigate potential mechanisms.
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http://dx.doi.org/10.1093/gerona/glab233DOI Listing
August 2021

An ethanethioate functionalized polythiophene as an optical probe for sensitive and fast detection of water content in organic solvents.

Anal Methods 2021 09 2;13(34):3792-3798. Epub 2021 Sep 2.

School of Materials Science & Engineering, Tianjin Key Laboratory for Photoelectric Materials and Devices, Key Laboratory of Display Materials & Photoelectric Devices, Ministry of Education, Tianjin University of Technology, Tianjin 300384, China.

A new polythiophene-based optical probe, namely PTS, was designed and prepared for detection and quantification of the water present in organic solvents. PTS exhibited sensitive and fast absorption and fluorescence signaling response to the changes of water content in tetrahydrofuran (THF), ,-dimethylformamide (DMF) and ,-dimethylacetamide (DMAc) due to the water-induced interpolymer-stacking aggregation as demonstrated by dynamic light scattering (DLS) analysis. The fluorescence intensity of PTS at 550 nm linearly reduced as a function of the water content in detection ranges of 0-30% (v/v) in THF, 0-10% in DMF and 0-10% in DMAc with the limit of detection (LOD) for water being 0.034% (v/v) in THF, 0.013% (v/v) in DMF, and 0.014% (v/v) in DMAc, respectively. Additionally, PTS-incorporated test paper was fabricated to successfully achieve naked-eye detection of water in DMF and DMAc. PTS was further applied to estimate the water content in real samples, convincingly demonstrating that our method was comparable with the standard Karl Fischer titration.
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http://dx.doi.org/10.1039/d1ay00967bDOI Listing
September 2021

Nab-paclitaxel promotes the cancer-immunity cycle as a potential immunomodulator.

Am J Cancer Res 2021 15;11(7):3445-3460. Epub 2021 Jul 15.

School of Chinese Materia Medica, Beijing University of Chinese Medicine Beijing 100029, China.

Paclitaxel is a widely used anti-tumor chemotherapeutic drug. Solvent-based paclitaxel causes bone marrow suppression, allergic reactions, neurotoxicity and systemic toxicity, which are associated with non-specific cytotoxicity and side effects of fat-soluble solvents. Studies have explored various new nano-drug strategies of paclitaxel, including nanoparticle albumin-bound paclitaxel (nab-paclitaxel) to improve the water solubility and safety of paclitaxel. Nab-paclitaxel is a targeted solvent-free formulation that inhibits microtubule depolymerization to anticancer. It is easily taken up by tumor and immune cells owing to the nano-scaled size and superior biocompatibility. The internalized nab-paclitaxel exhibits significant immunostimulatory activities to promote cancer-immunity cycle. The aim of this study was to explore the synergistic effect of nab-paclitaxel in tumor antigen presentation, T cell activation, reversing the immunosuppressive pattern of tumor microenvironment (TME), and the synergistic effect with cytotoxic lymphocytes (CTLs) in clearance of tumor cells. The effects of nab-paclitaxel on modulation of cancer-immunity cycle, provides potential avenues for combined therapeutic rationale to improve efficacy of immunotherapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8332864PMC
July 2021

Intermittent tube feeding for stroke patients with dysphagia: a meta-analysis and systematic review.

Ann Palliat Med 2021 Jul;10(7):7406-7415

Department of Nursing, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.

Background: Nutrition supports is essential to the prognosis of stroke patients with dysphagia. It's necessary to evaluate the effects and safety of intermittent tube feeding for stroke patients with dysphagia, to provide evidence for the management of dysphagia.

Methods: Cochrane Library et al. databases were searched for randomized controlled trials (RCTs) on the intermittent tube feeding for stroke patients with dysphagia up to Feb 15, 2021. Bias risk assessment tool recommended by Cochrane was used for quality assessment, and Revman5.3 software was used for data analysis.

