COVID-19 susceptibility, hospitalization and severity and the risk of brain cortical structure: a Mendelian randomization study

BACKGROUND

Observational studies have reported structural changes in the brains of patients with coronavirus disease 2019 (COVID-19); it remains unclear whether these associations are causal.

AIM

We evaluated the causal effects of COVID-19 susceptibility, hospitalization and severity on cortical structures.

DESIGN

Mendelian randomization (MR) study.

METHODS

Data on the different COVID-19 phenotypes were obtained from the latest large-scale genome-wide association study (R7) of the COVID-19 Host Genetics Initiative. Brain structure data, including cortical thickness (TH) and surface area (SA), were obtained from the ENIGMA Consortium. Additionally, we employed the round 5 dataset released in January 2021 as the validation cohort. The inverse-variance weighted (IVW) method was used as the primary analysis in MR. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. We performed enrichment analysis on the MR analyses that passed the sensitivity analysis filtering.

RESULTS

After IVW and sensitivity analyses, we observed causal associations between COVID-19 susceptibility and rostral middle frontal SAw (P = 0.0308, β = -39.1236), cuneus THw (P = 0.0170, β = -0.0121), medial orbitofrontal THw (P = 0.0002, β = 0.0225), postcentral THw (P = 0.0217, β = -0.0106), temporal pole THw (P = 0.0077, β = 0.0359), medial orbitofrontal SAnw (P = 0.0106, β = -24.0397), medial orbitofrontal THnw (P = 0.0007, β = 0.0232), paracentral SAnw (P = 0.0483, β = -20.1442), rostral middle frontal SAnw (P = 0.0368, β = -81.9719) and temporal pole THnw (P = 0.0429, β = 0.0353). COVID-19 hospitalization had causal effects on medial orbitofrontal THw (P = 0.0053, β = 0.0063), postcentral THw (P = 0.0143, β = -0.0042), entorhinal THnw (P = 0.0142, β = 0.0142), medial orbitofrontal THnw (P = 0.0147, β = 0.0065) and paracentral SAnw (P = 0.0119, β = -7.9970). COVID-19 severity had causal effects on rostral middle frontal SAw (P = 0.0122, β = -11.8296), medial orbitofrontal THw (P = 0.0155, β = 0.0038), superior parietal THw (P = 0.0291, β = -0.0021), lingual SAnw (P = 0.0202, β = -11.5270), medial orbitofrontal THnw (P = 0.0290, β = 0.0039), paracentral SAnw (P = 0.0180, β = -5.7744) and pars triangularis SAnw (P = 0.0151, β = -5.4520).

CONCLUSION

Our MR results demonstrate a causal relationship between different COVID-19 phenotypes and cortical structures.

Moisture content of tea dhool for the scenting process affects the aroma quality and volatile compounds of osmanthus black tea

To improve the quality of osmanthus black tea, samples produced with different scenting methods were prepared. The sensory quality was assessed and the characteristic aromatic components were explored using solid-phase microextraction (SPME) coupled with gas chromatography-mass spectrometry. According to the results, osmanthus black tea obtained by adding osmanthus scenting in the fermentation process had the strongest floral aroma. The major contributors to the aroma of osmanthus black tea were identified as β-ionone, dihydro-β-ionone, benzeneacetaldehyde, citral, geraniol, and linalool by calculating their relative odor activity values. An analysis of the causes revealed that the moisture content of tea dhool significantly affected the adsorption of fresh flower aroma by tea. The experimental results showed that osmanthus black tea produced using tea dhool containing 30% moisture content had the highest content of crucial aroma components, suggesting the tea dhool under this condition had the strongest adsorption capacity for osmanthus aroma.

Structural characterization and high-efficiency prebiotic activity of the polysaccharide from Tremella aurantialba endophytic bacteria

Herein, the low-molecular-weight heteropolysaccharide (designated as TABP), with a weight-average Mw of 5408 Da, was produced by the endophytic bacterium Bacillus sp. TAB, which was initially isolated from the fruiting bodies of the wild Tremella aurantialba. A relatively high TABP accumulation was obtained and enhanced to 6.94 g/L in 5 L fed-batch fermentation by high-density cultivation. Monosaccharide composition analysis showed that the TABP comprised arabinose, glucosamine, galactose, glucose, and mannose with a molar ratio of 0.073: 0.145: 0.406: 0.182: 0.195, respectively. Methylation and NMR analyses indicated that TABP contained 1,4-linked β-d-Galp and 1,4-linked β-d-Manp pyranosyl backbone, extensively substituted at the side chains to form a complex structure. Prebiotic potential analysis exhibited significant growth-promoting effects for various lactic acid bacteria by more than 90 %. Overall, this study initially provides valuable insights into the endophytic exopolysaccharides from T. aurantialba and their biological activity, which provides prospective sources of prebiotics for functional foods and aids in understanding the endophytes symbiosis mechanism in edible mushrooms.

