Publications by authors named "Juan Yang"

845 Publications

Characterization of the abnormal cortical effective connectivity in patients with sleep apnea hypopnea syndrome during sleep.

Comput Methods Programs Biomed 2021 Mar 21;204:106060. Epub 2021 Mar 21.

School of Biomedical Engineering, Sun Yat-sen University, China; Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, Sun Yat-sen University, China. Electronic address:

Background And Objectives: Sleep apnea hypopnea syndrome (SAHS) is a prevalent sleep breathing disorder that can lead to brain damage and is also a risk factor for cognitive impairment and some common diseases. Studies on cortical effective connectivity (EC) during sleep may provide more direct and pathological information and shed new light on brain dysfunction due to SAHS. However, the EC is rarely explored in SAHS patients, especially during different sleep stages.

Methods: To this end, six-channel EEG signals of 43 SAHS patients and 41 healthy participants were recorded by whole-night polysomnography (PSG). The symbolic transfer entropy (STE) was applied to measure the EC between cortical regions in different frequency bands. Posterior-anterior ratio (PA) was employed to evaluate the posterior-to-anterior pattern of information flow based on overall cortical EC. The statistical characteristics of the STE and PA and of the intra-individual normalized parameters (STE* and PA*) were served as different feature sets for classifying the severity of SAHS.

Results: Although the patterns of STE across electrodes were similar, significant differences were found between the patient and the control groups. The variation trends across stages in the PA were also different in multiple frequency bands between groups. Important features extracted from the STE* and PA* were distributed in multiple rhythms, mainly in δ, α, and γ. The PA* feature set gave the best results, with accuracies of 98.8% and 83.3% for SAHS diagnosis (binary) and severity classification (four-way).

Conclusions: These results suggest that modifications in cortical EC were existed in SAHS patients during sleep, which may help characterize cortical abnormality in patients.
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http://dx.doi.org/10.1016/j.cmpb.2021.106060DOI Listing
March 2021

[Effect of combined treatment with acupuncture, moxibustion and medication on endometrial receptivity and expression of serum HOXA10 in polycystic ovary syndrome of kidney deficiency and blood stagnation].

Zhongguo Zhen Jiu 2020 Nov;40(11):1154-8

School of Acupuncture and Moxibustion, Fujian University of TCM.

Objective: To compare the clinical effect of the combined treatment of acupuncture, moxibustion, Chinese herbal medicine and western medication and simple western medication on polycystic ovary syndrome (PCOS) of kidney deficiency and blood stagnation pattern and explore the effect on endometrial receptivity and the expression of serum homeobox gene A10 (HOXA10).

Methods: A total of 60 patients with PCOS of kidney deficiency and blood stagnation pattern were randomized into a combined treatment group and a western medication group, 30 cases in each one. In the western medication group, on the fifth day of menstruation, clomiphene citrate tablets were taken orally, 50 mg each time, once daily, consecutively for 5 days. On the day when the follicle diameter was ≥ 18 mm, chorionic gonadotrophin for muscular injection, a dose of 10 000 U was given. Before sleep, the aspirin enteric-coated tablets were taken orally, 50 mg (except during menstruation). In the combined treatment group, on the base of the treatment as the western medication group, acupuncture and moxibustion were adopted and the Chinese herbal for tonifying the kidney and activating blood circulation was taken orally. The acupoints were Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Sanyinjiao (SP 6), Zigong (EX-CA 1), etc. Acupuncture was remained for 30 min each time, once every two days and discontinued during menstruation. Chinese herbal was given from the 3rd day of menstruation till the onset of the next menstruation, one dose each day. After consecutive treatment for 3 menstrual cycles in the two groups, the real-time polymerase chain reaction (RT-PCR) method was adopted to determine the expression of serum HOXA10 before and after treatment in the patients of the two groups. The endometrial thickness at ovulatory phase, uterine arterial flow 7 days after ovulation [including uterine arterial pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV)/end diastolic velocity (EDV), meaning S/D], pregnancy rate and the score of Chinese medicine symptoms before and after treatment were compared in the patients between the two groups.

Results: ① After treatment, the expression of serum HOXA10 was higher than that before treatment in the patients of the two groups (<0.01). The increase range in the combined treatment group was larger than the western medication group (<0.01). ② After treatment, the endometrial thickness at the ovulatory phase was increased in the patients of the two groups (<0.01). The increase range of the endometrial thickness in the combined treatment group was larger than the western medication group (<0.01). ③ The pregnancy rate was 46.7% (14/30) in the combined treatment group, higher than 26.7% (8/30) in the western medication group (<0.05). ④ After treatment, the bilateral uterine arterial PI, RI and S/D values, as well as TCM symptom score were all lower than those before treatment in the patients of the two groups (<0.01). The decrease range of each index in the combined treatment group was greater than the western medication group (<0.01, <0.05).

Conclusion: The combined treatment with acupuncture, moxibustion and medication effectively improves endometrial receptivity and uterine arterial flow in the patients with PCOS of kidney deficiency and blood stagnation pattern and increases pregnancy rate. The therapeutic effect is better than the simple western medication and its mechanism is probably related to the regulation of serum HOXA10 expression.
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http://dx.doi.org/10.13703/j.0255-2930.20191022-k0006DOI Listing
November 2020

[Effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome with different glucose tolerance status].

Zhongguo Zhen Jiu 2021 Feb;41(2):155-60

Department of TCM, Fujian Maternal and Child Health Hospital Affiliated to Fujian Medical University, Fuzhou 350001, China.

Objective: To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).

Methods: A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared.

Results: Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (<0.05), and NO was increased (<0.05) in the two groups; FPG, 2hPG, FINS and HOMA-IR after treatment were decreased in the IGT group (<0.05), the improvement of the above indexes in the IGT group was more significant than that in the NGT group (<0.05). After treatment, the serum levels of ADMD, ET-1 and MDA were decreased (<0.05), and NO was increased (<0.05) in the obese subgroup. In the IGT group, the improvement of serum ADMD, ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (<0.05). In the NGT group, the improvement of ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (<0.05).