Results: A total of 11 RCTs involving 762 stroke patients with dysphagia were included. Meta-analysis indicated that intermittent tube feeding could significantly increase the rate of dysphagia function improvement [odd ratio (OR ) = 5.22, 95% confidence interval (CI): 3.38-8.07], serum albumin level [mean difference (MD) = 3.07, 95% CI: 1.65-4.49], hemoglobin level (MD =1.55, 95% CI: 1.19-1.95), prealbumin level (MD =1.79, 95% CI: 1.46-2.12), and reduce the incidence of aspiration pneumonia (OR = 0.28, 95% CI: 0.15-0.53), incidence of aspiration (OR =0.27, 95% CI: 0.08-0.93) for stroke patients with dysphagia (all P<0.05), o significant difference in the triceps skinfold thickness (TSF) (MD =0.46, 95% CI: -0.24 to 1.19) and arm muscle circumference (MD =0.04, 95% CI: -0.28 to 0.36) between two groups were found (all P>0.05). Egger regression tests indicated that there was no publication bias between included RCTs (all P>0.05).

Discussion: Intermittent tube feeding for stroke patients with dysphagia during the recovery period can not only ensure the nutritional supply, but also promote the recovery of swallowing function and reduce the occurrence of aspiration and aspiration associated pneumonia.
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http://dx.doi.org/10.21037/apm-21-736DOI Listing
July 2021

Better Islet Function and Cardiovascular Autonomic Function in Chinese Type 2 Diabetic Patients with Pure Small Fiber Neuropathy than with Mixed Neuropathy.

Diabetes Ther 2021 Sep 2;12(9):2423-2436. Epub 2021 Aug 2.

Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.

Introduction: The clinical characteristics and outcomes of small fiber neuropathy (SFN) in Chinese patients with type 2 diabetes mellitus (T2DM) have not been thoroughly described. In this study, we investigated the metabolic and neurological indexes and the prognosis of patients with T2DM based on skin biopsy.

Methods: A total of 34 healthy Chinese volunteers were recruited for skin biopsy to establish the reference range of intra-epidermal nerve fiber density (IENFD), and 89 patients with T2DM attending the Nanjing Drum Tower Hospital were evaluated at baseline. Of these 89 patients, 17 with pure SFN and nine with mixed diabetic polyneuropathy (DPN) were reassessed at the end of the follow-up.

Results: Glycated hemoglobin and postprandial blood glucose levels were lower (P = 0.005 and P = 0.041, respectively) and postprandial C-peptide and insulin levels were higher (P = 0.001 and P = 0.019, respectively) in the pure SFN group than in the mixed DPN group. A partial correlation study showed that there was a negative correlation between IENFD of the distal leg and cardiovascular autonomic reflex test (CART) scores (r = - 0.513, P = 0.001) after adjusting for age and duration of diabetes. Only vitamin B12 level (P = 0.028) and motor nerve conduction velocity (MCV) of the common peroneal nerve (P = 0.045) were increased in the patients with pure SFN at the final visit while MCVs of the common peroneal nerve (P = 0.025) and tibial nerve (P = 0.047) were decreased in the mixed DPN group at the final visit.

Conclusion: Better islet function and cardiovascular autonomic function were observed in patients with pure SFN compared with mixed DPN. The metabolic and neurological indexes remained relatively stable in the patients with pure SFN during the follow-up.
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http://dx.doi.org/10.1007/s13300-021-01111-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385000PMC
September 2021

Changes in the connection network of whole-brain fiber tracts in patients with Alzheimer's disease have a tendency of lateralization.

Neuroreport 2021 Oct;32(14):1175-1182

The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi.

Alzheimer's disease is a common progressive neurodegenerative disorder in the elderly. Diffusion tensor imaging (DTI) has been widely used to explore structural integrity and to describe white matter degeneration in Alzheimer's disease. Previous research has indicated that the change of connections between white matter fiber tracts is very important for investigating the brain function of Alzheimer's disease patients. However, whether white matter features can be used as potential biomarkers for predicting Alzheimer's disease tendency requires more in-depth research. In this study, we investigated the relationship between the damage in white matter tracts and the decline of cognitive function in Alzheimer's disease. DTI data were collected from 38 Alzheimer's disease patients and 30 normal controls. Fiber assignment by continuous tracking approach was used to establish connections between different brain regions of the whole brain, network-based statistical analysis and support vector machine classification analysis were used to explore the connection of whole-brain fiber bundles between the two groups. Most importantly, our results showed that the connections between brain regions of Alzheimer's disease patients were damaged, and the damage were mainly located in the right hemisphere, there was a certain degree of lateralization effect. Using whole-brain fiber bundle connection network as a feature for classification, we found it helped to improve the classification accuracy in Alzheimer's disease patients, which is useful for early clinical diagnosis of Alzheimer's disease. These findings further suggested that we can use the whole-brain fiber bundle connection network of Alzheimer's disease patients as a potential diagnostic indicator of Alzheimer's disease in the future.
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http://dx.doi.org/10.1097/WNR.0000000000001708DOI Listing
October 2021

Evaluation of redevelopment priority of abandoned industrial and mining land based on heavy metal pollution.