[Clinicopathological features of SMARCA4-deficient lung adenocarcinoma: a study of 42 cases]

Objective: To investigate the clinicopathological characteristics and genetic mutations of SMARCA4-deficient lung adenocarcinoma. Methods: From January 2021 to April 2023 in the First Affiliated Hospital of Zhengzhou University, 42 cases of SMARCA4-deficienct lung adenocarcinoma were diagnosed and now analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. The clinicopathological features were reviewed. Next-generation sequencing (NGS) was performed to investigate the mutations of related genes. Results: Among the 42 cases, there were 35 biopsy and 7 surgical specimens. There were 38 males and 4 females. The male to female ratio was 9.5∶1.0, with an age range from 42 to 78 years. Thirty-three patients were smokers. Overall, 4 cases (9.5%), 2 cases (4.7%), 18 cases (42.9%) and 18 cases (42.9%) were at stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. Microscopically, all the cases were non-mucinous adenocarcinoma, without lepidic pattern. The morphology was diverse. Rhabdomyoid cells, tumor giant cells and tumor necrosis were present. Most of the tumor cells had eosinophilic cytoplasm and occasionally clear cytoplasm. Defined cell borders and variable cytoplasmic hyaline secretory globules could be found. Inflammatory cells infiltrated the tumor stroma. Immunohistochemistry showed 29 cases (69.0%, 29/42) expressed TTF1, 10 cases (40.0%, 10/25) expressed Napsin A, and 20 cases (100.0%, 20/20) expressed INI1. Forty cases (95.2%, 40/42) showed BRG1 loss in all tumor cells, while 2 cases (4.8%, 2/42) had partial BRG1 loss. PD-L1 (22C3) was positive in 59.2% of the cases (16/27). NGS revealed mutations in EGFR, ROS1, MET, RET and KRAS. Six cases (6/8) showed SMARCA4 mutation, while some cases were accompanied by mutations of TP53 (7/15), STK11 (4/8), and KEAP1 (1/8). Driver gene mutations were more common in women (P<0.05). Patients were followed up for 1-25 months. Four patients died and 20 patients' diseases progressed. Conclusions: SMARCA4-deficient lung adenocarcinoma lacks characteristic morphology. Most of them express TTF1 and harbor driver gene mutations. It is necessary to identify this subset of lung adenocarcinoma by carrying out BRG1 stain routinely on lung adenocarcinoma. These patients can then be identified and benefit from targeted therapies.

[Analysis of clinical epidemiological characteristics of respiratory syncytial virus in children in a hospital of pediatric in Hubei Province from 2020 to 2023]

Objective: To explore the clinical epidemiological characteristics of respiratory syncytial virus in children in Hubei Province from 2020 to 2023. Method: A single-center and cross-sectional study was used to analyze the clinical data of 3 271 children with respiratory syncytial virus infection in Wuhan Children's Hospital affiliated to Huazhong University of Science and Technology from July 1, 2020 to June 30, 2023. Nonparametric rank sum test and χ2 test were used for comparative analysis. Results: From July 1, 2020 to June 30, 2023, a total of 25 583 children were included in the analysis, of which 3 271(12.8%) children infected RSV. The detection rate was 16.3% in 2020-2021, 14.7% in 2021-2022 and 9.1% in 2022-2023. The detection rate decreased year by year (χ2=222.054, P<0.05). From 2020 to 2023, there was an anti-seasonal epidemic of RSV in spring and autumn. The detection rate of RSV in infants under 1 year old was the highest, but the median ages of RSV positive children increased (H=140.575, P<0.05). Pneumonia was the main clinical manifestation of RSV respiratory tract infection. Conclusion: The epidemiological characteristics of RSV in children in Hubei Province were different from those before. From 2020 to 2023, the detection rate of RSV decreased year by year. Besides winter, the prevalence of RSV could also be seen in spring and autumn. The median age of children infected with RSV increased after the epidemic. Pneumonia was the main clinical manifestation after RSV infection.