Conclusion: Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.
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http://dx.doi.org/10.13703/j.0255-2930.20200110-k0007DOI Listing
February 2021

Tumor necrosis factor-α-induced protein 8-like 2 alleviates nonalcoholic fatty liver disease via suppressing TAK1 activation.

Hepatology 2021 Mar 26. Epub 2021 Mar 26.

Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background & Aims: Worldwide, Nonalcoholic fatty liver disease (NAFLD) prevalence increases rapidly and becomes a major global health problem. Tumor necrosis factor-α-induced protein 8-like 2 (TIPE2) plays a protective role in a cluster of liver diseases, such as autoimmune hepatitis, hepatitis B, and hepatocellular carcinoma. But the function of TIPE2 in NAFLD remained unknown. Here, we investigated the role of TIPE2 in the development of NAFLD.

Approach & Results: Our study found in vitro overexpression or knockout of TIPE2 significantly ameliorated or aggravated lipid accumulation and inflammation in hepatocytes exposed to metabolic stimulation, respectively. Consistently, in vivo hepatic steatosis, insulin resistance, inflammation, and fibrosis were alleviated in hepatic TIPE2 transgenic mice but exaggerated in hepatic TIPE2 knockout mice treated by metabolic challenges. RNA sequencing revealed TIPE2 was significantly associated with the mitogen-activated protein kinase (MAPK) pathway. Mechanistic experiments demonstrated that TIPE2 bound with transforming growth factor-beta-activated kinase 1 (TAK1) under metabolic stress, prevented tumor necrosis factor receptor-associated factor 6 (TRAF6)-mediated TAK1 ubiquitination and subsequently inhibited the phosphorylation and activation of TAK1-c-Jun NH2-terminal kinase (JNK)/p38 signaling. Further investigation showed that blocking the activity of TAK1 reversed the worsening of hepatic metabolic disorders and inflammation in TIPE2-HKO hepatocytes and mice treated with metabolic stimulation.

Conclusions: TIPE2 suppresses NAFLD advancement by blocking TAK1-JNK/p38 pathway and is a promising target molecule for NAFLD therapy.
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http://dx.doi.org/10.1002/hep.31832DOI Listing
March 2021

Irradiation with red light-emitting diode enhances proliferation and osteogenic differentiation of periodontal ligament stem cells.

Lasers Med Sci 2021 Mar 15. Epub 2021 Mar 15.

Hospital of Stomatology, Southwest Medical University, Lu Zhou, 646000, China.

This study aimed to evaluate the effects of low-energy red light-emitting diode (LED) irradiation on the proliferation and osteogenic differentiation of periodontal ligament stem cells (PDLSCs). PDLSCs were derived from human periodontal ligament tissues of premolars and were irradiated with 0 (control group), 1, 3, or 5 J/cm red LED in osteogenic induction medium. Cell proliferation was analyzed using the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. Osteogenic differentiation activity was evaluated by monitoring alkaline phosphatase (ALP) activity, alizarin red staining, and real-time polymerase chain reaction (RT-PCR) results. Osteoblast-associated proteins (Runx2, OCN, OPN, and BSP) were detected using western blotting. The results of the MTT assay indicated that PDLSCs in the irradiation groups exhibited a higher proliferation rate than those in the control group (P < 0.05). ALP results showed that after 7 days of illumination, only 5 J/cm promoted the expression of ALP of PDLSCs. However, after 14 days of illumination, the irradiation treatments did not increase ALP activity. The results of alizarin red staining showed that red LED promoted osteogenic differentiation of the PDLSCs. The real-time polymerase chain reaction (RT-PCR) results demonstrated that red LED upregulated the expression levels of osteogenic genes. Expression of the proteins BSP, OPN, OCN, and Runx2 in the irradiation groups was higher than that in the control group. Our results confirmed that low-energy red LED at 1, 3, and 5 J/cm promotes proliferation and osteogenic differentiation of PDLSCs.
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http://dx.doi.org/10.1007/s10103-021-03278-1DOI Listing
March 2021

Association of -C1858T Polymorphism With Susceptibility to and Infection: A Meta-Analysis.

Front Immunol 2021 25;12:592841. Epub 2021 Feb 25.

Department of Nephrology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.

It was previously published that single-nucleotide polymorphism rs2476601 ( [protein tyrosine phosphatase non-receptor type 22]-C1858T) might be related to increased sensibility to and infection. However, the results were inconclusive despite a high degree of similarity between both parameters. Herein, we carried out this meta-analysis to systematically summarize and articulate the correlation between -C1858T polymorphism and mycobacterial infection. The susceptibility of -C1858T carriers with autoimmune conditions receiving immunosuppressive therapy to and infection was determined. A systematic retrieval of studies on relevance of -C1858T polymorphism to susceptibility of or infection was performed in Chinese National Knowledge Infrastructure, PubMed and Embase databases. We regarded Odds ratios (ORs) and 95% confidence intervals (CIs) as the determined effect size. Finally, four and two case-control studies on tuberculosis and leprosy, respectively, were included. In all genetic models, without indicated association between -C1858T polymorphism and tuberculosis's susceptibility. [C versus T: OR = 0.22 (95% CI: 0.09-0.50, P = 0.887); CT versus CC: OR = 0.21 (95% CI: 0.09-0.49, P = 0.889); TT+CT versus CC: OR = 0.21 (95% CI: 0.09-0.49, P = 0.889)]. A significantly increased risk of leprosy was perceived in patients with the -C1858T polymorphism [C versus T: OR = 2.82 (95% CI: 1.02-7.81, P = 0.108)]. While the -C1858T polymorphism is irrelevant to higher susceptibility to the infection of in Caucasians and Asians, it is relevant to increased susceptibility to the infection of . However, the results of are supposed to interpreted with prudence owing to the limited quantity of studies and heterogeneity. Further well-designed studies with sufficient populations are required to verify our conclusions.
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http://dx.doi.org/10.3389/fimmu.2021.592841DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7950544PMC
February 2021

Formation of peroxyacetyl nitrate (PAN) and its impact on ozone production in the coastal atmosphere of Qingdao, North China.