PLoS One 2021 29;16(7):e0255509. Epub 2021 Jul 29.

School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China.

Heavy metal contamination in soil is an important factor affecting the determination of safe redevelopment methods for industrial and mining land. In this paper, the soil environment of a typical mining city in northern China was taken as the research object, 148 surface soil samples were collected and the contents of heavy metals were measured. The health risk classification criteria for heavy metal contamination of soils and the method of priority assessment for redevelopment were used. The results showed that: the risk of potential utilization types of heavy metals in the abandoned industrial and mining land is different. When the utilization type is agricultural land, the soil environmental quality is good as a whole, and a small number of plots are polluted by cadmium (Cd)and mercury (Hg); When the land use type is construction land, the risk of heavy metal pollution comes from chromium (Cr); The priority of development in this study area is as follows: agricultural land > construction land > ecological land.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255509PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321123PMC
July 2021

Preimplantation genetic testing is not a preferred recommendation for patients with X chromosome abnormalities.

Hum Reprod 2021 Aug;36(9):2612-2621

Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

Study Question: Should women with X chromosome abnormalities (XCAs) be recommended to have embryos selected by both morphological and cytogenetic assessment through preimplantation genetic testing (PGT) rather than morphological assessment only in conventional IVF/ICSI treatment?

Summary Answer: PGT is not a preferred recommendation for women with XCAs in the absence of other PGT indications.

What Is Known Already: XCAs are the most frequent sort of chromosomal aberrations in infertile women. Patients with a complete or partial absence of one X chromosome, diagnosed as Turner Syndrome (TS), demonstrate low spontaneous pregnancy rates (5-7%) and high miscarriage rates (22.8-30.8%), as well as high chances of birth defects (20%). PGT is known to improve pregnancy rates and decrease the incidence of miscarriage in couples with chromosomal aberrations such as Robertsonian and reciprocal translocations and Klinefelter Syndrome.

Study Design, Size, Duration: A retrospective cohort study was conducted with 394 women with XCAs and undergoing their first oocyte retrieval and first embryo transfer cycle from June 2011 to August 2019 in the Reproductive Hospital Affiliated to Shandong University.

Participants/materials, Setting, Methods: Pregnancy outcomes were compared between the conventional IVF/ICSI group (n = 284) and the PGT group (n = 110) in the first fresh or frozen embryo transfer cycle for each woman with XCAs. Three platforms were applied in PGT: fluorescence in situ hybridisation (FISH, n = 34), array comparative genomic hybridisation (aCGH, n = 24) and next-generation sequencing (NGS, n = 51). The embryo aneuploidy rate and distribution of embryonic chromosomal aberrations revealed by aCGH or NGS were analysed and stratified by maternal age and type of XCAs to assess the effect of maternal XCAs on embryo karyotypes.

Main Result And The Role Of Chance: The live birth rate (LBR) per embryo transfer was similar between the PGT group and IVF/ICSI group both in the first cycle of fresh or frozen embryo transfer respectively (39.13% in PGTFISH vs 42.58% in IVF/ICSI, Padj=0.558; 66.67% in PGTFISH vs 52.08% in PGTaCGH/NGS vs 53.06% in IVF/ICSI, Padj=0.756), as was the clinical pregnancy rate (60.87% in PGTFISH vs 50.97% in IVF/ICSI, Padj =0.672; 88.89% in PGTFISH vs 58.33% in PGTaCGH/NGS vs 69.39% in IVF/ICSI, Padj =0.480) and the pregnancy loss rate (35.71% in PGTFISH vs 16.46% in IVF/ICSI, Padj =0.136; 12.50% in PGTFISH vs 10.71% in PGTaCGH/NGS vs 23.53% in IVF/ICSI, Padj =0.352). The rates of maternal and neonatal complications were also comparable between the PGT and IVF/ICSI groups with fresh and frozen transfers respectively (10.00% vs 8.85%, P = 1.000; 21.74% vs 14.55%, P = 0.272). Intriguingly, the distribution of embryonic chromosome abnormalities was more frequent on autosomes 22 (20.39%), 21 (18.45%) and 16 (17.47%), compared with the X chromosome (8.73%).