Improving Bond Strength of Translucent Zirconia Through Surface Treatment With SiO2-ZrO2 Coatings

BACKGROUND

Translucent monolithic zirconia ceramics have been applied in dental clinics due to their esthetic translucent formulations and mechanical properties. Considering inherent ceramic brittleness, adhesive bonding with resin composite increases the fracture resistance of ceramic restorations. However, zirconia is a chemically stable material that is difficult to adhesively bond with resin.

OBJECTIVES

To investigate the influences of SiO2-ZrO2 coatings on adhesive bonding of zirconia and the surface characterization of those coatings.

METHODS AND MATERIALS

Translucent zirconia discs were classified into groups based on surface treatments: CT (control), SB (sandblasting), C21(SiO2:ZrO2=2:1), C11(SiO2:ZrO2=1:1), and C12 (SiO2:ZrO2=1:2) (n=10). Surface characterization of coatings on zirconia were analyzed by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), surface roughness assessment (Ra), X-ray diffraction (XRD), water contact angle (WCA), translucency parameter (TP), and shear bond strength (SBS). Two-way ANOVA for shear bond strength results and ANOVA for Ra and WCA were performed.

RESULTS

SEM images revealed SiO2 islands on zirconia disks coated with SiO2-ZrO2. Surface roughness of C12, C11, and C21 groups was significantly larger than those of groups SB and CT (p<0.05). XRD results showed that phase transformation of zirconia disks was detected only in the SB group. In addition, SiO2-ZrO2 coatings reduced WCA. The translucency decreased only in group C21. Group C11 showed the highest shear bond strength under both aging conditions.

CONCLUSION

SiO2-ZrO2 coating is a promising method to enhance the adhesive resin bonding of translucent zirconia without causing phase transformation of translucent zirconia.

The Effect of Guisangyou Tea on Abnormal Lipid Metabolism in Mice Induced by High-Fat Diet

This study was aimed to investigate the effect of Guisangyou tea (GSY tea) in improving abnormal lipid metabolism in mice with obesity induced by a high-fat diet (HFD). The results showed that intervention of the water extract of GSY tea (WE) decreased serum levels of lipids, and positively regulated the related antioxidant enzyme activities and the inflammatory factors in the serum and liver. In the liver, the mRNA and protein expression levels of sterol regulatory element-binding proteins-1 (SREBP-1), stearoyl-CoA desaturase-1 (SCD-1), fatty acid synthase (FASN), and acetyl CoA carboxylase (ACC) related to lipid synthesis were downregulated, and the mRNA and protein expression levels of the farnesoid X receptor (FXR) and small heterodimer partner (SHP) related to bile acid production were upregulated. The results demonstrate that GSY tea can improve abnormal lipid metabolism in obese mice by improving the body's antioxidant capacity, regulating the inflammatory state, and reducing the synthesis of lipids and increasing the production of bile acids. GSY tea can be processed and utilized as a safe and effective resource for improving abnormal lipid metabolism.

HTR2A agonists play a therapeutic role by restricting ILC2 activation in papain-induced lung inflammation

Group 2 innate lymphoid cells (ILC2s) are a category of heterogeneous cells that produce the cytokines IL-5 and IL-13, which mediate the type 2 immune response. However, specific drug targets on lung ILC2s have rarely been reported. Previous studies have shown that type 2 cytokines, such as IL-5 and IL-13, are related to depression. Here, we demonstrated the negative correlation between the depression-associated monoamine neurotransmitter serotonin and secretion of the cytokines IL-5 and IL-13 by ILC2s in individuals with depression. Interestingly, serotonin ameliorates papain-induced lung inflammation by suppressing ILC2 activation. Our data showed that the serotonin receptor HTR2A was highly expressed on ILC2s from mouse lungs and human PBMCs. Furthermore, an HTR2A selective agonist (DOI) impaired ILC2 activation and alleviated the type 2 immune response in vivo and in vitro. Mice with ILC2-specific depletion of HTR2A (Il5cre/+·Htr2aflox/flox mice) abolished the DOI-mediated inhibition of ILC2s in a papain-induced mouse model of inflammation. In conclusion, serotonin and DOI could restrict the type 2 lung immune response, indicating a potential treatment strategy for type 2 lung inflammation by targeting HTR2A on ST2+ ILC2s.