Sci Total Environ 2021 Mar 8;778:146265. Epub 2021 Mar 8.

Environment Research Institute, Shandong University, Qingdao, Shandong 266237, China; Ji'nan Eco-Environmental Monitoring Center of Shandong Province, Ji'nan, Shandong 250000, China. Electronic address:

Peroxyacetyl nitrate (PAN), acting as a relatively long-lived reservoir for both NO and radicals, plays a crucial role in ozone (O) formation in the troposphere. However, its quantitative impacts on radical concentrations and O production were rarely studied in the coastal atmosphere. In this study, ambient concentrations of PAN, O, and related species were simultaneously measured from October 5 to November 10, 2018 (autumn), and July 14 to August 24, 2019 (summer) at a rural coastal site in Qingdao, North China. The formation mechanism of PAN and its impact on in-situ O production were explored with an observation-based chemical box model. Photochemical formation of PAN and O was controlled by both NO and VOCs, and acetaldehyde and methylglyoxal were the main contributors to PAN formation. However, the sensitivities of PAN to precursors were larger than that of O in autumn while smaller in summer, which was mainly caused by the rapid decomposition of PAN at high temperatures. Zero-out sensitivity simulation showed that PAN could either promote or inhibit the in-situ O formation by affecting the radical chemistry. It tended to suppress O production by competing with precursors and terminating radical chain reactions under low-NO and low-RO circumstances but enhanced O production by supplying RO radicals under conditions with sufficient NO. This study provides some new complementary insights into the formation mechanism of PAN and its impacts on O production, and has implications for the formulation of control policy to mitigate regional photochemical pollution in northern China.
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http://dx.doi.org/10.1016/j.scitotenv.2021.146265DOI Listing
March 2021

Neural processing of the physical attractiveness stereotype: Ugliness is bad vs. beauty is good.

Neuropsychologia 2021 Mar 10;155:107824. Epub 2021 Mar 10.

Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China. Electronic address:

The physical attractiveness stereotype (PAS) is characterized by the belief that beauty is good and ugliness is bad. Although the belief is not encouraged, people still express "beauty is good" explicitly. However, expressing that ugliness is bad is considered impolite in public. In this study, the neural underpinnings of PAS were investigated, particularly the comparison of the neural processing of ugliness is bad and beauty is good. During functional magnetic resonance imaging scanning, participants were asked to create trait-conformity judgments based on the facial attractiveness of the images. Our results showed that brain areas, including the fusiform, thalamus, anterior insula (AI), precuneus, inferior temporal gyrus, dorsal lateral prefrontal cortex (dlPFC), and dorsal medial prefrontal cortex (dmPFC) were involved in the processing of PAS. The left AI, left dlPFC, and right dmPFC showed stronger activation for ugliness is bad than for the converse. Moreover, we found a stronger connectivity between the left dlPFC and AI in terms of ugliness is bad than in the converse. Our study suggests that participants were unwilling to express the stereotype of ugliness is bad, and more mental resources were needed to control its expression than the expression of beauty is good.
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http://dx.doi.org/10.1016/j.neuropsychologia.2021.107824DOI Listing
March 2021

Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis.

Lancet Glob Health 2021 Mar 8. Epub 2021 Mar 8.

School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China; Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China. Electronic address:

Background: A rapidly increasing number of serological surveys for antibodies to SARS-CoV-2 have been reported worldwide. We aimed to synthesise, combine, and assess this large corpus of data.

Methods: In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, and five preprint servers for articles published in English between Dec 1, 2019, and Dec 22, 2020. Studies evaluating SARS-CoV-2 seroprevalence in humans after the first identified case in the area were included. Studies that only reported serological responses among patients with COVID-19, those using known infection status samples, or any animal experiments were all excluded. All data used for analysis were extracted from included papers. Study quality was assessed using a standardised scale. We estimated age-specific, sex-specific, and race-specific seroprevalence by WHO regions and subpopulations with different levels of exposures, and the ratio of serology-identified infections to virologically confirmed cases. This study is registered with PROSPERO, CRD42020198253.

Findings: 16 506 studies were identified in the initial search, 2523 were assessed for eligibility after removal of duplicates and inappropriate titles and abstracts, and 404 serological studies (representing tests in 5 168 360 individuals) were included in the meta-analysis. In the 82 studies of higher quality, close contacts (18·0%, 95% CI 15·7-20·3) and high-risk health-care workers (17·1%, 9·9-24·4) had higher seroprevalence than did low-risk health-care workers (4·2%, 1·5-6·9) and the general population (8·0%, 6·8-9·2). The heterogeneity between included studies was high, with an overall I of 99·9% (p<0·0001). Seroprevalence varied greatly across WHO regions, with the lowest seroprevalence of general populations in the Western Pacific region (1·7%, 95% CI 0·0-5·0). The pooled infection-to-case ratio was similar between the region of the Americas (6·9, 95% CI 2·7-17·3) and the European region (8·4, 6·5-10·7), but higher in India (56·5, 28·5-112·0), the only country in the South-East Asia region with data.

Interpretation: Antibody-mediated herd immunity is far from being reached in most settings. Estimates of the ratio of serologically detected infections per virologically confirmed cases across WHO regions can help provide insights into the true proportion of the population infected from routine confirmation data.

Funding: National Science Fund for Distinguished Young Scholars, Key Emergency Project of Shanghai Science and Technology Committee, Program of Shanghai Academic/Technology Research Leader, National Science and Technology Major project of China, the US National Institutes of Health.

Translation: For the Chinese translation of the abstract see Supplementary Materials section.
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http://dx.doi.org/10.1016/S2214-109X(21)00026-7DOI Listing
March 2021

Nanomedicine promotes ferroptosis to inhibit tumour proliferation in vivo.

Redox Biol 2021 Feb 20:101908. Epub 2021 Feb 20.