Limitations, Reasons For Caution: Selection bias is an inherent drawback of a retrospective study. First, our participants hosted 4.84% X chromosome mosaicism with few typical somatic anomalies of TS. Second, the incidences of history of recurrent miscarriage and abnormal offspring in the PGT group were higher than in IVF/ICSI group although binary logistic regression analysis was performed to attenuate the modifying effect of confounding factors. Third, FISH performed in this study only used X/Y probes and lacked the reference of autosome, which might have resulted in misdiagnosis and bias. Finally, intrinsic disadvantages could not be totally avoided due to the retrospective nature of this study.

Wider Implication Of The Findings: In the current study, comparable pregnancy outcomes were revealed among a large cohort of women with XCAs undergoing their first cycles of PGT or conventional IVF/ICSI treatment. Moreover, the X chromosome abnormality was illustrated to cause no higher frequency of aberrations in embryos. Our data provided perspectives for genetic and reproductive counselling to XCAs individuals and their families.

Study Funding/competing Interest(s): This work was supported by National Research and Development Plan (2016YFC1000604 and 2017YFC1001100), the National Natural Science Foundation of China (81701406), Shandong Science Fund for Distinguished Young Scholars (JQ201720), Taishan Scholars Program for Young Experts of Shandong Province (tsqn20161069) and Projects of Medical and Health Technology Development Program in Shandong Province (202005010520, 202005010523 and 2016WS0368). There is no conflict of interest to declare.

Trial Registration Number: N/A.
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http://dx.doi.org/10.1093/humrep/deab177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373470PMC
August 2021

A clinical study of carbon dioxide lattice laser-assisted or microneedle-assisted 5-aminolevulinic acid-based photodynamic therapy for the treatment of hypertrophic acne scars.

Photodermatol Photoimmunol Photomed 2021 Jul 17. Epub 2021 Jul 17.

General Hospital of Air Force, PLA, Beijing, China.

Objective: To study the clinical efficacy, recurrence rate and safety of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with microneedle or CO2 lattice laser (CO2FL), in comparison with intrascar betamethasone injection in the treatment of hypertrophic acne scar.

Methods: Fifty-two patients with hypertrophic acne scars at the mandibular angle were enrolled and assigned to different therapy groups. Sixteen patients were treated with microneedle-assisted incorporation of ALA. Twenty-eight patients underwent CO2FL-assisted incorporation of ALA. Eight patients received standard therapy with intrascar injection of glucocorticoid. Two dermatologists, blinded to the therapy groups, independently evaluated the scars in all patients using the average value of the Vancouver Scar Scale score, which was treated as an integer variable.

Results: After three rounds of treatment, there was no significant difference in therapeutic effective rate among the microneedle, laser and topical glucocorticoid groups (93.75% vs 100% vs 100%, P = .855). One out of 16 patients (6.25%) in the microneedle group, no patient (0%) in the laser group and two out of eight patients (25%) in the topical glucocorticoid group had recurrence. The laser group showed a higher rate of adverse effects, which were usually mild and reversible, except for pigmentation. Adverse reactions could be completely subsided within 3 weeks.

Conclusions: Either CO2FL or microneedle combined ALA-PDT for hypertrophic scar, as to topical glucocorticoid therapy, showed equivalent clinical effects but lower recurrence rate within 6 months of follow-up period.
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http://dx.doi.org/10.1111/phpp.12716DOI Listing
July 2021

Review of applications of CRISPR-Cas9 gene-editing technology in cancer research.

Biol Proced Online 2021 Jul 15;23(1):14. Epub 2021 Jul 15.

The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, China.