Improved Stability and In Vitro Anti-Arthritis Bioactivity of Curcumin-Casein Nanoparticles by Ultrasound-Driven Encapsulation

Curcumin possesses beneficial biological functions, namely anti-inflammation and anti-diabetic functions. However, due to its low solubility and crystallinity, its applications are limited. In this work, curcumin was encapsulated in casein micelles in order to form curcumin-casein nanoparticles by ultrasound treatment (5 min). The ultrasound treatment induced the entry of the hydrophobic groups to the inner micelles and the polar sulfydryl groups to the surface of the micelles in order to form compact curcumin-casein nanoparticles of an appropriate size (100-120 nm) for cellular endocytosis. The product exhibited excellent stability during 8 months of cold storage, 6 days at room temperature, and 2 days at body temperature. Advanced in vitro experiments demonstrated that curcumin-casein nanoparticles displayed significantly greater inhibitory activity against the proliferation and proinflammatory cytokines of human fibroblast-like synoviocyte-osteo arthritis (HFLS-OA) cells and HFLS-rheumatoid (RA) cells than native curcumin due to better cellular uptake as a result of the low crystallinity and the appropriate nano-size of the nano-form. The results provide a reference for the use of ultrasound treatment to encapsulate other drug molecules and curcumin-casein nanoparticles as potential treatment for arthritis.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

[Effect of SiO2-ZrO2 slurry coating on shear bond strength of zirconia to resin cement]

Objective: To evaluate the effect of shear bond strength between resin cement and zirconia using SiO2-ZrO2 slurry coating. Methods: One hundred and forty pre-sintered zirconia discs were randomly divided into seven groups (n=20) according to the surface treatments: AS (as-sintered), SB (sand blasting with Al2O3), 2SiO2-1ZrO2 (2∶1 mole ratio SiO2-ZrO2 coating), 1SiO2-1ZrO2 (mole ratio 1∶1 SiO2-ZrO2 coating), 1SiO2-2ZrO2 (mole ratio 1∶2 SiO2-ZrO2 coating), 1SiO2-3ZrO2 (mole ratio 1∶3 SiO2-ZrO2 coating), 1SiO2-4ZrO2 (mole ratio 1∶4 SiO2-ZrO2 coating). Each zirconia disc was bonded to composite resin cylinder using resin cement. All specimens were stored in distilled water (37 ℃, 24 h). Each group was divided into two subgroups in which half specimens were tested using universal testing machine and another half specimens accepted artificial aging of 5 000 times thermocycling then tested. Scaning electron microscopy (SEM) was used to observe the micro-morphology of coating surface etched by hydrofluoric acid,then the coating thickness was measured. Results: Before artificial aging, 1SiO2-1ZrO2 showed a higher shear bond strength [(41.69±6.28) MPa] than all the other group (P<0.05). 1SiO2-2ZrO2 gained a higher strength than AS, SB, 1SiO2-3ZrO2 and 1SiO2-4ZrO2 (P<0.05). However, 1SiO2-2ZrO2 did not get a significant higher shear bond strength than 2SiO2-1ZrO2 (P>0.05). No significant differences were found among SB, 2SiO2-1ZrO2 and 1SiO2-3ZrO2 (P>0.05). After artificial aging, shear bond strength of all groups were decreased significantly besides 2SiO2-1ZrO2. 2SiO2-1ZrO2, 1SiO2-1ZrO2 and 1SiO2-2ZrO2 [(24.13±5.50), (22.28±4.40), (23.11±4.80) MPa] showed higher shear bond strength than SB and 1SiO2-3ZrO2 (P<0.05),no intergroup differences were observed (P>0.05). Shear bond strength of AS and 1SiO2-4ZrO2 fell to 0 MPa approximately. The SEM images of etched coating surface showed contraction fissure due to different thermal expansion coefficient between SiO2 and ZrO2 and intercrystal pores of zirconia. The thickness of coating was measured to be less than 30 μm. Conclusions: Mole ratio 1∶1 SiO2-1ZrO2 slurry coating showed the highest shear bond strength of resin cement to zirconia.