Department of General Surgery, Geriatrics, Obstetrics and Gynecology, Division of Pulmonary and Critical Care Medicine, Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

miR-101-3p may play a therapeutic role in various tumours. However, its anti-tumour mechanism remains unclear, and a definitive strategy to treat tumour cells in vivo is lacking. The objective of this study was to investigate the inhibitory mechanism of miR-101-3p on tumour cells and to develop relevant nanomedicines for in vivo therapy. The expression levels of miR-101-3p and its target protein TBLR1 in tumour tissues and cells were detected, and their relationship with ferroptosis was clarified. Furthermore, the efficacy of nanocarriers in achieving in vivo therapeutic gene delivery was evaluated. Nanomedicine was further developed, with the anti-proliferative in vivo therapeutic effect validated using a subcutaneous xenograft cancer model. The expression level of miR-101-3p negatively correlated with clinical tumour size and TNM stage. miR-101-3p restores ferroptosis in tumour cells by directly targeting TBLR1, which in turn promotes apoptosis and inhibits proliferation. We developed nanomedicine that can deliver miR-101-3p to tumour cells in vivo to achieve ferroptosis recovery, as well as to inhibit in vivo tumour proliferation. The miR-101-3p/TBLR1 axis plays an important role in tumour ferroptosis. Nanopharmaceuticals that increase miR-101-3p levels may be effective therapies to inhibit tumour proliferation.
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http://dx.doi.org/10.1016/j.redox.2021.101908DOI Listing
February 2021

Clinical significance of evaluation of collateral circulation in short-term prognosis of wake-up stroke patients.

Adv Clin Exp Med 2021 Feb;30(2):183-188

Department of Neurology, Pudong New Area People's Hospital, Shanghai, China.

Background: In recent years, the clinical significance of collateral circulation in vascular embolism has been gradually found.

Objectives: To investigate the relationship between collateral circulation and short-term prognosis of wake-up stroke patients.

Material And Methods: The present observational study enrolled 269 cases of wake-up ischemic stroke patients. All patients presented with mismatched low perfusion volume/main infraction volume and received thrombolytic therapy after admission. The hemorrhagic transformation rate was recorded. The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading was used for evaluation of collateral circulation. The stroke condition was determined using the National Institutes of Health Stroke Scale (NIHSS). The Barthel Index (BI) score was used for measurement of quality of life. The Modified Rankin Scale (mRS) was used for measurement of prognosis.

Results: The hypertension, diabetes and current smoker rates were significantly higher. The baseline NHISS scores and NIHSS scores after 24 h were remarkably lower. The NIHSS scores were markedly lower in ASITN/SIR grade 2-3 patients compared with ASITN/SIR grade 0-1 patients at 1 week, 2 weeks, 4 weeks, and 3 months after treatment. Patients with ASITN/SIR grade 2-3 had lower mRS score and higher BI scores. The ASITN/SIR grade was an independent risk factor for bad prognosis of wake-up ischemic stroke patients in 3 months.

Conclusions: Collateral circulation condition may be associated with short-term prognosis of wake-up stroke patients. Patients with worse collateral circulation may present higher risk for bad short-term prognosis.
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http://dx.doi.org/10.17219/acem/121927DOI Listing
February 2021

ZmSPL10/14/26 are required for epidermal hair cell fate specification on maize leaf.

New Phytol 2021 Feb 24. Epub 2021 Feb 24.

State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China.

The epidermal hair and stomata are two types of specialized structures on the surface of plant leaves. On mature maize leaves, stomatal complexes and three types of hairs are distributed in a stereotyped pattern on the adaxial epidermis. However, the spatiotemporal relationship between epidermal hair and stomata development and the regulatory mechanisms governing their formation in maize remain largely unknown. Here, we report that three homologous ZmSPL transcription factors, ZmSPL10, ZmSPL14 and ZmSPL26, act in concert to promote epidermal hair fate on maize leaf. Cytological analyses revealed that Zmspl10/14/26 triple mutants are completely glabrous, but possess ectopic stomatal files. Strikingly, the precursor cells for prickle and bicellular hairs are transdifferentiated into ectopic stomatal complexes in the Zmspl10/14/26 mutants. Molecular analyses demonstrated that ZmSPL10/14/26 bind directly to the promoter of a WUSCHEL-related homeobox gene, ZmWOX3A, and upregulate its expression in the hair precursor cells. Moreover, several auxin-related genes are downregulated in the Zmspl10/14/26 triple mutants. Our results suggest that ZmSPL10/14/26 play a key role in promoting epidermal hair fate on maize leaves, possibly through regulating ZmWOX3A and auxin-related gene expression, and that the fates of epidermal hairs and stomata are switchable.
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http://dx.doi.org/10.1111/nph.17293DOI Listing
February 2021

Integrative Medicine Treatment in Times of Pandemic Coronavirus Disease?

Med Acupunct 2021 Feb 16;33(1):107-114. Epub 2021 Feb 16.

Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Coronavirus disease (COVID-19) has expanded around the world, resulting in a pandemic with high morbidity and mortality. To date, no specific treatment or vaccine is available to treat or prevent this sudden and potentially deadly disease. Economic restructuring brings opportunities and challenges to integrative medicine treatment. In such complex situations, integrative medicine treatments are to be provided cautiously, and the shift from in-person visits to remote medical services might play an important role in how such services are delivered.
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http://dx.doi.org/10.1089/acu.2020.1441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894027PMC
February 2021

Effectively removing tetracycline from water by nanoarchitectured carbons derived from CO: Structure and surface chemistry influence.

Environ Res 2021 Apr 16;195:110883. Epub 2021 Feb 16.