Characterized by multiple complex mutations, including activation by oncogenes and inhibition by tumor suppressors, cancer is one of the leading causes of death. Application of CRISPR-Cas9 gene-editing technology in cancer research has aroused great interest, promoting the exploration of the molecular mechanism of cancer progression and development of precise therapy. CRISPR-Cas9 gene-editing technology provides a solid basis for identifying driver and passenger mutations in cancer genomes, which is of great value in genetic screening and for developing cancer models and treatments. This article reviews the current applications of CRISPR-Cas9 gene-editing technology in various cancer studies, the challenges faced, and the existing solutions, highlighting the potential of this technology for cancer treatment.
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http://dx.doi.org/10.1186/s12575-021-00151-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281662PMC
July 2021

Determination of the Geographical Origin of Coffee Beans Using Terahertz Spectroscopy Combined With Machine Learning Methods.

Front Nutr 2021 17;8:680627. Epub 2021 Jun 17.

State Key Laboratory of Precision Measuring Technology and Instruments, Tianjin University, Tianjin, China.

Different geographical origins can lead to great variance in coffee quality, taste, and commercial value. Hence, controlling the authenticity of the origin of coffee beans is of great importance for producers and consumers worldwide. In this study, terahertz (THz) spectroscopy, combined with machine learning methods, was investigated as a fast and non-destructive method to classify the geographic origin of coffee beans, comparing it with the popular machine learning methods, including convolutional neural network (CNN), linear discriminant analysis (LDA), and support vector machine (SVM) to obtain the best model. The curse of dimensionality will cause some classification methods which are struggling to train effective models. Thus, principal component analysis (PCA) and genetic algorithm (GA) were applied for LDA and SVM to create a smaller set of features. The first nine principal components (PCs) with an accumulative contribution rate of 99.9% extracted by PCA and 21 variables selected by GA were the inputs of LDA and SVM models. The results demonstrate that the excellent classification (accuracy was 90% in a prediction set) could be achieved using a CNN method. The results also indicate variable selecting as an important step to create an accurate and robust discrimination model. The performances of LDA and SVM algorithms could be improved with spectral features extracted by PCA and GA. The GA-SVM has achieved 75% accuracy in a prediction set, while the SVM and PCA-SVM have achieved 50 and 65% accuracy, respectively. These results demonstrate that THz spectroscopy, together with machine learning methods, is an effective and satisfactory approach for classifying geographical origins of coffee beans, suggesting the techniques to tap the potential application of deep learning in the authenticity of agricultural products while expanding the application of THz spectroscopy.
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http://dx.doi.org/10.3389/fnut.2021.680627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247636PMC
June 2021

Initial performance predicts improvements in computerized cognitive training: Evidence from a selective attention task.

Psych J 2021 Jul 4. Epub 2021 Jul 4.

School of Nursing, Yueyang Vocational and Technical College, Yueyang, China.

Computerized cognitive training (CCT) has been found to improve a range of skills such as attention, working memory, inhibition control, and decision making. However, the relationship between the initial performance, amount of improvement, time constant, and asymptotic performance level in CCT is still unclear. In the current study, we performed selective attention training on college students and addressed this issue by mathematically modeling the learning curve with an exponential function. Twenty-nine students completed approximately 10 days of CCT. Presentation time served as the dependent variable and was measured by three-down/one-up adaptive algorithms. We fitted an exponential function to the estimated block thresholds during CCT and obtained three learning parameters (amount of improvement, time constant, and asymptotic performance level) for all subjects. The initial performance was defined by the sum of the amount of improvement and the asymptotic performance level. Pearson correlation analyses were conducted between the initial performance and the three leaning parameters. The initial performance was positively correlated with the amount of improvement and asymptotic performance level, but was negatively correlated with the time constant. The time constant was negatively correlated with the amount of improvement and asymptotic performance level. Poorer initial performance was linked to a larger amount of improvement, shorter time constant, and higher asymptotic threshold, which supported the compensation account. Our results may help improve the present understanding of the nature of the CCT process and demonstrate the advantages of using a customized training protocol to enhance the efficiency of cognitive training in practical applications.
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http://dx.doi.org/10.1002/pchj.465DOI Listing
July 2021

[Rapid screening of illegally added poppy husk in hot pot sauce and soup by thermal desorption electrospray ionization-triple quadruple mass spectrometry].

Se Pu 2020 Jul;38(7):861-867

Lanzhou Institute for Food and Drug Control, Lanzhou 730050, China.