The Effect of Microwave Radiation on the Green Color Loss of Green Tea Powder

Microwave radiation is one of the main heating methods for food processing, especially affecting the color quality of colorful foods. This work presents the effect of microwave radiation on the green color loss of green tea powder (GTP) by the color description (L*, a*, b*, and H_a of green tea powder, L*:whiteness/darkness, a*: redness/greenness, and b*: yellowness/blueness; H_a derived from Hunter a and b could visually describe the color space) of the Hunter color system. First, the L*, a*, and b* were determined from the GTP samples treated with various microwave powers with the change of time to investigate the kinetic of color loss. Then, the L*, a*, and b*and temperature of GTP samples with serious thickness treated with constant microwave power (700 W) for a different time were determined to study the effect of sample thickness on the color loss. Finally, the chemicals that contributed to color change in the GTP samples treated with mild, moderate, and severe radiation were analyzed. The results showed that L*, |a*| (|a*|was the absolute value of a*), b*, and H_a decreased with the power increase in microwave radiation, and their changes conformed to the first-order kinetics. The activation energies (E_a) of different thickness GTP for change of L*, a*, b*, and H_a values could be predicted with the fitting models, and E_a for 20 mm-thick GTP were approximately 1/5, 1/8, 1/8, and 1/13 of those for 4 mm-thick GTP. The color loss was mainly caused by the Mg²⁺ loss of chlorophylls and the formation of derivates under mild radiation, the degradation of chlorophylls and the formation of theaflavin from catechins under moderate radiation, and the degradation of chlorophylls and their derivates accompanied by Maillard reaction between reducing sugar and amino acids under severe radiation. The results indicate that sample thickness and radiation time are two key parameters to keeping the color of GTP in food processing and microwave pasteurization.

Sensitive and high-accuracy detection of Salmonella based on CRISPR/Cas12a combined with recombinase polymerase amplification

Salmonella is a crucial food-borne pathogen causing food poisoning, leading to severe public health events. Here, we developed a technique by integrating recombinase polymerase amplification with CRISPR-LbCas12a and employing two targets with engineered crRNA for detection of Salmonella (RPA-LbCas12a-TTECDS). Our findings revealed that this novel method rapidly detects trace Salmonella in food through fluorescence intensity and provides a template for other food-borne pathogen detection methods. Further, crRNA was optimized to increase detection sensitivity. Double targets were used to enhance the detection accuracy, reaching the level of qPCR, which was superior to fluorescent RPA. The RPA-LbCas12a-TTECDS system specifically detected Salmonella levels as low as 50 CFU per ml at 37°C in 1 h. In summary, a simple, rapid, sensitive and high accuracy detection technique based on CRISPR-Cas12a was created for Salmonella detection without complicated equipment.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BACKGROUND

Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.

METHODS

In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.

RESULTS

One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.

CONCLUSION

High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Excess serum Na level in rats administered with high doses of (-)-epigallocatechin gallate-casein nanoparticles prepared with sodium caseinate

(-)-Epigallocatechin gallate (EGCG)-incorporated casein nanoparticles benefit from excellent antioxidant, anti-inflammatory and anti-cancer activities due to their synergistic efficiency, but few studies have evaluated their safety. In this study, the EGCG-casein nanoparticles (EGCG-NPs) formulated using caseinate by ultrasonic treatment were evaluated for their subacute toxicity. The subacute toxicity test of EGCG-NPs through 28-day oral administration in rats did not exhibit adverse effect, with a no-observed-adverse-effect level (NOAEL) of at least 5.0 g per kg body weight (BW) per day, which was equivalent to 500 mg per kg BW EGCG per day. However, the serum Na level in females and males treated with 10.0 g per kg BW EGCG-NPs increased significantly as compared to the control rats (P < 0.05). Similar indications appeared in rats treated with 10.0 g per kg BW pure casein nanoparticles without EGCG, which indicated that high doses of caseinate nanoparticles result in an excess serum Na level. Therefore, we should consider the safety of the nanoparticle formulation of caseinate when it is used as a loading nutrient and a functional substance in foods.

[Clinicopathological features and prognostic impact of MELF pattern in 512 endometrioid adenocarcinoma]

Objective: To investigate the relationship of microcystic elongated fragmented (MELF) and clinicopathological features of patients with low grade endometrial endometrioid carcinoma, and to analyze its impact on prognosis. Methods: The clinical pathological data of 512 cases with low grade endometrial endometrioid adenocarcinoma were collected. The MELF invasive pattern in all of the sections were reappraised. The correlations between MELF pattern and clinicopathological features were analyzed by chi-square test, and the independent risk factor of lymph node metastasis were evaluated by Logistic multivariate regression analysis. Survival curves was drawn by Kaplan-Meier method, and Log-rank test was used to compare progression free survival (PFS) between patients with or without MELF pattern. Disease progression-related multivariate analysis was carried out by Cox proportional hazards model. Results: MELF pattern was observed in 12.9% (66/512) low grade endometrioid adenocarcinoma. It was significantly associated with cervical stroma invasion, more than half of the depth of myometrial invasion, lymph node metastasis and vessel invasion (P<0.05). In addition, MELF pattern was an independent risk factor for lymph node metastasis (P<0.05). The 5-year PFS of patients with and without MELF pattern were 95.0% and 96.0% respectively (P>0.05). Conclusions: The patients with MELF pattern are more likely accompany with cervical stroma and deeper myometrium invasion, vessel invasion, and lymph node metastasis, and it is an independent risk factor of lymph node metastasis. However, MELF pattern has no significant impact on prognosis of patients with endometrioid carcinoma.