School of Resource and Environmental Science, Hubei International Scientific and Technological Cooperation Base of Sustainable Resource and Energy, Wuhan University, Wuhan, 430072, China; State Key Laboratory of Water Resources and Hydropower Engineering Science, Wuhan University, Wuhan, 430072, PR China. Electronic address:

Understanding of the correlation between physico-chemical property of adsorbent and the adsorption performance of contaminant is very significant for developing high-efficient materials to remove antibiotic contamination from water. In this work, a novel kind of carbon adsorbent (EC) derived from CO and activated ECs with modified structure via a facile chemical method using H and KOH were prepared. The synthetic carbon materials (EC, EC-H, and EC-KOH) were then applied to remove tetracycline (TC). The kinetics of adsorption for these three carbon materials all well fitted the pseudo-second-order kinetic model. The experimental data of adsorption isotherm had good compatibility with Langmuir and Freundlich models (R > 0.90), but the Temkin model was the most applicable for all adsorbents (R > 0.98). A super-high adsorption capacity of EC-KOH obtained from Langmuir fitting was 933.56 mg g, which was much higher than that of EC-H (538.91 mg g) and EC (423.30 mg g), possibly due to its larger specific surface area (S), pore volume, and specific surface chemical structure. Moreover, it was found that surface functional groups and large aperture of adsorbents had a positive effect on adsorption rate. More adsorption sites and surface functional groups of adsorbents were beneficial to enhance the adsorption affinity. These results are of great benefit to the directional control of carbon structure to increase the adsorption performance in rate, capacity, and affinity of antibiotics.
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http://dx.doi.org/10.1016/j.envres.2021.110883DOI Listing
April 2021

Can a COVID-19 vaccination program guarantee the return to a pre-pandemic lifestyle?

Res Sq 2021 Feb 9. Epub 2021 Feb 9.

COVID-19 vaccination programs have been initiated in several countries to control SARS-CoV-2 transmission and return to a pre-pandemic lifestyle. However, understanding when non-pharmaceutical interventions (NPIs) can be lifted as vaccination builds up and how to update priority groups for vaccination in real-time remain key questions for policy makers. To address these questions, we built a data-driven model of SARS-CoV-2 transmission for China. We estimated that, to prevent local outbreaks to escalate to major widespread epidemics, stringent NPIs need to remain in place at least one year after the start of vaccination. Should NPIs be capable to keep the reproduction number (Rt) around 1.3, a vaccination program could reduce up to 99% of COVID-19 burden and bring Rt below the epidemic threshold in about 9 months. Maintaining strict NPIs throughout 2021 is of paramount importance to reduce COVID-19 burden while vaccines are distributed to the population, especially in large populations with little natural immunity.
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http://dx.doi.org/10.21203/rs.3.rs-200069/v1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885929PMC
February 2021

Viral Respiratory Infections: An Ounce of Prevention Is Worth a Pound of Cure.

Mayo Clin Proc Innov Qual Outcomes 2021 Feb 6. Epub 2021 Feb 6.

Division of General Internal Medicine, Mayo Clinic, Rochester, MN.

The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated over the past few decades increasingly suggests the importance of recognizing the background and context of lifestyle factors in the prevention of VRIs recurrence. The focus of attention has specifically been on how to optimize respiratory barrier function and immune function during the period of the pandemic outbreak. This viewpoint discusses the impact of a healthy lifestyle on VRIs and demonstrates a practical approach to preventing the occurrence of VRIs based on contemporary evidence.
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http://dx.doi.org/10.1016/j.mayocpiqo.2020.12.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864792PMC
February 2021

Oral posaconazole and bronchoscopy as a treatment for pulmonary mucormycosis in pediatric acute lymphoblastic leukemia patient: A case report.

Medicine (Baltimore) 2021 Feb;100(6):e24630

Department of Pediatric Respiratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Rationale: Mucormycosis is a rare fungal infection that typically occurs in immunosuppressed patients following chemotherapy or hematopoietic stem cell transplantation.

Patient Concerns: An 11-year-old child with newly developed acute lymphoblastic leukemia suffered from the paroxysmal left chest pain, fever, and hemoptysis.

Diagnoses: We made a histopathologic diagnosis aided by bronchoscopy techniques, which indicated invasive fungal hyphae that are characteristic of mucormycosis.

Interventions: The patient was treated with oral posaconazole and repeated bronchoscopy interventions for 4 months.

Outcomes: The patient's clinical signs and symptoms and signs were no longer present. The prior lung lesions were also no longer observable using radiologic methods, and a 3-month follow-up with the patient showed no signs of mucormycosis recurrence. Finally, the patient was cured, when the cancer chemotherapy was stopped. Close follow-up for another 2 years showed no evidence of recurrence.

Lessons: Mucormycosis diagnosis is difficult as clinical and imaging findings vary. This case demonstrates that posaconazole monotherapy combined with bronchoscopy interventions may be a safe and effective treatment option for pediatric pulmonary mucormycosis.
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http://dx.doi.org/10.1097/MD.0000000000024630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886464PMC
February 2021

Neighborhood archetypes and breast cancer survival in California.

Ann Epidemiol 2021 Feb 10;57:22-29. Epub 2021 Feb 10.

Department of Epidemiology & Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Greater Bay Area Cancer Registry, San Francisco, CA.

Purpose: Previous studies on neighborhoods and breast cancer survival examined neighborhood variables as unidimensional measures (e.g. walkability or deprivation) individually and thus cannot inform how the multitude of highly correlated neighborhood domains interact to impact breast cancer survival. Neighborhood archetypes were developed that consider interactions among a broad range of neighborhood social and built environment attributes and examine their associations with breast cancer survival.

Methods: Archetypes were measured using latent class analysis (LCA) fit to California census tract-level data. Thirty-nine social and built environment attributes relevant to eight neighborhood domains (socioeconomic status (SES), urbanicity, demographics, housing, land use, commuting and traffic, residential mobility, and food environment) were included.  The archetypes were linked to cancer registry data on breast cancer cases (diagnosed 1996-2005 with follow-up through Dec 31, 2017) to evaluate their associations with overall and breast cancer-specific survival using Cox proportional hazards models. Analyses were stratified by race/ethnicity.

Results: California neighborhoods were best described by nine archetypal patterns that were differentially associated with overall and breast cancer-specific survival. The lowest risk of overall death was observed in the upper middle class suburb (reference) and high status neighborhoods, while the highest was observed among inner city residents with a 39% greater risk of death (95% CI = 1.35 to 1.44). Results were similar for breast cancer-specific survival. Stratified analyses indicated that differences in survival by neighborhood archetypes varied according to individuals' race/ethnicity.