A thermal desorption electrospray ionization-triple quadruple mass spectrometry (TD-ESI-MS/MS) method was developed for the rapid screening of poppy husk in hot pot sauce and soup. The solid surface or liquid sample was directly touched by a simple metal probe. The analytes collected on the probe were desorbed and ionized using a TD-ESI source, after which the analyte ions were detected by MS/MS in multiple reaction monitoring (MRM) mode. The results were compared with those of colloidal gold card rapid detection and verified by high performance liquid chromatography coupled with triple quadrupole mass spectrometry (HPLC-MS/MS). The instrument gave the best response with the highest sensitivity under the following conditions: thermal desorption temperature, 260 ℃; injection solvent, 0.1% formic acid aqueous solution containing 10 mmol/L formic ammonium-acetonitrile (1:1, v/v); flow rate, 200 μL/h. The limits of detection (LODs) for papaverine, noscapine, and thebaine in five alkaloids were 2 μg/kg, while those for codeine and morphine were 10 μg/kg in hot pot sauce and 5 μg/kg in soup. The sensitivity of this method was significantly superior to that of the colloidal gold card rapid detection. The method was applied to 50 batches of hot pot sauce and soup. Noscapine, papaverine, thebaine, and morphine were detected in a positive sample of chicken soup, which was consistent with the result of the HPLC-MS/MS method. This method without sample preparation and chromatographic separation is fast, green, and environmentally benign, thus being suitable for the rapid qualitative analysis of poppy husk in food.
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http://dx.doi.org/10.3724/SP.J.1123.2020.02002DOI Listing
July 2020

[Rapid screening of illegally added poppy husk in hot pot sauce and soup by thermal desorption electrospray ionization-triple quadruple mass spectrometry].

Se Pu 2020 Jul;38(7):861-867

Lanzhou Institute for Food and Drug Control, Lanzhou 730050, China.

A thermal desorption electrospray ionization-triple quadruple mass spectrometry (TD-ESI-MS/MS) method was developed for the rapid screening of poppy husk in hot pot sauce and soup. The solid surface or liquid sample was directly touched by a simple metal probe. The analytes collected on the probe were desorbed and ionized using a TD-ESI source, after which the analyte ions were detected by MS/MS in multiple reaction monitoring (MRM) mode. The results were compared with those of colloidal gold card rapid detection and verified by high performance liquid chromatography coupled with triple quadrupole mass spectrometry (HPLC-MS/MS). The instrument gave the best response with the highest sensitivity under the following conditions: thermal desorption temperature, 260 ℃; injection solvent, 0.1% formic acid aqueous solution containing 10 mmol/L formic ammonium-acetonitrile (1:1, v/v); flow rate, 200 μL/h. The limits of detection (LODs) for papaverine, noscapine, and thebaine in five alkaloids were 2 μg/kg, while those for codeine and morphine were 10 μg/kg in hot pot sauce and 5 μg/kg in soup. The sensitivity of this method was significantly superior to that of the colloidal gold card rapid detection. The method was applied to 50 batches of hot pot sauce and soup. Noscapine, papaverine, thebaine, and morphine were detected in a positive sample of chicken soup, which was consistent with the result of the HPLC-MS/MS method. This method without sample preparation and chromatographic separation is fast, green, and environmentally benign, thus being suitable for the rapid qualitative analysis of poppy husk in food.
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http://dx.doi.org/10.3724/SP.J.1123.2020.02002DOI Listing
July 2020

The complete chloroplast genome of , an herbal species of Verbenaceae family.

Mitochondrial DNA B Resour 2021 Jun 14;6(7):1982-1983. Epub 2021 Jun 14.

College of Medicine, Xi'an International University, Xi'an, China.

is one kind of traditional medical herb which has potential for multiple diseases' treatment. In this study, the complete chloroplast genome sequence of was assembled. Its complete circular chloroplast DNA length was 153,491 bp. The genome was made up of a large single-copy region of 84,518 bp, a small single-copy region of 17,357 bp, and a pair of inverted repeat regions of 25,808 bp. The genome totally encoded 128 genes, containing 83 protein-coding genes, 37 tRNA genes, and eight rRNA genes. Phylogenetic analysis indicates that belongs to the verbenaceae family.
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http://dx.doi.org/10.1080/23802359.2021.1938719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204982PMC
June 2021

Characterization of the complete chloroplast genome of Steud. (Lamiaceae).