[A multicenter randomized controlled study of bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang in the treatment of patients newly diagnosed with Helicobacter pylori infection and dyspepsia]

Objective: To investigate the Helicobacter pylori (H. pylori) eradication rate and improvement of dyspepsia in patients who were newly diagnosed with H. pylori infection and dyspepsia and treated by bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang(JHWK). Methods: Patients who were newly diagnosed with dyspepsia and H. pylori infection and treated in 16 medical centers in China between December 1, 2017 and September 30, 2019 were randomly divided into two groups. The experimental group received bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days), followed by JHWK (30 days), and the course of treatment was 44 days in total. In the control group, the administration regimen was bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days). The main outcome measure was H. pylori eradication rate, while the secondary outcome measures were dyspepsia symptom changes and adverse events during the treatment and the 1st month after treatment. Results: A total of 1 054 patients were included in the study. There were 522 cases enrolled in the experimental group, including 224(42.91%) men and 298(57.09%) women, and the age was 53(26, 73) years old; 532 cases enrolled in the control group, including 221(41.54%) men and 311(58.46%) women, and the age was 46(22, 71) years old. Based on PP analysis, it was found that the H. pylori eradication rate in the experimental group was significantly higher than those in the control group (93.85% vs 87.88%, P=0.001). In the group of all enrolled patients, the symptom dyspepsia after H. pylori eradication was significantly improved compared with that before treatment [4(4, 7) vs 15(10, 22), P<0.001], so was the superior and middle abdominal pain [1(1, 4) vs 4(1, 8), P<0.001], the postprandial fullness [1(1, 4) vs 4(4, 9), P<0.001], the early satiety [1(1, 1) vs 4(1, 4), P<0.001], and the heartburn [1(1, 1) vs 1(1, 4), P<0.001]. The symptom dyspepsia after treatment was significantly improved compared with that before treatment in the experimental, the control groups, the successful and the unsuccessful H. pylori eradication groups. The superior and middle abdominal pain after treatment was signifcantly improved than that before treatment [1(1, 2) vs 1(1, 4), P<0.001], so were the postprandial fullness [1(1, 3) vs 1(1, 4), P=0.002] and the dyspepsia[4(4, 7) VS 7(4, 10), P<0.001]. There was no statistically significant difference in the incidence of adverse events between the experimental group and the control group (1.34% vs 0.38%, P=0.09). Conclusions: Compared with bismuth-containing quadruple therapy, bismuth-containing quadruple therapy followed by JHWK significantly improves the H. pylori eradication rate without increasing the incidence of adverse events. H. pylori eradication therapy can improve symptoms of patients with H. pylori infection and dyspepsia.

Enhanced antibacterial activity of eugenol-entrapped casein nanoparticles amended with lysozyme against gram-positive pathogens

This study aimed to investigate the antibacterial efficiency and synergistic mechanisms of novel formulated eugenol-casein-lysozyme nanoparticles (ECL-NPs) against gram-positive bacteria. We obtained optimized ECL-NPs 151.9 nm in size and with an entrapment efficiency of 92.2%. ECL-NPs exhibited a satisfactory slow-release pattern, excellent storage stability (for 180 days at 4 °C), and freeze-drying stability. The synergy of low-dose lysozyme significantly enhanced the inhibitory efficiency of eugenol-casein nanoparticles against Staphylococcus aureus and Bacillus sp. by 5.83-fold and 5.53-fold, respectively; this resulted in a much lower minimum inhibitory concentration (3.75-fold and 4.16-fold) and minimum bacterial concentration (2.92-fold and 1.70-fold) values. Scanning electron microscopy clearly demonstrated that the entire cell morphological structure was broken into pieces after exposure to ECL-NPs. Furthermore, 100% microbial inhibition was observed in fresh fruits treated with ECL-NPs for 15 days. These findings suggest that ECL-NPs have an excellent potential for use in food industry against gram-positive bacteria.