Conclusions: By describing neighborhood archetypes that differentiate survival following breast cancer diagnosis, the study provides direction for policy and clinical practice addressing contextually-rooted social determinants of health including SES, unhealthy food environments, and greenspace.
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http://dx.doi.org/10.1016/j.annepidem.2021.01.004DOI Listing
February 2021

Can a COVID-19 vaccination program guarantee the return to a pre-pandemic lifestyle?

medRxiv 2021 Feb 5. Epub 2021 Feb 5.

COVID-19 vaccination has been initiated in several countries to control SARS-CoV-2 transmission. Whether and when non-pharmaceutical interventions (NPIs) can be lifted as vaccination builds up remains key questions. To address them, we built a data-driven SARS-CoV-2 transmission model for China. We estimated that, to prevent local outbreaks to escalate to major widespread epidemics, stringent NPIs need to remain in place at least one year after the start of vaccination. Should NPIs be capable to keep the reproduction number (Rt) around 1.3, vaccination could reduce up to 99% of COVID-19 burden and bring Rt below the epidemic threshold in 9 months. Maintaining strict NPIs throughout 2021 is of paramount importance to reduce COVID-19 burden while vaccines are distributed, especially in large populations with little natural immunity.
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http://dx.doi.org/10.1101/2021.02.03.21251108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872368PMC
February 2021

Who should be prioritized for COVID-19 vaccination in China? A descriptive study.

BMC Med 2021 02 10;19(1):45. Epub 2021 Feb 10.

School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.

Background: All countries are facing decisions about which population groups to prioritize for access to COVID-19 vaccination after the first vaccine products have been licensed, at which time supply shortages are inevitable. Our objective is to define the key target populations, their size, and priority for a COVID-19 vaccination program in the context of China.

Methods: On the basis of utilitarian and egalitarian principles, we define and estimate the size of tiered target population groups for a phased introduction of COVID-19 vaccination, considering evolving goals as vaccine supplies increase, detailed information on the risk of illness and transmission, and past experience with vaccination during the 2009 influenza pandemic. Using publicly available data, we estimated the size of target population groups, and the number of days needed to vaccinate 70% of the target population. Sensitivity analyses considered higher vaccine coverages and scaled up vaccine delivery relative to the 2009 pandemic.

Results: Essential workers, including staff in the healthcare, law enforcement, security, nursing homes, social welfare institutes, community services, energy, food and transportation sectors, and overseas workers/students (49.7 million) could be prioritized for vaccination to maintain essential services in the early phase of a vaccination program. Subsequently, older adults, individuals with underlying health conditions and pregnant women (563.6 million) could be targeted for vaccination to reduce the number of individuals with severe COVID-19 outcomes, including hospitalizations, critical care admissions, and deaths. In later stages, the vaccination program could be further extended to target adults without underlying health conditions and children (784.8 million), in order to reduce symptomatic infections and/or to stop virus transmission. Given 10 million doses administered per day, and a two-dose vaccination schedule, it would take 1 week to vaccinate essential workers but likely up to 7 months to vaccinate 70% of the overall population.

Conclusions: The proposed framework is general but could assist Chinese policy-makers in the design of a vaccination program. Additionally, this exercise could be generalized to inform other national and regional strategies for use of COVID-19 vaccines, especially in low- and middle-income countries.
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http://dx.doi.org/10.1186/s12916-021-01923-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872877PMC
February 2021

Driving the Interfacial Ion-Transfer Kinetics by Mesoporous TiO Spheres for High-Performance Aqueous Zn-Ion Batteries.

ACS Appl Mater Interfaces 2021 Feb 9;13(7):8181-8190. Epub 2021 Feb 9.

School of Metallurgy and Environment, Central South University, Changsha 410083, China.

The aqueous zinc-ion batteries (ZIBs) have been considered as a promising energy storage device. However, the ion transfer at the Zn metal anode-electrolyte interface is limited by the sluggish kinetics resulting in high interface resistance. Herein, mesoporous TiO (m-TiO) is coated on the Zn foil (Zn-TiO) driving the ion's faster transfer to reduce interface resistance (70.1 Ω vs 799.3 Ω of bare Zn). The lower interface resistance is ascribed to shortening the ion transfer path provided by the mesoporous structure and the smaller Zn absorption energy barrier of the surface of the Zn-TiO anode as well as the unobstructed ion transfer path at the crystal planes (100) of TiO, which have been supported by the density functional theory (DFT) calculation and experiments. Therefore, the Zn-TiO anodes in the symmetrical cells display a low voltage hysteresis (36.5 mV) and long-term cycling stability (500 h at 4.4 mA cm). Especially, the Zn-TiO/MnO full cells show superior cycling performance with a high capacity of 269.8 mAh g after 50 cycles at 0.2 A g and 210.9 mAh g after 1000 cycles at 0.5 A g. The analysis of ion-transfer kinetics at the interface provides deep enlightenment and reference for the study of the metal anodes.
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http://dx.doi.org/10.1021/acsami.0c18433DOI Listing
February 2021

Drought-induced ABA, HO and JA positively regulate CmCAD genes and lignin synthesis in melon stems.

BMC Plant Biol 2021 Feb 8;21(1):83. Epub 2021 Feb 8.

Key Laboratory of Protected Horticulture of Education Ministry and Liaoning Province, College of Horticulture, Shenyang Agricultural University, National & Local Joint Engineering Research Center of Northern Horticultural Facilities Design & Application Technology (Liaoning), Shenyang, 110866, Liaoning, People's Republic of China.

Background: Cinnamyl alcohol dehydrogenase (CAD) is an important enzyme functions at the last step in lignin monomer synthesis pathway. Our previous work found that drought induced the expressions of CmCAD genes and promoted lignin biosynthesis in melon stems.