Mitochondrial DNA B Resour 2021 Jun 14;6(7):1939-1940. Epub 2021 Jun 14.

College of Medicine, Xi'an International University, Xi'an, Shaanxi, China.

Steud. is one kind of traditional medical herb which can be used for airway hyperreactivity treatment. In this study, the complete chloroplast genome sequence of was assembled. Its complete circular chloroplast DNA length was 151,680 bp. The genome was made up of a large single-copy region of 83,189 bp, a small single-copy region of 17,311 bp, and a pair of inverted repeat regions of 25,590 bp. The genome totally encoded 130 genes, containing 85 protein-coding genes, 37 tRNA genes, and eight rRNA genes. The phylogenetic analysis indicates that belongs to the Lamiaceae family.
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http://dx.doi.org/10.1080/23802359.2021.1937359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204993PMC
June 2021

Large-Scale Brain Functional Network Integration for Discrimination of Autism Using a 3-D Deep Learning Model.

Front Hum Neurosci 2021 2;15:687288. Epub 2021 Jun 2.

The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Sciences and Technology, Xi'an Jiaotong University, Xi'an, China.

Goal: Brain functional networks (BFNs) constructed using resting-state functional magnetic resonance imaging (fMRI) have proven to be an effective way to understand aberrant functional connectivity in autism spectrum disorder (ASD) patients. It is still challenging to utilize these features as potential biomarkers for discrimination of ASD. The purpose of this work is to classify ASD and normal controls (NCs) using BFNs derived from rs-fMRI.

Methods: A deep learning framework was proposed that integrated convolutional neural network (CNN) and channel-wise attention mechanism to model both intra- and inter-BFN associations simultaneously for ASD diagnosis. We investigate the effects of each BFN on performance and performed inter-network connectivity analysis between each pair of BFNs. We compared the performance of our CNN model with some state-of-the-art algorithms using functional connectivity features.

Results: We collected 79 ASD patients and 105 NCs from the ABIDE-I dataset. The mean accuracy of our classification algorithm was 77.74% for classification of ASD versus NCs.

Conclusion: The proposed model is able to integrate information from multiple BFNs to improve detection accuracy of ASD.

Significance: These findings suggest that large-scale BFNs is promising to serve as reliable biomarkers for diagnosis of ASD.
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http://dx.doi.org/10.3389/fnhum.2021.687288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206477PMC
June 2021

Quantitative sensory testing can effectively predict cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus.

Acta Diabetol 2021 Jun 17. Epub 2021 Jun 17.

Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No 321 Zhongshan Road, Nanjing, 210008, China.

Aims: Cardiovascular autonomic neuropathy (CAN) is one of the most serious types of diabetic autonomic neuropathy and is a class of small fibre neuropathy. Among many inspection methods, quantitative sensory testing is an effective and convenient method for diagnosing diabetic small fibre neuropathy. This cross-sectional study aimed to identify the correlation between the development of cardiovascular autonomic neuropathy and quantitative sensory testing parameters in patients with type 2 diabetes mellitus.

Methods: A total of 266 participants with type 2 diabetes mellitus from Nanjing Drum Tower Hospital were enrolled in this study, and each of them received cardiovascular reflex tests (CARTs) and quantitative sensory testing, including testing of cold, warm, cold pain, and heat pain detection thresholds (CDT, WDT, CPT, and HPT, respectively). The results of CARTs were compared with the thermal detection thresholds in quantitative sensory testing by using SPSS 26.0.

Results: A total of 266 participants were divided into the CAN group, early CAN (ECAN) group, and without CAN (NCAN) group. There were significant differences in quantitative sensory testing parameters among three groups, and CARTs presented a positive correlation with the WDT and HPT and a negative correlation with the CDT. Moreover, after adjusting for age, sex, diabetes duration, and other influencing factors, WDT, HPT, and CDT were independent risk factors for cardiovascular autonomic neuropathy.