Results: Here we studied the effects of abscisic acid (ABA), hydrogen peroxide (HO) and jasmonic acid (JA) to CmCADs under drought stress. Results discovered that drought-induced ABA, HO and MeJA were prevented efficiently from increasing in melon stems pretreated with fluridone (Flu, ABA inhibitor), imidazole (Imi, HO scavenger) and ibuprofen (Ibu, JA inhibitor). ABA and HO are involved in the positive regulations to CmCAD1, 2, 3, and 5, and JA is involved in the positive regulations to CmCAD2, 3, and 5. According to the expression profiles of lignin biosynthesis genes, ABA, HO and MeJA all showed positive regulations to CmPAL2-like, CmPOD1-like, CmPOD2-like and CmLAC4-like. In addition, positive regulations were also observed with ABA to CmPAL1-like, CmC4H and CmCOMT, with HO to CmPAL1-like, CmC4H, CmCCR and CmLAC17-like, and with JA to CmCCR, CmCOMT, CmLAC11-like and CmLAC17-like. As expected, the signal molecules positively regulated CAD activity and lignin biosynthesis under drought stress. Promoter::GUS assays not only further confirmed the regulations of the signal molecules to CmCAD1~3, but also revealed the important role of CmCAD3 in lignin synthesis due to the strongest staining of CmCAD3 promoter::GUS.

Conclusions: CmCADs but CmCAD4 are positively regulated by ABA, HO and JA under drought stress and participate in lignin synthesis.
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http://dx.doi.org/10.1186/s12870-021-02869-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871556PMC
February 2021

Development and validation of a risk score using complete blood count to predict in-hospital mortality in COVID-19 patients.

Med (N Y) 2021 Jan 8. Epub 2021 Jan 8.

Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background: To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC).

Methods: We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with 2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM).

Findings: Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92-0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions.

Conclusions: The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients.

Funding: This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006).
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http://dx.doi.org/10.1016/j.medj.2020.12.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831644PMC
January 2021

Rome III, Rome IV, and Potential Asia Symptom Criteria for Functional Dyspepsia Do Not Reliably Distinguish Functional From Organic Disease.

Clin Transl Gastroenterol 2020 12;11(12):e00278

Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China.

Introduction: Although the Rome criteria were created primarily for research purposes, it was an important question whether the Rome criteria can distinguish organic dyspepsia from functional dyspepsia (FD). We evaluated the accuracy of the Rome IV criteria in identifying patients with FD and compared the differences between the Rome IV, Rome III, and potential Asia criteria in identifying patients with FD.

Methods: In this cross-sectional study, we analyzed data from patients who met the inclusion and exclusion criteria from March 2018 to January 2019 at 2 tertiary hospitals.

Results: A total of 600 patients were enrolled in this study, including 381 individuals met the Rome IV criteria for FD, 438 individuals met the Rome III criteria for FD, and 525 individuals met the potential Asia criteria for FD. The Rome IV criteria identified patients with FD with 67.3% sensitivity and 38.4% specificity, and the positive and negative likelihood ratios of FD identified by Rome IV criteria were 1.09 (95% confidence interval 0.97-1.24) and 0.85 (95% confidence interval 0.67-1.08), respectively. There was no significant difference in the area under Rome IV, Rome III, or potential Asia criteria receiver operating characteristic curves in identifying FD (P > 0.05).

Discussion: The Rome IV criteria were no better than the Rome III or potential Asia criteria in identifying FD and were not helpful in identifying patients with FD. Hence, although the Rome criteria remain useful for defining patients with FD for inclusion into clinical treatment trials, they should not be used for diagnosing FD.
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http://dx.doi.org/10.14309/ctg.0000000000000278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721216PMC
December 2020

Identification of differentially expressed long non-coding RNAs in mice intestines after severe burns and a preliminary study into the key gene H19.

J Burn Care Res 2021 Jan 29. Epub 2021 Jan 29.

Department of Burn Surgery, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.

Background: The intestine is considered the key organ in stress response to severe burns and injury to intestine after severe burns can be fatal. However, the injury and subsequent repair of intestinal tissues after severe burns at the genetic level are poorly understood. Long non-coding RNAs (lncRNAs) have important functions in regulating many biological processes, including gene transcription and translation. Autophagy is a process of intracellular degradation and reutilization of cytoplasmic proteins and organelles.

Methods: We herein analyzed the genome-wide expression profile of lncRNAs and mRNAs after severe burns in the intestines of mice by lncRNA microarray. qRT-PCR was performed to verify the reliability of microarray analysis results, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used for bioinformatics analysis of differentially expressed mRNAs. The common regulatory network between the top ten differentially expressed lncRNAs and trans-related mRNAs was visualized by Cytoscape (v3.7.2). Next, we hypothesized that H19 is the key gene for intestinal mucosal repair. After H19 was overexpressed, the changes in downstream autophagy protein expression levels were observed.

Results: GO and KEGG analysis indicated that the differentially expressed mRNAs were mainly enriched in a cell cycle- and mitosis-related genes.Overexpression of lncRNA-H19 showed that the autophagy-related gene Trim21 was up-regulated, while HIF1α was down-regulated.

Conclusion: LncRNA-H19 played a key role in repairing the intestinal mucosa, and overexpression of lncRNA-H19 activated autophagy and migration of intestinal epithelial cells (IEC-6).
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http://dx.doi.org/10.1093/jbcr/irab017DOI Listing
January 2021

Tui Na for Chronic Nonspecific Low Back Pain: Protocol for a Systematic Review and Meta-analysis.

JMIR Res Protoc 2021 Jan 27;10(1):e20615. Epub 2021 Jan 27.

Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States.

Background: Chronic nonspecific low back pain (CNLBP) is one of the most common complex pain conditions, and it is strongly associated with high rates of disability. Even though several studies on Tui na for CNLBP have been reported, to our knowledge there has been no systematic review of the currently available publications.

Objective: This study aims to develop a protocol for a systematic review and meta-analysis that will evaluate the effectiveness and safety of Tui na therapy for patients with CNLBP.