Conclusions: The thermal detection thresholds, including cold, warm, and heat pain detection thresholds, in quantitative sensory testing were found to be significantly related to the results of CARTs. Some thermal detection thresholds were independent risk factors for cardiovascular autonomic neuropathy. Therefore, this study showed that quantitative sensory testing has a reliable predictive ability for the occurrence and development of cardiovascular autonomic neuropathy.
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http://dx.doi.org/10.1007/s00592-021-01744-4DOI Listing
June 2021

Corneal confocal microscopy: A useful tool for diagnosis of small fiber neuropathy in type 2 diabetes.

J Diabetes Investig 2021 Jun 16. Epub 2021 Jun 16.

Department of Endocrinology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.

Aim: To investigate the diagnostic utility of corneal confocal microscopy (CCM) for small fiber neuropathy in type 2 diabetes.

Materials And Methods: There were 186 participants with type 2 diabetes enrolled in this cross-sectional research. Pure small fiber neuropathy and mixed fiber neuropathy were defined using clinical examination, electromyography, and quantitative sensory testing. Demographics and clinical data, corneal confocal microscopy parameters, and other neuropathy measures were compared among the groups. The diagnostic utility of corneal confocal microscopy for small fiber neuropathy was assessed by the receiver operating curve.

Results: Of the 186 patients, 24.7% had a pure small fiber neuropathy and 17.2% of patients were diagnosed with mixed fiber neuropathy. The corneal nerve fiber density (CNFD), corneal nerve fiber branch density (CNBD), and corneal nerve fiber length (CNFL) were significantly lower in subjects with pure small fiber neuropathy compared with those without diabetic peripheral neuropathy (all P < 0.05). The receiver operating curve analysis for corneal confocal microscopy diagnosing small fiber neuropathy demonstrated the area under the curve for CNFD of 0.791, CNFL of 0.778, CNBD of 0.710.

Conclusions: Patients with type 2 diabetes with pure small fiber neuropathy showed more corneal nerve loss compared with those without diabetic peripheral neuropathy. It was revealed that corneal confocal microscopy can be a reasonable marker in the diagnosis of small fiber neuropathy in type 2 diabetes.
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http://dx.doi.org/10.1111/jdi.13616DOI Listing
June 2021

PEDF Gene Deletion Disrupts Corneal Innervation and Ocular Surface Function.

Invest Ophthalmol Vis Sci 2021 06;62(7):18

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Purpose: The cornea is richly innervated by the trigeminal ganglion (TG) and its function supported by secretions from the adjacent lacrimal (LG) and meibomian glands (MG). In this study we examined how pigment epithelium-derived factor (PEDF) gene deletion affects the cornea structure and function.

Methods: We used PEDF hemizygous and homozygous knockout mice to study effects of PEDF deficiency on corneal innervation assessed by beta tubulin staining, mRNA expression of trophic factors, and PEDF receptors by adjacent supporting glands, corneal sensitivity measured using a Cochet-Bonnet esthesiometer, and tear production using phenol red cotton thread wetting.

Results: Loss of PEDF was accompanied by reduced corneal innervation and sensitivity, increased corneal surface injury and tear production, thinning of the corneal stroma and loss of stromal cells. PEDF mRNA was expressed in the cornea and its supporting tissues, the TG, LG, and MG. Deletion of one or both PEDF alleles resulted in decreased expression of essential trophic support in the TG, LG, and MG including nerve growth factor, brain-derived neurotrophic growth factor, and GDNF with significantly increased levels of NT-3 in the LG and decreased EGF expression in the cornea. Decreased transcription of the putative PEDF receptors, adipose triglyceride lipase, lipoprotein receptor-related protein 6, laminin receptor, PLXDC1, and PLXDC2 was also evident in the TG, LG and MG with the first three showing increased levels in corneas of the Pedf+/- and Pedf-/- mice compared to wildtype controls. Constitutive inactivation of ERK1/2 and Akt was pronounced in the TG and cornea, although their protein levels were dramatically increased in Pedf-/- mice.

Conclusions: This study highlights an essential role for PEDF in corneal structure and function and confirms the reported rescue of exogenous PEDF treatment in corneal pathologies. The pleiotropic effects of PEDF deletion on multiple trophic factors, receptors and signaling molecules are strong indications that PEDF is a key coordinator of molecular mechanisms that maintain corneal function and could be exploited in therapeutic options for several ocular surface diseases.
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http://dx.doi.org/10.1167/iovs.62.7.18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212434PMC
June 2021
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