Methods: An electronic literature search of PubMed, Embase, MEDLINE, Cochrane Library, Springer, Scopus, World Health Organization International Clinical Trials Registry Platform, Physiotherapy Evidence Database (PEDro), Clarivate Analytics, and Chinese biomedical databases (the China National Knowledge Infrastructure, Wan-fang database, Chinese Scientific Journals Database, and Chinese Biomedical Literature Databases) will be conducted. Studies will be screened by two reviewers independently based on titles and abstracts, followed by a full-text reading with eligibility criteria. Randomized controlled trials involving Tui na for patients with CNLBP will be reviewed. The primary outcomes of the study are improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event of Tui na intervention. Methodological quality and risk of bias will be assessed with the Cochrane Collaboration Risk of Bias Tool. If studies are sufficient, a meta-analysis of the effectiveness will be performed. If possible, we will evaluate publication bias using funnel plots. If substantial heterogeneity between studies is present, and there are sufficient studies, subgroup analyses will be conducted to explain the study findings.

Results: The review database searches will be initiated in December 2020, with findings expected by January 2021.

Conclusions: This protocol will establish a framework of a high-quality literature synthesis on the impact of Tui na treatment in patients with CNLBP. The proposed review will determine whether Tui na is effective and safe for CNLBP patients.

Trial Registration: PROSPERO CRD42020166731; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=166731.

International Registered Report Identifier (irrid): PRR1-10.2196/20615.
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http://dx.doi.org/10.2196/20615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875686PMC
January 2021

Acupuncture for palliative cancer pain management: systematic review.

BMJ Support Palliat Care 2021 Jan 13. Epub 2021 Jan 13.

Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

Background: Pain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care.

Objective: To critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings.

Methods: Multiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence.

Results: Five studies (n=189) were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings.

Conclusions: Acupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality, adequately powered studies are needed in the future.
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http://dx.doi.org/10.1136/bmjspcare-2020-002638DOI Listing
January 2021

The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19.

Cell Metab 2021 02 5;33(2):258-269.e3. Epub 2021 Jan 5.

Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China. Electronic address:

Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19. But one key question is how to objectively identify severely ill patients who may benefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitals in Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyte ratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly, however, corticosteroid treatment in such individuals was associated with a lower risk of 60-day all-cause mortality. Conversely, in individuals with an NLR ≤ 6.11 or with type 2 diabetes, corticosteroid treatment was not associated with reduced mortality, but rather increased risks of hyperglycemia and infections. These results show that in the studied cohort corticosteroid treatment is associated with beneficial outcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptoms as defined by NLR.
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http://dx.doi.org/10.1016/j.cmet.2021.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832609PMC
February 2021

AMOT suppresses tumor progression via regulating DNA damage response signaling in diffuse large B-cell lymphoma.

Cancer Gene Ther 2021 Jan 7. Epub 2021 Jan 7.

Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, China.

Angiomotin (AMOT) is a membrane protein that is aberrantly expressed in a variety of solid tumors. Accumulating evidence support that AMOT is involved in the pathological processes of tumor proliferation, apoptosis, and invasion. However, the potential role of AMOT in the pathogenesis of diffuse large B-cell lymphoma (DLBCL) remains elusive. In the present study, we investigated the expression level and biological function of AMOT in DLBCL. AMOT expression was significantly reduced in DLBCL biopsy section, and low AMOT expression was associated with poor clinical prognosis. Overexpression of AMOT by lentivirus in human DLBCL cells induced cell viability inhibition concomitant with an increased percentage of cells in G1 phase and decreased percentage in S phase. Moreover, AMOT upregulation increased the sensitivity of DLBCL cells to doxorubicin. Furthermore, overexpression of AMOT led to reduced activation of key kinases for the DNA damage response (DDR). The above results indicated that AMOT acts as a tumor suppressor via inhibition of the DDR, thus reducing the viability while increasing the chemosensitivity in DLBCL. In summary, AMOT may be a novel potential target for DLBCL therapeutic intervention.
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http://dx.doi.org/10.1038/s41417-020-00258-5DOI Listing
January 2021

The treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.

J Clin Pharm Ther 2021 Jan 6. Epub 2021 Jan 6.

Shandong Provincial Hospital Affiliated to Shandong first Medical University, Jinan, China.

What Is Known And Objective: In recent years, the resistance of Mycoplasma pneumoniae to macrolide antibiotics has increased significantly. The health systems are facing significant challenges in carrying out the diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia in children. Levofloxacin is suitable for treating infectious diseases in various systems but limited in children due to arthropathy issues in weight-bearing joints. This study aimed to evaluate the efficacy and safety of levofloxacin in children with macrolide-resistant Mycoplasma pneumoniae pneumonia.

Methods: We retrospectively enrolled six confirmed cases of refractory Mycoplasma pneumoniae pneumonia who were admitted in the paediatric respiratory ward of Shandong provincial hospital Affiliated to Shandong first Medical University between 1st January 2020 and 29th February 2020. Levofloxacin was given to the patients through the intravenous or oral route as per the following dosages :<5 years, 8-10 mg/kg q12 h; >5 years, 8-10 mg/kg, qd for 10 days. The clinical data were collected and analysed.

Results And Discussion: The average age of the enrolled cases was six years and nine months (range, four years, and seven months to eleven years and seven months). All cases were found to be drug-resistant and were treated with azithromycin combined with antibacterial drugs. Levofloxacin was used in the patient's refractory to macrolide antibiotics. The temperature of five cases returned to normal 1-2 days after treatment with levofloxacin, and the imaging of the four cases showed expected improvements. The gastrointestinal symptoms, neurological manifestations, joint symptoms, blood parameters, liver and kidney functions, and exercise conditions of the children were closely monitored. The follow-up time of the patients ranged from one week to five months. No drug-related adverse reactions were observed in patients during treatment or during follow-up.

What Is New And Conclusion: The clinical symptoms and imaging significantly improved after treatment with levofloxacin, and no drug-related adverse reactions were observed. Levofloxacin proved to be an effective and safe drug in the treatment of children with macrolide-resistant mycoplasma pneumonia. This study will provide a reference for evaluating the efficacy and safety of levofloxacin in the paediatric population.
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http://dx.doi.org/10.1111/jcpt.13331DOI Listing
January 2021